Infectious diseases and the role of needle biopsy post-mortem.

Post-mortem examinations continue to play a crucial role in understanding the epidemiology and pathogenesis of infectious diseases. However, the perceived infection risk can preclude traditional, invasive, complete diagnostic autopsy. Post-mortem examination is especially important in emerging infectious diseases with potentially unknown infection risks, but rapid acquisition of good quality tissue samples is needed as part of the scientific and public health response. Needle biopsy post-mortem is a minimally invasive, rapid, closed-body autopsy technique that was originally developed to minimise the infection risk to practitioners. Since its inception, needle biopsy post-mortem has also been used as a technique to support complete diagnostic autopsy provision in poorly resourced regions and to facilitate post-mortem examinations in communities that might have religious or cultural objections to an invasive autopsy. This Review analyses the evolution and applicability of needle biopsy post-mortem in investigating endemic and emerging infectious diseases.

Modelling the optimization of world-class 400†m and 1,500†m running performances using high-resolution data.

The 400 m and 1,500 m are track events that rely on different but important contributions from both the aerobic and anaerobic energy systems. The purpose of this study is to model men's and women's 400 m and 1,500 m championship performances to gain a deeper understanding of the key mechanical and physiological factors affecting running speed and bend running using high-resolution data from live competition (10 Hz). To investigate World-class athletes' instantaneous speeds, propulsive forces and aerobic and anaerobic energy, we model and simulate the performances of the men's and women's European Athletics 400 m champions, Matthew Hudson-Smith and Femke Bol, as well as the men's European Athletics 1,500 m champion, Jakob Ingebrigtsen, and the women's European Athletics U23 1,500 m champion, Gaia Sabbatini. The simulations show that a fast start is essential in both the 400 m and 1,500 m because of the need for fast oxygen kinetics, with peak running speeds occurring within the first ∼50 m in both events. Subsequently, 400 m athletes slow continually from this maximum speed to the finish, and a total anaerobic contribution of ∼77% is found for both male and female champions. The key to faster 400 m racing is to reduce the decrease in velocity: this comes from both a high VO2 and a high anaerobic contribution. Ingebrigtsen's winning tactic in the European 1,500 m final is to adopt a very fast cruising pace from 300 m onwards that is possible because he is able to maintain a high VO2 value until the end of the race and has a large anaerobic contribution. He has fast VO2 kinetics that does not require as fast a start as his opponents, but then he speeds up in the last two laps, without a fast sprint finish. The comparison between Sabbatini's slower and quicker races (∼8 s difference) shows that it is the improvement of aerobic metabolism that has the greatest effect on 1,500 m performance. Coaches should note in particular that the all-out pacing nature of the 400 m requires the prioritization of anaerobic energy system development, and those who coach the 1,500 m should note the differing energy contributions between even-paced races and championship racing.

Differences in pacing behaviour between global championship medal performances and world records in men's and women's middle- and long-distance running track events.

The differences in pacing demands between track distance-running championship and meet (e.g., World Record [WR]) races have not been specified yet in the current literature. Therefore, the aim of this study was to determine pacing behaviour differences between WRs and global championship (i.e., World Championships and Olympic Games) medal performances (GCMs) in middle- and long-distance running events. Percentages of mean race section speeds were compared through analysis of variance between men's and women's 169 WRs and 189 GCMs over 800 m, 1500 m, 3000 m steeplechase, 5000 m and 10,000 m. U-shaped and negative pacing approaches are observed during men's and women's 1500 m WRs and GCMs, respectively. The first and third 400 m of men's and women's 1500 m GCMs were relatively slower and faster, respectively (p ≤ 0.05, 1.31 ≤ d ≤ 1.69). Even profiles are followed during women's 3000 m steeplechase WRs and GCMs, whereas positive approaches were adopted in men's GCMs. Finally, whereas 5000 m and 10,000 m GCMs were finished with a fast endspurt, WRs had a U-shaped profile in men, with differences between the initial and last race stages (p ≤ 0.01, 1.20 ≤ d ≤ 3.66), and an even profile in women. Coaches should consider the different pacing demands existing among meet and global championship races to specifically implement training characteristics targeting either goal type.

Kinematic and spatiotemporal differences between footstrike patterns in elite male and female 10,000 m runners in competition.

