Spontanous pneumomediastinum after yoga practice - a case report

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenPneumomediastinum is defined as interstitial air in the mediastinum, without any apparent precipating factor such as trauma, oesophageal perforation or infections. It is very uncommon and usually affects young otherwise healthy individuals. The most common symtoms are chest pain and dyspnea with subcutaneous emphysema found on examination. Treatment is usually conservative with pain relief. Here, we present an unusual case of a 23-year-old previously healthy male who was diagnosed with pneumomediastinum after practising yoga. This case demonstrates the need to study patients with chest pain of unknown cause in details to find causes.Sjálfsprottið loftmiðmæti (spontanteous pneumo-mediastinum) er skilgreint sem óeðlileg loftsöfnun í miðmæti án augljóss orsakavalds. Þetta er sjaldgæfur kvilli sem aðallega greinist í annars hraustum karlmönnum. Langoftast er ekki þörf á neinni sérstakri meðferð né eftirfylgd og horfur eru mjög góðar. Hér er lýst 23 ára karlmanni sem leitaði á bráðamóttöku vegna brjóstverkja sem komu skyndilega við jógaæfingar og reyndist vera sjálfsprottið loftmiðmæti. Þetta tilfelli sýnir mikilvægi þess að rannsaka einstaklinga með brjóstverki ítarlega til að finna orsakir

Factors associated with improved patient and graft survival beyond 1 year in pediatric liver transplantation

With advances in surgical techniques, medical management, and more equitable allocation systems, children who receive a liver transplantation (LT) today can expect remarkable outcomes early after LT. However, beyond 1 year after transplant, attrition rates have not improved. We reviewed two separate eras (Era 1: January 1995-June 2004 vs. Era 2: July 2004-March 2018) of the Society of Pediatric Liver Transplant registry to explore the evolution and associated factors contributing to late graft loss (LGL) and late mortality (LM). The fraction of long-term pediatric LT recipients surviving after 1 year with their first graft significantly improved (81.5% in Era 1 vs. 85.7% in Era 2; p < 0.0001). This improvement occurred despite significant changes in patient selection toward higher risk populations (p < 0.001) and without notable improvement in perioperative complications such as hepatic artery thrombosis (p = 0.24) and early posttransplant reoperation (p = 0.94) that have historically contributed to poor late-allograft outcomes. Improved outcomes were associated with changes in patient characteristics and perioperative practices, which subsequently impacted both early post-LT complications as well as other sequalae known to contribute to adverse events in long-term pediatric LT recipients. In conclusion, despite significant changes in patient selection toward higher risk populations, and without notable improvement in several perioperative complications known to contribute to poor late-allograft outcomes, significant improvements in LGL and a trend toward improvement in LM was seen in a more contemporary cohort of children receiving an LT