Dissingayala0227
The present work seeks to illustrate the potential role MRgRT could play in personalizing rectal cancer treatment thus expanding the role of NOM in rectal cancer.
We hypothesized that a laparoscopic approach to sigmoidectomy for perforated diverticulitis is associated with less morbidity and mortality.
The NSQIP database was used to investigate adult patients who underwent emergent colectomy with end colostomy for perforated diverticulitis. A multivariate analysis using logistic regression was used to compare outcomes of patients by surgical approach.
We found a total of 2937 adult patients who underwent emergent colectomy for perforated diverticulitis during 2012-2017. The rate of minimally invasive surgery (MIS) was 11.4% with 38.6% conversion rate to open. The 30-day mortality and morbidity rates were 8.8% and 65.8%, respectively. Following adjustment using a multivariate analysis, the open approach was associated with higher morbidity (67.2% vs 56.8%, AOR 1.70,
< .01) and mean hospitalization length of patients (13 days vs 10 days,
< .01) compared to the MIS approach. Respiratory complications of ventilator dependency (14.3% vs 6%, AOR 2.95,
&l38.6%. Efforts should be directed toward increasing the utilization of laparoscopic approaches for the surgical treatment of perforated diverticulitis.
To compare efficacy of treat and extend (T&E) versus fixed regimen treatment protocols in neovascular age-related macular degeneration (nAMD).
Randomized clinical trials (RCTs) comparing T&E versus fixed regimen protocols for nAMD were systematically searched. Primary outcome was to compare the mean best corrected visual acuity (BCVA) change in T&E regimen versus fixed regimen. Secondary outcomes were change in the mean optical coherence tomography (OCT) central retinal thickness (CRT) and mean number of injections. Standardized mean difference (SMD) along with 95% confidence intervals (CIs) were calculated. Random-effect models were used for meta-analyses.
Four RCTs were included, with a total of 649 and 621 eyes in the T&E and fixed regimen cohort at 12 months, and 267 and 249 eyes at 24 months. Pooled analysis of mean BCVA change included all four RCTs at 12 months and two RCTs at 24 months, showing no difference between the two groups (12-month SMD = 0.08, 95% CI -0.20 to 0.35,
= 0.55; 24-month SMD = 0.04, 95% CI -0.13 to 0.21,
= 0.64). Pooled analysis of OCT CRT change at 12 months included three studies, showing no difference between the two groups (SMD = 0.03, 95% CI -0.46 to 0.51,
= 0.91). Pooled analysis of mean injection number included all four RCTs at 12 months and two RCTs at 24 months, showing significant difference between the two groups (12-month SMD = -1.11, 95% CI -1.67 to -0.56,
< 0.001; 24-month SMD = -1.34, 95% CI -1.54 to -1.15,
< 0.001).
A T&E regimen proved as effective as a fixed dosage regimen throughout a 24-month follow-up and with a lower number of injections.
A T&E regimen proved as effective as a fixed dosage regimen throughout a 24-month follow-up and with a lower number of injections.Since the second half of the 20th century, a massive increase in the consumption of refined carbohydrates has occurred, generating well-described detrimental health effects such as obesity, insulin resistance, type II diabetes, cardiovascular diseases and dental caries. Certain physiological mechanisms involved, particularly through chronic hyperglycaemia and hyperinsulinaemia, suggest that a non-medical trait such as facial attractiveness could also be affected. To explore this possibility, variation in facial attractiveness was evaluated relative to refined carbohydrate consumption. Attractiveness was assessed from facial pictures as judged by raters of the opposite sex. Estimates of refined carbohydrate consumption were based on the glycaemic load of three mealtimes at-higher glycaemic risk (breakfast, afternoon snack and between-meal snack). In the presence of several control variables, facial pictures of women and men with higher between-meal glycaemic loads were preferred by opposite-sex raters. Structural equation modeling suggests that this result is possibly mediated by an increase in apparent age for men and an increase in femininity for women. The different physiological ecologies of the three meals at-higher glycaemic risk are discussed as well as the interpretation of the results in terms of adaptation or maladaptation to the modern and unique dietary environment.
To evaluate the effect of IOP lowering on the capillary density of optic nerve head and retinal nerve fiber layer in patients with primary open angle glaucoma.
Twenty eyes of 14 glaucomatous patients and 15 eyes of nine normal patients were enrolled. The most appropriate hypotonic treatment was applied to every patient. A HD Angio Disc 4.5 scan (Avanti-AngioVue) was performed at baseline and after a month in the glaucomatous eyes. The following parameters were analyzed Radial Papillary Capillaries (RPC) density, inside disc, peripapillary, superior-hemi, inferior-hemi, quadrants, and peripapillary, hemi-superior, hemi-inferior, and quadrants RNFL thickness. Optic nerve head analysis was also evaluated. In addition, the RPC density and the RNFL were assessed in the eight sectors provided by the software.
The RPC density did not significantly change after IOP reduction (
> 0.05). The inferior-temporal (
= 0.005) and inferior-nasal sectors (
< 0.001) showed a greater capillary density than the respective superior sectors in healthy eyes. In contrast in the glaucomatous eyes, the superior-nasal exhibited greater capillary density with respect to the inferior-nasal sectors. The aggregate RPC density of the inferior sectors was greater than the superior ones in the control group (
< 0.001). An improvement of the average disc area (
= 0.01) and the average cup volume (
= 0.059) were also observed along with increased RNFL thickness at different locations (all,
< 0.05) after IOP lowering therapy was initiated.
