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排序方式: 共有882条查询结果,搜索用时 28 毫秒
1.
Dave R. Lal Samir K. Gadepalli Cynthia D. Downard Peter C. Minneci Michelle Knezevich Thomas H. Chelius Cooper T. Rapp Deborah Billmire Steven Bruch R. Carland Burns Katherine J. Deans Mary E. Fallat Jason D. Fraser Julia Grabowski Ferdynand Hebel Michael A. Helmrath Ronald B. Hirschl Rashmi Kabre Thomas T. Sato 《Journal of pediatric surgery》2019,54(4):688-692
Purpose
Right sided aortic arch (RAA) is a rare anatomic finding in infants with esophageal atresia with or without tracheoesophageal fistula (EA/TEF). In the presence of RAA, significant controversy exists regarding optimal side for thoracotomy in repair of the EA/TEF. The purpose of this study was to characterize the incidence, demographics, surgical approach, and outcomes of patients with RAA and EA/TEF.Methods
A multi-institutional, IRB approved, retrospective cohort study of infants with EA/TEF treated at 11 children's hospitals in the United States over a 5-year period (2009 to 2014) was performed. All patients had a minimum of one-year follow-up.Results
In a cohort of 396 infants with esophageal atresia, 20 (5%) had RAA, with 18 having EA with a distal TEF and 2 with pure EA. Compared to infants with left sided arch (LAA), RAA infants had a lower median birth weight, (1.96?kg (IQR 1.54–2.65) vs. 2.57?kg (2.00–3.03), p?=?0.01), earlier gestational age (34.5?weeks (IQR 32–37) vs. 37?weeks (35–39), p?=?0.01), and a higher incidence of congenital heart disease (90% vs. 32%, p?<?0.0001). The most common cardiac lesions in the RAA group were ventricular septal defect (7), tetralogy of Fallot (7) and vascular ring (5). Seventeen infants with RAA underwent successful EA repair, 12 (71%) via right thoracotomy and 5 (29%) through left thoracotomy. Anastomotic strictures trended toward a difference in RAA patients undergoing right thoracotomy for primary repair of their EA/TEF compared to left thoracotomy (50% vs. 0%, p?=?0.1). Side of thoracotomy in RAA patients undergoing EA/TEF repair was not significantly associated with mortality, anastomotic leak, recurrent laryngeal nerve injury, recurrent fistula, or esophageal dehiscence (all p?>?0.29).Conclusion
RAA in infants with EA/TEF is rare with an incidence of 5%. Compared to infants with EA/TEF and LAA, infants with EA/TEF and RAA are more severely ill with lower birth weight and higher rates of prematurity and complex congenital heart disease. In neonates with RAA, surgical repair of the EA/TEF is technically feasible via thoracotomy from either chest. A higher incidence of anastomotic strictures may occur with a right-sided approach.Level of evidence
Level III. 相似文献2.
3.
Prof. Dr. med. habil. Rosemarie Grabowski Günther Kundt Franka Stahl 《Journal of orofacial orthopedics》2007,68(6):462-476
AIM: It was the purpose of this study to analyze the relationship between selected types of malocclusion and specific types of static and dynamic orofacial dysfunction and to compare the results with subjects presenting regular occlusion. We aimed to identify which orthodontic and functional symptoms in early dentition would lead to malocclusion later on. SUBJECTS AND METHODS: Occlusal relations and myofunctional status were evaluated in 3,041 children. We diagnosed dynamic and static myofunctional disorders as well as oral habits by means of functional examinations. RESULTS: No orofacial dysfunctions were found in 11.2% of the children with primary dentition and in 10.2% of the children with early mixed dentition. We observed no correlation between the existence of distoclusion and functional disorders. Lateral crossbite in mixed dentition, as well as increased overjet and frontal open bite in primary and early mixed dentitions appeared significantly more frequently in children with orofacial dysfunctions. Individuals with frontal open bite, lateral crossbite, reduced and increased overjet presented static dysfunctions significantly more frequently than those in dentitions with normal occlusion. Dynamic dysfunctions were significantly more prevalent in subjects with frontal open bite and lateral crossbite than in those with normal occlusion. CONCLUSIONS: Our results enable us to prognosticate which children risk future orthodontic problems. Any child presenting one of the four occlusal disorders plus one static or two dynamic dysfunctions is a child more likely to develop orthodontic problems later on. Orthodontic prevention and early treatment must include functional rehabilitation so as to eliminate or at least diminish those factors causing undesirable developments. 相似文献
4.
Kristine S. Corkum Catherine J. Hunter Julia E. Grabowski Timothy B. Lautz 《Journal of pediatric surgery》2018,53(7):1295-1300
Background
Early postoperative fever is common. Adult data indicate that workup is unnecessary in the early postoperative period, but comparable data in children is limited. The objectives are to determine the incidence of fever and the utilization and yield of tests ordered in children.Methods
Single-institution, retrospective analysis of surgical patients undergoing an elective inpatient/observational surgery between 2011 and 2015 was performed. Early fever was defined > 38.0 °C within two days post-procedure. Encounters were queried for all blood cultures (BC), urinalysis (UA), urine cultures (UC), chest radiographs (CXR), and respiratory viral panels (RVP) obtained.Results
We identified 6943 patients, of whom 30.6% developed fever. UA was positive in 19.8% of patients tested. UC was positive in 15.7% of patients and 92.0% had a urinary catheter during surgery. BC was positive in 0.69% of patients, all with a central venous catheter. CXRs were considered infectious in 3.0% of patients tested. Patients with PICU stay and/or fever ≥ 38.9 °C were more likely to undergo BC and UC, but no more likely to have a positive result compared those without PICU stay and/or fever < 38.9°.Conclusion
Early postoperative fever is common in pediatric surgical populations and rarely associated with an infectious source. Workup should be applied selectively.Level of evidence
Level IV. 相似文献5.
