g protected against PPM occurrence. Severe PPM was independently associated with all-cause mortality.
  The aim of this study was to investigate whether the degree of aortic angulation (AA) affects outcomes after transcatheter aortic valve replacement (TAVR) using newer-generation transcatheter heart valves (THVs).
 
  AA≥48° has been reported to adversely influence accurate THV deployment, procedural success, fluoroscopy time, and paravalvular leak (PVL) in patients undergoing TAVR with early generation self-expanding (SE) THVs.
 
  A retrospective observational study was conducted among 841 patients across all risk strata who underwent transfemoral TAVR using the balloon-expandable (BE) SAPIEN 3 or the SE CoreValve Evolut PRO from 2015 to 2020. The previously published cutoff of 48° was used to analyze procedural success and in-hospital outcomes according to THV type. Receiver-operating characteristic analysis was performed to investigate the impact of AA on an in-hospital composite outcome (need for >1 THV, more than mild PVL, new permanent pacemaker implantation, stroke, and death).
 
  AA≥48° did not influetion.
  No standardized algorithm exists to identify patients at risk of bleeding after transcatheter aortic valve replacement (TAVR). The aim of this study was to generate and validate a useful predictive model.
 
  Bleeding events after TAVR influence prognosis and quality of life and may be preventable.
 
  Using machine learning and multivariate regression, more than 100 clinical variables from 5,185 consecutive patients undergoing TAVR in the prospective multicenter RISPEVA (Registro Italiano GISE sull'Impianto di Valvola Aortica Percutanea; NCT02713932) registry were analyzed in relation to Valve Academic Research Consortium-2 bleeding episodes at 1month. The model's performance was externally validated in 5,043 TAVR patients from the prospective multicenter POL-TAVI (Polish Registry of Transcatheter Aortic Valve Implantation) database.
 
  Derivation analyses generated a 6-item score (PREDICT-TAVR) comprising blood hemoglobin and serum iron concentrations, oral anticoagulation and dual antiplatelet therapy, commonAVR that can assist in decision making and event prevention.Transcatheter aortic valve replacement (TAVR) is approved for all patient risk profiles and is an option for all patients irrespective of age. However, patients enrolled in the low- and intermediate-risk trials were in their 70s, and those in the high-risk trials were in their 80s. TAVR has never been systematically tested in young ( less then 65 years), low-risk patients. Unanswered questions remain, including the safety and effectiveness of TAVR in patients with bicuspid aortic valves; future coronary access; durability of transcatheter heart valves; technical considerations for surgical transcatheter heart valve explantation; management of concomitant conditions such as aortopathy, mitral valve disease, and coronary artery disease; and the safety and feasibility of future TAVR-in-TAVR. The authors predict that balancing these questions with patients' clear preference for less invasive treatment will become common. In this paper, the authors consider each of these questions and discuss risks and benefits of theoretical treatment strategies in the lifetime management of young patients with severe aortic stenosis.
  and objective The aim of this work was to evaluate clinical outcomes of patients with biceps brachii tendon rupture who underwent a surgical tendon reconstruction using our own modified double approach technique.
 
  The study was performed in 20 patients (21 cases) with biceps brachii tendon rupture. Patients were treated with our own double-approach surgical technique consisting of 2 minimum incisions. After one year follow-up, functional evaluation was assessed using the mayo Elbow Performance Score, muscle strength was estimated with the Medical Research Council questionnaire and pain was evaluated with the Visual Analogic Scale. Range of motion was determined by measuring extension and flexion.
 
  One year after surgery all patients had returned to sports at the same level they had previously. Visual Analogic Scale was 1.90±0.89 (mean±standard deviation) and median Mayo Elbow Performance Score was 90 (minimum-maximum 80-100). Of them, 16 patients (76.2%) showed the highest Medical Research Council score, score 5, while 6 cases (26.1%) still scored 4+.  https://www.selleckchem.com/products/fl118.html  Patients had a mean of 136.67° flexion (95% CI 134.14°-139.19°) and -7.38° extension (95% CI -10.04° to -4.72°).
 
  Double-incision surgical approach for distal biceps brachial tendon rupture anatomical repair is a safe technique, providing results that allow patients muscle recovery and return to sports.
 Double-incision surgical approach for distal biceps brachial tendon rupture anatomical repair is a safe technique, providing results that allow patients muscle recovery and return to sports.
  Hip fracture (HF) in the elderly has a high prevalence and risk of morbidity and mortality in the short and long term. It can reduce life expectancy by almost 2 years, and require permanent socio-sanitary assistance in one in 5 patients. Its management as a process where the patient takes priority over the activities of the organisation can bring new perspectives, optimisation tools and redesign of the workflow to make it more efficient.
 
  to develop an in-hospital clinical guide for the management of patients with HR adapted to the environment, clear and concise, to be able to intervene in the best possible conditions and favour their adequate recovery.
 
  407 patients divided into 3 groups pre-implementation (knowing the scope of the problem and areas for improvement); implementation (after the development of the management guide) and post-implementation (valued its implementation).
 
  The clinical results obtained with this guide allowed improving surgical programming and reducing delay times (increasing the proportion of patients operated in the first 48h and reducing the average hospital stay in 3 days), raising awareness of the problem at all Services involved, improve the management of drugs that altered hemostasia, optimise transfusion therapy and reduce hospital stay and perioperative complications.
 
  The implementation of this guide, with integrated global criteria, has improved the results of this process, and achieved a more efficient management, reducing the consumption of resources and as a consequence, health expenditure.
 The implementation of this guide, with integrated global criteria, has improved the results of this process, and achieved a more efficient management, reducing the consumption of resources and as a consequence, health expenditure.