Objective: To compare the therapeutic effects of hemithyroidectomy (HT) versus total thyroidectomy (TT) on sporadic medullary thyroid carcinoma (sMTC). Methods: Clinical data of sMTC patients firstly treated in Tianjin Medical University Cancer Institute and Hospital from January 2011 to December 2019 were reviewed retrospectively. The patients were categorized into the HT group and the TT group based on the extents of primary tumor resection. The differences in clinical characteristics between the two groups were compared. A 1∶1 matching of variables including tumor stage and mulifocality was performed using propensity score matching (PSM) to balance the baseline differences between the two groups. Subsequently, the differences in biochemical cure rate, biochemical recurrence rate, and structural recurrence rate between the two groups were compared. Survival curves were plotted using the Kaplan-Meier method, and the log-rank test was utilized to compare the differences in progression-free survival and overall survival between the two groups. Results: A total of 199 patients with sMTC were included in the study, comprising 80 males and 119 females, with the age [M(Q1,Q3)] of 51.0 (42.0,59.0) years. Before PSM, 117 patients were in HT group and 82 patients were in TT group. There were statistically significant differences in preoperative calcitonin, N stage, TNM stage, and the number of lesions between the two groups (all P<0.05). After PSM, 63 patients were in HT group and 63 patients were in TT group. There was no statistically significant difference in all clinicopathological characteristics between the two groups (all P>0.05). Before PSM, the biochemical cure rate in the HT group was higher than that in the TT group [76.4% (81/106) vs 60.5% (46/76), P=0.021]. There were no statistically significant differences in the biochemical recurrence rate and structural recurrence rate between the HT group and the TT group [4.7% (5/106) vs 7.9% (6/76), 8.5% (10/117) vs 15.9% (13/82), both P>0.05]. The progression-free survival of the HT group was longer than that of the TT group [(137.26±3.53) vs (114.12±5.98) months, P=0.025]. There was no statistically significant difference in overall survival between the HT group and the TT group [(142.12±2.91) vs (126.92±5.15) months, P=0.140]. After PSM, there were no statistically significant differences between the HT group and the TT group in terms of biochemical cure rate [66.7% (40/60) vs 77.2% (44/57)], biochemical recurrence rate [5.0% (3/60) vs 7.0% (4/57)], structural recurrence rate [12.7% (8/63) vs 17.5% (11/63)], progression-free survival [(130.69±5.07) vs (112.19±6.91) months], and overall survival [(136.05±4.04) vs (124.71±6.83) months] (all P>0.05). Conclusions: The therapeutic effects of HT and TT on sMTC are comparable. With careful preoperative evaluation, selective performance of HT is safe and feasible.

Diabetes and cancer exhibit a high likelihood of co-occurrence. Diabetes serves as a risk factor for various forms of cancer and is associated with a poorer prognosis. SGLT2 (sodium-glucose cotransporter 2) inhibitors (SGLT2i) are effective antidiabetic therapies associated with reduced all-cause mortality in the general population; however, data among the population with cancer are scarce. We aimed to assess the safety and efficacy of SGLT2itherapy among patients with diabetes and cancer. A large retrospective, single-center study including 849 patients diagnosed with diabetes and active cancer. Patients were divided into 2 groups: 169 patients treated with SGLT2i before cancer diagnosis and 680 patients SGLT2i naive. The primary end point was all-cause mortality. The secondary end point was the composite of cardiovascular outcomes, including heart failure, acute coronary syndrome, and arrhythmias. After a median follow-up of 48 months (interquartile range, 27-72), all-cause mortality was significantly lower in the SGLT2i group (67% versus 53%, P=0.001). Multivariable Cox regression identified SGLT2i as an independent predictor of reduced all-cause mortality (hazard ratio, 0.676 [95% CI, 0.532-0.860], P=0.001). Cardiovascular outcomes were higher in the SGLT2i group (28% versus 16%, P=0.001), driven by increased heart failure events (14% versus 7%, P=0.008). After propensity score matching, SGLT2i remained a significant predictor of reduced mortality (P=0.016), with no significant differences in cardiovascular outcome (P=0.067). SGLT2i was associated with lower all-cause mortality in patients diagnosed with diabetes and cancer. Randomized clinical trials are needed to confirm these findings and explore the underlying mechanism.

