scholarly journals Risk factors associated with conversion of an Ommaya reservoir to a permanent cerebrospinal fluid shunt in preterm posthemorrhagic hydrocephalus

2020 ◽  
Vol 25 (4) ◽  
pp. 417-424
Author(s):  
Alexis Palpan Flores ◽  
Javier Saceda Gutiérrez ◽  
Juan Raúl Brin Reyes ◽  
Jaime Sierra Tamayo ◽  
Fernando Carceller Benito
Keyword(s):  
Risk Factors ◽  
Gestational Age ◽  
Conversion Rate ◽  
Ommaya Reservoir ◽  
Csf Shunt ◽  
Posthemorrhagic Hydrocephalus ◽  
Factors Associated ◽  
Shunt Group ◽  
Csf Lactate ◽  
Clinical Records

OBJECTIVEA considerable percentage of preterm infants with posthemorrhagic hydrocephalus initially managed with an Ommaya reservoir require a permanent CSF shunt. The objective of the study was to analyze possible risk factors associated with the need for converting an Ommaya reservoir to a permanent shunt.METHODSThe authors retrospectively reviewed the clinical records of premature infants weighing 1500 g or less with posthemorrhagic hydrocephalus (Papile grades III and IV) managed with an Ommaya reservoir at their institution between 2002 and 2017.RESULTSForty-six patients received an Ommaya reservoir. Five patients (10.9%) were excluded due to intraventricular infection during management with an Ommaya reservoir. Average gestational age and weight for the remaining 41 patients was 27 ± 1.8 weeks and 987 ± 209 grams, respectively. Thirty patients required a permanent shunt and 11 patients did not require a permanent shunt. The conversion rate from an Ommaya reservoir to a permanent shunt was 76.1%. Symptomatic persistent ductus arteriosus (PDA) was more frequent in the nonpermanent shunt group than in the shunt group (88.9% vs 50%, p = 0.04). The need for extraction of more than 10 ml/kg per day of CSF through the Ommaya reservoir was lower in the nonpermanent shunt group than in the shunt group (9.1% vs 51.7%, p = 0.015). CSF lactate was lower in the nonpermanent group than in the shunt group (mean 2.48 mg/dl vs 3.19 mg/dl; p = 0.004). A cutoff value of ≥ 2.8 mg/dl CSF lactate predicted the need for a permanent shunt with sensitivity and specificity of 82.4% and 80%, respectively. There were no significant differences in gestational age, sex, weight, Papile grade, ventricular index, or other biochemical markers. After the multivariate analysis, only CSF lactate ≥ 2.8 mg/dl was associated with a higher conversion rate to a permanent shunt.CONCLUSIONSThis study showed that a high level of CSF lactate, absence of symptomatic PDA, and a higher CSF extraction requirement were associated with a higher likelihood of implanting a permanent CSF shunt. The authors believe these findings should be considered in future studies.

Evaluation of Oxygen Supplementation Status as a Risk Factor Associated with the Development of Severe Retinopathy of Prematurity

2015 ◽  
Vol 234 (3) ◽  
pp. 135-138 ◽  
Author(s):  
Hiroko Enomoto ◽  
Akiko Miki ◽  
Wataru Matsumiya ◽  
Shigeru Honda
Keyword(s):  
Risk Factors ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Newborn Infants ◽  
Significant Risk ◽  
Oxygen Supplementation ◽  
Factors Associated ◽  
Clinical Records ◽  
Univariate Analyses ◽  
Inspiratory Oxygen

Purpose: The effects of oxygen supplementation status and other clinical risk factors on the development of severe retinopathy of prematurity (ROP) were evaluated. Methods: Clinical records of 143 newborn infants with a gestational age of 32 weeks or less were reviewed. Severe ROP was diagnosed when photocoagulation due to progression to stage 3 was identified or when ‘plus disease' developed. The factors were evaluated with univariate and multivariate logistic regression analyses between the groups with severe (n = 24) and non-severe (n = 119) ROP. Results: Gestational age, birth weight, duration of oxygen supplementation, duration of directional positive air pressure and maximum fraction of inspiratory oxygen (FiO2) were significantly associated with severe ROP in the univariate analyses. In the multivariate analysis, a longer duration of oxygen supplementation and a higher maximum FiO2 were revealed as significant risk factors associated with severe ROP. Conclusions: Duration of oxygen supplementation and maximum FiO2 required were important factors associated with severe ROP.

