The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Rodrigo Ruano - One of the best experts on this subject based on the ideXlab platform.
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serial amnioinfusion as regenerative therapy for Pulmonary Hypoplasia in fetuses with intrauterine renal failure or severe renal anomalies systematic review and future perspectives
Mayo Clinic Proceedings: Innovations Quality & Outcomes, 2020Co-Authors: Simrit Warring, Victoria Arruga Novoa Y Novoa, Sherif A Shazly, Mari Charisse Trinidad, David J Sas, Brenda Schiltz, Mikel Prieto, Andre Terzic, Rodrigo RuanoAbstract:Abstract The aim of this study was to investigate the effect of serial amnioinfusion therapy (SAT) for Pulmonary Hypoplasia in lower urinary tract obstruction (LUTO) or congenital renal anomalies (CRAs), introduce patient selection criteria, and present a case of SAT in bilateral renal agenesis. We conducted a search of the MEDLINE, EMBASE, Web of Science, and Scopus databases for articles published from database inception to November 10, 2017. Eight studies with 17 patients (7 LUTO, 8 CRA, and 2 LUTO + CRA) were included in the study. The median age of the mothers was 31 years (N=9; interquartile range [IQR], 29-33.5 years), the number of amnioinfusions was 7 (N=17; IQR, 4.5-21), gestational age at first amnioinfusion was 23 weeks and 4 days (N=17; IQR, 21-24.07), gestational age at delivery was 32 weeks and 2 days (N=17; IQR, 30 weeks to 35 weeks and 6.5 days), birthweight of newborns was 3.7 kg (N= 9; IQR, 2.7-3.7 kg), Apgar score at 1 minute was 2.5 (N=8; IQR, 1-6.5), and Apgar score at 5 minutes was 5.5 (N=8; IQR, 0-7.75). In conclusion, SAT may provide fetal Pulmonary palliation by reducing the risk of newborn Pulmonary compromise secondary to oligohydramnios. Multidisciplinary research efforts are required to further inform treatment and counseling guidelines. We propose a multidisciplinary approach to prenatal classification of fetuses with LUTO to inform patient selection.
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fetoscopic therapy for severe Pulmonary Hypoplasia in congenital diaphragmatic hernia a first in prenatal regenerative medicine at mayo clinic
Mayo Clinic proceedings, 2018Co-Authors: Rodrigo Ruano, William A Carey, Christopher E Colby, Denise B Klinkner, Karthik Balakrishnan, Victoria Arruga Novoa Y Novoa, Norman Davies, Dean D Potter, Amy B Kolbe, Katherine W ArendtAbstract:Abstract Objective To introduce the prenatal regenerative medicine service at Mayo Clinic for fetal endoscopic tracheal occlusion (FETO) care for severe congenital diaphragmatic hernia (CDH). Patients and Methods Two cases of prenatal management of severe CDH with FETO between January and August 2017 are reported. Per protocol, FETO was offered for life-threatening severe CDH at between 26 and 29 weeks' gestation. Regenerative outcome end point was fetal lung growth. Gestational age at procedure and maternal and perinatal outcomes were additional monitored parameters. Results Diagnosis by ultrasonography of severe CDH was based on extremely reduced lung size (observed-to-expected lung area to head circumference ratio [o/e-LHR], eg, o/e-LHR of 20.3% for fetus 1 and 23.0% for fetus 2) along with greater than one-third of the liver herniated into the chest in both fetuses. Both patients underwent successful FETO at 28 weeks. At the time of intervention, no maternal or fetal complications were observed. Postintervention, fetal lung growth was observed in both fetuses, reaching an o/e-LHR of 62.7% at 36 weeks in fetus 1 and 52.4% at 32 weeks in fetus 2. The balloons were removed successfully at 35 weeks and 4 days by ultrasound-guided puncture in the first patient and at 32 weeks and 3 days by ex utero intrapartum therapy-to-airway procedure in the second patient. Postnatal management followed standard of care with patch CDH therapy. At discharge, one patient was breathing normally, whereas the other required minimal nasal cannula oxygen support. Conclusion The successful launch of the first fetoscopic therapy for CDH at Mayo Clinic reveals its feasibility and safety, with early signs of benefit documented by fetal lung growth and reversal of severe Pulmonary Hypoplasia. Trial Registration clinicaltrials.gov Identifier: G170062.
