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101.
Ahmed Sharata Ashwin A. Kurian Christy M. Dunst Neil H. Bhayani Kevin M. Reavis Lee L. Swanstrom 《Surgical endoscopy》2014,28(4):1333-1333
Background
Per-Oral Endoscopic Myotomy (POEM) is becoming an acceptable alternative to laparoscopic cardiomyotomy for esophageal motility disorders. The aim of this video is to provide key technical steps to completing this procedure.Method
Each patient underwent diagnostic investigations including high resolution manometry (HRM), esophageogastroduodenoscopy (EGD), and timed-barium swallow for primary esophageal motility disorders preoperatively. Patients undergoing POEM procedures are preoperatively prepared by taking Nystatin swish-and-swallow for 3 days, 24 h of clear liquid diet, and 12 h of NPO. Preoperative antibiotics are given. Under general anesthesia and with the patient in the supine position, endoscopy with CO2 insufflation is prepared. Special endoscopic instruments and electrocautery settings are required to perform the POEM procedure, as illustrated in the slides. POEM is performed in six key/critical steps: (1) diagnostic endoscopy; (2) taking measurements; (3) esophageal mucosotomy creation; (4) submucosal tunneling; (5) selective circular myotomy of the anterior lower esophageal sphincter; and (6) closure of the mucosotomy. According to our protocol, all patients get an esophogram the next morning after surgery prior to discharge. The patient receives objective testing (HRM with 24 PH Impedance test, EGD, and timed-barium swallow) 6 months postoperatively.Conclusion
In six key steps, POEM can be accomplished as described in the video. 相似文献102.
Given that ecological models of development highlight the interacting influences of multiple environments, further research is needed that explores ethnic-racial socialization from multiple contexts. The current study explores how families, schools, neighborhoods, and the Internet jointly impact academic outcomes, critical consciousness, and psychological well-being in adolescents, both through socialization messages and experiences with racial discrimination. The research questions were: (a) What profiles of multiple contexts of socialization exist? and (b) How are the different profiles associated with academic outcomes, critical consciousness, and psychological well-being? The sample consisted of 1,084 U.S. adolescents aged 13–17 (M = 14.99, SD = 1.37; 49% girls) from four ethnic-racial groups: 25.6% Asian American, 26.3% Black/African American, 25.3% Latinx, and 22.9% White. The participants completed online surveys of socialization and discrimination from four contexts and three types of outcomes: academic outcomes, critical consciousness, and well-being. A latent profile analysis revealed three profiles: Average, High Discrimination, and Positive School. The Positive School class had the most positive academic outcomes and well-being. The High Discrimination class reported the highest critical consciousness. Their academic outcomes and well-being were similar to the Average group. The findings support complexity in perceptions of socialization from different contexts and the associations of socialization with youth outcomes. 相似文献
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Elise M. Rossiter W. Stewart Agras Christy F. Telch John A. Schneider 《The International journal of eating disorders》1993,13(4):349-357
The Personality Disorders Examination (PDE) was administered to 71 bulimia nervosa patients at baseline assessment in a study comparing the effectiveness of cognitive-behavioral treatment with desipramine or the combination of both treatments. Personality disorder sub-scales were combined into single DSM-III-R cluster scores. A high cluster B score (consisting of antisocial, borderline, histrionic, and narcissistic features) significantly predicted poor outcome at 16 weeks and was a better predictor of outcome than borderline personality characteristics alone or any other DSM-III-R. cluster score or combination of cluster scores. In contrast pretreatment depression level, self-esteem, degree of dietary restraint, frequency of purging, and history of anorexia nervosa were not significantly related to outcome. At 1-year follow-up there was still a trend toward high cluster B scores predicting poor treatment outcome. Cluster B score was not significantly correlated with percentage of sessions attended nor did subjects with higher cluster B scores have a better outcome with either specific treatment. These results suggest that further investigation of alternative treatments is warranted with high cluster B individuals to determine if treatment effectiveness can be improved. © 1993 by John Wiley & Sons, Inc. 相似文献
107.
Gaurav Parmar Priti Soin Pranav Sharma Christy French Bing Han Puneet S. Kochar 《Radiology Case Reports》2022,17(1):223
Intervertebral disc herniation is common condition, with majority occurring in lumbar and cervical spine. Most lumbar disk herniations occur within the spinal canal, with approximately 7%-10% identified within the foramen or extraforaminal location. Extraforaminal disc herniation in extreme lateral, retroperitoneal or anterior terms are used when disc material is seen towards anterolateral or anterior to the spine. Disc herniation in these locations is easily mistaken for an abscess or a neoplasm especially when it is not connected to the parent disc (sequestered disc). We describe a case of 60-year male who initially was misdiagnosed as psoas abscess and subjected to invasive investigation which later turned out to be histologically confirmed disc sequestration in the retroperitoneum. Thus, knowledge of this condition is essential in avoiding unnecessary workup and treatment. 相似文献
108.
Julie Wecsler MD Young Ju Jeong MD PhD Akshara S. Raghavendra MD MS Wendy J. Mack PhD Debasish Tripathy MD Mary W. Yamashita MD Pulin A. Sheth MD Linda Hovanessian Larsen MD Christy A. Russell MD Heather MacDonald MD Stephen F. Sener MD FACS Julie E. Lang MD FACS 《Journal of surgical oncology》2020,121(4):589-598
109.
Christy Boscardin Kirkpatrick B. Fergus Bonnie Hellevig Karen E. Hauer 《Medical teacher》2018,40(8):855-861
AbstractEasily accessible and interpretable performance data constitute critical feedback for learners that facilitate informed self-assessment and learning planning. To provide this feedback, there has been a proliferation of educational dashboards in recent years. An educational (learner) dashboard systematically delivers timely and continuous feedback on performance and can provide easily visualized and interpreted performance data. In this paper, we provide practical tips for developing a functional, user-friendly individual learner performance dashboard and literature review of dashboard development, assessment theory, and users’ perspectives. Considering key design principles and maximizing current technological advances in data visualization techniques can increase dashboard utility and enhance the user experience. By bridging current technology with assessment strategies that support learning, educators can continue to improve the field of learning analytics and design of information management tools such as dashboards in support of improved learning outcomes. 相似文献
110.
小儿淋巴管瘤的MRI诊断 总被引:7,自引:0,他引:7
目的分析小儿淋巴管瘤的磁共振表现及其病理基础。方法对6例经手术病理证实的、年龄7天至7岁的小儿淋巴管瘤患者的磁共振表现进行回顾性分析。结果淋巴管瘤磁共振表现为T1WI上呈与肌肉相似或稍高的信号,T2WI上高于脂肪信号。5例瘤内可见低信号分隔,1例瘤内见血管流空影,3例见明显包膜,3例边界不清。2例病理诊断为海绵状淋巴管瘤,4例诊断为囊状淋巴管瘤。结论磁共振成像可较好地显示肿瘤的大小、形态及范围,从而指导手术治疗。 相似文献