Abstract Objective To determine the impact of transesophageal echocardiography on the surgical management of patients undergoing nephrectomy and inferior vena cava tumor thrombectomy for renal cell ...carcinoma. Materials and Methods We retrospectively analyzed intraoperative records of 67 patients with renal cell carcinoma and level II-IV invasion of the inferior vena cava who underwent nephrectomy with tumor thrombectomy between 2007 and 2015. Based on preoperative imaging, patients were categorized according to vena cava thrombus level. Diagnostic utility and impact on surgical management were extracted from the operative note, anesthesia record, and intraoperative echocardiography report. Results Twelve of 34 patients (35%) with level II thrombus, 14 of 18 (78%) with level III thrombus, and 15 of 15 (100%) with level IV thrombus had intraoperative transesophageal echocardiography. With increasing level of tumor thrombus, the diagnostic yield and surgical impact increased. Echocardiography provided new diagnostic information in 7 of 12 (58%) patients with level II thrombus and altered surgical management in 16%. Among level III thrombus patients, echocardiography provided new diagnostic information in 12 of 14 (86%) and altered surgical management in 21%. Echocardiography provided new diagnostic information and impacted surgical management in all 15 (100%) patients with a level IV thrombus. Conclusions The diagnostic yield of intraoperative transesophageal echocardiography increases in patients with greater vena caval tumor thrombus extension. This information has a significant influence on surgical decision-making.
Microcapsules consisting of a calcium carbonate core template surrounded by shells containing magnetite nanoparticles and ethanol-soluble polyimide brushes with polymethacrylic acid side chains were ...assembled using a layer-by-layer technique under nonaqueous conditions. These microcapsules represent a potential solution to the challenging problem of encapsulating water-soluble compounds, particularly low molecular weight drugs. It was possible to move these microcapsules with magnetite nanoparticles in their shells by applying a magnetic field gradient. The novel microcapsules were characterized by optical microscopy, atomic force microscopy, and scanning electron microscopy. Using the brush-like polyanions instead of linear polyanions made it possible to increase the shell thickness gain per ionic assembly cycle by a factor of ~3.
This study aimed to survey urologists regarding their knowledge, acceptance and practice of active surveillance (AS) for low-risk prostate cancer.
An email-based survey was distributed to 4987 ...urologists. Respondents were surveyed regarding their knowledge and acceptance of AS. Those who felt AS was a reasonable strategy were asked their opinions on the criteria for AS enrollment and the details of their practice of AS. Respondents who felt AS was not a reasonable alternative were queried as to the reasons why.
A total of 425 (9%) urologists successfully completed the survey and 387 (91%) were both familiar with AS and aware that AS differed from watchful waiting. Of this latter group, 370 (96%) respondents felt AS was a reasonable management strategy, 95% of whom manage patients with this approach. A minority of respondents (6%) felt that patients with a PSA>10 ng ml(-1) were eligible for AS. Further, most participants (74%) felt that patients required a Gleason score ≤6. There was little agreement on the timing of follow-up biopsies. Respondents who objected to AS were most commonly concerned with missing an opportunity for curative treatment (76%) and the risk of tumor undergrading (65%).
The majority of participants were knowledgeable and accepting of AS. Respondents were in relative agreement regarding the PSA and Gleason score criteria for AS enrollment. In contrast, there was a lack of agreement on the timing of follow-up biopsies. In the future, comparative studies are required to determine the optimal enrollment criteria and follow-up protocol for patients managed with AS.
Abstract Purpose To describe the frequency and patient-reported readiness to change, desire to discuss, and perceived importance of 13 health risk factors in a diverse range of primary care ...practices. Methods Patients (n = 1,707) in 9 primary care practices in the My Own Health Report (MOHR) trial reported general, behavioral, and psychosocial risk factors (body mass index BMI, health status, diet, physical activity, sleep, drug use, stress, anxiety or worry, and depression). We classified responses as “at risk” or “healthy” for each factor, and patients indicated their readiness to change and/or desire to discuss identified risk factors with providers. Patients also selected 1 of the factors they were ready to change as most important. We then calculated frequencies within and across these factors and examined variation by patient characteristics and across practices. Results On average, patients had 5.8 (SD = 2.12; range, 0–13) unhealthy behaviors and mental health risk factors. About 55% of patients had more than 6 risk factors. On average, patients wanted to change 1.2 and discuss 0.7 risks. The most common risks were inadequate fruit/vegetable consumption (84.5%) and overweight/obesity (79.6%). Patients were most ready to change BMI (33.3%) and depression (30.7%), and most wanted to discuss depression (41.9%) and anxiety or worry (35.2%). Overall, patients rated health status as most important. Conclusions Implementing routine comprehensive health risk assessments in primary care will likely identify a high number of behavioral and psychosocial health risks. By soliciting patient priorities, providers and patients can better manage counseling and behavior change.
On the statistics of ~1.7 x 10.sup.8 interactions of positively charged kaons on copper nuclei, coherent events of the K.sup.+pi.sup.0 system production are selected. The cross sections for the ...Coulomb and coherent strong components and their interference in the region of the K*(892) meson are measured. The partial width for the decay K*(892) right arrow K.sup.+gamma is determined. When studying the mass spectrum of the K.sup.+pi.sup.0 system, an effect which can be interpreted as the interference of the chiral anomaly and the K*(892) s-channel amplitudes is found. This gives an estimate for the ratio of the observed amplitude of the chiral anomaly to the theoretical one: A.sub.exp/A.sub.th = 0.9 ± 0.24(stat.) ± 0.3(syst.).
