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Journal of Perinatology: Official Journal of the California Perinatal Association

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https://www.readbyqxmd.com/read/27906197/treatment-and-follow-up-of-venous-thrombosis-in-the-neonatal-intensive-care-unit-a-retrospective-study
#1
J C Bohnhoff, S A DiSilvio, R K Aneja, J R Shenk, Y A Domnina, B S Brozanski, M Good
OBJECTIVE: The critically ill, premature patients of neonatal intensive care units are susceptible to venous thrombosis, an adverse event associated with short- and long-term morbidity. Venous thrombosis is frequently treated with low-molecular-weight heparins (LMWHs) such as enoxaparin, but optimal dosing of LMWH must balance the morbidity of venous thrombosis with the potential adverse affects of anticoagulation. The optimal dosing of enoxaparin for premature infants is unclear. The objective of this study was to describe enoxaparin therapy and follow-up in critically ill neonates diagnosed with venous thrombosis...
December 1, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27906196/population-based-reference-curve-for-umbilical-cord-arterial-ph-in-infants-born-at-28-to-42-weeks
#2
B Skiöld, G Petersson, M Ahlberg, O Stephansson, S Johansson
OBJECTIVE: The objective of the study was to examine normal variations of umbilical cord arterial pH by gestational age (GA). STUDY DESIGN: Population-based cohort study of 46 199 infants born from 2008 to 2014 in Stockholm, Sweden, with GA 28 to 42 weeks, Apgar score ⩾7 at 5 min, non-instrumental vaginal delivery, and birth weight for GA⩾3rd and ⩽97th percentile. Quantile regression was used to investigate the associations between GA and infant sex, and pH...
December 1, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27906195/congenital-hypothyroidism-with-delayed-thyroid-stimulating-hormone-elevation-in-premature-infants-born-at-less-than-30-weeks-gestation
#3
D C Kaluarachchi, T T Colaizy, L M Pesce, M Tansey, J M Klein
OBJECTIVE: Congenital hypothyroidism (CH) with delayed thyroid-stimulating hormone (TSH) elevation is a common form of thyroid dysfunction among premature infants. Routine newborn screening (NBS) may miss infants with CH with delayed TSH elevation. The objective of the study is to determine the prevalence of CH with delayed TSH elevation in premature infants and to identify associated risk factors. STUDY DESIGN: Retrospective analysis of serum thyroid function screening (TFS) at day of life 30 in premature infants <30 weeks gestation, admitted to University of Iowa Neonatal Intensive Care Unit between 1 July 2012 to 30 June 2015...
December 1, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27906194/a-comparison-of-7-day-versus-10-day-course-of-low-dose-dexamethasone-for-chronically-ventilated-preterm-infants
#4
A Cuna, S Govindarajan, A Oschman, H Dai, K Brophy, M Norberg, W Truog
OBJECTIVE: The objective of the study was to compare the effect of two different dexamethasone regimens on respiratory outcomes of ventilator-dependent preterm infants. STUDY DESIGN: Retrospective study of ventilated preterm infants <29 weeks gestational age treated with either 7-day or 10-day dexamethasone course. Primary outcome was days to successful extubation. Other outcomes included rate of successful extubation and need for repeat steroid therapy. RESULTS: Fifty-nine infants were identified; 32 (54%) received 7 days of dexamethasone and 27 (46%) received 10 days of dexamethasone...
December 1, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27906193/roadmap-to-a-successful-quality-improvement-project
#5
J R Swanson, S A Pearlman
Although the benefits of quality improvement initiatives are largely understood by practicing neonatologists and perinatologists, the vast majority have not received any formal training in quality improvement methodology. Even as reporting requirements of quality metrics has increased from a number of outside agencies and public reporting entities, education for physicians regarding how to carry out quality improvement projects has largely remained the individual's responsibility. The first in a series of quality improvement education papers, we focus on the reasons why quality improvement matters and how to develop a team of stakeholders that will be functional and productive in addressing specific quality and safety concerns...
December 1, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27906192/thematic-analysis-of-barriers-and-facilitators-to-implementation-of-neonatal-resuscitation-guideline-changes
#6
H C Lee, V Arora, T Brown, A Lyndon
OBJECTIVE: To evaluate experiences regarding implementation of Neonatal Resuscitation Program (NRP) guideline changes in the context of a collaborative quality improvement (QI) project. STUDY DESIGN: Focus groups were conducted with local QI leaders and providers from nine sites that participated in a QI collaborative. Thematic analysis identified facilitators and barriers to implementation of NRP guideline changes and QI in general. RESULTS: Facilitators for QI included comparative process measurement and data tracking...
December 1, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27853323/ancient-texts-to-pubmed-a-brief-history-of-the-peer-review-process
#7
P R Farrell, L Magida Farrell, M K Farrell
The formal evaluation of scientific literature by invited referees (peer reviewers) is a relatively recent phenomenon and now is considered a cornerstone of modern science. However, its roots can be traced back to antiquity. As the speed and complexity of scientific information and publishing increases in the digital age, peer review must continue to evolve. To understand the future direction of peer review, we must understand its past. Here, we briefly explore the history of scientific peer review. This may help us predict and design appropriate peer review for the new era...
