Structured secondary preventions programs, called Fracture Liaison Services (FLSs), increase the rate of evaluation with bone densitometry and use of osteoporosis medication after fracture. However, the evidence regarding the effect on the risk of recurrent fracture is insufficient. The aim of this study was to investigate if implementation of FLS was associated with reduced risk of recurrent fractures. In this retrospective cohort study, electronic health records during 2012-2017 were used to identify a total of 21,083 patients from four hospitals in Western Sweden, two with FLS (n=15,449) and two without (n=5634). All patients 50 years or older (mean age 73.9 (SD 12.4) years, 76% women) with a major osteoporotic index fracture (hip, clinical spine, humerus, radius and pelvis) were included. The primary outcome was recurrent major osteoporotic fracture. All patients with an index fracture during the FLS period (n=13,946) were compared to all patients in the period prior to FLS implementation (n=7137) in an intention to treat analysis. Time periods corresponding to the FLS hospitals were used for the non-FLS hospitals. In the hospitals with FLSs, there were 1247 recurrent fractures during a median follow-up time of 2.2 years (range 0-6 years). In an unadjusted Cox model, the risk of recurrent fracture was 18% lower in the FLS period compared to the control period (Hazard Ratio 0.82 (95% CI 0.73-0.92), p=0.001), corresponding to a 3-year number needed to screen of 61, and did not change after adjustment for clinical risk factors. In the hospitals without FLSs, no change in recurrent fracture rate was observed. Treatment decisions were made according to the Swedish treatment guidelines. In conclusion, implementation of FLS was associated with a reduced risk of recurrent fracture, indicating that FLSs should be included routinely at hospitals treating fracture patients. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.BACKGROUND The second-generation cryoballoon (CB2) is widely used for pulmonary vein (PV) isolation (PVI) in patients with paroxysmal atrial fibrillation (AF). Recently, the novel fourth-generation CB (CB-Advance PRO) was introduced, incorporating a shortened catheter tip. HYPOTHESIS The aim of this study was to evaluate the feasibility and acute efficacy of PVI using the CB-Advance PRO. METHODS A total of 200 consecutive patients were analyzed. Hundred patients who underwent PVI due to symptomatic, drug-refractory AF were treated with the CB-Advance PRO (group I) and were included into this multicenter analysis. A group of 100 patients were treated with the CB2 and acted as controls (group II). RESULTS In total, 739 of 739 PVs (100%) were successfully isolated. There was a nonsignificant trend in the incidence of online registration of PV signals between both groups (group I 77.9% vs group II 71.4%, P = .09). Median time to PVI (time to isolation [TTI]) and mean total freezing time were significantly shorter when using the CB-Advance PRO (group I 33 [23, 50] vs group II 40 [26, 60] seconds and group I 166 ± 29 vs group II 183 ± 38 seconds, P less then  .01). In three of 100 (3%) patients of group I and one of 100 (1%) patients of group II, a transient phrenic nerve palsy occurred (P = .62). CONCLUSION The use of the novel CB-Advance PRO is feasible and associated with a significant reduction in mean TTI and mean total freezing time as compared to the CB2. © 2020 The Authors. Clinical Cardiology published by Wiley Periodicals, Inc.Pretransplant left ventricular hypertrophy (LVH) is a common finding during preoperative cardiac evaluation. We hypothesized that patients with pretransplant LVH were associated with a higher risk of postoperative myocardial injury (PMI) in adult patients undergoing liver transplantation (LT). A retrospective cohort analysis was performed by reviewing the medical records of adult patients who underwent LT between January 2006 and October 2013. Of 893 patients, the incidences of mild, moderate, and severe LVH were 7.8%, 5.6%, and 2.5%, respectively. Propensity match was used to eliminate the pretransplant imbalance between the LVH and non-LVH groups. In after-match patients, 23.5% of LVH patients developed PMI compared to 11.8% in the control group (P = .011). The incidence of PMI in patients with moderate-severe degrees of LVH was significantly higher compared with that in patients with mild LVH (27.9% vs 19.1%, P = .016). When controlling intraoperative variables, patients with LVH had 4.5 higher odds of developing PMI (95% CI1.18-17.19, P = .028). Patients experiencing PMI had significantly higher 1-year mortality (37.5% vs 15.7%, log-rank test P  less then  .001). Our results suggest that patients with pretransplant LVH were at a high risk of developing PMI and should be monitored closely in the perioperative period. More studies are warranted. © 2020 John Wiley & Sons A/S.  https://www.selleckchem.com/peptide/octreotide-acetate.html  Published by John Wiley & Sons Ltd.As median survival for left ventricular assist device (LVAD) patients increases, the incidence of adverse events requiring device exchange is likely to increase as well. Less invasive surgical approaches for device exchange of older generation pumps have demonstrated multiple potential benefits compared with median sternotomy. However, there remains a paucity of data in regard to less invasive surgical techniques for the exchange of the newest generation intrapericardial devices. In this report we describe a complete sternal-sparing technique for the LVAD exchange of a HeartMate 3 via bilateral minithoracotomies. © 2020 Wiley Periodicals, Inc.BACKGROUND Advanced glycation end products (AGEs) are reactive metabolites produced as a by-product of sugar metabolism and are consumed through the diet in high-fat and highly processed foods. They are associated with chronic inflammatory diseases, and evidence suggests that they play a role in carcinogenesis. The authors evaluated the association of dietary AGE intake and the risk of postmenopausal invasive breast cancer. METHODS This was a prospective cohort study of 183,548 postmenopausal women in the National Institutes of Health-AARP Diet and Health Study. The main outcome was incident invasive breast cancer. AGE intake was estimated from food-frequency questionnaires. Incident breast cancer cases were identified through state cancer registries. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals for developing breast cancer according to AGE intake quintiles. Multivariable regression models were adjusted for breast cancer risk factors. RESULTS The mean follow-up was 12.