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Sample records for 13-year single-center experience

  1. Home mechanical ventilation in childhood-onset hereditary neuromuscular diseases: 13 years' experience at a single center in Korea.

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    Young Joo Han

    Full Text Available Children with hereditary neuromuscular diseases (NMDs are at a high risk of morbidity and mortality related to respiratory failure. The use of home mechanical ventilation (HMV has saved the lives of many children with NMD but, due to a lack of studies, dependable guidelines are not available. We drew upon our experience to compare the various underlying NMDs and to evaluate HMV with regard to respiratory morbidity, the proper indications and timing for its use, and to develop a policy to improve the quality of home noninvasive ventilation (NIV.We retrospectively analyzed the medical records of 57 children with childhood-onset hereditary NMDs in whom HMV was initiated between January 2000 and May 2013 at Seoul National University Children's Hospital. The degree of respiratory morbidity was estimated by the frequency and duration of hospitalizations caused by respiratory distress.The most common NMD was spinal muscular atrophy (SMA, n = 33. Emergent mechanical ventilation was initiated in 44% of the patients before the confirmed diagnosis, and the indicators of pre-HMV respiratory morbidity (e.g., extubation trials, hypoxia, hospitalizations, and intensive care unit stay were greater in these patients than in others. The proportion of post-HMV hospitalizations (range, 0.00-0.52; median, 0.01 was lower than that of pre-HMV hospitalizations (0.02-1.00; 0.99 (P < 0.001. Eight patients were able to maintain home NIV. The main causes of NIV failure were air leakage and a large amount of airway secretions.The application of HMV helped reduce respiratory morbidity in children with childhood-onset hereditary NMD. Patients with SMA type I can benefit from an early diagnosis and the timely application of HMV. The choice between invasive and noninvasive HMV should be based on the patient's age and NIV trial tolerance. Systematic follow-up guidelines provided by a multidisciplinary team are needed.

  2. Early subclinical rejection treated with low dose i.v. steroids is not associated to graft survival impairment: 13-years' experience at a single center.

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    Gigliotti, Paolo; Lofaro, Danilo; Leone, Francesca; Papalia, Teresa; Senatore, Massimino; Greco, Rosita; Perri, Anna; Vizza, Donatella; Lupinacci, Simona; Toteda, Giuseppina; La Russa, Antonella; De Stefano, Roberto; Romeo, Francesco; Bonofiglio, Renzo

    2016-06-01

    Subclinical rejection (SCR) has been variably associated with reduced graft survival, development and progression of interstitial fibrosis/tubular atrophy and chronic allograft nephropathy, but data are controversial concerning SCR treatment in terms of graft survival improvement. In this single-center retrospective study, we enrolled 174 adult kidney transplant recipients with a protocol biopsy performed at 30 days after transplantation to evaluate the incidence rate and risk factors for early SCR and its impact on 10-year graft survival. Five patients showed primary non function and were excluded. Among 159/169 (94.08 %) patients with stable graft function who underwent protocol biopsy, 17 (10.7 %) showed signs of SCR and were treated with low-dose intravenous (i.v.) steroids. Ten patients showed functional impairment, 8 (4.73 %) resulting as acute rejection. At multivariate analysis, donor age [odds ratio (OR) 1.04, 95 % confidence interval (CI) 1.01-1.09], and delayed graft function (DGF) (OR 1.08, 95 % CI 1.03-1.12) were significantly associated with SCR. The 10-year graft survival rate in the SCR group was similar to that in the normal-findings group (76.5 vs. 74.9 % respectively; p = 0.61). At multivariate Cox regression, acute [hazard ratio (HR) 5.22, 95 % CI 1.70-16.01], but not sub-clinical, rejection was independently associated with long-term graft failure. In conclusion, early protocol biopsy is a useful and safe tool to detect early SCR which seems not to affect the long-term survival. We suggest that this could be, probably, linked to early SCR treatment with low dose i.v. steroids.

  3. Early subclinical rejection treated with low dose i.v. steroids is not associated to graft survival impairment: 13-years' experience at a single center.

    Science.gov (United States)

    Gigliotti, Paolo; Lofaro, Danilo; Leone, Francesca; Papalia, Teresa; Senatore, Massimino; Greco, Rosita; Perri, Anna; Vizza, Donatella; Lupinacci, Simona; Toteda, Giuseppina; La Russa, Antonella; De Stefano, Roberto; Romeo, Francesco; Bonofiglio, Renzo

    2016-06-01

    Subclinical rejection (SCR) has been variably associated with reduced graft survival, development and progression of interstitial fibrosis/tubular atrophy and chronic allograft nephropathy, but data are controversial concerning SCR treatment in terms of graft survival improvement. In this single-center retrospective study, we enrolled 174 adult kidney transplant recipients with a protocol biopsy performed at 30 days after transplantation to evaluate the incidence rate and risk factors for early SCR and its impact on 10-year graft survival. Five patients showed primary non function and were excluded. Among 159/169 (94.08 %) patients with stable graft function who underwent protocol biopsy, 17 (10.7 %) showed signs of SCR and were treated with low-dose intravenous (i.v.) steroids. Ten patients showed functional impairment, 8 (4.73 %) resulting as acute rejection. At multivariate analysis, donor age [odds ratio (OR) 1.04, 95 % confidence interval (CI) 1.01-1.09], and delayed graft function (DGF) (OR 1.08, 95 % CI 1.03-1.12) were significantly associated with SCR. The 10-year graft survival rate in the SCR group was similar to that in the normal-findings group (76.5 vs. 74.9 % respectively; p = 0.61). At multivariate Cox regression, acute [hazard ratio (HR) 5.22, 95 % CI 1.70-16.01], but not sub-clinical, rejection was independently associated with long-term graft failure. In conclusion, early protocol biopsy is a useful and safe tool to detect early SCR which seems not to affect the long-term survival. We suggest that this could be, probably, linked to early SCR treatment with low dose i.v. steroids. PMID:25966801

  4. Hepatoblastoma: Experience from a single center

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    Singh, T.; C T Satheesh; Appaji, L.; Aruna Kumari BS; M Padma; Kumar, M V; Mukherjee, G.

    2010-01-01

    Background: The cornerstones of successful treatment of hepatoblastoma (HB) include preoperative chemotherapy followed by complete anatomical resection of tumor, followed by chemotherapy. Advances in chemotherapy in the last 2 decades have been associated with a higher rate of tumor response and possibly a greater potential for resectability. Aims: We analyzed our single center experience with neoadjuvant chemotherapy (NACT) and surgery in HBs. Settings and Design: Our study included all ch...

  5. Hepatoblastoma: Experience from a single center

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    T Singh

    2010-01-01

    Full Text Available Background: The cornerstones of successful treatment of hepatoblastoma (HB include preoperative chemotherapy followed by complete anatomical resection of tumor, followed by chemotherapy. Advances in chemotherapy in the last 2 decades have been associated with a higher rate of tumor response and possibly a greater potential for resectability. Aims: We analyzed our single center experience with neoadjuvant chemotherapy (NACT and surgery in HBs. Settings and Design: Our study included all children with HBs who received NACT and underwent surgical excision from January 1997 to July 2004. Materials and Methods: Patient characteristics, clinical features, clinical course, treatment modalities, and long-term outcome were analyzed. Results: There were 9 boys and 3 girls, aged 5-60 months (median age at tumor diagnosis was 24 months. All received NACT containing cisplatin and doxorubicin. Of the 12 children, 9 underwent hepatectomy and among them, 4 patients each had right and left hepatectomy and 1 patient underwent right extended hepatectomy. After surgery, all patients completed rest of the chemotherapy course (total 6 cycles. R0 resection was carried out in all the 9 cases with no life-threatening complications. Conclusions: Our experience of the 9 cases, although less in number, reaffirms the advantages of NACT followed by surgery. The prognosis for patients with resectable tumors is fairly good in combination with chemotherapy.

  6. LIVER TRANSPLANTATION. A SINGLE CENTER EXPERIENCE OF 100 CASES

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    A. M. Granov

    2012-01-01

    Full Text Available A single center experience of first 100 liver transplantations (LTs is summarized. Analysis of trends in cadaver donor population and waiting list status changes, and also of early and late postoperative complications are presented. 100 LTs were performed for 95 patients (pts, retransplantation – 4 pts; one patient received 3 liver transplants (female – 55 pts, male – 40 pts, mean age – 39.9 ± 12.1 years. Cumulative 1-year survival rate of pts by Kaplan–Meyer was 91%, 3-year – 83%. Biliary complications were revealed in 9% of pts during 2–9 months after LT. 77 pts have been regularly observed in outpatient clinic, mean age – 44 ± 9.2 years, male – 35, fema- le – 42, follow-up period – 1 months up to 13 years after LT. 3.9% remained invalid with limitation of ability to work, 61.8% have been working, 22.3% were capable to work, retirees were 10.5%. Development of preoperati- ve planning, adequate organ selection will allow to improve the results of LT. Study of hematopoietic stem cells role will expand tools of prognosis of posttransplant complications. 

  7. Prenatal Diagnosis of Chromosome Abnormalities: A 13-Year Institution Experience

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    Carmen Comas

    2012-11-01

    Full Text Available Objective: To analyze trends in screening and invasive prenatal diagnosis of chromosome abnormalities (CA over a 13-year period and correlate them to changes in the national prenatal screening policy. Methods: We retrospectively reviewed Down syndrome (DS screening tests and fetal karyotypes obtained by prenatal invasive testing (IT in our fetal medicine unit between January 1999 and December 2011. Results: A total of 24,226 prenatal screening tests for DS and 11,045 invasive procedures have been analyzed. Over a 13-year period, utilization of non-invasive screening methods has significantly increased from 57% to 89%. The percentage of invasive procedures has declined from 49% to 12%, although the percentage of IT performed for maternal anxiety has increased from 22% to 55%. The percentage of detected CA increased from 2.5% to 5.9%. Overall, 31 invasive procedures are needed to diagnose 1 abnormal case, being 23 procedures in medical indications and 241 procedures in non-medical indications. Conclusions: Our experience on screening and invasive prenatal diagnostic practice shows a decrease of the number of IT, with a parallel decline in medical indications. There is an increasing efficiency of prenatal screening program to detect CA. Despite the increasing screening policies, our population shows a growing request for prenatal IT. The a priori low risk population shows a not negligible residual risk for relevant CA. This observation challenges the current prenatal screening strategy focused on DS; showing that the residual risk is higher than the current cut-off used to indicate an invasive technique.

  8. Prenatal Diagnosis of Chromosome Abnormalities: A 13-Year Institution Experience

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    Comas, Carmen; Echevarria, Mónica; Rodríguez, María Ángeles; Rodríguez, Ignacio; Serra, Bernat; Cirigliano, Vincenzo

    2012-01-01

    Objective: To analyze trends in screening and invasive prenatal diagnosis of chromosome abnormalities (CA) over a 13-year period and correlate them to changes in the national prenatal screening policy. Methods: We retrospectively reviewed Down syndrome (DS) screening tests and fetal karyotypes obtained by prenatal invasive testing (IT) in our fetal medicine unit between January 1999 and December 2011. Results: A total of 24,226 prenatal screening tests for DS and 11,045 invasive procedures have been analyzed. Over a 13-year period, utilization of non-invasive screening methods has significantly increased from 57% to 89%. The percentage of invasive procedures has declined from 49% to 12%, although the percentage of IT performed for maternal anxiety has increased from 22% to 55%. The percentage of detected CA increased from 2.5% to 5.9%. Overall, 31 invasive procedures are needed to diagnose 1 abnormal case, being 23 procedures in medical indications and 241 procedures in non-medical indications. Conclusions: Our experience on screening and invasive prenatal diagnostic practice shows a decrease of the number of IT, with a parallel decline in medical indications. There is an increasing efficiency of prenatal screening program to detect CA. Despite the increasing screening policies, our population shows a growing request for prenatal IT. The a priori low risk population shows a not negligible residual risk for relevant CA. This observation challenges the current prenatal screening strategy focused on DS; showing that the residual risk is higher than the current cut-off used to indicate an invasive technique. PMID:26859399

  9. Mycophenolate mofetil in pediatric renal transplantation: A single center experience.

    LENUS (Irish Health Repository)

    Raheem, Omer A

    2011-05-01

    Raheem OA, Kamel MH, Daly PJ, Mohan P, Little DM, Awan A, Hickey DP. Mycophenolate mofetil in pediatric renal transplantation: A single center experience. Pediatr Transplantation 2011: 15:240-244. © 2009 John Wiley & Sons A\\/S. Abstract:  We assessed our long-term experience with regards to the safety and efficacy of MMF in our pediatric renal transplant population and compared it retrospectively to our previous non-MMF immunosuppressive regimen. Forty-seven pediatric renal transplants received MMF as part of their immunosuppressive protocol in the period from January 1997 till October 2006 (MMF group). A previously reported non-MMF group of 59 pediatric renal transplants was included for comparative analysis (non-MMF group). The MMF group comprised 29 boys and 18 girls, whereas the non-MMF group comprised 34 boys and 25 girls. Mean age was 11.7 and 12 yr in the MMF and non-MMF groups, respectively. The incidence of acute rejection episodes was 11 (23.4%) and 14 (24%) in the MMF and non-MMF group, respectively. Two (3.3%) grafts were lost in the non-MMF group compared with one (2.1%) in the MMF group. Twenty-one (44.68%) patients in the MMF group developed post-transplant infections compared with 12 (20.33%) in the non-MMF group (p < 0.0001). In conclusion, the use of MMF in pediatric renal transplantation was not associated with a lower rejection rate or immunological graft loss. It did, however, result in a significantly higher rate of viral infections.

  10. Management of Cushing's disease: a single-center experience.

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    Solak, Mirsala; Kraljevic, Ivana; Dusek, Tina; Melada, Ante; Kavanagh, Marcel Marjanovic; Peterkovic, Vjerislav; Ozretic, David; Kastelan, Darko

    2016-03-01

    The purpose of this study was to review therapeutic outcomes and comorbidities of patients with Cushing's disease (CD) in a single center. We conducted a retrospective study of 33 patients with CD undergoing transsphenoidal surgery from January 2007 to February 2014 (27 females and 6 males, median age 38 years, range 18-71 years). The diagnosis of Cushing's syndrome was established on the basis of the patient's history, characteristic clinical features, and laboratory data including an elevated 24-h urinary free cortisol level, lack of serum cortisol suppression after dexamethasone suppression tests and an elevated midnight cortisol level. In 28/33 patients, the tumor was visualized on MR of the sellar region, while in 5 it was diagnosed using an inferior petrosal sinus sampling. Out of the 33 patients, 10 had macroadenoma and the remaining 23 had microadenoma. Twenty-one patients (63.6%) had hypertension, 17 (51.5%) dyslipidemia, and 7 (21.2%) had type 2 diabetes or impaired glucose tolerance. The median follow-up period was 28 months. Remission after transsphenoidal surgery was achieved in 78.8% of patients, while 7 patients failed to achieve disease remission. Those patients were treated with second-line treatment modalities (second operation, radiotherapy, bilateral adrenalectomy, and/or ketoconazole). One patient rejected all the treatment modalities after surgery. Cumulative remission after all the treatment modalities was achieved in 87.9% patients. Patients with Cushing's disease should be managed in centers with much experience due to high patient load. In our Center, the remission of the disease has been achieved in 78.8% of the patients following transsphenoidal surgery. Multimodal treatment which included radiotherapy and medical treatment led to biochemical remission of the disease in 87.9% of patients.

  11. Interventional Treatment of Pulmonary Valve Stenosis: A Single Center Experience

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    Shpend Idrizi

    2015-08-01

    Full Text Available BACKGROUND: Percutaneous pulmonary valvuloplasty is well established treatment of choice in pulmonary valve stenosis. AIM: The aim of our study was to present our experience with the interventional technique, its immediate and mid-term effectiveness as well as its complication rate. MATERIAL AND METHODS: The study included 43 patients, where 33 (74% of them were children between the age of 1 month and 15 years. RESULTS: The procedure was successful in 38 patients or 90%. Mean peak to peak transvalvular gradient was reduced from 91.2 mmHg (55-150 mmHg to 39.1 mmHg (20-80 mmHg. Follow- up of patients was between 2 and 13 years and included echocardiographic evaluation of pulmonary valve gradient, right heart dimensions and function as well as assessment of pulmonary regurgitation. We experienced one major complication pericardial effusion in a 5 months old child that required pericardiocenthesis. Six patients (13.9% required a second intervention. During the follow up period there was significant improvement of right heart function and echocardiography parameters. Mild pulmonary regurgitation was noted in 24 (55% patients, and four (9% patients developed moderate regurgitation, without affecting the function of the right ventricle. CONCLUSIONS: Percutaneous pulmonary valvuloplasty is an effective procedure in treatment of pulmonary stenosis with good short and mid-term results.

  12. Thrombolytics in VAD management — A single-center experience

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    Nair, N.; Schmitt, A A; E.M. Rau; Anders, S.; Sandler, D.; T.B. Icenogle

    2016-01-01

    Background: With continued increase in the use of mechanical circulatory support, the incidence of device thrombus remains a challenge. This study is a retrospective analysis of data at a single center to assess the safety and efficacy of thrombolytic use in durable mechanical assist devices. Methods: Data was analyzed retrospectively from 154 patients who underwent left ventricular assist device (LVAD) implantation from 1/1/2005 to 6/30/2014. The HMII device was implanted in 131 patients ...

  13. [Percutaneous treatment of calculosis in caliceal diverticulosis: 13-year experience].

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    Lancini, V; Liatsikos, E N; Bernardo, N O; Dinlenc, C Z; Kapoor, R; Smith, A D

    2000-06-01

    We report our experience with the composition and management of caliceal diverticular stones for the past 13 years at our institution. Fourty patients with caliceal diverticular stones were treated percutaneously at Long Island Jewish Medical Center. The size of the diverticula ranged from 1 to 4.8 cm, with a mean size of 2.27 cm. The stone size ranged from 0.2 to 4.5 cm in diameter with an average of 1.7 cm. Twenty patients underwent a metabolic evaluation. Follow-up ranged from 8 months to 140 months with a mean of 72.5 months. We achieved a stone free rate of 95%. All 40 patients were free of pain and infection. The chemical composition of stones was identified in 38 patients. Twelve patients were found to have mainly calcium phosphate stones, 16 mainly calcium oxalate stones, 7 mainly uric acid stones and 3 were found with milk of calcium in their diverticulum. Thirty-five patients had complete resolution of their diverticula with normal urograms. The remaining 5 patients had at least 50% diminution of the diverticulum size. No one of the latter patients was found to have stone recurrence. Metabolic evaluation of the 40 patients showed in the 75% of the cases any metabolic abnormality, an absorptive hypercalciuria type II in two patients (10%), hyperuricosuric hypercalciuria in two cases (10%) and hyperoxaluria in one (5%). Percutaneous management of caliceal diverticular stones is a safe and effective modality compared to the existing alternative procedures reported in the literature.

  14. SINGLE-CENTER EXPERIENCE OF ABO-INCOMPATIBLE LIVER TRANSPLANTATION

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    S. V. Gautier

    2011-01-01

    Full Text Available Since 2008 up to 2010 eight ABO-incompatible liver transplantations have been performed in our center: one of them was urgent liver transplantation to adult patient from deceased donor, other seven were transplantations of left lateral segment to children from living relative donors. Own experience, as well as world one, proves, that barrier of ABO-incompatibility can be overcome more successfully in liver transplantation, particularly in pediatric population, that in other solid organs transplantation. Good results can be achieved even with less ag- gressive immunosuppressive therapy. Recipient conditioning before operation can significantly improve results of ABO-incompatible liver transplantation, but as own experience has shown, often there’s no need to hold some special preparation of children, because their anti-ABO antibodies are very low or absent before transplantation and do not increase after it. Thereby ABO-incompatible liver transplantation is reasonable in urgent cases and in pediatric population because of the limited pull of living relative donors for children. 

  15. Single-center experience in double kidney transplantation.

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    Fontana, I; Magoni Rossi, A; Gasloli, G; Santori, G; Giannone, A; Bertocchi, M; Piaggio, F; Bocci, E; Valente, Umberto

    2010-05-01

    Use of organs from marginal donors for transplantation is a current strategy to expand the organ donor pool. Its efficacy is universally accepted among data from multicenter studies. Herein, we have reviewed outcomes of double kidney transplantation (DKT) over an 9-year experience in our center. The aim of this study was to evaluate possible important differences between a monocenter versus multicenter studies. Between 1999 and 2008, we performed 59 DKT. Recipient mean age was 63 +/- 5 years. Mean HLA-A, -B, and -DR mismatches were 3.69 +/- 0.922. Donor mean age was 69 +/- 7 years and mean creatinine clearance was 69.8 +/- 30.8 mL/min. Proteinuria was detected in three donors (5%). Mean cold ischemia and warm ischemia times were 1130 +/- 216 and 48 +/- 11 minutes, respectively. The right and left kidney scores were 4.18 +/- 2 and 4.21 +/- 2, respectively. Thirty patients (51%) displayed good postoperative renal function; 22 (37%), acute tubular necrosis with postoperative dialysis; 3 (5%), acute rejection episodes; 4 (7%), single-graft transplantectomy due to vascular thrombosis; 1 (2%), a retransplantation; 5 (8%), a lymphocele; 3 (5%) vescicoureteral reflux or stenosis requiring surgical correction. Cytomegalovirus infection was detected in five patients (8%). In three patients (5%) displayed de novo neoplasia. Three patients showed chronic rejection (5%), whereas we observed a cyclosporine-related toxicity in 7 (12%). Nine patients (15%) developed iatrogenic diabetes. Patient and graft survivals after 3 years from DKT were 93% and 86.3%, respectively. In this study, we applied successfully a widespread score to allocate organs to single kidney transplantation or DKT. In our experience, the score is suitable for the organ allocation but it may be overprotective, excluding potentially suitable organs for a single transplantation. PMID:20534235

  16. Mycophenolate mofetil in pediatric renal transplantation: a single center experience.

    LENUS (Irish Health Repository)

    Raheem, Omer A

    2012-02-01

    We assessed our long-term experience with regards to the safety and efficacy of MMF in our pediatric renal transplant population and compared it retrospectively to our previous non-MMF immunosuppressive regimen. Forty-seven pediatric renal transplants received MMF as part of their immunosuppressive protocol in the period from January 1997 till October 2006 (MMF group). A previously reported non-MMF group of 59 pediatric renal transplants was included for comparative analysis (non-MMF group). The MMF group comprised 29 boys and 18 girls, whereas the non-MMF group comprised 34 boys and 25 girls. Mean age was 11.7 and 12 yr in the MMF and non-MMF groups, respectively. The incidence of acute rejection episodes was 11 (23.4%) and 14 (24%) in the MMF and non-MMF group, respectively. Two (3.3%) grafts were lost in the non-MMF group compared with one (2.1%) in the MMF group. Twenty-one (44.68%) patients in the MMF group developed post-transplant infections compared with 12 (20.33%) in the non-MMF group (p < 0.0001). In conclusion, the use of MMF in pediatric renal transplantation was not associated with a lower rejection rate or immunological graft loss. It did, however, result in a significantly higher rate of viral infections.

  17. Five years' experience with capsule endoscopy in a single Center

    Institute of Scientific and Technical Information of China (English)

    Taylan Kav; Yusuf Bayraktar

    2009-01-01

    Capsule endoscopy (CE) is a novel technology that facilitates highly effective and noninvasive imaging of the small bowel. Although its efficacy in the evaluation of obscure gastrointestinal bleeding (OGIB) has been proven in several trials, data on uses of CE in different small bowel diseases are rapidly accumulating in the literature, and it has been found to be superior to alternative diagnostic tools in a range of such diseases.Based on literature evidence, CE is recommended as a first-line investigation for OGIB after negative bidirectional endoscopy. CE has gained an important role in the diagnosis and follow-up of Crohn's disease and celiac disease and in the surveillance of small bowel tumors and polyps in selected patients. Capsule retention is the major complication, with a frequency of 1%-2%. The purpose of this review was to discuss the procedure, indications, contraindications and adverse effects associated with CE. We also review and share our five-year experience with CE in various small bowel diseases. The recently developed balloon-assisted enteroscopies have both diagnostic and therapeutic capability. At the present time, CE and balloon-assisted enteroscopies are complementary techniques in the diagnosis and management of small bowel diseases.

  18. Valve replacement in pediatric patients:a single center experience

    Institute of Scientific and Technical Information of China (English)

    YU Jian-hua; GUO Hong-wei; ZHANG Gong; WU Shu-ming; SONG Guang-min; SUN Wen-yu

    2011-01-01

    Background Reconstructive surgery is the primary goal in pediatric patients with valve disease.However,in cases with irreparable valve lesions,valve replacement is the only option.This study aimed to retrospectively analyze the clinical experience of heart valve prosthesis replacement in children.Methods Between January 1990 and July 2009,35 pediatric patients (16 boys,19 girls) underwent mechanical valve replacement in Shandong University Qilu Hospital.The ages ranged from 2.5 to 14 years (mean,(8.8±3.8) years) and body weight varied from 11 to 37 kg (mean,(22.1±5.2) kg).Mechanical valve replacement was performed because of congenital heart disease in 23 patients,rheumatic disease in ten patients and infective endocarditis in two patients.St.Jude bileaflet mechanical valves were implanted in all the 35 patients including mitral valve replacement (MVR) in 18,aortic valve replacement (AVR) in 12,tricuspid valve replacement (TVR) in two,AVR and MVR in two and MVR and TVR in one.The size of the prostheses ranged between 19 and 27 mm.All patients received long-term anticoagulation treatment with sodium warfarin,aiming to maintain an international normalized ratio between 1.5 to 2.0.Follow-up was performed in all the patients with a total follow-up of 119.4 patient-years.Results The operative mortality was 8.57% (3/35).One patient,who underwent cardiac debridement and AVR,died 2 hours after being admitted to the intensive care unit because of severe low cardiac output syndrome and ventricular fibrillation.Two patients died of cardiogenic shock and renal failure during initial hospitalization after the operation.One patient who received replacement of a tricuspid valve developed complete heart block requiring temporary pacing and recovered sinus rhythm 4 days later.Thirty-two patients survived and their cardiac function was in New York Heart Association (NYHA) class Ⅰ to class Ⅱ when discharged.Late events included hemorrhage and endocarditis.Two patients required

  19. MRI-guided stereotactic amygdalohippocampectomy: a single center experience

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    Vojtěch Z

    2015-02-01

    Full Text Available Zdenek Vojtěch,1 Hana Malíková,2 Lenka Krámská,3 Roman Liščák,4 Vilibald Vladyka41Department of Neurology, 2Department of Radiodiagnostics, 3Department of Psychology, 4Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech RepublicBackground: This paper presents our experience of stereotactic radiofrequency amygdalohippocampectomy performed for intractable mesial temporal lobe epilepsy.Methods: The article describes the cases of 61 patients who were treated during the period from 2004 to 2010. Mean postoperative follow-up was 5.3 years. Neuropsychological results were obtained for a subset of 31 patients.Results: At their last postsurgical visit, 43 (70.5% patients were Engel class I, six (9.8% class II, nine (14.8% class III, and three (4.9% class IV. The surgery was complicated by four intracranial hematomas. One of them caused acute hydrocephalus and was treated by shunting and resolved without sequelae, while another caused transitory aphasia. The remaining hematomas were asymptomatic. There were two cases of meningitis which required antibiotic treatment. One patient committed suicide due to postoperative depression. After the procedure, we performed open epilepsy surgery and rethermolesions in three and two patients, respectively (8.2%. Patients showed increases in their mean full scale, verbal, and performance intelligence quotient (IQ scores of 4, 3, and 4 IQ points, respectively (P<0.05. Five (17.2%, four (13.8%, and four (13.3% patients improved their full scale, verbal, and performance IQ scores, respectively. No significant changes were found in memory performance, with a mean increase of 1, 3, and 0 memory quotient points in global, verbal, and visual memory, respectively (P<0.05. Global memory improved in three (10.3% patients, verbal memory in one (3.4%, and one patient (3.3% showed deterioration in visual memory.Conclusion: Stereotactic radiofrequency amygdalohippocampectomy offers a

  20. Outcome of deceased donor renal transplantation - A single-center experience from developing country

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    Himanshu V Patel

    2013-01-01

    Full Text Available Renal transplantation (RTx is considered as the best therapeutic modality for patient suffering from end-stage renal disease (ESRD. Dearth of donor kidneys is a major problem everywhere, and deceased donor renal transplantation (DDRTx is seen as at least a partial solution. Even so, DDRTx accounts for only less than 4% of RTx in India. We report our 6-year single-center experience on DDRTx vis-à-vis patient/graft survival, graft function in terms of serum creatinine (SCr, rejection episodes, and delayed graft function (DGF. Between January 2005 and March 2011, 236 DDRTx were performed. Majority of the donors were those with brain death due to road traffic/cerebrovascular accidents. The commonest recipient diseases leading to ESRD were chronic glomerulonephritis (42.8%, diabetes (12.7%, and hypertension (10.6%. Mean recipient age was 36.2 ± 14.2 years; 162 were males and 74 were females. Mean donor age was 45.3 ± 17.13 years; 144 were males and 92 were females. Mean dialysis duration pre-transplantation was 18.5 ± 2.5 months. All recipients received single-dose rabbit-anti-thymocyte globulin induction and steroids, calcinueurin inhibitor, and mycophenolate mofetil/azathioprine for maintenance immunosuppression. Delayed graft function was observed in 29.6% patients and 22% had biopsy-proven acute rejection. Over the mean follow-up of 2.18 ± 1.75 years, patient and graft survival rates were 74.57% and 86.8%, respectively, with mean SCr of 1.42 ± 0.66 mg%. DDRTx achieves acceptable graft function with patient/graft survival, encouraging the use of this approach in view of organ shortage.

  1. Outcomes of resections for pancreatic adenocarcinoma with suspected venous involvement: a single center experience.

    OpenAIRE

    Erkan, Murat Mert; Michalski, Christoph W.; Kong, Bo; Jaeger, Carsten; Kloe, Silke; Beier, Barbara; Braren, Rickmer; Esposito, Irene; Friess, Helmut; Kleeff, Jorg

    2015-01-01

    RESEARCH ARTICLE Open Access Outcomes of resections for pancreatic adenocarcinoma with suspected venous involvement: a single center experience Christoph W. Michalski1,4, Bo Kong1, Carsten Jäger1, Silke Kloe1, Barbara Beier1, Rickmer Braren2, Irene Esposito3,5, Mert Erkan1,6, Helmut Friess1† and Jorg Kleeff1*† Abstract Background: Pancreatic ductal adenocarcinoma (PDAC) patients frequently present with borderline resectable disease, which can be due to invasion of the ...

  2. Laparoscopy Versus Robotic Surgery for Colorectal Cancer: A Single-Center Initial Experience.

    Science.gov (United States)

    Ferrara, Francesco; Piagnerelli, Riccardo; Scheiterle, Maximilian; Di Mare, Giulio; Gnoni, Pasquale; Marrelli, Daniele; Roviello, Franco

    2016-08-01

    Background Minimally invasive approach has gained interest in the treatment of patients with colorectal cancer. The purpose of this study is to analyze the differences between laparoscopy and robotics for colorectal cancer in terms of oncologic and clinical outcomes in an initial experience of a single center. Materials and Methods Clinico-pathological data of 100 patients surgically treated for colorectal cancer from March 2008 to April 2014 with laparoscopy and robotics were analyzed. The procedures were right colonic, left colonic, and rectal resections. A comparison between the laparoscopic and robotic resections was made and an analysis of the first and the last procedures in the 2 groups was performed. Results Forty-two patients underwent robotic resection and 58 underwent laparoscopic resection. The postoperative mortality was 1%. The number of harvested lymph nodes was higher in robotics. The conversion rate was 7.1% for robotics and 3.4% for laparoscopy. The operative time was lower in laparoscopy for all the procedures. No differences were found between the first and the last procedures in the 2 groups. Conclusions This initial experience has shown that robotic surgery for the treatment of colorectal adenocarcinoma is a feasible and safe procedure in terms of oncologic and clinical outcomes, although an appropriate learning curve is necessary. Further investigation is needed to demonstrate real advantages of robotics over laparoscopy. PMID:26721500

  3. 13 Years of operating experience with bell-less top at Dofasco and new developments

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, A.J. (Dofasco Inc., Hamilton, Ontario (Canada)); Lonardi, E. (Paul Wurth S.A., Luxembourg (Luxembourg)); Peters, J.L. (Paul Wurth Inc., Carnegie, PA (United States))

    1994-09-01

    Dofasco's No. 4 blast furnace was retrofitted with a bell-less top in 1980 after nine years of operation using a 2-bell top. During the 1986 rebuild, the bell-less top gearbox cooling was converted from gas to water. The furnace throat diameter was also increased from 7.3 to 8.2 meters. In this presentation, Dofasco's experience using the bell-less top over the last 13 years will be reviewed. Topics to be discussed will include burden distribution with 100% pellets at various levels of tuyere injectants and productivity levels, instrumentation used to optimize distribution, and modeling requirements, as well as maintenance requirements for the top. In addition, the latest developments of the bell-less top system, including the new compact design will be reviewed.

  4. Leukapheresis in acute myeloid leukemia patients with hyperleukocytosis: A single center experience.

    Science.gov (United States)

    Berber, Ilhami; Kuku, Irfan; Erkurt, Mehmet Ali; Kaya, Emin; Bag, Harika Gozukara; Nizam, Ilknur; Koroglu, Mustafa; Ozgul, Mustafa; Bazna, Sezai

    2015-10-01

    Hyperleukocytosis is defined as WBC count above 100,000/mm(3) in peripheral blood. Increased WBC count leads to leukocyte aggregation, increased blood viscosity, and consequently results in stasis in small blood vessels. Ultimate neurological, pulmonary, gastrointestinal complications, coagulopathy, and tumor lysis syndrome cause increase in morbidity and mortality. Leukapheresis is a treatment modality used for hyperleukocytosis. In patients presenting with hyperleukocytosis the indications for leukapheresis were accepted as having symptoms of leukostasis and prophylactic. Indications for leukapheresis in prophylactic group evaluated according to WBC count. We report a single center experience about leukapheresis in managing 31 AML patients with hyperleukocytosis. In addition to demographic characteristics, disease-related clinical and laboratory findings of the patients were recorded. Survival rates were also calculated. Ten patients were female. The most common of AML subtype was AML-M2. The median number of leukapheresis per patient was 2 and totally 60 leukapheresis cycles were performed in all patients. There was a significant decrease in WBC count and LDH level after leukapheresis as compared with the baseline values (p 0.05). None of our patients suffered serious side effects and tumor lysis syndrome during or after apheresis. Leukapheresis is an effective and safe approach to reduce WBC counts in patients with AML with hyperleukocytosis. Further evidence-based data obtained from larger sample sizes are required to better understand the impact of prophylaxis leukapheresis on early and total mortality of AML patients with hyperleukocytosis. PMID:25843763

  5. Endovascular Aortic Aneurysm Repair for Abdominal Aortic Aneurysm: Single Center Experience in 122 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yun Young; Song, Jang Hyeon; Kim, Yong Tae; Yim, Nam Yeol; Kim, Jae Kyu; Lee, Ho Kyun; Choi, Soo Jin Na; Chung, Sang Young [Dept. of Radiology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju (Korea, Republic of); Kim, Soo Hyun; Chang, Nam Kyu [Dept. of Radiology, Chonnam National University Hwasun Hospital, Chonnam National University School of Medicine, Hwasun (Korea, Republic of)

    2013-02-15

    To analyze a single center experience of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms. Results of 122 patients who underwent EVAR were analyzed, retrospectively. Sex, age, aneurysmal morphology, hostile neck anatomy, preprocedural and postprocedural sac-diameter, technical and clinical success, postprocedural complication and need of additional procedure were analyzed. A total of 111 male and 11 female patients were included. Morphology of the aneurysms was as follows: fusiform (n = 108), saccular (n = 3) and ruptured type (n = 11). Sixty-four patients had hostile neck anatomy. The preprocedural mean sac-diameter was 52.4 mm. Postprocedural sac-diameter was decreased or stable in 110 patients (90.2%) and increased in 8 patients (6.6%). Technical success rate was 100% and clinical success rate was 86.1%. Fifty-one patients showed endoleak (41.8%) and 15 patients (12.3%) underwent secondary intervention due to type I endoleak (n = 4), type II endoleak (n = 4) and stent-graft thrombosis (n = 7). EVAR is a safe and effective therapy for abdominal aortic aneurysm, and it has high technical success and clinical success rate, and low complication rate.

  6. Liver Transplantation for Hepatocellular Carcinoma: A Single Center Resume Overlooking Four Decades of Experience

    Directory of Open Access Journals (Sweden)

    Nikos Emmanouilidis

    2016-01-01

    Full Text Available Background. This is a single center oncological resume overlooking four decades of experience with liver transplantation (LT for hepatocellular carcinoma (HCC. Methods. All 319 LT for HCC that were performed between 1975 and 2011 were included. Predictors for HCC recurrence (HCCR and survival were identified by Cox regression, Kaplan-Meier analysis, Log Rank, and χ2-tests where appropriate. Results. HCCR was the single strongest hazard for survival (exp⁡B=10.156. Hazards for HCCR were tumor staging beyond the histologic MILAN (exp⁡B=3.645, bilateral tumor spreading (exp⁡B=14.505, tumor grading beyond G2 (exp⁡B=8.668, and vascular infiltration of small or large vessels (exp⁡B=11.612, exp⁡B=18.324, resp.. Grading beyond G2 (exp⁡B=10.498 as well as small and large vascular infiltrations (exp⁡B=13.337, exp⁡B=16.737, resp. was associated with higher hazard ratios for long-term survival as compared to liver transplantation beyond histological MILAN (exp⁡B=4.533. Tumor dedifferentiation significantly correlated with vascular infiltration (χ2p=0.006 and intrahepatic tumor spreading (χ2p=0.016. Conclusion. LT enables survival from HCC. HCC dedifferentiation is associated with vascular infiltration and intrahepatic tumor spreading and is a strong hazard for HCCR and survival. Pretransplant tumor staging should include grading by biopsy, because grading is a reliable and easily accessible predictor of HCCR and survival. Detection of dedifferentiation should speed up the allocation process.

  7. Congenital bronchopulmonary malformations: A single-center experience and a review of literature

    Directory of Open Access Journals (Sweden)

    Kumar Basant

    2008-01-01

    Full Text Available Purpose: To present a single-center experience with 25 cases of bronchopulmonary malformations and the review the literature. Materials and Methods: We conducted a retrospective analysis of the medical records of patients with congenital bronchopulmonary malformations who were operated between July 1997 and July 2007 in our institute; we examined the modes of presentations, management, and outcome. Outcome of all patients was assessed over a short follow-up period (average 1.8 months. Results: Out of 25 patients, 18 (72% were male and 7 (28% were female. Age of patients ranged from 1 day to 11 years. The histopathological diagnosis was congenital cystic adenomatoid malformations [CCAM; n = 14 (56%], congenital lobar emphysema [CLE; n = 5 (20%], pulmonary sequestrations [PS; n = 3 (12%], and bronchogenic cysts [BC; n = 3 (12%]. Antenatal diagnosis was available in only 2 (8% patients. The common presenting symptoms were respiratory distress and chest infections. Lobectomy was the procedure of choice . Mortality was 16% (n = 4; M: F = 3: 1. Two patients died because of overwhelming sepsis, one from compromised cardiac function, and one from aspiration which might possibly have been prevented. Conclusion: Patients with progressive respiratory distress due to these anomalies may require urgent surgical intervention regardless of age. The surgical outcome is favorable, with manageable complications. Plain x-ray chest and CT of thorax are usually sufficient for diagnosis and planning of treatment. Pathological diagnosis may differ from the imaging diagnosis. Mortality is found to be more in neonates. Apart from initial stabilization, resection of lesion and careful postoperative care is necessary to reduce mortality and morbidity.

  8. Thirty-day outcome of carotid artery stenting in Chinese patients: a single-center experience

    Institute of Scientific and Technical Information of China (English)

    JIAO Li-qun; SONG Gang; LI Shen-mao; MIAO Zhong-rong; ZHU Feng-shui; JI Xun-ming; YIN Guo-yang

    2013-01-01

    Background Carotid artery stenting (CAS) as a competing treatment modality has had to adhere to limits to gain widespread acceptance in some studies.This study analyzed the clinical data of 1700 consecutive patients after CAS to retrospectively evaluate the 30-day outcome of CAS for internal carotid artery stenosis in a Chinese population.Methods Medical records of 1700 patients who underwent CAS at Xuanwu Hospital affiliated to Capital Medical University between January 2001 and August 2012 were reviewed.Postoperative 30-day complication rates were analyzed and compared with those of other studies.Univariate and multivariate Logistic regression analyses were used to identify factors associated with perioperation myocardial infarction (MI),stroke,and death.Results The overall 30-day rate of MI,stroke,and death after CAS was 2.53%.In univariate analysis,patients who were symptomatic,had a neurological deficit (modified Rankin score (mRS) ≥3; P=0.001),and who were not taking statins experienced a significantly increased rate of MI,stroke,and death (P=-0.017).In multivariate Logistic regression analysis,the presence of symptoms (odds ratio (OR)=2.485; 95% confidence interval (CI)=1.267-4.876; P=0.008) and a neurological deficit (mRS ≥3) (OR=3.025; 95% CI=1.353-6.763; P=0.007) were independent risk factors for perioperative MI,stroke,and death.Conclusions According to this single-center experience,CAS may effectively prevent and treat carotid artery stenosis that would otherwise lead to stroke.Being symptomatic and having a neurological deficit (mRS ≥3) increased the risk of perioperative MI,stroke,and death.

  9. Acute promyelocytic leukemia, study of predictive factors for Differentiation Syndrome, single center experience

    International Nuclear Information System (INIS)

    Reports about patients with acute promyelocytic leukemia from the Middle East are few; in this study we are reporting our single center experience of treating 29 patients over 6 years. Acute promyelocytic leukemia treatment response is markedly improved after the introduction of ATRA. Treatment related complication is still an important issue particularly Differentiation Syndrome. Prediction to its occurrence has been tried by other groups. We aimed to study all the possible predictive factors of acute promyelocytic leukemia. Our chemotherapy induction protocol is AIDA protocol which includes ATRA 45 mg/m2/d in divided doses every 12h, and Idarubicin 12 mg/ m2/d IV on days 3, 5, 7, and 9. Differentiation Syndrome occurred in 48.3% of patients and was mainly presented by pulmonary symptoms in 55.2%, 6 cases died during induction. None of the predictive factors studied showed a statistically significant difference between patients who developed Differentiation Syndrome and those who did not. Differentiation Syndrome did not affect overall survival. Cox regression showed an inverse yet a non significant association between PET- HEMA and overall survival probability (P = 0.168). In conclusion, Differentiation Syndrome has no clear predictive factor to date. The best approach is to hold ATRA and give dexamethasone which is quite effective as reported in the literature. PETHEMA risk model has a moderately significant prognostic value look for all possible predictive factors of Differentiation syndrome (DS) which were first described in 1992 by frankel et al. (4) and represented the major complication through this disease course: studies had reported conflicting results about this (5,6). In addition we will compare our data to other areas of the world

  10. Outcomes of adult-to-adult living donor liver transplantation:a single center experience

    Institute of Scientific and Technical Information of China (English)

    FENG Xi; YUAN Ding; WEI Yong-gang; LI Fu-qiang; WEN Tian-fu; ZENG Yong; ZHAO Ji-chun; WANG Wen-tao; XU Ming-qing; YANG Jia-yin; MA Yu-kui; CHEN Zhe-yu; YE Hui; YAN Lü-nan; LI Bo

    2009-01-01

    Background Since January 2002,adult-to-adult living donor liver transplantation (AALDLT) has gained increasing popularity in China in response to the shortage of cadaveric donor livers.This study presents a detailed analysis of the outcomes of AALDLT in a single center.Methods A total of 70 patients underwent AALDLT at our center between January 2002 and January 2007.Among these,67 patients received a right lobe graft without the middle hepatic vein and 3 patients received dual grafts.Three-dimensional volumetric computed tomography,magnetic resonance imaging with angiography and cholangiography were performed preoperatively.Recipient operation time,intraoperative transfusion requirement,length of intensive care unit stay,length of hospital stay,liver function tests,coagulation tests and surgical outcomes were routinely investigated throughout this study.Results All donors survived the procedure with an overall complication rate of 15.3%.Overall recipient 1-year survival and complication rates were 87.1% and 34.2%,respectively.Among the 70 cases,average graft recipient weight ratio was 0.94% (0.72%-1.43%) and average graft volume/standard liver volume ratio was 46.42% (31.74%-71.68%).All residual liver volumes exceeded 35%.Liver function and coagulation recovered rapidly within the first 7 days after transplantation.Conclusions AALDLT is a safe procedure for the donors and an effective therapy for patients with end-stage liver disease.Patient selection and timely decision-making for transplantation are essential in achieving good outcomes.With accumulation of experience in surgery and clinical management,timely feedback and proper modification,we foresee better outcomes in the future.

  11. Living Related Donor Kidney Transplantation in Libya: A Single Center Experience

    Directory of Open Access Journals (Sweden)

    Elusta Ahmed

    2008-01-01

    Full Text Available The aim of this study is to report the experience from a single center in Libya, on the prevailing live-related kidney transplantation program. The results of three years work on kidney transplantation at the Tripoli Central Hospital (National Organ Transplant Program in Libya were evaluated. The transplant program was launched on 17 th August, 2004 and 135 patients have been transplanted since then till 17 th August, 2007. All donors and recipients were screened thoroughly prior to transplant and monitored closely in the post-transplant period. Our immuno-suppressive protocol was cyclosporine-based. Among the 135 accepted pairs, donors and reci-pients were genetically-related in 133 cases (98.5% and emotionally-related in two others. The mean donor age was 37 ± 9.5 years (range 18-56 years and recipient age 37 ± 13.6 years (range 7-67 years. There were 95 males (70.4% and 40 females (29.6% among the recipients while among the donors, there were 102 males (75.6% and 33 females (24.4%. Delayed graft function was seen in three patients (2.2%, acute rejection in six (4.4%, post-transplant urinary tract infection in six (4.4%, pneumonia in three (2.2%, ureteric kink in two (1.5% and urine leak in four (3.0%. Graft survival at 36 months was 93.3% while patient survival at the same period was 96.3%. This report indicates that the results of our transplant program are good and comparable with other international programs.

  12. Collected World and Single Center Experience With Endovascular Treatment of Ruptured Abdominal Aortic Aneurysms

    NARCIS (Netherlands)

    Veith, Frank J.; Lachat, Mario; Mayer, Dieter; Malina, Martin; Holst, Jan; Mehta, Manish; Verhoeven, Eric L. G.; Larzon, Thomas; Gennai, Stefano; Coppi, Gioacchino; Lipsitz, Evan C.; Gargiulo, Nicholas J.; van der Vliet, J. Adam; Blankensteijn, Jan; Buth, Jacob; Lee, W. Anthony; Biasi, Giorgio; Deleo, Gaetano; Kasirajan, Karthikeshwar; Moore, Randy; Soong, Chee V.; Cayne, Neal S.; Farber, Mark A.; Raithel, Dieter; Greenberg, Roy K.; van Sambeek, Marc R. H. M.; Brunkwall, Jan S.; Rockman, Caron B.; Hinchliffe, Robert J.

    2009-01-01

    Background: Case and single center reports have documented the feasibility and suggested the effectiveness of endovascular aneurysm repair (EVAR) of ruptured abdominal aortic aneurysms (RAAAs), but the role and value of such treatment remain controversial. Objective: To clarify these we examined a c

  13. Collected world and single center experience with endovascular treatment of ruptured abdominal aortic aneurysms.

    NARCIS (Netherlands)

    Veith, F.J.; Lachat, M.; Mayer, D.; Malina, M.; Holst, J.; Mehta, M.; Verhoeven, E.L.; Larzon, T.; Gennai, S.; Coppi, G.; Lipsitz, E.C.; Gargiulo, N.J.; Vliet, J.A. van der; Blankensteijn, J.D.; Buth, J.; Lee, W.A.; Biasiol, G.; Deleo, G.; Kasirajan, K.; Moore, R.; Soong, C.V.; Cayne, N.S.; Farber, M.A.; Raithel, D.; Greenberg, R.K.; Sambeek, M.R. van; Brunkwall, J.S.; Rockman, C.B.; Hinchliffe, R.J.

    2009-01-01

    BACKGROUND: Case and single center reports have documented the feasibility and suggested the effectiveness of endovascular aneurysm repair (EVAR) of ruptured abdominal aortic aneurysms (RAAAs), but the role and value of such treatment remain controversial. OBJECTIVE: To clarify these we examined a c

  14. Axial lumbar interbody fusion: a 6-year single-center experience

    Directory of Open Access Journals (Sweden)

    Zeilstra DJ

    2013-08-01

    Full Text Available Dick J Zeilstra,1 Larry E Miller,2,3 Jon E Block3 1Bergman Clinics, Naarden and NedSpine, Ede, The Netherlands; 2Miller Scientific Consulting, Inc, Arden, NC, USA; 3The Jon Block Group, San Francisco, CA, USA Introduction: The aim of this study is to report our 6-year single-center experience with L5–S1 axial lumbar interbody fusion (AxiaLIF. Methods: A total of 131 patients with symptomatic degenerative disc disease refractory to nonsurgical treatment were treated with AxiaLIF at L5–S1, and were followed for a minimum of 1 year (mean: 21 months. Main outcomes included back and leg pain severity, Oswestry Disability Index score, working status, analgesic medication use, patient satisfaction, and complications. Computed tomography was used to determine postoperative fusion status. Results: No intraoperative complications, including vascular, neural, urologic, or bowel injuries, were reported. Back and leg pain severity decreased by 51% and 42%, respectively, during the follow-up period (both P < 0.001. Back function scores improved 50% compared to baseline. Clinical success, defined as improvement ≥30%, was 67% for back pain severity, 65% for leg pain severity, and 71% for back function. The employment rate increased from 47% before surgery to 64% at final follow-up (P < 0.001. Less than one in four patients regularly used analgesic medications postsurgery. Patient satisfaction with the AxiaLIF procedure was 83%. The fusion rate was 87.8% at final follow-up. During follow-up, 17 (13.0% patients underwent 18 reoperations on the lumbar spine, including pedicle screw fixation (n = 10, total disc replacement of an uninvolved level (n = 3, facet screw fixation (n = 3, facet screw removal (n = 1, and interbody fusion at L4–L5 (n = 1. Eight (6.1% reoperations were at the index level. Conclusion: Single-level AxiaLIF is a safe and effective means to achieve lumbosacral fusion in patients with symptomatic degenerative disc disease. Keywords: Axia

  15. Various anatomic locations of surgically proven endometriosis: A single-center experience

    OpenAIRE

    Lee, Hyun Ju; Park, Ye Mi; Jee, Byung Chul; Kim, Yong Beom; Suh, Chang Suk

    2015-01-01

    Objective To report the various anatomic locations of surgically and pathologically proven endometriosis. Methods Pathologic reports (n=1,376) of women who underwent surgeries at a single center between April 2005 and March 2013 were retrieved from the electronic medical record system of the hospital. Pathologic reports were included after performing a search by using the key-words "endometrial cyst," "endometriotic cyst," "endometriosis," or "endometrioma." Only reports dealing with female p...

  16. Exclusion Reasons of Living Kidney Donor Candidates: A Single-Center Experience

    Directory of Open Access Journals (Sweden)

    Ayşegül ORUÇ

    2014-05-01

    Full Text Available OBJECTIVE: Due to severe organ shortage, living kidney donors are important choices for transplantation. In Muslim countries, such as Turkey, living kidney donors are the main source of donor pool. In the literature, reasons for living donor exclusion are reported from several countries. However, there is no published study that focused on exclusion reasons of donor candidates in Turkey where living kidney transplantation rate is 73.4%. The goal of this retrospective study was to examine the exclusion reasons for donation among living kidney donor candidates at a single center in Turkey. MATERIAL and METHODS: A total 538 adults were evaluated as a living kidney donor candidate between December 1988 and January 2012. Evaluation outcome, exclusion reasons and demographic data were examined from electronic file system and immunology laboratory records. RESULTS: In this period 451 kidney transplantations (38.6% cadaveric, 61.4% living donor was performed. Overall 261 (48.5% donor candidates who underwent evaluation could not donate. We were able to find the precise cause of exclusion of 86 donors (33%. Among excluded donor candidates the most common exclusion reason was medical causes (64% such as diabetes mellitus, low glomerular filtration rate and hypertension. CONCLUSION: Our study suggests that medical causes are significant exclusion reasons for living kidney donation at our center.

  17. Aggressive Treatment of Patients with Metastatic Colorectal Cancer Increases Survival: A Scandinavian Single-Center Experience

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    Kristoffer Watten Brudvik

    2013-01-01

    Full Text Available Background. We examined overall and disease-free survivals in a cohort of patients subjected to resection of liver metastasis from colorectal cancer (CRLM in a 10-year period when new treatment strategies were implemented. Methods. Data from 239 consecutive patients selected for liver resection of CRLM during the period from 2002 to 2011 at a single center were used to estimate overall and disease-free survival. The results were assessed against new treatment strategies and established risk factors. Results. The 5-year cumulative overall and disease-free survivals were 46 and 24%. The overall survival was the same after reresection, independently of the number of prior resections and irrespectively of the location of the recurrent disease. The time intervals between each recurrence were similar (11 ± 1 months. Patients with high tumor load given neoadjuvant chemotherapy had comparable survival to those with less extensive disease without neoadjuvant chemotherapy. Positive resection margin or resectable extrahepatic disease did not affect overall survival. Conclusion. Our data support that one still, and perhaps to an even greater extent, should seek an aggressive therapeutic strategy to achieve resectable status for recurrent hepatic and extrahepatic metastases. The data should be viewed in the context of recent advances in the understanding of cancer biology and the metastatic process.

  18. Postoperative chemoradiation in patients with localized gastric adenocarcinoma: Single center experience

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    A Yoney

    2011-01-01

    Full Text Available Background : 5-Flourouracil (FU-based chemotherapy (CT and concurrent 45 Gy radiotherapy (RT is one of the standard postoperative approaches currently used in gastric carcinoma. The high toxicity rates of this treatment leads to interruption of treatment in the majority of patients. In our study, we investigated the rates of toxicity and treatment discontinuation observed during postoperative FU-based chemoradiotherapy (CRT; retrospectively evaluated the effect of CRT and the other prognostic factors on local and distant control and survival. Patients and Methods: A total of 160 patients consisting of 97 total and 63 subtotal gastrectomy receiving postoperative CRT, have been studied retrospectively. Results : Patients who had to discontinue the treatment for a median of 6 (range, 3-13 days experienced toxicity during treatment at a rate of 43%. During the 21 (range, 4-68 months of follow-up local recurrences were observed in 8 (5% patients and distant recurrences were observed in 41 (25.6% patients. While the 1-3 year overall survival (OS rates were 75% and 42%, 13-year disease-free survival (DFS rates were 63% and 42%, respectively. In the univariate analysis for OS and DFS demonstrated statistical significance for below those 60 years of age, D1-D2 dissection type, negative surgical margin, early treatment beginning, the absence of invasion, and early stage disease. D1D2 dissection type, early treatment begining, age below 60 years and early stage disease significantly improve OS and DFS in multivarite analysis. Conclusions: Survival is worse in patients older than 60 years, had late treatment begining, advanced stage and D0 dissection.

  19. Treatment of renovascular hypertension by transluminal angioplasty--13 years experience in a single centre

    DEFF Research Database (Denmark)

    Øvrehus, Kristian A; Andersen, Poul E; Jacobsen, Ib A

    2007-01-01

    OBJECTIVE: The study is a follow-up on treatment of renovascular hypertension (RVH) with percutaneous transluminal renal angioplasty (PTRA). METHODS: Patients were screened on the basis of clinical criteria of increased probability of RVH with renography and in selected cases with renal vein renin......: with improved control of blood pressure; group III: unchanged blood pressure control. Grouping was performed immediately after treatment, at 1 month, 6 months and at the latest follow-up. One hundred-and-twenty-two patients (124 atherosclerotic and 12 fibromuscular lesions) were treated during 13 years...... stable. CONCLUSION: PTRA is an effective treatment of RVH in patients selected by signs of a flow-restricting stenosis. Twelve percent were normotensive after angioplasty and a further 77% had better controlled hypertension. Few complications were seen and renal function was on average unchanged...

  20. Breast Conserving Surgery and Sentinel Lymph Node Biopsy in Locally Advanced Breast Cancer: Single Center Experience

    Directory of Open Access Journals (Sweden)

    Atakan Sezer

    2011-06-01

    Full Text Available Objective: Patients with locally advanced breast cancer may undergo breast conserving surgery after neoadjuvant chemotherapy. The aim of the study is to evaluate the results of locally advanced breast cancer patients who underwent breast conserving surgery, axillary dissection and sentinel lymph node biopsy in a single center. Material and Methods: 12 patients with locally advanced breast cancer stage IIIA/IIIB were included in the study between 2002-2009. The patients were given anthracycline-based regimen before surgery. Patients underwent breast conserving surgery, axillary dissection, and sentinel lymph node biopsy followed by radiotherapy. Results: There were five patients in stage IIIA, six in stage IIIB, and one in stage IIIC. Patients had received 3-6 regimen of FAC/FEC. Eight had partial and four had complete response. Five positive axilla were detected. The median value of the lymph nodes was 12 (n:8-19. Five patients underwent sentinel lymph node biopsy. The biopsy has failed in one patient and the median value of dissected sentinel node was 3.5 (n:3-4. Locoregional recurrence was not observed in any patients. The mean follow-up of the patients was 29.8 months and median time was 16 (n:2-80 months.Of the 12 patients 10 are alive and 2 were deceased. Conclusion: In selected locally advanced patients, breast conserving surgery and sentinel lymph node biopsy may be applied by a multidisciplinary approach, and excellent success may be achieved in those patients as in early breast cancer patients.

  1. Percutaneous CT-guided radiofrequency ablation of solitary small renal masses. A single center experience

    Energy Technology Data Exchange (ETDEWEB)

    Pieper, C.C.; Fischer, S.; Strunk, H.; Meyer, C.; Thomas, D.; Willinek, W.A.; Schild, H. [Univ. Bonn (Germany). Dept. of Radiology; Hauser, S. [Univ. Bonn (Germany). Dept. of Urology; Nadal, J. [Univ. Bonn (Germany). Inst. for Medical Biometry; Wilhelm, K. [Johanniter Hospital Bonn (Germany). Dept. of Radiology

    2015-07-15

    To analyze the outcome of patients undergoing percutaneous CT-guided radiofrequency ablation (RFA) of small renal masses (SRM) at a single center during a ten-year time period. Patient records of renal RFAs (07/2003 - 11/2013) were reviewed. Indications were SRM suspicious of malignancy on imaging and one of the following: severe comorbidity; old age; solitary kidney; impaired renal function; patient wish. Biopsy was performed at the time of RFA. Patients were excluded if no follow-up was available. Patient and procedural characteristics were recorded. Survival rates were calculated using the Kaplan-Meier's method and compared with log-rank or cox tests. 38 patients (16 females, mean age 70.0 years [range 52 - 87]) presenting with a solitary SRM were included in the study. Biopsy showed malignancy in 29 patients; 9 had benign tumors. 26 patients suffered from cardiovascular, respiratory or hepatic comorbidities. Technical success (complete ablation on first follow-up) was achieved in 95 % of cases. Two major complications (bowel perforation; hematothorax) occurred. The 3- and 7-year overall survival (OS) [any cause] rates were 73.4 ± 0.8 % and 50.3 ± 1.0 %, respectively (mean follow-up 54.6 months, range 1 - 127). 4 recurrences and 2 metastases were observed. The presence of comorbidities was the only independent predictor of OS. There was no difference in survival between patients with benign and malignant tumors. RFA of SRM is successful in a large percentage of cases with a low complication rate and durable local control. As RFA is typically performed in multimorbid patients, overall survival seems to depend primarily on comorbidities rather than cancer progression.

  2. Acute pancreatitis induced by transarterial chemoembolization:a single-center experience of over 1500 cases

    Institute of Scientific and Technical Information of China (English)

    Wong Hoi She; Albert CY Chan; Tan To Cheung; Kenneth SH Chok; See Ching Chan; Ronnie TP Poon; Chung Mau Lo

    2016-01-01

    BACKGROUND: Acute pancreatitis is a relatively rare but po-tentially lethal complication after transarterial chemotherapy. This study aimed to review the complications such as acute pancreatitis after transarterial chemotherapy with or without embolization for hepatocellular carcinoma. METHODS: A total of 1632 patients with hepatocellular car-cinoma who had undergone transarterial chemoembolization from January 2000 to February 2014 in a single-center were reviewed retrospectively. We investigated the potential com-plications of transarterial chemoembolization, such as acute pancreatitis and acute pancreatitis-related complications. RESULTS: Of the 1632 patients with hepatocellular carcinoma who had undergone 5434 transarterial chemoembolizations, 1328 were male and 304 female. The median age of these pa-tients was 61 years. Most (79.6%) of the patients suffered from HBV-related hepatocellular carcinoma. The median tumor size was 5.2 cm. Of the 1632 patients, 145 patients underwent transarterial chemoembolization with doxorubicin elut-ing bead, making up a total of 538 episodes. The remaining patients underwent transarterial chemoembolization with cisplatin. Seven (0.4%) patients suffered from acute pancre-atitis post-chemoembolization. Six patients had chemoembo-lization with doxorubicin and one had chemoembolization with cisplatin. Patients who received doxorubicin eluting bead had a higher risk of acute pancreatitis [6/145 (4.1%) vs 1/1487 (0.1%), P CONCLUSIONS: Acute pancreatitis after transarterial chemo-embolization could result in serious complications, especially after treatment with doxorubicin eluting bead. Continuation of current treatment with transarterial chemoembolization after acute pancreatitis is feasible providing the initial attack is completely resolved.

  3. Mycetoma: experience of 482 cases in a single center in Mexico.

    Directory of Open Access Journals (Sweden)

    Alexandro Bonifaz

    2014-08-01

    Full Text Available Mycetoma is a chronic granulomatous disease. It is classified into eumycetoma caused by fungi and actinomycetoma due to filamentous actinomycetes. Mycetoma can be found in geographic areas in close proximity to the Tropic of Cancer. Mexico is one of the countries in which this disease is highly endemic. In this retrospective study we report epidemiologic, clinical and microbiologic data of mycetoma observed in the General Hospital of Mexico in a 33 year-period (1980 to 2013. A total of 482 cases were included which were clinical and microbiology confirmed. Four hundred and forty four cases (92.11% were actinomycetomas and 38 cases (7.88% were eumycetomas. Most patients were agricultural workers; there was a male predominance with a sex ratio of 3:1. The mean age was 34.5 years old (most ranged from 21 to 40 years. The main affected localization was lower and upper limbs (70.74% and 14.52% respectively. Most of the patients came from humid tropical areas (Morelos, Guerrero and Hidalgo were the regions commonly reported. The main clinical presentation was as tumor-like soft tissue swelling with draining sinuses (97.1%. Grains were observed in all the cases. The principal causative agents for actinomycetoma were: Nocardia brasiliensis (78.21% and Actinomadura madurae (8.7%; meanwhile, for eumycetomas: Madurella mycetomatis and Scedosporium boydii (synonym: Pseudallescheria boydii were identified. This is a single-center, with long-follow up, cross-sectional study that allows determining the prevalence and characteristics of mycetoma in different regions of Mexico.

  4. Mycetoma: experience of 482 cases in a single center in Mexico.

    Science.gov (United States)

    Bonifaz, Alexandro; Tirado-Sánchez, Andrés; Calderón, Luz; Saúl, Amado; Araiza, Javier; Hernández, Marco; González, Gloria M; Ponce, Rosa María

    2014-08-01

    Mycetoma is a chronic granulomatous disease. It is classified into eumycetoma caused by fungi and actinomycetoma due to filamentous actinomycetes. Mycetoma can be found in geographic areas in close proximity to the Tropic of Cancer. Mexico is one of the countries in which this disease is highly endemic. In this retrospective study we report epidemiologic, clinical and microbiologic data of mycetoma observed in the General Hospital of Mexico in a 33 year-period (1980 to 2013). A total of 482 cases were included which were clinical and microbiology confirmed. Four hundred and forty four cases (92.11%) were actinomycetomas and 38 cases (7.88%) were eumycetomas. Most patients were agricultural workers; there was a male predominance with a sex ratio of 3:1. The mean age was 34.5 years old (most ranged from 21 to 40 years). The main affected localization was lower and upper limbs (70.74% and 14.52% respectively). Most of the patients came from humid tropical areas (Morelos, Guerrero and Hidalgo were the regions commonly reported). The main clinical presentation was as tumor-like soft tissue swelling with draining sinuses (97.1%). Grains were observed in all the cases. The principal causative agents for actinomycetoma were: Nocardia brasiliensis (78.21%) and Actinomadura madurae (8.7%); meanwhile, for eumycetomas: Madurella mycetomatis and Scedosporium boydii (synonym: Pseudallescheria boydii) were identified. This is a single-center, with long-follow up, cross-sectional study that allows determining the prevalence and characteristics of mycetoma in different regions of Mexico.

  5. The 10-year Trend of Periprocedural Complication Following Carotid Artery Stenting; Single Center Experience

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    Hong, Jeong-Ho [Keimyung University Dongsan Medical Center, Department of Neurology (Korea, Republic of); Kang, Jihoon; Yeo, Min-Ju; Kim, Beom Joon; Jang, Min Uk; Bae, Hee-Joon [Seoul National University College of Medicine, Department of Neurology, Stroke Center, Seoul National University Bundang Hospital (Korea, Republic of); Kwon, O-Ki; Hwang, Gyo Jun; Oh, Chang Wan [Seoul National University Bundang Hospital, Department of Neurosurgery (Korea, Republic of); Jung, Cheolkyu [Seoul National University Bundang Hospital, Department of Radiology (Korea, Republic of); Lee, Ji Sung [Soonchunhyang University Medical Center, Biostatistical Consulting Unit (Korea, Republic of); Han, Moon-Ku, E-mail: mkhan@snu.ac.kr [Seoul National University College of Medicine, Department of Neurology, Stroke Center, Seoul National University Bundang Hospital (Korea, Republic of)

    2015-04-15

    PurposeCarotid endarterectomy and stenting are used to treat carotid stenosis, with the volume of carotid artery procedures increasing over the past decade. We investigated the 10-year trend of periprocedural complications with an increasing procedure volume of carotid stenting at a single tertiary hospital.MethodsWe collected 416 consecutive cases (384 patients) of carotid artery stenting performed for either symptomatic (231 cases, 55.5 %) or asymptomatic (185 cases, 44.5 %) internal carotid artery stenosis at a single center. Periprocedural complication was defined as any stroke, myocardial infarction, or death. Procedure-related outcome included any dissection, hemodynamic event, or periprocedural complication.ResultsThe mean age was 68.8 years (82.8 % males; range of 20–89 years); 23.9 % were older than 75 years. Before the procedure, 99.3 and 56.0 % of patients received antiplatelet and lipid-lowering medication, respectively. The overall periprocedural complication rate was 3.6 % (1.6 and 5.2 % in the asymptomatic and symptomatic group, respectively). The composite outcome of any stroke or death was 3.4 %. Periprocedural complication and procedure-related outcome showed a decremental trend with increasing procedure volume, and this trend remained after adjusting for confounders.ConclusionsOur study suggests that carotid stenting at an experienced center might reduce the periprocedural complications. Our periprocedural complication rate of carotid artery stenting may be comparable to, or somewhat lower than, that reported in other clinical trials.

  6. Neonates born to mothers with immune thrombocytopenic purpura: a single-center experience of 20 years.

    Science.gov (United States)

    Bayhan, Turan; Tavil, Betül; Korkmaz, Ayşe; Ünal, Şule; Hanalioğlu, Damla; Yiğit, Şule; Gümrük, Fatma; Çetin, Mualla; Yurdakök, Murat

    2016-01-01

    Neonates born to mothers with immune thrombocytopenic purpura (ITP) have an increased risk of having thrombocytopenia and bleeding. The aim of our study was to determine maternal and fetal factors that can predict bleeding risk in neonates born to mothers with ITP, and effective treatment strategies by retrospective analysis of our single-center data. We performed a retrospective data review of neonates that were recorded as 'neonates born to mothers with ITP' in the Neonatal ICU of Hacettepe University, Ihsan Dogramacı Children's Hospital, Ankara, Turkey. Medical records of 36 neonates born from 35 mothers were analyzed. Among the 36 neonates born to mothers with ITP, thrombocytopenia (platelet count of less than 150 × 10/l) was detected in 20 (56.0%) neonates on the first day of life. Twelve of the 20 neonates with thrombocytopenia (60.0%) required treatment to increase the platelet counts. Clinical findings related to thrombocytopenia occurred in three (15.0%) neonates, but none of them presented with severe bleeding. There was no statistically significant association between neonatal lowest platelet count and maternal lowest platelet count, maternal platelet count at the time of delivery, and duration of thrombocytopenia, respectively. Neonates born to mothers with ITP have an increased tendency to develop thrombocytopenia, but severe bleeding is very rare in these neonates. Clinicians should pay special attention to follow these neonates. According to our results, both intravenous immunoglobulin and methyl prednisolone were found to be in equivalent efficacy for the treatment of neonatal thrombocytopenia due to maternal ITP. PMID:26258676

  7. Marginal living donor in kidney transplantation: experience in a Chinese single center

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    LI Gang; WANG Yun-peng; MA Lu-lin; ZHANG Jing; ZHANG Hong-xian; HUANG Yi; HOU Xiao-fei

    2013-01-01

    Background Living donor kidney transplantation is becoming popular in China,whereas,in clinical situations,some kidney donors may be sub-optimal,namely marginal living donor.The present study aimed to evaluate the safety and efficacy of marginal living donor kidney transplantation in a Chinese single center.Methods Between January 2001 and December 2009,888 kidney transplantations were performed in our center; 149were living donor kidney transplantations.The living donors and recipients were followed up regularly after the operation.Of the living donors,30 donors were marginal,who were older than 60 years or suffered from kidney anomaly or some benign diseases.Among the non-marginal living kidney transplantations,58 donors and recipients had complete perioperative and follow-up data.We compared the marginal and non-marginal living donor kidney transplantations with regard to donor age,follow-up period,donor's serum creatinine at the last follow-up,recipient's serum creatinine at the last follow-up,and graft survival at the last follow-up.Results The mean age of donors in the marginal and non-marginal living donors were (55±9) (37-66) and (43±12) (30-59) years.The mean follow-up times of the marginal and non-marginal groups were (26.4±13.4) months and (28.8±14.8)months.The donor and recipient serum creatinine levels at the last follow-up were (1.16±0.20) mg/dl and (1.30±0.24) mg/dl in the marginal group,and (1.12±0.32) mg/dl and (1.34±0.32) mg/dl in the non-marginal group.Three recipients in the marginal group and five recipients in the non-marginal group had acute rejection episodes during the first year.Actuarial 3-year graft survival was 96.7% in the marginal group and 100% in the non-marginal group.No significant differences were detected between the two groups with regard to these data.Conclusion Utilization of highly selective marginal living donors can be a safe,feasible,and effective way for the treatment of patients with end stage renal disease.

  8. Presentation, Management, and Outcome of Thyroglossal Duct Cysts in Adult and Pediatric Populations: A 14-Year Single Center Experience

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    Hassan Al-Thani

    2016-07-01

    Full Text Available Objectives: A thyroglossal duct cyst (TDC is a frequent congenital midline anomaly of the neck that usually manifests during the first decade of life. We aimed to describe the presentation, management, and outcome of TDC in pediatric and adult cases. Methods: A retrospective observational analysis was conducted for all patients diagnosed and treated for TDC between 2000 and 2014 in a single center in Qatar. Data included patients’ demographics, presentations, preoperative investigations, anesthesia type, histopathological findings, surgical management, recurrences, and complications. Results: We identified 102 patients, of which 57% were males. The mean age of patients was 20.2±15.6 years. A bimodal distribution of TDC has been observed, which peaked between the ages of 6–13 years and at ≥19 years. The preoperative evaluation mainly includes ultrasonography (66%, thyroid function test (44%, and fine-needle aspiration cytology (10%. The median size of the cyst was 25 (2–60 mm. Patients mainly presented with an asymptomatic midline neck mass at or below the hyoid bone (82%, followed by fistula (9%, infection (2%, and dysphagia (2%. Eighty-nine cases were identified preoperatively as TDC. The histopathological findings confirmed TDC with hyoid bone in 61 cases, and TDC alone in 38 cases. Eighty patients underwent the Sistrunk procedure while excision of TDC alone was observed in 18 cases. Five cases of recurrent disease were also treated. Adults had a greater median cyst size (30 (9–60 vs. 22 (2–55 mm; p = 0.005 and required prolonged operation time (69 (1–169 vs. 32.5 (1–140 mins; p = 0.004 compared to the pediatric group. Conclusion: The occurrence of TDC shows a bimodal age distribution. Preoperative evaluation and time for surgery vary whereas clinical presentations, surgical management, and postoperative outcomes are comparable among adult and pediatric groups. Ultrasonography is the preferred diagnostic modality, and the

  9. Charcot Neuropathic Arthropathy of the Foot: A Literature Review and Single-Center Experience

    Science.gov (United States)

    Shaikh, Haroun Hassan

    2016-01-01

    Charcot neuropathic osteoarthropathy of the foot is a relatively common complication of diabetic neuropathy. Incorrect diagnosis and improper treatment often result in the extremity having to be amputated. This paper summarises the current view on the etiology, diagnostics, and treatment of diabetic Charcot neuropathic osteoarthropathy, with particular focus on preserving the extremity through surgical intervention from our own experiences. PMID:27656656

  10. Minimally invasive video-assisted thyroidectomy: experience of 200 cases in a single center

    OpenAIRE

    Haitao, Zheng; Jie, Xu; Lixin, Jiang

    2014-01-01

    Introduction Minimally invasive techniques in thyroid surgery including video-assisted technique originally described by Miccoli have been accepted in several continents for more than 10 years. Aim To analyze our preliminary results from minimally invasive video-assisted thyroidectomy (MIVAT) and to evaluate the feasibility and effects of this method in a general department over a 4-year period. Material and methods Initial experience was presented based on a series of 200 patients selected f...

  11. Cardiovascular Impact of Eating Disorders in Adults: A Single Center Experience and Literature Review

    OpenAIRE

    Muhammad Rizwan Sardar; Andrea Greway; Michael DeAngelis; Erin O'Malley Tysko; Shawn Lehmann; Melinda Wohlstetter; Riti Patel

    2015-01-01

    Eating disorders have multiple medical sequelae, including potentially life-threatening cardiovascular complications. This article describes our cardiology practice experience of treating adults with eating disorders in the outpatient setting and documents baseline cardiac findings in this complex patient population. We describe our findings in patients across the spectrum of eating disorders; past studies have generally focused on anorexia only. This article also includes a review of the cur...

  12. Simultaneous liver and kidney transplantation:analysis of a single-center experience

    Institute of Scientific and Technical Information of China (English)

    MA Yi; WANG Guo-dong; HE Xiao-shun; LI Qiang; LI Jun-liang; ZHU Xiao-feng; WANG Chang-xi

    2010-01-01

    Background Simultaneous liver and kidney transplantation (SLKT) has been proven to be a favorable treatment for combined renal and hepatic end-stage disease.However, recipients receiving SLKT have a long medical history, poor general condition that is often accompanied by anemia, hypoalbuminemia, coagulopathy, water-electrolyte imbalance and acid-base disorders.This study aimed to explore the indications, surgical techniques, therapeutic experience,prevention and treatment of postoperative complications of SLKT.Methods The clinical data of 22 SLKTs cases performed at the First Affiliated Hospital of Sun Yat-sen University from January 2001 to December 2008 were retrospectively studied.Indications for SLKT, surgical techniques, perioperative fluid management, immunosuppressive regimen and experience in prevention and treatment of postoperative complications were analyzed.Results All operations were successfully performed.Postoperative complications occurred in 13 cases (59.1%), including pleural effusions (7), intra-abdominal bleeding (2), biliary complications (2), repeated upper gastrointestinal bleeding (1), and acute liver graft rejection (1).All complications were treated conservatively.In this study, there were five deaths during follow-up, in which three perioperative deaths occurred due to serious conditions.Mortality at 3 months was 13.6%.The one and three year patient survival rate was 81.3% and 73.9% respectively.Conclusions SLKT is an effective therapy for end-stage liver disease with chronic renal failure or severe damage to renal function.It is a complex surgical procedure, causing a large disturbance of circulation and fluid balance, and more postoperative complications.The SLKT surgical techniques selected are based on the experience of surgeons, the anatomy of the recipient and primary diseases.It is essential to use the correct perioperative fluid management, reasonable immunosuppressive regimen, and prevention and treatment of postoperative

  13. Lung transplantation in a Chinese single center:7 years of experience

    Institute of Scientific and Technical Information of China (English)

    HE Wen-xin; ZHANG Peng; LIU Ming; JIANG Ge-ning; DING Jia-an; GAO Wen; ZHU Yu-ming; ZHOU Xiao; CHEN Chang; WANG Hao; FAN Jiang

    2011-01-01

    Background Lung transplantation (LT) is a viable option for patients with end-stage lung diseases,but in China,the supply is limited,and the experience with LT is rare too. This study aimed to evaluate the survival and postoperative complications of recipients undergone LT.Methods From January 2003 to May 2010,all patients who underwent LT were included. The clinical data of recipients were analyzed retrospectively,including demographic characteristics,survival rate,and the occurrences of postoperative complications,acute rejection and bronchiolitis obliterans syndrome. Results In total,37 patients underwent LT. The early mortality (<30 days) was 14% (5/37). Cumulative survival rate was 78%,70%,70% and 42% at 1,3,5 and 6 years,respectively. In 37 patients,5 (14%) developed fungal infections,9 (24%)pulmonary bacterial infections,and 6 (16%) had bronchial anastomosis complications after LT. At three months posttransplantation,a significant improvement was observed in lung function (P <0.05). Fifteen recipients (41%) developed acute rejection within the first year. Freedom from bronchiolitis obliterans syndrome was 89%,85% and 80% at 1,2 and 3years after transplantation.Conclusions Despite the limited number of cases,the survival and occurrences of complications after LT were comparable to the international experience. Single LT may be a reasonable option for some patients with end-stage pulmonary diseases.

  14. Stent treatment for basilar artery dissection: A single-center experience of 21 patients.

    Science.gov (United States)

    Li, Li; Li, Tianxiao; Xue, Jiangyu; Wang, Ziliang; Bai, Weixing; Zhu, Liangfu; Feng, Guang; Xu, Gangqin; Yang, Bowen

    2016-06-01

    Basilar artery dissection is a rare disease with high morbidity and mortality. No well-established management strategy exists for this lesion. Endovascular reconstructive therapy using stents (with or without coiling) may be the optimum strategy.We describe our center's experience for this treatment strategy in 21 patients with basilar artery dissection from January 2009 to July 2014 (17 men, four women; age range, 18-70 years; median age, 56 years). We divided patients into two groups: Group 1 patients received stent-assisted coiling treatment, and Group 2 patients received stent-only treatment. Pre-treatment, peri-operation and follow-up evaluation were investigated for complications, clinical outcome and angiographic results. The median follow-up time was 20 months (range, 3-67 months).All patients were treated endovascularly by stent-assisted coiling (14 patients) or stent only (seven patients). Immediate angiography showed: in Group 1, five of 14 lesions were completely occluded, five were partially occluded, four revealed retention of contrast media; in Group 2, all patients (seven of seven) had contrast retention. At the follow-up visit (median seven months, 3-29 months), the aneurysms were angiographically improved in five of 13 patients in Group 1 compared with immediately post-operation, while six of sevenimproved in Group 2. Five patients (all in Group 1) had ischemic or hemorrhage peri-operation complications. Long-term good clinical outcomes (modified Rankin Scale score (mRS) ≤ 2) were achieved in all patients except three death cases (two in Group1, one in Group 2).In our experience, endovascular reconstructive therapy using stents (with or without coiling) for basilar artery dissection is effective and safe. Stent-only treatment seems have a better safety profile during the peri-operation period. PMID:26842610

  15. New insights into the clinical evaluation of hereditary transthyretin amyloidosis patients: a single center's experience

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    Suhr OB

    2012-08-01

    Full Text Available Ole B Suhr,1 Sandra Gustavsson,1 Victoria Heldestad,2 Rolf Hörnsten,3 Per Lindqvist,1 Erik Nordh,2 Urban Wiklund41Department of Public Health and Clinical Medicine, 2Department of Pharmacology and Clinical Neuroscience, 3Department of Surgical and Perioperative Sciences, Clinical Physiology, Heart Centre, 4Department of Radiation Sciences, Biomedical Engineering, Umeå University, Umeå, SwedenAbstract: Over the last decade, new medical treatment modalities have emerged based on increased insights into amyloid formation. With the increased possibilities for treatment of amyloidosis caused by transthyretin (TTR amyloid deposits comes the need for diagnostic procedures for early diagnosis and better tools to follow disease progression. This is of particular importance in clinical trials evaluating the efficacy of new treatments. Until recently, the treatment of TTR amyloidosis (ATTR was based solely on liver transplantation, a procedure that has halted disease progression in many patients. Liver transplantation has been especially effective in patients under the age of 50 years carrying the TTR V30M mutation, whereas the outcome of the procedure has been variable for others, particularly elderly male patients and those carrying a non-V30M mutation. This review concentrates on new insights derived from our center's experience with liver transplantation, how to implement this experience in evaluation of new treatment modalities for ATTR, and how to facilitate early diagnosis of neuropathy with easily available diagnostic tools. Attention has focused on manifestations of the disease that involve the heart and the peripheral nervous system; change in peripheral nerve function has been the primary endpoint in two controlled clinical trials, one finished and one ongoing. New insights into the amyloid formation process and the lessons learned from liver transplantation give the opportunity to design potentially effective treatment modalities for ATTR

  16. Transanal surgery for obstructed defecation syndrome: Literature review and a single-center experience

    Science.gov (United States)

    Liu, Wei-Cheng; Wan, Song-Lin; Yaseen, SM; Ren, Xiang-Hai; Tian, Cui-Ping; Ding, Zhao; Zheng, Ken-Yan; Wu, Yun-Hua; Jiang, Cong-Qing; Qian, Qun

    2016-01-01

    Obstructed defecation syndrome (ODS) is a functional disorder commonly encountered by colorectal surgeons and gastroenterologists, and greatly affects the quality of life of patients from both societal and psychological aspects. The underlying anatomical and pathophysiological changes of ODS are complex. However, intra-rectal intussusception and rectocele are frequently found in patients with ODS and both are thought to play an important role in the pathogenesis of ODS. With the development of evaluation methods in anorectal physiology laboratories and radiology studies, a great variety of new operative procedures, especially transanal procedures, have been invented to treat ODS. However, no procedure has been proved to be superior to others at present. Each operation has its own merits and defects. Thus, choosing appropriate transanal surgical procedures for the treatment of ODS remains a challenge for all surgeons. This review provides an introduction of the current problems and options for treatment of ODS and a detailed summary of the essential assessments needed for patient evaluation before carrying out transanal surgery. Besides, an overview of the benefits and problems of current transanal surgical procedures for treatment of ODS is summarized in this review. A report of clinical experience of some transanal surgical techniques used in the authors’ center is also presented. PMID:27672293

  17. Outcomes of arteriovenous fistula for hemodialysis in Sudanese patients: Single-center experience

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    Gamal Mustafa Ahmed

    2012-01-01

    Full Text Available A well-functioning arteriovenous fistula (AVF is essential for the maintenance of hemodialysis (HD in patients with chronic renal failure. Our aim is to review our experience of creating AVF and to asses its success rate and common complication. A prospective, hospital-based study was conducted on 73 patients (48 males and 25 females on chronic HD in Gezira Hospital for Renal Diseases and Surgery, from January to July 2007. Their mean age was 43.9 years (range from 18 to 72 years. Seventy-one (97.3% of the study subjects had been dialyzed before creation of the AVF, 67 (91.8% of them having undergone HD with temporary access. All patients (n=73 had a native AVF as the permanent vascular access (VA. A primary radiocephalic AVF was created in 78.1% of the patients, cubital fossa in 20.5% and one case had left snuff box AVF (1.4%. Percentage of AVF maturation was reported in 67.1% of the cases within the first six weeks and in 9.6% of the cases AVF never matured. Failure of AVF function occurred in 26% of the cases, due to thrombosis in 20.5% (n=15 and aneurysm in 5.5% of the cases. We conclude that an optimum outcome is likely when there is a multidisciplinary team approach, and early referral to vascular surgery is paramount.

