A retrospective chart review was performed in a pediatric cardiac intensive care unit at a tertiary care medical center. The subjects were 32 neonates who had undergone single-ventricle palliation including 13 Norwood-mBTS, 11 Sano, and 8 hybrid procedures. The measurements included baseline
as well as pre- and postoperative patient characteristics. click here The primary outcome was postoperative intraabdominal complications, and the secondary outcomes were feeding intolerance and necrotizing enterocolitis (NEC). Intraabdominal complications occurred for 34%, feeding intolerance for 13%, and NEC for 13% of the patients. The hybrid patients had a higher incidence of intraabdominal complications (75%) than the Norwood-mBTS (31%) or Sano (9%) patients (P = 0.01). The relative risk for intraabdominal complications in the hybrid group was 3.6 (95% confidence interval [CI], 1.5-8.7). selleck kinase inhibitor In the multivariate analysis, the hybrid procedure remained an independent predictor of intraabdominal complications (hazard ratio, 8.4; 95% CI, 2.0-34.5). The hybrid, Norwood-mBTS, and Sano patients did not differ significantly in terms of feeding intolerance (25, 15, and 0%, respectively; P = 0.25) or NEC (25, 8, and 9%; P = 0.46). Gastrointestinal
morbidity was common regardless of the palliative approach, although the hybrid patients had the highest incidence of intraabdominal complications. This supports the need for caution in using enteral nutrition with all single-ventricle this website patients, including the hybrid population. Patients
undergoing the hybrid procedure may benefit from implementation of standardized feeding protocols.”
“Objective: To explore the use of ultrasonography as a diagnostic alternative to the traditional “”gold standard”" imaging study of nuclear scintigraphy in the evaluation of thyrotoxicosis.
Methods: We review the relevant literature and share our own experience to highlight the promising role of ultrasonography in thyrotoxicosis. In addition, we present a diagnostic algorithm suggesting liberal use of ultrasonography in the evaluation of thyrotoxicosis.
Results: Ultrasonography has proved effective not only in the differentiation of Graves disease from other types and causes of thyrotoxicosis but also in the detection of subtle thyroid nodules. The latter role is emphasized in light of the recent observation of an increased risk of occurrence of papillary thyroid carcinoma in patients with Graves disease.
Conclusion: Ultrasonography is a cost-effective, non-invasive, portable, and safe imaging modality in the evaluation of thyrotoxicosis, both for physiologic assessment and for detection of nonpalpable thyroid cancers that may elude identification on physical examination and nuclear imaging studies.