Management of congenital esophageal stenosis associated with esophageal atresia and its impact on postoperative esophageal stricture

Aim The aim of this work was to study the incidence, management of congenital esophageal stenosis (CES) associated with esophageal atresia (EA) and tracheoesophageal fistula (TEF), and its impact on esophageal stricture (ES) after primary repair.Patients and methods From January 2006 to December 2014, 41 sequential cases of EA with distal TEF were retrospectively studied. Cases with significant ES after primary repair were included in the study. Associated CES was diagnosed in the neonatal period by taking histopathologic samples from the tips of the esophageal pouches, failure to pass a size-6 nasogastric tube distally during primary repair, and by initial esophagogram.Results Significant ES developed in 19 patients (46.3%); of them, six had CES (32%). Three patients had tracheobronchial remnants at the anastomotic site. Two of them had refractory strictures requiring resections and one had mainly major esophageal dysmotility. Patients 4 and 5 had CES distal to the anastomotic site on initial esophagogram. Patient 4 responded well to dilatations, whereas the other one had refractory stricture. Patient 6 had distal CES due to fibromuscular stenosis diagnosed by failure to pass a size-6 nasogastric tube distally. The patient responded well to dilatation, myectomy, and Thal’s fundoplication.Conclusion One-third of the patients with significant stricture had CES; half of them were refractory to dilatation. Failure to have histology specimens and a high index of suspicion will make the incidence of this association a rarity. Diagnosis and management of CES with EA/TEF in the neonatal period is possible. Esophageal dilatation is the initial management for all cases with a low threshold for gastric fundoplication and gastrostomy. Resection is reserved for refractory stenosis.Keywords: congenital esophageal stenosis, esophageal atresia, esophageal stricture, tracheoesophageal fistul

COVAD survey 2 long-term outcomes: unmet need and protocol

Vaccine hesitancy is considered a major barrier to achieving herd immunity against COVID-19. While multiple alternative and synergistic approaches including heterologous vaccination, booster doses, and antiviral drugs have been developed, equitable vaccine uptake remains the foremost strategy to manage pandemic. Although none of the currently approved vaccines are live-attenuated, several reports of disease flares, waning protection, and acute-onset syndromes have emerged as short-term adverse events after vaccination. Hence, scientific literature falls short when discussing potential long-term effects in vulnerable cohorts. The COVAD-2 survey follows on from the baseline COVAD-1 survey with the aim to collect patient-reported data on the long-term safety and tolerability of COVID-19 vaccines in immune modulation. The e-survey has been extensively pilot-tested and validated with translations into multiple languages. Anticipated results will help improve vaccination efforts and reduce the imminent risks of COVID-19 infection, especially in understudied vulnerable groups

КУРДСКИЙ ВОПРОС И ПОЛИТИЧЕСКИЕ ИНТЕРЕСЫ РОССИИ НА ПРОСТРАНСТВЕ БОЛЬШОГО БЛИЖНЕГО ВОСТОКА

The article is devoted to the actual problem of the Kurdish issue, as well as the interests of Russia in the Great Middle East. The problem of the Kurdish people gaining national independence and their own statehood is one of the most acute and complex issues. The desire of the Kurds, one of the most ancient and people to national self-determination, does not find a response from the leadership of the states that divided Kurdistan, that is, the territory in West Asia, located mainly in the Kurdistan mountains, within Turkey, Iran, Iraq and Syria. For Russia, the interests in the Great Middle East are an opportunity to show its power and combat capability, as well as contain and weaken Islamic extremism and radicalism, whose influence can spread to the territory of Russia.Статья посвящена актуальной проблеме курдского вопроса, а также интересам России на Большом Ближнем Востоке. Проблема курдского народа, стремящегося приобрети независимость и собственную государственность, является одним из самых острых и сложных вопросов. Стремление курдов, одного из самых древних и самобытных народов к национальному самоопределению, не находит понимания у руководства государств, разделяющих Курдистан, то есть территорию в Западной Азии, расположенную главным образом в Турции, Иране, Ираке и Сирии. Для России интересы на Большом Ближнем Востоке - это возможность продемонстрировать свою боевые возможности, а также сдержать и ослабить исламский экстремизм и радикализм, влияние которых может распространиться на территорию России

КУРДСКИЙ ВОПРОС И ПОЛИТИЧЕСКИЕ ИНТЕРЕСЫ РОССИИ НА ПРОСТРАНСТВЕ БОЛЬШОГО БЛИЖНЕГО ВОСТОКА

The article is devoted to the actual problem of the Kurdish issue, as well as the interests of Russia in the Great Middle East. The problem of the Kurdish people gaining national independence and their own statehood is one of the most acute and complex issues. The desire of the Kurds, one of the most ancient and people to national self-determination, does not find a response from the leadership of the states that divided Kurdistan, that is, the territory in West Asia, located mainly in the Kurdistan mountains, within Turkey, Iran, Iraq and Syria. For Russia, the interests in the Great Middle East are an opportunity to show its power and combat capability, as well as contain and weaken Islamic extremism and radicalism, whose influence can spread to the territory of Russia.Статья посвящена актуальной проблеме курдского вопроса, а также интересам России на Большом Ближнем Востоке. Проблема курдского народа, стремящегося приобрети независимость и собственную государственность, является одним из самых острых и сложных вопросов. Стремление курдов, одного из самых древних и самобытных народов к национальному самоопределению, не находит понимания у руководства государств, разделяющих Курдистан, то есть территорию в Западной Азии, расположенную главным образом в Турции, Иране, Ираке и Сирии. Для России интересы на Большом Ближнем Востоке - это возможность продемонстрировать свою боевые возможности, а также сдержать и ослабить исламский экстремизм и радикализм, влияние которых может распространиться на территорию России

islam untuk disiplin ilmu biologi

viii,ill,79hal;17 c

Jurnal Adabiyah : media dialog ilmu keislaman yang berlatar keadaban

Dalam edisi kali ini, sesuai dengan kajiannya, jurnal adabiyah menyajikan beberapan tulisan yang berkaitan sejarah dan bahasa. Dari aspek sejarah, para dosen sejarah menyajikan sejumlah tulisan yang cukup penting berkaitan dengan perkembangan islam di Mancanegara, juga ulasan berkenaan dengan tradisi masyarakat di Sulawesi Selatan. Sedangkan di bidang bahasa, para pakar bahasa Arab juga menampilkan karya ilmiyah yang membahas tentang perkembangan ilmu nahwu dan balaqah.102-113 hlm.; 29 c

Birth rates among male cancer survivors and mortality rates among their offspring: A population-based study from Sweden

10.1186/s12885-016-2236-yBMC Cancer16119