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

Impaired health-related quality of life in idiopathic inflammatory myopathies: a cross-sectional analysis from the COVAD-2 e-survey

Objectives To investigate health-related quality of life in patients with idiopathic inflammatory myopathies (IIMs) compared with those with non-IIM autoimmune rheumatic diseases (AIRDs), non-rheumatic autoimmune diseases (nrAIDs) and without autoimmune diseases (controls) using Patient-Reported Outcome Measurement Information System (PROMIS) instrument data obtained from the second COVID-19 vaccination in autoimmune disease (COVAD-2) e-survey database. Methods Demographics, diagnosis, comorbidities, disease activity, treatments and PROMIS instrument data were analysed. Primary outcomes were PROMIS Global Physical Health (GPH) and Global Mental Health (GMH) scores. Factors affecting GPH and GMH scores in IIMs were identified using multivariable regression analysis. Results We analysed responses from 1582 IIM, 4700 non-IIM AIRD and 545 nrAID patients and 3675 controls gathered through 23 May 2022. The median GPH scores were the lowest in IIM and non-IIM AIRD patients {13 [interquartile range (IQR) 10–15] IIMs vs 13 [11–15] non-IIM AIRDs vs 15 [13–17] nrAIDs vs 17 [15–18] controls, P < 0.001}. The median GMH scores in IIM patients were also significantly lower compared with those without autoimmune diseases [13 (IQR 10–15) IIMs vs 15 (13–17) controls, P < 0.001]. Inclusion body myositis, comorbidities, active disease and glucocorticoid use were the determinants of lower GPH scores, whereas overlap myositis, interstitial lung disease, depression, active disease, lower PROMIS Physical Function 10a and higher PROMIS Fatigue 4a scores were associated with lower GMH scores in IIM patients. Conclusion Both physical and mental health are significantly impaired in IIM patients, particularly in those with comorbidities and increased fatigue, emphasizing the importance of patient-reported experiences and optimized multidisciplinary care to enhance well-being in people with IIMs

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