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0 versus 35.7years, p<0.05). In the multivariate model, a high GTCS frequency at onset (p=0.026) was a prognostic factor of drug resistance.

JME is often regarded as a benign epileptic syndrome, although a quarter of the individuals have refractory epilepsy. The possibility of withdrawing ASMs in patients who have been free of seizures over an extended time seems feasible.

JME is often regarded as a benign epileptic syndrome, although a quarter of the individuals have refractory epilepsy. The possibility of withdrawing ASMs in patients who have been free of seizures over an extended time seems feasible.

Men develop gastric cancer more frequently than women, yet little is known about the mechanisms underlying this sex difference. Sex steroid hormones may influence gastric cancer risk. learn more We therefore assessed whether major circulating adrenal precursors, androgens and estrogens were associated with gastric cancer in a high-risk Mexican population.

Blood samples were collected at time of diagnosis from 50 noncardia gastric cancer patients and 50 histologically confirmed non-atrophic gastritis controls. Serum levels of estradiol, testosterone and dehydroepiandrosterone (DHEA) measured with a validated mass spectrometry method were categorized in tertiles as low (T1), middle (T2), and high (T3). Unconditional logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CI), adjusting for age, sex, and education.

Levels of DHEA were inversely associated with gastric cancer (p-trend per tertile increase <0.0001), with adjusted ORs (95% CI) of T2 and T3 (vs. T1) of 0.25 (0.09-0.70) and 0.10 (0.03-0.34), respectively. Levels of estradiol and testosterone were not significantly associated with gastric cancer.

Our study provides evidence that higher concentration of circulating DHEA may be associated with lower risk of noncardia gastric cancer. Longitudinal studies are needed to evaluate the temporality of this association and investigate mechanisms of disease pathogenesis.

Our study provides evidence that higher concentration of circulating DHEA may be associated with lower risk of noncardia gastric cancer. Longitudinal studies are needed to evaluate the temporality of this association and investigate mechanisms of disease pathogenesis.

Ubiquitin-52 amino acid fusion protein (UbA52) is an important factor in the pathogenesis of diabetic kidney disease (DKD) and has been suggested a potential marker in the disease. However, whether upregulation of UbA52 marks early kidney injury in T2DM mellitus (T2DM) patients remains unclear. In this study, we examine the diagnostic value of UbA52 as a biomarker in predicting early diabetic kidney disease (DKD) in T2DM patients.

We used two-step ELISA to test UbA52 level in urine of 3 defined patient groups. Samples from T2DM patients without albuminuria or diabetic retinopathy (DM-WNP; n=30), T2DM patients with albuminuria and diabetic retinopathy, excluding other renal diseases clinically (DM-NP; n=30) and healthy controls (n=30) were analyzed. Spearman's correlation analysis and multiple linear regression model were used to analyze the correlation of urinary UbA52 level with laboratory results regarding kidney function. Receiver operating characteristic curve (ROC) was used to evaluate the diagnosticbA52 level. Urinary UbA52 could serve as an early marker in the diagnosis of DKD. ClinicalTrials.gov Identifier NCT02204280.We present the case of a male patient with severe SARS-CoV-2 pneumonia, with simultaneous onset of p-ANCA positive rapidly progressive glomerulonephritis. We discuss the different therapeutic possibilities, emphasising the appropriateness of their administration according to the time in the course of the infection.

The quality of the digital cast obtained from an intraoral scanner is an important comparison parameter for computer-aided design and computer-aided manufacturing (CAD-CAM) restorations. However, data on cast quality are typically provided by manufacturers, and objective evaluation of these devices is lacking.

The purpose of this invitro study was to build an evaluation protocol of 8 intraoral scanners by using an objective method for a small-scale model equivalent in size to a 4-tooth wide cast. In addition, a laboratory scanner was included to compare the performance of intraoral and extraoral devices.

An 8-mm-thick zirconia gauge block was scanned 10 times with a laboratory scanner (Iscan D104) and 8 intraoral scanners (Omnicam, Primescan, Itero element 5D, CS 3600, TRIOS 3, Emerald, Planscan, and Medit i500). The obtained digital casts were extracted as standard tessellation language (STL) files and analyzed to evaluate the digitizing noise, dimensional trueness, and dimensional precision of each scided coherent and repeatable results.

Preliminary assessment, via OMERACT filter, of manual and automated MRI hip effusion Volumetric Quantitative Measurement (VQM).

For 358 hips (93 osteoarthritis subjects, bilateral, 2 time points), 2 radiologists performed manual VQM using custom Matlab software. A Mask R-CNN artificial-intelligence (AI) tool was trained to automatically compute joint fluid volumes.

Manual VQM had excellent inter-observer reliability (ICC 0.96). AI predicted hip fluid volumes with ICC 0.86 (status), 0.58 (change) vs. 2 human readers.

Hip joint fluid volumes are reliably assessed by VQM. It is feasible to automate this approach using AI, with promising initial reliability.

