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myelomeningoceles

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https://www.readbyqxmd.com/read/28219061/establishing-prenatal-surgery-for-myelomeningocele-in-asia-the-singapore-consensus
#1
Tuangsit Wataganara, Suresh Seshadri, Tak Yeung Leung, Citra Matter, Monawat Ngerncham, Namtip Triyasunant, Padmakar Vidyadhar Mali, Agnhitori Biswas, Katika Nawapun, Nisarat Phithakwatchara, Alan W Flake, Mark P Johnson, Arijit Biswas, Mahesh Choolani
OBJECTIVES: The Management of Myelomeningocele Study (MOMS Trial) has inspired many fetal therapy centers (FTCs) to offer open fetal surgery for myelomeningocele (MMC). This is an initial effort to create a candidate model that can be applicable to many parts of Asia. MATERIAL AND METHODS: A limited selection of specialists from 4 established FTCs in Thailand, Hong Kong, India, and Singapore met for a round table discussion. Experts from Children's Hospital of Philadelphia (CHOP) involved in the Trial moderated the session...
February 21, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28215830/initial-urological-evaluation-and-management-of-children-with-neurogenic-bladder-due-to-myelomeningocele
#2
Cristian Sager, Carol Burek, Juan Pablo Corbetta, Santiago Weller, Javier Ruiz, Ramiro Perea, Enrique Lago, Yesica Gomez, Victor Durán, Juan Carlos López
INTRODUCTION: The proactive management of children with myelomeningocele (MMC) has contributed to decreasing their progression to end-stage renal disease, thanks to early urological evaluation and timing implementation of treatments. OBJECTIVE: To demonstrate that early urological evaluation of the urinary tract in MMC shows functional alterations in most cases, and that it requires medical intervention, even when in some cases the complementary imaging studies do not show any abnormalities...
January 30, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28206781/cognitive-control-and-associated-neural-correlates-in-adults-with-spina-bifida-myelomeningocele
#3
Ashley L Ware, Paulina A Kulesz, Jenifer Juranek, Paul T Cirino, Jack M Fletcher
OBJECTIVE: Accelerated aging can occur in adult survivors of neurodevelopmental disorders, but has been narrowly studied in spina bifida myelomeningocele (SBM). Since discrete aspects of cognitive control and related neural network macrostructure deteriorate in normal aging, the specificity and trajectory of cognition and neuropathology incurred across adulthood in SBM were examined. METHOD: Adults (N = 120) with and without SBM completed working memory span and manipulation tasks, and an inhibitory control task...
February 16, 2017: Neuropsychology
https://www.readbyqxmd.com/read/28198945/rehabilitation-of-children-and-adolescents-with-myelomeningocele-the-daily-life-of-mothers-caregiversrehabilitation-of-children-and-adolescents-with-myelomeningocele-the-daily-life-of-mothers-caregivers
#4
Giselle Lima de Freitas, Roseni Rosângela de Sena, Josana Cristina Faleiros E Silva, Fabiana Faleiros Santana Castro
Objective: To analyze the daily routine of mothers-caregivers of children and adolescents with myelomeningocele at home. Method: Descriptive, exploratory, qualitative research. Data were collected with 16 mothers of children and adolescents with myelomeningocele by means of interviews and observation from May to August 2015, in municipalities of Minas Gerais, Brazil. The data were submitted to qualitative analysis. Results: The daily care routine of the mothers at home revealed two empirical categories: a) the impact of the birth on naturalization of care, and (b) changes in the routine of the mothers and women...
