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Neonatal rct

Kenji Yamada, Takeshi Taketani
Mitochondrial fatty acid oxidation disorders (FAODs) are caused by defects in β-oxidation enzymes, including very long-chain acyl-CoA dehydrogenase (VLCAD), trifunctional protein (TFP), carnitine palmitoyltransferase-2 (CPT2), carnitine-acylcarnitine translocase (CACT) and others. During prolonged fasting, infection, or exercise, patients with FAODs present with hypoglycemia, rhabdomyolysis, cardiomyopathy, liver dysfunction, and occasionally sudden death. This article describes the diagnosis, newborn screening, and treatment of long-chain FAODs with a focus on VLCAD deficiency...
November 6, 2018: Journal of Human Genetics
Li Lin, Yuchun Zhu, Boya Li, Huixia Yang
BACKGROUND: Low-dose aspirin (LDA) has been proposed as a safe and inexpensive prophylactic agent. Studies in European/Western populations have shown promising results indicating that LDA can reduce the occurrence of pre-eclampsia (PE) in women with identifiable risk factors. However, few controlled trials, particularly large randomized controlled trials, have been performed in Asian populations. The aim of this project is to evaluate the effect of LDA for PE prevention on high-risk pregnant women in China, where PE is highly prevalent and the LDA supply status is commonly suboptimal...
November 6, 2018: Trials
Olaide Ashimi Balogun, Baha M Sibai, Claudia Pedroza, Sean C Blackwell, Tyisha L Barrett, Suneet P Chauhan
OBJECTIVE: To evaluate whether serial ultrasound examinations in the third trimester increase identification of a composite of growth or amniotic fluid abnormalities when compared with routine care among pregnancies that are uncomplicated between 24 0/7 and 30 6/7 weeks of gestation. METHODS: Women without complications between 24 0/7 and 30 6/7 weeks of gestation were randomized (NCT0270299) to either routine care (control arm) or ultrasound examination every 4 weeks (intervention arm)...
November 5, 2018: Obstetrics and Gynecology
L Emery, E Hamm, K Hague, O Chorna, M Moore-Clingenpeel, N L Maitre
AIM: To compare the effectiveness of an intensive-intermittent vs. standard spaced protocolized music therapy intervention on supporting developmental milestone acquisition of infants >44 weeks post-menstrual age (PMA) hospitalized in a Neonatal Intensive Care Unit (NICU). METHOD: This was a comparative effectiveness study of infants 44-66 weeks PMA with a projected NICU stay of at least one month from recruitment. Infants were randomized to one of two treatment groups: traditional therapy (2x/week) and intermittent-intensive (4x/week, off, 4x/week, off)...
October 30, 2018: Acta Paediatrica
Baby S Nayak, Leslie Edward Lewis, Binu Margaret, Ramesh Bhat Y, Joslin D'Almeida, Tenzin Phagdol
AIM: To describe a randomized controlled trial protocol designed to evaluate the effectiveness of mobile health based Preterm Home Care Program (mHealthPHCP) known as "NeoRaksha" mobile health application in improving parent-infant-interaction, growth and development of preterms. DESIGN: A prospective, randomized controlled clinical trial. The protocol is approved and funded by Department of Biotechnology, Government of India on 2 August 2016. METHODS: A total of 300 preterm-mother dyads admitted to neonatal intensive care unit of a tertiary care hospital will be recruited and randomized to intervention and control group...
October 29, 2018: Journal of Advanced Nursing
Ronald I Clyman, Melissa Liebowitz, Joseph Kaempf, Omer Erdeve, Ali Bulbul, Stellan Håkansson, Johanna Lindqvist, Aijaz Farooqi, Anup Katheria, Jason Sauberan, Jaideep Singh, Kelly Nelson, Andrea Wickremasinghe, Lawrence Dong, Denise C Hassinger, Susan W Aucott, Madoka Hayashi, Anne Marie Heuchan, William A Carey, Matthew Derrick, Erika Fernandez, Meera Sankar, Tina Leone, Jorge Perez, Arturo Serize
OBJECTIVE: To compare early routine pharmacologic treatment of moderate-to-large patent ductus arteriosus (PDA) at the end of week 1 with a conservative approach that requires prespecified respiratory and hemodynamic criteria before treatment can be given. STUDY DESIGN: A total of 202 neonates of <28 weeks of gestation age (mean, 25.8 ± 1.1 weeks) with moderate-to-large PDA shunts were enrolled between age 6 and 14 days (mean, 8.1 ± 2.2 days) into an exploratory randomized controlled trial...
October 16, 2018: Journal of Pediatrics
Clément Chollat, Stéphane Marret
Antenatal administration of magnesium sulfate is an important part of the neuroprotective strategy for preterm infants. Strong evidence from five randomized controlled trials and five meta-analyses has demonstrated that magnesium sulfate, when administered before preterm delivery, significantly reduces the risk of cerebral palsy at two years. Through secondary analyses of randomized controlled trials and other original clinical studies, this state-of-the-art review highlights the absence of serious adverse effects in both pregnant women and neonates, as well as the impact of maternal body mass index and preeclamptic status on the maternal and neonatal magnesium levels, which could influence the magnitude of the neuroprotective effect...