The aim of this study was to examine spatiotemporal and joint kinematic differences between footstrike patterns in 10,000 m running. Seventy-two men's and 42 women's footstrike patterns were analysed during laps 5, 10, 15, 20 and 25 (of 25) using 2D video recordings. Approximately 47% of men were FFS throughout the race, 30% were MFS and 24% RFS; the respective frequencies in women were approximately 30%, 38% and 32%. Overall, 83% of men and 88% of women retained their footstrike pattern throughout the race. Amongst the 53 men and 33 women with symmetrical footstrike patterns, there were no differences in speed, step length or cadence between footstrike groups in either sex. Most lower limb joint angles did not change in these athletes during the event, with few differences between footstrike patterns apart from ankle and foot angles. A greater hip-ankle distance was found in RFS than in FFS (both sexes) and in RFS than in MFS (men only), although these differences were never more than 0.03 m. Coaches should note that habitual footstrike patterns were maintained during this long-distance track race despite changes in running speed and possible fatigue, and there were few performance differences between footstrike patterns.

Evolution of 1500-m Olympic Running Performance.

PURPOSE: This study determined the evolution of performance and pacing for each winner of the men's Olympic 1500-m running track final from 1924 to 2020. METHODS: Data were obtained from publicly available sources. When official splits were unavailable, times from sources such as YouTube were included and interpolated from video records. Final times, lap splits, and position in the peloton were included. The data are presented relative to 0 to 400 m, 400 to 800 m, 800 to 1200 m, and 1200 to 1500 m. Critical speed and D' were calculated using athletes' season's best times. RESULTS: Performance improved ∼25 seconds from 1924 to 2020, with most improvement (∼19 s) occurring in the first 10 finals. However, only 2 performances were world records, and only one runner won the event twice. Pacing evolved from a fast start-slow middle-fast finish pattern (reverse J-shaped) to a slower start with steady acceleration in the second half (J-shaped). The coefficient of variation for lap speeds ranged from 1.4% to 15.3%, consistent with a highly tactical pacing pattern. With few exceptions, the eventual winners were near the front throughout, although rarely in the leading position. There is evidence of a general increase in both critical speed and D' that parallels performance. CONCLUSIONS: An evolution in the pacing pattern occurred across several "eras" in the history of Olympic 1500-m racing, consistent with better trained athletes and improved technology. There has been a consistent tactical approach of following opponents until the latter stages, and athletes should develop tactical flexibility, related to their critical speed and D', in planning prerace strategy.

Recreational Runners Gain Physiological and Biomechanical Benefits From Super Shoes at Marathon Paces.

PURPOSE: Advanced footwear technology is prevalent in distance running, with research focusing on these "super shoes" in competitive athletes, with less understanding of their value for slower runners. The aim of this study was to compare physiological and biomechanical variables between a model of super shoes (Saucony Endorphin Speed 2) and regular running shoes (Saucony Cohesion 13) in recreational athletes. METHODS: We measured peak oxygen uptake (VO2peak) in 10 runners before testing each subject 4 times in a randomly ordered crossover design (ie, Endorphin shoe or Cohesion shoe, running at 65% or 80% of velocity at VO2peak [vVO2peak]). We recorded video data using a high-speed camera (300 Hz) to calculate vertical and leg stiffnesses. RESULTS: 65% vVO2peak was equivalent to a speed of 9.4 km·h-1 (0.4), whereas 80% vVO2peak was equivalent to 11.5 km·h-1 (0.5). Two-way mixed-design analysis of variance showed that oxygen consumption in the Endorphin shoe was 3.9% lower than in the Cohesion shoe at 65% vVO2peak, with an interaction between shoes and speed (P = .020) meaning an increased difference of 5.0% at 80% vVO2peak. There were small increases in vertical and leg stiffnesses in the Endorphin shoes (P < .001); the Endorphin shoe condition also showed trivial to moderate differences in step length, step rate, contact time, and flight time (P < .001). CONCLUSIONS: There was a physiological benefit to running in the super shoes even at the slower speed. There were also spatiotemporal and global stiffness improvements indicating that recreational runners benefit from wearing super shoes.

A retrospective, comparative, clinical study of occlusion rate of peripherally inserted central catheters fabricated of poly(vinyl alcohol)-based hydrogel composite.

