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Myelomeningocele

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101. Myelomeningocele (Diagnosis)

Myelomeningocele (Diagnosis) Spina Bifida: Background, Pathophysiology, Etiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMzExMTEzLW92ZXJ2aWV3 processing > Spina Bifida Updated: Sep 21, 2018 Author: Mark R (...) a range of presentations, from stillbirth to incidental radiographic findings of spina bifida occulta. Myelomeningocele, a form of , is visible at birth (see the images below). Patients with myelomeningocele present with a spectrum of impairments, but the primary functional deficits are lower limb paralysis and sensory loss, bladder and bowel dysfunction, and cognitive dysfunction. (See Clinical Presentation.) [ ] The lumbar region of a newborn baby with myelomeningocele. The skin is intact

2014 eMedicine.com

102. Myelomeningocele (Treatment)

Myelomeningocele (Treatment) Spina Bifida Treatment & Management: Approach Considerations, Bladder Management, Bowel Management Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMzExMTEzLXRyZWF0bWVudA== processing (...) is estimated to reach 70-80%. Children whose high bladder pressures are refractory to intermittent catheterization and/or medications (approximately 15-30% of patients with myelomeningocele) are candidates for surgical intervention. Various surgical techniques for augmentation cystoplasty and urinary diversion have been described in the literature. When infection occurs, antibiotics are used in combination with the usual techniques of bladder management. In general, high fluid intake is recommended

2014 eMedicine.com

103. Myelomeningocele (Overview)

Myelomeningocele (Overview) Spina Bifida: Background, Pathophysiology, Etiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMzExMTEzLW92ZXJ2aWV3 processing > Spina Bifida Updated: Sep 21, 2018 Author: Mark R (...) a range of presentations, from stillbirth to incidental radiographic findings of spina bifida occulta. Myelomeningocele, a form of , is visible at birth (see the images below). Patients with myelomeningocele present with a spectrum of impairments, but the primary functional deficits are lower limb paralysis and sensory loss, bladder and bowel dysfunction, and cognitive dysfunction. (See Clinical Presentation.) [ ] The lumbar region of a newborn baby with myelomeningocele. The skin is intact

2014 eMedicine.com

104. Myelomeningocele (Follow-up)

Myelomeningocele (Follow-up) Spina Bifida Treatment & Management: Approach Considerations, Bladder Management, Bowel Management Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMzExMTEzLXRyZWF0bWVudA== processing (...) is estimated to reach 70-80%. Children whose high bladder pressures are refractory to intermittent catheterization and/or medications (approximately 15-30% of patients with myelomeningocele) are candidates for surgical intervention. Various surgical techniques for augmentation cystoplasty and urinary diversion have been described in the literature. When infection occurs, antibiotics are used in combination with the usual techniques of bladder management. In general, high fluid intake is recommended

2014 eMedicine.com

105. Spinal Dysraphism/Myelomeningocele

Spinal Dysraphism/Myelomeningocele Imaging in Spinal Dysraphism and Myelomeningocele: Overview, Radiography, Computed Tomography Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNDEzODk5LW92ZXJ2aWV3 processing (...) > Imaging in Spinal Dysraphism and Myelomeningocele Updated: Sep 21, 2016 Author: Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR; Chief Editor: L Gill Naul, MD Share Email Print Feedback Close Sections Sections Imaging in Spinal Dysraphism and Myelomeningocele Overview Overview Preferred examination Choosing the most appropriate modality for imaging congenital malformation of the spine (eg, spinal dysraphism/myelomeningocele) involves considering many factors. Imaging of the bony spine requires methods

2014 eMedicine Radiology

106. Family-Based Association Study Between SLC2A1, HK1, and LEPR Polymorphisms With Myelomeningocele in Chile Full Text available with Trip Pro

Family-Based Association Study Between SLC2A1, HK1, and LEPR Polymorphisms With Myelomeningocele in Chile Obese/diabetic mothers present a higher risk to develop offspring with myelomeningocele (MM), evidence supporting the role of energy homeostasis-related genes in neural tube defects. Using polymerase chain reaction-restriction fragment length polymorphism, we have genotyped SLC2A1, HK1, and LEPR single-nucleotide polymorphisms in 105 Chilean patients with MM and their parents in order

2013 Reproductive Sciences

107. Prenatal Surgical Repair of Fetal Myelomeningocele

Prenatal Surgical Repair of Fetal Myelomeningocele Prenatal Surgical Repair of Fetal Myelomeningocele - 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. Prenatal Surgical Repair of Fetal Myelomeningocele (...) Information provided by (Responsible Party): Assistance Publique - Hôpitaux de Paris Study Details Study Description Go to Brief Summary: The open surgical repair of myelomeningoceles before 26 weeks gestational age provides a correction of the anomaly of Chiarri, reduces the incidence of ventriculomegaly (defined as a measure of the ventricles at the crossroads ≥ 10 mm), and get a lower of injury than one corresponding to the anatomical defect (as defined by the last upper normal vertebra before

