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https://www.readbyqxmd.com/read/28228969/prevention-and-treatment-of-neonatal-nosocomial-infections
#1
REVIEW
Jayashree Ramasethu
Nosocomial or hospital acquired infections threaten the survival and neurodevelopmental outcomes of infants admitted to the neonatal intensive care unit, and increase cost of care. Premature infants are particularly vulnerable since they often undergo invasive procedures and are dependent on central catheters to deliver nutrition and on ventilators for respiratory support. Prevention of nosocomial infection is a critical patient safety imperative, and invariably requires a multidisciplinary approach. There are no short cuts...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28224121/immunological-defects-in-neonatal-sepsis-and-potential-therapeutic-approaches
#2
REVIEW
Steven L Raymond, Julie A Stortz, Juan C Mira, Shawn D Larson, James L Wynn, Lyle L Moldawer
Despite advances in critical care medicine, neonatal sepsis remains a major cause of morbidity and mortality worldwide, with the greatest risk affecting very low birth weight, preterm neonates. The presentation of neonatal sepsis varies markedly from its presentation in adults, and there is no clear consensus definition of neonatal sepsis. Previous work has demonstrated that when neonates become septic, death can occur rapidly over a matter of hours or days and is generally associated with inflammation, organ injury, and respiratory failure...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28219965/a-public-health-response-to-opioid-use-in-pregnancy
#3
Stephen W Patrick, Davida M Schiff
The use of opioids during pregnancy has grown rapidly in the past decade. As opioid use during pregnancy increased, so did complications from their use, including neonatal abstinence syndrome. Several state governments responded to this increase by prosecuting and incarcerating pregnant women with substance use disorders; however, this approach has no proven benefits for maternal or infant health and may lead to avoidance of prenatal care and a decreased willingness to engage in substance use disorder treatment programs...
February 20, 2017: Pediatrics
https://www.readbyqxmd.com/read/28218158/influence-of-integrated-community-and-facility-based-interventions-on-select-maternal-and-neonatal-outcomes-in-northern-karnataka-india-lessons-for-implementation-and-measurement
#4
Rajaram Subramanian Potty, Mohan Harnahalli Lakkappa, Arin Kar, Mallika Bidappa, Ramesh Banadakoppa Manjappa, Krishnamurthy Jayanna
BACKGROUND: Sukshema project provided technical assistance to National Health Mission of government of Karnataka to improve maternal, newborn and child health (MNCH) outcomes in eight districts of Karnataka between 2009 and 2015. The project designed tools, processes and provided mentoring to frontline workers, community structures, and facilities to improve demand generation and quality of MNCH services. OBJECTIVES: To assess over time changes in selected MNCH care indicators among women who had delivered in the past 2 months in Bagalkot and Koppal districts...
January 2017: Indian Journal of Public Health
https://www.readbyqxmd.com/read/28214925/missed-opportunities-in-neonatal-deaths-in-rwanda-applying-the-three-delays-model-in-a-cross-sectional-analysis-of-neonatal-death
#5
Efua Wilmot, Marcel Yotebieng, Alison Norris, Fidele Ngabo
Objective Administered in a timely manner, current evidence-based interventions could reduce neonatal deaths from infections, intrapartum injuries and complications due to prematurity. The three delays model (delay in seeking care, in arriving at a health facility, and in receiving adequate care), which has been applied to understanding maternal deaths, may be useful for understanding neonatal deaths. We assess the main causes of neonatal deaths in Rwanda and their associated delays. Methods Using a cross-sectional study design, we evaluated data from 2012 from 40 facilities in which babies were delivered...
February 18, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28212589/a-multicenter-initiative-for-critical-congenital-heart-disease-newborn-screening-in-texas-neonatal-intensive-care-units
#6
Alice Gong, Charleta Guillory, Liza Creel, Judith Ellen Livingtson, Tiffany M McKee-Garrett, Regine Fortunov
Objective The objective of this study was to implement a strategy for critical congenital heart disease (CCHD) newborn screening in the neonatal intensive care unit (NICU). Design A NICU-specific curriculum, screening algorithm, slide presentations, and templates of orders, policies, and procedures were developed into a toolkit for training NICU personnel. Screening was conducted on first and second screen pre- and postductal oxygen saturations (SpO2) on newborns admitted or transferred to the NICU. Results We trained 347 NICU personnel in 13 Texas hospitals, representing rural, suburban, and metropolitan settings...
