Outcomes of Arch Reintervention for Recurrent Coarctation in Young Children

Author(s):  
Qi Jiang ◽  
Renjie Hu ◽  
Wei Dong ◽  
Ying Guo ◽  
Wen Zhang ◽  
...  

Abstract Objectives To evaluate the outcomes of reintervention for postrepair recoarctation in young children. Methods Between January 2011 and December 2020, all consecutive patients aged ≤3 years who were treated for postrepair recoarctation were included. Recoarctations were classified into two morphological types by three-dimensional imaging. Two methods, namely, surgical repair and balloon angioplasty (BA), were used to treat recoarctation. Results This study included 50 patients with a median age of 10.5 months (range, 2.0–36.0 months) and a mean weight of 9.3 ± 3.1 kg. Hypoplastic recoarctation occurred most frequently in patients who had undergone patch aortoplasty at initial repair (p = 0.001). No hospital mortality occurred, and all patients achieved an increased diameter (p < 0.001) and a decreased pressure gradient (p < 0.001) at the recoarctation site immediately after reintervention. The median follow-up time after reintervention was 3.5 years (range, 16.0 days–9.6 years). Late mortality occurred in four patients (8.0%): two in the surgical group and two in the BA group (chi-square test= 0.414, p = 0.520). There was no difference in arch reobstruction after reintervention between the surgical and BA groups (chi-square test = 1.383, p = 0.240). Recoarctation with a hypoplastic morphology was the leading risk factor for arch reobstruction after reintervention (hazard ratio, 6.552; 95% confidence interval, 2.045–20.992; p = 0.002). Conclusion Reintervention for recoarctation has favorable early outcomes in young children. However, late mortality is not rare, and arch reobstruction is common during close follow-up. For young children, recoarctation with hypoplastic morphology is the leading risk factor for reobstruction, while the choice of reintervention method exerts little effect on the outcomes of arch reintervention.

2019 ◽  
Vol 70 (6) ◽  
pp. 2072-2079
Author(s):  
Ana Maria Alexandra Stanescu ◽  
Constantin Stefani ◽  
Ioana Veronica Grajdeanu ◽  
Bogdan Serban ◽  
Gheorghe Ciobanu ◽  
...  

Although extensively studied, psoriasis still has negative consequences and is associated with multiple comorbidities, including metabolic syndrome. The severity of psoriasis seems to influence the occurrence of diagnostic criteria for metabolic syndrome. 208 patients diagnosed with psoriasis were identified, who were divided into lots depending on the severity of psoriasis, but also to the presence or absence of metabolic syndrome. Interpretation of statistical data was done with SPSS V21 (Statistical Package for Social Science) and MEDCALC (Statistical Software). The coexistence of severe psoriasis with metabolic syndrome increases the risk of developing cardiovascular diseases by 2.97 or greater, with a confidence interval of [1.60, 5.51], than that of patients with severe psoriasis who have no metabolic syndrome. The hypothesis was statistically confirmed by p = 0.003. Analyzing the total group with psoriasis by severity, we found the following distribution: from the total number of 208 patients, 39 (18.8%) had severe psoriasis, 83 (39.9%) moderate psoriasis and 86 (41.3%) mild psoriasis. The higher incidence of metabolic syndrome in patients with psoriasis is evidenced by the Pearson Chi-Square test, where p [0.001. The association of metabolic syndrome in patients with psoriasis is evident. The more severe the psoriasis, the more likely it is to develop metabolic syndrome.


2021 ◽  
Vol 108 (Supplement_3) ◽  
Author(s):  
G Martínez Izquierdo ◽  
A R Arnaiz Pérez ◽  
E Escolano Fernández ◽  
M Merayo Álvarez ◽  
B Carrasco Aguilera ◽  
...  

Abstract INTRODUCTION Renal cell carcinoma (RCC) represents 3% of overall malignant neoplasms in adults. However, its aetiology has not been clearly established. Although surgery represents the cornerstone in treatment, recurrence postoperative rates are around 20-30%, what implies prognostic factors search must be mandatory in order to help to plan de follow-up and the different adjuvant therapy possibilities available in case they were necessary. MATERIAL AND METHODS A retrospective observational study was carried out in 110 patients who underwent radical nephrectomy between 2004 and 2018, with the aim of identifying possible prognostic factors of recurrence of RCC after these surgeries. Preoperative data (epidemiological, comorbidities and laboratory tests), surgical, pathological and variables related to follow-up were taken into account. A univariate and multivariate analysis were performed, using chi-square test and logistic regression, respectively. RESULTS The median follow-up time was 53.5 months (SD = 35.8), time in which 19 patients had a recurrence of RCC after radical nephrectomy (17.2%). Histopathological items such as the surgical piece size, the nodal and microvascular invasion, the renal sinus invasion and the presence of necrosis in the surgical piece were associated with RCC recurrence in the univariate analysis, while only the presence of necrosis in the surgical piece showed a significant result in the multivariate analysis (p = 0.004). CONCLUSIONS Histopathological analysis, highlighting the presence of necrosis in the histological sample, was proved to be the main risk factor of RCC recurrence.


BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mei-Zhen Dai ◽  
Yi Qiu ◽  
Xing-Hong Di ◽  
Wei-Wu Shi ◽  
Hui-Hui Xu

Abstract Background Human papillomavirus (HPV) type 16 accounts for a larger share of cervical cancer and has been a major health problem worldwide for decades. The progression of initial infection to cervical cancer has been linked to viral sequence properties; however, the role of HPV16 variants in the risk of cervical carcinogenesis, especially with longitudinal follow-up, is not fully understood in China. Methods We aimed to investigate the genetic variability of HPV16 E6 and E7 oncogenes in isolates from cervical exfoliated cells. Between December 2012 and December 2014, a total of 310 single HPV16-positive samples were selected from women living in the Taizhou area, China. Sequences of all E6 and E7 oncogenes were analysed by PCR-sequencing assay. Detailed sequence comparison, genetic heterogeneity analyses and maximum-likelihood phylogenetic tree construction were performed with BioEdit Sequence Alignment Editor and MEGA X software. Data for cytology tests and histological diagnoses were obtained from our Taizhou Area Study with longitudinal follow-up for at least 5 years. The relationship between HPV16 variants and cervical carcinogenesis risk was analysed by the chi-square test or Fisher’s exact test. Results In this study, we obtained 64 distinct variation patterns with the accession GenBank numbers MT681266-MT681329. Phylogenetic analysis revealed that 98.3% of HPV16 variants belong to lineage A, in which the A4 (Asian) sublineage was dominant (64.8%), followed by A2 (12.1%), A1 (11.4%), and A3 (10.0%). The A4 (Asian) sublineage had a higher risk of CIN2+ than the A1–3 (European) sublineages (OR = 2.69, 95% CI = 1.04–6.97, P < 0.05). Furthermore, nucleotide variation in HPV16 E6 T178G is associated with the development of cervical cancer. Conclusion These data could provide novel insights into the role of HPV16 variants in cervical carcinogenesis risk in China.


2011 ◽  
Vol 44 (6) ◽  
pp. 657-660 ◽  
Author(s):  
Graça Maria de Castro Viana ◽  
Maria do Desterro Soares Brandão Nascimento ◽  
Aila de Menezes Ferreira ◽  
Érica Milena Fernandes Rabelo ◽  
João Arnaud Diniz Neto ◽  
...  

INTRODUCTION: One of the important current problems in HIV/AIDS infection is the establishment of epidemiological and laboratorial prognostic parameters during patient follow-up. This study aimed at analyzing the evolution of laboratory tests: CD4 lymphocyte count, viral load, hemoglobin (Hb), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and the epidemiological variables sex and age as prognostic factors for survival in progression to death among AIDS patients. METHODS: A retrospective study was conducted using analysis of medical records, and prospective 24-month follow-up of patients with HIV/ AIDS attended at the President Vargas Hospital Outpatient Clinic, a reference center in HIV/ AIDS attendance in the State of Maranhão, Brazil. The study analyzed patients aged 10 to 60 years old, who manifested AIDS and who were not using antiretroviral therapy or had used it for less than 5 years. The Chi-square test was used for statistical analysis. RESULTS: The sample included 100 patients - 57 were current outpatients, and 43 had died. The variables viral load (p=0.726), ALT (p=0.314), sex (p=0.687), and age (p=0.742) were analyzed, and no evidence of association between them and worst prognosis was observed. CONCLUSIONS: A significant relation was verified between low Hb levels (p=0.000) and CD4 (p=0.000) and shorter survival.


2021 ◽  
Author(s):  
Rong Xue ◽  
Ningdao Li ◽  
Zhurong Ji ◽  
Xingdong Cheng ◽  
Zhuqiu Zhang ◽  
...  

