Spontaneous resolution and the role of endoscopic surgery in the treatment of primary obstructive megaureter: a review of the literature

The megaureter accounts for almost a quarter of all urinary tract dilations diagnosed in utero and is the second leading cause of hydronephrosis in newborns, following pyeloureteral junction obstruction. The current standard treatment for progressive or persistent, symptomatic primary obstructive megaureter is ureteral anti-reflux reimplantation, which can be associated with ureteral remodeling or plication. Due to the associated morbidity, postoperative recovery challenges, and the complications that may arise from the open surgical approach, there has been a natural inclination towards validating new minimally invasive techniques. This study reviews the literature, extracting data from three major international databases, from 1998 to 2022. Out of 1172 initially identified articles, only 52 were deemed eligible, analyzing 1764 patients and 1981 renal units. Results show that 65% of cases required surgical intervention, with minimally invasive techniques constituting 56% of these procedures. High-pressure endoscopic balloon dilation was the preferred endourologic technique. The degree of ureterohydronephrosis is considered one of the factors indicating the need for surgery. There is an inverse relationship between the diameter of the ureter and the likelihood of spontaneous resolution. Conditions such as renal hypoplasia, renal dysplasia, or ectopic ureteral insertion strongly indicate a poor prognosis. Endoscopic surgical techniques for treating primary obstructive megaureter can be definitive, firstline treatment options. In selected cases, they might be at least as effective and safe as the open approach, but with advantages like quicker recovery, fewer complications, shorter hospital stays, and reduced costs

Liver resections in hepatocarcinoma – preliminary results

Clinica I Chirurgie, Sp. “Sf. Spiridon”, Iași, UMF “Gr.T. Popa”, Iași, Romania, Al XI-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova și cea de-a XXXIII-a Reuniune a Chirurgilor din Moldova „Iacomi-Răzeșu” 27-30 septembrie 2011Introducere. Carcinomul hepatocelular (CHC) este forma dominantă de malignitate hepatică primitivă şi este diferită histologic şi etiologic de alte forme de cancer hepatic. Incidența în lume variază între 2 şi 30 de cazuri/ 100000 locuitori/an, iar în România după ultimele date este de 4-10/100000 locuitori/an. Carcinomul hepatocelular este o cauză importantă de deces prin cancer în întreaga lume, iar incidența sa este de aşteptat să crească în continuare în următorii ani. Rezecția chirurgicală a tumorii este cea mai bună metodă de tratament și are șansa de vindecare cea mai mare. Material și Metodă. Am efectuat un studiu prospectiv în perioada 01.04.2009-30.06.2011 pe 17 pacienți cu hepatocarcinom tratați în Clinica I Chirurgie. Au fost incluși doar pacienții la care s-a practicat rezecție hepatică. Rezultate. Din numărul total de pacienți au predominat bărbații reprezentând 64,7%. Vârsta medie a fost de 59,6 ani cu extreme între 25 ani și 78 ani. În 14 cazuri CHC s-a dezvoltat pe hepatită virală cronică. La 58.8% din pacienți localizarea a fost în lobul drept, iar în lobul stâng la 41,2%. Am avut complicații postoperatorii la 4 pacienți și un deces. Concluzii. Rezecția hepatică se poate efectua la pacienții cu CHC în condiții sigure chiar și la cei cu ciroză hepatică. Această metodă de tratament trebuie efectuată de fiecare dată când este posibil deoarece are complicații minime și cel mai bun prognostic.Introduction. The hepatocarcinoma (HCC) is the dominant type of primary liver malignant tumors, with a different etiology and histology comparing to others liver malignancies. The worldwide annual incidence varies between 2 and 30 cases/100000 inhabitants. The incidence of hepatocarcinoma in Romania is 4 to 10 cases/100000 inhabitants per year. The hepatocellular carcinoma represent an important cause of death through malignancies, with a predictive raising in the next years. The liver resection is the rational and potentially curative therapy. Material and methods. This paper is based on a prospective study between 01.06.2009- 30.06.2011; we included 17 patients with hepatocarcinoma treated in 1st Surgical Clinic of St. Spiridon Hospital, considering only the patients with liver resection. Results. The males represented 64,5% of all the patients included in our study, the medium age was 54,7 years, with age limits between 25 and 78. In 14 of the cases the HCC developped on chronic viral hepatitis. In 58,5% of the cases the tumor was localised in the right liver, in the left liver the percentage being 41,5%. We had 4 postoperative complications and 1 death. Conclusions. The liver resection is a safe procedure for the patients with hepatocarcinoma, even the liver cirrhosis developped. This treatment procedure should be considered in all the selected cases, the resection having the best prognosis and minimally complications