  18. Results of candidemia treatment in children with hematologic malignancies: single center experience

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    I. I. Kalinina

    2014-07-01

    Full Text Available Candidemia is one of the most serious infectious complications in children with hematological malignancies and has a high morta lity rate.Seven-year experience of candidemia diagnosis and therapy in patients with various hematologic malignancies w as analyzed. Candidemia registered in 37 patients (AML and MDS — 14, ALL — 10, solid tumors — 5, histocytic syndromes — 4, AA — 3, other non-malignancy diseases— 2. C. non-albicans (36 isolates from 32 patients was common cause of, while C. albicans isolated in 5 patients (8 strains. Antifungal prophylactic therapy was applied to 31 patients. 22 patients at the time of candidemia have neutropenia (< 0.5 × 10 9/l. Main clinical manifestations were febrile fever (100 % cases and pneumonia (21.6 % cases. Less frequent multiorgan failure (8.1 %, septic shoc k (5.4 %, chronic disseminated candidiasis (5.4 % and meningitis (2.7 % were registered. All patients received antifungal therapy (monotherapy — 17, combination therapy — 20. Central venous catheter removed in 21 patients. In 14 patients hematopoietic recovery w as registered, none of these patients died, while from group of patients without hematopoietic recovery 6 patients died (p = 0.0001. Recurrent candidemia episodes were seen in 4 patients. Overall survival was 0.37 ± 0.09.

  19. Adult Living Donor Liver Transplantation with ABO-Incompatible Grafts: A German Single Center Experience

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    Armin D. Goralczyk

    2009-01-01

    Full Text Available Adult living donor liver transplantations (ALDLTs across the ABO blood group barrier have been reported in Asia, North Americas, and Europe, but not yet in Germany. Several strategies have been established to overcome the detrimental effects that are attached with such a disparity between donor and host, but no gold standard has yet emerged. Here, we present the first experiences with three ABO-incompatible adult living donor liver transplantations in Germany applying different immunosuppressive strategies. Four patient-donor couples were considered for ABO-incompatible ALDLT. In these patients, resident ABO blood group antibodies (isoagglutinins were depleted by plasmapheresis or immunoadsorption and replenishment was inhibited by splenectomy and/or B-cell-targeted immunosuppression. Despite different treatments ALDLT could safely be performed in three patients and all patients had good initial graft function without signs for antibody-mediated rejection (AMR. Two patients had long-term graft survival with stable graft function. We thus propose the feasibility of ABO-incompatible ALDLT with these protocols and advocate further expansion of ABO incompatible ALDLT in multicenter trials to improve efficacy and safety.

  20. Results of candidemia treatment in children with hematologic malignancies: single center experience

    Directory of Open Access Journals (Sweden)

    I. I. Kalinina

    2011-01-01

    Full Text Available Candidemia is one of the most serious infectious complications in children with hematological malignancies and has a high morta lity rate.Seven-year experience of candidemia diagnosis and therapy in patients with various hematologic malignancies w as analyzed. Candidemia registered in 37 patients (AML and MDS — 14, ALL — 10, solid tumors — 5, histocytic syndromes — 4, AA — 3, other non-malignancy diseases— 2. C. non-albicans (36 isolates from 32 patients was common cause of, while C. albicans isolated in 5 patients (8 strains. Antifungal prophylactic therapy was applied to 31 patients. 22 patients at the time of candidemia have neutropenia (< 0.5 × 10 9/l. Main clinical manifestations were febrile fever (100 % cases and pneumonia (21.6 % cases. Less frequent multiorgan failure (8.1 %, septic shoc k (5.4 %, chronic disseminated candidiasis (5.4 % and meningitis (2.7 % were registered. All patients received antifungal therapy (monotherapy — 17, combination therapy — 20. Central venous catheter removed in 21 patients. In 14 patients hematopoietic recovery w as registered, none of these patients died, while from group of patients without hematopoietic recovery 6 patients died (p = 0.0001. Recurrent candidemia episodes were seen in 4 patients. Overall survival was 0.37 ± 0.09.

  1. Robotic versus conventional laparoscopic colorectal operations: a-single center experience

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    Bozkurt, Mehmet Abdussamet; Kocataş, Ali; Gemici, Eyüp; Kalaycı, Mustafa Uygar; Alış, Halil

    2016-01-01

    Objective: Robotic surgery was first introduced in 2000 especially to overcome the limitations of low rectum cancer surgery. There is still no consensus regarding the standard method for colorectal surgery. The aim of this study was to compare robotic surgery with laparoscopic colorectal surgery. Material and Methods: This is a retrospective study. Data of patients with a diagnosis of colon or rectal cancer were analyzed for robotic colorectal surgery and laparoscopic colorectal surgery. Results: The cost of robotic surgery group was statistically higher than the laparoscopic surgery group (p=0.032). The average operation duration was 178 minutes in the laparoscopic surgery group and 228 minutes in the robotic surgery group, and this difference was statistically significant (p=0.044). There was no statistically significant difference between the groups regarding other parameters. Discussion: Disadvantages of robotic surgery seem to be its higher cost and longer operation duration as compared to laparoscopic surgery. We claim that an increase in the number of cases and experience may shorten the operation time while the increase in commercial interest may decrease the cost disadvantage of robotic surgery.

  2. Retroperitoneal Laparoscopic Nephroureterectomy for Tuberculous Nonfunctioning Kidneys: a single-center experience

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    Xiquan Tian

    2015-04-01

    Full Text Available Purpose To present our surgical techniques and experiences of retroperitoneal laparoscopic nephroureterectomy for the treatment of tuberculous nonfunctioning kidneys. Materials and Methods From March 2005 to March 2013, a total of 51 patients with tuberculous nonfunctioning kidney underwent retroperitoneal laparoscopic nephroureterectomy at our medical center. The techniques included early control of renal vessels and dissection of the diseased kidney along the underlying layer outside the Gerato’s fascia. The distal ureter was dissected through a Gibson incision and the entire specimen was removed en bloc from the incision. Patient demographics, perioperative characteristics and laboratory parameters as well as postoperative outcome were retrospectively reviewed. Results Retroperitoneal laparoscopic nephroureterectomy was successfully performed in 50 patients, whereas one case required conversion to open surgery due to non-progression of dissection. The mean operating time was 123.0 minutes (107-160 minutes and the mean estimated blood loss was 134 mL (80-650 mL.The mean postoperative hospital stay was 3.6 days (3-5days and the mean return to normal activity was 11.6 days (10-14days. Most intra-operative and post-operative complications were minor complications and can be managed conservatively. After 68 months (12-96 months follow-up, the outcome was satisfactory, and ureteral stump syndrome did not occur. Conclusions Retroperitoneal laparoscopic nephroureterectomy as a minimally invasive treatment option is feasible for treatment of tuberculous nonfunctioning kidneys.

  3. Linear accelerator-based stereotactic radiosurgery in recurrent glioblastoma: A single center experience

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    Sirin Sait

    2011-01-01

    Full Text Available Background/Aim. Management of patients with recurrent glioblastoma (GB comprises a therapeutic challenge in neurooncology owing to the aggressive nature of the disease with poor local control despite a combined modality treatment. The majority of cases recur within the highdose radiotherapy field limiting the use of conventional techniques for re-irradiation due to potential toxicity. Stereotactic radiosurgery (SRS offers a viable noninvasive therapeutic option in palliative treatment of recurrent GB as a sophisticated modality with improved setup accuracy allowing the administration of high-dose, precise radiotherapy. The aim of the study was to, we report our experience with single-dose linear accelerator (LINAC based SRS in the management of patients with recurrent GB. Methods. Between 1998 and 2010 a total of 19 patients with recurrent GB were treated using single-dose LINAC-based SRS. The median age was 47 (23-65 years at primary diagnosis. Karnofsky Performance Score was ≥ 70 for all the patients. The median planning target volume (PTV was 13 (7-19 cc. The median marginal dose was 16 (10-19 Gy prescribed to the 80%-95% isodose line encompassing the planning target volume. The median follow-up time was 13 (2-59 months. Results. The median survival was 21 months and 9.3 months from the initial GB diagnosis and from SRS, respectively. The median progression-free survival from SRS was 5.7 months. All the patients tolerated radiosurgical treatment well without any Common Toxicity Criteria (CTC grade > 2 acute side effects. Conclusion. Single-dose LINAC-based SRS is a safe and well- tolerated palliative therapeutic option in the management of patients with recurrent GB.

  4. Successful Splenectomy for Hypersplenism in Wilson’s Disease: A Single Center Experience from China

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    Chen, Huai-Zhen; Wu, Yun-Hu; Fang, Xiang; Zhang, Jing; Wang, Zhen; Han, Yong-Sheng; Wang, Yu

    2015-01-01

    Splenomegaly and pancytopenia are common in Wilson’s disease (WD) and splenectomy is one of the conventional treatments for splenomegaly and the associated pancytopenia. However, splenectomy remained controversial for hypersplenism in WD as it was reported that splenectomy leaded to serious emotional and neurological deterioration in WD patients with hypersplenism. In the current study, we present our experiences in 70 WD patients with hypersplenism who had undergone splenectomy, outlining the safety and efficacy of splenectomy in WD. The clinical database of 70 WD patients with hypersplenism who had undergone splenectomy in our hospital between 2009 and 2013 were reviewed and followed-up regularly. Before splenectomy, all the patients accepted a short period of anti-copper treatment with intravenous sodium 2, 3-dimercapto-1-propane sulfonate (DMPS). All the patients demonstrated a marked improvement in platelet and leucocyte counts after splenectomy. No severe postoperative complication was observed. In particular, none of the 37 patients with mixed neurologic and hepatic presentations experienced neurological deterioration after splenectomy, and none of the patients with only hepatic presentations newly developed neurological symptoms. During the one year follow-up period, no patient presented hepatic failure or hepatic encephalopathy, no hepatic patient newly developed neurological presentations, and only 3 patients with mixed neurologic and hepatic presentations suffered neurological deterioration and these 3 patients had poor compliance of anti-copper treatment. Quantative analysis of the neurological symptoms in the 37 patients using the Unified Wilson’s Disease Rating Scale (UWDRS) showed that the neurological symptoms were not changed in a short-term of one week after splenectomy but significantly improved in a long-term of one year after splenectomy. Additionally, compared to that before splenectomy, the esophageal gastric varices in most patients

  5. Minimally invasive esophagectomy for cancer: Single center experience after 44 consecutive cases

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    Bjelović Miloš

    2015-01-01

    Full Text Available Introduction. At the Department of Minimally Invasive Upper Digestive Surgery of the Hospital for Digestive Surgery in Belgrade, hybrid minimally invasive esophagectomy (hMIE has been a standard of care for patients with resectable esophageal cancer since 2009. As a next and final step in the change management, from January 2015 we utilized total minimally invasive esophagectomy (tMIE as a standard of care. Objective. The aim of the study was to report initial experiences in hMIE (laparoscopic approach for cancer and analyze surgical technique, major morbidity and 30-day mortality. Methods. A retrospective cohort study included 44 patients who underwent elective hMIE for esophageal cancer at the Department for Minimally Invasive Upper Digestive Surgery, Hospital for Digestive Surgery, Clinical Center of Serbia in Belgrade from April 2009 to December 2014. Results. There were 16 (36% middle thoracic esophagus tumors and 28 (64% tumors of distal thoracic esophagus. Mean duration of the operation was 319 minutes (approximately five hours and 20 minutes. The average blood loss was 173.6 ml. A total of 12 (27% of patients had postoperative complications and mean intensive care unit stay was 2.8 days. Mean hospital stay after surgery was 16 days. The average number of harvested lymph nodes during surgery was 31.9. The overall 30-day mortality rate within 30 days after surgery was 2%. Conclusion. As long as MIE is an oncological equivalent to open esophagectomy (OE, better relation between cost savings and potentially increased effectiveness will make MIE the preferred approach in high-volume esophageal centers that are experienced in minimally invasive procedures.

  6. Retrograde approach for the recanalization of coronary chronic total occlusion: preliminary experience of a single center

    Institute of Scientific and Technical Information of China (English)

    GE Lei; XU Shi-kun; ZHANG Feng; WANG Xiang-fei; WANG Qi-bing; FAN Bing; YAN Yan; FENG Qi; WANG Hao; SHEN An; ZHU Ming-hui; QIAN Ju-ying; GE Jun-bo; LIU Xue-bo; QIN Qing; CUI Shan-jing; YAO Kang; SHEN Li; MA Jian-ying; HUANG Dong

    2010-01-01

    Background The success rate of antegrade approach for chronic total occlusions (CTO) recanalization has not dramatically increased, especially in complex CTO subset. The retrograde technique may hold great promise. This report aimed to describe our experience of retrograde recanalization for CTO, focusing on its safety and feasibility. Methods We identified 42 patients who underwent revascularization in CTO with retrograde approach from July 2005 to November 2009 in our center.Results Three kinds of strategy were applied: retrograde as primary strategy (50.0%), retrograde immediately after antegrade failure (26.2%) and repeat procedure after previous antegrade failure (23.8%). Septal collaterals were more frequently used as the retrograde access route (92.9%). Overall success rate was 88.1%. In patients with successful retrograde wire crossing collateral channel to the distal cap of CTO, the success rate of recanalization was 94.1%. In patient with failure to cross the collaterals, the success rate was 62.5%. Eight different kinds of retrograde techniques were used: kissing wire technique (35.3%), wire trapped and reverse wire trapped technique (17.6%), back-end balloon and microcatherer reversal technique (14.7%), controlled antegrade and retrograde subintimal tracking (CART) technique (8.8%), reverse CART and modified reverse CART technique (8.8%), retrograde wire crossing technique (2.9%). There were 4 complications occurred without in-hospital major adverse cardiac events (MACE). In-hospital MACE was 7.7%. All of them were non-Q wave myocardial infarction. There were no cases of death or target vessel revascularization, either surgery or percutaneous.Conclusions The retrograde approach can be an effective tool for increasing the success rate of recanalization in the very complex CTO. To ensure the success and safety of the approach, careful case selection and device handling by experienced operators is essential.

  7. Postchemotherapy Retroperitoneal Lymph Node Dissection in Patients With Nonseminomatous Testicular Cancer: A Single Center Experiences

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    Nowroozi

    2015-09-01

    Full Text Available Background Testicular cancer accounts for about 1 - 1.5% of all malignancies in men. Radical orchiectomy is curative in 75% of patients with stage I disease, but advance stage with retroperitoneal lymph node involvement needs chemotherapy. All patients who have residual masses ≥ 1 cm after chemotherapy should undergo postchemotherapy retroperitoneal lymph node dissection (PC-RPLND. Objectives Treatment of advanced nonseminomatous testicular cancer is usually a combination of chemotherapy and surgery. We described our experience about postchemotherapy retroperitoneal lymph node dissection (PC-RPLND in our center. Patients and Methods In a retrospective cross-sectional study between 2006 and 2011, patients with a history of postchemotherapy retroperitoneal lymph node dissection (PC-RPLND in Imam Khomeini hospital were evaluated. All patients had normal postchemotherapy serum tumor markers and primary nonseminomatous cancer. We reviewed retrospectively clinical, pathological, and surgical parameters associated with PC-RPLND in our center. Results Twenty-one patients underwent bilateral PC-RPLND. Mean age was 26.3 years (ranged 16 - 47. Mean size of retroperitoneal mass after chemotherapy was 7.6 cm. Mean operative time was 198 minutes (120 - 246 minutes. Mean follow-up time was 38.6 months. Pathologic review showed presence of fibrosis/necrosis, viable germ cell tumor and teratoma in 8 (38.1%, 10 (47.6% and 3 (14.28% patients, respectively. One patient in postoperative period of surgery and three patients in two first years after surgery were expired. Of 17 alive patients, only two (11.8% had not retrograde ejaculation. Conclusions PC-RPLND is one the major operations in the field of urology, which is associated with significant adjunctive surgeries. In appropriate cases, PC-RPLND was associated with good cancer specific survival in tertiary oncology center.

  8. Successful Splenectomy for Hypersplenism in Wilson's Disease: A Single Center Experience from China.

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    Liang-Yong Li

    Full Text Available Splenomegaly and pancytopenia are common in Wilson's disease (WD and splenectomy is one of the conventional treatments for splenomegaly and the associated pancytopenia. However, splenectomy remained controversial for hypersplenism in WD as it was reported that splenectomy leaded to serious emotional and neurological deterioration in WD patients with hypersplenism. In the current study, we present our experiences in 70 WD patients with hypersplenism who had undergone splenectomy, outlining the safety and efficacy of splenectomy in WD. The clinical database of 70 WD patients with hypersplenism who had undergone splenectomy in our hospital between 2009 and 2013 were reviewed and followed-up regularly. Before splenectomy, all the patients accepted a short period of anti-copper treatment with intravenous sodium 2, 3-dimercapto-1-propane sulfonate (DMPS. All the patients demonstrated a marked improvement in platelet and leucocyte counts after splenectomy. No severe postoperative complication was observed. In particular, none of the 37 patients with mixed neurologic and hepatic presentations experienced neurological deterioration after splenectomy, and none of the patients with only hepatic presentations newly developed neurological symptoms. During the one year follow-up period, no patient presented hepatic failure or hepatic encephalopathy, no hepatic patient newly developed neurological presentations, and only 3 patients with mixed neurologic and hepatic presentations suffered neurological deterioration and these 3 patients had poor compliance of anti-copper treatment. Quantative analysis of the neurological symptoms in the 37 patients using the Unified Wilson's Disease Rating Scale (UWDRS showed that the neurological symptoms were not changed in a short-term of one week after splenectomy but significantly improved in a long-term of one year after splenectomy. Additionally, compared to that before splenectomy, the esophageal gastric varices in most

  9. Initial Management of Childhood Acute Immune Thrombocytopenia: Single-Center Experience of 32 Years.

    Science.gov (United States)

    Yildiz, Inci; Ozdemir, Nihal; Celkan, Tiraje; Soylu, Selen; Karaman, Serap; Canbolat, Aylin; Dogru, Omer; Erginoz, Ethem; Apak, Hilmi

    2015-01-01

    Immune thrombocytopenia (ITP) is an acute self-limited disease of childhood, mostly resolving within 6 months irrespective of whether therapy is given or not. Treatment options when indicated include corticosteroids, intravenous immune globulin (IVIG), and anti-RhD immunoglobulin. We reviewed our 32 years' experience for first-line therapy of acute ITP. Five hundred forty-one children (mean age: 5.3 years) diagnosed and treated for ITP were evaluated retrospectively. Among 491 acute ITP patients, IVIG was used in 27%, high-dose steroids in 27%, low-dose steroids in 20%, anti-D immunoglobulin G (IgG) in 2%, and no therapy in 22%. When the initial response (platelets >50 × 10(9)/L) to first-line treatment modalities were compared, 89%, 84%, and 78% patients treated by low-dose steroids, high-dose steroids, and IVIG responded to treatment, respectively (P > .05). Mean time to recovery of platelets was 16.8, 3.8, and 3.0 days in patients treated with low-dose steroids, high-dose steroids, and IVIG, respectively (P < .0001). Thrombocytopenia recurred in 23% of low-dose steroid, 39% of high-dose steroid, and in 36% of IVIG (P < .0001) treatment groups. Of 108 patients who were observed alone, 4 (3%) had a recurrence on follow-up and only 2 of these required treatment subsequently. Recurrence was significantly less in no therapy group compared with children treated with 1 of the 3 options of pharmacotherapy (P < .0001). Response rates were similar between patients treated by IVIG and low- and high-dose steroids; however, time to response was slower in patients treated with low-dose steroids compared with IVIG and high-dose steroids. PMID:26154620

  10. A Single-Center 10-Year Experience with Pasireotide in Cushing's Disease: Patients' Characteristics and Outcome.

    Science.gov (United States)

    Trementino, L; Michetti, G; Angeletti, A; Marcelli, G; Concettoni, C; Cardinaletti, C; Polenta, B; Boscaro, M; Arnaldi, G

    2016-05-01

    Pasireotide is the first pituitary-directed drug approved for treating patients with Cushing's disease (CD). Our 10-year experience with pasireotide in CD is reported here. Twenty patients with de novo, persistent, or recurrent CD after pituitary surgery were treated with pasireotide from December 2003 to December 2014. Twelve patients were treated with pasireotide in randomized trials and 8 patients with pasireotide sc (Signifor(®); Novartis AG, Basel, Switzerland) in clinical practice. The mean treatment duration was 20.5 months (median 9 months; range, 3-72 months). Urinary free cortisol (UFC) levels mean percentage change (± SD) at last follow-up was-40.4% (± 35.1; range, 2-92%; median reduction 33.3%) with a normalization rate of 50% (10/20). Ten patients achieved sustained normalized late night salivary cortisol (LNSC) levels during treatment. LNSC normalization was associated with UFC normalization in 7/10 patients. Serum cortisol and plasma ACTH significantly decreased from baseline to last follow-up. Body weight decrease and blood pressure improvement during pasireotide treatment were independent from UFC response. Glucose profile worsening was observed in all patients except one. The frequency of diabetes mellitus increased from 40% (8/20) at baseline to 85% (17/20) at last follow-up requiring initiation of medical treatment only in 44% of patients. Pasireotide treatment was associated with sustained biochemical and clinical benefit in about 60% of CD patients. Glucose profile alteration is a frequent complication of pasireotide treatment; however, it seems to be easy to manage with diet and lifestyle intervention in almost half of the patients. PMID:27127913

  11. Thromboprophylaxis and Outcomes for Total Joint Arthroplasty in Congenital Bleeding Disorders: A Single-Center Experience.

    Science.gov (United States)

    Holderness, Britt M; Goto, Yuika; McKernan, Laurel; Bernini, Philip; Ornstein, Deborah L

    2016-09-01

    Total joint arthroplasty (TJA) improves the quality of life for patients with end-stage osteoarthritis but is associated with an increased risk of venous thromboembolism (VTE), thus pharmacologic thromboprophylaxis is recommended for most patients. Patients with congenital bleeding disorders may develop severe arthropathies due to repeated hemarthroses and derive similar benefit from TJA as the general population. No guidelines for pharmacologic thromboprophylaxis in this population exist, however, as the risks and benefits are not well defined. We undertook the current study to assess the safety and efficacy of pharmacologic VTE prophylaxis in patients with congenital bleeding disorders undergoing TJA. We retrospectively reviewed the medical records of patients with bleeding disorders who underwent TJA at our academic institution between 1987 and 2012. We identified 28 patients who underwent 38 TJA procedures. Low-molecular-weight heparin (LMWH) was administered in 29 procedures (76%) and was discontinued early in 3 procedures (2 patients) due to nonjoint bleeding. No symptomatic VTE was identified, and no joint or deep wound infections were seen. Twenty-two patients accounting for 31 procedures were contacted to discuss their experience with TJA. All reported decreased pain, and 97% reported improved function after the surgery. Impressively, 97% stated that they would choose to have the surgery again. These results confirm the benefit of TJA in patients with congenital bleeding disorders and end-stage arthropathies and suggest that LMWH thromboprophylaxis is safe. No patient in our cohort developed symptomatic VTE, whether or not thromboprophylaxis was administered, thus necessity of thromboprophylaxis remains an unanswered question. PMID:27099385

  12. Single center experience in endovascular aortic repair: review of technical and clinical aspects

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    Sinan Demirtaş

    2014-09-01

    Full Text Available Objective: The aim of this study is sharing of our endovascular aortic repair experiments in patients with high risk for surgery and contributing to literature with comparing previous report according to mortality complicationsand additional operations. Methods:Patients with endovascular aortic repair application were evaluated retrospectively. Perioperative one month mortality, additional applications during procedure, occurred complications, endoleak types, approaching anesthetical technique, diagnosis of disease, comorbid factors and demographical data registered. Results were compared with data in the literature Results: Abdominal endovascular aortic repair (EVAR applicated into 19 patients. Thoracic endovascular aor tic repair (TEVAR applicated into 11 patients. EVAR patients were operated with diagnosis of abdominal aortic aneurysm. Nine of these patients were emergely operated due to rupture. TEVAR applicated 8 patients were operated due to Type 3 Aortic Dissection and 1 patient was operated due to transsection. One month mortality of all patients were found as 10% (three atients. Endoleaks were occurred 6 patients: Three of them were Type 1a, two of them were Type1b and one of them was Type2. Balloon angioplasty applicated in two patients due to Type 1a endoleak and, in one patient due to Type 1b endoleak. Chronic renal failure was developed in one patient (3.3% due to contrast nephropathy. Reexploration was applicated in two patients (6.7% due to hematoma. Conclusion: Endovascular techniques are become frequently preferred treatment modality with the developing technology. We believed that endovascular approaches are safely preferable alternative in patients with high surgical risk as our series.

  13. Early liver retransplantation versus late liver retransplantation:analysis of a single-center experience

    Institute of Scientific and Technical Information of China (English)

    CHEN Gui-hua; ZHANG Jun-feng; ZHANG Tong; WANG Guo-ying; FU Bin-sheng; YANG Yang; CAI Chang-jie; LU Min-qiang; LI Hua; WANG Gen-shu; YI Shu-hong; XU Chi

    2008-01-01

    Background Orthotopic liver retransplantation (re-OLT) is the only effective therapy for irreversible failure of a liver graft. Early and late graft failure gives way to two different clinical conditions that should be discussed separately. This study was designed to compare early and late re-OLT for patients with poor graft function after primary transplantation at our center and sum up our clinical experience in re-OLT.Methods The clinical data of 31 re-OLTs at our center from January 2004 to February 2007 were analyzed retrospectively, consisting of the first group with 14 cases of early re-OLT and the second group with 17 cases of late re-OLT.Results Biliary tract complications were the main indications for early re-OLT (57.1%) and late re-OLT (52.9%). Other common indications were vascular complications in early re-OLT and recurrence of primary diseases in late re-OLT. No significant differences were found between the groups with regard to the volume of bleeding during operation, cold ischemia time, operative duration, and perioperative mortality; except for the model of end-stage liver disease (MELD) score. Outcome was fatal for 7 patients in early re-OLT and 9 patients in late re-OLT. Two deaths were due to multiple organ failure with 3 deaths due to severe sepsis-related disease in early re-OLT, and 4 deaths were due to severe sepsis-related disease with 3 deaths due to recurrence of hepatocellular carcinoma (HCC) in late re-OLT. One and 2-year actuarial survival rates after re-OLT were 55.2% and 36.9%, respectively, for patients in early re-OLT, and 65.1% and 52% respectively, for patients in late re-OLT. No significant differences were found regarding survival rates between the two groups.Conclusions Similar clinical results can be achieved in early and late re-OLT. Proper indications and optimal operation timing, adequate preoperative preparation, experienced surgical procedures, and effective perioperative anti-infection strategy contribute to the

  14. Transrectal ultrasound-guided aspiration in the management of prostatic abscess: A single-center experience

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    Jigish B Vyas

    2013-01-01

    Full Text Available Objectives: The safety and efficacy of transrectal ultrasound (TRUS guided aspiration of prostatic abscess (PA is known. The objective of this study is to describe a treatment algorithm for management of PA with TRUS-guided aspiration, emphasizing on indications and factors predicting the treatment outcome. Materials and Methods: After the institutional review board approval was obtained, a retrospective study was done of all patients suspected with PA on digital rectal examination (DRE and confirmed on TRUS. An 18-gauge two-part needle was used for aspiration. The real-time TRUS-guided aspiration of PA was done in the longitudinal axis. The aspiration of pus and the sequential collapse of cavity was seen "real time." A suprapubic catheter was placed, if the patient had urinary retention, persistent dysuria, and/or severe lower urinary tract symptoms (LUTS. Success was defined as complete resolution of the abscess and/or symptoms. Results: Forty-eight patients were studied with PA, with a mean age of 54.6 ± 14.6 (range 26-79 years. The DRE diagnosed PA in 22 (45.83% patients, while abdominal sonography diagnosed PA in 13 (27.08% patients. TRUS revealed a hypoechoic area with internal echoes in all 48 (100% patients. The diagnosis was confirmed in all 48 cases with aspiration. The mean size of the lesion was 3.2 ± 1.2 (range 1.5-8 cm. Mean volume aspirated was 10.2 ml (range 2.5-30 ml. Complete resolution after first aspiration was observed in 20 (41.66% patients. An average of 4.1 (range 1-7 aspirations was required for complete resolution which was seen in 41 patients (85.42%. Seven (14.58% patients required transurethral resection (deroofing of the abscess cavity. We formulated a treatment algorithm based on the above findings. Conclusion: The proposed algorithm based on our experience suggests that patients with PA larger than 2 cm with severe LUTS and/or leukocytosis benefit from TRUS-guided aspiration. In addition, these patients are

  15. Outcomes of Surgical Repair for Persistent Truncus Arteriosus from Neonates to Adults: A Single Center's Experience

    Science.gov (United States)

    Chen, Qiuming; Gao, Huawei; Hua, Zhongdong; Yang, Keming; Yan, Jun; Zhang, Hao; Ma, Kai; Zhang, Sen; Qi, Lei; Li, Shoujun

    2016-01-01

    Objective This study aimed to report our experiences with surgical repair in patients of all ages with persistent truncus arteriosus. Methods From July 2004 to July 2014, 50 consecutive patients with persistent truncus arteriosus who underwent anatomical repair were included in the retrospective review. Median follow-up time was 3.4 years (range, 3 months to 10 years). Results Fifty patients underwent anatomical repair at a median age of 19.6 months (range, 20 days to 19.1 years). Thirty patients (60%) were older than one year. The preoperative pulmonary vascular resistance and mean pulmonary artery pressure were 4.1±2.1 (range, 0.1 to 8.9) units.m2 and 64.3±17.9 (range, 38 to 101) mmHg, respectively. Significant truncal valve regurgitation was presented in 14 (28%) patients. Hospital death occurred in 3 patients, two due to pulmonary hypertensive crisis and the other due to pneumonia. Three late deaths occurred at 3, 4 and 11 months after surgery. The actuarial survival rates were 87.7% and 87.7% at 1 year and 5 years, respectively. Multivariate analysis identified significant preoperative truncal valve regurgitation was a risk factor for overall mortality (odds ratio, 7.584; 95%CI: 1.335–43.092; p = 0.022). Two patients required reoperation of truncal valve replacement. One patient underwent reintervention for conduit replacement. Freedom from reoperation at 5 years was 92.9%. At latest examination, there was one patient with moderate-to-severe truncal valve regurgitation and four with moderate. Three patients had residual pulmonary artery hypertension. All survivors were in New York Heart Association class I-II. Conclusions Complete repair of persistent truncus arteriosus can be achieved with a relatively low mortality and acceptable early- and mid-term results, even in cases with late presentation. Significant preoperative truncal valve regurgitation remains a risk factor for overall mortality. The long-term outcomes warrant further follow-up. PMID:26752522

  16. Outcomes of Surgical Repair for Persistent Truncus Arteriosus from Neonates to Adults: A Single Center's Experience.

    Directory of Open Access Journals (Sweden)

    Qiuming Chen

    Full Text Available This study aimed to report our experiences with surgical repair in patients of all ages with persistent truncus arteriosus.From July 2004 to July 2014, 50 consecutive patients with persistent truncus arteriosus who underwent anatomical repair were included in the retrospective review. Median follow-up time was 3.4 years (range, 3 months to 10 years.Fifty patients underwent anatomical repair at a median age of 19.6 months (range, 20 days to 19.1 years. Thirty patients (60% were older than one year. The preoperative pulmonary vascular resistance and mean pulmonary artery pressure were 4.1±2.1 (range, 0.1 to 8.9 units.m2 and 64.3±17.9 (range, 38 to 101 mmHg, respectively. Significant truncal valve regurgitation was presented in 14 (28% patients. Hospital death occurred in 3 patients, two due to pulmonary hypertensive crisis and the other due to pneumonia. Three late deaths occurred at 3, 4 and 11 months after surgery. The actuarial survival rates were 87.7% and 87.7% at 1 year and 5 years, respectively. Multivariate analysis identified significant preoperative truncal valve regurgitation was a risk factor for overall mortality (odds ratio, 7.584; 95%CI: 1.335-43.092; p = 0.022. Two patients required reoperation of truncal valve replacement. One patient underwent reintervention for conduit replacement. Freedom from reoperation at 5 years was 92.9%. At latest examination, there was one patient with moderate-to-severe truncal valve regurgitation and four with moderate. Three patients had residual pulmonary artery hypertension. All survivors were in New York Heart Association class I-II.Complete repair of persistent truncus arteriosus can be achieved with a relatively low mortality and acceptable early- and mid-term results, even in cases with late presentation. Significant preoperative truncal valve regurgitation remains a risk factor for overall mortality. The long-term outcomes warrant further follow-up.

  17. [Post-transplant lymphoproliferative disease in liver transplant recipients--Merkur University Hospital single center experience].

    Science.gov (United States)

    Filipec-Kanizaj, Tajana; Budimir, Jelena; Colić-Cvrlje, Vesna; Kardum-Skelin, Ika; Sustercić, Dunja; Naumovski-Mihalić, Slavica; Mrzljak, Anna; Kolonić, Slobodanka Ostojić; Sobocan, Nikola; Bradić, Tihomir; Dolić, Zrinka Misetić; Kocman, Branislav; Katicić, Miroslava; Zidovec-Lepej, Snjezana; Vince, Adriana

    2011-09-01

    favoring the diagnosis. The management of PTLD poses a major therapeutic challenge and although there is reasonable agreement about the overall principles of treatment, there is still considerable controversy about the optimal treatment of individual patients. EBV-related PTLDs are a significant cause of mortality in patients undergoing orthotopic liver transplantation with the observed mortality rate of up to 50%. This paper presents the experience acquired at Merkur University Hospital in the diagnosis and treatment of patients with liver transplantation and PTLD. PMID:23126028

  18. Extracorporeal membrane oxygenation during double-lung transplantation: single center experience

    Institute of Scientific and Technical Information of China (English)

    XU Ling-feng; LI Xin; GUO Zhen; XU Mei-yin; GAO Cheng-xin; ZHU Jin-hong; JI Bing-yang

    2010-01-01

    Background For patients with end-stage lung diseases, lung transplantation is the final therapeutic option. Sequential double-lung transplantation is recognized as an established procedure to avoid cardiopulmonary bypass (CPB). But some of the sequential double-lung transplantations require CPB support during the surgical procedure for various reasons. However, conventional CPB may increase the risk of bleeding and early allograft dysfunction. Extracorporeal membrane oxygenation (ECMO) is more advantageous than conventional CPB during the perioperative period of transplantation. Replacing traditional CPB with ECMO is promising for those patients needing cardiopulmonary support during a sequential double-lung transplantation procedure. This study aimed to summarize the preliminary experience of ECMO practice in lung transplantation.Methods Between November 2002 and October 2008, twelve patients with end-stage lung diseases undergoing sequential double-lung transplantation were subjected to ECMO during the surgical procedure. Eleven patients were prepared were prepared for the procedure via transverse thoracostomy (clamshell) and cannulated through the ascending aorta and right atrium for ECMO. The first patient who underwent bilateral thoracotomy for bilateral sequential lung transplantation required emergency ECMO via the femoral artery and vein during the second lung implantation. The Medtronic centrifugal pump and ECMO package (CB1V97R1, Medtronic, Inc., USA) were used for all of the patients.Results During ECMO,the blood flow rate was set between 1.88-2.0 L·m~(-2)·min~(-1) to keep hemodynamic and oxyhgen saturation stable; colloid oncotic pressure was maintained at more than 18 mmHg with albumin and hematocrit (HCT) kept at 28% or more. Two patients died early in this series and the other 10 patients were weaned from ECMO successfully. The duration of ECMO was 1.38-67.00 hours, and postoperative intubation was 10.5-67.0 hours.Conclusions As an established

  19. Single-center experience in pediatric renal transplantation using thymoglobulin induction and steroid minimization.

    Science.gov (United States)

    Warejko, Jillian K; Hmiel, S Paul

    2014-12-01

    Our center has offered thymoglobulin induction with steroid minimization to our pediatric renal transplant patients for the last 10 yr. Steroid minimization or avoidance has shown favorable results in survival, kidney function, and growth in previous studies of pediatric patients. We report our experience with this protocol over the past 10 yr with respect to patient/graft survival, acute rejection episodes, renal function, linear growth, bone density, cardiovascular risk factors, and opportunistic infections. A retrospective chart review was performed for pediatric renal transplant patients on the steroid-minimized protocol between January 2002 and December 2011 on an intention to treat basis. Patient demographics, height, weight, serum creatinine, iGFR, biopsies, and survival data were collected. Height and weight z-scores were calculated with EpiInfo 7, using the CDC 2000 growth charts. Survival was calculated using Kaplan-Meier analysis. eGFR was calculated using the original and modified Schwartz equations. Forty-four pediatric patients were identified, aged 13 months to 19 yr. Five-yr survival was 95.5% for males and 94.4% for females. Only five patients had biopsy-proven ACR, two of which were at more than 12 months post-transplantation. Height delta z-scores from transplant to one, three, and five yr were 0.34, 0.38, and 0.79, respectively. Weight delta z-scores from transplant to one, three, and five yr were 0.87, 0.79, and 0.84, respectively. Mean original Schwartz eGFR was 84.3 ± 15.8 mL/min/1.73 m(2) , modified Schwartz eGFR was 59.3 ± 11.5 mL/min/1.73 m(2) , and iGFR was 64.2 ± 8.5 mL/min/1.73 m(2) at three yr. Of 18 subjects who had a bone density exam, none had a z-score less than -2 on DEXA exam at one-yr post-transplantation. Fifty-one percent of patients were on antihypertensives at the time of transplant compared with 43% at one-yr post-transplantation. Three yr post-transplantation, the average LDL was <100 mg/dL, and

  20. Technical and clinical success of infrarenal endovascular abdominal aortic aneurysm repair: A 10-year single-center experience

    Energy Technology Data Exchange (ETDEWEB)

    Steingruber, I.E. [Department of Radiology, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria)]. E-mail: iris.steingruber@uibk.ac.at; Neuhauser, B. [Department of Vascular Surgery, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Seiler, R. [Department of Vascular Surgery, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Greiner, A. [Department of Vascular Surgery, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Chemelli, A. [Department of Radiology, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Kopf, H. [Department of Radiology, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Walch, C. [Department of Radiology, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Waldenberger, P. [Department of Radiology, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Jaschke, W. [Department of Radiology, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Czermak, B. [Department of Radiology, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria)

    2006-09-15

    Objective: The aim of our retrospective study was to review our single-center experience with aortic abdominal aneurysm (AAA) repair retrospectively. Material and methods: From 1995 to 2005, 70 consecutive patients affected by AAA were treated by endovascular stent-graft repair. Mean follow-up was 23.9 months. Follow-up investigations were performed at 6 and 12 months and yearly thereafter. Five different stent-graft designs were compared to each other. Primary technical success (PTS), assisted primary technical success (APTS), primary clinical success (PCS) and secondary clinical success (SCS) were evaluated. Results: All over PTS was achieved in 94.3%, APTS in 97.1%, PCS in 61.4%, APCS in 64.3% and SCS in 70%. There were 3 type I endoleaks, 25 type II endoleaks, 4 type III endoleaks, 8 limb problems, 5 conversions to open surgery, 10 aneurysm sac expansions and 14 device migrations. Patients with newer generation devices showed better results than patients with first generation prosthesis. In addition results were better for grafts with suprarenal fixation (versus infrarenal fixation) and grafts with barbs and hooks (versus grafts without barbs and hooks). Patients with bad anatomic preconditions showed a higher complication rate. Conclusion: Contrary to first generation products, new stent-graft designs show acceptable technical and clinical results in endovascular AAA aneurysm repair. However, this therapy still should be reserved only for patients with significant comorbities and suitable anatomic conditions.

  1. Acute Renal Replacement Therapy in Children with Diarrhea-Associated Hemolytic Uremic Syndrome: A Single Center 16 Years of Experience

    Directory of Open Access Journals (Sweden)

    Silviu Grisaru

    2011-01-01

    Full Text Available Acute kidney injury (AKI is becoming more prevalent among hospitalized children, its etiologies are shifting, and new treatment modalities are evolving; however, diarrhea-associated hemolytic uremic syndrome (D+HUS remains the most common primary disease causing AKI in young children. Little has been published about acute renal replacement therapy (ARRT and its challenges in this population. We describe our single center's experience managing 134 pediatric patients with D+HUS out of whom 58 (43% required ARRT over the past 16 years. In our cohort, all but one patient were started on peritoneal dialysis (PD. Most patients, 47 (81%, received acute PD on a pediatric inpatient ward. The most common recorded complications in our cohort were peritoneal fluid leaks 13 (22%, peritonitis 11 (20%, and catheter malfunction 5 (9%. Nine patients (16% needed surgical revision of their PD catheters. There were no bleeding events related to PD despite a mean platelets count of 40.9 (±23.5 × 103/mm3 and rare use of platelets infusions. Despite its methodological limitations, this paper adds to the limited body of evidence supporting the use of acute PD as the primary ARRT modality in children with D+HUS.

  2. Image-guided cryoablation for the treatment of painful musculoskeletal metastatic disease: a single-center experience

    Energy Technology Data Exchange (ETDEWEB)

    Prologo, J.D. [Emory University Hospital, Department of Radiology and Imaging Sciences, Division of Interventional Radiology and Image-Guided Medicine, Atlanta, GA (United States); Passalacqua, Matthew; Patel, Indravadan; Bohnert, Nathan [University Hospitals Case Medical Center, Department of Radiology, Cleveland, OH (United States); Corn, David J. [University Hospitals Case Medical Center, Departments of Radiology and Biomedical Engineering, Cleveland, OH (United States)

    2014-11-15

    The role of image-guided thermal ablation techniques for the nonoperative local management of painful osseous metastatic disease has expanded during recent years, and several advantages of cryoablation in this setting have emerged. The purpose of this study is to retrospectively evaluate and report a single-center experience of CT-guided percutaneous cryoablation in the setting of painful musculoskeletal metastatic disease. This study was approved by the institutional review board and is compliant with the Health Insurance Portability and Accountability Act. Electronic medical records of all patients who underwent percutaneous image-guided palliative cryoablation at our institution were reviewed (n = 61). An intent-to-treat analysis was performed. Records were reviewed for demographic data and anatomical data, primary tumor type, procedure details, and outcome - including change in analgesic requirements (expressed as morphine equivalent dosages), pain scores (utilizing the clinically implemented visual analog scale), subsequent therapies (including radiation and/or surgery), and complications during the 24 h following the procedure and at 3 months. Patients were excluded (n = 7) if data were not retrospectively identifiable at the defined time points. Fifty-four tumors were ablated in 50 patients. There were statistically significant decreases in the median VAS score and narcotic usage at both 24 h and 3 months (p < 0.000). Six patients (11 %) incurred complications related to their therapy. Two patients had no relief at 24 h, of which both reported worsened pain at 3 months. One patient had initial relief but symptom recurrence at 3 months. Four patients went on to have radiation therapy of the ablation site at some point following the procedure. CT-guided cryoablation is a safe, effective, reproducible procedural option for the nonoperative local treatment of painful musculoskeletal metastatic disease. (orig.)

  3. The impact of interventional nephrologists on the growth of a peritoneal dialysis program: Long-term, single-center experience.

    Science.gov (United States)

    Ros-Ruiz, Silvia; Alonso-Esteve, Ángela; Gutiérrez-Vílchez, Elena; Rudas-Bermúdez, Edisson; Hernández, Domingo

    2016-01-01

    Peritoneal dialysis (PD) is an underutilized form of renal replacement therapy. Although a variety of factors have been deemed responsible, timely insertion of a PD catheter may also be a contributory factor. Furthermore, a good catheter implantation technique is important to allow for effective peritoneal access function and long-term technique survival. Studies regarding results obtained by nephrologists in comparison with surgeons have been limited to small single-center experiences. Thus, the objective of this study was to explore the impact of the peritoneal dialysis (PD) catheter insertion by nephrologists compared to surgeons on early catheter complications and on technique survival. We also examine whether PD catheter insertion by nephrologists has a positive impact on the growth in the number of patients using PD. We performed 313 consecutive procedures: 192 catheter insertions and 121 catheter removal from January 1, 2006 to December 31, 2013. The main reasons for catheter removal were: renal transplantation, 52 (43%) follow of transfer to HD, 48 (40%) and catheter malfunction, 16 (13%). The patients were mostly male (63.4%) with the mean age of 50.8±15.1 years and 23.8 were diabetics. We only observed seven (2.5%) early complications (<4 weeks) associated to peritoneal catheter surgery (3 peritonitis episodes, 2 hemoperitoneum episodes, one complicated hernia and one omental entrapment). There were not significant differences in surgery-related complications in both periods. The penetration ratio of PD after 2006 was 117% higher compared with procedures performing before this date. In conclusions, we have demonstrated a positive impact on the growth of the PD population when catheter insertion is performed by nephrologists with a minimal incidence of complications associated.

  4. The AmBulatory Closure Device Percutaneous Intervention (ABCD-PCI) study: a single-center experience

    OpenAIRE

    Falcone, Adam M.; Bose, Rahul; Stoler, Robert C; Kim, Michael; Laible, Emily; Kang, Lucy; Waters, Kim; Dunkerley, Janet; Choi, James W.

    2011-01-01

    The AmBulatory Closure Device Percutaneous Intervention (ABCD-PCI) study is a multicenter randomized prospective controlled trial evaluating the safety of and patient satisfaction with same-day discharge following ambulatory percutaneous intervention with a closure device. This article reviews the findings from a single center, Baylor Jack and Jane Hamilton Heart and Vascular Hospital, from October 2008 through April 2010, with 23 patients in the same-day discharge group and 21 patients in th...

  5. Leaving the lecture room and learning LCM: - Experiences from Aalborg University after 13 years and 1950 students on LCA and related issues

    DEFF Research Database (Denmark)

    Riisgaard, Henrik

    2003-01-01

    the above with focus on learning processes other than courses. The empirical data stems from 13 years experience of facilitating learning processes and a study of Aalborg University graduates with a professional career based on LCA. Besides ordinary LCA courses, this papers describes the problem...

  6. Carrier Screening for β Thalassemia in Pregnant Indian Women: Experience at a Single Center in Madhya Pradesh.

    Science.gov (United States)

    Baxi, Asha; Manila, Kaushal; Kadhi, Pooja; Heena, Baxi

    2013-06-01

    To study the prevalence of β thalassemia trait in pregnancy in urban population screening for β thalassemia in pregnant women at a single center in Indore (MP) has been conducted for a period of 2 year. Blood samples were tested for complete blood count and hemoglobin electrophoresis. During the 2 year period a total of 1,006 women were screened; 28 women who carried abnormal pattern were detected. The mean gestational age for screening was 13 ± 4 weeks. The prevalence of carriers was 2.78 %. As much as 99 % of pregnant women undergoing screening were willing for prenatal diagnosis if required. The economic burden to the society for treating thalassemic patients is huge. The institution of prevention programs like carrier screening has proven costeffective in populations with a high frequency of carriers. Screening of pregnant women early in pregnancy followed by prenatal diagnosis is acceptable and effective strategy for control of thalassemia in developing countries like India. PMID:24426339

  7. Achievement of Therapeutic Goals with Low-Dose Imiglucerase in Gaucher Disease: A Single-Center Experience

    Directory of Open Access Journals (Sweden)

    Irina Tukan

    2013-01-01

    Full Text Available Gaucher disease, a lysosomal storage disorder, is a multisystem disorder with variable and unpredictable onset and severity. Disease-specific enzyme replacement therapy (ERT has been shown to reverse or ameliorate disease-specific hepatosplenomegaly and anemia and thrombocytopenia. ERT also impacts bone manifestations, including bone crises, bone pain, and appearance of new osteonecrosis, and improves bone mineral density to varying degrees. The objective of this study was to assess achievement of predefined therapeutic goals based on international registry outcomes for Israeli patients with Gaucher disease receiving imiglucerase for four consecutive years on a low-dose regimen followed in a single center. All data were taken from patient files. The therapeutic goals were taken from standards published in the literature for disease-specific clinical parameters. Among 164 patients at baseline, values for spleen and liver volumes, hemoglobin and platelet counts, and Z-scores for lumbar spine and femoral were significantly different from the goal. After four years ERT, there was a significant improvement ( in each of the therapeutic goal parameters from baseline. 15.2% of these patients achieved all hematology-visceral goals. In children, there was achievement of linear growth and puberty. This survey highlights the good overall response in symptomatic patients receiving low-dose ERT with imiglucerase in Israel.

  8. Combined liver-thoracic transplantation: single-center experience with introduction of the 'Liver-first' principle.

    Science.gov (United States)

    Ceulemans, Laurens J; Strypstein, Sébastien; Neyrinck, Arne; Verleden, Stijn; Ruttens, David; Monbaliu, Diethard; De Leyn, Paul; Vanhaecke, Johan; Meyns, Bart; Nevens, Frederik; Verleden, Geert; Van Raemdonck, Dirk; Pirenne, Jacques

    2016-06-01

    Combined liver/thoracic transplantation (cLiThTx) is a complex procedure for end-stage/advanced liver and heart(H)/lung(Lu) disease. To avoid futile use of multiple organs in single recipients, results should be scrutinously analyzed. Single-center cLiThTx (04/2000-12/2015) were reviewed for the following: demographics, indications, surgical technique, complications, rejection, and five-year patient survival. Results are reported as median (range). Fourteen consecutive patients underwent cLiThTx: 3 cLiHTx, 10 cLiLuTx, and 1 cLiHLuTx. Recipient age was 42 years (17-63 years). Most frequent indications were cystic fibrosis (n = 5), hepatopulmonary fibrosis (n = 2), amyloidosis (n = 2), and epithelioid hemangio-endothelioma (n = 2). Thoracic organs were transplanted first, except in three where LiTx preceded LuTx. In the latter, lungs were preserved by normothermic ex vivo lung perfusion. Stenting was performed for stenosis of bile duct (n = 4), hepatic artery (n = 2), and bronchus (n = 2). Abdominal interventions were required for bleeding (n = 3), evisceration (n = 1), and adhesiolysis (n = 1). One liver (cLiLuTx) was lost to hepatic artery thrombosis 3 months post-transplant and successfully retransplanted. One patient (cLiHTx) died 4 months post-transplant (myocardial infarction). Follow-up was 4 years (2 months-16 years). One liver and 5 pulmonary rejections occurred, all mild and reversible. Two patients developed bronchiolitis obliterans, one is clinically well 16 years post-transplant, and the other successfully retransplanted. Estimated 5-year patient survival is 90%. CLiThTx is safe with excellent short-/long-term surgical and immunological results.

  9. Safety of atrial fibrillation ablation with novel multi-electrode array catheters on uninterrupted anticoagulation-a single-center experience.

    LENUS (Irish Health Repository)

    Hayes, Christopher Ruslan

    2012-02-01

    INTRODUCTION: A recent single-center report indicated that the performance of atrial fibrillation ablation in patients on uninterrupted warfarin using a conventional deflectable tip electrode ablation catheter may be as safe as periprocedural discontinuation of warfarin and bridging with heparin. Novel multi-electrode array catheters for atrial fibrillation ablation are currently undergoing clinical evaluation. While offering the possibility of more rapid atrial fibrillation ablation, they are stiffer and necessitate the deployment of larger deflectable transseptal sheaths, and it remains to be determined if they increase the risk of cardiac perforation and vascular injury. Such potential risks would have implications for a strategy of uninterrupted periprocedural anticoagulation. METHOD AND RESULTS: We audited the safety outcomes of our atrial fibrillation ablation procedures using multi-electrode array ablation catheters in patients on uninterrupted warfarin (CHADS2 score>or=2) and in patients not on warfarin (uninterrupted aspirin). Two bleeding complications occurred in 49 patients on uninterrupted warfarin, both of which were managed successfully without longterm sequelae, and no bleeding complication occurred in 32 patients not on warfarin (uninterrupted aspirin). There were no thromboembolic events or other complication with either anticoagulant regimen. CONCLUSION: Despite the larger diameter and increased stiffness of multi-electrode array catheters and their deflectable transseptal sheaths, their use for catheter ablation in patients with atrial fibrillation on uninterrupted warfarin in this single-center experience does not appear to be unsafe, and thus, an adequately powered multicenter prospective randomized controlled trial should be considered.

  10. The concept of negative pressure wound therapy (NPWT after poststernotomy mediastinitis – a single center experience with 54 patients

    Directory of Open Access Journals (Sweden)

    Vogt Peter M

    2009-01-01

    Full Text Available Abstract Deep sternal infections, also known as poststernotomy mediastinitis, are a rare but often fatal complication in cardiac surgery. They are a cause of increased morbidity and mortality and have a significant socioeconomic aspect concerning the health system. Negative pressure wound therapy (NPWT followed by muscular pectoralis plasty is a quite new technique for the treatment of mediastinitis after sternotomy. Although it could be demonstrated that this technique is at least as safe and reliable as other techniques for the therapy of deep sternal infections, complications are not absent. We report about our experiences and complications using this therapy in a set of 54 patients out of 3668 patients undergoing cardiac surgery in our institution between January 2005 and April 2007.

  11. Experience of limited pancreatic head resection for management of branch duct intraductal papillary mucinous neoplasm in a single center

    Institute of Scientific and Technical Information of China (English)

    Kwang Yeol Paik; Seong Ho Choi

    2009-01-01

    AIM: To share our surgical experience and the outcome of limited pancreatic head resection for the management of branch duct intraductal papillary mucinous neoplasm (IPMN). METHODS: Between May 2005 and February 2008, nine limited pancreatic head resections (LPHR) were performed for IPMN of the pancreatic head. We reviewed the nine patients, retrospectively. RESULTS: Tumor was located in the uncinate process of the pancreas in all nine patients. Three patients had stents inserted in the main pancreatic duct due to injury. The mean size of tumor was 28.4 mm. Postoperative complications were found in five patients: 3 pancreatic leakages, a pancreatitis, and a duodenal stricture. Pancreatic leakages were improved by external drainage. No perioperative mortality was observed and all patients are recorded alive during the mean follow-up period of 17.2 mo. CONCLUSION: In selected patients after careful evaluation, LPHR can be used for the treatment of branch duct type IPMN. In order to avoid pancreatic ductal injury, pre- and intra-operative definite localization and careful operative techniques are required.

  12. Epstein–Barr Virus in Gastro-Esophageal Adenocarcinomas – Single Center Experiences in the Context of Current Literature

    Science.gov (United States)

    Genitsch, Vera; Novotny, Alexander; Seiler, Christian A.; Kröll, Dino; Walch, Axel; Langer, Rupert

    2015-01-01

    Epstein–Barr virus (EBV)-associated gastric carcinomas (GC) represent a distinct and well-recognized subtype of gastric cancer with a prevalence of around 10% of all GC. In contrast, EBV has not been reported to play a major role in esophageal adenocarcinomas (EAC) and adenocarcinomas of the gastro-esophageal junction (GEJ). We report our experiences on EBV in collections of gastro-esophageal adenocarcinomas from two surgical centers and discuss the current state of research in this field. Tumor samples from 465 primary resected gastro-esophageal adenocarcinomas (118 EAC, 73 GEJ, and 274 GC) were investigated. Presence of EBV was determined by EBV-encoded small RNAs (EBER) in situ hybridization. Results were correlated with pathologic parameters (UICC pTNM category, Her2 status, tumor grading) and survival. EBER positivity was observed in 14 cases. None of the EAC were positive for EBER. In contrast, we observed EBER positivity in 2/73 adenocarcinomas of the GEJ (2.7%) and 12/274 GC (4.4%). These were of intestinal type (seven cases) or unclassifiable (six cases), while only one case was of diffuse type according to the Lauren classification. No association between EBV and pT, pN, or tumor grading was found, neither was there a correlation with clinical outcome. None of the EBER positive cases were Her2 positive. In conclusion, EBV does not seem to play a role in the carcinogenesis of EAC. Moreover, adenocarcinomas of the GEJ show lower rates of EBV positivity compared to GC. Our data only partially correlate with previous reports from the literature. This highlights the need for further research on this distinct entity. Recent reports, however, have identified specific epigenetic and genetic alterations in EBV-associated GC, which might lead to a distinct treatment approach for this specific subtype of GC in the future. PMID:25859432

  13. Preliminary experience in adult-to-adult living donor liver transplantation in a single center in China

    Institute of Scientific and Technical Information of China (English)

    YAN Lunan; CHEN Zheyu; LIU Jiangwen; WU Hong; LI Bo; ZENG Yong; WEN Tianfu; ZHAO Jichun; WANG Wentao; YANG Jiayin; XU Mingqing; MA Yukui

    2007-01-01

    The aim of this paper is to report the authors'experience in performing adult-to-adult living donor liver transplantation (LDLT)by using a modified technique in using grafts of the right lobe of the liver.From January 2002 to September 2006,56 adult patients underwent LDLT using right lobe grafts at the Wlest China Hospital.Sichuan University Medical School,China.All patients underwent a modified operation designed to improve the reconstruction of the right hepatic vein (RHV)and the tributariers of the middle hepatic vein(MHV)by interposing a vessel graft,and by anastomosing the hepatic arteries and bile ducts.There were no severe complications or deaths in all donors.Fifty-two (92.8%) recipients survived the operations.Among the 56 recipients,complications were seen in 15 recipients(26.8%),including hepatic vein stricture(one case),small-for-size syndrome(one case),hepatic artery thrombosis(two cases),intestinal bleeding (one case),bile leakage(two cases),left subphrenic abscess (one case),renal failure(two cases)and pulmonary infection (five cases).Within three months after transplantation,four recipients(7.1 4%)died due to smallfor-size syndrome(one case),renal failure(one case)and multiple organ failure(two cases).All patients underwent direct anastomoses of the RHV and the inferior vena cava (IVC),and in 23 cases,reconstruction of the right inferior hepatic vein was also done.In 24 patients,the reconstruction of the tributaries of the MHV was also done by interposing a vessel graft to provide sufficient venous outflow.Trifurcation of the portal vein was seen in nine cases.Thus,veno-plasty or separate anastomoses were performed.The graft and recipient body weight ratios(GRWR)were between 0.72%and 1.43%,and in three cases it was<0.8%.The graft weight to recipient standard liver volume ratios (GV/SLV) were between 31.86%and 71.68%.among which four cases had<40%.No "small-for-size syndrome"occurred.With modification of the surgical technique,especially in the

  14. O doador marginal: experiência de um centro de transplante de fígado The marginal donor: a single-center experience in orthotopic liver transplantation

    Directory of Open Access Journals (Sweden)

    Olival Cirilo Lucena da Fonseca-Neto

    2008-03-01

    Full Text Available RACIONAL: Desde que o uso de enxertos marginais é solução aceita para escassez de órgãos para transplante, ele tornou-se muito comum em todo mundo e a literatura vem mostrando efetividade desses enxertos no transplante de fígado. OBJETIVO: Apresentar a experiência do Serviço de Transplante Hepático do Hospital Universitário Oswaldo Cruz, em transplante de fígado com o uso de doadores marginais. MÉTODOS: Estudo retrospectivo em 137 transplantes ortotópicos de fígado, usando enxertos marginais entre 1999 e 2006, com acompanhamento mínimo de 180 dias. Os receptores foram classificados de acordo com a função inicial do enxerto no pós-operatório como normal (FN e disfunção primária (DP. RESULTADOS: Não foi observada diferença estatisticamente significante entre os grupos FN e DP com os seguintes parâmetros dos doadores: idade, sódio sérico, tempo de protrombina, esteatose hepática, transaminases sérica, pressão sanguínea, drogas vasoativas, índice de massa corpórea, parada cardíaca antes da doação de órgão, doador em assistolia e tempo de isquemia quente. Análise da curva de sobrevida (Kaplan-Meier de pacientes e de enxertos de fígado de pacientes que receberam fígado de doadores ideais versus doadores marginais não mostrou diferença com significância estatística. CONCLUSÃO: Pode ser recomendado o uso de enxertos marginais para transplantes hepáticos, inclusive os provenientes de doadores com o coração parado.BACKGROUND: Since marginal grafts are a solution to deal with the shortage of organ donors, its use became more common worldwide, and the literature had shown its effectiveness in the liver transplantation (LT outcomes. AIM: To present a single center experience, at the Liver Transplantation Unit of Oswaldo Cruz University Hospital, with orthotopic LT using marginal organ donors. METHODS: Retrospectivety review of 137 orthotopic LT using marginal grafts between 1999 and 2006, with a minimum 180

  15. The Place of Computed Tomography as a Guidance Modality in Percutaneous Nephrostomy: Analysis of a 10-Year Single-Center Experience

    Energy Technology Data Exchange (ETDEWEB)

    Egilmez, H.; Oztoprak, I.; Atalar, M.; Cetin, A.; Gumus, C.; Gultekin, Y.; Bulut, S.; Arslan, M.; Solak, O. [Depts. of Radiology, Obstetrics and Gynecology, and Urology, Cumhuriyet Univ. School of Medicine, Sivas (Turkey)

    2007-09-15

    Background: Percutaneous nephrostomy (PCN) has been established as an effective technique for urinary decompression or diversion. This procedure may be performed with the guidance of fluoroscopy, ultrasonography, a combination of fluoroscopy and ultrasonography, computed tomography (CT), or magnetic resonance imaging. Purpose: To retrospectively review experience with CT-guided PCN over a 10-year period in a single center. Material and Methods: All CT-guided PCN procedures performed in adults at our institution between 1995 and 2005 were evaluated. In 882 patients, 1113 nephrostomy catheters were inserted. Interventional radiologists or radiology residents under direct attending supervision inserted all catheters. During the PCN procedure, bleeding, sepsis, and injuries to adjacent organs were regarded as major complications. Clinical events requiring nominal therapy with no sequelae were regarded as minor complications. Results: PCN procedures were performed via 1-3 punctures in patients with grades 0-1 and 2 hydronephrosis, and via 1-2 punctures in patients with grade 3 hydronephrosis. They were carried out with a procedure time ranging from 9 to 26 min. All PCNs were considered as technically successful, and no major complications were observed. There were minor complications including transient macroscopic hematuria (28.6%, 19.9%, and 4.9% in patients with hydronephrosis grades 0-1, 2, and 3, respectively) and perirenal hematomas in a total of eight patients. No patient required additional intervention secondary to complications of the PCN procedure. Conclusion: CT-guided PCN is an efficient and safe procedure with major and minor complication rates below the accepted thresholds. It can be used for the management of patients requiring nephrostomy insertion in inpatient settings, and might be a preferable procedure in patients with minimal or no dilatation of the renal pelvis. Keywords: Computed tomography; percutaneous nephrostomy; urinary obstruction.

  16. Single-Center Experience and 1-Year Follow-up Results of 'Sandwich Technique' in the Management of Common Iliac Artery Aneurysms During EVAR

    Energy Technology Data Exchange (ETDEWEB)

    Ricci, Carmelo; Ceccherini, Claudio, E-mail: claudiocec@hotmail.it; Cini, Marco; Vigni, Francesco; Leonini, Sara [Policlinico Santa Maria alle Scotte, Azienda Ospedaliera Universitaria Senese, Radiologia Interventistica (Italy); Tommasino, Giulio; Muzzi, Luigi; Tucci, Enrico; Benvenuti, Antonio; Neri, Eugenio [Policlinico Santa Maria alle Scotte, Azienda Ospedaliera Universitaria Senese, Chirurgia del Cuore e dei grossi vasi (Italy)

    2012-10-15

    Purpose: Abdominal aortic aneurysm (AAA) accompanied by common iliac artery (CIA) aneurysms requires a more demanding procedure owing to the difficulties in obtaining an adequate distal landing zone for the stent-graft limb(s), a potential site of endoleak. The 'sandwich technique' is a procedure to increase EVAR feasibility in the setting of adverse or challenging CIA anatomy. Its main advantages include no restrictions in terms of CIA diameter or length or internal iliac artery (IIA) diameter, no need to wait for a specific stent-graft. Our purpose is to describe our single-center experience and one year follow-up results of this new procedure. Materials and Methods: From April 2009 to June 2010, the sandwich technique was performed in our institution in 7 patients treated for AAA and unilateral CIA aneurysms (n. 5) or bilateral CIA aneurysms (n. 2). Inclusion criteria were the presence of unilateral or bilateral CIA aneurysm (independently from its diameter), IIA artery measuring up to 9 mm in its maximum diameter, not dilatation of IIA and EIA. Results: The mean follow-up length was 15 months (range: 14-20 months). All stent-implanted iliac branches remained patent on 1 year follow-up and IIA flow was preserved. None of the patients had symptoms of pelvic ischemia. CT scan follow-up showed aneurysm shrinkage in five patients, without any sign of endoleaks in all cases. Conclusions: In selected cases, the 'sandwich technique' showed good outcomes confirming to be a safe and easy to perform way to overcome anatomical constraints and expanding the limits of EVAR.

  17. Minimally invasive percutaneous nephrolithotomy: an effective treatment for kidney stones in infants under 1 year of age. A single-center experience.

    Science.gov (United States)

    Dağgülli, Mansur; Sancaktutar, Ahmet Ali; Dede, Onur; Utanğaç, Mehmet Mazhar; Bodakçi, Mehmet Nuri; Penbegül, Necmettin; Hatipoğlu, Namık Kemal; Çakmakçı, Süleyman

    2015-11-01

    We aimed to present the outcomes of PNL surgery performed in infantile patients with small renal stones who were younger than 1 year of age. A single-center prospective trial was initiated and during the period between Jan 2013 and Jan 2015, PNL was applied to 20 renal units of 16 infants (6 girls and 10 boys), including 4 patients with bilateral kidney stones. PNL was performed in patients with renal stones larger than 2 cm, as well as stones resistant to SWL or renal stones that were undetectable during SWL. The mean age of the patients was 9.55 (5-12) months. Of the 20 renal units, 1 had complete staghorn stones, 3 had partial staghorn stones, 13 had renal pelvic stones, and 3 had lower pole stones. The mean stone size was 18.5 mm (range 12-36 mm). Mean operative time for PNL was 88 (25-135 min). Mean fluoroscopy time was estimated as 3.4 min. Mean hemoglobin loss was 0.72 g/L (0.2-3). The mean hospital stay was 4.1 days (2-8 days). On postoperative day 1, a complete stone-free state was achieved in 70% of renal units (14 of 20). At the end of the first postoperative week, the remaining two patients had insignificant residual fragments of 3 mm and were followed conservatively without any specific intervention. Thus, the total SFR was 80% (16 of 20) at discharge. In infants aged less than 1 year, minimal access tract dilation during PNL, the use of smaller caliber pediatric instruments, and the realization of this procedure by surgeons with adequate experience in adults carry utmost importance. In addition, special care should be taken to avoid hypothermia and radiation exposure during PNL.

  18. Minimally invasive percutaneous nephrolithotomy: an effective treatment for kidney stones in infants under 1 year of age. A single-center experience.

    Science.gov (United States)

    Dağgülli, Mansur; Sancaktutar, Ahmet Ali; Dede, Onur; Utanğaç, Mehmet Mazhar; Bodakçi, Mehmet Nuri; Penbegül, Necmettin; Hatipoğlu, Namık Kemal; Çakmakçı, Süleyman

    2015-11-01

    We aimed to present the outcomes of PNL surgery performed in infantile patients with small renal stones who were younger than 1 year of age. A single-center prospective trial was initiated and during the period between Jan 2013 and Jan 2015, PNL was applied to 20 renal units of 16 infants (6 girls and 10 boys), including 4 patients with bilateral kidney stones. PNL was performed in patients with renal stones larger than 2 cm, as well as stones resistant to SWL or renal stones that were undetectable during SWL. The mean age of the patients was 9.55 (5-12) months. Of the 20 renal units, 1 had complete staghorn stones, 3 had partial staghorn stones, 13 had renal pelvic stones, and 3 had lower pole stones. The mean stone size was 18.5 mm (range 12-36 mm). Mean operative time for PNL was 88 (25-135 min). Mean fluoroscopy time was estimated as 3.4 min. Mean hemoglobin loss was 0.72 g/L (0.2-3). The mean hospital stay was 4.1 days (2-8 days). On postoperative day 1, a complete stone-free state was achieved in 70% of renal units (14 of 20). At the end of the first postoperative week, the remaining two patients had insignificant residual fragments of 3 mm and were followed conservatively without any specific intervention. Thus, the total SFR was 80% (16 of 20) at discharge. In infants aged less than 1 year, minimal access tract dilation during PNL, the use of smaller caliber pediatric instruments, and the realization of this procedure by surgeons with adequate experience in adults carry utmost importance. In addition, special care should be taken to avoid hypothermia and radiation exposure during PNL. PMID:26002160

  19. Prognostic Factors for Tumor Recurrence after a 12-Year, Single-Center Experience of Liver Transplantations in Patients with Hepatocellular Carcinoma

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    Matteo Cescon

    2010-01-01

    Full Text Available Background. Factors affecting outcomes after orthotopic liver transplantation (OLT for hepatocellular carcinoma (HCC have been extensively studied, but some of them have only recently been discovered or reassessed. Methods. We analyzed classical and more recently emerging variables with a hypothetical impact on recurrence-free survival (RFS in a single-center series of 283 patients transplanted for HCC between 1997 and 2009. Results. Five-year patient survival and RFS were 75% and 86%, respectively. Thirty-four (12% patients had HCC recurrence. Elevated preoperative alpha-fetoprotein (AFP levels, preoperative treatments of HCC, unfulfilled Milan and up-to-seven criteria at final histology, poor tumor differentiation, and tumor microvascular invasion negatively affected RFS by univariate analysis. Milan and up-to-seven criteria applied preoperatively, and the use of m-TOR inhibitors did not reach statistical significance. Cox's proportional hazard model showed that only elevated AFP levels (Odds Ratio=2.88; 95% C.I.=1.43–5.80; =.003, preoperative tumor treatments (Odds Ratio=4.84; 95% C.I.=1.42–16.42; =.01, and microvascular invasion (Odds Ratio=4.82; 95% C.I.=1.87–12.41; =.001 were predictors of lower RFS. Conclusions. Biological aggressiveness and preoperative tumor treatment, rather than traditional and expanded dimensional criteria, conditioned the outcomes in patients transplanted for HCC.

  20. Experience with the Wujciak-Opelz allocation system in a single center: an increase in HLA-DR mismatching and in early occurring acute rejection episodes.

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    Vereerstraeten, P; Abramowicz, D; De Pauw, L; Kinnaert, P

    1998-01-01

    The present single-center, retrospective study was undertaken to assess the impact of the Wujciak-Opelz allocation system (XCOMB), currently used within Eurotransplant for renal allografts, on the incidence of early occurring rejection episodes (RE). Implementation of the system resulted in an increase of HLA-DR mismatches (MM), while the incidence of HLA-A + B + DR MM remained unchanged. During the 1st post-transplant month, the total number of RE, expressed per patient-months, increased by 64% (0.326 vs 0.199, P = 0.007); when considering only severe and irreversible RE, the increase was 76% (0.158 vs 0.090, P = 0.011). In contrast, from the 2nd to the 12th post-transplant month, the incidence of RE, regardless of severity, was similar before and after implementation of XCOMB. As early occurring RE have detrimental effects on long-term graft outcome, these observations, if confirmed on a larger scale, would justify changes in the allocation algorithm. PMID:9787415

  1. An evaluation of the robustness of organ-at-risk recommendations made by GEC/ESTRO according to interobserver variability: a single-center experience

    Science.gov (United States)

    Celada-Alvarez, Francisco; Roldán, Susana; Torregrosa, Asunción; Betancourt, Jesus; Bautista-Ballesteros, Juan; Farga, Dolores; Ibañez, Blanca; Tormo, Alejandro; Perez-Calatayud, Jose

    2016-01-01

    Purpose Groupe Européen de Curiethérapie (GEC) and European Society for Radiotherapy & Oncology (ESTRO) has proposed a rectal dose constraint of the most exposed 2-cc volume (D2cc of ≤ 75 Gy EQD2α/β = 3) during external-beam plus high-dose-rate brachytherapy (HDR-BT) in localized prostate cancer patients. This study aimed to evaluate D2cc for rectal contouring via interobserver variability. Material and methods Four blinded observers contoured rectums of 5 patients. Rectal contouring anatomical limits were determined through previous consensus. Dose-volume histogram (DVH) dosimetric parameters (D0.1cc, D1cc, and D2cc) were analyzed according to GEC/ESTRO recommendations and subjected to intra- and interobserver comparisons. Latter comparisons involved coefficients of variation. For each parameter, the mean, standard deviation (SD), and range were evaluated. The effect of interobserver variation on total dose was analyzed by estimating the biologically equivalent rectal dose (EQD2α/β = 3). Results Interobserver coefficients of variation for D0.1cc, D1cc, and D2cc were 5.7%, 4.5%, and 4%, respectively. The highest interobserver rectal delineation variation yielded a rectal dose difference up to 5.8 Gy EQD2. Estimated intraobserver variation for the reported D2cc was 5.5% in the worst-case scenario (non-significant). Conclusions We observed acceptable interobserver variability in EQD2 for D2cc, with strong impacts on clinical threshold levels (D2cc ≤ 75 Gy EQD2) in some cases. This small, single-center analysis will be extended in a multicenter study. PMID:27648090

  2. P08.11SURGICAL MANAGEMENT OF BRAIN METASTASES FROM LUNG ADENOCARCINOMA: A SINGLE CENTER EXPERIENCE AND REFLECTIONS ON MULTIPLE LESIONS

    Science.gov (United States)

    Fornaro, R.; Agnoletti, A.; Specchia, F.M. Calamo; Garbossa, D.; Lanotte, M.; Ducati, A.

    2014-01-01

    INTRODUCTION: Metastases are the most common intracerebral tumors, and they're expected to increase in the next years. Prognosis is linked to the progression of systemic and cerebral disease. Among patients in good conditions, removal of the cerebral metastasis represents the first treatment to apply. To evaluate the ideal conditions for surgery and its results we performed this single-center study on patients with solitary and multiple cerebral metastases. MATERIALS AND METHODS: We analyzed patients treated for cerebral metastasis between January 2004 and 2011. We considered only cases with non-small cell lung carcinoma (NSCLC) as primary tumor. We collected mortality and complication rates and analyzed the early outcomes before adjuvant therapy. Finally we used a χ2 test (p = 0.05) to assess if better early outcomes (improved or stable KPS) were significantly related to the presence of solitary VS multiple lesions. RESULTS: Our series included 199 patients; mean survival was 11.08 months. 95 patients harbored a single brain metastasis (Group 1) and 104 had more than one localization (Group 2). 67 patients underwent surgical operation. The mean pre-operative KPS was 75/100 in Group 1 and 65/100 in Group 2. After surgery in Group 1 the score improved in 69% of patients, was unchanged in 20% and worsened in 11%. In Group 2 the post-operative KPS was increased in 66% of cases, unchanged in 17% and worsened in 17% of cases. Statistical analysis did not show significant differences in the rates of good (KPS improved or stable) and poor outcomes in the two groups of operated patients. Patients with lesions in the posterior fossa improved after surgery more than those with supratentorial metastases. DISCUSSION: Observation of an high mortality for not-neurological causes confirms that modern treatments allow a significant control of the disease within the nervous system. Surgery entails the additional advantage of large tissue-samples availability for histological

  3. Radiofrequency Thermoablation of HCC Larger Than 3 cm and Less Than 5 cm Proximal to the Gallbladder without Gallbladder Isolation: A Single Center Experience

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    Antonio Orlacchio

    2014-01-01

    Full Text Available Radiofrequency ablation (RFA is an effective minimally invasive treatment for nonsurgical hepatocellular carcinoma (HCC, but ablation of tumors close to the gallbladder could be associated with several complications. We report our experience on the treatment of HCC close to the gallbladder with RFA. Eight RFA procedures were performed in eight patients with HCC larger than 3 cm and less than 5 cm close to the gallbladder. In all cases, a percutaneous approach was used. There were no major complications. Only in two patients a minimal wall thickening of the gallbladder was observed. Contrast enhanced computed tomography carried out after 30 days from the first procedure showed complete necrosis in seven patients (87%. Only one patient had local recurrence at 11 months of followup. Although limited, our experience suggests that, after careful preprocedural planning, in experienced hands and with appropriate technology, percutaneous RFA could be safely performed even for lesions larger than 3 cm located in close adjacency to the gallbladder.

  4. A Review of and Recommendations for the Management of Patients With Life-Threatening Dabigatran-Associated Hemorrhage: A Single-Center University Hospital Experience.

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    Kumar, Rohit; Smith, Roy E; Henry, Brian L

    2015-12-01

    Dabigatran is an oral direct thrombin inhibitor that is approved for the prevention of stroke and systemic embolism in nonvalvular atrial fibrillation. Dabigatran has several advantages over warfarin including predictable pharmacokinetics and pharmacodynamics which eliminates the need for routine laboratory monitoring, superiority over warfarin in preventing stroke, or systemic embolism without having an increased risk of bleeding. However, as with any anticoagulant, there remains a real chance of bleeding, including major or life-threatening hemorrhage. Many physicians feel comfortable managing bleeding complications on older anticoagulants like warfarin and heparin, due to extensive experience with the medications along with antidotes to reverse their effects as well as established protocols for treating anticoagulant-associated hemorrhage. However, most physicians have limited clinical experience with dabigatran, there is no specific antidote for dabigatran reversal and there is a paucity of protocols, guidelines, and recommendations for how to manage dabigatran-associated hemorrhage. In this review, we present a case series of patients admitted to our institution for management of bleeding while receiving dabigatran. We retrospectively reviewed these cases to evaluate the efficacy and rationale of the various anticoagulation reversal strategies employed in the context of the existing evidence found in the literature. Specific focus is placed on the therapies utilized and the coagulation studies used to manage these patients. PMID:24668159

  5. A Review of and Recommendations for the Management of Patients With Life-Threatening Dabigatran-Associated Hemorrhage: A Single-Center University Hospital Experience.

    Science.gov (United States)

    Kumar, Rohit; Smith, Roy E; Henry, Brian L

    2015-12-01

    Dabigatran is an oral direct thrombin inhibitor that is approved for the prevention of stroke and systemic embolism in nonvalvular atrial fibrillation. Dabigatran has several advantages over warfarin including predictable pharmacokinetics and pharmacodynamics which eliminates the need for routine laboratory monitoring, superiority over warfarin in preventing stroke, or systemic embolism without having an increased risk of bleeding. However, as with any anticoagulant, there remains a real chance of bleeding, including major or life-threatening hemorrhage. Many physicians feel comfortable managing bleeding complications on older anticoagulants like warfarin and heparin, due to extensive experience with the medications along with antidotes to reverse their effects as well as established protocols for treating anticoagulant-associated hemorrhage. However, most physicians have limited clinical experience with dabigatran, there is no specific antidote for dabigatran reversal and there is a paucity of protocols, guidelines, and recommendations for how to manage dabigatran-associated hemorrhage. In this review, we present a case series of patients admitted to our institution for management of bleeding while receiving dabigatran. We retrospectively reviewed these cases to evaluate the efficacy and rationale of the various anticoagulation reversal strategies employed in the context of the existing evidence found in the literature. Specific focus is placed on the therapies utilized and the coagulation studies used to manage these patients.

  6. Simultaneous multi-tear exclusion:an optimal strategy for type B thoracic aortic dissection initially proved by a single center's 8 years experience

    Institute of Scientific and Technical Information of China (English)

    YUAN Liang-xi; BAO Jun-min; ZHAO Zhi-qing; FENG Xiang; OU Le-feng; FENG Rui; LU Qing-sheng; MEI Zhi-jun; JING Zai-ping

    2007-01-01

    Background Endovascular stent-grafting is widely used to treat thoracic aortic dissection.However,little information is available regarding outcome following simultaneous exclusion of multiple tears.This report details eight years of experience using simultaneous multi-tear exclusion for treatment of Stanford type B thoracic aortic dissection resulting in successful aortic remodeling without adverse events.Methods From September 1998 to January 2006,29 type B thoracic aortic dissection patients(24 men,5 women;27 chronic,2 acute;mean age 58 years,range 45-77 years)were treated by simultaneous multi-tear exclusion in our center.Magnetic resonance angiography was used as the preoperative evaluation method.Different kinds of stent-grafts were used.The patients were followed up with contrast-enhanced spiral computed tomography at 6 months postoperatively and yearly thereafter.Results Twenty-nine surgeries were completed successfully using at least 2 stent-grafts per patient(range:2-6,mean:2.7).No major procedure-related complications,such as rupture,paraplegia,aortic branch ischemia or cerebral infarction,were observed.During follow-up,favorable remodeling of the aorta was observed.Conclusions The mid-term result of thoracic aortic dissection with simultaneous multi-tear exclusion was satisfactory.With the improvement of stent-grafts,simultaneous multi-tear exclusion should find wider application and become an optimal strategy for thoracic aortic dissection.

  7. Long-term outcomes of liver transplant patients with human immunodeficiency virus infection and end-stage-liver-disease: single center experience

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    Vernadakis S

    2011-08-01

    Full Text Available Abstract Objective Orthotopic-liver-transplantation (OLT in patients with Human-Immunodeficiency-Virus infection (HIV and end-stage-liver-disease (ESDL is rarely reported. The purpose of this study is to describe our institutional experience on OLT for HIV positive patients. Material and methods This is a retrospective study of all HIV-infected patients who underwent OLT at the University Hospital of Essen, from January 1996 to December 2009. Age, sex, HIV transmission-way, CDC-stage, etiology of ESDL, concomitant liver disease, last CD4cell count and HIV-viral load prior to OLT were collected and analysed. Standard calcineurin-inhibitors-based immunosuppression was applied. All patients received anti-fungal and anti-pneumocystis carinii pneumonia prophylaxis post-OLT. Results Eight transplanted HIV-infected patients with a median age of 46 years (range 35-61 years were included. OLT indications were HCV (n = 5, HBV (n = 2, HCV/HBV/HDV-related cirrhosis (n = 1 and acute liver-failure (n = 1. At OLT, CD4 cell-counts ranged from 113-621 cells/μl, and HIV viral-loads from Conclusions OLT in HIV-infected patients and ESLD is an acceptable therapeutic option in selected patients. Long-term survival can be achieved without HIV disease-progression under antiretroviral therapy and management of the viral hepatitis co-infection.

  8. Predictive Parameters of CyberKnife Fiducial-less (XSight Lung) Applicability for Treatment of Early Non-Small Cell Lung Cancer: A Single-Center Experience

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    Bahig, Houda; Campeau, Marie-Pierre; Vu, Toni; Doucet, Robert; Béliveau Nadeau, Dominic [Radiation Oncology Department, Centre Hospitalier de l' Université de Montréal, Montréal, Quebec (Canada); Fortin, Bernard [Radiation Oncology Department, Maisonneuve-Rosemont Hospital, Montréal, Quebec (Canada); Roberge, David; Lambert, Louise; Carrier, Jean-François [Radiation Oncology Department, Centre Hospitalier de l' Université de Montréal, Montréal, Quebec (Canada); Filion, Edith, E-mail: edith.filion.chum@ssss.gouv.qc.ca [Radiation Oncology Department, Centre Hospitalier de l' Université de Montréal, Montréal, Quebec (Canada)

    2013-11-01

    Purpose: To determine which parameters allow for CyberKnife fiducial-less tumor tracking in stereotactic body radiation therapy (SBRT) for early-stage non-small cell lung cancer. Methods and Materials: A total of 133 lung SBRT patients were preselected for direct soft-tissue tracking based on manufacturer recommendations (peripherally located tumors ≥1.5 cm with a dense appearance) and staff experience. Patients underwent a tumor visualization test to verify adequate detection by the tracking system (orthogonal radiographs). An analysis of potential predictors of successful tumor tracking was conducted looking at: tumor stage, size, histology, tumor projection on the vertebral column or mediastinum, distance to the diaphragm, lung-to-soft tissue ratio, and patient body mass index. Results: Tumor visualization was satisfactory for 88 patients (66%) and unsatisfactory for 45 patients (34%). Median time to treatment start was 6 days in the success group (range, 2-18 days) and 15 days (range, 3-63 days) in the failure group. A stage T2 (P=.04), larger tumor size (volume of 15.3 cm{sup 3} vs 6.5 cm{sup 3} in success and failure group, respectively) (P<.0001), and higher tumor density (0.86 g/cm{sup 3} vs 0.79 g/cm{sup 3}) were predictive of adequate detection. There was a 63% decrease in failure risk with every 1-cm increase in maximum tumor dimension (relative risk for failure = 0.37, CI=0.23-0.60, P=.001). A diameter of 3.6 cm predicted a success probability of 80%. Histology, lung-to-soft tissue ratio, distance to diaphragm, patient's body mass index, and tumor projection on vertebral column and mediastinum were not found to be predictive of success. Conclusions: Tumor size, volume, and density were the most predictive factors of a successful XSight Lung tumor tracking. Tumors >3.5 cm have ≥80% chance of being adequately visualized and therefore should all be considered for direct tumor tracking.

