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This presentation will provide an introduction into operational space medicine and radiation protection for humans in space as executed on ISS, in low earth orbit and in preparation for the scenarios 'beyond'.The aim of this research is to evaluate the clinical evidence of an herbal medicine (HM) treatment on influenza and describe the potential benefits and adverse events by reviewing all relevant randomized controlled trials. All papers published from 2010 to 2019 in all languages in six databases were searched, including all randomized controlled trials on adults and children, testing herbal medicine for treatment of influenza, alone or in combination with conventional antiviral therapy. The main outcome parameters of interest were total effective rate, time to resolution of fever, adverse events, complications, and duration of viral shedding. 25 trials of 3044 patients were included. Herbal medicine compared to placebo significantly reduced time to fever resolution by 4.96[Formula see text]h (mean difference, [Formula see text]4.96; 95% CI, [Formula see text]7.11 to [Formula see text]2.80; [Formula see text]), herbal medicine compared to oseltamivir showed no significant difference (mean difference, [Formula sisk difference, [Formula see text]0.04; 95% CI, [Formula see text]0.09 to 0.00; [Formula see text]), and the combined treatment did not increase adverse events compared to oseltamivir (risk difference, [Formula see text]0.02; 95% CI, [Formula see text]0.06 to 0.02; [Formula see text]). Research findings show that herbal medicine treatments have beneficial therapeutic effects on influenza and could decrease duration of fever and improve total effective rate. In addition, herbal medicine plus oseltamivir combined therapy could increase the therapeutic effect compared to a single treatment with oseltamivir.
Prosthetic valve endocarditis is burdened by high mortality and morbidity. #link# We reviewed our experience in the management of patients with acute prosthetic aortic valve infection and studied the implications and outcomes associated with surgical treatment and medical therapy.
Data of 118 consecutive patients admitted during the period 2008-2018 with definite acute prosthetic aortic valve endocarditis, and presenting a surgical indication, were retrieved from the hospital database. Univariate and multivariate analysis were undertaken to study the association of preoperative characteristics with hospital mortality and the probability of undergoing a reoperation. Survival was assessed with Kaplan-Meier analysis.
In the overall population, prosthesis dehiscence was independently associated with the possibility of undergoing surgical reoperation, while presentation with embolic stroke was associated with medical treatment. Hospital mortality was 24%, medical treatment was found to be independently associated with early death. One hundred (85%) patients underwent redo procedures; aortic valve replacement was performed in 53 and full root replacement in 47. Postoperative hospital mortality was 17%. Survival at 1-, 5-, and 8-years was 78%, 74%, and 66%, respectively. Freedom from reoperation and recurrent endocarditis was 95% at 8-year follow-up.Hospital mortality in patients who did not receive a redo operation was 61% with a survival rate of 17% at 1-year follow-up.
Surgical mortality after reoperation for prosthetic aortic valve endocarditis is still high but mid-term outcomes are satisfactory. Failure to undertake surgery when indicated is an independent risk factor for early death.
Surgical mortality after reoperation for prosthetic aortic valve endocarditis is still high but mid-term outcomes are satisfactory. Failure to undertake surgery when indicated is an independent risk factor for early death.
This study examined the feasibility, burden and acceptability of a legacy-making intervention in adults with cancer and preliminary effects on patient quality-of-life (QOL) measures.
We conducted a Stage IB pilot, intervention study. The intervention was a digital video legacy-making interview of adults with advanced cancer to create a digital video of their memories and experiences. Baseline and post-video QOL assessments included Functional Assessment of Cancer Therapy-General (FACT-G), Patient Dignity Inventory (PDI), Hospital Anxiety and Depression Scale (HADS), and Emotional Thermometers for distress, anxiety, anger, help and depression. Participants received a final copy of the digital video for distribution to their families.
Adults (n = 16) ages 38-83 years old with an advanced or life-limiting cancer diagnosis completed an intervention. Feasibility and acceptability was strong with 0% attrition. While the pilot study was not powered for quantitative significance, there were changes from baseline to post-intervention in the participants' total or subscale FACT-G scores, PDI, HADS anxiety or depression scores, and Emotional Thermometer scores.
A digital video legacy-making intervention is feasible for adults with cancer without significant negative outcomes for individuals completing the study. It remains unclear whether this intervention contributes to positive quality of life outcomes.
A digital video legacy-making intervention is feasible for adults with cancer without significant negative outcomes for individuals completing the study. It remains unclear whether this intervention contributes to positive quality of life outcomes.
Liver transplant hepatic venous anastomoses are usually created using "bicaval" or "piggyback" techniques, which may result in unfavorable angulation between the inferior vena cava and hepatic veins, and makes hepatic vein catheterization and tissue sampling during transjugular liver biopsy (TLB) technically challenging.
