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Rani V, Sharma R, Dalal JS, Saxena A, Lohchab SS, Dalal M. Newborns with congenital complete heart block: Advice for perinatal care providers. Trop Doct 2024; 54:167-171. [PMID: 38380895 DOI: 10.1177/00494755241231324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Congenital complete heart block (CCHB) is a rare, but a potentially life-threatening manifestation of autoimmune diseases in neonates. Bradycardia in CCHB can be misdiagnosed as foetal distress in utero and thus precipitating a Caesarean section. We report a case series of three neonates with bradycardia without any electrolyte abnormalities and structurally normal hearts with favourable outcomes.
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Affiliation(s)
- Vijay Rani
- Resident, Department of Pediatrics, Pt. B. D. Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Renu Sharma
- Resident, Department of Pediatrics, Pt. B. D. Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Jagjit Singh Dalal
- Senior Professor and Head, Department of Neonatology, Pt. B. D. Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Anita Saxena
- Vice-Chancellor, Pt B D Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Shamsher Singh Lohchab
- Senior Professor, Department of Cardiothoracic and Vascular Surgery, Pt. B. D. Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Monika Dalal
- Professor, Department of Obstetrics and Gynecology, Pt. B. D. Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
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2
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Walsh JR, Sun G, Balan J, Hardcastle J, Vollenweider J, Jerde C, Rumilla K, Koellner C, Koleilat A, Hasadsri L, Kipp B, Jenkinson G, Klee E. A supervised learning method for classifying methylation disorders. BMC Bioinformatics 2024; 25:66. [PMID: 38347515 PMCID: PMC10863277 DOI: 10.1186/s12859-024-05673-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/24/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND DNA methylation is one of the most stable and well-characterized epigenetic alterations in humans. Accordingly, it has already found clinical utility as a molecular biomarker in a variety of disease contexts. Existing methods for clinical diagnosis of methylation-related disorders focus on outlier detection in a small number of CpG sites using standardized cutoffs which differentiate healthy from abnormal methylation levels. The standardized cutoff values used in these methods do not take into account methylation patterns which are known to differ between the sexes and with age. RESULTS Here we profile genome-wide DNA methylation from blood samples drawn from within a cohort composed of healthy controls of different age and sex alongside patients with Prader-Willi syndrome (PWS), Beckwith-Wiedemann syndrome, Fragile-X syndrome, Angelman syndrome, and Silver-Russell syndrome. We propose a Generalized Additive Model to perform age and sex adjusted outlier analysis of around 700,000 CpG sites throughout the human genome. Utilizing z-scores among the cohort for each site, we deployed an ensemble based machine learning pipeline and achieved a combined prediction accuracy of 0.96 (Binomial 95% Confidence Interval 0.868[Formula: see text]0.995). CONCLUSION We demonstrate a method for age and sex adjusted outlier detection of differentially methylated loci based on a large cohort of healthy individuals. We present a custom machine learning pipeline utilizing this outlier analysis to classify samples for potential methylation associated congenital disorders. These methods are able to achieve high accuracy when used with machine learning methods to classify abnormal methylation patterns.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Alaa Koleilat
- Department of Molecular and Medical Genetics, Oregon Health and Science University, Portland, OR, USA
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Dou D, Jia Y, Yuan S, Wang Y, Li Y, Wang H, Ding J, Wu X, Bie D, Liu Q, An R, Yan H, Yan F. The protocol of Enhanced Recovery After Cardiac Surgery (ERACS) in congenital heart disease: a stepped wedge cluster randomized trial. BMC Pediatr 2024; 24:22. [PMID: 38183047 PMCID: PMC10768436 DOI: 10.1186/s12887-023-04422-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 11/14/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND The Enhanced Recovery After Cardiac Surgery (ERACS) programs are comprehensive multidisciplinary interventions to improve patients' recovery. The application of the ERAS principle in pediatric patients has not been identified completely. METHODS This study is a multicenter, stepwise design, cluster randomized controlled trial. 3030 patients presenting during control and intervention periods are eligible if they are aged from 28 days to 6 years old and awaiting elective correction surgery of congenital heart disease with cardiopulmonary bypass. 5 centers are randomly assigned to staggered start dates for one-way crossover from the control phase to the intervention phase. In the intervention periods, patients will receive a bundle strategy including preoperative, intraoperative, and postoperative approaches. During the control phase, patients receive the usual care. The primary outcome consists of major adverse cardiac and cerebrovascular events (MACCEs), postoperative pulmonary complications (PPCs), and acute kidney injury (AKI). DISCUSSION This study aims to explore whether the bundle of ERAS measurements could improve patients' recovery in congenital heart surgery. TRIAL REGISTRATION http://www. CLINICALTRIALS gov . (NCT05914103).
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Affiliation(s)
- Dou Dou
- Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 167 BeilishiRd, Xicheng District, Beijing, 100037, China
| | - Yuan Jia
- Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 167 BeilishiRd, Xicheng District, Beijing, 100037, China
| | - Su Yuan
- Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 167 BeilishiRd, Xicheng District, Beijing, 100037, China
| | - Yang Wang
- Department of Medical Research & Biometrics Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 167 BeilishiRd, Xicheng District, Beijing, 100037, China
| | - Yinan Li
- Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 167 BeilishiRd, Xicheng District, Beijing, 100037, China
| | - Hongbai Wang
- Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 167 BeilishiRd, Xicheng District, Beijing, 100037, China
| | - Jie Ding
- Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 167 BeilishiRd, Xicheng District, Beijing, 100037, China
| | - Xie Wu
- Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 167 BeilishiRd, Xicheng District, Beijing, 100037, China
| | - Dongyun Bie
- Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 167 BeilishiRd, Xicheng District, Beijing, 100037, China
| | - Qiao Liu
- Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 167 BeilishiRd, Xicheng District, Beijing, 100037, China
| | - Ran An
- Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 167 BeilishiRd, Xicheng District, Beijing, 100037, China
| | - Haoqi Yan
- Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 167 BeilishiRd, Xicheng District, Beijing, 100037, China
| | - Fuxia Yan
- Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 167 BeilishiRd, Xicheng District, Beijing, 100037, China.
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Velásquez CV, Moustafa MAM, Rocha SC, Parveen N. Borrelia burgdorferi colonizes the mammary glands of lactating C3H mice: does not cause congenital Lyme disease. Microbes Infect 2024; 26:105241. [PMID: 38380602 PMCID: PMC10882187 DOI: 10.1016/j.micinf.2023.105241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/19/2023] [Accepted: 10/23/2023] [Indexed: 02/22/2024]
Abstract
Transplacental transmission of syphilis causing spirochete, Treponema pallidum subspecies pallidum, from mother to child results in congenital syphilis, an ever-expanding devastating disease worldwide. Although adverse effects of untreated gestational Lyme disease, caused by a related spirochete, Borrelia burgdorferi on fetus viability and development have been observed, cases of congenital Lyme disease are not reported. In this study, we show that B. burgdorferi colonizes mammary glands of C3H mice only postpartum; however, neither transmission of these spirochetes from dams-to-pups occurs nor congenital Lyme disease is observed in pups.
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Affiliation(s)
- Clara Vásquez Velásquez
- Department of Microbiology, Biochemistry and Molecular Genetics, Rutgers New Jersey Medical School, Newark, NJ 07103, USA
| | - Mohamed A M Moustafa
- Department of Microbiology, Biochemistry and Molecular Genetics, Rutgers New Jersey Medical School, Newark, NJ 07103, USA
| | - Sandra C Rocha
- Department of Microbiology, Biochemistry and Molecular Genetics, Rutgers New Jersey Medical School, Newark, NJ 07103, USA
| | - Nikhat Parveen
- Department of Microbiology, Biochemistry and Molecular Genetics, Rutgers New Jersey Medical School, Newark, NJ 07103, USA.
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Fu T, Liu Y, Wang Z, Jing Y, Zhao Y, Shao C, Lv Z, Li G. The recombinant BMP-2 loaded silk fibroin microspheres improved the bone phenotype of mild osteogenesis imperfecta mice. PeerJ 2023; 11:e16191. [PMID: 37927786 PMCID: PMC10621593 DOI: 10.7717/peerj.16191] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/06/2023] [Indexed: 11/07/2023] Open
Abstract
Osteogenesis imperfecta (OI) is an inherited congenital disorder, characterized primarily by decreased bone mass and increased bone fragility. Bone morphogenetic protein-2 (BMP-2) is a potent cytokine capable of stimulating bone formation, however, its rapid degradation and unanticipated in vivo effects restrict its application. The sustained release characteristic of silk fibroin (SF) microspheres may potentially address the aforementioned challenges, nevertheless they have not previously been tested in OI treatment. In the current investigation, recombinant BMP-2 (rBMP-2) loaded SF (rBMP-2/SF) microspheres-based release carriers were prepared by physical adsorption. The SF microparticles were characterized by scanning electron microscopy (SEM) and were investigated for their cytotoxicity behavior as well as the release profile of rBMP-2. The rBMP-2/SF microspheres were administered via femoral intramedullary injection to two genotypes of OI-modeled mice daily for two weeks. The femoral microstructure and histological performance of OI mice were evaluated 2 weeks later. The findings suggested that rBMP-2/SF spheres with a rough surface and excellent cytocompatibility demonstrated an initial rapid release within the first three days (22.15 ± 2.88% of the loaded factor), followed by a transition to a slower and more consistent release rate, that persisted until the 15th day in an in vitro setting. The factor released from rBMP-2/SF particles exhibited favorable osteoinductive activity. Infusion of rBMP-2/SF microspheres, as opposed to blank SF spheres or rBMP-2 monotherapy, resulted in a noteworthy enhancement of femoral microstructure and promoted bone formation in OI-modeled mice. This research may offer a new therapeutic approach and insight into the management of OI. However, further investigation is required to determine the systematic safety and efficacy of rBMP-2/SF microspheres therapy for OI.
