scholarly journals Aspectos terapêuticos e nutricionais de neonatos submetidos a correção de atresia esofágica

2020 ◽  
Vol 10 (31) ◽  
pp. 35-44
Author(s):  
Karina Cristina Pinheiro Oliveira ◽  
Maria Victória Cravo Salustiano ◽  
Gilmara Lopes Vaz ◽  
Andressa Tavares Parente ◽  
Angeline Do Nascimento Parente ◽  
...  
Keyword(s):  
Esophageal Atresia ◽  
Normal Weight ◽  
Sample Mean ◽  
Nutritional Conditions ◽  
Full Diet ◽  
Reference Hospital ◽  
Correction Surgery ◽  
Type C ◽  
The Moment

Descrever as variáveis neonatais, condições clínicas e nutricionais de recém-nascidos portadores de Atresia Esofágica submetidos a correção cirúrgica. Estudo documental, retrospectivo e quantitativo em 50 prontuários de neonatos portadores de atresia de esôfago, internados em um hospital de referência. Na amostra: 96% das genitoras realizaram o pré-natal, com 64% nascidos de parto cesáreo, sendo 62% do sexo feminino e 60% dos neonatos nasceram com peso normal. Sobre a classificação da Atresia Esogágica, 84% tipo C. A média da amostra foi de 10 dias de vida a submissão da cirurgia de correção e 20 dias de vida para introdução da dieta. A idade média no alcance da dieta plena foi de 30 dias, sendo em torno do 21º dia de pós-operatório. A amamentação foi informada em 44% da amostra. Predominou consonâncias entre as variáreis do estudo comparadas com publicações nacionais e internacionais sobre o tema.Descritores: Atresia Esofágica, Anormalidades Congênitas, Enfermagem Pediátrica. Therapeutic and nutritional aspects of neonates submitted to esophageal atresia correctionAbstract: To describe the neonatal variables, clinical and nutritional conditions of newborns with esophageal atresia who underwent surgical correction. This is a documentary, retrospective and quantitative study of 50 medical records of neonates with Esophageal Atresia, admitted in a reference hospital. In the sample: 96% of mothers received prenatal care, with 64% of infants born by cesarean delivery, 62% of whom were female and 60% of neonates were born with normal weight. Regarding the classification of Esophageal Atresia, 84% were classified as type C. The sample mean was being 10 days old until the moment that the newborn underwent correction surgery and 20 days old to introduce the diet. The average age to tolerate the full diet was 30 days, being around the 21st postoperative day. Breastfeeding was reported in 44% of the sample. There was a consonance between the study variables compared to national and international publications on the subject.Descriptors: Esophageal Atresia, Congenital Abnormalities, Pediatric Nursing. Aspectos terapéuticos y nutricionales de los neonatos sujetos a la corrección de la atresia esofágicaResumen: Describir las variables neonatales, las condiciones clínicas y nutricionales de los recién nacidos con atresia esofágica sometidos a corrección quirúrgica. Estudio documental, retrospectivo y cuantitativo de 50 registros médicos de recién nacidos con atresia esofágica, internados en un hospital de referencia. En la muestra: 96% de las madres realizaron atención prenatal, 64% nacieron por cesárea, 62% de las cuales eran del sexo feminino y 60% de los recién nacidos teníam peso normal. Con respecto a la clasificación de la Atresia de Esófago, 84% eran del tipo C. La media de la muestra fue de 10 días hasta el momento de la realización de la cirugía de corrección y de 20 días para introducir la dieta. La media de edad para alcanzar la dieta completa fue de 30 días, alrededor del día 21 de postoperatorio. La lactancia materna se informó en 44% de la muestra. Hubo una consonancia entre las variables de estudio en comparación con las publicaciones nacionales e internacionales sobre el tema.Descriptores: Atresia Esofágica, Anomalías Congénitas, Enfermería Pediátrica.

DOZ047.100: Impact of fundoplication on pH-MII tracings in pediatric patients with esophageal atresia

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
V Busoni ◽  
J C Sabban ◽  
P Lobos ◽  
F Ursino ◽  
M Urquizo ◽  
...  
Keyword(s):  
Esophageal Atresia ◽  
Failure To Thrive ◽  
Type A ◽  
Mucosal Damage ◽  
Therapy Failure ◽  
Acid Clearance ◽  
Life Threatening ◽  
Type C ◽  
Group 2 ◽  
The Moment

