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Newborn AND neonatal Unit

Seohyuk Lee, Nicholas Czuzoj-Shulman, Haim Arie Abenhaim
Background Behcet's disease (BD) is a rare, multi-systemic inflammatory disorder for which only limited and contradictory data exists in the context of pregnancy. Our objective was to estimate the prevalence of BD in pregnancy and to evaluate maternal and fetal outcomes associated with pregnant women living with BD. Methods Using the 1999-2013 Healthcare Cost and Utilization Project-Nationwide Inpatient Sample from the United States, we performed a population-based retrospective cohort study consisting of pregnancies that occurred during this time period...
February 15, 2019: Journal of Perinatal Medicine
Dayane de Melo Costa, Khalid Johani, Dulcelene Sousa Melo, Lillian Kelly de Oliveira Lopes, Liwcy Keller de Oliveira Lopes Lima, Anaclara Ferreira Veiga Tipple, Honghua Hu, Karen Vickery
The aim of this study was to determine the epidemiology (location, microbial load, microbiome, presence/absence of biofilm, and pathogens, including ESKAPE - Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter species, and antimicrobial susceptibility profiles) of the bacterial contamination on intensive care units (ICUs) surfaces. Fifty-seven high-touched surfaces were collected from adult, paediatric and neonatal ICUs from two large public Brazilian hospitals from central and north regions...
February 13, 2019: Letters in Applied Microbiology
Sachiko Iwata, Masahiro Kinoshita, Hisayoshi Okamura, Kennosuke Tsuda, Mamoru Saikusa, Eimei Harada, Shinji Saitoh, Osuke Iwata
Backgrounds: Environmental factors during early life alter the hypothalamus-pituitary-adrenal (HPA) axis regulation and increase the risk of diseases in later life. However, adrenal function at each developmental stage has not fully been investigated in relation to pathological antenatal conditions. Cortisol levels of newborns with intrauterine growth restriction (IUGR) are elevated during the neonatal period; however, when studied during early childhood, cortisol levels are reduced compared with their peers, suggesting that the HPA axis regulation might be altered from activation to suppression, the timing of which remains uncertain...
2019: PeerJ
Harish Chellani, Pratima Mittal, Sugandha Arya
Health facilities in India are faced with the challenge of providing quality newborn care in the face of major skilled human resource shortage. A possible solution is the concept of Mother-Neonatal ICU (M-NICU), where the mother has her bed inside the neonatal intensive care unit (NICU) by the side of baby's warmer. Our observations in M-NICU of a public sector hospital in New Delhi, India, indicate that mothers can be easily trained to follow asepsis routines and monitor the neonates, and are better prepared for their post-discharge care...
December 15, 2018: Indian Pediatrics
Aurélie Maiguy-Foinard, Bertrand Décaudin, Pierre Tourneux, Bernard Guillois, Thierry Blanc, Sophie Galène-Gromez, Morgane Masse, Pascal Odou, Fannette Denies, Benoît Dervaux, Alain Duhamel, Laurent Storme
BACKGROUND: Catheter-related bacteremia (CRB) is the most frequent nosocomial infection in neonatal intensive care unit (NICU) patients, especially in very low-birth-weight infants. Administration of injectable drugs in premature newborn infants has many particularities and several types of infusion incidents have been reported. The Edelvaiss® Multiline NEO device is a novel multi-lumen access infusion device adapted to the specificities of infusion in neonatology. This multicenter, randomized, controlled study was therefore designed to determine whether or not Edelvaiss® Multiline NEO reduces the risk of CRB in preterm newborn infants in an NICU...
February 11, 2019: Trials
Tzy-Chyi Yu, Chi Nguyen, Nancy Ruiz, Siting Zhou, Xian Zhang, Elaine A Böing, Hiangkiat Tan
BACKGROUND: Prevalence of hemolytic neonatal hyperbilirubinemia (NHB) is not well characterized, and economic burden at the population level is poorly understood. This study evaluated the prevalence, clinical characteristics, and economic burden of hemolytic NHB newborns receiving treatment in U.S. real-world settings. METHODS: This cohort study used administrative claims from 01/01/2011 to 08/31/2017. The treated cohort had hemolytic NHB diagnosis and received phototherapy, intravenous immunoglobulin, and/or exchange transfusions...