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Affiliation(s)
- Ting Fu
- Department of Genetics, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Yi Liu
- Department of Genetics, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Zihan Wang
- Department of Genetics, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Yaqing Jing
- Department of Genetics, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Yuxia Zhao
- Department of Genetics, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Chenyi Shao
- Department of Genetics, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Zhe Lv
- Department of Genetics, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Guang Li
- Department of Genetics, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
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Perez E, Salinas L, Mendoza R, Guerrero ME, Oliva J, Mayta-Tovalino F. Osseointegration of Dental Implants in Patients with Congenital and Degenerative Bone Disorders: A Literature Review. J Int Soc Prev Community Dent 2023; 13:167-172. [PMID: 37564172 PMCID: PMC10411298 DOI: 10.4103/jispcd.jispcd_51_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/19/2022] [Accepted: 05/03/2022] [Indexed: 08/12/2023] Open
Abstract
Aims and Objectives The aim of this study was to describe the mechanism of dental implants osseointegration in patients with congenital and degenerative genetic bone disorders. Materials and Methods A PubMed and Scopus documents search was carried out between November 2021 in the, using words such as "osseointegration," "degenerative disease," "congenital disease," and "dental implants." Results The thirteen articles selected dealt with dental implants osseointegration in patients with congenital and degenerative bone disorders. The influence and repercussion of these diseases on the bone system, as well as the osseointegration process were described from healing to bone remodeling. In addition, certain articles described some considerations to improve the osseointegration process in patients suffering from these types of conditions. Conclusions Within the limitations of this literature review we can conclude that osseointegration in patients with ectodermal dysplasia and osteoporosis could be achieved. However, the planning process for dental implant placement in these patients should be more meticulous and individualized considering the degree of tissue involvement as well as the patient's age and skeletal development compared to systemically healthy patients.
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Affiliation(s)
- Edith Perez
- Academic Department, Faculty of Dentistry, Universidad Nacional Federico Villarreal, Lima, Peru
| | - Liliana Salinas
- Academic Department, Faculty of Dentistry, Universidad Nacional Federico Villarreal, Lima, Peru
| | - Roman Mendoza
- Academic Department, Faculty of Dentistry, Universidad Nacional Federico Villarreal, Lima, Peru
| | - Maria Eugenia Guerrero
- Academic Department of Medical and Surgical Stomatology, Faculty of Dentistry, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Jose Oliva
- Academic Department, Faculty of Dentistry, Universidad Nacional Federico Villarreal, Lima, Peru
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Dubucs C, Aziza J, Sartor A, Heitz F, Sevely A, Sternberg D, Jardel C, Cavallé-Garrido T, Albrecht S, Bernard C, De Bie I, Chassaing N. Severe Antenatal Hypertrophic Cardiomyopathy Secondary to ACAD9-Related Mitochondrial Complex I Deficiency. Mol Syndromol 2023; 14:101-108. [PMID: 37064341 PMCID: PMC10091013 DOI: 10.1159/000526022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 07/12/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction Antenatal presentation of hypertrophic cardiomyopathy (HCM) is rare. We describe familial recurrence of antenatal HCM associated with intrauterine growth restriction and the diagnostic process undertaken. Methods Two pregnancies with antenatal HCM were followed up. Biological assessment including metabolic analyses, genetic analyses, and respiratory chain study was performed. We describe the clinical course of these two pregnancies, antenatal manifestations as well as specific histopathological findings, and review the literature. Results The assessment revealed a deficiency in complex I of the respiratory chain and two likely pathogenic variations in the ACAD9 gene. Discussion and Conclusion Antenatal HCM is rare and a diagnosis is not always made. In pregnancies presenting with cardiomyopathy and intrauterine growth restriction, ACAD9 deficiency should be considered as one of the potential underlying diagnoses, and ACAD9 molecular testing should be included among other prenatal investigations.
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Affiliation(s)
- Charlotte Dubucs
- Département d'Anatomie et de Cytologie Pathologiques, Institut Universitaire du Cancer de Toulouse, Toulouse, France
- Service de Génétique Médicale, CHU Toulouse, Toulouse, France
| | - Jacqueline Aziza
- Département d'Anatomie et de Cytologie Pathologiques, Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | - Agnès Sartor
- Service d'Échographie Prénatale, CHU Toulouse, Toulouse, France
| | - François Heitz
- Service d'Échocardiographie, Clinique Pasteur, Toulouse, France
| | - Annick Sevely
- Service de Neuroradiologie, CHU Toulouse, Toulouse, France
| | - Damien Sternberg
- Service de Biochimie Métabolique, Centre de génétique moléculaire et chromosomique, CHU Pitié-Salpêtrière, AP-HP, Paris, France
| | - Claude Jardel
- Service de Biochimie Métabolique, Centre de génétique moléculaire et chromosomique, CHU Pitié-Salpêtrière, AP-HP, Paris, France
| | - Tiscar Cavallé-Garrido
- Division of Paediatric Cardiology, Department of Paediatrics, Montreal Children's Hospital of the McGill University Health Centre, Montreal, Québec, Canada
| | - Steffen Albrecht
- Department of Pathology, McGill University Health Centre, Montreal, Québec, Canada
| | - Chantal Bernard
- Department of Pathology, McGill University Health Centre, Montreal, Québec, Canada
| | - Isabelle De Bie
- Division of Medical Genetics, Department of Specialized Medicine, McGill University Health Centre, Montreal, Québec, Canada
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8
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Li M, Peng L, Wang Z, Liu L, Cao M, Cui J, Wu F, Yang J. Roles of the cytoskeleton in human diseases. Mol Biol Rep 2023; 50:2847-56. [PMID: 36609753 DOI: 10.1007/s11033-022-08025-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 10/12/2022] [Indexed: 01/08/2023]
Abstract
Recently, researches have revealed the key roles of the cytoskeleton in the occurrence and development of multiple diseases, suggesting that targeting the cytoskeleton is a viable approach for treating numerous refractory diseases. The cytoskeleton is a highly structured and complex network composed of actin filaments, microtubules, and intermediate filaments. In normal cells, these three cytoskeleton components are highly integrated and coordinated. However, the cytoskeleton undergoes drastic remodeling in cytoskeleton-related diseases, causing changes in cell polarity, affecting the cell cycle, leading to senescent diseases, and influencing cell migration to accelerate cancer metastasis. Additionally, mutations or abnormalities in cytoskeletal proteins and their related proteins are closely associated with several congenital diseases. Therefore, this review summarizes the roles of the cytoskeleton in cytoskeleton-related diseases as well as its potential roles in disease treatment to provide insights regarding the physiological functions and pathological roles of the cytoskeleton.
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Adamova P, Lotto RR, Powell AK, Dykes IM. Are there foetal extracellular vesicles in maternal blood? Prospects for diagnostic biomarker discovery. J Mol Med (Berl) 2023; 101:65-81. [PMID: 36538060 PMCID: PMC9977902 DOI: 10.1007/s00109-022-02278-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/14/2022] [Accepted: 12/05/2022] [Indexed: 03/02/2023]
Abstract
Prenatal diagnosis of congenital disease improves clinical outcomes; however, as many as 50% of congenital heart disease cases are missed by current ultrasound screening methods. This indicates a need for improved screening technology. Extracellular vesicles (EVs) have attracted enormous interest in recent years for their potential in diagnostics. EVs mediate endocrine signalling in health and disease and are known to regulate aspects of embryonic development. Here, we critically evaluate recent evidence suggesting that EVs released from the foetus are able to cross the placenta and enter the maternal circulation. Furthermore, EVs from the mother appear to be transported in the reverse direction, whilst the placenta itself acts as a source of EVs. Experimental work utilising rodent models employing either transgenically encoded reporters or application of fluorescent tracking dyes provide convincing evidence of foetal-maternal crosstalk. This is supported by clinical data demonstrating expression of placental-origin EVs in maternal blood, as well as limited evidence for the presence of foetal-origin EVs. Together, this work raises the possibility that foetal EVs present in maternal blood could be used for the diagnosis of congenital disease. We discuss the challenges faced by researchers in translating these basic science findings into a clinical non-invasive prenatal test.
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Affiliation(s)
- Petra Adamova
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Byrom St, Liverpool, L3 3AF, UK.,Liverpool Centre for Cardiovascular Science, Liverpool John Moores University, Liverpool, UK
| | - Robyn R Lotto
- Liverpool Centre for Cardiovascular Science, Liverpool John Moores University, Liverpool, UK.,School of Nursing and Allied Health, Liverpool John Moores University, Tithebarn St, Liverpool, L2 2ER, UK
| | - Andrew K Powell
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Byrom St, Liverpool, L3 3AF, UK.,Liverpool Centre for Cardiovascular Science, Liverpool John Moores University, Liverpool, UK
| | - Iain M Dykes
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Byrom St, Liverpool, L3 3AF, UK. .,Liverpool Centre for Cardiovascular Science, Liverpool John Moores University, Liverpool, UK.
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Gudeloglu E, Akillioglu M, Bedir Demirdag T, Unal NA, Tapisiz AA. Congenital Rubella syndrome: A short report and literature review. Trop Doct 2023; 53:171-175. [PMID: 36321169 DOI: 10.1177/00494755221134327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Rubella infections are rarely seen where immunization programmes are in place. Congenital rubella syndrome is however still observed where the vaccination programme against rubella is not administered or interrupted. We present such a case, with typical clinical anomalies including congenital cataracts, sensorineural hearing loss and bone lesions. The diagnosis was verified by detection of rubella immunoglobulin M positivity in the mother in the first trimester and positive rubella serology in both baby and mother.
