Lung Hypoplasia Associated With Ring-Sling Complex Is Usually Right-Sided.

Background: Pulmonary artery sling (PAS) is usually associated with long-segment congenital tracheal stenosis (LSCTS). This combination of abnormalities can also be associated with lung hypoplasia abnormalities (hypoplasia, aplasia, or agenesis). This study analyzed the association of lung hypoplasia abnormalities with combined PAS and LSCTS and its influence on its surgical outcomes.

Bronchial Dieulafoy's Disease in Children: A Case Report and Review of Literature.

Dieulafoy's disease is a rare vascular lesion characterized by presence of large aberrant arteries within the submucosa of gastrointestinal tract or respiratory tract with a potential to cause life-threatening hemorrhage. Treatment includes bronchoscopy ablation, angiographic embolization or surgery. We report management of 7-year old girl with Dieulafoy's disease in the airway who presented with recurrent hemoptysis.

Staging of Surgical Procedures in Comorbid Congenital Tracheal Stenosis and Congenital Cardiovascular Disease.

Background: Comorbid long segment congenital tracheal stenosis and congenital cardiovascular abnormalities in children pose significant challenges with regard to repairing these abnormalities simultaneously or in stages. The aim of this study was to explore whether this combination of abnormalities needs a staged approach for surgical repairs.

Methods: All children who underwent both tracheal and cardiac surgical procedures at a tertiary hospital from 1995 to 2018 were analyzed retrospectively for mortality, ventilation days, postoperative intensive care unit days, mediastinitis, and unplanned reoperation by dividing them into simultaneous repairs (group 1), staged repairs within the same admission (group 2), and staged repairs during different admissions (group 3).

Disturbingly high fracture rate of STRATOS bars in pectus corrections.

Objectives: Several procedures have been described to correct pectus excavatum and carinatum. We have used a modified Ravitch procedure (STRATOS titanium bars) for patients who were unsuitable for the minimally invasive Nuss procedure. The operation produced excellent cosmetic results, but we have noted several fractures and displacements of the STRATOS bars.

The neuropathology of stillbirth - correlation with apolipoprotein genotype in a Scottish population based study.

Background: The neuropathology of stillbirths has been widely studied but rarely on a population basis. Whether foetal apolipoprotein E (APOE) genotype exerts any influence has been little investigated, despite well known effects in adult brains.

Aims: To establish the neuropathology of a population cohort of stillbirths and compare with the APOE genotype.

An electronic surveillance system for monitoring the hospital presentation of nutritional vitamin D deficiency in children in Scotland.

Background: Routine surveillance would be valuable for vitamin D deficiency as symptomatic vitamin D deficiency may be common in Scotland.

Aim: To assess the effectiveness of an electronic surveillance system to determine the current incidence of hospital-based presentation of childhood vitamin D deficiency in Scotland.

Methods: Active surveillance was performed for 2 years as part of an electronic web-based surveillance programme by the Scottish Paediatric Surveillance Unit.

The epidemiology of hypernatraemia in hospitalised children in Lothian: a 10-year study showing differences between dehydration, osmoregulatory dysfunction and salt poisoning.

Introduction: The relative frequencies of the causes of hypernatraemia in children after the neonatal period are unknown. Salt poisoning and osmoregulatory dysfunction are extremely rare and potentially fatal. In this retrospective 10-year study, the incidence, causes and differential biochemistry of hypernatraemia in children is examined.

Normative values of substance P and neurokinin A in neonates.

Background: Substance P (SP) and neurokinin A (NKA) are neuropeptides that have been researched as pain markers in adults, as they are involved in transmission and modulation of pain signals. There is a potential role for them as neurochemical markers of pain in neonates, but this has never previously been investigated.

Aim: To establish normative values of SP and NKA in neonates.

Factorial switching linear dynamical systems applied to physiological condition monitoring.

Condition monitoring often involves the analysis of systems with hidden factors that switch between different modes of operation in some way. Given a sequence of observations, the task is to infer the filtering distribution of the switch setting at each time step. In this paper, we present factorial switching linear dynamical systems as a general framework for handling such problems.

A re-investigation of saliva collection procedures that highlights the risk of potential positive interference in cortisol immunoassay.

Background: The use of saliva for measurement of cortisol permits non-invasive study of adrenal function, but collection can be technically difficult, particularly in small infants. Saliva collection can be assisted by citric acid to increase saliva flow, or by the use of cotton or polyester swabs in the mouth.

Aim: To determine whether different methods of saliva collection affect cortisol radioimmunoassay (RIA) performance.

More information, less understanding: a randomized study on consent issues in neonatal research.

