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neonatal mortality

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https://www.readbyqxmd.com/read/28446176/health-care-providers-perspectives-regarding-the-use-of-chlorhexidine-gel-for-cord-care-in-neonates-in-rural-kenya-implications-for-scale-up
#1
Angela Muriuki, Francis Obare, Bill Ayieko, Dennis Matanda, Kenneth Sisimwo, Brian Mdawida
BACKGROUND: This paper explores the perspectives of health care providers regarding the use of 7.1% Chlorhexidine Digluconate (CHX) gel that releases 4% chlorhexidine for newborn umbilical cord care under a managed access program (MAP) implemented in Bungoma County of Kenya. Understanding the perspectives of providers regarding CHX is important since they play a key role in the health system and the fact that their views could be influenced by prior beliefs and inconsistent practices regarding umbilical cord care...
April 26, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28443559/the-evolution-of-modern-respiratory-care-for-preterm-infants
#2
REVIEW
Louise S Owen, Brett J Manley, Peter G Davis, Lex W Doyle
Preterm birth rates are rising, and many preterm infants have breathing difficulty after birth. Treatments for infants with prolonged breathing difficulty include oxygen therapy, exogenous surfactant, various modes of respiratory support, and postnatal corticosteroids. In this Series paper, we review the history of neonatal respiratory care and its effect on long-term outcomes, and we outline the future direction of the research field. The delivery and monitoring of oxygen therapy remains controversial, despite being in use for more than 50 years...
April 22, 2017: Lancet
https://www.readbyqxmd.com/read/28443531/probiotics-to-prevent-necrotising-enterocolitis-and-nosocomial-infection-in-very-low-birth-weight-preterm-infants
#3
J Uberos, E Aguilera-Rodríguez, A Jerez-Calero, M Molina-Oya, A Molina-Carballo, E Narbona-López
The aim of the study was to determine whether routine probiotic supplementation (RPS) with Lactobacillus rhamnosus GG (LGG) or Lactobacillus acidophilus +Lactobacillus bifidum is associated with reduced risk of necrotising enterocolitis (NEC)≥Stage II in preterm neonates born at ≤32 weeks' gestation. We conducted a retrospective cohort study on the effect of probiotic supplementation in very low birth weight infants in our neonatal unit by comparing two periods: before and after supplementation. The incidence of NEC≥Stage II, late-onset sepsis and all-cause mortality was compared for an equal period 'before' (Period I) and 'after' (Period II) RPS with LGG or L...
April 26, 2017: British Journal of Nutrition
https://www.readbyqxmd.com/read/28440985/-early-neonatal-sepsis-and-associated-factors
#4
Roberto Anaya-Prado, Cuauhtémoc Valero-Padilla, Augusto Sarralde-Delgado, Jorge Manuel Sánchez-González
BACKGROUND: Early-onset neonatal sepsis (EONS) is an infectious disease of low incidence but high morbidity and mortality with severe consequences to the newborn prognosis. Identifying the associated factors related to EONS allows to start a timely treatment and to take preventive measures. METHODS: In this case and controls study we identified all the newborns (NB) with and without EONS (cases and controls), diagnosed through blood culture in a period of three years...
May 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28440792/an-extra-uterine-system-to-physiologically-support-the-extreme-premature-lamb
#5
Emily A Partridge, Marcus G Davey, Matthew A Hornick, Patrick E McGovern, Ali Y Mejaddam, Jesse D Vrecenak, Carmen Mesas-Burgos, Aliza Olive, Robert C Caskey, Theodore R Weiland, Jiancheng Han, Alexander J Schupper, James T Connelly, Kevin C Dysart, Jack Rychik, Holly L Hedrick, William H Peranteau, Alan W Flake
In the developed world, extreme prematurity is the leading cause of neonatal mortality and morbidity due to a combination of organ immaturity and iatrogenic injury. Until now, efforts to extend gestation using extracorporeal systems have achieved limited success. Here we report the development of a system that incorporates a pumpless oxygenator circuit connected to the fetus of a lamb via an umbilical cord interface that is maintained within a closed 'amniotic fluid' circuit that closely reproduces the environment of the womb...