  9. Intracranial pressure monitoring in pediatric and adult patients with hydrocephalus and tentative shunt failure: a single-center experience over 10 years in 146 patients.

    Science.gov (United States)

    Sæhle, Terje; Eide, Per Kristian

    2015-05-01

    OBJECT In patients with hydrocephalus and shunts, lasting symptoms such as headache and dizziness may be indicative of shunt failure, which may necessitate shunt revision. In cases of doubt, the authors monitor intracranial pressure (ICP) to determine the presence of over- or underdrainage of CSF to tailor management. In this study, the authors reviewed their experience of ICP monitoring in shunt failure. The aims of the study were to identify the complications and impact of ICP monitoring, as well as to determine the mean ICP and characteristics of the cardiac-induced ICP waves in pediatric versus adult over- and underdrainage. METHODS The study population included all pediatric and adult patients with hydrocephalus and shunts undergoing diagnostic ICP monitoring for tentative shunt failure during the 10-year period from 2002 to 2011. The patients were allocated into 3 groups depending on how they were managed following ICP monitoring: no drainage failure, overdrainage, or underdrainage. While patients with no drainage failure were managed conservatively without further actions, over- or underdrainage cases were managed with shunt revision or shunt valve adjustment. The ICP and ICP wave scores were determined from the continuous ICP waveforms. RESULTS The study population included 71 pediatric and 75 adult patients. There were no major complications related to ICP monitoring, but 1 patient was treated for a postoperative superficial wound infection and another experienced a minor bleed at the tip of the ICP sensor. Following ICP monitoring, shunt revision was performed in 74 (51%) of 146 patients, while valve adjustment was conducted in 17 (12%) and conservative measures without any actions in 55 (38%). Overdrainage was characterized by a higher percentage of episodes with negative mean ICP less than -5 to -10 mm Hg. The ICP wave scores, in particular the mean ICP wave amplitude (MWA), best differentiated underdrainage. Neither mean ICP nor MWA levels showed any

  10. Patient experiences with self-monitoring renal function after renal transplantation: results from a single-center prospective pilot study

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    van Lint CL

    2015-12-01

    Full Text Available Céline L van Lint,1 Paul JM van der Boog,1 Wenxin Wang,2,3 Willem-Paul Brinkman,2 Ton JM Rövekamp,3 Mark A Neerincx,2 Ton J Rabelink,1 Sandra van Dijk1,4 1Department of Nephrology, Leiden University Medical Centre (LUMC, Leiden, 2Faculty of Electrical Engineering, Mathematics and Computer Science, Delft University of Technology, Delft, 3Department of Technology in Healthcare, Prevention and Health, Dutch Organization for Applied Scientific Research (TNO, Leiden, 4Department of Health, Medical and Neuropsychology, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, the Netherlands Background: After a kidney transplantation, patients have to visit the hospital often to monitor for early signs of graft rejection. Self-monitoring of creatinine in addition to blood pressure at home could alleviate the burden of frequent outpatient visits, but only if patients are willing to self-monitor and if they adhere to the self-monitoring measurement regimen. A prospective pilot study was conducted to assess patients’ experiences and satisfaction.Materials and methods: For 3 months after transplantation, 30 patients registered self-measured creatinine and blood pressure values in an online record to which their physician had access to. Patients completed a questionnaire at baseline and follow-up to assess satisfaction, attitude, self-efficacy regarding self-monitoring, worries, and physician support. Adherence was studied by comparing the number of registered with the number of requested measurements.Results: Patients were highly motivated to self-monitor kidney function, and reported high levels of general satisfaction. Level of satisfaction was positively related to perceived support from physicians (P<0.01, level of self-efficacy (P<0.01, and amount of trust in the accuracy of the creatinine meter (P<0.01. The use of both the creatinine and blood pressure meter was considered pleasant and useful, despite the level of trust in the

  11. Accuracy of magnetic resonance cholangiography compared to operative endoscopy in detecting biliary stones, a single center experience and review of literature

    Institute of Scientific and Technical Information of China (English)

    Francesco; A; Polistina; Mauro; Frego; Marco; Bisello; Emy; Manzi; Antonella; Vardanega; Bortolo; Perin

    2015-01-01

    AIM: To compare diagnostic sensitivity, specificity and accuracy of magnetic resonance cholangiopancreatography(MRCP) without contrast medium and endoscopic ultrasound(EUS)/endoscopic retrograde cholangiopancreatography(ERCP) for biliary calculi. METHODS: From January 2012 to December 2013, two-hundred-sixty-three patients underwent MRCP at our institution, all MRCP procedure were performed with the same machinery. In two-hundred MRCP was done for pure hepatobiliary symptoms and these patients are the subjects of this study. Among these two-hundred patients, one-hundred-eleven(55.5%) underwent ERCP after MRCP. The retrospective study design consisted in the systematic revision of all images from MRCP and EUS/ERCP performed by two radiologist with a long experience in biliary imaging, an experienced endoscopist and a senior consultant in Hepatobiliopancreatic surgery. A false positive was defined an MRCP showing calculi with no findings at EUS/ERCP; a true positive was defined as a concordance between MRCP and EUS/ERCP findings; a false negative was defined as the absence of images suggesting calculi at MRCP with calculi localization/extraction at EUS/ERCP and a true negative was defined as a patient with nocalculi at MRCP ad at least 6 mo of asymptomatic followup. Biliary tree dilatation was defined as a common bile duct diameter larger than 6 mm in a patient who had an in situ gallbladder. A third blinded radiologist who examined the MRCP and ERCP data reviewed misdiagnosed cases. Once obtained overall data on sensitivity, specificity, accuracy, positive predictive value(PPV) and negative predictive value(NPV) we divided patients in two groups composed of those having concordant MRCP and EUS/ERCP(Group A, 72 patients) and those having discordant MRCP and EUS/ERCP(Group B, 20 patients). Dataset comparisons had been made by the Student’s t-test and χ2 when appropriate.RESULTS: Two-hundred patients(91 men, 109 women, mean age 67.6 years, and range 25-98 years

  12. Neonatal gastric perforation: A single center experience

    Institute of Scientific and Technical Information of China (English)

    Jeik; Byun; Hyun; Young; Kim; Seung; Yeon; Noh; Soo; Hong; Kim; Sung; Eun; Jung; Seong; Cheol; Lee; Kwi; Won; Park

    2014-01-01

    AIM: To determine the etiology and prognostic factors for neonatal gastric perforation(NGP), a rare but life-threatening disease.METHODS: Between 1980 and 2011, nine patients un-derwent surgical intervention for NGP at Seoul National University Children’s Hospital. The characteristics and prognosis of the patients were retrospectively analyzed.RESULTS: Among the nine patients, three(33.3%) were preterm babies and five(55.5%) had associated anomalies, which included diaphragmatic eventration(n = 2), congenital diaphragmatic hernia, esophageal atresia with tracheoesophageal fistula, and antral web. Three(33.3%) patients were born before 1990 and three(33.3%) had a birth weight < 2500 g. Pneumo-peritoneum was found on preoperative images in six(66.7%) patients, and incidentally in the other three(33.3%) patients. Surgery was performed within 24 h after the onset of symptoms in seven(77.8%) patients. The overall mortality rate was 22.2%(2/9). The time between symptoms and surgical intervention was the only prognostic factor for survival, whereas premature birth and birth weight were not.CONCLUSION: Early detection and advances in neo-natal intensive care may improve the prognosis of NGP.

  13. Transplant nephrectomy - A single-center experience

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    Arun Ariyarathenam

    2015-01-01

    Full Text Available Transplant nephrectomy (TN is associated with significant morbidity and mortality and influences the outcome of subsequent renal transplantation. The aim of this study was to identify the reasons for TN in a single transplant center in the United Kingdom and to determine the complication rate, effect on relisting and re-transplantation. We studied all the TNs in our center from January 2000 to December 2011. Detailed information including cause of allograft failure and reason for TN were analyzed. Of 602 renal transplants performed at our center during the period of the study, 42 TNs were performed on 38 (6% patients (24 men and 14 women. The median age of the patients at the time of transplantation who subsequently underwent TN was 56 years (range: 28-73 years and 71% of the allografts were donated after circulatory death. The mean human leucocyte antigen mismatch for these patients was 2.3. The most commonly used immunosuppression was a combination of prednisolone, mycophenolate and tacrolimus, which was used in 50% of the patients. Twenty-five (60% of the TNs in this series were for allografts failing during the first month of transplantation. The most common indication for the TN was graft thrombosis (50%, with an overall in-hospital mortality rate of 9.5% and a morbidity rate of 31%. Seven of 19 patients listed underwent successful re-transplantation. Although TN is associated with a risk of significant morbidity and mortality, it does not preclude from listing for re-transplantation. The difficulty of access to complete information about transplant failures and TN highlights the need for a national registry.

  14. Ambulatory laparoscopic cholecystectomy: A single center experience

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    Cagri Tiryaki

    2016-01-01

    Full Text Available Aim: To evaluate the demographic and clinical parameters affecting the outcomes of ambulatory laparoscopic cholecystectomy (ALC in terms of pain, nausea, anxiety level, and satisfaction of patients in a tertiary health center. Materials and Methods: ALC was offered to 60 patients who met the inclusion criteria. Follow-up (questioning for postoperative pain or discomfort, nausea or vomiting, overall satisfaction was done by telephone contact on the same day at 22:00 p.m. and the first day after surgery at 8: 00 a.m. and by clinical examination one week after operation. STAI I and II data were used for proceeding to the level of anxiety of patients before and/or after the operation. Results: Sixty consecutive patients, with a mean age of 40.6 ± 8.1 years underwent ALC. Fifty-five (92% patients could be sent to their homes on the same day but five patients could not be sent due to anxiety, pain, or social indications. Nausea was reported in four (6.7% cases and not associated with any demographic or clinical features of patients. On the other hand, pain has been reported in 28 (46.7% cases, and obesity and shorter duration of gallbladder disease were associated with the increased pain perception (P = 0.009 and 0.004, respectively. Preopereative anxiety level was significantly higher among patients who could not complete the ALC procedure (P = 0.018. Conclusion: Correct management of these possible adverse effects results in the increased satisfaction of patients and may encourage this more cost-effective and safe method of laparoscopic cholecystectomy.

  15. Laparoscopic Nissen Fundoplication, Single Center Experience

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    Ahmet Serdar Karaca

    2014-03-01

    Full Text Available Aim: Evaluate the outcomes of laparoscopic Nissen fundoplication surgery for the treatment of gastroesophageal reflux disease. Material and Method: Examined in our clinic, between January 2008 and July 2012 of 81 patients laparoscopic Nissen fundoplication administered retrospectively. 45 patients were female (56% and 36 men (44%. Average age was 40 (20-67. Medical treatment was given to all patients for at least 2 months before the surgery. Endoscopy and esophageal biopsy was performed in all patients preoperatively. Operations were performed under general anesthesia, using 5 ports.Results: All patients, there were heartburn and stomach contents come into the mouth. The average time between the start of complaints surgery 12 months (range, 4 months-8 years. Endoscopic examination was detected esophagitis in all patients preoperatively. Barrett%u2019s esophagitis was found in 6 patients, histopathologic examination. Mean operative time was 68 min (45-120 min, and the median length of hospital stay 3 days (1-7 days. The median follow-up time was determined as 13 months (7-40 months. One patient was re-operated hiatus hernia recurrence of 10 months after the first surgery. The functional results were excellent in 76% of patients, 14% good, 10% as medium. Discussion: Laparoscopic Nissen fundoplication is a surgical initiative, the treatment of gastroesophageal reflux disease, with low morbidity and mortality rates can be applied, and an alternative to long-term drug treatment.

  16. Single Center Experience of Acute Disseminated Encephalomyelitis

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    J Gordon Millichap

    2013-01-01

    Investigators at Department of Pediatrics, Neurology Division, Adana Medical Research Center; and Division of Child Neurology, Ankara, Turkey, retrospectively evaluated 15 children with acute disseminated encephalomyelitis (ADEM) in children from the center in Adana.

  17. Pregnancy during Hemodialysis: A Single Center Experience

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    Bahadi Abdelali

    2010-01-01

    Full Text Available Successful pregnancy outcome is an uncommon occurrence in women requiring chronic dialysis treatment. We reviewed the course and outcome of 9 pregnancies occurred in women on chronic hemodialysis in our center from 1999-2007; 5 of them ended with delivery of alive newborns, 2 with fetal deaths in-utero, and 2 with abortions. The average age of patients was 34 years. The etiology of the original kidney disease was unknown in 44.4% of the cases, and only 22.2% of the patients maintained diuresis. Dialysis started in 8 cases before the diagnosis of pregnancy. The average gestational age at diagnosis was 14 weeks. We modified the prescription of dialysis in 4 patients by increasing the frequency of the dialysis sessions to 6 per week and in 3 by increasing the duration of each session to 6 hours. Anemia was present in all the cases; 3 patients received erythropoietin and 4 patients required transfusion. The pregnancy was com-plicated in 44% of the cases by a polyhydramnios. The average time at delivery was 33 weeks and it was achieved in 80% of pregnancies through vaginal route. The average weight of newborns was to 2380 g. We conclude that pregnancy in women on hemodialysis is possible. The success of pregnancy may be influenced by the residual diuresis and early diagnosis to improve the quality of dialysis by increasing the dialysis dose.

  18. Acometimento pulmonar na doença de Behçet: uma boa experiência com o uso de imunossupressores Pulmonary involvement in Behcet's disease: a positive single-center experience with the use of immunosuppressive therapy

    OpenAIRE

    Alfredo Nicodemos Cruz Santana; Telma Antunes; Juliana Monteiro de Barros; Ronaldo Adib Kairalla; Carlos Roberto Ribeiro de Carvalho; Carmen Silvia Valente Barbas

    2008-01-01

    OBJETIVO: A doença de Behçet (DB) representa uma patologia sistêmica, cuja sobrevida se relaciona com a presença de acometimento pulmonar. Entretanto, sugere-se que pacientes com diferentes tratamentos podem apresentar diferentes prognósticos. O objetivo deste estudo foi avaliar a evolução clínica e tomográfica, bem como a sobrevida deste pacientes com acometimento pulmonar relacionado à DB acompanhados em nosso serviço. MÉTODOS: Uma análise retrospectiva de nossa experiência com pacientes co...

  19. Acometimento pulmonar na doença de Behçet: uma boa experiência com o uso de imunossupressores Pulmonary involvement in Behcet's disease: a positive single-center experience with the use of immunosuppressive therapy

    Directory of Open Access Journals (Sweden)

    Alfredo Nicodemos Cruz Santana

    2008-06-01

    Full Text Available OBJETIVO: A doença de Behçet (DB representa uma patologia sistêmica, cuja sobrevida se relaciona com a presença de acometimento pulmonar. Entretanto, sugere-se que pacientes com diferentes tratamentos podem apresentar diferentes prognósticos. O objetivo deste estudo foi avaliar a evolução clínica e tomográfica, bem como a sobrevida deste pacientes com acometimento pulmonar relacionado à DB acompanhados em nosso serviço. MÉTODOS: Uma análise retrospectiva de nossa experiência com pacientes com acometimento pulmonar relaionado a DB acompanhados de 1 de Janeiro de 1988 a 30 de Abril de 2006. Os dados clínicos, radiológicos, terapêuticos e de sobrevida foram obtidos dos prontuários médicos. RESULTADOS: Foram identificados 9 pacientes, com idade média de 34 ± 11,5 anos, sendo 7 deles do sexo masculino. Os achados radiológicos foram aneurisma de artéria pulmonar (AAP em 8 pacientes, embolia pulmonar em 3 (resultando em uma incidencia de 5,11 casos/100 paciente-anos, hemorragia alveolar em 1 e hipertensão pulmonar em 1 de 9 doentes. O tratamento consistiu-se de prednisona mais clorambucil (ou ciclofosfamida ou micofenolato de mofetil em todos os 9 pacientes, com resolução total ou parcial dos AAP. O paciente com AAP e hipertensão pulmonar também recebeu sildenafil e warfarina, com boa resposta clínica e tomográfica. A sobrevida de nossos pacientes foi de 88,8% em 3 e 5 anos, com acompanhamento médio de 6,52 anos. CONCLUSÕES: Pacientes com acometimento pulmonar relacionado à DB podem apresentar boa sobrevida com tratamento imunossupressor, e a DB deve ser lembrada como uma possível causa de hipertensão pulmonar e hemorragia alveolar.OBJECTIVE: Behcet's syndrome, or Behcet's disease (BD, is a multisystem pathology, and survival is related to pulmonary involvement. However, it appears that different treatments correlate with different prognoses. The aim of this study was to evaluate clinical and tomographic evolution, as

  20. Safety and effectiveness of the Genous™ endothelial progenitor cell-capture stent in the first year following ST-elevation acute myocardial infarction: A single center experience and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Pereira-da-Silva, Tiago, E-mail: tiagopsilva@sapo.pt; Bernardes, Luís; Cacela, Duarte; Fiarresga, António; Sousa, Lídia; Patrício, Lino; Ferreira, Rui Cruz

    2013-11-15

    Purpose: The Genous™ stent (GS) is designed to accelerate endothelization, which is potentially useful in the pro-thrombotic environment of ST-elevation acute myocardial infarction (STEMI). We aimed to evaluate the safety and effectiveness of the GS in the first year following primary percutaneous coronary intervention (PCI) and to compare our results with the few previously published studies. Methods and Materials: All patients admitted to a single center due to STEMI that underwent primary PCI using exclusively GS, between May 2006 and January 2012, were enrolled. The primary study endpoints were major adverse cardiac events (MACEs), defined as the composite of cardiac death, acute myocardial infarction and target vessel revascularization, at one and 12 months. Results: In the cohort of 109 patients (73.4% male, 59 ± 12 years), 24.8% were diabetic. PCI was performed in 116 lesions with angiographic success in 99.1%, using 148 GS with median diameter of 3.00 mm (2.50–4.00) and median length of 15 mm (9–33). Cumulative MACEs were 2.8% at one month and 6.4% at 12 months. Three stent thromboses (2.8%), all subacute, and one stent restenosis (0.9%) occurred. These accounted for the four target vessel revascularizations (3.7%). At 12 months, 33.9% of patients were not on dual antiplatelet therapy. Conclusions: GS was safe and effective in the first year following primary PCI in STEMI, with an apparently safer profile comparing with the previously published data. Summary: We report the safety and effectiveness of the Genous™ stent (GS) in the first year following primary percutaneous coronary intervention in ST-elevation acute myocardial infarction. A comprehensive review of the few studies that have been published on this subject was included and some suggest a less safe profile of the GS. Our results and the critical review included may add information and reinforce the safety and effectiveness of the GS in ST-elevation in acute myocardial infarction.

  1. Laparoscopic cholecystectomy: A report from a single center

    Institute of Scientific and Technical Information of China (English)

    Konstantinos Vagenas; Stavros N Karamanakos; Charalambos Spyropoulos; Spyros Panagiotopoulos; Menelaos Karanikolas; Michalis Stavropoulos

    2006-01-01

    AIM: To review and evaluate our experience in laparoscopic cholecystectomy.METHODS: A retrospective analysis was performed on data collected during a 13-year period (1992-2005)from 1220 patients who underwent laparoscopic cholecystectomy.RESULTS: Mortality rate was 0%. The overall morbidity rate was 5.08% (n = 62), with the most serious complications arising from injuries to the biliary tree and the cystic artery. In 23 (1.88%) cases, cholecystectomy could not be completed laparoscopically and the operation was converted to an open procedure. Though the patients were scheduled as day-surgery cases, the average duration of hospital stay was 2.29 d, as the complicated cases with prolonged hospital stay were included in the calculation.CONCLUSION: Laparoscopic cholecystectomy is a safe,minimally invasive technique with favorable results for the patient.

  2. Trephine stoma: Outcomes in a single center

    Directory of Open Access Journals (Sweden)

    Abdullah Oğuz

    2015-06-01

    Full Text Available Objective: Fecal diversion is often indicated in cases with fecal incontinence, Fournier’s gangrene, anal fistula, and inoperable obstructive anorectal cancer. Trephine colostomy can be performed without necessitating laparotomy. We present our experience related to the outcome of trephine sigmoid colostomy. Methods: The retrospective study included 14 patients who underwent trephine colostomy due to various conditions including Fournier’s gangrene, inoperable anorectal cancer, recto-vaginal fistula, and benign stricture due to radiotherapy at our clinic between January 2010 and January 2015. Results: Patients comprised 4 females and 10 males with a mean age of 52.07 years. The indications for stoma formation were Fournier’s gangrene in 7 cases, inoperable anorectal cancer in 5, rectovaginal fistula in 1, and benign stricture due to radiotherapy in 1 case. Eight patients underwent surgery under regional anesthesia. All the patients underwent trephine loop sigmoid colostomy. One patient had second operation on the postoperative period due to colostomy prolapse. The temporary stomas were closed in 3 months. Mean length of hospital stay was 14 days. Conclusion: Trephine stoma is a relatively simple, safe and rapid procedure and an effective alternative to colostomy formation without laparotomy indications. It can be performed under emergency or elective conditions with low morbidity. J Clin Exp Invest 2015; 6 (2: 87-90

  3. 儿童粒细胞缺乏性小肠结肠炎的诊断和处理%A single center experience with diagnosis and treatment of neutropenic enterocolitis in children

    Institute of Scientific and Technical Information of China (English)

    李凯; 郑珊; 董岿然; 高怡瑾; 王宏胜; 柳龚堡; 高解春; 肖现民

    2011-01-01

    目的 粒细胞缺乏性小肠结肠炎在临床上以粒细胞缺乏、腹痛和高热为三大主症.本文回顾了粒细胞缺乏性小肠结肠炎患儿17例,对其临床特征、治疗和预后进行分析.方法 总结复旦大学附属儿科医院2004至2009年5年间粒细胞缺乏性盲肠炎息儿的临床资料,并进行文献复习.结果 17例患儿,男11例,女6例,平均年龄7.2岁.2例淋巴瘤,11例白血病,1例再生障碍性贫血,1例神经母细胞瘤,2例单纯性粒细胞缺乏而无明显的基础性疾病证据.所有患儿均有典型的临床表现,4例有弥漫性腹膜炎,中毒性休克,其中3例需要呼吸机辅助通气治疗.体检发现有右下腹压痛和肌紧张.伴有CRP的升高和电解质的紊乱.血培养阳性率47%.CT、B超提示肠壁增厚,盲肠或右侧结肠充气减少,气腹等.13例患儿接受内科保守治疗,4例手术干预.2例死亡.结论 粒细胞缺乏性小肠结肠炎是由粒细胞缺乏所引起的危及生命的消化道并发症,临床及CT表现可明确诊断.早期发现和积极的内科治疗可减少病死率.大多数的患儿可通过保守治疗,避免外科手术而获得良好的预后.%Objective To summarize our experience with disgnosis and treatment of neutropenic enterocolitis in children. Methods From 2004 to 2009, 17 patients were diagnosed with neutropenic enterocolitis, and treated at this center. Their clinical data were retrospectively analyzed to summarize the clinical features, managment experience and evaluate the outcome of neutropenic enterocolitis. Results Among the 17 patients, 11 were males and 6 were females. Their avergae age at diagnosis was 7. 2 years old. The primary diseases that caused neutropenia in these patients were lyphoma in 2 patients, leukemia in 11 patients,aplastic anemia in 1, neuroblastoma in 1, and primary neutropenia in 2. All the patients presented enterocolitis symptoms like fever, vomitting, and diarrhea. Physical examination found lower

  4. High feasibility and antileukemic efficacy of fludarabine, cytarabine, and idarubicin (FLAI) induction followed by risk-oriented consolidation: A critical review of a 10-year, single-center experience in younger, non M3 AML patients.

    Science.gov (United States)

    Guolo, Fabio; Minetto, Paola; Clavio, Marino; Miglino, Maurizio; Di Grazia, Carmen; Ballerini, Filippo; Pastori, Giordana; Guardo, Daniela; Colombo, Nicoletta; Kunkl, Annalisa; Fugazza, Giuseppina; Rebesco, Barbara; Sessarego, Mario; Lemoli, Roberto Massimo; Bacigalupo, Andrea; Gobbi, Marco

    2016-08-01

    About 105 consecutive acute myeloid leukemia (AML) patients treated with the same induction-consolidation program between 2004 and 2013 were retrospectively analyzed. Median age was 47 years. The first induction course included fludarabine (Flu) and high-dose cytarabine (Ara-C) plus idarubicin (Ida), with or without gemtuzumab-ozogamicin (GO) 3 mg/m(2) (FLAI-5). Patients achieving complete remission (CR) received a second course without fludarabine but with higher dose of idarubicin. Patients not achieving CR received an intensified second course. Patients not scheduled for early allogeneic bone marrow transplantation (HSCT) where planned to receive at least two courses of consolidation therapy with Ara-C. Our double induction strategy significantly differs from described fludarabine-containing regimens, as patients achieving CR receive a second course without fludarabine, to avoid excess toxicity, and Ara-C consolidation is administrated at the reduced cumulative dose of 8 g/m(2) per cycle. Toxicity is a major concern in fludarabine containing induction, including the recent Medical Research Council AML15 fludarabine, cytarabine, idaraubicin and G-CSF (FLAG-Ida) arm, and, despite higher anti-leukemic efficacy, only a minority of patients is able to complete the full planned program. In this article, we show that our therapeutic program is generally well tolerated, as most patients were able to receive subsequent therapy at full dose and in a timely manner, with a 30-day mortality of 4.8%. The omission of fludarabine in the second course did not reduce efficacy, as a CR rate of 83% was achieved and 3-year disease-free survival and overall survival (OS) were 49.6% and 50.9%, respectively. Our experience shows that FLAI-5/Ara-C + Ida double induction followed by risk-oriented consolidation therapy can result in good overall outcome with acceptable toxicity. Am. J. Hematol. 91:755-762, 2016. © 2016 Wiley Periodicals, Inc. PMID:27084986

  5. A single-center experience of 52 cases of donation after cardiac death (DCD) for kidney transplantation%心脏死亡器官捐献者供肾移植的可行性

    Institute of Scientific and Technical Information of China (English)

    刘煜; 朱雄伟; 王毅; 刘航; 沈中阳

    2015-01-01

    Objective To analyze the clinical effect of kidney transplantation using the donation after cardiac death( DCD) do-nors in this center, explore the feasibility of DCD and summarize the experience of DCD donor kidney transplantation.Methods From April 2012 to December 2013, the clinical data of 28 cases of DCD and 52 cases of DCD donor renal transplantation were retrospective-ly analyzed in this center.Results 28 DCD cases were performed by the classification of Maastricht Ⅲ criteria, resulting in fifty-two donated kidney for transplantations.Warm ischemic time of donor was (11.2 ±9.1) minutes, cold ischemic time of donor (4.1 ±2.2) h.Among 52 cases of kidney transplant recipients,postoperative renal delayed graft function (DGF) occurred in 12 cases (23.08%, 12/52) , their renal function returned to the normal level from postoperative day 20 to 72.2 cases were subjected to nephrectomy due to the rupture of the transplanted kidney caused by the irreversible acute rejection (3.85%, 2/52) in one week and two weeks after kidney transplantation.There was one death due to cytomegalovirus pneumonia after three months postoperatively, one death due to pri-mary non-function of renal graft and fungal pneumonia, one death due to rupture of kidney and septic shock.47 renal transplant recipi-ents with graft survival were followed up for 13 to 23 months,and the grafts functioned properly.Conclusions Donor pool can be largely expanded with DCD donors,the occurrence of complications should be paid attention to and the effects of DCD transplantation should be improved.%目的:总结心脏死亡器官捐献( donation after cardiac death, DCD )肾移植的临床资料,并探讨其可行性。方法回顾性分析2012-04至2013-12武警总医院28例DCD和52例DCD供肾移植的临床资料。结果28例DCD属于国际标准Maastricht Ⅲ类,共获取肾脏52个并实施肾移植52例。热缺血时间为(11.2±9.1)min,冷缺血时间为(4.1±2.2

  6. Single-center experience of perioperative treatment of liver transplantation for acute hepatic failure%急性肝功能衰竭急诊肝移植围术期治疗的单中心经验探讨

    Institute of Scientific and Technical Information of China (English)

    裴利娟; 徐鸿滨; 金鑫; 史宪杰

    2014-01-01

    BACKGROUND:Perioperative treatment of emergency liver transplantation for acute hepatic failure is extremely different from common liver transplantation, due to complex conditions, high risk, several complications, and high mortality. OBJECTIVE:To summarize the experience of emergency liver transplantation for acute hepatic failure during the perioperative period, and to increase the success rate in treatment of acute hepatic failure. METHODS:A retrospective analysis was undertaken on the clinical data of 38 cases undergone emergency liver transplantation for acute hepatic failure. There were 21 male and 17 female, who aged 15-69 years. Among them, 23 cases had hepatitis B virus (including 2 cases with hepatitis B and C virus), 7 cases had Wilsons disease, 3 cases had mushroom poisoning, 2 cases had unknown liver damage, 1 case had Tripterygium wilfordi poisoning, 1 case had decompensation after partial liver resection due to trauma, and 1 case had liver transplantation from corpse. RESULTS AND CONCLUSION:The survival time of the involve patients was 13-1 740 days, and the median survival time was 634 days. Perioperative survival rate was 76%, 1-year survival rate was 63%, and 2-year survival rate was 58%. During the perioperation nine cases died of brain edema and intracranial hypertension, renal failure, severe pulmonary infection, multiple organ failure, coagulation disorders (intracranial hemorrhage, upper digestive tract hemorrhage), acute respiratory distress syndrome and primary graft non-function. At present, emergency liver transplantation is stil the most effective way for acute liver failure. Hemorrhage, infection and rejection are the leading causes of the death. Each perioperative treatment is of great significance for the success of liver transplantation and long-term survival.%背景:急性肝衰竭行急诊肝移植患者围手术期治疗的病情复杂,风险大,并发症多,死亡率高,与普通肝脏移植有着明显不同。目的

  7. Application of da Vinci surgical system in hepatobiliary and pancreatic surgery: a single center experience%“达芬奇”机器人在肝胆胰手术中的应用(单中心报道)

    Institute of Scientific and Technical Information of China (English)

    顾磊; 詹茜; 邓侠兴; 彭承宏; 沈柏用

    2013-01-01

    目的:总结“达芬奇”机器人手术系统在我中心进行肝胆胰手术的临床经验.方法:回顾性分析我科2010年3月至2013年3月间机器人肝胆胰手术124例临床资料和手术并发症的发生率.结果:肝脏手术组15例,中转开腹1例,中转腹腔镜手术1例,该组所有病人围手术期无并发症,无死亡病例.手术时间(199.6±110.5)min,术中出血(703.3±1 260.7)mL,术后住院(11.0±3.6)d.胆囊手术组7例,无中转开腹病人,并发症发生率14.3%,无死亡病例.手术时间(212.9±64.2) min,术中出血(257.1±127.2)mL,术后住院(6.8±2.5)d.胰腺手术组102例,其中良性病人中1例中转开腹,并发症发生率50.0%,无死亡病例;恶性病人中2例中转开腹,并发症发生率55.9%,1例死亡.胰十二指肠切除术31例,手术时间(450.4±102.1)min,术中出血(506.5±266.5)mL,术后住院(34.4±7.8)d;胰体尾切除术42例,手术时间(161.0±68.7)min,术中出血(278.0±331.5) mL,术后住院(20.9±10.9)d;胰腺中段切除术16例,手术时间(215.6±45.7) min,术中出血(145.6±118.4)mL,术后住院(22.7±8.0)d;Beger术7例,手术时间(284.2±35.8) min,术中出血(321.7±244.2)mL,术后住院(26.3±7.7)d;局部切除术6例,手术时间(116.7±37.2)min,术中出血(61.7±69.1)mL,术后住院(27.8±11.8)d.结论:“达芬奇”机器人系统可独立完成各类肝胆胰手术,安全可行,推动了微创外科领域的发展进程,尤其在复杂的肝胆胰手术方面,有效地补充传统的腹腔镜手术.但在机器人手术开展初期,应慎重选择胰腺手术病人.%Objective To summarize the clinical experience of robotic hepatobiliary and pancreatic surgery in our center.Methods da Vinci surgical system was applied to perform robotic hepatobiliary and pancreatic operations for 124 patients from Mar 2010 to Mar 2013.The intra-and post-operative data including morbidity were analyzed.Results The robotic hepatectomy was performed in 15 cases.One case was

  8. Generalized quiver mutations and single-centered indices

    Energy Technology Data Exchange (ETDEWEB)

    Manschot, Jan [Institut Camille Jordan, Université Claude Bernard Lyon 1,43 boulevard du 11 novembre 1918, 69622 Villeurbanne cedex (France); Pioline, Boris [CERN PH-TH,Case C01600, CERN, CH-1211 Geneva 23 (Switzerland); Laboratoire de Physique Théorique et Hautes Energies, CNRS UMR 7589,Université Pierre et Marie Curie,4 place Jussieu, 75252 Paris cedex 05 (France); Sen, Ashoke [Harish-Chandra Research Institute,Chhatnag Road, Jhusi, Allahabad 211019 (India)

    2014-01-13

    Quiver quantum mechanics is invariant under Seiberg duality. A mathematical consequence is that the cohomology of the Higgs branch moduli space is invariant under mutations of the quiver. The Coulomb branch formula, on the other hand, conjecturally expresses the Poincaré/Dolbeault polynomial of the Higgs branch moduli space in terms of certain quantities known as single-centered indices. In this work we determine the transformations of these single-centered indices under mutations. Moreover, we generalize these mutations to quivers whose nodes carry single-centered indices different from unity. Although the Higgs branch description of these generalized quivers is currently unknown, the Coulomb branch formula is conjectured to be invariant under generalized mutations.

  9. Generalized quiver mutations and single-centered indices

    CERN Document Server

    Manschot, Jan; Sen, Ashoke

    2014-01-01

    Quiver quantum mechanics is invariant under Seiberg duality. A mathematical consequence is that the cohomology of the Higgs branch moduli space is invariant under mutations of the quiver. The Coulomb branch formula, on the other hand, conjecturally expresses the Poincar\\'e / Dolbeault polynomial of the Higgs branch moduli space in terms of certain quantities known as single-centered indices. In this work we determine the transformations of these single-centered indices under mutations. Moreover, we generalize these mutations to quivers whose nodes carry single-centered indices different from unity. Although the Higgs branch description of these generalized quivers is currently unknown, the Coulomb branch formula is conjectured to be invariant under generalized mutations.

  10. Assessment of adult patients with hypernatremia: A single center experience

    OpenAIRE

    Ercan Gündüz; Yılmaz Zengin; Mustafa İçer; Hasan Mansur Durgun; Recep Dursun; Ahmet Gündüzalp; Mustafa İpek; Cahfer Güloğlu

    2015-01-01

    Objective: In the present study, determination of symptoms, clinical characteristics, prevalence and recovery rates was aimed in patients who applied to the emergency service and diagnosed with hypernatremia.Methods: Patients who applied to Dicle University Medical School Emergency Service during January 2013-December 2014 and whose serum Na>148 mEq/L were included in the study. The study was conducted retrospectively.Results: Hypernatremia prevalence was determined as 0.21% in the cases w...

  11. Assessment of adult patients with hypernatremia: A single center experience

    Directory of Open Access Journals (Sweden)

    Ercan Gündüz

    2015-09-01

    Full Text Available Objective: In the present study, determination of symptoms, clinical characteristics, prevalence and recovery rates was aimed in patients who applied to the emergency service and diagnosed with hypernatremia. Methods: Patients who applied to Dicle University Medical School Emergency Service during January 2013-December 2014 and whose serum Na>148 mEq/L were included in the study. The study was conducted retrospectively. Results: Hypernatremia prevalence was determined as 0.21% in the cases who applied to the emergency service. The average age in all patients was 69±22 and the median age was 72 years. The average hospitalization period was 13.3±10.9 days. The mortality rate was 75.7% and male gender domination (56% was determined in patients who developed mortality. When mortality and recovery groups were compared statistically; significant difference was determined (p<0.05 in terms of hospitalization period, glucose, urea, creatinine and calcium averages. The complaints of our patients who applied to the emergency service were changes in consciousness (92.7%, oral intake disorder (83.4% and fever (48.6% based on frequency order. The accompanying comorbid states were cerebrovascular illness (36.9%, Dementia/Alzheimer (32.4% and hypertension (28.9% based on frequency order. Conclusion: Consequently, hypernatremia is a fluid-electrolyte disorder progressing with high mortality and could be observed in older patients and in patients whose oral intake is defective and who have cerebrovascular illness and dementia.

  12. Retrospective Analysis of Cancer with Behcets Disease: Single Center Experience

    Directory of Open Access Journals (Sweden)

    Berna Bozkurt Duman

    2014-02-01

    Results: One of our 105 patients with BD was found to have solid tumor in the rate of 0.9 %. The remaining 104 patients with BD were in follow up without any malignancy in this period. The malignancy that we reported was invasive right breast carcinoma in a 55-year-old woman with BD. A radically modified right mastectomy and axillary lymphadenectomy were performed and postoperative doxorubicin, cyclophosphamide therapy for four cycles and hormonal therapy with tamoxifen and leuprolide acetate was administered as adjuvant therapy. This patient had a history of 16 years colchicine usage as medication for BD. Conclusion:The rheumatologic diseases can predispose malignancy, the autoimmune nature of BD or the immunosupressive medicines could be possible causes of this carcinoma. However, in our study only one patient had malignancy. The another point of view; management and also prevention of cancer with BD is important entity.

  13. Clinical course of ectopic pregnancy: A single-center experience

    OpenAIRE

    Aqueela Ayaz; Sameh Emam; Mian Usman Farooq

    2013-01-01

    OBJECTIVES: The objective was to highlight the frequency, clinical profile, and predisposing factors of ectopic pregnancy (EP) in a general hospital. MATERIALS AND METHODS: This descriptive study was conducted at the Obstetrics and Gynaecology department of Hera General hospital, Makkah, Saudi Arabia, from July 1, 2009 to December 29, 2010. Data were collected on chief medical complaints, sociodemographic characteristics, past obstetrics and gynecological history, management done, and outcome...

  14. Obesity and metabolic syndrome in hemodialysis patients: Single center experience

    Directory of Open Access Journals (Sweden)

    Khalid Al Saran

    2011-01-01

    Full Text Available Recent evidence highlights the relationship between metabolic syndrome (MS and increased risk of cardiovascular (CV diseases. The overall prevalence of the MS is increased in hemodialysis population. To evaluate the prevalence of the MS and obesity in our hemodialysis (HD patients, we studied 234 HD patients and 34 patients were excluded from the study due to incomplete data at the time of analysis. For the remaining 200 patients, 92% were below the age of 70 years old, 162 (81% were hypertensive, 90(45% were diabetic, 54 (27% had ischemic heart diseases, and 116 (58% had MS. The incidence of MS in the male and female patients was 50% and 67%, respectively, with a mean abdominal girth more than 94 cm in males and only 14% of the patients revealed abdominal girth measurement below 80 cm in females. We conclude that there is a high prevalence of obesity and MS in our HD patients. Such patients may be at risk of developing morbidities and may benefit from therapy such as lifestyle changes including weight reduction and increased physical activity.

  15. Postpercutaneous Nephrolithotomy Nephrostogram: Is It Mandatory? A Single Center Experience

    Directory of Open Access Journals (Sweden)

    Abdul Rouf Khawaja

    2014-01-01

    Full Text Available Aims and Objective. “Postpercutaneous nephrolithotomy nephrostogram” (PPNN is routinely performed in most of the centers. No published series could be found in the literature without post percutaneous nephrolithotomy nephrostogram. Hence, the aim of our study is to highlight that post percutaneous nephrolithotomy nephrostogram is not mandatory and it only adds to cost and morbidity without adding any information in the management of such patients. Methods. It was a prospective study from 2005 to 2012, conducted in our institute. It included 119 patients of renal stones who underwent percutaneous nephrolithotomy performed under the guidance of a single surgeon. Postoperative nephrostogram was not done in any of the patients. Results. Complete stone clearance was achieved in 97.5% of patients and 2.5% of patients needed two to three sessions of ESWL later on. None of the patients needed second look percutaneous nephrolithotomy or nephrostogram. Conclusion. Postpercutaneous nephrolithotomy nephrostogram increases chances of infection, inconvenience, contrast related complications, and cost, with no added advantage over plain X-ray KUB, and it should not be done as a routine investigation prior to the removal of PCN tube in patients with complete stone clearance.

  16. Treatment of hepatocellular carcinoma: A single-center experience

    International Nuclear Information System (INIS)

    Purpose. The comparative efficacy of transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection (PEI) in the treatment of hepatocellular carcinoma (HCC) was investigated. Methods. Two hundred and sixty consecutive patients were retrospectively analyzed: 156 had received between one and six chemoembolization sessions at 3-month intervals, 33 had had PEI, and the remaining 71 patients refused any treatment. The follow-up ranged from 3 to 36 months. Survival rates were statistically analyzed by life-table analysis. Results. Patients' survival was affected by the number of nodules and by the Child's and Okuda's classes; no relationship was found between survival rates and the histologic grade or vascular supply of the tumor. In the case of a single lesion of Okuda's class I, TACE was more effective than PEI. In multifocal HCC, TACE was better than no treatment in Okuda's class I and Child's class A. Conclusion. We suggest TACE as the treatment of choice in Child A or Okuda I patients with multifocal HCCs; it seems of little help in Child B-C or Okuda II-III patients

  17. Surgical treatment of pulmonary aspergillosis: A single center experience

    Directory of Open Access Journals (Sweden)

    Biswajeet Mohapatra

    2016-01-01

    Full Text Available Background: Aspergillus fumigatus is a saprophytic fungus which colonizes in the cavitary lesions in the lungs. In our part of the world, where tuberculosis is endemic, the healed tubercular cavities form a good nidus for this fungus. The fungus forms a fungal ball or aspergilloma within the cavity, which erodes the walls of the cavity and causes hemoptysis by erosion of the bronchial vessels. Hemoptysis is the main symptom. Antifungal agents are not useful against the fungal ball. Surgery in the form of lobectomy is the primary treatment. Surgery for aspergilloma is known to be risky because of intra-pleural adhesions, obliteration of the interlobar fissures, massive hemorrhage during dissection and poor pulmonary reserve of the patient due to the underlying disease. Materials and Methods: Clinical presentation, radiological investigations, operative techniques, postoperative outcome, and follow-up of 24 cases of pulmonary aspergilloma treated surgically were studied prospectively between August 2010 and July 2013 at IPGMER and SSKM Hospital, Kolkata. Results: There were 15 male (62.5% and 9 female (37.5% patients. Mean age of the study population was 34.54 years. All the patients had complex aspergilloma. Tuberculosis was the underlying disease in 22 patients (91%. Hemoptysis was the main symptom in 79.16% cases. Chest X-ray was the first investigation, which gave a clue to the diagnosis. Computed tomography scan was diagnostic in all cases. Lobectomy was done in 16 patients (66.67%. There was one mortality and the overall complication was 33.33%. The average follow-up period was 21.65 months, during which there was no mortality and no recurrence of hemoptysis in these patients. Conclusions: Though surgery for aspergilloma is considered to be risky, excision of the cavity along with the involved lobe can be done with acceptable morbidity and mortality to provide the patient complete cure and symptom-free survival.

  18. Clinical spectrum of hypopituitarism in India: A single center experience

    Directory of Open Access Journals (Sweden)

    Abhay Gundgurthi

    2012-01-01

    Full Text Available Objectives: There is paucity of information regarding clinical profile of hypopituitarism from India. We report the clinical profile of hypopituitarism from a tertiary center in North India. Materials and Methods: This study was carried out in patients attending our endocrine center between January 2010 and December 2011. All new patients were studied prospectively and those registered before January 2010 retrospectively. Relevant clinical, hormonal, and imaging data were collected. Dynamic testing for pituitary functions was carried out as necessary. Hormonal deficiencies were defined as per prevailing recommendations. Results: This study included 113 subjects. The mean age was 38.6 ± 17.8 years (range, 4 - 76 years. There were 78 (69% males and 35 females (31%. There were 22 subjects aged ≤18 years (childhood and adolescence and 91 adults (>18 years. Visual disturbances were the most common presenting complaint (33%, though headache was the most common symptom (81%. Fifteen percent presented with pituitary apoplexy. Tumors comprised of 84% of cases. Hypogonadism (97% was the most common abnormality seen followed by hypothyroidism (83.2%, hypoadrenalism (79.6%, growth hormone deficiency (88.1% of the 42 patients tested, and diabetes insipidus (13.3%. Panhypopituitarism was seen in 104 (92% patients. There were no cases of hypopituitarism secondary to traumatic brain injury, subarachnoid hemorrhage, central nervous system infections, or cranial irradiation to extrasellar tumors. Conclusion: The most common cause of hypopituitarism at tertiary care center is pituitary tumors and the commonest presenting complaint is visual symptoms. Panhypopituitarism is present in 92% cases.

  19. Clinical course of ectopic pregnancy: A single-center experience

    Directory of Open Access Journals (Sweden)

    Aqueela Ayaz

    2013-01-01

    Full Text Available Objectives: The objective was to highlight the frequency, clinical profile, and predisposing factors of ectopic pregnancy (EP in a general hospital. Materials and Methods: This descriptive study was conducted at the Obstetrics and Gynaecology department of Hera General hospital, Makkah, Saudi Arabia, from July 1, 2009 to December 29, 2010. Data were collected on chief medical complaints, sociodemographic characteristics, past obstetrics and gynecological history, management done, and outcome of management. Data were analyzed using Microsoft Office Excel (version 2007. Results: Out of total 7564 pregnancies, 44 (0.58% patients were diagnosed as EP. Out of 44, 22 (50% patients presented within 24 h of onset of symptoms. Mean age was 28 ± 7 years. Multigravida were predominant in 25 (57%, and 21 (48% had gestational age of 6-8 weeks at the time of presentation; the common presenting features were amenorrhea (41, 93.2%, abdominal pain (39, 88.6%, and tenderness (38, 86%. Previous pelvic surgery (13, 29.5%, infertility treatment (11, 25%, and pelvic inflammatory disease (10, 22.7% were the common predisposing factors. Twenty-five (57% presented with ruptured EP and were operated within 24 h, and the remaining were kept under observation till further diagnosis. After confirming the diagnosis, 12/19 underwent laparoscopy, whereas 7/19 received medical treatment. Surgery confirmed fallopian tube pregnancies in 35 (94.5%. No mortality was observed. Conclusion: Previous pelvic surgeries were the major etiological factor for EP. Other factors were infertility treatment and pelvic inflammatory disease. The most common site of EP was fallopian tubes.

  20. Autotransplantation of pancreatic islets. A single-center first experience.

    Science.gov (United States)

    Magistri, Paolo; Andreani, Sara; Lo Conte, Domenico; Ferrari, Giovanni Carlo; Forgione, Antonello; Pugliese, Raffaele

    2016-01-01

    L’autotrapianto d’isole pancreatiche (IAT) è una procedura ben nota che consente di migliorare il controllo glicemico dopo una pancreasectomia totale (o completamento di pancreasectomia dopo duodenocefalopancreasectomia) rispetto alla sola terapia insulinica. In questo lavoro presentiamo la nostra esperienza nel campo dell’ IAT riportando il caso clinico di una donna di sessanta anni, sottoposta a completamento di pancreasectomia per episodi ricorrenti di acuzie in un quadro di pancreatite cronica. Il trattamento IAT è stato somministrato mediante iniezione trans-epatica intra-portale. Il recupero post-procedurale è stato ottimale, fatta eccezione per un’infezione di ferita che ha richiesto un trattamento con tecnologia a pressione negativa. La paziente è stata dimessa in ventisettesima giornata postoperatoria, in buone condizioni generali, dopo regolare ripresa dell’alimentazione e della canalizzazione. I dati presenti in letteratura dimostrano che la IAT è una procedura sicura, garantendo nel lungo periodo un vantaggio rispetto alla terapia insulinica in termini di rapporto costo-beneficio. Riguardo alla procedura chirurgica, è qui utile ricordare che la mortalità a 30 giorni dopo pancreasectomia totale associata a IAT è del 5%, ed è pertanto sovrapponibile ai risultati della pancreasectomia totale senza IAT. Riportando questa esperienza intendiamo contribuire alla crescita della casistica chirurgica attuale in questo campo, proponendo nel futuro un più ampio sviluppo e una più estesa applicazione di tale approccio.

  1. Acute renal transplant rejections: A single center experience

    Directory of Open Access Journals (Sweden)

    Jabur Wael

    2008-01-01

    Full Text Available We undertook this observational study to assess the incidence of acute rejections (AR in the first six months after transplantation at Al-Karama Hospital, Iraq. Sixty eight patients (49 males and 19 females underwent renal transplantation in 2006 and were followed up weekly. Forty six received kidneys from related donors and 22 from unrelated donors. During the first six months after transplantation AR occurred in 16 patients (23%; 11 (23% related and 5 (23% unrelated donor transplantation. We conclude that the incidence of acute rejection was similar in related and unrelated donor transplantation and the general incidence was comparable to that reported from most centers.

  2. Neurofibromatosis type 1: a single center's experience in Korea

    OpenAIRE

    Kim, Min Jeong; Cheon, Chong Kun

    2014-01-01

    Purpose Neurofibromatosis 1 (NF1) is an autosomal dominant condition caused by an NF1 gene mutation. NF1 is also a multisystem disorder that primarily affects the skin and nervous system. The goal of this study was to delineate the phenotypic characterization and assess the NF1 mutational spectrum in patients with NF1. Methods A total of 42 patients, 14 females and 28 males, were enrolled in this study. Clinical manifestations and results of the genetic study were retrospectively reviewed. Re...

  3. Features of Hemodialysis in Cirrhotic Patients: Single Center Experience

    Directory of Open Access Journals (Sweden)

    Süleyman KÖZ

    2015-09-01

    Full Text Available OBJECTIVE: End-stage kidney disease and advanced cirrhosis are sometimes seen concomitantly. Our purpose was to compare hemodialysis (HD sessions in critically ill cirrhotic patients from ICU versus stable cirrhotic patients from outpatient clinic, and observe endurance of both stable and acutely ill cirrhotic patients to intermittent HD. MATERIAL and METHODS: All of the Child-Pugh class B or C cirrhotic patients requiring renal replacement therapy during a period of three years were included in the study. If hypotension, arrhythmia, bleeding, or any other health problems were present during dialysis, the dialysis session was regarded as a troubled session. RESULTS: There were two groups of patients. All of the stable patients lived more than three months, whereas all patients in the ICU group died within a month. Mean ultrafiltration volume per session was 1786±210 ml in ICU and 1616±266 ml in stable patients (p>0.05. The number of the troubled sessions was 24 in ICU and 1 in stable patients (p<0.0001. Bleeding was a problem in a minority of the patients. CONCLUSION: Intermittent HD may be an acceptable choice for stable cirrhotic dialysis patients. Hypotension is a frequent complication of intermittent HD in ICU patients.

  4. Hemodialysis for methyl alcohol poisoning: A single-center experience

    Directory of Open Access Journals (Sweden)

    Vivek B Kute

    2012-01-01

    Full Text Available Methanol is a cheap and potent adulterant of illicit liquors. Hemodialysis (HD is the best method to rapidly remove both toxic acid metabolites and parent alcohols, and it plays a fundamental role in treating severely poisoned patients. This retrospective study was carried out on 91 patients with detectable serum methanol levels who underwent HD. Because toxic alcohol levels were not immediately available, the initial diagnosis and treatment was based on clinical history with evidence of toxic alcohol intake, presence of high anion metabolic acidosis and/or end organ damage. Patients received bicarbonate, ethanol, according to clinical features and blood gases. Patients underwent HD in the setting of known methanol ingestion with high anion gap metabolic acidosis, or evidence of end-organ damage, regardless of methanol level. HD prescription included large surface area dialyzer (≥1.5 m2, blood flow rate of 250-350 mL/min and dialysate flow rate of 500 mL/min for 4-6 h. Between 9 and 11 July 2009, 91 males with mean age 40 ± 8.5 years underwent HD, and 13 patients required a second HD session. Patients consumed 100-500 mL illicit liquors, and symptoms appeared six and 60 h later. Clinical features were gastro-intestinal symptoms (83.5%, visual disturbances (60.4%, central nervous system symptoms (59.3% and dyspnea (43.9%. Before HD, mean pH was 7.11 ± 0.04 (range 6.70- 7.33 and mean bicarbonate levels were 8.5 ± 4.9 mmol/L (range 2-18. Three patients died due to methanol intoxication. Mortality was associated with severe metabolic acidosis (pH ≤ 6.90, ventilator requirement and coma/seizure on admission (P < 0.001. Timely HD, bicarbonate, ethanol and supportive therapy can be life-saving in methanol intoxication.

  5. Multidisciplinary treatment of Wilms' tumour. 13 years' experience

    International Nuclear Information System (INIS)

    The authors describe the results obtained by them personally in their multidisciplinary treatment of Wilms' tumour. In the National Paediatric Institute, Mexico City, 116 cases of Wilms' tumour in children were studied between January 1971 and December 1983. Of these, only 57 were evaluated as only they had completed their multidisciplinary treatment and had been followed up for over two years. Wilms' tumour is the solid abdominal tumour most frequently found in Mexican children. It is the fifth most frequent malign tumour after leukaemia, tumours of the central nervous system, Hodgkin's disease and non-Hodgkin's lymphomas, and retinoblastoma. The multidisciplinary treatment included: radical surgery; radiotherapy (site and dosage by group and by age of the child) and chemotherapy (drugs according to the group and histology of the tumour). In 82% of cases, the tumours occurred before the age of five, predominantly in girls. The average growth time was three months. Where tumour histology was favourable, 78% survived; 45% survived when the histology was adverse. For the various groups, survival was 100% in group I, 83.5% in group II, and 71.5% in group III and 25% in group IV. The survival of all groups was 67% and the actuarial survival was 83%. (author)

  6. A Single-Center 7-Year Experience with End-Stage Renal Disease Care in Nigeria—A Surrogate for the Poor State of ESRD Care in Nigeria and Other Sub-Saharan African Countries: Advocacy for a Global Fund for ESRD Care Program in Sub-Saharan African Countries

    Directory of Open Access Journals (Sweden)

    Datonye Dennis Alasia

    2012-01-01

    Full Text Available Background. A single-center ESRD care experience in a Nigerian teaching hospital is presented as a surrogate case to demonstrate the prevailing ESRD care situation in Nigeria and most SSA countries. Methods. The data of 320 consecutive ESRD patients undergoing maintenance haemodialysis treatment during a seven-year period were retrospectively analyzed. Results. Over 80% of the subjects funded dialysis treatments from direct out of pocket payment. The mean duration on dialysis before dropout was 5.2±7.6 weeks, with majority 314 (98.1% of the patients unable to sustain dialysis above 12 weeks. Total dialysis sessions during the 7-year period was 1476 giving an average weekly dialysis session of 0.013 (0.05 hour/week per patient per week. One hundred and twenty-eight (40% patients died within 90 days of entry into dialysis care. Conclusions. ESRD care in this single centre was characterized by gross dialysis inadequacy and case fatality due to the inability to access and afford care. The opportunities for kidney transplantation are also very low. Poverty and the absence of government support for ESRD care are responsible for the poor outcomes. A global focus on ESRD care in SSA countries has thus become imperative.

  7. Autoimmune polyglandular syndrome in a 13-year old girl

    DEFF Research Database (Denmark)

    Borgwardt, L.; Pedersen, P.; Peitersen, B.

    2008-01-01

    Autoimmune polyglandular syndrome (APS) is an entity, defined by autoimmunity towards two or more endocrine organs. APS is classified in 3 subgroups (type-1, type-2a, type-2b), according to the organs involved. A case is presented of a 13-year old girl referred to the Department of Paediatrics...

  8. Endometrial adenocarcinoma in a 13-year-old girl.

    Science.gov (United States)

    Kim, Sung Mee; Shin, So Jin; Bae, Jin Gon; Kwon, Kun Young; Rhee, Jeong Ho

    2016-03-01

    Endometrial cancer is the third most common gynecologic cancer in the Korea and occurs mainly in menopausal women. Although it can develop in young premenopausal women cancer as well, an attack in the adolescent girl is very rare. A 13-year-old girl visited gynecology department with the complaint of abnormal uterine bleeding. An endometrial biopsy revealed FIGO (International Federation of Gynecology and Obstetrics) grade II endometrial adenocarcinoma. In the treatment of endometrial cancer, conservative management should be considered if the patient is nulliparous or wants the fertility preservation. Therefore, we decided to perform a hormonal therapy and a follow-up endometrial biopsy after progestin administration for eight months revealed no residual tumor. We report a case of endometrial cancer occurred in a 13-year-old girl with a brief review of the literature. PMID:27004208

  9. Dietary Habits of Welsh 12-13 Year Olds

    Science.gov (United States)

    Thomas, Non-Eleri; Cooper, Stephen-Mark; Graham, Mike; Boobier, Wyndham; Baker, Julien; Davies, Bruce

    2007-01-01

    This study examined the dietary habits of Welsh 12-13 year olds. A cohort of 84 boys and 81 girls, age 12.9 SD 0.3 years; body mass 51.3 SD 12.6kg; and stature 1.54 SD 0.08m, completed a food frequency questionnaire and seven-day food diary. Mean daily kilocalories (kcal/d), and percentages of total fat, saturated fat, carbohydrate, and protein,…

  10. Malignant pleural mesothelioma in a 13-year-old girl

    International Nuclear Information System (INIS)

    Pleural mesothelioma is an uncommon tumor in all age groups, but is especially rare in childhood. We describe the clinical and radiological features of malignant pleural mesothelioma in a 13-year-old girl. The chest radiograph showed nearly complete opacification and loss of volume in the left hemithorax. Computed tomography demonstrated a large pleural effusion centrally surrounded by a thick enhancing rind of soft tissue. The radiological features of childhood pleural mesothelioma in our case were similar to those described in adults with this disease. (orig.)

  11. Positive illusions in marital relationships: a 13-year longitudinal study.

    Science.gov (United States)

    Miller, Paul J E; Niehuis, Sylvia; Huston, Ted L

    2006-12-01

    This study examined the long-term consequences of idealization in marriage, using both daily diary and questionnaire data collected from a sample of 168 newlywed couples who participated in a 4-wave, 13-year longitudinal study of marriage. Idealization was operationalized as the tendency for people to perceive their partner as more agreeable than would be expected based on their reports of their partner's agreeable and disagreeable behaviors. Spouses who idealized one another were more in love with each other as newlyweds. Longitudinal analyses suggested that spouses were less likely to suffer declines in love when they idealized one another as newlyweds. Newlywed levels of idealization did not predict divorce.

  12. Global Ammonia Concentrations Seen by the 13-years AIRS Measurements

    Science.gov (United States)

    Warner, Juying; Wei, Zigang; Larrabee Strow, L.; Dickerson, Russell; Nowak, John; Wang, Yuxuan

    2016-04-01

    Ammonia is an integral part of the nitrogen cycle and is projected to be the largest single contributor to each of acidification, eutrophication and secondary particulate matter in Europe by 2020 (Sutton et al., 2008). The impacts of NH3 also include: aerosol production affecting global radiative forcing, increases in emissions of the greenhouse gases nitrous oxide (N2O) and methane (CH4), and modification of the transport and deposition patterns of SO2 and NOx. Therefore, monitoring NH3 global distribution of sources is vitally important to human health with respect to both air and water quality and climate change. We have developed new daily and global ammonia (NH3) products from AIRS hyperspectral measurements. These products add value to AIRS's existing products that have made significant contributions to weather forecasts, climate studies, and air quality monitoring. With longer than 13 years of data records, these measurements have been used not only for daily monitoring purposes but also for inter-annual variability and short-term trend studies. We will discuss the global NH3 emission sources from biogenic and anthropogenic activities over many emission regions captured by AIRS. We will focus their variability in the last 13 years.

  13. An experimental study of spider-related covariation bias in 8-to 13-year-old children

    NARCIS (Netherlands)

    Muris, P; de Jong, PJ; Meesters, C; Waterreus, B; van Lubeck, J

    2005-01-01

    Covariation bias can be defined as phobic subjects' tendency to overestimate the association between phobic stimuli and aversive outcomes. The current study presents two experiments that examined this type of cognitive bias in children aged 8-13 years (N = 147 in Experiment 1, N = 240 in Experiment

  14. Pituitary stalk lesion in a 13-year-old female.

    Science.gov (United States)

    Zilbermint, Mihail; Ramnitz, Mary S; Lodish, Maya B; Kanaka-Gantenbein, Christina; Kattamis, Antonis; Lyssikatos, Charalampos; Patronas, Nicholas J; Quezado, Martha M; Stratakis, Constantine A

    2014-03-01

    Germinomas presenting with a pituitary stalk lesion and panhypopituitarism are rare in children, and their definite diagnosis is challenging. An invasive diagnostic approach, such as a transsphenoidal biopsy, is often required prior to establishing a treatment regimen. A 13-year-old female presented with 1 year of secondary amenorrhea, fatigue, and progressive thirst with polyuria. Laboratory work-up revealed panhypopituitarism (central hypothyroidism, hypogonadotropic hypogonadism, adrenal insufficiency and central diabetes insipidus). α-Fetoprotein and β-human chorionic gonadotropin were not elevated in serum nor in cerebrospinal fluid. The magnetic resonance imaging (MRI) of the pituitary region showed an enhancing infundibular lesion, extending into the hypothalamus, and infiltrating the pituitary gland. A transsphenoidal biopsy of the infundibular lesion confirmed the diagnosis of germinoma (germ-cell tumor). After appropriate hormone replacement therapy, chemotherapy and low-dose radiation therapy, the patient achieved complete resolution of the pituitary stalk lesion on the MRI.

  15. Pituitary stalk lesion in a 13-year-old female

    Science.gov (United States)

    Zilbermint, Mihail; Ramnitz, Mary S.; Lodish, Maya B.; Kanaka-Gantenbein, Christina; Kattamis, Antonis; Lyssikatos, Charalampos; Patronas, Nicholas J.; Quezado, Martha M.

    2016-01-01

    Germinomas presenting with a pituitary stalk lesion and panhypopituitarism are rare in children, and their definite diagnosis is challenging. An invasive diagnostic approach, such as a transsphenoidal biopsy, is often required prior to establishing a treatment regimen. A 13-year-old female presented with 1 year of secondary amenorrhea, fatigue, and progressive thirst with polyuria. Laboratory work-up revealed panhypopituitarism (central hypothyroidism, hypogonadotropic hypogonadism, adrenal insufficiency and central diabetes insipidus). α-Fetoprotein and β-human chorionic gonadotropin were not elevated in serum nor in cerebrospinal fluid. The magnetic resonance imaging (MRI) of the pituitary region showed an enhancing infundibular lesion, extending into the hypothalamus, and infiltrating the pituitary gland. A transsphenoidal biopsy of the infundibular lesion confirmed the diagnosis of germinoma (germ-cell tumor). After appropriate hormone replacement therapy, chemotherapy and low-dose radiation therapy, the patient achieved complete resolution of the pituitary stalk lesion on the MRI. PMID:24129100

  16. Hospitalization patterns in schizophrenia. A 13-year follow-up.

    Science.gov (United States)

    Munk-Jørgensen, P; Mortensen, P B; Machón, R A

    1991-01-01

    All first admitted patients in 1972 from a catchment area of 582,000 inhabitants aged 15 years or more who were diagnosed as schizophrenic at least once from 1972 until September 1983 (n = 53) were followed-up on average 13 years after first admission. About 20% of the cohort was hospitalized on any given day throughout the length of the follow-up period. The duration of hospitalization decreased from a mean of 8.2 months for the first admission to 1.7 months for the tenth or later admission. The readmission risk increased as a function of the number of previous admissions. Patients with income from occupation or from grants for education had shorter duration of first in-patient period. If the patients were diagnosed as schizophrenics already during the first hospitalization the risk for prolonged duration of the first in-patient period was increased but the readmission risk diminished. Furthermore, readmission risk after the first discharge was diminished by own income and by out-patient treatment and increased by low social status. High proportion of follow-up time in hospital (greater than or equal to 30%) was correlated to affective flattening present at first admission. Of the cohorts' total number of admissions (n = 493) 12% were involuntary. Involuntary admissions were more frequent in the first half of the follow-up period and were correlated to a previous involuntary admission. PMID:2009251

  17. Congenital hypothyroidism: follow up of a case for 13 years.

    Directory of Open Access Journals (Sweden)

    Sudhir M Naik

    2014-04-01

    Full Text Available Background/objectives: Congenital hypothyroidism is one of the most common preventable causes of mental retardation in children. The prognosis of infants detected by neonatal screening and started on treatment early is excellent, with intelligence quotients similar to sibling or classmate without the disease. Setting: Department of ENT, Head and Neck Surgery, KVG Medical College, Sullia. 1Case report: A 15 year old boy came with history of head ache, generalized body ache and lack of concentration in school. He was a case of congenital hypothyroidism and was on irregular treatment for the last 13 years. Intervention: The patient was advised strictly to continue the oral l-thyroxine 100μg one hour before food and come for regular follow-up. Conclusion: Definite intellectual deterioration is seen if oral l-thyroxine is not started within 50 days of life and the deterioration is irreversible. So in India newborn screening programs should be implemented as a national program as it is very important to diagnose and treatcongenital hypothyroidism as soon as possible and to treat it effectively.

  18. Influence of hiking trainings on 13 years old adolescents’ health

    Directory of Open Access Journals (Sweden)

    Mulyk K.V.

    2015-08-01

    Full Text Available Purpose: determination of influence of hiking trainings on adolescents’ health. Material: the research covered adolescents, who train hiking for one year in hiking circles (20 boys and 16 girls and adolescents, who do not practice hiking trainings (18 boys and 20 girls. Age of participants was 13 years. The following indices were determined” Ketle -2 index, Robinson’s index, indices of Skibinskiy, Shapovalova, Ruffiet. Results: positive influence of hiking trainings on general health condition of adolescents was determined. It has been recommended to practice hiking at days off, summer holidays and during academic year. It was found that general health of group 2 adolescents (who did not practice hiking corresponds to level below middle (10-13 points. Adolescents of group 1 (who practice hiking level of general health reaches middle level (14-18 points. Conclusions: it is recommended to assess schoolchildren’s health in points. Besides, it is necessary to consider points of every separate index; it will permit to find weak points of adolescents organism’s functioning.

  19. Famitinib in metastatic renal cell carcinoma: a single center study

    Institute of Scientific and Technical Information of China (English)

    ZHANG Wen; ZHOU Ai-ping; QIN Qiong; CHANG Chun-xiao; JIANG Hao-yuan; MA Jian-hui; WANG Jin-wan

    2013-01-01

    Background Famitinib is a novel and potent multitargeting receptor tyrosine kinase inhibitor.The phase I clinical study showed that famitinib was well tolerated and had a broad anti-tumor spectrum.The purpose of this study was to examine the efficacy and safety of famitinib for the treatment of metastatic renal cell carcinoma (mRCC).Methods The data of famitinib in treating patients with mRCC from the single-center phases Ⅰ and Ⅱ clinical trials were analyzed.Famitinib was administered orally at the dose of 13-30 mg once daily until tumor progression,occurrence of intolerable adverse reactions or withdrawal of the informed consent.Results A total of 24 patients with mRCC were treated including 17 patients at a dose of 25 mg once daily,4 patients at a dose of 27 mg and 1 patient each at a dose of 13 mg,20 mg and 30 mg,respectively.Twelve (50.0%) patients achieved partial response (PR) and 9 patients achieved stable disease (SD).Progressive disease was found in 3 (12.5%) patients.The disease control rate was 87.5%.The median follow-up time was 17.6 months; the median progression free survival (PFS) was 10.7 (95% Cl7.0-14.4) months; and the estimated median overall survival (OS) time was 33.0 (95% Cl8.7-57.3) months.The adverse drug reactions mainly included hypertension (54.1%),hand-foot skin reactions (45.8%),diarrhea (33.3%),mucositis (29.2%),neutropenia (45.8%),thrombocytopenia (29.2%),hyperlipidemia (41.7%) and proteinuria (41.7%).The incidence rate of grades 3 and 4 adverse events was low,mainly including hypertension 12.5%,hand-foot skin reactions 4.2%,neutropenia 4.2%,thrombocytopenia 4.2%,hyperlipidemia 4.2% and proteinuria 12.5%.Conclusions Famitinib has significant anti-tumor activity in mRCC.The common adverse reactions are generally manageable.

  20. Drug use in college students: a 13-year trend

    Directory of Open Access Journals (Sweden)

    Gabriela Arantes Wagner

    2012-06-01

    Full Text Available OBJECTIVE: To analyze drug use trends among college students in 1996, 2001 and 2009. METHODS: A cross-sectional epidemiological study with a multistage stratified cluster sample with 9,974 college students was conducted in the city of São Paulo, southeastern Brazil. An anonymous self-administered questionnaire was used to collect information on drug use assessed in lifetime, the preceding 12 months and the preceding 30 days. The Bonferroni correction was used for multiple comparisons of drug use rates between surveys. RESULTS: There were changes in the lifetime use of tobacco and some other drugs (hallucinogens [6.1% to 8.8%], amphetamines [4.6% to 8.7%], and tranquilizers [5.7% to 8.2%] from 1996 to 2009. Differences in the use of other drugs over the 12 months preceding the survey were also seen: reduced use of inhalants [9.0% to 4.8%] and increased use of amphetamines [2.4% to 4.8%]. There was a reduction in alcohol [72.9% to 62.1%], tobacco [21.3% to 17.2%] and marijuana [15.0% to 11.5%] use and an increase in amphetamine use [1.9% to 3.3%] in the preceeding 30 days. CONCLUSIONS: Over the 13-year study period, there was an increase in lifetime use of tobacco, hallucinogens, amphetamines, and tranquilizers. There was an increase in amphetamine use and a reduction in alcohol use during the preceding 12 months. There was an increase in amphetamine use during the preceding 30 days.

  1. Fusão intersomática lombar transforaminal: experiência de uma instituição Fusión intersomática lumbar transforaminal: la experiencia de una institución Transforaminal lumbar interbody fusion: a single-center experience

    OpenAIRE

    Vinicius de Meldau Benites; Eduardo Augusto Iunes; Alexandre José dos Reis Elias; Rodrigo Miziara Yunes; Franz Jooji Onishi; Sérgio Cavalheiro

    2012-01-01

    OBJETIVO: Relatar a experiência inicial de um serviço de referência em cirurgia da coluna em São Paulo, Brasil com a técnica de fusão intersomática lombar transforaminal (TLIF) nas suas mais variadas indicações. MÉTODOS: Avaliamos retrospectivamente os dados gravados em prontuário de 25 pacientes que foram submetidos à cirurgia com a técnica de TLIF no ano de 2011. Um paciente foi excluído porque não consideramos que a TLIF foi a principal técnica empregada. As indicações incluíram nove casos...

  2. Fusão intersomática lombar transforaminal: experiência de uma instituição Fusión intersomática lumbar transforaminal: la experiencia de una institución Transforaminal lumbar interbody fusion: a single-center experience

    Directory of Open Access Journals (Sweden)

    Vinicius de Meldau Benites

    2012-12-01

    Full Text Available OBJETIVO: Relatar a experiência inicial de um serviço de referência em cirurgia da coluna em São Paulo, Brasil com a técnica de fusão intersomática lombar transforaminal (TLIF nas suas mais variadas indicações. MÉTODOS: Avaliamos retrospectivamente os dados gravados em prontuário de 25 pacientes que foram submetidos à cirurgia com a técnica de TLIF no ano de 2011. Um paciente foi excluído porque não consideramos que a TLIF foi a principal técnica empregada. As indicações incluíram nove casos de hérnia de disco lombar, sete espondilolisteses, quatro cirurgias de revisão, sendo duas por pseudoartrose e duas por lombalgias e, finalmente, quatro pacientes com estenose espinhal lombar. RESULTADOS: Todos os pacientes referiram melhora da dor e/ou claudicação neurológica em comparação com o estado pré-operatório. Apenas cinco pacientes continuaram usando alguma medicação analgésica. Cinco pacientes apresentaram alguma complicação, mas somente duas delas estão relacionadas diretamente com o procedimento. CONCLUSÕES: Trata-se de uma técnica segura, possível de ser realizada em todos os níveis da coluna lombar e aplicável a grande parte das doenças que acometem essa região da coluna.OBJETIVO: Relatar la experiencia de un servicio de referencia en cirugía de la columna en São Paulo, Brasil con la técnica de fusión intersomática lumbar transforaminal (TLIF en sus más variables indicaciones. MÉTODOS: Valoramos retrospectivamente el historial médico de 25 pacientes que fueron sometidos a la cirugía con la técnica de TLIF en el año de 2011. Un paciente fue excluido porque no consideramos que la TLIF fue la principal técnica empleada. Las indicaciones incluyeron nueve casos de hernia de disco lumbar, siete espondilolistesis, cuatro cirugías de revisión siendo dos por pseudoartrosis y dos por lumbalgias y, finalmente, cuatro pacientes con estenosis espinal. RESULTADOS: Todos los pacientes presentaron mejora

  3. Pediatric Heart Transplantation: Report from a Single Center in China

    Institute of Scientific and Technical Information of China (English)

    Fei Li; Jie Cai; Yong-Feng Sun; Jin-Ping Liu; Nian-Guo Dong

    2015-01-01

    Background:Although heart transplantation (HTx) has become a standard therapy for end-stage heart diseases,experience with pediatric HTx is limited in China.In this article,we will try to provide the experience with indications,complications,perioperative management,immunosuppressive therapy,and survival for pediatric HTx based on our clinical work.Methods:This is a retrospective chart review of the pediatric patients undergoing HTx at Department of Cardiovascular Surgery of Union Hospital from September 2008 to December 2014.We summarized the indications,surgical variables,postoperative complications,and survival for these patients.Results:Nineteen pediatric patients presented for HTx at Union Hospital of Tongji Medical College,of whom 10 were male.The age at the time of transplantation ranged from 3 months to 18 years (median 15 years).Patient weight ranged from 5.2 kg to 57.0 kg (median 38.0 kg).Pretransplant diagnosis included cardiomyopathy (14 cases),complex congenital heart disease (3 cases),and tumor (2 cases).All recipients received ABO-compatible donor hearts.Postoperative complications occurred in 12 patients,including cardiac dysfunction,arrhythmia,pulmonary infection,renal dysfunction,and rejection.Two of them experienced cardiac failure and required extracorporeal membrane oxygenation.The immunosuppression regimen was comprised of prednisone,a calcineurin inhibitor,and mycophenolate.All patients recovered with New York Heart Association (NYHA) Class Ⅰ-Ⅱ cardiac function and were discharged.Only one patient suffered sudden death 19 months after transplantation.Conclusion:Orthotopic HTx is a promising therapeutic option with satisfying survival for the pediatric population in China with end-stage heart disease.

  4. Computer animated relaxation therapy in children between 7 and 13 years with tension-type headache

    DEFF Research Database (Denmark)

    Tornoe, Birte; Skov, Liselotte

    2012-01-01

    participants and in Total Tenderness Score for children with frequent episodic tension-type headache. The children expressed a growing understanding of body reactions and an acquired ability to deactivate and regulate these reactions. Computer animated SEMG seems an applicable learning strategy for young......This pilot study evaluated the effect of computer animated relaxation therapy in children between 7 and 13 years with tension-type headache and the children's experiences with the therapy. The therapy consisted of an uncontrolled nine-session course in modified progressive relaxation therapy...... assisted by computer animated surface EMG provided from the trapezius muscles and with the physiotherapist as a participant observer. Outcome measures were (a) headache frequency and intensity, (b) pericranial tenderness, (c) tension patterns, and (d) evaluations assessed at baseline and at 3 months follow...

  5. Physical activity level of school children of age 10-13 years

    OpenAIRE

    Ronghe, Dr. Rashmi N; Gotmare, Dr. Neha A; Kawishwar, Dr. Shraddha

    2016-01-01

    Aim: To assess physical activity level of school children of age 10-13 years.Objectives: To assess and grade physical activity level in children of age 10-13 years using Physical Activity Questionnaire for Children (PAQ-C) classified into: Light Physical activity; Moderate Physical activity; Moderate to vigorous Physical activity and High Physical activity.Methodology: This is Questionnaire based survey study which was conducted on 100 school going children of 10-13 years who were present on ...

  6. Learning curve and perioperative outcomes analysis in three-port extraperitoneal laparoscopic radical prostatectomy : initial experience in 95 cases in single center%单中心95例三孔法经腹膜外途径腹腔镜下根治性前列腺切除术的学习曲线结果分析

    Institute of Scientific and Technical Information of China (English)

    刘茁; 孟一森; 虞巍; 金杰; 张骞

    2015-01-01

    showed that the operative time for all 95 cases was strongly correlated with additional experience (| rs | =0.612,P<0.01).Operative time,however,was not strongly correlated with the surgeon's experience in each group of A,B and C(P >0.05).Group A had longer operative time than that of Group B plus C(96.4 ± 11.3 min vs 73.2 ± 16.7 min,P <0.01).Group A plus B had longer operative time than that of group C (87.6 ± 17.2 min vs 67.5 ± 13.8 min,P < 0.01).For all cases,the estimated blood loss was strongly correlated with additional experience (| rs | =0.677,P < 0.01).Estimated blood loss was strongly correlated with the accumulation of experience for the initial 32 cases(| rs | =0.619,P < 0.01).However,no strong correlation was observed over the next 63 cases.Group A had more blood loss than that of Group B plus C (158.7 ± 81.3 ml vs 74.1 ± 54.4 ml,P < 0.01).Group A plus B had more blood loss than that of group C (125.5 ± 71.6 ml vs 55.3 ± 61.6 ml,P < 0.01).But hospital stay,drainage tube keeping days were not strongly correlated with additional experience in each group(P > 0.05).There were no significant correlation between the accumulation of experience and positive surgical margin rates,biochemical recurrence rates and urinary incontinence rates.Conclusion Our experience of three-port ELRP cases appears to be favorable with decreasing tendency in operative time,estimated blood loss with experience accumulation.Exposure to 32 surgeries,operative time and estimated blood loss reduced significantly,and after 64 cases operative time and estimated blood loss further reduced.

  7. Trastuzumab in the treatment of advanced breast cancer: Our single-center experience and spotlights of the latest national consensus meeting Trastuzumab en el tratamiento del cáncer de mama avanzado. Nuestra experiencia y aspectos de la última Reunión Nacional de Consenso

    Directory of Open Access Journals (Sweden)

    Adriana Tomadoni

    2004-02-01

    Full Text Available Human epidermal growth factor receptor (HER 2 is amplified in 25 to 30% of breast cancer patients and those whose tumors demonstrate HER 2 gene amplification and protein overexpression have an inferior prognosis manifested by shorter disease-free and overall survival. Trastuzumab, the humanized murine anti-HER 2 monoclonal antibody, inhibits tumor growth when used alone and has synergistic and additive effects when used with chemotherapeutic agents (paclitacel-doxorrubicine. At the present time, the accurate diagnostic assessment of HER 2 is essential for appropriate application of the humanized anti HER 2 monoclonal antibody, trastuzumab, for the treatment of patients with metastatic breast cancer.FDA has approved its use for patients with metastatic breast cancer with HER 2 over-expression since 1998, as a first line treatment in association with paclitaxel or as a second or third line monotherapy. In Argentina, two Consensus Meetings of HER 2 Diagnosis have taken place: the first one on May 15th, 2002 and the second on April 11th, 2003, supported by Roche Laboratories (Herceptin®. In this paper, some topics of these meetings are reviewed. Our single-public center experience is discussed.El receptor para el factor humano de crecimiento epidérmico (HER 2 se encuentra amplificado en el 25 a 30% de los cánceres de mama y aquellas pacientes con tumores que amplifiquen el gen HER 2 y sobreexpresen su proteína tienen un peor pronóstico que se traduce en menor sobreviva global y tiempo libre de enfermedad. Usado como monodroga, Trastuzumab, el anticuerpo monoclonal murino humanizado anti-HER 2, inhibe el crecimiento tumoral y posee efectos sinérgicos y aditivos cuando se agrega a otros agentes quimioterápicos (paclitaxel-doxorrubicina. La determinación diagnóstica precisa del HER 2 es esencial para establecer el uso racional de trastuzumab en el tratamiento de pacientes con cáncer de mama metastático. La FDA aprobó su uso para pacientes

  8. Vaginal Radical Trachelectomy for early stage cervical cancer. Results of the Danish National Single Center Strategy

    DEFF Research Database (Denmark)

    Hauerberg, L; Høgdall, C; Loft, A;

    2015-01-01

    OBJECTIVE: To present and evaluate an unselected national single center strategy with fertility preserving trachelectomy in cervical cancer. In 2003 nationwide single-center referral of women for trachelectomies was agreed upon between all Danish departments performing cervical cancer surgery...... with the purpose of increasing volume, to increase surgical safety and facilitate follow-up. METHODS: Prospective data were recorded in the Danish Gynecological Cancer Database of all Vaginal Radical Trachelectomies (VRT) performed in Denmark between 2002 and 2013. Oncologic, fertility and obstetrical outcomes...... of 120 unselected consecutive VRTs were assessed. To obtain complete follow-up about fertility treatment, pregnancy and obstetric outcome the women filled out an electronic questionnaire. Median follow-up: 55.7 months. RESULTS: 85.8% of the patients had stage IB1 disease, 68.3% squamous cell carcinomas...

  9. Presentation of 493 Consecutive Girls with Idiopathic Central Precocious Puberty: A Single-Center Study

    OpenAIRE

    Eloïse Giabicani; Slimane Allali; Adélaïde Durand; Julie Sommet; Ana-Claudia Couto-Silva; Raja Brauner

    2013-01-01

    BACKGROUND: Despite the number of reported data concerning idiopathic central precocious puberty (CPP) in girls, major questions remain including its diagnosis, factors, and indications of gonadotropin releasing hormone (GnRH) analog treatment. METHODS: A retrospective, single-center study was carried out on 493 girls with CPP. RESULTS: Eleven girls (2.2%) were aged less than 3 years. Breast development was either isolated (Group 0, n = 99), or associated with one sign, pubic hair development...

  10. Pediatric pulmonary hodgkin lymphoma: Analysis of 10 years data from a single center

    OpenAIRE

    Urasinski, T; Kamienska, E; Gawlikowska-Sroka, A; Ociepa, T; Maloney, E.; Chosia, K; Walecka, A

    2010-01-01

    Several reports indicate that lungs are the extralymphatic site most commonly affected in patients with Hodgkin lymphoma; however, the data in children are rather limited. This retrospective study aimed to assess the frequency, clinical picture, and the impact on prognosis in children with pulmonary Hodgkin lymphoma, who were diagnosed and treated in a single center during a 10-year period. Pulmonary lesions related to HL: nodules and parenchymal infiltrates with cavitations were found in 3 o...

