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Move Enhancing regarding Cre-box simply by Unspecific CRISPR/Cas9 Brings about CCR Launch along with Phenotypic Alterations in Bacillus pumilus.
Six patients had postoperative complications, including two who had local recurrence requiring excision. There was one mortality. All the other patients are doing well during follow-up. Conclusion NTs have varied presentations. SCT and STS were the most common benign and malignant tumor, respectively. Early diagnosis and complete surgical excision are often curative for all, regardless of the pathology with the minimal role of chemotherapy or radiotherapy. Copyright © 2020 Journal of Indian Association of Pediatric Surgeons.Introduction The management of lymphatic malformations (LMs) continues to improve with advancement in molecular genetics, imaging, and treatment options. However, the management of tongue LMs remains a challenge due to the location, function involved, and long-term disabilities. We propose injection sclerotherapy with bleomycin in the management of spectrum of tongue LMs. Methods Children with LMs involving the tongue were prospectively treated with bleomycin sclerotherapy. Outcome measured was the efficacy of sclerotherapy, complications, and functional outcome. Results A total of 11 children underwent sclerotherapy with bleomycin for varying tongue lesions. Excellent outcome was seen in children with macroglossia. Eight children with isolated (focal) lesions had a resolution of symptoms with a clearance of lesions. Specific complications related to bleomycin toxicity were not encountered in our series during the follow-up of 4 years. Conclusion In our series, children with macroglossia had an excellent outcome with normalization of tongue size and function. Children with focal tongue lesions also had good to excellent outcome. We recommend treatment of tongue LM with bleomycin sclerotherapy as the first line of management. Ease of treatment, early intervention, and excellent response makes it a favorable treatment option. Copyright © 2020 Journal of Indian Association of Pediatric Surgeons.Aim and Objective This study aimed to finding alternative ways for centers with nonavailability of ultrasonography or fluoroscopy for nonoperative pneumatic reduction of intussusceptions. Materials and Methods A total of 48 cases of intussusceptions were included in the study in-between October 2016 and March 2018. We tried stethoscope-guided pneumatic reduction using locally assembled equipment. The intraluminal pressure was monitored and maintained below 100 mmHg. A total of two attempts of 3 min each were allowed. We compared our results with the control group who have been performing laparotomy for every case of intussusception. Results There were 35 males and 13 females in our study. The average age of the patients was 7.5 months. Intussusceptions were reduced in 38 (80%) patients but could not be reduced in 10 (20%) patients. Majority of the intussusceptions had symptoms of at least 2 days. There were no complications such as perforation in our study. Conclusion Stethoscope-guided pneumatic reduction seems to be a feasible and alternative effective method for the treatment of intussusceptions in children where availability of ultrasonography and skilled radiologist with overburden of work is a great issue. Copyright © 2020 Journal of Indian Association of Pediatric Surgeons.Introduction Ultrasound-guided hydrostatic reduction (HSR) is currently the initial management tool in the treatment of intussusception. HSR is, however, confronted with failures besides there are still a number of patients who primarily undergo surgical intervention for the management of intussusception. We undertook this study to assess the efficacy of HSR and also to look for factors demanding the surgical exploration in patients with intussusception. Materials and Methods A total of 215 patients with intussusception from June 2014 to June 2017 were prospectively studied. HSR was carried out in 203 patients, which was successful in 187 and unsuccessful in 16. These two groups were compared using the Student's t-test. Significance was set at P 10 cm. The role of HSR is also dubious in situations such as neonatal intussusception, small-bowel intussusception, and multiple intussusceptions and also in preventing the future recurrence. Such patients ought to be managed by laparotomy or where feasible by laparoscopy. Furthermore, before embarking on HSR, peritonitis and bowel ischemia should be ruled out clinically and radiologically. In the suspicious cases of bowel ischemia, USG Doppler may be helpful. Copyright © 2020 Journal of Indian Association of Pediatric Surgeons.In this study, we explore different pathways during organizational socialization through the lens of the psychological contract using in-depth longitudinal qualitative methods. Analysis of 112 critical incident interviews with 27 newcomers across their first year of work reveals five distinct psychological contract pathways through socialization, within which fulfilment and breach influence adjustment by facilitating or restricting opportunities to learn and integrate, as well as influencing attitudes and behaviour. The analysis reveals that whilst perceived psychological contract fulfilment facilitates newcomer adjustment, perceived breach can disrupt the process. We provide a detailed account of the way socialization and the psychological contract unfold for newcomers over time, and show that psychological contract events can significantly alter the course of adjustment. Practitioner points Delivery of perceived promises that are of particular importance to newcomers during early tenure can accelerate adjustment. Managers should therefore attempt to find out which promised contributions are important to employees and prioritize their delivery.The negative effects of perceptions of broken promises on newcomer adjustment may be