2013 Clinical Trials

108. Anesthesia for In Utero Repair of Myelomeningocele. Full Text available with Trip Pro

Anesthesia for In Utero Repair of Myelomeningocele. Recently published results suggest that prenatal repair of fetal myelomeningocele is a potentially preferable alternative when compared to postnatal repair. In this article, the pathology of myelomeningocele, unique physiologic considerations, perioperative anesthetic management, and ethical considerations of open fetal surgery for prenatal myelomeningocele repair are discussed. Open fetal surgeries have many unique anesthetic issues (...) such as inducing profound uterine relaxation, vigilance for maternal or fetal blood loss, fetal monitoring, and possible fetal resuscitation. Postoperative management, including the requirement for postoperative tocolysis and maternal analgesia, are also reviewed. The success of intrauterine myelomeningocele repair relies on a well-coordinated multidisciplinary approach. Fetal surgery is an important topic for anesthesiologists to understand, as the number of fetal procedures is likely to increase as new fetal

2013 Anesthesiology

109. Novel single nucleotide polymorphisms in the superoxide dismutase 1 and 2 genes among children with myelomeningocele. Full Text available with Trip Pro

Novel single nucleotide polymorphisms in the superoxide dismutase 1 and 2 genes among children with myelomeningocele. Excessive oxidative stress has been demonstrated as a mechanism for neural tube defects (NTDs). The current exploratory study sought to examine sequence variations in the superoxide dismutase 1 (SOD1) and 2 (SOD2) genes in patients with myelomeningocele and to identify variants altering risk for myelomeningocele.We sequenced deoxyribonucleic acid from 96 patients (...) with myelomeningocele. The 11 exons were amplified by polymerase chain reaction, and the products were sequenced with the Sanger method. Results were compared with reference sequences (NM_000454, NM_000636, and NM_001024466) obtained from University of California Santa Cruz Genome Browser. Observed alleles that differed from the reference sequences were considered novel variants.We found 1 novel variant and 1 variant only recently described in phase 1 of the 1000 Genomes Project but not yet validated. The novel

2013 American Journal of Obstetrics and Gynecology

110. Functioning of peripheral Ia pathways in infants with Myelomeningocele. (Abstract)

Functioning of peripheral Ia pathways in infants with Myelomeningocele. The goal was to examine the accessibility of Ia-proprioceptive pathways to motoneurons of leg muscles associated with gait in infants with Myelomeningocele (MMC). Participants were 15 MMC infants, ages 2-10 months. We assessed over repeated trials, the tendon reflex (T-reflex), vibration-induced inhibition of T-reflex (VIM-T-reflex), and tonic vibration-induced reflex (VIR) when computer controlled stimuli were applied

2013 Infant behavior & development Controlled trial quality: uncertain

111. Single-Access Fetal Endoscopy (SAFE) for myelomeningocele in sheep model I: amniotic carbon dioxide gas approach. (Abstract)

Single-Access Fetal Endoscopy (SAFE) for myelomeningocele in sheep model I: amniotic carbon dioxide gas approach. This study aimed to assess the feasibility of single-access fetal endoscopy (SAFE) for the management of myelomeningocele (MMC) using intrauterine carbon dioxide as a distension medium in a sheep model.This prospective experimental case-control study investigated 12 lamb fetuses that had a myelomeningocele-like defect surgically created on the 75th day of gestation. Four fetuses

2013 Surgical endoscopy

112. Human induced pluripotent stem cell-derived neural crest stem cells integrate into the injured spinal cord in the fetal lamb model of myelomeningocele. (Abstract)

Human induced pluripotent stem cell-derived neural crest stem cells integrate into the injured spinal cord in the fetal lamb model of myelomeningocele. Neurological function in patients with myelomeningocele (MMC) is limited even after prenatal repair. Neural crest stem cells (NCSCs) can improve neurological function in models of spinal cord injury. We aimed to evaluate the survival, integration, and differentiation of human NCSCs derived from induced pluripotent stem cells (iPSC-NCSCs

2013 Journal of Pediatric Surgery

113. Morphology of nervous lesion in the spinal cord and bladder of fetal rats with myelomeningocele at different gestational age. (Abstract)

Morphology of nervous lesion in the spinal cord and bladder of fetal rats with myelomeningocele at different gestational age. To analyze the development and innervation of bladder smooth muscle and lesions of the spinal cord in fetal rats with meningomyelocele (MMC) at different gestational ages and to investigate interactions between spinal cord lesions and bladder.Each fetus was assigned to the MMC group or the normal group. Each group was further divided into three subgroups by gestational

