Notes

Lungs separation inside mature thoracic sedation.
sed release of free fatty acids and systemic insulin resistance. Additionally, angiotensin-converting enzyme 2 and dipeptidyl peptidase 4, which act as receptors for SARS-CoV-2 are also significantly increased in obese individuals. The present manuscript reviews these structural, immune, and molecular changes associated with obesity that make obese individuals more vulnerable to acquiring severe COVID-19 and more challenging to manage associated complications.Case reports are often the first step of innovations and new techniques in science and thus are fundamental for some later established procedures. In addition, they have a great educational effect and offer young scientists the opportunity to gain their first experiences in writing manuscripts. In addition to an interesting detail (e.g. figure), a clear message is essential for a good case report.In the current guidelines on treatment of atrial fibrillation, cryoballoon-based catheter ablation of atrial fibrillation is recommended in addition to radiofrequency ablation and has become established as a standard procedure in the clinical routine of many centers for index pulmonary vein isolation. A safe, simplified and often durable pulmonary vein isolation can be achieved by a systematic approach. This review article provides a practical guide for all steps of cryoballoon-based pulmonary vein isolation, including preprocedural preparation and postinterventional follow-up. Both cryoballoon systems currently available on the market are considered.This study aimed to determine the presence of cryptosporidiosis in immunosuppressed patients hospitalized at the Clinic of Haematology and Oncohaematology in a form of routine screening. Samples were collected from November 2019 to February 2020, when the first wave of the Coronavirus pandemic occurred in Slovakia. A total of 36 samples were collected from patients hospitalized at the Clinic of Haematology and Oncohaematology, both from the open ward and the intensive care unit. For the diagnosis of cryptosporidiosis, a nested PCR targeting the gp60 gene and the SSU rRNA locus was used. From the 36 samples, Cryptosporidium parvum subtype IIaA17G1R1 was diagnosed in 9 patients (7 from the open ward and 2 from the intensive care unit), all hospitalized at the clinic at the same time, in February 2020. The occurrence of the same species and subtype, Cryptosporidium parvum IIaA17G1R1, in 9 patients hospitalized at the same time, both at the open ward and the intensive care unit may suggest a possible transmission occurred at the clinic.
Diabetes during pregnancy increases the risk of maternal and fetal complications. This article reviews the types of CGM currently available, the glucose metrics which correlate with pregnancy outcomes, endocrine organization recommendations, clinical considerations for CGM implementation, and anticipated directions for future research.

CGM use during pregnancy is increasing, and recommendations for use have been incorporated into many organizations' consensus guidelines. Increased time spent within a target range of 63-140mg/dL and lower mean glucose are associated with lower risk of neonatal complications including large for gestational age infants. N-Nitroso-N-methylurea ic50 Use of CGM during pregnancy can detect postprandial and nocturnal hyperglycemia missed by self-monitoring of blood glucose (SMBG) which can be used for prognosis and to guide pharmacologic interventions. The use of continuous glucose monitoring (CGM) during pregnancies complicated by type 1, type 2, and gestational diabetes has been shown to improve outcomes.
CGM use during pregnancy is increasing, and recommendations for use have been incorporated into many organizations' consensus guidelines. Increased time spent within a target range of 63-140 mg/dL and lower mean glucose are associated with lower risk of neonatal complications including large for gestational age infants. Use of CGM during pregnancy can detect postprandial and nocturnal hyperglycemia missed by self-monitoring of blood glucose (SMBG) which can be used for prognosis and to guide pharmacologic interventions. The use of continuous glucose monitoring (CGM) during pregnancies complicated by type 1, type 2, and gestational diabetes has been shown to improve outcomes.There is no firm consensus about the optimal technique for the administration of exogenous surfactant in preterm neonates, and different techniques may be equally effective. The intubation-surfactant-extubation (INSURE) procedure has not been fully described, and important details, such as duration and mode of ventilation, remain unclear, leading to significant clinical practice variations and influencing its suitability and feasibility. Since the first INSURE description, our knowledge in respiratory care has largely progressed, but the technique has not been updated according to current evidence-based practice. Thus, our aim is to formally describe a modern way to perform INSURE, based on the current knowledge and technology, to increase its feasibility and patients' safety. We offer ENSURE (Enhanced INSURE) as an updated and standardised technique for surfactant administration, clarifying crucial issues of the original method by applying current state-of-the-art concepts of respiratory care. We performed a cross-sectional observational study enrolling 57 preterm neonates describing ENSURE feasibility and safety. Conclusion ENSURE can be used as a reference technique in clinical practice, teaching and research. What is Known • There is no consensus about the optimal method for surfactant administration. INSURE technique has been originally described many years ago without considering modern principles of neonatal respiratory care and the available state-of-the-art technology. What is New • We here describe a modern way to perform INSURE, based on the current knowledge and technology. We called it ENSURE (Enhanced INSURE) and clarified crucial points of the original technique, in light of the current knowledge. link2 We verified feasibility and safety of ENSURE in a cross-sectional observational study enrolling 57 preterm neonates.The cultivation of watermelons has been a fast growing agriculture industry in the arid, desert regions of Morocco, relying on groundwater pumping and transformation of rangelands to farms due to growing demand for the fruit in national and international markets. This study aims to measure the impact of watermelon expansion on groundwater resources in the Feija Basin, which is one of the largest watermelon cultivation areas in Southern Morocco. Field measurements, statistics, Kriging interpolation, and regression methods were used to measure the temporal variations in the groundwater level (GL) and salinity between 2013 and 2018 to determine the correlation between different parameters. Remote sensing data was also used to monitor the watermelon cultivation expansion. Results show a rapid expansion of agricultural areas from just 185.11 ha in 2007 to 2560.1 ha in 2018. The groundwater level declined rapidly by about 10 m below ground level during the 5 years of the study period. Additionally, the decline was accompanied by a significant increase in electrical conductivity (salinity) values over the same time interval from 1077.55 to 1211.9 µS/cm. As a consequence of the continuous overexploitation and unsustainable management, a lot of wells have run dry and there have been drinking water shortages in the city of Zagora, the closest city nearby. Results can help target efforts to improve the implementation of conservation strategies to ensure the sustainability of water use and food production in this region of Morocco.
Osteoid osteomas of the foot are rare, with avarying and atypical clinical as well as radiological presentation impeding early diagnosis and treatment. link3 The aim of the present multicentre study was to 1)analyze epidemiological, clinical and radiological findings of patients with foot osteoid osteomas and to 2)deduce adiagnostic algorithm based on the findings.

