Notes

Substantial rhabdomyosarcomatous distinction within persistent low-grade urothelial carcinoma with the bladder soon after transurethral resection: in a situation report.
After 3 months of follow-up, there was 71% maintenance of deprescription. Three patients were lost to follow-up and 6 patients resumed PPI.

The approach undertaken resulted in the suspension of PPI intake in almost 3 out of 10 cases. This result was maintained at least three months for a large majority of patients. It will be interesting to continue this process and extend the monitoring over longer periods, in order to ensure that PPI de-prescription is maintained in the long term.
The approach undertaken resulted in the suspension of PPI intake in almost 3 out of 10 cases. This result was maintained at least three months for a large majority of patients. It will be interesting to continue this process and extend the monitoring over longer periods, in order to ensure that PPI de-prescription is maintained in the long term.
First, this study aimed to assess the prognostic value of different definitions for resection margin status on disease-free survival (DFS) and overall survival (OS) in pancreatic ductal adenocarcinoma (PDAC). Second, preoperative predictors of direct margin involvement were identified.

This nationwide observational cohort study included all patients who underwent upfront PDAC resection (2014-2016), as registered in the prospective Dutch Pancreatic Cancer Audit. Patients were subdivided into three groups R0 (≥1mm margin clearance), R1 (<1mm margin clearance) or R1 (direct margin involvement). Survival was compared using multivariable Cox regression analysis. Logistic regression with baseline variables was performed to identify preoperative predictors of R1 (direct).

595 patients with a median OS of 18 months (IQR 10-32 months) months were analysed. R0 (≥1mm) was achieved in 277 patients (47%), R1 (<1mm) in 146 patients (24%) and R1 (direct) in 172 patients (29%). R1 (direct) was associated with a wging was associated with an increased risk of R1 (direct) resection with upfront surgery, neoadjuvant therapy might be considered in these patients.
Fasting guidelines for pediatric procedural sedation have historically been controversial. Recent literature suggests that there is no difference in adverse events regardless of fasting status.

The goal of this study was to examine adverse outcomes and departmental efficiency when fasting guidelines are not considered during pediatric emergency department (PED) sedation for orthopedic interventions.

Retrospective chart review identified 2674 patients who presented to a level I PED and required procedural sedation for orthopedic injuries between February 2011 and July 2018. This was a level III, retrospective cohort study. Patients were categorized into the following groups already within American Society of Anesthesiologists (ASA) fasting guidelines on presentation to the PED (n=671 [25%]), had procedural sedation not within the ASA guidelines (n=555 [21%]), and had procedural sedation after fasting in the PED to meet ASA guidelines (n=1448 [54%]). Primary outcomes were length of stay, time from admissiuivalent outcomes, the value of spending less time in the PED is evident. Overall, adverse events related to sedation are rare and not related to fasting guidelines.
Length of stay in the PED was significantly longer if ASA fasting guidelines were followed for children requiring sedation for orthopedic procedures. This is a substantial delay in a busy PED where beds and resources are at a premium. Although providing similar care with equivalent outcomes, the value of spending less time in the PED is evident. Overall, adverse events related to sedation are rare and not related to fasting guidelines.Acute bilirubin encephalopathy (ABE) is still an insufficiently addressed cause of mortality and long-term morbidity in low- and middle-income countries (LMICs). This article highlights that delayed or incorrect medical advice, inaccurate bilirubin measurements as well as ineffective phototherapy are some of the relevant causes predisposing jaundiced newborns to develop extreme hyperbilirubinemia [EHB, total serum/plasma bilirubin (TB) ≥ 25 mg/dL (428 µmol/L)] and subsequent ABE. Obstacles preventing state of the art management of such infants are also discussed. Prevention of ABE cannot occur without a system-based approach tailored to suit the needs and available resources of each community. Clear set protocols, rigorous training, monitoring, and accurate documentation together with simple innovative affordable technologies that can be locally produced, are essential to observe the change desired.
To analyze the presence of subretinal fluid (SRF), intraretinal fluid (IRF) and subretinal pigment epithelial fluid (SRPEF) in näive patients with exudative neovascular AMD at baseline and at one year follow-up and treatment, in clinical practice, and perform a concordance analysis between resident physicians.

A retrospective analysis of the näive patients who attended our service for 6months between 2016-2017 by neovascular AMD was performed. Optical coherence tomography (OCT), at baseline and at one year follow-up, were analyzed from independently by two resident doctors, determined the presence or not of SRF, IRF, SRPEF. A retina specialist ophthalmologist intervened in cases where there was no consensus among resident physicians. A descriptive and interobserver concordance analysis was performed.

27 eyes of 24 patients were evaluated, 20.8% being men and 79.16% women, with a mean age of 78.57±8years. 32.14% of the eyes presented the three types of fluid before the start of treatment and the frequencase and good for SRF and IRF and very good for SRPEF at one year of treatment.
Increasing amounts of time using digital media (i.e., texting, social media, electronic gaming, and general smartphone and computer use) among children and adolescents is becoming a growing concern given its potentially deleterious effects on health. However, little is known about the social and developmental underpinnings of digital media use among children and youth. PF-05221304 cell line This study examines the link between adverse childhood experiences and digital media use among a recent, nationally representative sample of children and adolescents.

Data pertaining to children/youth aged 6-17 years from the 2018 National Survey of Children's Health were analyzed in 2020 (N=21,954). The association between 9 distinct forms of childhood adversity and time spent on digital media among youth was assessed using multinomial logistic regression. The mediating roles of family-, parent-, and child-level factors were determined using the Karlson-Holm-Breen method.

Net of covariates, the relative risk of heavy digital media use was 3 times higher among youth experiencing ≥4 adverse childhood experiences than among those experiencing none.
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