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https://www.readbyqxmd.com/read/29792059/pitfalls-in-the-diagnosis-of-meningitis-in-neonates-and-young-infants-the-role-of-lumbar-puncture
#1
Luca Bedetti, Lucia Marrozzini, Alessandro Baraldi, Elisabetta Spezia, Lorenzo Iughetti, Laura Lucaccioni, Alberto Berardi
Meningitis occurs frequently in neonates and can lead to a number of acute, severe complications and long-term disabilities. An early diagnosis of neonatal meningitis is essential to reduce mortality and to improve outcomes. Initial clinical signs of meningitis are often subtle and frequently overlap with those of sepsis, and current haematologic tests do not distinguish sepsis from meningitis. Thus, lumbar puncture remains the gold standard for the diagnosis of meningitis in infants, and this procedure is recommended in clinical guidelines...
May 23, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29790842/reviewing-the-who-guidelines-for-antibiotic-use-for-sepsis-in-neonates-and-children
#2
Aline Fuchs, Julia Bielicki, Shrey Mathur, Mike Sharland, Johannes N Van Den Anker
Background Guidelines from 2005 for treating suspected sepsis in low- and middle-income countries (LMIC) recommended hospitalisation and prophylactic intramuscular (IM) or intravenous (IV) ampicillin and gentamicin. In 2015, recommendations when referral to hospital is not possible suggest the administration of IM gentamicin and oral amoxicillin. In an era of increasing antimicrobial resistance, an updated review of the appropriate empirical therapy for treating sepsis (taking into account susceptibility patterns, cost and risk of adverse events) in neonates and children is necessary...
November 2018: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/29789445/thermal-effect-of-a-woolen-cap-in-low-birth-weight-infants-during-kangaroo-care
#3
Francesco Cavallin, Giulia Segafredo, Damiano Pizzol, William Massavon, Marta Lusiani, Olivier Wingi, Manuela De Vivo, Liviana Da Dalt, Chiara Boscardin, Fabio Manenti, Giovanni Putoto, Daniele Trevisanuto
BACKGROUND AND OBJECTIVES: World Health Organization guidelines recommend covering the head during kangaroo mother care (KMC), but the effect of a cap on neonatal thermal control during KMC remains to be defined. Our objective was to assess the effectiveness and safety of a woolen cap in maintaining low birth weight infants (LBWIs) in normal thermal range during KMC. METHODS: Three hundred LBWI candidates for KMC in 3 African hospitals were randomly assigned to KMC with (CAP group) or without (NOCAP group) a woolen cap in a 1:1 ratio during the first week after birth...
May 22, 2018: Pediatrics
https://www.readbyqxmd.com/read/29784657/autism-spectrum-disorder-advances-in-diagnosis-and-evaluation
#4
REVIEW
Lonnie Zwaigenbaum, Melanie Penner
Autism spectrum disorder (ASD) has a variety of causes, and its clinical expression is generally associated with substantial disability throughout the lifespan. Recent advances have led to earlier diagnosis, and deep phenotyping efforts focused on high risk infants have helped advance the characterization of early behavioral trajectories. Moreover, biomarkers that measure early structural and functional connectivity, visual orienting, and other biological processes have shown promise in detecting the risk of autism spectrum disorder even before the emergence of overt behavioral symptoms...
May 21, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29784455/incidence-and-risk-factors-associated-with-30-day-post-operative-venous-thromboembolism-a-nsqip-pediatric-analysis
#5
Jennifer J Ahn, Paul A Merguerian, Margarett Shnorhavorian
INTRO: Venous thromboembolism (VTE) is a rare event in children, but can cause significant morbidity and mortality. The majority of research on pediatric VTE has been in the trauma and critical care populations. The incidence of VTE after surgery in children is not well-established. OBJECTIVE: The objective was to evaluate the incidence of VTE in the 30 days after surgery, as well as associated risk factors. STUDY DESIGN: All cases in the National Surgical Quality Improvement Program Pediatric (NSQIPP) database from 2012 to 2015 were assessed for presence of post-operative VTE...
