Coxhigh6588
4% said that not every therapy with their use would improve health and 42.9% declared lack of knowledge in this area. According to the survey outcomes, 16.7% of respondents unambiguously confirmed beneficial effect of phytoestrogens on menopause symptoms. Half of the respondents had no opinion whether phytoestrogens could be an effective replacement for synthetic drugs based therapies.
Incomplete knowledge of society regarding the use of phytoestrogens indicates the need for raising awareness of patients/consumers in this area by medical staff and dietitians. Phytoestrogens, when taken responsibly, can have many benefits for human health.
Incomplete knowledge of society regarding the use of phytoestrogens indicates the need for raising awareness of patients/consumers in this area by medical staff and dietitians. Phytoestrogens, when taken responsibly, can have many benefits for human health.
Healthcare-associated infections (HCAIs) are a global health problem, and the problem of HCAIs in Ukraine remains poorly understood because of problems with the registration system.
To analyze the official data of the number of registered HCAIs in Ukraine for the period 2009-2019, compare them with the available data in scientific publications.
Statistical analysis of information from the "Laboratory Centers of the Ministry of Health of Ukraine" kindly provided by the State Institution "Public Health Center of the Ministry of Health of Ukraine".
In 2019, 2,611 cases of HCAIs were registered, the lowest annual number of registered HCAIs in the last twelve years. The maximum number of HCAIs in 2011 was 7,448. An average of 5,089±756 cases of HCAIs has been registered annually. By age structure, the average for 2009-2019 was 78.0±5.8 % for adults and 22.0 % for children (0-17 y.o.). In 2019 13.8% of registered potential HCAIs agents were identified as MDR, and 80.0-87.0% belongs to the group of 12-17, the most common pathogens.
The estimated minimum number of HCAIs in Ukraine was expected to be about 1 million per year. Official statistics on registered cases of HCAIs in Ukraine do not reflect reality, so the registration system and investigation of HCAIs in Ukraine needs to be reformed.
The estimated minimum number of HCAIs in Ukraine was expected to be about 1 million per year. Official statistics on registered cases of HCAIs in Ukraine do not reflect reality, so the registration system and investigation of HCAIs in Ukraine needs to be reformed.
Tick-borne encephalitis (TBE) is endemic in many parts of Eurasia including countries previously considered to be free from the disease. The incidence of TBE is changing owing to various ecological and climatic factors. The factors influencing the variability of the number of TBE cases are still under investigation. In 2020 the new coronavirus SARS-CoV-2 emerged causing COVID-19 pandemic. Governments have reorganized health care systems to contain a surge of COVID-19 cases and avoid hospital overload. Moreover, new measures have modified several aspects of social habits leading to a change in the incidence of numerous diseases. We aimed to evaluate the epidemiology of TBE in the last decade (2010-2019) and to demonstrate the impact of the surge of SARS-CoV-2 infections on the TBE incidence as reported to a national surveillance database.
We performed the analysis of the TBE notification from the epidemiologic reports in the years 2010-2019 and in the pandemic year 2020 at a national and regional level in e of TBE incidence with surge of COVID-19 patients conceivably resulted from underreporting due to limited access to specialized diagnostics. In endemic areas, TBE should be included in the differential diagnostics in all the cases when the central nervous system infection in suspected.
Infectious diseases of the nervous system are most often manifested in the form of meningitis. We distinguish meningitis and/or encephalitis according to their etiology, i.e. bacterial and viral. The study discusses meningitis and encephalitis caused by N. meningitidis, S. pneumoniae, H. influenzae and tick-borne encephalitis virus. This is due to the epidemiological surveillance of these diseases and the available prevention in the form of vaccinations against these diseases.
The aim of the study is to assess the epidemiological situation of meningitis and encephalitis in Poland in 2018.
The epidemiological situation of meningitis and encephalitis in Poland was assessed on data from the annual bulletin "Infectious diseases and poisoning in Poland in 2018" and "Vaccinations in Poland in 2018".
In 2018, a total of 2406 cases of meningitis and/or encephalitis were registered in Poland. It is a 14.7% increase in incidence compared to 2017. An increase was recorded in the viral infections from 1212 to 153he problem of diagnosing cases of viral etiology should be considered. This is more related to the determination of the etiological factor than the diagnosis of viral meningitis and/or encephalitis. Difficulties in determining the etiological factor indicate that, meningitis and/or encephalitis remain a challenge for healthcare and epidemiological surveillance institutions.Lymphedema of the upper extremities in a common, chronic, progressive and debilitating disease, that affects the increasing population of cancer survivors. The gold standard is nowadays an integrated approach, including conservative and surgical treatment. Lymphatic surgery, particularly the physiologic procedures including lymphaticovenous anastomosis and vascularised lymph node transfer, should be offered to lymphedema patients as soon as possible, aimed to ameliorate the subjective symptoms and also to interrupt the degeneration cascade that makes this condition progressive over time. Indications for surgery, patient selection, and diagnostic tools will be discussed.
