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Neonatal clinical guides

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https://www.readbyqxmd.com/read/28327433/sonographic-prediction-of-outcome-of-vacuum-deliveries-a-multicenter-prospective-cohort-study
#1
Birgitte H Kahrs, Sana Usman, Tullio Ghi, Aly Youssef, Erik A Torkildsen, Elsa Lindtjørn, Tilde B Østborg, Sigurlaug Benediktsdottir, Lis Brooks, Lotte Harmsen, Pål R Romundstad, Kjell Å Salvesen, Christoph C Lees, Torbjørn M Eggebø
BACKGROUND: Safe management of the second stage of labor is of great importance. Unnecessary interventions should be avoided and correct timing of interventions focused. Ultrasound assessment of fetal position and station has a potential to improve the precision in diagnosing and managing prolonged or arrested labors. The decision to perform vacuum delivery is traditionally based on subjective assessment by digital vaginal examination and clinical expertise and there is currently no method of objectively quantifying the likelihood of successful delivery...
March 18, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28324899/infant-guided-co-regulated-feeding-in-the-neonatal-intensive-care-unit-part-i-theoretical-underpinnings-for-neuroprotection-and-safety
#2
Catherine S Shaker
The rapid progress in medical and technical innovations in the neonatal intensive care unit (NICU) has been accompanied by concern for outcomes of NICU graduates. Although advances in neonatal care have led to significant changes in survival rates of very small and extremely preterm neonates, early feeding difficulties with the transition from tube feeding to oral feeding are prominent and often persist beyond discharge to home. Progress in learning to feed in the NICU and continued growth in feeding skills after the NICU may be closely tied to fostering neuroprotection and safety...
April 2017: Seminars in Speech and Language
https://www.readbyqxmd.com/read/28324897/neonatal-feeding-behavior-as-a-complex-dynamical-system
#3
Eugene C Goldfield, Jennifer Perez, Katherine Engstler
The requirements of evidence-based practice in 2017 are motivating new theoretical foundations and methodological tools for characterizing neonatal feeding behavior. Toward that end, this article offers a complex dynamical systems perspective. A set of critical concepts from this perspective frames challenges faced by speech-language pathologists and allied professionals: when to initiate oral feeds, how to determine the robustness of neonatal breathing during feeding and appropriate levels of respiratory support, what instrumental assessments of swallow function to use with preterm neonates, and whether or not to introduce thickened liquids...
April 2017: Seminars in Speech and Language
https://www.readbyqxmd.com/read/28323911/monogenic-diabetes-accounts-for-6-3-of-cases-referred-to-15-italian-pediatric-diabetes-centers-during-2007-2012
#4
Maurizio Delvecchio, Enza Mozzillo, Giuseppina Salzano, Dario Iafusco, Giulio Frontino, Patrizia I Patera, Ivana Rabbone, Valentino Cherubini, Valeria Grasso, Nadia Tinto, Sabrina Giglio, Giovanna Contreas, Rosa Di Paola, Alessandro Salina, Vittoria Cauvin, Stefano Tumini, Giuseppe d'Annunzio, Lorenzo Iughetti, Vilma Mantovani, Giulio Maltoni, Sonia Toni, Marco Marigliano, Fabrizio Barbetti
Context: Etiologic diagnosis of diabetes may impact on therapeutic strategy, and prognosis of chronic complications. Objective: The aim of the study was to establish the relative percentage of different diabetes subtypes in patients attending Italian pediatric diabetes centers, and the influence of etiologic diagnosis on therapy. Design, Setting and Patients: This was a retrospective study. Clinical records of 3781 consecutive patients (age: 0-18 years) referred to fifteen pediatric diabetes clinics and diagnosed with diabetes or IFG between Jan/1/2007 and Dec/31/2012 were examined...
