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COVID-19 and also Cardiomyopathy: A planned out Review.
ational implications for virtual teaching and learning in nursing education.Microenvironmental cues in tumors induce in a wide variety of cellular states that subsequently lead to cancer cells with distinct cellular identity, behavior, and fate. Recent literature suggests that the ability to change cellular states, a process defined as cell state plasticity, enable cells to rapidly adapt to their changing environment during tumor progression and metastasis. In this review, we will discuss how recent high-resolution intravital microscopy studies have been instrumental to reveal the real-time dynamics of tumor cell state plasticity during the different steps of the metastatic cascade. In addition, we will highlight the role of tumor plasticity during anticancer treatment response, and how plasticity can be used as a potential druggable target.
To compare the neonatal and maternal adverse outcomes among women with cerclage and prepregnancy body mass index (BMI) < versus > 30 kg/m
STUDY DESIGN This retrospective cohort study utilized the U.S. Vital Statistics Datasets from 2011-2013. Inclusion criteria were women with non-anomalous singletons, with cerclage placement, without diabetes or hypertensive disorders, and who delivered at 20-41 weeks. The primary outcome was the composite neonatal adverse outcome (Apgar score below 5 at 5 min, birth injury, assisted ventilation for more than 6 h, neonatal seizure, or neonatal death). The secondary outcomes included the composite maternal adverse outcome (admission to intensive care unit, maternal transfusion, ruptured uterus, unplanned hysterectomy, or unplanned operating room procedure), chorioamnionitis, and cesarean delivery. Multivariable Poisson regression models with robust error variance were used, while adjusting for confounders. Adjusted relative risk with 95 % confidence intervals were cite neonatal adverse outcome was modestly increased in newborns delivered by women with BMI ≥ 30 kg/m2 than those delivered by women with BMI  less then  30 kg/m2. No significant difference was found in the risk of the composite maternal adverse outcome.The analyses of molecular data represent an effective tool for increasing the credibility of taxonomy and facilitate the description of species. Nevertheless, in haemoprotozoa, the growing amount of available sequential data is not matched by the still limited number of well-defined species. Endocrinology agonist We identified four protistan haemoparasites in North Iranian reptiles two Hepatozoon and two Schellackia species. Hepatozoon colubri and Hepatozoon ophisauri were morphologically identified in their type hosts, their partial 18S rDNA was analyzed, and thorough literature data were included in their redescription. The scarce data on the detected Schellackia spp. did not allow for their formal species description. Using an integrative approach, including morphological and geographical features, host specificity, molecular data, and the data published thus far, we face the following main difficulties hindering reliable diagnosis. (1) The lack of molecular data on well-described and named species. (2) The insufficiency of using only morphological and biological features, or only sequential data without morphology, to perform an absolutely reliable species diagnosis. (3) Typical morphological features are more substantial than metric means. (4) High risk of synonymy is present in taxonomy of blood Protista. (5) Artefacts caused by blood smear processing further complicate the correct morphological determination.
Subpial hemorrhages are underrecognized, underreported, and poorly understood. The spectrum of their clinical manifestations and consequences in neonates has not been fully described. Here, we describe the demographic, clinical, and radiographic characteristics of neonates with subpial hemorrhages.

We reviewed the medical records and neuroimaging studies of neonates with subpial hemorrhage who were admitted to our neonatal intensive care unit between September 2009 and December 2020.

Of 114 neonates with intracranial hemorrhage, 31 (27%) had subpial hemorrhage. The majority of neonates in our cohort were male (68%) and born at term (55%). The most common imaging indication was apneas and/or seizures in 58%. Common comorbid conditions included cardiorespiratory failure (42%), hypoxic-ischemic encephalopathy (26%), and coagulopathy (23%). Subpial hemorrhages were multifocal in 45% of neonates, located in the temporal lobe in 45% of neonates, and tended to be larger in neonates with coagulopathy, birth tratcomes.The inhibitory effect of estradiol (E2) on water intake has been recognized for 50 years. Despite a rich literature describing this phenomenon, we report here a previously unidentified dipsogenic effect of E2 during states of low fluid intake. Our initial goal was to test the hypothesis that the anti-dipsogenic effect of E2 on unstimulated water intake is independent of its anorexigenic effect in female rats. In support of this hypothesis, water intake was reduced during estrus, compared to diestrus, when food was present or absent. Water intake was reduced by E2 in ovariectomized rats when food was available, demonstrating a causative role of E2. Surprisingly, however, when food was removed, resulting in a significant reduction in baseline water intake, E2 enhanced drinking. Accordingly, we next tested the effect of E2 on water intake after an acute suppression of intake induced by exendin-4. The initial rebound drinking was greater in E2-treated, compared to Oil-treated, rats. Finally, to reconcile conflicting reports regarding the effect of ovariectomy on water intake, we measured daily water and food intake, and body weight in ovariectomized and sham-operated rats. Predictably, ovariectomy significantly increased food intake and body weight, but only transiently increased water intake. Together these results provide further support for independent effects of E2 on the controls of water and food intake. More importantly, this report of bidirectional effects of E2 on water intake may lead to a paradigm shift, as it challenges the prevailing view that E2 effects on fluid intake are exclusively inhibitory.
Hemodialysis patients with upper extremity vascular access and subclavian vein stenosis at the thoracic outlet can present with significant arm edema and threatened dialysis access that is frequently refractory to endovascular therapy without bone decompression. We have presented our long-term results of first rib resection, followed by endovascular therapy.