Recurrence of hepatocellular carcinoma

Clinica I Chirurgie, Spitalul “Sf.Spiridon”, Departamentul de Chirurgie, Universitatea de Medicină și Farmacie “Gr.T.Popa”, Iași, România, Al XII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova cu participare internațională 23-25 septembrie 2015Introducere: Rezecția hepatică rămâne “standardul de aur” în tratamentul cancerului hepatocelular (CHC). Alegerea variantei de rezecție hepatică depinde de mai mulți factori: localizarea tumorii, dimensiunile tumorii, starea parenchimului hepatic nontumoral, scorul Child-Pugh. Problema recurenței locoregionale în funcție de tipul de rezecție rămâne controversată. Scopul studiului: Ne-am propus să comparăm rata recurenței loco-regionale a CHC în funcție de tipul de rezecție hepatică (anatomică versus non-anatomică). Material și metode: Am analizat 64 de pacienți cu CHC, care au beneficiat de rezecție hepatică curativă în perioada 2005- 2013. Pacienții au fost împărțiți în două loturi: lotul A – 26 de pacienți la care s-a practicat o rezecție hepatică anatomică și lotul B – 38 de pacienți la care s-a practicat o rezecție hepatică non-anatomică. Rezultate: Pe o perioadă de urmărire postoperatorie cuprinsă între 12 și 60 de luni, rata recurenței CHC în cele două loturi a fost de 32% în grupul A și 31,4% în grupul B (P=0,963). Durata medie de apariție a recurenței a fost de 15,63±7,46 luni (între 5 și 25 luni) în lotul A și 16,91±9,35 luni (între 5 și 33 luni) în lotul B (P=0,753). Concluzii: Tipul de rezecție hepatică (anatomică sau non-anatomică) nu influențează apariția recurenței CHC, dacă se respectă limitele oncologice de rezecție.Introduction: Liver resection remains the gold standard in the treatment of hepatocellular cancer (HCC). Choosing liver resection depends on several factors: tumor location, tumor size, condition nontumoral liver parenchyma, Child-Pugh score. The locoregional recurrence problem depending on the type of resection remains controversial. The purpose of the study: We aimed to compare loco-regional recurrence rate of HCC according to the type of hepatic resection (anatomic versus non-anatomical). Material and methods: We analyzed 64 patients with HCC who received curative liver resection during the period 2005-2013. Patients were divided into two groups: group A – 26 patients who underwent hepatic anatomical resection and group B – 38 patients who underwent non-anatomical hepatic resection. Results: On a postoperative follow-up period between 12 and 60 months, HCC recurrence rate in the two groups was 32% in group A and 31.4% in group B (P=0.963). The average length of developing appellant was 15.63±7.46 months (between 5 and 25 months) in group A and 16.91±9.35 months (between 5 and 33 months) in group B (P=0.753). Conclusions: The type of liver resection (anatomical or non-anatomical) does not influence the occurrence of HCC recurrence, if we respect the oncologic limits resection

Installation of C4 photosynthetic pathway enzymes in rice using a single construct

Introduction of a C4 photosynthetic mechanism into C3 crops offers an opportunity to improve photosynthetic efficiency, biomass and yield in addition to potentially improving nitrogen and water use efficiency. To create a two-cell metabolic prototype for an NADP-malic enzyme type C4 rice, we transformed Oryza sativa spp. japonica cultivar Kitaake with a single construct containing the coding regions of carbonic anhydrase, phosphoenolpyruvate (PEP) carboxylase, NADP-malate dehydrogenase, pyruvate orthophosphate dikinase and NADP-malic enzyme from Zea mays, driven by cell-preferential promoters. Gene expression, protein accumulation and enzyme activity were confirmed for all five transgenes, and intercellular localization of proteins was analysed. 13CO2 labelling demonstrated a 10-fold increase in flux though PEP carboxylase, exceeding the increase in measured in vitro enzyme activity, and estimated to be about 2% of the maize photosynthetic flux. Flux from malate via pyruvate to PEP remained low, commensurate with the low NADP-malic enzyme activity observed in the transgenic lines. Physiological perturbations were minor and RNA sequencing revealed no substantive effects of transgene expression on other endogenous rice transcripts associated with photosynthesis. These results provide promise that, with enhanced levels of the C4 proteins introduced thus far, a functional C4 pathway is achievable in rice.This work was funded by a C4 Rice Project grant from Bill & Melinda Gates Foundation to the University of Oxford (2015– 2019; OPP1129902), Max Planck Society (SA, HI, RF, MG, JEL, MS) and Australian Research Council (DP150101037 to ML, JEL, MS and CE140100015). Work in the SK laboratory was supported by the European Union’s Horizon 2020 research and innovation programme under grant agreement number 637765; SK is a Royal Society University Research Fello