Potential Risk Factors for Ventriculoperitoneal Shunt Implantation in Paediatric Patients with Posthemorrhagic Hydrocephalus of Prematurity Treated with Subcutaneous Reservoir: An Institutional Experience

2021 ◽  
Author(s):  
Adam K. Bębenek ◽  
Stanisław Kwiatkowski ◽  
Olga Milczarek
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Ventriculoperitoneal Shunt ◽  
Gestational Age ◽  
Potential Risk ◽  
Statistical Significance ◽  
Skin Lesions ◽  
Ventricular Catheter ◽  
Posthemorrhagic Hydrocephalus ◽  
Medical Health Care

Abstract Background Posthemorrhagic hydrocephalus of prematurity (PHHP) is a result of intraventricular hemorrhage (IVH). IVH occurs in 6 to 23% of the preterms in countries with advanced medical health care. Most of these patients will eventually require the use of ventriculoperitoneal shunt (VPS). The purpose of this study is to assess the risk factors of VPS implantation in patients with PHHP who have been treated with ventricular catheter with subcutaneous reservoir (VCSR). Methods The retrospective study was conducted evaluating 35 premature patients who suffered from severe IVH. Their mean gestational age was 28 weeks. The assessment included antenatal factors such as gestational age, birth weight, and intrauterine and perinatal infection. Postparturient period factors such as the IVH grade, time between diagnosis, and VCSR implantation and body weight on VCSR implantation were also considered in the study. Postprocedural complications, such as bacterial cerebrospinal fluid (CSF) infection, sepsis, and skin lesions, were evaluated. Data were calculated with R program, version 4.04. Results From among 35 evaluated patients, 23 (65.71%) required a VPS. Median of birth weight was 1,190 g. Infections were observed in 11 (31.43%) cases. Mean time between IVH diagnosis and VCSR implantation was 2.6 weeks. Postprocedural complications occurred in 19 (54.29%) patients. None of the evaluated factors has proven its statistical significance (p > 0.05) for being a potential risk factor for VPS implantation. Conclusion External factors seem to not affect the necessity of VPS implantation in patients after the severe IVH. Ostensibly, there seems to be no difference between the grades III and the IV of Papile's IVH scale regarding VPS implantation necessity.

Prospective Study of 168 Infants with Transient Abnormal Myelopoiesis with Down Syndrome: Japan Pediatric Leukemia/Lymphoma Study Group, TAM-10 Study

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 1311-1311 ◽  
Author(s):  
Hideki Muramatsu ◽  
Tomoyuki Watanabe ◽  
Daisuke Hasegawa ◽  
Park Myoung-ja ◽  
Shotaro Iwamoto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Down Syndrome ◽  
Gestational Age ◽  
Early Death ◽  
Study Group ◽  
Pediatric Leukemia ◽  
Factors Associated ◽  
Transient Abnormal Myelopoiesis ◽  
Lymphoma Study Group ◽  
Wbc Count

