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Our case suggests that endoscopic cyanoacrylate injection therapy might be a useful and safe treatment option for rectal varices.We present the case of a 57-year-old woman who experienced 3 weeks of intermittent tarry stools and epigastric pain. She had a 25-year history of smoking and a 12-year history of heavy alcohol consumption but had discontinued both 12 years prior. Laboratory investigations revealed elevated anti-H. Pylori IgG antibody levels. Conventional upper gastrointestinal endoscopy revealed two lesions. Magnifying endoscopy with narrow-band imaging showed the characteristic appearance of a diffuse-type gastric cancer 0-IIc lesion with a demarcation line and abnormal vessels ("wavy micro-vessels" and a "cork-screw pattern"). There was also "ballooning" of the crypts and a "tree-like vessel appearance" in an "unstructured area" characteristic of gastric mucosa-associated lymphoid tissue lymphoma with ulceration. Accurate target biopsies were obtained. We performed a laparoscopic total gastrectomy with D1 lymphadenectomy. Pathological examination revealed poorly differentiated stage I adenocarcinoma of the stomach with features of signet ring cell carcinoma as well as stage I mucosa-associated lymphoid tissue lymphoma. In conclusion, we encountered a case of co-existing diffuse-type gastric cancer and gastric mucosa-associated lymphoid tissue lymphoma. Magnifying endoscopy with narrow-band imaging was effective for diagnosing these two co-existing tumors and resulted in the collection of adequate biopsy specimens allowing for an accurate pathological diagnosis and optimal treatment.
The most common cause of death among preterm infants in low- and middle-income countries is respiratory distress syndrome. The purpose of this review was to assess whether antenatal corticosteroids given to women at risk of preterm birth at ≤ 34weeks of gestation reduce rates of neonatal mortality and respiratory distress syndrome in low- and middle-income countries.
Two reviewers independently searched four databases including MEDLINE (through PubMed), CINAHL, Embase, and Cochrane Libraries. We did not apply any language or date restrictions. All publications up to April 2020 were included in this search.
The search yielded 71 articles, 10 of which were included in this review (3 randomized controlled trials, 7 observational studies, 36,773 neonates). The majority of studies reported associations between exposure to antenatal corticosteroids and lower rates of neonatal mortality and respiratory distress syndrome. However, a few studies reported that antenatal corticosteroids were not associated with imlity or respiratory distress syndrome. Further research on the impact of antenatal corticosteroids in resource-limited settings in low-income countries is a priority.In this paper, we understand the emergence of life as a pure individuation process. Individuation already occurs in open thermodynamics systems near equilibrium. We understand such open systems, as already recursively characterized (R1) by the relation between their internal properties, and their boundary conditions. Second, global properties emerge in such physical systems. We interpret this change as the fact that their structure is the recursive result of their operations (R2). We propose a simulation of the emergence of life in Earth by a mapping (R) through which (R1R2) operators are applied to themselves, so that RN = (R1R2)N. We suggest that under specific thermodynamic (open systems out of equilibrium) and chemical conditions (autocatalysis, kinetic dynamic stability), this mapping can go up to a limit characterized by a fixed-point equation [Formula see text]. In this equation, ([Formula see text]) symbolizes a regime of permanent resonance characterizing the biosphere, as open from inside, by the recursive differential relation between the biosphere and all its holobionts. As such the biosphere is closed on itself as a pure differential entity. ([Formula see text]) symbolizes the regime of permanent change characterizing the emergence of evolution in the biosphere. As such the biosphere is closed on itself, by the principle of descent with modifications, and by the fact that every holobiont evolves in a niche, while evolving with it.
Type 2 diabetes mellitus (T2DM) is the subject of numerous randomized controlled trials (RCTs). The validity of RCTs may be threatened by attrition bias due to the discontinuation of the study. The aim of this systematic review is to evaluate the reasons of patient's withdrawal from these RCTs.
A systematic literature search on PubMed, Cochrane Library, Web of Science, and Scopus databases was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram. The aim was to obtain all relevant blinded RCTs published before January 2017 in which the effectiveness of synthetic drugs, vitamins/minerals were compared to that of placebo or active control in T2DM. The quality of RCTs was assessed using the Jadad score. The frequency of withdrawal reasons was presented based on treatments with placebo/active control, national/international level of the studies, and publication year. Meta-analysis was not performed due to the heterogeneity.
Overall, 1368 aerse effects. Overall, the total number and reason of drop out were unsatisfactory.
High proportion of reported discontinuation in blinded RCTs on patients with T2DM was related to drug adverse effects. Overall, the total number and reason of drop out were unsatisfactory.
This study aimed to assess the prevalence and clinical status of molar incisor hypomineralisation (MIH) and other enamel defects and associated factors in Libyan children.
