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1.
T Okazaki K Nishimura H Koga G Miyano M Okawada H Shoji T Shimizu S Makino S Takeda E Inada GJ Lane A Yamataka 《Pediatric surgery international》2012,28(9):883-886
Purpose
We reviewed 24 consecutive cases of prenatally or immediately postnatally diagnosed left-sided congenital diaphragmatic hernia (CDH) to evaluate pulmonary artery (PA) size as an indication for thoracoscopic repair (TR).Methods
CDH repair is planned once echocardiography confirms improvement in pulmonary hypertension. TR is chosen if cardiopulmonary status is stable more than 10?min in the decubitus position in the neonatal intensive care unit (NICU) under conventional mechanical or high frequency oscillatory ventilation (HFOV) with/without nitric oxide (NO) and the patient appears likely to tolerate manual ventilation during transfer to the operating room. Otherwise open repair (OR) is performed in NICU. Proximal right PA (RPA) and left PA (LPA) diameters measured at birth were assessed with respect to the type of repair.Results
10/24 had TR and 14/24 had OR. TR cases had significantly larger RPA/LPA diameters (3.52?±?0.23 vs. 3.10?±?0.56?mm, p?0.05 for RPA; 3.04?±?0.26 vs. 2.48?±?0.37, p?0.01 for LPA), and significantly less requirement for HFOV (70 vs. 100?%, p?0.05) and NO (20 vs. 86?%, p?0.01). Four TR required conversion to OR for technical reasons (n?=?3) and cardiopulmonary instability (n?=?1).Conclusions
TR can be considered when RPA/LPA diameters are larger than 3.0/2.5?mm, respectively, and cardiopulmonary status is stable without NO. 相似文献2.
Jagdish Kumar Amit Upadhyay Ajeet Kumar Dwivedi Sunil Gothwal Vijay Jaiswal Sunny Aggarwal 《Indian journal of pediatrics》2013,80(6):465-469
Objective
To study the effect of oil massage on growth in preterm babies less than 1800 g.Methods
This randomised controlled trial was conducted in Neonatal intensive care unit of a level II hospital. Neonates with birth weight?<?1800 g, gestation?<?35 wk and?<?48 h of age at enrolment were included in the studies. Eligible neonates were randomized to one of the two groups (a) Oil massage along with standard care of low birth weight (b) Standard care of low birth weight without massage. Weight, length and head circumference was measured in the two groups at 7 d intervals. Serum triglyceride levels were measured at enrolment and at completion of study. Primary outcome variable was weight gain at 28 d after enrolment.Results
A total of forty-eight neonates were randomisd to either oil massage group (n?=?25) or standard care of low birth weight without massage group (n?=?23). Mean (SD) weight of babies in the two groups was 1466.4?±?226.8 g in oil massage group and 1416.6?±?229.9 g in the control group. At 28 d, weight gain in the oil massage group (476.76?±?47.9 g) was higher compared to the control group (334.96?±?46.4 g) (p?<?0.05). At 7 d, less weight loss (7.80?±?9.8 g) was observed in babies in oil massage group compared to control group (21.52?±?19.4 g) (p?=?0.003). However, there was no significant difference in serum triglycerides and other anthropometric parameters.Conclusions
Oil application has a potential to improve weight gain and cause less weight loss in first 7 d in low birth weight neonates 相似文献3.
