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Sample records for newborn infants unable

  1. Monitoring of cerebral haemodynamics in newborn infants

    DEFF Research Database (Denmark)

    Liem, K Djien; Greisen, Gorm

    2010-01-01

    The most important cerebrovascular injuries in newborn infants, particularly in preterm infants, are cerebral haemorrhage and ischemic injury. The typical cerebral vascular anatomy and the disturbance of cerebral haemodynamics play important roles in the pathophysiology. The term 'cerebral haemod...

  2. Immobility reaction at birth in newborn infant.

    Science.gov (United States)

    Rousseau, Pierre Victor; Francotte, Jacques; Fabbricatore, Maria; Frischen, Caroline; Duchateau, Delphine; Perin, Marie; Gauthier, Jean-Marie; Lahaye, Willy

    2014-08-01

    To describe an immobility reaction (IR) that was not previously reported at or immediately after birth in human newborns. We analyzed 31 videos of normal term vaginal deliveries recorded from Time 0 of birth defined as the as the moment that lies between the birth of the thorax and the pelvis of the infant. We searched for perinatal factors associated with newborn's IR. IR at birth was observed in 8 of the 31 newborns. The main features of their behavior were immobilization, frozen face, shallow breathing and bradycardia. One of the 8 newborns had sudden collapse 2h after birth. We found significant relationships between maternal prenatal stress (PS) and IR (p=.037), and a close to significant one between infants' lividness at Time 0 and IR (p=.053). The first breath of the 31 newborns occurred before and was not associated with the first cry (psyndrome. This first report of an IR reaction at birth in human infants could open up new paths for improving early neonatal care. Further research is needed for maternal PS, stress hormones, umbilical cord blood pH measurements in IR newborns. The challenge of education and support for parents of IR newborns is outlined. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Weaning newborn infants from mechanical ventilation

    OpenAIRE

    Paolo Biban; Marcella Gaffuri; Stefania Spaggiari; Davide Silvagni; Federico Zaglia; Pierantonio Santuz

    2013-01-01

    Invasive mechanical ventilation is a life-saving procedure which is largely used in neonatal intensive care units, particularly in very premature newborn infants. However, this essential treatment may increase mortality and cause substantial morbidity, including lung or airway injuries, unplanned extubations, adverse hemodynamic effects, analgosedative dependency and severe infectious complications, such as ventilator-associated pneumonia. Therefore, limiting the duration of airway intubation...

  4. Alternatives to hexachlorophene bathing of newborn infants.

    Science.gov (United States)

    Hnatko, S. I.

    1977-01-01

    In controlled trials newborn infants were bathed with Lactacyd, pHisoHex, Hibitane, Lanohex or tap water. Bacteriologic samples were taken from three sites (groin, axilla and cord) immediately after birth, following an initial bath with one of the test agents, and on day 3 or 5 after a water bath. Initial bathing with all agents, including water, reduced the concentration of bacteria on the skin to a similar extent. However, comparisons of bacterial flora at birth versus those on days 3 and 5 indicated differences in the actions of the various agents on pathogenic and nonpathogenic organisms. Lactacyd and Hibitane appeared to be suitable alternatives to hexachlorophene in the control of pathogenic bacteria on the skin of newborns. However, their absorption and toxicity in the newborn are unknown and, unless use of a skin disinfectant is warranted, routine bathing of newborns with tap water appears to be satisfactory. PMID:328126

  5. Respiratory distress of the term newborn infant.

    Science.gov (United States)

    Edwards, Martin O; Kotecha, Sarah J; Kotecha, Sailesh

    2013-03-01

    Respiratory distress is recognised as any signs of breathing difficulties in neonates. In the early neonatal period respiratory distress is common, occurring in up to 7% of newborn infants, resulting in significant numbers of term-born infants being admitted to neonatal units. Many risk factors are involved; the increasing number of term infants delivered by elective caesarean section has also increased the incidence. Additionally the risk decreases with each advancing week of gestation. At 37 weeks, the chances are three times greater than at 39-40 weeks gestation. Multiple conditions can present with features of respiratory distress. Common causes in term newborn infants include transient tachypnoea of the newborn, respiratory distress syndrome, pneumonia, meconium aspiration syndrome, persistent pulmonary hypertension of the neonate and pneumothorax. Early recognition of respiratory distress and initiation of appropriate treatment is important to ensure optimal outcomes. This review will discuss these common causes of respiratory distress in term-born infants. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Hexachlorophene lesions in newborn infants.

    Science.gov (United States)

    Gowdy, J M; Ulsamer, A G

    1976-03-01

    Vacuolization of the white matter of the brain is produced by a number of disease entities and chemicals, including hexachlorophene. Brains of 135 stillborn infants and infants dying in the neonatal period were examined for vacuole formation in the white matter to determine if any hexachlorophene-like lesions could be found. A nonsignificant excess of vaculoes was found in infants bathed in hexachlorophene at birth compared with infants not bathed in it. Analysis of 11 brains for hexachlorophene showed that detectable levels were present in five, all of which showed vacuolization. None was detected in the remaining six, three of which also showed vacuolization. In two of these there was no hexachlorophene exposure.

  7. Pharmacokinetic properties of mezlocillin in newborn infants.

    Science.gov (United States)

    Odio, C; Threlkeld, N; Thomas, M L; McCraken, G H

    1984-05-01

    The pharmacokinetic properties of mezlocillin were evaluated in newborn infants. Mean peak and trough concentrations of drug in plasma, after 75 mg of mezlocillin per kg given intravenously, were 252 and 72 micrograms/ml, respectively, in infants who were less than 38 weeks gestation and less than or equal to 7 days old, compared with 139 and 9 micrograms/ml, respectively, in infants greater than or equal to 38 weeks gestation and greater than 7 days old. The mean elimination half-life values were from 4.5 h in preterm infants who were less than or equal to 7 days old to 1.8 h in term infants greater than or equal to 7 days old. Median peak and trough bactericidal titers of drug in plasma from neonates treated with mezlocillin were 1:8 and 1:4, respectively, against a resistant (minimal bactericidal concentration, 512 micrograms/ml) Escherichia coli strain and 1:64 and 1:32, respectively, against a susceptible (minimal bactericidal concentration, 2 micrograms/ml) E. coli strain. We propose a dosage schedule of 75 mg of mezlocillin per kg administered every 12 h to preterm (gestational age less than 38 weeks) infants less than or equal to 7 days old, every 8 h to preterm infants greater than 7 days old or term infants less than or equal to 7 days old, and every 6 h to term infants greater than 7 days old.

  8. Estimation of gluconeogenesis in newborn infants.

    Science.gov (United States)

    Kalhan, S C; Parimi, P; Van Beek, R; Gilfillan, C; Saker, F; Gruca, L; Sauer, P J

    2001-11-01

    The rate of glucose turnover (R(a)) and gluconeogenesis (GNG) via pyruvate were quantified in seven full-term healthy babies between 24 and 48 h after birth and in twelve low-birth-weight infants on days 3 and 4 by use of [(13)C(6)]glucose and (2)H(2)O. The preterm babies were receiving parenteral alimentation of either glucose or glucose plus amino acid with or without lipids. The contribution of GNG to glucose production was measured by the appearance of (2)H on C-6 of glucose. Glucose R(a) in full-term babies was 30 +/- 1.7 (SD) micromol. kg(-1). min(-1). GNG via pyruvate contributed approximately 31% to glucose R(a). In preterm babies, the contribution of GNG to endogenous glucose R(a) was variable (range 6-60%). The highest contribution was in infants receiving low rates of exogenous glucose infusion. In an additional group of infants of normal and diabetic mothers, lactate turnover and its incorporation into glucose were measured within 4-24 h of birth by use of [(13)C(3)]lactate tracer. The rate of lactate turnover was 38 micromol. kg(-1). min(-1), and lactate C, not corrected for loss of tracer in the tricarboxylic acid cycle, contributed approximately 18% to glucose C. Lactate and glucose kinetics were similar in infants that were small for their gestational age and in normal infants or infants of diabetic mothers. These data show that gluconeogenesis is evident soon after birth in the newborn infant and that, even after a brief fast (5 h), GNG via pyruvate makes a significant contribution to glucose production in healthy full-term infants. These data may have important implications for the nutritional support of the healthy and sick newborn infant.

  9. Newborn infant skin: physiology, development, and care.

    Science.gov (United States)

    Visscher, Marty O; Adam, Ralf; Brink, Susanna; Odio, Mauricio

    2015-01-01

    Infant skin is critical to the newborn child's transition from the womb environment to the journey to self-sufficiency. This review provides an integrative perspective on the skin development in full term and premature infants. There is a particular focus on the role of vernix caseosa and on the implications of skin development for epidermal penetration of exogenous compounds. Healthy full-term newborn skin is well-developed and functional at birth, with a thick epidermis and well-formed stratum corneum (SC) layers. Transepidermal water loss is very low at birth, equal to, or lower than adults, indicating a highly effective skin barrier. Vernix facilitates SC development in full-term infants through a variety of mechanisms including physical protection from amniotic fluid and enzymes, antimicrobial effects, skin surface pH lowering, provision of lipids, and hydration. Premature infants, particularly those of very low birth weight, have a poor skin barrier with few cornified layers and deficient dermal proteins. They are at increased risk for skin damage, increased permeability to exogenous agents and infection. The SC barrier develops rapidly after birth but complete maturation requires weeks to months. The best methods for caring for infant skin, particularly in the diaper region, are described and related to these developmental changes. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Managing hypertension in the newborn infants

    Directory of Open Access Journals (Sweden)

    Azar Nickavar

    2014-01-01

    Full Text Available Hypertension in newborn infants, particularly those requiring intensive care, is becoming increasingly recognized, with prevalence of 0.2-3%. Recent studies have established normative tables for blood pressure (BP in both term and pre-term infants based on the gestational age, postnatal age, gender, weight and height, identifying the neonates at increased risk for early-onset cardiovascular disease. Common causes of neonatal hypertension include thromboembolic complications secondary to umbilical artery catheterization, congenital renal structural malformation, renovascular disease, aortic coarctation, as well as acute kidney injury and certain medications. A careful diagnostic evaluation should lead to identification of the underlying cause of hypertension in most infants. Treatment options should be tailored to the severity; and underlying cause of hypertension, including intravenous and/or oral therapy. This review summarizes recent work in these areas, focusing on optimal BP measurement, definition, evaluation and management of hypertension as well as advances in drug therapy of neonatal hypertension.

  11. Torsade de pointes ventricular tachycardia in a newborn infant.

    Science.gov (United States)

    Finley, J P; Radford, D J; Freedom, R M

    1978-01-01

    A case of paroxysmal ventricular tachycardia of torsade de pointes variety occurring in a newborn infant is described. A rare problem in the newborn, ventricular tachycardia has been associated with congenital heart disease, electrolyte abnormality, and cardiac tumour. In this case, the association was with myocarditis. The arrhythmia was refractory to treatment, and the infant died. Images PMID:646910

  12. Acoustic analysis of newborn infant cry signals.

    Science.gov (United States)

    Fort, A; Manfredi, C

    1998-09-01

    This paper aims at estimating the fundamental frequency (pitch) and the vocal tract resonant frequencies (formants) from newborn infant cry signals. Such parameters are of interest in exploring brain function at early stages of child development, for the timely diagnosis of neonatal disease and malformation. The paper compares a spectral parametric technique and the cepstrum approach, extending previous results. The parametric technique is based on autoregressive models whose order is adaptively estimated on subsequent signal frames by means of a new method. This allows the correct tracking of pitch and formant variations with time. The traditional cepstrum approach is modified in order to follow signal variability. In particular, the cepstrum spectral resolution is improved by applying the chirp Z-transform (CZT) and by adaptively varying the 'lifter' length. The two methods are tested on simulated data, as far as robustness to noise and spectral resolution are concerned, and are then applied to real baby cry data.

  13. Intracranial hemorrhage of the mature newborn infant

    International Nuclear Information System (INIS)

    Takemine, Hisao

    1983-01-01

    Concerning four mature newborn infants with intracranial hemorrhage diagnosed by CT, the labour course, treatment, and prognoses were discussed. Of intracranial hemorrhage, 70.7% was small hemorrhage along the cerebellar tentorium and the falx cerebri, 12.2% subdural hemorrhage in the posterior cranial fossa, and 9.8% subdural hemorrhage in the fornex. Intraventricular or extradural hemorrhage was rarely found. The prognosis is determined by severeness of neurotic symptoms due to cerebral hypoxia. Subdural hemorrhage of the posterior cranial fossa resulted in cerebral palsy in one fifth of the cases, and in slight enlargement of the ventricle in three fifths. Subdural hematoma left porencephaly in one fourth of the patients, but the remaining recovered to normal. (Ueda, J.)

  14. Neuromuscular paralysis for newborn infants receiving mechanical ventilation

    NARCIS (Netherlands)

    Cools, F.; Offringa, M.

    2005-01-01

    BACKGROUND: Ventilated newborn infants breathing in asynchrony with the ventilator are at risk for complications during mechanical ventilation, such as pneumothorax or intraventricular hemorrhage, and are exposed to more severe barotrauma, which consequently could impair their clinical outcome.

  15. FATAL UREAPLASMAL PNEUMONIA AND SEPSIS IN A NEWBORN-INFANT

    NARCIS (Netherlands)

    BRUS, F; VANWAARDE, WM; SCHOOTS, C; OETOMO, SB

    Ureaplasma urealyticum was isolated in pure culture from blood tracheal aspirate and lung tissue in a newborn infant, who died of a severe pneumonia within 48 h after birth. The clinical course was characterized by persistent pulmonary hypertension of the newborn (PPHN). Post-mortem examination

  16. Weaning newborn infants from mechanical ventilation

    Directory of Open Access Journals (Sweden)

    Paolo Biban

    2013-06-01

    Full Text Available Invasive mechanical ventilation is a life-saving procedure which is largely used in neonatal intensive care units, particularly in very premature newborn infants. However, this essential treatment may increase mortality and cause substantial morbidity, including lung or airway injuries, unplanned extubations, adverse hemodynamic effects, analgosedative dependency and severe infectious complications, such as ventilator-associated pneumonia. Therefore, limiting the duration of airway intubation and mechanical ventilator support is crucial for the neonatologist, who should aim to a shorter process of discontinuing mechanical ventilation as well as an earlier appreciation of readiness for spontaneous breathing trials. Unfortunately, there is scarce information about the best ways to perform an effective weaning process in infants undergoing mechanical ventilation, thus in most cases the weaning course is still based upon the individual judgment of the attending clinician. Nonetheless, some evidence indicate that volume targeted ventilation modes are more effective in reducing the duration of mechanical ventilation than traditional pressure limited ventilation modes, particularly in very preterm babies. Weaning and extubation directly from high frequency ventilation could be another option, even though its effectiveness, when compared to switching and subsequent weaning and extubating from conventional ventilation, is yet to be adequately investigated. Some data suggest the use of weaning protocols could reduce the weaning time and duration of mechanical ventilation, but better designed prospective studies are still needed to confirm these preliminary observations. Finally, the implementation of short spontaneous breathing tests in preterm infants has been shown to be beneficial in some centres, favoring an earlier extubation at higher ventilatory settings compared with historical controls, without worsening the extubation failure rate. Further

  17. [Cardiorespiratory arrest in full term newborn infants: six case reports].

    Science.gov (United States)

    Gatti, H; Castel, C; Andrini, P; Durand, P; Carlus, C; Chabernaud, J L; Vial, M; Dehan, M; Boithias, C

    2004-05-01

    Cardiorespiratory arrest occurring within the first two hours of life of a perfectly normal newborn is a very seldom event hitherto unreported. Six infants born after an uneventful pregnancy by normal vaginal delivery, with a normal Apgar score and physical examination, were found with unexpected cardiorespiratory arrest requiring cardiac and respiratory resuscitation early after birth. All were lying in the prone position, their face covered up while facing mother's abdomen, breast or neck. All mothers were primipara. All newborns but one died. Biological and bacteriological samples were normal and early onset neonatal sepsis was ruled out. Autopsy, performed in five infants, was not contributive. We hypothesize that the sudden and unexpected cardiorespiratory arrest occurring in these normal newborns was secondary to acute upper airway obstruction. To prevent this life threatening post-natal asphyxic episode, it is essential to ensure that the face of a newborn lying down upon mother's breast and abdomen is properly and continuously cleared.

  18. Neutropenia in infants with hemolytic disease of the newborn.

    Science.gov (United States)

    Blanco, Esther; Johnston, Donna L

    2012-06-01

    This study examined the incidence, outcome and risk factors of neutropenia in infants with hemolytic disease of the newborn (HDN). A retrospective chart review was performed on infants with HDN. Of 69 evaluable infants, 45% developed neutropenia. Only one infectious complication was recorded. In most instances the neutropenia resolved spontaneously, but in seven infants it persisted for a median of 397 days. Males were at higher risk for developing neutropenia, but severity of HDN, antibody specificity, or therapy were not significant risk factors. Neutropenia is a common feature of HDN, regardless of severity of disease, treatment received, or antibody specificity. Copyright © 2011 Wiley Periodicals, Inc.

  19. Water and heat--the priority for the newborn infant.

    Science.gov (United States)

    Sedin, Gunnar; Agren, Johan

    2006-01-01

    Maintaining fluid and heat balance is of vital importance to the newborn infant. At birth, the infant is exposed to a cold and dry environment, and preterm neonates in particular, are then at risk of dehydration and hypothermia. These conditions may have serious consequences and significantly influence mortality and morbidity. Preterm neonates have a high rate of water and heat loss mainly as a consequence of their immature skin. The care environment influences the magnitude of water and heat exchange and needs to be individually tailored on the basis of the infant's clinical status, maturity at birth and postnatal age. This paper reviews data obtained from series of studies on neonatal water and heat exchange using non-invasive measurements of insensible water loss and calculations of different modes of heat exchange. These studies have influenced the way in which newborn infants are being nursed today.

  20. Effect of tilting on oxygenation in newborn infants.

    Science.gov (United States)

    Thoresen, M; Cowan, F; Whitelaw, A

    1988-01-01

    Transcutaneous (tc) PO2 in newborn infants increased on head up tilting (median increase 0.5 kPa at term, 1.0 kPa preterm). Head down tilting was associated with an equivalent fall in tcPO2. There was no change in tcPCO2. Tilting of infants mechanically ventilated for respiratory distress syndrome or surgery produced no consistent change in PO2. PMID:3128187

  1. Hexachlorophene emulsions and antiseptic skin care of newborn infants.

    Science.gov (United States)

    Plueckhahn, V D; Collins, R B

    1976-05-29

    This paper reviews 81,756 live births and 858 infant deaths occurring during the years 1959 to 1969. Sixty-three instances of central nervous system vacuolation are reported. Prematurity is shown to be a necessary prerequisite for central nervous system vacuolation to occur during routine antiseptic skin care of newborn infants with 3% hexachlorophene emulsions. Hyperbilirubinaemia is a contributory factor in such premature infants. Long-term clinical follow-up studies show that, should central nervous system vacuolation occur in premature infants, there is no resultant detriment to their immediate clinical progress and physical and neurological development. Normal newborn infants weighing more than 2,000 g do not develop such central nervous system vacuolation during routine antiseptic skin care. The writers conclude that there is no rationale for regulations to restrict the use of 3% hexachlorophene emulsions in routine antiseptic skin care of normal newborn infants and that the benefits of such use far outweigh any possible risks from central nervous system vacuolation.

  2. The Profile Of Congenital Malformation Among Newborn Infants In ...

    African Journals Online (AJOL)

    Objective: The study pattern of congenital malformations (CM) among newborn infants in Calabar, South-south Nigeria. Patients and Methods: Medical records of all inborn and out-born neonates who were admitted and treated for CM in University of Calabar teaching Hospital (UCTH) from 1997 to 2006 (10 years) were ...

  3. Automated respiratory support in newborn infants.

    Science.gov (United States)

    Claure, Nelson; Bancalari, Eduardo

    2009-02-01

    A considerable proportion of premature infants requires mechanical ventilatory support and supplemental oxygen. Due to their immaturity, exposure to these forms of respiratory support contributes to the development of lung injury, oxidative stress and abnormal retinal development. These conditions are associated with poor long-term respiratory and neurological outcome. Mechanically ventilated preterm infants present with frequent fluctuations in ventilation and gas exchange. Currently available ventilatory modes and manual adjustment to the ventilator or supplemental oxygen cannot effectively adapt to these recurrent fluctuations. Moreover, the respiratory support often exceeds the infant's real needs. Techniques that adapt the mechanical ventilatory support and supplemental oxygen to the changing needs of preterm infants are being developed in order to improve stability of gas exchange, to minimise respiratory support and to reduce personnel workload. This article describes the preliminary evidence on the application of these new techniques in preterm infants and animal models.

  4. Management of Newborn Infants with Phenylketonuria.

    Science.gov (United States)

    Health Services Administration (DHEW/PHS), Rockville, MD. Bureau of Community Health Services.

    The booklet covers the identification, diagnosis, and clinical treatment of newborns with Phenylketonuria (PKU), an inborn error of metabolism, which, if untreated, can lead to mental retardation. An initial section considers biochemical and genetic factors of PKU including a diagram of aromatic amino acid hydroxylation systems. Screening…

  5. Lingual frenulum and effect on breastfeeding in Thai newborn infants.

    Science.gov (United States)

    Ngerncham, Sopapan; Laohapensang, Mongkol; Wongvisutdhi, Thidaratana; Ritjaroen, Yupin; Painpichan, Nipa; Hakularb, Pussara; Gunnaleka, Panidaporn; Chaturapitphothong, Penpaween

    2013-05-01

    Breastfeeding has abundant biological and psychological benefits. Effective breastfeeding requires good latching on, which is possible when the infant is able to cup around the maternal areola with his tongue. One of the most common conditions resulting in poor latching on is tongue-tie. To determine the prevalence of tongue-tie with subsequent breastfeeding difficulties and other factors affecting the success of breastfeeding in newborn infants. This was a prospective, cross-sectional study of healthy Thai infants without contraindications for breastfeeding. Physical examination of the infants and mothers and their breastfeeding practices were assessed between 24 and 48 hours of life. 2679 mother-infant dyads were recruited. The study detected a prevalence of 16% for severe tongue-tie, 37.9% of which was associated with breastfeeding difficulties. Using multiple logistic regression analysis, moderate (adjusted OR 13.3, 95% CI 7.2-24.5) and severe (adjusted OR 62, 95% CI 34.1-112.8) tongue-tie, short nipples (adjusted OR 1.5, 95% CI 1.1-2.2), mothers feeling the infant's tongue on the nipple area (adjusted OR 3.4, 95% CI 2.2-5.2) and mothers' inability to feel the infant's tongue (adjusted OR 11.8, 95% CI 4.3-32.4) independently increased the risk of breastfeeding difficulties. Tongue-tie is not uncommon and is associated with breastfeeding difficulty in newborn infants. Mothers of infants with severe tongue-tie should be closely and individually coached during breastfeeding and followed up, especially during the first critical weeks of the infant's life.

  6. Estimation of gluconeogenesis in newborn infants

    NARCIS (Netherlands)

    Kalhan, SC; Parimi, P; Van Beek, R; Gilfillan, C; Saker, F; Gruca, L; Sauer, P.J.J.

    2001-01-01

    The rate of glucose turnover (R-a) and gluconeogenesis (GNG) via pyruvate were quantified in seven full-term healthy babies between 24 and 48 h after birth and in twelve low-birth-weight infants on days 3 and 4 by use of [C-13(6)]glucose and (H2O)-H-2. The preterm babies were receiving parenteral

  7. Newborn infants detect the beat in music

    NARCIS (Netherlands)

    Winkler, I.; Háden, G.P.; Ladinig, O.; Sziller, I.; Honing, H.

    2009-01-01

    To shed light on how humans can learn to understand music, we need to discover what the perceptual capabilities with which infants are born. Beat induction, the detection of a regular pulse in an auditory signal, is considered a fundamental human trait that, arguably, played a decisive role in the

  8. Resuscitation of the Asphyxiated Newborn Infant

    African Journals Online (AJOL)

    1974-10-19

    Oct 19, 1974 ... tration of alkali, before respiration is establi bed. These two groups correspond roughly to the primary and secon- dary apnoea in experimental animals.' .... tion or palpation of the base of the umbilicus. Once the infant is breathing spontaneously, the tube may be removed. 9. If, after 3 - 5 minutes of positive ...

  9. Neuromuscular paralysis for newborn infants receiving mechanical ventilation.

    Science.gov (United States)

    Cools, F; Offringa, M

    2005-04-18

    Ventilated newborn infants breathing in asynchrony with the ventilator are at risk for complications during mechanical ventilation, such as pneumothorax or intraventricular hemorrhage, and are exposed to more severe barotrauma, which consequently could impair their clinical outcome. Neuromuscular paralysis, which eliminates spontaneous breathing efforts of the infant, has potential advantages in this respect. However, a number of complications have been reported with muscle relaxation in infants, so that concerns exist regarding the safety of prolonged neuromuscular paralysis in newborn infants. To determine whether routine neuromuscular paralysis of newborn infants receiving mechanical ventilation compared with no routine paralysis results in clinically important benefits or harms. The Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1, 2004), MEDLINE (from 1966 to April 2004) and EMBASE (from 1988 to April 2004) were searched. References of review articles were hand searched. Language restriction was not imposed. All trials using random or quasi-random patient allocation, in which the routine use of neuromuscular blocking agents during mechanical ventilation was compared to no paralysis or selective paralysis in newborn infants. Methodological quality was assessed blindly and independently by the two authors. Data were abstracted using standard methods of the Cochrane Collaboration and its Neonatal Review Group, with independent evaluation of trial quality, and abstraction and synthesis of data by both authors. Treatment effect was analysed using relative risk, risk difference and weighted mean difference. Ten possibly eligible trials were identified, of which six were included in the review. All the included trials studied preterm infants ventilated for respiratory distress syndrome, and used pancuronium as the neuromuscular blocking agent. In the analysis of the results of all trials, no significant difference was found in

  10. Positive pressure ventilation and cranial volume in newborn infants.

    OpenAIRE

    Milligan, D W

    1981-01-01

    The relationship between changes in airways pressure, pleural pressure, and cranial volume was studied in a group of sick newborn infants requiring ventilatory assistance. Cranial volume increased appreciably only when lung compliance was such that more than 20% of the applied airways pressure was transmitted to the pleural space, or if the absolute pleural pressure was greater than 4 cmH2O above atmospheric pressure. The findings stress the need for more-critical monitoring during periods of...

  11. Aortic mass in a newborn infant with respiratory distress

    Directory of Open Access Journals (Sweden)

    Michelle J. Vaz

    2017-10-01

    Full Text Available Thrombotic disease is rare in neonates. Many of the cases reported in literature are attributed to the placement of central catheters. We report on a case of aortic thrombosis in a newborn infant with significant respiratory distress due to meconium aspiration, necessitating intubation and placement of central catheters. Due to the location and size of the thrombus in our case, various subspecialties were involved, which ultimately guided therapy to anti-coagulate the patient.

  12. [Aftercare of newborn infants in a patient hotel].

    Science.gov (United States)

    Lindgren, C

    2000-05-10

    Postnatal care of the healthy term newborn and the mother has, in modern times, taken place in the hospital setting. As a result of tightened hospital budgets as well as maternal preferences the duration of hospital stay has successively been shortened. Most women in Scandinavia today leave the hospital within four days after delivery. Postnatal care in a hotel like setting has emerged as an alternative to the well-baby nursery unless medical conditions makes this option inappropriate. To evaluate the safety of postnatal care a study was undertaken to investigate whether correct criteria were being used for referral of the newborn to the hotel. We also wanted to document the duration of stay, unexpected medical complications, and weight development of the infants. Data from 865 infants were used for analysis. Ten (1.1%) newborns had to be readmitted to the hospital due to medical complications. 488 (56%) of the mothers went home within 96 hours, and only 23 (2.6%) stayed more than 120 hours. The weight of the infants reached a nadir on the fourth day post partum (-5.2% of birth weight). The patient hotel is a medically safe alternative to the traditional well-baby nursery, provided that appropriate criteria for referral are used.

  13. [Neonatal polysomnography in newborn infants with severe birth asphyxia].

    Science.gov (United States)

    Hernández-Duarte, A M; Domínguez-Dieppa, F; Roca-Molina, M C

    Neonatal polysomnography studies (electroencephalogram, electrooculography, body movements, cardiorespiratory frequencies) were performed in 101 newborn full-term infants diagnosed with severe birth asphyxia. To analyse results, the sample was divided into two groups, depending on whether hypoxic-ischaemic encephalopathy (HIE) had occurred or not. The results of the polysomnography studies were correlated with those from the full-term neurological examination and the sequelae from the neurological development during the first two years of life. Significant correlations were obtained among the variables that were studied. The normality observed in the electrophysiological study in the group of patients with severe asphyxia without HIE was associated with a full-term neurological examination and with a neurological development that has progressed in a satisfactory manner. In the group of patients with grade II HIE there was a predominance of severe alterations in the full-term neonatal polysomnography study, which were significantly correlated with the pathological full-term neurological examinations and serious sequelae from neurological development. It has been proved that neonatal polysomnography studies are a valuable aid in evaluating the neurological status of newborn infants in a critical condition and in predicting the sequelae of neurological development in the first two years of life. Further research should be aimed at determining the effects exerted by the daily administration of medication (sedatives, anaesthetics and antiepileptic agents) in critical newborn infants on electrical activity in the brain and the cyclic structuring of the different phases of sleep.

  14. [Eruptive pseudoangiomatosis in infant and newborns].

    Science.gov (United States)

    Guillot, B; Chraibi, H; Girard, C; Dereure, O; Lalande, M; Bessis, D

    2005-12-01

    Eruptive pseudoangiomatosis was first described in children in the form of an acute non-pruritic macular or papular rash that fades on application of a glass test and resolves within several days. Viral aetiology is suspected but has never been demonstrated to date. We discuss seven cases of infants presenting this disease: 5 boys and 2 girls aged 8 days to 16 months. The rash presented typical clinical features in all cases and affected the face and limbs in 6 of the 7 subjects. In one child, involvement of the face and back was observed with sparing of the limbs. The rash occurred after an episode of rhinolaryngeal infection in 3 cases and after gastrointestinal infection in 1 case. Spontaneous resolution was seen within 3 to 10 days in 6 patients although a longer course lasting over 9 months was observed in one infant. In another patient, the rash appeared after surgery for mesoblastic nephroma. In one child, a similar rash was seen in both parents. Screening for infectious agents was negative for the two children from whom samples were obtained. This series of paediatric cases of eruptive pseudoangiomatosis is characterised by the very young age of one of the children, coexistence of the condition with a renal tumour in another child, the familial nature of the rash in a third child and unusually long disease duration in the final child. However, this series did not allow identification of the causative infectious agent or agents. Probably, as with other syndromes such as Giannotti-Crosti syndrome or "gloves and socks" syndrome, eruptive pseudoangiomatosis forms a clinical picture common to a non-specific viral infection.

  15. Maternal lactation for preterm newborn infants.

    Science.gov (United States)

    Aguayo, J

    2001-11-01

    In recent decades, neonatologists have made considerable progress in life support techniques, especially in the treatment and prevention of respiratory disorders, which has led to a higher neonatal survival rate. Research into neonatal nutrition has also produced great benefits. It has been found that one of the key points regarding the improved survival rate of infants is the necessity for nutrition that is both adequate and as natural as possible. In this respect, it is necessary to achieve a better understanding of the process, protection, support and maintenance of maternal lactation in neonatal units. Humanization of perinatal attention during delivery, respect for the rights of parents and their children, protection of the mother and child bonding process, early skin contact with the mother and greater attention to individualized care are all key factors in the reinforcement of maternal lactation and are issues that must be addressed within the field of neonatology. Research activities need to concern themselves with: (1) acquiring greater knowledge concerning the common problems and difficulties that arise with mothers and their preterm babies; (2) training healthcare professionals in these aspects, for example in the extraction and storage of milk and in improving techniques of emotional and communicational skills; (3) by means of specific programmes such as the setting up of support groups, so that the effort made to encourage the initiation of breastfeeding is justified by its continuation for as long as possible. Thus, we hope to establish standards of care based on starting, encouraging and prolonging maternal lactation, in sufficient quantity and quality, always remembering that the fundamental goal of our research is the well-being of the child and its family.

  16. Obstetric Antecedents to Body Cooling Treatment of the Newborn Infant

    Science.gov (United States)

    Nelson, David B.; Lucke, Ashley M.; McIntire, Donald D.; Sánchez, Pablo J.; Leveno, Kenneth J.; Chalak, Lina F.

    2014-01-01

    Objective Obstetric antecedents were analyzed in births where the infant received whole-body cooling for neonatal encephalopathy. Methods This retrospective cohort study included all live-born singleton infants delivered at or beyond 36 weeks gestation from October 2005 through December 2011. Infants who had received whole-body cooling identified by review of a prospective neonatal registry were compared to a control group comprising the remaining obstetric population delivered at greater than 36 weeks but not cooled. Univariable analysis was followed by a staged, stepwise selection of variables with the intent to rank significant risk factors for cooling. Results A total of 86,371 women delivered during the study period and 98 infants received whole-body cooling (1.1/1,000 livebirths). Of these 98 infants, 80 (88%) newborns had moderate encephalopathy and 10 (12%) had severe encephalopathy prior to cooling. Maternal age less than or equal to 15 years, low parity, maternal body habitus (BMI ≥ 40 kg/m2), diabetes, preeclampsia, induction, epidural analgesia, chorioamnionitis, length of labor, and mode of delivery were associated with significantly increased risk of infant cooling during univariable analysis. Catastrophic events to include umbilical cord prolapse (OR 14; 95%CI, 3–72), placental abruption (OR 17; 95%CI, 7–44), uterine rupture (OR 130; 95%CI, 11–1477) were the strongest factors associated with infant cooling after staged-stepwise logistic analysis. Conclusion A variety of intrapartum characteristics were associated with infant cooling for neonatal encephalopathy with the most powerful antecedents being umbilical cord prolapse, placental abruption, and uterine rupture. PMID:24530976

  17. Ventilatory response of the newborn infant to mild hypoxia.

    Science.gov (United States)

    Cohen, G; Malcolm, G; Henderson-Smart, D

    1997-09-01

    The transition from an immature (biphasic) to a mature (sustained hyperpneic) response to a brief period of sustained hypoxia is believed to be well advanced by postnatal day 10 for newborn infants. However, a review of the supporting evidence convinced us that this issue warranted further, more systematic investigation. Seven healthy term infants aged 2 days to 8 weeks were studied. The ventilatory response (VR) elicited by 5 min breathing of 15% O2 was measured during quiet sleep. Arterial SaO2 (pulse oximeter) and minute ventilation (expressed as a change from control, delta V'i) were measured continuously. Infants were wrapped in their usual bedding and slept in open cots at room temperature (23 degrees-25 degrees). Infants aged 2-3 days exhibited predominantely a sustained hypopnea during the period of hypoxia (delta V'i = -2% at 1 min, -13% at 5 min). At 8 weeks of age, the mean response was typically biphasic (delta V'i = +9% at 1 min, -4% at 5 min). This age-related difference between responses was statistically significant (two-way ANOVA by time and age-group; interaction P < 0.05). These data reveal that term infants studied under ambient conditions during defined quiet sleep may exhibit an immature VR to mild, sustained hypoxia for at least 2 months after birth. This suggests that postnatal development of the O2 chemoreflex is slower than previously thought.

  18. [Is moderate labor stress for newborn infants an advantage? Pilot study of postpartum weight gain of 791 newborn infants].

    Science.gov (United States)

    Wenderlein, J M; Ritz-Schäfer, R

    1994-01-01

    Neonatal weight development in the first 5 postpartal days is favourably affected by intrapartal stress factors. 1. Pathological CTS during delivery were registered for every 8th infant. Slight postpartal weight loss occurred twice as often in this group, compared with the other newborns. The incidence of distinct weight decrease was the same in both groups. On the 5th postpartal day, almost double the number of infants with pathological CTG had either reached or exceeded their birth weight, compared to the normal CTG group. 2. Green amniotic fluid coincided with slight weight loss in double the number of affected children, compared to the rest of the study group. 3. Slight postpartal weight loss was seen more often in neonates with umbilical cord-pH values of up to 7.20 than in infants with pH values exceeding 7.20. Distinct postpartal weight loss was, however, not more frequent in the former group. 4. The birth mode of the 791 newborn was as follows: 16% Caesarean section, 7% vaginal forceps delivery, and 77% spontaneous birth. On the 5th postpartal day 11% of the forceps-delivery infants, 17% of the spontaneous births and 30% of the neonates delivered by Caesarean section had not regained their birth weight. 5. PDA on vaginal delivery was applied to one-third of the women. Slight postpartal weight loss was seen twice as often in these infants, compared to the others. In conclusion, the study reflected, that intrapartal stress aids transition to extrauterine life via "catecholamine peaks". Our current birth monitoring methods may therefore require revalidation with regard to set pathologic limits, using the adaptation parameter of neonatal weight development.

  19. Dosimetry of iodine-123 for newborn and infant

    International Nuclear Information System (INIS)

    Guilhem, M.T.; Therain, F.

    1987-01-01

    Iodine-123 ( 123 I) is a radionuclide of choice of neonatal hypothyroidism diagnosis. It is important to know infant main organs adsorbed doses during a thyroid scan with 123 I. Absorbed doses are already available for adults: for infants, they must be transformed taking account of organs sizes and inter-organs distances. Calculations are done for commercially available 123 I(p,2n) and 123 I(p,5n). Important contamination of 124 I in 123 I(p,2n) increases considerably the absorbed-dose during thyroid scan of a newborn (the ratio 124 I/ 123 I doubles every 15h). For routinely used activities, thyroid absorbed dose, 24 h after end of production, is fifteen times higher with 123 I(p,5n) than with 99m Tc: for one month old child; total body absorbed dose is of the same order of magnitude [fr

  20. Hepatitis B immunisation for newborn infants of hepatitis B surface antigen-positive mothers

    DEFF Research Database (Denmark)

    Lee, C; Gong, Yanzhang; Brok, J

    2006-01-01

    Hepatitis B vaccine and hepatitis B immunoglobulin are considered for newborn infants of HBsAg-positive mothers to prevent hepatitis B infection.......Hepatitis B vaccine and hepatitis B immunoglobulin are considered for newborn infants of HBsAg-positive mothers to prevent hepatitis B infection....

  1. Effect of hepatitis B immunisation in newborn infants of mothers positive for hepatitis B surface antigen

    DEFF Research Database (Denmark)

    Lee, Chuanfang; Gong, Yan; Brok, Jesper

    2006-01-01

    To evaluate the effects of hepatitis B vaccine and immunoglobulin in newborn infants of mothers positive for hepatitis B surface antigen.......To evaluate the effects of hepatitis B vaccine and immunoglobulin in newborn infants of mothers positive for hepatitis B surface antigen....

  2. Screening for congenital hypothyroidism (CH) among Filipino newborn infants. Philippine Newborn Screening Study Group.

    Science.gov (United States)

    Fagela-Domingo, C; Padilla, C D; Cutiongco, E M

    1999-01-01

    From June 1996 to June 1998 a total of 62.841 newborn infants were screened for congenital hypothyroidism with thyroid stimulating hormone assay as a primary test. The method used was an immunofluorescent assay using the DELFIA TSH Kit on dried blood specimens collected by heelprick on filter paper. All infants with TSH values greater than 20 microU/ml were retested. If the results remained abnormally high, confirmatory testing was done by radioimmunoassay. All infants who were confirmed to be hypothyroid were referred to pediatric endocrinologists for initial management. The overall weighted incidence of congenital hypothyroidism obtained in this study was 0.000277 (95% CI; 0.000122 - 0.000432) or 1:3,610 which may be higher than that reported by most screening programs worldwide. The recall rate was 0.16%. The higher recall rate may be explained by early testing in a number of cases and by the possibility of iodine deficiency in some of the mothers. On the basis of the results of this study, we would recommend (1) screening on a greater number of infants to verify the incidence of CH and (2) establishing normal TSH values at different hours of life to improve our recall rate.

  3. Neural breathing pattern in newborn infants pre- and postextubation.

    Science.gov (United States)

    Iyer, Narayan P; Dickson, John; Ruiz, Michelle E; Chatburn, Robert; Beck, Jennifer; Sinderby, Chister; Rodriguez, Ricardo J

    2017-12-01

    To describe the neural breathing pattern before and after extubation in newborn infants. Prospective, observational study. In infants deemed ready for extubation, the diaphragm electrical activity (EAdi) was continuously recorded from 30 minute before to two hours after extubation. Total of 25 neonates underwent 29 extubations; 10 extubations resulted in re-intubation within 72 hours. Postextubation, there was an increase in peak EAdi (EAdi-max) and EAdi-delta (peak minus minimum EAdi) in both groups. The pre- to postextubation change in EAdi-max (8.9-11.1 μv) and EAdi-delta (6-8 μv) was less in the failure group in comparison with the change in EAdi-max (10.2-13.4 μv) and EAdi-delta (6.3-10.6 μv) in the success group, (p = 0.02 and 0.01, respectively). In our neonatal cohort, extubation failure was associated with a smaller increase in peak and delta EAdi after extubation. If confirmed, these findings indicate an important cause of extubation failure in preterm infants. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  4. Vertically transmitted cytomegalovirus infection in newborn preterm infants.

    Science.gov (United States)

    Balcells, Carla; Botet, Francesc; Gayete, Sònia; Marcos, M Ángeles; Dorronsoro, Izaskun; de Alba, Concepción; Figueras-Aloy, Josep

    2016-07-01

    To determine the epidemiology of congenital and acquired cytomegalovirus (CMV) infections in preterm infants and to analyze the efficacy of breast milk freezing in decreasing the vertical transmission rate of CMV. During 2013 and 2014, preterm newborns who weighed ≤1500 g and were admitted to 22 Spanish neonatal units were included and screened for CMV infection according to the Spanish Neonatology Society recommendations. Each hospital treated the breast milk according to its own protocols. Among the 1236 preterm neonates included, 10 had a congenital infection (0.8%) and 49 had an acquired infection (4.0%) (82% demonstrated positive PCR-CMV in breast milk). The neonates who received only frozen milk presented less frequently with acquired infection (1.2%) than those fed fresh milk (5.5%) (RR=0.22; 95% CI 0.05-0.90; P=0.017). The newborns who received bank milk followed by frozen or fresh breast milk more frequently had an acquired infection (2.1% or 2.2%, respectively) than those fed only frozen breast milk. The incidence of congenital CMV infection in our sample is low, as described in the literature. To reduce acquired CMV infection, freezing breast milk might be an advisable procedure for preterm neonates born from seropositive mothers, either from the beginning of lactation or after a period of bank milk administration.

  5. Processing of Horizontal Sound Localization Cues in Newborn Infants.

    Science.gov (United States)

    Németh, Renáta; Háden, Gábor P; Török, Miklós; Winkler, István

    2015-01-01

    By measuring event-related brain potentials (ERPs), the authors tested the sensitivity of the newborn auditory cortex to sound lateralization and to the most common cues of horizontal sound localization. Sixty-eight healthy full-term newborn infants were presented with auditory oddball sequences composed of frequent and rare noise segments in four experimental conditions. The authors tested in them the detection of deviations in the primary cues of sound lateralization (interaural time and level difference) and in actual sound source location (free-field and monaural sound presentation). ERP correlates of deviance detection were measured in two time windows. Deviations in both primary sound localization cues and the ear of stimulation elicited a significant ERP difference in the early (90 to 140 msec) time window. Deviance in actual sound source location (the free-field condition) elicited a significant response in the late (290 to 340 msec) time window. The early differential response may indicate the detection of a change in the respective auditory features. The authors suggest that the late differential response, which was only elicited by actual sound source location deviation, reflects the detection of location deviance integrating the various cues of sound source location. Although the results suggest that all of the tested binaural cues are processed by the neonatal auditory cortex, utilizing the cues for locating sound sources of these cues may require maturation and learning.

  6. Psychological and neurodevelopmental outcome of high risk newborn infants.

    Science.gov (United States)

    Calame, A; Reymond-Goni, I; Maherzi, M; Roulet, M; Marchand, C; Prod'hom, L S

    1976-12-01

    Among 142 high-risk-newborns, 111 could be regularly followed-up to 3 years of age. 79 (71%) are normal, 6 (5.5%) have minor neurological sequels, 9 (8.1%) have major neurological sequels, associated in 4 cases with mental deficiency, 16 (14.5%) have developmental abnormalities (speech delay, behavioral problems, perceptual-motor and praxis disturbances), and one mental deficiency without neurological sequels. Neonatal cerebral distress proved to be the most dangerous clinical situation with regard to the ultimate neurodevelopmental prognosis (73.6% of neurological sequels or developmental abnormalities). The presence of transient abnormalities of tone in the course of the first year of life was associated with ultimate developmental abnormalities in 33.3% of the cases. Social and cultural status seemed to play a role in the intellectual, linguistic and perceptual-motor performance of this group of infants. In spite of these encouraging results, the need for a systematic long term follow-up of high risk newborns is stressed, since neurological sequels and developmental abnormalities are approximately 4 times more frequent in this group than in a normal infantile population.

  7. Physical therapy with newborns and infants: applying concepts of phenomenology and synactive theory to guide interventions.

    Science.gov (United States)

    Blanchard, Yvette; Øberg, Gunn Kristin

    2015-01-01

    Physical therapy involving newborns and young infants is a specialized area of practice reserved for therapists who have advanced training and the competence to help newborns, young infants and their families meet their goals. Beginning at birth, infants apply a significant amount of effort to actively participate in and shape their world. Infants make their intentions and requests for support known through their behaviors during social and physical therapy encounters. The therapeutic encounter viewed from the infant's perspective has received limited attention in the physical therapy literature. The purpose of this article is to discuss concepts related to phenomenology and synactive theory that are relevant to physical therapy with newborns and young infants during the first few months of life after birth.

  8. The Effects of Prenatal Cocaine Exposure on Mother-Infant Interaction and Infant Arousal in the Newborn Period.

    Science.gov (United States)

    Gottwald, Sheryl Ridener; Thurman, S. Kenneth

    1994-01-01

    This study compared the interactive behavior of 20 cocaine-using mothers and their neonates with a control group of drug-free mothers and newborns. Cocaine-exposed infants were asleep or distressed for significantly longer periods, and cocaine-using mothers spent significantly more time disengaged from, and passively looking at, infants than did…

  9. Effect of preeclampsia in the mother on the leucine metabolism in the newborn infant.

    NARCIS (Netherlands)

    Saenz De Pipaon Marcos, M.; Wattimena, D.J.; Beek, R.H. van; Lotgering, F.K.; Sauer, P.J.J.

    2002-01-01

    The leucine turnover in newborn infants is influenced by factors such as nutritional state and corticosteroid treatment. Little is known about maternal factors influencing the leucine turnover in the newborn. In order to approach the effect of preeclampsia in the mother on neonatal protein turnover,

  10. Effect of preeclampsia in the mother on the leucine metabolism in the newborn infant

    NARCIS (Netherlands)

    Marcos, MSD; Wattimena, DJL; Van Beek, RHT; Lotgering, FK; Sauer, PJJ

    2002-01-01

    The leucine turnover in newborn infants is influenced by factors such as nutritional state and corticosteroid treatment. Little is known about maternal factors influencing the leucine turnover in the newborn. In order to approach the effect of preeclampsia in the mother on neonatal protein turnover,

  11. Neurobehaviors of Japanese Newborns in Relation to the Characteristics of Early Mother-Infant Interaction

    Science.gov (United States)

    Loo, Kek Khee; Ohgi, Shohei; Howard, Judy; Tyler, Rachelle; Hirose, Taiko

    2005-01-01

    The authors examined the relationship between newborn neurobehavioral profiles and the characteristics of early mother-infant interaction in Nagasaki, Japan. The authors administered the Brazelton Neonatal Behavioral Assessment Scale (NBAS; T. B. Brazelton & J. K. Nugent, 1995) in the newborn period and the Nursing Child Assessment Teaching…

  12. Frenotomy for tongue-tie in newborn infants.

    Science.gov (United States)

    O'Shea, Joyce E; Foster, Jann P; O'Donnell, Colm Pf; Breathnach, Deirdre; Jacobs, Susan E; Todd, David A; Davis, Peter G

    2017-03-11

    Tongue-tie, or ankyloglossia, is a condition whereby the lingual frenulum attaches near the tip of the tongue and may be short, tight and thick. Tongue-tie is present in 4% to 11% of newborns. Tongue-tie has been cited as a cause of poor breastfeeding and maternal nipple pain. Frenotomy, which is commonly performed, may correct the restriction to tongue movement and allow more effective breastfeeding with less maternal nipple pain. To determine whether frenotomy is safe and effective in improving ability to feed orally among infants younger than three months of age with tongue-tie (and problems feeding).Also, to perform subgroup analysis to determine the following.• Severity of tongue-tie before frenotomy as measured by a validated tool (e.g. Hazelbaker Assessment Tool for Lingual Frenulum Function (ATLFF) scores frenotomy (≤ 10 days of age; > 10 days to three months of age).• Severity of feeding difficulty (infants with feeding difficulty affecting weight gain (as assessed by infant's not regaining birth weight by day 14 or falling off centiles); infants with symptomatic feeding difficulty but thriving (greater than birth weight by day 14 and tracking centiles). We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase and CINAHL up to January 2017, as well as previous reviews including cross-references, expert informants and journal handsearching. We searched clinical trials databases for ongoing and recently completed trials. We applied no language restrictions. Randomised, quasi-randomised controlled trials or cluster-randomised trials that compared frenotomy versus no frenotomy or frenotomy versus sham procedure in newborn infants. Review authors extracted from the reports of clinical trials data regarding clinical outcomes including infant feeding, maternal nipple pain, duration of breastfeeding, cessation of breastfeeding, infant pain, excessive bleeding, infection at the site of frenotomy, ulceration at the site of

  13. Lung lavage for meconium aspiration syndrome in newborn infants.

    Science.gov (United States)

    Hahn, Seokyung; Choi, Hyun Jin; Soll, Roger; Dargaville, Peter A

    2013-04-30

    Meconium aspiration syndrome (MAS) can occur when a newborn infant inhales a mixture of meconium and amniotic fluid into the lungs around the time of delivery. Other than supportive measures, little effective therapy is available. Lung lavage may be a potentially effective treatment for MAS by virtue of removing meconium from the airspaces and altering the natural course of the disease. To evaluate the effects of lung lavage on morbidity and mortality in newborn infants with MAS. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), MEDLINE, and EMBASE up to December 2012; previous reviews including cross-references, abstracts, and conference proceedings; and expert informants. We contacted authors directly to obtain additional data. We used the following subject headings and text words: meconium aspiration, pulmonary surfactants, fluorocarbons, bronchoalveolar lavage, lung lavage, pulmonary lavage. Randomised controlled trials that evaluated the effects of lung lavage in infants with MAS, including those intubated for the purpose of lavage. Lung lavage was defined as any intervention in which fluid is instilled into the lung that is followed by an attempt to remove it by suctioning and/or postural drainage. The review authors extracted from the reports of the clinical trial, data regarding clinical outcomes, including mortality, requirement for extracorporeal membrane oxygenation (ECMO), pneumothorax, duration of mechanical ventilation and oxygen therapy, length of hospital stay, indices of pulmonary function, and adverse effects of lavage. Data analysis was done in accordance with the standards of the Cochrane Neonatal Review Group. Only four small randomised controlled trials fulfilled the selection criteria. For one of these trials, no data are available for the control group. Two studies compared lavage using diluted surfactant with standard care. Meta-analysis of these two studies did not show a significant effect on

  14. Evaluations of diapers containing absorbent gelling material with conventional disposable diapers in newborn infants.

    Science.gov (United States)

    Lane, A T; Rehder, P A; Helm, K

    1990-03-01

    We evaluated 149 infants diapered in either conventional cellulose core disposable diapers or diapers containing cellulose core with absorbent gelling material. The infants were evaluated from 1 day of age to 14 weeks of age for the prevalence and severity of diaper dermatitis. We identified a low prevalence of diaper dermatitis throughout the study period. At 14 weeks of age, we noted that infants in diapers containing absorbent gelling material had significantly less diaper dermatitis than those in conventional disposable diapers. Despite the overall low prevalence of diaper dermatitis in the newborn period, 7 of 204 infants evaluated had small skin erosions in the diaper area noted within the first 4 days of age. Both diaper types were associated with infants with erosions. This surprisingly high incidence of erosions in newborn infants suggests previously undocumented increased skin fragility of full-term infants.

  15. [Toxoplasmosis investigation of pregnant women and newborn infants (author's transl)].

    Science.gov (United States)

    Thalhammer, O

    1975-10-31

    In the serological screening of pregnant women for the prevention of congenital toxoplasmosis a positive test with low titre in the first trimester indicates almost with certainty a preconceptional infection. The probability that such a result derives from a very recent maternal infection leading to fetal infection is about 5 in 39,000. In view of the very high extra expenses involved and the unnecessary anxiety induced in many thousands of pregnant women and the sparse results the serological control of women showing positive tests with low or medium titre in the first trimester is not recommendable. There is no indication that preconceptional toxoplasma infection, especially the countless infections of longer standing with low titres, damage the fetus or lead to habitual abortion. Practically only H. Werner and his Berlin group, succeeded in isolating toxoplasma from abortion material of women not primarily infected during pregnancy but then in 20% of cases and in serologically-negative women also. The late importation of such opinions to Austria is deeply regrettable and should not be allowed to induce uncertainty in physicians and anxiety in our women. Accurate studies in very large numbers of preconceptionally-infected women did not reveal a single case of prenatal damage or congenital infection. Hence, the serological control of newborn infants of preconceptionally-infected women is not indicated. High titres (SF) detected during the first trimester indicate only a very low probability of damage to the fetus. Desmonts and Couvreur found not one infected infant amongst the offspring of 191 women with high titres at the beginning of pregnancy.

  16. Surfactant proteins gene variants in premature newborn infants with severe respiratory distress syndrome.

    Science.gov (United States)

    Somaschini, Marco; Presi, Silvia; Ferrari, Maurizio; Vergani, Barbara; Carrera, Paola

    2017-12-19

    Genetic surfactant dysfunction causes respiratory failure in term and near-term newborn infants, but little is known of such condition in prematures. We evaluated genetic surfactant dysfunction in premature newborn infants with severe RDS. A total of 68 preterm newborn infants with gestational age ≤32 weeks affected by unusually severe RDS were analysed for mutations in SFTPB, SFTPC and ABCA3. Therapies included oxygen supplementation, nasal CPAP, different modalities of ventilatory support, administration of exogenous surfactant, inhaled nitric oxide and steroids. Molecular analyses were performed on genomic DNA extracted from peripheral blood and Sanger sequencing of whole gene coding regions and intron junctions. In one case histology and electron microscopy on lung tissue was performed. Heterozygous previously described rare or novel variants in surfactant proteins genes ABCA3, SFTPB and SFTPC were identified in 24 newborn infants. In total, 11 infants died at age of 2 to 6 months. Ultrastructural analysis of lung tissue of one infant showed features suggesting ABCA3 dysfunction. Rare or novel genetic variants in genes encoding surfactant proteins were identified in a large proportion (35%) of premature newborn infants with particularly severe RDS. We speculate that interaction of developmental immaturity of surfactant production in association with abnormalities of surfactant metabolism of genetic origin may have a synergic worsening phenotypic effect.

  17. [Endoscopic treatment of intestinal malrotation in newborns and infants].

    Science.gov (United States)

    Kozlov, Yu A; Novozhilov, V A; Rasputin, A A; Us, G P; Kuznetsova, N N; Pakelchuk, A

    To compare treatment of intestinal malrotation in newborns and infants using laparoscopy and laparotomy. For the period from January 2004 to December 2013 34 Ladd's procedures were performed. Children were divided into 2 groups by 17 patients: laparoscopic (group I) and open treatment (group II). Both groups had similar demographic and other preoperative parameters. There were significant differences in duration of operation between both groups (61 vs. 70 minutes). Nutrition was initiated earlier after mini-invasive treatment (1.5 days vs. 3 days) and the time need for full enteral nutrition was also less (4.2 days vs. 6.9 days). Hospital-stay was shorter in group I (7.7 vs. 10.2 days). Number of early postoperative complications was similar in groups. Incidence of remote complications was higher in laparotomy group but the differences were not significant. Our results showed that endoscopic correction of congenital anomalies of intestinal rotation provides better postoperative results than open surgery and can be widely used in young children.

  18. Urinary prostaglandin E2 in the newborn and infant.

    Science.gov (United States)

    Antonucci, Roberto; Cuzzolin, Laura; Arceri, Augusta; Fanos, Vassilios

    2007-08-01

    Prostaglandin E(2) (PGE(2)) belongs to a family of biologically active lipids derived from the 20-carbon essential fatty acids. Renal PGE(2) is involved in the development of the kidney; it also contributes to regulate renal perfusion and glomerular filtration rate, and controls water and electrolyte balance. Furthermore, this mediator protects the kidney against excessive functional changes during the transition from fetal to extrauterine life, when it counteracts the vasoconstrictive effects of high levels of angiotensin II and other mediators. There is evidence that PGE(2) plays an important pathophysiological role in neonatal conditions of renal stress, and in congenital or acquired nephropaties. Thus, measurement of urinary PGE(2) as an index of renal synthesis of this primary prostaglandin may represent a non-invasive and sensitive method of investigating the homeostatic function of the kidney in early life. The aim of this literature review is to examine urinary PGE(2) as a non-invasive marker of renal homeostasis in the newborn and infant under both physiological and pathological conditions, or during treatments with widely used, potentially toxic drugs.

  19. Continuous intravenous infusion of ampicillin and gentamicin during parenteral nutrition in 88 newborn infants

    DEFF Research Database (Denmark)

    Colding, H; Møller, S; Andersen, G E

    1982-01-01

    Ampicillin and gentamicin were dissolved once a day in an L-amino acid solution especially prepared for parenteral nutrition of newborn infants and infused continuously to 88 infants in whom septicaemia was suspected or had been proved. The mean dosages were 162 and 5.3 mg/kg per 24 hours...

  20. Diabetic mothers and their newborn infants - rooming-in and neonatal morbidity

    DEFF Research Database (Denmark)

    Stage, E; Mathiesen, E R; Emmersen, P B

    2010-01-01

    As a result of increased neonatal morbidity, the infants of diabetic mothers have routinely been admitted to a neonatal special care unit (NSCU). We therefore investigated whether the offer of rooming-in diabetic mothers and their newborn infants has an effect on neonatal morbidity....

  1. Hemodynamic responses to speech and music in newborn infants.

    Science.gov (United States)

    Kotilahti, Kalle; Nissilä, Ilkka; Näsi, Tiina; Lipiäinen, Lauri; Noponen, Tommi; Meriläinen, Pekka; Huotilainen, Minna; Fellman, Vineta

    2010-04-01

    We used near-infrared spectroscopy (NIRS) to study responses to speech and music on the auditory cortices of 13 healthy full-term newborn infants during natural sleep. The purpose of the study was to investigate the lateralization of speech and music responses at this stage of development. NIRS data was recorded from eight positions on both hemispheres simultaneously with electroencephalography, electrooculography, electrocardiography, pulse oximetry, and inclinometry. In 11 subjects, statistically significant (P < 0.02) oxygenated (HbO2) and total hemoglobin (HbT) responses were recorded. Both stimulus types elicited significant HbO2 and HbT responses on both hemispheres in five subjects. Six of the 11 subjects had positive HbO2 and HbT responses to both stimulus types, whereas one subject had negative responses. Mixed positive and negative responses were observed in four neonates. On both hemispheres, speech and music responses were significantly correlated (r = 0.64; P = 0.018 on the left hemisphere (LH) and r = 0.60; P = 0.029 on the right hemisphere (RH)). On the group level, the average response to the speech stimuli was statistically significantly greater than zero in the LH, whereas responses on the RH or to the music stimuli did not differ significantly from zero. This suggests a more coherent response to speech on the LH. However, significant differences in lateralization of the responses or mean response amplitudes of the two stimulus types were not observed on the group level. Copyright 2009 Wiley-Liss, Inc.

  2. Surveillance of extreme hyperbilirubinaemia in Denmark. A method to identify the newborn infants

    DEFF Research Database (Denmark)

    Bjerre, J.V.; Petersen, Jes Reinholdt; Ebbesen, F.

    2008-01-01

    serum bilirubin concentration (TSB) > or = 450 micromol/L were obtained by linking laboratory data to the unique Danish personal identification number. RESULTS: In total, 113 infants were included, that is, an incidence of 45/100,000 live births. Thirty-seven infants presented in hospital, 2 after home...... birth and the others after having been discharged. The maximum TSB was 485 (450-734) micromol/L (median [range]) and appeared latest amongst those infants admitted from home, but was not different from the maximum TSB of the nondischarged infants. Forty-three infants had symptoms of early-phase acute......AIM: To describe the incidence of infants born at term or near-term with extreme hyperbilirubinaemia. METHODS: The study period was between 1 January 2002 and 31 December 2005, and included all infants born alive at term or near-term in Denmark. Medical reports on all newborn infants with a total...

  3. Burst-suppression pattern in the electroencephalogram of newborns and infants. Its clinical expression

    Directory of Open Access Journals (Sweden)

    Cervantes Blanco Jorge Mauricio

    2014-07-01

    Full Text Available Burst-suppression pattern in the electroencephalogram (EEG is associated with severe brain damage and has a bad prognosis in 85% of the cases. Objectives. To identify the prevalence of the EEG burst-suppression pattern (BSP in fullterm newborns and infants, determine its etiol- ogy, clinical features and course. Methods. A retrospective study was conducted. Between January 2008 and December 2012, 4,891 EEGs were reviewed. The EEGs of newborns and infants (< 3 months of age with BSP were selected. Results. 11 cases identified with burst suppression pattern. The overall prevalence of which was 3.5%; 8.1% among the newborns and 1.2% among infants. Seizures were the main reason for doing an EEG in the newborn period in 7 patients and after day 28 in three. The clinical manifestations were abnormal level of consciousness (n=8, hypotonia (n=2, and spasticity (n=6. The main causes were hypoxic ischemic injury, stroke and kernicterus. There were two cases of early infantile epileptic encephalopathy. Two patients died before the third month of age; 8 survived an average of 13 months. All had epilepsy, neurologic retardation and disability. Two patients had persistent EEG burst-suppression pattern; 1 and 3 months after the neonatal period respectively; 7 had focal spikes and an asymmetric pattern. Conclusions. Electroencephalographic burst-suppression pat- tern predicts a severe neurologic injury in fullterm newborns and infants.

  4. Protocolized versus non-protocolized weaning for reducing the duration of invasive mechanical ventilation in newborn infants

    NARCIS (Netherlands)

    Wielenga, Joke M.; van den Hoogen, Agnes; van Zanten, Henriette A.; Helder, Onno; Bol, Bas; Blackwood, Bronagh

    2016-01-01

    Mechanical ventilation is a life-saving intervention for critically ill newborn infants with respiratory failure admitted to a neonatal intensive care unit (NICU). Ventilating newborn infants can be challenging due to small tidal volumes, high breathing frequencies, and the use of uncuffed

  5. [A phenomenological study on mother-infant interacting behavior patterns relating to newborn infant feeding in Korea].

    Science.gov (United States)

    Han, K J

    1991-04-01

    The purpose of this study was to describe mother-infant interacting behavior patterns related to newborn infant feeding and to explore the mother's cultural belief about their infant. The data collection was conducted by observation and interview. Twenty-five mothers and their newborn infants who were normally delivered and were also planned to breastfeed were comprised as the subjects of this study. All subjects were interviewed and observed individually at 1 to 5 days after the delivery at the hospital, mid-wife's clinic, Maternal Child Health Center and their home throughout the country from remote area to big city. The observation data were recorded with symbolic letter on a recording sheet newly developed as a result of preliminary study. The interview data were tape recorded and then recorded in narrative form. Mother-infant interaction behaviors in early-feeding period were analyzed based on 19 analytic sub-categories and their composing elements. Unit of analysis were mother, infant and mother-infant dyad. 8 analytic categories draw from the data. Each were preparation, instrument, interaction inducing, evaluation referred to mother's behavior, preparation, instrument, interaction inducing referred to infant's behavior and synchronic behaviors referred to mother-infant dyad. Frequencies of behavior items based on the categories were converted to percent. The result showed that in mother's preparation behavior, the breast condition of Korean mother can be an affecting factor for mother-infant interaction during feeding, and vocalization behavior was observed most frequently in interaction inducing behavior while the least frequent behavior observed was contacting. Subcultural characteristics of mother-infant interaction behaviors were analyzed for their relationships between groups of mothers who have lived in remote area vs urban area, and who were multipara vs primipara. Using a chi-square test, there were statistically significant relationships in the

  6. Chest X-ray in newborns and infants; Konventionelle Thoraxdiagnostik bei Neugeborenen und Kleinkindern

    Energy Technology Data Exchange (ETDEWEB)

    Moritz, Joerg D. [Universitaetsklinikum Schleswig-Holstein, Kiel (Germany). Klinik fuer diagnostische Radiologie, Paediatrische Radiologie und Sonographie

    2012-12-15

    Chest X-ray in newborns and infants shows great differences to that in adults. Therefore all radiologists, who engage in X-rays in this age group, must be familiar with the special features. At the beginning specific items of examination methods are explained, which must be strictly followed due to radiological protection. Focus of the paper is the discussion of the important chest diseases in newborn and infants, which are mostly unknown in chest diagnosis in adults. Many of them can be life-threatening, thus their knowledge is essential. Pathophysiological explanations shall make the special radiological signs understandable. (orig.)

  7. Beta-adrenoceptor responsiveness in intact leukocytes from adults and newborn infants; effect of phosphodiesterase inhibitors

    DEFF Research Database (Denmark)

    Foged, N; Bertelsen, Niels Haldor; Johansen, Torben

    1990-01-01

    Intact mononuclear and polymorphonuclear leukocytes from adults and newborn infants were used to estimate the beta 2-adrenoceptor responsiveness in vitro. The accumulation of cAMP in response to receptor stimulation by isoprenaline was used as a measure of the receptor responsiveness. The relevance......-1 inhibits the phosphodiesterase activity almost completely. By use of this concentration no age-dependent changes in the isoprenaline-stimulated cAMP accumulation in mononuclear and polymorphonuclear leukocytes from adults and newborn infants could be demonstrated....

  8. Newborn jaundice

    Science.gov (United States)

    Jaundice of the newborn; Neonatal hyperbilirubinemia; Bili lights - jaundice; Infant - yellow skin; Newborn - yellow skin ... newborns have some yellowing of the skin, or jaundice. This is called physiological jaundice. It is often ...

  9. Multiple versus single lumen umbilical venous catheters for newborn infants.

    Science.gov (United States)

    Kabra, N S; Kumar, M; Shah, S S

    2005-07-20

    Multiple lumen umbilical venous catheters (ML-UVCs) instead of single lumen UVCs (SL-UVCs) may decrease the need for additional venous lines. Although it seems self-evident that ML-UVCs would reduce the need of additional venous lines, the rates of associated complications might be different. To compare the effectiveness and the safety of ML-UVCs versus SL-UVCs in terms of need of additional vascular access, rates of complications, morbidity and mortality in newborn infants. Randomized and quasi-randomized trials were identified by searching the MEDLINE (1966 - February 2005), EMBASE (1980- February 2005), CINAHL (1982 - February 2005), the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 4, 2004) and Science Direct (subject area: medicine, journal and abstract database; 1967 to February 2005). Literature search also included a manual search of the abstracts of scientific meetings published in Pediatric Research (1990-2004). Additional citations were sought using references in articles retrieved from searches. Subject experts were contacted to identify the unpublished and ongoing studies. Randomized and quasi-randomized controlled clinical trials comparing safety and efficacy of multiple versus single lumen umbilical venous catheter in neonates (both term and preterm) who were in need of umbilical venous catheter insertion for vascular access in first four weeks of life. Each review author performed data extraction independently and differences were resolved by discussion. The following outcomes were determined: total number of additional peripheral intravenous lines per baby in first week and first four weeks of life, total number of additional percutaneously and surgically placed central venous lines per baby in first four weeks of life, and other safety and efficacy measures. The treatment effect estimators used were RR, RD, and WMD when appropriate along with their 95% CI. If RD was statistically significant, then number

  10. Administration of gentamicin and ampicillin by continuous intravenous infusion to newborn infants during parenteral nutrition

    DEFF Research Database (Denmark)

    Colding, H; Andersen, G E

    1982-01-01

    Gentamicin and ampicillin were dissolved in an L-amino acid solution especially prepared for newborn infants and infused intravenously over 24 h in 7 babies with serious neonatal surgical problems. Serum concentrations of the antibiotics were maintained rather constant and well above the minimal...

  11. 3-D cardiac MRI in free-breathing newborns and infants: when is respiratory gating necessary?

    Energy Technology Data Exchange (ETDEWEB)

    Seeger, Achim [University Hospital of Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); University Hospital of Tuebingen, Department of Diagnostic and Interventional Neuroradiology, Tuebingen (Germany); Krumm, Patrick; Schaefer, Juergen F.; Kramer, Ulrich [University Hospital of Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Hornung, Andreas; Sieverding, Ludger [University Hospital of Tuebingen, Department of Pediatric Cardiology, Tuebingen (Germany)

    2015-09-15

    Newborns and small infants have shallow breathing. To suggest criteria for when respiratory gating is necessary during cardiac MRI in newborns and infants. One-hundred ten data sets of newborns and infants with (n = 92, mean age: 1.9 ± 1.7 [SD] years) and without (n = 18, mean age: 1.6 ± 1.8 [SD] years) navigator gating were analysed retrospectively. The respiratory motion of the right hemidiaphragm was recorded and correlated to age, weight, body surface area and qualitative image quality on a 4-point score. Quantitative image quality assessment was performed (sharpness of the delineation of the ventricular septal wall) as well as a matched-pair comparison between navigator-gated and non-gated data sets. No significant differences were found in overall image quality or in the sharpness of the ventricular septal wall between gated and non-gated scans. A navigator acceptance of >80% was frequently found in patients ages <12 months, body surface area <0.40 m{sup 2}, body weight <10 kg and a size of <80 cm. Sequences without respiratory gating may be used in newborns and small infants, in particular if age <12 months, body surface area <0.40 m{sup 2}, body weight <10 kg and height <80 cm. (orig.)

  12. ENDOSCOPIC BALLOON DILATATION OF ACQUIRED AIRWAY STENOSIS IN NEWBORN-INFANTS - A PROMISING TREATMENT

    NARCIS (Netherlands)

    ELKERBOUT, SC; VANLINGEN, RA; GERRITSEN, J; ROORDA, RJ

    Acquired stenosis of the trachea or bronchus in newborn infants is a possible complication of perinatal intubation and mechanical ventilation. Although the exact pathophysiology is unknown, stenosis formation seems to be initiated by pressure necrosis. Prematurity is thought to be an important risk

  13. PHENYLKETONURIA, DETECTION IN THE NEWBORN INFANT AS A ROUTINE HOSPITAL PROCEDURE.

    Science.gov (United States)

    GUTHRIE, ROBERT; WHITNEY, STEWART

    A FIELD TRIAL OF AN INHIBITION ASSAY METHOD FOR SCREENING FOR PHENYLKETONURIA (PKU) TESTED MORE THAN 400,000 NEWBORN INFANTS PRIOR TO DISCHARGE FROM THE HOSPTIAL. IN ALL, 39 CASES WERE FOUND, A HIGHER INCIDENCE THAN HAD PREVIOUSLY BEEN EXPECTED. THE PRACTICALITY OF THE INHIBITION ASSAY METHOD WAS ALSO DEMONSTRATED. THE REPORT DETAILS THE TRIAL'S…

  14. Tissue oxygenation monitoring in newborn infants at risk of circulatory failure

    NARCIS (Netherlands)

    van der Laan, Michelle

    2015-01-01

    Seriously ill newborn infants admitted to the neonatal intensive care unit (NICU) are at high risk of developing organ damage as a result of impaired organ blood flow and therefore impaired tissue oxygen delivery. Currently, organ tissue oxygen delivery cannot be measured continuously. Due to the

  15. Administration of gentamicin and ampicillin by continuous intravenous infusion to newborn infants during parenteral nutrition

    DEFF Research Database (Denmark)

    Colding, H; Andersen, G E

    1982-01-01

    inhibitory concentration for most bacterial strains. One very sick newborn infant died with overwhelming Klebsiella pneumoniae septicemia. No signs of renal toxicity or ototoxicity were found. The serum amino acids remained within the normal range, except in 1 child with cytomegalovirus infection and liver...

