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https://www.readbyqxmd.com/read/28225884/clinical-hypoxic-ischemic-encephalopathy-score-of-the-iberoamerican-society-of-neonatology-siben-a-new-proposal-for-diagnosis-and-management
#1
José Maria Rodriguez Perez, Sergio G Golombek, Augusto Sola
Hypoxic ischemic encephalopathy is a major complication of perinatal asphyxia, with high morbidity, mortality and neurologic sequelae as cerebral palsy, mostly in poor or developing countries. The difficulty in the diagnosis and management of newborns in these countries is astonishing, thus resulting in unreliable data on this pathology and bad outcomes regarding mortality and incidence of neurologic sequelae. The objective of this article is to present a new clinical diagnostic score to be started in the delivery room and to guide the therapeutic approach, in order to improve these results...
January 1, 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27118761/reflections-of-the-changes-in-patent-ductus-arteriosus-management-during-the-last-10%C3%A2-years
#2
REVIEW
Afif El-Khuffash, Dany E Weisz, Patrick J McNamara
Despite a large body of scientific evidence on the management of premature infants with a patent ductus arteriosus controversy remains and neonatologists remain challenged for knowing which patient to treat, what is the most optimal timing of treatment and which treatments have a positive impact on both short-term and long-term outcomes. In this review article we discuss the increased body of evidence over the past 10 years, much of which questions the role of treatment and suggests the need to reconsider how haemodynamic significance is adjudicated...
September 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28114931/procalcitonin-guided-diagnosis-and-antibiotic-stewardship-revisited
#3
REVIEW
Ramon Sager, Alexander Kutz, Beat Mueller, Philipp Schuetz
Several controlled clinical studies have evaluated the potential of the infection biomarker procalcitonin (PCT) to improve the diagnostic work-up of patients with bacterial infections and its influence on decisions regarding antibiotic therapy. Most research has focused on lower respiratory tract infections and critically ill sepsis patients. A clinical utility for PCT has also been found for patients with urinary tract infections, postoperative infections, meningitis, and patients with acute heart failure with possible superinfection (i...
January 24, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28276062/ilae-classification-of-the-epilepsies-position-paper-of-the-ilae-commission-for-classification-and-terminology
#4
Ingrid E Scheffer, Samuel Berkovic, Giuseppe Capovilla, Mary B Connolly, Jacqueline French, Laura Guilhoto, Edouard Hirsch, Satish Jain, Gary W Mathern, Solomon L Moshé, Douglas R Nordli, Emilio Perucca, Torbjörn Tomson, Samuel Wiebe, Yue-Hua Zhang, Sameer M Zuberi
The International League Against Epilepsy (ILAE) Classification of the Epilepsies has been updated to reflect our gain in understanding of the epilepsies and their underlying mechanisms following the major scientific advances that have taken place since the last ratified classification in 1989. As a critical tool for the practicing clinician, epilepsy classification must be relevant and dynamic to changes in thinking, yet robust and translatable to all areas of the globe. Its primary purpose is for diagnosis of patients, but it is also critical for epilepsy research, development of antiepileptic therapies, and communication around the world...
April 2017: Epilepsia
https://www.readbyqxmd.com/read/28411000/meconium-aspiration-or-respiratory-distress-associated-with%C3%A2-meconium-stained-amniotic-fluid
#5
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/28264088/association-of-patent-ductus-arteriosus-ligation-with-death-or-neurodevelopmental-impairment-among-extremely-preterm-infants
#6
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...
May 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28389438/management-and-investigation-of-neonatal-encephalopathy-2017-update
#7
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/27514006/nebulised-hypertonic-saline-for-acute-bronchiolitis-or-there-and-back-again-to-use-tolkien-s-subtitle-for-the-hobbit
#8
EDITORIAL
Michael B Anthracopoulos
No abstract text is available yet for this article.
September 2016: Acta Paediatrica
https://www.readbyqxmd.com/read/27623808/a-quality-improvement-initiative-for-delayed-umbilical-cord-clamping-in-very-low-birthweight-infants
#9
Jeff Bolstridge, Tracy Bell, Barbara Dean, Amy Mackley, Gina Moore, Cheryl Swift, Dina Viscount, David A Paul, Stephen A Pearlman
BACKGROUND: Due to clinical benefits, delayed cord clamping (DCC) is recommended in infants born before 37 weeks gestational age. The objective was to institute a delayed cord clamping program and to evaluate clinical outcomes one year after initiation. METHODS: This study occured at Christiana Care Health System, a tertiary care facility with a 52 bed level 3 Neonatal Intensive Care Unit (NICU). A multidisciplinary team created a departmental policy, a DCC protocol and educational programs to support the development of a DCC program...
