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https://www.readbyqxmd.com/read/28109052/the-use-of-methadone-to-facilitate-opioid-weaning-in-pediatric-critical-care-patients-a-systematic-review-of-the-literature-and-meta-analysis
#1
REVIEW
Leslie A Dervan, Beryl Yaghmai, Robert Scott Watson, Fredric M Wolf
BACKGROUND: Continuous opioid infusion therapy is commonly utilized in the pediatric intensive care setting to treat pain and facilitate tolerance of invasive therapies. Transitioning to methadone is one common strategy for weaning from continuous opioid infusions, but in practice this transition can be challenging, and many children still experience iatrogenic withdrawal. AIM: We reviewed the literature to evaluate the best available evidence to guide methadone therapy in this setting, and to summarize associated adverse events...
January 20, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28108103/respiratory-support-for-very-low-birth-weight-infants-receiving-dexamethasone
#2
Yamini V Virkud, Christoph P Hornik, Daniel K Benjamin, Matthew M Laughon, Reese H Clark, Rachel G Greenberg, P Brian Smith
OBJECTIVE: To assess how neonatal intensive care units followed the American Academy of Pediatrics guidelines for use of dexamethasone in preterm infants by evaluating respiratory support at the time of dexamethasone administration. STUDY DESIGN: This is an observational study of infants discharged from one of 290 neonatal intensive care units from 2003 to 2010. The cohort included very low birth weight (<1500 g birth weight) infants born at ≤32 weeks gestational age...
January 18, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28106669/translational-studies-identify-long-term-impact-of-prior-neonatal-pain-experience
#3
Suellen M Walker
Pain sensitivity and risk of chronic pain can be influenced by past experience. Childhood stress/adversity has been associated with chronic pain, mood disorders, and altered disease vulnerability decades later. As the rate of preterm birth and survival at earlier gestational ages increases, and advances in peri-operative care and surgery allow more complex surgical interventions to be performed in neonates, evaluation of treatment 'success' must extend beyond acute morbidity and mortality to encompass effects on subsequent neurodevelopmental outcome, and also sensory, cognitive and behavioral responses to pain in later life...
January 12, 2017: Pain
https://www.readbyqxmd.com/read/28105373/vascular-changes-on-fluorescein-angiography-of-premature-infants-with-low-risk-of-retinopathy-of-prematurity-after-high-oxygen-exposure
#4
Maria Ana Martinez-Castellanos, Raul Velez-Montoya, Kenneth Price, Andree Henaine-Berra, Gerardo García-Aguirre, Virgilio Morales-Canton, Linda Alejandra Cernichiaro-Espinosa
PURPOSE: To describe a wide array of peripheral vascular changes using fluorescein angiography in preterm neonates, without high risk characteristics for developing retinopathy of prematurity, that were exposed to high oxygen concentration. METHODS: Retrospective, two center, case series. Newborns at two different hospitals with ≥1500 g or gestational age of ≥32 weeks, fluorescein angiography performed, and with high oxygen exposure without adequate control were included...
2017: International Journal of Retina and Vitreous
https://www.readbyqxmd.com/read/28104401/leading-causes-of-preterm-delivery-as-risk-factors-for-intraventricular-hemorrhage-in-very-preterm-infants-results-of-the-epipage-2-cohort-study
#5
Marie Chevallier, Thierry Debillon, Veronique Pierrat, Pierre Delorme, Gilles Kayem, Mélanie Durox, François Goffinet, Stephane Marret, Pierre Yves Ancel
BACKGROUND: Intraventricular hemorrhage is a major risk factor for neurodevelopmental disabilities in preterm infants. However, few studies have investigated how pregnancy complications responsible for preterm delivery are related to intraventricular hemorrhage. OBJECTIVE: To investigate the association between the main causes of preterm delivery and intraventricular hemorrhage in very preterm infants born in France during 2011 between 22 and 31 weeks of gestation...
