Thrombolysis for aneurysmal subarachnoid haemorrhage.

Background: Aneurysmal subarachnoid haemorrhage continues to cause a significant burden of morbidity and mortality despite advances in care. Trials investigating local administration of thrombolytics have reported promising results.

Objectives: - To assess the effect of thrombolysis on improving functional outcome and case fatality following aneurysmal subarachnoid haemorrhage - To determine the effect of thrombolysis on the risk of cerebral artery vasospasm, delayed cerebral ischaemia, and hydrocephalus following subarachnoid haemorrhage - To determine the risk of complications of local thrombolysis in aneurysmal subarachnoid haemorrhage SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (last searched 9 March 2023), MEDLINE Ovid (1946 to 9 March 2023), and Embase Ovid (1974 to 9 March 2023).

STAT3 Orchestrates Immune Dynamics in Hepatocellular Carcinoma: A Pivotal Nexus in Tumor Progression.

Hepatocellular carcinoma (HCC) presents a formidable challenge in oncology, attributed to its association with chronic liver diseases and global prevalence. The immune microenvironment profoundly influences HCC progression, balancing immune suppression and antitumor responses. The Signal Transducer and Activator of Transcription 3 (STAT3) is central to this equilibrium, orchestrating immune dynamics and intertwining tumor progression with immune evasion mechanisms.

Rating of overall childbirth experience: A qualitative study of a quantitative measurement.

Introduction: Overall childbirth experience scores are used both in research and in clinical settings. Since it is still not fully understood what assessment of childbirth experience on a single-item numeric rating scale or visual analog scale represents, the aim of this study was to explore women's reasoning and thoughts when rating overall childbirth experience numerically.

Material And Methods: A qualitative interview study of 26 women was conducted using a think-aloud technique at a university referral hospital in Sweden.

Validation of clinical T stages and of prognostic negative markers in patients with muscle invasive bladder cancer: data in the Swedish National Bladder Cancer Registry data from a detailed research database.

Background: A previously published study at Norrland University Hospital, Umeå, Sweden, found that in 29.5% of patients with urinary bladder cancer (UBC) who underwent cystectomy, incorrect cT-stage (clinical T-stage) was registered in the Swedish National Register of Urinary Bladder Cancer (SNRUBC). Tumor in bladder diverticulum (TIBD) and tumor-associated hydronephrosis (TAH) were common causes for misclassification.

Right Ventricular Function and Outcomes Stratified by the Effective Regurgitant Orifice Area in Secondary Tricuspid Regurgitation.

Background: In patients with moderate and severe secondary tricuspid regurgitation (STR), the effective regurgitant orifice area (EROA), corrected using the proximal isovelocity surface area (PISA) method for tricuspid valve leaflet tethering and low TR jet velocities, has an unclear threshold for identifying high-risk patients. This study aimed to establish a risk-based EROA cutoff and assess the impact of right ventricular (RV) remodeling on outcomes in low-risk STR patients according to EROA.

Methods: We included 513 consecutive outpatients (age 75±13 years, 47% male) with moderate and severe STR.

Free vascularized fibula transfer in single- or double-barrel technique for reconstruction of segmental bone defects following oncological resection or posttraumatic bone loss.

Background: Significant osseous defects or osteonecrosis, precipitated by open fractures, infections, or neoplastic conditions, represent infrequent yet critical medical conditions. The free vascularized fibular graft (FVFG) is a challenging but straightforward, reliable surgical intervention for the reconstruction of defects across various anatomical regions. This study aims to compare, quantify, and demonstrate the FVFG's versatility.

Effectiveness and safety of acupuncture for melasma: A meta-analysis of randomized controlled trials.

Background: Treating melasma remains challenging. We conducted a meta-analysis to assess the effectiveness and safety of acupuncture as a treatment option.

Methods: We searched three English and four Chinese databases up to January 2, 2024.

Effects of minocycline on patients with acute anterior circulation ischaemic stroke undergoing intravenous thrombectomy (MIST-A): the study protocol for a multicentre, prospective, randomised, open-label, blinded-endpoint trial.

Introduction: Despite the implementation of mechanical thrombectomy, acute ischaemic stroke with large vessel occlusion (AIS-LVO) remains a significant health concern, characterised by substantial morbidity and mortality. Our trial aims to evaluate the efficacy and safety of minocycline in reducing infarct volume and improving functional outcomes in patients undergoing mechanical thrombectomy for anterior circulation AIS-LVO.

