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Genitourinary syndrome of menopause (GSM) is a widespread condition with a great impact on quality of life and self-image.

We aimed to systematically review the current literature on CO2-Laser therapy efficacy for the treatment of GSM.

MEDLINE and Embase databases were systematically queried in December 2020 Studies included women with a diagnosis of Vulvo-Vaginal Atrophy (VVA) or GSM without an history of gynaecological and/or breast cancer, pelvic organ prolapse staged higher than 2, pelvic radiotherapy or Sjogren's Syndrome. The quality of the evidence was assessed with the Cochrane risk of bias tool. This study is registered on PROSPERO, number CRD42021238121.

Effects of CO2-Laser therapy on GSM symptoms assessed through subjective or objective efficacy measurement methods.

A total of 803 articles were identified. Of these, 25 studies were included in this review for a total of 1,152 patients. All studies showed a significant reduction in VVA and/or GSM symptoms (dryness, dyspareunia, itching, binary Syndrome of Menopause A Systematic Review and Meta-Analysis. J Sex Med 2022;19452-470.Hepatic veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) affecting the liver is a rare, possibly life-threatening complication of hematopoietic stem cell transplantation (HSCT). Sinusoidal endothelial cell (SEC) damage triggered by various factors (especially conditioning regimen) results in post sinusoidal portal hypertension due to obstruction of the hepatic vein. Diagnosis is guided by traditional clinical diagnostic criteria; the modified Seattle criteria, the Baltimore and revised European Group for Blood and Marrow Transplantation (EBMT), specifically. While there are promising results of imaging techniques studies in the diagnosis of VOD/SOS, none of those imaging techniques are routinely utilized in diagnosis yet. However, risk stratification is essential; conflicting results have been shown in studies aiming to define risk factors for development of VOD/SOS conducted to date. The only approved drug for the treatment of VOD/SOS yet is defibrotide, with early treatment offering higher chances of survival. In this review, we will focus on pathogenesis, clinical presentation and diagnostic criteria, risk factors, prophylaxis, and treatment of the VOD/SOS occurring post-HSCT.At the end of 2020 and previous to the second wave of COVID-19 in Mexico, the seroprevalence in unvaccinated people in the state of Campeche, Mexico was below 15 %. The prevalence changes with ongoing pandemic and per geographical areas. Blood donors screening is a powerful and cost-effective alternative to monitor the population's infection exposure. The aim of the study was to estimate IgG anti-SARS-CoV-2 seropositivity in the Campeche's main blood bank in Mexico. This was a cross-sectional study carried out at the main blood bank of the State of Campeche, located in the Yucatan peninsula, Mexico for the period of August through September 2021 during the third wave of the epidemic. A blood sample from 479 blood donors were included in the study, the overall seropositivity for SARS-CoV-2 IgG antibodies was 69.1 %. Vaccinated donors represented 69.9 % versus 29.4 % unvaccinated. The seropositivity in unvaccinated represented 42.5 % and 81.17 % in vaccinated. The seroconversion in vaccinated donors after first shot was 79 % for Astra-Zeneca-vaccine and 90 % for Pfizer-vaccine. In conclusion 69.1 % of blood donors are seropositive for SARS-CoV-2 and 42.5 percent unvaccinated people are already also seropositive.Hepatic veno-occlusive disease (VOD), also termed sinusoidal obstruction syndrome (SOS), is a rare and life threatening complication of hematopoetic stem cell transplantation (HSCT). Many conditions can mimic the clinical signs of VOD/SOS. Differential diagnosis and diagnosis of the disease at an early stage is important, since the severe form of the disease has higher mortality rates and early-initiated specific treatment has better response rates. A sensitive and specific non-invasive imaging technique that can diagnose the disease at an early stage is still an unmet need today. We aimed to determine the role of liver stiffness measurement (LSM) with transient elastograph (TE) for the diagnosis of VOD/SOS after allogeneic HSCT. Between January 2019 and October 2021, a total of 49 patients underwent allogeneic HSCT and were retrospectively analyzed. Thirty-one adult patients who had a two or more LSM value were included in the study. Revised European Society for Blood and Marrow Transplantation (EBMT) was the criteria used for the diagnosis of VOD/SOS. Two of 31 patients developed VOD/SOS (6.4 %). Very high LSM values were detected in all patients who developed VOD/SOS. Early and specific VOD/SOS treatment resulted in improvement of LSM values together with other related features. However, LSM values did not increase significantly in patients with high a bilirubin level (≥2 mg/dl) without VOD/SOS. This study demonstrates that TE might be a promising non-invasive imaging method for diagnosis, follow-up and differential diagnosis of this dismal complication of HSCT. Yet, these results need to be supported by prospective studies.

Adequate long-term follow-up after metabolic and bariatric surgery (MBS) remains a challenge.

To evaluate if type of insurance correlated with differences in the 5-year follow-up and outcomes of a cohort of bariatric surgery patients in a community-based accredited center.

Accredited private practice bariatric center in the United States.

We studied bariatric surgery patients that underwent MBS in 2015 by a single surgeon in an accredited, community practice. Electronic medical records were utilized to evaluate 5-year follow-up and outcomes data. This included demographics, type of insurance, number of follow-up visits, height, weight, body mass index (BMI), postbariatric procedures, and postbariatric emergency department (ED) utilization.