A cross-sectional survey of a randomly selected sample of 8- to 10-year-old Libyan school children was conducted in the city of Benghazi, Libya in 2019. The children were assessed for the presence of MIH and enamel defects according to EAPD evaluation criteria. The survey was supplemented by a questionnaire, completed by parents, about potential associated factors occurring before, around and after birth. Association with risk indicators was assessed using chi-square and Mann-Whitney U tests.
One thousand forty-seven children returned complete questionnaires and attended the clinical examination, with 87% response rate. MIH was the most common form of enamel defects, affecting 162 (15.5%) children. selleck chemicals llc The average number of MIH affected teeth was 3.54 (SD = 1.82). There were no statistically significant associations between the prevalence of MIH and health or demographic characteristics except for the history of early childhood health problems (P = 0.047).
In Libyan children, MIH appeared to be the most prevalent type of enamel defects affecting 15.5% of the participants. Although not statistically significant, MIH appeared to be associated with prenatal, perinatal and post-natal challenges.
In Libyan children, MIH appeared to be the most prevalent type of enamel defects affecting 15.5% of the participants. Although not statistically significant, MIH appeared to be associated with prenatal, perinatal and post-natal challenges.
The UK government introduced a nationwide lockdown on the 23rd March 2020 to prevent the spread of COVID-19. All elective hospital and dental practice assessments and procedures were mandated to stop. Key hospital dental workers were required to work, and Guy's and St Thomas' NHS Foundation Trust became a designated Urgent Dental Care Centre (UDC) for the greater London area. The paediatric dental emergency walk-in service was suspended and replaced with a telephone triage system and evaluation of digital images sent by parents/carers when needed. The aim of this paper is to describe the emergency service provided by staff in the department of Paediatric Dentistry at St Thomas' Hospital during the first lockdown.
A prospective service evaluation of the modified paediatric dental emergency service was carried out between 25th March and 29th May 2020.
Four-hundred and sixty-four patients accessedthe paediatric dental emergency service via telephone during the service evaluation period. Of these, 192 (41%) had dental pain, 121 (26%) had pain and swelling of dental origin, and 89 (19%) had trauma.
Remote telephone consultations and digital photographs were useful to screen emergency paediatric dental patients, but lack of face-to-face consultations with radiographic assessment and access to general anaesthetic services were major limiting factors.
Remote telephone consultations and digital photographs were useful to screen emergency paediatric dental patients, but lack of face-to-face consultations with radiographic assessment and access to general anaesthetic services were major limiting factors.
To evaluate the validity and reliability of the Child Perceptions Questionnaire 11-14 (CPQ11-14) for children attending public educational institutions in Floridablanca (Colombia).
An evaluation study of diagnostic technology was conducted. The questionnaire was completed by 500 students aged 11-14years who were selected by simple random sampling. The test-retest reproducibility was evaluated in 36 students chosen at random from one of the schools; the questionnaire was completed a second time by these students, with an interval of two weeks between administrations. Internal consistency was estimated using the Cronbach's alpha coefficient, and test-retest reproducibility was determined with the intraclass correlation coefficient (ICC). The Rasch Rating Scale Model was used to perform the validation; the structure of the categories, the quality of the items, the invariance and the one-dimensionality were analyzed; invariance was confirmed using differential item functioning (DIF). Informed consent was obtained from the parents or guardians, and assent was obtained from the minors.
The mean age was 12.7 ± 1.1years, and 210 (42.0%) participants were female. The Cronbach's alpha and ICC values were 0.91 and 0.63, respectively. The 37 items fit the Rasch model, but a uniform DIF was observed for an item that was eliminated. The questionnaire was not one-dimensional, and the proportion of variance explained by the model was poor (26.3%).
The CPQ11-14 showed unsatisfactory test-retest reproducibility and excellent internal consistency; no unidimensionality was observed, but the items fit the Rasch model.
The CPQ11-14 showed unsatisfactory test-retest reproducibility and excellent internal consistency; no unidimensionality was observed, but the items fit the Rasch model.
There is a compelling need to prepare our societies and healthcare systems to deal with the oncoming wave of population ageing. The majority of older persons maintain a desire to be valued and useful members of society and of their social networks.
We sought to investigate the perception of usefulness among persons aged 65years and over in four European countries.
We performed a cross-sectional survey with a representative sample of individuals aged 65years or older from the population of retired persons (including recently retired persons and oldest-old individuals) from 4 European countries selected using quota sampling. In February 2016, an internet questionnaire was sent to all selected individuals. The characteristics used for the quota sampling method were sex, age, socio-professional category, region, city size, number of persons in household, autonomy, marital status, place of residence, income and educational status. The questionnaire contained 57 questions. Sociodemographic characteristics were recorded.
