Azithromycin in early infancy and pyloric stenosis

Eberly et al, Pediatrics. 2015 March Abstract BACKGROUND AND OBJECTIVE: Use of oral erythromycin in infants is associated with infantile hypertrophic pyloric stenosis (IHPS). The risk with azithromycin remains unknown. We evaluated the association between exposure to oral azithromycin and erythromycin and subsequent development of IHPS. CONCLUSIONS: Ingestion of oral azithromycin and erythromycin places young infants at increased…

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Long-term effects of caffeine therapy for apnea of prematurity on sleep at school age

Marcus et al ,Am J Respir Crit Care Med. 2014 Oct Abstract RATIONALE: Apnea of prematurity is a common condition that is usually treated with caffeine, an adenosine receptor blocker that has powerful influences on the central nervous system. However, little is known about the long-term effects of caffeine on sleep in the developing brain. OBJECTIVES:…

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Angiotensin-converting enzyme inhibitor nephrotoxicity in neonates with cardiac disease

Lindle KA, et al, Pediatr Cardiol. 2014 March Abstract Angiotensin-converting enzyme inhibitors (ACEi) are commonly used for pediatric cardiology patients. However, studies examining their safety for neonates with cardiac disease are scarce. The current study aimed to test the hypothesis that ACEi-mediated nephrotoxicity occurs in neonates and may be underappreciated in this population.…

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Influence of hyperbilirubinemia and phototherapy on markers of genotoxicity and apoptosis in full-term infants.

Yahia et al, Eur J Pediatr. 2015 Apr Abstract Concerns of possible genotoxic effects of hyperbilirubinemia and phototherapy were raised from experimental and observational studies in neonates. This study aimed to assess the impact of hyperbilirubinemia and phototherapy on DNA damage and apoptosis in peripheral blood lymphocytes in healthy full-term infants.…

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Jaundice, phototherapy and DNA damage in full-term neonates.

Ramy et al, J Perinatol. 2016 Feb Abstract OBJECTIVE: Phototherapy is the standard therapeutic approach for neonatal hyperbilirubinemia. Oxidative effects of phototherapy may have potential harms, including DNA damage. Unconjugated bilirubin (UCB) might also possess antigenotoxic potential. Intensive phototherapy is more efficacious than conventional phototherapy in treating hyperbilirubinemia. This study aimed…

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Apnea of Prematurity.

AAP Issues Guidance on Apnea of Prematurity. Pediatrics, January 2016, Eric C. Eichenwald, COMMITTEE ON FETUS AND NEWBORN, From the American Academy of Pediatrics, Clinical Report Abstract   Apnea of prematurity is one of the most common diagnoses in the NICU. Despite the frequency of apnea of prematurity, it is unknown whether recurrent apnea, bradycardia, and…

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Neonatal glucocorticoid treatment: long-term effects on the hypothalamus-pituitary-adrenal axis, immune system, and problem behavior in 14-17 year old adolescents

Ter Wolbeek et al, Brain Behav Immun. 2015 Mar Neonatal glucocorticoid (GC) treatment is used to prevent bronchopulmonary dysplasia (BPD) in prematurely born babies. In the 1990s, treatment regimens with relatively high doses of dexamethasone (DEX) were common. As an alternative, hydrocortisone (HC) was used. Earlier, we compared long-term effects of both GCs in children aged 7-10…

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Fetal antiepileptic drug exposure: Adaptive and emotional/behavioral functioning at age 6years

Cohen et al, Epilepsy Behav. 2013 Nov The Neurodevelopmental Effects of Antiepileptic Drugs (NEAD) study is a prospective observational multicenter study in the USA and UK, which enrolled pregnant women with epilepsy on antiepileptic drug (AED) monotherapy from 1999 to 2004. The study aimed to determine if differential long-term neurodevelopmental effects exist…

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Supraventricular tachycardia after nebulized salbutamol therapy in a neonate: case report

Say et al, Arch Argent Pediatr. 2015 Apr;  Abstract Supraventricular tachycardia (SVT) is the most common sustained arrhythmia in neonates and infants. Presentation of SVT in the neonate is usually subtle and frequently complicated by congestive heart failure. Despite the widespread use of β2-agonists, their safety has been questioned. Several studies have reported an increased incidence…

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The effect of erythropoietin on the severity of retinopathy of prematurity.

