Postoperative courses were uneventful without sign of leakage in both cases. The patients started oral intake 2 weeks after the surgery. They have been alive without aspiration pneumonia and takes normal diet.
  Hangeshashinto is a Japanese Kampo medicine applied for the treatment of oral mucositis and gastroenteritis. Hangeshashinto exhibits broad-spectrum antibacterial activity and suppresses prostaglandin (PG)E2 production in the mucosa and has the ability to improve the inflammatory condition. In addition to these effects, because cAMP, a composition of Hangeshashinto, facilitates ciliary beat, Hangeshashinto could also improve the physiological function of the nasal mucosa, consist of ciliated epithelium, but details were unknown.
 
  This study was aimed to investigate the effects of Hangeshashinto on the nasal mucosa. Healthy nasal mucosal sections were collected from the nasal septum of ten Japanese white rabbits, placed in a collagen dish for tissue culture, and rinsed with two different concentrations of Hangeshashinto solution (1.0%, n=10 and 2.5%, n=10) and cAMP solution (50µM, n=10 and 100µM, n=10) or saline (control, n=10). Ciliary beat frequency (CBF) as a physiological function of the nasal mucosa wasphysiological functions of the nasal mucosal epithelium.
 Our results suggest that 1.0% Hangeshashinto solution facilitates the physiological function of the nasal mucosa by promoting ciliary functions without histological damage of cilia epithelium. When applied with the appropriate concentration, Hangeshashinto could have ability to improve the physiological functions of the nasal mucosal epithelium.
  Although oral appliance therapy is considered a validated treatment for obstructive sleep apnea, its therapeutic success varies significantly among patients. Drug-induced sleep endoscopy is often employed in order to identify candidates for upper airway surgery; however, it remains unknown whether its findings can be associated with success of oral appliance therapy. This study tested the hypothesis that drug-induced sleep endoscopy variables can predict the outcome of oral appliance therapy in obstructive sleep apnea patients.
 
  Forty-nine obstructive sleep apnea patients [45 men; mean apnea-hypopnea index 25.3±7.5 events/h; mean body mass index 28.2±3.0kg/m
  ] underwent drug-induced sleep endoscopy, followed by a one-month of oral appliance therapy, and subsequently a follow-up polysomnography to assess outcome.
 
  Thirty-three patients (67.3%) were responders and sixteen were non-responders (32.6%). Non-responders had a higher occurrence of complete or partial circumferential collapse at velum in comparison with responders. Multivariate logistic regression analysis revealed that, among baseline clinical and polysomnographic characteristics and sleep endoscopy findings, the presence of complete circumferential collapse at velum and increased body mass index were the only independent predictors of oral appliance therapy failure.
 
  Drug-induced sleep endoscopy can be used to predict a higher likelihood of success to oral appliance therapy in obstructive sleep apnea patients.
 Drug-induced sleep endoscopy can be used to predict a higher likelihood of success to oral appliance therapy in obstructive sleep apnea patients.
  Transcatheter aortic valve replacement (TAVR) has changed the treatment paradigm of severe aortic stenosis (AS). Nevertheless, in Portugal the penetration rate of TAVR is still very low and there is a paucity of data regarding its economic impact on the Portuguese healthcare system.
 
  To perform an economic analysis of the present and future impact of TAVR in Portugal and to propose health policy recommendations for a new reimbursement model.
 
  Hospital data from a high-volume center were used as a sample to calculate the costs of TAVR in Portugal. Information regarding the national penetration rate was derived from the EAPCI Valve for Life initiative. To estimate the future demand for TAVR, three scenarios (S) were constructed S1, TAVR penetration according to current guidelines; S2, including intermediate-risk patients; and S3, including low-risk patients aged over 75 years.
 
  The total cost of each TAVR procedure in Portugal was 22134.50 euros for the self-expanding valve (SEV) and 23 321.50 euros for the balloon-expanding valves (BEV). Most of the cost was driven by the price of the valve (SEV 74.5% vs. BEV 81.5%). The current national economic impact is estimated at 12500000 euros per year. In S1, the expected penetration rate would be 189 procedures per million population; in S2 we estimated an increase of 28% to 241 procedures per million population and in S3 an increase of 107% to 391 procedures per million population.  https://www.selleckchem.com/products/Sunitinib-Malate-(Sutent).html  The total economic impact would increase to 43770586 euros in S1 and to 90754310 euros in S3.
 
  TAVR is associated with a significant present and future economic impact on the Portuguese healthcare system. A new model of reimbursement in Portugal should be discussed and implemented.
 TAVR is associated with a significant present and future economic impact on the Portuguese healthcare system. A new model of reimbursement in Portugal should be discussed and implemented.
  Severe complications which may cause impaired physical functionoften develops over time following severe burn to the lower extremities. The purpose of this study was to clarify the clinical determinants of lower limb functional status, functional mobility and exercise capacity in moderate/major burns 3-6 months following the injury.
 
  The study included 42 patients, 12 with moderate injury and 30 with major injury, aged 19-59 years old. Lower Limb Functional Index was used to determine the lower limb functional status. Functional mobility and exercise capacity were evaluated with the Timed Up and Go test and the 6-min walk test, respectively. Scar quality and kinesiophobia were assessed with the Patient and Observer Scar Assessment Scale (POSAS) and the Tampa Scale for Kinesiophobia, respectively. Active range of motion (ROM) was measured with a universal goniometer.
 
  Significant and independent predictors of lower limb functional status, functional mobility and exercise capacity related to POSAS score, kinesiophobia level, gender, burn severity, the number of operations, the presence of burnsinvolving any of the lower limb joints, knee ROM limitations, limitation in any of the lower limb joint ROMs, comorbidities, and truncal burns (p < 0.