Neonatal Research Papers - Academia.edu (original) (raw)

The hammock positioning within the incubators simulates the intrauterine environment, however, there is little evidence of its benefits and possible risks. The aim of this study was to assess the effects of hammock positioning on... more

The hammock positioning within the incubators simulates the intrauterine environment, however, there is little evidence of its benefits and possible risks. The aim of this study was to assess the effects of hammock positioning on behavioral status, vital signs, and pain in very low birth weight preterm newborns. This is a quasi-experimental/case series study in which premature infants (<1500g) were positioned in supine for one hour in a hammock. The preterm newborns were assessed 10min before, during (2, 20, 40, and 60min), and 10min after hammock positioning with the Brazelton Neonatal Behavioral Assessment Scale, vital signs and pain by the Neonatal Facial Coding System. 28 preterm infants between 28 and 36 weeks of gestational age were evaluated. Regarding the behavioral state, the preterm newborns progressively evolved to light or deep sleep during hammock positioning. There was a statistically significant reduction of the heart and respiratory rate from 2 to 60th minute in a...

Haemolytic uremic syndrome (HUS) is characterised by the triad of non immune haemolytic anaemia, thrombocytopenia and renal failure. It is rare in newborns. Only 5 cases of neonatal HUS have been reported to-date. We describe a series of... more

Haemolytic uremic syndrome (HUS) is characterised by the triad of non immune haemolytic anaemia, thrombocytopenia and renal failure. It is rare in newborns. Only 5 cases of neonatal HUS have been reported to-date. We describe a series of 2 cases of neonatal HUS where one had definite history of birth asphyxia and another was an abandoned baby without clinical details about perinatal period. The known modalities of treatment include transfusion of plasma and plasmapheresis. In first baby haematological and renal parameters improved after double volume exchange transfusion while second baby responded to transfusion of fresh whole blood (packed red cells + plasma). Exchange transfusion essentially provides plasma exchange besides augmenting the haemoglobin levels. Arguably this is the first report of neonatal HUS treated with exchange transfusion.

In this chapter, we highlight the benefits of a comparative developmental approach, not only for revealing which social cognitive capacities are unique or shared across species, but also for uncovering environmental influences and... more

In this chapter, we highlight the benefits of a comparative developmental approach, not only for revealing which social cognitive capacities are unique or shared across species, but also for uncovering environmental influences and physiological underpinnings of social understanding in infancy. We discuss human and nonhuman primate infants’ (a) recognition of, and selective attention toward, social agents, (b) affiliation toward conspecifics and similar others, and (c) basic action understanding, as three examples of important social cognitive skills. These skills appear foundational, emerging early in development, and are shared across species, suggesting they may be (some of) the precursors upon which later, higher-order social cognitive abilities are built. Throughout, we emphasize how comparative studies can reveal nuances not readily observable in humans alone, including their developmental stability or plastic, early environmental contributions that may support or hinder such skills, and their underlying neural and physiological mechanisms.

Acquired Immuno Deficiency Syndrome has been remained one of the most health issue concerns till recently. HIV infection can be transmitted through unprotected sexual intercourse with an infected partner, unprotected oral sex, injection... more

Acquired Immuno Deficiency Syndrome has been remained one of the most health issue concerns till recently. HIV infection can be transmitted through unprotected sexual intercourse with an infected partner, unprotected oral sex, injection or transfusion of contaminated blood or blood products, sharing unsterilized injection equipment that was previously used by an infected person and maternal-fetal transmission during pregnancy, at birth or through breastfeeding. Transmission of HIV from an infected patient to a health-care worker has been documented after parenteral or mucous membrane exposure to blood. Oral manifestations are one of the earliest clinical indicators of HIV infection which is independent of CD4 status has a prognostic value. By the way, screening of the AIDS associated manifestations in the oral cavity is a noninvasive and feasible approach, these oral lesions should be used to help diagnose, prevent and intervene in the progression of HIV infection to AIDS. This review includes studies that investigate the impact of HIV infection on personal life and importance of oral lesion in early diagnosis of HIV infection in children. Articles were identified through searches of PubMed MEDLINE from 1970 to 2015, using the MESH based key words.

