Braswelldalsgaard2073
Priapism is a prolonged erection that lasts longer than four hours. It is a rare pathology in the pediatric population, with an estimation of 0.3-1.5 per 100,000 children per year. The diagnostic sequence includes clinical history, physical examination and penile Doppler ultrasound (PDUS). Puncture of corpora cavernosa is not always necessary to establish the differential diagnosis between high-flow and low-flow priapism. The treatment of choice in pediatric age is not well defined.
Multicentric, retrospective and descriptive study including patients under 14 years with high-flow priapism between 2010 and 2020.
A total of seven patients were diagnosed with high-flow priapism. None of them required puncture of the corpora cavernosa. Patients were treated with a conservative management, two patients required superselective arterial embolization due to persistent symptoms.
High-flow priapism is a very rare entity in pediatric age; therefore, knowing the proper diagnosis and management is crucial. Currently, penile doppler ultrasound is enough for diagnosis in most cases and allows obviating the use of blood gas analysis. Children should be initially treated with a conservative management, reserving embolization for refractory cases.
High-flow priapism is a very rare entity in pediatric age; therefore, knowing the proper diagnosis and management is crucial. Currently, penile doppler ultrasound is enough for diagnosis in most cases and allows obviating the use of blood gas analysis. Children should be initially treated with a conservative management, reserving embolization for refractory cases.
Transgender women (birth-assigned males, female gender identity) can choose to cryopreserve semen prior to their medical transition, to retain the possibility to parent genetically related offspring later in life. Our previous retrospective study showed that semen quality in transgender women is decreased compared to the general population. The etiology of this impaired semen quality remains largely unknown, but might be related to habitual behavior more typically observed in transgender women, e.g. the desire to hide their testicles due to genital dysphoria. Therefore, we decided to conduct a consecutive study with prospectively obtained data on behavior and lifestyle in transgender women OBJECTIVE To study the influence of a low ejaculation frequency, wearing tight undergarment, and bringing the testes in the inguinal position (tucking), on semen quality in transgender women at time of fertility preservation.
In this cohort study, transgender women were included between May 2018 and September 2020, at ts showed that the association with tucking was independent of demographic factors, lifestyle factors and medical history (OR 7.95, 95% CI 1.66-37.99). However, this was not the case for the association with always wearing tight undergarment (OR 2.89, 95% CI 0.95-8.82). Ejaculation frequency did not influence total motile sperm count.
Behavioral factors, including wearing tight undergarment and extensive tucking, may contribute to the lower semen quality in transgender women. These results enable optimization of fertility counseling on how to adjust lifestyle before pursuing semen cryopreservation.
Behavioral factors, including wearing tight undergarment and extensive tucking, may contribute to the lower semen quality in transgender women. These results enable optimization of fertility counseling on how to adjust lifestyle before pursuing semen cryopreservation.
Hysterectomy is commonly performed and may increase the risk of pelvic organ prolapse (POP). Previous studies in parous women have shown an increased risk of POP surgery after hysterectomy. Parity is a strong risk factor for POP and may confuse the true relation between hysterectomy and POP.
We aimed to investigate whether hysterectomy performed for benign conditions other than POP leads to an increased risk of POP surgery in a nulliparous cohort.
We conducted a historical matched cohort study based on a nationwide population of nulliparous women born 1947-2000 and living in Denmark during 1977-2018 (n = 549,197). The data were obtained from the Danish Civil Registration System, the Danish National Patient Registry, the Fertility Register and Statistics Denmark. Women who had a hysterectomy performed 1977 - 2018 were included (n = 9,535) and for each woman we randomly retrieved five non-hysterectomized women matched on age and calendar year to constitute the reference group (n = 47,370). We performed Copelvic organ prolapse surgery for nulliparous women by 60%. Previous studies of multiparous women have similarly shown increased risk of prolapse subsequent to hysterectomy. Since the largest risk factor for POP - vaginal birth - is eliminated and the women are not older than 72 years in this study, the numbers of POP surgeries are low. Despite low absolute risk of POP surgery, nulliparous women constitute an important population enabling an investigation on the association between hysterectomy and POP excluding the largest risk factor. Since this nulliparous cohort study finds increased risk of POP surgery after hysterectomy, it is implied that the uterus per se protects against POP. Gynecologists should be aware of the risks associated with hysterectomy, and alternative uterus-sparing treatments should be considered when possible. Women should be informed about the risks before being offered hysterectomy.
Maternal in-hospital cardiac arrest (IHCA) is a rare event with the potential for resuscitation treatment delays due to difficulty accessing hospital obstetrical units and limited simulation training or resuscitation experience of obstetrical staff. However, it is unclear whether survival rates and processes of care differ between women with a maternal and a non-maternal IHCA.
