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https://www.readbyqxmd.com/read/28283552/anaesthetic-considerations-for-surgery-in-newborns
#1
Constance S Houck, Amy E Vinson
Almost 30 years ago, the American Academy of Pediatrics Committee on Fetus and Newborn coauthored a policy statement strongly advocating for the use of anaesthesia in all neonates stating 'local or systemic pharmacologic agents now available permit relatively safe administration of anesthesia or analgesia to neonates undergoing surgical procedures and that such administration is indicated according to the usual guidelines for the administration of anesthesia to high-risk, potentially unstable patients'. With current techniques and advanced monitoring, preterm and full-term infants routinely undergo surgical procedures under general anaesthesia to repair congenital defects that were lethal in years past...
March 10, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28267443/balloon-removal-after-fetoscopic-endoluminal-tracheal-occlusion-for-congenital-diaphragmatic-hernia
#2
Julio A Jiménez, Elisenda Eixarch, Philip Dekoninck, João R Bennini, Roland Devlieger, Cleisson F Peralta, Eduard Gratacos, Jan Deprest
BACKGROUND: Isolated congenital diaphragmatic hernia (CDH) defect allows viscera to herniate into the chest, competing for space with the developing lungs. At birth, pulmonary hypoplasia leads to respiratory insufficiency and persistent pulmonary hypertension that is lethal in up to 30% of patients. Antenatal measurement of lung size and liver herniation can predict survival after birth. Prenatal intervention aims at stimulating lung development, clinically achieved by percutaneous fetal endoscopic tracheal occlusion (FETO) under local anesthesia...
March 3, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28256306/clinical-follow-up-of-pregnancy-in-myasthenia-gravis-patients
#3
Renata D Ducci, Paulo J Lorenzoni, Claudia S K Kay, Lineu C Werneck, Rosana H Scola
This study aimed to analyze the outcome and impact of pregnancy in women with myasthenia gravis (MG). Obstetric and clinical data were retrospectively analyzed before, during and after pregnancy. Predictors of outcome were studied. We included 35 pregnancies from 21 MG patients. In the course of MG symptoms in 30 pregnancies with live births, 50% deteriorated (mainly during the second trimester, p = 0.028), 30% improved, and 20% remained unchanged. The deterioration group had more frequent abnormal repetitive nerve stimulation (RNS) (p = 0...
February 1, 2017: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/28236860/effect-of-equipotent-doses-of-bupivacaine-and-ropivacaine-in-high-fat-diet-fed-neonatal-rodent-model
#4
Ying-Dong Lian, Zong-Xiang Chen, Kang-Ru Zhu, Shu-Yin Sun, Li-Ping Zhu
OBJECTIVES: The increase in the prevalence of obesity presents a significant health and economic problem. Obesity has been reported to be a major contributor to variety of chronic diseases. Childhood obesity has been rising over the past decades leading to various complications in health. Millions of infants and children undergo surgery every year on various health grounds. The present investigation was undertaken to evaluate the effect of spinal anesthesia of equipotent doses of ropivacaine and bupivacaine on over-weight neonatal rats...
March 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28218212/laryngeal-mask-airway-for-cesarean-delivery-a-5-year-retrospective-cohort-study
#5
Zhi-Yu Geng, Dong-Xin Wang
BACKGROUND: The laryngeal mask airway (LMA) is the most commonly used rescue airway in obstetric anesthesia. The aim of this retrospective cohort study was to evaluate the application of the LMA in parturients undergoing cesarean delivery (CD) for 5 years in our hospital. As a secondary objective, we investigated the incidence of airway-related complication in obstetric general anesthesia (GA). METHODS: We collected electronic data for all obstetric patients who received GA for CD between January 2010 and December 2014 in Peking University First Hospital...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28216060/incidence-of-fever-in-labor-and-risk-of-neonatal-sepsis
#6
Angela Yates, Craig V Towers, Nikki Zite, Casey Smith, Lindsey Chernicky, Bobby Howard
BACKGROUND: The current recommendation regarding the management of a term newborn delivered of a mother with an intrapartum fever or a diagnosis of clinical chorioamnionitis is that the neonate should have baseline laboratory work drawn along with blood cultures and be universally treated with antibiotics until culture results return. These guidelines report that the rate of intrapartum fever is about 3%; however, a few large studies suggest that the rate is higher at about 7%. OBJECTIVE: We sought to prospectively evaluate the rate of fever during labor in a large number of deliveries and determine the rate of early-onset neonatal sepsis in newborns delivered from mothers with an intrapartum fever compared with newborns delivered from mothers without intrapartum fever...
