Efficacy Evaluation of Amniotic Membrane in the Treatment of Neonatal Extravasation: a Pilot Study

Abstract Intravenous treatment exposes the neonates to extravasation due to fragile and small veins and the long period required for treatment. Extravasation is leakage of fluids, nutrition, or drugs from a peripheral intravenous which could cause tissue damage. The injured complications range from local irritation to skin necrosis and severe scar formation after the healing. Several methods have been used to control the complications of extravasation. We used an Amniotic membrane, a biological dressing, for healing the wounds. Our object in this study is to examine whether the amniotic membrane can induce healing wounds following extravasations.This prospective 13-week single-arm clinical trial study was performed on five neonates from February 2020 till May 2021 in the children's medical center of Tehran University. Neonates with any gestational age and diagnosis of the wound due to extravasation entered our study. Neonates with skin disorders and wound stages of 1 and 2 were excluded from the study. Established wounds without necrosis and infection are treated with an amniotic membrane. The amniotic membrane covers the wound, and after 48 hours, the wound is rechecked. The sequence of replacing or removing the bandages is five to seven days until healing occurs.An amniotic membrane was applied to the wounds and the average time for healing was 2.5 weeks. The average gestational age was 33.6 weeks. We did not report any adverse reaction, and healing was without scar formation.Implementing an amniotic membrane for treating wounds due to Extravasation can be a new approach. This treatment route decreases graft requirement and can be implemented by expert nurses, so in remote NICUs, its usage is easy.

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Evaluation efficacy of amniotic membrane in the treatment of neonatal Extravasation: a pilot study

10.21203/rs.3.rs-869349/v1 ◽

2021 ◽

Author(s):

Maliheh Kadivar ◽

maryam amini ◽

maryam afshani ◽

Seyed ali hashemi nasrabadi ◽

kayvan mirnia

Keyword(s):

Amniotic Membrane ◽

Gestational Age ◽

Medical Center ◽

Scar Formation ◽

Related Factors ◽

New Approach ◽

Intravenous Treatment ◽

Expert Nurses ◽

Healing Wounds ◽

Material Volume

Abstract Introduction: Intravenous treatment exposes the neonates to Extravasation due to Fragile and small veins and the long period required for treatment. Extravasation is leakage of fluids, nutrition, or drugs from a peripheral intravenous which could cause tissue damage. Based on extravasated material, volume, and patient-related factors, the injured complications range from local irritation to skin necrosis and severe scar formation after the healing. Several methods have been used to control the complications of Extravasation. We used an Amniotic membrane, a biological dressing, for healing the wounds. Our object in this study is to examine whether can the amniotic membrane induce healing wounds following extravasations. Methods: This prospective 13-week single-arm clinical trial study was performed on five neonates from February 2020 till May 2021 in the children's medical center of Tehran University. Neonates with any gestational age and with the diagnosis of the wound due to Extravasation entered our study. Neonates with skin disorders and wound stages of 1 and 2 were excluded from the study. Established Wounds without necrosis and infection are treated with an amniotic membrane. The amniotic membrane covers the wound, and After 48 hours, the wound is rechecked. Five days after the first bandage, the amniotic membrane is replaced with a new one, and the sequence of removing the bandages is five to seven days until healing occurs. Results: An amniotic membrane was applied to the wounds and the average time for healing was 2.5 weeks. The average gestational age was 33.6 weeks. We did not report any adverse reaction, and healing was without scar formation. Discussion/Conclusion: Implementing an amniotic membrane for treating wounds due to Extravasation can be a new approach. This treatment route decreases graft requirement and can be implemented by expert nurses, so in remote NICUs, its usage is easy.

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Analysis of Induced End-of-Life Failures in SRAM Through Nanoprobing

10.31399/asm.cp.istfa2018p0387 ◽

2018 ◽

Author(s):

Oberon Dixon-Luinenburg ◽

Jordan Fine

Keyword(s):

