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Reece Callahan posted an update 6 months, 2 weeks ago
To assess whether the combined vaginal-laparoscopic route may reduce the risk of postoperative bladder atony, when compared to an exclusively laparoscopic approach, in patients presenting with deeply infiltrating rectovaginal endometriosis with extensive vaginal infiltration.
Retrospective comparative cohort study using data prospectively recorded in the CIRENDO database.
Academic Tertiary Care Centre.
One hundred and thirty-two consecutive patients who underwent surgery of rectovaginal endometriosis with vaginal infiltration measuring greater than 3cm diameter.
Combined vaginal-laparoscopic versus laparoscopic approach.
Sixty-two patients underwent excision of endometriosis via a combined vaginal-laparoscopic approach (study group, or cases), while 71 patients underwent surgery via an exclusively laparoscopic route (controls). Rates of preoperative cyclical voiding difficulty and sensation of incomplete bladder emptying were comparable between the two groups. Preoperative urodynamic assessment waach, most likely due to a reduced risk of damage to the pelvic splanchnic nerves at the paravaginal level.Factors associating environmental degradation with human health have shown that air pollution is a source of morbi-mortality throughout the world. Unfortunately, hospitals are themselves “silent polluters”. As healthcare professionals, we are the guarantors not only of quality of patient care, but also of proper hospital conduct. The aim of this attempt at clarification is to outline what can be done in the operating theater to reduce the environmental impact of the treatments we administer. Our recommendations will go above and beyond regulatory frameworks and draw upon daily practice concerning waste management, energy consumption, utilization of anesthetic agents and multiple forms of waste. A number of French and international pilot experimentations have been carried out and could strongly contribute to the modification of clinical practices with a societal impact, at a time when ecology has become one of the main preoccupations of our fellow citizens.
Maintenance treatments with fluoropyrimidine alone or combined with bevacizumab after induction chemotherapy are two standard options in first-line metastatic colorectal cancer (mCRC). However, no trial has compared these two maintenance regimens.
BEVAMAINT is a multicenter, open-label, randomized phase III trial comparing fluoropyrimidine alone or plus bevacizumab as maintenance treatment after induction polychemotherapy in mCRC. The primary endpoint is the time-to-treatment failure (TTF), calculated from date of randomization to first radiological progression, death, start of a new chemotherapy regimen (different from induction or maintenance chemotherapy) or end of maintenance treatment without introduction of further chemotherapy. We expect a 2-month TTF improvement from 6 months in the monotherapy arm to 8 months in the combination arm (hazard ratio , 0.75). Based on a two-sided α risk of 5% and a power of 80%, using Schoenfeld method, 379 events are required (planned enrolment, 400 patients). Paiscontinued in the event of unbearable toxicity, progression or patient refusal. After maintenance discontinuation, reintroduction of induction polychemotherapy is recommended; otherwise a second-line treatment is started. The enrolment has begun in January 2020.Inflammatory responses stimulated by Propionibacterium acnes have been shown to be major etiological factors in the pathogenesis of acne. Scutellaria baicalensis, a popular traditional Chinese medicine, has been widely shown to have anti-inflammatory effects. In this study, primary component analysis and primary effective component analysis were conducted. The results showed that wogonin (1.15 mg/g S. baicalensis extract) possessed better anti-acne effects than wogonoside (8.71 mg/g S. baicalensis extract) in inhibiting the up-regulation of IL-1β and IL-8 level caused by P. acnes via inactivation of the MAPK and NF-κB signaling pathways. To enhance the anti-acne effects of S. baicalensis extract, an environmentally friendly and healthy plant fermentation strategy was used to efficiently convert glycoside-type constituents into bioactive aglycone. S. baicalensis extract was fermented by symbiotic fungus Penicillium decumbens f3-1 to transform wogonoside into wogonin with a conversion rate of 91.0% after 4 days. Fermented S. baicalensis extract (FSE) showed higher potential anti-acne effects than non-fermented S. baicalensis extract (NSE) by inhibiting the up-regulation of IL-1β and IL-8. Thus, P. learn more decumbens-fermented S. baicalensis Extract may be used for developing new anti-acne cosmetic ingredients.
E3L is an immediate-early protein of vaccinia virus (VV) that is detected within 0.5 h of infection, potentially before the many immune evasion genes of vaccinia can exert their protective effects. E3L is highly conserved among orthopoxviruses and hence could provide important protective T-cell epitopes that should be retained in any subunit or attenuated vaccine. We have therefore evaluated the immunogenicity of E3L in healthy VV-vaccinated donors.
Peripheral blood mononuclear cells from healthy volunteers (n=13) who had previously received a smallpox vaccine (Dryvax) were activated and expanded using overlapping E3L peptides and their function, specificity and antiviral activity was analyzed. E3L-specific T cells were expanded from 7 of 12 (58.3%) vaccinated healthy donors. Twenty-five percent of these produced CD8+ T-cell responses and 87.5% produced CD4+ T cells. We identified epitopes restricted by HLA-B35 and HLA-DR15.
E3L-specific T cells killed peptide-loaded target cells as well as vaccinia-infected cells, but only CD8+ T cells could prevent the spread of infectious virus in virus inhibition assays. The epitopes recognized by E3L-specific T cells were shared with monkeypox, and although there was a single amino acid change in the variola epitope homolog, it was recognized by vaccinia-specific T-cells.
It might be important to include E3L in any deletion mutant or subunit vaccine and E3L could provide a useful antigen to monitor protective immunity in humans.
It might be important to include E3L in any deletion mutant or subunit vaccine and E3L could provide a useful antigen to monitor protective immunity in humans.
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