CONCLUSION This form of diastolic dysfunction involves the activation of anaerobic metabolism and increased stretching of myofibrils facilitating LV filling.Coagulation processis highly influenced by solution pH, floc breakage, and coagulant aid.In this work, two-stage addition of alum-based coagulants, polyaluminum chloride (PACl) and aluminum sulfate (Al2(SO4)3), wascompared to their one-stage addition with the same total dosage.Thedoseratio of primary and secondaryadditionwasoptimized. The effects of solution pH, floc breakage and dosing timing of coagulant aid of non-ionic polyacrylamide(NPAM)on coagulation efficiency and floc propertywere investigated. The results showed that two-stage addition ofPAClshowedless sensitivitywith the variation ofpH.Compared to PACl, two-stage addition of Al2(SO4)3was more sensitive to the solution pH, especially when the pH ranged from 7 to 10.For all cases, the presence of floc breakage improved the removalof colloidal particles. The coagulation mechanism ofprimarycoagulantwas charge neutralization, while other mechanism was involved with the secondary addition ofcoagulant.Compared to one-stage addition, the settling performance of aggregates and particulates removal in two-stage addition was more effective with the variation of dosage or dosing timing of NPAM.The present work provides detailed operating parameters for this coagulationstrategy.in English, German Zusammenfassung. Bei Gicht steht im klinischen Alltag meist die akute Attacke im Vordergrund. Als diagnostischer Goldstandard gilt dabei der Kristallnachweis in der Gelenksflüssigkeit mittels Polarisationsmikroskopie. Auch bildgebende Verfahren wie der hochauflösende Ultraschall sind von Nutzen. Zur Behandlung der akuten Gichtattacke dienen nicht-steroidale Antirheumatika, Steroide und Colchizin (in der Schweiz nicht zugelassen, über Apotheken erhältlich). Ebenso wichtig wie Diagnose und Therapie der akuten Attacke ist aber die langfristige Behandlung der Hyperurikämie, um so weitere Gichtschübe sowie mögliche renale, kardiale oder metabolische Komplikationen zu verhindern. Daher sollte bei bestätigter Gichtdiagnose neben nicht-medikamentösen Massnahmen auch eine harnsäuresenkende Therapie, mit dem Zielwert von less then 360 µmol/l ( less then 6 mg/dl), erfolgen. Mittel der ersten Wahl stellen dabei Xanthinoxidasehemmer dar. Das Erreichen des Therapieziels ist regelmässig zu überprüfen und( less then 6 mg/dl), les médicaments de premier choix étant ici les inhibiteurs de la xanthine-oxydase. L’atteinte de l’objectif thérapeutique doit être régulièrement vérifiée et le traitement adapté si nécessaire.in English, German Zusammenfassung. Daten bezüglich Umsetzung der Empfehlung von «Smarter Medicine»/Schweiz zur Bildgebungsdiagnostik bei unspezifischen lumbalen Rückenschmerzen in der Hausarztpraxis sind spärlich. Methode Retrospektive Überprüfung der Indikation gemäss «Smarter Medicine» für 228 konventionelle Röntgenaufnahmen der lumbalen Wirbelsäule (LWS) aus drei Hausarztpraxen mit insgesamt 15 Ärztinnen und Ärzten. Ergebnisse Insgesamt entsprachen 75 % der innerhalb von sechs Wochen nach Schmerzbeginn durchgeführten Untersuchungen den Empfehlungen von «Smarter Medicine». Unbefriedigende Schmerzverbesserung trotz Analgetika und/oder Physiotherapie war der häufigste Grund für nicht-indizierte (in 36,6 %), «Red Flags» [Trauma (33,3 %), Malignität (19,5 %), Osteoporose (14,9 %)] für indizierte (in 64,4 %) Untersuchungen. Pro zehn Altersjahre sank die Wahrscheinlichkeit für ein nicht-indiziertes Röntgenbild um 20 % (p = 0,003). Schlussfolgerung Drei von vier konventionellen Röntgenaufnahmen der LWS wurden in den drei Hausarztpraxen gemäss der Empfehlung von «Smarter Medicine» durchgeführt. Die weitere Förderung von «Smarter Medicine» ist entscheidend, um unnötige diagnostische oder therapeutische Eingriffe zu vermeiden und Kosten zu sparen.in English, German Zusammenfassung. Patienten mit familiärer Hypercholesterinämie haben ein permanent erhöhtes kardiovaskuläres Risiko, weshalb eine Früherkennung und rechtzeitige, konsequent intensive Behandlung sehr wichtig ist. Eine besondere Herausforderung stellt die Behandlung einer familiären Hypercholesterinämie während der Schwangerschaft dar. https://www.selleckchem.com/products/azd6738.html Hier herrschen Unsicherheiten in der alltäglichen Praxis. Die Anwendung von Statinen peripartal ist nicht unbedenklich. Gemäss NICE-Richtlinien ist die Einnahme von Statinen drei Monate vor dem Empfängnisversuch aufgrund teratogener Effekte nicht empfohlen. Entsprechend sollte eine Beratung bezüglich Verhütung während der Behandlung mit Statinen bei Frauen im gebärfähigen Alter erfolgen. Eine Wiederaufnahme der Therapie ist erst nach Abschluss der Laktation empfohlen. Im Falle einer ungeplanten Schwangerschaft sollte eine Frau mit familiärer Hypercholesterinämie die Statine absetzen und sich umgehend an ihren