Mathisslot5799

To evaluate the evolution of vitamin D levels (25OHD) in patients submitted to bariatric surgery.

Retrospective study, conducted with patients submitted to bariatric surgery between 2013 and 2018, in a city in the Northeast of Brazil. The variations of 25OHD, weight, body mass index (BMI), and total lymphocyte count were analyzed and compared for preoperative and postoperative periods of 6 and 12 months. Vitamin D levels below 30ng/mL were considered insufficient. Analysis of variance (ANOVA) was used for repeated measures, followed by Bonferroni post hoc test. To identify variables related to vitamin D, Pearson's correlation test and linear regression analysis were used. A significance level of 5% (p <0.05) was adopted.

A total of 646 patients were evaluated, with a mean age of 41.3 ± 10.8 years. Most of the patients were female (75%) and had 25OHD insufficiency in the preoperative period (79.1%). It was found that in the postoperative period there was an increase in vitamin D levels. Linear regression showed that the variation in vitamin D is negatively influenced by BMI in the preoperative period (β = -0.20; p = 0.02) and by BMI (β = -0.38; p <0.001) and by age (β = -0.08; p = 0.02) in the 6-month postoperative period.

There was an increase in vitamin D levels in the postoperative period. BMI proved to be a negative factor for obtaining adequate levels of vitamin D in the preoperative period and in the 6-month postoperative period.

There was an increase in vitamin D levels in the postoperative period. selleck products BMI proved to be a negative factor for obtaining adequate levels of vitamin D in the preoperative period and in the 6-month postoperative period.Despite advances in coloanal anastomosis techniques, satisfactory procedures completed without complications remain lacking. We investigated the effectiveness of our recently developed 'Short stump and High anastomosis Pull-through' (SHiP) procedure for delayed coloanal anastomosis without a stoma. In this retrospective study, we analysed functional outcomes, morbidity, and mortality rates and local recurrence of 37 patients treated using SHiP procedure, out of the 282 patients affected by rectal cancer treated in our institution between 2012 and 2020. The inclusion criterion was that the rectal cancer be located within 4 cm from the anal margin. One patient died of local and pulmonary recurrence after 6 years, one developed lung and liver metastases after 2 years, and one experienced local recurrence 2.5 years after surgery. No major leak, retraction, or ischaemia of the colonic stump occurred; the perioperative mortality rate was zero. Five patients (13.51%) had early complications. Stenosis of the anastomosis, which occurred in nine patients (24.3%), was the only long-term complication; only three (8.1%) were symptomatic and were treated with endoscopic dilation. The mean Wexner scores at 24 and 36 months were 8.3 and 8.1 points, respectively. At the 36-month check-up, six patients (24%) had major LARS, ten (40%) had minor LARS, and nine (36%) had no LARS. The functional results in terms of LARS were similar to those previously reported after immediate coloanal anastomosis with protective stoma. The SHiP procedure resulted in a drastic reduction in major complications, and none of the patients had a stoma.The benefits from cardiovascular implantable electronic devices (CIED) implantation in hemodialysis (HD) patients are still far to be thoroughly defined, especially on primary prevention. In addition, CIED placement is not a risk-free procedure, because it could be followed by a not negligible burden of complications that could compromise the health and the vascular access of HD patients. In fact, the arteriovenous fistula (AVF) dysfunction following CIED implantation is usually due to a hemodynamically significant alteration of blood flow. This condition could lead to a potential decrease of dialysis efficacy and a raised risk of thrombosis of both the central vein and the efferent vein of the AVF.The pathological pathway that leads to AVF dysfunction after CIED implantation may involve the irritating actions of the CIED and their leads to the vascular wall in HD patients that are more prone to show previous vascular diseases.The aim of this review is to focus the physiopathology of the CIED-induced AVF dysfunction, the current treatment strategies and the novel perspectives that could be taken into consideration and offered to the HD population to preserve both their AVF and their quality of life.

To compare long-term outcomes between photoselective vaporization (PVP) and Open simple prostatectomy (OSP) for prostates > 80cc.

Men operated either by PVP or OSP for BPH > 80cc were included in two expert centres. Functional and uroflowmetric outcomes were assessed pre- and postoperatively. Data were collected prospectively in the PVP group and retrospectively in the OSP group and compared at long-term follow-up. Complications and re-intervention rates were used as main outcomes.

332 men underwent surgery 132 PVP were performed in a fist expert-centre and 200 OSP were performed in a second one with a median follow-up of 54 and 48 months, respectively. Mean Prostate volume was similar between OSP and PVP group (119 vs 116cc). Major complications were more common in the OSP group (12.5 vs 1.5%, p < 0.001). At long-term follow-up, Qmax was higher and PVR was lower (p < 0.05) in the OSP group. IPSS score was similar between groups (p = 0.45) but the Qol was better in the OSP group (0.9 vs. 1.6; p < 0.05). There were more re-interventions in the PVP group compared to OSP (15.2 vs. 0%, p < 0.005).