To compare the technical successes and complications of TLBs for recipients of liver transplants with bicaval and piggyback hepatic vein anastomoses.
Information on type of hepatic vein surgical anastomosis was available for 190 adult patients in whom 306 consecutive TLBs were performed during 2009-2017 158 with bicaval and 148 with piggyback anastomoses. The primary outcome of procedural success was defined as obtaining a tissue sample sufficient to make a pathologic diagnosis.
A technical success rate of 97% with adequate liver tissue for diagnosis was similar between the anastomotic groups (
= 0.50). TLB was unsuccessful in 3% of patients with piggyback anastomoses due to unfavorable hepatic venous anatomy whereas biopsy was successful in all patients with bicaval anastomoses (
= 0.02). Fluoroscopy times were not significantly different (12.1 vs. 13.9 min,
= 0.08). Rates of major complication were similar between the two groups (3% vs. 3%,
> 0.99).
TLB is safe and effective for liver transplant patients regardless of the type of hepatic vein anastomosis. While failure to catheterize or advance the stiffened biopsy cannula into the hepatic vein is more likely to occur in patients with piggyback anastomoses, this is a rare occurrence.
TLB is safe and effective for liver transplant patients regardless of the type of hepatic vein anastomosis. While failure to catheterize or advance the stiffened biopsy cannula into the hepatic vein is more likely to occur in patients with piggyback anastomoses, this is a rare occurrence.Significance Tissue-resident stem cells are essential for normal organ homeostasis as well as for functional tissue regeneration after severe injury. link2 Herein, mesenchymal stem cells, also designated as mesenchymal stromal cells (MSCs), contribute to the maintenance of organ integrity by their ability to replace dysfunctional cells or secrete cytokines locally and thus support the repair and healing processes of affected tissues. Recent Advances Besides epithelial stem and progenitor cells, substantial evidence exists that tissue-resident multipotent stem cells of mesenchymal nature also exist in adult human lungs. These lung MSCs may function to regulate pulmonary tissue repair and/or regeneration, inflammation, fibrosis, and tumor formation. Critical Issues Although therapeutically applied MSCs turned out to be a valuable therapeutic option for the prevention of lung diseases and/or the regeneration of diseased lung tissue, the true function of tissue-resident MSCs within the lung, and identification of their niche, which presumably dictates function, remain elusive. Future Directions A detailed understanding of lung MSC localization (in the potential vascular stem cell niche) as well as of the signaling pathways controlling stem cell fate is prerequisite to unravel how (i) endogenous MSCs contribute to lung diseases, (ii) exogenous MSCs affect the proliferation of endogenous stem cells to repair damaged tissue, and (iii) a potential on-site manipulation of these cells directly within their endogenous niche could be used for therapeutic benefits. This review focuses on the central role of lung-resident MSCs, which are closely associated with the pulmonary vasculature, in a variety of chronic and acute lung diseases.
The present study investigated the association between different sources of stress and depressive mood in Korean adults.
A total of 4464 adults who completed the 2018 Korean National Health and Nutrition Examination Survey were included in the analysis. link3 Data included sources of stress, depressive mood assessed by the nine-item Patient Health Questionnaire, sociodemographic characteristics, and health-related habits. Multiple logistic regression models were applied to calculate the odds ratio for depressive mood according to each source of stress and stratified by sex and age.
Fully adjusted models revealed that individuals who reported a financial problem or health concern as their main source of stress were more likely to experience depressive mood; when data were stratified by sex, these associations remained significant among females only. An age-stratified analysis indicated that financial problems were associated with depressive mood in middle-aged individuals and health concerns were associated with depressive mood in elderly.
Korean adults with specific sources of stress should be monitored for the development of emotional distress.
Korean adults with specific sources of stress should be monitored for the development of emotional distress.
To investigate beliefs about treatment capabilities of medicinal cannabis (MC), the effect of recreational cannabis (RC) on mental health and online cannabis search trends.
Akti-1/2 (
= 117) completed an online survey, and search engine optimisation software was used to analyse internet search trends.
Half the participants perceived RC as harmful to mental health but were uncertain if it impairs treatment for depression or prevents anxiety. Participants believed MC can treat depression and/or anxiety. The Google keyword 'CBD oil' is most popular when seeking cannabis information and provides misinformation.
Australians are exposed to misinformation about MC online, explaining why participants believed that MC could treat anxiety and/or depression and why there is a reduction in the belief that RC is harmful to mental health. Health authorities should incorporate search engine optimisation strategies to provide accurate information about cannabis.
Australians are exposed to misinformation about MC online, explaining why participants believed that MC could treat anxiety and/or depression and why there is a reduction in the belief that RC is harmful to mental health.
