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PURPOSE: We aimed to investigate controversial pediatric urolithiasis issues systematically, integrating expert consensus and comprehensive guidelines reviews. METHODS: Two semi-structured online focus group meetings were conducted to discuss the study's need and content, review current literature, and prepare the initial survey. Data were collected through surveys and focus group discussions. Existing guidelines were reviewed, and a second survey was conducted using the Delphi method to validate findings and facilitate consensus. The primary outcome measures investigated controversial issues, integrating expert consensus and guideline reviews. RESULTS: Experts from 15 countries participated, including 20 with 16+ years of experience, 2 with 11-15 years, and 4 with 6-10 years. The initial survey identified nine main themes, emphasizing the need for standardized diagnostic and treatment protocols and tailored treatments. Inter-rater reliability was high, with controversies in treatment approaches (score 4.6, 92% agreement), follow-up protocols (score 4.8, 100% agreement), and diagnostic criteria (score 4.6, 92% agreement). The second survey underscored the critical need for consensus on identification, diagnostic criteria (score 4.6, 92% agreement), and standardized follow-up protocols (score 4.8, 100% agreement). CONCLUSION: The importance of personalized treatment in pediatric urolithiasis is clear. Prioritizing low-radiation diagnostic tools, effectively managing residual stone fragments, and standardized follow-up protocols are crucial for improving patient outcomes. Integrating new technologies while ensuring safety and reliability is also essential. Harmonizing guidelines across regions can provide consistent and effective management. Future efforts should focus on collaborative research, specialized training, and the integration of new technologies in treatment protocols.
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Guías de Práctica Clínica como Asunto , Urolitiasis , Humanos , Niño , Urolitiasis/terapia , Urolitiasis/diagnóstico , Consenso , Técnica DelphiRESUMEN
Arteriovenous malformations of adrenal gland are extremely rare. We report a case of an adrenal arteriovenous malformation, mimicking an adrenal tumor in preoperative imaging. A 48-year-old woman presented to our clinic with abdominal pain. A 9x7 cm right adrenal tumor was detected. Based on the imaging findings, adrenal adenoma was suspected. However, clinical symptoms and endocrine abnormalities were absent, the lesion was thought to be non-functional. Laparoscopic right adrenalectomy was performed. Pathologically, this was diagnosed as an adrenal arteriovenous malformation. To the best of our knowledge, this is the first reported case of an adrenal arteriovenous malformation in the current literature.
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Pararectal splenosis is an extremely rare lesion caused by ectopic auto-transplantation of splenic tissue after splenic trauma or splenectomy. It is often asymptomatic and detected incidentally during radiologic evaluation. We present a 24-year-old male with pararectal splenosis. The patient had a history of splenectomy and presented with complaints of abdominal discomfort and chronic constipation. Contrast-enhanced computed tomography (CT) revealed multiple well-enhanced masses located in the abdominal cavity and one mass in pararectal area. Additionally, the pararectal lesion showed diffusion restriction on diffusion-weighted magnetic resonance imaging (DW-MRI). In this case report, we aim to highlight the significance of taking a detailed medical history; and using DW-MRI for diagnosis of splenosis by presenting a case in a rare location.
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Esplenosis , Adulto , Imagen de Difusión por Resonancia Magnética , Humanos , Masculino , Esplenectomía , Esplenosis/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adulto JovenRESUMEN
The cross section of the process e^{+}e^{-}âπ^{+}D^{0}D^{*-} for center-of-mass energies from 4.05 to 4.60 GeV is measured precisely using data samples collected with the BESIII detector operating at the BEPCII storage ring. Two enhancements are clearly visible in the cross section around 4.23 and 4.40 GeV. Using several models to describe the dressed cross section yields stable parameters for the first enhancement, which has a mass of 4228.6±4.1±6.3 MeV/c^{2} and a width of 77.0±6.8±6.3 MeV, where the first uncertainties are statistical and the second ones are systematic. Our resonant mass is consistent with previous observations of the Y(4220) state and the theoretical prediction of a DD[over ¯]_{1}(2420) molecule. This result is the first observation of Y(4220) associated with an open-charm final state. Fits with three resonance functions with additional Y(4260), Y(4320), Y(4360), ψ(4415), or a new resonance do not show significant contributions from either of these resonances. The second enhancement is not from a single known resonance. It could contain contributions from ψ(4415) and other resonances, and a detailed amplitude analysis is required to better understand this enhancement.
