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Pediatrics. 2002 Dec;110(6):1094-102.
Longitudinal, 15-year follow-up of children born at less than 29 weeks' gestation after introduction of surfactant therapy into a region: neurologic, cognitive, and educational outcomes.
D'Angio CT, Sinkin RA, Stevens TP, Landfish NK, Merzbach JL, Ryan RM, Phelps DL, Palumbo DR, Myers GJ.
Department of Pediatrics, Strong Children's Research Center, Golisano Children's Hospital at Strong, University of Rochester School of Medicine and Dentistry, Rochester, New York 14642, USA. carl_dangirmc.rochester.edu
OBJECTIVE: To measure the primary and secondary school-age neurologic, cognitive, and educational outcomes in a cohort of extremely premature infants born after the introduction of exogenous surfactant therapy in a circumscribed region. METHODS: Two hundred thirteen infants born at <29 weeks' gestation were cared for at a regional referral center during 1985-1987. At primary school age, neurologic and cognitive outcomes, educational achievement, school placement, health status, and socioeconomic status were determined by follow-up visit. At secondary school age, school placement and health status were evaluated by telephone interview. RESULTS: One hundred thirty-two infants survived to school age, of whom 127 (96%) were evaluated in 1992-1995 and 126 (95%) were evaluated in 2000. Mean ages were 7.0 years at first follow-up and 14.1 years at second follow-up. At primary-school age follow-up, 19 children (15%) had cerebral palsy, 24 (19%) had a general cognitive index <70, and 41 (32%) were placed in a self-contained, special classroom. Thirty-nine children (31%) had no physical or educational impairment, whereas 27 (21%) had at least 1 severe disability. At secondary school age, cerebral palsy incidence remained unchanged, whereas 36 children (29%) were placed in a special classroom. Fifty-one children (41%) had no physical or educational impairment, whereas 24 (19%) had at least 1 severe disability. Neonatal intraventricular hemorrhage and low socioeconomic status were the strongest predictors of adverse outcomes. CONCLUSIONS: Premature infants born in the surfactant era remain at high risk of neurodevelopmental compromise. Although many of these children do well, a significant minority will require intensive special educational services through secondary school age.
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12456905&dopt=Abstract hemorrhage
J Gynecol Obstet Biol Reprod (Paris). 2002 Nov;31(7):649-62.
[Complications of urinary incontinence surgery: 800 procedures]
[Article in French]
Debodinance P, Delporte P, Engrand JB, Boulogne M.
Service de Gynecologie Obstetrique, Centre Hospitalier de Dunkerque, 43, rue des pinsons, 59430 Saint-Pol-sur-mer, France. Ph.debodinancial.oleane.com
OBJECTIVE: To present the complications of urinary incontinence surgery through our experience over 13 years with 800 procedures in continuous practice. These complications were compared to those of the literature for the same type of procedure. STUDY DESIGN: From January 1988 to September 2001, 800 procedures were performed in the same hospital in the gynecology unit. The procedures were: Bologna (91 cases), laparotomic Burch (83 cases), laparoscopic Burch (62 cases), Pereyra (112 cases), Stamey (8 cases), Ingelman-Sundberg (27 cases), Mouchel (40 cases), autograft sling (22 cases), mesh sling: small size (62 cases), large size (12 cases) et TVT (tension free vaginal tape) (281 cases). These procedures were performed alone in 475 cases (125 cases with hysterectomy for other reason), and in 325 cases associated with prolapse surgery. The complications were noted during the hospitalization and at the control at 3 months and 1 year. We only noted the complications attributable to the different procedures. RESULTS: Bladder injuries are found in 3.5% (0 to 6%), hemorrhage in 1% (0 to 3.8%), urinary infection in 4.5% (0 to 11.3%), fever at 48 hours in 1.5% (0 to 9.7%), momentary urine retention in 17% (1.6 to 64.5%), de novo dysuria in 10.9% (0 to 35.5%), de novo urge in 6.9% (0 to 11%). For the other complications, which were less frequent or more procedure-specific, we noted: subcutaneous emphysema in 1.6% of the laparoscopic Burch procedures, cutting thread in 4.8% of the laparoscopic Burch procedures and 2.7% in Pereyra, rejection of prosthetic mesh in 9% of the large slings, 14% with the small sling and 28.2% with the Mouchel procedure, a wound abscess in 3.8% of the Bologna procedures, 1.2% of laparotomic Burch procedures. The percentage of women who had at least one complication was a minimum of 18% for TVT and a maximum of 62.9% for small synthetic sling. In summary, 32% of the patients presented at least one complication. Overall, we noted urinary complications in 41% of the patients, which accounted for 81% of the complications. DISCUSSION: We reviewed more than 100 references concerning complications of the procedures performed in these patients. "Blind" procedures gave more bladder injuries, slings more dysuria and urine retention and procedures using mesh gave more pool healing or rejection especially with the old materials. A particular place must be made for the TVT, recent procedure, which is widely studied. We reviewed 35 references explaining complications of TVT or proposing preventions measures. CONCLUSION: There are many complications of urinary incontinence surgery, but the majority is quickly resolved without consequence. The only after-effects are dysuria which are the most often slow micturition, and urge which are a real problem, sometimes leading to sling removal.
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12457137&dopt=Abstract hemorrhage
Thromb Haemost. 2002 Dec;88(6):967-74.
Targeted inactivation of the mouse locus encoding coagulation factor XIII-A: hemostatic abnormalities in mutant mice and characterization of the coagulation deficit.
Lauer P, Metzner HJ, Zettlmeissl G, Li M, Smith AG, Lathe R, Dickneite G.
Aventis Behring GmbH, Pharmacology/Toxicology, Marburg, Germany.
