Contribuição ao entendimento da patogenia da sepse

Directory of Open Access Journals (Sweden)

J. F. Fracasso

2009-02-01

Full Text Available

O choque vasodilatador mais freqüente resulta de sepse, uma inflamação sistêmica em resposta a uma infecção que se caracteriza por hipotensão, hiporreatividade às catecolaminas e coagulação intravascular disseminada. A causa mais comum de sepse é a infecção por bactérias Gram-negativas, principalmente de Escherichia coli, resultando na liberação de lipopolissacarídeos (endotoxinas da parede celular, quando da morte ou lise do microrganismo, com o envolvimento de muitos mediadores, incluindo o óxido nítrico. Mais tarde descobriu-se que os níveis sanguíneos de vasopressina, em pacientes com sepse, eram anormalmente baixos, e observou-se que alguns destes pacientes, com choque séptico avançado, eram extremamente sensíveis às ações pressóricas da vasopressina exógena. Palavras-chave: endotoxina; vasopressina; choque séptico; sepse; hiporreatividade; choque vasodilatador.

Codificação da sepse pulmonar e o perfil de mortalidade no Rio de Janeiro, RJ

Directory of Open Access Journals (Sweden)

Bruno Baptista Cardoso

Full Text Available RESUMO: Objetivo: Descrever os óbitos com menção de sepse pulmonar, medir a associação entre sepse pulmonar e pneumonia, assim como avaliar o impacto da regra de codificação no perfil de mortalidade, com a inclusão simulada do diagnóstico de pneumonia, nas declarações de óbito (DO com menção de sepse pulmonar, no Rio de Janeiro, em 2011. Métodos: Foram identificados os óbitos com menção de sepse pulmonar independentemente da causa básica. Aos médicos atestantes, aplicou-se questionário medindo a associação entre sepse pulmonar e pneumonia. O registro de pneumonia nos prontuários dos óbitos com menção de sepse pulmonar e sem menção de pneumonia na DO foi investigado. Foi descrito o perfil de mortalidade após a inclusão simulada do código de pneumonia nas declarações com sepse pulmonar. Resultados: Sepse pulmonar correspondeu a 30,9% das menções de sepse e a menção de pneumonia estava ausente em 51,3% dessas declarações. Pneumonia constava em 82,8% da amostra de prontuários investigados. Dos médicos entrevistados, 93,3% relataram pneumonia como a mais frequente causa de sepse pulmonar. A simulação revelou que a inclusão da pneumonia alterou a causa básica de 7,8% dos óbitos com menção de sepse e 2,4% de todos os óbitos, independentemente da causa original. Conclusão: Sepse pulmonar está associada à pneumonia e a simples inclusão do código de pneumonia nas declarações de óbito com menção de sepse pulmonar impactaria o perfil de mortalidade, apontando necessidade de aprimoramento das regras de codificação na Classificação Internacional de Doenças (CID-10.

A sepse como causa de lesão renal aguda: modelo experimental

Directory of Open Access Journals (Sweden)

Carolina Ferreira Pinto

2012-10-01

Full Text Available A sepse associada à falência de múltiplos órgãos como a lesão renal aguda (LRA demonstra alta taxa de mortalidade no paciente crítico. Este estudo investigou a LRA induzida pela sepse em modelo experimental. Foram utilizados ratos da raça Wistar, adultos e machos divididos nos seguintes grupos: Controle - controle cirúrgico e Sepse - indução da sepse pela ligadura e punção do cécon (LPC. Foram avaliados os parâmetros fisiológicos (temperatura retal, pressão arterial média - PAM, glicemia sérica e fluxo urinário; a função renal (clearance de creatinina; o estresse oxidativo (peróxidos urinários e substâncias reativas com ácido tiobarbitúrico - TBARS e realizada a análise histológica renal. O estudo conclui que a LRA induzida pela sepse caracteriza-se por lesão endotelial com disfunção hemodinâmica, liberação de mediadores inflamatórios e geração de espécies reativas de oxigênio (EROs por células tubulares, caracterizando-se como uma associação de vasoconstrição renal de origem hemodinâmica e inflamatória.

Uso de biomarcadores na sepse pediátrica: revisão de literatura

Directory of Open Access Journals (Sweden)

Vanessa Soares Lanziotti

Full Text Available RESUMO A despeito dos avanços nos últimos anos, a sepse ainda é uma das principais causas de internação e mortalidade em lactentes e crianças. A presença de biomarcadores na resposta a um insulto infeccioso resulta em seu uso na triagem, no diagnóstico, no prognóstico (estratificação de risco, na monitorização da resposta terapêutica e no uso racional de antibióticos (duração adequada, por exemplo. Os estudos sobre biomarcadores na sepse em crianças são ainda relativamente escassos. Esta revisão aborda o uso de biomarcadores na sepse em pacientes pediátricos, com ênfase em proteína C-reativa, procalcitonina, interleucinas 6, 8 e 18, gelatinase dos neutrófilos humanos e proadrenomedulina, que podem ser úteis na abordagem da sepse pediátrica.

Efeito da sinvastatina na sepse abdominal de ratos diabéticos

Directory of Open Access Journals (Sweden)

Irami Araújo-Filho

Full Text Available OBJETIVO: Analisar se o pré-tratamento com sinvastatina em modelo experimental de sepse abdominal é benéfico em ratos diabéticos. MÉTODOS: Cinquenta e seis ratos Wistar foram aleatoriamente distribuídos em: grupo não diabético (n-28 e grupo diabetes induzido por estreptozotocina (n=28. Sepse abdominal por ligadura e punção do ceco foi induzida em 14 ratos diabéticos e em 14 não diabéticos. Os demais 28 animais foram alocados em grupo sham. Os grupos de ratos com sepse e os sham (cada com sete animais foram tratados com microemulsão oral de simvastatina (20 mg kg-1 day-1 e solução salina 0,9%, respectivamente. Sangue periférico foi usado para dosagem de TNFα, IL-1β, IL-6, proteína C reativa, procalcitonina, contagem de leucócitos e neutrófilos em todos os animais. A análise estatística foi realizada pela ANOVA e teste de Tukey, com p<0,05. RESULTADOS: A sinvastatina reduziu a mortalidade nos ratos diabéticos. Os valores séricos de TNF-α, IL-1β, IL-6, proteína C reativa, procalcitonina, leucócitos e neutrófilos mostraram-se mais baixos nos ratos diabéticos e não diabéticos com sepse, tratados com sinvastatina, do que nos tratados com solução salina. CONCLUSÃO: A sinvastatina teve efeito antiinflamatório, que pode ter resultado em proteção contra a sepse em ratos diabéticos.

Gestantes colonizadas pelo Streptococcus do grupo B e seus recém-nascidos: análise crítica da conduta adotada no Instituto Fernandes Figueira, Fundação Oswaldo Cruz Beta-hemolytic streptococcus in pregnant women and their newborn infants: a critical analysis of the protocol used at Fernandes Figueira Institute, Oswaldo Cruz Foundation, in Brazil

Directory of Open Access Journals (Sweden)

Natalie Del-Vecchio L. Costa

2010-06-01

Full Text Available OBJETIVO: Avaliar a aplicação do protocolo do Centers of Disease Control (CDC, 2002 quanto à profilaxia da sepse neonatal precoce por Streptococcus do grupo B (SGB. MÉTODOS: Estudo retrospectivo com revisão de prontuários de 125 gestantes colonizadas pelo SGB e 133 recém-nascidos, no período de janeiro/2003 a dezembro/2006. A conduta intraparto foi considerada correta quando a gestante recebia antibioticoprofilaxia pelo menos quatro horas antes do parto, ou quando não recebia, mas era submetida a parto cesáreo eletivo. A conduta intraparto foi considerada incorreta quando a gestante recebia antibioticoprofilaxia menos de quatro horas antes do parto, a prescrição antibiótica estava incorreta ou quando não havia profilaxia prescrita. RESULTADOS: A prevalência de colonização materna pelo SGB foi de 4,7%. A época de coleta do swab vaginal/retal variou entre 14 e 40 semanas de gestação, com média de 32 semanas. Das gestantes colonizadas, 54 (43% receberam conduta intraparto correta. Dos 133 recém-nascidos estudados, 95 (71% receberam avaliação diagnóstica corretamente, 17 (13% evoluíram com sepse clínica e um (0,75% apresentou sepse comprovada. A incidência de sepse foi maior em recém-nascidos cujas mães não receberam profilaxia intraparto corretamente, porém esta associação não apresentou diferença estatística significativa (18 versus 7%, p>0,05. CONCLUSÕES: Apesar de o protocolo para prevenção de sepse precoce pelo SGB estar implementado na instituição, ainda é possível observar falhas na profilaxia intraparto materna. Essas falhas representam oportunidades perdidas na prevenção da sepse precoce pelo SGB.OBJECTIVE: To evaluate the use of the guidelines of the Centers of Disease Control (CDC, 2002 regarding the prophylaxes of group B Streptococcus (GBS early onset neonatal sepsis. METHODS: We conducted a retrospective study by chart review of 125 pregnant women colonized by GBS and 133 neonates born at a

Avanços no diagnóstico e tratamento da sepse Advances in sepsis diagnosis and treatment

Directory of Open Access Journals (Sweden)

Paulo R.A. Carvalho

2003-11-01

Full Text Available OBJETIVO: Apresentar uma revisão crítica e atualizada sobre a sepse, principalmente os aspectos diagnósticos e terapêuticos. FONTES DOS DADOS: Pesquisa bibliográfica em periódicos indexados em base Medline, tanto de revisão como ensaios clínicos e pesquisa laboratorial. SÍNTESE DOS DADOS: A Conferência Internacional sobre Definição de Sepse ampliou a relação de possíveis sinais clínicos e laboratoriais de sepse, o que poderá permitir a suspeição e manejo iniciais mais eficazes. Na avaliação laboratorial, além da pesquisa do agente infectante, vários marcadores da resposta inflamatória tais como as citoquinas inflamatórias e a procalcitonina, têm sido identificados, mas ainda sem sensibilidade e especificidade suficientes para diagnóstico seguro. Quanto ao tratamento, as intervenções precoces sobre os distúrbios hemodinâmicos continuam sendo primordiais para o desfecho, assim como o uso racional de antimicrobianos. Terapias de remoção de toxinas e de aumento da resposta imune inata ainda não provaram definitivamente seu valor. O uso de bloqueadores da resposta inflamatória isolados, em qualquer fase do seu estágio, falhou em reduzir a mortalidade. O corticóide ressurge com resultados animadores, mesmo em pacientes sem insuficiência adrenal relacionada à sepse. A proteína C ativada (drotrecogina-alfa, em um grande estudo, mostrou redução de 6% de mortalidade em uma amostragem selecionada, oferecendo uma possibilidade de melhor prognóstico na sepse. CONCLUSÕES: Comparativamente aos avanços dos últimos anos, pouco se obteve com relação à diminuição de mortalidade por sepse, pela complexidade das relações patógeno-hospedeiro. A regulação individual de cada reação do hospedeiro não mostrou o efeito esperado. Algumas estratégias, já conhecidas, foram reafirmadas como benéficas, e outras, como o uso de corticóide e a proteína C ativada, estão surgindo como terapias promissoras. As

Fatores perinatais associados ao óbito precoce em prematuros nascidos nos centros da Rede Brasileira de Pesquisas Neonatais Perinatal factors associated with early deaths of preterm infants born in Brazilian Network on Neonatal Research centers

Directory of Open Access Journals (Sweden)

Maria Fernanda Branco de Almeida

2008-08-01

Full Text Available OBJETIVO: Avaliar os fatores perinatais associados ao óbito neonatal precoce em prematuros com peso ao nascer entre 400 e 1.500 g. MÉTODOS: Coorte prospectiva e multicêntrica dos nascidos vivos com idade gestacional de 23 a 33 semanas e peso de 400-1.500 g, sem malformações em oito maternidades públicas terciárias universitárias entre junho de 2004 e maio de 2005. As características maternas e neonatais e a morbidade nas primeiras 72 horas de vida foram comparadas entre os prematuros que morreram ou sobreviveram até o sexto dia de vida. As variáveis perinatais associadas ao óbito neonatal precoce foram determinadas por regressão logística. RESULTADOS: No período, 579 recém-nascidos preencheram os critérios de inclusão. O óbito precoce ocorreu em 92 (16% neonatos, variando entre as unidades de 5 a 31%, e tal diferença persistiu controlando-se por um escore de gravidade clínica (SNAPPE-II. A análise multivariada para o desfecho óbito neonatal intra-hospitalar precoce mostrou associação com: idade gestacional de 23-27 semanas (odds ratio - OR = 5,0; IC95% 2,7-9,4, ausência de hipertensão materna (OR = 1,9; IC95% 1,0-3,7, Apgar 0-6 no 5º minuto (OR = 2,8; IC95% 1,4-5,4, presença de síndrome do desconforto respiratório (OR = 3,1; IC95% 1,4-6,6 e centro em que o paciente nasceu. CONCLUSÃO: Importantes fatores associados ao óbito neonatal precoce em prematuros de muito baixo peso são passíveis de intervenção, como a melhora da vitalidade fetal ao nascer e a diminuição da incidência e gravidade da síndrome do desconforto respiratório. As diferenças de mortalidade encontradas entre os centros apontam para a necessidade de identificar as melhores práticas e adotá-las de maneira uniforme em nosso meio.OBJECTIVE:To evaluate perinatal factors associated with early neonatal death in preterm infants with birth weights (BW of 400-1,500 g. METHODS: A multicenter prospective cohort study of all infants with BW of 400

Perfis de mortalidade neonatal precoce: um estudo para uma Maternidade Pública de Belo Horizonte (MG, 2001-2006 Profiles of early neonatal deaths: a study for a Public Maternity Hospital of Belo Horizonte (MG, 2001 - 2006

Directory of Open Access Journals (Sweden)

Heloísa Maria de Assis

2008-12-01

Full Text Available Trata-se de estudo seccional, com base em dados secundários, com o objetivo de traçar o perfil dos óbitos neonatais precoces ocorridos em uma Maternidade Pública de referência no Estado de Minas Gerais (Maternidade Odete Valadares, Belo Horizonte, no período de 2001 a 2006. Foram utilizadas variáveis relacionadas ao recém-nascido (período de ocorrência do óbito, idade ao óbito, sexo, idade gestacional e peso ao nascer, à mãe (tipo de gravidez, tipo de parto, idade, parturição e número de nascidos mortos, bem como causas múltiplas de mortalidade categorizadas. Obtiveram-se três perfis de óbitos neonatais precoces por meio do método Grade of Membership, que possibilitou também encontrar a prevalência destes perfis. O Perfil 1 foi caracterizado por óbitos de difícil redução e teve prevalência de 41,4%; o Perfil 2, pelos óbitos passíveis de redução (prevalência de 28,3%; e o Perfil 3, pelos óbitos redutíveis (prevalência de 30,4%. Estes perfis possibilitaram a compreensão da mortalidade neonatal precoce na Maternidade Odete Valadares e a análise da sua relação com a história reprodutiva e obstétrica materna, bem como com as condições do recém-nascido. Chama a atenção a elevada prevalência de óbitos evitáveis, realidade que deve ser enfrentada pelos profissionais e pela rede pública de saúde.This is a cross-sectional study with the aim of describing the early neonatal deaths that took place at a Public Maternity Hospital, Maternidade Odete Valadares in Belo Horizonte, Minas Gerais, Brazil, from 2001 to 2006. It used variables related to the newborn (period the death took place, age at death, gender, gestational age, and birth weight, to the mother (type of pregnancy, type of delivery, age, parity, and number of stillborn children, and to the multiple causes of death. Three profiles of early neonatal death were obtained through the Grade of Membership method (GoM, which also made it possible to find

Gas tonometry for evaluation of gastrointestinal mucosal perfusion: experimental and clinical sepsis¹. part 2 Tonometria a gás para a avaliação da perfusão da mucosa gastrointestinal: sepse clínica e experimental. Parte 2

Directory of Open Access Journals (Sweden)

Eliezer Silva

2002-09-01

Full Text Available Substantial clinical and animal evidences indicate that the mesenteric circulatory bed, particularly the gut mucosa, is highly vulnerable to reductions in oxygen supply and prone to early injury in the course of hemodynamic changes induced by sepsis and septic shock. Gut hypoxia or ischemia is one possible contributing factor to gastrointestinal tract barrier dysfunction that may be associated with the development of systemic inflammatory response and multiple organ dysfunction syndrome, the principal cause of death after sepsis. Monitoring gut perfusion during experimental and clinical sepsis may provide valuable insights over new interventions and therapies highly needed to reduce multiple organ dysfunction and sepsis-related morbidity and mortality. We present our experience with gas tonometry as a monitor of the adequacy of gastrointestinal mucosal perfusion in experimental models sepsis and with the use of vasoactive agents for hemodynamic management in patients with septic shock.Evidências clínicas e experimentais substanciais indicam que o território circulatório mesentérico, principalmente na mucosa intestinal, é altamente vulnerável a redução na oferta de oxigênio e predisposto a lesão precoce na presença de alterações hemodinâmicas induzidas pela sepse e choque séptico. A hipóxia ou isquemia intestinal é um dos possíveis mecanismos contribuintes para a disfunção da barreira gastrointestinal que pode estar associada com o desenvolvimento da resposta inflamatória sistêmica e com a síndrome da disfunção de múltiplos órgãos, a principal causa comum de morte na sepse. Monitorar a perfusão intestinal na sepse experimental e clínica pode fornecer dados valiosos quanto a novas intervenções e tratamentos altamente necessários para reduzir disfunção de múltiplos órgãos e mortalidade extremamente elevadas na sepse. Apresentamos nossa experiência com a tonometria a gás como monitor da adequação da perfus

Diagnosis of neonatal group B Streptococcus sepsis by nested-PCR of residual urine samples Diagnóstico de sepse neonatal causada pelo estreptococo do grupo B por meio de dupla amplificação de amostras residuais de urina

Directory of Open Access Journals (Sweden)

Bruno Nicolino Cezarino

2008-03-01

four patients. Moreover, PCR has enabled us to use residue volumes of urine samples collected by non invasive, non sterile methods, what is technically adequate as GBS is not part of the normal urine flora, thus avoiding invasive procedures such as suprapubic bladder punction or transurethral catheterization. At the same time, the use of urine instead of blood samples could help preventing newborns blood spoliation.O estreptococo do grupo B (GBS constitui a causa mais freqüente de sepse neonatal precoce. O teste de referência continua sendo o isolamento em cultura, apesar de apresentar problemas de sensibilidade. O objetivo do presente estudo foi validar uma técnica de dupla amplificação e determinar a possibilidade do uso de amostras residuais de urina colhidas por método não invasivo, não estéril, para a confirmação da sepse por GBS em recém-nascidos. As amostras foram amplificadas com primers do principal gene de superfície do GBS. A insuficiência de volume de material biológico para a realização de exames para suporte de vida, além de outros necessários à identificação do agente etiológico de infecções é muito freqüente em recém-nascidos. Mesmo assim, decidimos definir critérios bastante rigorosos para a inclusão de pacientes na casuística: os recém-nascidos deveriam apresentar sinais e sintomas compatíveis com infecção pelo GBS; deveriam ter tido ao menos uma amostra enviada para cultura, podendo ser sangue, urina ou líquor; disponibilidade de volumes residuais dessas amostras, ou de outras colhidas no dia da hospitalização, antes da introdução da antibioticoterapia, de forma a possibilitar a análise por PCR, e evolução favorável com a antibioticoterapia empírica. Em apenas um dos quatro recém-nascidos a infecção foi confirmada por cultura, enquanto nos outros três casos a infecção foi considerada presuntiva (pacientes preencheram os critérios de inclusão, mas o GBS não foi isolado. De um total de 12 amostras

Fatores de risco associados à mortalidade em pacientes com sepse em unidade de terapia intensiva de hospital privado de Pernambuco Risk factors associated to mortality on septic patients in an intensive care unit of a general private hospital from Pernambuco

Directory of Open Access Journals (Sweden)

Joana Corrêa de A. Koury

2007-03-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: Verificar a associação entre as características clínicas, epidemiológicas e laboratoriais com a mortalidade de pacientes com sepse, internados em UTI de hospital privado do estado de Pernambuco (Nordeste do Brasil, a fim de melhorar o atendimento a essa população, através da identificação precoce dos pacientes com risco de desenvolver falência de órgãos. MÉTODO: Estudo de caso-controle aninhado a uma coorte prospectiva e observacional que incluiu os pacientes adultos admitidos na UTI com sepse ou que a desenvolveram durante a internação. Foram colhidos os dados epidemiológicos, avaliados os escores clínicos e exames laboratoriais como: D-dímero, antitrombina III, INR, contagem de plaquetas, sódio, albumina, lactato e creatinina, sendo analisada sua associação com a mortalidade. Os pacientes foram acompanhados até a alta da UTI ou óbito. RESULTADOS: Foram incluídos no estudo 199 pacientes. Após regressão logística, apenas o tempo de internação na UTI maior que 72h, a presença de doença crônica associada, o número de órgãos acometidos superior a três e o lactato maior que 4 mmol/L estiveram associados com a mortalidade. Com relação à associação com o intervalo de tempo para o óbito, apenas o escore SOFA foi significativo, pois um terço dos pacientes com pontuação superior a 12 foram a óbito em menos de 72h. CONCLUSÕES: Os pacientes admitidos com sepse na UTI provenientes da comunidade (tempo de internação hospitalar BACKGROUND AND OBJECTIVES: Verify the association between clinical, epidemiological and laboratorial characteristics with mortality of septic patient in an Intensive Care Unit (ICU from Pernambuco, northeast of Brazil, to improve the attention for patients with sepse which are in risk of developing organ dysfunction. METHODS: Case-control study, without intervention, that included adults' patients admitted in ICU with sepsis or that developed it during ICU