  16. When courts intervene: public health, legal and ethical issues surrounding HIV, pregnant women, and newborn infants.

    Science.gov (United States)

    Tessmer-Tuck, Jennifer A; Poku, Joseph K; Burkle, Christopher M

    2014-11-01

    Ninety-three percent of pediatric AIDS cases are the result of perinatal HIV transmission, a disease that is almost entirely preventable with early intervention, which reduces the risk of perinatal HIV infection from 25% to treatment, public health, legal, and ethical dilemmas can result. Federal courts consistently uphold a woman's right to refuse medical testing and treatment, even though it may benefit her fetus/newborn infant. Federal courts also reliably respect the rights of parents to make health care decisions for their newborn infants, which may include declining medical testing and treatment. Confusing the issue of HIV testing and treatment, however, is the fact that there is no definitive United States Supreme Court ruling on the issue. State laws and standards vary widely and serve as guiding principles for practicing clinicians, who must be vigilant of ongoing legal challenges and changes in the states in which they practice. We present a case of an HIV-positive pregnant woman who declined treatment and then testing or treatment of her newborn infant. Ultimately, the legal system intervened. Given the rarity of such cases, we use this as a primer for the practicing clinician to highlight the public health, legal, and ethical issues surrounding prenatal and newborn infant HIV testing and treatment in the United States, including summarizing key state-to-state regulatory differences. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. IMMUNE-RESPONSE AFTER SURFACTANT TREATMENT OF NEWBORN-INFANTS WITH RESPIRATORY-DISTRESS SYNDROME

    NARCIS (Netherlands)

    Bambang Oetomo, S.; Bos, A.F.; de Lei, L.; Okken, A.; VANSONDEREN, L; HALLIDAY, HL; WALTI, H

    1993-01-01

    We examined the sera of 68 newborn infants with respiratory distress syndrome; 49 were treated with a natural porcine-derived surfactant preparation and 19 were controls. Serum of the patients was collected before, 3 weeks and 3 months after surfactant treatment. To detect any antibody that had been

  18. Reliability of the echoMRI infant system for water and fat measurements in newborns

    Science.gov (United States)

    The precision and accuracy of a quantitative magnetic resonance (EchoMRI Infants) system in newborns were determined. Canola oil and drinking water phantoms (increments of 10 g to 1.9 kg) were scanned four times. Instrument reproducibility was assessed from three scans (within 10 minutes) in 42 heal...

  19. A comparison of hexachlorophene and Lactacyd on growth of skin flora in healthy term newborn infants

    Science.gov (United States)

    McHattie, J. C.; Crossan, M.; Talukdar, C.; Elder, R.; Murdock, A. I.

    1974-01-01

    Reports of toxicity from the routine bathing of newborn infants with hexachlorophene resulted in discontinuing its use in the newborn nurseries of the Ottawa Civic Hospital, only to be followed by an outbreak of skin infections. As a result, a controlled trial of bathing newborn babies with either Lactacyd or pHisoHex was begun. The efficacy of the soaps was evaluated by comparing the colonization of the nose and umbilical cords of 158 pHisoHex-washed babies and 156 Lactacyd-washed babies on the day of discharge from hospital. The gram-negative and gram-positive bacterial flora of nose and cord of infants washed with pHisoHex and Lactacyd were identical in frequency and distribution. PMID:4834430

  20. Decreased cerebral blood flow after administration of sodium bicarbonate in the distressed newborn infant

    DEFF Research Database (Denmark)

    Lou, H C; Lassen, N A; Fris-Hansen, B

    1978-01-01

    In the course of our studies on cerebral blood flow in newborn infants, we have observed a striking depressing effect of sodium bicarbonate infusion on cerebral blood flow which in some cases may severely aggravate cerebral ischemia. We measured cerebral blood flow before and after the treatment...... with 1 to 8 meqs of sodium bicarbonate in seven distressed newborn infants. The 133 Xe clearance technique was used. The results showed in six of the seven cases a decrease in cerebral blood flow, which in most cases was reduced to 14 to 22 ml/100 g/min, which is about half the value prior...... to the bicarbonate infusion. In one case an extreme reduction occurred: cerebral blood flow was reduced to 3 ml/100 g/min, well below the level compatible with tissue survival. The results are discussed with regard to the optimal treatment of the acidotic newborn....

  1. Decreased cerebral blood flow after administration of sodium bicarbonate in the distressed newborn infant

    DEFF Research Database (Denmark)

    Lou, H C; Lassen, N A; Fris-Hansen, B

    1978-01-01

    with 1 to 8 meqs of sodium bicarbonate in seven distressed newborn infants. The 133 Xe clearance technique was used. The results showed in six of the seven cases a decrease in cerebral blood flow, which in most cases was reduced to 14 to 22 ml/100 g/min, which is about half the value prior......In the course of our studies on cerebral blood flow in newborn infants, we have observed a striking depressing effect of sodium bicarbonate infusion on cerebral blood flow which in some cases may severely aggravate cerebral ischemia. We measured cerebral blood flow before and after the treatment...... to the bicarbonate infusion. In one case an extreme reduction occurred: cerebral blood flow was reduced to 3 ml/100 g/min, well below the level compatible with tissue survival. The results are discussed with regard to the optimal treatment of the acidotic newborn....

  2. Outcomes of infants with indeterminate diagnosis detected by cystic fibrosis newborn screening.

    Science.gov (United States)

    Ren, Clement L; Fink, Aliza K; Petren, Kristofer; Borowitz, Drucy S; McColley, Susanna A; Sanders, Don B; Rosenfeld, Margaret; Marshall, Bruce C

    2015-06-01

    Cystic fibrosis transmembrane conductance regulator-related metabolic syndrome (CRMS) describes asymptomatic infants with a positive cystic fibrosis (CF) newborn screen (NBS) but inconclusive diagnostic testing for CF. Little is known about the epidemiology and outcomes of CRMS. The goal of this study was to determine the prevalence, clinical features, and short-term outcomes of infants with CRMS. We analyzed data from the US CF Foundation Patient Registry (CFFPR) from 2010 to 2012. We compared demographic, diagnostic, anthropometric, health care utilization, microbiology, and treatment characteristics between infants with CF and infants with CRMS. There were 1983 infants diagnosed via NBS between 2010 and 2012 reported to the CFFPR. By using the CF Foundation guideline definitions, 1540 and 309 infants met the criteria for CF and CRMS, respectively (CF:CRMS ratio = 5.0:1.0). Of note, 40.8% of infants with CRMS were entered into the registry with a clinical diagnosis of CF. Infants with CRMS tended to have normal nutritional indices. However, 11% of infants with CRMS had a positive Pseudomonas aeruginosa respiratory tract culture in the first year of life. CRMS is a common outcome of CF NBS, and some infants with CRMS may develop features concerning for CF disease. A substantial proportion of infants with CRMS were assigned a clinical diagnosis of CF, which may reflect misclassification or clinical features not collected in the CFFPR. Copyright © 2015 by the American Academy of Pediatrics.

  3. Retinal and Optic Nerve Hemorrhages in the Newborn Infant: One-Year Results of the Newborn Eye Screen Test Study.

    Science.gov (United States)

    Callaway, Natalia F; Ludwig, Cassie A; Blumenkranz, Mark S; Jones, Jennifer Michelle; Fredrick, Douglas R; Moshfeghi, Darius M

    2016-05-01

    To report the birth prevalence, risk factors, characteristics, and location of fundus hemorrhages (FHs) of the retina and optic nerve present in newborns at birth. Prospective cohort study at Stanford University School of Medicine. All infants who were 37 weeks postmenstrual age or older and stable were eligible for screening. Infants with known or suspected infectious conjunctivitis were excluded. Infants born at Lucile Packard Children's Hospital (LPCH) from July 25, 2013, through July 25, 2014, were offered universal newborn screening via wide-angle digital retinal photography in the Newborn Eye Screen Test study. Maternal, obstetric, and neonatal factors were obtained from hospital records. The location, retinal layer, and laterality of FH were recorded by 1 pediatric vitreoretinal specialist. Birth prevalence of FH. Secondary outcomes included rate of adverse events, risk factors for FH, hemorrhage characteristics, and adverse events. The birth prevalence of FH in this study was 20.3% (41/202 infants). Ninety-five percent of FHs involved the periphery, 83% involved the macula, and 71% involved multiple layers of the retina. The fovea was involved in 15% of FH cases (birth prevalence, 3.0%). No cases of bilateral foveal hemorrhage were found. Fundus hemorrhages were more common in the left eye than the right. Fundus hemorrhages were most commonly optic nerve flame hemorrhages (48%) and white-centered retinal hemorrhages (30%). Retinal hemorrhages were found most frequently in all 4 quadrants (35%) and more often were multiple than solitary. Macular hemorrhages most often were intraretinal (40%). Among the risk factors examined in this study, vaginal delivery compared with cesarean section (odds ratio [OR], 9.34; 95% confidence interval [CI], 2.57-33.97) showed the greatest level of association with FH. Self-identified ethnicity as Hispanic or Latino showed a protective effect (OR, 0.43; 95% CI, 0.20-0.94). Other study factors were not significant. Fundus

  4. [A mobile reanimation model (reanimationmobile) for initial newborn infant care].

    Science.gov (United States)

    Lang, N; Hansmann, M; Niesen, M

    1976-12-01

    A mobile unit for reanimation of the newborn is reported to be used alternatively in the deliveryroom or in the surgical tract. The following adventages are achieved: a large working plate easily accessible from three sides, a complete and variable instrumentation, an efficent warmth supply and the possibility for easy cleaning and desinfection.

  5. Climate change is associated with male:female ratios of fetal deaths and newborn infants in Japan.

    Science.gov (United States)

    Fukuda, Misao; Fukuda, Kiyomi; Shimizu, Takashi; Nobunaga, Miho; Mamsen, Linn Salto; Yding Andersen, Claus

    2014-11-01

    To evaluate whether climate change is associated with male:female ratios (sex ratios) of fetal deaths and births in Japan. A population-based cohort study. Not applicable. Newborn infants and fetuses spontaneously aborted after 12 weeks of gestation. None. Yearly sex ratios of fetal deaths and newborn infants and monthly fetal death rates and sex ratios of newborn infants. A statistically significant positive association was found between yearly temperature differences and sex ratios of fetal deaths; a statistically significant negative association was found between temperature differences and sex ratios of newborn infants from 1968 to 2012, and between sex ratios of births and of fetal deaths. The sex ratios of fetal deaths have been increasing steadily along with temperature differences, whereas the sex ratios of newborn infants have been decreasing since the 1970s. Two climate extremes, a very hot summer in 2010 and a very cold winter in January 2011, showed not only statistically significant declines in sex ratios of newborn infants 9 months later in June 2011 and October 2011 but also statistically significant increases of fetal death rates immediately, in September 2010 and January 2011. The recent temperature fluctuations in Japan seem to be linked to a lower male:female sex ratio of newborn infants, partly via increased male fetal deaths. Male concepti seem to be especially vulnerable to external stress factors, including climate changes. Copyright © 2014. Published by Elsevier Inc.

  6. Early warning- and track and trigger systems for newborn infants: A review.

    Science.gov (United States)

    Mortensen, Nicolay; Augustsson, Johan Henrik; Ulriksen, Jorunn; Hinna, Unni Tveit; Schmölzer, Georg M; Solevåg, Anne Lee

    2017-03-01

    Tools for clinical assessment and escalation of observation and treatment are insufficiently established in the newborn population. We aimed to provide an overview over early warning- and track and trigger systems for newborn infants and performed a nonsystematic review based on a search in Medline and Cinahl until November 2015. Search terms included 'infant, newborn', 'early warning score', and 'track and trigger'. Experts in the field were contacted for identification of unpublished systems. Outcome measures included reference values for physiological parameters including respiratory rate and heart rate, and ways of quantifying the extent of deviations from the reference. Only four neonatal early warning scores were published in full detail, and one system for infants with cardiac disease was considered as having a more general applicability. Temperature, respiratory rate, heart rate, SpO 2 , capillary refill time, and level of consciousness were parameters commonly included, but the definition and quantification of 'abnormal' varied slightly. The available scoring systems were designed for term and near-term infants in postpartum wards, not neonatal intensive care units. In conclusion, there is a limited availability of neonatal early warning scores. Scoring systems for high-risk neonates in neonatal intensive care units and preterm infants were not identified.

  7. Study of cardiac arrhythmias and other forms of conduction abnormality in newborn infants.

    Science.gov (United States)

    Southall, D P; Orrell, M J; Talbot, J F; Brinton, R J; Vulliamy, D G; Johnson, A M; Keeton, B R; Anderson, R H; Shinebourne, E A

    1977-01-01

    In an unselected population of 2030 newborn infants studied by electrocardiography (ECG) between April 1975 and April 1977, 35 were found to have arrhythmias or other cardiac conduction abnormalities. Further investigation by means of 24-hour ECG monitoring showed that apparently serious tachyarrhythmias, such as ventricular tachycardia and slow heart rates associated with sinoatrial block, may be present without clinical disturbance in some newborn babies. Six infants had both bradycardia and tachycardia in the 24-hour recording, although the screening ECG had shown only one of these abnormalities. The alarming ECG appearance of some of the arrhythmias suggested a possible aetiological link with some unexplained sudden infant deaths: a multicentre study could determine this more readily and is therefore recommended. Images FIGS 1-3 FIGS 4-6 PMID:901994

  8. INTESTINAL COLIC IN NEWBORNS AND INFANTS: FROM DIAGNOSTICS TO THE DIFFERENTIATED CORRECTION

    Directory of Open Access Journals (Sweden)

    I.A. Belyaeva

    2011-01-01

    Full Text Available Functional disorders of digestion are the most widespread disturbances of adaptation in infants. The article presents classification of colic in newborns and infants, characterizes their etiology and pathogenesis depending on maturity of a child, presence of perinatal pathology, defects of nursing and nutrition. Authors describe main principles of intestinal colic correction including diet and medicamental treatment in infants. «Mild» drugs (herbal therapy have some advantages in treatment of colic. The results of an observation of 47 mature and premature infants treated with Plantex are presented.Key words: infants, intestinal colics, dietotherapy, herbal therapy.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2: 137–140

  9. Pulmonary circulatory effects of norepinephrine in newborn infants with persistent pulmonary hypertension.

    Science.gov (United States)

    Tourneux, Pierre; Rakza, Thameur; Bouissou, Antoine; Krim, Gérard; Storme, Laurent

    2008-09-01

    To evaluate the respiratory and the pulmonary circulatory effects of norepinephrine in newborn infants with persistent pulmonary hypertension (PPHN)-induced cardiac dysfunction. Inclusion criteria were: 1) Newborn infants >35 weeks gestational age; 2) PPHN treated with inhaled nitric oxide; and 3) symptoms of circulatory failure despite adequate fluid resuscitation. Lung function and pulmonary hemodynamic variables assessed with Doppler echocardiography were recorded prospectively before and after starting norepinephrine. Eighteen newborns were included (gestational age: 37 +/- 3 weeks; birth weight: 2800 +/- 700 g). After starting norepinephrine, systemic pressure and left ventricular output increased respectively from 33 +/- 4 mm Hg to 49 +/- 4 mm Hg and from 172 +/- 79 mL/kg/min to 209+/-90 mL/kg/min (P ventilatory variables have not been changed, the post-ductal transcutaneous arterial oxygen saturation increased from 89% +/- 1% to 95% +/- 4%, whereas the oxygen need decreased from 51% +/- 24% to 41% +/- 20% (P newborn infants with PPHN through a decrease in pulmonary/systemic artery pressure ratio and improved cardiac performance.

  10. Evaluating a simple method of neuroprotective hypothermia for newborn infants.

    Science.gov (United States)

    Horn, A R; Harrison, M C; Linley, L L

    2010-06-01

    This study describes and evaluates a simple method of neuroprotective hypothermia for infants with hypoxic-ischaemic encephalopathy (HIE). Five term infants with HIE were cooled by applying soft, cold gel bags to the head. A radiant warmer, set to 34 degrees C, servo-controlled the temperature measured at a probe between the infant's back and the mattress. The infants' heads were shielded from the warmer. After 72 h, the infants were re-warmed by 0.2 degrees C per hour, by adjusting the radiant warmer. A rectal temperature of 34 degrees C was attained in a median time of 45 min. Mean rectal temperatures during cooling were 33.9 +/- 0.3 degrees C. There was good correlation between insulated back temperatures and deep rectal temperatures (r = 0.76). There were no major or irreversible adverse events during cooling. This method of cooling achieved rectal temperatures within the target range of 33-34 degrees C and re-warming was effective.

  11. Reference standard of penile size and prevalence of buried penis in Japanese newborn male infants.

    Science.gov (United States)

    Matsuo, Nobutake; Ishii, Tomohiro; Takayama, John I; Miwa, Masayuki; Hasegawa, Tomonobu

    2014-01-01

    The present study set forth the reference values for penile size and determined the prevalence of buried penis in Japanese full-term newborns. The stretched penile length was measured and the presence of buried penis was assessed at 1-7 days of age in 547 Japanese full-term newborn infants born between 2008 and 2012 in Tokyo. The stretched penile lengths were compared at 1-12 hours and 1-7 days of age in 63 infants and by two observers in 73 infants to estimate postnatal changes and interobserver variation, respectively. The mean stretched penile length was 3.06 cm (SD, 0.26; 95% confidence interval [CI], 3.04-3.08) and the mean ratio of penile length to body length was 6.24 × 100(-1) (SD, 0.55 × 100(-1)), both of which were significantly smaller than those in Caucasian newborn infants. Buried penis was identified in 20 of 547 infants (3.7%; 95% CI, 2.1-5.2%). The first measurements of penile length at 1-12 hours were significantly smaller than the next measurements at 1-7 days (95% CI of the difference, 0.22-0.34). The 95% CI for the limits of agreement in the penile lengths measured by the two observers was -0.58 to -0.40 for the lower limit and 0.33 to 0.51 for the upper limit. These findings indicate that the penile length should be assessed after 24 hours of age by the reference standard of the same ethnicity for identifying micropenis and that buried penis is not uncommon in Japanese full-term newborns.

  12. Secretory phospholipase A(2) in newborn infants with sepsis

    NARCIS (Netherlands)

    Schrama, A. J. J.; De Beaufort, A. J.; Poorthuis, B. J. H. M.; Berger, H. M.; Walther, F. J.

    2008-01-01

    Objective: To investigate secretory phospholipase A(2) ( sPLA(2)) activity in neonatal sepsis. Study Design: Plasma sPLA(2) activity, C- reactive protein ( CRP) concentration, leukocyte count and immature/ total neutrophil ( I/ T) ratio were assessed in a group of 156 infants admitted for neonatal

  13. NONIMMUNE HYDROPS-FETALIS AND BILATERAL PULMONARY HYPOPLASIA IN A NEWBORN-INFANT WITH EXTRALOBAR PULMONARY SEQUESTRATION

    NARCIS (Netherlands)

    BRUS, F; NIKKELS, PGJ; VANLOON, AJ; OKKEN, A

    Extralobar pulmonary sequestration was found in a newborn premature infant that presented with non-immune hydrops fetalis, massive bilateral hydrothorax and polyhydramnios in utero. The baby died of severe respiratory insufficiency 15 h after birth. Postmortem examination revealed distended

  14. Gastric emptying patterns of a liquid meal in newborn infants, measured by epigastric impedance

    DEFF Research Database (Denmark)

    Lange, Aksel; Funch-Jensen, Peter; Thommesen, Peter

    1997-01-01

    .A periodic change of the impedance signal, the phasic 3 CPM signal, was observed after a meal in 24 of the infants. The median frequency was 3.03 CPM in 20 mature and 2.93 CPM in 4 preterminfants. In 9 infants a phasic 3 CPM signal was observed during fasting state. The median frequency was 2.9 CPM......  Epigastric impedance was used to measure patterns of the gastric emptying of a liquid non-caloric meal (5 ml water/kg) in newborn infants. The emptying patterns consisted of two components, theemptying signal - the DC component - and a phasic 3 cycle per minutes (CPM) signal - the AC component...... time (T50) was calculated. For mature infants it was found to be 6.9 mins. For a second meal given within an hour after the first meal the half emptying time was 5.5 mins (p

  15. Risk factors associated with neonatal hypothermia during cleaning of newborn infants in labour rooms.

    Science.gov (United States)

    Cheah, F C; Boo, N Y

    2000-02-01

    Cleaning newborn infants with coconut oil shortly after birth is a common practice in Malaysian labour rooms. This study aimed: (1) to determine whether this practice was associated with a significant decrease in the core temperature of infants; and (2) to identify significant risk factors associated with neonatal hypothermia. The core temperature of 227 randomly selected normal-term infants immediately before and after cleaning in labour rooms was measured with an infrared tympanic thermometer inserted into their left ears. Their mean post-cleaning body temperature (36.6 degrees C, SD = 1.0) was significantly lower than their mean pre-cleaning temperature (37.1 degrees C, SD = 1.0; p radiant warmer before cleaning p = 0.03); and (2) lower labour room temperature (p temperature (p temperature (p temperature should be set at a higher level and cleaning infants in the labour room should be discouraged.

  16. Reciprocal face-to-face communication between rhesus macaque mothers and their newborn infants.

    Science.gov (United States)

    Ferrari, Pier Francesco; Paukner, Annika; Ionica, Consuel; Suomi, Stephen J

    2009-11-03

    Human mothers interact emotionally with their newborns through exaggerated facial expressions, speech, mutual gaze, and body contact, a capacity that has long been considered uniquely human [1-4]. Current developmental psychological theories propose that this pattern of mother-infant exchange promotes the regulation of infant emotions [4-6] and serves as a precursor of more complex forms of social exchange including perspective taking and empathy. Here we report that in rhesus macaques, mother-infant pairs also communicate intersubjectively via complex forms of emotional exchanges including exaggerated lipsmacking, sustained mutual gaze, mouth-mouth contacts, and neonatal imitation. Infant macaques solicit their mother's affiliative responses and actively communicate to her. However, this form of communication disappears within the infant's first month of life. Our data challenge the view that the mother-infant communicative system functions in order to sustain proximity and that infants are simply passive recipients in such interaction. Thus, emotional communication between mother and infant is not uniquely human. Instead, we can trace back to macaques the evolutionary foundation of those behaviors that are crucial for the establishment of a functional capacity to socially exchange with others.

  17. An Investigation of the Mortality Rate and Risk Factors in Newborn Infants With Meconium Aspiration Syndrome

    Directory of Open Access Journals (Sweden)

    Sabzehei

    2016-08-01

    Full Text Available Background One of the serious challenges facing neonatal medicine is meconium aspiration syndrome, delays in the treatment of which can lead to high mortality. Objectives This study was designed and conducted with the aim of determining the mortality rate and risk factors affecting this rate in newborn infants with meconium aspiration syndrome. Methods This study was conducted as a retrospective descriptive research on newborn infants with meconium aspiration syndrome hospitalized at the neonatal intensive care unit (NICU of Fatemieh and Be’sat hospitals in Hamadan city during a 10-year period from 2004 to 2014. Demographic information of the mother and the newborn, hospitalization course, the need for mechanical ventilation, and complications and outcomes of disease were extracted and were analyzed using the SPSS software version 22. Results Sixty-three newborn infants, diagnosed with meconium aspiration syndrome, were entered in this study, 40% of them were male, 85.7% wighed more than 2500 g, and 17.5% were post term, 25.3% had a five-minute Apgar Score (AS5min of less than seven, 39.6% were nonvigorous at birth, 31.8% needed to be placed on mechanical ventilation, and 14.3% died during the hospitalization course. There was a significant relationship between the need for mechanical ventilation, nonvigorous state at the birth, complications of disease and mortality rate. Conclusions Despite the progress made in medicine, meconium aspiration syndrome is still one of the causes of newborn infants’ mortality. The mortality and morbidity rates can be reduced by improvement in perinatal care, prevention of post term delivery, timely caesarean and effective neonatal resuscitation at birth.

  18. Treatable newborn and infant seizures due to inborn errors of metabolism.

    Science.gov (United States)

    Campistol, Jaume; Plecko, Barbara

    2015-09-01

    About 25% of seizures in the neonatal period have causes other than asphyxia, ischaemia or intracranial bleeding. Among these are primary genetic epileptic encephalopathies with sometimes poor prognosis and high mortality. In addition, some forms of neonatal infant seizures are due to inborn errors of metabolism that do not respond to common AEDs, but are amenable to specific treatment. In this situation, early recognition can allow seizure control and will prevent neurological deterioration and long-term sequelae. We review the group of inborn errors of metabolism that lead to newborn/infant seizures and epilepsy, of which the treatment with cofactors is very different to that used in typical epilepsy management.

  19. The effect of surgery on lung volume and conventional monitoring parameters in ventilated newborn infants.

    Science.gov (United States)

    Proquitté, H; Freiberger, O; Yilmaz, S; Bamberg, C; Degenhardt, P; Roehr, C C; Wauer, R R; Schmalisch, G

    2010-05-01

    In newborn infants, thoraco-abdominal surgery is a serious intervention with respect to gas exchange and lung mechanics. This prospective clinical study compared surgery-induced changes in functional residual capacity (FRC) and ventilation inhomogeneity (VI) indices with changes in conventional monitoring parameters. Of 29 ventilated newborns (mean weight 2,770+/-864 g at surgery), 13, nine and seven underwent thoracic, abdominal or congenital diaphragmatic hernia (CDH) surgery, respectively. The multiple breath washout (MBWO) technique using heptafluoropropane as tracer gas (Babylog 8000; Dräger, Lübeck, Germany) was performed ventilatory monitoring parameters. FRC decreased in non-CDH infants, while FRC increased and VI indices decreased in CDH infants. Despite improvements, the differences in FRC and VI between CDH and non-CDH infants indicated persistent impaired lung function in CHD infants. MBWO can be advantageously used to measure the effect of surgery on the lung. While FRC and VI indices changed following surgery, conventional monitoring parameters did not.

  20. Feasibility and safety of intact cord resuscitation in newborn infants with congenital diaphragmatic hernia (CDH).

    Science.gov (United States)

    Lefebvre, Caroline; Rakza, Thameur; Weslinck, Nathalie; Vaast, Pascal; Houfflin-Debarge, Véronique; Mur, Sébastien; Storme, Laurent

    2017-11-01

    Starting resuscitation before clamping the umbilical cord at birth may progressively increase pulmonary blood flow while umbilical venous blood flow is still contributing to maintenance of oxygenation and left ventricle preload. To evaluate the feasibility, safety, and effects of intact cord resuscitation (ICR) on cardiorespiratory adaptation at birth in newborn infants with CDH. Prospective, observational, single-center pilot study. Physiologic variables and outcomes were collected prospectively in 40 consecutive newborn infants with an antenatal diagnosis of isolated CDH. Infants were managed with immediate cord clamping (ICC group) from 1/2012 to 5/2014 or the cord was clamped after initiation of resuscitation maneuvers (ICR group) from 6/2014 to 4/2016 (20 in each group). Ante- and postnatal markers of CDH severity were similar between groups. Resuscitation before cord clamping was possible for all infants in the ICR group. No increase in maternal or neonatal adverse events was observed during the period of ICR. The pH was higher and the plasma lactate concentration was significantly lower at one hour after birth in the ICR than in the ICC group (pH=7.17±0.1 vs 7.08±0.2; lactate=3.6±2.3 vs 6.6±4.3mmol/l, pCDH. The procedure may support the cardiorespiratory transition at birth in infants with CDH. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Magnetic resonance and cranial ultrasound characteristics of periventricular white matter abnormalities in newborn infants

    International Nuclear Information System (INIS)

    Childs, Anne-Marie; Cornette, Luc; Ramenghi, Luca A.; Tanner, Steven F.; Arthur, Rosemary J.; Martinez, Delia; Levene, Malcolm I.

    2001-01-01

    OBJECTIVE: To characterize the range of abnormalities within the periventricular white matter (PVWM) in a cohort of newborns using magnetic resonance (MR) brain imaging and to compare the focal MR abnormalities with the cranial ultrasound (CUS) findings. METHODS: Retrospective study of MR brain and CUS findings of infants born in the 18-month period 1998-1999. PVWM abnormalities were identified by MR and focal lesions were characterized by size, number and distribution using a grading scale. Correspondence with CUS findings was assessed. RESULTS: 175 MR examinations corresponding to n = 105 preterm infants, (median GA 28, range 23-36 weeks) and n = 25 term infants (median GA 39, range 37-42 weeks) were analysed for PVWM abnormalities. In the preterm group, MR demonstrated a normal PVWM in n = 76, focal areas of altered signal intensity (SI) in PVWM in n = 26 and venous infarction inn 3. In the term group, MR demonstrated a normal PVWM in n = 15, focal areas of altered SI in PVWM in n = 4, oedematous PVWM in n = 2 and a middle cerebral artery infarction in n = 4. All infants with normal MR had normal CUS findings. A focal PVWM SI abnormality detectable on MR corresponded with an abnormality on CUS in only n = 10/30. CONCLUSIONS: MR appears considerably more sensitive than CUS in demonstrating the existence and extent of focal PVWM lesions in newborn infants. Satisfactory correspondence between the two imaging investigations is obtained only for cystic PVWM lesions. Childs, A.-M. et al. (2001)

  2. Multiple arterial anomalies in the newborn infant. Echocardiographic and angiographic diagnosis

    Directory of Open Access Journals (Sweden)

    Ivan Romero Rivera

    2000-08-01

    Full Text Available Multiple arterial anomalies characterized by tortuosity and rolling of the pulmonary arteries and aorta were diagnosed on echocardiography in an asymptomatic newborn infant with a phenotype suggesting Ehlers-Danlos syndrome. These changes were later confirmed on angiography, which also showed peripheral vascular abnormalities. The electrocardiogram showed a probable hemiblock of the left anterosuperior branch, and the chest x-ray showed an excavated pulmonary trunk with normal pulmonary flow.

  3. Overlap of clinical features of Smith-Magenis & Down Syndrome in newborns and infants

    Energy Technology Data Exchange (ETDEWEB)

    Thomson, K.A.; Finucane, B.M.; Bauer, M.S. [Integrated Genetics, West Paterson, NJ (United States)] [and others

    1994-09-01

    Smith-Magenis Syndrome (SMS) frequently goes unrecognized in newborns and infants as these patients do not yet demonstrate the characteristic behavioral phenotype and may only present with developmental delay and physical dysmorphism. Six of Hall`s ten cardinal features of trisomy 21 in the newborn are also frequently found in newborns with SMS, leading to an early presumptive diagnosis of DS in many of these patients. CASE No. 1: Based on clinical findings, a presumptive diagnosis of DS was given to the patient in the newborn period. Chromosome analysis of peripheral blood revealed a normal 46,XX karyotype. Given this result, the possibility of mosaic DS was raised, and a skin fibroblast study done. Again, the karyotype was reported as normal. Clinical features and cytogenetic analysis confirmed a diagnosis of SMS when the patient was 8 years old. CASE No. 2: A presumptive diagnosis of DS was made in an infant with hypotonia, facial dysmorphisms and congenital heart defects. A routine chromosome analysis was ordered, which revealed a 46,XY,del(17)(p11.2p11.2) karyotype. Indeed, approximately 38% of blood samples referred to our laboratory to rule out DS in an infant failed to demonstrate trisomy for chromosome 21. Given the high degree of clinical overlap with Down Syndrome, the diagnosis of SMS should be considered in all such patients. Additional analysis should be done to look for deletion 17p11.2 when faced with a {open_quotes}normal{close_quotes} karyotype in an infant referred to rule out DS.

  4. Newborn hearing screening and strategy for early detection of hearing loss in infants.

    Science.gov (United States)

    Jakubíková, Janka; Kabátová, Zuzana; Pavlovcinová, Gabriela; Profant, Milan

    2009-04-01

    More than 80% of permanent hearing losses (HL) in children are congenital. Newborn hearing screening (NHS) is the best method for early detection of suspected hearing loss. If the NHS is not universal more than 30% permanent hearing losses are not identified. There are various methods of NHS: otoacoustic emissions (TEOAE, DPOAE) and automatic auditory brainstem response (AABR). After hearing screening, and when hearing loss is suspected, tympanometry and audiological methods then used for determination of hearing threshold; these include ABR, ASSR or/and behavioral methods. The goal of this study is to evaluate the influence of UNHS on the early detection of hearing loss in children before and after the implementation of obligatory universal newborn hearing screening in Slovakia, and also on the etiologic evaluation of hearing impaired infants identified by screening. In Slovakia NHS started in 1998 and was provided in ENT departments. From May 1, 2006 UNHS has been mandatory in Slovakia, using two stages TEOAE in all newborn departments in Slovakia (64 newborn departments). In year 2005--42% of newborns in Slovakia were screened, in 2006--66% newborns and in 2007--94, 99% (three small newborn departments do not yet have equipment for OAE screening). For determination of hearing thresholds ASSR are used in two ENT departments and ABR in the other four ENT departments. Comparing the number of identified cases with bilateral severe permanent HL or deafness before and after UNHS, 22.8% more cases of PHL were identified in the first year of UNHS. Also the average age of diagnosis of PHL was lower. In the year 2007, 94% of newborns were screened. We found 0.947/1000 newborns with bilateral severe PHL (35.9%) more than before UNHS). After audiologic and etiologic assessment of the 76 infants who failed screening, 5 (6.58%) were found to have normal hearing, 16 (22.54%) had unilateral and 55 (77.46%) had bilateral SNHL. A non-syndromic genetic cause was present in 25

  5. [Somatometry in the full-term newborn infant (preliminary report)].

    Science.gov (United States)

    Ramos Galván, R; Díaz Graham, C; Martí Torroella, G; Pinal, A M

    1977-01-01

    As a preliminary comunication, the authors report a somatometric study carried out in 315 full term newborns from different socioeconomic situation; 152 were born at the Hospital General, S.S.A. and 163, in a private hospital where middle and high class families are attended. The information is grouped on whether measurements are related to physical growth, th state of nutrition or to physical development. Several conditions which necessarily must be taken as independent variables in a study of this sort, such as the age of the parents, but specially of the mother, the period of gestation and of course, the socioeconomic level, were analyzed. The finding of up to 17% of case with height under 47 cm. and/or weight under 2,500 g., outstands the necessity to study the homeorrhesis phenomenon as a very important detail in this type of material.

  6. HIV-Associated Tuberculosis in the Newborn and Young Infant

    Directory of Open Access Journals (Sweden)

    M. Adhikari

    2011-01-01

    Full Text Available Each year, approximately 250 000 women die during pregnancy, delivery, or postpartum. Maternal mortality rates due to tuberculosis (TB and HIV in Sub-Saharan Africa now supersede obstetric-related causes of mortality. The majority of cases occur in population-dense regions of Africa and Asia where TB is endemic. The vertical transmission rate of tuberculosis is 15%, the overall vertical transmission rate of HIV in resource-limited settings with mono- or dual-ARV therapy varies from 1.9% to 10.7%. If the millennium development goals are to be achieved, both HIV and TB must be prevented. The essential aspect of TB prevention and detection in the newborn is the maternal history and a positive HIV status in the mother. Perinatal outcomes are guarded even with treatment of both diseases. Exclusive breast feeding is recommended. The community and social impact are crippling. The social issues aggravate the prognosis of these two diseases.

  7. In vivo effect of pneumonia on surfactant disaturated-phosphatidylcholine kinetics in newborn infants.

    Science.gov (United States)

    Facco, Maddalena; Nespeca, Matteo; Simonato, Manuela; Isak, Ilena; Verlato, Giovanna; Ciambra, Gianluca; Giorgetti, Chiara; Carnielli, Virgilio P; Cogo, Paola E

    2014-01-01

    Bacterial pneumonia in newborns often leads to surfactant deficiency or dysfunction, as surfactant is inactivated or its production/turnover impaired. No data are available in vivo in humans on the mechanism of surfactant depletion in neonatal pneumonia. We studied the kinetics of surfactant's major component, disaturated-phosphatidylcholine (DSPC), in neonatal pneumonia, and we compared our findings with those obtained from control newborn lungs. We studied thirty-one term or near-term newborns (gestational age 39.7±1.7 weeks, birth weight 3185±529 g) requiring mechanical ventilation. Fifteen newborns had pneumonia, while 16 newborns were on mechanical ventilation but had no lung disease. Infants received an intratracheal dose of 13C labeled dipalmitoyl-phosphatidylcholine at the study start. We measured the amount and the isotopic enrichment of DSPC-palmitate from serial tracheal aspirates by gas chromatography and gas chromatography-mass spectrometry, respectively, and we calculated the DSPC half-life (HL) and pool size (PS) from the isotopic enrichment curves of surfactant DSPC-palmitate. The mean DSPC amount obtained from all tracheal aspirates did not differ between the two groups. DSPC HL was 12.7 (6.5-20.2) h and 25.6 (17.9-60.6) h in infants with pneumonia compared with control infants (p = 0.003). DSPC PS was 14.1 (6.6-30.9) mg/kg in infants with pneumonia and 34.1 (25.6-65.0) mg/kg in controls, p = 0.042. Myeloperoxidase (MPO) activity, as a marker of lung inflammation, was 1322 (531-2821) mU/ml of Epithelial Lining Fluid (ELF) and 371(174-1080) mU/ml ELF in infants with pneumonia and in controls, p = 0.047. In infants with pneumonia, DSPC PS and HL significantly and inversely correlated with mean Oxygenation Index (OI) during the study (DSPC PS vs. OI R = -0.710, p = 0.004 and HL vs. OI R = -0.525, p = 0.044, respectively). We demonstrated for the first time in vivo in humans that DSPC HL and PS were markedly impaired in

  8. Diagnosis and Treatment of Ankyloglossia in Newborns and Infants: A Review.

    Science.gov (United States)

    Walsh, Jonathan; Tunkel, David

    2017-10-01

    The influence of tongue tie, or ankyloglossia, on breastfeeding is the subject of growing debate. Restriction of tongue mobility from the frenulum varies greatly among newborns and infants (hereinafter referred to as infants). Controversies about whether an infant has ankyloglossia and which infants need treatment are evident with wide variations in medical practice and a lack of high-quality clinical studies that provide guidance. Diagnosis and management of ankyloglossia in infants can be a source of confusion and frustration for clinicians and families. Frenotomy is a low-risk procedure that is likely to be beneficial with careful patient selection, but the natural history of untreated ankyloglossia is not well documented. The variability in presentation and treatment outcomes of ankyloglossia indicate that the complexity of infant feeding and tongue development is not fully encapsulated in a simplistic ankyloglossia etiologic framework. Consistent terminology with emphasis on symptomatic ankyloglossia and a uniform grading system, such as the Hazelbaker Assessment Tool for Lingual Frenulum Function and Coryllos grading, are needed to improve the quality of research in the future. The ability to make definitive practice guidelines is limited with our current understanding of ankyloglossia. Additional research is needed to better understand the complexity of infant feeding and the role of ankyloglossia.

  9. Phototherapy rash in newborn infants: does it differ between conventional and light emitting diode phototherapy?

    Science.gov (United States)

    Surmeli-Onay, Ozge; Korkmaz, Ayse; Yigit, Sule; Yurdakok, Murat

    2013-01-01

    Data comparing the cutaneous side effects of light emitting diode (LED) phototherapy (LP) and conventional phototherapy (CP) devices in jaundiced newborn infants are very limited. We investigated the incidence and extent of skin eruptions caused by different phototherapy devices in preterm infants who are more prone to neonatal jaundice. This prospective, randomized controlled trial was conducted in the neonatal intensive care unit (NICU) of Hacettepe University Ihsan Dogramaci Childrens' Hospital in Ankara, Turkey. Preterm infants without skin lesions before and requiring phototherapy in the first week of life were included in the study. The infants were randomly assigned to receive CP or LP and were monitored closely for skin eruptions during phototherapy. Fifty-eight infants were included in the study: 25 (43.1%) received CP while 33 (56.9%) received LP. The duration of phototherapy was similar in the two groups (30.4 ± 9.6 hours and 31.8 ± 15.6 hours, respectively). Baseline and control bilirubin levels were similar for the two groups (p = 0.101 and p = 0.105, respectively). The frequency of skin eruptions was 36% in the CP group and 33% in the LP group (p = 0.83). The skin eruptions were macules in 13 (22.4%), papules in 5 (8.6%), and maculopapular rashes in 2 (3.4%) infants.There were no differences in the incidence and extent of skin eruptions in preterm infants who received CP or LP. © 2013 Wiley Periodicals, Inc.

  10. Plasma cytokine levels fall in preterm newborn infants on nasal CPAP with early respiratory distress.

    Science.gov (United States)

    Carvalho, Clarissa Gutierrez; Silveira, Rita de Cassia; Neto, Eurico Camargo; Procianoy, Renato Soibelmann

    2015-01-01

    Early nCPAP seems to prevent ventilator-induced lung injury in humans, although the pathophysiological mechanisms underlying this beneficial effect have not been clarified yet. To evaluate plasma levels IL-1β, IL-6, IL-8, IL-10, and TNF-α immediately before the start of nCPAP and 2 hours later in preterm infants. Prospective cohort including preterm infants with 28 to 35 weeks gestational age with moderate respiratory distress requiring nCPAP. Extreme preemies, newborns with malformations, congenital infections, sepsis, surfactant treatment, and receiving ventilatory support in the delivery room were excluded. Blood samples were collected right before and 2 hours after the start of nCPAP. 23 preterm infants (birth weight 1851±403 grams; GA 32.3±1.7 weeks) were treated with nCPAP. IL-1β, IL-10, TNF-α levels were similar, IL-8 levels were reduced in 18/23 preterm infants and a significant decrease in IL-6 levels was observed after 2 hours of nCPAP. All newborns whose mothers received antenatal steroids had lower cytokine levels at the onset of nCPAP than those whose mothers didn't receive it; this effect was not sustained after 2 hours of nCPAP. Early use nCPAP is not associated with rising of plasma pro-inflammatory cytokines and it seems to be a less harmful respiratory strategy for preterm with moderate respiratory distress.

  11. Plasma cytokine levels fall in preterm newborn infants on nasal CPAP with early respiratory distress.

    Directory of Open Access Journals (Sweden)

    Clarissa Gutierrez Carvalho

    Full Text Available Early nCPAP seems to prevent ventilator-induced lung injury in humans, although the pathophysiological mechanisms underlying this beneficial effect have not been clarified yet.To evaluate plasma levels IL-1β, IL-6, IL-8, IL-10, and TNF-α immediately before the start of nCPAP and 2 hours later in preterm infants.Prospective cohort including preterm infants with 28 to 35 weeks gestational age with moderate respiratory distress requiring nCPAP. Extreme preemies, newborns with malformations, congenital infections, sepsis, surfactant treatment, and receiving ventilatory support in the delivery room were excluded. Blood samples were collected right before and 2 hours after the start of nCPAP.23 preterm infants (birth weight 1851±403 grams; GA 32.3±1.7 weeks were treated with nCPAP. IL-1β, IL-10, TNF-α levels were similar, IL-8 levels were reduced in 18/23 preterm infants and a significant decrease in IL-6 levels was observed after 2 hours of nCPAP. All newborns whose mothers received antenatal steroids had lower cytokine levels at the onset of nCPAP than those whose mothers didn't receive it; this effect was not sustained after 2 hours of nCPAP.Early use nCPAP is not associated with rising of plasma pro-inflammatory cytokines and it seems to be a less harmful respiratory strategy for preterm with moderate respiratory distress.

  12. Respiratory function parameters in ventilated newborn infants undergoing whole body hypothermia.

    Science.gov (United States)

    Dassios, Theodore; Austin, Topun

    2014-02-01

    Whole body hypothermia (WBH) exerts proven neuroprotective effects in infants with hypoxic-ischaemic encephalopathy (HIE). Our aim was to describe how WBH could impact on respiratory function in mechanically ventilated newborn infants, by recording primary and composite indices of oxygenation and ventilation before, during and after WBH. The medical notes of 31 mechanically ventilated full-term newborn infants who underwent WBH for HIE were retrospectively reviewed. Fraction of inspired oxygen (FiO2), tidal volume (TV), mean airway Pressure (MAP), minute ventilation (MV), static compliance of the respiratory system (C(statRS)), ventilation efficiency index (VEI), alveolar-arterial gradient (A-a gradient) and oxygenation index (OI) were documented before and during hypothermic treatment, as well as during and after rewarming. Fraction of inspired oxygen, MAP, OI and A-a gradient decreased during induction of hypothermia and tended to increase during rewarming. C(statRS), VEI and TV increased during induction of hypothermia and tended to decrease during rewarming. None of the changes achieved statistical significance. These results suggest that WBH might affect respiratory function in mechanically ventilated infants with HIE. Oxygenation might be enhanced by hypothermia, probably as a result of decreased metabolism, while ventilation might also be facilitated as a result of the effect of hypothermia on lung mechanics. ©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  13. Extracting respiratory data from pulse oximeter plethysmogram traces in newborn infants.

    Science.gov (United States)

    Wertheim, D; Olden, C; Savage, E; Seddon, P

    2009-07-01

    To investigate whether valid respiratory data can be extracted from the pulse oximeter plethysmographic (pleth) trace in healthy newborn infants, pleth data were collected from the foot, and respiratory airflow was simultaneously measured using a facemask. The pleth waveform was analysed using fast Fourier transform (FFT), low-pass filtering (LPF), and by plotting the peak-to-peak amplitude variation (PtP). Using FFT in 14 term infants, the median (range) respiratory rate from the pleth signal was 43 (30-65) breaths/min, and from the flow signal it was 44 (30-67) breaths/min (median difference 0.01 breaths/min, p>0.05). Both LPF and PtP analysis yielded waveforms with a frequency similar to the respiratory rate. Respiratory information, including respiratory rate and a respiratory-like waveform, can reliably be extracted from the pleth trace of a standard pulse oximeter in newborn infants. Such analysis may be clinically useful for non-invasive assessment of respiratory problems in infants and young children.

  14. Eye-Mouth Associated Movement in the Human Newborn and Very Young Infant.

    Science.gov (United States)

    Futagi, Yasuyuki; Ozaki, Nozomu; Matsubara, Tamehito; Futagi, Masaharu; Suzuki, Yasuhiro; Kitajima, Hiroyuki

    2016-05-01

    The aim of this study is to demonstrate that goal-directed eye-mouth associated movement exists in the newborn and very young infant. The participants were 17 healthy term newborns or very young infants whose ages at the time of the first examination ranged from 1 to 24 days. The examiner held the tip of an index finger 20 to 30 cm in front of a participant's mouth, then suddenly moved it directly toward the mouth. Thirteen of the participants were also examined with the examiner's palm as the visual stimulus. The response was judged to be positive if clear mouth opening was elicited as the fingertip or palm was approaching the mouth. In the examinations using a fingertip, the frequency of a positive response as to the total number of examinations in the different age groups within the first two months of life ranged between 43.9% and 48.8%, and precipitously decreased to 6.3% at two months of age. A positive response was not elicited from age three months. On the other hand, in the examinations using a palm, the frequency of a positive response was 5.0% in the newborns, and 6.7% in the infants aged between seven days and one month. A positive response was never obtained from two months of age. This study demonstrated that visually guided mouth opening toward an approaching target exists in the human newborn. The eye-mouth associated movement may be controlled through rudimentary but functional visuomotor circuits in the brain interconnecting different cortices. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Neurophysiological measures of nociceptive brain activity in the newborn infant – the next steps

    Science.gov (United States)

    Hartley, Caroline; Slater, Rebeccah

    2014-01-01

    Infants within neonatal intensive care units can receive multiple medically essential painful procedures per day. How they respond to these events, how best to alleviate the negative effects, and the long-term consequences for the infant are all significant questions that have yet to be fully answered. In recent years, several studies have examined cortical responses to noxious stimuli in the neonate through the use of near-infrared spectroscopy (NIRS) and electroencephalography (EEG). These investigations dispel any notion that the newborn infant does not process noxious stimuli at a cortical level and open the way for future research. In this Viewpoint Article, we review these studies and discuss key clinical challenges which may be elucidated with the use of these techniques. Conclusion Simultaneously measuring the changes that are evoked in behaviour, physiology and the cortex following noxious events will provide the best approach to understanding the neonate's experience of pain. PMID:24180281

  16. Pulmonary surfactant kinetics of the newborn infant: novel insights from studies with stable isotopes.

    Science.gov (United States)

    Carnielli, V P; Zimmermann, L J I; Hamvas, A; Cogo, P E

    2009-05-01

    Deficiency or dysfunction of the pulmonary surfactant plays a critical role in the pathogenesis of respiratory diseases of the newborn. After a short review of the pulmonary surfactant, including its role in selected neonatal respiratory conditions, we describe a series of studies conducted by applying two recently developed methods to measure surfactant kinetics. In the first set of studies, namely 'endogenous studies', which used stable isotope-labeled intravenous surfactant precursors, we have shown the feasibility of measuring surfactant synthesis and kinetics in infants using several metabolic precursors, including plasma glucose, plasma fatty acids and body water. In the second set of studies, namely 'exogenous studies', which used a stable isotope-labeled phosphatidylcholine (PC) tracer given endotracheally, we estimated the surfactant disaturated phosphatidylcholine (DSPC) pool size and half-life. The major findings of our studies are presented here and can be summarized as follows: (a) the de novo synthesis and turnover rates of the surfactant (DSPC) in preterm infants with respiratory distress syndrome (RDS) are very low with either precursor; (b) in preterm infants with RDS, pool size is very small and half-life much longer than what has been reported in animal studies; (c) patients recovering from RDS who required higher continuous positive airway pressure pressure after extubation or reintubation have a lower level of intrapulmonary surfactant than those who did well after extubation; (d) term newborn infants with pneumonia have greatly accelerated surfactant catabolism; and (e) infants with uncomplicated congenital diaphragmatic hernia (CDH) and on conventional mechanical ventilation have normal surfactant synthesis, but those requiring extracorporeal membrane oxygenated (ECMO) do not. Information obtained from these studies in infants will help to better tailor exogenous surfactant treatment in neonatal lung diseases.

  17. Permanent Childhood Hearing Impairment: Aetiological Evaluation of Infants identified through the Irish Newborn Hearing Screening Programme

    LENUS (Irish Health Repository)

    Smith, A

    2017-11-01

    The Newborn Hearing Screening Programme (NHSP) was established in Cork University Maternity Hospital (CUMH) in April 2011. Between April 2011 and July 2014, 42 infants were identified with a Permanent Childhood Hearing Impairment (PCHI). Following this diagnosis, infants underwent a paediatric assessment according to recognised guidelines with the intention of identifying the underlying aetiology of the PCHI. The aim of this study was to assess the findings of this aetiological workup via retrospective chart review. PCHI data was obtained from the eSP database. This is a web based information system (eSP) used to track each baby through the screening and referral process A retrospective chart review of these patients was performed. Sixteen (38%) infants were diagnosed with a bilateral sensorineural hearing loss. Two infants had congenital CMV infection. A Connexin 26 gene mutation was detected in one infant. Two infants were diagnosed with Waardenburg syndrome, One with Pendred syndrome and one with Pfeiffer syndrome. Five babies underwent cochlear implantation. Through adherence to the recommended protocol a possible cause of PCHI may be determined. This study has identified areas of future improvement for this service in Ireland.

  18. Bioavailability of cadmium from infant diets in newborn rats

    Energy Technology Data Exchange (ETDEWEB)

    Eklund, G.; Oskarsson, A. [Dept. of Pharmacology and Toxicology, Swedish University of Agricultural Sciences, Uppsala (Sweden); Petersson Grawe, K. [Toxicology Div., National Food Administration, Uppsala (Sweden)

    2001-11-01

    Infants are exposed to higher levels of cadmium (Cd) from infant and follow-on formulas than from breast milk. We studied the bioavailability of {sup 109}CdCl{sub 2} from cows' milk formula, soy formula, wheat/oat/milk formula, wholemeal/milk formula and water in 11-day-old rat pups. The pups received a single oral dose of one diet labelled with {sup 109}Cd, 0.1 or 0.3 mg Cd/kg body weight. After 2 or 24 h or 4, 9 or 12 days the fractional retention of {sup 109}Cd in the whole body, in segments of rinsed small intestine and in tissue was measured in a gamma counter. Pups receiving {sup 109}Cd in water or cows' milk formula had the highest mean whole-body retention. It ranged from 67% of the dose in the water group to 52% in the wholemeal/milk formula group 4 days after dosing. The retention of {sup 109}Cd in the rinsed small intestine was significantly higher in the water group and the cows' milk formula group than in the cereal-based formula groups at 24 h and 4 days after dosing. It was still high in all groups on day 9, ranging from 26 to 11%. Initially most of the {sup 109}Cd was retained in the duodenum but by day 4 it had moved further down into the jejunum. In the liver, the highest and lowest retention on day 4 was 16 permille and 3 permille of the dose in the water group and wholemeal/milk formula group, respectively. In the kidney, {sup 109}Cd was still increasing 12 days after exposure in all groups. Whole-body retention and tissue levels were higher than previously reported in adult animals. The lower bioavailability of {sup 109}Cd from the cereal-based formulas compared to water and cows' milk formula on the longer survival times is most likely explained by Cd binding to dietary fibre and phytic acid in the cereal-based formulas reducing the intestinal binding and decreasing the bioavailability of Cd. The high retention of {sup 109}Cd in the small intestine, leading to a prolonged absorption period, emphasizes the importance of

  19. Physiological responses of preterm newborn infants submitted to classical music therapy.

    Science.gov (United States)

    da Silva, Camila Mendes; Cação, Jessica Marcelle R; Silva, Karin Cristina dos S; Marques, Cassia Fernandes; Merey, Leila Simone F

    2013-01-01

    To evaluate the physiological effects of music therapy on hospitalized preterm newborns. A noncontrolled clinical trial including 12 newborn infants with gestational age classical music therapy twice a day (morning and afternoon) for three consecutive days. The variables: heart and respiratory rates, oxygen saturation, diastolic and systolic arterial pressures, and body temperature were analyzed before and immediately after each music therapy session. There was a decrease in the heart rate after the second session of music therapy (paired t-test; p=0.002), and an increase at the end of the third session (paired t-test; p=0.005). Respiratory rate decreased during the fourth and fifth sessions (paired t-test; p=0.01 and 0.03, respectively). Regarding oxygen saturation, there was an increase after the fifth session (p=0.008). Comparison of physiological parameters among sessions, for the six studied sessions, showed only that the gain in oxygen saturation during the fifth session was significantly higher than during the sixth one (Tukey's test after variance analysis; p=0.04). Music therapy may modify short-term physiological responses of hospitalized preterm newborn infants.

  20. Sucrose for analgesia in newborn infants undergoing painful procedures.

    Science.gov (United States)

    Stevens, Bonnie; Yamada, Janet; Ohlsson, Arne; Haliburton, Sarah; Shorkey, Allyson

    2016-07-16

    heterogeneity by the I(2) test. We assessed the risk of bias of included trials using the Cochrane 'Risk of bias' tool, and assessed the quality of the evidence using the GRADE system. Seventy-four studies enrolling 7049 infants were included. Results from only a few studies could be combined in meta-analyses and for most analyses the GRADE assessments indicated low- or moderate-quality evidence. There was high-quality evidence for the beneficial effect of sucrose (24%) with non-nutritive sucking (pacifier dipped in sucrose) or 0.5 mL of sucrose orally in preterm and term infants: Premature Infant Pain Profile (PIPP) 30 s after heel lance WMD -1.70 (95% CI -2.13 to -1.26; I(2) = 0% (no heterogeneity); 3 studies, n = 278); PIPP 60 s after heel lance WMD -2.14 (95% CI -3.34 to -0.94; I(2) = 0% (no heterogeneity; 2 studies, n = 164). There was high-quality evidence for the use of 2 mL 24% sucrose prior to venipuncture: PIPP during venipuncture WMD -2.79 (95% CI -3.76 to -1.83; I(2) = 0% (no heterogeneity; 2 groups in 1 study, n = 213); and intramuscular injections: PIPP during intramuscular injection WMD -1.05 (95% CI -1.98 to -0.12; I(2) = 0% (2 groups in 1 study, n = 232). Evidence from studies that could not be included in RevMan-analyses supported these findings. Reported adverse effects were minor and similar in the sucrose and control groups. Sucrose is not effective in reducing pain from circumcision. The effectiveness of sucrose for reducing pain/stress from other interventions such as arterial puncture, subcutaneous injection, insertion of nasogastric or orogastric tubes, bladder catherization, eye examinations and echocardiography examinations are inconclusive. Most trials indicated some benefit of sucrose use but that the evidence for other painful procedures is of lower quality as it is based on few studies of small sample sizes. The effects of sucrose on long-term neurodevelopmental outcomes are unknown. Sucrose is effective for reducing procedural pain from single

  1. The effect of massage on neonatal jaundice in stable preterm newborn infants: a randomized controlled trial.

    Science.gov (United States)

    Basiri-Moghadam, Mahdi; Basiri-Moghadam, Kokab; Kianmehr, Mojtaba; Jani, Somaye

    2015-06-01

    To evaluate the effects of massage therapy on transcutaneous bilirubin of stable preterm infants. The controlled clinical trial was conducted in 2014 at Shahid Hasheminejhad Hospital, Iran, and comprised preterm neonatal children in the neonatal intensive care unit. The newborns were divided into two groups of massage and control via random allocation. The children in the control group received the routine therapy whereas those in the massage group underwent the same four days of routine plus 20 minutes of massage twice a day. The transcutaneous bilirubin and the number of excretions of the newborns were noted from the first to the fourth day of the intervention and results were compared between the two groups. There were 40 newborns in the study l 20(50%) each in the two groups. There was a significant difference in the number of times of defecation (p=0.002) and in the level of bilirubin (p=0.003) between the groups with those in the massage group having a higher number of defecations as well as a lower level of transcutaneous bilirubin. Through massage therapy the bilirubin level in preterm newborns can be controlled and a need for phototherapy can also be delayed.

  2. Complete rooming-in care of newborn infants

    Directory of Open Access Journals (Sweden)

    Yoo Min Lee

    2010-05-01

    Full Text Available Purpose : In Kyung Hee East-West Neo Medical Center, Seoul,Korea, efforts to raise rooming-in care success rate have been undertaken since when the hospital was established in 2006. We intended to analyze our experience over the past 3 years of period and to discuss the advantages of rooming-in. Methods : We analyzed the rooming-in practice rate, failure rate, and the breast feeding rate. Subjects were 860 normal healthy neonates from June 2006 to June 2009. Results: Among these 860 cases, 83 babies were required separation out of rooming-in in the middle of the course. Among these 83 cases, 70 cases had to stop the course due to poor condition of babies and 13 cases due to maternal condition. 70 cases of infant’s causes consist of 68 cases of NICU admission and 2 cases of poor feeding support. The other 13 cases of separation include refusal by maternal condition. Therefore the success rate of rooming-in for the last 3 years was 90.3%, that is 777 cases among the total 860 cases. The percentage of exclusive breast feeding was 64%, that of mixed feeding with breast and formula feeding was 25%, and formula feeding only was 11%. Conclusion : We experienced successful rooming-in care for the last 3 years. Nursery facilities should educate and encourage the advantages of rooming-in, including the good formation of attachment between mother and infant, emotional stability, protection from infection, and increased breast feeding rate so that rooming-in care can be fully established.

  3. Obstetric antecedents to body-cooling treatment of the newborn infant.

    Science.gov (United States)

    Nelson, David B; Lucke, Ashley M; McIntire, Donald D; Sánchez, Pablo J; Leveno, Kenneth J; Chalak, Lina F

    2014-08-01

    Obstetric antecedents were analyzed in births in which the infant received whole-body cooling for neonatal encephalopathy. This retrospective cohort study included all live-born singleton infants delivered at or beyond 36 weeks' gestation from October 2005 through December 2011. Infants who had received whole-body cooling identified by review of a prospective neonatal registry were compared with a control group comprising the remaining obstetric population delivered at greater than 36 weeks but not cooled. Univariable analysis was followed up by a staged, stepwise selection of variables with the intent to rank significant risk factors for cooling. A total of 86,371 women delivered during the study period and 98 infants received whole-body cooling (1.1 per 1000 live births). Of these 98 infants, 80 newborns (88%) had moderate encephalopathy and 10 (12%) had severe encephalopathy prior to cooling. Maternal age of 15 years or younger, low parity, maternal body habitus (body mass index of ≥40 kg/m(2)), diabetes, preeclampsia, induction, epidural analgesia, chorioamnionitis, length of labor, and mode of delivery were associated with significantly increased risk of infant cooling during a univariable analysis. Catastrophic events to include umbilical cord prolapse (odds ratio [OR], 14; 95% confidence interval [CI], 3-72), placental abruption (OR, 17; 95% CI, 7-44), uterine rupture (OR, 130; 95% CI, 11-1477) were the strongest factors associated with infant cooling after staged-stepwise logistic analysis. A variety of intrapartum characteristics were associated with infant cooling for neonatal encephalopathy, with the most powerful antecedents being umbilical cord prolapse, placental abruption, and uterine rupture. Copyright © 2014 Mosby, Inc. All rights reserved.

  4. Definitions of cardiovascular insufficiency and relation to outcomes in critically ill newborn infants

    Science.gov (United States)

    Fernandez, Erika; Watterberg, Kristi L.; Faix, Roger G.; Yoder, Bradley A.; Walsh, Michele C.; Lacy, Conra Backstrom; Osborne, Karen A.; Das, Abhik; Kendrick, Douglas E.; Stoll, Barbara J.; Poindexter, Brenda B.; Laptook, Abbot R.; Kennedy, Kathleen A.; Schibler, Kurt; Bell, Edward F.; Van Meurs, Krisa P.; Frantz, Ivan D.; Goldberg, Ronald N.; Shankaran, Seetha; Carlo, Waldemar A.; Ehrenkranz, Richard A.; Sanchez, Pablo J.; Higgins, Rosemary D.

    2015-01-01

    Background We previously reported on the overall incidence, management and outcomes in infants with cardiovascular insufficiency (CVI). However, there are limited data on the relationship of the specific different definitions of CVI to short term outcomes in term and late preterm newborn infants. Objective To evaluate how 4 definitions of CVI relate to short term outcomes and death. Study Design The previously reported study was a multicenter, prospective cohort study of 647 infants ≥ 34 weeks gestation admitted to a Neonatal Research Network (NRN) newborn intensive care unit (NICU) and mechanically ventilated (MV) during their first 72 hours. The relationship of five short term outcomes at discharge and 4 different definitions of CVI were further analyzed. Results All 4 definitions were associated with greater number of days on MV & days on O2. The definition using a threshold blood pressure (BP) measurement alone was not associated with days to full feeding, days in the NICU or death. The definition based on treatment of CVI was associated with all outcomes including death. Conclusions The definition using a threshold BP alone was not consistently associated with adverse short term outcomes. Using only a threshold BP to determine therapy may not improve outcomes. PMID:25825962

  5. Mechanical ventilation of newborns infant changes in plasma pro- and anti-inflammatory cytokines.

    Science.gov (United States)

    Bohrer, Betania; Silveira, Rita C; Neto, Eurico C; Procianoy, Renato S

    2010-01-01

    To evaluate plasma levels of interleukin (IL)-1beta, IL-6, IL-8, IL-10, and tumor necrosis factor (TNF)-alpha in newborn infants immediately before and after 2 hours of mechanical ventilation. Term and late preterm neonates with no history of mechanical ventilation and/or ventilatory support were studied prospectively. Exclusion criteria were congenital malformations, congenital infections, use of nitric oxide, resuscitation with positive-pressure ventilation, and any procedure in the delivery room or neonatal intensive care unit that resulted in tracheal intubation. Blood samples for IL-1beta, IL-6, IL-8, IL-10, and TNF-alpha levels were collected before intubation and mechanical ventilation and 2 hours later. Nineteen newborn infants with gestational age 35.8 +/- 1.9 weeks and birth weight 2280 +/- 370 g were included. Pro-inflammatory cytokines increased: IL-8 (2.5-fold), IL-1beta (7.5-fold), and TNF-alpha (10-fold), and the anti-inflammatory cytokine IL-10 decreased by 90%. Although median IL-6 levels were similar between before and after ventilation, IL-6 increased in 89.4% of infants. A short period of mechanical ventilation promotes an imbalance of plasma levels of pro-inflammatory and anti-inflammatory cytokines. The systemic alteration of cytokines in response to mechanical ventilation may lead to ventilator-induced lung injury.

  6. The status of newborn infants born to women with hypertensive disorders

    Directory of Open Access Journals (Sweden)

    N. A. Shakhbazova

    2014-01-01

    Full Text Available The status of 239 newborn infants born to mothers with hypertensive syndrome (a study group and that of 51 neonates from healthy mothers (a control group were analyzed. Neonatal mortality and morbidity rates were studied in relation to gestational age and the type and severity of hypertensive disorders. Hypertensive disorders in pregnancy were found to lead to still birth in 2,1% of cases, late miscarriage in 12,1%, prematurity in 47,7%, and intrauterine growth retardation in 27,6%. The incidence of diseases in the infants born to hypertensive mothers was 6,6 times higher than that in those from healthy mothers. The most common nosological entities among the newborn infants were intracranial hemorrhage (29,3%, respiratory distress syndrome (20,1%, hypoxic-ischemic brain damage (22,6%, polycythemia (8,4%, and hyperbihrubinemia (8,8%. Reproductive losses in hypertensive disorders accounted for 17,2% and occurred in 70,7% of cases in the early postnatal period. Severe pathology and prematurity are responsible for high neonatal morbidity and mortality rates.

  7. Neurological outcomes in symptomatic congenital cytomegalovirus-infected infants after introduction of newborn urine screening and antiviral treatment.

    Science.gov (United States)

    Nishida, Kosuke; Morioka, Ichiro; Nakamachi, Yuji; Kobayashi, Yoko; Imanishi, Takamitsu; Kawano, Seiji; Iwatani, Sota; Koda, Tsubasa; Deguchi, Masashi; Tanimura, Kenji; Yamashita, Daisuke; Nibu, Ken-Ichi; Funakoshi, Toru; Ohashi, Masanobu; Inoue, Naoki; Iijima, Kazumoto; Yamada, Hideto

    2016-02-01

    Newborn screening for urinary cytomegalovirus (CMV) and early introduction of antiviral treatment are expected to improve neurological outcomes in symptomatic congenital CMV-infected infants. This cohort study prospectively evaluated neurological outcomes in symptomatic congenital CMV-infected infants following the introduction of hospital-based newborn urinary CMV screening and antiviral treatment. Following institutional review board approval and written informed consent from their parents, newborns were prospectively screened from 2009 to 2014 for urinary CMV-DNA by PCR within 1 week after birth at Kobe University Hospital and affiliated hospitals. CMV-positive newborns were further examined at Kobe University Hospital, and those diagnosed as symptomatic were treated with valganciclovir for 6 weeks plus immunoglobulin. Clinical neurological outcomes were evaluated at age ⩾12 months and categorized by the presence and severity of neurologic sequelae. Urine samples of 6348 newborns were screened, with 32 (0.50%) positive for CMV. Of these, 16 were diagnosed with symptomatic infection and 12 received antiviral treatment. Four infants developed severe impairment (33%), three developed mild impairment (25%), and five developed normally (42%). This is the first Japanese report of neurological assessments in infants with symptomatic congenital CMV infection who received early diagnosis and antiviral treatment. Urinary screening, resulting in early diagnosis and treatment, may yield better neurological outcomes in symptomatic congenital CMV-infected infants. Copyright © 2015 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  8. Proceedings: regional lung function in the newborn infant assessed by means of 133Xe

    Energy Technology Data Exchange (ETDEWEB)

    Koch, G.

    1975-01-01

    Regional distribution of ventilation and perfusion was assessed in 14 normal newborn infants and in some with respiratory distress (RDS) using a gamma camera computer system and /sup 133/Xe as tracer. The normal infants were at ages when R-L shunting through fetal channels is mainly abolished but minor L-R shunting through the ductes arteriosus still may occur. In the normal infant, distribution of ventilation and perfusion is nearly identical to that in the adult. The disappearance constants after inhalation (ventilated areas) and injection (perfused areas) are high indicating great efficiency of ventilation. This finding of high ventilatory efficiency is in accordance with direct measurements of alveolar ventilation. Despite the high efficiency, however, its distribution even in the normal infant is suprisingly uneven. The most important data is the ventilation/perfusion ratio which shows, as in the adult, relative hyperperfusion basically, while relative hyperventilation in the upper parts is less pronounced than in the adult. During RDS, uneven ventilation and perfusion distribution is much more pronounced. Another striking feature is the low ventilatory efficiency, a finding in agreement with PaCO/sub 2/ data indicating alveolar hypoventilation. Repeated studies in the same infant have demonstrated striking differences in corresponding distribution data between different studies despite similar clinical conditions suggesting that the degree of regional contribution to the overall function disturbance may vary considerably in the course of the disease.

  9. Rotavirus-specific helper T cell responses in newborns, infants, children, and adults.

    Science.gov (United States)

    Offit, P A; Hoffenberg, E J; Pia, E S; Panackal, P A; Hill, N L

    1992-06-01

    An obstacle to developing a successful rotavirus vaccine has been the inability to consistently correlate the humoral immune response with protection against disease. Transplacental transfer of maternal rotavirus-specific antibodies may obscure the capacity to discriminate an active from a passively acquired humoral immune response in infants. In an attempt to circumvent this problem, an assay was developed to detect rotavirus-specific helper T cells among circulating mononuclear cells. Rotavirus-specific lymphoproliferative responses and rotavirus-specific neutralizing antibody titers in blood were determined in 11 mother/newborn pairs at the time of delivery and in 54 infants, children, and adults ranging in age from 16 days to 40 years. Only 1 of 11 infants tested between 16 days and 6 months of age had detectable rotavirus-specific helper T cell activity whereas 8 of 11 had circulating rotavirus-specific neutralizing antibodies. Acquisition of rotavirus-specific helper T cell activity over the first few years of life correlated with the age at which infants and young children are known to be infected with rotavirus. These findings support the hypothesis that detection of rotavirus-specific lymphoproliferative activity in infants may more accurately determine previous exposure to rotavirus than detection of rotavirus-specific antibodies.

  10. Cystic fibrosis newborn screening enables diagnosis of elder siblings of recalled infants--additional benefit.

    Directory of Open Access Journals (Sweden)

    Anna Nowakowska

    2010-06-01

    Full Text Available The different clinical manifestations of cystic fibrosis, with variable intensity and timing, often delay the diagnosis of this genetic autosomal recessive disorder. Many countries have introduced newborn screening for cystic fibrosis to facilitate diagnosis prior to the development of the disease. The advantages and harms of such screening programmes are regularly reassessed. In the five families presented in this article the elder siblings of screened infants were diagnosed thanks to CF NBS. This is an example of a benefit for children not even directly covered by the screening programme, adding another CF NBS advantage to the balance.

  11. Results of ultrasound screening of the hips in newborns and infants

    Directory of Open Access Journals (Sweden)

    Džoleva-Tolevska Roza

    2012-01-01

    Full Text Available The aim of this study is to analyze the results of ultrasound screening of the hips in newborns and infants and to establish the importance of ultrasonography in early diagnosis and treatment of developmental dysplasia of the hips (DDH. Material and Methods: In 2010, at the Clinic for orthopedic surgery in Skopje, 6333 newborns and infants were examined. They were classified in 2 groups: first group consisted of patients with normal ultrasound findings and second group consisted of patients with DDH on ultrasound finding. Patients underwent clinical examination and ultrasonography of the hips. Results: We examined 6333 newborns and infants up to 6 months of age. 3213 were female and 3120 were male. In the first group there were 5932 (93.67% patients with normal ultrasound of the hip-Graf Type 1. In the second group there were 401 (6.33% patients with DDH on ultrasound. The patients of the second group were divided in 3 types according to Graf method. Graf Type 2-Patients with dysplasia 378 (5.97% subdivided in 2a- 260 (4.11% patients, 2b 85 (1.34% patients and 2c 33 (0.52% patients. Graf Type 3 - Patients with subluxation of the hip 9 (0.1%, subdivided in 3a 3 (0.05% patients and 3b 3 (0.5% patients. Graf Type 4 -Patients with luxation of the hip 17 (0.27% patients. 124 patients (30.5% with DDH had an associated risk factors (65 patients with positive family history, 48 patients with breech delivery and 11 patients with clubfoot deformity. 387 patients with dysplasia and subluxation of the hips were treated with abduction brace and Pavlik harness. 17 patients with luxation of the hips were treated with exercises and overhead traction of the muscles, close reduction of the hip placed in spica cast or open reduction. Conclusion: Ultrasound screening of hips in newborns and infants is important for early diagnosis of DDH. This is necessary for adequate treatments. If this disease is not treated properly it gives long term morbidity such as gait

  12. A new computerised method for the assessment of skeletal maturity in the newborn infant

    International Nuclear Information System (INIS)

    Argemi, J.; Badia, J.

    1997-01-01

    Of the existing methods for assessment of skeletal maturity in children over 1 year of age none is particularly suited to the newborn infant. We describe a computerised method by which area, perimeter and progression in the shape of ossification centres of talus and calcaneus are evaluated separately. From single lateral radiographs of the left ankle of 302 normal term and preterm infants whose birth weights were appropriate for gestational age we constructed reference curves of areas and perimeters at different gestational ages, as well as frequency distributions of each morphological maturity stage. This method may be applicable in assessing skeletal maturity in pathological conditions, such as intrauterine growth retardation and congenital hypothyroidism. (orig.). With 6 figs

  13. [Effect of very early kangaroo care on extrauterine temperature adaptation in newborn infants with hypothermia problems].

    Science.gov (United States)

    Huang, Ya-Yi; Huang, Ching-Yi; Lin, Shiu-Mei; Wu, Shu-Chuan

    2006-08-01

    Increased morbidity and mortality has been associated with neonates admitted with body temperatures below 36 degrees C. We employed an experimental design in a randomized control trial to compare the effectiveness of using early kangaroo care (KC) for extrauterine temperature adaptation against that of using radiant warmers. Trial subjects included 78 consecutive cesarean newborn infants with hypothermia problems. The KC group received skin-to-skin contact with their mothers in the post-operative room, while infants in the control group received routine care under radiant warmers. The mean temperature of the KC group was slightly higher than that of the control group (36.29 degrees C vs. 36.22 degrees C, p = .044). After four hours, 97.43% of KC group infants had reached normal body temperatures, compared with 82.05% in the radiant warmer group. Results demonstrate the positive effects of KC for extrauterine temperature adaptation in hypothermia infants. In the course of evidence-based practice, KC could be incorporated into the standard care regimen in order to improve hypothermia care.

