Notes

Percutaneous water flow in the management of intrahepatic pancreatic pseudocyst together with Budd-Chiari symptoms: A case report.
The tumors also showed almost concurrent expression of p53 (in 9/10 cases) and ubiquitin-specific-processing protease 7 (USP7) (in 10/10 cases), which deubiquitinates and stabilizes MDM2, potentially resulting in its nuclear expression without MDM2 gene amplification. MDM2 expression may thus be a diagnostic pitfall for hibernoma particularly in differentiating it from ALT/WDLS.The Grade group is an important parameter for clinical decision-making in prostate cancer. Recently, percent Gleason pattern 4 and presence of invasive cribriform and/or intraductal carcinoma (CR/IDC) have been recognized for their independent predictive value for prostate cancer outcome. There is sparse data on the inter-observer agreement for these pathologic features in practice. Our objectives were to investigate inter-observer variability of percent Gleason pattern and CR/IDC and to relate individual tumour scores to clinical outcome. Our cohort included 80 consecutive radical prostatectomies with a median follow-up 87.1 months (interquartile range 43.3-119.2), of which the slide with largest tumour volume was scored by six pathologists for Grade group (four tiers 1, 2, 3 and 4/5), percent Gleason pattern 4 (four tiers 0-25%, 26-50%, 51-75% and 76-100%) and presence of CR/IDC (two tiers absent, present). The individual assignments were related to post-operative biochemical recurrence (20/80). Inter-observer agreement was substantial (Krippendorff's α 0.626) for assessment of Grade group and moderate for CR/IDC (α 0.507) and percent Gleason pattern 4 (α 0.551). For each individual pathologist, biochemical recurrence rates incremented by Grade group and presence of CR/IDC, although such relation was less clear for percent Gleason pattern 4. In conclusion, inter-observer agreement for CR/IDC and percent Gleason pattern 4 is lower than for Grade groups, indicating awareness of these features needs further improvement. Grade group and CR/IDC, but not percent Gleason pattern 4 was related to biochemical recurrence for each pathologist, indicating overall validity of individual grade assignments despite inter-observer variability.The epidemiology of mental disorders in early childhood is still under-researched. We aim to explore the incidence, comorbidities and risk factors of mental disorders in 0-3-year-olds referred to hospital settings. In a national cohort of 918,280 children born in 1997-2010, we calculated incidence rates per 1,000 person-years (IR) of first-time mental and developmental disorders diagnosed in hospitals before four years of age. Data were obtained from Danish population registries. We used logistic regression to analyse co-morbidity and Cox proportional hazard models to evaluate the influence of pre- and perinatal risk factors. A total of 16,164 children (1.76%) were diagnosed with a mental (0.90%) or developmental disorder (1.05%). Pervasive developmental disorders (PDD) and disorders of hyperactivity and inattention (ADHD) were increasingly diagnosed with age. Feeding and eating disorders and disorders of social functioning were most frequent among the youngest children. Comorbidity was found in 18%, e.g., between PDD and ADHD (OR 135.8; 95% CI 112.0-164.7) or between ADHD and disorders of social functioning (OR 148.0; 95% CI 106.4-205.7). Young maternal age, old paternal age, maternal smoking in pregnancy, boy sex, premature birth and being small for gestational age were associated with highly increased risk of mental and developmental disorders. Mental and developmental disorders diagnosed within the first four years of life show increasing incidence rates and a complex pattern of comorbidities. Study findings point to the need of clinical and research attention towards the manifestations of developmental psychopathology in very young children.
This study evaluated the relationship between postoperative knee flexion angles and the position of femoral and tibial components in unicompartmental knee arthroplasty (UKA).

Eighteen patients (atotalof 22 knees three men, four knees; 15 females, 18 knees) who underwent navigation-assisted UKA were included. Pre- and postoperative computed tomography images were applied on 3D software, which were matched and used to calculate the position of femoral and tibial components. Correspondingly, we investigated the relationship between the knee range of motion (ROM) at 1-year postoperative follow-up and the position of femoral and tibial components.

At 1-year post-UKA, the knee flexion angle was associated with the posterior flexion angle of tibial components. This particular angle was significantly greater in the group with equal or greater postoperative knee ROM compared to preoperative ROM (5.2 ± 2.1°) than in the group with less postoperative knee ROM compared to preoperative ROM (2.6 ± 1.6°, p < 0.01). There was no significant difference between both groups in the femoral component position, preoperative posterior slope of the medial tibial plateau, change in the pre- to postoperative posterior tibial slope, and postoperative knee society score.

