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[PMID]:28712519
[Au] Autor:Fullerton BS; Velazco CS; Sparks EA; Morrow KA; Edwards EM; Soll RF; Modi BP; Horbar JD; Jaksic T
[Ad] Endereço:Center for Advanced Intestinal Rehabilitation, Department of Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA. Electronic address: brenna.sullivan@childrens.harvard.edu.
[Ti] Título:Contemporary Outcomes of Infants with Gastroschisis in North America: A Multicenter Cohort Study.
[So] Source:J Pediatr;188:192-197.e6, 2017 Sep.
[Is] ISSN:1097-6833
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To quantify outcomes and analyze factors predictive of morbidity and mortality in infants with gastroschisis. STUDY DESIGN: Clinical data regarding neonates with gastroschisis born between 2009 and 2014 were prospectively collected at 175 North American centers. Multivariate regression was used to assess risk factors for mortality and length of stay (LOS). RESULTS: Gastroschisis was diagnosed in 4420 neonates with median birth weight 2410 g (IQR 2105-2747). Survival (discharge home or alive in hospital at 1 year) was 97.8% with a 37 day median LOS (IQR 27-59). Sepsis, defined by positive blood or cerebrospinal fluid culture, was the only significant independent predictor of mortality (P = .04). Significant independent determinants of LOS and the percentage of neonates affected were as follows: bowel resection (9.8%, P < .0001), sepsis (8.6%, P < .0001), presence of other congenital anomalies (7.6%, including 5.8% with intestinal atresias, P < .0001), necrotizing enterocolitis (4.5%, P < .0001), and small for gestational age (37.3%, P = .0006). Abdominal surgery in addition to gastroschisis repair occurred in 22.3%, with 6.4% receiving gastrostomy or jejunostomy tubes and 6.3% requiring ostomy creation. At discharge, 57.0% were less than the 10th percentile weight for age. The mode of delivery (52.4% cesarean delivery) was not associated with any differences in outcome. CONCLUSIONS: Although neonates with gastroschisis have excellent overall survival they remain at risk for death from sepsis, prolonged hospitalization, multiple abdominal operations, and malnutrition at discharge. Outcomes appear unaffected by the use of cesarean delivery. Further opportunities for quality improvement include sepsis prevention and enhanced nutritional support.
[Mh] Termos MeSH primário: Gastrosquise/epidemiologia
Gastrosquise/cirurgia
[Mh] Termos MeSH secundário: Estudos de Coortes
Anormalidades Congênitas/epidemiologia
Procedimentos Cirúrgicos do Sistema Digestório/estatística & dados numéricos
Enterocolite Necrosante/epidemiologia
Feminino
Gastrostomia/estatística & dados numéricos
Seres Humanos
Transtornos da Nutrição do Lactente/epidemiologia
Recém-Nascido
Recém-Nascido Pequeno para a Idade Gestacional
Atresia Intestinal/epidemiologia
Atresia Intestinal/cirurgia
Jejunostomia/estatística & dados numéricos
Tempo de Internação/estatística & dados numéricos
Masculino
América do Norte/epidemiologia
Fatores de Risco
Sepse/mortalidade
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170718
[St] Status:MEDLINE


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[PMID]:28555949
[Au] Autor:Biasutti S; Dart AJ; Dart CM; Uquillas E; Jeffcott LB
[Ad] Endereço:Research and Clinical Training Unit, Veterinary Teaching Hospital Camden, The University of Sydney, New South Wales, Australia.
[Ti] Título:End-to-side anastomosis of the left ventral colon to the small colon in a neonatal foal with segmental agenesis of the large colon.
[So] Source:Aust Vet J;95(6):217-219, 2017 Jun.
