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The focus of this review is on recent literature to critically discuss the emerging advanced materials used as a 3D scaffold in the development of a TM with cellular engineering, biomolecules, cells, and the fabrications of the TM and its pathway to the clinical application. In this review, we discuss the properties of TM and the advantages and disadvantages of the current clinical products for repair and replacement of the TM. Furthermore, we provide an overview of the in vitro and preclinical studies of emerging products over the past 5 years. The results of recent preclinical studies suggest that the tissue engineering field holds significant promise.Relational dissolution is often characterized by heightened feelings, especially around co-parenting and child custody. Lesbian mothers may experience their emotions in uniquely nuanced ways due to intersections among female gender, minority sexual orientation, and family structural change. Framed by a critical feminist perspective, we conducted a qualitative analysis of telephone interview and online survey responses by 17 lesbian adoptive mothers whose relationship ended. Four emotional response patterns emerged - mostly positive, mixed feelings, mostly negative, very negative - corresponding to four adaptation patterns adapted, improving, stalled, and stuck. We provide implications for individuals, families, and societal change related to LGBTQ divorcing families.Background Traditionally, stroke rehabilitation outcomes are based on indicators of physical function, such measures may underrate the all-inclusive impact of stroke such as oral health.Objectives To investigate the relationship between upper extremity motor function and oral hygiene status as well as the impact of stroke on Oral Health-Related Quality of Life (OHRQoL).Methods Sixty stroke survivors were included in this cross-sectional survey. Spasticity and motor function/mobility of the affected upper extremity were assessed using the Modified Ashworth Scale and Action Research Arm Test, respectively. Oral hygiene was assessed using the Simplified Oral Hygiene Index and oral health impact was assessed using the 14-item Oral Health Impact Profile. Pearson's moment correlation coefficient was used to determine the relationship between oral hygiene and upper extremity motor function variables.Results There were significant relationships between the oral hygiene index and Shoulder muscles spasticity (r = 0.374, p = .01), wrist muscles spasticity (r = 0.352, p = .01), as well as basic mobility (r = 0.423, p = .01). An estimated 8% (n = 5) of study participants have their QoL strongly impacted by their oral health.Conclusions Upper extremity motor function variables such as spasticity and basic mobility matters in determining oral hygiene status after stroke. Stroke has little impact on oral health-related quality of life.
To compare the safety and effectiveness of del Nido cardioplegia with blood-based St Thomas Hospital (BSTH) cardioplegia in myocardial protection in congenital heart surgery.
It is a prospective, open-labeled, randomized controlled study conducted at National Heart Institute, Kuala Lumpur from July 2018 to July 2019. find more All patients with simple and complex congenital heart diseases (CHD) with good left ventricular function (left ventricular ejection fraction [LVEF] >50%) were included while those with LVEF <50% were excluded. A total of 100 patients were randomized into two groups of 50 each receiving either del Nido or BSTH cardioplegia. Primary end points were the spontaneous return of activity following aortic cross-clamp release and ventricular function between two groups. Secondary end point was myocardial injury as assessed by troponin T levels.
Cardiopulmonary bypass and aortic cross-clamp time, return of spontaneous cardiac activity following the aortic cross-clamp release, the duration of mechanical ventilation, and intensive care unit stay were comparable between two groups. Statistically significant difference was seen in the amount and number of cardioplegia doses delivered (
< .001). The hemodilution was significantly less in the del Nido complex CHD group compared to BSTH cardioplegia (
= .001) but no difference in blood usage (
= .36). The myocardial injury was lesser (lower troponin T release) with del Nido compared to BSTH cardioplegia (
= .6).
Our study showed that both del Nido and BSTH cardioplegia are comparable in terms of myocardial protection. However, single, less frequent, and lesser volume of del Nido cardioplegia makes it more suitable for complex repair.
Our study showed that both del Nido and BSTH cardioplegia are comparable in terms of myocardial protection. However, single, less frequent, and lesser volume of del Nido cardioplegia makes it more suitable for complex repair.We present a rare case of iatrogenic type B aortic dissection due to ductal cannulation during stage 1 Norwood procedure.Anomalous origin of the circumflex or left anterior descending artery from the pulmonary artery (ACxAPA and ALADAPA, respectively) are rare congenital coronary anomalies with clinical presentation varying from an asymptomatic murmur to sudden cardiac arrest. A systematic review was performed, and 46 cases of ACxAPA and 51 cases of ALADAPA were identified in 87 articles. Data were collected and analyzed from each case. A better understanding of ACxAPA/ALADAPA can provide information to providers who encounter this lesion as well as provide insight into coronary artery development which may help in the understanding of coronary artery anomalies.
Coronary complications may present during or after repair of congenital heart defects. We report coronary artery bypass grafting (CABG) by internal thoracic artery (ITA) grafts to either coronary artery in children with congenital anomalies.
Four cases who underwent CABG with ITA grafts from March 2016 to March 2020 were retrospectively reviewed.
At the time of operation, patient's ages and weight were 7 and 20 months old and 14 and 15 years old and 6.5, 10, 40, and 45 kg, respectively. Diagnosis were anomalous origin of the left coronary artery from the pulmonary artery with leftward lateral ostial origin (n = 1), neopulmonary annulus hypoplasia post arterial switch with contiguous right coronary artery (RCA) arising from the left facing sinus (n = 1), RCA stenosis after the Ross procedure (n = 1), and right coronary ostial obstruction after aortic valve replacement in truncus arteriosus (n = 1). Procedures included left ITA to left coronary ostium (n = 1), right ventricular outflow tract (RVOT) enlargement with pulmonary valve replacement with left ITA to RCA (n = 1), RVOT enlargement with pulmonary valve replacement with right ITA to RCA (n = 1), and aortic valve re-replacement, pulmonary valve replacement, and right ITA to RCA (n = 1).
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