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  • Svensson posted an update 9 months ago

    makers should support the following strategies to increase vaccination coverage and reach elimination of measles, mumps, and rubella strengthening health systems and vaccination access; raising awareness of disease severity and vaccination impact; limiting disease propagation owing to global changing environment and population dynamics (traveling, migration); improving surveillance systems to rapidly address the immunity gaps against disease resurgence.Introduction The COVID-19 pandemic has affected the entire population with the most deleterious effects in elders. Elders, especially those with diabetes, are at the highest risk of COVID-19 related adverse outcomes and mortality. This is usually linked to the comorbidities that accumulate with age, diabetes-related chronic inflammation, and the pandemic’s psychosocial effects.Areas covered We present some approaches to manage these complicated elderly patients with diabetes during the COVID-19 pandemic. In the inpatient setting, we suggest similar (pre-pandemic) glycemic targets and emphasize the importance of using IV insulin and possible use of continuous glucose monitoring to reduce exposure and PPE utilization. Outside the hospital, we recommend optimal glycemic control within the limits imposed by considerations of safety. We also describe the advantages and challenges of using various technological platforms in clinical care.Expert opinion The COVID-19 pandemic has lifted the veil off serious deficiencies in the infrastructures for care at both the individual level and the population level and also highlighted some of the strengths, all of which affect individuals with diabetes and COVID-19. We anticipate that things will not return to ‘normal’ after the COVID-19 pandemic has run its course, but rather they will be superseded by ‘New Normal.’

    To evaluate the different techniques for Essure

    microinserts removal and to assess the risk of fracture of the device and the intra- and post-operative complications in relation to surgical technique variants.

    Electronic search in Medline, Scopus and Embase databases using the following keywords Essure; Essure removal; Essure surgical technique.

    Out of 95 articles in the initial database, 17 studies were eligible for inclusion in our literature review. selleck chemicals llc Several surgical techniques have been described in which the most frequent were laparoscopic salpingectomy (LS), laparoscopic cornuectomy (LC), laparoscopic or vaginal hysterectomy (LH, VH) with en-bloc salpingectomy. There were more fractures of the device with the LS procedure (6.25%) followed by the LC technique (2.77%), while there was no fracture with hysterectomy. However, peri-and post-operative complications were more severe and frequent with hysterectomy in comparison with the LC and LS procedures (respectively 8.1% Clavien Dindo grade 3 for the hysterectomy group, 1.11% for the LC procedure and 0.69% for the LS technique).

    Due to the lack of standardised surgical treatment guidelines, a system of care networks for symptomatic patients with adverse effects related to Essure

    headed by specialised centres may offer a suitable and high-quality management with the appropriate removal techniques within two objectives limiting the risk of fracture (with an en-bloc removal of the Essure

    microinserts) and avoiding intra- and post-operative complications.

    Due to the lack of standardised surgical treatment guidelines, a system of care networks for symptomatic patients with adverse effects related to Essure® headed by specialised centres may offer a suitable and high-quality management with the appropriate removal techniques within two objectives limiting the risk of fracture (with an en-bloc removal of the Essure® microinserts) and avoiding intra- and post-operative complications.

    Extranodal extension (ENE) is a prognostic factor for several types of malignant tumors, including esophageal cancer. Although the prognostic value of ENE has been investigated in esophageal cancer, its clinical utility warrants further investigation.

    This retrospective single-center study evaluated 105 patients who underwent esophagectomy and had histologically node-positive metastasis between January 2007 and June 2017. The abilities of ENE to predict overall survival (OS) and disease-free survival (DFS) were evaluated using the Kaplan-Meier method and log-rank test, as well as Cox proportional hazard models. Subgroup analyses of ENE’s prognostic value were performed according to each pathological tumor-node-metastasis category.

    Significant differences according to ENE status were observed in the Kaplan-Meier analyses of OS (

     = 0.001) and DFS (

     = 0.001), as well as in the Cox proportional hazards models for OS (

     = 0.009) and DFS (

     = 0.012). Relative to patients without ENE, patients with ENE had significantly poorer OS if they also had pT3 status, pN1 status, or pathological stage III disease. However, no significant differences were observed in the subgroup analyses of pN3 status and pathological stage IV disease.

    Among patients with esophageal cancer, ENE status can predict a poor prognosis and may be useful for patient stratification. However, the prognostic value of ENE status may be limited to patients with specific pathological factors.

    Among patients with esophageal cancer, ENE status can predict a poor prognosis and may be useful for patient stratification. However, the prognostic value of ENE status may be limited to patients with specific pathological factors.Background The permanence of Alexandrite laser hair removal (LHR) has been of great interest. However, studies on long-term outcome are lacking.Objective To evaluate the hair reduction rates (HRRs) and laser parameters of patients who no longer need epilation after LHR, and redefine permanence.Patients & Methods Out of 183, 100 patients who discontinue epilation at least 2 years after LHR were included in the study. Self-perceived HRRs and patient satisfaction were recorded through patient questionnaires. The correlations between HRRs and treatment parameters, and the presence of polycystic ovary syndrome (PCOS) were assessed.Results Treatment sites were the face, legs, trunk, arm and bikini regions. Twenty-one patients had PCOS. The means of results (in range) were as follows; HRRs [56.28% (±19.73) and 67.74% (±16.42)]; the session numbers [5.52 (±2.50) and 9.80 (±4.15)] and, the treatment durations [62.2 (±40.0) and 90.0 (±45.9) weeks]. All patients stated they no longer require epilation since the remaining hairs were too thin to be noticed.

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