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Hernia diafragmatica

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88 papers 100 to 500 followers
By Alejandro Peñarrieta Daher Residente de Cirugía Pediatrica en Hospital Infantil de México Federico Gómez
https://www.readbyqxmd.com/read/28331629/congenital-diaphragmatic-hernia-a-review
#1
REVIEW
Praveen Kumar Chandrasekharan, Munmun Rawat, Rajeshwari Madappa, David H Rothstein, Satyan Lakshminrusimha
Congenital Diaphragmatic hernia (CDH) is a condition characterized by a defect in the diaphragm leading to protrusion of abdominal contents into the thoracic cavity interfering with normal development of the lungs. The defect may range from a small aperture in the posterior muscle rim to complete absence of diaphragm. The pathophysiology of CDH is a combination of lung hypoplasia and immaturity associated with persistent pulmonary hypertension of newborn (PPHN) and cardiac dysfunction. Prenatal assessment of lung to head ratio (LHR) and position of the liver by ultrasound are used to diagnose and predict outcomes...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28295742/prognosis-of-isolated-congenital-diaphragmatic-hernia-using-lung-to-head-circumference-ratio-variability-across-centers-in-a-national-perinatal-network
#2
Marie-Victoire Senat, Hanane Bouchghoul, Julien Stirnemann, Pascal Vaast, Julia Boubnova, Laetitia Begue, Elizabeth Carricaburu, Agnes Sartor, Jacques Jani, Alexandra Benachi, Jean Bouyer
BACKGROUND: Congenital diaphragmatic hernia (CDH) is a severe congenital anomaly. The observed to expected lung area-to-head circumference ratio (o/e-LHR) has been shown to provide a useful prediction of subsequent survival in fetuses with CDH in reference centers with expertise and a large caseload. However, the accuracy of o/e-LHR measurements in unselected fetal medicine units or in centers with less expertise is not well known. OBJECTIVE: To evaluate o/e-LHR measurement in prognostic evaluation of postnatal survival when the measurement is performed in fetal medicine units with different levels of expertise...
March 13, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28095996/antenatal-predictors-of-outcome-in-prenatally-diagnosed-congenital-diaphragmatic-hernia-cdh
#3
REVIEW
Titilayo Oluyomi-Obi, Verena Kuret, Pramod Puligandla, Abhay Lodha, Helen Lee-Robertson, Kovid Lee, David Somerset, Joann Johnson, Greg Ryan
BACKGROUND: Pulmonary hypoplasia is the main cause of mortality in isolated congenital diaphragmatic hernia (CDH) and its prediction is paramount when counseling parents. We sought to identify antenatal parameters that predicted neonatal mortality in CDH. METHOD: Search was conducted in MEDLINE, EMBASE, Cochrane Database of Systematic reviews, PubMed, Scopus, and Web of Science on the ability of lung-to-head ratio (LHR), observed-to-expected LHR (o/e LHR), total fetal lung volume (TFLV), o/e TFLV, percentage predicted lung volume (PPLV) and degree of liver herniation to predict neonatal morbidity and mortality in fetuses with CDH...
December 21, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28051921/tube-thoracostomy-at-the-time-of-congenital-diaphragmatic-hernia-repair-reassessing-the-risks-and-benefits
#4
Avraham Schlager, Kelly Arps, Ragavan Siddharthan, Matthew S Clifton
PURPOSE: Postoperative pneumothorax and effusion remain a concern following congenital diaphragmatic hernia (CDH) repair. Despite a recent trend away from intraoperative thoracostomy, few studies have actually compared outcomes with and without a chest tube. Rationale commonly cited for the more minimalistic approach include the presumed low likelihood of postoperative complications, potential risk of patch infection, and prolonged intubation. We evaluate these theories, as well as the implications of intraoperative chest tube (IOCT) placement...
