Albrektsenmeincke9814

The estimated LD50 value was higher than 1612 mg/kg for both epimers. The LF, on the other hand, demonstrated an estimated LD50 of 422 mg/kg. Lignan cytotoxicity studies also evidenced that the higher cell viability was related to the higher concentration of fetal bovine serum as a source of albumin in medium. This is the first time the LD50 and safety of the isolated epimers were estimated, opening up great perspectives of success in in vivo studies. Georg Thieme Verlag KG Stuttgart · New York.OBJECTIVE  This study aimed to assess whether patient satisfaction differs between women beginning cervical ripening in the outpatient versus inpatient setting. STUDY DESIGN  We performed a planned secondary analysis evaluating patient satisfaction randomized to outpatient versus inpatient cervical ripening. In the original randomized controlled trial, low-risk parous women ≥39 weeks who required cervical ripening for induction and had reassuring fetal heart rate monitoring were included and randomized to inpatient versus outpatient ripening with a transcervical Foley's catheter. All women were then admitted to the labor ward on the following day. Patient satisfaction was evaluated using three separate surveys. The first two surveys, Six Simple Questions and Lady-X, were previously validated. The third survey used visual analog scales to assess overall pain experienced during Foley's placement, overall pain experienced during labor, how likely they would be to choose the same type of care for their next pregnancy, and how likely they would be to recommend their method of cervical ripening to friends/family. RESULTS  From May 2016 to October 2017, 129 women were randomized (outpatient, 65; inpatient, 64). Based on survey results, there was no difference in satisfaction between outpatient and inpatient cervical ripening with transcervical Foley's catheterization, with high satisfaction in both groups. Patients in both the outpatient and inpatient groups would choose the same type of care for their next pregnancy (on a scale of 1-7, median (25th-75th percentile) 7 [7-7] vs. 7 [6-7], respectively, p = 0.75) and would be very likely to recommend their method of induction to a friend or family member (on a scale of 0-100, 99 [80-100] vs. 99 [65-100], respectively, p = 0.60). CONCLUSION  Parous women's satisfaction does not differ between inpatient and outpatient cervical ripening with transcervical Foley's catheterization. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.in English, German ZIEL DER STUDIE Bestimmung von Determinanten und Einflussfaktoren der Wahrnehmungsentwicklung bzw. der kognitiven Entwicklung anhand des Mann-Zeichen-Tests bei Vorschulkindern. selleck chemicals METHODIK Datengrundlage bildeten Elternfragebögen, die im Rahmen einer Geburtskohortenstudie (Ersterhebung 2000/2001 in Ulm) eingesetzt wurden mit Folgeerhebungen im zweiten, dritten, vierten und sechsten Lebensjahr. Die kognitive Entwicklung wurde anhand von Zeichnungen von n=298 Kindern anlässlich der Schuleingangsuntersuchung (mittleres Alter=5,8 Jahre, SD=0,4) mithilfe des Mann-Zeichen-Tests gemessen. Bi- und multivariable lineare Regressionsanalysen dienten zur Analyse von möglichen Einflussfaktoren. ERGEBNISSE Bei Jungen fand sich eine positive Assoziation zwischen der einer hohen Schulbildung des Vaters und der kindlichen kognitiven Entwicklung (Regressionskoeffizient b, p-Wert 6,65, p=0,018). Tendenziell konnte darüber hinaus ein negativer Zusammenhang des Besuchs eines Kinderhorts (b=− 0,18/Monat, p=0,074) sgen.in English, German ZIEL  Die neue Strahlenschutz-Gesetzgebung sieht vor, dass eine Risikoanalyse neuer und bestehender Behandlungsverfahren mit offenen Radionukliden hinsichtlich der Patientensicherheit wiederkehrend durchzuführen ist, in welche der Medizinphysik-Experte maßgeblich involviert ist. MATERIAL UND METHODEN  Als Werkzeug für die Durchführung der Risikoanalyse wurde die Fehlermöglichkeits- und Einflussanalyse (FMEA) angewendet, wie vom Bundesamt für Strahlenschutz (BfS) und den Fachgesellschaften empfohlen. Für die Radiojodtherapie, die Radiosynoviorthese, die Peptid-Radiorezeptortherapie und die selektive interne Radiotherapie wurden die Prozesse gegliedert und zunächst individuell durch die verschiedenen am Prozess beteiligten Berufsgruppen und anschließend im Konsens kategorisiert. Für Risikoprioritätszahlen > 125 wurden Gegenmaßnahmen erarbeitet. Die Risikoprioritätszahl (RPZ) ergibt sich als Produkt aus dem Schweregrad, der Auftretenswahrscheinlichkeit und der Entdeckungswahrscheinlichkeit desezifische Faktoren (technische und personelle Ausstattung, Ablauf von Prozeduren) zu berücksichtigen sind, sodass ggf. weitere Risiken identifiziert und hier aufgeführte Risiken aufgrund anderer Abläufe als abweichend eingeschätzt werden können.in English, German ZIEL  Das Hauptziel von Systemen zur Risikostratifizierung mittels Ultraschalls (US) ist die Reduktion unnötiger Schilddrüsenbiopsien ohne jedoch den Verlust der Fähigkeit, Knoten mit klinisch bedeutsamer Malignität zu erkennen. Jedes der klassischen verdächtigen sonografischen Kriterien eines Schilddrüsenknotens (hypoechogene Struktur, Mikrokalzifizierungen, irregulärer Randsaum, Tiefer-als-breit Form, unregelmäßige Vaskularisierung) ist signifikant unabhängig mit der Wahrscheinlichkeit einer Malignität assoziiert, aber keines davon hat eine gute diagnostische Genauigkeit. Deshalb haben wir den Vorhersagewert eines binären Scores, der auf der Kombination dieser US-Kriterien basiert, unabhängig vom spezifischen Vorhersagewert jedes