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Neonatal Surgery

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https://www.readbyqxmd.com/read/28106669/translational-studies-identify-long-term-impact-of-prior-neonatal-pain-experience
#1
Suellen M Walker
Pain sensitivity and risk of chronic pain can be influenced by past experience. Childhood stress/adversity has been associated with chronic pain, mood disorders, and altered disease vulnerability decades later. As the rate of preterm birth and survival at earlier gestational ages increases, and advances in peri-operative care and surgery allow more complex surgical interventions to be performed in neonates, evaluation of treatment 'success' must extend beyond acute morbidity and mortality to encompass effects on subsequent neurodevelopmental outcome, and also sensory, cognitive and behavioral responses to pain in later life...
January 12, 2017: Pain
https://www.readbyqxmd.com/read/28106628/neonatal-micrognathia-national-trends-in-early-mandibular-surgery
#2
Hillary E Jenny, Benjamin B Massenburg, E Hope Weissler, Peter J Taub
BACKGROUND: Micrognathia is a congenital anomaly that may pose breathing and feeding limitations in newborns, sometimes necessitating invasive management. The present study aims to identify the complications associated with receiving mandibular surgery during the birth stay in order to better predict which patients may benefit from early surgical intervention. METHODS: A retrospective cohort study was performed using the 2000 to 2012 kids' inpatient databases. We included all live newborn infants born in the hospital through vaginal delivery or caesarean section...
January 19, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28100980/accessory-mitral-valve-leaflet-causing-severe-left-ventricular-outflow-tract-obstruction-in-a-preterm-neonate-with-a-partial-atrioventricular-septal-defect
#3
J Kevin Wilkes, Charles D Fraser, Thomas J Seery
Atrioventricular septal defects represent a class of congenital cardiac malformations that vary in presentation and management strategy depending upon the severity of the particular lesions present. We present the case of a premature neonate who had a partial atrioventricular septal defect and an accessory mitral (or left atrioventricular) valve leaflet. The latter caused severe left ventricular outflow tract obstruction and severely depressed left ventricular function. We found only one other report of this atrioventricular valve abnormality in association with atrioventricular septal defect...
December 2016: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28100873/microrna-10a-targets-t-box-5-to-inhibit-the-development-of-cardiac-hypertrophy
#4
Dan Wang, Guanqun Zhai, Yangfei Ji, Haiyun Jing
The mechanism of cardiac hypertrophy involving microRNAs (miRNAs) is attracting increasing attention. Our study aimed to investigate the role of miR-10a in cardiac hypertrophy development and the underlying regulatory mechanism.Transverse abdominal aortic constriction (TAAC) surgery was performed to establish a cardiac hypertrophy rat model, and angiotensin II (AngII) was used to induce cardiac hypertrophy in cultured neonatal rat cardiomyocytes. Expression of T-box 5 (TBX5) and miR-10a was altered by cell transfection of siRNA or miRNA mimic/inhibitor...
January 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28098429/natural-history-of-nonimmune-mediated-thrombocytopenia-and-acute-kidney-injury-in-pediatric-open-heart-surgery
#5
Shannon Tew, Manuel L Fontes, Nathaniel H Greene, Miklos D Kertai, George Ofori-Amanfo, Robert D B Jaquiss, Andrew J Lodge, Warwick A Ames, Hercilia Mayumi Homi, Kelly A Machovec, Edmund H Jooste
OBJECTIVE: Thrombocytopenia and acute kidney injury (AKI) are common following pediatric cardiac surgery with cardiopulmonary bypass (CPB). However, the relationship between postoperative nadir platelet counts and AKI has not been investigated in the pediatric population. Our objective was to investigate this relationship and examine independent predictors of AKI. DESIGN: After IRB approval, we performed a retrospective review of the institution's medical records and database...