February 17, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28203387/an-overview-of-available-drugs-for-management-of-opioid-abuse-during-pregnancy
#7
REVIEW
Jillian Laslo, Jon-Michael Brunner, Daniel Burns, Emily Butler, Autumn Cunningham, Ryan Killpack, Courtney Pyeritz, Kimberly Rinard, Jennifer Childers, Joseph Horzempa
The prevalence of opioid abuse in the United States has been steadily increasing over the last several years among many major demographics, including pregnant women. Rise in prenatal opioid abuse has resulted in subsequent escalation of neonatal abstinence syndrome incidence, prompting the US Congress to pass the Protecting Our Infants Act of 2015. This act specifically calls for a critical review of current treatment options for prenatal opioid abuse which may ultimately lead to the development of better therapies and a decreased incidence of neonatal abstinence syndrome...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28202717/%C3%AE-adrenoceptor-activation-enhances-l-type-calcium-channel-currents-in-anterior-piriform-cortex-pyramidal-cells-of-neonatal-mice-implication-for-odor-learning
#8
Abhinaba Ghosh, Bandhan Mukherjee, Xihua Chen, Qi Yuan
Early odor preference learning occurs in one-week-old rodents when a novel odor is paired with a tactile stimulation mimicking maternal care. β-Adrenoceptors and L-type calcium channels (LTCCs) in the anterior piriform cortex (aPC) are critically involved in this learning. However, whether β-adrenoceptors interact directly with LTCCs in aPC pyramidal cells is unknown. Here we show that pyramidal cells expressed significant LTCC currents that declined with age. β-Adrenoceptor activation via isoproterenol age-dependently enhanced LTCC currents...
March 2017: Learning & Memory
https://www.readbyqxmd.com/read/28196316/common-skin-conditions-in-children-neonatal-skin-lesions
#9
Brian Z Rayala, Dean S Morrell
Skin findings during the initial month of life are ubiquitous. One study estimated that more than 95% of newborns have cutaneous findings, which often are distressing to parents but frequently are benign and self-limited. Among them are milia, cutis marmorata, congenital dermal melanocytosis, and the benign neonatal pustular eruptions (eg, benign cephalic pustulosis, erythema toxicum neonatorum, transient neonatal pustular melanosis). Clinicians need to recognize these benign skin conditions and differentiate them from more serious conditions, such as infectious pustular eruptions from bacterial, viral, and fungal causes, and inflammatory conditions, such as Langerhans cell histiocytosis...
February 2017: FP Essentials
https://www.readbyqxmd.com/read/28193439/simulation-in-neonatal-transport-medicine
#10
REVIEW
Douglas M Campbell, Rita Dadiz
The safe transport of infants in critical condition requires highly reliable inter-professional transport teams that are equipped with the expertise to provide neonatal care in unfamiliar and resource-limited environments. Increasingly, transport teams are comprised of health professionals from various disciplines. Providing didactic and experiential learning alone is insufficient to fully prepare teams that have limited exposure to rare events. Simulation-based training supplements and reinforces knowledge, skills, and the experiences of team members...
November 2016: Seminars in Perinatology
https://www.readbyqxmd.com/read/28181934/novel-pump-control-technology-accelerates-drug-delivery-onset-in-a-model-of-pediatric-drug-infusion
#11
Michael J Parker, Mark A Lovich, Amy C Tsao, Hao Deng, Timothy Houle, Robert A Peterfreund
BACKGROUND: Laboratory data suggest that newly initiated drug infusions reach steady-state delivery after a significant time lag. Depending on drug and carrier flow rates and the infusion system's common volume, lag times may exceed 20 or more minutes, especially in the neonatal/pediatric critical care environment. This study tested the hypothesis that a computer-executed algorithm controlling infusion pumps in a coordinated fashion predictably hastens the achievement of the intended steady-state drug delivery in a model of neonatal/pediatric drug infusion...
February 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28168989/pediatric-surgical-capacity-in-africa-current-status-and-future-needs
#12
Asra Toobaie, Sherif Emil, Doruk Ozgediz, Sanjay Krishnaswami, Dan Poenaru
BACKGROUND: African pediatric surgery (PS) faces multiple challenges. Information regarding existing resources is limited. We surveyed African pediatric surgeons to determine available resources and clinical, educational, and collaborative needs. METHODS: Members of the Pan-African Pediatric Surgical Association (PAPSA) and the Global Pediatric Surgery Network (GPSN) completed a structured email survey covering PS providers, facilities, resources, workload, education/training, disease patterns, and collaboration priorities...
January 29, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28152539/hyperoxia-and-the-immature-brain
#13
Bettina Reich, Daniela Hoeber, Ivo Bendix, Ursula Felderhoff-Mueser
Despite major advances in obstetrics and neonatal intensive care, preterm infants frequently suffer from neurological impairments in later life. Preterm and also full-term neonates are generally susceptible to injury caused by reactive oxygen species due to the immaturity of endogenous radical scavenging systems. It is well known that high oxygen levels experienced during the critical phase of maturation can profoundly influence developmental processes. Supraphysiological oxygen concentrations used for resuscitation or in the care of critically ill infants are known to have deleterious effects on the developing lung and retina, contributing to the pathophysiology of neonatal diseases like bronchopulmonary dysplasia and retinopathy of prematurity...
February 3, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28148323/primary-care-management-of-patients-with-coarctation-of-the-aorta
#14
REVIEW
Jeffrey R Boris
Coarctation of the aorta is a congenital cardiac defect that results in a variable degree of obstruction to the left side of the heart. It can present with either acute shock in the neonatal period as a critical lesion or it can appear more insidiously with hypertension or other findings later in life. This article summarises aspects of outpatient care of patients with this lesion, including clinical history and physical examination, ancillary testing, and issues associated with long-term follow-up and management...
