DOZ047.54: Fundoplication outcomes in children with esophageal atresia

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
E Chung ◽  
M van Lennep ◽  
R Saoji ◽  
A Jiwane ◽  
M W N Oomen ◽  
...  
Keyword(s):  
Esophageal Atresia ◽  
Matched Control ◽  
Cumulative Risk ◽  
Control Group ◽  
Postoperative Dysphagia ◽  
Long Gap ◽  
Type C ◽  
New Diagnosis ◽  
Age And Sex

Abstract Background In esophageal atresia (EA) patients, cumulative risk of having a fundoplication ranges from 0% to 45%, with long gap patients with recurrent strictures at even higher risk. However, there are no controlled trials evaluating the outcomes postfundoplication. We hypothesized that children with EA undergoing fundoplication will suffer from more postoperative dysphagia compared to non-EA patients as the fundoplication increases the resistance to esophageal bolus flow, which is already hampered by abnormal motility. Aims Our study aimed to compare outcomes in EA patients with age- and sex-matched control patients postfundoplication. Methods This was an international multicenter retrospective cohort study. All EA patients who had fundoplication between 2006 and 2017 during this period were included. Data were also collected from age- and sex-matched children without EA who underwent fundoplication. Results A total of 40 EA patients had fundoplication during this period. Of the EA patients 82.5% were type C, and 82.5% were long gap. Table 1 compares EA patients with controls. Significantly more EA patients were failing to thrive, on nasogastric/gastrostomy feeds at time of surgery and needed gastrostomy placement at time of fundoplication compared to controls. A total of 17.5% of EA patients developed infection and 22.5% a leak postfundoplication. EA patients had postoperative dysphagia and oral aversion significantly more often than controls. Of 90% of EA patients had recurrence of gastrointestinal or respiratory symptoms, 35% had recurrent strictures, 5% had a new diagnosis of eosinophilic esophagitis postfundoplication. Median time to symptom recurrence was 64 days (12–165 days), 90% were back on PPI and 7.5% had redofundoplication. Conclusions Our study is the first to examine postfundoplication outcomes in EA patients and compare these with a matched control group. EA patients had significantly more dysphagia and oral aversion postfundoplication and majority were back on PPI within two months of surgery. Based on these data, the role of fundoplication in EA patients should be reconsidered. Prospective data are urgently needed.

scholarly journals Circulating miRNA-202-3p is a potential novel biomarker for diagnosis of type 1 gastric neuroendocrine neoplasms

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dou Dou ◽  
Xiao-kou Li ◽  
Qi-sheng Xia ◽  
Ying-ying Chen ◽  
Yuan-liang Li ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Matched Control ◽  
Future Research ◽  
Control Group ◽  
Neuroendocrine Neoplasms ◽  
Diagnostic Biomarkers ◽  
Standard Curve ◽  
Qrt Pcr ◽  
Age And Sex

Abstract Background Currently, there are no circulating diagnostic biomarkers for gastric neuroendocrine neoplasms (g-NENs). In previous studies, we found that miRNA-202-3p is overexpressed in the tumour tissue of type 1 g-NEN. We speculated that miRNA-202-3p is also likely to be highly expressed in circulating blood. Methods A total of 27 patients with type 1 g-NEN and 27 age- and sex-matched control participants were enrolled in this study. The miRNA-202-3p levels in serum obtained from the participants were measured by qRT‐PCR. The expression level of miRNA-202-3p in the samples was calculated by comparison with a standard curve. Results The clinical characteristics of the patients were similar to those of the patient samples in previous reports. Expression of miRNA-202-3p was significantly higher in the patient group (3.84 × 107 copies/nl) than in the control group (0.635 × 107 copies/nl). The area under the ROC curve (AUC) was 0.878 (95% CI: 0.788–0.968), and the optimal cut-off point was approximately 1.12 × 107 copies/nl. The sensitivity and specificity were 88.9% and 77.8%, respectively. Conclusion This study suggests that miRNA-202-3p is potentially useful as a biomarker of type 1 g-NEN; further investigation and verification should be performed in future research.

