People

Sorry, no results were found.

Circles

Sorry, no results were found.

Posts

02/08/2025


In addition, recombinant Pap in combination with M. xanthus recombinant enzymes Ppk1 or adenylate kinase (AdkA) could generate ATP from AMP and polyP60-70. These results suggest a functional role of Pap during M. xanthus starvation, when it might act in cooperation with Ppk1 and/or AdkA to produce ATP from AMP, ADP, and polyP.
Continuous spikes and waves during sleep (CSWS) is an epileptic encephalopathy characterized by generalised epileptiform activity and neurocognitive dysfunction. Causes and outcome are diverse and treatment is mainly empirical.

Retrospective descriptive analysis of clinical and EEG data of children with CSWS diagnosed between 1998 and 2018at the University Hospital Heidelberg.

Ninety-five children were included with a median age at diagnosis of 5.4 years. https://www.selleckchem.com/products/sirpiglenastat.html A structural/metabolic aetiology was found in 43.2%, genetic alterations in 17.9%, while it remained unknown in 38.9%. The proportion of patients with genetic aetiology increased from 10.3% (1998-2007) to 22.8% (2008-2018). On average, each patient received 5 different treatments. CSWS was refractory in >70% of cases, steroids and neurosurgery were most effective. No difference was observed between children with CSWS or Near-CSWS (Spike-Wave-Index 40-85%).

Our cohort confirms CSWS as an age-dependent epileptic encephalopathy. Structural brain abnormalities were most frequent, but genetic causes are increasingly identified. More specific criteria for the diagnosis and treatment goals should be elaborated and implemented based on evidence.

This study is the largest monocentric observational study on treatment effects in children with CSWS, providing data for diagnostic and therapeutic decisions.
This study is the largest monocentric observational study on treatment effects in children with CSWS, providing data for diagnostic and therapeutic decisions.
The objective of this study was to assess the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants' perceptions about ordering WIC groceries online.

Qualitative semistructured interviews were conducted with 24 WIC participants in East Tennessee from May to October 2019. Interviews were transcribed verbatim and analyzed using a grounded theory approach.

Participants were interested in online ordering and spoke favorably about delivery and pickup options. Participants were willing to pay $2-5 to order online, though they were more willing to pay for a home or curbside delivery than an in-store pickup. Participants suggested additional ways to integrate technology into WIC food retail operations, such as providing benefit balances via text message and developing a mobile phone application for Tennessee WIC.

Findings can inform pilot tests for WIC online ordering.
Findings can inform pilot tests for WIC online ordering.A2 or A4 annular finger pulley tears are common injuries in rock climbers. This study reviews the measurement procedures used and tendon-to-bone distance data obtained on high-resolution ultrasound images when diagnosing isolated rupture of the A2 or A4 pulleys. Out of 3447 records extracted, only 7 remained after applying the exclusion criteria. In diagnosing a complete rupture, tendon-to-bone distance used varied widely from 1.9 to 5.1 mm for A2 and from 1.8 to 3.1 mm for A4. Our findings point to a lack of consensus diagnostic criteria for pulley injuries and identify technical details needing further research.
High altitude polycythemia (HAPC) is a common chronic disease at high altitudes. It is characterized by excessive erythrocytosis (≥190 g·L
in females or ≥210 g·L
in males). HAPC severely jeopardizes the health status of plateau dwellers. The Qinghai-Tibet plateau, with an elevation above 4000 m, is the highest plateau in the world. Both Han and Tibetan populations residing there face the threat of HAPC. Therapeutic erythrocytapheresis (TE) was introduced to Tibet as an alternative to phlebotomy in 2015.

In this study, we retrospectively analyzed 155 patients with HAPC treated with TE in Tibet. Routine blood testing values before and after TE were compared to evaluate treatment efficacy. The efficiency rate, defined as the rate of increase in red blood cell depletion attained by TE compared with 450 mL whole blood phlebotomy, was calculated using whole blood volume and hematocrit before and after treatment and used to identify patients who maintained a normal hemoglobin level in the year after the TE procedure.

On average, TE reduced red blood cell levels by 1.5×10
·L
, hemoglobin concentration by 52 g·L
, and hematocrit by 14% (P<0.001 for each). Patients who underwent TE with an efficiency rate ≥1.9 were more likely to maintain a normal hemoglobin level in the following year than those who underwent TE with an efficiency rate <1.9 (90 vs 28%, P<0.01).

TE is a feasible therapeutic method to treat HAPC on the Qinghai-Tibet plateau. The efficiency rate is a useful tool to predict the expected interval between TE procedures.
TE is a feasible therapeutic method to treat HAPC on the Qinghai-Tibet plateau. The efficiency rate is a useful tool to predict the expected interval between TE procedures.
Our previous study showed that high-fat diet inhibited the increase in nitric oxide and endothelial nitric oxide synthase expression in the aortic endothelium of rats exposed to hypoxia, and hypoxia plus a high-fat diet led to earlier and more severe vascular endothelial dysfunction (VED) than hypoxia alone. The purpose of the present study was to investigate the effects of L-arginine on high-fat diet-induced VED of rats in hypoxia.

Forty male Sprague-Dawley rats were randomly divided into 4 groups and treated with hypoxia (H group), hypoxia plus high-fat diet (H+HFD group), hypoxia plus L-arginine (H+L-Arg group), and hypoxia plus high-fat diet and L-arginine (H+HFD+L-Arg group) for 1 wk. Hypoxia was simulated in a hypobaric chamber with an altitude of 5000 m. Aortic morphology and endothelium-dependent vasorelaxation were used to assess VED.

