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M Stavel, J Wong, Z Cieslak, R Sherlock, M Claveau, P S Shah
OBJECTIVE: To determine the effect of concomitant administration of prophylactic indomethacin and early enteral feeds on the risk of spontaneous intestinal perforation (SIP) in extremely low-birth-weight (ELBW) infants, and to describe the variation in prophylactic indomethacin use in Canada. STUDY DESIGN: A retrospective cohort study of 4268 ELBW infants born at <30 weeks' gestation admitted to Canadian neonatal units between 2010 and 2014 was conducted. Prophylactic indomethacin (I+ or I-, administered within 24 h) and early feeding (E+ or E-, initiated in the first 2 days) exposures were studied concurrently and independently...
October 20, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
G Chistyakova, I Gazieva, I Remizova, L Ustyantseva, V Lyapunov, S Bychkova
We conducted a study of markers of endothelial dysfunction and angiogenesis regulation, as well as the identification of the main lymphocyte populations, activated CD3 (+) CD95(+)-cells and cytokine-producing CD4 (+) IFN-γ(+)-, CD4 (+) IL-4(+ )-lymphocytes in the 1st trimester of gestation in women with ART-induced pregnancy and spontaneous pregnancy. We used the same indicators to assess the immune status of ELBW infants at birth and at the post-conceptual age of 38-40 weeks. It was determined that the risk factors of very early preterm delivery are: threatened miscarriage, chronic placental insufficiency, endothelial dysfunction, increased spontaneous production of intracellular cytokines...
October 2016: Gynecological Endocrinology
Feng Liu, Shu-Ping Han, Zhang-Bin Yu, Jun Zhang, Xiao-Hui Chen, Wei-Min Wu, Xue Chu, Bei-Bei Liu
OBJECTIVE: To study the effect of breastfeeding quality improvement on the breastfeeding rate in very low birth weight (VLBW) and extremely low birth weight (ELBW) infants in the neonatal intensive care unit (NICU). METHODS: A retrospective analysis was performed for the clinical data of VLBW and ELBW infants who were admitted from July 2014 to July 2015 (pre-improvement group) and those who were admitted from August 2015 to June 2016 after the implementation of breastfeeding quality improvement measures (post-improvement group)...
October 2016: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
John C Sheehan, Kimberly A Kerns, Ulrich Müller
OBJECTIVE: Planning is an important executive function (EF) skill that is fundamental to the capacity to achieve everyday goals that require a series of intermediate steps. This study examined the effect of preterm birth on planning skills in early and middle childhood using Tower problems that made different cognitive workload demands. METHOD: We administered a novel touchscreen Tower of Hanoi task (Monkey Tree Task; MTT) in three age cohorts (3, 6, and 9 years) to 485 children born between 2000 and 2010 (105 extremely low birth weight [ELBW], 248 late preterm [LP], and 132 term-born [Term])...
October 18, 2016: Clinical Neuropsychologist
Paola Salvatori, Erica Neri, Ilaria Chirico, Federica Andrei, Francesca Agostini, Elena Trombini
Introduction: Although preterm birth represents a risk factor for early mother-infant interactions, few studies have focused on toddlerhood, an important time for the development of symbolic play, autonomous skills, and child's socialization competences. Moreover, no study has looked at the effect of birth weight on mother-child interactions during this period. Expanding on the available literature on prematurity, the main objective of this study was to explore the quality of mother-toddler interactions during play, using a longitudinal research design, as well as taking into account the effect of birth weight...
2016: Frontiers in Psychology
A J Spittle, J Olsen, A Kwong, L W Doyle, P B Marschik, C Einspieler, Jly Cheong
INTRODUCTION: Infants born extremely preterm (EP; <28 weeks' gestation) and/or with extremely low birth weight (ELBW; <1000 g birth weight) are at increased risk for adverse neurodevelopmental outcomes. However, it is challenging to predict those EP/ELBW infants destined to have long-term neurodevelopmental impairments in order to target early intervention to those in most need. The General Movements Assessment (GMA) in early infancy has high predictive validity for neurodevelopmental outcomes in preterm infants...
October 3, 2016: BMJ Open
Masahito Sato, Yoshinori Hamada, Miyuki Kohno, Kazuya Ise, Keiichi Uchida, Hiromi Ogata, Hiroaki Masuyama, Yoshiki Morotomi, Masao Yasufuku, Motoshi Wada
PURPOSE: The purpose of this study is to identify the current clinical features of neonatal gastrointestinal perforation in Japan. METHODS: A questionnaire about cases of neonatal gastrointestinal perforation treated in recent 5 years was sent to participating institutions of the Japanese Society of Pediatric Surgeons (JSPS). RESULTS: Five hundred and thirty-six neonates with gastrointestinal perforation were treated. They consisted of 42 patients with gastric rupture/perforation (GR), 33 patients with intestinal atresia/stenosis (IA), 3 patients with malrotation (ML), 118 patients with necrotizing enterocolitis (NEC), 160 patients with focal intestinal perforation (FIP), 46 patients with meconium-related ileus (MRI), 77 patients with meconium peritonitis (MP), and 57 patients with other conditions...
