Congenital

先天性肌病
  • 文章类型: Journal Article
    这项研究的目的是介绍我们在接受后路脊柱切除术(PVCR)治疗各种脊柱畸形的患者中的经验。
    对2015年至2018年间进行PVCR的37例患者进行了回顾性评估。平均随访时间为24个月(范围:12-50个月)。患者的人口统计数据,平均失血,血液置换量,操作持续时间,重症监护和住院期间,PVCR级别,仪表级,术前弯曲量,术后曲率改善量,术前和术后神经状况,并检查并发症。在X射线上进行角度测量。
    患者的平均年龄为37.5岁(范围:3-80岁)。由于不同的病理(先天性,肿瘤转移,创伤后凸畸形,翻修脊柱侧弯,和感染)。平均手术时间为445.5min(260-720),平均失血量为1903ml(400-7000ml)。观察到26例晚期畸形患者的平均局部后凸角度从67.65°降低到7.42°(P<0.001)。当这些值在所有34名患者中进行比较时,13例先天性后凸畸形患者术前角度值由55.1°降至3.5°(P<0.001),由70°降至0°。
    PVCR是矫正严重脊柱畸形的有效方法,可用于矫正不同患者组的曲率。
    3级。
    UNASSIGNED: The purpose of this study was to present our experience in patients who had been treated with posterior vertebral column resection (PVCR) for various spinal deformities.
    UNASSIGNED: Thirty-seven patients who performed PVCR between 2015 and 2018 were evaluated retrospectively. The mean follow-up period was 24 months (range: 12-50 months). The demographic data of the patients, mean blood loss, amount of blood replacement, duration of operation, intensive care and hospitalization period, PVCR level, instrumentation level, amount of preoperative curvature, amount of postoperative curvature improvement, preoperative and postoperative neurological status, and complications were examined. Angular measurements were performed on X-ray.
    UNASSIGNED: The mean age of the patients was 37.5 years (range: 3-80 years). PVCR was applied to patients due to different pathologies (congenital, tumor metastasis, posttraumatic kyphosis, revision scoliosis, and infection). The mean operation time was 445.5 min (260-720) with an average blood loss of 1903 ml (400-7000 ml). It was observed that the average local kyphosis angle decreased from 67.65° to 7.42° in 26 patients who were operated for advanced deformity (P < 0.001). When these values were compared in all 34 patients, the preoperative angle value decreased from 55.1° to 3.5° (P < 0.001) and decreased from 70° to 0° in 13 congenital kyphosis patients.
    UNASSIGNED: PVCR is an effective method for correcting severe spinal deformities and can be used to correct curvature in different patient groups.
    UNASSIGNED: Level 3.
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  • 文章类型: Case Reports
    在以前的报告中,甲状腺功能减退,垂体功能减退,性腺功能减退是SCFE的常见内分泌原因,但这是第一次观察到先天性肾上腺增生。因此,接受长期内分泌治疗的先天性肾上腺增生患者可能面临更高的SCFE风险.
    In previous reports, hypothyroidism, hypopituitrism, and hypogonadism were common endocrine causes of SCFE, but this is the first time that congenital adrenal hyperplasia has been observed. As such, patients who have undergone long-term endocrine treatment for congenital adrenal hyperplasia could potentially be subjected to a higher risk for SCFE.
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  • 文章类型: Editorial
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  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    在母婴对中检查了母体寄生虫血症和胎盘寄生虫负荷,以确定其对克氏锥虫先天性传播的影响。通过微血细胞比容测试对母亲和新生儿的寄生虫血症进行了定性评估;通过检测T.cruziDNA和组织学来确定传播和非传播母亲的胎盘组织中的寄生虫负荷。与发射器母亲相比,发现寄生虫血症的频率和患病率在非遗传母亲中增加;然而,与非发射器母亲相比,发射器母亲的寄生虫负荷频率和患病率较高.此外,通过酶联免疫吸附试验(ELISA)测量外周血中干扰素(IFN)-γ的血清水平,胎盘,和脐带血样本.未感染新生儿脐带血中IFN-γ的中值明显增加。发射器和非发射器母亲的IFN-γ中位数没有显着差异;但是,在母亲组中,非传递者母亲的总IFN-γ产生量最高.总的来说,这项研究的结果表明,抗T。在胎盘和脐带中发生的克氏免疫反应受到母亲血液中细胞因子的影响,并导致未感染新生儿的寄生虫血症得到控制。
    Maternal parasitemia and placental parasite load were examined in mother-newborn pairs to determine their effect on the congenital transmission of Trypanosoma cruzi. Parasitemia was qualitatively assessed in mothers and newborns by the microhematocrit test; parasite load was determined in the placental tissues of transmitting and non-transmitting mothers by the detection of T. cruzi DNA and by histology. Compared to transmitter mothers, the frequency and prevalence of parasitemia were found to be increased in non-transmitter mothers; however, the frequency and prevalence of parasite load were higher among the transmitter mothers than among their non-transmitter counterparts. Additionally, serum levels of interferon (IFN)-γ were measured by an enzyme-linked immunosorbent assay (ELISA) in peripheral, placental, and cord blood samples. Median values of IFN-γ were significantly increased in the cord blood of uninfected newborns. The median IFN-γ values of transmitter and non-transmitter mothers were not significantly different; however, non-transmitter mothers had the highest total IFN-γ production among the group of mothers. Collectively, the results of this study suggest that the anti-T. cruzi immune response occurring in the placenta and cord is under the influence of the cytokines from the mother\'s blood and results in the control of parasitemia in uninfected newborns.
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  • 文章类型: Journal Article
    目的:先天性膈疝(CDH)定义为从腹部到胸腔的器官突出。Hadlock公式是计算估计胎儿体重(EFW)最常用的工具。CDH的解剖学性质通常会导致腹围的低估,导致胎儿体重的低估.准确的体重估计在出生前对于咨询至关重要,术前准备和ECMO。本研究是为了比较Hadlock公式和Faschingbauer公式在CDH胎儿人群中胎儿体重估算的准确性。方法:在我们的研究中,我们调查了42例CDH胎儿的EFW和实际出生体重与80例健康配对对照的差异.EFW是使用Hadlock公式和Faschingbauer等人描述的最近引入的公式计算的。,为患有CDH的胎儿量身定制。此外,两组的超声检查和分娩间隔时间均对两种公式进行了调整.结果:大多数疝是左侧(92.8%vs.7.2%)。调整超声和分娩之间的间隔后的EFW与两者的实际出生体重的相关性最高,研究组和对照组。我们比较了两种工具的结果,发现Hadlock公式预测CDH儿童的出生体重的误差为7.8±5.5%,而Faschingbauer公式的误差为7.9±6.5%。结论:针对超声和分娩之间的间隔进行调整的Hadlock公式是计算CDH胎儿EFW的更精确方法。使用Hadlock公式进行常规生物测量扫描对于预测出生体重仍然是可靠的。
    Objectives: Congenital diaphragmatic hernia (CDH) is defined as organ protrusion from the abdominal to the thoracic cavity. The Hadlock formula is the most commonly used tool for calculating estimated fetal weight (EFW). The anatomical nature of CDH usually leads to underestimation of the abdominal circumference, resulting in underestimation of fetal weight. Accurate weight estimation is essential before birth for counselling, preparation before surgery and ECMO. The research is made to compare the accuracy of Hadlock\'s formula and Faschingbauer\'s formula for fetal weight estimation in CDH fetuses population. Methods: In our study, we investigated differences between EFW and actual birthweight in 42 fetuses with CDH as compared to 80 healthy matched controls. EFW was calculated using the Hadlock formula and a recently introduced formula described by Faschingbauer et al., which was tailored for fetuses with CDH. Additionally, both of the formulas were adjusted for the interval between the ultrasound and delivery for both of the groups. Results: The majority of hernias were left-sided (92.8% vs. 7.2%). EFW adjusted for the interval between the ultrasound and delivery had the highest correlation with the actual birthweight in both, study group and controls. We compared the results for both tools and found the Hadlock formula to predict birthweight in CDH children with a 7.8 ± 5.5% error as compared to 7.9 ± 6.5% error for the Faschingbauer\'s formula. Conclusions: The Hadlock formula adjusted for the interval between the ultrasound and delivery is a more precise method of calculating EFW in fetuses with CDH. Routine biometry scan using Hadlock\'s formula remains reliable for predicting birthweight.
