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Costa S, Capolupo I, Bonadies L, Quercia M, Betta MP, Gombos S, Tognon C, Cavallaro G, Sgrò S, Pastorino R, Pires Marafon D, Dotta A, Vento G. Current management of surgical neonates: is it optimal or do we need to improve? A national survey of the Italian Society of Neonatology. Pediatr Surg Int 2024; 40:109. [PMID: 38622308 PMCID: PMC11018645 DOI: 10.1007/s00383-024-05680-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/19/2024] [Indexed: 04/17/2024]
Abstract
PURPOSE Few guidelines exist for the perioperative management (PM) of neonates with surgical conditions (SC). This study examined the current neonatal PM in Italy. METHODS We invited 51 neonatal intensive care units with pediatric surgery in their institution to participate in a web-based survey. The themes included (1) the involvement of the neonatologist during the PM; (2) the spread of bedside surgery (BS); (3) the critical issues concerning the neonatal PM in operating rooms (OR) and the actions aimed at improving the PM. RESULTS Response rate was 82.4%. The neonatologist is involved during the intraoperative management in 42.9% of the responding centers (RC) and only when the surgery is performed at the patient's bedside in 50.0% of RCs. BS is reserved for extremely preterm (62.5%) or clinically unstable (57.5%) infants, and the main barrier to its implementation is the surgical-anesthesiology team's preference to perform surgery in a standard OR (77.5%). Care protocols for specific SC are available only in 42.9% of RCs. CONCLUSION Some critical issues emerged from this survey: the neonatologist involvement in PM, the spread of BS, and the availability of specific care protocols need to be implemented to optimize the care of this fragile category of patients.
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Affiliation(s)
- Simonetta Costa
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
- Catholic University of Sacred Heart, Rome, Italy.
| | - Irma Capolupo
- Medical and Surgical Department of Fetus-Newborn-Infant, "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy
| | - Luca Bonadies
- Neonatal Intensive Care Unit, Department of Woman's and Child's Health, University of Padova, Padua, Italy
| | - Michele Quercia
- Department of Biomedical Science and Human Oncology, Neonatology and Neonatal Intensive Care Section, University of Bari Aldo Moro, Policlinico Hospital, Bari, Italy
| | - Maria Pasqua Betta
- Neonatal Intensive Care Unit, Azienda Ospedaliero-Universitaria Policlinico Rodolico San Marco, Catania, Italy
| | - Sara Gombos
- Unit of Pediatrics, Santobono-Pausillipon Hospital, Naples, Italy
| | - Costanza Tognon
- Anesthesiology Pediatric Unit, Department of Women's and Children's Health, Padua University Hospital, Padua, Italy
| | - Giacomo Cavallaro
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefania Sgrò
- Medical and Surgical Department of Fetus-Newborn-Infant, "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy
| | - Roberta Pastorino
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
- Catholic University of Sacred Heart, Rome, Italy
| | - Denise Pires Marafon
- Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea Dotta
- Medical and Surgical Department of Fetus-Newborn-Infant, "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy
| | - Giovanni Vento
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Catholic University of Sacred Heart, Rome, Italy
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Li XY, Wen MZ, Liu H, Shen YC, Su LX, Yang XT. Dietary magnesium intake is protective in patients with periodontitis. Front Nutr 2022; 9:976518. [PMID: 36091240 PMCID: PMC9453259 DOI: 10.3389/fnut.2022.976518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 07/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background Periodontitis is a chronic inflammatory disease of the oral cavity characterized by inflammation of the periodontal tissue and resorption of the alveolar bone, which has a high incidence and is the main cause of tooth loss in adults. In addition to its role in promoting osteogenesis, magnesium also has a role in regulating the inflammatory response, both systemically and locally. There is growing evidence that magnesium is an important factor in maintaining the normal functioning of the body's immune system. Hypomagnesaemia can lead to a variety of chronic inflammatory diseases throughout the body, including periodontitis. Two-thirds of the US population suffers from magnesium deficiency. The connection between dietary magnesium and periodontitis is unknown. As a result, we set out to investigate the link between dietary magnesium intake and periodontitis. Methods In this study, we collected data from the National Health and Nutrition Examination Survey (NHANES) database from 2013 to 2014. Through 24-h dietary recalls, information about food consumption was collected. We examined the association between the dietary magnesium and periodontitis using multivariable logistic regression model. Based on odds ratios (OR) and 95% confidence intervals (CIs), a strong association was detected. Results Multivariable logistic regression analysis showed that the OR for periodontitis comparing the highest to the lowest quintile of dietary magnesium intake was 0.69 (95% CIs = 0.52~0.92). The restricted cubic spline (RCS) analysis showed that the non-linear association between dietary magnesium and periodontitis was statistically significant and that dietary magnesium supplementation reduced the prevalence of periodontitis. Conclusion Dietary magnesium intake is associated with the prevalence of periodontitis. Dietary magnesium deficiency increases the prevalence of periodontitis.