February 11, 2019: BMC Pediatrics
Jennifer Ward, Jayashree Motwani, Nikki Baker, Matthew Nash, Andrew K Ewer, Gergely Toldi
Congenital methemoglobinemia is a rare condition caused by cytochrome b5 reductase deficiency, cytochrome b5 deficiency, or hemoglobin M disease. Newborn pulse oximetry screening was developed for the early detection of critical congenital heart disease; however, it also enables the early identification of other hypoxemic conditions. We present the case of a term neonate who was admitted to the neonatal unit after a failed pulse oximetry screening at 3 hours of age. Oxygen saturations remained between 89% and 92% despite an increase in oxygen therapy...
February 7, 2019: Pediatrics
Renata Aparecida Ribeiro Custódio, Clarissa Trzesniak, Renata Pinto Ribeiro Miranda, Guilherme Henrique Donda Angelini, Jade Souza Bordón, Leila Cristina Santos Vieira, Carlos Henrique Pereira Mello
This research aimed to find main users, frequent utilized tasks, major usability problems, and the context of use of a neonatal incubator (NI) present in a neonatal intensive care unit from a Brazilian hospital and to find out the problems faced by a new user. The chosen methods were the heuristics analysis, contextual investigation, and usability test (UT). Nurses and technicians are the main users of NIs. The predominant contexts of use are the admission of newborns and the replacement of the equipment. Eight selected tasks were performed in the UT, and the most significant problems refer to alarms and configuration of the Air and Skin Modes, because the interface is not intuitive to novice users...
2019: Journal of Healthcare Engineering
Vivienne Souter, Ian Painter, Kristin Sitcov, Aaron B Caughey
BACKGROUND: A growing body of evidence supports improved or not worsened birth outcomes with non-medically indicated induction of labor at 39 weeks compared to expectant management. This evidence includes two recent randomized control trials. However, concern has been raised as to whether these studies are applicable to a broader US pregnant population. OBJECTIVE: Our goal was to compare outcomes for electively induced births at 39 weeks or beyond with those that were not electively induced...
January 29, 2019: American Journal of Obstetrics and Gynecology
Ingrid Anne Mandy Schierz, Giuseppa Pinello, Ettore Piro, Mario Giuffrè, Giovanni Corsello
OBJECTIVE:  Methemoglobinemia (MetHb) is a rare congenital or acquired cause of infantile cyanosis. We examined the role of MetHb in a neonatal intensive care unit (NICU). STUDY DESIGN:  A retrospective observational study was conducted reviewing blood gas analyses of hospitalized newborns over a 2-year period. MetHb-positive patients (MetHb >1.8%) were matched with a control group for gestational age, weight, disease, and illness severity at admission. Maternal, neonatal, clinical, and laboratory parameters were collected and analyzed in both groups...
February 1, 2019: American Journal of Perinatology
Kaja Rahu, Kärt Allvee, Helle Karro, Mati Rahu
BACKGROUND: An increased risk of adverse conditions related to in vitro fertilization (IVF) pregnancies has been repeatedly reported. Our study aimed to summarize outcome differences between pregnancies after IVF and after spontaneous conception (SC) in Estonia. METHODS: Data on all liveborn singletons to primiparas women aged 25-40 years during the period 2005-2014 were obtained from the Estonian Medical Birth Registry. There were 1778 and 33,555 newborns in the IVF and SC cohort, respectively...
January 29, 2019: BMC Pregnancy and Childbirth
Meera S Meerkov, Fauziya Hassan, Ronald D Chervin, John D Barks, Martha D Carlson, Renée A Shellhaas
OBJECTIVE: Among older infants and children, sleep-disordered breathing (SDB) has negative neurocognitive consequences. We evaluated the frequency and potential impact of SDB among newborns who require intensive care. STUDY DESIGN: Term and near-term newborns at risk for seizures underwent 12-h attended polysomnography in the neonatal intensive care unit (NICU). Bayley Scales of Infant Development, third edition (Bayley-III) were administered at 18-22 months. RESULT: The 48 newborns (EGA 39...
January 27, 2019: Pediatric Pulmonology
Sanjay Gokhale, Sankalp Gokhale
BACKGROUND: Though blood transfusions are the common procedures in pediatric patients, transfusion reactions are rare in children. Though in adults, uncross-matched ABO group-specific blood is used in emergencies, there are no such reports in neonates and children. There are stray case reports about transfusing maternal blood for her baby and maternal blood is de facto compatible regardless of an ABO mismatch Objective: Confirming our previous hypothesis that maternal blood is compatible with her baby's blood; and maternal blood can be used for transfusion in her newborn baby irrespective of ABO match/ mismatch...