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predicting neonatal deaths and Pulmonary Hypoplasia in isolated congenital diaphragmatic hernia using the sonographic fetal lung volume body weight ratio
American Journal of Roentgenology, 2008Co-Authors: Rodrigo Ruano, M C Aubry, Y Dumez, Marcelo Zugaib, Alexandra BenachiAbstract:OBJECTIVE. The objective of our study was to evaluate the potential of the sonographic fetal lung volume–body weight ratio to predict neonatal deaths and Pulmonary Hypoplasia in fetuses with isolated congenital diaphragmatic hernia (CDH).SUBJECTS AND METHODS. Between January 2002 and December 2004, 40 fetuses with isolated CDH and 450 control subjects were prospectively evaluated in two centers. Fetal lung volumes were estimated on 3D sonography using the rotational technique and fetal weight on 2D sonography using the Hadlock equation. The ratio of sonographic fetal lung volume to body weight was calculated in each case and was correlated with neonatal deaths using the Mann-Whitney U test. Accuracies of the ratio in predicting neonatal deaths and pathologic diagnosis of Pulmonary Hypoplasia were also evaluated.RESULTS. The ratio of sonographic fetal lung volume to body weight is constant throughout gestation, with a mean value of 0.025. The ratio was significantly lower in neonates that died (median, 0.0...
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predicting Pulmonary Hypoplasia using the sonographic fetal lung volume to body weight ratio how precise and accurate is it
Ultrasound in Obstetrics & Gynecology, 2006Co-Authors: Rodrigo Ruano, Jelena Martinovic, M C Aubry, Y Dumez, Alexandra BenachiAbstract:Objectives To determine the precision and accuracy of ultrasound in estimating the fetal lung to body weight ratio (FLB ratio) using two-dimensional (2D) and three-dimensional (3D) ultrasound by comparison with postmortem measurements, and to evaluate its potential to diagnose Pulmonary Hypoplasia. Methods Lung volumes were estimated by 3D ultrasound (rotational technique) and fetal weights were measured by 2D ultrasound (Hadlock equation) in 35 fetuses immediately before termination of pregnancy at 15–38 weeks. Sonographic estimates of FLB ratio were compared with postmortem values. Based on the pathological definition of Pulmonary Hypoplasia, the accuracy of sonographic estimation of the FLB ratio was analyzed. Results The mean gestational age at termination of pregnancy was 26.7 (range, 15–38) weeks. The mean FLB ratios were 0.018 (SD, 0.006) on ultrasound and 0.019 (SD, 0.007) at autopsy (P = 0.730). Bias and precision of sonographic FLB ratio were − 0.001 and 0.003 (absolute limits, − 0.007 to + 0.006), respectively. Pulmonary Hypoplasia was diagnosed in 12 (34.3%) cases at autopsy. The sonographic FLB ratio was significantly lower in fetuses with Pulmonary Hypoplasia at autopsy (median, 0.011; range, 0.004–0.014) than it was in those without Pulmonary Hypoplasia (median, 0.022; range, 0.013–0.045, P < 0.001). The sensitivity and specificity of the sonographic FLB ratio for diagnosing Pulmonary Hypoplasia were 91.7% (11/12) and 91.3% (21/23), respectively, the positive and negative predictive values were 84.6% (11/13) and 95.5% (21/22), and the accuracy was 91.4% (32/35). Conclusion FLB ratio can be estimated precisely on ultrasound examination, albeit with wide limits of agreement. The sonographically estimated FLB ratio may be useful in the prediction and diagnosis of Pulmonary Hypoplasia. Copyright © 2006 ISUOG. Published by John Wiley & Sons, Ltd.
Alexandra Benachi - One of the best experts on this subject based on the ideXlab platform.
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predicting neonatal deaths and Pulmonary Hypoplasia in isolated congenital diaphragmatic hernia using the sonographic fetal lung volume body weight ratio
American Journal of Roentgenology, 2008Co-Authors: Rodrigo Ruano, M C Aubry, Y Dumez, Marcelo Zugaib, Alexandra BenachiAbstract:OBJECTIVE. The objective of our study was to evaluate the potential of the sonographic fetal lung volume–body weight ratio to predict neonatal deaths and Pulmonary Hypoplasia in fetuses with isolated congenital diaphragmatic hernia (CDH).SUBJECTS AND METHODS. Between January 2002 and December 2004, 40 fetuses with isolated CDH and 450 control subjects were prospectively evaluated in two centers. Fetal lung volumes were estimated on 3D sonography using the rotational technique and fetal weight on 2D sonography using the Hadlock equation. The ratio of sonographic fetal lung volume to body weight was calculated in each case and was correlated with neonatal deaths using the Mann-Whitney U test. Accuracies of the ratio in predicting neonatal deaths and pathologic diagnosis of Pulmonary Hypoplasia were also evaluated.RESULTS. The ratio of sonographic fetal lung volume to body weight is constant throughout gestation, with a mean value of 0.025. The ratio was significantly lower in neonates that died (median, 0.0...