[Is] ISSN:1751-0813
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:CASE REPORT: A newborn foal was referred for evaluation because it had not passed meconium, despite the administration of four enemas. Abdominal radiographs and ultrasound scans showed generalised gaseous distension of the intestine and there was no observable meconium in the colon. Positive contrast colography showed contrast medium extending to the transverse colon. An exploratory laparotomy confirmed the absence of the left and right dorsal colon and the pelvic and diaphragmatic flexures. An end-to-side anastomosis of the left ventral colon to the midpoint of the small colon was performed. The foal recovered from anaesthesia and surgery uneventfully and immediately began suckling from the mare, with no signs of abdominal pain in the postoperative period. The foal began to pass soft faeces 3 days after surgery and at 6 months after surgery the foal was clinically normal and growing at a similar rate to its cohort. CONCLUSION: Intestinal atresia is a rare condition in foals, but should be considered as a differential diagnosis in foals that fail to pass meconium. Early recognition and surgical intervention can offer an improved chance of short-term survival in cases where there is adequate intestine to anastomose. An end-to-side anastomosis technique can be used where an end-to-end technique is not practical because of the difference in diameter of the proximal and distal intestinal segments.
[Mh] Termos MeSH primário: Colo/anormalidades
Doenças dos Cavalos/congênito
Atresia Intestinal/veterinária
[Mh] Termos MeSH secundário: Anastomose Cirúrgica/veterinária
Animais
Colo/cirurgia
Doenças dos Cavalos/diagnóstico por imagem
Doenças dos Cavalos/cirurgia
Cavalos
Atresia Intestinal/diagnóstico por imagem
Atresia Intestinal/cirurgia
Masculino
Mecônio
New South Wales
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171006
[Lr] Data última revisão:
171006
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170531
[St] Status:MEDLINE
[do] DOI:10.1111/avj.12591


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[PMID]:28534331
[Au] Autor:Chen H; Geng Q; Lu C; Jiang W; Zhang J; Lyu X; Li W; Li H; Tang W
[Ti] Título:[Application of bowel plication combined with early enteral nutrition in the enhanced recovery after surgery for neonates with jejunal atresia].
[So] Source:Zhonghua Wei Chang Wai Ke Za Zhi;20(5):535-539, 2017 May 25.
[Is] ISSN:1671-0274
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:OBJECTIVE: To evaluate the efficacy of bowel plication combined with early enteral nutrition (EEN) in the enhanced recovery after surgery(ERAS) of jejunal atresia (JA) neonates. METHODS: Between January 2005 and January 2014, 58 neonates with JA underwent surgical treatment in Children's Hospital of Nanjing Medical University. Their clinical data, including operation procedures, ages, birth weight, concomitant diseases, age at surgery, hospital stay, total parenteral nutrition (TPN), postoperative intestinal function recovery (the time to the first oral feeding and the time to oral feeding volume reaching 150 ml·kg ·d ), complications and reoperation, were retrospectively analyzed. RESULTS: According to the surgical procedures, the 58 neonates were divided into three groups: control group(18 cases, undergoing atretic segments resection and primary anastomosis), bowel plication group(19 cases, undergoing bowel plication after atretic segments resection and primary anastomosis) and bowel plication combined with EEN group (21 cases, undergoing bowel plication combined with EEN). No significant differences of ages, birth weight, age at operation, and concomitant diseases were found among 3 groups (all P>0.05). The time of hospital stay, the time to the first oral feeding, the time to oral feeding volume reaching 150 ml·kg ·d , and the time of TPN in bowel plication group were significantly shorter than those of control group [(19.3±4.4) d vs. (22.7±3.1) d, t=2.696, P=0.011; (9.8±3.3) d vs. (12.5±3.0) d, t=2.630, P=0.013; (18.5±4.1) d vs. (21.5±2.5) d, t=2.726, P=0.011; (13.1±2.9) d vs. (15.0±2.3) d, t=2.219, P=0.033]. However, above parameters of bowel plication combined with EEN group were significantly shorter than those of bowel plication group [(15.3±3.5) d vs. (19.3±4.4), t=4.120, P=0.003; (7.7±2.2) d vs. (9.8±3.3) d, t=2.428, P=0.020; (14.8±2.5) d vs. (18.5±4.1) d, t=3.752, P=0.001; (9.5±3.0) vs. (13.1±2.9) d, t=4.370, P=0.000]. CONCLUSION: The bowel plication combined with EEN contributes to the early use of intestinal function, shorten the time to the first oral feeding, and reduces the use of TPN, which can improve the recovery of jejunal atresia neonates.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos do Sistema Digestório/métodos
Nutrição Enteral/métodos
Atresia Intestinal/reabilitação
Atresia Intestinal/cirurgia
Jejuno/anormalidades
Jejuno/cirurgia
[Mh] Termos MeSH secundário: Anastomose Cirúrgica
Pesquisa Comparativa da Efetividade
Defecação
Seres Humanos
Recém-Nascido
Tempo de Internação
Nutrição Parenteral Total
Período Pós-Operatório
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170524
[St] Status:MEDLINE


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[PMID]:28234123
[Au] Autor:Nakayama DK
[Ad] Endereço:Department of Surgery, Florida International University, Sacred Heart Medical Group, Pensacola, Florida, USA.
