Comparison of ultrasonographic findings in cats with and without azotaemia

US findings in 238 cats with (serum creatinine >180 μmol/l) and 270 cats without azotaemia were compared in a retrospective case-control study. Cats with pre-renal azotaemia or urethral obstruction were excluded. Data extracted from the medical records included age, body weight and body condition score (BCS). Quantitative and subjective US findings were extracted from archived ultrasound images and contemporaneous reports

Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Verbal Learning and Memory Deficits across Neurological and Neuropsychiatric Disorders: Insights from an ENIGMA Mega Analysis

Data Availability Statement: The raw data supporting the conclusions of this article and code used for analysis will be made available by the authors on reasonable request pending appropriate study approvals and data transfer agreements between participating institutions.Supplementary Materials: The following supporting information can be downloaded at: https://www.mdpi.com/article/10.3390/brainsci14070669/s1, Table S1: Inclusion/exclusion criteria for each data source; Table S2: Deficit in words recalled for each clinical condition relative to matched controls. Refs. [61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98,99,100] are cited in the Supplementary Materials.Deficits in memory performance have been linked to a wide range of neurological and neuropsychiatric conditions. While many studies have assessed the memory impacts of individual conditions, this study considers a broader perspective by evaluating how memory recall is differentially associated with nine common neuropsychiatric conditions using data drawn from 55 international studies, aggregating 15,883 unique participants aged 15–90. The effects of dementia, mild cognitive impairment, Parkinson’s disease, traumatic brain injury, stroke, depression, attention-deficit/hyperactivity disorder (ADHD), schizophrenia, and bipolar disorder on immediate, short-, and long-delay verbal learning and memory (VLM) scores were estimated relative to matched healthy individuals. Random forest models identified age, years of education, and site as important VLM covariates. A Bayesian harmonization approach was used to isolate and remove site effects. Regression estimated the adjusted association of each clinical group with VLM scores. Memory deficits were strongly associated with dementia and schizophrenia (p 0.05). Differences associated with clinical conditions were larger for longer delayed recall duration items. By comparing VLM across clinical conditions, this study provides a foundation for enhanced diagnostic precision and offers new insights into disease management of comorbid disorders.This research was funded by the Psychological Health/Traumatic Brain Injury Research Program Long-Term Impact of Military Relevant Brain Injury Consortium (LIMBIC), Grant/Award Numbers: W81XWH18PH, TBIRPLIMBIC under Awards Numbers: W81XWH1920067 and W81XWH1320095; US Department of Defense, Grant/Award Number: AZ150145; US Department of Veterans Affairs, Grant/Award Numbers: I01 CX002097, I01 CX002096, I01 HX003155, I01 RX003444, I01 RX003443, I01 RX003442, I01 CX001135, I01 CX001246, I01 RX001774, I01 RX001135, I01 RX002076, I01 RX001880, I01 RX002172, I01 RX002173, I01 RX002171, I01 RX002174, I01 RX002170, 1I01 RX003444; National Institutes of Health (NIH), Grant/Award Number(s): RF1NS115268, RF1NS128961, U01NS086625, U01MH124639, P50MH115846, R01MH113827, R25MH080663, K08MH068540, R01NS100973, R01EB006841, P20GM103472, RO1MH083553, T32MH019535, R01 HD061504, RO1MH083553, R01AG050595, R01AG076838, R01AG060470, R01AG064955, P01AG055367, K23MH095661, R01MH094524, R01MH121246, T32MH019535, R01NS124585, R01NS122827, R61NS120249, R01NS122184, U54EB020403, R01MH116147, R56AG058854, P41EB015922, R01MH111671, P41RR14075, M01RR01066, R01EB006841, R01EB005846, R01 EB000840, RC1MH089257, U24 RR021992, and NCRR 5 month-RR001066 (MGH General Clinical Research Center); National