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https://www.readbyqxmd.com/read/29783270/reducing-alarm-fatigue-in-two-neonatal-intensive-care-units-through-a-quality-improvement-collaboration
#1
Kendall R Johnson, James I Hagadorn, David W Sink
OBJECTIVE:  To reduce nonactionable oximeter alarms by 80% without increasing time infants were hypoxemic (oxygen saturation [SpO2 ] ≤ 80%) or hyperoxemic (SpO2  > 95% while on supplemental oxygen). STUDY DESIGN:  In 2015, a multidisciplinary team at Connecticut Children's Medical Center initiated a quality improvement project to reduce nonactionable oximeter alarms in two referral neonatal intensive care units (NICUs). Changes made through improvement cycles included reduction of the low oximeter alarm limit for specific populations, increased low alarm delay, development of postmenstrual age-based alarm profiles, and updated bedside visual reminders...
May 21, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29783163/maternal-hypothalamus-pituitary-adrenal-hpa-system-activity-and-stress-during-pregnancy-effects-on-gestational-age-and-infant-s-anthropometric-measures-at-birth
#2
Maria Gilles, Henrike Otto, Isabell A C Wolf, Barbara Scharnholz, Verena Peus, Michael Schredl, Marc W Sütterlin, Stephanie H Witt, Marcella Rietschel, Manfred Laucht, Michael Deuschle
BACKGROUND: Prenatal maternal stress might be a risk for the developing fetus and may have long-lasting effects on child and adult vulnerability to somatic and psychiatric disease. Over-exposure of the unborn to excess glucocorticoids and subsequent alteration of fetal development is hypothesized to be one of the key mechanisms linking prenatal stress with negative child outcome. METHODS: In this prospective longitudinal study, mothers-to-be (n = 405) in late pregnancy (36...
April 22, 2018: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/29783140/congenital-diaphragmatic-disease-an-unusual-presentation-in-adulthood-case-report
#3
Angela Gurrado, Roberta Maria Isernia, Alessandro De Luca, Valentina Ferraro, Daniela Virgintino, Anna Napoli, Giuseppe Cavallaro, Eugenio Maiorano, Angela Pezzolla, Mario Testini
INTRODUCTION: Congenital diaphragmatic disease is a quite common condition that usually occurs in the neonatal period, and the diagnosis of congenital diaphragmatic disease in adulthood is rare. CASE PRESENTATION: A 64-years-old Caucasian woman was admitted in emergency at our Department, due to a bowel obstruction and dyspnea. A CT-scan showed a diaphragmatic herniation in the left area, with malposition of dilated transverse and descending colon in the chest. An emergency laparatomy was performed, showing a toxic megacolon, in the absence of a true diaphragmatic hernia, and a left diaphragm and left liver hypoplasia...
May 7, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29782962/monosodium-glutamate-induced-nociception-and-oxidative-stress-dependent-on-time-of-administration-age-of-rats-and-susceptibility-of-spinal-cord-and-brain-regions
#4
Suzan Gonçalves Rosa, Pietro Maria Chagas, Ana Paula Pesarico, Cristina Wayne Nogueira
Monosodium glutamate (MSG), a food flavor enhancer used worldwide, has been studied because it may cause neurotoxicity, which is associated with oxidative stress. The aim of this study was to investigate whether spinal cord and brain regions are affected by oxidative stress and the temporal profile of nociceptive responses induced by MSG in newborn and adult rats. The newborn (post natal day, PND 1) Wistar rats received ten subcutaneous injections of MSG (4.0 g/kg) or saline solution. At PND 3, 11 or 90, the rats performed nociceptive tests and parameters of oxidative stress were evaluated in samples of spinal cord and brain regions...