Background: Chest physiotherapy (CPT) and positioning of neonates has been used in many developed countries around the world to improve airway clearance and avoid lung complications, but the combined effect of both techniques is less... more

Background: Chest physiotherapy (CPT) and positioning of neonates has been used in many developed countries around the world to improve airway clearance and avoid lung complications, but the combined effect of both techniques is less documented. The objective of the study was to compare the effectiveness of chest physiotherapy in prone position versus conventional chest physiotherapy in ventilated neonates on respiratory outcomes. Methods: The study design was randomized controlled pilot study. Participants: 12 ventilated neonates fitting in Inclusion Criteria. They were randomly divided into two groups (n=6 in each group) using simple random sampling i.e. Experimental group (4female and 2male) (Chest Physiotherapy and Prone Positioning) and the Control group (3 females and 3males) (Conventional Chest Physiotherapy). Primary outcome measures were SpO2 saturation, Partial Pressure of Arterial Oxygen (PaO2) & Peak Inspiratory Pressure (P.I.P.). Outcomes were recorded Pre & Post of every 120 minutes session of Intervention twice daily with a gap of 6 hours for consecutive three days for the experimental group while for the control group, parameters were measured at the same time of the day. Result: Total 10 participants completed the study protocol. On comparison of three parameters in two groups using the unpaired t-test we found that there was a significant difference (p< 0.05) in SpO2 and PaO2 in both groups but no difference (p >0.05) in P.I.P. levels. Conclusion: Chest physiotherapy in the prone position for ventilated neonate concluded with a higher oxygen saturation (SpO2) and partial pressure of oxygen in the arterial blood (PaO2) when compared to conventional chest physiotherapy.

Music therapy during end-of-life care has become an increasingly applied therapeutic option for a broad range of populations in a variety of settings. While music therapy in the Neonatal Intensive Care Unit (NICU) is a well-established... more

Music therapy during end-of-life care has become an increasingly applied therapeutic option for a broad range of populations in a variety of settings. While music therapy in the Neonatal Intensive Care Unit (NICU) is a well-established field of clinical research and practice, there is a lack of literature that specifically addresses issues related to end-of-life care in this setting. In this article, the author aims to reflect upon some of the potentials, difficulties, and challenges when accompanying babies and their families during their last stages of life in the NICU. Three case vignettes will be described in order to exemplify aspects related to rituality, culture, memory making, and family-centred care. It is hoped that these case studies prompt the exchange of ideas and experiences among music therapists and other health care professionals concerned with end-of-life care in the NICU.

Lack of teamwork among health science students can be especially challenging in emergency settings. A simulated neonatal intensive care (NICU) exercise was held with nursing, radiology, and respiratory therapy students to determine if... more

Lack of teamwork among health science students can be especially challenging in emergency settings. A simulated neonatal intensive care (NICU) exercise was held with nursing, radiology, and respiratory therapy students to determine if students valued interdisciplinary education and felt the experience enhanced clinical skills. A mixed methods study was conducted to determine if there was a significant difference in students' perceptions of their resuscitation and professional communication skills after the experience. A t-test addressed the following: H1: There will be an increase in students' perception of their confidence in using their professional skills in a hospital setting after the interdisciplinary communication NICU experience. H2: There will be an increase in students' perception of their ability to communicate with other disciplines after the interdisciplinary communication NICU experience. Students answered six pre-experience open-ended questions and seven post-experience open-ended questions; responses were coded, and multiple themes emerged. Students reported gaining confidence in using their skills within the hospital setting after participating in the experience and reported possessing more high quality interdisciplinary communication skills after participating in the experience. The open-ended questions indicated students valued the simulations, and they felt more prepared to interact in an interdisciplinary manner in the clinical setting. Students also desired more simulations during their education. Limitations were discrepancies in student clinical experiences, sample size, and self-reported levels of communication, skills, and teamwork abilities. This study could determine the potential need for growth and development of interdisciplinary simulation experiences within healthcare education course design and standards.

