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Neonatal Surgery

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https://www.readbyqxmd.com/read/28820429/propofol-s-effects-on-the-fetal-brain-for-non-obstetric-surgery
#1
REVIEW
Ajay Malhotra, Emily Yosh, Ming Xiong
While the use of Propofol has been increasing in usage for general surgical procedures since its release to market, there has been little work done on its potential link to neurotoxicity in humans. Only recently, following the release of a warning label from the United States Food and Drug Administration (USFDA) regarding a potential link to "neurotoxicity" in the neonate, did the surgical and anesthesiology communities become more aware of its potential for harm. Given the widespread use of this drug in clinical practice, the warning label naturally raised controversy regarding intrapartum Propofol usage...
August 18, 2017: Brain Sciences
https://www.readbyqxmd.com/read/28819007/effects-of-antenatal-melatonin-therapy-on-lung-structure-in-growth-restricted-newborn-lambs
#2
Graeme R Polglase, Jade Barbuto, Beth J Allison, Tamara Yawno, Amy Elizabeth Sutherland, Atul Malhotra, Keith E Schulze, Euan M Wallace, Graham Jenkin, Sharon D Ricardo, Suzanne L Miller
BACKGROUND: Oxidative stress arising from suboptimal placental function contributes to a multitude of pathologies in infants compromised by fetal growth restriction (FGR). FGR infants are at high risk for respiratory dysfunction after birth and poor long-term lung function. OBJECTIVES: To investigate the contribution of oxidative stress to adverse lung development and the effects of melatonin administration, a powerful anti-oxidant, on lung structure in FGR lambs...
August 17, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28818338/spinal-anesthesia-for-pediatric-urological-surgery-reducing-the-theoretic-neurotoxic-effects-of-general-anesthesia
#3
Emmett E Whitaker, Brianne Z Wiemann, Daniel G DaJusta, Seth A Alpert, Christina B Ching, Daryl J McLeod, Joseph D Tobias, Venkata R Jayanthi
BACKGROUND: Spinal anesthesia (SA) is an effective technique that has been used in children for years. With growing concern with regard to the risks of general anesthesia (GA), we developed a SA program to provide an alternative option. We present our initial experience with this program. OBJECTIVE: To implement a SA program at a large tertiary care pediatric center and assess the safety and efficacy of the technique as an alternative to GA for urologic surgery...
July 14, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28817167/body-mass-index-50-kg-m2-and-beyond-perioperative-care-of-pregnant-women-with-superobesity-undergoing-cesarean-delivery
#4
Marcela Carolina Smid, Sarah K Dotters-Katz, Robert M Silver, Jeffrey A Kuller
Importance: Superobesity, defined as body mass index 50 kg/m(2) or greater, is the fastest-growing obesity group in the United States. Currently, 2% of pregnant women in the United States are superobese, and 50% will deliver via cesarean delivery. Objective: To review evidence of perioperative care during cesarean delivery among superobese women. Evidence Acquisition: We performed an evidence-based review of maternal and neonatal risks of cesarean delivery and of intraoperative management and immediate postpartum care of superobese pregnant women...
August 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28812023/use-of-a-polyethylene-bag-to-reduce-perioperative-regional-and-whole-body-heat-losses-in-low-birth-weight-neonates
#5
Pierre Tourneux, Estelle Durand, Amandine Pelletier, Laurent Ghyselen, Véronique Bach, Jean-Pierre Libert
In the delivery room, wrapping a low-birth-weight neonate (defined as ≤2.499 g) in a polyethylene bag reduces the risk of hypothermia. However, extended use of the bag (e.g., during neonatal surgery) might conceivably increase the risk of thermal stress and thus body overheating. Here, we assessed the efficacy of a polyethylene bag in infants assigned to wrap (W) or nonwrap (NW, control) groups during placement of a percutaneous vena cava catheter by applying a new mathematical model that calculates heat exchanges for covered and uncovered body segments...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28801794/management-of-congenital-tracheal-stenosis-in-the-neonatal-period
#6
Keiichi Morita, Kosaku Maeda, Kiyoaki Yabe, Yoshihiro Oshima
PURPOSE: Few reports have focused on the management of congenital tracheal stenosis (CTS) in the neonatal period. The aim of this study was to determine appropriate management strategies for CTS in the neonatal period. METHODS: The medical records of eight neonatal patients with CTS at a single institution between January 2007 and December 2016 were retrospectively reviewed. RESULTS: Three patients with frequent ventilatory insufficiency despite assisted ventilation underwent surgical intervention (balloon tracheoplasty: n = 1, slide tracheoplasty: n = 2)...
