9 research outputs found
Outcomes following Microvascular Mandibular Reconstruction in Pediatric Patients and Young Adults
Background: The etiology and treatment of complex mandibular defects in children differ markedly from those of adults, although treatment with free bone flaps is historical in both groups. While adult outcomes and complication rates are well known, few pediatric data exist, especially for patients with congenital deficiencies. This study reports early and late outcomes from a cohort of young, primarily syndromic patients undergoing microvascular mandibular reconstruction. Methods: This is a retrospective case series of patients who underwent microvascular mandibular reconstruction between 1995 and 2016. Results: Thirteen patients received a total of 13 fibula transfers and 1 medial femoral condyle transfer. Most patients carried a congenital diagnosis (77%), and the average age during surgery was 11.7 ± 5.7 years. The median (interquartile range) [IQR] length of follow-up was 6.3 (5.7) years. There was a 100% flap survival rate, although 86% of all patients experienced at least one complication. Half of all procedures resulted in an early complication. Nine patients (69%) developed late complications, of which temporal mandibular joint ankylosis was the most common (n = 5; 38%). Conclusions: This study is one of few detailing outcomes following mandibular reconstruction by free flap transfer in pediatric patients. These patients were primarily syndromic with appreciable complication rates higher than in other adult and pediatric studies. Some complications are manageable or self-resolving, but others lead to functional problems that may require late operative interventions to correct. Microsurgical treatment should be reserved for children with large, complex mandibular defects when other options are unavailable or have been exhausted
The long-term effects of denominational secondary schools | Langfristige EinflĂĽsse der konfessionellen Mittelschule
In the present study we examined the graduate students of higher educational institutions with
Hungarian as the language of teaching in Hungary, Rumania and the Ukraine. We were interested
in seeing whether divergences could be traced, years after graduation, among students
coming from certain secondary school sectors. Our results revealed that the more advantageous
situation of former denominational high school students could be detected especially in the
attitude to one’s work, the work concept of serving the common good, and the consumption of
intellectual high culture in the traditional sense. These achievements of former denominational
school students could not be explained with their social status, since these young people, in
many respects, are more disadvantaged than the average. However, their value system and relationship
network, and most of all their religiosity have a characteristic aspect. In regression
models, we matched the strength of the seemingly significant explanations in the two-variable
analysis. On the basis of the matching, we found that minding the influence of other explanations,
regarding the readiness of entering service, the work concept of seeking social utility, as
well as time spent on reading, sector-effect (effect of school maintainer) carries a very remarkable
weight. After the passing of denominational school-years the personal or small-community
worship can also inspire the formation or observance of this type of work concept, the
attendance of students’ extracurricular tasks and the classical intellectual leisure time habits. |
In vorliegender Studie untersuchten
wir Absolventen von Hochschulen in Ungarn und in grenznahen ungarischsprachigen Gebieten
in Rumänien und der Ukraine unter dem Gesichtspunkt, ob Jahre nach dem Abitur Unterschiede zwischen den Studenten aus verschiedenen Mittelschulsektoren festzustellen seien. Die Ergebnisse
zeigten, dass sich der Vorsprung der ehemaligen SchĂĽler der konfessionellen Schulen vor
allem in der Einstellung zur Berufstätigkeit, einer dem Gemeinwohl verpflichteten Arbeitseinstellung
und der Teilnahme am kulturellen Leben der im herkömmlichen Sinne Intellektuellen
zeigt. Die Leistungen der einstigen SchĂĽler der konfessionellen Schulen in diesen Bereichen
lassen sich nicht durch den gesellschaftlichen Status der Studenten erklären, da diese Jugendlichen
in vielerlei Hinsicht schlechter gestellt sind als der Durchschnitt; ihr Werte- und Beziehungssystem
sowie ihre Religiosität besitzen jedoch eine charakteristische Ausprägung. Die
Stichhaltigkeit der in der bivariablen Analyse signifikant erscheinenden Erklärungen untersuchten
wir anhand regressiver Modelle. Auf dieser Grundlage stellten wir fest, dass dem Einfluss
des Schulsektors bezüglich der Bereitschaft zur Berufstätigkeit, einer dem gesellschaftlichen
Nutzen verpflichteten Arbeitseinstellung und der auf das Lesen verwendeten Zeit auch
unter Berücksichtigung des Einflusses anderer möglicher Erklärungen ausgesprochen große
Bedeutung beizumessen ist. Im Anschluss an die in der konfessionellen Schule verbrachte Zeit
sorgen auch die individuelle und die in kleinen Gemeinschaften gelebte Glaubenspraxis fĂĽr die
Entwicklung bzw. Wahrung der obigen Arbeitsauffassung, der Beteiligung der Studenten an
extracurriculären Aufgaben und der klassischen Freizeitgestaltung der Intellektuellen. |
Jelen tanulmányban Magyarország, Románia Ă©s Ukrajna határmenti, magyar tanĂtási nyelvű felsĹ‘oktatási intĂ©zmĂ©nyeinek vĂ©gzĹ‘s hallgatĂłit vizsgáltuk abbĂłl a szempontbĂłl, hogy kimutathatĂłak-e eltĂ©rĂ©sek az egyes közĂ©piskolai szektorokbĂłl Ă©rkezĹ‘ hallgatĂłk között Ă©vekkel az Ă©rettsĂ©gi után. Az eredmĂ©nyeink azt mutatták, hogy fĹ‘kĂ©ppen a munkába álláshoz valĂł viszony, a közjĂłt szolgálĂł munkafelfogás Ă©s a hagyományos Ă©rtelemben vett Ă©rtelmisĂ©gi magaskultĂşra fogyasztása terĂ©n mutathatĂł ki az egykori felekezeti közĂ©piskolások elĹ‘nye. Az egykori felekezeti iskolások ezen teljesĂtmĂ©nye nem magyarázhatĂł a hallgatĂłk társadalmi státusával, hiszen ezek a fiatalok több vonatkozásban hátrányosabb helyzetűek az átlagnál, azonban karakteres arculata van az Ă©rtĂ©krendjĂĽknek Ă©s a kapcsolatrendszerĂĽknek, de leginkább a vallásosságuknak. A kĂ©tváltozĂłs elemzĂ©sben szignifikánsnak tűnĹ‘ magyarázatok erejĂ©t regressziĂłs modellekben mĂ©rtĂĽk össze. Ennek alapján megállapĂtottuk, hogy a munkába állási kĂ©szsĂ©g, a társadalmi hasznosságra törekvĹ‘ munkafelfogás, valamint az olvasásra fordĂtott idĹ‘ vonatkozásában más magyarázatok befolyását is figyelembe vĂ©ve kifejezetten jelentĹ‘s sĂşlya van a szektorhatásnak. A felekezeti iskolás Ă©vek elmĂşltával a szemĂ©lyes Ă©s a kisközössĂ©gi vallásgyakorlat is ösztönzi az ilyen tĂpusĂş munkafelfogást, a hallgatĂłi extrakurrikuláris feladatokban valĂł rĂ©szvĂ©telt Ă©s a klasszikus Ă©rtelmisĂ©gi szabadidĹ‘s szokások kialakulását, valamint mindezek megtartását is
The influence of tectonic regime on chalk deposition: examples of the sedimentary development and 3D-seismic stratigraphy of the Chalk Group in the Netherlands offshore area
Body mass index and complications following major gastrointestinal surgery: A prospective, international cohort study and meta-analysis
Aim Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a metaanalysis of all available prospective data. Methods This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien–Dindo Grades III–V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results. Results This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery formalignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49–2.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46–0.75, P < 0.001) compared to normal weight patients. Conclusions In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease