Duranrojas3703

Determine outcomes of catheter intervention for aortic coarctation in infants. Aortic coarctation in infants following surgical repair and in high surgical risk native cases remains a challenging problem. Catheter intervention is an alternative to surgical intervention. Single-center, chart review of infants with biventricular anatomy who underwent coarctation stent placement or balloon angioplasty between 04/2004 and 04/2020. Outcomes of interest included change in aortic lumen diameter, peak gradient, number of re-interventions, time to re-intervention, and adverse events. Thirty-four patients were included in analysis, of those 16 underwent stent placement. Patients' mean age was 4.0 ± 3.0 months and weight of 5.3 ± 1.9 kg. Follow-up interval was 5.4 ± 5.1 years (0.2-16.1 years). Twelve (35%) patients underwent procedure due to ventricular dysfunction; the rest were for high resting gradient. Coarctation diameter increased from 2.4 ± 1.0 to 4.5 ± 1.3 (p  less then  0.01) and gradient decreased from 32.0 ± 18.4 mmHg to 9.2 ± 8.8 mmHg (p  less then  0.01). N6F11 Thirteen (81%) of the stented patients required at least one re-intervention, at an average of 1.7 ± 3.2 years from the index procedure. Five (28%) of those undergoing balloon angioplasty required repeat intervention. There was no mortality due to the procedure and one late mortality. One patient had a serious procedural adverse event. On follow-up, 12 (35%) were on anti-hypertensive medications. Catheter intervention, including stent placement, for aortic coarctation in infants is feasible with an acceptable adverse event profile. Repeat interventions are common.

Controversies regarding venous compression and trigeminal neuralgia (TN) still exist. The study demonstrates our experience for microvascular decompression (MVD) in TN caused by purely venous compression. The goal was to identify prognostic anatomical or surgical factors that may influence the outcome.

Between 2004 and 2020, 49 patients were operated with purely venous compression. Average age was 58.4years. Mean history of TN was 7.8years. Microsurgical procedures included transposition or separation of the vein, coagulation, and division. Several features have been analyzed with respect to BNI scores.

Evaluation on discharge revealed a complete pain relief in 39 (80%), partial improvement in 7 (14%), and no benefit in 3 (6%) patients. Facial hypesthesia was reported by 14 (28.6%) patients. Mean follow-up (FU) was 42.1months. BNI pain intensity score on FU revealed 71.4% excellent to very good scores (score 1 32 (65.3%); 2 3 (6.1%)). BNI facial numbness score 2 could be detected in 13 patients (26.5%) during FU. There was no statistical relationship between immediate pain improvement or BNI pain intensity score on FU with respect to surgical procedure, size of trigeminal cistern, type of venous compression, venous caliber, trigeminal nerve indentation, or neurovascular adherence. BNI facial numbness score was dependent on type of venous compression (p < 0.05).

We did not find typical anatomical features that could either predict or influence the outcome regarding pain improvement or resolution in any form. Neither classic microvascular decompression (interposition/transposition) nor sacrificing the offending vein made any difference in outcome.

We did not find typical anatomical features that could either predict or influence the outcome regarding pain improvement or resolution in any form. Neither classic microvascular decompression (interposition/transposition) nor sacrificing the offending vein made any difference in outcome.This review article discusses historical and contemporary research studies of asymmetric allylic oxidation of olefins using homogeneous and heterogeneous copper complexes of various kinds of oxazoline-based ligands, until the end of 2021. It is revealed that this strategy is a powerful method to form a new stereogenic center bearing an oxygen substituent adjacent to an unchanged C=C bond. Enantioselectivities as well as chemical yields, and also the reactivity, are strongly dependent on the type of substrate, oxidant, the copper salt and its oxidation state, ligand structure, temperature, nature of the solvent, and additives such as phenylhydrazine and porous materials.The pathophysiology of acute respiratory distress syndrome (ARDS) includes the accumulation of protein-rich pulmonary edema in the air spaces and interstitial areas of the lung, variable degrees of epithelial injury, variable degrees of endothelial barrier disruption, transmigration of leukocytes, alongside impaired fluid and ion clearance. These pathophysiological features are different between patients contributing to substantial biological heterogeneity. In this context, it is perhaps unsurprising that a wide range of pharmacological interventions targeting these pathophysiological processes have failed to improve patient outcomes. In this manuscript, our goal is to provide a narrative summary of the potential methods to capture the underlying biological heterogeneity of ARDS and discuss how this information could inform future ARDS redefinitions. We discuss what biological tests are available to identify patients with any of the following predominant biological patterns (1) epithelial and/or endothelial injury, (2) protein rich pulmonary edema and (3) systemic or within lung inflammatory responses.Gabriel Nové-Josserand (1868-1949) studied medicine in Lyon under Professor Louis Léopold Ollier at the very end of Ollier's career. He wrote his thesis on a subject close to his master's heart, bone growth disorders due to growth plate alteration, with an experimental and a clinical part, following the principles of Claude Bernard. In 1894, he came top in the first ever recruitment examination for surgeons in Lyon and became head of paediatric surgery at the Hôpital de la Charité, where he spent most of his surgical career. A brilliant and sought-after teacher, his work on congenital hip dislocation led to very early national and international recognition. After training with Lorenz in Vienna, he imported and improved on Lorenz's technique for surgical reduction, highlighting the importance of the labrum. He worked on a variety of conditions including tuberculous arthritis, coxalgia, poliomyelitis and clubfoot. He helped establish the French Society of Orthopaedics (Société Française d'Orthopédie) in 1918. In 1921, he became the first chair of paediatric surgery in Lyon, and in 1929, he and Prof. Louis Ombrédanne from Paris were among the ten French cofounders of the SICO(T), a society he chaired at its second conference in London in 1933. He was received on this occasion as an honorary fellow of the Royal College of Surgeons. A brilliant surgeon with a keen analytical sense, he left his mark on the Lyon school of orthopaedic surgery founded by his mentor, Ollier, which he helped to perpetuate.Dysphagia management is a core component of quality stroke care. Speech-Language Pathologists (SLPs) play a key role in the management of post-stroke dysphagia. We sought to elicit perceptions, attitudes, and practice patterns regarding post-stroke dysphagia management among SLPs in the United States. We conducted a survey among SLPs registered with the American Speech-Language-Hearing Association who indicated that they care for acute stroke patients. A total of 336 participants completed the survey. Over half of the participants (58.6%) indicated that they obtain objective swallow testing in ≥ 60% of their post-stroke dysphagia patients. Almost 1 in 5 SLPs indicated that they are often unable to perform objective dysphagia testing due to limited resources (18.8% indicated resource limitations; 78.9% indicated no resources limitations; 2.4% were unsure). SLPs in hospitals without stroke center certification had higher odds of indicating limited resources compared to SLPs in certified stroke centers (OR 2.08, 95% CI 1.11-3.87). Over 75% indicated that percutaneous endoscopic gastrostomy (PEG) tubes after stroke are placed too early. SLPs who obtain objective swallow testing in ≥ 60% of patients had higher odds of indicating that PEG tubes are placed too early (OR 1.70, 95% CI 1.13-2.56). While 19.4% indicated that the optimal timing for PEG after stroke is  12 days. Almost 35% indicated that health care system pressures influence their recommendations, and 47.6% indicated that ≥ 25% of PEGs could be avoided if patients were given up to 7 more days for swallowing recovery.The present paper is devoted to the investigation of population dynamics under climate change. The evolution of species is modelled by a reaction-diffusion equation in a spatio-temporally heterogeneous environment described by a climate envelope that shifts with a time-dependent speed function. For a general almost-periodic speed function, we establish the persistence criterion in terms of the sign of the approximate top Lyapunov exponent and, in the case of persistence, prove the existence of a unique forced wave solution that dominates the population profile of species in the long run. In the setting for studying the effects of fluctuations in the shifting speed or location of the climate envelope, we show by means of matched asymptotic expansions and numerical simulations that the approximate top Lyapunov exponent is a decreasing function with respect to the amplitude of fluctuations, yielding that fluctuations in the shifting speed or location have negative impacts on the persistence of species, and moreover, the larger the fluctuation is, the more adverse the effect is on the species. In addition, we assert that large fluctuations can always drive a species to extinction. Our numerical results also show that a persistent species under climate change is invulnerable to mild fluctuations, and becomes vulnerable when fluctuations are so large that the species is endangered. Finally, we show that fluctuations of amplitude less than or equal to the speed difference between the shifting speed and the critical speed are too weak to endanger a persistent species.Segmental zoster paresis (SZP) of the limbs is characterized by a focal, asymmetric neurogenic weakness that may occur in an extremity affected by herpes zoster (HZ). In this case report, we describe the case of a patient with SZP who presented with these problems and responded well to temporary spinal cord stimulation (SCS) and systematic rehabilitation. A 62-year-old female patient was referred for right upper limb pain, weakness, and insomnia due to pain. After completing the 14-day trial stimulation, the pain numerical rating scale of the patient in the right upper extremity decreased from 8/10 to 2/10. The Athens insomnia scale score decreased from 15/24 to 10/24. Furthermore, the grip strength of the right hands increased from 6.7 to 16.8 kg at discharge. We induced temporal SCS and rehabilitation of the right upper limb SZP and successfully reduced the pain. An in-depth understanding of the neurological complications secondary to HZ should be emphasized, with temporal SCS and rehabilitation expected to play a crucial role in the motor recovery of patients with SZP.