  14. Withdrawal of life-sustaining treatment for newborn infants from a Christian perspective.

    Science.gov (United States)

    Scott-Joynt, Michael

    2012-02-01

    The more vulnerable a person, of whatever age, therefore, the more there must be a presumption in favour of life; and care must be offered with particular respect and dignity, and in the best interests of the infant her/himself, not in those of others. The principles, that guide Christians in making ethical healthcare decisions, were derived from two core Christian beliefs: that all human beings, of whatever age, are "made in the image of God"--so human beings have a distinctive dignity and value, and may not be treated as possessions or commodities; and that we are therefore made to live relationally--so communal, as well as individual, perspectives ought to be considered in ethical decision-making. The article then notes and explores three areas in which it may not be in the infant's best interests for life-sustaining treatment to continue or to be initiated, noting the complexity of "quality of life" questions, and the danger of considering others' quality of life over that of the infant. So, to safeguard the vulnerable, the threshold for acceptable "quality of life" needs to be set at a "low" level; and a distinction should be drawn, in considering withdrawing life-sustaining treatment, between medical intervention and "assisted-care" - so that there are very limited circumstances in which life-sustaining treatments ought to be withheld or withdrawn from newborn infants. Copyright © 2011 Elsevier Ltd. All rights reserved.

  15. [Developmental parameters and vitality of newborn infants in the period 1991-2002 in the health centre in Subotica].

    Science.gov (United States)

    Durković, Jasmina; Pavlović, Mirjana

    2005-01-01

    Infants having a birth weight of 2500 g or less are known as low birth weight infants. There are multiple factors which affect the nutritional status of newborn children: genetic potential, maternal age, parity, maternal health and maternal nutrition, drugs, alcohol, smoking, geographical situation and socioeconomic living conditions. Developmental parameters were analyzed in 15,455 live newborn infants in Subotica, from 1991 to 2002. The following parameters were registred: body mass in the first hour of life, body length, head and thorax circumference. These parameters were examined and correlated with other indicators of maturity and vitality, such as gestational age and Apgar score values. Parameter mean values are presented for each year from 1991 to 2002. Mean body mass values ranged from 3335.74 g in 1991 to 3418.01 g in 1998. Compared with the estimates provided by World Health Organization, the percentage of newborn infants with birth weight under 2500 g has increased (5.64%) in 1991, which was the first year of war and sanctions in our country. From 1994 to 1997, there was a war in neighbouring republics and a huge number of refugees from war regions arrived. The percentage of newborn infants with low birth weight has increased (the gratest percentage 5.08% has been found in 1996). During 1999, our country was bombed and since then, we have an increased number of newborn infants with low birth weight (4.46% were registred in 1999 to 5.22% in 2002). The number of children born before 37th week of gestation is greatest in 2000 (3.17%). Average Apgar score in 1992 was (9.20), showing graduate decrease since 1999, with lowest value during 2001 (8.85). Harmful environmental factors can strongly affect fetal growth. Continual follow-up of developmental parameters and vitality of infants on populatin level is an index of interactions between genetic potential and environmental factors, pointing to quality of health care and preventive services.

  16. Hemodynamic response to visual stimulation in newborn infants using functional near-infrared spectroscopy.

    Science.gov (United States)

    Karen, Tanja; Morren, Geert; Haensse, Daniel; Bauschatz, Andrea S; Bucher, Hans Ulrich; Wolf, Martin

    2008-04-01

    Brain activity is associated with physiological changes, which alter the optical properties of tissue. These changes can be detected by near-infrared spectroscopy (NIRS). Aim of the study was to determine changes in cerebral oxygenation in response to stimulation in the visual cortex in newborn infants during spontaneous sleep in the first days of life. We used an in-house developed multichannel NIRS imaging instrument, the MCP-II, to measure changes in concentration of oxyhemoglobin (O(2)Hb) and deoxyhemoglobin (HHb) in specific brain areas. In 10 out of 15 subjects, a significant increase in O(2)Hb and/or a significant decrease in HHb were found in one or more channels over the occipital cortex. During stimulation, O(2)Hb increased by a mean of 0.98 mumol/l, HHb decreased by a mean 0.17 mumol/l, and total-Hb increased by a mean of 0.81 mumol/l. The hemodynamic response to visual stimulation in the occipital cortex in newborn infants is similar to adults. The increase in O(2)Hb and the simultaneous decrease in HHb during stimulation suggest an increase in cerebral blood flow (CBF) that overcompensates for the increased oxygen consumption (CMRO(2)) in the activated cortical area. (c) 2007 Wiley-Liss, Inc.

  17. Analysis of risk factors for hydrocephalus development in newborn infants with germinal matrix hemorrhage.

    Science.gov (United States)

    Romero, L; Ros, B; Arráez, M A; Ríus, F; González, L; Martín, A; Carrasco, A; Segura, M

    2015-10-01

    The aim of this study was to analyze risk factors for the development of hydrocephalus in newborn infants with germinal matrix (GM) hemorrhage. The study comprised 271 patients admitted to Carlos Haya University Hospital in Malaga with GM hemorrhage. The following data were recorded: gestational age, gender, twin birth, head circumference at birth, weight at birth, and Papile grade. Severe obstetrical (abruption, chorioamnionitis, pregnancy-induced hypertension, tocolytic treatment) and neonatal disorders (respiratory distress syndrome, neonatal infection, coagulation disorder, patent ductus arteriosus, necrotizing enterocolitis) were also recorded. Symptomatic hydrocephalus was diagnosed in the event of a progressive increase in head circumference and ventricular indices requiring shunting. Of the 271 patients, 139 (51%) developed posthemorrhagic ventriculomegaly; 47 patients (17%) developed symptomatic hydrocephalus and needed shunt implantation. We found a significant relationship between the development of symptomatic hydrocephalus and Papile grade, lower gestational age, lower birth weight, twin birth, and neonatal infection. Awareness of risk factors for the development of hydrocephalus in newborn infants with GM hemorrhage should be emphasized in order to enable an early diagnosis of ventriculomegaly and symptomatic hydrocephalus and thus make a correct therapeutic decision.

  18. [Ganciclovir therapy for congenital cytomegalovirus infection in newborn infants: a meta analysis].

    Science.gov (United States)

    Hu, Jin-Tao; Chen, Ping-Yang; Xie, Zong-De; Dang, Xi-Qiang; Wang, Tao; He, Xiao-Ri; Li, Wen; Bo, Tao

    2010-01-01

    To evaluate the efficacy and safety of ganciclovir therapy for congenital cytomegalovirus (CMV) infection in newborn infants. The randomized controlled trials (RCTs) and quasi-RCTs on ganciclovir therapy for congenital CMV were reviewed in the following electronic databases: PubMed (January 1988 to January 2009), EMbase (January 1988 to January 2009), the Cochrane library (Issue 3, 2003 and Issue 1, 2009), the Chinese Journals Full-text Database (January 1994 to January 2009), the Chinese Biological Medical Disc (January 1994 to January 2009) and the Chinese Medical Current Contents (January 1994 to January 2009). Quality assessment, data extraction, and meta analysis were performed. Ten papers were included. Meta analysis showed that the ganciclovir therapy increased the improvement rate (91.4% vs 34.0%; pCMV infection indexes to become negative in more patients (87.6% vs 15.3%; pCMV infection indexes becoming negative, and decrease incidence of hearing disturbance, with few side effects, in newborn infants with CMV infection. However the supporting evidence is not strong due to few trials and more high-quality research is needed.

  19. Nasal continuous positive airway pressure (CPAP) for the respiratory care of the newborn infant.

    Science.gov (United States)

    Diblasi, Robert M

    2009-09-01

    Nasal continuous positive airway pressure (CPAP) is a noninvasive form of respiratory assistance that has been used to support spontaneously breathing infants with lung disease for nearly 40 years. Following reports that mechanical ventilation contributes to pulmonary growth arrest and the development of chronic lung disease, there is a renewed interest in using CPAP as the prevailing method for supporting newborn infants. Animal and human research has shown that CPAP is less injurious to the lungs than is mechanical ventilation. The major concepts that embrace lung protection during CPAP are the application of spontaneous breathing at a constant distending pressure and avoidance of intubation and positive-pressure inflations. A major topic for current research focuses on whether premature infants should be supported initially with CPAP following delivery, or after the infant has been extubated following prophylactic surfactant administration. Clinical trials have shown that CPAP reduces the need for intubation/mechanical ventilation and surfactant administration, but it is still unclear whether CPAP reduces chronic lung disease and mortality, compared to modern lung-protective ventilation techniques. Despite the successes, little is known about how best to manage patients using CPAP. It is also unclear whether different strategies or devices used to maintain CPAP play a role in improving outcomes in infants. Nasal CPAP technology has evolved over the last 10 years, and bench and clinical research has evaluated differences in physiologic effects related to these new devices. Ultimately, clinicians' abilities to perceive changes in the pathophysiologic conditions of infants receiving CPAP and the quality of airway care provided are likely to be the most influential factors in determining patient outcomes.

  20. Neonatal facial coding system scores and spectral characteristics of infant crying during newborn circumcision.

    Science.gov (United States)

    Lehr, Victoria Tutag; Zeskind, Philip Sanford; Ofenstein, John P; Cepeda, Eugene; Warrier, Indulekha; Aranda, J V

    2007-06-01

    To determine the relations between Neonatal Facial Coding System (NFCS) scores and measures of infant crying during newborn circumcision. Video and audio recordings were made of infant facial activity and cry sounds, respectively, during the lysis phase of circumcisions of 44 healthy term males (analgesia before circumcision. NFCS scores were determined by blinded assistant from video recordings of facial activity. Measures of infant crying were determined via spectrum analysis of audio recordings by a blinded, independent researcher. Pearson product-moment correlations were used to examine relationship between NFCS scores and measures of crying. Principal component factor analysis detected dimensions underlying related measures of crying. Factor scores from a factor analysis were used in stepwise linear regression to predict NFCS scores. Higher NFCS scores correlated with lower peak fundamental frequency of crying (P<0.01) and with higher amplitudes of crying at peak fundamental frequency and dominant frequency and in overall cry sample (P<0.01). The factor analysis showed 3 significant orthogonal dimensions underlying measures of crying: Power and Velocity (amplitude and rapidity), Pitch of Crying (frequency characteristics), and Infant Arousal (turbulence and intensity) accounting for 42.3%, 17.8%, and 14.6% of variance, respectively. A regression analysis showed all 3 factor scores accounted for significant and separate portions of variance (P<0.001). The best predictor of NFCS score was Power and Velocity (P<0.002), followed by Infant Arousal (P<0.002), and Pitch of Crying (P<0.007). These data provide some of the first known evidence linking specific measures of infant crying with an independent, validated measure of pain.

  1. Permissive hypercapnia for the prevention of morbidity and mortality in mechanically ventilated newborn infants.

    Science.gov (United States)

    Woodgate, P G; Davies, M W

    2001-01-01

    Experimental animal data and uncontrolled, observational studies in human infants have suggested that hyperventilation and hypocapnia may be associated with increased pulmonary and neurodevelopmental morbidity. Protective ventilatory strategies allowing higher levels of arterial CO2 (permissive hypercapnia) are now widely used in adult critical care. The aggressive pursuit of normocapnia in ventilated newborn infants may contribute to the already present burden of lung disease. However, the safe or ideal range for PCO2 in this vulnerable population has not been established. To assess whether, in mechanically ventilated neonates, a strategy of permissive hypercapnia improves short and long term outcomes (esp. mortality, duration of respiratory support, incidence of chronic lung disease and neurodevelopmental outcome). Standard strategies of the Cochrane Neonatal Review Group were used. Searches were made of the Oxford Database of Perinatal Trials, MEDLINE, CINAHL, and Current Contents. Searches were also made of previous reviews including cross-referencing, abstracts, and conference and symposia proceedings published in Pediatric Research. All randomised controlled trials in which a strategy of permissive hypercapnia was compared with conventional strategies aimed at achieving normocapnia (or lower levels of hypercapnia) in newborn infants who are mechanically ventilated were eligible. Standard methods of the Cochrane Neonatal Review Group were used. Trials identified by the search strategy were independently reviewed by each author and assessed for eligibility and trial quality. Data were extracted separately. Differences were compared and resolved. Additional information was requested from trial authors. Only published data were available for review. Results are expressed as relative risk and risk difference for dichotomous outcomes, and weighted mean difference for continuous variables. Two trials involving 269 newborn infants were included. Meta-analysis of

  2. The Role of Lung Ultrasound in Diagnosis of Respiratory Distress Syndrome in Newborn Infants.

    Science.gov (United States)

    Liu, Jing; Cao, Hai Ying; Wang, Hua-Wei; Kong, Xiang Yong

    2015-02-01

    Respiratory distress syndrome (RDS) is one of the most common causes of neonatal respiratory failure and mortality. The risk of developing RDS decreases with both increasing gestational age and birth weight. The aim of this study was to evaluate the value of lung ultrasound in the diagnosis of respiratory distress syndrome (RDS) in newborn infants. From March 2012 to May 2013, 100 newborn infants were divided into two groups: RDS group (50 cases) and control group (50 cases). According to the findings of chest x-ray, there were 10 cases of grade II RDS, 15 grade III cases, and 25 grade IV cases in RDS group. Lung ultrasound was performed at bedside by a single expert. The ultrasound indexes observed in this study included pleural line, A-line, B-line, lung consolidation, air bronchograms, bilateral white lung, interstitial syndrome, lung sliding, lung pulse etc. In all of the infants with RDS, lung ultrasound consistently showed generalized consolidation with air bronchograms, bilateral white lung or alveolar-interstitial syndrome, pleural line abnormalities, A-line disappearance, pleural effusion, lung pulse, etc. The simultaneous demonstration of lung consolidation, pleural line abnormalities and bilateral white lung, or lung consolidation, pleural line abnormalities and A-line disappearance co-exists with a sensitivity and specificity of 100%. Besides, the sensitivity was 80% and specificity 100% of lung pulse for the diagnosis of neonatal RDS. This study indicates that using an ultrasound to diagnose neonatal RDS is accurate and reliable too. A lung ultrasound has many advantages over other techniques. Ultrasound is non-ionizing, low-cost, easy to operate, and can be performed at bedside, making this technique ideal for use in NICU.

  3. Results of a Targeted Screening Program for Congenital Cytomegalovirus Infection in Infants Who Fail Newborn Hearing Screening.

    Science.gov (United States)

    Vancor, Emily; Shapiro, Eugene D; Loyal, Jaspreet

    2018-01-24

    Congenital cytomegalovirus (CMV) infection is a major cause of sensorineural hearing loss. By law, newborns in Connecticut who fail newborn hearing screening are tested for infection with CMV. This targeted screening is controversial, because most children with congenital CMV infection are asymptomatic, and CMV-related hearing loss can have a delayed onset. Our hospital uses a saliva polymerase chain reaction (PCR) assay (confirmed by a urine PCR assay) to detect CMV. Here, we report the results of the first year of our screening program. We reviewed the medical records of newborns in the Yale New Haven Health System who failed the newborn hearing screening test between January 1 and December 31, 2016. Of 10964 newborns, 171 failed newborn hearing screening, and 3 of these newborns had positive saliva CMV PCR test results. Of these 3 newborns, 2 had positive results on the confirmatory test (for 1 of them the confirmatory test was not performed until the infant was 10 weeks old), and 1 had a negative result on the confirmatory test. Three additional newborns with congenital CMV infection were tested because of clinical indications (1 for ventriculomegaly on prenatal ultrasound and 2 for CMV infection of the mother). Results of audiology follow-up were available for 149 (87.1%) of the 171 newborns who failed newborn hearing screening; 127 (85.2%) had normal results. Our targeted screening program for congenital CMV infection had a low yield. Consideration should be given to other strategies for identifying children at risk of hearing loss as a result of congenital CMV infection. © The Author(s) 2018. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. Objective assessment of induced acute pain in neonatology with the Newborn Infant Parasympathetic Evaluation index.

    Science.gov (United States)

    Cremillieux, C; Makhlouf, A; Pichot, V; Trombert, B; Patural, H

    2018-01-25

    Objective tools are needed to improve pain assessment in newborns. The aim of this study was to assess the correlation between the Newborn Infant Parasympathetic Evaluation (NIPE) index and two pain scales during a painful procedure in premature infants. Each baby born at least at 26 weeks of gestational age (GA) undergoing a planned painful procedure in the Neonatal Intensive Care Unit (NICU) was eligible. NIPE index, heart rate variability (HRV) indices and Neonatal Acute Pain scale (DAN) were recorded across three periods: the first at rest 5 min before the painful procedure (T1), the second during it (T2) and the third 3 min after the end of it (T3). The Premature Infant Pain Profile-Revised (PIPP-R) pain scale was recorded at T2. Sixty-four recordings were performed in 29 preterm infants (mean GA = 29.9 ± 4.2 weeks). Twenty-eight tachograms were coupled to NIPE for analysis. We did not find a correlation between the NIPE index and DAN and PIPP-R at the pain time T2. Between T1 and T2, heart rate was higher (159 ± 16 vs. 169 ± 12, p < 0.001). Considering the linear HRV indices, we did not observe a modification in parasympathetic or sympathetic activity, while for the nonlinear HRV indices (H exponent, Approximate and conditional Entropy), a significant change towards a loss of physiological chaotic cardiac behaviour was detected. The NIPE index seems to be not reliable to assess acute pain in the preterm infant, but other HRV indices could be explored as additional tools next to pain scales in NICUs. The NIPE monitor was developed for objective pain assessment in neonates based on HFnu variations, but it does not seem reliable enough for assessing acute pain in real time in preterm neonates. Pain assessment in preterm babies still relies on pain scales. © 2018 European Pain Federation - EFIC®.

  5. [Predictors of extubation failure and reintubation in newborn infants subjected to mechanical ventilation].

    Science.gov (United States)

    Costa, Ana Cristina de Oliveira; Schettino, Renata de Carvalho; Ferreira, Sandra Clecêncio

    2014-01-01

    To identify risk factors for extubation failure and reintubation in newborn infants subjected to mechanical ventilation and to establish whether ventilation parameters and blood gas analysis behave as predictors of those outcomes. Prospective study conducted at a neonatal intensive care unit from May to November 2011. A total of 176 infants of both genders subjected to mechanical ventilation were assessed after extubation. Extubation failure was defined as the need to resume mechanical ventilation within less than 72 hours. Reintubation was defined as the need to reintubate the infants any time after the first 72 hours. Based on the univariate analysis, the variables gestational age mechanical ventilation (days), potential of hydrogen (pH) and partial pressure of oxygen (pO₂) remained associated with extubation failure, and the five-minute Apgar score and age at extubation were associated with reintubation. Low five-minute Apgar scores, age at extubation, length of mechanical ventilation, acid-base disorders and hyperoxia exhibited associations with the investigated outcomes of extubation failure and reintubation.

  6. Neurophysiological measures of nociceptive brain activity in the newborn infant--the next steps.

    Science.gov (United States)

    Hartley, Caroline; Slater, Rebeccah

    2014-03-01

    Infants within neonatal intensive care units can receive multiple medically essential painful procedures per day. How they respond to these events, how best to alleviate the negative effects, and the long-term consequences for the infant are all significant questions that have yet to be fully answered. In recent years, several studies have examined cortical responses to noxious stimuli in the neonate through the use of near-infrared spectroscopy (NIRS) and electroencephalography (EEG). These investigations dispel any notion that the newborn infant does not process noxious stimuli at a cortical level and open the way for future research. In this Viewpoint Article, we review these studies and discuss key clinical challenges which may be elucidated with the use of these techniques. Simultaneously measuring the changes that are evoked in behaviour, physiology and the cortex following noxious events will provide the best approach to understanding the neonate's experience of pain. © 2013 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

  7. Bacterial meningitis in newborn and infant: correlation between organism, CT findings and clinical outcome

    International Nuclear Information System (INIS)

    Choi, Hye Young; Park, Young Seo; Yoo, Shi Joon; Suh, Dae Chul; Chung, Young Kyo

    1993-01-01

    Acute bacterial meningitis often results in significant neurologic complications regardless of the antibiotics treatment Computed tomographic (CT) finding of tuberculous meningitis is fairly well known but not the findings of bacterial meningitis. This study was performed to determine the incidence of causative organisms and to correlate between the organisms and computed tomographic (CT) findings with clinical outcome of bacterial meningitis in newborns and infants. We analyzed the brain CT and clinical records of 15 infants who had been diagnosed as bacterial meningitis by CSF culture. We found that the most common organisms were Group B streptococcus in neonates without no neurologic complications in all but one and Hemophilus influenza in infants whose clinical outcomes were poor in all except one. CT findings related with poor prognosis in this study were cerebral edema, basal cisternal obliteration and enhancement, and cerebral infarction on initial CT and ventriculomegaly on follow-up CT. We concluded that CT diagnosed intracranial complications of bacterial meningitis well and could contributed to better treatment of bacterial meningitis

  8. Bacterial meningitis in newborn and infant: correlation between organism, CT findings and clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hye Young; Park, Young Seo; Yoo, Shi Joon; Suh, Dae Chul; Chung, Young Kyo [College of Medicine, University of Ulsan, Seoul (Korea, Republic of)

    1993-03-15

    Acute bacterial meningitis often results in significant neurologic complications regardless of the antibiotics treatment Computed tomographic (CT) finding of tuberculous meningitis is fairly well known but not the findings of bacterial meningitis. This study was performed to determine the incidence of causative organisms and to correlate between the organisms and computed tomographic (CT) findings with clinical outcome of bacterial meningitis in newborns and infants. We analyzed the brain CT and clinical records of 15 infants who had been diagnosed as bacterial meningitis by CSF culture. We found that the most common organisms were Group B streptococcus in neonates without no neurologic complications in all but one and Hemophilus influenza in infants whose clinical outcomes were poor in all except one. CT findings related with poor prognosis in this study were cerebral edema, basal cisternal obliteration and enhancement, and cerebral infarction on initial CT and ventriculomegaly on follow-up CT. We concluded that CT diagnosed intracranial complications of bacterial meningitis well and could contributed to better treatment of bacterial meningitis.

  9. A comparison of the general movements assessment with traditional approaches to newborn and infant assessment : Concurrent validity

    NARCIS (Netherlands)

    Snider, Laurie M.; Majnemer, Annette; Mazer, Barbara; Campbell, Suzann; Bos, Arend F.

    Background: Assessment of the quality of general movements (GMs) is an early clinical marker for prediction of cerebral palsy. Aims: To explore how the General Movements Assessment (GMsA) relates to traditional newborn and infant measures currently in use. Study design: A prospective cohort design

  10. Effects of antiretroviral agents during pregnancy on liver enzymes and amylase in HIV-exposed, uninfected newborn infants

    Directory of Open Access Journals (Sweden)

    Patrícia El Beitune

    Full Text Available This study assessed the effect of antiretroviral drugs administered to pregnant women on amylase and liver enzymes of the neonate. A prospective study was conducted on 52 neonates divided into three groups: infants born to HIV-infected mothers taking zidovudine (ZDV group, n = 18, infants born to mothers taking zidovudine + lamivudine + nelfinavir (TT group, n = 22 and infants born to normal women (control group, n = 12. Umbilical cord blood from the newborn infant was used to determine liver transaminases and amylase. Data were analyzed statistically by nonparametric tests, with the level of significance set at p<0.05. The median levels for TT group newborns were 33.3 U/L for oxaloacetic transaminase, 21.5 U/L for pyruvic transaminase, 1.9 mg/dL for total bilirubin, 153 mg/dL for alkaline phosphatase, and 9.6 U/L for amylase. These results did not differ from those obtained for Control newborns or newborns exposed to ZDV alone. No association was observed between the use of antiretroviral drugs during pregnancy and adverse effects on neonatal amylase and hepatic parameters at birth.

  11. Climate change is associated with male:female ratios of fetal deaths and newborn infants in Japan

    DEFF Research Database (Denmark)

    Fukuda, Misao; Fukuda, Kiyomi; Shimizu, Takashi

    2014-01-01

    OBJECTIVE: To evaluate whether climate change is associated with male:female ratios (sex ratios) of fetal deaths and births in Japan. DESIGN: A population-based cohort study. SETTING: Not applicable. PATIENT(S): Newborn infants and fetuses spontaneously aborted after 12 weeks of gestation...... to external stress factors, including climate changes....

  12. Detection of cytomegalovirus DNA in dried blood spots of Minnesota infants who do not pass newborn hearing screening.

    Science.gov (United States)

    Choi, K Yeon; Schimmenti, Lisa A; Jurek, Anne M; Sharon, Bazak; Daly, Kathy; Khan, Cindy; McCann, Mark; Schleiss, Mark R

    2009-12-01

    Up to 15% of infants with asymptomatic congenital cytomegalovirus (CMV) infection will experience some degree of sensorineural hearing loss. Many infants who fail newborn hearing screening (NHS) are likely to have congenital CMV infection, but may escape definitive virologic identification because diagnostic evaluation may not commence until several weeks or months of age, making differentiation between congenital and postnatal CMV infection difficult. Early diagnosis linking virologic identification of congenital CMV infection to infants failing NHS may improve diagnostic precision and enhance opportunities for therapeutic intervention. The goal of this study was to compare newborn dried blood spots from Minnesota infants who had failed NHS, and were designated for referral, with control infants who passed NHS, for the presence of CMV DNA by real-time PCR, using hybridization probes for the CMV gene UL54. Of 479 infants with a failed NHS (bilateral failure), 13 had CMV DNA present in the blood spot (2.7%). This compared with only 2/479 positive results from a control group of infants who passed the NHS (0.4%; P = 0.007, Fisher exact test). Comparisons of the glycoprotein B (gB) genotype as well as direct DNA sequencing of selected positives revealed that PCR positive samples represented unique clinical isolates. The mean viral load among the 15 positive samples was 1.6 x 10(3) genomes/microgram of total DNA. Newborn bloodspot CMV screening by real-time PCR may be a useful and rapid adjunct to functional NHS and may enable more rapid etiologic diagnosis of sensorineural hearing loss in newborns.

  13. Case of 46,XX/47,XY, +21 chimerism in a newborn infant with ambiguous genitalia

    Energy Technology Data Exchange (ETDEWEB)

    Sawai, Tomoko; Yoshimoto, Masaaki; Kinoshita, Ei-ichi; Baba, Tsuneyoshi; Matsumoto, Tadashi; Tsuji, Yoshiro, Niikawa, Norio [Nagasaki Univ. School of Medicine, Nagasaki (Japan); Fukuda, Shinpei [Ohmura Municipal Hospital, Ohmura (Japan); Harada, Naoki [Kyushu Medical Science, Nagasaki (Japan)

    1994-02-15

    The authors describe the whole-body chimerism in a newborn infant with small phallus, pseudo-vaginal perineal hypospadias, and a bifid scrotum containing gonads. The human testis determining factor gene (SRY) was detected by PCR amplification. GTG-banding chromosome analysis in peripheral blood lymphocytes and cultured fibroblasts derived from right cubital skin showed a 46,XX/47,XY, +21 karyotype. Their ratios in each cell line were 294:5 and 178:7, respectively. QFQ-banding chromosome analysis documented 3 heteromorphic satellites on trisomic chromsomes 21 in the 47,XY,+21 cell line and a homozygous satellite pattern in the 46,XX cell line. Heteromorphic patterns of chromsomes 4, 13, 14, and 22 were also different between the two cell lines. To our knowledge, such disomy/trisomy chimeras have not been described previously. 10 refs., 3 figs.

  14. Desferrioxamine treatment of iron overload secondary to RH isoimmunization and intrauterine transfusion in a newborn infant.

    Science.gov (United States)

    Yalaz, Mehmet; Bilgin, Betül Siyah; Köroğlu, Ozge Altun; Ay, Yılmaz; Arıkan, Ciğdem; Sagol, Sermet; Akısü, Mete; Kültürsay, Nilgün

    2011-11-01

    Intrauterine transfusion is the standard of care in the management of severe Rh isoimmunization. Desferrioxamine has been used for the treatment of iron overload secondary to hemolysis and intrauterine transfusions in Rh isoimmunization cases. Here, we report a preterm infant born at 34 weeks of gestational age who had formerly received intrauterine transfusions for Rhesus hemolytic disease and presented with severe hyperferritinemia and elevated liver enzymes in the first week of life. Desferrioxamine treatment was started due to a ferritin level of 28,800 ng/ml and continued for 13 weeks. Although the treatment was successful, we observed resistant leukopenia which resolved after the cessation of treatment. In conclusion, iron overload secondary to intrauterine transfusions can be treated successfully with desferrioxamine; however, neonatologists must be aware of the possible side effects of this drug which has been used in only a limited number of newborns.

  15. Significant decrease in congenital malformations in newborn infants of an unselected population of diabetic women

    DEFF Research Database (Denmark)

    Damm, P; Mølsted-Pedersen, L

    1989-01-01

    In an unselected and consecutive series of 1858 newborn infants of diabetic mothers, born in the Rigshospital, Copenhagen, in the period 1967 to 1986, congenital malformations were studied. The malformation rate in White Classes B to F was remarkably constant from 1967 to 1981, but a significant...... decrease in major congenital malformations was found in the period 1982 to 1986 versus 1977 to 1981 (2.7% vs. 7.4%, p less than 0.05). This decrease was mainly due to a fourfold decline in major congenital malformations in White Classes D and F (p less than 0.01), and consequently a correlation between...... the severity of maternal diabetes and the frequency of congenital malformations was no longer present. In the offspring of a control group of 1715 nondiabetic women, major congenital malformations were found in 1.7% (p greater than 0.05). Seventy-five percent of the diabetic pregnancies were planned...

  16. Avicenna (AD 980 to 1037) and the care of the newborn infant and breastfeeding.

    Science.gov (United States)

    Modanlou, H D

    2008-01-01

    A brief historical review of medicine during the fourth century Islamic civilization or eleventh century AD in Persia or Iran was undertaken with its focus on Avicenna. A physician-philosopher, named Ibn Sina or Avicenna (980 to 1037), followed and further expanded the tradition of western philosophy and medicine by Aristotle, Hippocrates and Galen. Avicenna, a physician, philosopher, astrologist, anatomist, pharmacologist, ethicist and poet wrote, the Canon of Medicine, the most comprehensive medical textbook of its time. This important textbook was extensively used in European medical schools for centuries after Avicenna's death. In the Canon of Medicine, a chapter is dedicated to the care of the newborn infant dealing with hygiene, breastfeeding and upbringing of the child.

  17. Colestasis del recién nacido y del lactante Cholestasis of newborn and infant

    Directory of Open Access Journals (Sweden)

    Norma Hondal Álvarez

    2010-09-01

    Full Text Available Los recién nacidos y lactantes pequeños tienen una inmadurez funcional y anatómica que justifica que las enfermedades hepáticas que se manifiestan en estas edades tengan la ictericia como signo principal y que otros procesos extrahepáticos o sistémicos puedan condicionar colestasis. La colestasis del lactante es un síndrome clínico caracterizado por ictericia, acolia o hipocolia, y coluria, que evoluciona con elevación de la bilirrubina directa y de los ácidos biliares séricos. La evaluación diagnóstica del lactante con colestasis, realizada por un equipo multidisciplinario, debe minimizar la realización de pruebas innecesarias para lograr un diagnóstico correcto en el menor tiempo posible, diferenciar entre colestasis intrahepática o extrahepática y lograr un diagnóstico etiológico, que incluya aquellos procesos que ponen en peligro la vida o requieren un tratamiento específico médico o quirúrgico. El presente trabajo pretende revisar las principales causas, procedimientos diagnósticos y el enfoque terapéutico de la colestasis del recién nacido y del lactante en aras de contribuir a su diagnóstico temprano y su tratamiento adecuado.The small newborns and infants have a functional anatomical immaturity justifying that liver diseases present at these ages have the jaundice as leading sign and that other extra-hepatic or systemic processes may conditioning the Cholestasis. Infant Cholestasis is a clinical syndrome characterized by jaundice, acholia or hypoacholia and choluria evolving with a rise of direct bilirubin and of serum biliary acids. The diagnostic assessment of infant presenting with Cholestasis made by a multidisciplinary staff must to minimize the carrying out of unnecessary tests to obtain an appropriate diagnosis in less time, to differentiate among the intrahepatic or extrahepatic cholestasis and to achieve an etiologic diagnosis including the processes threatening the life or that requiring a medical or

  18. A newborn infant with congenital cerebral arteriovenous malformation, and congestive heart failure: case report

    Directory of Open Access Journals (Sweden)

    Hamed Tabasizadeh

    2017-06-01

    Full Text Available Background: Cerebral arteriovenous malformations are rare congenital anomalies presenting as different symptoms depending on their size and the age of patient. Congestive heart failure is a rare condition in neonatal period and is most common due to structural heart defects, but rarely may be a result of peripheral shunts such as cerebral arteriovenous malformation. Case presentation: A term male newborn infant who was delivered by Caesarean Section in Chamran Hospital, Ferdows, South Khorasan Province, June 2016. The infant was admitted to neonatal care unit due to nonreactive nonstress (NST with normal Apgar score. In first postpartum visit, a systolic heart murmur was detected. Echocardiography showed small atrial septal defect secundum type and patent foramen ovale (PFO. He presented clinical manifestations of heart failure after 72 hours of birth. Antibiotic and treatment of heart failure was started. Following excluding most common etiologies of heart failure such as sepsis, anemia and arrhythmias, for detecting less common conditions such as cerebral vascular aneurism a transfontanelle ultrasonography was performed which showed dilated cerebral venous system. Magnetic resonance imaging (MRI and Magnetic resonance venography (MRV revealed a large congenital cerebral arterio-venous malformation (CAVM, in right cerebral hemisphere. Finally, he was expired 9 days after birth due to severe heart failure before any definitive treatment for closing CAVM could be done.  Conclusion: CAVM are extremely rare vascular anomalies in newborns which may present occasionally as congestive heart failure in neonatal period. So after excluding other most common etiologies of heart failure such as structural heart defects, screening CAVMs should be done. Inspite of early diagnosis, usually they have extremely poor prognosis.

  19. Urinary paraben concentrations among pregnant women and their matching newborn infants of Korea, and the association with oxidative stress biomarkers.

    Science.gov (United States)

    Kang, Sungeun; Kim, Sunmi; Park, Jeongim; Kim, Hae-Joong; Lee, Jeongjae; Choi, Gyuyeon; Choi, Sooran; Kim, Sungjoo; Kim, Su Young; Moon, Hyo-Bang; Kim, Sungkyoon; Kho, Young Lim; Choi, Kyungho

    2013-09-01

    Parabens have been used in multiple products including personal care products, pharmaceuticals, and foods for more than 50 years but increasing numbers of studies have raised concerns on their safety. The present study was designed to determine urinary paraben levels among pregnant women and their matching newborn infants (paraben levels and stress markers. Pregnant women (n=46) and their matching newborn infants were recruited from four university hospitals located in Seoul, Ansan and Jeju of Korea, 2011. Parabens including methyl paraben (MP), ethyl paraben (EP), n-propyl paraben (PP), and n-butyl paraben (BP) were measured in the urine using an automatic, high throughput online SPE-LC-MS/MS method. Urinary concentrations were normalized with specific gravity (SG). Free cortisol, malondealdehyde (MDA) and 8-hydroxydeoxyguanosine (8-OHdG) were measured in the urine as stress marker. Urinary MP was detected as the highest, and BP was detected as the lowest paraben in the urine samples of both pregnant women and their infants. Significant correlations between paraben concentrations of maternal and their newborn infant's urine were observed. The levels of urinary parabens among Korean pregnant women are comparable to those reported elsewhere, except for EP which were 4-9 folds higher than pregnant women of other countries. The ratios of infant to maternal urinary paraben concentrations varied between 0.5 and 0.6 for MP and PP, but approximately 10 fold lower for EP. Urinary MP or EP levels were associated with several oxidative stress related biomarkers such as urinary 8-OHdG and MDA, even after the adjustment of relevant covariates such as maternal age, mode of delivery, pre-pregnancy BMI, gestational age and parity. This is the first study that reported the levels of major parabens in the first urine of newborn infants. Further studies are warranted to understand the implications of paraben exposure among biologically susceptible human populations. Copyright

  20. Higher versus lower amino acid intake in parenteral nutrition for newborn infants.

    Science.gov (United States)

    Osborn, David A; Schindler, Tim; Jones, Lisa J; Sinn, John Kh; Bolisetty, Srinivas

    2018-03-05

    Sick newborn and preterm infants frequently are not able to be fed enterally, necessitating parenteral fluid and nutrition. Potential benefits of higher parenteral amino acid (AA) intake for improved nitrogen balance, growth, and infant health may be outweighed by the infant's ability to utilise high intake of parenteral AA, especially in the days after birth. The primary objective is to determine whether higher versus lower intake of parenteral AA is associated with improved growth and disability-free survival in newborn infants receiving parenteral nutrition.Secondary objectives include determining whether:• higher versus lower starting or initial intake of amino acids is associated with improved growth and disability-free survival without side effects;• higher versus lower intake of amino acids at maximal intake is associated with improved growth and disability-free survival without side effects; and• increased amino acid intake should replace non-protein energy intake (glucose and lipid), should be added to non-protein energy intake, or should be provided simultaneously with non-protein energy intake.We conducted subgroup analyses to look for any differences in the effects of higher versus lower intake of amino acids according to gestational age, birth weight, age at commencement, and condition of the infant, or concomitant increases in fluid intake. We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (2 June 2017), MEDLINE (1966 to 2 June 2017), Embase (1980 to 2 June 2017), and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1982 to 2 June 2017). We also searched clinical trials databases, conference proceedings, and citations of articles. Randomised controlled trials of higher versus lower intake of AAs as parenteral nutrition in newborn infants. Comparisons of higher intake at commencement, at maximal intake, and at both commencement and maximal

  1. Conductive hearing loss and middle ear pathology in young infants referred through a newborn universal hearing screening program in Australia.

    Science.gov (United States)

    Aithal, Sreedevi; Aithal, Venkatesh; Kei, Joseph; Driscoll, Carlie

    2012-10-01

    Although newborn hearing screening programs have been introduced in most states in Australia, the prevalence of conductive hearing loss and middle ear pathology in the infants referred through these programs is not known. This study was designed to (1) evaluate the prevalence of conductive hearing loss and middle ear pathology in infants referred by a newborn hearing screening program in north Queensland, (2) compare prevalence rates of conductive hearing loss and middle ear pathology in indigenous and nonindigenous infants, and (3) review the outcomes of those infants diagnosed with conductive hearing loss and middle ear pathology. Retrospective chart review of infants referred to the Audiology Department of The Townsville Hospital was conducted. Chart review of 234 infants referred for one or both ears from a newborn hearing screening program in north Queensland was conducted. A total of 211 infants attended the diagnostic appointment. Review appointments to monitor hearing status were completed for 46 infants with middle ear pathology or conductive hearing loss. Diagnosis of hearing impairment was made using an age-appropriate battery of audiological tests. Results were analyzed for both initial and review appointments. Mean age at initial diagnostic assessment was 47.5 days (SD = 31.3). Of the 69 infants with middle ear pathology during initial diagnostic assessment, 18 had middle ear pathology with normal hearing, 47 had conductive hearing loss, and 4 had mixed hearing loss. Prevalence of conductive hearing loss in the newborns was 2.97 per 1,000 while prevalence of middle ear pathology (with or without conductive hearing loss) was 4.36 per 1,000. Indigenous Australians or Aboriginal and Torres Strait Islander (ATSI) infants had a significantly higher prevalence of conductive hearing loss and middle ear pathology than non-ATSI infants (35.19 and 44.45% vs 17.83 and 28.66%, respectively). ATSI infants also showed poor resolution of conductive hearing loss

  2. The potential of vacuum therapy in the treatment of a newborn infant with severe thermal injury

    Directory of Open Access Journals (Sweden)

    L. I. Budkevich

    2015-01-01

    Full Text Available The paper describes a clinical case of successful combination therapy in a newborn infant with severe thermal injury. When admitted to the hospital, the infant was diagnosed with third-degree flame burn covering 75% of the body surface and shock. Specialized emergency care involved antishock measures and replacement of vital functions, stepwise surgical interventions aimed to excise necrotic tissues and to restore lost skin tissue, and antimicrobial and symptomatic therapies. Topical treatment included the use of current wound coatings. Skin autocells were used for significant skin defect. Aacuum therapy was performed to stimulate repair processes and to prepare wounds for further skin plasty. The techniques of vacuum therapy included RENAS\\S-GO and PICO apparatuses. Its efficiency was evaluated by microbiological, immunohistochemical, and planimetric examinations. Analysis of the decontaminating impact of a vacuum coating could establish its substantial effect in reducing wound bacterial contamination by 65% in the study group and by an average of 21% in the comparison group. That of immunohistochemical findings during vacuum therapy could reveal the high expression of two markers characterizing wound an-giogenesis. Comparative analysis of planimetric readings showed no significant differences in the use of vacuum therapy and current wound coatings. Thus, negative-pressure therapy creates favorable conditions for a wound healing process, providing effective wound decontamination and stimulating granulation tissue maturation as a factor to prepare for skin plasty.

  3. Effects of Fructans from Mexican Agave in Newborns Fed with Infant Formula: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Gabriel López-Velázquez

    2015-10-01

    Full Text Available Background: The importance of prebiotics consumption is increasing all over the world due to their beneficial effects on health. Production of better prebiotics from endemic plants raises possibilities to enhance nutritional effects in vulnerable population groups. Fructans derived from Agave Plant have demonstrated their safety and efficacy as prebiotics in animal models. Recently, the safety in humans of two fructans obtained from Agave tequilana (Metlin® and Metlos® was demonstrated. Methods: This study aimed to demonstrate the efficacy as prebiotics of Metlin® and Metlos® in newborns of a randomized, double blind, controlled trial with a pilot study design. Biological samples were taken at 20 ± 7 days, and three months of age from healthy babies. Outcomes of efficacy include impact on immune response, serum ferritin, C-reactive protein, bone metabolism, and gut bacteria changes. Results: There were differences statistically significant for the groups of infants fed only with infant formula and with formula enriched with Metlin® and Metlos®. Conclusions: Our results support the efficacy of Metlin® and Metlos® as prebiotics in humans, and stand the bases to recommend their consumption. Trial Registration: ClinicalTrials.gov, NCT 01251783.

  4. Effects of Fructans from Mexican Agave in Newborns Fed with Infant Formula: A Randomized Controlled Trial.

    Science.gov (United States)

    López-Velázquez, Gabriel; Parra-Ortiz, Minerva; Mora, Ignacio De la Mora-De la; García-Torres, Itzhel; Enríquez-Flores, Sergio; Alcántara-Ortigoza, Miguel Angel; Angel, Ariadna González-Del; Velázquez-Aragón, José; Ortiz-Hernández, Rosario; Cruz-Rubio, José Manuel; Villa-Barragán, Pablo; Jiménez-Gutiérrez, Carlos; Gutiérrez-Castrellón, Pedro

    2015-10-29

    The importance of prebiotics consumption is increasing all over the world due to their beneficial effects on health. Production of better prebiotics from endemic plants raises possibilities to enhance nutritional effects in vulnerable population groups. Fructans derived from Agave Plant have demonstrated their safety and efficacy as prebiotics in animal models. Recently, the safety in humans of two fructans obtained from Agave tequilana (Metlin(®) and Metlos(®)) was demonstrated. This study aimed to demonstrate the efficacy as prebiotics of Metlin(®) and Metlos(®) in newborns of a randomized, double blind, controlled trial with a pilot study design. Biological samples were taken at 20 ± 7 days, and three months of age from healthy babies. Outcomes of efficacy include impact on immune response, serum ferritin, C-reactive protein, bone metabolism, and gut bacteria changes. There were differences statistically significant for the groups of infants fed only with infant formula and with formula enriched with Metlin(®) and Metlos(®). Our results support the efficacy of Metlin(®) and Metlos(®) as prebiotics in humans, and stand the bases to recommend their consumption. ClinicalTrials.gov, NCT 01251783.

  5. Impact of congenital heart disease on brain development in newborn infants

    Directory of Open Access Journals (Sweden)

    Moustafa M Abdel Raheem

    2012-01-01

    Full Text Available Objective: To assess brain development and brain injury in neonates with cyanotic and acyanotic congenital heart disease (CHD. Methods: The study included 52 term infants with CHD who were divided into two groups: Cyanotic (n=21 and acyanotic (n=31. Fifteen healthy neonates of matched age and sex were enrolled in the study as controls. Three-dimensional proton magnetic resonance spectroscopic imaging and diffusion tensor imaging were used to assess brain development and injury. We calculated the ratio of N-acetylaspartate (NAA to choline (which increases with maturation, average diffusivity (which decreases with maturation, fractional anisotropy of white matter (which increases with maturation, and the ratio of lactate to choline (which increases with brain injury. Results: As compared with control neonates, those with CHD had significant decrease in NAA/choline ratio (P<0.001, significant increase in lactate/choline ratio (P<0.0001, significant increase in average diffusivity (P<0.0001, and significant decrease of white matter fractional anisotropy (P<0.001. Neonates with cyanotic CHD had significant less brain development and more brain injury than those with acyanotic CHD (P<0.05. Conclusions: Newborn infants with cyanotic and acyanotic CHD are at high risk of brain injury and impaired brain maturity.

  6. Comprehensive approach to newborns and infants with brachial plexus impairment – proposal of Slovenian guidelines

    Directory of Open Access Journals (Sweden)

    Katja Groleger Sršen

    2015-06-01

    Full Text Available The impairment of brachial plexus (IBP in the neonate and infant remains an important problem. Risk factors for IBP are well known, but the mechanisms of impairment are not yet fully understood. It is important to identify early signs of IBP and to evaluate the hand function. In the guidelines we propose to use the Toronto scale for evaluation of hand function. The newborn with IBP should be referred to physiotherapy, and then regularly followed-up once a month. If the arm and hand function, especially flexion of the elbow, is not improving at the age of two months, the infant should be referred to the tertiary level rehabilitation centre and to department for plastic surgery at the University Medical Centre in Ljubljana. When necessary, the reconstructive procedure should be done by the age of three to six months. After reconstruction of brachial plexus, the child needs a comprehensive therapy program, which involves passive stretching, sensory stimulation, exercises to promote the development of active voluntary movements, bimanual activities, and symmetrical posture and movement patterns.

  7. Reproducibility of cerebral tissue oxygen saturation measurements by near-infrared spectroscopy in newborn infants

    Science.gov (United States)

    Jenny, Carmen; Biallas, Martin; Trajkovic, Ivo; Fauchère, Jean-Claude; Bucher, Hans Ulrich; Wolf, Martin

    2011-09-01

    Early detection of cerebral hypoxemia is an important aim in neonatology. A relevant parameter to assess brain oxygenation may be the cerebral tissue oxygen saturation (StO2) measured by near-infrared spectroscopy (NIRS). So far the reproducibility of StO2 measurements was too low for clinical application, probably due to inhomogeneities. The aim of this study was to test a novel sensor geometry which reduces the influence of inhomogeneities. Thirty clinically stable newborn infants, with a gestational age of median 33.9 (range 26.9 to 41.9) weeks, birth weight of 2220 (820 to 4230) g, postnatal age of 5 (1 to 71) days were studied. At least four StO2 measurements of 1 min duration were carried out using NIRS on the lateral head. The sensor was repositioned between measurements. Reproducibility was calculated by a linear mixed effects model. The mean StO2 was 79.99 +/- 4.47% with a reproducibility of 2.76% and a between-infant variability of 4.20%. Thus, the error of measurement only accounts for 30.1% of the variability. The novel sensor geometry leads to considerably more precise measurements compared to previous studies with, e.g., ~5% reproducibility for the NIRO 300. The novel StO2 values hence have a higher clinical relevance.

  8. [Diagnosis of pulmonary hemorrhage of the newborn infants using lung ultrasonography].

    Science.gov (United States)

    Liu, J; Fu, W; Chen, S W; Wang, Y

    2017-01-02

    Objective: To investigate the accuracy and reliability of lung ultrasound in diagnosis of pulmonary hemorrhage of the newborn infants. Method: From January 2014 to May 2016, 142 neonates from the Army General Hospital of the Chinese PLA were enrolled in the study. They were divided into two groups: a study group of 42 neonates, who were diagnosed with pulmonary hemorrhage according to their medical history, clinical manifestations and chest X-ray findings, and a control group of 100 neonates with no lung disease. All subjects underwent bedside lung ultrasound in a quiet state in a supine, lateral or prone posture, performed by a single experienced physician. The ultrasound findings were compared between the two groups.Fisher's exact test was uesd for comparison between two groups. Result: The lung ultrasound main findings associated with pulmonary hemorrhage included: (1) Shred sign: which was seen in 40 patients(95%). (2) Lung consolidation with air bronchograms: which were seen in 35 patients(83%). (3) Pleural effusion: which was seen in 34 infants(81%), pleurocentesis confirmed that the fluid was really bleeding.(4)Atelectasis: which was seen in 14 cases(33%). (5) Pleural line abnormalities and disappearing A-lines with an incidence of 100%. (6) Alveolar-interstitial syndrome: 5 patients(12%)had the main manifestations of alveolar-interstitial syndrome. The above signs were not seen in normal controls (all P hemorrhage, which is suitable for routine application for the diagnosis of pulmonary hemorrhage in the neonatal intensive care unit.

  9. NAA, GC(EC) and SRXRF study of Hg species in head hair of mothers and their newborn infants

    International Nuclear Information System (INIS)

    Feng Weiyue; Qian Qinfang; Zhang Peiqun; Chai Zhifang

    1997-01-01

    Twenty-seven pairs of head from mothers and their new-born infants were collected at the time of delivery in a hospital in Beijing. The total mercury content in the hair samples was determined by INAA. The correlation between mercury content in hair of mothers and their new-born infants has been investigated. In addition, the change of Hg content in pregnant women's hair during their pregnancy was also studied by INAA and SRXRF. The results indicate a significant positive correlation between the mercury content in maternal and infant head hairs (r = +0.862, p < 0.001). The average content of Hg in infant and maternal hairs was (0.66 +- 0.31) μg/g and (0.59 +- 0.25) μg/g, respectively. The infant level exceeded the maternal by 12%. The Hg content in maternal head hair gradually reduced during pregnancy. Further, the methylmercury (Me-Hg) content in 3 maternal hair samples was analyzed by GC(EC). The Me-Hg was in accordance with the total mercury content. Thus a conclusion can be drawn that damage to the infant from Hg occurred in the early stages of pregnancy

  10. NAA, GC(EC) and SRXRF study of Hg species in head hair of mothers and their newborn infants

    International Nuclear Information System (INIS)

    Feng, W.Y.; Qian, Q.F.; Zhang, P.Q.; Chai, C.F.

    1995-01-01

    Twenty-seven pairs of head hair from mothers and their new-born infants were collected at the time of delivery in a hospital in Beijing. The total mercury content in the hair samples was determined by INAA. The correlation between mercury content in hair of mothers and their new-born infants has been investigated. In addition, the change of Hg content in pregnant women's hair during their pregnancy was also studied by INAA and SRXRF. The results indicate a significant positive correlation between the mercury content in maternal and infant head hairs (r = +0.862, p< 0.001). The average content of Hg in infant and maternal hairs was 0.66 ± 0.31 μg/g and 0.59 ± 0.25 μg/g, respectively. The infant level exceeded the maternal by 12%. The Hg content in maternal head hair gradually reduced during pregnancy. Further, the methylmercury (Me-Hg) content in 3 maternal hair samples was analyzed by GC(EC). The Me-Hg was in accordance with the total mercury content. Thus a conclusion can be drawn that damage to the infant from Hg occurred in the early stages of pregnancy. (author). 9 refs., 5 figs., 2 tabs

  11. Urinary tract infection in full-term newborn infants: risk factor analysis

    Directory of Open Access Journals (Sweden)

    Falcão Mário Cícero

    2000-01-01

    Full Text Available OBJECTIVE: To analyze the correlation of risk factors to the occurrence of urinary tract infection in full-term newborn infants. PATIENTS AND METHODS: Retrospective study (1997 including full-term infants having a positive urine culture by bag specimen. Urine collection was based on: fever, weight loss > 10% of birth weight, nonspecific symptoms (feeding intolerance, failure to thrive, hypoactivity, debilitate suction, irritability, or renal and urinary tract malformations. In these cases, another urine culture by suprapubic bladder aspiration was collected to confirm the diagnosis. To compare and validate the risk factors in each group, the selected cases were divided into two groups: Group I - positive urine culture by bag specimen collection and negative urine culture by suprapubic aspiration, and Group II - positive urine culture by bag specimen collection and positive urine culture by suprapubic aspiration . RESULTS: Sixty one infants were studied, Group I, n = 42 (68.9% and Group II, n = 19 (31.1%. The selected risk factors (associated infectious diseases, use of broad-spectrum antibiotics, renal and urinary tract malformations, mechanical ventilation, parenteral nutrition and intravascular catheter were more frequent in Group II (p<0.05. Through relative risk analysis, risk factors were, in decreasing importance: parenteral nutrition, intravascular catheter, associated infectious diseases, use of broad-spectrum antibiotics, mechanical ventilation, and renal and urinary tract malformations. CONCLUSION: The results showed that parenteral nutrition, intravascular catheter, and associated infectious diseases contributed to increase the frequency of neonatal urinary tract infection, and in the presence of more than one risk factor, the occurrence of urinary tract infection rose up to 11 times.

  12. Sensorineural and conductive hearing loss in infants diagnosed in the program of universal newborn hearing screening.

    Science.gov (United States)

    Wroblewska-Seniuk, Katarzyna; Dabrowski, Piotr; Greczka, Grazyna; Szabatowska, Katarzyna; Glowacka, Agata; Szyfter, Witold; Mazela, Jan

    2018-02-01

    The aim of this study was to analyze infants diagnosed with sensorineural or conductive hearing deficit and to identify risk factors associated with these defects. A retrospective analysis of infants diagnosed with hearing deficit based on the database of the universal newborn hearing screening program and medical records of the patients. 27 935 infants were covered by the universal neonatal hearing screening program. 109 (0.39%) were diagnosed with hearing deficit and referred for treatment and rehabilitation. 56 (51.4%) children were diagnosed with conductive, 38 (34.9%) with sensorineural and 15 (13.8%) with mixed type of hearing deficit. Children with sensorineural hearing deficit more frequently suffered from hyperbilirubinemia (p conductive hearing loss were more frequently diagnosed with isolated craniofacial anomalies (p hearing deficit occurred almost 3 times more often bilaterally than unilaterally (p hearing deficit, the difference was not significant. In children with conductive and mixed type of hearing loss the impairment was mainly mild while among those with sensorineural hearing deficit in almost 45% it was severe and profound (p hearing screening test by means of otoacoustic emissions and the final diagnosis of hearing deficit we found that the highest agreement rate was observed in children with sensorineural hearing loss (p hearing deficit was similar in children with sensorineural, conductive and mixed type of hearing loss, only hyperbilirubinemia seemed to predispose to sensorineural hearing deficit and isolated craniofacial malformations seemed to be associated with conductive hearing loss. Sensorineural hearing deficit usually occurred bilaterally and was severe or profound, while conductive and mixed type of hearing deficit were most often of mild degree. Most children with the final diagnosis of sensorineural hearing deficit had positive result of hearing screening by means of otoacoustic emissions. Copyright © 2017 Elsevier B.V. All

  13. Retinal and Optic Nerve Hemorrhages in the Newborn Infant: One-year Results of the Newborn Eye Screen Test (NEST) Study

    Science.gov (United States)

    Callaway, Natalia F.; Ludwig, Cassie A.; Blumenkranz, Mark S.; Jones, Jennifer Michelle; Fredrick, Douglas R.; Moshfeghi, Darius M.

    2016-01-01

    Purpose To report the birth prevalence, risk factors, characteristics and location of fundus hemorrhages (FH) of the retina and optic nerve present in newborns at birth. Design Prospective cohort study at Stanford University School of Medicine. Participants All infants who were 37 weeks postmenstrual age or older and were deemed stable by their pediatrician were eligible for screening. Infants who were anophthalmic or had known or suspected infectious conjunctivitis were excluded. Methods Infants born at Lucile Packard Children's Hospital (LPCH) from July 25, 2013 through July 25, 2014 were offered universal newborn screening via wide-angle digital retinal photography in the Newborn Eye Screen Test (NEST) study. Maternal, obstetric, and neonatal factors were obtained by reviewing hospital records prior to discharge. The location, retinal layer, and laterality of FH were recorded by one pediatric vitreoretinal specialist. Main Outcome Measures Birth prevalence of FH. Secondary outcomes included rate of adverse events, risk factors for FH, hemorrhage characteristics and adverse events. Results The birth prevalence of FH in this study was 20.3% (41/202 infants). Ninety-five percent of FHs involved the periphery, 83% involved the macula, and 71% involved multiple layers of the retina. The fovea was involved in 15% of FH cases (birth prevalence, 3.0%). No cases of bilateral foveal hemorrhage were found. Fundus hemorrhages were more common in the left eye than the right. Fundus hemorrhages were most commonly optic nerve flame hemorrhages (48%) and white-centered retinal hemorrhages (30%). Retinal hemorrhages were found most frequently in all 4 quadrants (35%) and more often were multiple than solitary. Macular hemorrhages most often were intraretinal (40%). Among the risk factors examined in this study, vaginal delivery compared with cesarean section (odds ratio [OR], 9.34; 95% confidence interval [CI], 2.57-33.97) showed the greatest level of association with FH. Self

  14. Comparison of the effect of topical application of human milk and dry cord care on the bacterial colonization of umbilical cord in newborn infants

    OpenAIRE

    Fatemeh Abbaszadeh; zanab Hajizadeh; Mahboobeh Kafaei Atrian; Azam Bagheri; Nahid Sarafraz

    2014-01-01

    Background: Breast milk contains significant amounts of compounds that act as natural antimicrobial agents. This study was conducted to compare the effect of topical application of human milk and dry cord care on bacterial colonization in the umbilical cord of newborn infants. Methods: This clinical trial study was carried out on 174 infants in Kashan. The newborns were randomized to mother's milk group and dry cord care group from the birth. In group 1, the mother rubbed her own milk on ...

  15. Vacuum assisted birth and risk for cerebral complications in term newborn infants: a population-based cohort study

    Science.gov (United States)

    2014-01-01

    Background Few studies have focused on cerebral complications among newborn infants delivered by vacuum extraction (VE). The aim of this study was to determine the risk for intracranial haemorrhage and/or cerebral dysfunction in newborn infants delivered by VE and to compare this risk with that after cesarean section in labour (CS) and spontaneous vaginal delivery, respectively. Methods Data was obtained from Swedish national registers. In a population-based cohort from 1999 to 2010 including all singleton newborn infants delivered at term after onset of labour by VE (n = 87,150), CS (75,216) or spontaneous vaginal delivery (n = 851,347), we compared the odds for neonatal intracranial haemorrhage, traumatic or non-traumatic, convulsions or encephalopathy. Logistic regressions were used to calculate adjusted (for major risk factors and indication) odds ratios (AOR), using spontaneous vaginal delivery as reference group. Results The rates of traumatic and non-traumatic intracranial hemorrhages were 0.8/10,000 and 3.8/1,000. VE deliveries provided 58% and 31.5% of the traumatic and non-traumatic cases, giving a ten-fold risk [AOR 10.05 (4.67-21.65)] and double risk [AOR 2.23 (1.57-3.16)], respectively. High birth weight and short mother were associated with the highest risks. Infants delivered by CS had no increased risk for intracranial hemorrhages. The risks for convulsions or encephalopathy were similar among infants delivered by VE and CS, exceeding the OR after non-assisted spontaneous vaginal delivery by two-to-three times. Conclusion Vacuum assisted delivery is associated with increased risk for neonatal intracranial hemorrhages. Although causality could not be established in this observational study, it is important to be aware of the increased risk of intracranial hemorrhages in VE deliveries, particularly in short women and large infants. The results warrant further studies in decision making and conduct of assisted vaginal delivery. PMID:24444326

  16. A laminar flow unit for the care of critically ill newborn infants.

    Science.gov (United States)

    Perez, Jose Mr; Golombek, Sergio G; Fajardo, Carlos; Sola, Augusto

    2013-01-01

    Medical and nursing care of newborns is predicated on the delicate control and balance of several vital parameters. Closed incubators and open radiant warmers are the most widely used devices for the care of neonates in intensive care; however, several well-known limitations of these devises have not been resolved. The use of laminar flow is widely used in many fields of medicine, and may have applications in neonatal care. To describe the neonatal laminar flow unit, a new equipment we designed for care of ill newborns. The idea, design, and development of this device was completed in Sao Paulo, Brazil. The unit is an open mobile bed designed with the objective of maintaining the advantages of the incubator and radiant warmer, while overcoming some of their inherent shortcomings; these shortcomings include noise, magnetic fields and acrylic barriers in incubators, and lack of isolation and water loss through skin in radiant warmers. The unit has a pump that aspirates environmental air which is warmed by electrical resistance and decontaminated with High Efficiency Particulate Air Filter (HEPA) filters (laminar flow). The flow is directed by an air flow directioner. The unit has an embedded humidifier to increase humidity in the infant's microenvironment and a servo control mechanism for regulation of skin temperature. The laminar flow unit is open and facilitates access of care providers and family, which is not the case in incubators. It provides warming by convection at an air velocity of 0.45 m/s, much faster than an incubator (0.1 m/s). The system provides isolation 1000 class (less than 1,000 particles higher than 0.3 micron per cubic feet at all times). This is much more protection than an incubator provides and more than radiant warmers, which have no isolation whatsoever. Additionally, it provides humidification of the newborn's microenvironment (about 60% relative humidity), which is impossible with a radiant warmer, which produces high water body loss. It

  17. Atrioventricular reciprocal rhythm and chronic reciprocating tachycardia in a newborn infant with concealed Wolff-Parkinson-White syndrome.

    Science.gov (United States)

    Sung, R J; Ferrer, P; Garcia, O L; Castellanos, A; Gelband, H

    1977-01-01

    A case of atrioventricular reciprocal rhythm and chronic reciprocating tachycardia in a newborn infant is presented. Electrophysiological studies suggest that these rhythm disturbances are related to the presence of a right-sided atrioventricular accessory pathway capable only of retrograde conduction (concealed Wolff-Parkinson-White syndrome). The technique of recording the sequence of atrial activation during the tachycardia is described and its clinical importance emphasised. PMID:884032

  18. Protocolized versus non-protocolized weaning for reducing the duration of invasive mechanical ventilation in newborn infants.

    Science.gov (United States)

    Wielenga, Joke M; van den Hoogen, Agnes; van Zanten, Henriette A; Helder, Onno; Bol, Bas; Blackwood, Bronagh

    2016-03-21

    Mechanical ventilation is a life-saving intervention for critically ill newborn infants with respiratory failure admitted to a neonatal intensive care unit (NICU). Ventilating newborn infants can be challenging due to small tidal volumes, high breathing frequencies, and the use of uncuffed endotracheal tubes. Mechanical ventilation has several short-term, as well as long-term complications. To prevent complications, weaning from the ventilator is started as soon as possible. Weaning aims to support the transfer from full mechanical ventilation support to spontaneous breathing activity. To assess the efficacy of protocolized versus non-protocolized ventilator weaning for newborn infants in reducing the duration of invasive mechanical ventilation, the duration of weaning, and shortening the NICU and hospital length of stay. To determine efficacy in predefined subgroups including: gestational age and birth weight; type of protocol; and type of protocol delivery. To establish whether protocolized weaning is safe and clinically effective in reducing the duration of mechanical ventilation without increasing the risk of adverse events. We searched the Cochrane Central Register of Controlled trials (CENTRAL; the Cochrane Library; 2015, Issue 7); MEDLINE In-Process and other Non-Indexed Citations and OVID MEDLINE (1950 to 31 July 2015); CINAHL (1982 to 31 July 2015); EMBASE (1988 to 31 July 2015); and Web of Science (1990 to 15 July 2015). We did not restrict language of publication. We contacted authors of studies with a subgroup of newborn infants in their study, and experts in the field regarding this subject. In addition, we searched abstracts from conference proceedings, theses, dissertations, and reference lists of all identified studies for further relevant studies. Randomized, quasi-randomized or cluster-randomized controlled trials that compared protocolized with non-protocolized ventilator weaning practices in newborn infants with a gestational age of 24 weeks or

  19. Newborn length predicts early infant linear growth retardation and disproportionately high weight gain in a low-income population.

    Science.gov (United States)

    Berngard, Samuel Clark; Berngard, Jennifer Bishop; Krebs, Nancy F; Garcés, Ana; Miller, Leland V; Westcott, Jamie; Wright, Linda L; Kindem, Mark; Hambidge, K Michael

    2013-12-01

    Stunting is prevalent by the age of 6 months in the indigenous population of the Western Highlands of Guatemala. The objective of this study was to determine the time course and predictors of linear growth failure and weight-for-age in early infancy. One hundred and forty eight term newborns had measurements of length and weight in their homes, repeated at 3 and 6 months. Maternal measurements were also obtained. Mean ± SD length-for-age Z-score (LAZ) declined from newborn -1.0 ± 1.01 to -2.20 ± 1.05 and -2.26 ± 1.01 at 3 and 6 months respectively. Stunting rates for newborn, 3 and 6 months were 47%, 53% and 56% respectively. A multiple regression model (R(2) = 0.64) demonstrated that the major predictor of LAZ at 3 months was newborn LAZ with the other predictors being newborn weight-for-age Z-score (WAZ), gender and maternal education∗maternal age interaction. Because WAZ remained essentially constant and LAZ declined during the same period, weight-for-length Z-score (WLZ) increased from -0.44 to +1.28 from birth to 3 months. The more severe the linear growth failure, the greater WAZ was in proportion to the LAZ. The primary conclusion is that impaired fetal linear growth is the major predictor of early infant linear growth failure indicating that prevention needs to start with maternal interventions. © 2013.

  20. [Carriage of group B beta-haemolytic streptococci among pregnant women in Iceland and colonisation of their newborn infants.].

    Science.gov (United States)

    Bjarnadóttir, Ingibjœrg; Kristinsson, Karl G; Hauksson, Arnar; Vilbergsson, Guðjón; Pálsson, Gestur; Dagbjartsson, Atli

    2003-02-01

    To determine the carrier rate of group B beta-haemolytic streptococci (GBS) of pregnant women in Iceland and the colonisation of their newborns. A prospective study was conducted from October 1994 until October 1997, where culture specimens for GBS were taken from vagina and rectum of pregnant women attending the prenatal clinics at the Department of Obstetrics and Gynecology, Landspitali University Hospital and the Reykjavik Health Centre. The samples were taken at 23 and 36 weeks gestation and at delivery. Culture samples were also taken from axilla, umbilical area and pharynx of their newborn infants immediately after birth. Included in the study were pregnant women born on every fourth day of each month. Carrier state was not treated during pregnancy, but Penicillin G was given i.v. at delivery if the last culture before delivery was positive and gestational age was 12 hours before delivery or the mother had a fever >38 degrees C. Cultures were taken from 280 women and their children. GBS carrier rate of pregnant women in Iceland was 24.3%. Twelve newborns had GBS positive cultures. No newborn had a confirmed septicemia. Cultures from 25% of newborns, who s mothers were still GBS carriers at birth, were positive for GBS. Positive predictive value of cultures taken at 23 weeks gestation was 64% and 78% at 36 weeks. Negative predictive value was 95% and 99% respectively. One out of every four pregnant women in Iceland is a GBS carrier. Twentyfive percent of newborns become colonised with GBS if the mother is a GBS carrier at delivery. When screening for GBS carrier state is done cultures from both vagina and rectum is more sensitive than cultures from vagina only. At least five percent of all newborns in Iceland are therefore expected to have positive skin cultures at birth. If the mother does not have positive GBS cultures during pregnancy, the likelihood that she will give birth to a GBS colonised child is almost none.

  1. Urinary paraben concentrations among pregnant women and their matching newborn infants of Korea, and the association with oxidative stress biomarkers

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Sungeun; Kim, Sunmi [School of Public Health, Seoul National University (Korea, Republic of); Park, Jeongim [College of Natural Sciences, Soonchunhyang University (Korea, Republic of); Kim, Hae-Joong [College of Medicine, Korea University (Korea, Republic of); Lee, Jeongjae; Choi, Gyuyeon [College of Medicine, Soonchunhyang University (Korea, Republic of); Choi, Sooran; Kim, Sungjoo [College of Medicine, Hallym University (Korea, Republic of); Kim, Su Young [College of Medicine, Jeju National University (Korea, Republic of); Moon, Hyo-Bang [College of Science and Technology, Hanyang University (Korea, Republic of); Kim, Sungkyoon [School of Public Health, Seoul National University (Korea, Republic of); Kho, Young Lim [Department of Health, Environment and Safety, Eulji University (Korea, Republic of); Choi, Kyungho, E-mail: kyungho@snu.ac.kr [School of Public Health, Seoul National University (Korea, Republic of)

    2013-09-01

    Parabens have been used in multiple products including personal care products, pharmaceuticals, and foods for more than 50 years but increasing numbers of studies have raised concerns on their safety. The present study was designed to determine urinary paraben levels among pregnant women and their matching newborn infants (< 48 h after delivery), and the association between paraben levels and stress markers. Pregnant women (n = 46) and their matching newborn infants were recruited from four university hospitals located in Seoul, Ansan and Jeju of Korea, 2011. Parabens including methyl paraben (MP), ethyl paraben (EP), n-propyl paraben (PP), and n-butyl paraben (BP) were measured in the urine using an automatic, high throughput online SPE–LC–MS/MS method. Urinary concentrations were normalized with specific gravity (SG). Free cortisol, malondealdehyde (MDA) and 8-hydroxydeoxyguanosine (8-OHdG) were measured in the urine as stress marker. Urinary MP was detected as the highest, and BP was detected as the lowest paraben in the urine samples of both pregnant women and their infants. Significant correlations between paraben concentrations of maternal and their newborn infant's urine were observed. The levels of urinary parabens among Korean pregnant women are comparable to those reported elsewhere, except for EP which were 4–9 folds higher than pregnant women of other countries. The ratios of infant to maternal urinary paraben concentrations varied between 0.5 and 0.6 for MP and PP, but approximately 10 fold lower for EP. Urinary MP or EP levels were associated with several oxidative stress related biomarkers such as urinary 8-OHdG and MDA, even after the adjustment of relevant covariates such as maternal age, mode of delivery, pre-pregnancy BMI, gestational age and parity. This is the first study that reported the levels of major parabens in the first urine of newborn infants. Further studies are warranted to understand the implications of paraben exposure

  2. [Cerebral damage in the full-term newborn infant. Causes and outcome].

    Science.gov (United States)

    Varangot, J; Henrion, R; Amiel-Tison, C; Papiernik-Berkhauer, E

    1975-04-26

    Modern obstetrics can no longer be content to statistically analyse deaths only but must also concern itself with injuries. Cerebral damage in the new-born at term may result in grave sequelae. A study was made in the maternity department of the Port-Royal hospital of 65 infants, born at 38 weeks or later, with neurological signs, over the period 1968/69. The study was aimed at clarifying neonatal neurological signs, analysing the obstetric circumstances in which the complications occurred and observing future development of the children involved. In most instances a combination of neurological signs was present, falling into three broad clinical categories on the basis of severity. These neurological signs may appear during the hours after birth even when the Apgar score was satisfactory. Analysis of the cases showed that obstetric factors were responsible for the neurological disorder in 45 cases. The obstetric circumstances were almost always identical: abnormalities of presentation, dynamic problems during labour, and trials of labour. Modern methods for in-utero foetal surveillance are excellent but can nerve replace a perfect and hard won understanding of basic obstetric principles. Follow-up showed that sequelae remained in 7 children. It would appear, then, that in addition to "high risk" pregnancies, there exist "high risk" deliveries in part unpredictable before the onset of labour. There exists also a group of children in whom risk is increased and in whom surveillance over many years is indicated.

  3. [Dermohypodermitis and gut translocation Escherichia coli septicemia in a newborn infant].

    Science.gov (United States)

    Gouache, E; Chantier, E; Hubert, N; Rivière, M-F

    2013-01-01

    The burden of neonatal bacterial infections continues. They remain a significant cause of death and morbidity, despite recommendations for prevention. The epidemiology of these infections has changed. Currently the two most causative pathogens for early-onset neonatal sepsis and for late-onset sepsis in term infants are Group B streptococci (GBS) and Escherichia coli. E. coli's role is increasingly important since the widespread use of intrapartum antibiotic prophylaxis. In late-onset infections, one of the suggested pathophysiological mechanisms is microbial translocation in the gut secondary to digestive colonization, particularly when E. coli is isolated in blood cultures. This can occur either before or after birth. Bacterial sepsis can be associated with various non-specific peripheral manifestations involving skin and soft tissues. We report the case of a full-term, 26-day-old newborn admitted to the hospital for fever. She presented with dermohypodermitis of the left trunk and was diagnosed with E. coli septicemia. She was discharged in good condition after appropriate intravenous antibiotic therapy. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  4. Cellular and humoral factors involvement in the enhanced NBT reduction by neutrophil leucocytes of newborn infants.