Proteômica na sepse: estudo piloto Proteomics in sepsis: a pilot study

Directory of Open Access Journals (Sweden)

Rita Azevedo de Paiva

2010-12-01

Full Text Available Na sepse ocorre desregulação da expressão gênica. Os marcadores genéticos revelam apenas o genótipo do indivíduo, não sendo afetados pelos processos biológicos decorrentes da ação do ambiente, estes expressos nas proteínas. Este estudo teve como objetivo alcançar maior compreensão sobre as bases moleculares da sepse. Para tal realizou a identificação e análise da expressão diferencial de proteínas no soro de paciente séptico em diferentes estágios de gravidade (sepse, sepse grave e choque séptico através de técnicas proteômicas. Amostras de soro referentes a cada estágio da sepse foram colhidas e submetidas à eletroforese unidimensional em fitas com gradiente de pH imobilizado seguida de eletroforese bidimensional em gel de poliacrilamida 12,5%. Os géis obtidos foram corados, escaneados e analisados através do programa ImageMasterPlatinum. As proteínas expressas diferencialmente nos géis foram excisadas, digeridas com tripsina e identificadas através de espectrometria de massa. Foram identificadas 14 proteínas expressas diferencialmente entre os estágios da sepse, assim como uma proteína não expressa em todos os estágios, sugerindo a existência de um possível biomarcador. Foram elas: amilóide sérico A, apolipoproteína A-1 (2 isoformas, proteína dedo de zinco 222, albumina humana, PRO 2619, imunoglobulina de cadeia leve kappa região VLJ, imunoglobulina M monoclonal de aglutinação a frio e 7 inibidoras de proteases - alfa-1 antitripsina. Os resultados obtidos neste estudo piloto demonstram a participação das vias do complemento e coagulação, do metabolismo lipídico e da informação genética na sepse. A grande maioria de proteínas identificadas está envolvida no sistema imune com predomínio das proteínas inibidoras de proteases.Gene expression is disrupted by sepsis. Genetic markers can only reveal a patient's genotype, and they are not affected by environmental biological processes. These

Dopamina e o rim na sepse: uma revisão sistemática

Directory of Open Access Journals (Sweden)

Katz Denise Varella

2003-01-01

Full Text Available A insuficiência renal aguda (IRA tem uma alta morbi-mortalidade em pacientes de terapia intensiva. A sepse grave e choque séptico são fatores de risco importantes para o desenvolvimento de IRA. A dopamina em dose baixa (0,5 a 3 mg/kg/min vem sendo empregada durante várias décadas como opção terapêutica para a proteção da função renal nestes pacientes, ainda que na ausência de estudos bem controlados. OBJETIVOS: Verificar evidências na literatura que justifiquem o uso rotineiro da dopamina em dose baixa nos pacientes com sepse grave e choque séptico. MÉTODOS: Busca sistemática da literatura, abrangendo bancos de dados eletrônicos (MEDLINE, EMBASE, LILACS e a busca manual de artigos. RESULTADOS: Dos cinco estudos clínicos randomizados encontrados, nenhum se enquadrou nos critérios de inclusão, pois não avaliavam a função renal. Dentre os estudos do tipo séries de casos, apenas oito foram passíveis de avaliação qualitativa. Foram descritos alguns efeitos adversos associados à dopamina, tais como aumento do shunt pulmonar, taquiarritmias, aumento na pressão de artéria pulmonar, que não foram estatisticamente significantes. A mortalidade também não se alterou com o uso da dopamina. CONCLUSÕES: Não existem evidências suficientes na literatura que suportem o uso rotineiro da dopamina em dose baixa como opção terapêutica para proteção da função renal na sepse grave e choque séptico.

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

Efeitos da castração pós-natal sobre o tecido pulmonar após sepse experimental de origem abdominal em ratos

Directory of Open Access Journals (Sweden)

d'Acampora Armando José

2004-01-01

Full Text Available OBJETIVO: Avaliar os efeitos da castração pós-natal sobre o tecido pulmonar na sepse de origem abdominal induzida em ratos. MÉTODOS: Foram utilizados 33 ratos Wistar distribuídos em dois grupos: Grupo Controle (GC = 5 machos adultos normais sem desafio séptico. Grupo Experimento (GE: 28 ratos submetidos a sepse por ligadura e perfuração de ceco (LPC e distribuídos em três subgrupos: Subgrupo Macho (SgM: nove ratos machos adultos, sem castracão e submetidos a sepse por LPC. Subgrupo Fêmea (SgF: nove ratos fêmeas adultos normais submetidas a sepse por LPC. Subgrupo Castrado (SgC: dez ratos machos que no quarto dia de vida foram submetidos a orquiectomia bilateral e quando adultos à sepse por LPC. Após a LPC os animais foram observados até o óbito, realizada análise histomorfométrica do pulmão, observando-se o número de polimorfonucleares e mononucleares. RESULTADOS: 50% dos animais do SgC sobreviveram 24 horas, contra 33% do SgF e 0% do SgM, mostrando uma nítida influência da castração na resposta ao desafio séptico. O número de polimorfonucleares e mononucleares não foi diferente estatisticamente entre o SgC e CG, estando estatisticamente aumentados no SgM e SgF. CONCLUSÃO: Os animais castrados apresentaram uma maior tendência à sobrevida e menor alteração pulmonar.

Prognostički značaj određivanja koncentracija citokina članova superfamilije tumor nekrozis faktora alfa kod obolelih od sepse

OpenAIRE

Lendak, Dajana

2015-01-01

Uvod: Nespecifičnost kliničke slike sepse, velike individualne razlike u odgovoru organizma na infekciju kao i neophodnost adekvatne inicijalne procene težine kliničke slike, toka i ishoda bolesti, čine istraživanja biomarkera koji bi doprineli pravovremenom postavljanju dijagnoze i adekvatnoj prognozi bolesti izuzetno značajnim. Do sada je ispitivano preko 200 biomarkera od kojih ni jedan nije pokazao zadovoljavajuću senzitivnost i specifičnost. Uloga B limfocita u patogenezi sepse pri tome ...

Sepsis: emerging role of nitric oxide and selectins Sepse: o papel das selectinas e do óxido nítrico

Directory of Open Access Journals (Sweden)

Abhijit Chandra

2006-02-01

Full Text Available Sepsis-a state of systemic bacterial infection-often leads to multiorgan failure and is associated with high mortality despite the recent advances achieved in intensive care treatment. Many of the ill effects of sepsis are attributed to an abnormally enhanced host inflammatory response that leads to neutrophil recruitment and activation involving selectins, a class of adhesion molecules, in the initial stages. Nitric oxide and its various isoforms have also been implicated in various vascular alterations and directly participate in the cellular toxicity in sepsis. This review briefly describes the role of selectins and nitric oxide in experimental and clinical sepsis as well as the therapeutic outcomes of blocking therapies.Sepse - um estado de infecção bacteriana sistêmica - frequentemente leva à falência múltipla de órgãos e associa-se a altos índices de mortalidade, apesar de progressos recentes no manejo de pacientes em unidades de terapia intensiva. Muitos dos efeitos maléficos associados à sepse são atribuídos a uma resposta inflamatória patologicamente ampliada que leva a recrutamento neutrofílico e ativação das moléculas de adesão do grupo das selectinas, durante as fases iniciais do processo . O óxido nítrico e sua diversas isoformas também foram implicados nas diversas manifestações vasculares da sepse como participantes diretos da toxicidade celular. Esta revisão descreve o papel das selectinas e do óxido nítrico em situações clínicas e experimentais de sepse, bem como os respectivos efeitos de processos terapêuticos de bloqueio.

Colonização materna e neonatal por estreptococo do grupo B em situações de ruptura pré-termo de membranas e no trabalho de parto prematuro Group B streptococcus maternal and neonatal colonization in preterm rupture of membranes and preterm labor

Directory of Open Access Journals (Sweden)

Marcelo Luís Nomura

2009-08-01

dois casos de sepse precoce por EGB nesta amostra, com prevalência de 10,8 casos por mil nascidos vivos e mortalidade de 50%. CONCLUSÕES: a amostra avaliada apresenta altas taxas de colonização materna por Streptococcus agalactiae. São necessários o uso de meio de cultura seletivo e a associação de culturas ano-retais e vaginais para aumentar a taxa de detecção do EGB. A incidência de sepse neonatal precoce foi elevada nesta população.PURPOSE: to indentify the prevalence and risk factors of maternal colonization by group B streptococcus (GBS in pregnant women with premature labor (PL and/or premature membrane rupture (PMR. METHODS: two anal and two vaginal swabs were collected from 203 pregnant women with diagnosis of PL or PMR assisted at the practice along one year. Pregnant women with imminent labor at admission were excluded. One swab of each source was placed in a transfer milieu and sent for culture in blood-agar plates; the two remaining swabs were incubated for 24 hours in Todd-Hewitt milieu for further sowing in blood-agar plates. Risk factors were analyzed by the chi-square test, Student's t-test (p-value set at 0.05 and 95% confidence interval and logistic regression. The following variables were analyzed: age, race, parity and mother schooling; culture results by source and type of culture; admission diagnosis; gestational age at admission; asymptomatic bacteriuria; gestational age at delivery; type of delivery; neonatal GBS colonization rate and immediate neonatal condition. RESULTS: prevalence of maternal GBS colonization was 27.6% (56 cases. The colonization rates according to gestational complications were 30% for PMR, 25.2% for PL and 17.8% for PL + PMR. Univariate analysis has shown that the variables Caucasian race, low level of schooling and bacteriuria were associated with higher colonization rates. Multivariate analysis showed that the presence of urinary infection was the only variable associated with maternal colonization. The GBS

Estatinas na sepse: nova arma terapêutica no arsenal da medicina intensiva? Statins on sepsis: a new therapeutic gun in intensive care medicine?

Directory of Open Access Journals (Sweden)

Luiz Eduardo Fonteles Ritt

2006-12-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: Sepse é uma síndrome de base inflamatória; diversos fármacos que -atuam sobre as vias de ativação da inflamação vêm sendo observados. As estatinas, além do conhecido efeito hipolipemiante detêm capacidades antiinflamatórias chamados pleiotrópicas. Essa ação pode ser benéfica no tratamento da sepse. O objetivo deste estudo foi revisar as principais publicações abordando o seu uso na sepse. MÉTODO: Busca por artigos originais cruzando os unitermos sepse e estatina no MedLine entre 1990 e 2006. RESULTADOS: Diversos estudos experimentais e retrospectivos investigaram o uso de estatinas em sepse, até o momento, em sua maioria mostraram melhora de mortalidade e morbidade. Não existem estudos prospectivos, aleatórios, placebo-controlados ou metanálises, o que demonstrou que a falta de evidências sólidas e comprovadas para indicação de uso desta conduta ainda é prevalente. Portanto ainda com seu beneficio questionável, são necessários estudos clínicos aleatórios que possam comprovar a teoria em questão. CONCLUSÕES: Diversos estudos experimentais e retrospectivos têm investigado o uso de estatinas em pacientes sépticos, porém, apesar da literatura demonstrar ser esta teoria promissora, ainda necessita-se de estudos clínicos abordando maior número de pacientes, de forma aleatória, para estar-se apto a entender e, possivelmente, recomendar o uso desta medicação no tratamento de pacientes com sepse.BACKGROUND AND OBJECTIVES: Sepsis is a syndrome with an important inflammatory component in its pathophysiology. Some drugs that act on the activation of inflammatory cascade have been tested in septic patients. Statins, beyond hypolipemic effects, have anti-inflammatory capacities, known as pleiotropic effects. That action may be of value on sepsis treatment. Review of publications who discuss the use of statins. This article has the objective to review the mainly papers about statins and

Estudo de associação genética entre fator de necrose tumoral alfa e sepse e choque séptico em pacientes pediátricos tailandeses

Directory of Open Access Journals (Sweden)

Suwannee Phumeetham

2012-10-01

Full Text Available OBJETIVOS: Avaliar a associação entre o polimorfismo genético do fator de necrose tumoral alfa (TNF-α e o desenvolvimento de sepse e choque séptico em pacientes pediátricos tailandeses e investigar o impacto clínico de polimorfismos do TNF-α nessa população. MÉTODOS: Para a realização deste estudo de associação genética, foram analisados prospectivamente pacientes pediátricos (idade < 18 anos com sepse clínica/choque séptico. Todos os dados foram coletados por especialistas em terapia intensiva pediátrica e as análises genéticas foram realizadas em um laboratório central. Um polimorfismo de nucleotídeo único [single nucleotide polymorphism (SNP], localizado na região promotora 5' na posição -308, foi genotipado e os resultados foram associados a fenótipos clínicos. RESULTADOS: Foram investigados 167 indivíduos tailandeses, dos quais 66 eram pacientes pediátricos com sepse/choque séptico e 101 eram controles saudáveis. Curiosamente, não foi possível identificar associação entre sepse e o polimorfismo -308 (G→A, um dos principais SNPs anteriormente associado à sepse em várias populações caucasianas, visto que não houve diferença de frequência entre casos e controles. CONCLUSÕES: Neste estudo, o principal polimorfismo do TNF-α -308 não esteve associado à sepse clínica/choque séptico na população tailandesa. Essa informação é importante para futuras análises que busquem identificar a função do TNF-α como risco genético para o desenvolvimento de imunopatologia subjacente a várias doenças no continente asiático.

Atualidades proteômicas na sepse Proteomic updates on sepsis

Directory of Open Access Journals (Sweden)

Rodrigo Siqueira-Batista

2012-06-01

Full Text Available A ampliação do conhecimento das técnicas de análise proteômica tem permitido maior compreensão das bases moleculares relacionadas à identificação de vias de sinalização celular, de proteínas modificadoras, de modificações pós-traducionais, além de caracterizar marcadores biológicos específicos. Desta feita, a documentação de determinadas proteínas expressas na sepse constitui uma promissora abordagem para elucidação dos aspectos fisiopatológicos, diagnósticos, terapêuticos e prognósticos dessa condição, com a finalidade de aplicação na prática clínica. Embora os resultados sejam ainda preliminares, a proteômica poderá oferecer bons subsídios para o melhor manejo dos pacientes sépticos. Dessa feita, o objetivo do presente artigo é apresentar uma breve revisão das aplicações dos estudos proteômicos na sepse.The increased knowledge regarding proteomic analysis techniques has allowed for better understanding of the molecular bases related to the identification of cell signaling, modifying protein, and post-translational modification pathways, in addition to the characterization of specific biological markers. Thus, documenting certain proteins expressed in sepsis is a promising approach to elucidate pathophysiological, diagnostic, therapeutic, and prognostic aspects in this condition with a purpose of applying them to clinical practice. Although the studies are still preliminary, proteomics may offer good benefits for the better management of septic patients. Thus, this article aims to introduce a short review of the applications of proteomic studies to sepsis.

Early neonatal deaths associated with perinatal asphyxia in infants ≥2500 g in Brazil

Directory of Open Access Journals (Sweden)

Maria Fernanda Branco de Almeida

2017-11-01

Full Text Available Objective: To assess the annual burden of early neonatal deaths associated with perinatal asphyxia in infants weighing ≥2500 g in Brazil from 2005 to 2010. Methods: The population study enrolled all live births of infants with birth weight ≥2500 g and without malformations who died up to six days after birth with perinatal asphyxia, defined as intrauterine hypoxia, asphyxia at birth, or meconium aspiration syndrome. The cause of death was written in any field of the death certificate, according to International Classification of Diseases, 10th Revision (P20.0, P21.0, and P24.0. An active search was performed in 27 Brazilian federative units. The chi-squared test for trend was applied to analyze early neonatal mortality ratios associated with perinatal asphyxia by study year. Results: A total of 10,675 infants weighing ≥2500 g without malformations died within six days after birth with perinatal asphyxia. Deaths occurred in the first 24 h after birth in 71% of the infants. Meconium aspiration syndrome was reported in 4076 (38% of these deaths. The asphyxia-specific early neonatal mortality ratio decreased from 0.81 in 2005 to 0.65 per 1000 live births in 2010 in Brazil (p < 0.001; the meconium aspiration syndrome-specific early neonatal mortality ratio remained between 0.20 and 0.29 per 1000 live births during the study period. Conclusions: Despite the decreasing rates in Brazil from 2005 to 2010, early neonatal mortality rates associated with perinatal asphyxia in infants in the better spectrum of birth weight and without congenital malformations are still high, and meconium aspiration syndrome plays a major role. Resumo: Objetivo: Avaliar a taxa anual de óbitos neonatais precoces associados à asfixia perinatal em neonatos de peso ≥2.500 g no Brasil de 2005 a 2010. Métodos: A população do estudo envolveu todos os nascidos vivos de neonatos com peso ao nascer ≥2.500 g e sem malformações que morreram até seis dias ap

A mortalidade neonatal em 1998, no município de Botucatu - SP La mortalidad neonatal en 1998, en el município de Botucatu-SP The neonatal mortality in 1998 at the municipality of Botucatu-SP

Directory of Open Access Journals (Sweden)

Kátia Poles

2000-07-01

Full Text Available Considerando que a mortalidade neonatal é indicador da qualidade da assistência prestada à gestante, ao parto e ao recém-nascido, realizamos o presente trabalho, cujo objetivo foi identificar as causas e o índice de mortalidade neonatal durante o ano de 1998 em Botucatu-SP. O coeficiente de mortalidade neonatal obtido foi de 8,3/1000 nascidos vivos e o coeficiente de mortalidade neonatal precoce foi de 7,3/1000 nascidos vivos, confirmando a importância dos óbitos na primeira semana de vida. Aproximadamente três quartos dos óbitos puderam ser classificados como reduzíveis por diagnóstico e tratamento precoces, reduzíveis por adequada atenção ao parto ou parcialmente reduzíveis por adequado controle da gravidez, evidenciando que para se reduzir os índices de morte neonatal, deveremos investir na melhoria da qualidade da assistência prestada à gestante, à parturiente e ao neonato.Considerando que la mortalidad neonatal es un indicador de la calidad de la asistencia ofrecida en la gestación, al parto y al recién- nacido, realizamos el presente trabajo, con el objetivo de estudiar la mortalidad neonatal durante el año de 1998 en Botucatu-SP. El coeficiente de mortalidad neonatal encontrado fue 8,3/1000 nacidos vivos y el coeficiente de mortalidad neonatal precoz fue de 7,3/1000 nacidos vivos, confirmando la importancia de las defunciones en la primera semana de vida. Los resultados mostraron que aproximadamente tres cuartos de las defunciones pueden ser reducidas con el control del embarazo, con el diagnóstico y tratamiento precoz o con la adecuada atención al parto, evidenciando que para reducir los índices de mortalidad neonatal, deberemos invertir en la mejoría de la calidad de la asistencia ofrecida en la gestación, en el parto y al recién-nacido.Considering that neonatal mortality is an indicator of the quality of the care provided to pregnant women, at childbirth as well as to the new born, authors developed the

Asfixia perinatal associada à mortalidade neonatal precoce: estudo populacional dos óbitos evitáveis Asfixia perinatal asociada a la mortalidad neonatal temprana: estudio de población de los óbitos evitables Perinatal asphyxia associated with early neonatal mortality: populational study of avoidable deaths

Directory of Open Access Journals (Sweden)

Mandira Daripa

2013-03-01

Full Text Available OBJETIVO: Comparar o perfil epidemiológico dos óbitos neonatais precoces evitáveis associados à asfixia perinatal conforme a região de ocorrência do óbito no Estado de São Paulo. MÉTODOS: Coorte populacional constituída por 2.873 óbitos evitáveis até seis dias de vida associados à asfixia perinatal ocorridos entre janeiro de 2001 e dezembro de 2003. Considerou-se como asfixia perinatal a presença de hipóxia intraútero, asfixia ao nascer ou síndrome de aspiração de mecônio em qualquer linha da Declaração de Óbito original. Variáveis epidemiológicas também foram extraídas das Declarações de Nascido Vivo. RESULTADOS: No triênio, 1,71 mortes por 1.000 nascidos vivos estavam associadas à asfixia perinatal, correspondendo a 22% dos óbitos neonatais precoces. Dos 2.873 óbitos evitáveis, 761 (27% ocorreram em São Paulo, capital; 640 (22%, na região metropolitana da capital; e 1.472 (51%, no interior do estado. Nas duas primeiras regiões predominaram as mortes em hospitais públicos, recém-nascidos com idade gestacional inferior a 37 semanas e peso abaixo de 2500g. No interior, os óbitos foram mais frequentes em entidades beneficentes, recém-nascidos a termo e com peso superior a 2500g. A maioria dos bebês nasceu durante o dia no município de residência materna e evoluiu para óbito no hospital de nascimento até 24 horas após o parto. A síndrome de aspiração de mecônio esteve presente em 18% dos óbitos. CONCLUSÕES: A asfixia perinatal é um contribuinte frequente para a morte neonatal precoce evitável no estado com o maior produto interno bruto per capita do Brasil, evidenciando a necessidade de intervenções específicas com enfoque regionalizado na assistência ao parto e ao nascimento.OBJETIVO: Comparar el perfil epidemiológico de los óbitos neonatales tempranos evitables asociados a la asfixia perinatal conforme a la región de ocurrencia del óbito en la provincia de São Paulo (Brasil. M�

