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A substantial classification-dependent multi-molecular custom modeling rendering study several biphenyl sulphonamide based MMP-8 inhibitors.
BACKGROUND  Endoscopic submucosal dissection (ESD) is widely used to treat gastrointestinal lesions. A traction-assisted (TA) strategy has been recently developed for ESD. In this study, we evaluated the safety and efficacy of TA-ESD compared with conventional ESD (C-ESD). METHODS  We searched PubMed, Embase, Web of Science, and the China National Knowledge Infrastructure to identify randomized clinical trials that compared TA-ESD and C-ESD. No filters for language or date of publication were used. Outcomes included complete resection rate, resected specimen size, procedure time, hemostasis usage (frequency), overall complication rate, perforation rate, and delayed bleeding rate. We used the mean difference (MD) for continuous outcomes in a random-effects model and Peto odds ratio (POR) for binary outcomes where any zero cell existed. Effect sizes and their 95 % confidence intervals (CIs) were determined. RESULTS  12 out of 929 identified articles, including 1499 patients, were analyzed. According to pooled results, TA-ESD produced similar R0 resections to C-ESD, but its procedure time (minutes) was shorter than that of C-ESD (MD - 16.02, 95 %CI - 22.71 to - 9.33). Moreover, TA-ESD had a lower complication rate (POR 0.47, 95 %CI 0.29 to 0.76) and perforation rate (POR 0.24, 95 %CI 0.10 to 0.56) than C-ESD. A nonsignificant difference in delayed bleeding rate was observed, although there was a trend toward this being lower in TA-ESD than C-ESD (POR 0.90, 95 %CI 0.46 to 1.75, I 2 = 12 %). CONCLUSIONS  The traction-assisted strategy improves safety and efficacy in the treatment of patients with ESD. However, we observed different effect sizes in the esophagus, stomach, and colorectum. © Georg Thieme Verlag KG Stuttgart · New York.BACKGROUND  To determine if International Microsurgery Club (IMC) is an effective online resource for microsurgeons worldwide, in providing an avenue for timely group discussions and advice regarding complicated cases, and an avenue for collaboration and information sharing. METHODS  All posts on the IMC Facebook group from member 1 to 8,000 were analyzed according to inclusion criteria and categorized into three categories-case discussion, question, and information sharing. Posts were retrospectively analyzed for number of responses, time of responses, number of "likes," number of treatment options, time of day, and demographics of authors and responders. RESULTS  A retrospective analysis of 531 cases showed an average response rate of 75.7% within 1 hour and as membership grew. The response rate stabilized averaging between 72.5 and 78% across all times of the day. An average of 11.8 microsurgeons was involved per case discussion, and 5.7 treatment options were provided per case. CONCLUSION  IMC is shown to be an effective resource to allow microsurgeons to access timely advice from other microsurgeons without time and distance limitation, and to have interactive group discussions on complicated cases. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.BACKGROUND  Preoperative ultrasound (US)-guided perforator mapping has immensely simplified perforator flap planning. It may be executed by the microsurgeon. Device settings and selection of ultrasound modes are of utmost significance for detection of low-flow microvessels. The following study evaluates different US modes. METHODS  A prospective complete data acquisition was performed from July 2018 to June 2019 in a subset of patients who underwent US-guided flap planning. Multifrequency linear transducers were used applying five US modes. Brightness (B)-mode, color flow (CF), power Doppler (PD), pulse wave (PW), and B-flow modes were evaluated regarding applicability by microsurgeons. Peak systolic velocity (PSV), end diastolic velocity (EDV), and resistance index (RI) were chosen to evaluate flow characteristics. US results were correlated to intraoperative findings. RESULTS  A total number of eight patients (six males and two females) undergoing anterolateral thigh (ALT) or superficial circumflex iliac armage and video materials are provided. CONCLUSION  CCDS proved to be a powerful tool for preoperative perforator characterization when using a structured approach and mapping algorithm. Different techniques may be applied for specific visualizations and performed by the microsurgeon. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Herbal medicines therapy is appreciated by many research works because herbal drugs have relatively high therapeutic window, lower side effects and more cost effective. Guggulipid is an ethyl acetate extract of resin known as guggul from the tree Commiphora wightii / mukul (Arn.) Bhandari. Chemical analysis revealed that the compounds responsible for the major activities of gum guggul are the isomers E- and Z-guggulsterone. Guggul has been used for thousands of years in the treatment of arthritis, inflammation, obesity, cardiac protection, anti-ulcer, anti-epileptic and disorders of lipid metabolism. This review is an assortment of available information reported on its chemical, pharmacological and toxicological properties in various research studies. EN4 concentration The available therapeutic properties of guggulipid make it suitable natural product for the treatment of various disorders like inflammation, pain, wounds, liver disorder and Acne etc. Graphical Abstract Graphical Abstract. © Georg Thieme Verlag KG Stuttgart · New York.OBJECTIVES In this communication we report an important findings, the effect of Al/Mg hydroxide antacid and food on the pharmacokinetics of dexibuprofen when administered concomitantly. METHODS Subjects were divided into four groups, each containing 6 subjects, to evaluate the effect of antacid and food on pharmacokinetic of dexibuprofen. A new HPLC method was developed and validated for plasma sample analysis. Mobile phase was comprised of Acetonitrile Methanol 0.05M Phosphate buffer (401050), pH was