WITHDRAWN: Dealing With the Right Side: Carcinoid Heart Disease.

The Publisher regrets that this article is an accidental duplication of an article that has already been published in Journal of Cardiothoracic and Vascular Anesthesia, 36 (2022) 2793-2802, http://dx.doi.org/10.1053/j.jvca.2021.10.030. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.

Impact of the SARS-CoV-2 (COVID19) pandemic on the morbidity and mortality of high risk patients undergoing surgery: a non-inferiority retrospective observational study.

BACKGROUND: During the COVID-19 crisis it was necessary to generate a specific care network and reconvert operating rooms to attend emergency and high-acuity patients undergoing complex surgery. The aim of this study is to classify postoperative complications and mortality and to assess the impact that the COVID-19 pandemic may have had on the results. METHODS: this is a non-inferiority retrospective observational study. Two different groups of surgical patients were created: Pre-pandemic COVID and Pandemic COVID. Severity of illness was rated according to the Diagnosis-related Groups (DRG) score. Comparisons were made between groups and between DRG severity score-matched samples. Non-inferiority was set at up to 10 % difference for grade III to V complications according to the Clavien-Dindo classification, and up to 2 % difference in mortality. RESULTS: A total of 1649 patients in the PreCOVID group and 763 patients in the COVID group were analysed; 371 patients were matched for DRG severity score 3-4 (236 preCOVID and 135 COVID). No differences were found in relation to re-operation (22.5 % vs. 21.5 %) or late admission to critical care unit (5.1 % vs. 4.5 %). Clavien grade III to V complications occurred in 107 patients (45.3 %) in the PreCOVID group and in 56 patients (41.5 %) in the COVID group, and mortality was 12.7 % and 12.6 %, respectively. During the pandemic, 3 % of patients tested positive for Covid-19 on PCR: 12 patients undergoing elective surgery and 11 emergency surgery; there were 5 deaths, 3 of which were due to respiratory failure following Covid-19-induced pneumonia. CONCLUSIONS: Although this study has some limitations, it has shown the non-inferiority of surgical outcomes during the COVID pandemic, and indicates that resuming elective surgery is safe. TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT04780594 .

A non-invasive tool for detecting cervical cancer odor by trained scent dogs.

BACKGROUND: Cervical Cancer (CC) has become a public health concern of alarming proportions in many developing countries such as Mexico, particularly in low income sectors and marginalized regions. As such, an early detection is a key medical factor in improving not only their population's quality of life but also its life expectancy. Interestingly, there has been an increase in the number of reports describing successful attempts at detecting cancer cells in human tissues or fluids using trained (sniffer) dogs. The great odor detection threshold exhibited by dogs is not unheard of. However, this represented a potential opportunity to develop an affordable, accessible, and non-invasive method for detection of CC. METHODS: Using clicker training, a male beagle was trained to recognize CC odor. During training, fresh CC biopsies were used as a reference point. Other samples used included cervical smears on glass slides and medical surgical bandages used as intimate sanitary pads by CC patients. A double-blind procedure was exercised when testing the beagle's ability to discriminate CC from control samples. RESULTS: The beagle was proven able to detect CC-specific volatile organic compounds (VOC) contained in both fresh cervical smear samples and adsorbent material samples. Beagle's success rate at detecting and discriminating CC and non-CC odors, as indicated by specificity and sensitivity values recorded during the experiment, stood at an overall high (>90%). CC-related VOC in adsorbent materials were detectable after only eight hours of use by CC patients. CONCLUSION: Present data suggests different applications for VOC from the uterine cervix to be used in the detection and diagnosis of CC. Furthermore, data supports the use of trained dogs as a viable, affordable, non-invasive and, therefore, highly relevant alternative method for detection of CC lesions. Additional benefits of this method include its quick turnaround time and ease of use while remaining highly accurate and robust.

The H2.0-like homeobox transcription factor modulates yolk sac vascular remodeling in mouse embryos.