Thrombotic accumulation is associated with surface interactions between blood proteins and vascular access devices. Catheter occlusion results from this process, and is a costly, common, occurrence with peripherally inserted central catheters (PICCs). Hydrophilic catheter materials exhibit antithrombotic properties. This retrospective study evaluates the occurrence of catheter occlusion of PICCs constructed of a poly(vinyl alcohol)-based hydrogel composite known as hydrophilic biomaterial (HBM), compared to thermoplastic polyurethane (TPU) control devices. A total of 121 PICCs, 60 HBM and 61 TPU, were placed in patients with a clinical need and were reviewed for the occurrence of catheter occlusion. The records review found that occlusions occurred in 0/60 (0.0%) of the HBM PICCs and 13/61 (21.3%) of TPU PICCs (p = 0.001). HBM exhibits favorable qualities for vascular access, most importantly its extreme hydrophilicity. Clinically, this may be responsible for the reduction in PICC occlusions, which could improve patient outcomes.

Short-Term Speed Variability as an Index of Pacing Stochasticity in Athletic Running Events.

We aimed to compare differences in performance and pacing variability indices between 5000 m heats and finals during major championships in men and women. Data with 100 m time resolution were used to compare overall pacing variability (standard deviation of 100 m section times, SD; and coefficient of variation, CV%) and short-term pacing variability (root mean square of successive differences between 100 m section times, RMSSD). The changes in performance and pacing indices differed between races and competitions. For instance, the men's final in Beijing 2008 was quicker than the heat (p < 0.01) while the CV% was reduced (p = 0.03) and RMSSD increased (p < 0.01). For women, the heats and the final exhibited a similar mean time in London 2017 (p = 0.33) but with CV% (p < 0.001) and RMSSD (p < 0.001) showing opposite trends. Individual analyses of men's and women's champions revealed highly individual variability metrics. The use of RMSSD can complement overall variability indices for better characterization of pacing stochasticity.

Changes in running biomechanics during the 2017 IAAF world championships men's 1500 m final.

The aim of this study was to analyze key kinematic, spatiotemporal, and global mechanical characteristics in world-class middle-distance racing. Eight men were recorded halfway along the home straight on the second, third, and final laps in the 2017 IAAF World Championship 1500 m final. Video data (150 Hz) from three high-definition camcorders were digitized to calculate relevant variables, subsequently analyzed in relation to running speed and finishing position. Better-placed finishers had greater hip extension at initial contact and through late stance, greater knee excursion throughout stance, and longer overstriding distances. Step length did not change with faster speeds as runners relied on increasing step frequency, but the highest-finishing athletes had longer contact phases and greater fluctuations in speed through the step cycle, which were related to higher normalized peak horizontal forces. The best athletes also had lower leg stiffnesses and vertical stiffnesses. The extended contact phase and greater compression could allow for more sustained force production, enabling better acceleration and maintenance of sprinting speed, indicating a trade-off between aerobic energetic efficiency and anaerobic power capacity. Coaches should note that these factors, as well as the best athletes' greater overstriding distances, show that elite 1500 m runners might prioritize a technique that favors running speed over economy.

Grizzlies and gazelles: Duty factor is an effective measure for categorizing running style in English Premier League soccer players.

English Premier League soccer players run at multiple speeds throughout a game. The aim of this study was to assess how well the duty factor, a dimensionless ratio based on temporal variables, described running styles in professional soccer players. A total of 25 players ran on an instrumented treadmill at 12, 16, and 20 km/h. Spatiotemporal and ground reaction force data were recorded for 30 s at each speed; video data (500 Hz) were collected to determine footstrike patterns. In addition to correlation analysis amongst the 25 players, two groups (both N = 9) of high and low duty factors were compared. The duty factor was negatively correlated with peak vertical force, center of mass (CM) vertical displacement, and leg stiffness (k leg) at all speeds (r ≥ -0.51, p ≤ 0.009). The low duty factor group had shorter contact times, longer flight times, higher peak vertical forces, greater CM vertical displacement, and higher k leg (p < 0.01). Among the high DF group players, eight were rearfoot strikers at all speeds, compared with three in the low group. The duty factor is an effective measure for categorizing soccer players as being on a continuum from terrestrial (high duty factor) to aerial (low duty factor) running styles, which we metaphorically refer to as "grizzlies" and "gazelles," respectively. Because the duty factor distinguishes running style, there are implications for the training regimens of grizzlies and gazelles in soccer, and exercises to improve performance should be developed based on the biomechanical advantages of each spontaneous running style.

Biomechanics of World-Class 800 m Women at the 2017 IAAF World Championships.