November 17, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27853322/risk-factors-for-group-b-streptococcal-disease-in-neonates-of-mothers-with-negative-antenatal-testing
#8
V Parente, R H Clark, L Ku, C Fennell, M Johnson, E Morris, A Romaine, U Utin, D K Benjamin, J A Messina, P B Smith, R G Greenberg
OBJECTIVE: The aim of this study was to identify risk factors for early-onset group B Streptococcus (EOGBS) disease in neonates of mothers with negative antenatal screening. STUDY DESIGN: We performed a retrospective cohort study of neonates born to mothers with negative antenatal GBS screening between 2002 and 2012. Our primary outcome was EOGBS infection. We used multivariable logistic regression to assess factors associated with EOGBS. RESULTS: EOGBS was confirmed in 492 of the 179 818 neonates that met the study inclusion criteria...
November 17, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27853321/contextual-factors-influencing-the-implementation-of-the-obstetrics-hemorrhage-initiative-in-florida
#9
C A Vamos, E L Thompson, A Cantor, L Detman, E Bronson, A Phelps, J M Louis, A R Gregg, J S Curran, W Sappenfield
OBJECTIVE: The purpose of this study was to explore the multilevel contextual factors that influenced the implementation of the Obstetric Hemorrhage Initiative (OHI) among hospitals in Florida. STUDY DESIGN: A qualitative evaluation was conducted via in-depth interviews with multidisciplinary hospital staff (n=50) across 12 hospitals. Interviews were guided by the Consolidated Framework for Implementation Research and analyzed in Atlas.ti using rigorous qualitative analysis procedures...
November 17, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27853320/burnout-in-the-neonatal-intensive-care-unit-and-its-relation-to-healthcare-associated-infections
#10
D S Tawfik, J B Sexton, P Kan, P J Sharek, C C Nisbet, J Rigdon, H C Lee, J Profit
OBJECTIVE: To examine burnout prevalence among California neonatal intensive care units (NICUs) and to test the relation between burnout and healthcare-associated infection (HAI) rates in very low birth weight (VLBW) neonates. STUDY DESIGN: Retrospective observational study of provider perceptions of burnout from 2073 nurse practitioners, physicians, registered nurses and respiratory therapists, using a validated four-item questionnaire based on the Maslach Burnout Inventory...
November 17, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27831551/changing-antiepileptic-drug-use-for-seizures-in-us-neonatal-intensive-care-units-from-2005-to-2014
#11
K A Ahmad, S J Desai, M M Bennett, S F Ahmad, Y-T Ng, R H Clark, V N Tolia
OBJECTIVE: Neonatal seizures are a common problem in the neonatal intensive care unit and are frequently treated with antiepileptic drugs. Limited data exist on current or changing antiepileptic drug use for seizures in the neonatal intensive care unit.We sought to describe trends of antiepileptic drug exposure in a large volume of US neonatal intensive care unit from 2005 to 2014 and we hypothesized increasing levetiracetam exposure over the 10-year study period. STUDY DESIGN: Retrospective cohort study of infants from the Pediatrix Medical Group Clinical Data Warehouse, a large, multicenter, deidentified data set...
November 10, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27831550/impact-of-a-dedicated-neonatal-stabilization-room-and-process-changes-on-stabilization-time
#12
S Shivananda, S Gupta, S Thomas, L Babb, C-L Meyer, A Symington, B Paes, G K Suresh
OBJECTIVE: Our objective was to evaluate the impact of a dedicated resuscitation and stabilization (RAS) room and process changes on infant stabilization time. STUDY DESIGN: A prospective quality improvement study was conducted on preterm infants in a tertiary care center. A dedicated RAS room, preresuscitation huddle, infant-isolette-ventilator pairing and improved documentation were implemented. The primary outcome was median time to stabilization and secondary outcomes were illness severity on day 1 and morbidity at discharge...
November 10, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27831549/establishing-an-integrated-human-milk-banking-approach-to-strengthen-newborn-care
#13
A DeMarchis, K Israel-Ballard, Kimberly Amundson Mansen, C Engmann
The provision of donor human milk can significantly reduce morbidity and mortality among vulnerable infants and is recommended by the World Health Organization as the next best option when a mother's own milk is unavailable. Regulated human milk banks can meet this need, however, scale-up has been hindered by the absence of an appropriate model for resource-limited settings and a lack of policy support for human milk banks and for the operational procedures supporting them. To reduce infant mortality, human milk banking systems need to be scaled up and integrated with other components of newborn care...