2013 Journal of Pediatric Surgery

114. 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

2015 FP Notebook

115. Maternal, fetal, and neonatal care in open fetal surgery for myelomeningocele. (Abstract)

Maternal, fetal, and neonatal care in open fetal surgery for myelomeningocele. Fetal myelomeningocele closure (fMMC) was demonstrated in a randomized, prospective clinical trial to improve outcomes for children diagnosed prenatally. Complex care of the maternal/fetal dyad undergoing fetal surgery requires a well-coordinated multidisciplinary team. Nurses in many roles are essential members of the team that cares for these women across the continuum. In this article we discuss the care

2012 Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG

116. Open fetal surgery for myelomeningocele. (Abstract)

Open fetal surgery for myelomeningocele. In a recently completed randomized, prospective clinical trial, fetal repair for myelomeningocele was shown to result in reduced rates of hydrocephalus requiring placement of a ventriculoperitoneal shunt, improvement in Chiari malformation Type II, and improvement in neurological function compared with standard postnatal repair. Successful fetal surgery requires the active participation and interaction of several clinical teams. Each group has a specific (...) role, and overlap is often required at different points of the treatment plan. Extensive multispecialty discussions with the patient and family are necessary before informed consent can be obtained. Fetal surgery carries significant risks to the mother and fetus and these must be carefully considered prior to a final treatment decision. This review will summarize the evaluation and treatment of patients undergoing fetal repair for myelomeningocele at one institution.

2012 Journal of neurosurgery. Pediatrics

117. Functional Significance of Atypical Cortical Organization in Spina Bifida Myelomeningocele: Relations of Cortical Thickness and Gyrification with IQ and Fine Motor Dexterity Full Text available with Trip Pro

Functional Significance of Atypical Cortical Organization in Spina Bifida Myelomeningocele: Relations of Cortical Thickness and Gyrification with IQ and Fine Motor Dexterity The cortex in spina bifida myelomeningocele (SBM) is atypically organized, but it is not known how specific features of atypical cortical organization promote or disrupt cognitive and motor function. Relations of deviant cortical thickness and gyrification with IQ and fine motor dexterity were investigated in 64 individuals

2012 Cerebral Cortex (New York, NY)

118. Poland syndrome with extracorporeal intercostal liver herniation and thoracic myelomeningocele. (Abstract)

Poland syndrome with extracorporeal intercostal liver herniation and thoracic myelomeningocele. Poland syndrome is characterized by hypoplastic unilateral chest wall structures. These chest wall deformities may be associated with upper extremity anomalies. The association of Poland syndrome with either intercostal liver herniation or a spinocerebral deformity has been described, but there is no report of both findings encountered simultaneously. This is the first report of a newborn child (...) with Poland syndrome associated with an intercostal liver segment herniation and thoracic myelomeningocele with features of an Arnold-Chiari II cerebral malformation.Copyright © 2012 Elsevier Inc. All rights reserved.

2012 Journal of Pediatric Surgery

119. In Utero Closure of Myelomeningocele Does Not Improve Lower Urinary Tract Function. (Abstract)

In Utero Closure of Myelomeningocele Does Not Improve Lower Urinary Tract Function. Recent data comparing prenatal to postnatal closure of myelomeningocele showed a decreased need for ventriculoperitoneal shunting and improved lower extremity motor outcomes in patients who underwent closure prenatally. A total of 11 children whose spinal defect was closed in utero were followed at our spina bifida center. We hypothesized that in utero repair of myelomeningocele improves lower urinary tract (...) between catheterizations or anticholinergic/antibiotic use. Urodynamic parameters including bladder capacity, detrusor pressure at capacity, detrusor overactivity and the presence of detrusor sphincter dyssynergia were not significantly different between the groups. There was no difference in the rate of ventriculoperitoneal shunting (p = 0.14) or untethering surgery (p = 0.99).While in utero closure of myelomeningocele has been shown to decrease rates of ventriculoperitoneal shunting and improve

2012 Journal of Urology

120. Evaluating the cost-effectiveness of prenatal surgery for myelomeningoceles: a decision analysis. (Abstract)

Evaluating the cost-effectiveness of prenatal surgery for myelomeningoceles: a decision analysis. To determine whether prenatal myelomeningocele repair is a cost-effective strategy compared to postnatal repair.Decision-analysis modeling was used to calculate the cumulative costs, effects and incremental cost-effectiveness ratio of prenatal myelomeningocele repair compared with postnatal repair in singleton gestations with a normal karyotype that were identified with myelomeningocele between T1 (...) and S1. The model accounted for costs and quality-adjusted life years (QALYs) in three populations: (1) myelomeningocele patients; (2) mothers carrying myelomeningocele patients; and (3) possible future siblings of these patients. Sensitivity analysis was performed using one-way, two-way and Monte Carlo simulations.Prenatal myelomeningocele repair saves $ 2 066 778 per 100 cases repaired. Additionally, prenatal surgery results in 98 QALYs gained per 100 repairs with 42 fewer neonates requiring shunts

2012 Ultrasound in Obstetrics and Gynecology

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