Abstract Background Intracorporeal urinary diversion (ICUD) has the potential benefits of a smaller incision, reduced pain, decreased bowel exposure, and reduced risk of fluid imbalance. Objective To ...compare the perioperative outcomes of patients undergoing extracorporeal urinary diversion (ECUD) and ICUD following robot-assisted radical cystectomy (RARC). Design, setting, and participants We reviewed the database of the International Robotic Cystectomy Consortium (IRCC) (18 international centers), with 935 patients who had undergone RARC and pelvic lymph node dissection (PLND) between 2003 and 2011. Intervention All patients within the IRCC underwent RARC and PLND as indicated. The urinary diversion was performed either intracorporeally or extracorporeally. Outcome measurements and statistical analysis Demographic data, perioperative outcomes, and complications in patients undergoing ICUD or ECUD were compared. All patients had at least a 90-d follow-up. The Fisher exact test was used to summarize categorical variables and the Wilcoxon rank sum test or Kruskal-Wallis test for continuous variables. Results and limitations Of 935 patients who had RARC and PLND, 167 patients underwent ICUD (ileal conduit: 106; neobladder: 61), and 768 patients had an ECUD (ileal conduit: 570; neobladder: 198). Postoperative complications data were available for 817 patients, with a minimum follow-up of 90 d. There was no difference in age, gender, body mass index, American Society of Anesthesiologists grade, or rate of prior abdominal surgery between the groups. The operative time was equivalent (414 min), with the median hospital stay being marginally longer for the ICUD group (9 d vs 8 d, p = 0.086). No difference in the reoperation rates at 30 d was noted between the groups. The 90-d complication rate was not significant between the two groups, but a trend favoring ICUD over ECUD was noted (41% vs 49%, p = 0.05). Gastrointestinal complications were significantly lower in the ICUD group ( p ≤ 0.001). Patients with ICUD were at a lower risk of experiencing a postoperative complication at 90 d (32%) (odds ratio: 0.68; 95% confidence interval, 0.50–0.94; p = 0.02). Being a retrospective study was the main limitation. Conclusions Robot-assisted ICUD can be accomplished safely, with comparable outcomes to open urinary diversion. In this cohort, patients undergoing ICUD had a relatively lower risk of complications.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Whether epithelial cells play a role in triggering the immune cascade leading to T helper 2 (T(H)2)-type allergic inflammation is not known. We show here that human thymic stromal lymphopoietin ...(TSLP) potently activated CD11c(+) dendritic cells (DCs) and induced production of the T(H)2-attracting chemokines TARC (thymus and activation-regulated chemokine; also known as CCL17) and MDC (macrophage-derived chemokine; CCL22). TSLP-activated DCs primed naïve T(H) cells to produce the proallergic cytokines interleukin 4 (IL-4), IL-5, IL-13 and tumor necrosis factor-alpha, while down-regulating IL-10 and interferon-gamma. TSLP was highly expressed by epithelial cells, especially keratinocytes from patients with atopic dermatitis. TSLP expression was associated with Langerhans cell migration and activation in situ. These findings shed new light on the function of human TSLP and the role played by epithelial cells and DCs in initiating allergic inflammation.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Anatomical nerve sparing radical prostatectomy provides excellent cancer control, although the recovery of sexual function is variable. We recently described a technique to preserve the prostatic ...fascia (veil of Aphrodite) that appears to enhance the quality of nerve preservation during robotic prostatectomy. In January 2003 we initiated a prospective study comparing patients undergoing prostatic fascia preservation with those undergoing conventional nerve sparing robotic radical prostatectomy. We report results at 12 months of followup
From January to August 2003, 58 potent men with a Sexual Health Inventory for Men score (SHIM) of greater than 21 without phosphodiesterase 5 inhibitors underwent Vattikuti Institute prostatectomy, including 35 with preservation of the prostatic fascia (study) and 23 with conventional nerve sparing (control). Potency was assessed with self-administered SHIM questionnaires 12 months after surgery. The primary end point was achievement of erections strong enough for penetration with or without oral medications. The secondary end point was the ability to achieve normal erections (SHIM greater than 21) with and without medications.
At 12 months of followup 17 of 23 control (74%) and 34 of 35 study (97%) patients achieved erections strong enough for intercourse (p = 0.002). Four control (17%) and 18 study (51%) patients achieved normal erections (SHIM greater than 21) without medication (p <0.0001). Six control (26%) and 30 study (86%) patients achieved normal erections with or without phosphodiesterase 5 inhibitors (p <0.0001).
