ARE/Nrf2 Transcription System Involved in Carotenoid, Polyphenol, and Estradiol Protection from Rotenone-Induced Mitochondrial Oxidative Stress in Dermal Fibroblasts.

Skin aging is associated with the increased production of mitochondrial reactive oxygen species (mtROS) due to mitochondrial dysfunction, and various phytonutrients and estrogens have been shown to improve skin health. Thus, the aim of the current study was to examine damage to dermal fibroblasts by chemically induced mitochondrial dysfunction and to study the mechanism of the protective effects of carotenoids, polyphenols, and estradiol. Rotenone, a Complex I inhibitor, caused mitochondrial dysfunction in human dermal fibroblasts, substantially reducing respiration and ATP levels, followed by increased mitochondrial and cytosolic ROS, which resulted in apoptotic cell death, an increased number of senescent cells, increased matrix metalloproteinase-1 (MMP1) secretion, and decreased collagen secretion.

Retrograde intrarenal surgery for lower pole stones utilizing stone displacement technique yields excellent results.

Objective: To evaluate the long-term stone-free rate (SFR) of retrograde intra-renal surgery (RIRS) in the treatment of lower pole renal calculi using only basket relocation and identify independent predictors of stone-free status.

Methods: All consecutive patients undergoing RIRS lower pole renal calculi at a single high-volume tertiary center were analyzed retrospectively. Lower pole stones were relocated to the upper pole, where laser lithotripsy was performed.

Post-operative pain following percutaneous nephrolithotripsy- clinical correlates.

Objectives: Management of postoperative pain following percutaneous nephrolithotripsy (PCNL) is a significant goal. We sought to identify risk factors and clinical correlates of postoperative pain in order to improve perioperative management and patient satisfaction.

Materials And Methods: A single-center, retrospective analysis, from a prospectively maintained database, of all consecutive patients who underwent PCNL for renal calculi between January 2011 and August 2018.

A non-invasive direct nose to brain drug delivery platform vs. invasive brain delivery approach: patient-centered care impact analysis.

Current literature lacks structured methodologies for analyzing medical technologies' impact from the patient-centered care perspective. This study introduces, applies and validates 'Patient-Centered Care Impact Analysis' (PCIA) as a method for identifying patient-centered care associated demands and expectations for a particular technology and assessing its compliance with these demands. PCIA involves five stages: (1) demand identification, (2) ranking demands' impact magnitude, (3) scoring demand compliance (DC), (4) demand priority (DP) assignment based on impact magnitude and compliance, (5) generating a summative impact priority number (IPN).

The Protective Effect of Carotenoids, Polyphenols, and Estradiol on Dermal Fibroblasts under Oxidative Stress.

Skin ageing is influenced by several factors including environmental exposure and hormonal changes. Reactive oxygen species (ROS), which mediate many of the effects of these factors, induce inflammatory processes in the skin and increase the production of matrix metalloproteinases (MMPs) in dermal fibroblasts, which leads to collagen degradation. Several studies have shown the protective role of estrogens and a diet rich in fruits and vegetables on skin physiology.

Endoscopic Management of Low-Grade Upper Tract Urothelial Carcinoma: Characterizing the Long-term Burden of Care in Comparison to Radical Nephroureterectomy.

Objective: To compare procedure burden, oncologic, surgical and renal-function outcomes between patients with low-grade upper urothelial cancer (UTUC) who were referred for either radical management (RM) or kidney-sparing endoscopic management (EM).

Patients And Methods: We retrospectively reviewed data of all patients treated for UTUC at our tertiary medical center between 2000 and 2018 and selected patients diagnosed with unilateral low-grade UTUC.

Results: Twenty-four patients were treated with EM and 37 with RM.

Improving STEMI management in the emergency department: Examining the role of minority groups and sociodemographic characteristics.

Objective: To evaluate whether a fast-track intervention program will reduce time-lags of patients with STEMI considering minority groups, various socioeconomic status (SES) and clinical risk factors.

Methods: A retrospective-archive study was conducted according to clinical guidelines, comparing all STEMI patients (n = 140) admitted to the emergency department (ED) before (n = 60) and during (n = 80) implementation of the fast track intervention program. The program comprised four steps: (1) immediate bed rest, (2) marking patient chart, (3) assessing time-lags according to defined clinical guidelines, and (4) physician signing a dedicated sticker on the ECG.

Uroflowmetry Before and After Meatotomy in Boys with Symptomatic Meatal Stenosis Following Neonatal Circumcision - A Long-term Prospective Study.

Objective: To assess uroflowmetry in the long-term follow-up of symptomatic meatal stenosis patients prior to and following meatotomy. Severity of symptoms and treatment success has been defined by patient history, physical examination, and witnessed voiding. Uroflowmetry might add objective parameters for the assessment, however long-term data are lacking.

Emergency department mortality: Fair and square.

Objective: This study explored the therapeutic approaches used for end-of-life (EOL) patients admitted to the emergency department (ED) and examined whether the decision to perform life-extending treatment (LET) or to allow natural death (AND) depends on patient characteristics, medical staff variables, and ED setting.