May 8, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29782437/skin-injuries-and-chlorhexidine-gluconate-based-antisepsis-in-early-premature-infants-a-case-report-and-review-of-the-literature
#6
Valentina Vanzi, Rosanna Pitaro
Early premature infants are subjected to many invasive procedures in neonatal intensive care units, and effective skin antisepsis is an essential step in caring for these vulnerable patients. Nevertheless, preterm infants have an anatomically and physiologically immature skin and preserving their skin integrity is essential to avoid the risk of local and systemic complications. Skin particularities of newborns reduce the list of available antiseptics in neonatology. Chlorhexidine gluconate (CHG) has excellent antiseptic properties and its antimicrobial efficacy cannot be understated, but there is great concern about its use for premature infants, referring to the risk of development skin injuries, such as skin erythema, burns, and blisters...
May 17, 2018: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/29782067/sublingual-immunotherapy-for-pediatric-allergic-conjunctivitis-a-meta-analysis-of-randomized-controlled-trials
#7
Jie Yang, Li Zhang, Zhixiang Zhao, Shiyu Liao
BACKGROUND: Allergic conjunctivitis (AC) is a common chronic condition, especially in children. Ocular symptoms are often overlooked during treatment of allergic rhinoconjunctivitis (ARC). Pediatric ARC can be effectively treated using sublingual immunotherapy (SLIT), which is a guideline-recommended safe treatment approach. However, the therapeutic efficacy of SLIT in terms of ameliorating eye symptoms has not been effectively evaluated. METHODS: We performed a meta-analysis of randomized controlled trials (RCTs) evaluating the use of SLIT for infants, children, and adolescents (aged from 3 to 18 years) with AC or ARC...
May 21, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29781882/no-hiv-transmission-from-virally-suppressed-mothers-during-breastfeeding-in-rural-tanzania
#8
Ezekiel Luoga, Fiona Vanobberghen, Rahel Bircher, Amina Nyuri, Alex J Ntamatungiro, Dorcas Mnzava, Getrud J Mollel, Emilio Letang, Manuel Battegay, Maja Weisser, Anna Gamell
BACKGROUND: To what extent antiretroviral therapy (ART) reduces mother-to-child HIV transmission (MTCT) during breastfeeding remains unclear. We assessed the MTCT risk from mothers on ART to their infants during breastfeeding. SETTING: Ifakara, rural Tanzania. METHODS: We included infants born between 01/2013 and 05/2016 to mothers who initiated ART before delivery, had a negative HIV DNA-PCR at 4-12 weeks, and exclusively breastfed for ≥6 months...
May 16, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/29780965/cochlear-implantation-in-infants-below-12-months-of-age
#9
Richard T Miyamoto, Bethany Colson, Shirley Henning, David Pisoni
Objectives: To provide safety and efficacy data on infants implanted below 12 months of age. Methods: With the wide application of newborn hearing screening programs, infants with deafness are being identified at birth. When a hearing aid trial fails, cochlear implantation is the only option to restore hearing. Mounting evidence suggests that age at implantation is a strong predictor of language outcomes. Using the minimally invasive surgical technique we have employed for nearly two decades, a limited clinical trial was initiated in the year 2000 because this age limitation fell outside of FDA guidelines...
December 2017: World Journal of Otorhinolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29778713/concluding-commentary-on-current-trends-to-enhance-the-clinical-safety-of-pediatric-transfusion-focusing-on-prevention-of-untoward-complications-of-hsc-transplantation-newer-strategies-for-improving-the-standards-of-safety-quality-of-stem-cells-expansion-for
#10
REVIEW
Irena Sniecinski, Jerard Seghatchian
Clinical practice and related diagnostic, development and research [DDR] strategies in pediatric transfusion and transplantation cover a broad range of multidisciplinary studies, performed by many professionals involved in this most challenging clinical field [1]. This commentary on the current position and future perspectives in pediatric transfusion field is aimed to highlight major unresolved transfusion complications in pediatric patients, namely red blood cell and platelet alloimmunisation, and new ones such as nosocomial infection, thrombosis and multi-organ failure...
