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Apnea of prematurity

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https://www.readbyqxmd.com/read/28446386/caffeine-citrate-is-it-a-silver-bullet-in-neonatology
#1
REVIEW
Bikash Shrestha, Gaurav Jawa
Caffeine citrate is one of the most prescribed drug in the present day NICU for apnea. Its efficacy, tolerability, wide therapeutic index and safety margin has made it the drug of choice among the methylxanthines. Its therapeutic uses in apnea of prematurity, mechanical ventilation, bronchopulmonary dysplasia has made it a "silver bullet" in neonatology. However, there are still controversies surrounding this drug. This review is aimed to update the reader about the basic pharmacology, current therapeutic uses, adverse effects, controversies as well as present and future research of caffeine...
March 27, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28438477/apnea-in-the-term-infant
#2
REVIEW
Mary Elaine Patrinos, Richard J Martin
Whereas apnea of prematurity has been well defined and its pathophysiology extensively studied, apnea in the term infant remains a greater challenge. Unfortunately, clear diagnostic criteria are lacking and pathogenesis and management vary widely. In this review we have arbitrarily organized the discussion chronologically into earlier and later postnatal periods. In the first days of life, presumed apnea may reflect physiologic events such as positional or feeding etiologies, or may be a manifestation of serious pathophysiology, such as a seizure disorder...
April 21, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28437520/academic-performance-motor-function-and-behavior-11-years-after-neonatal-caffeine-citrate-therapy-for-apnea-of-prematurity-an-11-year-follow-up-of-the-cap-randomized-clinical-trial
#3
Barbara Schmidt, Robin S Roberts, Peter J Anderson, Elizabeth V Asztalos, Lorrie Costantini, Peter G Davis, Deborah Dewey, Judy D'Ilario, Lex W Doyle, Ruth E Grunau, Diane Moddemann, Harvey Nelson, Arne Ohlsson, Alfonso Solimano, Win Tin
Importance: Caffeine citrate therapy for apnea of prematurity reduces the rates of bronchopulmonary dysplasia, severe retinopathy, and neurodevelopmental disability at 18 months and may improve motor function at 5 years. Objective: To evaluate whether neonatal caffeine therapy is associated with improved functional outcomes 11 years later. Design, Setting, and Participants: A follow-up study was conducted at 14 academic hospitals in Canada, Australia, and the United Kingdom from May 7, 2011, to May 27, 2016, of English- or French-speaking children who had been enrolled in the randomized, placebo-controlled Caffeine for Apnea of Prematurity trial between October 11, 1999, and October 22, 2004...
April 24, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28420694/caffeine-preferentially-protects-against-oxygen-induced-retinopathy
#4
Shuya Zhang, Rong Zhou, Bo Li, Haiyan Li, Yanyan Wang, Xuejiao Gu, Lingyun Tang, Cun Wang, Dingjuan Zhong, Yuanyuan Ge, Yuqing Huo, Jing Lin, Xiao-Ling Liu, Jiang-Fan Chen
Retinopathy of prematurity (ROP) is the leading cause of childhood blindness, but current anti-VEGF therapy is concerned with delayed retinal vasculature, eye, and brain development of preterm infants. The clinical observation of reduced ROP severity in premature infants after caffeine treatment for apnea suggests that caffeine may protect against ROP. Here, we demonstrate that caffeine did not interfere with normal retinal vascularization development but selectively protected against oxygen-induced retinopathy (OIR) in mice...
April 18, 2017: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/28416458/on-the-origins-of-sex-based-differences-in-respiratory-disorders-lessons-and-hypotheses-from-stress-neuroendocrinology-in-developing-rats
#5
REVIEW
Jean-Philippe Rousseau, Luana Tenorio-Lopes, Cécile Baldy, Tara Adele Janes, Stéphanie Fournier, Richard Kinkead
The environment plays a critical role in shaping development and function of the brain. Stress, especially when experienced early in life, can interfere with these processes. In the context of respiratory control, perinatal stress can therefore alter the ability to achieve the "fine-tuning" necessary for proper detection of chemosensory stimuli and production of an adequate motor (respiratory) command. Depending on the timing, intensity, and duration, the detrimental consequences of perinatal exposure to adverse conditions on the respiratory network become manifest at various life stages and can persist into adulthood...