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Using e^{+}e^{-} annihilation data of 2.93 fb^{-1} collected at center-of-mass energy sqrt[s]=3.773 GeV with the BESIII detector, we measure the absolute branching fraction of D^{0}âK^{-}µ^{+}ν_{µ} with significantly improved precision: B_{D^{0}âK^{-}µ^{+}ν_{µ}}=(3.413±0.019_{stat}±0.035_{syst})%. Combining with our previous measurement of B_{D^{0}âK^{-}e^{+}ν_{e}}, the ratio of the two branching fractions is determined to be B_{D^{0}âK^{-}µ^{+}ν_{µ}}/B_{D^{0}âK^{-}e^{+}ν_{e}}=0.974±0.007_{stat}±0.012_{syst}, which agrees with the theoretical expectation of lepton flavor universality within the uncertainty. A study of the ratio of the two branching fractions in different four-momentum transfer regions is also performed, and no evidence for lepton flavor universality violation is found with current statistics. Taking inputs from global fit in the standard model and lattice quantum chromodynamics separately, we determine f_{+}^{K}(0)=0.7327±0.0039_{stat}±0.0030_{syst} and |V_{cs}|=0.955±0.005_{stat}±0.004_{syst}±0.024_{LQCD}.
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Using a 3.19 fb^{-1} data sample collected at an e^{+}e^{-} center-of-mass energy of E_{cm}=4.178 GeV with the BESIII detector, we measure the branching fraction of the leptonic decay D_{s}^{+}âµ^{+}ν_{µ} to be B_{D_{s}^{+}âµ^{+}ν_{µ}}=(5.49±0.16_{stat}±0.15_{syst})×10^{-3}. Combining our branching fraction with the masses of the D_{s}^{+} and µ^{+} and the lifetime of the D_{s}^{+}, we determine f_{D_{s}^{+}}|V_{cs}|=246.2±3.6_{stat}±3.5_{syst} MeV. Using the câs quark mixing matrix element |V_{cs}| determined from a global standard model fit, we evaluate the D_{s}^{+} decay constant f_{D_{s}^{+}}=252.9±3.7_{stat}±3.6_{syst} MeV. Alternatively, using the value of f_{D_{s}^{+}} calculated by lattice quantum chromodynamics, we find |V_{cs}|=0.985±0.014_{stat}±0.014_{syst}. These values of B_{D_{s}^{+}âµ^{+}ν_{µ}}, f_{D_{s}^{+}}|V_{cs}|, f_{D_{s}^{+}} and |V_{cs}| are each the most precise results to date.