February 16, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28295509/measuring-tsh-receptor-antibody-trab-to-influence-treatment-choices-in-graves-disease
#5
Asha Hesarghatta Shyamasunder, Prakash Abraham
TSH receptor antibody (TRAb) plays a key role in the pathogenesis of Graves' disease (GD) and its levels correlate with the clinical course. The 2(nd) and 3(rd) generation TRAb assays have >95% sensitivity and specificity for the diagnosis of GD, and have improved the utility of TRAb to predict relapse. TRAb levels decline with antithyroid drug (ATD) therapy and after thyroidectomy. Its level increases for a year following radioactive iodine (RAI) therapy, with a gradual fall thereafter. TRAb level >12 IU/L at diagnosis of GD is associated with 60% risk of relapse at 2 years and 84% at 4 years...
March 13, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28267443/balloon-removal-after-fetoscopic-endoluminal-tracheal-occlusion-for-congenital-diaphragmatic-hernia
#6
Julio A Jiménez, Elisenda Eixarch, Philip Dekoninck, João R Bennini, Roland Devlieger, Cleisson F Peralta, Eduard Gratacos, Jan Deprest
BACKGROUND: Isolated congenital diaphragmatic hernia (CDH) defect allows viscera to herniate into the chest, competing for space with the developing lungs. At birth, pulmonary hypoplasia leads to respiratory insufficiency and persistent pulmonary hypertension that is lethal in up to 30% of patients. Antenatal measurement of lung size and liver herniation can predict survival after birth. Prenatal intervention aims at stimulating lung development, clinically achieved by percutaneous fetal endoscopic tracheal occlusion (FETO) under local anesthesia...
March 3, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28262550/pathways-for-neuroimaging-of-neonatal-stroke
#7
REVIEW
Sarah Lee, David M Mirsky, Lauren A Beslow, Catherine Amlie-Lefond, Amy R Danehy, Laura Lehman, Nicholas V Stence, Arastoo Vossough, Max Wintermark, Michael J Rivkin
PURPOSE: To provide consensus-based, suggested imaging protocols to facilitate the accurate and timely diagnosis of a neonate with symptoms concerning for stroke. METHODS: The Writing Group, an international collaboration of pediatric neurologists and neuroradiologists with expertise in perinatal and childhood stroke, participated in a series of pediatric stroke neuroimaging symposia. These discussions, in conjunction with extensive literature review, led to a consensus for imaging protocols to guide practitioners in the diagnosis of neonatal stroke subtypes as defined by the National Institute of Neurological Disorders and Stroke Common Data Elements...
January 26, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28260350/morphine-treatment-for-neonatal-abstinence-syndrome-huge-dosing-variability-underscores-the-need-for-a-better-clinical-study-design
#8
Paola Mian, Dick Tibboel, Enno D Wildschut, John N van den Anker, Karel Allegaert
INTRODUCTION: At present, morphine is the most commonly used first-line therapy to treat Neonatal Abstinence Syndrome (NAS). Unfortunately, there is still lack of evidence and consensus to guide pharmacologic therapy for NAS. In this review, we provide an overview on dosing regimens of morphine currently reported to treat NAS, with the aim to stimulate discussion on the need for a standardized dosing through better study design. METHODS: A search strategy was performed in Pubmed to identify studies that provide a dosing regimen used, or advised by a review or guideline for morphine to treat NAS...
March 3, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28252658/prognostic-neurodevelopmental-testing-of-preterm-infants-do-we-need-to-change-the-paradigm
#9
H W Kilbride, G P Aylward, L W Doyle, L T Singer, J Lantos
Longitudinal follow-up with assessment of developmental status at about 2 years of age is routine for high-risk newborns. The results of these assessments can be used for many purposes, including helping physicians, parents, and teachers plan educational or developmental interventions. These assessments also provide outcome measures for clinical research studies. Outcome results may also serve as a source of information for clinicians when counseling parents regarding provision of care for extreme preterm infants...