[Ti] Título:The Development of Total Parenteral Nutrition.
[So] Source:Am Surg;83(1):36-38, 2017 Jan 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The first patient to receive complete nourishment of a patient by intravenous infusion independent of the alimentary tract was an infant girl born with near-total small bowel atresia. Total parenteral nutrition, the intravenous infusion of nutrients, has been attempted since Harvey's description of the circulatory system in the early 17th century. The modern era of parenteral nutrition began in the early 20th century, when infusions of glucose, plasma, and emulsified fat into humans proved feasible. Robert Elman, working in the 1930s and 1940s, demonstrated that carefully prepared protein hydrolysates could be safely infused intravenously and incorporated by the body. Stanley Dudrick and Douglas Wilmore, surgeon researchers at the University of Pennsylvania, worked through the many details of preparation, administration, and clinical monitoring in beagle puppies before testing them on adult patients malnourished from a variety of surgical complications and gastrointestinal conditions. They applied their techniques and formulations on a newborn wasting away from congenital absence of the small bowel, the baby growing and developing for several months while being nourished completely by total parenteral nutrition. Their techniques, inspired by patients with progressive malnutrition from devastating intestinal conditions and malformations, form the basis of the practice of intravenous nutrition practiced today.
[Mh] Termos MeSH primário: Desnutrição/história
Nutrição Parenteral Total/história
[Mh] Termos MeSH secundário: Adulto
Animais
Cães
Emulsões Gordurosas Intravenosas/efeitos adversos
Emulsões Gordurosas Intravenosas/história
Feminino
História do Século XVII
História do Século XIX
História do Século XX
Seres Humanos
Recém-Nascido
Atresia Intestinal/complicações
Atresia Intestinal/história
Desnutrição/terapia
Nutrição Parenteral Total/efeitos adversos
Philadelphia
[Pt] Tipo de publicação:BIOGRAPHY; HISTORICAL ARTICLE; JOURNAL ARTICLE
[Ps] Nome de pessoa como assunto:Dudrick S
[Nm] Nome de substância:
0 (Fat Emulsions, Intravenous)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170310
[Lr] Data última revisão:
170310
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170225
[St] Status:MEDLINE


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[PMID]:28225489
[Au] Autor:Hui L; Dai Y; Guo Z; Zhang J; Zheng F; Bian X; Wu Z; Jiang Q; Guo M; Ma K; Zhang J
[Ad] Endereço:aDepartment of Pediatrics, Shanghai 6th People's East Hospital, Jiao Tong University, Pudong Nanhui New City bDepartment of Neonatology, Children's Hospital of Fudan University cEmergency Department, Shanghai 6th People's East Hospital, Jiao Tong University, Pudong Nanhui New City, Shanghai, China.
[Ti] Título:Immunoregulation effects of different γδT cells and toll-like receptor signaling pathways in neonatal necrotizing enterocolitis.
