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The challenging management of malignant ureteral obstruction:Analysis of a series of 188 cases

Current Urology 2024年第1期18卷 34-42页

作者： Alberto Artiles Medina Inés Laso García Fernando González Tello Sara Álvarez Rodríguez Manuel Hevia Palacios Marina Mata Alcaraz César Mínguez Ojeda Fernando Arias Funez Victoria Gómez dos Santos Francisco Javier Burgos Revilla Department of Urology Hospital Universitario Ramón y CajalMadridSpain Department of Radiology Hospital Universitario Ramón y CajalMadridSpain

Background:Malignant ureteral obstruction(MUO)is a common condition that complicates the course of advanced *** aims of this study are to analyze the causes,management,and survival of patients with obstructive nephropathy due to malignant ureteric obstruction and to determine prognostic ***,we studied the complications and outcomes in patients who underwent urinary *** and methods:A retrospective study was conducted on patients with computed tomography-confirmed MUO between January 2016 and November ***,clinical,radiological,laboratory,and management data were *** curves were estimated using the Kaplan-Meier method,and univariate and multivariate Cox proportional hazards models were used to test the association between parameters and ***:A total of 188 patients were *** mean age was 69.01 years(SD,14.95 years),and the majority(54.8%)were *** most common mechanism leading to MUO was compression by a pelvic mass(36.9%),and the 3 most frequent tumors causing MUO were prostate(17.6%),bladder(16.5%),and rectal cancer(11.7%).Forty-seven patients(25%)underwent urinary diversion:23(48.9%)underwent double-J stenting and 21(44.7%)underwent percutaneous *** most common reason for urinary diversion was acute kidney injury(53.3%).Recovery of renal function was observed in 55.8%of the patients after urinary *** most frequently identified complications after urinary diversion were urinary tract infection(24.4%),hematuria(17.0%),and urinary sepsis(14.9%).The median survival after hydronephrosis diagnosis was 6.43 months(interquartile range,1.91-14.81 months).In patients who underwent urinary decompression,the median survival after urinary diversion was 8.67 months(interquartile range,2.99-17.28 months).In the multivariate analysis,a lower grade of hydronephrosis and cancer cachexia negatively impacted ***:Cancer patients with MUO have a poor pro

关键词： Hydronephrosis Ureteral obstruction Neoplasms Urinary diversion Survival Prognosis

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Sound waves and solutions:Point-of-care ultrasonography for acute kidney injury in cirrhosis

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World Journal of Critical Care Medicine 2024年第2期13卷 83-92页

作者： David Aguirre-Villarreal mario Andrés de Jesús Leal-Villarreal Ignacio García-Juárez Eduardo R Argaiz Abhilash Koratala Departamento de Gastroenterología Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico City 14080Mexico Cardiología Instituto Nacional de Cardiología Ignacio ChávezMexico City 14080Mexico Unidad de Hepatología y Trasplante Departamento de GastroenterologíaInstituto Nacional de Ciencias Medicas y Nutricion Salvador ZubiranMexico City 14080Mexico Departamento de Nefrología y Metabolismo Mineral Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico City 14080Mexico Tecnológico de Monterrey Escuela de Medicina y Ciencias de la SaludMexico City 64710Mexico Department of Nephrology Medical College of WisconsinMilwaukeeWI 53226United States

This article delves into the intricate challenges of acute kidney injury(AKI)in cirrhosis,a condition fraught with high morbidity and *** complexities arise from distinguishing between various causes of AKI,particularly hemodynamic AKI,in cirrhotic patients,who experience hemodynamic changes due to portal *** term"hepatocardiorenal syndrome"is introduced to encapsulate the intricate interplay among the liver,heart,and *** narrative emphasizes the often-overlooked aspect of cardiac function in AKI assessments in cirrhosis,unveiling the prevalence of cirrhotic cardiomyopathy marked by impaired diastolic *** conventional empiric approach involving volume expansion and vasopressors for hepatorenal syndrome is critically analyzed,highlighting potential risks and variable patient *** advocate for a nuanced algorithm for AKI evaluation in cirrhosis,prominently featuring point-of-care ultrasonography(POCUS).POCUS applications encompass assessing fluid tolerance,detecting venous congestion,and evaluating cardiac function.

