scholarly journals Facial Transplantation: Complications, Outcomes, and Long-Term Management Strategies

2020 ◽  
Vol 34 (04) ◽  
pp. 245-253
Author(s):  
Tom Shokri ◽  
Robert Saadi ◽  
Weitao Wang ◽  
Likith Reddy ◽  
Yadranko Ducic
Keyword(s):  
Social Issues ◽  
Management Strategies ◽  
Medical Community ◽  
Facial Transplantation ◽  
Transplantation Surgery ◽  
Future Challenges ◽  
Reconstructive Microsurgery ◽  
Transplantation Complications

AbstractWithin the past two decades, vascularized facial composite allotransplantation has evolved into a viable option in the reconstructive surgeons' armamentarium for patients with extensive facial disfigurements. As it has expanded the frontiers of microsurgical reconstructive techniques, facial transplantation has come to garner widespread interest within both the medical community and the general public. The procedure has established itself as an amalgamation of the forefronts of reconstructive microsurgery, immunology, and transplantation science. Therein too lies its complexity as multifaceted scientific developments are met with ethical and social issues. Both patients and physicians are faced with the everlasting challenges of immunosuppression regimens and their inherent complications, long-term aesthetic and functional considerations, the role of revision procedures, and the inevitable psychosocial implications. This article reflects on the medical and surgical advancements in facial transplantation surgery and highlights anticipated future challenges. It aims to encourage discussion regarding anticipated barriers to current practice and suggest future directions as we transition into the next phase of facial allograft transplantation.

scholarly journals Hormone therapy for first-line management of menopausal symptoms: Practical recommendations

2019 ◽  
Vol 15 ◽  
pp. 174550651986400 ◽  
Author(s):  
Santiago Palacios ◽  
John C Stevenson ◽  
Katrin Schaudig ◽  
Monika Lukasiewicz ◽  
Alessandra Graziottin
Keyword(s):  
Hormone Therapy ◽  
Symptomatic Relief ◽  
Medical Community ◽  
First Line ◽  
Menopausal Women ◽  
Term Benefit ◽  
Practical Recommendations ◽  
Line Management

Hormone therapy use has undergone dramatic changes over the past 20 years. Widespread use of hormone therapy in the 1980s and 1990s came to an abrupt halt in the early 2000s after initial findings of the Women’s Health Initiative trial were published and the study was terminated. Since then, much has been learned about the characteristics of women most likely to benefit from hormone therapy. There is general agreement that women younger than 60 years or who initiate hormone therapy within 10 years of menopause onset gain short-term benefit in terms of symptomatic relief and long-term benefit in terms of protection from chronic diseases that affect postmenopausal women. Despite accumulating evidence in support of hormone therapy for symptomatic menopausal women, the slow response by the medical community has led to a ‘large and unnecessary burden of suffering’ by women worldwide. Greater efforts are clearly needed to educate physicians and medical students about the pathophysiology of menopause and the role of hormone therapy in supporting women through the transition. This article provides a brief historical perspective of events that led to the backlash against hormone therapy, explores the current position of guideline groups, and provides practical recommendations to guide first-line management of symptomatic menopausal women.

scholarly journals Gazing into the crystal ball: future considerations for ensuring sustained growth of the functional food and nutraceutical marketplace

2013 ◽  
Vol 26 (1) ◽  
pp. 12-21 ◽  
Author(s):  
Christopher P. F. Marinangeli ◽  
Peter J. H. Jones
Keyword(s):  
Performance Indicators ◽  
Functional Food ◽  
Food Industry ◽  
Functional Foods ◽  
Academic Community ◽  
Nutrient Requirements ◽  
Future Challenges

Over the last decade the concept of functional foods and nutraceuticals (FFN) has gained support from various stakeholders including the food industry, scientific and academic community, government institutions or regulators, producers and consumers. However, as one begins to evaluate the global FFN industry, several issues emerge including (i) a lack of consensus across jurisdictions for acknowledging safe and efficacious FFN, (ii) challenges regarding the classification of novel food-derived bioactives as FFN or drugs, and (iii) a disconnect between nutrient requirements and dosages of FFN required to facilitate health benefits. The objectives of the present review are to discuss the role of existing stakeholders within the FFN marketplace and identify performance indicators for growth within the FFN sector. In addition, the following report provides feasible resolutions to present and future challenges facing the global FFN industry to ensure sustained long-term growth.

