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premature care

Johannes Eimer, Jan Vesterbacka, Irina Savitcheva, Rayomand Press, Homayoun Roshanisefat, Piotr Nowak
RATIONALE: Cognitive dysfunction is a common presenting symptom in patients with HIV/AIDS. It is usually directly associated with HIV infection or due to opportunistic infection. Rapidly progressive dementia, however, is rarely observed in acute HIV infection or during immune reconstitution. Recently, a case of Creutzfeld-Jakob disease (CJD) has been reported in a patient with chronic HIV infection. The incidence of CJD is not known to be increased among immunocompromised patients. PATIENT CONCERNS: We here report the case of a 59-year-old male patient with a recent diagnosis of HIV/AIDS and Pneumocystis jiroveci pneumonia presenting with secondary behavioral changes and disorientation...
March 2018: Medicine (Baltimore)
Darius M Moshfeghi
PURPOSE OF REVIEW: This review highlights the common areas of medicolegal risk during retinopathy of prematurity (ROP) screening. RECENT FINDINGS: Most malpractice risk in ROP comes from systemic errors that ultimately result in failure to screen the patient in a timely fashion, resulting in failures to intervene and/or refer in a timely fashion. Currently, the emphasis is engaging the family members, the hospital staff, and clinic staff to pro-actively manage ROP patients and ensure that they are screened in a timely fashion...
March 20, 2018: Current Opinion in Ophthalmology
Mariana Chiaradia Dominguez, Beatriz Regina Alvares
Objective: To analyze the radiological aspects of pulmonary atelectasis in newborns on mechanical ventilation and treated in an intensive care unit, associating the characteristics of atelectasis with the positioning of the head and endotracheal tube seen on the chest X-ray, as well as with the clinical variables. Materials and Methods: This was a retrospective cross-sectional study of 60 newborns treated between 1985 and 2015. Data were collected from medical records and radiology reports...
January 2018: Radiologia Brasileira
Robert Freedman, Sharon K Hunter, M Camille Hoffman
Genes, infection, malnutrition, and other factors affecting fetal brain development are a major component of risk for a child's emotional development and later mental illnesses, including schizophrenia, bipolar disorder, and autism. Prenatal interventions to ameliorate that risk have yet to be established for clinical use. A systematic review of prenatal nutrients and childhood emotional development and later mental illness was performed. Randomized trials of folic acid, phosphatidylcholine, and omega-3 fatty acid supplements assess effects of doses beyond those adequate to remedy deficiencies to promote normal fetal development despite genetic and environmental risks...
March 21, 2018: American Journal of Psychiatry
Olivier Nardi, Elizabeth Zavala, Claude Martin, Serafim Nanas, Thomas Scheeren, Andrea Polito, Xavi Borrat, Djillali Annane
OBJECTIVE: Evaluation of the ratio of oxyhaemoglobin to total haemoglobin in skeletal muscle (StO2 ) using near-infrared spectroscopy may aid in the monitoring of patients with sepsis. This study assessed the benefits and risks of targeting StO2 in adults with severe sepsis or septic shock. DESIGN: A European randomised controlled trial was performed on two parallel groups. SETTING: Five intensive care units (ICU) in France, Greece, Spain and Germany were used for the study...
March 19, 2018: BMJ Open
John R Weinstein, Lisa M Thompson, Anaité Díaz Artiga, Joe P Bryan, William E Arriaga, Saad B Omer, John P McCracken
BACKGROUND: Preterm birth is the leading cause of death among children <5 years of age. Accurate determination of prematurity is necessary to provide appropriate neonatal care and guide preventive measures. To estimate the most accurate method to identify infants at risk for adverse outcomes, we assessed the validity of two widely available methods-last menstrual period (LMP) and the New Ballard (NB) neonatal assessment-against ultrasound in determining gestational age and preterm birth in highland Guatemala...
2018: PloS One
Anna Clara F Vieira, Cláudia M Alves, Vandilson P Rodrigues, Cecília C Ribeiro, Isaac S Gomes-Filho, Fernanda F Lopes
BACKGROUND: The rates of preterm births have been increasing worldwide. Complications related to preterm births are associated with increased costs of care, and have a direct impact on the health system of the countries. Therefore, it is important to address factors associated with preterm birth in order to provide prevention strategies. OBJECTIVE: This case-control study investigated oral, systemic, and socioeconomic factors associated with preterm birth in postpartum women...