reversed by later delivery. Managers should explain the reasons for any broken promises and seek to fulfil them in the future.Ongoing support from managers can help newcomers to negotiate the difficult period after organizational entry, even where promises are perceived to have been broken.Direct managers should be made aware of information provided and promises made to newcomers by those responsible for recruitment. © 2019 The Authors. Journal of Occupational and Organizational Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.Ecological studies and epidemiology need to use group averaged data to make inferences about individual patterns. However, using correlations based on averages to estimate correlations of individual scores is subject to an "ecological fallacy". The purpose of this article is to create distributions of Pearson R correlation values computed from grouped averaged or aggregate data using Monte Carlo simulations and random sampling. We show that, as the group size increases, the distributions can be approximated by a generalized hypergeometric distribution. The expectation of the constructed distribution slightly underestimates the individual Pearson R value, but the difference becomes smaller as the number of groups increases. The approximate normal distribution resulting from Fisher's transformation can be used to build confidence intervals to approximate the Pearson R value based on individual scores from the Pearson R value based on the aggregated scores.The spleen is the most commonly injured organ after blunt abdominal trauma. Nonoperative management with splenic arterial embolization (SAE) is the current standard of care for hemodynamically stable patients. Current data favor the use of proximal and coil embolization techniques in adults, while observation is suggested in the pediatric population. In this review, the authors describe the most recent evidence informing the clinical indications, techniques, and complications for SAE. © Thieme Medical Publishers.Thoracic aortic emergencies reflect a wide range of etiologies, pathologic processes, and clinical presentations. Accurate identification with an appropriate treatment algorithm is best accomplished in a multidisciplinary setting with interventional radiologists, vascular surgeons, and cardiothoracic surgeons. While knowledge of thoracic stent graft equipment and technique is essential in the treatment of thoracic aortic emergencies, many clinical settings may employ alternative treatment techniques. This article will review the most common thoracic aortic emergencies and treatment strategies. © Thieme Medical Publishers.Pyonephrosis is gross accumulation of pus within an obstructed renal collecting system that, if left untreated, can lead to potentially fatal septic shock. Treatment requires urgent decompression coupled with systemic antibiotics. Percutaneous nephrostomy (PCN) placement, first described in 1976 for the treatment of pyonephrosis, is now widely utilized for emergent decompression in these patients. When performed by an experienced interventional radiologist, PCN is a safe procedure with technical success rates of over 96 to 99%. This article will address the clinical presentation of pyonephrosis, and will discuss the indications, technique, complications, and outcomes of emergent PCN placement. Additionally, the expanded indications for PCN placement in nonemergent scenarios will also be described. © Thieme Medical Publishers.Pulmonary embolism is a common cause of morbidity and mortality which continues to increase in overall incidence. Because it can occur with a wide range of clinical presentations, different guidelines have been developed for appropriate risk stratification of patients; interventional radiology plays a vital role in the management of both massive and submassive pulmonary embolism. Catheter-directed therapy, including mechanical and aspiration thrombectomy, standard catheter-directed thrombolysis, and ultrasound-accelerated thrombolysis, has many benefits, including lower thrombolytic doses and intraclot administration of thrombolytic therapy. While the role of catheter-directed therapy is still being developed, four important prospective studies have demonstrated its safety and efficacy. Additional studies comparing short- and long-term clinical outcomes in patients treated with catheter-directed therapy versus anticoagulation are the next step in understanding its role within the management of submassive pulmonary embolism. Furthermore, multidisciplinary pulmonary embolism response teams, in which interventional radiology plays a crucial role, are becoming essential to appropriately managing pulmonary embolism patients, including selection of those who may benefit from catheter-directed therapy. THAL-SNS-032 purchase © Thieme Medical Publishers.Penetrating extremity trauma (PET) accounts for an estimated 5-15% of trauma with vascular injury and these injuries are accountable for a significant percentage of trauma-related deaths. Historically, vascular injuries were best treated by open repair. While a defined selection criteria and a comprehensive algorithm have not been validated, the advancement of endovascular techniques, embolotherapy, and stent grafting have become viable options for the treatment of penetrating arterial extremity trauma in select patients. Advantages endovascular repair offers include decreasing mortality and morbidity associated with open repair, decreasing blood loss, decreasing iatrogenic injury such as nerve injury, and lower rate of wound infection. Patients stability, type of vascular injury, and lesion location are main factors help deciding between endovascular and open repair. Patient selection between endovascular and open repair should be determined by on a case-by-case situation, individual hospital guidelines, a multidisciplinary approach, and technical expertise.
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