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https://www.readbyqxmd.com/read/28731912/assessing-infant-and-maternal-readiness-for-newborn-discharge
#1
Ling Jing, Casidhe-Nicole Bethancourt, Thomas McDonagh
PURPOSE OF REVIEW: The review highlights the shift from prescribed length of stay (LOS) to mother-infant dyad readiness as the basis for making discharge decisions for healthy term newborns. We describe the components of readiness that should be considered in making the decision, focusing on infant clinical readiness, and maternal and familial readiness. RECENT FINDINGS: Although the Newborns' and Mothers' Health Protection Act of 1996 aimed to protect infants and mothers by establishing a minimum LOS, the American Academy of Pediatrics 2015 policy on newborn discharge acknowledges the shift from LOS-based to readiness-based discharge decision-making...
July 20, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28729050/an-infant-with-concurrent-serotype-6c-invasive-pneumococcal-disease-and-infectious-mononucleosis
#2
Naoko Nishikawa-Nakamura, Takafumi Okada, Keiko Nishimura, Tsuyako Iwai, Kimiko Ubukata, Satoshi Iwata, Asayuki Iwai
Streptococcus pneumoniae is a main causative agent of serious invasive bacterial infections. However, concurrent infection with invasive pneumococcal disease (IPD) and viral infectious mononucleosis (IM) is rare. We report an infant with serotype 6C infection causing IPD occurring simultaneously with IM. A previously healthy 11-month-old girl referred to our hospital because of fever, leukopenia, and elevated C-reactive protein presented to us with disturbance of consciousness, tachycardia, tachypnea and agranulocytosis...
July 17, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28727130/the-utility-of-maternal-mean-platelet-volume-levels-for-early-onset-neonatal-sepsis-prediction-of-term-infants
#3
Yasemin Cekmez, Merve Dizdar Güleçoğlu, Cemile Özcan, Leyla Karadeniz, Gürkan Kıran
OBJECTIVES: This study is aimed to evaluate the role of maternal mean platelet volume (MPV) levels for antenatal prediction marker of early onset neonatal sepsis in term infants born to mothers who have low infection risk. MATERIAL AND METHODS: A total of 62 pregnant women who gave birth in our hospital and whose neonates were admitted to a third level Neonatal Intensive Care Unit due to confirmed neonatal sepsis between January 2010 and May 2016 were selected as a study group...
2017: Ginekologia Polska
https://www.readbyqxmd.com/read/28724325/use-and-timing-of-surfactant-administration-impact-on-neonatal-outcomes-in-extremely-low-gestational-age-infants-born-in-canadian-neonatal-intensive-care-units
#4
Amelie Stritzke, Khorshid Mohammad, Prakesh S Shah, Xiang Y Ye, Vineet Bhandari, Albert Akierman, Adele Harrison, Valerie Bertelle, Abhay Lodha
BACKGROUND: Use, timing and doses of surfactant in preterm infants are variable in practice in modern NICUs. OBJECTIVE: To explore the association between use and timing of surfactant administration and common neonatal adverse outcomes in preterm infants with gestational age (GA) < 28 weeks. MATERIAL AND METHODS: Neonates admitted to a participating Canadian Neonatal Network NICU between 2013 and 2015 were studied. Infants were divided into three groups based on surfactant administration: None, early (within 30 minutes of life), and late surfactant (> 30 minutes)...
July 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28720399/prenatal-and-postnatal-administration-of-prebiotics-and-probiotics
#5
REVIEW
Kristin Sohn, Mark A Underwood
Colonization of the neonatal gut by beneficial bacteria is important for the establishment and maintenance of the mucosal barrier, thus protecting the neonate from enteric pathogens and local and systemic inflammation. The neonatal microbiome is influenced by infant diet, environment, and the maternal microbiome. Dysbiosis in pregnancy increases the risk of pre-eclampsia, diabetes, infection, preterm labor, and later childhood atopy. Dysbiosis of the neonatal gut plays an important role in colic in the term infant, in the disease processes which plague preterm infants, including necrotizing enterocolitis and sepsis, and in the long-term outcomes of neonates...
