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Gleason Staal opublikował 1 rok, 3 miesiące temu
irculation, indicating new conditions that could be combined with, or could enhance, simulated microgravity for further studying the impact of short- or long-term outer space conditions on the retina. BACKGROUND Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder. Previous studies have yielded divergent results on the prevalence of depression and anxiety in HS patients. OBJECTIVE The aim of this meta-analysis was to provide a pooled estimate of the prevalence and odds of depression/anxiety in HS patients. METHODS Search for and extraction of relevant literature without restrictions from five databases (Cochrane Database, EMBASE, PubMed, PsychINFO, Science Direct) were performed. Pooled meta-analyses were made by using random-effects models. RESULTS Meta-analyses of 28 studies of depression in HS and 12 of anxiety showed a prevalence of 21% of depression [17-25] and 12% of anxiety [6; 17] in HS patients, with very wide variations in both cases. Analysis of case-control studies showed an association between depression and HS (OR 1.99 [1.63; 2.43]) and between anxiety and HS (OR 1.97 [1.65; 2.35]). LIMITATIONS The results of this meta-analysis are conditioned by the limitations of the studies included and by differences in patient population, methodological approach and data available. CONCLUSION Patients with HS have a high burden of depression and anxiety. Our results show that clinicians need to be vigilant to the presence of depression or anxiety and to refer patients when appropriate. Fractional flow reserve (FFR) provides an objective measurement of the severity of ischemia caused by coronary stenoses in downstream myocardial regions. Data from the interventional cardiology realm have suggested benefits of a FFR-guided percutaneous coronary intervention (PCI) strategy. Limited evidence is available on the use of FFR to guide coronary artery bypass grafting (CABG). The most recent data have shown that FFR might simplify CABG procedures and optimize patency of arterial grafts without any clear impact on clinical outcomes. The aim of this review was to summarize the available data on FFR-based CABG and discuss the rationale and potential consequences of a switch toward FFR-based surgical revascularization strategy. The allele frequency dependence of the ranges of all measures of linkage disequilibrium is well-known. The maximum values of commonly used parameters such as r2 and D vary depending on the allele frequencies at each locus. However, though this phenomenon is recognized and accounted for in many studies, the comprehensive mathematical framework underlying the limits of linkage disequilibrium measures at various frequency combinations is often heuristic or empirical. Here, it is demonstrated that underlying this behavior is the fundamental shift between linear and nonlinear dependence in the linkage disequilibrium structure between loci. The proportion of linear and nonlinear dependence can be estimated and it demonstrates how even the same values of r2 can have different implications for the nature of the overall dependence. One result of this is the value of D’, when defined as only a positive number, has a minimum value of |r|. Understanding this dependence is crucial to making correct inferences about the relationships between two loci in linkage disequilibrium. BACKGROUND Erectile dysfunction (ED) has been proposed as an early indicator for future coronary and peripheral vascular disease. AIM We aimed to investigate the longitudinal change in proportion and predictors for ED with changes in erectile function domain (EFD) of the International Index of Erectile Function-15 (IIEF-15) in patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PPCI). METHODS Between December 2018 and June 2019, 286 male patients aged between 40 and 70 years who were treated with PPCI for STEMI were included. The patients were asked to complete the IIEF-EFD form 3 days after the procedure for the evaluation of baseline erectile functions. During follow-up 3 months after the index procedure, the patients were asked to refill the IIEF-EFD form. Both baseline and third-month IIEF-EFD scores were calculated, and the patients were classified into ED severity groups as per the IIEF-EFD scores. A linear mixed model was used to id investigating the predictor variables for the development of ED after coronary artery disease treatment. The limitations include the lack of evaluation of anxiety and depression and the measurements of testosterone levels. CONCLUSION The prevalence of ED was high among patients with coronary artery disease, and the frequency of ED increased during 3-month follow-up. Advanced age, three-vessel disease, and diabetes were significant predictors of ED with changes in IIEF-EFD score in patients with STEMI who underwent PPCI. Karabay E, Karsiyakali N, Cinier G, et al. Change in Frequency and Predictors of Erectile Dysfunction With Changes in the International Index of Erectile Function-Erectile Function Domain Score in Patients With ST-Elevation Myocardial Infarction A Prospective, Longitudinal Study. J Sex Med 2020;XXXXX-XXX. INTRODUCTION Recommendations for the management of patients with gynecological cancer during the COVID-19 pandemic period. MATERIAL AND METHOD Recommendations based on the consensus conference model. RESULTS In the case of a COVID-19 positive patient, surgical management should be postponed for at least 15 days. For cervical cancer, the place of surgery must be re-evaluated in relation to radiotherapy and Radio-Chemotherapy-Concomitant and the value of lymph node staging surgeries must be