Julia Chevan, Sang S Pak, Steven G Wilkinson, Eric Toole
Building a Foundation for Health Informatics Content in Physical Therapy Education Through Concept Analysis and Concept Mapping
Journal, physical therapy education
hirschsprung disease hd manifests developmental anomaly affecting enteric nervous system absence ganglion cells lower part intestine deficiency leads functional blockages within intestines hd usually confirmed ruled rectal biopsy identification ganglion cells hematoxylin eosin staining rules hd ganglion cells absent staining acetylcholineesterase ache histochemistry calretinin immunohistochemistry ihc forms part standard procedure determining diagnosis hd 2017 institute pathology university hospital heidelberg changed hd diagnostic procedure ache histochemistry calretinin ihc paper report impact diagnostic procedure change surgical hd therapy procedures clinical outcome hd patients conducted retrospective review diagnostic procedures clinical data postoperative progress 29 patients underwent surgical treatment hd department pediatric surgery university heidelberg 2012 2021 patient sample divided two groups covering treatment period 5 years 20122016 hd diagnosis performed exclusively using ache histochemistry ache group n 17 20172021 hd diagnosis performed exclusively using calretinin ihc cr group n 12 significant differences groups sex distribution weeks gestation birth weight length aganglionic segment associated congenital anomalies almost half children ache group twice many cr group required enterostomy transanal endorectal pullthrough procedure terpt ache group 4 patients 235 required repeat bowel sampling confirm diagnosis compared ache group children cr group suffered constipation post terpt elevated ache expression linked hypertrophied extrinsic cholinergic nerve fibers aganglionic segment majority patients hd manifestation increased ache expression develops time therefore neonatal patients hd especially first 3 weeks life increase ache reaction detected calretinin ihc reliably identifies presence absence ganglion cells offers multiple benefits ache histochemistry include ability perform test paraffinembedded tissue sections straightforward staining pattern clear binary interpretation negative positive costeffectiveness utility regardless patient age ability calretinin ihc diagnose hd early timeindependently prevented repeated intestinal biopsies patient population allowed us perform onestage terpt first months life reducing number enterostomies restoring colonic continuity early patients undergoing transanal pullthrough age 3 months require close followup detect cases bowel movement problems