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Neonatal clinical guides

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https://www.readbyqxmd.com/read/28515115/impact-of-antihypertensive-treatment-on-maternal-and-perinatal-outcomes-in-pregnancy-complicated-by-chronic-hypertension-a%C3%A2-systematic-review-and-meta-analysis
#1
REVIEW
Louise M Webster, Frances Conti-Ramsden, Paul T Seed, Andrew J Webb, Catherine Nelson-Piercy, Lucy C Chappell
BACKGROUND: Chronic hypertension complicates around 3% of all pregnancies. There is evidence that treating severe hypertension reduces maternal morbidity. This study aimed to systematically review randomized controlled trials of antihypertensive agents treating chronic hypertension in pregnancy to determine the effect of this intervention. METHODS AND RESULTS: Medline (via OVID), Embase (via OVID) and the Cochrane Trials Register were searched from their earliest entries until November 30, 2016...
May 17, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28506869/model-based-clinical-dose-optimization-for-phenobarbital-in-neonates-an-illustration-of-the-importance-of-data-sharing-and-external-validation
#2
Swantje Völler, Robert B Flint, Leo M Stolk, Pieter L J Degraeuwe, Sinno H P Simons, Paula Pokorna, David M Burger, Ronald de Groot, Dick Tibboel, Catherijne A J Knibbe
BACKGROUND: Particularly in the pediatric clinical pharmacology field, data-sharing offers the possibility of making the most of all available data. In this study, we utilize previously collected therapeutic drug monitoring (TDM) data of term and preterm newborns to develop a population pharmacokinetic model for phenobarbital. We externally validate the model using prospective phenobarbital data from an ongoing pharmacokinetic study in preterm neonates. METHODS: TDM data from 53 neonates (gestational age (GA): 37 (24-42) weeks, bodyweight: 2...
May 12, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28504975/ce-original-research-the-experiences-of-pregnant-smokers-and-their-providers
#3
Geraldine Rose Britton, Rosemary Collier, Sean McKitrick, Lori Marie Sprague, Joyce Rhodes-Keefe, Ann Feeney, Gary D James
: Background: The U.S. Department of Health and Human Services' initiative Healthy People 2020 targets tobacco use, including smoking during pregnancy, as a continuing major health concern in this country. Yet bringing the U.S. Public Health Service's 2008 clinical practice guideline, Treating Tobacco Use and Dependence, into routine prenatal care remains challenging. Our previous nurse-managed intervention study of rural pregnant women found no significant cessation effect and significant discordance between self-reported smoker status and urinary cotinine levels...
June 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28499532/updates-on-the-recognition-prevention-and-management-of-hypertension-in-pregnancy
#4
REVIEW
Jessica R Jackson, Anthony R Gregg
Systematic reviews with meta-analysis represent the highest level of evidence used to guide clinical practice. The defining criteria used to diagnose preeclampsia have evolved, and will likely continue to evolve. Proteinuria is sufficient but not necessary when defining preeclampsia. Hypertension without proteinuria but with severe features is diagnostic. The methods used to measure urinary protein have changed. The gold standard remains the 24-hour urine test. The efficacy of low-dose aspirin in preventing preeclampsia is a function of baseline risk...