Kandasamy, Eye (Lond). 2014 July Abstract Exogenous human erythropoietin (EPO) artificially synthesised through recombinant DNA technology (rHuEPO) is currently used as a substitute for blood transfusion in preterm and low birth weight neonates. The objective of this study is to determine whether the use of rHuEPO is associated with an increased severity of retinopathy…

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Prophylactic systemic antifungal agents to prevent mortality and morbidity in very low birth weight infants

Cleminson, et al, Sept 2015 The Cochrane Library Abstract Background Invasive fungal infection is an important cause of mortality and morbidity in very preterm and very low birth weight infants. Early diagnosis is difficult and treatment is often delayed. Systemically absorbed antifungal agents (usually azoles) are increasingly used as prophylaxis…

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Effect of fluconazole prophylaxis on candidiasis and mortality in premature infants: a randomized clinical trial.

Benjamin et al, JAMA. 2014 May Abstract IMPORTANCE: Invasive candidiasis in premature infants causes death and neurodevelopmental impairment. Fluconazole prophylaxis reduces candidiasis, but its effect on mortality and the safety of fluconazole are unknown. OBJECTIVE: To evaluate the efficacy and safety of fluconazole in preventing death or invasive candidiasis in extremely low-birth-weight infants. Among infants with a…

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Pharmacokinetics and pharmacodynamics of antibacterials, antifungals, and antivirals used most frequently in neonates and infants.

Roberts ,et al, Clin Pharmacokinet. 2014 Jul Abstract Antimicrobials and antivirals are widely used in young infants and neonates. β-Lactam antibacterial activity is maximized when the plasma concentration exceeds the minimum inhibitory concentration for a prolonged period, suggesting that more frequent dosing may optimize β-lactam therapy. Aminoglycosides are typically administered at longer…

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Pharmacological Therapy of Gastroesophageal Reflux in Preterm Infants

Corvaglia et al, Gastroenterology Research and Practice, Volume 2013 (2013) Abstract Although gastroesophageal reflux (GER) is a very common phenomenon among preterm infants, its therapeutic management is still an issue of debate among neonatologists. A step-wise approach should be advisable, firstly promoting nonpharmacological interventions and limiting drugs to selected infants unresponsive to the conservative…

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Ranitidine is associated with infections, necrotizing enterocolitis, and fatal outcome in newborns

Terrin et al, Pediatrics, 2012 Gastric acidity is a major nonimmune defense mechanism against infections. The objective of this study was to investigate whether ranitidine treatment in very low birth weight (VLBW) infants is associated with an increased risk of infections, necrotizing enterocolitis (NEC), and fatal outcome. RESULTS: We evaluated 274 VLBW…

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Postnatal phenobarbital for the prevention of intraventricular haemorrhage in preterm infants

Smit et al, 2013, Cochrane neonatology group Intraventricular haemorrhage (IVH) is a major complication of preterm birth. Large haemorrhages are associated with a high risk of disability and hydrocephalus. Instability of blood pressure and cerebral blood flow are postulated as causative factors. Another mechanism may involve reperfusion damage from oxygen…

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A propensity-matched cohort study of vancomycin-associated nephrotoxicity in neonates

Constance et al, Arch Dis Child Fetal Neonatal Ed. 2015 Sep 23.  BACKGROUND: The incidence of nephrotoxicity among vancomycin-treated neonates has been reported to range from 2% to 20%. These widely varying estimates have led to confusion and controversy regarding the safety of vancomycin among neonates. OBJECTIVE: Evaluate the incidence of nephrotoxicity among neonates receiving vancomycin concomitantly…

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Videolaryngoscopy versus direct laryngoscopy for tracheal intubation in neonates

Cochrane review, 18 February 2015 Background Establishment of secure airway is a critical part of neonatal resuscitation both in the delivery room and in the neonatal unit. Videolaryngoscopy is a new technique that has the potential to facilitate successful endotracheal intubation and decrease adverse consequences of delay in airway stabilization.…

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Variation in Prenatal Diagnosis of Congenital Heart Disease in Infants

 Quartermain, et al Pediatrics, 2015 .  ABSTRACT BACKGROUND AND OBJECTIVE: Prenatal diagnosis allows improved perioperative outcomes for fetuses with certain forms of congenital heart disease (CHD). Variability in prenatal diagnosis has been demonstrated in other countries, leading to efforts to improve fetal imaging protocols and access to care, but has…

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