Summary Familial gastric cancer comprises at least three major syndromes: hereditary diffuse gastric cancer, gastric adenocarcinoma and proximal polyposis of the stomach, and familial intestinal ...gastric cancer. The risk of development of gastric cancer is high in families affected b-y these syndromes, but only hereditary diffuse gastric cancer is genetically explained (caused by germline alterations of CDH1 , which encodes E-cadherin). Gastric cancer is also associated with a range of several cancer-associated syndromes with known genetic causes, such as Lynch, Li-Fraumeni, Peutz-Jeghers, hereditary breast–ovarian cancer syndromes, familial adenomatous polyposis, and juvenile polyposis. We present contemporary knowledge on the genetics, pathogenesis, and clinical features of familial gastric cancer, and discuss research and technological developments, which together are expected to open avenues for new genetic testing approaches and novel therapeutic strategies.
Background:
Because of the multitude of variables that affect the retirement decisions of professional soccer players, it has proven difficult to isolate the effect of undergoing anterior cruciate ...ligament (ACL) reconstruction (ACLR) on career longevity.
Purpose:
To compare the career longevity of professional soccer players after a primary ACLR with that of an uninjured matched control cohort.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
A retrospective review of a consecutive series of primary ACLR was performed between 2008 and 2018 in professional male soccer players from the senior author's practice. Each athlete with ACLR was matched to 3 control athletes who had not undergone ACLR according to age, league, playing position, and preinjury game appearances/minutes played. Player career statistics—including league, game appearances, and game minutes—were compiled for each year until retirement or July 1, 2022.
Results:
A total of 82 soccer players in the English Premier League or Championship at the time of their primary ACLR were matched to 246 control athletes. The mean career length after ACLR was 6 ± 2.6 years, while that of the matched control athletes was 7.6 ± 2.8 years (P < .001). After primary ACLR, an athlete had a 2 times greater chance of retirement compared with the matched control athlete (hazard ratio, 2.19; P < .001). At 5 years after ACLR, 16% of athletes had retired from professional soccer, while 8.5% of the matched cohort were retired (P = .060). By 10 years, 72% of the ACLR cohort had retired compared with 43% of the matched cohort (P < .001). Forwards were more likely to have shortened careers compared with goalkeepers (P = .021); however, no significant differences were observed between midfielders, defenders, and forwards. Within the ACLR cohort, a contralateral ACL tear during the athlete's career caused a 2.30 times (P = .022) increased chance of retirement compared with athletes with only 1 ACL tear during their career. Mechanism of injury, meniscal pathology, graft rerupture, and chondral lesions did not affect career length.
Conclusion:
Professional male soccer players who underwent ACLR had decreased career length by approximately 1.6 years compared with a matched player cohort.
Background:
A number of studies have investigated return to play after anterior cruciate ligament reconstruction (ACLR) in professional soccer players, but it is unclear which factors are associated ...with a return to the preinjury performance and ability to play over time.
Purpose:
To identify factors that contribute to a professional soccer player's return to preinjury performance after ACLR, as well as to report their playing performance at 2 and 5 years after ACLR compared with their preinjury performance.
Study Design:
Case-control study; Level of evidence, 3.
Methods:
A consecutive cohort of professional soccer players undergoing primary ACLR were analyzed between 2005 and 2019. A minimum 2-year follow-up was required. The effect of patient, surgical, and postoperative factors on performance rates, defined as a combination of league level and playing time, was evaluated with univariate and multivariate logistic regression models.
Results:
A total of 200 male professional soccer players were included. When combining league level and playing time, 30% of athletes returned to their preinjury performance at 2 years and 22% at 5 years. However, 53% of athletes returned to their preinjury performance for at least 1 season by year 5. At 2 years, a chondral lesion of grade 3 or 4 decreased the odds of return to preinjury performance (odds ratio OR, 0.37; P = .010). Athletes receiving an ACLR with the addition of a lateral extra-articular tenodesis procedure were 2.42 times more likely to return to preinjury performance at 2 years than athletes with ACLR alone (P = .004). By 5 years after ACLR, athletes aged ≥25 years at the time of reconstruction were 3 times less likely to be performing at their preinjury performance (OR, 0.32; P < .001), and those with a grade ≥3 chondral lesion were >2 times less likely to be performing at their preinjury performance (OR, 0.43; P = .033).
