Baby Friendly Hospital Initiative Breastfeeding Outcomes in Mothers with COVID-19 Infection During the First Weeks of the Pandemic in Spain.

Background: Adherence to the Ten Steps of the Baby-Friendly Hospital Initiative has been shown to have a protective role for the initiation and maintenance of breastfeeding.

Research Aims: (1) To determine the breastfeeding rate during the first 6 months of life in children of mothers diagnosed with COVID-19 infection at the time of birth; and (2) to assess the possible influence of being born in a center with Baby-Friendly Hospital Initiative accreditation.

Methods: This was a two-group comparative longitudinal observational study of infants born to mothers with COVID-19 at the time of birth, between March 13-May 31, 2020 (the first wave of the pandemic) in Spain.

Congenital Cutaneous Candidiasis With Systemic Dissemination in a Preterm Infant.

Congenital cutaneous candidiasis is an infrequent invasive fungal infection that usually appears in the first days of life. Extremely low birth weight infants are the most frequently affected. Classic presentation includes diffuse extensive erythematous rash with papules, plaques, pustules and vesicles, which later undergoes desquamation.

Multicentre Spanish study found no incidences of viral transmission in infants born to mothers with COVID-19.

Aim: Our aim was to describe the clinical features of mothers infected with COVID-19 and examine any potential vertical mother to newborn transmission. We also assessed how effective the discharge recommendations were in preventing transmission during the first month of life.

Methods: This multicentre descriptive study involved 16 Spanish hospitals.

Neuroprotection by cannabidiol and hypothermia in a piglet model of newborn hypoxic-ischemic brain damage.

Objective: Hypothermia, the gold standard after a hypoxic-ischemic insult, is not beneficial in all treated newborns. Cannabidiol is neuroprotective in animal models of newborn hypoxic-ischemic encephalopathy. This study compared the relative efficacies of cannabidiol and hypothermia in newborn hypoxic-ischemic piglets and assessed whether addition of cannabidiol augments hypothermic neuroprotection.

3-lead electrocardiogram is more reliable than pulse oximetry to detect bradycardia during stabilisation at birth of very preterm infants.

Objectives: Current neonatal resuscitation guidelines suggest the use of ECG in the delivery room (DR) to assess heart rate (HR). However, reliability of ECG compared with pulse oximetry (PO) in a situation of bradycardia has not been specifically investigated. The objective of the present study was to compare HR monitoring using ECG or PO in a situation of bradycardia (HR <100 beats per minute (bpm)) during preterm stabilisation in the DR.

Technical aspects of transcarotid artery revascularization using the ENROUTE transcarotid neuroprotection and stent system.

Transcarotid artery revascularization (TCAR) with the ENROUTE transcarotid neuroprotection and stent system (Silk Road Medical, Inc, Sunnyvale, Calif) combines surgical principles of neuroprotection with less invasive endovascular techniques to treat high grade stenosis in the carotid artery. The ENROUTE Neuroprotection System allows the surgeon to directly access the common carotid artery to initiate high rate temporary blood flow reversal to protect the brain while performing carotid angioplasty and stenting. Unprotected catheterization of the arch and lesion is, thus, avoided.

Surgical treatment of abdominal aortic aneurysms in infancy and early childhood.

Objective: Pediatric abdominal aortic aneurysms (AAAs) are rare. The intent of this report was to review the presentation and surgical management of AAAs in infancy and early childhood.

Methods: The clinical courses of young children undergoing AAA surgery were subjected to a retrospective review and analysis.

Transthoracic Median Arcuate Ligament Release and Mesenteric Revascularization.

Surgical revascularization for chronic or acute mesenteric ischemia is often technically challenging. In many instances, because of the presence of hostile abdominal conditions or the lack of adequate intra-abdominal arterial inflow sources, alternative surgical approaches that avoid the abdomen and use a more proximal source of arterial inflow are necessary. In these situations, a bypass from the descending or ascending thoracic aorta to the mesenteric vessels may be the only viable option.