March 15, 2018: Women and Birth: Journal of the Australian College of Midwives
J Edy Siswanto, Nani H Widodo, Pieter J J Sauer
BACKGROUND: Retinopathy of prematurity (ROP) is a well-known complication in preterm infants. Data on the incidence of ROP in Indonesia, in relation to birth weight (BW) and gestational age (GA), are limited. OBJECTIVE: To report the incidence of ROP in one of the oldest and largest neonatal intensive care unit (NICU) in Indonesia. METHODS: We studied the incidence and severity of ROP in inborn infants with a BW of ≤1500 g and/or GA of ≤32 weeks, who were admitted to the NICU of Harapan Kita Women and Children Hospital, Jakarta...
March 17, 2018: Archives of Disease in Childhood
Charmaine M Teo, Woei Bing Poon, Selina Ky Ho
INTRODUCTION: Neonatal care advances have resulted in improved survival but have raised concerns of increase in neurodevelopmental impairment. This study looked at long-term neurodevelopmental outcomes at ages 5 and 8 years of very low birthweight infants born in the 2000s as compared to the 1990s. Neurodevelopmental assessment at 2 years old was compared to that at 5 and 8 years to determine if assessment at 2 years was predictive of later outcomes. MATERIALS AND METHODS: A retrospective cohort study of consecutive infants with birthweight less than 1250 grams admitted to a tertiary centre in Singapore between January 1994 to December 1995 (Epoch I) and January 2004 to December 2005 (Epoch II) were included...
February 2018: Annals of the Academy of Medicine, Singapore
Nathaly M Sweeney, Shareef A Nahas, Shimul Chowdhury, Miguel Del Campo, Marilyn C Jones, David P Dimmock, Stephen F Kingsmore, Rcigm Investigators
Congenital diaphragmatic hernia (CDH) results from incomplete formation of the diaphragm leading to herniation of abdominal organs into the thoracic cavity. CDH is associated with pulmonary hypoplasia, congenital heart disease and pulmonary hypertension. Genetically, it is associated with aneuploidies, chromosomal copy number variants, and single gene mutations. CDH is the most expensive non-cardiac congenital defect: Management frequently requires implementation of Extracorporeal Membrane Oxygenation (ECMO), which increases management expenditures 2...
March 16, 2018: Cold Spring Harbor Molecular Case Studies
David Morrison, James Shaffer, Gui-Shuang Ying, Gil Binenbaum
PURPOSE: To determine the prevalence of treatment-related ocular complications and disease progression following treatment for retinopathy of prematurity (ROP). METHODS: This was a retrospective cohort study of eyes treated for ROP at 30 North American neonatal intensive care units in the Postnatal Growth and ROP (G-ROP) Study. Data from the time of treatment through 15 months were abstracted from medical records by certified data collectors. Treatment-related complication (cataract, hyphema, glaucoma, corneal abrasion/opacity), and disease-progression (retinal fold, dragging, or stage 4 or 5 detachment) were calculated by treatment modality...
March 13, 2018: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
Krystin A Engelhardt, Elizabeth Hisle-Gorman, Gregory H Gorman, Nicole R Dobson
Background: The Military Health System (MHS) provides universal access to medical care to active duty service members, retirees, and their dependents. Observational data from small studies suggest lower preterm birth rates in the MHS compared with U.S. national averages. The objectives of this study are to determine the rate of preterm birth in the MHS from 2006 to 2012 compared with national rates and to analyze the impact of demographic factors on preterm birth in a universal access health care system...
March 14, 2018: Military Medicine
Margaret Mary Downey, Anu Manchikanti Gómez
Reproductive health disparities-particularly those experienced by racial and ethnic minority groups-are considered a persistent public health issue in the United States. Frameworks that focus on social determinants of health seek to identify the forces producing these disparities, particularly social conditions that create vulnerability to premature death and disease. Such frameworks pose challenges to health care provision, as structural factors can seem immutable to health care professionals trained to treat individual patients...
March 1, 2018: AMA Journal of Ethics
Mosarrat J Qureshi, Manoj Kumar
BACKGROUND: Providing effective positive pressure ventilation is considered to be the single most important component of successful neonatal resuscitation. Ventilation is frequently initiated manually with bag and face mask (BMV) followed by endotracheal intubation if respiratory depression continues. These techniques may be difficult to perform successfully resulting in prolonged resuscitation or neonatal asphyxia. The laryngeal mask airway (LMA) may achieve initial ventilation and successful resuscitation faster than a bag-mask device or endotracheal intubation...