High-fat diet impaired vascular remodeling and reduced endothelium-dependent vasodilator response to acetylcholine in rats exposed to hypoxia, secondary to dysregulation of the nitric oxide pathway.

02/07/2025


Neurocytomas represent 0,25 to 0,5 of brain tumours. https://www.selleckchem.com/products/vx803-m4344.html These tumours have neuronal differentiation. It's a young adult disease. The main treatment is neurosurgery. The place of other therapies is still unclear, noticeably with regards to radiotherapy. This review aim is to determine the place and the modalities of radiotherapy in the management of neurocytomas. A literature search using PubMed allowed to select the most relevant studies. Finally, 22 studies were selected according to pre-established criteria to answer the problem. All studies were retrospective studies except one. The analysis conclusion defined radiotherapy as a treatment of choice in selected patients, when surgical resection was incomplete or when tumour was atypical.New concepts of medical consultations are currently disrupting the practice of medicine. The use of standardized questionnaires, or patient-reported outcome (PRO and ePRO) has already significantly changed the relationship between the physician and the patient. Telemedicine, or even automatic conversational agents, such as chatbots, are also providing more convenient access to care and medical information for many patients. These tools have a major impact in oncology, precisely because of the rising chronicity of the diseases the radiation oncologists treat. In this article, we provide a detailed analysis of these new concepts.Prescription and delivery of protons are somewhat different compared to photons and may influence outcomes (tumour control and toxicity). These differences should be taken into account to fully exploit the clinical potential of proton therapy. Innovations in proton therapy treatment are also required to widen the therapeutic window and determine appropriate populations of patients that would benefit from new treatments. Therefore, strategies are now being developed to reduce side effects to critical normal tissues using alternative treatment configurations and new spatial or temporal-driven optimisation approaches. Indeed, spatiotemporal optimisation (based on flash, proton minibeam radiation therapy or hypofractionated delivery methods) has been gaining some attention in proton therapy as a mean of improving (biological and physical) dose distribution. In this short review, the main differences in planning and delivery between protons and photons, as well as some of the latest developments and methodological issues (in silico modelling) related to providing scientific evidence for these new techniques will be discussed.Symptoms of attention-deficit/hyperactivity disorder (ADHD) run a variable course through adolescence. While most affected individuals show some improvement, particularly of hyperactivity-impulsivity, symptoms of inattention are more persistent, and some individuals may meet diagnostic criteria for the first time during adolescence. Genetic factors affect adolescent symptom trajectories; those showing persistence likely carry a greater burden of common risk alleles. Rare structural genomic variants, such as copy number variants and point mutations, might also play a role. Although psychostimulant medication is associated with better functional outcomes, an impact on underlying adolescent symptom trajectories has been hard to demonstrate. At a neural level, several studies report that adolescents whose childhood ADHD symptoms have remitted are indistinguishable from neurotypical individuals. This finding could reflect the "carrying forward" of relatively typical childhood neural features among those destined for adolescent remission or the correction of early childhood anomalies with a convergence toward typical dimensions. Other studies have noted unique, possibly compensatory patterns of neural activity among adolescents whose ADHD has improved. Finally, different neural processes might occur in different brain regions. Thus, some functional imaging studies find that subcortical anomalies reflect the onset of ADHD and remain throughout life regardless of symptom change, whereas the variable clinical course of adolescent ADHD is determined by plasticity of the cerebral cortex. Integrating an understanding of the neural processes with genomic risk could elucidate the mechanisms underlying the complex course of adolescent ADHD.
The COVID-19 pandemic and associated response measures have led to unprecedented challenges for service providers working with vulnerable children and families around the world.

The goal of the present study was to better understand the impact of the pandemic and associated response measures on vulnerable children and families and provide data-informed recommendations for public and private service providers working with this population.

Representatives from 87 non-government organizations (NGOs) providing a variety of direct services (i.e. residential care, family preservation, foster care, etc.) to 454,637 vulnerable children and families in 43 countries completed a brief online survey.

Using a mixed methods design, results examined 1) ways in which children and families have been directly impacted by COVID-19, 2) the impact of the pandemic on services provided by NGOs, 3) government responses and gaps in services for this population during the pandemic, and 4) strategies that have been effective in filling these gaps.

Data revealed that the pandemic and restrictive measures were associated with increased risk factors for vulnerable children and families, including not having access to vital services. The NGOs experienced government restrictions, decreased financial support, and inability to adequately provide services. Increased communication and supportive activities had a positive impact on both NGO staff and the families they serve.

Based on the findings, ten recommendations were made for service providers working with vulnerable children and families during the COVID-19 pandemic.
Based on the findings, ten recommendations were made for service providers working with vulnerable children and families during the COVID-19 pandemic.The concept of a flow-through flap refers to a free flap in which both the proximal and distal ends of the vascular pedicle are anastomosed to provide blood flow to the distal tissues. The purpose of this paper is to highlight the use of this technique, which may be useful in selected cases of head and neck reconstruction. In certain situations, like bilateral resection of the base of the tongue involving both lingual arteries, the application of a flow-through forearm free flap can provide an anatomical and functional restoration of the defect while revascularizing the anterior two-thirds of the tongue. We review this technique, which was used in a case of adenoid cystic carcinoma of the base of the tongue with excellent results.