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Affiliation(s)
- Elif Gudeloglu
- Faculty of Medicine, Department of Pediatric Infectious Disease, 37511Gazi University, Ankara, Turkey
| | - Merve Akillioglu
- Faculty of Medicine, Department of Pediatric Infectious Disease, 37511Gazi University, Ankara, Turkey
| | - Tugba Bedir Demirdag
- Faculty of Medicine, Department of Pediatric Infectious Disease, 37511Gazi University, Ankara, Turkey
| | - Nursel Atay Unal
- Faculty of Medicine, Department of Pediatric Infectious Disease, 37511Gazi University, Ankara, Turkey
| | - Anil Aktas Tapisiz
- Faculty of Medicine, Department of Pediatric Infectious Disease, 37511Gazi University, Ankara, Turkey
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Grolaux R, Hardy A, Olsen C, Van Dooren S, Smits G, Defrance M. Identification of differentially methylated regions in rare diseases from a single-patient perspective. Clin Epigenetics 2022; 14:174. [PMID: 36527161 PMCID: PMC9758859 DOI: 10.1186/s13148-022-01403-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND DNA methylation (5-mC) is being widely recognized as an alternative in the detection of sequence variants in the diagnosis of some rare neurodevelopmental and imprinting disorders. Identification of alterations in DNA methylation plays an important role in the diagnosis and understanding of the etiology of those disorders. Canonical pipelines for the detection of differentially methylated regions (DMRs) usually rely on inter-group (e.g., case versus control) comparisons. However, these tools might perform suboptimally in the context of rare diseases and multilocus imprinting disturbances due to small cohort sizes and inter-patient heterogeneity. Therefore, there is a need to provide a simple but statistically robust pipeline for scientists and clinicians to perform differential methylation analyses at the single patient level as well as to evaluate how parameter fine-tuning may affect differentially methylated region detection. RESULT We implemented an improved statistical method to detect differentially methylated regions in correlated datasets based on the Z-score and empirical Brown aggregation methods from a single-patient perspective. To accurately assess the predictive power of our method, we generated semi-simulated data using a public control population of 521 samples and investigated how the size of the control population, methylation difference, and region size affect DMR detection. In addition, we validated the detection of methylation events in patients suffering from rare multi-locus imprinting disturbance and evaluated how this method could complement existing tools in the context of clinical diagnosis. CONCLUSION In this study, we present a robust statistical method to perform differential methylation analysis at the single patient level and describe its optimal parameters to increase DMRs identification performance. Finally, we show its diagnostic utility when applied to rare disorders.
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Affiliation(s)
- Robin Grolaux
- grid.4989.c0000 0001 2348 0746Interuniversity Institute of Bioinformatics in Brussels, Université Libre de Bruxelles, Brussels, Belgium
| | - Alexis Hardy
- grid.4989.c0000 0001 2348 0746Interuniversity Institute of Bioinformatics in Brussels, Université Libre de Bruxelles, Brussels, Belgium
| | - Catharina Olsen
- grid.8767.e0000 0001 2290 8069Clinical Sciences, Research Group Reproduction and Genetics, Brussels Interuniversity Genomics High Throughput Core (BRIGHTcore), Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium ,grid.8767.e0000 0001 2290 8069Clinical Sciences, Research Group Reproduction and Genetics, Centre for Medical Genetics, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium ,grid.8767.e0000 0001 2290 8069Interuniversity Institute of Bioinformatics in Brussels, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Sonia Van Dooren
- grid.8767.e0000 0001 2290 8069Clinical Sciences, Research Group Reproduction and Genetics, Brussels Interuniversity Genomics High Throughput Core (BRIGHTcore), Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium ,grid.8767.e0000 0001 2290 8069Clinical Sciences, Research Group Reproduction and Genetics, Centre for Medical Genetics, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium ,grid.8767.e0000 0001 2290 8069Interuniversity Institute of Bioinformatics in Brussels, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Guillaume Smits
- grid.4989.c0000 0001 2348 0746Interuniversity Institute of Bioinformatics in Brussels, Université Libre de Bruxelles, Brussels, Belgium ,grid.4989.c0000 0001 2348 0746Center of Human Genetics, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Matthieu Defrance
- grid.4989.c0000 0001 2348 0746Interuniversity Institute of Bioinformatics in Brussels, Université Libre de Bruxelles, Brussels, Belgium
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12
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Montalva L, Carricaburu E, Sfeir R, Fouquet V, Khen-Dunlop N, Hameury F, Panait N, Arnaud A, Lardy H, Schmitt F, Piolat C, Lavrand F, Ballouhey Q, Scalabre A, Hervieux E, Michel JL, Germouty I, Buisson P, Elbaz F, Lecompte JF, Petit T, Guinot A, Abbo O, Sapin E, Becmeur F, Forgues D, Pons M, Kamdem AF, Berte N, Auger-Hunault M, Benachi A, Bonnard A. Anti-reflux surgery in children with congenital diaphragmatic hernia: A prospective cohort study on a controversial practice. J Pediatr Surg 2022; 57:826-833. [PMID: 35618494 DOI: 10.1016/j.jpedsurg.2022.04.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 04/04/2022] [Accepted: 04/19/2022] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Gastro-esophageal reflux disease (GERD) is the most frequent long-term morbidity of congenital diaphragmatic hernia (CDH) survivors. Performing a preventive fundoplication during CDH repair remains controversial. This study aimed to: (1) Analyze the variability in practices regarding preventive fundoplication; (2) Identify predictive factors for fundoplication. (3) Evaluate the impact of preventive fundoplication on gastro-intestinal outcomes in children with a CDH patch repair; METHODS: This prospective multi-institutional cohort study (French CDH Registry) included CDH neonates born in France between January 1st, 2010-December 31st, 2018. Patch CDH was defined as need for synthetic patch or muscle flap repair. Main outcome measures included need for curative fundoplication, tube feed supplementation, failure to thrive, and oral aversion. RESULTS Of 762 CDH neonates included, 81 underwent fundoplication (10.6%), either preventive or curative. Median follow-up was 3.0 years (IQR: 1.0-5.0). (1) Preventive fundoplication is considered in only 31% of centers. The rates of both curative fundoplication (9% vs 3%, p = 0.01) and overall fundoplication (20% vs 3%, p < 0.0001) are higher in centers that perform preventive fundoplication compared to those that do not. (2) Predictive factors for preventive fundoplication were: prenatal diagnosis (p = 0.006), intra-thoracic liver (p = 0.005), fetal tracheal occlusion (p = 0.002), CDH-grade C-D (p < 0.0001), patch repair (p < 0.0001). After CDH repair, 8% (n = 51) required curative fundoplication (median age: 101 days), for which a patch repair was the only independent predictive factors identified upon multivariate analysis. (3) In neonates with patch CDH, preventive fundoplication did not decrease the need for curative fundoplication (15% vs 11%, p = 0.53), and was associated with higher rates of failure to thrive (discharge: 81% vs 51%, p = 0.03; 6-months: 81% vs 45%, p = 0.008), tube feeds (6-months: 50% vs 21%, p = 0.02; 2-years: 65% vs 26%, p = 0.004), and oral aversion (6-months: 67% vs 37%, p = 0.02; 1-year: 71% vs 40%, p = 0.03). CONCLUSIONS Children undergoing a CDH patch repair are at high risk of requiring a curative fundoplication. However, preventive fundoplication during a patch repair does not decrease the need for curative fundoplication and is associated with worse gastro-intestinal outcomes in children. LEVEL OF EVIDENCE II - Prospective Study.
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Affiliation(s)
- Louise Montalva
- Department of Pediatric General Surgery and Urology, Robert-Debré University Hospital, AP-HP, Paris, France; Sorbonne University, Paris, France.
| | - Elisabeth Carricaburu
- Department of Pediatric General Surgery and Urology, Robert-Debré University Hospital, AP-HP, Paris, France
| | - Rony Sfeir
- Lille University and University Hospital, Lille, France
| | - Virginie Fouquet
- Department of Pediatric Surgery, Paris South University Hospitals, AP-HP, Le Kremlin-Bicêtre, France
| | - Naziha Khen-Dunlop
- Department of Pediatric Surgery, Necker-Enfants Malades, AP-HP, Paris, France
| | - Frederic Hameury
- Department of Pediatric Surgery, Hôpital Femme Mère Enfant University Hospital, Hospices Civils de Lyon, Bron, France
| | - Nicoleta Panait
- Department of Pediatric Surgery, La Timone Children Hospital, Assistance Publique - Hôpitaux de Marseille, Aix-Marseille University, Marseille, France
| | - Alexis Arnaud
- Department of Pediatric Surgery, Rennes University Hospital, Rennes, France
| | - Hubert Lardy
- Department of Pediatric Surgery, Tours University Hospital, Tours, France
| | - Françoise Schmitt
- Department of Pediatric Surgery, Angers University Hospital, Angers, France
| | - Christian Piolat
- Department of Pediatric Surgery, Couple-Enfant Hospital, Grenoble, France
| | - Frederic Lavrand
- Department of Pediatric Surgery, University of Bordeaux, Pellegrin University Hospital, Bordeaux, France
| | - Quentin Ballouhey
- Department of Pediatric Surgery, Limoges University Hospital, Limoges, France
| | - Aurélien Scalabre
- Department of Pediatric Surgery, Hôpital Nord, Saint-Etienne, France
| | - Erik Hervieux
- Department of Pediatric Surgery, Armand Trousseau University Hospital, Paris, France
| | - Jean-Luc Michel
- Department of Pediatric Surgery, Felix Guyon Hospital, La Réunion, France
| | - Isabelle Germouty
- Department of Pediatric Surgery, Brest University Hospital, Brest, France
| | - Philippe Buisson
- Department of Pediatric Surgery, Amiens University Hospital, Amiens, France
| | - Frederic Elbaz
- Department of Pediatric Surgery, University Hospital, Rouen, France
| | - Jean-Francois Lecompte
- Department of Pediatric Surgery, Nice Pediatric Hospital, University of Nice-Sophia Antipolis, Nice, France
| | - Thierry Petit
- Department of Pediatric Surgery, Caen University Hospital, Caen, France
| | - Audrey Guinot
- Department of Pediatric Surgery, Hôtel-Dieu University Hospital, Nantes, France
| | - Olivier Abbo
- Department of Pediatric Surgery, Hôpital des Enfants, Toulouse, France
| | - Emmanuel Sapin
- Department of Pediatric Surgery, Dijon University Hospital, Dijon, France
| | - François Becmeur
- Department of Pediatric Surgery, Strasbourg University Hospital, Strasbourg, France
| | - Dominique Forgues
- Department of Pediatric Surgery, Montpellier University Hospital, Montpellier, France
| | - Maguelonne Pons
- Department of Pediatric Surgery, Clermont Ferrand University Hospital, Clermont Ferrand, France
| | - Arnaud Fotso Kamdem
- Department of Pediatric Surgery, Besançon University Hospital, Besançon, France
| | - Nicolas Berte
- Department of Pediatric Surgery, University Hospital, Nancy, France
| | - Marie Auger-Hunault
- Department of Pediatric Surgery, Poitiers University Hospital, Poitiers, France
| | - Alexandra Benachi
- Université Paris-Sud, Le Kremlin-Bicêtre, France; Centre de Référence des Maladies Rares, Hernie de Coupole Diaphragmatique, France; Service de Gynécologie-Obstétrique, Assistance Publique-Hôpitaux de Paris, Hôpital Antoine Béclère, Clamart, France
| | - Arnaud Bonnard
- Department of Pediatric General Surgery and Urology, Robert-Debré University Hospital, AP-HP, Paris, France
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13
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Jaber A, Schwarze M, Steinle V, Götze M, Hagmann S. Pediatric patient with a bilateral Salter-Harris II fracture and slipped capital femoral epiphysis secondary to autosomal recessive osteopetrosis. Orthopadie (Heidelb) 2022; 51:1015-1021. [PMID: 35802155 PMCID: PMC9715516 DOI: 10.1007/s00132-022-04278-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/08/2022] [Indexed: 06/15/2023]
Abstract
Treatment of femoral neck fractures secondary to osteopetrosis is an uncertain and puzzled decision. Experience in the treatment, especially in the pediatric population, is scarcely reported. The duration of conservative treatment is prolonged and poses the risks of non-union and development of coxa vara deformity. The recommended treatment is closed reduction and internal fixation; however, surgery on osteopetrotic bone is challenging due to defective bone marrow function, delayed consolidation and higher risk of intraoperative fractures. Slipped capital femoral epiphysis secondary to osteopetrosis is very rarely reported. This article presents the case of a 5-year-old female patient with rapidly deteriorating physical function due to bilateral proximal femoral Salter-Harris type II fractures with associated slippage of the growth plates secondary to confirmed autosomal recessive osteopetrosis. Operative treatment was performed in a tertiary level orthopedic center with closed reduction and internal fixation with cannulated screws. A loss of fixation with coxa vara deformity was seen on the left side 7 months postoperatively with increasing pain. A revision surgery with reosteosynthesis and a valgus osteotomy was thus performed which showed good subjective and objective results 1 year postoperatively with complete bony union.