Arzt wenden.in English, German Zusammenfassung. Depressionen gehören weltweit zu den führenden Erkrankungen. Sie sind von hoher Bedeutung für unterschiedlichste Bereiche innerhalb der Medizin, da Betroffene häufig ihren Hausarzt oder Internisten zuerst aufsuchen. Obwohl Symptome einer Depression sowohl bei Frauen als auch bei Männern beobachtet werden können, gibt es Besonderheiten der Symptomkonstellation bei Männern, die bislang nur unzureichend bekannt sind bzw. beachtet wurden. Diese Arbeit widmet sich dem Konzept der «Male Depression», das unter anderem durch sozialen Rückzug, Reizbarkeit oder Substanzmissbrauch gekennzeichnet ist. In diesem Kontext bestehen praxisrelevante Zusammenhänge zwischen Depression und gewalttätigem Verhalten, die anhand von zwei Fallbeispielen veranschaulicht werden sollen. Von besonderer Brisanz ist dabei das sogenannte suizidal-homizidale Syndrom, das zwingend einer weiteren psychiatrischen, wenn nicht sogar einer forensisch-psychiatrischen Abklärung zugeführt werden sollte.in English, German Zusammenfassung. Störungen der Bewegung sind gängig und vielfältig. Häufige Ursachen sind Systemerkrankungen wie die Parkinson-Syndrome und der essenzielle Tremor. Behandlungsoptionen in Praxis und Krankenhaus umfassen konservative, vorwiegend medikamentöse Strategien wie die orale Gabe von Dopamin-Präkursoren und -Agonisten, und pharmakologische oder nichtpharmakologische Eskalationsstrategien wie die intramuskulären Botulinumtoxin-A-Injektionen, die subkutanen oder enteralen Medikamentenpumpen für Apomorphin beziehungsweise Levodopa und Carbidopa, die wirkungsvolle Tiefe Hirnstimulation und die neuartige fokussierte Ultraschalltherapie, die an hierfür hochspezialisierte Zentren gebunden sind und allesamt durchaus früher und häufiger als Behandlungsoption in Betracht gezogen werden sollten.
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Therefore, by searching PubMed, Web of Science and SciFinder databases, this paper updates and summarizes the experimental and clinical evidence of TCM monomers for the treatment of NAFLD in the past six years (2015-2020), thus providing thoughts and prospects for further exploring the pathogenesis of NAFLD and TCM monomer therapies.Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the causative agent of the pandemic coronavirus disease 2019 (Covid-19) has claimed more than a million lives. Various in silico, in vitro, and in vivo studies are being conducted to understand the effect of SARS-CoV-2 on the cellular metabolism of humans and the various drugs and drug-targets that may be used. In this review, we discuss protein-protein interactions (PPIs) between viral and human proteins as well as viral targets like proteases. We try to understand the molecular mechanism of various repurposed antiviral drugs against SARS-CoV-2, their combination therapies, drug dosage regimens, and their adverse effects along with possible alternatives like non-toxic antiviral phytochemicals. Ultimately, randomized controlled trials are needed to identify which of these compounds has the required balance of efficacy and safety. We also focus on the recent advancements in diagnostic methods and vaccine candidates developed around the world to fight against Covid-19.
To compare the biochemical control rates (BCRs), late gastrointestinal (GI) and genitourinary (GU) toxicities in patients with low- and intermediate risk prostate cancer (PCa) treated with high-dose-rate brachytherapy (HDR BT) of 19Gy/1 fraction, 26Gy/2 fractions, or stereotactic ablative radiotherapy (SABR) of 36.25Gy/5 fractions.
Between August 2008 and December 2017, patients with low- and intermediate risk PCa who received single dose or 2-fraction HDR BT, or 5-fraction SABR at a single institution were included. BCR for the whole population and the individual treatment groups were calculated using the Phoenix definition. Post treatment GI and GU toxicities were evaluated according to the CTCAE v4.0 guidelines.
185 patients with low- and intermediate risk PCa were included in this study with a median follow up of 60.5months. BCRs at 3 and 5years were 95% and 85% for all patients. The 5-year BCRs were 69%, 95% and 92% for the 19Gy/1 fraction, 26Gy/2 fractions and 36.25Gy/5 fractions groups respective in future clinical trials.
26 Gy/2 fractions HDR BT provided equivalent BCR with lower toxicity compared to 36.25 Gy/5 fractions SABR. Both 2-fraction HBR BT and 5-fraction SABR achieved better BCRs than single dose 19 Gy HDR BT. The two-fraction HDR BT schedule should be considered as an important comparator in future clinical trials.
Cancer research faces the problem of high rates of clinical failure of new treatment approaches after positive preclinical data. https://www.selleckchem.com/products/su5402.html We hypothesize that a major confounding factor to this problem in radiooncology is the choice of the preclinical endpoint.
