Yuli Hospital

Background: Intrauterine Device (IUD) Multiload 375 is a method of contraception widely used worldwide. One of the rare complications is that the IUD punctures the uterus and moves into the bladder. Common manifestations are recurrent urinary tract infections and bladder stones. A long-term and neglected IUD increases the risk of uterine perforation and migration to other organs. Diagnosis: Clinical history, Cystoscopy, Transvaginal Ultrasound (US) or Computed Tomography helps confirm the diagnosis. Case Report: We report successful surgical treatment of a 39-year-old woman who neglected to insert a Multiload 375 IUD for 16 years, but still experienced 2 subsequent vaginal deliveries and eventually developed UTI. Bladder stone formation caused by the passage of the Multiload 375 intrauterine device through the bladder. Conclusions: Urologists should consider bladder foreign bodies as a displaced IUD in women with recurrent lower urinary tract infections or bladder stones, with a history of IUD use. The moving IUD needs to be removed through cystoscopy, laparoscopy, or open surgery. Proper monitoring and education for women’s health before and after IUD insertion helps to detect complications in a timely manner.

Penelitian ini bertujuan untuk mengetahui sejauh mana peningkatan pemahaman konsep siswa kelas VIII1 dengan menggunakan pembelajaran berdiferensiasi. Penelitian dilakukan pada Kelas VIII 1 di SMP Negeri 6 Denpasar semester 1 Tahun Pelajaran 2022-2023. Subjek penelitian sebanyak 41 siswa. Jenis penelitian yang digunakan dalam penelitian ini adalah penelitian tindakan kelas yang terdiri dari dua tindakan siklus yaitu siklus I dan siklus II. Penelitian ini menggunakan instrumen berupa tes tulis, lembar wawancara, dan lembar observasi. Hasil penelitian menunjukkan bahwa pembelajaran berdiferensiasi dapat meningkatkan pemahaman konsep matematika siswa dengan pencapaian ketutasan belajar dari kondisi awal pra siklus diperoleh 36,59% menjadi 63,41% pada siklus I dan pada siklus II telah mencapai 90,24%.

Los programas electorales de los partidos gobernantes se pueden considerar un compromiso con la ciudadanía. El objetivo de esta investigación es diseñar una metodología para evaluar el cumplimiento de los programas de los partidos políticos y aplicarla evaluando el nivel alcanzado en el primer año de legislatura, enero a diciembre 2020, del cumplimiento de (los 200 puntos) del acuerdo de coalición de gobierno entre los partidos PSOE y Unidas Podemos, en España. La metodología diseñada y aplicada se apoya en la recogida de documentación publicada en medios y fuentes oficiales acerca de cada medida a lo largo del año del análisis y puntuar de 0 a 10 los avances alcanzados. Los resultados se comparan con las otras 2 evaluaciones existentes: la del propio Gobierno y la de Newtral (referida a la mitad de los compromisos). En conclusión, tras un año de legislatura, el cumplimiento de programa alcanzó un 19,6% según nuestros resultados; mientras que los estudios de Newtral y presidencia del Gobierno estimaron un avance mayor y similar entre sí.

ABSTRACT Background: The overlapping symptoms of schizophrenia and dissociation have been increasingly recognized. This paper explains why it is reasonable to expect that there would be a substantial subgroup of patients diagnosed with schizophrenia spectrum disorders (SSDs) who suffer from pathological dissociation. Objective: As little is known about the prevalence of dissociative disorders and symptoms among patients with SSDs, we investigated the prevalence of dissociative disorders and symptoms among patients with SSDs. Method: We used both self-report measures and structured interviews to examine dissociative disorders and symptoms in a randomly recruited sample of inpatients with a clinical diagnosis of SSDs in Taiwan (N = 100). Results: Over 60% of participants exhibited pathological dissociation, and 54% had a dissociative disorder according to structured interview data; three participants met the DSM-5 diagnostic criteria for dissociative identity disorder. The concurrent validity of pathological dissociation in this sample was similar to that of depression among patients with schizophrenia reported in the literature. Participants with a dissociative disorder were more likely to report high-betrayal traumas and meet DSM-5 criteria for post-traumatic stress disorder; they also reported more psychotic symptoms than those without a dissociative disorder. Conclusions: This was one of very few studies that used structured interviews to examine pathological dissociation in patients with SSDs. The results indicate that pathological dissociation in SSDs is not uncommon. Clinical assessment should include measures of dissociation to facilitate early identification.

Abstract 1. Background: literature indicated the patient with schizophrenia showed worse cognitive deficit than those with BD, however, little study was to examine the differences of cognitive deficits from clinical data and alternative measurement instruments. Moreover, the report of Cognitive Ability Screening Inventory and chart review were applied in this study. 2. Methods: This study reviewed the charts of 354 patients seen between 1997 and 2017, and each chart included diagnosis, sex, educational level, age, and two copies of Cognitive Ability Screening Inventory (CASI) reports. Each chart contained a diagnosis of SZ, SAD, or BD, and each patient was 55 years old or older. Descriptive analysis, one-way ANOVA, and the Chi-square test were used to analyze differences in demographic information and measurement variables at the first visit. A Generalized Estimation Equation (GEE) was used to examine the effects of time, group, and interactions. The significance level was set at 0.05. 3. Results: Overall CASI scores did not have any significant differences by group, time, or interaction, but the attention subscale, orientation subscale, and fluency subscale had interaction effects. Through GEE analysis, our results partially support the idea that patients with SZ have stable cognitive deficits in all cognitive domains, whereas patients with SAD and BD show fluctuations in cognitive deficits in several cognitive domains, including CASI total scores, orientation, fluency, long-term memory, and abstract thinking.4. Conclusions: Based on the implications of our findings, more time-efficient cognitive assessments could be provided, and specific cognitive rehabilitation programs could be developed for older adults experiencing psychosis.

