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Seminars in Fetal & Neonatal Medicine

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https://www.readbyqxmd.com/read/27881286/renal-adaptive-changes-and-sodium-handling-in-the-fetal-to-newborn-transition
#1
REVIEW
Jeffrey L Segar
Appropriate fluid and electrolyte management is critical for optimal care of very low birth weight or sick infants. Delivery of such care requires an understanding of developmental changes in renal water and salt handling that occur with advancing gestational age as well as postnatal age. This review focuses on the principles of sodium homeostasis during fetal and postnatal life. The physiology of renal tubular transport mechanisms, as well as neurohumoral factors impacting renal tubular transport are highlighted...
November 20, 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27843077/renal-replacement-therapies-in-neonates-issues-and-ethics
#2
REVIEW
Lesley Rees
Chronic irreversible kidney disease requiring dialysis is rare in the neonate. Many such neonates are diagnosed following antenatal ultrasound with congenital abnormalities of the kidneys and urinary tract. There is an increased incidence of prematurity and infants that are small for gestational age. Given the natural improvement in renal function that occurs in the neonatal period, some with extremely poor renal function may, with careful management of fluid and electrolytes, be kept off dialysis until the creatinine reaches a nadir when a definitive plan can be made...
November 11, 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27733241/chronic-kidney-disease-in-the-neonate-etiologies-management-and%C3%A2-outcomes
#3
Jason Misurac
Neonatal chronic kidney disease (CKD) occurs with an estimated incidence of 1 in 10,000 live births, whereas the incidence of neonatal end-stage renal disease (ESRD) is about 7.1 per million age-related population. The most frequent etiologies are renal hypoplasia/dysplasia, posterior urethral valves, and other congenital anomalies of the kidney and urinary tract. Other etiologies include polycystic kidney disease, cortical necrosis, and renal vascular thrombosis. Management of CKD focuses primarily on replacing renal functions such as erythropoietin, 1,25-hydroxylation of vitamin D, electrolyte homeostasis/excretion, and, in ESRD, waste product removal...
October 9, 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27720664/pharmacological-management-of-acute-kidney-injury-and-chronic-kidney-disease-in-neonates
#4
Jennifer G Jetton, Mark Sorenson
Both acute kidney injury (AKI) and chronic kidney disease (CKD) are seen more frequently in the neonatal intensive care unit (NICU) as advances in supportive care improve the survival of critically ill infants as well as those with severe, congenital kidney and urinary tract anomalies. Many aspects of the infant's care, including fluid balance, electrolyte and mineral homeostasis, acid-base balance, and growth and nutrition require close monitoring by and collaboration among neonatologists, nephrologists, dieticians, and pharmacologists...
October 6, 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27692935/neurodevelopmental-outcomes-and-nutritional-strategies-in-very-low-birth-weight-infants
#5
Mandy Brown Belfort, Richard A Ehrenkranz
The developing brain of the very low birth weight (VLBW) infant is highly sensitive to effects of the nutritional milieu during the neonatal hospitalization and after discharge. Strategies to optimize nutritional care play an important role in reducing long-term neurodevelopmental morbidities in this population. Currently available interventions to ensure that the unique nutrient requirements of the VLBW infant are met include various dietary fortification strategies and parenteral nutrition. In this article, we review evidence regarding nutritional strategies and their beneficial effects on neurodevelopment in VLBW infants...
September 29, 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27649995/use-of-donor-milk-in-the-neonatal-intensive-care-unit
#6
Virginie de Halleux, Catherine Pieltain, Thibault Senterre, Jacques Rigo
Own mother's milk is the first choice in feeding preterm infants and provides multiple short- and long-term benefits. When it is unavailable, donor human milk is recommended as the first alternative. Donor milk undergoes processing (i.e. pasteurization) to reduce bacteriological and viral contaminants but influences its bioactive properties with potentially fewer benefits than raw milk. However, there is no clinical evidence of health benefit of raw compared to pasteurized human milk, and donor milk maintains documented advantages compared to formula...
