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Locally advanced rectal cancer has broadly been defined as T3, T4, or lymph node-positive disease. In the 1990s, adjuvant chemoradiation was considered the optimal management for locally advanced rectal cancer. However, the paradigm shifted when the German CAO/ARO/AIO-94 Rectal Cancer trial established neoadjuvant chemoradiation as the standard of care, based on reduced rates of toxicity and local recurrence, as well as higher rates of sphincter preservation compared with postoperative chemoradiation. Both short-course radiation and long-course chemoradiation are currently accepted methods for neoadjuvant treatment, with recent trials showing equivalence in outcomes. While surgery remains the cornerstone of treatment, there are data supporting the use of magnetic resonance imaging for risk stratification in rectal cancer and encouraging prospective data regarding nonoperative management. This review summarizes data on the evolution of treatment for locally advanced rectal cancer and discusses emerging evidence for nonoperative management.

Between 30 and 70% of patients admitted to the intensive care unit (ICU) have acute kidney injury (AKI), and 10% of these patients will require renal replacement therapy (RRT). A significant number of studies have compared the mortality of patients who require RRT versus those who do not require it, finding an increase in mortality rates in the short and medium term; however, few studies have evaluated the long-term survival in a mixture of patients admitted to the ICU.

To evaluate the impact of RRT on 5-year survival in patients with AKI admitted to the ICU.

Using administrative databases of insurers of the Colombian health system, a cohort of patients admitted to the ICU between 1 January 2012 and 31 December 2013 was followed until 31 December 2018. ICD-10 diagnoses, procedure codes, and prescribed medications were used to establish the frequencies of the comorbidities included in the Charlson index. Patients were followed for at least 5 years to evaluate survival and establish the adjusted risks by .High oxygen tension in blood and/or tissue affects clinical outcomes in several diseases. Thus, the optimal target PaO2 for patients recovering from cardiac arrest (CA) has been extensively examined. Many patients develop hypoxic brain injury after the return of spontaneous circulation (ROSC); this supports the need for oxygen administration in patients after CA. Insufficient oxygen delivery due to decreased blood flow to cerebral tissue during CA results in hypoxic brain injury. By contrast, hyperoxia may increase dissolved oxygen in the blood and, subsequently, generate reactive oxygen species that are harmful to neuronal cells. This secondary brain injury is particularly concerning. Oxaliplatin order Although several clinical studies demonstrated that hyperoxia during post-CA care was associated with poor neurological outcomes, considerable debate is ongoing because of inconsistent results. Potential reasons for the conflicting results include differences in the definition of hyperoxia, the timing of exposure to hyperoxia, and PaO2 values used in analyses. Despite the conflicts, exposure to PaO2 > 300 mmHg through administration of unnecessary oxygen should be avoided because no obvious benefit has been demonstrated. The feasibility of titrating oxygen administration by targeting SpO2 at approximately 94% in patients recovering from CA has been demonstrated in pilot randomized controlled trials (RCTs). Such protocols should be further examined.

While goose populations worldwide benefit from food provided by farmland, China's threatened wintering goose populations have failed to capitalize on farmland. It has been proposed that, due to an exceptionally intense human pressure on Chinese farmland, geese cannot exploit farmland in their wintering sites and hence are confined to their deteriorating natural habitat. If this were true, locally decreasing this human pressure on farmland 'refuges' would represent a promising conservation measure.

We investigate habitat use of two declining migratory goose species in their core wintering (Yangtze River Floodplain) and stopover (Northeast China Plain) regions, compare the human pressure level at both regions, and adopt a mixed-effect resource selection function model to test how human pressure, food resource type (farmland or wetland/grass), distance to roosts, and their interaction terms influence the utilization of food resources for each species and region. To this aim we use satellite tracking of 28 tus wintering goose populations. Our study has important conservation implications and offers a practical measure for migratory waterfowl conservation in areas of high human-wildlife conflict.

Our findings suggest that if human pressure were to decrease in the farmlands close to the roost, China's wintering geese could benefit from farmland. We recommend setting aside farmland near roosting sites that already experiences a relatively low human pressure as goose refuges, and adopt measures to further reduce human pressure and increase food quality and quantity, to help counter the decline of China's wintering goose populations. Our study has important conservation implications and offers a practical measure for migratory waterfowl conservation in areas of high human-wildlife conflict.Pseudoaneurysm should be considered in the differential diagnosis when the computed tomography (CT) findings show a mediastinal mass in patients with a history of cardiovascular surgery even if such surgery occurred over two decades previously.We report the case of a 24-year-old man who presented with chief complaints of shortness of breath and haemoptysis; chest radiography revealed complete collapse of the left lung. Bronchoscopy revealed an endobronchial tumour with complete obstruction of the left main bronchus. Cryosurgical excision was performed; tissue pathology confirmed the diagnosis of metastatic embryonal carcinoma. The patient underwent a right orchiectomy followed by a bleomycin + etoposide + cisplatin (BEP) chemotherapy regimen.Clinicians should be careful when examining a case with endobronchial hamartoma with concurrent malignant disease because radiographic imaging and symptoms cannot clearly differentiate between both diseases.