Secondary platelet activation peaks ≈2 hours after intravenous thrombolysis with alteplase. This study evaluated the safety and efficacy of ultra-early tirofiban administration and compared different tirofiban regimens following intravenous thrombolysis in patients with noncardioembolic acute ischemic stroke. This observational study enrolled patients with acute ischemic stroke who received tirofiban within 24 hours following intravenous thrombolysis. Patients were divided into ultra-early (within 2 hours) and early (2-24 hours) groups based on tirofiban initiation time. A secondary analysis was performed based on whether the tirofiban regimen included a bolus dose. The primary outcome was 90-day excellent functional outcome (modified Rankin Scale score 0-1). The safety outcomes included symptomatic intracranial hemorrhage, intracranial hemorrhage, and 3-month all-cause mortality. A total of 472 patients were enrolled, with 214 in the ultra-early tirofiban group and 258 in the early tirofiban group. The ultra-early tirofiban group was associated with 3-month excellent functional outcomes (67.5% versus 53.3%; adjusted odds ratio [aOR], 1.56 [95% CI, 1.01-2.42]). There were no significant differences in intracranial hemorrhage (3.7% versus 1.6%; P=0.18), symptomatic intracranial hemorrhage (0.5% versus 0.4%; P=0.99), or 3-month mortality (1.5% versus 2.5%; P=0.94). Propensity score matching analyses showed consistent outcomes. No significant differences in excellent functional outcomes (61.4% versus 71.0%; aOR, 0.68 [95% CI, 0.36-1.30]) or symptomatic intracranial hemorrhage (0.4% versus 0%; P=0.99) were observed between bolus and maintained groups for prophylactic tirofiban after intravenous thrombolysis. Ultra-early tirofiban administration following recombinant tissue plasminogen activator was associated with excellent functional outcomes without increasing the risk of symptomatic intracranial hemorrhage, intracranial hemorrhage, or mortality. The extra bolus dose did not show superiority over only maintained dose administration.

Previous studies have indicated an increased risk of cerebrovascular and coronary events shortly after cancer diagnosis. However, whether cancer affects mortality outcomes after stroke and myocardial infarction (MI) remains unclear. We aimed to investigate the relationship between cancer diagnosis and mortality after stroke and MI. Using linked nationwide databases from Taiwan, we conducted a population-based cohort study including 3 cohorts of patients with first-time ischemic stroke, hemorrhagic stroke, and MI between 2011 and 2019. The primary outcome was 90-day mortality, with follow-up beginning at the index stroke (for ischemic and hemorrhagic stroke cohorts) and MI (for the MI cohort) event date for all patients. Odds ratios (ORs) of 90-day mortality associated with all cancers combined and 15 cancer types were estimated through propensity score matching for potential confounding variables. Excess mortality rates (between patients with cancer and matched controls) were analyzed across time intervals after cancer diagnosis, stratified by age group, cancer stage, and cancer type. Overall, 440,664, 159,606, and 228,993 patients were included in ischemic stroke (mean age, 70.1 years; 40.7% female), hemorrhagic stroke (mean age, 65.4 years; 36.5% female), and MI (mean age, 67.8 years; 29.7% female) cohorts, respectively. Compared with matched controls, patients with cancer had higher risks of 90-day mortality in ischemic stroke (OR 2.71, 95% CI 2.63-2.79), hemorrhagic stroke (OR 2.20, 95% CI 2.11-2.29), and MI (OR 1.63, 95% CI 1.57-1.69). Across 3 cohorts, substantial variations existed among cancer types, with aggressive malignancies (e.g., pancreatic cancer) consistently presenting the highest risks. Excess mortality rates were highest during the first postdiagnosis year and declined progressively thereafter. This temporal pattern was consistent across age groups and cancer stages, with excess mortality rates highest among patients aged 18-59 years and those with stage 4 disease. Despite variability among cancer types, excess mortality typically peaked within 2 years. This population-based study showed that patients with cancer had higher risks of mortality after stroke and MI, with substantial variations by cancer type, although cause-specific mortality data were lacking. Excess mortality rates peaked shortly after diagnosis, particularly for early-onset cancer and advanced disease.