  11. Outcome of kidney transplantation for renal amyloidosis:a single-center experience.

    Science.gov (United States)

    Celik, A; Saglam, F; Dolek, D; Sifil, A; Soylu, A; Cavdar, C; Temizkan, A; Bora, S; Gulay, H; Camsari, T

    2006-03-01

    The aim of this retrospective study was to investigate the results of kidney transplantation in patients with renal amyloidosis. We analyzed the results of renal transplantation in 13 amyloidotic transplant recipients compared with those in a control group of 13 nonamyloidotic patients. While the etiology of amyloidosis was rheumatoid arthritis in one patient, in all of the others it was secondary to familial Mediterranean fever. Acute rejection episodes developed once in six and twice in one patient. The renal function in these patients was improved by antirejection treatment. Chronic rejection did not develop in any patient. However six patients (46%) died due to various complications despite functional grafts. The others are still being followed with well-functioning grafts. Among the control group, acute and chronic rejection were diagnosed in three and two patients, respectively: one patient returned to hemodialysis after 26 months of transplantation, while the others are still alive with functional grafts. There was no death in the control group. The 5- and 10-year actuarial patient survival rates of the amyloidosis and control groups were 52.2%, 26.6%, and 100%, 100%, respectively (P = .002). However, the graft survivals of the amyloidosis versus control groups were 100%, 100%, versus 87.5%, 87.5, respectively (P = .47). In conclusion, we observed a high rate of early mortality among recipients with amyloidosis associated with infectious complications. Moreover, patient survivals were lower among amyloidotic renal recipients. PMID:16549141

  12. PEDIATRIC HEAD INJURIES, MECHANISM TO MANAGEMENT: EXPERIENCE OF A SINGLE CENTER

    Directory of Open Access Journals (Sweden)

    Pankaj

    2016-01-01

    Full Text Available INTRODUCTION Head injury is very common in modern life. Patients of any age group may have head injury however mechanism of head injury, pathophysiology and outcome of head injury is quite different in adults as compared to children. Road traffic accident is a common mode of head injury in adults while fall from height and household abuse is common mode in children. In Western countries, there is a separate registry system for pediatric head injury but there is no such system exist in india. Our present study is focused on pediatric head injury and evaluation of factors that affect the final outcome in pediatric patients.

  13. P17.26IS NICU MANDATORY AFTER SURGERY IN ADULT HGG? A SINGLE CENTER EXPERIENCE

    Science.gov (United States)

    Fornaro, R.; Agnoletti, A.; Condello, C.; Rivera, A.; Altieri, R.; Garbossa, D.; Lanotte, M.; Ducati, A.

    2014-01-01

    Surgery in high grade gliomas (HGG) is often related to peri-operative complications, that may require neurocritical intensive care unit (NICU) admittance. Actually there is no consensus whether there is real need for NICU for this patients; often the possibility is related to surgeon preferences. In literature there are still little data on clinical parameters associated with long-term outcome after neurocritical care. We retrospectively analyzed 175 patients, that underwent surgical resection for HGG in our division; 15 of which needed NICU admittance after surgery. We compare this group with a homogeneous control group of 15 patients that did not need NICU after surgery. Statistical analysis (p value set at 0.05) did not show any statistical difference between the two groups and we suggest that NICU should not always be used after craniotomy for supratentorial HGG.

  14. Post-ERCP pancreatitis. A single center experience and an update on prevention strategies.

    Science.gov (United States)

    D'Arpa, Francesco; Tutino, Roberta; Battaglia, Emanuele Onofrio; Orlando, Giuseppina; Salamone, Giuseppe; Licari, Leo; Gulotta, Gaspare

    2015-01-01

    La pancreatite rimane ad oggi la maggiore complicanza dell’ERCP nonostante numerose misure tese alla sua prevenzione siano state proposte negli anni. La sua incidenza è del 3.5% e raggiunge in alcune serie di casi anche il 25%; solitamente è lieve-moderata nel 90%. La stratificazione dei pazienti in base al grado di rischio è necessaria per destinare i casi più complessi a centri di terzo livello presenti nel territorio; per far questo, un’analisi dei possibili fattori di rischio è stata originariamente proposta da Freeman ed è poi stata modificata dall’ESGE sulla base dei contributi dei singoli centri, con importanti modifiche. Il presente studio analizza l’incidenza di pancreatite post- ERCP in un centro di terzo livello analizzando, sulla scorta dei fattori di rischio proposti, l’aderenza dei dati. Negli anni 2012-2013, 492 pazienti sono stati sottoposti ad ERCP da due esperti endoscopisti. Secondo le classificazioni di Freeman e Cotton sono state osservate 14 PEP (2.8%), di cui 6 lievi, 4 moderate e 4 severe. È stata condotta un’analisi multivariata che ha evidenziato come fattori di rischio l’elevato numero di tentativi di incannulamento della via biliare e l’iniezione di mezzo di contrasto nel dotto pancreatico; sono risultati fattori protettivi l’early pre-cut e il fallimento della procedura con la sua interruzione. Nella discussione sono state inoltre brevemente analizzate le varie misure profilattiche, quali il posizionamento di protesi pancreatiche e l’utilizzo dei FANS. È interessante notare come i nostri risultati rafforzino gli ultimi orientamenti nel management dell’ERCP, circa l’utilizzo della tecnica di incannulamento filo-guidato e del pre-cut; questi infatti riducono il numero di tentativi di incannulamento ed il conseguente trauma alla papilla promuovendo un incannulamento biliare selettivo e prevenendo l’iniezione di mezzo di contrasto nel dotto pancreatico. Nonostante la pancreatite sia un’ineludibile complicanza dell’ERCP, reputiamo che questi accorgimenti tecnici possono essere utili nel prevenire la sua insorgenza.

  15. De novo cancers following liver transplantation: a single center experience in China.

    Directory of Open Access Journals (Sweden)

    Songfeng Yu

    Full Text Available BACKGROUND: De novo cancers are a growing problem that has become one of the leading causes of late mortality after liver transplantation. The incidences and risk factors varied among literatures and fewer concerned the Eastern population. AIMS: The aim of this study was to examine the incidence and clinical features of de novo cancers after liver transplantation in a single Chinese center. METHODS: 569 patients who received liver transplantation and survived for more than 3 months in a single Chinese center were retrospectively reviewed. RESULTS: A total of 18 de novo cancers were diagnosed in 17 recipients (13 male and 4 female after a mean of 41 ± 26 months, with an overall incidence of 3.2%, which was lower than that in Western people. Of these, 8 (3.32% cases were from 241 recipients with malignant liver diseases before transplant, while 10 (3.05% cases were from 328 recipients with benign diseases. The incidence rates were comparable, p = 0.86. Furthermore, 2 cases developed in 1 year, 5 cases in 3 years and 11 cases over 3 years. The most frequent cancers developed after liver transplantation were similar to those in the general Chinese population but had much higher incidence rates. CONCLUSIONS: Liver transplant recipients were at increased risk for developing de novo cancers. The incidence rates and pattern of de novo cancers in Chinese population are different from Western people due to racial and social factors. Pre-transplant malignant condition had no relationship to de novo cancer. Exact risk factors need further studies.

  16. Linear accelerator-based stereotactic radiosurgery in recurrent glioblastoma: A single center experience

    OpenAIRE

    Sirin Sait; Oysul Kaan; Surenkok Serdar; Sager Omer; Dincoglan Ferrat; Dirican Bahar; Beyzadeoglu Murat

    2011-01-01

    Background/Aim. Management of patients with recurrent glioblastoma (GB) comprises a therapeutic challenge in neurooncology owing to the aggressive nature of the disease with poor local control despite a combined modality treatment. The majority of cases recur within the highdose radiotherapy field limiting the use of conventional techniques for re-irradiation due to potential toxicity. Stereotactic radiosurgery (SRS) offers a viable noninvasive therapeutic option in palliative treatment...

  17. Clinical characterization and NPHP1 mutations in nephronophthisis and associated ciliopathies: A single center experience

    Directory of Open Access Journals (Sweden)

    Neveen A Soliman

    2012-01-01

    Full Text Available Nephronophthisis (NPHP is a recessive disorder of the kidney that is the leading genetic cause of end-stage renal failure in children. Egypt is a country with a high rate of consan-guineous marriages; yet, only a few studies have investigated the clinical and molecular charac-teristics of NPHP and related ciliopathies in the Egyptian population. We studied 20 children, from 17 independent families, fulfilling the clinical and the ultrasonographic criteria of NPHP. Analysis for a homozygous deletion of the NPHP1 gene was performed by polymerase chain reaction on the genomic DNA of all patients. Patients were best categorized as 75% juvenile NPHP, 5% infantile NPHP, and 20% Joubert syndrome-related disorders (JSRD. The mean age at diagnosis was 87.5 + 45.4 months, which was significantly late as compared with the age at onset of symptoms, 43.8 ± 29.7 months (P <0.01. Homozygous NPHP1 deletions were detected in six patients from five of 17 (29.4% studied families. Our study demonstrates the clinical phenotype of NPHP and related disorders in Egyptian children. Also, we report that homozygous NPHP1 deletions account for 29.4% of NPHP in the studied families in this cohort, thereby confirming the diagnosis of type-1 NPHP. Moreover, our findings confirm that NPHP1 deletions can indeed be responsible for JSRD.

  18. Clinical and immunogenetic characteristics of psoriatic arthritis: a single-center experience from South India

    Directory of Open Access Journals (Sweden)

    CB Mithun

    2013-02-01

    Full Text Available AimThe aim of this study was to determine the clinical characteristics and prevalence of HLA B27 in patients with psoriatic arthritis presenting to a tertiary care centre in South India. BackgroundAlthough the prevalence of psoriasis is high in India, there is paucity of data, especially on Ps A. Materials and methodsThis retrospective study included 141 patients satisfying the ClASsification criteria for Ps A (CASPAR. Demographic, clinical, and laboratory data of the patients were collected through personal interviews, clinical examination, appropriate investigations, and analysis of case records. HLA-B27 typing by PCR method was done for all patients. ResultsAmong the 141 patients, 89 subjects were males and 52 were females, and the male to female ratio was 1.7:1. Polyarthritis (n=51, 36.2% was the most common Ps A subtype noted during the study, followed by oligoarthritis (n=48, 34%, spondyloarthropathy (n=29, 20.6%, distal interphalangeal (DIP predominant arthritis (n=25, 7.8%, and arthritis mutilans (n=2, 1.4%. Arthritis preceded skin involvement in 9.2% (n=13 of the cases. Dactylitis was seen in 24.1% (n=34 of the patients. Extra-articular features like enthesitis (n=16, 11.3% and eye involvement (n=1, 0.7% were also observed. Deformities were seen in 32.6% (n=46 of the subjects. The most common type of psoriatic skin lesion noted was psoriasis vulgaris (n=119, 84.4%. Nail involvement was seen in 17.7% (n=25 of the patients and it was observed in all subjects with DIP predominant arthritis (100%. Family history of psoriasis was present in 11.3% (n=16 of the patients. The number of patients positive for HLA B27 was 16 (11.3%. Additionally, the antigen positivity was noted in 35.7% (n=10 of the patients with spondyloarthropathy. ConclusionPs A was more common in males. Polyarthritis and oligoarthritis were the most prevalent subtypes. The prevalence of HLA-B27 in our study population was 11.3% and was found to be strongly associated with spondyloarthropathy.

  19. Pulmonary valve regurgitation following balloon valvuloplasty for pulmonary valve stenosis: Single center experience

    Directory of Open Access Journals (Sweden)

    Asim Yousuf Al Balushi

    2013-01-01

    Full Text Available Background: Pulmonary valve regurgitation following balloon valvuloplasty for moderate to severe pulmonary valve stenosis is a known late outcome of this procedure. Objective: The aim of the study was to characterise the status of pulmonary regurgitation on follow up after pulmonary valve balloon dilatation (PVBD, and to study the determinant of the severity of PR. Materials and Methods: We retrospectively reviewed 50 consecutive patients, aged 2 days to 18 years, with isolated pulmonary valve stenosis, who had undergone PVBD in 2004-2009 and were assessed with follow-up Doppler echocardiography. The impact of balloon to annulus ratio, age, and valve anatomy on the late development of moderate and severe pulmonary valve regurgitation following balloon valvuloplasty was analysed. Results: Six patients (12% had no pulmonary valve regurgitation; 32 (64% had mild, 9 (18% had moderate, and 3 (6% had severe pulmonary valve regurgitation at a mean follow-up of 4 years. Balloon to annulus ratio, age, and valve anatomy were not statistically significant predictors for moderate and severe pulmonary valve regurgitation. Conclusions: The majority of patients in our population had mild pulmonary valve regurgitation. Moderate to severe pulmonary valve regurgitation was well tolerated at midterm follow-up. Age, balloon to annulus ratio, and valve anatomy were not statistically significant predictors for the late development of moderate and severe valve regurgitation. Large and longer follow-up studies are needed to address this question.

  20. BIOIMPEDANCE ANALYSIS IN HAEMODIALYSIS PRACTICE: SHORT REVIEW AND SINGLE CENTER EXPERIENCE

    Directory of Open Access Journals (Sweden)

    A.G. Strokov

    2012-01-01

    Full Text Available Bioimpedance analysis has been widely used to estimate a hydration state, lean and fat mass in haemodialysis patients. The aim of our study was to investigate the validity and usefulness of bioimpedance analysis in routine dialysis practice. Last two years we used the body composition monitoring (BCM, Fresenius Medical Care, method based on whole body multifrequency bioimpedance spectroscopy (BIS, compared with traditional clinical data. For BIS data verification, hydration status of 32 stable HD patients with dialysis vintage more than 3 years and clinically well established dry weight were studied. Only in three cases BIS data seems underestimated in serial measurements. Next step, 28 healthy subjects and 116 dialysis patients were studied. Total body water and extracellular volume (ECV were significantly higher in dialysis group (P<0.01, and there was not any difference in intracellular volume (ICV. Mean AP was similar in patients with moderate (<15% and massive (>15% relative overhydration (RO = overhydration / ECV, at the same time, average number of antihypertensive medications was significantly higher in more overhydrated patients (3.1 vs 1.2. In clinical practice RO is more convenient indicator as compared to standard overhydration volume /dry weight ratio. Mutual application of the BIS and blood volume monitoring allows more rapid and safe dry weight achievement. BIS was useful tool for hydration status monitoring in routine haemodialysis practice, and further work need to be done to clarify BIS validity for nutritional status estimation. 

  1. Clinical characterization and NPHP1 mutations in nephronophthisis and associated ciliopathies: a single center experience.

    Science.gov (United States)

    Soliman, Neveen A; Hildebrandt, Friedhelm; Otto, Edgar A; Nabhan, Marwa M; Allen, Susan J; Badr, Ahmed M; Sheba, Maha; Fadda, Sawsan; Gawdat, Ghada; El-Kiky, Hassan

    2012-09-01

    Nephronophthisis (NPHP) is a recessive disorder of the kidney that is the leading genetic cause of end-stage renal failure in children. Egypt is a country with a high rate of consanguineous marriages; yet, only a few studies have investigated the clinical and molecular characteristics of NPHP and related ciliopathies in the Egyptian population. We studied 20 children, from 17 independent families, fulfilling the clinical and the ultrasonographic criteria of NPHP. Analysis for a homozygous deletion of the NPHP1 gene was performed by polymerase chain reaction on the genomic DNA of all patients. Patients were best categorized as 75% juvenile NPHP, 5% infantile NPHP, and 20% Joubert syndrome-related disorders (JSRD). The mean age at diagnosis was 87.5 + 45.4 months, which was significantly late as compared with the age at onset of symptoms, 43.8 ± 29.7 months (P Egyptian children. Also, we report that homozygous NPHP1 deletions account for 29.4% of NPHP in the studied families in this cohort, thereby confirming the diagnosis of type-1 NPHP. Moreover, our findings confirm that NPHP1 deletions can indeed be responsible for JSRD. PMID:22982934

  2. Acute pancreatitis in pregnancy: a 6-year single center clinical experience

    Institute of Scientific and Technical Information of China (English)

    LI Hua-ping; HUANG Ya-juan; CHEN Xuan

    2011-01-01

    Background The acute abdomen remains a challenge for all obstetricians and physicians who take part in the care of women in pregnancy.To add substantially to our understanding of acute pancreatitis (AP) in pregnancy,in particular affirming the increased risks for mother and fetus associated with AP,we explored features of clinical manifestation and the strategy of management of this disease during pregnancy,and its effects on maternal and fetal outcomes.Methods A retrospective review of medical records of all pregnant patients diagnosed with AP admitted to the Department of Obstetrics and Gynecology,Sixth People's Hospital Affiliated to Shanghai Jiao Tong University between 2005 and 2010 was performed.Information was collected from presentation,management,and outcome from medical records.Results There were 11 cases in 2010,accounting for 44% of 25 cases.Among these cases,mild AP (MAP) occurred in 15 cases (60%),while the rest cases were severe AP (SAP) (40%).The major etiology of AP in pregnancy was due to gallstone and cholecystitis.Clinical features together with elevation of the plasma concentrations of pancreatic enzymes were the cornerstones of diagnosis.Positive conservative treatment was taken in most of the cases (21 cases,84%) with a favorable outcome.Seven cases of critically ill patients were monitored in intensive care unit,and 4 patients underwent surgical interventions.As a result,all of 25 patients had better prognosis,no maternal death was observed.There were 8 preterm labors and 2 fetal losses,accounting for the perinatal mortality of 8%.Fetal malformation was not observed.Conclusions While a pregnant woman suffers acute abdominal pain,early diagnosis and severity assessment of AP are very important.Conservative comprehensive treatment with intensive care is recommended.Surgical intervention should be performed as late as possible.

  3. Single center experience with intrathoracic impedance monitoring in chronic heart failure patients

    Institute of Scientific and Technical Information of China (English)

    QIAO Qing; HUA Wei; DING Li-gang; CHEN Ke-ping; WANG Jing; WANG Fang-zheng; ZHANG Shu

    2011-01-01

    Background The Medtronic InSync Sentry is the first available cardiac resynchronization therapy defibrillator (CRT-D)which can monitor fluid status by measuring intrathoracic impedance. This study was designed to observe the effectiveness of intrathoracic impedance monitoring on detecting aggravation of heart failure.Methods We retrospectively analyzed the clinical data of 14 consecutive patients. Patients were regularly followed up every 3-6 months after the implantation. At each visit, interrogation of the device was done. Patients were instructed to inform the researcher on hearing the device alert, and to take extra 40 milligrams of furosemidum if they had aggravated symptoms later. If the symptoms could not be relieved, they were asked to see a doctor. Data about heart failure hospitalization were collected from the medical record.Results During 18-48 months follow-up, a total of 7 patients encountered 28 alert events. On one hand, alert events appeared before all deteriorated symptoms and heart failure hospitalizations. On the other hand, there were 23 alerts followed by deterioration of heart failure symptoms, and 2 alerts related to 2 hospitalizations caused by pulmonary infection in one patient. Only 5 patients were hospitalized 10 times for deterioration of cardiac function.Conclusion The function of intrathoracic impedance monitoring is reliable in predicting deterioration of heart failure.

  4. Experience of a single center with congenital hepatic fibrosis:A review of the literature

    Institute of Scientific and Technical Information of China (English)

    Ali; Shorbagi; Yusuf; Bayraktar

    2010-01-01

    Congenital hepatic fibrosis(CHF) is an autosomal recessive inherited malformation defined pathologically by a variable degree of periportal fibrosis and irregularly shaped proliferating bile ducts.It is one of the fibropolycystic diseases,which also include Caroli disease,autosomal dominant polycystic kidney disease,and autosomal recessive polycystic kidney disease. Clinically it is characterized by hepatic fibrosis,portal hypertension,and renal cystic disease.CHF is known to occur in association with a ran...

  5. Bevacizumab plus chemotherapy in elderly patients with previously untreated metastatic colorectal cancer: single center experience

    OpenAIRE

    Ocvirk Janja; Moltara Maja Ebert; Mesti Tanja; Boc Marko; Rebersek Martina; Volk Neva; Benedik Jernej; Hlebanja Zvezdana

    2016-01-01

    Metastatic colorectal cancer (mCRC) is mainly a disease of elderly, however, geriatric population is underrepresented in clinical trials. Patient registries represent a tool to assess and follow treatment outcomes in this patient population. The aim of the study was with the help of the patients’ register to determine the safety and efficacy of bevacizumab plus chemotherapy in elderly patients who had previously untreated metastatic colorectal cancer.

  6. [De novo malignant tumors following liver transplantation. A single-center experience in Argentina].

    Science.gov (United States)

    Antinucci, Florencia; Anders, Margarita; Orozco, Federico; Mella, José; Cobos, Manuel; McCormack, Lucas; Mastai, Ricardo

    2015-01-01

    The aim of the present study was to evaluate the incidence and clinical features of de novo tumors in patients undergoing liver transplantation in our center as well as to assess survival. We retrospectively analyzed 168 liver transplantations (159 patients) performed from May 2006 to May 2014. The incidence of de novo tumors was 7.5% (n = 12). The mean age at diagnosis was 63 ± 7 years. The most frequent neoplasms were non melanoma skin tumors and adenocarcinomas. Fifty percent of the tumors developed in the second and third year after transplantation. Type of immunosuppression did not influence tumoral type, although most patients receive tacrolimus in combination with mycofenolate and/or corticoids. The mean duration of follow-up after diagnosis of the tumor was 25 ± 29 months (range 0-76) and the mortality was 41%. The actuarial probability of survival at 1 and 5 years was 83 and 55%, respectively. De novo tumors are frequent after liver transplantation and their clinical course differs from that in the general population. Because their clinical course is more aggressive, regular follow up of these patients is essential for early diagnosis. PMID:25637895

  7. Clinical and immunogenetic characteristics of psoriatic arthritis: a single-center experience from South India

    OpenAIRE

    CB Mithun; Paul T Antony; Christina M Mariaselvam; Vir S Negi

    2013-01-01

    AimThe aim of this study was to determine the clinical characteristics and prevalence of HLA B27 in patients with psoriatic arthritis presenting to a tertiary care centre in South India. BackgroundAlthough the prevalence of psoriasis is high in India, there is paucity of data, especially on Ps A. Materials and methodsThis retrospective study included 141 patients satisfying the ClASsification criteria for Ps A (CASPAR). Demographic, clinical, and laboratory data of the patients were collected...

  8. DISTRIBUTION OF CONGENITAL HEART DISEASES AT TERTIARY CARE CENTER: SINGLE CENTER EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Vaishali

    2016-02-01

    Full Text Available BACKGROUND The current study was undertaken at a tertiary care center, Bhopal, MP, India, with the objective of establishing frequency of occurrence of congenital heart diseases by echocardiography. MATERIALS AND METHOD 10,000 consecutive cases undergoing Echo Color Doppler in the Cardiology Department Hamidia Hospital, Bhopal, between 1st Jan 2009 and July 2011 were analysed. Echo CD was performed by consultant cardiologist using Acuson Aspen Color Doppler machine following the ASE guidelines. RESULTS AND CONCLUSIONS In the present study out of 10,000consecutive cases undergoing echo 648 were identified to having congenital heart diseases. Isolated VSD (30.5%, isolated ASD (23.6% PDA (9% and TOF (8.3% were commonest defect observed. Most common congenital heart disease found in the present study is VSD and is most prevalent in males and is highest among 0-5 yrs.

  9. The Evaluation of Amyloidosis Cases with Renal Involvement: A Single-Center Experience

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    Yavuz AYAR

    2015-09-01

    Full Text Available OBJECTIVE: Amyloidosis is a chronic disease associated with proteinuria and can progress to renal failure. The diagnosis and treatment of the underlying cause is therefore important. In this study at a university hospital, the diagnosis of amyloidosis patients with renal biopsies was evaluated retrospectively. MATERIAL and METHODS: 69 (42 males, 27 females, mean age: 51.7 ± 14.8 years patients were diagnosed with amyloidosis with renal biopsy. Indications for biopsy was nephrotic syndrome in 42 patients (60.9%, nephritic syndrome in 27 (39.1% and renal dysfunction with proteinuria in 31 (44.9%. RESULTS: The most common causes of secondary amyloidosis were Familial Mediterranean Fever in 17 of the 62 patients, chronic inflammatory diseases in 17 patients and chronic infection in 13 patients. No cause was determined in 12 patients. Multiple myeloma was present in 5 patients with primary amyloidosis. At the time of diagnosis with amyloidosis, 19 patients were stage 1, 15 stage 2, 5 stage 3A, 12 stage 3B, 10 stage 4 and 8 stage 5. The baseline hemoglobin, serum albumin, creatinine, sodium, potassium, calcium, phosphorus, AST, ALT, PTH, SAA, CRP levels, average daily urinary protein excretion and baseline GFR values were not significantly different in primary and secondary amyloidosis patients. The treatment was medical in 62.3% of the patients, dialysis in 31.9% and renal transplantation in 5.8%. CONCLUSION: The reliability of renal biopsy in the diagnosis of amyloidosis is high. However, genetic studies for the diagnosis of idiopathic cases and special histological staining methods should be considered.

  10. Clinical characteristics of a group of adults with nodular lymphoid hyperplasia: A single center experience

    Institute of Scientific and Technical Information of China (English)

    Alberto Rubio-Tapia; Jorge Hernéndez-Calleros; Sagrario Trinidad-Hernández; Luis Uscanga

    2006-01-01

    AIM: To describe the clinical and histological characteristics of a group of adults with small-bowel nodular lymphoid hyperplasia (NLH).METHODS: Patients were searched for five years in pathology records of our institution. The biopsy material was reassessed using strict histopathological criteria.Clinical data were obtained from medical records.RESULTS: Small-bowel NLH was diagnosed in 18 cases.The female: male ratio was 2: 1. The most frequent symptoms were diarrhea (72%), involuntary weight loss (72%) and abdominal pain (61%). Nine patients (50%)had immunodeficiency. Small-bowel bacterial overgrowth was found in three (17%) cases. At small-bowel NLH diagnosis, three (17%) had associated lymphoma: two intestinal and one extra-intestinal lymphomas. In two patients with villous atrophy and anti-endomysial antibodies the diagnosis of celiac disease was established.Giardia lamblia infection was found in only one patientwith hypogammaglobulinemia (Herman's syndrome).CONCLUSIONS; NLH is uncommon in adult patients.Associated diseases are immunodeficiency and lymphoid tissue malignancies.

  11. A single-center experience with abiraterone as treatment for metastatic castration-resistant prostate cancer

    DEFF Research Database (Denmark)

    Thortzen, Anita; Thim, Stine; Røder, Martin Andreas;

    2016-01-01

    BACKGROUND: Continuous stimulation of the androgen receptor (AR) axis is a prerequisite for growth in castration-resistant prostate cancer (CRPC). Abiraterone acetate (AA) is a potent inhibitor of extracellular and intracellular androgen synthesis by inhibition of the CYP-17 enzyme system, which...

  12. Evaluation of Sensorimotor Nerve Damage in Patients with Maxillofacial Trauma; a Single Center Experience

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    Behnaz Poorian

    2016-04-01

    Full Text Available Objective: To evaluate sensorimotor nerve damage in patients with maxillofacial trauma referring to Taleghani hospital, Tehran, Iran Methods: This cross-sectional study was conducted during a 2-year period from 2014 to 2012 in Taleghani hospital of Tehran. We included a total number of 495 patients with maxillofacial trauma referring to our center during the study period. The demographic information, type of fracture, location of fracture and nerve injuries were assessed and recorded in each patients. The frequency of sensorimotor injuries in these patients was recorded. Data are presented as frequencies and proportions as appropriate. Results: Overall we included 495 patients with maxillofacial trauma with mean age of 31.5±13.8 years. There were 430 (86.9% men and in 65 (13.1% women among the patients. The frequency of nerve injuries was 67.7% (336 patients. The mean age of the patients with nerve injuries was 33.4 ± 3.7 years. Marginal mandibular branch of facial nerve was the most common involved nerve being involved in 5 patients (1%. Regarding trigeminal nerve, the inferior alveolar branch (194 patients 39.1% was the most common involved branch followed by infraorbital branch (135 patients 27.2%. Mandibular fracture was the most common injured bone being reported in 376 patient (75.9% patients followed by zygomatic bone in 100 patient (20%. Conclusion: The most frequent fracture occurred in mandible followed by zygoma and the most injured nerve was inferior alveolar nerve followed by infraorbital branch of trigeminal nerve. In facial nerve the marginal branch was the most involved nerve. The frequency of nerve injury and the male to female ratio was higher in the current study compared to the literature.

  13. Sorafenib for Egyptian patients with advanced hepatocellular carcinoma; single center experience

    Directory of Open Access Journals (Sweden)

    Omar Abdel-Rahman

    2014-03-01

    Conclusions: In limited resource countries like Egypt, we suggest that the use of sorafenib for the treatment of advanced HCC cases should be restricted to a highly selected subgroup of patients with good performance and child A.

  14. Pictorial essay: Interventional radiology in the management of hemodialysis vascular access - A single-center experience

    Directory of Open Access Journals (Sweden)

    Suraj Mammen

    2012-01-01

    Full Text Available Chronic kidney disease (CKD is a worldwide public health problem and is associated with high morbidity and mortality. The majority of patients with CKD stage 5 (CKD-5, who cannot undergo renal transplant, depend on maintenance hemodialysis by surgically created access sites. Native fistulae are preferred over grafts due to their longevity. More than half of these vital portals for dialysis access will fail over time. Screening procedures to select high-risk patients before thrombosis or stenosis appears have resulted in aggressive management. These patients are referred for angiographic evaluation and/or therapy. We present the patterns of dialysis-related interventions done in our institution.

  15. Spectrum of intradialytic complications during hemodialysis and its management: A single-center experience

    Directory of Open Access Journals (Sweden)

    Prabhakar

    2015-01-01

    Full Text Available Hemodialysis (HD is one of the important modalities of renal replacement therapy in acute renal failure (ARF as well as chronic renal failure (CRF. This study was performed to evaluate the various intradialytic complications that occur during HD and their management. This is a retrospective study performed in patients who underwent conventional HD during the period of 1 January 2000 to 31 December 2011 at our center. Clinical details, various complications faced and their management were retrieved from dialysis case sheets. A total of 2325 patients of renal failure (790 ARF and 1535 CRF patients were assessed for the intradialytic complications of HD. During the study period, there were 12,785 bicarbonate dialyses performed on these patients. In the ARF patients, the common intradialytic complications were: Hypotension, seen in 1296 sessions (30.4%, nausea and vomiting seen in 1125 sessions (26.4%, fever and chills seen in 818 sessions (19.2%, headache seen in 665 sessions (15.6%, cramps seen in 85 sessions (2.0%, chest pain and back pain seen in 82 sessions (1.92%, hypoglycemia seen in 77 sessions (1.8%, first-use syndrome seen in 72 sessions (1.7% and femoral hematoma seen in 31 sessions (0.73%. In the CRF group, common complications were hypotension in 2230 sessions (26.1%, nausea and vomiting in 1211 sessions (14.2%, fever and chills in 1228 sessions (14.4%, chest pain and back pain in 1108 cases (13.0%, hypertension in 886 sessions (10.4%, headache in 886 sessions (10.4%, cramps in 256 sessions (3.0%, hematoma in 55 sessions (0.64%, intracerebral hemorrhage in three sessions (0.03% and catheter tip migration in three sessions (0.03%. There is a need for special attention for the diagnosis and management of intradialytic complications of HD because such complications could be managed successfully without the need for termination of the dialysis procedure.

  16. A single center experience: post-transplantation adjuvant chemotherapy impacts the prognosis of hepatocellular carcinoma patients

    Institute of Scientific and Technical Information of China (English)

    Wu Junyi; Sun Hongcheng; Han Zhongbo; Peng Zhihai

    2014-01-01

    Background The aim of this research was to investigate the impact of post-transplantation adjuvant chemotherapy in the prevention of tumor recurrence and metastasis for hepatocellular carcinoma (HCC) exceeding Milan criteria after liver transplantation.Methods A total of 117 patients with HCC exceeding the Milan criteria who had undergone orthotopic liver transplantation (OLT) from August 2002 to February 2009 were enrolled and retrospectively analyzed.The patients were divided into four groups according to chemotherapy regimens and the impact of different chemotherapy regimens on survival,disease-free survival,and adverse effects were compared.Results One year survival rates for the gemicitabine,conventional chemotherapy,oxaliplatin plus capecitabine and the best supportive care (BSC) group were 87.5%,84.2%,81.6%,and 67.5%.The 3-year survival rates were 48.1%,25.9%,31.6%,and 33.7%,respectively for the four groups.One year disease free survival rates for the four groups were 69.8%,47.4%,53.8%,and 45.7% respectively.And 3-year disease free survival rates were 43.2%,23.7%,23.6%,and 25.1% for the four groups.Stratification analysis showed that the gemcitabine regimen and conventional chemotherapy could significantly improve the survival rate and disease free survival rate for HCC patients who had major vascular invasion and/or microvascular invasion after liver transplantation compared with BSC group.Conclusions For HCC patients beyond Milan criteria,especially who had vascular invasion and/or micorvascular invasion,post-transplantation adjuvant chemotherapy can significantly improve survival.Gemcitabine is a proper regimen for postoperative adjuvant chemotherapy.Conventional chemotherapy can also benefit patients,but the adverse effects are not satisfactory.

  17. Clinical Characteristics and Outcomes for Solitary Fibrous Tumor (SFT): A Single Center Experience

    OpenAIRE

    DeVito, Nicholas; Henderson, Evita; Han, Gang; Reed, Damon; Marilyn M Bui; Lavey, Robert; Robinson, Lary; Zager, Jonathan S.; Gonzalez, Ricardo J; Sondak, Vernon K.; Letson, G. Douglas; Conley, Anthony

    2015-01-01

    Solitary fibrous tumor (SFT) is a mesenchymal neoplasm of fibrous origin. The 2013 WHO classification of soft tissue tumors defines malignant forms as hypercellular, mitotically active (>4 mitosis/10 high-power fields), with cytological atypia, tumor necrosis, and/or infiltrative margins. With an IRB-approved protocol, we investigated patient records and clinicopathologic data from our Sarcoma Database to describe the clinical characteristics of both benign and malignant SFT. All pathology sp...

  18. Outcomes of resections for pancreatic adenocarcinoma with suspected venous involvement: a single center experience.

    OpenAIRE

    Erkan, Murat Mert; Michalski, Christoph W.; Kong, Bo; Jaeger, Carsten; Kloe, Silke; Beier, Barbara; Braren, Rickmer; Esposito, Irene; Friess, Helmut; Kleeff, Jorg

    2015-01-01

    Background: Pancreatic ductal adenocarcinoma (PDAC) patients frequently present with borderline resectable disease, which can be due to invasion of the portal/superior mesenteric vein (PV/SMV). Here, we analyzed this group of patients, with emphasis on short and long-term outcomes. Methods: 156 patients who underwent a resection for PDAC were included in the analysis and sub-stratified into a cohort of patients with PV/SMV resection (n = 54) versus those with standard surgeries (n = 102). Res...

  19. Clinical Characteristics and Outcomes for Solitary Fibrous Tumor (SFT: A Single Center Experience.

    Directory of Open Access Journals (Sweden)

    Nicholas DeVito

    Full Text Available Solitary fibrous tumor (SFT is a mesenchymal neoplasm of fibrous origin. The 2013 WHO classification of soft tissue tumors defines malignant forms as hypercellular, mitotically active (>4 mitosis/10 high-power fields, with cytological atypia, tumor necrosis, and/or infiltrative margins. With an IRB-approved protocol, we investigated patient records and clinicopathologic data from our Sarcoma Database to describe the clinical characteristics of both benign and malignant SFT. All pathology specimens were reviewed by two pathologists. Descriptive statistics and univariate/multivariate survival analysis were performed. Patient records and Social Security Death Index were used to evaluate vital status. Of 82 patients, 47 (57% were women and 73 (89% were Caucasian. Median age was 62 years (range, 20 to 89. Thirty-two (39% patients succumbed to the disease. Primary tumor site was lung/pleura in 28 (34%, abdomen/pelvis in 23 (28%, extremity in 13 (16%, and head/neck in 9 (11% patients. Pathology was described as benign in 42 (51% and malignant in 40 (49% patients. Compared to benign SFT, malignant histology is associated with larger tumor size, higher mitotic counts, metastatic disease at diagnosis, and greater use of chemotherapy and radiation therapy. Gender, age, and tumor site were not significantly different between benign and malignant subtypes. By univariate analysis, only benign vs. malignant variant and complete resection positively impacted overall survival (P = 0.02 and P<0.0001, respectively. In the multivariable analysis of overall survival, receiving chemotherapy or not receiving surgery were two variables significantly associated with higher failure rate in overall survival: patients with chemotherapy vs. no chemotherapy (P = 0.003, HR = 4.55, with 95% CI: 1.68-12.34 and patients without surgery vs. with surgery (P = 0.005, HR = 25.49, with 95% CI: 2.62-247.57. Clear survival differences exist between benign and malignant SFT. While surgery appears to be the best treatment option for benign and malignant SFT, better systemic therapies are needed to improve outcomes of patients with metastatic, malignant SFT.

  20. Safety and benefits of large-volume liposuction: a single center experience

    OpenAIRE

    Saleh, Youssef; El-Oteify, Mahmoud; Abd-El-Salam, Abd-El-Radi; Tohamy, Ahmed; Alaa A Abd-Elsayed

    2009-01-01

    Background Liposuction is a surgical technique to remove excess fat deposits from specific areas of the body. Purpose of this study is to determine how far large volume liposuction is safe and effective. Methodology From July 2003 to December 2005, 60 female patients had liposuction of different areas of the body as waist, hips, buttocks, thighs, and knees. Their mean age was 30.6 ± 15.4 years old. A standard liposuction technique was done by using a tumescent infiltration formula. The averag...

  1. Glial heterotopia in head and neck, single center experience of 5 cases

    Directory of Open Access Journals (Sweden)

    Ramyapriyadarshini Arikeri

    2016-07-01

    Conclusions: Glial Heterotopias of head and neck are more common in the nasal cavity. Middle ear Glial heterotopias are very rare. Clinical and radiological findings along with histopathology and immuno-histochemistry are essential in diagnosing these lesions. [Int J Res Med Sci 2016; 4(7.000: 3009-3012

  2. Pregnancy-related acute renal failure: A single-center experience

    OpenAIRE

    K R Goplani; P R Shah; Gera, D. N.; M Gumber; Dabhi, M.; Feroz, A; Kanodia, K.; S. Suresh; Vanikar, A. V.; Trivedi, H. L

    2008-01-01

    Pregnancy-related acute renal failure (ARF) is a common occurrence and is associated with substantial maternal and fetal mortality. It also bears a high risk of bilateral renal cortical necrosis. We conducted this study to evaluate the contributing factors and to assess the frequency of cortical necrosis. In this prospective study, of the 772 patients with ARF admitted at our institute between January 2004 and May 2006, 70 had ARF associated with pregnancy complications. ARF was diagnosed by ...

  3. Bortezomib-based chemotherapy for patients with multipe myeloma:a single center experience

    Institute of Scientific and Technical Information of China (English)

    梁赜隐

    2014-01-01

    Objective To evaluate the efficacy and safety of bortezomib-based chemotherapy for 80 patients with multiple myeloma(MM).Methods A total of 80 cases with a median age of 57(range:25-78)years were enrolled in the study.Bortezomib-based regimens included VD(bortezomib and dexamethasone)and PAD(bortezomib,doxorubicin and dexamethasone).16 of the 80 patients

  4. Surgical management of gastric gastrointestinal stromal tumor: A single center experience

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    Ehab El-Hanafy

    2011-01-01

    Full Text Available Background/Aim: Gastrointestinal stromal tumors (GISTs are the most common mesenchymal tumors of the gastrointestinal tract. Surgery remains the mainstay of curative treatment. Our objective is to evaluate the outcome of surgical treatment of primary gastric GIST. Materials and Methods: Between January 1997 and April 2008, thirty seven consecutive patients underwent resection for GISTs (35 patients with primary gastric GISTs and two patients with intestinal GISTs who were excluded from the study. These patients underwent upper endoscopy ± biopsy, barium meal and abdominal CT scan. Patients′ demographics and clinical presentations were analyzed. Perioperative parameters measured included operative times, estimated blood loss, intraoperative finding, surgical techniques, morbidity and length of hospitalization. Recurrence and survival were also analyzed. Results: Of the 35 patients with gastric GISTs included in the study, 63% were female. The median age was 59 ± 14 years (range, 23 to 75 years. The primary presenting symptoms were bleeding and dyspepsia; 43% of these tumors were located mainly in the body of the stomach. Tumor size was < 10 cm in 80% of the patients. The average tumor size was 6.3 ±3.2 cm (range from 3 to 13 cm. Regarding the surgical management, 20 patients (57% underwent gastric wedge resection, eight patients (23% underwent partial gastrectomy and the remaining seven patients (20% underwent total gastrectomy. Radical resections were found in 32 patients (91.5% while palliative resections were found in three patients (8.5%. The resected lymph nodes were negative in 32 patients (91.5%. Recurrence was noted in three patients, with a median time to recurrence of 14.3 months (range, 7 to 28 months. The three- and five-years survival in patients who underwent wedge resection was 92% and 81%, respectively, where it was 95% and 87%, respectively, in patients who underwent gastrectomy (either partial or total. There were no major intraoperative complications or mortalities. Conclusion: Complete surgical resection either through wedge resection or gastrectomy with negative margins remains the gold standard treatment in the management of patients with primary resectable gastric GISTs.

  5. Results of Second-Look Laparotomy in Advanced Ovarian Cancer: One Single Center Experience

    Science.gov (United States)

    Damak, Tarak; Chargui, Riadh; Ben Hassouna, Jamel; Hechiche, Monia; Rahal, Khaled

    2012-01-01

    Objective. The goal of the study was to analyse the results of 85 cases of second-look laparotomy (SLL) and explore the influence of this procedure on survival. Patients and Methods. We reviewed retrospectively 85 cases of SLL collected and treated in our institute between 1994 and 2003. Results. Complete pathologic response (CPR) was 25.8%, microscopic disease (Rmicro) was 38.8%, and macroscopic disease (Rmacro) was 35.4%. In patients with negative SLL results, disease recurrence was diagnosed in 41%. The 3- and 5-year overall survival rates for the entire population were 91% and 87%, respectively. The 3- and 5-year disease-free survivals were, respectively, 76.3% and 58.5% in negative SLL versus 55.7% and 16% in positive SLL. The difference between the group of patients with complete response (76%) and the patients with residual microscopic disease (72%) was not significant. The tumoral residuum after initial surgery was the only prognostic factor influencing significantly the disease-free survival. On Cox regression model analysis, only initial tumoral residuum (P = 0.04) and tumoral residuum after SLL (P = 0.02) were independent prognostic factors for survival. Conclusions. The most important advantage of SLL is the early detection of recurrence and thus the early administration of consolidation treatment resulting in a better prognosis. PMID:23119177

  6. Temporary Placement of Stent Grafts in Postsurgical Benign Biliary Strictures: a Single Center Experience

    Energy Technology Data Exchange (ETDEWEB)

    Vellody, Ranjith; Willatt, Jnonathon M.; Arabi, Mohammad; Cwikiel, Wojciech B [Division of Interventional Radiology, University of Michigan, Ann Arbor (United States)

    2011-11-15

    To evaluate the effect of temporary stent graft placement in the treatment of benign anastomotic biliary strictures. Nine patients, five women and four men, 22-64 years old (mean, 47.5 years), with chronic benign biliary anastomotic strictures, refractory to repeated balloon dilations, were treated by prolonged, temporary placement of stent-grafts. Four patients had strictures following a liver transplantation; three of them in bilio-enteric anastomoses and one in a choledocho-choledochostomy. Four of the other five patients had strictures at bilio-enteric anastomoses, which developed after complications following laparoscopic cholecystectomies and in one after a Whipple procedure for duodenal carcinoma. In eight patients, balloon-expandable stent-grafts were placed and one patient was treated by insertion of a self-expanding stent-graft. In the transplant group, treatment of patients with bilio-enteric anastomoses was unsuccessful (mean stent duration, 30 days). The patient treated for stenosis in the choledocho-choledochostomy responded well to consecutive self-expanding stent-graft placement (total placement duration, 112 days). All patients with bilio-enteric anastomoses in the non-transplant group were treated successfully with stent-grafts (mean placement duration, 37 days). Treatment of benign biliary strictures with temporary placement of stent-grafts has a positive effect, but is less successful in patients with strictures developed following a liver transplant.

  7. P17.26IS NICU MANDATORY AFTER SURGERY IN ADULT HGG? A SINGLE CENTER EXPERIENCE

    OpenAIRE

    Fornaro, R.; Agnoletti, A.; Condello, C; RIVERA, A; Altieri, R.; Garbossa, D.; Lanotte, M.; Ducati, A.

    2014-01-01

    Surgery in high grade gliomas (HGG) is often related to peri-operative complications, that may require neurocritical intensive care unit (NICU) admittance. Actually there is no consensus whether there is real need for NICU for this patients; often the possibility is related to surgeon preferences. In literature there are still little data on clinical parameters associated with long-term outcome after neurocritical care. We retrospectively analyzed 175 patients, that underwent surgical resecti...

  8. Reducing the underreporting of percutaneous exposure incidents: A single-center experience.

    Science.gov (United States)

    Fritzsche, Carlos; Heine, Markus; Loebermann, Micha; Klammt, Sebastian; Podbielski, Andreas; Mittlmeier, Thomas; Reisinger, Emil C

    2016-08-01

    Although risk reduction strategies have been implemented throughout the world, underreporting of percutaneous exposure incidents (PEIs) is common among exposed health care workers. The aim of this study was to determine the incidence rate of reported PEIs before and after implementation of an intensified reporting management policy. The introduction of an intensified reporting system led to significantly increased reporting after a PEI has occurred. However, continuous education needs to be provided to improve awareness. PMID:27125915

  9. Transplant Tourism in the United States: A Single-Center Experience

    OpenAIRE

    Gill, Jagbir; Madhira, Bhaskara R.; Gjertson, David; Lipshutz, Gerald; Cecka, J. Michael; Pham, Phuong-Thu; Wilkinson, Alan; Bunnapradist, Suphamai; Danovitch, Gabriel M

    2008-01-01

    Background and objectives: Transplant “tourism” typically refers to the practice of traveling outside the country of residence to obtain organ transplantation. This study describes the characteristics and outcomes of 33 kidney transplant recipients who traveled abroad for transplant and returned to University of California, Los Angeles (UCLA) for follow-up.

  10. The outcome of early laparoscopic surgery to treat acute cholecystitis: a single-center experience

    OpenAIRE

    Ciftci, Fatih; Abdurrahman, Ibrahim; Girgin, Sadullah

    2015-01-01

    Aim: The aim of this study was to prospectively assess the outcome of early laparoscopic cholecystectomy (LC) in patients with acute cholecystitis. Materials and methods: Between July 2005 and December 2012, of 623 patients who had symptoms of acute cholecystitis during the first 72 h of hospital admission and who did not respond to non-operative treatment, 302 underwent surgical treatment. After initial treatment, all patients were followed up for 21 months on average (range: 5-27 months). T...

  11. Etiology and clinical profile of patients with Cushing's syndrome: A single center experience

    Science.gov (United States)

    Ammini, Ariacherry C.; Tandon, Nikhil; Gupta, Nandita; Bhalla, Ashu Seith; Devasenaspathy, Kandaswamy; Kumar, Guresh; Sahoo, Jaiprakash P.; Chittawar, Sachin; Philip, Jim; Baruah, Manas P.; Dwarakanath, C. S.; Tripathi, Sudhir

    2014-01-01

    Background: There is little published literature on the profile of patients with Cushing's syndrome (CS) from India. The aim of this study was to compile data of CS patients treated at this hospital. Materials and Methods: Patients referred to the endocrine services of this hospital for diagnosis/treatment of CS from January 1985 to July 2012 were the subjects for this study. All patients had detailed medical history, physical examination and biochemical and hormonal assays (which changed with availability of tests and changing views). Assays for plasma adrenocorticotropic hormone (ACTH) (late 90s), salivary cortisol estimation, IJV sampling for ACTH and corticotrophin releasing hormone stimulation tests were added on later. Imaging included computed tomography (CT), magnetic resonance imaging (since the late 80's) and 68Ga DOTA-TOC/FDG PET-CT (2008). Results: Three hundred sixty-four patients (250 females, 114 males, age 6 months to 65 years, mean 28 years + 12 years) were diagnosed to have CS during this period. Two hundred and ninety-three patients (80.5%) were ACTH dependent (CD 215, ectopic ACTH syndrome 22, occult ACTH source 56) while 71 (19.5%) were ACTH independent (adrenal carcinoma 36, adenoma 30, primary pigmented nodular adrenal disease 4, AIMAH 1). Pituitary macro adenoma was seen in 14% of the CD cases. The most common presenting complaints were hypertension and diabetes mellitus. A total of 63% patients complained of weight gain while 15% had lost weight. Myopathy, infections, skeletal fractures and psychiatric problems were the other common observations in our patients. Conclusion: The clinical spectrum was broad. CD was the most common cause for CS. PMID:24701438

  12. Five years renal transplantation data: Single-center experience from Iraq

    Directory of Open Access Journals (Sweden)

    Ala A Ali

    2016-01-01

    Full Text Available Renal transplantation is the treatment of choice for patients with end-stage renal disease. In Iraq, renal transplantation started in 1973 and has continued until now with live donor transplantation, since deceased donor transplant program is not approved as yet. Long-term transplant data are still scarce. The aim of our study is to present data on transplantation and medical follow-up at one year and, survival analysis at one, three and five years. A total of 250 renal transplantations were performed at the Nephrology and Renal Transplantation Center, Baghdad between January 2009 and January 2014. It is a living donor, blood group compatible donor program. All patients received triple immunosuppression (calcineurine inhibitor, mycophenolate mofetil or mycophenolic acid, and steroid. The Kaplan-Meier method was used to determine the survival rate. There were 92 live related donors, 143 unrelated donors, and 15 spouse donors. The mean age was 34.07 ± 12.2 years. The one-year graft survival for related and unrelated donor transplants was 98.9% and 91.8%, respectively. Graft survival was lower (82.9% in recipients with acute rejection episodes. The patient survival at one-year was 94%. The three-year graft and patient survival was 91% and 90%, respectively, and five-year survival for grafts and patients was 87.1% and 88%, respectively. The outcome of the renal transplantation in Iraq is improving. Long-term patient follow-up needs more meticulous attention. The development of renal transplant registry is critical for future planning. Moreover, renal transplantation practice in Iraq needs more social, religious, and governmental support.

  13. Blood blister-like aneurysms: Single center experience and systematic literature review

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez, Ana Marcos; Narata, Ana Paula; Yilmaz, Hasan [Interventional Neuroradiology Unit, Service of Neuroradiology, University Hospital of Geneva (Switzerland); Bijlenga, Philippe; Radovanovic, Ivan; Schaller, Karl [Service of Neurosurgery, University Hospital of Geneva (Switzerland); Lovblad, Karl-Olof [Interventional Neuroradiology Unit, Service of Neuroradiology, University Hospital of Geneva (Switzerland); Pereira, Vitor Mendes, E-mail: vitormpbr@hotmail.com [Interventional Neuroradiology Unit, Service of Neuroradiology, University Hospital of Geneva (Switzerland)

    2014-01-15

    Blood blister-like aneurysms (BBAs) are a controversial entity. They arise from non-branching sites on the supraclinoid internal carotid artery (ICA) and are suspected to originate from a dissection. Our aim is to describe the BBA cases seen in our center and to present a systematic review of the literature on BBAs. We analyzed the eleven cases of BBA admitted to our center from 2003 to 2012. We assessed the medical history, treatment modality (endovascular and/or surgery), complications and clinical outcome. The cohort included 8 women and 4 men with a mean age of 53.16 years. Treatment of the BBA consisted of stenting and coiling in 5 patients, stenting only in 4 patients, coiling and clipping in 1 patient, clipping only in 1 patient, and conservative treatment in 1 patient. A good outcome was found in 10 patients, as defined by a modified Rankin Scale (mRS) less than or equal to two at three months. A systematic review of the literature was performed, and 314 reported patients were found: 221 patients were treated with a primarily surgical approach, and 87 patients were treated with a primarily endovascular approach. A rescue or second treatment was required in 46 patients (21%). The overall estimated treatment morbidity rate was 17%, and the mortality rate was 15%. BBAs exhibit more aggressive behavior compared to saccular aneurysms, and more intra-operative complications occur with BBAs, independent of the treatment type offered. They are also significantly more likely to relapse and rebleed after treatment. Endovascular treatment offers a lower morbidity–mortality compared with surgical approaches. Multilayer flow-diverting stents appear to be a promising strategy.

  14. Twin anemia polycythemia sequence: a single center experience and literature review.

    Science.gov (United States)

    Moaddab, Amirhossein; Nassr, Ahmed A; Espinoza, Jimmy; Ruano, Rodrigo; Bateni, Zhoobin H; Shamshirsaz, Amir A; Mandy, George T; Welty, Stephen E; Erfani, Hadi; Popek, Edwina J; Belfort, Michael A; Shamshirsaz, Alireza A

    2016-10-01

    Twin anemia polycythemia sequence (TAPS) is defined by significant intertwin hemoglobin discordance without the amniotic fluid discordance that characterizes twin-twin-transfusion syndrome (TTTS) in monochorionic twin pregnancies. TAPS is an uncommon condition which can either occur spontaneously, or following fetoscopic laser ablation for TTTS. This complication is thought to result from chronic transfusion through very small placental anastomoses; however, the pathogenesis of TAPS remains unknown. Consequently, there is no consensus in the management of TAPS. In this article, three cases of TAPS are described and we review the literature on this uncommon pregnancy complication.

  15. Diagnosis and management of choledochal cyst: 20 years of single center experience.

    Science.gov (United States)

    Gadelhak, Nabil; Shehta, Ahmed; Hamed, Hosam

    2014-06-14

    We report the first case series from Africa and the Middle East on choledochal cyst, a disease which shows significant geographical distribution with high incidence in the Asian population. In this study, the epidemiological data of the patients are presented and analyzed. Attention was paid to diagnostic imaging and its accuracy in the diagnosis and classification of choledochal cyst. Most cases of choledochal cyst disease have type I and IV-A cysts according to the Todani classification system, which support the etiological theories of choledochal cyst, especially Babbitt's theory of the anomalous pancreaticobiliary duct junction, which are clearly stated. The difficulties and hazards of surgical management and methods used to avoid operative complications are clarified. Early and late postoperative complications are also included. This study should be followed by multicenter studies throughout Egypt to help assess the incidence of choledochal cysts in one of the largest populations in Africa and the Middle East.

  16. Mortality of IgA nephropathy patients: a single center experience over 30 years.

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    Hajeong Lee

    Full Text Available Research on the prognosis of IgA nephropathy (IgAN has focused on renal survival, with little information being available on patient survival. Hence, this investigation aimed to explore long-term patient outcome in IgAN patients. Clinical and pathological characteristics at the time of renal biopsy were reviewed in 1,364 IgAN patients from 1979 to 2008. The outcomes were patient death and end stage renal disease (ESRD progression. Overall, 71 deaths (5.3% and 277 cases of ESRD (20.6% occurred during 13,916 person-years. Ten-, 20-, and 30-year patient survival rates were 96.3%, 91.8%, and 82.7%, respectively. More than 50% patient deaths occurred without ESRD progression. Overall mortality was elevated by 43% from an age/sex-matched general population (GP (standardized mortality ratio [SMR], 1.43; 95% confidence interval [CI], 1.04-1.92. Men had comparable mortality to GP (SMR, 1.22; 95% CI, 0.82-1.75, but, in women, the mortality rate was double (SMR, 2.17; 95% CI, 1.21-3.57. Patients with renal risk factors such as initial renal dysfunction (estimated glomerular filgration rate <60 ml/min per 1.73 m(2; SMR, 1.70; 95% CI, 1.13-2.46, systolic blood pressure ≥ 140 mmHg (SMR, 1.88; 95% CI, 1.19-2.82 or proteinuria ≥ 1 g/day (SMR, 1.66; 95% CI, 1.16-2.29 had an elevated mortality rate. Patients with preserved renal function, normotension, and proteinuria <1 g/day, however, had a similar mortality rate to GP. When risk stratification was performed by counting the number of major risk factors present at diagnosis, low-risk IgAN patients had a mortality rate equal to that of GP, whereas high-risk patients had a mortality rate higher than that of GP. This investigation demonstrated that overall mortality in IgAN patients was higher than that of GP. Women and patients with renal risk factors had a higher mortality than that of GP, Therefore, strategies optimized to alleviate major renal risk factors are warranted to reduce patient mortality.

  17. Clinical profile of primary hyperparathyroidism from western India: A single center experience

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    Gopal R

    2010-01-01

    Full Text Available Background: Primary hyperparathyroidism (PHPT has a variable clinical presentation and symptomatic PHPT is still the predominant form of the disease in India. Data from western India is lacking. Aim : To present the clinical profile of PHPT from western India. Settings and Design : This retrospective study was conducted at a tertiary care referral center. Materials and Methods : We analyzed the clinical presentation, biochemical, radiological features, and operative findings in adult patients with PHPT (1986-2008 and compared with our published data of children and adolescent patients with PHPT. Statistical Analysis : was done with SPSS 16 software. Results : Seventy-nine patients (F: M-2:1 with age ranging from 21 to 55 years (mean 33.5±8.82 were analyzed. Skeletal manifestations (75.5%, renal calculi (40.5% and proximal muscle weakness (45.5% were the most common symptoms of presentation with mean duration of symptoms being 33.70 (median: 24, range 1-120 months. Biochemical features included hypercalcemia (total corrected calcium 12.55±1.77 mg/dl, low inorganic phosphorus (1.81±0.682 mg/dl, elevated total alkaline phosphatase (mean: 762.2; median: 559; range: 50-4930IU/L and high parathyroid hormone (PTH (mean±SD: 866.61±799.15; median: 639.5; range: 52-3820 pg/ml. Preoperative localization was achieved in 74 patients and single adenoma was found during surgery in 72 patients. Hungry bone disease was seen in 30.3% and transient hypoparathyroidism developed in 62% patients. In comparison to PHPT in children there were no significant differences with regard to clinical, laboratory and radiological features. Conclusions : PHPT in western India is symptomatic disorder with skeletal and renal mani-festations at a much younger age. Clinical profile of PHPT in children is similar to that of adults.

  18. Single center experience on talc poudrage morbidity: focus on high talc dosage

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    Congedo Maria

    2011-06-01

    Full Text Available Abstract Malignant pleural effusion (MPE is a common clinical problem of concern for most of the pneumologists and thoracic surgeons. A general consensus regarding the use of talc poudrage in treatment of MPE exists, but only few studies analyzed in detail talc insufflation related pulmonary morbidity. In particular, ARDS talc-related is caused by physical and chemical effects of the small talc particles (50% particle size

  19. Intercity deceased donor renal transplantation: A single-center experience from a developing country

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    T R Mehta

    2013-01-01

    Full Text Available In a developing country such as India, deceased donor renal transplantation (DDRTx accounts for only about 1% of all renal transplants (RTx. Our institute initiated an intercity DDRTx in the year 2006, which significantly increased the number of RTx. We retrieved 74 kidneys from 37 deceased donors from various cities of Gujarat from January 2006 to December 2009. We transplanted the allografts in 66 recipients and a retrospective analysis of the donor profile and management and recipient outcome was performed. The mean age of the donors was 43.3 ± 18.8 years. The causes of death included road traffic accident in 51.35% of the donors and cerebrovascular stroke in 48.65% of the donors; 83.78% of the donors required ionotropes for hemodynamic stability in addition to vigorous intravenous fluid replacement. The average urine output of the donors was 350 ± 150 mL. The organs were perfused and stored in HTK solution. The mean cold ischemia time (CIT was 9.12 ± 5.25 h. The mean anastomosis time in the recipient was 30.8 ± 8.7 min. 57.6% of the recipients established urine output on the operating table and 42.4% developed delayed graft function. At the end of 1 month after transplantation, the mean serum creatinine was comparable to the Ahmadabad city DDRTx, although the CIT was significantly longer in the intercity patients. Intercity organ harvesting is a viable option to increase the donor pool. Distance may not be an impediment, and good recipient outcome is possible in spite of prolonged CIT in case of proper harvesting and preservation.

  20. Mixed chimerism following hematopoietic stem cell transplantation in pediatric thalassemia major patients: a single center experience

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    Elif Ünal İnce

    2010-03-01

    Full Text Available Objective: Stable mixed chimerism (MC may result in cure for thalassemia major patients following hematopoietic stem cell transplantation (HSCT, but rejection can occur. Twenty-eight HSCTs for thalassemia major were reviewed retrospectively to evaluate the clinical course of MC with possible risk factors and predictors of outcome, with a median follow-up of 1669 days (811-3576 days. Materials and Methods: Chimerism was detected by fluorescence in situ hybridization (FISH or multiplex polymerase chain reaction depending on the sex match between the donor and the recipient. Results: Primary rejection, stable MC and full donor chimerism was detected in 3.6%, 17.8% and 78.6% of patients, respectively. Clinically, 4/5 patients with stable MC had thalassemia trait with donor chimerism as low as 14%. One patient was started on pRBC transfusions at 2.5 years postHSCT. Conclusion: Stable MC can result in cure for thalassemia major patients. The clinical picture remains as the best guide for intervention until a more reliable predictor is available.

  1. Conversion from temporary to tunneled catheters by nephrologists: report of a single-center experience

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    Silva BC

    2016-04-01

    Full Text Available Bruno C Silva, Camila E Rodrigues, Regina CRM Abdulkader, Rosilene M Elias Nephrology Division, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil Background: Nephrologists have increasingly participated in the conversion from temporary catheters (TC to tunneled-cuffed catheters (TCCs for hemodialysis. Objective: To prospectively analyze the outcomes associated with TCC placement by nephrologists with expertise in such procedure, in different time periods at the same center. The impact of vancomycin or cefazolin as prophylactic antibiotics on the infection outcomes was also tested. Patients and methods: Hemodialysis patients who presented to such procedure were divided into two cohorts: A (from 2004 to 2008 and B (from 2013 to 2015. Time from TC to TCC conversion, prophylactic antibiotics, and reasons for TCC removal were evaluated. Results: One hundred and thirty patients were included in cohort A and 228 in cohort B. Sex, age, and follow-up time were similar between cohorts. Median time from TC to TCC conversion was longer in cohort A than in cohort B (14 [3; 30] vs 4 [1; 8] days, respectively; P<0.0001. Infection leading to catheter removal occurred in 26.4% vs 18.9% of procedures in cohorts A and B, respectively, and infection rate was 0.93 vs 0.73 infections per 1,000 catheter-days, respectively (P=0.092. Infection within 30 days from the procedure occurred in 1.4% of overall cohort. No differences were observed when comparing vancomycin and cefazolin as prophylactic antibiotics on 90-day infection-free TCC survival in a Kaplan–Meier model (log-rank = 0.188. TCC removal for low blood flow occurred in 8.9% of procedures. Conclusion: Conversion of TC to TCC by nephrologists had overall infection, catheter patency, and complications similar to data reported in the literature. Vancomycin was not superior to cefazolin as a prophylactic antibiotic. Keywords: renal dialysis, tunneled catheters, interventional nephrology, infection, temporary catheters, prophylactic antibiotics

  2. A longitudinal prospective study of bleeding diathesis in Egyptian pediatric patients: single-center experience.

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    Mokhtar, Galila M; Tantawy, Azza A G; Adly, Amira A M; Telbany, Manal A S; El Arab, Sahar Ezz; Ismail, Mona

    2012-07-01

    Keeping an updated registry of bleeding disorders is crucial for planning care and documenting prevalence. We aimed to assess the prevalence of various bleeding disorders including rare inherited coagulation and platelet disorders concerning their clinico-epidemiological, diagnostic data and bleeding manifestations severity. Patients suffering from manifestations of bleeding or coagulation disorders presented to Hematology Clinic during 16 years were included and prospectively followed up. Demographics, clinical characteristics, complete blood count, bleeding, prothrombin and activated partial thromboplastin times, platelet aggregation tests and bone marrow aspiration were recorded. Overall 687 patients with bleeding disorders from total 2949 patients were identified. Inherited coagulation defects were found in 27.2%; hemophilia A (70.6%), hemophilia B (13.9%), factor I deficiency (2.3%), factor V deficiency (1.6%), factor X deficiency (4.2%), factor VII deficiency (2.6%), factor XIII deficiency (1.1%), combined factor deficiency (2.1%) and unclassified coagulation disorders in 1.6% of studied patients. Overall 72.7% had diagnosed with platelet disorders; immune thrombocytopenia was the commonest (74.8%), and inherited conditions represent (25.2%) in the following order: Glanzman's thrombasthenia (11.2%), von Willebrand disease (6.6%), Bernard-Soulier syndrome (1%) and Chediak Higashi in 0.4% and unclassified in 6%. Median age of diagnosis of coagulation and platelet disorders were 33 and 72 months. Presenting symptoms of coagulation disorders were: 25.1% post circumcision bleeding, 22.5% ecchymosis, 20.9% hemoarthrosis and 15% epistaxis. Symptoms of rare coagulation disorders were postcircumcision bleeding (20%), bleeding umbilical stump (20%), epistaxis (12%), hemoarthrosis (8%) and hematomas (4%). Presenting symptoms in rare inherited platelet disorders were purpura, ecchymosis, epistaxis and bleeding gums, respectively. Analysis of the clinico-epidemiological data of patients with bleeding disorders is a useful tool for monitoring and improving their quality of care.

  3. Ureteroscopic management of chronic unilateral hematuria: a single-center experience over 22 years.

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    Motoo Araki

    Full Text Available OBJECTIVE: To analyze the short and long term safety and efficacy of ureteroscopic evaluation and management of chronic unilateral hematuria. METHODS: We retrospectively reviewed patients with chronic unilateral hematuria from 1987 to 2008. The distal to middle ureter was evaluated with a semi-rigid ureteroscope without a guidewire. Subsequently, the flexible ureteroscope was advanced into the upper ureter to the renal pelvis using a low-pressure automated irrigant system (Uromat™. Lesions identified ureteroscopically were treated with diathermy fulguration. RESULTS: One hundred and four (56 male, 48 female patients were identified, with a median age of 37 (14-80 years and median follow-up of 139 (34-277 months. The median preoperative duration of gross hematuria was 5 (1-144 months. Endoscopic findings included 61 (56% minute venous rupture (MVR; a venous bleeding without clear abnormalities, 21 (20% hemangioma (vascular tumor-like structure, 3 (3% varix (tortuous vein, 1 (1% calculus and 18 (17% no lesions. The incidence of "no lesions" was less in the recent 12 years (9% than the first 10 years (27%, while the incidence of MVR increased from 40 to 66% (p<0.05. All patients were treated endoscopically. Immediate success rate was 96% (100% in the recent 12 years. Long-term recurrent gross hematuria rate was 7%. Six resolved spontaneously and only 1 required ureteroscopy, revealing a different bleeding site. CONCLUSION: Ureteroscopy and diathermy fulguration is highly useful for evaluation and treatment of chronic unilateral hematuria. Sophisticated technique and improved instrumentation contributes to a better outcome.

  4. Cost of a Recall of a Single-Center Experience Managing the Riata Defibrillator Lead

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    Hussain, Sarah; Moorman, Liza; Moorman, J. Randall; DiMarco, John P.; Malhotra, Rohit; Darby, Andrew; Bilchick, Kenneth; Mangrum, J. Michael; Ferguson, John D.; Mason, Pamela K.

    2014-01-01

    Riata and Riata ST defibrillator leads (St. Jude Medical, Sylmar, California) were recalled in 2011 due to increased risk of insulation failure leading to externalized cables. Fluoroscopic screening can identify insulation failure, although the relation between mechanical failure and electrical failure is unclear. At the time of the recall, the University of Virginia developed a screening program, including fluoroscopic evaluation, education sessions, device interrogation, and remote monitori...

  5. Clinical features and management of postural tachycardia syndrome in children: a single-center experience

    Institute of Scientific and Technical Information of China (English)

    Li Jiawei; Zhang Qingyou; Hao Hongjun; Jin Hongfang; Du Junbao

    2014-01-01

    Background The incidence of postural tachycardia syndrome (POTS) has been increasing in children and adolescents,while clinical characteristics of POTS in the pediatric population are not fully understood.Methods An observational study was performed in 150 pediatric patients aged between 5 and 18 years who underwent head-up tilt test (HUTT) with the diagnosis of POTS at Peking University First Hospital from March 2008 to August 2013.Demographic data,clinical presentation,autonomic parameters,laboratory findings,and treatments were recorded.Results POTS in children commonly occurred in the age of 7-14 years.Dizziness (84.00%) was the most common symptom,followed by weakness (72.00%) and orthostatic syncope (62.67%).Positive family history of orthostatic intolerance (Ol) was found in 24.64% of children with POTS.And 33.09% of them had preceding infection history as precipitating events.Ten percent of them suffered from orthostatic hypertension.Hyperadrenergic status was documented in 51.28% of 39 patients who were tested for the standing norepinephrine levels.More than half of POTS patients,with 24-hour urinary sodium level <124 mmol/24 hours,were suitable for treatment of salt supplementation.At least 25.74% of POTS patients were of positive acetylcholine receptor (AChR) antibody.Low iron storage in children with POTS was relatively rare.Most patients responded well to treatments,43.51% of patients recovered,while 7.63% of them had relapse after symptoms disappeared.Conclusions POTS is a relatively common condition with complex pathophysiology and heterogeneous clinical manifestation.A comprehensive therapeutic regimen is recommended for the treatment.

  6. IgA Nephropathy: A Twenty Year Retrospective Single Center Experience

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    Jacob Rube

    2009-01-01

    Full Text Available IgA nephropathy (IgAN is a common glomerular disease whose etiology is unknown. Previous studies have described the clinical and laboratory features but none have specifically compared patients during different time periods. This 20 year retrospective study was performed to assess trends in the severity of IgAN from 1989–2008. We reviewed 57 patient charts that contained a confirmed biopsy diagnosis of IgAN and recorded data at the time of diagnosis and the final follow-up appointment. Clinical data included physical examination, urine, and blood tests. Patients were separated into two cohorts, Cohort 1 1989–1998 and Cohort 2 1999–2008. An increase in severity was noted in Cohort 2 based on a significantly higher Up/c and lower serum albumin level. Other prognostic indicators including GFRe, hematocrit, and glomerular injury score also demonstrated a trend towards more severe disease over the past 20 years. The patients in both Cohorts received similar treatments and had comparable renal function at the last follow-up visit. Based on our findings, we suggest that although a kidney biopsy is required to diagnose IgAN, the procedure may not be necessary in patients clinically suspected of having the disease but who have normal kidney function and minimal urine abnormalities.

  7. Comparison between peritoneal tuberculosis and primary peritoneal carcinoma: a 16-year, single-center experience

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    WANG Dan; ZHANG Jun-ji; HUANG Hui-fang; SHEN Keng; CUI Quan-cai; XIANG Yang

    2012-01-01

    Background Peritoneal tuberculosis and primary peritoneal carcinoma can both present as an abdominal mass and ascites with elevated serum CA125.The purpose of our study was to evaluate the clinical features of peritoneal tuberculosis,compare them with features of primary peritoneal carcinoma,and establish definitive diagnostic procedures.Methods We conducted a retrospective study in patients with peritoneal tuberculosis from January 1995 to October 2010 at Peking Union Medical College Hospital.During this time,the data of 38 patients with primary peritoneal carcinoma were reviewed.Results The median age was 34 years (range,19-80 years).The most common symptoms were abdominal distension (16/30,53.3%) and an abdominal mass (12/30,40.0%).The serum CA125 level was elevated in 25 patients (83.3%).The median level of cancer antigen CA125 was 392.5 U/ml (range,0.64-850.0 U/ml).Abdominal ultrasound revealed a pelvic mass in 25 patients and ascites in 20 patients.Diagnostic laparoscopy was performed in 15 patients (50.0%) and exploratory laparotomy was performed in 12 patients (40.0%),and 3 patients (10.0%) who underwent laparoscopy converted to laparotomy because of severe adhesions.The intraoperative findings were adhesions,multiple white tubercles,and ascites.Frozen tissue sections were obtained in 17 patients,and 14 of whom showed chronic granulomatous reactions.Final pathological examinations confirmed the diagnosis.Conclusions Peritoneal tuberculosis should be considered as a differential diagnosis,especially for young women with an abdominal mass,ascites,and elevated serum CA125 levels.Laparoscopy is a useful diagnostic method for peritoneal tuberculosis,and intraoperative frozen sections are recommended when the diagnosis is in doubt.

  8. Clinical and demographic characteristics of patients with occupational contact dermatitis: A 3-year single center experience

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    Aslı Aytekin

    2015-12-01

    Full Text Available Background and Design: Occupational contact dermatitis (OCD is responsible for 80-90% of the occupational dermatoses. The aim of this work was to evaluate the clinical features of patients with OCD admitted to our hospital. Materials and Methods: The records of patients, who were admitted to our hospital with OCD between December 2009 and January 2013, were evaluated retrospectively. One hundred fifty-nine patients, who were diagnosed with OCD according to the Mathias criteria, were included in the study. Age, sex, location of the lesions, atopic status, glove use, occupational exposure time and total IgE levels of the patients were assessed. Patients with positive allergic reaction with "European Standard Series Skin Patch Test" were identified as allergic OCD and patients with negative test results as "irritant OCD". The clinical features and patch results of patients are evaluated. Results: One hundred fifty-nine patients with a mean age of 39±7.9 years consisted of 151 men and 8 women. The hands were the most common site of OCD; the palms were the most common affected areas of hand eczema. Eighty-one patients (50.1% were identified to have allergic OCD and 78 (49.9% as irritant OCD. Irritant OCD was most commonly seen in dental technicians, whereas allergic OCD was most commonly seen in tailors. The top 3 most frequent allergens were potassium dichromate (15.1%, nickel sulfate (9.11% and cobalt chloride (10.7%. Conclusion: In our country, there has been no comprehensive study presenting the clinical and descriptive characteristics of OCD. For preventing OCD and reducing sick leave we need to have data that belong to our country. Consequently, multicenter studies should be performed for establishing our own database on OCD.

  9. Occult Hepatitis C Virus Infection in Haemodialysis Unit: A Single-center Experience

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    Abdel Hamid A. Serwah1, Waleed S. Mohamed1, Mohamed Serwah1, Awateif Edreis2, Ahmad El Zaydi3

    2014-07-01

    Full Text Available Background & Aims: Detection of hepatitis C virus RNA in peripheral blood mononuclear cells (PBMC and/or hepatocytes in the absence of HCV RNA in serum, designated as ‘occult HCV infection’, has been a matter of controversy in the recent years. Occult hepatitis C virus (HCV infection has not been investigated in haemodialysis patients. We investigated for the first time the prevalence of occult HCV infection in large cohorts of chronic hemodialysis (CHD patients in a single heamodialysis center at Al-Taif, KSA. Methods: We enrolled 84 CHD patients, whose sera are negative for HCV markers. HCV RNA was tested in PBMC using a sensitive commercial real time assay. In this study, real-time PCR was used to test for the presence of genomic HCV-RNA in peripheral blood mononuclear cells of all of these patients. For comparison, 20 patients on HD with evidence of chronic hepatitis C virus infection were included as a control group. Results: In CHD patients, occult HCV infection, determined by the presence of genomic HCV-RNA in peripheral blood mononuclear cells (PBMNCs, was found in 13.4 % of the patients; 83 % of these patients had ongoing HCV replication, indicated by the presence of HCV-RNA. Patients with occult HCV infection had spent a significantly longer time on heamodialysis and had significantly higher mean alanine aminotransferase levels during the 3 months before study entry. Compared to CHCV patients, those with occult HCV have less elevated bilirubin, AST and ALT. Conclusions: The prevalence of occult HCV infection was moderate in our CHD patients, and it did not appear to be clinically relevant. Further studies in other geographic populations with high HCV endemicity are required to clarify the significance of occult HCV infection in these patient groups. Abbreviations HCV, Hepatitis C Virus ; antibody against HCV; PBMC, peripheral blood mononuclear cells; rRT-PCR, real time reverse transcriptase polymerase chain reaction; CHD, chronic hemodialysis.

  10. The influence of national guidelines on soft tissue sarcoma patient outcome: a single center experience

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    Annu Nummi

    2014-12-01

    Full Text Available Aim: The aim was to study the impact of nationwide clinical practice guidelines for soft tissue sarcomas (STS, introduced in 1994 and again in 2005 in North Savo, Finland. Methods: We retrospectively reviewed all the patients whose sarcoma was treated by a multidisciplinary team between the years 2000 and 2009 with mean follow-up time of 68 months. The patients were divided into 2 groups according to years: Group A (2000-2005, 72 patients and Group B (2006-2009, 64 patients. Primary outcomes were local recurrence, metastases, and overall survival. Results: Fifty-five percent were men with an average age of 59 years. The most common sarcomas were pleomorphic sarcoma (37% and liposarcoma (26%. Although there were significantly less amputations in Group B (A: 15%, B: 3%, there were more metastases (A: 10%, B: 23% with an overall lower overall survival rate (A: 70%, B: 58% than in Group A. Conversely, Group A had a higher 1st year survival rate (A: 100%, B: 87%. We found that upper limb sarcomas were more likely to be diagnosed with incisional biopsies, but there was no correlation between incisional biopsy and recurrence, metastases or survival. Conclusion: Due to nonadherence of the 2005 national treatment recommendations, there has been no improvement either in management or survival. The importance of educating guidelines to doctors referring patients to specialized units cannot be overemphasized to affect successful management in the treatment of STS.

  11. Surgicopathological classification of hepatic space-occupying lesions: A single-center experience with literature review

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    Wen-Ming Cong; Hui Dong; Lu Tan; Xu-Xu Sun; Meng-Chao Wu

    2011-01-01

    Accompanying rapid developments in hepatic surgery, the number of surgeries and identifications of histological types of primary hepatic space-occupying lesions (PHSOLs) have increased dramatically. This has led to many changes in the surgicopathological spectrum of PHSOLs, and has contributed to a theoretical basis for modern hepatic surgery and oncological pathology. Between 1982 and 2009 at the Eastern Hepatobiliary Surgery Hospital (EHBH) in Shanghai, 31 901 patients underwent surgery and were diagnosed as having a PHSOL. In this paper, we present an analysis of the PHSOL cases at the EHBH for this time period, along with results from a systematic literature review. We describe a surgicopathological spectrum comprising more than 100 types of PHSOLs that can be stratified into three types: tumor-like, benign, and malignant. We also stratified the PHSOLs into six subtypes derived from hepatocytes; cholangiocytes; vascular, lymphoid and hemopoietic tissues; muscular, fibrous and adipose tissues; neural and neuroendocrine tissues; and miscellaneous tissues. The present study provides a new classification system that can be used as a current reference for clinicians and pathologists to make correct diagnoses and differential diagnoses among various PHSOLs.

  12. Impact of surgical delay on outcomes in elderly patients undergoing emergency surgery: A single center experience

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    Marc; Ong; Tan; Yu; Guang; Tan; Kok; Yang

    2015-01-01

    AIM: To determine predisposing factors leading to surgical delay in elderly patients with acute abdominal conditions and its impact on surgical outcomes.METHODS: A retrospective review of a total of 144 patients aged 60 years and older who had undergone emergency abdominal surgery between 2010 and 2013 at a regional general hospital was analysed. The operations analysed were limited to perforated or gangrenous viscus and strangulated hernia. Patient demographic features, time taken to obtain a computed tomography scan, time taken to surgery and the impact on postoperative morbidity and mortality were analysed.RESULTS: The mean age was 70.5 ± 9.1 years and median time taken to surgery was 9 h. The overall mortality and complication rates(Clavien Dindo 3 and above) were 9% and 13.1% respectively. Diabetes mellitus was a significant predisposing factor which had an impact on surgical delays. Delays in surgery more than 24 h led to higher complication rates at 38.9%(P = 0.003), with multivariate analysis confirming it as an independent factor. Delays in obtaining a computed tomography(CT) scan was also shown to result in higher complication rates(Clavien Dindo 3 and above).CONCLUSION: Delays in performing emergency surgery in elderly lead to higher complication rates. Obtaining CT scans early also may facilitate prompt diagnosis of certain abdominal emergencies where presentation is more equivocal and this may lead to improved surgical outcomes.

  13. Clinical Aspects of Thyrotoxicosis in 592 Patients: A Single Center Experience from Turkey

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    Serap Baydur Şahin

    2014-12-01

    Full Text Available Purpose: To determine the main causes of thyrotoxicosis and to compare the clinical and biochemical fetaures of the patients according to the underlying cause of thyrotoxicosis. Material and Method: Five hundred ninety-two patients, who were consecutively diagnosed with thyrotoxicosis, were retrospectively analysed. Symptoms of thyrotoxicosis, serum thyroid-stimulating hormone (TSH, free T3 and free T4 levels, anti-thyroglobulin autoantibody (TGAb, anti-thyroid peroxidase autoantibody (TPOAb and ultrasonographic features were recorded. To determine the cause of thyrotoxicosis, Tc-99m pertechnetate thyroid scintigraphy was performed in all patients except for pregnant women. The clinical and biochemical results were compared between the patients with different diagnosis of thyrotoxicosis. Results: 40.9% of patients were diagnosed with toxic multinodular goiter (TMNG. The other main causes of thyrotoxicosis were: Graves’ disease (GD (22%, thyroiditis (14.8%, gestational thyrotoxicosis (12.7%, and toxic adenoma (9.6%. The clinical presentation and severity of thyrotoxicosis varied according to the underlying cause. Weight loss was more frequently observed in patients with GD (p=0.0001, while cardiac arrhythmia dominated in patients with TMNG (p=0.0001. Moderate (27% or severe (23.9% thyrotoxicosis was more common in patients with GD than in patients with other forms of thyrotoxicosis (p=0.0001. Discussion: Toxic multinodular goiter is the most common cause of thyrotoxicosis in our region.

  14. 5. Mitral valve replacement for mitral stenosis: 15 years single center experience

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    A. Arifi

    2016-07-01

    Full Text Available Mitral valve replacement (MVR with either a bioprosthetic or a mechanical valve is the treatment of choice for severe mitral stenosis. This study aimed to evaluate and compare the early and late outcome of mitral valve replacement (mechanical versus bioprosthetic for severe mitral stenosis. A retrospective cohort study was performed on prospectively collected data involving mitral stenosis patients who have undergone MVR with either bioprosthetic (BMV (n = 50 or mechanical (MMV (n = 145 valves in our institute from 1999 to 2012. Data were analyzed for early and late mortality, NYHA functional classes, stroke, early and late valve-related complications, and survival. Chi Square test, logistic regression, Kaplan Meier curve, and dependent proportions tests were performed. A total of 195 patients were included in the study with a follow-up of 190 patients (97.5%. One patient died early post-operatively; twelve patients died late in the post-operative period, BMV group (6 and the MMV (6. The Late mortality had significantly associated with post-op stroke (p < 0.001 and post-op NYHA classes III and IV (p = 0.002. Post-op NYHA class was significantly associated with age (p = 0.003, pulmonary disease (p = 0.02, mitral valve implant type (p = 0.01, and post-op stroke (p = 0.02; 14 patients had strokes in the MMV (9 and in the BMV (5 groups. NYHA classes were significantly better after the replacement surgeries (p < 0.001. Bioprosthetic valves were significantly associated with worse survival (p = 0.03, worse NYHA post-op (p = 0.01, and more re-operations (p = 0.006. Survival was significantly better with mechanical valves (p = 0.03. When the two groups were matched for age and mitral regurgitation, the analysis revealed that bioprosthetic valves were significantly associated with re-operations (p = 0.02 but not significantly associated with worse survival (p = 0.4 or worse NYHA (p = 0.4. Mechanical mitral valve replacement in mitral stenosis patients is associated with lower re-operation rate, but no difference in survival as compared to bioprosthetic mitral valve replacement. Furthermore, post-operative stroke occurrence (14% is associated with late mortality and worse NYHA classes.