Abstract
Results of a study of the
$$K^+ \rightarrow \pi ^{0} e^{+} \nu \gamma $$
K
+
→
π
0
e
+
ν
γ
decay at OKA setup are presented. More than 32,000 events of this decay are observed. The ...differential spectra over the photon energy and the photon–electron opening angle in kaon rest frame are presented. The branching ratios, normalized to that of
$$K_{e3}$$
K
e
3
decay are calculated for different cuts on
$$E^*_\gamma $$
E
γ
∗
and
$$cos\Theta ^{*}_{e\gamma }$$
c
o
s
Θ
e
γ
∗
. In particular, the branching ratio for
$$E^{*}_{\gamma }>30$$
E
γ
∗
>
30
MeV and
$$\Theta ^{*}_{e \gamma }>20^{\circ }$$
Θ
e
γ
∗
>
20
∘
is measured R =
$$\frac{Br(K^+ \rightarrow \pi ^{0} e^{+} \nu _{e} \gamma ) }{Br(K^+ \rightarrow \pi ^{0} e^{+} \nu _{e})} $$
B
r
(
K
+
→
π
0
e
+
ν
e
γ
)
B
r
(
K
+
→
π
0
e
+
ν
e
)
= = (0.587±0.010(
stat
.)±0.015(
syst
.))
$$\times 10^{-2}$$
×
10
-
2
, which is in a good agreement with ChPT
$$O(p^{4})$$
O
(
p
4
)
calculations.
Abstract Results of a study of the $$K^+ \rightarrow \pi ^{0} e^{+} \nu \gamma $$ K + → π 0 e + ν γ decay at OKA setup are presented. More than 32,000 events of this decay are observed. The ...differential spectra over the photon energy and the photon–electron opening angle in kaon rest frame are presented. The branching ratios, normalized to that of $$K_{e3}$$ K e 3 decay are calculated for different cuts on $$E^*_\gamma $$ E γ ∗ and $$cos\Theta ^{*}_{e\gamma }$$ c o s Θ e γ ∗ . In particular, the branching ratio for $$E^{*}_{\gamma }>30$$ E γ ∗ > 30 MeV and $$\Theta ^{*}_{e \gamma }>20^{\circ }$$ Θ e γ ∗ > 20 ∘ is measured R = $$\frac{Br(K^+ \rightarrow \pi ^{0} e^{+} \nu _{e} \gamma ) }{Br(K^+ \rightarrow \pi ^{0} e^{+} \nu _{e})} $$ B r ( K + → π 0 e + ν e γ ) B r ( K + → π 0 e + ν e ) = = (0.587±0.010(stat.)±0.015(syst.)) $$\times 10^{-2}$$ × 10 - 2 , which is in a good agreement with ChPT $$O(p^{4})$$ O ( p 4 ) calculations.
Lay Summary
During the coronavirus disease 2019 (COVID‐19) pandemic, cancer screening decreased precipitously; home screening for colorectal cancer diminished less than that for colonoscopy and ...breast and cervical cancer screening.
The authors have highlighted approaches for home cancer screening in addition to telemedicine.
During the coronavirus disease 2019 (COVID‐19) pandemic, cancer screening has decreased precipitously. Nevertheless, home screening for colorectal cancer appears to have diminished less than colonoscopy and breast cancer and cervical cancer screening in a large, academic midwestern medical center. Based on these findings, the current study highlights the promise for increasing home cancer screening in addition to telemedicine.
Summary
Strategies for relapse prevention after allogeneic transplantation in acute leukaemia are warranted. A registry‐based matched‐pair analysis evaluated the efficacy of prophylactic donor ...lymphocyte infusion (proDLI). Adults receiving proDLI in complete remission (CR) and controls were pair‐matched for age, diagnosis, cytogenetics, stage, donor, gender, conditioning and T‐cell depletion. Eighty‐nine pairs were identified (median follow‐up: 6.9 years). Within the entire cohort, no difference was observed. However, among patients with high‐risk acute myeloid leukaemia (AML) (unfavourable cytogenetics and/or transplanted beyond first CR), proDLI recipients had improved overall survival (69.8% vs. 40.2% in controls, P = 0.027). ProDLI has moderate efficacy, but can contribute to improved outcome in high‐risk AML.
Summary
Introduction
Digital tools are widely used and effective in weight management interventions; however, usage declines over time. Strategies to promote continued engagement should be explored. ...We examined the effects of offering additional modes of weight reporting as well as periodic online campaigns to promote engagement, assessed by frequency of weight reporting, in a weight gain prevention study for young adults.
Methods
Using an observational design, self‐reported weights obtained through digital tools were pooled across participants assigned to two interventions (n = 312). Analysis examined the effects before during and after introduction of an additional reporting modality (email) and for three time‐limited refresher campaigns over 2 years.
Results
Adding a new modality to the three existing modes (SMS, web, and mobile web) increased weight reporting as well as the number of modalities participants used to report weights. The use of several modes of reporting was associated with more weights submitted (p < 0.01). Refresher campaigns did not increase the proportion of participants reporting; however, the number of weights submitted during the 4‐week campaigns increased compared with the 4 weeks before the campaign (p's ≥ 0.45, <0.001, respectively).
Conclusion
Using multiple digital modalities and periodic campaigns shows promise for sustaining engagement with weight reporting in a young adult population, and incorporating such strategies may mitigate typical declines in eHealth and mHealth interventions.
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