Dysnatremia is a common electrolyte disturbance in critically ill patients that is associated with increased mortality. There are a few recommendations for the prophylaxis and treatment of intensive-care-acquired hypernatremia, but hardly any studies and no randomized trials. An observational before-and-after study investigating the introduction of a departmental protocol between July 2019 and July 2023 in a surgical intensive care unit of a university hospital to prevent the development of hypernatremia in the intensive care unit. The departmental protocol advised the use of free water either enteral or in the form of glucose 5% intravenously and the use of certain diuretics starting even before signs of hypernatremia appeared. In total, 10,656 patients were analyzed. The incidence of hypernatremia with sodium >150 mmol/L was markedly reduced from 13.1% to 8.9% (P<0.001) before and after implementation of the protocol. The measures, in particular enteral free fluid and glucose 5%, were used more frequently during the period after introduction. After propensity score matching and logistic regression analysis, at least an association with reduced mortality was observed following the introduction of the departmental protocol (OR 0.88 [95% CI 0.78-0.99], P=0.031). The effects varied in subgroups such as cardiac surgery, neurosurgery, patients with septic shock, COVID-19 pneumonia or acute kidney injury. With a departmental protocol, the incidence of hypernatremia may be reduced and even outcome may be improved in subgroups, such as cardiac surgery and acute kidney injury patients.

The prevalence of Peripheral Artery Disease (PAD) is rising globally, yet early risk stratification remains challenging due to the limitations of traditional obesity metrics. TyG-ABSI, an index combining Triglyceride-Glucose (TyG) with A Body Shape Index (ABSI), is a novel marker reflecting both functional insulin resistance and structural visceral adiposity. However, its predictive value for PAD remains unexplored in large prospective cohorts. We included 390,274 adults from the UK Biobank. Baseline characteristics were analyzed across TyG-ABSI quartiles and PAD status. Associations between TyG-related indices and incident PAD were assessed using multivariable-adjusted Cox regression, Kaplan-Meier survival curves, and restricted cubic splines. Robustness was evaluated via Fine-Gray competing risk models, propensity score matching, subgroup analyses, and external validation in the NHANES database. Consensus k-means clustering, integrating biochemical and insulin resistance markers, identified metabolic phenotypes and stratified PAD risk. Feature selection (LASSO, Boruta, and Minimum Redundancy Maximum Relevance [mRMR]) guided the development of six machine learning models (logistic regression, GBM, XGBoost, AdaBoost, LightGBM, and neural network) for PAD prediction, with interpretability assessed via SHAP analysis. Higher TyG-ABSI and related indices were strongly associated with increased PAD incidence (cumulative incidence at 15years: 4.16% in the top quartile vs. 0.98% in the bottom quartile; fully-adjusted Hazard Ratio [HR] per 1-SD increase for TyG-ABSI: 1.22, 95% Confidence Interval [CI] 1.17-1.27), which were robust in the NHANES external validation cohort. Clustering analysis revealed four distinct metabolic subgroups, with the highest PAD risk in the insulin resistance/glucose dysfunction cluster (HR vs. healthy phenotype: 7.48, 95% CI 6.82-8.21). Feature selection identified 19 key predictors. Logistic regression provided the most stable and generalizable prediction (validation Area Under the Curve [AUC] = 0.788, 95% CI 0.778-0.798), demonstrating superior generalizability compared to complex ensemble methods. SHAP analysis demonstrated TyG-ABSI, age, and neutrophil count as leading predictors for incident PAD and confirmed the interpretability of the model. TyG-ABSI is a robust, independent predictor of long-term PAD risk. Data-driven phenotyping and interpretable machine learning facilitate more precise risk stratification. Logistic regression offers optimal performance and interpretability, holding potential clinical utility for individualized PAD risk prediction.

