Muellerebsen4816

BACKGROUND Chronic subdural hematoma (CSDH) remains a neurosurgical condition with high recurrence rate after surgical treatment. The primary pathological mechanism is considered to be repeated microbleedings from fragile neo-vessels within the outer hematoma membrane. The neo-vessels are supplied from peripheral branches of the middle meningeal artery, and embolization of MMA (eMMA) has been performed to prevent re-bleeding episodes and thereby CSDH recurrence. OBJECTIVE To evaluate the published evidence for the effect of eMMA in patients with recurrent CSDH. Secondarily, to investigate the effect of eMMA as an alternative to surgery for primary treatment of CSDH. METHOD A systematic review of the literature on eMMA in patients with recurrent CSDH was conducted. PubMed, Embase, and Cochrane databases were reviewed using the search terms Embolization, Medial Meningeal Artery, Chronic Subdural Haematoma, and Recurrence. Furthermore, the following mesh terms were used Chronic Subdural Haematoma AND embolization AND medial meningeal artery AND recurrence. Eighteen papers were found and included. No papers were excluded. HRO761 ic50 The number of patients with primary CSDH and the number of patients with recurrent CSDH treated with eMMA were listed. Furthermore, the number of recurrences in both categories was registered. RESULTS Eighteen papers with a total of 191 included patients diagnosed with CSDH treated with eMMA for primary and recurrent CSDH were identified. Recurrence rate for patients treated with eMMA for recurrent CSDH was found to be 2.4%, 95% CI (0.5%; 11.0%), whereas the recurrence rate for patients treated with eMMA for primary CSDH was 4.1%, 95% CI (1.4%; 11.4%). CONCLUSION eMMA is a minimally invasive procedure for treatment of CSDH. Although this study is limited by publication bias, it seems that this procedure may reduce recurrence rates compared with burr hole craniostomy for both primary and recurrent hematomas. A controlled study is warranted.HPTN 065 utilized financial incentives to promote viral suppression among HIV-positive participants. Exit interviews were conducted in a sub-study of participants in Washington, DC and Bronx, NY. The present analyses explored lived experiences of social ties and stigma as individuals navigated the HIV care continuum, including gender differences in lived experiences. Using viral load data and informed by stages-of-change theory, participants were categorized into "Low-Adherers (n = 13)", "Action (n = 29)" and "Maintenance (n = 31)" stages. Secondary analyses of qualitative data were informed by grounded theory, and instances of social ties and stigma discussed by participants were quantified with descriptive statistics. Participants (N = 73) were mostly male (64%), African American (58%), with yearly income under $10,000 (52%). Low-adherers identified fewer, and sometimes more combative social ties than those in other adherence stages. Maintainers identified supportive ties as motivation for medication adherence (68%) but relied less on them for motivation than individuals in other adherence stages. Low-adherers described current experiences of stigma related to being diagnosed with HIV more than other adherence stages (23%). Individuals in Action reported stigma related to disclosing their HIV status to others (52%), while individuals in Maintenance mostly stigmatized others engaging in "risky" behaviors (32%). Findings suggest that women may perceive greater HIV stigma than men, perceive less supportive social ties, and were the majority of Low-adherers. Gender-informed approaches can facilitate community de-stigmatization of HIV, as African American women may be at greater risk of negative HIV health outcomes.PURPOSE Two parameters in particular span both health and performance; critical speed (CS) and finite distance capacity (D'). The purpose of the present study was to (1) classify performance norms, (2) distinguish athletic from non-athletic individuals using the 3-min all-out test (3MT) for running, and (3) introduce a deterministic model highlighting the relationship between variables of the 3MT. METHODS Athletic (n = 43) and non-athletic (n = 25) individuals participated in the study. All participants completed a treadmill graded exercise test (GXT) with verification bout and a 3MT on an outdoor sprinting track. RESULTS Meaningful differences between non-athletic and athletic individuals (denoted by mean difference scores, p value and Cohen's d with 95% confidence intervals) were evident for CS (- 0.74 m s-1, p  less then  0.001, d = - 1.41 [1.97, - 0.87]), exponential growth time constant ([Formula see text]; 2.75 s, p  less then  0.001, d = - 1.29 [- 1.45, - 0.42]), time to maximal speed ([Formula see text]; - 2.80 s, p  less then  0.001, d = - 0.98 [- 1.51, - 0.47]), maximal speed ([Formula see text]; - 1.36 m s-1, p  less then  0.001, d = - 1.56 [- 2.13, - 1.01]), gas exchange threshold (GET; - 5.62 ml kg-1 min-1, p  less then  0.001, d = - 0.97 [- 1.50, - 0.45]), distance covered in the first minute (1st min; - 81.69 m, p  less then  0.001, d = - 1.91 [- 2.52, - 1.33]), distance covered in the second minute (2nd min; - 52.02 m, p  less then  0.001, d = - 1.71 [- 2.30, - 1.15]) and maximal distance (- 153.78 m, p  less then  0.001, d = - 1.27 [- 1.82, - 0.74]). The correlation coefficient between key physiological and performance variables are shown in the form of a deterministic model created from the data derived from the 3MT. CONCLUSIONS Coaches and clinicians may benefit from the use of normative data to potentially identify exceptional or irregular occurrences in 3MT performances.PURPOSE We investigated the consequence of varying hypoxia severity during an initial set of repeated cycling sprints on performance, neuromuscular fatigability, and exercise-related sensations during a subsequent set of repeated sprints in normoxia. METHODS Nine active males performed ten 4-s sprints (recovery = 30 s) at sea level (SL; FiO2 ~ 0.21), moderate (MH; FiO2 ~ 0.17) or severe normobaric hypoxia (SH; FiO2 ~ 0.13). This was followed, after 8 min of passive recovery, by five 4-s sprints (recovery = 30 s) in normoxia. RESULTS Mean power decrement during Sprint 10 was exacerbated in SH compared to SL and MH (- 34 ± 12%, - 22 ± 13%, - 25 ± 14%, respectively, p  0.05). CONCLUSION Exercise-related sensations, rather than neuromuscular function integrity, may play a pivotal role in influencing performance of repeated sprints and its recovery.