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Affiliation(s)
- Ayham Jaber
- Department of Orthopedics and Trauma Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstr. 200a, 69118, Heidelberg, Germany.
| | - Martin Schwarze
- Department of Orthopedics and Trauma Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstr. 200a, 69118, Heidelberg, Germany
| | - Verena Steinle
- Department of Diagnostic and interventional Radiology, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
| | - Marco Götze
- Department of Orthopedics and Trauma Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstr. 200a, 69118, Heidelberg, Germany
| | - Sébastien Hagmann
- Department of Orthopedics and Trauma Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstr. 200a, 69118, Heidelberg, Germany
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14
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Galassi FM, Torrisi E, Varotto E. Comment on Turgut et al.'s Three mythic giants for common fetal malformation called "cyclopia": Polyphemus, Tepegöz, and Grendel. Childs Nerv Syst 2021; 37:3665-3666. [PMID: 34596767 DOI: 10.1007/s00381-021-05367-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 09/15/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Francesco M Galassi
- Archaeology, College of Humanities, Arts and Social Sciences, Flinders University, Adelaide, SA, Australia.,FAPAB Research Center, Avola (SR), Sicily, Italy
| | | | - Elena Varotto
- Archaeology, College of Humanities, Arts and Social Sciences, Flinders University, Adelaide, SA, Australia. .,FAPAB Research Center, Avola (SR), Sicily, Italy. .,Department of Humanities (DISUM), University of Catania, Catania, Sicily, Italy.
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15
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Deniz M, Tapısız A, Tezer H, Demirdag TB. Bilateral ocular involvement in congenital toxoplasmosis: A case report and literature review. Trop Doct 2021; 51:652-654. [PMID: 33476225 DOI: 10.1177/0049475520986387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We report a case of neuro-ophthalmological complications of congenital toxoplasmosis, a parasitic infection caused by Toxoplasma gondi. Its congenital form occurs either as a primary infection or as reactivation of the same due to immunosuppression during pregnancy. With an incidence rate of 1.5/1000 live births, this disease is an important cause of visual loss from chorio-retinal lesions in >82%. Recent studies have shown that treatment given in utero and in the first year of life can reduce ophthalmological complications.
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Affiliation(s)
- Melis Deniz
- MD, Research Fellow, Department of Pediatric Infectious Diseases, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Anıl Tapısız
- Professor, Department of Pediatric Infectious Diseases, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Hasan Tezer
- Professor, Department of Pediatric Infectious Diseases, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Tugba Bedir Demirdag
- Assistant Professor, Department of Pediatric Infectious Diseases, Faculty of Medicine, Gazi University, Ankara, Turkey
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16
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Nezami A, Heidari G, Tarhani F, Kariminia M. Prevalence of Congenital Heart Disease among Children in Khorramabad (West of Iran). Cardiovasc Hematol Disord Drug Targets 2021; 21:61-65. [PMID: 33390151 DOI: 10.2174/1871529x20999201231205746] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/20/2020] [Accepted: 11/13/2020] [Indexed: 11/22/2022]
Abstract
AIMS Congenital heart disease is among the most common congenital anomalies in pediatrics. The aim of this study was to evaluate the prevalence of congenital heart disease in children in Khorramabad, Iran. METHODS This is a descriptive-cross sectional study where all the children diagnosed with congenital heart disease by echocardiography were enrolled to the Shahid Madani Hospital. Patient information was collected by means of a questionnaire. Of 1600 children who underwent cardiac counseling, 9.75% presented congenital heart disease. These were most prevalent among the children of 0-28 days of the age (14.7%) and least in children aged 1 month-1 year. According to this study, atrial (20.3%) and ventricular septal defect (10.5%) were the most common heart defects, respectively. Among signs and symptoms of cardiac disease, 49.1% of children had cyanosis, 89.7% with increased CT (cardiothoracic)-ratio, and 82.7% of had heart murmur. Congenital heart disease was more prevalent in male infants (58%) and 6.6% patients had heart failure and 1.4% had other congenital conditions, such as Down syndrome. RESULTS According to our findings, atrial and ventricular septal defects are the most common congenital heart anomalies, respectively, in pediatric patients in Khorramabad.
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Affiliation(s)
- Alireza Nezami
- Department of Paediatrics, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Ghobad Heidari
- Department of Paediatrics, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad,, Iran
| | - Fariba Tarhani
- Department of Paediatrics, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad,, Iran
| | - Masoumeh Kariminia
- Student of Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
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17
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Hoefnagels JW, Fischer K, Bos RAT, Driessens MHE, Meijer SLA, Schutgens REG, Schrijvers LH. A feasibility study on two tailored interventions to improve adherence in adults with haemophilia. Pilot Feasibility Stud 2020; 6:189. [PMID: 33292771 PMCID: PMC7708110 DOI: 10.1186/s40814-020-00723-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 11/03/2020] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Haemophilia is a congenital bleeding disorder mainly affecting males. To prevent bleeding, patients need to perform regular intravenous injections (prophylaxis) throughout life. Non-adherence often occurs. Problems with acceptance or self-management appear to be the main reasons for non-adherence in haemophilia. The aim of this study was to test the feasibility and effects of two interventions focussed on acceptance (face-to-face) and self-management (online). METHODS Patients with severe haemophilia and acceptance or self-management problems were eligible. The face-to-face group intervention was based on Acceptance and Commitment Therapy (ACT) (8 sessions/6 months, target N = 8 participants). The online intervention was based on a successful online programme in rheumatoid arthritis (5-8 modules/2 months, target N = 8). Both interventions were designed according to the MRC framework in collaboration with the patient society and experts. We compared adherence (VERITAS-Pro, optimum 0), quality of life (SF-36, optimum 100) and illness perception (BIPQ, optimum 0) before start (T0) and after 2 months (T2). Feasibility criteria were as follows: completion of training by > 50% of participants and ability to collect at least 80% of outcome parameters. RESULTS The face-to-face intervention was feasible (89% enrolment and recruitment, 100% retention). One hundred percent of the outcome parameters was collected. Results were promising: although adherence (VERITAS-Pro) was stable (from 64 to 62 points), quality of life (SF-36) showed a clinically relevant improvement (> 5 points) in five of eight domains. Illness perception (BIPQ) showed a clinically relevant increase from 47 to 39 points. Patient evaluation was positive. The online intervention, however, was infeasible: enrolment was only 20% (6/30). Only three patients signed informed consent (recruitment 10%), and none completed more than one module (retention 0%). Consequently, the online intervention was terminated. CONCLUSION The face-to-face acceptance intervention was considered feasible with promising results. Unfortunately, the online intervention was infeasible and therefore terminated. These findings suggest that adapting effective interventions to other settings does not guarantee success, despite the use of established methodology and patient participation. Population differences (only male participants, congenital disease) could be an explanation for failure of the online intervention in haemophilia despite success in rheumatoid arthritis. TRIAL REGISTRATION NL55883.041.16.
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Affiliation(s)
- J W Hoefnagels
- Division Internal Medicine and Dermatology, Van Creveldkliniek, University Medical Center Utrecht, PO Box 85500, 3508, GA, Utrecht, The Netherlands.
| | - K Fischer
- Division Internal Medicine and Dermatology, Van Creveldkliniek, University Medical Center Utrecht, PO Box 85500, 3508, GA, Utrecht, The Netherlands
| | - R A T Bos
- Division Internal Medicine and Dermatology, Van Creveldkliniek, University Medical Center Utrecht, PO Box 85500, 3508, GA, Utrecht, The Netherlands
| | - M H E Driessens
- Netherlands Haemophilia Patient Society (NVHP), Nijkerk, The Netherlands
| | - S L A Meijer
- Netherlands Haemophilia Patient Society (NVHP), Nijkerk, The Netherlands
| | - R E G Schutgens
- Division Internal Medicine and Dermatology, Van Creveldkliniek, University Medical Center Utrecht, PO Box 85500, 3508, GA, Utrecht, The Netherlands
| | - L H Schrijvers
- Division Internal Medicine and Dermatology, Van Creveldkliniek, University Medical Center Utrecht, PO Box 85500, 3508, GA, Utrecht, The Netherlands
- Utrecht University of Applied Sciences, Utrecht, The Netherlands
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Chouchen IB, Nouira F, Ahmed YB, Bchini F, Jlidi S. Congenital urethrocele in children. A case report. Int J Surg Case Rep 2020; 77:45-47. [PMID: 33137671 PMCID: PMC7610034 DOI: 10.1016/j.ijscr.2020.10.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 10/21/2020] [Accepted: 10/21/2020] [Indexed: 11/19/2022] Open
Abstract
This article proposes to discuss clinical, paraclinical and therapeutic characteristics of congenital urethrocele in children. We report a case of a 19-month-old child presenting with a penoscrotal mass. Diagnosis rests essentially on the micturating cystourethrography. Management of the lesion can be by endoscopic or open surgery. It depends on the size of the diverticulum and the degree of obstruction. An early, precise diagnosis and awareness of the anterior urethral diverticulum in boys with obstructive symptoms can reduce incidence of advanced uropathies.
