Early diagnosis and management of maternal ureterohydronephrosis during pregnancy

xlomafota13 shared this article with you from Inoreader Early diagnosis and management of maternal ureterohydronephrosis during pregnancy Via Experimental and therapeutic medicine Exp Ther Med. 2022 Jan;23(1):27. doi: 10.3892/etm.2021.10949. Epub 2021 Nov 5. ABSTRACT Maternal ureterohydronephrosis (UHN) is a common anatomical change during the evolution of pregnancy, diagnosed especially after the 20th week of pregnancy. The aim of the present study was to evaluate the stages of UHN during pregnancy, depending on the gestational age, and to monitor the symptomatology and the adequate management. A total of 58 pregnant women with UHN, hospitalized in the Constanta County Emergency Hospital, were included in the present study, and had nephrological monitoring using ultrasound examination. Right UHN was observed in all cases and left UHN was observed in only 67.24% of the cases. Regarding the gestational age, right UHN grade III was most commonly seen between 27 and 31 weeks of pregnancy (48.6% of total right UHN grade III from the studied group). The data showed that gestational age and grade of UHN had a highly d ependent association in the studied group. The majority of our patients (67.24%) were symptomatic, and the most common complaint on presentation was lumbar pain. According to the visual analog scale (VAS) of the lumbar pain, the group could be distributed as follows: 17.24% with severe pain, 36.21% with moderate pain and 13.79% with mild pain. Eight pregnant women (13.79%) from the present study developed UHN due to passage of a ureteral stone, although the majority of the patients experienced complications with urinary tract infection and acute kidney injury. In addition, 97% of the symptomatic UHN responded to conservatory treatment and only 2 patients (3.45%) with severe symptomatic UHN needed ureteral stent insertion. Data analysis was performed using IBM SPSS Statistics 23. The study highlighted the existence of an association between gestational age and UHN grading. PMID:34824635 | PMC:PMC8611492 | DOI:10.3892/etm.2021.10949 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Morphological classification and changes in dementia (Review)

xlomafota13 shared this article with you from Inoreader Morphological classification and changes in dementia (Review) Via Experimental and therapeutic medicine Exp Ther Med. 2022 Jan;23(1):33. doi: 10.3892/etm.2021.10955. Epub 2021 Nov 9. ABSTRACT The progressive functional decline that involves both cognitive and neuropsychiatric symptoms characteristic to dementia is one of the leading research topics. The risk for dementia is an intertwined mix between aging, genetic risk factors, and environmental influences. APOEε4, which is one of the apolipoprotein E (APOE) alleles, is the major genetic risk factor for late-onset of the most common form of dementia, Alzheimer's. Advances in machine learning have led to the development of artificial intelligence (AI) algorithms to help diagnose dementia by magnetic resonance imaging (MRI) in order to detect it in the preclinical stage. The basis of the determinations starts from the morphometry of cerebral atrophies. The present review focused on MRI techniques which are a leading tool in identifying cortical atrophy, white matter dysfunctionalities, c erebral vessel quality (as a factor for cognitive impairment) and metabolic asymmetries. In addition, a brief overview of Alzheimer's disease was presented and recent neuroimaging in the field of dementia with an emphasis on structural MR imaging and more powerful methods such as diffusion tensor imaging, quantitative susceptibility mapping, and magnetic transfer imaging were explored in order to propose a simple systematic approach for the diagnosis and treatment of dementia. PMID:34824641 | PMC:PMC8611489 | DOI:10.3892/etm.2021.10955 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Impact of G-CSF administration post-allogeneic hematopoietic stem-cell transplantation on outcomes: a systematic review and meta-analysis

xlomafota13 shared this article with you from Inoreader Impact of G-CSF administration post-allogeneic hematopoietic stem-cell transplantation on outcomes: a systematic review and meta-analysis Via American Journal of Blood Research Am J Blood Res. 2021 Oct 15;11(5):544-563. eCollection 2021. ABSTRACT Granulocyte colony-stimulating factors (G-CSFs) have been used post hematopoietic stem cell transplant (HSCT) for earlier neutrophil engraftment. The use of G-CSFs, and their effect on other post-HSCT outcomes remains debatable. In this systematic review and meta-analysis, we searched PubMed, Embase, Cochrane library, Google Scholar, and IndMed using a predefined search strategy. We included randomized controlled trials (RCTs) and non-randomized studies (NRSs) reporting data on G-CSF administration post-HSCT, published in the English language from their inception until Jan 31, 2021. The primary outcome of this systematic review and meta-analysis was to evaluate the time to neutrophil engraftment (NE). The secondary outcomes were probability of NE, time to platelet engraftment (PE), the incidence of graft-versus-host disease (GVHD), duration of hospital stay (HS), and overall survival (OS). The review is registered with PROSPERO (CRD42020206989). Fourteen studies were extracted (n=9850), of which five were RCTs, and nine were NRSs. As per Egger's test, publication bias was not present for any outcome. After meta-analysis, we found that the duration of NE favouring G-CSF arm from RCTs was -0.94 days (SMD) [(95% CI: -1.38, -0.51); I2=35%], and from NRSs -1.2 days (SMD) [(95% CI: -1.43, -0.96); I2=74%]. For the outcome of GVHD, the relative risks (RR) of incidence for chronic GVHD and overall GVHD were not significant for the RCTs, and these were 1.11 (RR) [(95% CI: 1.00, 1.22); I2=43%] and 1.10 (RR) [(95% CI: 1.03, 1.18); I2=48%], respectively for NRSs. There was no difference in the incidence of GVHD (acute or chronic) in both arms. No significant difference was found between the two arms for the outcomes of PE, HS, and OS. For NE, there was a marginal benefit of around one day with the use of G-CSF. Th e use of G-CSF did not alter time to PE, the incidence of GVHD, HS, and OS in both arms. PMID:34824887 | PMC:PMC8610798 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Insula: A Stimulating Island of the Brain

