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Volatile sedation practices in patients with severe acute respiratory distress syndrome under VV-ECMO support.
No full textSubgroup analysis by chemotherapy regimen in the ENGOT-Ov41/GEICO 69-O/ANITA phase 3 trial evaluating atezolizumab combined with a platinum doublet and maintenance niraparib for late-relapsing ovarian cancer
No full textNew alternatives to holder pasteurization in processing donor milk in human milk banks.
No full text20.500.12530/87912Infectious and toxicological risks are the main potential hazards that operators of Human Milk Banks (HMBs) encounter and must eliminate. HMBs are trying to implement procedures that allow to manage and sanitize human milk without altering significantly its nutritional and biologically protective components, obtaining a product characterized by a valid balance between safety and biological quality. The history of human milk processing is linked to the origins of HMBs themselves. And although other forms of sterilization were used originally, pasteurization soon became the recognized most effective means for sanitizing milk: all the milk that arrives at the HMB must be pasteurized. Holder pasteurization (HoP) is the most used methodology, and it is performed using low temperature and long time (+62.5°C for 30 min). With HoP some bioactive milk components are lost to varying degrees, but many other precious bioactive compounds are completely or partially preserved. To improve the quality of human milk processed by HMBs, maintaining in the meantime the same microbiological safety offered by HoP, new technologies are under evaluation. At present, High-Temperature Short-Time pasteurization (HTST) and High-Pressure Processing are the most studied methodologies. HTST is already utilized in some HMBs for daily practical activity and for research purposes. They seem to be superior to HoP for a better preservation of some nutritional and biologically protective components. Freeze-drying or lyophilization may have advantages for room temperature storage and transportation. The aim of this study is to evaluate the advancement regarding the processing of DHM with a literature search from 2019 to 2022. The effects of the new technologies on safety and quality of human milk are presented and discussed. The new technologies should assure microbiological safety of the final product at least at the same level as optimized HoP, with an improved preservation of the nutritional and bioactive components of raw human milk
Unravelling the role of secretory Immnuoglobulin-A in COVID-19: a multicentre study in nursing homes during the first wave.
No full text20.500.12530/87871The function of mucosal secretory IgA (SIgA) seems to be paramount in the immune response against SARS-CoV-2 however, there are few studies addressing this issue specifically in the institutionalized older population. This study aims to determine the levels of secretory IgA against the S1 domain of the SARS-CoV-2 spike (SIgA-S1) in older people living in nursing homes (NH) and to investigate the differences in baseline characteristics, severity of COVID-19, duration of symptoms, 30-day mortality, and reinfection according to the levels of SIgA-S1. In this multicentre longitudinal study, conducted in two NHs attended in coordination with a hospital-based Geriatric team, 305 residents (87.3 years, 74.4% female) were included. A massive collection of nasopharyngeal samples was carried out after the first wave of COVID-19 in May 2020 and an ELISA analysis of SIgA-S1 was performed on frozen samples in May 2023. Values of SIgA-S1 ≥ 57.6 U/mL ("cut-off point") were considered "induced". Resident medical records were reviewed to assess symptoms, comprehensive geriatric assessment (CGA), reinfection, and overall 30-day mortality. At the time of sample collection, 274 residents (89.8%) exhibited "induced" SIgA-S1 levels (≥ 57.6 U/mL), 46 (15.1%) tested positive for PCR SARS-CoV-2, and 170 (57%) had experienced COVID-19 symptoms. "Induced" SIgA-S1 patients were more likely to be symptomatic (60.3% vs. 29%; p 10 days had higher levels of SIgA-S1 than those with mild disease (252 vs.192.6 U/mL; p = 0.012) or duration ≤ 10 days (270.5 vs. 208.1 U/mL; p = 0.043), respectively. No significant differences were observed in age, sex, CGA, duration of symptoms, disease severity, overall 30-day-mortality, or reinfection between "induced" and "non-induced" residents. Levels of SIgA-S1 are associated with the duration and type of COVID-19 symptoms, along with the severity of infection. While these findings shed light on the knowledge of SIgA-S1, further interdisciplinary studies are warranted to better understand the immune response to SARS-CoV-2 infection
Painful sexual intercourse, quality of life and sexual function in patients with endometriosis: not just deep dyspareunia.