January 18, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28089174/neonatal-acute-kidney-injury-severity-and-recovery-prediction-and-the-role-of-serum-and-urinary-biomarkers
#6
Deirdre U Sweetman
Neonatal acute kidney injury is common, in part due to incomplete renal maturation and also due to frequent exposure to risk factors for acute kidney injury such as perinatal asphyxia, extracorporeal-membrane-oxygenation, cardiac surgery, sepsis, prematurity and nephrotoxicity. However the current method by which acute kidney injury is diagnosed is sub-optimal and not universally accepted which impairs the accurate estimation of the true incidence of neonatal acute kidney injury. Serum Cystatin-C, urinary NGAL, KIM-1 and IL-18 are promising neonatal acute kidney injury biomarkers however the diagnosis of acute kidney injury remains serum creatinine/urine output-based in many studies...
January 11, 2017: Early Human Development
https://www.readbyqxmd.com/read/28077821/ascending-aortic-constriction-promotes-cardiomyocyte-proliferation-in-neonatal-rats
#7
Zhenhua Wang, Sebastian Schmull, Hui Zheng, Jianggui Shan, Rongjiang Zou, Song Xue
Adult heart suffering from increased workload will undergo myocardial hypertrophy, subsequent cardiomyocyte (CM) death, and eventually heart failure. However, the effect of increasing afterload on the neonatal heart remains unknown. We performed ascending aortic constriction (AAC) in neonatal rats 8-12 hours after birth (P0, P indicates postpartum). Seven days after surgery, in vivo heart function was evaluated using cardiac ultrasonography. Haematoxylineosin and Masson staining were used to assess CM diameter and collagen deposition...
January 11, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28077181/at-what-age-should-tetralogy-of-fallot-be-corrected
#8
Julien I E Hoffman
Tetralogy of Fallot can be corrected with very low mortality at any age, even in neonates, but this does not necessarily mean that it should be corrected in the neonatal period. Although there are many advantages to early correction, a high proportion of these neonates have residual stenosis or pulmonary regurgitation that impairs ventricular function and may require further surgery or implantation of a pulmonary valve. Before we had the ability to correct this anomaly with low mortality in small children, a variety of palliative procedures had to be performed...
January 12, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28074825/goldenhar-syndrome-cardiac-anesthesiologist-s-perspective
#9
REVIEW
Minati Choudhury, Poonam Malhotra Kapoor
Goldenhar syndrome or oculo-auriculo-vertebral dysplasia was defined by Goldenhar in 1952 and redefined by Grolin et al. later. As the name denotes, children with this syndrome present with craniofacial and vertebral anomalies which increase the risk of airway compromise. Neonates and infants with this syndrome often have premature internal organs, low birth weight, and airway disorders. For this reason, safe anesthesia in such infants requires a complete knowledge regarding metabolism and side effects of the drugs...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28067688/perioperative-near-infrared-spectroscopy-monitoring-in-neonates-with-congenital-heart-disease-relationship-of-cerebral-tissue-oxygenation-index-variability-with-neurodevelopmental-outcome
#10
Michael C Spaeder, Darren Klugman, Kami Skurow-Todd, Penny Glass, Richard A Jonas, Mary T Donofrio
OBJECTIVES: To evaluate the value of perioperative cerebral near-infrared spectroscopy monitoring using variability analysis in the prediction of neurodevelopmental outcomes in neonates undergoing surgery for congenital heart disease. DESIGN: Retrospective cohort study. SETTING: Urban, academic, tertiary-care children's hospital. PATIENTS: Neonates undergoing surgery with cardiopulmonary bypass for congenital heart disease...