Introduction: Skin-to-skin contact (CPP) is the placement of the naked newborn on the mother’sbreast, covered only with a cap, sheet or gown.Objective: To determine the effect of skin-to-skin contact in the breastfeeding of infants in... more

Introduction: Skin-to-skin contact (CPP) is the placement of the naked newborn on the mother’sbreast, covered only with a cap, sheet or gown.Objective: To determine the effect of skin-to-skin contact in the breastfeeding of infants in theNational Institute of Perinatology.Material and methods: Prospective, descriptive, observational, and cross-sectional study wasperformed, including a search for the information in the database of the Immediate Care Unitfor the Newborn from 1 August 2015 to 31 July 2016. The data obtained were Gestational age,weight, Apgar, maternal pathology, skin-to-skin contact, duration, and feeding.Results: There were 3175 births, with 2228 term neonates. CPP was performed in 1486 neona-tes (78.95%), with a weight of 2,045 to 4,200 g. The majority of patients who were breastfed(78.7%) had had skin-to-skin contact. Likewise, it was observed that CPP significantly favouredbreastfeeding (RR=143.28; 95% CI: 75.5-271.7).Discussion: CPP favours breastfeeding (99.2%), making the first food human milk, and reducingthe use of substitutes.Conclusions: Skin-to-skin contact is the best opportunity for the initiation of breastfeeding.The separation of mothers and their children at birth has become a common practice in thedelivery and operating rooms, due to hospital routines, placing the infant in a cradle of radiantheat, and initiating breastfeeding after one hour of life.

Advances in medical care have dramatically improved survival rates in preterm and critically ill newborns. Nonetheless, the patient experience of neonatal intensive care exposes these vulnerable individuals to numerous sources of stress,... more

Advances in medical care have dramatically improved survival rates in preterm and critically ill newborns. Nonetheless, the patient experience of neonatal intensive care exposes these vulnerable individuals to numerous sources of stress, to include noxious environmental stimuli, painful procedures, and prolonged separation from mother. This early life adversity, although medically necessary, alters the infant’s developmental trajectory through epigenetic, neuroendocrine and psychosocial mechanisms. Providing trauma-informed, neuroprotective care consistently and reliably in the neonatal intensive care setting offers clinicians an effective, evidence-based framework to transform the culture of care and improve short term and long term outcomes.

Background: Various strategies have been suggested for the treatment of neonatal respiratory distress syndrome (NRDS). Objectives: Nowadays, most of the high-risk pregnancies are successfully ended although they normally result in the... more

Background: Various strategies have been suggested for the treatment of neonatal respiratory distress syndrome (NRDS). Objectives: Nowadays, most of the high-risk pregnancies are successfully ended although they normally result in the delivery of premature and preterm neonates. The rate of NRDS increases in these neonates, which consequently demands for more interventions to save them. Methods: This was a case-control study in which, 52 neonates of 27-32 weeks' gestation and birth weight 1000-3000 g were treated with Curosurf (a natural surfactant) and NCPAP (Nasal continuous positive airway pressure) as the case group. The control group consisted of 52 matched neonates untreated with surfactant and NCPAP. Results: Studying 6 common NRDS-induced complications (pneumothorax, pulmonary hemorrhage, chronic lung disease, intra-ventricular hemorrhage, sepsis and patent ductus arteriosus) showed that there were no significant differences between the case and control groups (P > 0.05). Also, there were no significant differences in mortality and ventilator usage rates and duration of hospitalization (P > 0.05). In total, 9 neonates in the case group (17%) and 16 in the control group (30%) died consequently. Conclusions: The results showed that surfactant therapy had no significant effect on mortality and ventilator usage rates, duration of hospitalization, and NRDS-induced complications.

Aim The main aims of the study were to examine whether human neonates' responses to communication disturbance modelled by the still-face paradigm were stable and whether their responses were affected by their previous experience with the... more

Aim The main aims of the study were to examine whether human neonates' responses to communication disturbance modelled by the still-face paradigm were stable and whether their responses were affected by their previous experience with the still-face paradigm. Methods The still face procedure, as a laboratory model of interpersonal stress, was administered repeatedly, twice, to 84 neonates (0 to 4 day olds), with a delay of an average of 1.25 day. Results Frame-by-frame analysis of the frequency and duration of gaze, distressed face, crying, sleeping and sucking behaviours showed that the procedure was stressful to them both times, that is, the still face effect was stable after repeated administration and newborns consistently responded to such nonverbal violation of communication. They averted their gaze, showed distress and cried more during the still-face phase in both the first and the second administration. They also showed a carry-over effect in that they continued to avert their gaze and displayed increased distress and crying in the first reunion period, but their gaze behaviour changed with experience, in the second administration. While in the first administration the babies continued averting their gaze even after the stressful still-face phase was over, this carry-over effect disappeared in the second administration, and the babies significantly increased their gaze following the still-face phase.