einzelnen US-Kriteriums bewertet in Bezug auf die Ergebnisse der vermuteten Malignität in der Zytologie (Kategorien TIR3 bis TIR5 der SIAPEC-IAP (TIR+)). MATERIAL UND METHODEN  1009 Schilddrüsenknoten von 1081 Patienten wurden eingeschlossen. Die US-Kriterien fürläsionen, die in der Zytologie als mittelhohes Malignitätsrisiko eingestuft werden, gezeigt und könnte eine Kostensenkung in der Zytologie für risikoarme Knoten erlauben.BACKGROUND  Gastric variceal bleeding is a life-threating condition with challenging management. We aimed to compare the efficacy and safety of endoscopic ultrasonography (EUS)-guided coil embolization and cyanoacrylate injection versus EUS-guided coil embolization alone in the management of gastric varices. METHODS  A single-center, parallel-randomized controlled trial involving 60 participants with gastric varices (GOV II and IGV I) who were randomly allocated to EUS-guided coil embolization and cyanoacrylate injection (n = 30) or EUS-guided coil embolization alone (n = 30). The primary end points were the technical and clinical success rates of both procedures. The secondary end points were the reappearance of gastric varices during follow-up, along with rebleeding, the need for reintervention, and complication and survival rates. RESULTS  The technical success rate was 100 % in both groups. Immediate disappearance of varices was observed in 86.7 % of patients treated with coils and cyanoacrylate, versus 13.3 % of patients treated with coils alone (P  less then  0.001). Median survival time was 16.4 months with coils and cyanoacrylate versus 14.2 months with coils alone (P = 0.90). Rebleeding occurred in 3.3 % of patients treated with combined treatment and 20 % of those treated with coils alone (P = 0.04). With combined treatment, 83.3 % of patients were free from reintervention versus 60 % with coils alone (hazard ratio 0.27; 95 % confidence interval 0.095 - 0.797; P = 0.01). CONCLUSIONS  EUS-guided coil embolization with cyanoacrylate injection achieved excellent clinical success, with lower rates of rebleeding and reintervention than coil treatment alone. link2 Multicenter studies are required to define the most appropriate technique for gastric variceal obliteration. link3 © Georg Thieme Verlag KG Stuttgart · New York.in English, German Im Nachfolgenden wird der Fall einer 54-jährigen Patientin dargestellt, welche 3 Wochen nach perkutaner Nephrolithotomie persistierende Makrohämaturie mit Harnblasentamponadenbildung bot. Die Angiografie zeigte ein intrarenales Aneurysma, welches mittels Coiling ausgeschaltet werden konnte, was zum vollständigen Sistieren der Blutung führte.BACKGROUND  The purpose of the study was to evaluate the impact of craniotomy (CO) and decompressive craniectomy (DC) for evacuation of acute subdural hematoma (SDH) on pulmonary complications and sepsis. METHODS  Study data were obtained from the National Trauma Data Bank (2007-2010). Only patients who met all of the following criteria were included in this analysis sustained blunt injuries, presented with severe traumatic brain injury, sustained an associated SDH, presented with an initial Glasgow Coma Scale (GCS) score ≤ 8 and an Abbreviated Injury Scale score of head ≥ 3, and underwent a CO or DC within 4 hours of hospital arrival. Patient characteristics and outcomes were compared between CO and DC, the two procedural groups. The data were first compared between the two unmatched groups; then propensity score matching and a matched pairs analysis were performed. RESULTS  From the total population of 2,370 patients, 1,852 (78%) of them underwent CO, and the remaining 518 (22%) underwent DC. Some differences were found between the CO and DC groups regarding age (mean [standard deviation (SD)] 47.9 years [22.8] versus 39.6 years [20.1]; p  0.05). No significant differences were seen between the CO and DC groups in the incidences of these conditions acute respiratory distress syndrome (ARDS) (12.0% versus 8.1%; p = 0.20), pneumonia (34.9% versus 37.6%; p = 0.60), pulmonary embolism (PE) (3.5% versus 1.6%; p = 0.30), and systemic sepsis (6.2% versus 8.1%; p = 0.5). CONCLUSION  Although most of the patients underwent CO for acute SDH, no significant differences were observed in the incidence of ARDS, pneumonia, PE, or systemic sepsis when compared with patients who underwent DC. Georg Thieme Verlag KG Stuttgart · New York.AIM This study analyzed microvesicles and exosomes, called as extracellular vesicles (EVs) excreted in serum and cerebrospinal fluid (CSF) from patients with cerebral or gestational toxoplasmosis. METHODS Clinical samples from 83 individuals were divided into four groups. Group I, 20 sera from healthy individuals and pregnant women (seronegative for toxoplasmosis); group II, 21 sera from seropositive patients for toxoplasmosis (cerebral or gestational forms); group III, 26 CSF samples from patients with cerebral toxoplasmosis/HIV co-infection (CT/HIV) (seropositive for toxoplasmosis); and group IV, 16 CSF samples from seronegative patients for toxoplasmosis, but with HIV infection and other opportunistic infections (OI/HIV). Serum and CSF samples were ultracentrifuged to recover EVs. Next, vesicle size and concentration were characterized by Nanoparticle Tracking Analysis (NTA). RESULTS Concentrations of serum-derived EVs from toxoplasmosis patients (mean 2.4 x 1010 EVs/mL) were statically higher than of non-on of EVs and exosomal miRNAs in unbalance of immune response as elevation of TNF-α, IL-6; and downregulation of IFN-γ in cerebral and gestational forms of toxoplasmosis.