Benign Neonatal Shudders, Shivers, Jitteriness, or Tremors: Early Signs of Vitamin D Deficiency

Collins & Young Pediatrics, July 2017 Abstract and tremors in the newborn period typically precipitate an extensive, invasive, and expensive search for the etiology. Vitamin D deficiency has not been historically included in the differential of tremors. We report a shivering, jittery newborn who was subjected to a battery of testing, with…

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Ventilator-Associated Pneumonia in Low Birth Weight Neonates at a Neonatal Intensive Care Unit: A Retrospective Observational Study

Lee et al, February 2017 Background Ventilator-associated pneumonia (VAP) is one of the most common healthcare-associated infections among ventilated patients. The aim of this study was to determine the clinical characteristics and risk factors for the development of VAP in intubated low birth weight (LBW) neonates in a neonatal intensive care…

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Bosentan as Adjunctive Therapy for Persistent Pulmonary Hypertension of the Newborn: Results of the Randomized Multicenter Placebo-Controlled Exploratory Trial.

Steinhorn et al, J Pediatr. 2016 Oct Abstract OBJECTIVE: To evaluate the efficacy, safety, and pharmacokinetics of the endothelin receptor antagonist bosentan as adjunctive therapy for neonates with persistent pulmonary hypertension of the newborn (PPHN). STUDY DESIGN: This was a phase 3, multicenter, randomized, placebo-controlled exploratory trial (FUTURE-4). Eligible patients were >34 weeks gestation, <7 days old,…

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Risk Factors for Necrotizing Enterocolitis in Neonates: A Retrospective Case-Control Study

Lu et al, April 2017 Background Necrotizing enterocolitis (NEC) in neonates is devastating, and risk-factor identification is crucial. This study aimed to evaluate risk factors for NEC in different gestational age (GA) groups. Methods Risk factors associated with NEC were investigated using a retrospective case-control design.   Conclusion Intrahepatic cholestasis of…

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Probiotics Prevent Candida Colonization and Invasive Fungal Sepsis in Preterm Neonates: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Hua-Jian Hu, Pediatrics & neonatology, April 2017 To investigate whether probiotic supplementation could reduce the risk of fungal infection in preterm neonates in neonatal intensive care units (NICUs) The outcomes of interest were Candida colonization and invasive fungal sepsis. Seven trials involving 1371 preterm neonates were included. Limited data support that probiotic…

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Continuous Glucose Monitoring in Very Preterm Infants: A Randomized Controlled Trial

Galderisi et al, Pediatrics, October 2017, VOLUME 140 / ISSUE 4 Abstract BACKGROUND AND OBJECTIVES: Impaired glucose control in very preterm infants is associated with increased morbidity, mortality, and poor neurologic outcome. Strategies based on insulin titration have been unsuccessful in achieving euglycemia in absence of an increase in hypoglycemia and mortality.…

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Maternal and Placental Factors Associated with Congenital Hearing Loss in Very Preterm Neonates.

Kim et al, Pediatr Neonatol. 2017   BACKGROUND: Sensorineural hearing loss (SNHL) is a multifactorial disease that more frequently affects pretermnewborns. Although a number of maternal conditions have been reported to  be associated with preterm birth, little information is available concerning maternal risk factors for the development of SNHL. We aimed to identify maternaland placental risk factors associated with a “refer” result on the newborn hearing screening (NHS) test and subsequently confirmed SNHL in very preterm neonates.…

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Red Blood Cell Transfusion and Clinical Outcomes in Extremely Low Birth Weight Preterm Infants

Wang et al, Pediatr Neonatol. 2017  Background Red blood cell (RBC) transfusion is often considered a life-saving measure in critically ill neonates. The smallest and least mature  infants tend to receive the largest amount of transfusions. RBC transfusion itself has also been suggested as an independent risk facto r of poor…

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SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment

TASK FORCE ON SUDDEN INFANT DEATH SYNDROME Pediatrics, October 2016, From the American Academy of Pediatrics, Policy Statement Abstract Approximately 3500 infants die annually in the United  States from sleep-related infant deaths, including sudden infant death syndrome (SIDS; International Classification of Diseases, 10th Revision [ICD-10], R95), ill-defined deaths (ICD-10 R99), and accidental…

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Impact of the US Maternal Tetanus, Diphtheria, and Acellular Pertussis Vaccination Program on Preventing Pertussis in Infants <2 Months of Age: A Case-Control Evaluation

Skoff et al, Clinical Infectious Diseases, September 2017   Abstract Background Infants aged <1 year are at highest risk for pertussis-related morbidity and mortality. In 2012, Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) vaccine was recommended for women during each pregnancy to protect infants in the first months of life;…

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Risk of Autism Associated With Hyperbilirubinemia and Phototherapy

Wu et al, Pediatrics 2016 Abstract OBJECTIVE: Whether neonatal hyperbilirubinemia and/or phototherapy increase the risk of autism spectrum disorder(ASD) is unclear. We sought to quantify the risk of ASD associated with elevated total serum bilirubin (TSB) levels and with phototherapy. CONCLUSIONS: After adjustment for the effects of sociodemographic factors and birth weight, neither hyperbilirubinemia nor phototherapy was an…

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Assessing the neuroprotective benefits for babies of antenatal magnesium sulphate: An individual participant data meta-analysis.