January 27, 2019: Journal of Maternal-fetal & Neonatal Medicine
Salih Çağrı Çakır, Solmaz Çelebi, Hilal Özkan, Nilgün Köksal, Bayram Ali Dorum, Edanur Yeşil, Mustafa Hacımustafaoğlu
Invasive candidiasis is a common and serious infection in premature newborns. Preventing and treating fungal infections is very important to improve the prognosis of premature infants. Fluconazole and amphotericin B are used as the first choice in the treatment of invasive fungal infections of the newborns. In some cases, fluconazole and amphotericin B cannot be used due to nephrotoxicity, hepatotoxicity or resistant strains. Micafungin, which is among recently developed echinocandins, is the drug of choice in these cases...
January 2019: Mikrobiyoloji Bülteni
Geraldine Favrais, Moreno Ursino, Catherine Mouchel, Estelle Boivin, Vincent Jullien, Sarah Zohar, Elie Saliba
INTRODUCTION: Therapeutic schedules for treating neonatal seizures remain elusive. First-line treatment with phenobarbital is widely supported but without strong scientific evidence. Levetiracetam (LEV) is an emerging and promising antiepileptic drug (AED). The aim of this phase II trial is to determine the benefits of LEV by applying a strict methodology and to estimate the optimal dose of LEV as a first-line AED to treat seizures in newborns suffering from hypoxic-ischaemic encephalopathy...
January 24, 2019: BMJ Open
C Horwood, L Haskins, S Phakathi, N McKerrow
BACKGROUND: Many newborn infants die from preventable causes in South Africa, often these deaths occur in district hospitals. A multipronged intervention aiming to improve quality of newborn care in district hospitals was implemented comprising training in clinical care for sick and small newborns, skills development for health managers, on-site mentoring, and hospital accreditation. We present the results of the project evaluation. METHODS: We conducted three sequential cross-sectional surveys in 39 participating district hospitals at baseline, midpoint and endpoint of the three-year intervention period...
January 24, 2019: BMC Pediatrics
Amaya Caballero, Donald Dudley, James Ferguson, Kate Pettit, Annelee Boyle
INTRODUCTION: To determine whether maternal human papillomavirus (HPV) infection is associated with preterm premature rupture of membranes (PPROM). MATERIALS AND METHODS: We conducted a retrospective cohort study of singleton deliveries at our institution from 2010 to 2015. Women, ages 16-49, with HPV genotyping or cervical cytology results 3 years before delivery were included. Chi-squared and logistic regression analyses were used. RESULTS: In our cohort of 2153 women, 38...
January 24, 2019: Journal of Women's Health
Sandie Cabon, Fabienne Poree, Antoine Simon, Olivier Rosec, Patrick Pladys, Guy Carrault
Video and sound acquisition and processing technologies have known great improvements in the last decades, with many applications in the biomedical area. The motivation of this paper is to provide an overall state of the art of the advances within these topics in paediatrics, to evaluate their potential application for monitoring in Neonatal Intensive Care Unit (NICU). For this purpose, more than 150 papers dealing with video and audio processing were reviewed. For both topics, clinical applications are described according to the considered cohorts, either full-term newborns, infants and toddlers, or preterm newborns...
January 22, 2019: Physiological Measurement
Keyur Donda, Nandini Vijayakanthi, Fredrick Dapaah-Siakwan, Parth Bhatt, Deepa Rastogi, Shantanu Rastogi
BACKGROUND: The management practices of Respiratory Distress Syndrome (RDS) in the newborn have changed over time. We examine the trends in the epidemiology, resource utilization, and outcomes (mortality and bronchopulmonary dysplasia [BPD]) of RDS in preterm neonates ≤34 weeks gestational age (GA) in the United States. METHODS: In this retrospective serial cross-sectional study, we used ICD-9 codes to classify preterm infants GA ≤34 weeks between 2003 and 2014 from the National Inpatient Sample as having RDS or not...
January 20, 2019: Pediatric Pulmonology
Jennifer Valeska Elli Brown, Nicholas Meader, Jemma Cleminson, William McGuire
BACKGROUND: Late-onset infection is the most common serious complication associated with hospital care for newborn infants. Because confirming the diagnosis by microbiological culture typically takes 24 to 48 hours, the serum level of the inflammatory marker C-reactive protein (CRP) measured as part of the initial investigation is used as an adjunctive rapid test to guide management in infants with suspected late-onset infection. OBJECTIVES: To determine the diagnostic accuracy of serum CRP measurement in detecting late-onset infection in newborn infants...
January 14, 2019: Cochrane Database of Systematic Reviews
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