May 16, 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29778087/midwifery-management-of-pregnant-women-who-are-obese
#11
Margi Reither, Elaine Germano, Michele DeGrazia
INTRODUCTION: Obesity is associated with increased risks for adverse health outcomes during and after pregnancy in both the woman with obesity and her infant. This study was designed to investigate midwifery management of pregnant women with obesity. METHODS: Certified midwives and certified nurse-midwives who were members of the American College of Nurse-Midwives were sent a survey. The survey instrument was divided into 4 sections: demographic characteristics; practice guidelines and protocols; the role of the 2015 Levels of Maternal Care guidelines for referral, including transfer to a higher level of care; and factors that influence management of pregnant women with obesity...
May 19, 2018: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/29775548/open-versus-laparoscopic-approach-for-morgagni-s-hernia-in-infants-and-children-a-systematic-review-and-meta-analysis
#12
Giuseppe Lauriti, Elke Zani-Ruttenstock, Vincenzo D Catania, Lina Antounians, Pierluigi Lelli Chiesa, Agostino Pierro, Augusto Zani
INTRODUCTION: The laparoscopic repair of Morgagni's hernia (MH) has been reported to be safe and feasible. However, it is still unclear whether laparoscopy is superior to open surgery in repairing MH. MATERIALS AND METHODS: Using a defined search strategy, three investigators independently identified all comparative studies reporting data on open and laparoscopic MH repair in patients <18 years of age. Case reports and opinion articles were excluded. Meta-analysis was conducted according to PRISMA guidelines and using RevMan 5...
May 18, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29772928/a-clinical-carepath-for-obese-pregnant-women-a-pragmatic-pilot-cluster-randomized-controlled-trial
#13
Sarah D McDonald, Kristen A Viaje, Rebecca A Rooney, Alexander Jarde, Lucia Giglia, Cynthia V Maxwell, David Small, Tracy Pearce Kelly, B H Sc Midwifery, Lisa Sabatino, Lehana Thabane
OBJECTIVES: Obese women are at increased risks for complications during pregnancy, birth and in their infants. Although guidelines have been established for the clinical care of obese pregnant women, management is sometimes suboptimal. Our goal was to determine the feasibility of implementing and testing a clinical carepath for obese pregnant women compared to standard care, in a pilot cluster randomized controlled trial (RCT). METHODS: A pragmatic pilot cluster RCT was conducted, randomly allocating eight clinics to the carepath or standard care for obese pregnant women...
May 17, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29771871/trends-in-antiretroviral-therapy-eligibility-and-coverage-among-children-aged-15-years-with-hiv-infection-20-pepfar-supported-sub-saharan-african-countries-2012-2016
#14
Amanda Burrage, Monita Patel, Kelsey Mirkovic, Eric Dziuban, Wondimu Teferi, Laura Broyles, Emilia Rivadeneira
Rapid disease progression and associated opportunistic infections contribute to high mortality rates among children aged <15 years with human immunodeficiency virus (HIV) infection (1). Antiretroviral therapy (ART) has decreased childhood HIV-associated morbidity and mortality rates over the past decade (2). As accumulating evidence revealed lower HIV-associated mortality with early ART initiation, the World Health Organization (WHO) guidelines broadened ART eligibility for children with HIV infection (2)...
May 18, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29771301/anti-tnf-levels-in-cord-blood-at-birth-are-associated-with-anti-tnf-type
#15
Shannon L Kanis, Alison de Lima, Cokkie van der Ent, Dimitris Rizopoulos, C Janneke van der Woude
Background and Aims: Pregnancy guidelines for women with Inflammatory Bowel Disease (IBD) provide recommendations regarding anti-TNF cessation during pregnancy, in order to limit fetal exposure. Although infliximab (IFX) leads to higher anti-TNF concentrations in cord blood than adalimumab (ADA), recommendations are similar. We aimed to demonstrate the effect of anti-TNF cessation during pregnancy on fetal exposure, for IFX and ADA separately. Methods: We conducted a prospective single center cohort study...