End Of Life ◽

Soft Errors ◽

Cause Analysis ◽

New Approach ◽

Performance Loss ◽

Root Cause ◽

Long Period ◽

Atomic Force ◽

Stress Resultant ◽

Voltage Stress

Abstract In this paper, we demonstrate a novel nanoprobing approach to establish cause-and-effect relationships between voltage stress and end-of-life performance loss and failure in SRAM cells. A Hyperion II Atomic Force nanoProber was used to examine degradation for five 6T cells on an Intel 14 nm processor. Ten minutes of asymmetrically applied stress at VDD=2 V was used to simulate a ‘0’ bit state held for a long period, subjecting each pullup and pulldown to either VDS or VGS stress. Resultant degradation caused read and hold margins to be reduced by 20% and 5% respectively for the ‘1’ state and 5% and 2% respectively for the ‘0’ state. ION was also reduced, for pulldown and pullup respectively, by 4.5% and 5.4% following VGS stress and 2.6% and 33.8% following VDS stress. Negative read margin failures, soft errors, and read time failures all become more prevalent with these aging symptoms whereas write stability is improved. This new approach enables highly specific root cause analysis and failure prediction for end-of-life in functional on-product SRAM.

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Perinatal Asphyxia Among Neonates Admitted Jimma Medical Center, Jimma, Ethiopia

Global Pediatric Health ◽

10.1177/2333794x20981304 ◽

2020 ◽

Vol 7 ◽

pp. 2333794X2098130

Author(s):

Ebissa Bayana Kebede ◽

Adugna Olani Akuma ◽

Yonas Biratu Tarfa

Keyword(s):

Gestational Age ◽

Medical Center ◽

Perinatal Asphyxia ◽

Mode Of Delivery ◽

Large For Gestational Age ◽

Systematic Sampling ◽

P Value ◽

Health Extension Workers ◽

Severe Problem ◽

Prolonged Labor

Background: Perinatal asphyxia is a severe problem which causes serious problem in neonates in developing countries. This study is aimed to determine magnitude of perinatal asphyxia and its associated factors. Methods: A cross-sectional study design was conducted among neonates admitted over a period of 4 years on 740 samples. Systematic sampling method was employed to get required samples from log book. Epi-data 3.1 is used for data entry and the entered data was exported to SPSS Version 23 for analysis. Bivariable and multiple variable logistic regressions analysis were applied to see the association between dependent and independent variables. Finally, P-value <.05 at 95% CI was declared statistically significant. Results: The main significant factor associated to perinatal asphyxia were prolonged labor ( P = .04, AOR = 1.68 95%CI: [1.00, 2.80]), being primipara ( P = .003, AOR = 2.06, 95%CI: [1.28, 3.30]), Small for Gestational Age (SGA) ( P = .001, AOR = 4.35, 95%CI: [1.85, 10.19]), Large for Gestational Age ( P = .001, AOR = 16.75, 95%CI: [3.82, 73.33]) and mode of delivery. Conclusion: The magnitude of perinatal asphyxia was 18%. Prolonged labor, parity, birth size, mode of delivery, and APGAR score at 1st minute were significantly associated with perinatal asphyxia. So, Nurses, Midwives, Medical Doctors, and health extension workers have to engage and contribute to on how to decrease the magnitude of perinatal asphyxia.

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Human amniotic membrane grafts in therapy of chronic non-healing wounds: Table 1

British Medical Bulletin ◽

10.1093/bmb/ldv053 ◽

2016 ◽

Vol 117 (1) ◽

pp. 59-67 ◽

Cited By ~ 16

Author(s):

Dusko Ilic ◽

Ljiljana Vicovac ◽

Milos Nikolic ◽

Emilija Lazic Ilic

Keyword(s):

Amniotic Membrane ◽

Human Amniotic Membrane ◽

Healing Wounds

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Utility of routine urine CMV PCR and total serum IgM testing of small for gestational age infants: a single center review

Journal of Perinatal Medicine ◽

10.1515/jpm-2016-0287 ◽

2018 ◽

Vol 46 (1) ◽

pp. 81-86 ◽

Cited By ~ 2

Author(s):

Michael M. Espiritu ◽

Sean Bailey ◽

Elena V. Wachtel ◽

Pradeep V. Mally

Keyword(s):