Background: Valid consent for research requires comprehensive and understandable information to be disclosed to participants. The way that information is shared varies, but regulatory bodies usually determine style. Some reports have suggested that although information may be all-inclusive, it does little to support understanding.

Incidence of oronasal haemorrhage in infancy presenting to general practice in the UK.

The frequency of oronasal haemorrhage in infancy was estimated from two national GP research databases (6% UK population). When a case was identified, other presentations in the child over the first year were available from one dataset. In the first year haemoptysis is rare.

Summarising complex ICU data in natural language: demonstration of the BT-45 system.

As ICUs generate increasing amounts of information, writing medical reports involves complex time-consuming reasoning to build a coherent text which will be meaningful to those who will use it for decision making (e.g.: for nurse handover).

Summarising complex ICU data in natural language.

It has been shown that summarizing complex multi-channel physiological and discrete data in natural language (text) can lead to better decision-making in the intensive care unit (ICU). As part of the BabyTalk project, we describe a prototype system (BT-45) which can generate such textual summaries automatically. Although these summaries are not yet as good as those generated by human experts, we have demonstrated experimentally that they lead to as good decision-making as can be achieved through presenting the same data graphically.

How should we manage pain in ventilated neonates?

Newborn babies, even if extremely preterm, show responses to pain. The major stress responses seen with surgical pain are associated with serious adverse medical outcomes. There is an ethical imperative to consider pain relief in babies, despite the fact that they cannot verbalise their experience.

Myelin expression is altered in the brains of neonatal rats reared in a fluctuating oxygen atmosphere.

Background: Preterm infants receiving supplemental oxygen therapy experience frequent fluctuations in their blood oxygen levels, the magnitude of which has been associated with the incidence and severity of retinopathy of prematurity in such infants.

Objective: Our objective was to investigate in a relevant animal model whether the immature brain with its poorly vascularised white matter might also be susceptible to injury when exposed to such fluctuations in blood oxygen.

Methods: Newborn rats were reared in an atmosphere in which a computer reproduced the oxygen fluctuations derived from the transcutaneous oxygen levels of a 24-week preterm infant who had developed severe retinopathy.

Apolipoprotein E e4 and its prevalence in early childhood death due to sudden infant death syndrome or to recognised causes.

Background: Specific genetic polymorphisms have been shown to be more common in unexplained infant death. The APOE genotype exhibits opposite effects at the extremes of age with protective effects of e4 on perinatal mortality but detrimental effects as age progresses.

Objective: To determine whether the APOE e4 allele is associated with early childhood (1 week-2 years) unexplained death ('sudden infant death syndrome', SIDS) or with recognised causes (non-SIDS) and to compare these cohorts with published perinatal and adult data.

Pathogenesis of retinopathy of prematurity and possible preventive strategies.

Retinopathy of Prematurity (ROP) occurs when premature birth interrupts normal retinal vascular development. Postnatal tissue oxygen levels are significantly higher than those present in utero. Oxygen therapy further increases oxygen levels in the developing retina.

Bodily progression of motor responses to increasing mechanical force stimulation in the newborn infant and the effect of heel prick.

Background: The newborn infant's response to stimulation with von Frey filaments has previously been examined only at the spinal level as the flexion withdrawal response or abdominal reflex. The threshold for the spinal responses has been shown to be lower following skin damage and visceral pathology. Higher forces of mechanical stimulation elicit other body responses, which are likely to arise from higher levels in the nervous system: these have not been investigated before.

Prematurity and neonatal noxious events exert lasting effects on infant pain behaviour.

Background: There is concern that exposure of preterm infants to noxious insults over a prolonged period may have long term effects on their developing nervous system.

Aims: To investigate medium and long term effects of heel pricks in infants over the first year of life.

Study Design: Study 1-a longitudinal study, 2 days and 4 weeks after heel prick.

Epidemiology of oronasal hemorrhage in the first 2 years of life: implications for child protection.

Background: Epistaxis in childhood is common but unusual in the first years of life. Oronasal blood has been proposed as a marker of child abuse.

Methods: We performed a retrospective review of all hospital notes of children in the Lothian region of Scotland who were <2 years of age and in whom facial blood had been recorded over a 10-year period.

Assessment of persistent pain or distress and adequacy of analgesia in preterm ventilated infants.

Indicators of persistent pain in preterm neonates are poorly defined. In the setting of a double blind, placebo-controlled trial investigating morphine use in ventilated preterm infants (NEOPAIN Trial) we aimed to identify factors that may be useful in assessing persistent pain. Twenty-two babies (morphine 12; placebo 10) were assessed for comfort, pain or distress and clinical staff described the factors they had considered.