Search

Purpouse: Evaluation of the laboratory effectiveness of the antiplatelet drugs we use: clopidogrel, ticagrelor, aspirin. Assessment of the effectiveness of ticagrelor as an alternative treatment in patients with in vitro resistance, or HTPR (high on-treatment platelet reactivity) to clopidogrel. Methods: In our set of patients, the effectiveness of antiplatelet drugs was tested using the light transmission aggregometry (LTA) method from 16. 9. 2020 to 5. 12. 2022. The effectiveness of treatment in patients switched to an alternative medicine was monitored and the success of the change in therapy was evaluated. Results: In the monitored period, a total of 529 blood samples were tested for clopidogrel (n = 216), ticagrelor (n = 59) and aspirin (n = 254). The efficacy of clopidogrel treatment was 45.4 %. On the other hand, the efficacy of ticagrelor was 93.2 %, statistically significantly higher (p < 0.000). In case of conversion from clopidogrel to ticagrelor, treatment was successful in 49 of 54 patients (90.7 %). Conclusion: For the antiplatelet drugs tested, statistically significant differences in the effectiveness were demonstrated. In the case of clopidogrel, ticagrelor is a suitable alternative, significantly reducing incidence of HTPR. The number of patients with HTPR undergoing stent/flow diverter implantation can be significantly reduced by including platelet function testing in the algorithm of endovascular procedures. [ABSTRACT FROM AUTHOR]

Objective: To assess how traditional, simple markers of health independently affect postoperative morbidity of mandibular fracture open reduction‐internal fixations (ORIFs). Study Design: Cohort study. Setting: National Surgical Quality Improvement Project (NSQIP) Database. Methods: The 2005 to 2017 NSQIP database was queried for patients who underwent mandibular ORIF. To control for the severity of the trauma, an additional "concurrent surgery" variable was created. A modified 5‐item frailty index was calculated based on the following: presurgery‐dependent functional status, chronic hypertension, diabetes mellitus, history of chronic obstructive pulmonary disease, and history of congestive heart failure. Results: Among 1806 patients with mandibular ORIFs (mean age 34.8 ± 15.4 years), modified frailty index (mFI) was associated with 30‐day medical complications (p <.001), reoperation (p <.001), and readmission (p =.005) on univariate analysis. Increased age was associated with prolonged hospitalization (p <.001) and medical complications (p <.001). The increased American Society of Anesthesiologists (ASA) score was associated with all endpoints (p ≤.003), while increased body mass index (BMI) was associated with none. On multivariate analysis, only increased ASA was associated with any adverse event (reference: ASA 1; ASA 2, odds ratio [OR]: 2.17 [95% confidence interval, CI: 2.17‐3.71], p =.004; ASA 3‐4, OR: 3.63 [95% CI: 1.91‐6.91], p <.001). Similarly, mFI and BMI were not independently associated with prolonged hospitalization (≥2 days) (p ≥.015), but 65+ age (reference: 18‐49; OR: 2.33 [95% CI: 1.40‐3.86], p =.001) and ASA 3 to 4 groups (reference: ASA 1; OR: 3.26 [95% CI: 2.06‐5.14], p <.001) were. Conclusion: ASA status and age are more useful modalities than mFI or BMI in predicting poor postoperative morbidity in mandibular ORIF. These simple metrics can assist with managing surgeons' expectations for mandibular ORIF patients. [ABSTRACT FROM AUTHOR]

Objectives: Epistaxis is the most common otolaryngological emergency and one-third of epistaxis patients regularly take low-dose acetylsalicylic acid (ASA) for the prevention of cardiovascular disease (CVD). The shift in contemporary guidelines identifies little benefit of ASA intake in patients who have not previously had an infarction. Existing evidence confirms ASA intake as a factor for severe epistaxis, while the evidence concerning its impact on recurrence is ambiguous. There are no available studies which justify the administration of these drugs nor are there any studies correlating the effects of these drugs to the SCORE2 CVD risk stratifying scale. Study design: A retrospective analysis of all admitted epistaxis patients in a tertiary academic hospital for the 10 year period 2011 to 2021. Methods: Patient data were analysed using the hospital information software. A recurrence was defined as an epistaxis episode requiring hospital readmittance for at least one night. Patients taking anticoagulants were excluded (N = 421). Results: 444 patients were included: 246 were taking ASA and 198 were not (NoASA). ASA patients had more frequent recurrence in general (p = 0.03), more recurrences per patient (p = 0.002), and more changes in bleeding localisation (p = 0.04). Recurrence in the ASA group was associated with lower haemoglobin values (HR 0.62, p < 0.0001), while surgery (HR 6.83, p < 0.0001) was associated with recurrence in the NoASA group. ASA patients had a statistically significant (r 0.33, p = 0.032) correlation between the total number of epistaxis recurrences and SCORE2. The indication for drug intake was highly questionable in as much as 40% of ASA patients. Follow-up time was 5.27 years. Conclusions: Epistaxis patients taking prophylactic ASA are significantly more burdened by recurrence, because they have more frequent recurrences, a greater number of recurrences per patient, and more changes in bleeding localisations when compared to control patients. The drug indication is questionable in up to 40% of ASA patients, exposing them unnecessarily to recurrence. Level of evidence: 4. [ABSTRACT FROM AUTHOR]

Background: Dementia is associated with a greater burden of cardiovascular risk factors. There is a significant vascular contribution to dementia, and aspirin may play a role in targeting this vascular dysregulation via its anti-inflammatory and antiplatelet effects. We provide an overview of the effects of aspirin therapy on the prevention of dementia and cognitive decline in patients with or without dementia and/or cognitive impairment. Methods: We performed a search for studies enrolling adults with or without dementia or MCI and comparing aspirin with placebo, usual care, or active control with respect to cognitive outcomes. Results: We describe aspirin's effects on the primary prevention of cognitive impairment and various subtypes of dementia, as well as its role in cognitive decline in certain subsets of patients, including those with cerebral small vessel disease (CVSD), coronary heart disease (CHD), and gender differences. Overall, the benefits of aspirin in preventing dementia and cognitive decline remain inconclusive. The majority of cohort studies investigating aspirin's role in preventing cognitive decline or dementia looked promising, but this was not supported in most randomised controlled trials. However, aspirin may still be beneficial in certain subgroups of patients (such as CHD, VD, and CSVD) and warrants further investigation. [ABSTRACT FROM AUTHOR]