Remedial operations for failed endovascular therapy of 32 renal artery stenoses in 24 children.

Background: Percutaneous transluminal angioplasty (PTA) for the treatment of pediatric renovascular hypertension (RVH) in contemporary practice is accompanied with ill-defined complications. This study examines the mode of pediatric renal PTA failures and the results of their surgical management.

Methods: Twenty-four children underwent remedial operations at the University of Michigan from 1996 to 2014 for failures of renal PTA.

Evolution in the Management of Aberrant Subclavian Arteries and Related Kommerell Diverticulum.

Background: Various options have been described to treat aberrant subclavian arteries and associated Kommerell diverticulum. We describe our experience with the management of this entity over a 15-year period.

Methods: Twenty-two patients underwent repair of aberrant subclavian arteries and associated Kommerell diverticulum.

Isolated celiac artery dissection.

Objective: Spontaneous celiac artery dissection is rare, and its natural history is not well studied. The objective of this study was to review our experience with the evaluation and management of this condition.

Methods: During the last 8 years, 19 patients (14 men, five women) presented with the diagnosis of spontaneous celiac artery dissection.

Physiologic variations in venous and arterial hemodynamics in response to postural changes at the thoracic outlet in normal volunteers.

Background: Hemodynamic changes in vascular flow and waveforms measured across the thoracic outlet (TO) during positional changes may occur in normal individuals. The aim of this study was to establish the prevalence of significant arterial and venous hemodynamic variation in the limbs of normal volunteers during standardized upper extremity positional changes.

Methods: Using Doppler ultrasound and photoplethysmography (PPG), we evaluated arterial and venous flow in 100 limbs of 50 normal volunteers in neutral position and in 5 different standardized arm positions, including 90° arm abduction (with head in neutral position, head turned ipsilaterally, and head turned contralaterally), arm extended above the head at 180°, and arm hyperextended at 200°.

Relevance of bone anomalies in patients with thoracic outlet syndrome.

Background: Skeletal anomalies are recognized as potential causes of thoracic outlet syndrome (TOS); however, there is a paucity of information regarding the specific bone anomalies associated with TOS and their relative incidence among the different clinical types of TOS. This study describes the prevalence of bone anomalies in a population with TOS.

Methods: A retrospective chart review of the clinical records and imaging studies of all patients who were surgically treated at our institution for TOS between 1991-2011 was conducted.

Outcomes after late explantation of aortic endografts depend on indication for explantation.

Background: With the growing prevalence of endovascular repair for abdominal aortic aneurysm (AAA), the number of patients requiring graft explantation is increasing. Therefore, knowledge related to outcomes after explantation may lead to improvement in surgical options. In this study we compare our experience with explantation of aortic endografts, based on indication.

Contemporary outcomes after distal vertebral reconstruction.

Introduction: Flow-limiting lesions or embolic phenomena can produce vertebrobasilar ischemia. This study aims to differentiate the pathophysiology of vertebral ischemia and examine contemporary outcomes after distal vertebral reconstruction.

Methods: Between February 2005 and November 2011, 41 consecutive distal vertebral artery (VA) reconstructions were performed in 34 patients, including bypass to the third portion of the VA (V3) at the C1-2 level (n = 24) or the C0-1 level (n = 7); transposition of the external carotid artery or its occipital branch onto V3 (n = 6); transposition of V3 onto the internal carotid artery (n = 3); and bypass from the ipsilateral subclavian artery to V3 (n = 1).

Surgical treatment of Kommerell's diverticulum and other saccular arch aneurysms.

Background: Saccular aneurysms of the aortic arch are rare, and their surgical repair is challenging with potentially significant morbidity and mortality.

Methods: We examined our experience over a 3-year period with nine consecutive patients that include nine hybrid repairs with initial extra-anatomic carotid and/or subclavian bypass and subsequent endovascular exclusion of the saccular arch aneurysm.

