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BACKGROUND: Dengue has become an alarming global problem and is endemic in many countries, particularly in tropical and subtropical countries. The aim of this study was to investigate dengue fever outbreak in Banadir Region, Somalia, to understand the risk factors (time, place, personal characteristics). METHODS: A descriptive cross-sectional study was undertaken to determine the levels of circulating anti-dengue virus antibodies and DENV NS1 antigen among Banadir Region residents, while a questionnaire survey was conducted to understand the clinical and demographic characteristics of the patients. RESULTS: A total of 735 febrile patients were studied, with 55.6% men and 44.3% women. The majority of the participants were children aged 14 years and younger. Among them, 10.8% tested positive for IgM antibodies against dengue virus (DENV), while the prevalence of DENV NS1 antigen was 11.8%. Fever and myalgia were the most common symptoms observed in the DENV-positive patients. CONCLUSIONS: A dengue fever outbreak has been confirmed in Banadir region, Somalia. This study provides information on the most affected districts and identifies risk factors contributing to DF outbreaks. The study recommends improving outbreak readiness and response, particularly in surveillance and laboratory diagnostics, by fostering intersectoral collaboration and establishing regulatory frameworks for financial and operational participation.
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Vírus da Dengue , Dengue , Criança , Masculino , Humanos , Feminino , Dengue/epidemiologia , Estudos Transversais , Somália/epidemiologia , Ensaio de Imunoadsorção Enzimática , Fatores Socioeconômicos , Surtos de Doenças , Febre/epidemiologia , Anticorpos AntiviraisRESUMO
AIM: To assess the efficacy of positional therapy and oral appliance therapy for the management of positional obstructive sleep apnea. METHODS: We searched PubMed, Web of Science, Cochrane, and SCOPUS for relevant clinical trials. Quality assessment of the included trials was evaluated according to Cochrane's risk of bias tool. We included the following outcomes: The apnea-hypopnea index (AHI), AHI non-supine, AHI supine, sleep efficiency, percentage of supine sleep, Adherence (≥ 4 h/night, ≥ 5 days/week), Oxygen desaturation Index, Arousal Index, Epworth Sleepiness Scale score (ESS), Mean SpO2, and Functional Outcomes of Sleep Questionnaire. RESULTS: The AHI non-supine and the ESS scores were significantly lower in the OAT cohort than in the PT cohort. The PT cohort was associated with a significantly decreased percentage of supine sleep than the OAT cohort (MD= -26.07 [-33.15, -19.00], P = 0.0001). There was no significant variation between PT cohort and OAT cohort regarding total AHI, AHI supine, ODI, sleep efficiency, arousal index, FOSQ, adherence, and mean SpO2. CONCLUSION: Both Positional Therapy and Oral Appliance Therapy effectively addressed Obstructive Sleep Apnea. However, Oral Appliance Therapy exhibited higher efficiency, leading to increased supine sleep percentage and more significant reductions in the Apnea Hypopnea Index during non-supine positions, as well as lower scores on the Epworth Sleepiness Scale.
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Ensaios Clínicos Controlados Aleatórios como Assunto , Apneia Obstrutiva do Sono , Apneia Obstrutiva do Sono/terapia , Humanos , Decúbito Dorsal , Posicionamento do Paciente/métodosRESUMO
BACKGROUND: Minimally invasive surgery is an expanding field of surgery that has replaced many open surgical techniques. Surgery remains a cornerstone in the treatment of esophageal cancer, yet it is still associated with significant morbidity and technical difficulties. Mediastinoscope-assisted esophagectomy is a promising technique that aims to decrease the surgical burden and enhance recovery. METHODS: PubMed, MEDLINE, and EMBASE databases were searched for publications on mediastinoscope-assisted esophagectomies for esophageal cancer. The primary endpoint was a postoperative anastomotic leak, while secondary endpoints were assessment of harvested lymph nodes (LNs), blood loss, chyle leak, hospital length of stay (LOS), operative (OR) time, pneumonia, wound infection, mortality, and microscopic positive margin (R1). The pooled event rate (PER) and pooled mean were calculated for binary and continuous outcomes respectively. RESULTS: Twenty-six out of the 2274 searched studies were included. The pooled event rate (PER) for anastomotic leak was 0.145 (0.1144; 0.1828). The PERs for chyle leak, recurrent laryngeal nerve injury/hoarseness, postoperative pneumonia, wound infection, early mortality, postoperative morbidity, and microscopically positive (R1) resection margins were 0.027, 0.185, 0.09, 0.083, 0.020, 0.378, and 0.037 respectively. The pooled means for blood loss, hospital stay, operative time, number of total harvested LNs, and number of harvested thoracic LNs were 159.209, 15.187, 311.116, 23.379, and 15.458 respectively. CONCLUSIONS: Mediastinoscopic esophagectomy is a promising minimally invasive technique, avoiding thoracotomy, patient repositioning, and lung manipulation; thus allowing for shorter surgery, decreased blood loss, and decreased postoperative morbidity. It can also be reliable in terms of oncological safety and LN dissection.
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Neoplasias Esofágicas , Laparoscopia , Pneumonia , Humanos , Esofagectomia , Mediastinoscópios , Fístula Anastomótica/cirurgia , Neoplasias Esofágicas/patologia , Tempo de Internação , Pneumonia/etiologia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Complicações Pós-Operatórias/cirurgia , Laparoscopia/métodos , Resultado do TratamentoRESUMO
OBJECTIVE: This randomized controlled trial (RCT) aims to investigate the short-term effects of chlorhexidine mouthwash (MW) on gingival health surrounding orthodontic miniscrew implants (OMIs) and their overall survivability. MATERIALS AND METHODS: Thirty-two participants (mean age, 22.8 years) undergoing fixed orthodontic appliance treatment after maxillary premolar extraction were randomly allocated in a parallel fashion to either receive (1) MW with an active component of chlorhexidine or (2) a placebo. Each participant received two maxillary buccal OMIs for anchorage reinforcement purposes. Participants were assessed for their gingival oral health status around all inserted OMIs and had their OMI survivability recorded at three time points; T1 = 1 month, T2 = 3 months, and T3 = 6 months after OMI placement. A Kaplan-Meier plot was used to estimate the survival function of OMIs. RESULTS: All randomized participants completed the follow-up period. In terms of gingival oral health, there were no statistically significant differences at any time point between the chlorhexidine MW group and the placebo-controlled group (P > .05). One OMI was lost in the chlorhexidine MW group and another two OMIs in the control group. There was no significant difference between both groups in terms of survivability (P = .585). CONCLUSION: The use of chlorhexidine MW does not seem to have a significant clinical impact on gingival health around OMIs or their survivability in this pilot study.
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Clorexidina , Antissépticos Bucais , Humanos , Adulto Jovem , Adulto , Clorexidina/uso terapêutico , Antissépticos Bucais/uso terapêutico , Aparelhos Ortodônticos Fixos , Índice de Placa Dentária , Índice PeriodontalRESUMO
We present a case of extradural hematoma resulting from a relatively minor closed injury over the vertex where a plasma cell tumour had invaded the superior sagittal sinus. The patient underwent an emergency craniotomy and evacuation of the hematoma. Hemostasis and prevention of recollection of the hematoma were hampered by the erosion of the sagittal sinus making its direct repair impossible. This was achieved by hitching up the dura lateral to the sinus to become its lateral wall reinforced by hemostatic agents. The patient made a full recovery. Malignant tumours invading the dural venous sinuses and eroding the skull can cause life-threatening intracranial bleeding after relatively minor trauma.
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Hematoma Epidural Craniano , Fraturas Cranianas , Neoplasias Cranianas , Humanos , Cavidades Cranianas/cirurgia , Craniotomia/métodos , Hematoma Epidural Craniano/diagnóstico por imagem , Hematoma Epidural Craniano/etiologia , Hematoma Epidural Craniano/cirurgia , Crânio/cirurgia , Fraturas Cranianas/cirurgia , Neoplasias Cranianas/diagnóstico por imagem , Neoplasias Cranianas/cirurgia , Masculino , AdultoRESUMO
BACKGROUND: The steel industry is one of the noisiest industries, which can predispose workers to hearing loss. In Egypt, the demand for steel is increasing due to the construction of new infrastructures as bridges, flyover roads, buildings, and towers; however, little is known about the prevalence of occupational noise-induced hearing loss (NIHL) among steel workers. Understanding the distribution of the affected workers is crucial for planning prevention strategies. This study aimed to estimate the prevalence of occupational NIHL among Egyptian steel workers and identify its correlates. METHODS: This study was conducted at two steel factories in Egypt in November 2021. It involved an initial retrospective review of the factory medical records of the latest periodic medical examination conducted on workers from July to September in the year 2021 representing workers' health status in that year. Then, a case-control approach analysis was carried out. Eligible workers (n = 606) were enrolled and divided into two groups: noise-exposed workers (n = 396) and unexposed workers (n = 210). Univariate and multivariate regression analyses were performed. RESULTS: Occupational exposure to hazardous A-weighted equivalent noise level (> 85 dB) was associated with higher hearing thresholds at all frequencies (highest at 4 kHz followed by 6 kHz), particularly in younger workers below the age of 40 years. Nearly 71% of noise-exposed workers had hearing impairment, and 47% had NIHL compared with unexposed workers (45.7% and 11.9%, respectively). The probability of NIHL in noise-exposed workers was 6.55 times higher than that in unexposed workers (OR = 6.55, 95%CI = 4.13, 10.40; p < 0.001). In noise-exposed workers, age and tinnitus were independent predictors of hearing thresholds, while tinnitus was found to be an independent predictor of NIHL after adjusting for age and job duration (OR = 2.06, 95%CI = 1.01, 4.20; p = 0.045). CONCLUSION: Almost half of noise-exposed workers had NIHL. Tinnitus was found to be an independent predictor of NIHL. Decreasing noise exposure levels in steel plants is recommended to reduce hearing loss. Future research is required to study the effect of tinnitus on audiometry measurements among workers with NIHL.
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INTRODUCTION: Despite the significant clinical importance of sex among factors affecting cancer progression and survival, it remains one of the least studied factors. Therefore, we sought to examine these differences in relation to primary malignant cardiac tumors (PMCTs) using a national data set. METHODS: The 2004-2017 National Cancer Database was queried for patients with PMCTs. Annual trend of females' percent was assessed. Overall survival predictors were evaluated with Kaplan-Meier and Cox-regression. Subgroup analysis was done based on histology, comorbidity index, race, insurance, and surgical treatment. RESULTS: PMCTs were identified in 736 patients (median age 52, female [47.8%]). Most of them were high-grade (49.2%). About 60% underwent surgery. Angiosarcoma (43%), fibrosarcoma (5.2%), and leiomyosarcoma (5.2%) were the most common pathologies. Based on multivariate Cox-regression, higher income, higher comorbidity index, angiosarcoma, and Stage III/IV were associated with higher late mortality, while year of diagnosis and use of surgery or chemotherapy were associated with lower mortality. Among the surgical group, age, higher income, higher comorbidity index, angiosarcoma, and Stage III/IV were independent predictors of higher late mortality, while private insurance and year of diagnosis were associated with lower late mortality. No difference was seen between males and females in 30-day and late mortality (p = .71). Subgroup analysis based on Cox-regression showed no differences in late mortality between males and females. CONCLUSION: PMCTs have poor overall survival. Surgery and chemotherapy were associated with longer survival benefits. On the contrary, the associated risk factors for mortality were advanced age, higher comorbidity index, angiosarcoma histology, and Stage III/IV.
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Neoplasias Cardíacas , Hemangiossarcoma , Estudos de Coortes , Bases de Dados Factuais , Feminino , Neoplasias Cardíacas/epidemiologia , Neoplasias Cardíacas/cirurgia , Hemangiossarcoma/epidemiologia , Hemangiossarcoma/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Caracteres SexuaisRESUMO
INTRODUCTION: Coronavirus disease 2019 (COVID-19) is one of the most formidable challenges that influenced all domains of health care delivery. This research explored the experiences and challenges orthodontic patients faced in quarantine during the COVID-19 outbreak. The goal was to learn from patients about their oral health and general practices during this time to provide optimal delivery of orthodontic treatment care. METHODS: A phenomenographic qualitative design involving semistructured face-to-face interviews. A purposive sampling strategy was deployed to collect qualitative data from 24 orthodontic patients who quarantined during the COVID-19 pandemic. All interviews were digitally recorded, and afterwards, they were transcribed verbatim. RESULTS: Four main themes and associated subthemes were identified. The themes were (1) oral-health-related behavioral changes, (2) impact on treatment progression, (3) psychosocial impact and attitude changes, and (4) areas for future enhancements in health care delivery. Overall findings revealed both positive and negative behavioral changes in orthodontic patients regarding their adjustment during the quarantine and its implications to general health and well-being. CONCLUSIONS: Findings from this study suggest that COVID-19 impacted dental health care delivery to orthodontic patients during the quarantine. Patients reported psychosocial and behavioral changes as a consequence of treatment disruption and pandemic lockdown. The implications of these findings to the clinical dental environment and patient education are pivotal to further target areas in dental health care delivery that require strengthening. As such, clinicians could expect behavioral changes from orthodontic patients and identify better strategies to mitigate clinical challenges resulting from such changes.
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COVID-19 , Quarentena , Controle de Doenças Transmissíveis/métodos , Humanos , Pandemias/prevenção & controle , Pesquisa Qualitativa , Quarentena/psicologia , SARS-CoV-2RESUMO
OBJECTIVES: This study was designed to evaluate the safety and efficacy of erector spinae plane block and serratus anterior plane block versus thoracic epidural in perioperative pain control for patients with cancer undergoing lung surgeries. DESIGN: Single blinded, randomized, controlled trial. SETTING: The study was carried out at the National Cancer Institute in Cairo, Egypt. PARTICIPANTS: Fifty-one patients with cancer. INTERVENTIONS: Patients were allocated randomly into three groups: thoracic epidural analgesia (TEA) group, serratus anterior plane block (SAPB) group, and erector spinae plane block (ESPB) group. MEASUREMENTS AND MAIN RESULTS: Outcome measures were 24 hours postoperative visual analog scale (VAS), intraoperative rescue fentanyl consumption, perioperative heart rate, mean blood pressure (mean arterial pressure [MAP]), and total postoperative morphine consumption. VAS scores at rest were significantly lower in the TEA group at the postanesthesia care unit and 24 hours. VAS scores with cough were significantly higher in the SAPB group at eight and 24 hours. The first time to receive morphine was significantly longer in the TEA group. No patients in the TEA group required postoperative morphine, whereas 88.2% and 47.1% required morphine in the SAPB and ESPB groups, respectively, p < 0.001. In the TEA group, intraoperative MAP values were lower than the other two groups, p < 0.05. CONCLUSIONS: Erector spinae plane block can be used as an effective and safe alternative to thoracic epidural analgesia and shows superior analgesic profile to serratus anterior plane block for patients with lung cancer undergoing posterolateral thoracotomy.
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Analgesia Epidural , Bloqueio Nervoso , Dor Pós-Operatória , Toracotomia , Humanos , Dor Pós-Operatória/diagnóstico , Dor Pós-Operatória/prevenção & controleRESUMO
INTRODUCTION: The purpose of this study was to compare predicted anterior teeth intrusion measurements with the actual clinical intrusion measurements using cone-beam computed tomography. Understanding the precision of the software in anticipating changes may help practitioners predict the need for overcorrection. METHODS: Twenty-two patients, with a mean age of 23.74 years, who underwent Invisalign (Align Technology, Santa Clara, Calif) clear aligners treatment for both arches only after having completed treatment with an initial series of aligners were included in this study. The pretreatment and posttreatment cone-beam computed tomography scans after the initial series were acquired by a single orthodontist practitioner. ClinCheck measurements were recorded with Align Technology. The long axis of the anterior tooth intrusion movement was measured in 142 teeth. A comparison between the predicted and actual measurements of anterior intrusion of the teeth was performed, and the intraclass correlation coefficients showed an almost perfect agreement in the linear measurements. RESULTS: A statistically notable difference between the predicted and actual measurements of anterior intrusion. The predicted intrusion movement of the maxillary canines (P = 0.001), maxillary lateral incisors (P <0.0001), and maxillary central incisors (P <0.0001) significantly differed from the actual values. Similarly, the intrusion movement in the mandibular teeth seemed to be inaccurate, with significant differences in the mandibular canines (P <0.0001) and mandibular lateral and central incisors (P <0.0001). CONCLUSIONS: The mean precision of true anterior intrusion with Invisalign clear aligners was 51.19%, and the mean amount of correction was 48.81%. The use of other supplementary methods of anterior teeth intrusion may be helpful to reduce the rate of midcourse corrections and refinements.
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Desenho de Aparelho Ortodôntico , Aparelhos Ortodônticos Removíveis , Adulto , Tomografia Computadorizada de Feixe Cônico , Humanos , Incisivo/diagnóstico por imagem , Técnicas de Movimentação Dentária , Adulto JovemRESUMO
This study aimed to assess the dietary effects of rosemary and clove essential oils separately and in combination on the growth performance; immunological, hematological, and physiological responses; and antioxidant status of growing rabbits. One hundred forty-four of 42-day-old growing V-line rabbits (both sexes with initial live body weights of 765 ± 6 g) were randomly allocated into four treatment groups of 36 rabbits each. Each group was further sub-divided into 12 replicates of 3 rabbits in a completely randomized design. The 1st group was fed a basal diet free of additives and served as the control group, the 2nd and 3rd groups were fed basal diets supplemented with rosemary and clove essential oils, respectively, at doses of 400 mg/kg diet. The 4th group received a basal diet supplemented with a combination of clove and rosemary essential oils at doses of 200 mg/kg diet each. The results showed that the different supplementations did not influence rabbit performance or immunological traits. Opposite to performance or immunological traits, differences in red blood cells and hemoglobin value among all dietary treatments were improved (P < 0.05). Dietary essential oil supplementation with clove, rosemary oil, or a mixed of both increased (P < 0.05) blood concentrations of catalase, superoxide dismutase, and glutathione peroxidase by 47, 42, and 7%; 56, 35, and 36%; and 40, 39, and 37%, respectively, in supplemented rabbits versus control rabbits. In conclusion, clove and/or rosemary essential oils can potentially be used in rabbit diets to improve antioxidant status without change in rabbit's growth performance or immunological parameters.
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Óleos Voláteis , Rosmarinus , Syzygium , Ração Animal/análise , Animais , Antioxidantes , Dieta/veterinária , Suplementos Nutricionais , CoelhosRESUMO
A cross-sectional study was carried out in the period between January and April 2019 with the aim of establishing prevalence of Newcastle disease (ND) in backyard chickens in Banadir region of Somalia using indirect enzyme-linked immunosorbent assay (iELISA). A total of 373 unvaccinated free scavenging backyard chickens were sampled from five districts in Banadir region, namely Dharkenley, Hodan, Wadajir, Hawlwadag, and Daynile. The overall prevalence was found to be 39.4% (95% confidence interval: 34.6-44.4%) with a mean antibody titre of 3844.10 ± 263.3 (standard error). The seroprevalence of ND virus (NDV) antibody in Wadajir district was the highest (66.6%) followed by Hawlwadag, Daynile, Dharkenley, and Hodan with prevalence of 56%, 42.1%, 42.35%, and 10.6%, respectively, with statistically significant differences (P < 0.05). Adult chickens had significantly higher prevalence (43.8%) than growers (19.4%) (P < 0.05). The present study, which is the first of its kind in Somalia to the best of our knowledge, concluded that the disease is highly prevalent in the study area; therefore, molecular studies on the characteristics of circulating strains are to be carried out in order to develop an evidence-based control programme and minimize the economic and social impacts of ND on smallholders.