Impacto das malformações congênitas na mortalidade perinatal e neonatal em uma maternidade-escola do Recife Impact of congenital malformations on perinatal and neonatal mortality in an university maternity hospital in Recife

Directory of Open Access Journals (Sweden)

Melania Maria Ramos de Amorim

2006-05-01

Full Text Available OBJETIVOS: determinar a incidência de malformações congênitas em recém-nascidos assistidos em uma maternidade-escola de Recife e avaliar o impacto destas malformações na mortalidade perinatal e neonatal. MÉTODOS: realizou-se um estudo longitudinal durante os meses de setembro de 2004 a maio de 2005, analisando-se todos os partos assistidos no Instituto Materno Infantil Prof. Fernando Figueira, IMIP. Determinou-se a freqüência e o tipo de malformações congênitas e foram calculados os coeficientes de mortalidade fetal, mortalidade perinatal, mortalidade neonatal precoce e tardia. RESULTADOS: a freqüência de malformações foi de 2,8% (em 4043 nascimentos. O percentual de malformações entre os nativivos foi de 2,7%, e entre os natimortos foi de 6,7%. Dentre as malformações, as mais freqüentes foram as do sistema nervoso central (principalmente hidrocefalia e meningomielocele, as do sistema osteomuscular e as cardiopatias. Não houve associação entre malformações e sexo, porém a freqüência de prematuridade e baixo peso foi maior entre os casos de malformações. Constatou-se, entre os malformados, mortalidade neonatal precoce de 32,7% e tardia de 10,6%. Os casos de malformações representaram 6,7% dos natimortos, 24,2% das mortes neonatais precoces e 25,8% do total de mortes neonatais. CONCLUSÕES: a freqüência de malformações correspondeu a 2,8% dos nascimentos. As malformações representaram a segunda causa mais freqüente de mortes neonatais, depois da prematuridade.OBJECTIVES: to determine the incidence of congenital malformations in newborns in a university maternity hospital in Recife and assess the impact of malformation in perinatal and neonatal mortality. METHODS: a longitudinal study was performed from September 2004 to May 2005 with all deliveries at the Instituto Materno Infantil Prof. Fernando Figueira, IMIP analyzed. The type and incidence of congenital malformations were determined, and fetal mortality

Reposição de volume na sepse com solução salina hipertônica Sepsis volume reposition with hypertonic saline solution

Directory of Open Access Journals (Sweden)

Gilberto Friedman

2008-09-01

Full Text Available Esta revisão discute os efeitos hemodinâmicos e imunomoduladores da solução hipertônica em choque experimental e em pacientes com sepse. Comentamos sobre os mecanismos de ação da solução hipertônica, recorrendo a dados sobre choque hemorrágico e séptico. Atuações específicas da solução salina hipertônica aplicáveis a sepse grave e choque séptico são enfatizadas. Os dados disponíveis corroboram os benefícios em potencial da infusão de solução salina hipertônica em vários aspetos da fisiopatologia da sepse, inclusive hipoperfusão dos tecidos, consumo reduzido de oxigênio, disfunção endotelial, depressão miocárdica e presença de um amplo elenco de citocinas próinflamatórias e várias espécies de oxidantes. Uma terapia que, ao mesmo tempo, bloqueie os componentes prejudiciais da sepse terá um impacto no seu tratamento. Estudos prospectivos adequadamente desenhados poderão no futuro comprovar o papel benéfico da solução salina hipertônica.The present review discusses the hemodynamic and immune-modulatory effects of hypertonic saline in experimental shock and in patients with sepsis. We comment on the mechanisms of action of hypertonic saline, calling upon data in hemorrhagic and septic shock. Specific actions of hypertonic saline applicable to severe sepsis and septic shock are highlighted. Data available support potential benefits of hypertonic saline infusion in various aspects of the pathophysiology of sepsis, including tissue hypoperfusion, decreased oxygen consumption, endothelial dysfunction, cardiac depression, and the presence of a broad array of pro-inflammatory cytokines and various oxidant species. A therapy that simultaneously blocks the damaging components of sepsis will have an impact on the management of sepsis. Proper designed prospective studies may prove a beneficial role for hypertonic saline solution in the future.

Tendências da mortalidade neonatal em São Luís, Maranhão, Brasil, de 1979 a 1996 Neonatal mortality trends in São Luís, Maranhão, Brazil, from 1979 to 1996

Directory of Open Access Journals (Sweden)

Valdinar Sousa Ribeiro

2000-06-01

Full Text Available O propósito do presente trabalho é avaliar a evolução da mortalidade neonatal em São Luís nos últimos 18 anos, classificá-la de acordo com os dias de vida e pelo critério de evitabilidade de óbitos da Fundação SEADE, a partir de dados do IBGE e do Ministério da Saúde. Detectou-se aumento da mortalidade neonatal, às custas de aumento expressivo do seu componente precoce, especialmente pelas causas reduzíveis por diagnóstico e tratamento precoce, e parcialmente reduzíveis por adequado controle da gravidez. A mortalidade infantil, desse modo, manteve-se inalterada, apesar do decréscimo do seu componente pós-neonatal. O aumento expressivo no coeficiente de mortalidade neonatal a partir de 1995 aponta para a queda na qualidade da assistência obstétrica e neonatal, talvez motivada pelo elevado percentual de cesáreas e pela superlotação dos berçários. A tendência de estabilidade ou aumento da mortalidade neonatal é semelhante à observada recentemente no Brasil como um todo e difere da observada em outras cidades brasileiras, nas quais foi descrita queda lenta, mas persistente, da mortalidade neonatal, em oposição a uma redução mais dramática em países desenvolvidos.This study examined neonatal mortality trends in São Luís in the last 18 years. The early and late components were assessed and causes were classified according to SEADE Foundation criteria based on reducibility of deaths and timing of prevention (during prenatal care, childbirth, or neonatal care. Data were derived from official live birth and death records. We detected an unexpected increase in the neonatal mortality rate, due primarily to a steep rise in early neonatal deaths. Causes reducible by early diagnosis and treatment (other specific infections and other neonatal respiratory causes and those partially reducible by adequate monitoring of pregnancy (preterm births, low birth weight, and respiratory distress syndrome showed the largest increase

Interleucina-12 em crianças com sepse e choque séptico

Directory of Open Access Journals (Sweden)

Joelma Gonçalves Martin

2012-06-01

Full Text Available OBJETIVO: Examinar o comportamento da interleucina-12 e verificar se pode ser utilizada para diferenciar condições sépticas em crianças. MÉTODOS: Foram inscritas, de forma prospectiva, entre janeiro de 2004 e dezembro de 2005, crianças com idades de 28 dias a 14 anos, subdivididas nos grupos sepse (SG; n=47 e choque séptico (SSG; n=43. A interleucina-12 foi avaliada quando da admissão (T0 e 12 horas mais tarde (T12. A gravidade da doença foi avaliada utilizando o escore PRISM. RESULTADOS: A interleucina-12 não diferenciou crianças com sepse das com choque séptico quando da admissão [SSG: 0,24 (0-22,64=SG: 1,23 (0-511,6; p=0,135] e na avaliação T12 [SG: 6,11 (0-230,5=SSG: 1,32 (0-61,0; p=0,1239]. Na comparação entre os momentos, não foi observada diferença estatística para SG [SG, T0: 1,23 (0-511,6=T12: 6,11 (0-230,5; p=0,075]. Entretanto, em casos de SSG, a interleucina-12 aumentou entre as avaliações T0 e T12 [SSG, T0: 0,24 (0-226,40,05. Para ambos os grupos, não houve correlação entre interleucina-12 na admissão e o escore PRISM. CONCLUSÃO: A interleucina-12 não diferencia as condições sépticas e não se relaciona com a gravidade da doença por ocasião da admissão. Em pacientes com choque séptico, a interleucina-12 aumenta com o tempo.

Sepse por Staphylococus aureus resistente à meticilina adquirida na comunidade no sul do Brasil Sepsis due to community-acquired methicillin-resistant Staphylococcus aureus in southern Brazil

Directory of Open Access Journals (Sweden)

Luciane Cristina Gelatti

2009-08-01

Full Text Available Staphylococcus aureus resistente à meticilina foi inicialmente descrito como um típico microrganismo adquirido em infecções nosocomiais. No entanto, nos últimos anos Staphylococcus aureus resistente à meticilina adquirido na comunidade é causa de infecções de pele e tecidos moles, mas infecções graves como pneumonia e sepse podem ocorrer. Este relato descreve um caso de sepse em criança, complicado com pneumonia secundária a lesão em partes moles por Staphylococcus aureus resistente à meticilina adquirido na comunidade no Sul do Brasil. O paciente foi atendido em Unidade de Emergência com história de ferimento provocado por trauma em membro inferior que evoluiu para celulite, pneumonia e sepse.Methicillin-resistant Staphylococcus aureus was initially described as a typical microorganism acquired in nosocomial infections. However, over recent years, community-acquired methicillin-resistant Staphylococcus aureus has been a cause of skin and soft-tissue infections. Serious infections such as pneumonia and sepsis can also occur. This report describes a case of sepsis in a child that was complicated by pneumonia secondary to soft tissue lesions that were due to community-acquired methicillin-resistant Staphylococcus aureus in southern Brazil. The patient was attended at the Emergency Unit with a history of injury caused by lower-limb trauma that evolved to cellulitis, pneumonia and sepsis.

Quality of Life of Severe Sepsis Survivors After Hospital Discharge Calidad de vida de sobrevivientes de sepsis grave después del alta hospitalar Qualidade de vida de sobreviventes de sepse grave após alta hospitalar

Directory of Open Access Journals (Sweden)

Ligia Marcia Contrin

2013-06-01

ño comparado con los pacientes en estado crítico pero sin sepsis en el grupo control. Los pacientes ancianos (>60 años con sepsis tuvieron una prevalencia significativamente mayor de problemas. No hubo diferencias en EQ-VAS entre los entrevistados de ambos grupos. CONCLUSIONES: Después del alta de la UCI, los pacientes que sobrevivieron a la sepsis tuvieron una tasa de mortalidad más alta que los pacientes sin enfermedad crítica. Pacientes ancianos con sepsis tuvieron problemas moderados y graves en todas las cinco dimensiones de calidad de vida evaluadas. OBJETIVOS: avaliar a qualidade de vida em sobreviventes de sepse grave, utilizando os instrumentos EuroQol-5 Dimensions e Escala Analógica Visual. MÉTODO: caso controle aninhado, realizado em pacientes que receberam alta da unidade de terapia intensiva de um hospital de ensino, após admissão com sepse grave. A seleção foi feita a partir do cadastro sepse, contendo 349 prontuários. Cada paciente com sepse foi considerado como um sujeito e o paciente internado após foi considerado controle, desde que não tivesse sepse e tivesse sobrevivido à internação, totalizando 100 sujeitos. RESULTADOS: o grupo sepse apresentou mortalidade mais elevada em 1 ano comparado com pacientes críticos, porém, sem sepse no grupo controle. Pacientes mais velhos (>60 anos de idade no grupo sepse tiveram prevalência significativamente maior de problemas. Não houve diferença na Escala Visual Análoga entre os entrevistados de ambos os grupos. CONCLUSÕES: após alta da unidade de terapia intensiva, os pacientes que sobreviveram à sepse tiveram taxa de mortalidade mais elevada do que os pacientes críticos sem a doença. Pacientes idosos com sepse tiveram problemas variando de moderado a grave, em todas as cinco dimensões de qualidade de vida avaliadas.

Estudo epidemiológico das infecções neonatais no Hospital Universitário de Londrina, Estado do Paraná = Epidemiological study of neonatal infections at the University Hospital of Londrina, Paraná State

Directory of Open Access Journals (Sweden)

Gilselena Kerbauy Lopes

2008-01-01

Full Text Available A maior suscetibilidade dos neonatos às infecções resulta em taxas de infecção hospitalar (IH superiores às outras populações de pacientes. O objetivo deste trabalho foi determinar a frequência e o perfil das IH para os neonatos associando os principais fatoresde risco e óbito. Foi realizado estudo epidemiológico, retrospectivo, em registros de notificação de infecções neonatais da Comissão de Controle de Infecção Hospitalar do Hospital Universitário de Londrina, no período entre 2001 e 2005. A taxa média anual deIH neonatal foi 18,3% ao longo dos cinco anos. As infecções mais frequentes foram pneumonia (46,0% e sepse (49,1%, as quais estiveram relacionadas ao tempo de hospitalização superior a 60 dias e aos procedimentos invasivos como intubação orotraqueale o cateterismo vascular, que aumentaram três vezes o risco para sepse e respectivamente 3,26 e 2,50 vezes o risco para óbito. A IH contribuiu com 85,7% dos óbitos. O coeficiente de letalidade foi 15,8%.The greater susceptibility of neonates to infections results in higher rates of nosocomial infection (NIs than in other patient populations. The objective of this work was to determine the frequency and profile of NIs in neonates associated to the main risk and death factors. A retrospective epidemiological study wasconducted on neonates with NIs admitted to the neonatal sector at the University Hospital of Londrina, between 2001 and 2005. The mean annual rate of neonatal NI was 18.3% over the course of five years. The most frequent infections were pneumonia (46.0% and sepsis(49.1%, which were related to a hospitalization period of over 60 days. The use of tracheal tubes and vascular catheters increased threefold the risk of sepsis. The tracheal tubes and vascular catheters increased the risk of death by 3.26 and 2.50 times, respectively. NIs contributed to 85.7% of deaths. The mortality coefficient was 15.8%.

Early motor outpatient service intervention for postural control in preterm neonates Intervenção motora precoce ambulatorial para neonatos prematuros no controle postural

Directory of Open Access Journals (Sweden)

Clarissa Balbão Almeida

2008-12-01

Full Text Available Objective: To insure the motor acquisitions related to the Axial Spontaneous Not Communicative Development, which means postural control and displacement. This was done through an early motor intervention physiotherapy program in preterm neonates born at HSL-PUCRS. Materials and Methods: the interventional program included tasks of visual harassment, toys manipulation and postural control, based on Bobath concept. All five preterms who have participated in the program were evaluated by the physiotherapy service, using The Brazilian Scale of Child behavior Development in the First Year of Life, in the beginning of the study and repeated every two months. Results: The study shows no statistical significant results in relation to postural tasks, dynamic balance and displacement. However, a progression in the preterm’s classification evaluations was demonstrated. In the first month of evaluation the median was 3 (regular classification and in the third and fifth month of evaluation the median maintained in 4 (good classification. Conclusion: The early motor intervention provided a progression in the evaluation`s classification of motor acquisitions of the preterms development, however, no statistical significant results related to postural tasks, dinamic balance and displacemen was shown.Objetivo: Verificar as aquisições motoras relacionadas ao desenvolvimento axial espontâneo não comunicativo, ou seja, controle postural e deslocamento. Isto foi feito através de um programa de intervenção motora fisioterapêutica precoce em neonatos prematuros nascidos no Hospital São Lucas - PUCRS. Materiais e Métodos: Tarefas de perseguição visual, manipulação de brinquedos e de controle postural, baseados no conceito Bobath, foram implementadas no programa interventivo. Todos os 5 prematuros que participaram deste estudo foram avaliados pelo serviço de fisioterapia por meio da Escala de Desenvolvimento do Comportamento da Criança no Primeiro Ano

Behavioral aggressiveness in boys with sexual precocity

Directory of Open Access Journals (Sweden)

Bindu Kulshreshtha

2012-01-01

Full Text Available Background: Some boys with sexual precocity are known to have behavioral problems like increased physical and verbal aggression and school and social maladjustments. It is believed to be due to premature androgen exposure. However, it is not clear why only some develop this problem, difference in etiology could be one explanation. Aim: The aim of the study is to assess behavioral aggression in boys with sexual precocity due to different disorders. Materials and Methods: Seven children, ages three to seven years, were enrolled for this study. Two were diagnosed to have congenital adrenal hyperplasia (CAH, three had testotoxicosis, while two had central precocious puberty. Parents of children with precocious puberty underwent the (CASP questionnaire (children′s aggression scale-parent version. Results: Testosterone levels were high in all patients. Parents denied any history of physical or verbal aggression in the two boys with CAH. Their CASP rating was 0. In contrast, the CASP ratings in the two boys with testotoxicosis and the two with precocious puberty for five domains ranged from 3.1 - 24.2, 2.6 - 8.3,1-5.6,0 - 7.1, and 0 - 1, respectively. In the present study, increased aggression was seen among all the patients with testotoxicosis and both with precocious puberty. In contrast, there were no symptoms of either increased verbal or physical aggression in either of the two patients with CAH. Conclusions: The hormonal milieu in the boys with CAH versus those with sexual precocity due to other causes differed in terms of cortisol and androgen precursors. The androgen excess in CAH children was a consequence of cortisol deficiency. It is possible that cortisol sufficiency is required for androgen-mediated behavioral effects.

Transient sexual precocity and ovarian cysts.

OpenAIRE

Lyon, A J; De Bruyn, R; Grant, D B

1985-01-01

Nine girls presenting under the age of 7 years with unsustained sexual precocity are described. Large ovarian cysts were detected by ultrasound in three and laparotomy in one. In two girls the symptoms resolved after surgical removal of the cyst; the other seven had spontaneous remission of symptoms, but in two of these transient breast development and bleeding recurred: further ovarian cyst formation was found in one of these patients. Endocrine studies performed before resolution of the cys...

A bilirrubina altera a mielinização no período neonatal precoce

OpenAIRE

Barateiro, Andreia Pereira, 1982-

2012-01-01

Tese de doutoramento, Farmácia (Biologia Celular e Molecular), Universidade de Lisboa, Faculdade de Farmácia, 2012 Oligodendrocytes (OL) are neuroglial cells present in the central nervous system responsible for myelin sheath formation, that provide an electric insulation of axons fastening the transmission of electrical signals. During the neonatal period, the brain is particularly vulnerable to toxic insults, like the one induced by hyperbilirubinemia. It has been demonstrated that in th...

Diabetes gestacional - Otimização do controlo materno e morbilidade neonatal

OpenAIRE

Mimoso, Maria Gabriela

2018-01-01

Introdução - A diabetes gestacional (DG) é uma das complicações médicas mais frequentes na gravidez. O diagnóstico mais precoce e o rigor do controlo metabólico é fundamental para diminuir a morbilidade perinatal.A hiperglicémia materna ao induzir hiperglicémia fetal e consequente hiperinsulinismo, é responsável pela maioria das complicações do feto e no recém-nascido (RN).Objetivo - Avaliar a evolução da morbilidade neonatal de filhos de mães com DG explorando as possíveis correlações entre ...

Aspectos clínicos da fenilcetonúria em serviço de referência em triagem neonatal da Bahia Clinical aspects of phenylketonuria in a reference service for neonatal screening in Bahia

Directory of Open Access Journals (Sweden)

Tatiana Amorim

2005-12-01

Full Text Available OBJETIVOS: descrever as características clínicas dos pacientes com hiperfenilalaninemia acompanhados no Serviço de Referência em Triagem Neonatal (SRTN do estado da Bahia. MÉTODOS: estudo descritivo transversal, tendo como amostra todos os pacientes com diagnóstico conhecido de Hiperfenilalaninemia residentes no estado da Bahia e acompanhados no SRTN até setembro de 2005. Tal população é composta de 46 famílias, num total de 51 pacientes. A análise dos dados foi descritiva, incluindo medidas de tendência central e dispersão. RESULTADOS: houve discreto predomínio do gênero feminino (52,9%. A maioria dos pacientes (78,4% teve seu diagnóstico estabelecido através da triagem neonatal, tendo, portanto, tratamento precoce. Consangüinidade foi registrada em 32,6% das famílias. A média de início do tratamento entre os pacientes diagnosticados pela triagem neonatal foi de 56,6 37,8 dias, enquanto que entre os pacientes com diagnóstico tardio, foi de 7,1 anos. CONCLUSÕES: o estudo descreve um grupo de pacientes representativo de uma patologia incluída no Programa Nacional de Triagem Neonatal (PNTN, sendo, portanto, de relevância para a saúde pública. Entre os dados clínicos, chama a atenção a média de idade do início do tratamento, superior ao recomendado na literatura, alertando para a necessidade de um maior enfoque no diagnóstico precoce.OBJECTIVES: to describe clinical aspects of hyper-phenylalaninemia in patients followed up on the Reference Service for Neonatal Screening (SRTN in the state of Bahia. METHODS: cross-sectional study that enrolled all patients living in the state of Bahia and followed up on the SRTN who had a definite diagnosis of hyper-phenylalaninemia prior to September, 2005. That population was made up of 46 families, with 51 patients. The analysis of data was descriptive, using measures of central tendency and dispersion. RESULTS: a discrete predominance of females was found (52.9%. Most patients

Aspectos morfológicos e funcionais do implante de tecido esplênico autógeno previamente conservado em solução de Ringer-lactato

OpenAIRE

Argos Soares de Matos Filho

2013-01-01

Para interromper sangramentos em traumas esplênicos graves com pacientes instáveis, a operação mais adotada é a esplenectomia total. Esse procedimento pode salvar a vida, porém acompanha-se dos riscos do estado asplênico, incluindo sepse fulminante, tromboembolismo e óbito precoce. A conscientização da importância do baço na defesa orgânica vem estimulando o desenvolvimento de operações conservadoras, como a esplenectomia parcial, a esplenectomia subtotal e os implantes autógenos de tecido...

