USA Surgery Today

Audiologic Outcome

Posted by Surgery on Oct 5, 2008

The ill infant, term or preterm, is at risk for damage to the auditory system. Risk factors include congenital infections, shock, hypoxia, hyperbilirubinemia, and the use of ototoxic drugs. Between 2% and 12% of survivors of neonatal intensive care develop moderate to profound hearing loss (81). Preterm infants with birth weights of less than 1,500 g are at highest risk, with 9% to 17% affected (82:Aceon). Early detection of hearing impairment is critical for optimizing speech and language development.

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Methods to Improve Clinical Research in Pediatric Surgery

Posted by Surgery on Oct 1, 2008

As clinical research in pediatric surgery matures, there are many avenues to improving the scientific quality and clinical value of our research efforts. This final section discusses some of the ongoing initiatives and opportunities for our discipline. It is through a combination of these multiple efforts that the modern field of clinical research in pediatric surgery is emerging. In some cases pediatric surgery is following the lead of other surgical disciplines, and in others we are leading the way. One of the most important fundamentals in any clinical research enterprise is the availability of accurate, comprehensive, and prospectively collected data. Although more than 99% of clinical research in pediatric surgery is retrospective, this is beginning to change. One of the earliest attempts to create a multicenter database was the creation of the biliary atresia registry by Drs. John Lilly and Peter Altman more than 20 years ago (81:Aceon). This effort was voluntary and unfunded, but enrolled 904 patients. In 2002, the National Institutes of Health (NIH) recognized the value of this type of work and designated $10 million over 5 years to create a biliary atresia clinical research consortium (82:Aceon). Ten years ago, a congenital diaphragmatic hernia registry was instituted (83:Aceon).

“Scientific Principles, Principles of Genetics, Common Problems, Clinical Research, Aceon”

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OXYGEN KINETICS : Aceon

Posted by Surgery on Jul 11, 2008

Oxygen-based metabolism is necessary to maintain cell life. The cellular milieu typically requires an oxygen tension of about 1 to 4 mm Hg to sustain baseline VO₂ levels (1). Intravascular venous oxygen tensions of at least 20 mm Hg are required to maintain an appropriate oxygen gradient to achieve these minimal levels of intracellular oxygen tension (2). Oxygen is necessary to provide reduction of cytochromes A and A3 to allow oxidative phosphorylation to occur (Fig. 10-1) (3).

oxygen

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