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The Pan African Medical Journal 2022
Topics: Humans; Spinal Dysraphism; Meningomyelocele
PubMed: 36338552
DOI: 10.11604/pamj.2022.42.258.35894 -
Ultrasound in Obstetrics & Gynecology :... Jul 2023
Topics: Humans; Meningomyelocele; Spinal Cord
PubMed: 36178869
DOI: 10.1002/uog.26087 -
Ultrasound in Obstetrics & Gynecology :... Feb 2023
Topics: Pregnancy; Female; Humans; Meningomyelocele; Fetus; Fetoscopy; Prenatal Care
PubMed: 36178849
DOI: 10.1002/uog.26081 -
Journal of Pediatric Urology Oct 2022Patients with myelomeningocele often use clean intermittent catheterization (CIC) for renal preservation and to promote urinary continence. While starting CIC at an...
INTRODUCTION
Patients with myelomeningocele often use clean intermittent catheterization (CIC) for renal preservation and to promote urinary continence. While starting CIC at an early age is associated with better renal outcomes, the impact of age of CIC initiation on continence outcomes has not been examined.
OBJECTIVE
To examine whether earlier CIC initiation is associated with higher likelihood of current urinary continence for patients with myelomeningocele.
STUDY DESIGN
Data of patients aged ≥5 years at last visit were obtained from 35 spina bifida clinics participating in the National Spina Bifida Patient Registry from 2013 to 2018. Sociodemographic characteristics, disease characteristics, and current bladder management strategies were collected. Via univariate and multiple logistic regression models, the latter conducted controlling for all variables associated with current continent status, associations between continence and sociodemographic factors, condition characteristics, and age CIC began (<3 years of age, 3-5 years, 6-11 years, ≥12 years) were analyzed.
RESULTS
Data from 3510 individuals were included (mean age at last visit = 17.0 years, range 5.0-88.7). The sample was evenly distributed by sex (52% female); most individuals were non-Hispanic White (62.6%). The majority of patients (55.2%) started CIC before age 3 years. Continence varied markedly across those who never started CIC (0.6% of patients were continent) and those who started at any age (range 35.3-38.5%). Among those who started CIC, the magnitude of the association was not proportional to age CIC was started. Compared with those who started CIC at age 12 or older, estimated adjusted odds ratio of being continent ranged from 1.04 (6-11 years, 95% CI, 0.72-1.52) to 1.25 (<3 years, 95% CI, 0.89-1.76).
DISCUSSION
Although CIC may be positively associated with achieving urinary continence in individuals with myelomeningocele, we could not demonstrate that younger age at CIC initiation increased the likelihood of achieving this goal. Limitations include lack of data on reason for starting CIC, urodynamic data, and the observational nature of data collection.
CONCLUSIONS
Further study is needed addressing limitations of the current investigation to determine if urinary continence outcomes are influenced by the age of starting CIC among patients with myelomeningocele.
Topics: Humans; Female; Child, Preschool; Child; Adolescent; Young Adult; Adult; Middle Aged; Aged; Aged, 80 and over; Infant; Male; Intermittent Urethral Catheterization; Meningomyelocele; Spinal Dysraphism; Urinary Bladder, Neurogenic; Urinary Bladder; Urinary Catheterization
PubMed: 36163222
DOI: 10.1016/j.jpurol.2022.08.022 -
Ultrasound in Obstetrics & Gynecology :... Jan 2023
Topics: Pregnancy; Female; Humans; Spina Bifida Cystica; Hip Dislocation, Congenital; Fetoscopy; Meningomyelocele
PubMed: 36099428
DOI: 10.1002/uog.26069 -
Topics in Spinal Cord Injury... 2022Spina bifida is a congenital neural tube defect that affects the spine and spinal cord, as well as the brain in many cases, with life-long health-related consequences....
Spina bifida is a congenital neural tube defect that affects the spine and spinal cord, as well as the brain in many cases, with life-long health-related consequences. In most cases, the term refers to open myelomeningocele but includes a spectrum of dysraphic conditions. Early recognition and comprehensive care improve long-term health, well-being, and quality of life and decrease the use of emergency services and hospitalizations over the lifespan. Current evidence-based care guidelines are comprehensive, but they are not easily interpreted in busy primary care settings. The development of a periodicity schedule serves to simplify the current spina bifida guidelines into a document that is easy to use by all practitioners and families.
Topics: Humans; Meningomyelocele; Quality of Life; Spinal Cord Injuries; Spinal Dysraphism
PubMed: 36017126
DOI: 10.46292/sci21-00097 -
Topics in Spinal Cord Injury... 2022The purpose of this review is to describe the current scientific literature on the prevalence of metabolic syndrome in children with myelomeningocele and to gain insight... (Review)
Review
OBJECTIVES
The purpose of this review is to describe the current scientific literature on the prevalence of metabolic syndrome in children with myelomeningocele and to gain insight into the baseline levels of aerobic fitness, endurance, and strength in this population in order to identify gaps in knowledge, suggest potential primary prevention strategies, and provide recommendations for future studies.
METHODS
A literature review of articles published in English and French between 1990 and April 2020 was conducted.
RESULTS
Obese adolescents with myelomeningocele have an increased prevalence of components of the metabolic syndrome. Children and adolescents with myelomeningocele have decreased aerobic fitness and muscular strength, decreased lean mass, and increased fat mass, all of which, when combined with higher levels of physical inactivity, put them at higher risk of developing metabolic syndrome and cardiovascular diseases.
