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Neonatal review

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https://www.readbyqxmd.com/read/29353257/ethical-dilemmas-of-recording-and-reviewing-neonatal-resuscitation
#1
REVIEW
Maria C den Boer, Mirjam Houtlosser, Henriëtte Anje van Zanten, Elizabeth E Foglia, Dirk P Engberts, Arjan B Te Pas
Neonatal resuscitation is provided to approximately 3% of neonates. Adequate ventilation is often the key to successful resuscitation, but this can be difficult to provide. There is increasing evidence that inappropriate respiratory support can have severe consequences. Several neonatal intensive care units have recorded and reviewed neonatal resuscitation procedures for quality assessment, education and research; however, ethical dilemmas sometimes make it difficult to implement this review process. We reviewed the literature on the development of recording and reviewing neonatal resuscitation and have summarised the ethical concerns involved...
January 20, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29353034/impact-of-targeted-scanning-protocols-on-perinatal-outcomes-in-pregnancies-at-risk-of-placenta-accreta-spectrum-or-vasa-previa
#2
Yaakov Melcer, Eric Jauniaux, Shlomit Maymon, Anna Tsviban, Marina Pekar-Zlotin, Moshe Betser, Ron Maymon
BACKGROUND: Placenta accreta spectrum (PAS) and vasa previa (VP) are congenital disorders of placentation associated with high morbidity and mortality for both mothers and newborns when undiagnosed before delivery. Prenatal diagnosis of these conditions is essential to allow multidisciplinary management and thus improve perinatal outcomes. OBJECTIVES: To compare perinatal outcome in women with PAS or VP before and after implementation of targeted scanning protocols...
January 15, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29352997/microglia-and-neonatal-brain-injury
#3
Carina Mallard, Marie-Eve Tremblay, Zinaida S Vexler
Microglial cells are now recognized as the "gate-keepers" of healthy brain microenvironment with their disrupted functions adversely affecting neurovascular integrity, neuronal homeostasis, and network connectivity. The perception that these cells are purely toxic under neurodegenerative conditions has been challenged by a continuously-increasing understanding of their complexity, the existence of a broad array of microglial phenotypes, and their ability to rapidly change in a context-dependent manner to attenuate or exacerbate injuries of different nature...
January 15, 2018: Neuroscience
https://www.readbyqxmd.com/read/29352657/electroencephalographic-monitoring-for-seizure-identification-and-prognosis-in-term-neonates
#4
REVIEW
Shavonne L Massey, Frances E Jensen, Nicholas S Abend
Seizures represent a manifestation of neurological disease in the neonatal period. Historically, neonatal seizures were identified by direct clinical observation. However, since most seizures are electroencephalographic (EEG)-only (subclinical, non-convulsive) and clinical manifestations may be subtle, many clinicians place increasing importance on EEG data including conventional EEG or amplitude-integrated EEG to identify seizures in neonates. Beyond seizure identification, the EEG is a robust source of information about brain function that can be useful for neurobehavioral prognostication in some neonates...
January 15, 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29352491/continuous-glucose-monitoring-in-pregnant-women-with-type-1-diabetes-benefits-for-mothers-using-pumps-or-pens-and-their-babies
#5
Denice S Feig, Helen R Murphy
AIMS: To review the current literature on the use of continuous glucose monitoring during pregnancy in women with Type 1 diabetes. METHODS: We searched the literature for randomized controlled trials using continuous glucose monitoring during pregnancy in women with Type 1 diabetes. RESULTS: Three randomized trials were found and discussed in this review. One UK study found a reduction in large-for-gestational-age infants; however, only masked continuous glucose monitoring was used in that study...
