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Beyond Words/Signs: DHH Learners' Spatial Thought within Arithmetic since Embodied Understanding.
Antenatal corticosteroids are now established as one of the cornerstones of therapy in the prevention of neonatal morbidity and mortality prior to preterm birth. Although this practice is widely accepted, a significant number of controversies exist. This review explores the knowledge gaps regarding the use of antenatal corticosteroids in the preterm, late preterm and term populations. Furthermore, the role of antenatal corticosteroids in special populations, such as diabetes, multiple pregnancies and periviable gestations, where high-quality data from randomized controlled trials are lacking, is also considered. © 2020 John Wiley & Sons, Ltd.Extramammary Paget's disease (EMPD) often invades the dermis and metastasizes to the lymph nodes. Patients with EMPD associated with lymph node metastases have poor prognosis; to date, effective treatment has not yet been established. Lymph node dissection, aiming to control the local disease, is a standard form of management for EMPD patients with lymph node metastases (LNM). We investigated the clinical and pathological features, treatment strategies and prognostic factors of patients with metastatic EMPD who underwent lymph node dissection. We retrospectively evaluated 38 cases of extramammary Paget's disease with lymph node metastasis over 10 years. All patients underwent wide resection of the primary lesion and lymph node dissection. Univariate analysis revealed the number of metastatic nodes and lymphadenopathy as prognostic factors. In multivariate analysis, the number of metastatic lymph nodes retained statistical significance (hazard ratio, 35.3; 95% confidence interval, 3.23-387.0; P = 0.003). The 5-year survival rate was 100% and 19.1% in patients with two or less LNM and with three or more LNM, respectively. In patients with three or more LNM, the 5-year survival rate after adjuvant radiation therapy was better than that after surgery alone (75% vs 0%). In conclusion, patients with two or less LNM can be expected to have long-term survival with lymph node dissection only, while patients with three or more LNM may require adjuvant radiation therapy to improve prognosis. These results suggest that lymph node dissection may be a strategy to treat EMPD with regional LNM. © 2020 Japanese Dermatological Association.The role of high fat diet (HFD) in ovarian cancer and its underlying mechanisms are poorly known. In current investigation, we investigated inflammatory and oncogenic effect of dietary fats in female Wistar rats and ovarian cancer cell line (SKOV3). The ELISA kits were used for adipokines and inflammatory factors analyses in sera collected from rats fed with high fat diet (SR-HFD). Cell growth, proliferation, apoptosis, migration, and invasion were measured in SKOV3 cells treated with the SR-HFD and FA mix. IL6, IL1β, TNFα, NF-kβ, and p53 expression were measured in cells incubated with the mentioned treatments. learn more Leptin and inflammatory factors increased, while adiponectin decreased in SR-HFD. Moreover, FA mix significantly induced proliferation, migration, and invasion, promoted the expression of inflammatory factors and NF-κB and inhibited apoptosis markers in SKOV3 cells. Taken together, our findings revealed that diet might be a crucial factor in ovarian cancer progression through altering the inflammatory factors. PRACTICAL APPLICATIONS The HFD-mediated obesity promotes cancer progression in various tissues. This study highlights the progression of inflammation in female Wistar rats and the growth of ovarian cancer cells by dietary fats. Thus, dietary factors can be considered as key factors for the prevention of ovarian cancer. © 2020 Wiley Periodicals, Inc.Cefuroxime axetil pharmacokinetic profile was investigated in 12 Beagle dogs after single intravenous and oral administration of tablets or suspension at a dose of 20 mg/kg, under both fasting and fed conditions. A three-period, three-treatment crossover study (IV, PO under fasting and fed condition) was applied. Blood samples were withdrawn at predetermined times over a 12-hr period. Cefuroxime plasma concentrations were determined by HPLC. Data were analyzed by compartmental analysis. No statistically significant differences were observed between formulations and feeding conditions on PK parameters. Independently of the feeding condition, absorption of cefuroxime axetil after tablet administration was low and erratic. The drug has been quantified in plasma in 3 out of 6 and 5 out of 6 dogs in the fasted and fed groups. For this formulation, the bioavailability (F), peak plasma concentration (Cmax ), and area under the concentration-time curve (AUC) of cefuroxime axetil were significantly enhanced (p MIC (≤4 µg/ml) was ≈2.5 hr for fasted and fed dogs, respectively. Cefuroxime axetil as a suspension formulation seems to be a better option than tablets. However, its short permanence in plasma could reduce its clinical usefulness in dogs. © 2020 John Wiley & Sons Ltd.Selective supplementation of acetabular component fixation with a screw during primary total hip arthroplasty (THA) assumes that the surgeon can detect when an acetabular component needs additional stability. In contrast, nonselective screw users do not alter their practice based on their interpretation of stability and either use screws all or none of the time. We aimed to determine the effect of selective screw use on aseptic acetabular component loosening. We retrospectively reviewed aseptic failures of acetabular components after primaty THA. We compared the survivorship of selective and nonselective supplementation of acetabular fixation with respect to time to revision, obesity, and screw use. Selective screw use (n = 16) was associated with earlier acetabular component aseptic loosening (median 1.9 years; interquartile range [IQR] 1.1-5.0) compared to nonselective screw use (n = 22; median 5.6 years; IQR 2.0-15.3; P = .010). Selective screw use was independently associated with earlier revision after adjusting for patient obesity. Obesity was associated with selective screw use in 50% of the cases vs 14% of nonselective cases (odds ratio 6.3; confidence interval 1.2-25.2; P = .028), possibly reflecting the increased difficulty in achieving acetabular component stability in this and other settings with compromised bone. Surgeons should carefully assess component stability at time of primary THA. If the acetabulum is not stable, the addition of screws alone may not be sufficient for acetabular component stability. © 2020 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.
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