Amit Tagare Sudha Chaudhari Sandeep Kadam Umesh Vaidya Anand Pandit Mehmood G. Sayyad 《Indian journal of pediatrics》2013,80(1):16-20
Objective
To determine the morbidity and mortality in ELBW babies till discharge from a Neonatal Intensive Care Unit (NICU).Methods
This study was a prospective observational study conducted in a 40 bed well equipped level III care NICU between 01.12.2006 and 30.04.2008. All ELBW babies admitted during this period were assessed for morbidities and interventions required during NICU stay and for their outcome like survival or death.Results
The survival rate of 87 ELBW babies admitted during this period was 56.1 %. Pulmonary hemorrhage was the commonest cause of death (25 %) followed by respiratory distress syndrome (22.5 %), intraventricular hemorrhage (22.5 %) and sepsis (20 %). Significantly higher number of non-survivors were <750 g at birth (p?=?0.0001) and <28 wk gestation (p?=?0.0001). Small for gestational babies had better chances of survival compared to those appropriate for gestational age (p?=?0.005). RDS (67.8 %), probable sepsis (62.1 %) and hyperbilirubinemia (59.8 %) were the most frequent morbidities. Conventional ventilation (72.4 %) and nasal CPAP(48.3 %) were the commonest respiratory interventions. Surfactant replacement therapy was required in 47.1 % babies.Conclusions
ELBW babies have a major contribution to mortality in a NICU. Babies with birth weight <750 g and gestation <28 wk have poor survival. RDS, pulmonary hemorrhage, IVH and sepsis are the common causes of death while RDS, sepsis and hyperbilirubinemia are the most common morbidities. 相似文献4.
Does Mesenchymal Stem Cell Population in Umbilical Cord Blood Vary at Different Gestational Periods?
Ashish Jain Nitin Mathur M. Jeevashankar Asok Mukhopadhyay Ramesh Agarwal A. K Deorari V. K Paul 《Indian journal of pediatrics》2013,80(5):375-379
Objective
To identify and quantitatively determine Mesenchymal stem cells (MSCs) in the umbilical cord blood (UCB) of neonates born at different gestational periods.Methods
UCB was collected at birth in neonates of three different gestational groups. The mononuclear cells (MNCs) were phenotypically analyzed by flow cytometer.Results
The yield of total MNCs did not differ much with gestation; the average values were 22.6?±?6.48?×?106 cells/ml. The MSCs were significantly higher in the lower gestation group. These were 0.0219?±?0.012 %, 0.0044?±?0.003 % and 0.0022?±?0.003 % in 28 to 31 wk, 32 to 35 wk and >36 wk, respectively (P?=?0.00). There was a significant inverse correlation between the gestational age and the presence of MSCs with a correlation co-efficient of ?0.54 (P?=?0.0001).Conclusions
The MSCs population was significantly higher in infants born at lesser gestation than those born at term gestation. 相似文献5.
Xiawei Ou Charles M. Glasier Raghu H. Ramakrishnaiah Teresita L. Angtuaco Sarah B. Mulkey Zhaohua Ding Jeffrey R. Kaiser 《Pediatric radiology》2014,44(8):980-986
Background
Permissive hypercapnia is a ventilatory strategy used to prevent lung injury in ventilated extremely low birth weight (ELBW, birth weight ≤1,000 g) infants. However, there is retrospective evidence showing that high CO2 is associated with brain injury.Objective
The objective of this study was to compare brain white matter development at term-equivalent age in ELBW infants randomized to hypercapnic vs. normocapnic ventilation during the first week of life and in healthy non-ventilated term newborns.Materials and methods
Twenty-two ELBW infants from a randomized controlled trial were included in this study; 11 received hypercapnic (transcutaneous PCO2 [tcPCO2] 50–60 mmHg) ventilation and 11 normocapnic (tcPCO2 35–45 mmHg) ventilation during the first week of life while still intubated. In addition, ten term healthy newborns served as controls. Magnetic resonance imaging (MRI) with diffusion tensor imaging (DTI) was performed at term-equivalent age for the ELBW infants and at approximately 2 weeks of age for the control infants. White matter injury on conventional MRI was graded in the ELBW and control infants using a scoring system adopted from literature. Tract-based spatial statistics (TBSS) was used to evaluate for differences in DTI measured fractional anisotropy (FA, spatially normalized to a customized template) among the ELBW and term control infants.Results
Conventional MRI white matter scores were not different (7.3?±?1.7 vs. 6.9?±?1.4, P?=?0.65) between the hypercapnic and normocapnic ELBW infants. TBSS analysis did not show significant differences (P?<?0.05, corrected) between the two ELBW infant groups, although before multiple comparisons correction, hypercapnic infants had many regions with lower FA and no regions with higher FA (P?<?0.05, uncorrected) compared to normocapnic infants. When compared to the control infants, normocapnic ELBW infants had a few small regions with significantly lower FA, while hypercapnic ELBW infants had more widespread regions with significantly lower FA (P?<?0.05, fully corrected for multiple comparisons).Conclusions
Normocapnic ventilation vs. permissive hypercapnia may be associated with improved white matter development at term-equivalent age in ELBW infants. This effect, however, was small and was not apparent on conventional MRI. Further research is needed using larger sample sizes to assess if permissive hypercapnic ventilation in ELBW infants is associated with worse white matter development. 相似文献6.