The 800 m race challenges the aerobic and anaerobic energy systems, and athletes adopt a technique that allows for running efficiency as well as sprinting speeds. The aim of this novel study was to compare important kinematic variables between the two laps of the 2017 IAAF World Championships women's final. Video data (150 Hz) were collected of all eight finalists on both laps at a distance approximately 50 m from the finish line along the home straight. Running speed, step length, cadence, temporal variables, sagittal plane joint angles, and shank angle at initial contact were measured. Running speed was faster on lap 2 (p = 0.008) because of large increases in cadence (p = 0.012). These higher cadences resulted in large decreases in contact times (p = 0.031) and in flight times (p = 0.016) on lap 2. Greater knee flexion and ankle plantarflexion (p ≤ 0.039) at initial contact on lap 2 seemed partly responsible for shorter swing times (p = 0.016), and which accompanied a decrease in shank angle at initial contact from lap 1 (7°) to a more vertical position on lap 2 (4°) (p = 0.008). Coaches should note that the need for higher cadence, horizontal impulse production during shorter contact times, and the adoption of forefoot striking require strength and neural system training to allow for athletes to increase cadence during the sprint finish. Increasing cadence (and not step length) was the driving factor for faster finishing speeds in the women's 800 m.

Kinematic and Temporal Differences Between World-Class Men's and Women's Hurdling Techniques.

This study aimed to compare joint kinematics and center of mass parameters throughout hurdle clearance between world-class men and women sprint hurdlers, who were competing in a World Championships final. This was the first study to present time-series kinematic data around hurdle clearance, and given the technical ability of the athletes analyzed, it can be used as a template when analyzing the technique of other athletes in similar competitions and training. Video data were collected of the 16 finalists at the 2017 IAAF World Championships using four high-speed cameras (150 Hz). Video files were continuously digitized manually from touchdown before hurdle clearance to toe-off after landing around the sixth hurdle for men and the fifth hurdle for women, and sex-based comparisons were made at key discrete time points using independent t-tests, and throughout the entire hurdle phase using statistical parametric mapping. When calculated relative to hurdle height, the women's center of mass height was significantly greater than the men's throughout the full analyzed sequence (p < 0.001). Men also displayed more hip flexion in the lead leg at take-off before hurdle clearance (p = 0.029) as well as a more extended knee joint at intervals during flight and upon landing (p ≤ 0.037). Women completed the hurdle phase in a significantly shorter time than men (~11% difference, p < 0.001). Finally, women seemed to be more efficient by maintaining and even exceeding their entry velocity for the first 40% of the hurdle phase. These results show a lower technical demand for the women to successfully negotiate hurdle clearance, thus providing further evidence to support the argument that the women's hurdle height is too low for their performance capabilities and should be raised in senior competition.

Kinematics of the Final Approach and Take-Off Phases in World-Class Men and Women Pole Vaulters.

The pole vault is a highly technical event where the athletes must successfully convert horizontal velocity during the run-up to vertical velocity at take-off. The aim of this study was to compare the kinematics of men's and women's world-class pole vaulting. Video data were collected of the best clearances by 14 men and 11 women at the 2018 IAAF World Indoor Championships using three high-speed cameras (200 Hz). Running velocity, step lengths, step times, and pole angles were measured during the run-up; during take-off, distance from the plant box, angle and velocity of take-off, and relative positions of the foot and hands were measured. Men achieved greater clearance heights with faster run-ups, faster take-off velocities and higher hand grip positions (all p < 0.001), with each of the last three steps longer for men when expressed as absolute values (all p < 0.001), but not when expressed relative to stature. There were no differences in run-up pole angles, step times, take-off angle, take-off contact time or time from pole plant to take-off. Women differed in their approach and take-off for characteristics affected by stature and strength, such as fewer run-up steps, shorter take-off distances, and lower grip heights. These lower grips result from a shorter, lighter pole, and this disadvantage was greater than slower run-up velocities. Coaches should therefore note that sex-based differences occur in the pole vault that result from anthropometric differences, but which do not negate the adoption of similar technical models of vaulting.

COVID-19-Associated cardiac pathology at the postmortem evaluation: a collaborative systematic review.

