Migration of Umbilical Venous Catheters

2019 ◽  
Vol 36 (13) ◽  
pp. 1377-1381
Author(s):  
Anneloes M. Plooij-Lusthusz ◽  
Nick van Vreeswijk ◽  
Margriet van Stuijvenberg ◽  
Arend F. Bos ◽  
Elisabeth M. W. Kooi
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Primary Outcome ◽  
Complication Rates ◽  
Correct Position ◽  
X Ray ◽  
Correct Placement ◽  
Initial Placement ◽  
The Right

Objective Migration of umbilical venous catheters (UVCs) after initial correct position has been described. The aim of this study was to assess the incidence of malposition of the tip of the UVCs at 24 to 36 hours postinsertion. Study Design Retrospective analysis of all neonates who had UVC placement in a 14-month period. The primary outcome was the rate of UVCs incorrectly positioned 24 to 36 hours after initial correct placement, defined as the UVC tip below or more than 5 mm above the level of the right diaphragm on a thoracoabdominal X-ray. Results We included 86 neonates with a median (range) birth weight of 1,617 (535–5,000) grams, and gestational age of 31 (24–42) weeks. Of the 80 UVCs that were further analyzed, only in 38 (48%) of 80 patients, the tip of the UVC still had a correct position 24 to 36 hours after initial placement. In 22 (28%) of 80 patients, the UVCs had a position that was too high and in 20 (25%) that was too low. Conclusion More than half of UVCs migrated at 24 to 36 hours postinsertion to positions known to have higher complication rates. We, therefore, recommend follow-up evaluation at 24 to 36 hours postinsertion, to prevent complications from malposition.

scholarly journals Intracameral Bevacizumab Versus Sub-Tenon’s Mitomycin C as Adjuncts to Trabeculectomy: 3-Year Results of a Prospective Randomized Study

2021 ◽  
Vol 10 (10) ◽  
pp. 2054
Author(s):  
Gerasimos Kopsinis ◽  
Dimitrios Tsoukanas ◽  
Dimitra Kopsini ◽  
Theodoros Filippopoulos
Keyword(s):  
Mitomycin C ◽  
Primary Outcome ◽  
Randomized Study ◽  
Primary Outcome Measure ◽  
Complication Rates ◽  
Filtration Surgery ◽  
Significant Difference ◽  
Exfoliative Glaucoma

Conjunctival wound healing determines success after filtration surgery and the quest for better antifibrotic agents remains active. This study compares intracameral bevacizumab to sub-Tenon’s mitomycin C (MMC) in trabeculectomy. Primary open-angle or exfoliative glaucoma patients were randomized to either bevacizumab (n = 50 eyes) or MMC (n = 50 eyes). The primary outcome measure was complete success, defined as Intraocular Pressure (IOP) > 5 mmHg and ≤ 21 mmHg with a minimum 20% reduction from baseline without medications. Average IOP and glaucoma medications decreased significantly in both groups at all follow-up points compared to baseline (p < 0.001), without significant difference between groups at 3 years (IOP: bevacizumab group from 29 ± 9.4 to 15 ± 3.4 mmHg, MMC group from 28.3 ± 8.7 to 15.4 ± 3.8 mmHg, p = 0.60; Medications: bevacizumab group from 3.5 ± 0.9 to 0.5 ± 1, MMC group from 3.6 ± 0.7 to 0.6 ± 1.1, p = 0.70). Complete success, although similar between groups at 3 years (66% vs. 64%), was significantly higher for bevacizumab at months 6 and 12 (96% vs. 82%, p = 0.03; 88% vs. 72%, p = 0.04, respectively) with fewer patients requiring medications at months 6, 9 and 12 (4% vs. 18%, p = 0.03; 6% vs. 20%, p = 0.04; 8% vs. 24%, p = 0.03, respectively). Complication rates were similar between groups. In conclusion, intracameral bevacizumab appears to provide similar long-term efficacy and safety results as sub-Tenon’s MMC after trabeculectomy.

Developmental and Neurologic Sequelae of Neonatal Hyperviscosity Syndrome

PEDIATRICS ◽  
1982 ◽  
Vol 69 (4) ◽  
pp. 426-431
Author(s):  
Virginia D. Black ◽  
Lula O. Lubchenco ◽  
Dennis W. Luckey ◽  
Beverly L. Koops ◽  
Gail A. McGuinness ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Apgar Scores ◽  
Hyperviscosity Syndrome ◽  
Control Subjects ◽  
Poor Outcome ◽  
Follow Up Studies ◽  
Neurologic Sequelae

One hundred eleven consecutive infants with neonatal hyperviscosity were identified by screening all newborns for polycythemia in an 18-month period. These polycythemic infants were matched with nonpolycythemic newborns for birth weight, gestational age, Apgar scores, and sex. Maternal, intrapartum, and neonatal data were analyzed for associated morbidity. Maternal preeclampsia was more common among the hyperviscous patients than among control subjects. Hypoglycemia was also significantly increased among the hyperviscous patients. Follow-up studies at 1 to 3 years of age revealed a significantly higher incidence (38% vs 11%) of motor and neurologic abnormalities in the infants with neonatal hyperviscosity. The data suggested that concurrent hypoglycemia increased the risk of a poor outcome in hyperviscous infants inasmuch as 55% of infants with both characteristics were abnormal at follow-up. This, however, was not significantly different from the outcome of infants with hyperviscosity alone (P &gt; .05 but &lt; .1). Further studies will be needed to confirm or deny this relationship.