We present a comprehensive re-evaluation of large-scale preclinical in-vivo data on fractionated irradiation alone or simultaneously with Epidermal Growth Factor Receptor inhibition. Taking the permanent local tumour control assay as a gold standard, we evaluated different tumour volume dependent endpoints that are widely used for preclinical experiments.
The analysis showed the highest correlations between volume related and local tumour control endpoints after irradiation alone. For combined treatments, wide inter-tumoural variations were observed with reduced correlation between the endpoints. Evaluation of growth delay per Gray (GD/Gy) based on two or more dose levels showed closest correlation with local tumour control dose 50% (TCD
).
GD/Gy with at least two dose groups correlates with TCD
, but cannot replace the latter as the goldstandard.
GD/Gy with at least two dose groups correlates with TCD50, but cannot replace the latter as the goldstandard.
To assess bowel dose-volume relationships for acute patient-reported intestinal symptoms of patients treated with whole-pelvis intensity-modulated radiotherapy (WPRT) for prostate cancer.
Complete data of 415 patients enrolled in a multi institute, prospective trial (#NCT02803086) treated with radical (31%), adjuvant (33%) and salvage (36%) intent at a median dose to pelvic nodes/lymph-nodal area of 53Gy were available. The most severe changes between baseline and radiotherapy mid-point/end toxicity assessed by Inflammatory Bowel Disease Questionnaire (only Bowel Domain) were considered (ΔIBDQ). The 25th percentile values of these score variations were set as endpoints. DVHs of bowel loops for patients with/without toxicity were compared for each endpoint, having excluded patients with baseline scores <5 (rate ranging between 2% and 7% according to the endpoint) the resulting best dosimetric predictors were combined with selected clinical parameters through multivariate logistic regression (MVA) to derter impact for patients with lower IBDQ baseline scores.Several technologies have been proposed to preserve fruits and to avoid postharvest losses. The degradation of ethylene produced by the fruits using TiO2 photocatalysis has shown to be a good option to delay the ripening of fruits. This paper proposed a new application of biopolymers-TiO2 nanocomposites developed to extend the shelf-life of fruits. Photocatalytic coatings were applied on the expanded polyethylene foam nets to degrade ethylene. Gelatin and hydroxypropyl methylcellulose (HMPC) were tested as hydrophobic and hydrophilic matrices for the TiO2 incorporation. First, nanocomposite films prepared by casting were evaluated with regards to their photocatalytic properties. Both matrices, which were loaded with 1 wt% TiO2, degraded 40% of the ethylene injected in a batch reactor. By Langmuir-Hinshelwood model, ethylene degradation using gelatin-TiO2 films (kapp = 0.186 ± 0.021 min-1) was faster than the HPMC-TiO2 films (kapp = 0.034 ± 0.003 min-1). Then, gelatin-TiO2 dispersion was applied as a coating on the foam nets by dip coating. The gelatin-TiO2 bilayer exhibited higher concentration of ethylene degraded per photocatalytic area and photocatalyst mass unit (13.297 ± 0.178 ppmv m2 [Formula see text] ) than its film form (18.212 ± 1.157 ppmv m2 [Formula see text] ), which makes gelatin-TiO2/foam nets a promising composite design for fruit postharvest application.
Sofern eine Histologie zur Diagnoseeingrenzung erforderlich ist, soll diese in erster Linie mittels der transbronchialen Lungen-Kryobiopsie gewonnen werden. Die chirurgische Lungenbiopsie soll Patienten vorbehalten bleiben, die in ausreichender Verfassung für diesen Eingriff sind und bei denen die endoskopische Diagnostik keine Klärung der Diagnose ergab. Goldstandard ist auch weiterhin die interdisziplinäre Diskussion der erhobenen Befunde, um nach Ausschluss anderer Formen chronisch progredienter Lungenfibrosen die Diagnose der IPF zu stellen.in English, Portuguese Diversos fatores desencadeiam o desenvolvimento de mutações genéticas que são responsáveis por originar uma neoplasia. O meduloblastoma é uma neoplasia cerebelar maligna e invasiva que acomete crianças e adultos jovens. O carcinoma mucinoso é um tipo de câncer de mama especial por ser um subtipo atípico de carcinoma invasivo, que acomete com maior frequência mulheres de idade avançada e representa entre 1 a 7% do total de neoplasias mamárias. O caso relatado tem como objetivo mostrar a raridade da ocorrência do meduloblastoma desmoplásico e carcinoma mucinoso mamário em uma paciente jovem em um curto período de tempo, em diferentes sítios sem ligação anatômica direta e sem ocorrência de metástase. Inicialmente, esta paciente possuía um