transition from standing to sitting.

After L4-S1 fusion, increased proximal segment loading during sitting may cause discomfort in some patients and may lead to junctional breakdown over time. Preserving motion at L4-S1 may improve patient comfort and function during activities of daily living, and potentially decrease the need for adjacent level surgery.

After L4-S1 fusion, increased proximal segment loading during sitting may cause discomfort in some patients and may lead to junctional breakdown over time. #link# Preserving motion at L4-S1 may improve patient comfort and function during activities of daily living, and potentially decrease the need for adjacent level surgery.

Decompensated cirrhosis carries high inpatient morbidity and mortality. Consequently, advance care planning is an integral aspect of medical care in this patient population. Our study aims to identify do-not-resuscitate (DNR) order utilization and demographic disparities in decompensated cirrhosis patients.

Nationwide Inpatient Sample was used to extract the cohort of patients from January 1st, 2016 to December 31st, 2017, based on the most comprehensive and recent data. The first cohort included hospitalized patients with decompensated cirrhosis. The second cohort included patients with decompensated cirrhosis with at least one contraindication for liver transplantation.

A cohort of 585,859 decompensated cirrhosis patients was utilized. DNR orders were present in 14.2% of hospitalized patients. DNR utilization rate among patients with relative contraindication for liver transplantation was 15.0%. After adjusting for co-morbid conditions, disease severity, and inpatient mortality, African-American and Hre significant demographic and hospital-level predictors of DNR utilization. This information can guide resource allocation in educating patients and their families regarding prognosis and outcome expectations.

As copeptin is associated with lower-extremity amputation in patients with type 1 diabetes mellitus (T1DM), our study aimed to address the putative association between copeptin and asymptomatic peripheral artery disease (aPAD) in those patients.

This observational cross-sectional study included 112 patients with T1DM from a larger cohort (ClinicalTrials.gov NCT02910271), selected (12) as per the presence of aPAD (n = 37) or not (n = 75). aPAD was evaluated by ankle-brachial index (ABI), toe-brachial index (TBI), and peripheral Doppler ultrasound. The two groups of patients were matched by age, gender distribution and duration of T1DM. Fasting serum copeptin was measured by high-sensitivity ELISA, and its relationships with clinical and biochemical variables as well as aPAD were evaluated too.

The study population was aged 42 ± 8 years, duration of T1DM was 27 ± 7 years, and mean HbA

was 7.7 ± 1.1%. No significant differences in copeptin concentrations were found between patients with or without aPAD (16.9 ± 10.8 vs 17.3 ± 14.7 pmol/L, respectively; P = 0.462). Considering all patients as a whole, copeptin correlated with systolic blood pressure (SBP; ρ = -0.209, P = 0.027), eGFR ρ = -0.271, P = 0.004), and serum sodium (ρ = -0.208, P = 0.027), but not with ABI (ρ = -0.068, P = 0.476). Stepwise multiple linear regression analysis (R

0.059; P = 0.035) retained SBP (β -0.219, 95% CI -1.391; -0.089) as the only significant predictor of copeptin concentration.

As serum copeptin does not appear to be associated with aPAD in patients with T1DM, further studies are now needed to elucidate whether it has any other potential role to play in the subclinical vascular disease of this patient population.

As serum copeptin does not appear to be associated with aPAD in patients with T1DM, further studies are now needed to elucidate whether it has any other potential role to play in the subclinical vascular disease of this patient population.

Previous studies have reported inconsistent results regarding the association between metformin use and clinical outcomes in diabetes mellitus (DM) patients with coronavirus disease 2019 (COVID-19). This study aimed to evaluate the association between metformin use and clinical outcomes in DM patients with COVID-19.

This retrospective study was based on claims data. All diseases, including COVID-19, were defined using International Classification of Diseases 10th Revision (ICD-10) codes. Patients were divided into three groups depending on metformin use CON (those not taking DM medication); N-MFOM (those taking DM medications other than metformin); and MFOM (those taking metformin for DM). Ultimately, 1865 patients were included; CON, N-MFOM and MFOM groups comprised 1301, 95 and 469 patients, respectively.

Kaplan-Meier analyses showed that MFOM patients had poorer survival rates than those in the CON group, but there were no significant differences in survival rates between MFOM and N-MFOM groups. Multded to determine whether the use of metformin has favourable or unfavourable effects in DM patients with COVID-19.

Lateralization in reverse shoulder arthroplasty (L-RSA) was proposed to overcome some limitations of the original Grammont-style design (S-RSA). This systematic review aims to compare the clinical and functional outcomes and complications of S-RSA with L-RSA, and to assess the individual results of metallic and bony lateralization implants.

A systematic search from January 1980 to December 2019 was performed. Studies were selected in 2 phases by 2 independent reviewers; disagreements were solved by discussion. Inclusion criteria were (1) original studies; (2) written in English or French; (3) adult individuals submitted to RSA surgery; and (4) RSA with a lateralization device in at least one of the groups. Exclusion criteria were (1) nonoriginal studies or case reports; (2) absence of clinical or radiographic outcomes; and (3) no comparison group using S-RSA. Data were extracted for outcomes of functional status (American Shoulder and Elbow Surgeons, Constant, visual analog scale, Simple Shoulder Test, Suies comparing L-RSA and S-RSA and found significantly lower notching and complication rates in L-RSA groups. Raltitrexed nmr in clinical scores and a slight advantage for L-RSA in ROM, especially in external rotation. L-RSA was not associated with increased revision rates, while presenting lower complication and notching rates. Inclusion of studies with metallic and osseous lateralization has helped to provide further evidence on this subject, but heterogeneity and low evidence levels of the included studies may limit our conclusions.