Prof. Dr. E. Herting 《Monatsschrift für Kinderheilkunde》2013,161(5):417-424
Old vs. new BPD
Bronchopulmonary dysplasia (BPD) was described about 50 years ago as a fibroproliferative chronic lung disease in consequence of mechanical ventilation/oxygen exposure in premature infants with respiratory distress syndrome (old BPD). Surfactant therapy with increased survival of extremely premature infants identified a new type of an immaturity-related multisystem disorder that is characterized by a stop/simplification of alveolarisation and lung capillary development (new BPD).Therapy
To date, mainly symptomatic treatment exists. However, growth factors and stem cell therapy have recently been tested with some success in animal experiments.Outcome
Survivors of new BPD may have problems in adult life concerning lung and cardiovascular function, growth and neurosensory and/or motor development. 相似文献7.
Antonio Alberto Zuppa P. Catenazzi C. Orchi F. Cota V. Calabrese M. Cavani C. Romagnoli 《Indian journal of pediatrics》2013,80(6):455-459
Objective
To compare the characteristics of jaundice and hyperbilirubinemia in the newborn population of both immigrant and Italian mothers.Methods
The authors studied a group of 1,680 infants born at “A. Gemelli” hospital during 1 y. All were with appropriate weight for gestational age, weighting more than 2,500 g, born to low-risk pregnancy. Maternal ethnicity, clinically evident jaundice (that is total serum bilirubin (TSB)?>?7 mg/dL), hyperbilirubinemia (TSB?>?12 mg/dL), the duration of hospital stay and their need of phototherapy were evaluated.Results
In infants born to Asian mothers, hyperbilirubinemia was significantly more frequent (48.8 % vs. 26.5 %, p?=?0.003) and they reached mean TSB peak significantly later (86.5?±?38.5 vs. 74.5?±?20.6 h, P?=?0.0001) compared with Italian infants. The average length of hospitalization of infants of Asian and Latin American mothers is significantly longer compared to Italian newborns (4.5?±?1.9 vs. 3.6?±?1.1, p <0.0001 and 4.2?±?1.6 vs. 3.6?±?1.1, p?=?0.0004). With regard to the use of phototherapy, and to its duration, there are no significant differences between the populations studied.Conclusions
Having studied all infants at low risk, the greater length of hospitalization is due to later peak and the higher frequency of jaundice in newborns of immigrant mother, especially in Asia. Therefore, as it happens to the Italian newborns, it would be desirable to build forecasting nomograms in these populations, to reduce the length of hospitalization and facilitate protected discharge. 相似文献8.
