Background
The urinary tract dilation classification system has recently been developed to ensure a unified approach to describe urinary tract dilation in neonates and young infants. However, the ...predictive value of this system for surgical intervention or urinary tract infection (UTI) has not yet been evaluated in a meta-analysis.
Objective
This systematic review and meta-analysis aimed to evaluate the utility of a postnatal urinary tract dilation classification system for predicting surgical management or a UTI occurrence.
Materials and methods
As the urinary tract dilation classification system was introduced in 2014, we searched Embase and PubMed databases for studies published between January 2014 and December 2022. Original articles that reported surgical interventions or UTI episodes according to postnatal urinary tract dilation grades were included. The pooled odds ratio (OR) was calculated, using either the fixed-effects or random-effects model, given the lower urinary tract dilation grades as the base category. The quality of the included studies was evaluated using the Newcastle–Ottawa scale.
Results
Of the 285 articles reviewed, eight (comprising 2,165 children) were included in the analysis. The studies were of medium-to-high quality. Pooled analysis demonstrated that urinary tract dilation P3 (combined OR, 21.41; 95% confidence interval CI, 15.72–29.17) and urinary tract dilation P2–P3 (combined OR, 65.17; 95% CI, 33.08–128.38) were associated with surgical intervention. The urinary tract dilation P3 (combined OR, 2.11; 95% CI, 1.56–2.85) and urinary tract dilation P2–P3 (combined OR, 3.36; 95% CI, 2.43–4.63) were associated with UTI episodes.
Conclusion
The postnatal urinary tract dilation classification system is useful for predicting the need for surgical management and UTI episodes in infants with hydronephrosis.
Background Because of an increase in life expectancy and de‐institutionalisation, many adults with intellectual disability (ID) live with and are cared for by their parents throughout their adult ...lives. Because of caring demands, the quality of life (QOL) of parents may be affected. The study explored the impact of caring for an adult with ID on the QOL of parents.
Methods Participants were 12 parents who were the full‐time carers of an adult with ID. Participants were interviewed about the effect of caring on their QOL. Interviews were analysed thematically.
Results Caring had a positive impact on QOL by enabling participants to develop relationships and receive support, participate in leisure activities, achieve a sense of personal satisfaction and enable a more positive appraisal of their lives. Caring had a negative impact on participants' QOL by restricting their relationships, leisure activities and employment opportunities. Caring was also associated with financial insecurity, frustrations at the service system and fear of what the future held for their offspring.
Conclusions Caring for an adult with ID had both positive and negative effects on parents' QOL. Improving services and service delivery, including the provision of residential services and respite, would address many of the issues that were reported to have a negative impact on parents' QOL.
Objective: Bronchopulmonary dysplasia (BPD) is a significant respiratory disorder in premature infants, and its prevalence remains high at 35% to 40% of very low gestational age (<28 weeks ...gestation). The aim of this study is to analyze the respiratory outcomes of BPD in neonatal intensive care unit as well as respiratory outcomes over a corrected age of 18 to 24 months using 3 different definitions of BPD (National Institutes of Health NIH 2001, National Institute of Child Health and Human Development NICHD 2018 and Jensen 2019).
Methods: We conducted a study on infants under 32 weeks of gestation between 2012 and 2021 at Ajou university hospital. First, we compared the incidence of BPD, mortality, and length of hospital stays. To evaluate long-term respiratory outcomes, the number of re-admissions and prescriptions due to respiratory problems were analyzed.
Results: NIH 2001 showed an incidence of 281 (40.0%), NICHD 2018 showed 139 (19.7%), and Jensen 2019 showed 137 (19.5%). In grade III of Jensen 2019, it demonstrated the highest severity with mortality rate of 29.4% and an average length of hospital stay of 42.5 weeks. Also, it was confirmed that the period of use of invasive ventilator was the longest at 87.8±60.3 days. In the analysis of re-admission and prescription counts, grade III showed statistically significant higher occurrences in both NICHD 2018 and Jensen 2019 than NIH 2001.
Conclusion: The latest definitions of BPD have demonstrated to better represent both short-term and long-term respiratory severity in premature infants less than 32 weeks.
Nemaline myopathy is a genetically heterogeneous neuromuscular disorder and one of the most common congenital myopathies. The clinical manifestations usually vary depending on the age of onset. ...Neonatal nemaline myopathy has the worst prognosis, primarily due to respiratory failure. Several genes associated with nemaline myopathy have been identified, including NEB, ACTA1, TPM3, TPM2, TNNT1, CFL2, KBTBD13, KLHL40, KLHL41, LMOD3, and KBTBD13. Here, we report a neonatal Korean female patient with nemaline myopathy carrying compound heterozygous mutations in the gene KLHL40 as revealed using next generation sequencing (NGS). The patient presented with postnatal cyanosis, respiratory failure, dysphagia, and hypotonia just after birth. To identify the genetic cause underlying the neonatal myopathy, NGS-based gene panel sequencing was performed. Compound heterozygous pathogenic variants were detected in KLHL40: c.1405G>T;1582G>A (p. Gly469cys;Glu528Lys). NGS allows quick and accurate diagnosis at a lower cost compared to traditional serial single gene sequencing, which is greatly advantageous in genetically heterogeneous disorders such as myopathies. Rapid diagnosis will facilitate efficient and timely genetic counseling, prediction of disease prognosis, and establishment of treatments.