Early life experiences have long-lasting influence on a child. For an infant, the quality of caregiving is one of the most critical factors supporting growth and development. Adverse social events in infancy have the potency to alter the... more

Early life experiences have long-lasting influence on a child. For an infant, the quality of caregiving is one of the most critical factors supporting growth and development. Adverse social events in infancy have the potency to alter the child’s developmental trajectory and elevate the lifetime risk for a range of psychiatric disorders. Although clinical studies associate early childhood adversities with lifetime risk for mental disorders, the knowledge of underlying neural and molecular alterations leading to these disorders comes mostly from animal studies. In this article, we overview selected animal models of early life social adversity, including maternal abuse and neglect, and maternal trauma and fear. We first characterize the major behavioral and neural changes normally occurring in early life. We then present several animal models of maternally mediated early life adversity that contribute to reorient the developmental changes toward pathological outcomes. These models yielded to recently identified neurobiological mechanisms, including epigenetic alterations, through which these adversities lead to a lasting dysregulation of the stress response system, aberrant fear learning and memory, and increased anxiety or depression-like behaviors.

The neonatal incubator is an apparatus that provides a closed and controlled environment for the sustenance of premature babies. But recently, many premature babies have lost their lives due to lack of proper monitoring of the incubator... more

The neonatal incubator is an apparatus that provides a closed and controlled environment for the sustenance of premature babies. But recently, many premature babies have lost their lives due to lack of proper monitoring of the incubator that leads to accidents (leakage of gas and overheating causing short circuits and eventually, the bursting of incubators). This project deals with the cost- effective design of an embedded device that monitors certain parameters such as pulse rate of the baby, temperature, humidity, essential amount of gas and light inside the incubator. The details are sent as a message to the doctor or nurse through IoT, so that proper actions can be taken in advance, to maintain the apt environment inside the incubator and ensure safety to the infant's life. So, the objective of this project is to overcome the above-mentioned drawbacks and provide a safe and affordable mechanism for monitoring the incubator.

Objectives Neonatal jaundice (NNJ) is a common newborn disorder globally which is preventable and easily treatable. However, when detected late and/or poorly managed, it is a leading cause of hospitalization, neurological complications... more

Objectives Neonatal jaundice (NNJ) is a common newborn disorder globally which is preventable and easily treatable. However, when detected late and/or poorly managed, it is a leading cause of hospitalization, neurological complications and death in newborns. Since mother's knowledge of newborn jaundice is crucial to prompt recognition, intervention and prevention of morbidity and mortality associated with this condition, we sought to determine the knowledge, perception and care seeking behaviours of NNJ among mothers/caregivers. Methods This mixed method study enrolled four hundred and twenty one respondents attending infant welfare clinic in a community health centre in Nenwe town in Enugu state using pretested semi-structured questionnaire. Determinants of knowledge and health seeking behaviour of respondents for newborn jaundice were determined using chi-square and fisher's exact test where appropriate. Results Majority of the respondents had poor knowledge and incorrect perception of the causes and management of NNJ. Use of glucose water and instillation of breast milk into the eye of the newborn were some of the harmful home practices used by respondents in management of newborn jaundice. Educational attainment, experience in newborn care and type of occupation significantly determined knowledge, correct description of NNJ and seeking for care in a hospital among respondents. Conclusion There is poor knowledge and perception of NNJ among respondents. Targeted education during antenatal and infant welfare clinics by health professionals is needed to help mothers and care giver recognise NNJ, refrain from potentially harmful home interventions and promptly seek healthcare.

