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Neonatal end of life

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https://www.readbyqxmd.com/read/28804867/sources-of-distress-for-physicians-and-nurses-working-in-swiss-neonatal-intensive-care-units
#1
Sabine D Klein, Hans Ulrich Bucher, Manya J Hendriks, Ruth Baumann-Hölzle, Jürg C Streuli, Thomas M Berger, Jean-Claude Fauchère, On Behalf Of The Swiss Neonatal End-Of-Life Study Group
BACKGROUND: Medical personnel working in intensive care often face difficult ethical dilemmas. These may represent important sources of distress and may lead to a diminished self-perceived quality of care and eventually to burnout. AIMS OF THE STUDY: The aim of this study was to identify work-related sources of distress and to assess symptoms of burnout among physicians and nurses working in Swiss neonatal intensive care units (NICUs). METHODS: In summer 2015, we conducted an anonymous online survey comprising 140 questions about difficult ethical decisions concerning extremely preterm infants...
August 14, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28776242/neonatal-infant-and-under-5-mortality-and-morbidity-burden-in-the-eastern-mediterranean-region-findings-from-the-global-burden-of-disease-2015-study
#2
Ali H Mokdad
OBJECTIVES: Although substantial reductions in under-5 mortality have been observed during the past 35 years, progress in the Eastern Mediterranean Region (EMR) has been uneven. This paper provides an overview of child mortality and morbidity in the EMR based on the Global Burden of Disease (GBD) study. METHODS: We used GBD 2015 study results to explore under-5 mortality and morbidity in EMR countries. RESULTS: In 2015, 755,844 (95% uncertainty interval (UI) 712,064-801,565) children under 5 died in the EMR...
August 3, 2017: International Journal of Public Health
https://www.readbyqxmd.com/read/28758538/-you-can-only-give-warmth-to-your-baby-when-it-s-too-late-parents-bonding-with-their-extremely-preterm-and-dying-child
#3
Andrea Abraham, Manya J Hendriks
This study on end-of-life decisions in extremely preterm babies shows that the parents under study experience a multitude of stressors due to the immediate separation after birth, the alienating setting of the neonatal intensive care unit (NICU), the physical distance to the child, medical uncertainties, and upcoming decisions. Even though they are considered to be parents (assigned parenthood), they cannot act as primary caregivers. Instead, they depend on professional instructions for access and care. Embodied parenthood can be experienced only at the end-of-life, that is, during the dying trajectory and after the child's death...
July 1, 2017: Qualitative Health Research
https://www.readbyqxmd.com/read/28750370/social-birth-rites-of-passage-for-the-newborn
#4
Michael Obladen
Rites of passage mark important changes during human life and, for the neonate, its transition from intrauterine life into society. Their original intent was to purify the body from blood and meconium. But the cleansing rites had a spiritual dimension from the very start. When the rites of Mesopotamian, Egyptian, Jewish, Greek, Roman, Hindu, Nordic, Muslim, Maya, and Christian cultures are briefly compared, they reveal a remarkable similarity. What most rites had in common was the cleansing of the body, or sprinkling it with water; special clothing; the exorcism of evil spirits; blessings and prayers for good spirits; and a name-giving ceremony and a feast for family, relatives, and friends...
July 28, 2017: Neonatology
https://www.readbyqxmd.com/read/28730376/lower-urinary-tract-obstruction-fetal-intervention-based-on-prenatal-staging
#5
Rodrigo Ruano, Timothy Dunn, Michael C Braun, Joseph R Angelo, Adnan Safdar
The authors present an overview of lower urinary tract obstruction (LUTO) in the fetus with a particular focus on the insult to the developing renal system. Diagnostic criteria along with the challenges in estimating long-term prognosis are reviewed. A proposed prenatal LUTO disease severity classification to guide management decisions with fetal intervention to maintain or salvage in utero and neonatal pulmonary and renal function is also discussed. Stage I LUTO (mild form) is characterized by normal amniotic fluid index after 18 weeks, normal kidney echogenicity, no renal cortical cysts, no evidence of renal dysplasia, and favorable urinary biochemistries when sampled between 18 and 30 weeks; prenatal surveillance is recommended...
