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Neonatal pain

Alexa Craig, Christine James, Janelle Bainter, Francis L Lucas, Scott Evans, John Glazer, Donna Dowling
BACKGROUND: The traumatic experiences of parents of babies treated with therapeutic hypothermia (TH) have been described. No research has assessed neonatal intensive care unit (NICU) nurse experience in providing care to hypothermic babies and emotional support to their parents. PURPOSE: To assess NICU nurse attitudes to the provision of TH with respect to perceptions about baby pain/sedation, need for nurse and parent education, decision making about initiation of TH, and barriers to best care...
October 18, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Talia Orr, Marsha Campbell-Yeo, Britney Benoit, Brenda Hewitt, Jennifer Stinson, Patrick McGrath, Donna Dowling
BACKGROUND: Despite an abundance of research that identifies the benefits for both parent and child when parents are actively involved in their infant's care, challenges related to the best methods to engage families persist. PURPOSE: To conduct a feasibility study that aims to understand the preferences of smartphone and Internet use by parents of infants admitted to the neonatal intensive care unit (NICU) related to information seeking and active participation in infant care, with a focus on pain management interventions...
October 18, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Wanli Xu, Stephen Walsh, Xiaomei S Cong
High-risk neonates experience numerous painful/stressful procedures daily in neonatal intensive care units (NICUs). Accumulated pain and stress have a detrimental impact on infants' neurodevelopment. Few valid tools are available to measure accumulated pain/stressors among NICU infants. The aim of this study was to obtain nurses' perceptions about severity and acuity levels regarding each painful/stressful procedure that infants may experience in the NICU. The data will support developing a new instrument, the Accumulated Pain/Stressor Scale (APSS) in NICUs...
October 15, 2016: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
Sharon Baranoski, Kimberly LeBlanc, Mary Gloeckner
: Often perceived as minor injuries, these wounds can become painful, costly, and complex. ABSTRACT: Although skin tears are common, particularly among older adults and neonates, they are often inadequately documented and poorly managed, resulting in complications, extended hospital stays, and negative patient outcomes. In this article, the first in a series on wound care in collaboration with the World Council of Enterostomal Therapists (, the authors describe the complications that developed in an elderly patient whose skin tear was improperly dressed and discuss best practices for preventing, assessing, documenting, and managing skin tears...
October 13, 2016: American Journal of Nursing
Neil C Ford, Mark L Baccei
Spinal lamina I projection neurons serve as a major conduit by which noxious stimuli detected in the periphery are transmitted to nociceptive circuits in the brain, including the parabrachial nucleus (PB) and the periaqueductal gray (PAG). While neonatal spino-PB neurons are more than twice as likely to exhibit spontaneous activity compared to spino-PAG neurons, the underlying mechanisms remain unclear since nothing is known about the voltage-independent (i.e. 'leak') ion channels expressed by these distinct populations during early life...
October 14, 2016: Neuroscience
Sibel Kucukoglu, Aynur Aytekin, Ayda Celebioglu, Arzu Celebi, Ibrahim Caner, Rukiye Maden
The purpose of this study was to evaluate the effect of white noise as a distraction method in relieving procedural pain caused by vaccination for premature infants. This experimental study was performed at a neonatal intensive care unit (NICU) of a university hospital in Turkey between July and September 2013. The study population was composed of 75 premature infants (35 in the study group and 40 in the control group) who met the inclusion criteria. Premature infants in the study group were exposed to white noise using MP3 players placed at the head of the infants' open crib for 1 minute before vaccination...
October 14, 2016: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
Antoinette S Birs, Jose A Perez, Mark A Rich, Hubert S Swana
Iatrogenic bladder injuries have been reported in the neonate during umbilical artery/vein catheterization, voiding cystourethrogram, urinary catheterizations, and overwhelming hypoxic conditions. Patients with iatrogenic bladder perforations can present with acute abdomen indicating urinary peritonitis, septic-uremic shock, or subtle symptoms like abdominal distension, pain, hematuria, uremia, electrolyte imbalances, and/or difficulty urinating. The following neonatal case report of perforated bladder includes a review of the signs, symptoms, diagnostic tools, and management of bladder injury in neonates...