reviewed on a case-by-case basis. For advanced ovarian cancers, neo-adjuvant chemotherapy should be favored even if primary cytoreduction surgery could be envisaged. It is lawful not to offer hyperthermic intraperitoneal chemotherapy during a COVID-19 pandemic. In the case of patients who must undergo interval surgery, it is possible to continue the chemotherapy and to offer surgery after 6 cycles of chemotherapy. For early stage endometrial cancer, in case of low and intermediate preoperative ESMO risk, hysterectomy with bilateral annexectomy associated with a sentinel lymph node procedure should be favored. It is possible to consider postponing surgery for 1 to 2 months in low-risk endometrial cancers (FIGO Ia stage on MRI and grade 1-2 endometrioid cancer on endometrial biopsy). For high ESMO risk, it ispossible to favor the MSKCC algorithm (combining PET-CT and sentinel lymph node biopsy) in order to omit pelvic and lumbar-aortic lymphadenectomies. CONCLUSION During COVID-19 pandemic, patients suffering from cancer should not lose life chance, while limiting the risks associated with the virus. BACKGROUND The main side effect of long-term laparoscopic sleeve gastrectomy is the onset of severe gastroesophageal reflux disease (GERD). OBJECTIVES The aim of this study was to evaluate the effectiveness of gastric bypass conversion in controlling postsleeve GERD. SETTING University Hospital and Private Hospital, France and Private Hospital, Italy. METHODS This retrospective multicenter study included patients who underwent laparoscopic sleeve gastrectomy and suffered from postoperative GERD, who did not respond to medical treatment and were converted to laparoscopic Roux-en-Y gastric bypass. The study involved 2 French university hospitals, 4 French private centers, and an Italian public hospital. RESULTS A total of 80 patients were reviewed. Treatment of a hiatal hernia was performed during laparoscopic sleeve gastrectomy in 3 patients, while 19 patients were operated for hiatal hernia during conversion to bypass (P = .0004). Six months after surgery, 23 of 80 patients maintained reflux symptomatology with a daily frequency, for which continued proton pump inhibitor treatment was required. The persistence of GERD was significantly more frequent among patients with previous gastric banding (n = 19) compared with patients with no history of gastric banding (n = 4, P = .02). In other words, the likelihood of having poor clinical success from conversion of the sleeve to bypass because of intractable GERD was 3 times higher if the patient had a history of gastric banding (relative risk = 2.89, odds ratio = 3.69). CONCLUSION The results of this study show that, despite the conversion, the symptomatology of GERD does not always disappear, especially in patients with previous gastric banding. Autoinflammatory diseases comprise a wide range of syndromes caused by dysregulation of the innate immune response. They are difficult to diagnose due to their phenotypic heterogeneity and variable expressivity. Thus, the genetic origin of the disease remains undetermined for an important proportion of patients. We aim to identify causal genetic variants in patients with suspected autoinflammatory disease and to test the advantages and limitations of the clinical exome gene panels for molecular diagnosis. Twenty-two unrelated patients with clinical features of autoinflammatory diseases were analyzed using clinical exome sequencing (~4800 genes), followed by bioinformatic analyses to detect likely pathogenic variants. By integrating genetic and clinical information, we found a likely causative heterozygous genetic variant in NFKBIA (p.D31N) in a North-African patient with a clinical picture resembling the deficiency of interleukin-1 receptor antagonist, and a heterozygous variant in DNASE2 (p.G322D) in a Spanish patient with a suspected lupus-like monogenic disorder. We also found variants likely to increase the susceptibility to autoinflammatory diseases in three additional Spanish patients one with an initial diagnosis of juvenile idiopathic arthritis who carries two heterozygous UNC13D variants (p.R727Q and p.A59T), and two with early-onset inflammatory bowel disease harbouring NOD2 variants (p.L221R and p.A728V respectively). Our results show a similar proportion of molecular diagnosis to other studies using whole exome or targeted resequencing in primary immunodeficiencies. Thus, despite its main limitation of not including all candidate genes, clinical exome targeted sequencing can be an appropriate approach to detect likely causative variants in autoinflammatory diseases. PURPOSE Several sentinel phase III randomized trials have recently been published challenging traditional radiation therapy (RT) practices for small cell lung cancer (SCLC). This American Society for Radiation Oncology guideline reviews the evidence for thoracic RT and prophylactic cranial irradiation (PCI) for both limited-stage (LS) and extensive-stage (ES) SCLC. METHODS The American Society for Radiation Oncology convened a task force to address 4 key questions focused on indications, dose fractionation, techniques and timing of thoracic RT for LS-SCLC, the role of stereotactic body radiation therapy (SBRT) compared with conventional RT in stage I or II node negative SCLC, PCI for LS-SCLC and ES-SCLC, and thoracic consolidation for ES-SCLC. Recommendations were based on a systematic literature review and created using a consensus-building methodology and system for grading evidence quality and recommendation strength. RESULTS The task force strongly recommends definitive thoracic RT administered once or twice daily early in the course of treatment for LS-SCLC.


