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Pancreatic Neoplasms --- Prognosis --- Survival Rate --- surgery
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Cancer --- Developing Countries --- Neoplasms --- Survival Rate --- Reporting --- mortality
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Introduction: Nowadays, systemico-pulmonary shunting is still the gold standard for the palliative treatment of congenital cyanogenic heart diseases. Despite the progress of medical knowledge and the evolution of surgical technics, shunt-related morbi-mortalities stay constant over time. Our study aims to compare our results to literature's data and to assess the impact of shunt diameter on morbi-mortalities and vascular pulmonary tract development values. Material and method: We retrospectively analyzed the records of 138 patients operated in our center, Saint-Luc University Clinics, between 2000 and 2014. Complications, in-hospital mortality, interstage mortality and mortality risks factors have been studied. We also analyzed the growth of the pulmonary tract between palliative and curative surgery.Results: 135 patients undergone systemico-pulmonary shunt placement at a mean age of 182 days, a mean weight of 4.6kg, a mean "shunt-diameter/weight" ratio of 1.21 mm/kg and a mean "shunt index" of 69.2 mm2/m2 • Most frequent early postoperative complications are low cardiac outflow (43%), postoperative infection (21.5%) and shunt thrombosis (5.9%). Mortality rate to curative operation is 12.6% including 8.9% for in-hospital mortality rate and 3.7% for interstage mortality rate. Significative in-hospital mortality correlated risk factors are female gender, prematurity, central shunt, sternotomy, per-operative use of cardiopulmonary bypass, per-operative use of inotropic drugs, post-operative low cardiac outflow and highest lactatemia value within 24 or 48 postoperative hours higher than 2.2mmol/1. Up to curative surgery identified mortality risk factors are weight less than 3kg at palliative surgery, prematurity, central shunt, sternotomy, per-operative use of cardiopulmonary bypass, per-operative use of inotropic drugs and highest lactatemia value within 24 or 48 postoperative hours higher than 2.2mmol/1. Concerning vascular pulmonary tract development, at curative surgery, distal pulmonary arteries show significant growth (+2.9mm for right pulmonary artery and +3.7mm for the left one), correlated to a significant Nakata index increase of 88.2 mm2/m2•Conclusion: Our study shows the results of a cohort of patients operated at a relatively old age, a weight lightly over the average and a trend to use of a larger shunt diameter. However, our results concerning morbi-mortality and growth of the pulmonary tract are mostly similar to those described in the literature. Further studies will be needed to compare the results of systemico-pulmonary shunts to the results of congenital cyanogenic heart disease new treatments. Introduction : À l'heure actuelle, le « gold standard » préconisé dans le traitement des cardiopathies cyanogènes congénitales reste la mise en place, en période néonatale, d'un shunt systémico-pulmonaire. Malgré l'avancée des connaissances médicales et des techniques opératoires, la morbi-mortalité liée à cette intervention est relativement constante au cours du temps. Notre étude a pour but de comparer nos résultats à ceux présentés dans la littérature et d'évaluer l'impact du diamètre du shunt mis en place sur la morbi-mortalité et le développement de l'arbre vasculaire pulmonaire. Matériel et méthode : Nous avons analysé rétrospectivement les dossiers de 138 patients ayant été opérés pour mise en place d'un shunt systémico-pulmonaire au sein des Cliniques Universitaires Saint Luc entre les années 2000 et 2014. Les complications, les facteurs de risque de mortalité intra hospitalière et ceux de mortalité jusqu'à l'intervention curative ont été étudiés. De plus, le développement de l'arbre vasculaire pulmonaire a été analysé. Résultats : 135 patients ont été opérés à un âge moyen de 182 jours, avec un poids moyen de 4.6kg, un ratio « diamètre du shunt/poids » moyen de 1.21 mm/kg et un « index du shunt » moyen de 69.2 mm2/m2 • Les complications post-opératoires précoces les plus fréquentes sont un bas débit cardiaque (43%), une infection (21.5%) et une thrombose du shunt (5.9%). Le taux de mortalité jusqu'à l'intervention curative est de 12.6% dont 8.9% de mortalité intra-hospitalière lors de la réalisation du shunt. Les facteurs de risque corrélés à une augmentation de la mortalité intra-hospitalière identifiés sont le sexe féminin, la prématurité, la pose d'un shunt central, une sternotomie, le recours à la circulation extracorporelle en peropératoire, le recours aux inotropes en peropératoire, un bas débit cardiaque post-opératoire et une lactatémie maximale supérieure à 2.2mmol/l endéans les 24 ou 48 heures post-opératoires. Les facteurs de risque de mortalité jusqu'à l'opération curative identifiés sont un poids de moins de 3kg au moment de l'opération palliative, la prématurité, la pose d'un shunt central, une sternotomie, le recours à la circulation extracorporelle en peropératoire, le recours aux inotropes en peropératoire et une lactatémie maximale supérieure à 2.2mmol/l endéans les 24 ou 48 heures post-opératoires. Concernant le développement de l'arbre vasculaire pulmonaire, à l'intervention curative, les artères pulmonaires distales montrent une croissance significative (+2.9 mm à droite et +3.7 mm à gauche), corrélée à une augmentation de l'index de Nakata de 88.2 mm2/m2 •Conclusion :Notre cohorte est composée de patients opérés à un âge relativement avancé, un poids un peu plus élevé que la moyenne et une tendance au placement de shunts de large diamètre. Néanmoins, nos résultats en termes de morbi-mortalité et de développement de l'arbre pulmonaire concordent avec les résultats présentés dans la littérature. Des études complémentaires seront nécessaires afin de comparer les résultats concernant la mise en place d'un shunt systémico pulmonaire aux nouvelles techniques de prise en charge des cardiopathies cyanogènes congénitales récemment développées.
