Search

The European Society of Cardiology (ESC) has updated its guidelines on cardiac pacing and cardiac resynchronisation. As the majority are class II recommendations (61%) and based on expert opinion (59%), a critical appraisal for the Dutch situation was warranted. A working group has been established, consisting of specialists in cardiology, cardiothoracic surgery, geriatrics, allied professionals in cardiac pacing, and patient organisations with support from the Knowledge Institute of the Dutch Association of Medical Specialists. They assessed the evidence leading to the recommendations and the suitability for daily Dutch practice. Several recommendations have been amended or omitted altogether if a conflicting Dutch guideline has recently been published, such as a guideline on performing magnetic resonance imaging in patients with cardiac implantable electronic devices. The recent Dutch guideline on implantable cardioverter defibrillator implantation in patients with non-ischaemic cardiomyopathy has recommended implanting cardiac resynchronisation therapy devices without a defibrillator function. Shared decision making has received a more prominent role in the ESC guidelines and is discussed in more detail in this document. The recommendations given in this document are intended for health care professionals involved in the care of patients with an indication for cardiac pacing and are approved by the participating professional societies and the patient organisation Harteraad. [ABSTRACT FROM AUTHOR]

Background: The concept of calcar-guided short-stem THA (ssTHA) has largely emerged over the last decade, especially in Europe, and today modern calcar-guided short stems are among the most successful primary femoral implants in terms of complications and revision rates as indicated by multiple registry data. The philosophy originally comprised an individualised reconstruction of the hip anatomy by following the calcar of the femoral neck providing bone- and soft-tissue-sparing characteristics. However, as the stem design allows either metaphyseal fixation alone or additional diaphyseal anchoring, depending on the stem alignment and indication, distinct knowledge is required regarding the implantation technique, the broad variation of positioning and fixation and its potential clinical consequences. Aim: To report on and highlight the characteristics of different ways of performing calcar-guided ssTHA as well as to introduce a classification in order to systematically account for the variety of strategies and the respective implications on the type of fixation. Surgical technique: Already when templating preoperatively, surgeons need to weigh up the different fixation types taking into account a number of patient-related factors. Intraoperatively, by individually controlling the level of osteotomy, the intended type of anchorage can be implemented. Intraoperative radiography to confirm the result, is mandatory. Results: Despite numerous options of stem alignment, depending on the patient's anatomy, the bone quality or the indication for operation, a total of 4 categories were identified to characterise different fixation strategies in calcar-guided ssTHA. Conclusions: The classification system should be used for the preoperative determination of the intended type of anchorage. Whenever a short-stem philosophy with metaphyseal fixation (Type I (M)) is possible, it should be pursued. [ABSTRACT FROM AUTHOR]

Copyright of Jerash Journal for Research & Studies is the property of Jerash 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.)

The article studies the fault-tolerant self-timed (ST) counter design problem. Combinational ST circuits have a higher fault tolerance in comparison with synchronous counterparts due to redundant information coding and mandatory acknowledgment of all initiated circuit cells' switch completion. Sequential ST circuits, including counters, are more sensitive to soft errors because a soft error can change a state stored by their memory cells. For their fault-tolerant implementation, special circuitry methods, namely DICE and Quatro, are used. They are similar to the data processing channel duplication, but use transistor cross-connection in the circuit cells. This approach significantly reduces the likelihood of a change in the counter bit's state due to a soft error. The article proposes DICE-type and Quatro-type ST counter cases, compares their features, and resumes recommendations for the fault-tolerant ST counter implementation. [ABSTRACT FROM AUTHOR]

Aims Methods Results Conclusions Recording the indication for a medicine in the prescription supports communication. In May 2023, our district hospitals made the free‐text indication field in prescriptions compulsory for all medicines in the inpatient prescribing system. This study aimed to evaluate the effect of introducing a compulsory indication field in an inpatient prescribing system.Text in the indication field was manually classified as an indication, ‘other text’, ‘rubbish text’, ‘to be determined’ and ‘blank’. Prescribing data were extracted from the district data warehouse. The change in proportion of prescriptions with an indication was compared for 8 weeks after introduction of a compulsory indication field to an equivalent 8 weeks in 2022. Secondary outcomes included medication cessation and indication recording before discharge.We analysed 81 634 prescriptions before and 82 726 after indications were made compulsory. The proportion of prescriptions with an indication increased from 29.2% to 75.6%. ‘Rubbish text’ increased from 0% to 2.3%, ‘other text’ from 2.5% to 14.7%, and ‘to be determined’ from 0.0% to 6.6%. Of 5557 prescriptions with ‘to be determined’ initially, 18.1% were ceased and 2.7% had an indication before discharge.After making the prescription indication field compulsory, the proportion of medicines with an indication increased from 29% to 76%, with only a small increase in ‘rubbish text’. Following the system change, the quality of information recording improved but there was no change in medicine use. Compulsory fields should be combined with improvements in other components of care to improve medicine use. [ABSTRACT FROM AUTHOR]

This studdy dealt with (derivatives in douaa Alahad: a semantic morphologicalstudy) atopic that occupieslarge space in the Arabic language, especially the science of morphology, which is concerned with the structure of the Arabic word in terms of construction and declension, and the changes that occur to it, such as substitution, causative, derivation, and others. We focused on an important topic, which is the derivation, and tried to stand on several issues, the most important of which is highlighting the significant role that the research topic occupies. It is an attempt to provide a glimpse of it in the midst of studies about it and the identification of an important aspect of the Arabic language, which is the topic of derivatives, and their types, forms and how they are derived, through exposure to an important douaa from our immortal heritage, which is douaa Alahad. This topic is of clear importance in languages in general and Arabic in particular, as it constitutes a basic support in the linguistic research on the origins of words and their impact on sentences. [ABSTRACT FROM AUTHOR]

