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https://www.readbyqxmd.com/read/28332220/perspectives-on-risk-assessment-of-risk-profiles-and-outcomes-among-women-planning-community-birth-in-the-united-states
#1
Marit L Bovbjerg, Melissa Cheyney, Jennifer Brown, Kim J Cox, Lawrence Leeman
BACKGROUND: There is little agreement on who is a good candidate for community (home or birth center) birth in the United States. METHODS: Data on n=47 394 midwife-attended, planned community births come from the Midwives Alliance of North America Statistics Project. Logistic regression quantified the independent contribution of 10 risk factors to maternal and neonatal outcomes. Risk factors included: primiparity, advanced maternal age, obesity, gestational diabetes, preeclampsia, postterm pregnancy, twins, breech presentation, history of cesarean and vaginal birth, and history of cesarean without history of vaginal birth...
March 22, 2017: Birth
https://www.readbyqxmd.com/read/28322345/nursing-staff-fluctuation-and-pathogenic-burden-in-the-nicu-effective-outbreak-management-and-the-underestimated-relevance-of-non-resistant-strains
#2
Kai O Hensel, Rhea van den Bruck, Ingo Klare, Michael Heldmann, Beniam Ghebremedhin, Andreas C Jenke
In the course of a hospital management takeover, a microbial outbreak took place in a tertiary neonatal intensive care unit (NICU). Here, we characterize the outbreak and its management. About 4 months prior to takeover, there was a sharp increase in positive isolates for MSSA and multidrug-resistant organisms (MDROs). Simultaneously, the nursing staff sick leave rate increased dramatically which directly correlated with the number of infection/colonization per week (r(2) = 0.95, p = 0.02). During the following months we observed several peaks in positive isolates of methicillin-sensitive staphylococcus aureus (MSSA), MDROs and subsequently a vancomycin-resistant enterococcus (VRE) outbreak...
March 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28304316/perspectives-and-attitudes-of-pediatricians-concerning-post-discharge-care-practice-of-premature-infants
#3
A Gad, E Parkinson, N Khawar, A Elmeki, P Narula, D Hoang
OBJECTIVE: Survival rates of premature infants are at a historical high and increasingly more pediatricians are caring for former premature infants. The goal of this study was to describe the perspectives and attitudes of pediatricians, as well as, the challenges of rendering post-neonatal intensive care unit (NICU) discharge care for premature infants. METHODS: An anonymous 22-question web-based survey was emailed to pediatricians who are current members of the American Academy of Pediatrics (AAP) and practicing in Kings County, New York...
March 16, 2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28299295/stress-management-among-parents-of-neonates-hospitalized-in-nicu-a-qualitative-study
#4
Haydeh Heidari, Marzieh Hasanpour, Marjan Fooladi
Introduction: Infant hospitalization is stressful event for parent in NICU. Parents think that they have lost control because of unfamiliar environment. Therefore, stress management is very important in this period. The family as the main factor of strength and protection for infant is required as the bases of standard care in NICU. Therefore the aim of this study was to investigate stress management in Iranian NICU Parents. Methods: Using qualitative content analysis approach helped to collect and analysis data for open coding, classification, and theme abstraction...
March 2017: Journal of Caring Sciences
https://www.readbyqxmd.com/read/28294399/the-impact-of-italian-regionalisation-on-transporting-neonatal-patients-back-from-the-neonatal-intensive-care-unit-to-the-referring-level-two-unit
#5
Carlo Bellini, Luca A Ramenghi
Perinatal regionalisation networks aim to centralise highly skilled care for high-risk neonates and their mothers (1). This study examined how the regional policy in Liguria, Italy, had changed the management of very low birth weight preterm infants. We were particularly keen to look at the impact on back transports, namely transferring patients back to a Level II unit once they did not need to be in the neonatal intensive care unit (NICU) at the IRCCS Istituto Giannina Gaslini, Genoa, Italy. This article is protected by copyright...
