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Neonatal end of life

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https://www.readbyqxmd.com/read/28109243/neonatal-hyperbilirubinemia-in-a-marginalized-population-on-the-thai-myanmar-border-a-study-protocol
#1
Laurence Thielemans, Margreet Trip-Hoving, Germana Bancone, Claudia Turner, Julie A Simpson, Borimas Hanboonkunupakarn, Michaël Boele van Hensbroek, Patrick van Rheenen, Moo Kho Paw, François Nosten, Rose McGready, Verena I Carrara
BACKGROUND: This study aims to identify risk factors and the neurodevelopmental impact of neonatal hyperbilirubinemia in a limited-resource setting among a refugee and migrant population residing along the Thai-Myanmar border, an area with a high prevalence of glucose-6-phosphate dehydrogenase-deficiency. METHODS: This is an analytic, observational, prospective birth cohort study including all infants of estimated gestational age equal to or greater than 28 weeks from mothers who followed antenatal care in the Shoklo Malaria Research Unit clinics...
January 21, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28096704/neonatal-resuscitation-advances-in-training-and-practice
#2
REVIEW
Taylor Sawyer, Rachel A Umoren, Megan M Gray
Each year in the US, some four hundred thousand newborns need help breathing when they are born. Due to the frequent need for resuscitation at birth, it is vital to have evidence-based care guidelines and to provide effective neonatal resuscitation training. Every five years, the International Liaison Committee on Resuscitation (ILCOR) reviews the science of neonatal resuscitation. In the US, the American Heart Association (AHA) develops treatment guidelines based on the ILCOR science review, and the Neonatal Resuscitation Program (NRP) translates the AHA guidelines into an educational curriculum...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28092282/neonatal-palliative-care
#3
Elvira Parravicini
PURPOSE OF REVIEW: A significant number of newborns are affected by life-limiting or life-threatening conditions. When prolongation of survival is no longer a goal, or prognosis is uncertain, a plan of care focused on the infant's comfort is essential. The aim of this article is to review the most recent and relevant literature regarding neonatal palliative care (NPC). RECENT FINDINGS: A variety of perinatal and NPC programs are described, but most programs focus exclusively on end-of-life care...
January 13, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28064098/long-term-follow-up-after-abdominal-cerclage-a-population-based-cohort-study
#4
Kirstine Sneider, Ole Bjarne Christiansen, Iben Blaabjerg Sundtoft, Jens Langhoff-Roos
OBJECTIVE: To study the long-term pregnancy outcomes and complications after application of abdominal cerclage. STUDY DESIGN: Population-based cohort of 255 women with abdominal cerclage in 1999-2012 based on data from the Danish National Patient Register, supplemented and validated by medical records and a questionnaire. Women were categorized by surgical placement of abdominal cerclage via laparotomy or laparoscopy. OUTCOMES: were gestational length and results of subsequent pregnancies as well as perioperative and long-term complications...
January 3, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28041869/-palliative-care-after-neonatal-intensive-care-contributions-of-leonetti-law-and-remaining-challenges
#5
P Kuhn, L Dillenseger, N Cojean, B Escande, C Zores, D Astruc
The 2005 enactment of the "Patients' rights and end-of-life care" act, known as the Leonetti law, has been accompanied by practical changes in the processes of withdrawal and withholding of active life-sustaining treatments. This law has also promoted the implementation of palliative care in perinatal medicine to avoid unreasonable therapeutic interventions and to preserve the dying patient's quality of life and human dignity. Recently, a new law has been voted by the French National Assembly and new reflections on the ethical aspects of the end of life in neonatal medicine should resume again within the French Society of Neonatology in the working group on ethical issues in neonatology...
December 29, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28025333/modulation-of-bilirubin-neurotoxicity-by-the-abcb1-transporter-in-the-ugt1-lethal-mouse-model-of-neonatal-hyperbilirubinemia
#6
Luka Bočkor, Giulia Bortolussi, Simone Vodret, Alessandra Iaconcig, Jana Jašprová, Jaroslav Zelenka, Libor Vitek, Claudio Tiribelli, Andrés F Muro
Moderate neonatal jaundice is the most common clinical condition during newborn life. However, a combination of factors may result in acute hyperbilirubinemia, placing infants at risk of developing bilirubin encephalopathy and death by kernicterus. While most risk factors are known, the mechanisms acting to reduce susceptibility to bilirubin neurotoxicity remain unclear. The presence of modifier genes modulating the risk of developing bilirubin-induced brain damage is increasingly being recognised. The Abcb1 and Abcc1 members of the ABC family of transporters have been suggested to have an active role in exporting unconjugated bilirubin from the central nervous system into plasma...