July 21, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28727004/physiology-and-endocrinology-symposium-postnatal-reproductive-development-and-the-lactocrine-hypothesis
#6
F F Bartol, A A Wiley, A F George, D J Miller, C A Bagnell
Maternal effects on development can program cell fate and dictate offspring phenotype. Such effects do not end at birth, but extend into postnatal life through signals communicated from mother to offspring in first milk (colostrum). Transmission of bioactive factors from mother to offspring as a specific consequence of nursing defines a lactocrine mechanism. The female reproductive tract is not fully formed at birth (postnatal day = PND 0). Data for ungulates and mice indicate that disruption of development during neonatal life can have lasting effects on the form and function of uterine tissues...
May 2017: Journal of Animal Science
https://www.readbyqxmd.com/read/28718356/comparison-of-three-non-invasive-ventilation-strategies-nsippv-bipap-ncpap-for-rds-in-vlbw-infants
#7
Vincenzo Salvo, Gianluca Lista, Enrica Lupo, Alberto Ricotti, Luc J I Zimmermann, Antonio W D Gavilanes, Eloisa Gitto, Micaela Colivicchi, Valeria Ferraù, Diego Gazzolo
BACKGROUND: Non-invasive ventilation (NIV) significantly changed the management of respiratory distress syndrome (RDS) in preterm infants. Further perspectives for neonatologists regard the assessment of different NIV strategies in terms of availability, effectiveness, and failure. OBJECTIVE: The aim of the present study is to evaluate the effectiveness of three different NIV strategies: nasal continuous positive airway pressure (N-CPAP), nasal synchronized intermittent positive pressure ventilation (N-SIPPV), and nasal bilevel-CPAP (BiPAP), as first intention treatment for RDS in very low birth-weight infants (VLBW)...
August 1, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28711069/preterm-birth-and-its-impact-on-renal-health
#8
Valerie A Luyckx
Preterm birth occurs in approximately 10% of all births worldwide. Preterm infants have reduced nephron numbers at birth in proportion to gestational age, and are at increased risk of neonatal acute kidney injury as well as higher blood pressure, proteinuria, and chronic kidney disease later in life. Rapid catch-up growth in preterm infants, especially if resulting in obesity, is a risk factor for end-stage kidney disease among children with proteinuric renal disease. Preterm birth, however, is a risk factor not only for the infant because mothers who deliver preterm have an increased risk of having subsequent preterm deliveries as well as hypertension, cardiovascular disease, and renal disease later in life...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28693597/clinical-outcome-and-risk-factors-of-neonatal-sepsis-among-neonates-in-felege-hiwot-referral-hospital-bahir-dar-amhara-regional-state-north-west-ethiopia-2016-a-retrospective-chart-review
#9
Tilahun Tewabe, Seida Mohammed, Yibeltal Tilahun, Birhanie Melaku, Mequanint Fenta, Tsigiereda Dagnaw, Amare Belachew, Ashagre Molla, Habte Belete
BACKGROUND: Sepsis remains a major cause of morbidity and mortality among neonates. The risk factors and clinical outcomes of sepsis are poorly understood. Most cases of sepsis occurred mostly within the first week of newborns life related to perinatal risk factors. Late onset sepsis is related to hospital acquired infections which is seen after seven days of age. The purpose of this study was to assess clinical outcome and risk factors of neonatal sepsis in Felege Hiwot referral hospital Bahir Dar, North West Ethiopia...
July 11, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28685048/prioritizing-research-for-integrated-implementation-of-early-childhood-development-and-maternal-newborn-child-and-adolescent-health-and-nutrition-platforms
#10
Renee Sharma, Michelle F Gaffey, Harold Alderman, Diego G Bassani, Kimber Bogard, Gary L Darmstadt, Jai K Das, Joseph E de Graft-Johnson, Jena D Hamadani, Susan Horton, Luis Huicho, Julia Hussein, Stephen Lye, Rafael Pérez-Escamilla, Kerrie Proulx, Kofi Marfo, Vanessa Mathews-Hanna, Mireille S Mclean, Atif Rahman, Karlee L Silver, Daisy R Singla, Patrick Webb, Zulfiqar A Bhutta
BACKGROUND: Existing health and nutrition services present potential platforms for scaling up delivery of early childhood development (ECD) interventions within sensitive windows across the life course, especially in the first 1000 days from conception to age 2 years. However, there is insufficient knowledge on how to optimize implementation for such strategies in an integrated manner. In light of this knowledge gap, we aimed to systematically identify a set of integrated implementation research priorities for health, nutrition and early child development within the 2015 to 2030 timeframe of the Sustainable Development Goals (SDGs)...
