The remaining patient (11%) - who had tubeless PCNL without postop imaging presented five days postoperatively with a delayed bleed and underwent emergent splenectomy. Seven of the nine (78%) were successfully managed non operatively and without need for transfusion or embolization. CONCLUSION The majority of patients incurring splenic injury during PCNL can be successfully managed conservatively with maintenance of nephrostomy tube for two days or greater. Consequences of unrecognized splenic injury may include splenic bleed and may prompt transfusion and/or splenectomy, underscoring role of routine postoperative CT to allow timely diagnosis, particularly in those undergoing upper pole, supracostal left sided percutaneous renal access.Thalamic infusion of adeno-associated viral (AAV) vectors has been shown to have therapeutic effects in neuronopathic lysosomal storage diseases. Preclinical studies in sheep model of Tay-Sachs disease demonstrated that bilateral thalamic injections of AAV gene therapy are required for maximal benefit. Translation of thalamic injection to patients carries risks in that 1) it has never been done in humans, and 2) dosing scale-up based on brain weight from animals to humans requires injection of larger volumes. To increase the safety margin of this infusion, a flexible cannula was selected to enable simultaneous bilateral thalamic infusion in infants while monitoring by imaging and/or to enable awake infusions for injection of large volumes at low infusion rates. In this study, we tested various infusion volumes (200-800 µL) and rates (0.5-5 µL/min) to determine the maximum tolerated combination of injection parameters. Animals were followed for ~1 month post-injection with MRI performed at 14 and 28 days. T1-weighted MRI was used to quantify thalamic damage followed by histopathological assessment of the brain. Trends in data show that infusion volumes of 800 µL (2× the volume required in sheep based on thalamic size) resulted in larger lesions than lower volumes, where the long infusion times (between 13 to 26 hours) could have contributed to the generation of larger lesions. The target volume (400 µL, projected to be sufficient to cover most of the sheep thalamus) created the smallest lesion size. Cannula placement alone did result in damage, but this is likely associated with an inherent limitation of its use in a small brain due to the length of the distal rigid portion and lack of stable fixation. An injection rate of 5 µL/min at a volume approximately 1/3 of the thalamus (400µL-600µL) appears to be well tolerated in sheep both clinically and histopathologically.Objectives To investigate the occurrence of signs of altered psychomotor capacity (SAPC) associated with the violation of the dry law at the exits of nightclubs in the city of São Paulo, Brazil.Methods Data from drivers participating in the Balada com Ciência project were used. Alcohol dosages were measured with breathalyzer test. The use of other drugs was obtained by interviewees' self-report. SAPC (speech, walking, glazed eyes, and alcohol odor) were verified by the interviewers at the time of the interview and categorized as "no sign" or "at least one sign". All measurements were evaluated at the exit of the nightclubs. The population description considered the sample weighting. Logistic regression analysis evaluated the association between the occurrence of SAPC, alcohol and other drugs use, controlling for sociodemographic variables.Results At nightclubs, the SAPC among drivers are about 8 times higher when the breath alcohol concentration is above 0.05 mg/L if compared with those who did not drink alcohol, and about 30 times higher when the alcohol concentration was ≥ 0.34 mg/L in exhaled air. This finding is not generally verified in the literature for those who report the use of drugs inside nightclubs, which is interesting, since 20.4% of the interviewed population reported using drugs in the places surveyed.Conclusion This study suggests the potential of using the Perham (2007) physical test for alcohol intoxication in sobriety checkpoints at the exit of nightclubs. However, the verification of these signs is not enough for the identification of drug use by drivers.Introduction Oral nutritional supplementation (ONS) in cancer patients is justified by the low food intake caused by several factors. However, ONS can be affected by adverse events (AEs) correlated to treatment. 2-Aminoethyl chemical structure This study aimed to compare the safety and efficacy of ONS (whey protein isolated, leucin, zinc-IMMAX®) during oncologic treatment.Methods Patients in chemo/chemoradiotherapy were randomly assigned to receive IMMAX®+nutritional counseling (NC) according to daily requirements (S arm) or NC alone (C arm) for 4 weeks. Body weight (BW), %fat-free mass (%FFM) and nutrition intake were assessed before and after. In S arm, calories from IMMAX met the energy requirements. AEs were classified according to CTC-AE-NCI.Results Eighty-five patients were included (51 females). After 4 weeks, the median of caloric intake, BW and %FFM were not statistically different in C arm. In S arm, median ONS intake was 81 g/332 kcal/day, protein intake was higher (pre 66.75 ± 31.57 g; post 88.57 ± 35.11 g; p  less then  0.01) and calories as well (pre 1,549 ± 596 kcal; post 1,756 ± 614 kcal; p = 0.02). The most common treatment related AEs were anemia, nausea/vomiting, not different between the arms. AEs supplement related were constipation and diarrhea (2 patients/4.6% each).Conclusion IMMAX was safe, well tolerated, it did not interfere with oncologic treatment and provided significant amount of protein intake in this patient population, with few related AEs.Phytochemical studies of methylene chloride soluble fraction from the 70% aqueous-alcoholic extract of Polyalthia longifolia (leaves) resulted in the isolation of two known clerodane diterpenes, namely 16α-hydroxycleroda-3,13(14)-dien-16,15-olide (1) and (4→2)-abeo-16-hydroxy-cleroda-2,13(14)-dien-15,16-olide-3-al (2). The isolated compounds were evaluated for their anti-histaminic and anti-Helicobacter pylori activities. Compound 1 was more potent than 2 with IC50 29.7 μg/mL and 189.2 μg/mL in the anti-histaminic assay and MIC equals to 31.25 μg/mL and 125 μg/mL in the anti-H. pylori assay, as compared with diclofenac (IC50 = 17.9 μg/mL) and clarithromycin (MIC = 1.95 μg/mL), respectively. The differences in their structures, as well as their activity results, indicated important characteristic features necessary for activity. It was suggested that the decalin moiety in 1 was important for both activities. On the other hand, the (4→2)-abeo migration in 2 reduced both activities. The potent activities of 1 suggest its potential application as an anti-histaminic and antimicrobial agent.