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Combined treatments in hepatocellular carcinoma:Time to put them in the guidelines?

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World Journal of Gastrointestinal Oncology 2021年第12期13卷 1896-1918页

作者： Zeno Sparchez Pompilia Radu Adrian Bartos Iuliana Nenu Rares Craciun Tudor Mocan Adelina Horhat Mihaela Spârchez Jean-François Dufour 3^(rd)Medical department “Ïuliu Hatieganu”University of Medicine and PharmacyInstitute for Gastroenterology and HepatologyCluj-Napoca 400162Romania department of Visceral surgery and Medicine HepatologyInselspitalBern University HospitalUniversity of BernBern 3010Switzerland department of surgery “Ïuliu Hatieganu”University of Medicine and PharmacyInstitute for Gastroenterology and HepatologyCluj-Napoca 400162Romania department of Mother and Child 2nd Paediatric Clinic“Ïuliu Hatieganu”University of Medicine and PharmacyCluj-Napoca 400177Romania department for BioMedical Research HepatologyUniversity of BernBern 3008Switzerland

The time for battling cancer has never been more suitable than nowadays and fortunately against hepatocellular carcinoma(HCC)we do have a far-reaching ***,because liver cancer comprises a plethora of stages-from very early to advanced disease and with many treatment options–from surgery to immunotherapy trials–it leaves the clinician a wide range of *** scope of our review is to throw light on combination treatments that seem to be beyond guidelines and to highlight these using evidence-based analysis of the most frequently used combination therapies,discussing their advantages and flaws in comparison to the current standard of *** particular combination therapy seems to be in the forefront:Transarterial chemoembolization plus ablation for medium-size non-resectable HCC(3-5 cm),which is currently at the frontier between Barcelona Clinic Liver Cancer classification A and *** only does it improve the outcome in contrast to each individual therapy,but it also seems to have similar results to ***,the abundance of immune checkpoint inhibitors that have appeared lately in clinical trials are bringing promising results against *** the path of combination therapies in HCC is still filled with uncertainty and caveats,in the following years the hepatology and oncology fields could witness an HCC guideline revolution.

关键词： Hepatocellular carcinoma Transarterial chemoembolization Radiofrequency ablation Microwave ablation Systemic therapy Immunotherapy combined treatments

New guidelines for screening,evaluation and management of hepatobiliary disease in cystic fibrosis

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Hepatobiliary surgery and Nutrition 2024年第5期13卷 875-878页

作者： P.Aiden McCormick Emer Fitzpatrick Liver Unit St Vincent’s University HospitalDublinIreland department of Medicine UCD School of MedicineUniversity College DublinDublinIreland Gastroenterology and Liver department Children’s Health IrelandCrumlinDublinIreland

The recently published guidelines on screening,monitoring and treatment update previous guidelines published 25 years ago(1,2).This update is timely as much has happened in the *** fibrosis(CF)modulator therapy has dramatically improved prognosis for patients with CF,although it is not yet clear whether liver disease is *** understanding of the pathophysiology of CF liver disease has also changed with the recognition of the importance of non-cirrhotic portal hypertension(3,4).Non-invasive tests for fibrosis and elastography have changed the practice of hepatology and reduced the need for liver *** guideline committee was made up of experts from North America and Europe and included adult and paediatric hepatologists and pulmonologists together with allied health practitioners and representatives of the CF community.A systematic literature search was performed and a vote of 80%was required to adopt a *** guidelines contain 7 recommendations for screening,13 for disease monitoring and 14 for treatment.