Birth Weight ◽

Gestational Age ◽

Small For Gestational Age ◽

Medical Center ◽

Diagnostic Testing ◽

Retrospective Chart Review ◽

Hospital Charges ◽

Total Serum ◽

Growth Chart ◽

Torch Infections

AbstractBackground:Due to the extremely low incidence of TORCH (toxoplasmosis, rubella, CMV, herpes simplex virus) infections, diagnostic testing of all small for gestational age (SGA) infants aimed at TORCH etiologies may incur unnecessary tests and cost.Objective:To determine the frequency of urine CMV PCR and total IgM testing among infants with birth weight <10% and the rate of test positivity. To evaluate the frequency of alternative etiologies of SGA in tested infants.Methods:Retrospective chart review of SGA infants admitted to the neonatal intensive care unit (NICU) at NYU Langone Medical Center between 2007 and 2012. Subjects were classified as being SGA with or without intrauterine growth restriction (IUGR). The IUGR subjects were then further categorized as having either symmetric or asymmetric IUGR utilizing the Fenton growth chart at birth. Initial testing for TORCH infections, which included serum total IgM, CMV PCR and head ultrasound, were reviewed and analyzed.Results:Three hundred and eighty-six (13%) infants from a total of 2953 NICU admissions had a birth weight ≤10thpercentile. Of these, 44% were IUGR; 34% being symmetric IUGR and 10% asymmetric. A total of 32% of SGA infants had urine CMV PCR and total IgM tested with no positive results. As expected, significantly higher percentage of symmetric IUGR infants were tested compared to asymmetric IUGR and non-IUGR SGA infants, (64% vs. 47% vs. 19%) P≤0.01. However, 63% of infants with a known cause for IUGR had same testing done aimed at TORCH infections. We calculated additional charges of $64,065 that were incurred by such testing.Conclusions:The majority of infants in our study who received testing for urine CMV PCR and total IgM aimed at TORCH infections had one or more other known non-infectious etiologies for IUGR. Because the overall yield of such testing is extremely low, we suggest tests for possible TORCH infections may be limited to symmetric IUGR infants without other known etiologies. Improved guidelines testing for TORCH infections can result in reducing hospital charges and unnecessary studies.

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The association between gestational age and otitis media during childhood: a population-based cohort analysis

Journal of Developmental Origins of Health and Disease ◽

10.1017/s2040174418000685 ◽

2018 ◽

Vol 10 (02) ◽

pp. 214-220 ◽

Cited By ~ 4

Author(s):

Majdi Imterat ◽

Tamar Wainstock ◽

Jacob Moran-Gilad ◽

Eyal Sheiner ◽

Asnat Walfisch

Keyword(s):

Otitis Media ◽

Gestational Age ◽

Medical Center ◽

Cohort Analysis ◽

Population Based ◽

Weibull Regression ◽

Early Term ◽

Hazards Model ◽

Independent Association ◽

The Impact

AbstractOtitis media (OM) carries a tremendous global health burden and potentially severe long-term consequences. The objective of this study was to determine the impact of birth at different gestational ages on the incidence of childhood OM.A population-based cohort analysis was conducted. All singleton deliveries occurring between 1991 and 2014 at a regional tertiary medical center were included. Gestational age on delivery was divided into six subgroups: early (<34 weeks gestation; 0 out of 7) and late (34 weeks gestation; 0 out of 7 to 36 weeks gestation; 6 out of 7) preterm, and early (37 weeks gestation; 0 out of 7 to 38 weeks gestation; 6 out of 7), full (39 weeks gestation; 0 out of 7 to 40 weeks gestation; 6 out of 7), late (41 weeks gestation; 0 out of 7 to 41 weeks gestation; 6 out of 7) and post (⩾42 weeks 0 out of 7) term deliveries. Rates of OM-related hospitalizations up to 18 years of age were assessed. Weibull parametric hazards model was used to study the association between gestational age at birth and the risk for OM-related hospitalizations while controlling for potential confounders.During the study period, 238,622 deliveries met the inclusion criteria. OM-related hospitalizations of the offspring (n=4724) were significantly more common in the preterm (early 3.6%, late 2.4%) and early-term born children (2.2%) and decreased gradually across the full (1.9%), late (1.7%) and post (1.6%) term groups (χ2-test for trends P<0.001). In the Weibull regression model, early preterm, as well as early-term deliveries exhibited an independent association with pediatric OM (adjusted hazard ratios: 1.67 and 1.09, respectively, P<0.02).Deliveries occurring at preterm and early term are associated with higher rates of pediatric OM-related hospitalizations, which decrease gradually as gestational age advances.

