Notes

An inherited treatment.
There are two main accepted reasons of Proximal junctional kyphosis (PJK) after Scheuermann's kyphosis treatment; overcorrection of initial curve and fusion that is too short proximally. The purpose of this study was to evaluate the incidence of PJK in patients who have been previously treated for Schuermann's kyphosis with a curve exceeding 70° and corrected under 40° according to proximal fusion level T2 or T3.

We retrospectively evaluated 30 patients treated for Schuermann's kyphosis with single stage posterior only procedure. We included patients that we achieved at least 50% correction of the initial curve. The surgeries were performed at the same institution by a single senior spinal surgeon. Patients were divided into two groups according to proximal fusion level T2 (16 patients) or T3 (14 patients) and evaluated for PJK, follow-ups ended three years after surgery.

Mean age was 22.7 in T2 and 21.6 years in T3 group. Mean preoperative Cobb angle was 78° in T2 and 78.7° in T3 group. The mean postoperative Cobb angle was 33.2° in T2 and 35° in T3 group. None of the patients showed neurologic complications. Four patients had PJK in T3 group and one needed revision.

Selecting T2 as the proximal fusion level in Schuermann's kyphosis may decrease the incidence of PKJ. Studies with a larger number of patients needed to verify our results.
Selecting T2 as the proximal fusion level in Schuermann's kyphosis may decrease the incidence of PKJ. Studies with a larger number of patients needed to verify our results.
To utilize evidence-based medicine to help determine guidelines for spinal surgery during the Covid-19 era.

A literature review was performed of peer-reviewed articles focused on indications for common procedures in spine surgery. Based on these indications, we sub-categorized these procedures into elective, urgent and emergent categories. Case examples provided.

Indications for spinal surgery were reviewed based on current literature and categorized. This manuscript presents a decision-making algorithm to help provide a guideline for determining the appropriateness of proceeding with spinal surgery during this COVID-19 time period.

Spinal surgery during the COVID-19 pandemic is an intricate challenging decision-making process, involving clinical, sociologic and economic factors.
Spinal surgery during the COVID-19 pandemic is an intricate challenging decision-making process, involving clinical, sociologic and economic factors.
The objective of this study was to describe the clinicopathological details in patients referred to the Gynaecologic Oncology Department with possible ovarian or primary peritoneal cancer where the final diagnosis turned out to be abdominal tuberculosis.

Retrospective chart analysis of 23 cases diagnosed with abdominal tuberculosis who were admitted under the Division of Gynaecologic Oncology suspected to have disseminated peritoneal malignancy, during 2014-2017.

There were 23 patients who were referred to the Gynaecologic Oncology outpatient for evaluation of ascites, to rule out malignancy. The mean age of this patient group was 35years (SD 14.5, range 14-65). this website The mean CA 125 was 333.5 [400.7 (9.09-1568)]. Ascitic fluid analysis confirmed TB in 26%; omental biopsy revealed TB in 69%, and operative diagnostic procedures (laparoscopy and laparotomy) were done in 15 of the 23 patients which had a positive pick up rate of 100% to confirm the diagnosis of TB. Culture of ascitic fluid/omental tissue and PCR patients through multiple diagnostic algorithms using ascitic tap, USG biopsy and then an operative procedure, diagnostic laparoscopy could be considered early in the work up. It is a simple, time-saving and cost-effective way of establishing a diagnosis sooner with least complications.
This study analyses the socio-demographic characteristics associated with post-sterilization regret.

The study uses cross-sectional data from the fourth round of National Family Health Surveys (2015-2016).

Simple bivariate and binary logistic regressions analyses were used.

Research shows that 7% of women aged 15-49 reported sterilization regret, which increased by 2% from 2005 to 2016. It was found that factors significantly associated with sterilization regret were years since sterilization, child loss experience, regions of residence, and quality of services. Women who got sterilized at the age of 30 or more were more likely to express regret, than women who were sterilised before 25 years of age, when adjusted for confounding variables (aO.R= 1.006). Women having sons were less likely to report sterilization regret than women who had only daughters (aO.R.=1.3 for each) but on the contrary women having both son and daughter are significantly less likely to express regret in comparison with women haould result in decreased post-sterilization regret, and will improve sexual relationships following sterilization.
Women need to be counselled about the permanent nature of sterilization in order to avoid future regret as sterilization is largely dominated by socio-economic conditions. Thus, couples' decision-making towards using the contraceptive from the basket of choice would help in uplifting the social and cultural status of women in conservative societies and will have a positive effect on contraceptive use. In addition, efforts should be made to educate both the partners equally about contraceptive methods that have higher efficiency. Further, there is also a need to improve the quality of services, both in terms of counselling and service provision. Lastly, health-related policies should tackle disparities in the empowerment, and economic status of women that would result in decreased post-sterilization regret, and will improve sexual relationships following sterilization.
Women with response to primary treatment for advanced ovarian cancer are said to have progression if CA125 increases more than double the upper normal limit (70IU/L) on follow-up. It was, however, noted that large section of women with CA125 > 35IU/L had disease on imaging.

To compare values of CA125 rise at which radiological recurrence can be detected.

