Intrauterine repair of gastroschisis in fetal rabbits

Objective: Infants with gastroschisis (GS) still face severe morbidity. Prenatal closure may prevent gastrointestinal organ damage, but intrauterine GS repair (GSR) has not been established yet. Methods: In New Zealand White rabbits we developed and compared GS versus GSR: creation of GS was achieved by hysterotomy, right-sided laparotomy of the fetus and pressure on the abdominal wall to provoke evisceration. GSR was accomplished by careful reposition of eviscerated organs and a running suture of the fetal abdominal wall. For study purposes, 18 animals were divided equally into 3 groups: GS, GS with GSR after 2 h, and unmanipulated controls (C). Vitality was assessed by echocardiography. After 5 h all animals were sacrificed. Results: GSR inflicted no increased mortality, because all fetuses survived GS or GS with GSR. All fetuses with GS demonstrated significant evisceration of abdominal organs. In contrast, the abdominal wall of the fetuses from GSR was intact. Conclusion:The present animal model demonstrated the technical feasibility and success of an intrauterine repair of GS for the first time. However, further long-term studies (leaving GS and GSR in utero for several days) will be necessary to compare survival rates and intestinal injury, motility or absorption. The clinical application of GSR in utero remains a vision so far. Copyright (C) 2003 S. Karger AG, Basel

An acceptance model for the adoption of smart glasses technology by healthcare professionals

In the recent years, there has been an increase in the interest from different industries in the adoption of smart wearable devices in the light of their inevitable ubiquity. One type of these devices is the Augmented Reality Smart Glasses (ARSGs), which can have great effect in different areas through providing timely information to users. One of the industries that can significantly reap the benefits of this technology is healthcare. However, as healthcare is a very multi-dimensional industry, there is a need for a multifaceted look into the adoption and acceptance of smart glasses by health professionals. This study tends to examine the acceptance of smart glasses by healthcare professionals based on Technology Acceptance Model (TAM) as there is an imperative for empirical studies on user perceptions, attitudes, and intentions. For this purpose, five external factors are extracted from the literature and field study, being integration with information systems, external effects, hands-free feature, technological compatibility, and documentation. The model is examined by using PLS-SEM methodology. This study found documentation to have the strongest impact on intention due to the substitution of paperwork by mobile devices and facilitation of continuous documentation

Jungen sterben häufiger an nekrotisierender Enterokolitis

<jats:title>Zusammenfassung</jats:title><jats:sec> <jats:title>Hintergrund</jats:title> <jats:p>In den letzten Jahren verringerte sich die frühgeburtliche Morbidität und Mortalität über Ländergrenzen hinweg deutlich. Allen Untersuchungen gemeinsam ist aber eine höhere Betroffenheit und Sterblichkeit von Jungen gegenüber Mädchen, insbesondere bei der nekrotisierenden Enterokolitis.</jats:p> </jats:sec><jats:sec> <jats:title>Fragestellung</jats:title> <jats:p>Besteht in Deutschland auf Basis der amtlichen Krankenhausstatistik eine höhere Inzidenz oder Sterblichkeit von Jungen an nekrotisierender Enterokolitis?</jats:p> </jats:sec><jats:sec> <jats:title>Material und Methoden</jats:title> <jats:p>Die Autoren werteten die Diagnosedaten der amtlichen Krankenhausstatistik für die Jahre 2000–2017 für die Hauptdiagnose P77 – nekrotisierende Enterokolitis –, getrennt nach Geschlechtern und Überleben, aus. Der Zusammenhang zwischen Geschlecht und Versterben resp. Erkrankungshäufigkeit wurde mittels einseitigem χ<jats:sup>2</jats:sup>-Test auf ein höheres Risiko für Jungen untersucht.</jats:p> </jats:sec><jats:sec> <jats:title>Ergebnisse</jats:title> <jats:p>Zwischen 2000 und 2017 hatten 3119 Frühgeborene die Hauptdiagnose nekrotisierende Enterokolitis, davon 1769 Jungen (0,27 ‰ der männlichen Lebendgeburten) und 1350 Mädchen (0,22 ‰ der weiblichen Lebendgeburten). Jungen haben ein höheres Risiko, an nekrotisierender Enterokolitis zu erkranken (relatives Risiko 1,24, 95 %-Konfidenzintervall: 1,17–∞, <jats:italic>p</jats:italic> < 0,001) und zu versterben (relatives Risiko 1,25, 95 %-Konfidenzintervall: 1,02–∞, <jats:italic>p</jats:italic> = 0,036).</jats:p> </jats:sec><jats:sec> <jats:title>Diskussion</jats:title> <jats:p>Jungen erkranken und sterben häufiger an nekrotisierender Enterokolitis als Mädchen. Allerdings erfasst die amtliche Statistik nicht die leichteren Fälle einer nekrotisierenden Enterokolitis, da nur die Hauptdiagnose erfasst wird. Überdies ermöglicht die amtliche Statistik keine Adjustierung für verzerrende Faktoren. Die sekundäre Datennutzung der Qualitätssicherungsdaten der Neonatalerhebung könnte eine detailliertere Untersuchung dieser Fragestellung ermöglichen.</jats:p> </jats:sec&gt

Kinderchirurgische Operationen unter Einsatz von 5mm laparoskopischen Klammernahtgeräten

Roll 715a. SLU vs. Wash. U. (Washington University)(tennis); Pius Library. Image 16 of 35. (18 April 1961) [PHO 1.715a.16]The Boleslaus Lukaszewski (Father Luke) Photographs contain more than 28,000 images of Saint Louis University people, activities, and events between 1951 and 1970. The photographs were taken by Boleslaus Lukaszewski (Father Luke), a Jesuit priest and member of the University's Philosophy Department faculty

Methods for evaluating causality in observational studies.

Background: In clinical medical research. causality is demonstrated by randomized controlled trials (RCTs). Often, however, an RCT cannot be conducted for ethical reasons, and sometimes for practical reasons as well. In such cases, knowledge can be derived from an observational study instead. In this article, we present two methods that have not been widely used in medical research to date.Methods: The methods of assessing causal inferences in observational studies are described on the basis of publications retrieved by a selective literature search.Results: Two relatively new approaches-regression-discontinuity methods and interrupted time series-can be used to demonstrate a causal relationship under certain circumstances. The regression-discontinuity design is a quasi-experimental approach that can be applied if a continuous assignment variable is used with a threshold value. Patients are assigned to different treatment schemes on the basis of the threshold value. For assignment variables that are subject to random measurement error, it is assumed that, in a small interval around a threshold value, e.g.. cholesterol values of 160 mg/dL, subjects are assigned essentially at random to one of two treatment groups. If patients with a value above the threshold are given a certain treatment, those with values below the threshold can serve as control group. Interrupted time series are a special type of regression-discontinuity design in which time is the assignment variable, and the threshold is a cutoff point. This is often an extemal event, such as the imposition of a smoking ban. A before-and-after comparison can be used to determine the effect of the intervention (e.g.. the smoking ban) on health parameters such as the frequency of cardiovascular disease.Conclusion: The approaches described here can be used to derive causal inferences from observational studies. They should only be applied after the prerequisites for their use have been carefully checked