January 16, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28103590/risk-factors-for-intrapartum-fever-in-term-gestations-and-associated-maternal-and-neonatal-sequelae
#6
Angela P H Burgess, Justin E Katz, Michael Moretti, Nisha Lakhi
AIM: To determine factors associated with intrapartum fever and to examine associated maternal and neonatal outcomes. METHODS: Retrospective study of patients between 360/7 and 420/7 gestational weeks who entered spontaneous or induced active labor and developed temperature ≥38°C; a similar group that did not develop fever were controls. Univariate and multivariate analyses were performed with p < 0.05 as significant. RESULTS: Fifty-four febrile patients and 306 nonfebrile controls met inclusion criteria...
January 20, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/28102857/vocal-fold-paralysis-in-preterm-infants-prevalence-and-analysis-of-risk-factors
#7
J Jabbour, M Uhing, T Robey
OBJECTIVE: To calculate the prevalence of vocal fold paralysis (VFP) in preterm (<37 weeks of gestation) infants at a single neonatal intensive care unit (NICU) and identify risk factors for the development of VFP. STUDY DESIGN: This is a case control study of all surviving preterm infants admitted to the NICU at Children's Hospital of Wisconsin from 2006 to 2012, comparing those with and without VFP. Multivariate analysis was performed to identify significant risk factors for VFP...
January 19, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28102855/the-prevalence-of-feeding-problems-in-children-formerly-treated-in-a-neonatal-intensive-care-unit
#8
M Hoogewerf, H J Ter Horst, H Groen, T Nieuwenhuis, A F Bos, M W G van Dijk
OBJECTIVE: To determine the prevalence of oral feeding problems in neonatal intensive care unit (NICU) graduates at 1 to 2 years, and to identify clinical risk factors during NICU admission. STUDY DESIGN: Observational cohort study of 378 children, who received level III/IV NICU care for 4 days or more in 2011 to 2012, chromosomal abnormalities excluded. We detected feeding problems in four gestational age (GA) groups (<28, 28 to 31, 32 to 36 weeks, and term-borns) using the Dutch standardized Screeningslijst Eetgedrag Peuters, and collected clinical factors for logistic regression analyses...
January 19, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28102852/anthropometric-trends-from-1997-to-2012-in-infants-born-at-%C3%A2-28-weeks-gestation-or-less
#9
N Wells, T A Stokes, K Ottolini, C H Olsen, A R Spitzer, C E Hunt
OBJECTIVE: Postnatal growth failure is common after preterm birth, in particular for infants born at ⩽28 weeks' gestation, but it is unknown if growth-to-term equivalent age has improved over the years as neonatal intensive care in general, and infant nutrition in particular, have improved. The objective of the study was to evaluate anthropometric trends at NICU discharge for infants born at ⩽28 weeks' gestation using a large national database. STUDY DESIGN: Analysis of growth in weight, length, head circumference and body mass index (kg m(2)) in 23 005 infants born in 1997 to 2012 who survived to neonatal intensive care unit discharge at ⩽41 weeks' postmenstrual age...
January 19, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28102534/evacuation-performance-evaluation-tool
#10
Sharon Farra, Elaine T Miller, Matthew Gneuhs, Nathan Timm, Gengxin Li, Ashley Simon, Whittney Brady
OBJECTIVE: Hospitals conduct evacuation exercises to improve performance during emergency events. An essential aspect in this process is the creation of reliable and valid evaluation tools. The objective of this article is to describe the development and implications of a disaster evacuation performance tool that measures one portion of the very complex process of evacuation. DESIGN: Through the application of the Delphi technique and DeVellis's framework, disaster and neonatal experts provided input in developing this performance evaluation tool...
