Developments in the Surgical Approach to Staging and Resection of Rhabdomyosarcoma

Local treatment; Rhabdomyosarcoma; SurgeryTratamiento local; Rabdomiosarcoma; CirugíaTractament local; Rabdomiosarcoma; CirurgiaAlthough survival after rhabdosarcoma treatment has improved over the years, one third of patients still develop locoregional relapse. This review aims to highlight developments pertaining to staging and local treatment of specific RMS tumor sites, including head and neck, chest/trunk, bladder-prostate, female genito-urinary, perianal, and extremity sites

Adolescents' lived experience of making health choices : an ethical point of view

This paper describes and interpret adolescents´ lived experiences of their rights, duties and responsibilities in relation to their health choices. Fourteen focus group interviews with 67 adolescents aged 15 and 16 were conducted and analysed using the phenomenological hermeneutical method. Adolescents´ lived experiences of their rights in relation to their health choices were described as things that were allowed. Duties and responsibilities were perceived as something that they were required to carry out for their own health or other people´s health. Although their experiences of rights, duties and responsibilities overlapped, they referred to different aspects of their health choices. Adolescents viewed their rights, duties and responsibilities in the wider context, with parents and society defining their opportunities to make independent choices. We found that ethical considerations influenced adolescents´ choices and, the opportunities to exercise their rights, duties and responsibilities varied. Further consideration and recognition of these issues are needed

A UK wide cohort study describing management and outcomes for infants with surgical Necrotising Enterocolitis

The Royal College of Surgeons have proposed using outcomes from necrotising enterocolitis (NEC) surgery for revalidation of neonatal surgeons. The aim of this study was therefore to calculate the number of infants in the UK/Ireland with surgical NEC and describe outcomes that could be used for national benchmarking and counselling of parents. A prospective nationwide cohort study of every infant requiring surgical intervention for NEC in the UK was conducted between 01/03/13 and 28/02/14. Primary outcome was mortality at 28-days. Secondary outcomes included discharge, post-operative complication, and TPN requirement. 236 infants were included, 43(18%) of whom died, and eight(3%) of whom were discharged prior to 28-days post decision to intervene surgically. Sixty infants who underwent laparotomy (27%) experienced a complication, and 67(35%) of those who were alive at 28 days were parenteral nutrition free. Following multi-variable modelling, presence of a non-cardiac congenital anomaly (aOR 5.17, 95% CI 1.9-14.1), abdominal wall erythema or discolouration at presentation (aOR 2.51, 95% CI 1.23-5.1), diagnosis of single intestinal perforation at laparotomy (aOR 3.1 95% CI 1.05-9.3), and necessity to perform a clip and drop procedure (aOR 30, 95% CI 3.9-237) were associated with increased 28-day mortality. These results can be used for national benchmarking and counselling of parents

The theory and phenomenology of polarized deep inelastic scattering

Comprehensive review paper on the theory and phenomenology of polarized deep inelastic scattering, to appear in Physics ReportsComment: 113 pages, latex, 40 figures not included (hard copies available via mail upon request to [email protected]

Standardised practices in the networked management of congenital hyperinsulinism: a UK national collaborative consensus

Congenital hyperinsulinism (CHI) is a condition characterised by severe and recurrent hypoglycaemia in infants and young children caused by inappropriate insulin over-secretion. CHI is of heterogeneous aetiology with a significant genetic component and is often unresponsive to standard medical therapy options. The treatment of CHI can be multifaceted and complex, requiring multidisciplinary input. It is important to manage hypoglycaemia in CHI promptly as the risk of long-term neurodisability arising from neuroglycopaenia is high. The UK CHI consensus on the practice and management of CHI was developed to optimise and harmonise clinical management of patients in centres specialising in CHI as well as in non-specialist centres engaged in collaborative, networked models of care. Using current best practice and a consensus approach, it provides guidance and practical advice in the domains of diagnosis, clinical assessment and treatment to mitigate hypoglycaemia risk and improve long term outcomes for health and well-being

The impact of trisomy 21 on epidemiology, management, and outcomes of congenital duodenal obstruction: a population-based study