Institute of Mental Health (NIMH), Grant/Award Number: 1P20RR021938; Spanish Ministry of Science and Innovation, Instituto de Salud Carlos III, Grant/Award Numbers: PI15-00852, PI18-00945, JR19-00024, PI17-00481, PI20-00721; Sara Borrell contract, Grant/Award Number: CD19-00149; German Research Foundation DFG grant FOR2107, Grant/Award Numbers: JA 1890/7-1, JA 1890/7-2, NE2254/1-2, NE2254/2-1, NE2254/3-1, NE2254/4-1, KI588/14-1, KI588/14-2, DA1151/5-1, DA1151/5-2, SFB-TRR58, Projects C09 and Z02; European Union, NextGenerationEU, Grant/Award Numbers: PMP21/00051, PI19/01024; Structural Funds; Seventh Framework Program; H2020 Program under the Innovative Medicines Initiative 2 Joint Undertaking: Project PRISM-2, Grant/Award Number: 101034377; Project AIMS-2-TRIALS, Grant/Award Number: 777394; Horizon Europe; NSF, Grant/Award Number: 2112455; Madrid Regional Government, Grant/Award Number: B2017/BMD-3740 AGES-CM-2; Dalhousie Medical Research Foundation; Research Nova Scotia, Grant/Award Number: RNS-NHIG-2021-1931; NJ Commission on TBI Research Grants, Grant/Award Numbers: CBIR11PJT020, CBIR13IRG026; Department of Psychology, University of Oslo; Sunnaas Rehabilitation Hospital, Grant/Award Number: HF F32NS119285; Canadian Institutes of Health Research, Grant/Award Number: 166098; Neurological Foundation of New Zealand, Grant/Award Number: 2232 PRG; Canterbury Medical Research Foundation, University of Otago; Biogen US Investigator-initiated grant; Italian Ministry of Health, Grant/Award Number: RF-2019-12370182 and Ricerca Corrente RC 23; National Institute on Aging; National Health and Medical Research Council, Investigator Grant/Award Number: APP1176426; PA Health Research, Grant/Award Number: 4100077082; La Caixa Foundation, Grant/Award Number: 100010434, fellowship code: LCF/BQ/PR22/11920017; Research Council of Norway, Grant/Award Number: 248238; Health Research Council of New Zealand Sir Charles Hercus Early Career Development, Grant/Award Numbers: 17/039 and 14-440; Health Research Council of New Zealand, Grant/Award Numbers: 20/538 and 14/440; Research and Education Trust Pacific Radiology, Grant/Award Number: MRIJDA; South-Eastern Norway Regional Health Authority, Grant/Award Number: 2018076; Norwegian ExtraFoundation for Health and Rehabilitation, Grant/Award Numbers: 2015/FO5146; South-Eastern Norway Regional Health Authority, Grant/Award Number: 2015044; Stiftelsen K.G. Jebsen, Grant/Award Number: SKGJ MED-02; The Liaison Committee between Central Norway Regional Health Authority (RHA) and the Norwegian University of Science and Technology (NTNU), Grant/Award Number: 2020/39645; National Health and Medical Research Council, Grant/Award Number: APP1020526; Brain Foundation; Wicking Trust; Collie Trust; Sidney and Fiona Myer Family Foundation; U.S. Army Medical Research and Materiel Command (USAMRMC), Grant/Award Number: 13129004; Department of Energy, Grant/Award Number: DE-FG02-99ER62764; Mind Research Network; National Association for Research in Schizophrenia and Affective Disorders, Young Investigator Award; Blowitz Ridgeway and Essel Foundations; Interdisciplinary Center for Clinical Research (IZKF) of the medical faculty of Münster; NOW ZonMw TOP, Grant/Award Number: 91211021; UCLA Easton Clinic for Brain Health; UCLA Brain Injury Research Center; Stan and Patty Silver; Clinical and Translational Research Center, Grant/Award Numbers: UL1RR033176, UL1TR000124; Mount Sinai Institute for NeuroAIDS Disparities; VA Rehab SPIRE; CDMRP PRAP; VA RR&D, Grant/Award Number: IK2RX002922; Veski Fellowship; Femino Foundation grant; Fundación Familia Alonso; Fundación Alicia Koplowitz; CIBERSAM, Madrid Regional Government, Grant/Award Numbers: B2017/BMD-3740 AGES-CM-2, 2019R1C1C1002457, 21-BR-03-01, 2020M3E5D9079910, 21-BR-03-01; Deutsche Forschungsgemeinschaft (DFG), Grant/Award Numbers: NE2254/1-2, NE2254/2-1, NE2254/3-1, NE2254/4-1

2013 WSES guidelines for management of intra-abdominal infections

Peer reviewe

International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone