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Myelomeningocele

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https://www.readbyqxmd.com/read/29770571/using-poly-l-lactic-acid-and-poly-%C3%A9-caprolactone-blends-to-fabricate-self-expanding-watertight-and-biodegradable-surgical-patches-for-potential-fetoscopic-myelomeningocele-repair
#1
Rigwed Tatu, Marc Oria, Sarah Pulliam, Lorenzo Signey, Marepalli B Rao, Jose L Peiro, Chia-Ying Lin
Our study focuses on the development and characterization of a self-expanding, watertight and biodegradable patch for fetoscopic myelomeningocele (MMC) prenatal repair. We fabricated poly(l-lactic acid) (PLA) and poly(ɛ-caprolactone) (PCL) blend films by solution casting. Formulation c with average glass transition temperature of 37.6 ± 1.2°C was chosen for temporospatial recovery. Favorable results from surface studies reflected homogeneous dispersion of polymers in the blend. The cytotoxicity was studied in human foreskin fibroblasts...
May 16, 2018: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/29757767/the-prevalence-of-scoliosis-in-spina-bifida-subpopulations-a-systematic-review
#2
Arne Heyns, Stefano Negrini, Katrien Jansen, Pierre Moens, Sebastiaan Schelfaut, Koenraad Peers, Carlotte Kiekens
Prevalence of scoliosis within spina bifida subpopulations is important for diagnostics and therapeutic purposes. This review determined the prevalence of scoliosis within spina bifida subpopulations by means of a systematic literature review by using the following databases: Medline-Pubmed, Embase, Cochrane and Pedro. All Dutch- and English-written literature using the MESH-terms: "Spinal Dysraphism", "Neural Tube Defects", "Scoliosis" was analysed using the exclusion criteria: animal studies, case reports, studies regarding the prevalence of spina bifida among patients with scoliosis, studies with inclusion of patients with scoliosis <11° without possibility to identify subgroups with scoliosis >10°, studies without an own study group, articles comprising the same patient group as another article, neural tube defects besides spina bifida and articles without specification of spina bifida subtype...
May 11, 2018: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29757766/comorbidities-associated-with-early-mortality-in-adults-with-spina-bifida
#3
Brad E Dicianno, Adam Sherman, Christian Roehmer, Christina K Zigler
OBJECTIVE: The purpose of this quality improvement project was to identify secondary conditions and medical comorbidities in adult patients with spina bifida and to determine which factors were associated with an earlier age of death. DESIGN: Retrospective chart review of 487 patients who attended the University of Pittsburgh Medical Center (UPMC) Adult Spina Bifida Clinic between August 1, 2005 and June 6, 2017. RESULTS: Out of 487 patients who had received care at the UPMC Adult Spina Bifida Clinic, 48 were deceased...
May 11, 2018: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29750727/adipofascial-flaps-with-acellular-dermal-matrix-compared-with-myocutaneous-flap-reconstruction-in-lumbar-myelomeningocele-defects
#4
Navid Pourtaheri, Derek Wang, Daniel Calva, Karan Chopra, Anand R Kumar
BACKGROUND: Adipofascial flaps (AFF) with acellular dermal matrix (ADM) have the potential to reconstruct neural tube defects without sacrificing muscle that may be critical for long-term function. Comparative studies between myocutaneous flap (MF) reconstruction, the accepted standard reconstructive technique, and AFF/ADM remain under-reported. The aim of this study was to evaluate the safety and efficacy of myelomeningocele reconstruction using muscle sparing AFF/ADM versus MF. METHODS: A retrospective comparison was conducted on consecutive myelomeningocele patients reconstructed with MF or AFF/ADM over an 84-month period...
May 10, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29750436/fetal-blood-gas-values-during-fetoscopic-myelomeningocele-repair-performed-under-carbon-dioxide-insufflation
#5
Ahmet A Baschat, Edward S Ahn, Jamie Murphy, Jena L Miller
BACKGROUND: Fetoscopic myelomeningocele (MMC) repair is performed with intrauterine carbon dioxide (CO2 ) insufflation. While lamb experiments have shown significant fetal acidemia following CO2 insufflation corresponding information for human pregnancies is not available. CASES: We performed umbilical venous cord blood sampling in three patients during fetoscopic MMC repair at 25+1, 25+3 and 24+1 weeks gestation. Fetal venous pH at the beginning of CO2 insufflation were 7...
May 10, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29749884/perioperative-complications-and-risk-factors-in-neuromuscular-scoliosis-surgery
#6
Brandon J Toll, Amer F Samdani, M Burhan Janjua, Shashank Gandhi, Joshua M Pahys, Steven W Hwang
OBJECTIVE High rates of perioperative complications are associated with deformity correction in neuromuscular scoliosis. The current study aimed to evaluate complications associated with surgical correction of neuromuscular scoliosis and to characterize potential risk factors. METHODS Data were retrospectively collected from a single-center cohort of 102 consecutive patients who underwent spinal fusions for neuromuscular scoliosis between January 2008 and December 2016 and who had a minimum of 6 months of follow-up...
May 11, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29749881/reversible-ventriculoperitoneal-shunt-dysfunction-and-chronic-constipation-case-report
#7
Barbara A Morais, Daniel D Cardeal, Fernanda G Andrade, Wellingson S Paiva, Hamilton Matushita, Manoel J Teixeira
Constipation can cause transient malfunction of the ventriculoperitoneal shunt (VPS). Patients with myelomeningocele or cerebral palsy are often diagnosed with hydrocephalus and constipation due to neurogenic bowel. These patients are more prone to VPS dysfunction, often requiring surgical revision. The authors report the case of a 6-year-old girl with a VPS that had been implanted due to hydrocephalus secondary to myelomeningocele. The patient was brought to the emergency department with intermittent headache, vomiting, constipation, and abdominal distension and pain...
May 11, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29742660/management-of-labor-and-delivery-after-fetoscopic-repair-of-an-open-neural-tube-defect
#8
Jaden R Kohn, Vibha Rao, Allison A Sellner, Dina Sharhan, Jimmy Espinoza, Alireza A Shamshirsaz, William E Whitehead, Michael A Belfort, Magdalena Sanz Cortes
OBJECTIVE: To report labor, delivery, and neonatal outcomes in a cohort of women delivering neonates who had undergone fetoscopic neural tube defect repair. METHODS: We conducted a retrospective cohort study from April 2014 to January 2018. All patients met Management of Myelomeningocele Study eligibility criteria. We included patients with completed second-trimester fetoscopic neural tube defect repair (laparotomy, uterine exteriorization, and minimally invasive access through two or three uterine ports) followed by standardized management of labor and delivery at our institution...
May 7, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29713576/meningomyelocele-simulation-model-pre-surgical-management-technical-report
#9
Orna Rosen, Robert M Angert
This technical report describes the creation of a myelomeningocele model of a newborn baby. This is a simple, low-cost, and easy-to-assemble model that allows the medical team to practice the delivery room management of a newborn with myelomeningocele. The report includes scenarios and a suggested checklist with which the model can be employed.
February 26, 2018: Curēus
https://www.readbyqxmd.com/read/29694666/comparison-of-dorsal-intercostal-artery-perforator-propeller-flaps-and-bilateral-rotation-flaps-in-reconstruction-of-myelomeningocele-defects
#10
Goktekin Tenekeci, Yavuz Basterzi, Sakir Unal, Alper Sari, Yavuz Demir, Celal Bagdatoglu, Bahar Tasdelen
AIM: Bilateral rotation flaps are considered the workhorse flaps in reconstruction of myelomeningocele defects. Since the introduction of perforator flaps in the field of reconstructive surgery, perforator flaps have been used increasingly in the reconstruction of various soft tissue defects all over the body because of their appreciated advantages. The aim of this study was to compare the complications and surgical outcomes between bilateral rotation flaps and dorsal intercostal artery perforator (DICAP) flaps in the soft tissue reconstruction of myelomeningocele defects...