Red blood cell (RBC) transfusion is common after transcatheter aortic valve replacement (TAVR) to manage peri-procedural bleeding and has been associated with adverse outcomes in various studies. However, the prognostic impact of peri-procedural transfusion in TAVR patients remains unclear. This study aimed to assess the impact of peri-procedural RBC transfusion on cardiovascular outcomes in TAVR patients compared to those without transfusion. A retrospective cohort study was conducted using the TriNetX US Collaborative Research Network, including adults undergoing TAVR until August 31, 2025. Patients were divided into those receiving RBC transfusion (n = 3,176) and those without (n = 79,664) on the day of receiving TAVR. Propensity score matching (1:1) balanced cohorts (n = 3161 each) for demographics, comorbidities, medications, and laboratory values. Relative risks (RR) and hazard ratios (HR) were calculated using propensity-matched and Cox proportional hazard models. Transfused patients had significantly higher all-cause mortality (RR 3.933; 95% CI: 2.27-6.92; p < 0.001 at 7 days; RR 1.824; 95% CI: 1.466-2.268; p < 0.001 at 3 months). Secondary outcomes showed elevated risks for MACE (RR 1.324; 95% CI: 1.073-1.633; p = 0.009 at 7 days; RR 1.199; 95% CI: 1.060-1.358; p = 0.004 at 3 months), hemodynamic instability (RR 2.063; 95% CI: 1.655-2.571; p < 0.001 at 7 days; RR 1.638; 95% CI: 1.368-1.962; p < 0.001 at 3 months), acute kidney injury (RR 1.615; 95% CI: 1.295-2.013; p < 0.001 at 7 days; RR 1.379; 95% CI: 1.196-1.591; p < 0.001 at 3 months), and post-TAVR sepsis (RR 1.184; 95% CI: 0.771-1.819; p = 0.439 at 30 days; RR 0.899; 95% CI: 0.667-1.211; p = 0.483 at 3 months). Ischemic stroke/TIA risk was modestly increased in unadjusted analyses but attenuated post-matching (RR 1.123; 95% CI: 0.823-1.534; p = 0.464 at 7 days; RR 1.219; 95% CI: 0.995-1.493; p = 0.056 at 3 months). Cox models showed statistically significant risk elevations for most outcomes, including heart failure exacerbation (HR 1.418; 95% CI: 1.311-1.533; p < 0.001). Peri-procedural RBC transfusion was associated with increased risks of mortality and complications after TAVR, with attenuation over time. These findings support consideration of restrictive transfusion strategies.

At our breast reconstruction center we have over time developed a focused program to increase access to care for low resource patients. This program includes outreach clinics, physician extenders, care coordinators, and telehealth utilization. A retrospective review of all free flap breast reconstruction patients between 2017 and 2022 at our center was performed. Specific criteria including insurance carrier, educational attainment and zip code median household income, language barriers, and distance to hospital were used to create favorably-resourced (FR) and unfavorably-resourced (UR) cohorts. Propensity score matching was then used to control for clinical factors and comorbidities. 49 and 52 patients met inclusion criteria for FR and UR cohorts, respectively, producing 33 matched pairs. FR was associated with a greater average number of donor site revisions (0.73 vs. 0.45, p=0.05). Other statistically significant differences included average zip code household income ($109,477 FR vs. $71,996 UR, p<0.01), bachelor's degree education level (26% FR vs. 16% UR, p<0.01), and average distance to hospital (25 miles FR vs. 82 miles UR, p< 0.01). No significant differences were detected between groups regarding mastectomy skin flap necrosis, recipient site infection, recipient site wound, breast revisions, donor site infection, donor site wound, seroma, fat necrosis, hernia/bulge, length of follow-up, or drain removal time. This study shows that through the utilization of access to care programs equivalent results can be achieved in autologous breast reconstruction in both favorably and unfavorably resourced patients.