Abstract Studies addressing the hospitalization of patients affected by COVID-19 have reported that length of hospital stay in intensive care unit varies between 12 and 22 days. Part of these patients require orotracheal intubation (OTI) and, in cases where OTI is prolonged and/or with complications, they consequently end up undergoing open surgical tracheostomy (OST). In most hospitals, a multidisciplinary team composed of physicians, nurses, physiotherapists and speech-language therapists is responsible for this process, which allows early removal of the tracheal cannula, making it safer for patients, with reduced risk of failure and complications. Although safety recommendations and procedures support the most diverse protocols of weaning from mechanical ventilation and tracheostomy, there is no universally accepted protocol for this transition. This is a complex issue that is necessary in the current scenario, because studies establishing weaning and decannulation criteria in patients with COVID-19 are urgent at this moment. Purpose: To describe the process of weaning from the tracheostomy in COVID-19 patients. Methods: This is a descriptive study presenting a series of case reports. It describes the decannulation process in five tracheostomized patients with COVID-19 (3 men and 2 women) aged 41 and 74 years who agreed to participate in the study and remained hospitalized in a private hospital in the city of XXXX. Results: The decannulation process of the five COVID-19 patients lasted up to 10 days (mean duration of 6.4 days).

Craving is a core feature of heroin use disorder. Craving for heroin is a conscious cognitive process. Recently, implicit (i.e., an implicit attitude toward heroin use) cognitive processes have been thought to be precursors of cravings. This study aimed to explore the associations of craving and implicit attitude toward heroin use with the level of heroin use disorder and adherence to methadone maintenance treatment (MMT). This study recruited 213 intravenous heroin users (196 males and 17 females) from MMT clinics of two hospitals. The mean age of participants was 42.3 years. They provided details of their severity of heroin use disorder and craving for heroin via questionnaires and also completed a computerized test to assess implicit attitude toward heroin use. The relationships between implicit attitude, craving, age, heroin use disorder, and MMT adherence were examined using path analysis. Craving was positively related to heroin use disorder (beta = 0.4). Implicit attitude directly and indirectly positively contributed to heroin use disorder (betas: 0.1 and 0.3). Craving was positively related to MMT adherence (beta: 0.2), whereas implicit attitude had an indirect effect on MMT adherence (beta: 0.03). Age was negatively associated with craving but was not associated with implicit attitude toward heroin. Methadone dosage was negatively associated with craving. Craving is significantly associated with the levels of heroin use disorder and MMT adherence. Meanwhile, craving mediates the relationship between implicit attitude and heroin use disorder, as well as MMT adherence. Implicit attitude also contributes to the level of heroin use disorder directly. For reducing craving, adequate dosage may be necessary.

Oroxylin A (Oro-A), the main bioactive flavonoid extracted from Scutellaria radix, has been reported to inhibit migration in various human cancer cell models. In this study, we further explored the anti-migration effects of Oro-A on oral squamous cell carcinoma (OSCC) cells and investigated the underlying mechanisms. A 24-h (short-term) exposure of OSCC cells to non-cytotoxic concentrations (5–20 μM) of Oro-A significantly suppressed cell migration according to a wound-healing assay. Furthermore, a 30-day exposure (long-term) to Oro-A (20 μM), which did not exhibit a cytotoxic effect on OSCC cells, significantly suppressed cell migration more than short-term Oro-A exposure. To uncover the molecular mechanisms underlying the inhibitory effect of long-term Oro-A exposure on OSCC migration, a cDNA microarray and the Ingenuity software were used. Overall, 112 upregulated and 356 downregulated genes were identified in long-term Oro-A-exposed cells compared with untreated OSCC cells. Among them, 75 genes were reported to be associated with cancer cell migration. Consistent with the cDNA microarray results, we found that the expression levels of several cell migration-related genes, such as LCN2, ID-1, MDK, S100A9 and CCL2, were significantly decreased in long-term Oro-A-exposed OSCC cells using a quantitative real-time polymerase chain reaction (Q-PCR) assay. The Western blotting and enzyme-linked immunosorbent assay (ELISA) results also demonstrated that CCL2 expression at the mRNA and protein levels was significantly decreased in long-term Oro-A-exposed OSCC cells compared with untreated OSCC cells. Moreover, the expression levels of downstream CCL2 targets, including p-ERK1/2, NFκB, MMP2, and MMP9, were also decreased in long-term Oro-A-exposed OSCC cells. Further, Oro-A treatment suppressed in vivo metastasis. These results suggest that long-term Oro-A treatment inhibits metastasis via CCL2 signaling in OSCC cells.

This study examines the interaction effects among incidences of falls, visual conditions, and stance postures on the magnitude of center of pressure sway (MCOPS) in patients with schizophrenia. The coordinates of COP in ten postural control demands were measured in subjects with at least one or without any falls in the previous year. MCOPS was calculated by the default program in Balance 3.78 software. Cognitive functions were also measured. The findings include: (1) the MCOPS increased as the postural control demands increase in subjects who have fallen; (2) MCOPS in subjects without falls was the largest for the lowest postural control demands; (3) MCOPS increased when the eyes were closed in subjects without a history of falls but decreased in subjects with a history of falls; (4) cognition function in subjects who have fallen was inferior to that in those without falls. The interference visual condition and stance postures on MCOPS tended to be different in schizophrenia with or without incidences of falls indicating the possible association between psychomotor dysfunction and falls in the subjects.