PVP is a good alternative for prostates > 80cc particularly for fragile patients as it is associated with a lower complication rate. At long-term follow-up, IPSS was similar between groups, but Qol was better in the OSP group. Patients treated by PVP should be informed that they could require reoperation in 15% of the cases.

 80 cc particularly for fragile patients as it is associated with a lower complication rate. At long-term follow-up, IPSS was similar between groups, but Qol was better in the OSP group. Patients treated by PVP should be informed that they could require reoperation in 15% of the cases.There has perhaps been no issue as contentious in Covid-19 as face masks. The most contentious scientific debate has been between those who argue that "there is no scientific evidence", by which they mean that there are no randomized controlled trials (RCTs), versus those who argue that when the evidence is considered together, "the science supports that face coverings save lives". It used to be a 'given' that to decide whether a particular factor, either exogenous or endogenous, can cause a particular disease, and in what order of magnitude, one should consider all reasonably cogent evidence. This approach is being increasingly challenged, both scientifically and politically. The scientific challenge has come from methodologic views that focus on the randomized controlled trial (RCT) as the scientific gold standard, with priority being given, either to evidence from RCTs or to observational studies which closely mimic RCTs. The political challenge has come from various interests calling for the exclusion of epidemiological evidence from consideration by regulatory and advisory committees.

Toxic metabolic encephalopathy (TME) has been reported in 7-31% of hospitalized patients with coronavirus disease 2019 (COVID-19); however, some reports include sedation-related delirium and few data exist on the etiology of TME. We aimed to identify the prevalence, etiologies, and mortality rates associated with TME in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive patients.

We conducted a retrospective, multicenter, observational cohort study among patients with reverse transcriptase-polymerase chain reaction-confirmed SARS-CoV-2 infection hospitalized at four New York City hospitals in the same health network between March 1, 2020, and May 20, 2020. TME was diagnosed in patients with altered mental status off sedation or after an adequate sedation washout. Patients with structural brain disease, seizures, or primary neurological diagnoses were excluded. The coprimary outcomes were the prevalence of TME stratified by etiology and in-hospital mortality (excluding comfort care only rtality.

To assess the severity, evolution, and behaviour of several urinary symptoms in patients with obstructive sleep apnea syndrome (OSAS) before and after the treatment with continuous positive airway pressure (CPAP).

A prospective study was performedon patients with a recent diagnosis of sleep apnea confirmed by nocturnal sleep polygraphy and absence of medical urological past history. The symptom incidence was analysed seeking predictive factors for initial nocturia, nocturnal polyuria (NP), and unfavourable International Prostate Symptoms Score (IPSS)before and after a 1-year period of treatment using a CPAP device.Morphometric variables (body mass index, BMI; neck and abdominal diameter) and functional respiratory variables (FEV1, FVC, and FEV1/FVC) were analysed. A multivariate analysis was performed with a calculation of Pearson's correlation coefficient to establish a linear relation between the variables.

A total of 43 patients completed the two-step study (IPSS and bladder diary before and after the CPAP treatment). IPSS decreased by 3.58 points. Nocturia decreased to once per night. Neck diameter, FEV1, and FEV1/FVC significantly predicted the initial severity of somelower urinary tract symptoms (LUTS), (p=0.015, p=0.029, p=0.008, respectively). Neck diameter, abdominal perimeter, and FEV1/FVC significantly predicted the LUTS evolution throughout the study (p=0.023, p=0.007, p=0.05, respectively).

Some pre-treatment morphometry and spirometry parameters such as abdominal or neck diameter, FEV1, and FEV1/FVC were predictive of the severity and evolution of LUTS in patients with OSAS.

Some pre-treatment morphometry and spirometry parameters such as abdominal or neck diameter, FEV1, and FEV1/FVC were predictive of the severity and evolution of LUTS in patients with OSAS.Mining is responsible for drastic ecosystem changes and rehabilitation is used to promote the return of functions after these impacts. In this scenario, we investigated the responses of ant assemblages and diaspore removal by ants to the transformations caused by mining and rehabilitation predicting that (a) the increase in plant density (a proxy for mining intensity) led to an increase in ant richness, percentage of diaspores removed, and changes in species composition that in turn are correlated with changes in environmental variables; (b) the increase in vegetation structure (a proxy for rehabilitation ages) led to an increase in ant richness, percentage of diaspores removed, and changes in species composition that in turn are correlated with changes in environmental variables. Additionally, we also verified which functional groups were primarily responsible for diaspore removal. We sampled arboreal and epigeic ants, diaspore removal by ants, and environmental variables. We found that ant richness and diaspore removal in mining intensity gradient are positively correlated to plant density.