April 2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28101934/detection-of-neonatal-unit-clusters-of-candida-parapsilosis-fungaemia-by-microsatellite-genotyping-results-from-laboratory-based-sentinel-surveillance-south-africa-2009-2010
#11
Rindidzani E Magobo, Serisha D Naicker, Jeannette Wadula, Maphoshane Nchabeleng, Yacoob Coovadia, Anwar Hoosen, Shawn R Lockhart, Nelesh P Govender
Neonatal candidaemia is a common, deadly and costly hospital-associated disease. To determine the genetic diversity of Candida parapsilosis causing fungaemia in South African neonatal intensive care units (NICUs). From February 2009 through to August 2010, cases of candidaemia were reported through laboratory-based surveillance. C. parapsilosis isolates from neonatal cases were submitted for identification by internal transcribed spacer (ITS) region sequencing, antifungal susceptibility testing and microsatellite genotyping...
January 19, 2017: Mycoses
https://www.readbyqxmd.com/read/28101771/impact-of-relocation-and-environmental-cleaning-on-reducing-the-incidence-of-healthcare-associated-infection-in-nicu
#12
Qiu-Fang Li, Hong Xu, Xiao-Ping Ni, Rong Lin, Hui Jin, Ling-Ya Wei, Dan Liu, Lin-Hai Shen, Jie Zha, Xin-Fen Xu, Bo Wu
BACKGROUND: Hospital environment remains a risk for healthcare-associated infections (HAIs). This was a prospective study to evaluate the comprehensive impact of relocating a neonatal intensive care unit (NICU) to a new facility and improved environmental cleaning practice on the presence of methicillin-resistant Staphylococcus aureus (MRSA) on inanimate surfaces and the incident rate of HAIs. METHODS: New environmental cleaning measures were adopted after the NICU was moved to a new and better-designed location...
January 19, 2017: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/28101699/humanity-at-the-edge-the-moral-laboratory-of-feeding-precarious-lives
#13
Mette N Svendsen, Iben M Gjødsbøl, Mie S Dam, Laura E Navne
At the heart of anthropology and the social sciences lies a notion of human existence according to which humans and animals share the basic need for food, but only humans have the capacity for morality. Based on fieldwork in a pig laboratory, a neonatal intensive care unit (NICU), and a dementia nursing home, we follow practices of feeding precarious lives lacking most markers of human personhood, including the exercise of moral judgment. Despite the absence of such markers, laboratory researchers and caregivers in these three sites do not abstain from engaging in questions about the moral status of the piglets, infants, and people with dementia in their care...
January 18, 2017: Culture, Medicine and Psychiatry
https://www.readbyqxmd.com/read/28101656/off-label-use-of-antimicrobials-in-neonates-in-a-tertiary-children-s-hospital
#14
Niina Laine, Ann Marie Kaukonen, Kalle Hoppu, Marja Airaksinen, Harri Saxen
PURPOSE: Off-label (OL) use of drugs for hospitalized children is very common. OL use occurs especially in the youngest patients, neonates. This study focused on the OL use of antimicrobials in neonates. To our knowledge, only few studies have focused on the prevalence of OL use of antimicrobials in neonates. METHODS: We investigated the OL use of antimicrobials in neonates in a tertiary children's hospital. First, we investigated what were the most consumed OL antimicrobials in defined daily doses according to hospital's registry data from neonatal intensive care unit (NICU) during 2009-2014...
January 18, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28101156/clinical-and-microbiological-profile-of-babies-born-with-risk-of-neonatal-sepsis
#15
Bin Zhou, Xiao Liu, Jie-Bin Wu, Bao Jin, Yan-Yan Zhang
The aim of the present study was to evaluate the effects of antibiotics on the condition of babies born with risk of neonatal sepsis. From March, 2014 to February, 2015, 200 neonates born with risk factors of septicemia in the Neonatal Intensive Care Unit at Xuzhou Central Hospital, were enrolled in the present study. Venous blood samples were collected within 6 h of birth using aseptic technique. Part of the blood specimens were cultured using BACTEC PEDS PLUS/F Culture Vials. Subsequently, the subcultures were prepared from each presumptive positive vial and bacterial isolates were identified...
