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Neonatal clinical guides

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https://www.readbyqxmd.com/read/28446135/comparison-of-rapid-immunoassays-for-rupture-of-fetal-membranes
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
https://www.readbyqxmd.com/read/28267443/balloon-removal-after-fetoscopic-endoluminal-tracheal-occlusion-for-congenital-diaphragmatic-hernia
#16
Julio A Jiménez, Elisenda Eixarch, Philip DeKoninck, João R Bennini, Roland Devlieger, Cleisson F Peralta, Eduard Gratacos, Jan Deprest
BACKGROUND: Isolated congenital diaphragmatic hernia 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 under local anesthesia...
March 3, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28262550/pathways-for-neuroimaging-of-neonatal-stroke
#17
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
#18
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
#19
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
#20
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
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