[So] Source:Medicine (Baltimore);96(8):e6077, 2017 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of the study was to observe cytokine and T-cell-related toll-like-receptor (TLR) changes in intestinal samples of neonatal necrotizing enterocolitis patients.Four necrotic bowels were collected from neonatal NEC patients with gestational ages of 28 to 29 weeks in our hospital, whereas 4 neonatal patients who underwent intestinal atresia surgery served as the controls. Intestinal flora was examined and IL-1, IL-2, IL-4, IL-6, IL-8, IL-10, TNF-α, IFN-γ, and IL-17 expressions in resected intestine samples, as well as in isolated gamma delta T (γδT) cells, were analyzed immunohistochemically and via quantitative RT-PCR. γδT cells were isolated from the intestinal intraepithelial lymphocytes (IELs) and their TLR4/TLR9 distribution in the intestinal tissues was determined by flow cytometry.The bacterial flora of the neonatal NEC patients' contained significantly higher amounts of Gram-negative Enterobacteriaceae, Klebsiella, and Bacteroides but anaerobic Gram-positive Bifidobacteria occurred significantly less in the NEC than the control group. IL-1, IL-2, IL-4, IL-6, IL-8, IL-10, TNF-α, IFN-γ, and IL-17 expressions in the resected intestine samples and in isolated γδT cells were enhanced in NEC samples compared to the controls. γδT cells were less prevalent in NEC-derived intestinal tissues, but their TLR4/TLR9 expressions were significantly enhanced.The changed bacterial flora in preterm neonatal NEC patients led to an obvious inflammation of the intestines, which was accompanied by reductions of γδT cell localizations to the intestine and a shift of their surface expressions to TLR4 and TLR9.
[Mh] Termos MeSH primário: Enterocolite Necrosante/imunologia
Receptores de Antígenos de Linfócitos T gama-delta
Subpopulações de Linfócitos T/imunologia
Subpopulações de Linfócitos T/metabolismo
Receptor 4 Toll-Like/metabolismo
Receptor Toll-Like 9/metabolismo
[Mh] Termos MeSH secundário: Bactérias/isolamento & purificação
Enterocolite Necrosante/microbiologia
Enterocolite Necrosante/patologia
Enterocolite Necrosante/cirurgia
Citometria de Fluxo
Seres Humanos
Imuno-Histoquímica
Recém-Nascido
Interferon gama/metabolismo
Interleucinas/metabolismo
Atresia Intestinal/imunologia
Atresia Intestinal/microbiologia
Atresia Intestinal/patologia
Atresia Intestinal/cirurgia
Intestino Grosso/imunologia
Intestino Grosso/microbiologia
Intestino Grosso/patologia
Intestino Grosso/cirurgia
Intestino Delgado/imunologia
Intestino Delgado/microbiologia
Intestino Delgado/patologia
Intestino Delgado/cirurgia
Reação em Cadeia da Polimerase
Fator de Necrose Tumoral alfa/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (IFNG protein, human); 0 (Interleukins); 0 (Receptors, Antigen, T-Cell, gamma-delta); 0 (TLR4 protein, human); 0 (TLR9 protein, human); 0 (Toll-Like Receptor 4); 0 (Toll-Like Receptor 9); 0 (Tumor Necrosis Factor-alpha); 82115-62-6 (Interferon-gamma)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170317
[Lr] Data última revisão:
170317
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170223
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000006077


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[PMID]:28166972
[Au] Autor:Romano JE; Pinedo P; Bryan K; Ramos RS; Solano KG; Merchan D; Velez J
[Ad] Endereço:Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA. Electronic address: jromano@cvm.tamu.edu.
[Ti] Título:Comparison between allantochorion membrane and amniotic sac detection by per rectal palpation for pregnancy diagnosis on pregnancy loss, calving rates, and abnormalities in newborn calves.
[So] Source:Theriogenology;90:219-227, 2017 Mar 01.
