Notes

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7% (p = 0.0001), which is less than that of Group A, there is also, improvement of eGFR by 6.7% (p = 0.001), which is less than the eGFR improvement in Group A (12.3%). But there is no statistically significant difference is noted for creatinine clearance in Group B (p = 0.09).

The outcomes for PNL and SWL in patients with renal insufficiency and renal stones are encouraging as minimally invasive procedures with no negative effects on kidney function.
The outcomes for PNL and SWL in patients with renal insufficiency and renal stones are encouraging as minimally invasive procedures with no negative effects on kidney function.
The strategy for treating obstructive colon cancers with metastatic lesions remains unclear. Herein, we report a case of laparoscopic ileo-transverse colon bypass (LITB) before preoperative chemotherapy for an obstructive right colon cancer.

A 59-year-old woman was referred to our institution (Department of Gastroenterological Surgery, Chiba Cancer Center) for liver tumors detected on ultrasound. The clinical diagnosis was ascending colon cancer with multiple liver metastases. Based on the criteria of the International Union against Cancer Committee, 8th edition, the staging was confirmed as cT4aN1M1a(H), cStage IV. Although the primary tumor in the ascending colon extended beyond the colonic wall, curative resection was possible for both primary and metastatic tumors. We planned to administer chemotherapy before the radical surgery to obtain tumor-free resection margins; however, as the obstruction was fatal, LITB was prioritized and performed using five ports. An intracorporeal side-to-side anastomosis was performed between the ileum, 25cm from the terminal ileum, and the transverse colon. The patient was discharged on postoperative day 18 without any complications. After LITB, for preoperative chemotherapy, five courses of capecitabine plus oxaliplatin (CapeOX) + bevacizumab were administered. Six weeks after the preoperative chemotherapy, right hemicolectomy with D3 lymph node dissection and right hepatectomy were performed. Pathological findings of the resected specimen confirmed curative resection of both lesions, and a favorable effect of chemotherapy was obtained. The patient has been alive for over 8months after the surgery, with no evidence of cancer recurrence.

This case report demonstrates the effectiveness of LITB for obstructive right colon cancer in patients who need preoperative chemotherapy.
This case report demonstrates the effectiveness of LITB for obstructive right colon cancer in patients who need preoperative chemotherapy.We performed a meta-analysis to quantify the relationships among a diagnosis of attention-deficit/hyperactivity disorder (ADHD), the use of stimulant medication, and the risk of fracture. There was a significant positive association between ADHD and the risk of fracture. However, stimulant ADHD medication therapy appears to be associated with a reduced risk of fracture in patients with ADHD.
ADHD is associated with an increased fracture risk due to a lack of impulse control. ADHD medication may have a protective effect via behavior modification. However, previous research found an adverse effect of stimulant use on bone mass. Therefore, this meta-analysis study assessed the relationships among ADHD, the use of stimulant medication, and fracture risk.

A literature search was conducted using PubMed and EMBASE from inception through December 2020. Random-effects models were used to determine overall pooled estimates and 95% confidence intervals (CIs).

The meta-analysis included 10 observational studies. Ourant ADHD medication appears to be associated with a lower risk of traumatic fracture but not with a higher risk of stress fracture.
Individuals with ADHD are at higher risk of fracture than the general population. Stimulant ADHD medication appears to be associated with a lower risk of traumatic fracture but not with a higher risk of stress fracture.
The treatment of geriatric acetabular fractures remains controversial. Treatment options include nonoperative management, open reduction and internal fixation (ORIF), total hip arthroplasty (THA) with or without internal fixation, and closed reduction with percutaneous pinning (CRPP). There is currently no consensus on the optimal treatment strategy for geriatric patients with acetabular fractures. The purpose of this study is to compare adverse event rates, functional and radiographic outcomes, and intraoperative results between the various treatment modalities in order to help guide surgical decision making.

We performed a systematic review (registration number CRD42019124624) of observational and comparative studies including patients aged ≥ 55 with acetabular fractures.

Thirty-eight studies including 3,928 patients with a mean age of 72.6years (range 55-99years) and a mean follow-up duration of 29.4months met our eligibility criteria. The pooled mortality rate of all patients was 21.6% (95% confidennline Instructions to Authors www.springer.com/00266 .
On a national level, the minimally invasive approach is widely adopted in Denmark. The adoption of robotic colorectal surgery is increasing; however, the advantage of a robotic approach in right colectomy is still uncertain. The purpose of this study was to compare robotic right colectomy with laparoscopic right colectomy on a national level.

This was a nationwide database study based on data from the Danish Colorectal Cancer Group database. Patients from all colorectal centers in Denmark in the period 2014-2018 treated with curative intend in an elective setting with either robotic or laparoscopic right colectomy were identified. Propensity score matching was performed to adjust for confounding, and the groups were compared on demographics, disease characteristics, operative data, and postoperative and pathology outcomes. Reporting was done in accordance with the STROBE statement.

