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https://www.readbyqxmd.com/read/29050887/antibiotic-stewardship-in-the-newborn-surgical-patient-a%C3%A2-quality-improvement-project-in-the-neonatal-intensive-care-unit
#1
Sarah Walker, Ankur Datta, Roxanne L Massoumi, Erica R Gross, Michael Uhing, Marjorie J Arca
BACKGROUND: There is significant diversity in the utilization of antibiotics for neonates undergoing surgical procedures. Our institution standardized antibiotic administration for surgical neonates, in which no empiric antibiotics were given to infants with surgical conditions postnatally, and antibiotics are given no more than 72 hours perioperatively. METHODS: We compared the time periods before and after implementation of antibiotic protocol in an institution review board-approved, retrospective review of neonates with congenital surgical conditions who underwent surgical correction within 30 days after birth...
October 16, 2017: Surgery
https://www.readbyqxmd.com/read/29050860/eeg-power-spectrum-maturation-in-preterm-fetal-growth-restricted-infants
#2
Emily Cohen, Flora Y Wong, Euan M Wallace, Joanne C Mockler, Alexsandria Odoi, Samantha Hollis, Rosemary S C Horne, Stephanie R Yiallourou
Power spectral analysis of the electroencephalogram (EEG) is a non-invasive method to examine infant brain maturation. Preterm fetal growth restricted (p-FGR) neonates display an altered EEG power spectrum compared to appropriate-for-gestational-age (AGA) peers, suggesting delayed brain maturation. Longitudinal studies investigating EEG power spectrum maturation in p-FGR infants are lacking, however. We thus aimed to investigate brain maturation using sleep EEG power spectral analysis in p-FGR infants compared to preterm and term AGA controls (p-AGA and t-AGA, respectively)...
October 16, 2017: Brain Research
https://www.readbyqxmd.com/read/29050392/clinical-spectrum-and-genotype-phenotype-associations-of-kcna2-related-encephalopathies
#3
Silvia Masnada, Ulrike B S Hedrich, Elena Gardella, Julian Schubert, Charu Kaiwar, Eric W Klee, Brendan C Lanpher, Ralitza H Gavrilova, Matthis Synofzik, Thomas Bast, Kathleen Gorman, Mary D King, Nicholas M Allen, Judith Conroy, Bruria Ben Zeev, Michal Tzadok, Christian Korff, Fanny Dubois, Keri Ramsey, Vinodh Narayanan, Jose M Serratosa, Beatriz G Giraldez, Ingo Helbig, Eric Marsh, Margaret O'Brien, Christina A Bergqvist, Adrian Binelli, Brenda Porter, Eduardo Zaeyen, Dafne D Horovitz, Markus Wolff, Dragan Marjanovic, Hande S Caglayan, Mutluay Arslan, Sergio D J Pena, Sanjay M Sisodiya, Simona Balestrini, Steffen Syrbe, Pierangelo Veggiotti, Johannes R Lemke, Rikke S Møller, Holger Lerche, Guido Rubboli
Recently, de novo mutations in the gene KCNA2, causing either a dominant-negative loss-of-function or a gain-of-function of the voltage-gated K+ channel Kv1.2, were described to cause a new molecular entity within the epileptic encephalopathies. Here, we report a cohort of 23 patients (eight previously described) with epileptic encephalopathy carrying either novel or known KCNA2 mutations, with the aim to detail the clinical phenotype associated with each of them, to characterize the functional effects of the newly identified mutations, and to assess genotype-phenotype associations...
September 1, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29048415/antenatal-methadone-vs-buprenorphine-exposure-and-length-of-hospital-stay-in-infants-admitted-to-the-intensive-care-unit-with-neonatal-abstinence-syndrome
#4
V N Tolia, K Murthy, M M Bennett, E S Miller, D K Benjamin, P B Smith, R H Clark
OBJECTIVE: Antenatal exposure to methadone or buprenorphine often causes neonatal abstinence syndrome (NAS) in newborns. However, comparative effects on affected infants' hospital courses are inconclusive. We sought to estimate the relationship of antenatal exposure with methadone or buprenorphine and infants' length of stay among hospitalized infants with NAS. STUDY DESIGN: This was a retrospective cohort study of hospitalized infants with NAS with either maternal exposure...