Abstract Introduction: Transient abnormal myelopoiesis (TAM) occurs in approximately 10% of infants with Down syndrome (DS). Although most patients achieve spontaneous remission, some develop severe organ failure and die in their infancy. Previous studies have identified several risk factors associated with early death in such cases, including a high white blood cell (WBC) count, early gestational age, and ascites (Massey GV, 2006; Muramatsu H, 2008; Klusmann JH, 2008). Although chemotherapy with low-dose cytosine arabinoside (LDCA) has been applied for severe cases, its side effect profile has not been fully demonstrated in an adequate number of patients. Here we prospectively analyzed 168 infants with DS who were diagnosed with TAM, including 52 patients treated with LDCA. We assessed the efficacy and safety of LDCA therapy in these cases. Patient and Methods: Between May 2011 and February 2014, 168 infants (90 boys and 78 girls) were diagnosed with TAM and prospectively registered in the Japan Pediatric Leukemia/Lymphoma Study Group (JPLSG) TAM-10 study. GATA1 gene mutations were identified in all except 7 patients who had a very low blast percentage. The median (range) of WBC count was 38.6 (2.4-478.7) × 109 cells/L, and the median (range) of gestational age was 37 (29-40) weeks. Thirty one (18%) patients developed anasarca at diagnosis, and 23 (14%) patients developed acute megakaryocytic leukemia. Results: The overall survival (OS) rate and the event-free survival (EFS) rate at 1 year from diagnosis [95% confidential interval (CI)] were 86.3% (80.1-90.7), and 80.2% (73.2-85.5), respectively. Univariate analysis identified the following covariates as risk factors associated with early death (<9 months): early gestational age [<37 weeks; hazard ratio (HR; 95% CI) = 4.482 (1.826-10.997), p = 0.001], parenchymal bleeding [HR (95% CI) = 5.746 (2.241-14.734), p < 0.001], anasarca [HR (95% CI) = 13.344 (5.419-32.860), p < 0.001], and high WBC count [ ≥100 × 109 cells/L; HR (95% CI) = 8.013 (3.354-19.144), p < 0.001]. The multivariate Cox hazard model identified anasarca and a high WBC count (≥100 × 109 cells/L) as independent risk factors for early death. With regard to the 52 patients who received LDCA therapy, only anasarca remained an independent risk factor for early death. Subgroup analysis in patients with a high WBC count (≥100 × 109 cells/L; n = 36) showed that LDCA therapy significantly improved survival [1-year OS (95% CI) = 78.3% (55.4-90.3; n = 23) vs. 38.5% (14.1-62.8; n = 13); p = 0.009]. In contrast, the survival rate of patients with anasarca (n = 31) did not improve on receiving LDCA therapy [1-year OS (95% CI) = 58.3% (27.0-80.1; n = 12) vs. 47.4% (24.4-67.3; n = 19); p = 0.525]. The most common side effect of LDCA was neutropenia (grade 3-4 = 59%), and one patient died due to tumor lysis syndrome. Conclusion: This prospective study confirmed that a high WBC count and anasarca are risk factors for early death in patients with DS who were diagnosed with TAM. Although LDCA therapy could significantly improve the survival rate in patients with a high WBC count, it failed to change the prognosis of patients with anasarca. A new treatment modality is required for most severe TAM patients with anasarca at diagnosis. Disclosures No relevant conflicts of interest to declare.

scholarly journals 1349 Risk Factors Associated with Bronchopulmonary Displasia (BPD) in Extremely Low Gestational Age Newborns (ELGAN)

2010 ◽  
Vol 68 ◽  
pp. 668-668 ◽  
Author(s):  
Sánchez A M Torres ◽  
Elorza M D Fernández ◽  
Pérez J Rodriguez ◽  
Díaz A Redondo ◽  
Quero J Jiménez
Keyword(s):  
Risk Factors ◽  
Gestational Age ◽  
Factors Associated ◽  
Extremely Low Gestational Age

scholarly journals Prevalence and risk factors associated with low birth weight babies-a cross sectional study

2021 ◽  
Vol 8 (7) ◽  
pp. 1168
Author(s):  
Gurunathan Gopal
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Maternal Risk ◽  
Factors Associated ◽  
The World

Background: Babies with a birth weight of less than 2500 grams, irrespective of the period of their gestation are termed as low birth weight (LBW) babies. Despite consistent efforts to improve the quality of maternal and child health, more than twenty million LBW babies are born every year throughout the world. The present study was to explore the effects of various maternal risk factors associated with low birth-weight of institutionally delivered newborns. Across the world, neonatal mortality is 20 times more likely for LBW babies compared to normal birth weight (NBW) babies (>2.5 kg).Methods: A cross sectional study was conducted in neonatal intensive care unit (NICU) of ACS Medical College and Hospital, Chennai from December 2019 to October 2020. Altogether 350 babies were taken who were delivered at ACS hospital.Results: The number of times of ANC attendance was also significantly associated with LBW, odds ratio (OR)=1.296, and p=0.001. The number of meals was not associated with LBW OR=0.946, and p=0.831. The gestational age assessed as completed weeks of pregnancy was significantly associated with LBW OR=3.302; p=0.00001.Conclusions: This study suggests that there are several factors interplaying which lead to LBW babies. Socio-demographic factors (maternal age and gestational age) and antenatal care are more important.

scholarly journals Determination of Factors Associated with Low Birth Weight among Babies Born in Sulaimania City, Kurdistan-Iraq

2020 ◽  
Vol 62 (3) ◽  
Author(s):  
Sardar Weli
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Chronic Diseases ◽  
Gestational Age ◽  
Kurdistan Region ◽  
Level Of Education ◽  
Factors Associated ◽  
Low Level

Background: Low birth weight (LBW) is the main leading cause of infant death. It is contributing to a variety of short and long term poor health outcomes. Determination of risk factors associated with LBW is important to select a suitable action to prevent or reduce this outcome. Studies on LBW and maternal risk factors in the Kurdistan region of Iraq are scarce.Objectives: This study aimed to determine risk factors associated with Low birth weight in Sulaimania city, Kurdistan region of Iraq.Cases and Methods: This study was carried out in the Maternity Hospital in Sulaimania from first of July, 2019 to first of February, 2020. Participants were 300 randomly selected mothers who gave a live birth. The questionnaire form, which contains information about factors associated with low birth weight (infant’s weight at birth lower than 2.5 kg) were filled by collectors. Infants were weighed immediately after delivery, and the weight was recorded in addition to sex of the infants, gestational age (weeks), age of the mother, job of the mothers, mother’s educational levels, antenatal care attendance, gravidity, residency, exercise and history of chronic diseases of mothers were recorded.Results: The results of the present study indicate that LBW was reported in 44.7% of the participants. For the LBW group, 48.5% were males and 51.5% were females. The highest percentage of LBW was among those born preterm 75.4% and the lowest was among full term 24.6%. Many factors such as an employed mother (85.8%), no exercise during pregnancy (88.1%), residency in urban (61.9%), mothers with chronic diseases (86.6%) and low level of education (illiterate and primary) (67.9%) were found as the significant risk factors of LBW. However, other factors such as prenatal care visits, age of mothers and gravidity were not found to be associated with LBW.Conclusion: The current study concludes that multiple risk factors may be associated with LBW in Sulaimania city, Kurdistan region of Iraq. Gestational age (preterm delivery), working mothers, no regular exercise, urban residence, low level of education and mother’s diseases such as hypertension, respiratory conditions, chronic infections and diabetes mellitus were considered as the risk factors associated with LBW.

scholarly journals Risk Factors Associated with Statin-Associated Muscle Symptoms in Patients Attending a Specialized Regional Lipid Clinic

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
M. K. Saeed ◽  
J. Shah ◽  
R. Damani ◽  
F. Rahman ◽  
P. Patel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Statistical Significance ◽  
University Hospitals ◽  
Antihypertensive Medications ◽  
Factors Associated ◽  
Binomial Logistic Regression ◽  
Lipid Clinic ◽  
The Uk ◽  
Clinical Records

Background. Statin-associated muscle symptoms (SAMS) are the major side effects reported for statins. Data from previous studies suggest that 7–29% of patients on statin had associated muscle symptoms. In the UK, there is a lack of corresponding data on SAMS and factors associated with the development of SAMS. Objective. This analysis is aimed at establishing the prevalence of SAMS and identifying major contributory risk factors in patients attending a lipid clinic. Methods. Clinical records of 535 consecutive patients, who visited the lipid clinic in the University Hospitals of Leicester, were studied retrospectively between 2009 and 2012. SAMS were defined by the presence of muscle symptoms with two or more different statins. Patients who reported muscle symptoms to statin with one or no rechallenge were excluded. The association of SAMS with clinical characteristics such as age and BMI, sex, smoking, excess alcohol, comorbidities, and medications was tested for statistical significance. A binomial logistic regression model was applied to adjust for risk factors significantly associated with SAMS. Results. The prevalence of SAMS was found to be 11%. On unadjusted analysis, the mean age of patients who had SAMS was significantly higher than those without SAMS ( 59.4 ± 10.5 years vs. 50.3 ± 13.4 years, respectively, P < 0.001 ). Nonsmokers were more likely to develop SAMS in comparison to active smokers ( P = 0.037 ). Patients taking antihypertensive medications were more likely to develop SAMS ( P = 0.010 ). In binomial logistic regression analysis, only age was positively and significantly associated with SAMS after adjusting for other risk factors ( β = 0.054 , P = 0.001 ). Conclusion. To the best of our knowledge, this study is the largest cohort of patients with SAMS in the United Kingdom. Our data suggest that the prevalence of SAMS is 11% and increased age is a risk factor associated with the development of SAMS in our cohort of patients.