关键词： Point-of-care ultrasonography Bedside ultrasound Cirrhosis Congestion Acute kidney injury Congestive nephropathy

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Risk Stratification in Obstetrics: An Integrated Approach to Maternal Health

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Open Journal of Obstetrics and Gynecology 2024年第6期14卷 903-910页

作者： Taina Crespo Mendonca Bianca Beatriz Soares dos Reis Júlia Cruz Coelho Antônio de Oliveira Battistini Pestana Vitória Carolina Barreto Negri Alvaro Augusto Trigo Department of Medicine University of Franca Franca Brazil

Introduction: Prenatal care is crucial for maternal and fetal health, highlighting the importance of obstetric risk stratification. This enables personalized care, avoiding unnecessary interventions and reducing costs. Conditions such as first trimester bleeding, spontaneous abortion, gestational trophoblastic disease, and ectopic pregnancy require specific approaches. Early identification of these complications is vital, especially in urgent and emergency obstetric cases, which demand immediate hospital attention. Objective: Comprehensive review of first trimester pathologies and gestational hypertension, focusing on obstetric risks and personalized prenatal management. Methods: Literature review on bleeding and gestational hypertension. Results: The study provides a detailed analysis of pathologies associated with first trimester uterine bleeding and hypertensive disorders, focusing on obstetric risk stratification. The main causes of maternal and fetal mortality are hypertensive disorders, hemorrhages, infections, childbirth complications, and abortion. Spontaneous abortion is common, with different classifications, ranging from threatened to missed abortion. Infected abortion is a severe complication. Brazil has restrictive abortion laws, but many unsafe abortions occur, resulting in high public health costs. Pharmacological treatment with misoprostol is a safe option. Other pathologies include gestational trophoblastic disease, ectopic pregnancy, and placenta previa. Preeclampsia and eclampsia are severe conditions requiring immediate treatment to avoid complications. Conclusion: Early identification and management of obstetric risk factors, such as uterine bleeding, are essential for positive maternal and fetal outcomes. A multidisciplinary approach is fundamental.

关键词： Obstetrics Emergencies Hypertension Pregnancy-Induced Uterine Hemorrhage Pregnancy Trimester First

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Small Cell Neuroendocrine Carcinoma of the Vulva: Case Report and Literature Review

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Open Journal of Obstetrics and Gynecology 2024年第2期14卷 295-300页

作者： Gabriela Françóes Rostirolla Alessandra Guerra Maria Carolina Rey Alt Luiza Tesser Dalla Libera Maria Eduarda Appel Binda Márcia Appel Fernando De Marco dos Santos Department of Obstetrics and Gynecology Caxias do Sul University Caxias do Sul Brazil Department of Pathology UNIVATES Lajeado RS Medical Student Caxias do Sul University Caxias do Sul Brazil Department of Obstetric and Gynecology Federal University of Rio Grande do Sul Porto Alegre Brazil Department of Oncology Surgeon Caxias do Sul University Caxias do Sul Brazil

Background: Neuroendocrine neoplasms are those that develop from a neuroendocrine cell. They most commonly affect the lungs, gastrointestinal tract, and pancreas, being rare conditions in the female genital tract. When present, these neoplasms often manifest with nonspecific signs and symptoms such as pain, itching, swelling, single-focus lesions, bleeding, and enlargement of inguinal lymph nodes, in addition to the presence of progressively enlarging vulvar nodules. Consequently, the diagnostic investigation involves histopathological examination and confirmation through immunohistochemistry. Objective: To present a comprehensive understanding of this rarely studied pathology. The primary objective is to provide valuable insights that could aid in the future development of universally applicable treatment guidelines. Case Presentation: A 57-year-old female, with no prior comorbidities, menopause at 36, who presented with a left vulvar nodule accompanied by intense pain and swelling, later diagnosed with small cell neuroendocrine carcinoma in the vulva. Conclusion: This case report highlights the importance of enhancing our knowledge regarding small cell neuroendocrine carcinoma in the vulva, given its scarcity in medical literature. The information presented here underscores the need for standardized diagnostic and treatment approaches, paving the way for future consensus on managing this uncommon but challenging neoplasm.

