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61. Open Myelomeningocele Repair With High Maternal BMI

Open Myelomeningocele Repair With High Maternal BMI Open Myelomeningocele Repair With High Maternal BMI - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Open Myelomeningocele Repair With High Maternal BMI (...) of patients (>80%) also develop increased fluid in the brain, called hydrocephalus, and require additional surgery to treat this problem. Standard treatment of myelomeningocele (MMC) involves closing the opening in the back within the first 3 days of life. The surgery releases the spinal cord from the skin and brings the skin edges together to prevent infection and injury to the exposed nerves. Of note, this type of surgery does not improve function. The investigators want to study the open in-utero fetal

2016 Clinical Trials

62. A 4-year prospective urological assessment of in utero Myelomeningocele repair: Does gestational age at birth play a role at later neurogenic bladder pattern? (PubMed)

A 4-year prospective urological assessment of in utero Myelomeningocele repair: Does gestational age at birth play a role at later neurogenic bladder pattern? Premature delivery is a major complication of in utero myelomeningocele repair. The prematurity rate in MOMS (Management of Myelomeningocele Study) was 79%, with a mean gestational age at birth of 34 weeks. We speculated that prematurity could also influence urological outcome in patients operated on prenatally (...) for myelomeningocele.Beginning in November 2011, we prospectively followed a population of patients with myelomeningocele who had undergone in utero repair.We compared patients based on gestational age at birth, ie younger than 34 weeks (group 1, 42 patients) and 34 weeks or older (group 2, 37 patients). Mean gestational age at birth was 28.3 weeks (range 25 to 33) in group 1 and 35.2 weeks (34 to 38) in group 2. Of the cases 47.5% in group 1 were classified as high risk, 35% as incontinent, 10% as hypocontractile and 7.5

2016 Journal of Urology

63. Endoscopic surgery for the antenatal treatment of myelomeningocele: the CECAM trial. (PubMed)

Endoscopic surgery for the antenatal treatment of myelomeningocele: the CECAM trial. A recent randomized clinical trial named Management of Myelomeningocele Study (MOMS trial) showed that prenatal correction of open spina bifida (OSB) via open fetal surgery was associated with improved infant neurological outcomes relative to postnatal repair, but at the expense of increased maternal morbidity.We sought to report the final results of our phase I trial (Cirurgia Endoscópica para Correção

2016 American Journal of Obstetrics and Gynecology

64. Urological Outcome of the Xiao Procedure in Children with Myelomeningocele and Lipomyelomeningocele Undergoing Spinal Cord Detethering. (PubMed)

Urological Outcome of the Xiao Procedure in Children with Myelomeningocele and Lipomyelomeningocele Undergoing Spinal Cord Detethering. Although previous studies have revealed high success rates (70% to 85%) after an intradural somatic-to-autonomic nerve transfer procedure in children with spinal dysraphism, no study has had a control group or blinded observers. We report a rigorously designed study to investigate the effectiveness of the Xiao procedure.Children with neurogenic bladder (...) dysfunction related to myelomeningocele or lipomyelomeningocele who required spinal cord detethering were randomized to 2 groups at surgery, with half undergoing only spinal cord detethering and half undergoing the Xiao procedure in addition to detethering. Double-blind evaluations were performed at regular intervals during the 3-year followup.A total of 10 patients underwent spinal cord detethering only and 10 underwent detethering plus the Xiao procedure. The Xiao procedure did not result in voluntary

2016 Journal of Urology

65. Lack of efficacy of an intradural somatic-to-autonomic nerve anastomosis (Xiao procedure) for bladder control in children with myelomeningocele and lipomyelomeningocele: results of a prospective, randomized, double-blind study. (PubMed)

