Notes

Fresh anti-tumor aftereffect of emodin throughout suspensions - inside situ hydrogels formed with self-assembling peptide.
33 mU/107 cfu) as well. We anticipate that this strain can be innovatively applied to the valorization of marine crustaceans side streams.Alginate oligosaccharide (AOS) was reported to possess antioxidant and free radical scavenging activities, but the specific effects and mechanisms remain unclear. We investigated the effects of AOS on H2O2-induced oxidative stress and apoptosis in human umbilical vein endothelial cells (HUVECs) and the associated mechanisms. HUVECs were treated with 100-800 µM hydrogen peroxide (H2O2) for various periods (12, 24, and 36 h) to establish an in vitro oxidative stress and apoptosis HUVEC model. AOS protects HUVEC cells against oxidative stress-induced apoptosis by decreasing the expression levels of caspase 3 and Bax, and increasing Bcl-2 expression. Microarray assay, real-time PCR and western blot results revealed that AOS was able to effectively suppress H2O2-induced apoptosis via regulated integrin-α/FAK/PI3K pathway by influencing the expression of integrin-α, FAK, PI3K, PTEN, P21, and CDK2. In conclusion, our study suggests that AOS can protect endothelial cells against oxidative stress injury caused by H2O2, providing novel alternative strategies to prevent atherosclerosis in the future.This prospective cohort study evaluates associations between structural and ultrastructural parameters in baseline biopsies from human kidney transplants and long-term graft survival after more than 14 years' follow-up. Baseline kidney graft biopsies were obtained prospectively from 54 consecutive patients receiving a kidney transplant at a single institution. Quantitative measurements were performed on the baseline biopsies by computer-assisted light microscopy and electron microscopy. Stereology-based techniques estimated the fraction of interstitial tissue, the volume of glomeruli, mesangial fraction, and basement membrane thickness of glomerular capillaries. The fraction of occluded glomeruli and scores according to the Banff classification were achieved. Kidney graft survival was analyzed by Kaplan-Meier estimates and Cox regression. Association to long-term kidney function was also analyzed. The long-term surviving kidney transplants were characterized at implantation by less arteriolar hyaline thickening (P less then 0.001) and less interstitial fibrosis (P = 0.001), as well as a lower fraction of occluded glomeruli (P = 0.004) and lower glomerular volume (P = 0.03). At the latest follow-up, eGFR was decreased by 12 ml/min/1.73 m2 per unit increase in the score for arteriolar hyalinosis at implantation (P = 0.02), and eGFR was decreased by 19 ml/min/1.73 m2 per 106 μm3 increase in glomerular volume at baseline (P = 0.03). The unbiased Cavalieri estimate of glomerular volume and the ultrastructural parameters are the first to be evaluated in a cohort study with prospective follow-up for more than 14 years. The study shows that baseline biopsies from human kidney grafts contain extraordinary long-term prognostic information, and it highlights the importance of these intrinsic graft factors.
Optimal stroke prevention strategies for patients with atrial fibrillation (AF) who experience a major bleed are poorly defined. We sought to estimate the effectiveness and safety of oral anticoagulation (OAC) represcription after an OAC contraindication.

TREAT-AF is a retrospective cohort study of patients with newly diagnosed AF (2004-2012), treated in the Veterans Health Administration. From this cohort, we identified patients with a contraindication to OAC after AF diagnoses, defined as incident intracranial bleeding, non-intracranial bleeding requiring hospitalization, or unrepaired cerebral aneurysm or aortic dissection. We used multivariate Cox proportional hazards to estimate the association of OAC prescription in the 90days following OAC contraindication to ischemic stroke and rebleeding.

Among 167,190 patients with newly diagnosed AF (70 ± 11years, 1.7% female, CHA
DS
-VASc 2.7 ± 1.7), 19,285 patients (11.5%) had an incident bleed (n = 18,342) or an unrepaired cerebral aneurysm or aortic disevention approaches after major bleeding events could be beneficial if bleeding risk can be successfully mitigated.
Data on antithrombotic therapy after percutaneous left atrial appendage occlusion (LAAO) is scarce and no randomized evaluation has been performed to demonstrate what is the best antithrombotic strategy. Up to date, different antithrombotic regimens with variable durations are currently used. In fact, the use of oral anticoagulation (OAC) or dual antiplatelet therapy (DAPT) with aspirin and clopidogrel during the initial phase (∓ 3months post-LAAO) has been proposed as valid strategies. However, antiplatelet and OAC therapies have never been compared in a randomized study after left atrial appendage closure (LAAC). The purpose of the present study is to ascertain an optimal antithrombotic strategy after LAAC in terms of safety and efficacy. The study will compare a novel OAC (NOAC) with a highly safety profile like apixaban 5mg/12h or 2.5mg/12h (after dose adjustment or in high-risk patients) with standard antiplatelet therapy with DAPT. The aim of the study was tocompare a strategy of anticoagulation with apixaban 5mg/2.5mg bid to the current standard of care (DAPT with aspirin and clopidogrel) after LAAO in patients with non-valvular atrial fibrillation (AF).

This is a phase IV multicenter randomized, open-label, controlled trial comparing the efficacy and safety of apixaban vs. DAPT after LAAO, both for 3months. The primary endpoint is a combined endpoint of death, myocardial infarction, stroke, thromboembolic complications, and major or significant bleeding at 3months of follow-up. Approximately 160 subjects will be enrolled and followed 12months from randomization.

Considering the high risk of both thromboembolic and hemorrhagic events of patients undergoing LAAO, establishment of an appropriate antithrombotic therapy in terms of efficacy and safety after LAAO is of vital importance.

