Notes

Auto-immune gastritis, without or with pernicious anemia: epidemiology, risk factors, and also specialized medical management.
Nevertheless, further studies are needed to more accurately assess whether and how the type and quantity of sphingomyelins present in breast milk could affect the metabolic health of newborns.HIGHLIGHTSBreast milk is the golden standard for infants' nutritionSphingomyelins are the most represented polar lipids in breast milkThese molecules are involved in both intestinal and neural developments of newbornsMetabolomics is a very useful tool to investigate their precise roleFurther studies are needed to provide eventual nutritional treatment.
Although prophylactic clip closure after endoscopic mucosal resection may prevent delayed bleeding, information regarding colorectal endoscopic submucosal dissection (CR-ESD) is lacking. Therefore, this study evaluated the effect of prophylactic clip closure on delayed bleeding rate after CR-ESD.

A total of 614 CR-ESD procedures performed in 561 patients were retrospectively reviewed. The primary outcome, which was delayed bleeding rate, was analyzed between the prophylactic clip closure and non-closure groups. Furthermore, the predictors of delayed bleeding were also evaluated.

The patients were divided into the clip closure group (
 = 275) and non-closure group (
 = 339). Delayed bleeding rate was significantly lower in the closure group than in non-closure group (6 cases [2.2%] vs. 20 cases [5.9%],
 = .026). The univariate logistic regression analyses revealed that delayed bleeding was significantly associated with laterally spreading tumor-granular-nodular mixed type (LST-G-Mix; odds ratio [OR], 3.77; 95% confidence interval [CI], 1.70-8.34;
 = .001). By contrast, prophylactic clip closure was significantly associated with low delayed bleeding rate (OR, 0.36; 95%CI, 0.14-0.90;
 = .029). The multivariate logistic regression analyses revealed LST-G-Mix as a significant independent delayed bleeding predictor (OR, 3.25; 95%CI, 1.45-7.32;
 = .004), whereas, prophylactic clip closure was identified as a significant independent preventive factor of delayed bleeding (OR, 0.39; 95%CI, 0.15-1.00;
 = .049).

Prophylactic clip closure after CR-ESD is associated with low delayed bleeding rate. LST-G-Mix promotes delayed bleeding, and performing prophylactic clip closure may be advisable.
Prophylactic clip closure after CR-ESD is associated with low delayed bleeding rate. LST-G-Mix promotes delayed bleeding, and performing prophylactic clip closure may be advisable.
Fatty liver disease (FLD) and hypertension are separately associated with cardiovascular (CV) mortality. The two conditions are related in multiple ways. This work aimed to study the joint effect and interaction of FLD and hypertension in respect to overall and CV mortality.

The population-based cohort, Kuopio Ischaemic Disease Risk Factor Study, followed 1569 middle-aged non-diabetic Finnish men for 34 years. Considering adjustment for age, body mass index, smoking and alcohol consumption, separate and combined effects of FLD and hypertension and their interaction at the multiplicative and additive scales regarding all-cause and CV death were assessed using Cox proportional hazards models.

FLD and hypertension coexisted in 8.54% of the men (
 = 134). FLD and hypertension associated, independently and combined, with an increased hazard of all-cause and CV deaths. Non-CV mortality associated with FLD, but not with hypertension. We found a negative interaction between FLD and hypertension regarding the hazard of all-cause (relative excess risk due to interaction (RERI), -0.97; 95% confidence interval (CI), -1.65 to -0.28) and CV mortality (RERI, -1.74; 95% CI, -2.98 to -0.5). The interaction was also found on a multiplicative scale.

We found evidence of a negative interaction between FLD and hypertension in respect to CV mortality. We thus recommend adjusting for FLD or hypertension when studying the effect of the other condition on mortality or CV diseases in middle-aged men.
We found evidence of a negative interaction between FLD and hypertension in respect to CV mortality. We thus recommend adjusting for FLD or hypertension when studying the effect of the other condition on mortality or CV diseases in middle-aged men.
To explore/study/evaluate the relationships among umbilical twist direction, the degree of umbilical twist and differences of umbilical arterial diameters (UAD).

