Objective
Ultrasound is widely regarded as an important adjunct to antenatal care (ANC) to guide practice and reduce perinatal mortality. We assessed the impact of ANC ultrasound use at health ...centres in resource‐limited countries.
Design
Cluster randomised trial.
Setting
Clusters within five countries (Democratic Republic of Congo, Guatemala, Kenya, Pakistan, and Zambia)
Methods
Clusters were randomised to standard ANC or standard care plus two ultrasounds and referral for complications. The study trained providers in intervention clusters to perform basic obstetric ultrasounds.
Main outcome measures
The primary outcome was a composite of maternal mortality, maternal near‐miss mortality, stillbirth, and neonatal mortality.
Results
During the 24‐month trial, 28 intervention and 28 control clusters had 24 263 and 23 160 births, respectively; 78% in the intervention clusters received at least one study ultrasound; 60% received two. The prevalence of conditions noted including twins, placenta previa, and abnormal lie was within expected ranges. 9% were referred for an ultrasound‐diagnosed condition, and 71% attended the referral. The ANC (RR 1.0 95% CI 1.00, 1.01) and hospital delivery rates for complicated pregnancies (RR 1.03 95% CI 0.89, 1.20) did not differ between intervention and control clusters nor did the composite outcome (RR 1.09 95% CI 0.97, 1.23) or its individual components.
Conclusions
Despite availability of ultrasound at ANC in the intervention clusters, neither ANC nor hospital delivery for complicated pregnancies increased. The composite outcome and the individual components were not reduced.
Tweetable
Antenatal care ultrasound did not improve a composite outcome that included maternal, fetal, and neonatal mortality.
Tweetable
Antenatal care ultrasound did not improve a composite outcome that included maternal, fetal, and neonatal mortality.
Since the 1990s, big strides have been made in plastic and reconstructive surgery, thanks to the implementation of new techniques and resources for its execution. In cases where restoration is sought ...for small defects, biosurgery, involving the utilization of stem cells, biomaterials, chemical engineering, and tissue engineering, can be employed. The potential to stimulate the innate regenerative capacity of tissue and generate a persistent response over time, minimizing surgical trauma and re-interventions, lies in stem cell transplantation. However, the evidence published on this matter is very scarce, leading to divergence of opinions, suggestions, and recommendations. The aim of this review is to analyze the most recent evidence concerning the outcomes of using fat grafts enriched with stem cells in facial reconstruction, as compared to autologous fat grafts. The review of the literature demonstrates a marked trend suggesting that fat grafts enriched with stem cells may be superior to autologous grafts in facial reconstruction, with potential benefits in medium-term volume retention and faster attainment of results.
Breast cancer continues to be one of the main priorities in global health and public health, and remains the most frequent and deadly malignant neoplasm in women worldwide. Breast implant-associated ...anaplastic large cell lymphoma (BIA-ALCL) is a rare type of non-Hodgkin's lymphoma, whose pathogenesis and pathophysiology are not well known, but which is seen with increasing frequency due to the increase in cosmetic procedures. To date, there are limitations in terms of knowledge about the clinical behavior of the disease, which can manifest itself in many forms, with a variable evolution time and uncertain surgical outcomes in the medium- and long-term. Based on the above, the aim of this review is to summarize evidence on the clinical considerations and surgical outcomes of breast implant-associated cancer to facilitate the identification and management of this condition. A bibliographic search was performed in the search engines and databases PubMed, ScienceDirect, Embase, EBSCO and MEDLINE. Within the clinical and surgical considerations, the type of implant used (textured), the time of the implant history, the severity of the manifestations, and the staging, must be taken into account in order to determine the opportunity for surgical intervention and neoadjuvant therapy, and to try to guarantee survival and avoid recurrence. Patients who undergo complete capsulectomy with radiotherapy have better outcomes.
