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1.
Many studies identify the risk factors for joining street gangs, but few explore disengagement. This article provides a systematic review of the factors which contribute to disengagement from gangs. Understanding this area is of paramount importance to developing policy and guiding practitioners working with this population, given the impact this lifestyle has on gang members and society as a whole. Seven academic databases, reference lists of relevant publications, an online search engine and a government database were used to identify relevant studies. Inclusion and exclusion criteria and quality assessment methods were employed. Data were then extracted and synthesised. Of 2515 citations, seven were found to have methodological rigour. The findings suggest there is not one definitive reason for gang exit but rather that multiple factors contribute. Variability was found in the quality scores. The limitations of this review are discussed, along with clinical implications and suggestions for future research. 相似文献
2.
Aim
Tracheomalacia is flaccidity of the tracheal wall leading to tracheal collapse, particularly on expiration. When severe it can warrant surgical intervention. Aortopexy is one surgical option and has been described using a variety of approaches. We report outcomes of aortopexy performed via a suprasternal incision in a single centre by a single surgeon.Methods
All patients undergoing aortopexy between February 2016 and May 2018 were prospectively included. Patients were managed by a multi-disciplinary team (MDT) and underwent standardized work-up, including dynamic flexible bronchoscopy (DFB) and contrast enhanced CT. Aortopexy was performed via a suprasternal skin crease incision. Surgery was guided by intra-operative flexible bronchoscopy. Data regarding pre-operative symptoms, degree of tracheomalacia, and outcomes were recorded.Results
Twenty-two patients were included, 18 boys, median age 5?months (range 1?month–5?years). Two aortopexy sutures were used in all cases, and three patients required an additional tracheopexy suture. Median operating time was 1?h 24?min (range 47?min–2?h 35?min). Median pre-operative tracheal collapse on DFB was 85% (range 80–95%), improving to 35% (35–80%) intra-operatively. Median length of stay was 4?days (range 1–118).Conclusions
Aortopexy via a suprasternal incision is a useful treatment modality for tracheomalacia with short operating times and rapid recovery. Outcomes vary with the best results in the TOF and premature groups. Careful patient selection and MDT work-up are essential to optimize outcomes.Level of Evidence
Level 3 (Case Series). 相似文献3.
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Postoperative nomogram predicting the 10-year probability of prostate cancer recurrence after radical prostatectomy. 总被引:3,自引:0,他引:3
Andrew J Stephenson Peter T Scardino James A Eastham Fernando J Bianco Zohar A Dotan Christopher J DiBlasio Alwyn Reuther Eric A Klein Michael W Kattan 《Journal of clinical oncology》2005,23(28):7005-7012
PURPOSE: A postoperative nomogram for prostate cancer recurrence after radical prostatectomy (RP) has been independently validated as accurate and discriminating. We have updated the nomogram by extending the predictions to 10 years after RP and have enabled the nomogram predictions to be adjusted for the disease-free interval that a patient has maintained after RP. METHODS: Cox regression analysis was used to model the clinical information for 1,881 patients who underwent RP for clinically-localized prostate cancer by two high-volume surgeons. The model was externally validated separately on two independent cohorts of 1,782 patients and 1,357 patients, respectively. Disease progression was defined as a rising prostate-specific antigen (PSA) level, clinical progression, radiotherapy more than 12 months postoperatively, or initiation of systemic therapy. RESULTS: The 10-year progression-free probability for the modeling set was 79% (95% CI, 75% to 82%). Significant variables in the multivariable model included PSA (P = .002), primary (P < .0001) and secondary Gleason grade (P = .0006), extracapsular extension (P < .0001), positive surgical margins (P = .028), seminal vesicle invasion (P < .0001), lymph node involvement (P = .030), treatment year (P = .008), and adjuvant radiotherapy (P = .046). The concordance index of the nomogram when applied to the independent validation sets was 0.81 and 0.79. CONCLUSION: We have developed and validated as a robust predictive model an enhanced postoperative nomogram for prostate cancer recurrence after RP. Unique to predictive models, the nomogram predictions can be adjusted for the disease-free interval that a patient has achieved after RP. 相似文献
8.
Tass H Malik Iain A Bruce Gerard Kelly Richard T Ramsden Shakeel R Saeed 《Skull base》2007,17(4):235-238
In cases of cerebrospinal fluid (CSF) rhinorrhea following lateral skull base surgery, fibrosis and fibrin formation resulting from meningitis has been postulated as a mechanism of spontaneously resolving the CSF leak. This study was undertaken to explore any possible relationship between the cessation of CSF leak and meningitis. A retrospective study at a tertiary referral center of 232 consecutive patients was performed. Out of a total of 232 procedures, 29 patients developed CSF rhinorrhea, of whom 7 subsequently developed meningitis. Bacteria were isolated in CSF obtained at lumbar puncture in 5 cases, with the CSF analysis in the remaining 2 cases suggesting aseptic meningitis. Conservative treatment failed to stop the CSF rhinorrhea in 6 of 7 cases. In this study, the development of meningitis did not appear to aid in the resolution of the CSF rhinorrhea. We conclude that surgical intervention should not be delayed in the expectation that meningitis and conservative interventions may promote CSF leak resolution. 相似文献
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Timson C Appanna Shareen H Doak Spencer A Jenkins Howard G Kynaston Timothy P Stephenson James M Parry 《International journal of urology》2007,14(6):539-544
OBJECTIVE: Tumors arising within augmentation cystoplasties are aggressive, have poor prognosis and the majority are not detected at follow-up cystoscopy. Genetic changes in tumors precede morphological abnormalities. Therefore, the aim of this study was to investigate whether genetic abnormalities detected by comparative genomic hybridization (CGH) could be used to identify those patients with augmentation cystoplasties at increased risk of tumorigenesis. METHODS: Bladder biopsy samples were obtained from 16 augmentation cystoplasty patients both distant from and near to the enterovesical anastomosis. CGH was used to detect genetic abnormalities in DNA extracted from the biopsies, archival specimens of two augmentation cystoplasties and two de novo bladder adenocarcinomas. RESULTS: A greater number of amplifications on 2p, 3q, 8q, 9p, 17p, 18pq and 20pq, were observed in bladder biopsies obtained near to the enterovesical anastomosis compared to those taken distant to the suture line. CGH of archival augmentation cystoplasty tumor DNA indicated abnormalities at several loci with amplifications at 2q, 5q, 10p and 21pq, while deletions occurred at 5p and 16p. CONCLUSIONS: The results of this study suggest that the urothelium adjacent to the bladder and/or bowel anastomosis in augmentation cystoplasties is genetically unstable. Furthermore, longitudinal studies are required to establish whether or not patients exhibiting genetic instability following augmentation cystoplasty are at greater risk of developing tumors than those with genetically stable epithelia. 相似文献