February 16, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28215984/the-cost-of-nurse-midwifery-care-use-of-interventions-resources-and-associated-costs-in-the-hospital-setting
#7
Molly R Altman, Sean M Murphy, Cynthia E Fitzgerald, H Frank Andersen, Kenn B Daratha
INTRODUCTION: Obstetrical care often involves multiple expensive, and often elective, interventions that may increase costs to patients, payers and the health care system with little effect on patient outcomes. The objectives of this study were to examine the following hospital related outcomes: 1) use of labor and birth interventions, 2) inpatient duration of stay, and 3) total direct health care costs for patients attended by a certified nurse-midwife (CNM) compared with those attended by an obstetrician-gynecologist (OB-GYN), within an environment of safe and high-quality care...
February 15, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28213636/decrease-of-glial-cell-derived-neurotrophic-factor-contributes-to-anesthesia-and-surgery-induced-learning-and-memory-dysfunction-in-neonatal-rats
#8
Lingli Gui, Xi Lei, Zhiyi Zuo
Long duration of anesthesia may induce toxicity in the developing brain. However, little is known about the effects of the combination of surgery and anesthesia on the developing brain. The mechanisms for the effects are not clear. To determine these effects, postnatal day 7 male and female Sprague-Dawley rats were exposed to 3% sevoflurane for 2 h with or without right common carotid exposure. Pyrrolidine dithiocarbamate (PDTC), an anti-inflammatory agent, was given 30 min before and 6 h after the carotid exposure...
February 17, 2017: Journal of Molecular Medicine: Official Organ of the "Gesellschaft Deutscher Naturforscher und Ärzte"
https://www.readbyqxmd.com/read/28196356/therapeutic-hypothermia-provides-variable-protection-against-behavioral-deficits-after-neonatal-hypoxia-ischemia-a-potential-role-for-brain-derived-neurotrophic-factor
#9
Johana Diaz, Suleiman Abiola, Nancy Kim, Oliver Avaritt, Debra Flock, Jenny Yu, Frances J Northington, Raul Chavez-Valdez
BACKGROUND: Despite treatment with therapeutic hypothermia (TH), infants who survive hypoxic ischemic (HI) encephalopathy (HIE) have persistent neurological abnormalities at school age. Protection by TH against HI brain injury is variable in both humans and animal models. Our current preclinical model of hypoxia-ischemia (HI) and TH displays this variability of outcomes in neuropathological and neuroimaging end points with some sexual dimorphism. The detailed behavioral phenotype of this model is unknown...
February 15, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28195926/images-in-anesthesiology-use-of-ultrasound-to-facilitate-neonatal-spinal-anesthesia
#10
Stephen Kelleher, Karen Boretsky, Walid Alrayashi
No abstract text is available yet for this article.
March 2017: Anesthesiology
https://www.readbyqxmd.com/read/28178059/less-restrictive-food-intake-during-labor-in-low-risk-singleton-pregnancies-a-systematic-review-and-meta-analysis
#11
Andrea Ciardulli, Gabriele Saccone, Hannah Anastasio, Vincenzo Berghella
OBJECTIVE: To evaluate benefits and harms of food intake during labor. DATA SOURCES: Electronic databases such as MEDLINE and ClinicalTrials.gov were searched from their inception until October 2016. METHODS OF STUDY SELECTION: We included randomized trials comparing a policy of less-restrictive food intake with a policy of more restrictive food intake during labor. The primary outcome was the mean duration of labor. Meta-analysis was performed using the random-effects model of DerSimonian and Laird to produce summary treatment effects in terms of either a relative risk or a mean difference with 95% confidence interval (CI)...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28178055/pulmonary-hypertension-in-pregnancy-a-report-of-49-cases-at-four-tertiary-north-american-sites
#12
Marie-Louise Meng, Ruth Landau, Olof Viktorsdottir, Jennifer Banayan, Tamila Grant, Brian Bateman, Richard Smiley, Elena Reitman
OBJECTIVE: To identify whether pregnancy outcomes vary by etiology and severity of pulmonary hypertension and whether contemporary therapies influence outcomes. METHODS: A retrospective review of medical records at four academic institutions was conducted to identify pregnant women with pulmonary hypertension (2001-2015). International Classification of Diseases, 9th Revision codes for pulmonary hypertension and pregnancy were used to identify potential participants...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28160357/quantification-of-neonatal-lung-parenchymal-density-via-ultrashort-echo-time-mri-with-comparison-to-ct
#13
Nara S Higano, Robert J Fleck, David R Spielberg, Laura L Walkup, Andrew D Hahn, Robert P Thomen, Stephanie L Merhar, Paul S Kingma, Jean A Tkach, Sean B Fain, Jason C Woods
PURPOSE: To demonstrate that ultrashort echo time (UTE) magnetic resonance imaging (MRI) can achieve computed tomography (CT)-like quantification of lung parenchyma in free-breathing, non-sedated neonates. Because infant CTs are used sparingly, parenchymal disease evaluation via UTE MRI has potential for translational impact. MATERIALS AND METHODS: Two neonatal control cohorts without suspected pulmonary morbidities underwent either a research UTE MRI (n = 5; 1...
