Whitfieldmedeiros0256
More patients undergoing LGCP experienced nausea and vomiting. We obtained some different and new results compared to the previously published meta-analysis. Our meta-analysis showed significantly higher %EWL at 24 months (Z=2.08, p=0.04), significantly higher BMIL at 36 months (Z=9.11, p less then 0.00001), and significantly higher costs (Z=2.87, p=0.004) in the LSG group. In addition, for the first time, complications (i.e., GERD, wound infection, port-site hernia, and mortality) and improvement of dyslipidemia were compared between the two techniques. According to our pooled data, no significant differences were found in any of the above aspects. In conclusion, LSG is superior to LGCP with regard to providing effective weight loss in the short- and mid-term. LSG has a lower rate of minor complications, but was less effective when considering cost. The two procedures are similar in terms of improvement of comorbidities, major complications, operative time, and length of stay.
Sleeve gastrectomy (SG) has become one of the most performed bariatric procedures worldwide. Its main weaknesses are weight regain and gastroesophageal reflux disease (GERD). Conversion to Roux-en-Y gastric bypass (RYGB) is considered the gold standard to manage GERD and related symptoms.
Retrospective evaluation from a prospective bariatric surgery database of all our institution's patients converted from SG to RYGB due to GERD between January 2010 and December 2018. Clinical characteristics and workups before SG and before and after RYGB were analyzed.
During the study period, 35 patients needed a conversion to RYGB, due to GERD or GERD-related symptoms. Mean age was 48.6 years, 85.7% were women, and mean BMI was 31.4 kg/m
. The interval between SG and RYGB was in a range 7 to 70 months (mean 33 months). All conversions were completed laparoscopically, associating a hiatoplasty in 45.7% of cases. A complete remission of symptoms was observed in 74% of patients, some improvement in 20%, and no relief in 6%. There were 3 cases of hiatal hernia persistence and 2 of recidivism. Only 1 patient presented pathological pHmetry, while moderate esophagitis was demonstrated in 2 patients.
Conversion to RYGB was effective in almost all patients. Pathological acid exposure and hiatal hernias seem to be the main findings prior to conversion, justifying an exhaustive examination and aggressive approach to the hiatus. Due to the insufficient correlation between symptoms and findings on morphological and functional tests, actively searching for signs of GERD is advisable.
Conversion to RYGB was effective in almost all patients. Pathological acid exposure and hiatal hernias seem to be the main findings prior to conversion, justifying an exhaustive examination and aggressive approach to the hiatus. Due to the insufficient correlation between symptoms and findings on morphological and functional tests, actively searching for signs of GERD is advisable.
The aim of this study was to evaluate risk factors for COVID-19 infection and mortality and to document if any relation exists between 25 (OH) Vitamin D and COVID-19 infection.
This retrospective study evaluated 151 HD patients. Patients infected with COVID-19 were compared to patients without the infection. Risk factors for intensive care unit (ICU) stay and mortality were analyzed. Deceased infected patients were also compared to patients who died due to other causes.
The mean age of all HD patients was 57.15 ± 15.73years and 51.7% were male. The mean 25 (OH) Vitamin D level of all patients was 16.48 ± 8.45ng/ml. Thirty-five infected patients were significantly older, had a higher Charlson comorbidity index (CCI) score. They also had a higher number of patients with diabetic nephropathy, cerebrovascular accident (CVA) and coronary heart disease (CHD). Patients who needed to stay in ICU had higher CCI score, a higher number of patients with diabetic nephropathy, pulmonary diseases and had statisticallyre found as poor prognostic factors. The comparisons yielded no significant finding for 25 (OH) Vitamin D, acetylsalicylic acid, erythropoietin, intravenous iron, ACEI, ARBs, and dialysis adequacy parameters.
Ureteroscopy is widely applied in pregnant women with renal colic, but such patients are easy to experience uterine contraction after surgery. There are many factors which may affect uterine contraction, this study aims to explore the risk factors of uterine contraction triggered by ureteroscopy in pregnant women with renal colic.
One hundred and one pregnant women were retrospectively analyzed, the patients were hospitalized because of severe renal colic. All patients received ureteroscopy during which double J catheters were inserted into ureters for drainage. Patients received other medical treatments individually according to their condition and uterine contractions were detected by EHG within 12h after operation. Patients were classified as group A (uterine contraction) and group B (no uterine contraction) according to the presence or absence of continuously regular uterine contraction. Clinical characteristics were collected for further analysis, including history of childbirth, anesthesia method, aon is easy to occur within 12h after ureteroscopy in pregnant women. SIRS occurred after surgery is a risk factor for uterine contraction; on the contrary, no history of childbirth, shorter operation time, application of phloroglucinol, pain relief after surgery are protective factors.
Continuously regular uterine contraction is easy to occur within 12 h after ureteroscopy in pregnant women. SIRS occurred after surgery is a risk factor for uterine contraction; on the contrary, no history of childbirth, shorter operation time, application of phloroglucinol, pain relief after surgery are protective factors.
