Spatial Distribution of the Cannabinoid Type 1 and Capsaicin Receptors May Contribute to the Complexity of Their Crosstalk

Angelika Varga has been supported by a European Union Marie Curie Intra-European Fellowship (254661), a Hungarian Social Renewal Operation Program (TÁMOP 4.1.2.E-13/1/KONV-2013-0010) and the Hungarian Brain Research program (KTIA_NAP_13-2-2014-0005) of the Hungarian Government. Agnes Jenes has been supported by a BJA/RCoA Project Grant. This work has also been supported, in part, by the BIOSS-2 Grant, Project A6.

The Impact of the COVID-19 Pandemic on Racial Disparities in Patients Undergoing Total Shoulder Arthroplasty in the United States

INTRODUCTION: The purpose of this study was to assess racial disparities in total shoulder arthroplasty (TSA) in the US and to determine whether these disparities were affected by the COVID-19 pandemic. METHODS: Centers for Medicare and Medicaid Services (CMS) 100% sample was used to examine primary TSA volume from April-December from 2019-2020. Utilization was assessed for White/Black/Hispanic/Asian populations to determine if COVID-19 affected these groups differently. A regression model adjusted for age/sex/CMS-Hierarchical Condition Categories (HCC) score, dual enrollment (proxy for socioeconomic status), time fixed effects, and Core-based Statistical Area (CBSA) fixed effects was used to study difference across groups. RESULTS: In 2019, TSA volume/1000 beneficiaries was 1.51 for White and 0.57 for non-White, a 2.6-fold difference. In 2020, the rate of TSA in White patients (1.30/1000) was 2.9 times higher than non-White (0.45/1000) during the COVID-19 pandemic (P\u3c0.01). There was an overall 14% decrease in TSA volume/1000 Medicare beneficiaries in 2020; non-White patients had a larger percentage decrease in TSA volume than White (21% vs. 14%, estimated difference;8.7%,p = 0.02). Black patients experienced the most pronounced disparity with estimated difference of 10.1%,p = 0.05, compared with White patients. Similar disparities were observed when categorizing procedures into anatomic and reverse TSA, but not proximal humerus fracture. CONCLUSIONS: During the COVID-19 pandemic, overall TSA utilization decreased by 14% with White patients experiencing a decrease of 14%, and non-White patients experiencing a decrease of 21%. This trend was observed for elective TSA while disparities were less apparent for proximal humerus fracture

CD4陽性T細胞に発現するA20(tnfaip3) はTh2型アレルギー性気道炎症を抑制する

研究科: 千葉大学大学院医学薬学府（先端医学薬学専攻）学位記番号: 千大院医薬博甲第医1412号博士（医学）千葉大学 = Chiba Universit

Outcomes of resident-performed small incision cataract surgery in a university-based practice in the USA

Sidra Zafar, Xinyi Chen, Shameema Sikder, Divya Srikumaran, Fasika A Woreta Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD, USA Purpose: To assess outcomes of resident-performed small incision cataract surgery (SICS) at a single academic institute and to determine the availability of SICS-oriented educational resources in residency programs across the USA. Patients and methods: A retrospective chart review was conducted on all patients who underwent SICS performed by postgraduate year 4 residents between January 2014 and January 2018 at the Wilmer Eye Institute, Baltimore, MD, USA. Postoperative visual acuity, intraoperative complications, and postoperative complications were the main outcomes measured. In addition, a survey was administered to all ophthalmology residency program directors in the USA to assess the presence of SICS-related content in their surgical training curriculum. Results: Twenty-two eyes of 17 patients underwent planned resident-performed SICS, mainly for white cataracts. Intraoperative complications occurred in two (9.1%) eyes. The most common postoperative complication was transient increased intraocular pressure (two eyes, 9.1%). Mean preoperative best-corrected visual acuity (BCVA) was approximately 20/4,000. The large majority (95.2%) of eyes experienced improved BCVA following SICS, with a mean postoperative BCVA of 20/138 over an average follow-up of 4.2 months. Forty-seven programs responded to the survey (40.1% response rate). Residents were trained in SICS in 66.7% of these programs. However, more than half of all the programs did not have SICS-oriented educational resources available for residents. Conclusion: Resident-performed SICS was found to be a safe and effective technique for cataract management. Considering the limited surgical volume for SICS in the USA, training programs might instead consider implementing SICS-oriented content in their surgical curriculum, including wet labs. Keywords: resident, cataract, mature, SICS, surgical trainin

A retrospective study evaluating the association between hypoalbuminemia and postoperative outcomes for patients receiving open rotator cuff repair

Purpose: Malnutrition has historically been shown to influence surgical outcomes. Although the diagnosis of malnutrition can be multifactorial, serum albumin levels serve as a useful indicator of malnutrition in patients undergoing orthopaedic surgery. The purpose of this study is to examine the prevalence of post-operative complications in patients with malnutrition (hypoalbuminemia) who underwent open rotator cuff repair. We hypothesized that patients with low preoperative albumin levels will have an increased risk for postoperative complications, readmission, reoperation, and prolonged hospital stay. Methods: The National Surgical Quality Improvement Program database was queried for patients undergoing open rotator cuff repair from 2006 to 2019. Two patient cohorts were defined: patients with hypoalbuminemia (\u3c3.5 g/dL) and patients with normal preoperative serum albumin (≥3.5 g/dL), with the former being an indicator for malnutrition. In this analysis, demographics, comorbidities, and postoperative complications were compared between the two cohorts using bivariate analyses. Confounding factors found in the control group included sex, race, age, body mass index, smoking status, chronic obstructive pulmonary disease, hypertension, dialysis, diabetes, and dyspnea. To eliminate potential biases, multivariable logistic regression was used to adjust for these confounding factors. Results: Of 3,052 patients undergoing open rotator cuff repair with serum albumin levels recorded within 90 days before the surgery, 2,914 patients (95.5%), with an age range of 21-90 years, had normal albumin levels and 138 patients (4.5%), with an age range of 24-87 years, were hypoalbuminemic. Following adjustment on multivariate analyses, compared to patients with normal preoperative serum albumin, those with hypoalbuminemia had an increased risk of extended length of hospital stay (OR 7.47; p \u3c 0.001) and hospital readmission (OR 4.16; p = 0.002). Conclusion: Hypoalbuminemia is associated with extended length of stay and readmission after receiving open rotator cuff repair surgery