March 2, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28248319/safety-dosing-and-pharmaceutical-quality-for-studies-that-evaluate-medicinal-products-including-biological-products-in-neonates
#10
Robert M Ward, Daniel Benjamin, Jeffrey S Barrett, Karel Allegaert, Ronald Portman, Jonathan M Davis, Mark A Turner
The study of medications among pediatric patients has increased worldwide since 1997 in response to new legislation and regulations, but these studies have not yet adequately addressed the therapeutic needs of neonates. Additionally, extant guidance developed by regulatory agencies worldwide does not fully address the specificities of neonatal drug development, especially among extremely premature newborns who currently survive. Consequently, an international consortium from Canada, Europe, Japan, and the United States was organized by the Critical Path Institute to address the content of guidance...
March 1, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28246339/preterm-infant-growth-velocity-calculations-a-systematic-review
#11
REVIEW
Tanis R Fenton, Hilton T Chan, Aiswarya Madhu, Ian J Griffin, Angela Hoyos, Ekhard E Ziegler, Sharon Groh-Wargo, Susan J Carlson, Thibault Senterre, Diane Anderson, Richard A Ehrenkranz
CONTEXT: Clinicians assess the growth of preterm infants and compare growth velocity using a variety of methods. OBJECTIVE: We determined the numerical methods used to describe weight, length, and head circumference growth velocity in preterm infants; these methods include grams/kilogram/day (g/kg/d), grams/day (g/d), centimeters/week (cm/week), and change in z scores. DATA SOURCES: A search was conducted in April 2015 of the Medline database by using PubMed for studies that measured growth as a main outcome in preterm neonates between birth and hospital discharge and/or 40 weeks' postmenstrual age...
March 2017: Pediatrics
https://www.readbyqxmd.com/read/28236394/special-considerations-in-neonatal-mechanical-ventilation
#12
REVIEW
Stacey Dalgleish, Linda Kostecky, Irina Charania
Care of infants supported with mechanical ventilation is complex, time intensive, and requires constant vigilance by an expertly prepared health care team. Current evidence must guide nursing practice regarding ventilated neonates. This article highlights the importance of common language to establish a shared mental model and enhance clear communication among the interprofessional team. Knowledge regarding the underpinnings of an open lung strategy and the interplay between the pathophysiology and individual infant's response to a specific ventilator strategy is most likely to result in a positive clinical outcome...
December 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28208967/early-discharge-of-preterm-infants-an-indian-perspective
#13
Ankit Soni, Sandeep Kadam, Anand Pandit, Sanjay Patole
INTRODUCTION: Early home discharge of preterm infants is a priority in developing countries due to bed shortage and poor socio-economic status. There is wide variation in home discharge policies for preterm infants. Limited data exists on optimal timing for discharging such infants. In view of the socio-economic and medico-legal importance of the issue, we aimed to study the outcomes of our ex-preterm infants discharged home 'early', to guide our clinical practice. AIM: To study the rates of re-admissions/mortality within 4 weeks after discharge in preterm (born <34 weeks) infants...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28206723/clinical-study-on-amplitude-integrated-electroencephalogram-in-cerebral-injury-caused-by-severe-neonatal-hyperbilirubinemia
#14
Hongwei Wu, Zhenguang Li, Jinfeng Liu, Gang Liu, Xia Yang
BACKGROUND: This study was designed in order to assess the validity of the use of amplitude-integrated electroencephalogram (aEEG) in cerebral injury caused by severe neonatal hyperbilirubinemia. METHODS: A total of 56 full-term neonates diagnosed with severe neonatal hyperbilirubinemia and admitted to the NICU of our hospital from July 2013 to December 2014 were continuously selected for the study. The total serum bilirubin (TSB) was higher than 342 μmo/l, and was dominated by a higher amount of unconjugated bilirubin...
February 15, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28191626/intermittent-auscultation-ia-of-fetal-heart-rate-in-labour-for-fetal-well-being
#15
REVIEW
Ruth Martis, Ova Emilia, Detty S Nurdiati, Julie Brown
BACKGROUND: The goal of fetal monitoring in labour is the early detection of a hypoxic baby. There are a variety of tools and methods available for intermittent auscultation (IA) of the fetal heart rate (FHR). Low- and middle-income countries usually have only access to a Pinard/Laënnec or the use of a hand-held Doppler device. Currently, there is no robust evidence to guide clinical practice on the most effective IA tool to use, timing intervals and length of listening to the fetal heart for women during established labour...