    Science.gov (United States)

    Tovo, P A; Ponzone, A

    1977-09-01

    The histochemical NBT test was performed on blood samples from ten healthy newborn infants. High spontaneous NBT reduction has been confirmed for neutrophils and assessed for monocytes. The stimulation of both neutrophils and monocytes with Escherichia coli endotoxin induces a statistically significant increase of NBT positive cells. The reason for the false positive test results in neonates was investigated by incubating neutrophils from adult donors and for different time periods in either neonatal or adult plasma before the addition of NBT. NBT reduction by adult neutrophils was increased after incubation in neonatal plasma, and this increase was related to the concentration of the plasma used. Maximum NBT reduction was observed after 90 min of incubation, at which time the NBT scores of adult cells incubated in neonatal plasma were similar to the results of tests performed on whole neonatal blood. It is concluded that neonatal leucocytes demonstrate efficient spontaneous and stimulated phagocytosis, and that there are, in the plasma of neonates, humoral factors which stimulated phagocytosis by neutrophils and are thus responsible for the false positive NBT test results observed in these subjects.

  5. The window of opportunity: decision theory and the timing of prognostic tests for newborn infants.

    Science.gov (United States)

    Wilkinson, Dominic

    2009-11-01

    In many forms of severe acute brain injury there is an early phase when prognosis is uncertain, followed later by physiological recovery and the possibility of more certain predictions of future impairment. There may be a window of opportunity for withdrawal of life support early, but if decisions are delayed there is the risk that the patient will survive with severe impairment. In this paper I focus on the example of neonatal encephalopathy and the question of the timing of prognostic tests and decisions to continue or to withdraw life-sustaining treatment. Should testing be performed early or later; and how should parents decide what to do given the conflicting values at stake? I apply decision theory to the problem, using sensitivity analysis to assess how different features of the tests or different values would affect a decision to perform early or late prognostic testing. I draw some general conclusions from this model for decisions about the timing of testing in neonatal encephalopathy. Finally I consider possible solutions to the problem posed by the window of opportunity. Decision theory highlights the costs of uncertainty. This may prompt further research into improving prognostic tests. But it may also prompt us to reconsider our current attitudes towards the palliative care of newborn infants predicted to be severely impaired.

  6. Radiant warmers versus incubators for regulating body temperature in newborn infants.

    Science.gov (United States)

    Flenady, V J; Woodgate, P G

    2003-01-01

    The provision of a thermoneutral environment is an essential component of the immediate and longer term care of newborn infants. A variety of methods are currently employed including incubators and open-care systems, with or without modifications such as heat shields and plastic wrap. The system used must allow ready access to the infant but should also minimise alterations in the immediate environment. To assess the effects of radiant warmers versus incubators on neonatal fluid and electrolyte balance, morbidity and mortality. The standard search strategy of the Cochrane Neonatal Review Group was used. This included searches of electronic databases: Oxford Database of Perinatal Trials, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1, 2003), MEDLINE (1966 -2003), and CINAHL (1982-2003), previous reviews including cross references, abstracts, conferences, symposia proceedings, expert informants and journal hand searching mainly in the English language. Randomised or quasi-randomised trials in which radiant warmers were compared to incubators in a neonatal population. Independent data extraction and quality assessment of included trials was conducted by the authors. Data were analysed using relative risk (RR) and weighted mean difference (WMD). Results are presented with 95% confidence intervals. Meta-analysis was undertaken using a fixed effect model. Eight studies are included in this review; six employed a crossover design. In the overall comparison of radiant warmers vs incubators, radiant warmers caused a statistically significant increase in insensible water loss (IWL) [WMD 0.94g/Kg/day (95% CI 0.47, 1.41)] and a trend towards increased oxygen consumption which was not statistically significant [WMD 0.27mL/kg/min (95% CI -0.09, 0.63)]. Due to small numbers, effects on important clinical outcomes could not be adequately assessed. A comparison of radiant warmers with heat shields vs incubators without heat shields showed a

  7. Conservation of the fourth gene among rotaviruses recovered from asymptomatic newborn infants and its possible role in attenuation

    International Nuclear Information System (INIS)

    Flores, J.; Midthun, K.; Hoshino, Y.; Green, K.; Gorziglia, M.; Kapikian, A.Z.; Chanock, R.M.

    1986-01-01

    RNA-RNA hybridization was performed to assess the extent of genetic relatedness among human rotaviruses isolated from children with gastroenteritis and from asymptomatic newborn infants. 32 P-labeled single-stranded RNAs produced by in vitro transcription from viral cores of the different strains tested were used as probes in two different hybridization assays: (1) undenatured genomic RNAs were resolved by polyacrylamide gel electrophoresis, denatured in situ, electrophoretically transferred to diazobenzyloxymethyl-paper (Northern blots), and then hybridized to the probes under two different conditions of stringency; and (ii) denatured genomic double-stranded RNAs were hybridized to the probes in solution and the hybrids which formed were identified by polyacrylamide gel electrophoresis. When analyzed by Northern blot hybridization at a low level of stringency, all genes from the strains tested cross-hybridized, providing evidence for some sequence homology in each of the corresponding genes. However, when hybridization stringency was increased, a difference in gene 4 sequence was detected between strains recovered from asymptomatic newborn infants (nursery strains) and strains recovered from infants and young children with diarrhea. Although the nursery strains exhibited serotypic diversity, the fourth gene appeared to be highly conversed. These results were confirmed and extended during experiments in which the RNA-RNA hybridization was carried out in solution and the resulting hybrids were analyzed by polyacrylamide gel electrophoresis. Full-length hybrids did not form between the fourth genes from the nursery strains and the corresponding genes from the strains recovered from symptomatic infants and young children

  8. Transporting newborn infants with suspected duct dependent congenital heart disease on low‐dose prostaglandin E1 without routine mechanical ventilation

    Science.gov (United States)

    Carmo, Kathryn A Browning; Barr, Peter; West, Maureen; Hopper, Neil W; White, Jennifer P; Badawi, Nadia

    2007-01-01

    Aim To evaluate the safety of transporting newborn infants with suspected duct dependent congenital heart disease (CHD) treated with prostaglandin E1 (PGE1) without routine mechanical ventilation. Methods A retrospective population‐based audit of newborn infants with suspected CHD transported on PGE1 by the New South Wales newborn and paediatric Transport Service from 1995 through 2005. Results Mechanical ventilation was not used prior to treatment with PGE1 in 94 (31%) of the 300 infants. The indications for mechanical ventilation in the remaining 206 infants (69%) included elective mechanical ventilation because of the intention to use PGE1 (n  =  125) and severe hypoxaemia, acidosis or cardiorespiratory failure prior to commencing PGE1 (n  =  81). 16 (17%) of the 94 infants who were not ventilated initially required mechanical ventilation before transport because of apnoea, which developed within one hour of commencing PGE1. 2 (2.6%) of the 78 infants transported without mechanical ventilation developed apnoea in transit and both were receiving ⩾15 ng/kg/min of PGE1. Apnoea was more likely to occur in non‐ventilated infants when the PGE1 infusion rate was ⩾15 ng/kg/min compared with Newborn infants with suspected duct dependent CHD treated with low dose PGE1 (mechanical ventilation for safe transport. PMID:16905574

  9. Transporting newborn infants with suspected duct dependent congenital heart disease on low-dose prostaglandin E1 without routine mechanical ventilation.

    Science.gov (United States)

    Browning Carmo, Kathryn A; Barr, Peter; West, Maureen; Hopper, Neil W; White, Jennifer P; Badawi, Nadia

    2007-03-01

    To evaluate the safety of transporting newborn infants with suspected duct dependent congenital heart disease (CHD) treated with prostaglandin E1 (PGE1) without routine mechanical ventilation. A retrospective population-based audit of newborn infants with suspected CHD transported on PGE1 by the New South Wales newborn and paediatric Transport Service from 1995 through 2005. Mechanical ventilation was not used prior to treatment with PGE1 in 94 (31%) of the 300 infants. The indications for mechanical ventilation in the remaining 206 infants (69%) included elective mechanical ventilation because of the intention to use PGE1 (n = 125) and severe hypoxaemia, acidosis or cardiorespiratory failure prior to commencing PGE1 (n = 81). 16 (17%) of the 94 infants who were not ventilated initially required mechanical ventilation before transport because of apnoea, which developed within one hour of commencing PGE1. 2 (2.6%) of the 78 infants transported without mechanical ventilation developed apnoea in transit and both were receiving >or=15 ng/kg/min of PGE1. Apnoea was more likely to occur in non-ventilated infants when the PGE1 infusion rate was >or=15 ng/kg/min compared with Newborn infants with suspected duct dependent CHD treated with low dose PGE1 (mechanical ventilation for safe transport.

  10. Exogenous surfactant therapy in 2013: what is next? who, when and how should we treat newborn infants in the future?

    Science.gov (United States)

    2013-01-01

    Background Surfactant therapy is one of the few treatments that have dramatically changed clinical practice in neonatology. In addition to respiratory distress syndrome (RDS), surfactant deficiency is observed in many other clinical situations in term and preterm infants, raising several questions regarding the use of surfactant therapy. Objectives This review focuses on several points of interest, including some controversial or confusing topics being faced by clinicians together with emerging or innovative concepts and techniques, according to the state of the art and the published literature as of 2013. Surfactant therapy has primarily focused on RDS in the preterm newborn. However, whether this treatment would be of benefit to a more heterogeneous population of infants with lung diseases other than RDS needs to be determined. Early trials have highlighted the benefits of prophylactic surfactant administration to newborns judged to be at risk of developing RDS. In preterm newborns that have undergone prenatal lung maturation with steroids and early treatment with continuous positive airway pressure (CPAP), the criteria for surfactant administration, including the optimal time and the severity of RDS, are still under discussion. Tracheal intubation is no longer systematically done for surfactant administration to newborns. Alternative modes of surfactant administration, including minimally-invasive and aerosolized delivery, could thus allow this treatment to be used in cases of RDS in unstable preterm newborns, in whom the tracheal intubation procedure still poses an ethical and medical challenge. Conclusion The optimization of the uses and methods of surfactant administration will be one of the most important challenges in neonatal intensive care in the years to come. PMID:24112693

  11. Can an EPR support the concept of family-centred, individualized developmental care of premature infants and newborns?

    Science.gov (United States)

    Kohl, Christian D; Schott, Claus; Verveur, Doris; Linderkamp, Otwin; Knaup-Gregori, Petra

    2007-01-01

    At the University Children's Hospital Heidelberg the concept of 'Developmental, Family-Centred, Individual Care of Premature Infants and Newborns' was introduced to support optimal growth of premature infants. This interdisciplinary concept requires cooperation of different specialists. A well operating communication is a precondition for such cooperation. As a patient's record is not only used for storing information but also for exchanging information, the question was if a complete electronic patient record (EPR), in contrast to the existing patient's record, could sensibly support this new concept of care. To answer this question the whole communication of the staff in the infants ward was analysed using different observation methods. These observations delivered several issues which showed that an EPR could improve communication and workflow. Therefore an EPR for the neonatology at the University Children's Hospital Heidelberg can now be designed on the basis of our communication concept.

  12. Task-Oriented and Bottle Feeding Adversely Affect the Quality of Mother-Infant Interactions Following Abnormal Newborn Screens

    Science.gov (United States)

    Tluczek, Audrey; Clark, Roseanne; McKechnie, Anne Chevalier; Orland, Kate Murphy; Brown, Roger L.

    2010-01-01

    Objective Examine effects of newborn screening (NBS) and neonatal diagnosis on the quality of mother-infant interactions in the context of feeding. Methods Study compared the quality of mother-infant feeding interactions among four groups of infants classified by severity of NBS and diagnostic results: cystic fibrosis (CF), congenital hypothyroidism, heterozygote CF carrier, and healthy with normal NBS. The Parent-Child Early Relational Assessment and a task-oriented item measured the quality of feeding interactions for 130 dyads, infant ages 3–19 weeks (M=9.19, SD=3.28). The Center for Epidemiologic Studies Depression Scale and State-Trait Anxiety Inventory measured maternal depression and anxiety. Results Composite Indicator Structure Equation Modeling showed that infant diagnostic status and, to a lesser extent, maternal education predicted feeding method. Mothers of infants with CF were most likely to bottle feed, which was associated with more task-oriented maternal behavior than breastfeeding. Mothers with low task-oriented behavior showed more sensitivity and responsiveness to infant cues, as well as less negative affect and behavior in their interactions with their infants than mothers with high task-oriented scores. Mothers of infants with CF were significantly more likely to have clinically significant anxiety and depression than the other groups. However, maternal psychological profile did not predict feeding method or interaction quality. Conclusions Mothers in the CF group were the least likely to breastfeed. Research is needed to explicate long-term effects of feeding methods on quality of mother-child relationship and ways to promote continued breastfeeding following a neonatal CF diagnosis. PMID:20495477

  13. Activation of olfactory cortex in newborn infants after odor stimulation: a functional near-infrared spectroscopy study.

    Science.gov (United States)

    Bartocci, M; Winberg, J; Ruggiero, C; Bergqvist, L L; Serra, G; Lagercrantz, H

    2000-07-01

    In mammals, perception of smells during the first hours of life is an essential prerequisite for adaptation of the newborn to the new extrauterine world. Functional magnetic resonance studies have shown that olfactory impression is processed in the lateral and anterior orbito-frontal gyri of the frontal lobe. Near-infrared spectroscopy (NIRS) can detect changes in oxygenated [Hb O2], and deoxygenated [Hb H] Hb during cortical activation. The aim of this study was to assess by NIRS olfactory cortex activity in newborn infants receiving olfactory stimuli. Twelve males and 11 females were studied when awake at 6 h to 8 d after birth. NIRS monitoring was carried out using two optodes placed above the left anterior orbito-frontal gyri. Each newborn was exposed for 30 s to two different smell stimuli-mother's colostrum and vanilla-and to a negative control, distilled water. Changes in Hb concentration were measured over the orbitofrontal region. During exposure to vanilla, [Hb O2] increased significantly over the left orbito-frontal area in all babies. The magnitude of the [Hb O2] increase over the illuminated region during colostrum exposure was inversely related to postnatal age. We conclude that monitoring Hb changes by NIRS can be valuable in assessing olfactory responsiveness in infants.

  14. Severe hemolytic disease of the newborn in a group B African-American infant delivered by a group O mother.

    Science.gov (United States)

    Drabik-Clary, Kathryn; Reddy, Vishnu V B; Benjamin, William H; Boctor, Fouad N

    2006-01-01

    Maternal-fetal ABO incompatibility is a common hematological problem affecting the newborn. In general, hemolysis is minimal and the clinical course is relatively benign, rarely causing the escalating levels of hyperbilirubinemia and significant anemia commonly associated with Rh hemolytic disease of the newborn (HDN). The incidence of HDN ranges from one in 150 births to 1:3000 births, depending on the degree of anemia and level of serum bilirubin. The etiology of ABO hemolytic disease of the newborn (ABO-HDN) is complex because anti-A and anti-B antibodies are composed mainly of IgM. Since only IgG antibodies cross the placenta, those pregnant women with high levels of IgG anti-A,B, anti-A, or anti-B with an ABO incompatible fetus will be the ones to give birth to an infant with ABO-HDN. We describe a case of a B/Rh positive term newborn born to an O/Rh negative African-American mother demonstrating aggressive hemolysis and a robust response of the bone marrow. This case was successfully managed with phototherapy and simple RBC transfusion without the need for exchange transfusion.

  15. Evidence on Adrenaline Use in Resuscitation and Its Relevance to Newborn Infants: A Non-Systematic Review.

    Science.gov (United States)

    Pinto, Merlin; Solevåg, Anne Lee; OʼReilly, Megan; Aziz, Khalid; Cheung, Po-Yin; Schmölzer, Georg M

    2017-01-01

    Guidelines for newborn resuscitation state that if the heart rate does not increase despite adequate ventilation and chest compressions, adrenaline administration should be considered. However, controversy exists around the safety and effectiveness of adrenaline in newborn resuscitation. The aim of this review was to summarise a selection of the current knowledge about adrenaline during resuscitation and evaluate its relevance to newborn infants. A search in PubMed, Embase, and Google Scholar until September 1, 2015, using search terms including adrenaline/epinephrine, cardiopulmonary resuscitation, death, severe brain injury, necrotizing enterocolitis, bronchopulmonary dysplasia, and adrenaline versus vasopressin/placebo. Adult data indicate that adrenaline improves the return of spontaneous circulation (ROSC) but not survival to hospital discharge. Newborn animal studies reported that adrenaline might be needed to achieve ROSC. Intravenous administration (10-30 μg/kg) is recommended; however, if there is no intravenous access, a higher endotracheal dose (50-100 μg/kg) is needed. The safety and effectiveness of intraosseous adrenaline remain undetermined. Early and frequent dosing does not seem to be beneficial. In fact, negative hemodynamic effects have been observed, especially with doses ≥30 μg/kg intravenously. Little is known about adrenaline in birth asphyxia and in preterm infants, but observations indicate that hemodynamics and neurological outcomes may be impaired by adrenaline administration in these conditions. However, a causal relationship between adrenaline administration and outcomes cannot be established from the few available retrospective studies. Alternative vasoconstrictors have been investigated, but the evidence is scarce. More research is needed on the benefits and risks of adrenaline in asphyxia-induced bradycardia or cardiac arrest during perinatal transition. © 2016 S. Karger AG, Basel.

  16. Different methods for assessment of nutritional status in newborn infants based on physical and anthropometric indexes: a short review article

    Directory of Open Access Journals (Sweden)

    Ali Asghar Rashidi

    2017-01-01

    Full Text Available Several complications during childhood is associated with nutritional status of infants at birth. Therefore, nutritional status of newborns must be evaluated properly after birth. Assessment of the nutritional status of neonates based on anthropometric and physical indices is simple and inexpensive without the need for advanced medical equipment. However, no previous studies have focused on the assessment methods of the nutritional status of infants via anthropometric and physical indices. This study aimed to review some of the key methods used to determine the nutritional status of neonates using anthropometric and physical indices. To date, most studies have focused on the diagnosis of fetal malnutrition (FM and growth monitoring. In order to diagnose FM, researchers have used growth charts and Ponderal index (PI based on anthropometric indices, as well as Clinical Assessment of Nutritional (CAN Score based on physical features. Moreover, in order to assess the growth status of infants, growth charts were used. According to the findings of this study, standard intrauterine growth curves and the PI are common measurement tools in the diagnosis of FM. Furthermore, CAN score is widely used in the evaluation of the nutritional status of neonates. Given the differences in the physical features of term and preterm infants, this index should be adjusted for preterm neonates. Longitudinal growth charts are one of the most prominent methods used for monitoring of the growth patterns of infants.

  17. [A temporal bone CT study of the infants with hearing loss referred from universal newborn hearing screening].

    Science.gov (United States)

    Tao, Zheng; Li, Yun; Hou, Zheng; Cheng, Lan

    2007-02-01

    To explore the high resolution CT image of temporal bone in infants with hearing loss, and its value in evaluating the cause of hearing loss. In 2005, 0.12 million newborns have been included in the hearing screening system in Shanghai, and 1077 infants have failed to pass the hearing screening. One hundred and eight four infants were diagnosed as congenital hearing loss from mild to profound. A temporal bone HRCT scanning was performed to these infants. Among the 184 patients with congenital hearing loss, HRCT showed that 26 cases (14.1%) were associated with external ear malformation, and 21 cases (11.4%) were associated with middle ear malformation, 31 cases (16.8%) associated with inner ear malformation. The patients with inner ear malformation included 12 cases with Mondini malformation, 1 case with common cavity malformation, 6 cases with large vestibule malformation, 5 cases with internal auditory canal abnormalities, and 10 cases with vestibule, semicircular canals abnormalities. In addition, there were 20 cases (10.8%) with fluid in middle ear. HRCT image play an important role in the differential diagnosis and treatment of infants with congenital hearing loss.

  18. Antenatal smoking and substance-misuse, infant and newborn response to hypoxia

    OpenAIRE

    Ali, Kamal; Rosser, Thomas; Bhat, Ravindra; Wolff, Kim; Hannam, Simon; Rafferty, Gerrard F.; Greenough, Anne

    2016-01-01

    Objectives: To determine at the peak age for sudden infant death syndrome (SIDS) the ventilatory response to hypoxia of infants whose mothers substance misused in pregnancy (SM infants), or smoked during pregnancy (S mothers) and controls whose mothers neither substance misused or smoked. In addition, we compared the ventilatory response to hypoxia during the neonatal period and peak age of SIDS. Working hypothesis: Infants of S or SM mothers compared to control infants would have a poorer ve...

  19. The influence of gestation and mechanical ventilation on serum clara cell secretory protein (CC10) concentrations in ventilated and nonventilated newborn infants.

    Science.gov (United States)

    Loughran-Fowlds, Alison; Oei, Julee; Wang, He; Xu, Hongxiu; Wimalasundera, Neil; Egan, Claire; Henry, Richard; Lui, Kei

    2006-07-01

    Clara cell secretory protein (CC10) is an important anti-inflammatory mediator in the adult lung, but its role in newborn pulmonary protection is uncertain. We examined the early postnatal behavior of CC10 in newborn serum and tracheal fluid and hypothesized that CC10 production is positively influenced by gestation. Blood from 165 infants from the first, third/fourth, and seventh days of life (gestational ages: 23-29 wk, 30-36 wk, >36 wk) and tracheal fluid (TF) from the first day of life from 32 ventilated infants were analyzed for CC10. Surfactant proteins A (SPA) and B (SPB) were also analyzed from the blood of a subgroup of infants. Serum CC10 on day 1 was highest in term infants (69.4 ng/mL), followed by moderately preterm (55.8 ng/mL), and then extremely preterm infants (median 42.1 ng/mL). Term infants also had higher tracheal fluid CC10 than preterm infants. (20.152 ng/mL versus 882 ng/mL). Mechanical ventilation increased serum CC10 only in moderately preterm infants, and only on d 1 [68.4 ng/mL versus 42.1 ng/mL (nonventilated moderately preterm infants)]. Serum CC10 decreased progressively by the end of the first week in all infants, in contrast to SPA and SPB, which increased. Our results show that CC10 is detectable in the blood of newborn infants and that a production surge occurs at birth. This surge is more pronounced in term infants and may confer them with superior extrauterine pulmonary protection compared with preterm infants.

  20. [Immunological behavior (IgG, IgM, IgA) and total complement (CH50) of newborns infants with risk factors for early onset sepsis. Comparative analysis of newborns with and without infection].

    Science.gov (United States)

    Ceccon, M E; Diníz, E M; Carneiro-Sampaio, M M; Arslanian, C; Diogo, C L; Ramos, J L; Vaz, F A

    1998-01-01

    Immunological behavior (IgG, IgM, IgA) and total Complement (CH50) of newborns infants with risk factors for early onset sepsis. Comparative analysis between newborns with and without infection. Rev. Hosp. Clín. Fac. Med. S. Paulo, 53(6): 303-310, 1998. The objective of this study was to verify the immunological behavior of the newborn infant in front of an infection. We studied 60 newborn infants that had risk factors for early onset sepsis (premature rupture membranes, clinic amnionitis or tract urinary infection) from de immunological and infection point of view. They were classified into three gestational age groups: or = 37 weeks. Sepsis diagnosis was done through clinical and laboratorial data and we also included the followings exams: Immunological types (IgG, IgM, IgA) and total complement (CH50) obtained from the newborn at birth and on the fifth day of life. We could verify that 15 newborns (25%) presented early sepsis. There was a statistical association between perinatal asfixia and infection in the group with gestational age < 34 weeks and this same group presented statistical association between infection and death. The serical levels of IgG and CH50 were directly related to the gestational age and there were significant statistical differences between levels of IgG, IgM and total Complement between infected and not infected newborns within the same group os gestional age. We observed that the infection was associated to low levels of IgG and CH50, at birth and on the fifth day, mainly in the group of infected newborns with gestional age < 34 weeks, being this group, therefore, the one that would mostly benefit from an immunological support in front of and infection.

  1. The Foundations of Social Cognition: Studies on Face/Voice Integration in Newborn Infants

    Science.gov (United States)

    Streri, Arlette; Coulon, Marion; Guellai, Bahia

    2013-01-01

    A series of studies on newborns' abilities for recognizing speaking faces has been performed in order to identify the fundamental cues of social cognition. We used audiovisual dynamic faces rather than photographs or patterns of faces. Direct eye gaze and speech addressed to newborns, in interactive situations, appear to be two good candidates for…

  2. Noninvasive ventilatory strategies in the management of a newborn infant and three children with congenital central hypoventilation syndrome.

    Science.gov (United States)

    Tibballs, James; Henning, Robert D

    2003-12-01

    Four children with congenital central hypoventilation syndrome (CCHS) treated with noninvasive techniques of ventilation are presented. Two infants (one in the newborn period) were treated with nasal mask bilevel positive airway pressure (BiPAP), and then both were transitioned to negative pressure chamber ventilation at several years of age because of possible midface hypoplasia. Tracheostomies were not performed. Two older children were transitioned from mechanical ventilation via tracheostomy to nasal mask BiPAP, and then in one case to negative pressure chamber ventilation, and in the other to phrenic nerve pacing. Their tracheostomies were removed. Copyright 2003 Wiley-Liss, Inc.

  3. Conservative treatment of congenital false joint of shin in newborns and infants

    Directory of Open Access Journals (Sweden)

    O. V. Shchokin

    2017-04-01

    Full Text Available Congenital false joint of shin occurs in 1 case per 28 000 - 190 000 live births, but it is hard-to-treat and disabling disease. Objective: Improving treatment outcomes, reducing the number of surgical interventions for the treatment of congenital false joint of shin. Materials and Methods. The method is carried out using staged plaster casts with the gradual correction of deformities. When axis of the leg approximates to the normal one, axial load is added. First, it is done by tapping on the heel. When the child was 7-8 months old he was put on the legs and taught to walk. The plaster bandage is replaced by "Scotch cast" and "soft cast" bandage. The treatment lasted up to reaching of clinical effect – correction of shin deformation and absence of pathological mobility. Clinical effect must be confirmed by roentgenography which must demonstrate filling of false joint zone with bone tissue and restoration of intramedullary canal. During all the period of treating alternate courses of electrophoresis with calcium chloride, medical mud extracts and magnetic therapy are conducted. In the period from 1995 till 2015 in the Regional Zaporizhzhia Children Clinical Hospital 4 children (6 shins aged from 1 to 7 months with false joint of shin were treated using proposed method. Results and discussion. All 4 children (6 shins treated in clinic with proposed conservative method showed filling of false joint zone with bone tissue, restoration of intramedullary canal and significant extension of axis of the shin. The load on the leg in early terms results in compression of bone fragments (as in compression-distraction osteosynthesis, magnetic therapy, electrophoresis with calcium chloride and medical mud extracts promote active functioning of the muscles that improves regional blood supply and improves osteogenesis. Conclusions. Using the proposed method of treatment of congenital false joint of shins in newborns and infants can allow avoiding surgical

  4. Surveillance of extreme hyperbilirubinaemia in Denmark. A method to identify the newborn infants

    DEFF Research Database (Denmark)

    Bjerre, J.V.; Petersen, Jes Reinholdt; Ebbesen, F.

    2008-01-01

    bilirubin encephalopathy; one infant had advanced-phase symptoms. Four infants received an exchange transfusion. ABO blood group incompatibility was present in 52 infants. Thirty-seven infants were of non-Caucasian descent. CONCLUSION: A method to obtain the national epidemiological data is presented....... The observed incidence of extreme hyperbilirubinaemia is higher than previously reported in Denmark. This is mainly due to a very sensitive method of identifying the study group Udgivelsesdato: 2008/8...

  5. Evaluation of motor performance of preterm newborns during the first months of life using the Alberta Infant Motor Scale (AIMS).

    Science.gov (United States)

    Manacero, Sônia; Nunes, Magda Lahorgue

    2008-01-01

    To evaluate the motor performance of premature neonates using the Alberta Infant Motor Scale (AIMS) and to investigate the influence of birth weight on motor acquisition. A cross-sectional study was carried out of a prospective cohort of 44 premature newborn infants with gestational ages from 32 to 34 weeks, without neurological disorders, selected from the neonatal intensive care unit at the Pontifícia Universidade Católica's Hospital São Lucas in Rio Grande do Sul, Brazil. The neonates studied were stratified by birth weight and assessed using the AIMS scale at the 40th week of postconceptional age, and at 4 and 8 months of corrected age. The preterm infants studied exhibited a progressive sequence of motor ability acquisition in all of the positions tested (prone, supine, sitting, standing), which occurred variable manner, expressed by the mean percentile of 43.2 to 45.7%, but within the limits of normality defined by the AIMS. It was observed that there was a clear increase in AIMS scores from the first to the last of the three postnatal observation points. The rate at which these scores increased was similar for both groups, irrespective of birth weight category (or= 1,750 g). The motor performance of the sample of premature infants studied here was normal according to the AIMS and their scores on that scale were not influenced by birth weight.

  6. Noninvasive monitoring of gas in the lungs and intestines of newborn infants using diode lasers: feasibility study

    Science.gov (United States)

    Lundin, Patrik; Svanberg, Emilie Krite; Cocola, Lorenzo; Xu, Märta Lewander; Somesfalean, Gabriel; Andersson-Engels, Stefan; Jahr, John; Fellman, Vineta; Svanberg, Katarina; Svanberg, Sune

    2013-12-01

    Preterm newborn infants have a high morbidity rate. The most frequently affected organs where free gas is involved are the lungs and intestines. In respiratory distress syndrome, both hyperexpanded and atelectatic (collapsed) areas occur, and in necrotizing enterocolitis, intramural gas may appear in the intestine. Today, these conditions are diagnosed with x-ray radiography. A bed-side, rapid, nonintrusive, and gas-specific technique for in vivo gas sensing would improve diagnosis. We report the use of noninvasive laser spectroscopy, for the first time, to assess gas content in the lungs and intestines of three full-term infants. Water vapor and oxygen were studied with two low-power diode lasers, illuminating the skin and detecting light a few centimeters away. Water vapor was easily detected in the intestines and was also observed in the lungs. The relatively thick chest walls of the infants prevented detection of the weaker oxygen signal in this study. However, results from a previous phantom study, together with scaling of the results presented here to the typical chest-wall thickness of preterm infants, suggest that oxygen also should be detectable in their lungs.

  7. Tc-99m-labeled red blood cells for the measurement of red cell mass in newborn infants: concise communication

    International Nuclear Information System (INIS)

    Linderkamp, O.; Betke, K.; Fendel, H.; Klemm, J.; Lorenzen, K.; Riegel, K.P.

    1980-01-01

    In vitro and in vivo investigations were performed to examine the binding of Tc-99m to neonatal red blood cells (RBC). Labeling efficiency was about 90%, and unbound Tc-99m less than 3% after one washing, in premature and full-term newborns and in children. Thus presence of high percentages of fetal hemoglobin (Hb F) did not influence the labeling of RBCs with Tc-99m. RBCs of 11 newborns were hemolysed and the distribution of Tc-99m on RBC components was analyzed. Although Hb F percentage averaged (60.0 +- 8.10)% (s.d.), only (11.9 +- 3.7)% of Tc-99m was bound by Hb F, whereas (45.0 +- 6.1)% was associated with Hb A. RBC membranes bound (13.7 +- 4.3)% and (29.3 +- 4.0)% were found unbound in hemolysates. These results indicate that Tc-99m preferentially binds to beta chains. In vivo equilibration of Tc-99m RBCs and of albumin labeled with Evans blue was investigated in five newborn infants. Tc-99m RBCs were stable in each case during the first hour after injection. Elution of Tc-99m from RBCs was (3.4 +- 1.5)% per h. Body-to-venous hematocrit ratio averaged 0.86 +- 0.03

  8. Antibiotics at the time of removal of central venous catheter to reduce morbidity and mortality in newborn infants.

    Science.gov (United States)

    McMullan, Rowena L; Gordon, Adrienne

    2018-03-07

    Late-onset sepsis is associated with increased rates of mortality and morbidity in newborn infants, in addition to poorer long-term developmental outcomes and increased length of stay and hospital costs. Central line-associated blood stream infection (CLABSI) is the most common cause of late-onset sepsis in hospitalised infants, and prevention of CLABSI is a key objective in neonatal care. Increased frequency of CLABSI around the time of removal of central venous catheters (CVCs) has been reported, and use of antibiotics at the time of removal may reduce the incidence and impact of late-onset sepsis in vulnerable newborn infants. To determine the efficacy and safety of giving antibiotics at the time of removal of a central venous catheter (CVC) for reduction of morbidity and mortality in newborn infants, in particular effects on late-onset sepsis. We used the standard search strategy of the Cochrane Neonatal Review Group without language restriction to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 3), MEDLINE via PubMed (1966 to 6 April 2017), Embase (1980 to 6 April 2017), and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1982 to 6 April 2017). We also searched clinical trials databases, conference proceedings, and reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. Randomised, quasi-randomised, and cluster-randomised trials considering use of any antibiotic or combination of antibiotics at the time of CVC removal in newborn infants compared with placebo, no antibiotics, or another antibiotic or combination of antibiotics. We extracted data using standard methods of the Cochrane Neonatal Review Group. Two review authors independently selected, assessed the quality of, and extracted data from the included study. Only one randomised controlled trial was eligible for inclusion in this analysis. Forty-four of a total of 88 infants received two doses of cephazolin

  9. A proposed new international convention supporting the rights of pregnant women and girls and their newborn infants.

    Science.gov (United States)

    Winrow, Benjamin; Bile, Khalif; Hafeez, Assad; Davies, Hugh; Brown, Nick; Zafar, Shamsa; Cham, Mamady; Phillips, Barbara; MacDonald, Rhona; Southall, David P

    2012-05-01

    For a multitude of eminently modifiable reasons, death rates for pregnant women and girls and their newborn infants in poorly resourced countries remain unacceptably high. The concomitant high morbidity rates compound the situation. The rights of these vulnerable individuals are incompletely protected by existing United Nations human rights conventions, which many countries have failed to implement. The authors propose a novel approach grounded on both human rights and robust evidence-based clinical guidelines to create a 'human rights convention specifically for pregnant women and girls and their newborn infants'. The approach targets the 'right to health' of these large, vulnerable and neglected populations. The proposed convention is designed so that it can be monitored, audited and evaluated objectively. It should also foster a sense of national ownership and accountability as it is designed to be relevant to local situations and to be incorporated into local clinical governance systems. It may be of particular value to those countries that are not yet on target to meet the Millennium Development Goals (MDGs), especially MDGs 4 and 5, which target child and maternal mortality, respectively. To foster a sense of international responsibility, two additional initiatives are integral to its philosophy: the promotion of twinning between well and poorly resourced regions and a raising of awareness of how some well-resourced countries can damage the health of mothers and babies, for example, through the recruitment of health workers trained by national governments and taken from the public health system.

  10. Statistical modeling of the mother-baby system in newborn infants with cerebral ischemia

    Directory of Open Access Journals (Sweden)

    A. V. Filonenko

    2014-01-01

    Full Text Available The statistical model could consider the influence of specific maternal psychoemotional and personality factors on a newborn with cerebral ischemia and develop a procedure to prevent negative consequences of postpartum depression in the mother-baby system.

  11. [Anthropometric data on newborn infants: comparative study of two ethnic groups].

    Science.gov (United States)

    Martínez Cortés, F; Martínez Guerrero, M V; Valdivielso Felices, P; Legros Carrenard, J R; Martín Sánchez, J

    1992-11-01

    We have studied the birth weights, obstetrics data and anthropometrical data from 1.157 full-term newborns who were delivered in the Hospital del Insalud-Cruz Roja in Ceuta (Spain). Of these newborns, 489 were of arabic origin and 668 of hispanic origin. Arabic newborns were heavier (3.248 +/- 473 g versus 3.280 +/- 431 g, p < 0.001) and longer (50.2 +/- 1.8 cm versus 49.6 +/- 1.8 cm, p < 0.001) than their hispanic counterparts. These differences were not due to a disproportion in sex or gestational age between the groups. Furthermore, the differences were still present after adjustments were made for maternal age, parity and the mother's smoking habit. Thus, this difference in size at birth between arabic and hispanic newborns could be, at least in part, ethnically related.

  12. Maternal intrapartum antibiotic treatment continues to exert a bactericidal effect on the umbilical cord and peripheral venous blood of newborn infants.

    Science.gov (United States)

    Hershkovich-Shporen, C; Bardenstein, R; Blickstein, I; Shinwell, E S; Flidel-Rimon, O

    2017-11-01

    It is unclear whether maternal intrapartum antibiotic treatment (IAT) continues to exert a bactericidal effect on common pathogens in neonates. We studied the in vitro bactericidal effect of IAT on the cord and peripheral venous blood of newborn infants. Umbilical cord and peripheral venous blood from newborn infants born at Kaplan Medical Center, Israel, from April to October 2014 were studied for serum bactericidal titres against Group B Streptococcus (GBS) and Escherichia coli (E. coli) strains. We studied 60 samples of umbilical cord blood and 18 samples of peripheral venous blood from 60 newborn infants whose mothers received IAT. The controls were 10 samples of cord blood from mothers without IAT. Cord blood exerted a bactericidal effect against 98% of GBS isolates but only 8% of E.coli isolates. Peripheral blood exerted a bactericidal effect against GBS in 94% of cases, but not against E. coli. No bactericidal effect was seen in the blood from the controls. We found a continued bactericidal effect of umbilical cord blood and neonatal peripheral blood from newborn infants of IAT-treated mothers, mainly against GBS, but rarely against E. Coli. These findings may assist clinicians treating at-risk infants exposed to IAT. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  13. Impaired autoregulation of cerebral blood flow in the distressed newborn infant

    DEFF Research Database (Denmark)

    Lou, H C; Lassen, N A; Friis-Hansen, B

    1979-01-01

    Cerebral blood flow was measured, using the 133Xe clearance technique, a few hours after birth in 19 infants with varying degrees of respiratory distress syndrome. Ten of these infants had had asphyxia at birth. The least affected infants with normotension (systolic blood pressure 60 to 65 mm Hg...... at birth and infants with RDS only. CBF varied considerably with spontaneous variations in blood pressure, suggesting that autoregulation was lacking. This finding may explain why distressed premature infants are prone to develop massive capillary bleeding in the germinal layer with penetration...

  14. Impaired autoregulation of cerebral blood flow in the distressed newborn infant

    DEFF Research Database (Denmark)

    Lou, H C; Lassen, N A; Friis-Hansen, B

    1979-01-01

    Cerebral blood flow was measured, using the 133Xe clearance technique, a few hours after birth in 19 infants with varying degrees of respiratory distress syndrome. Ten of these infants had had asphyxia at birth. The least affected infants with normotension (systolic blood pressure 60 to 65 mm Hg...... at birth and infants with RDS only. CBF varied considerably with spontaneous variations in blood pressure, suggesting that autoregulation was lacking. This finding may explain why distressed premature infants are prone to develop massive capillary bleeding in the germinal layer with penetration......) had CBF values of about 40 ml/100 gm/minute. Hypotensive infants with asphyxia at birth or RDS or both had values for CBF of about 20 ml/100 gm/minute, or less. CBF was strongly correlated with the arterial blood pressure, showing a linear relationship that was identical in infants with asphyxia...

  15. In utero exposure to dioxins and dioxin-like compounds and anogenital distance in newborns and infants.

    Science.gov (United States)

    Vafeiadi, Marina; Agramunt, Silvia; Papadopoulou, Eleni; Besselink, Harrie; Mathianaki, Kleopatra; Karakosta, Polyxeni; Spanaki, Ariana; Koutis, Antonis; Chatzi, Leda; Vrijheid, Martine; Kogevinas, Manolis

    2013-01-01

    Anogenital distance in animals is used as a measure of fetal androgen action. Prenatal exposure to dioxins and dioxin-like compounds in rodents causes reproductive changes in male offspring and decreases anogenital distance. We assessed whether in utero exposure to dioxins and dioxin-like compounds adversely influences anogenital distance in newborns and young children (median age, 16 months; range, 1-31 months). We measured anogenital distance among participants of the "Rhea" mother-child cohort study in Crete and the Hospital del Mar (HMAR) cohort in Barcelona. Anogenital distance (AGD; anus to upper penis), anoscrotal distance (ASD; anus to scrotum), and penis width (PW) were measured in 119 newborn and 239 young boys; anoclitoral (ACD; anus to clitoris) and anofourchetal distance (AFD; anus to fourchette) were measured in 118 newborn and 223 young girls. We estimated plasma dioxin-like activity in maternal blood samples collected at delivery with the Dioxin-Responsive Chemically Activated LUciferase eXpression (DR CALUX®) bioassay. Anogenital distances were sexually dimorphic, being longer in males than females. Plasma dioxin-like activity was negatively associated with AGD in male newborns. The estimated change in AGD per 10 pg CALUX®-toxic equivalent/g lipid increase was -0.44 mm (95% CI: -0.80, -0.08) after adjusting for confounders. Negative but smaller and nonsignificant associations were observed for AGD in young boys. No associations were found in girls. Male infants may be susceptible to endocrine-disrupting effects of dioxins. Our findings are consistent with the experimental animal evidence used by the Food and Agriculture Organization/World Health Organization to set recommendations for human dioxin intake.

  16. HEART RHYTHM DISORDERS IN NEW-BORNS AND INFANTS: CLINICAL COURSE AND PERINATAL RISK FACTORS OF ARRHYTHMIAS APPEARANCE

    Directory of Open Access Journals (Sweden)

    I. A. Kovalyov

    2013-01-01

    Full Text Available Clinical course, prognosis and mechanisms of separate forms of heart rhythm disorders in children differ from those in adults. Especially, it refers to new-borns and infants whose conduction system differs by functional and morphologic immaturity. In connection with it, the assessment of natural history of heart rhythm disorders, occurred in a perinatal period, and determination of risk factors of arrhythmia appearance in infants are of some interest. 88 newborns took part in the study. The patients were involved by continuous sampling technique. Risk factors, occurred in a perinatal period and potentially influenced on development of heart rhythm disorders, were assessed. In our study we took biological, gynecologic and obstetric history, data of gestation and delivery course, early and late neonatal period, early infancy, Echo, neurosonography, Holter monitoring with determination of heart rhythm variability, and determined thyroid hormonal status. Maximum specific gravity had extrasystoles – 32.4% – in the structure of idiopathic arrhythmias in infants. Heart rhythm disorders with natural history were kept at six months of life only in 5,4% of children. Persistence of arrhythmias was marked during one year only for WPW syndrome. Heart rhythm disorders are often marked significantly in children whose mothers had acute respiratory disease during the pregnancy, or if the children were born from the first pregnancy, had the signs of central nervous system damage syndromes in an early perinatal period (arrest, intracranial hypertension, convulsive disorder. Disorders of autonomic imbalance of cardiac function and peculiarities of hemodynamics of pulmonary circulation contribute significantly into appearance and persistence of all types of arrhythmias. On the whole, the prognosis of heart rhythm disorders, occurred in the perinatal period, without organic and structural changes of myocardium is favorable. The exclusion can be made for

  17. Newborn Dried Blood Spot Polymerase Chain Reaction to Identify Infants with Congenital Cytomegalovirus-Associated Sensorineural Hearing Loss.

    Science.gov (United States)

    Ross, Shannon A; Ahmed, Amina; Palmer, April L; Michaels, Marian G; Sánchez, Pablo J; Stewart, Audra; Bernstein, David I; Feja, Kristina; Fowler, Karen B; Boppana, Suresh B

    2017-05-01

    To determine the utility of dried blood spot (DBS) polymerase chain reaction (PCR) in identifying infants with cytomegalovirus (CMV) infection-associated sensorineural hearing loss (SNHL). Newborns at 7 US hospitals between March 2007 and March 2012 were screened for CMV by saliva rapid culture and/or PCR. Infected infants were monitored for SNHL during the first 4 years of life to determine sensitivity, specificity, and positive and negative likelihood ratios of DBS PCR for identifying CMV-associated SNHL. DBS at birth was positive in 11 of 26 children (42%) with SNHL at age 4 years and in 72 of 270 children (27%) with normal hearing (P = .11). The sensitivity (42.3%; 95% CI, 23.4%-63.1%) and specificity (73.3%; 95% CI, 67.6%-78.5%) was low for DBS PCR in identifying children with SNHL at age 4 years. The positive and negative likelihood ratios of DBS PCR positivity to detect CMV-associated SNHL at age 4 years were 1.6 (95% CI, 0.97-2.6) and 0.8 (95% CI, 0.6-1.1), respectively. There was no difference in DBS viral loads between children with SNHL and those without SNHL. DBS PCR for CMV has low sensitivity and specificity for identifying infants with CMV-associated hearing loss. These findings, together with previous reports, demonstrate that DBS PCR does not identify either the majority of CMV-infected newborns or those with CMV-associated SNHL early in life. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Pulmonary surfactant disaturated-phosphatidylcholine (DSPC) turnover and pool size in newborn infants with congenital diaphragmatic hernia (CDH).

    Science.gov (United States)

    Cogo, Paola E; Zimmermann, Luc J I; Meneghini, Luisa; Mainini, Nicoletta; Bordignon, Linda; Suma, Vincenzo; Buffo, Marika; Carnielli, Virgilio P

    2003-11-01

    In animal CDH models, surfactant deficiency contributes to the pathophysiology of the condition but information on human disease is very limited. The aim of our study was to investigate surfactant kinetics in CDH newborns. We studied surfactant disaturated-phosphatidylcholine (DSPC) half-life, turnover and apparent pool size by stable isotope methodology in CDH newborns with no ExtraCorporeal Membrane Oxygenation (ECMO) support (n = 13, birth weight (BW) 3.2 +/- 2.2 kg, gestational age (GA) 39 +/- 0.4 wks, postnatal age 43 +/- 11 h) and in 8 term infants with no lung disease (CONTROLS, BW 2.7 +/- 0 kg, GA 38 +/- 0.8 wks, postnatal age 96 +/- 26 h). We administered a trace dose of 13C-palmitic acid dipalmitoyl-phosphatidylcholine (DPPC) through the endotracheal (ET) tube and we measured DSPC kinetics by gas chromatography-mass spectrometry from DSPC13C-enrichment decay curves obtained from sequential tracheal aspirates. DSPC amount from tracheal aspirates (TA-DSPC) was measured by gas chromatography. In CDH infants DSPC half-life was shorter (24 +/- 4 and 53 +/- 11 h, p = 0.01), turnover faster (0.6 +/- 0.1 and 1.5 +/- 0.3 d-1 p = 0.01), apparent pool size smaller (34 +/- 6 and 57 +/- 7 mg/kg body weight, p = 0.02) and tracheal aspirates DSPC amount lower (2.4 +/- 0.4 and 4.6 +/- 0.5 mg/mL Epithelial Lining Fluid (ELF), p = 0.007) than in CONTROLS. In conclusion surfactant kinetics is grossly abnormal in mechanically ventilated CDH. Whether alterations of DSPC kinetics in CDH infants are caused by a primary surfactant deficiency or are secondary to oxygen therapy and ventilator support has still to be determined.

  19. Air trapping on chest CT is associated with worse ventilation distribution in infants with cystic fibrosis diagnosed following newborn screening.

    Directory of Open Access Journals (Sweden)

    Graham L Hall

    Full Text Available BACKGROUND: In school-aged children with cystic fibrosis (CF structural lung damage assessed using chest CT is associated with abnormal ventilation distribution. The primary objective of this analysis was to determine the relationships between ventilation distribution outcomes and the presence and extent of structural damage as assessed by chest CT in infants and young children with CF. METHODS: Data of infants and young children with CF diagnosed following newborn screening consecutively reviewed between August 2005 and December 2009 were analysed. Ventilation distribution (lung clearance index and the first and second moment ratios [LCI, M(1/M(0 and M(2/M(0, respectively], chest CT and airway pathology from bronchoalveolar lavage were determined at diagnosis and then annually. The chest CT scans were evaluated for the presence or absence of bronchiectasis and air trapping. RESULTS: Matched lung function, chest CT and pathology outcomes were available in 49 infants (31 male with bronchiectasis and air trapping present in 13 (27% and 24 (49% infants, respectively. The presence of bronchiectasis or air trapping was associated with increased M(2/M(0 but not LCI or M(1/M(0. There was a weak, but statistically significant association between the extent of air trapping and all ventilation distribution outcomes. CONCLUSION: These findings suggest that in early CF lung disease there are weak associations between ventilation distribution and lung damage from chest CT. These finding are in contrast to those reported in older children. These findings suggest that assessments of LCI could not be used to replace a chest CT scan for the assessment of structural lung disease in the first two years of life. Further research in which both MBW and chest CT outcomes are obtained is required to assess the role of ventilation distribution in tracking the progression of lung damage in infants with CF.

  20. Association of US State Implementation of Newborn Screening Policies for Critical Congenital Heart Disease With Early Infant Cardiac Deaths.

    Science.gov (United States)

    Abouk, Rahi; Grosse, Scott D; Ailes, Elizabeth C; Oster, Matthew E

    2017-12-05

    In 2011, critical congenital heart disease was added to the US Recommended Uniform Screening Panel for newborns, but whether state implementation of screening policies has been associated with infant death rates is unknown. To assess whether there was an association between implementation of state newborn screening policies for critical congenital heart disease and infant death rates. Observational study with group-level analyses. A difference-in-differences analysis was conducted using the National Center for Health Statistics' period linked birth/infant death data set files for 2007-2013 for 26 546 503 US births through June 30, 2013, aggregated by month and state of birth. State policies were classified as mandatory or nonmandatory (including voluntary policies and mandates that were not yet implemented). As of June 1, 2013, 8 states had implemented mandatory screening policies, 5 states had voluntary screening policies, and 9 states had adopted but not yet implemented mandates. Numbers of early infant deaths (between 24 hours and 6 months of age) coded for critical congenital heart disease or other/unspecified congenital cardiac causes for each state-month birth cohort. Between 2007 and 2013, there were 2734 deaths due to critical congenital heart disease and 3967 deaths due to other/unspecified causes. Critical congenital heart disease death rates in states with mandatory screening policies were 8.0 (95% CI, 5.4-10.6) per 100 000 births (n = 37) in 2007 and 6.4 (95% CI, 2.9-9.9) per 100 000 births (n = 13) in 2013 (for births by the end of July); for other/unspecified cardiac causes, death rates were 11.7 (95% CI, 8.6-14.8) per 100 000 births in 2007 (n = 54) and 10.3 (95% CI, 5.9-14.8) per 100 000 births (n = 21) in 2013. Early infant deaths from critical congenital heart disease through December 31, 2013, decreased by 33.4% (95% CI, 10.6%-50.3%), with an absolute decline of 3.9 (95% CI, 3.6-4.1) deaths per 100 000 births after

  1. Effect of hematocrit and systolic blood pressure on cerebral blood flow in newborn infants

    International Nuclear Information System (INIS)

    Younkin, D.P.; Reivich, M.; Jaggi, J.L.; Obrist, W.D.; Delivoria-Papadopoulos, M.

    1987-01-01

    The effects of hematocrit and systolic blood pressure on cerebral blood flow were measured in 15 stable, low birth weight babies. CBF was measured with a modification of the xenon-133 ( 133 Xe) clearance technique, which uses an intravenous bolus of 133 Xe, an external chest detector to estimate arterial 133 Xe concentration, eight external cranial detectors to measure cephalic 133 Xe clearance curves, and a two-compartmental analysis of the cephalic 133 Xe clearance curves to estimate CBF. There was a significant inverse correlation between hematocrit and CBF, presumably due to alterations in arterial oxygen content and blood viscosity. Newborn CBF varied independently of systolic blood pressure between 60 and 84 mm Hg, suggesting an intact cerebrovascular autoregulatory mechanism. These results indicate that at least two of the factors that affect newborn animal CBF are operational in human newborns and may have important clinical implications

  2. Early Acquisition of Pneumocystis jirovecii Colonization and Potential Association With Respiratory Distress Syndrome in Preterm Newborn Infants.

    Science.gov (United States)

    Rojas, Pilar; Friaza, Vicente; García, Elisa; de la Horra, Carmen; Vargas, Sergio L; Calderón, Enrique J; Pavón, Antonio

    2017-09-15

    Pneumocystis pneumonia is a well-recognized lung disease of premature and malnourished babies. Even though serologic studies have shown that children are exposed to Pneumocystis jirovecii early in life, the epidemiology of human P. jirovecii infection and the host-microorganism relationship in infancy remain poorly understood. The aim of the present study was to investigate the prevalence of P. jirovecii colonization in preterm infants and its possible association with medical complications. A prospective observational study of preterm infants (birth weight newborns studied. A significant increase of respiratory distress syndrome in colonized group, even after adjusting for confounding factors (odds ratio, 2.7 [95% CI, 1.0-7.5]; P = .04), was observed. No differences were observed in other medical conditions between the 2 groups. Pneumocystis jirovecii colonization is frequent in preterm births and could be a risk factor to develop respiratory distress syndrome among preterm infants. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com

  3. Antenatal smoking and substance-misuse, infant and newborn response to hypoxia.

    Science.gov (United States)

    Ali, Kamal; Rosser, Thomas; Bhat, Ravindra; Wolff, Kim; Hannam, Simon; Rafferty, Gerrard F; Greenough, Anne

    2017-05-01

    To determine at the peak age for sudden infant death syndrome (SIDS) the ventilatory response to hypoxia of infants whose mothers substance misused in pregnancy (SM infants), or smoked during pregnancy (S mothers) and controls whose mothers neither substance misused or smoked. In addition, we compared the ventilatory response to hypoxia during the neonatal period and peak age of SIDS. Infants of S or SM mothers compared to control infants would have a poorer ventilatory response to hypoxia at the peak age of SIDS. Prospective, observational study. Twelve S; 12 SM and 11 control infants were assessed at 6-12 weeks of age and in the neonatal period. Changes in minute volume, oxygen saturation, heart rate, and end tidal carbon dioxide levels on switching from breathing room air to 15% oxygen were assessed. Maternal and infant urine samples were tested for cotinine, cannabinoids, opiates, amphetamines, methadone, cocaine, and benzodiazepines. The S and SM infants had a greater decline in minute volume (P = 0.037, P = 0.016, respectively) and oxygen saturation (P = 0.031) compared to controls. In all groups, the magnitude of decline in minute volume in response to hypoxia was higher in the neonatal period compared to at 6-12 weeks (P ventilatory decline was more marked in the neonatal period compared to the peak age for SIDS indicating a maturational effect. Pediatr Pulmonol. 2017;52:650-655. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  4. Outcome of infants diagnosed with 3-methyl-crotonyl-CoA-carboxylase deficiency by newborn screening

    NARCIS (Netherlands)

    Arnold, Georgianne L.; Salazar, Denise; Neidich, Julie A.; Suwannarat, Pim; Graham, Brett H.; Lichter-Konecki, Uta; Bosch, Annet M.; Cusmano-Ozog, Kristina; Enns, Greg; Wright, Erica L.; Lanpher, Brendan C.; Owen, Natalie N.; Lipson, Mark H.; Cerone, Roberto; Levy, Paul; Wong, Lee-Jun C.; Dezsofi, Antal

    2012-01-01

    Introduction: 3-Methyl CoA carboxylase (3-MCC) deficiency is an inborn error of metabolism in the catabolism of the amino acid leucine. Original reports suggested this disorder was associated with significant neurological and biochemical effects. However newborn screening has identified a higher

  5. Accidental overheating of a newborn under an infant radiant warmer: a lesson for future use.

    Science.gov (United States)

    Molgat-Seon, Y; Daboval, T; Chou, S; Jay, O

    2013-09-01

    A fully functional radiant warmer induced rapid and continuous increases in regional skin temperatures, heart rate, mean arterial blood pressure and respiratory rate in a newborn patient without corrective action. We report this case of passive overheating to create awareness of the risks associated with regulating radiant heat output based upon a single servo-controlled temperature.

  6. [Cerebral symptoms in the term newborn infant. Results of a prospective survey].

    Science.gov (United States)

    Amiel-Tison, C; Henrion, R; Esque-Vaucouloux, M T; Goujard, J; Firtion, G; Tchobroutsky, C; Varangot, J

    1977-01-01

    1785 newborns of 37 weeks GA or more, were studied during a 15 months period at the Port-Royal Maternity Hospital. This study suggests that cerebral abnormalities during the neonatal period in fullterm neonates are related to deleterious intra partum factors. In 57 newborns, clear cut signs of cerebral birth injury were observed, in 31 newborns only mild and transitory signs were observed. These 88 newborns were compared with 1655 having had a normal neurological examination within the first week of life. We focused particulary on dysfunctional labor patterns, specifically false labor, protracted active phase dilatation, protracted descent or a marked caput succedaneum. When these abnormal patterns are followed by oxytocin infusion and forceps extraction, primiparity appears linked with a high risk of cerebral birth injury. Within cephalic presentations, the occipito-posterior position is carrying the same high risk. The most severe degree of cerebral birth injury has nearly disappeared. However, the main problem of modern obstetrics is one of eradicating brain damage of moderate degree without reaching an excessive incidence of C. section.

  7. [Extracorporeal gas exchange--an alternative to ventilation of the premature newborn infant with respiratory insufficiency].

    Science.gov (United States)

    Schmidt, S; Dudenhausen, J W; Langner, K; Laiblin, C; Saling, E

    1984-01-01

    In spite of improvements in its prophylaxis and therapy the membrane syndrome is still one of the main causes of morbidity and mortality in newborns. In many perinatal centers in the United States extracorporeal gas exchange via an artificial lung is the ultimate step in therapy for this group of patients today. As a result of our own research work we are able to introduce an extracorporeal circulation system which is especially suited to the particular situation of the immature newborn and which enables a complete immobilization of the lung to avoid baro-trauma with alveolar oxygen diffusion and CO2-removal through the membrane lung. Using appropriate dimensions the system can be housed in a newborn incubator. With low total resistance the perfusion in the newborn is performed via an arterio-venous shunt of the umbilical vessels alternatively with and without a mechanical pump. We tested this perfusion system on premature lambs with a gestational age of 128 to 130 days. During a test period of from 6 to 8 hours at a low blood flow rate (200 ml/min) we achieved a sufficient CO2-removal via the membrane lung with enough oxygen supply through the non-ventilated lung. By means of suitable materials, and using CO2 gas priming procedure and employing prostacyclin analogons to inhibit thrombocyte aggregation, it was possible to lower the heparine dosage to a minimum.

  8. Gentamicin pharmacokinetics in term newborn infants receiving high-frequency oscillatory ventilation or conventional mechanical ventilation: a case-controlled study.

    Science.gov (United States)

    Bhatt-Mehta, Varsha; Donn, Steven M

    2003-10-01

    To compare the pharmacokinetics of gentamicin in infants receiving high-frequency oscillatory ventilation (HFOV) with infants receiving conventional mechanical ventilation. A case-controlled study design was used to compare the pharmacokinetics of gentamicin in critically ill infants receiving HFOV and conventional mechanical ventilation. Medical records of all full-term newborn infants (> or =37 weeks gestational age) who received either high-frequency mechanical ventilation or conventional mechanical ventilation between 1991 and 2001 were reviewed and relevant patient demographics, renal function tests and gentamicin administration and plasma concentration data collected. Elimination rate constant, half-life, volume of distribution and clearance for both groups were calculated using standard kinetics equations. A tertiary care children's hospital. Newborn infants, > or =37 weeks gestational age, receiving gentamicin and high-frequency mechanical ventilation or conventional mechanical ventilation. In total, 18 patients were included in the conventional mechanical ventilation group and 15 in the HFOV group. The mean gentamicin dose for conventional mechanical ventilation and HFOV groups infants were 2.52+/-0.07 and 2.5+/-0.07 mg/kg/dose, respectively. Initial dosing interval was 12 hours in all of the conventional mechanical ventilation infants and 13 of the 15 HFOV infants. The dosing interval for the remaining two HFOV infants was 18 hours. No patient in either group demonstrated oliguria. Statistical analysis using the Student t-test for unequal variances yielded significant differences between the two groups with regard to elimination rate constant, half-life, volume of distribution and clearance, with a p value of mechanical ventilation group (13.4+2.23) (p>0.05). Infants receiving HFOV had reduced gentamicin clearance. Full-term infants receiving HFOV should be initiated at gentamicin dosing intervals of 18 hours rather than the traditional 12 hours

  9. A new holder and surface MRI coil for the examination of the newborn infant hip

    Energy Technology Data Exchange (ETDEWEB)

    Krasny, R. (Dept. of Diagnostic Radiology, Univ. of Technology, Aachen (Germany)); Casser, H.R. (Dept. of Orthopedics, Univ. of Technology, Aachen (Germany)); Requardt, H. (Siemens AG, Erlangen (Germany)); Botschek, A. (Dept. of Diagnostic Radiology, Univ. of Technology, Aachen (Germany))

    1993-11-01

    A special holder was developed for examination of the infant hip joint using MRI. This holder allows the infant hip joint to be examined both in a neutral position and in various defined functional positions. A special integrated surface coil, also developed for this purpose, provides the high spatial resolution required for assessment of the fine joint structures. Thirty infants were examined and the new device has proved useful in advanced hip dysplasia, therapy-resistant subluxation and luxation, and for operative therapy planning (reconstruction of the acetabular roof, redirectional osteotomies). Interpretation errors due to misprojection can be eliminated to a large extent since the holder allows standardized and reproducible positioning. (orig.)

  10. A laminar flow unit for the care of critically ill newborn infants

    OpenAIRE

    Sola, Augusto; Perez,Jose; Golombek,Sergio; Fajardo,Carlos

    2013-01-01

    Jose MR Perez,1 Sergio G Golombek,2 Carlos Fajardo,3 Augusto Sola41Stella Maris Hospital, International Neurodevelopment Neonatal Center (CINN), Sao Paulo, Brazil; 2M Fareri Children’s Hospital, Westchester Medical Center, New York Medical College, Valhalla, NY, USA; 3University of Calgary, Calgary, Canada; 4St Jude Hospital, Fullerton, California, CA, USAIntroduction: Medical and nursing care of newborns is predicated on the delicate control and balance of several vital parameters....

  11. Newborn infant with maternal anti-SSA antibody-induced complete heart block accompanying cardiomyopathy.

    Science.gov (United States)

    Iida, Midori; Inamura, Noboru; Takeuchi, Makoto

    2006-01-01

    Newborn case of maternal anti-SSA antibody-induced congenital complete heart block (CCHB) accompanying cardiomyopathy is presented. Unexpectedly, she died of ventricular tachycardia, not bradycardia, 6 days after birth. Autopsy revealed left ventricular cardiomyopathy with endocardial fibroelastosis. Thus, when evaluating fetal cardiac performance in cases of maternal anti-SSA antibody-induced CCHB, it is necessary to pay attention to myocardial attributes such as endocardial hyperplasia.

  12. [Case report: severe hypothermia in a newborn infant - challenges in preclinical emergency medicine].

    Science.gov (United States)

    Knacke, Peer G; Strauss, Jochen; Gräsner, Jan-Thorsten; Saur, Petra; Scholz, Jens

    2008-04-01

    On the basis of a case report the prehospital management of a newborn child with deep accidental hypothermia (22oC) is discussed. The child was found in a garbage can. The continuous resuscitation during the transport into the clinic is done in an incubator and the child survives without neurologic damages. The used measures of the resuscitation are discussed on the basis of the therapy.

  13. Severe pulmonary hemorrhage in the premature newborn infant: analysis of presurfactant and surfactant eras.

    Science.gov (United States)

    Braun, K R; Davidson, K M; Henry, M; Nielsen, H C

    1999-01-01

    We undertook a case-control study of premature infants who developed clinically significant, severe pulmonary hemorrhage (PH) in the presurfactant and surfactant eras to learn more about the cause of severe PH and whether the pathogenesis of severe PH has changed with the advent of surfactant therapy. Severe PH was defined as an acute onset of severe endotracheal bleeding with an acute drop in hematocrit and the development of multilobar infiltrates on chest radiograph. Eleven premature infants from the presurfactant era population and 17 premature infants from the surfactant era population met the criteria for severe PH, all with gestational ages <32 weeks and birth weights <1,500 g (very low birth weight infants). These were each matched by gestational age, date of birth, birth order (for twins), and birth weight to 2 controls. The incidence of severe PH in infants of gestational age <32 weeks was similar in the two eras (1.8% in the presurfactant era and 3.0% in the surfactant era). Severe PH was not associated with maternal characteristics such as drug use or prenatal care, pregnancy complications, evidence of intrauterine anoxia, hyaline membrane disease, frequency of endotracheal suctioning, or patent ductus arteriosus. Premature infants suffering from severe PH in the presurfactant era required more delivery room resuscitation and had more severe early respiratory disease during the first 12 h of life as compared with their controls. However, these differences were not present in the group from the surfactant era. Infants with severe PH were more likely to have birth weights below the third percentile for gestation (severe intrauterine growth restriction). The proportion of infants receiving surfactant, and the number of surfactant doses used, did not differ between severe-PH infants and their controls in the surfactant era group. We conclude that severe intrauterine growth restriction represents a risk factor for severe PH in very low birth weight infants

  14. [Serum anion gap in the umbilical cord blood of healthy newborn infants].

    Science.gov (United States)

    Jóźwik, Michał; Jóźwik, Marcin; Pietrzycki, Bartosz

    2002-01-01

    This paper presents the results of the determination of serum anion gap in arterial and venous umbilical cord blood obtained from a carefully selected group of 47 healthy term newborns. In the arterial blood, the following concentrations of particular anions were found: chloride - 102.85 +/- 4.35 mmol/l, bicarbonate - 22.26 +/- 2.67 mmol/l, protein anions - 11.89 +/- 1.00 mmol/l, and residual anions - 14.26 +/- 4.35 mmol/l, while in the venous blood these values were: chloride - 104.28 +/- 4.14 mmol/l, bicarbonate - 20.79 +/- 2.70 mmol/l, protein anions - 12.48 +/- 1.23 mmol/l, and residual anions - 13.03 +/- 3.06 mmol/l. Provided strict clinical and biochemical (acid-base balance and blood gases) selections criteria are applied, these data are likely to represent normal values for term newborns and can be the basis for comparison of umbilical serum anion gap in newborns under depressed conditions, like asphyxia. As discussed, the role of serum anion gap studies in the diagnosis of the type of metabolic acidosis, as well as in the monitoring of neonatal therapy is most important.

  15. The use of ultrasonography in pediatric ophthalmology - diagnostics of ophthalmic disorders in newborns and infants

    International Nuclear Information System (INIS)

    Modrzejewska, M.; Karczewicz, D.; Wilk, G.

    2006-01-01

    Ultrasonographic (US) examinations in ophthalmology play a major role as one of the additional examination modes in the diagnostics of orbital diseases, and in cases of changes of a vascular origin it is useful in the evaluation of blood flow velocity. The special value of this examination in the assessment of the opaque optical structures on the fundus of the eye is emphasized. The aim of the study was 1) to present the ultrasonographic images and the efficacy of the method in the evaluation of some congenital and acquired bulbar diseases and 2) on the bases of the advantages of the examination, to determine whether ultrasonography could be included as a screening method in the diagnostics of preterm infants as well as a method of choice in term infants with ophthalmologic diseases. One thousand sixty-two children between the ages of 3 weeks to 12 months, of whom 1135 were preterm and 27 term infants, with ophthalmologic changes were examined. A real-time ultrasonographic apparatus with color Doppler (5-7.5 MHz sectoral and 7.5-10 MHz linear transducers). The US examinations of preterm infants were conducted four times and in term infants twice. In 105 children (8.99%) and in 184 eyes, premature retinopathy, intra-bulbar tumors, retinal ablation, posttraumatic changes, inflammatory processes in the posterior chamber of the eyeball, and congenital anomalies of the bulbar structures were diagnosed. Bulbar ultrasonography, being a safe, quick, and efficient examination, should be included as an additional screening method in preterm infants. Ultrasonography with color Doppler is an efficient method of choice for diagnosing problematic diseases of the eyeballs of infants. (author)

  16. A newborn infant chimpanzee snatched and cannibalized immediately after birth: Implications for "maternity leave" in wild chimpanzee.

    Science.gov (United States)

    Nishie, Hitonaru; Nakamura, Michio

    2018-01-01

    This study reports on the first observed case of a wild chimpanzee infant being snatched immediately after delivery and consequently cannibalized by an adult male in the Mahale Mountains, Tanzania. We demonstrate "maternity leave" from long-term data from the Mahale M group and suggest that it functions as a possible counterstrategy of mother chimpanzees against the risk of infanticide soon after delivery. The subjects of this study were the M group chimpanzees at Mahale Mountains, Tanzania. The case of cannibalism was observed on December 2, 2014. We used the long-term daily attendance record of the M group chimpanzees between 1990 and 2010 to calculate the lengths of "maternity leave," a perinatal period during which a mother chimpanzee tends to hide herself and gives birth alone. We observed a very rare case of delivery in a wild chimpanzee group. A female chimpanzee gave birth in front of other members, and an adult male snatched and cannibalized the newborn infant immediately after birth. Using the long-term data, we demonstrate that the length of "maternity leave" is longer than that of nonmaternity leave among adult and adolescent female chimpanzees. We argue that this cannibalism event immediately after birth occurred due to the complete lack of "maternity leave" of the mother chimpanzee of the victim, who might lack enough experience of delivery. We suggest that "maternity leave" taken by expecting mothers may function as a possible counterstrategy against infanticide soon after delivery. © 2017 Wiley Periodicals, Inc.

  17. A method for neurological evaluation within the first year of life: experience with full-term newborn infants with birth injury.

    Science.gov (United States)

    Amiel-Tison, C

    1978-01-01

    In a prospective study undertaken at Port-Royal Maternity Hospital, Paris, 1785 deliveries were studied during a 15-month period. Signs of cerebral dysfunction were observed in 57 newborn infants--mild signs in 38 infants, moderate in 17, severe in 2. There was a high incidence of abnormal labour in 28 of these 57 infants (50%) (dysfunctional labour patterns without obvious cephalopelvic disproportion, including false labour, prolonged active-phase dilatation, (prolonged descent, marked caput succedaneum). During the first year of life, 30 of the 57 infants were followed. In 14 of the 30 infants transitory abnormalities were observed. In five infants abnormalities persisted at the end of the first year. Eleven infants were normal throughout the first year. In another study the incidence of cerebral symptoms at birth was compared in full-term infants born in 1974 and those born in 1976. Thirteen infants with moderate and severe symptoms were observed out of 1578 deliveries during 1974 and five out of 1934 deliveries during 1976, the incidence of Caesarean section necessitated by acute fetal distress being the same in both groups. This decreasing percentage of complications appears to be linked with improving care, including more widespread use of fetal monitoring.

  18. Development and psychometric properties of the Swedish ALPS-Neo pain and stress assessment scale for newborn infants.

    Science.gov (United States)

    Lundqvist, Pia; Kleberg, Agneta; Edberg, Anna-Karin; Larsson, Björn A; Hellström-Westas, Lena; Norman, Elisabeth

    2014-08-01

    To validate and evaluate the psychometric properties of the ALPS-Neo, a new pain assessment scale created for the continuous evaluation of pain and stress in preterm and sick term infants. A unidimensional scale for continuous pain, Astrid Lindgren Children's Hospital Pain Scale (ALPS 1), was developed further to assess continuous pain and stress in infants treated in the neonatal intensive care unit (NICU). The pain scale includes observations of five behaviours. A manual was created, clarifying the scoring criteria. An internal and an external panel assessed face validity. Psychometric properties were evaluated in three different steps. Inter-rater reliability was estimated from video-based assessments (n = 625) using weighted kappa statistics (test I). Inter-rater reliability was further evaluated in test II (n = 125) and test III (n = 96) by real-time assessments using the intraclass correlation coefficient (ICC) and Cronbach's alpha. The final inter-rater reliability (test III) was assessed as good with ICC 0.91 for the total score and 0.62-0.81 for the five items. Cronbach's alpha showed 0.95 for the total score. ALPS-Neo is a new assessment tool for optimising the management of pain and stress in newborn infants in the NICU. It has proved easy to implement and user-friendly, permitting fast, reliable observations with high inter-rater reliability. ©2014 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

  19. [Complex cyanotic heart defect in a newborn infant with cat eye syndrome].

    Science.gov (United States)

    Paul, T; Reimer, A; Wilken, M; Miller, K; Kallfelz, H C

    1991-04-01

    In a cyanotic newborn with characteristic features of Cat-Eye-Syndrome, cytogenetic examination disclosed a supernumerary small bisatellited chromosome. Angiography showed Tetralogy of Fallot with pulmonary atresia and a narrow patent ductus arteriosus with additional stenosis of the bifurcation of the pulmonary artery. At an age of 14 weeks, the patient died after the attempt of corrective cardiac surgery. Congenital cardiac malformation is present in more than one third of patients with cat-eye-syndrome and is usually the lifelimiting malformation in this syndrome.

  20. Does Breast Feeding Protect the Hypothyroid Infant Diagnosed by Newborn Screening?

    Science.gov (United States)

    Rovet, Joanne F.

    Because breast milk contains small quantities of thyroid hormones not found in commercial formula preparations, it was hypothesized that breast feeding may provide some protective benefit to the hypothyroid infant before medical treatment is begun. Of 108 children with congenital hypothyroidism, breast-fed children had higher thyroid hormone…

  1. Disability, discrimination and death: is it justified to ration life saving treatment for disabled newborn infants?

    Science.gov (United States)

    Wilkinson, Dominic; Savulescu, Julian

    2014-01-01

    Disability might be relevant to decisions about life support in intensive care in several ways. It might affect the chance of treatment being successful, or a patient's life expectancy with treatment. It may affect whether treatment is in a patient's best interests. However, even if treatment would be of overall benefit it may be unaffordable and consequently unable to be provided. In this paper we will draw on the example of neonatal intensive care, and ask whether or when it is justified to ration life-saving treatment on the basis of disability. We argue that predicted disability is relevant both indirectly and directly to rationing decisions.

