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20% (38/192), p=0.42; TV 23% (22/97) versus 14% (12/87), p=0.11). Although lower, reinfections rates were not significantly different among patients who accepted versus did not accept EPT (CT 13% (6/48) vs. 21% (23/110), p=0.50 and TV 6% (1/18) vs. 18% (9/49), p=0.69).
Despite the implementation of an EPT protocol, STI reinfection rates among AYA females remained high, and many declined EPT. Further research is needed to identify barriers to the provision and acceptance of EPT and ways to address these factors.
Despite the implementation of an EPT protocol, STI reinfection rates among AYA females remained high, and many declined EPT. Further research is needed to identify barriers to the provision and acceptance of EPT and ways to address these factors.
Nearly 14% of US women report any lifetime infertility which is associated with healthcare costs and psychosocial consequences. Tubal factor infertility (TFI) often occurs as a result of sexually transmitted diseases and subsequent pelvic inflammatory disease. We sought to evaluate for and describe potential racial disparities in TFI and in vitro fertilization (IVF) prevalence.
Records of women aged 19-42 years in our retrospective cohort from two US infertility clinics were reviewed. We calculated TFI prevalence, IVF initiation prevalence, and prevalence ratios (PR), with 95% confidence intervals for each estimate, overall and by race.
Among 660 infertile women, 110 (16.7%; 95% confidence interval [CI] 13.8-19.5%) had TFI which was higher in black compared to white women (30.3% [33/109] vs. 13.9% [68/489]; PR 2.2 [95% CI 1.5-3.1]). For women with TFI, IVF was offered to similar proportions of women by race (51.5% [17/33] versus 52.9% [36/68] for black versus white women); however, fewer black than white women with TFI started IVF (6.7% [1/15] versus 31.0% [9/29]; PR 0.2 [95% CI 0-1.0]), although the difference was not statistically different.
TFI prevalence was two-fold higher among black than white women seeking care for infertility. Among women with TFI, data suggested a lower likelihood of black women starting IVF than white women. Improved sexually transmitted disease prevention and treatment might ameliorate disparities in TFI.
TFI prevalence was two-fold higher among black than white women seeking care for infertility. Among women with TFI, data suggested a lower likelihood of black women starting IVF than white women. Improved sexually transmitted disease prevention and treatment might ameliorate disparities in TFI.
Neoadjuvant chemoradiotherapy and total mesorectal excision comprise the standard of care for rectal cancer in multiple guidelines. However, neoadjuvant chemoradiotherapy has not exhibited clear survival benefits, but rather has led to an increase in adverse events. Conversely, neoadjuvant chemotherapy is expected to prevent adverse events caused by radiation, yet this treatment is still controversial.
To evaluate the feasibility and efficacy of S-1 and oxaliplatin neoadjuvant chemotherapy together with total mesorectal excision for resectable locally advanced rectal cancer.
The study was a prospective, single-arm phase II trial.
The study was conducted at multiple institutions.
Fifty-eight patients with resectable locally advanced rectal cancer were enrolled.
Three cycles of S-1 and oxaliplatin were administered before surgery. S-1 was administered orally at 80 mg/m2/day for 14 consecutive days, followed by a 7-day resting period. Oxaliplatin was given intravenously on the first day at a dose of See Video Abstract at http//links.lww.com/DCR/B555.
The combination of S-1 and oxaliplatin neoadjuvant chemotherapy and total mesorectal excision is a feasible and promising treatment option for resectable locally advanced rectal cancer. See Video Abstract at http//links.lww.com/DCR/B555.
Treatment of complex anal fistula is challenging, often mandating multiple procedures. The gracilis muscle has been used to treat perineal fistulas and to repair perineal defects.
This study aims to report the results of gracilis muscle interposition for complex anal fistula, including prognostic factors for success.
This is a retrospective analysis of a prospective database for patients who underwent gracilis muscle interposition for complex anal fistula from 2000 to 2018.
Patient demographics, operative data, and postoperative outcome were obtained from medical records. Maraviroc Office visits were used for follow-up.
All patients who underwent gracilis muscle interposition for complex anal fistula were included. Patients who underwent gracilis muscle interposition for reasons other than complex anal fistula were excluded.
The primary outcome measured was the healing of complex anal fistula following gracilis muscle interposition and following additional procedures, when needed.
A total of 119 patients re exitoso de la fístula. Además, debe evitarse el reposo prolongado en cama después de la interposición del músculo gracilis. Consulte Video Resumen en http//links.lww.com/DCR/B551.
Barium defecography can assess structural and functional abnormalities in patients with chronic constipation.
To determine the prevalence of individual and overlapping defecographic findings in this setting.
Cross-sectional.
University Hospital tertiary gastrointestinal physiology department.
Consecutive examinations of 827 consecutive patients presenting over a 30-month period with well-defined symptom severity (≥12 points on the Cleveland Clinic Constipation score) systematic evaluation of images with results stratified by sex.
Six individual functional or anatomical (intussusception, rectocele, enterocele, megarectum, excessive dynamic perineal descent) defecographic observations were defined a priori thus permitting 26 possible combinations of findings (i.e. 63 abnormal types + 1 normal).
Patients with constipation (mean symptom score, 19) were predominantly female (88%) with median age 49 (17-98) years. All 6 individual radiological findings were identified with a total of 43 combinations flww.com/DCR/B552.
These results provide a contemporary atlas of defecographic findings in constipation. Several individual structural and functional features have been systematically classified, with overlap greater than previously acknowledged and profound differences among sexes that carry implications for tailoring management. See Video Abstract at http//links.lww.com/DCR/B552.
Website: https://www.selleckchem.com/products/Maraviroc.html
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