[Is] ISSN:1879-3231
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The objectives of the present investigation were to evaluate the pregnancy diagnosis by detection of either the allantochorion membrane (FMS) or amniotic sac (ASP) by per rectum palpation (PRP) during late embryonic or early fetal period on pregnancy loss (PRL) at reexamination, calving rates, and abnormalities in newborn calves. A controlled randomized blind design with 800 lactating dairy pregnant cows diagnosed by transrectal ultrasonography (TRUS) between Days 35 and 57 of gestation from one dairy farm were included. The cows were randomly divided according to detection of allantochorion membrane (FMS group; n = 264), detection of amniotic sac (ASP group; n = 266), and TRUS (control [CON] group; n = 270). TRUS was considered as the criterion standard method of comparison. The entire PRP was performed by one experienced veterinarian. Then, all the cows were reexamined only by TRUS between 2 and 4 weeks later by two independent veterinarians to assess PRL. The calving rate one (number of cows calved divided by the number of cows initially pregnant) and calving rate two (number of cows calved divided by the number of cows pregnant at reexamination) for each group was calculated. All abortions and stillborns were necropsied, and calves alive were followed for 5 days. The overall initial PRL (between initial pregnant cows and reexamination) for FMS, ASP, and CON groups was 7.4% (19/258), 8.8% (23/262), and 9.2% (24/260), respectively (P = 0.75). The overall late PRL (between reexamination and calving) for FMS, ASP, and CON groups was 4.2% (9/213), 5.7% (12/209), and 4.2% (9/216), respectively (P = 0.71). The calving rate one for FMS, ASP, and TRUS groups was 79.1% (204/258), 75.2% (197/262), and 79.6% (207/260), respectively (P = 0.63). The calving rate two for the same groups was 85.4% (204/239), 82.4% (197/239), and 87.7% (207/236), respectively (P = 0.27). The number of fetuses aborted late, premature, and mature dead from FMS, ASP, and CON groups was 6, 4, and 5, respectively (P = 0.85), and no abnormalities at necropsy were detected. One stillborn male calf with atresia coli after 281 days of gestation from a cow examined by ASP at Day 51 was diagnosed. It was concluded that the use of either FMS or ASP for pregnancy diagnosis during late embryonic or early fetal period did not increase the PRL, affect calving rates, or produce calves with congenital abnormalities.
[Mh] Termos MeSH primário: Aborto Animal/diagnóstico
Doenças dos Bovinos/diagnóstico
Bovinos/anormalidades
Exame Retal Digital/veterinária
[Mh] Termos MeSH secundário: Animais
Animais Recém-Nascidos
Coeficiente de Natalidade
Exame Retal Digital/efeitos adversos
Feminino
Atresia Intestinal/veterinária
Masculino
Gravidez
Testes de Gravidez/veterinária
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170208
[St] Status:MEDLINE


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[PMID]:28116474
[Au] Autor:Rubio EI; Blask AR; Badillo AT; Bulas DI
[Ad] Endereço:Division of Diagnostic Imaging and Radiology, Children's National Medical System, 111 Michigan Ave. NW, Washington, DC, 20010, USA. rubioeva@yahoo.com.
[Ti] Título:Prenatal magnetic resonance and ultrasonographic findings in small-bowel obstruction: imaging clues and postnatal outcomes.
[So] Source:Pediatr Radiol;47(4):411-421, 2017 Apr.