Methods And Analysis: The MIST-A trial is a prospective, randomised, open-label, blinded-endpoint trial to be conducted across 12 medical centres.

Deep learning segmentation architectures for automatic detection of pancreatic ductal adenocarcinoma in EUS-guided fine-needle biopsy samples based on whole-slide imaging.

Background: EUS-guided fine-needle biopsy is the procedure of choice for the diagnosis of pancreatic ductal adenocarcinoma (PDAC). Nevertheless, the samples obtained are small and require expertise in pathology, whereas the diagnosis is difficult in view of the scarcity of malignant cells and the important desmoplastic reaction of these tumors. With the help of artificial intelligence, the deep learning architectures produce a fast, accurate, and automated approach for PDAC image segmentation based on whole-slide imaging.

DANCR Knockdown Alleviates Neuroinflammation and Functional Recovery after Spinal Cord Injury via Regulating the ACTN4 / STAT3 Axis.

Polarization of microglia following spinal cord injury (SCI) is a pivotal pathological process of secondary injury. Although differentiation antagonistic nonprotein coding RNA (DANCR) has been implicated in immune and inflammatory responses across various diseases, its role in SCI still unclear. This research aimed to clarify the underlying mechanisms of DANCR in SCI recovery by investigating its expression pattern in microglia.

High-Pressure Injection Injury of the Hand-A Rare but True Surgical Emergency.

: The aim is to bring attention to the existence of a rare type of trauma of the hand, high-pressure injection injury, that appears to be minor with negligible signs and symptoms within the first hours after the accident, but in reality, produces significant tissue destruction with severe consequences. Recognizing this type of trauma by medical personnel, understanding the mechanisms involved, and knowing the etiological and prognostic factors can lead to early treatment initiation and avoid severe mutilating sequelae. : A retrospective study on 16 patients diagnosed with high-pressure injection injuries, including water, air, paint, paint mixed paint with thinner, petroleum jelly, and lime (washable paint containing calcium oxide).

Clinically Significant and Germline Variants in Breast Cancer-A Single-Center Experience.

Background: Conditions associated with pathogenic (PVs) or likely pathogenic variants (LPVs) are often severe. The early detection of carrier status is ideal, as it provides options for effective case management.

Materials And Methods: The study involved 58 patients with a personal and familial history of breast cancer (BC) who underwent genetic testing at the Regional Centre for Medical Genetics Dolj over a three-year period.

Redosing with Intralymphatic GAD-Alum in the Treatment of Type 1 Diabetes: The DIAGNODE-B Pilot Trial.

Immunotherapies aimed at preserving residual beta cell function in type 1 diabetes have been successful, although the effect has been limited, or raised safety concerns. Transient effects often observed may necessitate redosing to prolong the effect, although this is not always feasible or safe. Treatment with intralymphatic GAD-alum has been shown to be tolerable and safe in persons with type 1 diabetes and has shown significant efficacy to preserve C-peptide with associated clinical benefit in individuals with the human leukocyte antigen DR3DQ2 haplotype.

Tailgut Cyst-Gynecologist's Pitfall: Literature Review and Case Report.

Retrorectal cystic hamartomas ("Tailgut cysts") are rare developmental cysts that appear in the retrorectal space, arising from aberrant remnants of the post-anal primitive gut in case of an incomplete embryogenetic involution. We present the case of a 30-year-old woman with a history of chronic lower abdominal pain. Other digestive symptoms, like rectal fullness, constipation, pain on defecation, rectal bleeding or genitourinary obstruction symptoms, were not associated.

Neutropenic event incidence in women with early-stage breast cancer receiving neoadjuvant or adjuvant chemotherapy: a retrospective study.

Objectives: To assess the incidence of neutropenia, febrile neutropenia, documented infection with neutropenia and fever associated with early-stage breast cancer (BC) in a real-life setting.

Methods: A retrospective study that includes 88 women with BC who received a first dose of Epirubicin plus Cyclophosphamide with or without 5-Fluorouracil, in the county hospital of Ryhov, Sweden. The patients were included continuously from May 2017 to November 2020 and were ≥18 years old.

The Family Doctor in the "COVID-19 Era".