In recent years, increasing evidence has highlighted the potential of remote management in cardiovascular diseases, with growing recognition of its feasibility and clinical value supporting its broad future application. This study aimed to investigate the efficacy of remote management for patients with heart failure (HF) in eastern China. A single-center, prospective, nonrandomized controlled trial enrolled 433 patients with HF, comprising 52 opting for remote management and 381 receiving usual care. Propensity score matching (1:2) yielded 95 patients (37 intervention and 58 control) for analysis. The intervention comprised a multi-level digital health ecosystem (WeChat mini-program and centralized digital health management platform), structured health monitoring (weight, blood pressure, heart rate, and oxygen saturation), and education. The primary outcome includes a composite of cardiovascular mortality and HF-related rehospitalization. The composite primary outcome occurred in 11 (30%) patients receiving intervention and 24 (41%) controls over a maximum 24-month follow-up period. The intervention group demonstrated a statistically significant reduction in the percentage of days lost due to unplanned HF rehospitalization or all-cause death (p = 0.049). Numerically lower rates were observed for HF-related rehospitalization, cardiovascular mortality, and all-cause mortality, along with higher quality of life scores, although with no statistical significance. Remote management demonstrated feasibility and potential clinical benefits, particularly in reducing the cumulative burden of illness. Further, it provides a foundation for integration into primary healthcare systems to optimize resource allocation and improve long-term patient outcomes.

This retrospective study aimed to compare the efficacy and safety of conventional lipiodol-based transarterial chemoembolization (TACE) combined with prophylactic right inferior phrenic artery (RIPA) embolization versus TACE alone for hepatocellular carcinoma (HCC) located in liver segments VII and VIII. After propensity score matching of 161 eligible patients, 52 received TACE alone (Group A) and 52 received TACE plus prophylactic RIPA embolization (Group B). Primary outcome was overall survival (OS). Secondary outcomes included progression-free survival (PFS), time to progression (TTP), tumor response, and adverse events (AEs). The combination therapy significantly improved survival outcomes. Median OS was 32.3 vs. 28.3 months, median PFS was 18.8 vs. 16.5 months, and median TTP was 19.3 vs. 17.5 months. Multivariable Cox analysis confirmed prophylactic RIPA embolization as an independent favorable prognostic factor for OS (HR 0.511, P=0.008), PFS (HR 0.528, P=0.003), and TTP (HR 0.502, P=0.002). Other independent factors included tumor number >3 and Child-Pugh class. The 1-month objective response rate showed no significant difference (67.3% vs. 55.8%, P=0.277). Regarding safety, the overall AE rate was similar between groups (44.2% vs. 42.3%). Complications specifically associated with RIPA embolization in Group B included shoulder pain (19.2%) and hiccups (13.5%), which were mild and self-limited. The incidence of major complications (SIR class C-F) was not significantly different (7.7% vs. 3.8%, P=0.678). One patient in Group B developed a grade 4 liver abscess. For HCC in segments VII/VIII, adding prophylactic RIPA embolization to conventional lipiodol-based TACE provides significant survival benefits, establishing it as an independent prognostic factor, without substantially increasing major treatment-related morbidity. This combined approach represents a valuable therapeutic strategy for this specific patient subset.