Enlargement of cerebrospinal fluid spaces in long-term benzodiazepine abusers

1987 ◽  
Vol 17 (4) ◽  
pp. 869-873 ◽  
Author(s):  
C. Schmauss ◽  
J.-C. Krieg
Keyword(s):  
Low Dose ◽  
Matched Control ◽  
Control Group ◽  
High Dose ◽  
Withdrawal Therapy ◽  
The Mean ◽  
Dose Dependent ◽  
Dose Dependent Effect ◽  
Age And Sex

SynopsisIn 17 benzodiazepine (BDZ) dependent in-patients a CT scan was performed before initiation of withdrawal therapy. The evaluation of the ventricular to brain ratio (VBR) by standardized and computerized measurements revealed significantly higher mean VBRs for both high-and low-dose BDZ-dependent patients compared to the mean VBR of an age- and sex-matched control group. In addition, the mean VBR of high-dose BDZ-dependent patients (N = 8) was significantly higher than the mean VBR of low-dose BDZ-dependent patients (N = 9). This difference could not be accounted for by the age of the patients or duration of BDZ-dependency and, therefore, suggests a dose-dependent effect of BDZs on the enlargement of internal CSF-spaces. On the other hand, higher values for the width of external CSF-spaces were found to be related to increasing age of the patients and duration of BDZ-dependency.

scholarly journals Prevalence of Venous Thromboembolism In Patients with Secondary Polycythemia

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 3164-3164
Author(s):  
Omar Nadeem ◽  
Jiang Gui ◽  
Deborah Ornstein
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Body Mass Index ◽  
Risk Reduction ◽  
Smoking History ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Age And Sex ◽  
Secondary Polycythemia

Abstract Abstract 3164 Background: Polycythemia vera is associated with an increased risk for venous thromboembolism (VTE). Although phlebotomy is employed as an adjunct to treatment with hydroxyurea and/or aspirin for VTE risk reduction, emerging data suggest that hematocrit is less of a determinant of VTE risk than leukocyte count and JAK2 V617F gene mutation allele burden. The role of secondary polycythemia as a risk factor for VTE is unknown, but phlebotomy for thrombosis risk reduction is frequently practiced. Based on the polycythemia vera model, however, we hypothesize that secondary polycythemia does not increase VTE risk. The purpose of this study was to determine the prevalence of VTE in patients with secondary polycythemia and to investigate the factors associated with VTE in this population. Methods: We performed a case control study that included patients admitted to Dartmouth-Hitchcock Medical Center with a diagnosis of chronic obstructive pulmonary disease (COPD) and a hematocrit greater than or equal to 50% from August 2004 to July 2009. The controls were matched for age and sex and carried a diagnosis of chronic obstructive pulmonary disease (COPD) without evidence of secondary polycythemia. Data were collected on body mass index (BMI), VTE history, comorbid conditions, thrombophilia and smoking history. Clinical characteristics of patients with and without secondary polycythemia were analyzed using chi square and t-test to evaluate for significant differences in the two populations. Results: Eighty-six patients with secondary polycythemia and 86 controls were included in the study. The mean hematocrit was 53.5% in the case group and 43.7% in the control group (p=<0.005). Among cases, a history of VTE was documented in 17/86 (19.8%), 10 of which (58.8%) were judged to be idiopathic. In the control group, VTE was documented in 12/86 (14%), 4 of which (33.3%) were judged to be idiopathic. There was no statistically significant difference in the number of total (OR=1.52, p=0.42) or idiopathic (OR=2.7; p=0.16) VTE between cases and controls, respectively. There were no statistically significant differences noted in age, sex, body mass index, presence of diabetes mellitus, smoking history or the presence of malignancy in the two groups. Patients with VTE in both groups had higher BMI, however, compared to patients without VTE. Conclusions: We did not observe an increased prevalence of VTE in patients with secondary polycythemia compared to age- and sex-matched controls. Our findings suggest that the high prevalence of VTE observed in patients with secondary polycythemia is more likely related to known risk factors such as obesity rather than hyperviscosity due to increased cell mass. The role of phlebotomy for VTE risk reduction in patients with secondary polycythemia is therefore questionable. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Effects of Functional Electrical Stimulation in Rehabilitation with Hemiparesis Patients