Study Objective: Aspirin (ASA) has demonstrated inconsistent results in primary prevention of cardiovascular disease (CVD). Guidelines are also inconsistent in the recommendation of routine ASA use for primary prevention of CVD, but advocate dosing as a "one‐size‐fits‐all" approach. Design: An intention‐to‐treat, double‐blind, randomized, controlled, clinical trial comparing three treatment arms of ASA 81, 325, and 500 mg daily dosed for 14 days were evenly randomized across the dosing categories to measure the impact of dosing by body mass index (BMI) (20–24.9, 25–29.9, ≥30 kg/m2) on ASA anti‐platelet effects. Setting: University Ambulatory Clinic. Patients: Healthy volunteers defined as individuals who were medication free without acute or chronic significant health problems. Intervention: Change in ASA reactivity unit (ARU), salicylate levels, and thromboxane B2 (TxB2) levels were measured across BMI dosing categories and time. Main Results: Fifty‐four participants with a mean (±SD) age of 34.4 ± 10.9 years (M:F; 23:31) completed the study. Baseline ARU and TxB2 levels were not significantly different between obese and non‐obese individuals. BMI was not a predictor of platelet inhibition. There was no interaction between gender and platelet activation at baseline or following ASA treatment. ASA 81 mg was associated with a lower ARU response (approximate 50% lower response) than either the 325‐mg or the 500‐mg doses of ASA. TxB2 and salicylate levels exhibited lower trends at 81 mg compared with higher doses. Conclusions: In healthy male and female participants administered ASA for 14 days, obesity is not associated with increased basal platelet activation or ASA resistance. ASA 81 mg was significantly less effective in reducing platelet aggregation compared with ASA 325 and 500 mg, independent of BMI. [ABSTRACT FROM AUTHOR]

Urea cycle disorders (UCDs) are one of the more common groups of inherited metabolic disorders (IMDs). The urea cycle carried out by cells of the liver, detoxifies ammonia into urea which the body then excretes in the urine. UCDs are genetically inherited deficiencies in the enzymes of the urea cycle. UCDs cause hyperammonaemia, a metabolic emergency which requires prompt and meticulous management to prevent significant neurological harm and death. Timely investigation and treatment alongside liaison with the specialist metabolic centre are essential for improved patient outcomes and diagnosis. This review highlights the importance of early recognition of UCDs and the initiation of clinical management. Three case presentations of UCDs are discussed including argininosuccinate lyase (ASL) deficiency, ornithine transcarbamylase (OTC) deficiency and carbamoylaspartate synthetase 1 (CPS1) deficiency. [ABSTRACT FROM AUTHOR]

Lead (Pb) is a non-essential element; however, plants uptake it from soils rich in Pb. Soybean [Glycine max (L.) Merr.] is an important legume crop, and Pb toxicity exerts negative impacts on its growth and yield. This study investigated the role of foliar-applied loquat (Eriobotrya japonica Lindl.) leaf extract in improving the morphological, physiological, and biochemical traits of soybean plants under Pb toxicity. Soybean plants were exposed to four Pb concentrations (0, 200, 400, and 800 µg/L) and supplemented with 0% or 5% loquat leaf aqueous extract (EJLE). Data relating to pigments, proline, total soluble sugars, malondialdehyde (MDA), hydrogen peroxide (H2O2), non-enzymatic antioxidant, i.e., [ascorbic acid (AsA), glutathione (GSH), total phenolic contents (TPC), and total flavonoids content (TFC)] and enzymatic antioxidant, i.e., [superoxide dismutase (SOD), catalase (CAT), peroxidase (POD), ascorbate peroxidase (APX), and glutathione reductase (GR)] were recorded. Total chlorophyll contents and carotenoids were significantly decreased by Pb stress, while lycopene and anthocyanin contents were increased. Similarly, proline, total soluble sugars, MDA, H2O2, AsA, GSH, TPC, TFC, SOD, CAT, POD, APX, and GR were increased under Pb stress. Foliar spray of EJLE lowered MDA and H2O2 accumulation and increased the contents of chlorophylls, carotenoids, lycopene, anthocyanins, proline, total soluble sugars, and the antioxidant system. The increase in the activities of antioxidant enzymes lowered the adverse effects of Pb stress in soybean. Similarly, the application of EJLE lowered Pb accumulation in different plant parts compared to those receiving no EJLE. It is concluded that EJLE can improve the Pb tolerance of soybean plants by enhancing morphological, physiological, and biochemical traits. However, the actual mechanisms behind these improvements warrant further investigation. [ABSTRACT FROM AUTHOR]

Jowita Biernawska,1 Katarzyna Kotfis,2 Jolanta Szyma&nacute;ska-Pasternak,3 Anna Bogacka,4 Joanna Bober3 1Department of Anesthesiology and Intensive Therapy, Pomeranian Medical University, Szczecin, Poland; 2Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University, Szczecin, Poland; 3Department of Medical Chemistry, Pomeranian Medical University, Szczecin, Poland; 4Department of Commodity Science, Quality Assessment, Process Engineering and Human Nutrition, West Pomeranian University of Technology, Szczecin, PolandCorrespondence: Katarzyna Kotfis, Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University, Szczecin, 70-111, Poland, Tel/Fax +48914661144, Email katarzyna.kotfis@pum.edu.plIntroduction: Cardiac surgery associated AKI (CSA-AKI) complicates recovery and may be associated with a greater risk of developing chronic kidney disease and mortality. The aim of this study was to assess long-term clinical consequences of transient increased activity of urinary enzymes after cardiac surgery (CS).Methods: An observational study was conducted in a group of 88 adult patients undergoing planned coronary artery bypass grafting (CABG), but all samples were obtained from 79 patients. The activity of urinary enzymes: N-acetyl-beta-glucosaminidase (NAG), arylsulfatase A (ASA) and beta-glucuronidase was evaluated in sequential urine samples. A comparative analysis of biochemical parameters was performed regarding the occurrence of acute kidney injury (AKI) defined by KIDGO at 24 hours, at day 30 and 5-years after the operation.Results: During the first 24 hours after CS AKI was diagnosed in 13 patients. A comparison of the activity of urinary enzymes in pre-defined time-points showed significant differences for ASA and NAG (post OP-sample p < 0.028 and p < 0.022; POD 1 sample p < 0.004 and p < 0.001 respectively). No patient had any biochemical or clinical features of kidney failure at day 30. In the AKI group kidney failure was diagnosed in 36% of patients within 5 years of follow-up as opposed to 5% in the no AKI group. The activities of tubular enzymes in urine reflect a general injury of kidney tubules during and after the operation. However, they are not ideal biomarkers for prediction of the degree of kidney injury and further poor prognosis of CS-AKI.Keywords: acute kidney injury, AKI, N-acetyl-beta-glucosaminidase, NAG, arylsulfatase A, ASA, beta-glucuronidase, B-GR, cardiac surgery