April 14, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28407825/-effect-of-pregnancy-induced-hypertension-syndrome-on-complications-in-very-low-birth-weight-preterm-infants
#6
Song-Zhou Xu, Xiao-Yan Hu, Fang Zhao, Yu-Xin Zhou, Shuang-Chuan Zhang
OBJECTIVE: To study the effect of pregnancy-induced hypertension syndrome (PIH) on complications in very low birth weight (VLBW) preterm infants. METHODS: The VLBW preterm infants were enrolled as research subjects, and according to the presence or absence of PIH in their mothers, they were divided into PIH group and non- PIH group. The incidence of major complications and length of hospital stay were compared between the two groups. RESULTS: There were no significant differences between the two groups in gestational age, birth weight, sex, incidence rate of maternal diabetes, and use of antepartum hormone...
April 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28356131/treatment-of-infants-with-syndromic-robin-sequence-with-modified-palatal-plates-a-minimally-invasive-treatment-option
#7
Silvia Müller-Hagedorn, Wolfgang Buchenau, Jörg Arand, Margit Bacher, Christian F Poets
BACKGROUND: Infants with Robin sequence (RS) suffer from upper airway obstruction (UAO) and feeding problems. We developed an oral appliance with a velar extension in combination with functional treatment and appropriate feeding techniques, which was proven effective in isolated RS. As the above problems are particularly challenging in syndromic RS, we set out to evaluate our treatment concept also in these patients. METHODS: We searched our electronic departmental database to identify all children admitted to our department between 01/01/2003 and 31/12/2009 because of syndromic RS...
March 30, 2017: Head & Face Medicine
https://www.readbyqxmd.com/read/28352512/effects-of-antecedent-manipulations-and-social-reinforcement-to-increase-lateral-positioning-in-a-premature-infant-with-obstructive-sleep-apnea
#8
Harry Voulgarakis, Solandy Forte, Cheryl Giacomelli, Debra Bendell-Estroff, Henry Krous
Recent research suggests supine positioning for sleeping infants is the safest position to prevent breathing related difficulties; however doing so can significantly increase obstruction in apneic infants resulting in decreased sleep quality. We implemented a multi-component treatment package compromised of antecedent interventions and parent-mediated social reinforcement to increase lateral positioning in a premature infant with obstructive sleep apnea. Results indicate that the intervention increased lateral positioning in the participant by over 80 % in the final phase of the study, indicating efficacy of the intervention...
March 2017: Behavior Analysis in Practice
https://www.readbyqxmd.com/read/28330778/intratracheal-lps-administration-attenuates-the-acute-hypoxic-ventilatory-response-role-of-brainstem-il-1%C3%AE-receptors
#9
A P Ribeiro, C A Mayer, C G Wilson, R J Martin, P M MacFarlane
Perinatal inflammation and infection are commonly associated with various respiratory morbidities in preterm infants including apnea of prematurity. In this study, we investigated whether pulmonary inflammation via intra-tracheal micro-injection of lipopolysaccharide (LPS) into neonatal rats modifies respiratory neural control via an IL-1β receptor-dependent mechanism. Prior to an intra-tracheal micro-injection of LPS (1mg/kg), 10day old (Postnatal age, P10) rats received an intraperitoneal (i.p.) or intracisternal (i...
March 19, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28224405/complications-of-acromegaly-cardiovascular-respiratory-and-metabolic-comorbidities
#10
REVIEW
Rosario Pivonello, Renata S Auriemma, Ludovica F S Grasso, Claudia Pivonello, Chiara Simeoli, Roberta Patalano, Mariano Galdiero, Annamaria Colao
Acromegaly is associated with an enhanced mortality, with cardiovascular and respiratory complications representing not only the most frequent comorbidities but also two of the main causes of deaths, whereas a minor role is played by metabolic complications, and particularly diabetes mellitus. The most prevalent cardiovascular complications of acromegaly include a cardiomyopathy, characterized by cardiac hypertrophy and diastolic and systolic dysfunction together with arterial hypertension, cardiac rhythm disorders and valve diseases, as well as vascular endothelial dysfunction...