Background/Objectives: This study evaluated the appropriateness of transmucosal immediate-release fentanyl (TIRF) prescriptions in a Madrid emergency room during 2019 and 2022, following a 2018 warning about off-label use. Methods: TIRF prescription in the emergency room search yielded 993 patients in 2019 and 1499 in 2022, of which 140 were randomized for the study, 70 in 2019, and 70 in 2022. Dose appropriateness and indication for TIRF were analyzed according to established criteria. Results: Despite a high prevalence of cancer diagnoses (77.9%, 109/140), only 32.9% (46/140) of patients met the appropriateness criteria pre-hospitalization. This improved to 42.5% (51/120) at discharge, but the change was not statistically significant overall. However, focusing on surviving patients reveals a significant improvement in appropriateness, increasing from 30.83% (37/120) to 42.50% (p = 0.002). This improvement was particularly pronounced in 2022 (p = 0.0269), but not in 2019 (p = 0.0771). Interestingly, appropriateness in patients with prior TIRF prescriptions remained relatively stable from pre-hospitalization (46.75%) to discharge (48.78%). A concerningly high proportion of patients with cancer diagnoses (68.75%) received low-dose opioid therapy (<60 MME) at discharge, and 36.8% of patients over 80 years old were co-prescribed benzodiazepines, contradicting prescribing guidelines. Conclusions: This study found inappropriate TIRF prescriptions were common in an emergency room setting, often due to low pre-hospital opioid doses. While hospitalization improved TIRF appropriateness in survivors, especially in 2022, concerning prescribing practices persisted. This emphasizes the need for better education and interventions to ensure safe and effective TIRF use. [ABSTRACT FROM AUTHOR]

Introduction: Proton pump inhibitors (PPIs) are anti-ulcer drugs that have reportedly been used inappropriately in therapeutic settings, raising the risk of adverse effects, drug interactions, and costs. Aim: This study aimed to evto evaluate the inappropriate use of PPI medication and which category of PPIs frequently was used for patients in Bangladeshi hospitals. Material and Methods: A one month cross-sectional study was carried out in a tertiary care hospital to evaluate the kinds of PPI prescriptions, their appropriateness, and their tendency to be utilized among patients. Results: Among 298 patients interviewed,140 patients used PPIs inappropriately. The most common reasons for inappropriate use included gastric appetite (29.59%, 29 individuals) and nausea. Other reasons included (15%) no clear indication, (20%) gastric discomfort, (13.57%) asthma, and (8.57%) infections. Esomeprazole was the most prescribed PPI, used by 41% of patients, followed by omeprazole at 32%. Nearly 44% of the 140 patients exhibited a strong tendency to use PPIs. Conclusion: Important steps must be taken to ensure that PPIs are used properly, to increase knowledge, and implement educational TV programs that can reduce the risk of drug interactions, side effects, and unnecessary expenses. [ABSTRACT FROM AUTHOR]

Background: More recently approved drugs have significantly fewer indications than drugs approved many years ago. One possible reason for this may be that, controlling for the number of years since approval or launch, more recently approved drugs have fewer indications (e.g. at the time of launch). The role of precision and personalised medicine has increased, and the goal of precision medicine is to provide a more precise approach for the prevention, diagnosis and treatment of disease. Drugs that have fewer indications may be 'more precise' than drugs that have many indications. Methods: We use different kinds of data from two countries – France and the U.S. – to analyze the relationship across many drugs between the number of indications of a drug, the drug's vintage – i.e. the year in which the drug was first marketed or approved – and its age – the number of years it has been marketed. Results: All the evidence from both countries indicates that, controlling for drug age, more recently approved drugs tend to have fewer indications than drugs approved many years ago. In the U.S., a 10-year increase in vintage is associated with a 10.7% decline in the effective number of indications of all drugs, and a 19.4% decline in the effective number of indications of drugs approved after 1989. In France, the positive effect on the number of indications of the increase in drug age was more than offset by the negative effect of the increase in drug vintage. Conclusions: More recently approved drugs are less likely to be 'general-purpose technologies' (or even multi-purpose technologies) than older drugs. The relative importance of 'precision medicine' has increased in recent decades. Drugs that have fewer indications may be 'more precise' than drugs that have many indications. [ABSTRACT FROM AUTHOR]

Background: Proton pump inhibitors (PPIs) are used for various conditions and are generally considered safe drugs; however, there has been a surge in their usage over time, partially related to their safety and overprescription. Purpose: This study is aimed to assess how much the public of Lahore knows about PPI, and how they use it, and if they follow their physician's instructions or not. Methods: A cross-sectional study was planned to attain the objective of the study. Respondents visiting various community pharmacies were inquired about their willingness to participate in this study. Chi-square was used to find the association between sociodemographic parameters and awareness of PPIs. p value less than 0.05 was considered statistically significant. Results: There were mostly university students (73.7%), with 82.2% having heard of PPIs. Prevalent use (86.85%) is observed, often after a medical condition. Notably, 60.1% use PPIs as needed, but only 52.3% complete the prescribed course. PPIs were taken before meals only by 69.3% of participants. Associations exist between having heard of PPIs, and age with younger participants (p < 0.001) exhibiting less awareness. Females also have heard lesser of PPIs (p = 0.011). Education correlates with unawareness (p < 0.001), and many participants are unaware of PPI side effects (51.04%). Conclusion: The study contributes valuable insights to the understanding of PPI usage perspectives, offering implications for healthcare practices and public health awareness campaigns. Overall, the public shows signs of awareness but those are not enough to eliminate the misuse of PPIs in Lahore. [ABSTRACT FROM AUTHOR]