December 2018: Neural Regeneration Research
Stefan Pilz, Armin Zittermann, Rima Obeid, Andreas Hahn, Pawel Pludowski, Christian Trummer, Elisabeth Lerchbaum, Faustino R Pérez-López, Spyridon N Karras, Winfried März
Vitamin D deficiency is common and there exists a huge gap between recommended dietary vitamin D intakes and the poor vitamin D supply in the general population. While vitamin D is important for musculoskeletal health, there are accumulating data suggesting that vitamin D may also be important for fertility, pregnancy outcomes and lactation. Significant changes in vitamin D metabolism during pregnancy such as increased production of the "active vitamin D hormone" calcitriol support the important role of vitamin D in this setting...
October 12, 2018: International Journal of Environmental Research and Public Health
Aakash Pandita, Astha Panghal, Girish Gupta, Anup Verma, Anish Pillai, Anita Singh, Kirti Naranje
BACKGROUND: Childhood vaccination is a common procedure and a part of routine medical care during infancy. Although vaccination is the cornerstone for prevention of many infectious diseases, it is associated with significant pain, which is often ignored. Non pharmacological interventions such as breast feeding and kangaroo mother care (KMC) have been used to decrease this procedural pain. However there is paucity of published data on effective use of KMC in term neonates and infants beyond the neonatal age...
October 12, 2018: Early Human Development
Dragan Soldo, Mikulić-Kajić Matija, Spalldi Barišić Lara, Penava Nikolina, Orlović Martina, Soldo Neven, Kajić Martin
Background The objective of the study was to compare the effect of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) dietary supplementation on their concentration in total lipids (TL) and lipid fractions of maternal and umbilical vein (UV) blood. The specific objective was to analyze the impact of EPA and DHA supplementation on pregnancy outcome and neonatal birth weight. Methods Women were randomly single-blinded (randomized controlled trial; ISRCTN36705743) allocated to the group receiving EPA and DHA supplementation (supplemented group) or the group receiving placebo-corn oil (control group) in the time period from January 1st, 2016 until March 1st, 2017...
October 13, 2018: Journal of Perinatal Medicine
Yi-Ran Liu, Cai-Xiu Pu, Xiao-Yan Wang, Xue-Yan Wang
OBJECTIVE: To assess the efficacy and safety of a double-balloon catheter versus dinoprostone insert for labour induction. STUDY DESIGN: PubMed, MEDLINE, Embase,, and the Cochrane Central Register of Clinical Trials databases were searched from 1985 to April 2018. Randomized controlled trials that compared a double-balloon catheter and dinoprostone insert for cervical ripening were identified. Eligible study populations consisted of women with singleton pregnancies that had any indication for labour induction and were randomly assigned to undergo induction with a double-balloon catheter or dinoprostone insert...
October 12, 2018: Archives of Gynecology and Obstetrics
Giulia M Benedetti Md, Faye S Silverstein Md
Targeted temperature management encompasses a range of clinical interventions to regulate systemic temperature, and includes both induction of varying degrees of hypothermia and fever prevention ("targeted normothermia"). Targeted temperature management plays a key role in the contemporary management of critically ill neonates and children with acute brain injury. Yet, many unanswered questions remain regarding optimal temperature management in pediatric neurocritical care. The introduction highlights experimental studies that have evaluated the neuroprotective efficacy of therapeutic hypothermia and explored possible mechanisms of action in several brain injury models...
July 21, 2018: Pediatric Neurology
Eva Rydahl, Lena Eriksen, Mette Juhl
OBJECTIVE: The objective of this review was to identify, assess and synthesize the best available evidence on the effects of induction prior to post-term on the mother and fetus. Maternal and fetal outcomes after routine labor induction in low-risk pregnancies at 41+0 to 41+6 gestational weeks (prior to post-term) were compared to routine labor induction at 42+0 to 42+6 gestational weeks (post-term). INTRODUCTION: Induction of labor when a pregnancy exceeds 14 days past the estimated due date has long been used as an intervention to prevent adverse fetal and maternal outcomes...
October 5, 2018: JBI Database of Systematic Reviews and Implementation Reports
David M Haas, Taylor J Hathaway, Patrick S Ramsey
BACKGROUND: Progesterone, a female sex hormone, is known to induce secretory changes in the lining of the uterus essential for successful implantation of a fertilized egg. It has been suggested that a causative factor in many cases of miscarriage may be inadequate secretion of progesterone. Therefore, clinicians use progestogens (drugs that interact with the progesterone receptors), beginning in the first trimester of pregnancy, in an attempt to prevent spontaneous miscarriage. This is an update of a review, last published in 2013...