Libre de asistencia de enfermería materno neonatal

In this paper a new dynamic simulation model for the building energy performance analysis of multi-enclosed thermal zones, where rigid air temperature and humidity conditions must be kept, is presented. The model was implemented in a... more

In this paper a new dynamic simulation model for the building energy performance analysis of multi-enclosed thermal zones, where rigid air temperature and humidity conditions must be kept, is presented. The model was implemented in a suitable computer code (DETECt 2.3.1) developed for research scopes. Such simulation model allows the hygrothermal analysis of buildings with multi-enclosed thermal zones surrounded by larger ones (e.g. display glass cases with valuable artefacts in museum halls, neonatal intensive care units for premature and full-term newborn babies in hospitals wards, etc.). For this purpose, a novel control algorithm, based on a model reference adaptive control scheme, enabling the online adaptation of the control gains, is implemented. Rigid air temperature and humidity conditions can be guaranteed also in case of sudden and rapid variability of hygrothermal loads. Through such new tool innovative techniques and operative strategies for obtaining energy efficiency and indoor comfort of special building spaces can be studied.
In order to show the capabilities of the tool and the robustness of the adaptive algorithm, as well as the potentiality of the proposed multidisciplinary approach to the energy-related behaviour in buildings (based on building energy modelling and simulation and control theory), two meaningful case studies have been developed. In particular, they refer to the museums and hospital indoor spaces where enclosed thermal zones have to be kept under stringent hygrothermal conditions.

Guía de administración de fármacos en el período neonatal para enfermería.

The use of age-appropriate care as an organized framework for care delivery in the neonatal intensive care unit is founded on the work of Heidelise Als, PhD, and her synactive theory of development. This theoretical construct has recently... more

The use of age-appropriate care as an organized framework for care delivery in the neonatal intensive care unit is founded on the work of Heidelise Als, PhD, and her synactive theory of development. This theoretical construct has recently been advanced by the work of Gibbins and colleagues with the ''universe of developmental care'' conceptual model and developmental care core measures which were endorsed by the National Association of Neonatal Nurses in their age-appropriate care of premature infant guidelines as best-practice standards for the provision of high-quality care in the neonatal intensive care unit. These guidelines were recently revised and expanded. In alignment with the Joint Commission's requirement for health-care professionals to provide age-specific care across the lifespan, the core measures for developmental care suggest the necessary competencies for those caring for the premature and critically ill hospitalized infant. Further supported by the Primer Standards of Accreditation and Health Canada, the institutional implementation of theses core measures requires a strong framework for institutional operationalization, presented in these guidelines. Part A of this article will present the background and rationale behind the present guidelines and their condensed table of recommendations.

The current rise of neurodevelopmental disorders poses a critical need to detect risk early in order to rapidly intervene. One of the tools pediatricians use to track development is the standard growth chart. The growth charts are... more

The current rise of neurodevelopmental disorders poses a critical need to detect risk early in order to rapidly intervene. One of the tools pediatricians use to track development is the standard growth chart. The growth charts are somewhat limited in predicting possible neurodevelopmental issues. They rely on linear models and assumptions of normality for physical growth data – obscuring key statistical information about possible neurodevelopmental risk in growth data that actually has accelerated, non-linear rates-of-change and variability encompassing skewed distributions. Here, we use new analytics to profile growth data from 36 newborn babies that were tracked longitudinally for 5 months. By switching to incremental (velocity-based) growth charts and combining these dynamic changes with underlying fluctuations in motor performance – as the transition from spontaneous random noise to a systematic signal – we demonstrate a method to detect very early stunting in the development of voluntary neuromotor control and to flag risk of neurodevelopmental derail.

