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scan may not be reliable in appropriate selection of candidacy for successful pyeloplasty.
Robot-assisted laparoscopic pyeloplasty is a safe and effective surgical intervention for correcting UPJ obstruction. Patients with symptoms of UPJ obstruction and discordant functional imaging studies demonstrate similar or improved success rates after pyeloplasty when compared to patients with documented high-grade obstruction. Based on these findings pre-operative renal scan may not be reliable in appropriate selection of candidacy for successful pyeloplasty.Monkeypox is a zoonotic disease, which is endemic in the central and west African regions, which has re-emerged, currently causing an outbreak as of May 2022. In this systematic review, we aimed to characterize the current face of the disease, with a detailed categorization of the mucocutaneous, as well as the systemic symptoms of the disease. We searched four main online databases with the keywords "monkeypox" and "Orthopoxvirus". A total of 46 articles were included, with a cumulative number of 1984 reports of confirmed cases (48 from case reports and 1936 from case series and observational studies). Cases are predominantly men who have sex with men (MSM), who are mostly in their 30s, with history of unprotected sexual contact or international travel. Among mucocutaneous manifestations, anogenital lesions were the most commonly observed, followed by lesions on the limbs, face, trunk, and palms or soles. Among lesion types, vesiculopustular lesions, vesicular-umbilicated lesion, pseudo-pustular lesions and ulcers were the most common. Lesions were mainly asynchronous, with less than 10 lesions presenting on each patient. Almost all patients reported systemic manifestations of the illness as well, mainly with fever, lymphadenopathy, fatigue, myalgia, headaches, pharyngitis and proctitis. We've compared these characteristic idiosyncratic findings of the new outbreak with the previous outbreaks. We've also gathered and categorized images from our included studies to make a "clinical atlas" for this "new" face of the disease, which can be of utmost importance for clinicians to be familiarized with, and have monkeypox in their differential diagnoses. This article is protected by copyright. All rights reserved.In humans, blastocyst hatching and implantation events are two sequential, critically linked and rate-limiting events for a prospective pregnancy. These events are regulated by embryo-endometrium derived molecular factors which include hormones, growth factors, cytokines, immune-modulators, cell adhesion molecules and proteases. Due to poor viability of blastocysts, they fail to hatch and implant, leading to a low 'Live Birth Rates', majorly contributing to infertility. Here, embryo-derived biomarkers analysis plays a key role to assess potential biological viability of blastocysts which are capable of implantation and prospective pregnancy. Thus far, embryo-derived biomarkers examined are mostly immune-modulators which are thought to be associated with blastocyst development-implantation and progression of pregnancy, leading to live births. There is an urgent need to develop a quantitative and a reliable non-invasive approach aiding embryo selection for elective single embryo transfer and to minimize recurrent pregnancy loss and multiple pregnancies. In this article, we provide a comprehensive review on our current knowledge and understanding of potential embryo-derived molecular regulators, that is, biomarkers, of development of human blastocysts, their hatching and implantation. We discuss their potential implications in the assessment of blastocyst implantation potential and pregnancy outcome in terms of live births in humans.
Infant massage is commonly practiced in many parts of the world. However, the effectiveness of this intervention has not been reviewed for term, healthy newborns.

This systematic review of randomized and quasi-randomized controlled trials assessed the effect of whole-body massage with or without oil, compared to no massage in term healthy newborns. Key outcomes were neonatal mortality, systemic infections, growth, behaviour (crying or fussing time, sleep duration), and neurodevelopment. We searched MEDLINE via PubMed, Cochrane CENTRAL, EMBASE, and CINAHL (updated till November 2021), and clinical trials databases and reference lists of retrieved articles. Two authors separately evaluated the risk of bias, extracted data, and synthesized effect estimates using mean difference (MD) and standardized mean difference (SMD). The GRADE approach was used to assess the certainty of evidence.

We included 31 randomized and quasi-randomized trials involving 3860 participants. Infant massage was performed by differe-body massage may improve the infant length at the end of the intervention period (median age 6 weeks, range 1-6 months) but the effect on other short- or long-term outcomes is uncertain. There is a need for further well-designed trials in future.

Priyadarshi M, Balachander B, Rao S, Gupta S, Sankar MJ. Effect of body massage on growth and neurodevelopment in term healthy newborns a systematic review. PROSPERO 2020 CRD42020177442.
Priyadarshi M, Balachander B, Rao S, Gupta S, Sankar MJ. Effect of body massage on growth and neurodevelopment in term healthy newborns a systematic review. PROSPERO 2020 CRD42020177442.We report the case of a 9-year-old girl who presented with asymptomatic lesions on the extensor surfaces of the elbows and knees, in keeping with tuberous xanthoma. She was investigated and diagnosed with homozygous familial hypercholesterolaemia, and commenced on lipid-lowering treatment. We highlight the importance of identification of this condition early, such that life-saving treatment can be initiated and premature death avoided. STC-15 research buy Click here for the corresponding questions to this CME article.
Evaluate the efficacy and safety of triple therapeutic method (Hepatic Aarterial Infusion Chemotherapy-HAIC, lenvatinib and sequential ablation) in the treatment for Advanced Hepatocellular carcinoma (Ad-HCC).

