The Experts below are selected from a list of 111 Experts worldwide ranked by ideXlab platform

Rosemary D Higgins - One of the best experts on this subject based on the ideXlab platform.

  • laparotomy versus Peritoneal Drainage for necrotizing enterocolitis or isolated intestinal perforation in extremely low birth weight infants outcomes through 18 months adjusted age
    Pediatrics, 2006
    Co-Authors: Martin L Blakely, Jon E Tyson, Kevin P Lally, Scott A Mcdonald, Barbara J Stoll, David K Stevenson, Kenneth W Poole, Alan H Jobe, Linda L Wright, Rosemary D Higgins
    Abstract:

    OBJECTIVE.Extremely low birth weight (ELBW; 1000 g) infants with necrotizing enterocolitis (NEC) or isolated intestinal perforation (IP) are treated surgically with either initial laparotomy or Peritoneal Drain placement. The only published data comparing these therapies are from small, retrospective, single-center studies that do not address outcomes beyond nursery discharge. The objective of this study was to conduct a prospective, multicenter, observational study to (1) develop a hypothesis about the relative effect of these 2 therapies on risk-adjusted outcomes through 18 to 22 months in ELBW infants and (2) to obtain data that would be useful in designing and conducting a successful trial of this hypothesis. METHODS.A prospective, cohort study was conducted at 16 clinical centers within the National Institute of Child Health and Human Development Neonatal Research Network. To assist in risk adjustment, the attending pediatric surgeon recorded the preoperative diagnosis and intraoperative diagnosis and identified infants who were considered to be too ill for laparotomy. Predefined measures of short- and longer-term outcome included (1) either predischarge death or prolonged parenteral nutrition (85 days) after enrollment and (2) either death or neurodevelopmental impairment on a standardized examination at 18 to 22 months’ adjusted age. RESULTS.Severe NEC or IP occurred in 156 (5.2%) of 2987 ELBW infants; 80 were treated with initial Drainage, and 76 were treated with initial laparotomy. By 18 to 22 months, 78 (50%) had died; 112 (72%) had died or were shown to be impaired. Outcome was worse in the subgroup with NEC. Laparotomy was never performed in 76% (28 of 36) of Drain-treated survivors.

  • laparotomy versus Peritoneal Drainage for necrotizing enterocolitis or isolated intestinal perforation in extremely low birth weight infants outcomes through 18 months adjusted age
    Pediatrics, 2006
    Co-Authors: Martin L Blakely, Jon E Tyson, Kevin P Lally, Scott A Mcdonald, Barbara J Stoll, David K Stevenson, Kenneth W Poole, Alan H Jobe, Linda L Wright, Rosemary D Higgins
    Abstract:

    OBJECTIVE. Extremely low birth weight (ELBW; ≤1000 g) infants with necrotizing enterocolitis (NEC) or isolated intestinal perforation (IP) are treated surgically with either initial laparotomy or Peritoneal Drain placement. The only published data comparing these therapies are from small, retrospective, single-center studies that do not address outcomes beyond nursery discharge. The objective of this study was to conduct a prospective, multicenter, observational study to (1) develop a hypothesis about the relative effect of these 2 therapies on risk-adjusted outcomes through 18 to 22 months in ELBW infants and (2) to obtain data that would be useful in designing and conducting a successful trial of this hypothesis. METHODS. A prospective, cohort study was conducted at 16 clinical centers within the National Institute of Child Health and Human Development Neonatal Research Network. To assist in risk adjustment, the attending pediatric surgeon recorded the preoperative diagnosis and intraoperative diagnosis and identified infants who were considered to be too ill for laparotomy. Predefined measures of short- and longer-term outcome included (1) either predischarge death or prolonged parenteral nutrition (>85 days) after enrollment and (2) either death or neurodevelopmental impairment on a standardized examination at 18 to 22 months9 adjusted age. RESULTS. Severe NEC or IP occurred in 156 (5.2%) of 2987 ELBW infants; 80 were treated with initial Drainage, and 76 were treated with initial laparotomy. By 18 to 22 months, 78 (50%) had died; 112 (72%) had died or were shown to be impaired. Outcome was worse in the subgroup with NEC. Laparotomy was never performed in 76% (28 of 36) of Drain-treated survivors. CONCLUSIONS. Drainage was commonly used, and outcome was poor. Our findings, particularly the risk-adjusted odds ratio favoring laparotomy for death or impairment, indicate the need for a large, multicenter clinical trial to assess the effect of the initial surgical therapy on outcome at ≥18 months.