The glaucomatous eyes presented rarefaction of the radial papillary capillaries density in the inferior sectors, but no significant changes in the density after IOP-lowering medications.
The glaucomatous eyes presented rarefaction of the radial papillary capillaries density in the inferior sectors, but no significant changes in the density after IOP-lowering medications.
To determine the efficacy of pars plana vitrectomy (PPV) in children with intraocular hemorrhage (IOH) secondary to Abusive head trauma (AHT).
A long-term retrospective analysis evaluating epidemiology, management, safety, anatomical and functional results of PPV for IOH in children with AHT at tertiary referral center for children in the Czech Republic from 2004 to 2017.
18 children were identified with IOH due to AHT during observation period of 14 years. Overall incidence of IOH related to AHT was 29.6/100 000, in children under 1 year 22.2/100 000, in children 1 to 5 years 7.4/100 000. Mean age at the time of diagnosis was 13.7 (SD±20.53) months, median 5 months. IOH resolved in 56% of children, 64% eyes, spontaneously. 44% children, 36% eyes, underwent PPV. PPV was performed 30.5 (SD±16.98) days after established diagnosis on average. Postoperatively, 80% of eyes had anatomical improvement, 20% eyes had preexisting irreversible changes in the posterior pole. Ebselen in vitro Vision of 50% eyes improved after surgery, vision of 20% eyes remained poor, 30% of eyes was not possible to test due to severe neurological impairment. Mean observational period was 33.4 (SD±38.21) months. Mortality rate of AHT in our group was 17%, all victims were younger 4 months.
PPV is a safe and effective procedure to clear IOH in children with AHT. Ophthalmology outcomes are strongly associated with degree of neurological impairment. Best outcomes were achieved with PPV performed between 2 and 5 weeks after trauma. Opportunity to plan surgery within this time frame indicates a good neurological prospect and prevents deprivation amblyopia.
PPV is a safe and effective procedure to clear IOH in children with AHT. Ophthalmology outcomes are strongly associated with degree of neurological impairment. Best outcomes were achieved with PPV performed between 2 and 5 weeks after trauma. Opportunity to plan surgery within this time frame indicates a good neurological prospect and prevents deprivation amblyopia.Ginkgo biloba leaf extract (GIN) is a popular Chinese herbal medicine. It has a nephroprotective effect against the nephrotoxicity induced by the chemotherapeutic agent methotrexate (MTX). This work was designed to explore the testicular protective role of GIN on MTX-induced testicular injury in a rat model. The experimental protocol lasted for 10 days for the 4 studied groups. First group received saline (normal control, NC group). The second group was administered GIN (100 mg/kg/day) orally for 10 days (GIN C). Third group injected with MTX (20 mg/kg ip) only on the fifth day (MTX group). Fourth group administered GIN for 10 days with MTX injection on the fifth day (GIN+MTX group). MTX induced testicular injury as evident by a marked rise in the malondialdehyde (MDA) content, interleukin-6 (IL-6) and IL-1β protein levels, nuclear factor kappa-B (NF-κB) protein expression, bcl-2 associated × protein (Bax) mRNA expression, p53 mRNA and protein expressions, and miRNA29-a expression along with a marked decline in the serum level of testosterone and superoxide dismutase (SOD) content in testicular tissue in relation to the NC group. Moreover, histopathological testicular damage with a notable decrease in the Johnsen score together with a significant elevation in the testicular injury score was observed in the MTX group in comparison to the NC group. The administration of GIN ameliorated the biochemical changes as well as the testicular histopathological findings and scores. GIN could protect against MTX-induced gonadotoxicity by its antioxidant, anti-inflammatory, antiapoptotic activities plus the regulation of the miRNA-29a testicular expression.A systematic review and a meta-analysis were conducted to examine the overall prevalence of psychological health outcomes during COVID-19. Seven databases were systematically searched to include studies reporting on at least one psychological outcome. The pooled prevalence of primary psychological outcomes was 26% (95%CI 21-32). Pooled prevalence for symptoms of PTSD was 33% (0-86), anxiety 28% (21-36), stress 27% (14-43), and depression 22% (13-33). The prevalence of psychological outcomes was similar in healthcare workers and in the general population (34% [24-44] and 33% [27-40] respectively). High prevalence figures support the importance of ensuring adequate provision of resources for mental health.Attention to the relationship between neighborhood context and child maltreatment is growing. However, no study exists that considers families' residential moves and neighborhood changes longitudinally. This is particularly relevant to disadvantaged families who move frequently. Our sample includes children who experienced a child maltreatment report (CMR) or an AFDC case in early childhood. We followed up these children from 1995 to 2009 through various administrative databases. We used multilevel logistic growth curve models to estimate the CMR likelihood at each age from 1 to 16. Estimates were limited to ages on AFDC/TANF to trace families' residential addresses based on AFDC/TANF payee records. Our findings highlight the importance of tracing residential neighborhoods in a longitudinal study. While doing so, we identify some possible neighborhood contextual influences. These, however, are small in contribution to overall risk and are less observable among children that are more vulnerable.