March 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28029369/management-and-outcomes-of-scoliosis-in-children-with-congenital-diaphragmatic-hernia
#5
Ryan M Antiel, John S Riley, Patrick J Cahill, Robert M Campbell, Lindsay Waqar, Lisa M Herkert, Natalie E Rintoul, William H Peranteau, Alan W Flake, N Scott Adzick, Holly L Hedrick
PURPOSE: The purpose of this study was to evaluate the management and outcomes of CDH patients with scoliosis. METHODS: From January 1996 to August 2015, 26 of 380 (7%) CDH patients were diagnosed with scoliosis. Six (23%) were prenatally diagnosed by ultrasound, and 9 (35%) were diagnosed postnatally. The remaining 11 (42%) developed scoliosis after discharge. Mean follow-up was 6.6years. RESULTS: Among the 15 patients with congenital scoliosis, there were 2 (13%) perinatal deaths...
September 15, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27986977/risk-factors-for-postoperative-mortality-in-congenital-diaphragmatic-hernia-a-single-centre-observational-study
#6
Darya Kadir, Helene Engstrand Lilja
BACKGROUND: The management of congenital diaphragmatic hernia (CDH) is a major challenge. The mortality is dependent on associated malformations, the severity of pulmonary hypoplasia, pulmonary hypertension and iatrogenic lung injury associated with aggressive mechanical ventilation. The aims of the study were to investigate the mortality over time in a single paediatric surgical centre, to compare the results with recent reports and to define the risk factors for mortality. METHODS: The medical records of infants with CDH from two time periods: 1995-2005 and 2006-2016 were reviewed...
March 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/27924390/technical-standardization-of-laparoscopic-repair-of-morgagni-diaphragmatic-hernia-in-children-results-of-a-multicentric-survey-on-43-patients
#7
Ciro Esposito, Maria Escolino, Francois Varlet, Amulya Saxena, Sabine Irtan, Paul Philippe, Alessandro Settimi, Mariapina Cerulo, Holger Till, Francois Becmeur, George W Holcomb
BACKGROUND: This study aimed to standardize the surgical correction technique of congenital Morgagni diaphragmatic hernia (CMDH), analyzing the results of an international multicentric survey. METHODS: The medical records of 43 patients (29 boys, 14 girls) who underwent laparoscopic repair of CMDH in 8 pediatric surgery units in a 5-year period were retrospectively reviewed. Their average age was 3.3 years. Ten patients (23.2%) presented associated malformations: 9 Down syndrome (20...
December 6, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27894762/bilateral-congenital-diaphragmatic-hernia-prognostic-evaluation-of-a-large-international-cohort
#8
Sanne Mbi Botden, Kim Heiwegen, Iris Alm van Rooij, Horst Scharbatke, Pamela A Lally, Arno van Heijst, Ivo de Blaauw
BACKGROUND: Congenital diaphragmatic hernia (CDH) is a lethal birth defect, which occurs in 1:2000-3000 live births. Bilateral CDH is a rare form (1%), with a high mortality. This study presents the outcomes of the largest cohort of bilateral CDH patients. METHODS: The records of patients with bilateral CDH from the Congenital Diaphragmatic Hernia Registry born between 1995 and 2015 were retrospectively analyzed to identify parameters associated with mortality. RESULTS: Eighty patients with a bilateral CDH were identified...
November 17, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27723858/evaluation-of-variability-in-inhaled-nitric-oxide-use-and-pulmonary-hypertension-in-patients-with-congenital-diaphragmatic-hernia
#9
Luke R Putnam, Kuojen Tsao, Francesco Morini, Pamela A Lally, Charles C Miller, Kevin P Lally, Matthew T Harting
Importance: Inhaled nitric oxide (iNO) is an expensive, commonly used therapy among patients with congenital diaphragmatic hernia (CDH); however, data to support its ongoing use in this patient population are lacking. Objective: To describe the spectrum of iNO use among patients with CDH and its association with pulmonary hypertension (pHTN) and mortality. Design, Setting, and Participants: A review was conducted of prospectively collected patient data in the Congenital Diaphragmatic Hernia Study Group registry between January 1, 2007, and December 31, 2014, from 70 participating centers in 13 countries...
