METHODS: Two hundred and eighty-eight patients who underwent isolated repair for coarctation of the aorta at Birmingham Children’s Hospital between 1991 and 2010 were enrolled in this study. Chart selleck products review and the Departmental database were used to determine demographics, operative details and complications.
RESULTS: The majority of patients (n = 237, 82%) underwent surgical repair via thoracotomy techniques, whereas median sternotomy
was used in patients where there was associated arch hypoplasia (n = 51, 18%). For all 288 patients, median age at operation was 24 days (range 0-14 years). Between 1991 and 2000, ten patients (6%) underwent repair through midline sternotomy, increasing to 41 patients (36%) between 2001 and 2010. Overall early mortality was 1% and late mortality was 3%. There was a statistically higher re-intervention
rate (16%) in the decade 1991-2000, compared to 5% in the period 2001-10 (P = 0.02). In patients with hypoplastic arch, the midline approach has a lower re-intervention rate than thoracotomy (P < 0.001).
CONCLUSIONS: In our institution, there has been a trend in recent years towards increased use of median sternotomy to repair the aortic arch, which has been associated with a reduced rate of re-intervention. The midline sternotomy approach for coarctation with arch hypoplasia significantly reduces the risk of re-coarctation.”
“Background and objective: Smoking is thought to modify the pattern of airway inflammation. Induced sputum provides useful information on cellular phenotype in Copanlisib nmr inflammatory airways disorders; however, it is time-consuming and difficult to implement in everyday clinical practice. The aim of this study was to determine whether exhaled NO (FeNO) and exhaled breath condensate (EBC) pH differed in asthmatic smokers compared with asthmatic non-smokers
and healthy subjects, and to evaluate the performance of FeNO and EBC pH for predicting the cellular phenotype of induced sputum.
Methods: Asthmatic smokers (n = 40) and nonsmoking asthmatic patients (n = 43) were recruited for the study. Healthy smoking (n = 30) or non-smoking selleck chemicals llc (n = 30) subjects served as controls. FeNO and EBC pH were measured and all subjects underwent sputum induction for assessment of cell counts.
Results: EBC pH was significantly lower in asthmatic smokers compared with non-smokers (P < 0.01). FeNO levels were also significantly lower in asthmatic smokers compared with non-smokers (P < 0.001). EBC pH was inversely associated with sputum eosinophils in both asthmatic smokers and non-smokers (P < 0.001), whereas it was inversely associated with sputum neutrophils only in asthmatic smokers (P < 0.001). FeNO was positively associated with sputum eosinophils both in asthmatic smokers and non-smokers (P < 0.001) but was not associated with sputum neutrophils.