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Neonatal clinical guides

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https://www.readbyqxmd.com/read/29678190/neonatal-and-congenital-malaria-a-case-series-in-malaria-endemic-eastern-uganda
#1
Peter Olupot-Olupot, Emma I E Eregu, Ketty Naizuli, Julie Ikiror, Linda Acom, Kathy Burgoine
BACKGROUND: Congenital malaria is the direct infection of an infant with malaria parasites from their mother prior to or during birth. Neonatal malaria is due to an infective mosquito bite after birth. Neonatal and congenital malaria (NCM) are potentially life-threatening conditions that are believed to occur at relatively low rates in malaria endemic regions. However, recent reports suggest that the number of NCM cases is increasing, and its epidemiology remains poorly described. NCM can mimic other neonatal conditions and because it is thought to be rare, blood film examinations for malaria are not always routinely performed...
April 20, 2018: Malaria Journal
https://www.readbyqxmd.com/read/29622012/if-you-can-t-measure-it-you-can-t-change-it-a-longitudinal-study-on-improving-quality-of-care-in-hospitals-and-health-centers-in-rural-kenya
#2
Michael Marx, Christine Nitschke, Maureen Nafula, Mabel Nangami, Marc Brodowski, Irmgard Marx, Helen Prytherch, Charles Kandie, Irene Omogi, Friederike Paul-Fariborz, Joachim Szecsenyi
BACKGROUND: The Kenyan Ministry of Health- Department of Standards and Regulations sought to operationalize the Kenya Quality Assurance Model for Health. To this end an integrated quality management system based on validated indicators derived from the Kenya Quality Model for Health (KQMH) was developed and adapted to the area of Reproductive and Maternal and Neonatal Health, implemented and analysed. METHODS: An integrated quality management (QM) approach was developed based on European Practice Assessment (EPA) modified to the Kenyan context...
April 5, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29621379/fluorescein-angiographic-characteristics-of-macular-edema-during-infancy
#3
Xi Chen, Shwetha Mangalesh, Du Tran-Viet, Sharon F Freedman, Lejla Vajzovic, Cynthia A Toth
Importance: Macular edema during infancy, a subclinical feature identified in premature infants by handheld spectral-domain optical coherence tomography (SD-OCT), has been associated with poorer visual acuity and neurodevelopmental outcomes. Features of macular edema on fluorescein angiography (FA) are needed to understand its pathophysiology, but to date have not been reported previously. Objective: To investigate the FA features of macular edema during infancy...
April 5, 2018: JAMA Ophthalmology
https://www.readbyqxmd.com/read/29621100/clinical-macrosystem-simulation-translates-between-organizations
#4
G Jesse Bender, James A Maryman
INTRODUCTION: Simulation has become an integral tool in healthcare facility redesign. Immersing clinical experts into their future environment has demonstrated benefits for transition planning. This study evaluates translation of a proven macrosystems testing protocol, TESTPILOT, to an organization with limited simulation experience. METHODS: An experienced TESTPILOT team guided Woman's Hospital Baton Rouge's simulation preparation for their new neonatal intensive care unit...
April 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29615159/antimicrobial-stewardship-in-neonates-challenges-and-opportunities
#5
Christopher McPherson, Caren Liviskie, Brandy Zeller, Miranda P Nelson, Jason G Newland
Neonatal infections result in significant morbidity and mortality. Antibiotics are vital for the treatment of infections but disrupt the neonatal microbiome, put the infant at risk for an adverse drug reaction, and may lead to the development of antibiotic resistance. Immediately after birth, clinicians must determine which infants require empiric antibiotics. Online risk stratification tools may provide a superior approach to decision trees. In infants who require empiric therapy for early-onset sepsis, ampicillin and an aminoglycoside with dosing based on recent pharmacokinetic studies represents the most appropriate first-line agents; third-generation cephalosporins should be reserved for patients with a high likelihood of Gram-negative meningitis...
March 1, 2018: Neonatal Network: NN
https://www.readbyqxmd.com/read/29602260/c-reactive-protein-and-immature-to-total-neutrophil-ratio-have-no-utility-in-guiding-lumbar-puncture-in-suspected-neonatal-sepsis
#6
Christopher D Goldfinch, Tony Korman, Despina Kotsanas, David P Burgner, Kenneth Tan
AIM: Meningitis may complicate neonatal sepsis, but there is scant evidence to inform the decision to perform a lumbar puncture (LP) and considerable variation in practice. We investigated whether inflammatory markers - C-reactive protein (CRP) and immature-to-total neutrophil ratio (ITR) - were predictive of meningitis or significant cerebrospinal fluid (CSF) pleocytosis and useful in guiding the decision to perform a LP. METHODS: We studied all inpatients in a single tertiary neonatal unit who were <6 months of age who had a LP performed between March 2011 and October 2014...
