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Real-Time Remote-Mentored Echocardiography in Management of Newborns with Critical Congenital Heart Defects

Congenital Heart Disease 2023年第5期18卷 551-559页

作者： Håvard Bjerkeseth Solvin Simone Goa Diab Ole Jakob Elle Henrik Holmstrøm Henrik Brun Institute of clinical Medicine University of OsloOsloNorway The Intervention Centre Technology and Innovation ClinicOslo University HospitalOsloNorway Department of Informatics University of OsloOsloNorway Department of pediatric Cardiology Oslo University HospitalOsloNorway Department of pediatrics Oslo University HospitalOsloNorway

Background:The management of suspected critical congenital heart defects(CCHD)relies on timely echocardiographic *** availability of experienced echocardiographers is limited or even non-existent in many hospitals with obstetric *** study evaluates remote-mentored echocardiography performed by physicians without experience in imaging of congenital heart defects(CHD).Methods:The setup included a pediatric cardiologist in a separate room,guiding a physician without experience in echocardiographic imaging of CHD in the examination of a symptomatic *** remote-mentoring pair was blinded to the diagnosis of the newborn and presented with a simplified patient *** echocardiographic images were streamed to the laptop of the mentor,along with a webcam feed showing the probe *** task was to identify CCHD in need of immediate transfer to a pediatric cardiac surgical *** result was compared to the previously completed echocardiographic report and the clinical decision of the patient-responsible pediatric ***:During 17 months,15 newborns were *** six newborns with CCHD were correctly labeled by the remotementoring *** newborn with Tetralogy of Fallot was erroneously labeled as needing immediate *** newborns without CCHD were correctly ***:Remote-mentored echocardiography performed by examiners without experience in imaging CHD identified all newborns with CCHD in need of immediate transfer for specialist *** setup shows promising results for improving the management of CCHD in hospitals without continuous pediatric cardiology service.

关键词： Remote-mentoring echocardiography telemedicine congenital heart defect

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无先前已知心脏病儿童的电轴左偏

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中国循证儿科杂志 2019年第4期14卷 319-320页

作者： Andrew E. Schneider Bryan C. Cannon Jonathan N. Johnson Michael J. Ackerman Philip L. Wackel 赵趣鸣(译) 刘芳(校) Division of pediatric Cardiology Department of Pediatric and Adolescent MedicineMayo ClinicRochesterMinnesota Division of Heart Rhythm Services Department of Cardiovascular DiseasesMayo ClinicRochesterMinnesota Department of Molecular Pharmacology and Experimental Therapeutics and Windland Smith Rice Sudden Death Genomics Laboratory Mayo ClinicRochesterMinnesota 不详

研究背景在儿童中,电轴左偏与一些特殊类型的心脏病理有关,许多患儿在婴儿期得到确诊;但目前尚不清楚无症状的电轴左偏儿童的心脏病发生率,也不清楚这类儿童需要做哪些其他检查。研究新知本研究确认,无先前已知心脏病的电轴左偏儿童可... 详细信息

研究背景在儿童中,电轴左偏与一些特殊类型的心脏病理有关,许多患儿在婴儿期得到确诊;但目前尚不清楚无症状的电轴左偏儿童的心脏病发生率,也不清楚这类儿童需要做哪些其他检查。研究新知本研究确认,无先前已知心脏病的电轴左偏儿童可能存在合并心脏病的危险因素,这些危险因素可以帮助临床医师在偶然发现电轴左偏时,决定哪些患儿应做进一步的检查。

关键词：电轴左偏心脏病理儿童危险因素临床医师婴儿期发生率无症状

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Combined liver-kidney transplantation for rare diseases

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World Journal of Hepatology 2020年第10期12卷 722-737页

作者： Mladen Knotek Rafaela Novak Alemka Jaklin-Kekez Anna Mrzljak Department of Medicine Tree Top HospitalHulhumale 23000Maldives Department of Medicine Merkur University HospitalZagreb 10000Croatia School of Medicine University of ZagrebZagreb 10000Croatia clinic for pediatric Diseases Helena Zagreb 10000Croatia

Combined liver and kidney transplantation(CLKT)is indicated in patients with failure of both organs,or for the treatment of end-stage chronic kidney disease(ESKD)caused by a genetic defect in the *** aim of the present review is to provide the most up-to-date overview of the rare conditions as indications for *** are major indications for CLKT in ***,in some of them(e.g.,atypical hemolytic uremic syndrome or primary hyperoxaluria),CLKT may be required in adults as *** hyperoxaluria is divided into three types,of which type 1 and 2 lead to *** has been proven effective in renal function replacement,at the same time preventing recurrence of the *** is associated with liver fibrosis in 5%of cases and these patients are candidates for *** alpha 1-antitrypsin deficiency,hereditary C3 deficiency,lecithin cholesterol acyltransferase deficiency and glycogen storage diseases,glomerular or tubulointerstitial disease can lead to chronic kidney *** transplantation as a part of CLKT corrects underlying genetic and consequent metabolic *** atypical hemolytic uremic syndrome caused by mutations in the genes for factor H,successful CLKT has been reported in a small number of ***,for this indication,CLKT has been largely replaced by eculizumab,an anti-C5 *** has been well established to provide immune protection of the transplanted kidney against donor-specific antibodies against class I HLA,facilitating transplantation in a highly sensitized recipient.

关键词： Combined liver-kidney transplantation Methylmalonic aciduria Hereditary complement C3 deficiency Glycogen storage diseases Homozygous protein C deficiency Primary hyperoxaluria Atypical hemolytic uremic syndrome Sensitization Donorspecific antibodies

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Expert consensus on pediatric orthodontic therapies of malocclusions in children

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International Journal of Oral Science 2024年第2期16卷 186-196页

作者： Chenchen Zhou Peipei Duan Hong He Jinlin Song Min Hu Yuehua Liu Yan Liu Jie Guo Fang Jin Yang Cao Lingyong Jiang Qingsong Ye Min Zhu Beizhan Jiang Wenhua Ruan Xiao Yuan Huang Li Rui Zou Yulou Tian Li Gao Rui Shu Jianwei Chen Renkai Liu Shujuan Zou Xiaobing Li State Key Laboratory of Oral Diseases&National Center for Stomatology&National clinical Research Center for Oral Diseases&Department of pediatric Dentistry West China Hospital of StomatologySichuan UniversityChengduChina State Key Laboratory of Oral Diseases&National Center for Stomatology&National clinical Research Center for Oral Diseases&Department of Orthodontics West China Hospital of StomatologySichuan UniversityChengduChina State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration&Key Laboratory of Oral Biomedicine Ministry of Education&Hubei Key Laboratory of Stomatology&Department of Orthodontics&Center for Dentofacial Development and Sleep Medicine School and Hospital of StomatologyWuhan UniversityWuhanChina Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences&Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education Stomatological Hospital of Chongqing Medical UniversityChongqing Medical University&College of StomatologyChongqing Medical UniversityChongqingChina Department of Orthodontics Hospital of StomatologyJilin UniversityChangchunChina Department of Orthodontic&Oral Biomedical Engineering Laboratory Shanghai Stomatological HospitalFudan UniversityShanghaiChina Department of Orthodontics Central LaboratoryPeking University School and Hospital for Stomatology&National Center for Stomatology&National Clinical Research Center for Oral Diseases&National Engineering Research Center of Oral Biomaterials and Digital Medical Devices&Beijing Key Laboratory of Digital Stomatology&Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health&NMPA Key Laboratory for Dental Materials&National Engineering Research Center of Oral Biomaterials and Digital Medical DevicesBeijingChina Department of Orthodontics School and Hospital of StomatologyCollege of MedicineShandong University&Shandong Key Laboratory of Oral Tissue Regeneration&Shandong Engineering Laboratory for Dental Materials and Oral Tissue