All obstetric patients presenting for prenatal care of singleton fetuses between 18 and 25 weeks gestation to a single provider (MN) from 2015 to 2018 had detailed umbilical cord Doppler measurements. Data including the cord twist direction, degree of twist and number of twists per cord segment length, and the diameters of each UA (UAD) and the umbilical vein (UVD) were extracted from the records. UAs were described as right or left depending on their position at the fetal cord insertion. Three groups were identified Group A right UAD > left UAD and Group B left UAD > right UAD Group C equal UAD. The coiling index was calculated as the inverse of the length of cord required for one complete 360 degrees wrap of the UA around the cord. According to the difference of UADs, the variables of right and left UADs, the coiling index, and frequencieaddition to other fetal characteristics such as fetal movement, or handedness of fetus or mother, fetal hemodynamic forces and structure of muscles of umbilical vessels.Food wastage is a global concern with high economic, social and environmental impacts. Pakistan, a developing country, is also significantly affected by the adverse impacts of food wastage. For overcoming this problem, the transition from a Linear to a Circular Economy (CE) for the management of food wastage can serve as a viable strategy. However, there are barriers of political, technical and cultural nature, which are impediments in the path of this transition. This study aims to identify and prioritize these barriers in order of their significance. This research study evaluated and ranked these barriers using a Fuzzy Multi-Criteria Decision Making (MCDM) technique, the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS). A total of 15 barriers were analyzed, and the 'complicated intrinsic nature of CE', 'misleading information about shelf-life leading to waste rather than distribution', 'the poor economic viability of start-ups with CE model', 'corporate and organizational hesitance to change/innovate' and 'technological backwardness of farmers/growers on the agricultural production side' were ranked as the most significant hurdles. The novelty of this study lies in its application. This study is unique as it has focused on developing countries and proposed policy recommendations for the transition towards a CE. In light of the above-mentioned results, this study provides policy recommendations for public and private sector policymakers that would facilitate the food industry in shifting towards the CE model.It is exceedingly rare to find studies that analyze the effect of gender differences in executive-function tasks in normal cognitive aging, Mild Cognitive Impairment (MCI) and Alzheimer's Disease (AD). The objective of the present study was to analyze the mean differences in performance in four executive-function tasks, the Clock Drawing Test verbal-command, Clock Drawing Test-copy, Phonetic Fluency Test and Trail Making Test-A, according to the gender and impairment group variables. A total of 90 participants (30 patients with Alzheimer's Disease, 30 patients with Mild Cognitive Impairment, and 30 healthy elderly participants; 50% men and 50% women in each group) took part in the study. Selleck BTK inhibitor As expected, the results showed a main effect of the group in most tasks, with a progressively worse performance according to cognitive impairment. Regarding the effect of gender, there were no significant differences in the Mild Cognitive Impairment and healthy elderly groups, but a significantly higher performance of women compared to men was found in the Alzheimer's group. The clinical and theoretical implications of these results are discussed. In particular, the abnormal performance of women with Alzheimer's in the sample may be related to a possible cognitive reserve due to social and educational background in their sociocultural and generational context.
Postpartum bleeding is a life-threatening obstetric complication. The most common cause is uterine atony. There is no method that can treat PPH with 100% effectiveness and therefore, efforts for the development of more effective conservative treatment methods continue. The aim of the study is to compare the effectiveness of the isthmic circumferential suture technique and the Bakri balloon tamponade in the treatment of postpartum bleeding due to uterine atony during cesarean operation.

This study was conducted by retrospectively evaluating the cases who developed uterine atony during cesarean section. Group 1 (
 = 15) consisted of the patients who had undergone the isthmic circumferential suture technique, and Group 2 (
 = 15) comprised patients who had undergone the Bakri balloon tamponade. The two groups were compared with regard to obstetric characteristics, operative time, preoperative and postoperative features, and neonatal outcomes.

The groups were similar with regard to age, obstetric characteless pre-operative blood loss, the isthmic circumferential suture technique may be a better alternative.Background Patent false lumens carry a high risk of aortic events including rupture. False lumen embolization is a useful method to promote thrombosis of false lumen. In the case presented here, direct penetration of the dissected membrane was employed to obtain access to the false lumen, enabling embolization. Case report The case was a 64-year-old female who developed a Stanford type A acute aortic dissection. Replacement of ascending aorta and aortic arch with frozen elephant trunk technique was performed. After the operation, there was a residual flow through the false lumen in the descending thoracic and abdominal aorta. Twenty months later, the patient complained of sudden back pain, and a CT scan demonstrated another new dissection at the distal edge of the open stent. Additionally, the false lumen that had remained since the onset of the type A aortic dissection enlarged during the observation period. An endovascular procedure was planned to exclude the false lumen. Despite closing all communicating channels between true and false lumen using a vascular plug, coils, and stent grafts, the false lumen continued to expand due to the residual flow at the visceral segment. The origin responsible for the flow was not identified. To perform an embolization of the false lumen, access into the false lumen was obtained by penetration of the dissected flap using a trans-septal needle. Following the successful penetration of the flap, embolization of the false lumen was performed using coils and glue. After the embolization, an angiogram of the false lumen confirmed the significant reduction of leakage into the true lumen. The size of the aorta and false lumen decreased after the embolization. Conclusion Direct penetration of the dissected membrane of the aorta was a safe and useful measure for regaining access to the false lumen and for the following endovascular intervention.
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