Breast sparing mastectomy to get a large phyllodes cancer an incident report

Anterior cruciate ligament reconstruction is the preferred treatment to anterior cruciate ligament injury. With the increase in anterior cruciate ligament injuries in both adults and skeletally immature patients comes the need for individualized anterior cruciate ligament reconstruction graft selection whether it is the type of graft (auto vs. allograft) or the harvesting site (hamstrings, iliotibial band, quadriceps, patella). Several factors need to be considered preoperatively in order to optimize the patients' recovery and restore anterior cruciate ligament strength and function. These include age and bone maturity, preoperative knee flexor/extensor strength, sport participation, patient's needs and anatomical characteristics. This paper aims at bringing evidence supporting the use of a personalized approach in graft selection for faster and more efficient return to sport and propose a theoretical framework to support the approach.In Portugal, there is no gold standard test to assess acute stroke patients in the hospital context. However, cognitive deficits are common after a stroke episode and are followed by a negative impact on a patient's quality of life and rehabilitation. Here, we first aimed to adapt the Oxford Cognitive Screening to European Portuguese speakers (OCS-Pt), develop normative data cut-offs, and report the psychometric properties of the OCS-Pt. The second aim was to test the incidence of impairments in acute stroke patients. We tested 137 healthy participants aged between 25 and 92 years old, and we report normative cut-offs based on the 5th and 95th percentile, and on the patterns for age and education level. Our results are similar to other European OCS versions, and results using convergent and divergent validity show satisfactory values ranged between moderate to high. Additionally, 146 acute stroke patients, in the first week after the stroke episode, performed the OCS-Pt. Results show that this is an inclusive test and allows to discriminate between impaired and preserved functions. In conclusion, OCS-Pt is a promising cognitive screening tool to assess acute stroke survivors to be used in stroke care in Portugal.
COVID-19 infection is associated with peripheral neuropathy. However, subclinical neurological involvement may occur anytime, and diagnostic methods that reveal this subclinical involvement are not well established. We aimed to assess the subclinical neurological involvement by visual evoked potential (VEP) measurements and nerve conduction studies (NCS) and explore the relationship between neurological electrophysiological findings and the severity of COVID-19 infection.
Seventy-six patients recovered from COVID-19 infection, and 44 healthy controls were enrolled in the study. Patients were assessed for clinical and demographic parameters. NCS and VEP analyses were performed to detect any peripheral neuropathy or optic neuropathy in both groups.
None of the COVID-19 patients had electrophysiological evidence of peripheral neuropathy. However, patients with COVID-19 pneumonia had significant abnormalities in several peripheral nerve measurements compared to patients without pneumonia. Although P100 parac neuropathy whether it has distinct clinical features and disease course.
Freezing of gait (FOG) is a disabling motor symptom occurring mainly in the advanced stage of Parkinson's disease (PD).
This review outlines the clinical manifestation of FOG and its relationship with levodopa treatment, the differential diagnosis with respect to other neurodegenerative and secondary forms and the available treatment.
We report the proposed models explaining the FOG phenomenon and summarize the available knowledge on FOG etiology's potential genetic contribution. A complete understanding of the mechanisms underlying FOG in PD is essential to find the best therapy. Different treatment options exist but are still not entirely successful, and often a combination of approaches is needed.
Further studies focusing on the potential genetic role in FOG may increase the knowledge on the FOG etiology and pathophysiology, allowing further individualized treatment strategies for this very disabling phenomenon.
Further studies focusing on the potential genetic role in FOG may increase the knowledge on the FOG etiology and pathophysiology, allowing further individualized treatment strategies for this very disabling phenomenon.Fibromyalgia (FM) is a condition characterized by chronic widespread pain whose pathogenesis is still not fully defined. Evidence based on structural and functional neuroimaging methods, electrophysiological, and morphological - skin biopsy - features demonstrated a central and peripheral nervous system involvement. A dysfunction in nociceptive inputs processing at the central level was highlighted as the primary cause of FM, but other data coming from different laboratories contributed to emphasize again the peripheral origin of FM. In fact, small fibers neuropathy (SFN) was observed in a large number of patients submitted to skin biopsy. The complex interaction between central and peripheral factors is opening a new scenario about the management of this neurological disorder. Whether proximal SFN is an initiating event leading to FM or is the consequence of stress-related insular hyper excitability remains unclear. Mild sufferance of peripheral afferents could function as a trigger for an exaggerated response of the so-called "salience matrix" in predisposed individuals. On the other side, the intriguing hypothesis rising from animal models could indicate that the cortical hyper function could cause peripheral small afferent damage. The research should go on the genetic origin of such peripheral and central abnormalities, the acquired facilitating factors, and the presence of different phenotypes in order to search for efficacious treatments, which are still lacking.Immunoglobulin G4-related disease (IgG4-RD) is a fibroinflammatory condition of unknown etiology. Although the salivary glands are currently considered among the most commonly affected among them, oral and maxillofacial surgeons are generally not familiar with the condition. Enlargement of the major salivary glands may be the first identifiable sign of IgG4-RD. A salivary gland biopsy along with IgG4 serum level assessment may help differentiate IgG4-related sialadenitis (IgG4-RS) from malignancies, infectious diseases, and obstructive conditions. Greater knowledge and higher levels of awareness of IgG4-RS may contribute to the expansion of differential diagnostic and treatment approaches. This case report describes a patient with bilateral submandibular salivary gland swelling who was diagnosed as having IgG4-RS on the basis of the histopathologic findings of a submandibular salivary gland biopsy and subsequent IgG4 levels.