Potency rates after radical prostatectomy vary with the measure used to define potency. Irrespective of the definition used patients undergoing prostatic fascia preserving radical prostatectomy have significantly better potency outcomes than patients undergoing conventional nerve sparing robotic prostatectomy at 12 months of followup.
Endovascular therapy has become the standard of care for patients with disabling anterior circulation ischemic stroke due to proximal intracranial thrombi. Our aim was to determine whether the ...beneficial effect of endovascular treatment on functional outcome could be explained by a reduction in posttreatment infarct volume in the Endovascular Revascularization With Solitaire Device Versus Best Medical Therapy in Anterior Circulation Stroke Within 8 Hours (REVASCAT) trial.
The REVASCAT trial was a multicenter randomized open-label trial with blinded outcome evaluation. Among 206 enrolled subjects (endovascular treatment,
= 103; control,
= 103), posttreatment infarct volume was measured in 204 subjects. Posttreatment infarct volumes were compared with treatment assignment and recanalization status. Appropriate statistical models were used to assess the relationship among baseline clinical and imaging variables, posttreatment infarct volume, the 24-hour NIHSS score, and functional status with the 90-day modified Rankin Scale score.
The median posttreatment infarct volume in all subjects was 23.7 mL (interquartile range = 68.9 mL) and 16.3 mL (interquartile range = 50.2 mL) in the endovascular treatment arm and 38.6 mL (interquartile range = 74.9 mL) in the control arm (
= .02 for endovascular treatment versus control subjects). Baseline NIHSS (
< .01), site of occlusion (
< .03), baseline NCCT ASPECTS (
< .01), and recanalization status (
= .02) were independently associated with posttreatment infarct volume. Baseline NIHSS (
< .01), time from symptom onset to randomization (
= .02), treatment type (
= .04), and recanalization status (
< .01) were independently associated with the 24-hour NIHSS scores. The 24-hour NIHSS score strongly mediated the relationship between treatment type and 90-day mRS (
< .01 for indirect effect when adjusted for age), while posttreatment infarct volume did not (
= .26).
Endovascular treatment saves brain and improves 90-day clinical outcomes primarily through a beneficial effect on the 24-hour stroke severity.
Sun drying is perhaps one of the oldest methods of food preservation that has been practiced for centuries. The direct usage of solar radiation which is renewable and abundant favours farmers that ...harvest and process at small quantity. As technology advances, an alternative to sun drying evolves to maximize the potential of solar radiation and this technology is known as solar drying. Solar drying has several inherent advantages over sun drying namely faster drying rate, better protection of products, reduce risk of prolonged drying, lesser risk of product spoilage and improvement in product quality. Various studies have reported the application of solar drying for fruits, vegetables, grains, seeds, beans, herbs, spices and medicinal plants. Product quality improvement is definitely associated with solar dried products as compared to sun dried and to some extent oven/hot air dried products. However, uptake of this technology especially among farmers in developing countries are still low despite the many years of research and technology advancement. Nonetheless, some successful application of solar drying have been reported in countries such as Indonesia, Laos, Zimbabwe, Tanzania, Brazil, Uganda, Kenya and Senegal.
Microstate analysis is a spatiotemporal method where instantaneous scalp potential topography represents the current state of the brain. The temporal evolution of these scalp topographies gives an ...understanding of quasi-stable periods of long-range coherence between distant electrodes, reflecting functional coordination within large-scale cortical networks. It has been proven potential in identification and characterization of neurophysiological indicators associated with neuropsychiatric conditions. Changes in microstates connected to symptoms and cognitive impairments of neuropsychiatric conditions. It is useful in the study of cognitive processes and disorders related to memory. Researchers may probe into the relationships between microstates and other cognitive processes, such as memory retrieval and encoding. This is a tool for clinicians to enhance the precision of diagnosis and inform possibilities for treatment by acquiring information regarding individual diversity in microstates could lead to tailored medical methods. Customizing treatment according to a patient's microstate patterns could improve the efficacy of treatment. The papers selected for the review span a broad-spectrum including memory related disorders, psychiatry and neurological disorders. A section in the review article has been dedicated to source localization of EEG microstates. The selection of review papers shed light on the importance and huge potential of application of EEG microstate analysis in various neuropsychological processes. The review concludes with the need for standardization of microstate analysis. It suggests the incorporation of widely accepted machine learning techniques for increasing the accuracy, reliability and acceptability of microstate analysis as reliable biomarkers for neurological conditions in the future.