November 10, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27831548/a-novel-more-efficient-staged-approach-for-critical-congenital-heart-disease-screening
#14
J Mouledoux, S Guerra, J Ballweg, Y Li, W Walsh
OBJECTIVE: Screening for critical congenital heart disease (CCHD) using pulse oximetry has been endorsed by the American Academy of Pediatrics and the American Heart Association. The recommended screening requires two saturation readings. We sought to determine the incidence of undetected CCHD in Tennessee for the 2 years following implementation of an algorithm that assigned an immediate pass to a single lower extremity saturation of 97% or higher. STUDY DESIGN: State Genetic Screening records and reports of missed cases from the Tennessee Initiative for Perinatal Quality Care were used to determine if CCHD cases were missed by the new screening algorithm...
November 10, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27831547/recombinant-tissue-plasminogen-activator-to-restore-catheter-patency-efficacy-and-safety-analysis-from-a-multihospital-nicu-system
#15
D M Scott, C Y Ling, B C MacQueen, V L Baer, E Gerday, R D Christensen
OBJECTIVE: In 2001, the US Food and Drug Administration approved recombinant tissue plasminogen activator (alteplase, Cathflo Activase) to reestablish patency of central catheters occluded, presumably, by a fibrin clot. We conducted a multicenter quality improvement study to determine the value of this procedure in our Neonatal Intensive Care Unit (NICUs), including analyses of efficacy, safety and costs. STUDY DESIGN: We conducted a retrospective quality analysis of neonates in level III NICUs, who received alteplase for the purpose of reestablishing patency of occluded central catheters...
November 10, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27831546/diurnal-variations-of-short-term-variation-and-the-impact-of-multiple-recordings-on-measurement-accuracy
#16
G Seliger, D Petroff, S Seeger, D Hoyer, M Tchirikov, U Schneider
OBJECTIVE: Short-term variation (STV) from computerized cardiotocogram heart rate analysis is a parameter that complements decision making, regarding the delivery of fetuses in several high-risk situations. Although studies on the effects of gestational age and fetal pathology are convincing, there is a lack of data exploring diurnal variation and the adequacy of a single measurement. STUDY DESIGN: In this prospective observational study, fetal STV was monitored with the AN24 fetal ECG monitor (Monica Healthcare) each hour for at least 10 h in total, beginning at different times...
November 10, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27809298/meconium-exposure-and-autism-risk
#17
K M Miller, G Xing, C K Walker
OBJECTIVE: This study aims to determine whether fetal meconium passage is associated with autism. STUDY DESIGN: This retrospective birth cohort analysis of 9 945 896 children born in California 1991 to 2008 linked discharge diagnosis and procedure codes for prenatal stressors, meconium-stained amniotic fluid (MSAF) and meconium aspiration syndrome (MAS) with autism diagnoses for 47 277 children through 2012. We assessed the relative risk of autism by meconium status using logistic regression, adjusting for demographic and clinical features...
November 3, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27787507/the-associations-between-early-pregnancy-lipid-profiles-and-pregnancy-outcomes
#18
C Wang, W Zhu, Y Wei, R Su, H Feng, E Hadar, M Hod, H Yang
OBJECTIVE: To evaluate the association between early pregnancy lipid profiles and pregnancy outcomes. STUDY DESIGN: Retrospective 6 months analysis of 5218 singleton pregnant women. Each participant's demographic and medical data were collected by questionnaires and medical records. Total cholesterol (TC), triglycerides (TG), high-density lipid cholesterol (HDL-C) and low-density lipid cholesterol (LDL-C) levels were divided into quartiles, and the women were categorized as having low (<25th percentile), referent (25 to <75th percentile) or high (>75th percentile) TC, TG, HDL-C and LDL-C values...
October 27, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27787506/resuscitation-practices-for-infants-in-the-nicu-picu-and-cicu-results-of-a-national-survey
#19
N Ali, T Sawyer, J Barry, T Grover, A Ades
OBJECTIVE: Infants requiring resuscitation at birth are resuscitated using neonatal resuscitation guidelines. Sometime after birth, resuscitation practice must transition to pediatric guidelines. There is no evidence on when this transition should occur. The objective of this study was to describe infant resuscitation practices in Neonatal Intensive Care Units (NICUs), Pediatric Intensive Care Units (PICUs) and Cardiac Intensive Care Units (CICUs). STUDY DESIGN: An electronic survey was sent to medical directors of NICUs, PICUs and CICUs in the U...
October 27, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27787505/real-vs-simulated-umbilical-cords-for-emergency-umbilical-catheterization-training-a-randomized-crossover-study
#20
T Sawyer, M Starr, M Jones, M Hendrickson, E Bosque, H McPhillips, M Batra
OBJECTIVE: To measure performance, fidelity and preference of two emergency umbilical vessel catheter (eUVC) simulation models. STUDY DESIGN: A randomized crossover trial of senior pediatric residents randomized to place an eUVC first using a real cord (RC) or simulated cord (SC), and then place an eUVC using the other model. The eUVC placement times were recorded and analyzed. Subjects rated physical and functional fidelity and preference for each model. RESULTS: The eUVC placement time (mean±s...
October 27, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
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