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  • 简介:AbstractObjective:Current guidelines for hypoglossal nerve stimulator (HGNS) implantation eligibility include drug-induced sleep endoscopy (DISE) findings and other patient characteristics but lead to highly variable rates of surgical success across institutions. Our objective was to determine whether additional factors seen on preoperative evaluation could be used as predictors of surgical success.Study design:Retrospective chart review.Setting:Single-institution academic tertiary care medical center.Subjects:and Methods:This study included patients with obstructive sleep apnea (OSA) who underwent HGNS implantation between 2015 and 2018. Surgical success was defined as a post-operative apnea-hypopnea index (AHI) of less than 20 events per hour and an AHI reduction of at least 50%. Preoperative polysomnogram (PSG) results, DISE findings, and physical parameters were compared between surgical successes and failures.Results:A total of 68 patients were included in the analysis. The overall surgical success rate was 79.4% (54/68). Elevated preoperative AHI was associated with an increased likelihood of treatment failure, with an AHI of (36.9 ± 16.8) events/hour in the success group compared to (49.4 ± 19.6) events/hour in the failure group (P = 0.05). Patients observed to have partial lateral oropharyngeal collapse on DISE was more frequently associated with the treatment failure group than in the success group (P = 0.04).Conclusion:Patients who underwent HGNS implantation overall had a very high treatment response rate at our institution. Factors that may predispose patients to surgical failure included the presence of lateral oropharyngeal collapse and a significantly elevated preoperative AHI. These should be considered when determining surgical candidacy for HGNS implantation.

  • 标签: Obstructive sleep apnea Hypoglossal nerve stimulator Drug-induced sleep endoscopy Treatment Predictor
  • 简介:DearEditor,WereadthearticlebyLeeetal~([1])withgreatinterest.Wewouldliketocongratulatetheauthorsforventuringintothisareathatassesstheconsecutiverecurrencefollowingearlysuccessofintermittentexotropia[X(T)]surgeryandtodeterminetheclinicalfactorsthataffectthesurvival.However,wewouldliketomakethefollowingcomments.Inthepresentstudy,itwasdiscussedaboutthecorrelationofearlypostoperativeovercorrectionwithlong-termoutcomes.ItisknownthatmostauthorswouldagreetoanearlypostoperativeovercorrectioninadultpatientswithX(T),the

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  • 简介:Flaviviruses包括约70个密切相关的RNA病毒。这些包括几忍受蚊子的病原体,例如黄发烧病毒(YFV),登革热病毒(DENV),和日本脑炎病毒(JEV),它能引起重要人的疾病并且因此具有大医药重要性。对YFV和JEV的疫苗为decades;在人成功地被使用了;然而,一支DENV疫苗的发展遇到了可观的障碍。这里,我们考察疫苗对YFV得到提供一些卓见进一支保护的DENV疫苗的发展的保护的有免疫力的回答。

  • 标签: 乙脑疫苗 登革热 热病 RNA病毒 应用 日本脑炎病毒
  • 简介:BackgroundAnimalmodelsofmyocardialinfarction(MI)havebeenwidelyusedtostudythepathologicalandphysiologicalchangesthatoccurinMI,andtoobjectivelyevaluatetheefficacyofnewtreatments.Theyareanimportanttoolinthisprocedure.However,themortalityrateofMIanimalmodelshassofarbeenhigherthaninreal-lifesituations.Theaimofthisstudywastoexploretheuseofamodifiedretrogradetractiontrachealintubation(MRTI)methodforincreasingthesuccessrateofMImodelsinrats.MethodsSixtymaleSprague-Dawleyratswereusedintheexperiment.UsingtheMRTImethodofartificialairwaygeneration,weestablishedtheMImodelbyligationoftheleftanteriordescendingbranchofthecoronaryartery.WeanalyzedtheeffectsofMRTI,theuseoflidocaine,operativedetails,nursingconsiderationsduringtheoperation,andpost-operativefactorsonthesuccessrateoftheMImodelinrats.ResultsThesuccessrateofgeneratinganMImodelinratscanbesignificantlyincreasedusingthefollowingmethods:1)SettinguptheartificialairwaythroughtheuseofMRTIbyusingasingle-lumencentralvenouscatheter;2)Selectingaligationsite2mmbelowthemidpointoftheconnectionbetweentheleftatrialappendageandthepulmonarycone;3)Addingadropoflidocainetothesurfaceofthehearttoslowdowntheheartrate,maketheoperationeasiertoperform,andpreventarrhythmiaspostoperatively;4)Clearingupairwaysecretionstimelybothintraandpostoperatively;5)Makingsurethatratsareinawarmstatebothintraandpostoperatively;6)Preventingwoundinfection.ConclusionsUseoftheMRTImethodcanquicklyestablishanartificialairwayinrats.Intraoperativeuseoflidocaine,selectingaprecisevascularligationsite,andappropriatecarebothintraandpostoperativelycanincreasethesuccessrateofMImodelgeneration.更多还原

  • 标签: 动物模型 SD大鼠 试验评价 心肌梗塞 气管插管 功率
  • 简介:AbstractBackground:One inevitable shortcoming of non-invasive prenatal screening (NIPS)/cell-free DNA (cfDNA) sequencing is the uninterpretable ( "no-call" ) result, which is mainly caused by an insufficient fetal fraction. This study was performed to investigate the factors associated with a successful second NIPS in these cases and determine the optimal management for women with initial no-call results.Methods:We retrospectively analyzed the data of women who underwent NIPS with initial no-call results due to an insufficient fetal fraction from 2017 to 2019 in our center. We compared these women’s maternal and pregnancy information with the data of women who had attained a successful second NIPS result and women who had received no-call results for a second time.Results:Among the 33,684 women who underwent NIPS, 137 with a no-call result underwent a retest. Comparison between the 87 (63.50%) women with a successful retest and the other 50 (36.50%) women showed a significant difference in both the initial fetal fraction and maternal body mass index (BMI), whereas the other factors showed no significant differences. In addition, with an initial fetal fraction of < 2.00%, the retest success rate was very limited.Conclusions:We identified two major factors associated with a successful NIPS retest: the initial fetal fraction and the maternal BMI. These findings suggest the need for specialized management for this subset of women and would be instructional for the counseling for these women.

  • 标签: Non-invasive prenatal screening Cell-free DNA No-call results Maternal body mass index Initial fetal fraction