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Neonatal Surgery

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https://www.readbyqxmd.com/read/29149877/key-bottlenecks-to-the-provision-of-safe-obstetric-anaesthesia-in-low-income-countries-a-cross-sectional-survey-of-64-hospitals-in-uganda
#1
Isabella Epiu, Agnes Wabule, Andrew Kambugu, Harriet Mayanja-Kizza, Jossy Verel Bahe Tindimwebwa, Gerald Dubowitz
BACKGROUND: Despite recent advances in surgery and anaesthesia which significantly improve safety, many health facilities in low-and middle-income countries (LMICs) remain chronically under-resourced with inability to cope effectively with serious obstetric complications (Knight et al., PLoS One 8:e63846, 2013). As a result many of these countries still have unacceptably high maternal and neonatal mortality rates. Recent data at the national referral hospitals in East Africa reported that none of the national referral hospitals met the World Federation of Societies of Anesthesiologists (WFSA) international standards required to provide safe obstetric anaesthesia (Epiu I: Challenges of Anesthesia in Low-and Middle-Income Countries...
November 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29148256/toward-standardization-of-care-the-feeding-readiness-assessment-after-congenital-cardiac-surgery
#2
Daniel E Ehrmann, Matthew Mulvahill, Shaunda Harendt, Jessica Church, Amy Stimmler, Piyagarnt Vichayavilas, Sanja Batz, Jennifer Rodgers, Michael DiMaria, James Jaggers, Cindy Barrett, Jon Kaufman
BACKGROUND: Feeding practices after neonatal and congenital heart surgery are complicated and variable, which may be associated with prolonged hospitalization length of stay (LOS). Systematic assessment of feeding skills after cardiac surgery may earlier identify those likely to have protracted feeding difficulties, which may promote standardization of care. METHODS: Neonates and infants ≤3 months old admitted for their first cardiac surgery were retrospectively identified during a 1-year period at a single center...
November 17, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/29148196/umbilicus-and-its-extensive-clinical-repertoire
#3
Spencer W Beasley
The umbilicus is involved in a wide range of abnormalities in infants and children. The most severe are evident at birth and include exomphalos (omphalocele) and gastroschisis, both of which can be life-threatening but are easy to diagnose. Exomphalos is often associated with other congenital abnormalities, whereas the associated problems in gastroschisis are largely confined to the gut. Infection of the umbilicus in the neonate presents as omphalitis. The causes of a moist umbilicus following separation of the umbilical stump are multiple, from the relatively minor umbilical granuloma or ectopic bowel mucosa to the more significant patent urachus that leaks urine...
November 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29147786/risk-factors-for-development-of-ectopic-atrial-tachycardia-in-post-operative-congenital-heart-disease
#4
Bradley C Clark, John T Berger, Charles I Berul, Richard A Jonas, Jonathan R Kaltman, Julianne Lapsa, Dilip S Nath, Elizabeth D Sherwin, Pranava Sinha, David Zurakowski, Jeffrey P Moak
Ectopic atrial tachycardia (EAT) is common in surgically repaired congenital heart disease (CHD) and carries the potential for significant hemodynamic compromise. Our objective was to determine the incidence, and risk factors of EAT after CHD surgery. Prospective study of patients that underwent surgery for CHD from February to October 2016 was performed. Demographic, perioperative and electrophysiologic data were collected. Sustained EAT (> 30 s) was documented by telemetry or electrocardiogram and confirmed by a pediatric electrophysiologist...
