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Outcomes of heat as well as ion funnel hindrances on dissemination of actions possible within myelinated axons.
In Cell Chemical Biology, Naineni et al. (2021) report the structure of a synthetic analog of the translation inhibitor pateamine A bound to initiation factor eIF4A and RNA. The drug stacks with RNA bases in the same pocket where unrelated rocaglate compounds bind, highlighting a druggable site for DEAD-box proteins.Astrocyte-secreted Hevin induces synapse formation by bridging the trans-synaptic organizers, neuroligins and neurexins. In this issue of Structure, Fan et al. (2021) elucidate the structural basis of Hevin's interaction with these molecules and reveal the competitive interplay between Hevin, SPARC, and MDGAs.In this issue of Cell Stem Cell, Grossmann et al. (2021) reconstructed the developmental history of the prostate gland in a 59-year-old male by 3D tracking of somatic mutations across 319 micro-dissected specimens. It provides a genetic picture of how the human prostate gland is shaped during embryogenesis, puberty, and adult life.Protein synthesis regulation constitutes a key node in directing decisions between hematopoietic stemness and differentiation. In this issue of Cell Stem Cell, Lv et al. (2021) describe a mechanism by which HSCs fine-tune translation rates by controlling 60S and 40S ribosomal subunit joining through targeted degradation of ZNF622 in response to stress.The mammalian cornea is maintained by the lifelong self-replenishing activity of its stem cells. In this issue of Cell Stem Cell, Altshuler et al. (2021) and Farrelly et al. (2021) identify two stem cell populations with diverse function and genetic signature, one "active" and one "quiescent," that support corneal health.This document was prepared by the College of Orthopedics of the Portuguese Medical Association with the aim of developing the guidelines on the resumption of elective surgical activity in Orthopedics during the COVID-19 pandemic. It sets the criteria that allow the prioritization of surgeries according to the severity of the clinical situation, based on existing and published classifications. Moreover, it provides an organizational model for patient preparation and describes the patient pathways in the preoperative, intraoperative and postoperative periods. It also describes safety rules for elective surgery and a model for monitoring patients after discharge according to scientific evidence.Postpartum Hemorrhage is still the leading cause of maternal mortality. The management of patients who refuse allogeneic blood transfusion, like in the case of Jehovah's Witnesses, is clinically and ethically challenging. We describe the case of a woman with several risk factors for major postpartum hemorrhage, specifically the presence of a giant uterine myoma. buy Crenolanib The multidisciplinary management of this patient included an elective c-section and the use of prophylactic tranexamic acid. The perioperative and peripartum care of Jehovah's Witnesses requires specific strategies to minimize blood loss, optimize oxygen delivery and consumption, enhance hemoglobin production, correct coagulation defects and promote hemostasis. We highlight the need for a multidisciplinary approach, point-of-care testing and the use of fibrinogen concentrate and tranexamic acid, according to the patients' informed consent.Abnormal uterine bleeding is the most common complaint that motivates female adolescents to seek medical advice. Abnormal uterine bleeding has a significant impact on quality of life, promoting school absenteeism and limitations in social life. Moreover, episodes can vary from mild to life threatening events if not recognized and treated promptly. Healthcare providers should be able to distinguish between a normal and abnormal menstrual pattern, as this may provide early diagnosis of a potential health concern. The PALM-COEIN classification system should be used in the evaluation. Anovulation is the most frequent cause, frequently due to immaturity of the hypothalamic-pituitary-ovarian axis. A careful history and physical examination are crucial in the differential diagnosis. Management is based on both the underlying cause and the severity of bleeding. Most patients improve with pharmacological treatment, frequently requiring a multidisciplinary approach. First line treatment consists of hormonal therapy. Surgery is rarely needed. Although the prevalence of abnormal uterine bleeding is higher in adolescents compared to adults, most recommendations are not specific for this age, which makes the diagnosis and management challenging. The literature reveals lack of standardized care for adolescents and regimens vary widely. Future studies on efficacy and safety of treatments specifically in adolescents are needed.
In the current century, increasing importance has been given to the opinions, expectations and experiences of women using healthcare services. The fulfillment of expectations is determined by satisfaction. This study aims to analyze both expectations and satisfaction during childbirth regarding labor epidural analgesia among parturients, with a focus on myths.

A prospective observational study was conducted in parturients at the Centro Hospitalar Universitário Lisboa Norte - Santa Maria Hospital in Lisbon, Portugal, applying a questionnaire to 317 random women. SPSS v22.0 was used for data analysis.

Three hundred questionnaires were returned, from women with a mean age of 31. Among the respondents, 46.3% had a college degree and 64% were employed, 46% were primiparas and only 14% had a previous anesthesiology appointment for childbirth purposes. The overall degree of satisfaction surrounding the birth experience was good/excellent for 87% of women. Labor epidural analgesia was performed on 96% of all patients, with an excellent/good outcome for 82.1% and a higher than expected results for 40.7% of them. Regarding the myths, 52.5% believed that epidural analgesia imposes a dose limit and 58.9% that it often causes permanent back pain. The level of education was significantly associated with some myths (p < 0.05), since women with a higher level of education do not believe most of them.

This study supports the need for an evaluation of the current information that women have about labor epidural analgesia/childbirth. Women's individual needs can be met by multidisciplinary teams including Anesthesiology specialists.

Maternal satisfaction with childbirth and analgesia is a complex and dynamic process that includes and is not limited to the relief of pain.
Maternal satisfaction with childbirth and analgesia is a complex and dynamic process that includes and is not limited to the relief of pain.
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