Gillpeters3175
It was not possible in one case due to hard adhesions. The diagnostic rate was 100%, and the complication rate was 6.1%. There were no major complications, and minor complications included mild pain (one case) and minor bleeding (one case) that was stanched spontaneously.
The new flex-rigid pleuroscope is effective and safe for diagnosing pleural effusions. The improved bending angle is likely to minimize the blind area. The new pleuroscopy fiberscope may improve the diagnostic rate.
The new flex-rigid pleuroscope is effective and safe for diagnosing pleural effusions. The improved bending angle is likely to minimize the blind area. The new pleuroscopy fiberscope may improve the diagnostic rate.
Neurogenic dysphagia is the difficulty in swallowing caused by neurological diseases, which is a very common symptom in neurological disorders. In this paper, we try to summarize the opinions in the pathophysiology and therapy of dysphagia in ancient China (before AD 1840) through the records in the literatures from all the dynasties.
We searched the databases including Chinese Medical Classics, China National Knowledge Infrastructure, Wanfang Data, MEDLINE, and ISI Proceedings until July 2020, with the search terms "dysphagia" and "difficulty in swallowing" in English and their Chinese equivalents.
The concept of neurogenic dysphagia was first described as Hou Bi in the Yellow Emperor's Internal Classic, which is the first Chinese medical classic and the origin of traditional Chinese medicine (TCM) theory. In the different eras, the pathogenesis of neurogenic dysphagia was explained mainly by three theories in TCM, that is, the wind-phlegm blocking collaterals, the deficiency of liver and kidney-essence, and the Qi-stagnation with static blood. In addition to the TCM prescriptions, acupuncture is characteristic treatment and seems to be effective. However, the evidences of efficacy and safety from clinical trials are still required.
The concept of neurogenic dysphagia was first described as Hou Bi in the Yellow Emperor's Internal Classic, which is the first Chinese medical classic and the origin of traditional Chinese medicine (TCM) theory. In the different eras, the pathogenesis of neurogenic dysphagia was explained mainly by three theories in TCM, that is, the wind-phlegm blocking collaterals, the deficiency of liver and kidney-essence, and the Qi-stagnation with static blood. In addition to the TCM prescriptions, acupuncture is characteristic treatment and seems to be effective. However, the evidences of efficacy and safety from clinical trials are still required.
The WHO recommends antiretroviral treatment (ART) for all HIV-positive patients regardless of CD4 count or disease stage, referred to as "Early Access to ART for All" (EAAA). The health systems effects of EAAA implementation are unknown. This trial was implemented in a government-managed public health system with the aim to examine the "real world" impact of EAAA on care retention and viral suppression.
In this stepped-wedge randomized controlled trial, 14 public sector health facilities in Eswatini were paired and randomly assigned to stepwise transition from standard of care (SoC) to EAAA. ART-naïve participants ≥18years who were not pregnant or breastfeeding were eligible for enrolment. We used Cox proportional hazard models with censoring at clinic transition to estimate the effects of EAAA on retention in care and retention and viral suppression combined.
Between September 2014 and August 2017, 3405 participants were enrolled. In SoC and EAAA respectively, 12-month HIV care retention rates were 80% the combined retention and viral suppression provides an important co-benefit of EAAA to HIV-positive adults themselves, at least in the short term. Our results from this "real world" health systems trial strongly support EAAA for Eswatini and countries with similar HIV epidemics and health systems. VL monitoring needs to be scaled up for appropriate care management.
Acute liver failure (ALF) patients with coma need to be revived not only for spontaneous recovery but also as a bridge to liver transplantation. We developed a new high-volume plasma purification system using an on-line continuous hemodiafiltration (CHDF) system, and evaluated its safety and efficacy in a multicenter study.
A single arm interventional study using the new apparatus was undertaken in the six major liver centers in Japan. The primary end-point was the proportion of patients who regained consciousness within 10days, which was compared with a historical control (47%). Nine ALF patients were enrolled and treated with the new machine. One patient was excluded because of the need for artificial respiration support according to the established protocol.
Seven of eight (87.5%) patients regained consciousness during the on-line CHDF session, with five of those seven waking within 4days. After waking, one patient spontaneously recovered, three received liver transplantation, two died of liver failure, and one died of another disease. The plasma ammonia levels significantly decreased after the start of on-line CHDF from 182.5 ± 64.8μg/dL (mean ± SD) on day 0 to 87.0 ± 38.9μg/dL on the last day of the session (P < 0.001). Similarly, the plasma glutamine level also significantly decreased from 2069 ± 1234μmol/L to 628 ± 193μmol/L. Oxaliplatin Although seven severe adverse events occurred during on-line-CHDF, no causal relationship with liver support was recognized.
The newly developed on-line CHDF system showed high efficacy for regain of consciousness and excellent therapeutic safety for managing ALF.
The newly developed on-line CHDF system showed high efficacy for regain of consciousness and excellent therapeutic safety for managing ALF.