2009 ◽  
Vol 9 (1) ◽  
pp. 49-53 ◽  
Author(s):  
Edina Tanović
Keyword(s):  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Cerebrovascular Accident ◽  
Control Group ◽  
Electrical Simulation ◽  
Significant Difference ◽  
Walking Rehabilitation ◽  
Demographical Data ◽  
Age And Sex

Cerebrovascular accident is a focal neurological deficiency occurring suddenly and lasting for more than 24 hours. The purpose of our work is to determine the role of the functional electrical simulation (FES) in the rehabilitation of patients with hemiparesis, which occurred as a consequence of a cerebrovascular accident. This study includes the analysis of two groups of 40 patients with hemiparesis (20 patients with deep hemiparesis and 20 patients with light hemi- paresis), a control group which was only treated with kinesiotherapy and a tested group which was treated with kinesiotherapy and functional electrical stimulation. Both groups of patients were analyzed in respect to their sex and age. Additional analysis of the walking function was completed in accordance with the BI and RAP index. The analysis of the basic demographical data demonstrated that there is no significant difference between the control and tested group. The patients of both groups are equal in respect of age and sex. After 4 weeks of rehabilitation of patients with deep and light hemiparesis there were no statistically significant differences between the groups after evaluation by the BI index. However, a statistically significant difference was noted between the groups by the RAP index among patients with deep hemiparesis. After 8 weeks of rehabilitation the group of patients who were treated with kinesiotherapy and functional electrical stimulation showed better statistically significant results of rehabilitation in respect to the control group with both the BI index and the RAP index (p<0,001).In conclusion, we can state that the patients in rehabilitation after a cerebrovascular accident require rehabilitation longer than 4 weeks. Walking rehabilitation after stroke is faster and more successful if we used functional electrical stimulation, in combination with kinesiotherapy, in patients with disabled extremities.

DOZ047.19: Outcomes in the management of long-gap esophageal atresia: is the Foker technique superior?

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
A Wiseman ◽  
J Krishnan ◽  
D Wanaguru ◽  
C Langusch ◽  
V Varjavandi ◽  
...  
Keyword(s):  
Esophageal Atresia ◽  
Type A ◽  
Small Sample ◽  
Type B ◽  
Repair Technique ◽  
Long Gap ◽  
Delayed Repair ◽  
Significant Difference ◽  
Long Gap Esophageal Atresia ◽  
Type C

Abstract Background Long-gap esophageal atresia (LGEA) has traditionally been managed by delayed anastamosis. However, over the last 10 years the Foker technique of esophageal growth elongation has been used. There is limited data evaluating outcomes using both techniques. Aims The aim of this study was to compare the outcomes in LGEA repair using the traditional delayed repair technique versus the Foker technique. Methods A retrospective chart review was done of LGEA patients at Sydney Children's Hospital between 1997 and 2016, comparing the Foker technique with the delayed repair technique. Results There were 9 children repaired using the Foker technique, and 10 by delayed repair. There were 7 patients with Type A, 1 with Type B, and 1 with Type C in the Foker group and in the delayed repair cohort, 5 were Type A, 2 Type B, 2 Type C, and 1 Type D esophageal atresia/tracheoesophageal fistula. There were 4 males in the Foker group and 5 in the non-Foker group. Median time to join was 59 days (15–117 days) for Foker repair and 173 days (16–433 days) for delayed repair. There was no significant difference in the incidence of post-operative leak, incidence of strictures needing dilation, presence of reflux symptoms, presence of reflux esophagitis on endoscopy, proton pump inhibitor use, need for fundoplication, incidence of cyanotic spells, occurrence of recurrent fistula, and symptoms of dysphagia when comparing both groups. Data on time to oral feeds and incidence of malnutrition was incomplete. Details are shown in Table 1. Conclusions Although the time to anastamosis was shorter in the Foker group and the incidence of post-operative leak, strictures needing dilation, need for fundoplication, and dysphagia were lower in the Foker group, the difference was not significant probably secondary to the small sample size. These results require validation in larger cohorts.