Background Real-world comparative evidence on systemic agents, phototherapy, and biologics for atopic dermatitis (AD) remains limited. Objective To compare 24-week effectiveness and safety of methotrexate (MTX), cyclosporine, narrowband ultraviolet B (NB-UVB) phototherapy, upadacitinib, and dupilumab in adults with AD. Methods In this multicenter retrospective cohort (N = 1000; 200 per monotherapy group) across Saudi Arabia, SCORAD was extracted at baseline and mapped to prespecified weeks 2, 6, 12, and 24. Confounding was addressed using a multinomial propensity score (baseline SCORAD, age, sex, nationality) with overlap weighting; balance was assessed using Max |SMD|. Longitudinal change from baseline (ΔSCORAD) was analyzed using overlap-weighted generalized estimating equations with a treatment-by-time interaction, reporting adjusted marginal mean ΔSCORAD (95% CI). Results Unadjusted 24-week improvement was highest with dupilumab (75.8%) and upadacitinib (74.1%) (p < 0.001). In overlap-weighted models, both were associated with the largest week-24 improvements (ΔSCORAD −27.04 and −26.68). NB-UVB and methotrexate were intermediate, whereas cyclosporine had smaller sustained improvement. Upadacitinib had the highest recorded adverse-event frequency (68.5%), whereas dupilumab had the lowest (9%). Conclusion Dupilumab and upadacitinib were associated with larger 24-week SCORAD improvements than conventional systemic therapies and NB-UVB within this stratified analytic cohort. Results are associative and may be affected by residual confounding.

Ischemic stroke remains a major cause of mortality and long-term disability worldwide, and improved strategies for identifying individuals at elevated vascular risk are needed. Serum autoantibodies have emerged as potential biomarkers reflecting vascular injury and immune activation; however, their integrative biological significance and incremental predictive value beyond established clinical risk factors remain unclear. We analyzed 833 participants, including patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA) and healthy controls. Serum levels of anti-PDCD11 antibody (Ab), anti-DNAJC2 antibody, and anti-PAI-1 (SERPINE1) antibody were quantified, and multivariable logistic regression and machine-learning (ML) models (logistic regression and random forest) were constructed using clinical variables with and without antibody markers. Model performance was evaluated using cross-validation, bootstrap-derived confidence intervals, calibration metrics, and reclassification indices. Model interpretability analyses, principal component analysis (PCA), unsupervised clustering, and propensity score matching were performed to explore latent biological structures. Clinical-only models demonstrated excellent discrimination (bootstrap Area Under the Curve (AUC) 0.917 for random forest and 0.919 for logistic regression). The addition of antibody markers yielded similar performance (AUC 0.913 and 0.923, respectively) without evidence of meaningful improvement in reclassification. However, SHapley Additive exPlanations (SHAP) analysis identified antibody markers as influential contributors following major clinical risk factors. PCA revealed a dominant antibody component explaining approximately 79% of the variance, which remained independently associated with stroke after age adjustment. Unsupervised clustering further identified a high-risk subgroup characterized by consistently elevated antibody levels. These findings support the presence of a latent antibody axis associated with vascular vulnerability. Although antibody markers did not substantially enhance global predictive performance, they captured integrated biological signals reflecting cumulative vascular and immunological stress. Autoantibody profiling may complement conventional risk assessment by improving biological characterization of stroke susceptibility. Prospective validation in independent cohorts is required prior to clinical implementation.

Pharmacy access and shingles vaccinations in the US: a propensity score matching analysis.

ABSTRACT Background Individuals with chronic obstructive pulmonary disease (COPD) face increased risk of severe respiratory syncytial virus (RSV)-related outcomes. We assessed the uptake of adjuvanted-RSVPreF3 vaccine and its effectiveness against RSV hospitalization in such individuals. Research design and methods We assembled a Danish nationwide cohort of individuals aged ≥ 60 years with COPD during the 2024/25 RSV season. Vaccinated and unvaccinated individuals were matched using exact and propensity score matching resulting in balanced groups. Individuals were followed from 21 days post-index date (vaccination) until the earliest of event, end of data availability (08/27/2025), migration, receipt of RSV vaccine, or death. Vaccine effectiveness was estimated as (1 – incidence rate ratio [IRR]) x 100, where IRRs were calculated using observed event counts and accumulated person-time. Confidence intervals (CIs) were based on Poisson distributions. Results Among 126,249 eligible individuals, 7448 (5.9%) received adjuvanted-RSVPreF3 vaccine. RSV hospitalization rates per 100,000 person-years were 0.0 (95% CI: 0.0 – 58.0) for vaccinated individuals and 200.6 (165.6 – 240.8) for unvaccinated individuals, yielding an effectiveness of 100.0% (71.1 – 100.0). Incidences of other RSV-related outcomes were lower among vaccinated individuals. Conclusions Adjuvanted-RSVPreF3 is highly effective in preventing RSV hospitalization in individuals aged ≥ 60 years with COPD. Disease outcomes could be improved by incorporating RSV vaccination into routine COPD management.