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predicting Pulmonary Hypoplasia using the sonographic fetal lung volume to body weight ratio how precise and accurate is it
Ultrasound in Obstetrics & Gynecology, 2006Co-Authors: Rodrigo Ruano, Jelena Martinovic, M C Aubry, Y Dumez, Alexandra BenachiAbstract:Objectives To determine the precision and accuracy of ultrasound in estimating the fetal lung to body weight ratio (FLB ratio) using two-dimensional (2D) and three-dimensional (3D) ultrasound by comparison with postmortem measurements, and to evaluate its potential to diagnose Pulmonary Hypoplasia. Methods Lung volumes were estimated by 3D ultrasound (rotational technique) and fetal weights were measured by 2D ultrasound (Hadlock equation) in 35 fetuses immediately before termination of pregnancy at 15–38 weeks. Sonographic estimates of FLB ratio were compared with postmortem values. Based on the pathological definition of Pulmonary Hypoplasia, the accuracy of sonographic estimation of the FLB ratio was analyzed. Results The mean gestational age at termination of pregnancy was 26.7 (range, 15–38) weeks. The mean FLB ratios were 0.018 (SD, 0.006) on ultrasound and 0.019 (SD, 0.007) at autopsy (P = 0.730). Bias and precision of sonographic FLB ratio were − 0.001 and 0.003 (absolute limits, − 0.007 to + 0.006), respectively. Pulmonary Hypoplasia was diagnosed in 12 (34.3%) cases at autopsy. The sonographic FLB ratio was significantly lower in fetuses with Pulmonary Hypoplasia at autopsy (median, 0.011; range, 0.004–0.014) than it was in those without Pulmonary Hypoplasia (median, 0.022; range, 0.013–0.045, P < 0.001). The sensitivity and specificity of the sonographic FLB ratio for diagnosing Pulmonary Hypoplasia were 91.7% (11/12) and 91.3% (21/23), respectively, the positive and negative predictive values were 84.6% (11/13) and 95.5% (21/22), and the accuracy was 91.4% (32/35). Conclusion FLB ratio can be estimated precisely on ultrasound examination, albeit with wide limits of agreement. The sonographically estimated FLB ratio may be useful in the prediction and diagnosis of Pulmonary Hypoplasia. Copyright © 2006 ISUOG. Published by John Wiley & Sons, Ltd.
Jan Deprest - One of the best experts on this subject based on the ideXlab platform.
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fetal tracheal occlusion for severe Pulmonary Hypoplasia in isolated congenital diaphragmatic hernia a systematic review and meta analysis of survival
Annals of Surgery, 2016Co-Authors: Jamila Almaary, Jan Deprest, Mary Patrice Eastwood, Francesca Russo, Richard KeijzerAbstract:Objective:To evaluate fetal survival after tracheal occlusion in fetuses with severe Pulmonary Hypoplasia and isolated congenital diaphragmatic hernia (CDH).Background:Despite recent advances in neonatal intensive care, CDH still has a high mortality and morbidity. Fetoscopic endoluminal tracheal oc
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medical interventions to reverse Pulmonary Hypoplasia in the animal model of congenital diaphragmatic hernia a systematic review
Pediatric Pulmonology, 2015Co-Authors: Mary Patrice Eastwood, Francesca Russo, Jaan Toelen, Jan DeprestAbstract:Summary Objective We aimed to systematically review all published pre-clinical research on prenatal medical treatment of Pulmonary Hypoplasia in congenital diaphragmatic hernia (CDH). Background The neonatal mortality due to isolated CDH remains high. Whether fetal endoscopic tracheal occlusion (FETO) reduces mortality is still to be demonstrated. Therefore more potent preferentially medical therapy would be welcomed. Methods We searched MEDLINE (Pubmed), Embase and the Web of Science including all studies from the earliest date (1951) to December 2013. Article quality was assessed using the modified CAMRADES checklist. Inclusion criteria were those animal studies addressing prenatal medical interventions and principal variables were confirmation of a diaphragmatic defect, lung to body weight ratio (LBWR), formal airway morphometry or DNA/protein content. Results In total 983 articles were identified. Following abstract review, 96 articles were assessed by two authors in agreement with a third for eligibility. Of these, 43 were included in the final analysis. The median number of study quality checklist items (maximum 10) scored was 4 (IQ range: 2–5). Thirty (69.8%) of studies were in the nitrofen rat. The majority were treated with vitamins or glucocorticoids. Single studies reported some improvement in lung morphology with alternative therapies. It was impossible to identify a pattern in animal model selection or creation, mode, time point or duration of treatment and readouts. Only one study reported a sample size calculation. Conclusion Comparison in pre-clinical studies in CDH is challenging due to methodological variation. Agreed standardized methods need to be applied in future investigation of new medical therapies. Pediatr Pulmonol. 2015; 50:820–838. © 2015 Wiley Periodicals, Inc.
