scholarly journals Weight Is More Accurate than Gestational Age When Estimating the Optimal Endotracheal Tube Depth in Neonates

Children ◽  
2021 ◽  
Vol 8 (5) ◽  
pp. 324
Author(s):  
Hsien-Kuan Liu ◽  
Yung-Ning Yang ◽  
Shu-Leei Tey ◽  
Pei-Ling Wu ◽  
San-Nan Yang ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Gestational Age ◽  
Linear Regression Analysis ◽  
Multivariate Linear Regression Analysis ◽  
Insertion Depth ◽  
Optimal Depth ◽  
Key Factor ◽  
Group 2 ◽  
Two Parameters ◽  
Group 1

Determining the optimal endotracheal tube (ETT) depth in neonates remains challenging for neonatologists. The guideline for optimal ETT depth is based on the patients’ weight or gestational age. However, there is a discrepancy in the suggested ETT depth between these two parameters. The aim of this retrospective study was to compare the recommended weight-based and age-based formulas for optimal ETT depth and obtain the optimal reference before intubation. Participants were assigned to group 1 if the recommended ETT insertion depth based on weight was concordant with the recommended depth based on gestational age, and to group 2 if the weight and age-based depth recommendations were discordant. After exclusion, 180 patients were included in the analysis. Results indicated that the predicted ETT depth suggested by age required more adjustment than by weight (p < 0.05). Furthermore, the required adjustment in the weight-based formula was smaller than the age-based formula (p < 0.05). Multivariate linear regression analysis revealed that weight was the key factor affecting the optimal depth (p < 0.001). These results imply that when there is a discrepancy in ETT depth between the weight-based and age-based recommendation, the weight-based one will be more accurate than the age-based one.

scholarly journals Hospitalization Costs of Lower Limb Ulcerations and Amputations in Patients with Diabetes in Romania

2021 ◽  
Vol 18 (5) ◽  
pp. 2230
Author(s):  
Diana I. Sima ◽  
Cosmina I. Bondor ◽  
Ioan A. Vereşiu ◽  
Norina A. Gâvan ◽  
Cristina M. Borzan
Keyword(s):  
Linear Regression Analysis ◽  
Case Control ◽  
Public Healthcare ◽  
Multivariate Linear Regression Analysis ◽  
Retrospective Case ◽  
Hospitalization Costs ◽  
Patients With Diabetes ◽  
Group 2 ◽  
Diabetes Center ◽  
Group 1

In this retrospective case-control study conducted in Cluj-Napoca, Romania, we assessed the effect of ulcerations/amputations on hospitalization costs of patients with diabetes. Patients with (Group 1) or without (Group 2) ulcerations/amputations (case-control ratio 3:1) admitted to a single diabetes center between 2012–2017 were included. The effects of hospitalization days, age, duration of diabetes, body mass index and glycated hemoglobin (HbA1c) on total costs was explored using a multivariate linear regression analysis, enter model. Overall, 876 patients were included (Group 1: 682, 323 [47.4%] with amputations; Group 2: 194). Median (interquartile range) total expenses in Group 1 were 40% higher compared to Group 2 (€724 [504; 1186] vs €517 [362; 645], p < 0.001). Significant differences were observed between hospitalization costs (p < 0.001), cost of food (p < 0.001), medication (p = 0.044), drugs administered at the emergency room/intensive care unit (p < 0.001) and other expenses (p = 0.003). Hospitalization costs represented 80.5% of total expenses in Group 1 and 76.3% in Group 2. In multivariate analysis, hospitalization days influenced significantly the total costs in both groups (p < 0.001); in Group 2, the effect of HbA1c was also significant (p = 0.021). Diabetic foot ulcers and subsequent amputations most likely impose a significant economic burden on the Romanian public healthcare system.

scholarly journals USE OF RADIOMIC MARKERS IN PREOPERATIVE DETECTION OF EXTRA-AXIAL TUMOR GRADE

2021 ◽  
Author(s):  
Tatyana Bergen ◽  
Ilya Soynov ◽  
Mariya Pustovetova
Keyword(s):  
Linear Regression Analysis ◽  
Maximum Size ◽  
Tumor Grade ◽  
Diffusion Method ◽  
Differential Diagnostics ◽  
Functional Markers ◽  
Multivariate Linear Regression Analysis ◽  
Diffusion Restriction ◽  
Group 2 ◽  
Group 1

