Case report: persistent double dorsal aorta Togni, Paulo Henrique Alves; de Oliveira, Ernani Alves; Mora, Eduardo Milani ...
Jornal vascular brasileiro,
01/2024, Letnik:
23
Journal Article
Recenzirano
Odprti dostop
Persistent double dorsal aorta is an extremely rare congenital anomaly, with only 13 cases published to date. The objective of this study is to present this embryological variant as observed in the ...abdominal aorta of a patient. The anatomical description was written up on the basis of a review of electronic medical records and imaging exams. The patient in this case was an elderly 79-year-old man who presented at emergency with pain at rest in the left lower limb. He was admitted and laboratory tests and imaging exams were ordered. The variation was an imaging finding observed on angiotomography, consisting of complete separation of the abdominal aorta into two portions - a ventral and a dorsal, with different calibers - at the level of the third lumbar vertebra. There was also an anomalous origin of the inferior mesenteric artery.
Background:
Marijuana is the most widely used illicit drug worldwide. From an occupational perspective, its use is paradoxical in that although it can be harmful to health and has criminal ...consequences, it can also promote well-being. This study examined predictors of well-being to determine the effects of marijuana use and its prohibition on the daily lives of Brazilian adults.
Methods:
This cross-sectional study used an anonymous online questionnaire with a final sample of 2637 respondents. Utilizing logistic regression, variables were selected pertaining to use and prohibition risks, benefits of use, and harm reduction associated with the socioeconomic characteristics of the respondents.
Results:
Using marijuana for fun was most likely among those self-identified as male, trans/non-binary people, college graduates, and those with higher incomes. Living with family members and using less frequently proved to be protective against the adverse effect of “getting high.” Indigenous peoples and youth were more likely to report trouble with the police due to marijuana use; individuals with higher education and longer use of marijuana reported more frequent use of harm reduction strategies; people who identified their color as yellow were more likely to report daily use compared to people who identified their color as white; women and people with higher income were less likely to report daily use.
Conclusions:
Social class, race, gender, and generation were predictors of well-being associated with marijuana use and its prohibition, indicating an interaction between different dimensions involving the use of illicit substances. Identifying the effects of the use and prohibition of marijuana in promoting well-being, from the conception of drug use as a non-sanctioned occupation, can broaden the understanding of this complex human phenomenon, with health and criminal repercussions, subsidizing the development of approaches more equitable and adequate into occupational therapy to reduce personal and social harm.
Here we describe a retrospective analysis of outcomes in 299 patients who underwent peripheral blood haplo-HCT with PTCy from July 2009 through May 2021 and their association with donor ...characteristics. Patients had mostly acute leukemias and high or very high DRI. Multivariate analyses were conducted examining OS, NRM, relapse, cytokine release syndrome, acute and chronic GVHD. Donor characteristics included age, sex, relationship, ABO status, CMV status, and HLA match grade. Our analysis revealed increasing donor age was associated with higher NRM (compared to age <30; age 30-44 HR, 1.65; P = 0.110, age >44 HR, 1.80; P = 0.056) but lower relapse risk (compared to age <30; age 30-44 HR, 0.61; P = 0.034, age > 44 HR, 0.71; P = 0.132). There were no differences in CRS, aGVHD or cGVHD. We found no difference in outcomes based on the donor-recipient relationship. No differences were found based on HLA match grade or DRB1 match status. Increasing donor age was associated with lower relapse risk but higher NRM, resulting in no difference in OS based on donor age. Other donor factors including relationship (parent/sibling/child/ maternal), CMV status, donor sex, HLA match grade, and DRB1 status were not associated with outcomes.