  15. Non-Hodgkin’s lymphoma with bone involvement: a single center experience with 18 patients

    Directory of Open Access Journals (Sweden)

    Filiz Vural

    2010-03-01

    Full Text Available Objective: Non-Hodgkin’s lymphoma (NHL of bone is a rare entity. The most common histological subtype is diffuse large B cell lymphoma (DLBCL. The major presenting symptoms are soft tissue swelling, bone pain and pathological fracture. Treatment options are chemotherapy, radiotherapy, surgery, or a combination of these modalities. Materials and Methods: We retrospectively analyzed the 18 patients (11 females, 7 males with NHL of bone who were diagnosed and treated between 1995-2005. The median age was 56.5 years. The median duration of symptoms was 4.5 months. The bone pain was the first symptom in all patients. Tru-cut biopsy was performed for diagnosis in most of the cases. Diagnosis in five patients (27.8% required open biopsy. Results: DLBCL (77.8% was the most common histological type among all patients. Other histological subtypes were anaplastic large cell lymphoma (11.1%, Burkitt-like lymphoma (5.6% and marginal zone lymphoma (5.6%. According to Ann Arbor staging system, 44.4% of patients were Stage I, 11.1% were Stage II and 44.4% were Stage IV. Bone marrow involvement was determined in four patients (22.2%. All patients except one were treated with anthracycline-containing regimens and eight patients (44.4% received rituximab combination with chemotherapy. Radiation therapy was performed as the first-line therapy in 9 (50% patients. The median follow-up was 37 months (range, 2-124 months. Among the 17 patients who achieved complete remission, five (27.8% relapsed. All patients were still alive. The five-year relapse-free survival was 73.5%.Conclusion: The treatment of bone lymphoma can be planned according to the stage and location of the disease. Although we had a relatively low number of patients, it could be concluded that whether or not radiation therapy is performed, rituximab in combination with systemic chemotherapy has been proven beneficial on survival.

  16. Stage one Norwood procedure in an emerging economy:Initial experience in a single center

    Directory of Open Access Journals (Sweden)

    Rakhi Balachandran

    2013-01-01

    Methods : Retrospective review of medical records of seven neonates who underwent Norwood procedure at our institute from October 2010 to August 2012. Results: The median age at surgery was 9 days (range 5-16 days. All cases were done under deep hypothermic cardiopulmonary bypass and selective antegrade cerebral perfusion. The median cardiopulmonary bypass (CPB time was 240 min (range 193-439 min and aortic cross-clamp time was 130 min (range 99-159 min. A modified Blalock-Taussig (BT shunt was used to provide pulmonary blood flow in all cases. There were two deaths, one in the early postoperative period. The median duration of mechanical ventilation was 117 h (range 71-243 h and the median intensive care unit (ICU stay was 12 days (range 5-16 days. Median hospital stay was 30.5 days (range 10-36 days. Blood stream sepsis was reported in four patients. Two patients had preoperative sepsis. One patient required laparotomy for intestinal obstruction. Conclusions:Stage one Norwood is feasible in a limited-resource environment if supported by a dedicated postoperative intensive care and protocolized nursing management. Preoperative optimization and prevention of infections are major challenges in addition to preventing early circulatory collapse.

  17. Congenital cystic lesions of the lungs: The perils of misdiagnosis - A single-center experience

    Directory of Open Access Journals (Sweden)

    V Shankar Raman

    2015-01-01

    Full Text Available Background: A majority of cystic lesions in the western world are detected antenatally, whereas, the diagnosis in our setup occurs once the child becomes symptomatic. Surgical management is primarily dictated by the presence of symptoms, recurrent infection, and rarely by the potential risk of malignant transformation. Materials and Methods: A retrospective analysis was carried out on all consecutive patients with cystic lung lesions managed at our center from January 2000 through June 2011 for antenatal diagnosis, presentation, diagnostic modalities, treatment, and complications. Results: Forty cystic lung lesions were identified. Only 8% were antenatally detected. Out of 40, the final diagnosis was congenital cystic adenomatoid malformation in 19, congenital lobar emphysema in 11, and bronchogenic cysts and pulmonary sequestration in five each. Of these, 20% had received a course of prior antitubercular therapy and 30% had an intercostal drain inserted prior to referral to our center. Postoperative morbidity in the form of bronchopleural fistula, pneumothorax, and non-expansion of the residual lung was noted in 10% of the patients. Conclusion: Antenatal diagnosis of these lesions is still uncommon in third world countries. Prior to referral to a pediatric surgical center a large number of patients received antitubercular drugs and an intercostal drain insertion, due to incorrect diagnosis.

  18. Survival in progressive systemic sclerosis with pulmonary involvement: a single-center experience in Istanbul, Turkey.

    Science.gov (United States)

    Zuhur, Ferit; Zuhur, Sayid Shafi; Zuhur, Cigdem; Musellim, Benan; Ongen, Gul

    2012-06-01

    The objective of the current study was to determine survival and factors that affect survival in progressive systemic sclerosis (SSc) with pulmonary involvement. A total of 102 SSc patients with pulmonary involvement, diagnosed between 1994 and 2008, enrolled into the study. Pulmonary involvement was defined based on the presence of interstitial changes on high-resolution CT (HRCT). Demographical, clinical, radiological, and laboratory data of the patients were found from patient records and were used for the evaluation of survival. The mean age of the patients at diagnosis was 50 ± 12 years. In follow-up, 22 (21.5%) patients were deceased. The mean age of the patients at death was 55 ± 12 years. Seventy-eight percent of known causes of mortality were related to pulmonary complications. After any initial systemic manifestation of disease, the mean survival was 447 ± 27 months and 5, 10, 15, and 20 year survival rates were 99, 92, 83, and 72%, respectively. The mean survival after initial pulmonary manifestation was 269 ± 23 months and 5, 10 and 15 year survival rates were 91, 73 and 57%, respectively. Mean survival was 113 ± 5 months, and 5- and 10-year survival rates after the lung involvement detected with HRCT were 85 and 66%, respectively. Pulmonary artery hypertension, disease onset after the age of 40, and honeycombing on HRCT were associated with poor survival. Our data suggest that pulmonary involvement is the most important determinant factor for poor prognosis in patients with SSc. Therefore, echocardiography, pulmonary function tests, and HRCT should be performed in early stages of the disease for early diagnosis of pulmonary artery hypertension and lung involvement before irreversible vascular and interstitial changes exist.

  19. Self-expanding metal stents for colonic obstruction: experiences from 104 procedures in a single center

    DEFF Research Database (Denmark)

    Meisner, Søren; Hensler, Margaret; Knop, Filip Krag;

    2004-01-01

    In the past, colonic obstruction caused by malignancy most often resulted in high-risk operations, usually involving two-step procedures or leaving the patient with a stoma in case of disseminated disease....

  20. Urea for treatment of acute SIADH in patients with subarachnoid hemorrhage: a single-center experience

    Science.gov (United States)

    2012-01-01

    Background Hyponatremia occurring as a result of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) or cerebral salt wasting syndrome is a common complication in patients with subarachnoid hemorrhage (SAH). The efficacy and safety of urea as treatment for SIADH-induced hyponatremia has not been reported in this population. Methods This is a retrospective analysis of all patients admitted to our department for nontraumatic SAH between January 2003 and December 2008 (n = 368). All patients with SIADH-induced hyponatremia (plasma sodium  20 mEq/L, and osmolality > 200 mOsm/kg; absence of overt dehydration or hypovolemia; no peripheral edema or renal failure; no history of adrenal or thyroid disease) routinely received urea per os when hyponatremia was associated with clinical deterioration or remained less than 130 mEq/L despite saline solution administration. Results Forty-two patients developed SIADH and were treated with urea. Urea was started after a median of 7 (IQR, 5–10) days and given orally at doses of 15–30 g tid or qid for a median of 5 (IQR, 3–7) days. The median plasma sodium increase over the first day of treatment was 3 (IQR, 1–6) mEq/L. Hyponatremia was corrected in all patients, with median times to Na+ >130 and >135 mEq/L of 1 (IQR, 1–2) and 3 (IQR, 2–4) days, respectively. Urea was well tolerated, and no adverse effects were reported. Conclusions Oral urea is an effective and well-tolerated treatment for SIADH-induced hyponatremia in SAH patients. PMID:22647340

  1. The Prevalence of Headache in Crohn's Disease: Single-Center Experience.

    Science.gov (United States)

    Anadol Kelleci, Ulker; Calhan, Turan; Sahin, Abdurrahman; Kahraman, Resul; Ozdil, Kamil; Sokmen, Haci Mehmet; Yalcin, Destina

    2016-01-01

    Objectives. This study is aimed at studying the prevalence and characteristics of different types of headaches in patients with Crohn's disease. Materials and Methods. 51 patients in Crohn's disease group (F/M: 26/25) and 51 patients in control group (F/M: 27/24) were involved. Patients in Crohn's disease group were diagnosed and monitored according to European Crohn's and Colitis Organization diagnostic criteria. The control group composed of healthy subjects with similar age and sex to Crohn's disease group. Headache was classified using the International Headache Society II criteria. Results. Headache was reported by 35/51 (68.6%) patients in Crohn's disease group and 21/51 (41.2%) patients in the control group. The prevalence of headache was statistically high in the group with Crohn's disease (OR: 3.125 (95% CI: 1.38-7.04); p = 0.01). Comparing two groups with respect to their subtypes of headaches resulted in that the tension-type headache was statistically (p = 0.008) higher in Crohn's disease group (26/51) than in the control group (12/51). However, no significant difference was found in the migraine-type headache (p = 1). Conclusions. This study indicates that the prevalence of headache is high in patients with Crohn's disease and most commonly associated with the tension-type headache.

  2. Perinatal Outcome of Discordant Anomalous Twins: A Single-Center Experience in a Developing Country.

    Science.gov (United States)

    Fernandes, Tatiana R M M; Carvalho, Paulo R N; Flosi, Fernanda B; Baião, Ana Elisa R; Junior, Sant Claire G

    2016-08-01

    A dramatic increase in twin pregnancies has been observed in the past few decades, primarily related to assisted reproductive techniques (ART) and increased average maternal age during pregnancy. Multiple pregnancies, compared to singleton pregnancies, are associated with greater perinatal morbidity and mortality. The present study evaluated the perinatal outcomes of pregnancies with discordant anomalous twins in a tertiary maternity ward in a developing country. Data were retrospectively collected from the Instituto Fernandes Figueira/FIOCRUZ, Brazil between January 2002 and December 2014. We identified 74 twin pregnancies with discordant anomalous twins. Final data analysis was based on 40 pregnancies. Congenital defects were classified according to the International Classification of Diseases: ICD-10: the digestive system was responsible in 27 (34%) cases; the central nervous system was responsible in 18 (22%) cases; the urinary tract was responsible in 14 (17%) cases; and the circulatory system was responsible in 14 (17%) cases. A total of 19 deaths occurred during the study period, and delivery before 30.4 weeks was a significant prediction of fetal death (p = .01). The presence of hydrops in the affected fetus was related to a higher number of deaths in healthy fetuses and contributed to a worse prognosis. The presence of this condition was the cause of 12 (55.6%) deaths in healthy fetuses. A 10 times higher risk of death of a normal co-twin was observed in cases of death of the anomalous twin (p = .002, OR 10.55, 95% CI: 1.9-58.52). PMID:27321141

  3. Coexistence of parathyroid adenoma and papillary thyroid carcinoma: Experience of a single center

    Directory of Open Access Journals (Sweden)

    Ebubekir Gündeş

    2013-01-01

    Full Text Available Objective: The aim of this study was to describe experienceswith concurrent parathyroid adenoma and papillarythyroid carcinoma.Methods: Eight patients with concurrent parathyroid adenomaand papillary thyroid carcinoma were identifiedbetween 2005 and 2012, and their medical records werereviewed retrospectively.Results: Of the eight patients identified, two were maleand six were female; their mean age was 53.6 years.The mean serum calcium concentration was 11.7 mg/dL.Intact parathyroid hormone (iPTH concentrations werehigh in all patients, with a mean concentration of 338 pg/mL. The most frequently used surgical technique was totalthyroidectomy plus parathyroid adenoma excision (n=6.The mean size of the thyroid carcinoma was 1.2 cm, andone case showed metastatic lymph nodes in the centralcompartment. The mean parathyroid adenoma size wasfound to be 2.1(0.6- 3.5 cm, according to the longest sizeof the adenom. Six patients (75% developed postoperativecomplications, including temporary symptomatic hypocalcemiain 4 patients (50%, hematoma developmentin 1 patient (12.5% and temporary vocal cord paralysis inone patient (12.5%.Conclusion: Thyroid carcinoma and parathyroid adenomaare rarely concomitant. Rarely hyperparathyroidismmay be accompanied with thyroid carcinomas so preoperativelythyroid gland should be properly examined. Thyroidwith parathyroid surgery are risk factors of recurrentlaryngeal nerve injury and hypoparathyroidism.Key words: Papillary thyroid cancer; parathyroid adenoma;thyroidectomy

  4. Extrapulmonary small cell carcinoma. An indication for prophylactic cranial irradiation? A single center experience

    Energy Technology Data Exchange (ETDEWEB)

    Frueh, Martin; Cerny, Thomas [Kantonsspital St. Gallen (Switzerland). Dept. of Oncology/Hematology; Kacsir, Bela; Plasswilm, Ludwig [Kantonsspital St. Gallen (Switzerland). Dept. of Radiation Oncology; Ess, Silvia [Cancer Registry, Canton of St. Gallen, Appenzell (Switzerland); Rodriguez, Regulo [Kantonsspital St. Gallen (Switzerland). Dept. of Pathology

    2011-09-15

    Information about extrapulmonary small cell carcinoma (EPSCC) is limited and the role of prophylactic cranial irradiation (PCI) is unknown. Disease presentation and outcome of all EPSCC at our hospital between 1990 and 2009 were retrospectively analyzed. Of 30 EPSCC, the male:female ratio was 58%:42%; 83% had a performance status of 0-2. Median age was 71 years (32-80). Seventeen (57%) had limited stage (LS), 13 (43%) extensive stage (ES). The location of the primary tumor was gastrointestinal (n = 8), unknown (6), gynecological (6), urogenital (5), and ear nose throat (5). Four (13%) developed brain metastases (2 ES, 2 LS). In ES, first line chemotherapy (CT) was given in 85%, mostly platinum-etoposide (64%). Response rate was 90%. In LS, CT and radiotherapy (RT) {+-} resection resulted in persistent remissions in 67% of patients. Median survival was 16 months (1-107 months), 18 months (1-107 months), and 9 months (0.4-25 months) for LS + ES, LS, and ES, respectively. Weight loss {>=}5 % and ECOG performance status 3 + 4 were associated with poorer survival (p < 0.001 and p < 0.01, respectively). The incidence of brain metastases was relatively low (13%). More studies are necessary, before routinely offering PCI to patients with EPSCC. Best survival outcomes in LS were achieved with multimodality treatment including CT and RT. Prognosis was poor in patients with ES. (orig.)

  5. Parathyroid Gland Function in Kidney Transplanted Patient: A single Center Experience

    Directory of Open Access Journals (Sweden)

    Azar BARADARAN

    2012-06-01

    Full Text Available Introduction: Information on the time course of serum parathormone levels after renal transplantation is scanty. Both the abrupt cessation of calcium-containing phosphorus binders and vitamin D (analogs at the time of surgery and the recovery of renal function may be hypothesized to affect parathyroid gland. This study firstly examined frequency distribution of various biochemical parameters such as alkaline phosphatase (ALP, phosphorus (P, intact parathormone (iPTH and calcium (Ca in renal transplanted patients and secondly examined the relationship between these parameters and various demographic data of renal transplanted recipients. Material and Methods: we studied 72 renal transplanted patients (47 men and 25 women with mean ages of 44 ± 12 years and mean body mass index of 24.2 ± 3.9. Serum Ca, P, ALP and serum iPTH were measured. Results: In this study, mean serum Ca and iPTH were 9.5 ± 0.7mg/dL and18.4 ± 8.2 Pg/mL (median=16.5. Mean serum ALP was 169 ± 133 IU/L (median=131. In this study, there was a negative relationship between serum iPTH and creatinine clearance (r=-0.44 P 0.05. There were inverse correlations of serum ALP with age (r=-0.35 P= 0.02 and duration of kidney transplantation (r=-0.29 P= 0.01. Conclusions: In contrast to previous findings, in this group of patients, there was not secondary hyperparathyroism or significantly increased bone activity. The results showed suppressed parathormone secretion. The reason may be due to excessive intake of calcium and Vitamin D analogues, which suppress the parathyroid gland, and may prone these patients to adynamic bone disease.

  6. Elastographic assessment of liver fibrosis in children: A prospective single center experience

    Energy Technology Data Exchange (ETDEWEB)

    Marginean, Cristina Oana, E-mail: marginean.oana@gmail.com [Department of Paediatrics, University of Medicine and Pharmacy of Tg. Mures (Romania); Marginean, Claudiu, E-mail: marginean.claudiu@gmail.com [Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Tg. Mures (Romania)

    2012-08-15

    Background: The assessment of liver damage in various disease states relies on a combination of clinical findings, biochemical parameters and invasive tests such as liver biopsy. The ultrasound elastography has emerged as a potential alternative test, providing quantifiable information on the elasticity/stiffness of the examined-tissues. We assessed the performance of ultrasound elastography using real-time Acoustic Radiation Force Imaging (ARFI) technology in evaluating the degree of liver fibrosis in children with and without liver disease. Methods: Children aged 0-18 years, hospitalized in the Emergency Clinical County Hospital Tg. Mures, Romania, between September 15, 2010 and January 15, 2011, were eligible for the study. Four groups were recruited as follow: patients with liver disease in the setting of various malignant disorders, children with non-malignant liver disease, overweight and obese children and healthy controls. The liver tissue elasticity was assessed in each individual using Shear Wave Velocity (SWV). Biochemical tests included transaminase levels. 19 children with chronic liver disease underwent biopsies. SWV was measured globally and separately for the liver-segments 1 and 8. Correlations between the SWV and laboratory test were established using non-parametric Spearman correlation test. Results: A total of 103 children underwent liver ultrasound elastographic assessments. Of these, 39 had malignancies, 19 had various chronic liver diseases, 13 had nonalcoholic fatty liver disease (NAFLD), and 32 were healthy controls. The transaminase values differed significantly between children with liver diseases and controls. In normal controls SWV values in the 1st segment were significantly lower compared to those in the in 8th segment of the liver (p = 0.0216). In the group with hepatic steatosis, the SWV values were statistically higher compared to those in healthy controls. Positive statistical correlations have been established between AST and SWV in the group of children with NAFLD and those with malignancies (p = 0.0032, p = 0.0045). Conclusions: Quantification of liver fibrosis by ARFI method correlates with the histological fibrosis stage in children with chronic liver disease and NAFLD. Clinical applications of this method in the diagnosis of pediatric liver disease deserve further study.

  7. Penile lichen sclerosus: An urologist′s nightmare! - A single center experience

    Directory of Open Access Journals (Sweden)

    Jitendra Pratap Singh

    2015-01-01

    Conclusion: LS varies from being a highly aggressive disease of the penis and anterior urethra to a burnt out condition affecting just the meatus and surrounding glans. Early diagnosis and treatment are required to prevent its complication and associated morbidity. Management depends on the anatomical location of lesion, extent of involvement, rapidity of progression and its severity. Use of BMG in LS induced urethral stricture has shown encouraging results.

  8. Vibrational angioplasty in recanalization of chronic femoropopliteal arterial occlusions: Single center experience

    Energy Technology Data Exchange (ETDEWEB)

    Kapralos, Ioannis, E-mail: jkapgr@yahoo.gr [251 Hellenic Air Force General Hospital, Athens (Greece); Kehagias, Elias, E-mail: eliaskmd@yahoo.gr [Interventional Radiology Unit, Department of Radiology, Faculty of Medicine, University of Crete, Heraklion, Crete (Greece); Ioannou, Christos, E-mail: ioannou@med.uoc.g [Faculty of Medicine, University of Crete, Heraklion, Crete (Greece); Bouloukaki, Izolde, E-mail: izolthi@gmail.com [Interventional Radiology Unit, Department of Radiology, Faculty of Medicine, University of Crete, Heraklion, Crete (Greece); Kostas, Theodoros, E-mail: kostasth@mailbox.gr [Faculty of Medicine, University of Crete, Heraklion, Crete (Greece); Katsamouris, Asterios, E-mail: asterios@med.uoc.gr [Faculty of Medicine, University of Crete, Heraklion, Crete (Greece); Tsetis, Dimitrios, E-mail: tsetis@med.uoc.gr [Interventional Radiology Unit, Department of Radiology, Faculty of Medicine, University of Crete, Heraklion, Crete (Greece)

    2014-01-15

    Purpose: This prospective study aims to present the overall success rate, safety and long-term outcome of vibrational angioplasty technique, in the treatment of chronic total femoropopliteal occlusions in our institute. Methods: Between October 2000 and December 2008, patients with chronic total femoropoliteal arterial occlusions, treated with vibrational angioplasty during the same session after a failed attempt with conventional recanalization technique, were included. Patient's follow up included serial ankle-brachial index measurements and arterial duplex ultrasound examinations at 1, 3, 6, 12, 24, 36 and 48 months. Results: Twenty-seven patients (16 males and 11 females) and twenty-eight lesions were included in our study. Twenty-five lesions (89.3%) were successfully recanalized. Pain relief was noticed in twenty-one cases. From ten lesions with tissue loss (ulcer or gangrene) in successfully recanalized occlusions, six healed without major, or minor amputation. One non-healing amputation stump was healed after recanalization, without further complications. Four limbs underwent amputation (one minor and three major) despite successful recanalization, however all had an excellent healing of the amputation stump without further complications. The Kaplan–Meier test demonstrated 90%, 85% and 70% amputation-free survival rate at 12, 24 and 36 months, respectively. No major or minor complications were encountered. Conclusions: Vibrational angioplasty is a safe, effective and durable endovascular technique for the treatment of chronic total occlusions in patients with limb ischemia that would be difficult to recanalize using conventional intraluminal techniques.

  9. Non-Hodgkin’s lymphoma with bone involvement: a single center experience with 18 patients

    OpenAIRE

    Filiz Vural; Nur Akad Soyer; Pınar Özen; Ayhan Dönmez; Serkan Ocakçı; Güray Saydam; Seçkin Çağırgan; Murat Tombuloğlu

    2010-01-01

    Objective: Non-Hodgkin’s lymphoma (NHL) of bone is a rare entity. The most common histological subtype is diffuse large B cell lymphoma (DLBCL). The major presenting symptoms are soft tissue swelling, bone pain and pathological fracture. Treatment options are chemotherapy, radiotherapy, surgery, or a combination of these modalities. Materials and Methods: We retrospectively analyzed the 18 patients (11 females, 7 males) with NHL of bone who were diagnosed and treated between 1995-2005. The me...

  10. Elastographic assessment of liver fibrosis in children: A prospective single center experience

    International Nuclear Information System (INIS)

    Background: The assessment of liver damage in various disease states relies on a combination of clinical findings, biochemical parameters and invasive tests such as liver biopsy. The ultrasound elastography has emerged as a potential alternative test, providing quantifiable information on the elasticity/stiffness of the examined-tissues. We assessed the performance of ultrasound elastography using real-time Acoustic Radiation Force Imaging (ARFI) technology in evaluating the degree of liver fibrosis in children with and without liver disease. Methods: Children aged 0–18 years, hospitalized in the Emergency Clinical County Hospital Tg. Mures, Romania, between September 15, 2010 and January 15, 2011, were eligible for the study. Four groups were recruited as follow: patients with liver disease in the setting of various malignant disorders, children with non-malignant liver disease, overweight and obese children and healthy controls. The liver tissue elasticity was assessed in each individual using Shear Wave Velocity (SWV). Biochemical tests included transaminase levels. 19 children with chronic liver disease underwent biopsies. SWV was measured globally and separately for the liver-segments 1 and 8. Correlations between the SWV and laboratory test were established using non-parametric Spearman correlation test. Results: A total of 103 children underwent liver ultrasound elastographic assessments. Of these, 39 had malignancies, 19 had various chronic liver diseases, 13 had nonalcoholic fatty liver disease (NAFLD), and 32 were healthy controls. The transaminase values differed significantly between children with liver diseases and controls. In normal controls SWV values in the 1st segment were significantly lower compared to those in the in 8th segment of the liver (p = 0.0216). In the group with hepatic steatosis, the SWV values were statistically higher compared to those in healthy controls. Positive statistical correlations have been established between AST and SWV in the group of children with NAFLD and those with malignancies (p = 0.0032, p = 0.0045). Conclusions: Quantification of liver fibrosis by ARFI method correlates with the histological fibrosis stage in children with chronic liver disease and NAFLD. Clinical applications of this method in the diagnosis of pediatric liver disease deserve further study.

  11. Analysis of periinterventional complications of intracranial angioplasty and stenting: A single center experience

    Energy Technology Data Exchange (ETDEWEB)

    Silber, Toni; Ziemann, Ulf [Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen (Germany); Ernemann, Ulrike [Department of Diagnostic and Interventional Neuroradiology, University of Tübingen (Germany); Bischof, Felix, E-mail: felix.bischof@uni-tuebingen.de [Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen (Germany)

    2014-12-15

    Highlights: • Periinterventional complications in 7.5% of patients with intracranial artery stenting. • 2.5% of periinterventional complications were perforator strokes. • 3.8% of patients developed a hemorrhagic stroke due to reperfusion injury. • Complications could be reduced by individualized measures to prevent perforator stroke or reperfusion injury. - Abstract: Background and purpose: Treatment of symptomatic intracranial atherosclerotic disease by angioplasty and stenting (PTAS) is limited by a high rate of periinterventional strokes. We performed a detailed analysis of these strokes at our center in order to identify strategies to reduce the risk of periinterventional complications. Methods: Case records and imaging data of 80 patients with a symptomatic 70–99% stenosis of a major intracranial artery treated with PTAS between July 2007 and December 2013 were reviewed. All patients had a sufficient response to aspirin and clopidogrel. Periinterventional strokes were categorized as either ischemic (perforator territory, distal embolic or delayed stent thrombosis) or hemorrhagic (intraparenchymal, subarachnoid). Results: Periinterventional complications occurred in 6/80 (7.5%) patients, consisting of 2 ischemic strokes (2.5%, both perforator territory), 3 hemorrhagic strokes (3.8%, 2 intraparenchymal due to reperfusion injury, 1 subarachnoid due to vessel rupture) and one death (1.3%) unrelated to stroke. All strokes occurred within 24 h after PTAS. Conclusion: Our retrospective data analysis suggests that the risk of periinterventional stroke after PTAS of symptomatic intracranial atherosclerotic disease might be reduced by sufficient antiplatelet therapy and optimized management of patients with high risk for reperfusion injury or perforator strokes, including selection of a stenting device adapted to individual vessel morphology.

  12. Analysis of periinterventional complications of intracranial angioplasty and stenting: A single center experience

    International Nuclear Information System (INIS)

    Highlights: • Periinterventional complications in 7.5% of patients with intracranial artery stenting. • 2.5% of periinterventional complications were perforator strokes. • 3.8% of patients developed a hemorrhagic stroke due to reperfusion injury. • Complications could be reduced by individualized measures to prevent perforator stroke or reperfusion injury. - Abstract: Background and purpose: Treatment of symptomatic intracranial atherosclerotic disease by angioplasty and stenting (PTAS) is limited by a high rate of periinterventional strokes. We performed a detailed analysis of these strokes at our center in order to identify strategies to reduce the risk of periinterventional complications. Methods: Case records and imaging data of 80 patients with a symptomatic 70–99% stenosis of a major intracranial artery treated with PTAS between July 2007 and December 2013 were reviewed. All patients had a sufficient response to aspirin and clopidogrel. Periinterventional strokes were categorized as either ischemic (perforator territory, distal embolic or delayed stent thrombosis) or hemorrhagic (intraparenchymal, subarachnoid). Results: Periinterventional complications occurred in 6/80 (7.5%) patients, consisting of 2 ischemic strokes (2.5%, both perforator territory), 3 hemorrhagic strokes (3.8%, 2 intraparenchymal due to reperfusion injury, 1 subarachnoid due to vessel rupture) and one death (1.3%) unrelated to stroke. All strokes occurred within 24 h after PTAS. Conclusion: Our retrospective data analysis suggests that the risk of periinterventional stroke after PTAS of symptomatic intracranial atherosclerotic disease might be reduced by sufficient antiplatelet therapy and optimized management of patients with high risk for reperfusion injury or perforator strokes, including selection of a stenting device adapted to individual vessel morphology

  13. Liver transplantation for severe hepatic trauma: Experience from a single center

    OpenAIRE

    Delis, Spiros G; Bakoyiannis, Andreas; Selvaggi, Gennaro; Weppler, Debbie; Levi, David; Tzakis, Andreas G.

    2009-01-01

    Liver transplantation has been reported in the literature as an extreme intervention in cases of severe and complicated hepatic trauma. The main indications for liver transplant in such cases were uncontrollable bleeding and postoperative hepatic insufficiency. We here describe four cases of orthotopic liver transplantation after penetrating or blunt liver trauma. The indications were liver failure, extended liver necrosis, liver gangrene and multiple episodes of gastrointestinal bleeding rel...

  14. Emphysematous infections of the kidney and urinary tract: A single-center experience

    Directory of Open Access Journals (Sweden)

    Vineet Behera

    2014-01-01

    Full Text Available Emphysematous pyelonephritis (EPN is a group of potentially life-threatening conditions seen particularly in diabetics, leading to high morbidity and mortality. Our aim was to study the profile of emphysematous infections of the kidney and urinary tract and evaluate the effect of early surgical intervention on mortality. This is an observational study conducted in a tertiary care hospital between January 2009 and January 2013, in which the clinical, laboratory, microbiological and radiological profiles of patients with EPN (diagnosed based on clinical, laboratory and imaging findings was studied. A total of 12 patients were studied, including 10 with diabetes. A total of 66.6% had pyelonephritis, 25% had both cystitis and pyelonephritis and 8.3% had only cystitis; involvement of the left kidney was more common and bilateral involvement was seen in two cases. The clinical features seen in the patients included fever (100%, features of urinary infection (66.6% and flank pain (50%. Culture positivity was seen in only 50% of the cases. Ten patients underwent percutaneous drainage (PCD within 24 h, and two of these patients required nephrectomy subsequently. All patients were followed-up for one month. There was one death (mortality 8.3%, and all other patients responded well and reco-vered. Our study suggests that EPN is a potentially life-threatening condition that requires aggressive and prompt medical therapy with early PCD to reduce morbidity and mortality. Nephrectomy should be reserved for cases that do not respond to PCD.

  15. Cystic fibrosis-related liver disease: a single-center experience

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    Paula Catarino Costa; Celeste Canha Barreto; Luisa Pereira; Maria Luisa Lobo; Maria Adília Costa; Ana Isabel Gouveia Lopes

    2011-01-01

    Prospective studies concerning liver disease in pediatric cystic fibrosis patients are scarce. The present study aimed to describe the prevalence and clinical expression of cystic fibrosis - related liver disease, in a cohort of 62 pediatric patients. Descriptive study, resulting from the prospective evaluation, between 1994 and 2009, of 62 pediatric patients (age <18 years) with cystic fibrosis. The follow-up protocol included a clinical assessment every 2 months, liver function tests eve...

  16. Emergency Operating Room Workload Pattern: A Single Center Experience from Southern Iran

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    Hamid Reza Abbasi

    2013-01-01

    Full Text Available Objective: To determine the epidemiology and pattern of emergency operating room workload in Nemazee hospital affiliated with Shiraz University of Medical Sciences, Shiraz, Iran.Methods: All surgical emergency operations which were performed in Nemazee hospital, Shiraz, Iran were collected over twelve months (September 2007 to September 2008. The data obtained included indications, presenting symptoms the services provided and the demographic information of the patients.Results: Overall number of recorded emergency operations in this cross sectional descriptive study was 3946, with males constituting 72% of the patients. The highest male/female ratio reported in trauma patients was 6.4:1 with the median age of 23 years, and the mean age of the operated patients was 27.8 years. Second to neurosurgery (19.64% the general surgery was the busiest discipline in emergency operations (59.14%. Appendectomy (11.77%, double/triple lumen/central venous catheter insertion (9.4%, and fiber optic/rigid bronchoscopy (3.27% were the commonest general surgical operations. Among trauma patients, neurotrauma was the commonest reason for operation (10%.Conclusion: Based on a new approach toward emergency operating room workload, in our country and centre, we showed that it is necessary to devote particular and individualized attention to the fields of agenda and hospital management of emergency operations. This is due to a high emergency operating room workload and its unique characteristics in our centre in contrast to other hospitals and departments. Although a decision making and operational strategy is recently seen to improve the quality and quantity of emergency services available to our patients, there is still a gap between present and optimal emergency healthcare which should be provided for our residents.

  17. Frequency of kidney diseases and clinical indications of pediatric renal biopsy: A single center experience.

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    Imtiaz, S; Nasir, K; Drohlia, M F; Salman, B; Ahmad, A

    2016-01-01

    Kidney biopsy occupies a fundamental position in the management of kidney diseases. There are very few renal pathology studies available in the literature from developing world. This study scrutinized the frequency and clinicopathological relationship of kidney biopsies done at the kidney center from 1997 to 2013 amongst pediatric patients. Kidney allograft biopsy were excluded. The specimen was examined under light microscopy and immunofluorescence while electron microscopy was not done. The study includes 423 patients, mean age was 10.48 ± 4.58 years, males 245 (57.9%) were more than females 178 (42.1%). Nephrotic syndrome 314 (74.2%) was the most common clinical presentation followed by acute nephritic syndrome 35 (8.3%) and acute renal failure 24 (5.7%). Primary glomerulonephritis (PGN) was the most common group of diseases, seen in 360 (85.1%) followed by secondary glomerulonephritis (SGN) in 27 (6.4%) and tubulointerstitial nephritis in 21 (5.0%). Among PGN, minimal change disease (MCD) was the most dominant disease, with 128 (30.3%) cases followed by focal segmental glomerulosclerosis FSGS in 109 (25.8%) and membranous glomerulonephropathy in 27 (6.4%). Lupus nephritis (LN) was the leading cause of glomerular disease in SGN followed by hemolytic uremic syndrome. In conclusion, MCD is the most common histological finding, especially in younger children and FSGS is second to it. SGN is rare, and the most common disease in this category is LN while tubulointerstitial and vascular diseases are infrequent. PMID:27194835

  18. Efficacy of liver transplantation for acute hepatic failure:a single-center experience

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    Xian-Jie Shi; Hong-Bin Xu; Wen-Bin Ji; Yu-Rong Liang; Wei-Dong Duan; Lei He; Ming-Jun Wang; Zhi-Ming Zhao

    2011-01-01

    BACKGROUND: Acute hepatic failure (AHF) is a devastating clinical syndrome with a high mortality rate. The outcome of AHF varies with etiology, but liver transplantation (LT) can significantly improve the prognosis and survival rate of such patients. This study aimed to detect the role of LT and artificial liver support systems (ALSS) for AHF patients and to analyze the etiology and outcome of patients with this disease. METHODS: A retrospective analysis was made of 48 consecutive patients with AHF who fulfilled the Kings College Criteria for LT at our center. We analyzed and compared the etiology, outcome, prognosis, and survival rates of patients between the transplantation (LT) group and the non-transplantation (N-LT) group. RESULTS: AHF was due to viral hepatitis in 25 patients (52.1%; hepatitis B virus in 22), drug or toxic reactions in 14 (29.2%; acetaminophen in 6), Wilson disease in 4 (8.3%), unknown reasons in 3 (6.3%), and miscellaneous conditions in 2 (4.2%). In the LT group, 36 patients (7 underwent living donor LT, and 29 cadaveric LT) had an average model for end-stage liver disease score (MELD) of 35.7. Twenty-eight patients survived with good graft function after a follow-up of 27.3± 4.5 months. During the waiting time, 6 patients were treated with ALSS and 2 of them died during hospitalization. The 30-day, 12-month, and 18-month survival rates were 77.8%, 72.2%, and 66.7%, respectively. In the N-LT group, 12 patients had an average MELD score of 34.5. Four patients were treated with ALSS and all died during hospitalization. The 90-day and 1-year survival rates were only 16.7% and 8.3%, respectively. CONCLUSIONS: Hepatitis is the most prominent cause of AHF at our center. Most patients with AHF, who fulfill the Kings College Criteria for LT, did not survive longer without LT. ALSS did not improve the prognosis of AHF patients, but may extend the waiting time for a donor. Currently, LT is still the most effective way to improve the prognosis of AHF patients.

  19. Surgical Management of Internal Pancreatic Fistula in Chronic Pancreatitis: A Single-Center Experience

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    Siarhei M Rashchynski

    2016-09-01

    Full Text Available Management of internal pancreatic fistula is challenging because it is a rare and uncommon complication of chronic pancreatitis. The aim of this study was to evaluate the efficiency of the different ways of diagnostics and treatment for internal pancreatic fistula. Material and methods The prospective analysis of surgical treatment of the internal pancreatic fistula among 39 patients was carried out. Patients’ data, diagnostic findings and surgical procedure were analyzed. The comparative estimation of surgical interventions was executed using questionnaire SF-36 v2тм. Results The results of the current study demonstrate good facilities of computed tomography, magnetic resonance cholangiopancreatography (92.3% for determination of internal pancreatic fistula. 28 patients underwent Frey’s procedure, 8 - cystopancreatojejunal anastomosis using Roux-en-Y loop, 3 - combination of Frey’s procedure and cystopancreatojejunal. Total morbidity and mortality was 12.8% and 2.6% respectively. We admitted significant improvement in comparison of life quality before and after operation (p<0.01. Conclusion Surgery remains an excellent and safe option for patients suffering from internal pancreatic fistula in chronic pancreatitis with significant improvement in their quality of life.

  20. Cholangiocarcinoma: A 7-year experience at a single center in Greece

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    Alexandra Alexopoulou; Aspasia Soultati; Spyros P Douralds; Larissa Vasilieva; Athanasios J Archimandritis

    2008-01-01

    AIM: To evaluate survival rate and clinical outcome of cholangiocarcinoma. METHODS: The medical records of 34 patients with cholangiocarcinoma, seen at a single hospital between the years 1999-2006, were retrospectively reviewed. RESULTS: Thirty-four patients with a median age of 75 years were included. Seventeen (50%) had painless jaundice at presentation. Sixteen (47.1%) were perihilar, 15 (44.1%) extrahepatic and three (8.8%) intrahepatic. Endoscopic retrograde cholangiography (ERCP) and/or magnetic resonance cholangiography (MRCP) were used for the diagnosis. Pathologic confirmation was obtained in seven and positive cytological examination in three. Thirteen patients had co-morbidities (38.2%). Four cases were managed with complete surgical resection. All the rest of the cases (30) were characterized as non-resectable due to advanced stage of the disease. Palliative biliary drainage was performed in 26/30 (86.6%). The mean follow-up was 32 mo (95% CI, 20-43 mo). Overall median survival was 8.7 mo (95% CI, 2-16 mo). The probability of 1-year, 2-year and 3-year survival was 46%, 20% and 7%, respectively. The survival was slightly longer in patients who underwent resection compared to those who did not, but this difference failed to reach statistical significance. Patients who underwent biliary drainage had an advantage in survival compared to those who did not (probability of survival 53% vs 0% at 1 year, respectively, P = 0.038). CONCLUSION: Patients with cholangiocarcinoma were usually elderly with co-morbidities and/or advanced disease at presentation. Even though a slight amelioration in survival with palliative biliary drainage was observed, patients had dismal outcome without resection of the tumor.

  1. Risk of Post-Gastric Bypass Surgery Hypoglycemia in Nondiabetic Individuals: A Single Center Experience

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    Lee, Clare J.; Craig Wood, G.; Lazo, Mariana; Brown, Todd T.; Clark, Jeanne M.; Still, Christopher; Benotti, Peter

    2016-01-01

    Objective The epidemiology of post-gastric bypass surgery hypoglycemia (PGBH) is incompletely understood. This study aimed to evaluate the risk of PGBH among nondiabetic patients and associated factors. Methods A cohort study of nondiabetic patients who underwent Roux-en-Y gastric bypass (RYGB) was conducted. PGBH was defined by any postoperative record of glucose hypoglycemia, or any medication use for treatment of PGBH. Kaplan-Meier analysis was used to describe PGBH occurrence, log-rank tests, and Cox regression to examine associated factors. Results Of the 1,206 eligible patients, 86% were female with mean age of 43.7 years, mean preoperative BMI of 48.7 kg/m2, and a mean follow-up of 4.8 years. The cumulative incidence of hypoglycemia at 1 and 5 years post-RYGB was 2.7% and 13.3%, respectively. Incidence of PGBH was identified in 158 patients and was associated with lower preoperative BMI (P = 0.048), lower preoperative HbA1c (P = 0.012), and higher 6-month percent of excess body weight loss (%EWL) (P = 0.001). A lower preoperative HbA1c (HR = 1.73, P = 0.0034) and higher 6-month %EWL (HR = 1.96, P = 0.0074) remained independently correlated with increased risk for PGBH in multi-regression analysis. Conclusions The 5-year incidence of PGBH among nondiabetic individuals was 13.3% and was associated with a lower preoperative HbA1c and greater weight loss at 6 months following surgery. PMID:27225597

  2. Prevalence of oral lesions in kidney transplant patients: A single center experience

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    Sumita Kaswan

    2015-01-01

    Full Text Available Kidney transplant patients (KTPs have a potential tendency to develop oral lesions due to the administration of immunosuppressive drugs, but their prevalence is still obscure. The aim of the present study was to investigate the oral clinical findings in a group of renal transplant patients in comparison with ageand sex-matched healthy controls (HCs. Three hundred KTPs who underwent transplantation at least six months earlier and 296 HCs were examined clinically for the presence of any oral lesions. Demographic and additional details regarding medications, systemic diseases and duration after transplantation were recorded. Statistical analysis was performed using the Chi-square test, with significance set at P 0.05. The findings of the present study indicate the need for a routine and regular oral health check-up, with emphasis on maintenance of oral hygiene for renal transplant patients.

  3. Retrograde intrarenal surgery in the management of symptomatic calyceal diverticular stones: a single center experience.

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    Chen, Xiong; Li, Dongjie; Dai, Yuanqing; Bai, Yao; Luo, Qizhan; Zhao, Zhongwei; Chen, Hequn; Zhang, Xiaobo

    2015-11-01

    To evaluate the outcome of RIRS in managing symptomatic calyceal diverticular as a minimally invasive option, we retrospectively reviewed the records of 43 patients who underwent RIRS from 2005 to 2014 for symptomatic calyceal diverticular stones. A month after the initial operation, the success rate was (81.4%, 35 patients) of which 21 (48.83%) patients were stone free and 14 (32.6%) patients had clinically insignificant residual fragments (CIRFs), and 90% patients were symptom free. Eight patients (16.6%) had significant residual fragments (>3 mm), five of them became completely stone free after the second procedure, other three patients were symptom free and underwent a routine follow-up. The final treatment success rate was 93.0%. The initial success rate in the lower calyx was significantly lower than the other calices (P = 0.040). In addition, the association between the stone size and the initial treatment success was significant (P = 0.036). There was no association between any of our other variables and the success rate. The mean first operative time was 60.95 ± 12.43 min (range 34-92). No major complication (Clavien III-V) occurred, although there were five minor complications (11.6%) (Clavien I-II). There were no admissions to intensive care or deaths in our series, the mean hospitalization time was 1.77 ± 0.80 days. The management of calyceal diverticular calculus with RIRS is highly effective and can be accomplished with low morbidity. PMID:26139572

  4. Metastases of esophageal carcinoma to skeletal muscle:Single center experience

    Institute of Scientific and Technical Information of China (English)

    Jan Cincibuch; Miroslav Myslive(c)ek; Bohuslav Melichar; (C)estmír Neoral; Iva Metelková; Michaela Zezulová; Hana Procházková-(S)tudentová

    2012-01-01

    Metastases of esophageal carcinoma to the skeletal muscle are rare,but the incidence may be increasing because of better diagnosis resulting from widespread use of positron emission tomography/computed tomography (PET/CT).A cohort of 205 patients with esophageal carcinoma treated at our center who had PET/CT between 2006 and 2010 was retrospectively evaluated for the presence of skeletal muscle metastases.Four patients had skeletal muscle metastases of esophageal carcinoma,including two patients with squamous cell carcinoma.In another patient with squamous cell carcinoma of the esophagus and synchronous skeletal muscle metastases,muscle metastases were subsequently shown to be related to second primary pancreatic adenocarcinoma.In all cases,skeletal muscle metastases were the first manifestation of systemic disease.In three patients palliation was obtained with the combination of external beam radiation therapy,systemic chemotherapy or surgical resection.Skeletal muscle metastases are a rare complication of esophageal carcinoma.

  5. A single-center experience with retrograde reperfusion in liver transplantation.

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    Kniepeiss, Daniela; Iberer, Florian; Grasser, Barbara; Schaffellner, Silvia; Stadlbauer, Vanessa; Tscheliessnigg, Karl-Heinz

    2003-10-01

    Poor graft function secondary to injury by ischemia and reperfusion remains a major problem with regard to morbidity and mortality in clinical liver transplantation (LTX). Up to one fifth of patients suffer from poor initial liver function due to severe damage to hepatocytes. This situation leads either to primary nonfunction described in approximately 6% of LTX or to slow recovery. We present a new method of reperfusion during LTX. From July 1998 to July 2002, 42 LTX in 39 recipients, (10 female, 52 years old (26-70) were performed. LTX was carried out in piggy-back technique. After completing the piggy-back anastomosis, the caval vein was declamped immediately, and retrograde low pressure reperfusion of the graft with low oxygenated venous blood was established. Portal anastomosis was performed using a running suture. In order to provide optimal retrograde liver perfusion, no clamping of the donor portal vein was done. After completing portal anastomosis, the recipient portal vein was declamped immediately. During arterial anastomosis, the transplanted liver was antegradely perfused via the portal vein. After completing hepatic artery anastomosis, declamping of the hepatic artery was done and arterial perfusion started. No backtable or in-situ-flushing except the described reperfusion technique was performed. Forty-two LTX in 39 recipients using piggy-back technique and retrograde reperfusion via the caval vein followed by antegrade reperfusion via the portal vein were performed; 38 out of 39 patients (97.44%) were alive and well at day 8 after LTX. One patient (2.56%) died of a pre-existing portal vein thrombosis on day 2 after LTX. Three patients had to undergo retransplantation for hepatic artery thrombosis (7.14%). Liver enzymes, bilirubine, prothrombine time and AT III on day 1, 3, 5 and 8 after LTX showed favourable values. Median aspartate aminotransferase (ASAT) was 219 U/l on day 1 after LTX. One-month survival rate was 95.23%, and 1-year survival rate 87.88%. Two patients died of liver-associated causes (5.12%). One patient died of a late hepatic artery thrombosis, and one more of rejection. No other severe case of rejection appeared. We can conclude that retrograde reperfusion might be highly sufficient method of removing perfusion fluid from the transplanted liver. Low pressure perfusion with low oxygenated blood might reduce the production of free oxygen radicals. Retrograde reperfusion via the caval vein and antegrade reperfusion via the portal vein seemed to lower postoperative liver enzyme values and to improve initial liver function after LTX.

  6. Dermatologic Diseases Presenting with Pigmentation Disorders in Children: A Single Center Experience

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    Ayse Akbas

    2015-12-01

    Full Text Available Background: To determine the incidence and demographic characteristics of skin diseases presenting with hyperpigmentation in children applying to the dermatology department. Methods: A total of 2815 children between the ages of 0 to 16 who applied to the dermatology clinic with the complaints of hyperpigmentation disorders were evaluated. The age, gender, socioeconomic status, place of residence and demographic characteristics of children with abnormal pigmentation skin lesions were investigated. Results: A total of 2815 children applied to the dermatology clinic during the study period. Of these patients 1491 were female (53% and 1324 were male (47%. Of these 266 (9.4% were diagnosed with skin disorders presenting with hyperpigmention. The causes of hyperpigmentation in these patients were was follows; pityriasis alba (2.6%, melanocytic nevus (2.1%, vitiligo (1.8% postinflammatory hyperpigmentation (0.5%, and postinflammatory hypopigmentation (0.5%. According to the gender, p.alba, vitiligo, Becker nevus, acanthosis nigricans, tuberosclerosis and albinism were seen more in boys and nevus depigmentosus ephelis, postinflammatory hyperpigmentation/hypopigmentation and melanocytic nevus were seen more in the girls. Pitriyazis versicolor was seen equally in both genders. According to age groups, melanocytis nevus were found to be more frequent between the ages of 0-2 and 12-16, whereas pityrsasis versicolor was more frequent in ages 12-16 and P. alba in the 3-11 age group. Conclusions: There are quite a substantial number of pigmentation diseases occurring in children. Early diagnosis and treatment are important because although these diseases mainly cause cosmetic problems, they can decrease the quality of life. Here, we attempted to define the demographic characteristics of diseases presenting with disorders in pigmentation in children.

  7. Neurological complications after allogeneic hematopoietic stem cell transplantation in children, a single center experience.

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    Azik, Fatih; Yazal Erdem, Arzu; Tavil, Betül; Bayram, Cengiz; Tunç, Bahattin; Uçkan, Duygu

    2014-06-01

    In this study, we retrospectively examined the data of children who underwent allo-HSCT from HLA-matched family donors. We analyzed the incidence, etiological factors, clinical characteristics, possible reasons, risk factors, and follow-up of neurologic complications. BU-based conditioning regimens were used in most of the cases (n = 62). The median duration of follow-up for the 89 patients was 20 months (range 1-41 months). Eleven percent of transplanted children developed one or more neurological symptoms after HSCT with a median observation time of two months (range -6 days to 18 months). The median age of the four girls and six boys with neurological complication was 13 yr (range 5.3-17.6 yr). Cylosporine A neurotoxicity was diagnosed in five children, four of them were PRES. The rest of complications were BU and lorazepam toxicity, an intracranial hemorrhage, a sinovenous thrombosis, and a transient ischemic attack during extracorpereal photopheresis. No difference was found between groups of neurological complication according to age, gender, diagnosis, hospitalization time, neutrophil and platelet engraftment time, stem cell source, and conditioning regimen, acute and chronic GVHD or VOD. Neurological complication was the cause of death in one patient (1.1%).

  8. Micro-percutaneous nephrolithotomy in infants: a single-center experience.

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    Dede, Onur; Sancaktutar, Ahmet Ali; Baş, Okan; Dağgüllu, Mansur; Utangaç, Mazhar; Penbegul, Necmettin; Soylemez, Haluk; Hatipoglu, Namık Kemal; Bodakci, Mehmet Nuri; Bozkurt, Yaşar; Atar, Murat; Dede, Gülay

    2016-04-01

    This study aimed to investigate the effectiveness and reliability of micro-percutaneous nephrolithotomy (micro-PNL) for the management of kidney stones in pediatric patients. This retrospective study included 24 infants that underwent micro-PNL for renal stones between March 2012 and April 2015. The inclusion criteria included: age younger than 2 years, stone size <20 mm, absence of urinary tract malformations and active infection, and no coagulopathy. Stone-free rates were assessed one month postoperatively by ultrasonography (USG) and kidneys, ureters, bladder (KUB) radiography. Complications were classified according to the Clavien classification system. The mean age of the patients was 15.8 ± 7.8 months (range, 8-23) and the mean stone size was 13.5 ± 3.84 mm. Intra-renal access was achieved using USG in 11 patients and KUB fluoroscopy in 13 patients. The operation time and fluoroscopic screening time were 53.7 ± 10.35 and 1.4 ± 0.9 min, respectively. The mean hospital stay was 2.5 ± 0.8 days, and the mean drop in the hemoglobin level was 0.51 ± 0.34 g/dL. Bleeding requiring blood transfusion was not observed. A ureteral J stent was implanted perioperatively in four patients because of stone burden. Four patients complained of postoperative renal colic (Clavien grade 1) and postoperative fever was observed in two patients. Definitive success rates were as follows: the stone-free rate was 83.3% (n = 20) and residual fragments were observed in four patients. PMID:26209010

  9. Single center experience of capsule endoscopy in patients with obscure gastrointestinal bleeding

    Institute of Scientific and Technical Information of China (English)

    Mahesh Kumar Goenka; Shounak Majumder; Sanjeev Kumar; Pradeepta Kumar Sethy; Usha Goenka

    2011-01-01

    AIM: To identify optimum timing to maximize diagnostic yield by capsule endoscopy (CE) in patients with obscure gastrointestinal bleeding (OGIB).METHODS: We identified patients who underwent CE at our institution from August 2003 to December 2009.Patient medical records were reviewed to determine type of OGIB (occult, overt), CE results and complications,and timing of CE with respect to onset of bleeding.RESULTS: Out of 385 patients investigated for OGIB,284 (74%) had some lesion detected by CE. In 222 patients (58%), definite lesions were detected that could unequivocally explain OGIB. Small bowel ulcer/erosions secondary to Crohn's disease, tuberculosis or non-steroidal anti-inflammatory agent use were the commonest lesions detected. Patients with overt GI bleeding for <48 h before CE had the highest diagnostic yield (87%).This was significantly greater (P < 0.05) compared to that in patients with overt bleeding prior to 48 h (68%),as well as those with occult OGIB (59%).CONCLUSION: We established the importance of early CE in management of OGIB. CE within 48 h of overt bleeding has the greatest potential for lesion detection.

  10. Challenges in the management of congenital heart disease in Vietnam: A single center experience

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    Vu Minh Phuc

    2015-01-01

    Full Text Available Vietnam, in Asia, is a low middle-income country with a relatively large population to cater to. Not many know about Vietnam, or its healthcare sector especially the field of pediatric cardiology and congenital heart disease. In contrast to the developed world, congenital heart disease (CHD is not diagnosed early. Since most of the patients visit the hospital only in later stages of the disease there are many complications during the operation and post-operatively. But during the past 5 years (from 2009, there has been major improvement in the treatment of CHD, both by intervention and surgery. At present, all kinds of CHD, both simple and complex are being successfully treated in our country. Today in Vietnam, all children under 6 years of age have health insurance coverage, under which almost all operations and catheter interventions are done free in government hospitals. It is helping many patients, especially those from the poor socioeconomic background. However, the present infrastructure is inadequate and a long waiting list has accumulated for treatment of CHD.

  11. Acute interstitial nephritis in patients with viperine snake bite: Single center experience of a rare presentation

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    Vishal Golay

    2012-01-01

    Full Text Available Acute renal failure following vasculotoxic viperine snake bites is very common in South Asia. Acute tubular necrosis and acute cortical necrosis are the common findings, with acute interstitial nephritis (AIN being a rare presentation. We conducted renal biopsies in all patients who were admitted in our institute with viperine snake bite-related acute kidney injury (AKI and who did not improve after three weeks of supportive care. Patients who had findings of AIN on renal histology were included for this study. Of a total of 42 patients, there were five patients (11.9% with AIN. Our series of five patients is the largest series of this rare presentation in the literature. All of these five patients had features of severe envenomation, severe AKI network stage of AKI and very high antivenom requirements. They had a very prolonged stay in the hospital, and four of the five patients developed chronic kidney disease on follow-up. The overall outcome in this group was worse as compared with those who did not have AIN. AIN following viperine snake bites is not a very rare presentation. The reason for the development of this pathology is unclear, but direct venom-related effects are possible. This presentation portends a poor overall long-term prognosis as demonstrated in our case series.

  12. "Awake Veno-arterial Extracorporeal Membrane Oxygenation" in Pediatric Cardiogenic Shock: A Single-Center Experience.

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    Schmidt, F; Jack, T; Sasse, M; Kaussen, T; Bertram, H; Horke, A; Seidemann, K; Beerbaum, P; Koeditz, H

    2015-12-01

    In pediatric patients with acute refractory cardiogenic shock (CS), extracorporeal membrane oxygenation (ECMO) remains an established procedure to maintain adequate organ perfusion. In this context, ECMO can be used as a bridging procedure to recovery, VAD or transplantation. While being supported by ECMO, most centers tend to keep their patients well sedated and supported by invasive ventilation. This may be associated with an increased risk of therapy-related morbidity and mortality. In order to optimize clinical management in pediatric patients with ECMO therapy, we report our strategy of veno-arterial ECMO (VA-ECMO) in extubated awake and conscious patients. We therefore present data of six of our patients with CS, who were treated by ECMO being awake without continuous analgosedation and invasive ventilation. Of these six patients, four were 14 years of age. Median time on ECMO was 17.4 days (range 6.9-94.2 days). Median time extubated, while receiving ECMO support was 9.5 days. Mean time extubated was 78 % of the total time on ECMO. Three patients reached full recovery of cardiac function on "Awake-VA-ECMO," whereas the other three were successfully bridged to destination therapy (VAD, heart transplantation, withdrawal). Four out of our six patients are still alive. Complications related to ECMO therapy (i.e., severe bleeding, site infection or dislocation of cannulas) were not observed. We conclude that "Awake-VA-ECMO" in extubated, spontaneously breathing conscious pediatric patients is feasible and safe for the treatment of acute CS and can be used as a "bridging therapy" to recovery, VAD implantation or transplantation.

  13. Febrile neutropenia in children with acute lymphoblastic leukemia: single center experience

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    Özdemir, Nihal; Tüysüz, Gülen; Çelik, Nigar; Yantri, Leman; Erginöz, Ethem; Apak, Hilmi; Özkan, Alp; Yıldız, İnci; Celkan, Tiraje

    2016-01-01

    Aim: An important life-threatening complication of intensive chemotherapy administered in children with leukemia is febrile neutropenia. The objective of this study was to evaluate the clinical features and consequences of febrile neutropenia attacks in children who were treated for acute lymphoblastic leukemia. Material and Methods: Nighty-six children who received chemotherapy for acute lymphoblastic leukemia in our center between January 1995 and December 2010 were included in the study. The data related to demographic characteristics, treatment features, relapse and febrile neutropenia incidences, risk factors, culture results and prognosis were retrospectively evaluated from the patients’ files. Results: A total of two hundred-ninety nine febrile neutropenia attacks observed in the patients during initial treatment and relapse treatment were evaluated. When the incidence of febrile neutropenia was evaluated by years, it was observed that the patients treated after year 2000 had statistically significantly more febrile neutopenia attacks compared to the patients treated before year 2000. When the incidences of febrile neutropenia during initial treatment and during relapse treatment were compared, it was observed that more febrile neutropenia attacks occured during relapse treatment. Fifty-nine percent of all febrile neutropenia attacks were fever of unknown origin. Eighty microorganisms grew in cultures during febrile neutropenia throughout treatment in 75 patients; 86% were bacterial infections (50% gram positive and 50% gram negative), 8% were viral infections and 6% were fungal infections. Coagulase negative staphylococcus (n=17) was the most frequent gram positive pathogen; E. Coli (n=17) was the most commonly grown gram negative pathogen. Conclusions: In this study, it was found that an increase in the incidence of febrile neutropenia occured in years. Increments in treatment intensities increase the incidence of febrile neutropenia while improving survival. Evaluation of febrile neutropenia results by hematology-oncology units in years will be directive in early and successful treatment. PMID:27489464

  14. A 5-year retrospective analysis of Necrotizing fasciitis: A single center experiences

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    Kiralj Aleksandar I

    2015-01-01

    Full Text Available Background/Aim. Necrotizing fasciitis (NF is usually an acute infection of superficial fascia with rapid progression in around soft tissue. If not promptly recognized and aggressively treated NF usualy leads to sepsis and multiorgan failure with fatal outcome, thus early diagnosis and prompt surgical treatment are crucial for healing of these patients. The aim of this article was to evaluate the clinical presentation of all patients with acute NF diagnosed and treated in surgical clinics of Clinical Center of Vojvodina, Novi Sad, Serbia. Methods. The medical records of patients treated for acute NF localized on a different parts of the body in Clinical Center of Vojvodina, Novi Sad, Serbia, during a 5- year period (from January 2008 to December 2012 were retrospectively evaluated. This study enrolled patients admitted via Emergency Center of Vojvodina with the diagnosis of acute NF either as the primary diagnosis or with the diagnosis at discharge after surgical treatment. Results. During a 5-year period there were 216 patients with final diagnosis of acute NF. Most of our patients (140 - 64.81% were admitted with the initial diagnosis of cellulitis, abscesses, phlegmons or sepsis. Unfortunately, the clinical symptoms of acute NF were atypical at time of initial examination. Pain and swelling of the affected localization were the most presented bias of symptoms (183 - 84.72%. The majority of our patients were male (164 - 75.92%. Among the 216 patients, the most common pre-existing single factor was drug abuse (39 - 18.05%, followed by obesity (38 - 17.59% and diabetes mellitus (31 - 14.35%. Trauma was most common etiological factor (22 - 10.8% in infected wounds, followed by abdominal (15 - 6.94% and orthopedic (11 - 5.09% surgical intervention. In the present study idiopathic acute NF was diagnosed in 22 (10.18% patients and more than one etiological factor were diagnosed in 20 (9.25% patients. The majority of our patients had type I acute NF (172 - 79.62% with Streptococcal species as the most common microorganism (125 - 71.02%. The most common localization was an extremity (151 - 69.90%. The minority of our patients had head and neck localization of infection (7 - 3.24%. Surgical treatment was performed in all the patients and most of them (183 - 84.72% received the first surgery within 24 h. Other patients (23 - 10.64% received operation after stabilization of general status or after getting the diagnosis of acute NF (unclear diagnosis on admission. During hospitalization, the most common complication among our patients was sepsis (156 - 72.22%. The mortality rate was 14.35%. Conclusion. Acute NF is a rare but very difficult and sometimes life-threatening disease of superficial fascia and around soft tissue. If acute NF is suspected, early radical excision of all the affected tissue with exploration and excision of superficial fascia with pathological and microbiological assessment are most significant for treatment. Appropriate antibiotics and intensive care setting to manage other organ failure of NF are recommended at the same time with surgery.

  15. Hereditary neuropathy with liability to pressure palsies: a single-center experience in southern Brazil

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    Paulo José Lorenzoni

    2016-09-01

    Full Text Available The spectrum of clinical and electrophysiological features in hereditary neuropathy with liability to pressure palsies (HNPP is broad. We analyze a series of Brazilian patients with HNPP. Correlations between clinical manifestations, laboratory features, electrophysiological analyze, histological and molecular findings were done. In five cases, more than one episode occurred before diagnosis. Median nerve in the carpal tunnel at the wrist, ulnar nerve in its groove at the elbow, fibular nerve in the head of the fibula at the knee, radial nerve in its groove of the humerus and suprascapular nerve in its notch at the supraspinous fossa were found as focal neuropathies. One patient presented with persistent writer’s cramp after ulnar nerve palsy. Nerve conduction studies showed focal neuropathy in all patients and concomitant generalized symmetrical neuropathy in eight patients. Molecular analysis of the PMP22 gene detected deletion of the 1.5-Mb fragment in all patients.

  16. Hereditary Neuropathy With Liability to Pressure Palsies: A Single-Center Experience in Southern Brazil

    Science.gov (United States)

    Lorenzoni, Paulo José; Kay, Cláudia Suemi Kamoi; Cavalet, Cristiane; Arndt, Raquel C.; Werneck, Lineu Cesar; Scola, Rosana Herminia

    2016-01-01

    The spectrum of clinical and electrophysiological features in hereditary neuropathy with liability to pressure palsies (HNPP) is broad. We analyze a series of Brazilian patients with HNPP. Correlations between clinical manifestations, laboratory features, electrophysiological analyze, histological and molecular findings were done. In five cases, more than one episode occurred before diagnosis. Median nerve in the carpal tunnel at the wrist, ulnar nerve in its groove at the elbow, fibular nerve in the head of the fibula at the knee, radial nerve in its groove of the humerus and suprascapular nerve in its notch at the supraspinous fossa were found as focal neuropathies. One patient presented with persistent writer’s cramp after ulnar nerve palsy. Nerve conduction studies showed focal neuropathy in all patients and concomitant generalized symmetrical neuropathy in eight patients. Molecular analysis of the PMP22 gene detected deletion of the 1.5-Mb fragment in all patients. PMID:27761228

  17. [Tenofovir and entecavir for chronic hepatitis B infection treatment: a single-center experience

    Directory of Open Access Journals (Sweden)

    Fabio Tarsetti

    2015-12-01

    DISCUSSION: Tenofovir seems to exert a better viral replication inhibition (though not statistically significant and to show transaminases improvement in comparison with entecavir, which, in turn, results more effective in HBeAg/HBsAg seroconversion. Both drugs have a high safety profile in terms of side effects. [Article in Italian

  18. Challenges in the management of congenital heart disease in Vietnam: A single center experience

    International Nuclear Information System (INIS)

    Vietnam, in Asia, is a low middle-income country with a relatively large population to cater to. Not many know about Vietnam, or its healthcare sector especially the field of pediatric cardiology and congenital heart disease. In contrast to the developed world, congenital heart disease (CHD) is not diagnosed early. Since most of the patients visit the hospital only in later stages of the disease there are many complications during the operation and post-operatively. But during the past 5 years (from 2009), there has been major improvement in the treatment of CHD, both by intervention and surgery. At present, all kinds of CHD, both simple and complex are being successfully treated in our country. Today in Vietnam, all children under 6 years of age have health insurance coverage, under which almost all operations and catheter interventions are done free in government hospitals. It is helping many patients, especially those from the poor socioeconomic background. However, the present infrastructure is inadequate and a long waiting list has accumulated for treatment of CHD

  19. Predictive factors of difficult procedure in octogenarians undergoing elective laparoscopic cholecystectomy: a single center experience

    Science.gov (United States)

    GUIDA, F.; MONACO, L.; SCHETTINO, M.; PORFIDIA, R.; IAPICCA, G.

    2016-01-01

    Aim To assess the feasibility and safety of laparoscopic cholecystectomy (LC) in very elderly patients with particular attention to the predicitive factors of difficulty. Patients and methods All patients aged ≥ 80 undergoing elective LC for lithiasis at our institution since 1st January 2015 to 31st December 2015 were included in the study. Exclusion criteria were: a) acute cholecystitis; b) biliary pancreatitis; c) biliary tract neoplasms; d) urgent procedure. Pre-, intra- and postoperative data were recorded. Results During the study period, we performed 72 LC and we enrolled 17 patients aged ≥ 80 with a M:F = 5:12. Of these, 10 patients had a “difficult” cholecystectomy. In seven cases an intraoperative cholangiography (IOC) was performed. Postoperative course was regular but in two patients we had an Oddian spasm in 1st postoperative day. Female sex (p=0.03) and preoperative high level of serum amylase (p= 0.02) were significantly associated to difficult cholecystectomy in elderly patients. Conclusion LC in octogenarians is feasible and safe. However, sex and serum amylase can help the surgeon to predict a more difficult procedure in elective LC. In this group of patients an approach based on the individual risk is desirable and the patient could be referred to a multidisciplinary approach. PMID:27381691

  20. Radical vs conservative surgery for hydatid liver cysts:Experience from single center

    Institute of Scientific and Technical Information of China (English)

    Sami; Akbulut; Ayhan; Senol; Arsenal; Sezgin; Bahri; Cakabay; Mehmet; Dursun; Omer; Satici

    2010-01-01

    AIM:To compare the efficacy and safety of radical and conservative surgical interventions for liver hydatid disease.METHODS:The study comprised 59 patients in two groups who had undergone radical and conservative surgical procedures for liver hydatid disease in our department between 2004 and 2009. Preoperative diagnostic tools,medical treatments,demographic and clinical characteristics,postoperative follow-up,and recurrence were compared in both groups. RESULTS:This non-randomized retrospective studyinclud...

  1. Clinical outcomes of liver transplantation for polycystic liver disease: a single center experience.

    Science.gov (United States)

    Chandok, Natasha; Uhanova, Julia; Marotta, Paul

    2010-01-01

    Polycystic liver disease (PLD) is a celiopathy characterized by progressive growth of multiple hepatic cysts. In a minority of patients, severe symptomatic hepatomegaly necessitates liver transplantation (LT). The purpose of this study is to describe the postoperative and long-term outcomes of all patients transplanted for PLD at our center. All patients who underwent LT for PLD were identified through our database. Using patient charts, data were extracted on patient demographics and medical history, postoperative surgical and medical complications, length of hospitalization, prevalence of chronic kidney failure, and patient and graft survival. Subjects were contacted in April 2010 to verify their survival and confirm their need, if any, for hemodialysis and/or kidney transplantation. Descriptive statistics for patient and graft survival were performed. From 1993 to 2010, 14 subjects underwent LT and 1 subject underwent combined kidney and LT; all subjects were female and the mean age was 49.0 years. 10 (66.7%) subjects had polycystic kidney disease. Patients experienced a high rate of vascular complications, including hepatic artery thrombosis (HAT) or stenosis in 3 (20%) and 2 (13.3%) subjects, respectively. One subject had early graft loss due to HAT and underwent re-transplantation. The mean length of hospitalization was 18.8 days. After a mean of 66.8 months of follow-up (3-200), 13 (86.7%) subjects are alive with satisfactory graft function, and no patients had renal failure. In conclusion, patients who underwent LT for PLD had a high rate of postoperative vascular complications. However, long-term patient and graft survival, and kidney function, is excellent. PMID:20720268

  2. Safety of Early Carotid Artery Stenting after Systemic Thrombolysis: A Single Center Experience

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    Fabrizio Sallustio

    2012-01-01

    Full Text Available Background. Patients with acute ischemic stroke due to internal carotid artery (ICA disease are at high risk of early stroke recurrence. A combination of IV thrombolysis and early carotid artery stenting (CAS may result in more effective secondary stroke prevention. Objective. We tested safety and durability of early CAS following IV thrombolysis in stroke patients with residual stenosis in the symptomatic ICA. Methods. Of consecutive patients treated with IV rtPA, those with residual ICA stenosis ≥70% or 24 hours. The protocol included pre-rtPA MRI and MR angiography, and post-rtPA carotid ultrasound and CT angiography. Stroke severity was assessed by the NIH Stroke Scale (NIHSS. Three- and twelve-month stent patency was assessed by ultrasound. Twelve-month functional outcome was assessed by the modified Rankin Scale (mRS. Results. Of 145 consecutive IV rtPA-treated patients, 6 (4% underwent early CAS. Median age was 76 (range 67–78 years, median NIHSS at stroke onset was 12 (range 9–16 and 7 (range 7-8 before CAS. Median onset-to-CAS time was 48 (range 30–94 hours. A single self-expandable stent was implanted to cover the entire lesion in all patients. The procedure was uneventful in all patients. After 12 months, all patients had stent patency, and the functional outcome was favourable (mRS ≤ 2 in all but 1 patient experiencing a recurrent stroke for new-onset atrial fibrillation. Conclusion. This small case series of a single centre suggests that early CAS may be considered a safe alternative to CEA after IV rtPA administration in selected patients at high risk of stroke recurrence.

  3. Outpatient parenteral antibiotic therapy in a renal transplant population: A single-center experience

    Directory of Open Access Journals (Sweden)

    Jade Harrison

    2015-01-01

    Full Text Available Outpatient parenteral antimicrobial therapy (OPAT is a well-established method in medical specialties. Its use in renal transplant recipients has not been thoroughly explored. No guidelines within this patient subset exist. This study describes OPAT outcomes within a UK teaching hospital renal transplant population. Renal function, mapped by estimated glomerular filtration rate (eGFR, and clinical response to infection were collected retrospectively. A total of 635 antimicrobial episodes were administered to nine renal transplant patients over 12 discrete OPAT courses during the study period. Eleven of 12 OPAT courses (91.67% produced a clinical improvement in infection. One course was terminated due to immunosuppressive-related neutropenia. No patient required admission due to failure of OPAT or adverse events. There was no significant change in graft function throughout the OPAT courses compared with baseline renal function (ANOVA, P = 0.06. One minor line infection was reported. This was treated conservatively and did not interrupt the OPAT. OPAT is safe and clinically effective in our renal transplant recipients with no significant deterioration in eGFR. The incidence of adverse events, specifically line complications, was lower in our population than those reported in the literature. Future work should develop OPAT guidelines designed for transplant recipients to outline the degree of monitoring required.

  4. Post–Endoscopic Retrograde Cholangiopancreaticography complications in liver transplanted patients, a single-center experience

    DEFF Research Database (Denmark)

    Ambrus, R B; Svendsen, Lars Bo; Hillingsø, J G;

    2015-01-01

    BACKGROUND: Complications in the biliary tract occur in 5%-30% after liver transplantation and the main part of the complications is successfully managed with endoscopic retrograde cholangiopancreaticography (ERCP). The incidence and risk factors for post-ERCP complications in liver transplantation...... patients are not well described. Our objective was to define the frequency of post-ERCP complications in liver transplantation patients at the Abdominal Center, Rigshospitalet, the only Liver Transplantation Center in Denmark. METHODS: Retrospective study of all ERCPs performed in liver transplantation...... cholangitis occurred after two procedures, respectively. Multivariate analysis concerning overall complications identified biliary sphincterotomy (p = 0.006) and time since liver transplantation within 90 days postoperatively (p = 0.044) as risk factors for post-ERCP complications. Specifically concerning...

  5. Liver transplantation for severe hepatic trauma: Experience from a single center

    Institute of Scientific and Technical Information of China (English)

    Spiros G Delis; Andreas Bakoyiannis; Gennaro Selvaggi; Debbie Weppler; David Levi; Andreas G Tzakis

    2009-01-01

    Liver transplantation has been reported in the literature as an extreme intervention in cases of severe and complicated hepatic trauma. The main indications for liver transplant in such cases were uncontrollable bleeding and postoperative hepatic insufficiency. We here describe four cases of orthotopic liver transplantation after penetrating or blunt liver trauma. The indications were liver failure, extended liver necrosis, liver gangrene and multiple episodes of gastrointestinal bleeding related to portal hypertension, respectively. One patient died due to postoperative cerebral edema. The other three patients recovered well and remain on immunosuppression. Liver transplantation should be considered as a saving procedure in severe hepatic trauma, when all other treatment modalities fail.

  6. Cystic fibrosis-related liver disease: a single-center experience

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    Paula Catarino Costa

    2011-10-01

    Full Text Available Prospective studies concerning liver disease in pediatric cystic fibrosis patients are scarce. The present study aimed to describe the prevalence and clinical expression of cystic fibrosis - related liver disease, in a cohort of 62 pediatric patients. Descriptive study, resulting from the prospective evaluation, between 1994 and 2009, of 62 pediatric patients (age <18 years with cystic fibrosis. The follow-up protocol included a clinical assessment every 2 months, liver function tests every 6 months and annual liver ultrasonography. The cumulative prevalence of liver disease was 11.2% (7/62 cases. All patients had ΔF508 mutation and pancreatic insufficiency, none had meconium ileus. The liver involvement became clinically evident at a mean age of 8 years (3-15 years, revealed by hepatomegaly or hepatosplenomegaly (3 cases and/ or abnormalities of liver function tests (3 cases changes of liver ultrasound (7 cases with evidence of portal hypertension (2 cases. Four patients were submitted to liver biopsy; biliary fibrosis was documented in one case, focal biliary cirrhosis in 2 cases and multilobular cirrhosis in another case. Within a median 11.6 years follow-up period (all patients under UDCA therapy after liver disease diagnosis, progression of liver disease was observed in 2 patients; one patient developed refractory variceal bleeding and progressive hepatic failure, requiring liver transplant. The results of the present study agree with those of previous pediatric studies, further documenting clinical expression of liver disease in CF patients, which is usually detected in the first decade of life and emphasize the contribution of ultrasound to early diagnosis of liver involvement. Moreover, although advanced liver disease is a relatively rare event, early isolated liver transplantation may have to be considered at this age group.

  7. Characteristics of atheromatous renovascular disease in Dubai: a single-center experience.

    Science.gov (United States)

    Jebur, Wael Lateef; Abdulla, Khalid; Tomaraei, Sohrab

    2013-09-01

    To determine the characteristics of atherosclerotic renal artery stenosis (ARAS) in a cohort of patients who attended the Nephrology Department of NMC Specialty Hospital in Dubai from 2006 through 2010, including their clinical and investigational features and their response to various remedial modalities, we studied 20 patients with a diagnosis of ARAS based on magnetic resonance angiography. Three (15%) patients developed acute renal failure (ARF) after the initiation of angiotensin converting enzyme inhibitors or angiotensin II receptor blockers and 13 (65%) patients presented with chronic kidney disease (CKD) of either ischemic nephropathy or nephroangiosclerosis etiology. Four (20%) patients presented with resistant arterial hypertension (RAH). Plasma renin activity was elevated in all the patients. Fifteen (75%) patients were diabetics. We conclude that CKD was the main presentation of ARAS followed by RAH and ARF in our study. Diabetes Mellitus was the main risk factor for ARAS found in our study.

  8. Characteristics of atheromatous renovascular disease in Dubai: A single-center experience

    Directory of Open Access Journals (Sweden)

    Wael Lateef Jebur

    2013-01-01

    Full Text Available To determine the characteristics of atherosclerotic renal artery stenosis (ARAS in a cohort of patients who attended the Nephrology Department of NMC Specialty Hospital in Dubai from 2006 through 2010, including their clinical and investigational features and their response to various remedial modalities, we studied 20 patients with a diagnosis of ARAS based on magnetic resonance angiography. Three (15% patients developed acute renal failure (ARF after the initiation of angiotensin converting enzyme inhibitors or angiotensin II receptor blockers and 13 (65% patients presented with chronic kidney disease (CKD of either ischemic nephropathy or nephroangiosclerosis etiology. Four (20% patients presented with resistant arterial hypertension (RAH. Plasma renin activity was elevated in all the patients. Fifteen (75% patients were diabetics. We conclude that CKD was the main presentation of ARAS followed by RAH and ARF in our study. Diabetes Mellitus was the main risk factor for ARAS found in our study.

  9. Clinical spectrum and outcomes of crescentic glomerulonephritis: A single center experience

    Science.gov (United States)

    Rampelli, S. K.; Rajesh, N. G.; Srinivas, B. H.; Harichandra Kumar, K. T.; Swaminathan, R. P.; Priyamvada, P. S.

    2016-01-01

    There is limited data on the etiology, clinical and histopathological spectrum and outcomes of crescentic glomerulonephritis (CrGN) in adult Indian population. This prospective study was done to evaluate the etiology, clinicohistological patterns and predictors of outcome of CrGN in South Indian population. All the patients received standard protocol based immunosuppression in addition to supportive care. Immune-complex glomerulonephritis (ICGN) was the most common etiology (n = 31; 77.5%) followed by pauci-immune glomerulonephritis (PauciGN; n = 8; 20%) and anti-glomerular basement membrane disease (n = 1; 2.5%). The most common etiology of ICGN was IgA nephropathy (n = 11; 27.5%) followed by lupus nephritis (n = 7; 17.5%) and post-infectious glomerulonephritis (PIGN) (n = 7; 17.5%). The patients with PauciGN were significantly older compared to those with ICGN (44.5 ± 15 years vs. 31.8 ± 11 years; P = 0.01). The patients with PauciGN presented with significantly higher serum creatinine (9.7 ± 4.4 vs. 6.6 ± 3.3 mg/dl; P = 0.03). The histopathologic parameters of ICGN and PauciGN were comparable except for a higher proportion of sclerosed glomeruli in ICGN. At the end of 3 months follow-up, only two patients went into complete remission (5.4%). Majority of the patients had end-stage renal failure (48.6%) and were dialysis dependent and seven patients (18.9%) expired. There was no signifi difference in the renal survival (10.9 ± 1.9 vs. 9.6 ± 3.3 months) or patient survival (17.5 ± 2.1 vs. 17.3 ± 4.3 months). The parameters associated with adverse outcomes at 3 months were hypertension (odds ratio [OR]: 0.58; confidence interval [CI]: 0.36–0.94), need for renal replacement therapy (OR: 0.19; CI: 0.04–0.9), serum creatinine at admission (P = 0.019), estimated glomerular filtration rate (P = 0.022) and percentage of fibrocellular crescents (P = 0.022). PMID:27512296

  10. Self-expanding metal stents for colonic obstruction: experiences from 104 procedures in a single center

    DEFF Research Database (Denmark)

    Meisner, Søren; Hensler, Margaret; Knop, Filip Krag;

    2004-01-01

    In the past, colonic obstruction caused by malignancy most often resulted in high-risk operations, usually involving two-step procedures or leaving the patient with a stoma in case of disseminated disease.......In the past, colonic obstruction caused by malignancy most often resulted in high-risk operations, usually involving two-step procedures or leaving the patient with a stoma in case of disseminated disease....

  11. Autologous stem cell transplantation in chronic myeloid leukemia: a single center experience.

    Science.gov (United States)

    Pigneux, A; Faberes, C; Boiron, J M; Mahon, F X; Cony-Makhoul, P; Agape, P; Lounici, A; Bernard, P; Bilhou-Nabera, C; Bouzgarrou, R; Marit, G; Reiffers, J

    1999-08-01

    Between 1980 and 1996, we transplanted 72 patients with CML using blood stem cells collected at diagnosis before treatment and without any mobilization. The median age of patients at diagnosis was 47.5 years (range 20.5-59.5). The median numbers of nucleated cells and CFU-GM transplanted were 10 x 10(8)/kg and 97 x 10(4)/kg, respectively. The median duration to reach more than 0.5 x 10(9)/l neutrophils and 50 x 10(9)/l platelets was 12 (range 5-19) and 11 days (range 0-79), respectively. Twenty patients (group I) were transplanted in chronic phase either for resistance to IFN (14 patients) (group IA) or because the Sokal index was more than 1.2 (six patients) (group IB). All those patients had preparative regimen with busulfan (4 mg/kg/day x 4) and melphalan (140 mg/m2). They were treated with recombinant alpha-interferon (IFN) after transplant. The cumulative incidence of major cytogenetic response (MCR) at 12 months was 25 +/- 21% (95% CI), the 5-year survival was 75 +/- 42% (95% CI). These results (observed in patients with bad prognosis factors) are similar to those usually observed in CML patients treated by IFN, whatever the Sokal risk. Thus autologous transplantation is able to reproduce for poor prognosis patients the results observed in standard risk patients treated with IFN. This suggests that it could prolong survival. Fifty-two other patients (group II) were transplanted for CML in transformation (accelerated phase = 32; blast crisis = 20) after a preparative regimen containing either total body irradiation (TBI) or busulfan. The median survival was short (10.4 months) and only 21 patients survived more than 1 year. The survival was longer for patients transplanted in accelerated phase (vs blast crisis), those who were due to receive a double transplant (vs single) (34 patients), those who were treated with IFN after transplant (vs hydroxyurea) and for the patients who obtained a complete hematologic response.

  12. Early Non-Immunological Post Transplant complications: A Single Center Experience

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    Jabur Wael

    2008-01-01

    Full Text Available To assess non-immunological complications affecting renal transplant patients in the first six months after transplantation in Al-Karama hospital, Baghdad, Iraq, we studied 68 patients (49 males, 19 females attending the clinic during the year 2006. Forty six (67% patients received kidneys from related and 22 (33% from unrelated donors. The patients revealed the following complications: post transplant hypertension in 28 (41% patient, infection (mostly bacterial in 27 (37%, new onset diabetes in 11 (16%, calcineurin inhibitor toxicity in 10 (14%, anemia in 8 (12%, surgical complications in 7 (10%, slow graft recovery in 4 (6%, cardiovascular complications in 3 (4%, and Kaposi sarcoma in 2 (2.9%.Transient hyperglycemia, hypertension, infection and diabetes mel-litus were the commonest early complications of renal transplantation. The incidence of complications is comparable to the average reported in the literature, especially in this region of the world.

  13. Characteristics of atheromatous renovascular disease in Dubai: A single-center experience

    OpenAIRE

    Wael Lateef Jebur; Khalid Abdulla; Sohrab Tomaraei

    2013-01-01

    To determine the characteristics of atherosclerotic renal artery stenosis (ARAS) in a cohort of patients who attended the Nephrology Department of NMC Specialty Hospital in Dubai from 2006 through 2010, including their clinical and investigational features and their response to various remedial modalities, we studied 20 patients with a diagnosis of ARAS based on magnetic resonance angiography. Three (15%) patients developed acute renal failure (ARF) after the initiation of angiotensin convert...

