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https://www.readbyqxmd.com/read/28723921/postnatal-dexamethasone-respiratory-and-neurodevelopmental-outcomes-at-two-years-in-babies-born-extremely-preterm
#1
Gordon Qin, Jessica W Lo, Neil Marlow, Sandy A Calvert, Anne Greenough, Janet L Peacock
IMPORTANCE: Postnatal dexamethasone is associated with reduction in bronchopulmonary dysplasia. There remains, however, concern that its short-term benefits are accompanied by long-term adverse effects e.g. poorer neurodevelopmental outcomes. OBJECTIVE: Our aim was to determine the effects of administration of postnatal dexamethasone on respiratory and neurodevelopmental outcome at two years of age after adjusting for neonatal and infant risk factors. MATERIALS AND METHODS: The study included 412 infants born at 23-28 weeks of gestation, 29% had received postnatal dexamethasone...
2017: PloS One
https://www.readbyqxmd.com/read/28723887/in-vitro-and-in-vivo-characterization-of-poractant-alfa-supplemented-with-budesonide-for-safe-and-effective-intratracheal-administration
#2
Francesca Ricci, Chiara Catozzi, Francesca Ravanetti, Xabier Murgia, Francesco D'Aló, Natalia Macchidani, Elisa Sgarbi, Valentina Di Lallo, Federica Saccani, Marisa Pertile, Antonio Cacchioli, Silvia Catinella, Gino Villetti, Maurizio Civelli, Francesco Amadei, Franco Stellari Fabio, Barbara Pioselli, Fabrizio Salomone
BACKGROUND: The intratracheal (IT) administration of budesonide using surfactant as a vehicle has been shown to reduce the incidence of bronchopulmonary dysplasia (BPD) in preterm infants. OBJECTIVE: To characterize the in vitro characteristics and in vivo safety and efficacy of the extemporaneous combination of budesonide and poractant alfa. METHODS: The stability, minimum surface tension, and viscosity of the preparation were evaluated by means of HPLC, Wilhelmy balance, and Rheometer, respectively...
July 19, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28723885/term-versus-preterm-cord-blood-cells-for-the-prevention-of-preterm-brain-injury
#3
Jingang Li, Tamara Yawno, Amy Sutherland, Jan Loose, Ilias Nitsos, Beth J Allison, Robert Bischof, Courtney A McDonald, Graham Jenkin, Suzanne L Miller
BACKGROUND: White matter brain injury in preterm infants can induce neurodevelopmental deficits. Umbilical cord blood (UCB) cells demonstrate neuroprotective properties, but it is unknown whether cells obtained from preterm versus term cord blood have similar efficacy. This study compared the ability of term cord blood (TCB) versus preterm cord blood (PCB) cells to reduce white matter injury in preterm fetal sheep. METHODS: Hypoxia-ischemia (HI) was induced in fetal sheep (0...
July 19, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28720571/the-integrated-stress-response-in-hypoxia-induced-diffuse-white-matter-injury
#4
Benjamin Ll Clayton, Aaron Huang, Rejani B Kunjamma, Ani Solanki, Brian Popko
Currently no treatments exist for preterm infants with diffuse white matter injury (DWMI) caused by hypoxia. Due to improved care of preterm neonates and increased recognition by advanced imaging techniques, the prevalence of DWMI is increasing. A better understanding of the pathophysiology of DWMI is therefore of critical importance. The integrated stress response (ISR), a conserved eukaryotic response to myriad stressors including hypoxia, may play a role in hypoxia-induced DWMI and may represent a novel target for much needed therapies...
July 18, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28720399/prenatal-and-postnatal-administration-of-prebiotics-and-probiotics
#5
REVIEW
Kristin Sohn, Mark A Underwood
Colonization of the neonatal gut by beneficial bacteria is important for the establishment and maintenance of the mucosal barrier, thus protecting the neonate from enteric pathogens and local and systemic inflammation. The neonatal microbiome is influenced by infant diet, environment, and the maternal microbiome. Dysbiosis in pregnancy increases the risk of pre-eclampsia, diabetes, infection, preterm labor, and later childhood atopy. Dysbiosis of the neonatal gut plays an important role in colic in the term infant, in the disease processes which plague preterm infants, including necrotizing enterocolitis and sepsis, and in the long-term outcomes of neonates...
July 15, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28720035/home-visiting-and-the-health-of-preterm-infants
#6
Patrick H Casey, Carmen Irby, Sandra Withers, Susan Dorsey, Jingyun Li, Malik Rettiganti
The results of home visiting programs which target medically fragile low-birth-weight preterm infants (LBWPT) have been inconsistent. We provided nurse/social worker home visits to families of LBWPT infants on a regular schedule. Teams were trained in approaches to improve the health and development of the infants. The completion of immunization series was sigmificantly higher and the infant mortality rates of the home visits childen were significanly lower compared to national and state rates. We used state Medicaid data and examined frequency of hospitalization, emergency department visits, routine and nonscheduled visits to primary care physician, and pharmacy use of the home-visited subjects compared with a propensity-matched group...