  2. [Evaluation of central parenteral alimentation in critically ill newborn infants at a provincial pediatric hospital].

    Science.gov (United States)

    Yunes-Zárraga, J L; de la Garza-Garza, G; Velázquez-Quintana, N

    1989-04-01

    A revision was made on files of newborns whom received total parenteral nutrition (TPN) in the neonatal intensive care unit of the Hospital Infantil de Tamaulipas during a two and a half years period. We try to correlate dosage and caloric intake with weight gain, survival and complications. We reviewed the principal indications that motivated the use of total parenteral nutrition. The average period of administration was 15 days and caloric intake average 75 cal. There was significance in weight gain in newborns older than 35 weeks (14.6 g/kg/day) compared with younger than 34 weeks (9.2 g/kg/day) (p less than 0.001). There was no relation between days and dosage in both groups. Only one case showed cholestatic jaundice. Hyperglycemia was present statistically more frequent in the group lesser gestational age. There were no important electrolytic disturbances. Necrotizing enterocolitis was present more frequent in the older group. Some comments are made in relation to sepsis and a discussion of possible causes that do no permit a better assimilation of nutrients in these babies.

  3. Inter-society consensus document on treatment and prevention of bronchiolitis in newborns and infants

    OpenAIRE

    Baraldi, Eugenio; Lanari, Marcello; Manzoni, Paolo; Rossi, Giovanni A; Vandini, Silvia; Rimini, Alessandro; Romagnoli, Costantino; Colonna, Pierluigi; Biondi, Andrea; Biban, Paolo; Chiamenti, Giampietro; Bernardini, Roberto; Picca, Marina; Cappa, Marco; Magazz?, Giuseppe

    2014-01-01

    Acute bronchiolitis is the leading cause of lower respiratory tract infection and hospitalization in children less than 1?year of age worldwide. It is usually a mild disease, but some children may develop severe symptoms, requiring hospital admission and ventilatory support in the ICU. Infants with pre-existing risk factors (prematurity, bronchopulmonary dysplasia, congenital heart diseases and immunodeficiency) may be predisposed to a severe form of the disease. Clinical diagnosis of bronchi...

  4. Learning, Play, and Your Newborn

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Learning, Play, and Your Newborn KidsHealth / For Parents / Learning, ... Some Other Ideas Print What Is My Newborn Learning? Play is the chief way that infants learn ...

  5. The impact of Neonatal Resuscitation Program courses on mortality and morbidity of newborn infants with perinatal asphyxia.

    Science.gov (United States)

    Duran, Ridvan; Aladağ, Nükhet; Vatansever, Ulfet; Süt, Necdet; Acunaş, Betül

    2008-01-01

    Neonatal care provided within the first few minutes of life plays a major role in the reduction of neonatal morbidity and mortality. Neonatal Resuscitation Program (NRP) courses had been held since 1996. The aim of this study was to evaluate the impact of the NRP on morbidity and mortality of newborn infants with perinatal asphyxia. This retrospective study comprised newborn infants who were born in hospitals at Trakya region of Turkey during the last 3 years and were diagnosed as perinatal asphyxia and were referred to our Neonatal Unit. Those patients who were referred before NRP course (pretraining period) were designated as Group 1, those who were referred after the first NRP course (transition period) as Group 2, and those who were referred after the second NRP course (post-training period) as Group 3. Chart review was performed with regard to gestational age, birth weight, Apgar scores, resuscitation type, stage of hypoxic ischemic encephalopathy (HIE), existence of meconium aspiration syndrome (MAS), progress of the disease, duration of hospitalization. The study comprised 66 patients; 35 in Group 1, 18 in Group 2 and 13 in Group 3. The number of cases who had not been resuscitated was 10 in the pretraining period, 3 in the transition period and 1 in the post-training period which decreased significantly. The first minute Apgar scores in three groups were as follows; 2.08+/-1.2, 2.2+/-1.1 and 3.7+/-1.4, and this increase was statistically significant. The fifth minute Apgar scores also increased from 5.43+/-1.5 in the pretraining period to 6.5+/-1.9 in the post-training period, but this increase was not statistically significant. The number of patients with Stage 1 and 2 HIE decreased more in Group 3 (n=11 in Stage 1 HIE, n=17 in Stage 2 HIE) compared to those in Group 1 (n=7 in Stage 1 HIE, n=5 in Stage 2 HIE) but the difference was not statistically significant. The duration of hospitalization decreased in post-training period (15.1+/-10.3 days in

  6. The relationship between nociceptive brain activity, spinal reflex withdrawal and behaviour in newborn infants

    Science.gov (United States)

    Hartley, Caroline; Goksan, Sezgi; Poorun, Ravi; Brotherhood, Kelly; Mellado, Gabriela Schmidt; Moultrie, Fiona; Rogers, Richard; Adams, Eleri; Slater, Rebeccah

    2015-01-01

    Measuring infant pain is complicated by their inability to describe the experience. While nociceptive brain activity, reflex withdrawal and facial grimacing have been characterised, the relationship between these activity patterns has not been examined. As cortical and spinally mediated activity is developmentally regulated, it cannot be assumed that they are predictive of one another in the immature nervous system. Here, using a new experimental paradigm, we characterise the nociceptive-specific brain activity, spinal reflex withdrawal and behavioural activity following graded intensity noxious stimulation and clinical heel lancing in 30 term infants. We show that nociceptive-specific brain activity and nociceptive reflex withdrawal are graded with stimulus intensity (p < 0.001), significantly correlated (r = 0.53, p = 0.001) and elicited at an intensity that does not evoke changes in clinical pain scores (p = 0.55). The strong correlation between reflex withdrawal and nociceptive brain activity suggests that movement of the limb away from a noxious stimulus is a sensitive indication of nociceptive brain activity in term infants. This could underpin the development of new clinical pain assessment measures. PMID:26228435

  7. Neonatal Respiratory Diseases in the Newborn Infant: Novel Insights from Stable Isotope Tracer Studies.

    Science.gov (United States)

    Carnielli, Virgilio P; Giorgetti, Chiara; Simonato, Manuela; Vedovelli, Luca; Cogo, Paola

    2016-01-01

    Respiratory distress syndrome is a common problem in preterm infants and the etiology is multifactorial. Lung underdevelopment, lung hypoplasia, abnormal lung water metabolism, inflammation, and pulmonary surfactant deficiency or disfunction play a variable role in the pathogenesis of respiratory distress syndrome. High-quality exogenous surfactant replacement studies and studies on surfactant metabolism are available; however, the contribution of surfactant deficiency, alteration or dysfunction in selected neonatal lung conditions is not fully understood. In this article, we describe a series of studies made by applying stable isotope tracers to the study of surfactant metabolism and lung water. In a first set of studies, which we call 'endogenous studies', using stable isotope-labelled intravenous surfactant precursors, we showed the feasibility of measuring surfactant synthesis and kinetics in infants using several metabolic precursors including plasma glucose, plasma fatty acids and body water. In a second set of studies, named 'exogenous studies', using stable isotope-labelled phosphatidylcholine tracer given endotracheally, we could estimate surfactant disaturated phosphatidylcholine pool size and half-life. Very recent studies are focusing on lung water and on the endogenous biosynthesis of the surfactant-specific proteins. Information obtained from these studies in infants will help to better tailor exogenous surfactant treatment in neonatal lung diseases. © 2016 S. Karger AG, Basel.

  8. Resuscitation of the Newborn

    Science.gov (United States)

    Kilduff, C. J.

    1975-01-01

    All infants have some degree of hypoxia and respiratory acidosis at birth, but these conditions are more profound in the asphyxiated newborn. The newborn infant is very susceptible to cooling and may require warming. Skin temperature should be maintained between 36-36.5°.2 Resuscitation of the asphyxiated newborn must include both ventilatory and metabolic correction. Newborn infants may have cardiorespiratory problems due to asphyxia, drugs given to the mother, intrathoracic disease, anemia, hypovolemia (due to antepartum hemorrhage), hypotension, etc. There is no substitute for oxygen which is the drug of choice in respiratory depression of the newborn. The use of stimulating drugs like Coramine, picrotoxin, alphalobectine, and Megamide has no place in the resuscitation of the asphyxiated newborn. Imagesp74-ap74-bp74-cp74-d PMID:20469196

  9. [Cerebral perfusion in newborn infants treated with high-frequency oscillation ventilation].

    Science.gov (United States)

    Schlösser, R L; Voigt, B; von Loewenich, V

    2000-01-01

    The effects of high-frequency oscillatory ventilation (HFOV) on hemodynamic parameters have been shown in animal as well as in clinical studies. In a further study we could demonstrate, that after change of a conventional positive pressure ventilation (CMV) to HFOV flow velocities in cerebral arteries decreased. In the following we added to the dopplerflow method the continuous examination of cerebral oxygenation with near infrared spectroscopy (NIRS). 19 measurements were prospectively conducted in 18 neonates. The infants were mechanically ventilated with HFOV and were in a stable condition. Before change from HFOV to CMV doppler signals of the anterior cerebral artery were measured. We repeated this at the end of the study in each patient. NIRS-optodes were placed on the front and the os parietale of each infant. After stabilization of the system we changed from HFOV to CMV without disconnection of the patient from the machine. PCO2 was registered continuously via a transcutaneous probe, as well as oxygen saturation via pulse oxymetry. Statistical analysis was performed with Wilcoxon test. There were no significant changes of doppler-signals during the study (median vs. 25 cm/s (+/- 6) during HFOV, 28 cm/s (+/-/) during CMV). The parameter of NIRS, oxygenated hemoglobin HbO [-1.5 U (+/- 22.78)] at 15 minutes after change), reduced hemoglobin HbR [-1.17 U (+/- 5.26)] and total hemoglobin HbT [-2.68 U (+/- 18.7)] remained stable during the change from HFOV to CMV, too. In five infants there was a decrease and in two an increase of HbO 15 minutes after change, which correlated with decrease or increase of pCO2. In a combined measurement of dopplerflow and NIRS we found no special effect of HFOV on cerebral hemodynamics comparing with CMV. Changes of cerebral oxygenation in NIRS correlated with pCO2.

  10. Scintigraphic hepatobiliary function studies in newborn infants to diagnose biliary hypoplasia or atresia

    International Nuclear Information System (INIS)

    Askari-Sabi, Z.

    1987-01-01

    The results obtained from scintigraphic hepatobiliary function studies, intraoperative cholangiography and histological examinations in a total of 17 infants suspected of having biliary atresia were compared and analysed with reference to the clinical signs and symptoms observed. In most cases, the individual diagnostic procedures led to consistent findings, even though there were some variations in the clinical picture. Patient outcome is largely determined by the site of atresia, due to which fact surgical correction should be carried out as soon as possible, in any case before the 8th week post partum. (TRV) [de

  11. A laminar flow unit for the care of critically ill newborn infants

    Directory of Open Access Journals (Sweden)

    Perez JM

    2013-10-01

    Full Text Available Jose MR Perez,1 Sergio G Golombek,2 Carlos Fajardo,3 Augusto Sola41Stella Maris Hospital, International Neurodevelopment Neonatal Center (CINN, Sao Paulo, Brazil; 2M Fareri Children’s Hospital, Westchester Medical Center, New York Medical College, Valhalla, NY, USA; 3University of Calgary, Calgary, Canada; 4St Jude Hospital, Fullerton, California, CA, USAIntroduction: Medical and nursing care of newborns is predicated on the delicate control and balance of several vital parameters. Closed incubators and open radiant warmers are the most widely used devices for the care of neonates in intensive care; however, several well-known limitations of these devises have not been resolved. The use of laminar flow is widely used in many fields of medicine, and may have applications in neonatal care.Objective: To describe the neonatal laminar flow unit, a new equipment we designed for care of ill newborns.Methods: The idea, design, and development of this device was completed in Sao Paulo, Brazil. The unit is an open mobile bed designed with the objective of maintaining the advantages of the incubator and radiant warmer, while overcoming some of their inherent shortcomings; these shortcomings include noise, magnetic fields and acrylic barriers in incubators, and lack of isolation and water loss through skin in radiant warmers. The unit has a pump that aspirates environmental air which is warmed by electrical resistance and decontaminated with High Efficiency Particulate Air Filter (HEPA filters (laminar flow. The flow is directed by an air flow directioner. The unit has an embedded humidifier to increase humidity in the infant’s microenvironment and a servo control mechanism for regulation of skin temperature.Results: The laminar flow unit is open and facilitates access of care providers and family, which is not the case in incubators. It provides warming by convection at an air velocity of 0.45 m/s, much faster than an incubator (0.1 m/s. The system

  12. Specific Newborn Individualized Developmental Care and Assessment Program movements are associated with acute pain in preterm infants in the neonatal intensive care unit.

    Science.gov (United States)

    Holsti, Liisa; Grunau, Ruth E; Oberlander, Tim F; Whitfield, Michael F

    2004-07-01

    The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) is widely used in neonatal intensive care units and comprises 85 discrete infant behaviors, some of which may communicate infant distress. The objective of this study was to identify developmentally relevant movements indicative of pain in preterm infants. Forty-four preterm infants were assessed at 32 weeks' gestational age (GA) during 3 phases (baseline, lance/squeeze, and recovery) of routine blood collection in the neonatal intensive care unit. The NIDCAP and Neonatal Facial Coding System (NFCS) were coded from separate continuous bedside video recordings; mean heart rate (mHR) was derived from digitally sampled continuous electrographic recordings. Analysis of variance (phase x gender) with Bonferroni corrections was used to compare differences in NIDCAP, NFCS, and mHR. Pearson correlations were used to examine relationships between the NIDCAP and infant background characteristics. NFCS and mHR increased significantly to lance/squeeze. Eight NIDCAP behaviors also increased significantly to lance/squeeze. Another 5 NIDCAP behaviors decreased significantly to lance/squeeze. Infants who had lower GA at birth, had been sicker, had experienced more painful procedures, or had greater morphine exposure showed increased hand movements indicative of increased distress. Of the 85 NIDCAP behaviors, a subset of 8 NIDCAP movements were associated with pain. Particularly for infants who are born at early GAs, addition of these movements to commonly used measures may improve the accuracy of pain assessment.

  13. Minimal access surgery in newborns and small infants; five years experience

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    Sandesh V Parelkar

    2013-01-01

    Full Text Available Aims and Objectives: The aim of this study was to assess and present the outcome (initial experience and lessons learnt of minimally invasive surgery for various indications in neonates and small infants (< 5 kg at a single medical centre. Materials and Methods: A retrospective analysis was performed on 65 patients (age day 2 to 10 months managed with minimal access surgery (MAS for various indications, between 2005 and 2010. We analyzed demographic information, procedures, complications, outcomes, and follow-up and overall feasibility of the procedure. Results: No serious complications except one death in congenital diaphragmatic hernia (CDH (due to other comorbidities occurred. Intra operative hypercarbia and hypoxia were observed more frequently in thoracoscopic procedures. Intra operative hypothermia was not common and was well tolerated. Conversion to open procedure (n = 5, post operative ileus (n = 3, port site infection (n = 5 were other complications. Conclusion: MAS in neonates and small infants is a technically demanding but a feasible choice available. Some prior experience in older children is required for safe and effective outcome. Good quality optics, video equipments and instruments are required for safe and effective procedure. Intra operative measurement of oxygen saturation and temperature, and diligent post operative ICU care are mandatory for safe and successful outcome.

  14. Mimo pillow--an intelligent cushion designed with maternal heart beat vibrations for comforting newborn infants.

    Science.gov (United States)

    Chen, Wei; Oetomo, Sidarto Bambang; Tetteroo, Daniel; Versteegh, Frank; Mamagkaki, Thelxi; Pereira, Mariana Serras; Janssen, Lindy; van Meurs, Andrea

    2015-05-01

    Premature infants are subject to numerous interventions ranging from a simple diaper change to surgery while residing in neonatal intensive care units. These neonates often suffer from pain, distress, and discomfort during the first weeks of their lives. Although pharmacological pain treatment often is available, it cannot always be applied to relieve a neonate from pain or discomfort. This paper describes a nonpharmacological solution, called Mimo, which provides comfort through mediation of a parent's physiological features to the distressed neonate via an intelligent pillow system embedded with sensing and actuating functions. We present the design, the implementation, and the evaluation of the prototype. Clinical tests at Máxima Medical Center in the Netherlands show that among the nine of ten infants who showed discomfort following diaper change, a shorter recovery time to baseline skin conductance analgesimeter values could be measured when the maternal heartbeat vibration in the Mimo was switched ON and in seven of these ten a shorter crying time was measured.

  15. Improving the outcome of bacterial meningitis in newborn infants in Africa: reflections on recent progress.

    Science.gov (United States)

    Molyneux, Elizabeth M; Dube, Queen; Newberry, Laura

    2015-06-01

    There has been a reduction in overall under fives mortality (UFM) but neonatal mortality has not fallen at the same rate as for older children. Bacterial meningitis remains a common, often unrecognized and devastating illness in many African newborns with high mortality and morbidity. Further progress in reducing UFM has to focus on quality of care for neonates. Recent efforts to improve diagnosis, treatment and outcome are reviewed. Diagnosis is often unsupported by laboratory tests and efforts have been made to improve the clinical diagnosis of bacterial meningitis. Simpler, robust bedside tests are being devised. The cause of bacterial meningitis is changing and first-line antimicrobial therapy and adjuvant therapies are evaluated. Programmes to reduce risk factors and prevent neonatal infections are identified. Neonatal care needs to improve in first referral hospitals with simple, low-cost, validated measures provided as bundles of care for both mother and child. First-line antibiotic therapy must be reconsidered in the light of increased infections by multiresistant and Gram-negative bacteria. Studies are needed for effective and safe lengths of antimicrobial therapy, the role of adjuvant therapy and the best anticonvulsants to use.

  16. Non-invasive gas monitoring in newborn infants using diode laser absorption spectroscopy: a case study

    Science.gov (United States)

    Lundin, Patrik; Svanberg, Emilie K.; Cocola, Lorenzo; Lewander, Märta; Andersson-Engels, Stefan; Jahr, John; Fellman, Vineta; Svanberg, Katarina; Svanberg, Sune

    2012-03-01

    Non-invasive diode laser spectroscopy was, for the first time, used to assess gas content in the intestines and the lungs of a new-born, 4 kg, baby. Two gases, water vapor and oxygen, were studied with two low-power tunable diode lasers, illuminating the surface skin tissue and detecting the diffusely emerging light a few centimeters away. The light, having penetrated into the tissue, had experienced absorption by gas located in the lungs and in the intestines. Very distinct water vapor signals were obtained from the intestines while imprint from oxygen was lacking, as expected. Detectable, but minor, signals of water vapor were also obtained from the lungs, illuminating the armpit area and detecting below the collar bone. Water vapor signals were seen but again oxygen signals were lacking, now due to the difficulties of penetration of the oxygen probing light into the lungs of this full-term baby. Ultra-sound images were obtained both from the lungs and from the stomach of the baby. Based on dimensions and our experimental findings, we conclude, that for early pre-term babies, also oxygen should be detectable in the lungs, in addition to intestine and lung detection of water vapor. The present paper focuses on the studies of the intestines while the lung studies will be covered in a forthcoming paper.

  17. Late versus early surgical correction for congenital diaphragmatic hernia in newborn infants.

    Science.gov (United States)

    Moyer, V; Moya, F; Tibboel, R; Losty, P; Nagaya, M; Lally, K P

    2002-01-01

    Congenital diaphragmatic hernia, although rare (1 per 2-4,000 births), is associated with high mortality and cost. Opinion regarding the timing of surgical repair has gradually shifted from emergent repair to a policy of stabilization using a variety of ventilatory strategies prior to operation. Whether delayed surgery is beneficial remains controversial. To summarize the available data regarding whether surgical repair in the first 24 hours after birth rather than later than 24 hours of age improves survival to hospital discharge in infants with congenital diaphragmatic hernia who are symptomatic at or immediately after birth. Search of MEDLINE (1966-2002), EMBASE (1978-2002) and the Cochrane databases using the terms "congenital diaphragmatic hernia" and "surg*"; citations search, and contact with experts in the field to locate other published and unpublished studies. Studies were eligible for inclusion if they were randomized or quasi-randomized trials that addressed infants with CDH who were symptomatic at or shortly after birth, comparing early (24 hours) surgical intervention, and evaluated mortality as the primary outcome. Data were collected regarding study methods and outcomes including mortality, need for ECMO and duration of ventilation, both from the study reports and from personal communication with investigators. Analysis was performed in accordance with the standards of the Cochrane Neonatal Review Group. Two trials met the pre-specified inclusion criteria for this review. Both were small trials (total n<90) and neither showed any significant difference between groups in mortality. Meta-analysis was not performed because of significant clinical heterogeneity between the trials. There is no clear evidence which favors delayed (when stabilized) as compared with immediate (within 24 hours of birth) timing of surgical repair of congenital diaphragmatic hernia, but a substantial advantage to either one cannot be ruled out. A large, multicenter randomized

  18. Perinatal Outcomes of Newborn Infants Conceived by Assisted Reproductive Techniques in Royan Institute

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    Sharareh Dadashloo

    2009-01-01

    Full Text Available Background: The outcomes of such pregnancies have been rarely evaluated in our country. Adescriptive study was planned to assess the health and condition of neonates conceived with assistedtechniques in a one year period.Materials and Methods: At Royan Institute, Tehran, 443 women who became pregnant by oneof the assisted techniques in vitro fertilization (IVF, intrauterine insemination (IUI andintracytoplasmic sperm injection (ICSI enrolled in a descriptive study during 16 month periodbeginning on September, 2007. The sampling method used was non-incidental, consecutive.Questionnaires regarding the contents of the baby birth card were completed after interviews withthe mothers. The time from fertilization of the ovum until delivery was considered as the gestational(conception age. Pregnant mothers were under periodic evaluation until delivery. Women withstillborn babies were followed via phone contact.Results: From a total of 443 conceptions, there were 13 (2.9% pregnancies demised in utero(stillbirths and 10 (2.6% who died during the neonatal period. Additionally, 133 (43% infantswere born after multifetal pregnancies and 96 (31% infants were prematurely born. There were 106(34.3% infants with low birth weight (LBW; less than 2500 g, of which 83 (78.3% LBW infantswere multiplets. After completion of the study, 71 women were still passing their pregnancy periodand no assessed.Conclusion: The most important factor for untoward perinatal events was multifetal pregnancy. Suchpregnancies were more frequently complicated and higher risk. Low birth weight and prematuritywere more frequent in singletons conceived by assisted techniques in respect to control singletons.

  19. A laminar flow unit for the care of critically ill newborn infants

    Science.gov (United States)

    Perez, Jose MR; Golombek, Sergio G; Fajardo, Carlos; Sola, Augusto

    2013-01-01

    Introduction Medical and nursing care of newborns is predicated on the delicate control and balance of several vital parameters. Closed incubators and open radiant warmers are the most widely used devices for the care of neonates in intensive care; however, several well-known limitations of these devises have not been resolved. The use of laminar flow is widely used in many fields of medicine, and may have applications in neonatal care. Objective To describe the neonatal laminar flow unit, a new equipment we designed for care of ill newborns. Methods The idea, design, and development of this device was completed in Sao Paulo, Brazil. The unit is an open mobile bed designed with the objective of maintaining the advantages of the incubator and radiant warmer, while overcoming some of their inherent shortcomings; these shortcomings include noise, magnetic fields and acrylic barriers in incubators, and lack of isolation and water loss through skin in radiant warmers. The unit has a pump that aspirates environmental air which is warmed by electrical resistance and decontaminated with High Efficiency Particulate Air Filter (HEPA) filters (laminar flow). The flow is directed by an air flow directioner. The unit has an embedded humidifier to increase humidity in the infant’s microenvironment and a servo control mechanism for regulation of skin temperature. Results The laminar flow unit is open and facilitates access of care providers and family, which is not the case in incubators. It provides warming by convection at an air velocity of 0.45 m/s, much faster than an incubator (0.1 m/s). The system provides isolation 1000 class (less than 1,000 particles higher than 0.3 micron per cubic feet at all times). This is much more protection than an incubator provides and more than radiant warmers, which have no isolation whatsoever. Additionally, it provides humidification of the newborn’s microenvironment (about 60% relative humidity), which is impossible with a radiant

  20. [Neonatal septicemia: differences in full-term and pre-term newborn infants].

    Science.gov (United States)

    Mancilla-Ramírez, J; Sánchez-Saucedo, L U

    1990-04-01

    Neonatal septicemia was assessed by blood cultures in 115 newborns (NB) during a two years study in a pediatric hospital of reference in Mexico City. The studied patients were divided in two groups of gestational age, and the differences of etiologic agents, clinical signs, laboratory findings and clinical outcome were compared at term and preterm neonates. We observed Staphylococcus epidermidis became the first cause of septicemia in at term NB (P less than 0.001), while Escherichia coli and Klebsiella pneumoniae (P less than 0.01) were more frequent in the preterm neonates. The clinical manifestations of fever (P less than 0.001), hepatomegaly (P less than 0.01), splenomegaly (P less than 0.05), and rejection to feeding (P less than 0.05) were more common in at term NB. On the other hand, apneas (P less than 0.01), hypothermia (P less than 0.02), and abdominal distension (P less than 0.05) were more frequent in the preterm NB. The altered white blood cell counts were more commonly observed in the preterm group, as leukopenia (P less than 0.05), neutropenia (P less than 0.01), and high I/T ratio (P less than 0.05). There were not significant differences in complications or sequels between the two groups; however, the mortality ratio was higher in the preterm NB group (P less than 0.02). Changing etiology of neonatal septicemia is discussed, and we propose these kind of data are very useful for purpose of detection, diagnostic and treatment of septic neonates.

  1. Assessing neonatal heat balance and physiological strain in newborn infants nursed under radiant warmers in intensive care with fentanyl sedation.

    Science.gov (United States)

    Molgat-Seon, Yannick; Daboval, Thierry; Chou, Shirley; Jay, Ollie

    2014-12-01

    To assess heat balance status of newborn infants nursed under radiant warmers (RWs) during intensive care. Heat balance, thermal status and primary indicators of physiological strain were concurrently measured in 14 newborns nursed under RWs for 105 min. Metabolic heat production (M), evaporative heat loss (E), convective (C) and conductive heat flow (K), rectal temperature (T re) and mean skin temperatures (T sk) were measured continuously. The rate of radiant heat required for heat balance (R req) and the rate of radiant heat provided (R prov) were derived. The rate of body heat storage (S) was calculated using a two-compartment model of 'core' (T re) and 'shell' (T sk) temperatures. Mean M, E, C and K were 10.5 ± 2.7 W, 5.8 ± 1.1 W, 6.2 ± 0.8 W and 0.1 ± 0.1 W, respectively. Mean R prov (1.7 ± 2.6 W) and R req (1.7 ± 2.7 W) were similar (p > 0.05). However, while the resultant mean change in body heat content after 105 min was negligible (-0.1 ± 3.7 kJ), acute time-dependent changes in S were evidenced by a mean positive heat storage component of +6.4 ± 2.6 kJ and a mean negative heat storage component of -6.5 ± 3.7 kJ. Accordingly, large fluctuations in both T re and T sk occurred that were actively induced by changes in RW output. Nonetheless, no active physiological responses (heart rate, breathing frequency and mean arterial pressure) to these bouts of heating and cooling were observed. RWs maintain net heat balance over a prolonged period, but actively induce acute bouts of heat imbalance that cause rapid changes in T re and T sk. Transient bouts of heat storage do not exacerbate physiological strain, but could in the longer term.

  2. Effect of maternal consumption of cocaine base paste on neurological behavior of newborn infants Comportamiento neurológico del recién nacido de madre consumidora de basuco durante su gestación

    OpenAIRE

    Luz E. Gómez; José E. Caicedo R.; Rafael J. Manotas Cabarcas

    1997-01-01

    Twenty newborn infants from mothers that consumed coca leaves' paste during pregnancy were compared with 19 controls as to their neurological behavior and supression evidences; the following alterations were significantly more frequent (p < 0.05) in infants from consumer mothers: Tremor, irritability, nausea, and depression of crying, suction and prension. The duration of these alterations as well as that of other neurological abnormalities was significantly longer in infants from consumer...

  3. Staphylococcus epidermidis isolated from newborn infants express pilus-like structures and are inhibited by the cathelicidin-derived antimicrobial peptide LL37.

    Science.gov (United States)

    Nelson, Annika; Hultenby, Kjell; Hell, Eva; Riedel, Hilde M; Brismar, Hjalmar; Flock, Jan-Ingmar; Lundahl, Joachim; Giske, Christian G; Marchini, Giovanna

    2009-08-01

    Coagulase-negative staphylococci and its subtype Staphylococcus epidermidis are major indigenous Gram-positive inhabitants of the human skin. Colonization occurs in direct connection with birth and terrestrial adaptation. This study focuses on factors that may influence skin colonization of the newborn infant that relates to the immune status of both the bacteria and the host. Skin is an effective barrier against bacteria, and this function is partly mediated by the presence of antimicrobial peptides including human cathelicidin peptide LL37. Gram-positive bacteria have been described to have adhesive pili on their surface that mediates specific attachment to the host. Here, we identify, by negative staining transmission electron microscopy (EM), two different types of pilus-like structures commonly expressed on S. epidermidis isolated from newborn infants. We also show that the cathelicidin antimicrobial peptide LL37, constitutively expressed in the skin barrier of the newborn, significantly inhibited growth of S. epidermidis indicating its importance for the ecological stability of the skin microbiota. Further studies are required to elucidate molecular mechanisms of host-microbe interactions, both for the maintenance of a mutually beneficial homeostatic relationship and for the protection of self when it results in overt disease.

  4. Screening programmes for developmental dysplasia of the hip in newborn infants

    Directory of Open Access Journals (Sweden)

    Damon Shorter

    Full Text Available BACKGROUND Uncorrected developmental dysplasia of the hip (DDH is associated with long term morbidity such as gait abnormalities, chronic pain and degenerative arthritis. OBJECTIVE To determine the effect of different screening programmes for DDH on the incidence of late presentation of congenital hip dislocation. METHODS Search methods: Searches were performed in CENTRAL (The Cochrane Library, MEDLINE and EMBASE (January 2011 supplemented by searches of clinical trial registries, conference proceedings, cross references and contacting expert informants. Selection criteria: Randomized, quasi-randomized or cluster trials comparing the effectiveness of screening programmes for DDH. Data collection and analysis: Three independent review authors assessed study eligibility and quality, and extracted data. MAIN RESULTS No study examined the effect of screening (clinical and/or ultrasound and early treatment versus not screening and later treatment. AUTHORS' CONCLUSIONS There is insufficient evidence to give clear recommendations for practice. There is inconsistent evidence that universal ultrasound results in a significant increase in treatment compared to the use of targeted ultrasound or clinical examination alone. Neither of the ultrasound strategies have been demonstrated to improve clinical outcomes including late diagnosed DDH and surgery. The studies are substantially underpowered to detect significant differences in the uncommon event of late detected DDH or surgery. For infants with unstable hips or mildly dysplastic hips, use of delayed ultrasound and targeted splinting reduces treatment without significantly increasing the rate of late diagnosed DDH or surgery.

  5. Screening programmes for developmental dysplasia of the hip in newborn infants

    Directory of Open Access Journals (Sweden)

    Damon Shorter

    2013-04-01

    Full Text Available BACKGROUND Uncorrected developmental dysplasia of the hip (DDH is associated with long term morbidity such as gait abnormalities, chronic pain and degenerative arthritis. OBJECTIVE To determine the effect of different screening programmes for DDH on the incidence of late presentation of congenital hip dislocation. METHODS Search methods: Searches were performed in CENTRAL (The Cochrane Library, MEDLINE and EMBASE (January 2011 supplemented by searches of clinical trial registries, conference proceedings, cross references and contacting expert informants. Selection criteria: Randomized, quasi-randomized or cluster trials comparing the effectiveness of screening programmes for DDH. Data collection and analysis: Three independent review authors assessed study eligibility and quality, and extracted data. MAIN RESULTS No study examined the effect of screening (clinical and/or ultrasound and early treatment versus not screening and later treatment. AUTHORS' CONCLUSIONS There is insufficient evidence to give clear recommendations for practice. There is inconsistent evidence that universal ultrasound results in a significant increase in treatment compared to the use of targeted ultrasound or clinical examination alone. Neither of the ultrasound strategies have been demonstrated to improve clinical outcomes including late diagnosed DDH and surgery. The studies are substantially underpowered to detect significant differences in the uncommon event of late detected DDH or surgery. For infants with unstable hips or mildly dysplastic hips, use of delayed ultrasound and targeted splinting reduces treatment without significantly increasing the rate of late diagnosed DDH or surgery.

  6. [Disorders of the mother-child relationship in newborn infants with low birth weight].

    Science.gov (United States)

    Heimann, J P; Calame, A; Marchand, C; Plancherel, B; Prod'hom, L S

    1981-02-01

    The influence of premature birth or intrauterine growth retardation (IUGR) on the mother-child relationship has been studied in 80 children with birth-weight below 2000 g, treated in the Neonatology Unit of the Pediatric Department of Lausanne University. 40 children with birth-weight over 2500 g and without perinatal complications born in the Obstetrical Department of the same hospital were used as controls. The 80 infants with low birth-weight presented only minor neonatal disturbances and showed later on a normal psychomotor development. The mother-child relationship was evaluated by free and structured interviews accompanied by a questionnaire and by regular contacts throughout the first 12 months. With the exception of the professional work of the mother during and after pregnancy, all the family and social factors were not significantly different in the 3 groups. The mothers of premature children showed significantly more disturbances of their family relationship than the mothers in the control group. On the other hand, a significantly higher number of attachment problems is the only difference observed in the group of mothers of IUGR-babies. There was no mathematical correlation between these problems and the characteristics of the family and social-economic environment of the mothers. The importance of subjective, i.e. psychological, factors as cause of difficulties in the mother-child relationship is stressed.

  7. Postmortem CT investigation of air/gas distribution in the lungs and gastrointestinal tracts of newborn infants: a serial case study with regard to still- and live birth.

    Science.gov (United States)

    Michiue, Tomomi; Ishikawa, Takaki; Kawamoto, Osamu; Sogawa, Nozomi; Oritani, Shigeki; Maeda, Hitoshi

    2013-03-10

    Flotation tests on the lungs and gastrointestinal tract to investigate aeration are classic procedures to examine the life of a newborn after birth; however, there are arguments about the reliability. The present study investigated serial forensic autopsy cases of newborn infants without marked decomposition (n=4) with regard to air/gas distribution in the lungs and gastrointestinal tracts by means of postmortem CT (PM-CT) as well as macromorphology and histology, compared with intrauterine and aborted fetuses (n=3). No gas was detected in the lungs or gastrointestinal tracts in all of three intrauterine fetal deaths. Gas was diffusely detected in the lungs of a newborn fatality attributed to smothering after birth; however, two neonatal fatalities had poor lung gas contents due to marked congestion with edema and diffuse atelectasis. In a case of unsuccessful cardiopulmonary resuscitation following possible birth asphyxia, pulmonary aeration was evidently localized on CT morphology, despite a larger amount of bowel gas, and was also uneven in histology, showing a membranous immunostaining pattern of pulmonary surfactant on the intra-alveolar surfaces of expanded alveoli. The combined use of PM-CT is useful to demonstrate air/gas distributions in the lungs and gastrointestinal tract for interpretation of spontaneous breathing after birth in newborn fatalities. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  8. Spinal sonography in newborns and infants - part II: spinal dysraphism and tethered cord.

    Science.gov (United States)

    Deeg, K-H; Lode, H-M; Gassner, I

    2008-02-01

    Patients with cutaneous markers in the lumbo-sacral region as well as infants with bladder and bowel dysfunction, orthopedic anomalies and progressive neurological dysfunction are at risk for spinal dysraphism and tethered cord. Three types of spinal dysraphism can be distinguished: Type I - open spinal dysraphisms with a non-skin covered back mass; type II - closed spinal dysraphisms with a skin covered back mass; type III - occult spinal dysraphisms without a back mass. All spinal dysraphisms can be associated with a tethered cord, characterized by a low position of the conus medullaris below L3. Type I dysraphisms are meningomyeloceles and myeloceles, which are associated with CHIARI-II malformations characterized by the low position of the cerebellar vermis within the foramen magnum. Type II dysraphisms are lipomyeloceles, lipomyelomeningoceles, posterior meningoceles and myelocystoceles. Lipomeningoceles and lipomyelomeningoceles are characterized by a subcutaneous echogenic mass which communicates with the spinal canal and may cause tethered cord. Posterior meningoceles are, dorsal cystic space occupying lesions without internal neural tissue. Myelocystoceles are characterized by a cystic dorsal mass which communicates with a dilated central canal characteristic of syringo-hydromyelia. Type III dysraphisms without a back mass are frequently associated with cutaneous markers in the lumbo-sacral region. Sonographically dermal sinus tracts, diastematomyelia, tight filum and lipoma of the filum terminale and the caudal regression syndrome have to be distinguished. Dermal sinuses are characterized by an echogenic tract from the skin to the spinal canal, often associated with a spinal dermoid. Diastematomyelia is characterized by a complete or partial duplication of the spinal cord which can only be shown on axial images. Tight filum terminale or lipoma of the filum terminale is characterized by a thick echogenic filum with a diameter of more than 2 mm, and a conus

  9. Inter-society consensus document on treatment and prevention of bronchiolitis in newborns and infants.

    Science.gov (United States)

    Baraldi, Eugenio; Lanari, Marcello; Manzoni, Paolo; Rossi, Giovanni A; Vandini, Silvia; Rimini, Alessandro; Romagnoli, Costantino; Colonna, Pierluigi; Biondi, Andrea; Biban, Paolo; Chiamenti, Giampietro; Bernardini, Roberto; Picca, Marina; Cappa, Marco; Magazzù, Giuseppe; Catassi, Carlo; Urbino, Antonio Francesco; Memo, Luigi; Donzelli, Gianpaolo; Minetti, Carlo; Paravati, Francesco; Di Mauro, Giuseppe; Festini, Filippo; Esposito, Susanna; Corsello, Giovanni

    2014-10-24

    Acute bronchiolitis is the leading cause of lower respiratory tract infection and hospitalization in children less than 1 year of age worldwide. It is usually a mild disease, but some children may develop severe symptoms, requiring hospital admission and ventilatory support in the ICU. Infants with pre-existing risk factors (prematurity, bronchopulmonary dysplasia, congenital heart diseases and immunodeficiency) may be predisposed to a severe form of the disease. Clinical diagnosis of bronchiolitis is manly based on medical history and physical examination (rhinorrhea, cough, crackles, wheezing and signs of respiratory distress). Etiological diagnosis, with antigen or genome detection to identify viruses involved, may have a role in reducing hospital transmission of the infection. Criteria for hospitalization include low oxygen saturation (bronchiolitis, and the mainstay of therapy is supportive care. This consists of nasal suctioning and nebulized 3% hypertonic saline, assisted feeding and hydration, humidified O2 delivery. The possible role of any pharmacological approach is still debated, and till now there is no evidence to support the use of bronchodilators, corticosteroids, chest physiotherapy, antibiotics or antivirals. Nebulized adrenaline may be sometimes useful in the emergency room. Nebulized adrenaline can be useful in the hospital setting for treatment as needed. Lacking a specific etiological treatment, prophylaxis and prevention, especially in children at high risk of severe infection, have a fundamental role. Environmental preventive measures minimize viral transmission in hospital, in the outpatient setting and at home. Pharmacological prophylaxis with palivizumab for RSV bronchiolitis is indicated in specific categories of children at risk during the epidemic period. Viral bronchiolitis, especially in the case of severe form, may correlate with an increased incidence of recurrent wheezing in pre-schooled children and with asthma at school age

  10. Use of Esophageal Hemoximetry to Assess the Effect of Packed Red Blood Cell Transfusion on Gastrointestinal Oxygenation in Newborn Infants.

    Science.gov (United States)

    Vora, Farha M; Gates, Judy; Gerard, Kimberley; Hanson, Shawn; Applegate, Richard L; Blood, Arlin B

    2017-07-01

    Objectives  There are no widely accepted methods of continuously monitoring gut oxygenation in the newborn during packed red blood cell transfusion. We investigated the use of an orally inserted light spectroscopy probe to measure lower esophageal oxyhemoglobin saturations (eStO 2 ) before, during, and after transfusion and made comparisons with abdominal near-infrared spectroscopy (NIRS) and superior mesenteric artery (SMA) flow. Study Design  Thirteen neonates with corrected gestational ages ranging from 22 weeks, 0 day to 37 weeks, 5 days were enrolled. eStO 2 and NIRS measurements were recorded continuously for a 25-hour period starting 1 hour prior to starting the 4-hour transfusion. Transabdominal ultrasound was used to measure SMA flow prior to, upon completion, and 20 hours after the transfusion. Results  Twelve infants completed the study. eStO 2 was well-tolerated and was weakly (r = 0.06) correlated ( p  NIRS. Compared with NIRS, eStO 2 demonstrated a markedly greater variation in oxyhemoglobin values. NIRS and SMA flow measurements did not change, while eStO 2 increased from 48 ± 5% and 45 ± 5% in the pre- and intratransfusion periods to 57 ± 4% in the posttransfusion period ( p  = 0.03). Conclusion  Measurement of eStO 2 is feasible in neonates and may provide a continuous and sensitive index of rapid changes in mesenteric oxygenation in this patient population. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  11. Ventilator-associated pneumonia in newborn infants diagnosed with an invasive bronchoalveolar lavage technique: a prospective observational study.

    Science.gov (United States)

    Cernada, María; Aguar, Marta; Brugada, María; Gutiérrez, Antonio; López, José Luis; Castell, Marta; Vento, Máximo

    2013-01-01

    To establish the incidence, etiology, risk factors, and outcomes associated with ventilator-associated pneumonia using an invasive sampling technique to avoid contamination. Eligible patients were intubated neonates treated with mechanical ventilation who followed the criteria of the Centers for Disease Control and Prevention/National Nosocomial Infection Surveillance. Bronchoalveolar lavage samples were collected using a blind-protected catheter to avoid contamination of upper respiratory microorganisms. Isolation of >10(3) colony-forming unit/mL was required for diagnosis. In 198 neonates intubated for >48 hrs, a total of 18 episodes of ventilator-associated pneumonia in 16 infants representing a prevalence of 8.1 were diagnosed. The pooled mean ventilator-associated pneumonia rate was 10.9/1,000 ventilator days. The mean age at diagnosis of ventilator-associated pneumonia was 29 ± 15 days after a mean of 21 ± 16 days of mechanical ventilation. Gram-negative bacteria were the most commonly isolated pathogens and Pseudomonas aeruginosa was the most frequent causative agent. Hospital length of stay was significantly longer for ventilator-associated pneumonia patients; however, no significant differences in mortality were found. Univariate analysis comparing patients with and without ventilator-associated pneumonia showed that days of mechanical ventilation, days of oxygen, number of reintubations, number of transfusions, bloodstream infection, and enteral feeding were all significantly associated with ventilator-associated pneumonia. However, in multivariate analysis the unique independent risk factor was days of mechanical ventilation (odds ratio 1.12, confidence interval 95% 1.07-1.17). Ventilator-associated pneumonia is a frequent nosocomial infection in newborns. Only duration of mechanical ventilation has been identified as an independent risk factor for ventilator-associated pneumonia. The use of a blind invasive sampling technique seems to diminish sample

  12. UNPACKING THE BURDEN OF CARE FOR INFANTS IN THE NICU.

    Science.gov (United States)

    D'Agata, Amy L; Sanders, Marilyn R; Grasso, Damion J; Young, Erin E; Cong, Xiaomei; Mcgrath, Jacqueline M

    2017-03-01

    Infants who begin early life in the medicalized environment of the neonatal intensive care unit (NICU) experience disruption to numerous fundamental expectancies. In the NICU, infants are exposed to chronic, extreme stressors that include painful medical procedures and parental separation. Due to their preverbal stage of development, infants are unable to fully express these experiences, and linking these experiences to long-term outcomes has been difficult. This clinical article proposes the terminology Infant Medical Trauma in the NICU (IMTN) to describe the infant experience. Following a discussion of the NICU as an adverse childhood event, the article has three sections: (a) the unique and critical factors that define the newborn period, (b) a review of the IMTN conceptual model, and (c) recommendations for supportive neuroprotective strategies to moderate the intensity of adverse NICU infant experiences. © 2017 Michigan Association for Infant Mental Health.

  13. Desenvolvimento cerebral em recém-nascidos prematuros Cerebral development in preterm newborn infants

    Directory of Open Access Journals (Sweden)

    Andrea Peterson Zomignani

    2009-06-01

    2007 along with textbooks whose content was relevant. DATA SYNTHESIS: The development of preterm infants differs from term neonates. Studies have shown that children born prematurely have anatomical changes related to cognitive impairments in the central nervous system. Some regions seem vulnerable, such as white and gray matter, corpus callosum, caudate nucleus, hippocampus and cerebellum, when evaluated by volumetric neuroimaging techniques. Thus, one would expect some functional and/or learning impairment in children, adolescents and adults born prematurely. When evaluated in late childhood and adolescence, they show deficits in the intelligence quotient, memory, calculations skills and in the overall cognitive function. Motor coordination, attention, planning and association deficits are also reported in the literature. CONCLUSIONS: Prematurity can lead to structural and anatomical changes of the brain due to interruption of the prenatal development. These changes can cause functional deficits and children born prematurely are more vulnerable to cognitive and motor problems as well as its effects on their daily activities, even in adolescence and adulthood.

  14. Economic and health consequences of non-invasive respiratory support in newborn infants: a difference-in-difference analysis using data from the Norwegian patient registry.

    Science.gov (United States)

    Kann, Inger Cathrine; Solevåg, Anne Lee

    2014-11-01

    Newborn infants with respiratory failure are often treated with intubation and mechanical ventilation for prolonged periods of time. Our objective was to evaluate whether increasing use of non-invasive respiratory support in newborn infants can improve patient health and reduce costs. We utilized a natural experiment that took place in October 2008 when a large neonatal intensive care unit in Norway moved into a new hospital building with new medical equipment. A change in respiratory support towards increasing use of nasal biphasic positive airway pressure (n-BiPAP) instead of invasive mechanical ventilation treatment followed the acquisition of the new equipment. We used a difference-in-difference method and data from the Norwegian National Patient Registry to assess morbidity, mortality, number of hospital days and hospital costs in our unit following this change. We stratified the results according to gestational age groups. We found a reduction in morbidity including bronchopulmonary dysplasia, retinopathy of prematurity and intraventricular hemorrhage. No change in mortality was found. We found a reduction in number of hospital days and hospital costs for preterm infants with gestational age <28 weeks and for term infants with diagnoses affecting respiration. We conclude that increasing use of n-BiPAP may improve health and reduce costs. However, more research is needed to establish best practice. Comparing hospitals where treatment practices change to hospitals where the same change does not occur may be a useful way to evaluate the efficacy of such a change, especially when hospitals can be studied over time.

  15. 24-hour tape recordings of ECG and respiration in the newborn infant with findings related to sudden death and unexplained brain damage in infancy

    Science.gov (United States)

    Southall, D P; Richards, Jean; Brown, D J; Johnston, P G B; De Swiet, M; Shinebourne, E A

    1980-01-01

    A system for simultaneous 24-hour tape recording of ECG and respiration has been developed and used in the study of 4 groups of newborn infants. In 50 randomly selected, healthy term infants, the mean lowest heart rate (>9 beats' duration; was 88 ± 13. 14 (28%) infants had junctional escape rhythms, 5 had supraventricular, and 2 ventricular premature beats. 34 (68%) subjects had apnoeic episodes ≥10 seconds' duration; the 95th centile for maximum duration of apnoea was 18 seconds, the longest episode being 28 seconds. Episodes of bradycardia 40 seconds, or extreme bradycardia arrhythmias on a standard ECG were studied. Of these, 6 with premature beats and 3 of 5 with episodes of bradycardia did not exhibit apnoea during arrhythmias. Two of the 5 babies with bradycardia however, demonstrated associated apnoea of 10-14 seconds. There may be a relationship between latent episodes of prolonged apnoea and bradycardia and hypoxaemic brain damage or sudden infant death. ImagesFig. 1 PMID:7377822

  16. Comparison of the effect of topical application of human milk and dry cord care on the bacterial colonization of umbilical cord in newborn infants

    Directory of Open Access Journals (Sweden)

    Fatemeh Abbaszadeh

    2014-04-01

    Full Text Available Background: Breast milk contains significant amounts of compounds that act as natural antimicrobial agents. This study was conducted to compare the effect of topical application of human milk and dry cord care on bacterial colonization in the umbilical cord of newborn infants. Methods: This clinical trial study was carried out on 174 infants in Kashan. The newborns were randomized to mother's milk group and dry cord care group from the birth. In group 1, the mother rubbed her own milk on the cord stump every 12 hours from 3 hours after birth to 2 days after the umbilical cord separation. In group 2, the mother was recommended not to use any material on the cord. Then, the cord samples were taken four times; 3hours after birth, at days 3 and 7, and 2 days after the umbilical cord separation. Results: The findings of the culture two days after umbilical cord separation indicated that low percentage of neonates in the breast milk (23.1% and dry cord care (28.8% groups had bacterial colonization. Moreover, no significant difference was found between the two groups in terms of growth of pathogenic organisms and normal flora of the skin (P>0.05. Conclusion: Given the low prevalence of pathogenic microorganisms in the two groups, it seems using breast milk and dry cord care are equally effective methods of taking care of umbilical cord.

  17. Discordant expression of pro-B-type and pro-C-type natriuretic peptide in newborn infants of mothers with type 1 diabetes

    DEFF Research Database (Denmark)

    Nybo, Mads; Nielsen, Lars Bo; Nielsen, Søren Junge

    2007-01-01

    CNP-derived peptides in newborn infants. METHODS: Plasma concentrations of proCNP-derived peptides were measured in umbilical cord plasma and human placental tissue extracts using sequence-specific radioimmunoassays raised against N-terminal and C-terminal proCNP regions, respectively. RESULTS: The median pro......CNP concentrations were similar in umbilical cord plasma from pregnant women with and without type 1 diabetes (17 pmol/L vs. 19 pmol/L, P not significant) and did not correlate with the proBNP concentrations in the same samples. However, the molar ratio between the proCNP and the CNP peptide was increased...... in umbilical cord plasma compared to adult plasma (4.6 vs. 1.1), which parallels our earlier findings for proBNP and BNP peptides. CONCLUSIONS: There is a discordant expression of CNP and BNP peptides in newborn infants of mothers with diabetes. Moreover, fetal metabolism of proCNP and CNP appears to differ...

  18. Infant - newborn development

    Science.gov (United States)

    ... day of life, mothers can tell their own baby's cry from that of other babies. By the first ... of life, most parents can tell if their baby's cry means hunger , pain, or anger. Crying also causes ...

  19. Vitamin C supplementation for pregnant smoking women and pulmonary function in their newborn infants: a randomized clinical trial.

    Science.gov (United States)

    McEvoy, Cindy T; Schilling, Diane; Clay, Nakia; Jackson, Keith; Go, Mitzi D; Spitale, Patricia; Bunten, Carol; Leiva, Maria; Gonzales, David; Hollister-Smith, Julie; Durand, Manuel; Frei, Balz; Buist, A Sonia; Peters, Dawn; Morris, Cynthia D; Spindel, Eliot R

    2014-05-01

    Maternal smoking during pregnancy adversely affects offspring lung development, with lifelong decreases in pulmonary function and increased asthma risk. In a primate model, vitamin C blocked some of the in-utero effects of nicotine on lung development and offspring pulmonary function. To determine if newborns of pregnant smokers randomized to receive daily vitamin C would have improved results of pulmonary function tests (PFTs) and decreased wheezing compared with those randomized to placebo. Randomized, double-blind trial conducted in 3 sites in the Pacific Northwest between March 2007 and January 2011. One hundred fifty-nine newborns of randomized pregnant smokers (76 vitamin C treated and 83 placebo treated) and 76 newborns of pregnant nonsmokers were studied with newborn PFTs. Follow-up assessment including wheezing was assessed through age 1 year, and PFTs were performed at age 1 year. Pregnant women were randomized to receive vitamin C (500 mg/d) (n = 89) or placebo (n = 90). The primary outcome was measurement of newborn pulmonary function (ratio of the time to peak tidal expiratory flow to expiratory time [TPTEF:TE] and passive respiratory compliance per kilogram [Crs/kg]) within 72 hours of age. Secondary outcomes included incidence of wheezing through age 1 year and PFT results at age 1 year. A subgroup of pregnant smokers and nonsmokers had genotyping performed. Newborns of women randomized to vitamin C (n = 76), compared with those randomized to placebo (n = 83), had improved pulmonary function as measured by TPTEF:TE (0.383 vs 0.345 [adjusted 95% CI for difference, 0.011-0.062]; P = .006) and Crs/kg (1.32 vs 1.20 mL/cm H2O/kg [95% CI, 0.02-0.20]; P = .01). Offspring of women randomized to vitamin C had significantly decreased wheezing through age 1 year (15/70 [21%] vs 31/77 [40%]; relative risk, 0.56 [95% CI, 0.33-0.95]; P = .03). There were no significant differences in the 1-year PFT results between the vitamin C and

  20. Indicadores de risco para perda auditiva em neonatos e lactentes atendidos em um programa de triagem auditiva neonatal Risk indicators for hearing loss of newborns and infants in a newborn hearing screening program

    Directory of Open Access Journals (Sweden)

    Silvana Maria Sobral Griz

    2011-04-01

    Full Text Available OBJETIVO: descrever os indicadores de risco para perda auditiva presentes em neonatos e lactentes que realizaram a Triagem Auditiva Neonatal no Hospital das Clínicas da Universidade Federal de Pernambuco, nascidos em 2008. MÉTODOS: foram pesquisados os 787 neonatos e lactentes que realizaram a Triagem Auditiva Neonatal no citado Hospital, nascidos em 2008. Foi montado um banco de dados com informações do formulário com histórico familiar e clínico dos pesquisados e resultado da triagem, para análise dos indicadores de risco. RESULTADOS: os indicadores de risco mais prevalentes na população estudada foram presença de hiperbilirrubinemia, nascimento pré-termo, baixo peso ao nascimento, uso de medicamento durante o período gestacional, permanência em Unidade de Terapia intensiva e presença de infecções intra-uterinas durante a gestação. Os indicadores de risco para perda auditiva com associação estatisticamente significante com o resultado falha na triagem foram nascimento pré-termo, baixo peso, permanência em Unidade de Terapia Intensiva, uso de ventilação mecânica e uso de medicamento ototóxicos. CONCLUSÃO: houve ocorrência de indicadores de risco pré, peri e pós-natais, porém apenas foi encontrada significância estatística entre alguns indicadores peri e pós-natais e a falha na triagem.PURPOSE: to characterize neonates and infants who were born in 2008 and have been submitted to the Newborn Hearing Screening Program of the Federal University of Pernambuco Hospital according to the presence of risk factors related to hearing loss. METHODS: a total of 787 newborns took part in the study. Information from clinical charts and tests results were collected in order set up a database. RESULTS: the most prevalent risk factors for hearing loss in the related population was hyperbilirubinemia, prematurity, low weigh at birth, use of medication during pregnancy, presence of diseases during pregnancy and permanence in a

  1. Newborn Screening

    Science.gov (United States)

    ... Laboratory Sciences Office of Public Health Genomics Publications & Articles Newborn Screening Lab Bulletin Laboratory Partners Multimedia Tools Newborn Screening Program – Role of Laboratories Meet the Scientist Newborn Screening: Family Stories Newborn Screening: Public Health ...

  2. Prenatal administration of the cytochrome P4501A inducer, Β-naphthoflavone (BNF), attenuates hyperoxic lung injury in newborn mice: Implications for bronchopulmonary dysplasia (BPD) in premature infants

    International Nuclear Information System (INIS)

    Couroucli, Xanthi I.; Liang Yanhong Wei; Jiang Weiwu; Wang Lihua; Barrios, Roberto; Yang Peiying; Moorthy, Bhagavatula

    2011-01-01

    Supplemental oxygen contributes to the development of bronchopulmonary dysplasia (BPD) in premature infants. In this investigation, we tested the hypothesis that prenatal treatment of pregnant mice (C57BL/6J) with the cytochrome P450 (CYP)1A1 inducer, ss-napthoflavone (BNF), will lead to attenuation of lung injury in newborns (delivered from these dams) exposed to hyperoxia by mechanisms entailing transplacental induction of hepatic and pulmonary CYP1A enzymes. Pregnant mice were administered the vehicle corn oil (CO) or BNF (40 mg/kg), i.p., once daily for 3 days on gestational days (17-19), and newborns delivered from the mothers were either maintained in room air or exposed to hyperoxia (> 95% O 2 ) for 1-5 days. After 3-5 days of hyperoxia, the lungs of CO-treated mice showed neutrophil infiltration, pulmonary edema, and perivascular inflammation. On the other hand, BNF-pretreated neonatal mice showed decreased susceptibility to hyperoxic lung injury. These mice displayed marked induction of ethoxyresorufin O-deethylase (EROD) (CYP1A1) and methoxyresorufin O-demethylase (MROD) (CYP1A2) activities, and levels of the corresponding apoproteins and mRNA levels until PND 3 in liver, while CYP1A1 expression alone was augmented in the lung. Prenatal BNF did not significantly alter gene expression of pulmonary NAD(P)H quinone reductase (NQO1). Hyperoxia for 24-72 h resulted in increased pulmonary levels of the F 2 -isoprostane 8-iso-PGF 2α , whose levels were decreased in mice prenatally exposed to BNF. In conclusion, our results suggest that prenatal BNF protects newborns against hyperoxic lung injury, presumably by detoxification of lipid hydroperoxides by CYP1A enzymes, a phenomenon that has implications for prevention of BPD in infants. - Highlights: → Supplemental oxygen is routinely administered to premature infants. → Hyperoxia causes lung injury in experimental animals. → Prenatal treatment of mice with beta-naphthoflavone attenuates oxygen injury

  3. A scale for home visiting nurses to identify risks of physical abuse and neglect among mothers with newborn infants

    NARCIS (Netherlands)

    Grietens, H; Geeraert, L; Hellinckx, W

    Objective: The aim was to construct and test the reliability (utility, internal consistency, interrater agreement) and the validity (internal validity, concurrent validity) of a scale for home visiting social nurses to identify risks of physical abuse and neglect in mothers with a newborn child.

  4. Cardiac rhythm abnormalities during intravenous immunoglobulin G(IVIG) infusion in two newborn infants: coincidence or association?

    OpenAIRE

    Tufekci, Sinan; Coban, Asuman; Bor, Meltem; Yasa, Beril; Nisli, Kemal; Ince, Zeynep

    2015-01-01

    Key Clinical Message We report the occurrence of supraventricular tachycardia during intravenous immunoglobulin (IVIG) infusion. Supraventricular tachycardia was observed in two newborn patients during IVIG infusion. Both of the babies responded to adenosine treatment. Cardiorespiratory monitoring during IVIG infusion can be recommended because of the possibility of this potentially lifethreatening adverse effect.

  5. High Frequency Jet Ventilation during Initial Management, Stabilization, and Transport of Newborn Infants with Congenital Diaphragmatic Hernia: A Case Series

    Directory of Open Access Journals (Sweden)

    Qianshen Zhang

    2013-01-01

    Full Text Available Objective. To review experience of the transport and stabilization of infants with CDH who were treated with high frequency jet ventilation (HFJV. Study Design. Retrospective chart review was performed of infants with antenatal diagnosis of CDH born between 2004 and 2009, at Mount Sinai Hospital Toronto, Ontario, Canada. Detailed information was abstracted from the charts of all infants who received HFJV. Results. Of the 55 infants, 25 were managed with HFJV at some point during resuscitation and stabilization prior to transport. HFJV was the initial ventilation mode in six cases and nineteen infants were placed on HFJV as rescue therapy. Blood gases procured from the umbilical artery before and/or after the initiation of HFJV. There was a significant difference detected for both PaCO2 (P=0.0002 and pH (P<0.0001. The pre- and posttransport vital signs remained stable and no transport related deaths or significant complications occurred. Conclusion. HFJV appears to be safe and effective providing high frequency rescue therapy for infants with CDH failing conventional mechanical ventilation. This paper supports the decision to utilize HFJV as it likely contributed to safe transport of many infants that would not otherwise have tolerated transport to a surgical centre.

  6. Haemolytic disease of the newborn infant. Long term efficiency of the screening and the prevention of alloimmunization in the mother: thirty years of experience.

    Science.gov (United States)

    Moncharmont, P; Juron Dupraz, F; Vignal, M; Rigal, D; Meyer, F; Debeaux, P

    1991-01-01

    During the last thirty years, the diagnosis, management and prevention of haemolytic disease of the newborn infant (HDN) have improved. From 1959 to 1988, 3004 HDN (ABO excluded) have been collected. The percentage of HDN with anti-D alloimmunization decreased significantly (98.4% from 1959 to 1968, 93.5% from 1969 to 1978 and 68.1% from 1979 to 1988). The anti-D HDN with exchange transfusion (ET) fell significantly between the first and second periods (577 versus 970; chi 2 = 19.92; P less than 0.001). On the other hand, the number of HDN other than anti-D increased during these three periods, but the percentage of these HDN which needed ET decreased. Our study shows the long term efficiency of the prevention of anti-D alloimmunization (since 1970) and of the irregular antibodies screening among all pregnant women (since 1979).

  7. Hybrid PET/MRI imaging in healthy unsedated newborn infants with quantitative rCBF measurements using 15O-water PET

    DEFF Research Database (Denmark)

    Andersen, Julie B; Lindberg, Ulrich; Olesen, Oline V

    2018-01-01

    were scanned in a PET/MRI scanner during natural sleep after median intravenous injection of 14 MBq 15O-water. Regional CBF was quantified using a one-tissue-compartment model employing an image-derived input function (IDIF) from the left ventricle. PET rCBF showed the highest values in the thalami.......36, significantly higher than previous ASL data. The rCBF ASL measurements were all unsuccessful primarily owing to subject movement. In this study, we demonstrated for the first time, a minimally invasive PET/MRI method using low activity 15O-water PET for quantitative rCBF assessment in unsedated healthy newborn...... infants and found a white/grey matter CBF ratio similar to that of the adult human brain....

  8. Radiation exposure of children in pediatric radiology, Pt. 8. Radiation doses during thoracoabdominal babygram and abdominal X-ray examination of the newborn and young infants

    International Nuclear Information System (INIS)

    Schneider, Karl; Seidenbusch, M.C.

    2010-01-01

    Purpose: Reconstruction of radiation doses for the thoracoabdominal babygram and the abdomen X-ray from radiographic settings and exposure data acquired at Dr. von Hauner's Kinderspital (children's hospital of the University of Munich, DvHK) between 1976 and 2007; comparison of these dose values with values reported in the literature; recommendation of a reference dose value for the thoracoabdominal babygram. Materials and Methods: The data from all X-ray examinations performed since 1976 at DvHK were stored electronically in a database. After 30 years of data collection, the database now includes 305 107 radiological examinations (radiographs and fluoroscopies), especially 1493 thoracoabdominal babygrams and 3632 abdomen X-rays of newborns and young infants. With the computer program PAeDOS, a specific dose reconstruction algorithm was developed. Results: the entrance dose values of thoracoabdominal babygrams and abdomen X-rays in DvHK could be reduced in the last 30 years by a factor of 5 to 8. They are far below the entrance dose values reported by other radiology departments in Europe. Nevertheless, a slight increase in the entrance doses that correlates with the introduction of a digital storage phosphor system could be observed in the last years. Conclusion: because nearly all radiosensitive body organs in early life are involved during a thoracoabdominal babygram and because of the high radiation sensitivity of newborns, thoracoabdominal babygrams should be performed in neonatology with caution. A dose value of 1.0 cGy cm 2 could serve as the actual reference dose value for the thoracoabdominal babygram of the newborn. (orig.)

  9. Comparison between two different modes of non-invasive ventilatory support in preterm newborn infants with respiratory distress syndrome mild to moderate: preliminary data

    Directory of Open Access Journals (Sweden)

    F. Ciuffini

    2014-08-01

    Full Text Available Despite of improved survival of premature infants, the incidence of long term pulmonary complications, mostly associated with ventilation-induced lung injury, remains high. Non invasive ventilation (NIV is able to reduce the adverse effects of mechanical ventilation. Although nasal continuous positive airway pressure (NCPAP is an effective mode of NIV, traumatic nasal complications and intolerance of the nasal interface are common. Recently high flow nasal cannula (HFNC is emerging as a better tolerated form of NIV, allowing better access to the baby’s face, which may improve nursing, feeding and bonding. HFNC may be effective in the treatment of some neonatal respiratory conditions while being more user-friendly for care-givers than conventional NCPAP. Limited evidence is available to support the specific role, efficacy and safety of HFNC in newborns and to demonstrate efficacy compared with NCPAP; some studies suggest a potential role for HFNC in respiratory care of the neonate as a distinct non invasive ventilatory support. We present the preliminary data of a randomized clinical trial; the aim of this study was to assess efficacy and safety of HFNC compared to NCPAP in preterm newborns with mild to moderate respiratory distress syndrome (RDS.

  10. Comparison between two different modes of non-invasive ventilatory support in preterm newborn infants with respiratory distress syndrome mild to moderate: preliminary data.

    Science.gov (United States)

    Ciuffini, F; Pietrasanta, C; Lavizzari, A; Musumeci, S; Gualdi, C; Sortino, S; Colnaghi, M; Mosca, F

    2014-08-31

    Despite of improved survival of premature infants, the incidence of long term pulmonary complications, mostly associated with ventilation-induced lung injury, remains high. Non invasive ventilation (NIV) is able to reduce the adverse effects of mechanical ventilation. Although nasal continuous positive airway pressure (NCPAP) is an effective mode of NIV, traumatic nasal complications and intolerance of the nasal interface are common. Recently high flow nasal cannula (HFNC) is emerging as a better tolerated form of NIV, allowing better access to the baby's face, which may improve nursing, feeding and bonding. HFNC may be effective in the treatment of some neonatal respiratory conditions while being more user-friendly for care-givers than conventional NCPAP. Limited evidence is available to support the specific role, efficacy and safety of HFNC in newborns and to demonstrate efficacy compared with NCPAP; some studies suggest a potential role for HFNC in respiratory care of the neonate as a distinct non invasive ventilatory support. We present the preliminary data of a randomized clinical trial; the aim of this study was to assess efficacy and safety of HFNC compared to NCPAP in preterm newborns with mild to moderate respiratory distress syndrome (RDS).

  11. Extracorporeal membrane oxygenation support for intractable primary arrhythmias and complete congenital heart block in newborns and infants: short-term and medium-term outcomes.

    Science.gov (United States)

    Dyamenahalli, Umesh; Tuzcu, Volkan; Fontenot, Eudice; Papagiannis, John; Jaquiss, R D B; Bhutta, Adnan; Morrow, William R; Erickson, Christopher C; Imamura, Michiaki; Prodhan, Parthak

    2012-01-01

    To describe the experience with extracorporeal membrane oxygenation support for intractable primary arrhythmias in newborns and infants. Retrospective study. A tertiary care pediatric hospital. Patients younger than 1 yr supported with extracorporeal membrane oxygenation for primary cardiac arrhythmias were identified from the institutional extracorporeal membrane oxygenation registry. Extracorporeal membrane oxygenation support. Clinical characteristics and outcomes were investigated for patients with primary cardiac arrhythmia supported with extracorporeal membrane oxygenation. Outcomes investigated were time from initiation of extracorporeal membrane oxygenation support to arrhythmia control, duration of extracorporeal membrane oxygenation support, and results of interventions performed while supported with extracorporeal membrane oxygenation. We summarized the independent categorical and continuous variables using frequencies, percentages, and medians and ranges, respectively. Extracorporeal membrane oxygenation support was used in nine patients for rescue therapy for primary tachyarrhythmia and bradycardia. The primary arrhythmias were: focal atrial tachycardia (n = 2); reentrant supraventricular tachycardia (n = 3); junctional ectopic tachycardia (n = 2); and congenital complete atrioventricular block (n = 2) patients. Seven patients presented with severe hemodynamic compromise, with six patients requiring extracorporeal cardiopulmonary resuscitation. All patients required extracorporeal membrane oxygenation within 24 hrs of initial presentation. Balloon atrial septostomy was performed in three patients and ablation was performed in two patients. Sinus rhythm was achieved in all reentrant supraventricular tachycardia and rate control was established in both patients with focal atrial tachycardia and in one patient with junctional ectopic tachycardia while using extracorporeal membrane oxygenation support. All patients survived to hospital discharge, and

  12. [Evaluation of sufficiency with vitamins C, B1 and B2 of newborn infants feeding different types of nutrition, by means of urinary excretion determination].

    Science.gov (United States)

    Vrzhesinskaya, O A; Kodentsova, V M; Pereverzeva, O G; Gmoshinskaya, M V; Pustograev, N N

    2015-01-01

    With the help of non-invasive methods the sufficiency with vitamins C, B1 and B2 in 58 newborns (38-40 weeks of gestation) on breastfeeding as well as on mixed or artificial feeding has been evaluated. Urinary excretion and breast content of ascorbic acid (measured by visual titration), thiamin (by thiochrome fluorimetric method) andriboflavin (fluorimetrically by titration with riboflavin-binding protein) was determined on the 3-10th day after birth. 35 infants were exclusively breastfed. 40% of their mothers regularly took multivitamin supplements during pregnancy and 42.9%--both during pregnancy and after childbirth, 17.1% did not use vitamin complexes either duringpregnancy or after childbearing. The content of vitamins C, B1 and B2 in the breast milk of women who did not additionally intake vitamins during pregnancy and lactation, was reduced compared with that of mothers who took multivitamin supplements, and provided only a half of the needs of their child in these vitamins. All these babies have urinary excretion of vitamins below the lower limit of norm. Among infants whose mothers took multivitamin supplements during pregnancy, but stop taking them immediately after their birth, only 28.6% of newborns were provided with vitamin C, while all the children identified a lack of vitamins By and B2. The insufficiency with vitamins C and B1 was detected in one third of children breastfed by mothers who took vitamins during pregnancy and continued intaking them after birth, adequate supplied with vitamin B2 was 35.7% of the surveyed. Determination of vitamin urinary excretion (perg creatinine) is useful for vitamin status evaluation. The content of vitamins in breast milk can be used for assessment of vitamin status both a nursing woman and her child. Taking into consideration that the diet of a breastfeeding woman is not always the best, there is no doubt about the need to continue multivitamin intake during breastfeeding. The question on the doses of vitamins

  13. Continuous infusion versus intermittent flushing to prevent loss of function of peripheral intravenous catheters used for drug administration in newborn infants.

    Science.gov (United States)

    Flint, A; McIntosh, D; Davies, M W

    2005-10-19

    The use of peripheral intravenous cannulae is common in newborn babies. Many of them require an intravenous line only for medications and not for fluid. Currently there is little uniformity in methods used to maintain cannula patency. The object of this review was to determine which method was better for maintaining intravenous lines used in neonates for intravenous medication only: intermittent flushing or continuous infusion We searched The Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 2, 2004), CINAHL (from 1982 to June 2004) and MEDLINE (from 1966 to June 2004) . Randomised controlled trials comparing continuous infusion to intermittent flushing to maintain patency of intravenous cannulas. Units of randomisation might include individual catheters or individual babies. Three reviewers independently assessed trial quality and extracted data. Two studies were eligible for inclusion. In one study only one of our primary outcomes was available: the duration of cannula patency for the first cannula used per infant was slightly longer in the continuous infusion group, but not significantly so, with a mean difference of -4.3 hours (95% CI -18.2 to 9.7). In the second study, only one of our primary outcomes was available: the mean (SD) number cannulas used per infant in the first 48 hours was less in the intermittent flush group with a mean difference of -0.76 cannulas (95% CI -1.37 to -0.15). No results were available for any of our other primary outcomes: in the published report, results were reported per catheter rather than per infant, a number of infants received more than one intravenous catheter (39 infants received an unknown number of catheters). The overall duration of cannula patency was significantly longer in the intermittent flush group with a mean duration of patency in the intermittent flush group of 2.1 days (SD 1.0) compared with the continuous infusion group where the mean duration of patency was 1.0 days (SD 0

  14. High blood pressure - infants

    Science.gov (United States)

    Hypertension - infants ... and blood vessels The health of the kidneys High blood pressure in infants may be due to kidney or ... blood vessel of the kidney) In newborn babies, high blood pressure is often caused by a blood clot in ...

  15. Neurally adjusted ventilatory assist (NAVA) in preterm newborn infants with respiratory distress syndrome-a randomized controlled trial.