Introduction Congenital urethrocele is a rare disease in children. The diagnosis is often easy but the management remain difficult due to the risk of urethral stenosis form. Case presentation We report a case of a 19-month-old child presenting with a penoscrotal mass. Cystourethroscopy confirmed the diagnosis of an urethrocele of the anterior urethra. Urethrocele repair was performed with good results. We propose to discuss clinical, paraclinical and therapeutic characteristics of congenital urethrocele in children. Conclusion An early, precise diagnosis and awareness of the anterior urethral diverticulum in boys with obstructive symptoms can reduce incidence of advanced uropathies.
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Affiliation(s)
- Ines Ben Chouchen
- Children's Hospital Bechir Hamza of Tunis, Tunisia; Pediatric Surgery Department B, Tunis, Tunisia
| | - Faouzi Nouira
- Children's Hospital Bechir Hamza of Tunis, Tunisia; Pediatric Surgery Department B, Tunis, Tunisia
| | - Yosra Ben Ahmed
- Children's Hospital Bechir Hamza of Tunis, Tunisia; Pediatric Surgery Department B, Tunis, Tunisia
| | - Fatma Bchini
- Children's Hospital Bechir Hamza of Tunis, Tunisia; Pediatric Surgery Department B, Tunis, Tunisia.
| | - Said Jlidi
- Children's Hospital Bechir Hamza of Tunis, Tunisia; Pediatric Surgery Department B, Tunis, Tunisia
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Floyd R, Michel AO, Piersigilli A, Aronowitz E, Voss HU, Ricart Arbona RJ. Ethmoidal meningoencephalocele in a C57BL/6J mouse. Lab Anim 2020; 55:181-188. [PMID: 32787540 DOI: 10.1177/0023677220944449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
An otherwise healthy two-month-old female C57BL/6J mouse presented with a left-sided head tilt. Differential diagnoses included idiopathic necrotizing arteritis, bacterial otitis media/interna (Pasteurella pneumotropica, Pseudomonas aeruginosa, Streptococcus sp., Mycoplasma pulmonis and Burkholderia gladioli), encephalitis, an abscess, neoplasia, a congenital malformation and an accidental or iatrogenic head trauma. Magnetic resonance imaging (MRI) revealed a large space-occupying right olfactory lobe intra-axial lesion with severe secondary left-sided subfalcine herniation. Following imaging, the animal was euthanized due to poor prognosis. Histopathologic examination revealed a unilateral, full-thickness bone defect at the base of the cribriform plate and nasal conchae dysplasia, resulting in the herniation of the olfactory bulb into the nasal cavity. There was also a left midline-shift of the frontal cortex and moderate catarrhal sinusitis in the left mandibular sinus. The MRI and histopathologic changes are consistent with a congenital malformation of the nasal cavity and frontal aspect of the skull known as an ethmoidal meningoencephalocele. Encephaloceles are rare abnormalities caused by herniation of contents of the brain through a defect in the skull which occur due to disruption of the neural tube closure at the level anterior neuropore or secondary to trauma, surgical complications, cleft palate or increased intracranial pressure. The etiology is incompletely understood but hypotheses include genetics, vitamin deficiency, teratogens, infectious agents and environmental factors. Ethmoidal encephaloceles have been reported in multiple species including humans but have not been reported previously in mice. There are multiple models for spontaneous and induced craniofacial malformation in mice, but none described for ethmoidal encephaloceles.
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Affiliation(s)
- Rebecca Floyd
- Tri-Institutional Training Program in Laboratory Animal Medicine and Science, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine, and The Rockefeller University, USA
| | - Adam O Michel
- Tri-Institutional Training Program in Laboratory Animal Medicine and Science, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine, and The Rockefeller University, USA.,Center of Comparative Medicine and Pathology, Memorial Sloan Kettering Cancer Center and Weill Cornell Medicine, USA.,Laboratory for Comparative Pathology, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine and The Rockefeller University, USA
| | - Alessandra Piersigilli
- Tri-Institutional Training Program in Laboratory Animal Medicine and Science, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine, and The Rockefeller University, USA.,Center of Comparative Medicine and Pathology, Memorial Sloan Kettering Cancer Center and Weill Cornell Medicine, USA.,Laboratory for Comparative Pathology, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine and The Rockefeller University, USA
| | - Eric Aronowitz
- Laboratory for Comparative Pathology, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine and The Rockefeller University, USA
| | - Henning U Voss
- Laboratory for Comparative Pathology, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine and The Rockefeller University, USA
| | - Rodolfo J Ricart Arbona
- Tri-Institutional Training Program in Laboratory Animal Medicine and Science, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine, and The Rockefeller University, USA.,Center of Comparative Medicine and Pathology, Memorial Sloan Kettering Cancer Center and Weill Cornell Medicine, USA
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20
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Dehaini H, Nasser Eldine R, Doughan S, Khalifeh M, Khasawneh H, Hussain H, Sbaity E. Presentation of intestinal malrotation and midgut volvulus in adults: Case report & literature review. Int J Surg Case Rep 2020; 73:27-30. [PMID: 32629217 PMCID: PMC7338997 DOI: 10.1016/j.ijscr.2020.06.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Malrotation is considered a newborn disease. This case report sheds light on the rare, but possible late presentation of malrotation in adulthood, which if missed, can leave the patient in a detrimental state. PRESENTATION OF CASE 28-year-old female presented in critical state with acute abdomen. Computed tomography abdomen/pelvis showed midgut volvulus, requiring urgent laparotomy. The patient's bowels were discolored, yet they normalized upon detorsion, except for a small portion, which was equivocal and left for observation. Ladd's bands were excised, and the abdomen was closed with Bogota bag for re-exploration. The patient underwent two more laparotomies to observe the intestinal segment until it was back to normal. Ladd procedure was then completed, and an absorbable mesh was applied. Follow-up of 20 months has been uneventful, except for a small, asymptomatic, incisional hernia. DISCUSSION Malrotation in adults is often missed due to its subacute, nonspecific presentation. It is often diagnosed by CT abdomen, which shows inversion or vertical positioning of the superior mesenteric vessels. Symptomatic, but stable patients, can undergo laparoscopic Ladd procedure, which carries the benefit of less length of stay. While an incidental malrotation can be prophylactically operated on, correcting asymptomatic malrotation beyond age of 20 is ineffective and possibly harmful. CONCLUSION Intestinal malrotation presenting in an adult should be on the differential diagnosis when dealing with abdominal pain, especially in the context of small bowel obstruction in a virgin abdomen. It is vital to consider a patient's age prior to prophylactically operate on malrotation discovered incidentally.
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Affiliation(s)
- Hassan Dehaini
- Division of General Surgery, Department of Surgery, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
| | - Rakan Nasser Eldine
- Division of Vascular & Endovascular Surgery, Department of Surgery, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
| | - Samer Doughan
- Division of General Surgery, Department of Surgery, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
| | - Mohammad Khalifeh
- Division of General Surgery, Department of Surgery, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
| | - Hala Khasawneh
- Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
| | - Hero Hussain
- Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
| | - Eman Sbaity
- Division of General Surgery, Department of Surgery, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
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21
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Gallo LG, Martinez-Cajas J, Peixoto HM, Pereira ACEDS, Carter JE, McKeown S, Schaub B, Ventura CV, de França GVA, Pomar L, Ventura LO, Nerurkar VR, de Araújo WN, Velez MP. Another piece of the Zika puzzle: assessing the associated factors to microcephaly in a systematic review and meta-analysis. BMC Public Health 2020; 20:827. [PMID: 32487247 PMCID: PMC7266116 DOI: 10.1186/s12889-020-08946-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 05/18/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Although it is known that Zika virus (ZIKV) infection during pregnancy may lead to microcephaly in the fetus, the prognostic factors associated with this tragic disorder remain unclear. We conducted a systematic review and meta-analysis to assess the prognostic factors associated with the incidence of microcephaly in congenital ZIKV infection. METHODS We conducted a comprehensive search in Ovid MEDLINE, Ovid MEDLINE (R) Epub ahead of print, Embase, Embase Classic, Web of Science, CINAHL, Cochrane CENTRAL, LILACS, and various thesis databases to identify human studies reporting microcephaly associated with congenital ZIKV infection. We requested primary data from the authors of the included studies to calculate summary estimates and conduct the meta-analysis of the most prevalent factors. RESULTS We screened 4106 titles and abstracts, and identified 12 studies for inclusion in the systematic review. The assessment of ZIKV infection and the definition of microcephaly varied among studies. A total of 6154 newborns/fetuses were enrolled; of those, 1120 (18.20%) had a diagnostic of ZIKV infection, of which 509 (45.45%) were diagnosed with microcephaly. Nine studies addressed the link between congenital ZIKV infection and neurological findings in newborns/fetuses. Half of the studies provided primary data. Three out of 11 factors of interest seem to be prognostic factors of microcephaly: infant's sex - males compared to females: Relative Risk (RR) 1.30, 95% Confidence Interval (95% CI) 1.14 to 1.49; the stage of pregnancy when infection occurred - infection in the first trimester of pregnancy compared to infection at other stages of pregnancy: RR 1.41, 95% CI 1.09 to 1.82; and asymptomatic infection compared to symptomatic infection during pregnancy: RR 0.68; 95% CI 0.60 to 0.77. CONCLUSION Our findings support the female-biased resistance hypothesis and reinforce the risk associated with the stage of pregnancy when ZIKV infection occurs. Continued surveillance of ZIKV infection during pregnancy is needed to identify additional factors that could contribute to developing microcephaly in affected fetuses. PROTOCOL REGISTRATION This systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration no. CRD 42018088075.