August 2017: Clinical Pediatrics
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: Noninvasive 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 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)...
July 18, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28716870/necrotising-enterocolitis-after-supraventricular-tachycardia-an-unusual-precursor-to-a-common-problem
#8
Jennie Saini, Aideen Moore, Kate Hodgson
Supraventricular tachycardia (SVT) is the most common neonatal arrhythmia. Necrotising enterocolitis (NEC) is a disease with multifactorial aetiology, most common in preterm infants. There are three previous case reports in the literature of NEC following neonatal SVT. We present two cases of late preterm infants with NEC, characterised by pneumatosis on abdominal X-ray and ultrasound, following recurrent SVT without haemodynamic instability. The infants were successfully treated with antibiotic therapy and bowel rest...
July 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28716018/prediction-of-extubation-readiness-in-extremely-preterm-infants-by-the-automated-analysis-of-cardiorespiratory-behavior-study-protocol
#9
Wissam Shalish, Lara J Kanbar, Smita Rao, Carlos A Robles-Rubio, Lajos Kovacs, Sanjay Chawla, Martin Keszler, Doina Precup, Karen Brown, Robert E Kearney, Guilherme M Sant'Anna
BACKGROUND: Extremely preterm infants (≤ 28 weeks gestation) commonly require endotracheal intubation and mechanical ventilation (MV) to maintain adequate oxygenation and gas exchange. Given that MV is independently associated with important adverse outcomes, efforts should be made to limit its duration. However, current methods for determining extubation readiness are inaccurate and a significant number of infants fail extubation and require reintubation, an intervention that may be associated with increased morbidities...
July 17, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28715355/repeated-exposure-to-sucrose-for-procedural-pain-in-mouse-pups-leads-to-long-term-widespread-brain-alterations
#10
Sophie Tremblay, Manon Ranger, Cecil M Y Chau, Jacob Ellegood, Jason P Lerch, Liisa Holsti, Daniel Goldowitz, Ruth E Grunau
Oral sucrose is administered routinely to reduce pain of minor procedures in premature infants and is recommended as standard care in international guidelines. No human or animal studies on effects of early repeated sucrose exposure on long-term brain development have been done in the context of pain. We evaluated the effects of repeated neonatal sucrose treatment before an intervention on long-term brain structure in mouse pups. Neonatal C57Bl/6J mice (n = 109) were randomly assigned to one of 2 treatments (vehicle vs sucrose) and one of 3 interventions (handling, touch, or needle-prick)...
August 2017: Pain
https://www.readbyqxmd.com/read/28714339/inhaled-and-systemic-steroid-exposure-and-neurodevelopmental-outcome-of-preterm-neonates
#11
Edmond N Kelly, Vibhuti S Shah, Jody Levenbach, Michael Vincer, Orlando DaSilva, Prakesh S Shah
OBJECTIVES: To compare death and/or neurodevelopmental outcomes of preterm infants exposed to inhaled and/or systemic steroids with those without exposure, and examine the impact of timing of exposure. METHODS: Retrospective study of infants born <29 weeks gestation and assessed at 18-21 months corrected age (CA). Neurodevelopmental impairment (NDI) was defined as any Bayley Scales of Infant and Toddler Development-III (BSID-III) score <85, cerebral palsy ≥ grade one, and visual or hearing impairment...
July 16, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28714327/elevated-levels-of-circulating-cell-free-dna-and-neutrophil-proteins-are-associated-with-neonatal-sepsis-and-necrotizing-enterocolitis-in-immature-mice-pigs-and-infants
#12
Duc Ninh Nguyen, Allan Stensballe, Jacqueline Cy Lai, Pingping Jiang, Anders Brunse, Yanqi Li, Jing Sun, Carina Mallard, Tom Skeath, Nicholas D Embleton, Janet E Berrington, Per T Sangild
Preterm infants are highly susceptible to late-onset sepsis (LOS) and necrotizing enterocolitis (NEC), but disease pathogenesis and specific diagnostic markers are lacking. Circulating cell-free DNA (cfDNA) and immune cell-derived proteins are involved in multiple immune diseases in adults but have not been investigated in preterm neonates. We explored the relation of circulating neutrophil-associated proteins and cfDNA to LOS and/or NEC. Using a clinically relevant preterm pig model of spontaneous LOS and NEC development, we investigated neutrophil-associated proteins and cfDNA in plasma, together with cytokines in gut tissues...
January 1, 2017: Innate Immunity
https://www.readbyqxmd.com/read/28714111/room-for-improvement-in-breast-milk-feeding-after-very-preterm-birth-in-europe-results-from-the-epice-cohort
#13
Emilija Wilson, Anna-Karin Edstedt Bonamy, Mercedes Bonet, Liis Toome, Carina Rodrigues, Elizabeth A Howell, Marina Cuttini, Jennifer Zeitlin
Breast milk feeding (BMF) is associated with lower neonatal morbidity in the very preterm infant (<32 weeks gestation) and breastfeeding is beneficial for maternal health. Previous studies show large variations in BMF after very preterm birth and recognize the need for targeted breastfeeding support in the neonatal intensive care units (NICU). In a European collaboration project about evidence-based practices after very preterm birth, we examined the association between maternal, obstetric, and infant clinical factors; neonatal and maternal care unit policies; and BMF at discharge from the NICU...
