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Pectus in children

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https://www.readbyqxmd.com/read/29606411/nonoperative-management-of-pectus-excavatum-with-vacuum-bell-therapy-a-single-center-study
#1
Robert J Obermeyer, Nina S Cohen, Robert E Kelly, M Ann Kuhn, Frazier W Frantz, Margaret M McGuire, James F Paulson
PURPOSE: The purpose of this study was to determine variables predictive of an excellent correction using vacuum bell therapy for nonoperative treatment of pectus excavatum. METHODS: A single institution, retrospective evaluation (IRB 15-01-WC-0024) of variables associated with an excellent outcome in pectus excavatum patients treated with vacuum bell therapy was performed. An excellent correction was defined as a chest wall depth equal to the mean depth of a reference group of 30 male children without pectus excavatum...
March 8, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29549009/a-novel-objective-approach-to-the-external-measurement-of-pectus-excavatum-severity-by-means-of-an-optical-device
#2
Francesca Uccheddu, Marco Ghionzoli, Yary Volpe, Michaela Servi, Rocco Furferi, Lapo Governi, Flavio Facchini, Roberto Lo Piccolo, Kathleen S McGreevy, Alessandra Martin, Monica Carfagni, Antonio Messineo
BACKGROUND: Current approaches to quantifying the severity of pectus excavatum (PE) require internal measurements based on cross-sectional imaging. The aim of this study is to exploit a novel index evaluated on the external surface of the chest with a 3D optical scanner. METHODS: 51 children (41 males, 10 females), between 2 and 17 years old, were evaluated with a 3D optical scanner. PE severity was calculated by using an ad hoc instant 3D scanner and defining an automatic procedure to generate an optical 3D index (CI-3D)...
March 13, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29500788/pigeon-chest-comparative-analysis-of-surgical-techniques-in-minimal-access-repair-of-pectus-carinatum-marpc
#3
REVIEW
Ancuta Muntean, Ionica Stoica, Amulya K Saxena
BACKGROUND: After minimally invasive repair for pectus excavatum (MIRPE), similar procedures for pectus carinatum were developed. This study aimed to analyse the various published techniques of minimal access repair for pectus carinatum (MARPC) and compare the outcomes. DATA SOURCES: Literature was reviewed on PubMed with the terms "pectus carinatum", "minimal access repair", "thoracoscopy" and "children". RESULTS: Twelve MARPC techniques that included 13 articles and 140 patients with mean age 15...
February 2018: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/29405934/perinatal-and-infantile-hypophosphatasia-clinical-features-and-treatment
#4
G Baujat, C Michot, K H Le Quan Sang, V Cormier-Daire
Hypophosphatasia (HPP) is a rare hereditary disease characterized by defective skeletal mineralization, and with a broad severity spectrum. The perinatal forms, lethal and non-lethal, are associated with severe neonatal respiratory distress, potential seizures, hypotrophy and marked hypotonia. The diagnosis is rapidly suggested by a combination of typical radiological signs, hypercalcemia, hyperphosphatemia and low alkaline phosphatase (ALP) activity. In the infantile form, the clinical signs appear before the age of six months, but the patients usually have no or very mild signs at birth...
May 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/29397201/are-foley-catheters-needed-after-minimally-invasive-repair-of-pectus-excavatum
#5
Tyler C Friske, Richard Sola, Yangyang R Yu, Abdur R Jamal, Eric Rosenfeld, Huirong Zhu, Mark V Mazziotti, Shawn D St Peter, Sohail R Shah
BACKGROUND: High narcotic requirements after minimally invasive repair of pectus excavatum (MIRPE) can increase the risk of urinary retention. Placement of intraoperative Foley catheters to minimize this risk is variable. This study determines the rate of urinary retention in this population to guide future practice. MATERIALS AND METHODS: We reviewed retrospectively all patients who underwent MIRPE from January 2012 to July 2016 at 2 academic children's hospitals...
