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Neonatal Surgery

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https://www.readbyqxmd.com/read/27921434/-actual-trends-in-diagnostics-and-treatment-of-congenital-hyperinsulinism
#1
Juraj Staník, Martina Škopková, Monika Rosoľanková, Iwar Klimeš, Daniela Gašperíková
Congenital hyperinsulinism (CHI) is the most common cause of severe persistent hypoglycemia in neonates and infants. Early diagnosis and effective treatment (based on the principles of pharmacogenetics) play the key role for the prognosis. The DNA anlysis, which can identify mutation in one of the 11 genes causing MODY, is crutial in the diagnostics. Moreover, The genotype determines also the optimal therapy approach (medicaments, diet or rarely surgery). There was a large progress of novel medicaments treating particularly most severe (diazoxide-resistant) forms of CHI...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27917566/perioperative-hypothermia-in-neonatal-intensive-care-unit-patients-effectiveness-of-a-thermoregulation-intervention-and-associated-risk-factors
#2
Branden M Engorn, Stephanie L Kahntroff, Karen M Frank, Sarabdeep Singh, Helen A Harvey, Charles T Barkulis, Annika M Barnett, Olamide O Olambiwonnu, Eugenie S Heitmiller, Robert S Greenberg
BACKGROUND: Hypothermia in neonatal intensive care unit patients is associated with morbidity. Perioperative normothermia is the standard of care. AIMS: We hypothesized that a quality improvement intervention (transport protocol, transport education, ongoing monitoring) would decrease the incidence of perioperative hypothermia. Secondarily, we hypothesized that patients undergoing surgery at a postmenstrual age of <37 weeks or at a weight of <1.5 kg would be at higher risk for perioperative hypothermia...
December 5, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27916446/gastrointestinal-complications-associated-with-the-surgical-treatment-of-heart-disease-in-children
#3
Lee P Ferguson, Tarriyo Gandiya, Christos Kaselas, Jigna Sheth, Asif Hasan, Hany Os Gabra
BACKGROUND/PURPOSE: The gastrointestinal system is prone to complications following heart surgery. We sought to determine the incidence and factors associated with gastrointestinal complication after cardiac surgery in children. METHODS: A retrospective review of patients aged <16years that underwent cardiac surgery between 2009 and 2013. Primary outcome was occurrence of gastrointestinal complication within 30days. Multivariable logistic regression was performed to identify variables related to occurrence of gastrointestinal complication...
November 14, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27915316/lack-of-screening-underlies-most-stage-5-retinopathy-of-prematurity-among-cases-presenting-to-a-tertiary-eye-center-in-india
#4
Rajvardhan Azad, Parijat Chandra, Anil Gangwe, Vivek Kumar
OBJECTIVE: To study the barriers to effective screening, early detection and treatment of Retinopathy of Prematurity leading to advanced disease. DESIGN: Cross-sectional study. SETTING: Tertiary eye care hospital in northern India. PARTICIPANTS: 115 babies with bilateral stage 5 ROP identified amongst 354 preterm infants examined over a one year period. METHODS: Information regarding gestational age, birthweight, duration of stay in nursery, duration of supplemental oxygen therapy and treatment details were obtained from discharge summary when available, and by interviewing carers...
November 7, 2016: Indian Pediatrics
https://www.readbyqxmd.com/read/27915035/hyperinsulinaemic-hypoglycaemia-in-children-and-adults
#5
REVIEW
Pratik Shah, Sofia A Rahman, Huseyin Demirbilek, Maria Güemes, Khalid Hussain
Pancreatic β cells are functionally programmed to release insulin in response to changes in plasma glucose concentration. Insulin secretion is precisely regulated so that, under normal physiological conditions, fasting plasma glucose concentrations are kept within a narrow range of 3·5-5·5 mmol/L. In hyperinsulinaemic hypoglycaemia, insulin secretion becomes dysregulated (ie, uncoupled from glucose metabolism) so that insulin secretion persists in the presence of low plasma glucose concentrations. Hyperinsulinaemic hypoglycaemia is the most common cause of severe and persistent hypoglycaemia in neonates and children...
