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Neonatal over exposure

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https://www.readbyqxmd.com/read/28426544/neonatal-abstinence-syndrome-where-are-we-and-where-do-we-go-from-here
#1
Laura Brandt, Loretta P Finnegan
PURPOSE OF REVIEW: Over the last 15 years the prevalence of neonatal abstinence syndrome (NAS) increased almost five-fold. A considerable diversity seems to prevail in the management of NAS. This review provides an overview of factors affecting the expression and course of NAS, and recent developments in NAS assessment and treatment. RECENT FINDINGS: Apart from different pharmacological and nonpharmacological treatment modalities, maturity of the infant and genetic variations likely are (co)responsible for interpatient variability in NAS severity, despite similar maternal exposure...
April 19, 2017: Current Opinion in Psychiatry
https://www.readbyqxmd.com/read/28421643/empiric-antibiotic-regimens-for-neonatal-sepsis-in-australian-and-new-zealand-neonatal-intensive-care-units
#2
Jeremy P Carr, David P Burgner, Rohan S Hardikar, Jim P Buttery
AIM: Neonatal sepsis remains an important cause of morbidity and mortality, and requires prompt empiric treatment. However, only a minority of babies who receive antibiotics for suspected sepsis have an infection. Antimicrobial exposure in infancy has important short- and long-term consequences. There is no consensus regarding empirical antimicrobial regimens. METHODS: The study included a survey of empiric antimicrobial regimens in all tertiary neonatal intensive care units in Australia and New Zealand in 2013-2014...
April 19, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28409661/adverse-neonatal-outcomes-in-relation-to-ambient-temperatures-at-birth-a-nationwide-survey-in-taiwan
#3
Yi-Hao Weng, Chun-Yuh Yang, Ya-Wen Chiu
This study investigated the temperature-specific risks of adverse neonatal outcomes in Taiwan. Over 2 million births between 2001 and 2010 were correlated with the daily mean outdoor temperatures at birth. A log-binomial model was used to estimate the risk of adverse neonatal outcomes in relation to ambient temperature at birth after adjusting for possible confounders. There was a significant correlation of temperature extremes with stillbirth, preterm birth, and low birth weight. Maternal exposure to temperature extremes carried greater risks of stillbirth (> 23...
April 14, 2017: Archives of Environmental & Occupational Health
https://www.readbyqxmd.com/read/28393462/current-use-of-factor-concentrates-in-pediatric-cardiac-anesthesia
#4
REVIEW
Nina A Guzzetta, Glyn D Williams
Excessive bleeding following pediatric cardiopulmonary bypass is associated with increased morbidity and mortality, both from the effects of hemorrhage and the therapies employed to achieve hemostasis. Neonates and infants are especially at risk because their coagulation systems are immature, surgeries are often complex, and cardiopulmonary bypass technologies are inappropriately matched to patient size and physiology. Consequently, these young children receive substantial amounts of adult-derived blood products to restore adequate hemostasis...
April 10, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28372649/can-we-reduce-anesthesia-exposure-neonatal-brain-mri-swaddling-vs-sedation-a-national-survey
#5
Benjamin J Heller, Francine S Yudkowitz, Scott Lipson
STUDY OBJECTIVE: Neonatal magnetic resonance imaging (MRI) is a diagnostic modality that requires minimal motion to acquire quality images. Sedation or even general anesthesia may be necessary to achieve acceptable scans. There is a growing body of literature, especially in animal studies, that links neurotoxicity with anesthetic exposure to the developing brain. There is no study outlining strategies used by neonatal intensive care units (NICU) to achieve quality MRI images with limited exposure to medications identified as possibly harmful to the developing brain...
May 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28348377/bilirubin-augments-ca-2-load-of-developing-bushy-neurons-by-targeting-specific-subtype-of-voltage-gated-calcium-channels
#6
Min Liang, Xin-Lu Yin, Hai-Bo Shi, Chun-Yan Li, Xin-Yi Li, Ning-Ying Song, Hao-Song Shi, Yi Zhao, Lu-Yang Wang, Shan-Kai Yin
Neonatal brain is particularly vulnerable to pathological levels of bilirubin which elevates and overloads intracellular Ca(2+), leading to neurotoxicity. However, how voltage-gated calcium channels (VGCCs) are functionally involved in excess calcium influx remains unknown. By performing voltage-clamp recordings from bushy cells in the ventral cochlear nucleus (VCN) in postnatal rat pups (P4-17), we found the total calcium current density was more than doubled over P4-17, but the relative weight of VGCC subtypes changed dramatically, being relatively equal among T, L, N, P/Q and R-type at P4-6 to predominantly L, N, R over T and P/Q at P15-17...
