Purpose This study clarified differences in players’ contributions to the team’s score in female wheelchair basketball at the 2016 Rio Paralympics by physical capacity classification, and examined ...the roles required in the team. Subjects and Methods This study used stats (record of play contents) for players who played for more than 20 minutes from the official box scores of all 31 games at the 2016 Paralympics. Players were divided into three groups by physical capacity classification: low, middle, and high. The average stats for each group were compared and the covariance structure was analyzed to determine the role of each group during the game. Results Comparisons showed that the higher the class, the higher the value of many stats items. Important elements were defensive rebound, steal, and turnover in the low group; and score, offensive rebound, and turnover in the high group. Conclusion Players in the high group have more plays related to the ball. Those in the low group should increase the numbers of steals and defensive rebounds and reduce turnover. High group players are required to have scoring ability, acquire offensive rebound, and reduce turnover.
Abstract Background Conventional pneumoperitoneum (CP) and automatically maintained pneumoperitoneum using AirSeal Intelligent Flow System (AiFS) were compared during pediatric laparoscopic ...appendectomy (LA) using intraperitoneal pressure (IPP) and hemodynamic parameters. Methods A prospective review of 39 children aged 3–14 years who had standard 3 trocar LA was performed. Pneumoperitoneum was either AiFS (n = 18) or CP (n = 21) according to the surgeon's preference. IPP during insertion of trocars in all subjects was initially 8-10 mmHg which was reduced to 5 mmHg then maintained until LA was completed. Data were collected 5 minutely during pneumoperitoneum. Results Subject demographics were similar for both groups. During pneumoperitoneum, average IPP (AiFS: 7.9; CP: 9.0 mmHg), average systolic blood pressure (AiFS: 100.4; CP: 106.9 mmHg), and average end-tidal CO2 (EtCO2; AiFS: 35.7; CP: 38.5 mmHg) were significantly different (p < .05, respectively), while pulse (AiFS: 92.1; CP: 96.4 bpm), oxygen saturation (AiFS: 98.8; CP: 98.8%), body temperature (AiFS: 37.2; CP: 37.4), urine output (AiFS: 2.7; CP: 2.4 mL/kg/h), operative time (AiFS: 72.2; CP: 76.2mins), blood loss (AiFS: 3.6; CP: 3.5 mL), recommencement of oral intake (AiFS: 1.3; CP: 1.4 days), and postoperative hospitalization (AiFS: 4.3; CP: 3.8 days) were not. Conclusion Because IPP was significantly lower during LA with AiFS, EtCO2 and BP were significantly lower. Treatment Study Prospective Comparative Study – Level II
Jejunoileal atresias associated with colonic atresia Hamada, Hiroshi; Hamada, Yoshinori; Doi, Takashi ...
Journal of pediatric surgery case reports,
June 2020, 2020-06-00, 2020-06-01, Letnik:
57
Journal Article
Recenzirano
Odprti dostop
Colonic atresia (CA) is one of the rarest causes of neonatal intestinal obstruction. The combination of jejunoileal atresia (JIA) and CA is particularly rare. To the best of our knowledge, only 21 ...cases of JIA associated with CA have been described in the English-language literature. We herein present a case involving a 34-week preterm female infant with bilious vomiting by the first day of life. Laparotomy revealed jejunal gap atresia and ileal gap atresia. In addition, colonic gap atresia was found at the hepatic flexure with a wide mesenteric defect. The JIA and CA appeared to have been caused by a thromboembolic event in the superior mesenteric artery. We also review the 21 previously published cases and discuss the etiologies of the association between JIA and CA.
•The combination of jejunoileal atresia (JIA) and colonic atresia (CA) is particularly rare.•Overlooking a CA was one of the factors associated with the worst prognosis.•The pathogenesis of CA might differ from that of JIA in cases of JIA associated with CA.