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Galinhas/virologia , Doença de Newcastle/epidemiologia , Doenças das Aves Domésticas/epidemiologia , Animais , Anticorpos Antivirais/imunologia , Estudos Transversais , Feminino , Masculino , Vírus da Doença de Newcastle/imunologia , Vírus da Doença de Newcastle/isolamento & purificação , Estudos Soroepidemiológicos , Somália/epidemiologiaRESUMO
Two NIR-emitting platinum [Pt(N^N^C)(phosphine)] and iridium [Ir(N^C)2(N^N)]+ complexes containing reactive succinimide groups were synthesized and characterized with spectroscopic methods (N^N^C, 1-phenyl-3-(pyridin-2-yl)benzo[4,5]imidazo[1,2-a]pyrazine, N^C, 6-(2-benzothienyl)phenanthridine, phosphine-3-(diphenylphosphaneyl)propanoic acid N-hydroxysuccinimide ether, and N^N, 4-oxo-4-((1-(pyridin-2-yl)-1H-1,2,3-triazol-4-yl)methoxy)butanoic acid N-hydroxysuccinimide ether). Their photophysics were carefully studied and analyzed using time-dependent density functional theory calculations. These complexes were used to prepare luminescent micro- and nanoparticles with the "core-shell" morphology, where the core consisted of biodegradable polymers of different hydrophobicity, namely, poly(d,l-lactic acid), poly(ε-caprolactone), and poly(ω-pentadecalactone), whereas the shell was formed by covalent conjugation with poly(l-lysine) covalently labeled with the platinum and iridium emitters. The surface of the species was further modified with heparin to reverse their charge from positive to negative values. The microparticles' size determined with dynamic laser scanning varies considerably from 720 to 1480 nm, but the nanoparticles' diameter falls in a rather narrow range, 210-230 nm. The species with a poly(l-lysine) shell display a high positive (>30 mV) zeta-potential that makes them essentially stable in aqueous media. Inversion of the surface charge to a negative value with the heparin cover did not deteriorate the species' stability. The iridium- and platinum-containing particles displayed emissions the spectral patterns of which were essentially similar to those of unconjugated complexes, which indicate retention of the chromophore nature upon binding to the polymer and further immobilization onto polyester micro- and nanoparticles for drug delivery. The obtained particles were tested to determine their ability to penetrate into different cells types: cancer cells, stem cells, and fibroblasts. It was found that all types of particles could effectively penetrate into all cells types under investigation. Nanoparticles were shown to penetrate into the cells more effectively than microparticles. However, positively charged nanoparticles covered with poly(l-lysine) seem to interact with negatively charged proteins in the medium and enter the inner part of the cells less effectively than nanoparticles covered with poly(l-lysine)/heparin. In the case of microparticles, the species with positive zeta-potentials were more readily up-taken by the cells than those with negative values.
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Portadores de Fármacos/química , Raios Infravermelhos , Irídio/química , Nanoestruturas/química , Platina/química , Polímeros/química , Animais , Camundongos , Células NIH 3T3 , Succinimidas/químicaAssuntos
Disparidades em Assistência à Saúde/economia , Neoplasias Cardíacas/mortalidade , Cobertura do Seguro , Seguro Saúde , Adulto , Idoso , Feminino , Neoplasias Cardíacas/cirurgia , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Estados Unidos/epidemiologiaRESUMO
BACKGROUND: There is no settled standard of care or even a consensus between neurosurgeons on the replacement of bone fragments in compound depressed skull fractures (CDSF). MATERIALS AND METHODS: This cohort study retrospectively reviewed the patients with nonmissile CDSF who were admitted to our university hospitals from January 2010 to January 2015. Patients who were managed nonoperatively, polytrauma, comatose patients, and CDSF over the air sinuses were excluded from this study. RESULTS: This study includes 87 consecutive patients with nonmissile CDSF who were surgically treated from January 2010 to January 2015. Follow-up varied from 12 to 36 months. All of the 87 patients presented within 1 week after injury; 76 patients (87.35 %) had surgery within the first 72 h of trauma, and these patients had primary bone fragment replacement (after decontamination) with or without miniplates and minimesh. The patients who presented after 72 h of trauma with no wound discharge had their bone fragments autoclaved then replaced. The patients who presented after 72 h of trauma and had pus or serous discharge from the wound had their bone fragments discarded and scheduled for delayed cranioplasty. The long-term infection rate in all patients who had a primary bone fragment replacement in this study is 0 %. CONCLUSIONS: Primary bone fragment replacement (after decontamination) is a safe option in the management of nonmissile CDSF within 72 h of trauma in selected patients.