May 18, 2018: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/29782696/routine-antenatal-ultrasound-in-low-and-middle-income-countries-first-look-a-cluster-randomized-trial
#5
Robert L Goldenberg, Robert O Nathan, David Swanson, Sarah Saleem, Waseem Mirza, Fabian Esamai, David Muyodi, Ana L Garces, Lester Figueroa, Elwyn Chomba, Melody Chiwala, Musaku Mwenechanya, Antoinette Tshefu, Adrien Lokangako, Victor Lokomba Bolamba, Janet L Moore, Holly Franklin, Jonathan Swanson, Edward A Liechty, Carl L Bose, Nancy F Krebs, K Michael Hambidge, Waldemar A Carlo, Nancy Kanaiza, Farnaz Naqvi, Irma Sayury Pineda, Walter López-Gomez, Dorothy Hamsumonde, Margo S Harrison, Marion Koso-Thomas, Menachem Miodovnik, Dennis D Wallace, Elizabeth M McClure
OBJECTIVE: Ultrasound is widely regarded as an important adjunct to antenatal care (ANC) to guide practice and reduce perinatal mortality. We assessed the impact of ANC ultrasound use at health centers in resource-limited countries. DESIGN: Cluster randomized trial. SETTING: Clusters within five countries (Democratic Republic of Congo, Guatemala, Kenya, Pakistan and Zambia). METHODS: Clusters were randomized to standard ANC or standard care plus two ultrasounds and referral for complications...
May 21, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29782488/insight-into-small-molecule-binding-to-the-neonatal-fc-receptor-by-x-ray-crystallography-and-100-khz-magic-angle-spinning-nmr
#6
Daniel Stöppler, Alex Macpherson, Susanne Smith-Penzel, Nicolas Basse, Fabien Lecomte, Hervé Deboves, Richard D Taylor, Tim Norman, John Porter, Lorna C Waters, Marta Westwood, Ben Cossins, Katharine Cain, James White, Robert Griffin, Christine Prosser, Sebastian Kelm, Amy H Sullivan, David Fox, Mark D Carr, Alistair Henry, Richard Taylor, Beat H Meier, Hartmut Oschkinat, Alastair D Lawson
Aiming at the design of an allosteric modulator of the neonatal Fc receptor (FcRn)-Immunoglobulin G (IgG) interaction, we developed a new methodology including NMR fragment screening, X-ray crystallography, and magic-angle-spinning (MAS) NMR at 100 kHz after sedimentation, exploiting very fast spinning of the nondeuterated soluble 42 kDa receptor construct to obtain resolved proton-detected 2D and 3D NMR spectra. FcRn plays a crucial role in regulation of IgG and serum albumin catabolism. It is a clinically validated drug target for the treatment of autoimmune diseases caused by pathogenic antibodies via the inhibition of its interaction with IgG...
May 21, 2018: PLoS Biology
https://www.readbyqxmd.com/read/29782439/the-positive-association-between-duration-of-skin-to-skin-contact-and-blood-glucose-level-in-full-term-infants
#7
Yuki Takahashi, Koji Tamakoshi
The aim of this study was to evaluate the contribution of the duration of skin-to-skin contact (SSC) on blood glucose levels at 2 hours after birth in healthy full-term infants. This observational study was done at one of the baby-friendly hospitals located in Aichi, Japan in 2009. Sixty newborn infants who were born vaginally from uncomplicated pregnancies were participated. All infants were held SSC within 5 minutes. All data regarding neonatal information, blood glucose levels at 2 hours of age, and maternal information were obtained from their medical history...
May 17, 2018: Journal of Perinatal & Neonatal Nursing
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
#8
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/29782436/effectiveness-of-the-neonatal-discharge-program-for-very-low-birth-weight-infants-on-parental-efficacy-and-psychological-distress
#9
Lakshmi Shandra Bos, Shefaly Shorey, Tamill Salvee Kulantaipian, Jane S P Sng, Wilson W S Tam, Serena S L Koh
This pilot study aimed to (i) evaluate the effectiveness of a neonatal discharge program, (ii) identify relationships between parent and infant factors and parental efficacy and psychological distress, and (iii) identify ways to improve the neonatal discharge program. A quasiexperimental 1-group pretest/posttest design was used. Through consecutive sampling, 42 participants were recruited. Data were collected using self-report questionnaires. Self-administering instruments gathered data on parental efficacy and psychological distress as well as feedback and recommendations on the intervention...