The aim of this study was to find out whether the vascular architecture of untreated macular neovascularisations (MNV) in neovascular age-related macular degeneration (nAMD) as visualised with optic coherence tomography angiography (OCTA) is associated with functional and known morphological alterations of the retina in optic coherence tomography (SD-OCT).
The study design was retrospective with consecutive patient inclusion. In 107 patients with newly diagnosed nAMD, MNV were detected by means of OCTA and automated quantitative vascular analysis was performed. The MNV characteristics measured were area, flow density, total vascular length (sumL), density of vascular nodes (numN), fractal dimension (FD) and average vascular width (avgW). These parameters were assessed for associations with vision (BCVA), central retinal thickness (CRT), fluid distribution, the elevation of any pigment epithelial detachment (PED), the occurrence of subretinal haemorrhage and atrophy.
BCVA was significantly worse with gretail. Differences in vascular morphology are associated with certain secondary changes in retinal morphology. There are thus grounds for optimism that further research may identify and classify OCTA-based markers to permit more individualised treatment of nAMD.
To assess the long-term clinical outcomes and identify factors predicting success of endoscopic treatment for symptomatic vesicoureteral reflux (VUR) after kidney transplantation.
A retrospective chart review of all patients who had a symptomatic VUR after renal transplantation at our centre between January 2000 and December 2020 was performed. VUR was documented by retrograde cystography and was determined by at least one episode of acute graft pyelonephritis (AGPN). Endoscopic injections of polydimethylsiloxane (MacroPlastique
) or dextranomer/hyaluronic acid copolymer (Deflux
) were performed by expert urologists via rigid cystoscopy with a bevelled needle system. The results of endoscopic treatment were evaluated by cystography at three months. The primary endpoint was clinical efficacy as defined by the absence of AGPN during follow-up. Radiological success was defined by the absence of VUR at the three months follow-up cystography.
Out of 2135 kidney transplantations, a total of 117 (5.5%) patients had symptomatic VUR 100 (85.5%) underwent Deflux
and 17 (14.5%) MacroPlastique
. selleck chemicals llc Preoperative high-grade VUR was recorded in 71% of patients. One postoperative complication was observed, Clavien > II. After a median follow-up of 11.2years (IQR 6.5-14.4), clinical success was achieved in 73 patients (62.4%). Radiological success was obtained in 42 patients (36%). Multivariable analysis failed to identify predictors of endoscopic treatment success, which was independent of the preoperative grade of VUR and the type of bulking agent used.
Endoscopic treatment of VUR is a simple and well-tolerated procedure with long-term clinical efficacy.
Endoscopic treatment of VUR is a simple and well-tolerated procedure with long-term clinical efficacy.This study was carried out to investigate the effects of methanolic extract of nettle (Urtica dioica) on growth, reproduction, biochemical and immunological parameters of female convict cichlid (Amatitlania nigrofasciata). For this purpose, 54 fish were distributed in 3 treatments included without supplementation (control), 0.1 g (NE0.1), and 0.5 g (NE0.5) nettle extract per kilogram feed over 56 days. The highest final weight (4.2 ± 0.1 g), weight gain (2.8 ± 0.1 g), and specific growth rate (2.0 ± 0.0% day-1) were recorded in NE0.1 group. Higher and lower feed conversion ratio were obtained in control and NE0.1 treatments, respectively. Hepatosomatic and viscerosomatic indices in NE0.1 treatment were significantly lower compared with control treatment. Fish fed NE0.1 showed significantly lower glucose (55.2 ± 6.5 mg g-1), cholesterol (28.4 ± 3.3 mg g-1), and triglyceride (211.5 ± 39.0 mg g-1) levels. Total protein (36.3 ± 3.4 mg g-1) and albumin (2.7 ± 0.1 mg g-1) showed a marked increase in NE0.1 treatment. Same trend was observed in C3, C4, and IgM concentrations. NE0.1 showed the highest number of eggs per female (183.7 ± 10.2), hatching rate (97 ± 0.7%), and larval survival rate at 3 days post hatch (86.3 ± 0.6%) compared with the other treatments. These findings indicated that 0.1 g methanolic extract of nettle kg feed-1 could enhance growth, improve metabolic, and immune function of convict cichlid. Moreover, this study confirmed that appropriate dose of nettle can positively promote reproductive performance which makes it as a valuable and cost-effective herb in aquaculture industry.