Notes

Botulinum killer type-A vs . 5-fluorouracil from the treatment of plaque skin psoriasis: Marketplace analysis research.
Pes cavus can be defined as an abnormal elevation of the longitudinal arches, which is often secondary to a muscle imbalance. This deformity affects the foot's three dimensions (3D) and our osteotomies are usually planned on a lateral (two-dimension) X-ray. Are we really considering all the spatial components of the deformity? The aim of this study is to present a technique tip to identify the apical plane of the pes cavus deformity and perform a midfoot dorsal-based wedge resection osteotomy by using customized 3D printed surgical guides.

Three patients underwent the presented technique, all for the indication of symptomatic neuromuscular pes cavus with both anterior and posterior deformity.

3D-printed patient-specific guides help the surgeon to minimize human error, improving intraoperative accuracy, while reducing surgical time and intraoperative X-ray exposure.

Closing wedge midfoot osteotomy to correct anterior pes cavus may be an interesting indication to use customized 3D printed surgical guides.
Closing wedge midfoot osteotomy to correct anterior pes cavus may be an interesting indication to use customized 3D printed surgical guides.
Testicular torsion is a common urologic emergency and one of the causes of infertility in males. Hence, prompt diagnosis and treatment are important to prevent testicular damages. It has been reported that memantine, a drug for Alzheimer's disease has anti-oxidative role against cerebral ischemic stroke and cardiac ischemia reperfusion.

In this experimental study, the effects of memantine on a testicular torsion injury in adolescent rat testis after ischemia/reperfusion (I/R) were evaluated.

Thirty-six adolescent rats were divided into three groups with 12 rats per group including sham-operated, T/D (torsion/detorsion)+vehicle, and T/D+memantine (10mg/kg). Testicular torsion was induced for 2h by rotating right testis 720
in the clockwise direction. In treated group 30min before detorsion, a single intraperitoneal dose of memantine was administered. After 4h of reperfusion, orchiectomy was conducted and Histopathological and biochemical evaluations of testicular tissue samples were performed.

The maar torsion. This drug probably acts through reduction of reactive oxygen species and support antioxidant enzyme systems.
These results suggest that administration of memantine before detorsion prevents I/R cellular damage in testicular torsion. This drug probably acts through reduction of reactive oxygen species and support antioxidant enzyme systems.Liposomal amphotericin B is a lipid formulation of the antifungal drug amphotericin B with some distinguishing characteristics in its pharmacological behavior that entail some clinical differences of great interest. The significant improvement in the systemic and renal tolerability is one of them. This fact is related to the great stability of the liposome, promoted by its negative charge, the presence of cholesterol and the remarkable thermo-stability of the remaining lipids that compose it. In this situation, amphotericin B seems to be released from the liposome not spontaneously but when the liposome binds to the ergosterol in the fungal cell membrane. For this reason, there is almost no free amphotericin B in plasma or tissues, although it seems that its availability is greater when there is fungal infection. As a consequence, when the pharmacokinetic behavior is studied, the concentration and availability of liposomal amphotericin B are very high, and its volume of distribution is reduced in comparison with the other formulations.Hormone receptor-positive (HR+) human epidermal growth factor receptor-2 negative (HER2-) tumors represent the most common subtype of metastatic breast cancer (MBC). International guidelines clearly state that endocrine therapy (ET) should be considered the preferred first-line therapy for these patients in the absence of very symptomatic visceral disease or evidence of endocrine resistance. Nonetheless compliance with guidelines significantly vary worldwide for many different reasons. Historically, a substantial proportion of patients with HR+ HER2- MBC have been treated with chemotherapy (CT) in first-line setting, jeopardizing patients' quality of life without a significant benefit in outcome. In 17 observational studies, including more than 63,000 patients, ET was most frequently used in first-line treatment of HR+/HER2- MBC (range, 42%-87%), nonetheless a high proportion of patients received CT (13%-66%) as initial therapy. More recently, results of clinical trials with CDK 4/6 inhibitors improved response, progression-free and overall survival in this population and are currently the standard of care. There was a trend toward increased use of ET in recent years. This review article aims to evaluate real-world data on patterns of first-line treatment of HR+ HER2- MBC with a special focus on the use of CT in this setting and the potential implications and perceived preliminary changes after the introduction of CDK 4/6 inhibitors.
The COVID-19 lockdown could see older adults facing increased anxiety levels due to social isolation. Additionally, the lockdown could be more difficult for those with lower Quality of Life (QoL). We aim to understand predictive factors of older adult's anxiety symptoms during the lockdown as it is a main psychological concern of COVID-19.

Four hundred eleven participants (M
 = 68.95, S.D. = 5.60) completed questionnaires at two time points - before the pandemic and during the lockdown period. Cross-lagged analysis was carried out on two structural equation models - social isolation and anxiety symptoms, and QoL and anxiety symptoms.