    Science.gov (United States)

    Kallio, Merja; Koskela, Ulla; Peltoniemi, Outi; Kontiokari, Tero; Pokka, Tytti; Suo-Palosaari, Maria; Saarela, Timo

    2016-09-01

    Neurally adjusted ventilatory assist (NAVA) improves patient-ventilator synchrony during invasive ventilation and leads to lower peak inspiratory pressures (PIP) and oxygen requirements. The aim of this trial was to compare NAVA with current standard ventilation in preterm infants in terms of the duration of invasive ventilation. Sixty infants born between 28 + 0 and 36 + 6 weeks of gestation and requiring invasive ventilation due to neonatal respiratory distress syndrome (RDS) were randomized to conventional ventilation or NAVA. The median durations of invasive ventilation were 34.7 h (quartiles 22.8-67.9 h) and 25.8 h (15.6-52.1 h) in the NAVA and control groups, respectively (P = 0.21). Lower PIPs were achieved with NAVA (P = 0.02), and the rapid reduction in PIP after changing the ventilation mode to NAVA made following the predetermined extubation criteria challenging. The other ventilatory and vital parameters did not differ between the groups. Frequent apneas and persistent pulmonary hypertension were conditions that limited the use of NAVA in 17 % of the patients randomized to the NAVA group. Similar cumulative doses of opiates were used in both groups (P = 0.71). NAVA was a safe and feasible ventilation mode for the majority of preterm infants suffering from RDS, but the traditional extubation criteria were not clinically applicable during NAVA. • NAVA improves patient-ventilator synchrony during invasive ventilation. • Lower airway pressures and oxygen requirements are achieved with NAVA during invasive ventilation in preterm infants by comparison with conventional ventilation. What is new: • Infants suffering from PPHN did not tolerate NAVA in the acute phase of their illness. • The traditional extubation criteria relying on inspiratory pressures and spontaneous breathing efforts were not clinically applicable during NAVA.

  16. Amino acid composition of parturient plasma, the intervillous space of the placenta and the umbilical vein of term newborn infants

    Directory of Open Access Journals (Sweden)

    J.S. Camelo Jr.

    2004-05-01

    Full Text Available The objective of the present study was to determine the levels of amino acids in maternal plasma, placental intervillous space and fetal umbilical vein in order to identify the similarities and differences in amino acid levels in these compartments of 15 term newborns from normal pregnancies and deliveries. All amino acids, except tryptophan, were present in at least 186% higher concentrations in the intervillous space than in maternal venous blood, with the difference being statistically significant. This result contradicted the initial hypothesis of the study that the plasma amino acid levels in the placental intervillous space should be similar to those of maternal plasma. When the maternal venous compartment was compared with the umbilical vein, we observed values 103% higher on the fetal side which is compatible with currently accepted mechanisms of active amino acid transport. Amino acid levels of the placental intervillous space were similar to the values of the umbilical vein except for proline, glycine and aspartic acid, whose levels were significantly higher than fetal umbilical vein levels (average 107% higher. The elevated levels of the intervillous space are compatible with syncytiotrophoblast activity, which maintain high concentrations of free amino acids inside syncytiotrophoblast cells, permitting asymmetric efflux or active transport from the trophoblast cells to the blood in the intervillous space. The plasma amino acid levels in the umbilical vein of term newborns probably may be used as a standard of local normality for clinical studies of amino acid profiles.

  17. Anemia in the Newborn

    Science.gov (United States)

    ... Version Blood Problems in Newborns Anemia in the Newborn Hemolytic Disease of the Newborn Polycythemia in the Newborn (See ... faster. Blood Problems in Newborns Anemia in the Newborn Hemolytic Disease of the Newborn Polycythemia in the Newborn NOTE: ...

  18. Functional residual capacity (FRC) and lung clearance index (LCI) in mechanically ventilated infants: application in the newborn with congenital diaphragmatic hernia (CDH).

    Science.gov (United States)

    Landolfo, Francesca; Savignoni, Ferdinando; Capolupo, Irma; Columbo, Claudia; Calzolari, Flaminia; Giliberti, Paola; Chukhlantseva, Natalia; Bagolan, Pietro; Dotta, Andrea

    2013-07-01

    volumes and ventilation inhomogeneity also in ventilated infants. NIRS is a non-invasive technique to monitor tissue oxygenation during surgery and mechanical ventilation. In CDH newborns these preliminary data show an improvement in both FRC and LCI after extubation. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Parental experiences of providing skin-to-skin care to their newborn infant--part 2: a qualitative meta-synthesis.

    Science.gov (United States)

    Anderzén-Carlsson, Agneta; Lamy, Zeni C; Tingvall, Maria; Eriksson, Mats

    2014-01-01

    To synthesize and interpret qualitative research findings focusing on parental experiences of skin-to-skin care (SSC) for newborn infants. SSC induces many benefits for newborn infants and their parents. Three meta-analyses have been conducted on physiological outcomes, but no previous qualitative meta-synthesis on parental experiences of SSC has been identified. The present meta-synthesis was guided by the methodology described by Paterson and co-workers. Four databases were searched, without year or language limitations, up until December 2013. Manual searches were also performed. The searches and subsequent quality appraisal resulted in the inclusion of 29 original qualitative papers from 9 countries, reporting experiences from 401 mothers and 94 fathers. The meta-synthesis entails a meta-data analysis, analysis of meta-method, and meta-theory in the included primary studies. Based on the three analyses, the meta-synthesis represents a new interpretation of a phenomenon. The results of the meta-data analysis have been presented as a qualitative systematic review in a separate paper. When synthesizing and interpreting the findings from the included analyses, a theoretical model of Becoming a parent under unfamiliar circumstances emerged. Providing SSC seems to be a restorative as well as an energy-draining experience. A supportive environment has been described as facilitating the restorative experience, whereas obstacles in the environment seem to make the provision of SSC energy-draining for parents. When the process is experienced as positive, it facilitates the growth of parental self-esteem and makes the parents ready to assume full responsibility for their child. The results show that SSC can be interpreted not only as a family-including and important health care intervention but also in terms of actually becoming a parent. The process of becoming a parent in this specific situation is influenced by external factors in three different levels; family and

  20. Antibiotic sensitivity of bacterial strains isolated from newborn infants Sensibilidad a los antibióticos de bacterias aisladas de neonatos hospitalizados

    Directory of Open Access Journals (Sweden)

    Alvaro Uribe

    1990-02-01

    Full Text Available

    Eighty nine bacterial strains isolated from newborn infants hospitalized at a Special Care Unit in Medellin, Colombia, were studied. The sensitivity of each one was determined by the Minimallnhibitory Concentration method against 21 antibiotics; a high frequency of resistance was found toward gentamycin, netilmycin, oxacillin, penicillin G and ampicillin, that are often employed as initial therapy in newborn infants; on the other hand both Gram positive and Gram negative bacteria exhibited high percentages of sensitivity against quinolones; aztreonam and third generation cephalosporins were also highly effective against Gram negative bacilli. On the basis of this new information the need to restate therapeutic conducts in the case of serious bacterial neonatal infections is emphasized.

    Se estudiaron 89 cepas bacterianas aisladas de neonatos hospitalizados en la sala de cuidados especiales de la Fundación Hospitalaria San Vicente de Paúl, de Medellín; a cada una se le determinó la sensibilidad frente a 21 antibióticos por el método de la concentración inhibitoria mínima (CIM; se halló una alta frecuencia de resistencia hacia la gentamicina, la netilmicina, la oxacilina y la ampicilina que se usan a menudo en esta institución como terapia inicial en las infecciones del recién nacido; por otra parte se demostraron altos porcentajes de sensibilidad hacia las quinolonas tanto de las bacterias gram positivas como de las gram negativas; contra estas últimas también fueron muy efectivos el aztreonam y las cefalosporinas de tercera generación. A la luz de esta nueva información se llama la atención hacia la necesidad de revaluar las normas de la antibioterapia en las infecciones graves del recién nacido.

  1. The influence of maternal vaginal flora on the intestinal colonization in newborns and 3-month-old infants.

    Science.gov (United States)

    Gabriel, Iwona; Olejek, Anita; Stencel-Gabriel, Krystyna; Wielgoś, Miroslaw

    2018-06-01

    The role of maternal vaginal bacteria on the colonization of neonatal gut is still a matter of discussion. Our aim was to estimate the role of maternal vaginal flora on the development of intestinal flora in neonates and 3-month-old infants. Seventy-nine maternal-neonatal pairs were included in the study. Vaginal swabs were taken before the rupture of membranes after admission to the delivery ward. First neonatal stool (meconium) and stool at 3-month-old infants were collected and cultured. All samples were subjected to microbiological analysis for Streptococcus, Staphylococcus, Bifidobacterium, Clostridium (including C. difficile), Lactobacillus, Escherichia coli, Klebsiella pneumoniae, and Candida. Maternal vagina was colonized mainly by streptococci (67%) followed by lactobacilli (58%) and Candida spp. (39%). Vaginal streptococci influenced the intestinal colonization in infants with staphylococci, C. difficile, and candida. Vaginal lactobacilli influenced colonization with C. difficile, and Candida. Vaginal flora is a potent factor influencing the development of bacterial flora in the neonatal and infantile gut. The extension of the observation period until 3 months of life allow to discover the potential changes in the intestinal flora of children.

  2. Can tissue oxygenation index (TOI) and cotside neurophysiological variables predict outcome in depressed/asphyxiated newborn infants?

    Science.gov (United States)

    Zaramella, Patrizia; Saraceni, Elisabetta; Freato, Federica; Falcon, Elena; Suppiej, Agnese; Milan, Anna; Laverda, Anna Maria; Chiandetti, Lino

    2007-08-01

    Diagnostic tools of birth asphyxia provide only an uncertain prediction of neurological outcome. To assess whether TOI and DeltaCBV, combined with a set of biochemical and neurophysiological variables, have any diagnostic and prognostic value in birth depression or asphyxia. Case control study at the nursery and NICU of the Padova University Children's Hospital. 22 term neonates with an Apgar score or = 36 weeks; 15 healthy term infants with an Apgar score > or = 9 at 5'. Troponin I and NIRS measurements (TOI and DeltaCBV) were assessed in both groups. Blood gases, neurological evaluation, US, NIRS, EEG and SEP were evaluated in the infants with depression or asphyxia. Troponin I was higher in the study group than in controls (p=0.04), showing a correlation with base excess values. In the depressed/asphyxiated neonates with an abnormal outcome at 1 year, TOI rose to 80.1% vs 66.4% in controls (p=0.04) and 74.7% in infants with a normal 1-year outcome. A multiple regression model showed a significant multiple correlation coefficient, R=0.79, p<0.001, where the predictive variables significantly associated with outcome were SEP and BE. Troponin I is a useful short-term index of birth asphyxia or perinatal depression. An increased TOI suggests a risk of abnormal neurological outcome at 1 year. Among the cotside variables, BE and evoked potential abnormalities were the best predictors of abnormal outcome in this study.

  3. Adverse reactions to the Bacillus Calmette-Guérin (BCG) vaccine in new-born infants

    DEFF Research Database (Denmark)

    Nørrelykke Nissen, Thomas; Birk, Nina Marie; Kjærgaard, Jesper

    2016-01-01

    OBJECTIVE: To evaluate adverse reactions of the Bacillus Calmette-Guérin (BCG) Statens Serum Institut (SSI) (Danish strain 1331) used as intervention in a randomized clinical trial. DESIGN: A randomized clinical multicenter trial, The Danish Calmette Study, randomizing newborns to BCG...... and eighty four families consented to participate and 4262 children, gestational age 32 weeks and above, were randomized: 2129 to BCG vaccine and 2133 to no vaccine. None of the participants withdrew because of adverse reactions. MAIN OUTCOME AND MEASURE: Trial-registered adverse reactions after BCG...... vaccination at birth. Follow-up at 3 and 13 months by telephone interviews and clinical examinations. RESULTS: Among the 2118 BCG-vaccinated children we registered no cases of severe unexpected adverse reaction related to BCG vaccination and no cases of disseminated BCG disease. Two cases of regional...

  4. Minimally invasive, imaging guided virtual autopsy compared to conventional autopsy in foetal, newborn and infant cases: study protocol for the paediatric virtual autopsy trial

    Science.gov (United States)

    2014-01-01

    Background In light of declining autopsy rates around the world, post-mortem MR imaging is a promising alternative to conventional autopsy in the investigation of infant death. A major drawback of this non-invasive autopsy approach is the fact that histopathological and microbiological examination of the tissue is not possible. The objective of this prospective study is to compare the performance of minimally invasive, virtual autopsy, including CT-guided biopsy, with conventional autopsy procedures in a paediatric population. Methods/Design Foetuses, newborns and infants that are referred for autopsy at three different institutions associated with the University of Zurich will be eligible for recruitment. All bodies will be examined with a commercial CT and a 3 Tesla MRI scanner, masked to the results of conventional autopsy. After cross-sectional imaging, CT-guided tissue sampling will be performed by a multifunctional robotic system (Virtobot) allowing for automated post-mortem biopsies. Virtual autopsy results will be classified with regards to the likely final diagnosis and major pathological findings and compared to the results of conventional autopsy, which remains the diagnostic gold standard. Discussion There is an urgent need for the development of alternative post-mortem examination methods, not only as a counselling tool for families and as a quality control measure for clinical diagnosis and treatment but also as an instrument to advance medical knowledge and clinical practice. This interdisciplinary study will determine whether virtual autopsy will narrow the gap in information between non-invasive and traditional autopsy procedures. Trial Registration ClinicalTrials.gov: NCT01888380 PMID:24438163

  5. Guidelines for the clinical management and follow-up of infants with inconclusive cystic fibrosis diagnosis through newborn screening.

    Science.gov (United States)

    Sermet-Gaudelus, I; Brouard, J; Audrézet, M-P; Couderc Kohen, L; Weiss, L; Wizla, N; Vrielynck, S; LLerena, K; Le Bourgeois, M; Deneuville, E; Remus, N; Nguyen-Khoa, T; Raynal, C; Roussey, M; Girodon, E

    2017-12-01

    Neonatal screening for cystic fibrosis (CF) can detect infants with elevated immunoreactive trypsinogen (IRT) levels and inconclusive sweat tests and/or CFTR DNA results. These cases of uncertain diagnosis are defined by (1) either the presence of at most one CF-associated cystic fibrosis transmembrane conductance regulator (CFTR) mutation with sweat chloride values between 30 and 59mmol/L or (2) two CFTR mutations with at least one of unknown pathogenic potential and a sweat chloride concentration below 60mmol/L. This encompasses various clinical situations whose progression cannot be predicted. In these cases, a sweat chloride test has to be repeated at 12 months, and if possible at 6 and 24 months of life along with extended CFTR sequencing to detect rare mutations. When the diagnosis is not definite, CFTR functional explorations may provide a better understanding of CFTR dysfunction. The initial evaluation of these infants must be conducted in dedicated CF reference centers and should include bacteriological sputum analysis, chest radiology, and fecal elastase assay. The primary care physicians in charge of these patients should be familiar with the current management of CF and should work in collaboration with CF centers. A follow-up should be performed in a CF reference center at 3, 6, and 12 months of life and every year thereafter. Any symptom indicative of CF requires immediate reevaluation of the diagnosis. These guidelines were established by the "neonatal screening and difficult diagnoses" working group of the French CF society. Their objective is to standardize the management of infants with unclear diagnosis. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  6. Effect of neonatal resuscitation courses on long-term neurodevelopmental outcomes of newborn infants with perinatal asphyxia.

    Science.gov (United States)

    Duran, Ridvan; Görker, Işik; Küçükuğurluoğlu, Yasemin; Çiftdemir, Nükhet Aladağ; Vatansever Özbek, Ulfet; Acunaş, Betül

    2012-02-01

    In previous studies, it has been demonstrated that Neonatal Resuscitation Program (NRP) courses improve the early outcomes of infants with perinatal asphyxia, but there has been no evidence to demonstrate the effect of NRP on long-term outcomes of perinatal asphyxia. The goal of the present study was to determine the effect of NRP courses on the long-term neurodevelopmental outcome of perinatal asphyxia. This prospective study included infants referred to the Neonatal Unit during the years 2003-2005. Those patients who were referred before NRP courses (pretraining period) were designated as group 1, those who were referred after the first NRP course (transition period) as group 2, and those who were referred after the second NRP course (post-training period) as group 3. Neurodevelopmental outcomes were assessed and compared at 4-6 years of age. The study involved 40 patients: 23 in group 1, nine in group 2 and eight in group 3. The number of patients who had been diagnosed with cerebral palsy was 13 in group 1, two in group 2, and one in group 3, which was a significant decrease. The number of patients with seizures and electroencephalography abnormality was 12 and 14 in group 1, three and two in group 2, and one and one in group 3, respectively, which was also a significant decrease. NRP courses have positive effects on short-term as well as long-term neurodevelopmental outcomes of infants with perinatal asphyxia. Further studies are required to determine the effects of NRP courses on minor deficits, such as cognitive and behavioral disturbances. © 2011 The Authors. Pediatrics International © 2011 Japan Pediatric Society.

  7. [Reversibility of cardiomyopathy after therapy of incessant left ventricular tachycardia with radiofrequency ablation in a newborn infant].

    Science.gov (United States)

    Benito Bartolomé F; Sánchez Fernández-Bernal C

    2000-08-01

    We present a 15-month-old infant with tachycardia-induced cardiomyopathy secondary to idiopathic left ventricular tachycardia, which was incessant despite medical treatment. In the electrocardiogram, the tachycardia showed right bundle branch morphology and left superior axis deviation and was successfully ablated with the application of radiofrequency in the inferior apical septal region of the left ventricle. One week after the procedure the shortening fraction increased from 12% to 30% and at 18 months of follow-up the patient is tachycardia-free.

  8. Intrauterine Growth Restriction and the Fetal Programming of the Hedonic Response to Sweet Taste in Newborn Infants

    Directory of Open Access Journals (Sweden)

    Caroline Ayres

    2012-01-01

    Full Text Available Intrauterine growth restriction is associated with increased risk for adult metabolic syndrome and cardiovascular disease, which seems to be related to altered food preferences in these individuals later in life. In this study, we sought to understand whether intrauterine growth leads to fetal programming of the hedonic responses to sweet. Sixteen 1-day-old preterm infants received 24% sucrose solution or water and the taste reactivity was filmed and analyzed. Spearman correlation demonstrated a positive correlation between fetal growth and the hedonic response to the sweet solution in the first 15 seconds after the offer (r=0.864, P=0.001, without correlation when the solution given is water (r=0.314, P=0.455. In fact, the more intense the intrauterine growth restriction, the lower the frequency of the hedonic response observed. IUGR is strongly correlated with the hedonic response to a sweet solution in the first day of life in preterm infants. This is the first evidence in humans to demonstrate that the hedonic response to sweet taste is programmed very early during the fetal life by the degree of intrauterine growth. The altered hedonic response at birth and subsequent differential food preference may contribute to the increased risk of obesity and related disorders in adulthood in intrauterine growth-restricted individuals.

  9. A Continuous Quality Improvement Project to Implement Infant-Driven Feeding as a Standard of Practice in the Newborn/Infant Intensive Care Unit.

    Science.gov (United States)

    Chrupcala, Kimberly A; Edwards, Taryn M; Spatz, Diane L

    2015-01-01

    To increase the number of neonates who were fed according to cues prior to discharge and potentially decrease length of stay. Continuous quality improvement. Eighty-five bed level IV neonatal intensive care unit. Surgical and nonsurgical neonates of all gestational ages. Neonates younger than 32 weeks gestation, who required intubation, continuous positive airway pressure (CPAP), high flow nasal cannula (HFNC), or did not have suck or gag reflexes were excluded as potential candidates for infant-driven feeding. The project was conducted over a 13-month period using the following methods: (a) baseline data collection, (b) designation of Infant Driven Feeding (IDF) Champions, (c) creation of a multidisciplinary team, (d) creation of electronic health record documentation, (e) initial staff education, (f) monthly team meetings, (g) reeducation throughout the duration of the project, and (h) patient-family education. Baseline data were collected on 20 neonates with a mean gestational age of 36 0/7(th) weeks and a mean total length of stay (LOS) of 43 days. Postimplementation data were collected on 150 neonates with a mean gestational age of 36 1/7(th) weeks and a mean total LOS of 36.4 days. A potential decrease in the mean total LOS of stay by 6.63 days was achieved during this continuous quality improvement (CQI) project. Neonates who are fed according to cues can become successful oral feeders and can be safely discharged home regardless of gestational age or diagnosis. © 2015 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  10. Quality of newborn care: adherence to guidelines for parenteral nutrition in preterm infants in four European countries.

    Science.gov (United States)

    Lapillonne, Alexandre; Carnielli, Virgilio Paolo; Embleton, Nicholas David; Mihatsch, Walter

    2013-09-18

    The level of adherence to guidelines should be explored particularly in preterm infants for whom poor nutrition has major effects on outcomes in later life. The objective was to evaluate compliance to international guidelines for parenteral nutrition (PN) in preterm infants across neonatal intensive care units (NICUs) of four European countries. Clinical practice survey by means of a questionnaire addressing routine PN protocols, awareness and implementation of guidelines. NICUs in the UK, Italy, Germany and France. One senior physician per unit; 199 units which represent 74% of the NICUs of the four countries. Adherence of unit protocol to international guidelines. Factors that influence adherence to guidelines. 80% of the respondents stated that they were aware of some PN clinical practice guidelines. For amino acid infusion (AA), 63% of the respondents aimed to initiate AA on D0, 38% aimed to administer an initial dose ≥1.5 g/kg/day and 91% aimed for a target dose of 3 or 4 g/kg/day, as recommended. For parenteral lipids, 90% of the respondents aimed to initiate parenteral lipids during the first 3 days of life, 39% aimed to use an initial dose ≥1.0 g/kg/day and 76% defined the target dose as 3-4 g/kg/day, as recommended. Significant variations in PN protocols were observed among countries, but the type of hospital or the number of admissions per year had only a marginal impact on the PN protocols. Most respondents indicated that their clinical practice was based on common guidelines. However, the initiation of PN is frequently not compliant with current recommendations, with the main differences being observed during the first days of life. Continuous education focusing on PN practice is needed, and greater efforts are required to disseminate and implement international guidelines.

  11. [Evolution of the frequency of congenital defects in newborn infants and fetuses from terminations of pregnancy after prenatal diagnosis in the period 1982-2009].

    Science.gov (United States)

    Sanchis Calvo, Amparo; Roselló-Sastre, Esther; Marcos Puig, Beatriz; Balanzá Chancosa, Reyes; Pérez Ebri, María Luisa; Alcover Barrachina, Inmaculada; Camarasa Lillo, Natalia; Bermejo-Sánchez, Eva; Escandón Alvarez, Jorge

    2013-08-17

    The study of congenital defects (CD) must include termination of pregnancy (TOP) for CD and evaluate risk factors that modify their frequency. Consecutive series of 517 newborn and 202 TOP with CD among 38,191 childbirths, between 1982-2009 years. The mean frequency for newborns with CD is 13.54‰ and for newborn and TOP with CD is 18.73‰. Single CD are 61.12% in newborns and 52.17% in TOP. The 18.37% of CD in newborn and 40.58% of TOP are syndromic. Mean gestational age for TOP is 17.92 weeks. Overall frequency of anencephaly is 2.62‰ for newborns and 6.77 for 10,000 for newborns and TOP. Spina bifida is 3.14 for 10,000 newborns and 5.99 for 10,000 newborns and TOP. Overall frequency of Down syndrome (DS) is 10.74 for 10,000 newborns and 22.14 for 10,000 newborns and TOP. The percentage of foreign mothers was 35.9% in 2009 and the mean maternal age significantly increased in this period. We observe a significant decrease of CD in newborns but not in their conception. We have not detected primary prevention for neural tube defects. The decrease in DS in newborns is not statistically relevant but ethnic diversity and maternal aging may be modifying the frequency. The 53% of CD were TOP in the period 2007-2009. It is mandatory a complete study for CD in TOP in order to offer serious reproductive counselling. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  12. Relationship Between Cerebral Oxygenation and Metabolism During Rewarming in Newborn Infants After Therapeutic Hypothermia Following Hypoxic-Ischemic Brain Injury.

    Science.gov (United States)

    Mitra, Subhabrata; Bale, Gemma; Meek, Judith; Uria-Avellanal, Cristina; Robertson, Nicola J; Tachtsidis, Ilias

    2016-01-01

    Therapeutic hypothermia (TH) has become a standard of care following hypoxic ischemic encephalopathy (HIE). After TH, body temperature is brought back to 37 °C over 14 h. Lactate/N-acetylasperatate (Lac/NAA) peak area ratio on proton magnetic resonance spectroscopy ((1)H MRS) is the best available outcome biomarker following HIE. We hypothesized that broadband near infrared spectroscopy (NIRS) measured changes in the oxidation state of cytochrome-c-oxidase concentration (Δ[oxCCO]) and cerebral hemodynamics during rewarming would relate to Lac/NAA. Broadband NIRS and systemic data were collected during rewarming from 14 infants following HIE over a mean period of 12.5 h. (1)H MRS was performed on day 5-9. Heart rate increased by 20/min during rewarming while blood pressure and peripheral oxygen saturation (SpO2) remained stable. The relationship between mitochondrial metabolism and oxygenation (measured as Δ[oxCCO] and Δ[HbD], respectively) was calculated by linear regression analysis. This was reviewed in three groups: Lac/NAA values 1. Mean regression coefficient (r (2)) values in these groups were 0.41 (±0.27), 0.22 (±0.21) and 0.01, respectively. The relationship between mitochondrial metabolism and oxygenation became impaired with rising Lac/NAA. Cardiovascular parameters remained stable during rewarming.

  13. Dopamine therapy is associated with impaired cerebral autoregulation in preterm infants

    DEFF Research Database (Denmark)

    Eriksen, Vibeke R; Hahn, Gitte H; Greisen, Gorm

    2014-01-01

    , but the anticipated difference in cerebral oxygenation was not detected. The need for mechanical ventilation in the first day of life and incidences of mortality was higher in the dopamine group. CONCLUSION: Dopamine therapy was associated with decreased CA in preterm infants. We were unable to determine whether......AIM: Hypotension is a common problem in newborn infants and is associated with increased mortality and morbidity. Dopamine is the most commonly used antihypotensive drug therapy, but has never been shown to improve neurological outcomes. This study tested our hypothesis that dopamine affects...

  14. Warmth is Analgesic in Healthy Newborns

    Science.gov (United States)

    Lang, Colleen W.; Porges, Stephen W.

    2014-01-01

    This study identifies a behavioral and nonpharmacologic means of preventing and reducing newborn pain. Our objective was to determine whether warmth is analgesic in newborn infants undergoing vaccination—a routine painful hospital procedure. We used a prospective randomized controlled trial of 47 healthy full-term newborn infants. Infants were randomized into one of three conditions prior to vaccination: warmth exposure, pacifier suckling, or sucrose taste. Crying, grimacing, and heart rate differences were analyzed between groups before, during, and after vaccination as outcome measures. Warmer infants cried significantly less than sucrose taste or pacifier suckling after vaccination. Heart rate patterns reflected this analgesia. Core temperature did not differ between study groups. Providing natural warmth to newborn infants during a painful procedure decreases the crying and grimacing on par with the “gold” standard treatments of sucrose or pacifier. PMID:22424877

  15. [Chromosome aberrations in malformed newborns].

    Science.gov (United States)

    Centeno Malfaz, F; Beltrán Pérez, A; Ruiz Labarga, C; Centeno Robles, T; Macías Pardal, J; Martín Bermejo, M

    2001-06-01

    To determine the prevalence of chromosome abnormalities in malformed newborn infants and to analyze the distribution of the types of anomalies, and the variation in their frequency with maternal age. We used the data collected according to the Spanish Collaborative Study of Congenital Malformations (ECEMC) methodology from March 1982 -September 1996. Of 33,562 newborns (live and stillborn), 1,409(4.1%) malformed infants were identified. A total of 332 karyotypes were performed in peripheral blood, representing 23.5% of the newborns with congenital defects. Results The frequency at birth of chromosome abnormalities was 5.4% of malformed newborns. There were 59 infants with Down's syndrome, 6 with trisomy 18, 3 with Turner's syndrome, 2 with trisomy 13, 2 with "Triple X", 1 tetraploidy, 1 triploidy, 1 trisomy 9 p, and 1 infant with a complex XXY mosaicism. The prevalence of Down's syndrome in the general population is 0.17%. The mean age of mothers with Down's syndrome infants was 34.2 years and paternal age was 36 years, and a non-statistically significant diminishing trend in mean maternal age was observed during the course of the study. The prevalence of Down's syndrome was higher in mothers aged more than 35 years. A non-statistically significant increase of the prevalence of Down's syndrome in newborns with mothers aged between 31 and 34 years was observed with time. The mean number of previous pregnancies was 2.81. Among a total of 49 mothers and fathers, two chromosome alterations were found. The prevalence of chromosome abnormalities in newborns with birth defects was 5.4%. The frequency of Down's syndrome was higher. Down's syndrome was more prevalent in mothers aged more than 35 years. The mean maternal age of Down's syndrome infants gradually diminished, and accumulated between the ages of 31 and 34 years.

  16. Agreement between Cochrane Neonatal reviews and clinical practice guidelines for newborns in Denmark a cross sectional study

    DEFF Research Database (Denmark)

    Brok, Jesper; Greisen, Gorm; Madsen, Lars P

    2007-01-01

    OBJECTIVE: To assess agreement between Cochrane Neonatal Group reviews and clinical practice guidelines in Denmark. DESIGN: Retrospective analysis of clinical guidelines for newborn infants. Materials:All Cochrane neonatal reviews and Danish local clinical guidelines for newborn infants. MAIN OUT...

  17. Prevalência de retinopatia da prematuridade em recém-nascidos de muito baixo peso The prevalence of retinopathy of prematurity in very low birth weight newborn infants

    Directory of Open Access Journals (Sweden)

    Viviane Levy Lermann

    2006-02-01

    . METHODS: A cross-sectional study investigating all newborn infants with birth weights > 1,500 g and/or gestational ages > 32 weeks, admitted to the Neonatal ICU at the Hospital de Clínicas de Porto Alegre, from October 2002 to March 2004. Patients underwent indirect binocular ophthalmoscopy of the fundus at six weeks postpartum. Infants who progressed to threshold disease were given laser therapy. RESULTS: One hundred and fourteen newborn infants were studied. Eighty-three patients were not diagnosed with retinopathy of prematurity, 18 had stage I retinopathy of prematurity, seven stage II retinopathy of prematurity and six patients had threshold retinopathy of prematurity. The prevalence of retinopathy of prematurity was 27.2% (95% CI: 19.28-36.32 affecting 31 newborn infants, and the prevalence of retinopathy of prematurity progressing to threshold disease was 5.26% (95% CI: 1.96-11.10, affecting six patients. Retinopathy of prematurity was confirmed in 50% of the patients with weights below 1,000 g and 71.5% of newborn infants born at gestational ages of less than 28 weeks. Gestational age and birth weight were significantly lower among patients with retinopathy of prematurity than among those without. CONCLUSIONS: Although the results of this study demonstrate that the observed prevalence was similar to that described in literature, this ROP frequency remains elevated among very low birth weight infants. The development of retinopathy of prematurity was inversely proportional to weight and gestational age at birth.

  18. The role of broth enrichment in Staphylococcus aureus cultivation and transmission from the throat to newborn infants: results from the Swedish hygiene intervention and transmission of S. aureus study.

    Science.gov (United States)

    Mernelius, S; Löfgren, S; Lindgren, P-E; Matussek, A

    2013-12-01

    Staphylococcus aureus is detected by direct plating, whereas incubation in enrichment broth prior to plating to increase the proportion of positive samples has not been fully evaluated. S. aureus throat colonization has been suggested to be more common than colonization of the anterior nares, but no data are available on the transmission of S. aureus from the throat. Swab samples were collected from the anterior nares and umbilicus from newborn infants (n = 168), anterior nares, throat, skin lesions, and vagina from parents (n = 332), and anterior nares, throat, and skin lesions from healthcare workers (n = 231) at three maternity wards. spa typing was used to elucidate the transmission routes of S. aureus. The use of enrichment broth prior to plating increased the proportion of positive samples by 46%. The prevalence of S. aureus colonization in adults was 58%. Throat colonization (47%) was significantly more common than colonization in any of the other screened sites (p aureus transmissions to newborn infants were detected. Although we detected an increased risk of transmission from the nares as compared to the throat, with an odds ratio of 4.8 [95% confidence interval (CI) 1.8-12.7], we detected a transmission rate of 7 % from the throat. We show that S. aureus throat colonization is more common than colonization in any of the other sites among the parents and staff. We also show evidence of transmission from the throat.

  19. Clinical course in infants diagnosed with transient tachypnea of newborn: A clinical trial assessing the role of conservative versus conventional management

    Directory of Open Access Journals (Sweden)

    M. Dehdashtian

    2018-02-01

    Conclusion: Newborns diagnosed with TTN without prenatal risk factors and a negative C reactive protein test do not need to be administered antibiotics and hospitalized until confirmatory blood culture results are obtained.

  20. [The estimation nourishment methods of newborns and infants hospitalized in the Department of Pediatric Propedeutics and Bone Metabolism Diseases and analysis of factors which determinate the way of alimentation among these children].

    Science.gov (United States)

    Ligenza, Iwona; Jakubowska-Pietkiewicz, Elzbieta; Łupińska, Anna; Jastrzebska, Anna; Chlebna-Sokół, Danuta

    2009-06-01

    Despite so many advantages of natural feeding, according to the research led in Poland between 2000 and 2005, in the sixth month of life only 8% of infants were strictly breast-fed. The aim of the study was to analyze the factors which have the influence on choosing the way of feeding of children hospitalized in the Department of Pediatric Propedeutics and Bone Metabolism Diseases. The inquiry was established among parents of newborns and infants up to 1 year old, hospitalized in the Department of Pediatric Propedeutics and Bone Metabolism Diseases between January and May 2008. The research was led on the group of 93 children (39 newborns and 54 infants). The inquiry consists of questions about the cause and duration of hospitalization, perinatal interview, ways of nourishment and parents' personal data. At the time of leading the inquiry 27 children (29%) were fed strictly naturally, 36 (38.7%) were bottle-fed, 23 (24.73%) were fed in the mixed way, 6 (6.5%) were fed by the stomach tube and 1 child (1.1%) was fed parenterally. 44.1% of parents obtained information about breast-feeding from media, whereas only 3 (3.2%) got it from medical staff. The most common reason for giving up breast feeding was the lack (or too little amounts) of mother's milk. The doctor appeared to be the main person who decided to introduce formula-feeding. Among children naturally-fed 21 (77.8%) were given formula in the first twenty-four hours after the labour. The factors which appeared to influence the choice of the way of alimentation, in statistically important way (p alimentation. The health care system (perinatal, labour and basic care) concerning mother and child, doesn't promote natural feeding.

  1. Educação em saúde auditiva do neonato e lactente para profissionais de enfermagem Newborn and infant hearing health education for nursing professionals

    Directory of Open Access Journals (Sweden)

    Camila Padilha Barbosa

    2013-04-01

    professional participating (nurses, technicians and assistants working in a university hospital between March and September of 2011. All of the interviewees answered a semi-structured questionnaire before and after the educational actions. RESULTS: We observed a significant change in the knowledge of the nursing professionals after the educational activity in most of the variables; such as: ideal age to perform the newborn hearing screening; ideal age to diagnose hearing loss; ideal age to start intervention against hearing loss and risk indicators for hearing loss. CONCLUSION: It is believed that the methodology used in educational activities, based on problems found in professional practice, education may have contributed greatly to increase knowledge about hearing health, especially concerning neonates and infants.

  2. Cystic Fibrosis Diagnosis and Newborn Screening.

    Science.gov (United States)

    Rosenfeld, Margaret; Sontag, Marci K; Ren, Clement L

    2016-08-01

    The diagnosis of cystic fibrosis (CF) has evolved over the past decade as newborn screening has become universal in the United States and elsewhere. The heterogeneity of phenotypes associated with CF transmembrane conductance regulator (CFTR) dysfunction and mutations in the CFTR gene has become clearer, ranging from classic pancreatic-insufficient CF to manifestations in only 1 organ system to indeterminate diagnoses identified by newborn screening. The tools available for diagnosis have also expanded. This article reviews the newest diagnostic criteria for CF, newborn screening, prenatal screening and diagnosis, and indeterminate diagnoses in newborn-screened infants and symptomatic adults. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Prevention of the HBsAg carrier state in newborn infants of mothers who are chronic carriers of HBsAg and HBeAg by administration of hepatitis-B vaccine and hepatitis-B immunoglobulin. Double-blind randomised placebo-controlled study

    NARCIS (Netherlands)

    Wong, V. C.; Ip, H. M.; Reesink, H. W.; Lelie, P. N.; Reerink-Brongers, E. E.; Yeung, C. Y.; Ma, H. K.

    1984-01-01

    Newborn infants of Chinese HBeAg-carrier mothers in Hong Kong were randomly assigned to one of four study groups. Group I was treated with 3 micrograms heat-inactivated hepatitis B (HB) vaccine at birth and at 1, 2, and 6 months thereafter, in conjunction with seven monthly HBIg injections; group II

  4. ABO incompatibility hemolytic disease following exchange transfusion 96 newborn

    OpenAIRE

    Khatami S.F; Behjati SH.

    2007-01-01

    Background: ABO incompatibility hemolytic disease of the newborn is a common cause of clinical jaundice and causes two-thirds of the hemolytic disease in newborns. This study was undertaken to determine the frequency of ABO incompatibility hemolytic disease and its complications in newborns undergoing exchange transfusion.Methods: This prospective and descriptive study was performed in jaundiced newborn infants during a three-year period. Inclusion criteria were: maternal blood type O, newbor...

  5. Birth defects in children with newborn encephalopathy

    NARCIS (Netherlands)

    Felix, JF; Badawi, N; Kurinczuk, JJ; Bower, C; Keogh, JM; Pemberton, PJ

    2000-01-01

    This study was designed to investigate birth defects found in association with newborn encephalopathy. All possible birth defects were ascertained in a population-based study of 276 term infants with moderate or severe encephalopathy and 564 unmatched term control infants. A strong association

  6. Newborn Jaundice

    Science.gov (United States)

    ... Legacy Society Make Gifts of Stock Donate Your Car Personal Fundraising Partnership & Support Share Your Story Spread the Word Give While You Shop Contact Us Donate Now Jaundice In Newborns Back ...

  7. A case-control study to estimate the effectiveness of maternal pertussis vaccination in protecting newborn infants in England and Wales, 2012-2013.

    Science.gov (United States)

    Dabrera, Gavin; Amirthalingam, Gayatri; Andrews, Nick; Campbell, Helen; Ribeiro, Sonia; Kara, Edna; Fry, Norman K; Ramsay, Mary

    2015-02-01

    Infants with pertussis infection are at risk of severe clinical illness and death. Several countries, including the United Kingdom, have introduced maternal pertussis vaccination during pregnancy to protect infants from infection following national increases in pertussis notifications. The objective of this study was to estimate the effectiveness of maternal pertussis vaccination in protecting infants against laboratory-confirmed pertussis infection. A case-control study was undertaken in England and Wales between October 2012 and July 2013. Cases were infants aged pertussis infection tested by real-time polymerase chain reaction or culture. Family doctors of each case were asked to identify healthy infants born consecutively after the case in each practice, to act as controls. Fifty-eight cases and 55 controls were included in this study. Odds ratios (ORs) were calculated for the association between maternal vaccination and infant pertussis infection. The vaccine effectiveness (VE) was calculated as 1 - OR. This was adjusted for sex, geographical region, and birth period. Mothers of 10 cases (17%) and 39 controls (71%) received pertussis vaccine in pregnancy. This gave an unadjusted VE of 91% (95% confidence interval [CI], 77%-97%). Adjusted VE was 93% (95% CI, 81%-97%). Maternal pertussis vaccination is effective in preventing pertussis infection in infants aged pertussis notifications. © Crown copyright 2014.

  8. Risk factors and adverse perinatal outcomes among term and preterm infants born small-for-gestational-age: secondary analyses of the WHO Multi-Country Survey on Maternal and Newborn Health.

    Directory of Open Access Journals (Sweden)

    Erika Ota

    Full Text Available Small for gestational age (SGA is not only a major indicator of perinatal mortality and morbidity, but also the morbidity risks in later in life. We aim to estimate the association between the birth of SGA infants and the risk factors and adverse perinatal outcomes among twenty-nine countries in Africa, Latin America, the Middle East and Asia in 359 health facilities in 2010-11.We analysed facility-based, cross-sectional data from the WHO Multi-country Survey on Maternal and Newborn Health. We constructed multilevel logistic regression models with random effects for facilities and countries to estimate the risk factors for SGA infants using country-specific birthweight reference standards in preterm and term delivery, and SGA's association with adverse perinatal outcomes. We compared the risks and adverse perinatal outcomes with appropriate for gestational age (AGA infants categorized by preterm and term delivery.A total of 295,829 singleton infants delivered were analysed. The overall prevalence of SGA was highest in Cambodia (18.8%, Nepal (17.9%, the Occupied Palestinian Territory (16.1%, and Japan (16.0%, while the lowest was observed in Afghanistan (4.8%, Uganda (6.6% and Thailand (9.7%. The risk of preterm SGA infants was significantly higher among nulliparous mothers and mothers with chronic hypertension and preeclampsia/eclampsia (aOR: 2.89; 95% CI: 2.55-3.28 compared with AGA infants. Higher risks of term SGA were observed among sociodemographic factors and women with preeclampsia/eclampsia, anaemia and other medical conditions. Multiparity (> = 3 (AOR: 0.88; 95% CI: 0.83-0.92 was a protective factor for term SGA. The risk of perinatal mortality was significantly higher in preterm SGA deliveries in low to high HDI countries.Preterm SGA is associated with medical conditions related to preeclampsia, but not with sociodemographic status. Term SGA is associated with sociodemographic status and various medical conditions.

  9. Culex mosquitoes are experimentally unable to transmit Zika virus.

    Science.gov (United States)

    Amraoui, Fadila; Atyame-Nten, Célestine; Vega-Rúa, Anubis; Lourenço-de-Oliveira, Ricardo; Vazeille, Marie; Failloux, Anna Bella

    2016-09-01

    We report that two laboratory colonies of Culex quinquefasciatus and Culex pipiens mosquitoes were experimentally unable to transmit ZIKV either up to 21 days post an infectious blood meal or up to 14 days post intrathoracic inoculation. Infectious viral particles were detected in bodies, heads or saliva by a plaque forming unit assay on Vero cells. We therefore consider it unlikely that Culex mosquitoes are involved in the rapid spread of ZIKV. This article is copyright of The Authors, 2016.

  10. Sleep and Newborns

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Sleep and Newborns KidsHealth / For Parents / Sleep and Newborns ... night it is. How Long Will My Newborn Sleep? Newborns should get 14 to 17 hours of ...

  11. Thrush in newborns

    Science.gov (United States)

    Candidiasis - oral - newborn; Oral thrush - newborn; Fungal infection - mouth - newborn; Candida - oral - newborn ... thrush. You paint this medicine on your baby's mouth and tongue. If you have a yeast infection on your nipples, your provider may recommend an ...

  12. Anemia in the Newborn

    Science.gov (United States)

    ... Overview of Biliary Atresia Additional Content Medical News Anemia in the Newborn By Andrew W. Walter, MS ... for the Professional Version Blood Problems in Newborns Anemia in the Newborn Hemolytic Disease of the Newborn ...

  13. Clinical course in infants diagnosed with transient tachypnea of newborn: A clinical trial assessing the role of conservative versus conventional management.

    Science.gov (United States)

    Dehdashtian, M; Aletayeb, M; Malakian, A; Aramesh, M R; Malvandi, H

    2018-02-01

    Transient tachypnea of the newborn (TTN) is a respiratory disorder secondary to inadequate or delayed clearance of lung fluids. Early symptoms of the disease are indistinguishable from neonatal respiratory distress syndrome, pneumonia, and persistent pulmonary hypertension. Therefore, these newborns, in addition to receiving conservative management, receive antibiotics until blood cultures provide definite results. In this study, we assessed the clinical course of neonates diagnosed with TTN who received conventional versus conservative management. One hundred and thirty neonates diagnosed as having TTN were randomly enrolled in two study groups. While patients belonging to one group received conservative management, those from the other group were treated with conventional medical therapy. Mean duration of hospitalization was 7 ± 0.2 in the conventional and 5 ± 1.5 in the conservative group. Duration of antibiotic therapy was 6.7 ± 2.47 days in the conventional group. Newborns diagnosed with TTN without prenatal risk factors and a negative C reactive protein test do not need to be administered antibiotics and hospitalized until confirmatory blood culture results are obtained. Copyright © 2017. Published by Elsevier Taiwan LLC.

  14. Repolarization abnormalities in the newborn.

    Science.gov (United States)

    Schwartz, Peter J; Stramba-Badiale, Marco

    2010-06-01

    The recognition of ventricular repolarization abnormalities in the newborn carries several and significant implications, because it calls attention to the possibility of dealing with an infant affected by the long QT syndrome (LQTS). This article provides key elements for the correct measurement of the QT interval in newborns and succinctly reviews some aspects of the disease. It gives normative values on the QT interval distribution in the first month of life based on a prospective study in more than 44,000 infants. It shows the probability, based on the QTc observed in two recordings, to find disease-causing mutations. The data indicate clearly that widespread electrocardiographic screening in the newborn allows early identification of most, if not all, the infants affected by LQTS with marked QT prolongation and thus of those at higher risk for life-threatening arrhythmias and sudden death. Through the affected infants, it becomes possible to identify the family members affected by LQTS, including the "silent mutation carriers"; our study shows that disease-causing mutations are found in 51% of the family members. Because early recognition leads to the implementation of effective preventive strategies, it follows that electrocardiographic screening will avoid preventable deaths either in the first year of life when they are usually labeled as "sudden infant death syndrome" or later in life. The case is made for medicolegal implications whenever neonatologists and pediatricians fail to inform the parents of a newborn child of the prevalence of LQTS (one in 2000), of the effectiveness of existing therapies, and of the diagnosis with a simple electrocardiogram.

  15. Newborn hearing screening.

    Science.gov (United States)

    Stewart, D L; Pearlman, A

    1994-11-01

    Congenital deafness is a relatively common problem with an incidence of 1/300 to 1/1000. Most states have no mass screening program for hearing loss, but the state of Kentucky compiles a High Risk Registry which is a historical survey of parents relating to risk factors for hearing loss. Unfortunately this survey can miss 50% of those who have a hearing deficit. If not detected prior to discharge, there is often a delay in diagnosis of deafness which prevents early intervention. We report 2 years' experience at Kosair Children's Hospital where 1,987 infants admitted to well baby, intermediate, or intensive care nurseries were screened using the ALGO-1 screener (Natus Medical Inc, Foster City, CA) which is a modified auditory brain stem evoked response (ABR). Our screening of this population led to an 11% incidence of referral for complete audiological evaluation. There were no significant complications. Forty-eight infants were found to have nonspecified, sensorineural, or conductive hearing loss. The positive predictive value of the test was 96%. Therefore, we feel that the use of the modified ABR in the newborn is a timely, cost efficient method of screening for hearing loss and should be used for mass screening of all newborns.

  16. Quality maternal and newborn care to ensure a healthy start for every newborn in the World Health Organization Western Pacific Region.

    Science.gov (United States)

    Obara, H; Sobel, H

    2014-09-01

    In the World Health Organization Western Pacific Region, the high rates of births attended by skilled health personnel (SHP) do not equal access to quality maternal or newborn care. 'A healthy start for every newborn' for 23 million annual births in the region means that SHP and newborn care providers give quality intrapartum, postpartum and newborn care. WHO and the UNICEF Regional Action Plan for Healthy Newborn Infants provide a platform for countries to scale-up Early Essential Newborn Care (EENC). The plan emphasises the creation of an enabling environment for the practice of EENC; thereby, preventing 50,000 newborn deaths annually. © 2014 Royal College of Obstetricians and Gynaecologists.

  17. Market mechanisms for newborn health in Nepal.

    Science.gov (United States)

    Lunze, Karsten; Dawkins, Rosie; Tapia, Abeezer; Anand, Sidharth; Chu, Michael; Bloom, David E

    2017-12-19

    In Nepal, hypothermia is a major risk factor for newborn survival, but the country's public health care sector has insufficient capacity to improve newborn survival given the burden imposed by distance to health facilities and cost. Low-cost technology to provide newborn thermal care in resource-limited environments exists, but lacks effective distribution channels. This study aims to develop a private sector distribution model for dedicated newborn thermal care technology to ensure equitable access to thermal protection and ultimately improve newborn health in Nepal. We conducted a document analysis of newborn health policy in Nepal and a scoping literature review of approaches to newborn hypothermia in the region, followed by qualitative interviews with key stakeholders of newborn health in Nepal. Current solutions addressing newborn hypothermia range from high-technology, high-cost incubators to low-cost behavioral interventions such as skin-to-skin care. However, none of these interventions  are currently implemented at scale. A distribution model that provides incentives for community health volunteers and existing public health services in Nepal can deliver existing low-cost infant warmers to disadvantaged mothers where and when needed. Newborn technology can serve as an adjunct to skin-to-skin care and potentially create demand for newborn care practices. Harnessing market forces could promote public health by raising awareness of newborn challenges, such as newborn hypothermia, and triggering demand for appropriate health technology and related health promotion behaviors. Market approaches to promoting public health have been somewhat neglected, especially in economically disadvantaged and vulnerable populations, and deserve greater attention in Nepal and other settings with limited public health service delivery capacity.

  18. Family knowledge on newborn care

    Directory of Open Access Journals (Sweden)

    Ana Leticia Monteiro Gomes

    2015-05-01

    Full Text Available Objective: analyzing the knowledge that families acquired on newborn care, before and after their participation in a mother-father-infant welcoming group. Methods: a quantitative and descriptive study that took place in a municipal health center, with 27 participants. Data were collected by a questionnaire applied before and after the educational activity, and was analyzed by comparing the answers of the items. Results: care actions properly modified were: the use of baby powder, soap, tea, objects in the navel, sun bathing time, correct hygiene of male genitalia, attention to child’s records and physiological eliminations. Conclusion: the families reported positive changes in newborn care through participation in health education activities, suggesting that the activity developed with caregivers can reduce risks to the health of newborn babies.

  19. Sudden unexpected infant death (SUDI in a newborn due to medium chain acyl CoA dehydrogenase (MCAD deficiency with an unusual severe genotype

    Directory of Open Access Journals (Sweden)

    Lovera Cristina

    2012-10-01

    Full Text Available Abstract Medium chain acyl CoA dehydrogenase deficiency (MCAD is the most common inborn error of fatty acid oxidation. This condition may lead to cellular energy shortage and cause severe clinical events such as hypoketotic hypoglycemia, Reye syndrome and sudden death. MCAD deficiency usually presents around three to six months of life, following catabolic stress as intercurrent infections or prolonged fasting, whilst neonatal-onset of the disease is quite rare. We report the case of an apparently healthy newborn who suddenly died at the third day of life, in which the diagnosis of MCAD deficiency was possible through peri-mortem blood-spot acylcarnitine analysis that showed very high concentrations of octanoylcarnitine. Genetic analysis at the ACADM locus confirmed the biochemical findings by demonstrating the presence in homozygosity of the frame-shift c.244dup1 (p.Trp82LeufsX23 mutation, a severe genotype that may explain the unusual and very early fatal outcome in this newborn. This report confirms that inborn errors of fatty acid oxidation represent one of the genetic causes of sudden unexpected deaths in infancy (SUDI and underlines the importance to include systematically specific metabolic screening in any neonatal unexpected death.

  20. O que os pediatras conhecem sobre avaliação e tratamento da dor no recém-nascido? What do pediatricians know about pain assessment and treatment in newborn infants?

    Directory of Open Access Journals (Sweden)

    Aurimery G. Chermont

    2003-06-01

    Full Text Available OBJETIVO: analisar os conhecimentos dos pediatras que atuam com pacientes neonatais em relação à avaliação e o tratamento da dor do recém-nascido. MÉTODOS: estudo transversal com 104 pediatras (de um total de 110 que trabalhavam em 1999 a 2001, nas sete unidades de terapia intensiva e nos 14 berçários da cidade de Belém, e responderam a um questionário escrito com perguntas a respeito do seu perfil demográfico e do conhecimento de métodos de avaliação e de tratamento da dor no recém-nascido. RESULTADOS: cem por cento dos médicos referiram acreditar que o recém-nascido sente dor, mas apenas um terço deles conhecia alguma escala para avaliar a dor nessa faixa etária. A maioria dos entrevistados referia perceber a presença de dor no recém-nascido por meio de parâmetros comportamentais. O choro foi o preferido para avaliar a dor do bebê a termo; a mímica facial para o prematuro, e a freqüência cardíaca para o neonato em ventilação mecânica. Menos de 10% dos entrevistados diziam usar analgesia para punções venosas e capilares; 30 a 40% referiam empregar analgesia para punções lombares, dissecações venosas, drenagens de tórax e ventilação mecânica. Menos da metade dos entrevistados referiu aplicar medidas para o alívio da dor no pós-operatório de cirurgia abdominal em neonatos. O opióide foi o medicamento mais citado para a analgesia (60%, seguido pelo midazolam (30%. CONCLUSÃO: os pediatras demonstraram pouco conhecimento a respeito dos métodos de avaliação e tratamento da dor no período neonatal. Há necessidade de reciclagens e de atualização no tema para os profissionais de saúde que atuam com recém-nascidos doentes.OBJECTIVE: to analyze the knowledge of pediatricians who work with neonatal patients regarding the evaluation and treatment of pain in newborn infants. METHODS: cross-sectional study of 104 pediatricians (out of 110 who were working during 1999 to 2001 in seven intensive care units

  1. Polycythemia - newborn

    Science.gov (United States)

    ... RBCs) in the infant's blood is called the "hematocrit." When this test is greater than 65%, polycythemia ... will be done. This test is called a hematocrit . Other tests may include: Blood gases to check ...

  2. Hip sonography in the newborn

    International Nuclear Information System (INIS)

    Riboni, G.; Serantoni, S.; De Simoni, M.; Bascape', P.; Facchini, R.; Pirovano, G.

    1991-01-01

    The authors report the data relative to 1507 cases studied with clinical and US examinations, in the neonatal period, in order to exclude hip dysplasia dislocation. US examination was carried out according to Graf's technique and the newborns were classified according to US hip type, to clinical examination and to possible risk factors. The patients were included in a protocol including orthopedic and US controls. Seventeen treated infants were considered as pathologic. Ten of them had IIc or D hips ar birth; the other 7, with IIa hips at birth, presented a X-ray pathologic hip after the 4th months of life. At about one year of age all infants could normally walk, excpet for one who was being treated with herness. No statistically significant differences were observed between the number of pathologic infants in the risk group (1.7%) and that in the no-risk group (0.8%). Clinical examination of the newborn has low sensitivity in detecting pathologic hips. On the basis of their results, thw authors belive US examination of the newborn to be a valuable screening method to diagnose hip dysplasia/dislocation. Moreover, Graf's morphologic method is the best one for US screening of the hip in the neonatal period

  3. Newborn behavior, parent-infant interaction, and developmental change processes: research roots of developmental, relational, and systems-theory-based practice.

    Science.gov (United States)

    Sparrow, Joshua

    2013-08-01

    The discovery of individual and cross-cultural differences among newborns, and their effects on caregiver behaviors, underpins a systems theory of human development and a resulting paradigm shift. This theory accommodates both epigenetics-mediating genes and environment within the individual, and culture-a dynamic, emergent phenomenon transmitting contextually adaptive child-rearing beliefs and practices. Within human systems, children and parents' development is also propelled by mutual adaptation occurring through the microprocesses of early interactions and through normative periods of disorganization and reorganization (touchpoints). This paradigm shift in developmental theory calls for parallel shifts in clinical practice and organizational structures and processes. © 2013 The Author. Journal of Child and Adolescent Psychiatric Nursing © 2013 Wiley Periodicals, Inc.

  4. A comparison of two interventions for HHHFNC in preterm infants weighing 1,000 to 1,500 g in the recovery period of newborn RDS

    Directory of Open Access Journals (Sweden)

    Alireza Sadeghnia

    2014-01-01

    Full Text Available Background: Nasal cannula, beside administering low-flow therapy, showed the capability for the administration of continuous positive airway pressure (CPAP through high-flow nasal cannula (HFNC. Meeting specific physical criteria of 100% relative humidity (RH and temperature of 37 o C are the basic interventional requirements to administer oxygen for the newborns through a nasal cannula. Recently, two systems, MR850 and PMH7000, received the Food and Drug Administration (FDA approval to administer heated, humidified HFNC (HHHFNC. These systems are evaluated in this study based on their humidifying and heating capabilities. Materials and Methods: This study was done as an RCT on newborns weighing 1,000 to 1,500 g recovering from respiratory distress syndrome (RDS while nCPAP was administered at CDP = 4 cmH 2 O, Fio 2 <30%. Patients were randomized to two groups of 35 receiving HHHFNC after treatment with nCPAP, with one group using MR850 humidifier and the other PMH7000. The patients were compared according to the duration of HHHFNC administration, repeated need for nCPAP respiratory support, the need for invasive ventilation, apnea, chronic lung disease (CLD, nasal trauma, RH, and temperature of the gases. Results: The average time of support with HHHNFC did not show any significant difference in the two groups. There was no significant difference between the groups in the need for nCPAP, invasive ventilation, apnea, nasal trauma, and CLD. The difference in the levels of average temperature and humidity was significant (P value <0.001. Conclusion: Although the records of temperature and RH in the PMH7000 system was lower than the records from the MR850 system, no clinical priority was observed for respiratory support with HHHNFC in the two systems.

  5. Newborn Care: 10 Tips for Stressed-Out Parents

    Science.gov (United States)

    ... a walk. If you can, let someone you trust take over for a while. When friends and ... lifestyle/infant-and-toddler-health/in-depth/newborn/art-20045498 . Mayo Clinic Footer Legal Conditions and Terms ...

  6. Mothers' knowledge on essential newborn care at Juba Teaching ...

    African Journals Online (AJOL)

    2017-08-03

    Aug 3, 2017 ... initiation of breastfeeding, immunization, eye care, recognition of danger signs, care of the preterm / low birth weight infant and management of newborn illnesses. This study aimed to identify the gaps in the knowledge and practices towards essential newborn care among postnatal mothers at Juba ...

  7. Posture as a Determinant of Visual Behavior in Newborns

    Science.gov (United States)

    Fredrickson, W. Timm; Brown, Josephine V.

    1975-01-01

    The effects of posture on the visual behavior of 15 3-day-old healthy, black, newborn infants were assessed. Findings suggest that the vestibular, proprioceptive, and contact stimulation provided by the on-shoulder position affects the newborn's ability to follow and process visual stimuli. (Author/CS)

  8. Neurocomportamento de recém-nascidos a termo, pequenos para a idade gestacional, filhos de mães adolescentes Neurobehavior of full-term small for gestational age newborn infants of adolescent mothers

    Directory of Open Access Journals (Sweden)

    Marina C. de Moraes Barros

    2008-06-01

    Full Text Available OBJETIVO: Comparar o neurocomportamento de recém-nascidos a termo pequenos (PIG e adequados (AIG para a idade gestacional, filhos de mães adolescentes. MÉTODOS: Estudo transversal prospectivo de nascidos a termo AIG e PIG, com 24-72 horas de vida, sem afecções do sistema nervoso central. Os neonatos foram avaliados por meio da Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS para: habituação, atenção, despertar, controle, manobras para a orientação, qualidade dos movimentos, excitabilidade, letargia, reflexos não ótimos, assimetria, hipertonia, hipotonia e sinais de estresse e abstinência. A comparação dos grupos AIG e PIG foi feita por análise de variância e teste do qui-quadrado. Aplicou-se a regressão multivariada para analisar os fatores associados ao escore de cada variável do NNNS. RESULTADOS: Dos 3.685 nascidos no local do estudo, 928 (25% eram de mães adolescentes. Desses, 477 satisfizeram os critérios de inclusão, sendo 419 (88% AIG e 58 (12% PIG. A análise univariada não mostrou diferença em nenhuma das variáveis da NNNS entre os PIG e os AIG. Na análise multivariada, os PIG nascidos de parto vaginal apresentaram menor escore na variável qualidade de movimentos do que os nascidos por cesárea. Os PIG nascidos com anestesia local ou sem anestesia apresentaram maior escore na variável excitabilidade do que os nascidos sob anestesia loco-regional. Os PIG femininos tiveram menor escore na variável sinais de estresse/abstinência que os masculinos. CONCLUSÃO: Os recém-nascidos PIG de mães adolescentes mostraram menor qualidade de movimento, mais excitabilidade e mais sinais de estresse, em associação com o sexo do neonato e com variáveis relacionadas ao parto.OBJECTIVE: To compare the neurobehavior of small (SGA and adequate (AGA for gestational age full-term neonates born to adolescent mothers. METHODS: This prospective cross-sectional study included full-term newborn infants aged 24

  9. Evaluation of RIT 4237 bovine rotavirus vaccine in newborn infants: correlation of vaccine efficacy to season of birth in relation to rotavirus epidemic period.

    Science.gov (United States)

    Ruuska, T; Vesikari, T; Delem, A; André, F E; Beards, G M; Flewett, T H

    1990-01-01

    A single oral dose of bovine rotavirus vaccine RIT 4237 or placebo was given to 2 groups of 5-day-old infants, born in October 1984 (n = 244) and June 1985 (n = 245), who remained in follow-up for 2.8 and 2.0 years, respectively. The vaccine had no effect on the total number of detectable episodes of rotavirus diarrhoea: there were 22 cases in the vaccinees and 24 in the placebo recipients in the October group and 18 and 16 respectively in the June group. However, vaccination decreased significantly the clinical severity of rotavirus diarrhoea, as assessed by a numerical score 0-20; this vaccine effect was much greater in the infants born in October. The mean severity scores for vaccine and placebo recipients were 4.55 and 10.75 respectively in the October group (p less than 0.0001, t-test) and 8.2 and 11.6 respectively in the June group (p = 0.010, t-test). Vaccine-induced clinical protection against rotavirus diarrhoea did not correlate well with serological response after vaccination, but showed good correlation to the presence of rotavirus antibodies before the rotavirus epidemic season. It is concluded that bovine rotavirus vaccine is more efficacious when given immediately before the rotavirus epidemic season: the vaccine effect may be amplified by exposure to wild rotaviruses during the season.

  10. Management of hypotension in preterm infants (The HIP Trial): a randomised controlled trial of hypotension management in extremely low gestational age newborns.

    Science.gov (United States)

    Dempsey, E M; Barrington, K J; Marlow, N; O'Donnell, C P; Miletin, J; Naulaers, G; Cheung, P-Y; Corcoran, D; Pons, G; Stranak, Z; Van Laere, D

    2014-01-01

    Extremely preterm babies (delivered at hypotension and treated with inotropic and pressor drugs in the immediate postnatal period. Dopamine is the most commonly used first-line drug. Babies who are treated for hypotension more frequently sustain brain injury, have long-term disability or die compared to those who are not. Despite the widespread use of drugs to treat hypotension in such infants, evidence for efficacy is lacking, and the effect of these agents on long-term outcomes is unknown. In extremely preterm babies, restricting the use of dopamine when mean blood pressure (BP) values fall below a nominal threshold and using clinical criteria to determine escalation of support ('restricted' approach) will result in improved neonatal and longer-term developmental outcomes. RESEARCH PLAN: In an international multi-centre randomised trial, 830 infants born at <28 weeks of gestation, and within 72 h of birth, will be allocated to 1 of 2 alternative treatment options (dopamine vs. restricted approach) to determine the better strategy for the management of BP, using a conventional threshold to commence treatment. The first co-primary outcome of survival without brain injury will be determined at 36 weeks' postmenstrual age and the second co-primary outcome (survival without neurodevelopmental disability) will be assessed at 2 years of age, corrected for prematurity. It is essential that appropriately designed trials be performed to define the most appropriate management strategies for managing low BP in extremely preterm babies.

  11. Clinical Features and Correlates of Outcomes for High-Risk, Marginalized Mothers and Newborn Infants Engaged with a Specialist Perinatal and Family Drug Health Service

    Directory of Open Access Journals (Sweden)

    Lee Taylor

    2012-01-01

    Full Text Available Background. There is a paucity of research in Australia on the characteristics of women in treatment for illicit substance use in pregnancy and the health outcomes of their neonates. Aims. To determine the clinical features and outcomes of high-risk, marginalized women seeking treatment for illicit substance use in pregnancy and their neonates. Methods. 139 women with a history of substance abuse/dependence engaged with a perinatal drug health service in Sydney, Australia. Maternal (demographic, drug use, psychological, physical, obstetric, and antenatal care and neonatal characteristics (delivery, early health outcomes were examined. Results. Compared to national figures, pregnant women attending a specialist perinatal and family drug health service were more likely to report being Australian born, Aboriginal or Torres Strait Islander, younger, unemployed, and multiparous. Opiates were the primary drug of concern (81.3%. Pregnancy complications were common (61.9%. Neonates were more likely to be preterm, have low birth weight, and be admitted to special care nursery. NAS was the most prevalent birth complication (69.8% and almost half required pharmacotherapy. Conclusion. Mother-infant dyads affected by substance use in pregnancy are at significant risk. There is a need to review clinical models of care and examine the longer-term impacts on infant development.

  12. Diuretics for transient tachypnoea of the newborn.

    Science.gov (United States)

    Kassab, Manal; Khriesat, Wadah M; Anabrees, Jasim

    2015-11-21

    Transient tachypnoea of the newborn (TTN) results from delayed clearance of lung liquid and is a common cause of admission of full-term infants to neonatal intensive care units. The condition is particularly common after elective caesarean section. Conventional treatment involves appropriate oxygen administration and continuous positive airway pressure in some cases. Most infants receive antibiotic therapy. Hastening the clearance of lung liquid may shorten the duration of the symptoms and reduce complications. To determine whether diuretic administration reduces the duration of oxygen therapy and respiratory symptoms and shortens hospital stay in term infants presenting with transient tachypnoea of the newborn. An updated search was carried out in September 2015 of the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library issue 9, 2015), MEDLINE via Ovid, EMBASE, PubMed, and CINAHL via OVID. We included randomised and quasi-randomised controlled trials that compared the effect of diuretics administration versus placebo or no treatment in infants of less than seven days of age, born at 37 or more weeks of gestation with the clinical picture of transient tachypnoea of the newborn. We extracted and analysed data according to the methods outlined in the latest Cochrane Handbook for Systematic Reviews of Interventions. Two review authors assessed trial quality in each potentially eligible manuscript and two review authors extracted data. Our previous systematic review included two trials enrolling a total of 100 infants with transient tachypnoea of the newborn (Wiswell 1985; Karabayir 2006). The updated search revealed no new trials. Wiswell 1985 randomised 50 infants to receive either oral furosemide (2 mg/kg body weight at time of diagnosis followed by a 1 mg/kg dose 12 hours later if the tachypnoea persisted) or placebo. Karabayir 2006 randomised 50 infants to receive either intravenous furosemide (2 mg/kg body

  13. Evaluation of Visunex Medical's PanoCam(TM) LT and PanoCam(TM) Pro wide-field imaging systems for the screening of ROP in newborn infants.

    Science.gov (United States)

    Wood, Edward H; Moshfeghi, Andrew A; Nudleman, Eric D; Moshfeghi, Darius M

    2016-08-01

    Retinopathy of Prematurity (ROP) is a leading cause of childhood blindness. The incidence of ROP is rising, placing greater demands on the healthcare providers that serve these patients and their families. Telemedicine remote digital fundus imaging (TM-RDFI) plays a pivotal role in ROP management, and has allowed for the expansion of ROP care into previously underserved areas. A broad literature review through the pubmed index was undertaken with the goal of summarizing the current state of ROP and guidelines for its screening . Furthermore, all currently used telemedicine remote digital fundus imaging devices were analyzed both via the literature and the companies' websites/brochures. Finally, the PanoCam LT™ and PanoCam™ Pro created by Visunex Medical were analyzed via the company website/brochures. Expert commentary: The PanoCam LT™ and PanoCam™ Pro have recently been approved for use within the USA and CE marked for international commercialization in European Union and other countries requiring CE mark. These wide-field imaging systems have the intended use of ophthalmic imaging of all newborn babies and meet the requirements for ROP screening, thereby serving as competition within the ROP screening market previously dominated by one camera imaging system.

  14. Cardiac injury of the newborn mammalian heart accelerates cardiomyocyte terminal differentiation

    DEFF Research Database (Denmark)

    Zebrowski, David C.; Jensen, Charlotte H.; Becker, Robert

    2017-01-01

    After birth cardiomyocytes undergo terminal differentiation, characterized by binucleation and centrosome disassembly, rendering the heart unable to regenerate. Yet, it has been suggested that newborn mammals regenerate their hearts after apical resection by cardiomyocyte proliferation. Thus, we ...

  15. Three-Month-Olds, but Not Newborns, Prefer Own-Race Faces

    Science.gov (United States)

    Kelly, David J.; Quinn, Paul C.; Slater, Alan M.; Lee, Kang; Gibson, Alan; Smith, Michael; Ge, Liezhong; Pascalis, Olivier

    2005-01-01

    Adults are sensitive to the physical differences that define ethnic groups. However, the age at which we become sensitive to ethnic differences is currently unclear. Our study aimed to clarify this by testing newborns and young infants for sensitivity to ethnicity using a visual preference (VP) paradigm. While newborn infants demonstrated no…

  16. Hypothyroidism in the Newborn Period

    Science.gov (United States)

    Wassner, Ari J.; Brown, Rosalind S.

    2014-01-01

    Purpose of Review This review summarizes significant advances in the epidemiology, pathophysiology, and treatment of congenital hypothyroidism (CH), with a focus on thyroid dysfunction in preterm infants. Recent Findings CH appears to be increasing in incidence, primarily due to increased stringency of screening strategies, with smaller contributions from changing demographics and improved survival of increasingly premature infants. The greatest increase has been in mildly affected infants. Although many such cases are transient, some eventually prove to be severe and/or permanent. In preterm infants, transient hypothyroidism is common and may be delayed in onset. The etiology is probably multifactorial, and inadequate iodine intake may contribute to some cases. Transient hypothyroxinemia of prematurity (THOP), also common in premature infants, is correlated with markers of inflammation. Despite concern about the potential morbidity of THOP, the benefits and safety of treatment have not been established. Novel genetic causes of CH continue to be identified, and accumulating data support the sensitivity of infants with severe CH to small changes in levothyroxine formulation. Summary Changes in newborn screening strategies have increasingly identified thyroid function abnormalities of unclear clinical significance. Novel causes of CH continue to be identified, and new data continue to emerge regarding optimal therapy. PMID:23974774

  17. ABO incompatibility hemolytic disease following exchange transfusion 96 newborn

    Directory of Open Access Journals (Sweden)

    Khatami S.F

    2007-09-01

    Full Text Available Background: ABO incompatibility hemolytic disease of the newborn is a common cause of clinical jaundice and causes two-thirds of the hemolytic disease in newborns. This study was undertaken to determine the frequency of ABO incompatibility hemolytic disease and its complications in newborns undergoing exchange transfusion.Methods: This prospective and descriptive study was performed in jaundiced newborn infants during a three-year period. Inclusion criteria were: maternal blood type O, newborn blood type A or B, rising indirect hyperbilirubinemia in the first two days of life, positive immunohematologic test for newborns and exchange transfusion. Exclusion criteria were: incomplete information, other accompanying diseases that induce hyperbilirubinemia. All newborn infants received phototherapy before and after exchange transfusion. We did not use intravenous immunoglobulin, hemoxygenase inhibitor drugs and blood products before exchange transfusion.Results: Double-volume exchange transfusion via umbilical cord catheter was performed in 96 patients, 19 (20% of whom suffered from ABO incompatibility. Of these 19 newborns, two-thirds (13 were preterm infants. The minimum level of serum bilirubin was 10 mg/dl and the maximum serum bilirubin level was 35 mg/dl. In six patients (32% serum bilirubin levels were >25mg/dl. The most common blood group was type A for newborns. Immunohematologic tests were positive in 84% of the mothers. ABO incompatibility hemolytic disease was the fourth and second most common reasons for blood exchange transfusion in preterm and term infants, respectively. Laboratory complications were more common than clinical complications. The etiology of 48% of the alloimmunization and 42% of the hemolytic disease in these newborns was ABO incompatibility.Conclusions: Mothers with blood group O and newborns with blood group A or B with positive immunohematologic tests in first hours of life are at high risk for hemolytic disease

  18. Usefulness of extracorporeal membrane oxygenation using double roller pumps in a low body weight newborn: A novel strategy for mechanical circulatory support in an infant

    Directory of Open Access Journals (Sweden)

    Keisuke Nakanishi

    2016-01-01

    Full Text Available Extracorporeal membrane oxygenation (ECMO with a centrifugal pump requires a certain flow rate; therefore, its application for low body weight infants is frequently accompanied by oxygenator membrane malfunction and/or inadequate perfusion. To prevent low-flow associated complications, we report a case in which a novel system of dual roller pumps was used. A baby girl with a body mass index 0.25 m 2 , who experienced difficulty weaning from cardiopulmonary bypass after a Norwood-like operation, required an ECMO. Concerns for the tube lifespan reduction due to roller pump friction led to the use of a double roller pump circulation. The termination of ECMO during tube exchange is not needed, because circulation is maintained by another roller pump. The novel strategy of ECMO with double roller pumps will allow low perfusion rate to provide adequate circulatory support for low body weight patients.

  19. [Blood lactate measurments as a diagnostic and prognostic tool after birth asphyxia in newborn infants with gestational age > or = 34 gestational weeks].

