Database : MEDLINE
Search on : meningomyelocele [Words]
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[PMID]: 29521607
[Au] Autor:Gökce IK; Turgut H; Ozdemir R; Onal SC
[Ad] Address:Department of Pediatrics, Division of Neonatology, and.
[Ti] Title:Development of severe hyponatremia due to cerebrospinal fluid leakage following meningomyelocele surgery in a newborn.
[So] Source:J Neurosurg Pediatr;:1-4, 2018 Mar 09.
[Is] ISSN:1933-0715
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Cerebrospinal fluid leakage following meningomyelocele surgery is a frequent complication in the wound-healing period and is associated with wound dehiscence. CSF loss can cause severe hyponatremia, especially in the newborn and early infancy periods when dietary sodium content is relatively low. Hyponatremia in the newborn period can result in adverse neurodevelopmental outcomes. In addition, hyponatremia's cerebral effects can increase complications in neurosurgery patients. The authors present the case of a newborn in whom CSF leakage from the operative site and severe hyponatremia developed following meningomyelocele surgery. To the best of their knowledge, severe hyponatremia caused by CSF leakage after meningomyelocele surgery has not been previously reported in the literature.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.3171/2017.11.PEDS17386

  2 / 3996 MEDLINE  
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[PMID]: 29485935
[Au] Autor:Leonardi-Figueiredo MM; de Souza MA; Lizzi EADS; de Oliveira LFL; Crescencio JC; Schwartzmann PV; Gallo L; Mattiello-Sverzut AC
[Ad] Address:1 University of São Paulo.
[Ti] Title:The Use of a Wheelchair Propulsion Field Test to Determine Peak Heart Rate in Children and Adolescents With Myelomeningocele.
[So] Source:Pediatr Exerc Sci;:1-8, 2018 Feb 27.
[Is] ISSN:1543-2920
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: We analyzed the evolution and pattern of heart rate (HR) during the 12-minute wheelchair propulsion field test (WPFT) and compared the peak HR (HR ) from the WPFT to the HR obtained in the progressive cardiopulmonary exercise test on arm cranking ergometer (ACT). We aimed to determine if the field test detects the HR consistently and could be used in clinical practice. METHODS: Eleven wheelchair-using children and adolescents with myelomeningocele (aged 8-15 y) performed a maximal ACT and a 12-minute WPFT. HR was recorded continuously at rest, during each minute of the tests, and at recovery. Mixed analysis of variance was used to compare the variables at rest and peak. Bland-Altman plot and Lin's concordance correlation coefficient were used to show agreement between the tests. RESULTS: During minute 2 of the WPFT, participants reached 73%-96% of the HR values recorded in the ACT. From minutes 4 to 12, participants reached HR values ranging 86%-109% of the values recorded in the ACT. There is agreement between the ACT and the WPFT tests. CONCLUSION: WPFT with minimal duration of 4 minutes may be an alternative tool to obtain HR in children and adolescents with myelomeningocele.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180227
[Lr] Last revision date:180227
[St] Status:Publisher
[do] DOI:10.1123/pes.2017-0094

  3 / 3996 MEDLINE  
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[PMID]: 29339865
[Au] Autor:Altiok H; Riordan A; Graf A; Krzak J; Hassani S
[Ad] Address:Shriners Hospitals for Children Chicago.
[Ti] Title:Response of Scoliosis in Children with Myelomeningocele to Surgical Release of Tethered Spinal Cord.
[So] Source:Top Spinal Cord Inj Rehabil;22(4):247-252, 2016.
[Is] ISSN:1945-5763
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:To examine the effect of surgical tethered cord release (TCR) on scoliosis in children with myelomeningocele. A retrospective review of 65 pediatric patients with myelomeningocele and TCR. The final sample consisted of 20 patients with scoliosis who were managed conservatively after TCR. Average age at TCR was 6.2 years with average follow-up of 3.8 years. Scoliosis of 1 (5%) patient improved, 7 (35%) were stable, and 12 (60%) worsened (≥10°). Fifty percent of patients ultimately required definitive spinal surgery. TCR release delayed definitive spine surgery for an average of 3.2 years. Sixty-four percent of patients with curves less than or equal to 45° had progression of their curves compared to 50% with curves greater than 45°. For patients with curves less than or equal to 45°, curves progressed in 80% of those younger than 10 years as compared to 25% of those older than 10 years. For patients with curves less than or equal to 45°, 43% required definitive spine surgery as opposed to 83% with curves greater than 45°. Level of neurological involvement (ie, lumbar versus thoracic) and age at untethering emerged as factors influencing the effects of TCR for patients with curves less than or equal to 45°. Lumbar curves had more favorable results. Pediatric patients with myelomeningocele and scoliosis should be closely assessed and monitored. A selective approach for youth with lumbosacral level myelomeningocele and progressive curves less than or equal to 45° may result in scoliosis stabilization and avoidance of definitive surgery.
[Mh] MeSH terms primary: Meningomyelocele/surgery
Scoliosis/surgery
[Mh] MeSH terms secundary: Child
Female
Humans
Male
Neural Tube Defects
Retrospective Studies
Thoracic Vertebrae
Treatment Outcome
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180220
[Lr] Last revision date:180220
[Js] Journal subset:IM
[Da] Date of entry for processing:180118
[St] Status:MEDLINE
[do] DOI:10.1310/sci2204-247

  4 / 3996 MEDLINE  
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[PMID]: 29285839
[Au] Autor:Ponde VC; Bedekar VV; Chavan D; Gursale A; Shah D
[Ad] Address:Surya Children Hospital, Mumbai, India.
[Ti] Title:Role of ultrasound guided epidural anesthesia for lower limb surgery in children with previously repaired meningomyelocele.
[So] Source:Paediatr Anaesth;28(3):287-290, 2018 Mar.
[Is] ISSN:1460-9592
[Cp] Country of publication:France
[La] Language:eng
[Ab] Abstract:BACKGROUND: Children that have had a meningomyelocele repair often present for hip and bilateral lower limb surgeries. Due to vertebral, epidural, and nerve root abnormalities, placement of epidural catheter is difficult. AIMS: We aim to describe the potential role of ultrasound in delineating the most appropriate intervertebral space for central neuroaxial blocks in these patients. METHODS: Twelve children with previous meningomyelocele repair, in the age group of 6-12 years posted for hip or bilateral lower limb surgeries were included. After induction of anesthesia, an ultrasound scan was done with the patient in the left lateral position. The central neuroaxial block was performed in the most appropriate intervertebral space seen on transverse scan of spine. These patients were studied with regard to visibility of the osseous framework of the spine, the anterior and posterior dural complexes, ease of insertion of catheter, evidence of dural puncture, and possibility of identification of the extent of peri-incisional fibrosis. RESULTS: One case required 2 attempts. There was no evidence of dural puncture. We could confirm the soft tissue shadow, the osseous framework, and the anterior and posterior dural complexes in all 12 patients. Ultrasonography guided in selecting the most appropriate space for epidural catheter placement. CONCLUSION: Ultrasound guidance aids in identification of normal intervertebral space and explicitly shows the abnormal space. It can be used as an aid to differentiate between normal and abnormal space in post-meningomyelocele repair.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180213
[Lr] Last revision date:180213
[St] Status:In-Data-Review
[do] DOI:10.1111/pan.13297