December 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/28141899/intravenous-midazolam-infusion-for-sedation-of-infants-in-the-neonatal-intensive-care-unit
#15
REVIEW
Eugene Ng, Anna Taddio, Arne Ohlsson
BACKGROUND: Proper sedation for neonates undergoing uncomfortable procedures may reduce stress and avoid complications. Midazolam is a short-acting benzodiazepine that is used increasingly in neonatal intensive care units (NICUs). However, its effectiveness as a sedative in neonates has not been systematically evaluated. OBJECTIVES: Primary objeciveTo assess the effectiveness of intravenous midazolam infusion for sedation, as evaluated by behavioural and/or physiological measurements of sedation levels, in critically ill neonates in the NICU...
January 31, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28133894/seven-cases-of-saccharomyces-fungaemia-related-to-use-of-probiotics
#16
Ujjwayini Roy, Laxman G Jessani, Shivaprakash M Rudramurthy, Ram Gopalakrishnan, Soma Dutta, Chandrashish Chakravarty, Joseph Jillwin, Arunaloke Chakrabarti
Probiotics are increasingly used in critically ill patients without enough safety data. The aim of the present study was to determine the association of probiotics with Saccharomyces cerevisiae fungaemia. Seven patients with S. cerevisiae fungaemia were reported at two hospitals in India between July 2014 and September 2015. Detailed clinical history of patients was recorded. Besides the seven patient isolates, three probiotics sachets used in those patients and five unrelated clinical isolates were used for association study by Fluorescent amplified fragment length polymorphism (FAFLP)...
January 30, 2017: Mycoses
https://www.readbyqxmd.com/read/28130784/time-to-electroencephalography-is-independently-associated-with-outcome-in-critically-ill-neonates-and-children
#17
Iván Sánchez Fernández, Arnold J Sansevere, Rejean M Guerriero, Ersida Buraniqi, Phillip L Pearl, Robert C Tasker, Tobias Loddenkemper
OBJECTIVE: To identify factors associated with in-hospital mortality in neonates and children undergoing continuous electroencephalography (cEEG) monitoring in the intensive care unit (ICU). METHODS: We performed a retrospective observational study in patients from birth to 21 years of age who underwent clinically indicated cEEG in the ICU from 2011 to 2013. The main outcome measure was in-hospital mortality. RESULTS: Six-hundred and twenty-five patients (54...
January 28, 2017: Epilepsia
https://www.readbyqxmd.com/read/28125511/dna-methylation-patterns-in-cord-blood-of-neonates-across-gestational-age-association-with-cell-type-proportions
#18
Susan M Braid, Kwame Okrah, Amol Shetty, Hector Corrada Bravo
BACKGROUND: A statistical methodology is available to estimate the proportion of cell types (cellular heterogeneity) in adult whole blood specimens used in epigenome-wide association studies (EWAS). However, there is no methodology to estimate the proportion of cell types in umbilical cord blood (also a heterogeneous tissue) used in EWAS. OBJECTIVES: The objectives of this study were to determine whether differences in DNA methylation (DNAm) patterns in umbilical cord blood are the result of blood cell type proportion changes that typically occur across gestational age and to demonstrate the effect of cell type proportion confounding by comparing preterm infants exposed and not exposed to antenatal steroids...
January 25, 2017: Nursing Research
https://www.readbyqxmd.com/read/28122592/barriers-and-enablers-of-health-system-adoption-of-kangaroo-mother-care-a-systematic-review-of-caregiver-perspectives
#19
Emily R Smith, Ilana Bergelson, Stacie Constantian, Bina Valsangkar, Grace J Chan
BACKGROUND: Despite improvements in child survival in the past four decades, an estimated 6.3 million children under the age of five die each year, and more than 40% of these deaths occur in the neonatal period. Interventions to reduce neonatal mortality are needed. Kangaroo mother care (KMC) is one such life-saving intervention; however it has not yet been fully integrated into health systems around the world. Utilizing a conceptual framework for integration of targeted health interventions into health systems, we hypothesize that caregivers play a critical role in the adoption, diffusion, and assimilation of KMC...
January 25, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28121760/striving-for-optimum-noise-decreasing-strategies-in-critical-care-initial-measurements-and-observations
#20
Timothy C Disher, Britney Benoit, Darlene Inglis, Stacy A Burgess, Barbara Ellsmere, Brenda E Hewitt, Tanya M Bishop, Christopher L Sheppard, Krista A Jangaard, Gavin C Morrison, Marsha L Campbell-Yeo
To identify baseline sound levels, patterns of sound levels, and potential barriers and facilitators to sound level reduction. The study setting was neonatal and pediatric intensive care units in a tertiary care hospital. Participants were staff in both units and parents of currently hospitalized children or infants. One 24-hour sound measurements and one 4-hour sound measurement linked to observed sound events were conducted in each area of the center's neonatal intensive care unit. Two of each measurement type were conducted in the pediatric intensive care unit...
January 2017: Journal of Perinatal & Neonatal Nursing
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