April 9, 2018: Turkish Neurosurgery
https://www.readbyqxmd.com/read/29675073/digeorge-syndrome-with-sacral-myelomeningocele-and-epilepsy
#11
Gülsüm Alkan, Melike Keser Emiroglu, Ayse Kartal
DiGeorge syndrome (DGS) is the most common microdeletion syndrome. The phenotype of DGS is highly variable involving facial, velopharyngeal, cardiac, immunologic, endocrinal, and neuropsychiatric abnormalities. Although neural tube defects (NTDs) have not been described as components of DGS in standard pediatric textbooks, there have been a few case reports of DGS with NTDs. Furthermore, in patients with DGS, seizures can occur due to hypocalcemia or cortical dysgenesis. Few cases of epilepsy have been reported with NTDs without a cortical defect...
October 2017: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/29672287/early-administration-of-magnesium-sulfate-during-open-fetal-myelomeningocele-repair-reduces-the-dose-of-inhalational-anesthesia
#12
Roopali Donepudi, Melissa Huynh, Kenneth J Moise, Ramesha Papanna, Anthony Johnson, Mary Austin, KuoJen Tsao, Ranu Jain
INTRODUCTION: Optimal uterine relaxation is achieved through higher minimum alveolar concentration (MAC) of inhalational anesthetics, increasing risks to mother and fetus. Our objective was to determine if earlier administration of magnesium sulfate would reduce the requirement of inhalational anesthetics in fetal myelomeningocele repair. MATERIALS AND METHODS: Prospective observational study of fetal myelomeningocele repair was performed from September 2011 to August 2017...
April 19, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29618582/uropathogens-and-pyuria-in-children-with-neurogenic-bladders
#13
Catherine S Forster, Nader Shaikh, Alejandro Hoberman, Elizabeth Jackson
: media-1vid110.1542/5727212324001PEDS-VA_2017-3006 Video Abstract BACKGROUND: A recent study revealed that specific uropathogens are associated with lower odds of pyuria in a general pediatrics population. Children with neurogenic bladders who require clean intermittent catheterization (CIC) frequently have pyuria. Our objective with this study was to determine if an association exists between pyuria and type of uropathogen in CIC-dependent children. METHODS: We obtained urinalysis and urine culture results from electronic medical records from January 2008 through December 2014 for patients ≤18 years of age with neurogenic bladders managed at a single institution...
May 2018: Pediatrics
https://www.readbyqxmd.com/read/29605699/tailored-strategies-to-manage-cerebrospinal-fluid-leaks-or-pseudomeningocele-post-surgery-for-tethered-cord-syndrome
#14
Suhas Udayakumaran, Chetan T Rathod
BACKGROUND: Cerebrospinal fluid (CSF) leaks are a dreaded complication after surgery for tethered cord and are associated with significant patient morbidity. Although many strategies for managing postoperative CSF leaks exist, this problem is still daunting, especially in the very young patients. In this article, the authors compared different management techniques for CSF leaks or significant pseudomeningocele in patients with tethered cord syndrome (TCS). METHODS: We analysed a cohort of children who underwent surgery for TCS from January 2011 to March 2016 (n = 260) and postoperatively experienced either a CSF leak or significant pseudomeningocele...
March 29, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29588216/bladder-management-and-continence-outcomes-in-adults-with-spina-bifida-results-from-the-national-spina-bifida-patient-registry-2009-to-2015
#15
John S Wiener, Kristina D Suson, Jonathan Castillo, Jonathan C Routh, Stacy Tanaka, Tiebin Liu, Elisabeth Ward, Judy Thibadeau, David Joseph
PURPOSE: Most children with spina bifida now survive into adulthood, although most have neuropathic bladder with potential complications of incontinence, infection, renal damage and diminished quality of life. In this study we sought to 1) describe contemporary bladder management and continence outcomes of adults with spina bifida, 2) describe differences from younger individuals and 3) assess for association with socioeconomic factors. MATERIALS AND METHODS: We analyzed data on bladder management and outcomes in adults with spina bifida from the National Spina Bifida Patient Registry...