Malocclusion,identified by the World Health Organization(WHO)as one of three major oral diseases,profoundly impacts the dental-maxillofacial functions,facial esthetics,and long-term development of~260 million children in *** its physical manifestations,malocclusion also significantly influences the psycho-social well-being of these *** intervention in malocclusion can foster an environment conducive to dental-maxillofacial development and substantially decrease the incidence of malocclusion or reduce the severity and complexity of malocclusion in the permanent dentition,by mitigating the negative impact of abnormal environmental influences on the *** orthodontic treatment encompasses accurate identification and treatment of dental and maxillofacial morphological and functional abnormalities during various stages of dental-maxillofacial development,ranging from fetal stages to the early permanent dentition *** an economic and societal standpoint,the urgency for effective early orthodontic treatments for malocclusions in childhood cannot be overstated,underlining its profound practical and social *** consensus paper discusses the characteristics and the detrimental effects of malocclusion in children,emphasizing critical need for early *** elaborates on corresponding core principles and fundamental approaches in early orthodontics,proposing comprehensive guidance for preventive and interceptive orthodontic treatment,serving as a reference for clinicians engaged in early orthodontic treatment.

关键词： permanent stated children

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The Influence of Leukocyte and Platelet Concentrate Enrich in Stem Cells on Bone Regeneration Processes:A clinical and Flow Cytometry Study

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Journal of Biomedical Science and Engineering 2015年第9期8卷 659-664页

作者： Tomasz Bielecki Krzysztof Wojcik Tadeusz Bold Bartlomiej Osadnik Tomasz Szczepanski Department and clinic of Orthopaedics Trauma Center St.Barbara HospitalMedical University of SilesiaSosnowiecPoland Department and clinic of Hematology and pediatric Oncology Medical University of SilesiaZabrzePoland

This article reports the efficacy of percutaneous autologous leukocyte- and platelet-rich plasma (L-PRP) injection into delayed union site as a minimally invasive method alternative to bone marrow aspirate and open grafting techniques. Each of 15 participants was followed on a regular basis with clinical examinations, roentgenograms. The average time to union was 8.4 weeks after L-PRP injection and the union was achieved in all cases. CD34+/45+ cells counts were increased by 410% and CD34+/45- cells counts were increased by 488% on average in L-PRP. Our investigation showed that L-PRP enrich in stem cells can produce the desired stimulatory response despite a substantial amount of vital bone cells from mesenchymal line. We believe that the using of L-PRP enriched in stem cells, growth factors and antimicrobial proteins might be a promising treatment method in regenerative medicine.

关键词： Healing Growth Factors Induction Stimulation Osteogenesis

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Lateral femoral neck stress fractures: A case report

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World Journal of Orthopedics 2024年第9期15卷 891-901页

作者： Christiaan AJ Oudmaijer Nuno R Paulino Pereira David Visser Alexander M Wakker Wout S Veltman Robbart van Linschoten Department of Surgery Division of Hepatobiliary and Transplantation SurgeryErasmus MC Transplant InstituteRotterdam 3015 GDZuid-HollandNetherlands Princess Maxima Center for pediatric Oncology Utrecht 3584 CSNetherlands Orthopaedics and Sports Medicine Erasmus MCErasmus University Medical Center RotterdamRotterdam 3015 GDZuid-HollandNetherlands Department of Surgery Division of Trauma SurgeryErasmus MCErasmus University Medical Center RotterdamRotterdam 3015 GDZuid-HollandNetherlands

BACKGROUND Sport-induced injuries particularly affect young,healthy,and active ***,a popular and accessible sport,can cause a wide range of injuries,including stress *** fractures can occur during high-intensity training or competitions,especially among well-trained amateurs and professional *** diagnosis can be complicated by the typically young age,unremarkable medical history,and vital condition of the *** fractures present insidiously,and this is specifically the case with stress fractures of the femoral *** intervention is crucial to prevent progressive displacement,as this can damage the blood supply to the femoral *** SUMMARY A 30-year-old male runner presented to our outpatient clinic with persistent pain 3 weeks after running a marathon.X-ray showed a complete lateral fracture of the left femoral neck,which was treated surgically with a dynamic hip *** It is essential for healthcare providers to be vigilant for the subtle symptoms of stress fractures to ensure timely *** recognition prevents com-plication and leads to a better prognosis.

