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HNO-Heilkunde in Österreich und der deutschsprachigen SchweizOtorhinolaryngology in Austria and German-speaking Switzerland
No full textImmunohistochemical expression of ephrin receptors in neuroendocrine neoplasms: a case-series of gastroenteropancreatic neuroendocrine neoplasms and a systematic review of the literature
No full textPURPOSE
Erythropoietin-producing hepatocellular (EPH) receptors are the largest known family of tyrosine kinases receptors (TKR) in humans, implicated in cell proliferation, adhesion, migration, tumor angiogenesis, invasion and metastasis. The aim of the present study is to assess the expression of EPHs in neuroendocrine neoplasms (NENs).
METHODS
Immunohistochemical staining of specimens of 30 patients with gastroenteropancreatic and lung NENs was performed for EPH-A1, EPH-A2, EPH-A4, EPH-A5 protein expression, in addition to ki-67 multiplication index and programmed death-ligand 1. Additionally, we performed a systematic review of the available literature in three different databases reporting on the expression of EPH in all neuroendocrine neoplasms.
RESULTS
Positive expression was seen in 16/19 (84%) specimens for EPH-A1, 15/23 (65%) for EPH-A2, 21/24 (88%) for EPH-A4, 24/26 (92%) for EPH-A5. EPH-A1 was expressed in 9/9 pancreatic, 3/4 small intestine, but not in one lung NEN, EPH-A2 in 5/10 pancreatic, 3/4 small intestine and lung, and in one of each of gastric, appendix, colorectal, and cervical NENs, respectively. EPH-A4 showed positive expression in 9/11 pancreatic, 4/4 small intestine, 3/3 lung specimens and EPH-A5 in 10/11, 4/4 and 4/4, respectively. Data retrieved from the systematic review of the literature in combination with the data from the present study are suggestive of a frequent EPH expression in pituitary, thyroid, lung and gastroenteropancreatic NENs, yet, with varying expressions of the single receptor subtypes.
CONCLUSION
EPHs may have a role in NEN tumorigenesis, prognosis as well as a role in the evolving molecular-targeted therapies
Ureteral stricture rate after endoscopic treatments for urolithiasis and related risk factors: systematic review and meta-analysis
No full textPURPOSE
We aimed to accurately determine ureteral stricture (US) rates following urolithiasis treatments and their related risk factors.
METHODS
We conducted a systematic review and meta-analysis following the PRISMA guidelines using databases from inception to November 2023. Studies were deemed eligible for analysis if they included ≥ 18 years old patients with urinary lithiasis (Patients) who were subjected to endoscopic treatment (Intervention) with ureteroscopy (URS), percutaneous nephrolithotomy (PCNL), or shock wave lithotripsy (SWL) (Comparator) to assess the incidence of US (Outcome) in prospective and retrospective studies (Study design).
RESULTS
A total of 43 studies were included. The pooled US rate was 1.3% post-SWL and 2.1% post-PCNL. The pooled rate of US post-URS was 1.9% but raised to 2.7% considering the last five years' studies and 4.9% if the stone was impacted. Moreover, the pooled US rate differed if follow-ups were under or over six months. Patients with proximal ureteral stone, preoperative hydronephrosis, intraoperative ureteral perforation, and impacted stones showed higher US risk post-endoscopic intervention with odds ratio of 1.6 (P = 0.05), 2.6 (P = 0.009), 7.1 (P < 0.001), and 7.47 (P = 0.003), respectively.
CONCLUSIONS
The overall US rate ranges from 0.3 to 4.9%, with an increasing trend in the last few years. It is influenced by type of treatment, stone location and impaction, preoperative hydronephrosis and intraoperative perforation. Future standardized reporting and prospective and more extended follow-up studies might contribute to a better understanding of US risks related to calculi treatment
Trends in the use of radiation protection and radiation exposure of European endourologists: a prospective trial from the EULIS-YAU Endourology Group
No full textINTRODUCTION
Due to the radiation exposure for the urology staff during endourology, our aim was to evaluate the trends of radiation protection in the operation room by endourologists from European centers and to estimate their annual radiation.
