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By Barbara Aninakwa Advance Neonatal Nurse Practitioner
Tuğba Acer, İbrahim Ötgün, Müge Sağnak Akıllı, Esra Elif Gürbüz, Lütfi Hakan Güney, Akgün Hiçsönmez
There are case reports of duplication of the colon, rectum, anus, urinary system, lower genital tract, and external genitalia, spinal anomalies, and abdominal wall defects. However, it is rare to encounter a single newborn with all of the mentioned abnormalities, which have been defined as the caudal duplication syndrome (CDS). Herein, we present a newborn with an omphalocele, duplex external genitalia (with duplex labia minora and labia majora), duplex urethral orifices, duplex vaginal orifices, and duplex anal dimple with imperforate anus and rectovestibular fistula on both sides...
May 2013: Journal of Pediatric Surgery
Samir Gupta, Steven M Donn
Nasal continuous positive airway pressure (CPAP) is increasingly used for respiratory support in preterm babies at birth and after extubation from mechanical ventilation. Various CPAP devices are available for use that can be broadly grouped into continuous flow and variable flow. There are potential physiologic differences between these CPAP systems and the choice of a CPAP device is too often guided by individual expertise and experience rather than by evidence. When interpreting the evidence clinicians should take into account the pressure generation sources, nasal interface, and the factors affecting the delivery of pressure, such as mouth position and respiratory drive...
June 2016: Seminars in Fetal & Neonatal Medicine
Huayan Zhang, Jie Zhang, Shunying Zhao
Over the past four decades, advances in neonatal intensive care have led to the survival of smaller and more immature infants. The improved survival of very low birth weight infants is associated with long term respiratory morbidity, most frequently in the form of bronchopulmonary dysplasia. In this review, we will discuss the pathogenesis, risk factor as well as management of commonly seen acquired airway disorders associated with prematurity, prolonged intubation and ventilation.
August 2016: Seminars in Fetal & Neonatal Medicine
S J Steggerda, G van Wezel-Meijler
Cranial ultrasonography (CUS) is a reliable and non-invasive tool to detect frequently occurring brain abnormalities and to monitor brain development and maturation in high risk neonates. Standard CUS views are obtained through the anterior fontanel. However, evaluation of the posterior fossa is often suboptimal with this approach. Cerebellar injury occurs frequently in preterm infants and has important prognostic consequences. Early detection is therefore important. This review focuses on techniques that optimize the performance of CUS when studying the preterm cerebellum, including the use of the mastoid fontanel and the adaptation of focus points and scan frequencies...
October 2016: Seminars in Fetal & Neonatal Medicine
Nidhi Agrawal Shah, Courtney J Wusthoff
Intracranial hemorrhage is a serious cause of morbidity and mortality in the neonate. Subgaleal, subdural, subarachnoid, and intraventricular hemorrhage have varying pathophysiology, but each can have serious long-term consequences. This article reviews the pathophysiology, presentation, and outcomes for intracranial hemorrhage in the newborn, as well as potential therapeutic interventions.
2016: Neonatal Network: NN
Dawn Gano
Preterm newborns are highly susceptible to brain injury. White matter injury is among the dominant patterns of brain injury in preterm newborns. the purpose of this review is to discuss the pathogenesis, diagnosis, management, and prevention of white matter injury in premature newborns. the long-term outcome of white matter injury in children born prematurely is also addressed.
2016: Neonatal Network: NN
David J Gallacher, Kylie Hart, Sailesh Kotecha
KEY POINTS: Respiratory distress is a common presenting feature among newborn infants.Prompt investigation to ascertain the underlying diagnosis and appropriate subsequent management is important to improve outcomes.Many of the underlying causes of respiratory distress in a newborn are unique to this age group.A chest radiograph is crucial to assist in diagnosis of an underlying cause. EDUCATIONAL AIMS: To inform readers of the common respiratory problems encountered in neonatology and the evidence-based management of these conditions...
March 2016: Breathe
Erik D Skarsgard
PURPOSE OF REVIEW: The diagnosis and treatment of gastroschisis spans the perinatal disciplines of maternal fetal medicine, neonatology, and pediatric surgery. Since gastroschisis is one of the commonest and costliest structural birth defects treated in neonatal ICUs, a comprehensive review of its epidemiology, prenatal diagnosis, postnatal treatment, and short and long-term outcomes is both timely and relevant. RECENT FINDINGS: The incidence of gastroschisis has increased dramatically over the past 20 years, leading to a renewed interest in causation...
June 2016: Current Opinion in Pediatrics
Raffaella Colombatti, Laura Sainati, Daniele Trevisanuto
Neonatal anemia is a frequent occurrence in neonatal intensive care units. Red blood cell transfusion criteria in case of blood loss are clearly defined but optimal hemoglobin or hematocrit thresholds of transfusion for anemia due to decreased production or increased destruction are less evident. This review focuses on the causes of anemia in the newborn period and the most recent evidence-based treatment options, including transfusion and erythropoiesis-stimulating agents.
February 2016: Seminars in Fetal & Neonatal Medicine
Hugh J Willison, Bart C Jacobs, Pieter A van Doorn
Guillain-Barré syndrome is the most common and most severe acute paralytic neuropathy, with about 100,000 people developing the disorder every year worldwide. Under the umbrella term of Guillain-Barré syndrome are several recognisable variants with distinct clinical and pathological features. The severe, generalised manifestation of Guillain-Barré syndrome with respiratory failure affects 20-30% of cases. Treatment with intravenous immunoglobulin or plasma exchange is the optimal management approach, alongside supportive care...