Surgical management of breast cancer patients carrying pathogenic variants (PV) on breast cancer genes (BRCA) 1 and 2 has changed throughout the last decade due to growing availability of genetic testing, and has shifted towards the diffusion of bilateral mastectomy. Today's scenario however is in further evolution because of emerging data that suggest a personalized modulation of treatment. In this work we aimed to gather recent evidence supporting a prophylactic or conservative surgical approach in order to define the state of the art in today's treatment of BRCA carriers with breast cancer.
We reviewed the literature to identify studies providing evidence on surgical treatment in breast cancer patients with BRCA 1 and 2 PVs. We included articles comparing outcomes between patients undergoing breast conserving surgery (BCS) and mastectomy, and articles investigating contralateral risk-reducing mastectomy (CRRM), with a particular focus on recent literature. International guidelines were also reviewed.
vary in different countries and provide no definite protocol, they highlight the importance of accurate surgical planning. Clinical, familial and psychosocial factors should be taken into account when approaching a BRCA PV carrier with breast cancer, in order to guarantee the best evidence-based patient care in an era of personalized treatment.
Treatment of de novo metastatic breast cancer is usually centered around systemic therapy, with local therapy (surgery and radiation therapy) largely reserved for palliation in patients with significant symptoms from primary tumour. The efficacy of locoregional treatment like surgery and/or radiotherapy is still controversial and the debate about surgical resection of primary tumor (PT) in de novo metastatic breast cancer (MBC) patients persists.
All patients with de novo MBC undergone surgical treatment between January 2015 and January 2020 at the Multidisciplinary Breast Center of the Fondazione Policlinico Universitario A. Gemelli IRCCS in Rome were included in this study. The primary endpoint was overall survival (OS) after PT resection, the secondary endpoint was progression free survival (PFS). The survival analyses were done using Kaplan-Meier method. Patients and tumour characteristics were analyzed in an exploratory modality in order to identify prognostic factor.
45 patients received resectionmetastatic setting seems to be an option after systemic therapies in luminal and HER2 positive breast cancer. Randomized prospective trials in for each immunophenotype are necessary order to confirm this evidence.
Sentinel node biopsy (SNB) is the standard of care in women with breast cancer (BC) and clinically non suspicious axillary lymph nodes (LNs), due to its high negative predictive value (NPV) in the assessment of nodal status. SNB has significantly reduced complications related to the axillary lymph node dissection, such as lymphedema and upper limb dysfunction.
The gold standard technique for SNB is the blue dye (BD) and technetium labelled nanocolloid (Tc-99m) double technique. However, nuclear medicine is not available in all Institutions and several new tracers and devices have been proposed, such as indocyanine green (ICG) and superparamagnetic iron oxides (SPIO). All these techniques show an accuracy and detection rate not inferior to that of the standard technique, with different specific pros and cons. The choice of how to perform a SNB primarily depends on the surgeon's confidence with the procedure, the availability of nuclear medicine and the economic resources of the Institutions. In this setting, new tracers, hybrid tracers and imaging techniques are being evaluated in order to improve the detection rate of sentinel lymph nodes (SNs) and minimize the number of unnecessary axillary surgeries through an accurate preoperative assessment of nodal status and to guide new minimally invasive diagnostic procedures of SNs. In particular, the contrast-enhanced ultrasound (CEUS) is an active field of research but cannot be recommended for clinical use at this time.
The ICG fluorescence technique was superior in terms of DR, as well as having the lowest FNR. The DR descending order was SPIO, Tc, dual modality (Tc/BD), CEUS and BD.
This paper is a narrative review of the most common SNB techniques in BC with a focus on recent innovations.
This paper is a narrative review of the most common SNB techniques in BC with a focus on recent innovations.
The aim was to evaluate the relevance of pneumoperitoneum on the success rate of non-operative management (NOM) of patients with complicated acute diverticulitis (AD), and the risk factors associated with failure.
Observational retrospective cohort study of patients attended at the emergency department for AD from January 2015-August 2019. Patient demographics, blood tests, radiological data and initial treatment strategies were registered. NOM, based on intravenous antibiotics (ATB) and bowel rest, was defined as unsuccessful when emergency surgery (ES) and/or infection-related death took place. Patients initially treated with ES were excluded. learn more Analysis was done with the IBM SPSS statistics 23.0.0.2 software.
According to modified Hinchey and WSES criteria, 99 (12%) of 826 AD episodes were complicated, with pneumoperitoneum on the CT scan in 89 (90.5%). NOM was undertaken in 93 (94%) cases, with a 91.5% success rate. Multivariate analysis revealed ASA class III-IV, and the presence of fluid collections >3cm in diameter, but not distant free air, to be associated with NOM failure.