Using data from 2000-2019 in the Get With The Guidelines-Resuscitation registry, we compared resuscitation outcomes between women 18-50 years of age with a maternal or non-maternal IHCA. Using a nonparsimonious propensity score, we matched patients with a maternal IHCA to as many as 10 women with a non-maternal IHCA. We constructed conditional logistic regression models to compare survival outcomes (survival to discharge, favorable neurologic survival [discharge cerebral performance score of 1], and return of spontaneous circulation [ROSC]) and processes-of-care (delayed defibrillation [>2 minutes] and administration of epinephri34.4%, OR 1.14 [95% CI 0.41-3.18], p=0.31) and delayed epinephrine treatment (13.8% vs. 10.6%, OR 0.96 [95% CI 0.50-1.86], p=0.09).
Although concerns have been raised about resuscitation outcomes in women with a maternal IHCA, rates of survival and resuscitation processes-of-care were not worse for women with a maternal IHCA.
Although concerns have been raised about resuscitation outcomes in women with a maternal IHCA, rates of survival and resuscitation processes-of-care were not worse for women with a maternal IHCA.Geobacter sulfurreducens possesses over 100 cytochromes that assure an effective electron transfer to the cell exterior. The most abundant group of cytochromes in this microorganism is the PpcA family, composed of five periplasmic triheme cytochromes with high structural homology and identical heme coordination (His-His). GSU0105 is a periplasmic triheme cytochrome synthetized by G. sulfurreducens in Fe(III)-reducing conditions but is not present in cultures grown on fumarate. This cytochrome has a low sequence identity with the PpcA family cytochromes and a different heme coordination, based on the analysis of its amino acid sequence. In this work, amino acid sequence analysis, site-directed mutagenesis, and complementary biophysical techniques, including ultraviolet-visible, circular dichroism, electron paramagnetic resonance, and nuclear magnetic resonance spectroscopies, were used to characterize GSU0105. The cytochrome has a low percentage of secondary structural elements, with features of α-helices and β-sheets. Nuclear magnetic resonance shows that the protein contains three low-spin hemes (Fe(II), S = 0) in the reduced state. Electron paramagnetic resonance shows that, in the oxidized state, one of the hemes becomes high-spin (Fe(III), S = 5/2), whereas the two others remain low-spin (Fe(III), S = 1/2). The data obtained also indicate that the heme groups have distinct axial coordination. The apparent midpoint reduction potential of GSU0105 (-154 mV) is pH independent in the physiological range. However, the pH modulates the reduction potential of the heme that undergoes the low- to high-spin interconversion. The reduction potential values of cytochrome GSU0105 are more distinct compared to those of the PpcA family members, providing the protein with a larger functional working redox potential range. Overall, the results obtained, together with an amino acid sequence analysis of different multiheme cytochrome families, indicate that GSU0105 is a member of a new group of triheme cytochromes.
The purpose of this study was to describe the MRI characteristics of intralabyrinthine schwannoma (ILS) on post contrast three-dimensional (3D) fluid-attenuation-inversion-recovery (FLAIR) images obtained four hours after intravenous administration of a gadolinium-based contrast agent (4h-3D-FLAIR).
This IRB-approved retrospective multi-center study included patients presenting with typical ILS from January 2016 to October 2020. All medical charts were systematically collected. All MRI examinations, including 4h-3D-FLAIR images, were reviewed by two board-certified neuroradiologists. Main outcome measures were location, signal intensity and associated anomalies of ILS.
Twenty-seven out of 8730 patients (0.31%) referred for the investigation of a cochleovestibular disorder had a final diagnosis of ILS. There were 13 men and 14 women with a mean age of 52±17 (SD) years (age range 20-86 years). The most common clinical presentation was unilateral progressive sensorineural hearing loss (16/27; 59%). All ILS were unilateral and 15 (15/27; 55%) were intracochlear. All ILS presented as a hypointense filling defect within the labyrinth on T2-weighted images that enhanced on post-contrast T1-weighted images. Ac-FLTD-CMK ic50 On 4h-3D-FLAIR images, all ILS presented as a hypointense filling defect, associated with diffuse perilymphatic hyperintensity. Two patients (2/27; 7%) presented with ipsilateral endolymphatic hydrops.
ILS displays consistent features on post-contrast 4h-3D-FLAIR images. ILS should not be confused with endolymphatic hydrops and requires a systematic analysis of the corresponding T2-weighted images.
ILS displays consistent features on post-contrast 4h-3D-FLAIR images. ILS should not be confused with endolymphatic hydrops and requires a systematic analysis of the corresponding T2-weighted images.
The objective of this study was to assess resident and faculty perception of the effect of the coronavirus disease 2019 pandemic on the training experience, education, and psychological well-being of oral medicine (OM) residents.
An anonymous 16-item online questionnaire was e-mailed to faculty and residents of all Commission on Dental Accreditation-accredited OM residency programs in North America. Survey questions asked about the pandemic's effect on resident educational, clinical, and research activities and the well-being of the residents. Survey data were collected using Qualtrics XM.
Forty participants (52.5% residents and 47.5% faculty members) responded to the survey. Regarding the effect on clinical activities, 67.5% reported 50% or less reduction in patient volume seen by residents at its worst during the pandemic. With respect to educational activities, most reported a complete switch of didactic training (85.3%), academic examinations (60%), and off-site resident rotations (45%) to a virtual platform.