January 20, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29351695/reasons-for-failure-of-systemic-to-pulmonary-artery-shunts-in-neonates
#6
Keti Vitanova, Cornelius Leopold, Jelena Pabst von Ohain, Cordula Wolf, Elisabeth Beran, Rüdiger Lange, Julie Cleuziou
BACKGROUND:  Systemic-to-pulmonary artery shunt placement is an established palliative procedure for congenital heart disease. Although it is thought to be a simple operation, it is associated with significant morbidity and mortality. METHODS:  Data for all neonates who underwent surgery for a systemic-to-pulmonary artery shunt between 2000 and 2016 were reviewed. The study endpoints were shunt failure and shunt-related mortality. Shunt failure was defined as a shunt dysfunction because of thrombosis or stenosis requiring intervention or reoperation; shunt mortality was defined as death because of a shunt dysfunction...
January 19, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29350401/neurodevelopmental-outcome-in-very-preterm-and-very-low-birthweight-infants-born-over-the-past-decade-a-meta-analytic-review
#7
REVIEW
Aurelie Pascal, Paul Govaert, Ann Oostra, Gunnar Naulaers, Els Ortibus, Christine Van den Broeck
AIM: The purpose of this systematic review was to provide an up-to-date global overview of the separate prevalences of motor and cognitive delays and cerebral palsy (CP) in very preterm (VPT) and very-low-birthweight (VLBW) infants. METHOD: A comprehensive search was conducted across four databases. Cohort studies reporting the prevalence of CP and motor or cognitive outcome from 18 months corrected age until 6 years of VPT or VLBW infants born after 2006 were included...
January 19, 2018: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/29350333/deltoid-muscle-morphometry-as-an-index-of-impaired-skeletal-muscularity-in-neonatal-intensive-care
#8
Theodore Dassios, Ourania Kaltsogianni, Miltiadis Krokidis, Ann Hickey, Anne Greenough
We hypothesised that extremely premature infants would have decreased muscle mass at term-corrected age compared to term-born infants and that the degree of reduced muscle mass acquisition would correlate with the duration of invasive mechanical ventilation. The MRI brain scans of infants admitted in the neonatal unit at King's College Hospital between 1 January 2010 and 1 June 2016 were retrospectively reviewed. The coronal cross-sectional area of the left deltoid muscle (DCSA) was measured in 17 infants born < 28 weeks of gestation and in 20 infants born at term...
January 19, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29348260/the-canadian-preterm-birth-network-a-study-protocol-for-improving-outcomes-for-preterm-infants-and-their-families
#9
Prakesh S Shah, Sarah D McDonald, Jon Barrett, Anne Synnes, Kate Robson, Jonathan Foster, Jean-Charles Pasquier, K S Joseph, Bruno Piedboeuf, Thierry Lacaze-Masmonteil, Karel O'Brien, Sandesh Shivananda, Nils Chaillet, Petros Pechlivanoglou
BACKGROUND: Preterm birth (birth before 37 wk of gestation) occurs in about 8% of pregnancies in Canada and is associated with high mortality and morbidity rates that substantially affect infants, their families and the health care system. Our overall goal is to create a transdisciplinary platform, the Canadian Preterm Birth Network (CPTBN), where investigators, stakeholders and families will work together to improve childhood outcomes of preterm neonates. METHODS: Our national cohort will include 24 maternal-fetal/obstetrical units, 31 neonatal intensive care units and 26 neonatal follow-up programs across Canada with planned linkages to provincial health information systems...
January 18, 2018: CMAJ Open
https://www.readbyqxmd.com/read/29347942/infant-and-child-mortality-in-relation-to-malaria-transmission-in-kemri-cdc-hdss-western-kenya-validation-of-verbal-autopsy
#10
Nyaguara O Amek, Annemieke Van Eijk, Kim A Lindblade, Mary Hamel, Nabie Bayoh, John Gimnig, Kayla F Laserson, Laurence Slutsker, Thomas Smith, Penelope Vounatsou
BACKGROUND: Malaria transmission reduction is a goal of many malaria control programmes. Little is known of how much mortality can be reduced by specific reductions in transmission. Verbal autopsy (VA) is widely used for estimating malaria specific mortality rates, but does not reliably distinguish malaria from other febrile illnesses. Overall malaria attributable mortality includes both direct and indirect deaths. It is unclear what proportion of the deaths averted by reducing malaria transmission are classified as malaria in VA...
