Notes

The actual TUNEL assay underestimates the occurrence of DNA injury inside pig semen on account of chromatin condensation.
were significantly higher after immunotherapy compared to those before immunotherapy (p = 0.001). Furthermore, Phl p specific IgG4 levels after immunotherapy were also significantly higher than in the control group (p = 0.001). Improvements in activities-practical problems and non-nose/eye symptoms quality of life scores were significantly different between two groups (p less than 0.05). There was no difference in terms of clinical and immunological parameters in mono- and polysensitized patients (p greater than 0.05). Conclusions. This study indicates that clinical improvement with pre-seasonal grass pollen immunotherapy is accompanied by important increase in specific IgG4 blocking antibodies. Furthermore, a single-allergen immunotherapy can lead to similar clinical efficacy and immunological changes in polysensitized as well as monosensitized patients with grass pollen allergy.
We retrospectively compared the outcomes of patients with severe aplastic anemia (SAA) who received haploidentical hematopoietic stem cell transplantation (haplo-HSCT) combined or not combined with umbilical cord-derived mesenchymal stem cells (UC-MSCs).

A total of 101 patients with SAA were enrolled in this study and treated with haplo-HSCT plus UC-MSC infusion (MSC group, n=47) or haplo-HSCT alone (non-MSC group, n=54).

The median time to neutrophil engraftment in the MSC and non-MSC group was 11 (range 8-19) and 12 (range 8-23) days, respectively (p=0.049), with a respective cumulative incidence (CI) of 97.82% and 97.96% (p=0.101). Compared to the non-MSC group, the MSC group had a lower CI of chronic graft-versus-host disease (GVHD) (8.60±0.25% vs. 24.57±0.48%, p=0.048), but similar rates of grades II-IV acute GVHD (23.40±0.39% vs. 24.49±0.39%, p=0.849), grades III-IV acute GVHD (8.51±0.17% vs. 10.20±0.19%, p=0.765), and moderate-severe chronic GVHD (2.38±0.06% vs. 7.45±0.18%, p=0.352) were observed. The estimated 5-year overall survival (OS) rates were 78.3±6.1% and 70.1±6.3% (p=0.292) while the estimated 5-year GVHD-free, failure-free survival (GFFS) rates were 76.6±6.2% and 56.7±6.9% (p=0.045) in the MSC and non-MSC groups, respectively.

In multivariate analysis, graft failure was the only adverse predictor for OS. Meanwhile, graft failure, grades III-IV acute GVHD, and moderate-severe chronic GVHD could predict worse GFFS. Our results indicated that haplo-HSCT combined with UC-MSCs infusion was an effective and safe option for SAA patients.
In multivariate analysis, graft failure was the only adverse predictor for OS. Meanwhile, graft failure, grades III-IV acute GVHD, and moderate-severe chronic GVHD could predict worse GFFS. Our results indicated that haplo-HSCT combined with UC-MSCs infusion was an effective and safe option for SAA patients.Asylum-seeking adolescents who have passed the age of mandatory schooling may not have had the opportunity to receive oral hygiene instructions (OHI) similar to Swiss adolescents. Therefore, the aim of this study was to evaluate the impact of a single information session with OHI on both the knowledge about the consequences of lacking oral hygiene and the likelihood of implementing these instructions in unaccompanied adolescent asylum seekers living in Switzerland. Before and after a single information session with OHI, adolescent asylum seekers in two asylum centres (Menziken and Suhr, AG) were surveyed with written questionnaires. During the event, the consequences of lacking oral hygiene on oral health were explained and the Bass brushing technique was instructed and practised. The present analysis included 30 male asylum seekers aged 15-18. In total, 90% (n=27) cleaned their teeth daily and 70% (n=13) had received previous OHI at their school (19.1%) or a doctor's office (9.5%) in their country of origin or in Switzerland (19.1%), respectively. Following the event, 90% (n=27) stated they had learned something new and 93.3% (n=28) wanted to implement the instructions in their daily routine. While 63.3% (n=19) of the respondents knew the consequences of lacking oral hygiene on oral health before the event, this value increased to 96.7% (n=29) reaching statistical significance (p=0.0039). In conclusion, the results of the present study suggest that the implementation of a single information session with OHI in asylum centres may improve the level of knowledge in adolescent asylum seekers and their oral health.
On any given day, there are >550,000 homeless persons in the United States. Little research has examined the relationship between the homeless population and traumatic injuries. We hypothesized that homeless trauma patients have a higher mortality compared to those who are not homeless.

The Pennsylvania Trauma Outcome Study database was retrospectively queried from 2003-2018 for all adult (age ≥15) patients admitted to trauma centers in Pennsylvania. Homelessness was defined as homeless on admission or homeless as their discharge status. Patient demographics, comorbidities, and clinical variables were compared between homeless and non-homeless patients. Logistic regression was used to control for age, gender, injury severity, injury type, admission Glasgow Coma Scale, and systolic blood pressure to assess morbidity and mortality.