July 17, 2017: Maternal & Child Nutrition
https://www.readbyqxmd.com/read/28711561/sensory-processing-disorder-in-preterm-infants-during-early-childhood-and-relationships-to-early-neurobehavior
#14
Justin Ryckman, Claudia Hilton, Cynthia Rogers, Roberta Pineda
BACKGROUND: Preterm infants are exposed to a variety of sensory stimuli that they are not developmentally prepared to handle, which puts them at risk for developing a sensory processing disorder. However, the patterns and predictors of sensory processing disorder and their relationship to early behavior at term equivalent age are poorly understood. OBJECTIVES: The aims of the study are to: 1) describe the incidence of sensory processing disorder in preterm infants at four to six years of age, 2) define medical and sociodemographic factors that relate to sensory processing disorder, and 3) explore relationships between early neurobehavior at term equivalent age and sensory processing disorder at age four to six years...
July 13, 2017: Early Human Development
https://www.readbyqxmd.com/read/28711457/comparison-of-the-finger-feeding-versus-cup-feeding-methods-in-the-transition-from-gastric-to-oral-feeding-in-preterm-infants
#15
Cláudia M D Moreira, Regina P G V Cavalcante-Silva, Cristina I Fujinaga, Francine Marson
OBJECTIVES: To assess the finger-feeding technique when compared with the cup feeding method during the early stage of preterm infant feeding transition regarding milk loss, milk ingestion period, and complications. METHODS: Experimental, randomized, prospective study including 53 preterm infants with gestation age<37 weeks, clinically stable, and with a score of >28 points in the Oral Feeding Readiness Assessment Scale. The preterm babies were randomized to be included in the control group, which underwent the feeding transition using a cup or in the experimental group, which used the finger-feeding technique...
July 13, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28711234/sleep-related-breathing-disorders-and-indications-for-polysomnography-in-preterm-infants
#16
Koen Joosten, Robbin de Goederen, Angelique Pijpers, Karel Allegaert
There is a range of breathing problems which occur and may persist in preterm infants, such as central apneas, obstructive apneas and periodic breathing. Preterm infants may also suffer from respiratory distress syndrome and chronic lung disease necessitating prolonged use of oxygen therapy after discharge from the hospital. Due to these persistent breathing pattern abnormalities in preterm infants, there is a higher risk of altered sleep and apparent life threatening events. Polysomnography can be a helpful tool to identify those infants who have abnormalities in their breathing pattern, to identify those infants who have an increased risk to get a sleep related breathing event at home and to decide about the discontinuation of oxygen therapy...
July 12, 2017: Early Human Development
https://www.readbyqxmd.com/read/28711233/review-of-sleep-eeg-in-preterm-and-term-neonates
#17
Anneleen Dereymaeker, Kirubin Pillay, Jan Vervisch, Maarten De Vos, Sabine Van Huffel, Katrien Jansen, Gunnar Naulaers
Neonatal sleep is a crucial state that involves endogenous driven brain activity, important for neuronal survival and guidance of brain networks. Sequential EEG-sleep analysis in preterm infants provides insights into functional brain integrity and can document deviations of the biologically pre-programmed process of sleep ontogenesis during the neonatal period. Visual assessment of neonatal sleep-EEG, with integration of both cerebral and non-cerebral measures to better define neonatal state, is still considered the gold standard...
July 12, 2017: Early Human Development
https://www.readbyqxmd.com/read/28711069/preterm-birth-and-its-impact-on-renal-health
#18
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/28710905/administration-of-fortifier-by-finger-feeder-during-breastfeeding-in-preterm-infants
#19
Margarita Thanhaeuser, Alexandra Kreissl, Claudia Lindtner, Sophia Brandstetter, Angelika Berger, Nadja Haiden
OBJECTIVE: To evaluate the acceptance, adherence, and feasibility of fortifier administration by finger feeder during breastfeeding and to determine weight, length, and head circumference gains after discharge for preterm infants. DESIGN: Observational pilot study. SETTING: A Level III NICU and its outpatient clinic in Vienna, Austria. PARTICIPANTS: Infants born at younger than 34 weeks gestation were included. METHODS: Mothers were screened in a tertiary NICU and trained by certified lactation consultants to administer fortifier with a finger feeder during breastfeeding...
July 12, 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/28709948/mechanical-ventilation-strategies
#20
REVIEW
Martin Keszler
Although only a small proportion of full term and late preterm infants require invasive respiratory support, they are not immune from ventilator-associated lung injury. The process of lung damage from mechanical ventilation is multifactorial and cannot be linked to any single variable. Atelectrauma and volutrauma have been identified as the most important and potentially preventable elements of lung injury. Respiratory support strategies for full term and late preterm infants have not been as thoroughly studied as those for preterm infants; consequently, a strong evidence base on which to make recommendations is lacking...
July 11, 2017: Seminars in Fetal & Neonatal Medicine
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