Clinical relevance of Scedosporium spp. and Exophiala dermatitidis in patients with cystic fibrosis: A nationwide study

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Position Paper on Global ECMO Education and Educational Agenda for the Future: A Statement from the Extracorporeal Life Support Organization ECMOed Taskforce

This is the author accepted version of the article at https://doi.org/10.1097/ccm.0000000000004158. Copyright © 2020 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.Objective The purpose of this position paper is two-fold: first, to describe the state of extracorporeal membrane oxygenation (ECMO) education worldwide, noting current limitations and challenges; and second, to put forth an educational agenda regarding opportunities for an international collaborative approach towards standardization. Design and Setting In 2018, the Extracorporeal Life Support Organization Education (ECMOed) Taskforce organized two structured, face-to-face meetings and conducted a review of published literature on ECMO education. Taskforce members generated a consensus statement using an iterative consensus process through teleconferences and electronic communication. Measurements and Main Results The ECMOed Taskforce identified seven educational domains that would benefit from international collaborative efforts. Of primary importance, the taskforce outlined actionable items regarding: (1) the creation of a standardized ECMO curriculum; (2) defining criteria for an ECMO course as a vehicle for delivering the curriculum; (3) outlining a mechanism for evaluating the quality of educational offerings; (4) utilizing validated assessment tools in the development of ECMO practitioner certification; and (5) promoting high-quality educational research to guide ongoing educational and competency assessment development. Conclusions Significant variability and limitations in global ECMO education exist. In this position paper, we outline a road map for standardizing international ECMO education and practitioner certification. Ongoing high-quality educational research is needed to evaluate the impact of these initiatives.Peer reviewe

More than fetal urine:enteral uptake of amniotic fluid as a major predictor for fetal growth during late gestation

Item does not contain fulltextThe purpose of our study was to investigate the importance of amniotic fluid (AF) for fetal growth during late gestation using esophageal atresia (EA) patients as a model. In this retrospective cohort study, we compared the z-scores adapted for birth weights (BW z-scores) for each of 517 European newborns with congenital pre-gastric intestinal atresia, i.e., EA, to a European reference population. To account for the influence of the intestinal atresia on fetal growth per se, we compared adapted birth weights for each of 504 European newborns with post colonic intestinal atresia (anorectal malformation (ARM) with atresia of the anus) to the same European reference population. Analysis of the complete cohort showed (i) a significantly higher rate of small for gestational age newborns among EA compared to ARM newborns (p < 0.001) and (ii) significantly lower BW z-scores among EA compared to ARM newborns (p < 0.001). BW z-scores of EA newborns were significantly lower in term compared to preterm newborns with an inverse correlation with gestational age (GA) (Spearman correlation coefficient, r = -0.185, p < 0.001). CONCLUSIONS: Enteral uptake of AF seems to play a pivotal role in fetal growth during late gestation. WHAT IS KNOWN: * Peak velocity of fetal weight gain occurs at 33 weeks of gestation and continues until birth. During this period, fetal growth is mainly characterized by cellular hypertrophy. * Amniotic fluid (AF) comprises large amounts of hormones and growth regulators. What is New: * A significantly higher rate of small for gestational age and lower birth weights and z-scores are observed among newborn infants with congenital pre-gastric intestinal atresia. * These findings suggest that enteral uptake of AF is a major predictor for fetal growth during late gestation

AGORA, a data- and biobank for birth defects and childhood cancer

Research regarding the etiology of birth defects and childhood cancer is essential to develop preventive measures, but often requires large study populations. Therefore, we established the AGORA data- and biobank in the Netherlands. In this study, we describe its rationale, design, and ongoing data collection.status: publishe

AGORA, a data- and biobank for birth defects and childhood cancer

BACKGROUNDResearch regarding the etiology of birth defects and childhood cancer is essential to develop preventive measures, but often requires large study populations. Therefore, we established the AGORA data- and biobank in the Netherlands. In this study, we describe its rationale, design, and ongoing data collection. METHODSChildren diagnosed with and/or treated for a structural birth defect or childhood cancer and their parents are invited to participate in the AGORA data- and biobank. Controls are recruited through random sampling from municipal registries. The parents receive questionnaires about demographics, family and pregnancy history, health status, prescribed medication, lifestyle, and occupational exposures before and during the index pregnancy. In addition, blood or saliva is collected from children and parents, while medical records are reviewed for diagnostic information. RESULTSSo far, we have collected data from over 6,860 families (3,747 birth defects, 905 childhood cancers, and 2,208 controls). The types of birth defects vary widely and comprise malformations of the digestive, respiratory, and urogenital tracts as well as facial, cardiovascular, kidney, skeletal, and central nervous system anomalies. The most frequently occurring childhood cancer types are acute lymphatic leukemia, Hodgkin and non-Hodgkin lymphoma, Wilms' tumor, and brain and spinal cord tumors. Our genetic and/or epidemiologic studies have been focused on hypospadias, anorectal malformations, congenital anomalies of the kidney and urinary tract (CAKUT), and orofacial clefts. CONCLUSIONThe large AGORA data- and biobank offers great opportunities for investigating genetic and nongenetic risk factors for disorders in children and is open to collaborative initiatives. Birth Defects Research (Part A) 106:675-684, 2016. (c) 2016 Wiley Periodicals, Inc