    Science.gov (United States)

    Varkilova, L; Slancheva, B; Emilova, Z; Nikolov, A; Metodieva, V; Hitrova, S; Doicheva, E

    2013-01-01

    Blood lactate at birth as result of activated anaerobic glycolysis is a marker of perinatal asphyxia. To evaluate the dynamics of blood lactate, pH and base excess (BE) as a tool for assessing the severity of fetal hypoxia and predicting neonatal outcome. 79 neonates (> or = 34 gestational weeks) were included and followed up until discharge: 43 with pathologic fetal hearth rate patterns and/or 1-minute Apgar score asphyxia group"); 36 without obstetric or clinical signs of asphyxia (control group). Samples from umbilical artery (u.a.), capillary blood at 2h and 12-24 h after birth were analyzed for blood lactate, pH and BE. Lactate value (u.a.) was significantly higher (5.3 +/- 3.4 mmol/l), pH and BE were lower (7.29 +/- 0.05 and -14.1 +/- 5.9 mmol/l) in the "asphyxia group" compared to the control group (2.7 +/- 1.2 mmol/l, 7.29 +/- 0.05 and -5.9 +/- 3.3 respectively). The 2 h lactate-values increased significantly in infants with asphyxia (6,.7 +/- 4.7) compared to the controls (3.2 +/- 1.1), the 12-24 h values were reduced in the main group (4.6 +/- 1.5) and without changes in the controls (3.2 +/- 0.88). Values of pH and BE at 2 h and 12-24 h increased progressively in both groups without significant differences between them. Hypoxic-ischemic encephalopathy (HIE) stage II-III was observed in infants with u.a. pH asphyxia. Increasing lactate concentration after birth is better predictor of severe HIE.

  20. Recent developments in care of the newborn.

    Science.gov (United States)

    Johnson, R V

    1990-06-01

    New developments in newborn care include body fluid precautions, especially the use of gloves and the use of mechanical suction instead of oral suction. Artificial surfactant is still investigational, but results to date are favorable. A recent report may lead to modification of practices for management of infants with possible meconium aspiration.

  1. Congenital malformations among newborns in Kenya | Muga ...

    African Journals Online (AJOL)

    Available literature suggests that congenital malformations are a major cause of prenatal infant deaths and postnatal physical defects [1, 2]. Therefore, a study was conducted to determine the patterns and incidence of congenital malformations at birth in newborns in Kenya and thereby analyze associated predisposing ...

  2. Newborn Screening for Biliary Atresia

    Science.gov (United States)

    Wang, Kasper S.

    2016-01-01

    Biliary atresia is the most common cause of pediatric end-stage liver disease and the leading indication for pediatric liver transplantation. Affected infants exhibit evidence of biliary obstruction within the first few weeks after birth. Early diagnosis and successful surgical drainage of bile are associated with greater survival with the child’s native liver. Unfortunately, because noncholestatic jaundice is extremely common in early infancy, it is difficult to identify the rare infant with cholestatic jaundice who has biliary atresia. Hence, the need for timely diagnosis of this disease warrants a discussion of the feasibility of screening for biliary atresia to improve outcomes. Herein, newborn screening for biliary atresia in the United States is assessed by using criteria established by the Discretionary Advisory Committee on Heritable Disorders in Newborns and Children. Published analyses indicate that newborn screening for biliary atresia by using serum bilirubin concentrations or stool color cards is potentially life-saving and cost-effective. Further studies are necessary to evaluate the feasibility, effectiveness, and costs of potential screening strategies for early identification of biliary atresia in the United States. PMID:26620065

  3. [Which legal consequences for those who provoke pain to infants?].

    Science.gov (United States)

    Bellieni, C V; Gabbrielli, M; Tataranno, M L; Perrone, S; Buonocore, G

    2012-02-01

    The advances in perinatal care have led to a significant increase in neonatal survival rate but also to the rise of the number of invasive procedures. Several scientific studies show that newborns are able to feel pain more intensely than adults. Despite this evidence, neonatal pain and the right to an appropriate analgesia are systematically underestimated, ignoring ethical and moral principles of beneficence and non-maleficence. Infants are more susceptible to pain and the prolonged exposure to painful sensations can alter the neural development and the response to pain causing hyperalgesia. Anyone who caused pain without using any analgesic procedure due to negligence or incompetence, should be severely punished. The right to analgesia, fundamental principle, is fully incorporated in the Italian code of Medical deontology (article 3). The doctor who does not use analgesia for newborns' treatment can be indicted by the Italian penal code (art.582 and 583), aggravated by being the victim an infant, who is unable to defend himself. To avoid penal consequences, a careful education and attention are needed: "pediatric analgesia" should become a basic teaching in Universities and in specialization schools; analgesic treatments should be mandatory and annotated in the patient's file even for minor potentially painful procedures.

  4. Métodos de alimentação alternativos para recém-nascidos prematuros Métodos de alimentación alternativa para recién-nacidos prematuros Alternative feeding methods for premature newborn infants

    Directory of Open Access Journals (Sweden)

    Claudia Peyres Lopez

    2012-06-01

    complementación de la alimentación de recién-nacidos prematuros mediante vaso/taza. Se debe realizar estudios controlados con la finalidad de rever riesgos y beneficios del uso de métodos alternativos en la alimentación del recién-nacido prematuro.OBJECTIVE: To present a literature review about the use of glass/cup as an alternative method of feeding premature newborns and to identify if there is a consensus on its indication for this population. DATA SOURCE: A narrative review of the literature. Articles were selected from Medline, Lilacs, SciELO, and Cochrane databases, regardless of year, using the following specific key-words: feeding, premature newborn, breastfeeding, feeding methods. DATA SYNTHESIS: Although some studies showed that feeding premature and term newborns using the glass/cup is safe and efficient, most of them did not apply an objective evaluation of the swallowing to identify the effect of the method in this population. CONCLUSIONS: There is no consensus in the literature about feeding premature newborn infants by glass/cup. Controlled studies should be conducted in order to evaluate risks and benefits of alternative feeding methods in preterm newborn infants.

  5. The Effect of Perinatal Hypoxia on Red Blood Cell Morphology in Newborns

    OpenAIRE

    S. A. Perepelitsa; V. A. Sergunova; O. E. Gudkova

    2017-01-01

    Aim. To study the red blood cell (RBC) morphology in newborn infants with a history of perinatal hypoxia using the atomic-force microscopy. Material and methods. The state of RBC membranes of 10 newborns with a history of perinatal hypoxia was studied. All infants were born with low Apgar scoring; the following resuscitative measures were carried out at birth: tracheal intubation, mechanical ventilation (MV). The study group newborns were transferred from the delivery room to the ICU, where M...

  6. Unilateral submandibular suppurative sialadenitis in a premature infant

    NARCIS (Netherlands)

    de Haan, T. R.; Grooters, E.; Frijns, J. H. M.; Walther, F. J.

    2003-01-01

    Isolated submandibular suppurative sialadenitis is extremely rare in newborn infants and is associated with prematurity and prolonged gavage feeding. This report describes a premature infant who developed a life-threatening airway obstruction due to suppurative submandibular sialadenitis. The

  7. Cost-effectiveness of targeted vaccination to protect new-borns against pertussis: comparing neonatal, maternal, and cocooning vaccination strategies.

    Science.gov (United States)

    Lugnér, Anna K; van der Maas, Nicoline; van Boven, Michiel; Mooi, Frits R; de Melker, Hester E

    2013-11-04

    Pertussis (whooping cough) is a severe infectious disease in infants less than 6 months old. Mass vaccination programmes have been unable to halt transmission effectively. Strategies to protect new-borns against infection include vaccination of the neonate or the mother directly after birth (cocooning), or the mother during pregnancy (maternal). Here we investigate the cost-effectiveness of these three strategies in the Netherlands. Costs for health care utilization and productivity losses, as well as impact on quality of life were calculated for a 10-year vaccination programme, assuming that vaccine-induced immunity lasts 5 years. Cocooning was the most attractive option from a cost-effectiveness viewpoint (€89,000/QALY). However, both cocooning and maternal vaccination would reduce the disease burden in infants and mothers vaccinated (about 17-20 QALY/year). Specifically, with a persistent epidemic as seen in 2012, there is need for reconsidering the vaccination schedules against pertussis in order to increase protection of the vulnerable new-borns. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Newborn cord care practices in Haiti.

    Science.gov (United States)

    Walsh, Susan; Norr, Kathleen; Sankar, Girija; Sipsma, Heather

    2015-10-01

    Newborn cord infections commonly lead to neonatal sepsis and death, particularly in low-resource countries where newborns may receive unhygienic cord care. Topical application of chlorhexidine to the newborn's cord has been shown to prevent infection. Such benefits may be particularly important in Haiti. We explored current cord care practices by conducting a qualitative study using five focus groups among key community stakeholders (mothers of newborns/children under age two years, pregnant women, traditional birth attendants, community health workers, traditional healers) in Petit-Goâve, Haiti. Data collection was guided by the Health Belief Model. Results suggest community stakeholders recognise that infants are susceptible to cord infection and that cord infection is a serious threat to newborns. Long-held traditional cord care practices are potential barriers to adopting a new cord care intervention. However, all groups acknowledged that traditional practices could be harmful to the newborn while expressing a willingness to adopt practices that would protect the newborn. Results demonstrate potential acceptability for altering traditional cord care practices among neonatal caretakers in Haiti. An informational campaign designed to educate local health workers and new mothers to eliminate unhygienic cord applications while promoting chlorhexidine application may be a strong approach for preventing neonatal cord infections.

  9. Intracranial epidural hematoma in a newborn with DIC secondary to ...

    African Journals Online (AJOL)

    Epidural hematoma in newborns is rare, it occurs more frequently in infants born from nulliparous mothers with delivery difficulties. Intracranial hemorrhage in infants is usually secondary to vascular malformations, anticoagulation, inherited or acquired coagulopathy. Hematological disorders are infrequently associated with ...

  10. Effect of maternal consumption of cocaine base paste on neurological behavior of newborn infants Comportamiento neurológico del recién nacido de madre consumidora de basuco durante su gestación

    Directory of Open Access Journals (Sweden)

    Luz E. Gómez

    1997-01-01

    Full Text Available Twenty newborn infants from mothers that consumed coca leaves' paste during pregnancy were compared with 19 controls as to their neurological behavior and supression evidences; the following alterations were significantly more frequent (p < 0.05 in infants from consumer mothers: Tremor, irritability, nausea, and depression of crying, suction and prension. The duration of these alterations as well as that of other neurological abnormalities was significantly longer in infants from consumer mothers. These findings reveal that neonates exposed to cocaine because their mothers consumed coca leaves' paste during pregnancy, reveal neurologic alterations as well as suppression signs that sugest a direct and lasting effect of the drug on their central nervous systems; these infants constitute a serious public health problem whose management requires decision and solid knowledge on its repercusions. Se estudiaron 20 niños recién nacidos, hijos de madres consumidoras de pasta base de coca (basuco, en comparación con 19 controles nacidos de madres no consumidoras, con el fin de detectar en los primeros alteraciones neurológicas y evidencias de supresión; se hallaron las siguientes con frecuencias significativamente mayores en los hijos de madres consumidoras: temblor (p: 0.00001, irritabilidad (p: 0.0015, náuseas (p: 0.003, llanto deprimido (p: 0.004 y succión deprimida (p: 0.02; en los restantes signos de supresión (vómito, anorexia, hipersomnia, hiposomnia, hipertonía, cólico y diarrea y alteraciones neurológicas (hipotonía o hipertonía musculares, enderezamiento anormal, marcha deprimida, alpinista deprimido, hiporreflexia no hubo diferencia significativa entre los casos y los controles. La duración del temblor, la irritabilidad y las náuseas, así como la depresión del llanto, la succión, la prensión y la marcha, el enderezamiento anormal, el alpinista deprimido y la hiporreflexia, fueron significativamente más prolongadas en los

  11. Skin Care of the Newborn

    Directory of Open Access Journals (Sweden)

    Serap Utaş

    2011-09-01

    Full Text Available Development of the skin barrier continues up to one year after birth. The immaturity of the epidermal barrier in the neonatal period may cause dry skin, vulnerability to trauma, rapid onset of microbial colonization and percutaneous drug toxicity. Skin barrier is essential for infants. Skin care practices should, however, preserve skin integrity, prevent toxicity and address concerns such as potential sensitivity from chemical exposure. This article reviews the skin care of the newborns. (Turk­derm 2011; 45: 123-6

  12. The brains of very preterm newborns in clinically stable condition may be hyperoxygenated

    DEFF Research Database (Denmark)

    Sorensen, Line Caroe; Greisen, Gorm

    2009-01-01

    mechanical ventilation and 11 received inotropic drugs. Later, 3 preterm infants developed intraventricular hemorrhage and 2 infants died. All term infants were healthy newborns recruited in the maternity ward. RESULTS: There was a significant difference in c-TOI (preterm: 78.6% [95% confidence interval: 76......OBJECTIVE: The objective was to compare cerebral oxygenation in preterm newborns with that in healthy term newborns. METHODS: Forty-six preterm newborns with gestational ages of newborns were included. The cerebral tissue oxygenation index (c-TOI) was measured by using.......9%-80.3%]; term: 74.7% [95% confidence interval: 72.3%-77.1%]). Preterm newborns had significantly lower fractional tissue oxygen extraction, which suggests lower oxygen extraction in this group. There was no significant correlation between head size and c-TOI. The mean peripheral oxygen saturation was 95...

  13. Respostas fisiológicas de recém-nascidos pré-termo submetidos à musicoterapia clássica Respuestas fisiológicas de recién nacidos pretérmino sometidos a musicoterapia clásica Physiological responses of preterm newborn infants submitted to classical music therapy

    Directory of Open Access Journals (Sweden)

    Camila Mendes da Silva

    2013-03-01

    Full Text Available OBJETIVO: Avaliar o efeito da musicoterapia nas respostas fisiológicas de recém-nascidos pré-termo hospitalizados. MÉTODOS: Ensaio clínico não controlado realizado com 12 recém-nascidos pré-termo, com idade gestacional OBJETIVO: Evaluar el efecto de la musicoterapia en las respuestas fisiológicas de recién nacidos pretérmino hospitalizados. MÉTODOS: Ensayo clínico no controlado realizado con 12 recién nacidos pretérmino internados en la Unidad de Terapia Intensiva Neonatal y en la Unidad Intermediaria, con edad gestacional OBJECTIVE: To evaluate the physiological effects of music therapy on hospitalized preterm newborns. METHODS: A noncontrolled clinical trial including 12 newborn infants with gestational age <36 weeks, spontaneously breathing. The preterm infants were submitted to 15-minute sessions of classical music therapy twice a day (morning and afternoon for three consecutive days. The variables: heart and respiratory rates, oxygen saturation, diastolic and systolic arterial pressures, and body temperature were analyzed before and immediately after each music therapy session. RESULTS: There was a decrease in the heart rate after the second session of music therapy (paired t-test; p=0.002, and an increase at the end of the third session (paired t-test; p=0.005. Respiratory rate decreased during the fourth and fifth sessions (paired t-test; p=0.01 and 0.03, respectively. Regarding oxygen saturation, there was an increase after the fifth session (p=0.008. Comparison of physiological parameters among sessions, for the six studied sessions, showed only that the gain in oxygen saturation during the fifth session was significantly higher than during the sixth one (Tukey's test after variance analysis; p=0.04. CONCLUSIONS: Music therapy may modify short-term physiological responses of hospitalized preterm newborn infants.

  14. Estudo retrospectivo de crianças pré-termo no Ambulatório de Especialidades Jardim Peri-Peri Retrospective study of preterm newborn infants at the ambulatory of specialities Jardim Peri-Peri

    Directory of Open Access Journals (Sweden)

    Silvia Helena Tavares Lorena

    2009-06-01

    ção mecânica convencional a mais utilizada. CONCLUSÕES: Neste trabalho, a incidência de retinopatia da prematuridade correspondeu aos dados estatísticos internacionais, uma vez que a doença limiar atingiu 3% dos casos. O perfil clínico do grupo I estudado revelou que todos os prematuros utilizaram a oxigenoterapia e apresentaram a síndrome do desconforto respiratório, com prevalência do estágio 1 da retinopatia da prematuridade.PURPOSE: To evaluate the prevalence of retinopathy of prematurity preterm newborn infants, associating it with its risk factors besides comparing the incidence of refractive errors like myopia and strabismus among preterm children who developed retinopathy of prematurity (Group I and those who did not present this retinopathy (Group II. METHODS: A cross-sectional, retrospective and documental study of records of 147 preterm children who were examined at the "Ambulatório de especialidades Jardim Peri Peri" (Ambulatory of Specialties Jardim Peri Peri was used in this paper. These children were born between July 7th, 2004 and July 10th, 2008 at "Maternidade Mário Degni" (Maternity Mário Degni. Fundus examination with escleral depression was first carried out between the 3rd and 8th weeks after birth and repeated every 1 to 4 weeks depending on the retinal imaging findings, until retina vascularization was complete or retinopathy of prematurity was present and it was followed by an annual ophthalmologic follow-up comprised of fundus examination and refraction. International Classification of Retinopathy of Prematurity criteria was used to classify the retinopathy of prematurity. Analysis of the whole group of preterm newborns was made and classified in group I and group II, and the incidence of Myopia and Astigmatism in each group was analyzed. RESULTS: This casuistry showed that retinopathy of prematurity was present in 35 preterm children (23% and 112 preterm children (77% did not develop this retinopathy. In Group I, 34 children (97

  15. Plasma leptin concentrations in newborns of diabetic and nondiabetic mothers.

    Science.gov (United States)

    Gross, G A; Solenberger, T; Philpott, T; Holcomb, W L; Landt, M

    1998-04-01

    Leptin plays an important role in regulating body composition through modulation of appetite and energy expenditure. We hypothesized that leptin levels in umbilical cord blood correlate with newborn body weight and habitus. We also hypothesized that infants of diabetic mothers would demonstrate altered leptin metabolism. Venous blood was sampled at birth from the umbilical cords of 105 infants (74 infants of nondiabetic mothers, and 31 infants of diabetic mothers). Thirty-nine mothers had plasma leptin concentrations measured. Analysis was done using Student's t-test, Pearson's correlation, and Spearman's correlation. Univariate/multivariate regression was used for analysis of factors associated with leptin concentration in umbilical cord plasma. Maternal and newborn characteristics were correlated with log leptin levels in umbilical venous plasma. Leptin concentration in umbilical cord plasma correlated best with birth weight for newborns of both nondiabetic and diabetic mothers (p relationship between umbilical cord leptin level and newborn birth weight, as well as maternal DM, but not with gestational age. Similarly, there was no significant correlation with maternal plasma leptin concentration. The strong correlation of leptin concentration in umbilical cord plasma with newborn birth weight, and the lack of significant correlation with maternal leptin plasma levels, suggest that normal fetal leptin metabolism reflects fetal size and/or body habitus independent of maternal leptin metabolism. On the other hand, the higher umbilical plasma levels in infants of diabetic mothers may reflect an influence of altered fetal insulin homeostasis on fetal leptin metabolism, and suggests that maternal diabetes may influence fetal leptin metabolism.

  16. Intervenção fonoaudiológica em recém-nascido pré-termo com gastrosquise Speech language therapy in a preterm newborn infant with gastroschisis

    Directory of Open Access Journals (Sweden)

    Marilene de Souza Rocha

    2007-03-01

    Full Text Available O objetivo deste estudo foi descrever a intervenção fonoaudiológica para a adequação da função alimentar por meio da avaliação e tratamento do sistema estomatognático e suas funções. O estudo foi feito a partir do relato de caso de um recém-nascido pré-termo com gastrosquise que foi alimentado por sonda, atendido na Neonatologia do Hospital Luterano, no período de 29/03/2005 a 22/04/2005. A avaliação fonoaudiológica foi realizada, seguindo o protocolo padronizado do serviço de Neonatologia e apresentou os seguintes resultados: órgãos do sistema estomatognático no que se refere à postura, conformação e mobilidade dentro da normalidade; reflexos orais presentes; força e ritmo adequados na sucção não nutritiva; alteração na sensibilidade oral com reflexo nauseoso anteriorizado e exacerbado; sinal de estresse de alteração respiratória durante a sucção nutritiva na mamadeira; e dificuldade de pegar o seio materno. Foram realizadas três sessões de intervenção fonoaudiológica, uma vez por semana, com orientação para a equipe de enfermagem dar continuidade na estimulação oral nos demais dias. Em uma das sessões, a mãe recebeu orientações sobre os benefícios da amamentação e a importância do uso adequado de chupetas e bico de mamadeira do tipo ortodôntico para o desenvolvimento adequado das funções orais. O recém-nascido do relato de caso teve alta sem alterações orais, mamando no seio materno com complementação de mamadeira, sugerindo desta forma, a importância da intervenção fonoaudiológica para a adequação da função alimentar.The aim of this study was to describe the speech-language therapy regarding the adequation of the feeding function by assessing and treating the stomatognathic system and its functions. The study was carried out based on a case report of a preterm newborn infant with gastroschisis, who was tube fed while assisted in the Neonatology division of Lutheran Hospital

  17. Hearing Loss: Screening Newborns

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Hearing Loss Screening Newborns Past Issues / Spring 2015 Table of ... of newborns in the U.S. are screened for hearing loss before they leave the hospital. Research improves the ...

  18. Newborn Screening Tests

    Science.gov (United States)

    ... the brain and spinal cord). Newborn screening for sickle cell disease can alert doctors to begin antibiotic treatment before infections happen. Newborn screening also helps doctors monitor symptoms more closely and can detect other disorders affecting ...

  19. A multicentre, randomised controlled, non-inferiority trial, comparing nasal high flow with nasal continuous positive airway pressure as primary support for newborn infants with early respiratory distress born in Australian non-tertiary special care nurseries (the HUNTER trial): study protocol

    Science.gov (United States)

    Manley, Brett J; Roberts, Calum T; Arnolda, Gaston R B; Wright, Ian M R; Owen, Louise S; Dalziel, Kim M; Foster, Jann P; Davis, Peter G; Buckmaster, Adam G

    2017-01-01

    Introduction Nasal high-flow (nHF) therapy is a popular mode of respiratory support for newborn infants. Evidence for nHF use is predominantly from neonatal intensive care units (NICUs). There are no randomised trials of nHF use in non-tertiary special care nurseries (SCNs). We hypothesise that nHF is non-inferior to nasal continuous positive airway pressure (CPAP) as primary support for newborn infants with respiratory distress, in the population cared for in non-tertiary SCNs. Methods and analysis The HUNTER trial is an unblinded Australian multicentre, randomised, non-inferiority trial. Infants are eligible if born at a gestational age ≥31 weeks with birth weight ≥1200 g and admitted to a participating non-tertiary SCN, are 1 hour. Infants are randomised to treatment with either nHF or CPAP. The primary outcome is treatment failure within 72 hours of randomisation, as determined by objective oxygenation, apnoea or blood gas criteria or by a clinical decision that urgent intubation and mechanical ventilation, or transfer to a tertiary NICU, is required. Secondary outcomes include incidence of pneumothorax requiring drainage, duration of respiratory support, supplemental oxygen and hospitalisation, costs associated with hospital care, cost-effectiveness, parental stress and satisfaction and nursing workload. Ethics and dissemination Multisite ethical approval for the study has been granted by The Royal Children’s Hospital, Melbourne, Australia (Trial Reference No. 34222), and by each participating site. The trial is currently recruiting in eight centres in Victoria and New South Wales, Australia, with one previous site no longer recruiting. The trial results will be published in a peer-reviewed journal and will be presented at national and international conferences. Trial registration number Australian and New Zealand Clinical Trials Registry (ANZCTR): ACTRN12614001203640; pre-results. PMID:28645982

  20. Interleucina 6 e proteína c reativa no diagnóstico de sepse tardia no recém-nascido Interleukins 6 and c - reactive protein for the diagnosis of late onset sepsis in the newborn infant

    Directory of Open Access Journals (Sweden)

    Maria Esther J. R. Ceccon

    2006-04-01

    Full Text Available OBJETIVO: Verificar a acurácia da interleucina 6 (IL-6 e da proteína C reativa (PCR para o diagnóstico de sepse tardia no recém-nascido (RN. MÉTODOS: Trata-se de estudo de coorte prospectivo com 43 RNs internados com suspeita de sepse tardia na UTIN. Foram dosados no dia da suspeita diagnóstica (dia 0 e nos dias 1, 3 e 7 de evolução os níveis séricos da IL-6 e da PCR e calculado o melhor valor de coorte para o diagnóstico de sepse. Também foram calculados os índices de sensibilidade (S, especificidade (E, valor preditivo positivo e negativo (VPP, VPN para cada um dos testes, assim como para a combinação entre eles. RESULTADOS: Os níveis séricos da IL-6 e da PCR estiveram acima do ponto de coorte nos RN com sepse e com sepse presumível com diferenças significantes entre ambos os grupos, nos quais a única diferença foi hemocultura positiva no primeiro. Foi possível afastar esse diagnóstico em seis RNs. Para o diagnóstico de sepse, a IL-6 obteve os melhores índices no dia da suspeita diagnóstica, dia 0 (S: 88,9%, E: 80%, VPP: 76,2%, VPN: 90,9%, seguida da proteína C reativa (S: 94%, E: 78,3%, VPP: 77,3%, VPN: 94,7% 24 horas após. A combinação dos dois (IL 6/PCR mostrou-se mais adequada para o diagnóstico precoce no dia 0 e até 24 horas de evolução com S e VPN de 100%. CONCLUSÃO: A combinação de IL6/PCR apresentou acurácia para o diagnóstico de sepse. A evolução destes testes ao longo dos dias refletiu a evolução clínica dos RN.BACKGROUND: Verify the accuracy of interleukin 6 (IL-6 and C-reactive protein (CRP for diagnosis of late onset sepsis in newborn (NB infants. METHODS: a prospective cohort study with 43 NB infants hospitalized at the NICU with suspicion of late onset sepsis was carried out. Levels of IL-6 and of CRP were dosed with suspicion diagnoses; day (0 and sequentially on day 1, 3, and 7 of the evolution and the best cut-off values were calculated for the diagnoses. Indices of sensibility (S

  1. Comportamiento de la colestasis del recién nacido y del lactante en el Hospital Pediátrico «William Soler» Behavior of newborn and infant cholestasis in the "William Soler" Children Hospital

    Directory of Open Access Journals (Sweden)

    Norma Hondal Álvarez

    2010-12-01

    reflejo en alguna medida de las diferencias en la composición de las distintas series.INTRODUCTION. The small newborns and infants have a functional and anatomical immaturity justifying that the liver diseases present in these ages have the jaundice as the main sign. The list of processes causing cholestasis during this period is very large including structural, extrahepatic, intrahepatic anomalies and also processes altering the mechanisms synthesis and the excretion of bile salts. The aim of present study was to describe the behavior of the cases of infants presenting with cholestasis seen in the Hepatology Service of the "William Soler" Children General Hospital, assessed in a programmed way between January, 2004 and December, 2006. METHODS. A retrospective and descriptive study was conducted. Sample included 76 patients diagnosed with cholestasis, assessed in a programmed way during this period. Variables analyzed were: sex, gestational age and birth weight, perinatal and postnatal backgrounds, presence or absence of cholestasis. A database was designed in SPSS (version 12 and the variables were analyzed in percentage way. RESULTS. There was predominance of male newborns (45, 59,2%, term (63, 82,9% of normal weight (50,65,7% and without perinatal and postnatal backgrounds. Only in the 9,2% of cases the cholestasis was associated with a liver failure. Frequency of intrahepatic and extrahepatic cholestasis was similar. The major causes of cholestasis present were: biliary tracts atresia (24, 31,5%, idiopathic neonatal hepatitis(15, 19,8%, cytomegalovirus infection (14, 18,5% and bile thickening (9,11,9%. CONCLUSIONS. Behavior of different causes of cholestasis is heterogeneous and the differences as regards the frequencies of cholestasis causes is in some extent a reflection of the differences in the composition of the group of series.

  2. Breastfeeding Determinants in Healthy Term Newborns

    OpenAIRE

    Colombo, Lorenzo; Crippa, Beatrice Letizia; Consonni, Dario; Bettinelli, Maria Enrica; Agosti, Viola; Mangino, Giulia; Bezze, Elena Nicoletta; Mauri, Paola Agnese; Zanotta, Lidia; Roggero, Paola; Plevani, Laura; Bertoli, Donatella; Giannì, Maria Lorella; Mosca, Fabio

    2018-01-01

    Breastfeeding is the normative standard for infant feeding. Despite its established benefits, different factors can affect breastfeeding rates over time. The purpose of this study was to evaluate breastfeeding determinants in healthy term newborns during the first three months of life. A prospective, observational, single-center study was conducted in the nursery of Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico in Milan, Italy. The mother-baby dyads that were admitted to the Clini...

  3. Anaesthetic management of nesidioblastosis in a newborn.

    Directory of Open Access Journals (Sweden)

    Soares A

    1996-01-01

    Full Text Available This report details the management of a newborn with nesidioblastosis who underwent a 95% pancreatectomy under general anaesthesia. The baby presented with hypoglycemic convulsions, due to hyperinsulinism, and was treated with 12.5% dextrose infusions, glucagon and anticonvulsants. Intraoperatively and postoperatively the baby remained hyperglycemic. A postoperative osmotic diuresis necessitated the use of insulin for brief period. The infant remained euglycemic and convulsion free, following discontinuation of the dextrose infusions and starting of oral feeds. Recovery was uneventful.

  4. Allergic enterocolitis in a preterm newborn

    Directory of Open Access Journals (Sweden)

    Clara Preto

    2017-01-01

    Full Text Available We report the case of an infant born at 28 weeks of gestation with a history of intestinal dysmotility over the first week of life, which was solved with the introduction of erythromycin. The infant was fed with breast milk and sporadic doses of special formula for preterm newborns. On the 17th day of life, post conceptional age of 30 weeks, she presented an episode of necrotizing enterocolitis treated with antibiotics. On the 45th day of life, post conceptional age of 34 weeks, the infant presented episodes of apnea, hemodynamic instability, abdominal distension, vomiting and mucous and bloody stools. Owing to the suspicion of a new episode of necrotizing enterocolitis, feeding was stopped and antibiotic therapy was started. Hypereosinophilia was detected in peripheral blood and tests were positive for specific IgE antibodies to cow’s milk proteins. Antibiotics were stopped after negative sepsis workups and feeding with breastmilk and extensively hydrolyzed formula was resumed. The newborn presented with good tolerance.Diagnosing allergy to cow’s milk protein in a newborn infant requires a high degree of suspicion, as it presents with non-specific symptoms. In most cases it manifests as non-IgE-mediated proctocolitis and cases of enterocolitis with specific IgE antibodies to cow’s milk proteins are rare. Some authors argue that the development of cow’s milk protein allergy requires an immunological maturation level not present before a gestational age of 30-32 weeks. Therefore, in preterm newborns, there may be an asymptomatic period of life with subsequent development of an allergy. In the case described, the diagnosis of IgE-mediated cow’s milk protein allergy was confirmed at 34 weeks of post conceptional age. However, the question remains whether the previous digestive symptoms were related to the allergy subsequently diagnosed.

  5. Cerebral oxygenation in newborn infants at risk

    NARCIS (Netherlands)

    Verhagen, Elisabeth Anna

    2012-01-01

    Een verminderd zuurstofgehalte in de hersenen van te vroeg geboren baby’s kan hersenschade tot gevolg hebben. UMCG-promovendus Elise Verhagen onderzocht het zuurstofgehalte in de hersenen van te vroeg geboren baby’s en de precieze gevolgen ervan. De gebruikte onderzoeksmethode, near-infrared

  6. Pantoea agglomerans septicemia in three newborn infants

    NARCIS (Netherlands)

    Bergman, Klasina A.; Arends, Jan P.; Scholvinck, Elisabeth H.

    Pantoea infections are rare in humans, especially in neonates. Infections are usually associated with plant thom injury or outbreaks traced to contaminated parenteral nutrition, intravenous anesthetics or packed er throcytes. Between I st of January 1994 and Ist of June 2005, 125 cf 6383 patients

  7. Surfactant protein D in newborn infants

    DEFF Research Database (Denmark)

    Dahl, Marianne; Juvonen, Pekka Olavi; Holmskov, Uffe

    2005-01-01

    Surfactant protein D (SP-D) is a collectin that plays an important role in the innate immune system. The role of SP-D in the metabolism of surfactant is as yet quite unclear. The aims of this study were to establish normal values of SP-D in the umbilical cord blood and capillary blood of mature...

  8. Infant and Newborn Care - Multiple Languages

    Science.gov (United States)

    ... Hindi (हिन्दी) Japanese (日本語) Korean (한국어) Levantine (Arabic dialect) (Levantine Arabic) Marshallese (Ebon) Modern Standard Arabic (al- ... Russian (Русский) Somali (Af-Soomaali ) Spanish (español) Sudanese (Arabic dialect) (Sudanese Arabic) Ukrainian (українська ) Vietnamese (Tiếng Việt) HealthReach ...

  9. Maternal assessment of pain in premature infants

    OpenAIRE

    Maria Carolina Correia dos Santos; Maria Fernanda Pereira Gomes; Verusca Kelly Capellini; Valéria Cristina dos Santos Carvalho

    2015-01-01

    Objective: to identify mothers' perceptions about the pain in their premature babies in the Neonatal Intensive Care Unit. Methods: evaluative, quantitative study with investigative nature conducted with 19 mothers of hospitalized premature newborns. Data were obtained from closed questions, answered by mothers. Results: from the participants, two (10.5%) reported that newborns are unable to feel pain. From the 17 mothers who said that premature babies can feel pain, the majority (94.1%) ident...

  10. Tachycardia in a newborn with enterovirus infection.

    Science.gov (United States)

    Banjac, Lidija; Nikcević, Drasko; Vujosević, Danijela; Raonić, Janja; Banjac, Goran

    2014-03-01

    Enterovirus infections are common in the neonatal period. Newborns are at a higher risk of severe disease including meningoencephalitis, sepsis syndrome, cardiovascular collapse, or hepatitis. The mechanism of heart failure in patients with enterovirus infection remains unknown. Early diagnosis may help clinicians predict complications in those infants initially presenting with severe disease. An 11-day-old male newborn was admitted to our neonatal intensive care unit because of tachycardia and crises of cyanosis. His elder brother had febrile illness. The newborn was cyanotic, in respiratory distress, with tachycardia, low blood pressure and prolonged capillary refilling time. Limb pulse oximeter was around 85%. During the first day of hospitalization, the newborn had one febrile episode. Laboratory data: elevated transaminases, markers of inflammation negative, all bacterial cultures negative. Enterovirus RNA was detected in blood sample. Other blood findings were without significant abnormalities. Electrocardiogram showed tachycardia, with narrow QRS complexes (atrial tachycardia) and heart rate up to 280/min. In order to convert the rhythm, the patient was administered adenosine and amiodarone. In the further course of hospitalization, the patient was in good general condition, eucardiac and eupneic. Newborns with tachycardia and a family history of febrile illness should be suspected to have enterovirus infection. Enterovirus infection is a highly contagious and potentially life-threatening infection if not detected early. The use of sensitive molecular-based amplification methods offers potential benefits for early diagnosis and timely treatment.

  11. Do wet diapers induce arousals in sleeping infants?

    Science.gov (United States)

    Zotter, H; Urlesberger, B; Pichler, G; Mueller, W; Kerbl, R

    2007-03-01

    To find out whether simulated bladder voiding was able to induce arousals in sleeping infants. Polygraphic recordings were performed in 34 infants and voiding was simulated by administering water into the diaper. Heart rate, respiratory frequency and electroencephalogram frequency did not change significantly during this procedure. Furthermore, simulated voiding was unable to cause an awakening or to induce body movements in sleeping infants. Simulated voiding was unable to induce arousals.

  12. NEWBORN CONDITION AND ANTHROPOMETRIC MEASURES IN BABY FRIENDLY PROGRAM

    Directory of Open Access Journals (Sweden)

    Momcilo Djordjevic

    2008-01-01

    Full Text Available Mother’s breast milk is the best product that the new born infant could be fed with. It contains nutritious matters necessary for growth and progress of the new born infants, ideally adapted for the baby. This is not only the food. It provides the support for protection against infections.The aim of the investigation was to establish whether the newborn condition right after the birth and anthropometric measures affect entering the baby friendly program. The study was conducted during 2003 in OGC CC Kragujevac and included 216 new born infants included in baby friendly program and 216 new born infants outside the program.The following parameters in newborn infants were observed: Apgar score, body mass, body length, head circumference.Significantly most often in both examined groups (73 up to 75%, the value of Apgar score of the new born infants was in the interval 9 – 10 and it did not affect the selection into baby friendly program.New born infants from baby friendly program statistically had significantly greater weight than the infants outside the program-on average for about 80 g. The greater weight positively affects entering the baby friendly program.Body length and infant head circumference did not statistically significantly differed between the examined groups.Statistically important difference in body mass can be justified by higher surveillance of pregnant women from the program. The treatment should reflect in controlled nourishment, avoidance of all harmful causes like consumption of cigarettes and alcoholic drinks, which are proven risks for the newborn infants from such pregnancies to have lesser body mass. The advantage of greater body mass lies in the fact that after the childbirth, the relative loss of the body weight is lesser compared to the infants outside the program.

  13. A Targeted Approach for Congenital Cytomegalovirus Screening Within Newborn Hearing Screening.

    Science.gov (United States)

    Fowler, Karen B; McCollister, Faye P; Sabo, Diane L; Shoup, Angela G; Owen, Kris E; Woodruff, Julie L; Cox, Edith; Mohamed, Lisa S; Choo, Daniel I; Boppana, Suresh B

    2017-02-01

    Congenital cytomegalovirus (cCMV) infection remains a leading cause of childhood hearing loss. Currently universal CMV screening at birth does not exist in the United States. An alternative approach could be testing infants who do not pass their newborn hearing screening (NHS) for cCMV. This study was undertaken to evaluate whether a targeted approach will identify infants with CMV-related sensorineural hearing loss (SNHL). Infants born at 7 US medical centers received NHS and were also screened for cCMV while in the newborn nursery. Infants who tested positive for CMV received further diagnostic audiologic evaluations to identify or confirm hearing loss. Between 2007 and 2012, 99 945 newborns were screened for both hearing impairment and cCMV. Overall, 7.0% of CMV-positive infants did not pass NHS compared with 0.9% of CMV-negative infants (P CMV-infected infants who passed their NHS had SNHL confirmed by further evaluation during early infancy. NHS in this cohort identified 57% of all CMV-related SNHL that occurred in the neonatal period. A targeted CMV approach that tests newborns who fail their NHS identified the majority of infants with CMV-related SNHL at birth. However, 43% of the infants with CMV-related SNHL in the neonatal period and cCMV infants who are at risk for late onset SNHL were not identified by NHS. Copyright © 2017 by the American Academy of Pediatrics.

  14. Septo-Optic Dysplasia in a Newborn Presenting with Bilateral Dilated and Fixed Pupils

    OpenAIRE

    Jabeen, Mehnaz; Hairfield, Amber; Swischuk, Leonard E.; Jain, Sunil K.

    2016-01-01

    Introduction?We describe a newborn female infant with septo-optic dysplasia (SOD) presenting with bilateral dilated and fixed pupils. Conclusion?Our report is unique because the incidental finding of bilateral dilated and fixed pupils on the newborn exam was the only clinical finding which led to a prompt work-up and eventual diagnosis of SOD.

  15. Salbutamol for transient tachypnea of the newborn.

    Science.gov (United States)

    Moresco, Luca; Bruschettini, Matteo; Cohen, Amnon; Gaiero, Alberto; Calevo, Maria Grazia

    2016-05-23

    Transient tachypnea of the newborn is characterized by tachypnea and signs of respiratory distress. Transient tachypnea typically appears within the first two hours of life in term and late preterm newborns. Although transient tachypnea of the newborn is usually a self limited condition, it is associated with wheezing syndromes in late childhood. The rationale for the use of salbutamol (albuterol) for transient tachypnea of the newborn is based on studies showing that β-agonists can accelerate the rate of alveolar fluid clearance. To assess whether salbutamol compared to placebo, no treatment or any other drugs administered to treat transient tachypnea of the newborn, is effective and safe in the treatment of transient tachypnea of the newborn in infants born at 34 weeks' gestational age or more. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, 2016, Issue 3), MEDLINE (1996 to March 2016), EMBASE (1980 to March 2016) and CINAHL (1982 to March 2016). We applied no language restrictions. We searched the abstracts of the major congresses in the field (Perinatal Society of Australia New Zealand and Pediatric Academic Societies) from 2000 to 2015 and clinical trial registries. Randomized controlled trials, quasi-randomized controlled trials and cluster trials comparing salbutamol versus placebo or no treatment or any other drugs administered to infants born at 34 weeks' gestational age or more and less than three days of age with transient tachypnea of the newborn. For each of the included trials, two review authors independently extracted data (e.g. number of participants, birth weight, gestational age, duration of oxygen therapy, need for continuous positive airway pressure and need for mechanical ventilation, duration of mechanical ventilation, etc.) and assessed the risk of bias (e.g. adequacy of randomization, blinding, completeness of follow-up). The primary outcomes considered in this review were duration of oxygen therapy, need for

  16. Electromyographic activity of preterm newborns in the kangaroo position: a cohort study

    OpenAIRE

    Miranda, Rafael Moura; Cabral Filho, José Eulálio; Diniz, Kaísa Trovão; Souza Lima, Geisy Maria; Vasconcelos, Danilo de Almeida

    2014-01-01

    Objective To compare the electromyographic activity of preterm newborns placed in the kangaroo position with the activity of newborns not placed in this position. Design A cohort study. Setting A Kangaroo Unit sector and a Nursery sector in a secondary and tertiary care at a mother-child hospital in Recife, Brazil. Participants Preterm infants of gestational age 27–34 weeks (n=38) and term infants (n=39). Primary and secondary outcome measures Surface electromyography was used to investigate ...

  17. A randomized trial of exothermic mattresses for preterm newborns in polyethylene bags.

    LENUS (Irish Health Repository)

    McCarthy, Lisa K

    2013-07-01

    Hypothermia on admission to the NICU is associated with increased mortality in preterm infants. Many newborns are hypothermic on admission despite using polyethylene bags (PBs). Using exothermic mattresses (EMs) in addition to PBs may reduce hypothermia but increase hyperthermia. We wished to determine whether placing preterm newborns in PBs on EMs in the DR results in more infants with rectal temperature outside the range 36.5 to 37.5°C on NICU admission.

  18. NUCLEOTIDES IN INFANT FEEDING

    Directory of Open Access Journals (Sweden)

    L.G. Mamonova

    2007-01-01

    Full Text Available The article reviews the application of nucleotides-metabolites, playing a key role in many biological processes, for the infant feeding. The researcher provides the date on the nucleotides in the women's milk according to the lactation stages. She also analyzes the foreign experience in feeding newborns with nucleotides-containing milk formulas. The article gives a comparison of nucleotides in the adapted formulas represented in the domestic market of the given products.Key words: children, feeding, nucleotides.

  19. Severe hemolytic disease of the newborn from anti-e.

    Science.gov (United States)

    McAdams, R M; Dotzler, S A; Winter, L W; Kerecman, J D

    2008-03-01

    Maternal antibody-mediated fetal red blood cell destruction secondary to non-D Rhesus (Rh) antibodies is a significant cause of hemolytic disease of the newborn (HDN). Here, we report a rare case of severe HDN associated with maternal antibody to Rh e. In addition to severe anemia, the infant developed thrombocytopenia, conjugated hyperbilirubinemia and cholelithiasis. Resolution of the infant's cholelithiasis occurred following treatment with ursodeoxycholic acid.

  20. Respiratory distress in the newborn.

    Science.gov (United States)

    Reuter, Suzanne; Moser, Chuanpit; Baack, Michelle

    2014-10-01

    Respiratory distress presents as tachypnea, nasal flaring, retractions, and grunting and may progress to respiratory failure if not readily recognized and managed. Causes of respiratory distress vary and may not lie within the lung. A thorough history, physical examination, and radiographic and laboratory findings will aid in the differential diagnosis. Common causes include transient tachypnea of the newborn, neonatal pneumonia, respiratory distress syndrome (RDS), and meconium aspiration syndrome (MAS). Strong evidence reveals an inverse relationship between gestational age and respiratory morbidity. (1)(2)(9)(25)(26) Expert opinion recommends careful consideration about elective delivery without labor at less than 39 weeks’ gestation. Extensive evidence, including randomized control trials, cohort studies, and expert opinion, supports maternal group B streptococcus screening, intrapartum antibiotic prophylaxis, and appropriate followup of high-risk newborns according to guidelines established by the Centers for Disease Control and Prevention. (4)(29)(31)(32)(34) Following these best-practice strategies is effective in preventing neonatal pneumonia and its complications. (31)(32)(34). On the basis of strong evidence, including randomized control trials and Cochrane Reviews, administration of antenatal corticosteroids (5) and postnatal surfactant (6) decrease respiratory morbidity associated with RDS. Trends in perinatal management strategies to prevent MAS have changed. There is strong evidence that amnioinfusion, (49) oropharyngeal and nasopharyngeal suctioning at the perineum, (45) or intubation and endotracheal suctioning of vigorous infants (46)(47) do not decrease MAS or its complications. Some research and expert opinion supports endotracheal suctioning of nonvigorous meconium-stained infants (8) and induction of labor at 41 weeks’ gestation (7) to prevent MAS.

  1. Salivary biomarkers are not suitable for pain assessment in newborns.

    Science.gov (United States)

    Shibata, Minoru; Kawai, Masahiko; Matsukura, Takashi; Heike, Toshio; Okanoya, Kazuo; Myowa-Yamakoshi, Masako

    2013-07-01

    Newborns admitted to the neonatal intensive care unit are repeatedly subjected to painful or stressful procedures; therefore, objective assessment of their pain is essential. An increasing number of scales for neonatal pain assessment have been developed, many of which are based on physiological and behavioral factors. Recently, salivary biomarkers have been used to assess stress in adults and older infants. This study aimed to determine whether salivary biomarkers can be useful objective indices for assessing newborn pain. A total of 47 healthy newborns were enrolled 3-4days after birth. Heel lancing was performed to collect blood for a newborn screening test. Before and after heel lancing, saliva was collected to analyze hormone levels, a video was recorded for behavioral observations, and heart rate was recorded. Two investigators independently assessed newborn pain from the video observations using the Neonatal Infant Pain Scale (NIPS). Salivary chromogranin (sCgA) and salivary amylase (sAA) levels were measured using an enzyme-linked immunosorbent assay kit and a dry chemistry system, respectively. No definite changes in salivary biomarkers (sCgA or sAA) were detected before and after heel lancing. However, newborn sCgA levels were markedly higher than reported adult levels, with large inter- and intra-subject variability, whereas newborn sAA levels were lower than adult levels. NIPS score and heart rate were dramatically increased after heel lancing. NIPS score (behavioral assessment) and heart rate are useful stress markers in newborns. However, neither sCgA nor sAA is suitable for assessing newborn pain. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Cerebral oximetry in preterm infants

    DEFF Research Database (Denmark)

    Greisen, Gorm; Andresen, Bjørn; Plomgaard, Anne Mette

    2016-01-01

    Preterm birth constitutes a major cause of death before 5 years of age and it is a major cause of neurodevelopmental impairment across the world. Preterm infants are most unstable during the transition between fetal and newborn life during the first days of life and most brain damage occurs...

  3. Prevalence of bacterial contamination of powdered infant feeds in a ...

    African Journals Online (AJOL)

    Background The study arose as part of a nutrition model regarding the introduction of ready-to-use (RTU) infant feeds in place of powdered infant feeds (PIFs) as a standard formula for infants under the age of 1 year who are unable to be breastfed. Internationally and locally there is grave concern regarding the safety and ...

  4. Development and evaluation of a newborn care education programme in primiparous mothers in Nepal.

    Science.gov (United States)

    Shrestha, Sharmila; Adachi, Kumiko; Petrini, Marcia A; Shrestha, Sarita; Rana Khagi, Bina

    2016-11-01

    the health and survival of newborns depend on high levels of attention and care from caregivers. The growth and development of some infants are unhealthy because of their mother's or caregiver's lack of knowledge or the use of inappropriate or traditional child-rearing practices that may be harmful. to develop a newborn care educational programme and evaluate its impact on infant and maternal health in Nepal. a randomised controlled trial. one hundred and forty-three mothers were randomly assigned to the intervention (n=69) and control (n=74) groups. Eligible participants were primiparous mothers who had given birth to a single, full-term, healthy infant, and were without a history of obstetric, medical, or psychological problems. prior to being discharged from the postnatal unit, the intervention group received our structured newborn care education programme, which consisted of one-on-one educational sessions lasting 10-15minutes each and one postpartum follow-up telephone support within two weeks after discharge, in addition to the hospital's routine general newborn care education. The control group received only the regular general newborn care education. Outcomes were measured by using Newborn care Knowledge Questionnaires, Karitane Parenting Confidence Scale, State-Trait Anxiety Inventory for Adults and infant health and care status. the number of mothers attending the health centre due to the sickness of their babies was significantly decreased in the intervention group compared to the control group. Moreover, the intervention group had significant increases in newborn care knowledge and confidence, and decreases in anxiety, compared with the control group. the structured newborn care education programme enhanced the infant and mother health. Moreover, it increased maternal knowledge of newborn care and maternal confidence; and reduced anxiety in primiparous mothers. Thus, this educational programme could be integrated into routine educational programs to

  5. Infant hearing loss and connexin testing in a diverse population.

    Science.gov (United States)

    Schimmenti, Lisa A; Martinez, Ariadna; Telatar, Milhan; Lai, Chih-Hung; Shapiro, Nina; Fox, Michelle; Warman, Berta; McCarra, Matthew; Crandall, Barbara; Sininger, Yvonne; Grody, Wayne W; Palmer, Christina G S

    2008-07-01

    Previous studies of connexin-related hearing loss have typically reported on mixed age groups or adults. To further address epidemiology and natural history of connexin-related hearing loss, we conducted a longitudinal study in an ethnically diverse cohort of infants and toddlers under 3 years of age. Our study compares infants with and without connexin-related hearing loss to examine differences in the prevalence of connexin and non-connexin-related hearing loss by ethnic origin, detection by newborn hearing screening, phenotype, neonatal risk factors, and family history. This is the first study to differentiate infants with and without connexin-related hearing loss. We enrolled 95 infants with hearing loss from whom both exons of Cx26 were sequenced and the Cx30 deletion was assayed. Demographic, family history, newborn hearing screening data, perinatal, and audiologic records were analyzed. Genetic testing identified biallelic Cx26/30 hearing loss-associated variants in 24.7% of infants with a significantly lower prevalence in Hispanic infants (9.1%). Eighty-two infants underwent newborn hearing screening; 12 infants passed, 3 had connexin-related hearing loss. No differences in newborn hearing screening pass rate, neonatal complications, or hearing loss severity were detected between infants with and without connexin-related hearing loss. Family history correlates with connexin-related hearing loss. Connexin-related hearing loss occurs in one quarter of infants in an ethnically diverse hearing loss population but with a lower prevalence in Hispanic infants. Not all infants with connexin-related hearing loss fail newborn hearing screening. Family history correlates significantly with connexin-related hearing loss. Genetic testing should not be deferred because of newborn complications. These results will have an impact on genetic testing for infant hearing loss.

  6. Hypothermia therapy for newborns with hypoxic ischemic encephalopathy.

    Science.gov (United States)

    Silveira, Rita C; Procianoy, Renato S

    2015-01-01

    Therapeutic hypothermia reduces cerebral injury and improves the neurological outcome secondary to hypoxic ischemic encephalopathy in newborns. It has been indicated for asphyxiated full-term or near-term newborn infants with clinical signs of hypoxic-ischemic encephalopathy (HIE). A search was performed for articles on therapeutic hypothermia in newborns with perinatal asphyxia in PubMed; the authors chose those considered most significant. There are two therapeutic hypothermia methods: selective head cooling and total body cooling. The target body temperature is 34.5 °C for selective head cooling and 33.5 °C for total body cooling. Temperatures lower than 32 °C are less neuroprotective, and temperatures below 30 °C are very dangerous, with severe complications. Therapeutic hypothermia must start within the first 6h after birth, as studies have shown that this represents the therapeutic window for the hypoxic-ischemic event. Therapy must be maintained for 72 h, with very strict control of the newborn's body temperature. It has been shown that therapeutic hypothermia is effective in reducing neurologic impairment, especially in full-term or near-term newborns with moderate hypoxic-ischemic encephalopathy. Therapeutic hypothermia is a neuroprotective technique indicated for newborn infants with perinatal asphyxia and hypoxic-ischemic encephalopathy. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  7. Prenatal air pollution exposure and newborn blood pressure

    NARCIS (Netherlands)

    van Rossem, Lenie; Rifas-Shiman, Sheryl L.; Melly, Steven J.; Kloog, Itai; Luttmann-Gibson, Heike; Zanobetti, Antonella; Coull, Brent A.; Schwartz, Joel D.; Mittleman, Murray A.; Oken, Emily; Gillman, Matthew W.; Koutrakis, Petros; Gold, Diane R.

    2015-01-01

    Background: Air pollution exposure has been associated with increased blood pressure in adults. oBjective: We examined associations of antenatal exposure to ambient air pollution with newborn systolic blood pressure (SBP). Methods: We studied 1,131 mother–infant pairs in a Boston, Massachusetts,

  8. Responses to lumbar magnetic stimulation in newborns with spina bifida.

    NARCIS (Netherlands)

    Geerdink, N.; Pasman, J.W.; Roeleveld, N.; Rotteveel, J.J.; Mullaart, R.A.

    2006-01-01

    Searching for a tool to quantify motor impairment in spina bifida, transcranial and lumbar magnetic stimulation were applied in affected newborn infants. Lumbar magnetic stimulation resulted in motor evoked potentials in both the quadriceps muscle and the tibialis anterior muscle in most (11/13)

  9. Maternal knowledge and care.seeking behaviors for newborn ...

    African Journals Online (AJOL)

    Background: Delay in the presentation of infants with jaundice at the hospital is a reason for the persistence of the severe forms of jaundice. Objective: The aim was to determine the influence of maternal knowledge on newborn jaundice on their care-seeking practices. Methods: In a cross-sectional survey, mothers whose ...

  10. Clinical monitoring of systemic hemodynamics in critically ill newborns.

    NARCIS (Netherlands)

    Boode, W.P. de

    2010-01-01

    Circulatory failure is a major cause of mortality and morbidity in critically ill newborn infants. Since objective measurement of systemic blood flow remains very challenging, neonatal hemodynamics is usually assessed by the interpretation of various clinical and biochemical parameters. An overview

  11. A Care Coordination Program for Substance-Exposed Newborns

    Science.gov (United States)

    Twomey, Jean E.; Caldwell, Donna; Soave, Rosemary; Fontaine, Lynne Andreozzi; Lester, Barry M.

    2011-01-01

    The Vulnerable Infants Program of Rhode Island (VIP-RI) was established as a care coordination program to promote permanency for substance-exposed newborns in the child welfare system. Goals of VIP-RI were to optimize parents' opportunities for reunification and increase the efficacy of social service systems involved with families affected by…

  12. Maternal knowledge and care‑seeking behaviors for newborn ...

    African Journals Online (AJOL)

    2014-06-24

    Jun 24, 2014 ... Background: Delay in the presentation of infants with jaundice at the hospital is a reason for the persistence of the severe forms of jaundice. Objective: The aim was to determine the influence of maternal knowledge on newborn jaundice on their care-seeking practices. Methods: In a cross-sectional survey, ...

  13. alpha-Thalassaemia and hyperbilirubinaemia in G-6-PD-deficient newborns.

    OpenAIRE

    Meloni, T; Corti, R; Costa, S; Mele, G; Franca, V

    1980-01-01

    53 newborn infants with both G-6-PD deficiency (29 male hemizygotes and 24 female heterozygotes) and alpha-thalassaemia, and 120 newborn infants with only the enzymatic defect (60 male hemizygotes and 60 female heterozygotes) were studied. 12 of those with both G-6-PD deficiency and alpha=thalassaemia, and 32 of those with only G-6-PD deficiency showed hyperbilirubinaemia. alpha-Thalassaemia does not seem to be implicated in the development of hyperbilirubinaemia in G-6-PD-deficient newborns.

  14. Neurobehavioural and Cognitive Development in Infants Born to Mothers with Eating Disorders

    Science.gov (United States)

    Barona, Manuela; Taborelli, Emma; Corfield, Freya; Pawlby, Susan; Easter, Abigail; Schmidt, Ulrike; Treasure, Janet; Micali, Nadia

    2017-01-01

    Introduction: Although recent research has focused on the effects of maternal eating disorders (EDs) on children, little is known about the effect of maternal EDs on neurobiological outcomes in newborns and infants. This study is the first to investigate neurobehavioural regulation and cognitive development in newborns and infants of mothers with…

  15. Amplitude-integrated electroencephalographic activity is suppressed in preterm infants with high scores on illness severity

    NARCIS (Netherlands)

    ter Horst, Hendrik J.; Jongbloed-Pereboom, Marjolein; van Eykern, Leo A.; Bos, Arend F.

    Background: The neonatal acute physiology score. SNAP-II, reflects the severity of illness in newborns. In term newborns, amplitude integrated EEG (aEEG), is depressed following asphyxia. In preterm infants aEEG is discontinuous, and therefore more difficult to assess compared to term infants. Aims:

  16. Clinical features of pneumocystic pneumonia in newborns

    Directory of Open Access Journals (Sweden)

    Gasanova T.A.

    2012-12-01

    Full Text Available The research goal is to study clinical features and incidence of pneumocystic pneumonia in newborns. The research methods: The research has included 227 newborns with pneumocystic pneumonia: 154 (67,8% — premature, 64 (28,1 % — mature with intrauterine growth retardation with body weight from 2232,0 up to 2840,0 gr., and 9 (3,9% — mature without intrauterine growth retardation. The indication of Pneumocystiscarini has been carried out by means of immunofluorescence with «Pnevmocistofluoskril» polyclonal antibodies by ZAO Niarmedik+, as well as stained by Romanovsky Giemsa technique and by Toluidine Blue. Results: Clinical and microbiological aspects of pneumocystic pneumonia in newborns of different maturity have been studied. The frequency of pneumocystic infection agent separation during the neonatal period has been characterized. Conclusion: The received data have indicated the potential intrauterine agent transmission from mother to infant. The high risk of generalization of the given infection form in newborns has been observed. It has been pointed out that biotopes are the most relevant means in neonatal pneumocystosis diagnostics.

  17. Vitamin D Deficiency among Newborns in Amman, Jordan

    Science.gov (United States)

    Khuri-Bulos, Najwa; Lang, Ryan D.; Blevins, Meridith; Kudyba, Katherine; Lawrence, Lindsey; Davidson, Mario; Faouri, Samir; Halasa, Natasha B.

    2014-01-01

    Objective: Vitamin D deficiency is well recognized in selected Middle Eastern countries, but neonatal vitamin D status is not well studied in Jordan and other nearby countries. The aim of this study is to determine the prevalence of vitamin D deficiency in Jordanian newborns and risk factors associated with low levels. Methods: This is a prospective cohort study of newborn infants who were delivered at the Al Bashir Government Hospital in Amman, Jordan, from January 31, 2010, to January 27, 2011. Heel stick blood samples for 25-hydroxyvitamin D [25(OH)D] levels were obtained within 96 hours of birth. Maternal dress pattern, vitamin supplementation, smoke exposure during pregnancy, mode of delivery, gestational age, and birth weight were documented. Results: Samples were obtained from 3,731 newborns. Median gestational age was 39 weeks, median birth weight was 3.1 kilograms, median maternal age was 27 years, and median newborn 25(OH)D level was 8.6nmol/L. A total of 3,512 newborns (94.1%) in this study were vitamin D deficient (< 50 nmol/L). Lower gestational age, maternal smoke exposure, and birth during winter months were associated with lower infant vitamin D levels, while vitamin D supplementation and time spent outside during pregnancy were associated with higher vitamin D levels. Conclusions: The prevalence of severely low vitamin D levels in newborn infants in Amman, Jordan, is substantial, even in newborns born during the spring and summer months. Vitamin D supplementation is needed in this population. PMID:24373276

  18. Newborn Respiratory Distress.

    Science.gov (United States)

    Hermansen, Christian L; Mahajan, Anand

    2015-12-01

    Newborn respiratory distress presents a diagnostic and management challenge. Newborns with respiratory distress commonly exhibit tachypnea with a respiratory rate of more than 60 respirations per minute. They may present with grunting, retractions, nasal flaring, and cyanosis. Common causes include transient tachypnea of the newborn, respiratory distress syndrome, meconium aspiration syndrome, pneumonia, sepsis, pneumothorax, persistent pulmonary hypertension of the newborn, and delayed transition. Congenital heart defects, airway malformations, and inborn errors of metabolism are less common etiologies. Clinicians should be familiar with updated neonatal resuscitation guidelines. Initial evaluation includes a detailed history and physical examination. The clinician should monitor vital signs and measure oxygen saturation with pulse oximetry, and blood gas measurement may be considered. Chest radiography is helpful in the diagnosis. Blood cultures, serial complete blood counts, and C-reactive protein measurement are useful for the evaluation of sepsis. Most neonates with respiratory distress can be treated with respiratory support and noninvasive methods. Oxygen can be provided via bag/mask, nasal cannula, oxygen hood, and nasal continuous positive airway pressure. Ventilator support may be used in more severe cases. Surfactant is increasingly used for respiratory distress syndrome. Using the INSURE technique, the newborn is intubated, given surfactant, and quickly extubated to nasal continuous positive airway pressure. Newborns should be screened for critical congenital heart defects via pulse oximetry after 24 hours but before hospital discharge. Neonatology consultation is recommended if the illness exceeds the clinician's expertise and comfort level or when the diagnosis is unclear in a critically ill newborn.

  19. CSF 5-HIAA and family history of antisocial personality disorder in newborns.

    Science.gov (United States)

    Constantino, J N; Morris, J A; Murphy, D L

    1997-12-01

    The relationship between genetic liability for antisocial behavior and CSF 5-hydroxyindoleacetic acid (5-HIAA) in newborns was explored. The authors assayed 5-HIAA in "leftover" CSF from 193 neurologically normal newborns and obtained family psychiatric histories of the newborns' first- and second-degree relatives. Levels of 5-HIAA were significantly lower in the infants with family histories of antisocial personality disorder than in the newborns without such family histories. These findings support the possibility that serotonin mediates one component of genetic liability to antisocial outcome, but the magnitude of that component may be less than what has been inferred from previously published reports.

  20. Optical coherence tomography of the newborn airway.

    Science.gov (United States)

    Ridgway, James M; Su, Jianping; Wright, Ryan; Guo, Shuguang; Kim, David C; Barretto, Roberto; Ahuja, Gurpreet; Sepehr, Ali; Perez, Jorge; Sills, Jack H; Chen, Zhongping; Wong, Brian J F

    2008-05-01

    Acquired subglottic stenosis in a newborn is often associated with prolonged endotracheal intubation. This condition is generally diagnosed during operative endoscopy after airway injury has occurred. Unfortunately, endoscopy is unable to characterize the submucosal changes observed in such airway injuries. Other modalities, such as magnetic resonance imaging, computed tomography, and ultrasound, do not possess the necessary level of resolution to differentiate scar, neocartilage, and edema. Optical coherence tomography (OCT) is an imaging modality that produces high-resolution, cross-sectional images of living tissue (8 to 20 microm). We examined the ability of this noninvasive technique to characterize the newborn airway in a prospective clinical trial. Twelve newborn patients who required ventilatory support underwent OCT airway imaging. Comparative analysis of intubated and non-intubated states was performed. Imaging of the supraglottis, glottis, subglottis, and trachea was performed in 12 patients, revealing unique tissue characteristics as related to turbidity, signal backscattering, and architecture. Multiple structures were identified, including the vocal folds, cricoid cartilage, tracheal rings, ducts, glands, and vessels. Optical coherence tomography clearly identifies in vivo tissue layers and regional architecture while offering detailed information concerning tissue microstructures. The diagnostic potential of this technology makes OCT a promising modality in the study and surveillance of the neonatal airway.

  1. Hemothorax in the newborn

    International Nuclear Information System (INIS)

    Oppermann, H.C.; Wille, L.

    1980-01-01

    Twenty cases of hemothorax in newborns are reviewed in detail. This unusual cause of acute respiratory distress within the neonatal period was observed in 14 males and 6 females. Most of the patients were fullterm newborns. As causal factors hemorrhagic disease of the newborn (vitamin K deficiency), disseminated intravascular coagulation, arteriovenous malformations and pleural/vascular rupture are considered. The time of occurrence of bleeding symptoms ranged from 1 to 28 days of life. Sixteen out of 20 patients survived without sequelae, but in 4 cases the outcome was lethal. (orig.) [de

  2. Late haemorrhagic disease of the newborn.

    Science.gov (United States)

    Zengin, Emine; Sarper, Nazan; Türker, Gülcan; Corapçioğlu, Funda; Etuş, Volkan

    2006-09-01

    Late haemorrhagic disease of the newborn (HDN) can occur owing to a lack of vitamin K prophylaxis, as a manifestation of an underlying disorder or idiopatically from the 8th day to 12 weeks after birth. Eight infants admitted to Kocaeli University Hospital with nine episodes of late HDN between January 2002 and April 2005 were evaluated retrospectively from hospital records. The median age at presentation was 46 (26-111) days. All the infants were born at full-term to healthy mothers and were exclusively breast-fed. All had an uneventful perinatal history, except one who had meconium aspiration. Four patients had received no vitamin K prophylaxis and another three had uncertain histories. At presentation, six had intracranial bleeding and the remainder had bleeding either from the venepuncture site or the gastro-intestinal tract. The presenting signs and symptoms were irritability, vomiting, bulging or full fontanelle, convulsions and diminished or absent neonatal reflexes. Galactosaemia was detected in a 2-month-old infant with prolonged jaundice. There was no surgery-related mortality or complications but one survived for only 2 days on ventilatory support following surgery. Only one of the six survivors had severe neurological sequelae. Late HDN frequently presents with intracranial haemorrhage, leading to high morbidity and mortality. HDN can be the manifestation of an underlying metabolic disorder. Vitamin K prophylaxis of the newborn should be routine in developing countries.

  3. Profile and Stability of Sensorineural Hearing Loss in Persistent Pulmonary Hypertension of the Newborn.

    Science.gov (United States)

    Walton, Joseph P.; Hendricks-Munoz, Karen

    1991-01-01

    This study found that 19 of 51 infants with persistent pulmonary hypertension of the newborn were diagnosed with sensorineural hearing loss, an incidence 25 times greater than that of intensive care unit infants in general. Treatment durations with mechanical ventilation were significantly longer for the hearing-impaired group compared to the…

  4. Chlamydia trachomatis Infections: Implications for Pregnant Adolescents and Their Infants

    Directory of Open Access Journals (Sweden)

    Marlene Melzer-Lange

    1994-01-01

    trachomatis in pregnant adolescents. This study was undertaken to determine if aggressive screening for C. trachomatis in pregnant adolescents and early treatment with erythromycin can prevent complications in their newborn infants.

  5. Skin findings in newborns and their relationship with maternal factors: observational research.

    Science.gov (United States)

    Ekiz, Ozlem; Gül, Ulker; Mollamahmutoğlu, Leyla; Gönül, Müzeyyen

    2013-02-01

    Cutaneous lesions are commonly seen in the newborn period and exhibit inconsistency from the skin lesions of an adult. The present study was carried out with an aim to determine the frequency of physiologic and pathologic cutaneous findings in newborns. Typically, 1234 newborns were included in this study. A questionnaire about maternal gestational history, maternal and family history was issued to the parents of each newborn. The presence of cutaneous lesions was recorded. Overall, 642 (52%) of the newborns were male and 592 (48%) were female. Typically, 831 newborns (67.3%) had at least one cutaneous lesion. The prevalence of genital hyperpigmentation and milia was significantly higher in males. In premature newborns, the pervasiveness of cutis marmorata and genital hyperpigmentation was found to be significantly higher. Caput succedaneum, transient neonatal pustular melanosis and cyanosis appeared predominantly in vaginally born infants. Erythema toxicum neonatorum was seen in infants, who were born by cesarean section. The predominance of Mongolian spots and erythema toxicum neonatorum were significantly higher in the newborns of the multiparous mothers; however, caput succedaneum was significantly higher in newborns of the primiparous mothers. A number of studies about neonatal dermatoses have been carried out involving different methods in various countries. We consider that our study may be useful in literature, as it has been carried out involving large number of maternal parameters.

  6. Jaundice in Healthy Newborns

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Jaundice in Healthy Newborns KidsHealth / For Parents / Jaundice in ... within a few days of birth. Types of Jaundice The most common types of jaundice are: Physiological ( ...

  7. Communication and Your Newborn

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Communication and Your Newborn KidsHealth / For Parents / Communication and ... to answer your little one's needs. How Babies Communicate Babies are born with the ability to cry, ...

  8. Infant access and handling in sooty mangabeys and vervet monkeys

    NARCIS (Netherlands)

    Noe, R.; Fruteau, C.; van Damme, E.E.C.

    2010-01-01

    Access to one’s newborn infant is a commodity that can be traded for other benefits such as grooming in nonhuman primates. According to the biological market paradigm, the price paid should fluctuate with the number of newborns in the group. We investigated the grooming sessions between mothers with

  9. Causes of Acute Intranatal and Postnatal Hypoxia in Neonatal Infants

    OpenAIRE

    S. A. Perepelitsa; A. M. Golubev; V. V. Moroz; S. V. Alekseyeva

    2012-01-01

    Objective: to study the causes of acute intranatal hypoxia and reveal a relationship of placental changes to respiratory failure (RF) in newborn infants. Subjects and methods. The investigation included 252 neonates with the complicated course of an early neonatal period. Their gestational age was 26 weeks to 40 weeks, birth weight varied from 850 g to 4100 g. 95.3% of the newborn infants were born with a low Apgar score and RF, which required mechanical ventilation immediately after birth. T...

  10. Proteção do recém-nascido contra o tétano pela imunização ativa da gestante com antitoxina tetânica: estudo original de 1953 Protection of newborn infants against tetanus by active immunization of the pregnant women with tetanus antitoxin: the 1953 original study

    Directory of Open Access Journals (Sweden)

    Augusto Gomes Mattos

    2008-12-01

    and after 15 days of life. One group of guinea pigs received a booster dose of tetanus toxoid 30 days before delivery and the immunization status of dam and offspring was also studied. In a clinical trial, pregnant women were vaccinated in any period of gestation with three doses of tetanus toxoid with a 30-day interval; the antibody levels were measured in the mother and in the newborn infant at birth and at the 15th day of life. RESULTS: The antibody levels of guinea pigs offspring immunized with tetanus toxoid during gestation were elevated at birth and at the 15th day of life. These levels were elevated by the booster dose 30 days prior to delivery. In pregnant women, the immunization with three doses of tetanus toxoid was followed by immunity in 95% of the studied infants studied. The newborn infants of vaccinated women presented elevated levels of antibodies at birth and at 15th day of life. CONCLUSIONS: Vaccination during gestation was followed by protective levels of antibodies in guinea pigs and in newborn infants.

  11. Newborn hearing screening protocol in tuscany region.

    Science.gov (United States)

    Berrettini, Stefano; Ghirri, Paolo; Lazzerini, Francesco; Lenzi, Giovanni; Forli, Francesca

    2017-09-20

    Newborn hearing screening has to be considered the first step of a program for the identification, diagnosis, treatment and habilitation/rehabilitation of children with hearing impairment. In Tuscany Region of Italy, the universal newborn hearing screening is mandatory since november 2007. The first guidelines for the execution of the screening have been released in June 2008; then many other Italian regions partially or totally adopted these guidelines. On the basis of the experience from 2008 and according to the recent evidences in the scientific literature, a new screening protocol was released in Tuscany region. The new protocol is an evolution of the previous one. Some issues reported in the previous protocol and in the Joint Committee on Infant Hearing statement published in 2007 were revised, such as the risk factors for auditory neuropathy and for late onset, progressive or acquired hearing loss. The new updated guidelines were submitted to the Sanitary Regional Council and then they have been approved in August 2016. The updated screening protocol is mainly aimed to identify newborns with a congenital moderate-to-profound hearing loss, but it also provides indications for the audiological follow-up of children with risk's factor for progressive or late onset hearing loss; further it provides indications for the audiological surveillance of children at risk for acquired hearing impairment. Then, in the new guidelines the role of the family paediatrician in the newborn hearing screening and audiological follow-up and surveillance is underscored. Finally the new guidelines provide indications for the treatment with hearing aids and cochlear implant, in accordance with the recent Italian Health Technology Assessment (HTA) guidelines. In the paper we report the modality of execution of the universal newborn hearing screening in the Tuscany Region, according to the recently updated protocol. The main features of the protocol and the critical issues are

  12. Pharmacokinetics and pharmacodynamics of medication in asphyxiated newborns during controlled hypothermia. The PharmaCool multicenter study

    NARCIS (Netherlands)

    Haan, T.R.; Bijleveld, Y.A.; van der Lee, J. H.; Groenendaal, F.; van den Broek, M.P.H.; Rademaker, C.M.A.; van Straaten, H.L.M.; van Weissenbruch, M.M.; Vermeulen, R.J.; Dijk, P.H.; Dudink, J.; Rijken, M.; van Heijst, A.; Dijkman, K.P.; Gavilanes, D.; van Kaam, A.H.; Offringa, M.; Mathot, R.A.A.