August 13, 2016: Lancet
Shyan Vijayasekaran, Janet Lioy, Kathryn Maschhoff
Differences between neonatal, pediatric and adult airway anatomy, structure and function are important to understand. Size, surface area, proportion, resistance and compliance are all very different between age groups and infants are certainly not small adults. Knowledge of these airway differences is essential in rapid correction of an emergency situation. Unanticipated airway emergencies are the most serious of all and may be classified into profiles such as the unanticipated emergency in the non-intubated patient, the unanticipated emergency in the intubated patient, and patients with tracheostomy...
August 2016: Seminars in Fetal & Neonatal Medicine
Sarah U Morton, Vincent C Smith
Apnoea of prematurity (AOP) affects almost all infants born at <28 weeks gestation or with birth weight <1000 g. When untreated, AOP may be associated with negative outcomes. Because of these negative outcomes, effective treatment for AOP is an important part of optimising care of preterm infants. Standard treatment usually involves xanthine therapy and respiratory support. Cutting-edge work with stochastic vibrotactile stimulation and new pharmaceutical agents continues to expand therapeutic options...
July 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Steven Pauwels, Karel Allegaert
Therapeutic drug monitoring (TDM) aims to integrate drug measurement results into clinical decision making. The basic rules apply when using TDM in neonates (aminoglycosides, vancomycin, phenobarbital, digoxin), but additional factors should also be taken into account. First, due to both pharmacokinetic variability and non-pharmacokinetic factors, the correlation between dosage and concentration is poor in neonates, but can be overcome with the use of more complex, validated dosing regimens. Second, the time to reach steady state is prolonged, especially when no loading dose is used...
April 2016: Archives of Disease in Childhood
Alex J Sinclair, Aaron Sturrock, Brendan Davies, Manjit Matharu
Headache is one of the most common conditions presenting to the neurology clinic, yet a significant proportion of these patients are unsatisfied by their clinic experience. Headache can be extremely disabling; effective treatment is not only essential for patients but is rewarding for the physician. In this first of two parts review of headache, we provide an overview of headache management, emerging therapeutic strategies and an accessible interpretation of clinical guidelines to assist the busy neurologist...
December 2015: Practical Neurology
Barbara Jones, Nathan Dean, Richard Wunderink, Marianna Sockrider
No abstract text is available yet for this article.
January 1, 2016: American Journal of Respiratory and Critical Care Medicine
Sophie T Williams, Mark C Sykes, Phang Boon Lim, Justin D Salciccioli
The International Liaison Committee on Resuscitation recently released updated 2015 recommendations for resuscitation. The guidelines form the basis for all levels of resuscitation training, now from first aid to advanced life support (ALS), and for trainees of varying medical skills, from schoolchildren to medical students and consultants. We highlight major updates relating to intra-arrest and postarrest care, and the evidence for their recommendation. We also summarise areas of uncertainty in the evidence for ALS, and highlight current discussions that will likely inform the next round of recommendations...
May 2016: Emergency Medicine Journal: EMJ
William E Benitz
Despite a large body of basic science and clinical research and clinical experience with thousands of infants over nearly 6 decades,(1) there is still uncertainty and controversy about the significance, evaluation, and management of patent ductus arteriosus in preterm infants, resulting in substantial heterogeneity in clinical practice. The purpose of this clinical report is to summarize the evidence available to guide evaluation and treatment of preterm infants with prolonged ductal patency in the first few weeks after birth...
January 2016: Pediatrics
Joses Jain, Cynthia Gyamfi-Bannerman
The problem of preterm birth continues to pose one of the most significant research challenges that we face due to its immense scope and complexity. With evidence that 95% of cases of spontaneous preterm birth are intractable to current interventions, our best hope in resolving this problem may lie in new, innovative ideas. Novel approaches to researching preterm birth are currently underway, building upon our prior discoveries and probing into the unknown on multiple fronts. Here we discuss some of the major focuses of future investigation that provide a promising outlook for discovery, including advanced techniques to evaluate the cervix, new strategies to identify the role of the microbiome, and advances in molecular and epigenetic-based research...
April 2016: Seminars in Fetal & Neonatal Medicine
Drew Provan, Adrian C Newland
Primary immune thrombocytopenia is an autoimmune disorder of unknown cause affecting both children and adults. The low peripheral blood platelet count is caused by premature platelet destruction by self-reacting antibodies in addition to an impairment of platelet production. The disease is heterogeneous in its pathophysiology, clinical features and responses to treatment. To date, most of the treatments used have been immune-modulating drugs and these contribute to increased morbidity and mortality in patients...
October 2015: Advances in Therapy
Hesham Abdel-Hady, Nehad Nasef, Abd Elazeez Shabaan, Islam Nour
Caffeine is the most commonly used medication for treatment of apnea of prematurity. Its effect has been well established in reducing the frequency of apnea, intermittent hypoxemia, and extubation failure in mechanically ventilated preterm infants. Evidence for additional short-term benefits on reducing the incidence of bronchopulmonary dysplasia and patent ductus arteriosus has also been suggested. Controversies exist among various neonatal intensive care units in terms of drug efficacy compared to other methylxanthines, dosage regimen, time of initiation, duration of therapy, drug safety and value of therapeutic drug monitoring...
November 8, 2015: World Journal of Clinical Pediatrics
2015-12-16 22:03:18
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