02/07/2025


ck cases require rapidly initiation of medical treatment against allergic reactions. Despite scolocidal agents, vesicular spread into peritoneal cavity account for the major risk factor for disease recurrence. Hence, abdominal cavity should be explored cautiously.
Intraperitoneal rupture of the hydatid cyst is a life-threatening complication of hydatid cyst disease, for which diagnosis without delay and timing of surgical treatment is essential. Anaphylactic shock cases require rapidly initiation of medical treatment against allergic reactions. Despite scolocidal agents, vesicular spread into peritoneal cavity account for the major risk factor for disease recurrence. Hence, abdominal cavity should be explored cautiously.
This study aims to compare clinical and radiographic outcomes of surgical treatment and conservative treatment with bracing in neurologically intact patients with score 4 of TLICS thoracolumbar vertebra fractures.

Patients with traumatic thoracolumbar junction fractures (T11-L2), the score of TLICS 4, and minimum 24-month follow-up were included in this study. Patients were divided into surgery and bracing groups. The groups were compared concerning clinical and demographical features, local kyphotic angles (LKA), vertebra height loss percentage (VHL), Oswestry Disability Index (ODI), Visual Analog Scale (VAS) and time to return to work.

There were 74 patients (71 males, 3 females) in the surgery group and 76 patients (58 males, 18 females) in the bracing group. Although the surgery group showed better improvement in VAS scores within six months postoperatively, no significant difference was observed at the 24th-month evaluation (p<0.001 and p=0.270, respectively). ODI, LKA and VHL were significantly lower in the surgery group (p<0.001, p<0.001 and p<0.001, respectively). In addition, return to work was significantly earlier in the surgery group (p<0.001).

The findings obtained in this study suggest that the surgical treatment for TLICS 4 patients with thoracolumbar fractures has better clinical and radiographic outcomes than the bracing. https://www.selleckchem.com/products/vx803-m4344.html Moreover, returning time to the work of patients is shortened with surgical treatment. The surgical treatment seems to be the first and the appropriate choice in the management of TLICS 4 thoracolumbar vertebral fractures.
The findings obtained in this study suggest that the surgical treatment for TLICS 4 patients with thoracolumbar fractures has better clinical and radiographic outcomes than the bracing. Moreover, returning time to the work of patients is shortened with surgical treatment. The surgical treatment seems to be the first and the appropriate choice in the management of TLICS 4 thoracolumbar vertebral fractures.
This study aims to investigate the clinical outcomes of patients who underwent closed continuous lumbar drainage (CLD) for post-traumatic cerebrospinal fluid (CSF) fistula and to compare with those of non-traumatic patients.

The data of patients who were treated in the department of neurosurgery between January 2018 and December 2019 and underwent CLD were analyzed. The diagnosis, demographic characteristics, CSF results and clinical outcomes of these patients were evaluated. The outcomes of the patients with dura defect and CSF fistula due to trauma were compared with patients who underwent CLD for other diagnoses.

In this study, 45 patients underwent CLD for 51 times. The mean age was 38.84 years, and 27 (60%) of the patients were male. Seven (15.55%) patients underwent CLD due to post-traumatic CSF fistula and 38 patients after tumor or malformation surgery. While five patients developed CSF fistula due to dura defect after gunshot injury, two patients developed CSF fistula secondary to motor vehicle accident. Staphylococcus Epidermidis was isolated in one patient among post-traumatic CSF fistula patients while Serratia Marcescens was isolated in patients with CSF fistula secondary to posterior fossa tumor surgery. While none of the seven patients died during the follow-up period in post-traumatic group, one of the 38 patients with CLD secondary to tumor surgery was lost due to sepsis in the follow-up period.

CLD in post-traumatic CSF fistulas is a safe and effective treatment method. Especially in patients with gunshot wounds, CLD should be performed before revision surgery in the treatment of CSF fistula. Studies with different parameters are needed in larger trauma populations.
CLD in post-traumatic CSF fistulas is a safe and effective treatment method. Especially in patients with gunshot wounds, CLD should be performed before revision surgery in the treatment of CSF fistula. Studies with different parameters are needed in larger trauma populations.
We aim to present our series on pediatric head traumas and discuss our results with the current literature.

The data of children who underwent treatment for head trauma in our department between 2010 and 2019 were retrospectively reviewed. Their clinical condition at admission, radiological findings, treatment methods and outcomes were analyzed.

Ninety children underwent treatment for head trauma, 60 of them were male and 30 were female. The mean age was 6.6 years. Linear skull fracture was seen 55 patients, while epidural hematoma in 15 patients. Twenty patients underwent surgical treatment, while 70 patients underwent conservative treatment. No patient died in our series, three patients underwent rehabilitation due to neurological deficits after discharge.

Children were more prone to head trauma, but their mortality was less than the adults. Conservative treatment should be the first goal, but surgical management should be reserved for children with significant hematoma and declining neurological conditions.
Children were more prone to head trauma, but their mortality was less than the adults. Conservative treatment should be the first goal, but surgical management should be reserved for children with significant hematoma and declining neurological conditions.
Appendicitis is one of the most common surgical emergencies. Early diagnosis of appendicitis is important in children because any delay in treatment substantially leads to complicated appendicitis. In this study, we aimed to test the diagnostic value of pentraxin 3 (PTX3) level in children with acute appendicitis and to investigate whether there is a relationship between the progression of the disease and PTX3 level.

This prospective study included 70 children. They were divided into three groups as follows group 1 (appendicitis; n=37), group 2 (abdominal pain; n=25), group 3 (control; n=8). Demographic data, medical history, the time from the onset of symptoms to blood sampling, operative and pathological findings of the patients were noted, and white blood cell (WBC), C-reactive protein (CRP) and PTX3 values were measured.

