Appropriate stewardship over cannabis use amongst our patient population will likely determine its full implications in terms of both oncologic and perioperative outcomes.
 We acknowledge that additional studies are required to elucidate the long-term effects of cannabis products, and that many potential biases and limitations exist in the literature due to self-reporting and limited survey studies.  https://www.selleckchem.com/products/Temsirolimus.html  Appropriate stewardship over cannabis use amongst our patient population will likely determine its full implications in terms of both oncologic and perioperative outcomes.
  To explore the feasibility and safety of modified subxiphoid thoracoscopic thymectomy for patients with locally invasive thymomas.
 
  Subxiphoid thoracoscopic thymectomy was performed on select patients with locally invasive thymomas (Masaoka stage III) using an auxiliary sternal retractor to create a larger operative field.
 
  From June 2015 to March 2019, we performed modified subxiphoid thoracoscopic thymectomy on 48 patients with locally invasive thymomas 39 patients had pericardium and/or lung infiltration and received a combination of a partial pericardium and/or lung wedge resection, and 9 patients had left innominate vein infiltration and underwent combined resection of the left innominate vein. Thoracoscopic thymectomy was performed from the subxiphoid pathway with an auxiliary sternal retractor in all 48 patients, and there were no conversions to median sternotomy. The median tumor size was 5.0 cm, and the maximal tumor size was 12 cm. The median blood loss was 50 ml. The median duration of chest tube placement was 3.0 days, and the median hospital stay was 4.5 days after surgery. All patients achieved a good recovery after surgery, and none had serious complications during the perioperative period. All patients underwent postoperative adjuvant radiotherapy and presented no local recurrence or distant metastasis until now.
 
  Modified subxiphoid thoracoscopic thymectomy with an auxiliary sternal retractor makes minimally invasive thymectomy easier and safer to perform and is an alternative approach for some patients with locally invasive thymomas.
 Modified subxiphoid thoracoscopic thymectomy with an auxiliary sternal retractor makes minimally invasive thymectomy easier and safer to perform and is an alternative approach for some patients with locally invasive thymomas.
  The aim of this study is to describe the characteristics and outcomes of patients with non-small-cell lung cancer undergoing salvage surgery after chemoradiotherapy, conventional external beam, stereotactic body radiotherapy (SBRT), and ion beam radiotherapy.
 
  We retrospectively evaluated patients who underwent salvage surgery between 2010 and 2016. Data on perioperative morbidity and mortality and patient outcomes were analyzed.
 
  In total, 156 patients were included; of them, 110 and 46 were categorized into Category 1 chemoradiotherapy or conventional external beam and Category 2 SBRT or ion beam radiotherapy, respectively. The 3-year overall survival (OS) and recurrence free survival (RFS) rates in Category 1 was 67.3% and 49.8%, respectively. In Category 1, pathological nodal stage was an independent prognosticator of both OS (hazard ratio [HR] 3.53, 95% CI 1.05-11.83) and RFS (HR 4.32, 95% CI 1.32-14.14). In Category 2, the 3-year OS and RFS rates were 57.7% and 46.4%, respectively. Age ≥70 years at initial treatment was the only independent prognosticator of OS (HR 5.61, 95% CI 1.44-21.87), while age at initial treatment (HR 6.13, 95% CI 1.38-27.12) and pathological nodal metastasis (HR 3.84, 95% CI 1.40-10.57) were independent prognosticators for RFS. The overall 30- and 90-day mortality rates were 0% and 0.9% in Category 1 and 0% and 4.3% in Category 2, respectively.
 
  Patients who undergo salvage surgery can have reasonable outcomes, and salvage surgery can be considered in selected patients.
 Patients who undergo salvage surgery can have reasonable outcomes, and salvage surgery can be considered in selected patients.
  Treatment of stage IIIA lung cancer remains controversial because it includes a very heterogeneous group of patients. The purpose of our study was to compare survival between stage IIIA-subsets, and to externally validate our results with another center's database.
 
  Patients with completely resected stage IIIA/B lung cancer were retrospectively analyzed. There were 424 patients with stage IIIA and 82 patients with stage IIIB (T3/4N2) (study cohort). Stage IIIA was divided into two subsets according to the tumor localization / tumor size (T3N1-T4N0/1, IIIA-T group; n=308) and the extension of nodal disease (T1/2N2, IIIA-N2 group; n=116). According to the study cohort results, a model for stage IIIA patients was created. It was validated with another center's database (validation cohort).
 
  In the multivariate analyses, age, stage IIIB and pN2 were all independent negative prognostic factors (p<0.0001). Five-year survival for patients in the IIIA-T group was 51.3% (median 64 months), whereas it was 25.7% (median 31 months) in the IIIA-N2 patients (HR=1.834, p<0.0001). There was no statistical difference in regard to the survival between the IIIA-N2 and stage IIIB groups (25.7% versus 25.3%, p=0.442). The created model was performed on patients in the validation cohort as a model IIIA-T (T3N1-T4N0/1, n=139), and model IIIA-N2 (T1/2N2, n=104). Model IIIA-T patients had a statistically better survival rate than model IIIA-N2 patients (median 62 months versus 37 months, HR=1.707, p=0.0007).
 
  There is a prognostic difference between stage IIIA subgroups in lung cancer patients who undergo surgical treatment.
 There is a prognostic difference between stage IIIA subgroups in lung cancer patients who undergo surgical treatment.
  Infective endocarditis (IE) is associated with significant morbidity and mortality, and successful management requires expertise in both cardiac surgery and infectious disease (ID). However, the impact of ID consultation on the clinical outcomes of IE is not clear.
 
  The present study was a quasi-experimental, interrupted time series analysis of the clinical outcomes of patients with IE before (April 1998-April 2008) and after (May 2008-March 2019) the establishment of an ID department at a tertiary care hospital in Japan. The primary outcome was clinical failure within 90 days, defined as a composite of all-cause mortality, unplanned cardiac surgery, new-onset embolic events, and relapse of bacteremia caused by the original pathogen.
 
  Of 238 IE patients, 59 patients (25%) were treated in the pre-intervention period, and 179 patients (75%) were treated in the post-intervention period. Establishment of an ID department was associated with a 54% reduction in clinical failure (relative risk, 0.46; 95% confidence interval, 0.