关键词： Cirrhosis oesophageal varices non-cirrhotic portal hypertension porto-sinusoidal vascular disease hepatobiliary

Epidemiology of isolated foot burns in children presenting to a Queensland paediatric burns centre—a two-year study in warmer climate

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Burns & Trauma 2017年第1期5卷 58-63页

作者： Florence Ngu Bhaveshkumar Patel Craig McBride Pegg Leditschke Children’s Burns Centre Department of Paediatric SurgeryLady Cilento Children’s Hospital501 Stanley StreetSouth Brisbane QLD 4101Australia Centre for Children’s Burns and Trauma Research Queensland Children’s Medical Research InstituteUniversity of QueenslandQueenslandAustralia

Background: European studies of paediatric foot burns report scalds as the leading cause. Mechanisms of injury are different in warmer climates. We sought to characterize the mechanisms and outcomes of isolated foot burns in our population. Methods: Retrospective review of a prospectively collected database of all children aged 0–15 years presenting to a Queensland paediatric burns centre over a 26-month period. Non-parametric analyses such as the Mann-Whitney U and Pearson Chi-square were used. Results: There were 218 children with foot burns treated over a period of 2 years and 2 months of which 214 had complete records. There were significantly more boys than girls (n=134, 62.6% cf. n=80, 37.4%, p<0.0001). The leading mechanism of injury was a contact burn accounting for 63.1% (n=135) followed by scalds (23.8%, n=51). Friction, flame and chemical burns were a minority but were significantly deeper (p=0.03) and significantly more likely to require grafting (p=0.04) and scar management (p<0.0001) compared to contact and scald burns. Conclusions: In our population, contact burns are the most common mechanism of injury causing burns to the feet. The leading aetiology is campfire burns, which account for one-third of all burns to the feet. Prevention campaigns targeted at this population could significantly reduce the burden of morbidity from these burns. Friction, flame and chemical burns constitute a minority of patients but are deeper and more likely to require skin grafting and scar management.

关键词： Epidemiology Foot burns paediatric Scald Australia Campfire

Severe acute respiratory syndrome coronavirus 2 pandemic related morbidity and mortality in patients with pediatric surgical diseases: A concerning challenge

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World Journal of Methodology 2022年第1期12卷 20-31页

作者： George Vaos Nikolaos Zavras department of paediatric surgery “ATTIKON”University General HospitalNational and Kapodistrian University of AthensSchool of MedicineAthens 12462Greece

The global spread of the novel severe acute respiratory syndrome coronavirus 2 has had serious consequences in terms of patient morbidity and mortality and overburdened health care systems as well as the socioeconomic *** the absence of effective therapies and vaccinations during the viral outbreak,the major and most concise means to control viral spread is spread *** information concerning the impact of severe acute respiratory syndrome coronavirus 2 on pediatric surgical patients has greatly expanded,relevant comprehensive studies are ***,pandemic related morbidity has increased,while under normal circumstances mortality could have been minimized.

关键词： SARS-CoV-2 COVID-19 Pandemic,Pediatric surgery Children Morbidity Mortality

Developing a tool for nurses to assess risk of infection in pediatric oncology patients in China:a modified Delphi study

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The Journal of Biomedical Research 2016年第5期30卷 386-392页

作者： Yufeng Zhou Yan Cui Hong Wang Fang Wang Chao Lu Yan Shen department of Basic and Community Nursing School of NursingNanjing Medical University department of Respiratory The First Affiliated HospitalNanjing Medical University department of paediatric The First Affiliated HospitalNanjing Medical University

Infections are identified as the most common preventable cause of death in pediatric oncology patients. Assessing and stratifying risk of infections are essential to prevent infection in these patients. To date, no tool can fulfill this demand in China. This study aimed to develop a nursing work-based and Chinese-specific tool for pediatric nurses to assess risk of infection in oncology patients. This research was a modified Delphi study. Based on a literature review, a 37-item questionnaire rating on a 0-5 scale was developed. Twenty-four experts from 8 hospitals in 6 provinces of China were consulted for three rounds. Consensus for each item in the first round was defined as： the rating mean was 〉 3 and the coefficient of variation （CV） was 〈 0.5. Consensus for each item in the second round was defined as CV 〈 0.3. Consensus among experts was defined as： P value of Kendall＇s coefficient of concordance （W）〈 0.05. After three rounds of consultation, a two-part tool was developed： the Immune Status Scale （ISS） and the Checklist of Risk Factors of Infection （CRFI）. There were 5 items in the ISS and 14 in the CRFI. Based on the ISS score, nurses could stratify children into the low-risk and high-risk groups. For high-risk children, nurses should screen risk factors of infection every day by the CRFI, and twice weekly for low-risk children. Further study is needed to verify this tool＇s efficacy.