Potential efficacy of dopaminergic antidepressants in treatment resistant anergic-anhedonic depression results of the chronic anergic-anhedonic depression open trial – CADOT

IntroductionAmong treatment-resistant depression (TRD), we identified anergic-anhedonic clinical presentations (TRAD) as putatively responsive to pro-dopaminergic strategies. Based on the literature, non-selective monoamine oxidase inhibitors (MAOI) and dopamine D2 receptor agonists (D2RAG) were sequentially introduced, frequently under the coverage of a mood stabilizer. This two-step therapeutic strategy will be referred to as the Dopaminergic Antidepressant Therapy Algorithm (DATA). We describe the short and long-term outcomes of TRAD managed according to DATA guidelines.MethodOut of 52 outpatients with TRAD treated with DATA in a single expert center, 48 were included in the analysis [severity – QIDS (Quick Inventory of Depressive Symptomatology) = 16 ± 3; episode duration = 4.1 ± 2.7 years; Thase and Rush resistance stage = 2.9 ± 0.6; functioning – GAF (Global Assessment of Functioning) = 41 ± 8]. These were followed-up for a median (1st – 3rd quartile) of 4 (1–9) months before being prescribed the first dopaminergic treatment and remitters were followed up 21 (11–33) months after remission.ResultsAt the end of DATA step 1, 25 patients were in remission (QIDS <6; 52% [38–66%]). After DATA step 2, 37 patients were in remission (77% [65–89%]) to whom 5 patients with a QIDS score = 6 could be added (88% [78–97%]). Many of these patients felt subjectively remitted (GAF = 74 ± 10). There was a significant benefit to combining MAOI with D2RAG which was maintained for at least 18 months in 30 patients (79% [62–95%]).ConclusionThese results support TRAD sensitivity to pro-dopaminergic interventions. However, some clinical heterogeneities remain in our sample and suggest some improvement in the description of dopamine-sensitive form(s)

Multidifferential study of identified charged hadron distributions in ZZ-tagged jets in proton-proton collisions at s=\sqrt{s}=13 TeV

Jet fragmentation functions are measured for the first time in proton-proton collisions for charged pions, kaons, and protons within jets recoiling against a $Z$ boson. The charged-hadron distributions are studied longitudinally and transversely to the jet direction for jets with transverse momentum 20 $< p_{\textrm{T}} < 100$ GeV and in the pseudorapidity range $2.5 < \eta < 4$. The data sample was collected with the LHCb experiment at a center-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 1.64 fb$^{-1}$. Triple differential distributions as a function of the hadron longitudinal momentum fraction, hadron transverse momentum, and jet transverse momentum are also measured for the first time. This helps constrain transverse-momentum-dependent fragmentation functions. Differences in the shapes and magnitudes of the measured distributions for the different hadron species provide insights into the hadronization process for jets predominantly initiated by light quarks.Comment: All figures and tables, along with machine-readable versions and any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-013.html (LHCb public pages

Study of the B−→Λc+Λˉc−K−B^{-} \to \Lambda_{c}^{+} \bar{\Lambda}_{c}^{-} K^{-} decay

The decay $B^{-} \to \Lambda_{c}^{+} \bar{\Lambda}_{c}^{-} K^{-}$ is studied in proton-proton collisions at a center-of-mass energy of $\sqrt{s}=13$ TeV using data corresponding to an integrated luminosity of 5 $\mathrm{fb}^{-1}$ collected by the LHCb experiment. In the $\Lambda_{c}^+ K^{-}$ system, the $\Xi_{c}(2930)^{0}$ state observed at the BaBar and Belle experiments is resolved into two narrower states, $\Xi_{c}(2923)^{0}$ and $\Xi_{c}(2939)^{0}$, whose masses and widths are measured to be $$m(\Xi_{c}(2923)^{0}) = 2924.5 \pm 0.4 \pm 1.1 \,\mathrm{MeV}, \\ m(\Xi_{c}(2939)^{0}) = 2938.5 \pm 0.9 \pm 2.3 \,\mathrm{MeV}, \\ \Gamma(\Xi_{c}(2923)^{0}) = \phantom{000}4.8 \pm 0.9 \pm 1.5 \,\mathrm{MeV},\\ \Gamma(\Xi_{c}(2939)^{0}) = \phantom{00}11.0 \pm 1.9 \pm 7.5 \,\mathrm{MeV},$$ where the first uncertainties are statistical and the second systematic. The results are consistent with a previous LHCb measurement using a prompt $\Lambda_{c}^{+} K^{-}$ sample. Evidence of a new $\Xi_{c}(2880)^{0}$ state is found with a local significance of $3.8\,\sigma$, whose mass and width are measured to be $2881.8 \pm 3.1 \pm 8.5\,\mathrm{MeV}$ and $12.4 \pm 5.3 \pm 5.8 \,\mathrm{MeV}$, respectively. In addition, evidence of a new decay mode $\Xi_{c}(2790)^{0} \to \Lambda_{c}^{+} K^{-}$ is found with a significance of $3.7\,\sigma$. The relative branching fraction of $B^{-} \to \Lambda_{c}^{+} \bar{\Lambda}_{c}^{-} K^{-}$ with respect to the $B^{-} \to D^{+} D^{-} K^{-}$ decay is measured to be $2.36 \pm 0.11 \pm 0.22 \pm 0.25$, where the first uncertainty is statistical, the second systematic and the third originates from the branching fractions of charm hadron decays.Comment: All figures and tables, along with any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-028.html (LHCb public pages

