Objective: To characterize the number and methods of closure of Persistent Ductus Arteriosus (PDA) over a span of 16 years in a third level maternity hospital. Methods: Retrospective study of neonates born between January 2003 and Deccember 2018, who underwent ductus arteriosus closure by pharmacological, surgical and/or transcatheter methods. Gestational age, birth weight, number and methods of closures per year were evaluated. The success rate of the pharmacologic method was calculated, as well as the mortality rate. The association between mortality and birthweight, treatment used and treatment failure was explored. Results: There were 47,198 births, 5,156 were preterm, 325 presented PDA and 106 were eligible for closure (median gestational age - 27 weeks, birthweight <1000 g - 61%). Frequency of PDA closure decreased during the study period, especially starting in 2010. Success rate with pharmacologic treatment was 62% after the first cycle and 74% after the second. After drug failure, 12 underwent surgical ligation and two underwent transcatheter closure. Exclusive surgical ligation was indicated in four infants. Ibuprofen replaced indomethacin in 2010, and acetaminophen was used in three infants. Among the 106 infants, hospital mortality was 12% and it was associated with birthweight <1000 g (13/65 <1000 vs. 0/41 >1000 g; p=0.002) and with failure in the first pharmacologic treatment cycle (13/27 with failure, vs. 0/75 without failure; p<0.001). Conclusions: The national consensus published in 2010 for the diagnosis and treatment of PDA in preterm infants led to a decrease in the indication for closure. Pharmacological closure was the method of choice, followed by surgical ligation. Birthweight <1000 g and first cycle of pharmacologic treatment failure were associated with higher mortality.
Congenital heart diseases (CHDs) are a group of malformations that are the leading cause of perinatal mortality. 1 Their prevalence is estimated to be six to 10 per 1,000 births. [1][2][3][4] Due to advances in diagnostic techniques, the prevalence of CHDs has increased over the years. 3,5,6 Therapeutic innovations, both medical and surgical, have contributed to reduction in mortality, 7 and most patients with CHD reach adulthood today. 5,6 However, these patients are at a higher risk of developing comorbidities, 8 including higher levels of psychological stress. 7 CHD was defined by Mitchel 9 in 1971 as a structural anomaly of the heart or large vessels that is could be of functional significance. Although the etiology of CHD is largely unknown, the risk factors known to be related to CHD include maternal infections (e.g., rubella) or conditions (gestational diabetes and obesity, use of vitamin A) and use of teratogenic drugs, tobacco, alcohol and cocaine during pregnancy. 1,4 Medically assisted reproduction 10 and being a child of a mother with heart disease are also associated with CHD. 11 Heart diseases that pose the greatest risk for the development of CHD in the offspring are aortic stenosis, atrioventricular septal
Cervical acute lymphadenitis is rarely described in neonates. We present the case of a 12-day-old preterm, fed by nasogastric tube, who presented a tender erythematous submandibular swelling. Laboratory data showed neutrophilia and an elevation of C reactive protein and procalcitonin. Ultrasound findings suggested cellulitis and adenitis with abscess. The culture of the drainage material identified methicillin-sensitive Staphylococcus aureus. With the administration of the right antibiotic treatment, a good clinical outcome was observed.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.