Nelsonrogers8947

Current studies about percutaneous endoscopic gastrostomy (PEG) tube placement report equivalent patient outcomes with prophylactic PEG tubes (pPEGs) versus common nutritional support. Unreported was if omitting a pPEG is associated with an increased risk of complications leading to a treatment-related unplanned hospitalization (TRUH).

TRUHs were retrospectively analyzed in patients with advanced head and neck squamous cell carcinoma (n = 310) undergoing (chemo)radiotherapy with (pPEG) or without PEG (nPEG).

In 88 patients (28%), TRUH was reported. One of the leading causes of TRUH in nPEG patients was inadequate oral intake (n = 16, 13%), and in pPEG patients, complications after PEG tube insertion (n = 12, 10%). Risk factors for TRUH were poor performance status, tobacco use, and surgical procedures.

Omitting pPEG tube placement without increasing the risk of an unplanned hospitalization due to dysphagia, dehydration or malnutrition, is an option in patients being carefully monitored. Patients aged > 60years with hypopharyngeal carcinoma, tobacco consumption, and poor performance status appear at risk of PEG tube-related complications leading to an unplanned hospitalization.

 60 years with hypopharyngeal carcinoma, tobacco consumption, and poor performance status appear at risk of PEG tube-related complications leading to an unplanned hospitalization.Hereditary transthyretin amyloidosis (ATTRv, v for variant) is a late-onset, autosomal dominant disease caused by progressive extracellular deposition of transthyretin amyloid fibrils, leading to organ damage and death. For other late-onset fatal diseases, as Huntington's disease, protocols for pre-symptomatic genetic testing (PST) are available since decades. For ATTRv, limited experience has been reported to date, mostly gathered before the availability of approved therapies. We aimed at developing recommendations for a safe and feasible PST protocol in ATTRv in the era of emerging treatments, taking also into account Italian patients' characteristics and healthcare system rules. After an initial survey on ongoing approaches to PST for ATTRv in Italy, two roundtable meetings were attended by 24 experts from 16 Italian centers involved in the diagnosis and care of this disease. Minimal requirements for PST offer and potential critical issues were highlighted. By November 2019, 457 families affected by ATTRv to offer at risk individuals the best chance for early diagnosis and timely treatment start, while respecting autonomous decisions and promoting safe psychological adjustment to the genetic result.

The aim was to investigate whether perceived work stress, overcommiment, balance in everyday life, individual factors and self-rated health in combination predict work ability among women and men in the public sector in Sweden.

A sample was randomly selected from the employee records of the participating public health care organisation in Western Sweden. In total, 2223 employees were included and answered a postal survey twice, at a 2 year interval. The survey included questions about work ability, perceived work stress, overcommitment, balance in everyday life, individual factors and self-rated health. Odds ratios with 95% confidence intervals for work ability were estimated using logistic regression.

Imbalance in everyday life and overcommitment predicted reduced work ability in women and imbalance in everyday life and low educational level predicted reduced work ability in men. However, when poor self-rated health was added to the models this was the strongest predictor of work ability for both genders.

A combination of poor self-rated health, imbalance in everyday life, and overcommitment predicted reduced work ability. This multifactorial nature of work ability should be taken into account in health promotion programmes.

A combination of poor self-rated health, imbalance in everyday life, and overcommitment predicted reduced work ability. This multifactorial nature of work ability should be taken into account in health promotion programmes.

To investigate the effect of cooking temperature and time on the total phenolic content, total flavonoid content and antioxidant activity of aqueous and ethanolic extracts of garlic.

The mean total phenolic content of fresh garlic were 303.07 ± 6.58mg gallic acid equivalent per 100g (GAE/100g) and 638.96 ± 15.30mg GAE/100g of plant material for the aqueous and ethanolic extracts respectively. The mean total flavonoid content 109.78 ± 6.78mg quercetin equivalent per 100g (QE/100g) and 258.47 ± 12.37 QE/100g for aqueous and ethanolic extracts respectively. Fourier transform infrared spectral data showed absorptions in the range for carboxylic acids, hydroxyl group, esters, and alcohols, confirming the presence of phenols and flavonoids in the extracts. Cooking temperature had a significant effect on total phenolic content and total flavonoid content while cooking time did not have a significant effect on the phytochemicals and antioxidant activity.

The mean total phenolic content of fresh garlic were 303.07 ± 6.58 mg gallic acid equivalent per 100 g (GAE/100 g) and 638.96 ± 15.30 mg GAE/100 g of plant material for the aqueous and ethanolic extracts respectively. The mean total flavonoid content 109.78 ± 6.78 mg quercetin equivalent per 100 g (QE/100 g) and 258.47 ± 12.37 QE/100 g for aqueous and ethanolic extracts respectively. Fourier transform infrared spectral data showed absorptions in the range for carboxylic acids, hydroxyl group, esters, and alcohols, confirming the presence of phenols and flavonoids in the extracts. Cooking temperature had a significant effect on total phenolic content and total flavonoid content while cooking time did not have a significant effect on the phytochemicals and antioxidant activity.