Methods: A retrospective archive study was conducted from January 2015 to December 2017 in the ED of a tertiary hospital. The study sample were 674 EOL patients who had died in the ED.

Round-off decision-making: Why do triage nurses assign STEMI patients with an average priority?

Unlabelled: Patients with suspected ST elevation myocardial infarction should be classified with a high-priority triage level in the Emergency Department. Accurate triage can reduce mortality and morbidity in ST elevation myocardial infarction patients. Yet, half of these patients were given a low-priority score, especially the average classification (P3 on a P1-P5 scale).

Comparison of Robotic Pyeloplasty and Standard Laparoscopic Pyeloplasty in Infants: A Bi-Institutional Study.

Purpose: To compare outcomes between robotic pyeloplasty (RP) and standard laparoscopic pyeloplasty (LP) in the infant population for the treatment of ureteropelvic junction (UPJ) obstruction.

Materials And Methods: We performed a retrospective cohort study of all children under 1 year of age who underwent RP or LP at two different medical centers between October 2009 and February 2016. Patient demographics, perioperative data, complications, and results were reviewed.

Minimally Invasive Approach for Treatment of Seminal Vesicle Cyst Associated with Ipsilateral Renal Agenesis.

Objectives: We reviewed the clinical presentation and approach for the treatment of symptomatic seminal vesicle cyst associated with ipsilateral renal agenesis while presenting our experience with a series of 5 patients treated with minimally invasive surgery for Zinner syndrome.

Materials And Methods: Between the years 2008 and 2016, we operated on 5 patients who presented with symptomatic seminal vesicle cyst and ipsilateral renal agenesis. Patients' charts and medical records were reviewed and compared with past published minimally invasive series.

A study of the workforce in emergency medicine in Israel 2012: what has changed in the last decade?

Objective: In 2003, we published a study on the Israeli workforce in emergency medicine (EM). We repeated the study in 2012 to assess changes in the workforce that have occurred in the interval decade.

Methods: This is an observational cross-sectional study of the physician workforce in EM in Israel in 2012.

[Non-traumatic unintentional injuries and risk factors for hospitalization in children presenting to a pediatric emergency department].

Objective: Unintentional injuries are a major cause of morbidity and mortality in children. The authors present the results of a study in which data was collected regarding unintentional injuries presented to the Pediatrics Emergency Department (PED) at Ha'Emek Medical Center. The present study represents the first collection and analysis of such data gathered from the Pediatric Emergency Department in Northern Israel.

[Biphasic versus monophasic shock waveforms for transthoracic cardioversion of atrial flutter in the emergency room].

Unlabelled: Transthoracic electrical cardioversion (ECV), traditionally using monophasic waveform (MW) shock, has an important role in the treatment of symptomatic atrial flutter (AFI). Biphasic waveform (BW) shock has been demonstrated to be more successful than MW shock for termination of atrial fibrillation, but data about its use for ECV of AFI are limited.

Methods And Results: We retrospectively analyzed the records of 53 patients (pts) admitted -to the ER due to symptomatic AFl during the period August 2004 to August 2005: 31 pts received BW shock and 22 pts MW shock.

[Intravenous flecainide administration for conversion of paroxysmal atrial fibrillation in the emergency room].

Introduction: Since the removal of intravenous propafenone from the Israeli market, flecainide is the only intravenous antiarrhythmic class 1C drug available nowadays in Israel.

Aim: The study aimed to report our experience of intravenous flecainide administration in the treatment of paroxysmal atrial fibrillation (PAF) in the Emergency Room (ER).

Methods: Patients with AF lasting > 1 hour and <48 hour duration were considered possible candidates for entry into the study.

[Biphasic shock waveform for cardioversion of atrial fibrillation in the emergency room].

Unlabelled: Transthoracic electrical cardioversion, traditionally monophasic shock waveform, has been a mainstay of the therapy for atrial fibrillation (AF) since its introduction into clinical practice. Recent studies have demonstrated that biphasic shock is more efficient than monophasic shock waveforms for terminating both ventricular fibrillation and AF; however, data on the recommended initial shock energy in conversion of AF by biphasic shocks are limited.

Aim: Our study aimed to evaluate the optimal dose of the initial shock energy for conversion of AF to sinus rhythm by transthoracic biphasic shock waveforms in the Emergency Room (ER).

[Intravenous propafenone for conversion of atrial fibrillation in the emergency room].

Atrial fibrillation (AF) is the most common sustained symptomatic arrhythmia encountered in the emergency room (ER). Rapid, safe and effective conversions of AF to sinus rhythm (SR) are important aspects in the treatment of arrhythmia in a busy ER setting. The aim of our study was to investigate the rate of conversion, efficacy and safety of intravenous (i.

[Propafenone dose for emergency room conversion of paroxysmal atrial fibrillation].

Paroxysmal atrial fibrillation (AF), a frequent cause of repeated hospitalization, is effectively treated with propafenone. The time to conversion to sinus rhythm is a consideration when managing AF in the emergency room. We investigated the conversion rates of paroxysmal AF by 3 different oral propafenone (P) regimens, in terms of time to conversion.