adjusted to 6.85±0.01 with NaOH. Mobile phase was eluted through C18-ODS column and drug was detected at 223 nm. Plasma was obtained and stored at - 70°C until analysis. Drug was extracted from each plasma sample of volunteer and quantified by using HPLC technique. RESULTS A decrease in dexibuprofen absorption was observed in Test Group-1 when administered with Antacid as compared to Controlled Group-1. Mean Cmax values showed a significant (p value 0.035) decrease from 44.14±2.3 to 33.1±0.8 μg/mL. Tmax, Area under curve, t1/2, Cl, Vd and Ke were not affected significantly. AUC increased from 195.7±8.9 μg.hr/mL to 222.8±14.7 μg.hr/mL. In contrast, test Group-2 showed an increase in dexibuprofen absorption. t1/2 increased significantly from 4.505±0.19 hrs to 6.216±0.36 hrs whereas Ke reduced from 0.159±0.00 to 0.116±0.006 hrs-1. Cmax increased from 44.877±2.263 to 51.721±0.096 μg/mL. CONCLUSION It is concluded that concomitant intake of Al/Mg hydroxide antacid or food with dexibuprofen has an impact to significantly alter its pharmacokinetic parameters. © Georg Thieme Verlag KG Stuttgart · New York.The frequency and antibiotic susceptibility of bacterial meningitis in children older than one month at Children's Medical Center during 2012-2017 were evaluated in this study. The CSF samples were cultured, and antibiotic sensitivity tests were performed. The samples were cultured on chocolate agar, blood agar (for gram positive) and Mkanky (for gram negative). The antimicrobial susceptibility of the isolates was determined using the disc diffusion method. In total, 72 samples were positive for bacterial infection where Staphylococcus epidermidis (20.8%) was seen most and Enterobacter (1.4%) and Pseudomonas aeruginosa (1.4%) was seen least. Most of these patients were under 1 year of the age and overall frequency of positive cultures of CSF in men (58.3%) was greater than women (41.7%). Bacterial meningitis has relatively diverse etiological factors that include; time of infection, geographical location and age. Most commonly seen bacteria were Staphylococcus aureus with S.epidermidis whereas, Escherichia coli and Pseudomonas aeruginosa was seen least. This result can be substantial in hospitalized patients, because these bacteria are also the result of nosocomial infections. © Georg Thieme Verlag KG Stuttgart · New York.Apolipoprotein C3 is a lipid-binding protein with a pivotal role in triglyceride metabolism and inflammation. This 11-year follow-up study aimed to evaluate apolipoprotein C3 levels and other parameters as markers of hepatic steatosis, in a random, population-based cohort in southern Germany. In 2013, we selected and re-examined 406 study participants (193 women, 213 men; average age 58.1±11.3 years) from the original "Echinococcus multilocularis and other internal diseases in Leutkirch I" (EMIL I) cohort studied in 2002. All participants received upper abdominal sonography to grade potential hepatic steatosis, and blood tests to determine apolipoprotein C3 levels and other laboratory parameters. Body mass index, waist-to-hip ratio, and anthropometric measures were documented. The follow-up study conducted in 2013 included a partial correlation analysis. We found an association between hepatic steatosis and elevated apolipoprotein C3 levels (p less then 0.0001). Study participants with a novel diagnosis of hepatic steatosis had the highest apolipoprotein C3 serum levels (p=0.0002). Hepatic steatosis was associated with low levels of high density lipoprotein cholesterol (p=0.0374), high levels of total cholesterol (p=0.0117), increased homeostasis model assessment of insulin resistance (p=0.0002), elevated alanine transaminase (p less then 0.0001), elevated aspartate transaminase (p=0.0003), and elevated C-reactive protein (p=0.0446). Apolipoprotein C3 serum levels were associated with the presence, disease grade, and new development of hepatic steatosis likewise to biomarkers of the metabolic syndrome. © Georg Thieme Verlag KG Stuttgart · New York.An intestinal stoma (greek στὁμα, stoma mouth, opening) is a surgically created opening of a gut section through the abdominal wall, which serves as an artificial intestinal exit for excretion of feces (synonym preternatural anus). A stoma of the gastrointestinal (GI) tract is often surgically created at the distal small intestine (ileostomy) and the colon (colostomy). Temporary or permanent deviation of fecal excretion may be required to treat various pathological conditions (e.g. congenital anomalies, ileus, inflammatory bowel diseases, posttraumatic, diverticulitis, colorectal malignancy). The creation of an end vs. a loop stoma is technically different. To achieve sufficient patient satisfaction close collaboration between surgeons, professional stoma care with guidance and training as well as support from self-help groups are required. In this way serious stoma-related complications can be avoided.Despite expanded access to HIV treatment worldwide, poor HIV care outcomes persist among adolescent girls and young women (AGYW). This study was conducted among AGYW recruited from the HPTN 068 cohort who had sero-converted to HIV during the main trial between 2011 and 2014. The aim was to examine correlates of anti-retroviral treatment (ART) use. Log binomial regression was used to estimate the crude associations between social support, stigma, and HIV status disclosure and current ART use. Adjusted analyses were also conducted controlling for age and time since diagnosis. Seventy-nine AGYW were included in this analysis. Median age of participants was 20 (range 17 to 24) and time since diagnosis ranged from 0.5 to 4.8 years (median = 2.1). Over 75% of AGYW (n = 60) had sought HIV care at some point, with the same number reporting previous disclosure of their sero-status. However, just 43% (n = 34) of participants were on treatment at the time of the interview. Over half of participants (n = 44; 55.7%) reported social support was available to them most or all of the time, and the median stigma score was 90 (range 80-113).
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