Background: Lettuce (Lactuca sativa L.) cultivated in facilities display low vitamin C (L-ascorbic acid (AsA)) contents which require augmentation. Although UV-B irradiation increases the accumulation of AsA in crops, processes underlying the biosynthesis as well as metabolism of AsA induced by UV-B in lettuce remain unclear. Results: UV-B treatment increased the AsA content in lettuce, compared with that in the untreated control. UV-B treatment significantly increased AsA accumulation in a dose-dependent manner up until a certain dose.. Based on optimization experiments, three UV-B dose treatments, no UV-B (C), medium dose 7.2 KJ·m− 2·d− 1 (U1), and high dose 12.96 KJ·m− 2·d− 1 (U2), were selected for transcriptome sequencing (RNA-Seq) in this study. The results showed that C and U1 clustered in one category while U2 clustered in another, suggesting that the effect exerted on AsA by UV-B was dose dependent. MIOX gene in the myo-inositol pathway and APX gene in the recycling pathway in U2 were significantly different from the other two treatments, which was consistent with AsA changes seen in the three treatments, indicating that AsA accumulation caused by UV-B may be associated with these two genes in lettuce. UVR8 and HY5 were not significantly different expressed under UV-B irradiation, however, the genes involved in plant growth hormones and defence hormones significantly decreased and increased in U2, respectively, suggesting that high UV-B dose may regulate photomorphogenesis and response to stress via hormone regulatory pathways, although such regulation was independent of the UVR8 pathway. Conclusions: Our results demonstrated that studying the application of UV-B irradiation may enhance our understanding of the response of plant growth and AsA metabolism-related genes to UV-B stress, with particular reference to lettuce. [ABSTRACT FROM AUTHOR]

Background: Suxamethonium, a depolarizing neuromuscular agent, was introduced in 1952 and since then has been used for tracheal intubation. It was favoured for its rapid onset and ultra-short duration of action but has numerous side effects, especially cardiovascular. So agents with low potency and shorter duration of action were developed, and in 1995, Rocuronium was introduced, which is a non-depolarizing agent and has the fastest onset of action. Aim and objective: The aim of the study was to compare the intubating conditions at 60 seconds after giving Rocuronium 0.6 mg/kg and Suxamethonium 1 mg/kg intravenously. Methods: In this clinical trial, a total of 60 patients were enrolled. Patients were divided into groups A and B. Group A received Rocuronium 0.6 mg/kg intravenously, and Group B received suxamethonium 1 mg/kg, and all were intubated after 1 minute. Intubation conditions were noted and scored according to a modification of the Kreig et al.,. method. Results: It was observed that intubation conditions were excellent in both groups; there was tachycardia associated with the Rocuronium group, and blood pressure was higher in the Suxamethonium group. Conclusion: Rocuronium can be acceptable for intubation instead of Suxamethonium, except in conditions anticipating difficult intubation. [ABSTRACT FROM AUTHOR]

The effects of acetylsalicylic acid (ASA) on mood disorders (MD) and on inflammatory parameters in preclinical and clinical studies have not yet been comprehensively evaluated. The aim of this study was to systematically summarize the available knowledge on this topic according to PRISMA guidelines. Data from preclinical and clinical studies were analyzed, considering the safety and efficacy of ASA in the treatment of MD and the correlation of inflammatory parameters with the effect of ASA treatment. Twenty-one studies were included. Both preclinical and clinical studies found evidence indicating the safety and efficacy of low-dose ASA in the treatment of all types of affective episodes in MD. Observational studies have indicated a reduced risk of all types of affective episodes in chronic low-dose ASA users (HR 0.92, 95% CI: 0.88, 0.95, p < 0.0001). An association between ASA response and inflammatory parameters was found in preclinical studies, but this was not confirmed in clinical trials. Further long-term clinical trials evaluating the safety and efficacy of ASA in recurrent MD, as well as assessing the linkage of ASA treatment with inflammatory phenotype and cytokines, are required. There is also a need for preclinical studies to understand the exact mechanism of action of ASA in MD. [ABSTRACT FROM AUTHOR]

The article provides nutritional information about Rosa roxburghii Tratt, a perennial rosebush native to China that is widely distributed in the southwestern provinces of China. It mentions that the plant roots are considered effective in the treatment of diarrhea, whereas its leaves are used for tea and dyspepsia treatment, and its fruits offer a wide range of nutritional and medicinal components.

Impaired microcirculation, along with an increase in chronic medical conditions in the geriatric cohort, may favor the development of soft-tissue defects in the lower extremity and equally impair the options for plastic-reconstructive surgery. In particular, outcome analyses in the increasing patient cohort ≥ 80 years (octogenarians) are limited. Setting 80 years as the cutoff, we conducted an age-related outcome analysis of all patients undergoing free-flap reconstruction of the lower extremity from 2014 to 2020, comprising the American Society of Anesthesiologists (ASA) score and Charlson Comorbidity Index (CCI) as the possible outcome predicting factors. During the study period, a total of 424 free flaps were performed in 385 patients (∅: 54.7 years ± 16.1; range: 9–89), including 19 octogenarians. Compared with the younger patient cohort, there was a significantly higher rate of early flap revision (p = 0.023) and flap loss (p = 0.028). Furthermore, the mean length of hospital (60.6 ± 37.6 vs. 51.1 ± 37.0) and intensive care unit/intermediate care stay (6.5 ± 15.0 vs. 3.5 ± 8.5) was extended (n.s.). The ASA score presented an independent predictor for major surgical [odds ratio (OR): 1.66; p = 0.041) and medical complications (OR: 3.97; p <0.001). Neither the CCI nor the ASA served as an independent predictor for total flap loss. Free-flap reconstruction of the lower extremity in octogenarians is associated with a higher risk of flap revision and flap loss. Considering the prolonged immobilization associated with increased morbidity following limb amputation, it presents still a reasonable option to achieve limb salvage in carefully chosen patients. An adequate tool to predict the success of free-flap survival is still unavailable. [ABSTRACT FROM AUTHOR]

Background: Patients with advanced illnesses are often admitted with acute surgical emergencies. There is currently no evidence characterising such admissions. We aimed to evaluate emergency patients, managed non-operatively, who died during the same admission.Methods: This single-centre retrospective, observational study collected data points for a 12 month period including age, prior documented do not resuscitate order (DNAR), existing cancer, Charlson Comorbidity Index, frailty, surgical diagnosis, interval from admission to death and care given. Patients who underwent surgical intervention were excluded. Non-parametric tests were used for statistical analysis.Results: A total of 72 patients were included in this study, of which 68.1% died within 6 days of admission (median 4.0 days). Patients with visceral perforation, obstruction, bowel ischaemia or known malignancy were more likely to die within 6 days than those with pancreatitis, sepsis or new malignancy (median 2 vs 7 days, p < 0.001). Patients with frailty (2 vs 4 days, p = 0.017) and existing DNAR (3 vs 4 days, p = 0.048) died more rapidly than those without. Age and comorbidity index did not impact time to death.Conclusion: Frailty, surgical diagnosis and existing DNAR were predictors of shorter admission to death interval, while age and comorbidity index were not. This has implications on inpatient palliative care service planning. [ABSTRACT FROM AUTHOR]