Meaning in literary texts such as poetry and novel etc., is not determined on the basis of a literal understanding of the words in it, but through a total evaluation of the devices such as metaphors and similes. This paper deals with metaphor to show its significance, to make us aware that metaphoric expressions do give a different kind of knowledge, and to pave the way to disclose a different kind of truth which is perhaps, more valuable than what the literal sense provides. Ordinarily metaphorical use is taken for rhetorical purposes. Literalists of the Western and Indian philosophical traditions believe that it is only the literal or primary meaning that can give us a precise account of language. Metaphors are viewed by them as fuzzy, lies, not corresponding to actual states of affairs, non-propositional in character, not having truth-conditions, and thus not providing us with any knowledge or truth. However, this paper tries to work out the fundamentality of metaphor, how metaphor widens our experience of the world, and how it has the power to take us to an alternative world to introduce with some new truth by exploring certain notions of the Indian aestheticians. [ABSTRACT FROM AUTHOR]

Copyright of Psychotherapie Forum is the property of Springer Nature 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.)

Background: Sex-based differences are common among diseases. We aimed to investigate the differences in colonoscopy indications and its findings between males and females. Methods: A large, multi-center, cross-sectional, retrospective study included all colonoscopies performed between 2016 and 2021 in seven endoscopy departments. The indications and findings of the procedures were compared between males and females. Results: A total of 151,411 (52.6%) women and 136,519 (47.4%) men were included, aged 56.54 ± 12.9 years and 56.59 ± 12.7. Cecal intubation was similar (95.6% vs 95.5%, p = 0.251). More females had excellent or good bowel preparation compared to males (71.4% vs 65.6%). Colonoscopy due to abdominal pain, constipation, diarrhea, and anemia was higher in females compared to males (15% vs 9.9%, 3.9% vs 2.2%, and 7.6% vs 4.9%, p < 0.001, respectively), while positive FOBT, rectal bleeding and post-polypectomy surveillance and screening were more common indications among males (9.5% vs 7.8%, 10.7% vs 7.8%, and 10.8% vs 7.1%, respectively). On colonoscopy, males were found to have significantly higher colorectal cancer and polyps (0.5% vs 0.4% and 35.1% vs 24.6%). Polyp detection rates were lower in females across all indications, whereas diverticulosis rates were higher in males. However, a clinically significant difference regarding diverticulosis was observed only in patients with anemia as the indication. Conclusions: Notable differences exist between males and females in terms of the indications and findings on colonoscopy. This highlights the need for identifying the factors contributing to these differences and the developing sex-specific approaches for the diagnosis and management of gastrointestinal diseases. [ABSTRACT FROM AUTHOR]

Background: To analyze the diagnostic efficiency of the four absolute endoscopic submucosal dissection (ESD) indications for lymph node metastasis (LNM) of Chinese patients with early gastric cancer (EGC). Methods: We retrospectively analyzed EGC patients who underwent radical D2 gastrectomy from January 2019 to December 2022. We evaluated the rate of LNM, false-negative rate, and negative predictive value of the four ESD indications. Results: Of enrolled 2722 EGC patients, 388 (14.3%) patients presented LNM. Tumor size > 2 cm, ulceration, submucosal invasion, undifferentiated type, and lymphovascular invasion were independent risk factors of LNM in patients with EGC. 1062 (39%) cases of EGC conformed to the four EDS indications; however, 4% of them had LNM. 451 cases were fully in accord with the fourth ESD indication (undifferentiated intramucosal carcinoma without ulceration and a maximum lesion diameter of ≤ 2 cm), and 35 of them had LNM, with a false-negative rate (FNR) of 9.02% and a negative predictive value (NPV) of 92.24%. There was significant difference among the four indications in terms of the rate of LNM (1.0% vs 1.5% vs 1.3% vs 7.8%, P < 0.001), FNR (1.03% vs 0.52% vs 0.26% vs 9.02%, P < 0.001), and NPV (98.99% vs 98.53% vs 98.75% vs 92.24%, P < 0.001). Conclusion: Overall, the fourth ESD indication was associated with a high rate of LNM compared to the other three indications. Thus, it might not be safe to classify it as an absolute indication in Chinese patients with EGC. [ABSTRACT FROM AUTHOR]

Land users and policy makers recognize importance of soil health and these types of evaluations are welcomed within sustainable land management. The aim of this study was to establish minimum and maximum values of soil health index across the breadth of agricultural used soils of Slovakia. Core objectives included (1) identifying the range of soil health benchmarks; (2) defining benchmarks for different land uses, and (3) defining benchmarks of soil health index for main groups of agricultural soils in Slovakia. These benchmarks represent the first soil health metrics of their kind in Slovakia using data from 266 locations. The soil health index (SHI) approach has been used as a quantitative tool to establish linkage between soil health and soil ecosystem services. We recorded the highest average SHI value in the very warm climatic region of the Slovak Republic, where the majority of agriculturally used arable soils (with an optimal pH value without contamination) are located. The locality with lowest SHI value is in a slightly warm area on soil used as arable soil with a very small depth of humus horizon, with by the pH value in an acidic area, and with a high content of clay. The typical SHI in humus-rich soil groups of Slovakia (Mollic Fluvisols, Chernozems and Cutanhic Luvisols) is higher contrasted with the typical SHI in other soil groups of Slovakia. [ABSTRACT FROM AUTHOR]