meduloblastoma desmoplásico e foi tratada com tumorectomia e radioterapia. Após 13 meses, a paciente foi diagnosticada com carcinoma mucinoso de mama, sendo submetida a mastectomia, quimioterapia adjuvante e atualmente está sendo tratada com endocrinoterapia. Concluímos, com base na característica metacrônica da neoplasia e características clínicas, que a paciente apresenta a síndrome de Li-Fraumeni, doença autossômica dominante com mutação do gene TP53, que é o principal gene envolvido nesta síndrome. Por não apresentar as características completas do fenótipo da síndrome, a paciente pode assim ser classificada como portadora de uma variante da síndorme de Li-Fraumeni ou síndrome do tipo Li-Fraumeni.Genital injury has a forensic relevance after a sexual assault and it has been discussed and investigated among professionals who work in this field. To analyze the studies published in the last decades, the present review examines different factors that may influence this finding, first clarifying terms of the forensic field, such as the peculiarity of the legal medical examination, and the distinction of the terms "legal" and "anatomical" vagina. Finally, it analyses if it is possible that the existence of these injuries in victims explain the lack of consent in sexual contact, and to clarify the meaning of the absence of injuries. Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil.in English, Portuguese OBJETIVO Avaliar o conhecimento sobre a infecção pelo vírus do papiloma humano (human papillomavirus, HPV, em inglês) e a taxa de vacinação entre estudantes calouros e veteranos do quarto ano dos cursos de medicina, farmácia, fonoaudiologia, enfermagem e educação física de uma universidade brasileira. MéTODOS Um primeiro questionário sobre aspectos sociodemográficos, antecedentes sexuais e conhecimento sobre o HPV e sua vacina foi aplicado a 492 estudantes. Três meses depois, foi aplicado um novo questionário, a 233 estudantes, que avaliava a nova taxa de vacinação entre eles. RESULTADOS Entre as 290 mulheres que responderam ao questionário, 47% das calouras e 13% das veteranas negaram início de atividade sexual. Entre os 202 calouros e veteranos do sexo masculino avaliados, essa taxa foi de 11%. Apesar de o conhecimento sobre o HPV ter sido maior entre as mulheres, elas declararam menor uso de preservativo. Mais de 83% das mulheres e 66% dos homens sabiam que o HPV causa câncer de colo de útero, mas menos de 30% de todos os alunos sabiam que o HPV pode causar câncer de vulva, ânus, pênis e orofaringe, e menos de 50% sabiam que o HPV pode causar verrugas genitais, anais e orofaríngeas. Comparando calouros e veteranos, houve um aumento no conhecimento de que o HPV é sexualmente transmitido, e de que sua infecção pode ser assintomática, entre os veteranos em comparação com os calouros. Pela taxa de vacinação analisada no segundo questionário, identificou-se que, antes do início da pesquisa, 26% das mulheres e 8% dos homens haviam sido vacinados, e, no momento da aplicação do segundo questionário, essas taxas subiram para 52% e 27%, respectivamente, entre os 233 alunos avaliados. CONCLUSãO Quase metade das calouras relataram não ser sexualmente ativas, e a maioria delas ainda não era vacinada contra o HPV. O ingresso no Ensino Superior parece um momento oportuno para a realização de campanhas governamentais de conscientização e vacinação contra o HPV.in English, Portuguese OBJETIVO Descrever características clínicas e sociodemográficas de mulheres com endometriose profunda infiltrativa e avaliar sua qualidade de vida dentro de 6 meses de tratamento clínico. https://www.selleckchem.com/products/phenazine-methosulfate.html MéTODOS Estudo de corte transversal descritivo com 60 mulheres em seguimento ambulatorial na Universidade de Campinas, Campinas, SP, Brasil, com endometriose profunda infiltrativa diagnosticada por cirurgia ou métodos de imagem (ultrassonografia ou ressonância magnética), em tratamento clínico há pelo menos 6 meses. Para avaliar a qualidade de vida, foram utilizados os questionários SF-36 e EHP-30. RESULTADOS A média etária das mulheres foi de 37,7 ± 6,0 anos; 50% delas apresentaram dismenorreia, 57% dispareunia e 50% dor pélvica crônica. O SF-36 e o EHP-30 mostraram comprometimento da qualidade de vida destas mulheres. No SF-36, os piores domínios foram os aspectos emocionais (40,2 ± 43,1) e a autoestima e disposição (46,1 ± 24,8), enquanto que no EHP-30 foram o bem-estar social (50,3 ± 30,6), a infertilidade (48,0 ± 36,3) e as relações sexuais (54,0 ± 32,1). CONCLUSãO Embora tratadas clinicamente, as mulheres com endometriose profunda apresentaram comprometimento em diferentes domínios da qualidade de vida independente do questionário utilizado para avaliação.