METHODS
We conducted a multicenter study involving experienced endourologists from different European centers to evaluate whether the protection and threshold doses recommended by the International Commission on Radiation Protection (ICRP) were being followed. A 36-question survey was completed on the use of fluoroscopy and radiation protection. Annual prospective data from chest, extremities, and eye dosimeters were collected during a 4-year period (2017-2020).
RESULTS
Ten endourologists participated. Most surgeons use lead aprons and thyroid shield (9/10 and 10/10), while leaded gloves and caps are rarely used (2/10 both). Six out of ten surgeons wear leaded glasses. There is widespread use of personal chest dosimeters under the apron (9/10), and only 5/10 use a wrist or ring dosimeter and 4 use an eye dosimeter. Two endourologists use the ALARA protocol. The use of ultrasound and fluoroscopy during PCNL puncture was reported by 8 surgeons. The mean number of PCNL and URS per year was 30.9 (SD 19.9) and 147 (SD 151.9). The mean chest radiation was 1.35 mSv per year and 0.007 mSv per procedure. Mean radiation exposure per year in the eyes and extremities was 1.63 and 11.5 mSv.
CONCLUSIONS
Endourologists did not exceed the threshold doses for radiation exposure to the chest, extremities and lens. Furthermore, the ALARA protocol manages to reduce radiation exposure
Antarctic Expeditions : A Systematic Review of the Physiological, Nutritional, Body Composition and Psychological Responses to Treks Across the Continental Ice
No full textBACKGROUND
Antarctic expeditions, although supported by scientific knowledge, face various challenges, with little research conducted to explore the physical demands that explorers experience.
OBJECTIVE
To summarise physiological, psychological, body composition and nutritional changes faced during trek expeditions in the Antarctic's continental portion.
DESIGN
Systematic review.
INFORMATION SOURCES
We used PubMed, SPORTDiscus, PsycINFO, Scopus, Cochrane databases, CINAHL and Medline Ovid to search for studies published up to January 2023.
ELIGIBILITY CRITERIA
We included original articles or case reports published in English and in peer-reviewed journals, involving both sexes, using both quantitative and qualitative approaches, that considered Antarctic continent expedition, as well as solo exploration/group exploration. Animal studies, in vitro studies, explorers < 18 years of age, overwintering at research stations, tourist/organized visits to Antarctica or the South Pole, not sleeping on the ice, and ultraendurance events were excluded. The JBI critical appraisal checklist for case studies was used for quality assessment.
RESULTS
A total of 12 studies met the eligibility criteria. The main findings are reversible changes in bone density and mineral content. Despite high-calorie intake (5000 kcal/day or more), participants experienced body weight loss and a decrease in appetite-regulating hormones. Motivation and goal orientation, positive interpersonal communication and support are important skills during polar expeditions. Multidisciplinary research revealed various physiological and cognitive responses, disrupted sleep patterns and mood changes.
CONCLUSION
Prolonged hypobaric hypoxia reduces aerobic capacity and increases anaerobic metabolism, while bone density changes are reversible and weight loss occurs despite high-calorie intake. Effective decision-making, teamwork and personal growth are crucial for Antarctic explorers. Future studies need to investigate strategies on how to improve physiological functions while maintaining homeostasis.
REGISTRATION
PROSPERO-CRD42022382609
¿Cómo escribir una historia de la literatura latina medieval?
