Cochranebond5744

Objective This study was designed to assess the impact of public health policy in Australia in response to the coronavirus disease identified in 2019 (COVID-19) pandemic on the delivery of neurosurgical services. Being essential services, we postulated that there would not be a decrease in elective and emergency neurosurgical presentations and surgeries. Methods This is a prospective, observational, epidemiologic study in strict adherence to the "STROBE" (Strengthening The Reporting of OBservational studies in Epidemiology) guidelines. It is a cross-sectional, multicentric study involving 5 tertiary neurosurgical centers to capture all public neurosurgical admissions in Queensland during the past 3 months (February-April, 2020) of significant public health policy changes to combat COVID-19. Results An analysis of the 1298 admissions for the Queensland population of 5.07 million Australians demonstrated a decrease in the number of elective and emergency admissions. The decline in elective admissions, particularly degenerative spine, benign neoplasms, and vascular pathologies, was a direct response of government strategy to curb activity to urgent surgical interventions only. Moreover, a trend toward fewer emergency admissions was also noted, partly explained by less trauma and also a decline in vascular pathologies including subarachnoid hemorrhage. Conclusions In comparison with Europe and North America, this study demonstrates the impact of proactive public health measures in Australia that successfully flattened the COVID-19 curve while facilitating ongoing care of acutely unwell neurosurgical patients.Background The coronavirus 2019 (COVD-19) pandemic has drastically disrupted the delivery of neurosurgical care, especially for the already at-risk neuro-oncology population. The sudden change to clinic visits has rapidly spurned the implementation of telemedicine. A recommendation care paradigm of neuro-oncologic patients limited by telemedicine has not been reported. Methods A summary of a multi-institution experience detailing the potential benefits, pitfalls, and the necessary considerations to outpatient care of neurosurgical oncology patients. Results There are limitations and advantages to incorporating telemedicine into the outpatient care of neuro-oncology patients. Telemedicine-specific considerations for each step and stakeholder of the appointment (physician, patient, scheduling, previsit, imaging, and physical examination) are examined. Conclusions Telemedicine, pushed to prominence during this COVID-19 pandemic, is a powerful and possibly preferential tool for the future of outpatient neuro-oncologic care.Objective CaO-SiO2-P2O5-B2O3 bioactive glass ceramic (BGC) is known to chemically bond with bones by forming a hydroxyapatite layer and inducing osteoblastic differentiation. The present study was conducted to compare the clinical outcomes, radiographic outcomes, and safety of a CaO-SiO2-P2O5-B2O3 BGC cage in anterior cervical discectomy and fusion (ACDF) with those of an allograft interbody spacer. Methods A total of 63 patients who underwent one-level ACDF to treat degenerative cervical radiculopathy/myelopathy were reviewed. Results from 26 patients who were recruited prospectively using CaO-SiO2-P2O5-B2O3 BGC as a cage material (BGC group) were compared with a historical control group of 37 patients who underwent surgery using an allograft (allograft group). Fusion rates, subsidence, and adjacent segment degeneration were compared between the groups. Demographic data, fusion rates, visual analog scale (VAS) scores for neck or arm pain, neck disability index (NDI), and complications were also compared. Results Fusion rates were 88.5% when assessed by ISM and 92.3% when assessed by intra-graft bone bridging in the BGC group at 12-month follow-up. The neck pain or arm pain VAS scores and NDI significantly improved in both groups. No material-related complications were observed in the BGC group, such as graft resorption and breakage. Fusion rates, subsidence, neck pain or arm pain VAS scores, and NDI did not significantly differ between the BGC and allograft groups. Conclusions CaO-SiO2-P2O5-B2O3 BGC cage was effective and safe when used in ACDF, conferring a high fusion rate and favorable clinical outcomes similar to those of the allograft.Objective Our aim was to describe risk factors associated with 34DPT in operative and non-operative vaginal deliveries, over a five-year period. Study design This was a retrospective cohort study including 39,227 vaginal deliveries from 2013 to 2017 in a single French University Hospital. Annual characteristics of the analyzed population were recorded. Univariate logistic regression was used to evaluate the association between these characteristics and 34DPT. Multivariate analysis was used to identify combinations of risk factors associated with instrumental delivery. Results The rate of perineal tears was constantly rising but rate of 34DPT was stable, ranging between 0.8 and 1.4% over the study period. Cesarean section rate was stable between 18.8% and 19.6%. Rate of diabetes, preeclampsia and obesity (BMI less then 40) was increasing and episiotomy rate decreasing (from 19.8% to 11.8%). Operative deliveries rate remained stable between 11 and 12.8%. Multivariate regression showed that gestational age over 39 weeks (aOR 1.18, 95% CI [1.02; 1.35]), birth weight over 3500 g (aOR 1.62, 95% CI [1.05; 2.49]) were associated with 34DPT in patients without operative vaginal deliveries but not episiotomy. Gestational age (aOR 1.71, 95% CI [1.18; 2.47]), episiotomy (aOR 0.55, 95% CI [0.38; 0.79]) and diabetes (aOR 1.73, 95% CI [1.15; 2.61]) were associated with 34DPT among patients with operative vaginal deliveries. Conclusion In a tertiary medical center model with low cesarean section rate, factors associated with 34DPT were different among patients with or without operative vaginal delivery. The question of the protective effect of mediolateral episiotomy against 34DPT in case of operative delivery deserves further investigations.Low basal endogenous concentrations (80%) of plasma LTE4 level was observed, providing pharmacological evidence that endogenous 5-LO pathway activity could be assessed.Background India is now regarded unfortunately as the country with one of the highest incidence of oral cancer in the world. Considering poor survival in cases with late diagnosis, early detection can reduce morbidity and mortality of cancer patients and impede malignant transformation in cases of oral potentially malignant disorders (OPMD). Most of the diagnostic aids are expensive and not available for mass screenings in developing countries. There is a felt need to develop a sensitive and affordable technique for screening of oral cancer, which can be accurate even in hands of health care workers with limited experience. Fluorescein dye has been used for tumour detection in colon, stomach, breast and brain. Cilengitide mw However, its utility in the diagnosis of oral cancer and OPMD has not yet been explored. Methods This is the first study to report the role of fluorescein in the detection of oral cancer and OPMD. The present cross sectional study was conducted at a tertiary care dental centre. It included 100 individuals presenting with 42 OPMDs, 40 oral squamous cell carcinoma (OSCC) and 18 controls. Results The sensitivity and specificity for the fluorescein detection method for OPMDs and OSCC was found to be 96.6% and 52.4% respectively. The positive predictive value was 73.7% and the negative predictive value was 91.7% for the fluorescein method. The likelihood ratios stood at 2.03 for a positive test and 0.066 for a negative test. Conclusion We conclude that fluorescein staining along with blue light is likely to improve detection of early oral cancers and dysplasia and can play a vital role in mass screening programmes of oral cancer.Background Obesity appears to govern peri-implant hard and soft tissue health. We hypothesized that adjunctive photodynamic therapy aPDT improves clinical peri-implant perimeters and alleviates peri-implant crevicular fluid (PICF) levels of tumour necrosis factor (TNF)-α, interleukin (IL)-6 and high sensitivity C-reactive protein (hsCRP) in obese with moderate peri-implantitis. The current clinic-laboratory study aimed to determine whether obesity influences the outcomes of aPDT in patients with moderate peri-implantitis. Methods A total of 49 patients (24 obese and 25 non-obese) with moderate periodontitis receiving aPDT were included. Clinical characteristics including peri-implant probing depth (PIPD), peri-implant bleeding on probing (PIBOP), and peri-implant plaque index (PIPI) were measured. PICF levels of TNF-a, IL-6 and hsCRP were assessed using enzyme-linked immunosorbent assay (ELISA). Both clinical and cytokine assessments were performed at baseline, three months and six months, respectively. Intrah moderate peri-implantitis. Obesity did not appear to influence aPDT outcome in patients with moderate peri-implantitis.The sequencing of the Crassostrea virginica genome has brought back the interest for gene delivery and editing methodologies. Here, we report the expression in oyster hemocytes of two heterologous expression vectors under the CMV promoter delivered with dendrimers. Expression was monitored using confocal microscopy, flow cytometry, and immunofluorescence assay. C. virginica hemocytes were able to express the green fluorescence protein and Crassostrea gigas vascular endothelial growth factor under CMV viral promoter both in vivo and in vitro. These results provide the bases for interrogating the genome and adapting genome editing methodologies.This study evaluated the effect of dietary inclusion of lyophilized açaí Euterpe oleracea (LEO) on redox status of shrimp Litopenaeus vannamei (initial weight 1.5 ± 0.39 g) upon exposure to cyanotoxin nodularin (NOD) in bioflocs system. Three hundred juvenile shrimps were randomly divided into two groups and fed twice a day with two diets one containing 0.00 (control diet) and the other 10.0% LEO (w/w) for 30-days. After the feeding period, both shrimp groups were submitted to three treatments (14 L; 7 shrimp/tank) with different concentrations of cyanotoxin NOD (0.00; 0.25; and 1.00 μg/L) dissolved in water with 96 h of exposure. Then, the shrimps were sampled (n = 15/treatment) for the determination of reduced glutathione (GSH), the activity of glutathione-S-transferase (GST), sulfhydryl groups associated to proteins (P-SH), and lipid peroxidation (TBARS) in the hepatopancreas, gills and muscle. The NOD accumulation was measured in the muscle. The results revealed that dietary LEO significantly increased GSH levels in the hepatopancreas and gills of the shrimps exposed to NOD. Toxin exposure did not modify GST activity in all organs. Muscle TBARS levels were lower in the shrimp fed with the LEO diet and exposed to NOD. The NOD toxin did not accumulate in the muscle but notably was detected in the control groups fed or not with dietary LEO. Açaí was able to induce the antioxidant system of L. vannamei, as well as lowered the oxidative damage in shrimps exposed to NOD, suggesting its use as a chemoprotectant against cyanotoxins.