November 30, 2016: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/27914275/inter-observer-agreement-of-the-general-movements-assessment-with-infants-following-surgery
#6
Cathryn Crowle, Claire Galea, Catherine Morgan, Iona Novak, Karen Walker, Nadia Badawi
BACKGROUND: The General Movements Assessment (GMA) is a validated and reliable method of identifying infants at risk of adverse neurodevelopmental outcomes, however there is minimal data available on the use of the GMA with infants following surgery. AIMS: The aim of this study was to investigate the inter-observer agreement for the GMA with this infant population. STUDY DESIGN: Reliability and agreement study. SUBJECTS: This was a prospective cohort study of 190 infants (male n=112) born at term (mean 38weeks, SD 2weeks)...
November 30, 2016: Early Human Development
https://www.readbyqxmd.com/read/27901294/performance-of-functional-fibrinogen-thromboelastography-in-children-undergoing-congenital-heart-surgery
#7
Nischal K Gautam, Chunyan Cai, Olga Pawelek, Muhammad B Rafique, Davide Cattano, Evan G Pivalizza
BACKGROUND: Functional Fibrinogen assay of the Thromboelastography (FFTEG), a whole blood viscoelastic hemostatic assay, has been used to estimate fibrinogen levels in adult patients undergoing major surgery but its performance in pediatric patients undergoing cardiac surgery requires evaluation. In this study, we evaluate the correlation between FFTEG parameters and standard laboratory tests for fibrinogen and platelet counts before and after cardiopulmonary bypass in children undergoing repair for congenital heart disease...
November 30, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27898990/european-paediatric-surgeons-association-survey-on-the-management-of-hirschsprung-disease
#8
Augusto Zani, Simon Eaton, Francesco Morini, Prem Puri, Risto Rintala, Ernest van Heurn, Marija Lukac, Pietro Bagolan, Joachim F Kuebler, Florian Friedmacher, Rene Wijnen, Juan A Tovar, Michael E Hoellwarth, Agostino Pierro
: Aim This study aims to define patterns of Hirschsprung disease (HD) management. Methods An online questionnaire was sent to all European Paediatric Surgeons' Association (EUPSA) members. Results A total of 294 members (61 countries) answered (response rate: 61%). DIAGNOSIS: All respondents perform rectal biopsies (61% rectal suction [RSBs], 39% open full-thickness), 96% contrast enema, and 31% anorectal manometry. At RSB, 17% take the most distal biopsy 1 cm above the dentate line, 34% take 2 cm, 30% take 3 cm, and 19% take > 3 cm...
November 29, 2016: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27896911/the-timing-and-prevalence-of-intraoperative-hypotension-in-infants-undergoing-laparoscopic-pyloromyotomy-at-a-tertiary-pediatric-hospital
#9
Allan F Simpao, Luis M Ahumada, Jorge A Gálvez, Christopher P Bonafide, Elicia C Wartman, William Randall England, Arul M Lingappan, Todd J Kilbaugh, Abbas F Jawad, Mohamed A Rehman
BACKGROUND: Intraoperative hypotension may be associated with adverse outcomes in children undergoing surgery. Infants and neonates under 6 months of age have less autoregulatory cerebral reserve than older infants, yet little information exists regarding when and how often intraoperative hypotension occurs in infants. AIMS: To better understand the epidemiology of intraoperative hypotension in infants, we aimed to determine the prevalence of intraoperative hypotension in a generally uniform population of infants undergoing laparoscopic pyloromyotomy...