Backgraund: Extra-axial tumors are one of the tumor groups which are difficult for primary differential diagnostics. Detection and standardization of radiomic markers is one of the main problems of our time. Aim: To detect radiomic markers for preoperative assessment of extra-axial tumor grade. Materials and methods: Retrospective analysis of MRI (1.5T) data of 156 patients with extra-axial tumors. The patients were divided into 2 groups: Group 1(n=106) with perifocal changes, Group 2 (n=50) extra-axial tumor without perifocal changes. Diffusion and perfusion sequences were included in the scanning protocol. The areas of interest were (1) the lesion and (2) the area of perifocal changes. Measurements were made from the lesion and the area of perifocal changes on ACD and DSE maps, DCE was analyzed. Results: The maximum lesion size in Group 1 was 2.2cm (1.4; 4.3), in Group 2 - 1.2cm (0.9; 3.5). In Group 1 diffusion restriction from the lesion was detected in 42 patients (39.6%), in Group 2 in 7 patients (14%). The maximum size of perifocal changes in Group 1 was 2.85cm (1.5; 4.7). Diffusion restriction was detected in 52 cases (49.1%). In patients of Group 2 with verified meningioma multivariate linear regression analysis showed that the maximum size of the lesion demonstrated a 3.3-time increase of rCBF from the area of perifocal changes (coef. 3.3 CI 1.27; 5.28) p = 0.003, however, it demonstrated a 4-time decrease of rCBF (coef. 4 CI -7.46;-0.71) p = 0.02. Conclusions: Perfusion and diffusion method combined with anatomical sequences show potential and can be used as radiomic markers for diagnostic assessment and treatment of extra-axial tumors. There is further potential in detecting radiomic functional markers from the area of perifocal changes.

scholarly journals Vermal Length and Transcerebellar Diameter in Gestational Age Estimation: A Guide to Forensic Expert

2019 ◽  
Vol 08 (03) ◽  
pp. 101-105
Author(s):  
Nadia Ahmad ◽  
S. L. Jethani ◽  
Deepa Singh ◽  
Ruchira Nautiyal
Keyword(s):  
Gestational Age ◽  
Age Determination ◽  
Linear Increase ◽  
Group 4 ◽  
Age Regression ◽  
Group 3 ◽  
Group 2 ◽  
Gestational Age Estimation ◽  
Formalin Fixed ◽  
Group 1

Abstract Background Transcerebellar diameter is one of the reliable, constant predicting parameters to assess the gestational age and fetal growth. Other than this, measurements of vermis, mostly the vermal length (height), have also been mentioned by authors to assess gestational age. Establishing a correlation between parameters and advancing gestation would be helpful in estimating the gestational age of fetus. Aims and Objectives To establish a correlation of vermal length and transcerebellar diameter with gestational age. Materials and Methods An observational and descriptive study conducted on 60 formalin-fixed human cerebellums. Fetuses with gross congenital/neurological abnormality were excluded. Fetuses were grouped into four groups—group 1 (13–17 weeks), group 2 (18–22 weeks), group 3 (23–27 weeks), and group 4 (28–32 weeks of gestation). Vermal length and transcerebellar diameter were measured with help of Vernier calipers. The data obtained were analyzed using statistical software SPSS version 20.0 and one-way analysis of variance. Observation A linear increase in vermal length parameters and transcerebellar diameter were seen with increasing gestational age. Regression analysis was done and regression equation was derived for each parameter. Conclusion Such correlations would help in fetal age determination in the field of forensic studies.

Decreased Circulating Insulin-Like Growth Factor 1 Levels Are Associated with Cardiac Diastolic Dysfunction in Small for Gestational Age Infants

2018 ◽  
Vol 35 (12) ◽  
pp. 1178-1185
Author(s):  
Shoko Yamazaki ◽  
Haruka Obinata ◽  
Akira Hachiya ◽  
Motoko Kamiya ◽  
Noriko Motoki ◽  
...  
Keyword(s):  
Growth Factor ◽  
Diastolic Dysfunction ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Linear Regression Analysis ◽  
Entire Population ◽  
Doppler Imaging ◽  
Multivariate Linear Regression Analysis ◽  
Insulin Like Growth Factor ◽  
The Impact