July 15, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28719503/central-peripheral-temperature-monitoring-as-a-marker-for-diagnosing-late-onset-neonatal-sepsis
#6
José Luis Leante-Castellanos, Antonio Martínez-Gimeno, Manuel Cidrás-Pidré, Gerardo Martínez-Munar, Ana García-González, Carmen Fuentes-Gutiérrez
BACKGROUND: The prognosis for late-onset sepsis depends largely on a timely diagnosis. We assess central-peripheral temperature difference monitoring as a marker for late-onset neonatal sepsis diagnosis. METHODS: We performed a prospective, observational study focusing on a cohort of 129 very low birth weight infants. Thermal gradient alteration was defined as a difference of > 2°C maintained during 4 hours. We then determined its association with the late-onset sepsis variable through logistic regression...
July 13, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28719479/a-simulation-based-quality-improvement-initiative-improves-pediatric-readiness-in-community-hospitals
#7
Travis Whitfill, Marcie Gawel, Marc Auerbach
BACKGROUND: The National Pediatric Readiness Project Pediatric Readiness Survey (PRS) measured pediatric readiness in 4149 US emergency departments (EDs) and noted an average score of 69 on a 100-point scale. This readiness score consists of 6 domains: coordination of pediatric patient care (19/100), physician/nurse staffing and training (10/100), quality improvement activities (7/100), patient safety initiatives (14/100), policies and procedures (17/100), and availability of pediatric equipment (33/100)...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28718488/infectious-disease-morbidity-and-growth-among-young-hiv-exposed-uninfected-children-in-jamaica
#8
Russell B Pierre, Toni-Anne Fulford, Kaye Lewis, Paulette Palmer, Christine Walters, Celia D C Christie
Objective: There is a growing body of data that demonstrates increased infectious disease outcomes for HIV-exposed uninfected (HIV-EU) infants as compared to their HIV-unexposed (HU) counterparts. We hypothesized that these HIV-EU infants are at greater risk for infectious morbidity and mortality when compared to the general childhood population. We therefore aimed to characterize infections and growth outcomes among HIV-EU infants in Jamaica during their first two years of life. By identifying these outcomes, specific interventions could be implemented to mitigate this risk of morbidity and mortality...
December 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/28714327/elevated-levels-of-circulating-cell-free-dna-and-neutrophil-proteins-are-associated-with-neonatal-sepsis-and-necrotizing-enterocolitis-in-immature-mice-pigs-and-infants
#9
Duc Ninh Nguyen, Allan Stensballe, Jacqueline Cy Lai, Pingping Jiang, Anders Brunse, Yanqi Li, Jing Sun, Carina Mallard, Tom Skeath, Nicholas D Embleton, Janet E Berrington, Per T Sangild
Preterm infants are highly susceptible to late-onset sepsis (LOS) and necrotizing enterocolitis (NEC), but disease pathogenesis and specific diagnostic markers are lacking. Circulating cell-free DNA (cfDNA) and immune cell-derived proteins are involved in multiple immune diseases in adults but have not been investigated in preterm neonates. We explored the relation of circulating neutrophil-associated proteins and cfDNA to LOS and/or NEC. Using a clinically relevant preterm pig model of spontaneous LOS and NEC development, we investigated neutrophil-associated proteins and cfDNA in plasma, together with cytokines in gut tissues...
January 1, 2017: Innate Immunity
https://www.readbyqxmd.com/read/28712519/contemporary-outcomes-of-infants-with-gastroschisis-in-north-america-a-multicenter-cohort-study
#10
Brenna S Fullerton, Cristine S Velazco, Eric A Sparks, Kate A Morrow, Erika M Edwards, Roger F Soll, Biren P Modi, Jeffrey D Horbar, Tom Jaksic
OBJECTIVE: To quantify outcomes and analyze factors predictive of morbidity and mortality in infants with gastroschisis. STUDY DESIGN: Clinical data regarding neonates with gastroschisis born between 2009 and 2014 were prospectively collected at 175 North American centers. Multivariate regression was used to assess risk factors for mortality and length of stay (LOS). RESULTS: Gastroschisis was diagnosed in 4420 neonates with median birth weight 2410 g (IQR 2105-2747)...
