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NIRS remote monitoring allowed for flap surveillance without requiring in-hospital presence and was able to identify both arterial and venous compromise.

NIRS was successfully implemented in a high-volume head and neck reconstructive practice. NIRS remote monitoring allowed for flap surveillance without requiring in-hospital presence and was able to identify both arterial and venous compromise.

Sarcopenia is associated with postoperative complications in patients undergoing digestive surgery. In this study, we investigated the impact of preoperative sarcopenia on postoperative complications in breast cancer patients who underwent total mastectomy.

Patients with breast cancer who underwent total mastectomy were included in the analysis. The relationship between the presence of sarcopenia and postoperative complications (e.g., skin flap necrosis and seroma) and between the incidence of these complications as well as preoperative and surgical factors was investigated. Moreover, the effects of sarcopenia on recurrence-free survival and overall survival were evaluated. The psoas muscle index calculated using values measured on preoperative computed tomography images was used to diagnose sarcopenia.

In total, 43 (49%) of 88 patients presented with sarcopenia. The number of patients with a Geriatric Nutritional Risk Index score <91 was higher in the sarcopenia group than in the non-sarcopenia group (p=0.011). Seroma was observed in 32 (36.4%) patients, and no significant difference was observed between the patients with and without sarcopenia (16 [35.6%] in the non-sarcopenia group vs 16 [37.2%] in the sarcopenia group). By contrast, skin flap necrosis was observed in 20 (22.7%) patients, and the number of patients with this complication was higher in the sarcopenia group than in the non-sarcopenia group (15 [34.9%] vs 5 [11.1%]).

Sarcopenia is a risk factor for skin flap necrosis and may be an important factor for preoperative evaluation in patients who will undergo total mastectomy.

Sarcopenia is a risk factor for skin flap necrosis and may be an important factor for preoperative evaluation in patients who will undergo total mastectomy.

Liver resection is an established treatment of choice for colorectal liver metastasis (CLM). However, the role of hepatectomy for non-colorectal liver metastasis (NCLM) is less clear.

From 2004 to 2017, 264 patients received curative hepatectomy for NCLM (n=28) and CLM (n=236). Propensity score (PS) matching was performed between two groups, with respect to the significant confounding factors. Short-term and long-term outcomes were compared between PS matched groups. Univariate analysis was performed to identify prognostic factors affecting overall and recurrence-free survival.

After PS matching, there were 28 patients in NCLM group and 56 patients in CLM group. With a median follow-up of 34 months, there was no significant difference in 5-year overall survival rate between NCLM and CLM groups (62% vs. 39%) (P=0.370). The 5-year recurrence-free survival rate was also comparable between NCLM and CLM groups (23% vs. 22%) (P=0.707). Use of pre-operative systemic therapy (hazard ratio 2.335, CI 1.157-4.712), multifocal tumors (hazard ratio 1.777, CI 1.010-3.127), tumor size (hazard ratio 1.135, CI 1.012-1.273), R1 resection (hazard ratio 2.484, CI 1.194-5.169) and severe complications (hazard ratio 6.507, CI 1.454-29.124), but not tumor type (NCLM vs. CLM), were associated with poor overall survival.

Hepatectomy for NCLM can achieve similar oncological outcomes in selected patients as those with CLM. Significant prognostic factors were identified associating with worse overall survival.

Hepatectomy for NCLM can achieve similar oncological outcomes in selected patients as those with CLM. Significant prognostic factors were identified associating with worse overall survival.The Coronavirus disease 2019 (COVID-19) has emerged as a new global health threat. By increasing the risk of isolation, fear, stigma, abuse and economic fallout, COVID-19 has led to increase in risk of psychiatric disorders, chronic trauma and stress, which eventually increase suicidality and suicidal behavior. There is limited data on association of pandemics and suicides. Cases of suicides have been rising since COVID-19 first emerged in China. The association between suicides and pandemics can possibly be explained through various models like Durkheim's theory, Joiner's interpersonal theory, social stress theory, biological theories, etc. The frontline workers, elderly, migrants, homeless, socio-economically impoverished classes as well as those with pre-existing mental disorders, substance abuse and family history of suicides are at higher risk. Suicides are preventable and need early detection, awareness and socio-culturally tailored interventions. This narrative review draws global perspectives on the association of suicidality and pandemics, the theories and risk factors related to same based on the available evidence. It also hypothesizes neuroimmunity and immune based risk factors as possible links between the psychosocial vulnerabilities and suicide during outbreaks like COVID-19. Proposed strategies of suicide-prevention, as an integral part of public health response to the pandemic are subsequently discussed.

Pregnant women and women who recently gave birth are vulnerable to COVID-19-related psychosocial stresses.

We assessed COVID-19-related health worries and grief, and current mental health symptoms (depression, generalized anxiety, and PTSD) in 1,123 U.S. Selleckchem Deferiprone women during the COVID-19 pandemic (May 21 to August 17, 2020) through a cross-sectional study design.