In total, 4002 patients were available for analysis. Propensity score matching in ratio 21 identified 718 laparoscopic and 359 robotic cases. After matching, we found a higher lymph node yield in the robotic group compared to the laparoscopic group, (32.5 vs. 28.4, P < 0.001), while radicality, plane of dissection, and pathological disease stages showed no differences. There were no statistical differences in morbidity and mortality. Intracorporeal anastomosis (23.7% vs. 4.5%, P < 0.001) was more commonly performed with a robotic approach.

Robotic approach was associated with a significant higher lymph node yield and with similar postoperative morbidity compared to a laparoscopic approach for right colectomy.
Robotic approach was associated with a significant higher lymph node yield and with similar postoperative morbidity compared to a laparoscopic approach for right colectomy.
Immune checkpoint inhibitors can induce a T cell-mediated anti-tumor immune response in patients with melanoma. Visualizing T cell activity using positron emission tomography (PET) might allow early insight into treatment efficacy. Activated tumor-infiltrating T cells express the high-affinity interleukin-2 receptor (IL-2R). Therefore, we performed a pilot study, using fluorine-18-labeled IL-2 ([
F]FB-IL2 PET), to evaluate whether a treatment-induced immune response can be detected.

Patients with metastatic melanoma received ~ 200MBq [
F]FB-IL2 intravenously, followed by a PET/CT scan before and during immune checkpoint inhibitor therapy. [
F]FB-IL2 uptake was measured as standardized uptake value in healthy tissues (SUV
) and tumor lesions (SUV
). Response to therapy was assessed using RECIST v1.1. Archival tumor tissues were used for immunohistochemical analyses of T cell infiltration.

Baseline [
F]FB-IL2 PET scans were performed in 13 patients. SUV
at baseline was highest in the kidneys (14.2, IQR 11.6-18.0) and liver (10.6, IQR 8.6-13.4). In lymphoid tissues, uptake was highest in spleen (10.9, IQR 8.8-12.4) and bone marrow (2.5, IQR 2.1-3.0). SUV
in tumor lesions (n = 41) at baseline was 1.9 (IQR 1.7-2.3). In 11 patients, serial imaging was performed, three at week 6, seven at week 2, and one at week 4. Median [
F]FB-IL2 tumor uptake decreased from 1.8 (IQR 1.7-2.1) at baseline to 1.7 (IQR 1.4-2.1) during treatment (p = 0.043). Changes in [
F]FB-IL2 tumor uptake did not correlate with response. IL-2R expression in four archival tumor tissues was low and did not correlate with baseline [
F]FB-IL2 uptake. click here No [
F]FB-IL2-related side effects occurred.

PET imaging of the IL-2R, using [
F]FB-IL2, is safe and feasible. In this small patient group, serial [
F]FB-IL2-PET imaging did not detect a treatment-related immune response.

Clinicaltrials.gov NCT02922283; EudraCT 2014-003387.20.
Clinicaltrials.gov NCT02922283; EudraCT 2014-003387.20.In grasslands worldwide, modified fire cycles are accelerating herbaceous species extinctions. Fire may avert population declines by increasing survival, reproduction, or both. Survival and growth after fires may be promoted by removal of competitors or biomass and increasing resource availability. Fire-stimulated reproduction may also contribute to population growth through bolstered recruitment. We quantified these influences of fire on population dynamics in Echinacea angustifolia, a perennial forb in North American tallgrass prairie. We first used four datasets, 7-21 years long, to estimate fire's influences on survival, flowering, and recruitment. We then used matrix projection models to estimate growth rates across several burn frequencies in five populations, each with one to four burns over 15 years. Finally, we estimated the contribution of fire-induced changes in each vital rate to changes in population growth. Population growth rates generally increased with burning. The demographic process underpinning these increases depended on juvenile survival. In populations with high juvenile survival, fire-induced increases in seedling recruitment and juvenile survival enhanced population growth. However, in populations with low juvenile survival, small changes in adult survival drove growth rate changes. Regardless of burn frequencies, our models suggest populations are declining and that recruitment and juvenile survival critically influence population response to fire. However, crucially, increased seedling recruitment only increases population growth rates when enough new recruits reach reproductive maturity. The importance of recruitment and juvenile survival is especially relevant for small populations in fragmented habitats subject to mate-limiting Allee effects and inbreeding depression, which reduce recruitment and survival, respectively.
To determine the diagnostic accuracy of dual-energy CT (DECT) virtual noncalcium (VNCa) reconstructions for assessing thoracic disk herniation compared to standard grayscale CT.

In this retrospective study, 87 patients (1131 intervertebral disks; mean age, 66 years; 47 women) who underwent third-generation dual-source DECT and 3.0-T MRI within 3 weeks between November 2016 and April 2020 were included. Five blinded radiologists analyzed standard DECT and color-coded VNCa images after a time interval of 8 weeks for the presence and degree of thoracic disk herniation and spinal nerve root impingement. Consensus reading of independently evaluated MRI series served as the reference standard, assessed by two separate experienced readers. Additionally, image ratings were carried out by using 5-point Likert scales.

MRI revealed a total of 133 herniated thoracic disks. Color-coded VNCa images yielded higher overall sensitivity (624/665 [94%; 95% CI, 0.89-0.96] vs 485/665 [73%; 95% CI, 0.67-0.80]), specificity (4775/4990 [96%; 95% CI, 0.
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