There were 89 patients. The follow-up rate decreased over time, with 1% of patients at 5 years. There was a slightly higher follow-up rate in patients with commercial versus public insurance. The average BMI of patients that followed up decreased by 13.6 kg/m

over the first postoperative year. The average number of ED visits was 1.46 (standard deviation 2.38) overall; however, of the 89 total patients, 35 patients (39.3%) had no documented ED visits, with the remaining 61 patients (63.5%) ranging from 1-15 visits (median = 1).

Overall follow-up rates were low with 4-year follow-up being 14% and 5-year follow-up being <1%. Publicly insured patients had a higher rate of follow-up. Despite low follow-up rates with the actual bariatric surgery practice, 63.5% of patients had an ED visit during the follow-up period.

Overall follow-up rates were low with 4-year follow-up being 14% and 5-year follow-up being less then 1%. Publicly insured patients had a higher rate of follow-up. Despite low follow-up rates with the actual bariatric surgery practice, 63.5% of patients had an ED visit during the follow-up period.

In rotational atherectomy (RA), the risk of coronary perforation is considered to increase when the wire is in contact with the healthy portion of the vessel. However, the relationship between the extent of wire bias in the healthy portion of the vessel and the risk of coronary perivascular trauma (CPT) has not been reported.

We examined 90 consecutive cases wherein intravascular ultrasound (IVUS) was performed before and after RA. The IVUS catheter in contact with the healthy region of the vessel was defined as the healthy portion wire bias (HWB), of which we measured the bias diameter, defined as the media-to-media length between the site where the IVUS catheter was in contact and the opposite side of the vessel. The bias ratio was defined as the ratio of the bias diameter to the short diameter at the region where the wire bias was the strongest. The relationship between the bias ratio and the CPT risk was evaluated.

CPT was significantly higher in the HWB group than in the non-HWB group (9% vs. 0%, P = 0.048). In the HWB group, the bias ratio was significantly greater in the CPT group than in the non-CPT group (1.31 ± 0.09 vs. 1.06 ± 0.06; P < 0.0001). The cutoff value of the bias ratio for CPT was 1.2, which was the maximum value of the sum of sensitivity 100% and specificity 97%.

Lesions without HWB had no CPT. CPT risk increased when the bias ratio exceeded 1.2.

Lesions without HWB had no CPT. CPT risk increased when the bias ratio exceeded 1.2.In industrial applications such as fermentation and heterologous protein production, various Aspergillus oryzae and A. sojae strains are used. Although genetic engineering techniques have been developed for these filamentous fungi, applying such classical techniques to many strains is difficult. Therefore, the establishment of innovative technologies applicable to various industrial strains is required. We previously developed a genome editing technology using the CRISPR/Cas9 system for the efficient genetic engineering of A. oryzae; however, this system is limited by its protospacer adjacent motif sequence. In A. sojae, no genetic engineering using genome editing has been developed. see more In this study, we aimed to develop a genome editing technology using the Cpf1 nuclease for the genetic engineering of A. oryzae and A. sojae. AMA1-based genome editing vectors bearing codon-optimized cpf1 expression cassettes were constructed, and guide RNA expression cassettes were inserted into the Cpf1 genome editing vectors. Using the resultant plasmids, we performed mutagenesis of the AowA and sC genes in A. oryzae and the AswA gene in A. sojae. We deleted these genes by co-introducing the Cpf1 genome editing plasmid and the donor plasmid. Our study demonstrates that the CRISPR/Cpf1 system can be used as an efficient alternative to the CRISPR/Cas9 system to genetically engineer A. oryzae and as a new approach for efficient genetic engineering of A. sojae.Acupoint autohemotherapy at bilateral Zusanli (ST36) and Xuehai (SP10) was used to treat a 26-year-old female patient who had suffered from recalcitrant atopic eczema (AE) for five years. The treatment was applied at a frequency of once per week for the first month, followed by a three-month period of once every other week. At the end of treatment, the patient's AE symptoms were entirely resolved, and by the end of a six-month follow-up her immunoglobulin E level had returned to the normal range. Further, there was no relapse of AE symptoms during the six-month follow-up. Therefore, we hypothesized that after the repeated treatments the local inflammatory reaction induced by autologous blood injection triggered a local immune response, followed by a systemic immune response after the repeated treatment, finally leading to the anti-inflammation and immunomodulation effects. This case suggests that acupoint autohemotherapy could be used as an effective complementary treatment for recalcitrant AE, especially in cases where other treatments have failed. Further comparative studies are needed to corroborate the value and mechanisms of this therapy.

High on-clopidogrel platelet reactivity could be partially explained by loss-of-function alleles of CYP2C19, the enzyme that converts clopidogrel into its active form. Shexiang Tongxin Dropping Pill (STDP) is a traditional Chinese medicine to treat angina pectoris. STDP has been shown to improve blood flow in patients with slow coronary flow and attenuate atherosclerosis in apolipoprotein E-deficient mice. However, whether STDP can affect platelet function remains unknown.

The purpose of this study is to examine the potential effects of STDP on platelet function in patients undergoing percutaneous coronary intervention (PCI) for unstable angina. The interaction between the effects of STDP with polymorphisms of CYP2C19 was also investigated.

This was a single-center, randomized controlled trial in patients undergoing elective PCI for unstable angina. Eligible subjects were randomized to receive STDP (210mg per day) plus dual antiplatelet therapy (DAPT) with clopidogrel and aspirin or DAPT alone.

The primary outcome was platelet function, reflected by adenosine diphosphate (ADP)-induced platelet aggregation and platelet microparticles (PMPs).