A modified pull-through (PT) distinguished by complete full-thickness removal of the posterior rectal cuff, initially developed as an open procedure in 1980, has been performed with laparoscopic ...assistance since 1997. Postoperative bowel dysfunction improved when the anatomic landmark for PT surgery was revised from the dentate line (DL) to the anorectal (or Herrmann's) line (ARL) in 2007. A 40-year (1980-2019) review of 153 consecutive rectal/rectosigmoid type Hirschsprung's disease (HD) patients is presented.
Data for postoperative bowel dysfunction and Hirschsprung-associated enterocolitis (HAEC) classified according to the American Pediatric Surgical Association (APSA) scale were obtained retrospectively.
PT was open (
= 43) and laparoscopic (
= 110). Dissection was DL (
= 57) and ARL (
= 96). Over 40 years, 5/153 patients (3.3%) had postoperative obstructive symptoms (POS), and 10/153 patients (6.5%) had 13 episodes of postoperative HAEC; APSA grades were: I (
= 4); II (
= 8); and III: (
= 1) presenting with explosive diarrhea (10/13; 76.9%), fever (10/13; 76.9%), abdominal distension (9/13; 69.2%), or bloody stools/shock (1/13 with grade III; 7.7%). The grade III case had histologically-proven transitional zone PT. Postoperative HAEC developed in 3/5 (60.0%) POS+ patients and 7/148 (4.7%) POS- patients (
= .002). Symptom duration and treatment were not correlated with APSA grades.
Complete full-thickness posterior rectal cuff excision and using the ARL reduced postoperative HAEC significantly in this series. Despite being anatomically distinct, the DL is inadequate as a precise landmark for PT surgery because it lacks functional relevance. The APSA scale could benefit from timely review to improve its clinical and prognostic value.
Purpose
The cadmium (Cd) chick model has been described as a reliable model of omphalocele. Skeletal anomalies, including lumber lordosis, can be seen in the Cd chick model, as well as in the human ...omphalocele. Bone deformations, such as lordosis, are associated with high bone mineral density (BMD). Recently, three-dimensional microcomputed tomography (3DMCT) has been used to investigate skeletal development in small animal embryos. We used 3DMCT to test the hypothesis that the BMD is increased in the Cd-induced omphalocele chick model.
Methods
After a 60-h incubation, chicks were exposed to either chick saline or Cd in ovo. Chick embryos were harvested at embryonic day 16.5 (E16.5) and were divided into control (
n
= 8) and Cd (
n
= 9). Chicks were then scanned by 3DMCT. The body volume, bone volume, bone/body volume ratio, bone mineral quantity and BMD were analysed statistically (significance was accepted at
p
< 0.05).
Results
Bone mineral density (mg/cm
3
) was significantly increased in the Cd group compared to control group (235.3 ± 11.7 vs 223.4 ± 4.6,
p
< 0.05), whereas there was no significant difference in the bone/body volume ratio between the Cd group and the control group (0.7 ± 0.1 vs 0.6 ± 0.0). The body volume (cm
3
) (0.3 ± 0.2 vs 0.3 ± 0.1), bone volume (cm
3
) (0.2 ± 0.2 vs 0.2 ± 0.1), and bone mineral quantity (mg) (51.3 ± 41.6 vs 41.5 ± 16.5) were not significantly different between the two groups.
Conclusions
Increased BMD may be associated with lordosis of the vertebral column in the Cd-induced omphalocele chick model, stimulating osteogenesis by activating the canonical Wnt signalling pathway.
Candida albicans is a common pathogen, especially in immunocompromised patients. What is concerning is that this pathogen is displaying increasing resistance to azole drugs, which are commonly used ...to treat it. We investigated the antifungal activity of Moringa oleifera leaves against C. albicans. The fungicidal effect of C. albicans exposed to Moringa oleifera leaves was determined using adenosine triphosphate (ATP) bioluminescence. Moringa oleifera leaves showed antifungal activity against C. albicans with a minimum inhibitory concentration (MIC) of 50 μg/mL. Additionally, at the MIC, the Moringa oleifera leaves significantly reduced ATP-leakage. This study provides sufficient evidence of the in vitro antifungal effects of Moringa oleifera leaves against C. albicans. (J Osaka Dent Univ 2023; 57: 295-299)
Purpose
Laparoscopically assisted anorectoplasty (LAARP) was compared to posterior sagittal anorectoplasty (PSARP) in the treatment of male imperforate anus associated with either recto-prostatic ...fistula (RPF) or recto-bulbar fistula (RBF).