August 11, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28797671/pregnancy-after-bariatric-surgery-the-effect-of-time-to-conception-on-pregnancy-outcomes
#7
Patricia O Yau, Manish Parikh, John K Saunders, Patricia Chui, Tara Zablocki, Akuezunkpa Ude Welcome
BACKGROUND: At our medical center, female patients who have undergone bariatric surgery are advised to defer pregnancy for 2 years after surgery to avoid the following complications and their potential consequences for the fetus: inadequate gestational weight gain, inadequate postsurgical weight loss, hyperemesis gravidarum, nutritional deficiencies, gestational diabetes, and gestational hypertension. OBJECTIVES: To examine the effect of time from surgery to conception on pregnancy course and outcomes in bariatric patients...
July 17, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28797657/systematic-review-of-transabdominal-cerclage-placed-via-laparoscopy-for-the-prevention-of-preterm-birth
#8
REVIEW
Gaby N Moawad, Paul Tyan, Tracey Bracke, Elias D Abi Khalil, Vicky Vargas, Alexis Gimovsky, Cherie Marfori
Preterm birth is the leading cause of neonatal mortality and morbidity. Multiple interventions have been put in place to minimize this occurrence. Despite current recommendations including medical management, cervical length screening, and transvaginal cerclage a substantial number of women still experience preterm birth. For those patients, experts recommend a transabdominal cerclage. In our systematic review, we compare 26 studies (1116 patients) on transabdominal cerclage placed via laparotomy (TAC-lap) to 15 studies (728 patients) on transabdominal cerclage placed via laparoscopy (TAC-lsc)...
August 7, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28796070/clinical-characteristics-of-meckel-diverticulum-in-children-a-retrospective-review-of-a-15-year-single-center-experience
#9
Xiao-Kun Lin, Xiao-Zhong Huang, Xiao-Zhou Bao, Na Zheng, Qiong-Zhang Xia, Cong-de Chen
Meckel diverticulum is the most prevalent congenital abnormality of the gastrointestinal tract in children. The aim of this study was to review and analyze clinical data on the diagnosis and management of Meckel diverticulum in pediatric patients. The records of 102 pediatric patients (<14 years old) who underwent surgery for Meckel diverticulum at our institute between 2001 and 2015 were reviewed. Clinical, imaging, laboratory, surgical, and pathological data were recorded. The series comprised 65 males and 37 females with a median age of 5...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28795472/does-ultrasound-guidance-add-accuracy-to-continuous-caudal-epidural-catheter-placements-in-neonates-and-infants
#10
Vrushali C Ponde, Vinit V Bedekar, Ankit P Desai, Kiran A Puranik
BACKGROUND: Caudo-lumbar and caudo-thoracic epidural anesthesia is an established technique that carries a low risk of dural puncture or spinal cord trauma in infants. Traditionally catheter advancement is based on external measurements. However, malpositioning of catheters are known to occur. We hypothesized that caudal-epidural catheters inserted under real-time ultrasound guidance may be more accurate than the accuracy of the measurements traditionally used for their placement. METHODS: We studied 25 patients, aged 2 days to 5 months, posted for abdominal or thoracic surgery, receiving general anesthesia followed by caudo-epidural continuous block...
