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Situation Report: Trans-Articular External Bone Fixation of the Fashionable for the Extremely Comminuted Juxta-Articular Break from the Proximal Femur Due to Gunshot Damage inside a Kitten.
Cancer-related cognitive impairment (CRCI) refers to a series of cognitive impairment symptoms associated with alternations in brain structure and function, caused by a non-central nervous system malignant tumor and its related treatment. CRCI may present as memory loss, impaired concentration, difficulty in multitasking and word retrieval, and reduced comprehension speed. CRCI has become one of the prevalent factors that compromise the quality of life for cancer survivors. Different treatments, including surgery, chemotherapy, radiotherapy, endocrine therapy, and targeted drugs, may contribute to CRCI. Meanwhile, patients' factors, including emotional challenges and genetic makeup, also contribute to the development of CRCI. The condition can be treated with using stimulants methylphenidate and modafinil, metabolites of nicotine cotinine, antidepressants of fluoxetine and fluvoxamine, dementia drug of donepezil, and antioxidants ZnSO4, n-acetyl cysteine, propofol, and Chinese herbal of silver leaf medicine. Psychotherapies, including meditation and relaxation, cognitive rehabilitation training, along with physical therapies, including aerobic exercise, resistance training, balance training, yoga, qigong, tai chi electroencephalogram biofeedback, and acupuncture, are also beneficial in alleviating cancer-related cognitive impairment symptoms. In recent years, researchers have focused on factors related to the condition and on the available interventions. However, most research was conducted independently, and no review has yet summarized the latest findings. This review details and discusses the status of related factors and potential treatments for CRCI. We also supply specific recommendations to facilitate future research and integration in this field.Joint line (JL) restoration is one of the major challenges in revision total knee arthroplasty (rTKA). There is debate regarding the most reliable methodology for the assessment of JL level during revision surgery. Among the strategies, the use of adductor tubercle (AT) as an anatomical landmark has been proposed. The purpose of this paper is to systematically review the available literature to understand the reliability of AT ratio to identify the JL, and the advantages and drawbacks of its application. A research was performed on the PubMed, Embase, Cochrane and Google Scholar databases based on the following inclusion criteria for articles' selection (I) clinical reports of any level of evidence, (II) written in the English language, (III) published from 2010 to 2020, (IV) dealing with the use of the adductor tubercle as a landmark to restore JL in revision TKA. All relevant data were extracted by two independent investigators, and discrepancies were resolved by discussion and consensus. A total of 13 studies were included nine were radiographic evaluations, 3 clinical reports and 1 was an ex-vivo study. Radiographic studies highlighted that AT is a landmark easy to identify, with high intra and inter-observer agreement, irrespective of gender, age and size of the patient. The comparison with other bony landmarks revealed superior reliability in favor of AT. Also during surgical procedures, AT can be safely located and some clinical studies confirmed that AT ratio helps surgeon in re-establishing a correct JL and achieve ligament balancing even in complex revision cases. AT is a reliable and easily detectable landmark, and AT ratio is a valid tool to determine the JL level and help surgeons to restore the JL and simultaneously achieve knee ligament balancing in r-TKA.Regenerative medicine is a field growing in popularity due to high hopes for stimulating in situ tissue restoration. Stem cell therapy remain at the center of regenerative medicine, due to early reports on its pluripotent differentiating capability. However, more recent reports suggest the paracrine activity of stem cells, and not direct differentiation, as the cause of its therapeutic effects. This paracrine activity can be harnessed in the form of conditioned media. Despite these capabilities, the clinical translation of stem cell conditioned media (i.e., secretome) is precluded by a variety of factors. These limitations include standardization of stem cell-conditioned media formulation, characterization of bioactive factors in conditioned media and dosing, optimizing modes of delivery, and uncovering of mechanisms of action of stem cell conditioned media. The purpose of this review is to provide a focused narration on the aforementioned preclusions pertaining to the clinical translation of stem cell conditioned media. Specifically, we will report on commonly use methodologies for the development of stem cell conditioned media, modalities for conditioned media characterization, modes of delivery, and postulated mechanisms of action for stem cell conditioned media in regenerative medicine.Acute pancreatitis (AP) is an inflammatory disease that can progress to severe acute pancreatitis (SAP), which increases the risk of death. AP is characterized by inappropriate activation of trypsinogen, infiltration of inflammatory cells, and destruction of secretory cells. Other contributing factors may include calcium (Ca2+) overload, mitochondrial dysfunction, impaired autophagy, and endoplasmic reticulum (ER) stress. In addition, exosomes are also associated with pathophysiological processes of many human diseases and may play a biological role in AP. However, the pathogenic mechanism has not been fully elucidated and needs to be further explored to inform treatment. Recently, the treatment guidelines have changed; minimally invasive therapy is advocated more as the core multidisciplinary participation and "step-up" approach. The surgical procedures have gradually changed from open surgery to minimally invasive surgery that primarily includes percutaneous catheter drainage (PCD), endoscopy, small incision surgery, and video-assisted surgery. The current guidelines for the management of AP have been updated and revised in many aspects. The type of fluid to be used, the timing, volume, and speed of administration for fluid resuscitation has been controversial. In addition, the timing and role of nutritional support and prophylactic antibiotic therapy, as well as the timing of the surgical or endoscopic intervention, and the management of complications still have many uncertainties that could negatively impact the prognosis and patients' quality of life. Orelabrutinib Consequently, to inform clinicians about optimal treatment, we aimed to review recent advances in the understanding of the pathogenesis of AP and its diagnosis and management.
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