Blood coagulation factor XIII (FXIII) promotes cross-linking of fibrin during blood coagulation; impaired clot stabilization in human genetic deficiency is associated with marked pathologies of major clinical impact, including bleeding symptoms and deficient wound healing. To investigate the role of FXIII we employed homologous recombination to generate a targeted deletion of the inferred exon 7 of the FXIII-A gene. FXIII transglutaminase activity in plasma was reduced to about 50% in mice heterozygous for the mutant allele, and was abolished in homozygous null mice. Plasma fibrin gamma-dimerization was also indetectable in the homozygous deficient animals, confirming the absence of activatable FXIII. Homozygous mutant mice were fertile, although reproduction was impaired. Bleeding episodes, hematothorax, hematoperitoneum and subcutaneous hemorrhage in mutant mice were associated with reduced survival. Arrest of tail-tip bleeding in FXIII-A deficient mice was markedly and significantly delayed; replacement of mutant mice with human plasma FXIII (Fibrogammin P) restored bleeding time to within the normal range. Thrombelastography (TEG) experiments demonstrated impaired clot stabilization in FXIII-A mutant mice, replacement with human FXIII led to dose-dependent TEG normalization. The mutant mice thus reiterate some key features of the human genetic disorder: they will be valuable in assessing the role of FXIII in other associated pathologies and the development of new therapies.
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12529747&dopt=Abstract hemorrhage
Arkh Patol. 2002 Nov-Dec;64(6):47-50.
[Morphological features of atherosclerotic plaques of internal carotid artery sinus (biopsy data from carotid endarterectomy)]
[Article in Russian]
Gulevskaia GS, Morgunov VA, Anufriev PL.
Research Institute of Neurology, 123367, Moscow.
A histological study was made of 140 atherosclerotic plaques in the sinus of the internal carotid artery (ICA) removed at carotid endarterectomy. New formed thin-walled vessels of various diameter having the structure of arteries, blocking arteries and, presumably, arteriolo-venous anastomoses were found in 112 plaques. The majority of the vessels were oriented along the ICA this indicating blood circulation parallel to that in ICA. It is assumed that deficiency of blocking arteries results in the development of intraplaque hemorrhages from thin-walled vessels.
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12534230&dopt=Abstract hemorrhage
Surg Endosc. 2003 Feb;17(2):190-5. Epub 2002 Dec 04.
Totally extraperitoneal endoscopic inguinal hernia repair (TEP).
Tamme C, Scheidbach H, Hampe C, Schneider C, Kockerling F.
Department of Surgery and Center for Minimally Invasive Surgery, Hanover Hospital, Roesebeckstrasse 15 (Siloah), 30449 Hanover, Germany. e.c.tamm-online.de
BACKGROUND: This report reviews our experience with 5,203 totally extraperitoneal (TEP) endoscopic hernia repairs performed in 3,868 patients over the 7.5-year period between May 1994 and December 2001, 34.5% of whom had bilateral hernias and 13% recurrent hernias. METHODS: We performed TEP as the method of choice in more than 92% of all the patients presenting with inguinal hernia, including those with incarcerated, strangulated, or inguinoscrotal hernias. After reduction of the hernial sac and appropriate dissection of the preperitoneal space, we placed a slit-free 10 x 15-cm polypropylene mesh without the use of staple fixation. RESULTS: Altogether, 29 recurrent hernias (0.6%) were observed, more than 50% of which occurred during the first 2 years after the technique was introduced (1.8%). During subsequent years, the recurrence rate settled to approximately 0.3%. Regarding intraoperative complications, we observed eight injuries to the bladder. At this writing, no bowel injuries or damage to iliac vessels has been seen. Postoperatively, we noted only a single case of mesh infection. In 14 cases (0.4%), postoperative hemorrhage necessitated either inguinal or endoscopic reoperation. As a further major complication, a small bowel obstruction caused by inadequate closure of a peritoneal lesion occurred in two patients (0.05%). The overall reoperation rate for the 3,868 patients was 0.6%. CONCLUSIONS: We consider TEP to be a procedure that carries an acceptably low complication rate, combining the advantages of minor access surgery and mesh reinforcement of the groin. This approach is associated with early postoperative return to usual activities and a very low recurrence rate.
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12457220&dopt=Abstract hemorrhage
The average human scalp is covered by approximatey 100,000 hair follicles. Each hair undergoes
Loss of hair itself does not pose critical health problems because biological role of human hair is relatively marginal. Hair on our scalp protects the head from mechanical shock, heat loss, and exposure to UV-light. The eyelashes and eyebrowes protect the eyes, and hair in the ear canal or the nasal passages help filter out particles and pathogens, thus protecting our internal organs.
However, hair does play important social role: it is one of the major determinants of our appearance and identity in daily life. Fullness of hair also implicates or manifests physical integrity and youthfulness of the person. Losing hair could have more than just emotional impacts on individuals.
The hair is a unique organ that goes through a characteristic cycle consisting of an immature phase, a growing phase called anagen, a transitional phase between the growing phase and the resting phase called catagen, and finally a resting phase called telogen in which the hair stops growing, waiting to fall out. 85-90% of hairs on our body are in anagen phase or growing phase, which lasts anywhere from two to five years. This phase is followed by a short regression phase, or catagen, which lasts 2-3 weeks. Approximately 1% of hair follicles are in catagen. Approximately 10-15% of hair follicles are in the resting phase, the telogen, which lasts about 3-5 months. Hair follicles typically goes through 10-20 asynchronous cycles during the lifetime.
Persistent loss of more than 150 hairs would consist a state of hair loss, or alopecia, albeit it could be temporary.
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