Abdullah Barış Akcan Fırat Kardelen Seyhan Erişir Oygucu Abdullah Kocabaş Deniz Özel Halide Akbaş Nihal Oygür 《Indian journal of pediatrics》2013,80(11):896-902
Objectives
To evaluate if cardiac dysfunctions are important in assessing the outcome in newborns with Bronchopulmonary Dysplasia (BPD), by evaluating cardiac functions with N-terminal prohormone of brain natriüretic peptide (NT-proBNP) levels, M-mode and tissue doppler echocardiography at 6–12 mo of age.Methods
Twenty eight patients were retrospectively classified as mild, moderate and severe according to the diagnostic criterias for BPD. All cases were assessed with standard M-mode, tissue doppler echocardiography and NT-proBNP levels. Control group consisted of 28 healthy infants, having similar postnatal ages as patients and were assessed with standard M-mode and tissue doppler echocardiography.Results
The age of patients with BPD was 9.8?±?2.3 mo and control group was 9.5?±?2.6 mo. There was no significant difference between the postnatal ages of two groups (p?>?0.05). Neither pulmonary hypertension nor pulmonary/tricuspid regurgitation was detected. The M-mode echocardiography measurements did not differ between patients and control group (p?>?0.05). Tissue doppler echocardiography, tricuspid valve medial segment early diastolic myocardial relaxation velocity (TME’) measurements of patients were found significantly lower, peak transtricuspid filling velocity in the early diastole (TE)/TME’ ratios and isovolumetric relaxation time (IVRT) measurements were found significantly higher than control group (p?<?0.05). Tricuspid E, TE/TLE’ (Tricuspid valve lateral segment early diastolic myocardial relaxation velocity), TE/RVLE’(Right ventricular lateral segment early diastolic myocardial relaxation velocity), TE/TME’ levels were also found as significantly abnormal in patients with severe BPD. A significant correlation was found between right ventricular diastolic disfunctions and severity of BPD (p?<?0.05). No statistically significant difference was found between NT-proBNP levels, BPD stages and tissue doppler echocardiography measurements (p?>?0.05).Conclusions
This is the first study evaluating cardiac findings in patients with BPD by tissue doppler echocardiography and NT-proBNP at the same time. On the basis of cardiac evaluations, tissue doppler echocardiography measurements were found as significant and specific for the early assessment of right ventricular diastolic disfunctions. 相似文献9.
Bozdag S Oguz SS Gokmen T Tunay Z Tok L Uras N Erdeve O Dilmen U 《Indian journal of pediatrics》2011,78(12):1503-1509
Objective
To determine whether serum fructosamine which is a good marker for detecting hyperglycemia during the previous 2 to 3 wk in infants could predict the development of retinopathy of prematurity in very low birth weight infants.Methods
One hundred sixty seven premature infants who had a birth weight of <1500 g and a gestational age of less than 32 wk were investigated in the present study. Blood glucose was measured at the bedside and infants were recorded as hyperglycemic if their mean blood glucose levels were higher than 150 mg/dL. Serum corrected fructosamine level was obtained from the cord blood at birth and after the first month of life. The infants’ eyes were examined by ophthalmologists to detect retinopathy of prematurity at the gestational age of 32 wk or at four wk after birth, whichever came first.Results
Corrected fructosamine was 319.6?±?59.6 and 272.8?±?50.6 mmol/l for group1 on 1st and 30th day respectively; 320?±?61.7 and 268.2?±?47.3 mmol/l for groups 2?+?3 on 1st and 30th day respectively which did not differ between groups (p?=?0.766 and p?=?0.665), whereas duration of hyperglycemia was 1.69?±?1.1 day in group 1 compared with 3.05?±?2.4 day in groups 2?+?3 which was significantly different (p?=?0.019). The multivariate regression analysis indicated that the duration of hyperglycemia in days was significantly correlated with the development of retinopathy of prematurity (OR 3.26; 95% CI 1.09–9.80; p?=?0.035).Conclusions
Although the duration of hyperglycemia may contribute to the development of retinopathy of prematurity, serum corrected fructosamine does not have a good predictive value in developing retinopathy of prematurity in very-low-birth-weight (VLBW) infants. 相似文献10.
Ozge Aydemir Emel Soysaldı Yusuf Kale Sumru Kavurt Ahmet Yagmur Bas Nihal Demirel 《Indian journal of pediatrics》2014,81(8):751-754
Objective
To determine changes in body temperature (BT) of hyperbilirubinemic newborns under conventional phototherapy with fluorescent lamps and light emitting diodes (LED) at different irradiances.Methods
Otherwise healthy newborn infants >34 wk gestational age (GA) hospitalized for indirect hyperbilirubinemia, requiring phototherapy in the first 10 d of life were enroled. Infants who received conventional phototherapy with fluorescent lamps (10–15 μW/cm2/nm irradiance) were defined as group 1, LED phototherapy of 26–60 μW/cm2/nm irradiance as group 2, and LED phototherapy of 60–120 μW/cm2/nm irradiance as group 3. Primary outcome measure was mean BT which was defined as arithmetical mean of axillary BT measured at 2 h intervals during the first day of phototherapy.Results
Thirty patients were enroled in each group. Mean birth weight and GA of the total cohort was 2800?±?530 g and 36.6?±?2 wk, respectively. Baseline demographic variables and serum total bilirubin levels were similar among groups. Mean BT was 36.7?±?0.1 °C in group 1, 36.6?±?0.2 °C in group 2, 37.7?±?0.2 °C in group 3. Mean BT was higher in group 3 compared to group 1 (p?<?0.001) and group 2 (p?<?0.001). Group 1 and group 2 had similar mean BT measurements (p?=?0.09). During phototherapy all the patients in group 3 had at least one BT measurement ≥37.5 °C and 77 % had BT ≥38 °C. Only one patient in group 2 had BT?≥?37.5 °C which was also ≥38 °C. During phototherapy all BT measurements were <37.5 °C in group 1.Conclusions
LED phototherapy of ≥60 μW/cm2/nm intensity significantly increases BT in hyperbilirubinemic newborns. 相似文献11.
