In the recent period the real economy presented a slow YoY growth pace, at the global, European, regional, and national levels, in the context of the consequences of the overlapping shocks over the ...pasts quarters, including the high level of the financing costs and the persistence of the geo-political tensions. However, at the beginning of 2024 there can be noticed the accumulation of stabilization signals for the macroeconomic climate, given the slowing-down of the inflationary pressures and the positive dynamics on the financial markets. This paper presents the recent macroeconomic developments and estimates the dynamics of the potential growth pace (by implementing standard econometric tools and using the IMF database), within an approach from the global economy to the national economy. According to the results of the estimates the YoY pace of the potential output slightly improved at the global level recently, to the highest level since 2018. However, this improvement hides the divergence between the dynamics in the developed countries and the evolutions in the emerging economies. Keywords: global economy, potential output, economic divergence
Background: Neonatal gastric perforation (NGP) is a life-threatening condition with a high mortality rate. It accounts for 7% of all gastrointestinal tract (GIT) perforations. The number of NGP cases ...has been increasing due to the rise in premature and low birth weight neonates. In this study, we present our experience with gastric perforation in neonates.
Methods: This retrospective study analyzed all cases of gastric perforation in neonates that were treated at Loma Linda University Medical Center's Neonatal Intensive Care Unit (NICU) between the years 2000 and 2023. The study looked at several variables including patient demographics, birth weight, age at admission and surgery, comorbidities, use of non-steroidal anti-inflammatory drugs (NSAIDs) and steroids, and mortality rate.
Results: We treated 15 patients with neonatal gastric perforation (NGP) during the study tenure. The median age at admission was 2 days, with 67% admitted within that timeframe. Surgery occurred at a median age of 5.5 days, and the median birth weight was 2.075 kg, with 26.67% below 1 kg. Males comprised 67%, and 60% had patent ductus arteriosus. Steroids were given to 46.66%, and 30-day mortality was 26.67%, with higher rates among males. Idiopathic cases were common, with notable etiologies including ischemia, necrosis, and congenital anomalies. Primary surgical repair was the main modality, and perforations occurred at various locations. Two cases had necrotizing enterocolitis. Six patients had favorable outcomes, while others experienced mild to moderate complications.
Conclusion: Our research supports the idea that males have a worse outcome in terms of both prevalence and survival rates in neonatal gastric perforation (NGP) patients. However, our findings did not confirm the notion that NGP mortality risk is higher in neonates with low birth weight. We also discovered that the median time between admission and surgery in our study group was 1.5 days, emphasizing the importance of early detection of NGP in neonates. Early diagnosis can lead to better decision-making regarding treatment options and surgical intervention.
Neonatal gastric perforation: Case report Vacaru, Alexandra; Sharafeddin, Fransua; Maidan, Alexandra ...
Journal of pediatric surgery case reports,
August 2023, 2023-08-00, 2023-08-01, Letnik:
95
Journal Article
Recenzirano
Odprti dostop
Neonatal gastric perforation (NGP) is a life-threatening condition associated with high morbidity and mortality rates. Despite several proposed etiological theories, the causative principle is still ...unclear and controversial.
A male neonate was born at 26 weeks 3 days gestation. The patient showed symptoms of acute respiratory failure and hypoxia and was admitted to the neonatal intensive care unit. On day of life (DOL) 2, a chest and abdominal radiography showed a large amount of free intraperitoneal air, for which exploratory laparotomy was performed. A small antimesenteric perforation in the distal ileum was found and repaired primarily. On DOL 7, a chest and abdominal radiography demonstrated recurrent pneumoperitoneum for which a repeat exploratory laparotomy was performed. The patient had global intestinal ischemia and a perforation in the anterior wall of the stomach, which was repaired. On DOL 12, a planned upper gastrointestinal water-soluble contrast study showed spillage of contrast into the anterior abdomen, for which the patient underwent a repeat exploratory laparotomy. We found a dehiscence of the prior gastric repair and closed it primarily. The remainder of the hospital course was uneventful and the patient reached full feedings on DOL 41.
Premature neonates are at risk for gastric perforation. Gastric perforation should be in the differential diagnosis of a premature neonate who presents abdominal distension and pneumoperitoneum. Due to the fragility of the premature neonatal tissues, confirming the integrity of the gastric closure with a contrast study is recommended prior to initiating enteral feedings.