April 25, 2017: Nature Communications
https://www.readbyqxmd.com/read/28440468/vitamin-d-attenuates-hyperoxia-induced-lung-injury-through-downregulation-of-toll-like-receptor%C3%A2-4
#6
Li Yao, Yongyan Shi, Xinyi Zhao, Ana Hou, Yujiao Xing, Jianhua Fu, Xindong Xue
With considerable morbidity and mortality, bronchopulmonary dysplasia (BPD) is a focus of attention in neonatology. Hyperoxia-induced lung injury has long been used as a model of BPD. Among all the signaling pathways involved, Toll-like receptor 4 (TLR4) has been demonstrated to play an important role, and is known to be regulated by vitamin D. This study aimed at elucidating the effect of vitamin D on hyperoxia-induced lung injury and the role of TLR4 in the process. Vitamin D was administered to hyperoxia-treated neonatal rats to investigate changes in the morphology of lungs and expression of pro-inflammatory cytokines, apoptotic proteins and TLR4...
April 21, 2017: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/28439384/characteristics-of-neonatal-pneumothorax-in-saudi-arabia-three-years-experience
#7
Abdulrahman Al Matary, Humariya H Munshi, Sameh Abozaid, Mostafa Qaraqei, Tariq A Wani, Amani K Abu-Shaheen
OBJECTIVES: To identify the incidence, clinical characteristics, predisposing factors, morbidity, and mortality among hospitalized neonates with pneumothorax. METHODS: The records of 2 204 infants admitted to the neonatal intensive care unit at King Fahad Medical City, Saudi Arabia, between 2011 and 2014 were reviewed. All newborns hospitalized in the neonatal intensive care unit with pneumothorax were included in the study. Participants were evaluated for baseline characteristics, predisposing factors of neonatal pneumothorax (NP), accompanying disorders, and mortality...
March 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/28439070/clinical-and-microbiological-characteristics-and-impact-of-therapeutic-strategies-on-the-outcomes-of-children-with-candidemia
#8
Ming-Horng Tsai, Jen-Fu Hsu, Shih-Ming Chu, Pey-Jium Chang, Mei-Yin Lai, I-Hsyuan Wu, Hsuan-Rong Huang, Ming-Chou Chiang, Ren-Huei Fu, Jang-Jih Lu
We aimed to determine the clinical and microbiological characteristics of Candida bloodstream infections in children and the impact of therapeutic strategies on outcomes. All pediatric patients with candidemia from a medical center in Taiwan over a 13-year period (2003-2015) were included and a total of 262 patients with 319 episodes of candidemia were analyzed. Overall susceptibility to fluconazole was 86.1%. Cumulative mortality at 7 and 30 days after the first episode of candidemia was 13.4% and 25.2%, respectively...
April 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28437598/the-potential-implications-of-using-disability-free-survival-and-number-needed-to-suffer-as-outcome-measures-for-neonatal-intensive-care
#9
Per-Arne Lönnqvist
The use of mortality and surrogate makers to determine outcomes after advanced medical treatment has been questioned, because often these dimensions do not agree with what both many medical staff and laypeople judge as adequate outcome measures. That is why Myles et al introduced the more adequate dimension of disability free survival (1-3). Furthermore, the suffering of other patients that is associated with one single individual having a good outcome has been discussed and the suggested term for this is the number needed to suffer (4), which reflects the similar terms of number needed to treat and number needed to harm...
April 24, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28437573/using-internal-and-external-reviewers-can-help-to-optimise-neonatal-mortality-and-morbidity-conferences
#10
Michael-Andrew Assaad, Annie Janvier, Anie Lapointe
AIM: This study determined if there was a difference in the conclusions reached by paediatricians in morbidity and mortality conferences based on their level of involvement in a case. METHODS: All neonatal deaths occurring between August 2014 and September 2015 at Sainte-Justine Hospital, Montreal, Quebec, Canada, were reviewed by internal physicians involved in the case and external physicians who were not. The reviewers were asked to identify positive and negative clinical practice items and provide written recommendations...
