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Overcoming LGBTQ+ wellness disparities through instituting a family group remedies program.
anticoagulation in other cancers, we conclude that the risk of VTE in men undergoing chemotherapy for metastatic germ cell tumours can be decreased by thromboprophylaxis with a reasonable risk-benefit profile and by avoidance of venous access devices.In atherosclerosis patients, vascular endothelial dysfunction is commonly observed alongside damage of the vascular endothelial glycocalyx, an extracellular matrix bound to and encapsulating the endothelial cells lining the blood vessel wall. Although atherosclerotic risk factors have been reported in severe patients with coronavirus disease 2019 (COVID-19), the exact mechanisms are unclear. The mortality associated with the COVID-19 outbreak is increased by comorbidities, including hypertension, diabetes, obesity, chronic obstructive pulmonary disease (COPD), and cardiovascular disease. Besides, older individuals and smokers have significantly worse outcomes. Interestingly, these comorbidities and risk factors are consistent with the pathophysiology that causes vascular endothelial glycocalyx damage. Moreover, vascular glycocalyx dysfunction causes microvascular leakage, which results in interstitial pulmonary abnormal shadows (multiple patchy shadows with a ground glass inter-pneumonic appearance). This is frequently followed by severe acute respiratory distress syndrome (ARDS), closely related to coagulo-fibrinolytic changes contributing to disseminated intravascular coagulation (DIC) and Kawasaki disease shock syndrome, as well as inducing activation of the coagulation cascade, leading to thromboembolism and multiple organ failure. Notably, SARS-CoV-2, the causative virus of COVID-19, binds to ACE2, which is abundantly present not only in human epithelia of the lung and the small intestine, but also in vascular endothelial cells and arterial smooth muscle cells. WP1130 Moreover, COVID-19 can induce severe septic shock, and sepsis can easily lead to systemic degradation of the vascular endothelial glycocalyx. In the current review, we propose new concepts and therapeutic goals for COVID-19-related vascular endothelial glycocalyx damage, based on previous vascular endothelial medicine research.
The use and impact of intravascular imaging in ST-elevation myocardial infarction (STEMI) patients has received limited study.

We queried the National Inpatient Sample database (NIS) between January 2016 and December 2017 to identify hospitalizations of STEMI patients who underwent percutaneous coronary intervention (PCI). We used a 12 propensity-score (PS) matched analysis to compare in-hospital outcomes in patients with vs. without use of intravascular imaging. We conducted a multivariable regression analysis to identify variables independently associated with in-hospital mortality.

We identified 252,970 weighted discharges of PCI in STEMI patients, 5.5% of which included intravascular imaging. Patients in whom intravascular imaging was used were more likely to have acute stent thrombosis (4.7% vs. 1.4%, p<0.001) and present with anterior STEMI (48.1% vs. 39.1%, p<0.001). After PS matching (intravascular imaging n=14,015, no intravascular imaging n=28,025), the use of intravascular imaging was associated with lower in-hospital mortality (3.6% vs. 4.8%, p=0.010). The risk of in-hospital complications and discharge to a facility (nursing facility or short-term acute hospital) was similar between both groups before and after PS matching. The use of intravascular imaging was associated with a higher index hospitalization cost [$25,218 vs. $20,515, p<0.001]. On multivariable analysis, intravascular imaging was independently associated with lower in-hospital mortality [OR 0.735 (95% CI 0.662-0.816), p<0.001].

Intravascular imaging was used in 5.5% of PCIs in STEMI patients and was independently associated with lower in-hospital mortality and higher index hospitalization cost.
Intravascular imaging was used in 5.5% of PCIs in STEMI patients and was independently associated with lower in-hospital mortality and higher index hospitalization cost.
About 35,000 people in Germany suffered from stroke-related aphasia in 2019. One of the most frequent manifestations of aphasia are word finding disorders. In times of the COVID-19 pandemic, the temporary approval of video therapy enables the maintenance of speech therapy treatment. This leads to the necessity to investigate the effectiveness of screen-to-screen therapy via a video conferencing system compared to conventional face-to-face therapy of adult aphasia patients.

For this scoping review, a literature search in the databases Cochrane, Pubmed and Web of Science was conducted for the period February 2010 to 2020. We included German- and English-language studies comparing the effectiveness of a classic face-to-face therapy with a screen-to-screen therapy of adults with aphasia. The studies were selected using the PRISMA flowchart.

A total of five studies were identified. Both face-to-face therapy and screen-to-screen therapy showed significant improvements in naming performance in an Italian crosss currently the only possibility to receive speech therapy treatment. Therefore it is a positive aspect that screen-to-screen therapy is as effective as face-to-face therapy. Screen-to-screen therapy can provide expanded access to health care and professional expertise in health services. In this way, speech therapy care during the COVID-19 pandemic can be largely maintained. Further research is needed on evidence-based treatment methods and user-oriented apps for video therapy.
For many patients screen-to-screen therapy is currently the only possibility to receive speech therapy treatment. Therefore it is a positive aspect that screen-to-screen therapy is as effective as face-to-face therapy. Screen-to-screen therapy can provide expanded access to health care and professional expertise in health services. In this way, speech therapy care during the COVID-19 pandemic can be largely maintained. Further research is needed on evidence-based treatment methods and user-oriented apps for video therapy.
To compare the reliability and accuracy of the pre-treatment dosimetry predictions using cone-beam computed tomography (CBCT) versus
Tc-labeled macroaggregated albumin (MAA) SPECT/CT for perfused volume segmentation in patients with hepatocellular carcinoma treated by selective internal radiation therapy (SIRT) using
Y-glass microspheres.

