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Neonatal rct

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https://www.readbyqxmd.com/read/30015674/gastric-residual-volumes-versus-abdominal-girth-measurement-in-assessment-of-feed-tolerance-in-preterm-neonates-a-randomized-controlled-trial
#1
Shemi Thomas, Saudamini Nesargi, Preena Roshan, Renjita Raju, Shiny Mathew, Sheeja P, Suman Rao
BACKGROUND: Preterm neonates often have feed intolerance that needs to be differentiated from necrotizing enterocolitis. Gastric residual volumes (GRV) are used to assess feed tolerance but with little scientific basis. PURPOSE: To compare prefeed aspiration for GRV and prefeed measurement of abdominal girth (AG) in the time taken to reach full feeds in preterm infants. METHODS: This was a randomized controlled trial. Infants with a gestational age of 27 to 37 weeks and birth weight of 750 to 2000 g, who required gavage feeds for at least 48 hours, were included...
August 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/30010835/a-web-based-dietary-intervention-in-early-pregnancy-and-neonatal-outcomes-a-randomized-controlled-trial
#2
R A K Kennedy, C M E Reynolds, S Cawley, E O'Malley, D M McCartney, M J Turner
Background: Maternal nutrition is a determinant of pregnancy outcomes. Few studies have evaluated the potential of online nutrition resources to modify behaviour. This randomized controlled trial aimed to determine whether access to a customized evidence-based nutrition website in pregnancy improved neonatal outcomes. Methods: Women <18 weeks gestation were recruited at their convenience. The control group received standard care. In addition to standard care, the intervention group received access to an evidence-based nutrition website, customized to the preferences of pregnant women...
July 13, 2018: Journal of Public Health
https://www.readbyqxmd.com/read/29997896/revert-to-the-original-time-to-re-establish-delayed-umbilical-cord-clamping-as-the-standard-approach-for-preterm-neonates
#3
EDITORIAL
Ryan M McAdams, Carl H Backes, Omid Fathi, David J R Hutchon
Delayed cord clamping, the common term used to denote placental-to-newborn transfusion at birth, is a practice now endorsed by the major governing bodies affiliated with maternal-newborn care. Despite considerable evidence, delayed cord clamping, not early cord clamping, continues to be viewed as the "experimental" intervention category when discussed in research studies. We provide a brief overview of placental-to-newborn transfusion in relation to birth transitional physiology and discuss areas where we may need to modify our interpretation of "normal" vital signs and laboratory values as delayed cord clamping becomes standardized...
2018: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/29989619/clinical-inquiries-what-are-the-benefits-risks-of-giving-betamethasone-to-women-at-risk-of-late-preterm-labor
#4
Lee Dresang, Christopher Hooper-Lane
Giving betamethasone to women at risk for delivery between 34 weeks 0 days and 36 weeks 6 days can lower by almost 40% the incidence of transient tachypnea of the newborn, severe respiratory distress syndrome, and the use of surfactant (strength of recommendation [SOR]: A, systematic review of randomized controlled trials [RCTs]). Betamethasone may increase neonatal hypoglycemia, but the hypoglycemia isn't associated with a prolonged hospital stay or other negative outcomes.
July 2018: Journal of Family Practice
https://www.readbyqxmd.com/read/29985874/erythromycin-and-reflux-events-in-premature-neonates-a-randomized-clinical-trial
#5
Cortney R Ballengee, Faranek Davalian, Mark R Conaway, Cary G Sauer, David A Kaufman
OBJECTIVE: Gastroesophageal reflux disease (GERD) in premature neonates may manifest as apnea, bradycardia, growth failure, aspiration or feeding intolerance. Erythromycin ethylsuccinate (EES), is often used as a pro-kinetic in the management of GERD, despite lack of evidence or safety from randomized controlled trials. We sought to study the efficacy of enteral EES at a dose of 50 mg/kg/day in decreasing the frequency of GER events as determined by pH-multichannel intraluminal impedance (pH-MII) monitoring...
July 6, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29981817/umbilical-cord-milking-in-preterm-neonates-requiring-resuscitation-a-randomized-controlled-trial
#6
G Ram Mohan, A Shashidhar, B S Chandrakala, Saudamini Nesargi, P N Suman Rao
OBJECTIVE: To evaluate the effect of cord milking on short term morbidity and hematologic parameters at 6 weeks in preterm neonates requiring resuscitation. METHODS: This trial randomized preterm infants requiring resuscitation to milking group and no milking group. Multiple pregnancy, Rh negative mothers, hydrops, cord abnormalities were excluded. The primary outcome was hemoglobin and serum ferritin at 6 weeks of life. Secondary outcomes were common preterm morbidities and mortality RESULTS: 60 neonates were included in the study...