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  • 文章类型: Case Reports
    蛋白质丢失性肠病(PLE)是一种罕见的疾病,具有多种原因,但是治疗方法有限,研究不足。它通常与显著的死亡率和发病率相关。未经任何干预的婴儿左心发育不良综合征(HLHS)的生存期通常为4.5天,30天死亡率为95%。然而,通过手术干预,20年生存率为80%。HLHS可导致蛋白质主导的肠病,并通过三步程序得到纠正(Norwood,格伦,和Fontan)在婴儿期。我们报告了一例与PLE相关的HLHS术后Fontan手术,并描述了其临床过程和结果。报告此病例的主要目的是在处理难治性低蛋白血症病例和根据文献进行适当管理的同时,提高医生的认识。
    Protein-losing enteropathy (PLE) is a rare disorder with diverse causes, but the treatments are limited and understudied. It is often associated with significant mortality and morbidity. The survival of hypoplastic left heart syndrome (HLHS) in infants without any intervention is usually 4.5 days, and 30-day mortality is 95%. However, with surgical intervention, survival at 20 years is 80%. HLHS can lead to protein-leading enteropathy and is corrected by the three-step procedures (Norwood, Glenn, and Fontan) during infancy. We report a case of Fontan procedure postoperative HLHS associated with PLE and describe its clinical course and outcome. The main intention of reporting this case is to provide awareness among physicians while dealing with refractory cases of hypoproteinemia and appropriate management based on the literature.
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  • 文章类型: Case Reports
    婴儿期广义动脉钙化(GACI)是一种罕见的遗传病,临床表现多样。因此,诊断经常延迟或漏诊。GACI预后不良,超过一半的患者在6个月大之前死亡。双膦酸盐的早期诊断和治疗已被证明可以改善这些患者的生存率。这是一例新生儿呼吸窘迫的病例报告,最初在超声心动图下被诊断为主动脉缩窄。CT进一步成像显示主动脉狭窄与GACI相关。关键词:遗传缺陷,先天性,血管,钙化/微积分,主动脉,肺动脉,CT血管造影,超声心动图,儿科学©RSNA,2024.
    Generalized arterial calcification of infancy (GACI) is a rare genetic condition with varied clinical presentation. Consequently, diagnosis is frequently delayed or missed. GACI has a poor prognosis, with more than half of patients dying before the age of 6 months. Early diagnosis and treatment with bisphosphonates have been shown to improve survival in these patients. This is a case report of a newborn with respiratory distress who was initially diagnosed with coarctation of the aorta at echocardiography. Further imaging with CT revealed the aortic narrowing to be associated with GACI. Keywords: Genetic Defects, Congenital, Vascular, Calcification/Calculi, Aorta, Pulmonary Arteries, CT Angiography, Echocardiography, Pediatrics © RSNA, 2024.
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  • 文章类型: Journal Article
    背景:本研究旨在收集有关体力活动(PA)的数据,出血,与健康相关的生活质量,和健康状况,使用可穿戴设备和电子患者报告结果(EPRO)应用程序,根据临床实践,在没有抑制剂的中度或重度血友病A(HA)患者中接受治疗。方法:这是一项在意大利进行的为期12个月的多中心队列研究。主要结果包括按类型和强度对PA的描述,遵守世界卫生组织的指导方针,出血,和健康相关生活质量的EQ-5D问卷。通过患者佩戴的健身追踪器连续收集PA数据;所有其他变量均通过ePRO问卷收集。结果:103名受试者中只有54名(52.4%)在定义的有效期内使用了健身追踪器;青少年是依从性最低的年龄组。以低速率和低强度进行PA。大约52%的受试者有久坐行为。平均EQ-5D值没有随时间变化。43.7%的受试者至少有一次出血,主要是久坐的行为。出血前2天的PA与整个观察期中观察到的PA相当。结论:通过健身追踪器和ePRO应用程序对数据的系统记录表明,没有抑制剂的HA受试者的PA低于预期,并且他们仍然遇到与出血有关的问题。
    Background: This study aimed to gather data on physical activity (PA), bleeding, health-related quality of life, and health status, using a wearable device and an electronic patient-reported outcome (ePRO) app, in individuals with moderate or severe hemophilia A (HA) without inhibitors receiving treatment according to the clinical practice. Methods: This is a 12-month multicenter cohort study conducted in Italy. The primary outcomes included the description of PA by type and intensity, adherence to World Health Organization guidelines, bleeding, and health-related quality of life by EQ-5D questionnaire. PA data were collected continuously through a fitness tracker worn by the patient; all the other variables were collected through ePRO questionnaires. Results: Only 54 of the 103 enrolled subjects (52.4%) used their fitness tracker for the defined valid period; adolescents were the least compliant age group. PA was performed at low rates and intensity. Approximately 52% of the subjects had sedentary behavior. The mean EQ-5D values did not change over time. At least one bleeding was reported in 43.7% of the subjects, mostly with sedentary behavior. The PA in the 2 days preceding the bleeding was comparable to the one observed in the overall observational period. Conclusions: The systematic recording of data through a fitness tracker and ePRO app shows that subjects with HA without inhibitors have lower-than-expected PA and that they still experience issues related to bleeding.
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