The posterior flexion angle of the tibial component affected the improvement/deterioration of the postsurgery knee flexion angle in navigation-assisted UKA. For improved outcomes after UKA using navigation systems, surgeons should aim to achieve a 5° to 8° posterior flexion angle of the tibial component.
The posterior flexion angle of the tibial component affected the improvement/deterioration of the postsurgery knee flexion angle in navigation-assisted UKA. For improved outcomes after UKA using navigation systems, surgeons should aim to achieve a 5° to 8° posterior flexion angle of the tibial component.Accumulating evidence over the past decade suggests that semantic deficits represent a consistent feature of Mild Cognitive Impairment (MCI). A meta-analysis was performed to examine if semantic deficits are consistently found in patients with MCI. Studies meeting all inclusion criteria were selected for the current meta-analysis. An effect size and a weight were calculated for each study. A random effect model was performed to assess the overall difference in semantic performances between MCI patients and healthy subjects. 22 studies (476 healthy participants, 476 MCI patients, mean Mini Mental Status Examination of the MCI patients 27.05 ± 0.58) were included in the meta-analysis. Results indicate that MCI patients systematically performed significantly worse than healthy matched controls in terms of overall semantic performance (mean effect size of 1.02; 95% CI [0.80; 1.24]). Semantic deficits are a key feature of MCI. Semantic tests should be incorporated in routine clinical assessments.A method for the theoretical estimation of the MTF of columnar phosphors with a homogeneous part at the end used in X-ray imaging has been developed. Remdesivir molecular weight This method considers the light transport inside the scintillator through an analytical modelling, the optical photon beams distribution on the scintillator-optical sensor interface, and uses the definition of the PSF and a Gauss fitted LSF to estimate the MTF of an indirect detector. This method was applied to a columnar CsITl scintillator and validated against experimental results found in literature, and a good agreement was observed. It was found that, by increasing the pixel size of the optical detector and the thickness of the scintillator, the MTF decreased as expected. This method may be used in evaluating the performance of the columnar phosphors used in medical imaging, given their physical and geometrical characteristics.Graphical abstract (a) Side view of a part of the scintillator where five crystal columns with homogeneous ends attached to an optical sensor is shown. (b) Propagation of two random optical photon beams emitted from point K with different angles of emission is shown. All the symbols are explained analytically in the text.
We aimed to examine the association of type 1 diabetes with school wellbeing among Danish children.

This is a population-based cohort study involving 436,439 Danish children, of which 1499 had a confirmed diagnosis of type 1 diabetes. The children were enrolled in grade levels 4 to 9 (middle school) in Danish public schools in the years 2014-2017. Questionnaire outcomes from the yearly National Wellbeing Survey related to self-efficacy, perceived competences, peer and teacher support, bullying and somatic symptoms were analysed. Ordered logistic regression was used to compare outcomes of children with and without type 1 diabetes, and to compare subgroups of children with type 1 diabetes by different levels of HbA
and diabetes duration. Primary outcomes were answers to seven pre-specified questionnaire items (scale, 1 to 5).

A total of 817,679 questionnaires were initiated, of which n = 2681 were from children with type 1 diabetes. Compared with the background population, children with type 1 diabetes expressed more peer support; adjusted OR 1.17 (95% CI 1.08, 1.27). Children with diabetes also reported more often having a headache; adjusted OR 1.09 (95% CI 1.00, 1.19). Overall, children with poor glycaemic control (HbA
>70mmol/mol) had worse outcomes on the wellbeing measures compared with the background population. Even after adjusting for socioeconomic status, they still reported significantly worse perceived competences, less teacher support and more somatic symptoms (stomach ache and headache).

In Denmark, children with type 1 diabetes generally feel well supported in school but have more headaches than other children. Poor glycaemic control is associated with worse psychological school-related wellbeing. Graphical abstract.
In Denmark, children with type 1 diabetes generally feel well supported in school but have more headaches than other children. Poor glycaemic control is associated with worse psychological school-related wellbeing. Graphical abstract.
Surgical staging in endometrial cancer has evolved and sentinel lymph node (SLN) mapping has replaced a full pelvic and paraaortic lymphadenectomy in several cases. An intraoperative evaluation of SLN might identify patients who could benefit the most from a full lymphadenectomy. The aim of this study is to evaluate the clinical relevance of frozen section of SLN.

A retrospective analysis in patients with endometrial cancer who underwent SLN mapping with intraoperative evaluation at frozen section between February 2016 and September 2019 was performed. In case of metastatic involvement, a full lymphadenectomy was performed.

Fifty-eight patients met the inclusion criteria. Clinical-pathologic characteristics of the patients and surgical data were analyzed. Overall, bilateral and unilateral detection rates were 100% (58/58), 89.7% (52/58), and 10.3% (6/58), respectively. Eight patients had a stage IIIC disease at permanent section. Frozen section detected SLN metastases in four of eight patients. Of these, two were micrometastases and two were macrometastases. At frozen section of the SLNs, no macrometastases were misdiagnosed. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value of frozen section in detecting metastases was 50%, 100%, 93%, 100% and 92.6%, respectively.

The intraoperative evaluation of SLN in endometrial cancer accurately identifies patients with macrometastases. This is the cohort that might benefit the most of a full lymphadenectomy for a higher risk of additional lymph node metastases.
The intraoperative evaluation of SLN in endometrial cancer accurately identifies patients with macrometastases. This is the cohort that might benefit the most of a full lymphadenectomy for a higher risk of additional lymph node metastases.
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