The mean WBC, CRP and PTX3 values were found to be significantly increased in the appendicitis group (p<0.001). PTX3 has the highest diagnostic value (AUC=0.828), specificity (88%) and positive predictive value (90%) in the appendicitis group.

Videos

Sorry, no results were found.

People

Sorry, no results were found.

Circles

Sorry, no results were found.

Videos

Sorry, no results were found.

Posts

02/08/2025


In addition, recombinant Pap in combination with M. xanthus recombinant enzymes Ppk1 or adenylate kinase (AdkA) could generate ATP from AMP and polyP60-70. These results suggest a functional role of Pap during M. xanthus starvation, when it might act in cooperation with Ppk1 and/or AdkA to produce ATP from AMP, ADP, and polyP.
Continuous spikes and waves during sleep (CSWS) is an epileptic encephalopathy characterized by generalised epileptiform activity and neurocognitive dysfunction. Causes and outcome are diverse and treatment is mainly empirical.

Retrospective descriptive analysis of clinical and EEG data of children with CSWS diagnosed between 1998 and 2018at the University Hospital Heidelberg.

Ninety-five children were included with a median age at diagnosis of 5.4 years. https://www.selleckchem.com/products/sirpiglenastat.html A structural/metabolic aetiology was found in 43.2%, genetic alterations in 17.9%, while it remained unknown in 38.9%. The proportion of patients with genetic aetiology increased from 10.3% (1998-2007) to 22.8% (2008-2018). On average, each patient received 5 different treatments. CSWS was refractory in >70% of cases, steroids and neurosurgery were most effective. No difference was observed between children with CSWS or Near-CSWS (Spike-Wave-Index 40-85%).

Our cohort confirms CSWS as an age-dependent epileptic encephalopathy. Structural brain abnormalities were most frequent, but genetic causes are increasingly identified. More specific criteria for the diagnosis and treatment goals should be elaborated and implemented based on evidence.

This study is the largest monocentric observational study on treatment effects in children with CSWS, providing data for diagnostic and therapeutic decisions.
This study is the largest monocentric observational study on treatment effects in children with CSWS, providing data for diagnostic and therapeutic decisions.
The objective of this study was to assess the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants' perceptions about ordering WIC groceries online.

Qualitative semistructured interviews were conducted with 24 WIC participants in East Tennessee from May to October 2019. Interviews were transcribed verbatim and analyzed using a grounded theory approach.

Participants were interested in online ordering and spoke favorably about delivery and pickup options. Participants were willing to pay $2-5 to order online, though they were more willing to pay for a home or curbside delivery than an in-store pickup. Participants suggested additional ways to integrate technology into WIC food retail operations, such as providing benefit balances via text message and developing a mobile phone application for Tennessee WIC.

Findings can inform pilot tests for WIC online ordering.
Findings can inform pilot tests for WIC online ordering.A2 or A4 annular finger pulley tears are common injuries in rock climbers. This study reviews the measurement procedures used and tendon-to-bone distance data obtained on high-resolution ultrasound images when diagnosing isolated rupture of the A2 or A4 pulleys. Out of 3447 records extracted, only 7 remained after applying the exclusion criteria. In diagnosing a complete rupture, tendon-to-bone distance used varied widely from 1.9 to 5.1 mm for A2 and from 1.8 to 3.1 mm for A4. Our findings point to a lack of consensus diagnostic criteria for pulley injuries and identify technical details needing further research.
High altitude polycythemia (HAPC) is a common chronic disease at high altitudes. It is characterized by excessive erythrocytosis (≥190 g·L
in females or ≥210 g·L
in males). HAPC severely jeopardizes the health status of plateau dwellers. The Qinghai-Tibet plateau, with an elevation above 4000 m, is the highest plateau in the world. Both Han and Tibetan populations residing there face the threat of HAPC. Therapeutic erythrocytapheresis (TE) was introduced to Tibet as an alternative to phlebotomy in 2015.

In this study, we retrospectively analyzed 155 patients with HAPC treated with TE in Tibet. Routine blood testing values before and after TE were compared to evaluate treatment efficacy. The efficiency rate, defined as the rate of increase in red blood cell depletion attained by TE compared with 450 mL whole blood phlebotomy, was calculated using whole blood volume and hematocrit before and after treatment and used to identify patients who maintained a normal hemoglobin level in the year after the TE procedure.

On average, TE reduced red blood cell levels by 1.5×10
·L
, hemoglobin concentration by 52 g·L
, and hematocrit by 14% (P<0.001 for each). Patients who underwent TE with an efficiency rate ≥1.9 were more likely to maintain a normal hemoglobin level in the following year than those who underwent TE with an efficiency rate <1.9 (90 vs 28%, P<0.01).

TE is a feasible therapeutic method to treat HAPC on the Qinghai-Tibet plateau. The efficiency rate is a useful tool to predict the expected interval between TE procedures.
TE is a feasible therapeutic method to treat HAPC on the Qinghai-Tibet plateau. The efficiency rate is a useful tool to predict the expected interval between TE procedures.
Our previous study showed that high-fat diet inhibited the increase in nitric oxide and endothelial nitric oxide synthase expression in the aortic endothelium of rats exposed to hypoxia, and hypoxia plus a high-fat diet led to earlier and more severe vascular endothelial dysfunction (VED) than hypoxia alone. The purpose of the present study was to investigate the effects of L-arginine on high-fat diet-induced VED of rats in hypoxia.