A total of 37 patients (25males, 67.6%, mean age 23.9years, range 8-57years) with osteoid osteomas of the foot were retrospectively included, treated between 2000 and 2014 at 6participating tertiary tumor centres. Radiographic images were analyzed, as were patients' minor and major complaints, pain relief and recurrence.

Most osteoid osteomas were located in the midfoot (n = 16) and hindfoot (n = 14). Painful lesions were present in all but one patient (97.3%). Symptom duration was similar for hindfoot and midfoot/forefoot (p = 0.331). Cortical lesions required fewer x‑rays for diagnosis than lesions at other sites (p = 0.026). Atypical nidus could be detected in only 23/37 of x‑rays (62.2%), compared to 25/29 CT scans (86.2%) and 11/22 MRIs (50%). Aspirin test was positive in 18/20patients (90%), 31 patients (83.8%) underwent open surgery. Pain relief was achieved in 34/36patients (outcome unknown in one), whilst pain persisted in two patients with later confirmed recurrence.

As previously reported, CT scans seem to be superior to MRIs towards detection of the typical nidus in foot osteoid osteomas. In patients with unclear pain of the foot and inconclusive x‑rays, osteoid osteoma should be considered as differential diagnosis.
As previously reported, CT scans seem to be superior to MRIs towards detection of the typical nidus in foot osteoid osteomas. In patients with unclear pain of the foot and inconclusive x‑rays, osteoid osteoma should be considered as differential diagnosis.Persistent thrombocytopenia (PT) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is associated with an increased risk of bleeding and poor survival. The exact pathogenesis underlying PT remains unclear, and its management is difficult. Here we conducted a retrospective study to evaluate the efficacy and safety of eltrombopag (EPAG) in 34 patients with PT after allo-HSCT. Seven patients suffered from prolonged isolated thrombocytopenia (PIT), and 27 had secondary failure of platelet recovery (SFPR). For most patients, the initial dose was 25 mg or 50 mg daily, then adjusted to the maximum dose of 50-100 mg per day according to the response of platelet recovery and toleration of patients. The cumulative incidence (CI) of platelet recovery to at least 20 × 109/L and 50 × 109/L without transfusion support for at least 7 days was 72.1% and 60.7%, respectively. Nineteen (86.4%) of 22 responders were able to taper off the medication; furthermore, the platelet counts remained stable 1 month after withdrawal of EPAG. Although two patients discontinued EPAG during treatment due to headache and nausea, no patients developed grade 3 or 4 toxicities. Hypoplasia of bone marrow and decreased megakaryocytes (MKs) were found to be risk factors for overall response (OR) and complete response (CR) in multivariate analysis, respectively. Overall, our results indicated that EPAG can be used in the treatment of PT and that continuous exposure to EPAG may not be necessary.
Due to intraoperative optical coherence tomography (iOCT), observation of retinal morphological changes during surgery has become possible.

To analyze the intraoperative morphology of full thickness macular holes (FTMH) and the correlation with the postoperative function, aretrospective, observational clinical study was performed analyzing 32eyes of patients treated at the hospital of the technical university of Munich.

Using iOCT in 32eyes of 32consecutive patients, the operative morphology was analyzed during surgery. These findings were then correlated with the postoperative visual outcome.

After posterior vitreous detachment (PVD) the macular hole index (MHI) decreased by -0.05 (p = 0.01) and the base diameter (BD) increased by +99.4 μm (SD = 197.8 μm; p = 0.04). Closure rate was 100% at the first visit after amean time of 73days and the postoperative best corrected visual acuity (BCVA) significantly improved (p < 0.05). There were significant correlations between intraoperative morphology and postoperative results indicating arelation between low MHI and better postoperative BCVA (SCC = 0.
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