Hoppeorr0740

Exploratory factor analysis demonstrated five constructs. The tool demonstrated discriminatory ability based on patient urgency, and subscale measurement was associated with patient satisfaction with care CONCLUSIONS The Questionnaire has demonstrable construct validity in adult patients presenting with acute pain to the ED.

The Questionnaire demonstrated construct validity in these patients. Exploratory factor analysis demonstrated five constructs. The tool demonstrated discriminatory ability based on patient urgency, and subscale measurement was associated with patient satisfaction with care CONCLUSIONS The Questionnaire has demonstrable construct validity in adult patients presenting with acute pain to the ED.

To assess the relationship between the rate of postoperative bowel fistula and surgeon experience.

Retrospective study.

Two referral centers.

1060 women managed for colorectal deep endometriosis by one gynecologist surgeon from January 2005 to March 2020.

Shaving, disc excision and segmental colorectal resection.

Rate of bowel fistula stratified according to 4 time periods P1 from 2005 to 2009, P2 from 2010 to 2014, P3 from 2015 to June 2018 and P4 from September 2018 to March 2020.

68 patients (6.4%) were managed during P1, 299 patients (28.2%) during P2, 422 patients (39.8%) during P3 and 271 patients (25.6%) during P4. Both diameter of rectal infiltration and rate of complex surgical procedures progressively increased from P1 to P4. Bowel fistula rate was comparable between all 4 time periods, respectively 2.9, 3.3, 4 and 4.4%. Logistic regression model revealed that risk of fistula decreased when shaving was performed when compared to segmental resection (adj OR 0.1, 95% CI 0-0.5) and increased when deep endometriosis nodules also involved sacral roots (adjOR 4.9, 95%CI 1.8-13.3) and infiltration of the vagina (adj OR 3, 95%CI 1.3-7). No statistically significant relationship was found between surgery time period and risk of fistula.

Crude rates of bowel fistula following surgical management of deep endometriosis infiltrating the colon and the rectum are not an accurate marker of surgeon expertise and should be considered in conjunction with expected higher risks related to challenging procedures performed by experienced surgeons.

Crude rates of bowel fistula following surgical management of deep endometriosis infiltrating the colon and the rectum are not an accurate marker of surgeon expertise and should be considered in conjunction with expected higher risks related to challenging procedures performed by experienced surgeons.

The purpose of this study was to predict pathologic complete response (pCR) to neoadjuvant therapy in breast cancer using radiomics based on pretreatment staging contrast-enhanced computed tomography (CECT).

A total of 215 patients were retrospectively analyzed. Based on the intratumoral and peritumoral regions of CECT images, radiomic features were extracted and selected, respectively, to develop an intratumoral signature and a peritumoral signature with logistic regression in a training dataset (138 patients from November 2015 to October 2017). We also developed a clinical model with the molecular characterization of the tumor. A radiomic nomogram was further constructed by incorporating the intratumoral and peritumoral signatures with molecular characterization. DSS Crosslinker The performance of the nomogram was validated in terms of discrimination, calibration, and clinical utility in an independent validation dataset (77 patients from November 2017 to December 2018). Stratified analysis was performed to develop a slized prediction of pCR to neoadjuvant therapy in breast cancer, which could assist clinical decision-making and improve patient outcome.The association between immediate breast reconstruction (IBR)-related wound complications and breast cancer recurrence (BCR) remains uncertain. This study aimed to investigate the oncological outcomes in patients with wound complications following mastectomy and IBR. A comprehensive search was undertaken for all studies describing complications in patients with breast cancer following IBR. Studies were included if they reported on complications and investigated their relationship with BCR. A meta-analysis was performed using a random-effects model, with data presented as odds ratios and 95% confidence intervals. A total of 1418 patients from five studies were included in the final analysis. The mean age of patients included was 47.2 years. A total of 382 (26.9%) patients had postoperative complications following a majority of implant-based IBR (929/1418). A total of 158 (11.1%) recurrences, which included 63 locoregional and 106 distant recurrences, was noted at a mean follow-up of 66 months. Although there was an increase in recurrence rates in the complication group (n = 66/382; 17.3% vs. n = 92/1036; 8.9%), there was no significant association between complications and BCR (17.3% vs. 8.9%; P = .18) or mortality (3.6% vs. 2.3%; P = .15). Time to adjuvant therapy was significantly increased in patients with complications (mean difference, 8.69 days; range, 1.18-16.21 days; P = .02; I2 = 0.02). This meta-analysis demonstrated a higher incidence of wound complications following IBR and a statistically significant increased time to adjuvant therapy. However, this did not translate into adverse oncological outcomes in patients with breast cancer undergoing IBR.

As the obesity epidemic worsens, anesthesiologists should expect to see more obese patients presenting for surgical procedures. Opioids cause respiratory depression, which has caused complications in patients with obstructive sleep apnea. Opioids can also cause nausea, prolonging the time that patients spend in the postanesthesia care unit. Ketamine is a potential analgesic alternative that may have advantages to narcotics in the bariatric population.

