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https://www.readbyqxmd.com/read/28106904/planned-early-delivery-versus-expectant-management-for-hypertensive-disorders-from-34-weeks-gestation-to-term
#1
REVIEW
Catherine Cluver, Natalia Novikova, Corine M Koopmans, Helen M West
BACKGROUND: Hypertensive disorders in pregnancy are significant contributors to maternal and perinatal morbidity and mortality. These disorders include well-controlled chronic hypertension, gestational hypertension (pregnancy-induced hypertension) and mild pre-eclampsia. The definitive treatment for these disorders is planned early delivery and the alternative is to manage the pregnancy expectantly if severe uncontrolled hypertension is not present, with close maternal and fetal monitoring...
January 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28065256/a-newborn-infant-with-oxygen-desaturation-during-sleep
#2
Ashley Deschamp, Ameet Daftary
The patient is a 1-week-old boy born at 37+2 weeks' gestational age through spontaneous vaginal delivery. The pregnancy was complicated by maternal gestational diabetes mellitus and pre-eclampsia. The Apgar score was 9 at both 1 minute and 5 minutes after birth. Because of hypoglycemia at delivery that required IV dextrose, he was admitted to the local neonatal intensive care unit. His blood glucose levels quickly stabilized, dextrose administration was discontinued, and the patient began breast-feeding. On day 2 of life, the patient began having intermittent oxygen desaturation, with oxygen saturation as measured by pulse oximetry down to 70% while sleeping; he was transferred to a tertiary-care NICU for further management...
January 2017: Chest
https://www.readbyqxmd.com/read/28050517/prosthodontic-approach-in-management-of-prolonged-neonatal-intubation
#3
Vikas B Kamble, Shital K Shah, Vishnu B Rathod, Priyanka S Ambadkar, Charudutt N Patil
Intubation is a routine intervention in the Neonatal Intensive Care Unit (NICU) for preterm neonates with respiratory distress, inadequate gag reflex, poor sucking and swallowing. Prolonged intubation in neonates can be done by nasal or oral route. Although naso-tracheal intubation may reduce movement of the tube, it may contribute to airway obstruction, possible hypoxia, and occlusion of the nasal aperture during a crucial period of development further contributing to laboured breathing. Being obligate nasal breathers, oro-tracheal route is the preferred method of intubation in premature infants as oral mucosa is less susceptible to damage than nasal mucosa...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28030487/neuro-trauma-or-med-surg-icu-does-it-matter-where-polytrauma-patients-with-tbi-are-admitted-secondary-analysis-of-aast-mitc-decompressive-craniectomy-study
#4
Sarah Lombardo, Thomas Scalea, Jason Sperry, Raul Coimbra, Gary Vercruysse, Gregory J Jurkovich, Ram Nirula
INTRODUCTION: Patients with non-traumatic acute intracranial pathology benefit from neurointensivist care. Similarly, trauma patients with and without 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...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28009331/a-study-of-acute-kidney-injury-in%C3%A2-hospitalized-preterm-neonates-in-nicu
#5
N Nagaraj, P K Berwal, A Srinivas, A Berwal
OBJECTIVES: This study was carried out to determine the incidence, clinical features, etiology and outcome of functional and intrinsic acute kidney injury (AKI) in preterm neonates. METHODS: This is a prospective observational study on premature infants admitted to the neonatal intensive care unit (NICU) over an eight month period. All biochemical parameters of renal function tests were monitored and statically analyzed. RESULTS: The study included 450 infants; of them 300 were inborn and 150 infants were outborn and transported to the NICU...
2016: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28005272/prophylactic-versus-selective-blood-transfusion-for-sickle-cell-disease-in-pregnancy
#6
REVIEW
Babasola O Okusanya, Olufemi T Oladapo
BACKGROUND: Pregnant women with sickle cell disease (HbSS, HbSC and HbSβThal) may require blood transfusion to prevent severe anaemia or to manage potential medical complications. Preventive blood transfusion in the absence of complications starting from the early weeks of pregnancy or blood transfusion only for medical or obstetric indications have been used as management policies. There is currently no consensus on the blood transfusion policy that guarantees optimal clinical benefits with minimal risks for such women and their babies...
22, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28005062/effects-of-delivery-room-quality-improvement-on-premature-infant-outcomes
#7
W Lapcharoensap, M V Bennett, R J Powers, N N Finer, L P Halamek, J B Gould, P J Sharek, H C Lee
OBJECTIVE: Delivery room management interventions have been successfully implemented via collaborative quality improvement (QI) projects. However, it is unknown whether these successes translate to reductions in neonatal morbidity and mortality. STUDY DESIGN: This was a prospective pre-post intervention study of three nonrandomized hospital groups within the California Perinatal Quality Care Collaborative. A collaborative QI model (Collaborative QI) was compared with a single-site QI model (NICU QI) and a non-participant population when implementing evidence-based delivery room practices...