December 25, 2016: Human Molecular Genetics
https://www.readbyqxmd.com/read/28007511/-neonatal-palliative-care-at-home-contribution-of-the-regional-pediatric-palliative-care-team
#7
N Cojean, C Strub, P Kuhn, L Calvel
The "patients' rights and end-of-life care" act, known as the Leonetti law, has allowed implementation of palliative care in neonatology as an alternative to unreasonable therapeutic interventions. A palliative care project can be offered to newborns suffering from intractable diseases. It must be focused on the newborn's quality of life and comfort and on family support. Palliative care for newborns can be provided in the delivery room, in the neonatal unit, and also at home. Going home is possible but requires medical support...
December 19, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27989403/-speaking-about-life-and-death-in-neonatology-how-can-communication-with-families-be-optimized
#8
T Pennaforte, A Moussa, A Janvier
Technological progress and improved clinical knowledge have increased survival of neonates who would previously have died. Survival is sometimes accompanied by a risk of short- or long-term adverse outcomes, which may lead to complex decisions about withholding or withdrawing life-sustaining interventions. These decisions are among the most difficult decisions in pediatric practice. They also involve communicating with parents and are emotionally charged. Many articles examining end-of-life decisions in neonatology state the need for healthcare providers to be caring, compassionate, and human without offering clear, practical advice...
December 15, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27974340/end-of-life-decisions-for-fragile-neonates-navigating-between-opinion-and-evidence-based-medicine
#9
EDITORIAL
Annie Janvier, Barbara Farlow, Eduard Verhagen, Keith Barrington
No abstract text is available yet for this article.
December 14, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/27965950/preterm-birth-during-influenza-season-is-associated-with-adverse-outcome-in-very-low-birth-weight-infants
#10
Christoph Härtel, Alexander Humberg, Dorothee Viemann, Anja Stein, Thorsten Orlikowsky, Jan Rupp, Matthias V Kopp, Egbert Herting, Wolfgang Göpel
OBJECTIVE: We investigated the relationship between influenza seasonality and outcome of very low birth weight infants (VLBWI) in a large observational cohort study of the German Neonatal Network. MATERIALS AND METHODS: Within the observational period (July 2009 until December 2014), five influenza seasons occurred (mean duration: 97 days, range: 48-131 days). We stratified VLBWI (n = 10,187) according to date of birth into three categories: (1) before influenza season, (2) during influenza season, and (3) 3 months after the end of the respective season...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27941515/parents-and-families-experiences-of-palliative-and-end-of-life-neonatal-care-in-neonatal-settings-a-systematic-review-protocol
#11
Jann Foster, Victoria Kain, Tiffany Patterson
The overall objective of this systematic review is to identify, critically appraise and synthesize the parents' and families' experiences of palliative and end-of-life neonatal care at facilities/services globally. The specific review question is: what are parents' and families' experiences of palliative and end-of-life neonatal care?
November 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/27910138/canine-and-feline-colostrum
#12
S Chastant-Maillard, C Aggouni, A Albaret, A Fournier, H Mila
Puppy and kitten survival over the first weeks is particularly dependent on colostrum, a specific secretion of the mammary gland produced during the first 2 days post-partum. Colostrum is a source of nutrients and immunoglobulins. It also contributes to the digestive tract maturation. Colostrum differentiates from milk mainly based on its concentration in immunoglobulins G: 20-30 g/L in dog colostrum, 40-50 g/L in cats' vs <1 g/L in milk. IgG concentration rapidly drops after parturition (-50% in 24 hr)...
November 30, 2016: Reproduction in Domestic Animals, Zuchthygiene
https://www.readbyqxmd.com/read/27894120/end-of-life-care-and-survival-without-major-brain-damage-in-newborns-at-the-limit-of-viability
#13
Fermín García-Muñoz Rodrigo, Lourdes Urquía Martí, José Ángel García Hernández, Josep Figueras Aloy, Alfredo García-Alix Pérez
BACKGROUND: The probabilities of survival and survival without major brain damage (MBD) are low in newborns at the limit of viability. Survival without MBD constitutes a major concern for parents and professionals. OBJECTIVES: To know the probabilities of survival without MBD in newborns ≤26 weeks' gestational age (GA) relative to the total number of survivors, whether these probabilities vary with GA, and how end-of-life (EoL) decisions influence these results...
November 29, 2016: Neonatology
https://www.readbyqxmd.com/read/27870444/sex-differences-and-estrogen-regulation-of-bdnf-gene-expression-but-not-propeptide-content-in-the-developing-hippocampus
#14
Katherine E Kight, Margaret M McCarthy
Sex differences in adult brain function are frequently determined developmentally through the actions of steroid hormones during sensitive periods of prenatal and early postnatal life. In rodents, various cellular end points of the developing brain are affected by estradiol that is derived from the aromatization of circulating testosterone and/or synthesized within the brain. We have previously described a sex difference in neurogenesis in the hippocampus of neonatal rats that is modulated by estradiol. In this report, we examined a potential downstream regulator of the effects of estradiol on hippocampal cell proliferation by measuring gene expression of brain-derived neurotrophin (BDNF) in male and female neonatal rats in response to estradiol...