Estudo epidemiológico das infecções neonatais no Hospital Universitário de Londrina, Estado do Paraná - DOI: 10.4025/actascihealthsci.v30i1.4386 Epidemiological study of neonatal infections at the University Hospital of Londrina, Paraná - DOI: 10.4025/actascihealthsci.v30i1.4386

Directory of Open Access Journals (Sweden)

Renata Aparecida Belei

2008-07-01

Full Text Available A maior suscetibilidade dos neonatos às infecções resulta em taxas de infecção hospitalar (IH superiores às outras populações de pacientes. O objetivo deste trabalho foi determinar a frequência e o perfil das IH para os neonatos associando os principais fatores de risco e óbito. Foi realizado estudo epidemiológico, retrospectivo, em registros de notificação de infecções neonatais da Comissão de Controle de Infecção Hospitalar do Hospital Universitário de Londrina, no período entre 2001 e 2005. A taxa média anual de IH neonatal foi 18,3% ao longo dos cinco anos. As infecções mais frequentes foram pneumonia (46,0% e sepse (49,1%, as quais estiveram relacionadas ao tempo de hospitalização superior a 60 dias e aos procedimentos invasivos como intubação orotraqueal e o cateterismo vascular, que aumentaram três vezes o risco para sepse e respectivamente 3,26 e 2,50 vezes o risco para óbito. A IH contribuiu com 85,7% dos óbitos. O coeficiente de letalidade foi 15,8%.The greater susceptibility of neonates to infections results in higher rates of nosocomial infection (NIs than in other patient populations. The objective of this work was to determine the frequency and profile of NIs in neonates associated to the main risk and death factors. A retrospective epidemiological study was conducted on neonates with NIs admitted to the neonatal sector at the University Hospital of Londrina, between 2001 and 2005. The mean annual rate of neonatal NI was 18.3% over the course of five years. The most frequent infections were pneumonia (46.0% and sepsis (49.1%, which were related to a hospitalization period of over 60 days. The use of tracheal tubes and vascular catheters increased threefold the risk of sepsis. The tracheal tubes and vascular catheters increased the risk of death by 3.26 and 2.50 times, respectively. NIs contributed to 85.7% of deaths. The mortality coefficient was 15.8%.

Identificação das bactérias envolvidas na sepse grave de fêmeas caninas com piometra submetidas a ovário-histerectomia terapêutica

Directory of Open Access Journals (Sweden)

Tabatha do Amaral Kalenski

2012-04-01

Full Text Available A piometra é uma afecção reprodutiva comum que acomete fêmeas caninas, podendo se agravar e progredir para o quadro de sepse grave e choque séptico. A precocidade da instituição da antibioticoterapia é determinante para um melhor prognóstico. O objetivo deste estudo foi avaliar os principais microrganismos envolvidos nos casos de sepse grave em cadelas acometidas por piometra e submetidas à ovário-histerectomia terapêutica, por meio de realização de hemocultura e cultura da secreção uterina e antibiograma. Foram avaliadas 33 fêmeas caninas e o principal agente envolvido com a sepse grave secundária à piometra foi a Escherichia coli, identificada em 57,57% dos casos. Também foram identificados Staphylococcus sp., com incidência de 9,09%, Citrobacter koseri, Enterobacter cloacae, Enterobacter faecalis, Eduardsiella sp., Klebsiella pneumoniae e Streptococcus sp., com 3,03% de frequência cada. Após a realização do antibiograma pelo método de difusão, os antimicrobianos que apresentaram maior eficácia contra as cepas de Escherichia coli foram a gentamicina, a enrofloxacina, a cefalexina e a associação de amoxicilina com ácido clavulânico, nesta ordem. A cultura da secreção uterina foi mais sensível que a hemocultura para identificação do agente microbiano (p<0,0001. A identificação bacteriana é útil para direcionar a antibioticoterapia empírica mais específica, de acordo com o perfil de sensibilidade, minimizando assim o desenvolvimento de resistência, o custo do tratamento e o risco de reações adversas aos antimicrobianos utilizados.

High risk pregnancies and factors associated with neonatal death.

Science.gov (United States)

Demitto, Marcela de Oliveira; Gravena, Angela Andréia França; Dell'Agnolo, Cátia Millene; Antunes, Marcos Benatti; Pelloso, Sandra Marisa

2017-04-03

To identify the factors associated with intra-hospital neonatal mortality based on the individual characteristics of at-risk pregnant mothers, delivery and newborns. This was a cross-sectional epidemiological study of live newborns delivered by women attended at the high-risk outpatient unit of a philanthropic hospital in Maringá, Paraná, Brazil between September 2012 and September 2013. Six hundred and eighty-eight women participated in the study. The neonatal mortality coefficient found was 17.7/1,000 live births, most in the early neonatal phase. Premature labor, fetal malformation and multiple gestations were associated with neonatal death. Premature, very low birth weight newborns and those with an Apgar score of less than seven, five minutes after birth were at high risk of death. Identifying risk factors can help plan actions to consolidate the perinatal network. Specific programs should be incentivized in other countries, in the search for significant perinatal results such as reducing neonatal mortality. Identificar os fatores associados à mortalidade neonatal intra-hospitalar com base nas características individuais de gestantes de risco, do parto e do recém-nascido. Estudo epidemiológico do tipo transversal, realizado com crianças nascidas vivas de partos hospitalares de mulheres acompanhadas pelo ambulatório de alto risco de um hospital filantrópico de Maringá, Paraná, Brasil, no período de setembro de 2012 a setembro de 2013.RESULTADOS Fizeram parte da pesquisa 688 mulheres. O coeficiente de mortalidade neonatal foi de 17,7 óbitos/1.000 nascidos vivos, sendo sua maioria no período neonatal precoce. Trabalho de parto prematuro, malformação fetal e gestação múltipla foram as intercorrências associadas ao óbito neonatal. Recém-nascidos prematuros, com muito baixo peso ao nascer e Índice de Apgar menor que sete no quinto minuto de vida apresentaram risco elevado de morte. A identificação de fatores de risco pode auxiliar no

Crescimento intra-uterino restrito diagnosticado pelo índice ponderal de Rohrer e sua associação com morbidade e mortalidade neonatal precoce Intrauterine growth retardation diagnosed by Rohrer's ponderal index and its association with morbidity and early neonatal mortality

Directory of Open Access Journals (Sweden)

Adehilde Maria Martins Santos

2005-06-01

Full Text Available OBJETIVO: diagnosticar o crescimento intra-uterino restrito (CIUR por meio do índice ponderal de Rohrer e sua associação com morbidade e mortalidade neonatal precoce. MÉTODOS: estudo retrospectivo, descritivo e de coorte transversal, no qual foram incluídos 2741 recém-nascidos (RN, sendo 2053 casos de grávidas hígidas, 228 de pré-eclâmpsia leve (PE, 52 com PE grave, 25 com PE que evoluiu para eclâmpsia, 136 de ruptura prematura das membranas (RPM e 247 de tabagistas. O índice ponderal (IP de Rohrer foi calculado segundo a equação: IP = peso/estatura³ x 100 e se utilizaram os valores 2,25 e 3,10 dos percentis 10 e 90 de Lubchenco. Classificou-se como CIUR assimétrico aquele RN com IP PURPOSE: to diagnose intrauterine growth restriction (IGR and its connection with early neonatal morbidity and mortality, through Roher's ponderal index (PI. METHODS: this was a retrospective, descriptive study of transversal cohort, in which 2741 newborns (NB were included, 2053 of them from healthy pregnant women, 228 from women with mild pregnancy-related hypertension, 52 from those with severe pregnancy-related hypertension, 25 from those with mild pregnancy-related hypertension that evolved to eclampsia, 136 from those with premature membrane rupture, and 247 from women who smoked along gestation. Roher's PI was calculated by the equation: PI = weight/height ³ x 100 and the values 2.25 and 3.10 of Lubchenco's 10 and 90 percentiles were used to classify the types of IGR. IGR was classified as asymmetric for NB with PI < 2.25 and weight lower than percentile 10, as symmetric, with PI from 2.25 to 3.10 and weight lower than percentile 10, and adequate for gestational age with PI from 2.25 to 3.10, and weight from 10 to 90 percentiles. Statistical analysis was performed using the non-paired t test, the non-parametric chi2 test and Fisher's exact test, with significance set at a value of p<0.05. RESULTS: low birth weight (< 2,500 g was present in 3

Contato precoce pele a pele entre mãe e filho: significado para mães e contribuições para a enfermagem

Directory of Open Access Journals (Sweden)

Thaís Alves Matos

2010-12-01

Full Text Available Tratou-se de uma pesquisa convergente-assistencial, realizada numa maternidade da Região Sul do Brasil entre abril e maio de 2009, objetivando compreender o significado do contato precoce pele-a-pele mãe-filho para o ser-mãe, identificar características do estabelecimento desse contato e contribuições da enfermagem. Os dados foram coletados pela observação participante e entrevista, com nove mães, identificando-se quatro categorias: a orientações acerca do contato pele-a-pele precoce mãe-filho antes do nascimento; b estabelecimento do contato precoce pele-a-pele mãe-filho; c significado do contato pele-a-pele precoce mãe-filho para o ser-mãe; e d contribuições da enfermagem no estabelecimento do contato precoce pele-a-pele mãe-filho. Conclui-se que o significado do contato precoce mãe-filho atribuído pelas mães é positivo, e a contribuição da enfermagem no estabelecimento desse contato é significativa.

Proteína C ativada no tratamento de recém-nascido com sepse, choque e disfunção de múltiplos órgãos e sistemas: relato de caso e revisão de literatura Activated C protein in the treatment of a newborn with sepsis, shock and multiple organ dysfunction systems: case report and literature review

Directory of Open Access Journals (Sweden)

Flávia Carolina Davini Georgetti

2006-12-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: A sepse grave representa a síndrome de resposta inflamatória sistêmica resultante de uma infecção, na presença de disfunção cardiovascular, síndrome do desconforto respiratório agudo ou duas ou mais disfunções orgânicas. Embora a mortalidade atribuída à sepse em crianças tenha sido reduzida de maneira significativa nas últimas décadas, a incidência de óbitos em recém-nascidos permanece elevada (20% a 40%, a despeito dos avanços em cuidados intensivos. O objetivo deste estudo foi descrever o caso de um recém-nascido com sepse, choque e disfunção de múltiplos órgãos e sistemas (DMOS que se beneficiou do uso da proteína C ativada. RELATO DO CASO: Recém-nascido prematuro, do sexo masculino, nascido de cesariana em decorrência de ruptura prematura de membranas e sofrimento fetal agudo. Internado na UTI-Neonatal por insuficiência respiratória aguda secundária à pneumonia intra-útero. Recebeu assistência ventilatória, surfactante pulmonar exógeno e antibioticoterapia precocemente, evoluindo, no entanto, com hipertensão pulmonar persistente e choque. Houve difícil controle do quadro infeccioso, a despeito de ajustes no esquema de antibioticoterapia, evoluindo com DMOS. No 28º dia, foi iniciado o uso da proteína C ativada. O paciente evoluiu favoravelmente à medicação, com resolução das disfunções orgânicas e ausência de sangramentos. CONCLUSÕES: A proteína C ativada não pode ser prescrita de maneira rotineira no tratamento de recém-nascidos com sepse grave. No caso relatado, no entanto, acredita-se que ela tenha contribuído para a resolução das disfunções orgânicas apresentadas pelo paciente.BACKGROUND AND OBJECTIVES: Severe sepsis represents the systemic inflammatory response resulting from an infection, associated with one of the following: cardiovascular organ dysfunction, acute respiratory distress syndrome or two or more organ dysfunctions. Although the

Prognostic value of non-reactive burst suppression EEG pattern associated to early neonatal seizures Valor prognóstico do EEG com padrão de surto-supressão não reativo associado a convulsões neonatais precoces

Directory of Open Access Journals (Sweden)

Magda Lahorgue Nunes

2005-03-01

como objetivo correlacionar aspectos clínicos e eletroencefalográficos associados a prognóstico em longo prazo de recém - nascidos (RN com padrão de surto - supressão não reativo no EEG. MÉTODO: Foram selecionados para este estudo RN com EEG neonatal realizado no Laboratório de Neurofisiologia Clínica do Hospital São Lucas da PUCRS e acompanhados na mesma instituição, com idade concepcional superior a 37 semanas (na data do EEG, cujos registros estivessem disponíveis para revisão. RESULTADOS: Foram incluídos 12 RN, 50% apresentaram crises convulsivas a partir do primeiro dia de vida. Em todos as convulsões eram refratárias ao tratamento medicamentoso. Em 50% a etiologia foi considerada criptogênica, 33% apresentavam erros inatos do metabolismo e 17% tinham história clínica e achados de neuroimagem sugestivos de encefalopatia hipóxico - isquêmica. O seguimento clínico demonstrou que 7/12 evoluíram para óbito, sendo 3 durante o primeiro ano de vida e um no período neonatal. Os sobreviventes apresentavam grave comprometimento do desenvolvimento neuropsicomotor e déficits neurológicos múltiplos, 92% seguiram com epilepsia refratária e 58% evoluíram para síndrome de West. CONCLUSÃO: O reconhecimento de padrão de surto - supressão não reativo no EEG neonatal pode ser relacionado a diversas doenças neurológicas e é associado a convulsões precoces e refratárias. Existe também definida associação entre este padrão e elevada morbi-mortalidade neonatal além do desenvolvimento de epilepsia pós-neonatal.

Influence of laparoscopy and laparotomy on gasometry, leukocytes and cytokines in a rat abdominal sepsis model Influência da laparoscopia e laparotomia na gasometria, leucócitos e citocinas em modelo de sepse abdominal em ratos

Directory of Open Access Journals (Sweden)

Irami Araújo Filho

2006-04-01

Full Text Available PURPOSE: Laparoscopic surgery is associated with reduced surgical trauma, and less acute phase response, as compared with open surgery. Cytokines are important regulators of the biological response to surgical and anesthetic stress. The aim of this study was to determine if CO2 pneumoperitoneum would change cytokine expression, gas parameters and leukocyte count in septic rats. METHODS: Wistar rats were randomly assigned to five groups: control (anesthesia only, laparotomy, CO2 pneumoperitoneum, cecum ligation and puncture by laparotomy, and laparoscopic cecum ligation and puncture. After 30 min of the procedures, arterial blood samples were obtained to determine leukocytes subpopulations by hemocytometer. TNFalpha, IL-1beta, IL-6 were determined in intraperitoneal fluid (by ELISA. Gas parameters were measured on arterial blood, intraperitoneal and subperitoneal exsudates. RESULTS: Peritoneal TNFalpha, IL-1beta and IL-6 concentrations were lower in pneumoperitoneum rats than in all other groups (pOBJETIVO: A cirurgia laparoscópica está associada com trauma reduzido e baixa resposta na fase aguda do trauma, quando comparada com a cirurgia aberta. As citocinas e o balanço ácido-base são fatores importantes da resposta biológica ao trauma cirúrgico-anestésico. O objetivo deste estudo foi determinar se o pneumoperitôneo com CO2 altera a expressão das citocinas, a gasometria e a contagem diferencial de leucócitos em ratos com sepse abdominal. MÉTODOS: Ratos Wistar foram aleatoriamente distribuídos em 5 grupos: controle (somente anestesia, laparotomia, pneumoperitôneo com CO2, ligadura e punção do ceco por laparotomia, ligadura e punção do ceco por laparoscopia. Após 30 minutos dos procedimentos, sangue arterial foi colhido para leucometria diferencial em hemocitômetro. TNFalfa, IL-1beta e IL-6 foram dosadas no líquido intraperitoneal (por ELISA. Os parâmetros gasosos foram medidos no sangue arterial e nos exsudatos

Intervenção motora precoce ambulatorial para neonatos prematuros no controle postural = Early motor outpatient service intervention for postural control in preterm neonates

Directory of Open Access Journals (Sweden)

Almeida, Carla Skilhan de

2008-01-01

Full Text Available Objetivo: Verificar as aquisições motoras relacionadas ao desenvolvimento axial espontâneo não comunicativo, ou seja, controle postural e deslocamento. Isto foi feito através de um programa de intervenção motora fisioterapêutica precoce em neonatos prematuros nascidos no Hospital São Lucas - PUCRS. Materiais e Métodos: Tarefas de perseguição visual, manipulação de brinquedos e de controle postural, baseados no conceito Bobath, foram implementadas no programa interventivo. Todos os 5 prematuros que participaram deste estudo foram avaliados pelo serviço de fisioterapia por meio da Escala de Desenvolvimento do Comportamento da Criança no Primeiro Ano de Vida no ingresso do estudo e repetida a cada dois meses. Resultados: O estudo evidencia que não houve resultados estatisticamente significativos referentes às atividades posturais, de equilíbrio dinâmico e de deslocamento, mas os prematuros obtiveram progressão na classificação das avaliações. No primeiro mês da avaliação a mediana foi de 3 (classificação regular, já no terceiro e quinto mês de avaliação a mediana se manteve em 4 (classificação bom. Conclusão: A intervenção motora precoce proporcionou uma progressão na classificação da avaliação das aquisições motoras do desenvolvimento de cada prematuro, porém, não houve resultados estatisticamente significativos, referentes a atividades posturais, de equilíbrio dinâmico e de deslocamento

Uso da peritoneostomia na sepse abdominal Laparostomy in abdominal sepsis

Directory of Open Access Journals (Sweden)

Juvenal da Rocha Torres Neto

2007-09-01

Full Text Available Dentre as modalidades terapêuticas da sepse abdominal, a peritoneostomia tem papel decisivo permitindo explorações e lavagens da cavidade de forma facilitada. Observamos pacientes com diagnóstico clínico de sepse abdominal internados no Serviço de Coloproctologia do Hospital Universitário da Universidade Federal de Sergipe, e que foram submetidos a peritoneostomia de janeiro de 2004 a janeiro de 2006. Foram avaliados quanto ao diagnóstico primário e secundário, tipo de peritonite secundária, antibioticoterapia, esquema de lavagens, tempo de peritoneostomia, complicações e desfecho. Estudamos 12 pacientes, com idade de 15 a 57, média de 39,3 anos. Diagnóstico primário: abdome agudo inflamatório em 6(50%, abdome agudo obstrutivo em 2(16,7%, abdome agudo perfurativo em 2(16,7%, fístula enterocutânea em 1(8,3% e abscesso intra-cavitário em 1(8,3%. Diagnóstico secundário: perfuração de cólon em 4(33,3%, abscessos intra-cavitários em 3(25%, deiscências de anastomoses em 3(25%, 1(8,3% com tumor perfurado de sigmóide e 1(8,3% com necrose de cólon abaixado. Peritonite fecal em 10(83,3% e purulenta em 2(16,7%. A antibioticoterapia teve duração média de 19 dias. Lavagens de demanda em 6(50%, programadas em 4(33,3% e regime misto em 2(16,7%. O tempo médio de peritoneostomia foi de 10,9 dias (1-36. Como complicações: evisceração em 2(16,7% e fistulização em 1(8,3%. Quatro pacientes evoluíram com óbito.Among the therapeutics approach form of abdominal sepsis, the laparostomy has a decisive role allowing cavity explorations and lavages in an easier way. We study patients with abdominal sepsis diagnoses admitted to our surgical service of Coloproctology form Sergipe´s Federal University Hospital who underwent a Bogotá Bag laparostomy associated or not with polypropylene mesh from January 2004 to January 2006. These patients were assessed as: first and second diagnosis; secondary peritonitis type; antibiotic

The timing of normal puberty and the age limits of sexual precocity

DEFF Research Database (Denmark)

Parent, Anne-Simone; Teilmann, Grete; Juul, Anders

2003-01-01

During the past decade, possible advancement in timing of puberty has been reported in the United States. In addition, early pubertal development and an increased incidence of sexual precocity have been noticed in children, primarily girls, migrating for foreign adoption in several Western European...

The timing of normal puberty and the age limits of sexual precocity

DEFF Research Database (Denmark)

Parent, Anne-Simone; Teilmann, Grete; Juul, Anders

2003-01-01

During the past decade, possible advancement in timing of puberty has been reported in the United States. In addition, early pubertal development and an increased incidence of sexual precocity have been noticed in children, primarily girls, migrating for foreign adoption in several Western Europe...