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Procedimentos Neurocirúrgicos/efeitos adversos , Fratura do Crânio com Afundamento/cirurgia , Infecção da Ferida Cirúrgica/epidemiologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos/normas , Padrão de CuidadoRESUMO
Infants learn their native language(s) at an amazing speed. Before they even talk, their perception adapts to the language(s) they hear. However, the mechanisms responsible for this perceptual attunement and the circumstances in which it takes place remain unclear. This paper presents the first attempt to study perceptual attunement using ecological child-centered audio data. We show that a simple prediction algorithm exhibits perceptual attunement when applied on unrealistic clean audio-book data, but fails to do so when applied on ecologically-valid child-centered data. In the latter scenario, perceptual attunement only emerges when the prediction mechanism is supplemented with inductive biases that force the algorithm to focus exclusively on speech segments while learning speaker-, pitch-, and room-invariant representations. We argue these biases are plausible given previous research on infants and non-human animals. More generally, we show that what our model learns and how it develops through exposure to speech depends exquisitely on the details of the input signal. By doing so, we illustrate the importance of considering ecologically valid input data when modeling language acquisition.
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Fonética , Percepção da Fala , Humanos , Lactente , Desenvolvimento da Linguagem , Aprendizagem , IdiomaRESUMO
We present a simple surgical technique aiming to improve urine outflow through the common urogenital sinus in cloaca and facilitate drainage of existing hydrocolpos. The study included three cases of cloaca with associated hydrocolpos that were operated during the period 2022 through 2023. The patient is placed in the prone position for a standard posterior sagittal anorectoplasty. The distal rectal fistula is severed flush with the vagina/sinus leaving an open defect in the posterior wall of the vagina/sinus. The defect is then widened distally via a vertical incision (â¼1 cm) through the posterior wall of the common urogenital sinus toward but not reaching the perineum. This vertical defect is then closed horizontally displacing the posterior vaginal wall downwards toward the perineum (posterior sinuplasty). The postoperative recovery was uneventful in the three cases. Adequate drainage of hydrocolpos was confirmed by imaging at follow-up, as well as improvement of upper urinary tract dilatation. In selected cases of cloaca, posterior sinuplasty is a simple procedure that can be applied during anorectoplasty to provide effective drainage of associated hydrocolpos.
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Antimicrobial resistance (AMR) trends in 114 generic Escherichia coli isolated from channel catfish and related fish species were investigated in this study. Of these, 45 isolates were from commercial-sized channel catfish harvested from fishponds in Alabama, while 69 isolates were from Siluriformes products, accessed from the U.S. Department of Agriculture Food Safety and Inspection Service' (FSIS) National Antimicrobial Resistance Monitoring System (NARMS) program. Antibiotic susceptibility testing and whole genome sequencing were performed using the GenomeTrakr protocol. Upon analysis, the fishpond isolates showed resistance to ampicillin (44%), meropenem (7%) and azithromycin (4%). The FSIS NARMS isolates showed resistance to tetracycline (31.9%), chloramphenicol (20.3%), sulfisoxazole (17.4%), ampicillin (5.8%) and trimethoprim-sulfamethoxazole, nalidixic acid, amoxicillin-clavulanic acid, azithromycin and cefoxitin below 5% each. There was no correlation between genotypic and phenotypic resistance in the fishpond isolates, however, there was in NARMS isolates for folate pathway antagonists: Sulfisoxazole vs. sul1 and sul2 (p = 0.0042 and p < 0.0001, respectively) and trimethoprim-sulfamethoxazole vs. dfrA16 and sul1 (p = 0.0290 and p = 0.013, respectively). Furthermore, correlations were found for tetracyclines: Tetracycline vs. tet(A) and tet(B) (p < 0.0001 each), macrolides: Azithromycin vs. mph(E) and msr(E) (p = 0.0145 each), phenicols: Chloramphenicol vs. mdtM (p < 0.0001), quinolones: Nalidixic acid vs. gyrA_S83L=POINT (p = 0.0004), and ß-lactams: Ampicillin vs. blaTEM-1 (p < 0.0001). Overall, we recorded differences in antimicrobial susceptibility testing profiles, phenotypic-genotypic concordance, and resistance to critically important antimicrobials, which may be a public health concern.