OBJECTIVE: The H2.0-like homeobox transcription factor (HLX) plays an essential role in visceral organogenesis in mice and has been shown to regulate angiogenic sprouting in vitro and in zebrafish embryos. We therefore examined the role of HLX in vascular development in mouse and avian embryos. APPROACH AND RESULTS: In situ hybridization showed that Hlx is expressed in a subset of sprouting blood vessels in postnatal mouse retinas and embryos. Hlx expression was conserved in quail embryos and upregulated in blood vessels at the onset of circulation. In vitro assays showed that Hlx is dynamically regulated by growth factors and shear stress alterations. Proangiogenic vascular endothelial growth factor induces Hlx expression in cultured endothelial cells, whereas signals that induce stalk cell identity lead to a reduction in Hlx expression. HLX was also downregulated in embryos in which flow was ablated, whereas injection of a starch solution, which increases blood viscosity and therefore shear stress, causes an upregulation in HLX. HLX knockdown in vitro resulted in a reduction in tip cell marker expression and in reduced angiogenic sprouting, but Hlx(-/-) embryos showed no defect in vascular sprouting at E8.5, E9.5, or E11.5 in vivo. Vascular remodeling of the capillary plexus was altered in Hlx(-/-) embryos, with a modestly enlarged venous plexus and reduction of the arterial plexus. CONCLUSIONS: Our findings indicate not only that Hlx regulates sprouting in vitro, but that its role in sprouting is nonessential in vivo. We find HLX is regulated by shear stress and a subtle defect in vascular remodeling is present in knockout embryos.

Proloterapia con dextrosa al 25% para el manejo del dolor en pacientes con fascitis planta / Prolotherapy with 25% dextrose for pain management in patients with plantar fasciitis

Introducción. La fascitis plantar (FP) es la principal causa de dolor en la parte inferior del talón y la proloterapia es una de las posibles opciones terapéuticas.Objetivo. Determinar el efecto de la proloterapia con dextrosa al 25% en la disminución del nivel de dolor en pacientes con FP.Metodología. Estudio de cohorte retrospectivo realizado en 70 pacientes con FP sometidos a proloterapia con dextrosa al 25% en una institución médica de Colombia en 2021. El nivel de dolor con el pie en reposo se midió con la escala visual análoga (EVA) en cada sesión de proloterapia, las cuales se realizaron a los 0, 1, 4, 7. 10 y 13 meses. Se realizó un análisis de varianza (ANOVA) con la prueba de Friedman y un análisis multivariado mediante modelos lineales mixtos para determinar la asociación entre variables. Resultados. Se realizaron 245 sesiones de proloterapia. La edad promedio fue 53 años y 80% de los pacientes eran mujeres. Las medianas de puntaje en la EVA fueron 9, 8, 6, 5, 4 y 2 en las 6 sesiones de proloterapia, respectivamente. Se evidenció una disminución progresiva del nivel de dolor a lo largo del tratamiento; sin embargo, solo hubo diferencias estadísticamente significativas desde la primera hasta la tercera sesión (p<0,05). Conclusiones. La proloterapia con dextrosa al 25% tuvo buenos resultados, ya que el nivel de dolor del pie en reposo disminuyó progresivamente, especialmente desde la primera sesión hasta la tercera

Introduction. Plantar fasciitis (PF) is the main cause of pain in the bottom of the heel and prolotherapy is one of the possible therapeutic options. Objective. Determine the effect of prolotherapy with 25% dextrose in reducing the level of pain in patients with PF.Methodology. Retrospective cohort study conducted in 70 patients with PF undergoing prolotherapy with 25% dextrose in a medical institution in Colombia in 2021. The level of pain with the foot at rest was measured with the visual analogue scale (VAS) in each session of prolotherapy, which were performed at 0, 1, 4, 7, 10 and 13 months. An analysis of variance (ANOVA) with the Friedman test and a multivariate analysis using linear mixed models were performed to determine the association between variables. Results. 245 prolotherapy sessions were carried out. The average age was 53 years and 80% of the patients were women. The median VAS scores were 9, 8, 6, 5, 4 and 2 in the 6 prolotherapy sessions, respectively. A progressive decrease in the level of pain is evident throughout the treatment; However, there were only statistically significant differences from the first to the third session (p<0.05). Conclusions. Prolotherapy with 25% dextrose had good results, since the level of foot pain at rest progressively decreased, especially from the first session to the third.