Cheekabel2735

To evaluate the possible role of ureteral wall thickness (UWT) assessment in the prediction of the success for stent placement in cases with obstructing ureteric stones. 227 adult patients with a single unilateral obstructing ureteral stone requiring internal ureteral stent placement were included. In addition to stone size, the ureteric wall thickness at the impacted stone site and the degree of hydronephrosis were also assigned on CT images. Patients were divided into two subgroups Group 1 patients in whom internal ureteral stent could not be passed beyond the stone and Group 2 patients in whom an internal ureteral stent was passed successfully. The possible relationship between the UWT values and the success of stent placement, degree of hydronephrosis were comparatively evaluated. The majority of the stones were located in the proximal ureter in Group 1 and the degree of hydronephrosis was also higher in these cases. Moreover, while the mean value of UWT calculated on CT images was 4.3 ± 0.9 mm in Group 1, this value was noted to be 2.5 ± 0.8 mm in cases of group 2. A cutoff UWT value of 3.35 mm was highly predictive for the stent insertion and cases with higher values required additional procedures or percutaneous nephrostomy tube placement. UWT value calculated at the obstructing stone site was found to be predictive enough for the likelihood of internal ureteral stent passage with high sensitivity and specificity. This evaluation may enable the urologist to make the best decision for urinary diversion in such cases.

The probability of structural remodeling in brain circuits may be modulated by molecules of perineuronal nets (PNNs) that restrict neuronal plasticity to stabilize circuits. Animal research demonstrates that addictive drugs can remodel PNNs in different brain regions, including the cerebellum.

This study aimed to investigate the effects of short versus extended access to cocaine self-administration on PNN expression around Golgi interneurons in the cerebellar cortex after different periods of abstinence.

After 1week of training (2h/day), Sprague-Dawley rats self-administered cocaine daily for 20days under short (ShA) or extended (LgA) access. PNN expression in the cerebellum was assessed after 1day, 7days, and 28days of forced abstinence. PNNs were immunolabeled using Wisteria floribunda agglutinin (WFA) and captured by confocal microscopy.

WFA intensity increased in PNN-bearing Golgi neurons over the abstinence period and a higher proportion of more intense PNNs were formed throughout the first monthshortly after the cessation of drug intake but PNNs become more intense during protracted abstinence in the LgA group, pointing to the stabilization of drug-induced synaptic changes. These findings indicate that extended access to cocaine self-administration dynamically regulates conditions for plasticity in the cerebellum during abstinence.

Middle phalanx physeal fractures in children are rare, and proper treatment gives good results. Despite treatment, these fractures may lead to physeal arrest and growth disturbances leading to severe angulation deformities. Closed wedge osteotomy with internal fixation efficiently corrects the angulation deformities in children.

We did a retrospective study analyzing 11 children with middle phalanx physeal injuries and severe angulation. Closed wedge osteotomy and internal fixation with plate and screw were done. We interpreted the pre- and postoperative correction of angles, middle phalanx length discrepancy, technical aspects, range of movement, grip strength, pain, and functional outcomes.

The mean age of the patients was 10.5years. The mean follow-up was 28months (range 24-30months). Ten of the 11 patients achieved good radiological union, range of motion, and good outcome. None of the patients had growth plate deformity in the follow-up. All patients had a significant correction of angulation/deformity, length, and improvement of grip strength in the postoperative period (p < 0.05). None had physeal disturbances/abnormalities in the follow-up.

Though middle phalanx physeal fractures are rare and innocuous, adequate treatment is essential to prevent angulation and growth disturbances. Close wedge corrective osteotomy and internal fixation with plates and screws provide stable and rigid fixation. Greater attention is needed to follow-up them until skeletal maturity.

IV.

IV.

To define factors influencing length of hospital stay (LOS) besides surgery delay.

We retrospectively analyzed 634 patients operated for hip fractures in 1-year period. Investigated characteristics were age, gender, American Society of Anesthesiologists score (ASA), time to surgery (first 48h was considered early), type of surgery, anticoagulant therapy and non-routine pre-operative tests. Univariate and multivariable analysis were performed. p values < 0.05 were considered statistically significant.

Median LOS was 12days. Patients operated within 48h had a LOS of 10days, while patients operated after 48h had 4days longer LOS (p < 0.01). In multiple regression analyses, it was predicted that patients operated after 48h with every 10h delay to surgery had 7.3h longer hospitalizations. All other factors did not influence the LOS. In early operation group, patients with hip arthroplasty had 3.3days longer hospitalization compared to patients with osteosynthesis, every higher ASA score was associated with 1.4days longer hospitalization, patients on anticoagulant therapy had 2.6days longer LOS but surgery delay had no influence on LOS. Preinjury residence at a nursing home was associated with 4.4days shorter hospitalizations compared to preinjury residence at home in both time frames.

In patients operated in first 48h longer LOS is associated with ASA, anticoagulant therapy and operation type but not with delay to surgery. If patients are operated after 48h, surgery delay is the only factor increasing LOS.

In patients operated in first 48 h longer LOS is associated with ASA, anticoagulant therapy and operation type but not with delay to surgery. LOXO-305 If patients are operated after 48 h, surgery delay is the only factor increasing LOS.