Safety of endoscopic mucosal resection (EMR) of large non-pedunculated colorectal adenomas in the elderly

Cellular mechanisms in basic and clinical gastroenterology and hepatolog

Detailed immune monitoring of a pregnant woman with critical Covid-19

A primigravid woman with Covid-19 related respiratory insufficiency was admitted into a tertiary Intensive Care Unit at 23 3/7 weeks' gestation. Highly sensitive flow cytometry of peripheral leukocytes indicated significantly suppressed naive T- and B-cell compartments. The suppressed immune cell responses led us keep the initially started administration of corticosteroids for fetal and maternal indication at a low dose. After three weeks her B-cell response peaked, SARS-CoV-2 was cleared and clinical improvement ensued a week later. At 28 weeks' gestation, a son of 1570 g was born by cesarean section. She was extubated two days postpartum and discharged from hospital 5.5 weeks postpartum.Perioperative Medicine: Efficacy, Safety and Outcome (Anesthesiology/Intensive Care

Short report: Post-operative wound infections after the gentle caesarean section

Developmen

Preoperative pain measurements in correlation to deep endometriosis classification with Enzian

Background: Deep Endometriosis (DE) classification studies with Enzian never compared solitary (A, B, C, F), and combinations of anatomical locations (A&B, A&C, B&C, A&B&C), in correlation to pain. Therefore, the results of these studies are challenging to translate to the clinical situation.Objectives: We studied pain symptoms and their correlation with the solitary and combinations of anatomical locations of deep endometriosis lesion(s) classified by the Enzian score.Materials and Methods: A prospective multi-centre study was conducted with data from university and non -university hospitals. A total of 419 surgical DE cases were collected with the web-based application called EQUSUM (www.equsum.org).Main outcome measures: Preoperative reported numeric rating scale (NRS) were collected along with the Enzian classification. Baseline characteristics, pain scores, surgical procedure and extent of the disease were also collected.Results: In general, more extensive involvement of DE does not lead to an increase in the numerical rating scale for pain measures. However, dysuria and bladder involvement do show a clear correlation AUC 0.62 (SE 0.04, CI 0.54-0.71, p< 0.01). Regarding the predictive value of dyschezia, we found a weak, but significant correlation with ureteric involvement; AUC 0.60 (SE 0.04, CI 0.53-0.67, p< 0.01).Conclusions:TPain symptoms poorly correlate with anatomical locations of deep endometriosis in almost all pain scores, with the exception of bladder involvement and dysuria which did show a correlation. Also, dyschezia seems to have predictive value for DE ureteric involvement and therefore MRI or ultrasound imaging (ureter and kidney) could be recommended in the preoperative workup of these patients.What's new? Dyschezia might have a predictive value in detecting ureteric involvement

The Role of Fish Oil in Psoriasis

In a randomized, double-blind, placebo-controlled study, patients received 10 fish or olive oil capsules three times daily for the whole study in addition to applying betamethasone diproprionate to their psoriatic plaques for the first 3 weeks. Most patients gradually worsened upon discontinuation of corticosteroids. Using survival analysis methods, no significant difference was found between the fish and olive oil groups. The authors attempt to put the role of fish oil in the therapy of psoriasis into perspective and discuss the efficacy of fish oil when used alone versus in combination therapy.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65334/1/j.1365-4362.1990.tb03477.x.pd

Towards Participatory E-Government?: Learning from E-Government Project Evaluations

Part 4: Critical ReflectionsInternational audienceThe question is whether citizens are sufficiently involved in the development of the facilities used to support e-Government, so they can safeguard the quality of these facilities. It is a relevant issue, as the projects in which these facilities are created often provide insufficient functionality. Based on a sample test, we selected evaluation reports of such projects and studied them based on a perceptual framework. It turns out that e-Government projects have been poorly evaluated and thereby governed. The evaluation governance instruments did not include any participative role of stakeholders. Principles of modern public administration theories are not sufficiently visible within the government in this regard. The quality can be improved substantially by involving representatives of industry and professional organizations, and by introducing co-creation before, during and after completion of projects, as well as during the corresponding evaluations and reflections