Fifteen patients (8 men, 7 women) with a mean age of 68.3±10.5 (SD) years (range 47-82 years) who underwent a total of 17 SIRT procedures using
Y-glass microspheres for unresectable hepatocellular carcinoma were retrospectively included. Pre-treatment dosimetry data were calculated from
Tc-MAA SPECT/CT using either CBCT or
Tc-MAA SPECT/CT to segment the perfused volumes. link2 Post-treatment dosimetry data were calculated using
Y imaging (SPECT/CT or PET/CT). The whole liver, non-tumoral liver, and tumor volumes were segmented on CT or MRI data. The mean absorbed doses of the tumor (D
), non-tumoral liver, perfused liver (D
) and perfused non-tumoral liver were ces not significantly increase the accuracy of dose prediction compared with that of
Tc-MAA SPECT/CT. At higher doses both methods tend to overestimate the doses to tumors and perfused livers.
CBCT may be a reliable segmentation method, but it does not significantly increase the accuracy of dose prediction compared with that of 99mTc-MAA SPECT/CT. At higher doses both methods tend to overestimate the doses to tumors and perfused livers.
The purpose of this study was to compare morphologic assessment and relaxometry of patellar hyaline cartilage between conventional sequences (fast spin-echo [FSE] T2-weighted fat-saturated and T2-mapping) and synthetic T2 short-TI inversion recovery (STIR) and T2 maps at 1.5T magnetic resonance imaging (MRI).

The MRI examinations of the knee obtained at 1.5T in 49 consecutive patients were retrospectively studied. There were 21 men and 28 women with a mean age of 45±17.7 (SD) years (range 18-88 years). link3 Conventional and synthetic acquisitions were performed, including T2-weighted fat-saturated and T2-mapping sequences. Two radiologists independently compared patellar cartilage T2-relaxation time on conventional T2-mapping and synthetic T2-mapping images. A third radiologist evaluated the patellar cartilage morphology on conventional and synthetic T2-weighted images. The presence of artifacts was also assessed. Interobserver agreement for quantitative variables was assessed using intraclass correlation coef] ms; range 26-49ms) (P<0.0001).

Despite a decrease in examination duration, synthetic images convey lower diagnostic performance for chondropathy, greater prevalence of motion artifacts, and an overestimation of T2 values compared to conventional MRI sequences.
Despite a decrease in examination duration, synthetic images convey lower diagnostic performance for chondropathy, greater prevalence of motion artifacts, and an overestimation of T2 values compared to conventional MRI sequences.
Dyspareunia, one of the main symptoms of the chronic gynecological pelvic pain disorder endometriosis, may interfere with the likelihood of reaching an orgasm, yet for women with dyspareunia, no data on orgasm rates in different sexual activities are available.

The aim of this study was to evaluate the ability to reach an orgasm and its association with sexual satisfaction during different sexual activities in women with a chronic pelvic pain disorder and in healthy control women.

A set of questionnaires including the brief index of sexual functioning and global sexual functioning was used to evaluate sexuality in women affected with endometriosis (n=434) and a nonaffected control group (n=434) recruited in German-speaking countries.

The primary outcome measure of this study was the orgasm rate during different types of sexual activities.

Only the ability to have an orgasm during sexual intercourse (P=.002) but not during masturbation (P=.509) or partnered noncoital sexual activities (P=.229) is affachieving an orgasm and overall sexual satisfaction. The one limitation is that the length and the intimate nature of the questionnaire possibly resulted in reluctance to answer this part of the questionnaire.

Partnered noncoital sexual activities may represent an alternative to reach orgasm for women with endometriosis-related chronic pelvic pain or anorgasmia during sexual intercourse. Hämmerli S, Kohl-Schwartz A, Imesch P, etal. Sexual Satisfaction and Frequency of Orgasm in Women With Chronic Pelvic Pain due to Endometriosis. J Sex Med 2020;172417-2426.
Partnered noncoital sexual activities may represent an alternative to reach orgasm for women with endometriosis-related chronic pelvic pain or anorgasmia during sexual intercourse. Hämmerli S, Kohl-Schwartz A, Imesch P, et al. Sexual Satisfaction and Frequency of Orgasm in Women With Chronic Pelvic Pain due to Endometriosis. J Sex Med 2020;172417-2426.
Domestic and family violence (DFV) is known to escalate during pregnancy. Routine screening for DFV in maternity departments is a widely acceptable practice according to staff and women. This study is part of a 3-year follow-up of an organisational intervention evaluation and aimed to identify clinicians' perceptions of current practices, as well as barriers and enablers to DFV antenatal screening.

Semi-structured interviews were conducted with ten midwives about conducting DFV screening within the maternity department of a large tertiary public hospital in Queensland, Australia. Interview transcripts were read and thematically analysed by two independent researchers.

Four main themes emerged from the data uncertainty despite education and training; fear of opening Pandora's Box; working with 'red flags' and 'gut feelings'; and it's all about the relationship.

Although clinicians identified the importance of guidelines for managing DFV and knowledge of resources and services, confidence varied. Ongoing, formal, mandatory training in the area of DFV was highlighted.
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