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https://www.readbyqxmd.com/read/28389438/management-and-investigation-of-neonatal-encephalopathy-2017-update
#1
Kathryn Martinello, Anthony R Hart, Sufin Yap, Subhabrata Mitra, Nicola J Robertson
This review discusses an approach to determining the cause of neonatal encephalopathy, as well as current evidence on resuscitation and subsequent management of hypoxic-ischaemic encephalopathy (HIE). Encephalopathy in neonates can be due to varied aetiologies in addition to hypoxic-ischaemia. A combination of careful history, examination and the judicious use of investigations can help determine the cause. Over the last 7 years, infants with moderate to severe HIE have benefited from the introduction of routine therapeutic hypothermia; the number needed to treat for an additional beneficial outcome is 7 (95% CI 5 to 10)...
April 6, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28264088/association-of-patent-ductus-arteriosus-ligation-with-death-or-neurodevelopmental-impairment-among-extremely-preterm-infants
#2
Dany E Weisz, Lucia Mirea, Erin Rosenberg, Maximus Jang, Linh Ly, Paige T Church, Edmond Kelly, S Joseph Kim, Amish Jain, Patrick J McNamara, Prakesh S Shah
Importance: Observational studies have associated patent ductus arteriosus (PDA) ligation among preterm infants with adverse neonatal outcomes and neurodevelopmental impairment in early childhood, with a resultant secular trend away from surgical treatment. However, to our knowledge, studies have inadequately addressed sources of residual bias, including survival bias and major neonatal morbidities arising before exposure to ligation. Objective: Evaluate the association between PDA ligation vs medical management and neonatal and neurodevelopmental outcomes...
March 6, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28411000/meconium-aspiration-or-respiratory-distress-associated-with%C3%A2-meconium-stained-amniotic-fluid
#3
REVIEW
Nestor E Vain, Daniel G Batton
The designation meconium aspiration syndrome (MAS) reflects a spectrum of disorders in infants born with meconium-stained amniotic fluid, ranging from mild tachypnea to severe respiratory distress and significant mortality. The frequency of MAS is highest among infants with post-term gestation, thick meconium, and birth asphyxia. Pulmonary hypertension is an important component in severe cases. Prenatal hypopharyngeal suctioning and postnatal endotracheal intubation and suctioning of vigorous infants are not effective...
April 11, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28333154/maternal-neonatal-vitamin-d-deficiency-a-new-risk-factor-for-necrotizing-enterocolitis-in-preterm-infants
#4
M Cetinkaya, T Erener-Ercan, T Kalayci-Oral, A Babayiğit, B Cebeci, S Y Semerci, G Buyukkale
OBJECTIVE: The objective of the study was to investigate the possible association between maternal/neonatal 25-hydroxy vitamin D (25-OHD) levels and development of necrotizing enterocolitis (NEC). STUDY DESIGN: One hundred and forty-five preterm infants ⩽36 weeks of gestation were enrolled. 25-OHD levels were determined in maternal/neonatal blood samples that were obtained at the time of admission to the neonatal intensive care unit. RESULTS: Of the 145 enrolled patients, 26 (18%) developed NEC...
March 23, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28283552/anaesthetic-considerations-for-surgery-in-newborns
#5
Constance S Houck, Amy E Vinson
Almost 30 years ago, the American Academy of Pediatrics Committee on Fetus and Newborn coauthored a policy statement strongly advocating for the use of anaesthesia in all neonates stating 'local or systemic pharmacologic agents now available permit relatively safe administration of anesthesia or analgesia to neonates undergoing surgical procedures and that such administration is indicated according to the usual guidelines for the administration of anesthesia to high-risk, potentially unstable patients'. With current techniques and advanced monitoring, preterm and full-term infants routinely undergo surgical procedures under general anaesthesia to repair congenital defects that were lethal in years past...
March 10, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28377385/the-role-of-prenatal-steroids-at-34-36-weeks-of-gestation
#6
Gordon Cs Smith, David Rowitch, Ben Wj Mol
No abstract text is available yet for this article.
April 4, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28351834/cutaneous-manifestations-of-tuberous-sclerosis-complex-and-the-paediatrician-s-role
#7
REVIEW
Michael A Cardis, Cynthia Marie Carver DeKlotz
Tuberous sclerosis complex (TSC) is a multisystem genetic disorder stemming from unregulated activation of the mammalian target of rapamycin (mTOR) pathway, resulting in the growth of hamartomas in multiple organs. TSC-related skin lesions often develop early in life and can be disfiguring, emotionally distressful and even painful at times. Recognition of TSC-associated skin features by paediatricians can be a catalyst for facilitating early implementation of treatment strategies and establishing appropriate follow-up care...
March 28, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28405492/a-rare-complication-of-central-venous-catheter-extravasation-in-a-preterm-neonate-hemidiaphragmatic-paralysis
#8
C Hobson, D Dubillot, H Lardy, D Sirinelli, E Saliba, E Lopez
We report a case of a preterm neonate born at 26 weeks' of gestation diagnosed with unilateral diaphragmatic paralysis. This paralysis was a consequence of a phrenic nerve injury due to extravasation of hyperosmolar parenteral nutrition fluid in the upper thorax. Chest X-rays and ultrasonography confirmed the diagnosis. The neonate was treated with prolonged respiratory support and did not require surgical treatment. This report describes a case of hemidiaphragmatic paralysis as a complication of central venous catheter insertion...
April 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28395369/antibiotics-prescriptions-in-the-neonatal-intensive-care-unit-how-to-overcome-everyday-challenges
#9
D Donà, E Mozzo, V Mardegan, U Trafojer, P Lago, S Salvadori, E Baraldi, C Giaquinto
Antimicrobial prescriptions in neonatal intensive care units (NICUs) represent a point of concern for the emergence of MDROs and for morbidity associated with prolonged antibiotic exposure (e.g., invasive candidiasis, necrotizing enterocolitis, and late-onset sepsis). Antimicrobial stewardship programs (ASPs) have shown to be a valuable tool for the prevention of resistance with the goals of optimizing clinical outcomes while decreasing unnecessary prescribing. The most frequent ASP strategies include the correct collection and interpretation of microbiological specimens, prescription of the narrowest-spectrum antibiotic appropriate for a particular case, and de-escalation or discontinuation of therapy in defined situations...
April 10, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28374415/biventricular-function-on-early-echocardiograms-in-neonatal-hypoxic-ischemic-encephalopathy
#10
Sanjeev Aggarwal, Girija Natarajan
AIM: To compare early (<24 hours) echocardiograms (ECHOs) in infants with perinatal hypoxic-ischemic encephalopathy (HIE) undergoing a)therapeutic hypothermia (TH) b) normothermia and c) normal controls. METHODS: This was a single center retrospective review of clinical early ECHOs of term infants with moderate or severe HIE and controls (with a normal ECHO <72 hours of age). Right (RVO) and left ventricular output (LVO), RV and LV myocardial performance index (MPI), systolic to diastolic duration ratio (S/D) and eccentricity indices (EI) in systole and diastole were compared using ANOVA...
April 4, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28382722/postnatal-growth-in-term-infants-born-small-for-gestational-age-is-associated-with-later-neurocognitive-and-metabolic-outcomes
#11
REVIEW
Esther Castanys-Muñoz, Kathy Kennedy, Eurídice Castañeda-Gutiérrez, Stewart Forsyth, Keith M Godfrey, Berthold Koletzko, Susan E Ozanne, Ricardo Rueda, Marieke Schoemaker, Eline M van der Beek, Stef van Buuren, Ken K Ong
We systematically reviewed papers published in English between 1994 and October 2015 on how postnatal weight gain and growth affects neurodevelopment and metabolic outcomes in term-born small for gestational age (SGA) infants. Two randomised trials reported that enriched infant formulas that promoted early growth also increased fat mass, lean mass and blood pressure, but had no effect on early neurocognitive outcomes. Meanwhile, 31 observational studies reported consistent positive associations between postnatal weight gain and growth with neurocognitive outcomes, adiposity, insulin resistance and blood pressure...
April 6, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28291720/congenital-cytomegalovirus-infection-in-pregnancy-and-the-neonate-consensus-recommendations-for-prevention-diagnosis-and-therapy
#12
REVIEW
William D Rawlinson, Suresh B Boppana, Karen B Fowler, David W Kimberlin, Tiziana Lazzarotto, Sophie Alain, Kate Daly, Sara Doutré, Laura Gibson, Michelle L Giles, Janelle Greenlee, Stuart T Hamilton, Gail J Harrison, Lisa Hui, Cheryl A Jones, Pamela Palasanthiran, Mark R Schleiss, Antonia W Shand, Wendy J van Zuylen
Congenital cytomegalovirus is the most frequent, yet under-recognised, infectious cause of newborn malformation in developed countries. Despite its clinical and public health importance, questions remain regarding the best diagnostic methods for identifying maternal and neonatal infection, and regarding optimal prevention and therapeutic strategies for infected mothers and neonates. The absence of guidelines impairs global efforts to decrease the effect of congenital cytomegalovirus. Data in the literature suggest that congenital cytomegalovirus infection remains a research priority, but data are yet to be translated into clinical practice...