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Affiliation(s)
- Xin-yu Li
- Department of Interventional Therapy, Multidisciplinary Team of Vascular Anomalies, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
- Department of Neurosurgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Ming-zhe Wen
- Department of Interventional Therapy, Multidisciplinary Team of Vascular Anomalies, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Hui Liu
- Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yu-chen Shen
- Department of Interventional Therapy, Multidisciplinary Team of Vascular Anomalies, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Li-xin Su
- Department of Interventional Therapy, Multidisciplinary Team of Vascular Anomalies, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Li-xin Su
| | - Xi-tao Yang
- Department of Interventional Therapy, Multidisciplinary Team of Vascular Anomalies, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
- Xi-tao Yang
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Gaiduchevici AE, Cîrstoveanu CG, Socea B, Bizubac AM, Herișeanu CM, Filip C, Mihălțan FD, Dimitriu M, Jacotă-Alexe F, Ceaușu M, Spătaru RI. Neonatal intensive care unit on-site surgery for congenital diaphragmatic hernia. Exp Ther Med 2022; 23:436. [PMID: 35607371 PMCID: PMC9121203 DOI: 10.3892/etm.2022.11363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 04/14/2022] [Indexed: 11/17/2022] Open
Abstract
The present study presents the experience gained in the Newborn Intensive Care Unit (NICU) of 'Maria S. Curie' Emergency Clinical Hospital for Children in Bucharest (Romania) after performing a series of bedside surgery interventions on newborns with congenital diaphragmatic hernia (CDH). We conducted a retrospective analysis of the data for all patients operated on-site between 2011 and 2020, in terms of pre- and post-operative stability, procedures performed, complications and outcomes. An analysis of a control group was used to provide a reference to the survival rate for non-operated patients. The present study is based on data from 10 cases of newborns, surgically operated on, on average, on the fifth day of life. The main reasons for operating on-site included hemodynamical instability and the need to administer inhaled nitric oxide (iNO) and high-frequency oscillatory ventilation (HFOV). There were no unforeseen events during surgery, no immediate postoperative complications and no surgery-related mortality. One noticed drawback was the unfamiliarity of the surgery team with the new operating environment. Our experience indicates that bedside surgery improves the likelihood of survival for critically ill neonates suffering from CDH. No immediate complications were associated with this practice.