We performed a multisite study to evaluate demographic and clinical conditions as potential modifiers of the particulate matter (PM)-mortality association. We selected 228,619 natural deaths of ...elderly persons (ages ≥65 years) that occurred in 12 Italian cities during the period 2006-2010. Individual data on causes of death, age, sex, location of death, and preexisting chronic and acute conditions from the previous 5 years' hospitalizations were collected. City-specific conditional logistic regression models were applied within the case-crossover "time-stratified" framework, followed by random-effects meta-analysis. Particulate matter less than or equal to 2.5 µm in aerodynamic diameter (PM2.5) and particulate matter less than or equal to 10 µm in aerodynamic diameter (PM10) were positively associated with natural mortality (1.05% and 0.74% increases in mortality risk for increments of 10 µg/m3 and 14.4 µg/m3, respectively), with greater effects being seen among older people, those dying out-of-hospital or during the warm season, and those affected by 2 or more chronic diseases. Limited associations were found among persons with no previous hospital admissions. Diabetes (1.98%, 95% confidence interval (CI): 0.54, 3.44) and cardiac arrhythmia (1.65%, 95% CI: 0.37, 2.95) increased risk of PM2.5-related mortality, while heart conduction disorders increased risk of mortality related to both PM2.5 (4.22%, 95% CI: 0.15, 8.46) and PM10 (4.19%, 95% CI: 0.38, 8.14). Among acute conditions, recent hospital discharge for heart failure modified the PM10-mortality association. The study found increases in natural mortality from PM exposure among people with chronic morbidity; diabetes and cardiac disorders were the main susceptibility factors.
Background
The superiority of early drain removal (EDR) versus late (LDR) after pancreaticoduodenectomy (PD) has been demonstrated only in RCTs.
Methods
A meta-analysis was conducted using a ...random-effects model and trial sequential analysis. The critical endpoints were morbidity, redrainage, relaparotomy, and postoperative pancreatic fistula (CR-POPF). Hemorrhage (PPH), delayed gastric emptying (DGE), length of stay (LOS), and readmission rates were also evaluated. Risk ratios (RRs) and mean differences (MDs) with a 95% confidence interval (CI) were calculated. Type I and type II errors were excluded, comparing the accrued sample size (ASS) with the required sample size (RIS). When RIS is superior to ASS, type I or II errors can be hypothesized.
Results
ASS was 632 for all endpoints except DGE and PPH (557 patients). The major morbidity (RR 0.55; 95% CI 0.32–0.97) was lower in the EDR group. The CR-POPF rate was lower in the EDR than in the LDR group (RR 0.50), but this difference is not statistically significant (95% CI 0.24–1.03). The RIS to confirm or exclude these results can be reached by randomizing 5959 patients. The need for percutaneous drainage, relaparotomy, PPH, DGE, and readmission rates was similar. The related RISs were higher than ASS, and type II errors cannot be excluded. LOS was shorter in the EDR than the LDR group (MD − 2.25; 95% CI − 3.23 to − 1.28). The RIS was 567, and type I errors can be excluded.
Conclusions
EDR, compared with LDR, is associated with lower major morbidity and shorter LOS.
The short-term scenarios of high-throughput satellite systems foresee the exploitation of (currently commercially unused) extremely high frequency bands in the feeder link to support broadband user ...access services. In this context, spatial diversity plays a key role, considering that this is the only technique that can allow high link availability at frequency bands higher than the Ka-band without requiring very high link margins, which results in a waste of system resources. In this framework, the most promising spatial diversity technique is the so-called smart gateway (SG) diversity. This paper focuses on the optimization of the SG technique following operator perspectives and needs. In particular, a design approach for the optimization of the SG architecture is proposed, which allows to select the best SG configuration (spare capacity, number of gateway groups, number of gateways in each group, geographical position of gateways in each group) given a set of constraints (geographical position of all available gateways, longitude of the GEO satellite, characteristics of satellite/ground terminals, system availability). Moreover, a practical case of SG diversity optimization is presented as a reference to guide the reader in the SG optimization process.