July 13, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28711318/procalcitonin-guided-decision-making-for-duration-of-antibiotic-therapy-in-neonates-with-suspected-early-onset-sepsis-a-multicentre-randomised-controlled-trial-neopins
#11
Martin Stocker, Wendy van Herk, Salhab El Helou, Sourabh Dutta, Matteo S Fontana, Frank A B A Schuerman, Rita K van den Tooren-de Groot, Jantien W Wieringa, Jan Janota, Laura H van der Meer-Kappelle, Rob Moonen, Sintha D Sie, Esther de Vries, Albertine E Donker, Urs Zimmerman, Luregn J Schlapbach, Amerik C de Mol, Angelique Hoffman-Haringsma, Madan Roy, Maren Tomaske, René F Kornelisse, Juliette van Gijsel, Eline G Visser, Sten P Willemsen, Annemarie M C van Rossum
BACKGROUND: Up to 7% of term and late-preterm neonates in high-income countries receive antibiotics during the first 3 days of life because of suspected early-onset sepsis. The prevalence of culture-proven early-onset sepsis is 0·1% or less in high-income countries, suggesting substantial overtreatment. We assess whether procalcitonin-guided decision making for suspected early-onset sepsis can safely reduce the duration of antibiotic treatment. METHODS: We did this randomised controlled intervention trial in Dutch (n=11), Swiss (n=4), Canadian (n=2), and Czech (n=1) hospitals...
July 12, 2017: Lancet
https://www.readbyqxmd.com/read/28709162/late-onset-sepsis-in-extremely-premature-infants-2000-2011
#12
Rachel G Greenberg, Sarah Kandefer, Barbara T Do, P Brian Smith, Barbara J Stoll, Edward F Bell, Waldemar A Carlo, Abbot R Laptook, Pablo J Sánchez, Seetha Shankaran, Krisa P Van Meurs, M Bethany Ball, Ellen C Hale, Nancy S Newman, Abhik Das, Rosemary D Higgins, C Michael Cotten
BACKGROUND: Late-onset sepsis (LOS) is an important cause of death and neurodevelopmental impairment in premature infants. The purpose of this study was to assess overall incidence of LOS, distribution of LOS-causative organisms and center variation in incidence of LOS for extremely premature infants over time. METHODS: In a retrospective analysis of infants 401-1000 g birth weight and 22-28 6/7 weeks of gestational age born at 12 National Institute of Child Health and Human Development Neonatal Research Network centers in the years 2000-2005 (era 1) or 2006-2011 (era 2) who survived >72 hours, we compared the incidence of LOS and pathogen distribution in the 2 eras using the χ test...
August 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28707191/clostridium-difficile-colitis-and-colonoscopy-pediatric-perspective
#13
REVIEW
Randolph McConnie, Arthur Kastl
PURPOSE OF THE REVIEW: Review tests available for detection of Clostridium difficile (C. Diff) induced disease, including when such tests should be done in children and how they should be interpreted. RECENT FINDINGS: Multiple tests are available for detecting disease due to C. diff. These include colonoscopy and stool analysis. Colonoscopy with biopsy is the most sensitive test for detecting the presence of colitis. The toxins produced by the C. diff. (toxin A, toxin B, and binary toxin) are the agents that cause injury and disease...
August 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28706618/isolated-ileal-perforation-in-infancy-a-lethal-initial-presentation-of-hirschsprung-s-disease
#14
Fadi Iskandarani, Chawki Hammoud, Sarah Srour, Gloria Pelizzo, Ghassan Nakib, Valeria Calcaterra, Amir Khanafer
Arare case of ileal perforation, as a fatal initial presentation of total colonic aganglionosis (TCA) in infancy is reported. A 10-week-old boy, was brought to the emergency department with symptoms of complicated intestinal obstruction. He looked ill, was lethargic, markedly dehydrated and had a severely distended abdomen. An abdominal X-ray revealed multiple air fluid levels seen in a distended small intestine. During exploratory laparotomy the ileum was massively dilated with distal segment perforation. Ileal perforation repair was performed...
June 26, 2017: Pediatric Reports
https://www.readbyqxmd.com/read/28701373/antibiotic-utilisation-in-very-low-birth-weight-infants-without-sepsis-or-necrotising-enterocolitis-is-associated-with-multiple-adverse-outcomes
#15
Jessica L Roberts, Ravi M Patel
No abstract text is available yet for this article.
July 12, 2017: Evidence-based Medicine
https://www.readbyqxmd.com/read/28701177/longitudinal-development-of-the-gut-microbiome-and-metabolome-in-preterm-neonates-with-late-onset-sepsis-and-healthy-controls
#16
Christopher J Stewart, Nicholas D Embleton, Emma C L Marrs, Daniel P Smith, Tatiana Fofanova, Andrew Nelson, Tom Skeath, John D Perry, Joseph F Petrosino, Janet E Berrington, Stephen P Cummings
BACKGROUND: Late onset sepsis (LOS) in preterm infants is associated with considerable morbidity and mortality. While studies have implicated gut bacteria in the aetiology of the disease, functional analysis and mechanistic insights are generally lacking. We performed temporal bacterial (n = 613) and metabolomic (n = 63) profiling on extensively sampled stool from 7 infants with LOS and 28 matched healthy (no LOS or NEC) controls. RESULTS: The bacteria isolated in diagnostic blood culture usually corresponded to the dominant bacterial genera in the gut microbiome...