Objective To evaluate the impact of serum insulin-like growth factor-1 (IGF-1) levels on cardiac function in small for gestational age (SGA) infants. Study Design This is a prospective, observational study. Serum IGF-1 levels at birth and echocardiography measurements at 1 week of age were compared between SGA and appropriate for gestational age (AGA) infants. Results Thirty-one SGA infants and 27 AGA infants were enrolled. Serum IGF-1 levels were lower in the SGA infants than in the AGA infants. SGA infants had lower mitral lateral annular systolic (S') and early diastolic (E') tissue Doppler imaging velocities compared with AGA infants (S', 5.1 ± 0.9 vs 5.7 ± 1.2 cm/s; E', 6.1 ± 1.5 cm/s vs 7.1 ± 1.3 cm/s; p < 0.05). Serum IGF-1 levels positively correlated with E' velocity in the entire population (r = 0.44, p < 0.001) and in SGA infants (r = 0.39, p < 0.05). In multivariate linear regression analysis, serum IGF-1 and S' velocity were independently associated with E' velocity in the entire population and in SGA infants. Conclusion Decreased serum IGF-I levels could account for cardiac diastolic dysfunction in SGA infants.

Induction of mixed apneas by inhalation of 100% oxygen in preterm infants

1994 ◽  
Vol 77 (4) ◽  
pp. 1666-1670 ◽  
Author(s):  
R. Alvaro ◽  
J. Alvarez ◽  
K. Kwiatkowski ◽  
D. Cates ◽  
H. Rigatto
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Flow Through ◽  
Group 2 ◽  
Central Apneas ◽  
Group 1

Administration of 100% O2 to preterm infants induces an apnea that is usually central. We hypothesized that this apnea may be “mixed” at times with an obstructive component appearing late during the respiratory pause. In addition, we reasoned that obstruction would depend on the duration of the apnea. Thus, we gave 100% O2 to 61 healthy preterm infants. Group 1 was > or = 1,500 g [birth wt 1.8 +/- 0.1 (SE) kg, gestational age 32 +/- 1 wk, postnatal age 19 +/- 2 days, n = 26] and group 2 was < 1,500 g [birth wt 1.2 +/- 0.1 kg, gestational age 29 +/- 1 wk, postnatal age 30 +/- 4 days, n = 35]. Ventilation was measured using a flow-through system. Respiratory efforts in the absence of flow were detected using chest and abdominal displacements or diaphragmatic electromyography. In group 1, 19% of the central apneas became obstructive at 17 +/- 3 s, whereas in group 2, 34% did so at 12 +/- 2 s. Mixed apneas were longer than those without obstruction (28 +/- 3 vs. 12 +/- 1 s; P = 0.0001). The incidence of mixed apneas was 0, 14, and 66% in group 1 and 0, 27, and 69% in group 2 in apneas of 3–10, 11–20, and > 20 s, respectively. These findings suggest that 1) a percentage of the central apneas induced by inhaling 100% O2 became obstructive, 2) the incidence of the obstructive component increased with the duration of apnea, and 3) smaller infants became obstructed sooner and had a higher incidence of obstruction than larger infants.(ABSTRACT TRUNCATED AT 250 WORDS)

The effects of intrafetal ACTH administration on the outcome of pregnancy in the mare

1998 ◽  
Vol 10 (4) ◽  
pp. 359 ◽  
Author(s):  
J. C. Ousey ◽  
P. D. Rossdale ◽  
F. E. Dudan ◽  
A. L. Fowden
Keyword(s):  
Gestational Age ◽  
Plasma Cortisol ◽  
Maternal Plasma ◽  
Sterile Water ◽  
Adaptive Responses ◽  
Gestational Length ◽  
Adrenocortical Activity ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Enhanced adrenocortical activity in the fetus is related to the onset of parturition in many species. The aim of this study was to determine the effect of injection of fetal ACTH on gestational length and fetal viability in the horse. Pony mares (n=23) were studied from 300 days gestation. Seven control mares (Group 1) received three consecutive intrafetal injections of sterile water, while fetuses of a further 16 mares received Depot ACTH1–24. These mares were either allowed to foal spontaneously (Group 2, n=4) or delivery was induced within 3 days of the last fetal injection (Group 3, n=7); 5 mares aborted within 48 h of intrafetal ACTH injection. Maternal plasma progestagen concentrations increased significantly (P<0.05) in Groups 2 and 3 mares following intrafetal ACTH injection, compared with Group 1 mares. All Group 1 mares delivered live foals at a median gestational age of 327 days (interquartile range, 323–334), except one that aborted 16 days after the last fetal injection. Gestational length was significantly (P<0.05) shortened in Group 2 mares (median 314 [312–314]) days compared with controls. Group 1 and Group 2 foals showed normal postnatal adaptive responses and endocrine (plasma cortisol/progestagens) patterns. Group 3 mares delivered live foals at 306 (306–308) days gestation except one that aborted. Their foals were less mature compared with Groups 1 and 2 foals. Eight ACTH-injected fetuses were meconium-stained at delivery, including four that were aborted. Eight mares had thickened placentae, including three that aborted. The data show that both precocious maturation of the equine fetus and a significant reduction in gestational length compared with controls may be achieved in pony mares by intrafetal ACTH injections. This is probably mediated via adrenal regulation of fetal maturation and production of maternal progestagens.