Objective
To measure the size of the anterior fontanelle (AF) in healthy late-preterm and term newborns and correlate it with birth weight, gestational age, gender, occipito-frontal circumference, small for gestational age status and birth weight z-score.Methods
This was an observational study carried out from October 2013 through April 2015 at a tertiary care hospital. Newborns?≥?34 wk gestation were enrolled. Fontanelle edge was palpated with index finger and size calculated by adding anterior-posterior and transverse diameters and dividing by two.Results
A total of 1010 neonates were enrolled. The mean AF size was 2.23?±?0.52 cm (mean?±?SD). There was a significant decrease in the size of the AF with advancing gestational maturity on one-way ANOVA (F?=?31.30) (P?<?0.001) and also by increasing birth weight (F?=?20.34) (P?<?0.001). There was no significant difference in the mean AF size between males; 2.21?±?0.54 cm and females; 2.25?±?0.55 cm (mean?±?SD) (P?=?0.575). There was a strong correlation between AF size with increasing birth weight; correlation (r)?=?0.985. In small for gestational age neonates the AF was larger, 2.27?±?0.55 (mean?±?SD) and a strong correlation between birth weight z-score and AF size was noted (r?=?1.012).Conclusions
The mean AF size in late-preterm and term Indian newborns in a mixed community hospital was 2.23?±?0.52. A strong correlation was found between AF size with increasing birth weight and with birth weight z-score in small for gestational age babies.12.
Objective
To determine outcome of children receiving carvedilol in addition to other standard drug therapy for treatment of dilated cardiomyopathy.Methods
Children receiving carvedilol for treatment of dilated cardiomyopathy with moderate to severe ventricular dysfunction were included into the study. Data on history, clinical examination and investigations were obtained and detailed echocardiography findings were recorded for the initial and all subsequent visits.Results
Thirty-three children, mean age 26?±?30 mo (range 7 mo to 138 mo) were enrolled. Carvedilol was initiated at a mean dose of 0.14?±?0.03 mg/kg/d and the maintenance dose was 0.46?±?0.14 mg/kg/d. At a follow up of 6–90 mo (mean of 28?±?23 mo), functional class using Ross classification for pediatric heart failure improved from 2.7 to 1.3. The left ventricular ejection fraction rose from a basal value of 22 %?±?7 % (10–40 %) to 42 %?±?15 % (15–65 %) (p?<?0.0001). Similarly, left ventricular fractional shortening increased significantly from 16?±?6 % (8–34 %) to 21?±?7 % (10–44 %) (p?<?0.0001). One patient deteriorated and died of refractory heart failure. Carvedilol was discontinued in two more patients temporarily due to bronchospasm during respiratory infection.Conclusions
The present study suggests that improvement in ventricular function and clinical symptoms is seen on oral carvedilol added to standard drug therapy in pediatric patients with dilated cardiomyopathy and moderate to severe ventricular dysfunction. The drug is well tolerated with minimal side effects but close monitoring is required as it may worsen heart failure and bronchospasm. 相似文献13.