2016: Case Reports in Urology
Siyang Yan, Amanda C Kentner
Exposure to painful procedures and/or stressors during the early neonatal period can reprogram the underlying neurocircuitry involved in nociception and neuropathic pain perception. The reprogramming of these systems can result in an enduring elevation in sensitivity towards mechanical and thermal stimuli. Recent evidence suggests that exposure to mild inflammatory mediators during the neonatal period can induce similar pain responses in both adolescent and adult rats. Therefore, we sought to profile changes in the expression of several genes across brain areas involved in the active modulation of nociception and neuropathic pain using a well-recognized model of neonatal inflammation...
October 11, 2016: Brain, Behavior, and Immunity
Shaojie Xin, Long Xiao
The clinical manifestations of hepatitis E are similar to those of other types of viral hepatitis. While acute hepatitis E is usually self-limited, pregnant women and chronic liver disease patients suffering from acute hepatitis E usually present with severe clinical manifestations that may develop into fulminant hepatic failure. Chronic HEV infection is typically only seen in organ transplant patients; most HEV cases are asymptomatic and rarely display jaundice, fatigue, abdominal pain, fever, fatigue, or ascites...
2016: Advances in Experimental Medicine and Biology
Timothy Disher, Britney Benoit, Celeste Johnston, Marsha Campbell-Yeo
AIMS: To assess the acceptability of methods that increase trial inclusion in meta-analyses, and the level of evidence for skin-to-skin contact for procedural pain in infants. BACKGROUND: The current Cochrane review of skin-to-skin contact for pain in newborns found it to be an effective intervention, but identified several methodological limitations. DESIGN: Meta-re-analysis. METHODS: Trial designs included randomized trials reporting a validated pain assessment tool as a primary outcome including term and preterm infants undergoing a tissue-breaking painful procedure...
October 12, 2016: Journal of Advanced Nursing
John J Mccarthy, Martin H Leamon, Loretta P Finnegan, Catherine Fassbender
Increase in the number of opioid dependent pregnant women delivering babies at risk for neonatal abstinence syndrome (NAS) prompted a General Accountability Office (GAO) report documenting deficits in research and provider knowledge about care of the maternal/fetal unit and the neonate. There are three general sources of dependence: untreated opioid use disorder (OUD), pain management, and medication assisted treatment with methadone or buprenorphine. A survey of methadone patients' experiences when telling a physician of their pregnancy and opioid dependence demonstrated physician confusion about proper care, frequent negative interactions with the mother, and failures to provide appropriate referral...
October 8, 2016: American Journal of Obstetrics and Gynecology
Maria Claudia Rodríguez, Perla Villamor, Tatiana Castillo
INTRODUCTION: Pain is a disease by itself and it's a public health concern of major implication in children, not just because of the emotional component of the child and his family, but also due to the potential morbidity and mortality involving it. A proper assessment of pain it's a challenge in the pediatric population, due to their lack of understanding and verbalization of hurt. Additionally, a satisfactory treatment of pediatric pain can be arduous due to a lack of clinical knowledge, insufficient pediatric research, and the fear to opioid side effects and addiction...
November 2016: International Journal of Pediatric Otorhinolaryngology
Bo Zhu, Yumei Chen, Xiaolu Shen, Xishi Liu, Sun-Wei Guo
BACKGROUND: Recently emerging evidence indicates that endometriotic lesions are wounds undergoing repeated tissue injury and repair (ReTIAR), and platelets induce epithelial-mesenchymal transition (EMT), fibroblast-to-myofibroblast transdifferentiation (FMT), leading ultimately to fibrosis. Due to the commonality of cyclic bleeding as in endometriosis, adenomyotic lesions are also wounds that undergo ReTIAR, and we have recently provided evidence corroborating platelet-induced EMT, FMT and fibrogenesis in adenomyosis...
October 10, 2016: Reproductive Biology and Endocrinology: RB&E
Arne Ohlsson, Prakeshkumar S Shah
BACKGROUND: Newborn infants have the ability to experience pain. Hospitalised infants are exposed to numerous painful procedures. Healthy newborns are exposed to pain if the birth process consists of assisted vaginal birth by vacuum extraction or by forceps and during blood sampling for newborn screening tests. OBJECTIVES: To determine the efficacy and safety of paracetamol for the prevention or treatment of procedural/postoperative pain or pain associated with clinical conditions in neonates...