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CONCLUSION This form of diastolic dysfunction involves the activation of anaerobic metabolism and increased stretching of myofibrils facilitating LV filling.Coagulation processis highly influenced by solution pH, floc breakage, and coagulant aid.In this work, two-stage addition of alum-based coagulants, polyaluminum chloride (PACl) and aluminum sulfate (Al2(SO4)3), wascompared to their one-stage addition with the same total dosage.Thedoseratio of primary and secondaryadditionwasoptimized. The effects of solution pH, floc breakage and dosing timing of coagulant aid of non-ionic polyacrylamide(NPAM)on coagulation efficiency and floc propertywere investigated. The results showed that two-stage addition ofPAClshowedless sensitivitywith the variation ofpH.Compared to PACl, two-stage addition of Al2(SO4)3was more sensitive to the solution pH, especially when the pH ranged from 7 to 10.For all cases, the presence of floc breakage improved the removalof colloidal particles. The coagulation mechanism ofprimarycoagulantwas charge neutralization, while other mechanism was involved with the secondary addition ofcoagulant.Compared to one-stage addition, the settling performance of aggregates and particulates removal in two-stage addition was more effective with the variation of dosage or dosing timing of NPAM.The present work provides detailed operating parameters for this coagulationstrategy.in English, German Zusammenfassung. Bei Gicht steht im klinischen Alltag meist die akute Attacke im Vordergrund. Als diagnostischer Goldstandard gilt dabei der Kristallnachweis in der Gelenksflüssigkeit mittels Polarisationsmikroskopie. Auch bildgebende Verfahren wie der hochauflösende Ultraschall sind von Nutzen. Zur Behandlung der akuten Gichtattacke dienen nicht-steroidale Antirheumatika, Steroide und Colchizin (in der Schweiz nicht zugelassen, über Apotheken erhältlich). Ebenso wichtig wie Diagnose und Therapie der akuten Attacke ist aber die langfristige Behandlung der Hyperurikämie, um so weitere Gichtschübe sowie mögliche renale, kardiale oder metabolische Komplikationen zu verhindern. Daher sollte bei bestätigter Gichtdiagnose neben nicht-medikamentösen Massnahmen auch eine harnsäuresenkende Therapie, mit dem Zielwert von less then 360 µmol/l ( less then 6 mg/dl), erfolgen. Mittel der ersten Wahl stellen dabei Xanthinoxidasehemmer dar. Das Erreichen des Therapieziels ist regelmässig zu überprüfen und( less then 6 mg/dl), les médicaments de premier choix étant ici les inhibiteurs de la xanthine-oxydase. L’atteinte de l’objectif thérapeutique doit être régulièrement vérifiée et le traitement adapté si nécessaire.in English, German Zusammenfassung. Daten bezüglich Umsetzung der Empfehlung von «Smarter Medicine»/Schweiz zur Bildgebungsdiagnostik bei unspezifischen lumbalen Rückenschmerzen in der Hausarztpraxis sind spärlich. Methode Retrospektive Überprüfung der Indikation gemäss «Smarter Medicine» für 228 konventionelle Röntgenaufnahmen der lumbalen Wirbelsäule (LWS) aus drei Hausarztpraxen mit insgesamt 15 Ärztinnen und Ärzten. Ergebnisse Insgesamt entsprachen 75 % der innerhalb von sechs Wochen nach Schmerzbeginn durchgeführten Untersuchungen den Empfehlungen von «Smarter Medicine». Unbefriedigende Schmerzverbesserung trotz Analgetika und/oder Physiotherapie war der häufigste Grund für nicht-indizierte (in 36,6 %), «Red Flags» [Trauma (33,3 %), Malignität (19,5 %), Osteoporose (14,9 %)] für indizierte (in 64,4 %) Untersuchungen. Pro zehn Altersjahre sank die Wahrscheinlichkeit für ein nicht-indiziertes Röntgenbild um 20 % (p = 0,003). Schlussfolgerung Drei von vier konventionellen Röntgenaufnahmen der LWS wurden in den drei Hausarztpraxen gemäss der Empfehlung von «Smarter Medicine» durchgeführt. Die weitere Förderung von «Smarter Medicine» ist entscheidend, um unnötige diagnostische oder therapeutische Eingriffe zu vermeiden und Kosten zu sparen.in English, German Zusammenfassung. Patienten mit familiärer Hypercholesterinämie haben ein permanent erhöhtes kardiovaskuläres Risiko, weshalb eine Früherkennung und rechtzeitige, konsequent intensive Behandlung sehr wichtig ist. Eine besondere Herausforderung stellt die Behandlung einer familiären Hypercholesterinämie während der Schwangerschaft dar. https://www.selleckchem.com/products/azd6738.html Hier herrschen Unsicherheiten in der alltäglichen Praxis. Die Anwendung von Statinen peripartal ist nicht unbedenklich. Gemäss NICE-Richtlinien ist die Einnahme von Statinen drei Monate vor dem Empfängnisversuch aufgrund teratogener Effekte nicht empfohlen. Entsprechend sollte eine Beratung bezüglich Verhütung während der Behandlung mit Statinen bei Frauen im gebärfähigen Alter erfolgen. Eine Wiederaufnahme der Therapie ist erst nach Abschluss der Laktation empfohlen. Im Falle einer ungeplanten Schwangerschaft sollte eine Frau mit familiärer Hypercholesterinämie die Statine absetzen und sich umgehend an ihren Arzt wenden.in English, German Zusammenfassung. Depressionen gehören weltweit zu den führenden Erkrankungen. Sie sind von hoher Bedeutung für unterschiedlichste Bereiche innerhalb der Medizin, da Betroffene häufig ihren Hausarzt oder Internisten zuerst aufsuchen. Obwohl Symptome einer Depression sowohl bei Frauen als auch