Crowther et al, PLoS Med. 2017 Abstract BACKGROUND: Babies born preterm are at an increased risk of dying in the first weeks of life, and those who survive have a higher rate of cerebral palsy (CP) compared with babies born at term. The aim of this individual par ticipant data (IPD) meta-analysis (MA)…

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Systematic Review of the Effect of Enteral Feeding on Gut Microbiota in Preterm Infants

Xu et al, J Obstet Gynecol Neonatal Nurs. 2017 Oct Abstract OBJECTIVE: To examine the effect of feeding type on microbial patterns among preterm infants and to identify feeding factors that promote the colonization of beneficial bacteria. Conclusion: Mothers’ own milk is considered the best form of nutrition for preterm infants and the gut microbial…

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Late (> 7 days) systemic postnatal corticosteroids for prevention of bronchopulmonary dysplasia in preterm infants.

Cochrane Database Syst Rev. 2017 Oct, Doyle et al Abstract BACKGROUND: Many preterm infants who survive go on to develop bronchopulmonary dysplasia, probably as the result of persistent inflammation in the lun gs. Corticosteroids have powerful anti-inflammatory effects and have been used to treat individuals with established bronchopulmonary dysplasia. However, it is unclear whether any…

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Neurally adjusted ventilatory assist compared to other forms of triggered ventilation for neonatal respiratory support.

Rossor et al, Cochrane Database Syst Rev. 2017 Oct  Abstract BACKGROUND: Effective synchronisation of infant respiratory effort with mechanical ventilation may allow adequate gas exchange to occur at lower peak airway pressures, potentially reducing barotrauma and volutrauma and development of air leaks and bronchopulmonary dysplasia. During neurally adjusted ventilatory assist ventilation (NAVA),…

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Oesophageal eosinophilia in children with coeliac disease

Ari et al, Arch Dis Child. 2017 Apr 12 Abstract OBJECTIVES: An association between coeliac disease (CD) and eosinophilicoesophagitis(EoE)/oesophageal eosinophilia (EE) has been suggested.  Setting: Single large, tertiary paediatric centre. CONCLUSION: Patients with CD found to have EE share characteristics with both isolated CD and EoE. It appears that these are two coexisting entities presenting in the same…

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Update on Postnatal Steroids.

Halliday, Neonatology. 2017 Abstract Antenatal steroid treatment to enhance fetal lung maturity and surfactant treatment to prevent or treat respiratory distress syndrome have been major advances in perinatal medicine in the past 40 years contributing to improved outcomes for preterm infants. Use of postnatal steroids to prevent or treat chronic…

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Umbilical Venous Catheter Malposition Is Associated with Necrotizing Enterocolitis in Premature Infants.

Sulemanji et al, Neonatology, 2017 Abstract OBJECTIVE: The etiology of necrotizing enterocolitis (NEC) remains elusive despite known associations with several factors, including intestinal ischemia related to the effects of umbilical arterial catheterization on the mesenteric circulation. However, the role of the mesenteric venous circulation has yet to be studied as a potential…

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Surfactant Need by Gestation for Very Preterm Babies Initiated on Early Nasal CPAP: A Danish Observational Multicentre Study of 6,628 Infants Born 2000-2013.

Wiingreen et al, Neonatology, 2017 Abstract BACKGROUND: In recent years, early nasal continuous positive airway pressure (nCPAP) as respiratory support for preterm infants is being advocated as an alternative to prophylactic surfactant and treatment with mechanical ventilation. A number of infants treated with early nCPAP do not need treatment with surfactant, but…

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Use of Transcutaneous Bilirubin to Determine the Need for Phototherapy in Resource-Limited Settings.

Olusanya and Emokpae, Neonatology. 2017  Abstract BACKGROUND: Routine and timely determination of total serum bilirubin (TSB) remains a challenge in many resource-limited countries with substantial burden of severe neonatal hyperbilirubinemia. Limited evidence exists on the potential usefulness of transcutaneous bilirubin (TcB) to identify infants who may require phototherapy based on possible treatment…

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