Cardiovascular outcomes of GLP-1RA vs SGLT2i in MASLD and type 2 diabetes: real-world evidence.

A dedicated spine team is more efficient and improves perioperative outcomes in idiopathic scoliosis surgery: A propensity score-matched study.

The International Study Group of Rectal Cancer (ISREC) provides a classification of anastomotic leakage (AL). This classification categorises the severity of AL according to its clinical management. The aim of this study was to determine whether AL and its management influence survival. Patients who underwent elective mesorectal excision (PME or TME) for primary rectal cancer stages I-III and who underwent anastomosis were included. A retrospective analysis of clinical data retrieved from a prospectively conducted database was performed. The primary endpoint was cancer-specific survival (CSS). Risk factors were adjusted by propensity score matching (PSM). The secondary endpoints were overall survival (OS), disease-free survival (DFS), and local recurrence-free rate (RFR). A total of 942 patients underwent surgery between 1991 and 2020 and were followed for a mean of 71.9 (SD 48.5) months. AL occurred in 141 patients (15.0%). Twenty-three patients had gradeA AL (16.3%), 48 patients had gradeB AL (34.0%), and 70 patients had gradeC AL (49.6%). AL had no significant negative influence on the 5-year propensity score-adjusted survival rate for CSS (no AL 92.2%, AL 87.9%, p = 0.161), but did so on OS (no AL 78.6%, AL 66.9%, p = 0.005), DFS (no AL 72.9%, AL 60.9%, p = 0.011), and RFR (no AL 94.2%, AL 88.5%, p = 0.047). The severity of AL did not have a significant influence on CSS (p = 0.642). AL had a negative influence on OS, DFS, and RFR. Whether aggressive surgical clinical management of AL has any influence on CSS remains unclear. The study was registered at ClinicalTrials.gov (NCT06059924).

Early liberal fluid resuscitation increased 30-day mortality in patients post out-of-hospital cardiac arrest: A retrospective analysis of the MIMIC-IV database.

Outcomes of arthroscopic meniscal repair versus partial meniscectomy on knee function and quality of life in middle-aged and elderly patients: a retrospective control study of 80 cases.

The Fat-Augmented Latissimus Dorsi (FALD) flap is an autologous flap that combines Latissimus Dorsi (LD) flap with intraoperative autologous fat transfer (AFT) in order to improve breast reconstruction (BR) volume. In recent years, our team has described the ergonomic FALD flap, an evolution of this technique which helps to achieve a complete BR in a single surgical step. In this case-control study, we analyze the long-term morphological variations of the breast after ergonomic FALD flap reconstruction compared to the traditional FALD flap technique. Between December 2020 and April 2023 we prospectively enroll patients undergoing BR using FALD flap into 2 groups: group A included ergonomic FALD flap, while group B included traditional FALD flap. The primary endpoint was to compare the two groups in terms of breast projection (BP), breast width (BW) and breast height (BH), while the second endpoint concerned the analysis of the aesthetic outcomes. 42 FALD flaps (31 patients) were performed for the group-A and 37 FALD flaps (29 patients) for group-B. The two groups were homogeneous regarding demographic variables. Using a propensity score weighting analysis, group-A showed a significantly higher breast projection compared to group-B (6.78 vs 5.75; p<0.0001), after 12 months of follow-up. Final aesthetic analyses showed to be superior in group-A concerning breast shape (p=0.003) and global score evaluation (p=0.023). The ergonomic FALD flap showed us a better long-term aesthetic outcome for autologous BR with higher breast projection compared to the traditional transverse FALD flap.