September 13, 2016: BMC Pediatrics
https://www.readbyqxmd.com/read/27815588/the-new-sepsis-consensus-definitions-the-good-the-bad-and-the-ugly
#10
EDITORIAL
Charles L Sprung, Roland M H Schein, Robert A Balk
No abstract text is available yet for this article.
December 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27540721/pulse-oximetry-could-significantly-enhance-the-early-detection-of-critical-congenital-heart-disease-in-neonatal-intensive-care-units
#11
COMPARATIVE STUDY
Xiao-Jing Hu, Qu-Ming Zhao, Xiao-Jing Ma, Wei-Li Yan, Xiao-Ling Ge, Bing Jia, Fang Liu, Lin Wu, Ming Ye, Guo-Ying Huang
AIM: Limited data have been available regarding critical congenital heart disease (CHD) screening in neonatal intensive care unit (NICUs). This study evaluated the feasibility of screening for CHD by adding pulse oximetry (POX) to clinical evaluation in a NICU in Shanghai, China. METHODS: We screened 4128 eligible consecutive NICU admissions using POX plus clinical evaluation. Infants with positive screening results were then evaluated with echocardiography. Those with negative screening results were put under observation, and they also underwent echocardiography if their oxygen saturation fell below 95% on room air during hospitalisation...
November 2016: Acta Paediatrica
https://www.readbyqxmd.com/read/25380678/safety-and-efficacy-of-oral-feeding-in-infants-with-bpd-on-nasal-cpap
#12
COMPARATIVE STUDY
Melissa Hanin, Sushma Nuthakki, Manish B Malkar, Sudarshan R Jadcherla
Safety and efficacy of oral feeding was examined in infants with bronchopulmonary dysplasia (BPD) on nasal continuous positive airway pressure (NCPAP). We hypothesized that repetitive oral feeding enhances aero-digestive outcomes and reduces resource utilization. Data from infants with BPD (37-42 weeks post menstrual age) that were orally fed while on NCPAP (n = 26) were compared with those that were exclusively gavage fed on NCPAP (n = 27). Subject assignment was random and physician practice based. Specifically, we compared the differences in aero-digestive milestones, resource utilization, and safety metrics...
April 2015: Dysphagia
https://www.readbyqxmd.com/read/27698754/oral-paracetamol-vs-oral-ibuprofen-in-the-treatment-of-symptomatic-patent-ductus-arteriosus-in-premature-infants-a-randomized-controlled-trial
#13
Bo Yang, Xiangyu Gao, Yi Ren, Yun Wang, Qinglin Zhang
The aim of the present study was to analyze the changes of plasma and urinary prostaglandin E2 (PGE2) levels in preterm infants with symptomatic patent ductus arteriosus (sPDA) treated with oral ibuprofen and acetaminophen. A total of 87 preterm infants with sPDA admitted to the Neonatal Ward of the Affiliated Xuzhou Hospital of Medical College of Southeast University from October, 2012 to June, 2015 were selected and randomly divided into the ibuprofen group (n=43, 10 mg/kg ibuprofen administered orally as initial dose, followed by 5 mg/kg during the first 24 and 48 h later) and acetaminophen group (n=44, 15 mg/kg acetaminophen administered orally once every 6 h for three days)...
October 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27827796/effect-of-body-position-and-ventilation-on-umbilical-artery-and-venous-blood-flows-during-delayed-umbilical-cord-clamping-in-preterm-lambs
#14
Stuart B Hooper, Kelly J Crossley, Valerie A Zahra, Jeroen van Vonderen, Alison Moxham, Andrew W Gill, Martin Kluckow, Arjan B Te Pas, Euan M Wallace, Graeme R Polglase
OBJECTIVE: While delayed umbilical cord clamping (UCC) is thought to facilitate placental to infant blood transfusion, the physiological factors regulating flow in the umbilical arteries and veins during delayed UCC is unknown. We investigated the effects of gravity, by changing fetal height relative to the placenta, and ventilation on umbilical blood flows and the cardiovascular transition during delayed UCC at birth. METHODS: Catheters and flow probes were implanted into preterm lambs (128 days) prior to delivery to measure pulmonary, carotid, umbilical artery (UaBF) and umbilical venous (UvBF) blood flows...