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Affiliation(s)
- Luciana Guerra Gallo
- Postgraduate Program in Tropical Medicine, University of Brasilia, Brasilia, Brazil
- Department of Obstetrics and Gynecology and Department of Public Health Sciences, Queen's University, Kingston, Canada
| | | | - Henry Maia Peixoto
- Postgraduate Program in Tropical Medicine, University of Brasilia, Brasilia, Brazil
| | | | - Jillian E Carter
- Department of Obstetrics and Gynecology and Department of Public Health Sciences, Queen's University, Kingston, Canada
| | - Sandra McKeown
- Bracken Health Sciences Library, Queen's University, Kingston, Canada
| | - Bruno Schaub
- Centre Pluridisciplinaire de Diagnostic Prénatal de le Martinique, Maison de la Femme, de la Mère et de l'Enfant, University Hospital of Martinique, Fort-de-France, Martinique
| | - Camila V Ventura
- Department of Scientific Investigation, Altino Ventura Foundation, Recife, Brazil
| | | | - Léo Pomar
- Materno-fetal and Obstetrics Research Unit, Département "Femme-Mère Enfant", University Hospital, Lausanne, Switzerland
- Department of Obstetrics and Gynaecology, Centre Hospitalier de l'Ouest Guyanais Franck Joly, Saint-Laurent-du-Maroni, French Guiana
| | - Liana O Ventura
- Department of Pediatric Ophthalmology and Strabismus, Altino Ventura Foundation, Recife, Brazil
| | - Vivek R Nerurkar
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, USA
| | | | - Maria P Velez
- Department of Obstetrics and Gynecology and Department of Public Health Sciences, Queen's University, Kingston, Canada.
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Hamad D, Yousef Y, Caminsky NG, Guadagno E, Tran VA, Laberge JM, Emil S, Poenaru D. Defining the critical pediatric surgical workforce density for improving surgical outcomes: a global study. J Pediatr Surg 2020; 55:493-512. [PMID: 31839371 DOI: 10.1016/j.jpedsurg.2019.11.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 11/02/2019] [Accepted: 11/05/2019] [Indexed: 12/20/2022]
Abstract
PURPOSE Low- and middle-income countries (LMICs) have only 19% of the global surgical workforce yet see 80% of worldwide deaths from noncommunicable diseases. We aimed to interrogate the correlation between pediatric surgical workforce density (PSWD) and survival from pediatric surgical conditions worldwide. METHODS A systematic review of online databases identified outcome studies for key pediatric surgical conditions (gastroschisis, esophageal atresia, intestinal atresia, and typhoid perforation) as well as PSWD data across low-income (LICs), middle-income (MICs), and high-income countries (HICs). PSWD was expressed as the number of PSs/million children under 15 years of age and we correlated this to surgical outcomes for our case series. RESULTS PSWD ranged between zero (Burundi, The Gambia, and Mauritania) and 125.2 (Poland) across 86 countries. Outcomes for at least one condition were obtained in 61 countries: 50 outcomes in HICs, 52 in MICs and 8 in LICs. The mean survival in our case series was 42.3%, 69.4% and 91.6% for LICs, MICs, and HICs, respectively. A PSWD ≥4 PSs/million children under 15 years of age significantly correlated to odds of survival ≥80% (OR 16.8, p < 0.0001, 95% CI 5.66-49.88). Specifically in the studied LICs and MICs, increasing the PSWD to 4 would require training 1427 additional surgeons. CONCLUSION Using a novel approach, we have established a benchmark for the scale-up of pediatric surgical workforce, which may support broader efforts to reduce childhood deaths from congenital disease. LEVELS OF EVIDENCE 2c - Outcomes Research.
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Affiliation(s)
- Doulia Hamad
- Division of Pediatric General and Thoracic Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Yasmine Yousef
- Division of Pediatric General and Thoracic Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Natasha G Caminsky
- Division of Pediatric General and Thoracic Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Elena Guadagno
- Division of Pediatric General and Thoracic Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Viet Anh Tran
- Division of Pediatric General and Thoracic Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Jean-Martin Laberge
- Division of Pediatric General and Thoracic Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Sherif Emil
- Division of Pediatric General and Thoracic Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Dan Poenaru
- Division of Pediatric General and Thoracic Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada.
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Nithiyanantham SF, Badawi A. Maternal infection with Zika virus and prevalence of congenital disorders in infants: systematic review and meta-analysis. Can J Public Health 2019; 110:638-648. [PMID: 31077071 DOI: 10.17269/s41997-019-00215-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 04/04/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Zika virus (ZIKV) infection is a vector-borne disease that can be transmitted sexually and vertically. The vertical transmission of the virus may lead to congenital Zika syndrome in infants. The aim of this study is to conduct a systematic review and meta-analysis of published reports documenting the prevalence of congenital Zika-related disorders in infants of mothers infected with ZIKV during pregnancy. METHODS We conducted a comprehensive search in Ovid MEDLINE, Ovid MEDLINE (R) Epub ahead of print, Embase, Embase Classic and Web of Science databases to identify human studies reporting prevalence of congenital disorders in infants of ZIKV-infected mothers. RESULTS We identified 25 reports selected for inclusion in the current study (n = 4683 subjects). The majority of the studies were from South American high-risk countries. Only one third of the identified studies were conducted in the United States. Clinical maternal symptoms included maculopapular rash (76.9%), arthralgia (46.4%), fever (45.5%) and headache (31.8%) with myalgia and conjunctivitis only presented in 25% of the cases. The most prevalent congenital disorder in the newborns was brain calcifications (42.6; 95% CI, 30.8-54.4), followed by ventriculomegaly (21.8; 95% CI, 15.2-28.4), joint abnormalities (13.2; 95% CI, 9.4-18.2), ocular abnormalities (4.2; 95% CI, 1.0-7.5) and microcephaly (3.9; 95% CI, 2.4-5.4). CONCLUSION The current study highlights the high prevalence of a range of congenital disorders in newborns of mothers infected with ZIKV. It warrants developing studies to further clarify the mechanisms by which each of these disorders occurs in response to the viral infection during pregnancy and its vertical transmission to the infants.
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Affiliation(s)
| | - Alaa Badawi
- Public Health Risk Sciences Division, Public Health Agency of Canada, 180 Queen Street West, Rm 8-15, Toronto, ON, M5V 3L7, Canada. .,Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
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24
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Hove MG, Gil JM, Rodríguez TS, Lomas ÁF, Casajús JP, López-Farré A, Guijarro JDJ. Laparoscopic approach to tailgut cyst (retrorectal cystic hamartoma). J Minim Access Surg 2019; 15:262-264. [PMID: 30416148 PMCID: PMC6561055 DOI: 10.4103/jmas.jmas_71_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Retrorectal cystic hamartomas, or tailgut cysts, are complex congenital cystic lesions which arise from embryologic tissues. Fewer than 200 cases have been reported worldwide, with women outnumbering men by 3:1. They are asymptomatic in 50% of the cases; the remainder present with back pain or mass effect as the most common symptoms. Malignant transformation rarely occurs. Guided biopsy is controversial, while surgery is the therapy of choice. We report the case of a 31-year-old woman complaining about perineal and vague lower abdominal pain, who was submitted to magnetic resonance imaging, which revealed a multilocular cystic, well-circumscribed retrorectal mass. Subsequently, laparoscopic excision was successfully accomplished. Operative time was 175 min. Intra- and post-operative course was uneventful. Hospital stay was 75 h. While any malignancy suspicion should lead to open surgery, given the risk of rupture, we support the benefits of laparoscopy may also be applied.
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Affiliation(s)
| | - Jorge Martín Gil
- Department of Surgery, Hospital Quironsalud San José, Madrid, Spain
| | | | | | | | - Antonio López-Farré
- Department of Medicine, School of Medicine, Complutense University, Madrid, Spain
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25
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Abstract
This case series of 51 patients (age range = 11-17 years; 30-month follow-up) describes a new modified approach to treatment of distal and mid-penile hypospadias that has fewer complications. The meatal locations were sub-coronal (51%), coronal (45%) and mid-penile (4%). Forty patients had chordee. Urethra with the corpus spongiosum was dissected off the corpus cavernosum up to the peno-scrotal junction. The distal 5 mm stenotic and avascular part of the urethral tube was excised. The elastic urethra was then stretched and sutured to form a neo-meatus. The urethra was anchored to the Buck's fascia at the glandular, sub-coronal and mid-penile levels. Meatal regression in one patient (2%), subcutaneous hematomas in two patients (4%) and wound dehiscence in two patients (4%) were the complications in the immediate postoperative period. None developed fistula, meatal stenosis or residual chordee in the 30-month follow-up.
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Affiliation(s)
- Sagar A Jawale
- 1 CEO, Jawale Institute of Pediatric Surgery, Jalgaon, Maharashtra, India
| | - Gnanaraj Jesudian
- 2 Professor of Surgical Innovation and Consultant Urologist & Laparoscopic Surgeon, Karunya Rural Community Hospital, Coimbatore, Tamil Nadu, India
| | - Rajendra Nehete
- 3 Head of Department, Vedant Plastic, Cosmetic, Hand & Orthopedic Hospital, Nashik, India
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26
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Abstract
In 2011 a phenomenon involving complex chromosomal rearrangements was discovered in cancer genomes. This phenomenon has been termed chromothripsis, on the basis of its chromosomal hallmarks, which point to an underlying process involving chromosome (chromo) shattering (thripsis). The prevailing hypothesis of cancer genome evolution as a gradual process of mutation and selection was challenged by the discovery of chromothripsis, because its patterns of chromosome rearrangement rather indicated an one-off catastrophic burst of genome rearrangement. The initial discovery of chromothripsis has led to many more examples of chromothripsis both in cancer genomes as well as in patients with congenital diseases and in the genomes of healthy individuals. Since then, a burning topic has been the study of the molecular mechanism that leads to chromothripsis. Cumulating evidence has shown that chromothripsis may result from lagging chromosomes encapsulated in micronuclei, as well as from telomere fusions followed by chromosome bridge formation. In this chapter, we will outline the genomic characteristics of chromothripsis, and we present genomic methodologies that enable the detection of chromothripsis. Furthermore, we will give an overview of recent insights into the mechanisms underlying chromothripsis.