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fetal body volume use at mr imaging to quantify relative lung volume in fetuses suspected of having Pulmonary Hypoplasia
Radiology, 2006Co-Authors: Mieke Cannie, Jacques Jani, Frederik De Keyzer, Roland Devlieger, Dominique Van Schoubroeck, Ingrid Witters, Guy Marchal, Steven Dymarkowski, Jan DeprestAbstract:Purpose: To retrospectively determine an algorithm based on fetal body volume (FBV) by using magnetic resonance (MR) imaging to calculate relative lung volume in fetuses with normally developed lungs and prospectively assess the use of this algorithm in predicting Pulmonary Hypoplasia in the late second and early third trimesters for fetuses at risk for Pulmonary Hypoplasia. Materials and Methods: Oral informed consent was obtained for the prospective component of this ethics committee–approved study. MR imaging lung volumetry was performed in 36 fetuses with normally developed lungs between 18 and 39 weeks gestational age by using T2-weighted single-shot fast spin-echo imaging in fetal transverse and sagittal planes. Findings were then correlated with biometric variables and gestational age. The best-performing algorithm was applied to 37 fetuses (between 18 and 29 weeks gestational age) at risk for Pulmonary Hypoplasia to determine observed-expected lung volume ratio. This group was stratified according...
M C Aubry - One of the best experts on this subject based on the ideXlab platform.
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predicting neonatal deaths and Pulmonary Hypoplasia in isolated congenital diaphragmatic hernia using the sonographic fetal lung volume body weight ratio
American Journal of Roentgenology, 2008Co-Authors: Rodrigo Ruano, M C Aubry, Y Dumez, Marcelo Zugaib, Alexandra BenachiAbstract:OBJECTIVE. The objective of our study was to evaluate the potential of the sonographic fetal lung volume–body weight ratio to predict neonatal deaths and Pulmonary Hypoplasia in fetuses with isolated congenital diaphragmatic hernia (CDH).SUBJECTS AND METHODS. Between January 2002 and December 2004, 40 fetuses with isolated CDH and 450 control subjects were prospectively evaluated in two centers. Fetal lung volumes were estimated on 3D sonography using the rotational technique and fetal weight on 2D sonography using the Hadlock equation. The ratio of sonographic fetal lung volume to body weight was calculated in each case and was correlated with neonatal deaths using the Mann-Whitney U test. Accuracies of the ratio in predicting neonatal deaths and pathologic diagnosis of Pulmonary Hypoplasia were also evaluated.RESULTS. The ratio of sonographic fetal lung volume to body weight is constant throughout gestation, with a mean value of 0.025. The ratio was significantly lower in neonates that died (median, 0.0...
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predicting Pulmonary Hypoplasia using the sonographic fetal lung volume to body weight ratio how precise and accurate is it
Ultrasound in Obstetrics & Gynecology, 2006Co-Authors: Rodrigo Ruano, Jelena Martinovic, M C Aubry, Y Dumez, Alexandra BenachiAbstract:Objectives To determine the precision and accuracy of ultrasound in estimating the fetal lung to body weight ratio (FLB ratio) using two-dimensional (2D) and three-dimensional (3D) ultrasound by comparison with postmortem measurements, and to evaluate its potential to diagnose Pulmonary Hypoplasia. Methods Lung volumes were estimated by 3D ultrasound (rotational technique) and fetal weights were measured by 2D ultrasound (Hadlock equation) in 35 fetuses immediately before termination of pregnancy at 15–38 weeks. Sonographic estimates of FLB ratio were compared with postmortem values. Based on the pathological definition of Pulmonary Hypoplasia, the accuracy of sonographic estimation of the FLB ratio was analyzed. Results The mean gestational age at termination of pregnancy was 26.7 (range, 15–38) weeks. The mean FLB ratios were 0.018 (SD, 0.006) on ultrasound and 0.019 (SD, 0.007) at autopsy (P = 0.730). Bias and precision of sonographic FLB ratio were − 0.001 and 0.003 (absolute limits, − 0.007 to + 0.006), respectively. Pulmonary Hypoplasia was diagnosed in 12 (34.3%) cases at autopsy. The sonographic FLB ratio was significantly lower in fetuses with Pulmonary Hypoplasia at autopsy (median, 0.011; range, 0.004–0.014) than it was in those without Pulmonary Hypoplasia (median, 0.022; range, 0.013–0.045, P < 0.001). The sensitivity and specificity of the sonographic FLB ratio for diagnosing Pulmonary Hypoplasia were 91.7% (11/12) and 91.3% (21/23), respectively, the positive and negative predictive values were 84.6% (11/13) and 95.5% (21/22), and the accuracy was 91.4% (32/35). Conclusion FLB ratio can be estimated precisely on ultrasound examination, albeit with wide limits of agreement. The sonographically estimated FLB ratio may be useful in the prediction and diagnosis of Pulmonary Hypoplasia. Copyright © 2006 ISUOG. Published by John Wiley & Sons, Ltd.