February 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28157275/continuous-cardiotocography-ctg-as-a-form-of-electronic-fetal-monitoring-efm-for-fetal-assessment-during-labour
#16
REVIEW
Zarko Alfirevic, Declan Devane, Gillian Ml Gyte, Anna Cuthbert
BACKGROUND: Cardiotocography (CTG) records changes in the fetal heart rate and their temporal relationship to uterine contractions. The aim is to identify babies who may be short of oxygen (hypoxic) to guide additional assessments of fetal wellbeing, or determine if the baby needs to be delivered by caesarean section or instrumental vaginal birth. This is an update of a review previously published in 2013, 2006 and 2001. OBJECTIVES: To evaluate the effectiveness and safety of continuous cardiotocography when used as a method to monitor fetal wellbeing during labour...
February 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28153467/water-balance-in-the-fetus-and-neonate
#17
REVIEW
Julie B Lindower
Fetal water balance is dependent prenatally on the placental transfer of water from maternal to fetal circulation. Adequate amniotic fluid volume is one indicator of stable fetal status and development. Excessive or less than expected amniotic fluid volume may be a precursor to postnatal morbidity and mortality. Postnatal transition is marked by predictable changes in body water including contraction of extracellular volume and insensible fluid loss, primarily across the skin barrier. The degree to which these occur is determined by gestational and postnatal age...
January 30, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28142138/three-dimensional-imaging-based-web-application-for-predicting-tracheal-tube-depth-in-preterm-neonates
#18
Raksa Tupprasoot, Dean Langan, J Ciaran Hutchinson, Hannah Barrett, Michael R J Sury, Owen J Arthurs
BACKGROUND: Positioning a tracheal tube (TT) to the correct depth in preterm infants is challenging. Currently, there is no reliable single-predictor model for neonates applicable to the whole range of size or age. OBJECTIVE: In this study, we used post-mortem magnetic resonance imaging (PMMRI) of preterm infants to measure tracheal dimensions and to develop a clinical guide for TT positioning. METHODS: We measured tracheal length (TL) and tracheal diameter (TD) in a cohort of normal neonates and foetuses that underwent PMMRI (cause of death unexplained)...
February 1, 2017: Neonatology
https://www.readbyqxmd.com/read/28138333/short-stature-and-hypoparathyroidism-in-a-child-with-kenny-caffey-syndrome-type-2-due-to-a-novel-mutation-in-fam111a-gene
#19
Mary B Abraham, Dong Li, Dave Tang, Susan M O'Connell, Fiona McKenzie, Ee Mun Lim, Hakon Hakonarson, Michael A Levine, Catherine S Choong
BACKGROUND: Hypoparathyroidism in children is a heterogeneous group with diverse genetic etiologies. To aid clinicians in the investigation and management of children with hypoparathyroidism, we describe the phenotype of a 6-year-old child with hypoparathyroidism and short stature diagnosed with Kenny-Caffey syndrome (KCS) Type 2 and the subsequent response to growth hormone (GH) treatment. CASE PRESENTATION: The proband presented in the neonatal period with hypocalcemic seizures secondary to hypoparathyroidism...
2017: International Journal of Pediatric Endocrinology
https://www.readbyqxmd.com/read/28126729/putting-the-pieces-together-clinically-relevant-genetic-and-genomic-resources-for-hospitalists-and-neonatologists
#20
Rebecca Miller, Alina Khromykh, Holly Babcock, Callie Jenevein, Benjamin D Solomon
Genetic conditions are individually rare but are common in aggregate, and they often present in the neonatal and early pediatric periods. These conditions are often severe, can be difficult to diagnose and manage, and may heavily affect patients, families, health care systems, and society. Because of recent technological advances, the availability and uptake of genetic and genomic testing are increasing rapidly. However, there is a dearth of trained geneticists and genetic counselors to help guide and explain these conditions and relevant tests...
January 26, 2017: Hospital Pediatrics
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