Notes

Dilated Mixed martial arts join cDAVF along with other arterial feeders upon Animations TOF MRA.
During follow-up, 79 patients (46.4%) died. A single PA isolation did not increase mortality, but PA persistence did (HR 3.06 [1.8-5.2], p = 0.001). We conclude that PA occurs frequently in clinically stable COPD patients, risk factors for a first PA isolation and PA persistence are different, and the latter (but not the former) is associated with increased all-cause mortality.
Multiple attempts have been made to manage the pancreatic stump and the pancreatic duct in order to reduce the rate of postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD), however radiofrequency-based technologies could help to achieve this goal. Previous encouraging clinical and experimental results support the use of endoluminal thermal ablation (ETHA) of the main pancreatic duct to reduce pancreatic exocrine secretion and hence POPF. We here describe our initial clinical experience with ETHA of the main pancreatic duct in two cases at high risk of POPF.

Two cases underwent PD for malignancy with a high risk of POPF (adenocarcinoma, obese patients, surgical difficulties with heavy intraoperative blood loss, soft pancreas or walled-off pancreatitis and a tight small pancreatic main duct). In both cases, ETHA of the main pancreatic duct was conducted intraoperatively just before Blumgart-type pancreatic-jejunal anastomosis using a ClosureFast catheter (Medtronic, Mansfield, MA, USA) normally used for varicose vein treatment (therefore an off-label use).

Although a clear radiological POPF was detected in the second case, the clinical postoperative course in both cases was uneventful. Little pancreatic fluid collected in the abdominal drainage with low levels of amylase enzyme, confirming low exocrine pancreatic function. No other procedure-related complications were detected.