November 17, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/29145339/alveolar-soft-part-sarcoma-with-multiple-brain-and-lung-metastases-in-pregnancy-a-case-report-and-literature-review
#5
Yubo Wang, Jiayue Cui, Xu Yan, Rihua Jin, Xinyu Hong
RATIONAL: Alveolar soft part sarcomas (ASPSs) with multiple brain metastases in pregnancy is a rare entity. PATIENT CONCERNS: We report our experience with a 19-year-old pregnant woman who presented with intermittent headaches and vomiting at 38 weeks gestation. DIAGNOSES: The patient was initially diagnosed as brain metastasis according to computed tomography and magnetic resonance imaging (MRI) imaging. INTERVENTIONS: Cesarean section and craniotomy (complete resection of both brain metastatic lesions) was performed sequentially...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145270/study-on-the-adverse-effects-following-chemotherapy-for-breast-cancer-diagnosis-during-pregnancy-the-first-case-report-in-china
#6
Xin Ye, Qi He, Xiaoyun Zhou
RATIONALE: Treatment of breast cancer during pregnancy (BCP) remains a challenge to physicians. Surgery and chemotherapy during pregnancy are widely used for the treatment of BCP. Herein, we reported 3 Chinese patients with BCP who underwent chemotherapy during pregnancy and were followed up for adverse effects. PATIENT CONCERNS: Three female patients (case 1, case 2, and case 3) of 37-, 32-, and 28-year-old with breast masses were enrolled. Case 1 had been pregnant for over 4 months, case 2 over 7 months, and case 3 for 7 months...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29144241/shifting-risks-and-conflicting-outcomes-ecmo-for-neonates-with-congenital-diaphragmatic-hernia-in-the-modern-era
#7
Joseph W Turek, Joseph R Nellis, Brenton G Sherwood, Meera Kotagal, Andrew L Mesher, Ravi R Thiagarajan, Sonali S Patel, Jeffrey R Avansino, Peter T Rycus, D Michael McMullan, Thomas V Brogan
OBJECTIVES: To update previously described trends for neonates with congenital diaphragmatic hernia (CDH) receiving ECMO with changes in recommendations for care, and to determine how recent advancements in respiratory care have affected this patient population. STUDY DESIGN: This study is a retrospective review of more than 2500 neonates with CDH who received ECMO listed in the Extracorporeal Life Support Organization (ELSO) registry. Cochran-Armitage and multivariate regression analyses were used to analyze changes in the patient population over time and in mortality-related risk factors...
November 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29143863/morphometric-properties-of-the-latissimus-dorsi-muscle-in-human-fetuses-for-flap-surgery
#8
Orhan Beger, Burhan Beger, Deniz Uzmansel, Semra Erdoğan, Zeliha Kurtoğlu
PURPOSE: Although latissimus dorsi (LD) flaps are extensively used in a wide range of interventions, fetus studies on this subject are quite limited. This study aims to obtain detailed information about the morphometric features of LD, thoracodorsal artery (TDA) and nerve (TDN). METHODS: The study was carried out on both sides of 50 formalin-fixed human fetuses (22 male/28 female) with a mean gestational age of 24.5 ± 4.7 (range 18-36) weeks, which were in the inventory of Anatomy Department of Mersin University Faculty of Medicine...
November 16, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/29132342/a-low-cost-uterine-balloon-tamponade-for-management-of-postpartum-hemorrhage-modeling-the-potential-impact-on-maternal-mortality-and-morbidity-in-sub-saharan-africa
#9
Tara Herrick, Mercy Mvundura, Thomas F Burke, Elizabeth Abu-Haydar
BACKGROUND: Postpartum hemorrhage (PPH) is the leading cause of maternal deaths worldwide. This study sought to quantify the potential health impact (morbidity and mortality reductions) that a low-cost uterine balloon tamponade (UBT) could have on women suffering from uncontrolled PPH due to uterine atony in sub-Saharan Africa. METHODS: The Maternal and Neonatal Directed Assessment of Technology (MANDATE) model was used to estimate maternal deaths, surgeries averted, and cases of severe anemia prevented through UBT use among women with PPH who receive a uterotonic drug but fail this therapy in a health facility...
November 13, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29128923/fluid-overload-independent-of-acute-kidney-injury-predicts-poor-outcomes-in-neonates-following-congenital-heart-surgery
#10
Kenneth E Mah, Shiying Hao, Scott M Sutherland, David M Kwiatkowski, David M Axelrod, Christopher S Almond, Catherine D Krawczeski, Andrew Y Shin
BACKGROUND: Fluid overload (FO) is common after neonatal congenital heart surgery and may contribute to mortality and morbidity. It is unclear if the effects of FO are independent of acute kidney injury (AKI). METHODS: This was a retrospective cohort study which examined neonates (age < 30 days) who underwent cardiopulmonary bypass in a university-affiliated children's hospital between 20 October 2010 and 31 December 2012. Demographic information, risk adjustment for congenital heart surgery score, surgery type, cardiopulmonary bypass time, cross-clamp time, and vasoactive inotrope score were recorded...