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Nesfatin-1, a recently discovered peptide, was shown to have anti-inflammatory effects. Acute pancreatitis (AP) is a life-threatening condition caused by various reasons. Although the etiology of AP is well-known, its pathogenesis is not clear. The aim of this study is to investigate the possible anti-inflammatory role of nesfatin-1 and its probable protective underlying mechanisms in an acute pancreatitis model. Caerulein was applied intraperitoneally to induce acute pancreatitis in Sprague-Dawley female rats. Nesfatin-1 was administered 5 minutes before the application of caerulein to determine its potential anti-inflammatory role on AP. Five minutes before nesfatin-1 injection, in order to investigate the underlying mechanism, oxytocin receptor antagonist (atosiban), melanocortin receptor antagonist (HS024), or ghrelin receptor antagonist (cortistatin) were administered. Five minutes after nesfatin-1 administration, two doses of caerulein were applied one hour apart. The rats were sacrified 12 hours after the first caerulein dose for serum and pancreatic tissue sampling. Microscopic damage scoring, malondialdehyde and glutathione levels, myeloperoxidase activity, luminol and lucigenin chemiluminescence levels in pancreatic tissue and amylase, lipase, trypsinogen-2 levels in serum were evaluated. Oxidative damage was decreased with nesfatin-1 treatment in the acute pancreatitis model (P < 0.05 - 0.001). The administration of HS024 reversed the effect of nesfatin-1, via increasing lipase, amylase, trypsinogen-2, malondialdehyde (MDA), myeloperoxidase (MPO) and lucigenin levels (P < 0.05 - 0.01). Atosiban pre-treatment elevated MPO activity, luminol and lucigenin chemiluminescence levels (P < 0.01 - 0.001) and cortistatin increased lucigenin and luminol chemiluminescence (P < 0.05 - 0.01). Although receptor antagonists reversed the effect of nesfatin-1 on related biochemical parameters, no significant difference was found in histological scoring. Our results indicated that nesfatin-1 had an anti-inflammatory effect on acute pancreatitis via mainly effecting melanocortin receptors.
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Antiinflamatorios/farmacología , Nucleobindinas/farmacología , Pancreatitis/prevención & control , Receptores de Melanocortina/metabolismo , Enfermedad Aguda , Animales , Antiinflamatorios/administración & dosificación , Ceruletida , Modelos Animales de Enfermedad , Femenino , Nucleobindinas/administración & dosificación , Ratas , Ratas Sprague-DawleyRESUMEN
Using a data sample corresponding to an integrated luminosity of 2.93 fb^{-1} taken at a center-of-mass energy of 3.773 GeV with the BESIII detector operated at the BEPCII collider, we perform an analysis of the semileptonic decays D^{0(+)}âπ^{-(0)}µ^{+}ν_{µ}. The branching fractions of D^{0}âπ^{-}µ^{+}ν_{µ} and D^{+}âπ^{0}µ^{+}ν_{µ} are measured to be (0.272±0.008_{stat}±0.006_{syst})% and (0.350±0.011_{stat}±0.010_{syst})%, respectively, where the former is of much improved precision compared to previous results and the latter is determined for the first time. Using these results along with previous BESIII measurements of D^{0(+)}âπ^{-(0)}e^{+}ν_{e}, we calculate the branching fraction ratios to be R^{0}≡B_{D^{0}âπ^{-}µ^{+}ν_{µ}}/B_{D^{0}âπ^{-}e^{+}ν_{e}}=0.922±0.030_{stat}±0.022_{syst} and R^{+}≡B_{D^{+}âπ^{0}µ^{+}ν_{µ}}/B_{D^{+}âπ^{0}e^{+}ν_{e}}=0.964±0.037_{stat}±0.026_{syst}, which are compatible with the theoretical expectation of lepton flavor universality within 1.7σ and 0.5σ, respectively. We also examine the branching fraction ratios in different four-momentum transfer square regions, and find no significant deviations from the standard model predictions.
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OBJECTIVES: To evaluate the effects of CyberKnife stereotactic radiotherapy for the treatment of vestibular schwannoma on hearing, as evaluated by audiological tests. METHODS: Patients with vestibular schwannoma were evaluated before and after CyberKnife radiosurgery. Evaluation included pure tone thresholds, speech discrimination scores, auditory brainstem responses and radiological signs. RESULTS: The study comprised 26 patients diagnosed with vestibular schwannoma and subsequently treated with CyberKnife radiosurgery. The mean follow-up time was 16.4 months. The mean post-treatment hearing preservation rate was 69.23 per cent. There was no significant relationship between hearing loss after treatment and patient age, radiation dosage during treatment, or size of tumour. With regard to auditory brainstem responses, patients with hearing loss following treatment had a significantly higher inter-peak latency between waves I-III than patients with preserved hearing. CONCLUSION: Stereotactic CyberKnife radiosurgery is an excellent alternative treatment modality for patients with vestibular schwannoma, and results in acceptable preservation of hearing. Residual hearing following CyberKnife therapy is not significantly affected by factors such as age, size of tumour or dosage of treatment.