Hydronephrosis is the dilation of the pelvicalyceal system due to the urine flow obstruction in one or both kidneys. Conventionally, renal pelvis anterior-posterior diameter (APD) was used for quantifying hydronephrosis in medical images (e.g., ultrasound, CT, and functional MRI). Our study aimed to automatically detect and quantify the fluid and kidney areas on ultrasonography, using a deep learning approach.
An attention-Unet was used to segment the kidney and the dilated pelvicalyceal system with fluid. The gold standard for diagnosing hydronephrosis was the APD >1.0cm. For semi-quantification, we proposed a fluid-to-kidney-area ratio measurement, i.e., [Formula see text], as a deep learning-derived biomarker. Dice coefficient, confusion matrix, ROC curve, and Z-test were used to evaluate the model performance. Linear regression was applied to obtain the fluid-to-kidney-area ratio cutoff for detecting hydronephrosis.
For regional kidney segmentation, the Dice coefficients were 0.92 and 0.83 for the kidney and dilated pelvicalyceal system, respectively. The sensitivity and specificity of detecting dilated pelvicalyceal system were 0.99 and 0.83, respectively. The linear equation was fluid-to-kidney-area ratio = (0.213 ± 0.004) × APD (in cm) for 95% confidence interval on the slope with R
=0.87. The fluid-to-kidney-area ratio cutoff for detecting hydronephrosis was 0.213. The sensitivity and specificity for detecting hydronephrosis were 0.90 and 0.80, respectively.
Our study confirmed the feasibility of deep learning characterization of the kidney and fluid, showing an automatic pediatric hydronephrosis detection.
Our study confirmed the feasibility of deep learning characterization of the kidney and fluid, showing an automatic pediatric hydronephrosis detection.
The chance of incidentally detecting brain tumors is increasing as the utilization of magnetic resonance imaging (MRI) becomes more prevalent. 1Thioglycerol In this background, knowledge is accumulating in relation to the prediction of their clinical sequence. However, their prevalence-especially the prevalence of glioma-has not been adequately investigated according to age, sex, and region.
We systematically reviewed the articles according to the PRISMA statement and calculated the prevalence of meningiomas and diffuse gliomas in adults using a generalized linear mixed model. Specifically, the differences related to age, sex, and region were investigated.
The pooled prevalence of incidental meningiomas in MRI studies was 0.52% (95% confidence interval (CI) [0.34-0.78]) in 37,697 individuals from 36 studies. A meta-regression analysis showed that the prevalence was significantly higher in elderly individuals, women, and individuals outside Asia; this remained statistically significant in the multivariate meta-regression analysis. The prevalence reached to 3% at 90years of age. In contrast, the prevalence of gliomas in 30,918 individuals from 18 studies was 0.064% (95%CI [0.040 - 0.104]). The meta-regression analysis did not show a significant relationship between the prevalence and age, male sex, or region. The prevalence of histologically confirmed glioma was 0.026% (95%CI [0.013-0.052]).
Most of meningiomas, especially those in elderlies, remained asymptomatic, and their prevalence increased with age. However, the prevalence of incidental gliomas was much lower and did not increase with age. The number of gliomas that developed and the number that reached a symptomatic stage appeared to be balanced.
Most of meningiomas, especially those in elderlies, remained asymptomatic, and their prevalence increased with age. However, the prevalence of incidental gliomas was much lower and did not increase with age. The number of gliomas that developed and the number that reached a symptomatic stage appeared to be balanced.
This study aimed to identify the association between the number of anterior choroidal arteries (AchoAs) and procedure-related ischemic complications in microsurgical clipping of unruptured AchoA aneurysms.
We retrospectively reviewed the clinical, radiological, and intraoperative findings of 153 patients with unruptured AchoA aneurysms treated with microsurgical clipping between January 2012 and November 2020 in a single tertiary institution. Intraoperative video clips were reviewed, and the AchoA type was categorized into two according to the number of AchoAs (1) single-type group with single origin and single branch and (2) multiple-type group with duplicated origin or divided multiple branches. Uni- and multivariate analyses were performed to assess the relationship between clinical and radiological factors and perioperative ischemic complications.
Of the 153 patients, 52 (34%) were categorized as multiple-type group. The frequency of perioperative ischemic complications, including decreased intraopeative ischemic complications can be minimized by recognizing these variations and using multimodal approach with MEP monitoring.It is essential for the sustainable development of agriculture to enhance nitrogen use efficiency (NUE) of crop plants by increasing yield and reducing nitrogen (N) losses. Biochar-based fertilizer (BF) has received increasing attention because of its full play to the advantages of chemical compounds with sufficient N and less N loss risk with good adsorption characteristics, but this potential was seldom reported for open-field vegetable crops, NUE of which were significantly lower than cereal crops. A field trial was conducted to investigate the efficacy of BF on NUE in vegetable cropping system by comparison with chemical fertilizer (CF) and partial substitution of organic fertilizers to chemical fertilizers (COF). The yield, plant N uptake, residual soil mineral N, and N losses via leaching and ammonia volatilization from an open vegetable (water spinach, Ipomoea aquatica L.) field were analyzed. The results indicated that BF treatment had significantly higher yield, plant N uptake, and NUE (agronomic efficiency and recovery efficiency as the NUE indicators), compared with those of CF and COF treatments.