关键词： Vulvar Neoplasms Carcinoma Small Cell Carcinoma Neuroendocrine Genital Neoplasms Female Vulvar Diseases

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Species richness and similarity of the flora on four lajedos in Boa Nova, Bahia, Brazil

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Journal of Mountain Science 2023年第6期20卷 1526-1539页

作者： Morgana Maria DO CARMO BARBOSA Anderson FERREIRA PINTO MACHADO Andrea Karla ALMEIDA dos SANTOS Raymundo JoséDE Sá-neto Michele MARTINS CORRêA Graduate Program in Environmental Sciences State University of Southwest BahiaUniversity Campus“Juvino Oliveira”BR 415km 0445700-000ItapetingaBahiaBrazil Secretary of Education of the State of Bahia Military Police College Eraldo TinocoBrasilia Avenue273Kadija45650-120Vitoria da ConquistaBahiaBrazil Mongoyós Herbarium Multidisciplinary Institute in HealthCampus Anísio TeixeiraFederal University of BahiaRua Hormindo Barros58Bairro Candeias45029-094Vitoria da ConquistaBahiaBrazil Department of Natural Sciences State University of Southwest BahiaEstrada do Bem Querers/nBairro Candeias45083-900Vitoria da ConquistaBahiaBrazil

The municipality of Boa Nova,in northeastern Brazil,is in an ecotone zone between the Caatinga and Atlantic Forest phytogeographic *** transition phytophysiognomy is seasonal forest and known locally as mata de cipó.In these phytophysiognomies there are lajedos,which are rock outcrops colonized by vegetation welladapted to extreme microclimatic variation and vegetation diversity is affected by the vegetation types of the surrounding *** to the singularity of these environments and the relevance of floristic studies for conservation,this work aimed to identify the species richness and compare the similarity of the flora on four rock outcrops in Boa *** flora was surveyed during exploratory walks along lajedos between 2016 and *** total,162 species were identified on the Boa Nova *** flora has a composition and structure similar to semiarid outcrops,as well as endemic species that also occur in surrounding *** the proximity,a similarity index revealed there is floristic dissimilarity between the *** new occurrences were recorded for the region,five species are threatened with extinction(Aosa gilgiana,Ficus cyclophylla,Hippeastrum stigmovittatum,Pleroma caatingae and Trixis pruskii),and 43 species are common in anthropogenic *** reinforces the importance of actions to conserve these areas.

关键词： Ecotone Flora Inselberg Rock outcrops Semiarid Similarity

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A Systematic Review of Cannabidiol Effects in Coronary Syndromes: Challenges to Clinical Translation

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Journal of Biosciences and Medicines 2024年第4期12卷 246-263页

作者： mario E. Zuñiga-Ayala Alejandra Meaney-Martínez Alejandro Alcocer-Chauvet Vidal Gonzalez-Coronado Nestor Rubio-Infante Gerardo Garcia-Rivas Department of Cardiology Instituto de Seguridad Social and Trabajadores del Estado (ISSSTE) Hospital Regional Primero de Octubre Mexico City Mexico Department of Interventional Cardiology Instituto de Seguridad Social y Trabajadores del Estado (ISSSTE) Hospital Regional Primero de Octubre Mexico City Mexico Instituto Tecnó logico de Monerrey Escuela de Medicina and Ciencias de la Salud C&#225tedra de Cardiolog&#237a and Medicina Vascular Monterrey Mexico