July 5, 2018: Resuscitation
https://www.readbyqxmd.com/read/29973212/efficacy-of-two-artemisinin-based-combinations-for-the-treatment-of-malaria-in-pregnancy-in-india-a-randomized-controlled-trial
#7
Anupkumar R Anvikar, Irene Kuepfer, Vinitkumar Mishra, Jane Bruce, Tushar Arya, Deb Ranjan Mishra, Sanjib Mohanty, Rajesh Mohanty, Bina Srivastava, Suryakant Sharma, Neelima Mishra, Brian Greenwood, Daniel Chandramohan, Neena Valecha
BACKGROUND: In India, the recommended first-line treatment for malaria in the second and third trimester of pregnancy is artesunate + sulfadoxine-pyrimethamine (AS+SP). However, data on safety and efficacy of artemisinin-based combination therapy (ACT) in pregnancy is limited. This study assessed the safety and efficacy of AS+SP and artesunate + mefloquine (AS+MQ) for treatment of Plasmodium falciparum in pregnancy in India. METHODS: This open-label, randomized clinical trial was conducted from October 2010 to December 2013 at three sites in India (Ranchi and Jamshedpur in Jharkhand state, and Rourkela in Odisha state)...
July 4, 2018: Malaria Journal
https://www.readbyqxmd.com/read/29965778/application-of-metabolomics-to-preeclampsia-diagnosis
#8
B Fatemeh Nobakht M Gh
Preeclampsia is a multifactorial disorder defined by hypertension and increased urinary protein excretion during pregnancy. It is a significant cause of maternal and neonatal deaths worldwide. Despite various research efforts to clarify pathogenies of preeclampsia and predict this disease before beginning of symptoms, the pathogenesis of preeclampsia is unclear. Early prediction and diagnosis of women at risk of preeclampsia has not markedly improved. Therefore, the objective of this study was to perform a review on metabolomic articles assessing predictive and diagnostic biomarkers of preeclampsia...
July 2, 2018: Systems Biology in Reproductive Medicine
https://www.readbyqxmd.com/read/29960105/efficacy-of-facilitated-tucking-combined-with-non-nutritive-sucking-on-very-preterm-infants-pain-during-the-heel-stick-procedure-a-randomized-controlled-trial
#9
Anne Perroteau, Marie-Christine Nanquette, Alexandra Rousseau, Sylvain Renolleau, Laurence Bérard, Delphine Mitanchez, Judith Leblanc
BACKGROUND: Reducing acute pain in premature infants during neonatal care improves their neurophysiological development. The use of pharmacological and non-pharmacological analgesia, such as sucrose, is limited per day, particularly for very preterm infants. Thus, the usual practice of non-nutritive sucking is often used alone. Facilitated tucking could be an additional strategy to non-nutritive sucking for reducing pain. To the best of our knowledge, no randomized trial has compared the combination of facilitated tucking and non-nutritive sucking to non-nutritive sucking alone...
June 15, 2018: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29957125/role-of-androgens-in-energy-metabolism-affecting-on-body-composition-metabolic-syndrome-type-2-diabetes-cardiovascular-disease-and-longevity-lessons-from-a-meta-analysis-and-rodent-studies
#10
Naoki Harada
Testosterone is a sex hormone produced by testicular Leydig cells in males. Blood testosterone concentrations increase at three time-periods in male life-fetal, neonatal (which can be separated into newborn and infant periods), and pubertal stages. After peaking in the early 20s, the blood bioactive testosterone level declines by 1-2% each year. It is increasingly apparent that a low testosterone level impairs general physical and mental health in men. Here, this review summarizes recent systematic reviews and meta-analyses of epidemiological studies in males (including cross-sectional, longitudinal, and androgen deprivation studies, and randomized controlled testosterone replacement trials) in relation to testosterone and obesity,  body composition, metabolic syndrome, type 2 diabetes, cardiovascular disease, and longevity...
