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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AAP Recommends Newborn Hepatitis B Vaccine by 24 Hours of Age

Amer­i­can acad­e­my of pedi­atrics COMMITTEE ON INFECTIOUS DISEASESCOMMITTEE ON FETUS AND NEWBORN. Pedi­atrics. Sep­tem­ber 2017  New rec­om­men­da­tions from the Amer­i­can Acad­e­my of Pedi­atrics (AAP) say med­ical­ly sta­ble new­borns weigh­ing 2000 g or more should receive their first dose of the hepati­tis B vac­cine with­in the first 24 hours of life. The AAP’s…

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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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Two-year development of children conceived by IVM: a prospective controlled single-blinded study

Roes­ner et al, Hum Reprod (2017)  Abstract STUDY QUESTION Is there a dif­fer­ence in men­tal devel­op­ment of chil­dren c onceived by IVM in com­par­i­son to IVF or ICSI, inde­pen­dent­ly, at the age of 2 years? SUMMARY ANSWER No dif­fer­ences could be found in men­tal devel­op­ment  of IVM chil­dren com­pared to IVF

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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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Medications That Increase Osmolality and Compromise the Safety of Enteral Feeding in Preterm Infants

Chan­dran et al, Neona­tol­ogy, 2017  Abstract BACKGROUND: Med­ica­tions added to preterm milk feeds have the poten­tial to raise osmo­lal­i­ty, caus­ing feed intol­er­ance and necro­tiz­ing ente­ro­col­i­tis. OBJECTIVE: The aim of this study was to eval­u­ate changes in the osmo­lal­i­ty of milk feeds and water with 14 med­ica­tions and the dilu­ent amounts required to…

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