Oral squamous cell carcinoma in the Sudan: clinical behavior, DNA ploidy and S-phase fraction characteristics.

Background: The DNA ploidy and the S phase fraction (SPF) are associated with advanced tumors progression. The present study aimed to investigate the clinicopathological behavior of oral squamous cell carcinoma(OSCC) and the prognostication of the DNA ploidy and the SPF on its clinical outcomes.

Methods: This a prospective longitudinal study of 93 OSCC patients (186 specimens).

Persistence of aerodigestive symptoms after vascular ring repair.

Objective: Vascular rings are often associated with respiratory and swallowing difficulties due to tracheal or esophageal compression. While the results of a vascular ring repair are considered excellent, the long-term effect of tracheal and esophageal remodeling and the persistence of symptoms have scarcely been reported. Our study aims to evaluate the respiratory and swallowing outcomes of vascular ring repair.

Outcomes of pediatric tracheostomy after surgery for congenital heart disease: A 20-year experience.

Objective: Children with congenital heart defects (CHD) requiring cardiovascular surgery (CVS) rarely require tracheostomy placement; however the mortality rate remains high. The study aimed to analyze the incidence of tracheostomy in children with CHD, and to determine factors contributing to postoperative outcomes, decannulation rates, and mortality.

Methods: Retrospective case series of children ≤18 years old with CHD status post-CVS who underwent tracheostomy placement between January 1, 2001 and December 31, 2020.

The aortic uncrossing procedure.

Objective: Cross-sectional imaging allows identification of rare patients with a vascular ring and circumflex aorta. The key diagnostic feature is crossing of the transverse aortic arch from right to left posterior to the trachea and superior to the carina in a patient with a right aortic arch. We evaluated our patients who received an aortic uncrossing procedure.

A four-drug standardized short regimen for highly resistant TB in South-West Nigeria.

Background: Patients with TB resistant to rifampicin (Rr-TB), and those with additional resistance to fluoroquinolones (pre-XDR-TB), should be treated with bedaquiline-pretomanid-linezolid-moxifloxacin and bedaquiline-pretomanid-linezolid, respectively. However, pretomanid is not yet widely available.

Methods: This is a pragmatic prospective single-arm study investigating the efficacy and safety of 9 mo of bedaquiline-delamanid-linezolid-clofazimine in patients with pre-XDR-TB or Rr-TB unresponsive to Rr-TB treatment in Nigeria.

Applicability and Durability of Valve-Sparing Tetralogy of Fallot Repair.

Background: Although valve-sparing repair remains ideal for patients with tetralogy of Fallot, the durability of valve-sparing repair and which patients may have been better served with a transannular patch remain unclear.

Methods: Retrospective review was performed of tetralogy of Fallot operations at our institution from January 2008 to December 2018. Standard demographic data were collected, including echocardiographic parameters, operative details, and clinical outcomes.

Chlorhexidine leads to the evolution of antibiotic-resistant Pseudomonas aeruginosa.

Antimicrobial resistance is a major public-health concern. We evaluate chlorhexidine role in selection of resistant Pseudomonas aeruginosa mutants and their antibiotic cross-resistance. Mutation frequency and mutation rate after short-term exposure to sub-inhibitory concentrations of chlorhexidine were compared to those after spontaneous chlorhexidine-exposure, in P.

MnO nanosheets anchored with polypyrrole nanoparticles as a multifunctional platform for combined photothermal/photodynamic therapy of tumors.

Herein, PPy@MnO nanocomposites were first harvested by anchoring MnO nanosheets on polypyrrole (PPy) nanoparticles via an in situ redox reaction, then polyethylene glycol (PEG) modifier and methylene blue (MB) photosensitizer were linked through electrostatic interactions to obtain PPy@MnO-PEG-MB nanoarchitectures. PPy nanoparticles ensure photothermal therapy (PTT) ability and MnO nanosheets ameliorate tumor hypoxia for enhanced photodynamic therapy (PDT). Therefore, a multifunctional nanotherapeutic system was constructed for the combined PTT/PDT of tumors.

Early-Onset Cardiomyopathy After Pacemaker Implanted in a Preterm Infant With Congenital Complete Heart Block and Anti-Ro/SSA Antibodies.

Congenital complete heart block is a potentially fatal complication that can occur in neonates whose mothers have autoimmune disorders; it has rarely been reported in the presence of Sjögren syndrome. Pacemaker implantation is recommended to treat rhythm abnormalities in these neonates. We report the case of a late-preterm infant with Sjögren-syndrome-antibody-induced complete heart block who underwent temporary bipolar epicardial pacing as a bridge to permanent pacemaker implantation.

Ectopia Cordis Sternal Cleft Repair With Mandibular Distractors: A Follow-Up Case Report.

A neonate with thoracic ectopia cordis presented following an uncomplicated delivery. A mandibular distractor was placed to bridge the sternal cleft and retracted (reverse distractor activation) over 24 days to facilitate sternal closure. Follow-up at five years postoperatively demonstrated a well-healed sternum.

Surveillance Cultures and Infection in 230 Pacemaker and Defibrillator Generator Changes in Pediatric and Adult Congenital Patients.

Background: Postoperative infections can occur during surgical replacement of pulse generators for pacemakers and implantable cardioverter-defibrillators. The incidence of infection is poorly documented in children and patients with adult congenital heart disease. The utility of surveillance cultures obtained from device pocket swabs is unknown in this group.

Influence of Fetal Diagnosis on Management of Vascular Rings.