February 2017: Pituitary
https://www.readbyqxmd.com/read/28215596/sex-specific-respiratory-effects-of-acute-and-chronic-caffeine-administration-in-newborn-rats
#11
REVIEW
Hayet Kouchi, NagaPraveena Uppari, Vincent Joseph, Aida Bairam
Caffeine is widely used for the treatment of apnea of prematurity (AoP) but whether this effect varies with sex is unknown. To shed some light on this question, we present a summary of data obtained on the effects of caffeine on the respiratory chemoreflexes and apnea frequency in 1- and 12-days old male and female rats. Caffeine was either administered as a single acute injection (10mg/kg, i.p.) or for 10 consecutive days (7.5mg/kg/day between 3 and 12days of life by gavage, simulating its clinical use). Acute caffeine had little effects on breathing in 1-day old male and female rats...
June 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28215268/periodic-limb-movements-and-restless-legs-syndrome-in-children-with-a-history-of-prematurity
#12
Christopher M Cielo, Lourdes M DelRosso, Ignacio E Tapia, Sarah N Biggs, Gillian M Nixon, Lisa J Meltzer, Joel Traylor, Ji Young Kim, Carole L Marcus
INTRODUCTION: Little is known about the pediatric population at an increased risk of restless legs syndrome (RLS) and periodic limb movement disorder (PLMD). Polysomnographic data from the Caffeine for Apnea of Prematurity-Sleep (CAPS) study showed a high prevalence of elevated periodic limb movement index (PLMI) in a cohort of ex-preterm children, but the clinical importance of this finding, such as association with RLS, is unknown. We hypothesized that ex-preterm children would have a high prevalence of RLS and PLMD...
February 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28213294/a-low-cost-simplified-and-scaleable-pneumotachograph-and-face-mask-for-neonatal-mouse-respiratory-measurements
#13
Jenny J Sun, Roshan Nanu, Russell S Ray
INTRODUCTION: Neonatal respiratory disorders are a leading cause of perinatal mortality due to complications resulting from premature births and prenatal exposure to drugs of abuse, but optimal treatments for these symptoms are still unclear due to a variety of confounds and risk factors. Mouse models present an opportunity to study the underlying mechanisms and efficacy of potential treatments of these conditions with controlled variables. However, measuring respiration in newborn mice is difficult and commercial components are expensive and often require modification, creating a barrier and limiting our understanding of the short and long-term effects of birth complications on respiratory function...
February 15, 2017: Journal of Pharmacological and Toxicological Methods
https://www.readbyqxmd.com/read/28169045/sleep-surgery-tool-a-medical-checklist-to-review-prior-to-operating
#14
Macario Camacho, Robert W Riley, Robson Capasso, Peter O'Connor, Edward T Chang, Lauren K Reckley, Christian Guilleminault
OBJECTIVE: The objective of this study was to systematically review the international literature for studies providing a preoperative checklist for medical disorders to be evaluated or treated before performing sleep surgery. If no checklist exists, then studies providing recommendations would be used to develop a checklist de novo. STUDY DESIGN: Systematic review combined with expert opinion. METHODS: Four databases, including PubMed/Medline were searched through August 10, 2016...
March 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28141790/caffeine-administration-modulates-tgf-%C3%AE-signaling-but-does-not-attenuate-blunted-alveolarization-in-a-hyperoxia-based-mouse-model-of-bronchopulmonary-dysplasia
#15
Philipp Rath, Claudio Nardiello, David E Surate Solaligue, Ronald Agius, Ivana Mižíková, Sebastian Hühn, Konstantin Mayer, István Vadász, Susanne Herold, Frank Runkel, Werner Seeger, Rory E Morty
BACKGROUND: Caffeine is widely used to manage apnea of prematurity, and reduces the incidence of bronchopulmonary dysplasia (BPD). Deregulated transforming growth factor (TGF)-β signaling underlies arrested post-natal lung maturation in BPD. It is unclear whether caffeine impacts TGF-β signaling or post-natal lung development in affected lungs. METHODS: The impact of caffeine on TGF-β signaling in primary mouse lung fibroblasts and alveolar epithelial type II cells was assessed in vitro...