January 6, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28063686/extubation-failure-after-neonatal-cardiac-surgery-a-multicenter-analysis
#11
Christopher W Mastropietro, Katherine Cashen, Lisa M Grimaldi, Keshava Murty Narayana Gowda, Kurt D Piggott, Michael Wilhelm, Eleanor Gradidge, Elizabeth A S Moser, Brian D Benneyworth, John M Costello
OBJECTIVES: To describe the epidemiology of extubation failure and identify risk factors for its occurrence in a multicenter population of neonates undergoing surgery for congenital heart disease. STUDY DESIGN: We conducted a prospective observational study of neonates ≤30 days of age who underwent cardiac surgery at 7 centers within the US in 2015. Extubation failure was defined as reintubation within 72 hours of the first planned extubation. Risk factors were identified with the use of multivariable logistic regression analysis and reported as OR with 95% CIs...
January 4, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28061000/prediction-of-neonatal-respiratory-distress-in-pregnancies-complicated-by-fetal-lung-masses
#12
Anna I Girsen, Susan R Hintz, Rami Sammour, Aasim Naqvi, Yasser Y El-Sayed, Katie Sherwin, Alexis S Davis, Valerie Y Chock, Richard A Barth, Erika Rubesova, Karl G Sylvester, Ritu Chitkara, Yair J Blumenfeld
OBJECTIVE: To evaluate the utility of fetal lung mass imaging for predicting neonatal respiratory distress. METHOD: Pregnancies with fetal lung masses between 2009 and 2014 at a single center were analyzed. Neonatal respiratory distress was defined as: Intubation and mechanical ventilation at birth, surgery before discharge, or ECMO. The predictive utility of the initial as well as maximal lung mass volume and congenital pulmonary airway malformation (CPAM) volume ratio (CVR) by US and MRI was analyzed...
January 6, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28055334/intestinal-malrotation-and-volvulus-in-neonates-laparoscopy-versus-open-laparotomy
#13
Luisa Ferrero, Yosra Ben Ahmed, Paul Philippe, Olivier Reinberg, Isabelle Lacreuse, Anne Schneider, Raphael Moog, Cindy Gomes-Ferreira, François Becmeur
BACKGROUND: Intestinal malrotations with midgut volvulus are surgical emergencies that can lead to life-threatening intestinal necrosis. This study evaluates the feasibility and the outcomes of laparoscopic treatment of midgut volvulus compared with classic open Ladd's procedure in neonates. MATERIALS AND METHODS: The medical records of all neonates with diagnosis of malrotation and volvulus, who underwent surgery between January 1993 and January 2014, were reviewed...
January 5, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28054340/fingolimod-confers-neuroprotection-through-activation-of-rac1-after-experimental-germinal-matrix-hemorrhage-in-rat-pups
#14
William B Rolland, Paul R Krafft, Tim Lekic, Damon Klebe, Julia LeGrand, Abby Jones Weldon, Liang Xu, John H Zhang
Fingolimod, a sphingosine-1-phosphate receptor (S1PR) agonist, is clinically available to treat multiple sclerosis and is showing promise in treating stroke. We investigated if fingolimod provides long-term protection from experimental neonatal germinal matrix hemorrhage (GMH), aiming to support a potential mechanism of acute fingolimod-induced protection. GMH was induced in P7 rats by infusion of collagenase (0.3 U) into the right ganglionic eminence. Animals euthanized at four weeks post-GMH received low or high dose fingolimod (0...
January 5, 2017: Journal of Neurochemistry
https://www.readbyqxmd.com/read/28043830/fetal-primary-cardiac-tumors-during-perinatal-period
#15
REVIEW
Shi-Min Yuan
Fetal primary cardiac tumors are rare, but they may cause complications, which are sometimes life threatening, including arrhythmias, hydrops fetalis, ventricular outflow/inflow obstruction, cardiac failure, and even sudden death. Among fetal primary cardiac tumors, rhabdomyomas are most common, followed by teratomas, fibromas, hemangiomas, and myxomas. Everolimus, a mammalian target of rapamycin inhibitor, has been reported to be an effective drug to cause tumor remission in three neonates with multiple cardiac rhabdomyomas...