November 11, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29127968/minimally-invasive-neonatal-surgery
#11
EDITORIAL
Mark L Wulkan, Hanmin Lee
No abstract text is available yet for this article.
December 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/29127965/minimally-invasive-neonatal-surgery-hirschsprung-disease
#12
REVIEW
Atsuyuki Yamataka, Go Miyano, Masahiro Takeda
Transanal pull-through (TAPT) is the procedure of choice for treating Hirschsprung disease and should be performed with laparoscopic assistance using the anorectal line (ARL) to ensure optimum postoperative bowel function (POBF). The dentate line (DL) has traditionally been used as the landmark for commencing dissection during TAPT, but we prefer the ARL because the DL is too subjective and can be associated with risk for injury to delicate sensory innervation required for normal defecation in the anal transition zone...
December 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/29125001/hypoxia-due-to-positive-pressure-ventilation-in-edwards-syndrome-a-case-report
#13
Sun Kyung Hoon, Seung-Woo Kang, Sang-Hyun Kwak, Joungmin Kim
Edwards' syndrome also known as trisomy 18 is a congenital disorder associated with cardiovascular issues including ventricular septal defect (VSD), atrial septal defect (ASD) and patent duct arteriosus (PDA). An emergency colostomy was performed on a neonate born with an imperforate anus. Pre-operative transthoracic echocardiography showed presence of VSD, a patent foramen ovale (PFO) or ASD. Even though the baby had a good general condition and optimal peripheral oxygen saturation (SpO2), during positive pressure ventilation, she suffered severe hypoxia (50% SpO2)...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/29118462/predictive-role-of-f2-isoprostanes-as-biomarkers-for-brain-damage-after-neonatal-surgery
#14
L J Stolwijk, P M A Lemmers, M Y A van Herwaarden, D C van der Zee, F van Bel, F Groenendaal, M L Tataranno, M Calderisi, M Longini, F Bazzini, M J N L Benders, G Buonocore
Objective: Neonates have a high risk of oxidative stress during anesthetic procedures. The predictive role of oxidative stress biomarkers on the occurrence of brain injury in the perioperative period has not been reported before. Methods: A prospective cohort study of patients requiring major surgery in the neonatal period was conducted. Biomarker levels of nonprotein-bound iron (NPBI) in plasma and F2-isoprostane in plasma and urine before and after surgical intervention were determined...
2017: Disease Markers
https://www.readbyqxmd.com/read/29115488/repeated-inhalation-of-sevoflurane-inhibits-the-information-transmission-of-purkinje-cells-and-delays-motor-development-via-the-gabaa-receptor-%C3%AE%C2%B5-subunit-in-neonatal-mice
#15
Hong Fang, Ze-Hua Wang, Ying-Jiang Bu, Zhi-Jun Yuan, Guo-Qiang Wang, Yan Guo, Xiao-Yun Cheng, Wen-Jie Qiu
General anesthesia is widely used in pediatric surgery, although the influence of general anesthesia on cerebellar information transmission and motor function is unclear. In the present study, neonatal mice received repeated inhalation of sevoflurane, and electrophysiological alterations in Purkinje cells (PCs) and the development of motor functions were detected. In addition, γ‑aminobutyric acidA receptor ε (GABAA‑R ε) subunit knockout mice were used to investigate the mechanism of action of sevoflurane on cerebellar function...
November 3, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29113677/stapled-intestinal-anastomoses-with-endoscopic-staplers-in-premature-infants
#16
Colin Muncie, Michael Morris, Barry Berch, David Sawaya, Christopher Blewett
PURPOSE: The safety and effectiveness of a stapled intestinal anastomosis in adults, children, and infants is well documented. However, in neonates it is not well validated. We hypothesized that premature infants who received a stapled bowel anastomosis utilizing endoscopic staplers had similar outcomes compared to patients with a handsewn anastomosis. METHODS: A retrospective study was performed reviewing premature infants who underwent an intestinal anastomosis over a 4-year period...