June 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28473093/acr-appropriateness-criteria-%C3%A2-urinary-tract%C3%A2-infection-child
#5
Boaz K Karmazyn, Adina L Alazraki, Sudha A Anupindi, Molly E Dempsey, Jonathan R Dillman, Scott R Dorfman, Matthew D Garber, Sheila G Moore, Craig A Peters, Henry E Rice, Cynthia K Rigsby, Nabile M Safdar, Stephen F Simoneaux, Andrew T Trout, Sjirk J Westra, Sandra L Wootton-Gorges, Brian D Coley
Urinary tract infection (UTI) is common in young children and may cause pyelonephritis and renal scarring. Long-term complications from renal scarring are low. The role of imaging is to evaluate for underlying urologic abnormalities and guide treatment. In neonates there is increased risk for underlying urologic abnormalities. Evaluation for vesicoureteral reflux (VUR) may be appropriate especially in boys because of higher prevalence of VUR and to exclude posterior urethral valve. In children older than 2 months with first episode of uncomplicated UTI, there is no clear benefit of prophylactic antibiotic...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28446135/comparison-of-rapid-immunoassays-for-rupture-of-fetal-membranes
#6
Irogue Igbinosa, Ferney A Moore, Cheri Johnson, Jon E Block
BACKGROUND: Rupture of membranes (ROM) before the onset of uterine contractions, particularly in pregnancies less than 37 weeks gestational age, is a common diagnostic problem in obstetrical practice. Timely detection of ROM is vital to support gestational age-specific interventions to optimize perinatal outcomes and minimize the risk of serious complications such as preterm delivery, fetal distress and maternal/fetal infections. Rapid bedside immunoassay tests designed to detect amniotic fluid proteins in cervicovaginal fluids have emerged as valuable clinical tools to provide timely ROM diagnosis...
April 26, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28441153/discharge-criteria-for-the-late-preterm-infant-a-review-of-the-literature
#7
Jenny M Quinn, Marteen Sparks, Sheila M Gephart
BACKGROUND: Standardized late preterm infant (LPI) discharge criteria ensure best practice and help guide the neonatal provider to determine the appropriate level of care following birth. However, the location can vary from the well newborn setting to the neonatal intensive care unit (NICU). PURPOSE: The purpose of this review is to examine differences in LPI discharge criteria between the well newborn setting and the NICU by answering the clinical questions, "What are the recommended discharge criteria for the LPI and do they differ if admitted to the well newborn setting versus the NICU?" SEARCH STRATEGY: Databases searched include CINAHL, TRIP, PubMed, and the Cochrane Library...
April 24, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/28407219/multiple-micronutrient-supplementation-for-women-during-pregnancy
#8
REVIEW
Batool A Haider, Zulfiqar A Bhutta
BACKGROUND: Multiple-micronutrient (MMN) deficiencies often coexist among women of reproductive age in low- to middle-income countries. They are exacerbated in pregnancy due to the increased demands, leading to potentially adverse effects on the mother and developing fetus. Though supplementation with MMNs has been recommended earlier because of the evidence of impact on pregnancy outcomes, a consensus is yet to be reached regarding the replacement of iron and folic acid supplementation with MMNs...
April 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28406856/treating-women-who-are-pregnant-and-parenting-for-opioid-use-disorder-and-the-concurrent-care-of-their-infants-and-children-literature-review-to-support-national-guidance
#9
Stacey L Klaman, Krystyna Isaacs, Anne Leopold, Joseph Perpich, Susan Hayashi, Jeff Vender, Melinda Campopiano, Hendrée E Jones
OBJECTIVES: The prevalence of opioid use disorder (OUD) during pregnancy is increasing. Practical recommendations will help providers treat pregnant women with OUD and reduce potentially negative health consequences for mother, fetus, and child. This article summarizes the literature review conducted using the RAND/University of California, Los Angeles Appropriateness Method project completed by the US Department of Health and Human Services Substance Abuse and Mental Health Services Administration to obtain current evidence on treatment approaches for pregnant and parenting women with OUD and their infants and children...
April 13, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28406855/beyond-the-treatment-box-perspectives-on-the-federal-response-to-opioid-use-pregnancy-and-neonatal-abstinence-syndrome
#10
Mishka Terplan
There has been much activity within Federal agencies in response to the opioid epidemic particularly in regards to pregnant women and their infants. Substance Abuse and Mental Health Services Administration's recently released document, Advancing the Care of Pregnant and Parenting Women With Opioid Use Disorder and Their Infants: A Foundation for Clinical Guidance, provides an important and timely guidance. Uptake of the guide should improve quality of care and hopefully help lessen the discrimination experienced by pregnant women with opioid use disorder...