Shunt infection in the first year of life

2013 ◽  
Vol 12 (1) ◽  
pp. 44-48 ◽  
Author(s):  
Meysam A. Kebriaei ◽  
Mohammadali M. Shoja ◽  
Steven M. Salinas ◽  
Kristina L. Falkenstrom ◽  
Eric A. Sribnick ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Birth Weight ◽  
Surgical Procedures ◽  
Gestational Age ◽  
Shunt Infection ◽  
Csf Shunt ◽  
Average Weight ◽  
Shunt Insertion ◽  
Average Birth Weight

Object Children younger than 1 year of age are unique in their physiology and comorbidities. Reports in the literature suggest that the risk factors for shunt infection may be different in this population compared with older children. Importantly, these infants often have other congenital malformations requiring various surgical interventions, which impose an additional risk of infection. Methods In the 3-year period between 2008 and 2010, 270 patients underwent initial CSF shunt placement during the 1st year of life. Clinical characteristics, hospital course, and shunt infections were prospectively recorded in the practice and hospital electronic medical record. Special attention was given to types and timing of other invasive procedures and their relationship with shunt infection. Results The average gestational age was 33.6 weeks, and the average birth weight was 2333 g. The average weight at the time of shunt insertion was 4281 g. Prior to shunt insertion, 120 patients underwent 148 surgical procedures, including ventricular access device insertion (n = 63), myelomeningocele closure (n = 37), and cardiac procedures (n = 11), among others. In the 12-month period after shunt insertion, 121 of the 270 patients underwent 135 surgical procedures, which included 79 CSF shunt revisions. Shunt infection occurred in 22 patients, and organisms were identified in 20 cases. Univariate analysis showed that of the very prematurely born infants (gestational age < 30 weeks), those who underwent preshunt cardiac surgery and any surgical procedures within 30 days after the shunt insertion were at a greater risk of shunt infection. In multivariate analysis, preshunt cardiac surgery and surgical procedures within 30 days postshunt placement were significant risk factors independent of gestational age, birth weight, and history of shunt revisions. Conclusions The results of this study suggest that surgical procedures within 30 days after shunt insertion and preshunt cardiac surgery are associated with a greater risk of shunt infection in children in whom these devices were inserted during the 1st year of life.

Risk Factors Associated with Intraventricular Hemorrhage in Preterm Infants with ≤28 Weeks Gestational Age

2016 ◽  
Vol 228 (05) ◽  
pp. 245-250 ◽  
Author(s):  
M. Waitz ◽  
S. Nusser ◽  
M. Schmid ◽  
J. Dreyhaupt ◽  
F. Reister ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preterm Infants ◽  
Gestational Age ◽  
Intraventricular Hemorrhage ◽  
Factors Associated

scholarly journals Rib fractures in infancy, case-series and register case-control study from Sweden

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Ulf Högberg ◽  
Ingemar Thiblin
Keyword(s):  
Risk Factors ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Bone Fractures ◽  
Case Series ◽  
Case Control ◽  
Rib Fractures ◽  
Young Infants ◽  
Clinical Records ◽  
Maternal Overweight

Abstract Objectives To assess cases with rib fractures in infants under observation for or with an abuse diagnosis, and to compare risk factors with that in infants with fractures but no abuse diagnosis. Methods Design was case-series and register case-control of infants (aged <1 year) with rib fractures. Data was clinical records for the case-series (n = 26) and from national health registers for the case-controls (n = 28 and n = 31). Outcome measures were maternal and perinatal characteristics, reasons for appointment, examination, diagnoses, blood tests, and radiologic findings. Results The case-series had a median age of 70 days. A majority were detected through a skeletal survey for abuse investigation. Sixteen were boys, three were preterm and six were small-for-gestational age. Three carers had noticed popping sound from the chest; no infants showed signs of pain at physical examination. Mean number of fractures was 4.2, and 24 had callus. Bone mineralisation was scarcely reported. Metabolic panel was not uniformly analysed. The register case-control had a median age of 76 days, sharing risk factors such as maternal overweight/obesity, male sex, prematurity, and being small-for-gestational age. Cases more often had subdural haemorrhage, retinal haemorrhage, or long-bone fractures, controls more often had neonatal morbidity, respiratory infection, or a fall accident. Detection of fracture at time of a major surgery (n = 6) and rickets/vitamin D deficiency (n = 5) appeared in both groups, but was delayed among the cases. Conclusions Rib fractures in young infants, diagnosed as abuse, are usually asymptomatic and healing. A substantial proportion had metabolic risk factors, suggesting false positive cases.

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