BACKGROUND: Many postmortem studies address the cardiovascular effects of COVID-19 and provide valuable information, but are limited by their small sample size. OBJECTIVES: The aim of this systematic review is to better understand the various aspects of the cardiovascular complications of COVID-19 by pooling data from a large number of autopsy studies. DATA SOURCES: We searched the online databases Ovid EBM Reviews, Ovid Embase, Ovid Medline, Scopus, and Web of Science for concepts of autopsy or histopathology combined with COVID-19, published between database inception and February 2021. We also searched for unpublished manuscripts using the medRxiv services operated by Cold Spring Harbor Laboratory. STUDY ELIGIBILITY CRITERIA: Articles were considered eligible for inclusion if they reported human postmortem cardiovascular findings among individuals with a confirmed SARS coronavirus type 2 (CoV-2) infection. PARTICIPANTS: Confirmed COVID-19 patients with post-mortem cardiovascular findings. INTERVENTIONS: None. METHODS: Studies were individually assessed for risk of selection, detection, and reporting biases. The median prevalence of different autopsy findings with associated interquartile ranges (IQRs). RESULTS: This review cohort contained 50 studies including 548 hearts. The median age of the deceased was 69 years. The most prevalent acute cardiovascular findings were myocardial necrosis (median: 100.0%; IQR, 20%-100%; number of studies = 9; number of patients = 64) and myocardial oedema (median: 55.5%; IQR, 19.5%-92.5%; number of studies = 4; number of patients = 46). The median reported prevalence of extensive, focal active, and multifocal myocarditis were all 0.0%. The most prevalent chronic changes were myocyte hypertrophy (median: 69.0%; IQR, 46.8%-92.1%) and fibrosis (median: 35.0%; IQR, 35.0%-90.5%). SARS-CoV-2 was detected in the myocardium with median prevalence of 60.8% (IQR 40.4-95.6%). CONCLUSIONS: Our systematic review confirmed the high prevalence of acute and chronic cardiac pathologies in COVID-19 and SARS-CoV-2 cardiac tropism, as well as the low prevalence of myocarditis in COVID-19.

Multisystem screening reveals SARS-CoV-2 in neurons of the myenteric plexus and in megakaryocytes.

SARS-CoV-2, the causative agent of COVID-19, typically manifests as a respiratory illness, although extrapulmonary involvement, such as in the gastrointestinal tract and nervous system, as well as frequent thrombotic events, are increasingly recognised. How this maps onto SARS-CoV-2 organ tropism at the histological level, however, remains unclear. Here, we perform a comprehensive validation of a monoclonal antibody against the SARS-CoV-2 nucleocapsid protein (NP) followed by systematic multisystem organ immunohistochemistry analysis of the viral cellular tropism in tissue from 36 patients, 16 postmortem cases and 16 biopsies with polymerase chain reaction (PCR)-confirmed SARS-CoV-2 status from the peaks of the pandemic in 2020 and four pre-COVID postmortem controls. SARS-CoV-2 anti-NP staining in the postmortem cases revealed broad multiorgan involvement of the respiratory, digestive, haematopoietic, genitourinary and nervous systems, with a typical pattern of staining characterised by punctate paranuclear and apical cytoplasmic labelling. The average time from symptom onset to time of death was shorter in positively versus negatively stained postmortem cases (mean = 10.3 days versus mean = 20.3 days, p = 0.0416, with no cases showing definitive staining if the interval exceeded 15 days). One striking finding was the widespread presence of SARS-CoV-2 NP in neurons of the myenteric plexus, a site of high ACE2 expression, the entry receptor for SARS-CoV-2, and one of the earliest affected cells in Parkinson's disease. In the bone marrow, we observed viral SARS-CoV-2 NP within megakaryocytes, key cells in platelet production and thrombus formation. In 15 tracheal biopsies performed in patients requiring ventilation, there was a near complete concordance between immunohistochemistry and PCR swab results. Going forward, our findings have relevance to correlating clinical symptoms with the organ tropism of SARS-CoV-2 in contemporary cases as well as providing insights into potential long-term complications of COVID-19. © 2022 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.

Repeatability and sensitivity of passive mechanical stiffness measurements in the triceps surae muscle-tendon complex.

Measurements of muscle-tendon unit passive mechanical properties are often used to illustrate acute and chronic responses to a training stimulus. The purpose of this study was to quantify the inter-session repeatability of triceps surae passive stiffness measurements in athletic and non-athletic populations, with the view to discussing its usefulness both as a muscle-tendon profiling tool and a control measure for studies with multiple data collection sessions. The study also aimed to observe the effects of quiet standing on passive stiffness parameters. Twenty-nine men (10 cyclists, nine triathletes, 10 controls) visited the laboratory on three separate occasions, where passive stiffness tests were carried out using an isokinetic dynamometer and B-mode ultrasound. Participants were fully rested on two of the sessions and subjected to 20 min of quiet standing in the other. The passive stiffness assessment generally showed only moderate inter-session repeatability but was still able to detect inter-group differences, with triathletes showing higher passive stiffness than cyclists (p < 0.05). Furthermore, quiet standing impacted passive stiffness by causing a reduction in ankle joint range of motion, although mechanical resistance to stretch in the muscle-tendon unit at a given joint angle was relatively unaffected. These findings show that passive stiffness assessment is appropriate for detecting inter-group differences in the triceps surae and even the effects of a low-intensity task such as quiet standing, despite showing some inter-session variation. However, the inter-session variation suggests that passive stiffness testing might not be suitable as a control measure when testing participants on multiple sessions.