[Is] ISSN:1432-1998
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Prenatal small-bowel obstruction can result from single or multiple atresias, and it can be an isolated abnormality or part of a syndrome. It is sometimes the first manifestation of cystic fibrosis. Accurate prediction of the level of obstruction and length of bowel affected can be difficult, presenting a challenge for counseling families and planning perinatal management. OBJECTIVE: To review the prenatal US and MRI findings of small-bowel obstruction and to assess whether fetal MRI adds information that could improve prenatal counseling and perinatal management. MATERIALS AND METHODS: We retrospectively reviewed 12 prenatally diagnosed cases of small-bowel obstruction evaluated by both US and MRI from 2005 to 2015. We analyzed gestational age at evaluation, US and MRI findings, gestational age at delivery and postnatal outcomes. RESULTS: The final diagnoses were jejunal atresia (7), ileal atresia (1), cystic fibrosis (3) and combined jejunal and anal atresia (1). Four of the eight with jejunal atresia were found to have multiple small-bowel atresias. Prenatal perforation was noted in three. We identified a trend of increasing complexity of bowel contents corresponding to progressively distal level of obstruction, as indicated by increasing US echogenicity and high T1 signal on MRI. Seven cases of jejunal atresia and one case of ileal atresia demonstrated small ascending, transverse and descending colon (microcolon) with filling of a normal-diameter rectum. In contrast, all three fetuses with cystic fibrosis and the fetus with jejunal-anal atresia demonstrated microcolon as well as abnormal paucity or absence of rectal meconium. Polyhydramnios was present in nine. Eight were delivered prematurely, of whom seven had polyhydramnios. The fetus with jejunal and anal atresia died in utero. Postnatally, three had short gut syndrome, all resulting from multiple jejunal atresias; these three were among a subset of four fetuses whose bowel diameter measured more than 3 cm. Eight infants had no further gastrointestinal complications. The presence of multiple atresias was not predicted by prenatal US or MRI. CONCLUSION: MR provides useful additional information regarding meconium distribution in the small bowel, which helps to clarify the level of obstruction. MR was additionally useful in the assessment of colon and rectal contents, serving as a fetal enema. Abnormally diminished meconium in the rectum suggests cystic fibrosis or combined small-bowel and colonic obstruction, information that is useful in counseling and preparing for postnatal care.
[Mh] Termos MeSH primário: Atresia Intestinal/diagnóstico por imagem
Obstrução Intestinal/diagnóstico por imagem
Intestino Delgado/anormalidades
Imagem por Ressonância Magnética/métodos
Diagnóstico Pré-Natal/métodos
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Intestino Delgado/diagnóstico por imagem
Masculino
Ultrassonografia Pré-Natal/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170125
[St] Status:MEDLINE
[do] DOI:10.1007/s00247-016-3770-0


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[PMID]:27890332
[Au] Autor:Erickson T; Vana PG; Blanco BA; Brownlee SA; Paddock HN; Kuo PC; Kothari AN
[Ad] Endereço:Loyola University Medical Center, One:MAP Division of Clinical Informatics and Analytics, Maywood, IL, USA.
[Ti] Título:Impact of hospital transfer on surgical outcomes of intestinal atresia.
[So] Source:Am J Surg;213(3):516-520, 2017 Mar.
[Is] ISSN:1879-1883
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Examine effects of hospital transfer into a quaternary care center on surgical outcomes of intestinal atresia. METHODS: Children <1 yo principally diagnosed with intestinal atresia were identified using the Kids' Inpatient Database (2012). Exposure variable was patient transfer status. Outcomes measured were inpatient mortality, hospital length of stay (LOS) and discharge status. Linearized standard errors, design-based F tests, and multivariable logistic regression were performed. RESULTS: 1672 weighted discharges represented a national cohort. The highest income group and those with private insurance had significantly lower odds of transfer (OR:0.53 and 0.74, p < 0.05). Rural patients had significantly higher transfer rates (OR: 2.73, p < 0.05). Multivariate analysis revealed no difference in mortality (OR:0.71, p = 0.464) or non-home discharge (OR: 0.79, p = 0.166), but showed prolonged LOS (OR:1.79, p < 0.05) amongst transferred patients. CONCLUSIONS: Significant differences in hospital LOS and treatment access reveal a potential healthcare gap. Post-acute care resources should be improved for transferred patients.