W B Van Leeuwen - One of the best experts on this subject based on the ideXlab platform.

  • detection of colon flora in Peritoneal Drain fluid after colorectal surgery can rt pcr play a role in diagnosing anastomotic leakage
    Iranian journal of microbiology, 2009
    Co-Authors: Niels Komen, M C Morsink, S Beiboer, A Miggelbrink, Johan F. Lange, Erwin Van Der Harst, Paul Willemsen, W B Van Leeuwen
    Abstract:

    Background and objectives: A semi-quantitative Real-Time PCR strategy was developed to identify indicator organisms for an indication on anastomotic leakage in Peritoneal Drainage fluid, Escherichia coli and Enterococcus faecalis. Materials and Methods: The analytical performance of the amplification method was validated with 10 culture-positive and 7 culture negative Peritoneal Drain fluid samples, obtained from 9 different patients with a colorectal anastomosis. Results: Real-Time PCR results were fully concordant with the microbiological culture results. However, among the culture negative samples, four false-positive RT-PCR results were found. All false-positives originated from a single patient with a surgical site infection. This may indicate an elevated sensitivity of the RT-PCR method. Conclusion: The results showed that the semi-quantitative RT-PCR method has the clear potential to be useful as a powerful tool in early detection of anastomotic leakage.

  • detection of colon flora in Peritoneal Drain fluid after colorectal surgery can rt pcr play a role in diagnosing anastomotic leakage
    Journal of Microbiological Methods, 2009
    Co-Authors: Niels Komen, M C Morsink, S Beiboer, A Miggelbrink, W B Van Leeuwen, Johan F. Lange, Erwin Van Der Harst, Paul Willemsen
    Abstract:

    A semi-quantitative Real-Time PCR strategy was developed to identify potential indicator organisms for anastomotic leakage in Peritoneal Drainage fluid, Escherichia coli and Enterococcus faecalis. The analytical performance of the amplification method was validated with 10 culture-positive and 7 culture-negative Peritoneal Drain fluid samples, obtained from 9 different patients with a colorectal anastomosis. Real-Time PCR results were fully concordant with the microbiological culture results. However, among the culture-negative samples, four false-positive RT-PCR results were found. All false-positives originated from a single patient with a surgical site infection. This may indicate an elevated sensitivity of the RT-PCR method. The results showed that the semi-quantitative RT-PCR method has a clear potential to be useful as a powerful tool in early detection of anastomotic leakage.

Martin L Blakely - One of the best experts on this subject based on the ideXlab platform.

  • laparotomy versus Peritoneal Drainage for necrotizing enterocolitis or isolated intestinal perforation in extremely low birth weight infants outcomes through 18 months adjusted age
    Pediatrics, 2006
    Co-Authors: Martin L Blakely, Jon E Tyson, Kevin P Lally, Scott A Mcdonald, Barbara J Stoll, David K Stevenson, Kenneth W Poole, Alan H Jobe, Linda L Wright, Rosemary D Higgins
    Abstract:

    OBJECTIVE.Extremely low birth weight (ELBW; 1000 g) infants with necrotizing enterocolitis (NEC) or isolated intestinal perforation (IP) are treated surgically with either initial laparotomy or Peritoneal Drain placement. The only published data comparing these therapies are from small, retrospective, single-center studies that do not address outcomes beyond nursery discharge. The objective of this study was to conduct a prospective, multicenter, observational study to (1) develop a hypothesis about the relative effect of these 2 therapies on risk-adjusted outcomes through 18 to 22 months in ELBW infants and (2) to obtain data that would be useful in designing and conducting a successful trial of this hypothesis. METHODS.A prospective, cohort study was conducted at 16 clinical centers within the National Institute of Child Health and Human Development Neonatal Research Network. To assist in risk adjustment, the attending pediatric surgeon recorded the preoperative diagnosis and intraoperative diagnosis and identified infants who were considered to be too ill for laparotomy. Predefined measures of short- and longer-term outcome included (1) either predischarge death or prolonged parenteral nutrition (85 days) after enrollment and (2) either death or neurodevelopmental impairment on a standardized examination at 18 to 22 months’ adjusted age. RESULTS.Severe NEC or IP occurred in 156 (5.2%) of 2987 ELBW infants; 80 were treated with initial Drainage, and 76 were treated with initial laparotomy. By 18 to 22 months, 78 (50%) had died; 112 (72%) had died or were shown to be impaired. Outcome was worse in the subgroup with NEC. Laparotomy was never performed in 76% (28 of 36) of Drain-treated survivors.

  • laparotomy versus Peritoneal Drainage for necrotizing enterocolitis or isolated intestinal perforation in extremely low birth weight infants outcomes through 18 months adjusted age
    Pediatrics, 2006
    Co-Authors: Martin L Blakely, Jon E Tyson, Kevin P Lally, Scott A Mcdonald, Barbara J Stoll, David K Stevenson, Kenneth W Poole, Alan H Jobe, Linda L Wright, Rosemary D Higgins
    Abstract:

    OBJECTIVE. Extremely low birth weight (ELBW; ≤1000 g) infants with necrotizing enterocolitis (NEC) or isolated intestinal perforation (IP) are treated surgically with either initial laparotomy or Peritoneal Drain placement. The only published data comparing these therapies are from small, retrospective, single-center studies that do not address outcomes beyond nursery discharge. The objective of this study was to conduct a prospective, multicenter, observational study to (1) develop a hypothesis about the relative effect of these 2 therapies on risk-adjusted outcomes through 18 to 22 months in ELBW infants and (2) to obtain data that would be useful in designing and conducting a successful trial of this hypothesis. METHODS. A prospective, cohort study was conducted at 16 clinical centers within the National Institute of Child Health and Human Development Neonatal Research Network. To assist in risk adjustment, the attending pediatric surgeon recorded the preoperative diagnosis and intraoperative diagnosis and identified infants who were considered to be too ill for laparotomy. Predefined measures of short- and longer-term outcome included (1) either predischarge death or prolonged parenteral nutrition (>85 days) after enrollment and (2) either death or neurodevelopmental impairment on a standardized examination at 18 to 22 months9 adjusted age. RESULTS. Severe NEC or IP occurred in 156 (5.2%) of 2987 ELBW infants; 80 were treated with initial Drainage, and 76 were treated with initial laparotomy. By 18 to 22 months, 78 (50%) had died; 112 (72%) had died or were shown to be impaired. Outcome was worse in the subgroup with NEC. Laparotomy was never performed in 76% (28 of 36) of Drain-treated survivors. CONCLUSIONS. Drainage was commonly used, and outcome was poor. Our findings, particularly the risk-adjusted odds ratio favoring laparotomy for death or impairment, indicate the need for a large, multicenter clinical trial to assess the effect of the initial surgical therapy on outcome at ≥18 months.

Linda L Wright - One of the best experts on this subject based on the ideXlab platform.

  • laparotomy versus Peritoneal Drainage for necrotizing enterocolitis or isolated intestinal perforation in extremely low birth weight infants outcomes through 18 months adjusted age
    Pediatrics, 2006
    Co-Authors: Martin L Blakely, Jon E Tyson, Kevin P Lally, Scott A Mcdonald, Barbara J Stoll, David K Stevenson, Kenneth W Poole, Alan H Jobe, Linda L Wright, Rosemary D Higgins
    Abstract:

    OBJECTIVE.Extremely low birth weight (ELBW; 1000 g) infants with necrotizing enterocolitis (NEC) or isolated intestinal perforation (IP) are treated surgically with either initial laparotomy or Peritoneal Drain placement. The only published data comparing these therapies are from small, retrospective, single-center studies that do not address outcomes beyond nursery discharge. The objective of this study was to conduct a prospective, multicenter, observational study to (1) develop a hypothesis about the relative effect of these 2 therapies on risk-adjusted outcomes through 18 to 22 months in ELBW infants and (2) to obtain data that would be useful in designing and conducting a successful trial of this hypothesis. METHODS.A prospective, cohort study was conducted at 16 clinical centers within the National Institute of Child Health and Human Development Neonatal Research Network. To assist in risk adjustment, the attending pediatric surgeon recorded the preoperative diagnosis and intraoperative diagnosis and identified infants who were considered to be too ill for laparotomy. Predefined measures of short- and longer-term outcome included (1) either predischarge death or prolonged parenteral nutrition (85 days) after enrollment and (2) either death or neurodevelopmental impairment on a standardized examination at 18 to 22 months’ adjusted age. RESULTS.Severe NEC or IP occurred in 156 (5.2%) of 2987 ELBW infants; 80 were treated with initial Drainage, and 76 were treated with initial laparotomy. By 18 to 22 months, 78 (50%) had died; 112 (72%) had died or were shown to be impaired. Outcome was worse in the subgroup with NEC. Laparotomy was never performed in 76% (28 of 36) of Drain-treated survivors.

  • laparotomy versus Peritoneal Drainage for necrotizing enterocolitis or isolated intestinal perforation in extremely low birth weight infants outcomes through 18 months adjusted age
    Pediatrics, 2006
    Co-Authors: Martin L Blakely, Jon E Tyson, Kevin P Lally, Scott A Mcdonald, Barbara J Stoll, David K Stevenson, Kenneth W Poole, Alan H Jobe, Linda L Wright, Rosemary D Higgins
    Abstract:

    OBJECTIVE. Extremely low birth weight (ELBW; ≤1000 g) infants with necrotizing enterocolitis (NEC) or isolated intestinal perforation (IP) are treated surgically with either initial laparotomy or Peritoneal Drain placement. The only published data comparing these therapies are from small, retrospective, single-center studies that do not address outcomes beyond nursery discharge. The objective of this study was to conduct a prospective, multicenter, observational study to (1) develop a hypothesis about the relative effect of these 2 therapies on risk-adjusted outcomes through 18 to 22 months in ELBW infants and (2) to obtain data that would be useful in designing and conducting a successful trial of this hypothesis. METHODS. A prospective, cohort study was conducted at 16 clinical centers within the National Institute of Child Health and Human Development Neonatal Research Network. To assist in risk adjustment, the attending pediatric surgeon recorded the preoperative diagnosis and intraoperative diagnosis and identified infants who were considered to be too ill for laparotomy. Predefined measures of short- and longer-term outcome included (1) either predischarge death or prolonged parenteral nutrition (>85 days) after enrollment and (2) either death or neurodevelopmental impairment on a standardized examination at 18 to 22 months9 adjusted age. RESULTS. Severe NEC or IP occurred in 156 (5.2%) of 2987 ELBW infants; 80 were treated with initial Drainage, and 76 were treated with initial laparotomy. By 18 to 22 months, 78 (50%) had died; 112 (72%) had died or were shown to be impaired. Outcome was worse in the subgroup with NEC. Laparotomy was never performed in 76% (28 of 36) of Drain-treated survivors. CONCLUSIONS. Drainage was commonly used, and outcome was poor. Our findings, particularly the risk-adjusted odds ratio favoring laparotomy for death or impairment, indicate the need for a large, multicenter clinical trial to assess the effect of the initial surgical therapy on outcome at ≥18 months.

Jon E Tyson - One of the best experts on this subject based on the ideXlab platform.