Period tracking is an increasingly widespread practice, and its emphasis is changing from monitoring fertility to encompassing a more broad-based picture of users' health. Delving into the data of ...one's menstrual cycle, and the hormones that are presumed to be intimately linked with it, is a practice that is reshaping ideas about health and wellness, while also shaping subjects and subjectivities that succeed under conditions of surveillance capitalism. Through close examination of six extended interviews, this article elaborates a version of period tracking that sidesteps fertility and, in doing so, participates in the "queering" of menstrual technologies. Apps can facilitate the integration of institutional medical expertise and quotidian embodied experience within a broader approach to the self as a management project. We introduce the concept of "hormonal health" to describe a way of caring for, and knowing about, bodies, one that weaves together mental and physical health, correlates subjective and objective information, and calls into question the boundary between illness and wellness. For those we spoke with, menstrual cycles are understood to affect selfhood across any simplistic body-mind division or reproductive imperative, engendering complex techniques of self-management, including monitoring, hypothesizing, intervening in medical appointments, adjusting schedules, and interpreting social interactions. Such techniques empower their proponents, but not within conditions of their choosing. In addition to problems with data privacy and profit, these techniques perpetuate individualized solutions and the internalization of pressures in a gender-stratified, neoliberal context, facilitating success within flawed structures.
A literature review was conducted aiming to understand the interface between the Intellectual Disability and Mental Health fields and to contribute to mitigating the path of institutionalizing ...individuals with intellectual deficiencies. The so-called dual diagnosis phenomenon remains underestimated in Brazil but is the object of research and specific public policy internationally. This phenomenon alerts us to the prevalence of mental health problems in those with intellectual disabilities, limiting their social inclusion. The findings reinforce the importance of this theme and indicate possible diagnostic invisibility of the development of mental illness in those with intellectual disabilities in Brazil, which may contribute to sustaining psychiatric institutionalization of this population.
The history of how the nonviolent proposal of Mahatma Gandhi resonates with Chinese intellectuals is a history of variability. In the late Forties, it seems appealing to some Chinese politicians who ...actually apply non-cooperative means, whereas during the Twenties, even if it is not at all a dominant idea, it resonates well with some Chinese intellectuals. However, during the Thirties, after Gandhi refused to compromise with Stalin, and while the Marxist proposal disseminated worldwide, the nonviolent leanings were paling. In Hu Yuzhi we find an example of this track toward nonviolence: he was a strong supporter during the Twenties, becoming an opponent in the Thirties. Copious are the difficulties in combining other political proposal with Gandhism, itself a comprehensive proposal, and not just a political one. Some perceived Gandhism as a competitor in the supremacy over the masses. Others disagreed about the possibility to use violent means. Another leading theme of objection concerned the industrialization, strongly opposed by Gandhi because of its deadly effects over the Indian population. Generally, an intense opposition came from the misunderstanding of the nonviolent path as a passive one. Moreover, the consideration of Gandhi’s experiments changed from it being perceived as “native” (because it came from an Asian country, and in opposition to Marxism coming from Europe) to a perception as an external one when Marxism was “sinicised.” Anyway, the main reason of the difficulty in implementing Gandhism is that it does not aim to triumph over the opponents, but it is rather a way to individuate and assert the Truth (satyagraha), with both side winning. When this intent is absent, it is impossible to realize it.
Abstract Paleogeographic reconstructions show that the Ligurian‐Piedmont Ocean (LPO) was a relatively narrow oceanic basin but the actual amount of oceanic lithosphere generated and the timing of ...magmatic accretion are still subjects of debate. New U–Pb dating of zircon from two pairs of FeTi‐oxide metagabbro and metaplagiogranite s.l. of the Susa and Lanzo Valleys Ophiolites (Western Alps) yields Late Jurassic magmatic ages (~150 Ma), 10–15 Ma younger than most of the magmatism in the LPO. The potential significance of the geochronological data presented are discussed in relation to the structural architecture of the LPO, emphasizing that the investigated ophiolites represent the youngest oceanic lithosphere accreted in the Western Alps.
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