Tilo Niemann Simon Henry Alain Duhamel Jean-Baptiste Faivre Antoine Deschildre Lucie Colas Teresa Santangelo Jacques Remy Martine Remy-Jardin 《Pediatric radiology》2014,44(11):1347-1357
Background
Before introducing 70-kVp settings in the low-kilovoltage strategies for pediatric examinations, it was mandatory to demonstrate, at similar dose levels, an equivalence of image quality at 70 kVp and 80 kVp.Objective
To assess image quality of chest CT examinations acquired at 70 kVp in comparison with standard scanning at 80 kVp.Materials and methods
We prospectively evaluated 129 children with a 70-kVp scanning protocol (group 1). All scanning parameters were kept similar to those usually selected for pediatric standard 80-kVp protocols, except the milliamperage increased by a factor of 1.6 to maintain comparable radiation dose. Image quality of group 1 examinations was compared to that of a paired population scanned at 80 kVp (group 2). The noninferiority hypothesis was fixed at 10% of the mean level of image noise.Results
There was no significant difference in the mean dose length product (DLP) and the volume computed tomography dose index (CTDIvol) between the groups (DLP: 20.5?±?5.8 mGy.cm [group 1] vs. 19.7?±?7.6 mGy.cm [group 2]; P?=?0.06) (CTDIvol: 0.8?±?0.1 mGy [group 1] vs. 0.8?±?0.18 mGy [group 2]; P?=?0.94). The mean of differences in image noise between group 1 and group 2 examinations was ?1.38 (?2.59; ?0.18), verifying the noninferiority hypothesis. Subjective image quality did not significantly differ between group 1 and group 2 examinations (P?=?0.18).Conclusion
At equivalent radiation dose levels, 70-kVp protocols provide similar image quality to that achievable at 80 kVp. 相似文献14.
Shuchismita Behera Sujata Dixit Gandham Bulliyya Shantanu Kumar Kar 《Indian journal of pediatrics》2014,81(3):270-274
Objective
To assess the antioxidant vitamins A (retinol) and E (α-tocopherol) levels, iron status and growth retardation in children with β-thalassemia major in Odisha, an eastern state of India.Methods
Forty three children aged 1–15 y diagnosed with β-thalassemia major (28 males and 15 females) and 42 age-matched healthy controls (22 males and 20 females) were studied. β-thalassemia was detected by using Bio-rad variant assay. Measurement of blood hemoglobin (Hb), hematocrit, serum vitamins (A and E) and ferritin was carried out by standard methods.Results
Mean hemoglobin (6.60?±?1.84 vs. 11.8?±?2.29 g/dL, p?<?0.01), serum retinol (28.0?±?17.67 vs. 54.4?±?36.56 μg/dL, p?<?0.001) and α-tocopherol (0.2?±?0.34 vs. 1.1?±?0.82 mg/dL, p?<?0.001) were significantly lower in children with thalassemia compared with control group, however, serum ferritin (storage iron) was elevated in thalassemia patients (553.7?±?176.80 vs. 57.3?±?40.73 ng/mL, p?<?0.001). Vitamin E had significantly correlated with hemoglobin and hematocrit values in the patients. Growth retardation in terms of stunting (79 % vs. 24 %, p?<?0.0001) and thinness (32.6 % vs. 9.5 %, p?<?0.05) was significantly higher in thalassemic children compared with normal children.Conclusions
This study shows that children with β-thalas-semia major are in a state of oxidative stress of hyperfer-ritinemia with deprived antioxidant vitamins (A and E) and poor growth status suggesting a possible need for reduction in iron overload and additional antioxidant supplementation. 相似文献15.
Hassan Boskabadi Abbas Navaee Boroujeni Hesam Mostafavi-Toroghi Golkoo Hosseini Majid Ghayour-Mobarhan Dariush Hamidi Alamdari Mahtab Biranvandi Hamidreza Saber Gordon A. Ferns 《Indian journal of pediatrics》2014,81(3):248-253
Objective
To determine the prooxidant-antioxidant balance (PAB) in neonatal asphyxia and compare it with values for PAB in healthy neonates.Methods
In a prospective observational study, serum PAB of umbilical cord blood of 30 neonates with asphyxia [pH <?7.2, low Apgar score, signs of respiratory distress syndrome (RDS)] as the case group and 35 healthy neonates (without an abnormal clinical event at birth and after the first week) as the control group were compared.Results
Among the 35 neonates in the control group, the average level of serum PAB was 20.00 HK units, which was significantly lower than for the 30 neonates within the case group (40.46 HK units; p?=?0.019). The blood pH in the case group was significantly lower than for control group (P?<?0.001). In controls, HCO3 - and pCO2 were 18.6 mmol/L and 38.5 mmHg respectively, whilst in the case group these values were 15.5 mmol/L and 45.7 mmHg respectively (p?<?0.05).Conclusions
Determination of PAB may be useful in the early diagnosis of perinatal asphyxia and is consistent with HCO3 -, pCO2 and Apgar score. 相似文献16.
