Branchbondesen3857

3% (n = 544/1,854) of all three-digit codes. A total of 30.6% (n = 542/1,773) of indications were supported by ≥2 questionnaires. Conclusions The current Vade-mecum covers more than half of all AMPs, used for more than one fourth of all ICD-10 three-digit codes. The Vademecum approach may be relevant for medicinal products from other whole medical systems.Introduction Smaller muscle size and higher adipose tissue ratio of the quadriceps femoris are often observed after stroke. However, it is unclear whether muscle size and the intramuscular fat ratio of the quadriceps measured with ultrasonography (US) reflect gait independence in individuals with mild or severe hemiparetic stroke. Objective The present study was performed to examine the relationships of gait independence with muscle thickness (MT) and echo intensity (EI) of the quadriceps femoris in individuals with hemiparesis after stroke. Methods We examined 43 individuals with hemiparetic stroke. We assessed functional independence measure (FIM) gait scores and measured thickness and EI of the quadriceps using US. The relationships of FIM gait scores with MT and EI were examined using Spearman's correlation coefficients in mild (n = 21) and severe (n = 22) hemiparetic stroke groups. Results In the mild hemiparetic group, FIM gait scores were correlated with paretic limb MT (rho = 0.60, p less then 0.01) and EI (rho = -0.57, p less then 0.01). In the severe hemiparetic group, FIM gait scores were correlated with paretic limb MT (rho = 0.67, p less then 0.01) and EI (rho = -0.43, p less then 0.05), as well as non-paretic limb MT (rho = 0.86, p less then 0.01) and EI (rho = -0.56, p less then 0.01). Conclusions Quadriceps thickness and EI were associated with the degree of gait independence. Atrophy and increased intramuscular fat of the quadriceps may be limiting factors for achieving gait independence.Optimum management of the patent ductus arteriosus (PDA) in preterm infants remains one of the most debated topics within the field of neonatology. Despite numerous observational studies and over 60 randomized control trials, consensus on PDA management remains elusive. In order to make meaningful progress on the controversial issue of PDA management, several key factors must be thoroughly addressed; namely (1) accurate identification of infants at greatest risk of long-term morbidities from PDA exposure, (2) acceptance that the PDA is not a dichotomous entity and an individualised approach to its management is required for each neonate, (3) international consensus on what constitutes a haemodynamically significant PDA and (4) the incorporation of multi-organ assessment when evaluating the impact a PDA may pose on overall neonatal physiology. This review assesses the evidence base available supporting various therapeutic strategies for PDA, the deficits in our current knowledge on the definition of haemodynamic significance and future directions to pursue in order to more successfully address this contentious subject.Introduction There are gaps in literature regarding outcome of multiple polyps and dilemmas in the management issues in polyposis syndromes in children. BMS-935177 in vitro Objective We aimed to study the clinical behaviour of gastrointestinal (GI) polyps with emphasis on therapeutic outcomes of polyposis syndrome. Methods Proven cases of GI polyp(s) on endoscopy were classified as, single polyp, multiple polyps and polyposis syndrome. Complex presentation was defined as one or more of the following severe anemia, anasarca, intussusception, rectal mucosal prolapse, diarrhea. A clinico-endoscopic criteria was applied in polyposis syndrome patients for the decision of surgery versus endoscopic therapy with surveillance. Results Of total 240 patients, there were no significant differences between single (52.5%, n=126) vs. multiple polyps (27.5%, n=66) with respect to age, symptoms, histology and recurrence. Polyposis syndrome (20%, n=48) presented with complex symptoms (50%), higher family history, significantly lower hemoglobin, total protein and albumin as compared to single and multiple polyps (p less then 0.01). 19 polyposis patients with favourable clinico-endoscopic criteria were endoscopically eradicated for polyps in 3 (1-4) sessions with sustenance of laboratory parameters at 1 year and 30% symptomatic recurrence at follow-up of 23.5 (7-40) months. There were no major endoscopic complications. 19 patients required proctocolectomy with improvement in laboratory parameters 6 months post-surgery. Conclusions Multiple polyps behave similar to single polyps in children. A clinico-endoscopic criteria may guide for optimal management of polyposis syndrome. Colectomy may be effectively deferred in a large proportion of polyposis syndrome patients if maintained on an endoscopic protocol.Background The relationship between the amount of adipose tissue and advanced-stage liver cirrhosis with esophageal varices (EV) is unknown. We aimed to reveal the prognostic significance of adipose tissues in patients with liver cirrhosis. Methods We enrolled 87 patients with EV who received initial endoscopic treatment and underwent scheduled treatments in our hospital. Computed tomography (CT) images were obtained of a 5-mm slice at the umbilical level. We evaluated the effect of mortality based on the visceral adipose tissue index (VATI), subcutaneous adipose tissue index (SATI), and visceral subcutaneous adipose tissue ratio (VSR). Results Cox hazard multivariate analysis showed that the presence of hepatocellular carcinoma (HCC; hazard ratio [HR] 4.650, 95% confidence interval [CI] 1.750-12.353, P = 0.002), γ-GTP (HR 1.003, 95% CI 1.001-1.006, P = 0.026) and VATI (HR 1.057, 95% CI 1.030-1.085, P less then 0.001) significantly affected mortality. Cox hazard multivariate analysis for liver-related death was also significantly affected by HCC (HR 1.057, 95% CI 1.030-1.085, P less then 0.001) and VATI (HR 1.052, 95% CI 1.019-1.086, P = 0.002). The difference between the Child-Pugh scores 12 months post-treatment and that during initial treatment were significantly positively correlated with VATI (r = 0.326, P = 0.027). Patients with high VSR had a significantly higher frequency of HCC after EV treatment by Kaplan-Meier analysis (P = 0.024). Conclusion Our findings suggest that VATI measured by CT could significantly predict mortality in cirrhosis patients through decreasing liver function and increasing HCC frequency and appropriately controlling VATI could improve their prognosis.