March 30, 2018: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29594439/dysplastic-megalencephaly-phenotype-presenting-with-prenatal-high-output-cardiac-failure
#7
Fernanda Del Campos Braojos, Carolina V A Guimaraes
Dysplastic megalencephaly, also known as bilateral hemimegalencephaly, is a rare cerebral malformation characterized by bilateral cerebral hemisphere overgrowth and extensive malformation of cortical development. Affected patients present clinically with intractable seizures, severe neurological impairment and global developmental delay. There is a small body of literature reporting megalencephaly's association with neonatal high-output cardiac failure and a lack of literature describing prenatal findings. We report a case of dysplastic megalencephaly presenting with progressive high-output cardiac failure during fetal life...
March 28, 2018: Pediatric Radiology
https://www.readbyqxmd.com/read/29564628/predictors-and-outcomes-of-the-neonatal-oral-motor-assessment-scale-nomas-performance-a-systematic-review
#8
REVIEW
Laura Longoni, Livio Provenzi, Anna Cavallini, Daniela Sacchi, Giunia Scotto di Minico, Renato Borgatti
The NOMAS is by far the most used tool to screen early oral-motor skills in newborns. Here we provide an updated review of scientific literature on the use of the Neonatal Oral Motor Assessment Scale (NOMAS) to screen early oral-motor skills in newborns. An integrative review has been carried out consistent with PRISMA guidelines and standardized qualitative appraisal. Data abstracting and synthesis were executed by two independent co-authors who solved disagreement in conference. Twenty records have been included and reviewed...
March 21, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29535260/high-flow-nasal-cannula-in-pediatric-patients-a-survey-of-clinical-practice
#9
Andrew G Miller, Michael A Gentle, Lisa M Tyler, Natalie Napolitano
BACKGROUND: High-flow nasal cannula (HFNC) use has greatly increased in recent years. In non-neonatal pediatric patients, there are limited data available to guide HFNC use, and clinical practice may vary significantly. The goal of this study was to evaluate current HFNC practice by surveying practicing pediatric respiratory therapists. METHODS: A survey instrument was posted on the American Association for Respiratory Care's AARConnect online social media platform in March 2017...
March 13, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29520504/fern-shaped-patch-as-a-hallmark-of-blue-rubber-bleb-nevus-syndrome-in-neonatal-venous-malformations
#10
Marta Ivars, Ana Martin-Santiago, Eulalia Baselga, Laurent Guibaud, Juan Carlos López-Gutiérrez
Blue rubber bleb nevus syndrome (BRBNS) is a rare congenital vascular disease associated with important morbidity and non-insignificant risk of mortality in cases of severe gastrointestinal or neurological involvement. Early diagnosis in the neonatal period can be difficult as very often skin lesions appear progressively during childhood having no correlation with gastrointestinal lesion development. The appearance of one large venous malformation (VM) in the neonatal period has suggested a characteristic finding of this syndrome...
March 8, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29506399/guidelines-on-treatment-of-perinatal-depression-with-antidepressants-an-international-review
#11
Nina M Molenaar, Astrid M Kamperman, Philip Boyce, Veerle Bergink
OBJECTIVE: Several countries have developed Clinical Practice Guidelines regarding treatment of perinatal depressive symptoms and perinatal use of antidepressant. We aimed to compare guidelines to guide clinicians in best clinical practice. METHODS: An extensive search in guideline databases, MEDLINE and PsycINFO was performed. When no guidelines were (publicly) available online, we contacted psychiatric-, obstetric-, perinatal- and mood disorder societies of all first world countries and the five largest second world countries...
March 1, 2018: Australian and New Zealand Journal of Psychiatry
https://www.readbyqxmd.com/read/29501409/genetic-diagnosis-in-neonatal-onset-epilepsies-back-to-the-future
#12
REVIEW
Francesco Pisani, Antonio Percesepe, Carlotta Spagnoli
Seizures are more frequent in newborns than in any other period of life. In most cases they are due to acute dysfunction of the central nervous system; however some can be true epileptic disorders with an early onset. Although rare, diagnosis of neonatal-onset epilepsies is rising as genetic testing increases. The spectrum of clinical severity associated with specific genes can vary widely with difficulties in providing genotype-phenotype correlations. Therefore, clinicians should strive in order to clearly delineate the clinical features associated with pathogenic genetic variants with the aim to guide the increasing use of genetic testing and improve clinical management...
February 16, 2018: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/29488389/identification-of-transcripts-associated-with-renal-damage-due-to-ureteral-obstruction-as-candidate-urinary-biomarkers
#13
Bo Wu, Xue Gong, William A Kennedy, James D Brooks
Renal obstruction is a common cause of renal failure in adults and children and is suspected when hydronephrosis is detected on imaging. Since not all cases of hydronephrosis are associated with renal damage, biomarkers are needed to guide intervention to relieve obstruction. We performed gene expression profiling on the kidneys from adult mice over a detailed time course after obstruction and compared these data to a neonatal model of bilateral high grade obstruction induced by conditional deletion of the calcineurin ß1 (Cnb1) gene...