Measurement of the ratios of branching fractions R(D∗)\mathcal{R}(D^{*}) and R(D0)\mathcal{R}(D^{0})

The ratios of branching fractions $\mathcal{R}(D^{*})\equiv\mathcal{B}(\bar{B}\to D^{*}\tau^{-}\bar{\nu}_{\tau})/\mathcal{B}(\bar{B}\to D^{*}\mu^{-}\bar{\nu}_{\mu})$ and $\mathcal{R}(D^{0})\equiv\mathcal{B}(B^{-}\to D^{0}\tau^{-}\bar{\nu}_{\tau})/\mathcal{B}(B^{-}\to D^{0}\mu^{-}\bar{\nu}_{\mu})$ are measured, assuming isospin symmetry, using a sample of proton-proton collision data corresponding to 3.0 fb${ }^{-1}$ of integrated luminosity recorded by the LHCb experiment during 2011 and 2012. The tau lepton is identified in the decay mode $\tau^{-}\to\mu^{-}\nu_{\tau}\bar{\nu}_{\mu}$. The measured values are $\mathcal{R}(D^{*})=0.281\pm0.018\pm0.024$ and $\mathcal{R}(D^{0})=0.441\pm0.060\pm0.066$, where the first uncertainty is statistical and the second is systematic. The correlation between these measurements is $\rho=-0.43$. Results are consistent with the current average of these quantities and are at a combined 1.9 standard deviations from the predictions based on lepton flavor universality in the Standard Model.Comment: All figures and tables, along with any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-039.html (LHCb public pages

Laser In Dental Medicine. The Psychological Impact In Privat Practice

The aim of these study is to use the laser anaesthesia, a non-contact technique, in the minimal invaziv treatment of the profound and medium carrious lesions, at different erbium laser parameters. Material and method: The study group included 68 patiens with ages between 6 and 20; a two-year study (january 2006 – november 2008) performed in a private practice. The carious lesions treatment was performed with a saphire G6 erbium laser tip. Both laser anaesthesia techniques were used, assessing the patients dental anxiety with Hamilton Anxiety Scale and the intraoperatory sensitivity with the Wong-Baker FACES Pain Rating Scale. Results: Before chosing the anaesthesia techniques, 73% of the subjects were diagnosticated with moderate anxiety and a rigid, fear face; 20% severe symptoms, with distracted, tearful face and 7% of the patients had mild anxiety with a happy face. At the end of the treatment, 61,1% of the children and young adults with moderate symptoms of anxiety had a happy, hurts a little bit face; and those with severe anxiety had an indifferent face

EVALUATION OF INTEGRATIVE PERIODONTAL, SURGICAL, ORTHODONTIC AND PROSTHETIC TREATMENT IN SEVERE GENERALIZED AGGRESSIVE PERIODONTITIS

Aim of the study Evaluation and improving of periodontal status through alignment of the molars in mesial tipping. Material and methods We studied 26 patients, affected by aggresive periodontitis, with age between 26-35 years old, with extracted 3.6 and 4.6 from different reasons and second molar rotated and mesialized. Periodontal clinical exam revealed thin gingival tissue of 3-4 mm (21 cases, 80, 7%) on the mesial surface of the second molar. Radiographic exam revealed the enlargement of the periodontal space and the resorbtion of the interproximal mesial bone. The treatment for the second molar consisted in fixed orthodontic devices and different uprighting techniques depending on the periodontal status of the patient: 50% with uprighting spring, 30% with orthodontic implant and 20% with tip back technique. Results After treatment it was noticed an improving of the gingival tissue status, the reduction of the periodontal pockets with 2 mm and the reshaping of the bone. Conclusions Orthodontic treatment applied to partial toothless aims to create optimal conditions for the insertion of oral implants to represent elements of support for future prosthetic reconstruction