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In the 2nd group, there were 2 cases of seroma, 2 cases of T-junction dehiscence, and 1 case of full nipple-areola complex necrosis, which resulted in implant loss. There was no significant difference in patient satisfaction between the study groups. The dermal flap is more suitable for breasts with pronounced ptosis. The use of the synthetic mesh is suitable for smaller breasts, where the possible dermal flap would be too small to cover the implant. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Anastomotic leakage after right-sided colon cancer surgery is a serious complication that affects postoperative mortality. The Charlson comorbidity index (CCI) has been reported to be a useful predictor of postoperative complications.
A total of 593 cases of right-sided colon cancer resections performed from 2016 to 2020 were examined. The patients were divided into two groups according to the presence or absence of anastomotic leakage (AL, n = 28; no-AL, n = 565); clinicopathological and surgical characteristics were compared between the groups.
The AL group patients had a higher comorbidity rate (96.4% vs. 66.9%, p < 0.001), higher CCI score (p < 0.001), higher blood loss (42mL vs. learn more 23mL, p = 0.046), and longer hospital stay (30days vs. 12days, p < 0.001) than the no-AL group patients. The percentages of chronic pulmonary disease (14.3% vs. 3.9%, p = 0.029), cerebrovascular disease (14.3% vs. 1.9%, p = 0.022), connective tissue disease (39.3% vs. 3.2%, p < 0.001), leukemia (3.6% vs. 0%, p = 0.042), and moderate to severe liver disease (7.1% vs. 0%, p = 0.002) were significantly higher in the AL group. In the multivariate analysis, CCI ≥ 2 was identified as an independent predictor of postoperative anastomotic leakage (hazard ratio 4.91, 95% confidence interval 2.23-10.85, p < 0.001).
CCI could predict anastomotic leakage after right-sided colon cancer surgery.
CCI could predict anastomotic leakage after right-sided colon cancer surgery.In this cross-sectional study, we aimed to assess the reliability, validity, and efficiency of the Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Global Health scale (PGH-7) to reduce patient burden when assessing overall health in clinical practice. In total, 1082 children (8-18), representative of the Dutch population, completed the PGH-7 and the Pediatric Quality of Life Inventory (PedsQL™ 4.0), a common legacy instrument used in clinical practice to assess overall health. The assumptions for fitting an item response theory model were assessed unidimensionality, local independence, and monotonicity. Subsequently, a model was fitted to the data to assess item fit and cultural differential item functioning (DIF) between Dutch and US children. A strong correlation (> .70) was expected between the PGH-7 and PedsQL, as both instruments measure physical, mental, and social domains of health. Percentages of participants reliably measured (> 0.90) were assessed using the standard errormes in clinical practice. What is New • The PROMIS Pediatric Global Health (PGH-7) can be used in research and clinical practice to briefly assess overall pediatric health, while providing valid and reliable measurements. • The PGH-7 provides more efficient assessment of pediatric overall health than the Pediatric Quality of Life Inventory.
This study aimed to report return to sports (RTS) and return to work (RTW) outcomes after distraction arthroplasty (DA) plus lateral meniscal allograft transplantation (MAT) combined with cartilage repair in active patients with advanced osteoarthritis. It was hypothesised that DA combined with lateral MAT would improve clinical and radiological outcomes and enable RTS and RTW for most patients.
In total, 21 patients with advanced osteoarthritis (moderate to severe joint space narrowing at lateral edge on Rosenberg view and large cartilage defect of lateral femoral condyle) who underwent concomitant DA and MAT were retrospectively reviewed. Clinical outcomes were assessed using subjective knee scores [Lysholm score, International Knee Documentation Committee (IKDC) subjective knee score, and Tegner activity scale (TAS)] and functional tests (isokinetic extensor muscle strength test, single-leg vertical jump test, and single-leg hop for distance test). The rates of RTS, RTW, and satisfaction were evaluatedfied or somewhat satisfied with the outcome at the last follow-up. The JSW increased by 0.8 ± 0.4 to 2.3 ± 0.6mm (p = 0.005). In more than 90% of patients, > 50% of cartilage lesion was covered. The mean graft extrusion was 2.6 ± 1.0mm.
All patients who underwent distraction arthroplasty plus lateral MAT combined with cartilage repair returned to any sports and work at the last follow-up. Significant improvements in clinical outcomes and the radiographic joint space width were observed. However, the activity ability was somewhat reduced compared with the best preoperative level. This one-stage joint salvage treatment is a promising option for young and active patients with advanced OA who wish to return to high levels of sports activity and occupation intensity (≥ Tegner activity scale 4).
III.