July 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/27694281/interventions-to-improve-patient-safety-during-intubation-in-the-neonatal-intensive-care-unit
#15
L Dupree Hatch, Peter H Grubb, Amanda S Lea, William F Walsh, Melinda H Markham, Patrick O Maynord, Gina M Whitney, Ann R Stark, E Wesley Ely
OBJECTIVE: To improve patient safety in our NICU by decreasing the incidence of intubation-associated adverse events (AEs). METHODS: We sequentially implemented and tested 3 interventions: standardized checklist for intubation, premedication algorithm, and computerized provider order entry set for intubation. We compared baseline data collected over 10 months (period 1) with data collected over a 10-month intervention and sustainment period (period 2). Outcomes were the percentage of intubations containing any prospectively defined AE and intubations with bradycardia or hypoxemia...
October 2016: Pediatrics
https://www.readbyqxmd.com/read/27733360/antenatal-corticosteroids-for-maturity-of-term-or-near-term-fetuses-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#16
REVIEW
Gabriele Saccone, Vincenzo Berghella
OBJECTIVE:  To evaluate the effectiveness of antenatal corticosteroids given at ≥34 weeks' gestation. DESIGN:  Systematic review with meta-analysis. DATA SOURCES:  Electronic databases were searched from their inception to February 2016. ELIGIBILITY CRITERIA FOR STUDY SELECTION:  Randomized clinical trials comparing antenatal corticosteroids with placebo or no treatment in women with a singleton pregnancy at ≥34 weeks' gestation...
October 12, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/19710677/spoon-feeding-results-in-early-hospital-discharge-of-low-birth-weight-babies
#17
RANDOMIZED CONTROLLED TRIAL
A Kumar, P Dabas, B Singh
OBJECTIVE: To evaluate the adequacy and feasibility of spoon feeding in terms of physical growth and transition to breast feeding in early hospital-discharged low birth weight (LBW) neonates. STUDY DESIGN: A trial with two independent randomized controlled trials (RCTs), which was conducted at the tertiary-level neonatal unit of a teaching hospital and included home-based treatment. Singleton live-born neonates with a gestational age of >or=32 weeks, a birth weight of >1250 g and <or=1600 g, and fulfilling the feeding criteria were included in the study...
March 2010: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/23765172/a-standardized-nutrition-approach-for-very-low-birth-weight-neonates-improves-outcomes-reduces-cost-and-is-not-associated-with-increased-rates-of-necrotizing-enterocolitis-sepsis-or-mortality
#18
COMPARATIVE STUDY
T J Butler, L J Szekely, J L Grow
OBJECTIVE: To assess how a standard practice for nutrition support in very low birth weight (VLBW) neonates would impact on their hospital course. STUDY DESIGN: This was a prospective, single center, before vs after comparison of a non-standardized approach to nutrition in VLBW neonates to a standardized approach. Standardization of feeding initiation, feeding volume and caloric advancement, management of feeding aspirates (residuals), use of starter parenteral nutrition (PN), use of breast milk and donor breast milk, initiation and discontinuation of intravenous (IV) intralipids, documentation of protein use, and utilization of percutaneously inserted central venous catheters were performed...
November 2013: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27692935/neurodevelopmental-outcomes-and-nutritional-strategies-in-very-low-birth-weight-infants
#19
REVIEW
Mandy Brown Belfort, Richard A Ehrenkranz
The developing brain of the very low birth weight (VLBW) infant is highly sensitive to effects of the nutritional milieu during the neonatal hospitalization and after discharge. Strategies to optimize nutritional care play an important role in reducing long-term neurodevelopmental morbidities in this population. Currently available interventions to ensure that the unique nutrient requirements of the VLBW infant are met include various dietary fortification strategies and parenteral nutrition. In this article, we review evidence regarding nutritional strategies and their beneficial effects on neurodevelopment in VLBW infants...
February 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27643988/isolated-cystic-periventricular-leukomalacia-differs-from-cystic-periventricular-leukomalacia-with-intraventricular-hemorrhage-in-prevalence-risk-factors-and-outcomes-in-preterm-infants
#20
Lan-Wan Wang, Yung-Chieh Lin, Yi-Fang Tu, Shan-Tair Wang, Chao-Ching Huang
BACKGROUND: Cystic periventricular leukomalacia (cPVL) is the most severe white matter injury and is often associated with intraventricular hemorrhage (IVH) in preterm infants. OBJECTIVE: The aim of this study was to investigate the prevalence, risk factors and neurodevelopmental outcomes of isolated cPVL and cPVL with low-grade and high-grade IVH in premature infants. METHODS: From 2001 to 2012, 9,964 infants with <31 weeks' gestational age (GA) admitted to Taiwan hospitals were enrolled...
2017: Neonatology
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