April 13, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28388951/implementing-the-emergency-triage-assessment-and-treatment-plus-admission-care-etat-clinical-practice-guidelines-to-improve-quality-of-hospital-care-in-rwandan-district-hospitals-healthcare-workers-perspectives-on-relevance-and-challenges
#11
Celestin Hategeka, Leah Mwai, Lisine Tuyisenge
BACKGROUND: An emergency triage, assessment and treatment plus admission care (ETAT+) intervention was implemented in Rwandan district hospitals to improve hospital care for severely ill infants and children. Many interventions are rarely implemented with perfect fidelity under real-world conditions. Thus, evaluations of the real-world experiences of implementing ETAT+ are important in terms of identifying potential barriers to successful implementation. This study explored the perspectives of Rwandan healthcare workers (HCWs) on the relevance of ETAT+ and documented potential barriers to its successful implementation...
April 7, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28373969/the-molecular-apgar-score-a-key-to-unlocking-evolutionary-principles
#12
John S Torday, Heber C Nielsen
One of the first "tools" used for systematically evaluating successful newborn transitional physiology at birth was the Apgar Score, devised by Virginia Apgar in 1953. This objective assessment tool allowed clinicians to immediately gauge the relative success of a newborn infant making the transition from the in utero liquid immersive environment to the ex utero gas environment in the delivery room during the first minutes after birth. The scoring system, although eponymous, is generally summarized as an acronym based on Appearance, Pulse, Grimace, Activity, and Respiration, criteria evaluated and scored at 1 and 5 min after birth...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28355608/new-wavelet-neurovascular-bundle-for-bedside-evaluation-of-cerebral-autoregulation-and-neurovascular-coupling-in-newborns-with-hypoxic-ischemic-encephalopathy
#13
Lina F Chalak, Rong Zhang
Neonatal encephalopathy (NE) resulting from birth asphyxia constitutes a major global public health burden for millions of infants every year, and despite therapeutic hypothermia, half of these neonates have poor neurological outcomes. As new neuroprotective interventions are being studied in clinical trials, there is a critical need to establish physiological surrogate markers of therapeutic efficacy, to guide patient selection and/or to modify the therapeutic intervention. The challenge in the field of neonatal brain injury has been the difficulty of clinically discerning NE severity within the short therapeutic window after birth or of analyzing the dynamic aspects of the cerebral circulation in sick NE newborns...
March 30, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28349526/pushing-bearing-down-methods-for-the-second-stage-of-labour
#14
REVIEW
Andrea Lemos, Melania Mr Amorim, Armele Dornelas de Andrade, Ariani I de Souza, José Eulálio Cabral Filho, Jailson B Correia
BACKGROUND: Maternal pushing during the second stage of labour is an important and indispensable contributor to the involuntary expulsive force developed by uterine contraction. There is no consensus on an ideal strategy to facilitate these expulsive efforts and there are contradictory results about the influence on the mother and fetus. OBJECTIVES: To evaluate the benefits and possible disadvantages of different kinds of techniques regarding maternal pushing/breathing during the expulsive stage of labour on maternal and fetal outcomes...
March 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28335806/effectiveness-of-early-interventions-for-parental-sensitivity-following-preterm-birth-a-systematic-review-protocol
#15
Andréane Lavallée, Marilyn Aita, Anne Bourbonnais, Gwenaëlle De Clifford-Faugère
BACKGROUND: Parental sensitivity is the interaction process by which parents (a) recognize cues from their infant, (b) interpret these cues adequately, (c) identify an appropriate response and (d) apply this response in an appropriate time frame. In the neonatal intensive care unit, parents of preterm infants often encounter factors hampering the establishment of their parental sensitivity. Parents report the need to be in proximity to and to participate in their preterm infant's care in order to develop their sensitivity to their newborn infant...
March 23, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28327433/sonographic-prediction-of-outcome-of-vacuum-deliveries-a%C3%A2-multicenter-prospective-cohort-study
#16
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 should be 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 19, 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
#17
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
#18
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
#19
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-to-influence-treatment-choices-in-graves-disease
#20
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 second- and third-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...
May 2017: Clinical Endocrinology
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