To determine whether an intraoperative ketamine infusion would reduce postoperative narcotic use in patients during the first 48 hours after laparoscopic gastric bypass.

Major academic medical center.

There were 54 participating patients. The intervention group (n = 27) was randomized to receive 100 μg of fentanyl with anesthesia induction, then a 20-mg bolus of ketamine, followed by a 5 μg/kg/min intraoperative ketamine infusion starting after anesthesia induction and ending after wound closure commenced. The control group (narcotic only, n = 27) also rd to group differences during the first 6 hours after surgery.

Ketamine successfully reduced the amount of opioids required to control bariatric patients' pain at 24 hours postoperatively, but not over the 48-hour postoperative period.

Ketamine successfully reduced the amount of opioids required to control bariatric patients' pain at 24 hours postoperatively, but not over the 48-hour postoperative period.

Increasing concern has been expressed about the declining sperm count of humans and the potential fertility effects of clomiphene citrate, a synthetic oestrogen-antagonist on human reproductive health in the last few decades. This study aims to investigate the influence of cashew nut supplemented diet on fertility activity of clomiphene citrate in male rats.

The rats were divided into six groups n=6 rats fed basal diet; rats fed basal diet and then given clomiphene citrate (cc) orally; rats fed diet supplemented with 10% processed cashew nut and given cc orally; and rat fed diet supplemented with 20% processed cashew nut and given cc orally; rats fed diet supplemented with 10% processed cashew nut and rat fed diet supplemented with 20% processed cashew nut for fourteen days.

The results revealed that there was a significant (p<0.05) improvement of total testosterone level and epididymal sperm count, viability and progressive motility in all the groups, in comparison to control, with more significance diet and clomiphene citrate could modulate vital biomolecules associated with male reproductive function. Thus, this finding supports the concept that the combination therapy of cashew nut and clomiphene citrate may be used to treat male partners suffering from infertility.In the dairy calf feeding, supplementation of forage to the starter feed is commonly practiced. However, data are insufficient about how changes in particle size (PS) of forage affect calf performance and behavior in a free-choice forage provision system. This study aimed to assess the effects of supplementing wheat straw varying in PS on performance, skeletal growth characteristics, ruminal pH, nutritional behaviors, and blood metabolites of dairy calves. Forty-eight Holstein calves (43.8 ± 3.2 kg of BW) from d 15 of age were randomly assigned to one of the four treatments (n = 12/treatment; six males and six females) (1) starter without wheat straw supplementation (CON), (2) CON supplemented with wheat straw chopped at 1 mm geometrical mean particle length (GMPL) (fine PS), (3) CON supplemented with wheat straw at 4 mm GMPL (medium PS), and (4) CON supplemented with wheat straw at 7 mm GMPL (long PS). The calves were given ad libitum access to feed and water throughout the study. All calves were weaned on dtarter feed on d 35. In conclusion, supplementing wheat straw as a free-choice increased solid feed intake, rumen pH, and calves' welfare, however, PS of wheat straw had no effect.

An advisory board concluded that a new, comprehensive overactive bladder (OAB) patient-reported outcome (PRO) measure should be developed in accordance with regulatory guidelines. The OAB-Bladder Assessment Tool (OAB-BAT) was developed with qualitative input from OAB patients and experts to measure symptoms, bother, impacts, and satisfaction with treatment.

Psychometric evaluation of the OAB-BAT assessing PRO OAB symptoms, bother, and impacts during a 7-d recall period.

Psychometric testing was conducted for a 28-d observational study of 170 OAB patients. Eligibility criteria included clinician-confirmed OAB diagnosis with at least eight micturitions per day.

Assessments included the OAB-BAT, a 7-d bladder diary, and co-validating OAB PROs. Analysis included classical and modern test theories. A scoring algorithm was developed and psychometric properties were assessed.

The majority of participants were women (72.4%) with moderate OAB symptom severity (53.5%). More than one-third of participants (34.rnative to a bladder diary in measuring OAB outcomes.

Acute lymphoblastic leukemia (ALL) is a malign disease with poor prognosis in adults. After remission is achieved by induction therapy, administration of allogeneic hematopoietic stem-cell transplantation (AHSCT) is one of the standard treatment in adult ALL patients. Pediatric-inspired chemotherapy has been demonstrated to improve outcomes of adult ALL. The aim of this study was to compare the Berlin-Frankfurt-Münster-95 chemotherapy (BFM-95) regimen and AHSCT results in ALL patients with first complete remission.

Forty-seven patients who received the BFM-95 regimen and 83 patients who underwent AHSCT were compared. Primary endpoints were comparison of overall survival (OS) and disease-free survival (DFS) between groups.

There was no significant difference between the groups in terms of age, gender, or performance status. In BFM-95 and AHSCT, relapsed disease occurred in 11 (23.4%) and 24 (28.9%), respectively; the respective values for treatment-related mortality were 6 (12.7%) and 10 (12%) (P= .32 and .