January 18, 2018: Malaria Journal
https://www.readbyqxmd.com/read/29346142/neonatal-abstinence-syndrome-an-update
#11
Lauren A Sanlorenzo, Ann R Stark, Stephen W Patrick
PURPOSE OF REVIEW: The current review provides an update focused on the evolving epidemiology of neonatal abstinence syndrome (NAS), factors influencing disease expression, advances in clinical assessment of withdrawal, novel approaches to NAS treatment, and the emerging role of quality improvement in assessment and management of NAS. RECENT FINDINGS: The rise in the incidence of NAS disproportionately occurred in rural and suburban areas. Polysubstance exposure and genetic polymorphisms have been shown to modify NAS expression and severity...
January 17, 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29346141/caffeine-controversies
#12
Samuel J Gentle, Colm P Travers, Waldemar A Carlo
PURPOSE OF REVIEW: Caffeine use in preterm infants has endured several paradigms: from standard of care to possible neurotoxin to one of the few medications for which there is evidence of bronchopulmonary dysplasia (BPD) risk reduction. The purpose of the review is to analyze this dynamic trajectory and discuss controversies that still remain after decades of caffeine use. RECENT FINDINGS: Following concerns for caffeine safety in preterm infants, a large randomized controlled trial demonstrated a reduction in BPD and treatment for patent ductus arteriosus...
January 17, 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29346139/blood-biomarkers-for-evaluation-of-perinatal-encephalopathy-state-of-the-art
#13
Ernest M Graham, Allen D Everett, Jean-Christophe Delpech, Frances J Northington
PURPOSE OF REVIEW: The rapid progress in biomarker science is on the threshold of significantly changing clinical care for infants in the neonatal ICU. Infants with neonatal brain injuries will likely be the first group whose management is dramatically altered with point-of-care, rapidly available brain biomarker analysis. Providing an interim update on progress in this area is the purpose of this review. RECENT FINDINGS: Highlighted findings from the past 18 months of publications on biomarkers in neonatal brain injury include; Specific nonbrain markers of cardiac health and global asphyxia continue to provide information on brain injury after hypoxic-ischemic encephalopathy (HIE)...
January 17, 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29345589/neonatal-systemic-thrombosis-an-updated-overview
#14
Salvatore Santo Signorelli, Gea Oliveri Conti, Angelo Claudio Molinari, Martino Ruggieri, Alfina Grasso, Margherita Ferrantea
Thromboembolic disease is a complex disorder with a multifactorial aetiology and a severe outcome. In newborns and children it may be missed or diagnosed late, thus worsening the prognosis. The neonatal disease is different from the disorder affecting older children and adults. However, scant epidemiological data and few randomised clinical trials regarding paediatric patients are available, and treatment recommendations are largely based on adult guidelines. Younger patients then have several decades over which they will suffer from the complications of thrombosis and risk of a new thrombotic episode...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29345159/weighing-in-on-the-risks-and-benefits-of-probiotic-use-in-hiv-infected-and-immunocompromised-populations
#15
A U Happel, S L Barnabas, R Froissart, J S Passmore
Probiotics are used in the prophylaxis and treatment of several conditions, including irritable bowel syndrome, diarrhoea, necrotising enterocolitis (NEC) and colic in infants. Despite the long history of probiotic use in humans, there is still significant debate about their efficacy and safety, particularly in HIV-infected and immunocompromised individuals. Here, we reviewed the safety and adverse event (AE) reporting from clinical trials that have tested probiotics in at risk populations, including HIV-infected individuals, the terminally ill and elderly, and neonates...