January 31, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28141547/efficacy-of-and-potential-morbidities-associated-with-the-use-of-antacid-medications-in-preterm-neonates
#16
Uday P Patil, Sean M Bailey, Elena V Wachtel, Evan Orosz, Rebecca Zarchin, Pradeep V Mally
OBJECTIVES: Antacid medications are frequently administered to preterm infants. These medications can change gastric pH levels and can affect regular gastrointestinal function and gut micro-bacterial flora. We hypothesized that preterm infants exposed to antacid medications are at a greater risk of necrotizing enterocolitis (NEC) and sepsis, and set out to determine any association, as well as to assess the clinical efficacy of these medications. MATERIALS AND METHODS: Retrospective chart review of preterm infants ≤30 weeks' gestational age or birth weight ≤1250 g over a 2-year period at New York University Langone Medical Center...
January 31, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28078997/lipoprotein-a-and-cardiovascular-risk-the-show-must-go-on
#17
Niki Katsiki, Khalid Al-Rasadi, Dimitri P Mikhailidis
Lipoprotein (a) [Lp(a)] is an independent but moderate, predictor for coronary heart disease (CHD) prevalence and severity. Several established and emerging cardiovascular (CV) risk factors including age, gender, ethnicity, smoking, dyslipidemia, hypertension, obesity, type 2 diabetes mellitus, alcohol consumption, arterial stiffness and hyperuricemia have been linked to Lp(a) metabolism. Apart from CHD, Lp(a) has been also associated with non-cardiac vascular diseases and diseases associated with increased CV risk such as chronic kidney disease, metabolic syndrome, non-alcoholic fatty liver disease, erectile dysfunction, obstructive sleep apnea syndrome, inflammatory bowel diseases and human immunodeficiency virus infection...
January 12, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28009338/atrial-arrhythmia-after-newborn-eye-exam-to-caffeine-or-not-to-caffeine
#18
A Ahmad, T Mondal, B Klein
Mydriatic drops are routinely administered to premature neonates to screen for retinopathy of prematurity. Adverse anticholinergic side effects, particularly convulsions and tachycardia have been reported in the pediatric age group following instillation of mydriatics for diagnostic fundus examination [1, 2]. Caffeine is frequently used for apnea of prematurity. In the neonatal intensive care unit, the combined use of caffeine and mydriatic drops is a common practice. Here we report two cases of atrial arrhythmias after neonatal eye exam that improved with conservative management...
2016: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28003553/economics-of-home-monitoring-for-apnea-in-late-preterm-infants
#19
Brian L Montenegro, Michael Amberson, Lauren Veit, Christina Freiberger, Dmitry Dukhovny, Lawrence M Rhein
BACKGROUND: Apnea of prematurity affects a small proportion but large absolute number of late preterm infants, with out-patient management variably utilized despite relative clinical equipoise and potential for improved cost-effectiveness. METHODS: Over a 5-y period, from 2009 to 2013, infants born at ≥34 weeks gestational age at a level IIIB academic center in Boston, Massachusetts, with discharge-delaying apnea, bradycardia, and desaturation (ABD) events were identified...
January 2017: Respiratory Care
https://www.readbyqxmd.com/read/27899304/caffeine-for-apnea-of-prematurity-effects-on-the-developing-brain
#20
REVIEW
Anzari Atik, Richard Harding, Robert De Matteo, Delphi Kondos-Devcic, Jeanie Cheong, Lex W Doyle, Mary Tolcos
Caffeine is a methylxanthine that is widely used to treat apnea of prematurity (AOP). In preterm infants, caffeine reduces the duration of respiratory support, improves survival rates and lowers the incidence of cerebral palsy and cognitive delay. There is, however, little evidence relating to the immediate and long-term effects of caffeine on brain development, especially at the cellular and molecular levels. Experimental data are conflicting, with studies showing that caffeine can have either adverse or benefical effects in the developing brain...
January 2017: Neurotoxicology
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