Suchergebnisse

"As we leave behind the tumultuous year of 2020, we have the growing sense that most Americans are eager to calm our strident politics and move forward in a way that brings peace, justice, and prosperity to all citizens, but particularly to Black Americans. Jason Riley argues that to do so, we have an obligation to look dispassionately at the policies of recent past administrations and decide which ones worked and which ones did not. Riley, a longtime columnist for the Wall Street Journal, has dug into the data and concluded that the economic lives of Black people improved under policies put into place during the Trump Administration. To admit as much is not to endorse the 45th president but rather to champion policies that achieve a clear moral end. From the inauguration day of 2017 until the onset of the pandemic in 2020, Black people in the United States enjoyed higher wages and homeownership, record-low unemployment and poverty, and a narrowing of social inequality. Without question, these are outcomes that everyone wants. The trouble is that we have fallen into the collective habit of allowing our disapproval of a political personality to skew our appraisal of effective policies. If we want to make actual progress, says Riley, we must look at what actually works, and keep doing it. We must not let partisanship allow us to sit back and watch these economic gains vanish, especially when we know better"--

Abstract
Background Neonatal intraventricular hemorrhage (IVH) may evolve into posthemorrhagic hydrocephalus and cause neurodevelopmental impairment, becoming a common complication of premature infants, occurring in up to 40% of preterm infants weighing less than 1,500 g at birth. Around 10 to 15% of preterm infants develop severe (grades III–IV) IVH. These infants are at high risk of developing posthemorrhagic hydrocephalus. Neuroendoscopic lavage (NEL) is a suitable alternative for the management of this pathology. In this study, an endoscopic surgical approach directed toward the removal of intraventricular hematoma was evaluated for its safety and efficacy.
Methods Between August 2016 and December 2019 (29 months), 14 neonates with posthemorrhagic hydrocephalus underwent NEL for removal of intraventricular blood by a single senior neurosurgeon. Complications such as reintervention and ventriculoperitoneal (VP) shunt placement were evaluated prospectively with an 18-month follow-up on average.
Results In total, 14 neonates with IVH grades III and IV were prospectively recruited. Of these, six neonates did not need a VP shunt in the follow-up after neuroendoscopy (group 1), whereas eight neonates underwent a VP shunt placement (group 2). Nonsignificant difference between the groups was found concerning days after neuroendoscopy, clot extraction, third ventriculostomy, lamina terminalis fenestration, and septum pellucidum fenestration. In group 2, there was shunt dysfunction in five cases with shunt replacement in four cases.
Conclusion NEL is a feasible technique to remove intraventricular blood degradation products and residual hematoma in neonates suffering from posthemorrhagic hydrocephalus. In our series, endoscopic third ventriculostomy (ETV) + NEL could be effective in avoiding hydrocephalus after hemorrhage (no control group studied). Furthermore, patients without the necessity of VP-shunt had a better GMFCS in comparison with shunted patients.