No full text20.500.12530/87857To evaluate the prevalence of deep and superficial dyspareunia in women with diagnosis of endometriosis. Secondly, to assess the temporal relation between deep and superficial dyspareunia in women reporting both symptoms (concomitant dyspareunia) and the impact on quality of life (QoL) and sexual function. This is a cross-sectional cohort study that included fertile women with diagnosis of endometriosis. Enrolled subjects reported pain symptoms including dyspareunia and its temporal onset and completed two one-time validated questionnaires regarding sexual function (Female Sexual Function Index) and QoL (International QoL Assessment SF-36). Among the 334 enrolled patients, 75.7% (95%) reported dyspareunia. Women were divided into four groups according to the presence and type of dyspareunia: isolated superficial dyspareunia (6.3%), isolated deep dyspareunia (26.0%), concomitant dyspareunia (43.4%) and no dyspareunia (24.3%). Women with concomitant dyspareunia reported higher NRS scores than women with isolated dyspareunia or no dyspareunia (P ≤ 0.001). The majority of women with concomitant dyspareunia (56.6%) reported that deep dyspareunia developed before superficial dyspareunia. Women with concomitant dyspareunia reported worse QoL and worse sexual function than women with isolated dyspareunia or without dyspareunia (P ≤ 0.001). Dyspareunia is a common symptom in women with endometriosis, with many reporting concomitant deep and superficial dyspareunia. Concomitant dyspareunia can significantly impact sexual function and quality of life (QoL). Therefore, it is crucial to investigate dyspareunia thoroughly and differentiate between its types to tailor effective therapeutic strategies
Gastric calcinosis ulcer in a renal transplanted patient.
No full text20.500.12530/87912A 53-year-old lady with dysfunctional renal transplant and post-surgical hypoparathyroidism with phosphocalcic metabolism impairment was admitted to hospital because of long-lasting epigastric pain and nausea. An esophagogastroduodenoscopy was performed, visualising a nodular lesion of 1 cm diameter with a depressed and ulcerated base. Microscopically the lesion was in relation with a metastatic calcinosis ulcer. Pantoprazole was initiated and serum phosphocalcic levels adjusted, achieving symptom remission. In the follow-up esophagogastroduodenoscopy, the lesion was healing with a fibrinous base and the histopathological report diagnosed superficial gastritis
Aspectos prácticos de la trombectomía pulmonar mediante aspiración en pacientes soportados con ECMO.
No full text20.500.12530/8791
A case report of a 5 mm trocar-site evisceration after transabdominal preperitoneal (TAPP) hernia repair
No full text20.500.12530/87887Background: The incidence of trocar hernias in large published series ranges between 0.18% and 2.8%. Only a few cases are reported at trocar sites smaller than 10 mm in adult surgery, being even more uncommon in 5 mm incisions with an estimated incidence of 0.0005%. Case Description: We present a case report of an evisceration through a 5 mm laparoscopic trocar incision after transabdominal preperitoneal (TAPP) inguinal hernioplasty. The patient is a 75-year-old woman with multiple abdominal surgeries. TAPP hernioplasty was performed as a scheduled surgery, with placement of two laparoscopic 5 mm balloon trocars in both flanks. The patient was discharged the following day. On the third postoperative day, the patient arrived to the emergency room with diffuse abdominal pain and vomiting. It was initially managed conservatively, but an abdominal computed tomography (CT) scan was performed that showed a small intestine herniation through a 5 mm laparoscopic trocar incision in the left flank. An urgent intervention was performed, using a laparoscopic approach. The herniated ileal loop was identified through the hole of the previous trocar. The incarcerated intestine was reduced and the abdominal defect was closed with barbed suture. Conclusions: The presence of hernias in 5 mm trocars is very rare and can go unnoticed, therefore, we must keep this clinical suspicion in mind. In cases with high risk and excessive manipulation of the 5 mm trocar, we must try to close these trocars. This complication, although rare, can appear in the transabdominal approach to inguinal hernia; however, it does not with the extraperitoneal approach. The use of a laparoscopic approach for the repair of incarcerated/incisional hernias is increasing, as it is a safe technique with the advantage of being a minimally invasive surgery. Barbed sutures allow us to close the defect in the abdominal wall more easily than with other types of sutures
Corrigendum: Personalized monitoring of circulating tumor DNA with a specific signature of trackable mutations after chimeric antigen receptor T-cell therapy in follicular lymphoma patients.
No full text20.500.12530/87912[This corrects the article DOI: 10.3389/fimmu.2023.1188818.]