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  • 文章类型: Journal Article
    目的:这项研究的目的是调查参加全国儿科泌尿外科会议的代表对现场病例演示(LCD)的意见,以了解将来是否可以用录音病例演示(TCD)代替这些意见。
    方法:在为期3天的年度会议和儿科泌尿外科现场手术研讨会结束时进行了问卷调查。除了一般数据,如受访者的年龄和执业类型,关于LCD的四个关键问题包括:如果没有LCD,您会参加这次会议吗?未经编辑的视频(TCD)与LCD一样有效地进行教学吗?您认为LCD应该继续进行吗?您会允许您的孩子由专家在LCD中进行手术吗?对于问题3,在初级外科医生(<45岁)和高级外科医生(>45岁)之间比较了结果。
    结果:关于分析,88/140(62%)受访者(95%置信区间[CI]:54%-70%)表示,如果没有LCD,他们将不会参加会议;70/139(50%)受访者(95%CI:42%-58%)认为TCD可能是LCD的有效替代品;129/144(90%)受访者(95%CI:83%-94%)认为应继续使用LCD。对于问题4,101/129(79%)表示他们将允许他们的孩子由专家在LCD中进行操作,而28人(21%)不同意他们的孩子在液晶显示器上手术。初级和高级外科医生对LCD的支持没有显着差异(P=0.15)。
    结论:在印度情况下,LCD被认为是儿科泌尿外科会议的重要组成部分,吸引更多参与,并且可能对会议的成功很重要。
    OBJECTIVE: The purpose of the study was to survey the opinion of delegates attending national pediatric urology meeting regarding live case demonstrations (LCDs) to see whether these can be replaced with taped case demonstrations (TCDs) in future.
    METHODS: A questionnaire-based survey was conducted at the end of the 3-day annual conference and live operative workshop in pediatric urology. Apart from general data such as age of the respondent and type of practice setting, four key questions on LCDs with yes/no responses included: would you have attended this meeting if there were no LCDs? Are unedited videos (TCDs) as effective as LCDs for teaching? Do you think LCDs should be continued? Would you allow your child to be operated in LCD by an expert? For question 3, the outcomes were compared between junior surgeons (<45-year-old) and senior surgeons (>45-year-old).
    RESULTS: On analysis, 88/140 (62%) respondents (95% confidence interval [CI]: 54%-70%) said that they would not have attended the meeting if there were no LCDs; 70/139 (50%) respondents (95% CI: 42%-58%) felt that TCDs may be an effective alternative to LCDs; 129/144 (90%) respondents (95% CI: 83%-94%) felt that LCDs should be continued. For question 4, 101/129 (79%) said they would allow their child to be operated in LCD by an expert, while 28 (21%) did not agree for their child to be operated in LCD. There was no significant difference between junior and senior surgeons regarding support for LCDs (P = 0.15).
    CONCLUSIONS: In the Indian scenario, LCDs were favored as an essential part of pediatric urology meeting, attract more participation, and are likely to be important for the success of the meeting.
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  • 文章类型: Journal Article
    Less Invasive Ventricular Enhancement (LIVE) with Revivent TC is an innovative therapy for symptomatic ischemic heart failure (HF). It is designed to reconstruct a negatively remodeled left ventricle (LV) after an anterior myocardial infarction (MI) by plication of the scar tissue. Its indications are specific, and as with any other structural heart intervention, the success of the procedure starts with appropriate patient selection. We aim to present the indications of the technique, crucial aspects in patient selection, and individual case planning approach.
    After clinical evaluation, transthoracic echocardiography is the first imaging modality to be performed in a potential candidate for the therapy. However, definitive indication and detailed case planning rely on late gadolinium-enhanced cardiac magnetic resonance imaging or multiphasic contrast-enhanced cardiac computed tomography. These imaging modalities also assist with relative or absolute contra-indications for the procedure. Individual assessment is done to tailor the procedure to the specifics of the LV anatomy and location of the myocardial scar.
    LIVE procedure is a unique intervention to treat symptomatic HF and ischemic cardiomyopathy after anterior MI. It is a highly customizable intervention that allows a patient-tailored approach, based on multimodality imaging assessment and planification.
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  • 文章类型: Case Reports
    BACKGROUND: We report the case of a 43-year-old female patient with systemic lupus erythematosus, class III lupus nephritis, with predialysis creatinine levels around 350 μmol/L (3.95 mg/dL) after partial resection of the left kidney with histologically verified papillary carcinoma in 2010. Preoperative computed tomography of the abdomen revealed a small 8 mm tumor in the left upper kidney pole. The patient was indicated for simultaneous bilateral nephrectomy and orthotopic renal transplantation with the aim to minimize invasiveness of the procedure as well as for curable tumor removal.
    METHODS: The procedure was performed under the full anesthesia trough upper middle laparotomy. As the first step, bilateral transperitoneal nephrectomy was performed. The live donor surgery started in a parallel theater to shorten the cold ischemic time of the graft. The renal graft had singe vessels and ureter; it was placed into the recipient\'s right orthotopic position. End-to-end anastomosis of the right renal vein and artery anastomosis were performed; ureter was anastomosed end-to-end using recipient\'s ureter.
    RESULTS: The postoperative period was uneventful with repeatedly excellent ultrasonography check-up of the graft\'s perfusion. The patient was discharged after 13 days with a good renal function of the graft (urea: 15 mmol/L, creatinine 160 μmol/L [1.80 mg/dL]).
    CONCLUSIONS: Orthotopic renal transplantation is a technically challenging but valid alternative for patients who are unsuitable candidates for heterotopic renal transplantation or in cases where there is a clear benefit of orthotopic renal transplantation.
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