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Stapled Intestinal Anastomosis in Neonates: Validation of Safety and Efficacy

The American Surgeon ◽

10.1177/000313481007600632 ◽

2010 ◽

Vol 76 (6) ◽

pp. 644-646 ◽

Cited By ~ 5

Author(s):

Jon D. Simmons ◽

Joseph W. Gunter ◽

Justin D. Manley ◽

David E. Sawaya ◽

Christopher J. Blewett

Keyword(s):

Small Bowel ◽

Gestational Age ◽

Medical Center ◽

Intestinal Anastomosis ◽

Outcome Data ◽

High Rate ◽

Average Weight ◽

Colon Anastomosis ◽

Long Term Effects ◽

Intestinal Anastomoses

The safety and effectiveness of a stapled intestinal anastomosis in adults and children is well documented. However, the role of this technique in neonates is not well validated. We report our experience with stapled intestinal anastomoses in the neonate at the University of Mississippi Medical Center. All patients from the neonatal intensive care unit who had a stapled intestinal anastomosis between February 2007 and May 2008 were identified. A stapled side-to-side functional end-to-end intestinal anastomosis was performed in all patients using a gastrointestinal anastomosis stapler. Demographic, management, and outcome data were collected via chart review. Variables collected included: birth weight, estimated gestational age at birth and surgery, weight at surgery, the use of vasopressors, associated diagnoses, location of the anastomosis, and postoperative clinic visits. A total of 18 patients were identified during the study period. Nine had small bowel to small bowel, eight had ileum to colon, and one had a colon to colon anastomosis. The average weight at time of operation was 2.8 kilograms (Kg) and the average estimated gestational age at surgery was 38.7 weeks. The only complication reported was a partial small bowel obstruction on postoperative day 12, which was successfully treated nonoperatively. Two patients died from problems not associated with the anastomosis. There were no anastomotic leaks or strictures. The literature regarding the use of stapled bowel anastomoses in neonates is scant. Stapled intestinal anastomoses can be performed safely in neonates without a high rate of complication. The long term effects of stapled intestinal anastomoses in the neonate are unknown. Future areas of interest would include effects on postoperative feeding and operative time.

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Unilateral Adrenalectomy for Primary Bilateral Macronodular Adrenal Hyperplasia: Analysis of 71 Cases

Experimental and Clinical Endocrinology & Diabetes ◽

10.1055/a-0998-7884 ◽

2019 ◽

Vol 128 (12) ◽

pp. 827-834

Author(s):

Mohammad Sheikh-Ahmad ◽

Gabriel Dickstein ◽

Ibrahim Matter ◽

Carmela Shechner ◽

Jacob Bejar ◽

...

Keyword(s):

Medical Center ◽

Urinary Free Cortisol ◽

Adrenal Hyperplasia ◽

Unilateral Adrenalectomy ◽

Long Period ◽

Pubmed Database ◽

Free Cortisol ◽

Adrenal Masses ◽

Current Article

Abstract Objective Primary bilateral macronodular adrenal hyperplasia (PBMAH) is characterized by benign bilateral enlarged adrenal masses, causing Cushing’s syndrome (CS). The aim of the current article is to define the role of unilateral adrenalectomy (UA) in treating patients with CS related to PBMAH. Methods A PubMed database search was conducted to identify articles reporting UA to treat PBMAH. We also report cases of PBMAH from our medical center treated by UA. Results A total number of 71 cases of PBMAH (62 cases reported in the literature and 9 cases from our center) are presented. Most patients were women (73.2%) and most UA involved the left side (64.3%). In most cases, the resected gland was the larger one. Following UA, 94.4% of cases had remission of hypercortisolism. Recurrence rate of CS was 19.4% and hypoadrenalism occurred in 29.6%. After UA, when the size of the remained adrenal gland was equal or greater than 3.5 cm, CS persisted in 21.4% of cases, and recurrence occurred in 27.3% of cases (after 20±9.2 months). However, when the size of the remained gland was less than 3.5 cm, CS resolved in all cases and recurrence occurred in 21.2% of cases after a long period (65.6±52.1 months). High levels of urinary free cortisol (UFC) were not correlated with post-surgical CS recurrence or persistence. Conclusions UA leads to beneficial outcomes in patients with CS related to PBMAH, also in cases with pre-surgical elevated UFC or contralateral large gland.

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