关键词： pediatrics oncology nursing infection control risk assessment Delphi technique

Primary malignant vascular tumors of the liver in children:Angiosarcoma and epithelioid hemangioendothelioma

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World Journal of Gastrointestinal Oncology 2021年第4期13卷 223-230页

作者： Sami Bannoura Juan Putra department of paediatric Laboratory Medicine Hospital for Sick Children555 University AveToronto M5G 1X8OntarioCanada

Primary malignant vascular neoplasms of the liver,angiosarcoma and epithelioid hemangioendothelioma,are extremely rare entities in the pediatric *** Society for the Study of Vascular Anomalies classification system is recommended for the pathologic diagnosis of hepatic vascular lesions in this age *** this article,we highlight the clinicopathologic characteristics of hepatic angiosarcoma and epithelioid hemangioendothelioma in the pediatric *** angiosarcoma in children shows a slight female predominance with an average age of 40 mo at *** distinct histologic features include whorls of atypical spindled cells and eosinophilic globules,in addition to the general findings of *** diagnosis of pediatric hepatic angiosarcoma is not always straightforward,and the diagnostic challenges are discussed in the *** epithelioid hemangioendothelioma also demonstrates a female predominance,but is more commonly identified in adolescents(median age at diagnosis:12 years).Histologically,the lesion is characterized by epithelioid cells and occasional intracytoplasmic lumina with a background of fibromyxoid *** WWTR1-CAMTA1 and YAP1-TFE3 fusions have been associated with epithelioid hemangioendothelioma,there are currently no known signature genetic alterations seen in pediatric hepatic *** in molecular pathology,particularly for pediatric hepatic angiosarcoma,is necessary for a better understanding of the disease biology,diagnosis,and development of targeted therapies.

关键词： Pediatric Hepatic angiosarcoma Epithelioid hemangioendothelioma Infantile hemangioma Liver tumor Molecular genetics

Outcome of meniscal repairs in paediatric population:A tertiary centre experience

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World Journal of Orthopedics 2024年第6期15卷 547-553页

作者： Ayman Gabr Samson Williams Sophie Dodd Nick Barton-Hanson department of Trauma&Orthopaedics West Suffolk HospitalSuffolk IP332QZUnited Kingdom department of Trauma and Orthopaedics Alder Hey Children's HospitalLiverpool L145ABUnited Kingdom

BACKGROUND Meniscal sparing surgery is a widely utilised treatment option for unstable meniscal tears with the aim of minimising the risk of progression towards ***,there is limited data in the literature on meniscal repair outcomes in skeletally immature *** To evaluate the re-operation rate and functional outcomes of meniscal repairs in children and *** We performed a retrospective review of all patients who underwent arthroscopic meniscal repair surgery between January 2007 and January *** patients were under the age of 18 at the time of *** were all performed by a single *** was gathered from our hospital Electronic Patient Records *** primary outcome measure was re-operation rate(need for further surgery on the same meniscus).Secondary outcome measures were surgical complications and patient reported outcome measures that were International Knee Documentation Committee(IKDC),Tegner and Lysholm *** We identified 59 patients who underwent 66 All-inside meniscal repairs(32 medial meniscus and 34 Lateral meniscus).Meniscal repairs were performed utilizing FasT-Fix(Smith and Nephew)*** were 37 males and 22 females with an average age of 14 years(range 6-16).The average follow-up time was 53 months(range 26-140).Six patients had concomitant anterior cruciate ligament reconstruction surgery along with the meniscal *** were no requiring further meniscal repairs and 9 patients underwent partial *** mean postoperative IKDC score was 88(44-100),Tegner score was 7(2-10)and Lysholm score was 94(57-100).CONCLUSION Our results showed that arthroscopic repair of meniscal tears in the paediatric population is an effective treatment option that has a low failure rate and good postoperative clinical with the advantage of preserving meniscal tissues.