Y Dumez - One of the best experts on this subject based on the ideXlab platform.
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predicting neonatal deaths and Pulmonary Hypoplasia in isolated congenital diaphragmatic hernia using the sonographic fetal lung volume body weight ratio
American Journal of Roentgenology, 2008Co-Authors: Rodrigo Ruano, M C Aubry, Y Dumez, Marcelo Zugaib, Alexandra BenachiAbstract:OBJECTIVE. The objective of our study was to evaluate the potential of the sonographic fetal lung volume–body weight ratio to predict neonatal deaths and Pulmonary Hypoplasia in fetuses with isolated congenital diaphragmatic hernia (CDH).SUBJECTS AND METHODS. Between January 2002 and December 2004, 40 fetuses with isolated CDH and 450 control subjects were prospectively evaluated in two centers. Fetal lung volumes were estimated on 3D sonography using the rotational technique and fetal weight on 2D sonography using the Hadlock equation. The ratio of sonographic fetal lung volume to body weight was calculated in each case and was correlated with neonatal deaths using the Mann-Whitney U test. Accuracies of the ratio in predicting neonatal deaths and pathologic diagnosis of Pulmonary Hypoplasia were also evaluated.RESULTS. The ratio of sonographic fetal lung volume to body weight is constant throughout gestation, with a mean value of 0.025. The ratio was significantly lower in neonates that died (median, 0.0...
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predicting Pulmonary Hypoplasia using the sonographic fetal lung volume to body weight ratio how precise and accurate is it
Ultrasound in Obstetrics & Gynecology, 2006Co-Authors: Rodrigo Ruano, Jelena Martinovic, M C Aubry, Y Dumez, Alexandra BenachiAbstract:Objectives To determine the precision and accuracy of ultrasound in estimating the fetal lung to body weight ratio (FLB ratio) using two-dimensional (2D) and three-dimensional (3D) ultrasound by comparison with postmortem measurements, and to evaluate its potential to diagnose Pulmonary Hypoplasia. Methods Lung volumes were estimated by 3D ultrasound (rotational technique) and fetal weights were measured by 2D ultrasound (Hadlock equation) in 35 fetuses immediately before termination of pregnancy at 15–38 weeks. Sonographic estimates of FLB ratio were compared with postmortem values. Based on the pathological definition of Pulmonary Hypoplasia, the accuracy of sonographic estimation of the FLB ratio was analyzed. Results The mean gestational age at termination of pregnancy was 26.7 (range, 15–38) weeks. The mean FLB ratios were 0.018 (SD, 0.006) on ultrasound and 0.019 (SD, 0.007) at autopsy (P = 0.730). Bias and precision of sonographic FLB ratio were − 0.001 and 0.003 (absolute limits, − 0.007 to + 0.006), respectively. Pulmonary Hypoplasia was diagnosed in 12 (34.3%) cases at autopsy. The sonographic FLB ratio was significantly lower in fetuses with Pulmonary Hypoplasia at autopsy (median, 0.011; range, 0.004–0.014) than it was in those without Pulmonary Hypoplasia (median, 0.022; range, 0.013–0.045, P < 0.001). The sensitivity and specificity of the sonographic FLB ratio for diagnosing Pulmonary Hypoplasia were 91.7% (11/12) and 91.3% (21/23), respectively, the positive and negative predictive values were 84.6% (11/13) and 95.5% (21/22), and the accuracy was 91.4% (32/35). Conclusion FLB ratio can be estimated precisely on ultrasound examination, albeit with wide limits of agreement. The sonographically estimated FLB ratio may be useful in the prediction and diagnosis of Pulmonary Hypoplasia. Copyright © 2006 ISUOG. Published by John Wiley & Sons, Ltd.