Objective To discuss the evaluation basis of the clinical rational use of Dahuang Zhechong Capsule and to establish its rationality evaluation criterion to promote the sensible use of Dahuang Zhechong Capsule. Methods The rationality evaluation criterion for Dahuang Zhechong Capsule was formulated by referring to the package insert, treatment guidelines, and other literature. According to the criterion, 270 outpatient prescriptions using Dahuang Zhechong Capsule in Xiyuan Hospital, China Academy of Chinese Medical Sciences were reviewed from January to June 2020. The indication, usage and dosage, drug combination, and repeated administration were analyzed. The pharmaceutical intervention was performed to address the problems found in the prescription reviews, and 328 outpatient prescriptions using Dahuang Zhechong Capsule in October 2020 were reevaluated. Results The irrational use rate of Dahuang Zhechong Capsule from January to June 2020 was 42. 22% (114 cases), including 108 (40%) cases of inappropriate indications, five (1.85%) cases of improper usage and dosage, and one (0.37%) case of inappropriate administration route. However, the pharmaceutical intervention in October 2020 remarkably reduced the irrational use rate of Dahuang Zhechong Capsule (4.27%, 14 cases), all of which were inappropriate indications. Conclusion Dahuang Zhechong Capsule is being used irrationally ； therefore, establishing an evaluation criterion is required. The specific situation of irrational drug use can be identified by prescription review according to its rationality evaluation criterion to manage its clinical use better and promote its rational use. [ABSTRACT FROM AUTHOR]

Objective: Awake craniotomy (AWC) allows intraoperative evaluation of functions involving the cortical surface and subcortical fibers. In epilepsy surgery, indications for and the role of AWC have not been established because evaluation with intracranial electrodes is considered the gold standard. We report herein our case series of patients who underwent AWC in epilepsy surgery and propose the scenarios for and roles of AWC. Methods: Patients who underwent AWC in epilepsy surgery at our institutions between 2014 and 2023 were included. Information about age, sex, etiology, location of epileptogenicity, seizure type, use of intracranial electrode placement, surgical complications, neurological deficits, additional surgery, and seizure outcomes was reviewed. Following a diagnostic and treatment flow for epilepsy surgery, we clarified three different scenarios and roles for AWC. Results: Ten patients underwent AWC. Three patients underwent AWC after non-invasive evaluations. Two patients underwent AWC after intracranial evaluation with stereotactic electroencephalography (SEEG). Five patients underwent AWC after intracranial evaluation with subdural grid electrodes (SDG). Among these, two patients were initially evaluated with SEEG and with SDG thereafter. One patient reported slight numbness in the hand, and one patient showed slight cognitive decline. Seizure outcomes according to the Engel outcome scale were class 1A in three patients, IIA in two patients, IIIA in four patients, and IVA in one patient. Conclusions: AWC can be used for purposes of epilepsy surgery in different situations, either immediately after non-invasive studies or as an additional invasive step after invasive monitoring with either SEEG or SDG. The application of AWC should be individualized according to each patient's specific characteristics. [ABSTRACT FROM AUTHOR]

Copyright of HNO is the property of Springer Nature 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.)

Abstract Background Fluoroquinolones are the most commonly prescribed antibiotics. Because of their known tendency to drive antimicrobial resistance, their prescribing patterns need to be more restricted. This study aimed to describe the clinical practice of fluoroquinolone prescription, dose adjustments for renal impairment patients and bacterial resistance profiles, eventually providing evidence-based recommendations to optimize antibiotic prescribing practices in the local population. Methods This retrospective, cross-sectional study was conducted at An-Najah National University Hospital in Palestine. The data were collected from admitted patients who were given ciprofloxacin or levofloxacin from July 2021 to June 2023. Data from 692 inpatients across various hospital departments were examined (409 for levofloxacin and 283 for ciprofloxacin). Statistical analysis was performed via IBM SPSS version 23.0 to summarize the demographic, clinical, and epidemiological data. Results The sociodemographic profile revealed diverse age distributions, with 25.4% and 39% older than 50 years for ciprofloxacin and levofloxacin, respectively. Ciprofloxacin was predominantly used in the oncology department (28.2%), with surgical prophylaxis (22.6%) and febrile or afebrile neutropenia (21.1%) being the most common indications. Levofloxacin was predominantly used in the medical ward (45.7%), mainly for lower respiratory tract infection (58.8%) and prophylaxis for bone marrow transplantation (16.5%). Enterococcus and methicillin-resistant Staphylococcus aureus were the most commonly isolated pathogens, with 62.5% of the isolates demonstrating resistance to ciprofloxacin. Moreover, extended-spectrum beta-lactamase-producing Enterobacterales were the most common pathogen isolated, with 33.3% being resistant to levofloxacin. Statistical analysis revealed a significant association between the choice of antibiotic and the approach to therapy. Levofloxacin was significantly more likely than ciprofloxacin to be used as empiric therapy (p

Copyright of Kufa Studies Center Journal is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) 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.)

This paper tackles Husserl's early analysis of alien experience and its relation to the methodological framework of the Logical Investigations (LI). Since intersubjectivity first becomes a central theme for Husserl in his writings of 1905 (Seefeld Blätter), less attention is usually paid to his analysis of our experience of other minds in the LI. In this context, I attempt to highlight both the fundamental insights gained by Husserl in this analysis that will also remain key for his later accounts of empathy, as well as the challenges alien experiences raises for the theoretical framework of LI. I begin by discussing the main relevant traits of the phenomenological project of LI as a preparatory endeavor for the elucidation of logical objectualities, and the radical way in which Husserl defines its domain, i.e., the sphere of immanent content. Then I analyse Husserl's understanding of alien experience in terms of an indicative unity based on associative motivations. I argue that, in doing this, Husserl accounts for a non-inferential intuitive access to other minds and, at the same time, maintains their essential alienness. Finally, I show that this account rests on what I call an "intentional contamination" of Husserl's reductive method of LI. [ABSTRACT FROM AUTHOR]

Copyright of Angle Health Law Review is the property of Angle Publishing Co., Ltd. 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.)