•The temporal evolution of scalp topographies gives an understanding of quasi-stable periods of long-range coherence between distant electrodes, reflecting functional coordination within large-scale cortical networks.•The papers selected for the review span a broad-spectrum including memory related disorders, psychiatry, neurological disorders including epilepsy, sleep and drowsiness and human consciousness.•A section in the review article has been dedicated to source localization of EEG microstates.•The review concludes with the suggestion that the incorporation of widely accepted machine learning techniques for increasing the accuracy, reliability and acceptability of microstate analysis as reliable biomarkers for neurological conditions.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Regular aspirin use is associated with reduced risk of several malignancies. Epidemiologic studies analyzing aspirin, nonaspirin nonsteroidal anti-inflammatory drug (NSAID), and acetaminophen use and ...ovarian cancer risk have been inconclusive.
We analyzed pooled data from 12 population-based case-control studies of ovarian cancer, including 7776 case patients and 11843 control subjects accrued between 1992 and 2007. Odds ratios (ORs) for associations of medication use with invasive epithelial ovarian cancer were estimated in individual studies using logistic regression and combined using random effects meta-analysis. Associations between frequency, dose, and duration of analgesic use and risk of ovarian cancer were also assessed. All statistical tests were two-sided.
Aspirin use was associated with a reduced risk of ovarian cancer (OR = 0.91; 95% confidence interval CI = 0.84 to 0.99). Results were similar but not statistically significant for nonaspirin NSAIDs, and there was no association with acetaminophen. In seven studies with frequency data, the reduced risk was strongest among daily aspirin users (OR = 0.80; 95% CI = 0.67 to 0.96). In three studies with dose information, the reduced risk was strongest among users of low dose (<100 mg) aspirin (OR = 0.66; 95% CI = 0.53 to 0.83), whereas for nonaspirin NSAIDs, the reduced risk was strongest for high dose (≥500 mg) usage (OR = 0.76; 95% CI = 0.64 to 0.91).
Aspirin use was associated with a reduced risk of ovarian cancer, especially among daily users of low-dose aspirin. These findings suggest that the same aspirin regimen proven to protect against cardiovascular events and several cancers could reduce the risk of ovarian cancer 20% to 34% depending on frequency and dose of use.
Nanocrystalline Cr:ZnAl2O4 was synthesized for the first time by rapid thermal annealing the corresponding hydroxide precipitate in just 10 min. The XRD patterns showed that synthesis between 500 °C ...and 700 °C had smaller crystallites (∼2.4 – 4 nm), while at 800 °C and 900 °C, had ∼10 nm crystallites. HRTEM images of the 900 °C sample showed the well-developed lattice fringes confirming the high crystallinity. The particles were polyhedral having an average size of ∼16 nm. The diffuse reflectance spectra showed characteristic 4A2g → 4T1g and 4A2g → 4T2g transitions, while the photoluminescence emission spectrum comprised of the zero phonon line (R-line) along with other multi-phonon side bands that are characteristic of the spin – parity forbidden transitions of the Cr3+ ion. The emission spectra and photoluminescence lifetimes are comparable with reports on sensing and imaging applications. Our work demonstrates the suitability of this technique to quickly synthesise phosphors for a variety of applications.
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•10 min synthesis of highly crystalline Cr:ZnAl2O4 nanoparticles by Rapid Annealing.•Polyhedral, single crystalline particles obtained at 900 °C with average size 16 nm.•Optical properties were comparable with those obtained by conventional annealing.•Well resolved, characteristic Cr3+ emission bands obtained above 800 °C.
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Studies have linked vitamin D to risk factors for cardiovascular disease. Obesity is a potential confounder in these studies. This study examined the relationship of 25 (OH) cholecalciferol (25OH D3) ...with insulin resistance, blood glucose, and lipid profile in lean male adults.
We enrolled two hundred and thirty four military recruits before beginning of military training. Demographic and anthropometric data were collected from them. The participants underwent body mass composition analysis by dual energy X ray absorptiometry. Fasting samples were collected for measurement of blood glucose, lipid profile, 25(OH) D3, serum parathormone (PTH) and insulin.
Vitamin D deficiency and insufficiency was found in 47.7% (107/224) and 31.6% (71/224) of participants, respectively. Using Pearson's correlation coefficient 25(OH) cholecalciferol and fasting blood glucose (FBG) were inversely correlated (p = 0.023). However, similar relation was not found between 25(OH) D3 and total cholesterol, triglycerides, high-density lipoprotein–cholesterol, low-density lipoprotein–cholesterol, homeostatic model assessment of insulin resistance and levels of PTH. On body composition analysis, there was no correlation of 25(OH) cholecalciferol with body mass index or fat mass index.
This study showed that in lean young male population, 25(OH) cholecalciferol and FBG are inversely correlated but no association of 25(OH) D3 with other cardiometabolic risk factors could be demonstrated.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
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