February 9, 2017: Revista Gaúcha de Enfermagem
https://www.readbyqxmd.com/read/28196729/delayed-expansion-of-an-intracranial-cyst-induced-by-ventriculoperitoneal-shunt-in-a-patient-with-chiari-malformation-type-2
#5
Yoshinori Maki, Tsuyoshi Ohta, Hirokazu Onishi, Naoki Fukui, Masanori Morimoto
A male neonate was referred to our hospital for the treatment of myelomeningocele and hydrocephalus related to Chiari malformation type 2. After the placement of ventriculoperitoneal (VP) shunt for hydrocephalus, an intracranial cyst, which was asymptomatic at first, expanded and caused clinical symptoms due to increased intracranial pressure. The expansion of the cyst was confirmed dominantly in the right lateral ventricle where the VP shunt was inserted. Intraoperative findings through a neuroendoscope suggested that the expanded cyst was an isolated lesion...
February 11, 2017: Brain & Development
https://www.readbyqxmd.com/read/28186476/risk-factors-for-surgical-site-infection-following-nonshunt-pediatric-neurosurgery-a-review-of-9296-procedures-from-a-national-database-and-comparison-with-a-single-center-experience
#6
Brandon A Sherrod, Anastasia A Arynchyna, James M Johnston, Curtis J Rozzelle, Jeffrey P Blount, W Jerry Oakes, Brandon G Rocque
OBJECTIVE Surgical site infection (SSI) following CSF shunt operations has been well studied, yet risk factors for nonshunt pediatric neurosurgery are less well understood. The purpose of this study was to determine SSI rates and risk factors following nonshunt pediatric neurosurgery using a nationwide patient cohort and an institutional data set specifically for better understanding SSI. METHODS The authors reviewed the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (ACS NSQIP-P) database for the years 2012-2014, including all neurosurgical procedures performed on pediatric patients except CSF shunts and hematoma evacuations...
February 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28186474/morbidity-associated-with-30-day-surgical-site-infection-following-nonshunt-pediatric-neurosurgery
#7
Brandon A Sherrod, Brandon G Rocque
OBJECTIVE Morbidity associated with surgical site infection (SSI) following nonshunt pediatric neurosurgical procedures is poorly understood. The purpose of this study was to analyze acute morbidity and mortality associated with SSI after nonshunt pediatric neurosurgery using a nationwide cohort. METHODS The authors reviewed data from the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (NSQIP-P) 2012-2014 database, including all neurosurgical procedures performed on pediatric patients...
February 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28174536/exploring-the-pharmacokinetic-profile-of-remifentanil-in-mid-trimester-gestations-undergoing-fetal-intervention-procedures
#8
Judith A Smith, Roopali V Donepudi, Pedro S Argoti, Anita L Giezentanner, Ranu Jain, Noemi Boring, Elisa Garcia, Kenneth J Moise
Background: Indications for surgery during pregnancy have increased. Specifically fetal interventions have increased from conditions that were considered lethal like twin-twin transfusion syndrome and severe fetal anemia to non-lethal conditions like myelomeningocele. The optimal anesthetic agent for in utero surgery is yet to be determined. Success of the procedure is often dictated by the efficacy of the anesthetic to immobilize the fetus without over-sedating mom. Remifentanil is used as preferred agent due to its short half-life however pharmacokinetics in pregnancy is unknown...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28157255/current-views-on-fetal-surgical-treatment-of-myelomeningocele-the-management-of-myelomeningocele-study-moms-trial-and-polish-clinical-experience
#9
Jacek Zamłyński, Ewa Horzelska, Mateusz Zamłyński, Katarzyna Olszak-Wąsik, Leszek Nowak, Piotr Bodzek, Tomasz Horzelski, Rafał Bablok, Anita Olejek
Myelomeningocele (MMC) is the most frequent congenital defect of the central nervous system for which there is no satisfactory alternative to postnatal treatment. On the contrary prenatal MMC surgery is conducting before birth and is aimed at protecting from Chiari II malformation. The main goal of fetal MMC repair is to improve development and life quality of children with Chiari II malformation. Management of Myelomeningocele Study (MOMS) which was published in 2011 clearly confirmed effectiveness of prenatal surgery...
