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They have also called for additional support in the form of supply of vaccines, enhancement of workforce capacity and appropriate incentives to address hesitancy. Australia remains burdened by the legacy of centuries of harm and damage to its First Nations people. Urgent steps must be taken to avoid a renewed assault on Aboriginal and Torres Strait Islander health. This article is protected by copyright. All rights reserved.
The surgical management of left-sided malignant large bowel obstruction (MLBO) is associated with high morbidity and mortality. Recently, self-expandable metallic colonic stent (SEMS) and transanal decompression tube (TDT) used as a 'bridge to surgery' (BTS) have been widely used. This study aims to compare the clinical outcomes and oncological safety of SEMS and TDT as BTS to transform MLBO into elective surgery.
Between February 2013 and March 2019, 62 patients with MLBO received SEMS (n=32) or TDT (n=30), and elective one-stage surgery later. We evaluated decompression efficiency and oncological safety in selective operation in TDT and SEMS groups, including preoperative preparation time, surgical approach, number of lymphatic dissection and vascular invasion, ulcer formation and histopathological findings of resected specimens.
The preoperative preparation time in the SEMS group was shorter than that of the TDT group (P < 0.05). However, there was no significant difference between the groups in postoperative length of hospital stay (P > 0.05). The number of vascular invasions in the TDT group was less than that in the SEMS group (P < 0.05). Furthermore, the risk of wound abscess and ulcer formation in the TDT group was significantly lower than that in the SEMS group (P < 0.05).
Our findings suggest that SEMS is associated with a relatively poor oncological outcome and the placement of TDT as BTS in MLBO patients may be a better alternation.
Our findings suggest that SEMS is associated with a relatively poor oncological outcome and the placement of TDT as BTS in MLBO patients may be a better alternation.
Patients undergoing laparotomy for emergency general surgery (EGS) have poor outcomes. Attempts have been made to improve these outcomes by adopting damage control principles known to benefit polytraumatized patients. Studies describing the use of staged laparotomy (SL) in EGS have been modest in size and heterogenous. The aim of this study was to describe our experience with SL at a tertiary hospital in KwaZulu-Natal, South Africa.
The Hybrid Electronic Medical Registry (HEMR) at Greys Hospital was interrogated for all consecutive admissions undergoing staged EGS laparotomy. Descriptive and inferential statistics were performed.
From 2012 to 2018, 242 patients (16.5% of all EGS laparotomies) underwent SL for an EGS condition. The median patient age was 38 years old (IQR 27-56 years). Physiological indications were present in 125 patients (51.7%) and non-physiological indications (NPI) in 117 (48.3%). Haemodynamic instability was the most common physiological indication (51; 21.1%) and gross contamination was the most non-physiological indication (91; 37.6%). Adverse event and mortality rates were 84.8% and 26.9%, respectively. Independent predictors of mortality were enteric breach (OR3.9; 95% CI (2.1-7.8)), physiological indication (OR 2.1; 95% CI (1.1-3.7)) and anastomosis (OR 2.0; 1.05-3.73). "Clip and drop" did not contribute to mortality (P= 0.43; OR1.34 (0.64-2.7)). Mortality was higher in the group without repeat laparotomy. Mortality rate was not associated with increasing number of relaparotomies.
Patients undergoing EGS laparotomy form a high-risk group. "Clip and drop" approach and number of relaparotomies were not associated with mortality. Indications and components of this approach need to be standardized.
Patients undergoing EGS laparotomy form a high-risk group. "Clip and drop" approach and number of relaparotomies were not associated with mortality. Indications and components of this approach need to be standardized.Retraction Statement Ali, M, Imran, M M, Ahmad, U, Usman, U, Shaukat, A, Gul, N Neutrophil/lymphocyte ratio-A marker of COVID-19 pneumonia severity. Int J Clin Pract. 2020; 75e13698. https//onlinelibrary.wiley.com/doi/10.1111/ijcp.13698. The above article from the International Journal of Clinical Practice, published online on 6 September 2020 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the authors, the journal's Editor in Chief, Dr Charles Young, and John Wiley and Sons Ltd. The retraction has been agreed following a disclosure by the authors that the data in their article was not original and was sourced from two previously published articles (1 and 2). Lu J, Zhang Y, Cheng G, He J, Wu F, Hu H, Sha T, Zeng Z, Chen Z. [Clinical characteristics and outcomes of adult critically ill patients with COVID-19 in Honghu, Hubei Province]. Nan Fang Yi Ke Da Xue Xue Bao. 2020 Jun 30;40(6)778-785. Chinese. 10.12122/j.issn.1673-4254.2020.06.02. PMID 32895195; PMCID PMC7321274. Xia X, Wen M, Zhan S, He J, Chen W. [An increased neutrophil/lymphocyte ratio is an early warning signal of severe COVID-19]. Nan Fang Yi Ke Da Xue Xue Bao. 2020 Mar 30;40(3)333-336. Chinese. 10.12122/j.issn.1673-4254.2020.03.06. PMID 32376581; PMCID PMC7167308.
To examine the outcome of patients treated with complete mesocolic excision (CME) with central vascular ligation (CVL) after conventional and laparoscopic surgery.
We retrospectively evaluated stage I-IV colon adenocarcinoma patients treated by the same surgeon (L.M.) from 2013 to 2018. Postoperative complications, recurrences and survival are assessed.