关键词： Stress fractures Atypical Femoral Neck Marathon Diagnosis Case report

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Axon injury induced endoplasmic reticulum stress and neurodegeneration

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Neural Regeneration Research 2016年第10期11卷 1557-1559页

作者： Yang Hu Shriners Hospitals pediatric Research Center (Center for Neural Repair and Rehabilitation) Temple University School of Medicine

Injury to central nervous system axons is a common early characteristic of neurodegenerative diseases. Depending on its location and the type of neuron, axon injury often leads to axon degeneration, retrograde neuronal cell death and progressive permanent loss of vital neuronal functions. Although these sequential events are clearly connected, ample evidence indicates that neuronal soma and axon degenerations are active autonomous processes with distinct molecular mechanisms. By exploiting the anatomical and techni- cal advantages of the retinal ganglion cell （RGC）/optic nerve （ON） system, we demonstrated that inhibition of the PERK-eIF2a-CHOP pathway and activation of the X-box binding protein 1 pathway synergistically protect RGC soma and axon, and preserve visual function, in both acute ON traumatic injury and chronic glaucomatous neuropathy. The autonomous endoplasmic reticulum （ER） stress pathway in neurons has been implicated in several other neurodegenerative diseases. In addition to the emerging role of ER mor- phology in axon maintenance, we propose that ER stress is a common upstream signal for disturbances in axon integrity, and that it leads to a retrograde signal that can subsequently induce neuronal soma death. Therefore manipulation of the ER stress pathway may be a key step toward developing the effective neuro- protectants that are greatly needed in the clinic.

关键词： endoplasmic reticulum stress axonopathy retinal ganglion cell optic nerve neurodegeneration CHOP XBP-1

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Pain-Relieving Effect of Music on Preschoolers during Immunization: A Randomized Controlled Trial

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Health 2018年第1期10卷 145-158页

作者： Yui Shiroshita Kotaro Muraki Tatsuya Kamei Ikuko Sobue Division of Nursing Science Graduate School of Biomedical & Health Sciences Hiroshima University Hiroshima Japan Muraki pediatric clinic Hiroshima Japan

Background: Immunization is a medical procedure many children frequently undergo. As it involves pain, it is important to develop effective pain relief methods that are applicable from infancy. Objective: To clarify the pain-relieving effect of music from speakers on preschoolers during immunization. Methods: A randomized controlled trial using sex-based stratified randomization was conducted at a Japanese pediatric clinic between October and December 2016, involving 48 preschoolers aged 5 - 6. Among these, 25 listened to music (“Twinkle Twinkle Little Star” played by a music box) from speakers before, during, and after influenza immunization (Music group), while the other 23 were not treated with musical intervention (Control group), with the following outcomes: primary: the Face Scale score;and secondary: the heart rate (HR) and oxygen saturation (SpO2) and salivary alpha amylase (sAA) levels. Results: The Face Scale score and HR of the Control group immediately after influenza immunization were significantly higher than their baseline values (P < 0.0001, P < 0.05). There were no significant differences between the Music and Control groups in the Face Scale score, HR, or SpO2 level immediately after influenza immunization or in the sAA level 10 minutes after it. Conclusion: Influenza immunization was painful for preschoolers. When based on the Face Scale score, HR, SpO2 and sAA levels as indices to measure immunization-related pain, music did not show pain-relieving effects.