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Affiliation(s)
- Alessio Marcozzi
- Division of Biomedical Genetics, Department of Genetics, Center for Molecular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Franck Pellestor
- Laboratory of Chromosomal Genetics, Department of Medical Genetics, Arnaud de Villeneuve Hospital, Montpellier CHRU, Montpellier, France.,INSERM Unit Plasticity of the Genome and Aging, Institute of Functional Genomics, Montpellier, France
| | - Wigard P Kloosterman
- Division of Biomedical Genetics, Department of Genetics, Center for Molecular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
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27
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Manickchund Y, Hadley GP. Paediatric surgery outreach: analysis of referrals to a tertiary paediatric surgery service to plan an outreach programme Kwa-Zulu Natal, South Africa. Trop Doct 2017; 47:305-311. [PMID: 28682220 DOI: 10.1177/0049475517718103] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Paediatric surgical disease is a neglected health problem. Patients travel great distances to tertiary level care for management. This study aimed at analysing referral patterns to design an outreach programme for paediatric surgery in KwaZulu Natal. Data forms of patients referred to the service between January and July 2016 were correlated with the clinical record. Delays in management were compared to morbidity and mortality. Out of 781, 158 referrals were accepted as emergencies. The majority (62%) were children aged < 1 year. Gastro-intestinal problems (38.4%) and congenital anomalies (26.9%) formed the majority. Patients who died had a significantly longer delay in transfer. Longer total delay was associated with statistically significant greater morbidity. In a setting where a large rural population is served by single-centre tertiary care, delays exist and contribute to morbidity. The authors advocate the establishment of an outreach programme to address these issues.
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Affiliation(s)
- Yashoda Manickchund
- 1 Paediatric Surgery Registrar, Department of Paediatric Surgery Nelson R Mandela School of Medicine, University of Kwazulu Natal, Durban, South Africa
| | - G P Hadley
- 2 Professor Emeritus, Department of Paediatric Surgery, Nelson R Mandela School of Medicine, University of Kwazulu Natal, Durban, South Africa
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28
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Alsaywid BS, Mohammedkhalil AK, Mesawa AA, Alzahrani SY, Askar AH, Abuznadah WT, Alrimawi MH. Role of tubularization of urethral plate in development of urethrocutaneous fistula post hypospadias repair. Urol Ann 2017; 9:141-144. [PMID: 28479764 PMCID: PMC5405656 DOI: 10.4103/ua.ua_152_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Introduction: This study aimed to demonstrate the outcome of hypospadias repair in the pediatric population using the tubularized urethral plate technique and to compare the incidence of fistula between incised and unincised urethral plate. Methodology: This is a retrospective cohort study of pediatric patients who had hypospadias repair in a tertiary hospital in Jeddah, Saudi Arabia, between January 2000 and December 2012. They were divided into two main groups according to the status of the urethral plate: Group A included patients who had incision of the urethral plate just before tubularization, and Group B included patients who underwent tubularization without incision. Results: After reviewing 310 medical records, 106 patients were included in the final analysis, with a median age of 2 years (interquartile range = 3 years). There was no statistically significant relationship between types of hypospadias and the development of fistula (P = 0.26). In Group A, we identified 87 patients (82%), and in Group B, there were 19 patients (18%). The overall incidence of fistula was 34.9% (n = 37). The incidence of fistula in Groups A and B was 36% (n = 31) and 32% (n = 6), respectively. This difference was not statistically significant. Despite a high fistula rate, only 12 patients (11%) were required to repeat surgery. Conclusion: Incision of the urethral plate did not affect the fistula rate. In comparison to international literature, the incidence of fistula was significantly higher which could be explained by the fact that one-third of those patients had a previous hypospadias repair.
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Affiliation(s)
- Basim S Alsaywid
- Department of Surgery, Urology Section, King Khalid National Guard Hospital, King Abdulaziz Medical City, Jeddah, Saudi Arabia.,Department of Surgery, Urology Section, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Abdullah K Mohammedkhalil
- Department of Surgery, Urology Section, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Abdullah A Mesawa
- Department of Surgery, Urology Section, King Khalid National Guard Hospital, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Saif Y Alzahrani
- Department of Surgery, Urology Section, College of Medicine, Umm Al Qura University, Makkah, Saudi Arabia
| | - Aseel H Askar
- Department of Surgery, Urology Section, College of Medicine, Ibn Sina College, Jeddah, Saudi Arabia
| | - Wesam T Abuznadah
- Department of Surgery, Urology Section, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Mohamoud H Alrimawi
- Department of Surgery, Urology Section, King Khalid National Guard Hospital, King Abdulaziz Medical City, Jeddah, Saudi Arabia
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29
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Di Zazzo A, Bonini S, Crugliano S, Fortunato M. The challenging management of pediatric corneal transplantation: an overview of surgical and clinical experiences. Jpn J Ophthalmol 2017; 61:207-217. [PMID: 28374268 DOI: 10.1007/s10384-017-0510-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 02/27/2017] [Indexed: 12/28/2022]
Abstract
PURPOSE Pediatric keratoplasty is an immense challenge because of the technical complexity of the procedure and the high risk of rejection in young graft recipients. Our aim is to describe the major indications and appropriate timing of corneal transplantation intervention, including a report of our experience and surgical tips, in conjunction with the current literature. METHODS Review of the literature on indications for keratoplasty in pediatric patients classified as: congenital, traumatic and acquired non-traumatic opacities. We additionally explored the challenges corneal surgeons face in performing this type of surgery and review the most pressing transplant-related problems and their management. RESULTS Outcomes after pediatric keratoplasty, in terms of visual development, restoration and clarity of the graft, are influenced by peri-operative local and systemic conditions and factors, and by intraoperative management of the transplantation procedure itself. CONCLUSION Pediatric corneal transplantation is a critical tool for visual restoration and development in young patients with corneal opacities, particularly during the critical period of visual development. Successful management of the significant challenges associated with pediatric keratoplasty requires customized clinical and surgical management of each patient with particular attention paid to proper post-operative rehabilitation.
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Affiliation(s)
- Antonio Di Zazzo
- IRCCS G.B. Bietti Foundation ONLUS, via Livenza n.3, 00198, Rome, Italy.
| | - Stefano Bonini
- Department of Ophthalmology, University Campus Bio-Medico of Rome, Rome, Italy
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30
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Murgiano L, Jagannathan V, Piffer C, Diez-Prieto I, Bolcato M, Gentile A, Drögemüller C. A frameshift mutation in MOCOS is associated with familial renal syndrome (xanthinuria) in Tyrolean Grey cattle. BMC Vet Res 2016; 12:276. [PMID: 27919260 DOI: 10.1186/s12917-016-0904-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 11/30/2016] [Indexed: 11/17/2022] Open
Abstract
Background Renal syndromes are occasionally reported in domestic animals. Two identical twin Tyrolean Grey calves exhibited weight loss, skeletal abnormalities and delayed development associated with kidney abnormalities and formation of uroliths. These signs resembled inherited renal tubular dysplasia found in Japanese Black cattle which is associated with mutations in the claudin 16 gene. Despite demonstrating striking phenotypic similarities, no obvious presence of pathogenic variants of this candidate gene were found. Therefore further analysis was required to decipher the genetic etiology of the condition. Results The family history of the cases suggested the possibility of an autosomal recessive inheritance. Homozygosity mapping combined with sequencing of the whole genome of one case detected two associated non-synonymous private coding variants: A homozygous missense variant in the uncharacterized KIAA2026 gene (g.39038055C > G; c.926C > G), located in a 15 Mb sized region of homozygosity on BTA 8; and a homozygous 1 bp deletion in the molybdenum cofactor sulfurase (MOCOS) gene (g.21222030delC; c.1881delG and c.1782delG), located in an 11 Mb region of homozygosity on BTA 24. Pathogenic variants in MOCOS have previously been associated with inherited metabolic syndromes and xanthinuria in different species including Japanese Black cattle. Genotyping of two additional clinically suspicious cases confirmed the association with the MOCOS variant, as both animals had a homozygous mutant genotype and did not show the variant KIAA2026 allele. The identified genomic deletion is predicted to be highly disruptive, creating a frameshift and premature termination of translation, resulting in severely truncated MOCOS proteins that lack two functionally essential domains. The variant MOCOS allele was absent from cattle of other breeds and approximately 4% carriers were detected among more than 1200 genotyped Tyrolean Grey cattle. Biochemical urolith analysis of one case revealed the presence of approximately 95% xanthine. Conclusions The identified MOCOS loss of function variant is highly likely to cause the renal syndrome in the affected animals. The results suggest that the phenotypic features of the renal syndrome were related to an early onset form of xanthinuria, which is highly likely to lead to the progressive defects. The identification of the candidate causative mutation thus enables selection against this pathogenic variant in Tyrolean Grey cattle. Electronic supplementary material The online version of this article (doi:10.1186/s12917-016-0904-4) contains supplementary material, which is available to authorized users.
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Abstract
In recent years, there has been increasing interest in transitional urology, or how to best prepare patients with major congenital urologic diseases, such as bladder exstrophy and neuropathic bladder, to manage their own health care with adult urologists. However, common pediatric urologic conditions may be encountered by the adult urologist with more regularity. This review focuses on three relatively common conditions which may be identified in childhood, the consequences from which a patient may seek help from an adult urologist: cryptorchidism, varicocele, and Klinefelter syndrome.
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Affiliation(s)
- Kristina D Suson
- Children's Hospital of Michigan, 3901 Beaubien, Detroit, MI, 48201, USA.
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32
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Abstract
Pulmonary alveolar microlithiasis (PAM) is a genetic lung disorder that is characterized by the accumulation of calcium phosphate deposits in the alveolar spaces of the lung. Mutations in the type II sodium phosphate cotransporter, NPT2b, have been reported in patients with PAM. PAM progresses gradually, often producing incremental dyspnea on exertion, desaturation in young adulthood, and respiratory insufficiency by late middle age. Treatment remains supportive, including supplemental oxygen therapy. For patients with end-stage disease, lung transplantation is available as a last resort. The recent development of a laboratory animal model has revealed several promising treatment approaches for future trials.