To utilize a matrix of single-fiber hair testing methodologies to mechanistically understand the impact of common oiling treatments-coconut oil and mineral oil-on hair strands. Further, the effect of hair twisting-experienced in everyday grooming practices-on hair strength was investigated under different scenarios.
Study involved multiple surfactant wash cycles of hair swatches with and without overnight hair oil treatments. Instrumental testing was done on strands from hair swatches-Tensile Extension, Torsional Stretching, and Tensile Extension of twisted hair fibers.
Differentiation was observed in tensile and torsional testing parameters with 20 wash cycles, while no statistical significance was observed in single wash. However, when we combine the two stresses together by extending the twisted hair strands, a clear differentiation was seen even in single cycle for coconut oil in comparison with mineral oil and surfactant wash. The differentiation in tensile parameters for twisted fibers becomes muc its penetration inside hair core.Museums are used in every discipline to collect, classify, and present information for scientific purposes. They also serve as an effective educational medium. Since the establishment of a boutique anatomy museum at Bahçeşehir University, lectures, conferences, and seminars have been organized there over the past four years on the history of human anatomy and the human body. In order to raise awareness about the need to make anatomy accessible to kindergarteners and school-aged children, rather than exclusively to undergraduate students, activities that are suited to a wide range of ages have been developed at the museum and at the anatomy laboratory. Four different sessions were conducted, including activities such as lectures using plastic models as props, shaping organs out of playdough, anatomy puzzles, watching cartoons, and examining specimens through a microscope. Healthy and pathologic anatomies were chosen to match daily themes. Among the kindergarteners and elementary school children, no grading was done, nor was any questionnaire administered; however, a survey was administered in the 10-12 age group (N = 64). According to the students' written feedback, 93.75% said they "are happy with microscope activities" while 84.37% said they "had so much fun" participating in the playdough activities. However, 18.75% criticized the activities, saying they "could have been longer." In conclusion, it is believed that these "getting to know our bodies" activities that were hosted in the anatomy museum, including conferences, workshops, material preparation, and instructional movies, may play an important role in the development of a healthy society.Circulating tumor cells (CTCs) in the blood of cancer patients are of high clinical relevance. Since detection and isolation of CTCs often rely on cell dimensions, knowledge of their size is key. We analyzed the median CTC size in a large cohort of breast (BC), prostate (PC), colorectal (CRC), and bladder (BLC) cancer patients. Images of patient-derived CTCs acquired on cartridges of the FDA-cleared CellSearch® method were retrospectively collected and automatically re-analyzed using the accept software package. The median CTC diameter (μm) was computed per tumor type. The size differences between the different tumor types and references (tumor cell lines and leukocytes) were nonparametrically tested. A total of 1962 CellSearch® cartridges containing 71 612 CTCs were included. In BC, the median computed diameter (CD) of patient-derived CTCs was 12.4 μm vs 18.4 μm for cultured cell line cells. For PC, CDs were 10.3 μm for CTCs vs 20.7 μm for cultured cell line cells. CDs for CTCs of CRC and BLC were 7.5 μm and 8.6 μm, respectively. Finally, leukocytes were 9.4 μm. CTC size differed statistically significantly between the four tumor types and between CTCs and the reference data. CTC size differences between tumor types are striking and CTCs are smaller than cell line tumor cells, whose size is often used as reference when developing CTC analysis methods. Based on our data, we suggest that the size of CTCs matters and should be kept in mind when designing and optimizing size-based isolation methods.The clinical course of COVID-19 in pediatric solid organ transplant recipients remains ambiguous. Though preliminary experiences with adult transplant recipients have been published, literature centered on the pediatric population is limited. We herein report a multi-center, multi-organ cohort analysis of COVID-19-positive transplant recipients ≤ 18 years at time of transplant. Data were collected via institutions' respective electronic medical record systems. Local review boards approved this cross-institutional study. Among 5 transplant centers, 26 patients (62% male) were reviewed with a median age of 8 years. Six were heart recipients, 8 kidney, 10 liver, and 2 lung. Presenting symptoms included cough (n = 12 (46%)), fever (n = 9 (35%)), dry/sore throat (n = 3 (12%)), rhinorrhea (n = 3 (12%)), anosmia (n = 2 (8%)), chest pain (n = 2 (8%)), diarrhea (n = 2 (8%)), dyspnea (n = 1 (4%)), and headache (n = 1 (4%)). Six patients (23%) were asymptomatic. No patient required supplemental oxygen, intubation, or ECMO. Eight patients (31%) were hospitalized at time of diagnosis, 3 of whom were already admitted for unrelated problems. Post-transplant immunosuppression was reduced for only 2 patients (8%). All symptomatic patients recovered within 7 days. Our multi-institutional experience suggests the prognoses of pediatric transplant recipients infected with COVID-19 may mirror those of immunocompetent children, with infrequent hospitalization and minimal treatment, if any, required.
