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"We don't have any wonder bullet": Analytic valuations throughout veterans' gentle upsetting injury to the brain evaluations.
This study aimed to assess the effect of spirituality on quality of life of end-stage renal disease patients undergoing hemodialysis (HD). A cross-sectional study was carried out in six HD Units. The sample consisted of 367 patients averaging 61.8 years of age. For the measuring of spirituality and the quality of life, the FACIT-Sp-12 and the Missoula Vitas Quality of Life Index-15, respectively, were completed. Social and demographic data were, also, collected. Spirituality and its dimensions such as Meaning in Life and Peace had a positive effect on Global QoL, Symptoms, Interpersonal and in Well-being. Spirituality can have a positive effect on the QoL of HD patients. Therefore, in the context of the holistic approach of the individual, health systems can include spiritual evaluation and care of HD patients.Peritoneal dialysis (PD) is valuable for patients starting on renal replacement therapy because it preserves residual renal function, maintains hemodynamic stability, and affords higher quality of life than hemodialysis. Amyloid-related kidney disease is a rare condition and a cause of end-stage renal disease, the incidence of which appears to be rising in recent years. Hemoperitoneum is a common complication of PD. In some cases, it requires urgent treatment and careful monitoring for deterioration and potential complications. Although the kidney is a retroperitoneal organ, renal hemorrhage can cause bloody peritoneal dialysate. We encountered a rare case of amyloid light-chain amyloidosis where bilateral perirenal hematoma occurred shortly after initiation of PD. Amyloid angiopathy with increased blood vessel fragility and impaired vasoconstriction may promote bleeding. Therefore, hemoperitoneum in a patient on PD with disease causing fragile blood vessels, such as amyloidosis, should alert the physician to the possibility of underlying angiopathy.
Anxiety and depression are more frequent in cancer patients than general population and may be correlated with cancer prognosis; however, their value in prostate cancer patients is largely unknown. We aimed to evaluate prevalence of anxiety and depression in prostate cancer survivors post the surgeries, and their correlations with patients' disease-free survival (DFS) and overall survival (OS).

A hundred and ninety-four patients with prostate cancer who underwent radical prostatectomy were enrolled. After discharged from hospital, patients were assessed for post-surgery anxiety and depression every 3months using Zung Self-rating Anxiety/Depression Scale (SAS/SDS) for a total of 36months. In addition, disease conditions, DFS, and OS were also documented.

SAS score (P < 0.001), anxiety rate (P = 0.004), SDS score (P < 0.001), and depression rate (P < 0.001) gradually elevated from baseline to month 36 in prostate cancer patients. Anxiety at baseline (P = 0.009) and anxiety at 3years (P = 0.017) were correlated with worse DFS, and anxiety at baseline (P = 0.009) was also correlated with shorter OS in prostate cancer patients. Furthermore, depression at baseline (P = 0.005) and depression at 2years (P = 0.008) were associated with unfavorable DFS, and depression at baseline (P = 0.001), 1year (P = 0.025), and 2years (P = 0.008) were associated with worse OS in prostate cancer patients. Moreover, multivariate Cox's proportional hazards regression analysis elucidated that depression at baseline (P = 0.027) was an independent predictive factor for shorter DFS in prostate cancer patients.

Anxiety and depression both gradually deteriorate, and they correlate with unfavorable survival profile in prostate cancer patients after radical prostatectomy.
Anxiety and depression both gradually deteriorate, and they correlate with unfavorable survival profile in prostate cancer patients after radical prostatectomy.Although safe and feasible, partial adrenalectomy is not a widespread procedure. Endorsement of robotic technologies and fluorescence techniques in adrenal surgery might help develop partial adrenalectomy and could avoid unnecessary total adrenalectomies. learn more When performed in selected cases, partial adrenalectomy is associated with good postoperative outcomes comparable with those reported after total adrenalectomy. It has been hypothesized that one of the advantages of the robotic approach in adrenal-sparing surgery is to reduce manipulation of the gland allowing preservation of the vascularization of the residual adrenal, overcoming some limits when performing a laparoscopic conventional approach. A major drawback of the robotic surgery is its cost, but the overcost due to the use of the robotic system could be balanced by the execution of a high number of partial adrenalectomies leading to fewer life-long replacement steroid treatment. Partial adrenalectomy could become the recommended management for small benign and hormonal active adrenal tumors. Indocyanine green fluorescence (IGF) also seems to be a useful technique to help surgeons identify the adrenal gland and to locate small tumors from the normal adrenal tissue in difficult patients. It is likely that the use of a robotic approach associated with IGF may extend indications of partial adrenalectomy in the years to come.Robotic approach to the liver may allow to perform difficult resections with a minimally invasive strategy in an easier way as compared to standard laparoscopy. The aim of this study is to review our experience with robotic major hepatectomies, reporting technical considerations, and describing the outcomes of patients that underwent either left (LRH) or right robotic hepatectomy (RRH). Our prospectively maintained database was screened to identify all patients that received a major liver resection for benign or malignant disease. Preoperative data and postoperative short-term and long-term outcomes were reported. 261 robotic procedures were performed in our Center between May 2014 and October 2020. 12 patients underwent robotic left hepatectomy (RLH) and 10 patients were treated by robotic right hepatectomy (RRH). In the RLH group, median operative time (OT) was 383 min, median estimated blood loss (EBL) was 300 ml, and median in-hospital stay was of 3 days. In the RRH group, median OT was 490 min, median EBL 725 ml, and median hospital stay was 5 days.
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