May 17, 2018: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/29782383/genetic-testing-of-xy-newborns-with-a-suspected-disorder-of-sex-development
#10
Malika Alimussina, Louise Ann Diver, Ruth McGowan, Syed Faisal Ahmed
PURPOSE OF REVIEW: The current review focuses on the neonatal presentation of disorders of sex development, summarize the current approach to the evaluation of newborns and describes recent advances in understanding of underlying genetic aetiology of these conditions. RECENT FINDINGS: Several possible candidate genes as well as other adverse environmental factors have been described as contributing to several clinical subgroups of 46,XY DSDs. Moreover, registry-based studies showed that infants with suspected DSD may have extragenital anomalies and in 46,XY cases, being small for gestational age (SGA), cardiac and neurological malformations are the commonest concomitant conditions...
May 17, 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29782306/urticarial-lesions-in-a-pregnant-woman
#11
Sergio Santos-Alarcón, Cesar Benavente-Villegas, Isabel García-Briz, Magdalena Moneva-Léniz, Celia Sanchis-Sánchez, Almudena Mateu-Puchades
Dear Editor, Gestational pemphigoid (GP) is a rare autoimmune bullous dermatosis in pregnancy. GP usually occurs during the second or third month of pregnancy. It clinically manifests as the development of either early-onset urticarial lesions or late-onset subepidermal blisters that may linger for weeks or even months. Herein we report the case of a 45-year-old woman with the distinctive clinical onset of GP. A forty-five-year-old woman, gravida I, para 0, at 27 weeks gestation, was referred for evaluation to our Department with an extensive pruritic eruption that had developed over the previous 7 days...
April 2018: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/29782214/physiologic-changes-in-a-small-animal-model-for-neonatal-minimally-invasive-surgery
#12
Steffi Mayer, Nicole Peukert, Richard Gnatzy, Jan-Hendrik Gosemann, Martin Lacher, Anne Suttkus
BACKGROUND: Minimally invasive surgery (MIS) has gained increasing importance in neonatal surgery but the effects on neonatal physiology remain unclear. We aimed to characterize the impact of capnoperitoneum on physiologic parameters in a small animal model for neonatal MIS. MATERIAL AND METHODS: Twenty-four 10-day-old Sprague Dawley rats underwent inhalative anesthesia (1% isoflurane in 100% O2 250 mL/minutes) and were allowed to breathe spontaneously. CO2 was insufflated into the abdominal cavity for 1 hour via a 24G cannula...
May 21, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29781955/involvements-of-parents-in-the-care-of-preterm-infants-a-pilot-study-evaluating-a-family-centered-care-intervention-in-a-chinese-neonatal-icu
#13
Rong Zhang, Rui-Wena Huang, Xi-Ronga Gao, Xiao-Minga Peng, Li-Hui Zhu, Ramanathan Rangasamy, Jos M Latour
OBJECTIVES: To evaluate the effectiveness and safety of a family-centered care intervention in a Chinese neonatal ICU. DESIGN: Pilot study using a randomized controlled trial design to inform a main randomized controlled trial study. SETTING: Stand-alone tertiary children's hospital in China with a 60-bed neonatal ICU serving as a regional neonatal ICU center. PATIENTS: Premature infants (n = 61) and their parents (n = 110)...
May 17, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29781876/postpartum-pain-management
#14
(no author information available yet)
Pain and fatigue are the most common problems reported by women in the early postpartum period. Pain can interfere with a woman's ability to care for herself and her infant. Untreated pain is associated with a risk of greater opioid use, postpartum depression, and development of persistent pain. Nonpharmacologic and pharmacologic therapies are important components of postpartum pain management. Because 81% of women in the United States initiate breastfeeding during the postpartum period, it is important to consider the drug effects of all prescribed medications on the mother-infant dyad...
May 17, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29781686/the-prevalence-of-neonatal-jaundice-and-risk-factors-in-healthy-term-neonates-at-national-district-hospital-in-bloemfontein
#15
Hanneke Brits, Jeanie Adendorff, Dyanti Huisamen, Dahne Beukes, Kristian Botha, Hanre Herbst, Gina Joubert
BACKGROUND:  Neonatal jaundice affects one in two infants globally. The jaundice is the result of an accumulation of bilirubin as foetal haemoglobin is metabolised by the immature liver. High serum levels of bilirubin result in lethargy, poor feeding and kernicterus of the infant. AIM:  The main aim of this article was to determine the prevalence of neonatal jaundice and secondly to explore its risk factors in healthy term neonates. SETTING:  Maternity ward, National District Hospital, Bloemfontein, South Africa...