Development and Maintenance of Sprint Training Adaptations: An Uphill-Downhill Study.

ABSTRACT: Bissas, A, Paradisis, GP, Nicholson, G, Walker, J, Hanley, B, Havenetidis, K, and Cooke, CB. Development and maintenance of sprint training adaptations: an uphill-downhill study. J Strength Cond Res 36(1): 90-98, 2022-We examined the development of performance adaptations resulting from an uphill-downhill training program and monitored the decline of adaptations during detraining. Twenty-eight men were randomly assigned to 1 of 2 sprint training groups who trained 3 times per week for 6 weeks and a control group (C). The uphill-downhill group (U+D) trained on an 80-m platform with 3° slopes, whereas the horizontal (H) group trained on flat track. Subjects were tested for maximal running speed (MRS), associated kinematics, and leg strength before and after training, with U+D subjects also tested after weeks 2 and 4 of training, and after a 3-week detraining period. The U+D group increased their MRS by 3.7% (from 8.75 ± 0.72 to 9.07 ± 0.64 m·s-1, p < 0.05), their stride rate by 3.1% (from 4.21 ± 0.21 to 4.34 ± 0.18 Hz, p < 0.05), and their knee extensors' maximum isometric force by 21% (from 2,242 ± 489 to 2,712 ± 498 N, p < 0.05) after training. The time course of changes showed declines for weeks 1-4 (1.4-5.1%), but an ascending trend of improvement compensated all losses by the end of week 6 (p < 0.05). During detraining, no decreases occurred. No changes were observed for the H and C groups. The minimum period to produce positive effects was 6 weeks, with a very good standard of performance maintained 3 weeks after training. U+D training will prove useful for all athletes requiring fast adaptations, and it can fit into training mesocycles because of its low time demands.

Comparative Analysis of Patients with Robotic Hiatal Hernia Repairs with and without Collis Gastroplasty.

INTRODUCTION: After extensive mediastinal dissection fails to achieve adequate intra-abdominal esophageal length, a Collis gastroplasty(CG) is recommended to decrease axial tension and reduce hiatal hernia recurrence. However, concerns exist about staple line leak, and long-term symptoms of heartburn and dysphagia due to the acid-producing neoesophagus which lacks peristaltic activity. This study aimed to assess long-term satisfaction and GERD-related quality of life after robotic fundoplication with CG (wedge fundectomy technique) and to compare outcomes to patients who underwent fundoplication without CG. Outcomes studied included patient satisfaction, resumption of proton pump inhibitors (PPI), length of surgery (LOS), hospital stay, and reintervention. METHODS: This was a single-center retrospective analysis of patients from January 2017 through December 2018 undergoing elective robotic hiatal hernia repair and fundoplication. 61 patients were contacted for follow-up, of which 20 responded. Of those 20 patients, 7 had a CG performed during surgery while 13 did not. There was no significant difference in size and type of hiatal hernias in the 2 groups. These patients agreed to give their feedback via a GERD health-related quality of life (GERD HRQL) questionnaire. Their medical records were reviewed for LOS, length of hospital stay (LOH), and reintervention needed. Statistical analysis was performed using SPSS v 25. Satisfaction and need for PPIs were compared between the treatment and control groups using the chi-square test of independence. RESULTS: Statistical analysis showed that satisfaction with outcome and PPI resumption was not significantly different between both groups (P > .05). There was a significant difference in the average ranks between the 2 groups for the question on postoperative dysphagia on the follow-up GERD HRQL questionnaire, with the group with CG reporting no dysphagia. There were no significant differences in the average ranks between the 2 groups for the remaining 15 questions (P > .05). The median LOS was longer in patients who had a CG compared to patients who did not (250 vs. 148 min) (P = .01). The LOH stay was not significantly different (P > .05) with a median length of stay of 2 days observed in both groups. There were no leaks in the Collis group and no reoperations, conversions, or blood transfusions needed in either group. CONCLUSION: Collis gastroplasty is a safe option to utilize for short esophagus noted despite extensive mediastinal mobilization and does not adversely affect the LOH stay, need for reoperation, or patient long-term satisfaction.