Sistema hospitalar como fonte de informações para estimar a mortalidade neonatal e a natimortalidade The Brazilian hospital system as a source of information to estimate stillbirth and neonatal mortality rates

Directory of Open Access Journals (Sweden)

Joyce MA Schramm

2000-06-01

Full Text Available OBJETIVO: Apesar da reconhecida importância em acompanhar a evolução temporal da mortalidade infantil precoce, a deficiência das estatísticas vitais no Brasil ainda permanece na agenda atual dos problemas que impedem o seu acompanhamento espaço-temporal. Realizou-se estudo com o objetivo de investigar o Sistema de Informações Hospitalares (SIH/SUS como fonte de informações, para estimar a natimortalidade e a mortalidade neonatal. MÉTODOS: Propõe-se um método para estimar a natimortalidade e a mortalidade neonatal, o qual foi aplicado para todos os Estados das regiões Nordeste, Sul e Sudeste e para o Pará, no ano de 1995. Para fins comparativos, o Sistema de Informações sobre Mortalidade (SIM/MS foi utilizado para estimar as taxas sob estudo, após a correção do número de nascidos vivos por um método demográfico. RESULTADOS: O SIH/SUS forneceu mais óbitos fetais e neonatais precoces do que o SIM/MS em grande parte das unidades federadas da região Nordeste. Adicionalmente para os Estados localizados nas regiões Sul e Sudeste, que apresentam, em geral, boa cobertura do registro de óbitos, as taxas calculadas pelos dois sistemas de informação tiveram valores semelhantes. CONCLUSÕES: Considerando a cobertura incompleta das estatísticas vitais no Brasil e a agilidade do SIH/SUS em disponibilizar as informações em meio magnético, conclui-se que o uso do SIH/SUS poderá trazer inúmeras contribuições para análise do comportamento espaço-temporal do componente neonatal da mortalidade infantil no território brasileiro, em anos recentes.OBJECTIVE: Studies on the evolution of infant mortality rate are very relevant. Nevertheless, lack of vital statistics in Brazil limits the temporal and spatial analysis of this indicator. This study aims to investigate the possible use of the Brazilian Hospital Information System as an alternative information source for stillbirth and neonatal mortality rates by age group. METHODS: A

PÚRPURA DE HENOCH-SCHONLEIN – O ENVOLVIMENTO RENAL PRECOCE

Directory of Open Access Journals (Sweden)

Inês Medeiros

2016-07-01

Comentários: O caso descrito ilustra um acometimento renal precoce e pouco frequente na PHS, de acordo com o descrito na literatura. A presença de proteinúria nefrótica e de síndrome nefrótica, secundárias à PHS, está associada a um prognóstico menos favorável, pelo que se ressalva a importância do seguimento a longo prazo.

ser precoce na intervenção

OpenAIRE

Bernardo, Ana Carolina Couto

2013-01-01

Dissertação apresentada à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Ciências da Educação: Educação Especial, área de especialização em Domínio da Intervenção Precoce na Infância Este estudo centra-se na implementação de uma Escola de Mães, programa de educação parental realizado em seis sessões na freguesia de Calhetas, ilha de S. Miguel, e na avaliação comparativa, anterior e posterior ao programa, das três mães participantes no que...

The roles of talent, physical precocity and practice in the development of soccer expertise.

Science.gov (United States)

Helsen, W F; Hodges, N J; Van Winckel, J; Starkes, J L

2000-09-01

Here we consider the potential contributions of talent, physical precocity and deliberate practice in the development of soccer expertise. After presenting a working definition of 'talent', we examine how coaches perceive and select potential talent. Our findings suggest that much of what coaches see as early talent may be explained by physical precocity associated with a relative age advantage. Finally, as a test of the model of Deliberate Practice, we review the results of studies that assessed the progress of international, national and provincial players based on accumulated practice, amount of practice per week and relative importance and demands of various practice and everyday activities. A positive linear relationship was found between accumulated individual plus team practice and skill. Various practical suggestions can be made to improve talent detection and selection and to optimize career practice patterns in soccer.

Sepse no pós-operatório de cirurgia cardíaca: descrição do problema Sepsis in the postoperative period of cardiac surgery: problem description

Directory of Open Access Journals (Sweden)

Dinaldo Cavalcanti de Oliveira

2010-03-01

Full Text Available FUNDAMENTOS: A despeito do avanço no diagnóstico e na terapêutica da sepse nos últimos anos, a morbidade e mortalidade são elevadas. OBJETIVO: Avaliar a prevalência, a evolução hospitalar e o prognóstico de pacientes que apresentaram sepse no pós- operatório de cirurgia cardíaca. MÉTODOS: Trata-se de um registro prospectivo que incluiu pacientes (n = 7.332 submetidos à cirurgia cardíaca (valvar ou coronariana entre janeiro de 1995 e dezembro de 2007. Utilizamos os critérios clássicos de diagnóstico de sepse para identificar os pacientes que evoluíram com tal enfermidade e avaliamos as comorbidades pré-operatórias, a evolução hospitalar e o prognóstico. RESULTADOS: A sepse ocorreu em 29 pacientes (prevalência = 0,39%. O sexo masculino predominou sobre o feminino (79% vs. 21%. A idade média foi de 69 ± 6,5 anos. As principais comorbidades pré-operatórias eram: hipertensão arterial sistêmica (79%, dislipidemia (48% e antecedente familiar de doença arterial coronariana (38%. O índice Apache médio foi de 18 ± 7, enquanto o Sofa indicou 14,2 ± 3,8. O foco infeccioso primário foi pulmonar em 19 pacientes (55%. Houve 19 culturas positivas, e a média de hidratação endovenosa nas primeiras 24 horas foi de 1.016 ± 803 ml. As principais complicações foram: insuficiência renal aguda (65%, síndrome de baixo débito cardíaco (55% e arritmia ventricular maligna (55%. A mortalidade foi de 79% (23 pacientes. CONCLUSÃO: A sepse após cirurgia cardíaca foi um evento raro, porém com desfechos clínicos catastróficos. O índice elevado de morbidade e mortalidade revelou a necessidade de um aprimoramento no tratamento, visando melhorar a evolução clínica dos pacientes.BACKGROUND: In spite of the advances in sepsis diagnosis and treatment in the last years, the morbidity and mortality are still high. OBJECTIVE: To assess the prevalence, in-hospital evolution and prognosis of patients that presented sepsis in the

Função adrenal na sepse e choque séptico Adrenal function in sepsis and septic shock

Directory of Open Access Journals (Sweden)

Cristiane Freitas Pizarro

2007-11-01

Full Text Available OBJETIVO: Rever os critérios diagnósticos e o tratamento de insuficiência adrenal, em pacientes da faixa etária pediátrica, com sepse grave e choque séptico. FONTES DOS DADOS: Os artigos foram selecionados através das bases de dados MEDLINE (1966-junho 2007, Embase (1994-2007 e Cochrane Library (2000-2007. As seguintes palavras-chave foram utilizadas: choque séptico, sepse, corticosteróides, insuficiência adrenal e crianças. SÍNTESE DOS DADOS: Não existe um critério bem estabelecido e aceito para definir insuficiência adrenal em pacientes criticamente enfermos. A incidência de insuficiência adrenal varia de acordo com o critério utilizado, podendo alcançar desde valores inferiores a 15% até superiores a 61%. O teste rápido de estímulo com hormônio adrenocorticotrófico (ACTH é largamente utilizado como um teste simples para a identificação de não responsividade adrenocortical, mas existe muita discussão quanto à dose de corticotropina a ser utilizada. A dose de 250 µg é a dose padrão. Recentemente, baixas doses de corticotropina (1 µg têm sido propostas, com a sugestão de que elas possam ter uma maior sensibilidade. Dúvidas ainda persistem quanto à eficácia da reposição com baixas doses de corticosteróides em crianças com choque refratário às catecolaminas. Mais estudos são necessários para determinar se o tratamento de tais pacientes alteraria morbidade e/ou mortalidade. CONCLUSÃO: Insuficiência adrenal é comum em crianças com sepse grave e choque séptico e pode contribuir para o desenvolvimento de choque refratário às catecolaminas. Contudo, dúvidas ainda persistem em relação à eficácia da terapêutica com baixas doses de corticosteróides.OBJECTIVE:To review diagnostic criteria and treatment of adrenal insufficiency in pediatric patients with severe sepsis and septic shock. SOURCES: Articles were selected using MEDLINE (1966-June 2007, Embase (1994-2007 and Cochrane Library (2000

Óbitos fetais e neonatais de filhos de pacientes classificadas com near miss

Directory of Open Access Journals (Sweden)

Daniele Marin Nardello

Full Text Available RESUMO Objetivo: identificar os aspectos epidemiológicos dos óbitos fetais e neonatais precoces em filhos de pacientes classificadas com near miss e os fatores associados a este desfecho. Método: estudo transversal realizado com 79 mulheres identificadas com near miss e seus recém-nascidos. As variáveis foram analisadas utilizando-se o teste Exato de Fisher. Os fatores de risco foram estimados com base nas razões de chances não ajustadas e ajustadas, e por meio de análise de correspondência múltipla, com significância para p < 0,05. Resultados: as desordens hipertensivas totalizaram 40,5%; destas, 58,3% tiveram desfecho fetal e neonatal adverso. Mostraram-se significantes para o desfecho os recém-nascidos admitidos na Unidade Terapia Intensiva Neonatal (70,8%, idade gestacional < 32 semanas (41,6%, peso ao nascer < 2500 (66,7%, asfixia neonatal (50% e desconforto respiratório precoce (72,2%. Conclusão: prematuridade, asfixia neonatal e desconforto respiratório precoce constituíram características significantes para o desfecho entre os recém-nascidos.

Inibição da atividade da citrato sintase cerebral em um modelo animal de sepse Inhibition of brain citrate synthase activity in an animal model of sepsis

Directory of Open Access Journals (Sweden)

Giselli Scaini

2011-06-01

Full Text Available OBJETIVO: Um amplo corpo de evidência oriundo de estudos experimentais indica que a sepse se associa com um aumento da produção de espécies de oxigênio reativo, depleção de antioxidantes, e acúmulo de marcadores de estresse oxidativo. Além disto, a disfunção mitocondrial foi implicada na patogênese da síndrome de disfunção de múltiplos órgãos. A citrato sintase é uma enzima que se localiza no interior das células, na matriz mitocondrial, sendo uma etapa importante do ciclo de Krebs; esta enzima foi utilizada como um marcador enzimático quantitativo da presença de mitocôndrias intactas. Assim, investigamos a atividade da citrato sintase no cérebro de ratos submetidos ao modelo sepse com de ligadura e punção do ceco. MÉTODOS: Em diferentes horários (3, 6, 12, 24 e 48 horas após cirurgia de ligadura e punção do ceco, seis ratos foram sacrificados por decapitação, sendo seus cérebros removidos e dissecados o hipocampo, estriato, cerebelo, córtex cerebral e córtex pré-frontal, e utilizados para determinação da atividade de citrato sintase. RESULTADOS: Verificamos que a atividade de citrato sintase no córtex pré-frontal estava inibida após 12, 24 e 48 horas da ligadura e punção do ceco. No córtex cerebral, esta atividade estava inibida após 3, 12, 24 e 48 horas da ligadura e punção do ceco. Por outro lado a citrato sintase não foi afetada no hipocampo, estriato e cerebelo até 48 horas após a ligadura e punção do ceco. CONCLUSÃO: Considerando-se que é bem descrito o comprometimento da energia decorrente da disfunção mitocondrial na sepse, e que o estresse oxidativo desempenha um papel essencial no desenvolvimento da sepse, acreditamos que o comprometimento da energia pode também estar evolvido nestes processos. Se a inibição da citrato sintase também ocorre em um modelo de sepse, é tentador especular que a redução do metabolismo cerebral pode provavelmente estar relacionada com a

REVISÃO SISTEMÁTICA INTEGRATIVA DA LITERATURA SOBRE MODELOS E PRÁTICAS DE INTERVENÇÃO PRECOCE NO BRASIL

Directory of Open Access Journals (Sweden)

Bruna Pereira Ricci Marini

2017-09-01

Full Text Available RESUMO Objetivo: Identificar quais práticas e modelos de Intervenção Precoce na Infância estão descritos na literatura científica brasileira. Fontes de dados: Realizou-se uma revisão sistemática integrativa da literatura indexada entre 2005 e 2015 nas bases Biblioteca Virtual em Saúde, Bielefeld Academic Search Engine, Education Resources Information Center e Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Ensino Superior. Foram incluídos artigos publicados em língua inglesa ou portuguesa, na íntegra e disponibilizados online que: contivessem os termos “Intervenção Precoce” ou “Estimulação Precoce” ou “Estimulação Essencial” no título, resumo ou palavras-chave; contassem como participantes crianças de 0 a 6 anos, seus cuidadores ou profissionais de serviços de Intervenção Precoce; estivessem indexados em uma revista com classificação igual ou superior a B2, segundo avaliação do WebQualis (Qualis 2014, para as áreas de Educação ou Educação Física; e descrevessem práticas de Intervenção Precoce. Síntese dos dados: Verifica-se que a Intervenção Precoce parece desenvolver-se exclusivamente aliada ao setor da saúde, com prevalência de práticas voltadas à estimulação de habilidades, com enfoque centrado na criança, estruturadas a partir de um modelo reabilitativo de cuidado e do emprego de abordagens clínicas. Conclusões: Os resultados apontam para a adoção de práticas e modelos de Intervenção Precoce distantes daqueles recomendados e reconhecidos como boas práticas pela literatura internacional. Nesse sentido, aponta-se a necessidade da atualização dos profissionais que atuam nessa área, bem como do investimento em pesquisas que incidam sobre a temática.

Análise de desempenho do Programa de Triagem Neonatal do Estado do Rio de Janeiro, Brasil, de 2005 a 2007 Performance analysis of the Rio de Janeiro State Neonatal Screening Program, 2005-2007

Directory of Open Access Journals (Sweden)

Judy Botler

2011-12-01

Full Text Available As diretrizes enfatizam o momento adequado para a coleta do teste de triagem neonatal entre o 3º e o 7º dias de vida, em 100% dos recém-natos. O tratamento do hipotireoidismo congênito e da fenilcetonúria iniciado até 2 semanas de vida é capaz de evitar as sequelas neurológicas dessas doenças. O programa de triagem neonatal do Estado do Rio de Janeiro foi credenciado para Fase II do Programa Nacional de Triagem Neonatal com dois modelos de programa - modelo A e modelo B. Foi realizada análise de desempenho do PTN de 2005 a 2007. Entre 2002 e 2007, a cobertura foi crescente e chegou a 80,4%, com 33,8% das coletas realizadas até 7 dias. Ambos os modelos tiveram desempenhos semelhantes e aquém das metas preconizadas, com 50% dos casos confirmados obtendo diagnóstico com mais de 48 dias de vida. Os atrasos acumulados nas diversas etapas do processo podem anular os benefícios da detecção precoce, fundamento da triagem neonatal. Os efeitos deletérios de longo prazo transcendem a esfera individual acarretando impacto no sistema de saúde e grande ônus social.Guidelines emphasize that the appropriate time frame for neonatal screening with the heel stick test is from the 3rd to 7th day of life, in 100% of newborns. Treatment for congenital hypothyroidism and phenylketonuria, when initiated in the first two weeks of life, is capable of preventing the neurological sequelae of these diseases. The Rio de Janeiro State Neonatal Screening Program was accredited for Phase 2 of the National Neonatal Screening Program, with two program models (A and B. A performance analysis was conducted for the Neonatal Screening Program, for the years 2005 to 2007. Coverage increased from 2002 to 2007, reaching 80.4%, with 33.8% of the blood samples drawn in the first 7 days of life. The two models showed similar performance, short of the targets, with 50% of the confirmed cases receiving their diagnosis at more than 48 days of life. The delays accumulated in

Reflexões sobre precoces, prodígios, gênios e as altas habilidades, com base na neurociência cognitiva

Directory of Open Access Journals (Sweden)

Carlos Eduardo Paulino

2011-10-01

Full Text Available Em Educação Especial, altas habilidades designam pessoas que demonstram capacidades, potenciais ou desempenho, em atividades humanas, bem acima da média. Objetivamos, utilizando-se da neurociência, entender os precoces, prodígios, gênios e altas habilidades como resultantes de um processo único das formações da memória. Trata-se de uma pesquisa bibliográfica, em que as obras foram identificadas, localizadas, compiladas, fichadas e analisadas. O material foi localizado a partir de palavras-chave em bases de dados. Para a compilação, foram utilizados, como critério de inclusão, a intersecção dos unitermos adotados, bem como os trabalhos de pesquisadores da educação, psicologia e neurociência, publicados entre 1966 e 2009. Analisamos qualitativamente 40 referências, sendo 18 artigos e 22 outros textos. A trajetória de análise foi desenvolvida tendo a questão norteadora: há necessidade de se explicar diferentemente os precoces, prodígios, gênios e as AH? Chegamos a três proposições lógicas. Procuramos demonstrar, por meio desse exercício lógico, que não haveria necessidade de se explicar diferentemente os precoces, prodígios, gênios e as AH, mas concluímos que há necessidade de tais diferenciações, mesmo dentro da área da neurociência, no entanto, a demonstração acima aponta para a teoria de Renzulli como válida para gênios e AH, com ressalvas para precoces e prodígios, que merecem um olhar mais aprofundado.Palavras-chave: Altas habilidades. Memória. Neurociência cognitiva. Neurotransmissores.

Manifestações precoces dos transtornos do comportamento na criança e no adolescente Early manifestations of behavioral disorders in children and adolescents

Directory of Open Access Journals (Sweden)

Eugênio Grillo

2004-04-01

Full Text Available OBJETIVO: Revisão sobre o diagnóstico precoce dos principais transtornos do comportamento na criança e no adolescente, fornecendo informações práticas relativas às primeiras manifestações clínicas e à importância do diagnóstico precoce. FONTES DOS DADOS: Revisão narrativa, com levantamento na PubMed das publicações que contêm aspectos do diagnóstico precoce, especialmente na última década. SÍNTESE DOS DADOS: Os pediatras devem estar preparados e atentos para detectar precocemente um transtorno do comportamento, já que, em alguns desses transtornos, intervenções precoces podem melhorar a evolução. Além disso, essas intervenções podem levar ao diagnóstico de doenças de herança mendeliana, passíveis de aconselhamento genético. São enfocadas as manifestações precoces dos transtornos invasivos do desenvolvimento, do transtorno do déficit de atenção/hiperatividade, do transtorno de ansiedade de separação, do transtorno de ansiedade generalizada, da depressão, da esquizofrenia, dos principais transtornos alimentares da criança maior ou adolescente (anorexia nervosa e bulimia nervosa e do uso e abuso de substâncias. CONCLUSÕES: As manifestações precoces dos principais transtornos do comportamento na criança e no adolescente podem ser observadas antes da idade na qual o diagnóstico tem sido habitualmente estabelecido. O diagnóstico precoce implica intervenções precoces e orientação dos pais a respeito do prognóstico ou, em algumas situações, aconselhamento genético. A comorbidade entre esses transtornos é muito freqüente, e a manifestação de uma delas pode ser a pista para o diagnóstico de outra.OBJECTIVE: To discuss the early diagnosis of behavioral disorders in childhood and adolescence and to provide the pediatrician with practical knowledge about the first symptoms of the main behavioral disorders at this age. SOURCES OF DATA: PubMed (emphasis on the past decade. SUMMARY OF THE FINDINGS

The timing of normal puberty and the age limits of sexual precocity

DEFF Research Database (Denmark)

Parent, Anne-Simone; Teilmann, Grete; Juul, Anders

2003-01-01

During the past decade, possible advancement in timing of puberty has been reported in the United States. In addition, early pubertal development and an increased incidence of sexual precocity have been noticed in children, primarily girls, migrating for foreign adoption in several Western European...... the environment has been considered. These observations urge further study of the onset of puberty as a possible sensitive and early marker of the interactions between environmental conditions and genetic susceptibility that can influence physiological and pathological processes....

STUDY OF CLINICAL PROFILE OF PATIENTS PRESENTING WITH SEXUAL PRECOCITY TO A TERTIARY CARE HOSPITAL

Directory of Open Access Journals (Sweden)

Binoy Kumar Mohanty

2016-07-01

Full Text Available BACKGROUND Precocious puberty is a common paediatric endocrine disorder seen in clinical practice. OBJECTIVE To study the various aetiologies and clinical presentations of patients presenting with sexual precocity to a tertiary care hospital. DESIGN Cross sectional study. MATERIAL AND METHODS We collected and analysed the clinical data including hormonal status of 24 consecutive patients who presented to our department from January 2014 to December 2015 for evaluation of sexual precocity. RESULTS Most of the patients presenting to us had evidence of precocious puberty (n=16, followed by premature adrenarche (n=5 and premature thelarche (n=3 respectively. The females outnumbered males in our study (68.75% of total cases. Females presenting with central precocious puberty had no appreciable cause (idiopathic in majority (85.72% of cases. While, males presenting with central precocious puberty had an organic cause (60% in majority of cases. CONCLUSIONS Precocious puberty is more common among females as compared to males. Organic lesion must be ruled out in all patients presenting with central precocious puberty especially in males.

Contato precoce pele a pele entre mãe e filho: significado para mães e contribuições para a enfermagem

OpenAIRE

Matos, Thaís Alves; Souza, Morgana Stefani de; Santos, Evanguelia Kotzias Atherino dos; Velho, Manuela Beatriz; Seibert, Eli Rodrigues Camargo; Martins, Nezi Maria

2010-01-01

Tratou-se de uma pesquisa convergente-assistencial, realizada numa maternidade da Região Sul do Brasil entre abril e maio de 2009, objetivando compreender o significado do contato precoce pele-a-pele mãe-filho para o ser-mãe, identificar características do estabelecimento desse contato e contribuições da enfermagem. Os dados foram coletados pela observação participante e entrevista, com nove mães, identificando-se quatro categorias: a) orientações acerca do contato pele-a-pele precoce mãe-fil...

Considerações sobre o diagnóstico precoce na clínica do autismo e das psicoses infantis

Directory of Open Access Journals (Sweden)

Paola Visani

2012-06-01

Full Text Available Este artigo se refere a uma pesquisa de Iniciação Científica. Esta se baseou na teoria de Marie-Christine Laznik para investigar, por meio do estudo de prontuários, como aconteceu em um Centro de Atenção Psicossocial Infantil, localizado no município de São Paulo, o diagnóstico precoce do autismo e das psicoses infantis e como se deu a trajetória destas famílias até a chegada à instituição. A pesquisa revelou que o início do tratamento de crianças autistas e psicóticas se dá de maneira tardia em consequência da não realização da detecção precoce, da demora por parte de profissionais e/ou instituições de saúde em dar um diagnóstico formal e realizar um encaminhamento e da insegurança dos profissionais da saúde para lidar com estas psicopatologias graves. Os resultados desse trabalho ajudam a pensar ações futuras e necessidades de maior concentração de esforços para que o tratamento do autismo e das psicoses infantis possa acontecer de maneira cada vez mais precoce, frente a quadros não cronificados.