April 24, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28437325/presenting-features-and-prognosis-of-ischemic-and-nonischemic-neonatal-liver-failure
#11
Carlos Zozaya Nieto, Beatriz Fernández Caamaño, Gema Muñoz Bartolo, Juan J Menéndez Suso, Esteban Frauca Remacha, Eva Valverde Núñez
OBJECTIVES: To describe the epidemiological features, clinical characteristics and outcomes of neonates diagnosed with liver failure, as well as determine prognostic factors. METHODS: Cohort study conducted at a single tertiary referral and university-affiliated pediatric center. Hospital records of all neonates diagnosed with liver failure between January 2003 and December 2015 were retrospectively reviewed, and data on clinical and laboratory findings, treatment, and outcomes were collected...
May 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28435137/group-b-streptococcus-and-perinatal-mortality
#12
Piet Cools, Pierrette Melin
The World Health Organization estimates that every year, one million neonatal deaths occur because of neonatal infection. Furthermore, an equal number of stillbirths are thought to be caused by infections. Here we discuss the role of Streptococcus agalactiae (group B Streptococcus, GBS) in neonatal disease and stillbirth.
April 20, 2017: Research in Microbiology
https://www.readbyqxmd.com/read/28434651/neonatal-sepsis
#13
REVIEW
Andi L Shane, Pablo J Sánchez, Barbara J Stoll
Neonatal sepsis is the cause of substantial morbidity and mortality. Precise estimates of neonatal sepsis burden vary by setting. Differing estimates of disease burden have been reported from high-income countries compared with reports from low-income and middle-income countries. The clinical manifestations range from subclinical infection to severe manifestations of focal or systemic disease. The source of the pathogen might be attributed to an in-utero infection, acquisition from maternal flora, or postnatal acquisition from the hospital or community...
April 20, 2017: Lancet
https://www.readbyqxmd.com/read/28434210/changes-in-perinatal-hospital-deaths-occurring-outside-the-neonatal-intensive-care-unit-over-a-decade
#14
Amélie Du Pont-Thibodeau, Keith Barrington, Catherine Taillefer, Annie Janvier
AIM: Perinatal deaths occurring outside the neonatal intensive care unit (NICU) are rarely recorded in outcome studies, despite having a direct impact on perinatal statistics. Our aim was to investigate the timing and modes of perinatal deaths that occurred outside the NICU and changes over time. METHOD: We reviewed all perinatal deaths from 22 weeks of gestation onwards, without NICU admissions, during two periods in a Canadian tertiary mother and baby hospital and categorised deaths according to nine specific categories...
April 23, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28432737/outcome-reporting-across-randomised-controlled-trials-evaluating-therapeutic-interventions-for-pre-eclampsia-a-systematic-review
#15
REVIEW
James M N Duffy, Martin Hirsch, Anusuya Kawsar, Chris Gale, Louise Pealing, Maria N Plana, Marian Showell, Paula R Williamson, Khalid S Khan, Sue Ziebland, Richard J McManus
BACKGROUND: Standardising outcome collection and reporting in pre-eclampsia trials requires an appraisal of current outcome reporting. OBJECTIVES: To map maternal and offspring outcome reporting across randomised trials evaluating therapeutic interventions for pre-eclampsia. SEARCH STRATEGY: Randomised trials were identified by searching bibliographical databases from inception to January 2016. SELECTION CRITERIA: Randomised controlled trials...
