Gastrostomy tube (GT) dislodgement is a common reason for emergency department (ED) visits. We aim to assess the efficacy of our institution’s algorithm in reducing surgical consultation and GT contrast studies for replacement of dislodged GT and to examine the need for operation before and after algorithm implementation.

A retrospective review was performed between March 2017-February 2018 (prealgorithm) and March 2018-December 2018 (postalgorithm) for patients <18 years presenting to the ED with GT dislodgement. Demographics and outcomes were analyzed.

A total of 433 visits among 279 patients were included, 200 (46.2%) pre and 233 (53.8%) postalgorithm implementation. Median ED LOS was 2.1h (IQR 1.4, 3.0). Surgery was consulted in 92 visits (21.3%) and a contrast study obtained in 287 (66.3%). The GT was replaced by ED providers in 363 visits (83.8%) and by surgery in 70 (16.2%). Surgical consultation increased postalgorithm (16.5% vs. 25.3%; p=0.03). Six (1.4%) patients required reoperation, with 5 occurring postalgorithm, p=0.22. For GTs placed < 8 weeks prior to the dislodgment, there were no differences in surgical consultations, contrast studies performed, or need for reoperation pre and postalgorithm.

An algorithm for replacement of dislodged GT is usable, effective, and increased surgical team involvement without significant changes in patient outcomes. TYPEOFSTUDY Treatment Study. LEVELOFEVIDENCE Level III.

An algorithm for replacement of dislodged GT is usable, effective, and increased surgical team involvement without significant changes in patient outcomes. TYPE OF STUDY Treatment Study. LEVEL OF EVIDENCE Level III.Stem cell-based therapy has recently offered a promising alternative for the remedy of neurodegenerative disorders like Huntington’s disease (HD). Herein, we investigated the potential ameliorative effects of implantation of dental pulp stem cells (DPSCs) in 3-nitropropionic acid (3-NP) rat models of HD. In this regard, human DPSCs were isolated, culture-expanded and implanted in rats lesioned with 3-NP. Post-transplantation examinations revealed that DPSCs were able to survive and augment motor skills and muscle activity. Histological analysis showed DPSCs treatment hampered the shrinkage of the striatum along with the inhibition of gliosis and microgliosis in the striatum of 3-NP rat models. We also detected the downregulation of Caspase-3 and pro-inflammatory cytokines such as TNF and IL-1β upon DPSCs grafting. Overall, these findings imply that the grafting of DPSCs could repair motor-skill impairment and induce neurogenesis, probably through the secretion of neurotrophic factors and the modulation of neuroinflammatory response in HD animal models.The impact of kinking of the nonstented part of a frozen elephant trunk on the development of adverse effects is unclear. We report a case of an infected thrombus within the kinked nonstented portion of the frozen elephant trunk that resulted in multiorgan embolization. A 45-year-old man presented with a 1-month history of high-grade fever and fatigue. He had undergone emergent total arch replacement and frozen elephant trunk implantation for type A acute aortic dissection 7 years previously. Computed tomography showed an intraluminal thrombus within the kinked nonstented portion of the frozen elephant trunk. An autopsy also showed an intraluminal thrombus within the graft and diffuse microembolization in the abdominal organs. learn more Therefore, in this case, kinking of the nonstented part of the frozen elephant trunk had resulted in an infected intraluminal thrombus, which subsequently caused multiorgan embolization.

Electroencephalography (EEG) patterns are predictive of neurological prognosis in comatose survivors from cardiac arrest but intensive care clinicians are dependent of neurophysiologist reports to identify specific patterns. We hypothesized that the proportion of correct assessment of neurological prognosis would be higher from short statements confirming specific EEG patterns compared with descriptive plain text reports.

Volunteering intensive care clinicians at two university hospitals were asked to assess the neurological prognosis of a fictional patient with high neuron specific enolase. They were presented with 17 authentic plain text reports and three short statements, confirming whether a “highly malignant”, “malignant” or “benign” EEG pattern was present. Primary outcome was the proportion of clinicians who correctly identified poor neurological prognosis from reports consistent with highly malignant EEG patterns. Secondary outcomes were how the prognosis was assessed from reports consistent with malignant and benign patterns.

Out of 57 participants, poor prognosis was correctly identified by 61% from plain text reports and by 93% from the short statement “highly malignant” EEG patterns. Unaffected prognosis was correctly identified by 28% from plain text reports and by 40% from the short statement “malignant” patterns. Good prognosis was correctly identified by 64% from plain text reports and by 93% from the short statement “benign” pattern.

Standardized short statement, “highly malignant EEG pattern present”, as compared to plain text EEG descriptions in neurophysiologist reports, is associated with more accurate identification of poor neurological prognosis in comatose survivors of cardiac arrest.

Standardized short statement, “highly malignant EEG pattern present”, as compared to plain text EEG descriptions in neurophysiologist reports, is associated with more accurate identification of poor neurological prognosis in comatose survivors of cardiac arrest.The aim of this study was to investigate the effects of microRNA (miR)-599 targeting Yes-associated protein 1 (YAP1) on the proliferation, invasion and apoptosis of bladder urothelial carcinoma cell line J82. J82 cells cultured in vitro were divided into miR-nc group (transfected with analog negative control miR-NC), miR-599 group (transfected with miR-599 analog), miR-599 + pcDNA3.1 group (co transfected with miR-599 analog and pcDNA3.1 empty vector), miR-599 + pcDNA3.1-YAP1 group (co transfected with miR-599 analog and pcDNA3.1-YAP1 over expression vector), the targeting relationship between miR-599 and YAP1 was detected by double luciferase reporter gene assay, the expression level of miR-599 was detected by real-time fluorescence quantitative PCR, the expression of YAP1 was detected by Western blot, cell proliferation was detected by MTT method, cell invasion was detected by Transwell’s cell experiment, and apoptosis was detected by flow cytometry. The miR-599 was able to bind to YAP1 targetingly; compared with those in miR-NC group, miR-599 expression level and apoptosis rate in miR-599 group were significantly higher, however, the expression level of YAP1 protein and the abilities of cell proliferation and invasion were significantly lower (P 0.