Radical nephroureterectomy is the gold standard of treatment for high-risk non-metastatic urothelial carcinoma of the upper urinary tract. However, the optimal surgical approach remains a controversial debate. This study compared the perioperative and oncological outcomes of open and robot-assisted radical nephroureterectomies.
 
  131 consecutive radical nephroureterectomies (66 robot-assisted nephroureterectomies vs. 65 open nephroureterectomies) for urothelial carcinoma of the upper urinary tract at a single tertiary referral center were included from 2009 to 2019. The perioperative and oncological outcomes were compared between both surgical approaches, including logistic regression analysis, propensity score matching, Kaplan Meier analyses, and Cox regression models.
 
  Overall, robot-assisted surgery had less blood loss (150ml vs. 250, p=0.004) and less positive surgical margins (1.5% vs. 15.4%, p=0.004) at a comparable operating time (robotic 188min vs. 178). Any grade complications were more frequent a of the upper urinary tract at a high volume center, experienced in robotic surgery.
 Robot-assisted radical nephroureterectomy had significant perioperative advantages at comparable oncological outcomes compared to open surgery for the treatment of urothelial carcinoma of the upper urinary tract at a high volume center, experienced in robotic surgery.
  Over the past decade numbers of bilateral mastectomy have increased steadily. As a result, bilateral breast reconstruction is gaining popularity. The presented study compares complications and outcomes of unilateral and bilateral DIEP free-flap breast reconstructions using the largest database available in Europe.
 
  Female breast cancer patients (n=3926) receiving DIEP flap breast reconstructions (n=4577 free flaps) at 22 different centers were included in this study. Free flaps were stratified into two groups a unilateral- (UL) and a bilateral- (BL) breast reconstruction group. Groups were compared with regard to surgical complications and free flap outcome.
 
  Mean operative time was significantly longer in the BL group (UL 285.2±107.7 vs. BL 399.1±136.8min; p<0.001). Mean ischemia time was comparable between groups (p=0.741). There was no significant difference with regard to total (UL 1.8% vs. BL 2.6%, p=0.081) or partial flap loss (UL 1.2% vs. BL 0.9%, p=0.45) between both groups. Rates of venous or arterial thrombosis were comparable between both groups (venous UL 2.9% vs. BL 2.2%, p=0.189; arterial UL 1.8% vs.  https://www.selleckchem.com/products/bos172722.html  BL 1.2%, p=0.182). However, significantly higher rates of hematoma at the donor and recipient site were observed in the UL group (donor site UL 1.1% vs. BL 0.1%, p=0.001; recipient site UL 3.9% vs. BL 1.7%, p<0.001).
 
  The data underline the feasibility of bilateral DIEP flap reconstruction, when performed in a setting of specialized centers.
 The data underline the feasibility of bilateral DIEP flap reconstruction, when performed in a setting of specialized centers.
  The mortality risk attributable to the classifications of chronic obstructive pulmonary disease (COPD) remains unclear. We investigated the associations of mortality with COPD classifications and reduced lung function in a large longitudinal cohort in Taiwan.
 
  A total of 388,401 adults (≥25 years of age) were recruited between 1996 and 2016 underwent 834,491 medical examinations including spirometry. We used the Global Initiative for Chronic Obstructive Lung Disease (GOLD) to establish the COPD classifications. A time-dependent Cox regression model was used to investigate the associations between the morality risk and COPD classifications. We also examined the associations between mortality and lung function.
 
  The mean age of the participants was 42.1 years, and the median follow-up duration was 16.2 years. We identified 28,283 natural-cause deaths, and the mortality rate was 4.7 per 1,000 person-years. The hazard ratios (HRs) [95%confidence interval (95%CI)] of mortality in the participants with restrictive spirometry pattern and COPD GOLD Ⅰ-Ⅳ were 1.31 (1.27-1.35), 1.18 (1.00-1.39), 1.43 (1.35-1.51), 1.78 (1.66-1.90), and 2.13 (1.94-2.34), respectively, with reference to the participants with normal lung function. The natural-cause mortality risk increased by 33% [HR(95%CI) 1.33 (1.28-1.39)] for participants with COPD. Reduced lung function was also associated with a higher mortality risk.
 
  A more advanced classification of COPD was associated with a greater increase in the mortality risk. Our study suggests that early detection of COPD and slowing the disease progress in patients with COPD are crucial for mortality prevention.
 A more advanced classification of COPD was associated with a greater increase in the mortality risk. Our study suggests that early detection of COPD and slowing the disease progress in patients with COPD are crucial for mortality prevention.Patients recovering from coronavirus disease 2019 (COVID-19) may not return to a pre-COVID functional status and baseline levels of healthcare needs after discharge from acute care hospitals. Since the long-term outcomes of COVID-19 can be more severe in patients with underlying cardiorespiratory diseases, we aimed at verifying the impact of a preexisting cardiorespiratory comorbidity on multidisciplinary rehabilitation in post-COVID-19 patients. We enrolled 95 consecutive patients referring to the Pulmonary Rehabilitation Unit of Istituti Clinici Scientifici Maugeri Spa SB, IRCCS of Telese Terme, Benevento, Italy after being discharged from the COVID-19 acute care ward and after recovering from acute COVID-19 pneumonia. Forty-nine of them were not suffering from underlying comorbidities, while 46 had a preexisting cardiorespiratory disease. Rehabilitation induced statistically significant improvements in respiratory function, blood gases and the ability to exercise both in patients without any preexisting comorbidities and in those with an underlying cardiorespiratory disease. Response to the rehabilitation cycle tended to be greater in those without preexisting comorbidities, but DLco%-predicted was the only parameter that showed a significant greater improvement when compared to the response in the group of patients with underlying cardiorespiratory comorbidity. This study suggests that multidisciplinary rehabilitation may be useful in post-COVID-19 patients regardless of the presence of preexisting cardiorespiratory comorbidities.