January 2, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/27824769/palliative-care-in-obstetrics-and-gynecology
#15
Carolyn Lefkowits, Caroline Solomon
Palliative care is specialized care for people with life-limiting illness; it focuses on symptom management and quality of life and ensures that a patient's care is concordant with her goals and values. Unlike end-of-life care, palliative care can be offered concurrently with disease-directed therapies, including when the goal is cure. Obstetrics and gynecology patients for whom palliative care is most appropriate include women with gynecologic cancer and women with a fetus or neonate with a potentially life-limiting illness...
December 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27793420/measuring-and-communicating-meaningful-outcomes-in-neonatology-a-family-perspective
#16
REVIEW
Annie Janvier, Barbara Farlow, Jason Baardsnes, Rebecca Pearce, Keith J Barrington
Medium- and long-term outcomes have been collected and described among survivors of neonatal intensive care units for decades, for a number of purposes: (1) quality control within units, (2) comparisons of outcomes between NICUs, (3) clinical trials (whether an intervention improves outcomes), (4) end-of-life decision-making, (5) to better understand the effects of neonatal conditions and/or interventions on organs and/or long-term health, and finally (6) to better prepare parents for the future. However, the outcomes evaluated have been selected by investigators, based on feasibility, availability, cost, stability, and on what investigators consider to be important...
December 2016: Seminars in Perinatology
https://www.readbyqxmd.com/read/27779495/exploring-nicu-nurses-affective-responses-to-end-of-life-care
#17
Stephanie Lacefield Lewis
BACKGROUND: The survival rate for infants born with life-threatening problems has improved greatly over the last few decades. Nevertheless, infants still die in neonatal intensive care units (NICUs) every day. Despite existing standards of care, some aspects of end-of-life care (EOLC) are still not delivered consistently. Little is known about how NICU nurses' individual experiences affect EOLC. PURPOSE: The purpose of this study was to explore, through lived and told stories, the affective, interactional, and meaning-related responses that NICU nurses have while caring for dying infants and their families...
October 24, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/27775989/evidence-for-implementation-strategies-to-provide-palliative-care-in-the-neonatal-intensive-care-unit
#18
Megan Quinn, Sheila Gephart
BACKGROUND: Palliative care is a holistic framework that is designed to improve quality of life by identifying and treating distressing symptoms of life-threatening or complex conditions. Neonatal palliative care (NPC) has potential benefits for parents, staff, and patients, yet evidence suggests that implementation and utilization of organized NPC services are low. PURPOSE: The purpose of this study is to answer the clinical question: In neonatal intensive care, what evidence can be used to guide implementation of palliative care protocols? SEARCH STRATEGY: A literature search was conducted using CINAHL (Cumulative Index of Nursing and Allied Health Literature), PubMed, and the Cochrane Library databases...
December 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/27774445/ecls-in-pediatric-cardiac-patients
#19
Matteo Di Nardo, Graeme MacLaren, Marco Marano, Corrado Cecchetti, Paola Bernaschi, Antonio Amodeo
Extracorporeal life support (ECLS) is an important device in the management of children with severe refractory cardiac and or pulmonary failure. Actually, two forms of ECLS are available for neonates and children: extracorporeal membrane oxygenation (ECMO) and use of a ventricular assist device (VAD). Both these techniques have their own advantages and disadvantages. The intra-aortic balloon pump is another ECLS device that has been successfully used in larger children, adolescents, and adults, but has found limited applicability in smaller children...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27733523/perinatal-dietary-choline-deficiency-in-sows-influences-concentrations-of-choline-metabolites-fatty-acids-and-amino-acids-in-milk-throughout-lactation
#20
Austin T Mudd, Lindsey S Alexander, Stacey K Johnson, Caitlyn M Getty, Olga V Malysheva, Marie A Caudill, Ryan N Dilger
BACKGROUND: Choline is essential for synthesis of phospholipids, neurodevelopment, and DNA methylation. It is unknown whether dietary perinatal choline deficiency affects maternal milk composition. OBJECTIVE: We examined whether perinatal maternal dietary choline deficiency influences porcine-milk composition. METHODS: Yorkshire sows were fed choline-deficient (CD) or choline-sufficient (CS) gestation diets [544 or 1887 mg choline/kg dry matter (DM), respectively] from 65 d before to 48 h after parturition and then fed lactation diets (517 or 1591 mg choline/kg DM, respectively) through day 19 of lactation...
October 12, 2016: Journal of Nutrition
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