March 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28343092/the-impact-of-cumulative-pain-stress-on-neurobehavioral-development-of-preterm-infants-in-the-nicu
#7
Xiaomei Cong, Jing Wu, Dorothy Vittner, Wanli Xu, Naveed Hussain, Shari Galvin, Megan Fitzsimons, Jacqueline M McGrath, Wendy A Henderson
BACKGROUND: Vulnerable preterm infants experience repeated and prolonged pain/stress stimulation during a critical period in their development while in the neonatal intensive care unit (NICU). The contribution of cumulative pain/stressors to altered neurodevelopment remains unclear. The study purpose was to investigate the impact of early life painful/stressful experiences on neurobehavioral outcomes of preterm infants in the NICU. METHODS: A prospective exploratory study was conducted with fifty preterm infants (28 0/7-32 6/7weeks gestational age) recruited at birth and followed for four weeks...
March 23, 2017: Early Human Development
https://www.readbyqxmd.com/read/28322168/pediatric-off-label-and-unlicensed-drug-use-and-its-implications
#8
Rajeshwari Gore, Preeta Kaur Chugh, Chakra Dhar Tripathi, Yangshen Lhamo, Sandhya Gautam
BACKGROUND: Worldwide, in the absence of standard pediatric prescribing information, clinicians often use medicines in children in a dosage form or for an indication that has not been approved for use. Inadequate clinical trials increase exposure to drugs that lack safety-efficacy data in pediatric population. Hence, off-label and unlicensed drug use must be regarded as a patient safety-issue that is known to be associated with increased risks of adverse drug reactions apart from under- or over-dosing due to lack of pharmacokinetic data...
March 17, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28321983/chloroprocaine-for-epidural-anesthesia-in-infants-and-children
#9
REVIEW
Giorgio Veneziano, Joseph D Tobias
Continuous epidural infusions are an effective and safe method of providing anesthesia and postoperative analgesia in infants and children with multiple advantages over systemic medications, including earlier tracheal extubation, decreased perioperative stress response, earlier return of bowel function, and decreased exposure to volatile anesthetic agents with uncertain long-term neurocognitive effects. Despite these benefits, local anesthetic toxicity remains a concern in neonates and infants because of their decreased metabolic capacity for amide local anesthetics...
March 21, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28320639/exposure-to-polycyclic-aromatic-hydrocarbons-and-volatile-organic-compounds-among-recently-pregnant-rural-guatemalan-women-cooking-and-heating-with-solid-fuels
#10
John R Weinstein, Renée Asteria-Peñaloza, Anaité Diaz-Artiga, Gilberto Davila, S Katharine Hammond, Ian T Ryde, Joel N Meyer, Neal Benowitz, Lisa M Thompson
BACKGROUND: Household air pollution is a major contributor to death and disability worldwide. Over 95% of rural Guatemalan households use woodstoves for cooking or heating. Woodsmoke contains carcinogenic or fetotoxic polycyclic aromatic hydrocarbons (PAHs) and volatile organic compounds (VOCs). Increased PAHs and VOCs have been shown to increase levels of oxidative stress. OBJECTIVE: We examined PAH and VOC exposures among recently pregnant rural Guatemalan women exposed to woodsmoke and compared exposures to levels seen occupationally or among smokers...