January 31, 2018: Surgery
https://www.readbyqxmd.com/read/29302749/simultaneous-repair-of-congenital-heart-defects-and-pectus-excavatum-in-young-children
#6
Junke Wang, Quan Wang, Zhengxia Pan
PURPOSE: The present study was undertaken to summarize our experience with the concurrent repair of pectus excavatum (PE) and congenital heart defects in young children over the past 15 years. METHODS: A retrospective study was conducted that included patients who underwent combined repair of PE and a congenital heart defect in a large clinical center between 2002 and 2017. Intraoperative and postoperative patient characteristics, postoperative complications and surgical outcomes were recorded...
March 2018: Pediatric Surgery International
https://www.readbyqxmd.com/read/29175559/desmosterolosis-presenting-with-multiple-congenital-anomalies
#7
Mersedeh Rohanizadegan, Stephanie Sacharow
Desmosterolosis is a rare multiple congenital anomaly syndrome caused by a defect in the enzyme 3-beta-hydroxysterol delta-24-reductase (DHCR24) in the cholesterol biosynthesis pathway. Defects in this enzyme cause increased level of the cholesterol precursor desmosterol while disrupting development of cholesterol, impacting embryogenesis. A total of 9 cases of desmosterolosis have been reported to date. We report a 20-month-old male from consanguineous parents with multiple congenital anomalies including corpus callosum hypoplasia, facial dysmorphism, cleft palate, pectus deformity, short and wide neck and distal contractures...
March 2018: European Journal of Medical Genetics
https://www.readbyqxmd.com/read/29027531/-costal-cartilage-structural-and-functional-changes-in-children-with-a-funnel-or-keeled-chest
#8
A V Kurkov, A B Shekhter, V S Paukov
Congenital chest wall deformities (CCWDs) in children are severe diseases leading to cosmetic defects and diseases of the respiratory and cardiovascular systems. The most common of these deformities are funnel-shaped (pectus excavatum, FD) and keeled (pectus carinatum, KD) ones. The pathogenesis of CCWDs and the role of costal cartilage structural and functional changes in their pathogenesis have now been not well studied, which makes it difficult to elaborate pathogenetic approaches to correcting these diseases...
2017: Arkhiv Patologii
https://www.readbyqxmd.com/read/28857528/-benefits-of-magnetic-resonance-for-the-study-of-pectus-excavatum-in-children-initial-experience
#9
M Dore Reyes, C De La Torre, M Bret Zurita, P Triana Junco, J Jiménez Gómez, M Romo Muñoz, A Vilanova Sánchez, M Parrón Pajares, A Pérez Vigara, J L Encinas Hernández, L Martínez Martínez, F Hernández Oliveros, M López-Santamaría
INTRODUCTION/AIM OF THE STUDY: In patients with PE, cardiovascular alterations ensue as a result of the mediastinum compression caused by sternum impingement and is responsible of many of the symptoms. Anatomical and functional assessment is of the utmost importance for a comprehensive understanding of the disease and an adequate treatment plan. Our aim was to describe the use of magnetic resonance image (MRI) in the study of PE and whether it is comparable to imaging techniques. PATIENTS AND METHODS: A retrospective study of the first 10 patients in which an MRI was performed as part of PE assessment within august 2015-2016...
April 20, 2017: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28827049/the-effect-of-thoracoscopy-upon-the-repair-of-pectus-excavatum
#10
Nicole Mennie, Geoff Frawley, Joe Crameri, Sebastian K King
BACKGROUND/AIMS: The Nuss procedure is the most commonly performed operation to correct pectus excavatum (PE). Thoracoscopic assistance has been anecdotally noted to improve the safety of this operative approach. This study aimed to compare complications and clinical outcomes before and after the introduction of thoracoscopy in a single-center. METHODS: A retrospective review was performed of all patients who underwent the Nuss procedure at The Royal Children's Hospital over an 11-year period (2005-2015), collecting data on all intra-operative and post-operative outcomes...