August 10, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28795028/neonatal-patent-ductus-arteriosus-ligation-operations-performed-by-adult-cardiac-surgeons
#11
Yoon Sang Chung, Dai Yun Cho, Hyun Kang, Na Mi Lee, Joonhwa Hong
BACKGROUND: Patent ductus arteriosus (PDA) ligation is usually performed by congenital cardiac surgeons. However, due to the uneven distribution of congenital cardiac surgeons in South Korea, many institutions depend solely on adult cardiac surgeons for congenital cardiac diseases. We report the outcomes of PDA ligations performed by adult cardiac surgeons at our institution. METHODS: The electronic medical records of 852 neonates at Chung-Ang University Hospital, Seoul, South Korea from November 2010 to May 2014 were reviewed to identify patients with PDA...
August 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28794133/presence-and-pattern-of-scarring-in-children-born-very-preterm
#12
Anna C Tottman, Jane M Alsweiler, Frank H Bloomfield, Jane E Harding
The long-term scarring burden of preterm infants undergoing modern neonatal intensive care is not known. This observational cohort study aimed to document the presence and pattern of scarring in children born <30 weeks' gestation or <1500 g birth weight and cared for at the National Women's Health neonatal intensive care unit, Auckland, New Zealand. Children were examined at 7 years' corrected age and the presence, size, number and distribution of scars documented. Scarring was seen in 90% of 129 children assessed, with 81% having multiple scars, 60% having large scars (85% of whom had no history of major neonatal surgery) and 75% having more than one body area scarred...
August 9, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28783102/the-pulmonary-circulation-in-the-single-ventricle-patient
#13
REVIEW
Amanda Hauck, Nicolas Porta, Steven Lestrud, Stuart Berger
In recent decades, survival of children with complex congenital heart disease has improved considerably. Specifically, children with a variety of congenital heart defects resulting in 'single ventricle' physiology can now undergo palliative surgery that allows survival beyond the neonatal period, and in many cases into adulthood, despite having a single functional ventricular pumping chamber supplying both the pulmonary and systemic circulation. Our growing understanding of the functionally univentricular heart has resulted in freedom from Fontan failure of >50% at 25 years post-Fontan...
August 7, 2017: Children
https://www.readbyqxmd.com/read/28780633/lvc-timing-in-infant-pig-swallowing-and-the-effect-of-safe-swallowing
#14
Andrew Gross, Jocelyn Ohlemacher, Rebecca German, Francois Gould
Recurrent laryngeal nerve (RLN) injury in neonates, a complication of head and neck surgeries, leads to increased aspiration risk and swallowing dysfunction. The severity of resulting sequelae range from morbidity, such as aspiration pneumonia, to mortality from infection and failure to thrive. The timing of airway protective events including laryngeal vestibule closure (LVC) is implicated in aspiration. We unilaterally transected the RLN in an infant pig model to observe changes in the timing of swallowing kinematics with lesion and aspiration...
August 5, 2017: Dysphagia
https://www.readbyqxmd.com/read/28780390/a-12-year-experience-with-tracheostomy-for-neonates-and-infants-in-northern-taiwan-indications-hospital-courses-and-long-term-outcomes
#15
Chia-Huei Chen, Jui-Hsing Chang, Chyong-Hsin Hsu, Nan-Chang Chiu, Chun-Chin Peng, Wai-Tim Jim, Hung-Yang Chang, Kuo-Sheng Lee
BACKGROUND: Tracheostomy is a valuable procedure in infants and neonates with chronic respiratory failure or severe airway obstruction. The aim of this study is to identify the indication, hospital course, and long-term outcome in a cohort of infants who required tracheostomy in a neonatal and pediatric tertiary care center in northern Taiwan. METHODS: Medical records of infants, who underwent tracheostomy between January 2002 and December 2013, were retrospectively reviewed...