bei Männern beobachtet werden können, gibt es Besonderheiten der Symptomkonstellation bei Männern, die bislang nur unzureichend bekannt sind bzw. beachtet wurden. Diese Arbeit widmet sich dem Konzept der «Male Depression», das unter anderem durch sozialen Rückzug, Reizbarkeit oder Substanzmissbrauch gekennzeichnet ist. In diesem Kontext bestehen praxisrelevante Zusammenhänge zwischen Depression und gewalttätigem Verhalten, die anhand von zwei Fallbeispielen veranschaulicht werden sollen. Von besonderer Brisanz ist dabei das sogenannte suizidal-homizidale Syndrom, das zwingend einer weiteren psychiatrischen, wenn nicht sogar einer forensisch-psychiatrischen Abklärung zugeführt werden sollte.in English, German Zusammenfassung. Störungen der Bewegung sind gängig und vielfältig. Häufige Ursachen sind Systemerkrankungen wie die Parkinson-Syndrome und der essenzielle Tremor. Behandlungsoptionen in Praxis und Krankenhaus umfassen konservative, vorwiegend medikamentöse Strategien wie die orale Gabe von Dopamin-Präkursoren und -Agonisten, und pharmakologische oder nichtpharmakologische Eskalationsstrategien wie die intramuskulären Botulinumtoxin-A-Injektionen, die subkutanen oder enteralen Medikamentenpumpen für Apomorphin beziehungsweise Levodopa und Carbidopa, die wirkungsvolle Tiefe Hirnstimulation und die neuartige fokussierte Ultraschalltherapie, die an hierfür hochspezialisierte Zentren gebunden sind und allesamt durchaus früher und häufiger als Behandlungsoption in Betracht gezogen werden sollten.
Therefore, by searching PubMed, Web of Science and SciFinder databases, this paper updates and summarizes the experimental and clinical evidence of TCM monomers for the treatment of NAFLD in the past six years (2015-2020), thus providing thoughts and prospects for further exploring the pathogenesis of NAFLD and TCM monomer therapies.Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the causative agent of the pandemic coronavirus disease 2019 (Covid-19) has claimed more than a million lives. Various in silico, in vitro, and in vivo studies are being conducted to understand the effect of SARS-CoV-2 on the cellular metabolism of humans and the various drugs and drug-targets that may be used. In this review, we discuss protein-protein interactions (PPIs) between viral and human proteins as well as viral targets like proteases. We try to understand the molecular mechanism of various repurposed antiviral drugs against SARS-CoV-2, their combination therapies, drug dosage regimens, and their adverse effects along with possible alternatives like non-toxic antiviral phytochemicals. Ultimately, randomized controlled trials are needed to identify which of these compounds has the required balance of efficacy and safety. We also focus on the recent advancements in diagnostic methods and vaccine candidates developed around the world to fight against Covid-19.
To compare the biochemical control rates (BCRs), late gastrointestinal (GI) and genitourinary (GU) toxicities in patients with low- and intermediate risk prostate cancer (PCa) treated with high-dose-rate brachytherapy (HDR BT) of 19Gy/1 fraction, 26Gy/2 fractions, or stereotactic ablative radiotherapy (SABR) of 36.25Gy/5 fractions.
Between August 2008 and December 2017, patients with low- and intermediate risk PCa who received single dose or 2-fraction HDR BT, or 5-fraction SABR at a single institution were included. BCR for the whole population and the individual treatment groups were calculated using the Phoenix definition. Post treatment GI and GU toxicities were evaluated according to the CTCAE v4.0 guidelines.
185 patients with low- and intermediate risk PCa were included in this study with a median follow up of 60.5months. BCRs at 3 and 5years were 95% and 85% for all patients. The 5-year BCRs were 69%, 95% and 92% for the 19Gy/1 fraction, 26Gy/2 fractions and 36.25Gy/5 fractions groups respective in future clinical trials.
26 Gy/2 fractions HDR BT provided equivalent BCR with lower toxicity compared to 36.25 Gy/5 fractions SABR. Both 2-fraction HBR BT and 5-fraction SABR achieved better BCRs than single dose 19 Gy HDR BT. The two-fraction HDR BT schedule should be considered as an important comparator in future clinical trials.
Cancer research faces the problem of high rates of clinical failure of new treatment approaches after positive preclinical data. https://www.selleckchem.com/products/su5402.html We hypothesize that a major confounding factor to this problem in radiooncology is the choice of the preclinical endpoint.
We present a comprehensive re-evaluation of large-scale preclinical in-vivo data on fractionated irradiation alone or simultaneously with Epidermal Growth Factor Receptor inhibition. Taking the permanent local tumour control assay as a gold standard, we evaluated different tumour volume dependent endpoints that are widely used for preclinical experiments.
The analysis showed the highest correlations between volume related and local tumour control endpoints after irradiation alone. For combined treatments, wide inter-tumoural variations were observed with reduced correlation between the endpoints. Evaluation of growth delay per Gray (GD/Gy) based on two or more dose levels showed closest correlation with local tumour control dose 50% (TCD
).