BJECTIVE: The objective of the study was to evaluate the efficacy of antibiotic prophylaxis in women with term or near-term premature rupture of membranes. STUDY DESIGN: Searches were performed in MEDLINE, OVID, Scopus,... more

BJECTIVE:
The objective of the study was to evaluate the efficacy of antibiotic prophylaxis in women with term or near-term premature rupture of membranes.
STUDY DESIGN:
Searches were performed in MEDLINE, OVID, Scopus, ClinicalTrials.gov, the PROSPERO International Prospective Register of Systematic Reviews, EMBASE, ScienceDirect.com, MEDSCAPE, and the Cochrane Central Register of Controlled Trials with the use of a combination of key words and text words related to antibiotics, premature rupture of membranes, term, and trials from inception of each database to September 2014. We included all randomized trials of singleton gestations with premature rupture of membranes at 36 weeks or more, who were randomized to antibiotic prophylaxis or control (either placebo or no treatment). The primary outcomes included maternal chorioamnionitis and neonatal sepsis. A subgroup analysis on studies with latency more than 12 hours was planned. Before data extraction, the review was registered with the PROSPERO International Prospective Register of Systematic Reviews (registration number CRD42014013928). The metaanalysis was performed following the Preferred Reporting Item for Systematic Reviews and Meta-analyses statement.
RESULTS:
Women who received antibiotics had the same rate of chorioamnionitis (2.7% vs 3.7%; relative risk [RR], 0.73, 95% confidence interval [CI], 0.48-1.12), endometritis (0.4% vs 0.9%; RR, 0.44, 95% CI, 0.18-1.10), maternal infection (3.1% vs 4.6%; RR, 0.48, 95% CI, 0.19-1.21), and neonatal sepsis (1.0% vs 1.4%; RR, 0.69, 95% CI, 0.34-1.39). In the planned subgroup analysis, women with latency longer than 12 hours, who received antibiotics, had a lower rate of chorioamnionitis (2.9% vs 6.1%; RR, 0.49, 95% CI, 0.27-0.91) and endometritis (0% vs 2.2%; RR, 0.12, 95% CI, 0.02-0.62) compared with the control group.
CONCLUSION:
Antibiotic prophylaxis for term or near-term premature rupture of membranes is not associated with any benefits in either maternal or neonatal outcomes. In women with latency longer than 12 hours, prophylactic antibiotics are associated with significantly lower rates of chorioamnionitis by 51% and endometritis by 88%.

Increased rates of cesarean section, as seen currently worldwide, are associated with negative consequences on maternal and child health. Aim: to evaluate the rate and neonatal short term prognosis after cesarean section versus vaginal... more

Increased rates of cesarean section, as seen currently worldwide, are associated with negative consequences on maternal and child health. Aim: to evaluate the rate and neonatal short term prognosis after cesarean section versus vaginal delivery. Material and methods: The retrospective, cohort study included all neonates admitted in the Neonatology I Dpt., Maternity Hospital Sibiu, between 01.01.2011-30.12.2012. Neonatal data was collected from the electronic database and the outcomes of the infants delivered operatively were compared to those of the vaginally born infants. Results: Newborns delivered by cesarean section, compared to those vaginally born, had significantly lower gestational age, Apgar scores at 1 minute, and increased risk for transient tachypnea, persistent pulmonary hypertension, and hypoglycemia. Conclusion: Most of the results are similar with data reported in the literature but a larger study and stratified analysis may help a better identification of the risk factors associated with cesarean delivery at different gestational age.

The use of age-appropriate care as an organized framework for care delivery in the NICU is founded on the work of Heidelise Als, PhD, and her synactive theory of development. This theoretical construct has recently been advanced by the... more

The use of age-appropriate care as an organized framework for care delivery in the NICU is founded on the work of Heidelise Als, PhD, and her synactive theory of development. This theoretical construct has recently been advanced by the work of Gibbins and colleagues with the ''universe of developmental care'' conceptual model and developmental care core measures which were endorsed by the National Association of Neonatal Nurses in their age-appropriate care of premature infant guidelines as best-practice standards for the provision of high-quality care in the NICU. These guidelines were recently revised and expanded. In alignment with the Joint Commission's requirement for healthcare professionals to provide age-specific care across the lifespan, the core measures for developmental care suggest the necessary competencies for those caring for the premature and critically ill hospitalized infant. Further supported by the Primer Standards of Accreditation and Health Canada, the institutional implementation of these core measures require a strong framework for institutional operationalization presented in these guidelines. Part B will present the recommendations and justification of each steps behind the present guidelines to facilitate their implementation.

Neonatología y médico quirúrgicas.