July 24, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28776389/congenital-aortic-stenosis-treatment-outcomes-in-a-nationwide-survey
#16
Merja Kallio, Otto Rahkonen, Ilkka Mattila, Jaana Pihkala
OBJECTIVE: To evaluate treatment outcomes of pediatric valvar aortic stenosis (AS) in a nationwide follow-up. DESIGN: Balloon aortic valvuloplasty (BAV) has been the preferred treatment for congenital AS in Finland since the year 2000. All children treated due to isolated AS during 2000-2014 were included in this retrospective study. Treatment outcomes were categorized into Optimal: residual gradient  ≤35 mmHg and trivial or no aortic regurgitation (AR), Adequate: gradient ≤35 mmHg with mild AR, or Inadequate: gradient >35 mmHg and/or moderate to severe AR...
August 4, 2017: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/28774507/clinical-factors-associated-with-in-hospital-death-in-pediatric-surgical-patients-admitted-to-the-neonatal-intensive-care-unit-a-15-year-single-tertiary-center-experience
#17
Kohei Otake, Keiichi Uchida, Michiko Kubo, Akira Yamamoto, Yuka Nagano, Ryo Uratani, Kiyoshi Hashimoto, Kohei Matsushita, Mikihiro Inoue, Hirofumi Sawada, Masato Kusunoki
BACKGROUND/PURPOSE: The purpose of this study was to explore clinical characteristics and primary surgical diagnoses associated with in-hospital death in pediatric surgical patients admitted to the neonatal intensive care unit (NICU) of a tertiary hospital. METHODS: This retrospective study includes all patients admitted to our NICU for pediatric surgical diseases between January 2001 and December 2015. Univariate and multivariate binary logistic regression were performed to assess independent factors associated with in-hospital death...
July 15, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28771764/surgical-management-and-long-term-outcome-of-umbilical-infection-in-65-foals-2010-2015
#18
Gil L Oreff, Amos J Tatz, Roee Dahan, Gilad Segev, Dalia Berlin, Gal Kelmer
OBJECTIVE: To report the short- and long-term outcomes of surgical management of umbilical infection in foals. STUDY DESIGN: Retrospective case series. ANIMALS: Foals (n = 65). METHODS: Medical records (2010-2015) of foals up to 1 month of age, surgically treated for an umbilical infection were reviewed. Short-term (at the time of discharge from hospital) and long-term (1 year after surgery) survival rates were obtained...
August 3, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/28766834/transseptal-puncture-using-surgical-electrocautery-in-children-and-adults-with-and-without-complex-congenital-heart-disease
#19
Srinath T Gowda, Athar M Qureshi, Daniel Turner, Nitin Madan, Justin Weigand, Richard Lorber, Harinder R Singh
BACKGROUND: Atrial transseptal puncture (TSP) for cardiac catheterization procedures remain challenging in children and adults with complex congenital heart disease (CHD). OBJECTIVES: We sought to evaluate our experience using radiofrequency (RF) current via surgical electrocautery needle for TSP to facilitate diagnostic and interventional procedures. METHODS: Retrospective chart review of all patients (pts) who underwent TSP using RF energy (10-25 W) via surgical electrocautery from three centers from January 2011 to January 2017 were evaluated...
August 2, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28764674/arabin-cervical-pessary-for-prevention-of-preterm-birth-in-cases-of-twin-to-twin-transfusion-syndrome-treated-by-fetoscopic-laser-coagulation-the-pecep-laser-randomised-controlled-trial
#20
Carlota Rodó, Sílvia Arévalo, Liesbeth Lewi, Isabel Couck, Bettina Hollwitz, Kurt Hecher, Elena Carreras
BACKGROUND: Fetoscopic LASER coagulation of the placental anastomoses has changed the prognosis of twin-twin transfusion syndrome. However, the prematurity rate in this cohort remains very high. To date, strategies proposed to decrease the prematurity rate have shown inconclusive, if not unfavourable results. METHODS: This is a randomised controlled trial to investigate whether a prophylactic cervical pessary will lower the incidence of preterm delivery in cases of twin-twin transfusion syndrome requiring fetoscopic LASER coagulation...
August 1, 2017: BMC Pregnancy and Childbirth
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