Method
19 RPF patients (12 treated by LAARP and 7 by PSARP) and 26 RBF patients (14 treated by LAARP and 12 by PSARP) between 1995 and 2014 were retrospectively assessed using a fecal continence evaluation questionnaire (FCE) (with a maximum score of 10), an FCE score coefficient variation, as well patients’ MRI scores, anorectal angle values (AA), and incidence of postoperative complications. Statistical significance was determined at
p
< 0.05.
Results
Both groups were similar in mean age and mean weight at repair, as well as sacral status. Postoperatively, mean MRI scores, mean AA, and biochemistry were also similar (
p
= NS). All cases treated with LAARP showed consistently higher and less variable FCES values, fewer wound infection incidence, but greater rectal mucosal prolapse unrelated with sacrum status. Significantly lower doses of postoperative analgesia were needed in all LAARP cases (
p
< 0.05).
Conclusion
Technical outcomes appear to be similar based on imaging studies, but FCES-assessed functional outcomes appear to favor LAARP for treatment of both RPF and RBF.
It is unclear whether adaptive servo-ventilation (ASV) therapy for heart failure with preserved ejection fraction (HFpEF) is effective. The aim of this study was to investigate the details of ASV ...use, and to evaluate the effectiveness and safety of ASV in real-world HFpEF patients. We retrospectively enrolled 36 HFpEF patients at nine cardiovascular centers who initiated ASV therapy during hospitalization or on outpatient basis and were able to continue using it at home from 2012 to 2017 and survived for at least one year thereafter. The number of hospitalizations for heart failure (HF) during the 12 months before and 12 months after introduction of ASV at home was compared. The median number of HF hospitalizations for each patient was significantly reduced from 1 interquartile range: 1–2 in the 12 months before introduction of ASV to 0 0–0 in the 12 months after introduction of ASV (p < 0.001). In subgroup analysis, reduction in heart failure hospitalization was significantly greater in female patients, patients with a body mass index < 25, and those with moderate or severe tricuspid valve regurgitation. In patients with HFpEF, the number of HF hospitalizations was significantly decreased after the introduction of ASV. HFpEF patients with female sex, BMI < 25, or moderate to severe tricuspid valve regurgitation are potential candidates who might benefit from ASV therapy.
Anorectal malformations (ARM) represent a broad spectrum of patients with different level of the rectum and type of a fistula. Standardized approaches are usually successful, but patients ...occasionally present with an unusual course of fistula which requires a modified surgical strategy. We present here three male ARM patients with an atypical fistula which did not have connection with the urinary tract, but ran near the fistula. Case 1 has a low-type ARM with a rectoscrotal fistula running deep and partly involved in the corpus spongiosum. Anorectoplasty was performed through an anterior sagittal incision and the anterior wall of the fistula was laid open leaving the posterior wall undetached. Case 2 was diagnosed with an intermediate-type ARM with a long rectoscrotal fistula running near and parallel the urethra. Posterior sagittal anorectoplasty (PSARP) was performed leaving the fistula untouched. Case 3 presented with an intermediate-type ARM with a rectoperineal fistula adherent to the urethra. The patient was treated by PSARP leaving the fistula and part of the muscle coat of the rectum in situ. All the cases were smoothly discharged and no urological complication nor problem associated with the residual fistula was observed at the latest follow-up (17 months–2 years). Preoperative distal colostography with the aid of diverting colostomy was importantly useful for deciding surgical procedure.
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