January 18, 2018: Beneficial Microbes
https://www.readbyqxmd.com/read/29344053/an-overview-of-exposure-to-ethanol-containing-substances-and-ethanol-intoxication-in-children-based-on-three-illustrated-cases
#16
REVIEW
Kam Lun Hon, Alexander Kc Leung, Eddie Cheung, Bryan Lee, Michelle Mc Tsang, Alcy R Torres
Alcohol addiction and intoxication are major health problems worldwide. Acute alcohol intoxication is well reported in adults and adolescents but less frequently reported in children of younger ages. We report three anonymized cases of pediatric ethanol exposure and illustrate the different mechanisms of intoxication. In all cases, a focused history is the key to prompt diagnosis and timely management. Physicians should be aware of this potential poison in children presented with acute confusional or encephalopathic state...
2018: Drugs in Context
https://www.readbyqxmd.com/read/29343506/how-to-use%C3%A2-procalcitonin
#17
Philip Robinson, Surjo Kiran De
Diagnosing bacterial infection in the unwell or febrile child is a common challenge faced by all paediatricians. Despite the advent of novel molecular techniques, there is ongoing need for diagnostic assays with adequate performance and turnaround time to facilitate safe clinical decision-making when bacterial sepsis is suspected, such as whether to commence empirical treatment with antibiotics. Procalcitonin is an established marker of infection that has a potential role in the diagnosis and exclusion of serious or invasive bacterial infection in neonates and children...
January 17, 2018: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/29341045/approach-to-infants-born-through-meconium-stained-amniotic-fluid-evolution-based-on-evidence
#18
Munmun Rawat, Sushma Nangia, Praveen Chandrasekharan, Satyan Lakshminrusimha
Meconium-stained amniotic fluid (MSAF) during delivery is a marker of fetal stress. Neonates born through MSAF often need resuscitation and are at risk of meconium aspiration syndrome (MAS), air leaks, hypoxic-ischemic encephalopathy, extracorporeal membrane oxygenation (ECMO), and death. The neonatal resuscitation approach to MSAF has evolved over the last three decades. Previously, nonvigorous neonates soon after delivery were suctioned under the vocal cords with direct visualization technique using a meconium aspirator...
January 16, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29336924/immunization-of-preterm-infants-with-gsk-s-hexavalent-combined-diphtheria-tetanus-acellular-pertussis-hepatitis-b-inactivated-poliovirus-haemophilus-influenzae-type-b-conjugate-vaccine-a-review-of-safety-and-immunogenicity
#19
Felix Omeñaca, Liliana Vázquez, Pilar Garcia-Corbeira, Narcisa Mesaros, Linda Hanssens, Jan Dolhain, Ivonne Puente Gómez, Johannes Liese, Markus Knuf
BACKGROUND: Infants with history of prematurity (<37 weeks gestation) and low birth weight (LBW, <2500 g) are at high risk of infection due to functional immaturity of normal physical and immunological defense mechanisms. Despite current recommendations that infants with history of prematurity/LBW should receive routine immunization according to the same schedule and chronological age as full-term infants, immunization is often delayed. METHODS: Here we summarize 10 clinical studies and 15 years of post-marketing safety surveillance of GSK's hexavalent vaccine (DTPa-HBV-IPV/Hib), a combined diphtheria-tetanus-acellular-pertussis-hepatitis-B-inactivated-poliovirus-Haemophilus influenzae-type-b (Hib) conjugate vaccine, when administered alone, or co-administered with pneumococcal conjugate, rotavirus, and meningococcal vaccines and respiratory syncytial virus IgG to infants with history of prematurity/LBW in clinical trials...
January 11, 2018: Vaccine
https://www.readbyqxmd.com/read/29336834/an-overview-of-medical-ecmo-for-neonates
#20
REVIEW
Kathryn Fletcher, Rachel Chapman, Sarah Keene
Extracorporeal membrane oxygenation (ECMO), a life-saving therapy for respiratory and cardiac failure, was first used in neonates in the 1970s. The indications and criteria for ECMO have changed over the years, but it continues to be an important option for those who have failed other medical therapies. Since the Extracorporeal Life Support Organization (ELSO) Registry was established in 1989, more than 29,900 neonates have been placed on ECMO for respiratory failure, with 84% surviving their ECMO course, and 73% surviving to discharge or transfer...
January 11, 2018: Seminars in Perinatology
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