March 10, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28277921/does-implementing-a-regime-of-dexamethasone-before-planned-cesarean-section-at-term-reduce-admission-with-respiratory-morbidity-to-neonatal-intensive-care-unit-a-randomized-controlled-trial
#6
Ahmed Mohamed Nooh, Hussein Mohammed Abdeldayem, Eisa Arafa, Sherin Attia Shazly, Hany Elsayed, Wesam A Mokhtar
OBJECTIVE: To assess effectiveness of Dexamethasone before plannedcesarean section at term in reducing admission with respiratory morbidity to neonatal intensive care units. METHODS: A prospective randomized controlled trial which was conducted at an Egyptian teaching hospital. Participants at ≥ 38 weeks gestation who were planned to have planned CS were recruited. They were randomized into a treatment group (636 women) who received three IM doses of Dexamethasone 8 mg, 8 hours apart, and control group (636 women) who have not received Dexamethasone, before having planned CS...
February 9, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28267444/a-multicenter-prospective-study-of-neonatal-outcomes-at-less-than-32-weeks-associated-with-indications-for-maternal-admission-and-delivery
#7
Thomas J Garite, C Andrew Combs, Kimberly Maurel, Anita Das, Kevin Huls, Richard Porreco, Dale Reisner, George Lu, Melissa Bush, Bruce Morris, April Bleich
BACKGROUND: Counseling for patients with impending premature delivery has been traditionally based primarily on the projected gestational age at delivery. There are limited data regarding how the indications for the preterm birth affect the neonatal outcome and whether this issue should be taken into account in decisions regarding management and patient counseling. OBJECTIVE: We performed a prospective study of pregnancies resulting in premature delivery at less than 32 weeks to determine the influence of both the Indications for Admission and their associated Indications for Delivery on neonatal mortality and complications of prematurity...
March 3, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28266919/outpatient-management-of-neonatal-abstinence-syndrome-a-quality-improvement-project
#8
Kim T Chau, Jacqueline Nguyen, Branko Miladinovic, Carol M Lilly, Terri L Ashmeade, Maya Balakrishnan
BACKGROUND: An increasing number of infants are diagnosed with neonatal abstinence syndrome (NAS). The study's primary objectives were to describe an academic medical center's level IV neonatal ICU's (NICU's) comprehensive outpatient NAS management effort, measure guideline compliance, and assess its safety. Secondary objectives were to describe the duration and cumulative methadone exposure, and to improve parent and provider knowledge of NAS. METHODS: The study included 22 infants having a gestational age of 35-41 weeks, diagnosed with NAS, and discharged for outpatient methadone management...
November 2016: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28264595/uterine-rupture-after-previous-low-segment-transverse-cesarean-is-rarely-catastrophic
#9
Sofia Soltsman, Yuri Perlitz, Moshe Ben Ami, Izhar Ben Shlomo
OBJECTIVE: The cornerstone of concerns over trial of labor after cesarean (TOLAC) is the risk of uterine rupture. The purpose of this study was to document the rate of uterine rupture during TOLAC and to delineate its severity and consequences. MATERIALS AND METHODS: We retrospectively collected the data on vaginal and cesarean deliveries after a previous cesarean section with specific emphasis on uterine rupture and dehiscence in our center from 2006 through 2013...
March 6, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28250024/care-system-redesign-for-preterm-children-after-discharge-from-the-nicu
#10
Dennis Z Kuo, Robert E Lyle, Patrick H Casey, Christopher J Stille
Approximately 1 in 8 children in the United States are born preterm. Existing guidelines and research examine the cost of prematurity from the NICU stay and developmental surveillance and outcomes after discharge from the NICU. Preterm children are at greater risk for excess hospitalizations, outpatient visits, and societal costs after NICU discharge. Improved delivery of care and health promotion from the community setting, particularly from the patient-centered medical home, may result in improved growth, health, and development, with accompanying reduction of post-NICU discharge costs and encounters...
