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Due to significant heterogeneity regarding the main endpoints, direct comparison of the included prediction scores was inevitable. The majority referred to patients with heart failure with reduced ejection fraction, while only two out of 16 prediction scores have been developed exclusively for heart failure patients with preserved ejection fraction. Ischemic heart disease was the most common aetiology of heart failure in the included studies. Finally, more than half of the prediction scores have not been externally validated. Conclusion Prediction models aiming at heart failure patients with a preserved or mid-range ejection fraction are lacking. Prediction scores incorporating recent advances in pharmacotherapy should be developed in the future.Non-alcoholic fatty liver disease (NAFLD) is a growing cause of liver disease worldwide, involving about 25% of people. NAFLD embraces a large spectrum of patological conditions, from simple steatosis, to non-acoholic steatohepatis (NASH), cirrhosis and its complications, including hepatic decompensation and hepatocellular carcinoma (HCC). This progression occurs, over many years, in asymptomatic way, until advanced fibrosis appears. Thus, the differentiation of NASH from simple steatosis and identification of advanced hepatic fibrosis are key issues. To date, hystological assessment of fibrosis with liver biopsy is the gold standard but obviously invasiveness is the greater threshold. In addiction, rare but potentially life-threatening complications, poor acceptability, sampling variability and cost maybe restrict its use. Furthemore, due to the epidemic of NAFLD worldwide and several limits of liver biopsy evaluation, nonivasive assessment tools to detect fibrosis in NAFLD patients are needed.Tanshinones is an important type of natural products isolated from Salvia miltiorrhiza Bunge with various bioactivities. Tanshinone IIa, cryptotanshinone and tanshinone I are three kinds of tanshinones which have been widely investigated. Particularly, sodium tanshinone IIa sulfonate is a water-soluble derivative of tanshinone IIa and it is used in clinical in China for treating cardiovascular diseases. In recent years, there are increasing interests for investigation of tanshinones derivatives in various diseases. This article present a review of the anti-atherosclerotic effects, cardioprotective effects, anticancer activities, antibacterial activities and antiviral activities of tanshinones and structural modification work in recent years.This report describes the clinical and pathologic characteristics of cystic and myxomatous lesions of synovial joints in 16 cats. The average age was 13.4 years. The elbow was most commonly affected (12/16), and all lesions were unilateral. Degenerative joint disease was a frequent concurrent but bilateral condition. The lesions consisted of fluid-filled cysts lined by synoviocytes (3 cases), solid foci of stellate cells in a myxomatous matrix (2 cases), or a combination of the two (11 cases). In some cases there were areas of transition between the cystic and myxomatous lesions. Mitoses and other features of malignancy were rare to nonexistent. In the 13 cats with follow-up information, the lesion gradually increased in size over a period of years. None of the cats died or were euthanized because of this lesion. We propose that some cats with degenerative joint disease develop synovial cysts, which have the potential to transform to a synovial myxoma.Magnesium alloy is generally accepted as a potential cardiovascular stent material due to its good mechanical properties, biocompatibility, and biodegradability, and has become one of the research hotspots in this field. However, too fast degradation rate and delayed surface endothelialization have been the bottleneck of further application of magnesium alloy stent. In this study, we selected Mg-Zn-Y-Nd, a kind of biodegradable magnesium alloy for cardiovascular stent, and passivated its surface by alkali heat treatment and silane treatment to improve the corrosion resistance, subsequently conjugated Arg-Glu-Asp-Val (REDV) peptide and anti-CD34 to promote endothelial cells adhesion and capture endothelial progenitor cells respectively, further improving surface endothelialization. In addition, the heparin was also immobilized to the Mg-Zn-Y-Nd surface for the consideration of anti-coagulation and anti-inflammation. Systematic material characterization and biological evaluation show that we have successfully developed this composite surface on Mg-Zn-Y-Nd alloy, and achieved multiple functions such as corrosion resistance, promoting endothelialization, and inhibiting platelet/macrophage adhesion.The forced and coerced sterilisation of women living with HIV (WLHIV) is a phenomenon reported in several countries. In Namibia, litigation efforts for cases of forced and coerced sterilisation were successful, yet the psychological and socio-cultural well-being of those affected has not been adequately investigated and addressed. To determine the psychological and socio-cultural effects of involuntary sterilisation on WLHIV in Namibia, qualitative data from seven WLHIV were collected through face-to-face interviews. Our analysis showed that, firstly, there are negative psychological effects manifesting in psychological symptoms associated with anxiety and depression. Secondly, there are negative socio-cultural effects including discrimination, victimisation and gender-based violence. Patriarchal cultural values regarding reproduction, marriage and decision-making contribute to negative psychological and socio-cultural effects. Finally, negative psychological and socio-cultural effects of involuntary sterilisation are long-lasting. selleck products For participants, coping remains difficult, even over a decade after the sterilisations. Given the considerable long-lasting negative psychological and socio-cultural effects, psychological interventions