GD/Gy with at least two dose groups correlates with TCD
, but cannot replace the latter as the goldstandard.
GD/Gy with at least two dose groups correlates with TCD50, but cannot replace the latter as the goldstandard.
To assess bowel dose-volume relationships for acute patient-reported intestinal symptoms of patients treated with whole-pelvis intensity-modulated radiotherapy (WPRT) for prostate cancer.
Complete data of 415 patients enrolled in a multi institute, prospective trial (#NCT02803086) treated with radical (31%), adjuvant (33%) and salvage (36%) intent at a median dose to pelvic nodes/lymph-nodal area of 53Gy were available. The most severe changes between baseline and radiotherapy mid-point/end toxicity assessed by Inflammatory Bowel Disease Questionnaire (only Bowel Domain) were considered (ΔIBDQ). The 25th percentile values of these score variations were set as endpoints. DVHs of bowel loops for patients with/without toxicity were compared for each endpoint, having excluded patients with baseline scores <5 (rate ranging between 2% and 7% according to the endpoint) the resulting best dosimetric predictors were combined with selected clinical parameters through multivariate logistic regression (MVA) to derter impact for patients with lower IBDQ baseline scores.Several technologies have been proposed to preserve fruits and to avoid postharvest losses. The degradation of ethylene produced by the fruits using TiO2 photocatalysis has shown to be a good option to delay the ripening of fruits. This paper proposed a new application of biopolymers-TiO2 nanocomposites developed to extend the shelf-life of fruits. Photocatalytic coatings were applied on the expanded polyethylene foam nets to degrade ethylene. Gelatin and hydroxypropyl methylcellulose (HMPC) were tested as hydrophobic and hydrophilic matrices for the TiO2 incorporation. First, nanocomposite films prepared by casting were evaluated with regards to their photocatalytic properties. Both matrices, which were loaded with 1 wt% TiO2, degraded 40% of the ethylene injected in a batch reactor. By Langmuir-Hinshelwood model, ethylene degradation using gelatin-TiO2 films (kapp = 0.186 ± 0.021 min-1) was faster than the HPMC-TiO2 films (kapp = 0.034 ± 0.003 min-1). Then, gelatin-TiO2 dispersion was applied as a coating on the foam nets by dip coating. The gelatin-TiO2 bilayer exhibited higher concentration of ethylene degraded per photocatalytic area and photocatalyst mass unit (13.297 ± 0.178 ppmv m2 [Formula see text] ) than its film form (18.212 ± 1.157 ppmv m2 [Formula see text] ), which makes gelatin-TiO2/foam nets a promising composite design for fruit postharvest application.
Sofern eine Histologie zur Diagnoseeingrenzung erforderlich ist, soll diese in erster Linie mittels der transbronchialen Lungen-Kryobiopsie gewonnen werden. Die chirurgische Lungenbiopsie soll Patienten vorbehalten bleiben, die in ausreichender Verfassung für diesen Eingriff sind und bei denen die endoskopische Diagnostik keine Klärung der Diagnose ergab. Goldstandard ist auch weiterhin die interdisziplinäre Diskussion der erhobenen Befunde, um nach Ausschluss anderer Formen chronisch progredienter Lungenfibrosen die Diagnose der IPF zu stellen.in English, Portuguese Diversos fatores desencadeiam o desenvolvimento de mutações genéticas que são responsáveis por originar uma neoplasia. O meduloblastoma é uma neoplasia cerebelar maligna e invasiva que acomete crianças e adultos jovens. O carcinoma mucinoso é um tipo de câncer de mama especial por ser um subtipo atípico de carcinoma invasivo, que acomete com maior frequência mulheres de idade avançada e representa entre 1 a 7% do total de neoplasias mamárias. O caso relatado tem como objetivo mostrar a raridade da ocorrência do meduloblastoma desmoplásico e carcinoma mucinoso mamário em uma paciente jovem em um curto período de tempo, em diferentes sítios sem ligação anatômica direta e sem ocorrência de metástase. Inicialmente, esta paciente possuía um meduloblastoma desmoplásico e foi tratada com tumorectomia e radioterapia. Após 13 meses, a paciente foi diagnosticada com carcinoma mucinoso de mama, sendo submetida a mastectomia, quimioterapia adjuvante e atualmente está sendo tratada com endocrinoterapia. Concluímos, com base na característica metacrônica da neoplasia e características clínicas, que a paciente apresenta a síndrome de Li-Fraumeni, doença autossômica dominante com mutação do gene TP53, que é o principal gene envolvido nesta síndrome. Por não apresentar as características completas do fenótipo da síndrome, a paciente pode assim ser classificada como portadora de uma variante da síndorme de Li-Fraumeni ou síndrome do tipo Li-Fraumeni.Genital injury has a forensic relevance after a sexual assault and it has been discussed and investigated among professionals who work in this field. To analyze the studies published in the last decades, the present review examines different factors that may influence this finding, first clarifying terms of the forensic field, such as the peculiarity of the legal medical examination, and the distinction of the terms "legal" and "anatomical" vagina. Finally, it analyses if it is possible that the existence of these injuries in victims explain the lack of consent in sexual contact, and to clarify the meaning of the absence of injuries. Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil.in English, Portuguese OBJETIVO Avaliar o conhecimento sobre a infecção pelo vírus do papiloma humano (human papillomavirus, HPV, em inglês) e a taxa de vacinação entre estudantes calouros e veteranos do quarto ano dos cursos de medicina, farmácia, fonoaudiologia, enfermagem e educação física de uma universidade brasileira. MéTODOS Um primeiro questionário sobre aspectos sociodemográficos, antecedentes sexuais e conhecimento sobre o HPV e sua vacina foi aplicado a 492 estudantes. Três meses depois, foi aplicado um novo questionário, a 233 estudantes, que avaliava a nova taxa de vacinação entre eles. RESULTADOS Entre as 290 mulheres que responderam ao questionário, 47% das calouras e 13% das veteranas negaram início de atividade sexual. Entre os 202 calouros e veteranos do sexo masculino avaliados, essa taxa foi de 11%. Apesar de o conhecimento sobre o HPV ter sido maior entre as mulheres, elas declararam menor uso de preservativo. Mais de 83% das mulheres e 66% dos homens sabiam que o HPV causa câncer de colo de útero, mas menos de 30% de todos os alunos sabiam que o HPV pode causar câncer de vulva, ânus, pênis e orofaringe, e menos de 50% sabiam que o HPV pode causar verrugas genitais, anais e orofaríngeas. Comparando calouros e veteranos, houve um aumento no conhecimento de que o HPV é sexualmente transmitido, e de que sua infecção pode ser assintomática, entre os veteranos em comparação com os calouros. Pela taxa de vacinação analisada no segundo questionário, identificou-se que, antes do início da pesquisa, 26% das mulheres e 8% dos homens haviam sido vacinados, e, no momento da aplicação do segundo questionário, essas taxas subiram para 52% e 27%, respectivamente, entre os 233 alunos avaliados. CONCLUSãO Quase metade das calouras relataram não ser sexualmente ativas, e a maioria delas ainda não era vacinada contra o HPV. O ingresso no Ensino Superior parece um momento oportuno para a realização de campanhas governamentais de conscientização e vacinação contra o HPV.in English, Portuguese OBJETIVO Descrever características clínicas e sociodemográficas de mulheres com endometriose profunda infiltrativa e avaliar sua qualidade de vida dentro de 6 meses de tratamento clínico. https://www.selleckchem.com/products/phenazine-methosulfate.html MéTODOS Estudo de corte transversal descritivo com 60 mulheres em seguimento ambulatorial na Universidade de Campinas, Campinas, SP, Brasil, com endometriose profunda infiltrativa diagnosticada por cirurgia ou métodos de imagem (ultrassonografia ou ressonância magnética), em tratamento clínico há pelo menos 6 meses. Para avaliar a qualidade de vida, foram utilizados os questionários SF-36 e EHP-30. RESULTADOS A média etária das mulheres foi de 37,7 ± 6,0 anos; 50% delas apresentaram dismenorreia, 57% dispareunia e 50% dor pélvica crônica. O SF-36 e o EHP-30 mostraram comprometimento da qualidade de vida destas mulheres. No SF-36, os piores domínios foram os aspectos emocionais (40,2 ± 43,1) e a autoestima e disposição (46,1 ± 24,8), enquanto que no EHP-30 foram o bem-estar social (50,3 ± 30,6), a infertilidade (48,0 ± 36,3) e as relações sexuais (54,0 ± 32,1). CONCLUSãO Embora tratadas clinicamente, as mulheres com endometriose profunda apresentaram comprometimento em diferentes domínios da qualidade de vida independente do questionário utilizado para avaliação.
Is BRICS the end of the dollar? Join the conversation about gold, currency, & global power shifts! Watch now!
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💰 Is BRICS the end of the dollar? 🤔 Join the conversation about gold, currency, & global power shifts! Watch now! 🔥 #BRICS #GoldStandard #CurrencyCrisis #Dollar #FinanceTalk #EconomicTrends #InvestSmart #GlobalEconomy #WealthSecrets #MoneyMatters
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Is BRICS the end of the dollar? Join the conversation about gold, currency, & global power shifts! Watch now!
https://www.brighteon.com/cb32d65d-7ce5-4ef4-8721-55b70f2714f0
#BRICS #GoldStandard #CurrencyCrisis #Dollar #FinanceTalk #EconomicTrends #InvestSmart #GlobalEconomy #WealthSecrets #MoneyMatters
🎥 Watch the full interview at www.brighteon.com/channels/hrreport
💰 Is BRICS the end of the dollar? 🤔 Join the conversation about gold, currency, & global power shifts! Watch now! 🔥 #BRICS #GoldStandard #CurrencyCrisis #Dollar #FinanceTalk #EconomicTrends #InvestSmart #GlobalEconomy #WealthSecrets #MoneyMatters
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