773 patients were identified upon query. Homeless trauma patients were more likely to be male, younger, black, and of Hispanic ethnicity. Compared to non-homeless, they were more likely to have a positive drug screen or mental illness at the time of injury. They were not more significantly injured than their counterparts; however, in adjusted analysis, the homeless had significantly higher odds of both complications (Adjusted Odds Ratio [AOR] 3.11; 95%CI 2.64-3.66,
< .001) and mortality (AOR 1.79; 95%CI 1.29-2.50,
= .001).

Although homeless patients were not more severely injured than the general trauma population, they had significantly higher odds of both complications and mortality. This population represents a very vulnerable community in need of medical intervention and injury prevention programs.
Although homeless patients were not more severely injured than the general trauma population, they had significantly higher odds of both complications and mortality. This population represents a very vulnerable community in need of medical intervention and injury prevention programs.Rural patients have fewer complications and deaths, shorter hospital stay, and less resource utilization than their urban counterparts. They also tend to have fewer chronic illnesses; this reflects a system working as intended, with high-risk patients transferred to better-resourced institutions, while others receive surgical care closer to home. Deciding which operations a modern rural surgeon should-and shouldn't-perform starts with the question "Who decides?" Government, insurers, hospitals, surgeons, and patients are all stakeholders, with a vested interest in the answer.Rural hospitals depend on surgeons for their financial existence, and rural surgeons need hospitals to function. The closure of rural hospitals throughout the country threatens the future of rural surgery. Without surgeons, rural patients will die unnecessarily. During the first COVID surge, patients died from such basic surgical emergencies as small bowel obstruction, when tertiary referral hospitals were full. Rural surgeons are essential in providing timely care of the injured patient; even today, patients die in isolated facilities from treatable injuries from lack of a surgeon who can do a splenectomy, or tube thoracostomy for traumatic pneumothorax, for example.Recruitment of rural surgeons requires identifying interested trainees, often from rural backgrounds, and a defined residency curriculum with emphasis on endoscopy and vascular surgery plus basic gynecology, obstetrics, urology, and orthopedics. Financial incentives & credentials support are also essential for the new rural surgeon. We need to develop many more focused rural surgery programs, and quickly, before the possibility of a broadly skilled rural surgeon in the USA evaporates.
Proximal gastrectomy (PG) has been excluded from the arsenal of western surgical oncologists for fear of bile reflux and diet intolerance. However, it is often an appropriate, less morbid operation for patients requiring resection of a proximal gastric cancer.

Between 2013 and 2017, we performed 19 PG and 37 total gastrectomies (TGs), of whom 15 and 25 were alive at the time of data collection. In this single-center series, we present findings of a 10-question interview of patients who underwent proximal (n = 8) or TG (n = 16) regarding postgastrectomy food-related symptoms, based on a modified version of the validated Postgastrectomy Syndrome Assessment Scale.

Out of 7 Likert scale questions, there were no statistically significant differences between the groups regarding bile reflux, early satiety, appetite, energy level, physical activity limitations, pain, or general dissatisfaction with their surgery. Patients from both groups reported eating similar amounts of their preoperative volume per meal and overall food volume for the day. Both groups reported eating a similar number of snacks and meals throughout the day. Food satisfaction scores, calculated by summation of the Likert scores, were not different.

Although limited by the small population, we did not find a clinically relevant difference in food-related symptoms comparing PG and TG patients. This pilot study suggests that PG is an appropriate alternative to TG in certain populations. Anecdotal beliefs regarding potential bile reflux or diet intolerance should be reconsidered.
Although limited by the small population, we did not find a clinically relevant difference in food-related symptoms comparing PG and TG patients. This pilot study suggests that PG is an appropriate alternative to TG in certain populations. Anecdotal beliefs regarding potential bile reflux or diet intolerance should be reconsidered.
The leading cause of morbidity and mortality in the pediatric population is unintentional injury. Emergent thoracotomies are rarely performed in pediatric patients, especially in the very young pediatric population. We present a case of a 10-year-old male who survived emergent clamshell thoracotomy for penetrating chest trauma.

Our patient sustained aortic lacerations after being shot with an air-powered rifle. Thoracotomy was performed in the emergency department. The incision was extended to a clamshell thoracotomy for repair of the aortic lacerations. He survived and made a full recovery.

This case is one of the youngest reported survivors of an emergent thoracotomy. Air-powered gun injuries can be life-threatening despite their perception as safe toys for children. Surprisingly, there is very little regulation on sale of air guns to minors in the United States. Increased public awareness and regulation of sale may prevent unintentional injury in this population.
This case is one of the youngest reported survivors of an emergent thoracotomy. Air-powered gun injuries can be life-threatening despite their perception as safe toys for children. Surprisingly, there is very little regulation on sale of air guns to minors in the United States. Increased public awareness and regulation of sale may prevent unintentional injury in this population.
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