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Balasubramanian K Kumar P Saini SS Attri SV Dutta S 《Acta paediatrica (Oslo, Norway : 1992)》2012,101(3):236-241
Aim: To compare the incidence of hyponatremia in full‐term neonates with severe hyperbilirubinemia, receiving intravenous fluid supplementation with 0.2% saline in 5% dextrose versus 0.9% saline in 5% dextrose, to prevent blood exchange transfusion (BET). Methods: In this double‐blind, randomized, controlled trial, full ‐ term newborns (≥37 weeks), appropriate for gestational age, with severe non‐haemolytic hyperbilirubinemia (serum bilirubin ≥ 20 mg/dL) were enrolled. Eligible neonates were randomized to receive either 0.2% saline in 5% dextrose (hypotonic fluid group) or 0.9% saline in 5% dextrose (isotonic fluid group) over 8 hrs, in addition to phototherapy. The primary outcome was proportion of neonates developing hyponatremia (serum Na < 135 mmol/L) after 8 h. Results: Forty‐two neonates were analysed in each group. Proportion of neonates developing hyponatremia after 8 h was higher in hypotonic fluid group as compared to isotonic fluid group (48.8% vs. 10.5%, p < 0.001). However, a larger proportion in isotonic fluid group developed hypernatremia (39.5% vs. 12.2%, p < 0.001). The rate of BET was similar in both groups. Conclusion: In full‐term neonates with severe hyperbilirubinemia, administration of hypotonic fluid to prevent BET was associated with a higher incidence of hyponatremia while isotonic fluid was associated with an increased incidence of hypernatremia. 相似文献
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Sri Dantuluri Arun Urs Sivaramakrishnan Venkatesh Karthik 《Pediatric transplantation》2012,16(8):E372-E374
Dantuluri S, Urs A, Karthik SV. Follicular carcinoma of thyroid following successful liver transplantation – A report. Abstract: Follicular carcinoma of the thyroid is a relatively rare malignancy in childhood even in paediatric solid organ transplant recipients. The risk of developing de novo malignancies after liver transplantation is higher compared to the general population. We report an 18‐yr‐old girl who had successfully undergone liver transplantation five yr earlier for neonatal sclerosing cholangitis complicated by the development of dysplastic nodules. Baseline immunosuppression was with tacrolimus and prednisolone. Mycophenolate mofetil was later added in view of steroid‐resistant episodes of graft rejection. She subsequently suffered from marked obesity and essential hypertension needing antihypertensive medication. Five yr after liver transplantation, she presented with a right‐sided thyroid swelling that was rapidly progressive with no associated lymphadenopathy and normal systemic examination. Ultrasound of her neck revealed a solid lesion in the right lobe of the thyroid gland with ill‐defined margins, and a diagnostic right thyroid lobectomy confirmed the diagnosis of follicular carcinoma with focal capsular and vascular invasion. She underwent total thyroidectomy and currently remains well on thyroxine supplements. Our report highlights the need for high level of suspicion and prompt investigation into any abnormal lesion in the long‐term follow‐up of solid organ transplant recipients. 相似文献
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Nandakumar?Venkatesan Sunil?Shroff Karthik?Jeyachandran Mukesh?DobleEmail author 《Urological research》2011,39(1):29-37
Polyurethane stents are used when there is an obstruction to the flow of urine. A majority of the patients with such stents are at the risk of urinary tract infection and salt encrustation. The present study is aimed at analyzing the in vitro encrustation of calcium oxalate and other salts in the presence of common uropathogens (E. coli and P. mirabilis) on films made from Tecoflex®, a commercial grade polyurethane. In the absence of uropathogens, sodium ions and ammonia favor calcium adsorption whereas magnesium ions greatly depress it, resulting in increased hydrophillicity of the stent. With E. coli, Mg ions enhance the encrustation of calcium, whereas the other salts decrease its deposition. In case of P. mirabilis, irrespective of the type of salt, it enhances calcium encrustation except in the presence of sodium ions. Adhesion of uropathogens to the stent surface was higher in the presence of bovine serum albumin. Understanding the dynamics between various salts and microorganism in the urine, and urine–stent interface would aid in designing stents that are inert, resist encrustation and biofilm formation. 相似文献
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Jayaraman S Trejos AL Naish MD Lyle A Patel RV Schlachta CM 《Surgical endoscopy》2011,25(5):1439-1445
Minimally invasive surgical training is complicated due to the constraints imposed by the surgical environment. Sensorized
laparoscopic instruments capable of sensing force in five degrees of freedom and position in six degrees of freedom were evaluated.
Novice and expert laparoscopists performed the complex minimally invasive surgical task of suturing using the novel instruments.
Their force and position profiles were compared. The novel minimally invasive surgical instrument proved to be construct valid
and capable of detecting differences between novices and experts in a laparoscopic suturing task with respect to force and
position. Further evaluation is mandated for a better understanding of the ability to predict performance based on force and
position as well as the potential for new metrics in minimally invasive surgical education. 相似文献