Forty male Sprague-Dawley rats were randomly divided into 4 groups and treated with hypoxia (H group), hypoxia plus high-fat diet (H+HFD group), hypoxia plus L-arginine (H+L-Arg group), and hypoxia plus high-fat diet and L-arginine (H+HFD+L-Arg group) for 1 wk. Hypoxia was simulated in a hypobaric chamber with an altitude of 5000 m. Aortic morphology and endothelium-dependent vasorelaxation were used to assess VED.

High-fat diet impaired vascular remodeling and reduced endothelium-dependent vasodilator response to acetylcholine in rats exposed to hypoxia, secondary to dysregulation of the nitric oxide pathway.

02/07/2025


Neurocytomas represent 0,25 to 0,5 of brain tumours. https://www.selleckchem.com/products/vx803-m4344.html These tumours have neuronal differentiation. It's a young adult disease. The main treatment is neurosurgery. The place of other therapies is still unclear, noticeably with regards to radiotherapy. This review aim is to determine the place and the modalities of radiotherapy in the management of neurocytomas. A literature search using PubMed allowed to select the most relevant studies. Finally, 22 studies were selected according to pre-established criteria to answer the problem. All studies were retrospective studies except one. The analysis conclusion defined radiotherapy as a treatment of choice in selected patients, when surgical resection was incomplete or when tumour was atypical.New concepts of medical consultations are currently disrupting the practice of medicine. The use of standardized questionnaires, or patient-reported outcome (PRO and ePRO) has already significantly changed the relationship between the physician and the patient. Telemedicine, or even automatic conversational agents, such as chatbots, are also providing more convenient access to care and medical information for many patients. These tools have a major impact in oncology, precisely because of the rising chronicity of the diseases the radiation oncologists treat. In this article, we provide a detailed analysis of these new concepts.Prescription and delivery of protons are somewhat different compared to photons and may influence outcomes (tumour control and toxicity). These differences should be taken into account to fully exploit the clinical potential of proton therapy. Innovations in proton therapy treatment are also required to widen the therapeutic window and determine appropriate populations of patients that would benefit from new treatments. Therefore, strategies are now being developed to reduce side effects to critical normal tissues using alternative treatment configurations and new spatial or temporal-driven optimisation approaches. Indeed, spatiotemporal optimisation (based on flash, proton minibeam radiation therapy or hypofractionated delivery methods) has been gaining some attention in proton therapy as a mean of improving (biological and physical) dose distribution. In this short review, the main differences in planning and delivery between protons and photons, as well as some of the latest developments and methodological issues (in silico modelling) related to providing scientific evidence for these new techniques will be discussed.Symptoms of attention-deficit/hyperactivity disorder (ADHD) run a variable course through adolescence. While most affected individuals show some improvement, particularly of hyperactivity-impulsivity, symptoms of inattention are more persistent, and some individuals may meet diagnostic criteria for the first time during adolescence. Genetic factors affect adolescent symptom trajectories; those showing persistence likely carry a greater burden of common risk alleles. Rare structural genomic variants, such as copy number variants and point mutations, might also play a role. Although psychostimulant medication is associated with better functional outcomes, an impact on underlying adolescent symptom trajectories has been hard to demonstrate. At a neural level, several studies report that adolescents whose childhood ADHD symptoms have remitted are indistinguishable from neurotypical individuals. This finding could reflect the "carrying forward" of relatively typical childhood neural features among those destined for adolescent remission or the correction of early childhood anomalies with a convergence toward typical dimensions. Other studies have noted unique, possibly compensatory patterns of neural activity among adolescents whose ADHD has improved. Finally, different neural processes might occur in different brain regions. Thus, some functional imaging studies find that subcortical anomalies reflect the onset of ADHD and remain throughout life regardless of symptom change, whereas the variable clinical course of adolescent ADHD is determined by plasticity of the cerebral cortex. Integrating an understanding of the neural processes with genomic risk could elucidate the mechanisms underlying the complex course of adolescent ADHD.
The COVID-19 pandemic and associated response measures have led to unprecedented challenges for service providers working with vulnerable children and families around the world.

The goal of the present study was to better understand the impact of the pandemic and associated response measures on vulnerable children and families and provide data-informed recommendations for public and private service providers working with this population.

Representatives from 87 non-government organizations (NGOs) providing a variety of direct services (i.e. residential care, family preservation, foster care, etc.) to 454,637 vulnerable children and families in 43 countries completed a brief online survey.

Using a mixed methods design, results examined 1) ways in which children and families have been directly impacted by COVID-19, 2) the impact of the pandemic on services provided by NGOs, 3) government responses and gaps in services for this population during the pandemic, and 4) strategies that have been effective in filling these gaps.

Data revealed that the pandemic and restrictive measures were associated with increased risk factors for vulnerable children and families, including not having access to vital services. The NGOs experienced government restrictions, decreased financial support, and inability to adequately provide services. Increased communication and supportive activities had a positive impact on both NGO staff and the families they serve.

Based on the findings, ten recommendations were made for service providers working with vulnerable children and families during the COVID-19 pandemic.
Based on the findings, ten recommendations were made for service providers working with vulnerable children and families during the COVID-19 pandemic.The concept of a flow-through flap refers to a free flap in which both the proximal and distal ends of the vascular pedicle are anastomosed to provide blood flow to the distal tissues. The purpose of this paper is to highlight the use of this technique, which may be useful in selected cases of head and neck reconstruction. In certain situations, like bilateral resection of the base of the tongue involving both lingual arteries, the application of a flow-through forearm free flap can provide an anatomical and functional restoration of the defect while revascularizing the anterior two-thirds of the tongue. We review this technique, which was used in a case of adenoid cystic carcinoma of the base of the tongue with excellent results.