Fifty-one patients (M/F 24/27) underwent laparoscopic right hemicolectomy with CME (L-CME) or open CME (O-CME) plus CVL. Tumour location was the caecum in 39.2% of cases, the transverse in 23.5%, the hepatic colonic flexure in 21.5%, and the ascending colon in 15.6%. Twenty-four patients underwent L-CME while 27 underwent O-CME. More than 15 harvested lymphnodes are reported in 74.1% of O-CME patients and in 66.7% of L-CME patients (p=0.562). Postoperative complications occurred in 7 O-CME and 5L-CME patients, respectively (p=0.669). Three-year overall survival, including stage IV, was of 75% versus 77.8% for L-CME and O-CME patients, respectively, whileally invasive surgery are the undiscussed key outcome variables.Retraction Statement Ali, M, Nagra, M H, Ehsan, S, Ahmad, U, Hussain, H A, Bakar, A, Implementation of a telemedicine service during COVID-19 pandemic in Pakistan. Int J Clin Pract. 2021; 75e14310. https//onlinelibrary.wiley.com/doi/10.1111/ijcp.14310. The above article from the International Journal of Clinical Practice, published online on 1 May 2021 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the authors, the journal's Editor in Chief, Dr Charles Young, and John Wiley and Sons Ltd. The retraction has been agreed following a review of the data in which errors were identified that affect the outcome of the paper.
Djulis (Chenopodium formosanum Koidz.) is a cereal food and its antioxidant and pigment constituents may protect skin from photoaging, but conclusive experiments have not been carried out.
This investigation evaluates the effects of djulis extract as a functional supplement.
In this study, the effects of djulis functional drinks on the free radical scavenging activities, promotion of collagen synthesis and protection against oxidative stress and the effects of ultraviolet B (UVB)-irradiated of pUC119 DNA were explored. Thirty healthy subjects (aged 35-55years old) were randomly allocated to djulis or placebo drinks groups (50ml of a djulis/placebo drink daily for 8weeks for each subject) in a double-blind crossover study.
The regular consumption of the djulis functional drinks significantly increased levels of the serum biochemical superoxide dismutase (SOD) and catalase (+9.5% and +124.8%) after 8weeks, relative to baseline controls. The improvements in skin moisture, brightness, elasticity, crow's feet, texture, wrinkles, pores, and collagen content after 8weeks in the djulis group were +13.3%, +3.8%, +13.2%, -21.8%, -12.1%, -11.0%, -1.4%, and +33.7%, respectively, relative to the baseline without treatment.
These work findings suggest the daily consumption of djulis drinks can protect the skin against oxidative stress-induced damage, delay skin aging and improve skin conditions.
These work findings suggest the daily consumption of djulis drinks can protect the skin against oxidative stress-induced damage, delay skin aging and improve skin conditions.Postoperative hormone therapy for hormone-sensitive patients with breast cancer is important to prevent a recurrence. As hormone therapy does not induce infertility in patients, fertility-preserving therapy is not provided during treatment. Here, however, we performed controlled ovarian stimulation and embryo freezing for fertility preservation under the influence of a sustained-release gonadotropin-releasing hormone agonist in a patient with breast cancer whose postoperative treatment plan was changed from hormone therapy to chemotherapy. After oocyte retrieval, the patient developed treatment-resistant severe symptomatic ovarian hyperstimulation syndrome. Following treatment with oral gonadotropin-releasing hormone antagonist, her symptoms immediately improved, and she could receive chemotherapy on schedule.Retraction Statement Ali, M, Imran, M M, Ahmad, U, Usman, U, Shaukat, A, Gul, N Clinical characteristics and outcomes of patients with COVID-19 pneumonia admitted to an intensive care unit in Faisalabad, Pakistan. Int J Clin Pract. 2021; 75e14152. https//onlinelibrary.wiley.com/doi/10.1111/ijcp.14152. The above article from the International Journal of Clinical Practice, published online on 17 March 2021 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the authors, the journal's Editor in Chief, Dr Charles Young, and John Wiley and Sons Ltd. The retraction has been agreed following a disclosure by the authors that the data in their article was not original and was sourced from two previously published articles (1 and 2). Lu J, Zhang Y, Cheng G, He J, Wu F, Hu H, Sha T, Zeng Z, Chen Z. [Clinical characteristics and outcomes of adult critically ill patients with COVID-19 in Honghu, Hubei Province]. Nan Fang Yi Ke Da Xue Xue Bao. 2020 Jun 30;40(6)778-785. Chinese. 10.12122/j.issn.1673-4254.2020.06.02. PMID 32895195; PMCID PMC7321274. Xia X, Wen M, Zhan S, He J, Chen W. Selleckchem CM 4620 [An increased neutrophil/lymphocyte ratio is an early warning signal of severe COVID-19]. Nan Fang Yi Ke Da Xue Xue Bao. 2020 Mar 30;40(3)333-336. Chinese. 10.12122/j.issn.1673-4254.2020.03.06. PMID 32376581; PMCID PMC7167308.Chemical exchange saturation transfer (CEST) methods measure the effect of magnetization exchange between solutes and water. While CEST methods are often implemented using a train of off-resonant shaped RF pulses, they are typically analyzed as if the irradiation were continuous. This approximation does not account for exchange of rotated magnetization, unique to pulsed irradiation and exploited by chemical exchange rotation transfer methods. In this work, we derive and test an analytic solution for the steady-state water signal under pulsed irradiation by extending a previous work to include the effects of pulse shape. The solution is largely accurate at all offsets, but this accuracy diminishes at higher exchange rates and when applying pulse shapes with large root-mean-squared to mean ratios (such as multi-lobe sinc pulses).