June 2017: Journal of Global Health
https://www.readbyqxmd.com/read/28678849/community-health-promotion-and-medical-provision-for-neonatal-health-champion-cluster-randomised-trial-in-nagarkurnool-district-telangana-formerly-andhra-pradesh-india
#11
RANDOMIZED CONTROLLED TRIAL
Peter Boone, Alex Eble, Diana Elbourne, Chris Frost, Chitra Jayanty, Rashmi Lakshminarayana, Vera Mann, Rohini Mukherjee, Gilda Piaggio, Padmanabh Reddy
BACKGROUND: In the mid-2000s, neonatal mortality accounted for almost 40% of deaths of children under 5 years worldwide, and constituted 65% of infant deaths in India. The neonatal mortality rate in Andhra Pradesh was 44 per 1,000 live births, and was higher in the rural areas and tribal regions, such as the Nagarkurnool division of Mahabubnagar district (which became Nagarkurnool district in Telangana in 2014). The aim of the CHAMPION trial was to investigate whether a package of interventions comprising community health promotion and provision of health services (including outreach and facility-based care) could lead to a reduction of the order of 25% in neonatal mortality...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28669487/-functional-and-aesthetic-evaluation-of-sacrococcygeal-teratomas-not-everything-ends-with-surgery
#12
Vanesa Villamil, Oscar Girón Vallejo, María Fernández-Ibieta, Ángela Sánchez Sánchez, Paulo Y Reyes Ríos, Irene Martínez Castaño, Javier Rojas-Ticona, Ramón Ruiz Pruneda, José I Ruiz Jiménez
INTRODUCTION: Sacrococcygeal teratoma is the most common solid neonatal tumour. The improvement in survival has meant that postoperative sequelae can be diagnosed and treated. The aim of this article is to evaluate the long-term outcomes of patients treated in our centre. MATERIAL AND METHODS: Records of patients treated for a sacrococcygeal teratoma in our hospital from 1977 to 2014 were retrospectively reviewed. Personal data was collected and a telephone questionnaire was used to assess long-term bowel and urinary habits, as well as an aesthetic and functional self-assessment...
June 29, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28663110/sucrose-and-naltrexone-prevent-increased-pain-sensitivity-and-impaired-long-term-memory-induced-by-repetitive-neonatal-noxious-stimulation-role-of-bdnf-and-%C3%AE-endorphin
#13
Khawla Q Nuseir, Karem H Alzoubi, Ahmed Alhusban, Areej Bawaane, Mohammed Al-Azzani, Omar F Khabour
Pain in neonates is associated with short and long-term adverse outcomes. Data demonstrated that long-term consequences of untreated pain are linked to the plasticity of the neonate's brain. Sucrose is effective and safe for reducing painful procedures from single events. However, the mechanism of sucrose-induced analgesia is not fully understood. The role of the opioid system in this analgesia using the opioid receptor antagonist Naltrexone was investigated, plus the long-term effects on learning and memory formation during adulthood...
June 27, 2017: Physiology & Behavior
https://www.readbyqxmd.com/read/28646647/successful-maintenance-of-key-physiological-parameters-in-preterm-lambs-treated-with-ex%C3%A2-vivo-uterine-environment-therapy-for-a-period-of-1-week
#14
Haruo Usuda, Shimpei Watanabe, Yuichiro Miura, Masatoshi Saito, Gabrielle C Musk, Judith Rittenschober-Böhm, Hideyuki Ikeda, Shinichi Sato, Takushi Hanita, Tadashi Matsuda, Alan H Jobe, John P Newnham, Sarah J Stock, Matthew W Kemp
BACKGROUND: Extremely preterm infants born at the border of viability (22-24 weeks' gestation) have high rates of death and lasting disability. Ex vivo uterine environment therapy is an experimental neonatal intensive care strategy that provides gas exchange using parallel membranous oxygenators connected to the umbilical vessels, sparing the extremely preterm cardiopulmonary system from ventilation-derived injury. OBJECTIVE: In this study, we aimed to refine our ex vivo uterine environment therapy platform to eliminate fetal infection and inflammation, while simultaneously extending the duration of hemodynamically stable ex vivo uterine environment therapy to 1 week...