April 12, 2018: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/29781571/new-approach-to-accurate-interpretation-of-sickle-cell-disease-newborn-screening-by-applying-multiple-of-median-cutoffs-and-ratios
#16
Bichr Allaf, Franck Patin, Jacques Elion, Nathalie Couque
BACKGROUND: The main goal of newborn screening (NBS) for sickle cell disease (SCD) is to detect affected neonates so that specific preventive care can be implemented. High-performance liquid chromatography (HPLC) used for NBS has high sensitivity and specificity, but we lack guidelines for quantitative hemoglobin (Hb) fraction interpretation. The purpose of this study was to determine cutoff values to standardize quantitative interpretation in SCD NBS for different clinical situation such as, red blood cell transfusion or beta-thalassemia, which can be real screening pitfalls...
May 21, 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29781504/epidural-versus-non-epidural-or-no-analgesia-for-pain-management-in-labour
#17
REVIEW
Millicent Anim-Somuah, Rebecca Md Smyth, Allan M Cyna, Anna Cuthbert
BACKGROUND: Epidural analgesia is a central nerve block technique achieved by injection of a local anaesthetic close to the nerves that transmit pain, and is widely used as a form of pain relief in labour. However, there are concerns about unintended adverse effects on the mother and infant. This is an update of an existing Cochrane Review (Epidural versus non-epidural or no analgesia in labour), last published in 2011. OBJECTIVES: To assess the effectiveness and safety of all types of epidural analgesia, including combined-spinal-epidural (CSE) on the mother and the baby, when compared with non-epidural or no pain relief during labour...
May 21, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29781223/delayed-injury-of-hippocampal-interneurons-after-neonatal-hypoxia-ischemia-and-therapeutic-hypothermia-in-a-murine-model
#18
Raul Chavez-Valdez, Paul Emerson, Janasha Goffigan-Holmes, Alfredo Kirkwood, Lee J Martin, Frances J Northington
Delayed hippocampal injury and memory impairments follow neonatal hypoxia-ischemia (HI) despite the use of therapeutic hypothermia (TH). Death of hippocampal pyramidal cells occurs acutely after HI, but characterization of delayed cell death and injury of interneurons (INs) is unknown. We hypothesize that injury of INs after HI is: i) asynchronous to that of pyramidal cells, ii) independent of injury severity, and iii) unresponsive to TH. HI was induced in C57BL6 mice at p10 with unilateral right carotid ligation and 45 min of hypoxia (FiO2 =0...
May 21, 2018: Hippocampus
https://www.readbyqxmd.com/read/29781085/effect-of-hypothermia-treatment-on-gentamicin-pharmacokinetics-in-neonates-with-hypoxic-ischaemic-encephalopathy-a-systematic-review-and-meta-analysis
#19
REVIEW
D W Choi, J H Park, S Y Lee, S H An
WHAT IS KNOWN AND OBJECTIVE: Hypothermia is the current standard therapy for asphyxiated neonates with hypoxic-ischaemic encephalopathy (HIE). Gentamicin is used for the empirical treatment of early-onset neonatal sepsis. We investigated the influence of hypothermia treatment on gentamicin pharmacokinetics and suggested the appropriate dosing recommendations for gentamicin in neonates with HIE receiving hypothermia treatment. METHODS: We searched studies published until February 2017 in MEDLINE using PubMed, EMBASE and the Cochrane Library...
May 20, 2018: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29781043/comparison-of-four-days-versus-seven-days-duration-of-antibiotic-therapy-for-neonatal-pneumonia-a-randomized-controlled-trial
#20
N B Mathur, A Murugesan
OBJECTIVE: To compare the effect of 4 day course (study group) with 7 day course (control group) of antibiotic treatment in neonatal pneumonia, on treatment success rate. METHODS: This randomized controlled trial was conducted in a tertiary teaching hospital. Seventy, term and near-term neonates with pneumonia who had clinical remission by 48 h of antibiotic therapy were included. The neonates were randomized to receive a total of 4 d of antibiotics (Group 1) or 7 d of antibiotics (Group 2)...
May 21, 2018: Indian Journal of Pediatrics
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