April 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28774473/hyperinflation-of-the-left-anterior-basal-segment-a-new-sign-of-pectus-excavatum-severity-on-ct
#11
S Singh, S B Greenberg
AIM: To describe a new finding in patients with pectus excavatum - left lower lobe anterior basal segment hyperinflation [LABSH]. A secondary objective is to determine the frequency of the new finding and association with pectus excavatum severity. MATERIAL AND METHODS: The study population included 52 children who underwent preoperative computed tomography (CT) for the evaluation of pectus excavatum. A control group of 50 children was obtained after evaluating 137 CT examinations performed for other reasons...
November 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28759900/advantages-of-cardiac-magnetic-resonance-imaging-for-severe-pectus-excavatum-assessment-in-children
#12
Mariela Dore, Paloma Triana Junco, Monserrat Bret, Manuel Gomez Cervantes, Martha Muñoz Romo, Javier Jimenez Gomez, Ana Perez Vigara, Manuel Parron Pajares, Jose Luis Encinas, Francisco Hernandez, Leopoldo Martinez, Manuel Lopez Santamaria, Carlos De La Torre
AIM:  Cardiac function can be impaired in patients with pectus excavatum (PE) due to anatomic and dynamic compression of the heart. Efforts for radiation dose reduction in imaging techniques have allowed cardiac magnetic resonance imaging (c-MRI) to play a major role in PE assessment. The aim of our study is to describe the findings of c-MRI 18 months after we changed the PE assessment protocol from chest computed tomography to c-MRI. PATIENTS AND METHODS:  Since mid-2015 all patients with severe PE (suspected Haller's index > 3...
February 2018: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28714634/-pectus-excavatumn-and-carinatum-in-children-and-adolescents-what-to-say-what-to-do
#13
Pierre Lascombes, Isabelle Ruchonnet-Métrailler, Maurice Beghetti, Armand Bottani, James Wilde
In children presenting with a pectus excavatum (PE) or pectus carinatum (PC) an underlying syndrome including Marfan's syndrome needs to be excluded. In adolescents, severe chest wall deformities may cause cardiac or respiratory problems but most commonly they have a psychological impact. The conservative treatment is a Vacuum Bell for PE, and a Dynamic Compression System for PC ; they play an increasing role in young patients. These devices need to be worn multiple hours per day for several months for an optimal result...
February 15, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28624480/evaluation-of-thoracic-vertebrae-rotation-in-patients-with-pectus-excavatum
#14
Ryszard Tomaszewski, Łukasz Wiktor, Ludwina Machała
PURPOSE: The aim of our study was to evaluate thoracic vertebrae rotation in patients with pectus excavatum. Moreover, we wanted to assess the prevalence, the severity and relationship between pectus excavatum and adolescent idiopathic scoliosis (AIS). METHODS: We performed retrospective analysis of 82 preoperative chest CT in children with pectus excavatum performed between January 2008 and December 2011. For each patient Haller Index and Cobb angle was measured...
July 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28618768/psychosocial-functioning-in-pediatric-patients-with-pectus-excavatum-and-pectus-carinatum
#15
Aliye Tuğba Bahadir, Pınar Kuru Bektaşoğlu, Aylin Çakiroğlu Eser, Ceyda Afacan, Mustafa Yüksel
BACKGROUND/AIM: Pectus excavatum and pectus carinatum are the most commonly seen anterior chest wall deformities. Recent studies reveal that minimal invasive repair of pectus deformities improves the quality of life. Our aim is to assess the psychosocial functioning and sociodemographic characteristics of pediatric patients with pectus deformities and evaluate the differences between patients operated on with minimal invasive repair techniques and nonoperated patients. MATERIALS AND METHODS:  Thirty-two patients with pectus deformities who were operated on 6 months or more before and 31 nonoperated patients participated in the study...