December 1, 2016: JAMA Pediatrics
https://www.readbyqxmd.com/read/27622588/neurodevelopmental-outcomes-at-5years-of-age-in-congenital-diaphragmatic-hernia
#10
Enrico Danzer, Casey Hoffman, Jo Ann D'Agostino, Marsha Gerdes, Judy Bernbaum, Ryan M Antiel, Natalie E Rintoul, Lisa M Herkert, Alan W Flake, N Scott Adzick, Holly L Hedrick
OBJECTIVE: To evaluate neurodevelopmental sequelae in congenital diaphragmatic hernia (CDH) children at 5years of age. MATERIALS AND METHODS: The study cohort of 35 CDH patients was enrolled in our follow-up program between 06/2004 and 09/2014. The neurodevelopmental outcomes assessed at a median of 5years (range, 4-6) included cognition (Wechsler Preschool and Primary Scale of Intelligence [WPPSI], n=35), Visual-Motor-Integration (n=35), academic achievement (Woodcock-Johnson Tests of Achievement, n=25), and behavior problems (Child Behavior Check List [CBCL], n=26)...
August 30, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27663123/echocardiographic-predictors-of-poor-prognosis-in-congenital-diaphragmatic-hernia
#11
MULTICENTER STUDY
Masaya Yamoto, Noboru Inamura, Keita Terui, Kouji Nagata, Yutaka Kanamori, Masahiro Hayakawa, Yuko Tazuke, Akiko Yokoi, Hajime Takayasu, Hiroomi Okuyama, Koji Fukumoto, Naoto Urushihara, Tomoaki Taguchi, Noriaki Usui
BACKGROUND/PURPOSE: The purpose of this study was to investigate echocardiographic parameters in relation to the outcomes of isolated left-sided congenital diaphragmatic hernia (CDH). METHODS: This multicenter, retrospective, observational study was conducted among patients with CDH born between 2006 and 2010. Patients in this study did not have severe cardiac malformations or chromosomal aberrations. Patients with incomplete echocardiographic examinations were excluded...
December 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/18310215/postdischarge-follow-up-of-infants-with-congenital-diaphragmatic-hernia
#12
REVIEW
Kevin P Lally, William Engle
Infants with congenital diaphragmatic hernia often require intensive treatment after birth, have prolonged hospitalizations, and have other congenital anomalies. After discharge from the hospital, they may have long-term sequelae such as respiratory insufficiency, gastroesophageal reflux, poor growth, neurodevelopmental delay, behavior problems, hearing loss, hernia recurrence, and orthopedic deformities. Structured follow-up for these patients facilitates early recognition and treatment of these complications...
March 2008: Pediatrics
https://www.readbyqxmd.com/read/27016974/improved-survival-in-left-liver-up-congenital-diaphragmatic-hernia-by-early-repair-before-extracorporeal-membrane-oxygenation-optimization-of-patient-selection-by-multivariate-risk-modeling
#13
David W Kays, James L Talbert, Saleem Islam, Shawn D Larson, Janice A Taylor, Joy Perkins
BACKGROUND: Delayed repair of congenital diaphragmatic hernia (CDH) for days or longer has become standard, allowing improved stabilization for many, but potentially complicating treatment in severely affected infants who require extracorporeal membrane oxygenation (ECMO) and arrive unrepaired. Survival in left liver-up CDH, the most severe anatomic subset, averages 45% in published studies, with deaths often occurring in patients who failed to improve on ECMO and are repaired late, or not at all...
April 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/25933923/outcomes-in-the-physiologically-most-severe-congenital-diaphragmatic-hernia-cdh-patients-whom-should-we-treat
#14
David W Kays, Saleem Islam, Joy M Perkins, Shawn D Larson, Janice A Taylor, James L Talbert
PURPOSE: Centers that care for newborns with congenital diaphragmatic hernia (CDH) may impose selection criteria for offering or limiting aggressive support in those patients most severely affected. The purpose of this study was to analyze outcomes in newborns with highly severe CDH uniformly treated for survival. METHODS: We reviewed 172 consecutive inborn patients without associated lethal anomalies treated at a single institution with a dedicated CDH program...
June 2015: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27378767/fertility-pregnancy-and-gynecological-outcomes-after-fetoscopic-surgery-for-congenital-diaphragmatic-hernia
#15
C Gregoir, A C Engels, O Gomez, P DeKoninck, L Lewi, E Gratacos, J A Deprest
STUDY QUESTION: What is the impact of fetoscopic surgery for isolated Congenital Diaphragmatic Hernia (CDH) on future reproductive and gynecological outcomes? SUMMARY ANSWER: We did not observe an increase of obstetric or gynecological problems after fetoscopic surgery nor was there an increased risk for subsequent infertility. WHAT IS KNOWN ALREADY: The reproductive and gynecological outcomes of patients undergoing open maternal-fetal surgery are known...