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Pérdida Auditiva/complicaciones , Audición/fisiología , Neuroma Acústico/radioterapia , Radiocirugia/efectos adversos , Adulto , Potenciales Evocados Auditivos del Tronco Encefálico/fisiología , Femenino , Pérdida Auditiva/prevención & control , Pruebas Auditivas/instrumentación , Humanos , Masculino , Persona de Mediana Edad , Neuroma Acústico/patología , Dosis de Radiación , Radiocirugia/métodos , Estudios RetrospectivosRESUMEN
Based on an e^{+}e^{-} collision data sample corresponding to an integrated luminosity of 567 pb^{-1} taken at the center-of-mass energy of sqrt[s]=4.6 GeV with the BESIII detector, we measure the absolute branching fraction of the inclusive decay Λ_{c}^{+}âΛ+X to be B(Λ_{c}^{+}âΛ+X)=(38.2_{-2.2}^{+2.8}±0.9)% using the double-tag method, where X refers to any possible final state particles. In addition, we search for direct CP violation in the charge asymmetry of this inclusive decay for the first time, and obtain A_{CP}≡[B(Λ_{c}^{+}âΛ+X)-B(Λ[over ¯]_{c}^{-}âΛ[over ¯]+X)]/[B(Λ_{c}^{+}âΛ+X)+B(Λ[over ¯]_{c}^{-}âΛ[over ¯]+X)]=(2.1_{-6.6}^{+7.0}±1.6)%, a statistically limited result with no evidence of CP violation.
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We report the first observation of a_{0}^{0}(980)-f_{0}(980) mixing in the decays of J/ψâÏf_{0}(980)âÏa_{0}^{0}(980)âÏηπ^{0} and χ_{c1}âa_{0}^{0}(980)π^{0}âf_{0}(980)π^{0}âπ^{+}π^{-}π^{0}, using data samples of 1.31×10^{9} J/ψ events and 4.48×10^{8} ψ(3686) events accumulated with the BESIII detector. The signals of f_{0}(980)âa_{0}^{0}(980) and a_{0}^{0}(980)âf_{0}(980) mixing are observed at levels of statistical significance of 7.4σ and 5.5σ, respectively. The corresponding branching fractions and mixing intensities are measured and the constraint regions on the coupling constants, g_{a_{0}K^{+}K^{-}} and g_{f_{0}K^{+}K^{-}}, are estimated. The results improve the understanding of the nature of a_{0}^{0}(980) and f_{0}(980).
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Using a low background data sample of 9.7×10^{5} J/ψâγη^{'}, η^{'}âγπ^{+}π^{-} events, which are 2 orders of magnitude larger than those from the previous experiments, recorded with the BESIII detector at BEPCII, the decay dynamics of η^{'}âγπ^{+}π^{-} are studied with both model-dependent and model-independent approaches. The contributions of ω and the ρ(770)-ω interference are observed for the first time in the decays η^{'}âγπ^{+}π^{-} in both approaches. Additionally, a contribution from the box anomaly or the ρ(1450) resonance is required in the model-dependent approach, while the process specific part of the decay amplitude is determined in the model-independent approach.
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The cross section of the e^{+}e^{-}âΛ_{c}^{+}Λ[over ¯]_{c}^{-} process is measured with unprecedented precision using data collected with the BESIII detector at sqrt[s]=4574.5, 4580.0, 4590.0 and 4599.5 MeV. The nonzero cross section near the Λ_{c}^{+}Λ[over ¯]_{c}^{-} production threshold is cleared. At center-of-mass energies sqrt[s]=4574.5 and 4599.5 MeV, the higher statistics data enable us to measure the Λ_{c} polar angle distributions. From these, the Λ_{c} electric over magnetic form-factor ratios (|G_{E}/G_{M}|) are measured for the first time. They are found to be 1.14±0.14±0.07 and 1.23±0.05±0.03, respectively, where the first uncertainties are statistical and the second are systematic.