    2012-01-01

    Background: In the Netherlands, perinatal asphyxia (severe perinatal oxygen shortage) necessitating newborn resuscitation occurs in at least 200 of the 180-185.000 newly born infants per year. International randomized controlled trials have demonstrated an improved neurological outcome with

  13. Newborn Body Indices in Housewives and Working Mothers

    Directory of Open Access Journals (Sweden)

    Alieh Torabizadeh

    2008-06-01

    Full Text Available Objective: This study aimed to compare newborns anthropometric indices of housewives and employed women.Materials and Methods: This case control study compared newborns’ anthropometric indices (weight, length, head circumference and first minute APGAR between working women and housewives. Two hundred consecutive term pregnant women during active phase of labor without any pregnancy complications were evaluated. For each participant a questionnaire was filled by the researcher. Employed women according to their standing position during work time were divided into three groups: heavy, light and moderate jobs.   Results: The mean weight, length and head circumference of the newborns were higher in employed women (p=0.018, p<0.001, p=0.010, respectively. After eliminating effect of the interfering variables by using a general linear model, it was observed that the mother’s job has a direct influence on newborn's length and head circumference. But infant's weight was similar in two groups (p=0.340. The newborn's anthropometric indices and first minute APGAR had not significant difference in subgroups of job difficulty.Conclusion: Maternal job has a direct positive influence on newborn's length and head circumference. But infant's weight is not related to maternal job.

  14. Newborn physiological responses to noise in the neonatal unit,

    Directory of Open Access Journals (Sweden)

    Sandra Maria Schefer Cardoso

    2015-12-01

    Full Text Available ABSTRACT INTRODUCTION: The incorporation of technologies in the care of infants has contributed to increased survival; however, this has turned neonatal unit into a noisy environment. OBJECTIVE: To evaluate the physiological and functional effects resulting from the exposure to noise on low-weight newborns in incubators in a neonatal unit. METHODS: Prospective, observational, quantitative, exploratory, descriptive study. The adopted statistical method included tables of frequency, descriptive statistics, and Student's t-test, with a 0.05 level of significance. As data collection tools, the environmental noise and the noise inside of the incubator were evaluated, and the Assessment of Preterm Infant Behavior scale was used to assess premature newborn behavior and projected specifically to document the neurobehavioral functioning of preterm infants. The data collection occurred from September of 2012 to April of 2013; 61 low-weight newborns admitted in the neonatal unit and in incubators were observed. RESULTS: Significant differences in the variables heart rate and oxygen saturation were noted when newborns were exposed to noise. CONCLUSION: Low-weight neonates in incubators present physiological alterations when facing discomfort caused by environmental noise in neonatal units.

  15. Newborn physiological responses to noise in the neonatal unit.

    Science.gov (United States)

    Cardoso, Sandra Maria Schefer; Kozlowski, Lorena de Cássia; Lacerda, Adriana Bender Moreira de; Marques, Jair Mendes; Ribas, Angela

    2015-01-01

    The incorporation of technologies in the care of infants has contributed to increased survival; however, this has turned neonatal unit into a noisy environment. To evaluate the physiological and functional effects resulting from the exposure to noise on low-weight newborns in incubators in a neonatal unit. Prospective, observational, quantitative, exploratory, descriptive study. The adopted statistical method included tables of frequency, descriptive statistics, and Student's t-test, with a 0.05 level of significance. As data collection tools, the environmental noise and the noise inside of the incubator were evaluated, and the Assessment of Preterm Infant Behavior scale was used to assess premature newborn behavior and projected specifically to document the neurobehavioral functioning of preterm infants. The data collection occurred from September of 2012 to April of 2013; 61 low-weight newborns admitted in the neonatal unit and in incubators were observed. Significant differences in the variables heart rate and oxygen saturation were noted when newborns were exposed to noise. Low-weight neonates in incubators present physiological alterations when facing discomfort caused by environmental noise in neonatal units. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  16. Safety of a dual potential prebiotic system from Mexican agave "Metlin® and Metlos®", incorporated to an infant formula for term newborn babies: a randomized controlled trial.

    Science.gov (United States)

    López-Velázquez, Gabriel; Díaz-García, Luisa; Anzo, Anahi; Parra-Ortiz, Minerva; Llamosas-Gallardo, Beatriz; Ortiz-Hernández, Ana Alejandra; Mancilla-Ramírez, Javier; Cruz-Rubio, José Manuel; Gutiérrez-Castrellón, Pedro

    2013-01-01

    Infant formulae are being supplemented with probiotics, prebiotics, or symbiotic despite uncertainties regarding their efficacy. Mexican agave is an interesting source of fructans with particular features and with potential prebiotic effects. RCT in 600 healthy term babies (20 ± 7 days), allocated to receive standard infant formula (control) or infant formula added with a dual prebiotic system "Metlin® and Metlos®", from Mexican agave. Primary outcomes include stools frequency, stools consistency, gastrointestinal intolerance (frequency of abdominal distension, flatulency, regurgitations, vomiting). Secondary outcomes include changes on weight and height along the study and frequency of dermatologic problems (eczema). In 66,120 days of total follow-up, there were no differences on the frequency of stools passage (Human Milk: 3.8 ± 2.4 evacuations per day; Pro + Metlin + Metlos 3.6 ± 2.0; Pro + Metlin 3.6 ± 2; only Pro 3.4 ± 2.3¸ only formula 3.4 ± 2.0; p NS). Consistency of stools was similar between human milk and prebiotics supplemented groups. Also the frequency of gastrointestinal symptoms was significantly low between these groups. Fructans derivate from agave and added to infant formula are safe and well tolerated by Mexican healthy term babies.

  17. Maternal assessment of pain in premature infants

    Directory of Open Access Journals (Sweden)

    Maria Carolina Correia dos Santos

    2015-12-01

    Full Text Available Objective: to identify mothers' perceptions about the pain in their premature babies in the Neonatal Intensive Care Unit. Methods: evaluative, quantitative study with investigative nature conducted with 19 mothers of hospitalized premature newborns. Data were obtained from closed questions, answered by mothers. Results: from the participants, two (10.5% reported that newborns are unable to feel pain. From the 17 mothers who said that premature babies can feel pain, the majority (94.1% identified crying as a characteristic of pain sensation. Eleven (64.7% stated that uneasiness is a sign of pain in newborns. Conclusion: for the proper management of neonatal pain it is essential that mothers know the signs of pain in premature newborns, and that health professionals instruct this recognition, through the enhancement of the maternal presence and practice of effective communication between professionals and newborns’ families.

  18. White matter injury in newborns with congenital heart disease: a diffusion tensor imaging study.

    Science.gov (United States)

    Mulkey, Sarah B; Ou, Xiawei; Ramakrishnaiah, Raghu H; Glasier, Charles M; Swearingen, Christopher J; Melguizo, Maria S; Yap, Vivien L; Schmitz, Michael L; Bhutta, Adnan T

    2014-09-01

    Brain injury is observed on cranial magnetic resonance imaging preoperatively in up to 50% of newborns with congenital heart disease. Newer imaging techniques such as diffusion tensor imaging provide sensitive measures of the white matter integrity. The objective of this study was to evaluate the diffusion tensor imaging analysis technique of tract-based spatial statistics in newborns with congenital heart disease. Term newborns with congenital heart disease who would require surgery at less than 1 month of age were prospectively enrolled (n = 19). Infants underwent preoperative and postoperative brain magnetic resonance imaging with diffusion tensor imaging. Tract-based spatial statistics, an objective whole-brain diffusion tensor imaging analysis technique, was used to determine differences in white matter fractional anisotropy between infant groups. Term control infants were also compared with congenital heart disease infants. Postmenstrual age was equivalent between congenital heart disease infant groups and between congenital heart disease and control infants. Ten infants had preoperative brain injury, either infarct or white matter injury, by conventional brain magnetic resonance imaging. The technique of tract-based spatial statistics showed significantly lower fractional anisotropy (P tensor imaging analysis technique that may have better sensitivity in detecting white matter injury compared with conventional brain magnetic resonance imaging in term newborns with congenital heart disease. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Management of severe hypertension in the newborn.

    Science.gov (United States)

    Dionne, Janis M; Flynn, Joseph T

    2017-12-01

    Blood pressure is considered a vital sign, as values too low or too high can be related with serious morbidity and mortality. In neonates, normal blood pressure values undergo rapid changes, especially in premature infants, making the recognition of abnormal blood pressures more challenging. Severe hypertension can occur in neonates and infants and is a medical emergency, often manifesting with congestive heart failure or other life-threatening complications. The cause or risk factors for the hypertension can usually be identified and may guide management. Most classes of antihypertensive medications have been used in the neonatal population. For severe hypertension, intravenous short-acting medications are preferred for a controlled reduction of blood pressure. In this article, we focus on identification, aetiology and management of severe hypertension in the newborn. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Studies on the prevention of respiratory distress syndrome of infants due to hyaline membrane disease with plasminogen.

    Science.gov (United States)

    Ambrus, C M; Choi, T S; Weintraub, D H; Eisenberg, B; Staub, H P; Courey, N G; Foote, R J; Goplerud, D; Moesch, R V; Ray, M; Bross, I D; Jung, O S; Mink, I B; Ambrus, J L

    1975-07-01

    Hyaline membrane disease (HMD) is leading single cause of death of newborn, premature infants. The "hyaline membranes" consist chiefly of fibrin. The clinical manifestation of HMD is the respiratory distress syndrome (RDS). Infants with RDS were treated with urokinase-activated human plasmin in a previous clinical trial. Survival rate was increased in the plasmin treated group as compared to the placebo recipients. However, cost and difficulty in the preparation of the enzyme made this treatment impractical. We, as well as others, have shown the premature infants lack serum plasminogen; thus they are unable to develop effective fibrinolysis and are defenseless against pulmonary fibrin deposition. Therefore, plamsinogen was tested as a possible preventive agent in RDS due to HMD. In a double blind, randomized study, infants between 1 and 2.5 kg birth weight received plasminogen or placebo shortly after birth, and were then followed for development of RDS. After 100 infants were entered into the study, the code was broken and results were evaluated to assure safety of the procedure. Among the 100 infants, 51 received placebo, 49 received plasminogen. Among the infants who received placebo, seven developed mild, and ten developed severe respiratory distress; of these ten, five died with histopathologically documented HMD. Two infants died from causes other than HMD. Among the 49 infants treated with plasminogen, 13 developed mild and three developed severe respiratory distress. There was no death due to HMD. Two deaths were due to other causes. Factors placing the infant at risk from HMD (degree of prematurity, sex, cesarean section, bleeding episodes during pregnancy, maternal diabetes) were found to be evenly distributed between control and treated groups. Since completing the first phase of the study, data of an additional 277 infants has become available. Although the code was not broken in this series, a preliminary look at mortality data in comparison with

  1. Newborn screening program for hemoglobinopathies in Rio de Janeiro, Brazil.

    Science.gov (United States)

    Lobo, Clarisse Lopes de Castro; Ballas, Samir K; Domingos, Ana Carolina Bonini; Moura, Patricia G; do Nascimento, Emilia Matos; Cardoso, Gilberto Perez; de Carvalho, Silvia Maia Farias

    2014-01-01

    Newborn screening for hemoglobinopathy in Brazil has been decentralized until 2001 when the Health Ministry of Brazil established the National Newborn Hemoglobinopathy Screening Program. The State of Rio de Janeiro started a program in collaboration with the State Health Department and the Institute of Hematology in Rio (HEMORIO). The goal of this study was to evaluate the effectiveness of the first 10 years of the Newborn Hemoglobinopathy Screening Program in identifying and managing infants with Sickle cell disease (SCD) in the State of Rio de Janeiro. Blood samples from 1,217,833 neonates were analyzed by High Performance Liquid Chromatography. Infants with SCD were enrolled in comprehensive treatment programs. Data showed that 4.87% of the newborns were heterozygous for a hemoglobin variant, 0.08% were homozygous or doubly heterozygous for abnormal hemoglobins and 95.02% had normal hemoglobin. All the 912 newborns with SCD were referred for treatment at HEMORIO, 34 (3.7%) of these died due to acute chest syndrome, sepsis or splenic sequestration. Four more children died of unknown causes. The implementation of the Rio de Janeiro Newborn Screening Program gradually increased the area of the State covered by the program. Data collected during the 10 years of the program showed reduction in mortality of patients with SCD in comparison to available historical statistical data before the implementation of the national screening program. This 10-year study showed that early diagnosis and treatment of newborns was associated with improved survival and quality of life of Brazilian children with SCD. © 2013 Wiley Periodicals, Inc.

  2. Observations in the bone marrow of newborn height

    OpenAIRE

    Reynafarje, César

    2014-01-01

    Has been studied in bone marrow 9 newborns and infants 9 week old, from great heights. These investigations were carried out at two levels of altitude: 14,900 feet (Morococha) and 12,250 feet (La Oroya). From the results it follows that there is a hyperplasia of the elements of the red series, which is not, however, significantly higher than that found in newborns of sea level. After a week of birth occurred, an inhibition of erythropoietic activity, which does not reach as low as seen in inf...

  3. Maternal and neonatal vaccination protects newborn baboons from pertussis infection.

    Science.gov (United States)

    Warfel, Jason M; Papin, James F; Wolf, Roman F; Zimmerman, Lindsey I; Merkel, Tod J

    2014-08-15

    The United States is experiencing a pertussis resurgence that resulted in a 60-year high of 48 000 cases in 2012. The majority of hospitalizations and deaths occur in infants too young to be vaccinated. Neonatal and maternal vaccination have been proposed to protect newborns until the first vaccination, currently recommended at 2 months of age. These interventions result in elevated anti-Bordetella pertussis titers, but there have been no studies demonstrating that these measures confer protection. Baboons were vaccinated with acellular pertussis vaccine at 2 days of age or at 2 and 28 days of age. To model maternal vaccination, adult female baboons primed with acellular pertussis vaccine were boosted in the third trimester of pregnancy. Neonatally vaccinated infants, infants born to vaccinated mothers, and naive infants born to unvaccinated mothers were infected with B. pertussis at 5 weeks of age. Naive infant baboons developed severe disease when challenged with B. pertussis at 5 weeks of age. Baboons receiving acellular pertussis vaccine and infants born to mothers vaccinated at the beginning of their third trimester were protected. Our results demonstrate that neonatal vaccination and maternal vaccination confer protection in the baboon model and support further study of these strategies for protection of newborns from pertussis. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2013. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  4. Intensive care unit: results of the Newborn Hearing Screening.

    Science.gov (United States)

    Rechia, Inaê Costa; Liberalesso, Kátia Pase; Angst, Otília Valéria Melchiors; Mahl, Fernanda Donato; Garcia, Michele Vargas; Biaggio, Eliara Pinto Vieira

    2016-01-01

    Procedures for extending the life of newborns are closely related to potential causes of hearing loss, justifying the identification and understanding of risk factors for this deficiency. To characterize the population, analyze the frequency of risk factors for hearing loss, and assess the audiological status of infants attended in a Newborn Hearing Screening program (NHS). This was a retrospective study that analyzed medical records of 140 patients from a neonatal intensive care unit, identifying the frequency of risk factors for hearing loss and audiological status, utilizing transient otoacoustic emissions and brainstem auditory evoked potential (BAEP). Prematurity was present in 78.87% of cases; 45% of the infants were underweight and 73% received ototoxic medication. Audiologically, 11.42% failed the NHS, and 5% of cases failed retest; of these, one had results compatible with hearing loss on BAEP. A higher rate of low birth weight, and prematurity was observed in infants who underwent screening and had an audiological diagnosis by the third month of life. Only one newborn presented a change in audiological status. The authors emphasize the importance of auditory monitoring for all infants, considering this as a high-risk sample for hearing loss. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  5. [Early discharge of newborns: what problems should we anticipate?].

    Science.gov (United States)

    Straczek, H; Vieux, R; Hubert, C; Miton, A; Hascoet, J-M

    2008-06-01

    Following Nordic and Anglo-Saxon countries, France is directing towards an early discharge policy from maternity hospitals. French National Authority for Health has published recommendations focusing on the importance to highlight the dangers of such a policy so as to be able to anticipate them. To describe the complications diagnosed in the newborn infants from day 2 to the current hospital's discharge (noteworthy, if infants are discharged early, these complications may occur at home) to determine predictive factors and to validate those proposed by the French National Authority for Health. Prospective study conducted in the maternity ward of Nancy's level III facility, from January 6th to May 6th 2005. Nine hundred and three newborn infants were included. Forty-two (4.6%) presented with complications diagnosed from day 2 to hospital's discharge, among which 4 required urgent neonatal care. The most frequent complication was hyperbilirubinemia: 23 newborns were treated with phototherapy between day 2 and day 10. Statistically significant risk factors of hyperbilirubinemia after day 2 in multivariate analysis were instrumental vaginal delivery (OR=2.94; CI 95% [1.04-8.34]) and jaundice before day 2 (OR=7.39; CI 95% [2.66-20.55]). According to the French National Authority for Health's policy, 33 among 42 infants presenting with a complication would have been withdrawn from an early discharge program. In our population, French National Authority for Health's recommendations were relevant to guide an early discharge project.

  6. Validation of Greek Versions of the Neonatal Infant Pain Scale and Premature Infant Pain Profile in Neonatal Intensive Care Unit.

    Science.gov (United States)

    Dionysakopoulou, Christina; Giannakopoulou, Margarita; Lianou, Loukia; Bozas, Evangelos; Zannikos, Kirikas; Matziou, Vasiliki

    2017-09-22

    The Neonatal Infant Pain Scale and the Premature Infant Pain Profile have been used widely in neonatal intensive care units for pain assessment. This study reports the evaluation and validation of these scales in full-term newborns who were hospitalized in two Greek neonatal intensive care units. Evaluation and validation of the Neonatal Infant Pain Scale and the Premature Infant Pain Profile in full-term newborns who were hospitalized in two Greek neonatal intensive care units. A cross-sectional study. Two neonatal intensive care units at a large General Children's Hospital in Greece. A total of 81 full-term newborns. This cross-sectional study was conducted in two neonatal intensive care units at a large General Children's Hospital in Greece. We studied 81 full-term newborns, who were exposed to various painful routine procedures. A single measurement was taken from each neonate. Two observers were present during each procedure and evaluated pain using both the Neonatal Infant Pain Scale and Premature Infant Pain Profile. Internal consistency coefficient Cronbach's α, internal class agreement coefficient, and κ factor were appropriately measured. The weighting of the Neonatal Infant Pain Scale and Premature Infant Pain Profile pointed out an excellent coherence between the two scales and agreement among the researchers. The internal consistency coefficient Cronbach's α was >.8 and the internal class agreement coefficient was >.98 for both scales, which indicates an excellent consistency between scales. The κ factor for Neonatal Infant Pain Scale was >.73 and for the Premature Infant Pain Profile it was >.6, which indicates a significant agreement among investigators. The Neonatal Infant Pain Scale and Premature Infant Pain Profile were successfully adjusted in Greek standards with reliability between the scales and among the researchers. Moreover, they constitute reliable tools for the evaluation of neonatal procedural pain in full-term newborns in Greece

  7. El recién nacido febril sin signos de focalización y con punción lumbar fallida en la evaluación inicial The febrile newborn infant with signs of focalization and with failed lumbar puncture in the initial evaluation

    Directory of Open Access Journals (Sweden)

    Manuel Díaz Álvarez

    2008-03-01

    grave y el manejo del tratamiento antibiótico, ante la situación de una punción lumbar fallida, no determinó una evolución adversa.INTRODUCTION. The lumbar puncture is indicated in the initial evaluation of the febrile newborn without signs of focalization. However, it may fail and create uncertainty in the management of the antibiotic treatment. The objective of this paper was to verify the treatment and evolution of the febrile newborn infants without signs of focalization, when the lumbar puncture failed in the initial evaluation. METHODS. 150 febrile newborn infants without signs of focalization and with failed lumbar puncture in the initial evaluation that were admitted in the neonatology service of our hospital between 1992 and 2000 were studied. All the patients were classified according to the criterion of low risk of severe bacterial infection. The use of antibiotic treatment was subjected to the consideration of the physician that made the initial evaluation. The index and rate of failed lumbar puncture were calculated and the relation between the indication of the antibiotic treatment at the beginning and the classification of severe bacterial infection risk was measured. The evolution of the patients was checked. RESULTS. 150 of the 1174 lumbar punctures failed (8.5 % for an index of 9.2. The newborn infants considered as high risk received antibiotic treatment more frequently (23.3 % compared with those classified as low risk, who were predominantly treated without antibiotics (36.0 % (p = 0.03. 149 neonates were discharged alive (99.3 %, with or without use of antibiotics. However, there was a dead child classified as high risk for severe bacterial infection that received antibiotic treatment from the beginning. CONCLUSIONS. The lumbar puncture may fail on evaluating the febrile newborn infants without signs of focalization. The indication of antimicrobial treatment in these patients was significantly connected with the classification of risk for

  8. Using APOS Theory Framework: Why Did Students Unable To Construct a Formal Proof?

    Directory of Open Access Journals (Sweden)

    Syamsuri Syamsuri

    2017-08-01

    Full Text Available Mathematical thinking is necessary in mathematics learning especially in college level. One of activities in undergraduate mathematics learning is proving. This article describes students’ thinking process who unable to construct mathematical formal proof. The description uses APOS Theory to explore students’ mental mechanism and students’ mental structure while they do proving. This research is qualitative research that conducted on students majored in mathematics education in public university in Banten province, Indonesia. Data was obtained through asking students to solve proving-task using think-aloud and then following by interview based task. Results show that the students could not construct a formal proof because they unable to appear encapsulation process. They merely enable to think interiorization and coordination. Based on the results, some suitable learning activities should designed to support the construction of these mental mechanism.

  9. Intraventricular hemorrhage of the newborn

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007301.htm Intraventricular hemorrhage of the newborn To use the sharing features on this page, please enable JavaScript. Intraventricular hemorrhage (IVH) of the newborn is bleeding into the ...

  10. Influência da fisioterapia respiratória sobre a função cardiopulmonar em recém-nascidos de muito baixo peso Effects of respiratory physiotherapy on the cardiopulmonary function of very low birth weight newborn infants

    Directory of Open Access Journals (Sweden)

    Carla Marques Nicolau

    2010-06-01

    Full Text Available OBJETIVO: Avaliar as repercussões da fisioterapia respiratória sobre a função cardiopulmonar em recém-nascidos pré-termo (RNPT submetidos à ventilação mecânica. MÉTODOS: Estudo prospectivo de RNPT com peso de nascimento menor que 1500g, sendo verificados os valores de frequência cardíaca (FC, saturação de oxigênio (SatO2, frequência respiratória (FR e pressão arterial sistêmica (PA antes e após a fisioterapia respiratória e a aspiração endotraqueal. Os RNPT incluídos foram avaliados em sessões sequenciais entre o 3º-7º dias de vida por dois fisioterapeutas da unidade neonatal. Os valores de FC, SatO2 e PA foram coletados por monitorização eletrônica e a FR, por cronômetro. Na análise estatística, foi utilizado o teste de ANOVA para medidas repetidas, sendo significante pOBJECTIVE: To assess the effects of respiratory physiotherapy on cardiopulmonary function of ventilated preterm newborns infants (PTNB. METHODS: This prospective study included PTNB with birth weight lower than 1500g. Before and after respiratory physiotherapy and endotracheal suction, the following parameters were evaluated: heart rate (HR, oxygen saturation (O2Sat, respiratory rate (RR and blood pressure (BP. The newborns were evaluated in consecutive sessions between the 3rd-7th day of life by two therapists in the neonatal unit. HR, O2Sat and BP data were collected by electronic monitoring and RR by a stopwatch. Results were analyzed by repeated measures ANOVA, being significant p<0.05. RESULTS: We evaluated 42 PTNB, 57% females, with a mean birth weight of 1024g and a mean gestational age of 29.5 weeks. Only three PTNB had a 5th minute Apgar lower than 5. Respiratory Distress Syndrome was the most prevalent disease (88%. In total, 252 physiotherapy sessions were applied to these 42 infants. HR, RR, O2Sat and BP remained within the physiological limits after procedures, including endotracheal suction. CONCLUSIONS: Procedures for physiotherapy

  11. Prevalência de infecção congênita por citomegalovírus em recém-nascidos de uma unidade de tratamento intensivo de um hospital público The prevalence of congenital cytomegalovirus infection in newborn infants at an intensive care unit in a public hospital

    Directory of Open Access Journals (Sweden)

    Clarissa Schreiner Miura

    2006-02-01

    Full Text Available OBJETIVO: Determinar a prevalência da infecção congênita por citomegalovírus em recém-nascidos internados na unidade de terapia intensiva neonatal de um hospital público de Porto Alegre. METODOS: Estudo transversal, incluindo 261 recém-nascidos que nasceram em um hospital público da cidade de Porto Alegre no ano de 2003 e foram internados na unidade de terapia intensiva neonatal. Foi coletada amostra de urina nos primeiros 7 dias de vida e realizado o teste de reação em cadeia da polimerase para a pesquisa do DNA do citomegalovírus. RESULTADOS: A prevalência de infecção congênita por citomegalovírus na população estudada foi de 0,8% (IC 95%: 0,097-2,86. Devido à baixa prevalência, não foi possível associar fatores de risco. CONCLUSÕES: A prevalência de infecção congênita por citomegalovírus em uma unidade de terapia intensiva neonatal de um hospital público de Porto Alegre não foi considerada elevada, sendo semelhante à prevalência encontrada em outros estudos realizados.OBJECTIVE: To determine the prevalence of congenital cytomegalovirus infection in newborn infants admitted to an intensive care unit in a public hospital in Porto Alegre. METHODS: A cross-sectional study of 261 newborn infants born at a public hospital in the city of Porto Alegre in 2003 and admitted to the intensive care ward. Urine samples were collected within 7 days of birth and a polymerase chain reaction-PCR performed to test for cytomegalovirus DNA. RESULTS: The prevalence of congenital cytomegalovirus infection among the study population was 0.8% (95% CI: 0.097%-2.86%. It was not possible to assess risk factors because this prevalence was so low. CONCLUSIONS: The prevalence of congenital cytomegalovirus infection in an intensive care unit at a public hospital in Porto Alegre was not considered elevated and was comparable with prevalence rates found by other studies.

  12. Domestic maternal experience with preterm newborn children.

    Science.gov (United States)

    de Souza, Nilba Lima; Pinheiro-Fernandes, Ana C; Clara-Costa, Iris do Céu; Cruz-Enders, Bertha; de Carvalho, Jovanka Bittencourt Leite; da Silva, Maria de Lourdes Costa

    2010-06-01

    Exploring maternal experience with premature newborn children in a domestic environment. The study was qualitative and used focus group interviews with 24 women who had had preterm deliveries in a public maternity hospital located in Northeast Brazil during June and October 2005. The mothers returned to the hospital facility at least 30 days after the newborn were discharged to share their experiences in caring for a premature infant at home. Interview data was analysed for content, four thematic nuclei being identified: hospital discharge, preparing the family for discharge, caring for a premature baby at home and life changes arising from the premature birth. The greatest difficulties reported by the mothers in caring for their premature children at home were related to feeding and feelings of insecurity and fear were expressed which showed the need for a support network for the families following discharge. The mothers care of premature infants at home represented changes for parents in everyday family life, work and social life, thus showing the need for a support network for them during the transition from hospital to home when considering premature children.

  13. Epinephrine for transient tachypnea of the newborn.

    Science.gov (United States)

    Moresco, Luca; Calevo, Maria Grazia; Baldi, Federica; Cohen, Amnon; Bruschettini, Matteo

    2016-05-23

    Transient tachypnea of the newborn is characterized by tachypnea and signs of respiratory distress. Transient tachypnea typically appears within the first two hours of life in term and late preterm newborns. Although transient tachypnea of the newborn is usually a self limited condition, it is associated with wheezing syndromes in late childhood. The rationale for the use of epinephrine (adrenaline) for transient tachypnea of the newborn is based on studies showing that β-agonists can accelerate the rate of alveolar fluid clearance. To assess whether epinephrine compared to placebo, no treatment or any other drugs (excluding salbutamol) is effective and safe in the treatment of transient tachypnea of the newborn in infants born at 34 weeks' gestational age or more. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, 2016, Issue 3), MEDLINE (1996 to March 2016), EMBASE (1980 to March 2016) and CINAHL (1982 to March 2016). We applied no language restrictions. We searched the abstracts of the major congresses in the field (Perinatal Society of Australia and New Zealand and Pediatric Academic Societies) from 2000 to 2015. Randomized controlled trials, quasi-randomized controlled trials and cluster trials comparing epinephrine versus placebo or no treatment or any other drugs administered to infants born at 34 weeks' gestational age or more and less than three days of age with transient tachypnea of the newborn. For the included trial, two review authors independently extracted data (e.g. number of participants, birth weight, gestational age, duration of oxygen therapy (hours), need for continuous positive airway pressure and need for mechanical ventilation, duration of mechanical ventilation, etc.) and assessed the risk of bias (e.g. adequacy of randomization, blinding, completeness of follow-up). The primary outcomes considered in this review were duration of oxygen therapy (hours), need for continuous positive airway pressure and need for

  14. Avaliação da função pulmonar de recém-nascidos com síndrome do desconforto respiratório em diferentes pressões finais expiratórias positivas Assessment of pulmonary function of preterm newborn infants with respiratory distress syndrome at different positive end expiratory pressure levels

    Directory of Open Access Journals (Sweden)

    Luiz C.T. Consolo

    2002-09-01

    Full Text Available RESUMO\tABSTRACT \t Objetivo: verificar as alterações da função pulmonar: complacência dinâmica (Cdyn, volume corrente inspiratório (V Tinsp, pressão arterial de dióxido de carbono (PaCO2, em recém-nascidos pré-termo com síndrome do desconforto respiratório. Pacientes e Métodos: estudo de caso controle, incluindo 11 pré-termos com idade gestacional Objective: to verify the alterations of pulmonary function in preterm newborn infants with respiratory distress syndrome (RDS. The parameters analyzed were Dynamic Compliance (Cdyn, Inspiratory Tidal Volume (TVinsp, partial arterial pressure of carbon dioxide (PaCO2. Methods: eleven preterm newborn infants, with gestational age < 35 weeks, and birth weight < 2.500 g, were include in a control case study. All infants presented RDS and were treated with 120 mg/Kg of porcine surfactant. The initial positive end expiratory pressure (PEEP was 3 cm H2O. A pneumotachograph with a graphical monitor was used to assess the pulmonary function. After each increase in the PEEP (4 and 6 cm H2O, there was an interval of 20 minutes before measuring the arterial data of pulmonary function and arterial gases. Results: there were three males and eight females (1:2,7 among the infants with RDS. The mean gestational age was 30.78. 2.05 weeks, ranging from 26 to 34 weeks. The increase in the PEEP from 3 to 6 cm H2O caused significant decrease in the TVinsp (6.46 ±3.43 to 4.20 ±2.35, P=0.0262. With the increase in the PEEP from 4 to 6 cm H2O, there was also a decrease in the TVinsp (5.98.± 3.33 to 4.20.± 2.35, (P=0.0044. Regarding the Cdyn, when there was an increase in the PEEP from 3 to 6 cm H2O, the reduction was statistically significant (0.58.± 0.27 to 0.46± 0.25, P=0.0408 and from 4 to 6 cm H2O, the reduction in the Cdyn was also important (0.77± 0.27 to 0.46± 0.25, (P=0.0164. Increases in the PEEP from 4 to 6 cm H2O caused increases in the PaCO2 (52.81± 15.49 to 64.90± 12.69, (P= 0,0141. A

  15. Preventing Hypothermia in Preterm Infants: A Program of Research ...

    African Journals Online (AJOL)

    Neonatal hypothermia is a worldwide problem and leads to increased morbidity and mortality in newborn infants. This paper describes a program of research to examine thermoregulation in premature infants and to decrease neonatal hypothermia. Our studies include 1) examining an intervention to reduce heat loss in ...

  16. Hyponatraemia in very low birth weight infants | Ndwiga | East ...

    African Journals Online (AJOL)

    Objective: To evaluate the influence of infant early neonatal morbidity on serum sodium levels and justify regular monitoring and supplementation. Design: Comparative cohort study. Setting: Newborn Unit, Kenyatta National Hospital, Nairobi. Subjects: Fifty six very low birth weight (1000-1500 grams at birth) infants during ...

  17. Dietary transition difficulties in preterm infants: critical literature review

    Directory of Open Access Journals (Sweden)

    Carla Lucchi Pagliaro

    2016-01-01

    Conclusion: Very low birth weight preterm newborns are more likely to have feeding problems in early postnatal stages and during childhood when compared with full‐term infants. Monitoring the feeding of these infants after hospital discharge is strictly recommended in an early intervention program aiming at better development of feeding skills.

  18. Women's groups' perceptions of neonatal and infant health ...

    African Journals Online (AJOL)

    Aims To present the perceptions of women in rural Malawi regarding the health problems affecting neonates and infants and to explore the relevance of these perceptions for child health policy and strategy in Malawi. Methods Women's groups in Mchinji district identified newborn and infant health problems (204 groups, ...

  19. Sensorial saturation for infants' pain.

    Science.gov (United States)

    Bellieni, Carlo Valerio; Tei, Monica; Coccina, Francesca; Buonocore, Giuseppe

    2012-04-01

    Sensorial saturation (SS) is a multisensorial stimulation consisting of delicate tactile, gustative, auditory and visual stimuli. This procedure consists of simultaneously: attracting the infant's attention by massaging the infant's face; speaking to the infant gently, but firmly, and instilling a sweet solution on the infant's tongue. We performed a systematic Medline search of for articles focusing on human neonatal studies related to SS. The search was performed within the last 10 years and was current as of January 2012. We retrieved 8 articles that used a complete form of SS and 2 articles with an incomplete SS. Data show that the use of SS is effective in relieving newborns' pain. Oral solution alone are less effective than SS, but the stimuli without oral sweet solution are ineffective. the partial forms of SS have some effectiveness, but minor than the complete SS. Only one article showed lack of SS as analgesic method, after endotracheal suctioning. SS can be used for all newborns undergoing blood samples or other minor painful procedures. It is more effective than oral sugar alone. SS also promotes interaction between nurse and infant and is a simple effective form of analgesia for the neonatal intensive care unit.

  20. Newborn Black Holes

    Science.gov (United States)

    Science Teacher, 2005

    2005-01-01

    Scientists using NASA's Swift satellite say they have found newborn black holes, just seconds old, in a confused state of existence. The holes are consuming material falling into them while somehow propelling other material away at great speeds. "First comes a blast of gamma rays followed by intense pulses of x-rays. The energies involved are much…

  1. Severe late anemia of hemolytic disease of the newborn

    Science.gov (United States)

    Mitchell, Simon; James, Andrew

    1999-01-01

    Late anemia is a well-recognized complication of Rhesus hemolytic disease of the newborn (HDN). The incidence of Rhesus HDN is declining, with a tendency for more severely affected pregnancies to be managed in specialist centres. Consequently, many paediatric departments may see relatively few affected infants with comparatively mild disease, and the risk of late anemia in such cases may not always be appreciated. Two cases of infants born with evidence of Rhesus isoimmunization noted at birth and encountering no immediate problems other than mild hyperbilirubinemia are described. After an uneventful early neonatal course, both infants were discharged without follow-up and presented in the second to third weeks of life with severe, life-threatening anemia, leading to neurological sequelae in one case. The importance of close surveillance, including hemoglobin measurements, in all infants with Rhesus hemolytic disease, irrespective of initial severity, is reiterated. PMID:20212966

  2. Black lung persistent pulmonary hypertension of the newborn

    Science.gov (United States)

    Alnemri, AbdulRahman M.

    2017-01-01

    Objectives: To determine the clinical presentation, risk factors, diagnosis, and treatment outcome of Saudi infants with black lung persistent pulmonary hypertension of the newborn (PPHN). Methods: This is a retrospective review of all neonates with PPHN presented to the Armed Force Hospital Southern Region, Kingdom of Saudi Arabia from January 2012 to December 2014. Results: Ten term and near term infants presented with PPHN were included. Maternal diabetes and Down syndrome were the most common identified risk factors for PPHN in the study group. Nine infants were treated with oral sildenafil and did not require mechanical ventilation. Only one infant required mechanical ventilation and inhaled nitric oxide in addition to oral sildenafil. Conclusion: Most of the patients in this cohort with PPHN had risk factors, they did not require mechanical ventilation and responded well to oral sildenafil. PMID:28042638

  3. Child-rearing history and emotional bonding in parents of preterm and full-term infants

    NARCIS (Netherlands)

    Hall, R.A.S.; Hoffenkamp, H.N.; Tooten, A.; Braeken, J.; Vingerhoets, A.J.J.M.; van Bakel, H.J.A.

    2015-01-01

    Some parents fail to develop strong emotional bonds with their newborn infants. As the quality of the parent–infant relationship contributes to the infant’s development, it is of great importance to identify protective and risk factors that facilitate or impede the development of the parent–infant

  4. Spot diagnosis: An ominous rash in a newborn

    Directory of Open Access Journals (Sweden)

    Wong William

    2009-04-01

    Full Text Available Abstract Purpura fulminans (PF is an ominous cutaneous condition usually associated with meningococcemia. PF in the newborn is rarely reported. We report the case of a female preterm infant with extensive PF due to group B streptococcus (GBS septicemia. She developed multi-organ system failure despite neonatal intensive care support and succumbed 9 days later. GBS, sensitive to penicillin, was isolated from the blood cultures of the mother and the infant. Invasive early GBS infection is common in the newborn and is empirically treated with prompt institution of intravenous antibiotics. PF associated with GBS is a rare cutaneous sign that must not be missed. Mortality remains high despite aggressive treatment and ICU support.

  5. Measurements and monitoring of phototherapy in newborn jaundice

    International Nuclear Information System (INIS)

    Sisson, T.R.

    1982-01-01

    Hyperbilirubinemia in the newborn (neonatal jaundice) may cause irreversible brain damage if plasma concentrations of bilirubin exceed the number of binding sites on albumin and other blood components. Phototherapy or exchange transfusions to prevent the excessive rise in concentration of the pigment should be instituted in appropriate clinical situations. In phototherapy, the jaundiced infant is exposed to visible light containing the wavelength (about 450 nm) bilirubin will absorb. Because bilirubin is quite photolabile and will readily isomerize in vivo, it is rapidly converted to excretable forms. The effectiveness of this therapy, however, depends upon the maintenance of adequate radiant flux in the required wavelength. Energy output and spectral distributions of phototherapy lamps must be measured. The long-term effects of irradiation of newborn infants over several days are not yet known

  6. A Newborn Case of “c” Subgroup Mismatch Presenting with Severe Hemolysis and Anemia

    OpenAIRE

    Ezgi Yangın Ergon; Senem Alkan Özdemir; Rüya Çolak; Kıymet Çelik; Özgür Olukman; Şebnem Çalkavur

    2017-01-01

    Hemolysis and jaundice related to Rh incompatibility in the neonatal period has decreased substantially due to the widespread use of anti-D gammaglobulin in recent years. Nevertheless, the rate of subgroup mismatch in the etiology of hemolytic diseases of the newborn has increased significantly. In this article an 8-day-old newborn infant with “c” subgroup incompatibility and presenting with severe anemia, in whom hemolysis could be controlled with intravenous immunoglobulin infusion and subg...

  7. Severe hyperbilirubinaemia and kernicterus: more caution is needed in newborn jaundice surveillance.

    LENUS (Irish Health Repository)

    Allen, N M

    2012-02-01

    Since the 1990s, there has been a re-emergence of cases of severe hyperbilirubinaemia and kernicterus. The current UK incidence of bilirubin encephalopathy is 0.9\\/100,000 with a higher reported incidence in some countries. Three otherwise healthy newborn infants, who presented with severe hyperbilirubinaemia, including one who developed kernicterus, are reported here. Some of the current challenges in newborn jaundice surveillance are highlighted.

  8. Recurrent supraventricular tachycardia in a newborn treated with amiodarone: is hyperkalemia the apparent cause?

    Science.gov (United States)

    Yildirim, S V; Tiker, F; Cengiz, N; Kiliçdağ, H

    2005-01-01

    Supraventricular tachycardia (SVT) is the most common type of arrhythmia observed in children, especially in newborns. Infants with severe SVT must be treated immediately with first-line drugs such as amiodarone. There are some minor and major side effects of amiodarone in this patient group, but no associated electrolyte disorders have been observed. This report describes a newborn whose recurrent SVT attacks during amiodarone treatment were suspected to have been caused by hyperkalemia.

  9. Does bathing newborns remove potentially harmful pathogens from the skin?

    Science.gov (United States)

    Medves, J M; O'Brien, B

    2001-09-01

    Newborn infants are routinely bathed after birth partly to reduce the possibility of transmitting potential pathogens to others. The extent to which a mild soap reduces the quantity and type of microbes found on the skin through normal colonization has not been reported. The objective of the study was to compare colonization rates between infants bathed in soap and water and infants bathed in plain water. One hundred and forty infants were randomly assigned to one group bathed in a mild pH neutral soap and water or to another group bathed in water alone. Microbiology swabs were taken on three occasions (before the first bath, 1 hour after the bath, and 24 hours after birth) from two sites (anterior fontanelle and umbilical area). No difference occurred between groups on type or quantity of organisms found at each time period. Skin colonization is a function of time, and the quantity of organisms identified increased over time (Friedman A 2 = 111.379, df = 5, p newborns, health care professionals may wish to wear gloves until the infant has been bathed.

  10. "Unwilling" versus "Unable": Capuchin Monkeys' ("Cebus Apella") Understanding of Human Intentional Action

    Science.gov (United States)

    Phillips, Webb; Barnes, Jennifer L.; Mahajan, Neha; Yamaguchi, Mariko; Santos, Laurie R.

    2009-01-01

    A sensitivity to the intentions behind human action is a crucial developmental achievement in infants. Is this intention reading ability a unique and relatively recent product of human evolution and culture, or does this capacity instead have roots in our non-human primate ancestors? Recent work by Call and colleagues (2004) lends credence to the…

  11. Peculiaridades da circulação mesentérica em recém-nascidos e suas implicações em doenças gastrintestinais do período neonatal Mesenteric circulation peculiarities in infant newborns and its implications in gastrointestinal illnesses of the neonatal period

    Directory of Open Access Journals (Sweden)

    Chang Yin Chia

    2009-06-01

    flow by the Doppler ultrasound method. DATA SOURCES: Textbooks and publications listed in Medline and SciELO from the last 20 years were searched using the key-words: "mesenteric artery", "intestinal superior mesenteric artery", "newborn circulation", "necrotizing enterocolitis", and "Doppler flow velocimetry". DATA SYNTHESIS: Alterations in the mesenteric flow are predisposing factors for necrotizing enterocolitis, which is a neonatal illness with high morbidity and mortality that occurs mainly in premature infants. The mesenteric circulation is peculiar at the neonatal period regarding its baseline status as well as its response from physiological stimulation. Mesenteric irrigation varies according to the proper phase of intestinal vascular development. Mesenteric irrigation can be damaged by perinatal factors, such as placental insufficiency, asphyxia, infection, umbilical catheters, drugs (indomethacin and caffeine, phototherapy, artificial feeding and fast diet progression. Doppler flow velocimetry allows the study of gut irrigations and may quantify blood flow and vascular resistance. The exam can predict risk situations for gastrointestinal illnesses during the neonatal period. CONCLUSIONS: The newborn infant presents peculiarities on gastrointestinal blood circulation. Superior mesenteric artery Doppler ultrasound provides non-invasive measures of the intestinal circulatory conditions.

  12. Maternal active smoking and newborn body composition.

    Science.gov (United States)

    Samper, M P; Jiménez-Muro, A; Nerín, I; Marqueta, A; Ventura, P; Rodríguez, G

    2012-03-01

    Maternal smoking during pregnancy is associated with a reduction in birth size but very few studies have collated changes in neonatal anthropometry. Our aims were both to assess body composition differences by anthropometry between new-borns from smoking mothers and those from non-smoking mothers, and to show whether these differences affect proportional body mass distribution. Caucasian mothers and their full term singleton new-borns (N=1216) were selected during 2009. A structured questionnaire was completed regarding obstetric and demographic data, as well as tobacco consumption. Women were categorized, according to their smoking habits, into a non-smoking group (never smoked or stopped smoking prior to pregnancy) and a smoking group (smoked throughout pregnancy). 22.1% of mothers smoked during pregnancy (median: 6 cigarettes/day, range: l-40). Smoking mothers were significantly younger than non-smoking mothers but there were no differences regarding other aspects which could affect infant weight. Infants from non-smoking mothers were heavier, longer, and body circumferences were all larger than those from smoking mothers (pfat distribution did not show statistical differences between the two groups. After gestational age, to smoke during gestation is the second main determinant of birth weight. Smoking during pregnancy involves a generalized reduction of most axiological parameters as a result of proportionate fetal growth impairment. In those infants born from mothers who smoked during gestation, neonatal lean body mass appears to be more affected than body fat, and distribution of subcutaneous fat is not different. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  13. Consensus Based Definition of Growth Restriction in the Newborn.

    Science.gov (United States)

    Beune, Irene M; Bloomfield, Frank H; Ganzevoort, Wessel; Embleton, Nicholas D; Rozance, Paul J; van Wassenaer-Leemhuis, Aleid G; Wynia, Klaske; Gordijn, Sanne J

    2018-02-28

    To develop a consensus definition of growth restriction in the newborn that can be used clinically to identify newborn infants at risk and in research to harmonize reporting and definition in the current absence of a gold standard. An international panel of pediatric leaders in the field of neonatal growth were invited to participate in an electronic Delphi procedure using standardized methods and predefined consensus rules. Responses were fed back at group-level and the list of participants was provided. Nonresponders were excluded from subsequent rounds. In the first round, variables were scored on a 5-point Likert scale; in subsequent rounds, inclusion of variables and cut-offs were determined with a 70% level of agreement. In the final round participants selected the ultimate algorithm. In total, 57 experts participated in the first round; 79% completed the procedure. Consensus was reached on the following definition: birth weight less than the third percentile, or 3 out of the following: birth weight definition for growth restriction in the newborn. This definition recognizes that infants with birth weights 10th percentile can be growth restricted. This definition can be adopted in clinical practice and in clinical trials to better focus on newborns at risk, and is complementary to the previously determined definition of fetal growth restriction. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Sucrose and warmth for analgesia in healthy newborns: an RCT.

    Science.gov (United States)

    Gray, Larry; Garza, Elizabeth; Zageris, Danielle; Heilman, Keri J; Porges, Stephen W

    2015-03-01

    Increasing data suggest that neonatal pain has long-term consequences. Nonpharmacologic techniques (sucrose taste, pacifier suckling, breastfeeding) are effective and now widely used to combat minor neonatal pain. This study examined the analgesic effect of sucrose combined with radiant warmth compared with the taste of sucrose alone during a painful procedure in healthy full-term newborns. A randomized, controlled trial included 29 healthy, full-term newborns born at the University of Chicago Hospital. Both groups of infants were given 1.0 mL of 25% sucrose solution 2 minutes before the vaccination, and 1 group additionally was given radiant warmth from an infant warmer before the vaccination. We assessed pain by comparing differences in cry, grimace, heart rate variability (ie, respiratory sinus arrhythmia), and heart rate between the groups. The sucrose plus warmer group cried and grimaced for 50% less time after the vaccination than the sucrose alone group (P < .05, respectively). The sucrose plus warmer group had lower heart rate and heart rate variability (ie, respiratory sinus arrhythmia) responses compared with the sucrose alone group (P < .01), reflecting a greater ability to physiologically regulate in response to the painful vaccination. The combination of sucrose and radiant warmth is an effective analgesic in newborns and reduces pain better than sucrose alone. The ready availability of this practical nonpharmacologic technique has the potential to reduce the burden of newborn pain. Copyright © 2015 by the American Academy of Pediatrics.

  15. Newborn Care in the Home and Health Facility: Formative Findings for Intervention Research in Cambodia

    Directory of Open Access Journals (Sweden)

    Alessandra N. Bazzano

    2016-12-01

    Full Text Available Global coverage and scale up of interventions to reduce newborn mortality remains low, though progress has been achieved in improving newborn survival in many low-income settings. An important factor in the success of newborn health interventions, and moving to scale, is appropriate design of community-based programs and strategies for local implementation. We report the results of formative research undertaken to inform the design of a newborn health intervention in Cambodia. Information was gathered on newborn care practices over a period of three months using multiple qualitative methods of data collection in the primary health facility and home setting. Analysis of the data indicated important gaps, both at home and facility level, between recommended newborn care practices and those typical in the study area. The results of this formative research have informed strategies for behavior change and improving referral of sick infants in the subsequent implementation study. Collection and dissemination of data on newborn care practices from settings such as these can contribute to efforts to advance survival, growth and development of newborns for intervention research, and for future newborn health programming.

  16. Evidence for Vertical Transmission of HPV from Mothers to Infants

    Directory of Open Access Journals (Sweden)

    Elaine M. Smith

    2010-01-01

    Full Text Available Few large studies have evaluated concordance based on a broad spectrum of human papillomavirus (HPV types in oral and genital specimens of mothers and their recently born infants. This information is important in determining whether HPV vaccines administered prior to pregnancy may be useful for preventing vertical transmission. HPV DNA was positive in 30% of mothers and 1.5% of newborns. Maternal/newborn concordance (HPV+/+ or HPV−/− was 71%. Among HPV DNA+ mothers, only 3% of their infants were DNA+ and only 1 pair had the same HPV type. Among HPV− women, 0.8% of infants were HPV+. HPV DNA detected in hospitalized newborns reflects current infection transmitted to infants during pregnancy or delivery. None of the mother/baby HPV DNA+ concordance pairs detected viral types found in HPV vaccines suggesting that vaccination prior to pregnancy is unlikely to be efficacious in preventing vertical transmission.

  17. Effects of massage on behavior of full-term newborns

    OpenAIRE

    Tri Sunarti Wahyutami; Soedjatmiko Soedjatmiko; Agus Firmansyah; Rulina Suradi

    2010-01-01

    Background Baby massage is one of the touch stimulation that could be applied as soon as possible after birth. Giving massage regularly will affect the behavior of newborn. Objectives To explore the effects of ten-day massage on infant's behavior. Methods A randomized control trial was done from December 200S to March 2009. Full-term newborm were randomly assigned into massage group or control group. Babies in massage group were given massage by their mothers and supervised by midwive...

  18. Influência do tempo de hospitalização sobre o desenvolvimento neuromotor de recém-nascidos pré-termo Influence of length of hospitalization on neuromotor development in premature newborn infants

    Directory of Open Access Journals (Sweden)

    Luciana Giachetta

    2010-03-01

    Full Text Available O objetivo deste estudo foi avaliar a influência do tempo de hospitalização sobre o desenvolvimento neuromotor de recém-nascidos pré-termo (RNPT. Foi feito um estudo prospectivo com 67 RNPT de idade gestacional 34 dias. Na análise estatística considerou-se o nível de significância pThe purpose of this study was to assess the influence of the length of hospital stay on the neuromotor development of preterm newborns (PTNB. This prospective study was carried out with 67 PTNB (gestational age 34 days. In statistical analysis significance level was set at p<0.05. Median AIMS scores (possible range 0-21 were 7 in group A, 5 in group B; weak, significant correlations were found at both groups (r=0.32; r=0.34 between AIMS scores and HP. Results show that PTNB who stayed in hospital for more than 34 days showed developmental delay, suggesting that, without excluding other factors, the longer PTNB length of stay, the greater the motor impairment.

  19. Nutritional support for the infant's immune system

    NARCIS (Netherlands)

    Niers, L.; Stasse-Wolthuis, M.; Rombouts, F.M.; Rijkers, G.T.

    2007-01-01

    Newborn babies possess a functional but immature immune system as a defense against a world teeming with microorganisms. Breast milk contains a number of biological, active compounds that support the infant's immune system. These include secretory immunoglobulin A (IgA), which confers specific

  20. Feeding Your Newborn

    Science.gov (United States)

    ... a baby is usually based on the mother's comfort level with breastfeeding and her lifestyle. In some ... Many infants "spit up" a small amount after eating or during burping, but a baby should not ...

  1. Hormonal effects in newborns

    Science.gov (United States)

    ... can cause an infection under the skin ( abscess ). Hormones from the mother may also cause some fluid to leak from the infant's nipples. This is called witch's milk. It is common and most often goes away ...

  2. Congenital CMV infection: prevalence in newborns and the impact on hearing deficit.

    Science.gov (United States)

    Engman, Mona-Lisa; Malm, Gunilla; Engstrom, Lotta; Petersson, Karin; Karltorp, Eva; Tear Fahnehjelm, Kristina; Uhlen, Inger; Guthenberg, Claes; Lewensohn-Fuchs, Ilona

    2008-01-01

    Congenital cytomegalovirus (CMV) infection is asymptomatic in 90% of infected newborns but approximately 10-20% of these infants are at risk of developing sequelae later, mostly hearing deficit. The aims of the study were to investigate the prevalence of congenital CMV infection in a Swedish population of newborns and investigate the relative risk of hearing deficit in newborns with congenital CMV infection. The dried blood spot (DBS) samples of 6060 newborns in southern Stockholm during 12 months (October 2003-June 2004; August 2004-October 2004) were analysed for CMV DNA by TaqMan based real-time PCR. Hearing deficit was assessed by otoacoustic emission (OAE) within a newborn screening programme. 12 infants out of 6060 or 0.2% (95% CI 0.1-0.3%) had congenital CMV infection. One boy among the 12 infected infants had unilateral hearing loss, indicating that the risk of hearing loss is greatly increased (about 20 times) in CMV infected infants. No child developed ocular complications such as chorioretinopathy during 3 y of follow-up. Congenital CMV has an impact on child health but can easily be overlooked due to lack of signs in the neonatal period. Surveillance for congenital CMV is important in addition to programmes for prevention and treatment.

  3. Immunoglobulin transfusion in hemolytic disease of the newborn: place in therapy

    Directory of Open Access Journals (Sweden)

    Mundy CA

    2015-06-01

    Full Text Available Cynthia A Mundy, Jatinder Bhatia Department of Pediatrics, Division of Neonatology, Georgia Regents University, Children's Hospital of Georgia, GA, USA Abstract: Hemolytic disease of the newborn continues to be a common neonatal disorder that requires a comprehensive understanding on the part of those caring for infants. Common treatments include hydration and phototherapy. Exchange transfusion is used in severe hemolytic disease, but infants undergoing this treatment are exposed to many adverse effects. Intravenous immunoglobulin is a newer strategy that is showing promise in the treatment of the disease. This review discusses the current use and future expectations of intravenous immunoglobulin therapy in newborns. Keywords: hyperbilirubinemia, ABO incompatibility, neonatal jaundice 

  4. Occurrence of Bifidobacterium in the intestine of newborns by fluorescence in situ hybridization.

    Science.gov (United States)

    Bezirtzoglou, E; Maipa, V; Chotoura, N; Apazidou, E; Tsiotsias, A; Voidarou, C; Kostakis, D; Alexopoulos, A

    2006-11-01

    Colonization by Bifidobacterium occurs generally within 4 days of life. The new method FISH has been applied for molecular detection of Bifidobacteria. The study was carried out on 26 healthy newborns delivered by vaginal delivery. Breast-fed infants harbor a gastrointestinal flora characterized by an increased concentration of Bifidobacterium cells (by a factor of 1.75). In artificial alimentation, some infants either did not harbor any Bifidobacterium or showed lower numbers of Bifidobacterium. Moreover, male newborns show higher numbers of Bifidobacterium, but in both sexes the predominance of Bifidobacterium is evident after maternal alimentation.

  5. Gingival Cyst of Newborn.

    Science.gov (United States)

    Moda, Aman

    2011-01-01

    Gingival cyst of newborn is an oral mucosal lesion of transient nature. Although it is very common lesion within 3 to 6 weeks of birth, it is very rare to visualize the lesion thereafter. Presented here is a case report of gingival cyst, which was visible just after 15 days of birth. Clinical diagnoses of these conditions are important in order to avoid unnecessary therapeutic procedure and provide suitable information to parents about the nature of the lesion.

  6. Adverse reactions to the Bacillus Calmette-Guérin (BCG) vaccine in new-born infants-an evaluation of the Danish strain 1331 SSI in a randomized clinical trial.

    Science.gov (United States)

    Nissen, Thomas Nørrelykke; Birk, Nina Marie; Kjærgaard, Jesper; Thøstesen, Lisbeth Marianne; Pihl, Gitte Thybo; Hoffmann, Thomas; Jeppesen, Dorthe Lisbeth; Kofoed, Poul-Erik; Greisen, Gorm; Benn, Christine Stabell; Aaby, Peter; Pryds, Ole; Stensballe, Lone Graff

    2016-05-11

    To evaluate adverse reactions of the Bacillus Calmette-Guérin (BCG) Statens Serum Institut (SSI) (Danish strain 1331) used as intervention in a randomized clinical trial. A randomized clinical multicenter trial, The Danish Calmette Study, randomizing newborns to BCG or no intervention. Follow-up until 13 months of age. Pediatric and maternity wards at three Danish university hospitals. All women planning to give birth at the three study sites (n=16,521) during the recruitment period were invited to participate in the study. Four thousand one hundred and eighty four families consented to participate and 4262 children, gestational age 32 weeks and above, were randomized: 2129 to BCG vaccine and 2133 to no vaccine. None of the participants withdrew because of adverse reactions. Trial-registered adverse reactions after BCG vaccination at birth. Follow-up at 3 and 13 months by telephone interviews and clinical examinations. Among the 2118 BCG-vaccinated children we registered no cases of severe unexpected adverse reaction related to BCG vaccination and no cases of disseminated BCG disease. Two cases of regional lymphadenitis were hospitalized and thus classified as serious adverse reactions related to BCG. The most severe adverse reactions were 10 cases of suppurative lymphadenitis. This was nearly a fivefold increase compared to what was expected based on the summary of product characteristics of the vaccine. All cases were treated conservatively and recovered. Six of 10 (60%) families of children experiencing suppurative lymphadenitis compared to 117/2071 (6%) of those with no lymphadenitis indicated that the vaccine had more adverse effects than expected (p-value <0.001). BCG vaccination was associated with only mild morbidity and no mortality. A higher incidence of suppurative lymphadenitis than expected was observed. All children were treated conservatively without sequelae or complications. Trial registration number NCT01694108 at www

  7. Behavioral pain assessment tool for critically ill adults unable to self-report pain.

    Science.gov (United States)

    Rose, Louise; Haslam, Lynn; Dale, Craig; Knechtel, Leasa; McGillion, Michael

    2013-05-01

    Critically ill adults often cannot self-report pain. To determine the effect of the Critical-Care Pain Observation Tool on frequency of documentation of pain assessment and administration of analgesics and sedatives in critically ill patients unable to self-report pain. Data on patients in 2 intensive care units of a university-affiliated hospital were collected before and after implementation of the tool. Patients were prospectively screened for eligibility; data were extracted retrospectively. Data were recorded for a maximum of 72 hours before and after implementation of the tool in the cardiovascular intensive care unit (130 patients before and 132 after) and in the medical/surgical/trauma unit (59 patients before and 52 after). Proportion of pain assessment intervals with pain assessment documented increased from 15% to 64% (P tool increased frequency of pain assessment and appeared to influence administration of analgesics in both units.

  8. Cost estimate of hospital stays for premature newborns in a public tertiary hospital in Brazil

    Directory of Open Access Journals (Sweden)

    Claudia Maria Desgualdo

    2011-01-01

    Full Text Available OBJECTIVES: To estimate the direct costs of hospital stays for premature newborns in the Interlagos Hospital and Maternity Center in São Paulo, Brazil and to assess the difference between the amount reimbursed to the hospital by the Unified Health System and the real cost of care for each premature newborn. METHODS: A cost-estimate study in which hospital and professional costs were estimated for premature infants born at 22 to 36 weeks gestation during the calendar year of 2004 and surviving beyond one hour of age. Direct costs included hospital services, professional care, diagnoses and therapy, orthotics, prosthetics, special materials, and blood products. Costs were estimated using tables published by the Unified Health System and the Brasindice as well as the list of medical procedures provided by the Brazilian Classification of Medical Procedures. RESULTS: The average direct cost of care for initial hospitalization of a premature newborn in 2004 was $2,386 USD. Total hospital expenses and professional services for all premature infants in this hospital were $227,000 and $69,500 USD, respectively. The costs for diagnostic testing and blood products for all premature infants totaled $22,440 and $1,833 USD. The daily average cost of a premature newborn weighing less than 1,000 g was $115 USD, and the daily average cost of a premature newborn weighing more than 2,500 g was $89 USD. Amounts reimbursed to the hospital by the Unified Health System corresponded to only 27.42% of the real cost of care. CONCLUSIONS: The cost of hospital stays for premature newborns was much greater than the amount reimbursed to the hospital by the Unified Health System. The highest costs corresponded to newborns with lower birth weight. Hospital costs progressively and discretely decreased as the newborns' weight increased.

  9. [Maternal and neonatal vitamin B12deficiency detected by expanded newborn screening].

    Science.gov (United States)

    Papp, Ferenc; Rácz, Gábor; Lénárt, István; Kóbor, Jenő; Bereczki, Csaba; Karg, Eszter; Baráth, Ákos

    2017-12-01

    Infant vitamin B 12 deficiency can manifest as a severe neurodegenerative disorder and is usually caused by maternal deficiency due to vegetarian diet or pernicious anaemia. Its early recognition and treatment can prevent potentially serious and irreversible neurologic damage. Biochemically, vitamin B 12 deficiency leads to an accumulation of methylmalonic acid, homocysteine, and propionylcarnitine. Expanded newborn screening using tandem mass spectrometry may identify neonatal and maternal vitamin B 12 deficiency by measurement of propionylcarnitine and other metabolites in the dried blood spot sample of newborns. To summarize our experiences gained by screening for vitamin B 12 deficiency. Clinical and laboratory data of vitamin B 12 -deficient infants diagnosed in Szeged Screening Centre were retrospectively analysed. In Hungary, expanded newborn screening was introduced in 2007. Since then approximately 395 000 newborns were screened in our centre and among them, we identified four newborns with vitamin B 12 deficiency based on their screening results. In three cases an elevated propionylcarnitine level and in the fourth one a low methionine level were indicative of vitamin B 12 deficiency. We also detected an additional vitamin B 12 -deficient infant with neurological symptoms at 4 months of age, after a normal newborn screening, because of elevated urinary methylmalonic acid concentration. Vitamin B 12 deficiency was secondary to maternal autoimmune pernicious anaemia in all the five infants. As a result of the recognized cases the incidence of infant vitamin B 12 deficiency in the East-Hungarian region was 1.26/100 000 births, but the real frequency may be higher. Conslusions: Optimizing the cut off values of current screening parameters and measuring of methylmalonic acid and/or homocysteine in the dried blood spot, as a second tier test, can improve recognition rate of vitamin B 12 deficiency. Orv Hetil. 2017; 158(48): 1909-1918.

  10. Right Ventricular Myocardial Ischemia with Arrhythmia in an Asphyxiated Newborn.

    Science.gov (United States)

    Solevåg, Anne Lee; Schmölzer, Georg M; Cheung, Po-Yin

    2016-04-01

    Background Infant and neonatal myocardial infarction (MI) has been described in association with congenital heart disease, coronary artery abnormalities, myocarditis, and tumors. MI in the perinatal period in a structurally normal heart and with ventricular arrhythmia as a presenting feature has not been thoroughly described. Published case reports describe treatment methods extrapolated from adult MI. However, due to the rare occurrence, the most appropriate acute treatment for both MI and ventricular arrhythmia in newborn infants remains unknown. Case A male term infant with perinatal asphyxia and need for extensive cardiopulmonary resuscitation at birth had ventricular tachyarrhythmia and ST-elevations on electrocardiogram. Four hours after birth, he died from cardiogenic failure. A thrombus at the right coronary artery was found on autopsy. Conclusion MI in the perinatal period in a structurally normal heart is very rare and mortality is high. Although acute treatments extrapolated from adult MI has been described to result in favorable outcomes in newborn infants, guidelines are lacking on how to manage acute MI and associated ventricular arrhythmia.

  11. Right Ventricular Myocardial Ischemia with Arrhythmia in an Asphyxiated Newborn

    Science.gov (United States)

    Solevåg, Anne Lee; Schmölzer, Georg M.; Cheung, Po-Yin

    2016-01-01

    Background Infant and neonatal myocardial infarction (MI) has been described in association with congenital heart disease, coronary artery abnormalities, myocarditis, and tumors. MI in the perinatal period in a structurally normal heart and with ventricular arrhythmia as a presenting feature has not been thoroughly described. Published case reports describe treatment methods extrapolated from adult MI. However, due to the rare occurrence, the most appropriate acute treatment for both MI and ventricular arrhythmia in newborn infants remains unknown. Case A male term infant with perinatal asphyxia and need for extensive cardiopulmonary resuscitation at birth had ventricular tachyarrhythmia and ST-elevations on electrocardiogram. Four hours after birth, he died from cardiogenic failure. A thrombus at the right coronary artery was found on autopsy. Conclusion MI in the perinatal period in a structurally normal heart is very rare and mortality is high. Although acute treatments extrapolated from adult MI has been described to result in favorable outcomes in newborn infants, guidelines are lacking on how to manage acute MI and associated ventricular arrhythmia. PMID:27280062

  12. Immunoglobulin transfusion in hemolytic disease of the newborn: place in therapy

    OpenAIRE

    Mundy CA; Bhatia J

    2015-01-01

    Cynthia A Mundy, Jatinder Bhatia Department of Pediatrics, Division of Neonatology, Georgia Regents University, Children's Hospital of Georgia, GA, USA Abstract: Hemolytic disease of the newborn continues to be a common neonatal disorder that requires a comprehensive understanding on the part of those caring for infants. Common treatments include hydration and phototherapy. Exchange transfusion is used in severe hemolytic disease, but infants undergoing this treatment are exposed to ...

  13. Effects of white noise and holding on pain perception in newborns.

    Science.gov (United States)

    Karakoç, Ayse; Türker, Funda

    2014-12-01

    This experimental study on newborns was conducted to compare the effects of various atraumatic care procedures during an infant's crying response to pain. Included in this study were 120 newborns chosen from among healthy infants admitted to the Obstetrics Department of Çanakkale State Hospital between April 2010 and June 2010. The patients were divided into three physically homogeneous groups. Infants in group 1 were held on the mothers' laps, infants in group 2 were held on the mother's laps and listened to white noise, and infants in group 3 lay in their cribs and listened to white noise while undergoing a painful procedure. Data collection included the Neonatal Infant Pain Scale, which was used to evaluate the behavioral responses to pain during a heel prick blood draw and a newborn information sheet developed by the researcher. Changes in cardiac and respiratory rates recorded during the invasive procedure were statistically significant among the three groups (p white noise. This group was then followed by the infants who listened to white noise while being held by their mothers. The highest behavioral reaction was reported by those infants who were held by their mothers but did not listen to white noise. According to the results, white noise is an effective nonpharmacologic method to control pain, reduce crying time, and positively effect vital signs. Therefore, it is recommended that the use of white noise be practiced on newborns when they undergo painful procedures. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  14. Exclusive 6 month-breastfeeding and associated factors among healthy newborns

    OpenAIRE

    Cairo Lavado, Javier

    2014-01-01

    OBJECTIVES: To determine if factors such as maternal characteristics, hospital procedures and neonatal weight loss, were related to exclusive breastfeeding (EBF) up to 6 months among healthy newborns at the Navy Medical Center (NMC) in 1998. MATERIALS AND METHODS: Clinical histories of infants born in 1998 were reviewed, and was assessed the existence of a relationship between the up-to-6-month EBF and mother's parity and age, military rank of the navy member relative, infant gender, neonatal...

  15. Intraperitoneal microdialysis in the postoperative surveillance of infants undergoing surgery for congenital abdominal wall defect

    DEFF Research Database (Denmark)

    Risby, Kirsten; Pedersen, Mark Ellebæk; Jakobsen, Marianne S

    2015-01-01

    PURPOSE: This study aims to investigate the safety and clinical implication of intraperitoneal microdialysis (MD) in newborns operated on for congenital abdominal wall defect. PATIENTS AND METHODS: 13 infants underwent intraperitoneal microdialysis (9 with gastroschisis and 4 with omphalocele). MD...

  16. Inhaled nitric oxide improves systemic microcirculation in infants with hypoxemic respiratory failure

    NARCIS (Netherlands)

    Top, Anke P. C.; Ince, Can; Schouwenberg, Patrick H. M.; Tibboel, Dick

    2011-01-01

    To investigate the effect of inhaled nitric oxide on the systemic microcirculation. We hypothesized that inhaled nitric oxide improves the systemic microcirculation. Inhaled nitric oxide improves outcome in infants with persistent pulmonary hypertension of the newborn diagnosed by improving

  17. Body composition of women with newborns who are small for gestational age.

    Science.gov (United States)

    Levario-Carrillo, Margarita; Rodríguez, Nora; Tufiño-Olivares, Edith; Jiménez, María del Refugio; Delgado-Monge, Martha Cecilia; Reza-López, Sandra

    2009-01-01

    The relationship between maternal and placental hemodynamic disorders and fetal growth is well known, but few studies have evaluated a link between maternal extracellular water (EW) and newborn birth weight. To identify the characteristics of body composition (BC) of women with small for gestational age (SGA) newborns, and to determine the relationship between maternal EW and birth weight of the baby. We studied maternal BC using multifrequency bioelectric impedance in the second and third trimesters of pregnancy. Newborns with weight below the 10th percentile were classified as SGA; those with weights between the 10th and 90th percentiles as appropriate for gestational age (AGA), and large for gestational age (LGA) were those with weights above the 90th percentile. We studied 460 women and their BC varied depending on whether their newborns were SGA, AGA or LGA. EW was lower in the mothers of SGA (11 +/- 2 l) compared to AGA (12 +/- 3 l) newborns (p relationship (p maternal EW in the second trimester and the weight of the newborn, beta = 43 (95% CI 27-58). BC of women whose newborns are SGA differs significantly from that of women whose newborns are AGA, a result which suggests that the mothers of SGA infants may have a disordered hemodynamic state during the second trimester of pregnancy. (c) 2008 S. Karger AG, Basel.

  18. Newborn exoplanet eyed for moons and rings

    Science.gov (United States)

    Clery, Daniel

    2018-01-01

    Astronomers are staring at a nearby star in hopes of seeing a giant baby of a planet—perhaps accompanied by dust clouds, rings, or newborn moons—pass across its face. Last week, the newest and tiniest telescope joined the vigil, when the French-built PicSat rode into orbit on an Indian rocket. It will be able to continuously monitor the star, β Pictoris, until chances of seeing the once-in-20-year transit event diminish in a few months' time. Astronomers are fascinated by β Pictoris, a bright star just 63 light-years away, because it is a natural laboratory for how solar systems form given its age of only 24 million years—an infant in stellar terms.

  19. Avaliação do desempenho motor de prematuros nos primeiros meses de vida na Escala Motora Infantil de Alberta (AIMS Evaluation of motor performance of preterm newborns during the first months of life using the Alberta Infant Motor Scale (AIMS

    Directory of Open Access Journals (Sweden)

    Sônia Manacero

    2008-02-01

    Full Text Available OBJETIVOS: Avaliar o desempenho motor de neonatos prematuros pela Escala Motora Infantil de Alberta (AIMS e verificar a influência do peso de nascimento nas aquisições motoras. MÉTODOS: Foi realizado estudo transversal associado à coorte prospectiva, envolvendo 44 recém-nascidos prematuros com idade gestacional entre 32 e 34 semanas, sem distúrbios neurológicos, selecionados na unidade de terapia intensiva neonatal do Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul. Os neonatos incluídos foram estratificados de acordo com o peso de nascimento e avaliados pela escala AIMS na 40ª semana de idade concepcional, aos 4 e 8 meses de idade corrigida. RESULTADOS: Os prematuros estudados apresentaram seqüência progressiva de aparecimento de habilidades motoras em todas as posturas estudadas (prono, supino, sentado, em pé, a qual ocorreu de forma variável, expressa pelo percentil médio de 43,2 a 45,7%, mas dentro dos limites de normalidade previstos pela escala AIMS. Observou-se que houve um nítido aumento dos escores da AIMS ao longo dos três momentos de observação pós-natal. O ritmo de aumento nesses escores foi semelhante em ambos os grupos, independente do peso de nascimento (OBJECTIVES: To evaluate the motor performance of premature neonates using the Alberta Infant Motor Scale (AIMS and to investigate the influence of birth weight on motor acquisition. METHODS: A cross-sectional study was carried out of a prospective cohort of 44 premature newborn infants with gestational ages from 32 to 34 weeks, without neurological disorders, selected from the neonatal intensive care unit at the Pontifícia Universidade Católica's Hospital São Lucas in Rio Grande do Sul, Brazil. The neonates studied were stratified by birth weight and assessed using the AIMS scale at the 40th week of postconceptional age, and at 4 and 8 months of corrected age. RESULTS: The preterm infants studied exhibited a progressive

  20. Newborn jaundice - what to ask your doctor

    Science.gov (United States)

    Jaundice - what to ask your doctor; What to ask your doctor about newborn jaundice ... What causes jaundice in a newborn child? How common is newborn jaundice? Will the jaundice harm my child? What are the ...