The paracrine effects of multipotent mesenchymal stromal cells (MSCs) are mediated by their secretome composed by soluble factors (i.e., cytokines, growth factors, hormones) and extracellular vesicles (EVs). EVs promote intercellular communication, and the EV cargoes [e.g., proteins, soluble factors, microRNAs (miRNAs), messenger RNA (mRNA), DNA] reflect the molecular and functional characteristics of their parental cells. MSC-derived EVs (MSC-EVs) are currently evaluated as subcellular therapeutics. A key function of the MSC secretome is its ability to promote immune tolerance (i.e., immunopotency), a property that is enhanced by priming approaches (e.g., cytokines, hypoxia, chemicals) and inversely correlates with the age of the MSC donors. We evaluated mechanisms underlying MSC vesiculation and the effects of inflammation and aging on this process.

We evaluated the effects of interferon gamma (IFN-γ) and tumor necrosis factor alpha (TNF-α) on human adipose-derived MSC (a) vesiculation (custom RT

Profl applications.

Cytokine priming is a useful strategy to harvest anti-inflammatory MSC-sEVs for clinical applications. Of relevance, donor age should be considered in the selection of MSC-sEVs for clinical applications.The enthusiasm for immune checkpoint inhibitors (ICIs), an efficient tumor treatment model different from traditional treatment, is based on their unprecedented antitumor effect, but the occurrence of immune-related adverse events (irAEs) is an obstacle to the prospect of ICI treatment. IrAEs are a discrete toxicity caused by the nonspecific activation of the immune system and can affect almost all tissues and organs. read more Currently, research on biomarkers mainly focuses on the gastrointestinal tract, endocrine system, skin and lung. Several potential hypotheses concentrate on the overactivation of the immune system, excessive release of inflammatory cytokines, elevated levels of pre-existing autoantibodies, and presence of common antigens between tumors and normal tissues. This review lists the current biomarkers that might predict irAEs and their possible mechanisms for both nonspecific and organ-specific biomarkers. However, the prediction of irAEs remains a major clinical challenge to screen and identify patients who are susceptible to irAEs and likely to benefit from ICIs.

Circular RNAs (circRNAs), important members of the noncoding RNA family, have been recently revealed to play a role in the pathogenic progression of diseases, particularly in the malignant progression of cancer. With the application of high-throughput sequencing technology, a large number of circRNAs have been identified in tumor tissues, and some circRNAs have been demonstrated to act as oncogenes. In this study, we analyzed the circRNA expression profile in colorectal cancer (CRC) tissues and normal adjacent tissues by high-throughput sequencing. We focused on circRNA_0000392, a circRNA with significantly increased expression in CRCtissues, and further investigated its function in the progression of colorectal cancer.

The expression profile of circRNAs in 6 pairs of CRC tissues and normal adjacent tissues was analyzed by RNA sequencing. We verified the identified differentially expressed circRNAs in additional samples by qRT-PCR and selected circRNA_0000392 to evaluate its associations with clinicopathoictive marker for CRC patients.

CircRNA_0000392 functions as an oncogene through the miR-193a-5p/PIK3R3/Akt axis in CRC cells, suggesting that circRNA_0000392 is a potential therapeutic target for the treatment of colorectal cancer and a predictive marker for CRC patients.

Multiple trauma in mountain environments may be associated with increased morbidity and mortality compared to urban environments.

To provide evidence based guidance to assist rescuers in multiple trauma management in mountain environments.

All articles published on or before September 30th 2019, in all languages, were included. Articles were searched with predefined search terms.

PubMed, Cochrane Database of Systematic Reviews and hand searching of relevant studies from the reference list of included articles.

Evidence was searched according to clinically relevant topics and PICO questions.

Two-hundred forty-seven articles met the inclusion criteria. Recommendations were developed and graded according to the evidence-grading system of the American College of Chest Physicians. The manuscript was initially written and discussed by the coauthors. Then it was presented to ICAR MedCom in draft and again in final form for discussion and internal peer review. Finally, in a face-to-face discussion within sfer to a trauma centre and should be as short as possible. Reduced on-scene times may be achieved with helicopter rescue. Advanced diagnostics (e.g. ultrasound) may be used and treatment continued during transport.

Little is known on the association between local signs and intravascular catheter infections. This study aimed to evaluate the association between local signs at removal and catheter-related bloodstream infections (CRBSI), and which clinical conditions may predict CRBSIs if inflammation at insertion site is present.

We used individual data from four multicenter randomized controlled trials in intensive care units (ICUs) that evaluated various prevention strategies for arterial and central venous catheters. We used multivariate logistic regressions in order to evaluate the association between ≥ 1 local sign, redness, pain, non-purulent discharge and purulent discharge, and CRBSI. Moreover, we assessed the probability for each local sign to observe CRBSI in subgroups of clinically relevant conditions.

A total of 6976 patients and 14,590 catheters (101,182 catheter-days) and 114 CRBSI from 25 ICUs with described local signs were included. More than one local sign, redness, pain, non-purulent discharge, and purulent discharge at removal were observed in 1938 (13.