November 29, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27896160/neonatal-intestinal-obstruction-when-to-suspect-duplication-cyst-of-bowel-as-the-cause
#10
Rizwan Ahmad Khan, Shagufta Wahab, Imran Ghani
BACKGROUND: Duplication cyst is a rare cause of neonatal intestinal obstruction. Their most common location is the small intestine. The clinical presentation is extremely variable depending upon its size, location and type and the age of the patient and are mainly encountered during infancy or early childhood. The diagnosis is very difficult in neonates. This study was undertaken to study their presentation, diagnostic modality of choice and further management in neonatal age group. MATERIALS AND METHODS: This was a retrospective study performed at the Department of Paediatric Surgery, J ...
October 2016: Journal of Neonatal Surgery
https://www.readbyqxmd.com/read/27896154/use-of-t-tube-enterostomy-in-neonatal-gastro-intestinal-surgery
#11
Maher Al-Zaiem, Abdulhai F Al-Garni, Abdulrahman Al-Maghrebi, Asim A Asghar
Aim: To evaluate the results of the use of the T-tube ileostomy in neonatal intestinal surgery cases. Materials and Methods: A retrospective review of sixty two neonates underwent intestinal obstruction surgery by using T-tube ileostomy was conducted between January 1990 and January 2013.The pathologies of the intestinal obstruction were; thirty four of jejunoileal atresia cases, thirteen case meconium ileus, eight cases perforated necrotizing enterocolitis (NEC), three cases meconium peritonitis, three cases with bowel resection due to intestinal volvulus, and one case of gastroschisis...
October 2016: Journal of Neonatal Surgery
https://www.readbyqxmd.com/read/27896153/a-minor-innovation-in-constructing-a-small-bowel-stoma-in-neonates-with-small-bowel-atresia-to-reduce-the-morbidity
#12
Naeem Khan, Saba Bakht, Nadia Zaheer
BACKGROUND: Intestinal atresia has still significant morbidity in developing countries. Stomas are now not recommended in every case of intestinal atresia; primary anastomosis is the goal of surgery after resection of dilated adynamic gut. A new type of stoma formation along with primary anastomosis is being presented here. MATERIALS AND METHODS: This report is based on our experience of many cases with this technique in last 12 years but all the details and long follow-up of each case is not available...
October 2016: Journal of Neonatal Surgery
https://www.readbyqxmd.com/read/27896151/alimentary-tract-atresias-associated-with-anorectal-malformations-10-years-experience
#13
Manoj Saha
Anorectal malformation (ARM) is one of the most common congenital anomaly that requires emergency surgery in the neonatal period. ARMs are frequently associated with other life threatening congenital anomalies. Commonly associated anomalies are genito-urinary, cardiovascular, gastro-intestinal, skeletal and spinal. Alimentary tract anomalies are frequently masked by the intestinal obstruction produced by the anorectal atresia. This retrospective study was carried out to find out the incidence of associated alimentary tract atresias with ARM...
October 2016: Journal of Neonatal Surgery
https://www.readbyqxmd.com/read/27896150/early-reoperations-after-primary-repair-of-jejunoileal-atresia-in-newborns
#14
Fanny Yeung, Yuk Him Tam, Yuen Shan Wong, Siu Yan Tsui, Hei Yi Wong, Kristine Kit Yi Pang, Christopher H Houben, Jennifer Wai Cheung Mou, Kin Wai Chan, Kim Hung Lee
Aim: To review nine-year experience in managing jejuno-ileal atresia (JIA) by primary resection and anastomosis and identify factors associated with reoperations. Methods: From April 2006 to May 2015, all consecutive neonates who underwent bowel resection and primary anastomosis for JIA were analyzed retrospectively. Patients with temporary enterostomy were excluded. Patient demographics, types of atresia, surgical techniques, need for reoperations, and long-term outcomes were investigated. Results: A total of forty-three neonates were included, in which nineteen (44...
