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The purpose of this study was to analyze brain natriuretic peptide (BNP) serum levels of patients with chronic subdural hematoma (cSDH) and their clinical implication. Patients with cSDH who underwent surgery in our department between November 2016 and October 2019 were eligible for enrollment in the study. Patients with recurrent bleedings, traumatic brain injury, cSDH associated with other intracranial pathologies, and those with a history of congestive heart failure, renal or endocrine disease were excluded. We measured BNP serum levels pre- and post-operatively and at discharge. The BNP values were analyzed with respect to patient medical history and neurological condition. The Glasgow Coma Scale score and the modified Rankin Scale score classified the clinical and neurological condition at the time of admission and discharge, respectively. The data of 100 surgically treated patients with cSDH (mean age 73.2, range 42 - 94 years, male/female 3.51) were analyzed. Pre-operative BNP serum levels (BNP-1) were elevated in 67% of the patients (n = 67; median = 101.6 pg/mL; p 0.05). In addition, elevated BNP-1 showed a significant statistical association with the presence of atrial fibrillation (p less then 0.01) and antiplatelet and/or anticoagulant therapy (p less then 0.01). This study provides new evidence regarding BNP serum levels and their secretion pattern in patients with cSDH. Whether BNP-1 can predict the long-term functional outcome of patients with cSDH is being investigated in this ongoing prospective study.The management of prosthetic dialysis arteriovenous graft infection comprises antibiotic treatment and total or partial excision of infected grafts for infectious source control. Partial excision with graft bypass is an important graft preservation strategy for localized infection but carries a higher reinfection risk. selleck compound Here, we report a case of prosthetic graft infection that was successfully treated with partial excision, a graft bypass procedure, and a portable negative pressure wound therapy system, PICO, applied to the open wound postoperatively. The combined approach may be a useful strategy that decreases reinfection risk, shortens the length of hospital stay, and preserves graft patency.There is a growing need for biomaterial scaffolds that support engineering of soft-tissue substitutes featuring structure and mechanical properties similar to those of the native tissue. This work introduces a new biomaterial system that is based on cm-long collagen fibers extracted from Sarcophyton soft corals, wrapped around frames to create aligned fiber arrays. The collagen arrays displayed hyperelastic and viscoelastic mechanical properties that resembled those of collagenous-rich tissues. Cytotoxicity tests demonstrated that the collagen arrays were non-toxic to fibroblast cells. In addition, fibroblast cells seeded on the collagen arrays demonstrated spreading and increased growth for up to 40 days, and their orientation followed that of the aligned fibers. The possibility to combine the collagen cellular arrays with poly(ethylene glycol) diacrylate (PEG-DA) hydrogel, in order to create integrated bio-composites, was also demonstrated. This study showed that coral collagen fibers in combination with a hydrogel can support biological tissue-like growth, with pre-defined orientation over a long period of time in culture. As such, it is an attractive scaffold for the construction of various tissues engineered to match their native oriented morphology.Background In patients with rheumatoid arthritis (RA) exercise improves muscle strength and decreases fat mass, whereas the consumption of a Mediterranean diet (MD) also has been associated with higher grip strength. Therefore, it is important to explore the combined effects of these interventions on hand grip strength and weight in RA. Objective To determine the combined effect of an MD and a dynamic exercise program (DEP) on hand grip strength in women with RA. Method In a randomized clinical trial, 106 women with RA were included and assigned to the DEP-MD, DEP and MD groups. Weight, body circumferences, Disease Activity Score-28, Health Assessment Questionnaire Disability Index [HAQ-DI], and hand grip strength were measured at baseline and 24 weeks after the interventions. Results After 24 weeks, hand grip strength showed a significant increase in the DEP group (median 2 kg) compared with DEP-MD (median 0.5 kg) and MD (median -0.5 kg) groups (p = 0.03). In the MD group weight and waist circumference showed a significant decrease (-2.2 kg and -4.3 cm) compared with DEP-MD (0.85 kg and 1.9 cm) and DEP (0.35 kg and 0.5 cm) groups (p less then 0.01). Finally, a significant decrease was observed in the HAQ-DI after treatment in the DEP-MD group of -0.5 and the DEP group of -0.25 compared with the MD group with no change (p = 0.03). Conclusion In women with RA, in addition to pharmacological treatment, DEP increases hand grip strength and an MD decreases weight and waist circumferences, while the combination of DEP and MD improves disability.Background Newborns admitted to neonatal units often require vascular access. Peripheral intravenous cannulas allow essential medication, fluids, and/or parenteral nutrition to be delivered. Peripheral intravenous cannulas are often associated with complications, such as extravasation, infiltration, phlebitis, leakage, spontaneous dislodgement, and catheter-associated blood stream infection. Methods A secondary analysis of a randomized controlled trial evaluating standard replacement versus elective replacement (72-96 h) of peripheral intravenous cannula was conducted in a tertiary-level neonatal unit in Melbourne, Australia. The main outcome of this analysis was to assess the risk of combined adverse events associated with elective replacement of peripheral intravenous cannula. A cost analysis of the intervention was also conducted. Results Combined adverse outcomes noted per infant were 48 (87.27%) in the standard replacement group versus 44 (75.86%) in the elective replacement group (RR 0.87; 95% CI 0.71-1.04, p = 0.15). In terms of combined adverse outcome per 1000 intravenous hours, there was a significant risk ratio of 0.81 in the elective group compared with the standard group (95% CI 0.65-0.98, p = 0.04). Gestation (adjusted odds ratio (AOR) 0.58; 95% CI 0.35-0.96, p = 0.03), male gender (AOR 4.65; 95% CI 1.07-20.28, p = 0.04), elective replacement (AOR 0.12; 95% CI 0.03-0.68, p = 0.01), and the total number of re-sites (AOR 27.84; 95% CI 4.61-168.18, p less then 0.001) were significant risk factors associated with adverse events. There were also significantly higher costs involved with elective replacement. Conclusion Elective replacement of peripheral intravenous cannulas was not shown to reduce the risk of combined adverse events. Elective peripheral intravenous cannula replacement also incurred a higher cost.