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Meta-analyses in the effectiveness associated with pharmacotherapies as well as sublingual allergic reaction immunotherapy capsules pertaining to hypersensitive rhinitis in adults and kids.
Background Anal cancer is a rare disease, which might be the reason for the "one size fits all" approach still used for radiotherapy target contouring. To refine and individualize future guidelines, detailed and contemporary pattern of recurrence studies are needed. Methods Consecutive anal cancer patients, all treated with curative intent intensity-modulated radiotherapy (IMRT), were retrospectively studied (n = 170). Data was extracted from medical records and radiological images. Radiotherapy planning CT's and treatment plans were reviewed, and recurrences were mapped and categorized according to radiation dose. Results The mean dose to the primary tumor was 59.0 Gy. With a median follow-up of 50 months (range 14-117 months), 5-year anal cancer specific survival was 86.1%. Only 1 of 20 local recurrences was located outside the high dose (CTVT) volume. More patients experienced a distant recurrence (n = 34; 20.0%) than a locoregional recurrence (n = 24; 14.1%). Seven patients (4.2%) had a common iliac and/or para-aortic (CI/PA) recurrence. External iliac lymph node involvement (P = 0.04), and metastases in ≥3 inguinal or pelvic lymph node regions (P = 0.02) were associated with a 15-18% risk of CI/PA recurrence. Following chemoradiotherapy, 6 patients with recurrent or primary metastatic CI/PA lymph nodes were free of recurrence at last follow-up. The overall rate of ano-inguinal lymphatic drainage (AILD) recurrence was 2 of 170 (1.2%), and among patients with inguinal metastases at initial diagnosis it was 2 of 65 (3.1%). Conclusions We conclude that other measures than increased margins around the primary tumor are needed to improve local control. selleck chemical Furthermore, metastatic CI/PA lymph nodes, either at initial diagnosis or in the recurrent setting, should be considered potentially curable. Patients with certain patterns of metastatic pelvic lymph nodes might be at an increased risk of harboring tumor cells also in the CI/PA lymph nodes.Objective To observe the surgical index at the different learning stages of thoraco-laparoscopic esophagectomy in the prone position for esophageal cancer and to investigate the learning curve of this surgical procedure. Methods Sixty thoraco-laparoscopic esophagectomies in the prone position for esophageal cancer conducted by the same group of surgeons between January 2014 and December 2015 were retrospectively analyzed. The surgeries were divided into 5 groups, A, B, C, D, and E, in chronological order. The duration of surgery, intraoperative blood loss, total number of lymph nodes removed, rate of the intraoperative conversion to open surgery, complication rate, and length of postoperative hospitalization were recorded and analyzed. Results The general information of the patients did not significantly differ among the 5 groups (P > 0.05). The duration of surgery, intraoperative blood loss, number of lymph node removed, rate of intraoperative conversion to open surgery, and number of injuries to the recurrent laryngeal nerve all significantly differed (P 0.05). Conclusion Thoracic physicians with some endoscopic experience can meet the requirements of the thoraco-laparoscopic esophagectomy in the prone position for esophageal cancer after completing 24-30 surgeries.Background Repeatedly adolescents in Africa have been experiencing early pregnancy by more than 50%, early parenthood by 30% and new HIV infections by more than 80%. Parent - Adolescent communication as an effective strategy on sexual and reproductive health has not been taken up in most of African countries including Ethiopia. The aim of the study was to assess the challenges of Parent - Adolescent communication on sexual and reproductive health practices in Addis Ababa, Ethiopia. Methods A qualitative cross-sectional study exploring Parent - Adolescent communication practices was conducted in two high schools Yeka sub-city, Addis Ababa, Ethiopia. Students aged 15-19 years were recruited for in-depth interviews and focused group discussions (FGD) as well as respective parents for in-depth interviews and parents' FGD. Results Twenty students were available for in-depth interviews and all of them for FDG. Sixteen parents were available for in-depth interviews and nine of them for parent's FGD. Parent - Adolescent communication on sexual and reproductive was reported to be important by both adolescents and parents. The parental initiation is rare. The initial sexual activity by the adolescents triggers initiation by parents. The communications are gender dependent, not planned and not continuous and inhibited by intergenerational cultural taboo. A gap exists in parental knowledge on such communications. Parents deny responsibilities to communicate with adolescent as they fear it will perpetuate early sex practices, adolescents are too young it's an embarrassment, often being busy for household income retards their wills to communicate. Conclusions Parent-Adolescent communications on sexual and reproductive health is not a common practice in Addis Ababa, Ethiopia due to taboo, cultural structures, gender domains and parental knowledge. These findings alarm the risk of adolescent exposure towards unwanted pregnancies, transmissions of HIV/AIDS and Sexually Transmitted Infections in Addis Ababa.Background Emissions from road traffic are under constant discussion since they pose a major threat to human health despite the increasingly strict emission targets and regulations. Although the new passenger car regulations have been very effective in reducing the particulate matter (PM) emissions, the aged car fleet in some EU countries remains a substantial source of PM emissions. Moreover, toxicity of PM emissions from multiple new types of bio-based fuels remain uncertain and different driving conditions such as the sub-zero running temperature has been shown to affect the emissions. Overall, the current literature and experimental knowledge on the toxicology of these PM emissions and conditions is scarce. Methods In the present study, we show that exhaust gas PM from newly regulated passenger cars fueled by different fuels at sub-zero temperatures, induce toxicological responses in vitro. We used exhaust gas volume-based PM doses to give us better insight on the real-life exposure and included one older diesel car to estimate the effect of the new emissions regulations.
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