Endoluminal thermal ablation of the main pancreatic duct may be a feasible and safe technique to reduce the adverse effects of POPF after PD.
Endoluminal thermal ablation of the main pancreatic duct may be a feasible and safe technique to reduce the adverse effects of POPF after PD.OBJECTIVE The aim of the study was to assess the potential role of oxidative stress and lipid status in the onset of preeclampsia.METHODS 138 high-risk pregnant women were prospectively followed. Assessment of oxidative stress (TAS, TOS, AOPP and SH groups) and lipid status (t-C, LDL-C, HDL-C, TGC, APO-A1, APO-B) was carried out during the pregnancy.RESULTS 30 women developed preeclampsia. TGC, atherogenic index of plasma, TAS and SH levels were higher in women who subsequently developed preeclampsia (p less then 0.05).CONCLUSION Oxidative stress and lipid status disturbance have a potential role in the onset of preeclampsia in high risk pregnancies.Over the past decade, minimally invasive sacroiliac joint (SIJ) fusion has become an effective treatment for patients suffering from low back pain (LBP) originating from the SIJ. Perioperative C-arm fluoroscopy-assisted surgical navigation during SIJ fusion remains challenging due to the lack of 3D spatial information. This study developed and assessed a 3D CT/2D fluoroscopy integration approach based on digitally reconstructed radiographs (DRRs) obtained from pre-operative CT scans. Development of this approach proved feasible and landmarks were successfully translated, in retrospect, to perioperatively acquired fluoroscopies. Further expansion of and research into the proposed approach to increase perioperative navigation is indicated and additional validation should be performed.Drug overdose is a leading cause of injury and death in the United States, and opioids are among the most significant of causes. For people with opioid use disorders (OUDs), opioid stigma can lead to devastating consequences, including anxiety and depression. Still, mass media may stigmatize people with OUDs by ascribing stigmatizing labels (e.g., "opioid addict") and other stigma features to those individuals. However, it is unclear how these stigmatizing messages influence public perceptions of people with OUDs and public support for rehabilitation and Naloxone administration policies. The model of stigma communication (MSC) provides a framework for understanding these relationships. This study used the MSC in two online factorial experiments, the first among college undergraduates (N = 231) and the second among Amazon Mechanical Turk workers (N = 245), to examine how stigmatizing messages about people with OUDs influence stigma-related outcomes. Results reveal that opioid stigma messages influence different outcomes depending on the content of those messages. Classification messages with a stigmatizing mark (e.g., "Alex appears unkempt") and label (e.g., "opioid addict") led to greater perceptions of dangerousness and threat in both studies. High stigma classification messages also led to an increased desire for behavioral regulation and social distance in Study 2. Structural equation modeling in Study 1 also supported the applicability of the MSC in the opioid context. Implications for health communication theory development and practice are discussed.Child and adolescent psychiatrists are well situated to have meaningful conversations with a population at high risk of substance use youth receiving psychiatric care. However, there has been a dearth of research about behavioral determinants that may influence psychiatrists' willingness to engage in these discussions. This study proposes a model of determinants to help identify influences on psychiatrists' levels of self-efficacy, which theoretically should predict their discussions about substance use. A national survey of child and adolescent psychiatrists was conducted to gather data to test this model, which predicted that training, past experiences with substance use discussions, and communication apprehension would influence self-efficacy. Results showed that the model was an excellent fit to the data, accounting for 49% of the variance in self-efficacy. We discuss how these findings could inform future training initiatives for child and adolescent psychiatrists.While previous reports showed ADP-induced platelet reactivity to be an independent predictor of bleeding after PCI in stable patients, this has never been investigated in patients with cardiogenic shock. The association of bleeding events with respect to ADP-induced platelet aggregation was investigated in patients undergoing primary PCI for acute myocardial infarction complicated by cardiogenic shock and with available on-treatment ADP-induced platelet aggregation measurements. Out of 233 patients, 74 suffered from a severe BARC3 or higher bleed. ADP-induced platelet aggregation was significantly lower in patients with BARC≥3 bleedings (p less then .001). Multivariate analysis identified on-treatment ADP-induced platelet aggregation as an independent risk factor for bleeding (HR = 0.968 per AU). An optimal cutoff value of less then 12 AU for ADP-induced platelet aggregation to predict BARC≥3 bleedings was identified via ROC analysis. Moreover, the use of VA-ECMO (HR 1.972) or coaxial left ventricular pump (HR 2.593), first lactate (HR 1.093 per mmol/l) and thrombocyte count (HR 0.994 per G/l) were independent predictors of BARC≥3 bleedings. In conclusion, lower on-treatment ADP-induced platelet aggregation was independently associated with severe bleeding events in patients with AMI-CS. The value of platelet function testing for bleeding risk prediction and guidance of anti-thrombotic treatment in cardiogenic shock warrants further investigation.The goal of this study was to investigate the effects of sources of information on COVID-19 risk perceptions. Using data from a representative sample of the Portuguese population (N = 1,411) collected early in the pandemic, we find that while media sources were more frequently used, scientific sources played a more important role on perceived personal and societal-level risks; higher trust in scientific sources associated with increased risk perceptions (i.e., amplified perceived risk), trust in social media associated with dismissing personal threat (i.e., attenuated perceived risk). These findings suggest that people's relations with science were determinant factors in risk perceptions, and dimensions that measure these deserve further investigation.The COVID-19 pandemic has made death more salient to individuals, which has partly contributed to the amplification of hostility toward others who have different perspectives from oneself. Recognizing that the politicization of COVID-19 and the resulting polarization have become increasingly critical issues, this study investigates how death-related thinking and hope about the pandemic can affect hostility toward outgroups as well as how conservative and liberal media usages moderate the indirect effects of hope. An online survey experiment of people in the U.S. (N = 759) during the pandemic showed that death arousal reduced hope and that these low levels of hope exacerbated hostility toward outgroups in the pandemic context, confirming the positive impact of hope. Importantly, however, our study did not show that hope had a beneficial impact for heavy conservative media users.Despite the rapid transmission of and death toll claimed by COVID-19, there is evidence of resistance toward behaviors shown to effectively prevent and slow the spread of the disease, such as mask wearing and social distancing. This study applies psychological reactance theory to examine COVID-19 message factors (i.e., message fatigue, issue importance) that may be linked to nonadherence to CDC recommendations via the experience of reactance. Participants (N = 268) were current U.S. residents over the age of 18 who completed an online survey about their perceptions of COVID-19 messaging in general as well as toward a specific COVID-19 message they recalled. learn more Results of structural equation modeling indicated that perceived freedom threat toward a COVID-19 message was predicted positively by message fatigue and negatively by issue importance. Greater perceived freedom threat was linked to greater reactance, which in turn was associated with lower levels of adherence to hygiene- and social-related COVID-19 preventive behavior. Notably, the negative association between reactance and social-related adherence was stronger than that between reactance and hygiene-related adherence. Implications for the role of reactance in risk and crisis communication as well as for public health messaging during the COVID-19 pandemic are discussed.Health policy plays a critical role in determining a state's or nation's overall population health, and health system change has been a priority for a majority of Americans for at least a decade. News coverage can influence health policy development, but little research has examined the quality of that coverage, in part because no consensus exists regarding what information health policy stories should include. This paper describes a series of in-depth interviews with eight health policy experts and 12 experienced journalists who have covered health policy. While rejecting the notion of strict quality criteria that could be applied to all health policy stories, the interviewees agreed on several factors that would improve health policy coverage. They recommended that health policy stories should include information about financial costs to consumers, evidence that a policy will have its intended effect, historical context for the policy, and "relatable hooks" that help consumers understand which groups a policy will affect and how.
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