Baseline social isolation was associated with more anxiety symptoms at follow-up. However, baseline anxiety symptoms were not associated with social isolation subsequently. For QoL and anxiety symptoms, the relationship was bidirectional.

Older adults who were previously socially isolated and had a lower QoL are particularly vulnerable to the negative psychological impacts of the COVID-19 lockdown.
Older adults who were previously socially isolated and had a lower QoL are particularly vulnerable to the negative psychological impacts of the COVID-19 lockdown.
Race/ethnicity may predispose to higher active treatment rates in septuagenarian or older low risk prostate cancer (CaP) patients. We tested this hypothesis within a contemporary North American cohort.

We relied on the Surveillance, Epidemiology and End Results (SEER) database 2010-2016. The effect of race/ethnicity was tested in univariable and multivariable logistic regression analyses predicting definitive treatment administration. Treatment rates (no local treatment [NLT], external beam radiotherapy [EBRT], radical prostatectomy [RP] and brachytherapy) were examined without, as well as with adjustment for age, socioeconomic status, marital status, residence type, year of diagnosis, other-cause mortality, prostate-specific antigen (PSA) and clinical T stage across races/ethnicities. Moreover, temporal trend analyses were performed.

Of 15,118 septuagenarian or older low risk CaP patients, 11,509 (76.1%) were Caucasian, 1,613 (10.7%) African-American, 1,293 (8.5%) Hispanic/Latino and 703 (4.7%) Asian. line patient and tumor characteristics.
The rates of active treatment in septuagenarian or older low risk CaP patients are surprisingly elevated in all races/ethnicities, even though they decreased over time. All differences in active treatment rates according to race/ethnicity depend on baseline patient and tumor characteristics.
There are limited data to support the safety of active surveillance in men with favorable-intermediate risk prostate cancer due only to a prostate specific antigen (PSA) above 10 ng/ml. We therefore evaluated the impact of pretreatment PSA on risk-stratification in men with Gleason 6 prostate cancer.

We identified men aged 18 to 75 with cT1-2cN0cM0, pre-treatment PSA < 20 ng/ml, Gleason 6 prostate cancer diagnosed from 2010 to 2016 in the National Cancer Database who underwent radical prostatectomy. The associations of patient and disease features with Gleason score upgrading or adverse pathologic features at prostatectomy were evaluated using logistic regression. To evaluate for non linear relationships between PSA and each outcome, we examined predicted marginal event rates standardized for baseline characteristics with PSA modeled using restricted cubic splines RESULTS A total of 75,566 patients were included in the cohort. In unadjusted analyses, patients with pretreatment PSA ≥ 10 ng/ml had higher associated with increased risks of Gleason score upgrading and adverse pathologic features at prostatectomy. Flexible modeling of the relationship between PSA and each outcome did not support dichotomization at a threshold of 10 ng/ml. These results can be used to improve patient risk-stratification for active surveillance.
Acute otitis media is a highly prevalent disease in children. Although guidelines in many countries recommend amoxicillin as the first-line treatment for acute otitis media, the prescribing pattern in Japan is not clear. Our objective was to clarify the amoxicillin prescriptions as first-line antibiotics for acute otitis media and factors associated with amoxicillin prescriptions. Also, changes in amoxicillin prescriptions during the study period by medical facilities were investigated.

Using an administrative claims database, we included new episodes of acute otitis media prescribed antibiotics in children under seven years of age between 2014 and 2018. The proportion of amoxicillin prescription was described. find more Using multivariate logistic regression analysis, factors associated with amoxicillin prescription were evaluated. Rate differences were calculated to describe changes in amoxicillin prescription by medical facilities.

207,213 episodes in 149,929 patients were identified. Amoxicillin prescription tions focused on clinics are needed.The aim of this prospective observational study was to investigate the parameter 'hidden blood loss' (HBL) in the context of orthognathic surgery, incorporating undetected bleeding volumes occurring intra- and postoperatively. Orthognathic bleeding volumes were recorded at three different time points. At the end of the operation the visible intraoperative blood loss (VBL) was measured. Additionally, the perioperative blood loss was calculated 24 h and 48 h postoperatively using the 'haemoglobin balance method'. Analysis of the HBL was based on the difference between the visible intraoperative blood loss (VBL) and calculated blood loss (CBL), determined 48 h after surgery. 82 patients (male 33, female 49) were included in this study, of whom 41 underwent bimaxillary surgery and of whom 41 underwent Bilateral Sagittal Split Osteotomy (BSSO). Statistically significant differences with reference to the absolute bleeding volumes were found when comparing the two treatment modalities. In terms of HBL, a bleeding volume of 287.2 ml (±265.9) in the bimaxillary group and 346.9 ml (±271.3) in the BSSO cohort was recorded. This accounted for 32.2% (bimaxillary surgery) and 62.6% (BSSO) of the CBL after 48 h (BIMAX vs. BSSO, p less then 0.001). HBL is a valuable adjunct to record within the perioperative management of orthognathic surgery to further improve patient safety and postoperative outcomes.
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