October 8, 2018: Cochrane Database of Systematic Reviews
Alexandros Sotiradis, Stamatios Petousis, Basky Thilaganathan, Francesc Figueras, Wellington P Martins, Anthony O Odibo, Konstantinos Dinas, Jon Hyett
OBJECTIVE: The rate of maternal and perinatal complications increases after 39 weeks in both unselected and complicated pregnancies. The aim of this study was to synthesize quantitatively the evidence on the effect of elective induction of labor at term on the risk of Cesarean section, and maternal and perinatal outcome. METHODS: We searched PubMed, US Registry of Clinical Trials, SCOPUS and CENTRAL databases from inception to August 2018. We additionally searched the references of retrieved articles...
October 8, 2018: Ultrasound in Obstetrics & Gynecology
Lekha M Rao, Shaun A Hussain, Timothy Zaki, Alexander Cho, Teresa Chanlaw, Meena Garg, Raman Sankar
PURPOSE: Seizures are common in term infants with hypoxic-ischemic encephalopathy (HIE) undergoing therapeutic hypothermia. Although phenobarbital (PHB) is generally considered first-line therapy, some centers have embraced third-generation antiepileptic drugs (AEDs) such as levetiracetam (LEV) given the impression of comparable efficacy and superior tolerability. We set out to compare the efficacy of PHB and LEV in a large single-center cohort. METHODS: We retrospectively identified consecutive newborns with HIE who were monitored with continuous video-electroencephalogram (VEEG) for the duration of therapeutic hypothermia...
October 5, 2018: Epilepsy & Behavior: E&B
Maziar Gholampour Dehaki, Sana Niknam, Rasoul Azarfarin, Hooman Bakhshandeh, Mohammad Mahdavi
Blood priming is needed for cardiopulmonary bypass (CPB) in neonates and infants to avoid exceeding hemodilution; however, transfusion-related inflammation affects post-CPB outcomes in infant open-heart surgery. Procalcitonin, a newly detected inflammatory moderator and a sensitive parameter for predicting pulmonary dysfunction secondary to CPB, rises after CPB. We hypothesized that the hemofiltration of priming blood before CPB might decrease inflammatory mediators in the blood and post-CPB inflammatory replications, thereby improving the respiratory function after CPB in infants...
October 5, 2018: Artificial Organs
Beatrice Beebe, Michael M Myers, Sang Han Lee, Adrianne Lange, Julie Ewing, Nataliya Rubinchik, Howard Andrews, Judy Austin, Amie Hane, Amy E Margolis, Myron Hofer, Robert J Ludwig, Martha G Welch
Although preterm infants are at risk for social deficits, interventions to improve mother-infant interaction in the neonatal intensive care unit (NICU) are not part of standard care (SC). Study participants were a subset from a randomized controlled trial of a new intervention for premature infants, the Family Nurture Intervention (FNI), designed to help mothers and infants establish an emotional connection. At infants' 4 months corrected age, mother-infant face-to-face interaction was filmed and coded on a 1-s time base for mother touch, infant vocal affect, mother gaze, and infant gaze...
November 2018: Developmental Psychology
Sharon L Hillier, Patricia Ferrieri, Morven S Edwards, Marian Ewell, Daron Ferris, Paul Fine, Vincent Carey, Leslie Meyn, Dakota Hoagland, Dennis L Kasper, Lawrence C Paoletti, Heather Hill, Carol J Baker
Background: Group B Streptococcus (GBS) frequently colonizes pregnant women and can cause sepsis and meningitis in young infants. If colonization was prevented through maternal immunization, a reduction in perinatal GBS disease might be possible. A GBS type III capsular polysaccharide (CPS)-tetanus toxoid conjugate (III-TT) vaccine was evaluated for safety and efficacy in preventing acquisition of GBS colonization. Methods: Healthy, age 18-40 years, non-pregnant women, screened to be GBS III vaginal and rectal culture negative, were randomized to receive III-TT conjugate or tetanus diphtheria toxoid (Td) vaccine in a multicenter, observer blinded trial...
October 3, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Amanda Skoll, Amélie Boutin, Emmanuel Bujold, Jason Burrows, Joan Crane, Michael Geary, Venu Jain, Thierry Lacaze-Masmonteil, Jessica Liauw, William Mundle, Kellie Murphy, Suzanne Wong, K S Joseph
OBJECTIVE: To assess the benefits and risks of antenatal corticosteroid therapy for women at risk of preterm birth or undergoing pre-labour Caesarean section at term and to make recommendations for improving neonatal and long-term outcomes. OPTIONS: To administer or withhold antenatal corticosteroid therapy for women at high risk of preterm birth or women undergoing pre-labour Caesarean section at term. OUTCOMES: Perinatal morbidity, including respiratory distress syndrome, intraventricular hemorrhage, bronchopulmonary dysplasia, infection, hypoglycemia, somatic and brain growth, and neurodevelopment; perinatal mortality; and maternal morbidity, including infection and adrenal suppression...
September 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
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