  14. Characteristics of atheromatous renovascular disease in Dubai: a single-center experience.

    Science.gov (United States)

    Jebur, Wael Lateef; Abdulla, Khalid; Tomaraei, Sohrab

    2013-09-01

    To determine the characteristics of atherosclerotic renal artery stenosis (ARAS) in a cohort of patients who attended the Nephrology Department of NMC Specialty Hospital in Dubai from 2006 through 2010, including their clinical and investigational features and their response to various remedial modalities, we studied 20 patients with a diagnosis of ARAS based on magnetic resonance angiography. Three (15%) patients developed acute renal failure (ARF) after the initiation of angiotensin converting enzyme inhibitors or angiotensin II receptor blockers and 13 (65%) patients presented with chronic kidney disease (CKD) of either ischemic nephropathy or nephroangiosclerosis etiology. Four (20%) patients presented with resistant arterial hypertension (RAH). Plasma renin activity was elevated in all the patients. Fifteen (75%) patients were diabetics. We conclude that CKD was the main presentation of ARAS followed by RAH and ARF in our study. Diabetes Mellitus was the main risk factor for ARAS found in our study. PMID:24029285

  15. Long-term cyclic intravenous iloprost in systemic sclerosis: clinical experience from a single center

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    A. Di Vita

    2012-07-01

    Full Text Available The aim of the present study was to retrospectively evaluate response to therapy in 73 patients affected by systemic sclerosis (SSc who underwent long-term cyclic treatment with intravenous iloprost for peripheral vascular involvement (average duration of treatment 54.12±41.04 months. Seventy-three SSc patients were enrolled. Data were collected by reviewing clinical records and by phone or direct interview. Patients underwent a thorough physical examination at the end of follow up. The incidence of severe vascular manifestations was also assessed. Statistical analysis was performed by Wilcoxon’s signed rank test and descriptive statistics using Statview software. In this study cohort, 55 of 73 (75.2% patients had a history of ischemic digital ulcers (DUs; 28 patients (38.4% had active DUs at the beginning of treatment. Skin ulcers healed completely in 25 of 28 patients (89.3% at the end of the first treatment. However, 40 of 55 patients (72.6% relapsed after an average of 24 months. There was a significant correlation between relapse rate and/or number of ulcers and clinical factors (diffuse subset, changes in results of Allen’s test, NT-pro BNP levels. The annual incidence of pulmonary arterial hypertension (PAH was 2.34 (95%CI: 0.94-4.83 per 100 person years, the rate of gangrene was 2.7%, and no cases of scleroderma renal crisis were recorded. The incidence of PAH and of digital gangrene was higher than that observed in unselected SSc case series. These data suggest that our patients treated with iloprost have a higher vascular involvement than large case series of unselected SSc patients. A number of clinical factors are correlated to the severity of vascular involvement and could have an impact on the response to therapy. The clinical significance of these findings requires clarification and further investigation is needed.

  16. Uncommon Surgical Causes Of Right Lower Quadrant Pain In Children. Single Center Experience.

    Science.gov (United States)

    Lambropoulos, Vassilis; Papageorgiou, Irene; Kepertis, Chrysostomos; Sfoungaris, Dimitrios; Spyridakis, Ioannis

    2015-05-01

    Right lower quadrant pain is one of the major reasons of children reference at the emergency department. The most common surgical cause, which needs appropriate management, is acute appendicitis. The purpose of this study is to reveal uncommon surgical causes found during surgery in children who were misdiagnosed as acute appendicitis in our department during the last 10 y. Data of patients who have undergone appendicectomy during a ten year period (since Feb 2004 until Mar 2014) were collected retrospectively. Eight hundred twenty children have undergone appendicectomy in our department. In six children another uncommon cause of the symptoms was revealed during surgery. In one patient the cause was a duplication cyst of the terminal ileum, in two patients an omental torsion, in one patient a meckel diverticulum torsion, in one patient a splenic rupture and in one patient a retroperitoneal tumor. All of the patients were successfully managed during the first operation. The possibility of other uncommon causes of right quadrant abdominal pain should always be kept in mind, especially when there is a negative appendicitis. However, the transaction of further paraclinical examinations - ultrasonography or computed tomography- preoperatively is under discussion. Nevertheless a thoroughly taken case history is undoubtedly always necessary.

  17. Clinical presentation and management of Fasciola hepatica infection: Single-center experience

    Institute of Scientific and Technical Information of China (English)

    Muhsin Kaya; Remzi Be(s)ta(s); Sedat (C)etin

    2011-01-01

    AIM: To identify the characteristic clinical, laboratory and radiological findings and response to treatment in patients with fascioliasis.METHODS: Patients who were diagnosed with Fasciola hepatica infection were included in this prospective study. Initial clinical, laboratory and radiological findings were recorded. All patients were followed until a complete response was achieved or for 6 mo after treatment discontinuation.RESULTS: Fasciola hepatica infection was diagnosed in 30 patients (24 females; mean age: 42.6 years) between January 2008 and February 2011. Twenty-two (73%) patients had hepatic phase fascioliasis, 5 patients had biliary phase, and 3 patients had biliary phase associated with acute pancreatitis. Of the 8 patients with biliary phase fascioliasis, 2 patients displayed features that overlapped with both hepatic and biliary phase. Abdominal pain and right upper abdominal tenderness were the most prominent signs and symptoms in all patients. Eosinophilia was the most prominent laboratory abnormality in both patients with hepatic and biliary phase (100% and 50%, respectively).Multiple nodular lesions like micro-abscesses on abdominal computerized tomography were the main radiological findings in patients with hepatic phase. Small linear filling defects in the distal choledochus were the main endoscopic retrograde cholangiopancreatography (ERCP) findings in patients with biliary phase. Patients with hepatic phase were treated with triclabendazole alone, and patients with biliary phase were treated with triclabendazole and had live Fasciola hepatica extracted from the bile ducts during ERCP.CONCLUSION: Fasciola hepatica infection should be considered in the differential diagnosis of patients with hepatic or biliary disease and/or acute pancreatitis associated with eosinophilia.

  18. Rapid steroid discontinuation for pediatric renal transplantation: a single center experience.

    Science.gov (United States)

    Lau, Keith K; Haddad, Maha N; Berg, Gerre M; Perez, Richard V; Butani, Lavjay

    2007-08-01

    To determine the outcomes of pediatric renal transplant recipients who received immunosuppression consisting of early withdrawal of corticosteroids at a single Northern California center. Protocols using minimal steroid exposure have been recently reported in adult transplant recipients with successful results. We examined the outcomes of pediatric renal transplant recipients who were managed at our center using a protocol with very early discontinuation of steroids after renal transplantation. We retrospectively studied the medical records of all renal transplant recipients followed at the Children's Hospital at the University of California, Davis Medical Center from 01/2004 to 12/2005. All patients were less than 18 yr of age at the time of transplantation. The immunosuppressive protocol included three tapering daily doses of methylprednisolone, together with five doses of thymoglobulin followed by maintenance therapy with tacrolimus and MMF. Eight patients with equal numbers of males and females were transplanted during this time period. There were equal numbers of Caucasians, African-Americans, Hispanics, and Asians. A total of 37.5% (3/8) of the subjects received preemptive transplantation, 25% (2/8) received peritoneal, and 37.5% (3/8) received hemodialysis before transplantation. The median (range) age at transplantation was 12.3 (3.1-16.0) year with a follow-up of 1.7 (0.9-2.8) year. At one yr post-transplantation, 57% (4/7) of patients still required anti-hypertensives. Three children required erythropoietin supplementation after transplantation. The mean delta height standard deviation score at 12 months was 0.20 +/- 0.56. There were no episodes of clinical acute rejection. One patient switched from tacrolimus to sirolimus due to biopsy-proven CAN. No patient became diabetic or required hypoglycemic agents. Surveillance biopsies showed no subclinical acute rejection in any patient. Steroid-free immunosuppression is safe in children after renal transplantation. Larger number of patients and longer follow-up are required to further confirm the effectiveness and safety of immunosuppression with rapid steroid discontinuation.

  19. Sorafenib for Egyptian patients with advanced hepatocellular carcinoma; single center experience

    International Nuclear Information System (INIS)

    Background: According to the results of a number of phase 3 randomized studies, sorafenib is the only approved systemic therapy for advanced HCC; however the issue of high eco- Sorafenib nomic cost remains challenging; thus we have conducted this retrospective analysis of our HCC patients treated with sorafenib. Methods: HCC Shams University Hospitals, in the period between 2010 and 2012 were reviewed. Eligible patients were those who had received sorafenib for advanced HCC not eligible for or progressed after surgery or locoregional therapy. We investigated the impact of baseline clinico pathological factors (age, gender, child status, performance score, BCLC tumor stage, cause of chronic liver disease, median baseline alpha fetoprotein level and previous treatment received for HCC) on overall survival (OS) in an adjusted Cox regression model. Results: 41 patients were included in the analysis fulfilling the inclusion criteria. At a median follow up period of 13 months, the median PFS for the whole group was 4 months; the median OS for the whole group is 6.25 months. Multivariate analysis identified three baseline characteristics that were prognostic indicators for overall survival: ECOG performance status (median OS for ECOG 1 = 7.01 months and for ECOG 2 = 3.03 months), Child-Pugh status (median OS for child A = 12.04 months and for child B = 5.23 months), and median baseline levels of alpha-fetoprotein. Conclusions: In limited resource countries like Egypt, we suggest that the use of sorafenib for the treatment of advanced HCC cases should be restricted to a highly selected subgroup of patients with good performance and child A.

  20. How to organize a neutron imaging user lab? 13 years of experience at PSI, CH

    Science.gov (United States)

    Lehmann, E. H.; Vontobel, P.; Frei, G.; Kuehne, G.; Kaestner, A.

    2011-09-01

    PSI has a relatively long tradition in neutron imaging since the first trials were done at its formerly existing research reactor SAPHIR with film methods. This reactor source was replaced after its shutdown in 1994 by the spallation neutron source SINQ in 1996, driven by the 590 MeV cyclotron for protons with presently up to 2.3 mA beam current. One of the first experimental devices at SINQ was the thermal neutron imaging facility NEUTRA, which was designed from scratch and has been the first device of its kind at a spallation source. Until now, NEUTRA has been successfully in use for many investigations in a wide range of studies covering fuel cell research, environmental behavior of plants, nuclear fuel inspection and the research on cultural heritage objects. It has been the host of PhD projects for students from all over Europe for years. In a previous meeting it has been offered as a European reference facility. Some of its features were really adapted to the layout of new installations. In 2004, it was possible to initiate the project of a second beam line at SINQ for imaging with cold neutrons. Previous studies have shown the potential of this option in order to broaden the user profile and to extend the scientific basis for neutron imaging. It was inaugurated with a workshop at PSI in 2005. The user service was started at the facility ICON in 2006. Beside the setup, installation and optimization of the facilities, the organization of the user program plays an important role. The two neutron imaging beam lines are equal installations at SINQ among the 14 scientific devices. Therefore, the user approach is organized via "calls for proposals", which are sent out each half year via the "Digital User Office (DUO)" (see http://duo.web.psi.ch). The evaluation of the proposals is done by the "Advisory Committee for Neutron Imaging (ACNI)" consisting of 6 external and PSI internal members. Further requests are given by industrial collaborations. This beam time allocation is handled more directly and in time in order to fulfill the companies' demands. Here, the confidentiality plays a more important role than in scientific studies that are done with the aim of a free publication. It has been possible to earn money regularly from the industrial projects in order to cover the salary cost of some positions within the NIAG group. The permanent improvement of the methodology and performance in neutron imaging is a third major activity of the NIAG team. Running projects in this direction are the permanent insert of a grating interferometry device, improved energy selection with the help of single graphite crystals and utilization of the beam line BOA at SINQ for the energy range between 4 and 15 Å.

  1. Prognostic factors in primary adenocarcinoma of the small intestine: 13-year single institution experience

    Directory of Open Access Journals (Sweden)

    Jacobs Michael J

    2008-01-01

    Full Text Available Abstract Background Adenocarcinoma of the small bowel is a relatively rare malignancy as compared to the other malignancies of the gastrointestinal tract. Nonspecific presentation and infrequent occurrence often leads to a delay in diagnosis and consequent poor prognosis. Various other factors are of prognostic importance while managing these tumors. Methods The medical records of a total of 27 patients treated for adenocarcinoma of the small bowel at Providence Hospital and Medical Centers from year 1990 through 2003 were reviewed retrospectively. Data were analyzed using SPSS software (version 10.0; SPSS, Inc., Chicago, IL. Survival analyses were calculated using the Kaplan Meier method with the log rank test to assess the statistical significance. The socio-demographics (age, gender were calculated using frequency analyses. Results The patients included nine males and eighteen females with a median age at diagnosis of 62 years. Only 48% of the patients had an accurate preoperative diagnosis while another 33% had a diagnosis suspicious of small bowel malignancy. None of the patients presented in stage 1. The cumulative five-year survival was 30% while the median survival was 3.3 years. There was no 30-day mortality in the postoperative period in our series. Conclusion The univariate analysis demonstrated that tumor grade, stage at presentation, lymph nodal metastasis and resection margins were significant predictors of survival.

  2. Climatology of monsoon precipitation over the Tibetan Plateau from 13-year TRMM observations

    Science.gov (United States)

    Aijuan, Bai; Guoping, Li

    2015-07-01

    Based on the 13-year data from the Tropical Rainfall Measuring Mission (TRMM) satellite during 2001-2013, the influencing geographical location of the Tibetan Plateau (Plateau) monsoon is determined. It is found that the domain of the Plateau monsoon is bounded by the latitude between 27° N and 37° N and the longitude between 60° E and 103° E. According to the annual relative precipitation, the Plateau monsoon can be divided into three sections: the Plateau winter monsoon (PWM) over Iran and Afghanistan, the Plateau summer monsoon (PSM) over the central Plateau, and the transiting zone of the Plateau monsoon (TPM) over the south, west, and east edges of the Plateau. In PWM and PSM, the monsoon climatology has a shorter rainy season with the mean annual rainfall of less than 800 mm. In TPM, it has a longer rainy season with the mean annual rainfall of more than 1800 mm. PWM experiences a single-peak monthly rainfall with the peak during January to March; PSM usually undergoes a multi-peak pattern with peaks in the warm season; TPM presents a double-peak pattern, with a strong peak in late spring to early summer and a secondary peak in autumn. The Plateau monsoon also characterizes an asymmetrical seasonal advance of the rain belt. In the east of the Plateau, the rain belt migrates in a south-north orientation under the impact of the tropical and subtropical systems' oscillation. In the west of the Plateau, the rain belt advances in an east-west direction, which is mainly controlled by the regional Plateau monsoon.

  3. Research of level of motive internals of young bicyclists 12-13 years, which are specialized in ВМХ.

    Directory of Open Access Journals (Sweden)

    Prudnikova М.S.

    2011-06-01

    Full Text Available The dynamics of motive internalss of young bicyclists at the age of 12-13 years is considered which engage in the extreme type of the cycle racing (ВМХ. Research of motive internalss of young bicyclists is conducted with the use of the special and non-special facilities of training during two macrocycles. The special pedagogical experiment which allowed to educe the level of motive internalss of young bicyclists 12-13 years at employments bicycle motocross is shown.

  4. Identifying with Science: A case study of two 13-year-old `high achieving working class' British Asian girls

    Science.gov (United States)

    Wong, Billy

    2012-01-01

    This paper provides an in-depth, 'case study' style analysis of the experiences of two 13-year-old British Asian girls from a larger qualitative study investigating minority ethnic students' aspirations in science. Through the lens of identity as performativity and Bourdieu's notions of habitus and capital, the ways in which two girls engage with the field of science is examined. Samantha is British Indian and Fay is British Bangladeshi and they are both 'top set' students in science, but only one aspired to study triple science, while the other desired to be 'famous'. The experiences of the two girls are explicated in this paper, teasing out their experiences and constructions of science. It is argued that cultural discourses of family, peers and teacher expectations can shape students' perceptions of science and education.

  5. Multifocal sclerotic BCG spondylitis in a 13-year-old girl

    International Nuclear Information System (INIS)

    A case is reported of multifocal BCG osteomyelitis in a 13-year-old girl. The lesions in the skull, ribs and in several vertebrae were mainly sclerotic and healed with antituberculotic therapy. The case is unusual because of the late onset, sclerotic changes, and involvement of the spine. (orig.)

  6. Maternal mortality in a teaching hospital in southern India. A 13-year study.

    Science.gov (United States)

    Rao, K B

    1975-10-01

    During the 13 years 1960-1972, in a teaching hospital that serves a predominantly rural and semiurban population in southern India, there were 74,384 deliveries and 1245 maternal deaths, a maternal mortality rate of 16.7 per 1000 births. Direct obstetric factors caused 854 (65.5%) of these deaths. The leading indirect or associated causes of maternal deaths were anemia, cerebrovascular accidents, and infectious hepatitis. During the past 13 years, monthly maternal mortality meetings have helped to reduce the incidence of avoidable factors in maternal deaths among patients from the city but not among those brought from the surrounding countryside. The important causes of maternal deaths in this developing country, and their prevention, are individually discussed. PMID:1080844

  7. Pulmonary Aspergillosis in a Previously Healthy 13-Year-Old Boy

    Directory of Open Access Journals (Sweden)

    Jonathan H. Rayment

    2016-01-01

    Full Text Available Chronic granulomatous disease (CGD is a rare, polygenic primary immunodeficiency. In this case report, we describe a previously healthy 13-year-old boy who presented with multifocal pulmonary aspergillosis and was subsequently diagnosed with an autosomal recessive form of chronic granulomatous disease. CGD has a variable natural history and age of presentation and should be considered when investigating a patient with recurrent or severe infections with catalase-positive organisms.

  8. First 13 Years of HIGH-Tc:. Brief Review and Open Questions

    Science.gov (United States)

    Pavuna, Davor

    Exactly 13 years ago, in April 1986, appeared the famous paper1 by Bednorz and Müller, that announced a striking discovery of high-Tc superconductivity in cuprates. Some 40'000 papers later, we are still struggling to understand the high-Tc superconductivity. Here I summarize some of the most relevant recent results and open questions by discussing the observed phenomena in a rather complex electronic phase diagram of high-Tc oxides.

  9. First 13 years of high-{Tc}: Brief review and open questions

    Energy Technology Data Exchange (ETDEWEB)

    Pavuna, D.

    1999-12-20

    Exactly 13 years ago, in April 1986, appeared the famous paper by Bednorz and Mueller, that announced a striking discovery of high-{Tc} superconductivity in cuprates. Some 40,000 papers later, scientists are still struggling to understand the high-{Tc} superconductivity. Here the author summarizes some of the most relevant recent results and open questions by discussing the observed phenomena in a rather complex electronic phase diagram of high-{Tc} oxides.

  10. Langerhans Cell Histiocytosis of the Clavicle in a 13-Year-Old Boy

    OpenAIRE

    Parikh, Shital N.; Desai, Vishal R.; Anita Gupta; Anton, Christopher G.

    2014-01-01

    Langerhans Cell Histiocytosis (LCH) is a rare neoplasm characterized by abnormal proliferation of histiocytic cells. In this case report, we describe a unique case of a 13-year-old boy who presented to the clinic with an insidious onset of mid-clavicular pain. The provisional radiologic diagnosis of Langerhans Cell Histiocytosis of the clavicle was confirmed by an incisional biopsy of the left mid-clavicle lesion. The patient’s lesion was treated by curettage, bone grafting, and internal fixa...

  11. The global tropospheric ammonia distribution as seen in the 13-year AIRS measurement record

    OpenAIRE

    Warner, Juying X.; Wei, Zigang; Strow, L. Larrabee; Dickerson, Russell R.; Nowak, John B.

    2016-01-01

    Ammonia (NH3) plays an increasingly important role in the global biogeochemical cycle of reactive nitrogen as well as in aerosol formation and climate. We present extensive and nearly continuous global ammonia measurements made by the Atmospheric Infrared Sounder (AIRS) from the Aqua satellite to identify and quantify major persistent and episodic sources as well as to characterize seasonality. We examine the 13-year period from September 2002 through August 2015 with a retr...

  12. Activity compensation and activity synergy in British 8-13 year olds

    OpenAIRE

    Goodman, A.; Mackett, R.L.; Paskins, J.

    2011-01-01

    Objectives. To examine whether children compensate for participating in physically active behaviors by reducing activity at other times (the 'activitystat' hypothesis); or alternatively become more active at other times (activity synergy).Methods. In 2002-2006, 345 British children (8-13 years) completed activity diaries and wore accelerometers. This generated 1077 days of data which we analyzed between-children (comparing all days) and within-child (comparing days from the same child).Result...

  13. The relationships between anthropometric and motor measurements with 13 years old children

    OpenAIRE

    Nehat Rrudhani

    2015-01-01

    Developmental psychology studies the changes that occur to human body with age, consisting of the human body, the way of thinking, emotions, behaviour, relationships and human behaviours throughout life. Physical development has to do with changes that occur only in the human body (height, weight, changes in different organs of the body etc.). The aim of this research is to conclude the main characteristics of physical and motor development of children aged 13 years old. During the period of ...

  14. Six physical education lessons a week can reduce cardiovascular risk in school children aged 6-13 years

    DEFF Research Database (Denmark)

    Christensen, Heidi Klakk; Andersen, Lars B; Heidemann, Malene Søborg;

    2014-01-01

    Aims: Cardiovascular disease (CVD) originates during childhood and adolescence. Schools are potentially effective settings for early public health prevention strategies. The aim of this study was to evaluate the effect of six physical education (PE) lessons on children's CVD risk. Methods......: This longitudinal study in 10 public schools (1218 children, aged 6-13 years), 6 intervention and 4 control schools evaluates a natural experiment, where intervention schools tripled PE to six lessons per week compared to the mandatory two PE lessons in the control schools. Baseline (2008) and 2-year follow...... to estimate effect of intervention taking the hierarchical structure of data into account. Individual, class and school were considered random effects. Intra class correlation (ICC) was calculated. Results: Intervention significantly lowered mean of composite risk score with 0.17 SD (95% CI: -0.34 to -0...

  15. INFECTIONS IN THE INTENSIVE CARE UNIT FOLLOWING LIVER TRANSPLANTATION: PROFILE OF A SINGLE CENTER

    Directory of Open Access Journals (Sweden)

    E. Otan

    2013-01-01

    Full Text Available Introduction. Despite the advances in antibiotherapy and critical care management, infectious complications remain among the leading complications after liver transplantation related with mortality and morbidity. This study analysis the incidence and pattern of infections and possible prognostic factors of infectious compli- cations retrospectively in a single center. Patients and Methods. Results of 30 consecutive patients with a primary liver transplantation history in a single center between August 2011 and August 2012 and a positive culture result in the first month in the ICU were analysed retrospectively. Results. During the first 1 month stay in the ICU postoperatively 30 (13,63% patients had at least 1 infection. Total number of infections were 68. Mortality rate of the infected patients was 53,3% (n = 16. Among these infections, 25 (36,76% of them were in deep surgical sites. Eighteen of the 30 patients (60% were infected with a single microorganism. Eleven patients (36,66% had a single infection episode. Microorganism were gram negative in 52 (76,47% of the infections, gram positive in 14 (20,58% of the infections, rest of the 2 (2,94% infections were due to Candidiasis. Among the possible risk factors contributing to mortality, there was a statistically significant dif- ference (p < 0,001 between the platelet counts of the mortality and surviving groups of the patients. Conclu- sion. Infections are among the preventable risk factors for mortality and morbidity after liver transplantation. Our data reveals a significant relation between trombocytopenia and mortality among the infected patients. Further studies focusing on this relation would expose the mechanisms and any possible contribution in cli- nical management of the patients. 

  16. Atypical Fibroxanthoma in a 13-Year-Old Guatemalan Girl with Xeroderma Pigmentosum.

    Science.gov (United States)

    Chappell, Ava G; Chase, Elizabeth P; Chang, Beverly; Cunningham, Eric; Mihm, Fred; Calame, Antoanella; Fudem, Gary; Cunningham, Bari

    2016-05-01

    Xeroderma pigmentosum (XP) is a rare, autosomal recessive disease involving a defect in DNA repair leading to the premature development of numerous aggressive cutaneous malignancies. Although atypical fibroxanthoma (AFX) is a neoplasm typically found in the setting of extensive sun exposure or therapeutic radiation, AFXs are rarely associated with children with XP. We report the case of a 13-year-old Guatemalan girl with the XP type C variant who developed one of the largest AFXs reported on a child's finger. PMID:27046537

  17. Renal artery thrombosis and hypertension in a 13 year old girl with antiphospholipid syndrome.

    Science.gov (United States)

    Ostuni, P A; Lazzarin, P; Pengo, V; Ruffatti, A; Schiavon, F; Gambari, P

    1990-01-01

    The case of a 13 year old girl with renal artery thrombosis and hypertension is described. A cerebrovascular accident and a probable occlusion of the superior mesenteric artery also occurred. Very high levels of 'lupus anticoagulant', anticardiolipin antibodies as well as false positive Venereal Disease Research Laboratory tests were repeatedly shown. Moreover, the patient fulfilled at least four classification criteria for systemic lupus erythematosus, but only a slight positivity for antinucleolar antibodies was present. The striking relation between antiphospholipid antibody levels and clinical events and the treatment of this complex syndrome are discussed. Images PMID:2108619

  18. Human papillomavirus vaccine initiation among 9–13-year-olds in the United States

    OpenAIRE

    Donahue, Kelly L.; Hendrix, Kristin S.; Lynne A. Sturm; Zimet, Gregory D.

    2015-01-01

    The quadrivalent and 9-valent human papillomavirus (HPV) vaccines are licensed for administration among 9–26-year-old males and females, with routine vaccination recommended for 11–12-year-olds. Despite the availability of the vaccine at younger ages, few studies have explored vaccine uptake prior to age 13, and national HPV vaccination surveillance data is limited to 13–17-year-olds. Our objective was to examine rates and predictors of HPV vaccine initiation among 9–13-year-olds in the Unite...

  19. Six physical education lessons a week can reduce cardiovascular risk in school children aged 6–13 years: a longitudinal study

    OpenAIRE

    Klakk, Heidi; Andersen, Lars Bo; Heidemann, Malene; Møller, Niels Christian; Wedderkopp, Niels

    2013-01-01

    Aims: Cardiovascular disease (CVD) originates during childhood and adolescence. Schools are potentially effective settings for early public health prevention strategies. The aim of this study was to evaluate the effect of six physical education (PE) lessons on children’s CVD risk. Methods: This longitudinal study in 10 public schools (1218 children, aged 6–13 years), 6 intervention and 4 control schools evaluates a natural experiment, where intervention schools tripled PE to six lessons per w...

  20. Global Ammonia Distributions and Recent Trends from AIRS 13-years Measurements

    Science.gov (United States)

    Warner, J. X.; Wei, Z.; Strow, L. L.; Nowak, J. B.; Dickerson, R. R.

    2015-12-01

    Ammonia is an integral part of the nitrogen cycle and is projected to be the largest single contributor to each of acidification, eutrophication and secondary particulate matter in Europe by 2020 (Sutton et al., 2008). The impacts of NH3 also include: aerosol production affecting global radiative forcing, increases in emissions of the greenhouse gases nitrous oxide (N2O) and methane (CH4), and modification of the transport and deposition patterns of SO2 and NOx. Therefore, monitoring NH3 global distribution of sources is vitally important to human health with respect to both air and water quality and climate change. We have developed new daily and global ammonia (NH3) products from AIRS hyperspectral measurements. These products add value to AIRS's existing products that have made significant contributions to weather forecasts, climate studies, and air quality monitoring. With longer than 13 years of data records, these measurements have been used not only for daily monitoring purposes but also for inter-annual variability and short-term trend studies. We will discuss the global NH3 emission sources from biogenic and anthropogenic activities over many emission regions captured by AIRS. We will focus their variability in the last 13 years. Validation examples using in situ measurements for AIRS NH3 will also be presented.

  1. Retrospective Single Center Study of Granulocyte Monocyte Adsorption Apheresis Treatment in Inflammatory Bowel Disease.

    Science.gov (United States)

    Edfors, Kajsa; Ståhlberg, Dagny; Söderman, Charlotte

    2016-02-01

    Patients with active inflammatory bowel disease (IBD) have elevated and activated myeloid leukocytes, which infiltrate the intestinal mucosa. A significant proportion of IBD patients do not respond adequately to conventional treatment regimes. Studies have suggested that treatment with granulocyte monocyte apheresis (GMA) could be a safe and efficacious alternative for these patients. We evaluated the efficacy and safety of granulocyte/monocyte apheresis in patients with IBD in a retrospective cohort study, conducted from a single center in Stockholm. Clinical details from consecutive apheresis treated patients were retrospectively reviewed from 2004 to 2012. A total of 37 patients were included, 23 patients with ulcerative colitis (UC) and 14 with Crohn's disease (CD). Clinical response was seen in 11 patients (30%) and complete remission in 11 patients (30%). The remission rate was higher in UC patients compared to CD patients, 39% (N = 9) and 14% (N = 2) respectively. A total of 9 patients experienced adverse events. Most frequently reported was headache (N = 4). GMA seems to be a valuable adjuvant treatment regime in the care of patients with refractory IBD.

  2. Economic Burden of Road Traffic Accidents; Report from a Single Center from South Eastern Iran

    Directory of Open Access Journals (Sweden)

    Aliyeh Sargazi

    2016-01-01

    Full Text Available Objective: To determine the economic burden of road traffic accidents (RTAs in patients admitted to a single center in south eastern Iran. Methods: This cross-sectional study was conducted in Amir-Al-Momenin hospital of Zabol affiliated with Zabol University of Medical Sciences during a 12-month period from April 2012 to April 2013. All the RTAs patients who were admitted to our emergency department were included. The direct expenses of hospital care were recorded according to their medical charts and the accountant registration information. Data are presented according to different RTAs characteristics. Results: Overall 1155 patients were included in the current study with mean age of 36.7 ± 5.14 years among whom there were 673(58.3% men and 482 (41.7% women. The annual incidence of RTAs were calculated to be 288 per 100,000 population. The RTAs economic burden in our center was 589,448.49 USD which accounted for 10.4% of total hospital expenses during the study period. The money spend on RTAs in our center was 130 times more than gross national income per capita. Cost of each patient in road traffic was 15 times more than cost of an average patient of the hospital in other sections. Conclusion: With considerable high ratio of accidents in Zabol, proper intervention is needed for controlling and preventing RTAs in order to decrease its injuries, impact and the associated economic burden.

  3. EVALUATION AND MANAGEMENT OF DIFFICULT AIRWAY IN OBESITY A SINGLE CENTER RETROSPECTIVE STUDY.

    Science.gov (United States)

    Ayhan, Asude; Kaplan, Serife; Kayhan, Zeynep; Arslan, Gulnaz

    2016-03-01

    The primary aim of this single center retrospective study was to evaluate difficult mask ventilation (DMV) and difficult laryngoscopy (DL) in a unique group of obese patients. A total of 427 adult patients with body mass index (BMI) ≥ 25 and surgically treated for endometrial cancer from 2011 to 2014 were assessed. Additional increase in BMI, comorbidities, bedside screening tests for risk factors, and the tools used to manage the patients were noted and their effects on DMV and/or DL investigated. Every escalation in the number of risk factors increased the probability of DMV 2.2-fold, DL 1.8-fold and DMV+DL 3.0-fold. Among bedside tests, limited neck movement (LNM), short neck (SN) and absence of teeth were significant for DMV (p sleep apnea for DL (p risk factor when patients with BMI > 25% were considered. In conclusion, LNM and SN are independent risk factors for developing DMV and/or DL in obese endometrial cancer patients, while BMI increase over 30 was not additionally affecting difficult airway. PMID:27276769

  4. Posttraumatic nonunion of the clavicle in a 13-year-old boy causing an arteriovenous fistula

    Directory of Open Access Journals (Sweden)

    Feiran Wu

    2013-01-01

    Full Text Available Context: Fractures of the clavicle are one of the most common injuries to the bone in childhood, but posttraumatic nonunion of pediatric clavicle fractures are extremely rare, with only isolated reports in literature. Case Report: We report a case of a posttraumatic painful nonunion of a clavicle fracture in a 13-year-old boy that caused symptomatic compression of the external jugular vein (EJV and the formation of an arteriovenous fistula. The fracture was treated successfully with open reduction and internal fixation with a contoured recon plate 6 months following the injury. The fistula was treated by ligation and closure. Conclusion: The patient made a full recovery 6 months following surgery and was asymptomatic with full range of shoulder movement. Fracture union was confirmed by computed tomography (CT scanning and no residual fistula was found.

  5. Azithromycin for episodes with asthma-like symptoms in young children aged 1-3 years

    DEFF Research Database (Denmark)

    Stokholm, Jakob; Chawes, Bo L; Vissing, Nadja H;

    2016-01-01

    BACKGROUND: Bacteria and viruses are equally associated with the risk of acute episodes of asthma-like symptoms in young children, suggesting antibiotics as a potential treatment for such episodes. We aimed to assess the effect of azithromycin on the duration of respiratory episodes in young...... children with recurrent asthma-like symptoms, hypothesising that it reduces the duration of the symptomatic period. METHODS: In this randomised, double-blind, placebo-controlled trial, we recruited children aged 1-3 years, who were diagnosed with recurrent asthma-like symptoms from the Copenhagen...... (respiratory frequency of ≥50 breaths per min; fever of ≥39°C; C-reactive protein concentration of ≥476·20 nmol/L [≥50 mg/L]). Each episode of asthma-like symptoms lasting at least 3 days was randomly allocated to a 3-day course of azithromycin oral solution of 10 mg/kg per day or placebo after thorough...

  6. XYY syndrome: a 13-year-old boy with tall stature.

    Science.gov (United States)

    Jo, Won Ha; Jung, Mo Kyung; Kim, Ki Eun; Chae, Hyun Wook; Kim, Duk Hee; Kwon, Ah Reum; Kim, Ho-Seong

    2015-09-01

    When evaluating the underlying causes of tall stature, it is important to differentiate pathologic tall stature from familial tall stature. Various pathologic conditions leading to adult tall stature include excess growth hormone secretion, Marfan syndrome, androgen or estrogen deficiency, testicular feminization, and sex chromosome anomaly, such as Klinefelter syndrome and XYY syndrome. Men with 47,XYY syndrome can exhibit multiple phenotypes. A 13-year-old boy visited the hospital for evaluation of tall stature. The boy had no other physical abnormalities except tall stature. All biochemical and imaging studies were within the normal ranges. He was diagnosed with XYY syndrome in this chromosome study. When evaluating men with tall stature, XYY syndrome should be ruled out. PMID:26512355

  7. Langerhans Cell Histiocytosis of the Clavicle in a 13-Year-Old Boy

    Directory of Open Access Journals (Sweden)

    Shital N. Parikh

    2014-01-01

    Full Text Available Langerhans Cell Histiocytosis (LCH is a rare neoplasm characterized by abnormal proliferation of histiocytic cells. In this case report, we describe a unique case of a 13-year-old boy who presented to the clinic with an insidious onset of mid-clavicular pain. The provisional radiologic diagnosis of Langerhans Cell Histiocytosis of the clavicle was confirmed by an incisional biopsy of the left mid-clavicle lesion. The patient’s lesion was treated by curettage, bone grafting, and internal fixation, due to the presence of pathologic fracture. At the 2-year followup, the patient was asymptomatic, and the lesion showed complete resolution without recurrence. The case report highlights the characteristic features of Langerhans Cell Histiocytosis in an unusual location, the knowledge of which would help avoid delayed or missed diagnosis in the future.

  8. Alternative fruit and vegetables consumption for 1-3 year old Indonesian children

    Directory of Open Access Journals (Sweden)

    Nurhayati Nurhayati

    2014-02-01

    Full Text Available AbstrakLatar belakang:World Health Organization merekomendasikan konsumsi sayur dan buah paling sedikit 400 gr atau 5 (lima porsi sayur dan buah sehari. Penelitian ini untuk menentukan alternatif jumlah dan jenis anjuran konsumsi sayur dan buah dan kecukupan vitamin A, vitamin C, potasium, asam folat dan serat yang dapat dipenuhi untuk kelompok umur 1-3 tahun anak Indonesia. Metode:Penelitian menggunakan data konsumsi sayur dan buah dari data Riskesdas tahun 2010. Analisis data menggunakan analisis linier programming untuk memperoleh lima alternatif jumlah dan jenis sayur dan buah untuk anak usia 1-3 tahun.Hasil:Hasil penelitian menunjukkan bahwa lima jenis buah yang paling banyak dikonsumsi anak usia 1-3 tahun adalah pisang, jeruk, pepaya, apel dan semangka. Lima jenis sayur yang paling banyak dikonsumsi anak usia 1-3 tahun adalah sayur bayam, sayur sop, sayur kangkung, sayur daun singkong, dan sayur asam. Jumlah anjuran konsumsi sayur dan buah untuk anak usia 1-3 tahun adalah 100-200 gram sayuran dan 150-200 gram buah Kesimpulan: Alternatif anjuran konsumsi sayur dan buah untuk anak usia 1-3 tahun adalah 100-200 gram (1-2 mangkok sayuran dan 150-200 gram (3-4 potong buah. (Health Science Indones 2013;2:74-7Kata kunci: anjuran, konsumsi, sayur, buah, anak usia 1-3 tahunAbstractBackground: WHO recommends the daily consumption of fruit and vegetables at least 400 grams or 5 servings. Based on national health survey Indonesia in 2007, means of daily portion of fruit and vegetable for Indonesian was less than 5 portion. This study was conducted to assess consumption of fruit and vegetables in 1-3 year old Indonesian children, and adequacy of daily requirement of vitamin A, vitamin C, potasium, folic acid and fiber. Methods: The study used consumption data from 2010 National Health Survey Indonesia. Using linier programming, we then could present 5 alternatives of combination of fruits and vegetables. Result:  The  study  found  five  kind  of  mostly  consumed  fruit  were  banana,  orange,  papaya,  apel,  and watermelon. Five mostly consumed vegetables were spinach, vegetable soup, kangkung, cassava leaves, and tamarind dish. The alternative amount of fruit and vegetable consumption for 1-3 year old Indonesian children is 100-200 gramsof vegetables and 150-200 grams of fruit. Conclusion: Alternative fruit and vegetables consumption for 1-3 year old Indonesian children are 100-200 grams (1-2 bowls gramsof vegetables and 150-200 grams(3-4 pieces of fruit. (Health Science Indones 2013;2:74-7Key words: guidance, fruit, vegetables, consumption, 1-3 year children

  9. Urological complications after 134 pediatric kidney transplants: a single-center study.

    Science.gov (United States)

    Almeida, F; Branco, F; Cavadas, V; Ribeiro, S; Osório, L; Rocha, A; Ramos, M; Martins, L; Castro-Henriques, A; Mota, C; Reis, A; Fraga, A

    2013-04-01

    The incidence of surgical complications after kidney transplantation has been reported to range from 1% to 33%. The aim of this work was to report surgical urological complications among our cohort of 134 pediatric kidney transplantations. Epidemiological and clinical data of all patients younger than 18 years transplanted between January 1984 and May 2012 were collected from our prospective database. Urologic complications and management are reported herein. One hundred twenty-four patients, including 44% females underwent 134 renal transplants. Median age at the time of the surgery was 13 years. Mean time of end-stage renal disease was 25 months. We identified 10 subjects (7.5%) with urological complications: 5 ureterovesical stenoses, 2 lymphoceles, and 3 lower ureteral fistulas. All of the renal allografts were obtained from cadaveric donors. Mean age of these patients at the time of transplantation was 13 years. Mean cold ischemia time was 1613 minutes. All the patients required surgical management. All patients with ureterovesical stenoses underwent ureteral reimplantation using a Boari flap; those with lymphoceles underwent open marsupialization; 2 with ureteral fistulas underwent reimplantation of the ureter, and the other patient's case required placement of a nephrostomy tube and an antegrade ureteral catheter. All patients were treated successfully. Mean follow-up time of cases with urological complications was 9.5 years. Currently, 60% has nonfunctioning allografts; the mean current glomerular filtration rate of the functioning renal allografts is 55 mL/min. Despite requiring surgical management, all patients were treated successfully. Prompt identification and treatment of any complication are critical for graft and patient survival.

  10. Clinical Results After Prostatic Artery Embolization Using the PErFecTED Technique: A Single-Center Study

    Energy Technology Data Exchange (ETDEWEB)

    Amouyal, Gregory, E-mail: gregamouyal@hotmail.com; Thiounn, Nicolas, E-mail: nicolas.thiounn@aphp.fr; Pellerin, Olivier, E-mail: olivier.pellerin@aphp.fr [Université Paris Descartes - Sorbonne - Paris - Cité, Faculté de Médecine (France); Yen-Ting, Lin, E-mail: ymerically@gmail.com [Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Interventional Radiology Department (France); Giudice, Costantino Del, E-mail: costantino.delgiudice@aphp.fr [Université Paris Descartes - Sorbonne - Paris - Cité, Faculté de Médecine (France); Dean, Carole, E-mail: carole.dean@aphp.fr [Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Interventional Radiology Department (France); Pereira, Helena, E-mail: helena.pereira@aphp.fr [Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit (France); Chatellier, Gilles, E-mail: gilles.chatellier@aphp.fr; Sapoval, Marc, E-mail: marc.sapoval2@aphp.fr [Université Paris Descartes - Sorbonne - Paris - Cité, Faculté de Médecine (France)

    2016-03-15

    BackgroundProstatic artery embolization (PAE) has been performed for a few years, but there is no report on PAE using the PErFecTED technique outside from the team that initiated this approach.ObjectiveThis single-center retrospective open label study reports our experience and clinical results on patients suffering from symptomatic BPH, who underwent PAE aiming at using the PErFecTED technique.Materials and MethodsWe treated 32 consecutive patients, mean age 65 (52–84 years old) between December 2013 and January 2015. Patients were referred for PAE after failure of medical treatment and refusal or contra-indication to surgery. They were treated using the PErFecTED technique, when feasible, with 300–500 µm calibrated microspheres (two-night hospital stay or outpatient procedure). Follow-up was performed at 3, 6, and 12 months.ResultsWe had a 100 % immediate technical success of embolization (68 % of feasibility of the PErFecTED technique) with no immediate complications. After a mean follow-up of 7.7 months, we observed a 78 % rate of clinical success. Mean IPSS decreased from 15.3 to 4.2 (p = .03), mean QoL from 5.4 to 2 (p = .03), mean Qmax increased from 9.2 to 19.2 (p = .25), mean prostatic volume decreased from 91 to 62 (p = .009) mL. There was no retrograde ejaculation and no major complication.ConclusionPAE using the PErFecTED technique is a safe and efficient technique to treat bothersome LUTS related to BPH. It is of interest to note that the PErFecTED technique cannot be performed in some cases for anatomical reasons.

  11. Treatment of intracranial aneurysms by flow diverter devices: Long-term results from a single center

    Energy Technology Data Exchange (ETDEWEB)

    Briganti, Francesco, E-mail: frabriga@unina.it [Unit of Interventional Neuroradiology, Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Napoli, Manuela, E-mail: napoli.manuela@gmail.com [Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Leone, Giuseppe, E-mail: g.leonemd@gmail.com [Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Marseglia, Mariano, E-mail: mariano-marseglia@libero.it [Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Mariniello, Giuseppe, E-mail: giuseppe.mariniello@unina.it [Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Caranci, Ferdinando, E-mail: ferdinando.caranci@unina.it [Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Tortora, Fabio, E-mail: fabiotor@libero.it [Chair of Neuroradiology, “Magrassi Lanzara” Clinical-Surgical Department, Second University of Naples, Viale Colli Aminei 21, 80131 Naples (Italy); Maiuri, Francesco, E-mail: frmaiuri@unina.it [Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy)

    2014-09-15

    Highlights: • We report the long-term results (2–4 years) with Flow Diverter Devices (FDD) from a single-center. • We recommend the use of FDD for large-neck aneurysms of the ICA syphon. • We think that more sophisticate FDD will reduce the incidence of technical adverse events. - Abstract: Objectives: Flow-Diverter Devices (FDD) are a new generation stents designed for the treatment of the intracranial aneurysms. This article reports the long-term results (2–4 years) of this treatment from a single-center. Methods: From November 2008 to January 2012, 35 patients (29 females and 6 males; mean age 53.9 y) with 39 intracranial aneurysms were treated by FDD. Five patients (14.3%) had ruptured aneurysms and 30 (85.7%) had no previous hemorrhage. The procedures were performed in 5 patients (14.3%) with SILK and in 30 (85.7%) with PED. In 3 patients FDDs were used as a second treatment after failure of previous coiling (2 cases) or stenting (one case). The 39 aneurysms were in supraclinoid ICA in 26 (66.7%), cavernous ICA in 2 (5.1%), PCoA in 4 (10.2%), MCA in 5 (12.9%), SCA in 1 (2.6%) and PICA in 1 (2.6%). The aneurysms were small (<10 mm) in 32 cases (82%), large (11–25 mm) in 6 (15.3%) and giant in 1 (2.6%). The occlusion rate according to the aneurysm location, size and neck and the complications were evaluated. Results: Peri-procedural complications included transient dysarthria (2 patients), vasospasm with acute intra-stent aggregation (one), microwire rupture (one) and failure of the stent opening (one). The follow-up was made between 24 and 62 months (mean 41 months); clinical examination and CTA were performed at 1, 3, 6 and 12 months after the procedure. The complete occlusion was confirmed by CTA and DSA. MRI with angiographic-studies was taken every year. Complete occlusion was obtained in 35 aneurysms (92.1%) and subtotal in 3 (7.9%). Complete occlusion occurred at 3 months in 24 cases (68.6%), within 3 and 6 months in 9 (25.7%). The rate and

  12. Prevalence of hyponatremia among patients who used indapamide and hydrochlorothiazide: A single center retrospective study

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    M Al Qahtani

    2013-01-01

    Full Text Available Hyponatremia is the most frequently encountered electrolyte abnormality among hospitalized patients and thiazide users. In this large single-center retrospective study, we aim to determine the prevalence and risk factors of hyponatremia among patients at the King Abdulaziz Medical City (KAMC, Riyadh, Saudi Arabia.To the best of our knowledge, this is the first such study in Saudi Arabia. A chart review was done for the years 2011-2012 of all admitted Saudi patients at KAMC who were treated with indapamide and hydrochlorothiazide. A total of 2000 patients were included [1237 females (629 indapamide and 608 hydrochlorothiazide and 762 males (371 indapamide and 391 hydrochlorothiazide]. Majority of the patients had type-2 diabetes mellitus (T2DM with an overall prevalence of 72.2%. The overall prevalence of hyponatremia, regardless of severity, in the indapamide group was 37.3% versus 38.7% in the hydrochlorothiazide group. Stratification for age revealed that older patients had relatively higher levels of sodium (Na as compared with younger patients, and this inverse association was significant (R = - 0.123; P <0.001. Increasing age, female gender and presence of T2DM were the significant risk factors for hyponatremia, explaining the 4.7% of the variance perceived (P <0.001. Our study suggests that the prevalence of hyponatremia among Saudi thiazide users is relatively high, and more so for the elderly and for those with T2DM. Early identification of this condition is important and caution should be exercised while prescribing thiazide drugs, particularly to those who are most at risk of developing hyponatremia to prevent related complications.

  13. External validation of the SEDAN score: The real world practice of a single center

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    Sombat Muengtaweepongsa

    2015-01-01

    Full Text Available Background and Purpose: Symptomatic intracranial hemorrhage (sICH is the most serious adverse event in stroke patients who received i.v. rt-PA and is usually associated with poor outcomes. The SEDAN score is built up to predict sICH. We aim to externally validate the SEDAN score in Thai patients from single center in the real world practice. Methods: The SEDAN score of stroke patients treated with intravenous rt-PA at Thammasat University Hospital from January 2010 to June 2012 was calculated. Patients were divided into three groups including symptomatic intracranial hemorrhage (sICH, asymptomatic intracranial hemorrhage (AsICH and no intracerebral hemorrhage (NoICH. The primary outcome of analyses was sICH. Each parameter of the SEDAN score and correlation between score and sICH were analyzed with univariate and multivariate model. Results: 295 patients (18.6% of stroke admission were treated with i.v. rt-PA. 13 patients (4.4% had sICH and 31 patients (10.4% had AsICH. Baseline blood sugar >12 mmol/l, early infarction, hyperdense cerebral artery, age >75 years-old and NIHSS ≥10(SEDAN were associated with sICH by univariate analysis (P value = 0.018, 12 mmol/l, early infarction, hyperdense cerebral artery, age >75 years-old and NIHSS ≥10 were 1.248, 2.503, 1.107, 1.532 and 1.263 respectively. Conclusions: The SEDAN score was practical to use and predictive in Thai population. Each parameter of the SEDAN score was an independent risk factor for sICH after treatment with i.v. rt-PA.

  14. Cancer Therapy Directed by Comprehensive Genomic Profiling: A Single Center Study.

    Science.gov (United States)

    Wheler, Jennifer J; Janku, Filip; Naing, Aung; Li, Yali; Stephen, Bettzy; Zinner, Ralph; Subbiah, Vivek; Fu, Siqing; Karp, Daniel; Falchook, Gerald S; Tsimberidou, Apostolia M; Piha-Paul, Sarina; Anderson, Roosevelt; Ke, Danxia; Miller, Vincent; Yelensky, Roman; Lee, J Jack; Hong, David S; Kurzrock, Razelle

    2016-07-01

    Innovative molecular diagnostics deployed in the clinic enable new ways to stratify patients into appropriate treatment regimens. These approaches may resolve a major challenge for early-phase clinical trials, which is to recruit patients who, while having failed previous treatments, may nevertheless respond to molecularly targeted drugs. We report the findings of a prospective, single-center study conducted in patients with diverse refractory cancers who underwent comprehensive genomic profiling (CGP; next-generation sequencing, 236 genes). Of the 500 patients enrolled, 188 (37.6%) received either matched (N = 122/188, 65%) or unmatched therapy (N = 66/188, 35%). The most common reasons that patients were not evaluable for treatment included insufficient tissue, death, or hospice transfer. The median number of molecular alterations per patient was five (range, 1-14); median number of prior therapies, four. The most common diagnoses were ovarian cancer (18%), breast cancer (16%), sarcoma (13%), and renal cancer (7%). Of the 339 successfully profiled patients, 317 (93.5%) had at least one potentially actionable alteration. By calculating matching scores, based on the number of drug matches and genomic aberrations per patient, we found that high scores were independently associated with a greater frequency of stable disease ≥6 months/partial/complete remission [22% (high scores) vs. 9% (low scores), P = 0.024], longer time-to-treatment failure [hazard ratio (HR) = 0.52; 95% confidence interval (CI) = 0.36-0.74; P = 0.0003], and survival (HR = 0.65; 95% CI = 0.43-1.0; P = 0.05). Collectively, this study offers a clinical proof of concept for the utility of CGP in assigning therapy to patients with refractory malignancies, especially in those patients with multiple genomic aberrations for whom combination therapies could be implemented. Cancer Res; 76(13); 3690-701. ©2016 AACR. PMID:27197177

  15. Atrial Fibrillation Following Surgical Management of Ischemic Heart Disease; One Year, Single Center, Single Surgeon Results

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    Ahmet Barış Durukan

    2012-08-01

    Full Text Available Introduction: Postoperative atrial fibrillation is the most common arrhythmia following bypasssurgery with significant morbidity, mortality and increased healthcare costs. The aim of this studyis to determine the incidence and timing of atrial fibrillation, identify the risk factors coveringpreoperative and intraoperative periods, evaluate rate of return to sinus rhythm by disharge, andexplore the impact on postoperative outcomes in a large group of patients operated in a singlecenter by a single surgeon.Patients and Methods: Between January 2011 and January 2012, 418 patients on preoperativesinus rhythm were operated for ischemic heart disease and associated complications (left ventricleaneurysm repair and ischemic mitral insufficiency in a single center, by a single surgeon.The preoperative, intraoperative and postoperative variables were studied.Results: The mean age of the patients were 61.92 ± 10.05, and 77.5% were male. Atrial fibrillationdeveloped in 68 (16.3% patients. The incidence peaked at second day. Patients with atrialfibrillation were older (p< 0.001. Gender, preoperative comorbidities, ejection fraction, left atrialdiameter, preoperative beta-blocker use, leukocyte count, type of operation and intraoperativevariables did not affect its occurence. Intensive care unit and hospital length of stay were longer(p< 0.05. 95.5% (n= 65 of patients were in normal sinus rhythm at discharge.Conclusion: Postoperative atrial fibrillation is a popular subject with unknowns and controversialresults which may lead to wrong interpretations. We believe that every center has its own risk factors related with the population of that region. Discussion will last, but simple precautions and close monitoring will help to minimizeadverse outcomes.

  16. The Risk Factors and Pregnancy Outcomes of 48 Cases of Heterotopic Pregnancy from a Single Center.

    Science.gov (United States)

    Jeon, Ji Hyun; Hwang, Yu Im; Shin, Im Hee; Park, Chan Woo; Yang, Kwang Moon; Kim, Hye Ok

    2016-07-01

    The purpose of this study was to investigate risk factors that are associated with heterotopic pregnancy (HP) following in vitro fertilization (IVF)-embryo transfer (ET) and to demonstrate the outcomes of HP after the surgical treatment of ectopic pregnancies. Forty-eight patients from a single center, who were diagnosed with HP between 1998 and 2012 were included. All of the patients had received infertility treatments, such as Clomid with timed coitus (n = 1, 2.1%), superovulation with intrauterine insemination (n = 7, 14.6%), fresh non-donor IVF-ET (n = 33, 68.8%), and frozen-thawed cycles (n = 7, 14.6%). Eighty-four additional patients were randomly selected as controls from the IVF registry database. HP was diagnosed at 7.5 ± 1.2 weeks (range 5.4-10.3) gestational age. In six cases (12.5%), the diagnosis was made three weeks after the patients underwent treatment for abortion. There were significant differences in the history of ectopic pregnancy (22.5% vs. 3.6%, P = 0.002). There were no significant differences in either group between the rates of first trimester intrauterine fetal loss (15.0% vs. 13.1%) or live birth (80.0% vs. 84.1%) after the surgical treatment for ectopic pregnancy. The risk factors for HP include a history of ectopic pregnancy (OR 7.191 [1.591-32.513], P = 0.010), abortion (OR 3.948 [1.574-9.902], P = 0.003), and ovarian hyperstimulation syndrome (OHSS) (OR 10.773 [2.415-48.060], P = 0.002). In patients undergoing IVF-ET, history of ectopic pregnancy, abortion, and OHSS may be risk factors for HP as compared to the control group of other IVF patients. The surgical treatment of HP does not appear to affect the rates of first trimester fetal loss or live birth. PMID:27366008

  17. Relative age effect on the reaction time of soccer players under 13 years old

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    Eduardo Macedo Penna

    2015-06-01

    Full Text Available The relative age effect, which is the advantage obtained by an athlete born closer to the beginning of the selection year, has been shown to be an important variable in the development of soccer players. This study aimed to evaluate the influence of the season of birth on the choice reaction time (CRT of elite soccer athletes in the under 13 years of age category. Seventy-six athletes participated who were 13.36 ± 0.45 years old. The volunteers were tested with a CRT test, and the results were divided according to the semester of birth (S1 or S2. We conducted a t-test in order to compare the results between groups and a Pearson correlation analysis to verify the associations between variables. The results indicated no differences in reaction time (r= .033 and p = .772 or movement time (r = .0073 and p = .530. It was concluded that for this population, the season of birth does not influence the performance of the capabilities tested.

  18. Teething and nutritional condition in children between 5 and 13 years.

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    Clotilde de la Caridad Mora Pérez

    2009-04-01

    Full Text Available Background: During last decades it has become increasingly evident the importance of nutritional factors in the development and renovation of buccal tissues, particularly of teeth. Objective: To characterize permanent teething and its relation with nutritional factors in children between 5 and 13 years. Methods: Cross-sectional descriptive, observational study developed in a universe formed by 1003 children of Health Area II in Cienfuegos, out of which a sample of 330 children was selected. Data was collected from schools, regarding the teething age and nutritional status. Ponder and measurements were carried out. Results: The average teething age was lower for girls in both maxillary bones; teething sequence was 6,1,2,4,5,3,7 for the maxilla and 6,1,2,3,4,5,7 for the inferior maxillary bone. There was a prevalence of normal weight among girls, followed by thin and undernourished values. Among boy, there was a prevalence of obesity, overweight and normal weight in that order. Nutritional statuses of thin and undernourished were related with a delayed teething, mainly in the inferior maxillary bone. Permanent teething was delayed with regard to the national media. Conclusion: A clear relation was established between teething age and nutrition, mainly among thin and undernourished children.

  19. Hypoglycemia and Risk Factors for Death in 13 Years of Pediatric Admissions in Mozambique.

    Science.gov (United States)

    Madrid, Lola; Acacio, Sozinho; Nhampossa, Tacilta; Lanaspa, Miguel; Sitoe, Antonio; Maculuve, Sónia Amós; Mucavele, Helio; Quintó, Llorenç; Sigaúque, Betuel; Bassat, Quique

    2016-01-01

    Hypoglycemia is a life-threatening complication of several diseases in childhood. We describe the prevalence and incidence of hypoglycemia among admitted Mozambican children, establishing its associated risk factors. We retrospectively reviewed clinical data of 13 years collected through an ongoing systematic morbidity surveillance in Manhiça District Hospital in rural Mozambique. Logistic regression was used to identify risk factors for hypoglycemia and death. Minimum community-based incidence rates (MCBIRs) for hypoglycemia were calculated using data from the demographic surveillance system. Of 49,089 children death among hypoglycemic children included prostration, unconsciousness, edema, malnutrition, and bacteremia. Hypoglycemic children were significantly more likely to die (odds ratio [OR] = 7.11; P < 0.001), with an associated case fatality rate (CFR) of 19.3% (245/1,267). Overall MCBIR of hypoglycemia was 1.57 episodes/1,000 child years at risk (CYAR), significantly decreasing throughout the study period. Newborns showed the highest incidences (9.47 episodes/1,000 CYAR, P < 0.001). Hypoglycemia remains a hazardous condition for African children. Symptoms and signs associated to hypoglycemia should trigger the verification of glycemia and the implementation of life-saving corrective measures. PMID:26503282

  20. Changes in community mobility in older men and women. A 13-year prospective study.

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    Sofi Fristedt

    Full Text Available Community mobility, defined as "moving [ones] self in the community and using public or private transportation", has a unique ability to promote older peoples' wellbeing by enabling independence and access to activity arenas for interaction with others. Early predictors of decreased community mobility among older men and women are useful in developing health promoting strategies. However, long-term prediction is rare, especially when it comes to including both public and private transportation. The present study describes factors associated with community mobility and decreased community mobility over time among older men and women. In total, 119 men and 147 women responded to a questionnaire in 1994 and 2007. Respondents were between 82 and 96 years old at follow-up. After 13 years, 40% of men and 43% of women had decreased community mobility, but 47% of men and 45% of women still experienced some independent community mobility. Cross-sectional independent community mobility among men was associated with higher ratings of subjective health, reporting no depression and more involvement in sport activities. Among women, cross-sectional independent community mobility was associated with better subjective health and doing more instrumental activities of daily living outside the home. Lower subjective health predicted decreased community mobility for both men and women, whereas self-reported health conditions did not. Consequently, general policies and individual interventions aiming to improve community mobility should consider older persons' subjective health.

  1. Sugar consumption pattern of 13-year-old school children in Belgaum city, Karnataka

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    Hegde P

    2005-01-01

    Full Text Available To determine the sugar consumption pattern of the school children in Belgaum city and to organize for a diet-counseling program. Easy availability of sugar containing food and high consumption of these sweets if continued unabated, the dental caries among children would become a major public health problem. In this instance, Dietary counseling can be just appropriate to inhibit the carious process. 342 school children aged 13 years, from four schools in Belgaum city participated in the study. The pattern of sugar consumption was assessed using a 4-day diet diary. Analysis was done according to the method described by Nizel and Papas (Nutrition in clinical dentistry, 1989, 277 and the variables were: the sweet score, At meal sugar exposure (AMSE, Between meal sugar exposure (BMSE and Total sugar exposure (TSE. The mean, standard deviation and/or frequency were calculated for all variables. Student′s t-test was used to statistically analyze the gender difference. The mean + SD of the recorded variables were: sweet score 31 + 12.78/day, AMSE 0.88 + 0.33/day, BMSE 3.95 + 0.87/day, and TSE 4.83 + 0.96/day. No statistical significant gender difference with respect to the variables was observed. ′Tell Show And Do′ Diet counseling session will perhaps have a greater impact as compared to the most common strategy of simply exhorting the children to eat less sugar.

  2. Reference values for acoustic rhinometry in children from 4 to 13 years

    DEFF Research Database (Denmark)

    Straszek, Sune; Moeller, Alexander; Hall, Graham L;

    2008-01-01

    a reference range for nasal volumes and minimum cross-sectional areas (MCA) in healthy non-decongested children aged 4 to 13 years. Methods: 256 primary school children (mean 7.95 years, range 3.8 - 13.1 ys, 123m/133f) were measured by acoustic rhinometry. Variables were MCA (first, second and absolute...... minimum) and nasal volumes from 0 to 4 (Vol0-4), 0 to 5 (Vol0-5), 1 to 4 (Vol1-4) and 2 to 5 (Vol2-5) cm into the nasal cavity. Height and weight were measured and atopic status determined by skin prick test. Age and current and past respiratory health were recorded from a questionnaire. Results...... nasal patency. Conclusion: This paper presents the presently most extensive reference material for AR inm non-decongested pre-pubescent healthy children. The presented reference material will facilitate the interpretation and evaluation of future and present epidemiological studies based on AR...

  3. Serial Analysis of Gene Expression (SAGE): 13 years of application in research.

    Science.gov (United States)

    Anisimov, Sergey V

    2008-10-01

    A number of molecular methods of gene expression analysis can approach genomic level. Among those, Serial Analysis of Gene Expression (SAGE) stands out. Unlike many other techniques, SAGE allows both qualitative and quantitative analysis of previously unknown transcripts. Over the course of the last 13 years, SAGE has became a recognized tool of large-scale gene expression profiling, being used extensively in human, animal, yeast and plant studies of various nature. A number of important adaptations was introduced both to the protocol of SAGE library construction and to the analytical algorithm employed. Moreover, some variations of the original protocol (MAGE, SADE, microSAGE, miniSAGE, longSAGE, superSAGE, deepSAGE, etc.) were derived to improve the utility of SAGE in certain conditions. Current review aims comparing the benefits and drawbacks of the techniques for high-throughput gene expression analysis (including SAGE) in a realistic, balanced manner. Issues related to modifications to the original protocol and further development of the SAGE are discussed.

  4. Childhood autism in a 13 year old boy with oculocutaneous albinism: a case report

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    Bakare Muideen O

    2008-02-01

    Full Text Available Abstract Introduction Hypomelanotic skin disorders like tuberous sclerosis and hypomelanosis of Ito that present with multiple systemic manifestations have been reported in association with childhood autism. Oculocutaneous albinism is another hypomelanotic skin disorder that rarely presents with multiple systemic manifestations. It is infrequently reported in association with childhood autism when compared to tuberous sclerosis and hypomelanosis of Ito. Case presentation This article reports a case of co-morbid childhood autism and oculocutaneous albinism in a 13-year old boy from Nigeria in Sub-Saharan Africa. Conclusion The observation in this case report and in two previous reports which documented association between oculocutaneous albinism and childhood autism both in the affected individuals and families of individuals with childhood autism, raises the question of a possible genetic and clinical association between oculocutaneous albinism and childhood autism. More family and genetic studies into the relationship between oculocutaneous albinism and childhood autism is desirable. This may provide useful clues into the etiology, prevention and management of childhood autism as well as oculocutaneous albinism.

  5. The development of fear learning and generalization in 8-13 year-olds.

    Science.gov (United States)

    Glenn, Catherine R; Klein, Daniel N; Lissek, Shmuel; Britton, Jennifer C; Pine, Daniel S; Hajcak, Greg

    2012-11-01

    The current study examined developmental changes in fear learning and generalization in 40 healthy 8-13 year-olds using an aversive conditioning paradigm adapted from Lau et al. [Lau et al. [2008] Journal of the American Academy of Child and Adolescent Psychiatry 47:94-102]. In this task, the conditioned stimuli (CS+/CS-) are two neutral female faces, and the unconditioned stimulus is a fearful, screaming face. The second phase of the study also included a generalization stimulus (GS): a 50% blend of the CS± faces. The eye-blink startle reflex was utilized to measure defensive responding. Patterns of fear learning and generalization were qualified by child age. Older children demonstrated greater fear learning (i.e., larger startle during CS+ than CS-) than younger children. In addition, older children exhibited the typical pattern of generalization observed in adults, whereas younger children did not. Finally, fear learning also related to contingency awareness; only children who correctly identified the CS+ demonstrated fear-potentiated startle to the CS+. Clinical implications and future directions are discussed. PMID:22072276

  6. The relationships between anthropometric and motor measurements with 13 years old children

    Directory of Open Access Journals (Sweden)

    Nehat Rrudhani

    2015-07-01

    Full Text Available Developmental psychology studies the changes that occur to human body with age, consisting of the human body, the way of thinking, emotions, behaviour, relationships and human behaviours throughout life. Physical development has to do with changes that occur only in the human body (height, weight, changes in different organs of the body etc.. The aim of this research is to conclude the main characteristics of physical and motor development of children aged 13 years old. During the period of growing and development of organism, anthropometric and motor parameters change constantly, so that the whole body is under major adaption and changes, as we have noticed in the Primary and Lower Secondary School “Xhavit Ahmeti” in Hodonoc of Kamenica in the Republic of Kosovo. We implemented a survey with a number of 73 male students. The first measurements were performed in September (autumn measurements, while the second measurements in March (spring measurements. Students who have been subjected to measurement procedures were regular students of the school as well as capable in terms of psychophysical to do all the tasks set out in research.

  7. A media violence-inspired juvenile sexual homicide offender 13 years later.

    Science.gov (United States)

    Myers, Wade C; Eggleston, Chris F; Smoak, Pamela

    2003-11-01

    No follow-up studies exist on how minors who commit sexual homicides adjust once released back into the community. This is an important question given the extreme nature of their crimes, lack of recidivism data, and the expectation that one-half of them will be freed from prison by mid-life. Likewise, no studies exist on the role our culture's pervasive media violence plays in these offenses. This report describes a 13-year-old boy who committed a witnessed media violence-inspired sexual homicide. Follow-up information is provided on his community adjustment as an adult four years after release from prison. He had multiple indicators of brain dysfunction, and watched a "slasher" film just before committing the blitz style crime upon a female neighbor. Media violence literature is reviewed--against a backdrop of developmental abnormalities, neuropsychiatric vulnerabilities, family dysfunction, and mental illness. This case illustrates how the confluence of such variables, combined with the tinder of erotic screen violence, may lead to sexual murder. PMID:14640290

  8. Presentation of 493 consecutive girls with idiopathic central precocious puberty: a single-center study.

    Directory of Open Access Journals (Sweden)

    Eloïse Giabicani

    Full Text Available BACKGROUND: Despite the number of reported data concerning idiopathic central precocious puberty (CPP in girls, major questions remain including its diagnosis, factors, and indications of gonadotropin releasing hormone (GnRH analog treatment. METHODS: A retrospective, single-center study was carried out on 493 girls with CPP. RESULTS: Eleven girls (2.2% were aged less than 3 years. Breast development was either isolated (Group 0, n = 99, or associated with one sign, pubic hair development, growth rate greater than 2 standard deviation score (SDS or bone age (BA >2 years above chronological age, (Group 1, n = 187, two signs (Group 2, n = 142 or three signs (Group 3, n = 65. The interval between onset of puberty and evaluation, body mass index (BMI SDS, plasma luteinising hormone (LH concentrations (basal and peak and LH/ follicle-stimulating hormone (FSH peak ratio after GnRH test, plasma estradiol and uterus length were significantly greater in Groups 2 and 3 than in Groups 0 and 1 respectively. 211 (42.8% patients were obese and/or had excessive weight gain during the year before puberty. Obese girls more often had BA advance of >2 years (p = 0.0004 and pubic hair development (p = 0.003 than the others. BMI did not correlate with LH or with LH/FSH peak ratio. Girls with familial history of early puberty (41.4% had greater frequencies of pubertal LH/FSH peak ratios (p = 0.02 than the others. During the 31 years of the study, there was no increase in the frequency of CPP or variation in its characteristics. CONCLUSION: Obesity is associated with a higher BA advance and higher frequency of pubic or axillary hair development but not with LH secretion, suggesting that obesity accelerates adrenarche but not the maturation of the hypothalamic-pituitary-ovarian axis. The LH/FSH peak ratio was more frequently pubertal in girls with a familial history of early puberty, suggesting that this maturation depends on genetic factors.

  9. Intensity modulated radiation therapy (IMRT) for sinonasal tumors: a single center long-term clinical analysis

    International Nuclear Information System (INIS)

    Radiotherapy has a central role in the treatment of sinonasal malignancies, either as postoperative or as primary therapy. To study the efficacy and safety of intensity modulated radiotherapy (IMRT) for sinonasal tumors a single center retrospective evaluation focusing on survival and therapy related toxicity was performed. One hundred twenty two patients with primary (n = 82) or recurrent (n = 40) malignant sinonasal tumors were treated with intensity modulated radiotherapy between 1999 and 2009 at the University Clinic of Heidelberg and the German Cancer Research Center and retrospectively analyzed. Most patients had adenoid cystic carcinomas (n = 47) or squamous cell carcinoma (n = 26). 99 patients received postoperative radiotherapy. The median total dose was 64 Gy in conventional fractionation (1.8–2 Gy). Overall survival (OS), progression free survival (PFS) and local recurrence free survival (LRFS) rates were calculated using the Kaplan-Meier method. The log-rank test and Fishers Exact test were applied for univariate analysis, Cox-regression was used for multivariate analysis. Median follow up was 36 months. 1-, 3- and 5-year estimated overall survival rates were 90, 70 and 54 % respectively. Median progression free survival and local recurrence free survival was 45 and 63 months respectively. Progression free survival and local recurrence free survival at 1, 3 and 5 years were 76, 57 and 47, and 79, 60 and 51 % respectively. 19 patients (15.5 %) were diagnosed with distant metastases. Univariate analysis revealed significantly improved OS and LRFS for treatment of tumors after primary diagnosis, first series of irradiation and radiation dose ≥60 Gy. Multivariate analysis revealed only treatment in primary situation as an independent prognostic factor for OS and LRFS. Acute CTC grade III mucositis was seen in 5 patients (4.1 %) and CTC grade II dysgeusia in 19 patients (15.6 %). Dysgeusia, dysosmia and ocular toxicity were the most common late adverse

  10. Changes of indicators of high-speed and high-speed and power preparedness at volleyball players of 12–13 years old

    Directory of Open Access Journals (Sweden)

    Oleg Shevchenko

    2016-04-01

    Full Text Available Purpose: to define changes of indicators of high-speed and high-speed and power preparedness of volleyball players of 12–13 years old. Material & Methods: the test exercises, which are recommended by the training program of CYSS on volleyball, were used for the definition of the level of development of high-speed and high-speed and power abilities of volleyball players. 25 young volleyball players from the group of the previous basic preparation took part in the experiment. Sports experience of sportsmen is 3–4 years. The analysis of scientifically-methodical literature, pedagogical testing, pedagogical experiment, methods of mathematical statistics were carried out. Results: the analyzed level of high-speed and high-speed and power abilities of volleyball players. Conclusions: the results had reliable changes (t=2,2–2,4 at р<0,05 of the level of high-speed and high-speed and power abilities of volleyball players of 12–13years old in the experimental group at the end of the experiment, except run on 30 m that demonstrates a positive influence of application of special exercises in the educational-training process.

  11. A 13 Years Statistical Evaluation on Maxillofacial Malignant Tumors in Hamedan

    Directory of Open Access Journals (Sweden)

    M. H Ansari

    2003-02-01

    Full Text Available Cancer is considered as one of human's complications, particularly in oral and maxillofacial region which leads to undesirable effects and sometimes endangers individual's life. The aim of this study was to investigate the frequency of maxillofacial malignant tumors, during 13 years, (1985- 1998, in Hamedan. Three hundred and eighty - six records of biopsies were selected from the private files of physicians, 7 private and governmental pathological centers and other educational and research organizations in Hamedan. After observing the samples by oral pathologist, they were presented as thestatistical population for this retrospective study. The highest rate of biopsies was observed in the sixth (42.7%, seventh (39.6% and third (10.6% decades. The average age was 43.5 years, for women and1.52 45.5 for men. The ratio of men to women was . The oldest patient was a 91- year - old man with malignant melanoma, while the youngest was a 3-year-old girl with Burkit lymphoma. The commonest site of involvement was nasal region (17.3% and the anterior neck triangle showed the least common tumoral site (2.3%. The commonest tumor, observed in this study, was BBC (41.4% and the least common was malignant fibrous histocytoma (0.2%. Baso cellular and epidermoid carcinomas have been the commonest cancers in this investigation, while lymphoma and salivary galnd cancers have been placed as the second ones. The results of this study showed that the lower lip and tongue are considered as the commonest sites for cancer.

  12. Spirometric reference values for Hopi Native American children ages 4-13 years.

    Science.gov (United States)

    Arnall, David A; Nelson, Arnold G; Hearon, Christopher M; Interpreter, Christina; Kanuho, Verdell

    2016-04-01

    Spirometry is the most important tool in diagnosing pulmonary disease and is the most frequently performed pulmonary function test. Respiratory disease is also one of the greatest causes for morbidity and mortality on the Hopi Nation, but no specific reference equations exist for this unique population. The purpose of this study was to determine if population reference equations were necessary for these children and, if needed, to create new age and race-specific pulmonary nomograms for Hopi children. Two hundred and ninety-two healthy children, ages 4-13 years, attending Hopi Nation elementary schools in Arizona, were asked to perform spirometry for a full battery of pulmonary volumes and capacities of which the following were analyzed: forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1 ), FEV1 % (FEV1 /FVC), FEF25-75% and peak expiratory flow rate (PEFR). Spirometric data from Navajo children living in the same geographical region as the Hopi children were compared as well as spirometric data from common reference values used for other ethnic groups in the USA. Spirometry tests from 165 girls and 127 boys met American Thoracic Society quality control standards. We found that the natural log of height, body mass and age were significant predictors of FEV1 , FVC, and FEF25-75% in the gender-specific models and that lung function values all increased with height and age as expected. The predictions using the equations derived for Navajo, Caucasian, Mexican-American, African-American youth were significantly different (P ≤ 0.05) from the predictions derived from the Hopi equations for all of the variables across both genders, with the exceptions of Hopi versus Navajo FEV1 /FVC in the males and Hopi versus Caucasians FEF25-75% in the females. Thus it would appear for this population important to have specific formulae to provide more accurate reference values.

  13. Spectrum of Lesions Affecting the Renal Pelvis and Pelviureteric Junction: A 13-Year Retrospective Analysis

    Science.gov (United States)

    Kini, Hema; Suresh, Pooja Kundapur; Guni, Laxman Prabhu Gurupur; Bhat, Shaila; Kini, Jyoti Ramanath

    2016-01-01

    Introduction Both, the renal pelvis and the ureter, are affected by developmental, reactive and neoplastic disorders, though rare in incidence. Aim This series of cases were analysed to study the clinicopathological characteristics of the common and comparatively rare lesions involving the renal pelvis and pelviureteric junction. Materials and Methods A retrospective collection of 476 nephrectomies and pelviureteric junction resections, received over a period of 13 years from 2001 to 2013 was done. The patients’ clinical details were obtained and the histopathological findings reviewed. The lesions were classified into non-neoplastic and neoplastic categories. Results Primary involvement of the renal pelvis and pelviureteric junction was seen in 105 of 476 specimens. The mean age was 54.5 years with a male to female ratio of 2.2:1. The non-neoplastic lesions accounted for 76.2% of cases with a majority being pelviureteric junction obstruction due to inflammation induced fibromuscular hypertrophy (68.6%) causing hydronephrosis. Urothelial carcinomas were encountered in 20% of the cases. A majority of the urothelial carcinomas were infiltrative (81%) and high grade (71%) tumours. Conclusion Renal pelvis, a conduit to propel urine, can be the site for numerous disorders. Non-neoplastic lesions were more common than neoplasms. Pelviureteric junction obstruction due to inflammation induced fibromuscular hypertrophy was the commonest lesion in our study. In the neoplastic category, urothelial carcinoma was most common. However, rare lesions such as hamartomatous fibroepithelial polyp, Von Brunn’s nests, flat urothelial hyperplasia and intramuscular haemangioma of upper ureter at the pelviureteric junction were encountered along with occasional cases of tuberculosis and squamous cell carcinomas. PMID:27042468

  14. Spirometric reference values for Hopi Native American children ages 4-13 years.

    Science.gov (United States)

    Arnall, David A; Nelson, Arnold G; Hearon, Christopher M; Interpreter, Christina; Kanuho, Verdell

    2016-04-01

    Spirometry is the most important tool in diagnosing pulmonary disease and is the most frequently performed pulmonary function test. Respiratory disease is also one of the greatest causes for morbidity and mortality on the Hopi Nation, but no specific reference equations exist for this unique population. The purpose of this study was to determine if population reference equations were necessary for these children and, if needed, to create new age and race-specific pulmonary nomograms for Hopi children. Two hundred and ninety-two healthy children, ages 4-13 years, attending Hopi Nation elementary schools in Arizona, were asked to perform spirometry for a full battery of pulmonary volumes and capacities of which the following were analyzed: forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1 ), FEV1 % (FEV1 /FVC), FEF25-75% and peak expiratory flow rate (PEFR). Spirometric data from Navajo children living in the same geographical region as the Hopi children were compared as well as spirometric data from common reference values used for other ethnic groups in the USA. Spirometry tests from 165 girls and 127 boys met American Thoracic Society quality control standards. We found that the natural log of height, body mass and age were significant predictors of FEV1 , FVC, and FEF25-75% in the gender-specific models and that lung function values all increased with height and age as expected. The predictions using the equations derived for Navajo, Caucasian, Mexican-American, African-American youth were significantly different (P ≤ 0.05) from the predictions derived from the Hopi equations for all of the variables across both genders, with the exceptions of Hopi versus Navajo FEV1 /FVC in the males and Hopi versus Caucasians FEF25-75% in the females. Thus it would appear for this population important to have specific formulae to provide more accurate reference values. PMID:26584469

  15. A 13-year-old caucasian boy with cleidocranial dysplasia: a case report

    Directory of Open Access Journals (Sweden)

    Kolokitha Olga-Elpis

    2013-01-01

    Full Text Available Abstract Background Cleidocranial dysplasia (CCD is a rare congenital autosomal dominant skeletal disorder. The disorder is caused by heterozygosity of mutations in human RUNX2, which is present on the short arm of chromosome 6p21. The incidence of CCD is one per million births. CCD appears spontaneously with no apparent genetic cause in approximately 40% of affected patients, and one in three patients has unaffected parents. The most prevalent features associated with CCD are aplastic or hypoplastic clavicles, supernumerary teeth, failed eruption of permanent teeth, and a hypoplastic maxilla. Case presentation A 13-year-old Caucasian boy presented with a chief complaint of delayed eruption of the permanent anterior teeth. The patient was subsequently diagnosed with CCD based on the clinical examination, panoramic X-ray, anterior-posterior and lateral cephalogram, and chest radiograph findings. The details of this case are herein reported because of the extremely low incidence of this disorder. Conclusions CCD is of clinical importance in dentistry and medicine because it affects the bones and teeth and is characterized by many changes in skeletal patterning and growth. Particularly in dentistry, CCD is of great clinical significance because is associated with delayed ossification of the skull sutures, delayed exfoliation of the primary teeth, lack of permanent teeth eruption, multiple supernumerary teeth, and morphological abnormalities of the maxilla and mandible. Patients with CCD seek treatment mainly for dental problems. Knowledge of the pathogenesis, clinical characteristics, and diagnostic tools of CCD will enable clinicians to render the appropriate treatment to improve function and aesthetics. Early diagnosis of CCD is crucial for timely initiation of an appropriate treatment approach.

  16. The global tropospheric ammonia distribution as seen in the 13-year AIRS measurement record

    Science.gov (United States)

    Warner, Juying X.; Wei, Zigang; Larrabee Strow, L.; Dickerson, Russell R.; Nowak, John B.

    2016-05-01

    Ammonia (NH3) plays an increasingly important role in the global biogeochemical cycle of reactive nitrogen as well as in aerosol formation and climate. We present extensive and nearly continuous global ammonia measurements made by the Atmospheric Infrared Sounder (AIRS) from the Aqua satellite to identify and quantify major persistent and episodic sources as well as to characterize seasonality. We examine the 13-year period from September 2002 through August 2015 with a retrieval algorithm using an optimal estimation technique with a set of three, spatially and temporally uniform a priori profiles. Vertical profiles show good agreement (˜ 5-15 %) between AIRS NH3 and the in situ profiles from the winter 2013 DISCOVER-AQ (DISCOVER-Air Quality) field campaign in central California, despite the likely biases due to spatial resolution differences between the two instruments. The AIRS instrument captures the strongest consistent NH3 concentrations due to emissions from the anthropogenic (agricultural) source regions, such as South Asia (India/Pakistan), China, the United States (US), parts of Europe, Southeast (SE) Asia (Thailand/Myanmar/Laos), the central portion of South America, as well as Western and Northern Africa. These correspond primarily to irrigated croplands, as well as regions with heavy precipitation, with extensive animal feeding operations and fertilizer applications where a summer maximum and a secondary spring maximum are reliably observable. In the Southern Hemisphere (SH) regular agricultural fires contribute to a spring maximum. Regions of strong episodic emissions include Russia and Alaska as well as parts of South America, Africa, and Indonesia. Biomass burning, especially wildfires, dominate these episodic NH3 high concentrations.

  17. Association between Number of Teeth and Chronic Systemic Diseases: A Cohort Study Followed for 13 Years.

    Directory of Open Access Journals (Sweden)

    Kolade Oluwagbemigun

    Full Text Available There is growing evidence of an association between oral health, specifically dental status, and chronic systemic diseases. However, varying measures of dental status across different populations and low study sample has made comparison of studies and conclusion of findings unclear. Our aim is to examine whether the number of teeth as a measure of dental status is associated with incident chronic diseases in a cohort setting.We conducted a cohort study among 24,313 middle-aged Germans followed up for 13 years. Data on number of teeth as a measure of dental status were obtained through self-reports. Outcomes were clinically-verified incident non-fatal myocardial infarction, stroke, type 2 diabetes mellitus, and cancer. Hazard ratio (HR and 95% confidence intervals (CI were obtained from Cox regression models.Increasing number of teeth is inversely related to risk of myocardial infarction (HR: 0.97; 95% CI: 0.96, 0.99. The full multivariate model of teeth groups showed a strong linear trend for myocardial infarction, a less strong trend for stroke, and no relation with type 2 diabetes mellitus and cancer in a competing risk model. Participants with 18-23 teeth and those without teeth were at 76% (95%CI: 1.04, 3 and 2.93 times (95%CI: 1.61, 5.18 higher risk of myocardial infarction compared to those with nearly all teeth (28-32 teeth.Number of teeth is specifically associated with myocardial infarction and not with other chronic disease indicating that dental status further strengthens the link between oral health and cardiovascular diseases.

  18. A Single-Center, Adult Chronic Intestinal Failure Cohort Analyzed According to the ESPEN-Endorsed Recommendations, Definitions, and Classifications

    DEFF Research Database (Denmark)

    Brandt, Christopher Filtenborg; Tribler, Siri; Hvistendahl, Mark;

    2015-01-01

    BACKGROUND/AIMS: The objective of this study was to describe a clinically well-defined, single-center, intestinal failure (IF) cohort based on a template of definitions and classifications endorsed by the European Society for Clinical Nutrition and Metabolism (ESPEN). METHODS: A cross-sectional, ......BACKGROUND/AIMS: The objective of this study was to describe a clinically well-defined, single-center, intestinal failure (IF) cohort based on a template of definitions and classifications endorsed by the European Society for Clinical Nutrition and Metabolism (ESPEN). METHODS: A cross......-sectional, retrospective, adult IF cohort, receiving parenteral support (PS), was extracted from the Copenhagen IF database at the tertiary IF center, Copenhagen University Hospital, Rigshospitalet, Denmark. RESULTS: Rigshospitalet provided PS to 188 adult patients with IF on December 31, 2011. Six patients received only...