Background: Although the American Society of Anesthesiologists (ASA) score of 3 is relatively common in elderly patients, there have been few debates on the indications for gastrectomy in elderly gastric cancer (GC) patients with ASA3. Therefore, this study aimed to investigate gastrectomy's clinical relevance in elderly patients with GC and ASA3. Methods: We retrospectively analyzed 228 consecutive elderly GC patients (aged ≥ 75 years) without prior treatments who underwent curative gastrectomy between 2013 and 2017. Results: Thirty-three patients with ASA3 showed significantly poorer prognosis than those with ASA1 and 2 (p = 0.004). The multivariate Cox proportional hazards model showed that ASA3 (p = 0.021) and pStage (p = 0.007) were independent prognostic factors, respectively. Elderly GC patients with pStage III and ASA3 exhibited uniquely dismal prognosis (p < 0.001); however, several survivors were still confirmed. Postoperative complications (PCs) were only the final remnant independent prognostic factor (p = 0.020) among the 33 elderly GC patients with ASA3, where dead patients included cancer-specific and other deaths, especially pneumonia. PCs were independently associated with prognostic nutritional index (PNI) (< 42.7) in elderly GC patients, and the most frequent complication was pneumonia, which was significantly associated with ASA3 and marginally associated with PNI in a multivariate analysis. Conclusions: ASA3 has a dismal prognosis after curative gastrectomy in the elderly GC patients, but the number of survivors was confirmed. Curative gastrectomy is not considered contraindicated even in elderly GC with ASA3. Preoperative malnutrition is associated with PCs, which proposing preoperative nutritional intervention in the context of treatment strategy for the elderly GC patients with ASA3. [ABSTRACT FROM AUTHOR]

Improvements in perioperative care have decreased complication rates following arthroplasty surgery and enabled outpatient surgery. Although studies have suggested selective routine postoperative blood tests for lower limb arthroplasty, there is currently a paucity of research into its utility for shoulder arthroplasty. Our aim was to define an algorithm based on Charlson Comorbidity Index (CCI) value as part of a predictive algorithm to identify low-risk patients undergoing elective anatomic and reverse shoulder arthroplasty that can safely do without routine postoperative blood tests. Electronic medical records were retrospectively reviewed for patients who underwent elective primary shoulder arthroplasty at our institution, both anatomic and reverse, between January 2009 and October 2020. Inclusion criteria included patients who underwent reverse or anatomic shoulder arthroplasty for glenohumeral joint osteoarthritis or rotator cuff arthropathy and had documented preoperative and postoperative blood tests including full blood count and serum electrolytes. Exclusion criteria included patients who had revision and trauma indications for surgery because of the increased complication rates associated with these indications. Variables recorded included age, gender, body mass index, indication for surgery, comorbidities, American Society of Anesthesiologists score, CCI score, preoperative blood test values from preadmission assessment, postoperative day one blood test values, and interventions required based on blood results. A total of 140 patients were included in the study. Eighteen patients (12.85%) required intervention based on postoperative blood tests, the most common indications being anemia and hyponatremia. Patients that required intervention had higher CCI (P =.001) and lower preoperative hemoglobin (P =.014). With the application of cutoff values of hemoglobin of ≥106 g/L, and CCI score of less than 4, only one patient in our study required intervention. Routine postoperative blood test following primary elective shoulder arthroplasty is not required in low-risk patients, defined as those with a CCI score of <4 and a preoperative hemoglobin of >106 g/L. [ABSTRACT FROM AUTHOR]

Aim: to evaluate the effectiveness of using low molecular weight heparin (LMWH) and low-dose acetylsalicylic acid (ASA) in preventing recurrence of early and late fetal growth retardation (FGR) in patients with antiphospholipid syndrome (APS) and/or genetic thrombophilia.Materials and Methods. A prospective randomized controlled study was conducted by examining 32 patients aged 23 to 43 years with a history of early and late II and III FGR as well as thrombophilia. Prevention protocol using LMWH and ASA was carried out from the pregravid period or early pregnancy. The control group included 35 women with uncomplicated pregnancy. Antiphospholipid antibodies (APA) were measured according to the Sydney antiphospholipid syndrome (APS) criteria by using enzyme immunoassay (ELISA): cardiolipin, β2-glycoprotein 1 and additionally antibodies to annexin V, prothrombin, etc. (IgG/IgM isotypes); lupus anticoagulant – by a three-stage method with Russell's viper venom; antithrombin III and protein C levels – by chromogenic method; prothrombin gene polymorphisms G20210A as well as factor V Leiden polymorphism – by chain reaction; homocysteine – by ELISA.Results. It was found that prevention protocol was effective in 78.1 % cases. FGR re-developed in 7 (21.9 %) pregnant women: in 2 (6.3 %) at 20 and 22 weeks, in 3 (9.4 %) at 30–32 weeks, in 2 (6.3 %) after 34 weeks of pregnancy. All these patients were found to have APA exceeding 40 U/ml with low dynamics of decline, 3 (9.4 %) were older than 35 years, 2 (6.3 %) had chronic kidney pathology and 1 (3.1 %) had a hypertension in the anamnesis.Conclusion. The use of LMWH and low-dose ASA starting from the pre-pregnancy period and early pregnancy as a part of complex therapy allows to effectively prevent re-development of FGR in patients with thrombophilia. In case of high APA titers, the use of LMWH and low-dose ASA may be ineffective, and alternative treatment methods in addition to anticoagulant therapy should be used to improve obstetric results.

Introducción: Las fracturas de cadera se asocian con un importante impacto en la morbimortalidad. El objetivo de este estudio fue identificar las variables relacionadas con el desarrollo de complicaciones y la muerte luego de una fractura de cadera. Materiales y Métodos: Se realizó un análisis de los datos provenientes de las primeras 1000 encuestas de fracturas de cadera del Comité de Morbimortalidad de la Asociación Argentina de Ortopedia y Traumatología. Mediante un análisis bivariado y una regresión multivariada se identificaron las variables independientes relacionadas con la aparición de complicaciones o la muerte. Resultados: Las complicaciones se relacionaron con anemia preoperatoria, demora en el tratamiento, aumento de los días de internación y transfusiones de glóbulos rojos. La muerte se asoció con la anemia preoperatoria, las transfusiones de glóbulos rojos, el total de días de internación, el puntaje de la ASA y la presencia de complicaciones posoperatorias. La anemia y la internación prolongada fueron los factores predictivos independientes de complicaciones identificados, mientras que la anemia y el puntaje de la ASA fueron los factores predictivos de muerte. Conclusiones: Este estudio destaca el valor predictivo de la anemia, un puntaje III y IV de la ASA, y la estancia hospitalaria en relación con la morbimortalidad de pacientes con fractura de cadera. Se deberán destinar esfuerzos para optimizar la condición de estos pacientes y el sistema de salud en pos de disminuir este impacto en la morbimortalidad.

