IDEAL screened 13,808 subjects, 1632 were
eligible and consented and 176 mothers were enrolled. Only biological mothers with Custody of their child at the one-month visit (n = 50 MA; n = 86 comparison) had the Addiction Severity Index (ASI) administered. The NNNS was administered to the neonate by an examiner blinded to MA exposure within the first five days of life. General Linear Models tested the effects of maternal depression and prenatal MA exposure on NNNS outcomes, with and without covariates. Significance was accepted at p<.05.
Results: After adjusting for covariates, regardless of exposure status, maternal depressive symptoms were associated with lower handling and arousal scores, elevated physiological stress scores PD173074 ic50 and an increased incidence of hypotonicity. When adjusting for covariates, MA exposure was associated with lower arousal and higher lethargy scores.
Conclusions: Maternal depressive symptoms are associated with neurodevelopmental patterns of decreased arousal and increased stress. Prenatal MA exposure combined with maternal depression was Dorsomorphin ic50 not associated with any additional neonatal neurodevelopmental differences. (C) 2009 Published by Elsevier Inc.”
“Purpose: We determined the rate of stone clearance in children following percutaneous nephrolithotomy,
endoscopic assessment of residual stone and the Judicious use of second Thymidylate synthase look nephroscopy.
Materials and Methods: We retrospectively
reviewed the charts of all children undergoing percutaneous nephrolithotomy from 1996 to 2007. Cases were reviewed for pertinent details including preoperative and postoperative imaging, specifies of the procedure and followup. On completion of percutaneous nephrolithotomy the collecting system was assessed via combined nephrostogram and direct nephroscopy. If the collecting system could not be completely visualized or all stone fragments could not be cleared, the patient was referred for second look nephroscopy. Any residual stone present on initial followup imaging constituted a treatment failure.
Results: A total of 24 patients underwent. percutaneous nephrolithotomy for 30 separate renal calculi. Mean patient age was 9.6 years, and mean stone burden was 2.53 cm. The success rate for percutaneous nephrolithotomy (inclusive of second look nephroscopy) was 87%. Of 30 cases 16 were managed by second look nephroscopy, with findings of residual fragments in all 16. Treatment failure was noted in 1 patient without second look nephroscopy and in 3 patients with second look nephroscopy. Of the 4 patients with treatment failure all were eventually rendered stone-free.
Conclusions: Second look nephroscopy based on endoscopic findings during initial percutaneous nephrolithotomy is a reliable method of detecting and clearing residual stone fragments.