Extracorporeal shock wave therapy is one of the essential conservative treatment methods for musculoskeletal disorders. In Korea, it has been widely used since it was recognized as a non-payment item in 2005. On the other hand, there are still many controversies about the indications for use, and there are few clear standards for this in Korea. Therefore, the authors present guidelines for extracorporeal shock wave therapy by confirming the latest trends through this review and focusing on indications. [ABSTRACT FROM AUTHOR]

Objective: The aim of our study was to examine the factors associated with mortality in patients who underwent percutaneous endoscopic gastrostomy (PEG) and identify biomarkers that may guide clinical practice. Methods: This retrospective observational study included adults who underwent PEG placement in our center. Demographic data, date of PEG placement, inpatient ward, PEG indication, time from admission to PEG placement, post-PEG complications, and outcome (discharge/mortality) were recorded. Logistic regression analysis was performed to identify factors associated with 90-day and 6-month mortality. Results: Of 100 patients included in the study, 52% were men and the median age was 73 years. The most common indication for PEG was malignancy (n=25, 25%). The most common minor complication was minor peristomal bleeding and peristomal infection requiring tube removal The most common major complication was aspiration pneumonia. Thirty-eight patients (38.0%) died within 90 days and 52 patients (52.0%) died within 6 months of PEG placement. The odds of 90-day mortality were 57.5% lower per 1-unit increase in total serum protein level (odds ratio [OR]: 0.425, 95% CI: 0.230-0.888; p=0.021), 1.6% higher per 1-unit increase in serum CRP (OR: 1.016, 95% CI: 1.006-1.027; p=0.003), and 13.6 times higher in patients with aspiration pneumonia (OR: 13.631, 95% CI: 2.997-61.988; p=0.001). For 6-month mortality, a 1-unit increase in serum albumin level was associated with 81.4% lower odds (OR: 0.186, 95% CI; 0.081-0.430; p<0.001) and aspiration pneumonia with 22 times higher odds (OR: 21.984, 95% CI: 2.412-200.342; p=0.006). Conclusion: Aspiration pneumonia, low total serum protein and albumin levels, and high CRP level were associated with higher mortality. [ABSTRACT FROM AUTHOR]

Copyright of Eurasian Journal of Applied Biotechnology is the property of National Center for Biotechnology 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.)

Copyright of Estudios de Derecho is the property of Estudios de Derecho 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.)

Abstract Background The mortality rate associated with open abdominal surgery is a significant concern for patients and healthcare providers. This is particularly worrisome in Africa due to scarce workforce resources and poor early warning systems for detecting physiological deterioration in patients who develop complications. Methods This prospective cohort study aimed to follow patients who underwent emergency or elective abdominal surgery at Lacor Hospital in Uganda. The participants were patients who underwent abdominal surgery at the hospital between April 27th, 2019 and July 07th, 2021. Trained research staff collected data using standardized forms, which included demographic information (age, gender, telephone contact, and location), surgical indications, surgical procedures, preoperative health status, postoperative morbidity and mortality, and length of hospital stay. Results The present study involved 124 patients, mostly male, with an average age of 35 years, who presented with abdominal pain and varying underlying comorbidities. Elective cases constituted 60.2% of the total. The common reasons for emergency and elective surgery were gastroduodenal perforation and cholelithiasis respectively. The complication rate was 17.7%, with surgical site infections being the most frequent. The mortality rate was 7.3%, and several factors such as preoperative hypotension, deranged renal function, postoperative use of vasopressors, and postoperative assisted ventilation were associated with it. Elective and emergency-operated patients showed no significant difference in survival (P-value = 0.41) or length of hospital stay (P-value = 0.17). However, there was a significant difference in morbidity (p

There are two main concerns regarding the hadiths, seen as one of the fundamental source of Islam along with the Holy Quran: Confirmation (subût) and indication (delâlet). While the problem of the confirmation focuses on determining whether the hadiths belong to the Prophet Muhammad, the indication, in this sense, deal with the problems regarding the comprehension of evidence. A holistic approach is extremely very important in understanding the hadith texts correctly. This approach is based on two basic elements. The first is to evaluate all aspects of the narration together, and the second is to collect information about the narrations, called non-textual context. This article aims to introduce the work called "Background Information in the Understanding of Hadiths", which concretely demonstrates that to acknowledge the non-textual context is a prerequisite for correct interpretation in comprehending the hadiths, in throught the narration reported in Sahih al-Bukhari at which the meeting of Abu Sufyan and Heraclius is described, is used as an example. [ABSTRACT FROM AUTHOR]