March 1, 2017: Pediatrics
https://www.readbyqxmd.com/read/28240343/term-twin-birth-impact-of-mode-of-delivery-on-outcome
#11
Elina Ylilehto, Outi Palomäki, Heini Huhtala, Jukka Uotila
The main aims of this study were to compare maternal and neonatal outcomes in term twin birth according to the planned mode of delivery and to study the effects of chorionicity and inter-twin delivery time on neonatal outcome MATERIAL AND METHODS: A single-center cohort study of 495 women with twin deliveries at ≥ 37+0 weeks of gestation. Term twin deliveries were divided into a trial of labor group (TOL, 69.3%) and a planned cesarean section (CS) group (30.7%). The primary outcomes were maternal and neonatal morbidity RESULTS: 80...
February 27, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28225527/neuro-trauma-or-med-surg-intensive-care-unit-does-it-matter-where-multiple-injuries-patients-with-traumatic-brain-injury-are-admitted-secondary-analysis-of-the-american-association-for-the-surgery-of-trauma-multi-institutional-trials-committee-decompressive
#12
Sarah Lombardo, Thomas Scalea, Jason Sperry, Raul Coimbra, Gary Vercruysse, Toby Enniss, Gregory J Jurkovich, Raminder Nirula
INTRODUCTION: Patients with nontraumatic acute intracranial pathology benefit from neurointensivist care. Similarly, trauma patients with and without traumatic brain injury (TBI) fare better when treated by a dedicated trauma team. No study has yet evaluated the role of specialized neurocritical (NICU) and trauma intensive care units (TICU) in the management of TBI patients, and it remains unclear which TBI patients are best served in NICU, TICU, or general (Med/Surg) ICU. METHODS: This study is a secondary analysis of The American Association for the Surgery of Trauma Multi-Institutional Trials Committee (AAST-MITC) decompressive craniectomy study...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28214832/the-burden-of-respiratory-disease-in-very-low-birth-weight-infants-changes-in-perinatal-care-and-outcomes-in-a-decade-in-spain
#13
Fermín García-Muñoz Rodrigo, Antonio Losada Martínez, María Dolores Elorza Fernández, Julio Moreno Hernando, Josep Figueras Aloy, Máximo Vento Torres
BACKGROUND: Advances in perinatal care have led to a significant reduction in morbidity and mortality among very-low-birth-weight (VLBW) infants. Much of this progress is related to the prevention and management of respiratory disease. OBJECTIVES: To evaluate changes in perinatal care and its influence on respiratory morbidity and mortality among VLBW infants in Spain in 2 consecutive periods (2002-2006 and 2007-2011). METHODS: This is a retrospective analysis of data prospectively collected of all VLBW infants included in the Spanish SEN1500 network...
February 18, 2017: Neonatology
https://www.readbyqxmd.com/read/28203324/lived-experience-of-caregivers-of-family-centered-care-in-the-neonatal-intensive-care-unit-evocation-of-being-at-home
#14
Zahra Hadian Shirazi, Farkhondeh Sharif, Mahnaz Rakhshan, Narjes Pishva, Faezeh Jahanpour
BACKGROUND: In recent decades, family-centered care (FCC) has come to be known, accepted, and reported as the best care strategy for admitted children and their families. However, in spite of the increasing application of this approach, the experiences of the caregivers have not yet been studied. OBJECTIVES: The present study aimed at the description and interpretation of the FCC experience in two neonatal intensive care units (NICU) at Shiraz University of Medical Sciences...
October 2016: Iranian Journal of Pediatrics
https://www.readbyqxmd.com/read/28190975/reduced-platelet-hyper-reactivity-and-platelet-leukocyte-aggregation-after-periodontal-therapy
#15
Efthymios Arvanitidis, Sergio Bizzarro, Elena Alvarez Rodriguez, Bruno G Loos, Elena A Nicu
BACKGROUND: Platelets from untreated periodontitis patients are hyper-reactive and form more platelet-leukocyte complexes compared to cells from individuals without periodontitis. It is not known whether the improvement of the periodontal condition achievable by therapy has beneficial effects on the platelet function. We aimed to assess the effects of periodontal therapy on platelet reactivity. METHODS: Patients with periodontitis (n = 25) but unaffected by any other medical condition or medication were included and donated blood before and after periodontal therapy...