The hyperinflammation microenvironment after spinal cord injury (SCI) remains a great challenge for neural regeneration. Methylprednisolone has been used to reduce the inflammatory response after SCI, but it is controversial due to side effects associated with off-specific targeting effects. In this study, we synthesized in situ 5-ASA grafted chitosan electrospun fibers (ASA-EF) with excellent injectable and self-healing properties to reprogram nerve cells via displaying biological distribution, gene expression, and functional changes. With the support of ASA-EF, the downregulation of inflammatory cytokines expression and the upregulation of anti-inflammatory and regenerative gene expression were found in vitro studies. Moreover, ASA-EF administration polarized macrophages toward proregenerative phenotypes in the injured lesion, and significantly reduced cavity area. In addition, ASA-EF administration increased myelination and regenerating axons and improved motor function (score of 5 versus 2 for SCI group). These results illustrate that the neuroprotective effect of this artificial nanoplatform will facilitate the clinical treatment of traumatic-related diseases via forming a recycled microenvironment that supports regeneration and functional recovery. These particles may be applied to trauma and potential other inflammatory diseases.

Purpose: We investigated the effects of age, American Society of Anesthesiologists Physical Status Classification (ASA) grading and Charlson Comorbidity Index (CCI) on the survival outcomes of upper tract urothelial carcinoma (UTUC). Methods: The CROES-UTUC registry was an international, multicenter study on patients with UTUC. Primary outcomes were overall survival (OS) and disease-free survival (DFS). Kaplan–Meier and multivariate Cox regression analyses were performed by stratifying patients according to their age (≤ 70 and > 70 years old) and ASA grade (I–II and III–V)/CCI (0–1 and ≥ 2). Results: A total of 2352 patients were included in this study. Patients aged ≤ 70 years with ASA grading of I–II (p = 0.002), and patients aged ≤ 70 years with a CCI of 0–1 (p = 0.002) had the best OS. Upon multivariate analysis, both in patients aged ≤ 70 and > 70 years, ASA grading and CCI were not significantly associated with OS. Patients aged ≤ 70 years with ASA grading of III–IV (p = 0.024) had the best DFS. When stratified according to age and CCI, no significant difference in DFS was noted. Upon multivariate analysis, radical nephroureterectomy (RNU) was significantly associated with better DFS in patients aged ≤ 70 and > 70 years; CCI of ≥ 3 was significantly associated with worse DFS in patients ≤ 70 years; ASA grading was not associated with DFS in patients aged ≤ 70 and > 70 years. Conclusions: A high ASA grading and CCI should not be considered contraindications for RNU. RNU should be considered even in elderly patients when it is deemed feasible and achievable after a geriatric assessment. [ABSTRACT FROM AUTHOR]

Copyright of Acta Vet Indones. The Indonesian Veterinary Journal / Jurnal Acta Veterinaria Indonesiana is the property of IPB University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aspirin is one of the most frequently used and cheapest drugs in medicine. It belongs to the non-steroidal anti-inflammatory drugs with a wide range of pharmacological activities, including analgesic, antipyretic, and antiplatelet properties. Currently, it is accepted to prescribe a low dose of aspirin to pregnant women who are at high risk of preeclampsia (PE) because it reduces the onset of this complication. Drug produce degradation profiles essential to establish to monitor the stable formulation and provide appropriate drug shelf life valuation. Structural description of impurities and degeneracy production in bulk API has become integral part of pharmaceutical product development. The study of these minor leveled unidentified impurities and degradent are very challenging. Various regulatory bodies related International Council for Harmonisation, United States Food and Drug Administration. [ABSTRACT FROM AUTHOR]

Objective:Postoperative pulmonary complications (PPC) are one of the most important causes of postoperative morbidity and mortality. The ARISCAT Risk Index is a seven-variable regression model that classifies patients as low, intermediate, and high risk and is used to estimate the overall incidence of postoperative pulmonary complications. In our study, we aimed to evaluate the effectiveness of ASA and ARISCAT index in predicting pulmonary complications in after laparoscopic abdominal cancer surgery. Materials and Method:After the approval of Hospital Ethics Committee, 100 patients scheduled to have major laparoscopic abdominal cancer surgery were included in the study. Preoperative ASA and ARISCAT score, comorbidities, intraoperative fluid amount, ventilation parameters, pneumoperitoneum pressure and duration of surgery were recorded. Patients were followed up for pulmonary complications until discharge from hospital. The length of hospital stay was recorded. Results:Pulmonary complications developed in 11 patients postoperatively. PPC incidence was found similiar within ASA and ARISCAT risk groups (p> 0.05). There was no significant correlation between ASA and ARISCAT risk index and PPC (p= 0.23 and p= 0.89, respectively). The number of fluids administered intraoperatively was significantly higher in patients who developed PPC (p= 0.018). There was a significant correlation between sugical site and PPC development (p= 0.012). The duration of surgery and length of hospital stay was longer in patients with PPC (pË,0.05). Conclusion:We found that both ASA score and ARISCAT risk index are not sufficient to predict postoperative pulmonary complications in laparoscopic major abdominal cancer surgery, and the surgical site, long operation time and the volume of fluid used intraoperatively are important independent risk factors for pulmonary complications. [ABSTRACT FROM AUTHOR]

3D printing is more and more often used for the development and manufacturing of electronic devices and components. These applications require knowledge about the dielectric properties of the used materials—in particular minimal and stable values of relative permittivity and dielectric losses. The paper deals with the testing of the relative permittivity and loss factor of materials as follows: PLA (in three dye modifications), PET-G, and ABS and ASA in the frequency range 1–100 MHz. It was found that relative permittivity varied between 2.88–3.48 and the loss factor was in the range 0.03–4.31%. In terms of relative permittivity, all tested materials manifested a slight decline with increasing frequency. Concerning loss factor PLA (colorless) and ABS were proven to be more suitable for electrotechnical application due to the lower values and frequency dependences of the loss factor. Different results were observed in PLA-Silver and PLA-Metallic green. These materials showed a higher frequency dependency of loss factor with increasing frequency. The reasonable influence of added dyes was found. A study of the internal structure of the tested materials has not proven any significant defects (air gaps) that could affect the material's dielectric properties. [ABSTRACT FROM AUTHOR]