xlomafota13 shared this article with you from Inoreader The Insula: A Stimulating Island of the Brain Via cortical auditory Brain Sci. 2021 Nov 19;11(11):1533. doi: 10.3390/brainsci11111533. ABSTRACT Direct cortical stimulation (DCS) in epilepsy surgery patients has a long history of functional brain mapping and seizure triggering. Here, we review its findings when applied to the insula in order to map the insular functions, evaluate its local and distant connections, and trigger seizures. Clinical responses to insular DCS are frequent and diverse, showing a partial segregation with spatial overlap, including a posterior somatosensory, auditory, and vestibular part, a central olfactory-gustatory region, and an anterior visceral and cognitive-emotional portion. The study of cortico-cortical evoked potentials (CCEPs) has shown that the anterior (resp. posterior) insula has a higher connectivity rate with itself than with the posterior (resp. anterior) insula, and that both the anterior and posterior insula are closely connected, notably between the homologous insula r subdivisions. All insular gyri show extensive and complex ipsilateral and contralateral extra-insular connections, more anteriorly for the anterior insula and more posteriorly for the posterior insula. As a rule, CCEPs propagate first and with a higher probability around the insular DCS site, then to the homologous region, and later to more distal regions with fast cortico-cortical axonal conduction delays. Seizures elicited by insular DCS have rarely been specifically studied, but their rate does not seem to differ from those of other DCS studies. They are mainly provoked from the insular seizure onset zone but can also be triggered by stimulating intra- and extra-insular early propagation zones. Overall, in line with the neuroimaging studies, insular DCS studies converge on the view that the insula is a multimodal functional hub with a fast propagation of information, whose organization helps understand where insular seizures start and how they propagate. PMID:34827532 | DOI:10.3390/brainsci11111533 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Paraneoplastic acute vestibular syndrome: What, when and how

xlomafota13 shared this article with you from Inoreader Paraneoplastic acute vestibular syndrome: What, when and how Via Acta Otorrinolaringologica English Publication date: November–December 2021 Source: Acta Otorrinolaringologica (English Edition), Volume 72, Issue 6 Author(s): Carolina Moreno-de-Jesús, Lucía Prieto-Sánchez-de-Puerta, Irene Mármol-Szombathy, Emilio Domínguez-Durán View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Rare anastomosis between a replaced right hepatic artery and left branch of the proper hepatic artery

xlomafota13 shared this article with you from Inoreader Rare anastomosis between a replaced right hepatic artery and left branch of the proper hepatic artery Via radiol anat Surg Radiol Anat. 2021 Nov 27. doi: 10.1007/s00276-021-02863-x. Online ahead of print. ABSTRACT Appreciation of the potential anatomical variation of the hepatic arterial supply and branches of the abdominal aorta is of paramount importance in pancreatic and hepatobiliary surgery. Here we describe a hitherto un-reported coelio-mesenteric anastomotic connection between a replaced right hepatic artery, originating from the superior mesenteric artery, and the left hepatic branc h of the proper hepatic artery. The embryological origins of the variant anatomy as well as its potential surgical implications are discussed with a view to encourage thorough pre-operative interrogation of available imaging by radiologists and surgeons to successfully identify such variants and take advantage of their potentially useful functionality. PMID:34837499 | DOI:10.1007/s00276-021-02863-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Double‐Barrel Versus Single‐Barrel Fibula Flaps for Mandibular Reconstruction: Safety and Outcomes

xlomafota13 shared this article with you from Inoreader Double‐Barrel Versus Single‐Barrel Fibula Flaps for Mandibular Reconstruction: Safety and Outcomes Via The Laryngoscope Objectives/Hypothesis Fibula flaps are routinely used for osseous reconstruction of head and neck defects. However, single-barrel fibula flaps may result in a height discrepancy between native mandible and grafted bone, limiting outcomes from both an aesthetic and dental standpoint. The double-barrel fibula flap aims to resolve this. We present our institution's outcomes comparing both flap designs. Study Design Retrospective cohort study. Methods We conducted a retrospective review of all patients undergoing free fibula flap mandibular reconstruction at our institution between October 2008 and October 2020. Patients were grouped based on whether they underwent single-barrel or double-barrel reconstruction. Postoperative outcomes data were collected and compared between groups. Differences in categorical and continuous variables were assessed using a Chi-square test or Student's t-test, respectively. Results Out of 168 patients, 126 underwent single-barrel and 42 underwent double-barrel reconstruction. There was no significant difference in postoperative morbidity between approaches, including total complications (P = .37), flap-related complications (P = .62), takeback to the operating room (P = .75), flap salvage (P = .66), flap failure (P = .45), and mortality (P = .19). In addition, there was no significant difference in operative time (P = .86) or duration of hospital stay (P = .17). After adjusting for confounders, primary dental implantation was significantly higher in the double-barrel group (odds ratio, 3.02; 95% confidence interval, 1.2–7.6; P = .019). Conclusion Double-barrel fibula flap mandibular reconstruction can be performed safely without increased postoperative morbidity or duration of hospital stay relative to single-barrel reconstruction. Moreover, the double-barrel approach is associated with higher odds of primary dental implantation and may warrant further consideration as part of an expanded toolkit for achieving early dental rehabilitation. Level of Evidence III Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.