Results: Three patients presented with dysphagia from aberrant right subclavian arteries with aneurysm at the origin of the artery, two had asymptomatic aneurysms at the origin of the left subclavian, and four patients had isolated saccular aneurysms of the arch, three of whom presented with thoracic pain.

Specialized vascular floors after open aortic surgery: cost containment while preserving quality outcomes.

Background: Postoperative care of open abdominal aortic surgery (OAAS) traditionally involves the intensive care unit (ICU). We hypothesized that in patients without an indication for postoperative ICU admission, admission to a specialized vascular floor unit (hemodynamic monitoring, 2:1 nursing) offers cost savings to both payer and institution without compromising care.

Methods: The electronic medical record was used to collect perioperative data for patients who underwent OAAS between July 2007 and July 2011.

Composite stent-grafts are not associated with increased endoleak or reintervention rates after endovascular abdominal aneurysm repair.

Background: Although present-generation endografts have expanded the indications for endovascular abdominal aneurysm repair, arterial anatomy frequently dictates the use of a combination of commercially available endografts and components for successful aneurysm repair. This study sought to determine whether there was an increase in endoleak or secondary intervention rates in individuals treated with composite endografts compared with noncomposite, or standard, endografts.

Methods: From 1999 to 2009, 421 endovascular abdominal aneurysm repairs were performed at a single institution.

A diffusion-weighted magnetic resonance imaging-based study of transcervical carotid stenting with flow reversal versus transfemoral filter protection.

Background: Transfemoral carotid artery stenting (CAS) has been associated with a high incidence of embolic phenomena and silent brain infarction. The goal of this study was to compare the incidence of new ischemic cerebral lesions on diffusion-perfusion magnetic resonance imaging (MRI) sequences after transcervical CAS performed with carotid flow reversal vs stenting via transfemoral approach with distal filter protection.

Methods: During a 26-month period, 64 consecutive patients diagnosed with significant carotid stenosis by ultrasound imaging were assigned to transcervical CAS with carotid flow reversal or a transfemoral approach with a distal filter.

Endovascular aortic aneurysm repair with carbon dioxide-guided angiography in patients with renal insufficiency.

Objective: Renal dysfunction following endovascular abdominal aortic aneurysm repair (EVAR) remains a significant source of morbidity and mortality. We studied the use of carbon dioxide (CO(2)) as a non-nephrotoxic contrast agent for EVAR.

Methods: Recorded data from 114 consecutive patients who underwent EVAR with CO(2) as the contrast agent over 44 months were retrospectively analyzed.

Late gastrointestinal complications of inferior vena cava filter placement: case report and literature review.

In current practice, inferior vena cava (IVC) filters are commonly used in the prevention of pulmonary embolism. Despite their widespread use, periprocedural as well as late complications do occur. Filter penetration of the IVC wall into surrounding structures, including bowel, is a known although rare complication.

Postoperative fluid collection after hybrid debranching and endovascular repair of thoracoabdominal aortic aneurysms.

Objective: Hybrid thoracic endovascular aneurysm repair (H-TEVAR) to include visceral and renal debranching has emerged as a potential therapeutic option for thoracoabdominal aneurysms (TAAA). This study was performed to characterize the frequently noted development of postoperative fluid collections surrounding the bypass grafts.

Methods: All patients undergoing H-TEVAR from 2000-2010 (n = 39, 43.

Experimental contamination assessment of a novel closed ultravitrification device.

Objective: To evaluate the safety of a new ultravitrification closed device.

Design: Ultravitrification research.

Setting: Private assisted reproduction center.

Human oocyte ultravitrification with a low concentration of cryoprotectants by ultrafast cooling: a new protocol.

Objective: To evaluate the efficacy of a new ultravitrification technique with a low concentration of cryoprotectants.

Design: Ultravitrification research.

Setting: Private assisted reproduction center.