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

Aim This study evaluated the long-term effects of enteral glutamine supplementation on neurodevelopmental outcomes of a Dutch cohort of very preterm children at 13 years of age. Methods The cohort was enrolled in a randomised... more

In Neonatal Intensive Care Units (NICUs), parent satisfaction and their experiences are fundamental to assess clinical practice and improve the quality of care delivered to infants and parents. Recently, a specific instrument, the... more

In Neonatal Intensive Care Units (NICUs), parent satisfaction and their experiences are fundamental to assess clinical practice and improve the quality of care delivered to infants and parents. Recently, a specific instrument, the EMpowerment of PArents in THe Intensive Care-Neonatology (EMPATHIC-N), has been developed in the Netherlands. This instrument investigated different domains of care in NICUs from a family-centered care perspective. In Italy, no rigorous instruments are available to evaluate parent satisfaction and experiences in NICU with family-centered care. The aim of this study was to translate and validate the EMPATHIC-N instrument into Italian language measuring parent satisfaction. A psychometric study was conducted in nine Italian NICUs. The hospitals were allocated across Italy: four in the North, four in Central region, one in the South. Parents whose infants were discharged from the Units were enrolled. Parents whose infants died were excluded. Back-forward tran...

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.

flora plays an important role in the enterohepatic circuit by breaking bilirubin down into metabolites that are easily excreted in feces and urine as well as by blocking beta-glucuronidase. Newborns lack intestinal flora until about day... more

flora plays an important role in the enterohepatic circuit by breaking bilirubin down into metabolites that are easily excreted in feces and urine as well as by blocking beta-glucuronidase. Newborns lack intestinal flora until about day 3, when the first Lactobacillus and Bifidobacterium colonies begin to appear. [4] By the 2 nd week of life, the number of colonies has grown to resemble those of adults, although studies have shown delayed colonization in babies born by C-section. [4] Research into probiotic usage in some medical fields has made significant progress over the past two decades. While most studies have focused on preventing and treating acute infectious diarrhea and antibiotic-associated diarrhea, probiotics have a broader spectrum and have been successfully used to treat allergic diseases, Helicobacter pylori infections, and in Original Article for the most subjects (45%) in the low-to-intermediate-risk zone, compared to 30% in control Group 1 and 29% in Group 3 (P < 0.05). Eight subjects required light therapy, including two in Group 2 and three in each of control Group 1 and Group 3 (P > 0.05). Conclusions: The use of probiotics to prevent neonatal hyperbilirubinemia or bring down phototherapy admissions does not appear to be cost-effective.

Preterm birth complications are responsible for almost one-third of the global neonatal mortality burden, and respiratory distress syndrome remains the single most common cause of these preventable deaths. Since its inception, almost half... more

Preterm birth complications are responsible for almost one-third of the global neonatal mortality burden, and respiratory distress syndrome remains the single most common cause of these preventable deaths. Since its inception, almost half a century ago, nasal continuous positive airway pressure (NCPAP) has evolved to become the primary modality for neonatal respiratory care in both the developed and developing world. Although evidence has demonstrated the effectiveness of low-cost bubble NCPAP in reducing newborn mortality, its widespread use is yet to be seen in resource-constrained settings. Moreover, many tertiary hospitals in developing countries still utilise an inexpensive locally assembled bNCPAP system of unknown efficacy and safety. This review provides a brief overview of the history, physiological benefits, indications, contraindications, and complications of bNCPAP. Evidence regarding the effectiveness of low-cost bNCPAP in the neonatal intensive care unit is also summarised. The article further details a locally assembled bNCPAP system used in resource-constrained settings and highlights the care package for neonates receiving bNCPAP, failure criteria, and strategies for weaning.

Fathers of premature infants have been primarily marginalized caregivers up until the last 20 years, but change in both the societal definition and expectation of fathers as well as tremendous evolution in the Neonatal Intensive Care Unit... more

Fathers of premature infants have been primarily marginalized caregivers up until the last 20 years, but change in both the societal definition and expectation of fathers as well as tremendous evolution in the Neonatal Intensive Care Unit (NICU) and neonatal care towards integrative practice inclusive of music therapy has rendered a unique time in history. Fathers, now viewed as integral to optimal parenting outcomes, are well matched to the unique therapeutic offering of music therapy. In this article, three music psychotherapists have provided literature review across the helping professions as well as case studies to bring the complex role of NICU fathers into much greater salience.

Chronic twin-to-twin transfusion syndrome (TTTS) is a complication of monochorionic twin gestations and is associated with high perinatal mortality and increased neurological, cardiovascular and renal morbidity. To report the risk of... more

Chronic twin-to-twin transfusion syndrome (TTTS) is a complication of monochorionic twin gestations and is associated with high perinatal mortality and increased neurological, cardiovascular and renal morbidity. To report the risk of severe persistent pulmonary hypertension of the newborn (PPHN) in TTTS and discuss the possible association between severe PPHN and TTTS. All cases of monochorionic twins with severe PPHN at birth admitted to our nursery between June 2002 and July 2006 were reviewed retrospectively. We compared the incidence of severe PPHN in monochorionic twins with and without TTTS. Severe PPHN was diagnosed according to clinical and ultrasound criteria when an infant with a structurally normal heart had (1) severe hypoxemia and (2) evidence of a right-to-left shunt on persistent ductus arteriosus or foramen ovale, requiring treatment with inhaled nitric oxide (iNO). In a consecutive series of 73 twin pregnancies with TTTS, 4 of the 135 live-born twins (3%) were affec...

