It has not been conclusively established whether, or to what extent, the time to surgery affects mortality and the risk of complications after the surgical treatment of proximal femoral fractures.
 
  Data on 106 187 hospitalizations over the period 2015-2017 involving insurees of the German AOK health insurance company aged 20 and above were drawn from pseudonymized billing data and stratified in three subgroups osteosynthesis for pertrochanteric fracture (PTFOS N = 52 358), osteosynthesis for femoral neck fracture (FNF-OS N = 7970), and endoprosthesis for femoral neck fracture (FNF-EP N = 45 859). Multivariate regression models were used to analyze the relation between preoperative in-hospital stay (time to surgery, TTS 0 days [reference category], 1, 2, 3, 4-7 days) and mortality and general complications within 90 days, with risk adjustment for fracture site, operative method, age, sex, accompanying illnesses, and antithrombotic medication in the preceding year.
 
  Mortality was significantly elevated only with PTF-OS, and only with a TTS of 2 days (odds ratio 1.12 [95% confidence interval (1.02; 1.23)]). General complications in relation to TTS were significantly elevated in the following situations PTF-OS 2 days OR 1.24 [1.13; 1.37], 3 days OR 1.33 [1.11; 1.60], 4-7 days OR 1.47 [1.21; 1.78]; FNF-EP 3 days OR 1.21 [1.06; 1.37], 4-7 days OR 1.42 [1.25; 1.62]; FNF-OS 4-7 days OR 1.86 [1.26; 2.73].
 
  A prolonged time to surgery is associated with an elevated general complication risk depending on the site of the fracture and the type of surgical procedure used.
 A prolonged time to surgery is associated with an elevated general complication risk depending on the site of the fracture and the type of surgical procedure used.
  The treatment of arterial hypertension can be monitored by office blood pressure (office BP), home blood pressure (home BP), or 24 hours ambulatory blood pressure (ABPM). In this review, we present current recommendations from Germany and from international guidelines as well as the findings of the main studies on the use of these methods to guide treatment.
 
  This review is based on pertinent publications retrieved by a selective search in PubMed up to and including March 2020. Special attention was paid to guidelines and position papers.
 
  The guidelines offer heterogeneous recommendations for treatment monitoring. Home BP is the most reproducible method, with test-retest correlation coefficients of 0.91/0.86 (systolic/diastolic), in comparison to office BP (0.77/0.76). Two meta-analyses revealed better blood pressure control with home measurement than with usual care (systolic, -3.2 to -8.9 mmHg). A meta-analysis of randomized controlled trials also suggests that home measurement promotes adherence. In tf treatment should be based on average values (28 home measurements) from seven days (two morning and two evening measurements per day). Office BP is mainly used for for screening purposes.  https://www.selleckchem.com/products/bevacizumab.html  There have not yet been any randomized trials comparing the three measuring methods in terms of hard cardiovascular endpoints.
  Advances in neonatology now enable increasing numbers of very low birth weight neonates (<1500 g) to survive into early adulthood and beyond. What are the implications for their long-term care?
 
  Selective literature search on the outcome of very low birth weight neonates in adulthood ("adults born preterm").
 
  Robust data are available on the pulmonary, metabolic, cardiovascular, renal, neurocognitive, sensory-visual, social-emotional, mental, reproductive, and musculoskeletal long-term risks. On the somatic level, elevated rates have been documented for asthma (odds Ratio [OR] 2.37), diabetes mellitus (OR 1.54), and chronic renal disease (hazard ratio [HR] 3.01), along with the cardiovascular and cerebrovascular sequelae of a tendency toward arterial hypertension. On the psychosocial level, the main findings are deficits in romantic partnerships (OR 0.72) and a lower reproduction rate (relative risk [RR] male/female 0.24/0.33). The affected women also have an elevated risk of preterm delivery.
 
  A riskin adulthood as well.Children's hospitals responded to COVID-19 by limiting nonurgent healthcare encounters, conserving personal protective equipment, and restructuring care processes to mitigate viral spread. We assessed year-over-year trends in healthcare encounters and hospital charges across US children's hospitals before and during the COVID-19 pandemic. We performed a retrospective analysis, comparing healthcare encounters and inflation-adjusted charges from 26 tertiary children's hospitals reporting to the PROSPECT database from February 1 to June 30 in 2019 (before the COVID-19 pandemic) and 2020 (during the COVID-19 pandemic). All children's hospitals experienced similar trends in healthcare encounters and charges during the study period. Inpatient bed-days, emergency department visits, and surgeries were lower by a median 36%, 65%, and 77%, respectively, per hospital by the week of April 15 (the nadir) in 2020 compared with 2019. Across the study period in 2020, children's hospitals experienced a median decrease of $276 million in charges.
  American Society of Hematology 2020 Guidelines for Sickle Cell Disease Management of Acute and Chronic Pain RELEASE DATE June 19, 2020 PRIOR VERSION Not applicable DEVELOPER American Society of Hematology Guideline Panel on Sickle Cell Disease-Related Pain FUNDING SOURCE American Society of Hematology TARGET POPULATION Adult and pediatric patients with a history of sickle cell disease with acute and chronic pain.
 American Society of Hematology 2020 Guidelines for Sickle Cell Disease Management of Acute and Chronic Pain RELEASE DATE June 19, 2020 PRIOR VERSION Not applicable DEVELOPER American Society of Hematology Guideline Panel on Sickle Cell Disease-Related Pain FUNDING SOURCE American Society of Hematology TARGET POPULATION Adult and pediatric patients with a history of sickle cell disease with acute and chronic pain.A patient's supine posture redistributes plasma into the vascular space, leading to dilution of blood constituents. The extent to which posture may influence identification of hospital-acquired anemia is unknown. Patients in this quasi-experimental study had blood obtained for hemoglobin measurement while recumbent for at least 6 hours, and then again after sitting upright for at least 1 hour. Of the 35 patients who completed the study, 13 were women (37%). Patients had a median increase in hemoglobin of 0.60 g/dL (range, -0.6 to 1.4 g/dL) with sitting, a 5.2% (range, (-4.5% to 15.1%) relative change (P less then .001). Ten of 35 patients (29%) exhibited an increase in hemoglobin of 1.0 g/dL or more. Posture influences hemoglobin levels in hospitalized patients on general medicine wards; this knowledge may help curb unnecessary testing to evaluate small changes in hemoglobin concentration.