scholarly journals Efficacy and safety of mifepristone-misoprostol combination with extraamniotic ethacridine lactate-misoprostol for termination of second trimester pregnancy

2018 ◽  
Vol 7 (10) ◽  
pp. 4229
Author(s):  
Hemavathi G. ◽  
Jagruthi C.
Keyword(s):  
Gestational Age ◽  
Second Trimester ◽  
Efficacy And Safety ◽  
Trimester Abortion ◽  
Medical College ◽  
Incomplete Abortion ◽  
Ethacridine Lactate ◽  
Second Trimester Pregnancy ◽  
Group 2 ◽  
Group 1

Background: Mid trimester termination of pregnancy is one of the most controversial areas of gynecological practice. It has moral, emotional, social and technical issues. This study was designed for comparison of efficacy and safety of Mifepristone-Misoprostol combination with exrtaamniotic Ethacridine Lactate-misoprostol for termination of second trimester pregnancy.Methods: The present was undertaken among the patients admitted to hospitals attached to J.J.M. Medical College; Bapuji hospital, Women and Children hospital and Chigateri general hospital Davangere during the study period   from November 2016 - October 2017.  Patients coming for second trimester abortion to above mentioned hospitals were assigned serial number from 1 to 80 and all patients with even number will be allocated to group 1 and all patients with odd number will be allocated in group 2, each group comprising 40 women each.Results: Majority of the cases in both the groups were between 21-25 yrs. Majority of the cases in both the groups were multigravidas. 11 cases from group 1 and 12 cases from group 2 were of gestational age between 14-16 wks. 29 cases from group 1 and 28 cases from group 2 were of gestational age between 18-20 wks. In the present study the mean induction abortion interval for group 1 was 19.56±1.82 hours and group 2 was 14.13±2.72 hours. This was statistically significant. Of the 40 cases in each group, 37 had complete abortion i.e. 92.5% 3 cases (7.5%) from both the groups had incomplete abortion. The side effects were relatively more in more in group 1 when compared to group 2.Conclusions: It was concluded that with this combination success rate was high (92.5 %), with Short induction abortion interval, less rate of incomplete abortion without any major complications.

scholarly journals Different clinical parameters inform epicardial fat thickness in pre- and post-menopausal women with obstructive sleep apnea

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yong Zhang ◽  
Jian Wang ◽  
Wen Shui ◽  
Zhenxia Zhang ◽  
Juan Li ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Independent Predictor ◽  
Linear Regression Analysis ◽  
Stepwise Linear Regression Analysis ◽  
Obstructive Sleep ◽  
Menopausal Women ◽  
Fat Thickness ◽  
Group 2 ◽  
Post Menopausal ◽  
Group 1

Abstract Background Obstructive sleep apnea (OSA) is a sleep-related disorder with breathing difficulties. Previous studies revealed that epicardial fat thickness (EFT) correlates with OSA severity. Interestingly, female patients display a stronger EFT-OSA correlation than males. The purpose of this study is to investigate the relationship between EFT and different clinical characteristics in pre- and post-menopausal women diagnosed with OSA. Methods Patients diagnosed with OSA were divided into pre/early peri-menopausal (Group 1) and post/late peri-menopausal (Group 2) according to the menopause status. EFT was obtained from parasternal long-axis echocardiographic images. We also collected general clinical characteristics of patients involved in this study, and performed spearman correlation analysis to explore the correlations between EFT and the general clinical characteristics. We further applied Multiple stepwise linear regression analysis to explore the predictors for EFT in both groups. Results A total number of 23 and 59 patients were enrolled in Group 1 and Group 2 respectively. EFT in Group 2 was significantly higher than that of Group 1. In both groups, EFT was positively correlated with apnea–hypopnea index (AHI), percentage of total sleep time when blood oxygen saturation was less than 90% (T90), oxygen desaturation index (ODI) and glucose; while EFT was negatively correlated with mean and lowest SaO2 (oxygen saturation) levels. However, EFT was positively correlated with total cholesterol (TC) only in Group 1 and body mass index (BMI) only in Group2, respectively. Multiple stepwise linear regression analysis showed that AHI was independently associated with EFT in Group 1. However, both AHI and BMI were independent predictors of EFT in Group 2. Conclusion EFT was notably correlated with menopausal status in women with OSA. AHI was the independent predictor of EFT in women with OSA. BMI was the independent predictor of EFT in post/late peri-menopausal women with OSA.