Abstract Introduction Gastroesophageal reflux disease (GERD) is the most common long-term complication in esophageal atresia (EA) patients. Fundoplication in EA is controversial but may be an option in those with maximum GER therapy failure, acute life-threatening event, failure to thrive, persistent esophagitis, and recurrent anastomotic stenosis. Aim The aim of this study was to compare GERD characteristics according pH-MII parameters in EA patients with and without fundoplication. Materials and Methods Retrospective review of pH-MII tracings performed at a Gastroenterology Unit between 2011 and 2018 was carried out. Inclusion criteria were children under 18 years with history of EA, with and without fundoplication, with both pH-MII and endoscopy performed, histology of esophageal biopsies, and off antireflux medications at the moment of examination. GER therapy failure was the indication for surgery. The total number of reflux episodes (acid, nonacidic), bolus and acid clearance time (ACT), and baseline values in distal channels (5–6) were evaluated. Group 1 (G1): patients with EA and fundoplication. Group 2 (G2): patients with EA without fundoplication. T-test was performed to compare results between G1 and G2. Results Fifteen tracings in EA patients were evaluated. Out of 15, 8 (53%) underwent fundoplication (G1), median age 7.4 years, 87.5% EA type C, 12.5% type A (long gap). Esophagitis was observed in 100% postfundoplication: 2 macroscopic, 1 eosinophilic, 5 microscopic esophagitis. Out of 15, 7 (47%) were EA without fundoplication (G2), median age 3.25 years, 57% EA type C, 43% type A–B. Esophagitis was observed in 85% in G2, all of them microscopic. No statistical differences were observed in pH-MII parameters between both groups. Number of refluxes, ACT, and distal channels (ch-6) were pathological in both groups. Nevertheless better acid clearance and more mucosal damage were observed in G1. Conclusion In this pediatric series of EA patients, pH-MII data show persistence of GERD even postfundoplication. This observation could be due to severe esophageal dismotility. Even asymptomatic EA patients should undergo monitoring of GER with pH-MII and endoscopy.

Classification of Esophageal Strictures following Esophageal Atresia Repair

2017 ◽  
Vol 28 (03) ◽  
pp. 243-249 ◽  
Author(s):  
Francesco Macchini ◽  
Giovanni Parente ◽  
Giorgio Farris ◽  
Valerio Gentilino ◽  
Ernesto Leva ◽  
...  
Keyword(s):  
Esophageal Atresia ◽  
Linear Regression Analysis ◽  
Type D ◽  
Anastomotic Strictures ◽  
Esophageal Strictures ◽  
Type C ◽  
The Mean

Introduction The aim of this study was to stratify anastomotic strictures (AS) following esophageal atresia (EA) repair and to establish predictors for the need of dilations. Materials and Methods A retrospective study on children operated on for EA between 2004 and 2014 was conducted. The stricture index (SI) was measured both radiologically (SIXR) and endoscopically (SIEND). A correlation analysis between the SI and the number of dilations was performed using Spearman's test and linear regression analysis. Results In this study, 40 patients were included: 35 (87.5%) presented with Gross's type C EA, 3 (7.5%) type A, 1 (2.5%) type B, and 1 (2.5%) type D. The mean follow-up time was 101 ± 71.1 months (range: 7.8–232.5, median: 97.6). The mean SIXR was 0.56 ± 0.16 (range: 0.15–0.86). The mean SIEND was 0.45 ± 0.22 (range: 0.15–0.85). Twenty-four patients (60%) underwent a mean of 2 endoscopic dilations (range: 1–9). The number of dilations was poorly correlated with SIXR, while significantly correlated with SIEND. Patients who did not need dilations had a SIEND < 0.33, patients who needed only one dilation had 0.33 ≤ SIEND < 0.44, and those with SIEND ≥ 0.44 needed two or more dilations. No significant association with other clinical variables was found. All patients were asymptomatic at the time of the first endoscopy. Conclusion SIEND is a useful tool to classify AS and can represent a predictor of the need for endoscopic dilation. The role of the SIEND becomes even more important as clinical characteristics have a low predictive value for the development of an AS and the need for subsequent endoscopic esophageal dilatations.

Classification of small type B/C follicles as primordial follicles in mature rats

Reproduction ◽  
2000 ◽  
pp. 43-48 ◽  
Author(s):  
S Meredith ◽  
G Dudenhoeffer ◽  
K Jackson
Keyword(s):  
Dna Synthesis ◽  
Granulosa Cells ◽  
Single Layer ◽  
Reliable Indicator ◽  
Type B ◽  
Primordial Follicles ◽  
Type C