Lack of efficacy of an intradural somatic-to-autonomic nerve anastomosis (Xiao procedure) for bladder control in children with myelomeningocele and lipomyelomeningocele: results of a prospective, randomized, double-blind study. OBJECTIVE Xiao et al. and other investigators have studied an intradural somatic-to-autonomic (e.g., L-5 to S3-4) nerve transfer as a method to create a reflex arc to allow bladder emptying in response to cutaneous stimulation (the Xiao procedure). In previous clinical (...) children with myelomeningocele (MM), lipomyelomeningocele (LMM), and neurogenic bladder dysfunction who were scheduled for spinal cord detethering (DT) for the usual indications. At the time of DT, patients were randomized between 2 arms of the study: half of the patients underwent a standard spinal cord DT procedure alone (DT group) and half underwent DT as well as the Xiao procedure (DT+X group). Patients, families, and study investigators, all of whom were blinded to the surgical details, analyzed

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2016 Journal of neurosurgery. Pediatrics

66. Managing fecal incontinence in patients with myelomeningocele in Sub-Saharan Africa: Role of antegrade continence enema (ACE). (PubMed)

Managing fecal incontinence in patients with myelomeningocele in Sub-Saharan Africa: Role of antegrade continence enema (ACE). Neural tube defects (NTDs) are among the major causes of sphincter dysfunctions. Fecal incontinence (FI) because of myelomeningocele (MMC) leads to problems with social acceptability and decreased quality of life (QOL), life satisfaction in addition to other morbidities. This is a report of experience with antegrade continence enema (ACE) in the management of FI

2016 Journal of Pediatric Surgery

67. Closure of Myelomeningocele Defects Using a Limberg Flap or Direct Repair (PubMed)

Closure of Myelomeningocele Defects Using a Limberg Flap or Direct Repair The global prevalence of myelomeningocele has been reported to be 0.8-1 per 1,000 live births. Early closure of the defect is considered to be the standard of care. Various surgical methods have been reported, such as primary skin closure, local skin flaps, musculocutaneous flaps, and skin grafts. The aim of this study was to describe the clinical characteristics of myelomeningocele defects and present the surgical (...) outcomes of recent cases of myelomeningocele at our institution.Patients who underwent surgical closure of myelomeningocele at our institution from January 2004 to December 2013 were included in this study. A retrospective chart review of their medical records was performed, and comorbidities, defect size, location, surgical procedures, complications, and the final results were analyzed.A total of 14 patients underwent surgical closure for myelomeningocele defects. Twelve cases were closed with direct

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2016 Archives of plastic surgery

68. Quantitative Analysis of Lower Leg Adipose Tissue Distribution in Youth with Myelomeningocele (PubMed)

Quantitative Analysis of Lower Leg Adipose Tissue Distribution in Youth with Myelomeningocele Children with myelomeningocele have a high prevalence of obesity and excess fat accumulation in their lower extremities. However, it is not known if this is subcutaneous or intramuscular fat, the latter of which has been associated with insulin resistance and metabolic disorders. This study quantified lower leg bone, muscle, and adipose tissue volume in children with myelomeningocele, classifying (...) adipose as subcutaneous or muscle-associated. Eighty-eight children with myelomeningocele and 113 children without myelomeningocele underwent lower leg computed tomographic scans. Subcutaneous and muscle-associated adipose were classified based on location relative to the crural fascia. No differences were seen in subcutaneous adipose. Higher level disease severity was associated with increased muscle-associated adipose volume and decreased muscle volume. Bone volume tended to decrease with higher

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2016 Journal of child neurology

69. Myelomeningocele

Myelomeningocele Myelomeningocele Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Myelomeningocele Myelomeningocele Aka (...) : Myelomeningocele , Severe Spina Bifida From Related Chapters II. Epidemiology Occurs in 1 per 1000 live births III. Risk Factors Maternal Prior history of child with Myelomeningocele (4% risk) (1-2% risk if taken during pregnancy) IV. Pathophysiology Severe form of Affects lumbosacral region in 75% of cases Associated with dysfunction of multiple organ systems V. Signs of lower extremities es absent VI. Associated Conditions (80% of cases) Neurogenic VII. Management Supportive care may be appropriate in severe

