Primary closure of a sternal cleft in the neonatal period

Sternal cleft is a rare malformation of the midline fusion of the sternal bars; the most common form is the superior partial defect. Surgical correction with primary closure is the gold standard. It is recommended that the procedure be performed before 3 months of age because of the greater compliance and maximal flexibility of the thoracic wall. These features ensure a safer repair with a low risk of complications and allow for a less extensive procedure that does not require the use of additional techniques. A midline incision is performed in the anterior thoracic wall, and the major pectoralis flaps are raised. The main surgical goal is to change the remaining sternum from a U to a V shape. Transfixing interrupted sutures are placed in the cartilaginous borders for midline closure. Hemodynamics and ventilation are monitored at this time. Closure is performed by layers.Vídeo: Não é possível instalar um arquivo de vídeo. Apenas transfira-o para seu computador e abra como um arquivo comum. Arquivos de vídeo não podem ser editados, mas podem ser visualizados em players como o VLC Media Player (que é gratuito), o Windows Media Player ou o QuickTime. Os formatos mais comuns de vídeo serão executados normalmente por estes players (avi, mpeg e mp4). PDF: Estes arquivos não podem ser editados, pois é um formato fechado. Este formato permite que sejam feitas edições — como marcação de texto e comentários, além de preenchimento de formulários — caso o autor permita. Este arquivo pode ser visualizado em leitores de PDF como o Adobe Acrobat Reader ou em navegadores da web.VídeoTo illustrate the technique for primary closure of an upper portion Sternal Cleft in the neonatal period

Complex ventral hernia repair in a child : an association of botulinumtoxin, progressive pneumoperitoneum and negative pressure therapy : a case report on an arising surgical technique

INTRODUCTION: The purpose of this manuscript is to report the management of a child born with giantomphalocele (GO) that developed a complex ventral hernia secondary to an unsuccessful attempt ofclosing the primary defect. PRESENTATION OF CASE: The patient underwent a one-step surgery to correct a ventral hernia associatedwith a largely prolapsed enteroatmospheric fistula (EAF) along with an ileostomy. It was managed bya pre-operative association of botulinum toxin agent (BTA) application with preoperative progressivepneumoperitoneum (PPP) and trans-operative negative pressure wound therapy (NPWT) dressing withstaged abdominal closure. The patient needed 4 reoperations due to enteric fistulas. Nine days after thefirst surgery, it was possible to completely close the abdominal wall without mesh substitution. No signsof hernia in 9 months of follow-up. DISCUSSION: This is the second report in the literature and it reinforces the safety and effectiveness ofthe BTA injection associated with PPP in children. CONCLUSION: The use of BTA in association with PPP should be encouraged and best investigated inpatients with GO. The fistulas were not attributed to the negative pressure. Maybe it is time to startdefining better criteria to categorize GO in order to choose the best management for each patient

The Progress Test of the European Hematology Association: A New Tool for Continuous Learning.

info:eu-repo/semantics/publishedVersio

Molecular cloning and functional expression of the Equine K+ channel KV11.1 (Ether à Go-Go-related/KCNH2 gene) and the regulatory subunit KCNE2 from equine myocardium

The KCNH2 and KCNE2 genes encode the cardiac voltage-gated K+ channel KV11.1 and its auxiliary β subunit KCNE2. KV11.1 is critical for repolarization of the cardiac action potential. In humans, mutations or drug therapy affecting the KV11.1 channel are associated with prolongation of the QT intervals on the ECG and increased risk of ventricular tachyarrhythmia and sudden cardiac death--conditions known as congenital or acquired Long QT syndrome (LQTS), respectively. In horses, sudden, unexplained deaths are a well-known problem. We sequenced the cDNA of the KCNH2 and KCNE2 genes using RACE and conventional PCR on mRNA purified from equine myocardial tissue. Equine KV11.1 and KCNE2 cDNA had a high homology to human genes (93 and 88%, respectively). Equine and human KV11.1 and KV11.1/KCNE2 were expressed in Xenopus laevis oocytes and investigated by two-electrode voltage-clamp. Equine KV11.1 currents were larger compared to human KV11.1, and the voltage dependence of activation was shifted to more negative values with V1/2 = -14.2±1.1 mV and -17.3±0.7, respectively. The onset of inactivation was slower for equine KV11.1 compared to the human homolog. These differences in kinetics may account for the larger amplitude of the equine current. Furthermore, the equine KV11.1 channel was susceptible to pharmacological block with terfenadine. The physiological importance of KV11.1 was investigated in equine right ventricular wedge preparations. Terfenadine prolonged action potential duration and the effect was most pronounced at slow pacing. In conclusion, these findings indicate that horses could be disposed to both congenital and acquired LQTS

The Progress Test of the European Hematology Association: A New Tool for Continuous Learning

The European Hematology Curriculum, first launched in 2006, was created by the European Hematology Association (EHA) with the aim of harmonizing hema tology training in Europe. Its goals were to define the different areas hematologists are expected to cover during their training, and to establish the minimum recommended levels of competence that a hematology trainee should attain. EHA's education platform (EHA Campus) offers opportu nities for continuous learning for both trainees and specialists. Content is guided by the European Hematology Curriculum, which provides a structure for individual study and self-assess ment. To complete this organized learning environment, a tool for objective assessment of knowledge during and after specialist training was needed. In the spring of 2020, EHA started offering a progress test: a longitudinal test based on equivalent evalua tions given at fixed intervals, assessing developments in knowl edge. The EHA Progress Test was inspired by an earlier version developed by the Swedish Hematology Association in 2013, which has become widely used by specialist trainees and spe cialists in Sweden. Noticeable pedagogical effects, like targeted study efforts in weak knowledge areas, changes in clinical rota tions, and more have been reported in personal questionnaires

Recruitment of adolescent young carers to a psychosocial support intervention study in six European countries: lessons learned from the ME-WE project

Young carers provide a substantial amount of care to family members and support to friends, yet their situation has not been actively addressed in research and policy in many European countries or indeed globally. Awareness of their situation by professionals and among children and young carers themselves remains low overall. Thus, young carers remain a largely hidden group within society. This study reports and analyses the recruitment process in a multi-centre intervention study offering psychosocial support to adolescent young carers (AYCs) aged 15–17 years. A cluster-randomised controlled trial was designed, with recruitment taking place in Italy, the Netherlands, Slovenia, Sweden, Switzerland and the United Kingdom exploiting various channels, including partnerships with schools, health and social services and carers organisations. In total, 478 AYCs were recruited and, after screening failures, withdrawals and initial dropouts, 217 were enrolled and started the intervention. Challenges encountered in reaching, recruiting and retaining AYCs included low levels of awareness among AYCs, a low willingness to participate in study activities, uncertainty about the prevalence of AYCs, a limited school capacity to support the recruitment; COVID-19 spreading in 2020–2021 and related restrictions. Based on this experience, recommendations are put forward for how to better engage AYCs in research

The first cross-national study of adolescent young carers aged 15-17 in six European countries

This paper provides an original cross-national profile of adolescents who provide unpaid care to ill or disabled family members ('Adolescent Young Carers/AYCs') in six European countries. Utilizing an online survey, 2,099 AYCs were identified in Italy, the Netherlands, Slovenia, Sweden, Switzerland, and the United Kingdom. This paper focuses on the impact of care onto their mental health well-being, physical health, and education, as well as their preferences for informal and formal support. These groundbreaking findings help promote a 'rights' approach for AYCs, which can serve as a critical driver for supportive policy creation on both a country-specific and Pan-European level