April 22, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28432736/severe-primary-autoimmune-thrombocytopenia-itp-in-pregnancy-a-national-cohort-study
#16
A Care, S Pavord, M Knight, Z Alfirevic
OBJECTIVE: To quantify UK incidence of severe ITP in pregnancy, determine current treatment strategies and establish maternal and neonatal morbidity and mortality associated with severe ITP in pregnancy. DESIGN: A prospective national cohort study SETTING: United Kingdom POPULATION: Women with severe ITP; defined as platelets <50 x 10(9) /l in pregnancy or antenatal treatment of isolated low platelets. METHODS: Data collected via United Kingdom Obstetric Surveillance System (UKOSS) between 1(st) June 2013-31(st) January 2015 from all UK Consultant led obstetric units...
April 22, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28431858/third-trimester-preterm-and-term-premature-rupture-of-membranes-is-there-any-difference-in-maternal-characteristics-and-pregnancy-outcomes
#17
Ivana Chandra, Lizhou Sun
BACKGROUND: The clinical significance and management of preterm premature rupture of membranes (PPROM) remains a topic of a controversy. Although PROM is associated with a low rate of complications, PPROM may lead to significant neonatal and maternal morbidity. METHODS: We performed a retrospective study of 714 women who presented to Jiangsu Province Hospital with third trimester PPROM or PROM between January and December 2015. The data were analyzed by SPSS; the significance of maternal characteristics, and maternal and neonatal outcomes were tested using Student's t test and the χ(2) test...
April 18, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28431283/zika-virus-infection-of-adult-and-fetal-stat2-knock-out-hamsters
#18
Venkatraman Siddharthan, Arnaud J Van Wettere, Rong Li, Jinxin Miao, Zhongde Wang, John D Morrey, Justin G Julander
Zika virus (ZIKV) infection was investigated in adult and fetal STAT2 knock-out (KO) hamsters. Subcutaneous injection of ZIKV of adults resulted in morbidity, mortality, and infection of the uterus, placenta, brain, spinal cord, and testicles, thus providing an opportunity to evaluate congenital ZIKV infection in a second rodent species besides mice. ZIKV-infected cells with morphologies of Sertoli cells and spermatogonia were observed in the testes, which may have implications for sexual transmission and male sterility...
April 18, 2017: Virology
https://www.readbyqxmd.com/read/28431170/early-total-enteral-feeding-in-stable-very-low-birth-weight-infants-a-before-and-after-study
#19
Sushma Nangia, Amit Bishnoi, Ankita Goel, Piali Mandal, Soumya Tiwari, Arvind Saili
Background: Fear of necrotizing enterocolitis (NEC) has perpetuated delayed initiation and slow advancement of enteral feeding in very low birth weight (VLBW) infants with inherent risks of parenteral alimentation. The objective of this study was to assess effect of early total enteral feeding (ETEF) on day of achievement of full enteral feeds, feed intolerance, NEC and sepsis. Methods: In total, 208 stable VLBW neonates (28-34 weeks) admitted during 6 month periods of three consecutive years were enrolled...
April 18, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28428425/neonatal-acquisition-of-clostridia-species-protects-against-colonization-by-bacterial-pathogens
#20
Yun-Gi Kim, Kei Sakamoto, Sang-Uk Seo, Joseph M Pickard, Merritt G Gillilland, Nicholas A Pudlo, Matthew Hoostal, Xue Li, Thomas D Wang, Taylor Feehley, Andrew T Stefka, Thomas M Schmidt, Eric C Martens, Shinji Fukuda, Naohiro Inohara, Cathryn R Nagler, Gabriel Núñez
The high susceptibility of neonates to infections has been assumed to be due to immaturity of the immune system, but the mechanism remains unclear. By colonizing adult germ-free mice with the cecal contents of neonatal and adult mice, we show that the neonatal microbiota is unable to prevent colonization by two bacterial pathogens that cause mortality in neonates. The lack of colonization resistance occurred when Clostridiales were absent in the neonatal microbiota. Administration of Clostridiales, but not Bacteroidales, protected neonatal mice from pathogen infection and abrogated intestinal pathology upon pathogen challenge...
April 21, 2017: Science
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