  19. Cytomegalovirus Pneumonia in Patients with Rheumatic Diseases After Immunosuppressive Therapy: A Single Center Study in China

    Institute of Scientific and Technical Information of China (English)

    Yu Xue; Li Jiang; Wei-Guo Wan; Yu-Ming Chen; Jiong Zhang; Zhen-Chun Zhang

    2016-01-01

    Background: Rheumatic diseases involve multiple organs that are affected by immunological mechanisms.Treatment with corticosteroids and immunosuppressive agents may also increase the frequency of infection.Cytomegalovirus (CMV) is a widespread herpes virus and a well-recognized pathogen, which causes an opportunistic and potentially fatal infection in immunocompromised patients.This retrospective study aimed to investigate the clinical and laboratory characteristics of CMV pneumonia in patients with rheumatic diseases after immunosuppressive therapy in a single center in Shanghai, China.Methods: Eight hundred and thirty-four patients with rheumatic diseases who had undergone CMV-DNA viral load tests were included, and the medical records of 142 patients who were positive for CMV-DNA in plasma samples were evaluated.GraphPad Prism version 5.013 (San Diego, CA, USA) was used to conduct statistical analysis.The correlation between CMV-DNA viral loads and lymphocyte counts was assessed using the Spearman rank correlation coefficient test.Significance between qualitative data was analyzed using Pearson's Chi-squared test.The cut-offthresholds for CMV-DNA viral load and lymphocyte count were determined by receiver operating characteristic (ROC) curve analysis.Results: One hundred and forty-two patients had positive CMV viral load tests.Of these 142 patients, 73 patients with CMV pneumonia were regarded as symptomatic, and the other 69 were asymptomatic.The symptomatic group received higher doses ofprednisolone (PSL) and more frequently immunosuppressants than the asymptomatic group (P < 0.01).The symptomatic group had lower lymphocyte counts, especially CD4+ T-cells, than the asymptomatic group (P < 0.01).By ROC curve analysis, when CD4+ T-cell count was <0.39 × 109/L, patients with rheumatic diseases were at high risk for symptomatic CMV infection.The CMV-DNA load was significantly higher in the symptomatic patients than that in asymptomatic patients (P < 0

  20. Clinical features of severe malaria associated with death: a 13-year observational study in the Gambia.

    Directory of Open Access Journals (Sweden)

    Muminatou Jallow

    Full Text Available BACKGROUND: Severe malaria (SM is a major cause of death in sub-Saharan Africa. Identification of both specific and sensitive clinical features to predict death is needed to improve clinical management. METHODS: A 13-year observational study was conducted from 1997 through 2009 of 2,901 children with SM enrolled at the Royal Victoria Teaching Hospital in The Gambia to identify sensitive and specific predictors of poor outcome in Gambian children with severe malaria between the ages 4 months to 14 years. We have measured the sensitivity and specificity of clinical features that predict death or development of neurological sequelae. FINDINGS: Impaired consciousness (odds ratio {OR} 4.4 [95% confidence interval {CI}, 2.7-7.3], respiratory distress (OR 2.4 [95%CI, 1.7-3.2], hypoglycemia (OR 1.7 [95%CI, 1.2-2.3], jaundice (OR 1.9 [95%CI, 1.2-2.9] and renal failure (OR 11.1 [95%CI, 3.3-36.5] were independently associated with death in children with SM. The clinical features that showed the highest sensitivity and specificity to predict death were respiratory distress (area under the curve 0.63 [95%CI, 0.60-0.65] and impaired consciousness (AUC 0.61[95%CI, 0.59-0.63], which were comparable to the ability of hyperlactatemia (blood lactate>5 mM to predict death (AUC 0.64 [95%CI, 0.55-0.72]. A Blantyre coma score (BCS of 2 or less had a sensitivity of 74% and specificity of 67% to predict death (AUC 0.70 [95% C.I. 0.68-0.72], and sensitivity and specificity of 74% and 69%, respectively to predict development of neurological sequelae (AUC 0.72 [95% CI, 0.67-0.76].The specificity of this BCS threshold to identify children at risk of dying improved in children less than 3 years of age (AUC 0.74, [95% C.I 0.71-0.76]. CONCLUSION: The BCS is a quantitative predictor of death. A BCS of 2 or less is the most sensitive and specific clinical feature to predict death or development of neurological sequelae in children with SM.

  1. Backstroke Technical Characterization of 11-13 Year-Old Swimmers

    Science.gov (United States)

    Silva, Ana Filipa; Figueiredo, Pedro; Seifert, Ludovic; Soares, Susana; Vilas-Boas, João Paulo; Fernandes, Ricardo J.

    2013-01-01

    The aim of this study was to characterize the backstroke swimming technique of 11-13 year-old swimmers when performing at very high intensity. A sample of 114 swimmers was divided into four groups regarding maturational and gender effect, who performed 25- m backstroke swimming at 50-m pace. Using two underwater cameras the general biomechanical parameters (speed, stroke rate, stroke length and stroke index), the arm stroke phases and two indexes of arm coordination (Index of Coordination 1, which characterizes the continuity between propulsive phases of each arm and Index of Coordination 2 that evaluates the simultaneity between the beginning of the pull of one arm and of the recovery of the other arm) were measured. Post- pubertal swimmers achieved higher values of speed (1.06 ± 0.14 and 1.18 ± 0.14 m·s-1 for pubertal and 1.13 ± 0.14 and 1.24 ± 0.12 m·s-1 for post-pubertal girl and boy swimmers, respectively), stroke length (1.64 ± 0.26 and 1.68 ± 0.25 m·cycle-1 for pubertal and 1.79 ± 0.22 and 1.75 ± 0.27 m·cycle-1 for post-pubertal girls and boys, respectively) and stroke index. Regar-ding genders, male were faster than female swimmers. Boys also showed a higher stroke rate and stroke index than girls, who achieved higher results in the ratio between stroke length and arm span. As it was expected, no hand lag time was noticed in young swimmers. Although no differences were noticed between genders, the Index of Coordination 1 was in catch-up mode (-9.89 ± 3.16 and -10.16 ± 3.60 % for girls and -9.77 ± 2.93 and -10.39 ± 2.44 % for boys pubertal and post-pubertal, respectively) and the Index of Coordination 2 was in superposition mode (1.86 ± 4.39 and 2.25 ± 2.25 % from girls and 1.72 ± 2.62 and 1.95 ± 2.95 % for boys, pubertal and post-pubertal, respectively). Key Points Young swimmers adopt the catch-up arm coordina-tion when swimming backstroke. These swimmers present lower stroking parameters then those published for older and higher level

  2. Monitoring of effects of land subsidence at Ameland-Oost, Netherlands. Evaluation after 13 years of natural gas exploration. Summary

    International Nuclear Information System (INIS)

    One year after the start of the natural gas exploitation on the Dutch island Ameland a survey started to investigate and monitor the effect of the exploitation on land subsidence and related environmental effects. In this summary evaluated results of that survey over the last 13 years are presented and discussed

  3. Gender, Popularity and Notions of In/Authenticity amongst 12-Year-Old to 13-Year-Old School Girls

    Science.gov (United States)

    Read, Barbara; Francis, Becky; Skelton, Christine

    2011-01-01

    This paper draws on data from a research project investigating gendered identities and interactions of high-achieving students in Year Eight in England (12-13 years old), particularly in relation to students' "popularity" amongst their peers. As part of this study 71 students were interviewed from nine different schools in urban, rural and small…

  4. Migratory polyarthritis as an adverse effect of thiamazole use in a 13-year-old girl with Graves' disease

    NARCIS (Netherlands)

    Janson, J.A.; Laat, P. de; Draaisma, J.M.T.

    2015-01-01

    Graves' disease is the most prevalent cause of hyperthyroidism in children. The treatment commonly involves antithyroid therapy using a thionamide. We present a case of a 13-year-old girl with the antithyroid arthritis syndrome, presenting as a migratory polyarthritis, after the initiation of thiona

  5. What Is Happening when Teachers of 11-13-Year-Old Students Take Guided Reading: A New Zealand Snapshot

    Science.gov (United States)

    Fletcher, Jo Florence; Greenwood, Janinka; Grimley, Michael; Parkhill, Faye; Davis, Niki

    2012-01-01

    This paper focuses on eight teachers nominated as effective in teaching reading to 11-13-year-old students. Data consisted of interviews and unstructured and structured observations of the guided reading lessons. The qualitative data and their analysis explored the research participants' views to give more detail and filter the quantitative…

  6. Brain Activation and Deactivation during Location and Color Working Memory Tasks in 11-13-Year-Old Children

    Science.gov (United States)

    Vuontela, Virve; Steenari, Maija-Riikka; Aronen, Eeva T.; Korvenoja, Antti; Aronen, Hannu J.; Carlson, Synnove

    2009-01-01

    Using functional magnetic resonance imaging (fMRI) and n-back tasks we investigated whether, in 11-13-year-old children, spatial (location) and nonspatial (color) information is differentially processed during visual attention (0-back) and working memory (WM) (2-back) tasks and whether such cognitive task performance, compared to a resting state,…

  7. Peritoneal dialysis-related peritonitis due to Staphylococcus aureus: a single-center experience over 15 years.

    Directory of Open Access Journals (Sweden)

    Pasqual Barretti

    Full Text Available Peritonitis caused by Staphylococcus aureus is a serious complication of peritoneal dialysis (PD, which is associated with poor outcome and high PD failure rates. We reviewed the records of 62 S. aureus peritonitis episodes that occurred between 1996 and 2010 in the dialysis unit of a single university hospital and evaluated the host and bacterial factors influencing peritonitis outcome. Peritonitis incidence was calculated for three subsequent 5-year periods and compared using a Poisson regression model. The production of biofilm, enzymes, and toxins was evaluated. Oxacillin resistance was evaluated based on minimum inhibitory concentration and presence of the mecA gene. Logistic regression was used for the analysis of demographic, clinical, and microbiological factors influencing peritonitis outcome. Resolution and death rates were compared with 117 contemporary coagulase-negative staphylococcus (CoNS episodes. The incidence of S. aureus peritonitis declined significantly over time from 0.13 in 1996-2000 to 0.04 episodes/patient/year in 2006-2010 (p = 0.03. The oxacillin resistance rate was 11.3%. Toxin and enzyme production was expressive, except for enterotoxin D. Biofilm production was positive in 88.7% of strains. The presence of the mecA gene was associated with a higher frequency of fever and abdominal pain. The logistic regression model showed that diabetes mellitus (p = 0.009 and β-hemolysin production (p = 0.006 were independent predictors of non-resolution of infection. The probability of resolution was higher among patients aged 41 to 60 years than among those >60 years (p = 0.02. A trend to higher death rate was observed for S. aureus episodes (9.7% compared to CoNS episodes (2.5%, (p = 0.08, whereas resolution rates were similar. Despite the decline in incidence, S. aureus peritonitis remains a serious complication of PD that is associated with a high death rate. The outcome of this infection is negatively influenced by host factors such as age and diabetes mellitus. In addition, β-hemolysin production is predictive of non-resolution of infection, suggesting a pathogenic role of this factor in PD-related S. aureus peritonitis.

  8. Long-Term Outcome after Laparoscopic Bowel Resections for Deep Infiltrating Endometriosis: A Single-Center Experience after 900 Cases

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    Giacomo Ruffo

    2014-01-01

    Full Text Available Background. Laparoscopic bowel resections for endometriosis are safe and effective but only short-term follow-up has been evaluated. In the present study long-term outcome in terms of intestinal and urinary function, fertility, chronic pain, and recurrence was assessed. Materials and Methods. From January 2002 to December 2010 nine hundred patients underwent laparoscopic bowel resection for endometriosis, and on 774 (86% a questionnaire was administered. Patients were divided into 3 groups on the strength of the operation date. Postoperative diarrhea, constipation, rectal bleeding, tenesmus, dyschezia, dysuria, dyspareunia, fertility, and recurrence of disease were assessed. Results. The median follow-up was 54 months (range 1–120. All the evaluated symptoms significantly improved over time, with P=0.0001 for dyspareunia, constipation, and pelvic pain and P=0.004 for diarrhea. Nonsignificant improvement was reported for dysuria and rectal bleeding (with P=0.452 and P=0.097, resp.. Conclusions. The present results confirm that bowel resections for endometriosis are correlated with an acceptable complication rate even at long-term follow-up and that symptoms significantly improve over time, except for rectal bleeding and dysuria, the latter associated with a neurological damage.

  9. Long-Term Outcome after Laparoscopic Bowel Resections for Deep Infiltrating Endometriosis: A Single-Center Experience after 900 Cases

    OpenAIRE

    Ruffo, Giacomo; Scopelliti, Filippo; Manzoni, Alberto; Sartori, Alberto; Rossini, Roberto; Ceccaroni, Marcello; Minelli, Luca; Crippa, Stefano; Partelli, Stefano; Falconi, Massimo

    2014-01-01

    Background. Laparoscopic bowel resections for endometriosis are safe and effective but only short-term follow-up has been evaluated. In the present study long-term outcome in terms of intestinal and urinary function, fertility, chronic pain, and recurrence was assessed. Materials and Methods. From January 2002 to December 2010 nine hundred patients underwent laparoscopic bowel resection for endometriosis, and on 774 (86%) a questionnaire was administered. Patients were divided into 3 groups o...

  10. The value of transesophageal echocardiography in the investigation and management of cryptogenic cerebral ischemia: a single-center experience.

    Science.gov (United States)

    Katsanos, Aristeidis H; Patsouras, Dimitrios; Tsivgoulis, Georgios; Kosmidou, Maria; Katsanos, Konstantinos H; Kyritsis, Athanassios P; Giannopoulos, Sotirios

    2016-04-01

    The diagnostic utility of transesophageal echocardiography (TEE) has often been challenged in patients with cryptogenic stroke (CS). We estimated the prevalence of different findings on TEE examination of CS patients, their impact on secondary stroke prevention and the presence of potential age or gender disparities. We reviewed all TEE examinations that were performed in a single echocardiography laboratory during a 7-year-old period to identify CS patients that underwent investigation with TEE. Of the 518 total TEE examinations, we identified 88 CS patients. TEE revealed abnormal findings in 69.3 % of them. Patent foramen ovale (PFO) and atrial septal aneurysm (ASA) were identified in 30.6 and 22.7 % of the patients. Ascending aorta and aortic arch atheromatosis was present in 26.1 % of the patients, with complex atheromatosis diagnosed in 14.7 % of them. Cardiac myxomas were uncovered in 2.3 %. Thrombi in the left atrium and in cardiac valves were reported in 3.4 and 2.3 % of the patients, respectively. Based on TEE findings, the therapeutic management would be very likely modified in 9.1 % of the patients. Subgroup analysis revealed no gender disparities on the prevalence of TEE findings and in secondary stroke prevention, while linear regression analyses revealed significant associations of age with the prevalence of PFO, ASA, aorta atheromatosis and complex aorta atheromatosis. TEE examination should be included in the diagnostic work-up of all CS patients, irrespective of age and gender status, since it can reveal potential sources of embolism and has a significant impact for secondary stroke prevention. PMID:26705252

  11. Donor safety in adult living donor liver transplantation using the right lobe:Single center experience in China

    Institute of Scientific and Technical Information of China (English)

    Fu-Gui Li; Lu-Nan Yan; Yong Zeng; Jia-Yin Yang; Qi-Yuan Lin; Xiao-Zhong Jiang; Bin Liu

    2007-01-01

    AIM: To evaluate the safety of donors in adult living donor liver transplantation (LDLT) using the right lobe in a single liver transplantation center in China.METHODS: We investigated retrospectively 52 living donor liver resections performed from October 2003 to July 2006. All patients were evaluated by blood tests and abdominal CT. The mean donor age was 28.2±7.4years. Residual liver volume was 42.1%±4.7%. Mean operative time was 420±76.2 min; mean ICU stay, less than 36 h; mean hospital stay, 16.4±8.6 d; and mean follow-up period, 6 mo.RESULTS: There was no mortality. The overall complication rate was 40% (21 donors). Major complications included biliary leak in two, and pneumonia in 2 donors. Minor complications included mild pleural effusion in 12 donors, transient ascites in 6, mild depression in 4, intra-abdominal collections in 2,and wound infections in 1 donor. Residual liver volume did not affect the complication rate. None required reoperation. Return to pre-donation activity occurred within 5-8 wk.CONCLUSION: Right hemi-hepatectomy can be performed safely with minimal risk in cases of careful donor selection. Major complications occurred in only 7.7% of our series.

  12. CLINICO - ETIOLOGICAL PROFILE OF YOUNG STROKE AND CORRELATION OF PATIENT’S OUTCOME WITH RADIOLOGICAL FEATURES : A SINGLE CENTER EXPERIENCE

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    Shaheen

    2015-07-01

    Full Text Available BACKGROUND : Stroke is one of the most important cause of high morbidity and mortality all over the world. Stroke in the young is particularly tragic because of its potential to create a long - term burden on the victims, their families, and the community. OBJECTIVE: To study the etiology, risk factor, clinical presentation and radiological profile of young stroke and correlate radiological profile with prognosis and outcome in young stroke patients. SETTINGS AND DESIGN: A prospective observational, clinical study. MATER IALS AND METHODS: Patient diagnosed to have stroke in young individuals between 15 and 45 years of age, admitted in Department of Medicine, Hamidia Hospital, Gandhi Medical College, Bhopal, were included in study. RESULTS: A total of 100 patients, 58 males (58% and 42 females (41% who were diagnosed to have stroke were included in the study. Mean age of the study group was 31.92±8.59 years and that of male and female were 29.67±9.51 and 33.65±7.63 respectively. Majority of strokes (24% overall occurred b etween the ages of 36 - 40 years. 60 patients had ischemic stroke. Overall mortality in our study group was 23 percent. About 16 percent of hemorrhagic stroke were died in hospital. Among infarct most of deaths were due to cortical infarct. Atherosclerosis wa s emerged as main aetiological factor in 23 percent of patient in study. CONCLUSION: This was one of few studies done in young stroke in central India . This study helps to understand better the etiological profile of young stroke with emphasis on radiologi cal features.

  13. MERS-CoV: Middle East respiratory syndrome corona virus: Can radiology be of help? Initial single center experience

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    Ahmed Hamimi

    2016-03-01

    Conclusions: MERS CoV virus may have a specific pattern in chest X-ray and CT developing a single or multiple opacities progressing into a widespread multifocal bilateral patches of ground glass opacities or confluent consolidation resembling organizing pneumonia.

  14. The value of transesophageal echocardiography in the investigation and management of cryptogenic cerebral ischemia: a single-center experience.

    Science.gov (United States)

    Katsanos, Aristeidis H; Patsouras, Dimitrios; Tsivgoulis, Georgios; Kosmidou, Maria; Katsanos, Konstantinos H; Kyritsis, Athanassios P; Giannopoulos, Sotirios

    2016-04-01

    The diagnostic utility of transesophageal echocardiography (TEE) has often been challenged in patients with cryptogenic stroke (CS). We estimated the prevalence of different findings on TEE examination of CS patients, their impact on secondary stroke prevention and the presence of potential age or gender disparities. We reviewed all TEE examinations that were performed in a single echocardiography laboratory during a 7-year-old period to identify CS patients that underwent investigation with TEE. Of the 518 total TEE examinations, we identified 88 CS patients. TEE revealed abnormal findings in 69.3 % of them. Patent foramen ovale (PFO) and atrial septal aneurysm (ASA) were identified in 30.6 and 22.7 % of the patients. Ascending aorta and aortic arch atheromatosis was present in 26.1 % of the patients, with complex atheromatosis diagnosed in 14.7 % of them. Cardiac myxomas were uncovered in 2.3 %. Thrombi in the left atrium and in cardiac valves were reported in 3.4 and 2.3 % of the patients, respectively. Based on TEE findings, the therapeutic management would be very likely modified in 9.1 % of the patients. Subgroup analysis revealed no gender disparities on the prevalence of TEE findings and in secondary stroke prevention, while linear regression analyses revealed significant associations of age with the prevalence of PFO, ASA, aorta atheromatosis and complex aorta atheromatosis. TEE examination should be included in the diagnostic work-up of all CS patients, irrespective of age and gender status, since it can reveal potential sources of embolism and has a significant impact for secondary stroke prevention.

  15. Clinical Outcomes of Myasthenia Gravis with Thymoma and Thymic Hyperplasia Undergoing Extended Transsternal Thymectomy: A Single-Center Experience

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    Nazarbaghi, Surena; Amiri-Nikpour, Mohammad Reza; Mahmodlou, Rahim; Arjmand, Nasim; Rezaei, Yousef

    2015-01-01

    Background: Despite the widespread use of thymectomy in myasthenia gravis (MG) patients, it has remained controversial as to whether this procedure is of a similar efficacy and clinical outcome among MG patients with thymoma and thymic hyperplasia. Aim: We sought to determine the long-term clinical outcomes of MG patients who received extended transsternal thymectomy associated with pyridostigmine and prednisolone postoperatively. Materials and Methods: In a retrospective study from January 1999 to December 2013, MG patients who underwent thymectomy were followed up. Out of 41 MG patients admitted in our center, 25 patients had undergone thymectomy adjunctive to pyridostigmine and prednisolone therapy postoperatively. The primary endpoints included improvement in individual diplopia, ptosis, dysphagia, dysarthria, dyspnea, and limb weakness. In addition, according to the MG Foundation of America (MGFA) criteria, response to therapy was defined as complete stable remission (CSR), pharmacologic remission (PR), and minimal manifestation (MM) as secondary endpoints. Results: Majority of the patients were male (60%) and the mean age of the patients was 32.2 ± 13.9 years. Fifteen (60%) and 10 patients (40%) had thymoma and thymic hyperplasia, respectively. All the patients were followed up during a mean period of of 86.9 ± 50.3 months (minimum 10 months and maximum 168 months). The rates of CSR, PR, and MM were comparable between the thymoma and thymic hyperplasia groups (P = 0.584). Based on the Kaplan Meier analysis, the probabilities of CSR, PR, and MM were not significantly different between patients with thymoma and thymic hyperplasia. Conclusion: The extended transsternal thymectomy, along with the postoperative regimen of pyridostigmine and prednisolone was associated with a high rate of clinical improvement among MG patients with thymoma or thymic hyperplasia. PMID:26713298

  16. Clinical Outcomes of Myasthenia Gravis with Thymoma and Thymic Hyperplasia Undergoing Extended Transsternal Thymectomy: A Single-Center Experience

    OpenAIRE

    Surena Nazarbaghi; Mohammad Reza Amiri-Nikpour; Rahim Mahmodlou; Nasim Arjmand; Yousef Rezaei

    2015-01-01

    Background: Despite the widespread use of thymectomy in myasthenia gravis (MG) patients, it has remained controversial as to whether this procedure is of a similar efficacy and clinical outcome among MG patients with thymoma and thymic hyperplasia. Aim: We sought to determine the long-term clinical outcomes of MG patients who received extended transsternal thymectomy associated with pyridostigmine and prednisolone postoperatively. Materials and Methods: In a retrospective study from January 1...

  17. Clinical outcomes of myasthenia gravis with thymoma and thymic hyperplasia undergoing extended transsternal thymectomy: A single-center experience

    Directory of Open Access Journals (Sweden)

    Surena Nazarbaghi

    2015-01-01

    Full Text Available Background: Despite the widespread use of thymectomy in myasthenia gravis (MG patients, it has remained controversial as to whether this procedure is of a similar efficacy and clinical outcome among MG patients with thymoma and thymic hyperplasia. Aim: We sought to determine the long-term clinical outcomes of MG patients who received extended transsternal thymectomy associated with pyridostigmine and prednisolone postoperatively. Materials and Methods: In a retrospective study from January 1999 to December 2013, MG patients who underwent thymectomy were followed up. Out of 41 MG patients admitted in our center, 25 patients had undergone thymectomy adjunctive to pyridostigmine and prednisolone therapy postoperatively. The primary endpoints included improvement in individual diplopia, ptosis, dysphagia, dysarthria, dyspnea, and limb weakness. In addition, according to the MG Foundation of America (MGFA criteria, response to therapy was defined as complete stable remission (CSR, pharmacologic remission (PR, and minimal manifestation (MM as secondary endpoints. Results: Majority of the patients were male (60% and the mean age of the patients was 32.2 ± 13.9 years. Fifteen (60% and 10 patients (40% had thymoma and thymic hyperplasia, respectively. All the patients were followed up during a mean period of of 86.9 ± 50.3 months (minimum 10 months and maximum 168 months. The rates of CSR, PR, and MM were comparable between the thymoma and thymic hyperplasia groups (P = 0.584. Based on the Kaplan Meier analysis, the probabilities of CSR, PR, and MM were not significantly different between patients with thymoma and thymic hyperplasia. Conclusion: The extended transsternal thymectomy, along with the postoperative regimen of pyridostigmine and prednisolone was associated with a high rate of clinical improvement among MG patients with thymoma or thymic hyperplasia.

  18. The Prognostic Value of the Charlson's Comorbidity Index in Patients with Prolonged Acute Mechanical Ventilation: A Single Center Experience

    Science.gov (United States)

    Song, Seung Eon; Lee, Sang Hee; Jo, Eun-Jung; Eom, Jung Seop; Mok, Jeong Ha; Kim, Mi-Hyun; Kim, Ki Uk; Lee, Min Ki

    2016-01-01

    Background The aim of our study was to evaluate the prognostic value of Charlson's weighted index of comorbidities (WIC) in patients with prolonged acute mechanical ventilation (PAMV, ventilator care ≥96 hours). Methods We retrospectively enrolled 299 Korean PAMV patients who were admitted in a medical intensive care unit (ICU) of a university-affiliated tertiary care hospital between 2008 and 2013. Survivors were defined as patients who survived for 60 days after ICU admission. Results The patients' mean age was 65.1±14.1 years and 70.6% were male. The mean ICU and hospital length of stay was 21.9±19.7 and 39.4±39.1 days, respectively. In addition, the 60-day mortality rate after ICU admission was 35.5%. The mean WIC was 2.3±1.8, with significant differences between nonsurvivors and survivors (2.7±2.1 vs. 2.1±1.7, pday survival, WIC ≥5 had statistically lower survival than WIC day mortality in PAMV patients.

  19. Insulation Failure of the Linox Defibrillator Lead: A Case Report and Retrospective Review of a Single Center Experience.

    Science.gov (United States)

    Howe, Andrew J; McKeag, Nicholas A; Wilson, Carol M; Ashfield, Kyle P; Roberts, Michael J

    2015-06-01

    Implantable cardioverter defibrillator (ICD) lead insulation failure and conductor externalization have been increasingly reported. The 7.8F silicon-insulated Linox SD and Linox S ICD leads (Biotronik, Berlin, Germany) were released in 2006 and 2007, respectively, with an estimated 85,000 implantations worldwide. A 39-year-old female suffered an out-of-hospital ventricular fibrillation (VF) arrest with successful resuscitation. An ICD was implanted utilizing a single coil active fixation Linox(Smart) S lead (Biotronik, Berlin, Germany). A device-triggered alert approximately 3 years after implantation confirmed nonphysiological high rate sensing leading to VF detection. A chest X-ray showed an abnormality of the ICD lead and fluoroscopic screening confirmed conductor externalization proximal to the defibrillator coil. In view of the combined electrical and fluoroscopic abnormalities, urgent lead extraction and replacement were performed. A review of Linox (Biotronik) and Vigila (Sorin Group, Milan, Italy) lead implantations within our center (n = 98) identified 3 additional patients presenting with premature lead failure, 2 associated with nonphysiological sensed events and one associated with a significant decrease in lead impedance. All leads were subsequently removed and replaced. This case provides a striking example of insulation failure affecting the Linox ICD lead and, we believe, is the first to demonstrate conductor externalization manifesting both electrical and fluoroscopic abnormalities. PMID:25711237

  20. Experience of a Single Center in NTBC Use in Management of Hereditary Tyrosinemia Type I in Libya

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    Hanna Alobaidy

    2015-10-01

    Full Text Available Background: Hereditary Tyrosinemia type I (HTI is a metabolic disease caused by deficiency of fumarylacetoacetate hydrolase enzyme. Objectives: This study reports beside its clinical and biochemical presentation, the outcome of NTBC [2- (2-nitro-4-trifloro-methylbenzoyl-1, 3-cyclohexanedion] treatment of the disease and evaluates its biochemical markers in 16 pediatric Libyan patients. Patients and Methods: The diagnosis was based on presence of high tyrosine levels in blood and succinylacetone in urine. Results: The consanguinity rate was 81.2%, the median age at onset, at diagnosis and at starting treatment were 4.5, 8, and 9.5 months respectively. At presentation hepatomegaly, jaundice, rickets and high gamma glutamyl transferase (GGT were observed in 87.5% of patients. All patients had extremely high alpha fetoprotein (AFP and high alkaline phosphatase (ALP levels. Fifteen patients were treated with NTBC, normalization of PT (Prothrombine time was achieved in average in 14 days. The other biochemical parameters of liver function (transaminases, GGT, ALP, bilirubin and albumin took longer to improve and several months to be normalized. Survival rate with NTBC was 86.6%. Patients who started treatment in a median of 3 months post onset observed a fast drop of AFP in 90.6% of patients (P = 0.003. Abnormal liver function and rickets were the common presentations, GGT was an early cholestatic sensitive test. ALP was constantly high even in asymptomatic patients. Conclusions: In HT1 a faster dropping of AFP is a marker of good prognosis.

  1. The Natural Course of Biopsy-Proven Isolated Microscopic Hematuria: a Single Center Experience of 350 Patients.

    Science.gov (United States)

    Lee, Hae Min; Hyun, Ji In; Min, Ji-Won; Lee, Kyungsoo; Kim, Yong Kyun; Choi, Euy Jin; Song, Ho Cheol

    2016-06-01

    The increasing interest in healthcare and health screening events is revealing additional cases of asymptomatic isolated microscopic hematuria (IMH). However, a consensus of the evaluation and explanation of the IMH prognosis is controversial among physicians. Here, we present the natural course of IMH together with the pathological diagnosis and features to provide supportive data when approaching patients with IMH. We retrospectively evaluated 350 patients with IMH who underwent a renal biopsy between 2002 and 2011, and the pathological diagnosis and chronic histopathological features (glomerulosclerosis, interstitial fibrosis, and tubular atrophy) were reviewed. Deterioration of renal function was examined during follow up. The patients with IMH were evaluated for a mean of 86 months. IgA nephropathy was the most common diagnosis in 164 patients (46.9%). Chronic histopathological changes were observed in 166 (47.4%) but was not correlated with proteinuria or a decline in renal function. Ten patients developed proteinuria, and all of them had IgA nephropathy. Three patients progressed to chronic kidney disease with an estimated glomerular filtration rate observation, although IgA nephropathy should be monitored if it progresses to proteinuria. Future prospective randomized studies may help conclude the long-term prognosis and lead to a consensus for managing IMH. PMID:27247500

  2. Impact of Clinical Pharmacy Services on KAP and QOL in Cancer Patients: A Single-Center Experience

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    Yan Wang

    2015-01-01

    Full Text Available This study was to evaluate the efficacy of pharmaceutical intervention (PI on chemotherapy knowledge-attitude-practice (KAP and quality of life (QOL in cancer patients. A prospective, randomized, controlled study was carried out at Oncology Ward in a tertiary hospital affiliated to Southern Medical University, China. Eligible patient was randomly assigned to pharmaceutical intervention (PI group or control group. Each patient in PI group was given information booklets and was given 30 min face-to-face medication education and psychological counseling by clinical pharmacists, 2 sessions per week for 2 months. Patients in control group only received conventional treatment. All participants were asked to complete a structured Chemotherapy KAP Questionnaire and QOL Questionnaire at pre- and poststudy time. A total of 149 cancer patients (77 in PI group and 72 in control group completed the study. The baseline scores of KAP and QOL in 2 groups were similar. At the end of study, only knowledge score was significantly increased; meanwhile no difference existed for attitude, practice, and QOL scores in control group; both KAP scores and QOL score were significantly increased in PI group. As for the between-group comparison, both KAP scores and QOL score in PI group were significantly higher than those in control group. In conclusion, pharmaceutical intervention has a positive role in increasing chemotherapy-related knowledge, improving patients’ positive emotions, dealing with chemotherapy adverse reactions, and improving the quality of life of patients.

  3. Comparison of surgical and endovascular approach in management of spinal dural arteriovenous fistulas: A single center experience of 27 patients

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    Sankalp Gokhale

    2014-01-01

    Conclusions: Endovascular embolization and surgical ligation are effective treatment strategies for SDAVF. Our observations show that surgical ligation may offer permanent cure without any recurrence. Endovascular approach is associated with higher incidence of recurrence, especially with use of onyx.

  4. Early Conversion From Twice-Daily Tacrolimus to Prolonged-Release Tacrolimus in Liver Transplantation: A Single-Center Experience.

    Science.gov (United States)

    Ogura, Yasuhiro; Imai, Hisashi; Kamei, Hideya; Hori, Tomohide; Kurata, Nobuhiko; Onishi, Yasuharu

    2016-07-19

    BACKGROUND Prolonged-release tacrolimus (Tac QD) is widely used in organ transplantation. However, the conversion from twice-daily tacrolimus (Tac BID) to Tac QD in Japan is usually done in stable patients months or years after liver transplantation. The aim of this study was to assess the early conversion of Tac QD during liver transplant hospital stay. MATERIAL AND METHODS Eighteen liver transplants (excluding pediatric) were performed during 2014-2015. All cases except 2 early-expired patients were enrolled. Our standard immunosuppression is oral Tac BID and steroid taper, and we add mycophenolate mofetil if indicated. Conversion criteria from Tac BID to Tac QD were: 1) relatively stable liver function with stable trough level by oral Tac BID, and 2) good general condition (no or well-controlled complications). We did not fix the exact conversion date because each patient's recovery was different. Dose conversion rate from Tac BID to Tac QD was set at 1:1. RESULTS The median number of conversion days after liver transplant was 27 days. Sixty-two percent of patients were converted within 4 weeks after liver transplant, and 56% were discharged from the hospital within 2 weeks after conversion. The comparison of the last week of Tac BID and the first week of Tac QD revealed that the mean tacrolimus trough level declined by 30.4%, resulting in the 26.2% tacrolimus dose increase during the first 2 weeks after conversion. Adverse events after conversion were limited, and all patients show normal liver function to date. CONCLUSIONS Early Tac QD conversion is safe and feasible, but its long-term effects need further investigation.

  5. Prevalence of serum anti M-type phospholipase A2 receptor antibody in primary membranous nephropathy: A single center experience.

    Science.gov (United States)

    Gopalakrishnan, N; Abeesh, P; Dineshkumar, T; Murugananth, S; Sakthirajan, R; Raman, G Srinivasa; Dhanapriya, J; Balasubramaniyan, T; Haris, Md

    2016-01-01

    We conducted a prospective study to assess utility of detection of antibodies to phospholipase A2receptor (PLA2R) in the serum of patients with membranous nephropathy. Seventy five patients with biopsy proven membranous nephropathy admitted between January 2011 and September 2014 were studied. Serum anti- PLA2R was tested by indirect immunofluorescence. The test was positive in 45 out of 60 patients with primary membranous nephropathy (PMN) and in none of the 15 patients with secondary membranous nephropathy, with a sensitivity of 75% and specificity of 100% for PMN. Anti PLA2R positivity also showed a significant correlation with quantum of proteinuria and negative correlation with serum albumin. This study has validated detection of serum anti PLA2R in PMN as a non invasive diagnostic tool in Indian patients.

  6. Fate of Central Venous Catheters Used for Acute Extracorporeal Treatment in Critically Ill Pediatric Patients: A Single Center Experience.

    Science.gov (United States)

    Rus, Rina R; Premru, Vladimir; Novljan, Gregor; Grošelj-Grenc, Mojca; Ponikvar, Rafael

    2016-06-01

    Renal replacement treatment (RRT) is required in severe acute kidney injury, and a functioning central venous catheter (CVC) is crucial. Twenty-eight children younger than 16 years have been treated at the University Medical Centre Ljubljana between 2003 and 2012 with either acute hemodialysis (HD) and/or plasma exchange (PE), and were included in our study. The age of the patients ranged from 2 days to 14.1 years. Sixty-six CVCs were inserted (52% de novo, 48% guide wire). The sites of insertion were the jugular vein in 20% and the femoral vein in 80%. Catheters were in function from 1 day to 27 days. The most common cause for CVC removal or exchange was catheter dysfunction (50%). CVCs were mostly inserted in the femoral vein, which is the preferred site of insertion in acute HD/PE because of the smaller number of complications. PMID:27312920

  7. Is Antibiotic Prophylaxis for Percutaneous Radiofrequency Ablation (RFA) of Primary Liver Tumors Necessary? Results From a Single-Center Experience

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    Bhatia, Shivank S., E-mail: sbhatia1@med.miami.edu [University of Miami, Vascular/Interventional Radiology, Department of Radiology, Miller School of Medicine (United States); Spector, Seth, E-mail: sspector@med.miami.edu [University of Miami, Department of Surgery, VA Hospital (Veterans Affairs Medical Center) (United States); Echenique, Ana, E-mail: aechenique@med.miami.edu; Froud, Tatiana, E-mail: tfroud@med.miami.edu; Suthar, Rekha, E-mail: rsuthar@med.miami.edu; Lawson, Ivy, E-mail: i.lawson1@med.miami.edu; Dalal, Ravi, E-mail: rdalal@med.miami.edu [University of Miami, Vascular/Interventional Radiology, Department of Radiology, Miller School of Medicine (United States); Dinh, Vy, E-mail: vdinh@med.miami.edu [VA Hospital (Veterans Affairs Medical Center), Department of Medicine (United States); Yrizarry, Jose, E-mail: jyrizarr@med.miami.edu; Narayanan, Govindarajan, E-mail: gnarayanan@med.miami.edu [University of Miami, Vascular/Interventional Radiology, Department of Radiology, Miller School of Medicine (United States)

    2015-08-15

    PurposeThe purpose of this study was to evaluate need for antibiotic prophylaxis for radiofrequency ablation (RFA) of liver tumors in patients with no significant co-existing risk factors for infection.Materials and MethodsFrom January 2004 to September 2013, 83 patients underwent 123 percutaneous RFA procedures for total of 152 hepatocellular carcinoma (HCC) lesions. None of the patients had pre-existing biliary enteric anastomosis (BEA) or any biliary tract abnormality predisposing to ascending biliary infection or uncontrolled diabetes mellitus. No pre- or post-procedure antibiotic prophylaxis was provided for 121 procedures. Data for potential risk factors were reviewed retrospectively and analyzed for the frequency of infectious complications, including abscess formation.ResultsOne patient (1/121 (0.8 %) RFA sessions) developed a large segment 5 liver abscess/infected biloma communicating with the gallbladder 7 weeks after the procedure, successfully treated over 10 weeks with IV and PO antibiotic therapy and percutaneous catheter drainage. This patient did not receive any antibiotics prior to RFA. During the procedure, there was inadvertent placement of RFA probe tines into the gallbladder. No other infectious complications were documented.ConclusionThese data suggest that the routine use of prophylactic antibiotics for liver RFA is not necessary in majority of the patients undergoing liver ablation for HCC and could be limited to patients with high-risk factors such as the presence of BEA or other biliary abnormalities, uncontrolled diabetes mellitus, and large centrally located tumors in close proximity to central bile ducts. Larger randomized studies are needed to confirm this hypothesis.

  8. Evaluation of macrophage activation syndrome associated with systemic juvenile idiopathic arthritis: single center experience over a one-year period

    Science.gov (United States)

    Barut, Kenan; Yücel, Gözde; Sinoplu, Ada Bulut; Şahin, Sezgin; Adroviç, Amra; Kasapçopur, Özgür

    2015-01-01

    Aim: This study aimed to evaluate the demographic, clinical, laboratory properties of patients with macrophage activation syndrome and treatment outcomes. Material and Methods: The data of the patients who were diagnosed with macrophage activation syndrome secondary to systemic juvenile idiopathic arthritis between June 2013–May 2014 were evaluated by screening patient records. Results: Ten patients with macrophage activation syndrome were followed up in one year. The mean age at the time of diagnosis was found to be 7.6±4.5 years. The most common clinical finding at presentation (80%) was increased body temperature. Hepatosplenomegaly was found in half of the patients. The most common hematological finding (90%) was anemia. The mean erythrocyte sedimentation rate was found to be 71.8±36.2 mm/h, whereas it was measured to be lower (31.2±25.2 mm/h) at the time of the diagnosis of macrophage activation syndrome. Increased ferritin level was found in all of our patients (the mean ferritin level was found to be 23 957±15 525 ng/mL). Hypertriglyceridemia was found in nine patients (90%). The mean triglyceride level was found to be 397±332 mg/dL. Systemic steroid treatment was administered to all patients. Cyclosporine A was given to eight patients (80%), canakinumab was given to four patients (40%) and anakinra was given to five patients (50%). Plasmapheresis was performed in two patients. Improvement was found in all patients except for one patient. The patient in whom no improvement was observed showed a chronic course. Conclusions: The diagnosis of macrophage activation syndrome should be considered in presence of sudden disturbance in general condition, resistant high fever and systemic inflammation findings in children with active rheumatic disease. Complete recovery can be provided with early and efficient treatment in macrophage activation syndrome which develops secondary to systemic juvenil idiopathic arthritis. PMID:26884689

  9. Use of triple microcatheters for endovascular treatment of wide-necked intracranial aneurysms: A single center experience

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Young Dae; Rhim, Jong Kook; Kang, Hyun Seung; Kim, Jeong Eun; Cho, Won Sang; Han, Moon Hee [Seoul National University Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of); Park, Jeong Jin [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Jeon, Jin Pyeong [Dept. of Neurosurgery, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon (Korea, Republic of)

    2015-10-15

    The dual microcatheter technique is common practice for coil embolization of a wide-necked aneurysm, due to safety and efficacy. However, technical limitations of some complex configurations may necessitate additional microcatheters to bolster coil stability, compact the coil, or for protection. Described herein is a triple microcatheter technique for endovascular management of wide-necked intracranial aneurysms. Data accruing prospectively between January 2006 and October 2014 on simultaneously executed triple microcatheter coil embolization procedures done in 38 saccular aneurysms were reviewed. Clinical and morphological outcomes were assessed, with emphasis on technical aspects of treatment. The triple microcatheter technique was successfully applied to all 38 saccular aneurysms, involving the posterior communicating artery (n = 13), the middle cerebral artery (n = 10), the basilar tip (n = 7), the anterior cerebral artery (n = 5), and the internal carotid artery (n = 3). Stent protection was added in four patients and balloon remodeling in one. Dual microcatheters (n = 24) were usually deployed to deliver the coil within sacs of aneurysms, with the additional microcatheter used for protection. Otherwise, triple microcatheters were deployed for coil delivery (n = 11) or coils were delivered via a single microcatheter, with dual microcatheters deployed for protection (n = 3). Successful occlusion of aneurysms was achieved in 89.5% of cases, with no procedure-related morbidity or mortality. Stable occlusion was maintained in 72.2% (26/36) of the aneurysms at the final follow-up (mean interval, 30.2 ± 22.7 months). The outcomes of this limited study suggest that the triple microcatheter technique may be an effective and safe therapeutic option for wide-necked aneurysms, using technical strategies tailored to complex angio-anatomic configurations.

  10. Endovascular therapy for abdominal aortic aneurysm and iliac artery aneurysm using SEAL aortic stent-graft: A single center experience

    Energy Technology Data Exchange (ETDEWEB)

    Park, Su Young; Kim, Jeong Ho; Byun, Sung Su; Kang, Jin Mo; Choi, Sang Tae; Park, Jae Hyung [Gachon University Gil Hospital, Incheon (Korea, Republic of)

    2015-03-15

    The aim of this study was to evaluate the safety and efficacy of SEAL aortic stent-graft for abdominal aortoiliac aneurysms. Between October 2007 and January 2014, 33 patients with abdominal aortoiliac aneurysms were treated with SEAL aortic stent-graft. We evaluated the technical success rate, clinical and CT follow-up periods, major complications, need for additional interventional treatment, aneurysm-related mortality and clinical success rate. SEAL bifurcated aortic stent-graft was successfully placed in 32 patients (97%). Clinical and CT follow-up periods were 24 and 14 months, respectively. Endoleak developed in 13 patients (41%): spontaneous regression or decrease in 6, need for additional treatment in 4 and follow-up loss in 3. Significant stenosis of stent-graft occurred in 4 patients (12%) and was treated with stenting in 3. Migration of stent-graft was noted in 3 patients (9%) and treated with additional stent-grafting. Aneurysm-related mortality was 9% (3 of 33). The placement of SEAL stent-graft was effective in 26 patients (79%). The placement of SEAL aortic stent-graft was safe and effective in patients with aneurysms of abdominal aorta and iliac arteries. However, complicating endoleaks, stenosis and migration of the stent-graft developed during the follow-up. Therefore, regular CT follow-up seems to be mandatory.

  11. Diagnostics of common microdeletion syndromes using fluorescence in situ hybridization: Single center experience in a developing country

    Science.gov (United States)

    Kurtovic-Kozaric, Amina; Mehinovic, Lejla; Stomornjak-Vukadin, Meliha; Kurtovic-Basic, Ilvana; Catibusic, Feriha; Kozaric, Mirza; Dinarevic, Senka Mesihovic; Hasanhodzic, Mensuda; Sumanovic-Glamuzina, Darinka

    2016-01-01

    Microdeletion syndromes are caused by chromosomal deletions of less than 5 megabases which can be detected by fluorescence in situ hybridization (FISH). We evaluated the most commonly detected microdeletions for the period from June 01, 2008 to June 01, 2015 in the Federation of Bosnia and Herzegovina, including DiGeorge, Prader-Willi/Angelman, Wolf-Hirschhorn, and Williams syndromes. We report 4 patients with DiGeorge syndromes, 4 patients with Prader-Willi/Angelman, 4 patients with Wolf-Hirschhorn syndrome, and 3 patients with Williams syndrome in the analyzed 7 year period. Based on the positive FISH results for each syndrome, the incidence was calculated for the Federation of Bosnia and Herzegovina. These are the first reported frequencies of the microdeletion syndromes in the Federation of Bosnia and Herzegovina. PMID:26937776

  12. Diagnostics of common microdeletion syndromes using fluorescence in situ hybridization: single center experience in a developing country

    Directory of Open Access Journals (Sweden)

    Amina Kurtovic-Kozaric

    2016-03-01

    Full Text Available Microdeletion syndromes are caused by chromosomal deletions of less than 5 megabases which can be detected by fluorescence in situ hybridization (FISH. We evaluated the most commonly detected microdeletions for the period from June 01, 2008 to June 01, 2015 in the Federation of Bosnia and Herzegovina, including DiGeorge, Prader-Willi/Angelman, Wolf-Hirschhorn, and Williams syndromes. We report 4 patients with DiGeorge syndromes, 4 patients with Prader-Willi/Angelman, 4 patients with Wolf-Hirschhorn syndrome, and 3 patients with Williams syndrome in the analyzed 7 year period. Based on the positive FISH results for each syndrome, the incidence was calculated for the Federation of Bosnia and Herzegovina. These are the first reported frequencies of the microdeletion syndromes in the Federation of Bosnia and Herzegovina.

  13. Liver transplantation and combined liver-heart transplantation in patients with familial amyloid polyneuropathy: a single-center experience.

    Science.gov (United States)

    Barreiros, Ana-Paula; Post, Felix; Hoppe-Lotichius, Maria; Linke, Reinhold P; Vahl, Christian F; Schäfers, Hans-Joachim; Galle, Peter R; Otto, Gerd

    2010-03-01

    Liver transplantation (LT) is the only curative option for patients with familial amyloid polyneuropathy (FAP) at present. Twenty patients with FAP underwent LT between May 1998 and June 2007. Transthyretin mutations included predominantly the Val30Met mutation but also 10 other mutations. Seven patients received a pacemaker prior to LT, and because of impairment of mechanical cardiac function, 4 combined heart-liver transplants were performed, 1 simultaneously and 3 sequentially. The first patient, who underwent simultaneous transplantation, died. Seven patients died after LT, with 5 dying within the first year after transplantation. The causes of death were cardiac complications (4 patients), infections (2 patients), and malnutrition (1 patient). One-year survival was 75.0%, and 5-year survival was 64.2%. Gly47Glu and Leu12Pro mutations showed an aggressive clinical manifestation: 2 patients with the Gly47Glu mutation, the youngest patients of all the non-Val30Met patients, suffered from severe cardiac symptoms leading to death despite LT. Two siblings with the Leu12Pro mutation, who presented only with grand mal seizures, died after LT because of sepsis. In conclusion, the clinical course in patients with FAP is very variable. Cardiac symptoms occurred predominantly in patients with non-Val30Met mutations and prompted combined heart-liver transplantation in 4 patients. Although early LT in Val30Met is indicated in order to halt the typical symptoms of polyneuropathy, additional complications occurring predominantly with other mutations may prevail and lead to life-threatening complications or a fatal outcome. Combined heart-liver transplantation should be considered in patients with restrictive cardiomyopathy. PMID:20209591

  14. Higher Rates of Retinopathy of Prematurity after Increasing Oxygen Saturation Targets for Very Preterm Infants: Experience in a Single Center.

    Science.gov (United States)

    Manley, Brett J; Kuschel, Carl A; Elder, James E; Doyle, Lex W; Davis, Peter G

    2016-01-01

    Randomized trials of oxygen saturation target ranges for extremely preterm infants showed increased survival but increased retinopathy of prematurity with higher compared with lower target ranges. In our center, changing from a target range of 88%-92% to 91%-95% has been associated with increased rates and severity of retinopathy of prematurity. PMID:26548746

  15. Experience of a Single Center in NTBC Use in Management of Hereditary Tyrosinemia Type I in Libya

    OpenAIRE

    Hanna Alobaidy; Emna Barkaoui

    2015-01-01

    Background: Hereditary Tyrosinemia type I (HTI) is a metabolic disease caused by deficiency of fumarylacetoacetate hydrolase enzyme. Objectives: This study reports beside its clinical and biochemical presentation, the outcome of NTBC [2- (2-nitro-4-trifloro-methylbenzoyl)-1, 3-cyclohexanedion] treatment of the disease and evaluates its biochemical markers in 16 pediatric Libyan patients. Patien...

  16. Clinical utility of panfungal polymerase chain reaction for the diagnosis of invasive fungal disease: a single center experience.

    Science.gov (United States)

    Trubiano, J A; Dennison, A M; Morrissey, C O; Chua, K Y; Halliday, C L; Chen, S C-A; Spelman, D

    2016-02-01

    The role of panfungal polymerase chain reaction (PCR) assays for diagnosis of invasive fungal disease (IFD) is inadequately defined. We describe the use of an internal transcribed spacer 1 (ITS-1) region-directed panfungal PCR in this context at a tertiary referral transplant center. A retrospective review of patients at Alfred Health, Melbourne, Australia (2009-2014) who had clinical samples referred for panfungal PCR testing was conducted. Baseline patient characteristics, antifungal drug history, fungal culture/histopathology, and radiology results were recorded. For bronchoalveolar lavage (BAL) fluid samples, identification of a fungus other than a Candida spp. was defined as a potential pathogen.Of 138 panfungal PCR tests (108 patients), 41 (30%) were positive for a fungal product. Ninety-seven percent (134/138) of specimens were from immunocompromised hosts. Thirteen percent (19/138) of panfungal PCR positive results were for potential pathogens and potential pathogens were detected more frequently in tissue as compared with BAL (12/13 vs. 6/26; P = .0001). No positive panfungal PCR results were obtained from CSF specimens. If histopathology examination was negative, panfungal PCR identified a potential pathogen in only 12% (11/94) of specimens. For the 20 culture negative/histopathology positive specimens, diagnosis of IFD to causative species level by panfungal PCR occurred in 35% (6/20).Sterile site specimens, in particular tissue, were more frequently panfungal PCR positive for potential pathogens than BAL. The utility of panfungal PCR appears greatest in tissue specimens, as an adjunct to histopathology to improve diagnostic sensitivity and specificity. Based on the results of this study we are now only testing tissue specimens by panfungal PCR.

  17. A 2-week Nitazoxanide-based quadruple treatment as a rescue therapy for Helicobacter pylori eradication: A single center experience.

    Science.gov (United States)

    Abd-Elsalam, Sherief; Kobtan, Abdelrahman; El-Kalla, Ferial; Elkhalawany, Walaa; Nawasany, Sally El; Saif, Sabry Abou; Yousef, Mohamed; Ali, Lobna Abo; Soliman, Samah; Mansour, Loai; Habba, Eslam; Soliman, Hanan; Rizk, Fatma; Shehata, Mona Ah

    2016-06-01

    As there are increasing reports of fluoroquinolone resistance on use as a first- or second-line treatment for Helicobacter pylori (H pylori), we aimed at evaluation of the efficacy and safety of nitazoxanide-based regimen as a rescue regimen in Egyptian patients whose previous traditional treatment for H pylori infection failed.In total, 100 patients from the outpatient clinic of the Tropical medicine department, Tanta University hospital in whom the standard triple therapy (clarithromycin-based triple therapy) failed were enrolled in the study. Nitazoxanide (500 mg bid), levofloxacin (500 mg once daily), omeprazole (40 mg bid), and doxycyclin (100 mg twice daily) were prescribed for 14 days. Eradication was confirmed by stool antigen for H pylori 6 weeks after the end of treatment. Among the patients enrolled in the study, 44% of patients were men and the mean age for the participants in the study was 46.41 ± 8.05, 13% of patients were smokers, and 4% of patients had a previous history of upper gastro-intestinal bleeding. A total of 94 patients (94%) completed the study with excellent compliance. Only 1 patient (1%) discontinued treatment due to intolerable side effects and 5 patients (5%) did not achieve good compliance or were lost during follow up. However, 83 patients had successful eradication of H pylori with total eradication rates 83% (95 % CI 75.7-90.3%) and 88.30% (95 % CI 81.8-94.8%) according to an intention-to-treat and per-protocol analysis, respectively. Adverse events were reported in 21% of patients: abdominal pain (6%), nausea (9%) and constipation (12%), (2%) headache, and (1%) dizziness. A 2-week nitazoxanide-based regimen is an effective and safe rescue therapy in Egyptian patients whose previous standard triple therapy has failed. PMID:27310977

  18. Effectiveness of percutaneous metal stent placement in cholangiocarcinoma patients with midterm follow-up: Single center experience

    Energy Technology Data Exchange (ETDEWEB)

    Kose, Fatih, E-mail: fatihkose@gmail.com [Baskent University Faculty of Medicine, Department of Medical Oncology, Adana (Turkey); Oguzkurt, Levent [Department of Interventional Radiology, Adana (Turkey); Besen, Ayberk; Sumbul, Taner; Sezer, Ahmet; Karadeniz, Cemile; Disel, Umut; Mertsoylu, Huseyin; Ozyilkan, Ozgur [Baskent University Faculty of Medicine, Department of Medical Oncology, Adana (Turkey)

    2012-08-15

    Purpose: Patients with advanced cholangiocarcinoma present with high rate of local complications. The primary aim of this study is to report clinical course of advanced cholangiocarcinoma patients those who were presented with biliary obstruction and treated with percutaneous biliary stenting. Material and methods: Patients with unresectable locally advanced or metastatic cholangiocarcinoma followed by our center for a period of 4 years were analyzed. For statistical analysis demographic and clinical characteristics of patients, primary biliary drainage method, metal stent occlusion rate, time to stent occlusion, and overall survival rates were recorded. Results: A total of 34 eligible patients were analyzed. 27 patients had metal stent placement. These 27 patients formed the basis of this study. Median overall survival (OS) was 6.0 months. After metal stent deployment bilurubin levels were normalized within a mean of 10 days. During the follow-up period, 13 patients were experienced metal stent occlusion. Median TtSO was 10 weeks. Cytotoxic chemotherapy was administered to 14 (52%) patients. Patients without stent dysfunction had significantly higher rate of chemotherapy exposure rate (p = 0.021). Statistical analysis, however, failed to exhibit significant effect of stent dysfunction on OS. Conclusion: In advanced cholangiocarcinoma, relief of bile duct obstruction is an important part of the initial patient management. This study therefore described the clinical value of percutaneous metal stent in cholangiocarcinoma patients and raises the question about patency of metal stent in cholangiocarcinoma whether we can expect success similar to the success achieved in pancreas carcinoma.

  19. Effectiveness of percutaneous metal stent placement in cholangiocarcinoma patients with midterm follow-up: Single center experience

    International Nuclear Information System (INIS)

    Purpose: Patients with advanced cholangiocarcinoma present with high rate of local complications. The primary aim of this study is to report clinical course of advanced cholangiocarcinoma patients those who were presented with biliary obstruction and treated with percutaneous biliary stenting. Material and methods: Patients with unresectable locally advanced or metastatic cholangiocarcinoma followed by our center for a period of 4 years were analyzed. For statistical analysis demographic and clinical characteristics of patients, primary biliary drainage method, metal stent occlusion rate, time to stent occlusion, and overall survival rates were recorded. Results: A total of 34 eligible patients were analyzed. 27 patients had metal stent placement. These 27 patients formed the basis of this study. Median overall survival (OS) was 6.0 months. After metal stent deployment bilurubin levels were normalized within a mean of 10 days. During the follow-up period, 13 patients were experienced metal stent occlusion. Median TtSO was 10 weeks. Cytotoxic chemotherapy was administered to 14 (52%) patients. Patients without stent dysfunction had significantly higher rate of chemotherapy exposure rate (p = 0.021). Statistical analysis, however, failed to exhibit significant effect of stent dysfunction on OS. Conclusion: In advanced cholangiocarcinoma, relief of bile duct obstruction is an important part of the initial patient management. This study therefore described the clinical value of percutaneous metal stent in cholangiocarcinoma patients and raises the question about patency of metal stent in cholangiocarcinoma whether we can expect success similar to the success achieved in pancreas carcinoma.

  20. Results of treatment of lymphoblastic lymphoma at the children cancer hospital Egypt – A single center experience

    Directory of Open Access Journals (Sweden)

    Hany Abdel Rahman Sayed

    2016-09-01

    Results of treatment of LBL on the St Jude’s total therapy XV study are comparable to most of the similar reported studies. Outcome of relapsing patients is extremely poor, hence there is a need to identify biologic or clinical prognostic factors including minimal residual tumor to better evaluate chemotherapy response. Steroid induced AVN, and cerebral vascular thrombosis were the main chemotherapeutic adverse events.

  1. Allogeneic Stem Cell Transplantation in Congenital Hemoglobinopathies Using a Tailored Busulfan-Based Conditioning Regimen: Single-Center Experience.

    Science.gov (United States)

    Zaidman, Irina; Rowe, Jacob M; Khalil, Abdalla; Ben-Arush, Myriam; Elhasid, Ronit

    2016-06-01

    Hematopoietic stem cell transplantation (HSCT) is the only proven curative option for patients with hemoglobinopathies, both thalassemia and sickle cell anemia (SCA). A busulfan-based myeloablative conditioning regimen is the standard of care for HSCT in these patients, although increased treatment-related morbidity, including veno-occlusive disease (VOD), has been demonstrated. Thirty-eight pediatric patients, median age 8 years (range, 6 months to 22 years), suffering from hemoglobinopathy were treated at Rambam Medical Center in Haifa, Israel, between 1998 and 2011. Thirty-four patients had thalassemia major and 4 had SCA. The 38 patients underwent 40 HSCTs, 34 of which were first transplants and 6 second transplants. Most transplants (32/40) were from matched sibling donors. Sources of stem cells were peripheral blood in 30 transplants, bone marrow in 7 transplants, and cord blood in 3 transplants. All received different customized busulfan-based conditioning regimens tailored by pharmacokinetic analysis of busulfan levels. Primary engraftment occurred in 37 of 40 transplants. Neutrophil engraftment (>.5 × 10(9)/L) occurred at a median of 15.3 days post-transplantation (range, 10 to 45). Platelet transfusion independence (>20 × 10(9)/L) occurred at a median of 22.3 days (range, 11 to 60). The rate of 5-year overall survival for thalassemia patients after first transplantation was 90.5% ± 5.3%. The rate of 5-year thalassemia-free survival was 81.7% ± 6.8%. Cumulative incidence of acute graft-versus-host disease (GVHD) was 17.6%. Rate of grades III to IV GVHD was 8.8%. Cumulative incidence of chronic GVHD was 23.5%, with 11.8% incidence of extensive chronic GVHD. One patient developed VOD. Full donor chimerism occurred in 36.4% of patients with class 1 + 2 thalassemia, compared with 78.6% in class 3 thalassemia (P = .049). Overall survival above 90% in patients undergoing their first transplant was demonstrated using busulfan-based conditioning regimens. The low incidence of VOD was probably due to busulfan area under the curve measurements and dose adjustment.

  2. Radiotherapy and Sorafenib in the Management of Patients with Hepatocellular Carcinoma Have Led to Improved Survival: A Single Center Experience

    Science.gov (United States)

    Moore, Assaf; Cohen-Naftaly, Michal; Benjaminov, Ofer; Braun, Marius; Issachar, Assaf; Mor, Eitan; Tovar, Anna; Sarfaty, Michal; Gordon, Noa; Stemmer, Salomon M.

    2016-01-01

    Background & Aims: Hepatocellular Carcinoma (HCC) is the sixth most common malignancy and the third most common cause of cancer mortality worldwide. We aimed to assess the effect of novel treatment options on the survival of HCC patients. Methods: This retrospective study included all HCC patients diagnosed between 2000 and 2013 referred to the Davidoff center and treated by a multidisciplinary team. Results: The analysis included 321 patients (median age, 64 years; 74.8% males; 74.1% viral carriers; 76.0% cirrhosis; 56.7% diagnosis at an early stage). The estimated hazard ratio by multivariate analysis for the effect of the period of diagnosis (2007-2013 vs. 2000-2006) on survival was 0.72 (95% CI: 0.54-0.96; p=0.027). There was no difference in the distribution by CP score, by BCLC stage at diagnosis or in the proportion of patients undergoing surgical procedures (liver transplantation or resection). In the later time frame, there was a significant decrease in the proportion of patients undergoing percutaneous treatments (14.6% vs.4.2%, p=0.004) and embolization (46.9% vs.24.6%, p=0.001), and a significant increase in radiotherapy (1.5% vs. 8.4%, p=0.009) and treatment with sorafenib (6% vs. 18.3%, p=0.002). Conclusion: Technological/pharmaceutical innovations have led to advancement in HCC treatment. Since there was no significant difference in the proportion of patients undergoing surgical procedures during the evaluated timeframe, the improved survival may stem from better management of advanced stage patients by a multidisciplinary team. PMID:27313777

  3. Iron chelation with deferasirox for the treatment of secondary hemosiderosis in pediatric oncology patients: a single-center experience.

    Science.gov (United States)

    Ktena, Yiouli P; Athanasiadou, Anastasia; Lambrou, George; Adamaki, Maria; Moschovi, Maria

    2013-08-01

    Pediatric oncology patients are often iron overloaded, due to the multiple blood transfusions necessary during the course of chemotherapy. Our aim is to report the efficacy and safety of deferasirox, an oral iron chelator, in this patient group. Deferasirox was administered to 13 children with malignancies in remission and iron overload. Ferritin, blood urea nitrogen, creatinine, transaminases, and bilirubin were recorded at 4- to 8-week intervals, and hepatic and cardiac iron overload were assessed with magnetic resonance imaging before initiation of treatment. Deferasirox was administered for an average of 6 months (SD=4.5; range, 0.3 to 18.2). Two children presented with skin rash, 1 with gastrointestinal disturbances, and 1 with fully reversible acute renal failure. The mean monthly rate of change in ferritin levels was -10.8 μg/L before initiation of treatment (95% confidence interval [CI], -19.8 to -1.8; P=0.02) and -93.6 μg/L during deferasirox treatment (95% CI, -118.1 to -69.1; Piron burden. The adverse effects were easily monitored and managed. Further studies are warranted to investigate the effect of deferasirox on mortality and morbidity in this population.

  4. Infections with the 2009 H1N1 influenza virus among hematopoietic SCT recipients: a single center experience.

    Science.gov (United States)

    Rihani, R; Hayajneh, W; Sultan, I; Ghatasheh, L; Abdel-Rahman, F; Hussein, N; Hussein, A; Al-Zaben, A; Sarhan, M; Saad, M

    2011-11-01

    We retrospectively reviewed medical records of 39 hematopoietic SCT (HSCT) recipients who presented at our hospital between 1 October 2009 and 31 January 2010 with the 2009 H1N1 influenza infection. The median age at presentation was 13.8 years (range: 3.3-56.9), infections developed at a median of 585 days (range: 0-2316) post transplant, the majority (n=27, 69%) occurred in allogeneic HSCT recipients, 12 (31%) patients were on immunosuppressive therapy and 12 (31%) had GVHD. Lower airway disease was present in 8 patients (21%). In total, 15 patients (39%) were hospitalized with a median duration of 4.5 days (range: 3-27 days) and 3 (8%) required mechanical ventilation; 2 of whom died. PMID:21243021

  5. Wireless microcurrent-generating antimicrobial wound dressing in primary total knee arthroplasty: a single-center experience

    Directory of Open Access Journals (Sweden)

    James Chow

    2016-06-01

    Full Text Available The spread of multidrug-resistant bacteria and financial burden of periprosthetic joint infection (PJI further the need for treatments to address pathogenic contamination and expedite healing. This retrospective study was a chart review of a series of 92 patients who underwent 100 total knee arthroplasties performed by the same surgeon and treated with a novel microcurrent-generating antimicrobial dressing (MCD. Mean hospital length of stay was 2.3±0.9 days, while the mean length of treatment with MCD was 8.3±1.2 days. No major complications, PJI or major infectious complications were reported, with two readmissions (2% within 30 days of surgery. Knee Society Score function showed statistically significant improvements post-operatively, with a mean six-month score of 75.0±20.3 and mean change from baseline of 36.3±21.1 (P<0.0001. These results support previous findings that use of the MCD may result in improved outcomes as an element in postoperative wound management.

  6. Surgical results of cranioplasty with a polymethylmethacrylate customized cranial implant in pediatric patients: a single-center experience.

    Science.gov (United States)

    Fiaschi, Pietro; Pavanello, Marco; Imperato, Alessia; Dallolio, Villiam; Accogli, Andrea; Capra, Valeria; Consales, Alessandro; Cama, Armando; Piatelli, Gianluca

    2016-06-01

    OBJECTIVE Cranioplasty is a reconstructive procedure used to restore skull anatomy and repair skull defects. Optimal skull reconstruction is a challenge for neurosurgeons, and the strategy used to achieve the best result remains a topic of debate, especially in pediatric patients for whom the continuing skull growth makes the choice of material more difficult. When the native bone flap, which is universally accepted as the preferred option in pediatric patients, is unavailable, the authors' choice of prosthetic material is a polymethylmethacrylate (PMMA) implant designed using a custom-made technique. In this paper the authors present the results of their clinical series of 12 custom-made PMMA implants in pediatric patients. METHODS A retrospective study of the patients who had undergone cranioplasty at Gaslini Children's Hospital between 2006 and 2013 was conducted. A total of 12 consecutive cranioplasties in 12 patients was reviewed, in which a patient-specific PMMA implant was manufactured using a virtual 3D model and then transformed into a physical model using selective laser sintering or 3D printing. All patients or parents were administered a questionnaire to assess how the patient/parent judged the aesthetic result. RESULTS Patient age at craniectomy ranged from 5 months to 12.5 years, with a mean age of 84.33 months at cranioplasty. The mean extension of the custom-made plastic was 56.83 cm(2). The mean time between craniectomy and cranioplasty was 9.25 months. The mean follow-up duration was 55.7 months. No major complications were recorded; 3 patients experienced minor/moderate complications (prosthesis dislocation, granuloma formation, and fluid collection). CONCLUSIONS In this patient series, PMMA resulted in an extremely low complication rate and the custom-made technique was associated with an excellent grade of patient or parent satisfaction on long-term follow up. PMID:26824593

  7. Liver Transplantation without Perioperative Transfusions Single-Center Experience Showing Better Early Outcome and Shorter Hospital Stay

    Directory of Open Access Journals (Sweden)

    Nicolás Goldaracena

    2013-01-01

    Full Text Available Background. Significant amounts of red blood cells (RBCs transfusions are associated with poor outcome after liver transplantation (LT. We report our series of LT without perioperative RBC (P-RBC transfusions to evaluate its influence on early and long-term outcomes following LT. Methods. A consecutive series of LT between 2006 and 2011 was analyzed. P-RBC transfusion was defined as one or more RBC units administrated during or ≤48 hours after LT. We divided the cohort in “No-Transfusion” and “Yes-Transfusion.” Preoperative status, graft quality, and intra- and postoperative variables were compared to assess P-RBC transfusion risk factors and postoperative outcome. Results. LT was performed in 127 patients (“No-Transfusion” = 39 versus “Yes-Transfusion” = 88. While median MELD was significantly higher in Yes-Transfusion (11 versus 21; P=0.0001 group, platelet count, prothrombin time, and hemoglobin were significantly lower. On multivariate analysis, the unique independent risk factor associated with P-RBC transfusions was preoperative hemoglobin (P<0.001. Incidence of postoperative bacterial infections (10 versus 27%; P=0.03, median ICU (2 versus 3 days; P=0.03, and hospital stay (7.5 versus 9 days; P=0.01 were negatively influenced by P-RBC transfusions. However, 30-day mortality (10 versus 15% and one- (86 versus 70% and 3-year (77 versus 66% survival were equivalent in both groups. Conclusions. Recipient MELD score was not a predictive factor for P-RBC transfusion. Patients requiring P-RBC transfusions had worse postoperative outcome. Therefore, maximum efforts must be focused on improving hemoglobin levels during waiting list time to prevent using P-RBC in LT recipients.

  8. New and Safe Treatment of Food Impacted in the Esophagus: A Single Center Experience of 100 Consecutive Cases

    Directory of Open Access Journals (Sweden)

    Muhammad Shafique

    2013-01-01

    Full Text Available Aim. Large food bits can get stuck in the esophagus and must be removed by endoscopy. In some cases, this can be difficult or unsafe. We describe a new and safe treatment for such patients. Materials and Methods. 100 consecutive patients were referred to Akershus University Hospital with impacted food in the esophagus. In 36 patients (36%, the food passed spontaneously. In 59 (92% of the remaining 64 patients, the food was removed by endoscopic intervention. In the last five patients, endoscopic removal was judged difficult or unsafe. These patients received the new treatment: one capsule Creon 10000 IU dissolved in 30 mL of Coca-Cola administered by a nasooesophageal tube four times daily for 2-3 days. Results. Of the 59 patients treated with endoscopic procedure, complications occurred in four (7%: three bleedings and one perforation of the esophagus. In five patients treated with Coca-Cola and Creon, the food had either passed or was soft after 2-3 days and could easily be removed. Conclusion. The treatment of choice of impacted food in the esophagus is endoscopic removal. In cases where this is difficult, we recommend treatment with Coca-Cola and Creon for 2-3 days before complications occur.

  9. Application of negative pressure wound therapy in patients with wound dehiscence after abdominal open surgery: a single center experience

    OpenAIRE

    Jang, Ji Young; Shim, Hongjin; Lee, Yun Jin; Lee, Seung Hwan; Lee, Jae Gil

    2013-01-01

    Purpose Since the 1990's, negative pressure wound therapy (NPWT) has been used to treat soft tissue defects, burn wounds, and to achieve skin graft fixation. In the field of abdominal surgery, the application of NPWT is increasing in cases with an open abdominal wound requiring temporary wound closure and a second look operation. In the present study, the authors analyzed patients that underwent NPWT for postoperative wound dehiscence. Methods The computerized records of patients that had und...

  10. The concept of negative pressure wound therapy (NPWT) after poststernotomy mediastinitis – a single center experience with 54 patients

    OpenAIRE

    Vogt Peter M; Pietrowski Detlef; Malkoc Anita; Ennker Ina C; Ennker Juergen; Albert Alexander

    2009-01-01

    Abstract Deep sternal infections, also known as poststernotomy mediastinitis, are a rare but often fatal complication in cardiac surgery. They are a cause of increased morbidity and mortality and have a significant socioeconomic aspect concerning the health system. Negative pressure wound therapy (NPWT) followed by muscular pectoralis plasty is a quite new technique for the treatment of mediastinitis after sternotomy. Although it could be demonstrated that this technique is at least as safe a...

  11. Role of endorectal coil magnetic resonance imaging in local staging of rectal cancer: Experience from a single center

    Directory of Open Access Journals (Sweden)

    Rayees Ahmad Dar

    2013-01-01

    Full Text Available Purpose: In order to obtain an improvement in preoperative staging accuracy for rectal cancer, new imaging modalities are now under investigation. The purpose of our study was to evaluate the accuracy of endorectal coil magnetic resonance imaging (ECMRI in the preoperative local staging of rectal cancer and correlation with intraoperative and histopathologic staging of retrieved specimen with respect to depth of tumor invasion and lymph node metastasis. Materials and Methods: The study was a prospective one and included 38 patients with biopsy proved rectal cancer. ECMRI studies were performed on a 1.5 Tesla MR unit using a standard endorectal coil. All patients underwent surgery and a comparative evaluation of ECMRI and surgical and pathological staging was done. Accuracy, sensitivity, specificity, and positive and negative predictive value (PPV and NPV were assessed. Results: The diagnostic accuracy of ECMRI for T1/T2 tumors was 90%; for T3 and T4 tumors accuracy was 100% each. For perirectal lymph node metastasis, the diagnostic accuracy of ECMRI was 83.3%. Conclusion: ECMRI is a reliable radiologic tool for local (T staging of rectal cancer and has excellent diagnostic accuracy, sensitivity, and specificity. ECMRI is also useful in detecting perirectal lymph node metastasis, but accuracy is not as good as that for T staging.

  12. Preliminary safety and efficacy results with robotic high-intensity focused ultrasound : A single center Indian experience

    OpenAIRE

    Mishra, Shashikant; Sharma, Rajan; Garg, Chandra Prakash; Muthu, V.; Ganpule, Arvind; Sabnis, Ravindra B.; Desai, Mahesh R

    2011-01-01

    Background: There are no Indian data of high-intensity focused ultrasound (HIFU). Being an alternative, still experimental modality, reporting short-term safety outcome is paramount. Aims: This study was aimed at to assess the safety and short-term outcome in patients with prostate cancer treated by HIFU. Settings and Design: A retrospective study of case records of 30 patients undergoing HIFU between January 2008 to September 2010 was designed and conducted. Materials and Methods: The proced...

  13. Hyperthermic intraperitoneal chemotherapy as palliative treatment for malignant ascites A single-center experience and a review of the literature.

    Science.gov (United States)

    Graziosi, Luigina; Marino, Elisabetta; De Angelis, Verena; Rebonato, Alberto; Donini, Annibale

    L’ascite maligna rappresenta il quadro avanzato di anormale accumulo di liquido intraperitoneale in pazienti con carcinosi peritoneale. Questa condizione clinica può rappresentare la condizione terminale di questa patologia a pessima prognosi inficiando inoltre la qualità di vita dei pazienti. Le opzioni terapeutiche includono differenti procedure che hanno tuttavia una limitata efficacia e alcune criticità; diuretici, paracentesi, shunt veno-peritoneali, inibitori delle metallo proteasi, immunomodulatori e agenti biologici rappresentano alcuni esempi di queste procedure. Nessuno di questi approcci terapeutici rappresenta a oggi lo standard of care per questa patologia data la scarsa efficienza e l’alto grado di effetti collaterali. L’introduzione della chirurgia citoriduttiva e della chemio terapia ipertermica intraperitoneale sembra essere un approccio terapeutico valido nel trattamento dell’ascite maligna refrattaria, introdotto nelle ultime due decadi e che tutt’ora necessita di validazione scientifica. In questo lavoro condividiamo la nostra esperienza di tre casi affetti da ascite maligna refrattaria trattati con HIPEC; facciamo inoltre una revisione della letteratura.

  14. A Single-Center Experience of CNS Anomalies or Neural Tube Defects in Patients With Jarcho-Levin Syndrome.

    Science.gov (United States)

    Demir, Nihat; Peker, Erdal; Gülşen, İsmail; Ağengin, Kemal; Kaba, Sultan; Tuncer, Oğuz

    2016-03-01

    Jarcho-Levin syndrome (JLS) is a genetic disorder characterized by distinct malformations of the ribs and vertebrae, and/or other associated abnormalities such as neural tube defect, Arnold-Chiari malformation, renal and urinary abnormalities, hydrocephalus, congenital cardiac abnormalities, and extremity malformations. The study included 12 cases at 37-42 weeks of gestation and diagnosed to have had Jarcho-Levin syndrome, Arnold-Chiari malformation, and meningmyelocele. All cases of Jarcho-Levin syndrome had Arnold-Chiari type 2 malformation; there was corpus callosum dysgenesis in 6, lumbosacral meningmyelocele in 6, lumbal meningmyelocele in 3, thoracal meningmyelocele in 3, and holoprosencephaly in 1 of the cases. With this article, the authors underline the neurologic abnormalities accompanying Jarcho-Levin syndrome and that each of these abnormalities is a component of Jarcho-Levin syndrome. PMID:26239489

  15. Diagnostic whole body scan (pre-therapy scan in differentiated thyroid cancer: A single center community hospital experience

    Directory of Open Access Journals (Sweden)

    P Santhanam

    2016-01-01

    Full Text Available Objective: Diagnostic whole body scan (pre-therapy scan with either I-123 or I-131 (radioactive isotopes of iodine is performed to assess the extent of thyroid cancer especially distant metastasis prior to administering the therapeutic dose of I-131. Our aim of the following study was to determine the utility of the diagnostic pre-therapy scan in the management of differentiated thyroid cancer. Materials and Methods: It was a case-control study carried out by retrospective chart review, of a randomly selected 100 patients with differentiated thyroid cancer who had followed in our community hospital over the course of 1 year. We collected data on multiple variables in the subjects - including age, gender, pre-operative size of the nodules, diagnosis, stage of the malignancy, size of the tumor, multifocality, lymphovascular invasion, dose of radioiodine used for remnant ablation, recurrence rates and persistence rates. Continuous variables were compared using the independent sample Mann-Whitney U-test whereas the Chi-square test was used for nominal variables. Results: The mean dose of radioactive iodine administered was 97.56 (±27.98 in the pre-therapy scan group and it was 97.23 (±32.40 in the control group. There was no difference between the two groups (P - 0.45. There was also no difference in the recurrence rates between the groups (P = 1.0. There was a trend toward a higher degree of persistent cancer in the group that had the pre-therapy scans (P - 0.086. Conclusion: Pre-therapy scan may not affect the dose of radio-iodine I-131 used for remnant ablation of differentiated thyroid cancer and does not influence the recurrence rates. This was especially true with respect to I-131 remnant ablation for low risk tumors.

  16. Clinical and microbiologic characteristics of vulvovaginitis in Korean prepubertal girls, 2009–2014: a single center experience

    Science.gov (United States)

    Kim, Hounyoung; Chai, Sun Myung; Ahn, Eun Hee

    2016-01-01

    Objective To update information on the clinical and microbiologic characteristics of pediatric vulvovaginitis in Korean prepubertal girls. Methods A total of 120 girls (aged 0 to 9 years) with culture-confirmed pediatric vulvovaginitis, diagnosed between 2009 and 2014, were enrolled in the study. The epidemiologic and microbiologic characteristics, and clinical outcomes were assessed. Patients with sexual precocity, as well as those who were referred for suspected sexual abuse, were excluded. Results Girls aged 4 to 6 years were at the highest risk of pediatric vulvovaginitis. Seasonal distribution indicated obvious peaks in summer and winter. Of the 120 subjects, specific pathogens were identified in the genital specimens in only 20 cases (16.7%). Streptococcus pyogenes (n=12, 60%) was the leading cause of specific vulvovaginitis. Haemophilus influenzae was isolated in one patient. No cases presented with enteric pathogens, such as Shigella or Yersinia. A history of recent upper respiratory tract infection, swimming, and bubble bath use was reported in 37.5%, 15.8%, and 10.0% of patients, respectively. Recent upper respiratory tract infection was not significantly correlated with the detection of respiratory pathogens in genital specimens (P>0.05). Of 104 patients who underwent perineal hygienic care, 80 (76.9%) showed improvement of symptoms without antibiotic treatment. Furthermore, the efficacy of hygienic care was not significantly different between patients with or without specific pathogens (P>0.05). Conclusion Specific pathogens were only found in 16.7% of pediatric vulvovaginitis cases. Our results indicate an excellent outcome with hygienic care, irrespective of the presence of specific pathogens. PMID:27004204

  17. Clinical and microbiologic characteristics of vulvovaginitis in Korean prepubertal girls, 2009–2014: a single center experience

    OpenAIRE

    Kim, Hounyoung; Chai, Sun Myung; Ahn, Eun Hee; Lee, Mee-Hwa

    2016-01-01

    Objective To update information on the clinical and microbiologic characteristics of pediatric vulvovaginitis in Korean prepubertal girls. Methods A total of 120 girls (aged 0 to 9 years) with culture-confirmed pediatric vulvovaginitis, diagnosed between 2009 and 2014, were enrolled in the study. The epidemiologic and microbiologic characteristics, and clinical outcomes were assessed. Patients with sexual precocity, as well as those who were referred for suspected sexual abuse, were excluded....

  18. Staging and therapy monitoring of multiple Myeloma by 99mTc-Sestamibi Scintigraphy: a five year single center experience

    International Nuclear Information System (INIS)

    The aim of the present study was the evaluation of the diagnostic value of 99mTc-sestamibi (MIBI) in the detection of bone marrow involvement in patients suffering from multiple myeloma (MM) and its possible role in the follow-up. Between 1998 and 2003, 68 patients with MM and 42 pts with monoclonal gammopathy of undetermined significance (MGUS) were consecutively enrolled in this study. 51/68 MM patients had active disease (AD), 11/62 were in complete remission (CR) and 6/68 in partial remission (PR) after chemotherapy. 18 patients with MM repeated a 99mTc-MIBI scintigraphic study at least 2 months after high-dose chemotherapy. All the scans were score semi quantitatively according to extension and intensity of tracer uptake. All MGUS pts had a negative 99mTc-MIBI. As far as the MM pts are concerned, 54/68 (49%) pts (48 with AD, 5 with PR and 1 with CR) had a positive 99mTc-MIBI scan, while the 99mTc-MIBI scan was negative in 14/68 pts (10 with CR, 1 with PR and 3 with AD). The overall sensitivity of the 99mTc-MIBI scintigraphy was 92%; specificity was 96%. In the follow up of the pts treated with chemotherapy 99mTc-MIBI closely paralleled the activity of myeloma bone disease. In conclusion, these results indicate that 99mTc-MIBI scintigraphy closely reflects myeloma disease activity in the bone marrow, and that a negative 99mTc-MIBI scan in patients with suspected MM clearly, though not absolutely, indicates absence of disease or clinical remission. The results of this study suggest a clear diagnostic value of 99mTc-MIBI scintigraphy in patients with MM and its potential role during the follow-up for the monitoring of MM bone disease

  19. Computed tomography-guided needle aspiration and biopsy of pulmonary lesions - A single-center experience in 1000 patients

    Energy Technology Data Exchange (ETDEWEB)

    Poulou, Loukia S.; Tsagouli, Paraskevi; Thanos, Loukas [Dept. of Medical Imaging and Interventional Radiology, General Hospital of Chest Diseases ' Sotiria' , Athens (Greece)], e-mail: ploukia@hotmail.com; Ziakas, Panayiotis D. [Program of Outcomes Research, Div. of Infectious Diseases, Warren Alpert Medical School, Brown Univ., RI, and Div. of Infectious Diseases, Rhode Island Hospital, Rhode Island (United States); Politi, Dimitra [Dept. of Cythopathology, General Hospital of Chest Diseases ' Sotiria' Athens (Greece); Trigidou, Rodoula [Dept. of Pathology, General Hospital of Chest Diseases ' Sotiria' Athens (Greece)

    2013-07-15

    Background: Computed tomography (CT)-guided fine needle aspiration (FNA) and biopsies are well-established, minimally invasive diagnostic tools for pulmonary lesions. Purpose: To analyze retrospectively the results of 1000 consecutive lung CT-guided FNA and/or core needle biopsies (CNB), the main outcome measures being diagnostic yield, and complication rates. Material and Methods: Patients considered eligible were those referred to our department for lung lesions. The choice of FNA, CNB, or both was based upon the radiologist's judgment. Diagnostic yield was defined as the probability of having a definite result by cytology/histology. Results: The study included 733 male patients and 267 female patients, with a mean (SD) age of 66.4 (11.4) years. The mean (SD) lesion size was 3.7 (2.4) cm in maximal diameter. Six hundred and forty-one (64%) patients underwent an FNA procedure, 245 (25%) a CNB, and 114 (11%) had been subjected to both. The diagnostic yield was 960/994 (96.6%); this decreased significantly with the use of CNB only (odds ratio [OR] 0.32; 95% CI 0.12 - 0.88; P = 0.03), while it increased with lesion size (OR 1.35; 95% CI 1.03 - 1.79; P = 0.03 per cm increase). In 506 patients (52.7%), a malignant process was diagnosed by cytopathology/histology. The complication rate reached 97/1000 (9.7%); complications included: hemorrhage, 62 (6.2%); pneumothorax, 28 (2.8%); hemorrhage and pneumothorax, 5 (0.5%); and hemoptysis, 2 (0.2%). It was not significantly affected by the type of procedure or localization of the lesion. The overall risk for complications was three times higher for lesions <4 cm (OR 3.26; 95% CI 1.96 - 5.42; P < 0.001). Conclusion: CT-guided lung biopsy has a high diagnostic yield using FNA, CNB, or both. The CNB procedure alone will not suffice. Complication rates were acceptable and correlated inversely with lesion size, not localization or type of procedure.