September 2016: Human Reproduction
https://www.readbyqxmd.com/read/26514398/differences-in-preductal-and-postductal-arterial-blood-gas-measurements-in-infants-with-severe-congenital-diaphragmatic-hernia
#16
Jason Gien, John P Kinsella
OBJECTIVE: To determine whether right-to-left shunting across the ductus arteriosus (DA) in patients with congenital diaphragmatic hernia (CDH) with suprasystemic pulmonary hypertension (PH) results in differences between preductal and postductal arterial blood gas (ABG) measurements. DESIGN: Demographics, baseline echocardiographic parameters and differences in simultaneous right upper extremity (preductal) and umbilical artery (postductal) ABG samples were determined in newborns with PH and CDH...
July 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/27376883/improved-pulmonary-function-in-the-nitrofen-model-of-congenital-diaphragmatic-hernia-following-prenatal-maternal-dexamethasone-and-or-sildenafil
#17
Carmen Mesas Burgos, Erik G Pearson, Marcus Davey, John Riley, Huimin Jia, Pablo Laje, Alan W Flake, William H Peranteau
BACKGROUND: Pulmonary hypoplasia and hypertension is a leading cause of morbidity and mortality in congenital diaphragmatic hernia (CDH). The etiologic insult occurs early in gestation highlighting the potential of prenatal interventions. We evaluated prenatal pharmacologic therapies in the nitrofen CDH model. METHODS: Olive oil or nitrofen were administered alone or with dexamethasone (DM), sildenafil, or DM+sildenafil to pregnant rats. Newborn pups were assessed for lung function, structure and pulmonary artery (PA) flow and resistance...
October 2016: Pediatric Research
https://www.readbyqxmd.com/read/27339082/a-modern-era-comparison-of-right-versus-left-sided-congenital-diaphragmatic-hernia-outcomes
#18
COMPARATIVE STUDY
Michael Collin, Sarah Trinder, Corrado Minutillo, Shripada Rao, Jan Dickinson, Naeem Samnakay
BACKGROUND/PURPOSE: This study aims to retrospectively review outcomes, including neurodevelopmental outcomes, of neonatal right sided congenital diaphragmatic hernias (RCDH) compared with left sided congenital diaphragmatic hernias (L-CDH) treated surgically at our institute. METHODS: A retrospective review was undertaken of all cases of congenital diaphragmatic hernia (CDH) treated at Princess Margaret Hospital for Children (PMH), Perth, born between 1st January 2002 and 1st August 2012...
September 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27342009/right-versus-left-sided-congenital-diaphragmatic-hernia-a-comparative-outcomes-analysis
#19
Emily A Partridge, William H Peranteau, Lisa Herkert, Norma Rendon, Haylee Smith, Natalie E Rintoul, Alan W Flake, N Scott Adzick, Holly L Hedrick
PURPOSE: Right-sided congenital diaphragmatic hernia (R-CDH) occurs in up to 25% of all CDH cases, but has been less widely studied compared to left-sided defects. We sought to compare characteristics and outcomes of left- versus right-sided defects in a large cohort of CDH patients who underwent standardized treatment and follow-up at a single institution. METHODS: We retrospectively reviewed charts of all CDH patients in our pulmonary hypoplasia program from January 2002 through December 2014...
June 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/18280293/redefining-outcomes-in-right-congenital-diaphragmatic-hernia
#20
Jason C Fisher, Rashida A Jefferson, Marc S Arkovitz, Charles J H Stolar
PURPOSE: Available data comparing the management and outcome of right-sided (R-CDH) vs left-sided congenital diaphragmatic hernia (L-CDH) are inconsistent. Large-volume CDH studies are limited by small numbers of R-CDH or are confounded by compilations from multiple institutions with multiple treatment strategies. Consequently, they are underpowered to draw conclusions. To define the behavior and outcomes of R-CDH better, we report the largest single-institution series of R-CDH and ask if factors traditionally linked to poor prognosis in L-CDH were applicable to R-CDH...
February 2008: Journal of Pediatric Surgery
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