December 22, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28000130/early-mobilization-in-the-neuro-icu-how-far-can-we-go
#8
Brian F Olkowski, Syed Omar Shah
Immobility that is frequently encountered in the intensive care unit (ICU) can lead to patient complications. Early mobilization of patients in the ICU has been shown to reduce the complications associated with critical illness; however, early mobilization in the neurological intensive care unit (NICU) presents a unique challenge for the multidisciplinary team. The early mobilization of patients with acute neurologic injuries such as acute ischemic stroke, aneurysmal subarachnoid hemorrhage, intracerebral hemorrhage, and neurotrauma varies because of differing disease processes and management...
December 20, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27994358/retrospective-analysis-of-multiplex-polymerase-chain-reaction-based-molecular-diagnostics-ses-in-70-patients-with-suspected-central-nervous-system-infections-a-single-center-study
#9
Rama Krishnan Tiruppur Chinnappan Ramalingam, Dipanjan Chakraborty
BACKGROUND: Central nervous system (CNS) infections present a grave health care challenge due to high morbidity and mortality. Clinical findings and conventional laboratory assessments are not sufficiently distinct for specific etiologic diagnosis. Identification of pathogens is a key to appropriate therapy. AIM: In this retrospective observational study, we evaluated the efficacy and clinical utility of syndrome evaluation system (SES) for diagnosing clinically suspected CNS infections...
October 2016: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/27982770/the-semisitting-position-analysis-of-the-risks-and-surgical-outcomes-in-a-contemporary-series-of-425-adult-patients-undergoing-cranial-surgery
#10
Andrea Saladino, Massimo Lamperti, Antonella Mangraviti, Federico G Legnani, Francesco U Prada, Cecilia Casali, Luigi Caputi, Paola Borrelli, Francesco DiMeco
OBJECTIVE The objective of this study was to analyze the incidence of the primary complications related to positioning or surgery and their impact on neurological outcome in a consecutive series of patients undergoing elective surgery in the semisitting position. METHODS The authors prospectively collected and retrospectively analyzed data from adult patients undergoing elective surgery in the semisitting position for a cranial disease. Patients were managed perioperatively according to a standard institutional protocol, a standardized stepwise positioning, and surgical maneuvers to decrease the risk of venous air embolism (VAE) and other complications...
December 16, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27940703/use-of-gastroesophageal-reflux-medications-in-premature-infants-after-nicu-discharge
#11
Jo Ann D'Agostino, Molly Passarella, Ashley E Martin, Scott A Lorch
OBJECTIVES: To describe the epidemiology and management of gastroesophageal reflux (GER) medications started in the first year of life for premature infants. METHODS: Retrospective review of a cohort of infants ≤35 weeks' gestation presenting for care by 168 days of age to a 30-site network between 2005 and 2009 (n = 2217) and followed to 3 years of age. Medication frequency, types, and duration of use were assessed. Logistic regression identified factors associated with treatment...
December 2016: Pediatrics
https://www.readbyqxmd.com/read/27935148/customized-versus-population-based-growth-charts-to-identify-neonates-at-risk-of-adverse-outcomes-a-systematic-review-and-bayesian-meta-analysis-of-observational-studies
#12
REVIEW
Giuseppe Chiossi, Claudia Pedroza, Maged M Costantine, Van Thi Thanh Truong, Giancarlo Gargano, George R Saade
OBJECTIVE: To compare the effectiveness of customized versus population-based growth charts for prediction of adverse pregnancy outcomes. METHODS: we searched MEDLINE, http://ClinicalTrials.gov and the Cochrane library up to May 31(st) 2016 to identify interventional and observational studies comparing adverse outcomes among large (LGA) and small (SGA) for gestational age neonates, when classified with customized versus population-based growth charts. We studied perinatal mortality and NICU admission among both SGA and LGA neonates, IUFD and neonatal mortality among SGA, shoulder dystocia, 3(rd) and 4(th) degree perineal lacerations, as well as neonatal hypoglycemia among LGA...
December 9, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27924661/sleep-disordered-breathing-in-pregnancy-the-maternal-and-fetal-implications
#13
Shanthi Carnelio, Adam Morton, H David McIntyre
Sleep disordered breathing (SDB) which includes obstructive sleep apnoea (OSA) and upper airway resistance syndrome (UARS), has emerged as a risk factor for adverse maternal-foetal outcomes in pregnancy. Physiological changes of pregnancy predispose a woman 'at risk' towards developing SDB. The increasing incidence of OSA in pregnancy closely correlates with the population trends of obesity. Common screening tools validated in non-pregnant subjects including Epworth Sleepiness Scale (ESS) and Berlin Questionnaire (BQ) are poor predictors of SDB in pregnancy...
December 7, 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27922841/stress-resiliency-practices-in-neonatal-nurses
#14
Lisa M Pannell, Lynn Rowe, Salena Tully
BACKGROUND: Multiple environmental changes were experienced in a large level III neonatal intensive care unit (NICU) causing a perception of work-related stress leading to high nurse turnover, decreased engagement, and decreased satisfaction. PURPOSE: To identify a preintervention measure of perceived stress resiliency and ranking of interpretive styles in a population of neonatal, bedside registered nurses faced with a change in the physical practice environment...