October 12, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29111080/morbidity-and-mortality-among-big-babies-who-develop-necrotizing-enterocolitis-a-prospective-multicenter-cohort-analysis
#17
Cristine S Velazco, Brenna S Fullerton, Charles R Hong, Kate A Morrow, Erika M Edwards, Roger F Soll, Tom Jaksic, Jeffrey D Horbar, Biren P Modi
BACKGROUND: Necrotizing enterocolitis (NEC) is classically a disease of prematurity, with less reported regarding morbidity and mortality of this disease among other infants. METHODS: Data were prospectively collected from 2009 to 2015 at 252 Vermont Oxford Network member centers on neonates with birth weight>2500g admitted to a participating NICU within 28days of birth. RESULTS: Of 1629 neonates with NEC, gestational age was 37 (36, 39) weeks, and 45% had major congenital anomalies, most commonly gastrointestinal defects (20%), congenital heart defects (18%), and chromosomal anomalies (7%)...
October 12, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29101225/weighing-the-social-and-ethical-considerations-of-maternal-fetal-surgery
#18
Ryan M Antiel, Alan W Flake, Christopher A Collura, Mark P Johnson, Natalie E Rintoul, John D Lantos, Farr A Curlin, Jon C Tilburt, Stephen D Brown, Chris Feudtner
OBJECTIVES: The ethics of maternal-fetal surgery involves weighing the importance of potential benefits, risks, and other consequences involving the pregnant woman, fetus, and other family members. We assessed clinicians' ratings of the importance of 9 considerations relevant to maternal-fetal surgery. METHODS: This study was a discrete choice experiment contained within a 2015 national mail-based survey of 1200 neonatologists, pediatric surgeons, and maternal-fetal medicine physicians, with latent class analysis subsequently used to identify groups of physicians with similar ratings...
November 3, 2017: Pediatrics
https://www.readbyqxmd.com/read/29097611/trends-in-intravenous-antibiotic-duration-for-urinary-tract-infections-in-young-infants
#19
William W Lewis-de Los Angeles, Cary Thurm, Adam L Hersh, Samir S Shah, Michael J Smith, Jeffrey S Gerber, Sarah K Parker, Jason G Newland, Matthew P Kronman, Brian R Lee, Thomas V Brogan, Joshua D Courter, Alicen Spaulding, Sameer J Patel
OBJECTIVES: To assess trends in the duration of intravenous (IV) antibiotics for urinary tract infections (UTIs) in infants ≤60 days old between 2005 and 2015 and determine if the duration of IV antibiotic treatment is associated with readmission. METHODS: Retrospective analysis of infants ≤60 days old diagnosed with a UTI who were admitted to a children's hospital and received IV antibiotics. Infants were excluded if they had a previous surgery or comorbidities, bacteremia, or admission to the ICU...
November 2, 2017: Pediatrics
https://www.readbyqxmd.com/read/29097208/effect-of-eldecalcitol-on-articular-cartilage-through-the-regulation-of-transcription-factor-erg-in-a-murine-model-of-knee-osteoarthritis
#20
Kazumasa Yamamura, Yoichi Ohta, Kenji Mamoto, Ryo Sugama, Yukihide Minoda, Hiroaki Nakamura
Clinical studies have reported an association between low blood levels of 25-hydroxyvitamin D and the progression of osteoarthritis (OA), but the mechanism and effects of vitamin D signaling on articular chondrocytes and cartilage remains unclear. The purpose of this study was to investigate the effects of vitamin D on articular cartilage degeneration using eldecalcitol (ED-71), which is an active vitamin D3 analog. Eight-week old male C57BL/6NCrSlc mice were subjected to experimental surgery to induce OA and local treatments with 10 μL ED-71 (0...
October 30, 2017: Biochemical and Biophysical Research Communications
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