Abstract: Purpose: Congenital duodenal obstruction (CDO) is associated with trisomy 21 (T21), or Down’s syndrome, in around a third of infants. The aim of this study was to explore the impact of T21 on the epidemiology, management, and outcomes of infants with CDO. Methods: Data were prospectively collected from specialist neonatal surgical centres in the United Kingdom over a 12 month period from March 2016 using established population-based methodology for all babies with CDO. Infants with T21 were compared to those without any chromosomal anomaly. Results: Of 102 infants with CDO that underwent operative repair, T21 was present in 33 [32% (95% CI 23–41%)] babies. Cardiac anomalies were more common in those with T21 compared to those without a chromosomal anomaly (91 vs 17%, p < 0.001), whereas associated gastrointestinal anomalies were less common in infants with T21 (3 vs 12%, p = 0.03). Surgical management was not influenced by T21. Time to achieve full enteral feed, need for repeat related surgery, and mortality were similar between groups. Infants with T21 had a longer median initial inpatient stay (23 vs 16.5 days, p = 0.02). Conclusions: Infants with T21 have a higher incidence of cardiac anomalies and a longer initial inpatient stay; however, it does not change CDO management or outcomes. This information is important for prenatal and postnatal counselling of parents of infants with CDO and T21

The impact of trisomy 21 on epidemiology, management, and outcomes of congenital duodenal obstruction: a population-based study

Abstract: Purpose: Congenital duodenal obstruction (CDO) is associated with trisomy 21 (T21), or Down’s syndrome, in around a third of infants. The aim of this study was to explore the impact of T21 on the epidemiology, management, and outcomes of infants with CDO. Methods: Data were prospectively collected from specialist neonatal surgical centres in the United Kingdom over a 12 month period from March 2016 using established population-based methodology for all babies with CDO. Infants with T21 were compared to those without any chromosomal anomaly. Results: Of 102 infants with CDO that underwent operative repair, T21 was present in 33 [32% (95% CI 23–41%)] babies. Cardiac anomalies were more common in those with T21 compared to those without a chromosomal anomaly (91 vs 17%, p < 0.001), whereas associated gastrointestinal anomalies were less common in infants with T21 (3 vs 12%, p = 0.03). Surgical management was not influenced by T21. Time to achieve full enteral feed, need for repeat related surgery, and mortality were similar between groups. Infants with T21 had a longer median initial inpatient stay (23 vs 16.5 days, p = 0.02). Conclusions: Infants with T21 have a higher incidence of cardiac anomalies and a longer initial inpatient stay; however, it does not change CDO management or outcomes. This information is important for prenatal and postnatal counselling of parents of infants with CDO and T21

An investigation into the use of video image analysis (VIA) and visible-near infrared (NIR) spectroscopy for carcase evaluation : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Animal Science at Massey University, Palmerston North, New Zealand

In order for the meat industry to move towards a carcase payment system that is more consumer-focused, there is a need to identify carcases that have a higher yield of superior eating quality meat. Through a series of experiments, this thesis investigates the relationships between video image analysis (VIA) variables and saleable meat yield (SMY%) of high-value cuts in beef carcases, and also the relationships between visible-near infrared (NIR) spectra and instrumental meat quality parameters in beef, lamb and venison of various breeds and genders. Results showed that VIA could effectively replace the visual classifier for classifying beef carcases according to the EUROP carcase classification system, and that both visual and VIA systems showed some promise for predicting the yield of high-value sirloin yield through the EUROP-grid information. Both VIA and visual systems could only account for approximately 57% of the variation in sirloin SMY%, but the relationship between SMY% and other possible VIA outputs such as lengths, widths and volumes remains largely uncharacterized. Instrumental measures of meat quality (shear force, pH and colour) of M. longissimus thoracis et lumborum (LTL) from 234 beef carcases and 208 Texel lambs showed that gender had a larger effect on meat quality than breed. Data from these two experiments was used to determine the relationship between NIR spectra and instrumental meat quality parameters in beef and lamb LTL. NIR showed promise for identifying beef with high ultimate pH values and lamb with high intramuscular fat percentages, but the prediction of shear force using NIR spectra in both beef and lamb was less accurate. The effects on meat quality of sex, breed, chilled aging and location within venison M. Longissimus lumborum, for samples from 79 farmed deer showed that all factors influenced venison meat quality, with aging time and gender having the largest effects. The relationships between NIR spectra and venison meat quality indicated that NIR spectra could be used to identify samples with high ultimate pH and high shear force values