2018 FP Notebook

70. Prenatal surgery for myelomeningocele. (PubMed)

Prenatal surgery for myelomeningocele. This review summarizes outcomes of fetal surgery for myelomeningocele (MMC) as they compare to postnatal MMC repair and provides insights into areas of investigation to improve fetal MMC repair.Recent studies confirm the findings of the Management of Myelomeningocele Study and support the decreased need for postnatal ventricular shunts, improved hindbrain herniation, and improved neurofunctional outcome following open fetal repair compared to postnatal

2016 Current Opinion in Obstetrics and Gynecology

71. Current Selection Criteria and Perioperative Therapy Used for Fetal Myelomeningocele Surgery. (PubMed)

Current Selection Criteria and Perioperative Therapy Used for Fetal Myelomeningocele Surgery. To determine the current maternal and fetal selection criteria and operative approaches used at centers performing fetal myelomeningocele surgery.The 17 principal investigators participating in the Fetal Myelomeningocele Consortium were asked to participate in an anonymous online survey regarding the current practice of maternal-fetal surgery for neural tube defect repair and results were tabulated (...) microarray. There is also variation from the Management of Myelomeningocele Study with regard to body mass index (BMI) (1/11; 9% would offer surgery with BMIs higher than 35), maternal medical risk factors (surgery would be offered for controlled pregestational diabetes [3/10 (30%)]), hepatitis C with negative viral load (4/11 [36%]), and human immunodeficiency virus with an undetectable viral load (1/10 [10%] or an obstetric history [3/11 (27%)] would offer surgery with a history of preterm delivery

2016 Obstetrics and Gynecology

72. Health-related quality of life in children with myelomeningocele: a systematic review of the literature. (PubMed)

Health-related quality of life in children with myelomeningocele: a systematic review of the literature. Myelomeningocele (MMC) is the most complex congenital birth defect compatible with life. To provide the best health care for children with MMC, clinicians and researchers have to understand health and functional status of their patients as well as factors influencing their quality of life (QOL). The objective is to review studies that assess health-related quality of life (HRQOL

2016 Child: care, health and development

73. Closure of a Large Thoracolumbar Myelomeningocele Using a Modified Bilateral Keystone Flap (PubMed)

Closure of a Large Thoracolumbar Myelomeningocele Using a Modified Bilateral Keystone Flap The keystone flap, an emerging reconstructive option that can be used in many parts of the body, is gaining popularity among reconstructive surgeons. These reliable and versatile flaps can be used for large myelomeningocele closure. A modified bilateral keystone flap was used to achieve tension-free closure of a large thoracolumbar myelomeningocele associated with severe kyphosis in a newborn girl (...) , and protective. Wound healing was prompt, and the patient had a satisfactory cosmetic result. No postoperative complications were observed, such as flap necrosis, dehiscence, leakage of cerebrospinal fluid, or infection. The proposed modified keystone flap is a promising addition to the armament of reconstructive surgeons that might improve outcomes and minimize complications in myelomeningocele repair. Keystone flaps provide an ideal reconstructive option for large thoracolumbar myelomeningocele repair

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2016 Plastic and Reconstructive Surgery Global Open

74. Rate of shunt revision as a function of age in patients with shunted hydrocephalus due to myelomeningocele (PubMed)

Rate of shunt revision as a function of age in patients with shunted hydrocephalus due to myelomeningocele OBJECTIVE It is generally accepted that cerebrospinal fluid shunts fail most frequently in the first years of life. The purpose of this study was to describe the risk of shunt failure for a given patient age in a well-defined cohort with shunted hydrocephalus due to myelomeningocele (MMC). METHODS The authors analyzed data from their institutional spina bifida research database including