Introduction: The use of antibiotic-loaded cement is an intraoperative tool that has demonstrated potential benefits in hip arthroplasty. However, the global landscape of research on this topic ...remains unknown. The objective of this study was to analyze the scientific growth, characteristics, and metrics of global and historical research on the use of antibiotic-loaded cement in hip arthroplasty. Material and methods: A cross-sectional bibliometric study was conducted using Scopus as the data source. Results: A total of 523 documents published between 1973 and 2023 were selected. 89.9% (n=470) of the production consisted of original articles, with 11.85% being multi-center. 84.1% of the authors have published a single article, followed by 10.3% who have published two articles. Research has predominantly focused on adults or the elderly, with an emphasis on outcome evaluation (notably reoperation), assessing various antibiotic agents, and frequently employing retrospective designs. Conclusions: There has been a sustained increase in research on the use of antibiotic-loaded cement in hip arthroplasty over the last 50 years. The research trend has shifted towards the evaluation of adult or elderly patients, exploration of antimicrobial agents, techniques, and health outcomes, primarily using observational and retrospective designs. An emerging research-focus is the study of hip arthroplasty in rheumatoid arthritis patients.
The progression developed in this book is essential to understand new test methodologies, algorithms and industrial practices. Without the insight into the physics of nano-metric technologies, it ...would be hard to develop system-level test strategies that yield a high IC fault coverage. Obviously, the work on defect-oriented testing presented in the book is not final, and it is an evolving field with interesting challenges imposed by the ever-changing nature of nano-metric technologies. Test and design practitioners from academia and industry will find that Defect-Oriented Testing for Nano-Metric CMOS VLSI Circuits lays the foundations for further pioneering work.
The discovery of mirror neurons and of a mirror neuron system in the human brain raises the interesting possibility that 'mirroring' may constitute novel instances of mental simulation. It also ...provides the basis for unique processes such as 'mindreading', the ability to make inferences about the actions of others. That an elementary process in motor cognition may be foundational to mindreading goes a long way in providing a rational basis for the study of social cognition. Social cognition is a broad discipline that encompasses many issues not yet adequately addressed by neurobiologists. In Mirror Neuron Systems: The Role of Mirroring Processes in Social Cognition, leading thinkers in this nascent field craft chapters aimed at sparking a dialogue regarding the relevance of mirroring neural systems in cognition. Thought-provoking and cutting-edge, Mirror Neuron Systems: The Role of Mirroring Processes in Social Cognition provides the basis for extended discussion among interested readers and lays down the guidelines for future research in this fascinating and expanding field. It addresses issues common to different perspectives, raises contrary views, and creates the basis for an extended dialogue and discussion.
This paper has two purposes. First, it seeks to explain the reason why a relatively small shock (in the subprime market in the United States) had a systemic effect on the world economy. It is argued ...that this responds to the combination of off balance sheet funding and pro-cyclical leverage management. Second, it analyses the transmission mechanisms and the possible effects of the crisis on Latin American economies. Past crises had generalized, deep and enduring effects across the region, and restricted access to external finance and the disruption of international trade turned out to be their main channels transmission. In spite of specificities, the current episode and its manifestations are not an exception to the pattern of previous crises. The final outcome will depend on the type of recovery that takes place in the developed world and on the effectiveness of the counter-cyclical policies applied in Latin America.
Escleromixedema. Reporte de un caso Leroux, MB; Gorosito; Bergero ...
Revista argentina de dermatología,
03/2020, Letnik:
101, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Resumen Se presenta una paciente femenina con erupción papulosa generalizada que compromete cara, tronco y cuatro miembros. En el examen físico se visualizaengrosamientoy oscurecimiento de la piel. ...Se realiza el estudio integral y el correspondiente diagnóstico diferencial.El estudio histopatológico cutáneo exhibió un incremento excesivo de mucina intersticial, actividad fibroblástica y engrosamiento de los haces de colágeno. Se arriba al diagnóstico de escleromixedema debido a las manifestaciones cutáneas características. Se constata compromiso extracutáneo en ausencia de gammapatía monoclonal. Se indica prednisona, talidomida ehidroxicloroquina con excelente evolución.
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