Notes

Practical use regarding Procalcitonin in Diagnosing Diabetic person Base Osteomyelitis: A Pilot Review.
Complications associated with this access contribute to significant morbidity and mortality, while the loss of access is an increasingly common reason for intestinal transplant referral. As more emphasis has been placed on the prevention of central line-associated bloodstream infections and new technologies have developed, care for central lines has improved; however, because care has evolved independently in local centers, care of central venous access varies significantly in this vulnerable population. The present position paper from the Intestinal Failure Special Interest Group of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) reviews current evidence and provides recommendations for central line management in children with intestinal failure.
To evaluate non-invasive predictive factors of varices with a high risk of bleeding in pediatric cirrhotic patients.

This retrospective, cross-sectional study included data from 158 children with cirrhosis, median age of 5.38 years (interquartile [IQ] 2.08-11.52 years), and no history of upper gastrointestinal bleeding. Patients underwent an endoscopy to screen for esophageal varices. Varices with a high risk of bleeding were defined as those with a medium to large caliber, presence of red spots, or the presence of gastric varices and identified as high-risk varices (HRV). Laboratory and clinical factors were evaluated as possible predictors of HRV.

HRV were detected in 30 children (19%) after the first endoscopy. In the multivariate analysis, only the risk score (RS), as described by Park et al, and the aspartate aminotransferase-to-platelet ratio index (APRi) were predictive of HRV. The best non-invasive predictor of HRV was the RS with an area under the receiver operating characteristic curve of 0.764. When used a cut-off point of -1.2, the sensitivity of the RS was 90% and specificity was 53%. The use of RS or APRi correctly identified 96% of children with HRV.

The described predictors allow the correct identification of patients with HRV. The association of RS >-1.2 or APRi >1.4 has a good sensitivity to identify HRV and to prevent unnecessary endoscopy in about one-third of children with no HRV.
1.4 has a good sensitivity to identify HRV and to prevent unnecessary endoscopy in about one-third of children with no HRV.
The perimenopause is associated with increased hormone fluctuations and an elevated risk of depression. Selleckchem MEK inhibitor A number of predictors of depressive symptoms in the menopausal transition have previously been suggested. The purpose of this study was to investigate a set of biopsychosocial predictors of depressive symptoms in perimenopausal women.

This cross-sectional study, investigating 114 perimenopausal women (according to the STRAW criteria) aged 40-56 years, was conducted within the scope of the Swiss Perimenopause Study. Multiple regression analyses were performed to identify the most accurate model predicting perimenopausal depressive symptoms. Depressive symptoms were assessed with the German version of the Center of Epidemiologic Studies Depression Scale (CES-D). Validated questionnaires were used to examine psychophysiological complaints, stress, self-esteem, self-compassion, body image, and social support. Estradiol (E2) and progesterone (P4) were assessed through saliva samples, and follicle-stimulatine perimenopause. Moreover, the presence of burdensome complaints and chronic stress as well as a poor self-evaluation seem to promote depressive symptoms in perimenopausal women.
In women, the risk of cardiovascular disease (CVD) is higher in the postmenopausal period. The effect that menopausal type, natural versus surgical, or the age at natural menopause has on CVD needs further investigation. To this end, we assessed the association between menopausal type and timing and the 10-year office-based Framingham Risk Score (FRS) in women from the Canadian Longitudinal Study on Aging.

We included women aged 45 to 85 years from the Canadian Longitudinal Study on Aging Comprehensive cohort of seven Canadian provinces who were menopausal at the time of recruitment and had no prior CVD. Poisson regressions were used to evaluate the association between menopausal characteristics and the FRS. Natural menopause was defined as the cessation of menstrual periods for at least 1 year in women with no history of hysterectomy. Surgical menopause was defined as hysterectomy with or without oophorectomy prior to natural menopause. As main covariates, we examined age, education, province of residenc considered in surgical menopausal women and women with an age at natural menopause less than 45 years.
To review the short-term effects and safety of vulvovaginal fractional microablative CO2 laser therapy on atrophy symptoms using validated questionnaires pre- and posttreatment.

This is a retrospective chart review from January, 2016 to December, 2019 on 139 women with vulvovaginal atrophy symptoms, who completed three treatments about 6 weeks apart. All were >18 years old and nonpregnant. As is the practice in our clinic for all women receiving treatment, they were surveyed prior to the 1st and 3rd treatments with validated questionnaires, Female Sexual Function Index (FSFI) and Vulvovaginal Symptoms Questionnaire (VSQ), as well as a visual analog scale (VAS). Paired t test was completed on the pre- and post FSFI and VAS scores. Pre- and postproportions of the VSQ were evaluated by the Fisher's exact test. Means were presented for each study variable. Multivariable regression analysis was completed on continuous and binomial variables for scores predictors.

Mean age was 62 years with a mean follow-up of 13.8 weeks. Concomitant topical estrogen was reported in 53% (n = 74). Breast cancer diagnosis was documented in 27% (n = 38), and lichen sclerosus in 22% (n = 31). All FSFI scores improved (pre 12.7, post 19.0, P < 0.001). The VSQ showed 18 of 21 questions significantly improved (P < 0.05). The VAS showed significant improvement in painful intercourse (pre 6.6, post 2.4, P < 0.001), and vulvar dryness (pre 4.6, post 1.5, P < 0.001). Posttreatments, 17 additional women became sexually active. No major adverse events were reported.

Fractional CO2 laser may be effective and safe for the treatment vulvovaginal atrophy.
Fractional CO2 laser may be effective and safe for the treatment vulvovaginal atrophy.
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