Benefits and Risks of Antiretroviral Therapy for Perinatal HIV Prevention

Fowler et al, N Engl J Med. 2016 Nov   Abstract BACKGROUND: Ran­dom­ized-tri­al data on the risks and ben­e­fits of anti­retro­vi­ral ther­a­py (ART) as com­pared with zidovu­dine and sin­gle-dose nevi­rap­ine to pre­vent trans­mis­sion of the human immun­od­e­fi­cien­cy virus (HIV) in HIV-infect­ed preg­nant women with high CD4 counts are lack­ing. CONCLUSIONS: Ante­na­tal ART result­ed in sig­nif­i­cant­ly low­er rates of ear­ly HIV trans­mis­sion than…

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Survival and Neurodevelopmental Outcomes among Periviable Infants

Younge et al, N Engl J Med. 2017 Feb Abstract BACKGROUND: Data report­ed dur­ing the past 5 years indi­cate that rates of sur­vival have increased among infants born at the bor­der­line of via­bil­i­ty, but less is known about how increased rates of sur­vival among these infants relate to ear­ly child­hood neu­rode­vel­op­men­tal out­comes.   CONCLUSIONS: The rate of sur­vival with­out neu­rode­vel­op­men­tal impair­ment increased between 2000 and 2011 in this…

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 “عظماء أبو الريش الراحلون من ظلمات صندوق النسيان إلى أضواء المعرفة والعرفان”

  السيدات والسادة الزملاء الأفاضل السلام عليكم ورحمة الله وبركاته،،،  وفاء للوعد الذى قطعه عل نفسه ا.د. صلاح نصار الأستاذ المتفرغ بقسم طب الأطفال بكلية طب قصر العينى — جامعة القاهرة، والخادم العاشق فى محراب “البيت الكبير”، فقد وفقنا الله سبحانه وتعالى، إلى وضع استرتيجية، وأهداف وخطة تنفيذ الكتاب، الذى…

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Ventilation in Extremely Preterm Infants and Respiratory Function at 8 Years

Doyle et al, N Engl J Med. 2017 Jul BACKGROUND: Assist­ed ven­ti­la­tion for extreme­ly preterm infants (<28 weeks of ges­ta­tion) has become less inva­sive, but it is unclear whether such devel­op­ments in care are asso­ci­at­ed with improve­men ts in short-term or long-term lung func­tion. We com­pared changes over time in the use of assist­ed ven­ti­la­tion and oxy­gen ther­a­py…

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Delayed versus Immediate Cord Clamping in Preterm Infants

Tarnow-Mor­di W et al, N Engl J Med. 2017 Dec BACKGROUND The pre­ferred tim­ing of umbil­i­cal-cord clamp­ing in preterm infants is unclear.  METHODS The pri­ma­ry com­pos­ite out­come was death or major mor­bid­i­ty (defined as severe brain injury on post­na­tal ultra­sonog­ra­phy, severe retinopa­thy of pre­ma­tu­ri­ty, necro­tiz­ing ente­ro­col­i­tis, or late-onset sep­sis) by 36 weeks…

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Long-Term Effects of Inhaled Budesonide for Bronchopulmonary Dysplasia

Bassler et at, N Engl J Med. 2018 Jan BACKGROUND : The long-term effects on neu­rode­vel­op­ment of the use of inhaled glu­co­cor­ti­coids in extreme­ly preterm infants for the pre­ven­tion or treat­ment of bron­chopul­monary dys­pla­sia are uncer­tain.  CONCLUSIONS   Among sur­viv­ing extreme­ly preterm infants, the rate of neu­rode­vel­op­men­tal dis­abil­i­ty at 2 years did…

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Vitamin D supplementation during pregnancy: state of the evidence from a systematic review of randomised trials

Roth et al, BMJ, 2017 Abstract Objec­tives: To esti­mate the effects of vit­a­min D sup­ple­men­ta­tion dur­ing preg­nan­cy on 11 mater­nal and 27 neonatal/infant out­comes; to deter­mine fre­quen­cies at which tri­al out­come data were miss­ing, unre­port­ed, or incon­sis­tent­ly report­ed; and to project the poten­tial con­tri­bu­tions of reg­is­tered ongo­ing or planned tri­als. Design: Sys­tem­at­ic…

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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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The recent updates in Congenital Zika management in Infants

Cen­ters for Dis­ease Con­trol and Pre­ven­tion CDC Zika virus test­ing is rec­om­mend­ed for infants with clin­i­cal find­ings con­sis­tent with con­gen­i­tal Zika syn­drome and pos­si­ble mater­nal Zika virus expo­sure dur­ing preg­nan­cy, regard­less of mater­nal test­ing results. Test­ing CSF for Zika virus RNA and Zika virus IgM anti­bod­ies should be con­sid­ered, espe­cial­ly…

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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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Gestational Age and Cardiorespiratory Fitness in Individuals Born At Term: A Life Course Study

Fer­reira et al, J Am Heart Assoc. 2017 Sep Abstract BACKGROUND: In con­trast to the effects of preterm birth, the extent to which short­er ges­ta­tion­al age affects the car­diores­pi­ra­to­ry fit­ness (CRF) lev­els of indi­vid­u­als who were born at term (ie, between 37 and 42 weeks) is large­ly unknown. The aim of this study was…

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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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