scholarly journals Birth weight for gestational age, recovery of growth and anthropometric profile of pre-school children born full term: a follow-up study

2021 ◽  
Vol 27 (1) ◽  
pp. 26-31
Author(s):  
Louise P.M. Cunha ◽  
Ana Cecília Santiago ◽  
Thaís Florence ◽  
Mariana Costa ◽  
Sandra Valois ◽  
...  
Keyword(s):  
Birth Weight ◽  
School Children ◽  
Gestational Age ◽  
Full Term ◽  
Follow Up Study ◽  
Anthropometric Profile

scholarly journals Leisure-Time Physical Activity in Pregnancy and the Birth Weight Distribution: Where Is the Effect?

2012 ◽  
Vol 9 (8) ◽  
pp. 1168-1177 ◽  
Author(s):  
Lanay M. Mudd ◽  
Jim Pivarnik ◽  
Claudia B. Holzman ◽  
Nigel Paneth ◽  
Karin Pfeiffer ◽  
...  
Keyword(s):  
Physical Activity ◽  
Birth Weight ◽  
Quantile Regression ◽  
Gestational Age ◽  
Weight Distribution ◽  
Leisure Time ◽  
Leisure Time Physical Activity ◽  
Large For Gestational Age ◽  
Birth Weight Distribution

Background:Leisure-time physical activity (LTPA) is recommended during pregnancy and has been associated with lower risk of delivering a large infant. We sought to characterize the effect of LTPA across the entire birth weight distribution.Methods:Women enrolled in the Pregnancy Outcomes and Community Health (POUCH) Study (1998–2004) were followed-up in 2007. Follow-up efforts were extensive for a subcohort and minimal for the remainder (nonsubcohort). Thus, 596 subcohort and 418 nonsubcohort women who delivered at term participated. Offspring were categorized as small-, appropriate-, or large-for-gestational-age (SGA, AGA, and LGA, respectively) based on gender and gestational age-specific birth weight z-scores (BWz). At follow-up, women recalled pregnancy LTPA and were classified as inactive, insufficiently active or meeting LTPA recommendations. Linear, logistic, and quantile regression analyses were conducted separately by subcohort status.Results:Meeting LTPA recommendations decreased odds of LGA significantly among the nonsubcohort (aOR = 0.30, 95% CI: 0.14–0.64) and nonsignificantly among the subcohort (aOR = 0.68, 95% CI: 0.34–1.34). In quantile regression, meeting LTPA recommendations reduced BWz among the upper quantiles in the nonsubcohort.Conclusions:LTPA during pregnancy lowered odds of LGA and reduced BWz among the upper quantiles, without shifting the entire distribution. LTPA during pregnancy may be useful for reducing risks of large fetal size.

First-Stage Long Buccal Mucosal Graft (BMG) Urethroplasty on Adult Failed Hypospadia Surgery Repair: Our Initial Experience

2018 ◽  
Vol 24 (8) ◽  
pp. 6151-6154
Author(s):  
Adistra Imam Satjakoesoemah ◽  
Prahara Yuri ◽  
Yonas Hutasoit
Keyword(s):  
External Genitalia ◽  
Complication Rates ◽  
Initial Experience ◽  
Long Term Outcomes ◽  
Penile Shaft ◽  
Buccal Mucosal Graft ◽  
Male External Genitalia ◽  
The Right

Hypospadia is one of the most common congenital anomalies of male external genitalia and the only proper management for most cases is repair surgery. Nevertheless, initial hypospadia repair could end up failed, followed by subsequent various complications. BMG has gain popularity due to its good long-term outcomes and favourable complication rates, especially for residual hypospadia. A 24-year-old male came to our outpatient department complaining his urethral orificium was located on the penile shaft since birth. He had a previous hypospadia repair surgery conducted by non-urologist surgeon at the age of seven. Several months after the repair surgery, his penis slightly rotated to the right side and urine remain came out through the hole on his ventral penile shaft. We performed first-stage inlay BMG urethroplasty using a long (6×1 cm) and short (2×1 cm) graft patch. The graft patches were quilted in proximal-distally fashion rather than side-by-side. No scarring or contracture on the neourethral plate was noted during two months of follow-up. We have successfully performed our initial experience on first-stage inlay BMG urethroplasty using a long and short graft patch. Within two months, the graft were completely take without any complications. The second-stage urethroplasty, consisting of tubularization and glansplasty will be performed 6 months after the first procedure.

scholarly journals Diabetes during Pregnancy Does Not Alter Whole Body Bone Mineral Content in Infants

