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Foster Egelund posted an update 1 day, 16 hours ago
PURPOSE To evaluate the onlay technique using the appendix for ureteric reconstruction and describe the initial experience of nine operations performed by one surgeon. METHODS Nine patients with complex ureteral strictures who underwent appendiceal onlay flap ureteroplasty since May 2019 were recruited from our RECUTTER date base. There were seven men and two women, with a mean age of 38.9 years; four patients underwent robot-assisted laparoscopic surgery, and five patients underwent traditional laparoscopic surgery. All patients had iatrogenic injuries of the ureter after treatment of stone disease. Seven patients had proximal ureteric strictures, and two had mid-ureteric strictures. The mean stricture length of the 9 patients was 3.9 (range 3-4.5) cm. Nephrostomy was performed in 7 patients before they presented to our center, and the other 2 patients had indwelling double-J ureteral stents. RESULTS All 9 operations were successfully completed without open conversion. The mean operation time was 182 (range 135-220) min, the mean estimated blood loss was 71 (range 20-100) mL, and the mean length of postoperative hospital stay was 9 (range 6-12 ) days. No postoperative complications of a high grade (Clavien-Dindo III and IV) occurred within 30 days of surgery. All the patients had their double-J ureteral stents and nephrostomy tubes removed after complete ureteroscopy and upper urinary tract urodynamic examination or computed tomography urography, which showed that the anastomosis healed well and that the urinary tract was unobstructed, respectively. The objective success rate was 100% (all the patients had endoscopic and radiographic resolution of their ureteral strictures). The subjective success rate was 88.9% (one patient developed recurrent back discomfort and a 0.5 cm calculus was found in her renal pelvis). CONCLUSIONS Appendiceal onlay flap ureteroplasty is a viable and effective technique for treating complex proximal and middle ureteral strictures at the right side.Jolanda Kluin speaks to Julia Titova, Commissioning Editor at Future Cardiology Jolanda Kluin started her medical training at the Erasmus University Rotterdam in 1989 and obtained her medical degree cum laude in 1996. Thereafter, she worked as a PhD student on the project “Photodynamic therapy for Barrett’s esophagus with use of 5-aminolevulinic acid”, receiving her PhD degree cum laude in 1999. In 2006 she finished her residency in cardiothoracic surgery. From 2006 to 2014 she worked as a staff cardiothoracic surgeon at the Department of Cardiothoracic Surgery of the University Medical Center Utrecht and since 2015 she works at the Academic Medical Center, Amsterdam as congenital cardiac surgeon. In 2018 she became a professor in translational cardiothoracic surgery at the University of Amsterdam. Her main interests are grown ups with congenital heart disease cardiac surgery, mitral valve surgery, and reconstructive surgery of the aortic valve and the thoracic aorta. Alongside her clinical tasks, she has started a new line of research in translational cardiothoracic surgery, including tissue engineering of heart valves, valve pathophysiology and the development of a hybrid soft robotic total artificial heart. She is the current chair of the EACTS Women in Cardiothoracic Surgery Committee.Veterans experiencing combat-related PTSD often refrain from seeking mental health services due to the stigma attached, which can lead to extreme and life-threatening consequences including depression, substance abuse, and suicide. Attaining a better understanding of coping mechanisms is important because it has the ability to help veterans better manage their stigma in the future and potentially help them survive PTSD and the stigma associated with it. Thus, the current study uses stigma management communication theory to uncover the ways in which veterans with PTSD communicatively manage their stigmatized identity. In-depth one-on-one interviews with United States veterans show that veterans with PTSD manage stigma using all six major strategies of stigma management communication. Some veterans managed stigma by blending contradictory strategies together. In addition, new stigma management communication strategies appeared. Not only do these results offer advancement for communication theory, but they could aid in the development of military training, military policy, mental health assessments, interventions, and destigmatizing campaigns.The cashew nut is an important product in Brazil, both for consumption and export, with the pulp of the cashew fruit being considered a by-product despite its high flavonoid content. In this study, the use of cashew pulp extract as a treatment for acne and in the prevention of early skin damage was investigated. Its flavonoid content was determined using spectrophotometric identification, and its effects on cell and bacterial viability, the migration of keratinocytes, and antioxidant activity in vitro were evaluated. Furthermore, it was incorporated into an emulsion for topical administration, and the physical-chemical stability parameters of the formulation were determined. EGFR targets The cashew pulp contained flavonoids with healing and antioxidant activity, and was not toxic to keratinocyte cells in a viability test. The flavonoid-rich formulation was stable, indicating that this is a promising formulation for use in the treatment of acne and protection of skin against premature damage.Phytochemical study on the EtOAC-soluble extract of the leaves of Gnetum gnemon furnished the isolation of a new phenylheptanoid, gnetumal (1), along with five known compounds (2-6). Their isolation was carried out by using the column chromatography and their structures were elucidated based on the basis of the spectral interpretation. Bioactivity assay of these compounds indicated that gnetumal (1) and p-coumaric acid (5) possessed more potent tyrosinase inhibitory activity, with IC50 values of 31.6 and 2.3 µM, respectively, than that of a positive control kojic acid (IC50; 44.6 µM).Increasingly, health scholars are paying attention to the health experiences of immigrant communities, particularly in the backdrop of the global flows of goods, services, and people across borders. In spite of the increasing public health emphasis on health outcomes of immigrants within the Middle Eastern (ME) countries, immigrant communities are often constructed as monoliths and the voices of immigrant communities are traditionally absent from mainstream health policy and program discourses. The health experiences of immigrants, their access to resources, and the health trajectories through the life-course followed by them and their descendants influence the deep-seated patterns of ethnic health disparities documented in the ME. Based on the culture-centered approach, we engaged in in-depth face-to-face interviews, and focus groups discussions with a total of 44 research participants, to understand how low-income Bangladeshi migrant workers in the United Arab Emirates (UAE), who live at the borders of mainstream Arab society, define, construct, and negotiate health issues.