[Mh] Termos MeSH primário: Atresia Intestinal/mortalidade
Atresia Intestinal/cirurgia
Transferência de Pacientes
[Mh] Termos MeSH secundário: Feminino
Mortalidade Hospitalar
Seres Humanos
Renda
Lactente
Seguro Saúde
Tempo de Internação/estatística & dados numéricos
Masculino
Análise Multivariada
Setor Privado
População Rural
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170417
[Lr] Data última revisão:
170417
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161129
[St] Status:MEDLINE


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[PMID]:27023781
[Au] Autor:Goruppi I; Arévalo S; Gander R; Molino JA; Oria M; Carreras E; Peiro JL
[Ad] Endereço:a Pediatric Surgery Department , and.
[Ti] Título:Role of intraluminal bowel echogenicity on prenatal ultrasounds to determine the anatomical level of intestinal atresia.
[So] Source:J Matern Fetal Neonatal Med;30(1):103-108, 2017 Jan.
[Is] ISSN:1476-4954
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate the correlation between different degrees of bowel intraluminal echogenicity showed by prenatal ultrasounds and the anatomic level of intestinal atresia. METHODS: We report three cases of intestinal atresia at different intestinal levels verified during the neonatal surgery with specific ultrasonographic prenatal features. Intensity of sonolucency was analyzed using the image-processing program ImageJ for quantitative measurements based on the gray-scale intensity values. RESULTS: A total of three cases are reported, a jejunal, an ileal and a colonic atresia. All cases showed intestinal dilatation. Both, jejunal and ileal atresia, showed two degrees of hypoechoic intestinal content, while colonic atresia showed hyperechogenic content dilated loop at prenatal ultrasound scan. CONCLUSIONS: We propose the use of prenatal ultrasounds echogenicity of intestinal dilated loop fluid content to help in determining the level of obstruction in bowel atresia. These are initial results, to be confirmed by a multicentric research with more cases.
[Mh] Termos MeSH primário: Colo/anormalidades
Atresia Intestinal/diagnóstico por imagem
Intestino Delgado/anormalidades
Ultrassonografia Pré-Natal/métodos
[Mh] Termos MeSH secundário: Adulto
Colo/diagnóstico por imagem
Feminino
Seres Humanos
Recém-Nascido
Intestino Delgado/diagnóstico por imagem
Masculino
Gravidez
Estudos Retrospectivos
Ultrassonografia Doppler
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170609
[Lr] Data última revisão:
170609
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160330
[St] Status:MEDLINE


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[PMID]:28003230
[Au] Autor:Chouikh T; Mottet N; Cabrol C; Chaussy Y
[Ad] Endereço:Department of Chirurgie Pédiatrique, Centre Hospitalier Regional Universitaire de Besançon, Besançon, France.
[Ti] Título:Prenatal intestinal volvulus: look for cystic fibrosis.
[So] Source:BMJ Case Rep;2016, 2016 Dec 21.
[Is] ISSN:1757-790X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Intestinal volvulus is a life-threatening emergency requiring prompt surgical management. Prenatal intestinal volvulus is rare, and most are secondary to intestinal atresia, mesenteric defect or without any underlying cause. Cystic fibrosis (CF) is known to cause digestive tract disorders. After birth, 10-15% of newborns with CF may develop intestinal obstruction within a few days of birth because of meconial ileus. This obstruction is a result of dehydrated thickened meconium obstructing the intestinal lumen. We report two cases of fetuses with prenatal diagnosis of segmental volvulus in whom CF was diagnosed.
[Mh] Termos MeSH primário: Fibrose Cística/complicações
Doenças Fetais/diagnóstico por imagem
Doenças do Íleo/diagnóstico por imagem
Volvo Intestinal/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adulto
Anastomose Cirúrgica
Cesárea
Feminino
Doenças Fetais/etiologia
Seres Humanos
Doenças do Íleo/etiologia
Recém-Nascido
Atresia Intestinal/cirurgia
Perfuração Intestinal/cirurgia
Volvo Intestinal/etiologia
Masculino
Mecônio
Pneumoperitônio/diagnóstico por imagem
Gravidez
Radiografia
Resultado do Tratamento
Ultrassonografia Pré-Natal
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170306
[Lr] Data última revisão:
170306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161223
[St] Status:MEDLINE



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