• Penn Moser posted an update 6 months, 1 week ago

    In this study, a major challenge identified was the deficit of law enforcement in the criminal justice system as to the detection and investigation of a crime involving child victims. On the other hand, the initiatives to introduce child protection units and child-friendly police stations, provision of support and assistance, and awareness-raising about child-friendly practices among the criminal justice system are the major prospects that have been taken place within the criminal justice system.

    Small cell carcinoma of ovary (SCCO) is extremely rare. Two types of SCCO are recognized, the pulmonary type (SCCOPT) and the hypercalcemic type (SCCOHT). Establishing an accurate diagnosis is challenging, owing to its rarity and paucity of data describing the distinctive histopathologic and immunohistochemical (IHC) features.

    This was a retrospective study conducted over a period of 4 years. All cases reported as SCCO on histopathology were retrieved. All the available clinical, histopathological, and IHC features were studied in detail.

    A total of 7 cases of SCCO were diagnosed during the study period. There were 4 cases of SCCOPT and 3 cases of SCCOHT and with mean age of 57.25 and 22 years, respectively. All the cases presented as stage IV disease. Among the SCCOPT cases, 3 showed bilateral involvement with 1 showing concurrent uterine endometrioid adenocarcinoma. Microscopy revealed small hyperchromatic cells with brisk mitosis and multifocal necrosis. On IHC, these were consistently positive for chromogranin, CD56, and synaptophysin. All the SCCOHT cases showed unilateral involvement. Microscopically, in addition to small hyperchromatic cells, larger “rhabdoid” tumor cells were also seen. On IHC, chromogranin was negative, with positivity for vimentin and epithelial membrane antigen. Apoptosis inhibitor The expression of SMARCA4/BRG1 was lost while SMARCB1/INI1 was retained in all cases. All of these patients developed recurrence and died due to disease progression despite treatment.

    SCCO is an extremely infrequent ovarian malignancy with poor prognosis. Knowledge about its characteristic features is important for accurate tissue diagnosis and appropriate management.

    SCCO is an extremely infrequent ovarian malignancy with poor prognosis. Knowledge about its characteristic features is important for accurate tissue diagnosis and appropriate management.

    Patients with bilateral aural atresia often exhibit poor sound localisation due to bone conduction (BC) features. However, most patients using cartilage conduction (CC) hearing aids reported improvement of sound localisation.

    CC hearing aids were fitted binaurally. Subsequently, sound localisation was evaluated in three conditions unaided, aided with previously used hearing aids (air conduction or BC hearing aids), and aided with CC hearing aids. Ears were evaluated with eight loudspeakers positioned in a full-circle at 45-degree interval. Loudspeakers were classified into left and right by midline and front and back by horizontal line. The abilities to distinguish left from right and front from back were compared among three conditions.

    Thirteen patients with bilateral aural atresia participated.

    The ability to distinguish sounds originating from left or right for participants aided with CC hearing aids was significantly better than that for other conditions (

     < 0.05). For distinguishing sounds originating from front or back, unaided ears were significantly better than ears aided with CC hearing aids (

     < 0.05).

    CC hearing aids provide the ability to distinguish left from right in patients with bilateral aural atresia.

    CC hearing aids provide the ability to distinguish left from right in patients with bilateral aural atresia.

    Coronary artery disease (CAD) commonly coexists with atrial fibrillation (AF), requiring oral anticoagulation (OAC) in a significant subset of patients. These patients also often require revascularization with percutaneous coronary intervention (PCI), which traditionally is supported with dual antiplatelet therapy (DAPT) to prevent complications including stent thrombosis (ST). Recent clinical studies have demonstrated that dual therapy (DAT, i.e. OAC plus single P2Y

    inhibitor) has a more favorable safety profile than triple antithrombotic therapy (TAT). As none of these trials were sufficiently powered for evaluating ischemic outcomes, some concerns remain regarding ischemic complications, in particular ST, a catastrophic complication of PCI.

    In this narrative review, we summarize and critically evaluate current data on the efficacy and the safety of DAT vs TAT in AF patients undergoing PCI particularly focusing on their implication in ST.

    The choice of antithrombotic strategy in this context is challenging and requires tailored decision making with careful consideration of bleeding, thrombotic and ischemic risk for each patient. As the risk of thrombosis and bleeding varies from patient to patient, care is moving away from a ‘one size fits all’ therapy approach toward more individualized antithrombotic treatment.

    The choice of antithrombotic strategy in this context is challenging and requires tailored decision making with careful consideration of bleeding, thrombotic and ischemic risk for each patient. As the risk of thrombosis and bleeding varies from patient to patient, care is moving away from a ‘one size fits all’ therapy approach toward more individualized antithrombotic treatment.

    The increasing global prevalence of the symptoms of constipation adversely affects the quality of life (QOL) of symptomatic patients. An acceptable universal definition of constipation does not exist and a detailed history taking form each patient with various complaints including stool consistency, sensing of incomplete evacuation or a manual need to assist evacuation is required. Complexity of obtaining etiologic diagnosis and the wide range of therapeutic options can mislead physicians in choosing correct treatment.

    This review, considers the pathophysiology of constipation and the diagnostic approach to identify the etiology of constipation. Available interventions including non-pharmacological, pharmacological, and invasive methods such as acupuncture and surgical management are discussed. This review utilized on PubMed, Google Scholar, Scopus, and clinicaltrials.gov to search for studies and reviews published between 2000 and 2020.

    Constipation necessitates careful considerations to detect the exact pathophysiology.

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