March 10, 2017: International Journal of Hygiene and Environmental Health
https://www.readbyqxmd.com/read/28295779/allergic-disease-in-8-year-old-children-is-preceded-by-delayed-b-cell-maturation
#11
Anna Strömbeck, Inger Nordström, Kerstin Andersson, Helen Andersson, Susanne Johansen, Cristina Maglio, Hardis Rabe, Ingegerd Adlerberth, Agnes E Wold, Bill Hesselmar, Anna Rudin, Anna-Carin Lundell
BACKGROUND: We previously reported that exposure to a farming environment is allergy-protective, while high proportions of neonatal immature/naïve CD5(+) B cells and putative regulatory T cells (Tregs) are risk factors for development of allergic disease and sensitization up to 3 years of age. OBJECTIVE: To examine if B- and T-cell maturation are associated with allergic disease and farming environment over the first 8 years in life. METHODS: In the prospective FARMFLORA study, including both farming and non-farming families, 48 out of 65 children took part in the 8-year follow-up study...
March 14, 2017: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28287056/the-total-inotrope-exposure-score-an-extension-of-the-vasoactive-inotrope-score-as-a-predictor-of-adverse-outcomes-after-paediatric-cardiac-surgery
#12
Harish Bangalore, Michael Gaies, Elena C Ocampo, Jeffrey S Heinle, Danielle Guffey, Charles G Minard, Paul Checchia, Lara S Shekerdemian
OBJECTIVE: The aim of the present study was to explore and compare the association between a new vasoactive score - the Total Inotrope Exposure Score - and outcome and the established Vasoactive Inotrope Score in children undergoing cardiac surgery with cardiopulmonary bypass DESIGN: The present study was a single-centre, retrospective study. SETTING: The study was carried out at a 21-bed cardiovascular ICU in a Tertiary Children's Hospital between September, 2010 and May, 2011 METHODS: The Total Inotrope Exposure Score is a new vasoactive score that brings together cumulative vasoactive drug exposure and incorporates dose adjustments over time...
March 13, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28279842/tooth-manganese-as-a-biomarker-of-exposure-and-body-burden-in-rats
#13
Christine Austin, Cardius Richardson, Donald Smith, Manish Arora
BACKGROUND: Neonates and children are particularly vulnerable to the toxic effects of excess manganese (Mn), but studies of Mn exposure during these developmental periods are hampered by a lack of validated biomarkers. Deciduous teeth may be used to assess Mn exposure during these developmental periods but require further validation to determine the relationship between tooth Mn, Mn in target tissues, and exposure. OBJECTIVES: To determine the relationship of tooth Mn concentrations with: (i) exposure dose, (ii) the timing/duration of exposure, and (iii) with Mn concentrations in blood, brain and bone...
May 2017: Environmental Research
https://www.readbyqxmd.com/read/28279186/continuum-of-care-in-maternal-newborn-and-child-health-in-pakistan-analysis-of-trends-and-determinants-from-2006-to-2012
#14
Sarosh Iqbal, Sidra Maqsood, Rubeena Zakar, Muhammad Zakria Zakar, Florian Fischer
BACKGROUND: Pakistan, being a developing country, presents the dismal picture of maternal and neonatal mortality and morbidity. The majority of maternal and neonatal deaths could be avoided if Continuum of Care (CoC) is provided in a structured pathway from pregnancy to birth and to the first week of life of the newborn child. This study aimed to analyse the trends of CoC at all three levels (antenatal care, skilled delivery and postpartum care) and to identify various factors affecting the continuation in receiving CoC in Pakistan during 2006 to 2012...
March 9, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28264723/developmental-pathways-to-adiposity-begin-before-birth-and-are-influenced-by-genotype-prenatal-environment-and-epigenome
#15
Xinyi Lin, Ives Yubin Lim, Yonghui Wu, Ai Ling Teh, Li Chen, Izzuddin M Aris, Shu E Soh, Mya Thway Tint, Julia L MacIsaac, Alexander M Morin, Fabian Yap, Kok Hian Tan, Seang Mei Saw, Michael S Kobor, Michael J Meaney, Keith M Godfrey, Yap Seng Chong, Joanna D Holbrook, Yung Seng Lee, Peter D Gluckman, Neerja Karnani
BACKGROUND: Obesity is an escalating health problem worldwide, and hence the causes underlying its development are of primary importance to public health. There is growing evidence that suboptimal intrauterine environment can perturb the metabolic programing of the growing fetus, thereby increasing the risk of developing obesity in later life. However, the link between early exposures in the womb, genetic susceptibility, and perturbed epigenome on metabolic health is not well understood...