关键词： Meniscus Meniscal repair Outcome Meniscal preservation

Application of MPVR and TL-VR with 64-row MDCT in neonates with congenital EA and distal TEF

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World Journal of Gastroenterology 2011年第12期17卷 1649-1654页

作者： Yang Wen Yun Peng Ren-You Zhai Ying-Zi Li National Key Discipline of Pediatrics (Capital Medical University) Ministry of Education Department of Radiology Beijing Children's Hospital Affiliated to Capital Medical University Beijing 100045 China department of Radiology Chaoyang Hospital Affiliated to Capital Medical University Beijing 100020 China National Key Discipline of Pediatrics (Capital Medical University) Ministry of Education Department of Paediatric Surgery Beijing Children's Hospital Affiliated to Capital Medical University Beijing 100045 China

AIM:To assess the application of multiple planar volume reconstruction(MPVR) and three-dimensional (3D) transparency lung volume rendering(TL-VR) with 64-row multidetector-row computed tomography (MDCT) in neonates with congenital esophageal atresia (EA) and distal tracheoesophageal fistula(TEF).METHODS:Twenty neonates(17 boys,3 girls) with EA and distal TEF at a mean age of 4.6 d(range 1-16 d) were enrolled in this study.A helical scan of 64-row MDCT was performed at the 64 mm×0.625 mm *** and TEF were reconstructed with MPVR and TL-VR,*** diagnosis of EA was made by chest radiography showing the inserted catheter in the proximal blind-ended esophageal *** of MDCT images were compared with the findings at ***:MDCT showed the proximal and distal esophageal pouches in 20 *** significant difference was observed in gaps between the proximal and distal esophageal pouches detected by MPVR and *** lengths of gaps between the proximal and distal esophageal pouches detected by MPVR and TL-VR correlated well with the findings at surgery(R=0.87,P<0.001).The images of MPVR revealed the orifice of TEF in 13 cases,while TL-VR images showed the orifice of TEF in 4 ***:EA and distal TEF can be reconstructed using MPVR and TL-VR of 64-row MDCT,which is a noninvasive technique to demonstrate the distal esophageal pouches and inter-pouch distance in neonates with EA and distal TEF.

关键词： Children Computed tomography Congenital malformation Esophagus Tracheoesophageal fistula

Adolescent Lisfranc injury treated with TightRope^(TM):A case report and review of literature

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World Journal of Orthopedics 2019年第2期10卷 115-122页

作者： Themistoklis Tzatzairis Gregory Firth Lee Parker Royal London Hospital Paediatric Orthopaedic Department Barts NHS Trust Royal London Hospital Foot and Ankle Orthopaedic department Barts NHS Trust

BACKGROUND Lisfranc injuries are rare and can be easily missed. This injury is extremely rare in children, with limited published data. Different treatment options have been described; one of the options in adults is the "mini" TightRope^(TM) Syndesmosis Device that provides non-rigid fixation with impressive results. However, there is no reference regarding the use of this device in *** SUMMARY We describe the case of an 11-year-old girl who sustained a Lisfranc injury of her right foot that was initially missed in the Accident and Emergency department of her local hospital. This case was a ligamentous/periosteal sleeve avulsion type of Lisfranc injury and a percutaneous technique using the "mini" TightRope^(TM)syndesmosis device was used. Clinical and radiological results were excellent at final follow *** The "mini" TightRope^(TM) syndesmosis device is a promising method of fixation for children with certain Lisfranc injuries. This method has many advantages,including the non-rigid type of the fixation and no need for subsequent metalwork removal.

关键词： Lisfranc Injury Foot Tightrope paediatric Case report