October 19, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29048412/parental-assessment-of-comfort-in-newborns-affected-by-life-limiting-conditions-treated-by-a-standardized-neonatal-comfort-care-program
#5
E Parravicini, M Daho', G Foe, R Steinwurtzel, M Byrne
OBJECTIVE: To assess the perception of parents concerning the state of comfort maintained in their infants born with life-limiting conditions and treated by a standardized neonatal comfort care program. STUDY DESIGN: Participants were parents (n=35 families) who elected comfort care for their newborns diagnosed with life-limiting conditions. Standardized comfort measures including family/infant bonding, warmth, nutrition/hydration and pain/discomfort management were provided to all infants...
October 19, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29048406/disparity-in-fetal-growth-between-twin-and-singleton-gestation-the-role-of-adipokines
#6
R Zemet, Y Shulman, R Hemi, B Brandt, E Sivan, H Kanety, S Mazaki-Tovi
OBJECTIVE: Twin pregnancies are characterized by unique pattern of attenuated fetal weight gain during late gestation compared with singleton gestation. The mechanism(s) responsible for regulating twin growth has not yet elucidated. Leptin and adiponectin are two adipocytokines implicated in metabolism and energy balance of fetuses, newborns and adults. Moreover, these hormones have been suggested to play a role in fetal growth. The objective of the study was to determine cord blood adiponectin and leptin in twins and singletons, with and without growth impairment...
October 19, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29047128/onset-of-labour-epidural-analgesia-with-low-dose-bupivacaine-and-different-doses-of-fentanyl
#7
R Vedagiri Sai, S I Singh, F Qasem, D Nguyen, S Dhir, K Marmai, R Adam, P M Jones
This study investigated the effects of different doses of epidural fentanyl on the time to onset of epidural analgesia in women in early labour. We hypothesised that onset of epidural labour analgesia (the primary outcome defined as time in minutes from completion of epidural bolus to the first uterine contraction with a numeric pain rating scale [NPRS] score ≤ 3) would be faster with 100 μg of fentanyl epidural bolus compared with 20 μg or 50 μg. Epidural labour analgesia was initiated with 20 μg of fentanyl (F20 group), 50 μg (F50 group) or 100 μg (F100 group) along with 10 ml bupivacaine 0...
November 2017: Anaesthesia
https://www.readbyqxmd.com/read/29045850/comparison-of-conventional-2d-ultrasound-to-mr-imaging-for-prenatal-estimation-of-birth-weight-in-twin-pregnancy
#8
Caroline Kadji, Elisa Bevilacqua, Ivan Hurtado, Andrew Carlin, Mieke M Cannie, Jacques C Jani
BACKGROUND: During prenatal follow-up of twin pregnancies, accurate identification of birthweight and birthweight discordance is important in order to identify the high risk group and plan perinatal care. Unfortunately prenatal evaluation of birthweight discordance by 2-dimensional ultrasound (US) has been far from optimal. OBJECTIVE: To prospectively compare estimates of fetal weight based on 2-dimensional US (US-EFW) and MR imaging (MR-EFW) to actual birth weight in women carrying twin pregnancies...
October 15, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29045834/a-latent-propriospinal-network-can-restore-diaphragm-function-after-high-cervical-spinal-cord-injury
#9
Jared M Cregg, Kevin A Chu, Lydia E Hager, Rachel S J Maggard, Daimen R Stoltz, Michaela Edmond, Warren J Alilain, Polyxeni Philippidou, Lynn T Landmesser, Jerry Silver
Spinal cord injury (SCI) above cervical level 4 disrupts descending axons from the medulla that innervate phrenic motor neurons, causing permanent paralysis of the diaphragm. Using an ex vivo preparation in neonatal mice, we have identified an excitatory spinal network that can direct phrenic motor bursting in the absence of medullary input. After complete cervical SCI, blockade of fast inhibitory synaptic transmission caused spontaneous, bilaterally coordinated phrenic bursting. Here, spinal cord glutamatergic neurons were both sufficient and necessary for the induction of phrenic bursts...
October 17, 2017: Cell Reports
https://www.readbyqxmd.com/read/29045568/loss-of-protein-kinase-novel-1-pkn1-is-associated-with-mild-systolic-and-diastolic-contractile-dysfunction-increased-phospholamban-thr17-phosphorylation-and-exacerbated-ischaemia-reperfusion-injury
#10
Asvi A Francois, Kofo Obasanjo-Blackshire, James E Clark, Andrii Boguslavskyi, Mark R Holt, Peter Parker, Michael S Marber, Richard J Heads
Aims: PKN1 is a stress-responsive protein kinase acting downstream of small GTP-binding proteins of the Rho/Rac family. The aim was to determine its role in endogenous cardioprotection. Methods and Results: Hearts from PKN1 knockout (KO) or wild type (WT) littermate control mice were perfused in Langendorff mode and subjected to global ischemia and reperfusion (I/R). Myocardial infarct size was doubled in PKN1 KO hearts compared to WT hearts. PKN1 was basally phosphorylated on the activation loop Thr778 PDK1 target site which was unchanged during I/R...