Migraine Patients Experience Poorer Subjective Well-Being/Quality of Life Even Between Attacks

Cephalalgia ◽  
1995 ◽  
Vol 15 (1) ◽  
pp. 31-36 ◽  
Author(s):  
CGH Dahlöf ◽  
E Dimenäs
Keyword(s):  
Migraine Patient ◽  
Matched Control ◽  
Well Being ◽  
Control Group ◽  
Subjective Well Being ◽  
Subjective Symptoms ◽  
Matched Control Group ◽  
Patients Experience ◽  
Age And Sex

The aim of the present study was to compare the general well-being of migraine patients between attacks with that of an age- and sex-matched control group. One hundred and forty-five consecutive and eligible patients at the Gothenburg Migraine Clinic were asked about their well-being and their complaints. Using three self-administered standardized questionnaires, the Minor Symptoms Evaluation Profile (MSEP), Subjective Symptoms Assessment Profile (SSAP) and the Psychological General Well-Being (PGWB) Index, evaluable responses were obtained from 138 migraine patients. Compared with control subjects, migraineurs perceived more symptoms and greater emotional distress as well as disturbed contentment, vitality and sleep. It is concluded that the general well-being of the migraine patient is impaired, even between the attacks.

scholarly journals Corneal Epithelial Damage and Impaired Tear Functions in Patients with Inflamed Pinguecula

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Erkut Küçük ◽  
Uğur Yılmaz ◽  
Kürsad Ramazan Zor
Keyword(s):  
Matched Control ◽  
Tear Film ◽  
Control Group ◽  
Healthy Controls ◽  
Epithelial Defect ◽  
Epithelial Integrity ◽  
Corneal Epithelial ◽  
Matched Control Group ◽  
Age And Sex ◽  
Fellow Eyes

Purpose. In this study, we evaluated corneal epithelial integrity and tear film parameters in patients with inflamed pinguecula and compared these findings with their fellow eyes and with healthy controls. Methods. We evaluated the fluorescein staining properties and performed the tear break-up time (TBUT) test and Schirmer 2 test (ST2) measurements of 32 patients who had symptomatic unilateral inflamed pinguecula and compared the results with their fellow eyes and also with an age- and sex-matched control group. Results. Twenty-three eyes (72%) in the inflamed pinguecula group and 1 eye (3.1%) in the fellow eyes group had punctate epithelial staining (PES) or epithelial defect on the nasal cornea (p<0.001). There was no PES or epithelial defect in the control group. Eyes with inflamed pinguecula (n = 32) had lower TBUT and ST2 values compared to the control group (n = 32) (p<0.001 for both). Fellow eyes (n = 32) also had lower TBUT and ST2 values compared to the control group (p=0.003 for both). There was no difference in the TBUT and ST2 results between the eyes with inflamed pinguecula and fellow eyes (p=0.286 and p=0.951, respectively). Conclusion. A high percentage of eyes with inflamed pinguecula had nasal corneal epithelial staining or epithelial defect. We also found lower TBUT and ST2 results in eyes with inflamed pinguecula and the fellow eyes compared to the control group. These findings may be important in pathogenesis of pinguecula and pterygium and also in uncovering their relation.

