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  • Church Kamper posted an update 1 day, 9 hours ago

    BACKGROUND The purpose of this study was to 1) determine the incidence of POUR in patients undergoing lung resection at our institution; 2) identify differences in potential risk factors between patients who did and did not develop POUR; and 3) describe patient outcomes across POUR status. METHODS The charts of 225 patients between 2016 and 2017 were reviewed and 191 met criteria for inclusion. All patients followed the institution’s catheterization removal protocol. Re-catheterization was defined as requiring either in-and-out catheterization or Foley catheter placement. Fisher’s exact and Wilcoxon tests were used for analysis. RESULTS 35 (18%) patients developed POUR. Patients with POUR were older (p=0.01), had increased baseline creatinine (p=0.04), and a higher prevalence of benign prostatic hyperplasia (p=0.007). POUR patients were also less likely to get a Foley catheter intraoperatively (p=0.0002). Other intraoperative factors, like surgical approach and extent of resection were not significantly different between patients who did and did not develop POUR. Postoperative factors (epidural use or days with chest tube) were similar. While patients with POUR were more likely to be discharged with a Foley catheter (13% vs. 0%, p=0.002), no difference in length of stay, or incidences of urinary tract infections 30-day readmission were observed. CONCLUSIONS Roughly 1 in 5 patients undergoing lung resection develop POUR. Patients who developed POUR were more likely to not have a Foley catheter placed intraoperatively. However, patients who had POUR did not have worsened patient outcomes (urinary tract infections, length of stay, 30-day readmission). Tricaine methanesulfonate BACKGROUND Previous reports suggest that lung cancer arising in the lower lobe is associated with a poorer prognosis than upper lobe disease. However, the reason remains controversial. We evaluated the relationship among the affected lobe, postoperative infectious complications, and cancer recurrence in patients who underwent lobectomy for clinical stage I lung cancer. METHODS We retrospectively reviewed 422 cases of resected lung cancer. We recorded the postoperative complications that developed within 30 days after surgery. The following covariates were included in the outcome analysis patient demographic variables, surgical approach, laterality, affected lobe, tumor size, histological type, tumor grade, pleural lavage cytology, pleural invasion, lymphovascular invasion, and lymph node metastasis. RESULTS Lower lobectomy was associated with significantly poorer recurrence-free (excluding non-specific death) and overall survival than upper lobectomy. According to a stepwise multiple cox-proportional hazards analysis, lower lobectomy, lymph node metastasis, tumor grade, and pleural invasion, were independent predictors of recurrence. The following postoperative complications were significantly associated with cancer recurrence and predominantly developed after lower lobectomy any grade ≥3 complications (n=61), space/organ surgical site infection of any grade (n=55), and any infection requiring antibiotics (n=61). CONCLUSIONS The current study revealed significant relationship among the site of resection (upper or lower lobe), cancer recurrence, and occurrence of infectious complications. We must clarify the role of preventing infectious complications in improving the early- and long-term outcomes of lower lobe cancer. Olfactory ensheathing cells (OECs) are special glial cells localized in olfactory system which secrete large number of neurotrophic factors and promote the migration and survival of neurons. Canonical Wnt/β-catenin signaling is activated in OECs during development and facilitates the growth and regeneration of axons. In the present study, we investigated the effects of Wnt-activated OECs on the proliferation and differentiation of neural stem cells (NSCs) in vitro. Primary neonatal mouse OECs were cultured and identified by immunostaining of P75 and GFAP. Wnt activation was achieved by lentivirus transfection of dominant-active-β-catenin (EbC) and examined by immunostaining of PY489. The conditioned medium (CM) of Wnt-activated OECs (wOECs-CM) and control OECs (cOECs-CM) was used to stimulate NSCs. In proliferation assay, wOECs-CM could increase the percentage of Ki67/Sox2 double positive cells. Under differentiation condition, wOECs-CM could maintain the expression of Nestin and promote the differentiation of NSCs into Tuj1-positive neurons. Taken together, our data revealed that wOECs stimulates the proliferation and differentiation of NSCs in a secretory manner, indicating that combined transplantation of wOECs and NSCs may be beneficial for regeneration. OBJECTIVE Trans bulbar B-mode sonography (TBS) is a recently proposed method but there is little known about its diagnostic accuracy in patients with multiple sclerosis without acute optic neuritis. Therefore we assessed the correlation between OND, ONSD and OND/ONSD ratio with clinical/para clinical parameters. METHODS In a comparative study, we intended to examine possible differences in optic nerve diameter (OND) and optic nerve sheath diameter (ONSD) between 60 patients with multiple sclerosis (MS) and 60 individuals as matched healthy controls. RESULTS The OND, ONSD and OND/ONSD ratio in both eyes showed significantly lower amounts in patients compared to healthy controls (p  less then  0.05). There were no correlations, between either OND or ONSD and factors including gender, age, P100 amplitude, disease duration, history of optic neuritis and number of T2 lesions in MRI (P ≥ 0.05). Expanded disability status scale (EDSS) and p100 Latency were correlated with both OND and ONSD values (P  less then  0.05). CONCLUSIONS TBS showed significantly lower amounts of OND, ONSD and OND/ONSD ratio in MS patients without current attack compared to their healthy controls indicating a subclinical axonal loss over time. It is suggested that TBS could be an applicable tool for early detection of optic nerve damages along with clinical and para-clinical findings. There is increasing evidence that COPD is a disease of accelerated lung aging, with the accumulation of senescent cells, which lose their ability to repair and secrete multiple inflammatory proteins known as the senescence-associated secretory phenotype (SASP), which mimics the profile of inflammatory mediators secreted in COPD. This review discusses novel drugs (senotherapies) that target cellular senescence which may be a promising therapeutic approach to prevent currently unaddressed disease progression and mortality in COPD. A major pathway leading to senescence is via the activation of PI3 kinase-mammalian target of rapamycin (mTOR) signaling. Existing drugs, such as rapamycin and metformin, target this pathway. Mitochondrial oxidative stress is a key driving mechanism for this pathway and mitochondria-targeted antioxidants are promising. A key finding in COPD is loss of anti-aging molecules such as sirtuin-1 and sirtuin-6, which are reduced by PI3K-mTOR signaling through microRNA-34a. Sirtuin activators are in development and inhibiting miR-34a restores sirtuin expression experimentally in COPD cells.

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