We performed a retrospective review of 15 consecutive hemodialysis patients with subclavian vein stenosis treated with first rib resection and endovascular therapy from 2013 to January 2021. The diagnosis was confirmed by ultrasound and venography. Bone decompression was performed with transaxillary or infraclavicular rib resection.

During the study period, we treated 1440 unique dialysis patients. Of these 1440 patients, 346 had undergone subclavian vein angioplasty. Of the 346 patients, 15 had undergone first rib resection and were the subject of the present report. Of the 15 patients, 10 were women and 5 were men. Their mean age was 56.4years (ray and successfully treated with first rib resection, followed by endovascular techniques. The procedure resulted in no morbidity and preserved dialysis access function in all patients during follow-up. Our experience has confirmed that excellent secondary patency and long-term clinical success can be obtained with regular follow-up, although with multiple secondary interventions. The median survival of 69 months after the procedure suggests it is worthwhile to expend this effort to maintain the hemodialysis access function of these patients.
To study the long-term outcomes in patients with occlusive Iliofemoral chronic venous insufficiency of benign etiology treated by dedicated venous stents (Zilver Vena stents; Cook, Bloomington, IN, USA) placed at a single center MATERIALS AND METHODS Retrospective analysis of prospectively collected data from 58 patients with symptomatic benign lower limb chronic venous insufficiency during the period from January 2013 to October 2020. Patients underwent recanalization using Zilver Vena stents at Ain Shams University hospitals. We excluded Patients requiring stenting after intervention for acute DVT, CVI due to malignancy or vascular malformations, previous ipsilateral venous interventions, or CVI due to non-obstructive pathology (reflux). Patients were clinically classified at enrollment by CEAP class, VDS (venous disability score) and Villalta score. Primary, Primary assisted and Secondary stent patency were assessed. Patients were followed clinically and by duplex, at 1, 3, 6, 12 months and annually for ESULTS There were 31 males and 27 females, with ages ranging between 25 to 60 years (mean 43.84 years). All patients had Post Thrombotic Syndrome (PTS) with a mean Villalta score of 16.8 (range 10-31).Patients were treated with dedicated venous stents and had median follow up of 60 months. Median VDS was 3 at the start of the study with a significant decrease to 1 at 5 year follow up (p less then 0.001). 12-month primary patency, assisted primary patency, and the secondary patency were 91.4%, 96.6%, and 98.3%. At the five-year follow-up, primary patency 60.3%, assisted primary patency 65.5%, and secondary patency was 81%. There were no instances of stent fracture, migration, or structural deformities CONCLUSIONS Treating diseased Iliofemoral venous occlusive disease with a dedicated venous stent is an excellent choice for occlusive post-thrombotic syndrome patients. The technique has good 1-year and 5-year patency and is associated with significant clinical improvement and few complications.
Aging is one of the causes of primary lymphedema. However, the effects of aging on the lymphatic system are still not completely understood. We investigated the effects of aging on the lymphatic vessels in the lower extremities of healthy volunteers using photoacoustic imaging.

Healthy volunteers who underwent photoacoustic lymphangiography between March 2018 and January 2019 were enrolled. To visualize lymphatics, indocyanine green (ICG, 5.0mg/mL) was injected subcutaneously into the first and fourth web spaces of the foot and under the lateral malleolus. Subsequently, near-infrared fluorescence lymphography was performed to confirm good ICG flow, and photoacoustic lymphangiography was performed on the medial side of the lower leg. Neodymium-doped yttrium aluminum garnet laser irradiation at 797 and 835nm, the optimal wavelengths for visualizing ICG and blood, was applied. The number of lymphatic vessels shown at areas 10cm (L10) and 20cm (L20) cranially from the internal malleolus was counted.

Nineteen healthy volunteers (4 males and 15 females) were enrolled in the study. Their mean age was 42.9± 12.8years. One volunteer was bilaterally imaged; 15 left lower limbs and 5 right lower limbs were imaged. The number of lymphatic vessels visualized increased with age. There were strong positive correlations between age and L10 (R= 0.729, P< .001) and between age and L20 (R= 0.570, P= .009).

Photoacoustic imaging indicates that the number of lymphatic vessels increases with age. Lymphatic stasis resulted in visualization of not only normal drainage pathways but also nonfunctional lymphatic pathways.
Photoacoustic imaging indicates that the number of lymphatic vessels increases with age. Lymphatic stasis resulted in visualization of not only normal drainage pathways but also nonfunctional lymphatic pathways.
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