Laura Glaganski

14 statements · 2 topics · summaries given as host listed separately

Featured statements

▶ Ep 5 · 0:00
Overall, a diagnosis of trisomy 13 or 18 doesn't preclude resection with a curative curative intent for these patients, but just like with cardiac surgery, uh, it's important to take the individual patient uh considerations into account to make a a multidisciplinary decision.
quote · Trisomy 13
▶ Ep 5 · 0:00
We do know that tracheomalacia does improve with time and growth. Uh, however, severe malaia often requires additional surgery, can require tracheostomy, and long-term mechanical ventilation.
quote · Trisomy 13
▶ Ep 5 · 14:13
For low birth weight children needing post-pyloric feeding, a fluoroscopic nasojejunal tube can be placed to allow growth before GJ-tube placement.
clinical · Trisomy 18
▶ Ep 5 · 14:13
The preference is for G-tubes over GJ-tubes due to risk of perforation with GJ-tubes; a 5 kg weight cutoff is used at this institution.
clinical · Trisomy 18

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Laura's statements about Trisomy 13 7 statements

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Laura Glaganski, MD & Jagroop (Rupi) Parikh - 2024 Fetal Care Center Navigating Perinatal Care for Trisomy 13 & 18

▶ Ep 5 · 0:00
quote Overall, a diagnosis of trisomy 13 or 18 doesn't preclude resection with a curative curative intent for these patients, but just like with cardiac surgery, uh, it's important to take the individual patient uh considerations into account to make a a multidisciplinary decision. ↗
▶ Ep 5 · 0:00
clinical Tracheomalacia improves with time and growth, but severe malacia often requires tracheostomy and long-term mechanical ventilation. ↗
▶ Ep 5 · 0:00
quote We do know that tracheomalacia does improve with time and growth. Uh, however, severe malaia often requires additional surgery, can require tracheostomy, and long-term mechanical ventilation. ↗
▶ Ep 5 · 0:00
quote I think it's important to bring this up, um, because for these patients, that's an important consideration for what their quality of life is and what the family's, um, ability is, um, and willingness to take care of, uh, complicated, um, A medically complex patient at home because to take a patient home with mechanical ventilation requires significant resources and, uh, whether that's nursing support, um, potentially a parent taking off work. ↗
▶ Ep 5 · 14:13
clinical Elective surgeries like G-tube placement can be delayed following planned cardiac repair to avoid anesthetic risk. ↗
▶ Ep 5 · 14:13
clinical The preference is for G-tubes over GJ-tubes due to risk of perforation with GJ-tubes; a 5 kg weight cutoff is used at this institution. ↗
▶ Ep 5 · 14:13
clinical For low birth weight children needing post-pyloric feeding, a fluoroscopic nasojejunal tube can be placed to allow growth before GJ-tube placement. ↗
Laura's statements about Trisomy 18 7 statements

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Laura Glaganski, MD & Jagroop (Rupi) Parikh - 2024 Fetal Care Center Navigating Perinatal Care for Trisomy 13 & 18

▶ Ep 5 · 0:00
quote Overall, a diagnosis of trisomy 13 or 18 doesn't preclude resection with a curative curative intent for these patients, but just like with cardiac surgery, uh, it's important to take the individual patient uh considerations into account to make a a multidisciplinary decision. ↗
▶ Ep 5 · 0:00
clinical Tracheomalacia improves with time and growth, but severe malacia often requires tracheostomy and long-term mechanical ventilation. ↗
▶ Ep 5 · 0:00
quote We do know that tracheomalacia does improve with time and growth. Uh, however, severe malaia often requires additional surgery, can require tracheostomy, and long-term mechanical ventilation. ↗
▶ Ep 5 · 0:00
quote I think it's important to bring this up, um, because for these patients, that's an important consideration for what their quality of life is and what the family's, um, ability is, um, and willingness to take care of, uh, complicated, um, A medically complex patient at home because to take a patient home with mechanical ventilation requires significant resources and, uh, whether that's nursing support, um, potentially a parent taking off work. ↗
▶ Ep 5 · 14:13
clinical Elective surgeries like G-tube placement can be delayed following planned cardiac repair to avoid anesthetic risk. ↗
▶ Ep 5 · 14:13
clinical The preference is for G-tubes over GJ-tubes due to risk of perforation with GJ-tubes; a 5 kg weight cutoff is used at this institution. ↗
▶ Ep 5 · 14:13
clinical For low birth weight children needing post-pyloric feeding, a fluoroscopic nasojejunal tube can be placed to allow growth before GJ-tube placement. ↗

Summaries Laura gave as host · 42 summaries

Recaps of other experts' statements, not Laura's own clinical position.

Summaries Laura gave as host · Trisomy 13 21 summaries

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Laura Glaganski, MD & Jagroop (Rupi) Parikh - 2024 Fetal Care Center Navigating Perinatal Care for Trisomy 13 & 18

▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: 41 children with trisomy 13 underwent 135 surgical procedures; 39% had one lifetime procedure, but 15 children had four or more lifetime procedures. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: 35 children with trisomy 18 underwent 92 surgical procedures. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: Median survival after first surgery was more than one year in all organ system categories except eye surgeries and cardiac surgeries in trisomy 18. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: In the Indiana retrospective study (1990–2020), 53% of 117 patients underwent a procedure, with median age of first procedure 65 days. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: Higher birth weight and later gestational age were associated with lower surgical mortality in trisomy 13/18. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: Patients with other chromosome 18 variants (including mosaicism) had lower surgical mortality. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: General surgical anomalies (including esophageal atresia) were associated with higher surgical mortality. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: Neurologic procedures, ENT procedures, abdominal wall defects, genitourinary procedures, and endocrine comorbidities were not associated with increased surgical mortality. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: In the Cincinnati Children's bronchoscopy series (2011–2021), all patients with trisomy 13 had more than three significant airway findings, and most trisomy 18 patients had two or more significant findings. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: 65% of trisomy 13/18 patients who underwent bronchoscopy at Cincinnati Children's required tracheostomy, and almost all required mechanical ventilation. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: Previous studies showed a tracheostomy rate around 17% in trisomy 13/18, but the Cincinnati series found 65% in patients who underwent airway evaluation. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: In a pooled analysis of 70 trisomy 18 patients with hepatoblastoma, 64% had surgical treatment; tumors were more solitary, less multifocal, and smaller overall. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: Only one-fifth of hepatoblastomas in trisomy 18 were identified through screening. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: The most common reasons patients with trisomy 18 and hepatoblastoma did not pursue surgery were severe cardiopulmonary comorbidities, advanced hepatoblastoma, and family decision. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: Five-year survival for trisomy 18 patients with hepatoblastoma receiving multimodal treatment was 43.7%, compared to 76.6% in patients without trisomy 18. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: Patients with trisomy 18 and hepatoblastoma have undergone liver transplant to provide curative treatment. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: 23% of patients with trisomy 13 and 18% of patients with trisomy 18 underwent surgery in the Ontario longitudinal population study. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: Many of the patients had either a gastrostomy tube or Jinnostomy tube placed to help with feeding. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: Of the people, of the children undergoing surgery, um, 16 of them, which was 39% with trisomy 13, had one lifetime procedure, but 15 of those children had 4 or more lifetime procedures. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: Higher birth weight and later gestational age had a lower mortality, um, just as you heard from Doctor Sonoda, um, that that impacts the cardiac, uh, outcomes, um, that applies for all other, um, surgical procedures. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: All of the patients with trisomy 13 had more than 3 significant findings on bronchoscopy. These are findings that affected both the upper and lower airways, meaning the trachea and into the bronchi, most commonly, and most patients with trisomy 18 also had two or more significant findings on the bronchoscopy. ↗
Summaries Laura gave as host · Trisomy 18 21 summaries

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Laura Glaganski, MD & Jagroop (Rupi) Parikh - 2024 Fetal Care Center Navigating Perinatal Care for Trisomy 13 & 18

▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: Only one-fifth of hepatoblastomas in trisomy 18 were identified through screening. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: 23% of patients with trisomy 13 and 18% of patients with trisomy 18 underwent surgery in the Ontario longitudinal population study. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: 41 children with trisomy 13 underwent 135 surgical procedures; 39% had one lifetime procedure, but 15 children had four or more lifetime procedures. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: Median survival after first surgery was more than one year in all organ system categories except eye surgeries and cardiac surgeries in trisomy 18. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: In the Indiana retrospective study (1990–2020), 53% of 117 patients underwent a procedure, with median age of first procedure 65 days. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: Higher birth weight and later gestational age were associated with lower surgical mortality in trisomy 13/18. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: Patients with other chromosome 18 variants (including mosaicism) had lower surgical mortality. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: General surgical anomalies (including esophageal atresia) were associated with higher surgical mortality. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: Neurologic procedures, ENT procedures, abdominal wall defects, genitourinary procedures, and endocrine comorbidities were not associated with increased surgical mortality. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: In the Cincinnati Children's bronchoscopy series (2011–2021), all patients with trisomy 13 had more than three significant airway findings, and most trisomy 18 patients had two or more significant findings. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: 65% of trisomy 13/18 patients who underwent bronchoscopy at Cincinnati Children's required tracheostomy, and almost all required mechanical ventilation. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: Previous studies showed a tracheostomy rate around 17% in trisomy 13/18, but the Cincinnati series found 65% in patients who underwent airway evaluation. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: In a pooled analysis of 70 trisomy 18 patients with hepatoblastoma, 64% had surgical treatment; tumors were more solitary, less multifocal, and smaller overall. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: The most common reasons patients with trisomy 18 and hepatoblastoma did not pursue surgery were severe cardiopulmonary comorbidities, advanced hepatoblastoma, and family decision. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: Five-year survival for trisomy 18 patients with hepatoblastoma receiving multimodal treatment was 43.7%, compared to 76.6% in patients without trisomy 18. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: Patients with trisomy 18 and hepatoblastoma have undergone liver transplant to provide curative treatment. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: 35 children with trisomy 18 underwent 92 surgical procedures. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: Many of the patients had either a gastrostomy tube or Jinnostomy tube placed to help with feeding. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: Of the people, of the children undergoing surgery, um, 16 of them, which was 39% with trisomy 13, had one lifetime procedure, but 15 of those children had 4 or more lifetime procedures. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: Higher birth weight and later gestational age had a lower mortality, um, just as you heard from Doctor Sonoda, um, that that impacts the cardiac, uh, outcomes, um, that applies for all other, um, surgical procedures. ↗
▶ Ep 5 · 0:00
host summary Laura Glaganski summarizes what Dr. Jagroop (Rupi) Parikh said: All of the patients with trisomy 13 had more than 3 significant findings on bronchoscopy. These are findings that affected both the upper and lower airways, meaning the trachea and into the bronchi, most commonly, and most patients with trisomy 18 also had two or more significant findings on the bronchoscopy. ↗