June 20, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28619775/retrospective-cohort-study-of-all-deaths-among-infants-born-between-22-and-27-completed-weeks-of-gestation-in-switzerland-over-a-3-year-period
#15
T M Berger, M A Steurer, H U Bucher, J C Fauchère, M Adams, R E Pfister, R Baumann-Hölzle, D Bassler
OBJECTIVES: The aim of this research is to assess causes and circumstances of deaths in extremely low gestational age neonates (ELGANs) born in Switzerland over a 3-year period. DESIGN: Population-based, retrospective cohort study. SETTING: All nine level III perinatal centres (neonatal intensive care units (NICUs) and affiliated obstetrical services) in Switzerland. PATIENTS: ELGANs with a gestational age (GA) <28 weeks who died between 1 July 2012 and 30 June 2015...
June 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28601197/a-comparative-study-to-evaluate-myogenic-differentiation-potential-of-human-chorion-versus-umbilical-cord-blood-derived-mesenchymal-stem-cells
#16
Nikoo Bana, Davood Sanooghi, Mansoureh Soleimani, Nasim Hayati Roodbari, Sepideh Alavi Moghaddam, Mohammad Taghi Joghataei, Forough Azam Sayahpour, Faezeh Faghihi
OBJECTIVE: Musculodegenerative diseases threaten the life of many patients in the world. Since drug administration is not efficient in regeneration of damaged tissues, stem cell therapy is considered as a good strategy to restore the lost cells. Since the efficiency of myogenic differentiation potential of human Chorion- derived Mesenchymal Stem Cells (C-MSCs) has not been addressed so far; we set out to evaluate myogenic differentiation property of these cells in comparison with Umbilical Cord Blood- derived Mesenchymal Stem Cells (UCB-MSCs) in the presence of 5-azacytidine...
May 11, 2017: Tissue & Cell
https://www.readbyqxmd.com/read/28598947/moral-distress-in-picu-and-neonatal-icu-practitioners-a-cross-sectional-evaluation
#17
Charles Philip Larson, Karen D Dryden-Palmer, Cathy Gibbons, Christopher S Parshuram
OBJECTIVES: To measure the level of moral distress in PICU and neonatal ICU health practitioners, and to describe the relationship of moral distress with demographic factors, burnout, and uncertainty. DESIGN: Cross-sectional survey. SETTING: A large pediatric tertiary care center. SUBJECTS: Neonatal ICU and PICU health practitioners with at least 3 months of ICU experience. INTERVENTIONS: A 41-item questionnaire examining moral distress, burnout, and uncertainty...
August 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28598570/the-outcome-of-isolated-prenatal-ventricular-size-disproportion-in-the-absence-of-aortic-coarctation
#18
A E L van Nisselrooij, L Rozendaal, I Linskens, S A Clur, J Hruda, E Pajkrt, C L van Velzen, N A Blom, M C Haak
OBJECTIVES: Ventricular size disproportion is a marker for aortic coarctation (CoA) in fetal life, however, approximately 50% of fetuses do not develop CoA after birth. The aim of this study was to evaluate the postnatal outcome of cases with ventricular disproportion in the absence of CoA in this cohort. METHODS: All cases with prenatal isolated ventricular size disproportion in the period 2002-2015 were extracted from a prenatal congenital heart defects (CHD) registry of a regional cohort...
June 9, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28597060/-early-bilateral-nephrectomy-in-neonatal-autosomal-recessive-polycystic-kidney-disease-improved-prognosis-or-unnecessary-effort
#19
REVIEW
S Riechardt, M Koch, J Oh, M Fisch
BACKGROUND: Neonatal autosomal recessive polycystic kidney disease (ARPKD) is associated with giant kidneys, lung hypoplasia, pulmonal hypertension, and end-stage renal failure. Depending on the study, mortality is reported to range between 20 and 80%. OBJECTIVES: Does bilateral nephrectomy improve survival? PATIENTS AND METHODS: Between 2010 and 2016, we treated 7 children with prenatally diagnosed ARPKD. All had a planned delivery by cesarean section...
July 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28581892/radiation-exposure-enhances-hepatocyte-proliferation-in-neonatal-mice-but-not-in-adult-mice
#20
Yi Shang, Yurika Sawa, Benjamin J Blyth, Chizuru Tsuruoka, Hiroyuki Nogawa, Yoshiya Shimada, Shizuko Kakinuma
There is a natural tendency to expect that irradiation of an infant organ prior to development-related expansion will result in a higher risk of developing cancer than that of fully-developed adult tissue, and this has generally been observed. However, if tissues also vary in their initial responses to radiation depending on age, the interplay between tissue- and age-dependent risk would potentially be quite complex. We have previously shown opposing age-dependent induction of apoptosis for the intestinal epithelium and hematopoietic cells in mice, but such data are not yet available for the liver...
August 2017: Radiation Research
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