December 5, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/27902504/a-password-protected-web-site-for-mothers-expressing-milk-for-their-preterm-infants
#15
MaryAnn Blatz, Donna Dowling, Patricia W Underwood, Amy Bieda, Gregory Graham
BACKGROUND: Research has demonstrated that breast milk significantly decreases morbidities that impact length of stay for preterm infants, but there is a need to test interventions to improve breastfeeding outcomes. Since many Americans are using technologies such as the Intranet and smartphones to find health information and manage health, a Web site was developed for mothers who provide breast milk for their preterm hospitalized infants. PURPOSE: This study examined the efficacy of a Web site for mothers to educate them about breast milk expression and assist them in monitoring their breast milk supply...
November 29, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/27878781/successful-elimination-of-extended-spectrum-beta-lactamase-esbl-producing-nosocomial-bacteria-at-a-neonatal-intensive-care-unit
#16
Borbála Szél, Zsolt Reiger, Edit Urbán, Andrea Lázár, Krisztina Mader, Ivelina Damjanova, Kamilla Nagy, Gyula Tálosi
BACKGROUND: Extended-spectrum beta-lactamase (ESBL)-producing Gram-negative bacteria are highly dangerous to neonates. At our Neonatal Intensive Care Unit (NICU), the presence of these bacteria became so threatening in 2011 that immediate intervention was required. METHODS: This study was conducted during a nearly two-year period consisting of three phases: retrospective (9 months), educational (3 months) and prospective (9 months). Based on retrospective data analysis, a complex management plan was devised involving the introduction of the INSURE protocol, changes to the antibiotic regimen, microbiological screening at short intervals, progressive feeding, a safer bathing protocol, staff hand hygiene training and continuous monitoring of the number of newly infected and newly colonized patients...
November 23, 2016: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/27871683/perioperative-support-not-volume-is-necessary-to-optimize-outcomes-in-surgical-management-of-necrotizing-enterocolitis
#17
Adrienne N Cobb, Yee M Wong, Sarah A Brownlee, Barbara A Blanco, Yoshiki Ezure, Heather N Paddock, Paul C Kuo, Anai N Kothari
BACKGROUND: This study examines the relationship between hospital volume of surgical cases for necrotizing enterocolitis (NEC) and patient outcomes. METHODS: A retrospective cross-sectional review was performed using the HCUP SID for California from 2007 to 2011. Patients with NEC who underwent surgery were identified using ICD-9CM codes. Risk-adjusted models were constructed with mixed-effects logistic regression using patient and demographic covariates. RESULTS: 23 hospitals with 618 patients undergoing NEC-related surgical intervention were included...
November 9, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27869210/delivery-room-quality-improvement-project-improved-compliance-with-best-practices-for-a-community-nicu
#18
Charles W Sauer, Mallory A Boutin, Aayah N Fatayerji, James A Proudfoot, Nabil I Fatayerji, David J Golembeski
A Quality Improvement bundle was implemented with the goal of standardizing the multidisciplinary approach to delivery room management. We used a Pre-Post Quality Improvement initiative with the following aims: (1) Placement of a functioning pulse oximeter by two minutes after birth, (2) Delayed intubation, (3) Normothermia on Neonatal Intensive Care Unit Admission, (4) Use of a pre-brief, debrief, and delivery room checklist. Data was collected for 548 infants, which represents every admission to the Palomar Rady Children's Hospital Neonatal Intensive Care Unit during the 35 month study period from January 1, 2010 to November 30, 2012...
November 21, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27862529/implementation-of-dextrose-gel-in-the-management-of-neonatal-hypoglycaemia
#19
Marene Ter, Ikhwan Halibullah, Laura Leung, Susan Jacobs
AIM: The aim of this study was to evaluate dextrose gel in the management of neonatal hypoglycaemia in the postnatal wards at an Australian tertiary level perinatal centre. METHODS: An audit was performed before and after implementation of dextrose gel. Pre-implementation, neonatal hypoglycaemia was managed with feed supplementation alone, and dextrose gel was used in addition to feed supplementation in the post-implementation phase. Outcomes included admission to neonatal intensive care unit (NICU) for management of hypoglycaemia, proportion of neonates who achieved normoglycaemia (defined as blood glucose ≥2...
November 15, 2016: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/27857513/difficulties-in-the-diagnosis-and-management-of-hyponatremia
#20
REVIEW
Mihaela Mocan, Lia Manuela Terheş, Sorin Nicu Blaga
Hyponatremia is the most common electrolyte imbalance encountered in clinical practice. Beside the difficulty of the etiological diagnosis, the general lack of awareness regarding the negative impact of hyponatremia on the quality of life and the lack of targeted treatments until recent years may be responsible for the poor management of the disorder. Therefore we consider of utmost importance to improve the knowledge regarding the diagnosis and management of hyponatremia, by underlining the difficulties of the etiological diagnosis and its management...
2016: Clujul Medical (1957)
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