The SARS-CoV-2 virus infection, the most severe pandemic in recent human history, found healthcare systems around the world more or less unprepared. Adjusting to this challenge involved changes in the daily routines of healthcare systems, as well as the patients, once again highlighting the importance of primary care (family physician or general practitioner). In the context of the COVID-19 pandemic, the family doctor in Romania played a crucial role in patient management, rapidly adapting to the changes and challenges imposed by the state of emergency.

Results from a UK consensus about the optimal prescribing of medium strength triple therapy in uncontrolled adult asthma patients in the NHS.

Context: An inhaled corticosteroid (ICS) in combination with a long-acting β2-agonist (LABA) is a common treatment approach for asthma patients not controlled on ICS alone, but a significant proportion of patients remain uncontrolled on this combination and treatment adherence can also be a challenge. One of the options for adults whose asthma is uncontrolled in an ICS/LABA is the addition of a long-acting muscarinic receptor antagonist (LAMA), an approach commonly referred to as 'triple therapy'. The use of medium-strength ICS/LABA/LAMA is established in treating chronic obstructive pulmonary disease but is less well-established in asthma.

Effects of Plant-Based Diet on Metabolic Parameters, Liver and Kidney Steatosis: A Prospective Interventional Open-label Study.

This interventional single-center prospective open-label study aims to evaluate the effects of a vegan diet, compared to a vegetarian and omnivorous diet, on metabolic parameters, insulin sensitivity, and liver and kidney steatosis in healthy adults. The study included 53 omnivorous participants aged 18-40 years, body-mass index 18-30 kg/m2, without any chronic disease, chronic medication use, active smoking, or significant alcohol consumption. All participants were omnivorous at baseline and selected to continue an omnivorous diet or transition to a vegetarian or vegan diet, with follow-up over six months.

Expert Rater Agreement for Symptoms and Diagnosis of Bipolar Disorder in Youth.

The diagnosis of bipolar disorder (BD) in young children has been a topic of debate, in part owing to varied interpretation of manic-like symptoms. We examined how expert academic clinicians participating in the pediatric bipolar biobank varied in their interpretation and application of Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria and diagnoses. Study co-investigators reviewed 12 standardized narratives and for each marked a visual analog scale with their confidence in the presence of manic episodes and criteria.

Determinants of growth differentiation factor 15 plasma levels in outpatients with peripheral arterial disease.

Background: Growth differentiation factor 15 (GDF-15) is a robust prognostic biomarker in patients with cardiovascular (CV) disease, and a better understanding of its clinical determinants is desirable. We aimed to study the associations between GDF-15 levels and in outpatients with peripheral arterial disease (PAD).

Methods: An explorative cross-sectional study (Study of Atherosclerosis in Vastmanland, Västerås, Sweden) included 439 outpatients with carotid or lower extremity PAD.

Cardiac dose comparison of abdominal and thoracic deep inspiration breath hold in adult female with left-sided breast cancer receiving radiation therapy: A systematic review and meta-analysis.

Introduction: Deep inspiration breath hold technique has shown promise in reducing cardiac toxicity and improving patient outcomes. However, there is a lack of consensus regarding the implementation of abdominal breath hold technique and its impact on cardiac dose. This systematic review and meta-analysis aim to provide insights into the comparative effectiveness of abdominal and thoracic breath hold in mitigating cardiac toxicity during radiation therapy for left-sided breast cancer.

Investigations for Suspected Head and Neck Squamous Cell Carcinoma of Unknown Primary (HNSCCUP): A National Cohort Study.

Objectives: Head and neck squamous cell carcinoma from unknown primary (HNSCCUP) is a rare and challenging condition. This study aimed to investigate the diagnostic pathways of suspected HNSCCUP patients in the United Kingdom.

Methods: A retrospective observational cohort study was conducted, over 5 years from January 2015, in UK Head and Neck centres of consecutive adults undergoing 18F-Fluorodeoxyglucose-PET-CT (PET-CT) within 3 months of diagnosis with metastatic cervical squamous cell carcinoma.

Effect of Prior Bariatric Surgery on the Outcomes of Joint Arthroplasty: A Systematic Review and Meta-Analysis.

Objective: Obesity is a risk factor for joint arthroplasty complications. With this systematic review and meta-analysis, we assessed whether a positive history of bariatric surgery influences postoperative outcomes in patients undergoing various types of joint arthroplasty.

Methods: We conducted a comprehensive search database such as Scopus, PubMed, Medline Ovid, CNKI, and CENTRAL for studies comparing outcomes between patients undergoing arthroplasty with and without a history of bariatric surgery.