Conclusion:
The presence of >50% thickness chondral pathology, ACLR without lateral extra-articular tenodesis, and age >25 years at the time of surgery were all significant risk factors of worse performance rates after ACLR. Significant decreases in performance rates were noted at 2 and 5 years postoperatively.
Introduction
Patients with bladder exstrophy subjected to reconstructive surgeries are at risk of developing urinary calculus.
Case presentation
We report the case of a 29‐year‐old male patient with ...bladder exstrophy who presented with a recurrent episode of extrusion of calculus through the neobladder and anterior abdominal wall. Calculus removal and reconstructive repair of the neobladder and abdominal wall were performed in 2010. Nine years following the procedure, the patient returned with new large neobladder calculus extrusion.
Conclusion
Recurrence of large calculus should be seen as the new paradigm for the importance of close follow‐up in bladder exstrophy patients.
Biofuels are promising alternatives to partially or fully replace oil and natural gas-based fuels in combustion engines due to less environmental impact than fossil fuels. The production of biofuels ...through alcoholic fermentation in chemical reactors has been an increasing interest to the industry. Several kinetic models have been examined to determine the kinetics of fermentation of microorganisms. The study and determination of this kinetic model are considered the most important step of a fermentative process since it will define the rate of production and consumption of the main constituents. The mathematical method used to model the chemical reactor equation is based on fractional calculations, more specifically the Caputo fractional derivative is applied in the Monod equation, which is responsible for modeling the reactors. It is noteworthy that fractional derivatives are an excellent tool for describing processes involving the so-called memory effect and heredity properties since in many cases they refine the solution.
Purpose
To demonstrate return to play (RTP) rates, the level of RTP and time taken to RTP in different sports after anterior cruciate ligament reconstruction (ACL-R) and compare the differences ...between football and rugby. The secondary aims were to compare the differences in intra articular injuries and their treatments and reoperation rates between these sports.
Methods
A retrospective review of a consecutive series of all primary ACL-R undertaken by the senior author between 2005 and 2019 was undertaken. Patients were included if they were elite athletes and were a minimum of 2 year post-primary autograft ACL-R. The outcomes measured were RTP (defined as participation in a professional match or in national/international-level competition in amateur sports), time to RTP after surgery and RTP level (Tegner score).
Results
Three hundred and ninety-four elite athletes, with 420 ACL-Rs were included. 235 (55.9%) were in footballers and 125 (29.8%) were in rugby players. 399 (95.0%) of all elite athletes returned to competition at an average of 10.3 months after ACL-R. 386 (90.2% played at the same or higher level post-surgery. Although there was no difference in RTP rates between different sports, rugby players RTP significantly faster than footballers (9.6 vs 10.6 months, (
p =
0.027). Footballers were more likely to rupture their ACL during jumping/landing manoeuvres and to receive a PT graft than rugby players. There were no other significant differences between football and rugby players regarding patient characteristics, intraoperative findings, re-rupture and re-operation rates.
Conclusions
Over 95% of all elite athletes RTP after primary ACL-R with 90% able to play at the same level. Rugby players RTP significantly faster than footballers.
Level of evience
Level IV.