Among our respondents, 36.4% reported clinically significant levels of depression, 22.7% for generalized anxiety, and 10.3% for PTSD. Women with pre-existing mental health diagnoses based on their self-reported history were 1.6-to-3.7 more likely to score at clinically significant levels of depression, generalized anxiety, and PTSD. Approximately 18% reported high levels of COVID-19-related health worries and were 2.6-to-4.2 times more likely to score above the clinical threshold for mental health symptoms. Approximately 9% reported high levels of grief and were 4.8-to-5.5 times more likely to score above the clinical threshold for mental health symptoms.

Perinatal women with pre-existing mental health diagnoses show elevated symptoms during the COVID-19 pandemic. Although causation cannot be inferred, COVID-19-related health worries and grief experiences may increase the likelihood of mental health symptoms among those without pre-existing mental health concerns. Providers should develop strategies for addressing health-related worry and grief within their practice.

Perinatal women with pre-existing mental health diagnoses show elevated symptoms during the COVID-19 pandemic. Although causation cannot be inferred, COVID-19-related health worries and grief experiences may increase the likelihood of mental health symptoms among those without pre-existing mental health concerns. Providers should develop strategies for addressing health-related worry and grief within their practice.Environmental risk factors that operate at foetal or neonatal levels increase the vulnerability to schizophrenia, plausibly via stress-immune activation that perturbs the epidermal growth factor (EGF) system, a system critical for neurodevelopment. We investigated potential associations between environmental insults and immune and EGF system changes through a maternal immune activation (MIA) model, using the precocial spiny mice (Acomys cahirinus). After mid-gestation MIA prepubescent offspring showed elevated NF-κB1 protein in nucleus accumbens, decreased EGFR in caudate putamen and a trend for increased PI3K-110δ in ventral hippocampus. Thus, prenatal stress may cause a heightened NF-κB1-mediated immune attenuation of EGF system signalling.A concise chemoenzymatic route toward enantiomerically enriched active pharmaceutical ingredients (API) - diprophylline and xanthinol nicotinate - is reported for the first time. The decisive step is an enantioselective lipase-mediated methanolysis of racemic chlorohydrin-synthon acetate, namely 1-chloro-3-(1,3-dimethyl-2,6-dioxo-1,2,3,6-tetrahydro-7H-purin-7-yl)propan-2-yl acetate, performed under kinetically-controlled conditions on a preparative 500 mg-scale. The best results in terms of reaction enantioselectivity (E = 14) were obtained for the enantiomers resolution performed with lipase type B from Candida antarctica immobilized on acrylic resin (CAL-B, Novozym 435) suspended in homophasic acetonitrile-methanol mixture. The elaborated biocatalytic system furnished the key chlorohydrin intermediate (in 71% ee and 38% yield), which was then smoothly converted into enantioenriched active agents (R)-(-)-diprophylline (57% ee) and (S)-(+)-xanthinol nicotinate (65% ee). To support the assignment of absolute configurations of EKR-products as well as to confirm the stereochemical outcome of the remaining reaction steps, docking studies toward the prediction of enantiomers binding selectivity in CAL-B active site as well as the respective chemical correlations with enantiomerically enriched analytical standards obtained from commercially available (R)-(-)-epichlorohydrin, were applied. In addition, single-crystal X-ray diffraction (XRD) analyses were performed for the synthesized optically active APIs furnishing by this manner a first crystal structures of nicotinic acid salt of xanthinol.A new series of pyrrole analogs were developed via the microwave irradiation synthesis. Consequently, got a high yield of the products. As pyrroles are familiar for showing various biological properties, all obtained compounds were screened for their antioxidant properties, most of the compounds showing significant activity. In fact, the motifs 5e, 5g, 5h and 5m showed outstanding antioxidant properties. Further, to enlighten the biologically energetic behavior underlying the antioxidant activity, compounds DFT studies were performed. Noteworthy results have been attained and the structure activity relationship (SAR) was discussed with the support of this results. It was found that highly biological active compounds exhibited a low HOMO-LUMO energy gap (Eg) and the high Eg value compounds show very low/negligible or inactive antioxidant activities. In other cases, compounds containing high HOMO energy levels also provide high antioxidant activity. The thought-provoking point of our results is that theoretical descriptors of the HOMO-LUMO energy gap and the highest occupied molecular orbital energy are important descriptors in the bioorganic research to support the biological experiments.A small library of derivatives carrying a polycyclic scaffold recently identified by us as a new privileged structure in medicinal chemistry was designed and synthesized, aiming at obtaining potent MDR reverting agents also endowed with antitumor properties. In particular, as a follow-up of our previous studies, attention was focused on the role of the spacer connecting the polycyclic core with a properly selected nitrogen-containing group. A relevant increase in reverting potency was observed, going from the previously employed but-2-ynyl- to a pent-3-ynylamino moiety, as in compounds 3d and 3e, while the introduction of a triazole ring proved to differently impact on the activity of the compounds. The docking results supported the data obtained by biological tests, showing, for the most active compounds, the ability to establish specific bonds with P-glycoprotein. Moreover, a multifaceted anticancer profile and dual in vitro activity was observed for all compounds, showing both revertant and antitumor effects on leukemic cells.