Reducing pain during vaccine injections: clinical practice guideline

 Anna Tad­dio et al, CMAJ 2015.  Clin­i­cians who admin­is­ter vac­cines can take a series of proac­tive actions, includ­ing shuf­fling the order of injec­tions, lever­ag­ing the calm­ing influ­ence of par­ents and breast-feed­ing, and rou­tine­ly apply­ing top­i­cal anes­thet­ic, to alle­vi­ate pain for patients of all ages, accord­ing to a new clin­i­cal prac­tice guide­line.…

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Estimating umbilical catheter insertion depth in newborns using weight or body measurement: a randomised trial

 Kier­an et al, Arch Dis Child Fetal Neona­tal 2014  Abstract Objec­tive Incor­rect­ly posi­tioned umbil­i­cal venous and arte­r­i­al catheters (UVC and UAC) are asso­ci­at­ed with increased rates of com­pli­ca­tions in new­borns. Catheter inser­tion depth is often esti­mat­ed using body sur­face mea­sure­ment. We wished to deter­mine whether esti­mat­ing inser­tion depth of umbil­i­cal catheters…

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Preterm Birth and Poor Fetal Growth as Risk Factors of Attention-Deficit/Hyperactivity Disorder

Sucks­dorff, et al, Pedi­atrics, August, 2015 Abstract BACKGROUND: Pre­vi­ous stud­ies have shown an asso­ci­a­tion between pre­ma­tu­ri­ty and atten­tion-deficit/hy­per­ac­tiv­i­ty dis­or­der (ADHD). Results con­cern­ing late preterm infants are con­tro­ver­sial, and stud­ies exam­in­ing fetal growth rep­re­sent­ed by weight for ges­ta­tion­al age are scarce. Our objec­tive was to exam­ine the asso­ci­a­tion between ges­ta­tion­al age…

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A Randomized Trial of Phototherapy with Filtered Sunlight in African Neonates

Slush­er, et al, N Engl J Med 2015 BACKGROUND Seque­lae of severe neona­tal hyper­biliru­bine­mia con­sti­tute a sub­stan­tial dis­ease bur­den in areas where effec­tive con­ven­tion­al pho­tother­a­py is unavail­able. We pre­vi­ous­ly found that the use of fil­tered sun­light for the pur­pose of pho­tother­a­py is a safe and effi­ca­cious method for reduc­ing total biliru­bin. How­ev­er,…

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Mental performance in 8-year-old children fed reduced protein content formula during the 1st year of life: safety analysis of a randomised clinical trial.

Escrib­ano et al, Br J Nutr. 2016 Jan In humans, max­i­mum brain devel­op­ment occurs between the third trimester of ges­ta­tion and 2 years of life. Nutri­tion dur­ing these crit­i­cal win­dows of rapid brain devel­op­ment might be essen­tial for lat­er cog­ni­tive func­tion­ing and behav­iour. In the last few years, trends on pro­tein rec­om­men­da­tions dur­ing infan­cy…

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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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Clinical pharmacology of furosemide in neonates: a review.

Paci­fi­ci, Phar­ma­ceu­ti­cals (Basel), 2013 Abstract Furosemide is the diuret­ic most used in new­born infants. It blocks the Na+-K+-2Cl- sym­porter in the thick ascend­ing limb of the loop of Hen­le increas­ing uri­nary excre­tion of Na+ and Cl-. This arti­cle aimed to review the pub­lished data on the clin­i­cal phar­ma­col­o­gy of furosemide in neonates…

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

Am J Respir Crit Care Med.  2014; Mar­cus et al 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…

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