Periventricular nodular heterotopia (PNH) is a neuronal migration disorder that occurs during early brain development. Patients with PNH may be asymptomatic and have normal intelligence; however, PNH ...is also known to cause various symptoms such as seizures, dyslexia, and cardiovascular anomalies. PNH is not commonly diagnosed during early infancy because of the lack of clinical manifestations during this period. We present the case of a female infant diagnosed with PNH based on brain magnetic resonance imaging, who had symptomatic patent ductus arteriosus that had to be ligated surgically and had prolonged feeding cyanosis with frequent apneic spells.
Nemaline myopathy is a genetically heterogeneous neuromuscular disorder and one of the most common congenital myopathies. The clinical manifestations usually vary depending on the age of onset. ...Neonatal nemaline myopathy has the worst prognosis, primarily due to respiratory failure. Several genes associated with nemaline myopathy have been identified, including NEB, ACTA1, TPM3, TPM2, TNNT1, CFL2, KBTBD13, KLHL40, KLHL41, LMOD3, and KBTBD13. Here, we report a neonatal Korean female patient with nemaline myopathy carrying compound heterozygous mutations in the gene KLHL40 as revealed using next generation sequencing (NGS). The patient presented with postnatal cyanosis, respiratory failure, dysphagia, and hypotonia just after birth. To identify the genetic cause underlying the neonatal myopathy, NGS-based gene panel sequencing was performed. Compound heterozygous pathogenic variants were detected in KLHL40: c.1405G>T;1582G>A (p. Gly469cys;Glu528Lys). NGS allows quick and accurate diagnosis at a lower cost compared to traditional serial single gene sequencing, which is greatly advantageous in genetically heterogeneous disorders such as myopathies. Rapid diagnosis will facilitate efficient and timely genetic counseling, prediction of disease prognosis, and establishment of treatments.
Although delivery is widely used for preterm babies failing to thrive in utero, the effect of altering delivery timing has never been assessed in a randomised controlled trial. We aimed to compare ...the effect of delivering early with delaying birth for as long as possible.
548 pregnant women were recruited by 69 hospitals in 13 European countries. Participants had fetal compromise between 24 and 36 weeks, an umbilical-artery doppler waveform recorded, and clinical uncertainty about whether immediate delivery was indicated. Before birth, 588 babies were randomly assigned to immediate delivery (n=296) or delayed delivery until the obstetrician was no longer uncertain (n=292). The main outcome was death or disability at or beyond 2 years of age. Disability was defined as a Griffiths developmental quotient of 70 or less or the presence of motor or perceptual severe disability. Analysis was by intention-to-treat. This trial has been assigned the International Standard Randomised Controlled Trial Number ISRCTN41358726.
Primary outcomes were available on 290 (98%) immediate and 283 (97%) deferred deliveries. Overall rate of death or severe disability at 2 years was 55 (19%) of 290 immediate births, and 44 (16%) of 283 delayed births. With adjustment for gestational age and umbilical-artery doppler category, the odds ratio (95% CrI) was 1·1 (0·7–1·8). Most of the observed difference was in disability in babies younger than 31 weeks of gestation at randomisation: 14 (13%) immediate versus five (5%) delayed deliveries. No important differences in the median Griffiths developmental quotient in survivors was seen.
The lack of difference in mortality suggests that obstetricians are delivering sick preterm babies at about the correct moment to minimise mortality. However, they could be delivering too early to minimise brain damage. These results do not lend support to the idea that obstetricians can deliver before terminal hypoxaemia to improve brain development.
We report theoretical and experimental results on single and multiple looped graphene sheets. Experimental images of stable closed-edge structures in few-layer graphene samples obtained by ...high-resolution transmission electron microscopy (HRTEM) are compared with first-principles density functional theory calculations. We demonstrate that the electronic structure of a graphene nanoribbon is not significantly perturbed upon closing. By contrast, a significant modulation of the electronic structure is observed for closed-edge graphene structures deposited on a planar graphene substrate. This effect is due to an enhanced reactivity of the looped (coalesced) edges observed experimentally. The coexistence of different degrees of curvature in the graphene sheet induced by folding indicates that these materials could be used for surface chemistry engineering.
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