2017: Thrombosis Journal
https://www.readbyqxmd.com/read/28187810/management-of-infections-associated-with-neurocritical-care
#16
REVIEW
L Rivera-Lara, W Ziai, P Nyquist
The reported incidence of hospital-acquired infections (HAIs) in the neurointensive care unit (NICU) ranges from 20% to 30%. HAIs in US hospitals cost between $28 and $45 billion per year in direct medical costs. These infections are associated with increased length of hospital stay and increased morbidity and mortality. Infection risk is increased in NICU patients due to medication side-effects, catheter and line placement, neurosurgical procedures, and acquired immune suppression secondary to steroid/barbiturate use and brain injury itself...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28178172/effects-of-combined-oral-sucrose-and-nonnutritive-sucking-nns-on-procedural-pain-of-nicu-newborns-2001-to-2016-a-prisma-compliant-systematic-review-and-meta-analysis
#17
REVIEW
Yi Liu, Xinchun Huang, Biru Luo, Wentao Peng
BACKGROUND: Both oral sucrose (OS) and nonnutritive sucking (NNS) are effective nonpharmacological methods to alleviate procedures pain in neonatal intensive care unit (NICU) newborns when they were used alone, but the combined effect of OS+NNS remains controversial. So, we conducted this study to evaluate the efficiency of NNS combined with oral sucrose on pain relief in NICU newborns undergoing painful procedures. METHODS: We searched PubMed, Ovid (Medline), Embase (Medline), Cochrane Central Library, and other resources such as Google Scholar, bibliographies of included literatures for all available articles...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28151493/surfactant-reduced-the-mortality-of-neonates-with-birth-weight-%C3%A2-1500%C3%A2-g-and-hypoxemic-respiratory-failure-a-survey-from-an-emerging-nicu-network
#18
H Wang, X Gao, C Liu, C Yan, X Lin, Y Dong, B Sun
OBJECTIVE: We evaluated the efficacy of surfactant therapy and assisted ventilation on morbidity and mortality of neonates with birth weight (BW) ⩾1500 g and hypoxemic respiratory failure (HRF). STUDY DESIGN: We retrospectively analyzed 5650 patients with BW ⩾1500 g for incidence, management and outcome of HRF, defined as acute hypoxemia requiring mechanical ventilation and/or nasal continuous positive airway pressure ⩾24 h. The patients were allocated into groups of moderate preterm (1735, 30...
February 2, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28141719/-more-than-meets-the-eye-when-the-neonatal-course-may-impact-several-years-out
#19
Fadiyla Dopwell, John Maypole, Bharati Sinha, Heidi Currier, William DeBassio, Marilyn Augustyn
Nadia is a 7-year-old girl who you have followed since her discharge from the Neonatal Intensive Care Unit (NICU). Her parents are here today for an urgent visit with behavioral concerns, such as inattention, hyperactivity, and aggression.Nadia is a former 40-weeker born through vacuum-assisted vaginal delivery at 9 pounds 7 ounces. Her delivery was complicated with shoulder dystocia, which resulted in resuscitation. Her Apgar scores were 1, 3, and 4 at 1, 5, and 10 minutes, respectively. After intubation and stabilization on mechanical ventilation, Nadia was transferred to the NICU...
February 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28139411/-improving-patient-safety-usefulness-of-safety-checklists-in-a-neonatal-unit
#20
María Arriaga Redondo, Ester Sanz López, Ana Rodríguez Sánchez de la Blanca, Itziar Marsinyach Ros, Laura Collados Gómez, Alicia Díaz Redondo, Manuel Sánchez Luna
INTRODUCTION: Due to the complexity and characteristics of their patients, neonatal units are risk areas for the development of adverse events (AE). For this reason, there is a need to introduce and implement some tools and strategies that will help to improve the safety of the neonatal patient. Safety check-lists have shown to be a useful tool in other health areas but they are not sufficiently developed in Neonatal Units. MATERIAL AND METHODS: A quasi-experimental prospective study was conducted on the design and implementation of the use of a checklist and evaluation of its usefulness for detecting incidents...
January 27, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
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