Marcelo F. Kozak Andrew Redington Shi-Joon Yoo Mike Seed Andreas Greiser Lars Grosse-Wortmann 《Pediatric radiology》2014,44(4):403-409
Background
Adverse ventricular remodeling after tetralogy of Fallot (TOF) repair is associated with diffuse myocardial fibrosis.Objective
The goal of this study was to measure post-contrast myocardial T1 in pediatric patients after TOF repair as surrogates of myocardial fibrosis.Materials and methods
Children after TOF repair who underwent cardiac magnetic resonance imaging with T1 mapping using the modified look-locker inversion recovery (MOLLI) sequence were included. In addition to routine volumetric and flow data, we measured post-contrast T1 values of the basal interventricular septum, the left ventricular (LV) lateral wall, and the inferior and anterior walls of the right ventricle (RV). Results were compared to data from age-matched healthy controls.Results
The scans of 18 children who had undergone TOF repair and 12 healthy children were included. Post-contrast T1 values of the left ventricular lateral wall (443?±?54 vs. 510?±?77 ms, P?=?0.0168) and of the right ventricular anterior wall (333?±?62 vs. 392?±?72 ms, P?=?0.0423) were significantly shorter in children with TOF repair than in controls, suggesting a higher degree of fibrosis. In children with TOF repair, but not in controls, post-contrast T1 values were shorter in the right ventricle than the left ventricle and shorter in the anterior wall of the right ventricle than in the inferior segments. In the TOF group, post-contrast T1 values of the RV anterior wall correlated with the RV end-systolic volume indexed to body surface area (r?=?0.54; r2?=?0.30; P?=?0.0238).Conclusion
In children who underwent tetralogy of Fallot repair the myocardium of both ventricles appears to bear an abnormally high fibrosis burden. 相似文献17.
Antonio Di Mauro Manuela Capozza Sergio Cotugno Silvio Tafuri Francesco Paolo Bianchi Federico Schettini Raffaella Panza Nicola Laforgia 《Italian journal of pediatrics》2017,43(1):116
Background
Pulmonary disorders and respiratory failure represent one of the most common morbidities of preterm newborns admitted to neonatal intensive care units (NICUs). The use of nasal high-flow therapy (nHFT) has been more recently introduced into the NICUs as a non-invasive respiratory (NIV) support.Methods
We performed a retrospective study to evaluate safety and effectiveness of nHFT as primary support for infants born <?29 weeks of gestation and/or VLBW presenting with mild Respiratory Distress Syndrome (RDS).The main outcome was the percentage of patients that did not need mechanical ventilation. Secondary outcomes were rate of bronchopulmonary dysplasia (BDP), air leaks, nasal injury, late onset sepsis (LOS), intraventricular hemorrhage (IVH), retinopathy (ROP), necrotizing enterocolitis (NEC), hemodynamically-significant patent ductus arteriosus (PDA) and death.Results
Sixty-four preterm newborns were enrolled. Overall, 93% of enrolled patients did not need mechanical ventilation. In a subgroup analysis, 88.5% of infants <?29 weeks and 86.7% of infants ELBW (<?1000 g BW) did not need mechanical ventilation.BPD was diagnosed in 26.6% of preterms enrolled (Mild 20%, Moderate 4.5%, Severe 1.5%). In subgroup analysis, BPD was diagnosed in 53.9% of newborns with GA <?29 weeks, in 53.3% of ELBW newborns and in 11.1% of small for gestational age (SGA) newborns.Neither air leaks nor nasal injury were recorded as well as no exitus occurred. LOS, IVH, ROP, NEC and PDA occurred respectively in 16.1%, 0%, 7.8%, and 1.6% of newborns.Conclusions
According to our results, n-HFT seems to be effective as first respiratory support in preterm newborns with mild RDS. Further studies in a larger number of preterm newborns are required to confirm nHFT effectiveness in the acute phase of RDS.18.