March 26, 2018: Journal of Urology
https://www.readbyqxmd.com/read/29584611/a-descriptive-retrospective-study-of-using-an-oblique-downward-design-gluteus-maximus-myocutaneous-flap-for-reconstruction-of-ischial-pressure-ulcers
#16
Chang-Yi Chou, Yu-Shan Sun, Yu-Jen Shih, Yuan-Sheng Tzeng, Shun-Cheng Chang, Niann-Tzyy Dai, Chin-Ta Lin
Despite advances in reconstruction techniques, ischial pressure ulcers continue to present a challenge for the plastic surgeon. The purpose of this retrospective study was to evaluate outcomes of using an oblique downward gluteus maximus myocutaneous (GMM) flap for coverage of grade IV ischial ulcers. Data regarding defect size, flap size, operation time, duration of wound healing, and surgical outcome were abstracted from the medical records of patients whose ischial pressure ulcers had been reconstructed using GMM island flaps between January 2010 and December 2015...
March 2018: Ostomy/wound Management
https://www.readbyqxmd.com/read/29582171/experience-in-shunt-management-on-revision-free-survival-in-infants-with-myelomeningocele
#17
Sara Al-Hakim, Andreas Schaumann, Joanna Schneider, Matthias Schulz, Ulrich-Wilhelm Thomale
OBJECTIVE: Depending on the etiology of hydrocephalus in childhood, the shunt therapy still remains challenging due to frequent shunt complications leading to possible revisions such as shunt infection or shunt malfunction. In myelomeningocele (MMC) patients who often require shunt therapy, higher revisions rates were reported. In a single-center retrospective study, experiences on shunt regimen on hydrocephalus associated with MMC are presented. METHODS: Data of 160 infant hydrocephalus cases younger than 1 year of age at the time of implantation were retrospectively reviewed from the hospital database...
March 26, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29581920/first-clinical-applications-of-a-high-definition-three-dimensional-exoscope-in-pediatric-neurosurgery
#18
Thomas Beez, Christopher Munoz-Bendix, Kerim Beseoglu, Hans-Jakob Steiger, Sebastian A Ahmadi
The ideal visualization tools in microneurosurgery should provide magnification, illumination, wide fields of view, ergonomics, and unobstructed access to the surgical field. The operative microscope was the predominant innovation in modern neurosurgery. Recently, a high-definition three-dimensional (3D) exoscope was developed. We describe the first applications in pediatric neurosurgery. The VITOM 3D exoscope (Karl Storz GmbH, Tuttlingen, Germany) was used in pediatric microneurosurgical operations, along with an OPMI PENTERO operative microscope (Carl Zeiss AG, Jena, Germany)...
January 24, 2018: Curēus
https://www.readbyqxmd.com/read/29579008/functional-mobility-improved-after-intensive-progressive-resistance-exercise-in-an-adolescent-with-spina-bifida
#19
Carol L Baym, James B Hedgecock, Mary Jane K Rapport
PURPOSE: To describe the use and effectiveness of a novel intensive progressive resistance exercise (PRE) approach to address the functional goals of a 14-year-old adolescent with a myelomeningocele. SUMMARY OF KEY POINTS: The child had lower extremity weakness, knee and hip flexion contractures, impaired somatosensation, and cardiopulmonary deconditioning, affecting gait mechanics and functional ambulation. An 8-week intensive PRE-based intervention was designed to improve walking in the home by targeting both power-generating and stabilizing lower extremity musculature...
April 2018: Pediatric Physical Therapy
https://www.readbyqxmd.com/read/29570035/predictors-of-mortality-in-children-with-myelomeningocele-and-symptomatic-chiari-type-ii-malformation
#20
Michael M McDowell, Jason E Blatt, Christopher P Deibert, Nathan T Zwagerman, Zachary J Tempel, Stephanie Greene
OBJECTIVE Chiari malformation type II (CM-II) in myelomeningocele is associated with a significant rate of mortality and poor outcome. Death is frequently heralded by the onset or progression of neurological symptoms. The authors sought to identify predictors of poor outcome and mortality within the myelomeningocele population at Children's Hospital of Pittsburgh. METHODS A retrospective chart and radiology review was performed on all infants who underwent primary closure of a myelomeningocele defect at Children's Hospital of Pittsburgh between the years of 1995 and 2015...
March 23, 2018: Journal of Neurosurgery. Pediatrics
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