Abstract Hereditary Diffuse Gastric Cancer is an autosomal dominant inherited gastric cancer syndrome caused by germline alterations in CDH1 (E-cadherin) and CTNNA1 (alpha-E-catenin) genes. Germline ...CDH1 alterations encompass small frameshifts, splice-site, nonsense, and missense mutations, as well as large rearrangements. Most CDH1 truncating mutations are pathogenic, and several missense CDH1 mutations have a deleterious effect on E-cadherin function. CDH1 testing should be performed in probands. Screening of at-risk individuals is indicated from the age of consent following counselling with a multidisciplinary team. In mutation-positive individuals prophylactic gastrectomy is recommended. Endoscopic surveillance is an option for those refusing/postponing gastrectomy, those with mutations of undetermined significance, and in CDH1 -negative families. Ongoing research focus on the search of genetic causes other than CDH1 or CTNNA1 germline defects; assessment of the pathogenicity and penetrance of CDH1 missense mutations and identification of somatic mechanisms behind the progression from early (indolent) lesions to invasive (lethal) carcinomas.
During COVID-19 pandemic, healthcare workers (HCWs) have had high workload and have been exposed to multiple psychosocial stressors. The aim of this study was to evaluate HCWs in terms of the ...relative contributions of socio-demographic and mental health variables on three burnout dimensions: personal, work-related, and client-related burnout.
A cross-sectional study was performed using an online questionnaire spread via social networks. A snowball technique supported by health care institutions and professional organizations was applied.
A total of 2008 subjects completed the survey. Gender, parental status, marriage status, and salary reduction were found to be significant factors for personal burnout. Health problems and direct contact with infected people were significantly associated with more susceptibility to high personal and work-related burnout. Frontline working positions were associated with all three dimensions. Higher levels of stress and depression in HCWs were significantly associated with increased levels of all burnout dimensions. Higher levels of satisfaction with life and resilience were significantly associated with lower levels of all burnout dimensions.
All three burnout dimensions were associated with a specific set of covariates. Consideration of these three dimensions is important when designing future burnout prevention programs for HCWs.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
E-cadherin and P-cadherin are major contributors to cell–cell adhesion in epithelial tissues, playing pivotal roles in important morphogenetic and differentiation processes during development, and in ...maintaining integrity and homeostasis in adult tissues. It is now generally accepted that alterations in these two molecules are observed during tumour progression of most carcinomas. Genetic or epigenetic alterations in E- and P-cadherin-encoding genes (CDH1 and CDH3, respectively), or alterations in their proteins expression, often result in tissue disorder, cellular de-differentiation, increased invasiveness of tumour cells and ultimately in metastasis. In this review, we will discuss the major properties of E- and P-cadherin molecules, its regulation in normal tissue, and their alterations and role in cancer, with a specific focus on gastric and breast cancer models.
Key message
The leaflet area of acai (
Euterpe oleracea
) can be estimated by an exponential regression model adjusted by the relationship of leaflet maximum length and width.
This work was carried ...out aiming to fit linear regression models for the non-invasive estimation of leaflet area (LA) in acai (
Euterpe oleracea
Mart.). Thus, 5010 leaflets were sampled from 403 fronds sampled on 100 acai seedlings. Maximum length (LL) and width (LW) of each leaflet were measured with a ruler and LA was determined using a leaf area meter. Half of the data set was used to adjust the models and the other half was used for model validation. The Jackknife re-sampling method was applied to reduce model bias. Two double-entry models (models A and B) were fitted using LL and LW simultaneously, while these linear dimensions of the leaves were separately considered in single-entry models (models C to F). The adjusted coefficients of determination varied between 0.9075 and 0.9785, with the highest values observed in models A and B, which also showed the lowest standard error of the estimate and Akaike's information criterion (AIC) score. All models were highly accurate in estimating LA, with values above 0.9156; however, the double-entry models A and B showed the best performance regarding the relationship between estimated and observed LA. Comparing the double-entry models, the lowest AIC score in model B indicates that this model is the most parsimonious for non-invasive estimation of acai leaflet area in relation to model A. Therefore, the equation
LA
=
1.0147
e
0.3685
+
0.8165
ln
LL
×
LW
, deduced from model B, is the more precise model for the non-invasive determination of leaflet area in acai seedlings.
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