The long-term treatment of schizophrenia

2012 ◽  
Vol 153 (26) ◽  
pp. 1007-1012
Author(s):  
Róbert Herold
Keyword(s):  
Pharmacological Treatment ◽  
Management Strategies ◽  
Psychosocial Interventions ◽  
Term Treatment ◽  
Long Term Treatment ◽  
Challenging Tasks ◽  
Achievable Goal ◽  
Long Acting

The long-term treatment of schizophrenia is one of the most challenging tasks for practicing physicians. The most pronounced difficulty arises from the deficient compliance due to the lack of insight. Thus the treatment of schizophrenia requires a multimodal approach, which always includes psychosocial interventions beside the pharmacological treatment. The antipsychotic medication means the cornerstone in the pharmacological treatment of schizophrenia within which an increasing role of the long-acting second-generation injections can be detected. The outcome of schizophrenia can be modified by adequately organized management strategies, which in turn can lead to better quality of life and social functioning. If patients are provided with timely initiated effective medication and rehabilitation, then enduring remission can be a realistically achievable goal for the patients. Orv. Hetil., 2012, 153, 1007–1012.

scholarly journals Urinary Tract Infection in Children: An Update

2012 ◽  
Vol 36 (2) ◽  
pp. 90-97 ◽  
Author(s):  
Kamrul Laila ◽  
Eliza Roy ◽  
Md Habibur Rahman ◽  
Ranjit Ranjan Roy
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Management Strategies ◽  
Single Species ◽  
Common Disease ◽  
Urinary Tract Abnormality ◽  
Number Of Children

Background: A large number of children with Urinary Tract Infection (UTI) are seen in the community by general practitioners , but there is frequently delay in treatment and not all are referred for further investigations. There is evidence that many cases are misdiagnosed. It is important to optimize diagnostic and management strategies. Result: UTI is an important cause of acute illness, it may be a marker of underlying urinary tract abnormality. Bacteria causes the large majority of UTI in children- Escherichia coli is the most common (90%) bacterial cause. Urine culture & sensitivity is the gold standard for the diagnosis and mandatory for confirmation of UTI. On culture, a colony count of more than 105/ml organisms of a single species is considered confirmatory of UTI. But there is a strong recommendation that , presence of both pyuria and at least 50,000 Colony Forming Unit (CFU) / ml of a single uropathogen in an appropriately collected specimen makes the diagnosis . There is a recommended imaging schedule in childhood UTI to detect anatomical abnormality. Management depends on type of infection. There is no role of prophylactic antibiotics to prevent febrile recurrent UTI without VUR. Conclusion: UTI is a very common disease and may be associated with renal abnormalities and long term squeale. There is debate about best investigation and management strategies. The greatest potential for prevention of renal damage lies in increased awareness, better diagnosis and management of young children with UTI in primary healthcare. DOI: http://dx.doi.org/10.3329/bjch.v36i2.13085 Bangladesh J Child Health 2012; Vol 36 (2): 90-97

scholarly journals Common irrigation drivers of freshwater salinisation in river basins worldwide

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Josefin Thorslund ◽  
Marc F. P. Bierkens ◽  
Gualbert H. P. Oude Essink ◽  
Edwin H. Sutanudjaja ◽  
Michelle T. H. van Vliet
Keyword(s):  
Water Use ◽  
Irrigation Water ◽  
Management Strategies ◽  
River Basins ◽  
Irrigation Water Use ◽  
Salinity Levels ◽  
The Impact ◽  
Human Component

AbstractFreshwater salinisation is a growing problem, yet cross-regional assessments of freshwater salinity status and the impact of agricultural and other sectoral uses are lacking. Here, we assess inland freshwater salinity patterns and evaluate its interactions with irrigation water use, across seven regional river basins (401 river sub-basins) around the world, using long-term (1980–2010) salinity observations. While a limited number of sub-basins show persistent salinity problems, many sub-basins temporarily exceeded safe irrigation water-use thresholds and 57% experience increasing salinisation trends. We further investigate the role of agricultural activities as drivers of salinisation and find common contributions of irrigation-specific activities (irrigation water withdrawals, return flows and irrigated area) in sub-basins of high salinity levels and increasing salinisation trends, compared to regions without salinity issues. Our results stress the need for considering these irrigation-specific drivers when developing management strategies and as a key human component in water quality modelling and assessment.

scholarly journals Electronic Waste in China, Japan, and Vietnam: A Comparative Analysis of Waste Management Strategies

2018 ◽  
Vol 9 (1) ◽  
pp. 29-58 ◽  
Author(s):  
Eva Ignatuschtschenko
Keyword(s):  
Waste Management ◽  
Best Practice ◽  
Electronic Waste ◽  
Management Strategies ◽  
Management Approach ◽  
Practice Model ◽  
National Characteristics ◽  
Management Approaches

Abstract This paper comparatively analyses the e-waste sector in China, Japan, and Vietnam by examining progress towards the international best practice model of Integrated Sustainable Waste Management (ISWM) within each country. Through three distinct, yet interdependent dimensions of ISWM (stakeholders, waste system elements, and sustainability aspects), similarities and differences between the three East Asian countries are identified. The analysis shows that the e-waste management approaches differ substantially. The Vietnamese e-waste management approach is least consistent with the ISWM framework, while Japan complies the most with the ideals of the model and Chinese progress towards ISWM is mostly located between the two countries. However, a substantial proportion of Japanese e-waste is exported to developing countries in an uncontrolled manner. The analysis further suggests that the state of development and national characteristics have a significant impact on how the three countries approach e-waste management. In particular, the central role of the informal e-waste sectors in China and Vietnam poses a challenge to the establishment of an effective integrated sustainable e-waste management system. In light of the transnational flow of e-waste in the region, only joint actions will lead to long-term solutions to the increasing threat of e-waste to the environment and human health.