No full textThis paper focuses on the practical necessity of teaching literary history to students and argues that this should be done according to transparent criteria. It proposes as a theoretical basis the consideration of literature as a particular form of communication and discusses all the factors that must be taken into account: periodization (examining some pitfalls); literary space (articulated in regions and communities, itineraries, and global space); vectors (people and institutions) that facilitate the transmission of texts; media (material or intangible, such as the voice, as medium not only of some genres but also as an important channel for the transmission of ideas), audiences (considering the rhetorical codification of works intended for a particular group as well as t historical reception), and authors (with the particular social and cultural conditions of authorship)
Biomechanical evaluation of double-stranded knot configurations in high-strength sutures and tapes
No full textPURPOSE
Recently, a new dynamic high-strength suture (DC) was introduced, also available in tape form (DT), featuring a salt-infused silicone core attracting water in a fluid environment to preserve tissue approximation. The aims of this study were to (1) assess the influence of securing throw number on knot security of two double-stranded knot configurations (Cow-hitch and Nice-knot) tied with either dynamic (DC and DT) or conventional (FW and ST) high-strength sutures and tapes, and (2) compare the ultimate force and knot slippage of the novel dynamic versus conventional sutures and tapes when used with their minimal number of needed securing throws.
METHODS
Seven specimens of each FW, ST, DC and DT were considered for tying with Cow-hitch or Nice-knots. The base of these Cow-hitch and Nice-knots was secured with surgeons` knots using 1-3 alternating throws. Tensile tests were conducted under physiologic conditions to evaluate knot slippage, ultimate force at rupture, and minimum number of throws ensuring 100% knot security. RESULTS: For both Cow-hitch and Nice-knots, 100% security was achieved with 2 securing throws for DC, DT, ST, and with 3 securing throws for FW. With these minimum numbers of securing throws, ultimate force was significantly higher for Nice-knots versus Cow-hitch tied with DT (p = 0.001) and slippage was significantly less with Nice-knots versus Cow-hitch tied with DC (p = 0.019).
CONCLUSIONS
The minimum number of securing throws required to achieve 100% security was 2 with DC, DT and ST for both Cow-hitch and Nice-knots configurations, in contrast to FW where 3 securing throws were needed. With these minimum numbers of securing throws, Nice-knots were associated with significantly higher ultimate forces when using DT and lower slippage with DC versus Cow-hitch knots
Effects of high- versus low-intensity lipid-lowering treatment in patients undergoing serial coronary computed tomography angiography: results of the multi-center LOCATE study
No full textAIM
To evaluate the effects of lipid-lowering medications of different intensities on total, calcified, and non-calcified plaque volumes in patients undergoing serial cardiac computed tomography angiography (CCTA).
METHODS
Individuals with chronic coronary syndromes from 11 centers were included in a retrospective registry. Total, calcified, and non-calcified plaque volumes were quantified and the relative difference in plaque volumes between baseline and follow-up CCTA was calculated. The intensity of lipid-lowering treatment was designated as low, moderate, or high, based on current recommendations.
RESULTS
Of 216 patients (mean age 63.1 ± 9.7 years), undergoing serial CCTA (median timespan = 824.5 [IQR = 463.0-1323.0] days), 89 (41.2%) received no or low-intensity lipid-lowering medications, and 80 (37.0%) and 47 (21.8%) moderate- and high-intensity lipid-lowering agents, respectively. Progression of total and non-calcified plaque was attenuated in patients on moderate-/high- versus those on no/low-intensity treatment and arrested in patients treated with high-intensity statins or PCSK9 inhibitors (p < 0.001). Halted increase of non-calcified plaque was associated with LDL-cholesterol reduction (p < 0.001), whereas calcified plaque mass and Agatston score increased irrespective of the lipid-lowering treatment (p = NS). The intensity of lipid-lowering therapy robustly predicted attenuation of non-calcified plaque progression as a function of the time duration between the two CCTA scans, and this was independent of age and cardiovascular risk factors (HR = 3.83, 95% CI = 1.81-8.05, p < 0.001).
CONCLUSION
The LOCATE multi-center observational study shows that progression of non-calcified plaques, which have been previously described as precursors of acute coronary syndromes, can be attenuated with moderate-intensity, and arrested with high-intensity lipid-lowering therapy.
GERMAN CLINICAL TRIALS REGISTER
DRKS00031954