October 16, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/29044830/optimal-management-of-apparatus-dead-space-in-the-anesthetized-infant
#11
REVIEW
Michael R King, Jeffrey M Feldman
Mechanical ventilation of the anesthetized infant requires careful attention to equipment and ventilator settings to assure optimal gas exchange and minimize the potential for lung injury. Apparatus dead space, defined as dead space resulting from devices placed between the endotracheal tube and the Y-piece of the breathing circuit, is the primary source of dead space controlled by the clinician. Due to the small tidal volumes required by infants and neonates, it is easy to create excessive apparatus dead space resulting in unintended hypercarbia or increased minute ventilation in an effort to achieve a desirable PCO2 ...
October 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29044674/haem-is-associated-with-thrombosis-in-neonates-and-infants-undergoing-cardiac-surgery-for-congenital-heart-disease
#12
M Stolla, K Henrichs, J M Cholette, A P Pietropaoli, R P Phipps, S L Spinelli, N Blumberg
BACKGROUND: Haem levels are associated with thrombosis in a variety of diseases, as well as being a contributing cause of thrombotic events in animal models. MATERIALS AND METHODS: We retrospectively analyzed samples from 39 children who underwent cardiac surgery with cardiopulmonary bypass, including 15 children who developed a postoperative thrombosis and 24 controls. RESULTS: Patients who developed thrombosis postoperatively had statistically significant higher average haem levels over time (presurgery to 12 h postsurgery) compared to patients who did not develop thrombosis...
October 16, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/29043690/-prevention-of-the-wound-infection-little-changes-huge-results
#13
I Martínez Castaño, M J Aranda García, J M Sánchez Morote, R Ruiz Pruneda, M Fernández Ibieta, J Rojas Ticona, V Villamil, A Sánchez Sánchez, M C Giménez Aleixandre, J I Ruiz Jiménez
INTRODUCTION: Neonatal surgical wound infection occurs in almost 50% of neonatal procedures. It increases the rates of morbimortality in neonatal units. There is no guidelines about prevention of wound infection in neonatal surgery. We present our results after changing our behaviour in neonatal surgery. MATERIALS AND METHODS: Comparative study between 2 groups. In order to decrease wound infection at the end of the procedure gloves, covertures and surgical instruments were changed and saline and antiseptic solutions were used during laparotomy closing...
July 20, 2017: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/29043286/perceived-social-support-and-maternal-competence-in-primipara-women-during-pregnancy-and-after-childbirth
#14
Sara Esmaelzadeh Saeieh, Mitra Rahimzadeh, Mansooreh Yazdkhasti, Shoukofeh Torkashvand
BACKGROUND: Developing maternal competence in first time mothers has a significant impact on neonate's growth psychosocial development and neonates growth and psychological development. Social support can be an important element for becoming a new mother. We aimed to investigate how social support and maternal competence change during pregnancy and 4 months after it and examine the relationships among social support and maternal competence. METHODS: This longitudinal study was conducted on 100 first time mothers attending health centers in Alborz city, Alborz Province, between February 2015 and January 2016...
October 2017: International Journal of Community Based Nursing and Midwifery
https://www.readbyqxmd.com/read/29042836/evaluation-of-the-effects-of-extracorporeal-membrane-oxygenation-on-antiepileptic-drug-serum-concentrations-in-pediatric-patients
#15
Nicholas O Dillman, Mindl M Messinger, Kimberly N Dinh, Jennifer L Placencia, Brady S Moffett, Milenka Cuevas Guaman, Jennifer C Erklauer, Jeffrey R Kaiser, Angus A Wilfong
OBJECTIVES: Patients supported on extracorporeal membrane oxygenation (ECMO) have an increased incidence of seizures. Phenobarbital (PB) and fosphenytoin (fos-PHT) are common antiepileptic drugs (AEDs) used to manage seizures in the pediatric population; however, it is unknown what effect ECMO has on the serum concentrations of AEDs. The purpose of this study is to evaluate the effect of ECMO on AED serum concentrations. METHODS: A retrospective, matched-cohort study was performed in patients younger than 18 years who received ECMO and were treated with intravenous (IV) PB or fos-PHT at Texas Children's Hospital between 2004 and 2014...