July 12, 2017: Microbiome
https://www.readbyqxmd.com/read/28697406/efficacy-of-pharmacologic-closure-of-patent-ductus-arteriosus-in-small-for-gestational-age-extremely-preterm-infants
#17
Nansi S Boghossian, Barbara T Do, Edward F Bell, John M Dagle, Jane E Brumbaugh, Barbara J Stoll, Betty R Vohr, Abhik Das, Seetha Shankaran, Pablo J Sanchez, Myra H Wyckoff, M Bethany Ball
BACKGROUND: Optimal management of the patent ductus arteriosus (PDA) in preterm infants remains controversial. Therefore, studies identifying infants who are most likely to benefit from PDA treatment are needed. AIM: We sought to examine if significant intrauterine growth restriction, defined by birth weight z-score, reduces the efficacy of PDA closure with indomethacin or ibuprofen and thereby increases the need for surgical closure of PDA after pharmacologic treatment...
July 8, 2017: Early Human Development
https://www.readbyqxmd.com/read/28694292/specialized-pro-resolving-mediators-spm-rescue-infant-mice-from-lethal-citrobacter-rodentium-infection-and-promote-immunity-against-re-infection
#18
Luis Alonso Diaz, Norman H Altman, Wasif Khan, Charles N Serhan, Becky Adkins
Infants are generally highly susceptible to oral pathogens. Intestinal infection and the associated diarrhea are significant global causes of morbidity and mortality in infants. Among the enteric pathogens, enteropathogenic E. coli (EPEC) stands out as showing the highest risk for infection-induced death in infants ≤ 12 months old. We have developed an experimental model of infant infection with EPEC, using the murine specific pathogen Citrobacter rodentium Our murine infant model is similar to EPEC infection in human infants since infant mice are much more susceptible to C...
July 10, 2017: Infection and Immunity
https://www.readbyqxmd.com/read/28693558/zinc-as-an-adjunct-treatment-for-reducing-case-fatality-due-to-clinical-severe-infection-in-young-infants-study-protocol-for-a-randomized-controlled-trial
#19
Nitya Wadhwa, Sudha Basnet, Uma Chandra Mouli Natchu, Laxman P Shrestha, Shinjini Bhatnagar, Halvor Sommerfelt, Tor A Strand, Siddarth Ramji, K C Aggarwal, Harish Chellani, Anuradha Govil, Mamta Jajoo, N B Mathur, Meenakshi Bhatt, Anup Mohta, Imran Ansari, Srijana Basnet, Ram H Chapagain, Ganesh P Shah, Binod M Shrestha
BACKGROUND: An estimated 2.7 of the 5.9 million deaths in children under 5 years of age occur in the neonatal period. Severe infections contribute to almost a quarter of these deaths. Mortality due to severe infections in developing country settings is substantial despite antibiotic therapy. Effective interventions that can be added to standard therapy for severe infections are required to reduce case fatality. METHODS/DESIGN: This is a double-blind randomized placebo-controlled parallel group superiority trial to investigate the effect of zinc administered orally as an adjunct to standard therapy to infants aged 3 days up to 2 months (59 days) hospitalized with clinical severe infection, that will be undertaken in seven hospitals in Delhi, India and Kathmandu, Nepal...
July 10, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28690615/impact-of-early-life-exposures-to-infections-antibiotics-and-vaccines-on-perinatal-and-long-term-health-and-disease
#20
REVIEW
Steven L Raymond, Jaimar C Rincon, James L Wynn, Lyle L Moldawer, Shawn D Larson
Essentially, all neonates are exposed to infections, antibiotics, or vaccines early in their lives. This is especially true for those neonates born underweight or premature. In contrast to septic adults and children who are at an increased risk for subsequent infections, exposure to infection during the neonatal period is not associated with an increased risk of subsequent infection and may be paradoxically associated with reductions in late-onset sepsis (LOS) in the most premature infants. Perinatal inflammation is also associated with a decreased incidence of asthma and atopy later in life...
2017: Frontiers in Immunology
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