CONCLUSION
Until more research is conducted, addressing weight-related challenges and promoting healthy habits (such as optimal activity levels) could be easily integrated into yearly myelomeningocele clinics. An actionable suggestion might be to systematically weigh and measure children in these clinics and utilize the results and trends as a talking point with the parents and children. The follow-up appointments could also be used to develop physical activity goals and monitor progress. We recommend that the health care practitioner tasked with this intervention (physician, nurse, etc.) should be aware of locally available accessible sports platforms and have knowledge of motivational interviewing to facilitate removal of perceived barriers to physical activity.
Topics: Adolescent; Child; Exercise; Humans; Meningomyelocele; Metabolic Syndrome; Muscle Strength; Spinal Cord Injuries
PubMed: 36017122
DOI: 10.46292/sci21-00032 -
The Pan African Medical Journal 2022
Topics: Adolescent; Humans; Magnetic Resonance Imaging; Male; Meningomyelocele; Spinal Dysraphism
PubMed: 35949460
DOI: 10.11604/pamj.2022.42.60.33893 -
AJNR. American Journal of Neuroradiology Aug 2022There is a wide range of clinical and radiographic factors affecting individual surgeons' ultimate decision for CSF diversion for pediatric patients following prenatal...
BACKGROUND AND PURPOSE
There is a wide range of clinical and radiographic factors affecting individual surgeons' ultimate decision for CSF diversion for pediatric patients following prenatal myelomeningocele repair. Our aim was to construct a composite index (CSF diversion surgery index) that integrates conventional clinical measures and neuroimaging biomarkers to predict CSF diversion surgery in these pediatric patients.
MATERIALS AND METHODS
This was a secondary retrospective analysis of data from 33 patients with prenatal myelomeningocele repair (including 14 who ultimately required CSF diversion surgery). Potential independent variables, including the Management of Myelomeningocele Study Index (a dichotomized variable based on the shunt-placement criteria from the Management of Myelomeningocele Study), postnatal DTI measures (fractional anisotropy and mean diffusivity in the genu of the corpus callosum and the posterior limb of internal capsule), fronto-occipital horn ratio at the time of DTI, gestational ages, and sex, were evaluated using stepwise logistic regression analysis to identify the most important predictors.
RESULTS
The CSF diversion surgery index model showed that the Management of Myelomeningocele Study Index and fractional anisotropy in the genu of the corpus callosum were significant predictors (< .05) of CSF diversion surgery. The predictive value of the CSF diversion surgery index was also affected by fractional anisotropy in the posterior limb of the internal capsule and sex with marginal effect (.05<< .10), but not by the fronto-occipital horn ratio (> .10). The overall CSF diversion surgery index model fit the data well with statistical significance (eg, likelihood ratio: < .001), with the performance (sensitivity = 78.6%; specificity = 86.5%, overall accuracy = 84.8%) superior to all individual indices in sensitivity and overall accuracy, and most of the individual indices in specificity.
CONCLUSIONS
The CSF diversion surgery index model outperformed all single predictor models and, with additional validation, may potentially be developed and incorporated into a sensitive and robust clinical tool to assist clinicians in hydrocephalus management.
Topics: Pregnancy; Female; Humans; Child; Meningomyelocele; Retrospective Studies; Hydrocephalus; Ventriculoperitoneal Shunt; Ventriculostomy
PubMed: 35902125
DOI: 10.3174/ajnr.A7585 -
Indian Journal of Public Health 2022The neonatal period is a highly vulnerable time for an infant, who is completing many of the physiologic adjustments required for extra- uterine survival. If the neonate...
BACKGROUND
The neonatal period is a highly vulnerable time for an infant, who is completing many of the physiologic adjustments required for extra- uterine survival. If the neonate has a coexisting pathology which needs surgery, this challenge is magnified. Neonatal surgical conditions are unique in their type because some require early diagnosis, prompt surgery and postoperative care to improve the survival and outcome.
OBJECTIVE
The aim of this study was to know the clinical profile of congenital surgical conditions and to estimate the burden and outcome in special new born care unit.
METHOD
The study population include 138 surgical neonate admitted in special new born care unit, department of paediatrics, Kamla Raja Hospital, Gajra Raja Medical College, Gwalior (M.P.) from April 2017 to April 2018 including six month follow up period.
RESULTS
Total admission in special new born care unit were 5378 out of which 138 (2.5%) neonates of surgical condition were admitted in the study period. Incidence of neonatal surgical condition was found to be 8.48%. Surgery was performed in 57 (41.30%) neonates. The Commonest neonatal surgical condition was constituted by gastrointestinal system (39.13%). Among gastrointestinal system anomalies, tracheoesophageal fistula were 28.6% of total gastrointestinal system cases. The most common surgical condition encountered was meningomyelocele, 23.36% of total cases. The survival of neonatal surgical condition in hospital was 52.89% and after six month follow up was 26.08%. The overall mortality with neonatal surgical condition in this study was 73.91%. Maternal age, antenatal care, history of congenital malformation, socioeconomic status, mode of delivery, prematurity, type of admission, single or multiple surgical condition, inotropic and ventilation support, post operative complication were significantly associated with final outcome of neonatal surgical condition.
CONCLUSION
High mortality was found in neonates suffering from surgical conditions. Commonest anomaly includes conditions of gastrointestinal tract. Maternal age more than 35 year, poor antenatal care, prematurity, vaginal delivery, extra mural neonate, multiple surgical condition, inotropic and ventilation support and post operative complications were associated with increased mortality.
Topics: Child; Female; Humans; India; Infant; Infant, Low Birth Weight; Infant, Newborn; Infant, Newborn, Diseases; Pregnancy; Prospective Studies; Tertiary Care Centers
PubMed: 35859494
DOI: 10.4103/ijph.ijph_1564_21