scholarly journals Neonatal Problems and Infancy Growth of Term SGA Infants: Does “SGA” Definition Need to Be Re-evaluated?

2021 ◽  
Vol 9 ◽  
Author(s):  
Saygin Abali ◽  
Serdar Beken ◽  
Eda Albayrak ◽  
Aysegul Inamlik ◽  
Burcu Bulum ◽  
...  
Keyword(s):  
Gestational Age ◽  
Severe Hypoglycemia ◽  
Point Of View ◽  
Control Group ◽  
Term Infants ◽  
Group 3 ◽  
Group 2 ◽  
Definition Of ◽  
Neonatal Problems ◽  
Group 1

Introduction: The exact definition of small-for-gestational-age (SGA) infant is still controversial among clinicians. In this study, we aimed to understand which definition is better in terms of establishing both early postnatal problems and growth. In this way, we compared early neonatal problems and infancy growth of term infants with birth weight (BW) &lt; -2 SDS and with BW between 10th percentile (−1.28 SDS) and −2 SDS.Methods: A single center retrospective cohort study was conducted. Preterm infants, multiple gestations and newborns with any congenital anomalies were excluded from the study. Study group was defined as Group 1 (n = 37), infants BW &lt; −2.00 SDS; Group 2 (n = 129), between −1.28 and −2.00 SDS; and Group 3 (n = 137), randomly selected newborns with optimal-for-gestational-age (BW between −0.67 and +0.67 SDS) as a control group.Results: The incidence of severe hypoglycemia was highest in Group 1 (%10.8) and Group 2 and 3 had similar rates of severe hypoglycemia (0.8 and 0.7%, respectively). The incidence of polycythemia was 5.4% in Group 1 and was significantly higher than Group 3 (0.0%) while it was 2.3% in Group 2. Short stature (length &lt; −2 SDS) ratio at the age of 1 and 2 years were similar in each group. Overweight/obesity ratio at the age of 1 were 9.5, 20.8 and 16.7% in each group, respectively (p = 0.509).Conclusion: This study was planned as a pilot study to determine potential differences in the problems of hypoglycemia, polycythemia, and growth according to the differences in definition. Short term disturbances such as hypoglycemia and polycythemia are found to be higher in infants with a BW SDS below −2. From this point of view, of course, it will not be possible to change the routine applications immediately, however this study will be an initiative for discussions by making long-term studies.

Nasal insertion depths for neonatal intubation

2020 ◽  
Vol 105 (6) ◽  
pp. 663-665
Author(s):  
Christian Achim Maiwald ◽  
Patrick Neuberger ◽  
Ingo Mueller-Hansen ◽  
Rangmar Goelz ◽  
Jörg Michel ◽  
...  
Keyword(s):  
Body Weight ◽  
Endotracheal Tube ◽  
Gestational Age ◽  
Thoracic Vertebrae ◽  
Nasal Intubation ◽  
X Rays ◽  
Insertion Depth

AimData on the depth of nasal intubation in neonates are rare, although this is the preferred route in some countries. Therefore, recommendations on optimal nasal intubation depths based on gestational age (GA) and weight are desirable.MethodsWe determined the distances between the middle of thoracic vertebrae 2 (T2) and the tip of the endotracheal tube in 116 X-rays from nasally intubated neonates. The intubation depth (tip to nostril distance) that was documented in the digital patient’s file was then corrected for this distance to reach an optimal nasal insertion depth. Results were plotted against the infant’s GA and weight.ResultsGA-based and birthweight-based charts and formulas for the nasal intubation depth in infants with a GA between 24 and 43 weeks and body weight between 400 and 4500 g were created.ConclusionsGenerated data may help in predicting optimal insertion depths for nasal intubation in neonates.

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