2017: Ginekologia Polska
https://www.readbyqxmd.com/read/28120066/myelomeningocele-repair-surgical-management-based-on-a-30-year-experience
#10
Pier Paolo Mattogno, Luca Massimi, Giampiero Tamburrini, Paolo Frassanito, Concezio Di Rocco, Massimo Caldarelli
BACKGROUND: Myelomeningocele (MMC) is a rare but severe spinal defect resulting from a failed neurulation process. Surgical repair is a delicate procedure that needs accurate neuroanatomical knowledge and adequate surgical planning. MATERIALS AND METHODS: The authors report on the main problems of the surgical management of this type of dysraphism. The technique used for reconstruction, and the management strategies, are analyzed according to the authors' experience with more than 600 cases, in comparison with the relevant literature...
2017: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/28116279/bilateral-femoral-fracture-in-a-newborn-with-myelomeningocele-at-cesarean-section-a-case-report
#11
Yusuf Erdem, Serkan Akpancar, M Hanifi Gemci
INTRODUCTION: Femur fractures as a result of birth trauma can still occur during the C/S, in spite of recent developments of surgical and anesthetic techniques. In this study, we aimed to present a rare case of a newborn with myelomeningocele who delivered by cesarean section due to breech presentation and sustained bilateral fracture of femoral shaft. CASE PRESENTATION: A 2690 g female newborn with myelomeningocele sustained bilateral femoral shaft fractures during cesarean section...
July 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28108023/the-intersection-of-fetal-palliative-care-and-fetal-surgery-addressing-mortality-and-quality-of-life
#12
David Munson
Over the last few decades, the fields of fetal surgery and maternal-fetal medicine have developed interventions aimed at modifying severe diseases in utero. Innovations in fetal approaches to congenital diaphragmatic hernia and myelomeningocele have shown considerable promise in modifying the clinical course with fetal intervention. Patients who present to fetal centers to be evaluated for these interventions face challenging decisions that directly relate to questions of mortality and quality of life. This article explores how clinicians might apply the tools and principles of fetal palliative care to supporting a woman and her family who are considering fetal surgery...
January 17, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28106513/long-term-follow-up-of-superior-gluteal-artery-perforator-flap-closure-of-large-myelomeningoceles
#13
Brett A Whittemore, Dale M Swift, Bradley E Weprin, Frederick J Duffy
OBJECTIVE Large myelomeningocele defects and poor surrounding tissue quality make some defects particularly difficult to close primarily. This paper describes the superior gluteal artery perforator (SGAP) flap technique for defect closure and long-term clinical outcomes. METHODS The technique for closing a myelomeningocele with an SGAP flap is described. A retrospective chart review was performed on a cohort of 11 patients who underwent closure in this manner. RESULTS Between 1999 and 2015, 271 myelomeningoceles were closed, 11 of which were SGAP flap closures...
January 20, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28099558/the-mortality-rate-after-hospital-discharge-in-patients-with-myelomeningocele-decreased-after-implementation-of-mandatory-flour-fortification-with-folic-acid
#14
Renato Manganelli Salomão, Tatiana Protzenko Cervante, José Francisco Manganelli Salomão, Soniza Vieira Alves Leon
Objective: To evaluate the mandatory folic acid fortification of flour on mortality rates after the hospital discharge of children born with myelomeningocele, the most affected age group and the most frequent cause of death. Methods: A retrospective study of 383 children born with myelomeningocele from January 1990 to December 2013 in a high-fetal-risk reference hospital. Results: A total of 39 patients died (10.1%),of which 23 (6%) died after discharge...
January 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/28058487/fetal-surgery-a-critical-review
#15
REVIEW
H Kitagawa, K C Pringle
Therapeutic fetal surgical procedures are predicated upon the ability to make an accurate fetal diagnosis. The earliest open fetal surgical procedures were introduced in the 1960s to treat Rh isoimmunisation. They were introduced when it became possible to predict impending fetal demise. Open procedures were abandoned when percutaneous approaches proved superior. The introduction of fetal ultrasound allowed the diagnosis of other congenital anomalies, some being amenable to fetal interventions. Open fetal surgical procedures were initially utilised, with significant maternal morbidity...