September 16, 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27522308/the-human-gut-microbiota-in-perinatology-and-neonatology
#7
EDITORIAL
Josef Neu
No abstract text is available yet for this article.
December 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27350143/the-national-institutes-of-health-human-microbiome-project
#8
REVIEW
Lita M Proctor
This overview describes the impetus for and the goals of the National Institutes of Health (NIH)'s Human Microbiome Project (HMP) and the research resources available through the HMP. As the HMP also serves as a catalyst for human microbiome research at the NIH, NIH Institutes and Centers support for this field is also briefly addressed.
December 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27345372/gut-bacteria-and-late-onset-neonatal-bloodstream-infections-in-preterm-infants
#9
REVIEW
Phillip I Tarr, Barbara B Warner
Late-onset neonatal bloodstream infections remain challenges in neonatology. Hand hygiene, line care, and judicious use of indwelling lines are welcome interventions, but might not reduce the incidence of late-onset neonatal bloodstream infections from bacteria originating in the gut. Accumulating data suggest that many pathogens causing late-onset neonatal bloodstream infections are of gut origin, including Gram-positive cocci. In addition to the host-canonical paradigm (i.e., all bacteria have equal risk of invasion and bloodstream infections are functions of variable infant susceptibility), we should now consider bacteria-canonical paradigms, whereby late-onset neonatal bloodstream infection is a function of colonization with a specific subset of bacteria with exceptional invasive potential...
December 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27343151/necrotizing-enterocolitis-and-preterm-infant-gut-bacteria
#10
REVIEW
Barbara B Warner, Phillip I Tarr
Necrotizing enterocolitis remains an intractable consequence of preterm birth. Gut microbial communities, especially bacterial communities, have long been suspected to play a role in the development of necrotizing enterocolitis. Direct-from-stool nucleic acid sequencing technology now offers insights into the make-up of these communities. Data are now converging on the roles of Gram-negative bacteria as causative agents, despite the dynamic nature of bacterial populations, the varying technologies and sampling strategies, and the overall small sample sizes in these case-control studies...
December 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27255860/fetal-neonatal-and-infant-microbiome-perturbations-and-subsequent-effects-on-brain-development-and-behavior
#11
REVIEW
Rochellys Diaz Heijtz
The human gastrointestinal tract harbors a diverse and complex community of microbes, termed gut microbiota, that normally assemble during the first postnatal years of life. This evolution-driven process has been shown to contribute to the developmental programming of epithelial barrier function, gut homeostasis, and angiogenesis, as well as the development and function of the immune system. Research over the last few years has revealed that the actions of the gut microbiota have much wider effects on host physiology and development than originally believed, including the modulation of brain development and behavior...
December 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27133778/microbial-therapeutic-interventions
#12
REVIEW
Nicole G Grady, Elaine O Petrof, Erika C Claud
The microbiome comprises all the microbes living in and on the human body. Human cells are greatly outnumbered by bacterial cells; thus human health depends on the health of the microbial ecosystem. For the immature preterm infant, the microbiome also influences intestinal and immune system development. This has implications for short term morbidities such as neonatal necrotizing enterocolitis and sepsis, but also long term health outcomes. Optimization of the preterm infant microbiome is a growing topic of interest...
December 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27481764/the-vulnerable-immature-cerebellum
#13
EDITORIAL
Catherine Limperopoulos
No abstract text is available yet for this article.
October 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27357079/novel-insights-from-quantitative-imaging-of-the-developing-cerebellum
#14
REVIEW
Matthew P G Allin
There is increasing evidence that points to the central role of the cerebellum in many areas of human behaviour - in health and in illness. The findings reviewed here shed further light on the developmental vulnerability of cerebellar cell types, and highlight the new imaging techniques being used in this research. This article reviews some new advances in our understanding of the normal cerebellar growth trajectory, and how this may become disturbed by pathological processes. Cerebellar development is now being implicated in many conditions, from autism and other neuropsychiatric disorders to diabetes...