Nutrição precoce de neonatos prematuros estáveis e pequenos para a idade gestacional: um ensaio clínico randomizado

Directory of Open Access Journals (Sweden)

Shmuel Arnon

2013-08-01

Full Text Available OBJETIVO: Examinar o efeito da nutrição precoce sobre o tempo para atingir a nutrição completa em neonatos prematuros (PIG estáveis pequenos para a idade gestacional. MÉTODO: Os neonatos prematuros com idade gestacional inferior a 37 semanas e peso ao nascer inferior a 10% foram alocados aleatoriamente para um regime de nutrição precoce (nas primeiras 24 horas de vida ou tardia (após as primeiras 24 horas de vida. Todos os neonatos apresentaram uma evidência intrauterina de fluxo diastólico reverso ou ausente. Os neonatos incapazes de iniciar uma nutrição precoce foram excluídos. O tempo para a alimentação completa, a progressão da nutrição e morbidez correspondente foram comparados. A eletrogastrografia (EGG foi utilizada para mensurar a motilidade gástrica pré e pós-prandial no segundo e no sétimo dias após o início da nutrição. RESULTADOS: Foram incluídos 60 neonatos no estudo, sendo 30 em cada grupo. Os neonatos incluídos no regime de nutrição precoce atingiram a nutrição enteral completa antes dos neonatos do grupo de controle (98±80-157 em comparação a 172±1 23-261 horas de idade, respectivamente; p = 0,004 e recebiam alta hospitalar antes (p = 0,04. Nenhuma enterocolite necrosante (ECN foi comprovada em ambos os grupos de estudo. A motilidade gástrica melhorou no sétimo dia após o início da nutrição em ambos os grupos de estudo, sem diferença entre eles. CONCLUSÕES: Os neonatos prematuros PIG estáveis em regime de nutrição precoce atingiram alimentação enteral completa e receberam alta hospitalar significativamente antes que aqueles em regime de nutrição tardio, sem morbidez excedente.

O CONTATO E A AMAMENTAÇÃ O PRECOCES: SIGNIFICADOS E VIVÊNCIAS

OpenAIRE

Eloana Ferreira D\\u2019Artibale; Luciana Olga Bercini

2014-01-01

Este estudio tiene como objetivo analizar los significados y las experiencias del contacto y amamantamiento precoces de las puérperas internadas en un Hospital Amigo del Niño. Se trata de un estudio descriptivo, exploratorio, con abordaje cualitativo, que se desarrolló en un hospital universitario en el Noroeste de Paraná, de noviembre de 2011 a enero de 2012, con la participación de 16 puérperas. Los datos fueron colectados por medio de la observación sistemática no participante de los parto...

Imunodeficiência Combinada Grave – O Diagnóstico Precoce é Importante?

OpenAIRE

Simão, I; Valente, R; Farela Neves, J; Neves, C

2011-01-01

Introdução: Os doentes com Imunodeficiência Combinada Grave (SCID) não diagnosticados evoluem inexoravelmente para a morte no primeiro ano de vida. Um elevado índice de suspeição é fundamental para o diagnóstico precoce, o factor mais importante para a sobrevida destas crianças. Objectivo: Apresentam-se três casos clínicos ilustrativos da importância da precocidade diagnóstica no prognóstico final. Casos clínicos: Caso clínico 1: Lactente do sexo masculino, com antecedentes de inf...

Tendência das taxas de mortalidade infantil e de seus componentes em Guarulhos-SP, no período de 1996 a 2011

Directory of Open Access Journals (Sweden)

Daniel Hideki Bando

Full Text Available OBJETIVO: analisar as tendências das taxas de mortalidade infantil (TMI e seus componentes em Guarulhos-SP, no período 1996-2011. MÉTODOS: regressão linear segmentada, para estimar as variações percentuais anuais (VPA. RESULTADOS: em 1996, a TMI e de seus componentes neonatal precoce, neonatal tardio e pós-neonatal foram, respectivamente, de 31,6, 16,7, 3,4 e 11,6 por 1000 nascidos vivos; em 2011, essas taxas foram de 12,6, 5,9, 1,6 e 5,1 respectivamente; houve diminuição significativa das TMI em todo o período; de 1996 a 2002, a VPA foi de -9,9, e de 2002 a 2011, foi de -3,7; o componente neonatal apresentou igual padrão; o componente neonatal precoce apresentou diminuição de 1996 a 2002 (VPA: -12,8, permanecendo estável até 2011; verificou-se diminuição do componente neonatal tardio de 1996 a 2009 (VPA: -2,8; o componente pós-neonatal apresentou redução em todo o período (VPA: -5,7. CONCLUSÃO: observou-se tendência de diminuição das TMI e de seus componentes.

Seleção precoce para a produtividade de grãos no feijoeiro

Directory of Open Access Journals (Sweden)

ROSAL CARLOTA JOAQUINA DE SOUSA

2000-01-01

Full Text Available O objetivo do presente trabalho foi avaliar a eficiência da seleção precoce para o caráter produtividade de grãos na cultura do feijão (Phaseolus vulgaris L.. Para tanto foi utilizado o cruzamento entre os cultivares Carioca (P1 e FT- Tarumã (P2. Foram avaliadas 192 famílias, 64 das quais derivadas de plantas F2, outras 64 de plantas F2 do RC1 (F1 x P1 e 64, ainda, de plantas F2 de RC2 (F1 x P2. As famílias foram conduzidas empregando-se o método Bulk dentro de famílias F2 e avaliadas nas gerações F2:3 (fevereiro de 1997, F2:4 (julho de 1997, F2:5 (novembro de 1997, F2:6 (fevereiro de 1998, na área experimental do Departamento de Biologia da Universidade Federal de Lavras (MG. Utilizou-se o delineamento látice simples 14 x 14 na avaliação das 192 famílias juntamente com os pais e duas testemunhas. A partir das análises de variância dos dados da produtividade de grãos, foram estimados os componentes da variância genética e fenotípica, a herdabilidade realizada, as estimativas de correlações entre as famílias nas sucessivas gerações e o ganho observado com a seleção divergente. Constatou-se que: as famílias de melhor desempenho foram observadas no RC2; a interação genótipos x ambientes afetou a seleção precoce, valendo destacar que, para melhorar sua eficiência, as famílias devem ser avaliadas no mínimo durante duas gerações; a seleção precoce foi eficiente principalmente para a eliminação das famílias com pior desempenho, reduzindo, dessa forma, o trabalho dos melhoristas em gerações avançadas.

Fósforo na produtividade e qualidade de sementes de feijão Carioca Precoce cultivado no período das águas Phosphorus on the productivity and seed quality of bean Carioca Precoce cultivated during the rainy season

Directory of Open Access Journals (Sweden)

Claudemir Zucareli

2011-03-01

Full Text Available O fósforo é o nutriente que mais limita a produtividade do feijoeiro em solos brasileiros, podendo influenciar na qualidade fisiológica de sementes. Objetivou-se com o trabalho avaliar a produtividade e a qualidade de sementes de feijão (Phaseolus vulgaris L. do cultivar Carioca Precoce cultivado no período das águas em resposta à adubação fosfatada. Foram avaliadas seis doses de P (0; 30; 60; 90; 120 e 150 kg de P2O5 ha-1, aplicados no sulco da semeadura na forma de superfosfato triplo, com cinco repetições. A produtividade de sementes foi determinada com base na massa das sementes produzidas na área útil da parcela experimental. A qualidade das sementes foi avaliada por meio das seguintes determinações: massa de 100 sementes, teor de água, germinação, primeira contagem, teor de água após o envelhecimento acelerado, germinação após o envelhecimento acelerado, condutividade elétrica, emergência de plântulas no campo e massa de matéria seca de plântulas. A produtividade de sementes do feijão Carioca Precoce, cultivado no período das águas, aumentou linearmente em função do suprimento de P. A massa de 100 sementes e a qualidade fisiológica das sementes não foram alteradas pelo incremento das doses de P.Common bean is an important crop in Brazilian agriculture and phosphorus (P deficiency is one of the most yield limiting factors for this crop, thus plant P-deficiency can hamper the seed physiological quality. The objective of this study was to evaluate the productivity and quality of common bean seeds cv. Carioca Precoce cultivated during the rainy season in response to phosphate fertilizer. Six levels of P (0; 30; 60; 90; 120 and 150 kg of P2O5 ha-1, with five replications, were applied in the groove of sowing as triple superphosphate. The seeds yield, at the experimental plot, was determined by the dry weight. Seed quality was evaluated through the following determinations: 100-seed mass, seed moisture content

Genomic association for sexual precocity in beef heifers using pre-selection of genes and haplotype reconstruction.

Directory of Open Access Journals (Sweden)

Luciana Takada

Full Text Available Reproductive traits are of the utmost importance for any livestock farming, but are difficult to measure and to interpret since they are influenced by various factors. The objective of this study was to detect associations between known polymorphisms in candidate genes related to sexual precocity in Nellore heifers, which could be used in breeding programs. Records of 1,689 precocious and non-precocious heifers from farms participating in the Conexão Delta G breeding program were analyzed. A subset of single nucleotide polymorphisms (SNP located in the region of the candidate genes at a distance of up to 5 kb from the boundaries of each gene, were selected from the panel of 777,000 SNPs of the High-Density Bovine SNP BeadChip. Linear mixed models were used for statistical analysis of early heifer pregnancy, relating the trait with isolated SNPs or with haplotype groups. The model included the contemporary group (year and month of birth as fixed effect and parent of the animal (sire effect as random effect. The fastPHASE® and GenomeStudio® were used for reconstruction of the haplotypes and for analysis of linkage disequilibrium based on r2 statistics. A total of 125 candidate genes and 2,024 SNPs forming haplotypes were analyzed. Statistical analysis after Bonferroni correction showed that nine haplotypes exerted a significant effect (p<0.05 on sexual precocity. Four of these haplotypes were located in the Pregnancy-associated plasma protein-A2 gene (PAPP-A2, two in the Estrogen-related receptor gamma gene (ESRRG, and one each in the Pregnancy-associated plasma protein-A gene (PAPP-A, Kell blood group complex subunit-related family (XKR4 and mannose-binding lectin genes (MBL-1 genes. Although the present results indicate that the PAPP-A2, PAPP-A, XKR4, MBL-1 and ESRRG genes influence sexual precocity in Nellore heifers, further studies are needed to evaluate their possible use in breeding programs.

Neonatal Death

Science.gov (United States)

... Home > Complications & Loss > Loss & grief > Neonatal death Neonatal death E-mail to a friend Please fill in ... cope with your baby’s death. What is neonatal death? Neonatal death is when a baby dies in ...

Neonatal Hyperglycemia due to Transient Neonatal Diabetes Mellitus in Puerto Rico

OpenAIRE

Fargas-Berríos, N.; García-Fragoso, L.; García-García, I.; Valcárcel, M.

2015-01-01

Neonatal hyperglycemia is a metabolic disorder found in the neonatal intensive care units. Neonatal diabetes mellitus (NDM) is a very uncommon cause of hyperglycemia in the newborn, occurring in 1 in every 400,000 births. There are two subtypes of neonatal diabetes mellitus: permanent neonatal diabetes mellitus (PNDM) and transient neonatal diabetes mellitus (TNDM). We describe a term, small for gestational age, female neonate with transient neonatal diabetes mellitus who presented with poor ...

Novas diretrizes na abordagem clínica da neutropenia febril e da sepse em oncologia pediátrica New guidelines for the clinical management of febrile neutropenia and sepsis in pediatric oncology patients

Directory of Open Access Journals (Sweden)

Ana Verena Almeida Mendes

2007-05-01

Full Text Available OBJETIVOS: Fornecer subsídios à abordagem diagnóstica, profilática e terapêutica da neutropenia febril e da sepse em criança com doença oncológica, dando especial atenção aos novos protocolos e diretrizes. FONTES DE DADOS: Revisão de literatura científica utilizando uma busca bibliográfica eletrônica nas páginas do MEDLINE, Medscape, SciELO, Google, Cochrane e PubMED com as palavras-chave febrile, neutropenic, cancer, children, sepse, intensive, care. Foram selecionados artigos publicados entre 1987 e 2007, preferencialmente artigos de revisão, protocolos, revisões sistemáticas, estudos epidemiológicos, recomendações de força-tarefa e ensaios clínicos fase III. Foram revistos os consensos publicados pela Infectious Diseases Society of America, Center for Diseases Control e Infectious Diseases Working Party da German Society of Hematology and Oncology, além de recomendações da World Federation of Pediatric Intensive and Critical Care Societies e da Society of Critical Care Medicine. SÍNTESE DOS DADOS: A utilização de esquemas quimioterápicos agressivos, transplante de medula óssea e recursos de terapia intensiva aumentaram a sobrevida nas crianças com câncer e também a morbidade infecciosa, sendo as complicações sépticas a principal causa de mortalidade. Diversos fatores de risco têm sido identificados, como neutropenia, tipo oncológico, sinais clínicos e marcadores de resposta inflamatória (reação em cadeia da polimerase, procalcitonina, assim como a maior resistência aos antimicrobianos e antifúngicos. Protocolos de classificação de risco, de diagnóstico e tratamento devem ser estabelecidos em cada serviço, respeitando a flora microbiológica da população estudada. A terapia intensiva pediátrica tem aumentado a sobrevida a curto e longo prazo nestes pacientes. CONCLUSÕES: Pacientes oncológicos são particularmente vulneráveis a complicações infecciosas. A identificação e o tratamento

VDRL falso-positivo em recém-nascido filho de mãe portadora de síndrome antifosfolípide – relato de caso

Directory of Open Access Journals (Sweden)

Marina Helena Mariano

2015-10-01

Full Text Available A incidência de sífilis congênita foi de 1,9 para cada 1000 nascimentos em 2005. Para alterar esse quadro, a prevenção e o diagnóstico no pré-natal e no parto foram reforçados pelo rastreamento com o VDRL. Apesar da alta sensibilidade desse teste, os resultados falso-positivos são possíveis, principalmente em doenças autoimunes e infecções, podendo ocorrer também a transferência passiva para o recém-nascido (RN. RN de J.L.S.A., 16 dias de vida, masculino, nascido em Sorocaba. Mãe com infecção urinária vigente no parto, sorologias negativas no 1º e 3º trimestre e histórico obstétrico de natimorto e aborto anteriores. Parto cesárea de urgência por pré-eclâmpsia e centralização fetal realizado com 30 semanas. RN pré-termo, pequeno para idade gestacional, muito baixo peso, desconforto neonatal precoce, infecção neonatal presumida. Evoluiu com apneia, sepse, plaquetopenia e crises convulsivas, permanecendo na UTI por 16 dias. Realizadas hemocultura e urocultura – negativas - e VRDL no RN e na mãe cujos resultados foram 1/2. Desse modo, iniciou-se o tratamento para o RN por sífilis congênita presumida. Devido baixos títulos e antecedentes maternos, foi pesquisada e confirmada Síndrome Antifosfolípide para mãe, concluindo-se tratar de um falso positivo para ambos. O relato tem como objetivo enfatizar a importância no cuidado do rastreamento eficaz da sífilis congênita, por se tratar de transmissibilidade vertical de uma doença sexualmente transmissível, o que pode abalar a integridade de uma família.

Neonatal Hyperglycemia due to Transient Neonatal Diabetes Mellitus in Puerto Rico.

Science.gov (United States)

Fargas-Berríos, N; García-Fragoso, L; García-García, I; Valcárcel, M

2015-01-01

Neonatal hyperglycemia is a metabolic disorder found in the neonatal intensive care units. Neonatal diabetes mellitus (NDM) is a very uncommon cause of hyperglycemia in the newborn, occurring in 1 in every 400,000 births. There are two subtypes of neonatal diabetes mellitus: permanent neonatal diabetes mellitus (PNDM) and transient neonatal diabetes mellitus (TNDM). We describe a term, small for gestational age, female neonate with transient neonatal diabetes mellitus who presented with poor feeding tolerance and vomiting associated with hyperglycemia (385 mg/dL), glycosuria, and metabolic acidosis within the first 12 hours of life. The neonate was treated with intravenous insulin, obtaining a slight control of hyperglycemia. An adequate glycemia was achieved at 5 weeks of life. The molecular studies showed complete loss of maternal methylation at the TND differentially methylated region on chromosome 6q24. The etiology of this neonate's hyperglycemia was a hypomethylation of the maternal TND locus. A rare cause of neonatal diabetes mellitus must be considered if a neonate presents refractory hyperglycemia. To our knowledge, this is the first case reported in Puerto Rico of transient neonatal mellitus due to the uncommon mechanism of maternal hypomethylation of the TND locus. Its prevalence in Puerto Rico is unknown.

Transient neonatal diabetes or neonatal hyperglycaemia: A case ...

African Journals Online (AJOL)

Transient neonatal diabetes and neonatal hyperglycaemia both present in the neonatal period with features of hyperglycaemia, dehydration and weight loss. Differentiating these conditions clinically is difficult. We describe the case of a 13 day old female whom we managed recently who could have had either condition.

Neonatal Hyperglycemia due to Transient Neonatal Diabetes Mellitus in Puerto Rico

Directory of Open Access Journals (Sweden)

N. Fargas-Berríos

2015-01-01

Full Text Available Neonatal hyperglycemia is a metabolic disorder found in the neonatal intensive care units. Neonatal diabetes mellitus (NDM is a very uncommon cause of hyperglycemia in the newborn, occurring in 1 in every 400,000 births. There are two subtypes of neonatal diabetes mellitus: permanent neonatal diabetes mellitus (PNDM and transient neonatal diabetes mellitus (TNDM. We describe a term, small for gestational age, female neonate with transient neonatal diabetes mellitus who presented with poor feeding tolerance and vomiting associated with hyperglycemia (385 mg/dL, glycosuria, and metabolic acidosis within the first 12 hours of life. The neonate was treated with intravenous insulin, obtaining a slight control of hyperglycemia. An adequate glycemia was achieved at 5 weeks of life. The molecular studies showed complete loss of maternal methylation at the TND differentially methylated region on chromosome 6q24. The etiology of this neonate’s hyperglycemia was a hypomethylation of the maternal TND locus. A rare cause of neonatal diabetes mellitus must be considered if a neonate presents refractory hyperglycemia. To our knowledge, this is the first case reported in Puerto Rico of transient neonatal mellitus due to the uncommon mechanism of maternal hypomethylation of the TND locus. Its prevalence in Puerto Rico is unknown.

The neonatal brain

International Nuclear Information System (INIS)

Flodmark, O.

1987-01-01

The clinical examination of the CNS in the neonate is often difficult in cases of complex pathology. Diagnostic imaging of the neonatal brain has become extremely useful and in the last decade has developed in two main directions: CT and US. MR imaging has been used recently with varying success in the diagnosis of pathology in the neonatal brain. Despite technical difficulties, this imaging method is likely to become increasingly important in the neonate. The paper examines the normal neonatal brain anatomy as seen with the different modalities, followed by pathologic conditions. Attention is directed to the common pathology, in asphyxiated newborns, the patholphysiology of intraventicular hemorrhage and periventricular leukomalacia in the preterm neonate, and hypoxic-ischemic brain injury in the term neonate. Pitfalls, artifacts, and problems in image interpretation are illustrated. Finally, the subsequent appearance of neonatal pathology later in infancy and childhood is discussed

Neonatal hypertension.

Science.gov (United States)

Sharma, Deepak; Farahbakhsh, Nazanin; Shastri, Sweta; Sharma, Pradeep

2017-03-01

Neonatal hypertension (HT) is a frequently under reported condition and is seen uncommonly in the intensive care unit. Neonatal HT has defined arbitrarily as blood pressure more than 2 standard deviations above the base as per the age or defined as systolic BP more than 95% for infants of similar size, gestational age and postnatal age. It has been diagnosed long back but still is the least studied field in neonatology. There is still lack of universally accepted normotensive data for neonates as per gestational age, weight and post-natal age. Neonatal HT is an important morbidity that needs timely detection and appropriate management, as it can lead to devastating short-term effect on various organs and also poor long-term adverse outcomes. There is no consensus yet about the treatment guidelines and majority of treatment protocols are based on the expert opinion. Neonate with HT should be evaluated in detail starting from antenatal, perinatal, post-natal history, and drug intake by neonate and mother. This review article covers multiple aspects of neonatal hypertension like definition, normotensive data, various etiologies and methods of BP measurement, clinical features, diagnosis and management.

