Preparing the Surgical Team for a Quick and Efficient Procedure

Author(s):  
David H. Kahat ◽  
Robert F. Laprade
2020 ◽  
Vol 15 (3) ◽  
pp. 250-262
Author(s):  
Maryam Islami ◽  
Fatemeh Soleimanifar

Transplantation of hematopoietic stem cells (HSCs) derived from umbilical cord blood (UCB) has been taken into account as a therapeutic approach in patients with hematologic malignancies. Unfortunately, there are limitations concerning HSC transplantation (HSCT), including (a) low contents of UCB-HSCs in a single unit of UCB and (b) defects in UCB-HSC homing to their niche. Therefore, delays are observed in hematopoietic and immunologic recovery and homing. Among numerous strategies proposed, ex vivo expansion of UCB-HSCs to enhance UCB-HSC dose without any differentiation into mature cells is known as an efficient procedure that is able to alter clinical treatments through adjusting transplantation-related results and making them available. Accordingly, culture type, cytokine combinations, O2 level, co-culture with mesenchymal stromal cells (MSCs), as well as gene manipulation of UCB-HSCs can have effects on their expansion and growth. Besides, defects in homing can be resolved by exposing UCB-HSCs to compounds aimed at improving homing. Fucosylation of HSCs before expansion, CXCR4-SDF-1 axis partnership and homing gene involvement are among strategies that all depend on efficiency, reasonable costs, and confirmation of clinical trials. In general, the present study reviewed factors improving the expansion and homing of UCB-HSCs aimed at advancing hematopoietic recovery and expansion in clinical applications and future directions.


AORN Journal ◽  
2020 ◽  
Vol 113 (1) ◽  
pp. 64-75
Author(s):  
Christopher H. Stucky ◽  
Marla J. De Jong

2021 ◽  
Vol 09 (01) ◽  
pp. e46-e49
Author(s):  
Niveshni Maistry ◽  
Giulia Brisighelli ◽  
Chris Westgarth-Taylor

AbstractWe present a case and discuss the management of a posterior cloacal variant not as yet described in the literature. A 5-week-old infant presented to our institution with a posterior cloacal variant and transposition of the clitoris and labia. After initial radiological investigations, staged operative intervention was performed over a 1-year period. This included an initial laparotomy (with drainage of hydrocolpos and formation of a colostomy), a left ureteric reimplantation and a posterior sagittal anorectoplasty due to a rectoperineal fistula. The child is under continued long-term follow-up by our specialist pediatric surgical team.


Author(s):  
Xun E. Zhang ◽  
Zhi Geng ◽  
Jun Shao ◽  
Hao Yao ◽  
Lu Wang ◽  
...  

Abstract Background Congenital heart disease (CHD) accounts for the most common birth defects in China, pressuring both the physical and mental health in children. The inaccessibility of CHD children in rural China due to financial difficulties is demanding inputs from both the government and society. The Heartguard project is a program developed to improve the delivery of CHD care in rural China. Methods The Heartguard project partners with county hospitals and performs CHD screening to diagnose patients with CHD in rural China. Diagnosed children with CHD who are unable to afford therapy will subsequently receive treatment sponsored by the financial partners. All patients are followed up by the local partner and visiting surgical team members. Results More than 10,000 children across 9 provinces underwent CHD screening. A total of 240 (accounting for an incidence of 2.4%) was treated by the program, of which 226 patients were managed invasively, the other 14 patients conservatively. Open surgery was performed in 162 patients, while endovascular procedures were applied in another 64. No mortality or significant complications occurred during the transfer. There was no perioperative or late death. Conclusion This humanitarian cardiac surgery program is able to promote accessibility of care for CHD children in rural China. The quality of life of these patients can be improved with continuous input from the society.


2013 ◽  
Vol 178 (4) ◽  
pp. 385-388 ◽  
Author(s):  
Michael Woll ◽  
Paul Brisson
Keyword(s):  

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