Renal Transplant Complications: Diagnostic and Therapeutic Role of Radiology

2014 ◽  
Vol 65 (3) ◽  
pp. 242-252 ◽  
Author(s):  
Mehmet Fatih Inci ◽  
Fuat Ozkan ◽  
Teik Choon See ◽  
Servet Tatli
Keyword(s):  
Renal Transplantation ◽  
Surgical Techniques ◽  
Diagnosis And Treatment ◽  
Tubular Necrosis ◽  
Transplantation Surgery ◽  
Wide Range ◽  
Transplantation Complications ◽  
Fluid Collections ◽  
Vein Stenosis

Kidney was the first and is the most frequently transplanted organ. Despite improved surgical techniques and transplantation technology, complications do occur and, if left untreated, may lead to catastrophic consequences. Renal transplantation complications may be vascular (eg, renal artery and vein stenosis and thrombosis, arteriovenous fistula, and pseudoaneurysms); urologic (eg, urinary obstruction and leak, and peritransplantation fluid collections, including hematoma, seroma, lymphocele, and abscess formation); and nephrogenic, including acute tubular necrosis, graft rejection, chronic allograft nephropathy, and neoplasm. Early diagnosis and treatment of these complications are paramount to prevent graft failure and other significant morbidities to the patients. Radiology plays a pivotal role in the diagnosis and treatment of these complications, with minimally invasive percutaneous techniques. In this article, we reviewed renal transplantation anatomy, a wide range of complications that may occur after renal transplantation surgery, typical imaging appearances of the complications on varies imaging modalities, and percutaneous interventional techniques that are used in their treatment.

scholarly journals Orthopaedic implant failure: aseptic implant loosening–the contribution and future challenges of mouse models in translational research

2014 ◽  
Vol 127 (5) ◽  
pp. 277-293 ◽  
Author(s):  
Luis Alberto Cordova ◽  
Verena Stresing ◽  
Bérengère Gobin ◽  
Philippe Rosset ◽  
Norbert Passuti ◽  
...  
Keyword(s):  
Aseptic Loosening ◽  
Mouse Models ◽  
Implant Failure ◽  
Orthopaedic Implant ◽  
Implant Loosening ◽  
Periprosthetic Osteolysis ◽  
New Era ◽  
Future Challenges

Aseptic loosening as a result of wear debris is considered to be the main cause of long-term implant failure in orthopaedic surgery and improved biomaterials for bearing surfaces decreases significantly the release of micrometric wear particles. Increasingly, in-depth knowledge of osteoimmunology highlights the role of nanoparticles and ions released from some of these new bearing couples, opening up a new era in the comprehension of aseptic loosening. Mouse models have been essential in the progress made in the early comprehension of pathophysiology and in testing new therapeutic agents for particle-induced osteolysis. However, despite this encouraging progress, there is still no valid clinical alternative to revision surgery. The present review provides an update of the most commonly used bearing couples, the current concepts regarding particle–cell interactions and the approaches used to study the biology of periprosthetic osteolysis. It also discusses the contribution and future challenges of mouse models for successful translation of the preclinical progress into clinical applications.

scholarly journals Histology of maize seeds and young germinating embryos after liquid nitrogen exposure

2021 ◽  
Vol 26 (4) ◽  
pp. 2855-2861
Author(s):  
ARIEL VILLALOBOS-OLIVERA ◽  
ROSMERY PEREIRA ◽  
DAVIEL GÓMEZ ◽  
JULIA MARTÍNEZ ◽  
DORIS ESCALANTE ◽  
...  
Keyword(s):  
Liquid Nitrogen ◽  
Short Communication ◽  
Histological Evaluation ◽  
Agricultural Commodity ◽  
Histological Changes ◽  
Germplasm Preservation ◽  
Maize Seeds ◽  
Future Challenges

Maize represents a staple food crop and is the second most important agricultural commodity globally. Considering the important role of maize for food security, the long-term conservation of valuable germplasm is critical to ensure that high levels of genetic diversity are available for breeding superior cultivars to face future challenges. Cryopreservation is regarded as the most appropriate tool for long-term germplasm preservation and has been investigated in different crops. This short communication adds to the existing knowledge on maize cryopreservation by describing histological changes observed in maize seeds and young germinating embryos after liquid nitrogen (LN) exposure. Plants were examined immediately after recovery from LN (day zero) and following 3 days of germination. At day 3, seeds exposed to LN showed lower germination rates than non-cryostored seeds, i.e., 60.7% vs. 83.3%. Histological evaluation at day 3 revealed that the thickness of the conical endosperm and the scutellum did not show any statistically significant differences between control and cryopreserved seeds. In contrast, for the other histological evaluations made, mostly regarding the thickness of mesocarp, mealy endosperm, plumule, radicle and the epidermis, significant differences were observed between control and cryostored seeds with the former consistently displaying higher average values than the latter.

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