January 5, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28058485/the-current-profile-of-persistent-cloaca-and-cloacal-exstrophy-in-japan-the-results-of-a-nationwide-survey-in-2014-and-a-review-of-the-literature
#16
Masayuki Kubota
PURPOSE: The current profile of persistent cloaca (PC) and cloacal exstrophy (CE) in Japan was first examined in 2014. MATERIALS AND METHODS: Information was obtained by sending a questionnaire to 244 university hospitals and children's hospitals. RESULTS: Responses from 113 institutions reported 466 PC cases and 229 CE cases. The incidences of PC and CE from 1980 to 2012 were 0.97 and 0.49 per 100,000 live births, respectively. In the previous 5 years, antenatal abnormalities were found in 57...
January 5, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28043315/right-sided-congenital-diaphragmatic-hernia-and-myelomeningocele-a-rare-association
#17
Syed Rehan Ali, Shakeel Ahmed
Congenital diaphragmatic hernia (CDH) is a rare birth defect with a prevalence of < 0.5 per 1,000 live births. Majority of these defects are left-sided as most studies suggest that frequency of right-sided CDH was 10% of the total. The association of CDH with myelomeningocele (MMC) is extremely rare; as in Sweed's study of 116 consecutive cases of CDH, the incidence of associated MMC with CDH was stated as 4.3%. There has been one previous case report of leftsided CDH, MMC and hydrocephalus prenatally diagnosed; but to the best of authors' knowledge, this is the first reported case of the above constellation with a right-sided CDH diagnosed prenatally...
December 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28028598/a-comparison-of-the-moms-trial-results-to-a-contemporaneous-single-institution-postnatal-closure-cohort
#18
Nicholas M B Laskay, Anastasia A Arynchyna, Samuel G McClugage, Betsy Hopson, Chevis Shannon, Benjamin Ditty, John C Wellons, Jeffrey P Blount, Brandon G Rocque
PURPOSE: We evaluate a single-institution cohort of mothers contemporaneous with the Management of Myelomeningocele Study (MOMS) trial to determine the generalizability of MOMS results and compare shunt rates. METHODS: A retrospective chart review identified patients with myelomeningocele born between 2003 and 2009. We applied MOMS eligibility criteria and compared sociodemographic variables between patients at our institution who would have been eligible or ineligible and MOMS participants...
December 27, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28005733/an-ideal-flap-alternative-for-closure-of-myelomeningocele-defects-dorsal-intercostal-artery-perforator-flap
#19
Omer Faruk Kocak, Canser Yilmaz Demir
BACKGROUND: Dorsal intercostal artery perforator (DICAP) flap is an ideal flap to be used for posterior trunk defects since it leads to lower donor-site morbidity and shorter operative times, offers easy surgical planning, and uses a reliable and easily identifiable artery. MATERIALS AND METHODS: The study retrospectively reviewed 52 patients with meningomyelocele defects that were closed with DICAP flap between January 2007 and May 2015. SURGICAL TECHNIQUE: Each of the 4th to 12th posterior intercostal arteries can be used as dorsal perforators...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27997256/ultrasound-functional-evaluation-of-fetuses-with-myelomeningocele-study-of-the-interpretation-of-results
#20
A Maroto, T Illescas, M Meléndez, S Arévalo, C Rodó, J L Peiró, M Belfort, A Cuxart, E Carreras
OBJECTIVE: To assess the reliability of the interpretation of a new technique for the ultrasound evaluation of the level of neurological lesion in fetuses with myelomeningocele. METHODS: Observational study including myelomeningocele fetuses, referred to our center for the sonographic assessment of the fetal lower-limb movements, made and recorded by an expert in Maternal-fetal medicine and a specialist in Rehabilitation. Two observers, with different levels of expertise and blinded to each other's results, interpreted each recorded scan two different times...
December 20, 2016: Journal of Maternal-fetal & Neonatal Medicine
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