Background: Fetal diagnoses of vascular rings have been increasing. We compared management strategies and outcomes of infants with fetal diagnosis with those with postnatal diagnosis to inform recommendations regarding optimal management.

Methods: A retrospective review was performed of vascular ring operations from January 2000 to June 2019.

24-Year Results of Nonfenestrated Extracardiac Fontan Including Fontan Conversions.

Background: There is active debate regarding the optimal method of Fontan palliation. In light of this, we reviewed our experience with the nonfenestrated extracardiac Fontan including Fontan conversion.

Methods: We performed a retrospective review of all nonfenestrated extracardiac Fontan and Fontan conversion operations at our institution from December 1, 1994 to December 31, 2018.

Does Value Vary by Center Surgical Volume for Neonates With Truncus Arteriosus? A Multicenter Study.

Background: Truncus arteriosus is a congenital heart defect with high resource use, cost, and mortality. Value assessment (outcome relative to cost) can improve quality of care and decrease cost. This study hypothesized that truncus arteriosus repair at a high-volume center would result in better outcomes at lower cost (higher value) compared with a low-volume center.

Evolution and Current Results of a Unified Strategy for Sinus Venosus Surgery.

Background: Given recent reports of percutaneous closure of sinus venosus atrial septal defects, we reviewed our experience with surgical repair. Owing to the high incidence of arrhythmias with the two-patch technique, since 2001 we have used either one-patch repairs or the Warden procedure.

Methods: A retrospective review was performed of pediatric patients undergoing sinus venosus atrial septal defect repair at our institution from January 1, 1990, to July 1, 2018.

Dual Photoluminescence Emission Carbon Dots for Ratiometric Fluorescent GSH Sensing and Cancer Cell Recognition.

We developed a facile strategy for the fabrication of dual-emission carbon nanodots (CDs) and demonstrated their applications for ratiometric glutathione (GSH) sensing and for differentiating cancer cells from normal cells. Dual-emission CDs were synthesized using a simple hydrothermal treatment of alizarin carmine as the carbon source, manifesting intriguing dual-emission behavior at 430 and 642 nm. With increasing GSH concentration, the fluorescence band at 430 nm increased gradually, whereas that at 642 nm decreased slightly.

Normalization of hemodynamics is delayed in patients with a single ventricle after pediatric heart transplantation.

Objectives: The time course for hemodynamic normalization after pediatric heart transplantation has not been well characterized. We hypothesized that patients with a single ventricle would normalize later than those with dilated cardiomyopathy. Establishing the expected course based on the underlying pathophysiology will allow identification of patients who are outliers, requiring further investigation.

Pediatric Tracheal Surgery: A 25-Year Review of Slide Tracheoplasty and Tracheal Resection.

Background: The purpose of this study was to assess the outcomes of slide tracheoplasty and tracheal resection in pediatric patients and analyze the data for predictors of outcomes.

Methods: A retrospective review of tracheal surgery from January 1, 1993 to May 1, 2018 was performed. Demographic data, operative details, perioperative data, and clinical outcomes were collected.

Mitral Valve Replacement in Infants Using a 15-mm Mechanical Valve.

Background: The 15-mm mechanical valve was approved by the US Food and Drug Administration in March 2018. We review our experience in infants with this valve in the mitral position (MV), focusing on outcomes and timing to repeat MV replacement (MVR).

Methods: Between 2006 and 2017 7 patients underwent eight MVRs (one repeat) with a 15-mm mechanical valve.

Double Aortic Arch With Kommerell Diverticulum.

Background: Vascular rings with a Kommerell diverticulum (KD) most commonly occur in patients with a right aortic arch. We report on a less commonly seen subset of vascular ring patients-those with a double aortic arch and a KD.

Methods: Between 2002 and 2017, 66 patients underwent an operation for a double aortic arch.

Successful Bridge to Transplant in a Pediatric Patient Using the SynCardia 50 cc Total Artificial Heart.

Pediatric heart transplant candidates have the highest wait-list mortality of all organ candidates. Mechanical circulatory support has improved survival for many patients awaiting transplant. Biventricular mechanical circulatory support remains a particular challenge for pediatric patients.

Long-Term Outcomes of Coarctation Repair Through Left Thoracotomy.

Background: Optimal surgical approach for repair of coarctation of the aorta (CoA) remains controversial. This study aimed to evaluate reintervention rates and its predictors by using a strategy of resection with extended end-to-end anastomosis (REEEA) through left thoracotomy.

Methods: A retrospective analysis was performed for all patients who underwent isolated CoA repair or simultaneous repair of CoA and ventricular septal defect repair by REEEA between January 2000 and December 2015 at Ann & Robert H.

Addressing the under-reporting of adverse drug reactions in public health programs controlling HIV/AIDS, Tuberculosis and Malaria: A prospective cohort study.

Background: Adverse Drug Reactions (ADRs) are a major clinical and public health problem world-wide. The prompt reporting of suspected ADRs to regulatory authorities to activate drug safety surveillance and regulation appears to be the most pragmatic measure for addressing the problem. This paper evaluated a pharmacovigilance (PV) training model that was designed to improve the reporting of ADRs in public health programs treating the Human Immunodeficiency Virus (HIV), Tuberculosis (TB) and Malaria.

Brom Aortoplasty for Supravalvular Aortic Stenosis.

Background: Controversy remains regarding the optimal surgical approach for children with supravalvular aortic stenosis (SVAS).

Methods: Since 1997 we have used Brom three-patch aortoplasty for patients with SVAS. We prefer computed tomography (CT) imaging for preoperative evaluation rather than cardiac catheterization as it avoids the well-known morbidity of general anesthesia.