February 28, 2018: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/29486497/physiological-approach-to-sodium-supplementation-in-preterm-infants
#14
David E Segar, Elizabeth K Segar, Lyndsay A Harshman, John M Dagle, Susan J Carlson, Jeffrey L Segar
OBJECTIVE:  To implement and evaluate a clinical practice algorithm to identify preterm infants with sodium deficiency and guide sodium supplementation based on urine sodium concentrations. STUDY DESIGN:  Urine sodium concentration was measured in infants born at 260/7 to 296/7 weeks' gestation at 2-week intervals. Sodium supplementation was based on the urine sodium algorithm. Growth and respiratory outcomes in this cohort were compared with a matched cohort cared for in our neonatal intensive care unit prior to algorithm implementation (2014-2015 cohort)...
February 27, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29467102/acute-symptomatic-neonatal-seizures-in-preterm-neonates-etiologies-and-treatments
#15
REVIEW
Francesco Pisani, Carlotta Spagnoli
Acute symptomatic neonatal seizures in preterm newborns are a relevant clinical challenge due to the presence of many knowledge gaps. Etiology-wise, acute symptomatic seizures have an age-specific epidemiology, with intraventricular hemorrhage and its complications representing the first cause in extremely and very preterm neonates, whereas other etiologies have similar occurrence rates as in full-term infants. Specific treatment strategies for the premature neonates are not yet available. Studies suggest a similarly low response rate with even more unfavorable prognosis than in full-term infants...
December 15, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29436355/care-of-the-neonate-on-nasal-continuous-positive-airway-pressure-a-bedside-guide
#16
Jennifer M Guay, Dru Carvi, Deborah A Raines, Wendy A Luce
Respiratory distress continues to be a major cause of neonatal morbidity. Current neonatal practice recommends the use of nasal continuous positive airway pressure (nCPAP) in the immediate resuscitation and continued support of neonates of all gestations with clinical manifestations of respiratory distress. Despite the many short- and long-term benefits of nCPAP, many neonatal care units have met resistance in its routine use. Although there have been numerous recent publications investigating the use and outcomes of various modes of nCPAP delivery, surfactant administration, mechanical ventilation, and other forms of noninvasive respiratory support (high-flow nasal cannula, nasal intermittent positive pressure ventilation), there has been a relative lack of publications addressing the practical bedside care of infants managed on nCPAP...
January 1, 2018: Neonatal Network: NN
https://www.readbyqxmd.com/read/29433814/acute-symptomatic-seizures-in-term-neonates-etiologies-and-treatments
#17
Janet S Soul
Acute symptomatic seizures caused by either diffuse or focal perinatal hypoxic-ischemic insults and intracranial hemorrhage in term newborns make up the large majority of all neonatal seizures. Acute seizures are one of the most common neurological disorders in term newborns who require admission to the neonatal intensive care unit. Despite elucidation of seizure pathogenesis in this population using animal models, treatment is limited by a lack of good evidence-based guidelines because of a paucity of rigorously conducted clinical trials or prospective studies in human newborns...
February 6, 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29426317/barriers-and-enablers-to-skin-to-skin-contact-at-birth-in-healthy-neonates-a-qualitative-study
#18
Amala James Alenchery, Joanne Thoppil, Carl Denis Britto, Jimena Villar de Onis, Lavina Fernandez, P N Suman Rao
BACKGROUND: Skin to skin contact (SSC) at birth is the standard of care for newborns without risk factors. However, implementation of SSC at birth has been far from optimal. A qualitative study was undertaken to determine the barriers, enablers and potential solutions to implementation of SSC at birth in healthy newborn infants in a level III neonatal-care facility in Bangalore, India. METHODS: Consultants and residents/postgraduates (PG) from the departments of Obstetrics (n = 19) and Pediatrics (n = 14) and nurses (n = 8) in the labor room (LR) participated in the study...
February 9, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29394221/functional-recovery-in-critically-ill-children-the-weecover-multicenter-study
#19
Karen Choong, Douglas Fraser, Samah Al-Harbi, Asm Borham, Jill Cameron, Saoirse Cameron, Ji Cheng, Heather Clark, Tim Doherty, Nora Fayed, Jan-Willem Gorter, Margaret Herridge, Mary Khetani, Kusum Menon, Jamie Seabrook, Racquel Simpson, Lehana Thabane
OBJECTIVES: To evaluate functional outcomes and evaluate predictors of an unfavorable functional outcome in children following a critical illness. DESIGN: Prospective observational longitudinal cohort study. SETTING: Two tertiary care, Canadian PICUs: McMaster Children's Hospital and London Health Sciences. PATIENTS: Children 12 months to 17 years old, admitted to PICU for at least 48 hours with one or more organ dysfunction, were eligible...
February 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29369374/fragile-lives-with-fragile-rights-justice-for-babies-born-at-the-limit-of-viability
#20
Manya J Hendriks, John D Lantos
There is an inconsistency in the ways that doctors make clinical decisions regarding the treatment of babies born extremely prematurely. Many experts now recommend that clinical decisions about the treatment of such babies be individualized and consider many different factors. Nevertheless, many policies and practices throughout Europe and North America still appear to base decisions on gestational age alone or on gestational age as the primary factor that determines whether doctors recommend or even offer life-sustaining neonatal intensive care treatment...
March 2018: Bioethics
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