Hip joint fluid volumes are reliably assessed by VQM. It is feasible to automate this approach using AI, with promising initial reliability.In 2017, the Brazilian Society of Anesthesiology (SBA) and the National Medical Residency Committee (CNRM) presented a joint competence matrix to train and evaluate physicians specializing in Anesthesiology, which was enforced in 2019. The competency-based curriculum aims to train residents in relation to certain results, in that residents are considered capable when they are able to act in an appropriate and effective manner within certain standards of performance. Canada and the United States (US) also use competency-based curriculum to train their professionals. In Canada, the format is the basis for using an evaluation method known as Entrustable Professional Activities (EPA), in which the mentor assesses residents' capacity to perform certain tasks, classified in 5 levels. The US, in turn, uses Milestones as evaluation, in which competencies and sub-competencies are assessed according to residents' progress during training. The present article aims to describe and compare the different competency-based curriculum and the evaluation methods used in the three countries, and proposes a reflection on future paths for medical education in Anesthesiology in Brazil.

One of the potential negative effects of a lockdown are changes in dietary and lifestyle patterns, which can lead to weight gain. Our objective was to assess the changes on dietary habits and eating patterns in a lockdown situation and their impact on weight. We aimed to determine whether the treatment with GLP1 analogues (aGLP1) could impact on these parameters.

100 overweight/obese patients were consecutively recruited for a review at the end of the lockdown. A structured interview was designed to see changes in dietary habits, routines and exercise.

52% patients gained weight during lockdown. The percentage of subjects with an active history of depression or anxiety was higher among the group of patients who gained weight. The percentage of patients who worsened their hyperphagia was higher in those who gained weight (71.2% vs. 10.6%; P<0.0001); similar results were observed with binge eating (92% vs. 10.6%; p<0.0001) and cravings, both sweet and salty (69.2% vs. 21.3% and 69.2% vs. 14.9%; p<0.0001 and p<0.0001 respectively). Of the 48 patients who did not gain weight, 30 were under aGLP1 treatment (61.7%). The worsening of abnormal eating patterns was lower among patients treated with aGLP-1.

A lockdown is a vulnerable period to gain weight, especially in those patients with a psychopathological history. aGLP1 manage to control emotional eating, making them a valuable therapeutic option.

A lockdown is a vulnerable period to gain weight, especially in those patients with a psychopathological history. aGLP1 manage to control emotional eating, making them a valuable therapeutic option.

The modified Glasgow prognostic score (mGPS) has been reported to have a prognostic value in various patient populations. However, the prognostic significance of mGPS has not been studied inacute pulmonary embolism (APE).

This study aimed to investigate the predictive value of mGPS on in-hospital mortality in patients with hemodynamically stableAPE.

We retrospectively included 258 hemodynamically stableAPE patients. Clinical, echocardiographic, and laboratory data recorded on admission. The mGPS scored as 0, 1, or 2 based on the C-reactive protein (CRP) and albumin levels.

A total of 258hemodynamically stableAPE patients were included, and 28 (10.9%) died during the hospital stay. Compared with survivors, non-survivors were older, had higher N-terminal pro-B-type natriuretic peptide, CRP, creatinine, high-sensitive cardiac troponin T (hs-cTnT), and mGPS levels, and had higher pulmonary embolism severity index (PESI) at study entry. In the multivariate logistic regression analysis, NT-proBNP>2350pg/mL (OR 2.180, 95% CI 1.102-5.213, p<0.001), hs-cTnT>21pg/mL (OR 1.426, 95% CI 0.951-3.751, p=0.001), CRP>3.1mg/dL (OR 1.567, 95% CI 1.072-4.429, p=0.001), PESI>139 (OR 2.745, 95% CI 0.869-6.369, p=0.001), systolic blood pressure<100mmHg (OR 3.465, 95% CI 0.867-8.934, p<0.001), mGPS=1 (OR 2.120, 95% CI 1.089-3.754, p=0.011), and mGPS=2 (OR 3.350, 95% CI 1.457-5.367, p<0.001) were independently associated with in-hospital mortality.

This study demonstrates the mGPS, which is a new and easily measurable marker, is a useful predictor in-hospital mortality in hemodynamically stableAPE.

This study demonstrates the mGPS, which is a new and easily measurable marker, is a useful predictor in-hospital mortality in hemodynamically stableAPE.

Post-operative pain is a common clinical problem after surgery, yet its predictors are inconsistent and unclear. This study examined whether pre-surgical vagal cardiac efferent nerve activity, indirectly indexed by heart rate variability (HRV), predicts patients' pain after epileptic surgery.

Using a prospective design, HRV was measured at rest during 5min in n=30 patients, prior to undergoing epileptic surgery. Post-operative pain was assessed every 8h during the first 2days after surgery, and our analyses focused on the worse pain level. We used multiple regression analyses and statistically considered several confounders (age, surgical duration, and analgesics during various surgical phases).

Multiple HRV indexes strongly and inversely predicted post-operative pain, with high-frequency HRV (HF-HRV) being the strongest predictor (r=-0.81, p<0.001). In a hierarchical multiple regression, HF-HRV accounted for an additional and significant 18% of the variance in post-operative pain, after statistically considering effects of age, surgical duration and effects of two anaesthetics.