While plant fibers are abundant and biodegradable natural polymers, their high hydrophilicity often limits their applicability. To broaden the applicability of plant fiber materials across diverse fields, the present study employed cellulosic paper as a substrate and alkenyl succinic anhydride (ASA) as a low surface free energy material to fabricate a series of hydrophobic cellulosic papers (ASAP, ASA-P@Si, ASA-P@Ca, and ASA-P@Ti) through surface coating and physical vapor deposition of ASA. The results demonstrated that, in comparison to uncoated cellulosic paper, the coated variants exhibited significantly improved hydrophobicity. Notably, ASA-P@Si demonstrated superior hydrophobic performance with a contact angle of 140.90° and a sizing degree of 7.2 s, thereby meeting the requirements for specific fine paper grades. In contrast to the traditional ASA internal sizing process, the method in this study necessitates only approximately one-tenth of the conventional ASA internal sizing agent to achieve or even exceed the hydrophobic properties of paper attainable with ASA inter sizing process. Furthermore, the mechanism through which hydrophobic properties are conferred to paper can be elucidated by its surface roughness and low surface free energy, distinguishing it from the traditional ASA internal sizing approach., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Objective: This study aimed to analyze factors associated with recent complications after colorectal cancer surgery, constructing a nomogram to aid gastrointestinal surgeons in preoperative decision-making for patients at risk of such complications., Methods: In this retrospective study, clinical data were collected from patients undergoing radical colorectal cancer surgery at the Department of Gastrointestinal Surgery of the Affiliated Cancer Hospital of Guizhou Medical University and the Second People's Hospital of Chengdu from November 1, 2021, to January 26, 2024. Univariable and multivariable logistic regression analyses were conducted to assess risk factors for recent postoperative complications and develop a prediction model. External validation was performed using data from 48 postoperative colorectal cancer patients in the Second People's Hospital of Chengdu City from January 1, 2023, to May 30, 2023. Evaluation included receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis using R4.2.2 statistical software., Results: A total of 324 patients who underwent radical colorectal cancer surgery were enrolled. The training cohort (n=176) identified four independent risk factors for recent complications: PNI ≥45 (OR=4.17, P<0.001), Albumin <40 g/L (OR=3.9, P<0.001), ASA score III-IV (OR=6.29, P<0.001), and Tumor diameter ≥5 cm (OR=4.24, P<0.001). A nomogram was constructed incorporating these factors. The AUC of the nomogram model in the training cohort was 0.835, with subsequent internal and external validation cohort AUCs of 0.815 and 0.819, respectively, indicating strong discriminatory ability. The calibration curve demonstrated good consistency, and decision curve analysis indicated high clinical utility., Conclusion: PNI ≥45, Albumin <40 g/L, ASA score III-IV, and Tumor diameter ≥5 cm emerged as independent risk factors for recent complications following colorectal cancer surgery. We developed a nomogram model for these complications, potentially aiding gastrointestinal surgeons in preoperative patient evaluation and treatment planning for colorectal cancer surgery., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Ou, Yang, Yang, Pan, Tian, Wang, Yu, Luo and Wang.)

Rosa roxburghii Tratt is a well-known horticultural crop that produces fruits with extremely high l-ascorbic acid (AsA) levels, and GDP-l-galactose phosphorylase2 (RrGGP2) encodes a major enzyme operating in AsA biosynthesis. This study aims to elucidate the transcriptional mechanism of RrGGP2 underlying AsA overproduction under abiotic stress. Herein, the sequence of RrGGP2 promoter (PRrGGP2) was isolated. The analysis of the PRrGGP2 detected an upstream open reading frame encoding a 64-amino acid peptide as well as a number of cis-acting elements responsive to environmental factors and hormones. Several truncated promoter fragments were constructed for dual-luciferase assays which revealed a critical promoter region (-1949 to -2089 bp) for PRrGGP2 activity. Overexpressing β-glucuronidase (GUS) and RrGGP2 under the control of PRrGGP2 in transgenic Arabidopsis thaliana increased the GUS activity and AsA content, respectively. Furthermore, the extent of the increases was significantly influenced by temperature and abscisic acid. Yeast one-hybrid and dual-luciferase assays indicated that RrNAC56 could activate PRrGGP2. Cold stress significantly increased the transcription of RrNAC56 and RrGGP2 in R. roxburghii fruits, which resulted in AsA accumulation. These findings offer a theoretical foundation for understanding the transcriptional regulation of RrGGP2, while also uncover a novel mechanism of RrNAC56-RrGGP2 module-mediated abiotic stress response via regulating AsA synthesis., Competing Interests: Declaration of competing interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Introduction: The Scoliosis Research Society 22r (SRS-22r) questionnaire is a proven tool in assessing healthcare-related quality of life (HRQoL) in idiopathic scoliosis and is the adopted patient-reported outcome measure for the deformity pathway recorded into the British Spinal Registry (BSR). Surgery for adolescent idiopathic scoliosis (AIS) is performed frequently in teenagers; however, patients also present with curves in the surgical range into adulthood. This work aimed to assess HRQoL differences between patients following surgery for AIS performed in adolescence and adulthood using SRS-22r data collected from the BSR., Methods: An anonymised BSR search of pre- and postoperative SRS-22r scores for patients with diagnoses of AIS and adult idiopathic scoliosis was conducted. Data from all subdomains were compared preoperatively and at the two-year postoperative timepoint., Results: Preoperative SRS-22r scores were analysed for 1,912 patients with AIS and 65 with adult idiopathic scoliosis. Patients with adult idiopathic scoliosis had significantly lower preoperative SRS-22r scores in all subdomains ( p <0.05). By two years postoperatively, both groups of patients had improved SRS-22r scores significantly compared with baseline in all subdomains ( p <0.001). A cross-group analysis revealed patients with AIS had significantly better function scores years postoperatively than their adult counterparts ( p =0.005)., Conclusions: This work confirms there are benefits following surgery for AIS in improving HRQoL, but has also provided HRQoL data in adult patients, who again show similar improvements following surgery from baseline. This is of value when counselling patients regarding anticipated benefits of surgery performed in childhood and adulthood.