As the utilization and success of reverse total shoulder arthroplasty (RTSA) have continued to grow, so have its surgical indications. Despite the adoption of RTSA for the treatment of glenohumeral osteoarthritis (GHOA) with an intact rotator cuff and irreparable massive rotator cuff tears (MCTs) without arthritis, the literature remains sparse regarding the differential outcomes after RTSA among these varying indications. Thus, the purpose of this study was to examine the postoperative clinical outcomes of RTSA based on indication. A retrospective review of 2 large institutional databases was performed to identify all patients who underwent RTSA between 2015 and 2019 with minimum 2-year follow-up. Patients were stratified by indication into 3 cohorts: GHOA, rotator cuff tear arthropathy (CTA), and MCT. Baseline demographic characteristics were collected to determine differences between the 3 cohorts. Clinical outcomes were measured preoperatively and postoperatively, including active range of motion, American Shoulder and Elbow Surgeons (ASES) score, Single Assessment Numeric Evaluation score, and visual analog scale pain score. Multivariate linear regression was performed to determine the factors independently predictive of the postoperative ASES score. A total of 625 patients (383 with GHOA, 164 with CTA, and 78 with MCTs) with a mean follow-up period of 33.4 months were included in the analysis. Patients with GHOA had superior ASES scores (85.6 ± 15.7 vs. 76.6 ± 20.8 in CTA cohort [ P <.001] and 75.9 ± 19.9 in MCT cohort [ P <.001]), Single Assessment Numeric Evaluation scores (86 ± 20.9 vs. 76.7 ± 24.1 in CTA cohort [ P <.001] and 74.2 ± 25.3 in MCT cohort [ P <.001]), and visual analog scale pain scores (median [interquartile range], 0.0 [0.0-1.0] vs. 0.0 [0.0-2.0] in CTA cohort [ P <.001] and 0.0 [0.0-2.0] in MCT cohort [ P <.001]) postoperatively. Postoperative active forward elevation (P <.001) and improvement in active external rotation (P <.001) were greatest in the GHOA cohort compared with other indications. Multivariate linear regression demonstrated that the factors independently associated with the postoperative ASES score included a diagnosis of GHOA (β coefficient, 7.557 [ P <.001]), preoperative ASES score (β coefficient, 0.114 [ P =.009]), female sex (β coefficient, −4.476 [ P =.002]), history of surgery (β coefficient, −3.957 [ P =.018]), and postoperative complication (β coefficient, −13.550 [ P <.001]). RTSA for the treatment of GHOA generally has superior patient-reported and functional outcomes when compared with CTA and MCTs without arthritis. Long-term follow-up is needed to identify the lasting implications of such outcome differences. [ABSTRACT FROM AUTHOR]

BACKGROUND: Patient's age is considered to be one of the most relevant factors in selecting surgical candidates for decompressive hemicraniectomy after malignant hemispheric infarction. However, questions about surgical indication in older patients, patients with consciousness disorder or patients with large infarctions remain unanswered. OBJECTIVE: Our aim was to design a multifactorial scoring scale based on a combination of patient-specific factors in order to optimize the assessment of prognosis in patients after hemicraniectomy malignant strokes. METHODS: In this prospective observational study with a one-year follow-up, we assessed clinical and imaging data of patients who underwent decompressive hemicraniectomy due to malignant brain infarction. Barthel index was used as a single outcome measure to distinguish favorable vs. unfavorable outcomes. Associations between multiple variables and clinical outcome were assessed. Subsequently, a design of a predictive scoring system was proposed. RESULTS: Age of the patient, preoperative level of consciousness, midline shift, and volume of infarction showed a significant association with postoperative Barthel index. According to the identified factors, a multifactorial prognostic scoring system was introduced, aimed to distinguish between favorable and unfavorable outcomes. Using ROC analysis, it has achieved an AUC of 0.74 (95%CI 0.58-0.89, p=0.01) CONCLUSIONS: Prediction of postoperative outcome should be based on multiple variables. Our scale, based on the clinical and imaging data, can be used during decision-making to estimate potential benefit of decompressive craniectomy in patients after malignant brain infarction [ABSTRACT FROM AUTHOR]

This study is based on the assumption that each word in the Holy Quran exists in its suitable position, and that it was especially selected for its position, and this idea applies to highly, and rarely occurring words in the Holy Quran.In this papers pursuit to highlight the correctness of this assumption, this study took an analytical inductive methodology, the induction was based on ensuring that a collection of picked words that are assumed to be related to the topic of hypocrisy, are in fact related to that topic, therefore some vocabulary that were not proven to be related to this topic were not considered for this study, and that's by studying the Siraa, Tafseer, and Asbab-al-Nozoul books, and others, the picked words were studied in depth via a proofbased analytical approach. [ABSTRACT FROM AUTHOR]

Purpose: Clinical studies regarding medial open‐wedge high tibial osteotomy (MOWHTO) often analyse a large group of mechanical varus knees rather than differentiating for its primary varus‐inducing component. This study aims to compare the radiological and clinical outcomes of the most prevalent varus malalignment phenotypes using the coronal plane alignment of the knee (CPAK) classification. Methods: MOWHTO cases with minimal 2‐year clinical follow‐up were retrospectively selected from a knee osteotomy database (2016–2020). Based on the medial proximal tibial angle (MPTA) and lateral distal femoral angle (LDFA), subjects were allocated to the correct CPAK phenotype pre‐ and postoperatively. Clinical outcomes were the numeric rating scale (NRS), the knee injury and osteoarthritis outcome score (KOOS) and the therapeutic response rate (TRR) at 2‐year follow‐up. Inter‐observer correlation coefficient (ICC) and unpaired student t test were performed for cross‐phenotype comparison. Results: One hundred thirty‐five (135) subjects were found eligible (53.0 years old ±9.6 [19–77], 72% male, 53% left‐sided). The most prevalent preoperative phenotype was CPAK 1 (n = 70 (52%)) and the postoperative phenotype was CPAK 6 (n = 66 (49%)). All CPAK phenotypes improved significantly relative to baseline but cross‐phenotype comparison yielded no significant differences in clinical outcome. The TRR at 2 years was 67% for CPAK 1, 69% for CPAK 2 and 87% for CPAK 4. The TRR for CPAK 6 was 64% compared with 80% for CPAK 9, which was not significantly different. Conclusion: At 2‐year follow‐up, no clinically significant differences are observed between different CPAK phenotypes. Accurate MOWHTO corrections provide significant clinical improvement even in the femoral‐driven varus knee and the constitutional varus knee dominated by intra‐articular wear. The clinical indication for MOWHTO performance should not be reduced to the medial arthritic varus knee with underlying tibial varus alone. Level of Evidence: Level IV, retrospective comparative study. [ABSTRACT FROM AUTHOR]