Etiologies of Prolonged Unconjugated Hyperbilirubinemia in Neonates Admitted to Neonatal Wards

Directory of Open Access Journals (Sweden)

Mohammad Kazem Sabzehei

2015-12-01

Full Text Available Background: Jaundice is a common condition among neonates. Prolonged unconjugated hyperbilirubinemia occurs when jaundice persists beyond two weeks in term neonates and three weeks in preterm neonates. This study aimed to determine the etiologies of prolonged unconjugated hyperbilirubinemia in infants admitted to the neonatal ward of Besat Hospital in Hamadan, Iran. Methods: This study was conducted on all infants diagnosed with prolonged unconjugated hyperbilirubinemia during 2007-2012 in the neonatal ward of Besat Hospital in Hamadan, Iran. Demographic characteristics of infants, physical examination and laboratory findings were collected and analyzed to determine the etiologies of neonatal hyperbilirubinemia. Results: In total, 100 infants diagnosed with neonatal hyperbilirubinemia were enrolled in this study, including 49 male and 51 female neonates with mean age of 20±1 days and mean bilirubin level of 17.5±4.0 mg/dL. Main causes of hyperbilirubinemia were urinary tract infection, ABO incompatibility, hypothyroidism and glucose-6-phosphate dehydrogenase deficiency in 14%, 5%, 6% and 5% of neonates, respectively. Moreover, unknown etiologies, such as breastfeeding, were detected in 70% of the studied infants. Conclusion: According to the results of this study, determining the main causes of prolonged unconjugated hyperbilirubinemia in neonates is of paramount importance. In the majority of cases, neonatal hyperbilirubinemia is associated with physiological factors, such as breastfeeding.

Knowledge, attitudes and practices of neonatal staff concerning neonatal pain management

Directory of Open Access Journals (Sweden)

Sizakele L.T. Khoza

2014-11-01

Full Text Available Background: Neonatal pain management has received increasing attention over the past four decades. Research into the effects of neonatal pain emphasises the professional, ethical and moral obligations of staff to manage pain for positive patient outcomes. However, evaluation studies continuously report evidence of inadequate neonate pain management and a gap between theory and practice. Objective: This study reviewed current practice in neonatal pain management to describe the knowledge, attitudes and practices of nurses and doctors regarding pain management for neonates in two academic hospitals. Method: A non-experimental, prospective quantitative survey, the modified Infant Pain Questionnaire, was used to collect data from 150 nurses and doctors working in the neonatal wards of two academic hospitals in central Gauteng. Results: The response rate was 35.33% (n = 53, most respondents being professional nurses (88.68%; n = 47 working in neonatal intensive care units (80.77%; n = 42; 24 (45.28% had less than 5 years’ and 29 respondents 6 or more years’ working experience in neonatal care. A review of pain management in the study setting indicated a preference for pharmacological interventions to relieve moderate to severe pain. An association (p < 0.05 was found between pain ratings on 5 procedures and frequency of administration of pharmacological pain management. Two-thirds of respondents (64% reported that there were no pain management guidelines in the neonatal wards in which they worked. Conclusion: The interventions to manage moderate neonatal pain are in line with international guidelines. However, neonatal pain management may not occur systematically based on prior assessment of neonatal pain, choice of most appropriate intervention and evaluation. This study recommends implementation of a guideline to standardise practice and ensure consistent and adequate pain management in neonates.

The timing of normal puberty and the age limits of sexual precocity

DEFF Research Database (Denmark)

Parent, Anne-Simone; Teilmann, Grete; Juul, Anders

2003-01-01

During the past decade, possible advancement in timing of puberty has been reported in the United States. In addition, early pubertal development and an increased incidence of sexual precocity have been noticed in children, primarily girls, migrating for foreign adoption in several Western European...... countries. These observations are raising the issues of current differences and secular trends in timing of puberty in relation to ethnic, geographical, and socioeconomic background. None of these factors provide an unequivocal explanation for the earlier onset of puberty seen in the United States....... In the formerly deprived migrating children, refeeding and catch-up growth may prime maturation. However, precocious puberty is seen also in some nondeprived migrating children. Attention has been paid to the changing milieu after migration, and recently, the possible role of endocrine- disrupting chemicals from...

Neonatal retinoblastoma

Directory of Open Access Journals (Sweden)

Tero T Kivelä

2017-01-01

Full Text Available From 7% to 10% of all retinoblastomas and from 44% to 71% of familial retinoblastomas in developed countries are diagnosed in the neonatal period, usually through pre- or post-natal screening prompted by a positive family history and sometimes serendipitously during screening for retinopathy of prematurity or other reasons. In developing countries, neonatal diagnosis of retinoblastoma has been less common. Neonatal retinoblastoma generally develops from a germline mutation of RB1, the retinoblastoma gene, even when the family history is negative and is thus usually hereditary. At least one-half of infants with neonatal retinoblastoma have unilateral tumors when the diagnosis is made, typically the International Intraocular Retinoblastoma Classification (Murphree Group B or higher, but most germline mutation carriers will progress to bilateral involvement, typically Group A in the fellow eye. Neonatal leukokoria usually leads to the diagnosis in children without a family history of retinoblastoma, and a Group C tumor or higher is typical in the more advanced involved eye. Almost all infants with neonatal retinoblastoma have at least one eye with a tumor in proximity to the foveola, but the macula of the fellow eye is frequently spared. Consequently, loss of reading vision from both eyes is exceptional. A primary ectopic intracranial neuroblastic tumor known as trilateral retinoblastoma is no more common after neonatal than other retinoblastoma. For many reasons, neonatal retinoblastoma may be a challenge to eradicate, and the early age at diagnosis and relatively small tumors do not guarantee the preservation of both eyes of every involved child. Oncology nurses can be instrumental in contributing to better outcomes by ensuring that hereditary retinoblastoma survivors receive genetic counseling, by referring families of survivors to early screening programs when they are planning for a baby, and by providing psychological and practical support

Predição de pré-eclâmpsia em suas formas tardia e precoce pela dilatação fluxo-mediada da artéria braquial

Directory of Open Access Journals (Sweden)

Augusto Henriques Fulgêncio Brandão

2014-08-01

Full Text Available Objetivo:Avaliar a capacidade de predição das formas precoce e tardia da pré-eclâmpsia pela dilatação fluxo-mediada da artéria braquial (FMD, marcador biofísico de disfunção endotelial.Materiais e Métodos:Um total de 91 pacientes de alto risco para desenvolvimento de pré-eclâmpsia foi submetido a FMD entre 24 e 28 semanas de gestação.Resultados:Das pacientes selecionadas, 19 desenvolveram pré-eclâmpsia, sendo 8 em sua forma precoce e 11 em sua forma tardia. Usando-se um valor de corte de 6,5%, a sensibilidade (S da FMD para predição de pré-eclâmpsia precoce foi 75,0%, com especificidade (E de 73,3%, valor preditivo positivo (VPP de 32,4% e valor preditivo negativo (VPN de 91,9%. Para predição de pré-eclâmpsia tardia, encontrou-se valor de S de 83,3%, E de 73,2%, VPP de 34,4% e VPN de 96,2%. Para a predição de todas as formas associadas de pré-eclâmpsia, encontrou-se valor de S de 84,2%, E de 73,6%, VPP de 45,7% e VPN de 94,6%.Conclusão:A FMD se mostrou uma ferramenta com boa capacidade de predição de pré-eclâmpsia, nas suas formas tardia e precoce, o que pode representar um impacto positivo no acompanhamento de gestantes de alto risco para desenvolvimento dessa síndrome.

Formação em comunicação aumentativa e alternativa dos profissionais de intervenção precoce: um estudo qualitativo na região norte de Portugal

OpenAIRE

Fernandes, Hugo André da Silva Martins

2014-01-01

Dissertação de mestrado em Educação Especial (área de especialização em Intervenção Precoce) A capacidade de comunicar permite criar oportunidades de interação, influenciar o comportamento de outros e através disso exercer controlo sobre o meio ambiente da pessoa. Este facto, requere da parte dos profissionais de Intervenção Precoce (IP) um conjunto de competências para intervir junto de crianças com perturbações da comunicação. Este estudo tem por finalidade conhecer as per...

Advancing Neurologic Care in the Neonatal Intensive Care Unit with a Neonatal Neurologist

Science.gov (United States)

Mulkey, Sarah B.; Swearingen, Christopher J.

2014-01-01

Neonatal neurology is a growing sub-specialty area. Given the considerable amount of neurologic problems present in the neonatal intensive care unit, a neurologist with expertise in neonates is becoming more important. We sought to evaluate the change in neurologic care in the neonatal intensive care unit at our tertiary care hospital by having a dedicated neonatal neurologist. The period post-neonatal neurologist showed a greater number of neurology consultations (Pneurology encounters per patient (Pneurology became part of the multi-disciplinary team providing focused neurologic care to newborns. PMID:23271754

INTERVENÇÃO PRECOCE NA PSICOSE: DE ESTRATÉGIA CLÍNICA A POSSÍVEL CATEGORIA DIAGNÓSTICA

Directory of Open Access Journals (Sweden)

Luna Rodrigues Freitas-Silva

2014-12-01

Full Text Available No campo psiquiátrico, as possibilidades de prevenir o risco de desenvolver transtornos mentais começam a reunir interesse, motivar pesquisas e provocar controvérsias. Entre as diversas investigações sobre risco e categorias psiquiátricas que vêm sendo conduzidas no cenário internacional destacam-se as propostas destinadas a detectar e intervir precocemente no desenvolvimento da psicose. Os programas de detecção precoce da psicose têm como objetivo atingir duas categorias de pacientes: os que vivem o primeiro surto psicótico e aqueles considerados em estado mental de risco ou pré-psicóticos. Apesar da controvérsia em torno do estado mental de risco, com a elaboração de uma nova versão do DSM aventou-se a possibilidade de criar uma categoria específica que identificasse o risco para a psicose. Neste artigo analisamos as propostas de intervenção precoce na psicose de estratégia clínica dividindo essa análise em três etapas: 1- a do surgimento das ações no contexto de refinamento da clínica do primeiro surto; 2- a da sistematização controversa da noção de estado mental de risco; 3- a da formalização da proposta de nova categoria diagnóstica durante a elaboração do DMS-5.

Neonatal hypocalcemia, neonatal seizures, and intellectual disability in 22q11.2 deletion syndrome

Science.gov (United States)

Cheung, Evelyn Ning Man; George, Susan R.; Andrade, Danielle M.; Chow, Eva W. C.; Silversides, Candice K.; Bassett, Anne S.

2015-01-01

Purpose Hypocalcemia is a common endocrinological condition in 22q11.2 deletion syndrome. Neonatal hypocalcemia may affect neurodevelopment. We hypothesized that neonatal hypocalcemia would be associated with rare, more severe forms of intellectual disability in 22q11.2 deletion syndrome. Methods We used a logistic regression model to investigate potential predictors of intellectual disability severity, including neonatal hypocalcemia, neonatal seizures, and complex congenital heart disease, e.g., interrupted aortic arch, in 149 adults with 22q11.2 deletion syndrome. Ten subjects had moderate-to-severe intellectual disability. Results The model was highly significant (P < 0.0001), showing neonatal seizures (P = 0.0018) and neonatal hypocalcemia (P = 0.047) to be significant predictors of a more severe level of intellectual disability. Neonatal seizures were significantly associated with neonatal hypocalcemia in the entire sample (P < 0.0001), regardless of intellectual level. There was no evidence for the association of moderate- to-severe intellectual disability with other factors such as major structural brain malformations in this sample. Conclusion The results suggest that neonatal seizures may increase the risk for more severe intellectual deficits in 22q11.2 deletion syndrome, likely mediated by neonatal hypocalcemia. Neonatal hypocalcemia often remains unrecognized until the postseizure period, when damage to neurons may already have occurred. These findings support the importance of early recognition and treatment of neonatal hypocalcemia and potentially neonatal screening for 22q11.2 deletions. PMID:23765047

Failure to thrive among neonates, associated factors and early neonatal outcome

International Nuclear Information System (INIS)

Thomas, Erica; Manji, Karim; Mpembeni Rose

2005-01-01

Failure to thrive or growth failure is an important feature of problems prevalent in the neonate. It remains one of the greatest challenges for the practicing pediatrician and it is a common pathway or outcome of several different underlaying infant and maternal conditions. To determine the prevalence, possible causes and early neonatal outcome of failure to thrive among young infants admitted to the Neonatal Unit in this hospital. A cross-sectional descriptive hospital based study, was carried for 10 months from April 2001 to January 2002 at the Neonatal Unit at Muhimbili National Hospital. (author)

Risk Factors for Neonatal Mortality Among Very Low Birth Weight Neonates

Directory of Open Access Journals (Sweden)

Fatemeh Nayeri

2013-05-01

Full Text Available The objective of this study is to determine risk factors causing increase in very low birth way (VLBW neonatal mortality. The medical files of all neonates weighing ≤1500 g, born in Vali-e-Asr hospital (2001-2004 were studied. Two groups of neonates (living and dead were compared up to the time of hospital discharge or death. A total of 317 neonates were enrolled. A meaningful relationship existed between occurrence of death and low gestational age (P=0.02, low birth weight, lower than 1000 g (P=0.001, Apgar score <6 at 5th minutes (P=0.001, resuscitation at birth (P=0.001, respiratory distress syndrome (P=0.001 need for mechanical ventilation (P=0.001, neurological complications (P=0.001 and intraventricular hemorrhage (P=0.001. Regression analysis indicated that each 250 g weight increase up to 1250 g had protective effect, and reduced mortality rate. The causes of death of those neonates weighting over 1250 g should be sought in factors other than weight. Survival rate was calculated to be 80.4% for neonates weighing more than 1000 g. The most important high risk factors affecting mortality of neonates are: low birth weight, need for resuscitation at birth, need for ventilator use and intraventricular hemorrhage.

Hiperbilirrubinemia neonatal agravada Aggravated neonatal hyperbilirubinemia

Directory of Open Access Journals (Sweden)

Ana Campo González

2010-09-01

Full Text Available INTRODUCCIÓN. La mayoría de las veces la ictericia en el recién nacido es un hecho fisiológico, causado por una hiperbilirrubinemia de predominio indirecto, secundario a inmadurez hepática e hiperproducción de bilirrubina. El objetivo de este estudio fue determinar el comportamiento de la hiperbilirrubinemia neonatal en el Hospital Docente Ginecoobstétrico de Guanabacoa en los años 2007 a 2009. MÉTODOS. Se realizó un estudio descriptivo y retrospectivo de 173 recién nacidos que ingresaron al Departamento de Neonatología con diagnóstico de hiperbilirrubinemia agravada. RESULTADOS. La incidencia de hiperbilirrubinemia neonatal agravada fue del 3,67 % y predominó en hermanos con antecedentes de ictericia (56,65 %. El tiempo de aparición fue de 48 a 72 h (76,87 % y entre los factores agravantes se hallaron el nacimiento pretérmino y el bajo peso al nacer. La mayoría de los pacientes fueron tratados con luminoterapia (90,17 %. CONCLUSIÓN. La hiperbilirrubinemia neonatal agravada constituye un problema de salud. Los factores agravantes son la prematuridad y el bajo peso al nacer. La luminoterapia es una medida terapéutica eficaz para su tratamiento.INTRODUCTION. Most of times jaundice in newborn is a physiological fact due to hyperbilirubinemia of indirect predominance, secondary to liver immaturity and to bilirubin hyperproduction. The aim of present of present study was to determine the behavior of neonatal hyperbilirubinemia in the Gynecology and Obstetrics Teaching Hospital of Guanabacoa municipality from 2007 to 2009. METHODS. A retrospective and descriptive study was conducted in 173 newborn patients admitted in the Neonatology Department diagnosed with severe hyperbilirubinemia. RESULTS. The incidence of severe neonatal hyperbilirubinemia was of 3,67% with predominance in brothers with a history of jaundice (56,65%. The time of appearance was of 48 to 72 hrs (76,87% and among the aggravating factors were the preterm birth and

Evolução funcional de pacientes graves submetidos a um protocolo de reabilitação precoce

Directory of Open Access Journals (Sweden)

Fernanda Murata Murakami

2015-06-01

Full Text Available RESUMO Objetivo: Avaliar a evolução funcional dos pacientes submetidos a um protocolo de reabilitação precoce do paciente grave da admissão até a alta da unidade de terapia intensiva. Métodos: Foi conduzido um estudo transversal retrospectivo, incluindo 463 pacientes adultos com diagnóstico clínico e/ou cirúrgico, submetidos a um protocolo de reabilitação precoce. A força muscular global foi avaliada na admissão da unidade de terapia intensiva por meio da escala Medical Research Council. De acordo com a pontuação da Medical Research Council os pacientes foram alocados em um dos quatro planos de intervenção, de acordo com a adequação ou não desses parâmetros, com a escala crescente do plano significando melhor status funcional. Os pacientes não colaborativos foram alocados nos planos de intervenção, conforme seu status funcional. A força muscular global e/ou o status funcional foram reavaliados na alta da unidade de terapia. Por meio do comparativo entre o plano de Intervenção na admissão (Planoinicial e na alta (Planofinal. Os pacientes foram categorizados em três grupos, de acordo com a melhora ou não do status funcional: respondedores 1 (Planofinal > Planoinicial, respondedores 2 (Planofinal = Planoinicial e não respondedores (Planofinal < Planoinicial. Resultados: Dos 463 pacientes submetidos ao protocolo, 432 (93,3% pacientes responderam positivamente à estratégia de intervenção, apresentando manutenção e/ou melhora do status funcional inicial. Os pacientes clínicos classificados como não respondedores apresentaram idade superior (74,3 ± 15,1 anos; p = 0,03 e maior tempo de internação na unidade de terapia intensiva (11,6 ± 14,2 dias; p = 0,047 e no hospital (34,5 ± 34,1 dias; p = 0,002. Conclusão: A manutenção e/ou melhora do status funcional admissional esteve associada com menor tempo de internação na unidade de terapia intensiva e hospitalar. Os resultados sugerem que o tipo de diagn

Management of neonatal abstinence syndrome in neonates born to opioid maintained women.

Science.gov (United States)

Ebner, Nina; Rohrmeister, Klaudia; Winklbaur, Bernadette; Baewert, Andjela; Jagsch, Reinhold; Peternell, Alexandra; Thau, Kenneth; Fischer, Gabriele

2007-03-16

Neonates born to opioid-maintained mothers are at risk of developing neonatal abstinence syndrome (NAS), which often requires pharmacological treatment. This study examined the effect of opioid maintenance treatment on the incidence and timing of NAS, and compared two different NAS treatments (phenobarbital versus morphine hydrochloride). Fifty-three neonates born to opioid-maintained mothers were included in this study. The mothers received methadone (n=22), slow-release oral morphine (n=17) or buprenorphine (n=14) throughout pregnancy. Irrespective of maintenance treatment, all neonates showed APGAR scores comparable to infants of non-opioid dependent mothers. No difference was found between the three maintenance groups regarding neonatal weight, length or head circumference. Sixty percent (n=32) of neonates required treatment for NAS [68% in the methadone-maintained group (n=15), 82% in the morphine-maintained group (n=14), and 21% in the buprenorphine-maintained group (n=3)]. The mean duration from birth to requirement of NAS treatment was 33 h for the morphine-maintained group, 34 h for the buprenorphine-maintained group and 58 h for the methadone-maintained group. In neonates requiring NAS treatment, those receiving morphine required a significantly shorter mean duration of treatment (9.9 days) versus those treated with phenobarbital (17.7 days). Results suggest that morphine hydrochloride is preferable for neonates suffering NAS due to opioid withdrawal.

Neonatal pain

Science.gov (United States)

Walker, Suellen M

2014-01-01

Effective management of procedural and postoperative pain in neonates is required to minimize acute physiological and behavioral distress and may also improve acute and long-term outcomes. Painful stimuli activate nociceptive pathways, from the periphery to the cortex, in neonates and behavioral responses form the basis for validated pain assessment tools. However, there is an increasing awareness of the need to not only reduce acute behavioral responses to pain in neonates, but also to protect the developing nervous system from persistent sensitization of pain pathways and potential damaging effects of altered neural activity on central nervous system development. Analgesic requirements are influenced by age-related changes in both pharmacokinetic and pharmacodynamic response, and increasing data are available to guide safe and effective dosing with opioids and paracetamol. Regional analgesic techniques provide effective perioperative analgesia, but higher complication rates in neonates emphasize the importance of monitoring and choice of the most appropriate drug and dose. There have been significant improvements in the understanding and management of neonatal pain, but additional research evidence will further reduce the need to extrapolate data from older age groups. Translation into improved clinical care will continue to depend on an integrated approach to implementation that encompasses assessment and titration against individual response, education and training, and audit and feedback. PMID:24330444

Experiências de adversidade precoce e sintomas medicamente não explicados : o caso particular da fibromialgia

OpenAIRE

Campos, Ana Catarina da Costa

2013-01-01

Trabalho final do mestrado em medicina do desporto com vista à atribuição do Grau de Mestre (área científica de psiquiatria), apresentado à Faculdade de Medicina da Universidade de Coimbra Vários estudos têm tornado aparente de como as experiências de adversidade precoce podem influenciar a vida das suas vítimas, nomeadamente no que diz respeito às suas consequências a nível da saúde tanto física como mental dos indivíduos. O objetivo deste trabalho é o de efetuar uma revisão bibliográfica...