Background: Perianchor cyst formation (PCF) can occur after arthroscopic rotator cuff repair with poly-L-lactic acid (PLLA) anchors; however, little is known about PCF after all-suture anchor (ASA) use. Methods: We reviewed patients who underwent double-row arthroscopic rotator cuff repair from 2012 to 2017 with ASAs implanted in the medial row and PLLA anchors in the lateral row. We evaluated PCF (graded on magnetic resonance imaging) and compared physical examination and functional surveys between patients with PCF (WC) and without PCF (WoC) at long-term follow-up. Results: Among twenty-two patients (23 shoulders), 93% of PLLA anchors (vs. 79% ASA) displayed a grade 0 PCF, P = .100. No PLLA anchors had a grade 3 or 4 PCF, compared to 11% of ASAs, P = .158. At a mean postoperative follow-up time of 113 weeks, there was no significant difference between WC and WoC cohorts with regard to range of motion, rotator cuff strength, American Shoulder and Elbow Surgeons survey scores, or retear rates. However, the WoC cohort had a significantly higher University of California at Los Angeles shoulder survey score at final follow-up (34.3 WoC vs. 30.9 WC, P = .024). Conclusion: No difference was found in PCF between ASAs and PLLA anchors. At long-term follow-up, WoC patients had significantly improved functional outcome scores, based on the University of California at Los Angeles survey, but equivalent range of motion and rotator cuff strength examinations compared with WC patients.

One of the most used additive manufacturing methods in the market is fused filament fabrication (FFF) due to its affordability and ease of operation. However, identification of optimal processing parameters is still a challenge and can help to achieve desired results in parts made by FFF. This paper presents the influence of two process parameters, i.e. layer height and line width on FFF-printed thermoplastics. Premium PLA, Haydale's Synergy Graphene Enhanced Super Tough PLA, ABS Extrafill and ASA Extrafill have been manufactured and tested according to British and International standards for this study. An extensive comparative analysis has been provided where parts have been manufactured using Anet® ET4 Pro 3D printer with the four materials at five different line widths (0.2 mm, 0.4 mm, 0.6 mm, 0.8 mm, 1 mm) and four different layer heights (0.1 mm, 0.2 mm, 0.3 mm, 0.4 mm). The study analyses the effects of line widths and layer heights on mass, dimensional accuracy, surface texture and mechanical properties of the four materials. Microstructural analysis has also been carried out to evaluate the fractured surfaces and to determine the impact of modifying the two processing parameters on failure modes. Results have shown the trade-offs that can be made with the different materials in terms of properties and manufacturing time by modifying the layer heights and line widths. Designers and manufacturers can use this comparative analysis amongst the four materials to identify the limitations with the default printing settings (0.2 mm layer height and 0.4 mm line width) on most 3D printers and achieve desired results by leveraging the layer heights and line widths. [ABSTRACT FROM AUTHOR]

Thyroidectomy and parathyroidectomy are relatively safe procedures, with overall morbidity rates of 2%-5%. The increasing age is associated with higher likelihood of poor outcomes. The modified five-point frailty index (mFI-5) is associated with complications, but many surgeons are unfamiliar with mFI-5. We assessed the accuracy of the mFI-5 versus the commonly-used American Society of Anesthesiologists (ASA) classification to predict complications following thyroidectomy and parathyroidectomy. Patients undergoing thyroidectomy or parathyroidectomy in 2015-2018 NSQIP datasets were identified. The mFI-5 scores were calculated by adding the number of the following comorbidities: congestive heart failure, hypertension requiring medication, chronic obstructive pulmonary disease, diabetes, and nonindependent functional status. Receiver operating characteristics curves were plotted for 30-d mortality and serious morbidity (defined as deep surgical site infection, dehiscence, unplanned intubation, failure to wean from the ventilator 48-h postoperatively, acute renal failure, pneumonia, pulmonary embolism, myocardial infarction, cardiac arrest requiring cardiopulmonary resuscitation, sepsis, septic shock, cerebrovascular accident, or reoperation) using mFI-5 and ASA classification. Areas under these curves (AUC) were compared. Ninety-two thousand, six hundred and ninety-one patients were studied. The mFI-5 and ASA were fair predictors of 30-d mortality (AUC 0.75 and 0.82, respectively) and good predictors of serious morbidity (AUC 0.61 and 0.64). After stratification by age, ASA was superior to mFI-5 in predicting mortality for patients aged 65, 70, 80 y, and older, for the entire population and for thyroidectomy and parathyroidectomy separately. The ASA classification is a better predictor of mortality and serious morbidity than mFI-5 among patients undergoing thyroidectomy or parathyroidectomy and may be a better prognostic indicator to use when counseling patients before low-risk neck surgery. [ABSTRACT FROM AUTHOR]

This article examines the impact of regional alliances in the shaping of Philippines-Malaysia relations. Philippines-Malaysia bilateral relations have been predominantly driven by the Philippines’ Sabah claim. This is a long-held misconception that warrants a reevaluation by considering other driving factors such as regional cooperation, which has played a big part in Philippines-Malaysia relations which is indeed the novelty of this article. A shared vision by Philippine and Malaysian leaders was the key factor in the formation of the ASA and ASEAN. Their involvement in initiating regional cooperation began when President Garcia met Tunku Abdul Rahman, the Malaysia Prime Minister, in Manila in January 1959. This effort led to the formation of the Association of South-East Asia (ASA) in July 1961 which was the first regional body established in Southeast Asia. Garcia and Tunku shared a vision to establish a regional organization to counter communist threats and enhance mutual security in the region. The establishment of ASA has been a factor in the establishment of ASEAN. Through ASEAN, concepts such as musyawarah and muafakat are accepted by the Philippines and Malaysia to resolve the Sabah issue. This article also discusses the geopolitical situation in the region during the 1960s and beyond, influenced by the spread of communist ideology was an important factor for non-communist countries in Southeast Asia to stay united. This article will explore the extent to which commitment to regional alliances such as ASA, MAPHILINDO (Malaysia, Philippines, Indonesia) and ASEAN emerged as driving forces in the development Philippines-Malaysia bilateral relations. Philippines and Malaysia have cooperated in various regional initiatives which have generated many and tremendous mutual benefits. Successful cooperation and collaboration in many areas brought positive impacts and significance in bilateral ties which have been overlooked in other studies. Furthermore, this article also contributes to the understanding that regional cooperation was and is the cornerstone of the Philippines’ and Malaysia’s foreign policy direction. [ABSTRACT FROM AUTHOR]

