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71.
D?Anil?Kumar RN?Suresh?Kumar PN?Rao S?Chandran H?Mahmoud AS?Pillay DK?Saxena CG?Venkitachalam T?Cartmill IM?RaoEmail author 《Indian Journal of Thoracic and Cardiovascular Surgery》2003,19(4):159-162
Background The major strategy for palliation of cyanotic lesions in neonates is the systemic to pulmonary arterial shunt.
Methods Between May 1995, and December 2002, 48 consecutive neonates underwent systemic to pulmonary arterial shunts for cyanosis
with reduced pulmonary blood flow. The mean age was 11.6 days (±SD 7.38) and the mean weight, 3.2kg (±SD 0.52). The babies
were classified into three groups: Group I-Tetralogy-pulmonary Atresia (n=18), Group II-single Ventricle-Pulmonary atresia
without (n=19) and with (n=5) isomerism, Group III-Pulmonary Atresia with Intact ventricular septum (n=6). Diagnosis was made
by 2D echocardiography. Indication for cardiac catheterization was delineation of pulmonary anatomy/ductus laterality (n=4)
or balloon atrial septostomy (n=4). The surgical procedure was a modified Blalock-Taussig shunt on the side of the situs.
Post-operatively, no anti-coagulation or anti-platelet medication was employed.
Results There was no mortality. Four cases required revision of the shunt in the immediate post-operative period for shunt thrombosis.
The mean follow up was 17.54 months (±SD 8.36). In Group I, nine patients have undergone total correction with or without
a conduit, while three required new arterial shunts for shunt/pulmonary artery stenosis. In Group II, nine patients have undergone
bi-directional Glenn with atrial septectomy (n=2) and pulmonary artery plasty (n=4) and one patient underwent Fontan completion.
In Group III, two patients underwent bi-directional Glenn and two had pulmonary valvotomy with/without right ventricular outflow
tract widening. All the remaining babies are waiting for the second/final stage palliation or total correction.
Conclusion Systemic to pulmonary arterial shunts in neonates is a gratifying and reasonably safe surgical procedure. Most babies become
candidates for eventual univentricular/bi-ventricular repair. 相似文献
72.
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74.
PN Malleson 《Archives of disease in childhood》1976,51(5):373-376
Four children with severe diabetic ketosis were successfully treated with a regimen of low-dose intermittent insulin infusions in the rehydrating fluid. The children all rapidly regained consciousness and tolerated oral fluids within 12 hours of admission. Hypoglycaemia and hypokalaemia, both complications of conventional large dose insulin treatment, did not occur. Plasma insulin levels obtained by this method were maintained in the optimum range recommended by S?nksen et al. (1972). 相似文献
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77.
Martin Omedo Michael Ogutu Alphonce Awiti Rosemary Musuva Geoffrey Muchiri Susan P. Montgomery W. Evan Secor Pauline Mwinzi 《The American journal of tropical medicine and hygiene》2014,91(5):982-988
Compliance with mass drug administration (MDA) can be affected by rumors and mistrust about the drug. Communication campaigns are an effective way to influence attitudes and health behaviors in diverse public health contexts, but there is very little documentation about experiences using health communications in schistosomiasis control programs. A qualitative study was conducted with community health workers (CHWs) as informants to explore the effect of a health communication campaign on their experiences during subsequent praziquantel MDA for schistosomiasis. Discussions were audio-recorded, transcribed verbatim, translated into English where applicable, and analyzed thematically using ATLAS.ti software. According to the CHWs, exposure to mass media messages improved awareness of the MDA, which in turn, led to better treatment compliance. Our findings suggest that communication campaigns influence health behaviors and create awareness of schistosomiasis control interventions, which may ultimately improve praziquantel MDA. 相似文献
78.
C Wilfert JE Aronson DT Beck AR Fleischman MW Kline LM Mofenson GB Scott DW Wara PN Whitley-Williams 《Pediatrics》1999,103(2):509-511
Although the character of acquired immunodeficiency syndrome is changing into a chronic illness, it is estimated that by the end of this century, 80 000 children and adolescents in the United States will be orphaned by parental death caused by human immunodeficiency virus infection. Plans for these children need to be made to ensure not only a stable, consistent environment that provides love and nurturing, but also the medical and social interventions necessary to cope with the tragic loss. Pediatricians should become aware of local laws and community resources and initiate discussion early in the course of parental illness to facilitate planning for the future care and custody of the children. States need to adopt laws and regulations that provide flexible approaches to guardianship and placement of children orphaned by acquired immunodeficiency syndrome. 相似文献
79.
Rigsby CM; Taylor KJ; Weltin G; Burns PN; Bia M; Princenthal RA; Kashgarian M; Flye MW 《Radiology》1986,158(2):375-378
Sixty-nine duplex sonographic studies were performed in 24 patients who had received renal allografts. After a prospective qualitative analysis of the Doppler waveforms, results were correlated with biopsy material and each patient's clinical course. Increased pulsatility of the Doppler waveform of intrarenal arterial flow constituted an abnormal study, indicating acute rejection. Overall sensitivity varied with the histologic form of rejection, with a 60% sensitivity for acute interstitial rejection with or without vascular rejection and an 82% sensitivity for acute vascular rejection. Overall specificity was 95% and 96%, respectively. Early rejection was also accurately detected in three patients less than 48 hours following kidney transplantation. Duplex sonography has a useful role in evaluating posttransplantation renal failure. Abnormal study results may obviate the need for biopsy and help in guiding clinical management. 相似文献
80.
Members of the carcinoembryonic antigen family (CEACAMs) are widely expressed, and, depending on the tissue, capable of regulating
diverse functions including tumor promotion, tumor suppression, angiogenesis, and neutrophil activation. Four members of this
family, CEACAM1, CEACAM8, CEACAM6, and CEACAM3 (recognized by CD66a, CD66b, CD66c, and CD66d mAbs, respectively), are expressed
on human neutrophils. CD66a, CD66b, CD66c, and CD66d antibodies each increase neutrophil adhesion to human umbilical vein
endothelial cell monolayers. This increase in neutrophil adhesion caused by CD66 antibodies is blocked by CD18 mAbs and is
associated with upregulation of CD11/CD18 on the neutrophil surface. To examine potential interactions of CEACAMs in neutrophil
signaling, the effects on neutrophil adhesion to human umbilical vein endothelial cells of a set of CD66 mAbs was tested following
desensitization to stimulation by various combinations of these mAbs. Addition of a CD66 mAb in the absence of calcium results
in desensitization of neutrophils to stimulation by that CD66 mAb. The current data show that desensitization of neutrophils
to any two CEACAMs results in selective desensitization to those two CEACAMs, while the cells remain responsive to the other
two neutrophil CEACAMs. In addition, cells desensitized to CEACAM-3, -6, and -8 were still responsive to stimulation of CEACAM1
by CD66a mAbs. In contrast, desensitization of cells to CEACAM1 and any two of the other CEACAMs left the cells unresponsive
to all CD66 mAbs. Cells desensitized to any combination of CEACAMs remained responsive to the unrelated control protein CD63.
Thus, while there is significant independence of the four neutrophil CEACAMs in signaling, CEACAM1 appears to play a unique
role among the neutrophil CEACAMs. A model in which CEACAMs dimerize to form signaling complexes could accommodate the observations.
Similar interactions may occur in other cells expressing CEACAMs. 相似文献