02/07/2025


ck cases require rapidly initiation of medical treatment against allergic reactions. Despite scolocidal agents, vesicular spread into peritoneal cavity account for the major risk factor for disease recurrence. Hence, abdominal cavity should be explored cautiously.
Intraperitoneal rupture of the hydatid cyst is a life-threatening complication of hydatid cyst disease, for which diagnosis without delay and timing of surgical treatment is essential. Anaphylactic shock cases require rapidly initiation of medical treatment against allergic reactions. Despite scolocidal agents, vesicular spread into peritoneal cavity account for the major risk factor for disease recurrence. Hence, abdominal cavity should be explored cautiously.
This study aims to compare clinical and radiographic outcomes of surgical treatment and conservative treatment with bracing in neurologically intact patients with score 4 of TLICS thoracolumbar vertebra fractures.

Patients with traumatic thoracolumbar junction fractures (T11-L2), the score of TLICS 4, and minimum 24-month follow-up were included in this study. Patients were divided into surgery and bracing groups. The groups were compared concerning clinical and demographical features, local kyphotic angles (LKA), vertebra height loss percentage (VHL), Oswestry Disability Index (ODI), Visual Analog Scale (VAS) and time to return to work.

There were 74 patients (71 males, 3 females) in the surgery group and 76 patients (58 males, 18 females) in the bracing group. Although the surgery group showed better improvement in VAS scores within six months postoperatively, no significant difference was observed at the 24th-month evaluation (p<0.001 and p=0.270, respectively). ODI, LKA and VHL were significantly lower in the surgery group (p<0.001, p<0.001 and p<0.001, respectively). In addition, return to work was significantly earlier in the surgery group (p<0.001).

The findings obtained in this study suggest that the surgical treatment for TLICS 4 patients with thoracolumbar fractures has better clinical and radiographic outcomes than the bracing. https://www.selleckchem.com/products/vx803-m4344.html Moreover, returning time to the work of patients is shortened with surgical treatment. The surgical treatment seems to be the first and the appropriate choice in the management of TLICS 4 thoracolumbar vertebral fractures.
The findings obtained in this study suggest that the surgical treatment for TLICS 4 patients with thoracolumbar fractures has better clinical and radiographic outcomes than the bracing. Moreover, returning time to the work of patients is shortened with surgical treatment. The surgical treatment seems to be the first and the appropriate choice in the management of TLICS 4 thoracolumbar vertebral fractures.
This study aims to investigate the clinical outcomes of patients who underwent closed continuous lumbar drainage (CLD) for post-traumatic cerebrospinal fluid (CSF) fistula and to compare with those of non-traumatic patients.

The data of patients who were treated in the department of neurosurgery between January 2018 and December 2019 and underwent CLD were analyzed. The diagnosis, demographic characteristics, CSF results and clinical outcomes of these patients were evaluated. The outcomes of the patients with dura defect and CSF fistula due to trauma were compared with patients who underwent CLD for other diagnoses.

In this study, 45 patients underwent CLD for 51 times. The mean age was 38.84 years, and 27 (60%) of the patients were male. Seven (15.55%) patients underwent CLD due to post-traumatic CSF fistula and 38 patients after tumor or malformation surgery. While five patients developed CSF fistula due to dura defect after gunshot injury, two patients developed CSF fistula secondary to motor vehicle accident. Staphylococcus Epidermidis was isolated in one patient among post-traumatic CSF fistula patients while Serratia Marcescens was isolated in patients with CSF fistula secondary to posterior fossa tumor surgery. While none of the seven patients died during the follow-up period in post-traumatic group, one of the 38 patients with CLD secondary to tumor surgery was lost due to sepsis in the follow-up period.

CLD in post-traumatic CSF fistulas is a safe and effective treatment method. Especially in patients with gunshot wounds, CLD should be performed before revision surgery in the treatment of CSF fistula. Studies with different parameters are needed in larger trauma populations.
CLD in post-traumatic CSF fistulas is a safe and effective treatment method. Especially in patients with gunshot wounds, CLD should be performed before revision surgery in the treatment of CSF fistula. Studies with different parameters are needed in larger trauma populations.
We aim to present our series on pediatric head traumas and discuss our results with the current literature.

The data of children who underwent treatment for head trauma in our department between 2010 and 2019 were retrospectively reviewed. Their clinical condition at admission, radiological findings, treatment methods and outcomes were analyzed.

Ninety children underwent treatment for head trauma, 60 of them were male and 30 were female. The mean age was 6.6 years. Linear skull fracture was seen 55 patients, while epidural hematoma in 15 patients. Twenty patients underwent surgical treatment, while 70 patients underwent conservative treatment. No patient died in our series, three patients underwent rehabilitation due to neurological deficits after discharge.

Children were more prone to head trauma, but their mortality was less than the adults. Conservative treatment should be the first goal, but surgical management should be reserved for children with significant hematoma and declining neurological conditions.
Children were more prone to head trauma, but their mortality was less than the adults. Conservative treatment should be the first goal, but surgical management should be reserved for children with significant hematoma and declining neurological conditions.
Appendicitis is one of the most common surgical emergencies. Early diagnosis of appendicitis is important in children because any delay in treatment substantially leads to complicated appendicitis. In this study, we aimed to test the diagnostic value of pentraxin 3 (PTX3) level in children with acute appendicitis and to investigate whether there is a relationship between the progression of the disease and PTX3 level.

