Commissurotomy Using Carbon Dioxide Laser in 67 Dogs.

Commissurotomy is a surgical technique whereby the lip commissure is incised. Indications for commissurotomy include cheiloplasty, partial commissurectomy, or access to the caudal portion of the maxilla or mandible for oral surgery. Carbon dioxide (CO2) laser was used for commissurotomy in dogs for partial commissurectomy (n = 7) or access for oral surgery (n = 60). All dogs had oral or maxillofacial neoplasms that required resective surgery. The CO2 laser was used to perform commissurotomy or commissurectomy, as indicated. Commissurotomy healing was evaluated at 2 weeks with longer-term follow-up of a minimum of 6 weeks (104.6 ± 99.2 weeks) postoperatively. Postoperative complications related to commissurotomy (n = 6) included mucosal dehiscence (n = 3) less than 1.5 cm, lip margin dehiscence (n = 2) less than 1.0 cm, and complete commissurotomy wound dehiscence (n = 1). Two wound dehiscence cases, including the complete wound dehiscence, had uncomplicated healing following revision surgery. Minor marginal and mucosal dehiscence cases healed by the second intention. Periwound edema ranged from mild to severe and resolved by the 2-week postoperative examination. Statistical analysis showed that complications associated with commissurotomy/commissurectomy were independent of the type of surgical procedure, tumor type, and surgical margin evaluation when using the CO2 laser. Commissurotomy using CO2 laser provided rapid and unimpeded exposure with minimal hemorrhage of the caudal maxilla and mandible for resective oral and maxillofacial surgery.

Hospitalization for permanent pacemaker implantation in the context of isolated sinus node dysfunction is associated with increased mortality compared with an outpatient strategy.

BACKGROUND: Permanent pacemaker (PPM) implantation is a well-established treatment for symptomatic sinus node dysfunction (SND). The optimal timing of this intervention is unclear, with atrioventricular blocks often prioritized in resource stressed waiting lists due to mortality concerns. METHODS: Mortality data was compared between patients receiving elective outpatient (OP) PPM implantation, and those presenting to hospital for urgent inpatient (IP) management for symptomatic SND. Survival analysis was conducted using Kaplan-Meier plots and compared using the log-rank test. Univariable and multivariable Cox regression, as well as propensity score matching analyses were performed to assess the prognostic effect on 30-day and 1-year all-cause mortality of inpatient implant. RESULTS: Of the 1269 patients identified with isolated SND, 740 (58%) had PPMs implanted on an OP and 529 (42%) on an IP basis. Mortality was significantly worse in patients where management was driven by hospital admission on an urgent basis (Log-Rank χ2 = 21.6, p < 0.001) and remained an independent predictor of 1-year all-cause mortality (HR 3.40, 95% CI 1.97-5.86, p < 0.001) on multivariable analysis. CONCLUSIONS: SND is predominantly a disease associated with ageing and comorbid populations, where avoidance of deconditioning, hospitalization acquired infections, and polypharmacy is advantageous. Admission avoidance is therefore the preferable strategy.

Why We Swab: A library of stories in stem cell donation.

BACKGROUND: Stories are powerful in their ability to disseminate information in a meaningful way. We hypothesized that a stem cell donation story library optimized for social media could support the education and recruitment of committed unrelated hematopoietic stem cell donors from needed demographic groups. STUDY DESIGN AND METHODS: We developed Why We Swab, a library of stories on stem cell donation (facebook.com/WhyWeSwab; instagram.com/WhyWeSwab; twitter.com/WhyWeSwab), and evaluated its impact across social and traditional media as well as on eligible potential donors' knowledge and attitudes towards donation. RESULTS: As of December 2021, the library included 28 story arcs featuring 45 storytellers from diverse ancestral backgrounds, including 8 donor-recipient stories. Overall, the stories reached >92,000 people across social media. Notably, stories were republished by 18 print/ broadcast media outlets in Canada and by major medical organizations. A series of stories shown to 33 eligible potential donors improved mean total scores on a donation knowledge test (64% to 85%, p < 0.001), reduced mean ambivalence scale scores (3.85 to 2.70, p < 0.001), and improved participants' willingness to register as donors (45% to 73%, p < 0.005). Data are also shown demonstrating that stakeholders valued the library and that its deployment was associated with improved donor recruitment outcomes in Canada. CONCLUSION: Why We Swab is accessible and relevant to a wide audience, including stem cell donor registries and recruitment organizations seeking to improve their recruitment efforts as well as to blood and organ & tissue donation organizations who can adapt the Why We Swab model to their audiences.