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OBJECTIVE: To assess the effects of physical and depressive symptoms on the sexual life of women in the climacteric period. METHODS: This study was conducted with 572 women at a university hospital. The Beck Depression Inventory (BDI), Menopause Rating Scale (MRS) and Female Sexual Function Index (FSFI) were used to evaluate depressive symptoms, intensity of menopausal symptoms and sexual function. RESULTS: Sexual dysfunction and depressive symptoms were determined in 86.4% and 54.9% of the women, respectively. In univariate analysis, women without health insurance, with low income, being married for longer than 21 years and being in menopause had low FSFI but high BDI and MRS scores. In multiple regression analysis, advanced age of women, women with low income, unemployed women, low educated women and their husbands and women with depressive symptoms had low FSFI scores. There was a negative relationship between total FSFI and MRS and BDI scores. CONCLUSION: Determination and treatment of sexual, emotional and physical problems in the climacteric period are very important for the improvement of the quality of life of women.
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Climaterio/psicología , Depresión/epidemiología , Calidad de Vida/psicología , Disfunciones Sexuales Fisiológicas/epidemiología , Disfunciones Sexuales Fisiológicas/psicología , Anciano , Estudios Transversales , Escolaridad , Femenino , Hospitales Universitarios , Humanos , Masculino , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , Análisis de Regresión , Encuestas y Cuestionarios , Turquía/epidemiologíaRESUMEN
Using a data sample of e^{+}e^{-} collisions corresponding to an integrated luminosity of 567 pb^{-1} collected at a center-of-mass energy of sqrt[s]=4.6 GeV with the BESIII detector, we measure the absolute branching fraction of the inclusive semileptonic Λ_{c}^{+} decay with a double-tag method. We obtain B(Λ_{c}^{+}âXe^{+}ν_{e})=(3.95±0.34±0.09)%, where the first uncertainty is statistical and the second systematic. Using the known Λ_{c}^{+} lifetime and the charge-averaged semileptonic decay width of nonstrange charmed mesons (D^{0} and D^{+}), we obtain the ratio of the inclusive semileptonic decay widths Γ(Λ_{c}^{+}âXe^{+}ν_{e})/Γ[over ¯](DâXe^{+}ν_{e})=1.26±0.12.
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The spin and parity of the Z_{c}(3900)^{±} state are determined to be J^{P}=1^{+} with a statistical significance larger than 7σ over other quantum numbers in a partial wave analysis of the process e^{+}e^{-}âπ^{+}π^{-}J/ψ. We use a data sample of 1.92 fb^{-1} accumulated at sqrt[s]=4.23 and 4.26 GeV with the BESIII experiment. When parametrizing the Z_{c}(3900)^{±} with a Flatté-like formula, we determine its pole mass M_{pole}=(3881.2±4.2_{stat}±52.7_{syst}) MeV/c^{2} and pole width Γ_{pole}=(51.8±4.6_{stat}±36.0_{syst}) MeV. We also measure cross sections for the process e^{+}e^{-}âZ_{c}(3900)^{+}π^{-}+c.c.âJ/ψπ^{+}π^{-} and determine an upper limit at the 90% confidence level for the process e^{+}e^{-}âZ_{c}(4020)^{+}π^{-}+c.c.âJ/ψπ^{+}π^{-}.