Neonatal sepsis is considered critical for a significant increase in neonatal morbidity and mortality among hospitalized neonates. Neonatal sepsis, in most cases, coexists with coagulopathy, which can prove to be life-threatening. Complex... more

Neonatal sepsis is considered critical for a significant increase in neonatal morbidity and mortality among hospitalized neonates. Neonatal sepsis, in most cases, coexists with coagulopathy, which can prove to be life-threatening. Complex molecular and cellular systems are involved in the cross-talk between inflammation and hemostasis during sepsis. Disturbances in the regulating systems of the vascular endothelium, and platelet-endothelial and platelet-neutrophil interactions play a pivotal role in both inflammation and coagulation. This complex process is poorly understood in neonates. In addition to the developmental maturation of hemostasis and the immune response in neonatal sepsis, a cellular model of hemostasis during sepsis should be taken into account. This review focused on the molecular and cellular mechanisms underlying inflammation and hemostasis during neonatal sepsis, taking the developmental immune response and developmental hemostasis into account in order to provide future diagnostic approaches to be applied in everyday clinical settings. Regarding the diagnostic modalities, we briefly provide the limitations of the currently used conventional coagulation assays, focusing on viscoelastic tests and platelet flow cytometry.

Juan Paola, Becci Irene, 2018. "Le "soin spirituel" pratiqué à l'hôpital. Un regard en néonatologie. Entretien avec Isaline Chammartin, infirmière", dans Pahud de Mortanges René, Schmid Hansjörg, Becci Irene (eds.) Spitalseelsorge in... more

Juan Paola, Becci Irene, 2018. "Le "soin spirituel" pratiqué à l'hôpital. Un regard en néonatologie. Entretien avec Isaline Chammartin, infirmière", dans Pahud de Mortanges René, Schmid Hansjörg, Becci Irene (eds.) Spitalseelsorge in einer vielfältigen Schweiz. Interreligiöse, rechtliche und praktische Herausforderungen, Schulthess, pp. 135-146.

Background: The satisfaction of pregnant women with the quality of antenatal services results in adherence to antenatal care regimen, return for subsequent visits and better materno-fetal outcomes. Objectives: The objectives of the study... more

Background: The satisfaction of pregnant women with the quality of antenatal services
results in adherence to antenatal care regimen, return for subsequent visits and better
materno-fetal outcomes.
Objectives: The objectives of the study were to determine pregnant women’s satisfaction
with the antenatal services they receive from midwives with regard to general satisfaction,
satisfaction with technical quality of the antenatal care provided by midwives, satisfaction
with interpersonal aspect of the services, communication, financial, time spent with the
midwives and availability/access/convenience of the antenatal services provided by the
midwives in the health care facilities in South-South Nigeria.
Materials and Methods: The study was a cross sectional survey research design. A total of
1500 pregnant women were selected for the study using multi-stage sampling technique.
Patient Satisfaction Questionnaire was the instrument used for data collection. The reliability
of the instrument was established through test-retest method using Cronbach’s Alpha which
yielded a co-efficient of 0.709. Data collected were analyzed using frequencies, percentages,
mean and standard deviation to determine the objectives of the study. Factorial Analysis of
Variance was used to test the hypothesis at 0.05 level of significance.
Results: The result showed mean of 56.12 ± 10.17 for general satisfaction, satisfaction with
technical quality mean = 65.04 ± 7.12, interpersonal satisfaction mean = 71.07 ± 11.23,
satisfaction with communication mean 63.07 ± 16.59, satisfaction with financial aspect mean
= 59.75 ± 9.88, mean for time spent with midwife = 73.33 ± 29.82, and satisfaction with
convenience of antenatal services had mean of 59.86 ± 7.62. There were significant
associations between the satisfaction expressed by pregnant women and their occupation
F=3.088, p-value = 0.027, and religion F=5.469, p-value=0.016.
Conclusion: Pregnant women were satisfied with the antenatal services provided by
midwives in Government-owned Health care facilities in South-South Nigeria. Nongovernmental organizations should support the funding of human and material resources
needed to further improve the performance of midwives and maintain satisfaction of pregnant
women with antenatal services.

High flow nasal cannula for respiratory support in preterm infants.