Introduction: To supply high-quality neonatal care, it is essential to provide adequate infrastructures and material. Exceeding the visible simplicity of this condition, we suggest analyzing finely the relationship between the arrangement... more

Introduction: To supply high-quality neonatal care, it is essential to provide adequate infrastructures and material. Exceeding the visible simplicity of this condition, we suggest analyzing finely the relationship between the arrangement of the care spaces in maternity, their uses, and the quality of the care delivered to the newborns. Method: An ethnographic investigation in ten hospitals of Cameroon, among which one by region chosen from the various levels of the sanitary pyramid, allowed us to examine how the arrangement of the sanitary spaces and the arrangement of the material could contribute to the vulnerability of the newborn in maternity wards. Two hundred observations of the care given at birth were transcribed, then used as support for interviews with healthcare professionals in the aims of explaining their actions. Results: The sanitary spaces, with habits and modes of organization, do not optimize the quality of the care to the newborns. The fragmentation of places used in the coverage of the newborn children engenders delays in care in case of complication at the birth. The ways in which the space and material are used in the wards reveal a lack of anticipation and coordination of care. The appropriations of places and arrangement of equipment are not favorable to recommended neonatal care practices, in particular concerning the fight against the hypothermia and the promotion of early breast-feeding. Indeed, the spatial organization in maternity wards appears to be more centered on the obstetrical care. Discussion: Reflecting on care spaces can provide a basis for local collective processes of improvement of newborn care practices. It allows to re-question the biomedical professional culture, the segmentation of the tasks and the techniques, and to durably anchor evolutions favorable to neonatal survival.

ABSTRAK Kelainan kongenital adalah suatu kelainan pada struktur, fungsi maupun metabolisme tubuh yang ditemukan pada neonatus. Kelainan kongenital merupakan kelainan dalam pertumbuhan struktur bayi yang timbul semenjak kehidupan hasil... more

ABSTRAK Kelainan kongenital adalah suatu kelainan pada struktur, fungsi maupun metabolisme tubuh yang ditemukan pada neonatus. Kelainan kongenital merupakan kelainan dalam pertumbuhan struktur bayi yang timbul semenjak kehidupan hasil konsepsi sel telur.Adapun penyebab dari kelainan kongenital adalah faktor usia, faktor kromosom, faktor mekanik, faktor infeksi, faktor obat, faktor hormonal, faktor radiasi, faktor fisik pada rahim, faktor gizi, riwayat kesehatan ibu, paritas, jarak kehamilan. Penelitian ini menggunakan rancangan penelitian case control. Populasi kelompok kasus adalah semua ibu yang melahirkan neonatus dengan kelainan kongenital di RSUD Cilacap kurun waktu 1 Januari 2011-31 Desember 2013.Untuk kelompok kontrol adalah ibu yang melahirkan neonatus normal di RSUD Cilacap kurun waktu 1 Januari 2011-31 Desember 2013 dengan data rekam medik lengkap. Teknik pengambilan sampel dengan purposive sampling. Jenis data yang digunakan adalah data sekunder.Alat pengumpulan data dalam penelitian ini menggunakan checklist.Analisa data menggunakan regresi logistik. Hasil penelitian didapatkan bahwa faktor yang berisiko terjadinya kelainan kongenital adalah riwayat kesehatan ibu dengan nilai p-value 0,001 dan nilai OR 40,25; 95% CI 4,96-326,54. Kesimpulan yang dapat ditarik dalam penelitian ini adalah ibu yang mempunyai riwayat kesehatan dengan penyakit mempunyai risiko sebesar 40,25 kali untuk melahirkan neonatus dengan kelainan kongenital. Kata Kunci : usia, paritas, jarak kelahiran, riwayat penyakit, kelainan kongenital ABSTRACT Congenital disorder is an abnormality in the structure, function and metabolism of the body that was found in neonates. Congenital abnormalities are abnormalities in the baby's growth structure arising since the life of the products of conception egg. As for the causes of congenital abnormalities is the age factor, chromosomal factors, mechanical factors, infectious factors, drug factors, hormonal factors, radiation factors, physical factors in the uterus, nutritional factors, maternal medical history, parity, spacing pregnancies. This study uses a case control study design. Population case group is all women who gave birth neonates with congenital abnormalities in hospitals Cilacap period of 1 January 2011-31 December 2013. For the control group were mothers who gave birth in hospitals Cilacap normal neonatal period of 1 January 2011-December 31, 2013 with medical records complete. The sampling technique with purposive sampling. The data used is data sekunder.Alat collecting data in this study using a checklist. Data were analyzed using logistic regression.The result showed that the risk factors of congenital abnormality is the mother's health history with p-value of 0.001 and the value of OR 40.25; 95% CI 4.96 to 326.54. The conclusion that can be drawn in this study is a mother who has a medical history of the disease have a risk of 40.25 times to give birth neonates with congenital abnormalities.