This prospective study included 70 children. They were divided into three groups as follows group 1 (appendicitis; n=37), group 2 (abdominal pain; n=25), group 3 (control; n=8). Demographic data, medical history, the time from the onset of symptoms to blood sampling, operative and pathological findings of the patients were noted, and white blood cell (WBC), C-reactive protein (CRP) and PTX3 values were measured.

The mean WBC, CRP and PTX3 values were found to be significantly increased in the appendicitis group (p<0.001). PTX3 has the highest diagnostic value (AUC=0.828), specificity (88%) and positive predictive value (90%) in the appendicitis group.

02/07/2025


At our department, we have completed the diagnosis and proceeded to perform the surgery with which we have the greatest experience. Although slightly at variance with established procedures, the surgery provides a sufficient solution for the patient also in postoperative follow-up.INTRODUCTION Maisonneuve fracture (MF) is a generally known entity in ankle trauma. However, details about this type of injury can be found only rarely in the literature. For these reasons we have decided to perform a study on MF epidemiology and pathoanatomy. METHODS The group comprised 70 patients (47 men, 23 women), with the mean age of 48 years, who sustained an ankle fracture-dislocation involving the proximal quarter of the fibula. Ankle radiographs in three views and lower leg radiographs in two views were performed in all patients. A total of 59 patients underwent CT examination in three views, including 3D CT reconstruction in 49 of these patients. MRI was performed in 4 patients. https://www.selleckchem.com/products/dorsomorphin-2hcl.html Operative treatment was used in 67 patients; open reduction of the distal fibula into the fibular notch was opted for in 54 of them. RESULTS The highest MF incidence rate was recorded in the 5th decade in the whole group and in men, while in women the peak incidence was in the 6th decade. After the age of 50, the share of wudes a wide range of injuries both to bone and ligamentous structures of the ankle. Therefore, CT examination is an indispensable part of assessment of this type of fracture.INTRODUCTION The aim of the study was to radiologically analyse the results of expandable implant insertion in one- to two-level cervical spine somatectomy. METHODS A total of 28 patients undergoing one- to two-level somatectomy in cervical spine were postoperatively examined by CT. The following radiological parameters were studied Cobb angle C2-7, segmental Cobb angle, implant subsidence and bone fusion. RESULTS The average Cobb angle of C2-7 in preoperative images was 13.7 degrees, 13.4 degrees in the early postoperative period (p=0.88), and 10.3 degrees (p=0.043) 2 years after the surgery. The average segmental Cobb angle in preoperative images was 4.4 degrees, 5.2 degrees in the early postoperative period (p=0.61), and 0.2 degrees (p=0.01) 2 years after the surgery. Significant implant subsidence was observed in 15 cases (53.6%). Grade I fusion was achieved in 6 cases (21.4%), grade II fusion in 12 cases (42.9%), and stable pseudoarthrosis (grade III) in 9 cases (32.1%). No cases of unstable pseudoarthrosis (grade IV) were detected. CONCLUSION Implantation of an expandable vertebral body implant in one- to two-level cervical spine somatectomy with ventral plate fixation is a fully acceptable way to reconstruct the ventral column of the cervical spine, providing sufficient long-term stability of the cervical spine and instrumentation and an adequate cervical spine curve.ntroduction Unintended perioperative dural tear is a common complication in spine surgery. Methods Retrospective analysis of patients over 60 years of age who underwent surgery for degenerative disease of the lumbar spine at the Department of Neurosurgery (University Hospital in Martin) from January 2016 to December 2017. Incidence of incidental perioperative durotomy was analyzed. We analyzed selected risk factors gender, ASA (American Society of Anesthesiologists), surgical diagnosis, type of surgical performance, range of surgical procedure, revision surgery and comorbidities. The results were statistically evaluated using descriptive statistics and Fisher›s test. Results with p.INTRODUCTION Until recently, there was a lack of information on sagittal axis parameters of the cervical spine, its relationship to the global sagittal axis of the spine, and their possible implications for long-term clinical outcomes in patients following subaxial cervical spine surgery. The aim of the authors is to provide an overview of the issue from available literature. METHODS The authors present a complete overview of local radiological parameters of the sagittal axis of the cervical spine, an overview of radiological parameters of the total sagittal axis of the spine, and also spinopelvic parameters. Normative values ​​of the majority of individual parameters are summarized. The authors discuss several topics such as The possible effects of sagittal axis parameters on the clinical condition of an individual before surgery; furthermore, whether a change in sagittal parameters of the cervical and whole spine after subaxial cervical spine surgery can affect the clinical condition and postoperative patient satisfaction. Finally, the methodology of specific operations is discussed, including their ability to change the parameters of the sagittal axis of the spine. CONCLUSION Short patient monitoring times and the predominant use of retrospective methodology are common drawbacks of most studies. Also, there are no clearly determined procedures and specifications for surgical correction of the sagittal axis of the cervical spine. As it turns out, multi-stage procedures are more appropriate to achieve changes of the cervical sagittal axis. It is also gradually becoming apparent that any local change of the cervical spine may affect the sagittal axis of the entire spine.The realization of the full potential of nitrogen-containing solid-state materials is limited by the inert and gaseous nature of N2. In this Communication, we describe the simple synthesis yet complex structure of the new phase Mn39Si9Nx (x = 0.84). The formation of this intermetallic subnitride appears to be facilitated by the high solubility of nitrogen in manganese metal, while its structural features are guided by the complementary internal packing strains of Mn-Si and Mn-N domains, an effect known as epitaxial stabilization. These domains intergrow into a composite structure based on the interpenetration of tetrahedrally close-packed (TCP) and Mackay cluster-like modules. We anticipate that other systems combining nitrogen with the TCP packing of metals will be similarly driven toward intergrowth, opening a path to a broader family of intermetallic nitrides.