May 15, 2018: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29767700/effects-of-iodized-salt-and-iodine-supplements-on-prenatal-and-postnatal-growth-a-systematic-review
#16
Jessica Farebrother, Celeste E Naude, Liesl Nicol, Zhongna Sang, Zhenyu Yang, Pieter L Jooste, Maria Andersson, Michael B Zimmermann
Hypothyroidism due to iodine deficiency can impair physical development, most visibly in the marked stunting of myxedematous cretinism caused by severe in utero iodine deficiency. Whether iodine repletion improves growth in noncretinous children is uncertain. Therefore, the aim of our systematic review was to assess the effects of iodine fortification or supplementation on prenatal and postnatal growth outcomes in noncretinous children. Following Cochrane methods and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) reporting guidelines, we searched 10 databases including 2 Chinese databases (latest search February 2017)...
May 1, 2018: Advances in Nutrition
https://www.readbyqxmd.com/read/29767435/approaches-to-the-evaluation-of-cultural-adaptations-of-home-visiting-in-tribal-communities
#17
Aleta Meyer, Erin Geary, Debra Heath, Vanessa Hiratsuka, Melina Salvador, Jenae Sanchez, Nancy Whitesell
The research that underlies evidence-based practices is often based on relatively homogenous study samples, thus limiting our ability to understand how the study findings apply in new situations as well as our understanding of what might need to be adapted. In a preliminary effort to address those gaps, the requirements for the Tribal Maternal Infant and Early Childhood Home Visiting Program (MIECHV) included the expectation that grantees design and implement rigorous evaluations to address local priorities and to help build the knowledge base regarding the use of evidence-based home-visiting programs in tribal communities...
May 16, 2018: Infant Mental Health Journal
https://www.readbyqxmd.com/read/29765787/liver-failure-and-conjugated-hyperbilirubinemia-in-a-preterm-neonate-role-of-early-ivig-and-exchange-transfusion
#18
Jayasree Nair, Vasantha H S Kumar
Neonatal liver failure (NLF) is a rare diagnosis but carries with it significant risks of mortality and morbidity. Common etiologies for NLF include metabolic causes, gestational alloimmune liver disease (GALD or neonatal hemochromatosis), and viral infections. We report a case of liver failure in a premature infant with abnormal iron profile within 48 hours of birth. Lack of accepted guidelines for the initial management of severe jaundice with a high direct component in the first week after birth made treatment challenging...
April 2018: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29764471/inhaled-nitric-oxide-as-a-rescue-therapy-in-a-preterm-neonate-with-severe-pulmonary-hypertension-a-case-report
#19
Martina Busè, Francesco Graziano, Fabio Lunetta, Giorgio Sulliotti, Vincenzo Duca
BACKGROUND: Inhaled nitric oxide (iNO) has been approved for the treatment of persistent pulmonary hypertension of the newborn (PPHN) in term and near-term newborns. Its role in the management of persistent pulmonary hypertension in preterm infants is not clear. Although guidelines do not exist, some studies have shown that iNO could be used as a rescue therapy in preterm neonate with severe pulmonary hypertension. CASE PRESENTATION: We describe the case of a preterm neonate, born at 30 + 1 weeks of gestation, with hypoxic respiratory failure not responding to maximal conventional therapy...
May 15, 2018: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29762472/weaning-time-in-preterm-infants-an-audit-of-italian-primary-care-paediatricians
#20
Maria Elisabetta Baldassarre, Antonio Di Mauro, Annarita Pedico, Valentina Rizzo, Manuela Capozza, Fabio Meneghin, Gianluca Lista, Nicola Laforgia
INTRODUCTION: According to the 2016 Italian National Institute of Statistics (Istat) data in Italy, about 6.7% of all newborns are born prematurely. Due to the lack of data on current complementary feeding in preterm infants in Italy, the aim of the survey was to evaluate individual attitudes of primary care paediatricians, concerning the introduction of complementary foods in preterm infants. METHODS: An internet-based survey was conducted among primary care paediatricians, working in Italy, regarding (1) timing of the introduction of complementary foods to preterm newborns; (2) type of complementary foods introduced; (3) vitamin D and iron supplementations...
May 15, 2018: Nutrients
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