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2016 Neurosurgical focus

75. Management of Lumbosacral Myelomeningocele (PubMed)

Management of Lumbosacral Myelomeningocele 28090243 2019 02 26 1937-5719 16 2016 Eplasty Eplasty Management of Lumbosacral Myelomeningocele. ic51 DeJong Peter M PM Michigan State University College of Human Medicine, Grand Rapids, Mich. Adams Nicholas S NS Michigan State University College of Human Medicine, Grand Rapids, Mich; Plastic and Reconstructive Surgery Residency, Grand Rapids Medical Education Partners, Grand Rapids, Mich. Mann Robert J RJ Michigan State University College of Human (...) , Grand Rapids, Mich. Girotto John A JA Michigan State University College of Human Medicine, Grand Rapids, Mich; Plastic and Reconstructive Surgery Residency, Grand Rapids Medical Education Partners, Grand Rapids, Mich; Pediatric Plastic and Craniofacial Surgery, Helen DeVos Children's Hospital, Grand Rapids, Mich. eng Case Reports 2016 12 27 United States Eplasty 101316107 1937-5719 fascial flap myelomeningocele neural tube defect paraspinal fascial turnover flap spina bifida 2017 1 17 6 0 2017 1 17

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2016 Eplasty

76. Surgical Management of Hip Problems in Myelomeningocele: A Review Article (PubMed)

Surgical Management of Hip Problems in Myelomeningocele: A Review Article Children with myelomeningocele (MMC) develop a wide variety of hip deformities such as muscle imbalance, contracture, subluxation, and dislocation. Various methods and indications have been introduced for treatment of muscle imbalances and other hip problems in patients with MMC but there is no study or meta-analysis to compare the results and complications. This review aims to find the most acceptable approach to hip (...) of hip dislocation in myelomeningocele has been missing, however, muscular balancing with/out osseous procedure seems a reasonable approach especially in unilateral mid-lumbar MMC.

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2016 Archives of bone and joint surgery

77. Impact on family and parental stress of prenatal vs postnatal repair of myelomeningocele. (PubMed)

Impact on family and parental stress of prenatal vs postnatal repair of myelomeningocele. The Management of Myelomeningocele Study was a multicenter, randomized controlled trial that compared prenatal repair with standard postnatal repair for fetal myelomeningocele.We sought to describe the long-term impact on the families of the women who participated and to evaluate how the timing of repair influenced the impact on families and parental stress.Randomized women completed the 24-item Impact

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2016 American Journal of Obstetrics and Gynecology

78. Bladder Function After Fetal Surgery for Myelomeningocele (PubMed)

Bladder Function After Fetal Surgery for Myelomeningocele A substudy of the Management of Myelomeningocele Study evaluating urological outcomes was conducted.Pregnant women diagnosed with fetal myelomeningocele were randomly assigned to either prenatal or standard postnatal surgical repair. The substudy included patients randomly assigned after April 18, 2005. The primary outcome was defined in their children as death or the need for clean intermittent catheterization (CIC) by 30 months of age (...) . The implications of these findings are unclear now, but support the need for long-term urologic follow-up of patients with myelomeningocele regardless of type of surgical repair.Copyright © 2015 by the American Academy of Pediatrics.

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2015 EvidenceUpdates

79. Distribution of interstitial cells of Cajal in the bladders of fetal rats with retinoic acid induced myelomeningocele (PubMed)

Distribution of interstitial cells of Cajal in the bladders of fetal rats with retinoic acid induced myelomeningocele Myelomeningocele (MMC) is one of the most common reason of neurogenic bladder dysfunction in children. Although neurogenic bladder dysfunction occurrence is related with bladder innervation, also there are some changes seen in the smooth muscle and neural cells of the bladder. Interstitial cells of Cajal (ICC) are the pacemaker cells found in organs with peristaltic activity

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2016 Turkish journal of urology

80. Maternal, fetal, neonatal and childhood outcomes for pregnancies complicated by fetal myelomeningocele (spina bifida): a systematic review to develop a core outcome set

Maternal, fetal, neonatal and childhood outcomes for pregnancies complicated by fetal myelomeningocele (spina bifida): a systematic review to develop a core outcome set Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation

2018 PROSPERO

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