September 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29040312/end-tidal-carbon-dioxide-measurement-in-preterm-infants-with-low-birth-weight
#16
Hsin-Ju Lin, Ching-Tzu Huang, Hsiu-Feng Hsiao, Ming-Chou Chiang, Mei-Jy Jeng
OBJECTIVE: There are conflicting data regarding the use of end-tidal carbon dioxide (PetCO2) measurement in preterm infants. The aim of this study was to evaluate the effects of different dead space to tidal volume ratios (VD/VT) on the correlation between PetCO2 and arterial carbon dioxide pressure (PaCO2) in ventilated preterm infants with respiratory distress syndrome (RDS). METHODS: We enrolled ventilated preterm infants (with assist control mode or synchronous intermittent mandatory mode) with RDS who were treated with surfactant in this prospective study...
2017: PloS One
https://www.readbyqxmd.com/read/29039746/preclinical-testing-of-an-oncolytic-parvovirus-standard-protoparvovirus-h-1pv-efficiently-induces-osteosarcoma-cell-lysis-in-vitro
#17
Carsten Geiss, Zoltán Kis, Barbara Leuchs, Monika Frank-Stöhr, Jörg R Schlehofer, Jean Rommelaere, Christiane Dinsart, Jeannine Lacroix
Osteosarcoma is the most frequent malignant disease of the bone. On the basis of early clinical experience in the 1960s with H-1 protoparvovirus (H-1PV) in osteosarcoma patients, this effective oncolytic virus was selected for systematic preclinical testing on various osteosarcoma cell cultures. A panel of five human osteosarcoma cell lines (CAL 72, H-OS, MG-63, SaOS-2, U-2OS) was tested. Virus oncoselectivity was confirmed by infecting non-malignant human neonatal fibroblasts and osteoblasts used as culture models of non-transformed mesenchymal cells...
October 17, 2017: Viruses
https://www.readbyqxmd.com/read/29039686/prevention-and-treatment-of-hiv-infection-in-neonates-evidence-base-for-existing-who-dosing-recommendations-and-implementation-considerations
#18
Diana F Clarke, Martina Penazzato, Edmund Capparelli, Tim R Cressey, George Siberry, Nandita Sugandhi, Mark Mirochnick
Antiretroviral drugs are used in neonates for prevention and treatment of HIV infection. Use of antiretrovirals to prevent perinatal HIV transmission is well established. Early identification of neonates infected with HIV and rapid initiation of combination antiretroviral treatment during the neonatal period is now recommended by WHO and DHHS. However, few antiretrovirals are available in formulations suitable for neonates and there are limited safety and pharmacokinetic data for most antiretrovirals in neonates...
October 17, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/29039534/apurinic-apyrimidinic-endonuclease-1-ape1-contributes-to-resveratrol%C3%A2-induced-neuroprotection-against-oxygen%C3%A2-glucose-deprivation-and-re%C3%A2-oxygenation-injury-in-ht22-cells-involvement-in-reducing-oxidative-dna-damage
#19
Jiao-Ying Jia, Zhi-Gang Tan, Min Liu, Yu-Gang Jiang
Resveratrol, a naturally occurring polyphenolic compound, exhibits a neuroprotective role in models of central nervous system diseases, including cerebral ischemia/reperfusion injury. Apurinic/apyrimidinic endonuclease 1 (APE1) is a multifunctional enzyme that contributes to base excision repair of oxidative DNA damage and redox activation of transcription factors, associated with neuronal survival against hypoxic‑ischemic injury. It was hypothesized that resveratrol protects HT22 cells against oxygen‑glucose deprivation and re‑oxygenation (OGD/R)‑induced injuries through upregulation of APE1...
October 17, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29037785/novel-bilayer-dissolving-microneedle-arrays-with-concentrated-plga-nano-microparticles-for-targeted-intradermal-delivery-proof-of-concept
#20
Lalit K Vora, Ryan F Donnelly, Eneko Larraneta, Patricia González-Vázquez, Raghu Raj Singh Thakur, Pradeep R Vavia
Polymeric microneedle (MN) arrays continue to receive growing attention due to their ability to bypass the skin's stratum corneum barrier in a minimally-invasive fashion and achieve enhanced transdermal drug delivery and "targeted" intradermal vaccine administration. In this research work, we fabricated biodegradable bilayer MN arrays containing nano - microparticles for targeted and sustained intradermal drug delivery. For this study, model drug (vitamin D3, VD3)-loaded PLGA nano- and microparticles (NMP) were prepared by a single emulsion solvent evaporation method with 72...
October 13, 2017: Journal of Controlled Release: Official Journal of the Controlled Release Society
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