Heart Defects, Congenital --- Pulmonary Artery --- Infant, Newborn --- Retrospective Studies --- Survival Rate
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Hodgkin Disease --- Prognosis. --- Survival Rate. --- Mean Survival Time --- Cumulative Survival Rate --- Survivorship --- Cumulative Survival Rates --- Mean Survival Times --- Rate, Cumulative Survival --- Rate, Survival --- Rates, Cumulative Survival --- Rates, Survival --- Survival Rate, Cumulative --- Survival Rates --- Survival Rates, Cumulative --- Survival Time, Mean --- Survival Times, Mean --- Time, Mean Survival --- Times, Mean Survival --- Prognoses --- metabolism. --- mortality. --- drug therapy. --- Theses --- Prognostic Factors --- Factor, Prognostic --- Factors, Prognostic --- Prognostic Factor --- Prognosis --- Survival Rate --- metabolism --- mortality --- drug therapy
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Models, Statistical --- Survival Rate --- Survie --- Survival analysis (Biometry) --- Medicine --- Research --- Statistical methods --- Statistique --- Medicine - Research - Statistical methods
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Neoplasms --- Survival Rate. --- Survivors --- Cancer --- Cancer --- mortality. --- statistics & numerical data. --- Mortality --- SEER Program (National Cancer Institute (U.S.)) --- United States.
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Neoplasms --- Survival Rate. --- Survivors --- Cancer --- Cancer --- mortality. --- statistics & numerical data. --- Mortality --- SEER Program (National Cancer Institute (U.S.)) --- United States.
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Heart Transplantation --- Waiting Lists. --- Survival Rate. --- Kidney Transplantation --- Tissue and Organ Procurement --- Tissue Donors --- #GBIB:CBMER --- Mean Survival Time --- Cumulative Survival Rate --- Survivorship --- Cumulative Survival Rates --- Mean Survival Times --- Rate, Cumulative Survival --- Rate, Survival --- Rates, Cumulative Survival --- Rates, Survival --- Survival Rate, Cumulative --- Survival Rates --- Survival Rates, Cumulative --- Survival Time, Mean --- Survival Times, Mean --- Time, Mean Survival --- Times, Mean Survival --- List, Waiting --- Lists, Waiting --- Waiting List --- mortality. --- physiology. --- organization & administration. --- supply & distribution. --- Theses --- Waiting Lists --- Survival Rate --- mortality --- physiology --- organization & administration --- supply & distribution --- Grafting, Kidney --- Renal Transplantation --- Transplantation, Kidney --- Transplantation, Renal --- Kidney Grafting --- Kidney Transplantations --- Renal Transplantations --- Transplantations, Kidney --- Transplantations, Renal --- Kidney --- transplantation
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Child. --- Infant. --- Liver Transplantation. --- Prognosis. --- Survival Rate. --- Mean Survival Time --- Cumulative Survival Rate --- Cumulative Survival Rates --- Mean Survival Times --- Rate, Cumulative Survival --- Rate, Survival --- Rates, Cumulative Survival --- Rates, Survival --- Survival Rate, Cumulative --- Survival Rates --- Survival Rates, Cumulative --- Survival Time, Mean --- Survival Times, Mean --- Time, Mean Survival --- Times, Mean Survival --- Prognostic Factors --- Factor, Prognostic --- Factors, Prognostic --- Prognoses --- Prognostic Factor --- Grafting, Liver --- Hepatic Transplantation --- Transplantation, Hepatic --- Transplantation, Liver --- Hepatic Transplantations --- Liver Grafting --- Liver Transplantations --- Transplantations, Hepatic --- Transplantations, Liver --- Liver --- Infants --- Children --- Minors --- transplantation --- Theses --- Liver Transplant --- Liver Transplants --- Transplant, Liver --- Child --- Infant --- Liver Transplantation --- Prognosis --- Survival Rate
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Sex determination (SD) is a biological mechanism leading to formation of male or female gonad from undifferenciated gonad. SD is controlled by genetic and environmental factors in Nile tilapia. High temperature reduces growth performance of Nile tilapia and once applied up to 36.5oC during 10 to 30 dpf it induces sex reversal in both directions depending on the genotype.Prolonged photoperiod improve growth rate without affecting survival and sex ratio.
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