Background: Myocardial ischemia in addition to other several cardiac syndromes represent a pathological proinflammatory state alongside a complex cellular microenvironment that can be modified by using cannabinoids. Cannabidiol (CBD), a non-psychoactive compound of cannabis has been recently proposed as an immudomodulatory and cardioprotective drug. Objectives: In this systematic review we sought to clarify and summarize the clinical and preclinical evidence of potential benefit of the use of CBD in coronary syndromes. Methods: We conducted a systematic search and review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Review of Animal Data from Experimental Studies (CAMARADES) guidelines, in the electronic database from PubMed, Web of Science and Scopus up to April 2022 using predefined search terms. Pre-specified exclusion and inclusion criteria were considered, finally 11 articles were chosen to be included for this peer review. Results: Currently there are no good-quality clinical trials with the use of CBD in acute or chronic coronary syndromes. A total of 11 preclinical studies where prescreened and 5 demonstrated reproducible positive cardiovascular outcomes on in-vivo models treated with CBD. Mechanisms of CBD cardioprotection observed: 1) reduction in oxidative stress and inflammation, 2) activation of adenosine receptors and 3) increased expression of angiotensin type 2-receptor. Experimental models included ischemia/reperfusion injury, myocardial infarction, arrhythmias, and metabolic syndrome-like conditions. Conclusion: No clinical recommendation can be issued with the current evidence, on the use of CBD in acute and chronic coronary syndromes. Based on preclinical evidence, we considered there is enough evidence to propose the development of well-designed clinical trials that include CBD in the management of coronary syndromes.

关键词： Cannabis Cannabidiol Acute Coronary Syndromes Myocardial Infarction Myocardial Ischemia and Oxidative Stress

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植物提取物在环境应激时对蛋鸡的益处

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国外畜牧学（猪与禽） 2024年第3期44卷 97-99页

作者：孙丹彤(译) 范美红(校) 李红(审) 张涛(图) Mojca Osredkar Mergole Roberto Montanhini neto 不详

气候条件对家禽生产有一定的影响,如高温会降低家禽的生产性能。但有研究证明,在饲料中添加植物提取物会对家禽的生产性能、血液代谢产物及免疫和抗氧化状态有积极影响,从而提高家禽的生产性能。文章阐述了气候应激对家禽的影响以及如... 详细信息

气候条件对家禽生产有一定的影响,如高温会降低家禽的生产性能。但有研究证明,在饲料中添加植物提取物会对家禽的生产性能、血液代谢产物及免疫和抗氧化状态有积极影响,从而提高家禽的生产性能。文章阐述了气候应激对家禽的影响以及如何通过添加植物性饲料添加剂,缓解气候对家禽的应激,以期为蛋鸡生产提供有益帮助。

关键词：植物性饲料添加剂环境应激家禽

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Long chikungunya?An overview to immunopathology of persistent arthralgia

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World Journal of Virology 2024年第2期13卷 48-57页

作者： Jayme Euclydes Picasky Silveira-Freitas Maria Luiza Campagnolo Mariana dos Santos Cortez Fabrício Freire de Melo Ana Carla Zarpelon-Schutz Kádima Nayara Teixeira Campus Toledo Universidade Federal do ParanáToledoParaná85919-899Brazil Instituto Multidisciplinar em Saúde Universidade Federal da BahiaCampus Anísio TeixeiraVitória da ConquistaBahia 45029-094Brazil Programa de Pós-graduação em Biotecnologia PalotinaUniversidade Federal do Paraná-Setor PalotinaParaná85950-000Brazil Programa Multicêntrico de Pós-graduação em Bioquímica e Biologia Molecular PalotinaUniversidade Federal do Paraná-Setor PalotinaParaná85950-000Brazil