In the present study, follicles were classified according to the morphology of their granulosa cells. Type B follicles contained only flattened granulosa cells; type B/C follicles had a mixture of flattened and cuboidal granulosa cells in a single layer, and type C follicles had a single layer of cuboidal granulosa cells. The primary objectives of the study were to determine whether 5-bromo-2-deoxyuridine incorporation into type B/C follicles was a marker for initiation of growth and how long type B/C follicles could remain at the same stage before transformation to type C follicles. Female Holtzman rats received bromo-deoxyuridine for 7 days. After the infusion (day minipumps were removed = day 0), rats were ovariectomized on days 0 (n = 9), 30 (n = 8), 90 (n = 8) and 150 (n = 9). The numbers of type B, B/C and C follicles within one ovary were determined using modified fractionator counting. Analysis over all times demonstrated that there were more (P < 0.0001) type B/C (941 +/- 61 per ovary) than type C (140 +/- 18 per ovary) or type B (159 +/- 19 per ovary) follicles. The numbers of type B and type C follicles did not differ from each other at any time. Only one of 34 rats evaluated had bromo-deoxyuridine-labelled type B follicles. On day 150, 57% of the bromo-deoxyuridine-labelled type B/C follicles remained from day 0. It is concluded that (1) DNA synthesis in granulosa cells of type B/C follicles is not a reliable indicator of impending growth; and (2) type B and type B/C follicles are both components of the pool of primordial follicles.

Improving management as a way to increase labour productivity

Upravlenie ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 24-30
Author(s):  
A. O. Ivanov
Keyword(s):  
Productivity Growth ◽  
Labour Productivity ◽  
Production Costs ◽  
Managerial Practices ◽  
Industrial Enterprises ◽  
Labour Productivity Growth ◽  
Period 2 ◽  
Main Factors ◽  
The Moment

The article gives an overview, performs analysis and classification of successful managerial practices applied at Russian industrial enterprises in the framework of the national project “Labour productivity and employment support”. The paper emphasizes the main factors of labour productivity growth as follows: investment policy, growth of human capital, and efficient use of managerial capital of enterprise. In order to determine the need of enterprises to increase labour productivity, the author proposes four universal criteria that signal the existing inefficiency even before the loss of competitiveness: 1) the dynamics of labour productivity in the company is not positive during a given period; 2) the company is behind competitors by labour productivity indicator; 3) the company is behind competitors by labour productivity growth rates indicator for a certain period; 4) unit production costs rise. These criteria allow you to take into account the situation both within the enterprise and in comparison with other enterprises. Each criteria can be considered separately or in combination with the others, applied to enterprises of different industries, specialization, and scale. Criteria indicate the direction of development in which the company is experiencing difficulties at the moment, or may experience them in the future.

scholarly journals Discordance between Body-Mass Index and Body Adiposity Index in the Classification of Weight Status of Elderly Patients with Stable Coronary Artery Disease

2021 ◽  
Vol 10 (5) ◽  
pp. 943
Author(s):  
Bartosz Hudzik ◽  
Justyna Nowak ◽  
Janusz Szkodzinski ◽  
Aleksander Danikiewicz ◽  
Ilona Korzonek-Szlacheta ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Body Mass Index ◽  
Coronary Artery ◽  
Weight Status ◽  
Stable Coronary Artery Disease ◽  
Reference Method ◽  
Normal Weight ◽  
Body Adiposity ◽  
Artery Disease

Background and Aims: Body-mass index (BMI) is a popular method implemented to define weight status. However, describing obesity by BMI may result in inaccurate assessment of adiposity. The Body Adiposity Index (BAI) is intended to be a directly validated method of estimating body fat percentage. We set out to compare body weight status assessment by BMI and BAI in a cohort of elderly patients with stable coronary artery disease (CAD). Methods: A total of 169 patients with stable CAD were enrolled in an out-patient cardiology clinic. The National Research Council (US) Committee on Diet and Health classification was used for individuals older than 65 years as underweight BMI < 24 kg/m2, normal weight BMI 24–29 kg/m2, overweight BMI 29–35 kg/m2, and obesity BMI > 35 kg/m2. In case of BAI, we used sex- and age-specific classification of weight status. In addition, body fat was estimated by bioelectrical impedance analysis (BImpA). Results: Only 72 out of 169 patients (42.6%) had concordant classification of weight status by both BMI and BAI. The majority of the patients had their weight status either underestimated or overestimated. There were strong positive correlations between BMI and BImpA (FAT%) (R = 0.78 p < 0.001); BAI and BImpA (FAT%) (R = 0.79 p < 0.001); and BMI and BAI (R = 0.67 p < 0.001). BMI tended to overestimate the rate of underweight, normal weight or overweight, meanwhile underestimating the rate of obesity. Third, BMI exhibited an average positive bias of 14.4% compared to the reference method (BImpA), whereas BAI exhibited an average negative bias of −8.3% compared to the reference method (BImpA). Multivariate logistic regression identified independent predictors of discordance in assessing weight status by BMI and BAI: BImpA (FAT%) odds ratio (OR) 1.29, total body water (%) OR 1.61, fat mass index OR 2.62, and Controlling Nutritional Status (CONUT) score OR 1.25. Conclusions: There is substantial rate of misclassification of weight status between BMI and BAI. These findings have significant implications for clinical practice as the boundary between health and disease in malnutrition is crucial to accurately define criteria for intervention. Perhaps BMI cut-offs for classifying weight status in the elderly should be revisited.