This is a retrospective observational study where women with advanced epithelial ovarian cancer who underwent interval debulking surgery and completed treatment at Tata Medical Center, Kolkata, India, from 2012 to 2016, and were followed up with Ca125. If CA125 doubled or exceeded 35IU/L or increased to ≥ 70IU/L, women were subjected to imaging.

Among 142 women who underwent treatment, 64 women with response to primary treatment had recurrence. Recurrence was noted in two (3%) patients with doubling of Ca125 but ≤ 35IU/, 18 (24%) patients with CA125 > 35IU/L and 41 (64%) patients when CA125 was ≥ 70IU/L. Three patients (5%) with normal CA125 had recurrence. Among the recurrence group, 45 women had R0 during surgery of which 27 (60%) had CA125 ≥ 70IU/L and 14 (31%) had CA125 > 35IU/L during recurrence. Sensitivity and specificity of value > 35IU/L were 30.51% and 33.33%, respectively, with accuracy of 32.03%, while sensitivity and specificity at > 70IU/L were 69.49% and 66.67%, respectively, with accuracy of 67.97%.

CA125 value of ≥ 70IU/L is a better predictor of recurrence; however, imaging done when value rises > 35IU/L would be able to detect significant recurrences early thus allowing early treatment.
 35 IU/L would be able to detect significant recurrences early thus allowing early treatment.
To evaluate β-hCG concentration in vaginal fluid as a biochemical marker for PPROM in suspected cases and its correlation with onset of labour.

This is a prospective case-control study carried out in tertiary care centre in 1year. Total 150 pregnant women of gestational age 28-36week + 6days were included and were divided into two groups control (Group 1) (
 = 50) normal antenatal patients. Group 2 cases with history of leaking per vaginum subdivided into two groups-Group 2A-(
 = 50) with no detectable leakage of amniotic fluid present on per speculum examination and Group 2B-(
 = 50) with minimal leaking per vaginum present upon per speculum examination (frank leaking were excluded). β-hCG level was measured by chemiluminescent microparticle assay, and all women were followed till onset of labour.

Mean β-hCG level in vaginal fluid was measured as 6.10 ± 8.52 mIU/mL, 57.10 ± 30.86 mIU/mL and 111.35 ± 36.01 mIU/mL in Group 1, Group 2A and Group 2B, respectively. By taking 21.5 mIU/ml as cut-off, receiver operating characteristic curve shows sensitivity 100%, specificity 92.0%, positive predictive value 92.6%, negative predictive value 100% and diagnostic accuracy 96%. Regarding the correlation of β-hCG level with onset of labour if the β-hCG level is < 21.5 mIU/ml, 100% pregnancy continued beyond 4weeks and 56% women delivered within 4weeks when β-hCG level is > 75 mIU/ml.

β-hCG in vaginal fluid is a reliable biochemical marker for diagnosing suspected cases of PPROM and is well correlated with onset of labour.
β-hCG in vaginal fluid is a reliable biochemical marker for diagnosing suspected cases of PPROM and is well correlated with onset of labour.Passively-generated data, such as GPS data and cellular data, bring tremendous opportunities for human mobility analysis and transportation applications. Since their primary purposes are often non-transportation related, the passively-generated data need to be processed to extract trips. Most existing trip extraction methods rely on data that are generated via a single positioning technology such as GPS or triangulation through cellular towers (thereby called single-sourced data), and methods to extract trips from data generated via multiple positioning technologies (or, multi-sourced data) are absent. And yet, multi-sourced data are now increasingly common. Generated using multiple technologies (e.g., GPS, cellular network- and WiFi-based), multi-sourced data contain high variances in their temporal and spatial properties. In this study, we propose a "Divide, Conquer and Integrate" (DCI) framework to extract trips from multi-sourced data. We evaluate the proposed framework by applying it to an app-based data, which is multi-sourced and has high variances in both location accuracy and observation interval (i.e. time interval between two consecutive observations). On a manually labeled sample of the app-based data, the framework outperforms the state-of-the-art SVM model that is designed for GPS data. The effectiveness of the framework is also illustrated by consistent mobility patterns obtained from the app-based data and an externally collected household travel survey data for the same region and the same period.Expectation maximization (EM) is a technique for estimating maximum-likelihood parameters of a latent variable model given observed data by alternating between taking expectations of sufficient statistics, and maximizing the expected log likelihood. For situations where sufficient statistics are intractable, stochastic approximation EM (SAEM) is often used, which uses Monte Carlo techniques to approximate the expected log likelihood. Two common implementations of SAEM, Batch EM (BEM) and online EM (OEM), are parameterized by a "learning rate", and their efficiency depend strongly on this parameter. We propose an extension to the OEM algorithm, termed Introspective Online Expectation Maximization (IOEM), which removes the need for specifying this parameter by adapting the learning rate to trends in the parameter updates. We show that our algorithm matches the efficiency of the optimal BEM and OEM algorithms in multiple models, and that the efficiency of IOEM can exceed that of BEM/OEM methods with optimal learning rates when the model has many parameters.
Website: https://www.selleckchem.com/products/blu9931.html