Notes

Introducing 3 dimensional produced models of the upper urinary system with regard to high-fidelity sim associated with retrograde intrarenal surgical treatment.
The association between hemoglobin (Hb) level including anemia and fracture has not been studied thoroughly.

197, 187 adults ≥ 50years from the National Health Insurance Service of Korea were studied. Hb was determined during health screening examinations in 2004 or 2005. From 1 January 2006, participants were followed up for fracture until 31 December 2013. Hb levels (g/dL) were categorized into five groups, with normal hemoglobin levels subdivided into three groups (low normal, normal, and high normal Hb) < 13, ≥ 13 to < 14, ≥ 14 to < 16, ≥ 16 to < 17, 17 for men and < 12, ≥ 12 to < 13, ≥ 13 to < 14, ≥ 14 to < 16, ≥ 16 for women. Anemia was defined as Hb < 13g/dL and < 12g/dL for men and women, respectively. Cox proportional hazards regression was used to determine the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for fracture according to Hb.

Compared to individuals with normal Hb, those with anemia and low normal Hb were associated with significantly increased risk of fracture. In women, those with anemia had a higher risk for any (aHR 1.11, 95% CI 1.05-1.17), hip (aHR 1.27, 95% CI 1.01-1.59), and radius fracture (aHR 1.15, 95% CI 1.05-1.25). In men, those with anemia had a higher risk for any (aHR 1.37, 95% CI 1.23-1.51), vertebral (aHR 1.33, 95% CI 1.15-1.53), and hip fracture (aHR 1.64, 95% CI 1.30-2.08). This risk-enhancing association was preserved among various subgroups.

Among adults ≥ 50years, anemia and low normal Hb are risk factors for fracture.
Among adults ≥ 50 years, anemia and low normal Hb are risk factors for fracture.Acoustic/ultrasonic sensors are devices that can convert mechanical energy into electrical signals. The Fabry-Perot cavity is processed on the end face of the double-clad fiber by a two-photon three-dimensional lithography machine. In this study, the outer diameter of the core cladding was 250 μm, the diameter of the core was 9 μm, and the microcavity sensing unit was only 30 μm. It could measure ultrasonic signals with high precision. The characteristics of the proposed ultrasonic sensor were investigated, and its feasibility was proven through experiments. Its design has a small size and can replace a larger ultrasonic detector device for photoacoustic signal detection. The sensor is applicable to the field of biomedical information technology, including medical diagnosis, photoacoustic endoscopy, and photoacoustic imaging.Acquired laryngotracheal stenosis (LTS) is a rare condition causing dyspnea and stridor. Patients often require multiple surgical procedures with no guarantee of a definitive outcome. Difficulty swallowing is a recognised problem associated with LTS and the reconstructive surgeries required to manage the condition. The breathlessness patient's experience impacts on swallowing, and the vulnerable structures of the larynx are implicated during complex surgeries. This leads to dysphagia post-surgery, with some patients experiencing more chronic symptoms depending on the biomechanical impact of the surgery, or a pre-existing dysphagia. Despite this there is limited observational research about the dysphagia associated with LTS, with no exploration of the patient experience. Our aim was to investigate patient experience of living with LTS focussing on dysphagia in order to guide clinical practice. A qualitative study was completed using focus groups and semi-structured interviews with 24 patients who have had reconstructive surgery for LTS. Thematic analysis was used to identify three over-arching themes The Physical Journey, The Emotional Journey and The Medical Journey. Key sub-themes included the importance of self-management and control, presence of symptoms, benefits of therapy, living with a life-long condition, fear and anxiety, autonomy, medicalisation of normal processes and the dichotomy between staff expertise and complacency. Swallowing was connected to all themes. The results are reviewed with consideration of the wider literature of lived experience particularly in relation to other chronic conditions and those that carry a high symptom burden such as head and neck cancer. Future clinical and research recommendations have been made. Akin to other clinical groups, adults with LTS are keen that management of their swallowing is person-centred and holistic.A brief esophageal dysphagia questionnaire (BEDQ) was recently developed in English to evaluate frequency and intensity of dysphagia. Our aim was to validate this questionnaire in French in a cohort of patients referred for esophageal manometry. Patients referred for esophageal high resolution manometry were offered to fill out different questionnaires including Eckart score, GERDQ score and BEDQ. BEDQ was translated in French by two French native speakers and experts in esophageal motility. Patients were grouped according to the indications of esophageal high resolution manometry (dysphagia, GERD, others). The total BEDQ score was calculated and compared between groups. The validation method used the assessment of internal consistency with Cronbach's alpha and reliability with Guttman split-half reliability. selleck chemicals BEDQ questionnaire was completed by 608 patients (44% males, mean age 54 years). The total score had an excellent internal consistency (Cronbach's alpha = 0.90) and reliability (Guttman statistic = 0.92). The correlation was good with Eckardt score (r = 0.65, p  less then  0.001) but poor with the GERDQ score (r = 0.21, p  less then  0.01). Patients referred for dysphagia (n = 197) had an Eckardt score and a BEDQ score significantly higher than those referred for GERD or other indications (5.48 vs 3.65 and 3.53 respectively for Eckardt score and 15.85 vs 4.64 and 5.78 for BEDQ, p  less then  0.001). BEDQ is a valid questionnaire in French to assess dysphagia in clinical practice. It remains to be determined if this score is sensitive to symptom variation and thus useful for the follow up of patients with dysphagia.
compare incidences of maternal-fetal complications during pregnancy, labor, and early puerperium according to baseline BMI in a consecutive cohort of pregnant women.

This retrospective cohort study compares pregnancy outcome indicators by body mass index (BMI) in 1236 pregnant women managed over the period January 2017 to May 2018. Data were collected regarding the personal history (smoking, diabetes and hypertension), obstetrics and BMI (kg/m
) (normoweight 18.5-24.9, overweight 25-29.9, obese ≥ 30).

Of the 1236 women, 354 (28.6%) were overweight and 206 (16.7%) were obese at the start of pregnancy follow-up. Mean age at this time was 33years (SD 6). Risk factors for a cesarean-section delivery assessed through logistic regression were maternal age (OR 1.05 95% CI 2.06-6.15; p < 0.001) and previous C-section (OR 4.21 95% CI 2.89-6.14; p < 0.001) regardless of BMI. In a propensity score analysis, pregnancy weight gain was found lower in obese vs normoweight (- 2.73kg 95% CI - 3.74 to - 1.72 p < 0.
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