June 12, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28615652/development-of-a-computer-aided-design-and-finite-element-analysis-combined-method-for-customized-nuss-bar-in-pectus-excavatum-surgery
#16
Longhan Xie, Siqi Cai, Liang Xie, Gang Chen, Haiyu Zhou
Pectus excavatum (PEX) is the most common chest deformity in children, which is usually corrected by using the minimally invasive Nuss method. The orthopedic effect of the Nuss operation is mainly evaluated by both the Haller index and the appearance of the chest wall configuration, which is dependent on the operator's clinical experience to a great extent. To improve the orthopedic effect, we proposed a novel method to individually design and optimize the shape of the Nuss bar and to advise its location as well as the incisions...
June 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28602524/monitoring-the-effectiveness-of-the-vacuum-bell-during-pectus-excavatum-treatment-technical-innovation
#17
Sergio B Sesia, David Hradetzky, Frank-Martin Haecker
BACKGROUND: The vacuum bell (VB) is a valid and the only non-invasive treatment for pectus excavatum (PE). To elevate the sternum the patient himself creates a differential negative pressure inside the VB using a hand pump. A distance and differential pressure measuring device (DPMD) enables us for the first time to assess objectively those parameters. METHODS: After approval by the institutional review board, 53 patients recruited from our outpatient clinic were included in this retrospective study and distributed into three groups (group 1 aged 6 to 10years; group 2 aged 11 to 15years; group 3 aged 16 to 20years)...
May 31, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28202768/respiratory-morbidity-in-infants-born-with-a-congenital-lung-malformation
#18
MULTICENTER STUDY
Celine Delestrain, Naziha Khen-Dunlop, Alice Hadchouel, Pierrick Cros, Héloïse Ducoin, Michael Fayon, Isabelle Gibertini, André Labbé, Géraldine Labouret, Marie-Noëlle Lebras, Guillaume Lezmi, Fouad Madhi, Guillaume Thouvenin, Caroline Thumerelle, Christophe Delacourt
BACKGROUND AND OBJECTIVES: The actual frequency of respiratory symptoms related to congenital pulmonary malformations (CPMs) remains undetermined. The goal of this study was to prospectively evaluate the respiratory symptoms occurring in infants with prenatally diagnosed CPMs, identify factors associated with the occurrence of these symptoms, and evaluate their resolution after surgery. METHODS: Infectious and noninfectious respiratory symptoms were prospectively collected in a French multicenter cohort of children with CPMs...
March 2017: Pediatrics
https://www.readbyqxmd.com/read/28087135/surgical-site-infection-related-to-use-of-elastomeric-pumps-in-pectus-excavatum-repair-lessons-learned-from-root-cause-analysis
#19
Nadja Apelt, Joshua Schaffzin, Christina Bates, Rebeccah L Brown, Marc Mecoli, Senthilkumar Sadhasivam, Victor Garcia
BACKGROUND: Pectus excavatum repair (PEX) is among the most painful thoracic procedures performed. Continuous peripheral nerve blockade (CPNB) is known to be efficacious in optimizing pain control while limiting narcotic use in adult thoracic procedures. It was introduced in May 2015 as a bridge to oral pain control in children undergoing PEX. Consequently, the surgical site infection (SSI) rate increased from 2.7% to 27.7%. METHODS: SSI surveillance followed national guidelines...
January 6, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27847075/combined-nuss-procedure-and-cardiac-procedure-through-a-left-anterolateral-thoracotomy
#20
François Roubertie, Sowmya Ramanan, Frederic Lavrand, Jean-Benoit Thambo
Aortic root aneurysms associated with severe pectus excavatum caused by Marfan's syndrome can be challenging to correct in children. Recent reports suggest single-stage correction of both cardiac and chest wall deformities through a median sternotomy. We report a 9-year-old girl with Marfan's syndrome, an ascending aorta aneurysm, mitral regurgitation, and pectus excavatum, who underwent David's procedure with mitral valve repair and the Nuss procedure to correct the thoracic deformity. This single-stage combined procedure was performed through a left anterolateral thoracotomy...
December 2016: Annals of Thoracic Surgery
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