Reports of different synchronous tumors involving both ovaries are rare, and most fall in the malignant category. This is the case of a 15-year-old female with an unremarkable past medical history ...who presented with acute onset lower abdominal pain. Imaging studies demonstrated a large complex cystic and solid mass in the midline pelvis. During robotic pelvic mass excision, she was found to have two separate masses, one involving each ovary. The patient underwent successful bilateral ovarian-sparing mass excision. Pathology examination of the specimens revealed mature cystic teratoma of the right ovary and left ovarian serous cystadenoma. We present this case for the uniqueness of the bilateral ovarian pathology as well as to show that robotic-assisted resection of ovarian tumors in certain children is safe and feasible.
Esophageal atresia with tracheoesophageal fistula (EA/TEF) and annular pancreas are both rare congenital anomalies, with very few reports of neonates presenting with both. More specifically, there ...are no reported cases of neonates with both annular pancreas and the rarest form of TEF, the H-type fistula.
Here, we present the case of a neonate with annular pancreas diagnosed at birth requiring duodenoduodenostomy with delayed diagnosis of concomitant H-type TEF requiring subsequent fistula ligation with favorable outcomes.
When patients with known congenital anomalies have persistent symptoms of unidentified etiology, heightened suspicion for other concomitant congenital anomalies can lead to prompt diagnosis, timely surgical management and good outcomes.
Trisomy 18 and necrotizing enterocolitis Maidan, Alexandra; Sacks, Marla A.; Raymond, Steven L. ...
Journal of pediatric surgery case reports,
October 2022, 2022-10-00, 2022-10-01, Letnik:
85
Journal Article
Recenzirano
Odprti dostop
Both Trisomy 18 (T18) and Necrotizing enterocolitis totalis (NEC-T) are major causes of morbidity and mortality in neonates. However, to our knowledge there has never been a case of a full-term ...infant born with both T18 and NEC-T published in the literature.
We present a case of NEC totalis in male neonate born at 39 weeks gestation with Trisomy 18. He was diagnosed with T18 in-utero, and after genetic counseling, the mother carried the pregnancy to term. After delivery, the newborn developed signs of respiratory distress, requiring use of continuous positive airway pressure support. On day of life (DOL) 8, multiple bloody bowel movements raised suspicion for NEC and after supplemental investigations prompted a series of exploratory laparotomies that revealed extensive necrotizing enterocolitis involving the entire gastrointestinal tract. On DOL 12, the family opted for palliative care and the patient subsequently expired.
To our knowledge, after searching through the English literature, no cases were found showing a neonate with a combination of T18 and NEC-T.
Unusual cause of appendicitis: Orthodontic wire Sacks, Marla A.; Goodman, Laura F.; Khan, Faraz A. ...
Journal of pediatric surgery case reports,
August 2021, 2021-08-00, 2021-08-01, Letnik:
71
Journal Article
Recenzirano
Odprti dostop
Appendicitis is one of the most common childhood diseases requiring surgery and the appendectomy is the most common surgical procedure performed in children. Typical findings on physical exam and ...imaging points the child toward a surgical consult and, ultimately, removal of the inflamed appendix. Our aim is to present an interesting case and, to our knowledge, never before described cause of appendicitis in the pediatric population.
We introduce the case of an 11-year-old female who presented with 3 days of abdominal pain, unremarkable laboratory findings, and a computer tomography (CT) showing a radiopaque object in the terminal ileum adjacent to the appendix. She underwent diagnostic laparoscopy with findings of a metallic wire that perforated the ileal wall and irritated the appendix. The wire was removed without need for intestinal repair and a standard appendectomy was performed. The patient recovered uneventfully.
While standard presentation and treatment of appendicitis is at the forefront, occasionally imaging or intra-operative findings can present a surprise. This case of clinical symptoms of appendicitis but discordant imaging, led the patient to the operating room for the intended surgery. A foreign body was the irritator of the appendix, a differential to consider.
•Foreign bodies are a rare cause of appendicitis in children.•Abdominal pain is more common than leukocytosis in appendicitis secondary to a foreign body.•Prompt management of foreign bodies decreases morbidity and prolonged hospital stay.
Lipoblastomas and liposarcomas are rare causes of soft tissue masses in paediatric patients. In this retrospective clinical case series we identified 11 patients from our paediatric database (10 with ...a lipoblastoma and one with a liposarcoma) who had attended our hospital between 1998 and 2019. The median age of patients with lipoblastoma was 29 months. All lipoblastoma cases were managed with surgical excision and histological examination. The 18-year old patient with liposarcoma presented with a metastatic and unresectable tumour that was unresponsive to chemotherapy and radiation. Our experience demonstrates the importance of differentiating the type of soft tissue mass in children.
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