Abstract Background: Dysphagia is one of the most common complications after anterior cervical spine surgery. The study aimed to evaluate the risk factors for dysphagia after anterior cervical discectomy and fusion (ACDF) with the Zero-P Implant System by multidimensional analysis and investigated the predictive values of these risk factors for dysphagia. Methods: A retrospective analysis of 260 patients who underwent ACDF with the Zero-P Implant System and had at least 2 year of follow-up ware performed. All patients were divided into a non-dysphagia group and a dysphagia group. Sex, age, body mass index (BMI), intraoperative time, estimated blood loss, diabetes mellitus, hypertension, smoking, alcohol consumption, prevertebral soft-tissue thickness, the levels of surgery, O-C2 angle, C2–7 angle, T1 slope and segmental angle were analyzed. Chi-square test and logistic regression were performed to analyze the predictive value of each dimension for dysphagia. Results: In total, the non-dysphagia group comprised 170 patients and the dysphagia group comprised 90 patients. Chi-square test results indicated that number of operated levels, operation time dT1 slope, dO-C2 angle, dC2–7 angle, segmental angle and dPSTT were associated with a high incidence of dysphagia. Multivariate logistic regression analysis showed that number of operated levels, operation time, dC2–7 angle and dPSTT were significantly associated with postoperative dysphagia.Conclusions: Number of operated levels, operation time, dC2–7 angle and dPSTT were significantly associated with postoperative dysphagia. In additionally, sufficient preoperative preparation, evaluation combining with proficient and precise treatment measures are suggested to reduce the incidence of postoperative dysphagia when ACDF is performed.


CytoJournal ◽  
2020 ◽  
Vol 17 ◽  
pp. 22
Author(s):  
Pingping Zhong ◽  
Chenghong Yin ◽  
Yulan Jin ◽  
Tianbao Chen ◽  
Yang Zhan ◽  
...  

Objectives: Atypical glandular cells (AGC) detected by Papanicolaou (Pap) smears are in close relation with adenocarcinoma and precursors detected by histopathology. Yet, sometimes the cytological diagnosis of AGC has been neglected. With increase of adenocarcinoma and precursors, we need more focus on glandular abnormalities. Material and Methods: Clinicopathological data of patients who had AGC on Pap smears between April 2015 and October 2018 and underwent histological follow-up were retrieved from the computerized database of Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Patients with a prior history of cancer were excluded from the study. Statistical analyses were performed using Pearson’s Chi-square test in SPSS software version 23. P < 0.05 (two sided) was considered as statistical significance. Results: Liquid-based cytological examination of the uterine cervix was carried out in 164,080 women. Five hundred and twenty-five women were diagnosed with AGC, 314 with not otherwise specified (AGC-NOS), and 211 with favor neoplastic (AGC-FN). Only 310 cases had histological follow-up, 168 women (168/314, 53.5%) originally with AGC-NOS on Pap smears, and 142 (142/211, 67.3%) with AGC-FN. The median age of histological significant abnormalities was 46.7 years, and 126 women (126/162, 77.8%) were postmenopausal. Sixty-six cases (66/168, 39.3%) of AGC-NOS had significant abnormalities (96/142, 67.6%, AGC-FN). One hundred and sixty-two cases of significant abnormalities included 40 high-grade squamous abnormalities and 122 glandular abnormalities. AGC-FN was more likely to be associated with a clinically significant abnormalities (P < 0.001) compared to AGC-NOS. Conclusions: Patients with AGC on Pap smears are in close relation with significant abnormalities, especially with significant glandular abnormalities on histopathology slices. AGC should be evaluated vigilantly with histological workup, especially if patients are diagnosed with AGC-FN and are aged 41–60 years. We need more focus on AGC.


CADMO ◽  
2012 ◽  
pp. 65-94
Author(s):  
Francesca Corradi

Kindergarten teachers' attitudes toward immigrant children and children of immigrant families is the subject of research conducted between 2009 and 2010. The study compares teachers in the public schools of Avignon, France, with state school teachers of Reggio Emilia, Italy. The analysis conducted mainly considered relations between two variables. However, the research tools used (participant observation, Likert type-scale questionnaire and semi-structured interviews) also allowed for the triangulation of data. The intent of this article is to elaborate on the methodological contribution to the research using multivariate analysis. This analysis provides both three-dimensional representations of the teachers' attitudes as well as individualized representations of relevant relations between variables. The statistic test of the null hypotheses, the "chi-square test" is used. The analysis points out attitude and behaviour differences between Reggio Emilia teachers and Avignon teachers. Differences are mostly observed in the synchronic dimension data analysis. Nevertheless, if the point of observation is changed and data are studied in the diachronic dimension, that general view demonstrates how a current historical period influences educational choices within a particular educational system and consequently influences teachers' attitudes.