DOZ047.08: Endoscopic management of esophageal stenosis in patients with congenital esophageal atresia: experience of a single tertiary care center in Italy

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
M Deganello Saccomani ◽  
V Bortolotti ◽  
A Gastaldi ◽  
F S Camoglio ◽  
G Piacentini ◽  
...  
Keyword(s):  
Esophageal Atresia ◽  
Anastomotic Stricture ◽  
Care Center ◽  
Tertiary Care ◽  
Esophageal Stenosis ◽  
Endoscopic Management ◽  
Tertiary Care Center ◽  
Endoscopic Dilation ◽  
Long Gap ◽  
Type C

Abstract Objective and Study Esophageal stenosis is the most common morbidity associated with congenital esophageal atresia (EA). There is no consensus regarding the endoscopic management of strictures in terms of timing and techniques of dilations. The aim of this study is to describe the endoscopic management of esophageal stenosis in children with EA admitted to our tertiary care center. Methods A retrospective descriptive single-center study was conducted. Data were collected of all patients diagnosed with EA admitted to the ‘Women's and Children's Hospital’ of Verona, Italy, between 2004 and 2017. Results Thirty-seven patients with EA were admitted to our center between 2004 and 2017. Twenty of them were excluded for insufficient data. All patients underwent surgical correction within 2 months of life. An endoscopic control with upper gastrointestinal endoscopy was performed in all of them. Eleven (65%) subjects had tracheoesophageal fistula. All of them had type C EA. Three (18%) had long-gap EA. Eleven patients (65%), 8 with Type C EA and 3 with Type A EA, underwent endoscopic dilation. Semirigid Savary-Giliard bougies were used in most of them. Pneumatic dilation with balloon was performed only in one case. Nine (81%) needed more than one dilation due to anastomotic stricture recurrence. In 3 of the 11 subjects (27%) more than 3 dilations were necessary. Two of them had long-gap EA. The median age of first endoscopic dilation was 3 months (range: 1–12 months). The median age of the last dilation was 6 months (range: 1–18 months). One of the 11 patients who underwent dilations (Type C EA with long gap) underwent surgical retreatment due to fistula recurrence. Six of the 17 subjects (35%) enrolled developed long-term complications. Conclusion Our data confirmed that anastomotic stricture is frequent in patients with EA who underwent surgical correction. Endoscopic management of stenosis is a safe and effective procedure that leads to a limited number of complications. Side effects are more likely to occur in patients with long-gap EA. Timing of dilations and endoscopic technique should be defined by international guidelines in order to improve patient's outcome.

The role of fiberoptic endoscopy in the evaluation and management of long gap isolated esophageal atresia

2010 ◽  
Vol 26 (12) ◽  
pp. 1223-1227 ◽  
Author(s):  
Erica Rachel Gross ◽  
Ari Reichstein ◽  
Jeffrey W. Gander ◽  
Charles J. H. Stolar ◽  
Arnold G. Coran ◽  
...  
Keyword(s):  
Esophageal Atresia ◽  
Fiberoptic Endoscopy ◽  
Long Gap ◽  
Isolated Esophageal Atresia

Identity formation in suicidal and nonsuicidal youth: The role of self-continuity

1989 ◽  
Vol 1 (3) ◽  
pp. 257-275 ◽  
Author(s):  
Lorraine Ball ◽  
Michael Chandler
Keyword(s):  
Identity Formation ◽  
Older Persons ◽  
Matched Control ◽  
Sense Of Self ◽  
Control Group ◽  
Psychiatrically Hospitalized ◽  
Almost All ◽  
Normal Identity ◽  
Special Risk

AbstractAdolescents attempt to end their own lives with greater frequency than do either younger or older persons. The aim of this study was to provide a developmental account of this anomaly by examining the contrastive ways in which suicidal and nonsuicidal adolescents reason about their own personal continuity through time. Drawing upon an earlier program of normative research into the links between a maturing sense of personal continuity and the development of a sense of commitment to the future, and capitalizing on recent methodologic advances in the study of young persons' maturing sense of self-continuity, a series of comparisons were made between 30 psychiatrically hospitalized adolescents, at varying degrees of risk to suicide, and a matched control group of their nonsuicidal agemates. The results of this study show that, while almost all of the hospitalized adolescents evidenced some degree of developmental immaturity in their attempts to reason about their own identity across time, the high-risk suicidal group was unique in their special inability to locate any grounds upon which to justify their own continuity through time. These findings are interpreted in terms of their relevance for understanding both the normal identity formation process, and for the diagnosis and treatment of adolescents at special risk to suicide.

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