关键词： Pain Immunization Music Preschoolers

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A Rare Cause of Leukocoria in Children: Persistent Hyperplastic Primary Vitreous

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Open Journal of Ophthalmology 2024年第1期14卷 63-68页

作者： Prudence Ada Assoumou Davy Alex Mouinga Abayi Yoan Mboussou Annick Kougou Ntoutoume Helene Nyinko Aboughe Olive Matsanga Tatiana Harly Mba Aki Emmanuel Mve Mengome Owendo University Hospital Center Department of Surgery at the Faculty of Medicine of the University of Health Sciences Libreville Gabon Omar Bongo Ondimba Military Instructions Hospital Department of Surgery at the Faculty of Medicine of the University of Health Sciences Libreville Gabon Médivision clinic Libreville Gabon Jeanne Ebori Foundation Mother and Child University Hospital Center Department of Surgery at the Faculty of Medicine of the University of Health Sciences Libreville Gabon

Introduction: Leukocoria, a whitish pupillary reflection, is a common warning sign of various pediatric ocular pathologies, including Persistent hyperplastic primary vitreous (PHVP). This case report describes the observation of a 3-year-old child with melanoderma, presenting with a white spot in the left eye since birth. Observation: Uncorrected distance visual acuity was 2/10 in the right eye and hand movements were perceived at 2 meters in the left eye. Examination of the anterior segment in the left eye revealed leukocoria and microphthalmia. The fundus examination was normal in the right eye but revealed a white mass extending from the center of the optic disc towards the temporal region in the left eye. Ocular imaging, including ocular ultrasound and optical coherence tomography, confirmed the diagnosis of PHVP, illustrated by a residual white mass at the center of the optic disc in the left eye. Conclusion: PHVP should be considered in the presence of leukocoria in a child, with urgent exclusion of retinoblastoma. This observation underscores the importance of early diagnosis for appropriate management. .

关键词： PHVP Leukocoria Amblyopia Ocular Imaging Childhood

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Do Immaturity, Dehydratation or Alkalosis Predispose to Intraoperative Complications at Pyloromyotomy?

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Open Journal of pediatrics 2016年第3期6卷 203-212页

作者： Ralf-Bodo Tröbs Lars Burghardt Micha Bahr Matthias Nissen Department of pediatric Surgery clinic Marien Hospital Herne St. Elisabeth Gruppe Ruhr-Universit?t Bochum Herne Germany

Background: Hypertrophic pyloric stenosis is the most important cause for propulsive non-bilious vomiting in infants of the first trimester. Extramucous splitting of the hypertrophic pyloric muscle is the surgical gold standard for treatment. Serious major complications of pyloromyotomy (PM) are mucosal perforation and incomplete muscle splitting. The aim of the presented study is to find out if intraoperative complications are predisposed by biometric or biochemical factors. Furthermore, we looked for the influence of the board certification of the primary surgeon. Patients and Methods: 162 infants with IHPS were operated during a six-year period (n = 150 laparoscopic operations). We had 8 major complications (4.9%): iatrogenic mucosal perforation occurred in 6 cases, and incomplete PM in 2 infants. Preoperative demographic data and data resulting from the blood acid-base- and ion-analysis were compared with data of a previously published reference group from our institution (Tr?bs RB. Open J Pediatr, 2014;4: 208-215). Results: The duration of vomiting, the grade of dehydration and the severity of blood alkalosis did not differ between both groups. Furthermore, we found no influence of the gestational age and birth weight on the occurrence of intraoperative complications. It seems that early postnatal age (p = 0.07) and low body weight at surgery (p = 0.055) may contribute to surgical problems. Board certification as a paediatric surgeon did not influence the rate of intraoperative complications. Conclusions: Laboratory data did not show any predisposition to intraoperative complications. It is assumed that small infants with early occurring symptoms carry an elevated risk for intraoperative events. Our data support the hypothesis that the rate of intraoperative complications at PM is mainly influenced by skills and experience of the surgeon.

关键词： Hypertrophic Pyloric Stenosis Pyloromyotomy Complication Perforation Alkalosis Surgical Training

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