March 7, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28254052/accumulation-of-polybrominated-diphenyl-ethers-in-breast-milk-of-women-from-an-e-waste-recycling-center-in-china
#16
Xinghong Li, Yuan Tian, Yun Zhang, Yujie Ben, Quanxia Lv
Polybrominated diphenyl ethers (PBDEs) can be transferred to infants through the ingestion of breast milk, resulting in potential health risk. In this study, PBDEs, hydroxylated polybrominated diphenyl ethers (OH-PBDEs) and 2,2',4,4',5,6'-hexachlorobiphenyl (CB-153) in human milk from women living adjacent to e-waste recycling sites of Wenling, China, were investigated. The median level of PBDEs in samples from residents living in the e-waste recycling environment >20years (R20 group, 19.5ng/g lipid weight (lw)) was significantly higher than that for residents living in Wenling <3years (R3 group, 3...
February 2017: Journal of Environmental Sciences (China)
https://www.readbyqxmd.com/read/28236860/effect-of-equipotent-doses-of-bupivacaine-and-ropivacaine-in-high-fat-diet-fed-neonatal-rodent-model
#17
Ying-Dong Lian, Zong-Xiang Chen, Kang-Ru Zhu, Shu-Yin Sun, Li-Ping Zhu
OBJECTIVES: The increase in the prevalence of obesity presents a significant health and economic problem. Obesity has been reported to be a major contributor to variety of chronic diseases. Childhood obesity has been rising over the past decades leading to various complications in health. Millions of infants and children undergo surgery every year on various health grounds. The present investigation was undertaken to evaluate the effect of spinal anesthesia of equipotent doses of ropivacaine and bupivacaine on over-weight neonatal rats...
March 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28235599/diazinon-and-parathion-diverge-in-their-effects-on-development-of-noradrenergic-systems
#18
Theodore A Slotkin, Samantha Skavicus, Frederic J Seidler
Organophosphate pesticides elicit developmental neurotoxicity through mechanisms over and above their shared property as cholinesterase inhibitors. We compared the consequences of neonatal exposure (postnatal days PN1-4) to diazinon or parathion on development of norepinephrine systems in rat brain, using treatments designed to produce equivalent effects on cholinesterase, straddling the threshold for barely-detectable inhibition. Norepinephrine levels were measured throughout development from the immediate posttreatment period (PN5), to early adolescence (PN30), young adulthood (PN60) and full adulthood (PN100); we assessed multiple brain regions containing all the major noradrenergic synaptic projections...
February 21, 2017: Brain Research Bulletin
https://www.readbyqxmd.com/read/28202123/-expression-of-long-non-coding-rna-nanci-in-lung-tissues-of-neonatal-mice-with-hyperoxia-induced-lung-injury-and-its-regulatory-effect-on-nkx2-1
#19
Yuan Zhang, Huai-Ping Cheng, Tian-Ping Bao, Xiu-Gui Wang, Zhao-Fang Tian
OBJECTIVE: To investigate the expression of long non-coding RNA NANCI in lung tissues of neonatal mice with hyperoxia-induced lung injury and its regulatory effect on NKX2.1. METHODS: A total of 48 neonatal C57BL/6J mice were randomly divided into an air group and a hyperoxia group, with 24 mice in each group. Each group was further divided into 7-day, 14-day, and 21-day subgroups, with 8 mice in each subgroup. The mice in the air group were fed in the indoor environment (FiO(2)=21%) and those in the hyperoxia group were fed in a high-oxygen box (oxygen concentration: >95%)...
February 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28168591/neonatal-abstinence-syndrome-trend-and-expenditure-in-louisiana-medicaid-2003-2013
#20
Ekwutosi M Okoroh, Rebekah E Gee, Baogong Jiang, Melissa B McNeil, Beverly A Hardy-Decuir, Amy L Zapata
Objectives Determine trends in incidence and expenditure for perinatal drug exposure and neonatal abstinence syndrome (NAS) among Louisiana's Medicaid population. We also describe the maternal characteristics of NAS affected infants. Methods Retrospective cohort analysis using linked Medicaid and vital records data from 2003 to 2013. Conducted incidence and cost trends for drug exposed infants with and without NAS. Also performed comparison statistics among drug exposed infants with and without NAS and those not drug exposed...
February 6, 2017: Maternal and Child Health Journal
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