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Abstract
Congenital tracheobronchial stenosis is a rare disease characterized by complete tracheal rings that can affect variable lengths of the tracheobronchial tree. It causes high levels of morbidity and mortality both due to the stenosis itself and to the high incidence of other associated congenital malformations. Successful management of this complex condition requires a highly individualized approach delivered by an experienced multidisciplinary team, which is best delivered within centralized units with the necessary diverse expertise. In such settings, surgical correction by slide tracheoplasty has become increasingly successful over the past 2 decades such that long-term survival now exceeds 88%, with normalization of quality of life scores for patients with non-syndrome-associated congenital tracheal stenosis. Careful assessment and planning of treatment strategies is of paramount importance for both successful management and the provision of patients and carers with accurate and realistic treatment counseling.
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Affiliation(s)
- Richard J Hewitt
- Department of Ear, Nose and Throat Surgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
| | - Colin R Butler
- Department of Ear, Nose and Throat Surgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK; Department of Paediatric Surgery, Stem Cell and Regernerative Medicine Group, UCL Institute of Child Health, London, UK; Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, University College London, London, UK
| | - Elizabeth F Maughan
- Department of Paediatric Surgery, Stem Cell and Regernerative Medicine Group, UCL Institute of Child Health, London, UK; Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, University College London, London, UK
| | - Martin J Elliott
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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Maughan E, Lesage F, Butler CR, Hynds RE, Hewitt R, Janes SM, Deprest JA, Coppi PD. Airway tissue engineering for congenital laryngotracheal disease. Semin Pediatr Surg 2016; 25:186-90. [PMID: 27301606 DOI: 10.1053/j.sempedsurg.2016.02.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Regenerative medicine offers hope of a sustainable solution for severe airway disease by the creation of functional, immunocompatible organ replacements. When considering fetuses and newborns, there is a specific spectrum of airway pathologies that could benefit from cell therapy and tissue engineering applications. While hypoplastic lungs associated with congenital diaphragmatic hernia (CDH) could benefit from cellular based treatments aimed at ameliorating lung function, patients with upper airway obstruction could take advantage from a de novo tissue engineering approach. Moreover, the international acceptance of the EXIT procedure as a means of securing the precarious neonatal airway, together with the advent of fetal surgery as a method of heading off postnatal co-morbidities, offers the revolutionary possibility of extending the clinical indication for tissue-engineered airway transplantation to infants affected by diverse severe congenital laryngotracheal malformations. This article outlines the necessary basic components for regenerative medicine solutions in this potential clinical niche.
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Affiliation(s)
- Elizabeth Maughan
- Stem Cells and Regenerative Medicine Section, DBC, UCL Institute of Child Health, 30 Guilford St, London, UK; Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Flore Lesage
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK; Department of Development and Regeneration, Biomedical Sciences Group, University of Leuven, Leuven, Belgium
| | - Colin R Butler
- Stem Cells and Regenerative Medicine Section, DBC, UCL Institute of Child Health, 30 Guilford St, London, UK; Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Robert E Hynds
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Richard Hewitt
- Ear, Nose and Throat Department, Great Ormond Street Hospital, London, UK
| | - Sam M Janes
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Jan A Deprest
- Stem Cells and Regenerative Medicine Section, DBC, UCL Institute of Child Health, 30 Guilford St, London, UK; Department of Development and Regeneration, Biomedical Sciences Group, University of Leuven, Leuven, Belgium; Department of Paediatric Surgery, Great Ormond Street Hospital, London, UK; Department of Obstetrics and Gynaecology, Fetal Medicine Unit, University Hospitals Leuven, Leuven, Belgium
| | - Paolo De Coppi
- Stem Cells and Regenerative Medicine Section, DBC, UCL Institute of Child Health, 30 Guilford St, London, UK; Department of Paediatric Surgery, Great Ormond Street Hospital, London, UK.
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Canavese F, Samba A, Rousset M. Pathological fractures in children: Diagnosis and treatment options. Orthop Traumatol Surg Res 2016; 102:S149-59. [PMID: 26774903 DOI: 10.1016/j.otsr.2015.05.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Revised: 05/12/2015] [Accepted: 05/20/2015] [Indexed: 02/02/2023]
Abstract
A fracture is defined as pathological when it arises in a bone tissue that has been modified and reshaped by a local or systemic pathological process. In children, pathological fractures can be secondary to several conditions, ranging from metabolic diseases to tumors, infections or neuromuscular pathologies. History, clinical examination and radiologic assessment are essential to making a diagnosis, to identifying the underlying cause and to planning the right treatment of a pathological fracture. Treatment must be tailored to both the fracture and the underlying cause. The objective of this work is to present the diagnostic approach and the course to follow when a child presents with a pathological fracture. The most common causes of pathological fractures, as well as their characteristics, will be described. Pathological fractures occurring in osteogenesis imperfecta and in abused children as well as stress fractures will not be discussed.
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Affiliation(s)
- F Canavese
- CHU Estaing, université d'Auvergne, service de chirurgie infantile, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand, France.
| | - A Samba
- CHU Estaing, université d'Auvergne, service de chirurgie infantile, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand, France
| | - M Rousset
- CHU Estaing, université d'Auvergne, service de chirurgie infantile, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand, France
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Saba L, Fellini F, Greco FG, Leonzio A, Cionci G, Consolo D, Ariozzi I, Zambrini EI, Bocchi C, Concari G, Rossi C, De Filippo M. MRI evaluation of not complicated Tailgut cyst: Case report. Int J Surg Case Rep 2014; 5:761-4. [PMID: 25255474 PMCID: PMC4189078 DOI: 10.1016/j.ijscr.2014.02.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 02/26/2014] [Accepted: 02/27/2014] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION The Tailgut cyst (cystic hamartoma) is an uncommon congenital disease of presacral retrorectal space and is embryologically part of some forms of enteric cysts. It is a benign malformation, although cases have been described in neoplastic degeneration. PRESENTATION OF CASE A caucasian 24 year old female presented shortly after childbirth with hypogastric abdominal discomfort associated with rectal tenderness, bleeding and moderate urinary symptoms for about three weeks. No previous similar episodes were reported. The patient was not suffering from haemorrhoids or inflammatory disease of the gastrointestinal tract. Clinical examination revealed no significant abnormalities or in the perianal area and gluteal surface. Digital rectal examination was suspicious of the presence of a presacral retrorectal mass. However, it could not exclude a trans-sphinteric perianal fistula. There was no fistulous communication with the exterior and the pain seemed to be more pronounced in the rectum. MRI, which has a diagnostic accuracy of 76–100% for the detection of any perianal fistulae, was performed and demonstrated the presence of a retrorectal cystic hamartoma (Tailgut cyst). DISCUSSION The most common retrorectal space cystic lesions includes epidermoid cysts, dermoid cysts and enteric cysts. It presents with pelvic pain, and sometimes with local abscess, secondary to a sinus cyst. There can also be a communication between Tailgut cyst and fistula; in the absence of primary infection may develop postinflammatory fibrosis. Radiological investigation is carried out by TRUS, CT and MRI. During MRI, on T1-weighted images, the signal intensity may change from hypointense to hyperintense as protein concentration increases, as well as in the case of bleeding. On T2-weighted images, signal intensity of mucinous fluids can decrease from highly hyperintense to hypointense with increasing protein concentration and viscosity. CONCLUSION MRI is a non-invasive useful imaging investigation with high diagnostic accuracy when a retrorectal cyst is suspected. Despite its rarity, Tailgut cyst should be considered, both for acute complications, like infection or bleeding, and for the risk, however infrequent, of neoplastic degeneration.
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Affiliation(s)
- Luca Saba
- Department of Radiology, University of Parma, Parma Hospital, Via Gramsci 14, 43126 Parma, Italy.
| | - Federica Fellini
- Department of Cardiology, University of Parma, Parma Hospital, Via Gramsci 14, 43126 Parma, Italy.
| | | | - Annelise Leonzio
- Department of Radiology, University of Parma, Parma Hospital, Via Gramsci 14, 43126 Parma, Italy.
| | - Giovanni Cionci
- Department of Radiology, University of Parma, Parma Hospital, Via Gramsci 14, 43126 Parma, Italy.
| | - Dina Consolo
- Department of Radiology, University of Parma, Parma Hospital, Via Gramsci 14, 43126 Parma, Italy.
| | - Irene Ariozzi
- Department of Radiology, University of Parma, Parma Hospital, Via Gramsci 14, 43126 Parma, Italy.
| | | | - Carlo Bocchi
- Department of Radiology, University of Parma, Parma Hospital, Via Gramsci 14, 43126 Parma, Italy.
| | - Giorgio Concari
- Department of Radiology, University of Parma, Parma Hospital, Via Gramsci 14, 43126 Parma, Italy.
| | - Cristina Rossi
- Department of Radiology, University of Parma, Parma Hospital, Via Gramsci 14, 43126 Parma, Italy.
| | - Massimo De Filippo
- Department of Radiology, University of Parma, Parma Hospital, Via Gramsci 14, 43126 Parma, Italy.
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Shin WJ, Kim SD, Kim KH. The general anesthesia experience of deletion 8p syndrome patient -A case report-. Korean J Anesthesiol 2011; 61:332-5. [PMID: 22110888 PMCID: PMC3219781 DOI: 10.4097/kjae.2011.61.4.332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Revised: 02/21/2011] [Accepted: 03/11/2011] [Indexed: 11/10/2022] Open
Abstract
A deletion 8p syndrome is a relatively uncommon congenital disease characterized by mental retardation associated with multiple malformation that make anesthetic management a challenge. Anesthetic management of a patient with deletion 8p syndrome may pose a serious problem mainly from difficult tracheal intubation, aspiration complication and cardiac malformation. We experienced a case of 10 year-old boy with a deletion 8p syndrome who underwent appendectomy under the general anesthesia. Intubation was performed by video glidescope after unsuccessful attempt with Macintosh laryngoscope. A high arched palate, short neck, poor patient cooperation due to mental retardation and occasional autistic behaviour made airway management difficult. This case should alert anesthesiologists to the greater difficulties of managing patients with deletion 8p syndrome.
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Affiliation(s)
- Woo Jong Shin
- Department of Anesthesiology and Pain Medicine, College of Medicine, Hanyang University, Seoul, Korea
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