Background Around one-third of the world's 2.8 million neonatal deaths are caused by infections. Most of these deaths are preventable, but occur due to delays in care-seeking, and access to effective antibiotic treatment with supportive... more

Umbilicus is considered a mirror of the abdomen in newborns. Despite its importance, the umbilicus has been stated in literature and textbooks as discrete subjects with many body systems, such as the urinary, digestive, and cardiovascular... more

Umbilicus is considered a mirror of the abdomen in newborns. Despite its importance, the umbilicus has been stated in literature and textbooks as discrete subjects with many body systems, such as the urinary, digestive, and cardiovascular ones. This article aimed to address the basic knowledge of the umbilicus in relation to clinical disorders under one integrated topic to aid physicians and surgeons in assessing newborns and infants. The umbilicus appears as early as the fourth week of fetal life when the folding of the embryonic plate occurs. The umbilicus appears initially as a primitive umbilical ring on the ventral aspect of the body. The primitive umbilicus contains the connecting stalk, umbilical vessels, vitelline duct and vessels, allantois, and loop of the intestine. Changes occur to form the definitive cord, which contains three umbilical vessels, namely, " one vein and two arteries, " embedded in Wharton's jelly. After birth, the umbilical vessels inside the body obliterate and gradually form ligaments. Congenital disorders at the umbilicus include herniation, bleeding, and discharge of mucous, urine, or feces. Some of these disorders necessitate emergent surgical interference, whereas others may be managed conservatively. The umbilicus has many embryological remnants. Thus, the umbilicus is prone to various clinical disorders. Detecting these disorders as early as possible is essential to prevent or minimize possible complications.

Petechial rash in neonatal period commonly results from thrombocytopenia. Disorders of coagulation and those affecting vascular integrity may cause purpuric rash. Common causes of neonatal thrombocytopenia include early onset... more

Petechial rash in neonatal period commonly results from thrombocytopenia. Disorders of coagulation and those affecting vascular integrity may cause purpuric rash. Common causes of neonatal thrombocytopenia include early onset thrombocytopenia (onset < 72 hours) due to ...

Background: Oromotor stimulation is currently preferred intervention for influencing oral skills in preterms. Thus, this review is carried out to generate evidence showing efficacy of prefeeding oromotor stimulation among preterm babies.... more

Background: Oromotor stimulation is currently preferred intervention for influencing oral skills in preterms. Thus, this review is carried out to generate evidence showing efficacy of prefeeding oromotor stimulation among preterm babies. Methods: PRISMA guidelines are followed and searched in PubMed, Cochrane library, Clinical trials database, and reference list of related articles which were published from Jan. 2000 to 31 Dec. 2020 in English language. We included only randomized controlled trials. Results: Twelve eligible studies out of 88 studies were screened and included for qualitative synthesis. It was found that prefeeding oromotor stimulation initiates early achievement of independent oral feeding though the treatment protocol is not standardized. Conclusions: Practice of prefeeding oral stimulation has variety of protocol thus results should be comprehended carefully.

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.

Introduction: Pregnancy induced hypertension (PIH) is one of the leading cause of maternal and fetal morbidity and mortality. Oxidative stress is considered as one of the aetiological factor in PIH. The present study was done to study the... more

Introduction: Pregnancy induced hypertension (PIH) is one of the leading cause of maternal and fetal morbidity and mortality. Oxidative stress is considered as one of the aetiological factor in PIH. The present study was done to study the levels of plasma malondialdehyde (MDA) and serum superox-ide dismutase (SOD) level in pregnancy and their association with PIH. Material and methods: Study was conducted in the MP. 100 antenatal patients were included in the study and they were divided into two groups: normotensive group (50 patients) and pregnancy induced hypertension group (PIH) (50 patients). MDA was estimated as per Jean et al method and SOD by Mishra and Fridovich in all the patients. Results: Mean MDA level in normotensive, mild PIH and severe PIH patients was 4.15±0.35 nmol/ml, 5.11±0.41 nmol/ml and 6.27±0.37 nmol/ml respectively. Mean SOD level in nor-motensive, mild PIH and severe PIH patients was 3.15±0.21 unit/mg/ml, 2.56±0.32 unit/mg/ml and 2.02±0.19 unit/mg/ml respecti...

Hypospadias is a relatively common genital condition in which the urethral opening forms on the underside of the penis, as opposed to at the tip of the glans. Patients with hypospadias are typically referred for surgery during infancy or... more

Hypospadias is a relatively common genital condition in which the urethral opening forms on the underside of the penis, as opposed to at the tip of the glans. Patients with hypospadias are typically referred for surgery during infancy or early childhood. Recent evidence, however, indicates that many individuals with hypospadias do not experience the functional or psychosocial difficulties that are commonly attributed to the condition, and that surgical intervention for hypospadias carries substantial risk of adverse outcomes. In this article, we review published outcomes data and conduct an in-depth analysis of the typical rationales for hypospadias surgery, taking into consideration both the potential benefits and harms of the procedure, as well as the existence of non-surgical alternatives. We argue, firstly, that most childhood surgeries for hypospadias are performed for anticipated future problems concerning function and cosmesis, rather than extant problems that serve to undermine the child’s well-being. Secondly, we contend that the surgery can be safely performed after an age of consent without increasing the absolute risk of surgical complications to an ethically meaningful degree. We conclude that surgery for hypospadias should typically be performed only if requested by the affected individual, under conditions of informed consent.