Introduction Meningiomas—the most common extra-axial tumors—are benign, slow-growing dural-based lesions that can involve multiple cranial fossae and can progress insidiously for years until coming to clinical attention secondary to compression of adjacent neurovascular structures. For complex, multicompartmental lesions, multistaged surgeries have been increasingly shown to enhance maximal safe resection while minimizing adverse sequela. Here, we systematically review the extant literature to highlight the merits of staged resection. Methods PubMed, Scopus, and Web of Science databases were queried to identify articles reporting resections of intracranial meningiomas using a multistaged approach, and articles were screened for possible inclusion in a systematic process performed by two authors. Results Of 118 identified studies, 36 describing 169 patients (mean age 42.6 ± 21.3 years) met inclusion/exclusion criteria. Petroclival lesions comprised 57% of cases, with the most common indications for a multistaged approach being large size, close approximation of critical neurovascular structures, minimization of brain retraction, identification and ligation of deep vessels feeding the tumor, and resection of residual tumor found on postoperative imaging. Most second-stage surgeries occurred within 3 months of the index surgery. Few complications were reported and multistaged resections appeared to be well tolerated overall. Conclusions Current literature suggests multistaged approaches for meningioma resection are well-tolerated. However, there is insufficient comparative evidence to draw definitive conclusions about its advantages over an unstaged approach. There are similarly insufficient data to generate an evidence-based decision-making framework for when a staged approach should be employed. This highlights the need for collaborative efforts among skull base surgeons to establish an evidentiary to support the use of staged approaches and to outline those indications that merit such an approach. [ABSTRACT FROM AUTHOR]

Background: The "Yasui Classification" categorizes the indication for Kampo medicine into four main types in the medical field where standard treatment of Western medicine exists regardless of the school of Kampo medicine. We aimed to elucidate how Kampo case reports are presented from the viewpoint of the Yasui Classification. Methods: Using the general presentations at the 69th Japan Society for Oriental Medicine (JSOM) Academic Meeting held in Osaka in June 2018, the contents of each abstract were analyzed with the Yasui Classification. Results: There were 289 abstracts. The numbers of included abstracts was 140 (48.4%), and their breakdown was as follows: Type 1: 97, Type 2: 27, Type 3: 12, and Type 4: 4. Therefore, Kampo monotherapy yielded the greatest number of presentations where Western medicine‐refractory cases were treated with Kampo medicine. In Type 2, which is the combination of Kampo and Western medicines, there were various applications of Kampo medicine in clinical fields such as pain control, respiratory, cardiovascular, and psychiatric subspecialties. Furthermore, in Type 3, which is also the combination of Kampo and Western medicines, 7 of 12 presentations were related to the alleviation of the side effects of cancer therapy. Conclusions: Kampo monotherapy is most popularly reported at the Congress of JSOM in various fields of medicine, whereas the concurrent use of Kampo and Western medicines is also reported in a variety of clinical subspecialties. A new horizon of clinical significance for Kampo medicine will be opened with the Yasui Classification. [ABSTRACT FROM AUTHOR]

Copyright of Die Orthopädie is the property of Springer Nature 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.)

Introduction, aim: At present, tooth autotransplantation is considered one of the therapeutic methods for the replacement of lost teeth. In the last 30 years, the method of tooth autotransplantation has been developed and refined and has become a basic knowledge of dental practitioners. The aim of this clinical retrospective study was to examine children and adult patients with tooth autotransplantation and obtain survival and success rates. Another aim was to determine other specifics of autotransplantation in each group with conclusions relevant for clinical practice. Methods: The study population consisted of the patients referred consecutively for tooth autotransplantation to a specialist department between years 2016 and 2021. The specialization of the referring dentist, the suitability and feasibility of the transplantation, and the donor and recipient area of the tooth graft were recorded. In 2022, clinical and radiological evaluation of the autotransplanted teeth was performed. Patients were divided into two groups according to age in time of autotransplantation, namely under 18 years and over 18 years. Results: Overall, 73 patients in the age range of 10-59 years were referred for autotransplantation. The mean age was 21.43 years with a median age of 17 years. Autotransplantation was not recommended in 12 patients. A total of 68 autotransplantations were performed, but at the time of examination, 12 did not meet the minimum 6-month follow up, so they were excluded from the evaluation. A total of 56 autotransplants were evaluated. In the group of children, there were 27 patients aged 10-17 years who underwent autotransplantation of at least one permanent tooth. A total of 34 teeth were transplanted. The evaluation of the transplanted teeth was performed 6-50 months after the transplantation with a mean follow-up time of 24 months. The survival rate was 100% and the success rate was 91%. The adult group consisted of 22 patients aged 18-59 years and a total of 22 teeth were transplanted. The evaluation of the transplanted teeth was performed 6-72 months after transplantation with a mean of 33 months. The survival rate was 95%, the success rate 77%. Conclusion: The use of autograft to replace undeveloped or lost teeth was most often indicated by orthodontists. In the patients under 18 years of age, the premolars are the predominant donor area and recipient area. In patients over 18 years of age, the third molars are the predominant donor area and the mandibular molars the predominant recipient area. Both age groups have high survival and success rates of autograft and this procedure can be considered as a predictable method of tooth replacement.