  20. New insights into the clinical evaluation of hereditary transthyretin amyloidosis patients: a single center's experience

    OpenAIRE

    Suhr OB; Gustavsson S.; Heldestad V; Hörnsten R; Lindqvist P; Nordh E; Wiklund U

    2012-01-01

    Ole B Suhr,1 Sandra Gustavsson,1 Victoria Heldestad,2 Rolf Hörnsten,3 Per Lindqvist,1 Erik Nordh,2 Urban Wiklund41Department of Public Health and Clinical Medicine, 2Department of Pharmacology and Clinical Neuroscience, 3Department of Surgical and Perioperative Sciences, Clinical Physiology, Heart Centre, 4Department of Radiation Sciences, Biomedical Engineering, Umeå University, Umeå, SwedenAbstract: Over the last decade, new medical treatment modalities have eme...

  1. Single port laparoscopic and open surgical accesses of chronic peritoneal dialysis in children: A single center experience over 12 years

    Directory of Open Access Journals (Sweden)

    Ünal Biçakci

    2016-01-01

    Full Text Available Introduction: The aim of this study was to evaluate patients with end stage renal failure (ESRD who underwent chronic peritoneal dialysis (CPD. The clinical outcomes of laparoscopic and open placements of catheters were compared. Materials and Methods: We reviewed 49 (18 male and 31 female children with CPD according to age, sex, cause of ESRD, catheter insertion method, kt/V rate, complications, presence of peritonitis, catheter survival rate between January 2002 and February 2014. Results: Thirty-three patients were with open placement and 16 patients were with laparoscopic placement. The rate of the peritonitis is significantly less in patients with laparoscopic access than open access (n = 4 v sn = 25 (P<0.01. Patients with peritonitis were younger than those who had no attack of peritonitis (10.95 ± 0.8 years vs 13.4 ± 0.85 years. According to the development of complications, significant difference has not been found between the open (n = 9 and laparoscopic (n = 3 approaches except the peritonitis. Catheter survival rate for the first year was 95%, and for five years was 87.5%. There was no difference between open and laparoscopic group according to catheter survival rate. The mean kt/V which indicates the effectiveness of peritoneal dialysis was mean 2.26 ± 0.08. No difference was found between laparoscopic and open methods according to kt/V. Conclusion: Laparoscopic placement of CPD results in lower peritonitis rate. Catheter survival rate was excellent in both groups. Single port laparoscopic access for CPD catheter insertion is an effective and safe method.

  2. Single port laparoscopic and open surgical accesses of chronic peritoneal dialysis in children: A single center experience over 12 years

    Science.gov (United States)

    Bıçakcı, Ünal; Genç, Gürkan; Tander, Burak; Günaydın, Mithat; Demirel, Dilek; Özkaya, Ozan; Rızalar, Rıza; Arıtürk, Ender; Bernay, Ferit

    2016-01-01

    INTRODUCTION: The aim of this study was to evaluate patients with end stage renal failure (ESRD) who underwent chronic peritoneal dialysis (CPD). The clinical outcomes of laparoscopic and open placements of catheters were compared. MATERIALS AND METHODS: We reviewed 49 (18 male and 31 female) children with CPD according to age, sex, cause of ESRD, catheter insertion method, kt/V rate, complications, presence of peritonitis, catheter survival rate between January 2002 and February 2014. RESULTS: Thirty-three patients were with open placement and 16 patients were with laparoscopic placement. The rate of the peritonitis is significantly less in patients with laparoscopic access than open access (n = 4 vs n = 25) (P V which indicates the effectiveness of peritoneal dialysis was mean 2.26 ± 0.08. No difference was found between laparoscopic and open methods according to kt/V. CONCLUSION: Laparoscopic placement of CPD results in lower peritonitis rate. Catheter survival rate was excellent in both groups. Single port laparoscopic access for CPD catheter insertion is an effective and safe method. PMID:27073310

  3. Hepatitis C virus infection and biological false-positive syphilis test:a single-center experience

    Institute of Scientific and Technical Information of China (English)

    Wei-Fang Zhu; Shui-Ying Lei; Lan-Juan Li

    2011-01-01

    BACKGROUND: Rapidplasmaregainpositiveand/ortreponema pallidum hemagglutination negative [RPR(+)/TPHA(-)] results were designated as biologic false-positive (BFP). There are limited data about BFP reactions against syphilis in patients with hepatitis C virus (HCV) infection. This study aimed to determine the prevalence of BFP reactions for syphilis in patients with HCV infection in a large sample and assess the relationship between BFP reactions and HCV infection. METHODS:  A total of 2656 patients with positive anti-HCV and 5600 healthy control subjects were enrolled in this study. Hepatitis C serology was determined by a second generation ELISA test for HCV antibody. Syphilis serology was determined by the RPR test. Those subjects with reactive RPR positive underwent the TPHA test. Demographics and laboratory data were collected by trained clinicians. RESULTS: Among 2656 patients, 111 (4.2%) had a reactive RPR test. Of the 111 patients who were subjected to reactive RPR test, 30 (27.0%) showed HCV(+)/RPR(+). Of 5600 healthy controls, 80 (1.4%) had a reactive RPR test. Fourteen (17.5%) controls with HCV(-)/RPR(+) had a non-reactive TPHA test. These represented 1.1% of all HCV-positive and 0.3% of all HCV-negative subjects (P0.05). CONCLUSIONS: The data of this study demonstrate that HCV infection is associated with a false-positive RPR test. In this study BFPs were significantly more common in HCV positive patients compared to HCV-negative ones. Eosinophil abnormality can be considered as a predictor for BFP. Excessive BFPs must be considered in assessing the frequency of syphilis in a HCV-positive population and the importance of the treponemal specific serologic test should be emphasized for a diagnosis of syphilis in such population.

  4. Diagnostics of common microdeletion syndromes using fluorescence in situ hybridization: single center experience in a developing country.

    Science.gov (United States)

    Kurtovic-Kozaric, Amina; Mehinovic, Lejla; Stomornjak-Vukadin, Meliha; Kurtovic-Basic, Ilvana; Catibusic, Feriha; Kozaric, Mirza; Mesihovic-Dinarevic, Senka; Hasanhodzic, Mensuda; Glamuzina, Darinka

    2016-01-01

    Microdeletion syndromes are caused by chromosomal deletions of less than 5 megabases which can be detected by fluorescence in situ hybridization (FISH). We evaluated the most commonly detected microdeletions for the period from June 01, 2008 to June 01, 2015 in the Federation of Bosnia and Herzegovina, including DiGeorge, Prader-Willi/Angelman, Wolf-Hirschhorn, and Williams syndromes. We report 4 patients with DiGeorge syndromes, 4 patients with Prader-Willi/Angelman, 4 patients with Wolf-Hirschhorn syndrome, and 3 patients with Williams syndrome in the analyzed 7 year period. Based on the positive FISH results for each syndrome, the incidence was calculated for the Federation of Bosnia and Herzegovina. These are the first reported frequencies of the microdeletion syndromes in the Federation of Bosnia and Herzegovina. PMID:26937776

  5. Determinants of graft survival in pediatric and adolescent live donor kidney transplant recipients: a single center experience.

    Science.gov (United States)

    El-Husseini, Amr A; Foda, Mohamed A; Shokeir, Ahmed A; Shehab El-Din, Ahmed B; Sobh, Mohamed A; Ghoneim, Mohamed A

    2005-12-01

    To study the independent determinants of graft survival among pediatric and adolescent live donor kidney transplant recipients. Between March 1976 and March 2004, 1600 live donor kidney transplants were carried out in our center. Of them 284 were 20 yr old or younger (mean age 13.1 yr, ranging from 5 to 20 yr). Evaluation of the possible variables that may affect graft survival were carried out using univariate and multivariate analyses. Studied factors included age, gender, relation between donor and recipient, original kidney disease, ABO blood group, pretransplant blood transfusion, human leukocyte antigen (HLA) matching, pretransplant dialysis, height standard deviation score (SDS), pretransplant hypertension, cold ischemia time, number of renal arteries, ureteral anastomosis, time to diuresis, time of transplantation, occurrence of acute tubular necrosis (ATN), primary and secondary immunosuppression, total dose of steroids in the first 3 months, development of acute rejection and post-transplant hypertension. Using univariate analysis, the significant predictors for graft survival were HLA matching, type of primary urinary recontinuity, time to diuresis, ATN, acute rejection and post-transplant hypertension. The multivariate analysis restricted the significance to acute rejection and post-transplant hypertension. The independent determinants of graft survival in live-donor pediatric and adolescent renal transplant recipients are acute rejection and post-transplant hypertension. PMID:16269048

  6. The role of argon plasma coagulation in the management of Barrett's esophagus: a single-center experience

    Directory of Open Access Journals (Sweden)

    Gad YZ

    2011-04-01

    Full Text Available Yahia Z Gad1, Adel A Zeid21Associate Professor of Internal Medicine, Mansoura Specialized Medical Hospital, Mansoura University, Mansoura, Egypt; 2Consultant Surgeon, Al Nil Hospital, Mansaura, EgyptBackground/aim: Patients with Barrett's esophagus (BE are 30 times more likely to develop esophageal adenocarcinoma (EAC than the general population. Data regarding the use of argon plasma coagulation (APC for treatment of patients with BE in Egypt are still limited. This article discusses the efficacy and safety of APC as a thermoablative modality in Egyptian patients with BE.Materials and methods: A total of 73 referred eligible patients with a confirmed endoscopic and histopathologic diagnosis of BE were enrolled in this study and subjected to thermoablation by high-power (hp-APC equipment at a 60 W setting until complete ablation or a maximum of five sessions and were followed up clinically and endoscopically at 3-month intervals. Computer-generated randomization allocated patients into APC-treated and control groups (n = 75, all of whom were treated with a proton pump inhibitor.Results: Minor and major complications occurred in 8 of 73 (10.95% and 1 of 73 (1.36% patients, respectively. Macroscopic ablation was achieved after one session in 37 of 73 (50.63% patients, and complete histologic ablation was confirmed after 167 sessions in 69 of 73 (94.52% patients. At 1-year follow-up, no relapses of BE or progression to EAC were observed.Conclusion: hp-APC at a medium-energy setting of 60 W in an acid-reduced environment can ablate BE effectively and safely with promising initial results.Keywords: Barrett's esophagus, argon plasma coagulation

  7. Successful treatment of anastomotic jejunal varices with N-butyl-2-cyanoacrylate (Histoacryl): single-center experience.

    Science.gov (United States)

    Gubler, C; Glenck, M; Pfammatter, T; Bauerfeind, P

    2012-08-01

    Obscure gastrointestinal bleeding can lead to extensive diagnostic work-up, as well as repeated episodes of hospitalizations with significant morbidity. Patients with a previous small-bowel anastomosis seem to be prone to varices at this site, even in the absence of portal hypertension. We report here five cases with varices of this type. All the anastomoses in these patients were reached using overtube-assisted single- or double-balloon enteroscopy. The bleeding varices were treated by injecting N-butyl-2-cyanoacrylate (Histoacryl). Bleeding was stopped in all five patients without any adverse events, requiring one session in four patients and a second session in one patient. PMID:22833023

  8. Endoscopic treatment of bleeding gastric varices with histoacryl (N-butyl-2-cyanoacrylate): a South European single center experience

    OpenAIRE

    Monsanto, P.; Almeida, N.; Rosa, A.; Maçôas, F; Lérias, C; Portela, F; Amaro, P.; Ferreira, MC; Gouveia, H.; Sofia, C

    2013-01-01

    BACKGROUND: Endoscopic injection of N-butyl-2-cyanoacrylate is the current recommended treatment for gastric variceal bleeding. Despite the extensive worldwide use, there are still differences related to the technique, safety, and long term-results. We retrospectively evaluated the efficacy and safety of cyanoacrylate in patients with gastric variceal bleeding. PATIENTS AND METHODS: Between January 1998 and January 2010, 97 patients with gastric variceal bleeding underwent endoscopic...

  9. The Impact of a Surgical Protocol for Enhanced Recovery on Living Donor Right Hepatectomy: A Single-Center Cohort Study.

    Science.gov (United States)

    Kim, Seong Hoon; Kim, Young Kyu; Lee, Seung Duk; Lee, Eung Chang; Park, Sang Jae

    2016-04-01

    The concept of surgery for enhanced recovery (SFER) program has never been an issue in the context of living donor right hepatectomy (LDRH), much less its effects. The purpose of this study was to evaluate outcomes after the establishment of an SFER protocol for LDRH in a single center.A single-center cohort study was performed in 500 consecutive living donors who underwent right hepatectomy from January 2005 to June 2014 by analyzing the outcomes before and after an established SFER protocol that evolved with continuous refinements in surgical technique and management over 300 LDRHs, being in place on September 2011. Donor characteristics, operative outcomes, and postoperative complications divided into 2 groups (group 1, stepwise adjustment; group 2, complete adherence to the protocol) were compared.Donor characteristics were comparable in the 2 groups. Overall complication rate was 10.0% with no mortality. In group 2, operative time, hospital stay, and overall complication rate decreased significantly, and the morbidity was 1% and confined in grade I complication without reoperation, perioperative blood transfusion, or readmission. All donors in this series recovered fully and returned to the previous functional lifestyle.An SFER protocol on LDRH can be established by the gradual implementation of various refinements of surgical technique, and the recent outcomes achieved after the establishment of an SFER protocol could provide a current guidance on LDRH toward the ultimate goal of zero morbidity. PMID:27057855

  10. Experiential learning in the animal sciences: effect of 13 years of a beef cattle management practicum.

    Science.gov (United States)

    Marshall, T T; Hoover, T S; Reiling, B A; Downs, K M

    1998-11-01

    As the source of students shifts from rural to urban and suburban communities, students entering agricultural programs have less practical livestock experience. The career goals indicated by most of these students require knowledge of and experience with practical applications of their course work. The objective of this study was to examine the profile of students enrolled in an experiential beef cattle course 1) to describe the demographic and occupational characteristics of students enrolled and 2) to assess the perceived value of course activities to graduates completing the course as related to their skill attainment and career development. The questionnaire was sent to all 312 students who were enrolled in the course from 1983 to 1996. Over 61% of the respondents indicated they had enrolled in the course to gain experience working with beef cattle. Over 39% took the course to enhance their application to the College of Veterinary Medicine. When asked to rate the value of the course, as it related to skill development, they noted it was most helpful in teaching cattle handling skills, growth performance measurement, live animal evaluation, nutritional management, carcass and meat product value determination, and breed identification. PMID:9856406

  11. Assessing progress in reducing the at-risk population after 13 years of the global programme to eliminate lymphatic filariasis.

    OpenAIRE

    Pamela J Hooper; Brian K Chu; Alexei Mikhailov; Ottesen, Eric A.; Mark Bradley

    2014-01-01

    In 1997, the World Health Assembly adopted Resolution 50.29, committing to the elimination of lymphatic filariasis (LF) as a public health problem, subsequently targeted for 2020. The initial estimates were that 1.2 billion people were at-risk for LF infection globally. Now, 13 years after the Global Programme to Eliminate Lymphatic Filariasis (GPELF) began implementing mass drug administration (MDA) against LF in 2000-during which over 4.4 billion treatments have been distributed in 56 endem...

  12. Intra-abdominal metastasis of an intracranial germinoma via ventriculo-peritoneal shunt in a 13-year-old female.

    Science.gov (United States)

    Murray, Matthew J; Metayer, Lucy E; Mallucci, Conor L; Hale, Juliet P; Nicholson, James C; Kirollos, Ramez W; Burke, G A Amos

    2011-12-01

    A 13-year-old patient presented with massive intra-abdominal metastasis and spontaneous acute tumour lysis syndrome, 17-months after VP shunt placement for metastatic pineal germinoma treated with cranio-spinal-irradiation. Hyperhydration/rasburicase improved renal function, allowing chemotherapy with subsequent surgery. The patient remains event-free 34-months later. Risk of intra-abdominal metastasis from VP shunts is discussed. PMID:21501064

  13. Surgical Treatment of 13-year-old Patient with Coronary Artery Disease and Supravalvular Aortic Stenosis with Familial Hypercholesterolemia

    Directory of Open Access Journals (Sweden)

    Yüksel Atay

    2011-12-01

    Full Text Available Familial hypercholesterolemia is a genetic disorder caused by a mutation in low density lipoprotein (LDL gene. The homozygous type of the disease is rare and causes tendon xanthomas and coronary artery disease during the early years of life. Because of that, some of these patients needs early coronary revascularization. We presented 13-year-old patient who underwent coronary artery bypass graft due to familial hypercholesterolemia and repair of supravalvular aortic stenosis at the same time.

  14. Surgical Treatment of 13-year-old Patient with Coronary Artery Disease and Supravalvular Aortic Stenosis with Familial Hypercholesterolemia

    OpenAIRE

    Yüksel Atay; Mirali Mecidov; Fatih Ayık; Emrah Oğuz

    2011-01-01

    Familial hypercholesterolemia is a genetic disorder caused by a mutation in low density lipoprotein (LDL) gene. The homozygous type of the disease is rare and causes tendon xanthomas and coronary artery disease during the early years of life. Because of that, some of these patients needs early coronary revascularization. We presented 13-year-old patient who underwent coronary artery bypass graft due to familial hypercholesterolemia and repair of supravalvular aortic stenosis at the same time.

  15. Assessing Progress in Reducing the At-Risk Population after 13 Years of the Global Programme to Eliminate Lymphatic Filariasis

    OpenAIRE

    Pamela J Hooper; Brian K Chu; Alexei Mikhailov; Ottesen, Eric A.; Mark Bradley

    2014-01-01

    Background In 1997, the World Health Assembly adopted Resolution 50.29, committing to the elimination of lymphatic filariasis (LF) as a public health problem, subsequently targeted for 2020. The initial estimates were that 1.2 billion people were at-risk for LF infection globally. Now, 13 years after the Global Programme to Eliminate Lymphatic Filariasis (GPELF) began implementing mass drug administration (MDA) against LF in 2000—during which over 4.4 billion treatments have been distributed ...

  16. Family and home correlates of television viewing in 12–13 year old adolescents: The Nepean Study

    OpenAIRE

    Crawford David; Garnett Sarah P; Baur Louise A; Hardy Louise L; Campbell Karen J; Shrewsbury Vanessa A; Cowell Christopher T; Salmon Jo

    2006-01-01

    Abstract Background Few young people meet television viewing guidelines. Purpose To determine the association between factors in the family and home environment and watching television, including videos and DVDs, in early adolescence. Methods Cross-sectional, self-report survey of 343 adolescents aged 12–13 years (173 girls), and their parents (338 mothers, 293 fathers). Main measures were factors in the family and home environment potentially associated with adolescents spending ≥ 2 hours pe...

  17. Gender differences in mortality and risk factors in a 13-year cohort study of street-recruited injecting drug users

    OpenAIRE

    Gjersing, Linn; Bretteville-Jensen, Anne Line

    2014-01-01

    Background Injecting drug users (IDUs) are at risk of premature mortality. This study examined gender differences in mortality, risk factors, and causes of death among IDUs. Methods In a 13-year cohort study including 172 street-recruited IDUs from Oslo, Norway in 1997, interview data was merged with the National Cause of Death Registry. Crude mortality rate (CMR) and indirect standardized mortality ratio (SMR) were estimated with 95% confidence intervals (CI). A log-logistic multivariate sur...

  18. STUDY OF TITANIUM ELASTIC NAILING FOR FRACTURE SHAFT FEMUR IN CHILDREN BETWEEN 3 TO 13 YEARS OF AGE

    Directory of Open Access Journals (Sweden)

    Rajesh

    2015-03-01

    Full Text Available Treatment of Displaced diaphyseal femoral shaft fracture in children between 3 to 13 years is controversial. Various methods are available for treatment. Titanium elastic nailing is one of the methods for treatment of femur shaft fracture in children. In our study we have assessed the outcome of titanium elastic nailing for fracture shaft femur in children. We have found that titanium elastic nailing has excellent results in treatment of femur shaft fracture in children. Also it is less time consuming

  19. Donor safety in living donor liver transplantation: a single-center analysis of 300 cases.

    Directory of Open Access Journals (Sweden)

    Jianyong Lei

    Full Text Available AIM: To evaluate the safety to donors of living-donor liver transplantation. METHODS: This study included 300 consecutive living liver tissue donors who underwent operations at our center from July 2002 to December 2012. We evaluated the safety of donors with regard to three aspects complications were recorded prospectively and stratified by grade according to Clavien's classification, and the data were compared in two stages (the first 5 years' experience (pre-January 2008 and the latter 5 years' experience (post-January 2008; laboratory tests such as liver function and blood biochemistry were performed; and the health-related quality of life was evaluated. RESULTS: There was no donor mortality at our center, and the overall morbidity rate was 25.3%. Most of the complications of living donors were either grade I or II. There were significantly fewer complications in the latter period of our study than in the initial period (19.9% vs 32.6%, P<0.001, and biliary complications were the most common complications, with an incidence of 9%. All of the liver dysfunction was temporary; however, the post-operative suppression of platelet count lasted for years. Although within the normal range, eight years after operation, 22 donors showed lower platelet levels (189 × 10(9/L compared with the pre-operative levels (267 × 10(9/L (P<0.05. A total of 98.4% of donors had returned to their previous levels of social activity and work, and 99.2% of donors would donate again if it was required and feasible. With the exception of two donors who experienced grade III complications (whose recipients died and a few cases of abdominal discomfort, fatigue, chronic pain and scar itching, none of the living donors were affected by physical problems. CONCLUSION: With careful donor selection and specialized patient care, low morbidity rates and satisfactory long-term recovery can be achieved after hepatectomy for living-donor liver transplantation.

  20. Handwriting tics in Tourette’s syndrome: a single center study.

    Directory of Open Access Journals (Sweden)

    Carlotta eZanaboni Dina

    2016-02-01

    Full Text Available Tourette’s syndrome (TS is a neurodevelopmental disorder typically defined by multiple motor tics and at least one sound tic (1, beginning in childhood or in adolescence. More recently, Tourette’s syndrome has been acknowledged as a broad spectrum syndrome (2, including different comorbidities and coexisting symptoms. When beginning in early childhood TS mainly presents with attention deficit and hyperactivity disorder (ADHD and tics, when beginning in adolescence instead tics and obsessive-compulsive behavior or disorder (OCB/OCD are predominant. OCB/OCD trait is present in 60-80% of patients (3, and they are considered as thought tics (4. In many cases motor and sound tics resolve spontaneously in adulthood, though OCB/OCD generally remain. Tics often interfere with subject’s daily activities (5 affecting Quality of Life and causing Social Impairment, particularly in schooling and working. Handwriting is one of the most impaired school activity for TS patients because of the tics presence that hamper learning processes.In our clinical experience handwriting tics (HT could severely affect and condition TS subjects, but they are not often pointed out in the Literature. For this reason there are not precise data regarding the incidence of HT neither in Tourette’s syndrome patients nor in healthy population.

  1. The Outcome of Shield Graft Tympanoplasty: A Single Center Descriptive Study at KAMC

    Directory of Open Access Journals (Sweden)

    Mohamed Sa’ad Eldin Aly

    2014-04-01

    Full Text Available Cartilage has proven to be a favorable graft material to close tympanic membrane perforations. Objective: In this study we describe our experience with cartilage shield graft tympanoplasty in reconstruction of tympanic membrane perforations. Study Design: A retrospective review was done on 42 patients. The male to female ratio was 19:23 and the age range 11-72 years. Cases varied between Chronic Otitis Media with Dry Perforation and Ossicular Discontinuity and were treated with cartilage shield graft tympanoplasty type I or III, respectively. The corresponding author performed all operations over a period of 2 years at the department of Otolaryngology Head and Neck Surgery at King Abdullah Medical City, Makkah, Saudi Arabia. Methods: Patient and disease information were collected retrospectively and analyzed. Results: Graft take was achieved in 42 patients (100%. No statistically significant association between the postoperative pure tone average – air bone gap results and age, sex, or type of tympanoplasty was observed (p>0.05. The overall mean preoperative pure tone average – air bone gap was 27.0±10.5 dB, and it decreased to 14.9±7.0 dB 3 months postoperatively. A statistically significant improvement was observed (p<0.001. Conclusion: Excellent graft take results were achieved and hearing outcomes were satisfactory. Therefore, shield cartilage graft is a valid alternative in all tympanoplasty procedures.

  2. Long-term outcome on kidney retransplantation: a review of 100 cases from a single center.

    Science.gov (United States)

    Barocci, S; Valente, U; Fontana, I; Tagliamacco, A; Santori, G; Mossa, M; Ferrari, E; Trovatello, G; Centore, C; Lorenzi, S; Rolla, D; Nocera, A

    2009-05-01

    Renal transplantation has become an effective form of treatment for end-stage renal failure. Unfortunately, as a consequence of immunological and nonimmunological pathogenic mechanisms, chronic allograft nephropathy is responsible for the loss of a large proportion of kidney grafts after several years and return to dialysis. We have reported herein our 24 years of experience with second kidney transplantations. Of 1,302 kidney transplantations between January 1983 and June 2007 performed in our transplantation center, 100 were second transplantations. Kidney retransplantation was performed in 74 men and 26 women of overall mean age of 35.4 +/- 12.6 years. Cadaveric donor grafts were transplanted in 92 patients, whereas the remaining 8 were living-related donor kidneys. At 1, 5, and 10 years after kidney transplantation, patient survival rates were 100%, 96%, and 92%, respectively, whereas graft survival rates were 85%, 72%, and 53%, respectively. Immunosuppressive therapy included induction therapy with polyclonal anti-lymphocyte antibodies (ALG/ATG) or (starting from 1999) monoclonal anti CD 25 antibody. Our results demonstrated good outcomes for kidney retransplantations with allocation based on anti- HLA antibody identification together with induction immunosuppression.

  3. Chronic idiopathic thrombocytopenic purpura in adult Chinese patients: a retrospective single-centered analysis of 1791 cases

    Institute of Scientific and Technical Information of China (English)

    LI Hong-qiang; ZHANG Lei; ZHAO Hui; JI Lin-xiang; YANG Ren-chi

    2005-01-01

    Background Adult chronic idiopathic thrombocytopenic purpura (ITP) is a common hematologic disease characterized by persistent thrombocytopenia. So far, there were only a few reports on adult Chinese patients with chronic ITP. This study aimed at defining the treatment outcome and prognostic factors for chronic ITP based on a large cohort of Chinese patients followed up for over 25 years at a single center.Methods The medical records of 1791 patients aged 14 years or older who were diagnosed as having chronic ITP at our hospital from 1974 to 1999 were retrospectively analyzed.Conclusions Adult Chinese chronic ITP patients can have long-term remission after steroid therapy and splenectomies. Primary steroid refractoriness is a prognostic factor predicting poor subsequent response to a splenectomy.

  4. AB INITIO STUDY OF THE POSSIBLE SINGLE-CENTER UNITS FOR BINUCLEAR IRON COMPLEX [Fe2(bpym3Cl4

    Directory of Open Access Journals (Sweden)

    Tihonovschi Andrei

    2008-12-01

    Full Text Available In present work we study two possible single-center units for binuclear iron complex Fe2(bpym3Cl4 –[Fe(bpym3]2+ and Fe(bpym2Cl2. The obtained ground states for both studied systems are singlet states. In the case of Fe(bpym2Cl2 the lowest excited states were calculated to be 240cm-1 (triplet and 660cm-1 (quintet above the ground state and so are placed according to Lande rule. These states could be populated at room temperatures. For [Fe(bpym3]2+ first excited state was found to be about 6000cm-1 above the ground state and so cannot be populated at normal temperatures.

  5. Polyethylene Glycol Electrolyte Lavage Solution versus Colonic Hydrotherapy for Bowel Preparation before Colonoscopy: A Single Center, Randomized, and Controlled Study.

    Science.gov (United States)

    Cao, Yan; Zhang, Kai-Yuan; Li, Jiao; Lu, Hao; Xie, Wan-Ling; Liao, Sheng-Tao; Chen, Dong-Feng; Zeng, Deng-Feng; Lan, Chun-Hui

    2014-01-01

    This single center, randomized, and controlled study aimed to compare the effectiveness and safety of polyethylene glycol electrolyte lavage (PEG-EL) solution and colonic hydrotherapy (CHT) for bowel preparation before colonoscopy. A total of 196 eligible outpatients scheduled for diagnostic colonoscopy were randomly assigned to the PEG-EL (n = 102) or CHT (n = 94) groups. Primary outcome measures included colonic cleanliness and adverse effects. Secondary outcome measures were patient satisfaction and preference, colonoscopic findings, ileocecal arrival rate, examiner satisfaction, and cecal intubation time. The results show that PEG-EL group was associated with significantly better colonic cleanliness than CHT group, fewer adverse effects, and increased examiner satisfaction. However, the CHT group had higher patient satisfaction and higher diverticulosis detection rates. Moreover, the results showed the same ileocecal arrival rate and patient preference between the two groups (P > 0.05). These findings indicate that PEG-EL is the preferred option in patients who followed the preparation instructions completely.

  6. Liver transplant recipients with portal vein thrombosis:a single center retrospective study

    Institute of Scientific and Technical Information of China (English)

    Yi-Feng Tao; Fei Teng; Zheng-Xin Wang; Wen-Yuan Guo; Xiao-Min Shi; Gui-Hua Wang; Guo-Shan Ding; Zhi-Ren Fu

    2009-01-01

    . Development of therapeutic approaches and accumulation of experience in dealing with PVT further improve the outcomes of LT inPVT recipients.

  7. 13 years of OPALEO: half-way towards calibration of opal as a paleoproductivity proxy?

    Science.gov (United States)

    Ragueneau, O.; Gallinari, M.; Dittert, N.; Moriceau, B.; Schultes, S.; Leynaert, A.; Pondaven, P.; de La Rocha, C.

    2009-04-01

    out the importance of a better characterization of the quality of the biogenic silica reaching the sediment-water interface. This made us conduct a series of original experiments on diatoms as single cells, being more or less silicified, more or less degraded. On diatoms incorporated inside aggregates and fecal pellets as well. These experiments suggested in turn that biogenic opal may be constituted of different phases and we are exploring today the origin of these phases because their existence may have profound implications for our paleoceanographic interpretations. Do they have a purely siliceous origin or are they related to a variable strength of Si-C interactions inside diatoms? We are now studying these Si-C interactions inside diatoms, from their origin during silicification to their implications for the dissolution of silica and the degradation of diatom-carbon. In a very parallel manner, we started our studies on Si and C decoupling in the sediments and very rapidly, ended up in trying to understand the origin of the spatial variations encountered in the sediments of various biogeochemical provinces. For this aspect of proxy calibration, we combined process studies and the construction of a global data base of Si and C fluxes, from surface waters down to the accumulation in sediments. This global analysis showed that sedimentary signals find their origin in surface waters and in fact, spatial variations in Si:C ratios observed during production are carried out relatively unchanged down to the sediments. The Si:C ratio is increasing by two orders of magnitude between production and accumulation (only one order of magnitude on continental margins) but in such a homogeneous manner that spatial variations seem well preserved. This homogeneity is remarkable, given the many different characteristics of the biogeochemical provinces studied. This is particularly true when we realize that grazers, both in the water column and at the sediment-water interface, seem to

  8. Prevalence of Overweight and Obesity among Primary School Children Aged 8–13 Years in Dar es Salaam City, Tanzania

    Science.gov (United States)

    Pangani, Ismail N.; Kiplamai, Festus K.; Kamau, Jane W.; Onywera, Vincent O.

    2016-01-01

    Background. The understanding of obesity as a growing health problem in Africa and Tanzania in particular is hampered by lack of data as well as sociocultural beliefs in which overweight and obesity are revered. This study sought to determine the prevalence of overweight and obesity among primary school children aged 8–13 years in Dar es Salaam, Tanzania. Method. A cross-sectional analytical research design was used to study overweight and obesity in primary schools in Dar es Salaam, Tanzania. The target population was 150,000 children aged 8–13 years. Stratified random sampling was used to select 1781 children. Weight and height were taken and WHO standards for children were used to determine weight status. Results. Findings showed that the prevalence of overweight and obesity was 15.9% and 6.7%, respectively (N = 1781). However, 6.2% of the children were underweight. There were significant differences in mean BMI between children in private and public schools (p = 0.021), between male and female (p obesity among primary school children is significant and requires management and prevention strategies.

  9. Molar-incisor hypomineralization: Prevalence, severity and clinical characteristics in 8- to 13-year-old children of Udaipur, India

    Directory of Open Access Journals (Sweden)

    Shubha Arehalli Bhaskar

    2014-01-01

    Full Text Available Background: The last couple of decades has seen an increasing interest in molar-incisor hypomineralization (MIH. Although the reported prevalence of MIH ranges from 2.4% to 40.2% worldwide, very little data is available from India. Objective: To assess the prevalence, clinical characteristics, distribution, severity and association with caries of MIH defects in children aged 8-13 years of Udaipur, Rajasthan. Study design: This cross-sectional descriptive study consisted of 1173 children aged 8-13 years selected by random sampling procedure. The European Academy of Pediatric Dentistry criteria were followed for MIH diagnosis. The presence of dental caries and treatment need for MIH-affected teeth were recorded as per the WHO criteria. Results: The prevalence of MIH in the children examined was 9.46%. Severity of the defects increased with the age of the children. Involvement of incisors increased when more First permanent molars (FPMs were affected. An average of 3.65 teeth was involved per MIH-affected individual. Significantly larger numbers of mandibular FPMs and maxillary central incisors were diagnosed with MIH. The association of dental caries was significantly higher with MIH-affected FPMs. Primary molars and permanent canines and premolars were also showed MIH like lesions in some of the MIH-affected children. Conclusion: MIH was observed in about 10% of the children examined. MIH-affected FPMs appear to be more vulnerable to early caries and subsequent pulp involvement with need for extensive dental treatment.

  10. Odontogenic Tumors: A 13-year Retrospective Study of 395 Cases in a South Indian Teaching Institute of Kerala

    Directory of Open Access Journals (Sweden)

    Deepak Pandiar

    2015-07-01

    Full Text Available Objective: T he aim o f the present study was to determine the epidemiology and clinicopathological presentation of odonto­ genic tumors (OTs seen in a Government Teaching Institute from Kozhikode district of Kerala (South India, over a period of 13 years and to compare the data obtained with previous reports published in literature from different world population. Study design: Records of the Oral Pathology and Microbio logy, Government Dental College, Kozhikode (Kerala, South India, were analyzed during a period of 13 years and reclassified accor- ding to World Health Organization (WHO 2005 Classification. Results: A total of 6.08% of odontogenic tumors were reported out of which (96.7% were benign and (3.3% were malignant. Keratocystic odontogenic tumor (35.9% was the most frequent type, followed by ameloblastoma (25.9%, calcifying cystic odonto genic tumor (10.6% , and odontoma (8.9%. The mean age was 32.69 ± 17.2 7, and males were more commonly affected. Conclusion: A marked geographic and demographic variation was observed in the relative frequency of various odontogenic tumors in the South Indian population which stresses upon the influence of genetic and/or environmental (epigenetic factors on tumor pathogenesis.

  11. Is the igeneration a 'we' generation? Social networking use among 9- to 13-year-olds and belonging.

    Science.gov (United States)

    Quinn, Sally; Oldmeadow, Julian A

    2013-03-01

    Research suggests that online communication is associated with increased closeness to friends and friendship quality. Children under 13 years of age are increasingly using social networking sites (SNSs), but research with this younger age group is scarce. This study examined the relationship between SNS use and feelings of belonging among children aged 9-13 years. A self-report questionnaire was administered to 443 children (48.98% boys), asking about their SNS use and their sense of belonging to their friendship group. SNS users reported a stronger sense of belonging to their friendship group than non-users, but this was found only among older boys. Furthermore, among boy SNS users, a positive linear relationship was found between the intensity of usage and feelings of belonging. No significant relationships were found for girls. These findings suggest that boys who use these sites are gaining friendship benefits over and above those boys who are non-users or low-intensity users. Longitudinal studies should investigate the causal relationships between SNS use and social effects within this age group. PMID:23331112

  12. Chernobyl, 13 years after

    International Nuclear Information System (INIS)

    This is an annual report, regularly issued by IPSN, that presents the ecological and health consequences of the Chernobyl Nuclear Accident. The present status of the Chernobyl Nuclear Plant, which Ukraine engaged to stop definitively in year 2000, is summarized. The only reactor unit now in operation is Chernobylsk-3 Reactor which poses two safety questions: evolution of cracks in part of the tubing and behaviour of the pressure tubes. Although, some improvements in the RBMK reactor types were introduced, problems remain that make IPSN to stress the requirement of stopping this NPP completely. In the contaminated territories surrounding Chernobyl incidence rate of infant thyroid cancers continues to grow, reaching values 10 to 100 times higher than the natural rate. In France the IPSN analyzed 60,000 records carried out in 17 sites during May 1986 and April 1989. It was estimated that the individual dose received during 60 years (1986-2046) by the inhabitants of the most affected zone (eastern France) is lower than 1.5 mSv, a value lower than 1% of the natural cosmic and telluric radioactivity exposure for the same period. For the persons assumed to live in the most attacked forests (from eastern France) and nourishing daily with venison and mushrooms the highest estimate is 1 mSv a year. Concerning the 'hot spots', identified in mountains by IPSN and CRIIRAD, the doses received by excursionists are around 0.015 mSv. For an average inhabitant of the country the dose piled up in the thyroid due to iodine-131 fallout is estimated to 0.5-2 mSv for an adult and 6.5-16 mSv for an infant. These doses are 100 to 1000 times lower than the ones to which the infants living in the neighbourhood of Chernobyl are exposed to. The contents of the report is displayed in the following six chapters: 1. Chernobyl in some figures; 2. The 'sarcophagus' and the reactors of the Chernobyl NPP; 3. Health consequences of the Chernobyl accident;. 4. The impact of Chernobyl fallout in France; 5. Chernobyl's environment and the management of contaminated territories.; 6. The French-German initiative for Chernobyl

  13. CCDB 13 years on

    CERN Document Server

    Ferran, G

    2000-01-01

    The Computer Centre DataBase (CCDB) has been in operation for over thirteen years. This paper discusses how the project was initiated, the structure of the database and its interfaces and services, and how it has evolved from the time of mainframe computing to today's situation of highly inter-related distributed computer services. The primary CCDB services provided include management of computer services, accounts, e-mail addresses and e-mail routing, resources (such as CPU, disk space) and provision of data for the division's information dissemination tools such as xwho, phone and phonebook. It feeds data to these tools and many other database applications CERN-wide and uses/provides data from/to HR (Human Resources) and Landb (IT networking database).

  14. Development of Emotion Word Comprehension in Chinese Children from 2 to 13 Years Old: Relationships with Valence and Empathy.

    Science.gov (United States)

    Li, Yanwei; Yu, Dongchuan

    2015-01-01

    Children's emotion word comprehension (EWC) has constantly received a great deal of attention in developmental science. However, since previous reports focused on only English emotion vocabulary, researchers thus far remained unclear as to the developmental trajectories of EWC (to Chinese emotion words) in Chinese children, let alone the cross-cultural difference of EWC in different languages (i.e., English V.S. Chinese). Furthermore, the influence of valence on EWC, as well as the interaction mechanism between EWC and empathy, has not been fully investigated. Finding answers to these research gaps has become the main motivation of the current study. For this purpose, a Chinese emotion vocabulary was first constructed to estimate EWC of Chinese children (ages 2-13 years old). Then, the valence of each emotion word was evaluated using the standard 9-point scale approach. After that, the Chinese children's EWC and empathy were measured in terms of parental ratings. Finally, all data collected were statistically analyzed to reveal the influence of the valence of EWC, the relation between EWC and empathy, and the cross-cultural difference of children's EWC between China and UK from the viewpoint of developmental science. The main results of the current study included the following: (i) EWC in general increased with age for Chinese children ages 2-13 years old, however, there was a dramatic increase during ages 6-8 years old; (ii) EWC of positive emotion words in general developed better than that of negative and neutral ones for Chinese children (ages 2-13 years old); and the disadvantage of EWC to negative emotion words over neutral ones was gradually observed with the increase of age, even though there were no significant differences between them from the beginning; (iii) EWC completely mediated the effect of age on empathy; and (iv) EWC of children in UK developed better than Chinese counterparts during the early childhood period (ages 4-6 years old), then Chinese

  15. Development of Emotion Word Comprehension in Chinese Children from 2 to 13 Years Old: Relationships with Valence and Empathy.

    Science.gov (United States)

    Li, Yanwei; Yu, Dongchuan

    2015-01-01

    Children's emotion word comprehension (EWC) has constantly received a great deal of attention in developmental science. However, since previous reports focused on only English emotion vocabulary, researchers thus far remained unclear as to the developmental trajectories of EWC (to Chinese emotion words) in Chinese children, let alone the cross-cultural difference of EWC in different languages (i.e., English V.S. Chinese). Furthermore, the influence of valence on EWC, as well as the interaction mechanism between EWC and empathy, has not been fully investigated. Finding answers to these research gaps has become the main motivation of the current study. For this purpose, a Chinese emotion vocabulary was first constructed to estimate EWC of Chinese children (ages 2-13 years old). Then, the valence of each emotion word was evaluated using the standard 9-point scale approach. After that, the Chinese children's EWC and empathy were measured in terms of parental ratings. Finally, all data collected were statistically analyzed to reveal the influence of the valence of EWC, the relation between EWC and empathy, and the cross-cultural difference of children's EWC between China and UK from the viewpoint of developmental science. The main results of the current study included the following: (i) EWC in general increased with age for Chinese children ages 2-13 years old, however, there was a dramatic increase during ages 6-8 years old; (ii) EWC of positive emotion words in general developed better than that of negative and neutral ones for Chinese children (ages 2-13 years old); and the disadvantage of EWC to negative emotion words over neutral ones was gradually observed with the increase of age, even though there were no significant differences between them from the beginning; (iii) EWC completely mediated the effect of age on empathy; and (iv) EWC of children in UK developed better than Chinese counterparts during the early childhood period (ages 4-6 years old), then Chinese

  16. Development of Emotion Word Comprehension in Chinese Children from 2 to 13 Years Old: Relationships with Valence and Empathy.

    Directory of Open Access Journals (Sweden)

    Yanwei Li

    Full Text Available Children's emotion word comprehension (EWC has constantly received a great deal of attention in developmental science. However, since previous reports focused on only English emotion vocabulary, researchers thus far remained unclear as to the developmental trajectories of EWC (to Chinese emotion words in Chinese children, let alone the cross-cultural difference of EWC in different languages (i.e., English V.S. Chinese. Furthermore, the influence of valence on EWC, as well as the interaction mechanism between EWC and empathy, has not been fully investigated. Finding answers to these research gaps has become the main motivation of the current study. For this purpose, a Chinese emotion vocabulary was first constructed to estimate EWC of Chinese children (ages 2-13 years old. Then, the valence of each emotion word was evaluated using the standard 9-point scale approach. After that, the Chinese children's EWC and empathy were measured in terms of parental ratings. Finally, all data collected were statistically analyzed to reveal the influence of the valence of EWC, the relation between EWC and empathy, and the cross-cultural difference of children's EWC between China and UK from the viewpoint of developmental science. The main results of the current study included the following: (i EWC in general increased with age for Chinese children ages 2-13 years old, however, there was a dramatic increase during ages 6-8 years old; (ii EWC of positive emotion words in general developed better than that of negative and neutral ones for Chinese children (ages 2-13 years old; and the disadvantage of EWC to negative emotion words over neutral ones was gradually observed with the increase of age, even though there were no significant differences between them from the beginning; (iii EWC completely mediated the effect of age on empathy; and (iv EWC of children in UK developed better than Chinese counterparts during the early childhood period (ages 4-6 years old, then

  17. Prevalence of skin changes in diabetes mellitus and its correlation with internal diseases: A single center observational study

    Directory of Open Access Journals (Sweden)

    Kaushik Ghosh

    2015-01-01

    Full Text Available Background and Aim: This single-center observational cross-sectional study has been done in an attempt to find out the prevalence of various skin manifestations in diabetes patients (DM and their correlation with diabetes control and complications. Materials and Methods: Skin manifestations present over 12 months among those attend diabetes clinic were included in the study. Apart from demographic data and type, patients were also screened for micro vascular complications and control of diabetes over last 3 months. Results and Discussion: Sixty (n = 60 diabetes patisents (Type 1 DM, 9 patients and Type 2 DM 51 patients have been found to have various skin lesions. Thirty-one (51.67% patients presented with infectious conditions, vascular complications were present in 21 (35% and dermatomes belonging to the miscellaneous group were present in 50 (83.33% patients. Pyoderma, diabetic dermopathy, and pruritus without skin lesions were found to be most common manifestations in infective, vascular and miscellaneous group, respectively. Higher level of HB1 AC was found in patient with diabetic bulla (10.5 ± 0, scleredema (9.75 ± 0.77, lichen planus (9.3 ± 1.6, and acanthosis nigricans (9.15 ± 0.89. Patients with psoriasis and vitiligo had statistically significant lower level of glycosylated hemoglobin (P =< 0.001 and 0.03, respectively. However, no association of any kind of skin manifestation with DM with other microangiopathic complications was found in this study.

  18. Validation of four different risk stratification models in patients undergoing heart valve surgery in a single center in China

    Institute of Scientific and Technical Information of China (English)

    ZHANG Chun-xiao; XU Jian-ping; GE Yi-peng; WEI Yu; YANG Yan; LIU Feng; SHI Yi

    2011-01-01

    Background Several risk stratification models have been developed for cardiac surgery. This study aimed to evaluate the accuracy of four existing risk stratification models, the Fuwai System for Cardiac Operative Risk Evaluation (FuwaiSCORE), the Society of Thoracic Surgeons 2008 cardiac surgery risk model for isolated valve surgery (the STS model), the European System for Cardiac Operative Risk Evaluation (EuroSCORE) and the initial Parsonnet's score (the Parsonnet model) in predicting prolonged intensive care unit (ICU) stay in Chinese patients undergoing heart valve surgery. Methods Data were collected retrospectively from records of 1333 consecutive patients who received heart valve surgery in a single center between November 2006 and December 2007. Prolonged ICU stay was defined as not less than 124 hours. Calibration was assessed using the Hosmer-Lemeshow (H-L) goodness of fit test. Discrimination was assessed using the receiver-operating-characteristic (ROC) curve area. Results The FuwaiSCORE showed good calibration and discrimination compared with other risk models. According to the H-L statistics, the value of the FuwaiSCORE was 12.82, P>0.1. The area under ROC curve of the FuwaiSCORE was 0.81 (95%C/0.78-0.84). Conclusions Our study suggests that the FuwaiSCORE is superior to the other three risk models in predicting prolonged length of ICU stay in Chinese patients with heart valve surgery. Having fewer variables, the system is much easier for bedside use than other systems.

  19. Urinary tract infection in children after cardiac surgery: Incidence, causes, risk factors and outcomes in a single-center study.

    Science.gov (United States)

    Kabbani, Mohamed S; Ismail, Sameh R; Fatima, Anis; Shafi, Rehana; Idris, Julinar A; Mehmood, Akhter; Singh, Reetam K; Elbarabry, Mahmoud; Hijazi, Omar; Hussein, Mohamed A

    2016-01-01

    Nosocomial urinary tract infection (UTI) increases hospitalization, cost and morbidity. In this cohort study, we aimed to determine the incidence, risk factors, etiology and outcomes of UTIs in post-operative cardiac children. To this end, we studied all post-operative patients admitted to the Pediatric Cardiac Intensive Care Unit (PCICU) in 2012, and we divided the patients into two groups: the UTI (UTI group) and the non-UTI (control group). We compared both groups for multiple peri-operative risk factors. We included 413 children in this study. Of these, 29 (7%) had UTIs after cardiac surgery (UTI group), and 384 (93%) were free from UTIs (control group). All UTI cases were catheter-associated UTIs (CAUTIs). A total of 1578 urinary catheter days were assessed in this study, with a CAUTI density rate of 18 per 1000 catheter days. Multivariate logistic regression analysis demonstrated the following risk factors for CAUTI development: duration of urinary catheter placement (pcongenital abnormalities of kidney and urinary tract (CAKUT) (purinary catheter, the presence of CAKUT, and the presence of syndromes comprised the main risk factors for CAUTI. Gram-negative organisms were the main causes for CAUTI, and one-third of them found to be resistant in this single-center study. PMID:26829892

  20. Polyethylene Glycol Electrolyte Lavage Solution versus Colonic Hydrotherapy for Bowel Preparation before Colonoscopy: A Single Center, Randomized, and Controlled Study

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    Yan Cao

    2014-01-01

    Full Text Available This single center, randomized, and controlled study aimed to compare the effectiveness and safety of polyethylene glycol electrolyte lavage (PEG-EL solution and colonic hydrotherapy (CHT for bowel preparation before colonoscopy. A total of 196 eligible outpatients scheduled for diagnostic colonoscopy were randomly assigned to the PEG-EL (n=102 or CHT (n=94 groups. Primary outcome measures included colonic cleanliness and adverse effects. Secondary outcome measures were patient satisfaction and preference, colonoscopic findings, ileocecal arrival rate, examiner satisfaction, and cecal intubation time. The results show that PEG-EL group was associated with significantly better colonic cleanliness than CHT group, fewer adverse effects, and increased examiner satisfaction. However, the CHT group had higher patient satisfaction and higher diverticulosis detection rates. Moreover, the results showed the same ileocecal arrival rate and patient preference between the two groups (P>0.05. These findings indicate that PEG-EL is the preferred option in patients who followed the preparation instructions completely.

  1. Attachment-Based Family Therapy With a 13-Year-Old Girl Presenting With High Risk for Suicide.

    Science.gov (United States)

    Krauthamer Ewing, E Stephanie; Levy, Suzanne A; Boamah-Wiafe, Linda; Kobak, Roger; Diamond, Guy

    2016-01-01

    This article describes the application of Attachment-Based Family Therapy (ABFT) to the treatment of a 13-year-old female adolescent presenting with high risk of suicide, complicated by a history of depression and sexual trauma. The article begins with an overview of ABFT, including (a) how attachment theory guides treatment; (b) the structure of the clinical model; and (c) the data that provide empirical support. A case example is then presented that exemplifies the primary clinical procedures used to reach therapeutic goals in ABFT, including attachment repair and autonomy/competence promotion. Weekly changes in suicide ideation and depression scores are presented. The article concludes with a discussion about implications for family-based treatment of suicidal youth. PMID:25329356

  2. Reciprocal relations between body satisfaction and self-esteem: A large 13-year prospective study of adolescents.

    Science.gov (United States)

    Wichstrøm, Lars; von Soest, Tilmann

    2016-02-01

    Previous research has demonstrated that body satisfaction and self-esteem are highly correlated in adolescence, but reasons are poorly understood. We tested three explanations: (i) the two constructs are actually one; (ii) the correlation is explained by a third factor; (iii) there are prospective relationships between body satisfaction and self-esteem. A population based sample of Norwegian adolescents (n = 3251) was examined four times over a 13-year period. Confirmatory factor analysis showed that body satisfaction and self-esteem were separate constructs and the correlation between them was not attenuated when adjusting for 3rd variables. Autoregressive cross-lagged analysis showed reciprocal relations between body satisfaction and self-esteem. The prospective relationship between body satisfaction during adolescence and self-esteem in late adolescence and emerging adulthood was stronger than at later stages.

  3. Clinical evaluation of a lumbar interspinous dynamic stabilization device (the Wallis system) with a 13-year mean follow-up.

    Science.gov (United States)

    Sénégas, Jacques; Vital, Jean-Marc; Pointillart, Vincent; Mangione, Paolo

    2009-07-01

    The authors determined current health status of patients who had been included in a long-term survivorship analysis of a lumbar dynamic stabilizer. Among 133 living patients, 107 (average age at surgery, 44.2 +/- 9.9 years) completed health questionnaires. All patients had initially been scheduled for decompression and fusion for canal stenosis, herniated disc, or both. In 20 patients, the implant was removed, and fusion was performed. The other 87 still had the dynamic stabilizer. Satisfaction, Oswestry disability index, visual analog scales for back and leg pain, short-form (SF-36) quality-of-life physical composite score, physical function, and social function were significantly better (p stabilization device. SF-36 scores of the fused subgroup were no worse than those reported elsewhere in patients who had primary pedicle-screw enhanced lumbar fusion. This anatomy-sparing device provided a good 13-year clinical outcome and obviated arthrodesis in 80% of patients.

  4. Relationship and significance of serum leptin with blood insulin and lipid in 6-13 years old obese children

    International Nuclear Information System (INIS)

    To explore relationship and significance of Serum Leptin with BMI, Insulin, triglyceride (TG) and total cholesterol (TC) in obese children aged 6-13 years. Serum Leptin of school-age children 118 (64 male, 54 female; normal non-obese 56 and obese 62) were deter- mined and compared with BMI, Insulin, TG and TC. The results showed that: (1) Each index of obese children was remarkably higher than that of non-obese children (P0.05). (3) Leptin was poritinely corelation with BMI, insulin, TG and TC(P=0.001). Leptin level in serum may varied according to sex, BMI or blood lipid level. It is of great significance in prevention and treatment of obesity to use drug which may improve Leptin receptor effect. (authors)

  5. Maximum bite force at age 70 years predicts all-cause mortality during the following 13 years in Japanese men.

    Science.gov (United States)

    Iwasaki, M; Yoshihara, A; Sato, N; Sato, M; Taylor, G W; Ansai, T; Ono, T; Miyazaki, H

    2016-08-01

    There is limited information on the impact of oral function on mortality among older adults. The aim of this prospective cohort study was to examine whether an objective measure of oral function, maximum bite force (MBF), is associated with mortality in older adults during a 13-year follow-up period. Five hundred and fifty-nine community-dwelling Japanese (282 men and 277 women) aged 70 years at baseline were included in the study. Medical and dental examinations and a questionnaire survey were conducted at baseline. Maximum bite force was measured using an electronic recording device (Occlusal Force-Meter GM10). Follow-up investigation to ascertain vital status was conducted 13 years after baseline examinations. Survival rates among MBF tertiles were compared using Cox proportional hazards regression models stratified by sex. There were a total of 111 deaths (82 events for men and 29 for women). Univariable analysis revealed that male participants in the lower MBF tertile had increased risk of all-cause mortality [hazard ratio (HR) = 1·94, 95% confidence interval (CI) = 1·13-3·34] compared with those in the upper MBF tertile. This association remained significant after adjustment for confounders (adjusted HR = 1·84, 95% CI = 1·07-3·19). Conversely, no association between MBF and all-cause mortality was observed in female participants. Maximum bite force was independently associated with all-cause mortality in older Japanese male adults. These data provide additional evidence for the association between oral function and geriatric health. PMID:27084614

  6. Family and home correlates of television viewing in 12–13 year old adolescents: The Nepean Study

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    Crawford David

    2006-09-01

    Full Text Available Abstract Background Few young people meet television viewing guidelines. Purpose To determine the association between factors in the family and home environment and watching television, including videos and DVDs, in early adolescence. Methods Cross-sectional, self-report survey of 343 adolescents aged 12–13 years (173 girls, and their parents (338 mothers, 293 fathers. Main measures were factors in the family and home environment potentially associated with adolescents spending ≥ 2 hours per day in front of the television. Factors examined included family structure, opportunities to watch television/video/DVDs, perceptions of rules and regulations on television viewing, and television viewing practices. Results Two-thirds of adolescents watched ≥ 2 hours television per day. Factors in the family and home environment associated with adolescents watching television ≥ 2 hours per day include adolescents who have siblings (Adjusted Odds Ratio [95%CI] AOR = 3.0 [1.2, 7.8]; access to pay television (AOR = 2.0 [1.1, 3.7]; ate snacks while watching television (AOR = 3.1 [1.8, 5.4]; co-viewed television with parents (AOR = 2.3 [1.3, 4.2]; and had mothers who watched ≥ 2 hours television per day (AOR = 2.4 [1.3, 4.6]. Conclusion There are factors in the family and home environment that influence the volume of television viewed by 12–13 year olds. Television plays a central role in the family environment, potentially providing a means of recreation among families of young adolescents for little cost. Interventions which target family television viewing practices and those of parents, in particular, are more likely to be effective than interventions which directly target adolescent viewing times.

  7. Oral cleanliness of 12-13-year-old and 15-year-old school children of Sunsari District, Nepal

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    Yee R

    2006-09-01

    Full Text Available The aim of the study was to evaluate the oral cleanliness of school children in the District of Sunsari, Nepal. A multi-stage random sampling oral epidemiological survey was conducted in private and government, urban, rural town and rural village schools in 15 illakas of Sunsari District, Eastern Nepal. A total of 600, 12-13-year-old and 600 15-year-old school children were examined by trained examiners using the simplified oral hygiene index (OHI-S. The average age-group, debris and calculus index scores were combined to obtain the simplified oral hygiene index (OHI-S. The mean OHI-S scores were compared and evaluated using the parametric t-test for two independent samples. The mean OHI-S for urban 12-13-year-old school children was 0.98 compared to 1.34 for school children of rural towns and 1.44 for school children of rural villages and these differences in mean OHI-S were statistically significant ( P < 0.005. In the 15-year-old age group, urban school children had a mean OHI-S score of 1.00 compared to 1.37 for rural towns and 1.43 for rural villages. The variance in the mean OHI-S scores were statistically significant ( P < 0.005. The overall level of cleanliness in the school children surveyed was good. Children of urban schools had the lowest scores followed by school children from rural towns and then rural villages. When the mean OHI-S scores were compared with the DMFT scores, there was an inverse relationship between oral cleanliness and dental caries. Frequency of sugar consumption and the availability and affordability of fluoridated toothpaste may be important factors in the development of dental caries than oral cleanliness.

  8. Clinical profile and outcome of acute kidney injury related to pregnancy in developing countries: a single-center study from India.

    Science.gov (United States)

    Godara, Suraj M; Kute, Vivek B; Trivedi, Hargovind L; Vanikar, Aruna V; Shah, Pankaj R; Gumber, Manoj R; Patel, Himanshu V; Gumber, Vandana M

    2014-07-01

    Acute kidney injury (AKI) is one of the most challenging and serious complications of pregnancy. We present our experience on the clinical profile and outcome of 57 patients with pregnancy-related AKI, of a total of 580 patients with AKI seen during the study period. This is a prospective single-center study in a civil hospital conducted from January to December 2010. The most common age group of the study patients was 20-25 years; 43.8% of the patients had received antenatal care. AKI was observed in the puerperium (n = 34), early pregnancy (n = 10) and late pregnancy (n = 13). The cause of AKI included puerperal sepsis (63.1%), pregnancy-induced hypertension (PIH) (33.33%), post-abortion (22.80%), ante-partum hemorrhage (APH) (14%) and post-partum hemorrhage (PPH) (8%). Complete, partial and no renal recovery was observed in 52.64%, 21.05% and 26.31% of the patients, respectively. Low platelet count and plasma fibrinogen and high bilirubin, D-dimer and activated partial thromboplast in time were observed more commonly in patients with partial recovery. Of the 57 patients, 50 received hemodialysis, three received peritoneal dialysis and seven patients were managed conservatively. A total of 13 patients developed cortical necrosis that was associated with sepsis in six, PPH and pre-eclampsia/eclampsia in three patients each and APH in one. Nine patients died, and the cause of death was septicemia in four, pre-eclampsia in three and APH and PPH in one patient each. In our study, puerperal sepsis was the most common etiological factor for pregnancy-related AKI. Prolonged oliguria or anuria were bad prognostic factors for renal recovery. Sepsis, thrombocytopenia, disseminated intra-vascular coagulation and liver involvement were associated with increased mortality. PMID:24969215

  9. Clinical profile and outcome of acute kidney injury related to pregnancy in developing countries: A single-center study from India

    Directory of Open Access Journals (Sweden)

    Suraj M Godara

    2014-01-01

    Full Text Available Acute kidney injury (AKI is one of the most challenging and serious complications of pregnancy. We present our experience on the clinical profile and outcome of 57 patients with pregnancy-related AKI, of a total of 580 patients with AKI seen during the study period. This is a prospective single-center study in a civil hospital conducted from January to December 2010. The most common age group of the study patients was 20-25 years; 43.8% of the patients had received antenatal care. AKI was observed in the puerperium (n = 34, early pregnancy (n = 10 and late pregnancy (n = 13. The cause of AKI included puerperal sepsis (63.1%, pregnancy-induced hypertension (PIH (33.33%, post-abortion (22.80%, ante-partum hemorrhage (APH (14% and post-partum hemorrhage (PPH (8%. Complete, partial and no renal recovery was observed in 52.64%, 21.05% and 26.31% of the patients, respectively. Low platelet count and plasma fibrinogen and high bilirubin, D-dimer and activated partial throm-boplastin time were observed more commonly in patients with partial recovery. Of the 57 patients, 50 received hemodialysis, three received peritoneal dialysis and seven patients were managed conserva-tively. A total of 13 patients developed cortical necrosis that was associated with sepsis in six, PPH and pre-eclampsia/eclampsia in three patients each and APH in one. Nine patients died, and the cause of death was septicemia in four, pre-eclampsia in three and APH and PPH in one patient each. In our study, puerperal sepsis was the most common etiological factor for pregnancy-related AKI. Prolonged oliguria or anuria were bad prognostic factors for renal recovery. Sepsis, thrombocytopenia, disseminated intra-vascular coagulation and liver involvement were associated with increased mortality.

  10. PRIMARY NOCTURNAL ENURESIS IN CHILDREN WITH ALLERGIC RHINITIS AND SEVERE ADENOTONSILLAR HYPERTROPHY: A SINGLE CENTER PILOT STUDY.

    Science.gov (United States)

    Chimenz, R; Manti, S; Fede, C; Stroscio, G; Visalli, C; Nicotera, A; Di Rosa, G; Romeo, A C; Salpietro, V; Cuppari, C

    2015-01-01

    Nocturnal enuresis is defined as intermittent urinary incontinence during sleep that occurs at least twice a week for three consecutive months. There is no unifying etiology for nocturnal enuresis in the pediatric population and the disorder is likely to be multifactorial. We aimed to investigate the relationship between primary nocturnal enuresis, allergic rhinitis, and related complications in a paediatric case series from a single Center. We retrospectively reviewed and prospectively followed-up at our Institution (i) 32 children (14 females, 18 males; mean age 6.31±1.21 yrs) affected by allergic rhinitis with adenoidal hypertrophygrade I-II (group A) and (ii) 27 children (11 females, 16 males; mean age 6.52±1.33 yrs) affected by allergic rhinitis with adenoidal hypertrophy grade III-IV (group B). Allergic rhinitis was diagnosed on the basis of (a) typical nasal symptoms due to atopic sensitization (e.g., rhinorrhea , itching, sneezing fits, and nasal congestion and obstruction) and (b) positive skin prick testing and/or increased level of total serum IgE. We identified discrepancies between group A and group B in terms of risk of primary nocturnal enuresis. In fact, only 1 child of group A (3.12%) reported uncomplicated primary nocturnal enuresis; conversely, 6 children of group B (22.22%) showed a history of uncomplicated primary nocturnal enuresis (p=0.040). There was no statistically significant difference between the two groups in terms of atopic sensitization and serum total IgE levels (p=0.43). Allergic rhinitis may potentially influence the onset and the natural history of nocturnal enuresis in some children. Children with allergic rhinitis and more severe respiratory manifestations, seem to be more prone to developing primary nocturnal enuresis, likely due to potential multi-factorial causes (e.g., sleep disorders, chronic phlogosis, immune deregulation).

  11. Hepatitis B virus is still the most common etiologic factor of liver cirrhosis: Results from a single center in Turkey

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    Sebahat Başyigit

    2015-12-01

    Full Text Available Objective: It is important to examine the epidemiology of liver cirrhosis (LC because of it is a preventable disease. In this single-center study, we aimed to determine the epidemiological characteristics and etiology of LC in Central Anatolian region of Turkey. Methods: We reviewed data of patients with liver cirrhosis who presented to outpatient and inpatient clinics of our medical center between January 1, 2011 and September 31, 2014 Results: Overall, 135 patients were included to the study: 91 men (67.4% and 44 women (33% with a mean age of 63±14,3 years (range: 15–87years. The primary causes of cirrhosis were chronic hepatitis B (CHB (n: 52, 38.5% and cryptogenic cirrhosis (n: 33, 24.4%. CHB was the main etiology of cirrhosis in men (49.5% and cryptogenic LC was predominant in women (40.9%. Patients with alcoholic cirrhosis were solely male. Percentage of patients with autoimmune hepatitis was significantly higher among women (70%. The percentage of patients with HBV was similar between patients aged50 years (31.6% and 39.7%, respectively, but percentage of patients with hepatitis C virus was lower (5.3% in patients aged50 years (14.7%. There was no cirrhotic patients under 50 years of age due to a genetic disorder Conclusion: Despite national vaccination program, effective treatment regimens and intensive screening methods against hepatitis B virus, it remains to be the most common cause of LC in our country.

  12. Clinical manifestations of autoimmune disease-related non-Hodgkin lymphoma: a Korean single-center, retrospective clinical study

    Science.gov (United States)

    Jeon, Young-Woo; Yoon, Jae-Ho; Lee, Sung-Eun; Eom, Ki-Seong; Kim, Yoo-Jin; Kim, Hee-Je; Lee, Seok; Min, Chang-Ki; Lee, Jong Wook; Min, Woo-Sung; Cho, Seok-Goo

    2016-01-01

    Background/Aims: Recently, large cohort studies regarding associations between autoimmune disease and lymphomas have been reported in a few Western countries. However, Asian data concerning autoimmune-related lymphomas are limited. Therefore, we evaluated the clinical characteristics and prognostic factors of patients with autoimmune disease-related non-Hodgkin lymphoma (NHL) in a single center in Korea. Methods: We analyzed the data from 11 patients with autoimmune-related NHL. Patients were categorized into two groups, those with rheumatoid arthritis (RA) and those with non-RA-related NHL. Then patients were re-categorized into a group with methotrexate (MTX) usage and a MTX non-usage group. Histological subtype, MTX duration, autoimmune disease duration, treatment modalities, and other data were collected and analyzed. Results: Our study revealed that older RA patients have a greater likelihood of occurrence of NHL (p = 0.042). We confirmed that MTX duration and cumulative dose of MTX have no significant correlation with autoimmune disease and NHL (p = 0.073). In the management of autoimmune disease-related NHL, all patients were directly treated with systemic chemotherapy instead of employing a wait and watch approach. Overall survival (OS) and progression-free survival (PFS) in all autoimmune disease-related NHL were 100% and 87.5%, with no treatment-related mortality during the 2-year follow-up period of our study. Conclusions: Our study suggests that patients with RA-NHL are characterized by older age at onset compared to those with non-RA-NHL. Also considering of OS and PFS, intensive treatment strategy instead of delayed watchful managements may be required for autoimmune disease-related NHL including of old age group. PMID:27384438

  13. Single-center open-label randomized study of anemia management improvement in ESRD patients with secondary hyperparathyroidism

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    Bellasi Antonio

    2016-04-01

    Full Text Available Whether anemia and mineral bone abnormalities (chronic kidney disease–mineral bone disorder [CKD-MBD] are associated still remains to be elucidated. Both anemia and CKD-MBD have been associated with adverse cardiovascular outcome and poor quality of life. However, recent evidence suggests that use of large doses of erythropoietin-stimulating agents (ESAs to correct hemoglobin (Hb may be detrimental in CKD. The Optimal Anemia Treatment in End Stage Renal Disease (ESRD (Optimal ESRD Treatment study will assess whether lowering of parathyroid hormone (PTH is associated with a reduction in ESA consumption. The Optimal ESRD Treatment study is a pilot single-center open-label study with blinded end point (a prospective randomized open blinded end-point [PROBE] design enrolling 50 patients on maintenance dialysis. Eligible patients with intact PTH (iPTH 300-540 pg/mL and Hb 10-11.5 g/dL will be randomized 1:1 to strict PTH control (150-300 pg/mL versus standard care (PTH range 300-540 pg/mL. Available drugs for CKD-MBD and anemia treatment will be managed by the attending physician to maintain the desired levels of PTH (according to study arm allocation and Hb (10-11.5 g/dL. Echocardiographic data for cardiac structure and function as well as arterial stiffness will be assessed at study inception and completion. The Optimal ESRD Treatment study should shed light on the complicated interplay of anemia and CKD-MBD and on the feasibility of clinical trials in this domain. The study results are expected in the spring of 2017.

  14. Quality of life after pertrochanteric femoral fractures treated with a gamma nail: a single center study of 62 patients

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    Giessauf Christian

    2012-10-01

    Full Text Available Abstract Background Intramedullary nailing of pertrochanteric femoral fractures has grown in popularity over the past 2 decades likely because this procedure is associated with a low risk for postoperative morbidity and a fast recovery of function. The evaluation of outcomes associated with pertrochanteric nailing has mainly been based on objective measures. The purpose of the present study is to correlate patients’ health-related quality of life results after intramedullary nailing of pertrochanteric fractures with objective outcome measures. Methods We conducted a single-center study including 62 patients (mean age 80 ± 10 years with pertrochanteric fractures treated with a Gamma 3 Nail. Health related quality of life was measured using the Short Form-36. These results were compared to both US and Austrian age and sex-adjusted population norms. The objective outcome measures studied at one year postoperatively included Harris Hip Score, range of motion, leg length, body mass index, neck-shaft angle and grade of osteoarthritis. Results According to the Harris Hip Score 43 patients (67% had excellent or good results. There was no significant difference in the average neck-shaft angle comparing affected hip to non-affected hip at 12 months postoperatively. The average osteoarthritis score, for both the injured and uninjured hip, did not differ significantly. We found significant differences between the bodily pain, social functioning and mental health subscales and two summary scores of the Short-Form 36 in comparison to Austrian population norms. Complication rate was 8%. Conclusions The results of this study confirm that intramedullary nailing with the use of a Gamma Nail is a safe treatment option for stable and unstable pertrochanteric fractures. Despite good functional and radiographic results we noticed a substantial fall off in patients’ quality of life up to 12 months after operation.

  15. Non-Hodgkin′s lymphoma "masquerading" as Pott′s disease in a 13-year old boy

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    Olasunkanmi Abdulrasheed Adegboye

    2011-01-01

    Full Text Available Lymphomas are malignant neoplasms of the lymphoid lineage. They are broadly classified as either Hodgkin disease or as non-Hodgkin lymphoma (NHL. Burkitt′s lymphoma, a variety of NHL, is significantly most common in sub-Saharan Africa, where it accounts for approximately one half of childhood cancers. Lymphoblastic lymphoma is less common. A case of paravertebral high grade non-Hodgkin′s lymphoma (lymphoblastic lymphoma "masquerading" as Pott′s disease in a 13-year-old child is reported. The present report was informed by the unusual presentation of this case and the intent of increasing the index of diagnostic suspicion. A brief appraisal is provided of the clinical parameters, management strategies and challenges. AT was a 13-year boy that presented on account of a slowly evolving and progressively increasing hunch on the back and inability to walk over 4 and 8 months duration, respectively. There was subsequent inability to control defecation and urination. There was no history of cough. He and his twin brother lived with their paternal grandfather who had chronic cough with associated weight loss. The grandfather died shortly before the child′s admission. The child had no BCG immunization. The essential findings on examination were in keeping with lower motor neurons (LMN paralysis of the lower limbs. The upper limbs appeared normal. There was loss of cutaneous sensation from the umbilicus (T10 downward. There was a firm, (rather tense, non-tender non-pulsatile, smooth swelling over the mid-third of the back (T6-L1 the mass had no differential warmth. It measures about 20×12 cm. Chest radiograph showed no active focal lung lesion, but the thoraco-lumbar spine showed a vertebral planner at L1 and a wedged collapse of T11-T12 vertebrae. There was sclerosis of the end plates of all the vertebral bodies with associated reduction in the bone density. He had an excision biopsy on the 90th day on admission, following which his clinical

  16. Lifetime Paid Work and Mental Health Problems among Poor Urban 9-to-13-Year-Old Children in Brazil

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    Isabel A. Bordin

    2013-01-01

    Full Text Available Objective. To verify if emotional/behavioral problems are associated with lifetime paid work in poor urban children, when taking into account other potential correlates. Methods. Cross-sectional study focused on 9-to-13-year-old children (n=212. In a probabilistic sample of clusters of eligible households (women 15–49 years and son/daughter <18 years, one mother-child pair was randomly selected per household (n=813; response rate = 82.4%. CBCL/6-18 identified child emotional/behavioral problems. Potential correlates include child gender and age, socioeconomic status/SES, maternal education, parental working status, and family social isolation, among others. Multivariate analysis examined the relationship between emotional/behavioral problems and lifetime paid work in the presence of significant correlates. Findings. All work activities were non-harmful (e.g., selling fruits, helping parents at their small business, and baby sitting. Children with lower SES and socially isolated were more involved in paid work than less disadvantaged peers. Children ever exposed to paid work were four times more likely to present anxiety/depression symptoms at a clinical level compared to non-exposed children. Multivariate modeling identified three independent correlates: child pure internalizing problems, social isolation, and low SES. Conclusion. There is an association between lifetime exposure to exclusively non-harmful paid work activities and pure internalizing problems even when considering SES variability and family social isolation.

  17. The effect of Ramadan fasting on thyroid hormones in 9‐13 years old pre‐menarche girls

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    Shohereh Bahrayni

    2013-12-01

    Full Text Available Introduction: Muslims fast from dawn to dusk during Ramadan. The effects of prolonged food deprivation on endocrine hormones have been studied in healthy adults but no previous study has investigated this effect on children. This study aimed to evaluate the feasible changes in serum level of thyroxin (T3, tetraiodothyronin (T4, thyroid stimulating hormone (TSH and body composition in pre-menarche girls. Methods: This cohort study was performed through Ramadan 2012. We enrolled fifty-eight 9-13years old girls (weight 34.20±7.96 kg, height 142.01±7.76 cm in two groups from (31  and 27 in fasted and non-fasted groups, respectively prior to Ramadan until afterwards. Weight and height of the subjects were measured using standard methods, and then Body Mass Index (BMI was calculated.  Body composition was measured using Bio Impedance Analyzer (BIA method.  Serum concentrations of T3, T4 and TSH hormones were measured by Radio Immunoassay (RIA. Paired t-test was used to compare result of each group before and after Ramadan. Independent t-test was used to compare two groups together. Tanner intervention variable was controlled by generalized linear models intervening test. SPSS.11 software was used for data analysis. Results: Ramadan fasting induces a significant decrease in BMI and weight on fasted group (p=0.005, p=0.044, respectively while a significant increase was observed in non-fasted group (p

  18. Hematometra presenting as an acute abdomen in a 13-year-old postmenarchal girl: a case report

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    Klimek Peter

    2012-12-01

    Full Text Available Abstract Introduction Most underlying diseases for abdominal pain in children are not dangerous. However some require rapid diagnosis and treatment, such as acute ovarian torsion or appendicitis. Since reaching a diagnosis can be difficult, and delayed treatment of potentially dangerous diseases might have significant consequences, exploratory laparoscopy is a diagnostic and therapeutic option for patients who have unclear and potentially hazardous abdominal diseases. Here we describe a case where the anomaly could not be identified using a laparoscopy in an adolescent girl with acute abdomen. Case presentation A 13-year old postmenarchal caucasian female presented with an acute abdomen. Emergency sonography could not exclude ovarian torsion. Accurate diagnosis and treatment were achieved only after an initial laparoscopy followed by a laparotomy and after a magnetic resonance imaging scan a further laparotomy. The underlying disease was hematometra of the right uterine horn in a uterus didelphys in conjunction with an imperforate right cervix. Conclusion This report demonstrates that the usual approach for patients with acute abdominal pain may not be sufficient in emergency situations.

  19. Superficial paramucosal clear cell sarcoma of the soft parts resembling melanoma in a 13-year-old boy.

    Science.gov (United States)

    Sidiropoulos, Michael; Busam, Klaus; Guitart, Joan; Laskin, William B; Wagner, Annette M; Gerami, Pedram

    2013-02-01

    Clear cell sarcoma (CCS) of tendons and aponeuroses, also known as melanoma of soft parts, represents an aggressive rare malignancy that is characterized by a nested or fascicular pattern of spindled cells and a pathognomonic reciprocal translocation, t(12;22)(q13;q12), that results in the fusion of EWSR1 and ATF1 genes. Numerous recent studies have recognized the importance of a cutaneous CCS variant that can mimic a broad spectrum of entities, including spindle cell melanoma, spindle cell squamous carcinoma, cutaneous leiomyosarcoma and atypical fibroxanthoma. We report a case of a 13-year-old boy with cutaneous CCS who presented with a few months history of an asymptomatic papule on the lower lip that was suggestive of a mucocele. Biopsy of the lesion showed a wedge shaped neoplasm arranged in nests and fascicles of epithelioid- to oval-shaped cells with pale cytoplasm, open chromatin and prominent nucleolus. The superficial component was closely opposed to the basal epithelium resembling the junctional nests of a melanocytic neoplasm. The process extended into and involved the striated muscle of the lip. The cells expressed S-100, CD99 and synaptophysin by immunohistochemistry, and there was focal HMB-45 and microphthalmia transcription factor (MiTF) positivity as well. Fluorescence in situ hybridization confirmed the presence of the t(12;22) (ESWR1-ATF1) translocation. PMID:23228147

  20. Oral health status and oral hygiene habits among children aged 12-13 years in Yangon, Myanmar.

    Science.gov (United States)

    Phyo, Aung Zaw Zaw; Chansatitporn, Natkamol; Narksawat, Kulaya

    2013-11-01

    We conducted a cross sectional study among children aged 12-13 years in Yongon, Myanmar to assess the oral health status and oral hygiene habits. The studied 220 students were from two high schools, one urban and the other rural. We conducted an oral health examination following WHO criteria and used a self-administrated questionnaire. The prevalence rate of dental caries among the study population was 53.2%. The mean number of decayed, missing and filled teeth (DMFT) was 1.7 +/- 2.1 teeth per person (decayed, 1.5 +/- 1.9); missing 0.0 +/- 0.2; filled, 0.1 +/- 0.4). Multivariate analysis revealed significant risk factors for dental caries were: the geographical location of the school (adjusted OR=2.24; 95% CI: 1.01-4.94), occupational status of the father (adjusted OR=2.83; 95% CI: 1.05-7.62) and the child's attitude about dental caries (adjusted OR=2.35; 95% CI: 1.18-4.67). Knowledge and oral hygiene habits were not associated with dental caries. The results of this study suggest the need to change from restoration orientated dentistry to dental public health care services, to reduce of the high level of dental caries in this age group.

  1. [Diagnosis of mild hemophilia A made by massive intraabdominal bleeding in a 13-year-old boy].

    Science.gov (United States)

    Terao, Yoko; Akiyama, Masaharu; Yokoi, Kentaro; Yamaoka, Masayoshi; Shimizu, Mika; Kato, Yoko; Tanaka, Keiichiro; Baba, Yuji; Kuwashima, Naruo; Ashizuka, Shuichi; Yoshizawa, Jyoji; Motoki, Takanori; Saito, Yoshihiro; Ida, Hiroyuki

    2012-08-01

    We report a 13-year-old boy who had massive intra-abdominal bleeding without a history of bleeding episodes or traumatic cause of bleeding. The patient underwent surgical treatment because bleeding was not controlled after treatment with tranexamic acid and transfusions including fresh-frozen plasma. Bleeding was traced to the lower left lobe of the liver. The mother's side of the family had a history of bleeding episodes in the boy's grandfather, great uncle, and son of a great aunt. A low level of plasma factor VIII coagulant activity (22%) led to a diagnosis of mild hemophilia A. Compared with severe hemophilia, mild hemophilia is more difficult to diagnose because bleeding episodes are less frequent. Most cases are found after incidental trauma or uncontrolled surgery-related bleeding, there is rarely a family history of hemophilia and activated partial thromboplastin time is normal or slightly prolonged. However, bleeding episodes in mild hemophilia may result in excessive, sometimes life-threatening hemorrhage and require early diagnosis and replacement treatment with adequate amounts of factor VIII, as in severe hemophilia. PMID:22975817

  2. Assessing progress in reducing the at-risk population after 13 years of the global programme to eliminate lymphatic filariasis.

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    Pamela J Hooper

    2014-11-01

    Full Text Available In 1997, the World Health Assembly adopted Resolution 50.29, committing to the elimination of lymphatic filariasis (LF as a public health problem, subsequently targeted for 2020. The initial estimates were that 1.2 billion people were at-risk for LF infection globally. Now, 13 years after the Global Programme to Eliminate Lymphatic Filariasis (GPELF began implementing mass drug administration (MDA against LF in 2000-during which over 4.4 billion treatments have been distributed in 56 endemic countries-it is most appropriate to estimate the impact that the MDA has had on reducing the population at risk of LF.To assess GPELF progress in reducing the population at-risk for LF, we developed a model based on defining reductions in risk of infection among cohorts of treated populations following each round of MDA. The model estimates that the number of people currently at risk of infection decreased by 46% to 789 million through 2012.Important progress has been made in the global efforts to eliminate LF, but significant scale-up is required over the next 8 years to reach the 2020 elimination goal.

  3. Dynamics of display of power capabilities for girls 4-13 years of central region of Ukraine

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    Voropay S. M.

    2012-06-01

    Full Text Available The dynamics of display of power capabilities of different muscular groups for girls in ontogenesis is considered. More than 1000 girls of preschool and school establishments were inspected (age 4-13 years. There were taken types of tests in basis of battery of tests: dynamometry of prepotent hand; bending and unbending of hands in support, lying on the floor; hang on arcuated hands; raising of trunk in grey for 1 minute; broad jump and upwards from a place. It is set that speed-power potential of muscles of lower extremities is most expressed shows a tendency to growth for girls 4-7 years. Thus there is an increase speed-power to potential scope from 18% to 67,4% annually. It is set that the most favorable period of display of power endurance of muscles of humeral belt was observed from 6 to 9 years. A general tendency was thus saved to the increase from a year to the year of power potential from 35,5% to 40,6%.

  4. A single-center study evaluating the effect of the controlled adverse environment (CAEsm model on tear film stability

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