Reasons for conversions in thoracoscopic repairs of neonatal congenital diaphragmatic hernias: a systematic review.

PURPOSE: This systematic review focused on reasons for conversions in neonates undergoing thoracoscopic congenital diaphragmatic hernia (CDH) repair. METHODS: Systematic search of Medline/Pubmed and Embase was performed for English, Spanish and Portuguese reports, according to PRISMA guidelines. RESULTS: Of the 153 articles identified (2003-2023), 28 met the inclusion criteria and offered 698 neonates for analysis. Mean birth weight and gestational age were 3109 g and 38.3 weeks, respectively, and neonates were operated at a mean age of 6.12 days. There were 278 males (61.50%; 278/452) and 174 females (38.50%; 174/452). The reasons for the 137 conversions (19.63%) were: (a) defect size (n = 22), (b) need for patch (n = 21); (c) difficulty in reducing organs (n = 14), (d) ventilation issues (n = 10), (e) bleeding, organ injury, cardiovascular instability (n = 3 each), (f) bowel ischemia and defect position (n = 2 each), hepatopulmonary fusion (n = 1), and (g) reason was not specified for n = 56 neonates (40.8%). The repair was primary in 322 neonates (63.1%; 322/510) and patch was used in 188 neonates (36.86%; 188/510). There were 80 recurrences (12.16%; 80/658) and 14 deaths (2.48%; 14/565). Mean LOS and follow-up were 20.17 days and 19.28 months, respectively. CONCLUSIONS: Neonatal thoracoscopic repair for CDH is associated with conversion in 20% of cases. Based on available data, defect size and patch repairs have been identified as the predominant reasons, followed by technical difficulties to reduce the herniated organs and ventilation related issues. However, data specifically relating to conversion is poorly documented in a high number of reports (40%). Accurate data reporting in future will be important to better estimate and quantify reasons for conversions in neonatal thoracoscopy for CDH.

Encapsulation of coenzyme Q10 in a simple emulsion-based nutraceutical formulation and application in cheese manufacturing.

Coenzyme Q10 (CoQ10) was encapsulated successfully in a nutraceutical formulation composed of calcium caseinate, flaxseed oil and lecithin. The effect of CoQ10 on the physico-chemical stability of emulsions was compared to emulsions without CoQ10. According to ATR-FTIR analysis, emulsions were found to be more stable in the presence of CoQ10. The emulsion with CoQ10 was used as a functional cream in the cheese making process. The retention rate of CoQ10, composition and cheese yield were also determined. Quantification of CoQ10 by HPLC showed that the retention of this lipophilic agent into cheese matrix was 93% and equivalent to the total lipid retention. Protein retention and cheese yield were not affected by the addition of the functional cream. For the first time, CoQ10 has been encapsulated in a cheese matrix, hence demonstrating that CoQ10 could be used in the development of functional cheeses.