EudraCT number 2018-001013-32.
EudraCT number 2018-001013-32.
To evaluate the associations between computed tomography (CT) imaging features extracted from the structured American Pancreatic Association (APA)/Society of Abdominal Radiology (SAR) template and overall survival in patients with resected pancreatic ductal adenocarcinoma (PDAC).

This retrospective analysis included consecutive patients with PDAC who consented to genomic tumor testing and underwent preoperative imaging and curative intent surgical resection from December 2006 to July 2017. Two radiologists assessed preoperative CT imaging using the APA/SAR PDAC-reporting template. Univariable associations between overall survival and imaging variables were evaluated using Cox proportional hazards regression.

The study included 168 patients (66years ± 11; 91 women). 126/168 patients (75%) received upfront surgical resection whereas 42/168 (25%) received neoadjuvant therapy prior to surgical resection. In the entire cohort, features associated with decreased overall survival were tumor arterial contact of any kind (hazard ratio (HR) 1.89, 95% CI 1.13-3.14, p = 0.020), tumor contact with the common hepatic artery (HR 2.33, 95% CI 1.35-4.04, p = 0.009), and portal vein deformity (HR 3.22, 95% CI 1.63-6.37, p = 0.003). read more In the upfront surgical group, larger tumor size was associated with decreased overall survival (HR 2.30, 95% CI 1.19-4.42, p = 0.013). In the neoadjuvant therapy group, the presence of venous collaterals was the only feature associated with decreased overall survival (HR 2.28, 95% CI 1.04-4.99, p = 0.042).

The application of the APA/SAR pancreatic adenocarcinoma reporting template may identify predictors of survival that can aid in preoperative stratification of patients.
The application of the APA/SAR pancreatic adenocarcinoma reporting template may identify predictors of survival that can aid in preoperative stratification of patients.
To determine whether reduced field-of-view (rFOV) DWI sequences can improve image quality and diagnostic performance compared with conventional full FOV (fFOV) DWI in the prediction of complete response (CR) to neoadjuvant chemoradiotherapy (CRT) in patients with locally advanced rectal cancers.

Between September 2015 and December 2017, seventy-three patients with locally advanced rectal cancers (≥ T3 or lymph node positive) who underwent CRT and subsequent surgery were included in this retrospective study. All patients had tumor located no more than 10cm from the anal verge, and underwent rectal MRI including fFOV b-1000 DWI and rFOV b-1000 DWI at 3T before and after CRT. Image quality and diagnostic performance in predicting CR were compared between rFOV DWI and fFOV DWI sets by two reviewers.

Based on a 12-point scale, rFOV DWI provided better image quality scores than fFOV DWI (9.1 ± 1.7 vs. 8.4 ± 1.0, respectively, P < 0.001). Diagnostic accuracy (A
) in evaluating CR was better with the rFOV DWI set than with the fFOV DWI set for both reviewers reviewer 1, 0.78 vs. 0.57 (P = .004); reviewer 2, 0.72 vs. 0.61 (P = .031).

rFOV DWI of rectal cancer can provide better overall image quality, and its addition to conventional rectal MRI may provide better diagnostic accuracy than fFOV DWI in the evaluation of CR to neoadjuvant CRT in patients with locally advanced rectal cancer.
rFOV DWI of rectal cancer can provide better overall image quality, and its addition to conventional rectal MRI may provide better diagnostic accuracy than fFOV DWI in the evaluation of CR to neoadjuvant CRT in patients with locally advanced rectal cancer.The aim of this paper is to describe our surgical technique and results of proper 6-branch autologous sling tensioning during RALP employing intraoperatively the Retrograde Perfusion Sphincterometry (RPS). Between May 2016 and February 2020, 374 patients underwent RALP with the 6-branch suburethral autologous sling tensioned under intraoperative guidance of RPS. Surgical procedure Retrograde Leak Point pressure (RLPP) was evaluated by means of RPS after pneumoperitoneum induction (RLPPp), after urethrovescical anastomosis (RLPPa) and during proper sling tensioning (RLPPs). The goal of the sling tensioning was to obtain at the end of the procedure similar pressures as after pneumoperitoneum induction (RLPPs ≅ RLPPp). Intraoperative variables, postoperative complications, and continence recovery outcomes were assessed. A descriptive statistical analysis was performed. Sling positioning and tensioning was feasible in all patients. Mean operative time was 215 min. Proper sling tensioning allowed for the possibility to restore sphincteric efficacy to preoperative value (RLPPs vs. RLPPp (42.5 vs. 42.6) cmH2O). Urinary continence was achieved, respectively, in 58%, 67%, 74%, 88% and 92% of patients after 24 h, 10 days, 1 month, 6 months and 1 year after catheter removal. In conclusion, RPS revealed a valid option for proper autologous 6-branch sling tensioning during RALP, offering the possibility to restore sphincteric apparatus efficiency to its preoperative status to improve EUC.
Search engine optimisation (SEO) in plastic surgery practice is crucial for increasing web traffic. Knowing what patients are searching for online can help plastic surgeons understand public interest, enhance patient engagement, and improve service provision. This study analyses the correlation between Google Trends (GT) search activity and the number of cosmetic procedures carried out in the UK.

GT search term data were analysed for popularity of use and geographical variation in the UK. Pearson's correlation coefficient was used to analyse GT data against the number of cosmetic surgery procedures undertaken in the UK in the corresponding year and with 1-year time lag.

GT score was higher for most colloquial search terms, such as "tummy tuck" compared to "abdominoplasty" (GT score 59 vs 6), but "otoplasty" was higher than "ear correction" (GT score 55 vs 19). Geographical variation showed that London ranked first in proportional search term activity for "brow lift" and Birmingham for "tummy tuck". There was statistically significant positive correlation for three search terms and the number of corresponding surgeries undertaken.
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