Background and aims: The therapeutic strategy for the treatment of known sequelae of COVID‐19 has shifted from reactive to preventative. In this study, we aim to evaluate the effects of acetylsalicylic acid (ASA), and anticoagulants on COVID‐19 related morbidity and mortality. Methods: This record‐based analytical cross‐sectional study targeted 539 COVID‐19 patients in a single United States medical center between March and December 2020. Through a random stratified sample, we recruited outpatient (n = 206) and inpatient (n = 333) cases from three management protocols, including standard care (SC) (n = 399), low‐dose ASA only (ASA) (n = 112), and anticoagulation only (AC) (n = 28). Collected data included demographics, comorbidities, and clinical outcomes. The primary outcome measure was inpatient admission. Exploratory secondary outcome measures included length of stay, 30‐day readmission rates, medical intensive care unit (MICU) admission, need for mechanical ventilation, the occurrence of acute respiratory distress syndrome (ARDS), bleeding events, clotting events, and mortality. The collected data were coded and analyzed using standard tests. Results: Age, mean number of comorbidities, and all individual comorbidities except for asthma, and malignancy were significantly lower in the SC compared to ASA and AC. After adjusting for age and comorbidity via binary logistic regression models, no statistical differences were found between groups for the studied outcomes. When compared to the SC group, ASA had lower 30‐day readmission rates (odds ration [OR] 0.81 95% confidence interval [CI] 0.35–1.88, p = 0.63), MICU admission (OR 0.63 95% CI 0.34–1.17, p = 0.32), ARDS (OR 0.71 95% CI 0.33–1.52, p = 0.38), and death (OR 0.85 95% CI 0.36–1.99, p = 0.71). Conclusion: Low‐dose ASA has a nonsignificant but potentially protective role in reducing the risk of COVID‐19 related morbidity and mortality. Our data suggests a trend toward reduced 30‐day readmission rates, ARDS, MICU admissions, need for mechanical ventilation, and mortality compared to the standard management protocol. Further randomized control trials are needed to establish causal effects. [ABSTRACT FROM AUTHOR]

A method is proposed for the determination of sultones in the anionic surfactant sodium α-olefin sulfonate (AOS Na) and products based on this surfactant. The importance and necessity of quality control in the production of AOS Na and detergents for the presence of sultone impurities is due to their toxic effect on a human body. Under production conditions, the analysis procedure should be rapid and provide results at the ppm level. In the present work, a procedure for determining sultones based on gas chromatography–mass spectrometry is improved. δ-Hexadecanesultone isolated from the sulfonation reaction mass is used as a standard in the determination. Satisfactory performance characteristics of the procedure, ensuring its use for production control, are obtained. Foreign commercial samples of AOS Na from different manufacturers are tested for the content of sultones along with model mixtures of detergents prepared on the basis of these samples. The results of tests for the stability of model mixtures of detergents over time showed that a high concentration of sultones results in the formation of precipitates in the finished product. [ABSTRACT FROM AUTHOR]

Introduction: Stem cell therapy is considered as a promising strategy to treat neurological disorders. Amongst different cell types that are recruited under these devastating conditions, epidermal neural crest stem cells (EPI-NCSCs) are known as potential candidates. Acetylsalicylic acid (ASA or aspirin) is one of the commonly prescribed drugs that might affect the therapeutic potential of the transplanted stem cells. Hence, the present study aimed to evaluate the effects of ASA on the expression of fundamental growth factors involved in restorative pathways expressed by EPI-NCSCs in vitro for possible combination therapy’s purpose. Methods: EPI-NCSCs were obtained from the rat’s hair follicle. The appropriate ASA concentration to treat the cells was defined based on the MTT assay and then the obtained cells were treated with 80 or 800μM ASA for 1, 3 or 7 days. The relative expressions of Bdnf, Gdnf, Ngf, Neurotrophin-3, Vegf, Gfap, and doublecortin were finally assessed by qRT-PCR. Results: The obtained data revealed that the growth factors expressions are influenced by concentration and duration of the treatment applied. One-day ASA treatment was found to be able to increase the expression of all the evaluated genes, except Gdnf and doublecortin, which elevated three days later. Herein, seven-day treatment of stem cells with 800μM ASA resulted in higher levels of Bdnf, Vegf, and doublecortin. Conclusion: Therefore, combination of aspirin and EPI-NCSCs might increase the therapeutic potential of these stem cells to treat neurological disorders. [ABSTRACT FROM AUTHOR]

Objective We aimed to evaluate the effect of hematoma volumes and preoperative ASA scores on mortality of the patients we operated on due to intraparenchymal hematoma. Materials and Methods This study was conducted by retrospectively scanning the files of 34 patients operated on for intraparenchymal hematoma in our hospital's neurosurgery clinic between February 2015 and February 2020. The preoperative glasgow coma score, hematoma volume, antiaggregant use, presence of hypertension, localization of bleeding and whether it was opened to the ventricle and ASA scores of the patients were collected to evaluate. Results Of the 34 patients included in the study, 20 were male, and 14 were female. Preoperative mean hematoma volumes of the patients were 120 cm3 (min: 41 - max: 278 cm3). In the follow-up of the patients, 28 of them were dead, and our mortality rate was 82%. A significant correlation was found between hematoma volumes and mortality (P<0.05). 11 of the patients were evaluated as ASA 2, 4 as ASA 3, 17 as ASA 4, and 2 patients as ASA 5. No significant correlation was found between the patients' ASA score and mortality (P>0.05). Conclusion Glasgow coma score and ASA score are important factors determining mortality. The glasgow coma score and ASA score should be evaluated together. Even if the glasgow coma score score is low, mortality decreases in patients without comorbid diseases. [ABSTRACT FROM AUTHOR]

Background: Laparoscopic hepatectomy (LH) is nowadays considered as the standard of care for various liver malignancies. However, studies focusing on perioperative outcome after LH in patients with severe comorbidities are still sparse. Methods: 247 patients, who underwent LH between January 2016 and March 2020 at European surgical center Aachen Maastricht (ESCAM) were retrospectively analyzed regarding surgical outcome. All patients were categorized according to the ASA guidelines and a propensity score matched (PSM) analysis was performed to compare patients with severe comorbidities with patients with minor or no comorbidities. Results: After PSM, no statistically significant differences regarding clinical characteristics were observed. We performed major resections in 26.4% of h‐ASA (ASA > 2) patients and 19.4% of l‐ASA (ASA≤2) patients, respectively (P =.322). Overall morbidity (Clavien‐Dindo≥1) was observed more frequently in the h‐ASA group (h‐ASA: 25.0% vs. l‐ASA: 8.3%; P =.007) while analysis of major morbidity (Clavien‐Dindo≥3b) showed a non‐significant tendency for more complications in h‐ASA patients (h‐ASA: 8.3% vs. l‐ASA: 1.4%; P =.053). A subgroup analysis identified major resection (HR = 5.05; P =.006) as an independent risk factor for the occurrence of any postoperative complication and chronic kidney disease (HR = 22.59; P =.030) and liver fibrosis (HR = 30.16; P =.031) as risk factors for the occurrence of major complications in h‐ASA patients. Conclusion: LH in patients with severe systemic comorbidities shows a strong tendency towards an increased rate of major complications. Careful patient selection with respect to the planned extent of resection and the presence of chronic kidney disease and liver fibrosis should be performed to improve perioperative results. [ABSTRACT FROM AUTHOR]