December 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28099979/milrinone-pharmacokinetics-and-pharmacodynamics-in-neonates-with-persistent-pulmonary-hypertension-of-the-newborn
#16
Annie Giaccone, Athena F Zuppa, Beena Sood, Meryl S Cohen, Michael L O'Byrne, Ganesh Moorthy, Amit Mathur, Haresh Kirpalani
Objective To describe the pharmacokinetics and pharmacodynamics of milrinone in infants with persistent pulmonary hypertension of the newborn (PPHN) and to explore the impact of age on milrinone disposition. Design Randomized, open label pilot study. Setting Multicenter; level 3 and level 4 neonatal intensive care units. Patients Six infants ≥34 weeks' gestational age and <10 days of life with persistent hypoxemia receiving inhaled nitric oxide. Intervention Intravenous milrinone lactate in one of two dosing regimens: (1) low dose, 20 mcg/kg bolus followed by 0...
January 18, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28099786/labor-intervention-and-outcomes-in-women-who-are-nulliparous-and-obese-comparison-of-nurse-midwife-to-obstetrician-intrapartum-care
#17
Nicole S Carlson, Elizabeth J Corwin, Nancy K Lowe
BACKGROUND: Women who are obese have slower labors than women of normal weight, and show reduced response to interventions designed to speed labor progress like oxytocin augmentation and artificial rupture of membranes. The optimal labor management for these women has not been described. METHODS: This retrospective cohort study compared 2 propensity score-matched groups of women (N = 360) who were healthy, nulliparous, spontaneously laboring, and obese (body mass index ≥ 30 kg/m(2) )...
January 18, 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28099725/maternal-and-newborn-outcomes-at-a-tertiary-care-hospital-in-lusaka-zambia-2008-2012
#18
Bellington Vwalika, Marie C D Stoner, Mulindi Mwanahamuntu, K Cherry Liu, Eugene Kaunda, Getrude G Tshuma, Somwe W Somwe, Yusuf Ahmed, Elizabeth M Stringer, Jeffrey S A Stringer, Benjamin H Chi
OBJECTIVE: To measure key obstetric and neonatal outcomes recorded at a tertiary hospital in Zambia over a 5-year period. METHODS: A retrospective analysis was conducted among women who had delivered at the University Teaching Hospital in Lusaka, between January 1, 2008, and December 31, 2012. Data were extracted from electronic medical records. The main outcomes were maternal mortality, cesarean delivery, prenatal or intrapartum hemorrhage, stillbirth, a 5-minute Apgar score of less than 7, and admission to the neonatal intensive care unit...
February 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28097843/colonization-and-infection-in-the-newborn-infant-does-chlorhexidine-play-a-role-in-infection-prevention
#19
Lizeth Ortegón, Marcela Puentes-Herrera, Ivohne F Corrales, Jorge A Cortés
Healthcare-associated infections are a major problem in newborn infants, considering their high morbidity, mortality, and long-term sequelae. In preterm infants, it has been shown that skin and gastrointestinal tract colonization undergoes variations compared to healthy term infants, and that preterm infants are more exposed to nosocomial microorganisms given their higher probability of being admitted to the neonatal intensive care unit where they are cared for. This document reviews normal colonization, the changes observed during hospitalization, prematurity, and the potential role of chlorhexidine in the prevention of resistant microorganism transmission, as well as its side effects in newborn infants admitted to the neonatal intensive care unit...
1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28097694/serial-cytokine-alterations-and-abnormal-neuroimaging-in-newborn-infants-with-encephalopathy
#20
Fiona M O'Hare, R William G Watson, Amanda O'Neill, Ricardo Segurado, Deirdre Sweetman, Paul Downey, Eoghan Mooney, John Murphy, Veronica Donoghue, Eleanor J Molloy
AIM: Inflammatory cytokines may play a role in the final common pathway in the pathogenesis of hypoxic-ischaemic injury in experimental models. We aimed to profile the systemic pro- and anti-inflammatory response over the first week of life in term infants at risk of neonatal encephalopathy. METHOD: In a tertiary referral university neonatal intensive care unit, serial blood samples were analysed from 41 term infants (requiring resuscitation at birth) in this prospective observational pilot study...
January 17, 2017: Acta Paediatrica
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