to expedite positive coping and well-being must be prioritised.A nationwide survey describing Swedish post-anaesthesia care units (PACUs), n = 75 was undertaken. The patients most commonly cared for at PACUs were patients who had undergone laparoscopic surgery, 69.3%, followed by patients who had undergone minor orthopaedic surgery, 68%. At the majority of the PACUs, 86.7%, the staff cared for emergency surgery patients and 48% for day surgery patients. In 31% of the PACUs, a pain relief service was offered through a specific pain service team. During the daytime, the anaesthetist in charge most frequently worked in the operating room 42.7%, and on call in the intensive care unit, 37.3% of the time. In 88% of the PACUs, either all or most registered nurses had a specialist education at an advanced level. The most frequent ratio of registered nurses to patients was 1 to 4, 37.3%. However, Swedish PACUS are also staffed by assistant nurses and the most frequent ratio of registered nurse to assistant nurse was 11. Thirty-three (44%) of the PACUs had access to a physiotherapist during the daytime. Almost all PACUs (93.3%) had predetermined discharge criteria but in the majority of PACUs' high-risk patients (68%) were not followed up by an anaesthetist after discharge from the PACU.Purpose To investigate the incidence and clinical predictors, including institutional annual case volume, of critical in-hospital complications after endovascular therapy (EVT) for peripheral artery disease (PAD). Materials and methods The data were extracted from the nationwide registry of peripheral interventions in Japan [Japanese EVT (J-EVT)] between 2012 and 2017. A total of 92,224 EVT cases either for chronic limb-threatening ischemia (CLTI) or intermittent claudication were included in the analysis. The primary outcome measure was critical in-hospital complications, which were defined as a composite of urgent surgery and in-hospital death within 30 days after EVT. The institutional volume was classified into quartiles. The association of institutional volume, as well as baseline characteristics, with the critical in-hospital complications was explored using a multivariable logistic regression model with multiple imputation for missing data. Results are presented as the adjusted odds ratio (OR) with theospital complications than the 1st quartile (OR 0.13, 95% CI 0.07 to 0.23). Conclusion After EVT for symptomatic PAD, 0.3% of the population encountered critical in-hospital complications. A higher institutional volume was significantly associated with a lower risk of critical in-hospital complications.Purpose To evaluate the feasibility and safety of sac embolization with N-butyl cyanoacrylate (NBCA) in emergency endovascular aneurysm repair (EVAR) for ruptured abdominal aortic aneurysm (AAA) and iliac artery aneurysm (IAA) in comparison to EVAR without sac embolization. Materials and methods Between February 2012 and December 2019, among 44 consecutive patients with ruptured AAA or IAA, 29 underwent EVAR. Of these, 22 patients (median age 77.5 years; 18 men) had concomitant sac embolization using NBCA; the remaining 7 patients (median age 88 years; 6 men) underwent EVAR without sac embolization and form the control group. The technical success, clinical success (hemodynamic stabilization), procedure-related complications, and mortality were compared between the groups. Results All EVAR procedures and embolizations were successful. The clinical success rates in the NBCA and control groups were 95% (21/22) and 71% (5/7), respectively (p=0.14). There was no complication related to the procedure. Type II endoleak occurred in 4 of 21 patients (19%) in the NBCA group vs none of the control patients. One patient (5%) died in the NBCA group vs 3 (43%) in the controls (p=0.034). Conclusion Sac embolization using NBCA in emergency EVAR appears to be feasible and safe for ruptured AAA and IAA.Purpose To assess periprocedural results and secondary endovascular procedure outcomes over 5 years in patients aged ≥80 vs less then 80 years undergoing endovascular aneurysm repair (EVAR). Materials and methods Data from the Endurant Stent Graft Natural Selection Global post-market registry (ENGAGE) were used for the analyses. A total of 1263 consecutive patients were enrolled in the prospective, observational, single-arm registry and divided into 2 groups according to age ≥80 years (290, 22.9%) and less then 80 years (973, 77.1%). Baseline patient characteristics, risk scores according to the Society for Vascular Surgery (SVS) reporting standards, American Society of Anesthesiologists (ASA) classification, quality of life assessments [EuroQol 5 (EQ5D) index], and treatment outcomes, including all-cause mortality, aneurysm-related mortality, major adverse events, secondary endovascular procedures, and endoleaks were compared between groups. Results Octogenarians were classified into the highest category of the SVS risk stratification system; however, this did not result in a significant difference in the 30-day mortality [1.4% (4/290) vs 1.2% (12/973) for controls; p=0.85] or major adverse event rates [5.2% (15/290) vs 3.6% (35/973), p=0.23]. Multivariable analysis confirmed that age ≥80 years, pulmonary disease, large aneurysm diameter, and renal insufficiency were significantly associated with all-cause mortality, whereas diameter was the only parameter associated with increased aneurysm-related mortality. The differences in freedom from secondary endovascular procedures over 5 years between octogenarians and controls did not reach statistical significance (88.5% vs 83.2%, p=0.07). Conclusion EVAR can be performed in individuals aged ≥80 years with no statistically significant difference in midterm aneurysm-related deaths compared with younger patients. The findings in this elderly patient cohort show that EVAR can be safely performed with acceptable morbidity rates in octogenarians.
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