From November 2018 to June 2021, data from 150 consecutive Ad-HCC patients were collected. All patients received HAIC combined with lenvatinib (H-L group, n=97) or HAIC combined with lenvatinib and sequential ablation (H-L-A group, n=53). Complications, overall survival (OS), progression-free survival (PFS) and intrahepatic progression-free survival (IPFS) were compared between both groups.

No significant differences of baseline characteristics were found between groups. The time of median follow-up was 17.8months (range, 6.8, 37.6months). In comparison to the H-L group, the H-L-A group patients showed significantly longer median OS (>30 months vs 13.6months, respectively; p =0.010), PFS (12.8 vs. 5.6months, respectively; p < 0.001), and IPFS (14.6 vs. 6.8months, respectively; p=0.002). According to the results from uni- and multivariable analyses, we considered α-fetoprotein and treatment modality as two survival independent prognostic factors. No significant change of the complication incidences was observed between H-L group and H-L-A group (12.4% vs. 11.3%, p=0.890).

Compared to HAIC combined with lenvatinib only, HAIC combined with lenvatinib and sequential ablation was safer and more effective, improving survival outcomes of Ad-HCC patients. A prospective study will be designed validate the retrospective results.
Compared to HAIC combined with lenvatinib only, HAIC combined with lenvatinib and sequential ablation was safer and more effective, improving survival outcomes of Ad-HCC patients. A prospective study will be designed validate the retrospective results.Climate change is a significant public health crisis that is both rooted in pre-existing inequitable socioeconomic and racial systems and will further worsen these social injustices. In the face of acute and slow-moving natural disasters, women, and particularly women of color, will be more susceptible to gender-based violence, displacement, and other socioeconomic stressors, all of which have adverse mental health outcomes. Among the social consequences of climate change, eco-anxiety resulting from these negative impacts is also increasingly a significant factor in family planning and reproductive justice, as well as disruptions of the feminine connection to nature that numerous cultures historically and currently honor. This narrative review will discuss these sociologic factors and also touch on ways that practitioners can become involved in climate-related advocacy for the physical and mental well-being of their patients.The outbreak of immunotherapy has revolutionized cancer treatment. Despite the results confirming the effectiveness of immunotherapy, some studies have reported poor responsiveness to this therapeutic approach. The effectiveness of immunotherapy is dependent on numerous factors related to patients' lifestyles and health status. Diet, as an essential component of lifestyle, plays a major role in determining immunotherapy outcomes. It can significantly influence the body, gut microbiome composition, and metabolism, both in general and in tumor microenvironment. Consuming certain diets has resulted in either improved or worsened outcomes in patients receiving immunotherapy. For example, several recent studies have associated ketogenic, plant-based, and microbiome-favoring diets with promising outcomes. Moreover, obesity and dietary deprivation have impacted immunotherapy responsiveness, yet the studies are inconsistent in this context. This narrative review aims to integrate the results from many articles that have studied the contribution of diet to immunotherapy. We will start by introducing the multiple effects of dietary status on cancer progression and treatment. Then we will proceed to discuss various regimens known to affect immunotherapy outcomes, including ketogenic, high-fiber, and obesity-inducing diets and regimens that either contain or lack specific nutrients. Finally, we will elaborate on how composition of the gut microbiome may influence immunotherapy.
To demonstrate the equivalence and substitutability of two blood collection methods the push-pull method from a CVC and direct venous puncture (DVP).

A comparative, within-subject study was conducted between September 2021 and December 2021 at a hospital in NanTong city. The sample comprised critically ill patients aged 18 and older in critical care units such as general, emergent, cardiac, respiratory, and neurological units. A total of 154 paired blood samples were collected via a CVC and direct venous puncture. This study focused on the laboratory results of the coagulation and hematologic tests. The reproducibility and reliability of the results were calculated by the mean of the coefficient of variation (CV) and the intraclass correlation coefficient (ICC). Bland-Altman statistics were used to analyze the substitutability of the two blood collection methods.

The difference in the means between the two methods ranged from -1.61 to 0.09, and the coefficients of variation for both methods were similar. The ICCs of the two methods were all above 0.90, which indicated excellent reliability. In the Bland-Altman plots, all of the blood samples that obtained by the push-pull method were within clinically acceptable ranges compared to the samples obtained by direct venous puncture.

The push-pull method of collecting blood specimens from a CVC should be acceptable for coagulation and hematologic laboratory tests.
The push-pull method of collecting blood specimens from a CVC should be acceptable for coagulation and hematologic laboratory tests.
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