MRI analysis and surgical treatment of Wassel Type IV duplicated thumbs

2021 ◽  
pp. 175319342098321
Author(s):  
Anyuan Wang ◽  
Jian Ding ◽  
Long Wang ◽  
Tinggang Chu ◽  
Zhipeng Wu ◽  
...  
Keyword(s):  
Type A ◽  
Surgical Reconstruction ◽  
Mri Findings ◽  
Level Of Evidence ◽  
Type D ◽  
Type Iv ◽  
Secondary Operations ◽  
Type C

We present the MRI findings for 39 Wassel Type IV duplicated thumbs in 38 patients. We found that MRI revealed the morphology of the cartilaginous connection between the thumb anlages and the location of the deviation corresponding to the classification of Horii, which allowed precise preoperative planning of corrective osteotomies. All 39 thumbs were available for follow-up after surgical reconstruction at a mean of 29 months (range 25 to 39). Four out of nine Horii Type A cases and all 12 Type B, as well as the six Type C and the six Type D cases, achieved good results according to the Tada scoring system. Five Type A cases achieved fair results with residual stiffness of the interphalangeal joint. No secondary operations were needed. We conclude that MRI proved useful in subclassifying Wassel Type IV duplicated thumbs and may aid in planning the osteotomies needed for their reconstruction. Level of evidence: IV

scholarly journals The Obesity Paradox and Heart Failure: A Systematic Review of a Decade of Evidence

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Emmanuel Aja Oga ◽  
Olabimpe Ruth Eseyin
Keyword(s):  
Heart Failure ◽  
Weight Status ◽  
Obesity Paradox ◽  
Normal Weight ◽  
Conclusive Evidence ◽  
Study Endpoint ◽  
Nyha Classification ◽  
Improved Outcomes ◽  
Observational Cohort

There is scientific consensus that obesity increases the risk of cardiovascular diseases, including heart failure. However, among persons who already have heart failure, outcomes seem to be better in obese persons as compared with lean persons: this has been termed theobesity paradox, the mechanisms of which remain unclear. This study systematically reviewed the evidence of the relationship between heart failure mortality (and survival) and weight status. Search of the PubMed/MEDLINE and EMBASE databases was done according to the PRISMA protocol. The initial search identified 9879 potentially relevant papers, out of which ten studies met the inclusion criteria. One study was a randomized clinical trial and 9 were observational cohort studies: 6 prospective and 3 retrospective studies. All studies used the BMI, WC, or TSF as measure of body fatness and NYHA Classification of Heart Failure and had single outcomes, death, as study endpoint. All studies included in review were longitudinal studies. All ten studies reported improved outcomes for obese heart failure patients as compared with their normal weight counterparts; worse prognosis was demonstrated for extreme obesity (BMI>40 kg/m2). The findings of this review will be of significance in informing the practice of asking obese persons with heart failure to lose weight. However, any such recommendation on weight loss must be consequent upon more conclusive evidence on the mechanisms of the obesity paradox in heart failure and exclusion of collider bias.

DEVELOPMENT OF AN ALGORITHM FOR FINDING ANOMALIES IN WEATHER REPORTS TO IMPROVE THE QUALITY OF FORECASTS

2021 ◽  
pp. 45-52
Author(s):  
K. G. Yashchenkov ◽  
K. S. Dymko ◽  
N. O. Ukhanov ◽  
A. V. Khnykin
Keyword(s):  
Optimal Method ◽  
Implementation Processes ◽  
Advantages And Disadvantages ◽  
Message Exchange ◽  
Text Information ◽  
Preliminary Preparation ◽  
Using Data ◽  
The Moment

The issues of using data analysis methods to find and correct errors in the reports issued by meteorologists are considered. The features of processing various types of meteorological messages are studied. The advantages and disadvantages of existing methods of classification of text information are considered. The classification methods are compared in order to identify the optimal method that will be used in the developed algorithm for analyzing meteorological messages. The prospects of using each of the methods in the developed algorithm are described. An algorithm for processing the source data is proposed, which consists in using syntactic and logical analysis to preclean the data from various kinds of noise and determine format errors for each type of message. After preliminary preparation the classification method correlates the received set of message characteristics with the previously trained model to determine the error of the current weather report and output the corresponding message to the operator in real time. The software tools used in the algorithm development and implementation processes are described. A complete description of the process of processing a meteorological message is presented from the moment when the message is entered in a text editor until the message is sent to the international weather message exchange service. The developed software is demonstrated, in which the proposed algorithm is implemented, which allows to improve the quality of messages and, as a result, the quality of meteorological forecasts. The results of the implementation of the new algorithm are described by comparing the number of messages containing various types of errors before the implementation of the algorithm and after the implementation.

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