September 30, 2016: Pediatric Surgery International
Calan Savoy, Mark A Ferro, Louis A Schmidt, Saroj Saigal, Ryan J Van Lieshout
BACKGROUND: Mortality rates among extremely low birthweight (ELBW) infants have declined since the advent of antenatal glucocorticoid use. However, the long term neuropsychiatric effects of exposure are not well understood. We utilized the world's oldest longitudinally followed cohort of ELBW survivors to compare psychopathology over two decades in adulthood in those exposed to prenatal betamethasone and those who were not. METHODS: ELBW survivors (n=179) and matched normal birth weight (NBW) controls (n=145) completed the Young Adult Self-Report questionnaire at 22-26 and 29-36 years, and the Beck Depression and Anxiety Inventories at 29-36 years...
September 28, 2016: Psychoneuroendocrinology
Andreas Repa, Ruth Lochmann, Lukas Unterasinger, Michael Weber, Angelika Berger, Nadja Haiden
BACKGROUND: Parenteral nutrition associated cholestasis (PNAC) is a frequently observed pathology in extremely low birth weight (ELBW) infants. Its pathogenesis is determined by the composition and duration of parenteral nutrition (PN) as well as the tolerance of enteral feeds (EF). "Aggressive" nutrition is increasingly used in ELBW infants to improve postnatal growth. Little is known about the effect of "aggressive" nutrition on the incidence of PNAC. We analyzed the influence of implementing an "aggressive" nutritional regimen on the incidence of PNAC and growth in a cohort of ELBW infants...
2016: PeerJ
Sascha Meyer, Ludwig Gortner
The aim of the NeoVitaA Trial is to assess the role of postnatal additional high-dose oral vitamin A supplementation for 28 days in reducing Bronchopulmonary dysplasia (BPD) or death in extremely low birth weight (ELBW) infants at 36 weeks postmenstrual age (PMA). All infants (both intervention and control group) will be provided with basic vitamin A (1000 IU/kg/day) in addition to trial intervention.In this short communication, we will give an up-date on obstacles, challenges as well as perspectives and potential solutions when putting into place a multicenter, double-blind, randomized trial in this cohort of extremely susceptible infants...
September 26, 2016: Wiener Medizinische Wochenschrift
Airi Tiirats, Triin Viltrop, Margit Nõukas, Ene Reimann, Andres Salumets, Sulev Kõks
BACKGROUND: Despite extensive research the genetic component of extremely low birth weight (ELBW) in newborns has remained obscure. RESULTS: The aim of the case study was to identify candidate gene(s) causing ELBW in newborns and hypotrophy in infants. A family of four was studied: mother, father and two ELBW-phenotype children. Studies were made of the medical conditions of the second child at birth and post-partum - peculiar phenotype, micro-anomalies, recurrent infections, suspicion of autoimmune hepatitis, multifactorial encephalopathy and suspected metabolic and chromosomal abnormalities...
2016: BMC Genetics
J I Lund, K L Day, L A Schmidt, S Saigal, R J Van Lieshout
Preterm birth and exposure to childhood sexual abuse (CSA) are early physiological and psychological adversities that have been linked to reduced social functioning across the lifespan. However, the joint effects of being born preterm and being exposed to CSA on adult social outcomes remains unclear. We sought to determine the impact of exposure to both preterm birth and CSA on adult social functioning in a group of 179 extremely low birth weight (ELBW; 2500 g) participants in the fourth decade of life. Social outcome data from a prospective, longitudinal, population-based Canadian birth cohort initiated between the years of 1977 and 1982 were examined...
September 19, 2016: Journal of Developmental Origins of Health and Disease
Changsin Kim, Jeong Eun Shin, Soon Min Lee, Ho Seon Eun, Min Soo Park, Kook In Park, Ran Namgung, Sungsoo Lee, Choon Sik Yoon
The pulmonary interstitial emphysema (PIE) is a life-threatening illness in premature infants with mechanical ventilation. While most are managed conservatively, decompression would be necessary. Here, we report the first case of PIE treated by percutaneous catheter insertion in an extremely low birth weight (ELBW) infant in Korea. The patient, born with 660 g in 23+2 weeks of gestation, showed PIE in left lower lung on postnatal day 12. Percutaneous catheter insertion was performed on postnatal day 25. The size of PIE decreased, but didn't disappear completely...