  5 / 3996 MEDLINE  
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[PMID]: 29314321
[Au] Autor:Lapa Pedreira DA; Acacio GL; Gonçalves RT; Sá RAM; Brandt RA; Chmait R; Kontopoulos E; Quintero RA
[Ad] Address:Fetal Therapy Program, Albert Einstein Hospital, São Paulo, Brazil.
[Ti] Title:Percutaneous fetoscopic closure of large open spina bifida using a bilaminar skin substitute.
[So] Source:Ultrasound Obstet Gynecol;, 2018 Jan 04.
[Is] ISSN:1469-0705
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:OBJECTIVE: We have previously described our percutaneous fetoscopic technique for the treatment of open spina bifida (OSB). However, approximately 20-30% of OSB defects are too large to allow primary skin closure. We hereby describe a modification of our standard technique using a bilaminar skin substitute to allow closure of such large spinal defects. The aim of this study was to report our clinical experience with the use of a bilaminar skin substitute and a percutaneous fetoscopic technique for the prenatal closure of large spina bifida defects. METHODS: Surgeries were performed between 24.0 and 28.9 gestational weeks under general anesthesia, using an entirely percutaneous fetoscopic approach with partial CO2 insufflation of the uterine cavity, as previously described. If there was enough skin to be sutured in the midline, only a biocellulose patch was placed over the placode. In cases where skin approximation was not possible, a bilaminar skin substitute (two layers: one silicone and one dermal matrix) was placed over the biocellulose. The surgical site was assessed at birth, and long-term follow-up was performed. RESULTS: Forty-seven consecutive fetuses underwent percutaneous fetoscopic OSB repair. Premature preterm rupture of membranes (PPROM) occurred in 38 (84%), and the mean gestational age at delivery was 32,8 + 2.5 weeks. A bilaminar skin substitute was required in 13 (29%), of which 5 was associated with myeloschisis. In all cases the skin substitute was found at the surgical site, at birth. In 3 (15%) of these cases, postnatal additional repair was needed. In the other 10 cases, the silicone layer detached spontaneously from the dermal matrix (average 25 days after birth), and the lesion healed by secondary-intention. Operating time was significantly longer in cases requiring the bilaminar skin substitute (additional 42 minutes). The subgroup with bilaminar skin substitute had similar PPROM rate and delivery gestational age compared to the one patch group. Complete reversal of hindbrain herniation occurred in 68% of the one patch and in 33% (p < 0.05) of the two patches group. In 4 cases there was no reversal and 3 of them were myeloschisis cases. CONCLUSIONS: Large OSB defects may be successfully treated in utero using a bilaminar skin substitute over a biocellulose patch through an entirely percutaneous approach. Although the operating time is longer, surgical outcomes are similar to cases closed primarily. Myeloschisis seems to have a worse prognosis then myelomeningocele cases. PPROM and preterm birth continue to be a challenge. Further experience is needed to assess the risks and benefits of this technique for management of large OSB defects.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180124
[Lr] Last revision date:180124
[St] Status:Publisher
[do] DOI:10.1002/uog.19001

  6 / 3996 MEDLINE  
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[PMID]: 29345722
[Au] Autor:Beger O; Koç T; Beger B; Uzmansel D; Kurtoglu Z
[Ad] Address:obeger@gmail.com.
[Ti] Title:Morphometric properties of the tensor fascia lata muscle in human fetuses.
[So] Source:Folia Morphol (Warsz);, 2018 Jan 18.
[Is] ISSN:0015-5659
[Cp] Country of publication:Poland
[La] Language:eng
[Ab] Abstract:In neonatal and early childhood surgeries such as meningomyelocele repairs, closing deep wounds and oncological treatment, tensor fasciae lata (TFL) flaps are used. However, there are not enough data about structural properties of TFL in fetuses, which can be considered as the closest to neonates in terms of sampling. This study's main objective is to gather data about morphological structures of TFL in human fetuses to be used in newborn surgery. Fifty formalin-fixed fetuses (24 Male - 26 Female) with gestational age ranging from 18 - 30 weeks (mean 22.94±3.23 weeks) were included in the study. TFL samples were obtained by bilateral dissection and then surface area, width and length parameters were recorded. Digital calipers were used for length and width measurements whereas surface area was calculated using digital image analysis software. No statistically significant differences were found in terms of numerical value of parameters between sides and sexes (p>0.05). Linear functions for TFL surface area, width, anterior and posterior margin lengths were calculated as y = -225.652 + 14.417 x Age (weeks), y = -5.571 + 0.595 x Age (weeks), y = -4.276 + 0.909 x Age (weeks) and y = -4.468 + 0.779 x Age (weeks), respectively. Linear functions for TFL surface area, width and lengths can be used in designing TFL flap dimensions in newborn surgery. In addition, using those described linear functions can also be beneficial in prediction of TFL flap dimensions both in autopsy studies.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180118
[Lr] Last revision date:180118
[St] Status:Publisher
[do] DOI:10.5603/FM.a2018.0007