March 15, 2018: Cochrane Database of Systematic Reviews
Alireza Sadeghnia, Behzad Koorang Beheshti, Majid Mohammadizadeh
Background: Considering all the latest achievements in neonatal respiratory care, bronchopulmonary dysplasia (BPD) is still among the most prevalent morbidity causes in premature infants. Involvement in this process results in longer period of hospitalization for the newborn and in the long run makes the living conditions more difficult. Taking the multifactorial pathogenesis into account, approaches to tackle chronic lung disease (CLD) are mainly focused on interventions and prevention procedures...
2018: International Journal of Preventive Medicine
Charlene Eliza Thornton, Hannah Grace Dahlen
OBJECTIVES: To determine incidence, associated factors, outcomes and geographical occurrence of born before arrival (BBA) in New South Wales, Australia. DESIGN: A linked population data study involving population-based surveillance systems was undertaken for the years 2000-2011. SETTING: New South Wales, Australia. PARTICIPANTS: All women who underwent BBA compared with women who birthed in hospital/birth centre settings...
March 14, 2018: BMJ Open
Francesca Maria Notarangelo, Giuseppe Maglietta, Paola Bevilacqua, Marco Cereda, Piera Angelica Merlini, Giovanni Quinto Villani, Paolo Moruzzi, Giampiero Patrizi, Guidantonio Malagoli Tagliazucchi, Antonio Crocamo, Angela Guidorossi, Filippo Pigazzani, Elisa Nicosia, Giorgia Paoli, Marco Bianchessi, Mario Angelo Comelli, Caterina Caminiti, Diego Ardissino
BACKGROUND: Clopidogrel is still frequently used in patients with acute coronary syndromes (ACS), but its efficacy is hampered by interpatient response variability, due to genetic polymorphisms associated with clopidogrel metabolism. OBJECTIVE: To evaluate whether selecting antiplatelet therapy (clopidogrel, prasugrel or ticagrelor) on the basis of a patient's genetic and clinical characteristics leads to better clinical outcomes in comparison with the standard of care, which bases the selection on clinical characteristics alone METHODS: Patients hospitalised for ACS were randomly assigned to standard of care or pharmacogenomic arm, which included the genotyping of ABCB1, CYP2C19*2, CYP2C19*17 using an ST Q3 system that provide the data within 70 minutes at each patient's bedside...
February 24, 2018: Journal of the American College of Cardiology
Daisy Oliveira Costa, Fabíola Isabel Suano de Souza, Glaura César Pedroso, Maria Wany Louzada Strufaldi
This study aimed to determine the presence and association of possible mental disorders diagnoses in primary care pregnant women and newborns' conditions. This is a longitudinal study with pregnant women (18-39 years), in the second and third trimesters of pregnancy, attended at primary care facilities in the metropolitan region of São Paulo (February to August/2014). The following tools were used: sociodemographic questionnaire; Mental Disorders in Primary Care Assessment tool; and an interview with information and mother´s perception of the behavior of newborns...
March 2018: Ciência & Saúde Coletiva
Kavitha Gopalan, Surjit Singh, Pandiarajan Vignesh, Anju Gupta, Manojkumar Rohit, Savita Verma Attri
BACKGROUND: Kawasaki disease (KD) has a predilection to involve coronary arteries, leading to several long-term cardiovascular sequelae. Apart from coronary artery abnormalities, children with KD are also prone to develop premature atherosclerosis, endothelial dysfunction, and lipid abnormalities. Some of these complications may occur even in children who have received appropriate treatment with intravenous immunoglobulin in the acute phase. METHODS: In 2009, we had studied carotid intima-media thickness (cIMT) and lipid profile in 27 children with KD at least 1 year after the acute episode...
March 13, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Joseph B Cantey, Kelsey R Anderson, Ram R Kalagiri, Lea H Mallett
BACKGROUND: Coagulase-negative staphylococci (CoNS) are the most common cause of late-onset sepsis in the neonatal intensive care unit (NICU) and usually require vancomycin treatment. Our objective was to determine whether CoNS are associated with neonatal morbidity and mortality. METHODS: This was a retrospective cohort study of very-low-birth-weight (VLBW, ≤ 1500 g) infants from 1989 to 2015. Exclusion criteria were major congenital anomaly or death within 72 h...
March 13, 2018: World Journal of Pediatrics: WJP
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