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Affiliation(s)
- Alina Elena Gaiduchevici
- Neonatal Intensive Care Unit, ‘Maria S. Curie’ Emergency Clinic Hospital for Children, 077120 Bucharest, Romania
| | - Cătălin Gabriel Cîrstoveanu
- Neonatal Intensive Care Unit, ‘Maria S. Curie’ Emergency Clinic Hospital for Children, 077120 Bucharest, Romania
- Discipline of Pediatrics, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Bogdan Socea
- Department of Surgery, ‘Sf. Pantelimon’ Emergency Clinical Hospital, 021659 Bucharest, Romania
- Discipline of Surgery, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Ana Michaela Bizubac
- Neonatal Intensive Care Unit, ‘Maria S. Curie’ Emergency Clinic Hospital for Children, 077120 Bucharest, Romania
| | - Carmen Mariana Herișeanu
- Neonatal Intensive Care Unit, ‘Maria S. Curie’ Emergency Clinic Hospital for Children, 077120 Bucharest, Romania
| | - Cristina Filip
- Department of Cardiology, ‘Maria S. Curie’ Emergency Clinic Hospital for Children, 077120 Bucharest, Romania
| | - Florin Dumitru Mihălțan
- Department of Pneumology, ‘Marius Nasta’ National Institute of Pneumology, 050159 Bucharest, Romania
- Discipline of Pneumology, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Mihai Dimitriu
- Department of Obstetrics and Gynecology, ‘Sf. Pantelimon’ Emergency Hospital, 021659 Bucharest, Romania
- Discipline of Obstetrics and Gynecology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Florentina Jacotă-Alexe
- Department of Obstetrics and Gynecology, ‘Sf. Pantelimon’ Emergency Hospital, 021659 Bucharest, Romania
| | - Mihail Ceaușu
- Department of Histopathology, ‘Alexandru Trestioreanu’ National Institute of Oncology, 022328 Bucharest, Romania
- Discipline of Histopathology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Radu-Iulian Spătaru
- Department of Pediatric Surgery, ‘Maria S. Curie’ Emergency Clinical Hospital for Children, 077120 Bucharest, Romania
- Discipline of Pediatric Surgery, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
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Operieren auf der neonatologischen Intensivstation. Monatsschr Kinderheilkd 2021. [DOI: 10.1007/s00112-021-01300-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Anand S, Sandlas G, Nabar N, Joshi P, Terdal M, Suratkal S. Operating Within the Neonatal Intensive Care Unit: A Retrospective Analysis From a Tertiary Care Center. Cureus 2021; 13:e16077. [PMID: 34345557 PMCID: PMC8324603 DOI: 10.7759/cureus.16077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2021] [Indexed: 11/05/2022] Open
Abstract
Background Despite ongoing advances in the field of neonatology, the survival outcomes among critically ill preterm surgical neonates remain unfavorable. Intrahospital transport is one of the major risk factors associated with early mortality (within 30 days) in these newborns. To overcome this, the approach of performing bedside surgeries is being followed. We aim to assess the safety and feasibility of performing bedside neonatal surgeries by analyzing our archives. Methods The study focused on retrospective evaluation of all the newborns who have undergone surgical procedures in the neonatal intensive care unit (NICU) at our center from August 2015 through February 2021. Newborns were operated within the NICU if they had very low birth weight or other risk factors making their transport to the operation room risky. The outcomes of surgeries were assessed in terms of postoperative complications, one-month survival, and overall survival. Results Thirteen children (M:F=9:4) underwent twenty-two surgical procedures. The median (range) gestational age and birth weight of our cohort were 30 (26-36) weeks and 1200 (500-2860) grams, respectively. One-month and overall survival rates in our cohort were 84% (11/13) and 77% (10/13), respectively. No major postoperative complications were observed. The requirement of multiple inotropes and/or high-frequency oscillatory ventilation (HFOV) was the only factor having a significant association with unfavorable survival outcomes. Conclusions Bedside surgery is a safe and feasible alternative to surgeries within the operation room for at-risk newborns. In the present study, the requirement of multiple inotropes and/or HFOV was the only factor significantly associated with early mortality.
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Affiliation(s)
- Sachit Anand
- Pediatric Surgery, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, IND
| | - Gursev Sandlas
- Pediatric Surgery, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, IND
| | - Neha Nabar
- Neonatology, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, IND
| | - Preetha Joshi
- Neonatology, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, IND
| | - Mohan Terdal
- Anaesthesiology, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, IND
| | - Shaila Suratkal
- Neonatology, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, IND
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