Purpose of Review
This review summarizes the use of genetic similarity clusters to understand HIV transmission and inform prevention efforts.Recent Findings
Recent emphases include the development of real-time cluster identification in order to interrupt transmission chains, the use of clusters to estimate rates of transmission along the HIV care cascade, and the extension of cluster analyses to understand transmission in the generalized epidemics of sub-Saharan Africa. Importantly, this recent empirical work has been accompanied by theoretical work that elucidates the processes that underlie HIV genetic similarity clusters; multiple studies suggest that clusters are not necessarily enriched with individuals with high transmission rates, but rather can reflect variation in sampling times within a population, with individuals sampled early in infection more likely to cluster.Summary
Analyses of genetic similarity clusters have great promise to inform HIV epidemiology and prevention. Future emphases should include the collection of additional sequence data from underrepresented populations, such as those in sub-Saharan Africa, and further development and evaluation of clustering methods.6.
Grabowski Matthew M. Sankey Eric W. Ryan Katherine J. Chongsathidkiet Pakawat Lorrey Selena J. Wilkinson Daniel S. Fecci Peter E. 《Journal of neuro-oncology》2021,151(1):3-12
Journal of Neuro-Oncology - The overall survival in patients with gliomas has not significantly increased in the modern era, despite advances such as immunotherapy. This is in part due to their... 相似文献
7.
Vaziri SA Hill J Chikamori K Grabowski DR Takigawa N Chawla-Sarkar M Rybicki LR Gudkov AV Mekhail T Bukowski RM Ganapathi MK Ganapathi R 《Molecular cancer therapeutics》2005,4(12):1880-1890
Proteasome inhibition following DNA damage results in the synergistic induction of apoptosis via a nuclear factor-kappaB-independent mechanism. In this study, we identify the role of p53 in mediating apoptosis by the sequence-specific treatment involving the DNA-damaging, topoisomerase I-targeting drug SN-38 followed by the proteasome inhibitor PS-341 (SN-38-->PS-341). The p53-dependent sensitization of DNA damage-induced apoptosis by PS-341 is accompanied by persistent inhibition of proteasome activity and increased cytosolic accumulation of p53, including higher molecular weight forms likely representing ubiquitinated species. In contrast, pretreatment with PS-341 followed by treatment with SN-38 (PS-341-->SN-38), which leads to an antagonistic interaction, results in transient inhibition of proteasome activity and accumulation of significantly lower levels of p53 localized primarily to the nucleus. Whereas cells treated with PS-341-->SN-38 undergo G2 + M cell cycle arrest, cells treated with SN-38-->PS-341 exhibit a decreased G2 + M block with a concomitant increase in the sub-G1 population. Decreased accumulation of cells in the G2 + M phase of the cell cycle in SN-38-->PS-341-treated cells compared with PS-341-->SN-38-treated cells correlates with enhanced apoptosis and reduced expression of two p53-modulated proteins, 14-3-3sigma and survivin, both of which play critical roles in regulating G2 + M progression and apoptosis. The functional role of 14-3-3sigma or survivin in regulating the divergent function of p53 in response to SN-38-->PS-341 and PS-341-->SN-38 treatment in inducing apoptosis versus G2 + M arrest/DNA repair, respectively, was confirmed by targeted down-regulation of these proteins. These results provide insights into the mechanisms by which inhibition of proteasome activity modulates DNA damage-induced apoptosis via a p53-dependent pathway. 相似文献
8.
9.
Huczek Z Filipiak KJ Kochman J Horszczaruk GJ Piatkowski R Grabowski M Karpiński G Wilczyńska J Opolski G 《Kardiologia polska》2004,61(10):370-373
Patient with stable ischaemic heart disease and essential thrombocythemia in Invasive Cardiology Laboratory -- role of the automated systems for estimation of platelet aggregation. A case of a 63-year-old male patient with essential thrombocythemia and coronary artery disease is presented. The patient underwent elective coronary angiography and subsequent angioplasty of the intermediate branch. The procedure was complicated by a massive thrombosis of the right coronary artery. Tirofiban and subsequent stenting relieved anginal symptoms. Next, platelet activity was monitored using the platelet function analyser PFA-100 which enabled optimisation of the antiplatelet agent dosages. The usefulness of this device in the catheterisation laboratory is discussed. 相似文献
10.
Robert Baird Dave R. Lal Robert L. Ricca Karen A. Diefenbach Cynthia D. Downard Julia Shelton Stig Sømme Julia Grabowski Tolulope A Oyetunji Regan F. Williams Tim Jancelewicz Roshni Dasgupta L. Grier Arthur Akemi L. Kawaguchi Yigit S. Guner Ankush Gosain Robert L. Gates Juan E. Sola Adam Goldin 《Journal of pediatric surgery》2019,54(4):675-687