October 2016: Journal of Neonatal Surgery
https://www.readbyqxmd.com/read/27895842/postoperative-outcome-of-caesarean-sections-and-other-major-emergency-obstetric-surgery-by-clinical-officers-and-medical-officers-in-malawi
#15
Garvey Chilopora, Caetano Pereira, Francis Kamwendo, Agnes Chimbiri, Eddie Malunga, Staffan Bergström
BACKGROUND: Clinical officers perform much of major emergency surgery in Malawi, in the absence of medical officers. The aim of this study was to validate the advantages and disadvantages of delegation of major obstetric surgery to non-doctors. METHODS: During a three month period, data from 2131 consecutive obstetric surgeries in 38 district hospitals in Malawi were collected prospectively. The interventions included caesarean sections alone and those that were combined with other interventions such as subtotal and total hysterectomy repair of uterine rupture and tubal ligation...
September 2016: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/27893069/new-medical-and-surgical-insights-into-neonatal-necrotizing-enterocolitis-a-review
#16
Brandy L Frost, Biren P Modi, Tom Jaksic, Michael S Caplan
Importance: Necrotizing enterocolitis (NEC) has long remained a significant cause of morbidity and mortality in neonatal intensive care units. While the mainstay of treatment for this devastating condition remains largely supportive, research efforts continue to be directed toward understanding pathophysiology as well as how best to approach surgical management when indicated. Observations: In this review, we first examine recent medical observations, including overviews on the microbiome and a brief review of the use of probiotics...
November 21, 2016: JAMA Pediatrics
https://www.readbyqxmd.com/read/27892784/management-and-outcome-challenges-in-newborns-with-gastroschisis-a-6-year-retrospective-french-study
#17
B Tosello, M Zahed, F Guimond, K Baumstarck, A Faure, F Michel, O Claris, C Gire, I Berakdar, J Massardier, C D'Ercole, T Merrot
OBJECTIVE: to identify the gestational age (GA) at which risk of mortality and severe outcome was minimized comparing preterm delivery and expectant management. METHODS: Retrospective study performed between 2009 to 2014 of newborns with gastroschisis in three large French level III neonatal intensive care units. Each department followed two distinct strategies: elective delivery at 35 weeks GA and, a delayed approach. RESULTS: We included 69 gastroschisis cases...
November 28, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27891584/an-observational-study-of-the-macro-and-micro-haemodynamic-implications-of-epidural-anaesthesia-in-children
#18
L Triffterer, P Marhofer, G Lechner, T C Marksz, O Kimberger, W Schmid, D Marhofer
The haemodynamic implications of epidural anaesthesia in children are poorly documented. We report macro- and micro-haemodynamic data from an observational study of 25 children ranging from neonates to six-years old, who underwent surgery conducted with a specific combination of monitoring systems. We analysed 90 min of study-related monitoring after epidural catheterisation, with skin incision taking place after around 30 min. We recorded macrohaemodynamic parameters (monitored using LiDCOrapid) including heart rate, mean arterial pressure, cardiac output, stroke volume, systemic vascular resistance and stroke volume variation...
November 28, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27890314/endoscopic-surgery-in-children-the-challenge-goes-on
#19
REVIEW
David C van der Zee
: Paediatric endoscopic surgery is greatly indebted to Karl Storz for developing paediatric endoscopic instruments. In more recent years, there is an increasing interest in endoscopic surgery in neonates. Now more complex procedures are being performed, although it will take another generation before these will be more generally applied. One of the key factors to success is training. More sophisticated training models are becoming available, allowing practicing in a safe environment before putting the procedure to practice...
November 12, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27890313/laparoscopic-fundoplication-in-neonates-and-young-infants-failure-rate-and-need-for-redo-at-a-high-volume-center
#20
Pablo Laje, Thane A Blinman, Michael L Nance, William H Peranteau
AIM OF THE STUDY: Present the outcomes of patients younger than 2years who underwent laparoscopic fundoplication, highlighting the failure rate and need for redo fundoplication. METHODS: Retrospective review of patients <2years who underwent laparoscopic fundoplication between January 2009 and December 2014. MAIN RESULTS: 458 infants younger than 2years underwent laparoscopic fundoplication in the 6-year period (360 Nissen, 77 Toupet and 21 Thal fundoplications)...
November 14, 2016: Journal of Pediatric Surgery
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