October 7, 2016: Cochrane Database of Systematic Reviews
Zijo Begic, Edin Begic, Senka Mesihovic-Dinarevic, Izet Masic, Senad Pesto, Mirza Halimic, Almira Kadic, Amra Dobraca
OBJECTIVE: To show the place and role of continuous electrocardiographic twenty-four-hour ECG monitoring in daily clinical practice of pediatric cardiologists. METHODS: According to protocol, 2753 patients underwent dynamic continuous ECG Holter monitoring (data collected from the "Register of ECG Holter monitoring" of Pediatric Clinic, UCC Sarajevo in period April 2003- April 2015). RESULTS: There were 50,5% boys and 49,5% girls, aged from birth to 19 years (1,63% - neonates and infants, 2,6% - toddlers, 9,95% - preschool children, 35,5% - gradeschoolers and 50,3% children in puberty and adolescence)...
July 16, 2016: Acta Informatica Medica: AIM
Jake A Nieto, Michael A Yamin, Itzhak D Goldberg, Prakash Narayan
Autosomal recessive polycystic kidney disease (ARPKD) is associated with progressive enlargement of the kidneys fuelled by the formation and expansion of fluid-filled cysts. The disease is congenital and children that do not succumb to it during the neonatal period will, by age 10 years, more often than not, require nephrectomy+renal replacement therapy for management of both pain and renal insufficiency. Since increasing cystic index (CI; percent of kidney occupied by cysts) drives both renal expansion and organ dysfunction, management of these patients, including decisions such as elective nephrectomy and prioritization on the transplant waitlist, could clearly benefit from serial determination of CI...
2016: PloS One
Fen Wang, Yun-Xia Cao, Shan-Gao Ke, Tao-Hua Zhu, Miao Zhang
OBJECTIVE: To determine whether combined spinal-epidural analgesia (CSEA) during labor increases the frequency of emergency cesarean delivery among Chinese nulliparous women. METHODS: In a retrospective study, the medical records of nulliparous women with a singleton fetus in cephalic presentation who delivered at term at Tongling Maternity Hospital, China, between January 2012 and December 2014 were reviewed. Information about CSEA, mode of delivery, labor duration, oxytocin augmentation, and neonatal outcome was obtained...
August 24, 2016: International Journal of Gynaecology and Obstetrics
Amaka Akalonu, Mona Yasrebi, Zarela Molle Rios
BACKGROUND Spontaneous gastric perforation is a rare clinical disorder. The majority of the available data have been reported in the neonatal age group. There are a few cases of spontaneous gastric perforation in preschool children. To our knowledge, there is no published information on spontaneous gastric perforation in older children and adolescents. CASE REPORT We describe the presentation and clinical course of two adolescent children who presented with spontaneous gastric perforation. Both children presented with acute onset abdominal pain, which progressively worsened...
2016: American Journal of Case Reports
Timothy J Ness, Alan Randich, Dwight E Nelson, Xin Su
BACKGROUND AND OBJECTIVES: Neuromodulation has been reported to reliably improve symptoms of bladder overactivity and sometimes pain. The effect of electrical stimulation of several nerve pathways demonstrated to alter cystometric responses to bladder distension was examined on nociceptive responses in models of bladder hypersensitivity. METHODS: Bladder hypersensitivity was produced by several published methods including neonatal inflammation, acute inflammation, and chronic stress...
September 28, 2016: Regional Anesthesia and Pain Medicine
Genevieve E Becker, Hazel A Smith, Fionnuala Cooney
BACKGROUND: Breastfeeding is important, however not all infants can feed at the breast and methods of expressing milk need evaluation. OBJECTIVES: To assess acceptability, effectiveness, safety, effect on milk composition, contamination and costs of methods of milk expression. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (21 March 2016), handsearched relevant journals and conference proceedings, and contacted experts in the field to seek additional published or unpublished studies...
September 29, 2016: Cochrane Database of Systematic Reviews
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