02/07/2025


Althoughaortic valve replacement (AVR) has been the standard of treatment for severe aortic stenosis, a small aortic annulus (SAA) poses significant challenges. Improvements in valve designs and evolution in surgical techniques have led to improved outcomes, however, the ideal prosthetic valve remains elusive.

We performed a comprehensive literature review to discuss the surgical management of aortic stenosis, with a special focus on patients with SAA.

Stentless valves and root replacement techniques have been shown to overcome the hemodynamic challenges associated with conventional stented bioprostheses, but are technically challenging and require longer cross-clamp times. Sutureless and rapid deployment valves mitigate the long operative time while maintaining the hemodynamic advantages. The use of transcatheter AVR has emerged as another reasonable alternative and has shown promise among patients with SAA, however, long-term outcomes are awaited.

There is no consensus regarding the type of valve prosthesis or replacement technique among patients with SAA. Consideration of patient comorbidities and valvular anatomy is paramount in planning the optimal strategy for AVR. Further long-term clinical trials are necessary to assess outcomes and achieve progress towardthe development of the ideal prosthesis.
There is no consensus regarding the type of valve prosthesis or replacement technique among patients with SAA. Consideration of patient comorbidities and valvular anatomy is paramount in planning the optimal strategy for AVR. Further long-term clinical trials are necessary to assess outcomes and achieve progress toward the development of the ideal prosthesis.
The number of maternal deaths due to pregnancy-associated hemorrhagic stroke has not decreased despite a gradual decrease of maternal death in Japan. This study aimed to clarify the risk factors of hypertensive disorders of pregnancy-associated hemorrhagic stroke.

This retrospective study analyzed pregnancy-associated hemorrhagic stroke patients with hypertensive disorders of pregnancy between 2013 and 2017 among 407 Japanese maternal and perinatal centers. Patients were divided into good or poor outcome groups and their maternal backgrounds and neonatal prognoses were compared.

We analyzed 61 cases, including 41 survival and 20 death cases, obtained from a secondary survey. Among the 61 hemorrhagic stroke cases, 62% were related to hypertensive disorders. Hypertensive disorders of pregnancy were observed in 75% of death cases. Use of MgSO
or antihypertensive medication did not differ between the poor and good outcomes groups. https://www.selleckchem.com/products/cpi-613.html In cases with antepartum onset of hypertensive disorders of pregnancy, outcomes were poor in 12 and good in 6 cases. Nine patients with poor outcomes and one with a good outcome had hypertension at the outpatient department without systemic evaluation (p=0.043). Six poor outcomes patients and one good outcome spent more than 1day from diagnosis at an outpatient clinic. Neurosurgery was performed in 11 poor outcome patients.

Pregnant women who present with a hypertensive disorder at an outpatient clinic probably need to undergo blood tests and careful observation. Delayed systemic evaluation and intensive care for only a few days may result in the development of hemorrhage.
Pregnant women who present with a hypertensive disorder at an outpatient clinic probably need to undergo blood tests and careful observation. Delayed systemic evaluation and intensive care for only a few days may result in the development of hemorrhage.
Dementia patients represent a significant volume of hospital admissions and impose a high cost on the health system. There is a significantly higher length of hospital stay (LOHS) for elderly demented patients.

This study was carried out in an acute psychogeriatric unit specialising in behavioural and psychological symptoms in dementia. Socio-demographic, cognitive and nutritional variables were taken into account. We first compared the patients returning home (group 1) after hospital discharge with those transferred to the rehabilitation psychogeriatric unit (group 2). We secondarily explored the correlation of LOHS with the variables described above for the two groups.

We retained 92 patients (of 375 admitted) for our study, mean age 83.9 ± 6.6, Mini-Mental State Examination 12.8 ± 9.6, initial weight 61.7 ± 13.2 kg and body mass index 24.8± 4.7. We noticed significant differences in cognitive status but not in nutritional variables or in socio-demographic characteristics between the two groups. Only weight in nutritional variables was significantly associated with LOHS in the acute psychogeriatric unit.

Our main finding underlined the key role of cognitive factors in patient discharge home. And only initial weigh seems have an influence in LOHS instead of cognitive status or socio-demographic characteristics.
Our main finding underlined the key role of cognitive factors in patient discharge home. And only initial weigh seems have an influence in LOHS instead of cognitive status or socio-demographic characteristics.
To evaluate the prognostic impact of sarcopenia and myosteatosis on survival after radical cystectomy for bladder cancer.

We retrospectively reviewed consecutive patients who underwent radical cystectomy for bladder cancer between 2010 and 2019, and 123 patients were finally included in this single-center study. Pretreatment computed tomography images at the L3 level were used to calculate skeletal muscle index and skeletal muscle density. Sarcopenia and myosteatosis were diagnosed according to the gender-specific cutoff values of skeletal muscle index and skeletal muscle density used in a previous study. We compared overall survival and cancer-specific survival between patients with and without sarcopenia/myosteatosis. We also performed Cox proportional regression analyses to identify the predictors of overall survival and cancer-specific survival.

The median patient age was 74years, and 20 patients (16%) were female. Thirty-eight patients (31%) died from bladder cancer and 13 (11%) died from other causes.