1997 ◽  
Vol 82 (12) ◽  
pp. 3993-3997 ◽  
Author(s):  
Alexandre Lapillonne ◽  
Sophie Guerin ◽  
Pierre Braillon ◽  
Olivier Claris ◽  
Pierre D. Delmas ◽  
...  
Keyword(s):  
Birth Weight ◽  
Bone Mineral Content ◽  
Bone Mineral ◽  
Fat Mass ◽  
Gestational Age ◽  
Mineral Content ◽  
Whole Body ◽  
X Ray ◽  
Diabetic Mothers ◽  
Body Bone

A previous study using single photon absorptiometry has reported low bone mineral density of the radius in infants of diabetic mothers. The aim of this study was to assess by dual x-ray absorptiometry the whole body bone mineral content (WbBMC) and the body composition of 40 infants of diabetic mothers at birth (mean gestational age ± sd, 37.5 ± 1.3 weeks; mean birth weight ± sd, 3815 ± 641 g). WbBMC was not correlated with gestational age, but was well correlated with birth weight (r = 0.73; P = 0.0001) and also with fat mass (r = 0.87; P = 0.0001) and lean mass (r = 0.42; P = 0.008). The z-scores ± sd adjusted for weight for WbBMC and fat mass were significantly increased (1.3 ± 0.9 and 2.6 ± 1.3, respectively (P &lt; 0.0001), but were not significantly influenced either by in utero growth or by the type of the diabetes mellitus of the mother. Bone mineralization and fat mass studied by whole body dual x-ray absorptiometry are increased at birth in these infants compared with reference curves.

scholarly journals GROWTH, NEURODEVELOPMENT IN EXTREMELY LOWBIRTH BABIES AT TWO YEAR OF CORRECTED AGE

2019 ◽  
Vol 3 (5) ◽  
Author(s):  
Dr. Ashok Kumar ◽  
Dr. Kanya Mukhopadhyay ◽  
Dr. Prabhjot Malhi ◽  
Dr. Anil Kumar Bhalla
Keyword(s):  
Birth Weight ◽  
Neurological Examination ◽  
Gestational Age ◽  
Head Circumference ◽  
Control Group ◽  
Case Group ◽  
Significant Difference ◽  
Catch Up

According to national neonatal perinatal data (NNPD) the survival of ELBW babies has improved from 37% in 2000 to 45% in 2002-3 reports. In our neonatal unit in PGIMER the survival of ELBW babies has been 54-56% in last 5 years, however unfortunately there is very scanty reports of long term outcome of ELBW babies from India. There is very scanty report of long term growth outcome of VLBW and ELBW Babies in our country, we reported VLBW and ELBW babies in our follow up had poor catch up growth, though some catch-up was observed at 6 month but subsequent lag in growth probably reflects poor weaning at 1 year.  Infants with extremely low birth weights (ELBWs) are more susceptible to all of the possible complications of premature birth, both in the immediate neonatal period and after discharge from the nursery. These babies are at risk of poor growth and developmental. in the present study a total of 39 cases of ELBW Babies were enrolled during one year study period from July 2011- June2012 attending the neonatal follow up clinic attained 2year±3month of corrected age. Their detail birth data and postnatal illnesses retrieved from their initial hospital files and unit discharge record. A similar number of babies enrolled at 2yrs±3months of age in the control group. In the presence study, we assessed the growth, and neurological out come in extremely low birth baby attained 2yrs±3 months of corrected age. The study population consisted of 39 children of ELBW baby born during 2009 -10 at PGIMER & same number of normal birth weight children at 2yr±3 months of corrected age who satisfied the inclusion and exclusion criteria. These children were enrolled from neonatal follow up clinic who were already undergoing long term follow up. For growth outcome, we used weight, height & head circumference measurement of child, for neurological and developmental outcome used clinical neurological examination and DP-III .Base line demographic characteristics of our ELBW babies (Cases) where as follows.   Mean (S.D) gestational age of  ELBW babies was 29.87±2.3 week. Mean (S.D) birth weight 867±71.1 grams, Mean (S.D) lenght35±2.1cm & head circumference was 25.76±1.9 cm. Mean hospital stay in the ELBW babies was 48.6±19.9 days. Mean birth weight and gestational age of control group where 2684±166.2grm and 39.03±0.9 weeks. At 2year of corrected age we found  - Weight was similar in both in case group & control group. (10.04±1.4 Vs 10.75±1.1). Height and head circumference were smaller in cases than control group. (81.4±4.3 Vs 84.4±3.3 and 45.9±1.6 Vs 46.8±1.5. 5% Babies had cerebral palsy in case group (N=2/39) and none in control group. Gross development score(GDS) in Development profile-III in both study group (cases & controls) was  similar  (72.49±8.08 Vs 73.54±9.3,p=0.596). Significant difference in domains physical (84.5±7.8 Vs.90±3.5, p=0.000) and domains adaptive (81±6.7 Vs. 85.3±5.4,p= 0.003) in cases as compared to controls. There was no difference between SGA and AGA among cases in growth and neurological development. There was no difference between male and female in case group in any parameter .There is very scanty data from our country on longterm follow up of ELBW babies. Our data shows that our ELBW cohort remained small in height and had smaller head circumference though weight was similar as compared to normal control babies.  Key words: ELBW, VLBW, birth weight, neurological examination.

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