Insertion of peripherally inserted central catheters (PICC) is a commonly performed procedure in both preterm and term infants. Tetracaine 4% gel (Ametop; Smith &amp;amp;amp;amp;amp;amp;amp;amp;amp; Nephew Inc, St. Laurent, Quebec), a... more

Insertion of peripherally inserted central catheters (PICC) is a commonly performed procedure in both preterm and term infants. Tetracaine 4% gel (Ametop; Smith &amp;amp;amp;amp;amp;amp;amp;amp;amp; Nephew Inc, St. Laurent, Quebec), a topical anesthetic, although reported to be effective for reducing the pain of venipuncture in neonates, has not been investigated for the management of pain associated with the PICC procedure. To determine the efficacy of tetracaine gel for managing the pain associated with the PICC procedure in preterm and term infants. A double-blind, placebo-controlled, randomized controlled trial (RCT) design was used. Infants undergoing nonurgent PICC insertion were randomized to receive either the treatment (1.0 g of tetracaine 4% gel) or placebo control (1.0 g of eucerin-plus cream) applied to the skin under occlusion for 30 minutes before the procedure. Data on the behavioral (facial expression) and physiologic (heart rate and oxygen saturation) indicators of pain were collected via videotaping and computer monitoring throughout the procedure. Data then were coded and measured by independent observers using the Premature Infant Pain Profile (PIPP; Stevens et al, 1996), and analyzed using descriptive statistics and repeated-measures analyses of variance. Forty-nine infants, gestational age 27 to 41 weeks (mean = 33; SD = 4.2) and age at time of insertion 2 to 85 days (mean = 18; SD = 22.5) participated. No differences were found between the groups at the time of randomization. There were no adverse cardiorespiratory events or local skin reactions in either group. There was a significant within-subjects main effect of time across the procedure (F[48,3] = 11.03; P &amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). There was no significant between-subjects main effect of group (F[48,1] = 0.11; P = 0.74) and no (group x time) interaction (F[48,3] = 0.45; P = 0.72). Tetracaine gel was not effective for pain relief for PICC insertion in infants. Its use for pain relief cannot be recommended based on the results of this study. Other pharmacologic, behavioral, and physical interventions should be investigated for safety and relief of procedural pain in this population of infants.

Dyshidrotic eczema, also known as dyshidrotic dermatitis or pompholyx, is characterized by pruritic, tense, deep-seated vesicles mainly on the palms and lateral surfaces of the fingers. In the chronic phase, scaling, desquamation,... more

Dyshidrotic eczema, also known as dyshidrotic dermatitis or pompholyx, is characterized by pruritic, tense, deep-seated vesicles mainly on the palms and lateral surfaces of the fingers. In the chronic phase, scaling, desquamation, fissuring, and, sometimes, lichenification may be seen. The peak age of onset is between 20 and 30 years of age. The sex incidence is approximately equal. Most cases are idiopathic. Predisposing factors include atopy, contact allergens, contact irritants, dermatophyte infection, allergy to ingested metal, hyperhidrosis, prolonged use of protective gloves, intravenous immunoglobulin, psychological stress, and smoking. Although the disease is benign, it tends to run a chronic and relapsing course. Successful treatment requires a systemic multipronged approach that consists of avoidance of triggering factors, optimal skin care, pharmacotherapy during acute exacerbations, and education of patients/caregivers. Ultrapotent topical corticosteroids are the mainstay of pharmacotherapy.