  7 / 3996 MEDLINE  
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[PMID]: 29332115
[Au] Autor:Çevikkalp E; Erbüyün K; Erbüyün S; Ok G
[Ad] Address:Department of Anesthesiology and Reanimation, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey. E-mail. eralpcevikkalp@hotmail.com.
[Ti] Title:Ultrasound guided transversus abdominis plane block. Postoperative analgesia in children with spinal dysraphism.
[So] Source:Saudi Med J;39(1):92-96, 2018 Jan.
[Is] ISSN:0379-5284
[Cp] Country of publication:Saudi Arabia
[La] Language:eng
[Ab] Abstract:Pediatric regional anesthesia is widely used to relieve postoperative pain after abdominal surgery. Commonly used techniques of regional anesthesia include lumbar epidural and caudal block. However, the use of central neuraxial blockade has limitations. It is contraindicated in patients with clotting abnormalities, spinal dysraphism with tethered cord syndrome, meningomyelocele, and following spinal surgery with instrumentation. Ultrasound guided transversus abdominis plane block is a new method of regional anesthesia that can be used in settings where central neuraxial blockade is contraindicated. In this study, we present 5 pediatric cases in which major abdominal surgery was performed but central neuraxial blockade could not be carried out due to spinal abnormalities.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180114
[Lr] Last revision date:180114
[St] Status:In-Process
[do] DOI:10.15537/smj.2018.1.20943

  8 / 3996 MEDLINE  
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[PMID]: 29215525
[Au] Autor:Belfort MA; Whitehead WE; Bednov A; Shamshirsaz AA
[Ad] Address:Texas Children's Fetal Center and the Departments of Obstetrics and Gynecology and Neurosurgery, Baylor College of Medicine, Houston, Texas.
[Ti] Title:Low-Fidelity Simulator for the Standardized Training of Fetoscopic Meningomyelocele Repair.
[So] Source:Obstet Gynecol;131(1):125-129, 2018 Jan.
[Is] ISSN:1873-233X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Fetoscopic meningomyelocele repair in a gas-filled uterus is a new technique performed in very few centers. There are few opportunities as well as ethical prohibitions on the initial development and subsequent refinement of innovative fetal surgery techniques in humans, and using an animal model is both very expensive and logistically difficult. METHOD: We developed a low-fidelity endoscopic fetal surgery simulation using a plastic doll and pieces of chicken breast to simulate a fetal meningomyelocele, and a polyurethane ball to simulate a gas-filled uterus, along with a standard endoscopy system and instruments. EXPERIENCE: A unique two-port technique with significant differences from the standard laparoscopic surgery procedure was developed and refined through an iterative phase into a standardized methodology, and the simulator was then used to train three other teams to perform standardized fetoscopic meningomyelocele repair. CONCLUSION: A low-fidelity fetoscopic surgery simulator is a useful tool for developing new fetoscopic operations and for training multidisciplinary fetal surgery teams without the need for extensive use of an animal model. This simulator may be used to further explore the human uterus as a new surgical space for additional fetal surgeries.
[Mh] MeSH terms primary: Clinical Competence
Fetoscopy/education
Meningomyelocele/surgery
Neurosurgical Procedures/education
Simulation Training/methods
[Mh] MeSH terms secundary: Computer Simulation
Female
Fetoscopy/methods
Humans
Models, Anatomic
Neurosurgical Procedures/methods
Pregnancy
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180108
[Lr] Last revision date:180108
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:171208
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000002406

