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Hydrogen evolution on Ir nanoparticles supported by glassy carbon and graphene nanoplatelets
No full textA study on optimistic and pessimistic pareto-fronts in multiobjective bilevel optimization via [delta]-perturbation
No full textHow does an external electric field in the normal-direction affect the cyclo[18]carbon molecule?
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Dataset on parameters of natural forest regeneration a decade after silvicultural treatment in Dinaric fir-beech forests
No full textColorectal-vaginal fistula after rectal cancer resection
Full text linkA colorectal-vaginal fistula (CRVF) can occur as a complication of rectal cancer surgery. They can cause discomfort, repeated infection, need for treatment/further surgery, and a permanent stoma (an opening in the abdomen to collect bowel contents). This study looked at how often CRVF happened after surgery complicated by a leak where bowels ends have been joined together, how they were treated, and how likely patients were to live without a stoma 1 year after surgery. Researchers collected data on women from around the world who had rectal cancer surgery between 2014 and 2018 and developed a bowel leak (called anastomotic leakage). They compared those with and without a CRVF. A total of 88 out of 694 patients (12.7%) developed a CRVF. These patients more often had major surgery involving removal of nearby organs, including part of the vagina. They were more likely to have ongoing problems and needed more surgeries to manage them. Most had a temporary stoma, but only 29.5% could live without it after 1 year, compared with 48.7% of women without CRVF. CRVF is a serious complication that makes recovery harder. These patients are less likely to live without a stoma and usually need more surgery. However, if the leak is small, the chances of recovery without a permanent stoma are better
Adult congenital heart disease training in Europe
Full text linkObjectives: This study aimed to determine the status of training of adult congenital heart disease (ACHD) cardiologists in Europe. Methods: A questionnaire was sent to ACHD cardiologists from 34 European countries. Results: Representatives from 31 of 34 countries (91%) responded. ACHD cardiology was recognised by the respective ministry of Health in two countries (7%) as a subspecialty. Two countries (7%) have formally recognised ACHD training programmes, 15 (48%) have informal (neither accredited nor certified) training and 14 (45%) have very limited or no programme. Twenty-five countries (81%) described training ACHD doctors ‘on the job’. The median number of ACHD centres per country was 4 (range 0–28), median number of ACHD surgical centres was 3 (0–26) and the median number of ACHD training centres was 2 (range 0–28). An established exit examination in ACHD was conducted in only one country (3%) and formal certification provided by two countries (7%). ACHD cardiologist number versus gross domestic product Pearson correlation coefficient=0.789 (p<0.001). Conclusion: Formal or accredited training in ACHD is rare among European countries. Many countries have very limited or no training and resort to ‘train people on the job’. Few countries provide either an exit examination or certification. Efforts to harmonise training and establish standards in exit examination and certification may improve training and consequently promote the alignment of high-quality patient care
Dynamic changes in oxidative stress biomarkers in a child with idiopathic nephrotic syndrome
Full text linkIdiopathic nephrotic syndrome (INS) is the most prevalent glomerular illness in children. Even while immunologic processes are well-established, oxidative stress is becoming more widely acknowledged as a significant factor in the etiopathogenesis of illness. Assessing its activity and treatment response may be made easier with the use of trustworthy, non-invasive indicators to track redox balance. We report on the oxidative stress levels of a 10.7-year-old boy with INS with five clinical time points in one year. The FRAS5 analyzer was used to calculate the oxidative stress index (OSI), plasma antioxidant capacity (PAT) and derivatives of reactive oxygen metabolites (d-ROMs) as biomarkers. A 4-tier oxidative state classification scheme based on d-ROM and PAT thresholds was used to interpret the values. The patient had low antioxidant defense, moderate oxidative and increased OSI at relapses, a positive transition to reduced oxidative burden and enhanced defense during remission. The order of events showed a dynamic redox response associated with glucocorticoid (GC) medication and disease activity. The potential value of d-ROM, PAT, and OSI as dynamic biomarkers for tracking disease activity, response to treatment and residual oxidative burden in pediatric INS is supported by this case. To confirm their function in more comprehensive clinical decision-making, more research is required