III.Anamnestic findings, clinical examination and radiological findings are presented, as well as thoughts for differential diagnosis and the introduction of a stage concept for treatment. The treatment of FAI is based on a patient's individual symptoms, the clinical examination and radiological findings. The procedure depends on a number of facts. Individual conditions have to be considered, and the procedure needs to follow principal rules. Therefore, we propose a standard for treatment, which ranges from purely conservative measurements to extensive surgery.FAIS is a well-defined clinical entity with morphological alterations, whether constitutional or acquired, that can lead to damage of the labrum and acetabular cartilage following distinct injury patterns with subsequent osteoarthritis. The combination pathology of cam and pincer deformity is the most common variant. The characteristic changes of the chondrolabral complex that are caused by the dysplasia differ from these FAIS changes. Furthermore, femoral torsion also has an impact on the clinical appearance of Cam- or Pincer-FAIS.(-)-Englerin A (EA), a potential novel anti-cancer drug, is a potent selective activator of classical transient receptor potential 4 and 5 (TRPC4, TRPC5) channels. As TRPC4 channels are expressed and functional in the lung endothelium, possible side effects such as lung edema formation may arise during its administration. Well-established in vivo rodent models for toxicological testing, however, rapidly degrade this compound to its inactive derivative, englerin B. Therefore, we chose an ex vivo isolated perfused and ventilated murine lung (IPVML) model to detect edema formation due to toxicants, which also reduces the number of incriminating animal experiments required. To evaluate the sensitivity of the IPVML model, short-time (10 min) drops of the pH from 7.4 down to 4.0 were applied, which resulted in linear changes of tidal volumes, wet-to-dry weight ratios and incorporation of FITC-coupled dextran particles from the perfusate. As expected, biological activity of EA was preserved after perfusion in the IPVML model. Concentrations of 50-100 nM EA continuously perfused through the IPVML model did not change tidal volumes and lung weights significantly. Wet-to-dry weight ratios were increased after perfusion of 100 nM EA but permeation of FITC-coupled dextran particles from the perfusate to the lung tissues was not significantly different. Therefore, EA shows little or no significant acute pulmonary toxicity after application of doses expected to activate target ion channels and the IPVML is a sensitive powerful ex vivo model for evaluating acute lung toxicity in accordance with the 3R rules for animal experimentation.In the recent years, yeasts have evolved as potent bioremediative candidates for the detoxification of xenobiotic compounds found in the natural environment. Candida sp. are well-studied apart from Saccharomyces sp. in heavy metal detoxification mechanisms. In the current study, Candida parapsilosis strain ODBG2, Candida sp. strain BANG3, and Candida viswanathii strain ODBG4 were isolated from industrial effluents and contaminated ground water, and were studied for their metal tolerance. Among these three isolates, the metal tolerance was found to be more towards Lead (Pb 2 mM), followed by Cadmium (Cd 1.5 mM) and Chromium [Cr(VI), 1 mM]. On further exploring the involvement of primary defensive enzymes in these isolates towards metal tolerance, the anti-oxidative enzyme superoxide dismutase was found to be prominently high (25% with respect to the control) during first 24 h of metal-isolate interaction. The Catalase enzyme assay was observed to have increased enzyme activity at 48 h. It also triggered the activity of peroxidases, which lead to the increase in reduced glutathione in the organism by 0.87-1.9-fold as a metal chelator and also as a second-line defensive molecule. The exoproteome profile showed the early involvement (exponential growth phase) of secreted proteins (low-molecular-weight) of about ~ 40-45 kDa under Cd and Pb stress (0.5 mM). The exoproteome profiling under heavy metal stress in Candida parapsilosis strain ODBG2 and Candida viswanathii strain ODBG4 is the first report.
Optimal first-line chemotherapy regimens are crucial for epithelial ovarian cancer (EOC) treatment. Nab-paclitaxel has showed its considerable survival and low toxicity profiles in first-line treatment for three solid tumors and is recommended as a treatment for recurrent EOC. We focus on clinical efficacy and safety outcomes of nab-paclitaxel in current clinical studies of EOC treatment and aim to explore the potential feasibility of nab-paclitaxel as the first-line treatment for EOC.
We searched for eligible studies up to January 2020 in Pubmed. Outcomes of interests included drug regimes, objective response rate (ORR), median progression free survival (PFS), median overall survival (OS) and main adverse events to determine feasibility of nab-paclitaxel.
This review included nine eligible studies. One study about nab-paclitaxel with carboplatin as first-line therapy in ten cases after hypersensitivity to paclitaxel had an ORR of 100%, median PFS of 16.7months and median OS of 65.4months. Evidence of nab-paclitaxel activity in platinum-sensitive EOC demonstrated an ORR of 64%, a median time to response of 1.3months and PFS of 8.5months. The ORR, median PFS and median OS range in patients with recurrent platinum-resistant EOC from 23%-72%, 4.0-8.5months, 16.8-17.4months, respectively. All studies demonstrated manageable toxicity profile in EOC patients.
Nab-paclitaxel presents potentials as the first-line chemotherapy for considerable survival and safety in EOC compared to conventional paclitaxel. However, there is no prospective trial in EOC so far. Therefore, more studies about nab-paclitaxel are needed.
Nab-paclitaxel presents potentials as the first-line chemotherapy for considerable survival and safety in EOC compared to conventional paclitaxel. However, there is no prospective trial in EOC so far. Therefore, more studies about nab-paclitaxel are needed.