  9 / 3996 MEDLINE  
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[PMID]: 29292618
[Au] Autor:Shahar-Nissan K; Bilavsky E; Rajz G; Schonfeld T; Rom E
[Ad] Address:Department of Pediatrics C, Schneider Children's Medical Center of Israel, Petah Tikva.
[Ti] Title:[INSPIRATORY STRIDOR OF A NON-TRADITIONAL CAUSE].
[So] Source:Harefuah;156(12):783-785, 2017 Dec.
[Is] ISSN:0017-7768
[Cp] Country of publication:Israel
[La] Language:heb
[Ab] Abstract:INTRODUCTION: Stridor is a respiratory sound caused by turbulent air flow through narrow airways. The most common cause for acute inspiratory stridor is a viral infection of the upper airways, causing laryngotracheitis (Croup). Other common causes include an allergic reaction, foreign body aspiration and trauma. BACKGROUND: A nine week old infant with a history of meningomyelocele repair perinatally presented to the emergency room with alternating inspiratory stridor. The infant did not have a history of a recent febrile illness, and he did not suffer from cough or any other symptoms suggesting a foreign body aspiration. After the common causes of stridor were ruled out, an MRI was performed - demonstrating Chiari malformation Type 2, with herniation of the cerebellar tonsils and medullary compression. Bronchoscopy demonstrated the rare cause of the intermittent stridor - intermittent vocal cord paralysis, caused by the raised intracranial pressure and medullary compression. Due to rapid clinical deterioration, emergent surgical decompression was performed with complete recovery. CONCLUSIONS: This case report raises a rare and important cause of inspiratory stridor. Physicians should be alert to the symptoms suggesting a Chiari malformation in every child with a relevant medical history presenting with stridor. DISCUSSION: Intermittent stridor is mostly caused by an upper respiratory infection in a child with narrowed airways, allergic laryngotracheitis, or laryngomalacia. A less common cause of stidor of this kind is vocal cord paralysis, which may be caused by a symptomatic Chiari malformation.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180102
[Lr] Last revision date:180102
[St] Status:In-Process

  10 / 3996 MEDLINE  
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[PMID]: 29190654
[Au] Autor:Kancherla V; Ibne Hasan MOS; Hamid R; Paul L; Selhub J; Oakley G; Quamruzzaman Q; Mazumdar M
[Ad] Address:Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America.
[Ti] Title:Prenatal folic acid use associated with decreased risk of myelomeningocele: A case-control study offers further support for folic acid fortification in Bangladesh.
[So] Source:PLoS One;12(11):e0188726, 2017.
[Is] ISSN:1932-6203
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Neural tube defects contribute to severe morbidity and mortality in children and adults; however, they are largely preventable through maternal intake of folic acid before and during early pregnancy. We examined the association between maternal prenatal folic acid supplement intake and risk of myelomeningocele (a severe and common type of neural tube defect) in the offspring. We performed secondary analysis using data from a case-control study conducted at Dhaka Community Hospital, Bangladesh between April and November of 2013. Cases and controls included children with and without myelomeningocele, respectively, and their mothers. Cases were identified from local hospitals and rural health clinics served by Dhaka Community Hospital. Controls were selected from pregnancy registries located in the same region as the cases, and matched (1:1) to cases by age and sex. Myelomeningocele in the offspring was confirmed by a pediatrician with expertise in classifying neural tube defects. Maternal prenatal folic acid supplement intake was the main exposure of interest. We estimated crude and adjusted odds ratios (OR) and 95% confidence intervals (CI) using conditional logistic regression analysis. There were 53 pairs of matched cases and controls in our study. Overall, 51% of case mothers reported using folic acid supplements during pregnancy compared to 72% of control mothers (p = 0.03). Median plasma folate concentrations at the time of study visit were 2.79 ng/mL and 2.86 ng/mL among case and control mothers, respectively (p = 0.85). Maternal prenatal folic acid use significantly decreased the odds of myelomeningocele in the offspring (unadjusted OR = 0.42, 95% CI = 0.18-0.96). The association was slightly attenuated after adjusting for maternal age at the time of pregnancy (adjusted OR = 0.43, 95% CI = 0.18-1.02). Our study confirms the protective association between maternal prenatal folic acid supplement use and myelomeningocele among children born in Bangladesh. Our findings point to an overall low folic acid supplement use and low plasma folate concentrations among women of reproductive age in Bangladesh. Mandatory fortification of staple foods with folic acid can address low folate status among women of child-bearing age, and prevent child morbidity and mortality associated with myelomeningocele in Bangladesh.
[Mh] MeSH terms primary: Folic Acid/administration & dosage
Meningomyelocele/prevention & control
Prenatal Care
[Mh] MeSH terms secundary: Adolescent
Adult
Bangladesh
Case-Control Studies
Female
Humans
Infant, Newborn
Pregnancy
Risk Factors
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:935E97BOY8 (Folic Acid)
[Em] Entry month:1712
[Cu] Class update date: 171226
[Lr] Last revision date:171226
[Js] Journal subset:IM
[Da] Date of entry for processing:171201
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0188726


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