1,720,995 research outputs found
Cardiogenic necrotizing enterocolitis: a clinically distinct entity from classical necrotizing enterocolitis
No full textAIM: The main purpose of this study was to investigate if necrotizing enterocolitis (NEC) has a different presentation and outcome in patients with congenital heart defect (CHD) (cardiogenic NEC) from those without (classical NEC). MATERIALS AND METHODS: A systematic review of the literature on the characteristics of infants with NEC and CHD was performed by three independent investigators using a defined strategy (PubMed, Cochrane, Embase, and Web of Science). A meta-analysis was conducted on studies comparing NEC in infants with CHD and non-CHD infants using RevMan 5.3. RESULTS: Systematic review: Of 7,291 abstracts screened, 126 full-text articles were analyzed and 51 studies were included. NEC had an incidence of 5.1% in CHD infants (7,728/151,046, range 0-24%) and 0.8% in non-CHD infants (26,430/3,256,891, range 0.1-8.9%; p < 0.0001). In very low birth weight infants, NEC occurred in 6.3% of CHD patients (6,361/100,454pts) and in 8.9% of non-CHD (23,201/257,794pts; p < 0.0001). In CHD cases, NEC occurred before cardiac surgery in 48% cases and surgery for NEC was required in 31% infants (2,037/6,683). Meta-analysis: In eight comparative studies, the incidence of NEC was higher in CHD infants (6%, 768/13,145) than in infants with no CHD (0.9%, 32,625/3,354,323pts; p < 0.00001, odds ratio [OR] 1.84, 95% confidence interval [CI] 1.7-1.9). The overall mortality was higher in infants with CHD and NEC (38%, 243/640) than in those without CHD (27%, 6651/24810; p < 0.00001, OR 3.4, 95% CI 2.8-4.1). CONCLUSION: This is the first evidence-based study showing that infants with cardiogenic NEC have different demographics and outcomes than those with classical NEC. The risk of developing NEC and the mortality rate are higher among infants with CHD than in those without. Conversely, the need for intestinal surgery is lower in babies with cardiogenic NEC than in those with classical NEC. Further studies are needed to establish preventative and management interventions that are specific to infants with or at risk of developing cardiogenic NEC
La prima prova del modello neoparlamentare: stabilità e governo delle città nel decennio 1993-2002
No full textil capitolo tratta delle trasformazioni avvenute nel governo delle città italiane a seguito della riforma che nel 1993 ha introdotto l'elezione diretta dei sindac
The Application of Quality Risk Management to the Bacterial Endotoxin test: Use of Hazard Analysis and Critical Control Points
No full textABSTRACT: Risk analysis is widely used in the pharmaceutical industry to manage production processes, validation
activities, training, and other activities. Several methods of risk analysis are available (for example, failure mode and
effects analysis, fault tree analysis), and one or more should be chosen and adapted to the specific field where they
will be applied.
Among the methods available, hazard analysis and critical control points (HACCP) is a methodology that has been
applied since the 1960s, and whose areas of application have expanded over time from food to the pharmaceutical
industry. It can be easily and successfully applied to several processes because its main feature is the identification,
assessment, and control of hazards. It can be also integrated with other tools, such as fishbone diagram and
flowcharting. The aim of this article is to show how HACCP can be used to manage an analytical process, propose
how to conduct the necessary steps, and provide data templates necessary to document and useful to follow current
good manufacturing practices
Re: Dawidek et al: Assessing Time of Full Renal Recovery Following Minimally Invasive Partial Nephrectomy (Urology 2018;112:98-102)
No full textExtra-abdominal cryptorchidism associated with gastroschisis and impacted urethral calculus: two uncommon urologic conditions in one patient
Full text linkThe testis is rarely encountered within the organs prolapsed outside the abdominal wall defect of patients with gastroschisis. Optimal treatment strategy of this unusual type of cryptorchidism remains undefined, with less than 30 cases reported to date. We describe a new case where simple relocation of the testis into the abdomen was followed by spontaneous testicular descent. Additionally, he developed a urinary calculus impacted in the navicular fossa 4 years later. Given the rarity of the 2 conditions, the probability of their co-occurrence is exceptionally rare, especially considering that they seem to be causally and temporally unrelated to one another
Carrier tests to assess the effective sporicidal concentration of a liquid chemical disinfectant for a sanitization program.
No full textThe aim of the present investigation was to evaluate the microbial efficacy against highly resistant bacterial spores on different substrates using the lowest effective concentration of a market liquid sporicide based on peracetic acid. The validation was carried out following modified European regulatory agencies procedures or test methods and USP guidelines, employing carriers of materials usually treated with the sporicidal solution and present in grade A cleanrooms and spores of four different microorganisms: Bacillus subtilis and Clostridium sporogenes, both from the ATCC collection, and Bacillus cereus and Bacillus sphaericus as environmental isolates. A statistical evaluation of data was made to estimate the variance for different study conditions. The experiments highlighted that 70% suitable dilution of the ready-to-use peracetic acid solution was effective in both clean and dirty conditions, showing at least 2 log spore reduction after treatment. To obtain effective sporicidal action on the surfaces in cleanrooms it is sufficient to use a sporicidal solution with a ready-to-use concentration of 70% while ensuring a contact time of 10 min. In any case, the reduction of sporicide concentration ensures a high degree of disinfection and provides a consumption savings. LAY ABSTRACT: Wide-spectrum disinfectants are used in the pharmaceutical industry for the decontamination of work surfaces and equipment, but these products have some degree of toxicity for operators. This work arises from the needs of pharmaceutical companies to find the lowest effective concentration of sanitizers in order to reduce toxicity to personnel. The sanitizer used in the study was a market liquid sporicide based on peracetic acid. When we started our work no similar studies were reported in the literature, so we took European regulatory agencies and USP guidelines as a starting point, employing carriers of hard, non-porous materials usually treated with the sporicidal solution and present in sterile rooms and spores of four different microorganisms. The experiments highlighted that it is sufficient to use a 70% sporicidal solution concentration with a contact time of 10 min to reduce the number of spores to acceptable values for medicinal production. The reduction of sporicide concentration both ensures a high degree of disinfection and provides a safer working environment and consumption savings
Renal function up to the 5th decade of life after nephrectomy in childhood: a literature review
No full textThe aim of the present study was to find out if in children ablation of 50% of renal mass may be associated with a progressive renal damage (Brenner’s hypothesis). We collected 1035 adult or adolescent survivors who underwent nephrectomy for unilateral oncological or non-oncological causes during childhood. Stratification of all survivors for age revealed that the number of subjects with blood hypertension and/or renal dysfunction (glomerular filtration rate < 90 mL/min per 1.73 m2) to be significantly higher in survivors ≥30 years old in comparison with younger patients. Available data on long-term renal function after nephrectomy during childhood support the Brenner’s hypothesis
Unilateral Wilms tumor: the relevance of pre- and postnephrectomy evaluation of renal function
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