Chikungunya fever(CF)is caused by an arbovirus whose manifestations are extremely diverse,and it has evolved with significant severity in recent *** clinical signs triggered by the Chikungunya virus are similar to those of other ***,fever starts abruptly and reaches high levels,followed by severe polyarthralgia and myalgia,as well as an erythematous or petechial maculopapular rash,varying in severity and *** 40%to 60%of affected individuals report persistent arthralgia,which can last from months to *** symptoms of CF mainly represent the tissue tropism of the virus rather than the immunopathogenesis triggered by the host's immune *** main mechanisms associated with arthralgia have been linked to an increase in T helper type 17 cells and a consequent increase in receptor activator of nuclear factor kappa-Βligand and bone *** review suggests that persistent arthralgia results from the presence of viral antigens post-infection and the constant activation of signaling lymphocytic activation molecule family member 7 in synovial macrophages,leading to local infiltration of CD4+T cells,which sustains the inflammatory process in the joints through the secretion of pro-inflammatory *** term"long chikungunya"was used in this review to refer to persistent arthralgia since,due to its manifestation over long periods after the end of the viral infection,this clinical condition seems to be characterized more as a sequel than as a symptom,given that there is no active infection involved.

关键词： Chikungunya Immunopathology Inflammation process Persistent arthralgia Signaling lymphocytic activation molecule family member 7

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海风轻轻吹阿威罗盐色之家

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室内设计与装修 2024年第8期 44-49页

作者： [葡萄牙]Rómulo De Almeida.neto Ivo Tavares Studio(摄影) 西竹(编译) 不详

盐色之家(Salt Color House)位于阿威罗新海岸绿地(Costa Nova do Prado)一个被称为Mira channel的海峡沿岸。由于海水和周围植被的盐度,这个地方的颜色和散发的气味让建筑师回想起过去的时光,唤醒了童年在类似海洋氛围中的居住记忆。... 详细信息

盐色之家(Salt Color House)位于阿威罗新海岸绿地(Costa Nova do Prado)一个被称为Mira channel的海峡沿岸。由于海水和周围植被的盐度,这个地方的颜色和散发的气味让建筑师回想起过去的时光,唤醒了童年在类似海洋氛围中的居住记忆。在构思这个项目的时候,建筑师面临着巨大的挑战。一方面要抱有建筑理性的创造性,同时也要切换使用者的身份去权衡整体的使用需求。

关键词： House 海风轻轻吹建筑师

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Comparison between Care Strategies for Patients with Osteoarthritis of the Hands Based on the Use of Joint Protection, Assistive Technology and Exercises

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Open Journal of Orthopedics 2024年第7期14卷 295-311页

作者： Daniele dos Santos Scarcella Talita Dias da Silva Victoria Yanara Hernandes da Silva Maria Cândida de Miranda Luzo Selma Lancman Marcia Uchoa de Rezende Carlos Bandeira de Mello Monteiro Instituto de Ortopedia e Traumatologia Hospital das Clnicas HCFMUSP Faculdade de Medicina Universidade de So Paulo So Paulo Brazil Programa de Ps-Graduao em Cincias da Reabilitao Faculdade de Medicina Universidade de So Paulo So Paulo Brazil Escola de Artes Cincias e Humanidades Universidade de So Paulo So Paulo Brazil

Background: Osteoarthritis (OA) is a disabling disease that can affect 6% to 12% of the adult population and more than a third of people over 65 years of age. Purpose: To assess whether a group of people with hand osteoarthritis (hOA) who received different types of treatment improved their function after two years of follow-up. Method: The entire sample (n = 97) underwent three follow-up assessments regarding anthropometric parameters of the upper limbs and ability to perform functional activities. Subsequently, the sample was divided into two groups for the intervention periods, called the First Period (n = 73) and the Second Period (n = 24);the First Period kept the same protocol with orientations, and the Second Period went to an intervention with orientation strength exercises and use of orthosis. Findings: In the separate analysis of the three questions of the DASH pain module, no differences were found between the assessment moments for groups of guidelines, treatment, or symptoms. Significant effects were observed for F(2, 162) = 3.5, p = 0.033, η2 = 0.04, and interaction for moments and intervention F(2, 162) = 4.3, p = 0.016, η2 = 0.05. Implications: It can be concluded that only guidance treatment does not benefit patients with hand osteoarthritis. In contrast, guidance, exercise, and orthosis treatment can significantly improve the disease.

关键词： Hand Osteoarthritis Hand Deformities Occupational Therapy

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