June 29, 2018: Bioscience, Biotechnology, and Biochemistry
https://www.readbyqxmd.com/read/29942340/metformin-in-the-management-of-diabetes-during-pregnancy-and-lactation
#11
REVIEW
Gagan Priya, Sanjay Kalra
This review explores the current place of metformin in the management of gestational diabetes (GDM) and type 2 diabetes during pregnancy and lactation. The rationale and basic pharmacology of metformin usage in pregnancy is discussed along with the evidence from observational and randomized controlled trials in women with GDM or overt diabetes. There seems to be adequate evidence of efficacy and short-term safety of metformin in relation to maternal and neonatal outcomes in GDM, with possible benefits related to lower maternal weight gain and lower risk of neonatal hypoglycemia and macrosomia...
2018: Drugs in Context
https://www.readbyqxmd.com/read/29941233/intravenous-fish-oil-containing-lipid-emulsion-attenuates-inflammatory-cytokines-and-the-development-of-bronchopulmonary-dysplasia-in-very-premature-infants-a-double-blind-randomized-controlled-trial
#12
Chien-Chou Hsiao, Hung-Chih Lin, Yu-Jun Chang, Shih-Pan Yang, Lon-Yen Tsao, Cheng-Han Lee, Hsiao-Neng Chen, Jia-Yuh Chen, Yi-Giien Tsai
BACKGROUND & AIMS: Preterm infants have lower levels of long-chain polyunsaturated fatty acids (LCPUFAs). Supplementing very premature infants with intravenous lipid emulsions that fish oil, which is rich in n-3 LC-PUFAs, may decrease bronchopulmonary dysplasia (BPD) by modulating inflammation and neonatal immune function. METHODS: Sixty very low birth weight (VLBW) premature infants requiring ventilator support were randomized in a double-blind manner to 2 groups and received total parenteral nutrition with fish oil containing LE (intervention group, n = 30) or soybean oil containing LE (control group, n = 30) for 7 days...
June 18, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29940953/study-protocol-of-a-cluster-randomized-controlled-trial-to-evaluate-effectiveness-of-a-system-for-maintaining-high-quality-early-essential-newborn-care-in-lao-pdr
#13
Sayaka Horiuchi, Sommana Rattana, Bounnack Saysanasongkham, Outhevanh Kounnavongsa, Shogo Kubota, Julie Cayrol, Kenzo Takahashi, Mariko Inoue, Asuka Nemoto, Kazue Yamaoka
BACKGROUND: Reduction in neonatal deaths has been a major challenge globally. To prevent neonatal deaths, improvements in newborn care have been promoted worldwide. The World Health Organization Western Pacific Regional Office has been promoting the Early Essential Newborn Care (EENC), a package of specific simple and cost-effective interventions, in their region. However, mere introduction of EENC cannot reduce neonatal deaths unless quality of care is ensured. In Lao PDR, the government introduced self-managed continuous monitoring as a sustainable way to improve the quality of care described in the EENC...
June 25, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29938227/pulse-oximetry-targets-in-extremely-premature-infants-and-associated-mortality-one-size-may-not-fit-all
#14
Thomas M Raffay, Michele C Walsh
Oxygen saturation targets in premature infants have been investigated in multiple international randomized controlled trials. Some trials have shown increased mortality with targeting lower (85% to 89%) compared to higher (91% to 95%) oxygen saturation ranges, while others have not. We will review the mortality outcomes of the largest multi-centered trials and a post hoc study that observed increased mortality at lower target ranges among small for gestational age infants. The planned Neonatal Oxygen Prospective Meta-analysis (NeOProM) collaborative will hopefully provide further insight into patient-specific risks, which include growth status...
2018: Journal of Nature and Science
https://www.readbyqxmd.com/read/29936590/epinephrine-versus-dopamine-in-neonatal-septic-shock-a-double-blind-randomized-controlled-trial
#15
Kishore Baske, Shiv Sajan Saini, Sourabh Dutta, Venkataseshan Sundaram
We compared epinephrine and dopamine as a first-line vasoactive drug in 40 neonates (enrolled in two gestational age strata ≤ 306/7 and ≥ 310/7  weeks) with fluid-refractory septic shock. Epinephrine or dopamine was initiated at 0.2 or 10 μg/kg/min, respectively. If shock persisted after 15 min, epinephrine or dopamine was increased to 0.3 or 15 μg/kg/min, respectively (16-30 min), and thereafter to 0.4 or 20 μg/kg/min (31-45 min). Proportion of neonates achieving 'reversal of shock' (defined as systolic and diastolic BP > fifth centile and capillary filling time < 3 s and left ventricular output ≥ 150 mL/kg/min) by 45 min [5 (25%) vs 6 (30%), RR 0...