October 28, 2016: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28043688/neonatal-surgery-for-noncardiac-congenital-anomalies-neonates-at-risk-of-brain-injury
#16
Lisanne J Stolwijk, Kristin Keunen, Linda S de Vries, Floris Groenendaal, David C van der Zee, Maud Y A van Herwaarden, Petra M A Lemmers, Manon J N L Benders
OBJECTIVE: To evaluate the incidence of brain injury after neonatal surgery for noncardiac congenital anomalies using magnetic resonance imaging (MRI). STUDY DESIGN: An MRI was obtained in 101 infants at 7 days [range: 1-115] after neonatal surgery for major noncardiac congenital anomalies. Brain injury was assessed using T1, T2, diffusion weighted imaging, and susceptibility-weighted imaging. RESULTS: Thirty-two preterm infants (<37 weeks of gestation) and 69 full-term infants were included...
December 30, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/28043455/validation-of-a-simple-score-to-determine-risk-of-hospital-mortality-after-the-norwood-procedure
#17
Shahryar M Chowdhury, Eric M Graham, Andrew M Atz, Scott M Bradley, Minoo N Kavarana, Ryan J Butts
The ability to quantify patient-specific hospital mortality risk before the Norwood procedure remains elusive. This study aimed to develop an accurate and clinically feasible score to assess the risk of hospital mortality in neonates undergoing the Norwood procedure. All patients (n = 549) in the publically available Pediatric Heart Network Single Ventricle Reconstruction trial database were included in the analysis. Patients were randomly divided into a derivation (75%) and validation (25%) cohort. Preoperative factors found to be associated with mortality upon univariable analysis (P < 0...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28034892/how-i-treat-anemia-in-pregnancy-iron-cobalamin-and-folate
#18
Maureen M Achebe, Anat Gafter-Gvili
Anemia of pregnancy is considered a global health problem, affecting almost 50% of pregnant women. Anemia is an important risk factor for both fetal and maternal morbidity. The purpose of this article is to discuss diagnosis and management of the most frequent causes of anemia in pregnancy: iron, cobalamin and folate deficiencies. This paper considers three clinical cases. Iron deficiency is the most common cause. The laboratory tests that define iron deficiency, the recognition of developmental delays and cognitive abnormalities in iron-deficient neonates and the literature addressing the efficacy and safety of intravenous iron in pregnancy are reviewed...
December 29, 2016: Blood
https://www.readbyqxmd.com/read/28033074/preoperative-feeding-neonates-with-cardiac-disease
#19
Carly J Scahill, Eric M Graham, Andrew M Atz, Scott M Bradley, Minoo N Kavarana, Sinai C Zyblewski
BACKGROUND: The potential for necrotizing enterocolitis (NEC) in neonates requiring cardiac surgery has contributed largely to wide feeding practice variations and a hesitation to initiate enteral feeding during the preoperative period, specifically those patients with hypoplastic left heart syndrome. METHODS: A retrospective chart review of neonates undergoing cardiac surgery at a single institution between July 2011 and July 2013 was performed. The primary objective of this study was to determine if preoperative feeding was associated with NEC in neonates requiring cardiac surgery...
January 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28031099/low-dose-simvastatin-increases-skeletal-muscle-sensitivity-to-caffeine-and-halothane
#20
Xu-Lei Cui, Ying-Lin Wang, Gang Tan, Ai-Lun Luo, Xiang-Yang Guo
Objective To determine whether the myotoxic side effects of statin simvastatin affect skeletal muscle's sensitivity to caffeine and halothane.Methods Primary cultured neonate rat skeletal myotubes were treated with 0.01-5.0 μmol/L simvastatin for 48 hours. MTT was used to evaluate cellular viability. The gross morphology and microstructure of the myotubes were observed with a light and electron microscope, respectively. The intracellular calcium concentrations ([Ca(2+)]i) at rest and in response to caffeine and halothane were investigated by fluorescence calcium imaging...
June 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
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