October 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27209280/diagnostic-imaging-of-posterior-fossa-anomalies-in-the-fetus
#15
REVIEW
Ashley James Robinson, M Ashraf Ederies
Ultrasound and magnetic resonance imaging are the two imaging modalities used in the assessment of the fetus. Ultrasound is the primary imaging modality, whereas magnetic resonance is used in cases of diagnostic uncertainty. Both techniques have advantages and disadvantages and therefore they are complementary. Standard axial ultrasound views of the posterior fossa are used for routine scanning for fetal anomalies, with additional orthogonal views directly and indirectly obtainable using three-dimensional ultrasound techniques...
October 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27189326/cranial-ultrasonography-of-the-immature-cerebellum-role-and%C3%A2-limitations
#16
REVIEW
S J Steggerda, G van Wezel-Meijler
Cranial ultrasonography (CUS) is a reliable and non-invasive tool to detect frequently occurring brain abnormalities and to monitor brain development and maturation in high risk neonates. Standard CUS views are obtained through the anterior fontanel. However, evaluation of the posterior fossa is often suboptimal with this approach. Cerebellar injury occurs frequently in preterm infants and has important prognostic consequences. Early detection is therefore important. This review focuses on techniques that optimize the performance of CUS when studying the preterm cerebellum, including the use of the mastoid fontanel and the adaptation of focus points and scan frequencies...
October 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27184462/cerebellar-disruptions-and-neurodevelopmental-disabilities
#17
REVIEW
Thangamadhan Bosemani, Andrea Poretti
The vulnerability of the cerebellum during prenatal life to disruptive events such as hemorrhage and infection leads to a wide variety of morphological abnormalities. This review discusses various prenatal cerebellar disruptions including cerebellar agenesis, unilateral cerebellar hypoplasia, cerebellar cleft, global cerebellar hypoplasia, and vanishing cerebellum in Chiari type II malformation. For each entity, we discuss the definition, potential pathomechanism, clinical findings including neurocognitive and behavioral problems, neuroimaging features, and management...
October 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27184461/structure-function-relationships-in-the-developing-cerebellum-evidence-from-early-life-cerebellar-injury-and-neurodevelopmental-disorders
#18
REVIEW
Catherine J Stoodley, Catherine Limperopoulos
The increasing appreciation of the role of the cerebellum in motor and non-motor functions is crucial to understanding the outcomes of acquired cerebellar injury and developmental lesions in high-risk fetal and neonatal populations, children with cerebellar damage (e.g. posterior fossa tumors), and neurodevelopmental disorders (e.g. autism). We review available data regarding the relationship between the topography of cerebellar injury or abnormality and functional outcomes. We report emerging structure-function relationships with specific symptoms: cerebellar regions that interconnect with sensorimotor cortices are associated with motor impairments when damaged; disruption to posterolateral cerebellar regions that form circuits with association cortices impact long-term cognitive outcomes; and midline posterior vermal damage is associated with behavioral dysregulation and an autism-like phenotype...
October 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27179922/autism-and-cerebellar-dysfunction-evidence-from-animal-models
#19
REVIEW
Peter T Tsai
Autism is a prevalent neurodevelopmental disorder whose origins are not well understood. Cerebellar involvement has been implicated in the pathogenesis of autism spectrum disorders with increasing evidence from both clinical studies and animal models supporting an important role for cerebellar dysfunction in autism spectrum disorders. This article discusses the various cerebellar contributions to autism spectrum disorders. Both clinical and preclinical studies are discussed and future research directions highlighted...
October 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27161081/preterm-birth-and-cerebellar-neuropathology
#20
REVIEW
Christopher R Pierson, Fahd Al Sufiani
Improved survival rates in premature infants and more sensitive neuroimaging techniques have expanded the scope of recognized neurodevelopmental disabilities in this vulnerable population and have implicated a role for cerebellar pathology in their origin. Although supratentorial pathologies are well studied, cerebellar pathology has been under-recognized in premature infants. The purpose of this review is to provide a concise description of established acquired cerebellar pathologies in premature infants including cerebellar atrophy/hypoplasia, hemorrhage, and infarction...
October 2016: Seminars in Fetal & Neonatal Medicine
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