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Using 4.479×10^{8} ψ(3686) events collected with the BESIII detector, we search for the decays ψ(3686)âe^{+}e^{-}χ_{cJ} and χ_{cJ}âe^{+}e^{-}J/ψ, where J=0, 1, 2. The decays ψ(3686)âe^{+}e^{-}χ_{cJ} and χ_{cJ}âe^{+}e^{-}J/ψ are observed for the first time. The measured branching fractions are B(ψ(3686)âe^{+}e^{-}χ_{cJ})=(11.7±2.5±1.0)×10^{-4}, (8.6±0.3±0.6)×10^{-4}, (6.9±0.5±0.6)×10^{-4} for J=0, 1, 2, and B(χ_{cJ}âe^{+}e^{-}J/ψ)=(1.51±0.30±0.13)×10^{-4}, (3.73±0.09±0.25)×10^{-3}, (2.48±0.08±0.16)×10^{-3} for J=0, 1, 2, respectively. The ratios of the branching fractions B(ψ(3686)âe^{+}e^{-}χ_{cJ})/B(ψ(3686)âγχ_{cJ}) and B(χ_{cJ}âe^{+}e^{-}J/ψ)/B(χ_{cJ}âγJ/ψ) are also reported. Also, the α values of helicity angular distributions of the e^{+}e^{-} pair are determined for ψ(3686)âe^{+}e^{-}χ_{c1,2} and χ_{c1,2}âe^{+}e^{-}J/ψ.
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Disfunción Eréctil , Neoplasias de la Próstata , Humanos , Masculino , Prostatectomía , Encuestas y CuestionariosRESUMEN
We report the first direct measurement of decays of the Λ_{c}^{+} baryon involving the neutron. The analysis is performed using 567 pb^{-1} of e^{+}e^{-} collision data collected at sqrt[s]=4.599 GeV with the BESIII detector at the BEPCII collider. We observe the decay Λ_{c}^{+}ânK_{S}^{0}π^{+} and measure the absolute branching fraction to be B(Λ_{c}^{+}ânK_{S}^{0}π^{+})=[1.82±0.23(stat)±0.11(syst)]%. A comparison to B[Λ_{c}^{+}âp(K[over ¯]π)^{0}] provides an important test of isospin symmetry and final state interactions.
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OBJECTIVE: To investigate the efficacy and safety of retrograde intrarenal surgery (RIRS) in the treatment of pediatric cystine stones. STUDY DESIGN: Data of the pediatric patients who underwent RIRS for kidney stones were retrospectively evaluated. A total of 14 children with cystine stones managed with RIRS were identified. In addition to the patient demographics and stone characteristics, all retrospectively obtained operative data were evaluated and discussed in detail, with an emphasis on the success and complication rates. RESULTS: Mean age of the 14 cases was 10.9 ± 2.2 years (range: 7-15). Mean stone size was 13.6 ± 2.4 mm (range: 10-18) (Summary table). Of these stones, four were located in the renal pelvis, three were in the lower, three were in the middle and the remaining four were located in upper calyx. Ureteral access sheath was used in 12 (85.7%) patients. The double-J ureteral stent was placed pre-operatively in one case and was inserted postoperatively in 12 cases. Mean operation time was 38.2 ± 7.2 min (range: 30-50). Complications were observed in two cases: mild ureteral laceration in the first and fever on the second postoperative day in the second patient. All of the patients were stone free on sonographic evaluation at the 4-week follow-up evaluation. Although potassium citrate treatment was initiated in 11 patients, tiopronin treatment was initiated in four patients for recurrence prophylaxis during long-term follow-up. During a mean follow-up period of 25.7 ± 5.2 months, stone recurrence was noted in one patient. DISCUSSION: Treatment of patients with cystine stones is challenging, due to high risk of rapid recurrence in the presence of residual fragments. Besides allowing complete stone clearance in all cases in the current series, RIRS is a highly reproducible method that can be safely performed, even in recurrences. The major limitations of the current study were low number of patients and short follow-up period. CONCLUSION: The results clearly indicated that RIRS is a safe treatment modality in the management of pediatric cystine stones.