March 10, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/27480246/inhaled-nitric-oxide-therapy-for-pulmonary-disorders-of-the-term-and-preterm-infant
#13
Gregory M Sokol, Girija G Konduri, Krisa P Van Meurs
The 21st century began with the FDA approval of inhaled nitric oxide therapy for the treatment of neonatal hypoxic respiratory failure associated with pulmonary hypertension in recognition of the 2 randomized clinical trials demostrating a significant reduction in the need for extracorporeal support in the term and near-term infant. Inhaled nitric oxide is one of only a few therapeutic agents approved for use through clinical investigations primarily in the neonate. This article provides an overview of the pertinent biology and chemistry of nitric oxide, discusses potential toxicities, and reviews the results of pertinent clinical investigations and large randomized clinical trials including neurodevelopmental follow-up in term and preterm neonates...
October 2016: Seminars in Perinatology
https://www.readbyqxmd.com/read/27637133/the-problems-of-moderate-preterm-infants
#14
Andrea N Trembath, Allison H Payne, Tarah T Colaizy, Edward F Bell, Michele C Walsh
Moderate preterm infants are the largest group of preterm infants but are an understudied population. Care practices are adapted from studies of full term infants or extremely preterm infants. Studies are needed to tailor treatments for this vulnerable population. The NRN began investigation in this population with a registry of characteristics, and neonatal outcomes of these infants. This work compares outcomes of MPR with those of full term infants reported in the literature.
October 2016: Seminars in Perinatology
https://www.readbyqxmd.com/read/27817912/language-and-hearing-outcomes-of-preterm-infants
#15
REVIEW
Betty R Vohr
Multiple factors including degree of prematurity, neonatal morbidities, illness severity, hearing status, gender, language environment in the neonatal intensive care unit and in the home, maternal education level, social and environmental status of the family, and access to early intervention all contribute to the language outcomes of extremely preterm infants with and without hearing loss. Early screening, early diagnosis, and early intervention services by 6 months of age are necessary to optimize the language outcomes of preterm infants with permanent hearing loss...
December 2016: Seminars in Perinatology
https://www.readbyqxmd.com/read/27866661/a-critical-question-for-nec-researchers-can-we-create-a-consensus-definition-of-nec-that-facilitates-research-progress
#16
REVIEW
Phillip V Gordon, Jonathan R Swanson, Brianna C MacQueen, Robert D Christensen
In the last decades the reported incidence of preterm necrotizing enterocolitis (NEC) has been declining in large part due to implementing comprehensive NEC prevention initiatives, including breast milk feeding, standardized feeding protocols, transfusion guidelines, and antibiotic stewardship and improving the rigor with which non-NEC cases are excluded from NEC data. However, after more than 60 years of NEC research in animal models, the promise of a "magic bullet" to prevent NEC has yet to materialize. There are also serious issues involving clinical NEC research...
February 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/27989327/pathogenesis-of-pain
#17
REVIEW
Pradeep Dinakar, Alexandra Marion Stillman
The pathogenesis of pain sensation includes mechanisms that result in acute or chronic pain. Pain itself is described as an unpleasant sensory and emotional experience beginning with a peripheral stimulus that undergoes a physiological process ultimately resulting in the sensation of pain. Biologists recognize pain to be a common sign of potential tissue damage. Hence, pain sensation is protective in function. However, pathologic states of pain exist secondary to disruption of the nociceptive process both peripherally and centrally or secondary to psychological conditions...
August 2016: Seminars in Pediatric Neurology
https://www.readbyqxmd.com/read/28284388/neonatal-screening-for-inherited-metabolic-diseases-in-2016
#18
Judit Garcia Villoria, Sonia Pajares, Rosa María López, José Luis Marin, Antonia Ribes
The scope of newborn screening (NBS) programs is continuously expanding. NBS programs are secondary prevention interventions widely recognized internationally in the "field of Public Health." These interventions are aimed at early detection of asymptomatic children affected by certain diseases, with the objective to establish a definitive diagnosis and apply the proper treatment to prevent further complications and sequelae and ensure a better quality of life. The most significant event in the history of neonatal screening was the discovery of phenylketonuria in 1934...
November 2016: Seminars in Pediatric Neurology
https://www.readbyqxmd.com/read/27189326/cranial-ultrasonography-of-the-immature-cerebellum-role-and%C3%A2-limitations
#19
REVIEW
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
https://www.readbyqxmd.com/read/27209280/diagnostic-imaging-of-posterior-fossa-anomalies-in-the-fetus
#20
REVIEW
Ashley James Robinson, M Ashraf Ederies
Ultrasound and magnetic resonance imaging are the two imaging modalities used in the assessment of the fetus. Ultrasound is the primary imaging modality, whereas magnetic resonance is used in cases of diagnostic uncertainty. Both techniques have advantages and disadvantages and therefore they are complementary. Standard axial ultrasound views of the posterior fossa are used for routine scanning for fetal anomalies, with additional orthogonal views directly and indirectly obtainable using three-dimensional ultrasound techniques...
October 2016: Seminars in Fetal & Neonatal Medicine
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