June 23, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29934478/gestational-diabetes-mellitus-and-diet-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials-examining-the-impact-of-modified-dietary-interventions-on-maternal-glucose-control-and-neonatal-birth-weight
#16
REVIEW
Jennifer M Yamamoto, Joanne E Kellett, Montserrat Balsells, Apolonia García-Patterson, Eran Hadar, Ivan Solà, Ignasi Gich, Eline M van der Beek, Eurídice Castañeda-Gutiérrez, Seppo Heinonen, Moshe Hod, Kirsi Laitinen, Sjurdur F Olsen, Lucilla Poston, Ricardo Rueda, Petra Rust, Lilou van Lieshout, Bettina Schelkle, Helen R Murphy, Rosa Corcoy
OBJECTIVE: Medical nutrition therapy is a mainstay of gestational diabetes mellitus (GDM) treatment. However, data are limited regarding the optimal diet for achieving euglycemia and improved perinatal outcomes. This study aims to investigate whether modified dietary interventions are associated with improved glycemia and/or improved birth weight outcomes in women with GDM when compared with control dietary interventions. RESEARCH DESIGN AND METHODS: Data from published randomized controlled trials that reported on dietary components, maternal glycemia, and birth weight were gathered from 12 databases...
July 2018: Diabetes Care
https://www.readbyqxmd.com/read/29932814/infant-cortisol-stress-response-is-associated-with-thymic-function-and-vaccine-response
#17
M Nazmul Huda, Shaikh M Ahmad, Md Jahangir Alam, Afsana Khanam, Md Nure Alam Afsar, Yukiko Wagatsuma, Rubhana Raqib, Charles B Stephensen, Kevin D Laugero
Stress can impair T cell-mediated immunity. To determine if infants with high stress responses had deficits in T-cell mediated immunity, we examined the association of pain-induced cortisol responsiveness with thymic function and vaccine responses in infants. This study was performed among 306 (male = 153 and female = 153) participants of a randomized, controlled trial examining the effect of neonatal vitamin A supplementation on immune function in Bangladesh (NCT01583972). Salivary cortisol was measured before and 20 min after a needle stick (vaccination) at 6 weeks of age...
June 22, 2018: Stress: the International Journal on the Biology of Stress
https://www.readbyqxmd.com/read/29931679/protein-supplementation-of-human-milk-for-promoting-growth-in-preterm-infants
#18
REVIEW
Emma A Amissah, Julie Brown, Jane E Harding
BACKGROUND: Preterm infants require high protein intake to achieve adequate growth and development. Although breast milk feeding has many benefits for this population, the protein content is highly variable, and inadequate to support rapid infant growth. This is a 2018 update of a Cochrane Review first published in 1999. OBJECTIVES: To determine whether protein-supplemented human milk compared with unsupplemented human milk, fed to preterm infants, improves growth, body composition, cardio-metabolic, and neurodevelopmental outcomes, without significant adverse effects...
June 22, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29927746/ameliorative-potential-of-acupressure-on-gestational-diabetes-mellitus-a-randomized-controlled-trial
#19
Fayiz F El-Shamy, Sanad S El-Kholy, Mahmoud Labib, Ahmed M Kabel
Background and aim Gestational diabetes mellitus (GDM) poses a threat to the mother and child. The aim of this study was to examine the effect of acupressure on the glycemic control and insulin requirement of GDM females. Materials and methods Thirty GDM female patients were randomized to either the study group (SG; n=15), which was treated with acupressure and the standard antenatal care, or the control group (CG; n=15), which was treated with the standard antenatal care. Fasting and 2-h post-prandial blood glucose levels, requirement for insulin and insulin resistance were measured at 24 and 36 weeks' gestation (WG)...
June 21, 2018: Journal of Complementary & Integrative Medicine
https://www.readbyqxmd.com/read/29924388/fat-supplementation-of-human-milk-for-promoting-growth-in-preterm-infants
#20
REVIEW
Emma A Amissah, Julie Brown, Jane E Harding
BACKGROUND: As preterm infants do not experience the nutrient accretion and rapid growth phase of the third trimester of pregnancy, they are vulnerable to postnatal nutritional deficits, including of fat. Consequently, they require higher fat intakes compared to their full term counterparts to achieve adequate growth and development. Human milk fat provides the major energy needs of the preterm infant and also contributes to several metabolic and physiological functions. Although human milk has many benefits for this population, its fat content is highly variable and may be inadequate for their optimum growth and development...
June 19, 2018: Cochrane Database of Systematic Reviews
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