“
“Background. Spontaneous AZD1390 solubility dmso regression in the foetal period has been described for congenital hydrothorax. Hydrothorax may become larger and bilateral with hydrops and pulmonary hypoplasia. Prenatal thoracentesis and thoracoamniotic shunting of massive hydrothorax are indicated to decrease perinatal morbidity. In the neonatal period, persistent hydrothorax may require intensive care.
Objective. To investigate neonatal outcome after thoracoamniotic shunting for congenital primary hydrothorax with hydrops/polydramnios.
Methods. Retrospective study on the postnatal management of a cohort of 28 congenital primary hydrothorax cases after thoracoamniotic shunting (January 2000-August
2005).
Results. Congenital hydrotorax without major structural anomalies complicated by polidramnios and/or hydrops <34 weeks’ gestation were the criteria accepted for thoracoamniotic shunting. There were neither pregnancy terminations nor utero deaths. Although 64% of cases were complicated by severe neonatal respiratory insufficiency, neonatal mortality rate was low (21.4%) if compared with literature. Univariate analysis identified ‘birth at gestational age (GA) 535 weeks’ and ‘time between prenatal shunting and birth’ as predictive factors for needing of ventilation. Multivariate analysis identified ‘birth at GA <35 weeks’ as the only independent predictor for needing ventilation. (OR=0.08, CI 95% =0.01-0.96, p=0.046).
No risk factors for death selleck chemicals llc or JNK-IN-8 supplier adverse neurological outcomes were reported.
Conclusions. Congenital hydrothorax although corrected by thoracoamniotic shunting is complicated by severe respiratory distress. The neonatal outcome may be improved limiting degree of prematurity; the presence of thoracoamniotic shunt is not per se an indication of premature birth, at least until GA >35 weeks and adequate pulmonary maturity is reached.”
“Background:
Anterior cervical discectomy and fusion is one of the most common surgical interventions performed by spine surgeons. As efforts are made to control healthcare spending because of the limited or capped resources offered by the National Health Insurance, surgeons are faced with the challenge of offering high-level patient care while minimizing associated healthcare expenditures. Routine ordering of postoperative hematologic tests and observational intensive care unit (ICU) stay might be areas of potential cost containment. This study was designed to determine the necessity of routine postoperative hematologic tests and ICU stay for patients undergoing elective anterior cervical discectomy and fusion and to investigate whether the elimination of unnecessary postoperative laboratory blood studies and ICU stay inhibits patient care.
Methods: The necessity for postoperative blood tests was determined if there were needs for a postoperative blood transfusion and hospital readmission within 1 month after surgery.