Abstract Introduction Several studies conducted worldwide revealed the magnitude of early relaparotomy and its outcome among patients undergoing laparotomy. However, there was very little evidence on the magnitude of early relaparotomy and its outcome among patients who underwent laparotomy in Ethiopia, especially in the study area. Objective this study aimed to the assess magnitude of early relaparotomy and its outcome among patients who underwent laparotomy in a Tertiary Hospital in Eastern Ethiopia. Methods A retrospective cross-sectional study was conducted. All patients who underwent laparotomy during the data retrieval period were included. Data were collected using a data abstraction checklist from patients’ medical records. The collected data were entered, cleaned, and analyzed by using SPSS version 23. Descriptives statistics were generated where by continuous variables were summarized into means and standard deviation and categorical variables were summarized as the frequency with proportions. Result The magnitude of relaparotomy was 6.8%. Among 82 patients included in the final analysis, 53 (64.6%) were males and the mean (± SD) age of patients was 33.32 ± 16.63 years. The major indications for relaparotomy were intra-abdominal collection (26.8%) and anastomotic leak (24.4%). Among 82 patients who underwent relaparotomy, 52(63.4%) were developed post relaparotomy complications, and 30(36.6%) patients died. Conclusion The magnitude of early relaparotomy was 6.8%. The magnitude of in-hospital mortality was high in comparison to earlier study findings from developing countries. About three fourth of patients who underwent relaparotomy were developed postoperative complications.

Abstract Purpose To investigate the indications and efficacy of gamma knife radiosurgery (GKRS) as a salvage treatment for recurrent low-and high-grade glioma. Methods This retrospective study of 107 patients with recurrent glioma treated with GKRS between 2009 and 2022, including 68 high-grade glioma (HGG) and 39 low-grade glioma (LGG) cases. The Kaplan-Meier method was used to calculate the overall survival (OS) and progression-free survival (PFS). The log-rank test was used to analyze the multivariate prognosis of the Cox proportional hazards model. Adverse reactions were evaluated according to the Common Terminology Criteria for Adverse Events version 4.03. The prognostic value of main clinical features was estimated, including histopathology, Karnofsky performance status (KPS), recurrence time interval, target location, two or more GKRS, surgery for recurrence, site of recurrence, left or right side of the brain and so on. Results The median follow-up time was 74.5 months. The median OS and PFS were 17.0 months and 5.5 months for all patients. The median OS and PFS were 11.0 months and 5.0 months for HGG, respectively. The median OS and PFS were 49.0 months and 12.0 months for LGG, respectively. Multivariate analysis showed that two or more GKRS, left or right side of the brain and brainstem significantly affected PFS. Meanwhile, the KPS index, two or more GKRS, pathological grade, and brainstem significantly affected OS. Stratified analysis showed that surgery for recurrence significantly affected OS and PFS for LGG. KPS significantly affected OS and PFS for HGG. No serious adverse events were noted post-GKRS. Conclusion GKRS is a safe and effective salvage treatment for recurrent glioma. Moreover, it can be applied after multiple recurrences with tolerable adverse effects.

Abstract Background In the period of the early implant placement, the socket is mainly occupied by provisional matrix (PM). Keratinized epithelium (KE) is critical for primary wound closure. Although both KE and PM are important, the detailed relationship among migrating KE, PM formation and indication of the early implant placement is still unclear. Objective This research aimed to locate a healing stage of KE with highest osteogenic PM formation after tooth extraction, which could be treated as the optimal time point for early implant placement. Material and methods Mice were sacrificed on days 1, 2, 3, 4 and 6 after incisor extraction. Clinical, histological, and immunohistochemical evaluations of the extraction sockets were performed, and statistical analyses were conducted. We then inserted implants into the PM with the greatest bioactivity and observed its osseointegration pattern for 3, 10, 17 and 30 days. Result When KE fusion was reached, sockets were dominated by PM with the greatest expression of osteocalcin (OC, P

Transesophageal Echocardiography (TEE) is an important imaging method for the evaluation of cardiac structure and function, and it holds significant value in the clinical management of cardiovascular diseases. Unlike transthoracic echocardiography (TTE), which is non-invasive, TEE involves semi-invasive intracavity operations, leading to increasing attention to its safety and potential complications. Especially with the increasing demand for TEE applications in clinical practice and the rapid growth in the number of facilities utilizing it, the standardized application and safe operation of TEE technology have become particularly crucial. This article will review the literature and draw upon personal experience to analyze the complications and safety of TEE examinations from a technical perspective.

BackgroundEndobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive technique for biopsy of lung, peri-pulmonary tissue and lymph nodes under real-time ultrasound-guided biopsy. It is used in the diagnosis and/or staging of benign and malignant pulmonary and non-pulmonary diseases. Our study is based on a large sample size, in a diversified population which provides a representative real-world cohort for analysis.MethodsPatients who underwent EBUS-TBNA procedure between September 2019 and August 2022 were included in this retrospective study. For cases diagnosed as benign and unclassified lesions by EBUS-TBNA, the final diagnosis was determined by further invasive surgery or a combination of therapy and clinical follow-up for at least 6 months.ResultsA total of 618 patients were included in the study, including 182 females (29.4%) and 436 males (70.6%). The mean age of all patients was 61.9 ± 10.5 years. These patients were successfully punctured by EBUS-TBNA to obtain pathological results. The pathological diagnosis results of EBUS-TBNA were compared with the final clinical diagnosis results as follows: 133 cases (21.5%) of benign lesions and 485 cases (78.5%) of malignant lesions were finally diagnosed. Among them, the pathological diagnosis was obtained by EBUS-TBNA in 546 patients (88.3%) (464 malignant lesions and 82 benign conditions), while EBUS-TBNA was unable to define diagnosis in 72 patients (11.6%). 20/72 non-diagnostic EBUS-TBNA were true negative. The overall diagnostic sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of EBUS-TBNA were 91.3%, 100%, 100%, 27.8%, and 91.6% [95% confidence interval (CI): 89.1–93.6%], respectively. In this study, only one case had active bleeding without serious complications during the EBUS-TBNA procedure.ConclusionGiven its low invasiveness, high diagnostic accuracy, and safety, EBUS-TBNA is worth promoting in thoracic lesions.