  • laparotomy versus Peritoneal Drainage for necrotizing enterocolitis or isolated intestinal perforation in extremely low birth weight infants outcomes through 18 months adjusted age
    Pediatrics, 2006
    Co-Authors: Martin L Blakely, Jon E Tyson, Kevin P Lally, Scott A Mcdonald, Barbara J Stoll, David K Stevenson, Kenneth W Poole, Alan H Jobe, Linda L Wright, Rosemary D Higgins
    Abstract:

    OBJECTIVE.Extremely low birth weight (ELBW; 1000 g) infants with necrotizing enterocolitis (NEC) or isolated intestinal perforation (IP) are treated surgically with either initial laparotomy or Peritoneal Drain placement. The only published data comparing these therapies are from small, retrospective, single-center studies that do not address outcomes beyond nursery discharge. The objective of this study was to conduct a prospective, multicenter, observational study to (1) develop a hypothesis about the relative effect of these 2 therapies on risk-adjusted outcomes through 18 to 22 months in ELBW infants and (2) to obtain data that would be useful in designing and conducting a successful trial of this hypothesis. METHODS.A prospective, cohort study was conducted at 16 clinical centers within the National Institute of Child Health and Human Development Neonatal Research Network. To assist in risk adjustment, the attending pediatric surgeon recorded the preoperative diagnosis and intraoperative diagnosis and identified infants who were considered to be too ill for laparotomy. Predefined measures of short- and longer-term outcome included (1) either predischarge death or prolonged parenteral nutrition (85 days) after enrollment and (2) either death or neurodevelopmental impairment on a standardized examination at 18 to 22 months’ adjusted age. RESULTS.Severe NEC or IP occurred in 156 (5.2%) of 2987 ELBW infants; 80 were treated with initial Drainage, and 76 were treated with initial laparotomy. By 18 to 22 months, 78 (50%) had died; 112 (72%) had died or were shown to be impaired. Outcome was worse in the subgroup with NEC. Laparotomy was never performed in 76% (28 of 36) of Drain-treated survivors.

  • laparotomy versus Peritoneal Drainage for necrotizing enterocolitis or isolated intestinal perforation in extremely low birth weight infants outcomes through 18 months adjusted age
    Pediatrics, 2006
    Co-Authors: Martin L Blakely, Jon E Tyson, Kevin P Lally, Scott A Mcdonald, Barbara J Stoll, David K Stevenson, Kenneth W Poole, Alan H Jobe, Linda L Wright, Rosemary D Higgins
    Abstract:

    OBJECTIVE. Extremely low birth weight (ELBW; ≤1000 g) infants with necrotizing enterocolitis (NEC) or isolated intestinal perforation (IP) are treated surgically with either initial laparotomy or Peritoneal Drain placement. The only published data comparing these therapies are from small, retrospective, single-center studies that do not address outcomes beyond nursery discharge. The objective of this study was to conduct a prospective, multicenter, observational study to (1) develop a hypothesis about the relative effect of these 2 therapies on risk-adjusted outcomes through 18 to 22 months in ELBW infants and (2) to obtain data that would be useful in designing and conducting a successful trial of this hypothesis. METHODS. A prospective, cohort study was conducted at 16 clinical centers within the National Institute of Child Health and Human Development Neonatal Research Network. To assist in risk adjustment, the attending pediatric surgeon recorded the preoperative diagnosis and intraoperative diagnosis and identified infants who were considered to be too ill for laparotomy. Predefined measures of short- and longer-term outcome included (1) either predischarge death or prolonged parenteral nutrition (>85 days) after enrollment and (2) either death or neurodevelopmental impairment on a standardized examination at 18 to 22 months9 adjusted age. RESULTS. Severe NEC or IP occurred in 156 (5.2%) of 2987 ELBW infants; 80 were treated with initial Drainage, and 76 were treated with initial laparotomy. By 18 to 22 months, 78 (50%) had died; 112 (72%) had died or were shown to be impaired. Outcome was worse in the subgroup with NEC. Laparotomy was never performed in 76% (28 of 36) of Drain-treated survivors. CONCLUSIONS. Drainage was commonly used, and outcome was poor. Our findings, particularly the risk-adjusted odds ratio favoring laparotomy for death or impairment, indicate the need for a large, multicenter clinical trial to assess the effect of the initial surgical therapy on outcome at ≥18 months.