Abdulaziz Al-Othman Sara Al-Musharaf Nasser M Al-Daghri Soundararajan Krishnaswamy Deqa S Yusuf Khalid M Alkharfy Yousef Al-Saleh Omar S Al-Attas Majed S Alokail Osama Moharram Shaun Sabico George P Chrousos 《BMC pediatrics》2012,12(1):1-6
Background
1) To evaluate calcium absorption in infants fed a formula containing prebiotics (PF) and one without prebiotics (CF). 2) To compare calcium absorption from these formulas with a group of human milk-fed (HM) infants.Methods
A dual tracer stable isotope method was used to assess calcium absorption in infants exclusively fed CF (n?=?30), PF (n?=?25) or HM (n?=?19). Analysis of variance was used to analyze calcium intake, fractional calcium absorption, and the amount of calcium absorbed.Results
Calcium intake (Mean ± SEM) for PF was 534?±?17?mg/d and 557?±?16?mg/d for CF (p?=?0.33). Fractional calcium absorption was 56.8?±?2.6?% for PF and 59.2?±?2.3?% for CF (p?=?0.49). Total calcium absorbed for PF was 300?±?14?mg/d and 328?±?13?mg/d for CF (p?=?0.16). For HM infants calcium intake was 246?±?20?mg/d, fractional calcium absorption was 76.0?±?2.9?% and total calcium absorbed was 187?±?16?mg/d (p <0.001, compared to either PF or CF).Conclusions
Despite lower fractional calcium absorption of CF and PF compared to HM, higher calcium content in both led to higher total calcium absorption compared to HM infants. No significant effect of prebiotics was observed on calcium absorption or other markers of bone mineral metabolism. 相似文献19.
Johannes Boos Patric Kröpil Dirk Klee Philipp Heusch Lars Schimmöller Jörg Schaper Gerald Antoch Rotem S. Lanzman 《Pediatric radiology》2014,44(9):1065-1069
Background
Organ-specific dose reduction significantly reduces the radiation exposure of radiosensitive organs.Objective
The purpose of this study was to assess the impact of a novel organ-specific dose reduction algorithm on image quality of pediatric chest CT.Materials and methods
We included 28 children (mean age 10.9?±?4.8 years, range 3–18 years) who had contrast-enhanced chest CT on a 128-row scanner. CT was performed at 100 kV using automated tube current modulation and a novel organ-specific dose-reduction algorithm (XCare?; Siemens, Forchheim, Germany). Seven children had a previous chest CT performed on a 64-row scanner at 100 kV without organ-specific dose reduction. Subjective image quality was assessed using a five-point scale (1-not diagnostic; 5-excellent). Contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) were assessed in the descending aorta.Results
Overall mean subjective image quality was 4.1?±?0.6. In the subgroup of the seven children examined both with and without organ-specific dose reduction, subjective image quality was comparable (score 4.4?±?0.5 with organ-specific dose reduction vs. 4.4?±?0.7 without it; P?>?0.05). There was no significant difference in mean signal-to-noise ratio and contrast-to-noise ratio with organ-specific dose reduction (38.3?±?10.1 and 28.5?±?8.7, respectively) and without the reduction (35.5?±?8.5 and 26.5?±?7.8, respectively) (P?>?0.05). Volume computed tomography dose index (CTDIvol) and size-specific dose estimates did not differ significantly between acquisitions with the organ-specific dose reduction (1.7?±?0.8 mGy) and without the reduction (1.7?±?0.8 mGy) (P?>?0.05).Conclusion
Organ-specific dose reduction does not have an impact on image quality of pediatric chest CT and can therefore be used in clinical practice to reduce radiation dose of radiosensitive organs such as breast and thyroid gland. 相似文献20.