2017 ◽  
Vol 11 (03) ◽  
pp. 317-322 ◽  
Author(s):  
Naser Sargolzaie ◽  
Hamid Reza Arab ◽  
Marzieh Mohammadi Moghaddam

ABSTRACT Objective: The purpose of this clinical study was to evaluate the effect of implant body form (cylindrical and conical implants) on crestal bone levels during 6 months' follow-up after loading. Materials and Methods: A total of 32 SPI implants (19 conical implants/13 cylindrical implants) were randomly placed in 12 male patients using a submerged approach. None of the patients had compromising medical conditions or parafunctional habits. Periapical radiographs using the parallel technique were taken after clinical loading and 6 months later. Clinical indices including pocket depth and bleeding on probing (BOP) were recorded on 6-month follow-up. Data were analyzed by independent samples t-test and Chi-square test with a significance level of 0.05. Results: Six months after loading, crestal bone loss was 0.84 (±0.29) mm around the cylindrical implants and 0.73 (±0.62) mm around the conical types, which was not significantly different (P = 0.54). Pocket depth around the cylindrical and conical implants was 2.61 (±0.45) mm and 2.36 (±0.44) mm, respectively (P = 0.13). BOP was observed among 53.8% and 47.4% of the cylindrical implants and conical (P = 0.13). Bone loss and pocket depth in the maxilla and mandible had no significant difference (P = 0.46 and P = 0.09, respectively). Conclusion: In this study, although bone loss and clinical parameters were slightly higher in the cylindrical implants, there was no significant difference between the conical- and cylindrical-shaped implants.


2006 ◽  
Vol 104 (6) ◽  
pp. 867-875 ◽  
Author(s):  
Michael Söderman ◽  
Göran Edner ◽  
Kaj Ericson ◽  
Bengt Karlsson ◽  
Tiit Rähn ◽  
...  

Object The aim of this study was to assess the clinical efficacy of gamma knife surgery (GKS) in the treatment of dural arteriovenous shunts (DAVSs). Methods From a database of more than 1600 patients with intracranial arteriovenous shunts that had been treated with GKS, the authors retrospectively and prospectively identified 53 patients with 58 DAVSs from the period between 1978 and 2003. Four patients were lost to follow-up evaluation and were excluded from the series. Thus, this study is based on the remaining 49 patients with 52 DAVSs. Thirty-six of the shunts drained into the cortical venous system, either directly or indirectly, and 22 of these were associated with intracranial hemorrhage on patient presentation. The mean prescription radiation dose was 22 Gy (range 10–28 Gy). All patients underwent a clinical follow-up examination. In 41 cases of DAVS a follow-up angiography study was performed. At the 2-year follow-up visit, 28 cases (68%) had angiographically proven obliteration of the shunt and in another 10 cases (24%) there was significant flow regression. Three shunts remained unchanged. There was one immediate minor complication related to the administration of radiation. Furthermore, one patient had a radiation-induced complication 10 years after treatment, although she recovered completely. There was one posterior fossa bleed 2 months after radiosurgery; a hematoma, as well as a lesion, was evacuated, and the patient recovered uneventfully. A second patient had an asymptomatic occipital hemorrhage approximately 6 months postradiosurgery. The clinical outcome after GKS was significantly better than that in patients with naturally progressing shunts (p < 0.01, chi-square test); figures on the latter have been reported previously. Conclusions Gamma knife surgery is an effective treatment for DAVSs, with a low risk of complications. Major disadvantages of this therapy include the time elapsed before obliteration and the possibility that not all shunts will be obliterated. Cortical venous drainage from a DAVS, a risk factor for intracranial hemorrhage, is therefore a relative contraindication. Consequently, GKS can be used in the treatment of both benign DAVSs with subjectively intolerable bruit and aggressive DAVSs not responsive to endovascular treatment or surgery.


2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Eunsu Jang ◽  
Younghwa Baek ◽  
Kihyun Park ◽  
Siwoo Lee

The Sasang Constitutional Medicine is a traditional Korean customized medicine that classifies people into four types: Tae-eumin (TE), Soyangin (SY), Soeumin (SE), and Taeyangin. The aim of this study was to show whether the Sasang Constitution (SC) could be an independent risk factor for the metabolic syndrome (MS). Totally, 3,334 subjects from 24 Korean medicine clinics participated in this study. A one-way ANOVA for the continuous variables and a chi-square test for the prevalence of MS were conducted. A logistic regression was conducted to calculate the propensity score and the odds ratios (ORs). The prevalence for MS in TE, SY, and SE was 50.6%, 30.9%, and 17.7% (P<0.001) before matching, and 36.7%, 28.6% and 28.2% (P=0.042) after matching, respectively. The TE was associated with an increased OR for MS compared with the SE and SY in both crude (OR 4.773, 95% CI 3.889–5.859, and OR 2.292, 95% CI 1.942–2.704, resp.) and matched groups (OR 1.476, 95% CI 1.043–2.089, and OR 1.452, 95% CI 1.026–2.053, resp.). This study reveals that the SC, especially the TE type, could be considered as a risk element for MS even in people with otherwise similar physical characteristics.


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