November 2016: Yonsei Medical Journal
Saroj Saigal, Mark A Ferro, Ryan J Van Lieshout, Louis A Schmidt, Katherine M Morrison, Michael H Boyle
OBJECTIVES: To compare the health-related quality of life (HRQL) trajectories of a regional cohort of extremely low birth weight (ELBW, <1000 g) survivors (births from 1977 to 1982) and a group of normal birth weight (NBW) controls, at 3 ages: 12-16 years, 22-26 years, and 29-36 years, spanning over 20 years. We hypothesized that the HRQL of the ELBW cohort would be significantly compromised compared with their NBW peers, and that neurosensory impairments (NSI) would have an additional negative effect...
August 31, 2016: Journal of Pediatrics
Katherine M Morrison, Laura Ramsingh, Elizabeth Gunn, David Streiner, Ryan Van Lieshout, Michael Boyle, Hertzel Gerstein, Louis Schmidt, Saroj Saigal
BACKGROUND: Young adults born with extreme prematurity have increased blood pressure and insulin resistance. This study documents their metabolic health as they enter their fourth decade of life. The study objective was to compare body composition, glycemia, lipid levels, and blood pressure in adults born with extremely low birth weight (ELBW) versus age- and sex- matched normal birth weight (NBW) control subjects and to examine related previous and current exposures. METHODS: The study examines one of the oldest regionally representative cohorts of ELBW subjects (birth weight <1 kg) and NBW individuals born between 1977 and 1982...
September 2, 2016: Pediatrics
Pinkal Patel, Jatinder Bhatia
Preterm infants, especially very low birth weight (VLBW; <1500 g) and extremely low birth weight (ELBW; <1000 g) infants, are susceptible to growth failure in postnatal life if nutritional demands are not met. Poor postnatal growth in preterm infants is associated with adverse neurodevelopmental outcomes during childhood. Early parental nutrition is of paramount importance to provide appropriate protein and energy in VLBW infants when enteral nutrition is not feasible or is suboptimal. An "early and aggressive" approach of parenteral nutrition in preterm infants has been shown to prevent protein catabolism, induce positive nitrogen balance and improve postnatal growth...
August 26, 2016: Seminars in Fetal & Neonatal Medicine
Zoe Lansdowne, Elizabeth Griffiths
AIMS: ELBW infants on NICU were found to have poor growth compared to network data. Previous audit work1 showed that the time from birth to PN did not meet unit guideline targets and did not achieve optimal protein intake. Intensive work was done to publicise this and to decrease the time from birth to PN. Stock PN recipes were also reformulated to concentrate nutrition. The aim of audits 2 and 3 was to analyse whether publicising the 4 P's of PN (prompt, protein, protected and peripheral) could improve protein intake and ultimately increase growth velocity...
September 2016: Archives of Disease in Childhood
Qiong Zhang, Yun-Qin Wu, Yan Zhuang, Jing Cao, Xi-Rong Gao
OBJECTIVE: To investigate the neurodevelopmental outcomes of extremely low birth weight (ELBW) and very low birth weight (VLBW) infants at a corrected age (CA) of 18 months and related factors influencing the outcomes. METHODS: The ELBW and VLBW infants who were admitted to the neonatal intensive care unit, survived, and discharged between January 2013 June 2014 were enrolled. These infants were followed up at CAs of 40 weeks and 1, 3, 6, 12, and 18 months to evaluate the neurodevelopmental outcomes...
August 2016: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Justin D Crane, Samuel A Yellin, Frank J Ong, Nina P Singh, Norman Konyer, Michael D Noseworthy, Louis A Schmidt, Saroj Saigal, Katherine M Morrison
Premature birth in conjunction with extremely low birth weight (<1 kg, ELBW) is associated with insulin resistance and increased cardiometabolic health risk compared to birth at full term with normal birth weight (NBW). However, little is known regarding the biologic mediators of these effects. Abdominal and ectopic lipid accumulation is linked to insulin resistance and metabolic dysfunction, yet whether ELBW survivors are predisposed to aberrant lipid deposition in adulthood is unknown. We used magnetic resonance imaging in a cohort of 16 NBW and 29 ELBW participants to determine if ELBW survivors have differences in pancreatic, hepatic, subcutaneous and visceral fat distribution compared to NBW participants...
2016: Scientific Reports
Magdalena Zasada, Małgorzata Klimek, Wojciech Durlak, Monika Kotula, Tomasz Tomasik, Przemko Kwinta
BACKGROUND: Children born with extremely low birth weight (ELBW) have more respiratory tract complications during childhood. Little is known about respiratory and allergy problems in ELBW children at the threshold of adolescence. MATERIALS AND METHODS: A follow-up study was conducted at the age of 11 among ELBW children (n=65) and age-matched controls (n=36). The primary outcomes in the study were the occurrence of respiratory and allergy problems and the rate of hospitalization due to respiratory complications at the age of 11 years, assessed with a questionnaire...
2016: Przegla̧d Lekarski
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