February 3, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28101779/randomized-controlled-trial-of-topical-emla-and-vapocoolant-spray-for-reducing-pain-during-wdpt-vaccination
#14
Navratan Kumar Gupta, Amit Upadhyay, Ajeet Kumar Dwivedi, Astha Agarwal, Vijay Jaiswal, Abhishek Singh
BACKGROUND: Intramuscular vaccination is among the most common source of iatrogenic pain in infants. Vapocoolant sprays are rapid-acting alternative to topical anesthetics. They provide transient anesthesia via evaporation induced skin cooling, and reduce pain due to vaccine injection in children and adults. The objective was to compare the synergistic analgesic effect of eutectic mixture of local anesthetics (EMLA) with breastfeeding (EB group) and vapocoolant spay with breastfeeding (VB group) to that of only breastfeeding (BO group) during whole cell diptheria, pertussis and tetanus (wDPT) vaccination...
January 19, 2017: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/28099786/labor-intervention-and-outcomes-in-women-who-are-nulliparous-and-obese-comparison-of-nurse-midwife-to-obstetrician-intrapartum-care
#15
Nicole S Carlson, Elizabeth J Corwin, Nancy K Lowe
BACKGROUND: Women who are obese have slower labors than women of normal weight, and show reduced response to interventions designed to speed labor progress like oxytocin augmentation and artificial rupture of membranes. The optimal labor management for these women has not been described. METHODS: This retrospective cohort study compared 2 propensity score-matched groups of women (N = 360) who were healthy, nulliparous, spontaneously laboring, and obese (body mass index ≥ 30 kg/m(2) )...
January 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28086911/enhanced-neuroinflammation-mediated-by-dna-methylation-of-the-glucocorticoid-receptor-triggers-cognitive-dysfunction-after-sevoflurane-anesthesia-in-adult-rats-subjected-to-maternal-separation-during-the-neonatal-period
#16
Yangzi Zhu, Yu Wang, Rui Yao, Ting Hao, Junli Cao, He Huang, Liwei Wang, Yuqing Wu
BACKGROUND: Mounting evidence indicates that children who experience abuse and neglect are prone to chronic diseases and premature mortality later in life. One mechanistic hypothesis for this phenomenon is that early life adversity alters the expression or functioning of the glucocorticoid receptor (GR) throughout the course of life and thereby increases sensitivity to inflammatory stimulation. An exaggerated pro-inflammatory response is generally considered to be a key cause of postoperative cognitive dysfunction (POCD)...
January 7, 2017: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/28074825/goldenhar-syndrome-cardiac-anesthesiologist-s-perspective
#17
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/28056424/neonatal-anesthetic-neurotoxicity-insight-into-the-molecular-mechanisms-of-long-term-neurocognitive-deficits
#18
REVIEW
Deshui Yu, Linji Li, Weiguo Yuan
Mounting animal studies have demonstrated that almost all the clinically used general anesthetics could induce widespread neuroapoptosis in the immature brain. Alarmingly, some published findings have reported long-term neurocognitive deficits in response to early anesthesia exposure which deeply stresses the potential seriousness of developmental anesthetic neurotoxicity. However, the connection between anesthesia induced neuroapoptosis and subsequent neurocognitive deficits remains controversial. It should be noted that developmental anesthesia related neurotoxicity is not limited to neuroapoptosis...
March 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28031099/low-dose-simvastatin-increases-skeletal-muscle-sensitivity-to-caffeine-and-halothane
#19
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
https://www.readbyqxmd.com/read/28030871/obesity-and-neonatal-cord-blood-gas-results-at-cesarean-effect-of-intraoperative-blood-pressure
#20
Mark F Powell, Charity J Morgan, Jessica A Cantu, Yasser Sakawi, Joseph R Biggio, Alan T N Tita, Jeff M Szychowski, Rodney K Edwards
Objective Our aims were to evaluate whether there is an inverse association between body mass index (BMI) and umbilical artery pH and to investigate the contribution of intraoperative hypotension on the umbilical artery pH. Study Design We conducted a retrospective cohort study of all women with a nonanomalous singleton at 37 to 41 weeks who underwent a scheduled cesarean delivery under spinal anesthesia at our facility from January 2006 to March 2012. The primary outcome was the proportion of patients in each BMI category with arterial cord pH < 7...
December 28, 2016: American Journal of Perinatology
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