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排序方式: 共有7521条查询结果,搜索用时 22 毫秒
1.
Nicolas Zhou Matthew Bott Bernard J. Park Eric Vallières Candice L. Wilshire Kazuhiro Yasufuku Jonathan D. Spicer David R. Jones Boris Sepesi 《The Journal of thoracic and cardiovascular surgery》2021,161(3):760-771.e2
BackgroundAdjuvant chemotherapy, postoperative radiation (PORT), and prophylactic cranial irradiation (PCI) have been individually examined in limited-stage small cell lung cancer (SCLC). There is a paucity of data on the effectiveness of each adjuvant treatment modality when used in combination after surgical resection of SCLC.MethodsData were collected from 5 cancer centers on all patients with limited-stage SCLC who underwent surgical resection between 1986 and 2019. Univariate and multivariable models were conducted to identify predictors of long-term outcomes, focusing on freedom from recurrence and survival benefit of adjuvant chemotherapy, PORT, and PCI.ResultsA total of 164 patients were analyzed. Multivariable Cox regression analysis did not identify any adjuvant therapies to significantly influence recurrence in this cohort. Specifically, PORT was not associated with a significant influence on locoregional recurrence and PCI was not significantly associated with intracranial outcomes. Adjuvant chemotherapy improved survival in all stage I through III disease (hazard ratio, 0.49; 95% confidence interval, 0.29-0.81; P = .005) and even in pathologically node negative patients (hazard ratio, 0.49; 95% confidence interval, 0.27-0.91; P = .024). Although PCI was found to improve survival in univariate analysis, it was not significant in a multivariable model. PORT was not found to affect survival on either univariate or multivariable analysis.ConclusionsThis is among the largest multi-institutional studies on surgically resected limited-stage SCLC. Our results highlight survival benefit of adjuvant chemotherapy, but did not identify a statistically significant influence from mediastinal PORT or PCI in our cohort. Larger prospective studies are needed to determine the benefit of PORT or PCI in a surgically resected limited-stage SCLC population. 相似文献
2.
Alexander Becker Kobi Peleg Joseph Dubose Yaakov Daskal Adi Givon Boris Kessel 《Journal of pediatric surgery》2019,54(4):780-782
Background
Penetrating stab wounds in children are relatively rare and no clear recommendations for the optimal evaluation have been devised. An acceptable traditional approach to the patient with an abdominal stab wound who does not require urgent surgery is selective nonoperative management and serial exams. The use of routine computed tomography remains an actively utilized investigation for these patients at many institutions.Purpose
We hypothesize that the approach to pediatric stab wound victims should be distinctly different than that of adult counterparts in order to minimize radiation exposure.Methods
A retrospective cohort study involving abdominal stab wounds among pediatric trauma patients (age < 14) compared with adults between the years 1997 and 2016 was conducted utilizing the Israeli National Trauma Registry.Results
A total of 92 children and 4444 adults were identified from the registry for inclusion. Among the children 20 (21.7%) patients had intraabdominal injury compared to 1730 (38.9%) among adult counterparts. Four children were hemodynamically unstable, two of them were referred directly to operating room and two others were treated without surgery. Among the remaining 88 children there was no observed mortality.Conclusions
The majority of pediatric stab wounds trauma victims have minor abdominal injuries. We do not recommend the routine utilization of abdominal CT scan in the evaluation of abdominal stab wounds. Observation with serial exams and minimization of radiation exposure from CT are warranted in this unique population.Type of study
Retrospective comparative study.Level of evidence
3. 相似文献3.
John A. Kalapurakal Mahesh Gopalakrishnan David O. Walterhouse Cynthia K. Rigsby Alfred Rademaker Irene Helenowski Sandy Kessel Karen Morano Fran Laurie Ken Ulin Natia Esiashvili Howard Katzenstein Karen Marcus David S. Followill Suzanne L. Wolden Anita Mahajan Thomas J. Fitzgerald 《International journal of radiation oncology, biology, physics》2019,103(1):28-37
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Alexander Becker Ori Yaslowitz Joseph Dubose Kobi Peleg Yaakov Daskal Adi Givon Israel Trauma Group Boris Kessel 《中华创伤杂志(英文版)》2020,23(3):181-184
Purpose: Pelvic fracture evaluation with abdominopelvic computed tomography (CT) and formal CT cystography for rule out of urine bladder injury have been commonly employed in pediatric trauma patients. The additional delayed imaging required to obtain optimal CT cystography is, however, associated with increased doses of ionizing radiation to pelvic organs and represent a significant risk in the pediatric population for future carcinogenic risk. We hypothesized that avoidance of routine CT cystography among pediatric pelvic fracture victims would not result in an appreciable rate of missed bladder injuries and would aid in mitigating the radiation exposure risk associated with these additional
images.
Methods: A retrospective cohort study involving blunt trauma pelvic fractures among pediatric trauma patients (age<14) between the years 1997 and 2016 was conducted utilizing the Israeli National Trauma Registry. Statistical analysis was performed using SAS statistical software version 9.4 via the tests of Chisquare test and two-sided Fisher''s exact test. A p value of less than 0.05 was considered statistically significant.
Results: A total of 1072 children were identified from the registry for inclusion. Mean age of patients was 7.7 years (range 0-14) and 713 (66.5%) were male. Overall mortality in this population was 4.1% (44/1072). Only 2.1% (23) of pediatric patients with pelvic fractures had bladder injury identified, with just 9 children having intraperitoneal bladder rupture (0.8% of all the patients).
Conclusion: The vast majority of blunt pediatric trauma victims with pelvic fractures do not have urine bladder injuries. Based on our study results we do not recommend the routine utilization of CT cystography in this unique population. 相似文献
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10.
Ekaterina A. Grebenik Leonid P. Istranov Elena V. Istranova Semyon N. Churbanov Boris S. Shavkuta Ruslan I. Dmitriev Nadezhda N. Veryasova Svetlana L. Kotova Alexander V. Kurkov Anatoly B. Shekhter Peter S. Timashev 《Xenotransplantation》2019,26(3)
Decellularized bovine pericardium (DBP)‐based biomeshes are the gold standard in reconstructive surgery. In order to prolong their stability after the transplantation, various chemical cross‐linking strategies are employed. However, structural and functional properties of the biomeshes differ in dependence on the cross‐linker used. Here, we performed a bottom‐up study of structural and functional alterations of DBP‐based biomeshes following cross‐linking with hexamethylene diisocyanate (HMDC), ethylene glycol diglycidyl ether (EGDE), 1‐ethyl‐3‐(3‐dimethylaminopropyl)carbodiimide (EDC) and genipin. The in vitro cytotoxicity tests supported their clinical applicability. Their structural differences (eg roughness, fibre thickness, pore morphology) were evaluated using the two‐photon confocal laser scanning, atomic force, scanning electron and polarized light microscopies. HMDC and EDC samples appeared to be the roughest. Complex mechanical trials indicated the tendency to reduced Young’s Modulus and mechanical anisotropy values of DBP upon cross‐linking. The lowest mechanical anisotropy was found in EDC and genipin sample groups. In vitro collagenase susceptibility was the highest for EDC samples and the lowest for EGDE samples. The comparative analysis of the results allowed us to recognize the strengths and weaknesses of each cross‐linker in relation to a particular clinical application. 相似文献