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Background Palliative care remains suboptimal in end-stage liver disease. Aim To inform a definitive study, we assessed palliative long-term abdominal drains in end-stage liver disease to determine recruitment, attrition, safety/potential effectiveness, questionnaires/interview uptake/completion and make a preliminary cost comparison. Methods A 12-week feasibility nonblinded randomised controlled trial comparing large-volume paracentesis vs long-term abdominal drains in refractory ascites due to end-stage liver disease with fortnightly home visits for clinical/questionnaire-based assessments. Study success criteria were attrition not >50%, less then 10% long-term abdominal drain removal due to complications, the long-term abdominal drain group to spend less then 50% ascites-related study time in hospital vs large-volume paracentesis group and 80% questionnaire/interview uptake/completion. Results Of 59 eligible patients, 36 (61%) were randomised, 17 to long-term abdominal drain and 19 to large-volume paraceonclusions The REDUCe study demonstrates feasibility with preliminary evidence of long-term abdominal drain acceptability/effectiveness/safety and reduction in health resource utilisation. Trial registration ISRCTN30697116, date assigned 07/10/2015.Endoscopic therapies have evolved significantly over the last decade as minimally invasive therapies for GERD (1). Antireflux Mucosectomy (ARMS) was first described in 2003, however the pilot series was reported in Refractory GERD in 2014. Sumi et al recently published their findings of ARMS in a retrospective series of 109 patients with PPI refractory GERD (2). There was significant improvement in the FSSQ and GERDQ for subjective assessment of symptoms, with decrease in Acid Exposure Time (AET) and DeMeester's score.Background Stack-of-radial multiecho gradient-echo MRI is promising for free-breathing liver R 2 * quantification and may benefit children. Purpose To validate stack-of-radial MRI with self-gating motion compensation in phantoms, and to evaluate it in children. Study type Prospective. Phantoms Four vials with different R 2 * driven by a motion stage. Subjects Sixteen pediatric patients with suspected nonalcoholic fatty liver disease or steatohepatitis (five females, 13 ± 4 years, body mass index 29.2 ± 8.6 kg/m2 ). Field strength/sequences Stack-of-radial, and 2D and 3D Cartesian multiecho gradient-echo sequences at 3T. Assessment Ungated and gated stack-of-radial proton density fat fraction (PDFF) and R 2 * maps were reconstructed without and with self-gating motion compensation. Stack-of-radial R 2 * measurements of phantoms without and with motion were validated against reference 2D Cartesian results of phantoms without motion. In subjects, free-breathing stack-of-radial and reference breath-hold 3D Cartesctively. https://www.selleckchem.com/products/ertugliflozin.html Interobserver agreement was excellent (ICC for PDFF = 0.99, ICC for R 2 * = 0.90; P less then 0.0003). Data conclusion Stack-of-radial MRI with self-gating motion compensation seems to allow free-breathing liver R 2 * and PDFF quantification in children. Level of evidence 2 TECHNICAL EFFICACY STAGE 2.Aim Rapid eye movement sleep behaviour disorder (RBD) is characterized by abnormal behaviours accordant with nightmares during rapid eye movement sleep and is considered a prodromal marker of dementia with Lewy body. Most common in the elderly population, RBD is generally treated with clonazepam (CZP), a long-term acting benzodiazepine antiepileptic. As such, alternative drugs for RBD are urgently needed to minimize the adverse effects peculiar to benzodiazepines. The efficacy of yokukansan (YKS), a traditional Japanese herbal medicine, on RBD was initially reported by Shinno et al. in 2008. However, no study has compared YKS with CZP. Therefore, this study aimed to clarify the possibility of using YKS as an alternative to CZP. Methods This was a retrospective cohort study conducted at Jikei University Affiliated Hospital. The subjects were selected from 36 outpatients who had been diagnosed with RBD based on the International Classification of Sleep Disorders, third edition. Of the 23 who met the inclusion cble adverse events. Further study is needed to prospectively clarify the efficacy and safety of YKS in more detail.Background A walking blood bank (WBB) refers to the use of fellow combatants for battlefield blood donation. This requires pretesting combatants for infectious diseases and blood type. A fundamental prerequisite for this technique is that the donating soldier will suffer minimal physiological and mental impact. The purpose of the current study is to assess the effect of blood shedding on battlefield performance. Methods This is a double-blind randomized control trial. Forty Israel Defense Forces combatants volunteered for the study. Participants underwent baseline evaluation, including repeated measurement of vital signs, cognitive evaluation, physical evaluation, and a strenuous shooting test. Three weeks after the baseline evaluation, subjects were randomized to either blood donation or the control group. For blinding purposes, all subjects underwent venous catheterization for the duration of a blood donation. Repeated vital signs and function evaluation were then performed. Results Thirty-six patients were available for randomization. Baseline measurements were similar for both groups. Mean strenuous shooting score was 80.5 ± 9.5 for the control group and 82 ± 6.6 for the test group (p = 0.58). No clinically or statistically significant differences were found in tests designed to evaluate cognitive performance or physical functions. Vital signs taken multiple times were also similar between the test and control groups. Conclusions Executive, cognitive, and physical functions were well preserved after blood donation. This study supports the hypothesis that a WBB does not decrease donor combat performance. The categorical prohibition of physical exercise following blood donation might need to be reconsidered in both military and civilian populations.In mouse motor synapses tetanic neuromuscular activity (30 Hz, 2 min) led to a delayed posttetanic potentiation of amplitude and duration of spontaneous miniature endplate potentials (MEPPs). Microelectrode recordings of MEPPs before and after nerve stimulation showed an increase in MEPP amplitude and time course by 30% and 15%, respectively, without changes in their frequency. Peak effect was detected 20 min after tetanic activity and progressively faded throughout the next 40 min of recording. The revealed potentiation of MEPPs was fully preserved in preparations from pannexin 1 knockout mice. It means, that myogenic ATP released via pannexin 1 channels from contracting muscle fibers is not likely to participate in the described phenomenon. But posttetanic potentiation of MEPPs was fully prevented by competitive antagonist of calcitonin gene-related peptide (CGRP) receptors CGRP8-37 , ryanodine receptors inhibitor ryanodine and by vesicular acetylcholine transporter inhibitor vesamicol. It is suggested that the combination of intensive synaptic and contractile activity in neuromuscular junctions is required to induce Ca2+ -dependent exocytosis of endogenous CGRP.