Articles: hospitals.
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Unilateral aldosterone-producing adrenal adenomas (APAs) are the potentially curable cause of 5% of all cases of hypertension. Their localisation (via adrenal vein sampling [AVS]) and removal (by laparoscopic adrenalectomy) require invasive procedures that are unattractive to patients. Molecular imaging-located, endoscopic ultrasound-guided trans-gastric radiofrequency ablation (EUS-RFA) is a potential novel, minimally invasive alternative to AVS and total adrenalectomy for the treatment of APAs in the left adrenal gland, which is very close to the stomach. We aimed to determine whether EUS-RFA can safely target a heterogeneous set of such tumours without damaging the rest of the adrenal gland or adjacent organs. ⋯ National Institute for Health and Care Research Biomedical Research Centres at Barts, University College Hospitals, and Cambridge University Hospitals, Barts Charity, and British Heart Foundation.
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Pediatric emergency care · Feb 2025
Pediatric Golf Cart Injuries and Morbidity: A Single-Center Trauma Experience.
The primary aim of this study was to characterize pediatric golf cart injuries at our center including demographic, clinic, and outcome data. The secondary outcomes explored were associations between patient and driver age and mechanism of injury with hospital admission, length of stay, and surgical interventions. ⋯ Golf carts are a considerable source of injury for our pediatric population, with some accidents leading to serious morbidity. There is a need for consistent safety regulation of golf carts and increased public knowledge of the hazards they pose to children.
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To test the hypothesis that peripheral nerve block (PNB) use might be associated with improved perioperative outcomes following major surgery. ⋯ Use of PNB was associated with shortened length of hospital stay and reduced major complications in older patients after major non-cardiac thoracic and abdominal surgery, possibly due to improved analgesia.
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Dtsch. Med. Wochenschr. · Feb 2025
[Unstable heart failure: practical guidelines for avoiding frequent hospital admissions].
Heart failure is the leading cause of hospital admissions in Germany. The prevention of hospitalizations due to heart failure has recently improved, encompassing guideline-based basic therapy, targeted medication escalation options, and structured outpatient care incorporating telemedicine. An early identification of parameters that precede or indicate acute heart failure is crucial. ⋯ It is recommended to start or up-titrate guideline-recommended medical therapy and additionally initiate treatment with the soluble guanylate cyclase stimulator Vericiguat in patients with heart failure with a reduced ejection fraction. Initiation and up-titration should begin during hospitalization and should be completed during careful follow-up within the first 6 weeks after discharge. This guide provides recommendations for the comprehensive and coordinated treatment of worsening heart failure, considering all these aspects which are crucial for improving patient outcomes.