Fatores de risco para óbito em unidade de terapia intensiva neonatal, utilizando a técnica de análise de sobrevida Risk factors for neonatal death in neonatal intensive care unit according to survival analysis

Directory of Open Access Journals (Sweden)

Susana de Paula Risso

2010-03-01

Full Text Available OBJETIVO: Identificar fatores de risco associados ao óbito de recém-nascidos internados na unidade de terapia intensiva neonatal do Hospital Universitário de Taubaté, SP. MÉTODOS: É um estudo longitudinal com informações obtidas dos prontuários dos recém-nascidos internados na unidade de terapia intensiva neonatal, do Hospital Universitário da Universidade de Taubaté. A variável dependente foi o tipo de desfecho: alta ou óbito. As variáveis independentes foram variáveis maternas e gestacionais: idade materna, hipertensão, diabetes, terapia com corticóide e parto; variáveis do recém-nascido: peso ao nascer, duração da gestação, escore de Apgar no primeiro e quinto minutos de vida, nascimento múltiplo, malformações congênitas e sexo; variáveis relativas à internação: relato de ventilação mecânica, ventilação pressão positiva, relato de nutrição parenteral prolongada, sepse, entubação, massagem cardíaca, fototerapia, doença da membrana hialina, oxigênioterapia, tempo de internação e fração inspirada de oxigênio. Foi construído um modelo de forma hierarquizada em três níveis para análise de sobrevida, através do modelo de Cox; o programa computacional utilizado foi o Stata v9 e permaneceram no modelo final as variáveis com pOBJECTIVE: To identify risk factors associated with death of infants admitted to neonatal intensive care unit of Taubaté University Hospital. METHODS: It is a longitudinal study with information obtained from medical records of newborns admitted to the neonatal intensive care unit of Taubaté University Hospital. Type of outcome, discharge or death, was dependent variable. The independent variables were maternal and gestational variables: maternal age, hypertension, diabetes, corticosteroid therapy and delivery; variables of the newborn: birth weight, gestation length, Apgar score in the first and fifth minutes of life, multiple birth, congenital malformations and sex

Programa de Triagem Neonatal do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Brasil Neonatal Screening Program at the University Hospital of the Ribeirao Preto School of Medicine, São Paulo University, Brazil

Directory of Open Access Journals (Sweden)

Patrícia Künzle Ribeiro Magalhães

2009-02-01

Full Text Available O Programa de Triagem Neonatal do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Brasil, instituído em 1994 diagnosticou, até 2005, 76 crianças com hipotireoidismo congênito, 10 com fenilcetonúria e 25 com hemoglobinopatias, o que representou uma incidência de 1:2.595, 1:19.409, 1:4.120, respectivamente. Foram diagnosticadas 2.747 crianças com traço falciforme (1:37,5 nascidos vivos. A cobertura média do programa foi de 94,5%. Houve uma considerável melhora nos parâmetros de avaliação da qualidade do programa no período, porém, sem atingir os índices ideais. Campanhas visando à maior divulgação da importância da triagem neonatal são necessárias para aumentar a cobertura e a instituição do 3º dia de vida do recém-nascido como sendo o Dia do Teste do Pezinho poderia contribuir para que idades mais precoces de tratamento fossem atingidas, melhorando o prognóstico das crianças acometidas.The Neonatal Screening Program at the University Hospital of the Ribeirao Preto School of Medicine, São Paulo University, Brazil, was introduced in 1994. As of December 2005, congenital hypothyroidism had been diagnosed in 76 infants, phenylketonuria in 10, and hemoglobinopathies in 25, representing incidence rates of 1:2,595, 1:19,409, and 1:4,120, respectively. A total of 2,747 newborns had the sickle cell trait, i.e., were heterozygous for the sickle mutation (1:37.5 live births. The program's mean coverage during this period was 94.5%. There was major improvement in the parameters for evaluating the program's quality, although they were still far from ideal. Public-awareness campaigns on the importance of neonatal screening are needed to increase the program's coverage. Setting postnatal day 3 as the standard Day for the Heel Stick Test would help ensure treatment at earlier ages, thus improving prognosis for affected infants.

Maternal or neonatal infection: association with neonatal encephalopathy outcomes.

Science.gov (United States)

Jenster, Meike; Bonifacio, Sonia L; Ruel, Theodore; Rogers, Elizabeth E; Tam, Emily W; Partridge, John Colin; Barkovich, Anthony James; Ferriero, Donna M; Glass, Hannah C

2014-07-01

Perinatal infection may potentiate brain injury among children born preterm. The objective of this study was to examine whether maternal and/or neonatal infection are associated with adverse outcomes among term neonates with encephalopathy. This study is a cohort study of 258 term newborns with encephalopathy whose clinical records were examined for signs of maternal infection (chorioamnionitis) and infant infection (sepsis). Multivariate regression was used to assess associations between infection, pattern, and severity of injury on neonatal magnetic resonance imaging, as well as neurodevelopment at 30 mo (neuromotor examination, or Bayley Scales of Infant Development, second edition mental development index encephalopathy, chorioamnionitis was associated with a lower risk of brain injury and adverse outcomes, whereas signs of neonatal sepsis carried an elevated risk. The etiology of encephalopathy and timing of infection and its associated inflammatory response may influence whether infection potentiates or mitigates injury in term newborns.

Tuberculosis neonatal

OpenAIRE

Pastor Durán, Xavier

1986-01-01

PROTOCOLOS TERAPEUTICOS. TUBERCULOSIS NEONATAL 1. CONCEPTO La tuberculosis neonatal es la infección del recién nacido producida por el bacilo de Koch. Es una situación rara pero grave que requiere un diagnóstico precoz y un tratamiento enérgico..

PRODUÇÃO DE SEMENTES DE CULTIVARES PRECOCES DE SOJA EM DUAS ÉPOCAS E DOIS LOCAIS PAULISTAS: II. QUALIDADE FISIOLÓGICA

Directory of Open Access Journals (Sweden)

MEDINA PRISCILA FRATIN

1997-01-01

Full Text Available Tendo em vista os sérios problemas encontrados na qualidade de sementes de soja, principalmente de cultivares precoces produzidas na época de cultivo tradicional no Estado de São Paulo (com semeadura em novembro, este trabalho foi realizado com o objetivo de reunir informações sobre a qualidade fisiológica de sementes de cinco cultivares de ciclo precoce, semeados em duas épocas e regiões distintas do Estado. Assim, sementes dos cultivares IAC-100, IAC-16, IAC-Foscarin-31, BR-4 e IAS-5 foram obtidas de semeaduras realizadas em novembro de 1989 e março/abril de 1990, nos municípios de Campinas e de Votuporanga. A avaliação da qualidade fisiológica, realizada por meio de diferentes testes, após as colheitas e na época de semeadura da safra seguinte, demonstrou que o retardamento da semeadura para o final do verão/início de outono proporcionou a obtenção de sementes com maiores níveis de viabilidade e de vigor em ambas as localidades, sendo que, em Votuporanga, as vantagens foram ainda maiores.

Effects of bromopride on the healing of left colonic anastomoses in rats with induced abdominal sepsis Efeitos da bromoprida na cicatrização de anastomoses no cólon esquerdo de ratos sob sepse abdominal induzida

Directory of Open Access Journals (Sweden)

Silvana Marques e Silva

2012-06-01

Full Text Available PURPOSE: To evaluate the effects of bromopride on the healing of left colonic anastomoses in rats with induced abdominal sepsis. METHODS: Forty rats were divided into two groups to receive either bromopride (experimental group- E or saline (control group- C. Each group was divided into subgroups of ten animals each to be euthanized on third (E3 and C3 or seventh day (E7 and C7 after surgery. Sepsis was induced by cecal ligation and puncture. The rats underwent segmental left colon resection and end-to-end anastomosis. Adhesion formation, tensile strength and hydroxyproline concentration were assessed. Histomorphometry of collagen and histopathological analysis were also performed. RESULTS: On postoperative third day, anastomoses in bromopride-treated animals showed lower tensile strength (p=0.02 and greater reduction in hydroxyproline concentration (p=0.04 than in control animals. There was no statistical difference in these parameters on seventh day, and the remaining parameters were similar across subgroups. Collagen content was also similar across subgroups. CONCLUSION: In the presence of abdominal sepsis, the administration of bromopride was associated with decreased tensile strength and hydroxyproline concentration in left colonic anastomoses in rats three days after surgery.OBJETIVO: Avaliar os efeitos da bromoprida sobre a cicatrização de anastomoses de cólon esquerdo de ratos na presença de sepse abdominal. MÉTODOS: Quarenta ratos distribuídos em grupos contendo 20 animais para administração de bromoprida ou salina. Cada grupo foi dividido em subgrupos contendo dez animais, para eutanásia no terceiro ou no sétimo dia de pós-operatório. A indução da sepse foi realizada pelo método de ligadura e punção do ceco. Foi realizada ressecção de um segmento do cólon esquerdo e anastomose término-terminal. À re-laparotomia, foi avaliada a quantidade total de aderências e removido um segmento colônico contendo a anastomose

Neonatal doses from X ray examinations by birth weight in a neonatal intensive care unit

Energy Technology Data Exchange (ETDEWEB)

Ono, K.; Akahane, K.; Aota, T.; Hada, M.; Takano, Y.; Kai, M.; Kusama, T

2003-07-01

The aim of this study was to investigate the frequency and type of X ray examinations performed on neonates classified according to their birth weight in a neonatal intensive care unit (NICU). In this study, the radiology records of 2408 neonates who were admitted to the NICU of Oita Prefectural Hospital between January 1994 and September 1999 were investigated. This study revealed that the neonates with earlier gestational ages and lower birth weights required longer NICU stays and more frequent X ray examinations made using a mobile X ray unit. The average number of X ray examinations performed on neonates of less than 750 g birth weight was 26 films per neonate. In regard to computed tomography and fluoroscopy, no significant relationship was found between the birth weight and number of X rays. This study revealed that the entrance-surface dose per neonate was dependent upon the birth weight, while the maximum dose was not dependent upon the birth weight. The average neonatal dose in the NICU was predominantly from computed tomography and fluoroscopy. The individual dose varied widely among neonates. (author)

Neonatal doses from X ray examinations by birth weight in a neonatal intensive care unit

International Nuclear Information System (INIS)

Ono, K.; Akahane, K.; Aota, T.; Hada, M.; Takano, Y.; Kai, M.; Kusama, T.

2003-01-01

The aim of this study was to investigate the frequency and type of X ray examinations performed on neonates classified according to their birth weight in a neonatal intensive care unit (NICU). In this study, the radiology records of 2408 neonates who were admitted to the NICU of Oita Prefectural Hospital between January 1994 and September 1999 were investigated. This study revealed that the neonates with earlier gestational ages and lower birth weights required longer NICU stays and more frequent X ray examinations made using a mobile X ray unit. The average number of X ray examinations performed on neonates of less than 750 g birth weight was 26 films per neonate. In regard to computed tomography and fluoroscopy, no significant relationship was found between the birth weight and number of X rays. This study revealed that the entrance-surface dose per neonate was dependent upon the birth weight, while the maximum dose was not dependent upon the birth weight. The average neonatal dose in the NICU was predominantly from computed tomography and fluoroscopy. The individual dose varied widely among neonates. (author)

Neonatal neurosonography

Energy Technology Data Exchange (ETDEWEB)

Riccabona, Michael, E-mail: michael.riccabona@klinikum-graz.at

2014-09-15

Paediatric and particularly neonatal neurosonography still remains a mainstay of imaging the neonatal brain. It can be performed at the bedside without any need for sedation or specific monitoring. There are a number of neurologic conditions that significantly influence morbidity and mortality in neonates and infants related to the brain and the spinal cord; most of them can be addressed by ultrasonography (US). However, with the introduction of first CT and then MRI, neonatal neurosonography is increasingly considered just a basic first line technique that offers only orienting information and does not deliver much relevant information. This is partially caused by inferior US performance – either by restricted availability of modern equipment or by lack of specialized expertise in performing and reading neurosonographic scans. This essay tries to highlight the value and potential of US in the neonatal brain and briefly touching also on the spinal cord imaging. The common pathologies and their US appearance as well as typical indication and applications of neurosonography are listed. The review aims at encouraging paediatric radiologists to reorient there imaging algorithms and skills towards the potential of modern neurosonography, particularly in the view of efficacy, considering growing economic pressure, and the low invasiveness as well as the good availability of US that can easily be repeated any time at the bedside.

Socioeconomic factors and adolescent pregnancy outcomes: distinctions between neonatal and post-neonatal deaths?

Directory of Open Access Journals (Sweden)

Flick Louise H

2005-07-01

Full Text Available Abstract Background Young maternal age has long been associated with higher infant mortality rates, but the role of socioeconomic factors in this association has been controversial. We sought to investigate the relationships between infant mortality (distinguishing neonatal from post-neonatal deaths, socioeconomic status and maternal age in a large, retrospective cohort study. Methods We conducted a population-based cohort study using linked birth-death certificate data for Missouri residents during 1997–1999. Infant mortality rates for all singleton births to adolescent women (12–17 years, n = 10,131; 18–19 years, n = 18,954 were compared to those for older women (20–35 years, n = 28,899. Logistic regression was used to estimate adjusted odds ratios (OR and 95% confidence intervals (CI for all potential associations. Results The risk of infant (OR 1.95, CI 1.54–2.48, neonatal (1.69, 1.24–2.31 and post-neonatal mortality (2.47, 1.70–3.59 were significantly higher for younger adolescent (12–17 years than older (20–34 years mothers. After adjusting for race, marital status, age-appropriate education level, parity, smoking status, prenatal care utilization, and poverty status (indicated by participation in WIC, food stamps or Medicaid, the risk of post-neonatal mortality (1.73, 1.14–2.64 but not neonatal mortality (1.43, 0.98–2.08 remained significant for younger adolescent mothers. There were no differences in neonatal or post-neonatal mortality risks for older adolescent (18–19 years mothers. Conclusion Socioeconomic factors may largely explain the increased neonatal mortality risk among younger adolescent mothers but not the increase in post-neonatal mortality risk.

Neonatal adrenal hemorrhage presenting as late onset neonatal jaundice

OpenAIRE

Qureshi, Umar Amin; Ahmad, Nisar; Rasool, Akhter; Choh, Suhail

2009-01-01

Clinical manifestations of adrenal hemorrhage vary depending on the degree and rate of hemorrhage, as well as the amount of adrenal cortex compromised by hemorrhage. We report here a case of neonatal adrenal hemorrhage that presented with late onset neonatal jaundice. The cause of adrenal hemorrhage was birth asphyxia.

Impact of maternal diabetes mellitus on mortality and morbidity of very low birth weight infants: a multicenter Latin America study

Directory of Open Access Journals (Sweden)

Carlos Grandi

2015-05-01

ajustados foram calculados para mortalidade e morbilidade neonatal em função da DM materna. Mulheres sem DM serviram como grupo de referência. Resultados: A taxa de DM materna foi 2,8% (IC 95% 2,5-3,1, mas um aumento significativo (p = 0,019 entre 2001-2005 (2,4% e 2006-2010 (3,2% foi observado. As mães com DM eram mais propensas a terem recebido um curso completo de esteróides pré-natais que as sem DM. Os bebês de mães diabéticas tinham uma idade gestacional e peso ao nascer um pouco maior do que crianças filhas de não DM. Distribuição dos z escores de peso ao nascer, pequeno para idade gestacional e escores de Apgar foram semelhantes. Não houve diferenças significativas entre os dois grupos em termos de síndrome do desconforto respiratório, displasia broncopulmonar, hemorragia intraventricular, leucomalácia periventricular e persistência do ductus arteriosus. Mortalidade na sala de parto, mortalidade total, necessidade de ventilação mecânica e as taxas de sepse neonatal precoce foram significativamente menores no grupo diabético, enquanto enterocolite necrosante (NEC foi significativamente maior em recém-nascidos de mães diabéticas. Em análises de regressão logística NEC foi a única condição independentemente associada com DM (OR ajustado 1,65 [IC 95% 1,21 -2,27]. Conclusões: Crianças de MBP de mães com DM não têm aumento do risco de mortalidade ou morbidade precoce, exceto NEC. Keywords: Very low birth weight, Diabetes mellitus, Morbidity, Mortality, Neonatal, Network, Palavras-chave: Muito baixo peso, Diabetes mellitus, Morbilidade, Mortalidade, Neonatal, Redes

Exposure assessment of neonates in israel to x-ray radiation during hospitalization at neonatal intensive care unit

International Nuclear Information System (INIS)

Datz, H.

2005-03-01

Nowadays nearly 10% of all births in western countries are premature. In the last decade, there has been an increase of 45% in the number of neonates that were born in Israel. At the same time, the survival of neonates, especially those with very low birth weight, VLBW, (less than 1,500 gr), has increased dramatically. Diagnostic radiology plays an important role in the assessment and treatment of neonates requiring intensive care. During their prolonged and complex hospitalization, these infants are exposed to multiple radiographic examinations involving X-ray radiation. The extent of the examinations that the infant undergoes depends on its birth weight, gestational age and its medical problems, where most of the treatment effort is focused especially on VLBW neonates. Most of the diagnostic X-ray examinations taken during the hospitalization of neonates in the neonatal intensive care unit (NICU) consist of imaging of the respiratory and gastrointestinal systems, namely, the chest and abdomen. The imaging process is done using mobile X-ray units located at the NICUs. Due to their long hospitalization periods and complex medical condition, all neonates, and neonates with VLBW in particular, are exposed to a much higher level of diagnostic radiation, compared to normal newborns. The goal of this research was to assess the extent of the exposure of neonates in Israel to X-ray radiation during their hospitalization at the neonatal intensive care unit. Five NICUs, located at different geographical zones in Israel and treating 20% of all newborns in Israel every year, participated in this research. The research was conducted in three phases: Phase I: Collection of information on radiographic techniques and exposure parameters (e.g. kV, mAs, focus to skin distance (FSD), examination borders). 499 X-ray examinations (from 157 neonates) were evaluated for necessary and unnecessary exposure of the neonate's organs to X-ray radiation during these examinations. Phase II

Efeitos celulares da variante polimórfica Ala-9Val da MnSOD humana sobre o estresse oxidativo durante o processo infeccioso : estudo in vitro

OpenAIRE

Francis Jackson de Oliveira Paludo

2013-01-01

A compreensão da fisiologia e dos mecanismos moleculares da sepse tem sido foco de muitos estudos. As infecções severas, como a sepse, são responsáveis por 10% do total de mortes registradas em Unidades de Tratamento Intensivo em todo o mundo. O desfecho da sepse ocorre devido a influência de fatores ambientais e genéticos, cuja expressão de variantes genéticas suportam ou não este desfecho. Muitos mecanismos estão envolvidos na sepse, incluindo a liberação de citocinas e a ativação de neutró...

Neonatal pain management

Directory of Open Access Journals (Sweden)

Tarun Bhalla

2014-01-01

Full Text Available The past 2-3 decades have seen dramatic changes in the approach to pain management in the neonate. These practices started with refuting previously held misconceptions regarding nociception in preterm infants. Although neonates were initially thought to have limited response to painful stimuli, it was demonstrated that the developmental immaturity of the central nervous system makes the neonate more likely to feel pain. It was further demonstrated that untreated pain can have long-lasting physiologic and neurodevelopmental consequences. These concerns have resulted in a significant emphasis on improving and optimizing the techniques of analgesia for neonates and infants. The following article will review techniques for pain assessment, prevention, and treatment in this population with a specific focus on acute pain related to medical and surgical conditions.

REVISÃO SISTEMÁTICA INTEGRATIVA DA LITERATURA SOBRE MODELOS E PRÁTICAS DE INTERVENÇÃO PRECOCE NO BRASIL

OpenAIRE

Bruna Pereira Ricci Marini; Mariane Cristina Lourenço; Patrícia Carla de Souza Della Barba

2017-01-01

RESUMO Objetivo: Identificar quais práticas e modelos de Intervenção Precoce na Infância estão descritos na literatura científica brasileira. Fontes de dados: Realizou-se uma revisão sistemática integrativa da literatura indexada entre 2005 e 2015 nas bases Biblioteca Virtual em Saúde, Bielefeld Academic Search Engine, Education Resources Information Center e Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Ensino Superior. Foram incluídos artigos publicados em língua ...

Causes of Neonatal Mortality in the Neonatal Intensive Care Unit of Taleghani Hospital

Directory of Open Access Journals (Sweden)

Ali Hossein Zeinalzadeh

2017-09-01

Full Text Available Background: Neonatal survival is one of the most important challenges today. Over 99% of neonatal mortalities occur in the developing countries, and epidemiologic studies emphasize on this issue in the developed countries, as well. In this study, we attempted to investigate the causes of neonatal mortality in Taleghani Hospital, Tabriz, Iran.Methods: In this cross-sectional study, we studied causes of neonatal mortality in neonatal intensive care unit (NICU of Taleghani Hospital, Tabriz, Iran, during 2013-2014. Data collection was performed by the head nurse and treating physician using a pre-designed questionnaire. Most of the data were extracted from the neonatal records. Information regarding maternal underlying diseases and health care during pregnancy was extracted from mothers' records.Results: A total of 891 neonates were admitted to NICU of Taleghani Hospital of Tabriz, Iran, during 2013-2014, 68 (7.5% of whom died. Among these cases, 37 (%54.4 were male, 29 (29.4% were extremely low birth weight, and 16 (23.5% weighed more than 2.5 kg. The main causes of mortality were congenital anomalies (35.3%, prematurity (26.5%, and sepsis (10.3%, respectively.Conclusion: Congenital anomaly is the most common cause of mortality, and the pattern of death is changing from preventable diseases to unavoidable mortalities

Developments in neonatal care and nursing responses.

Science.gov (United States)

Healy, Patricia; Fallon, Anne

This article reviews the origins and evolution of neonatology and considers the role of the neonatal nurse within this specialty. Neonatal nurses are a vital part of the neonatal team that provides care for sick babies. The nursing care required by sick babies and their families on a neonatal unit can be variable and complex. The past century has seen significant changes in the role of the neonatal nurse. This has come about through dramatic technological developments on neonatal units, an increased understanding of neonatal physiology and pathology, changes in the education of neonatal nurses, and active and ongoing clinical research within the specialty. The resulting significant advances in neonatal care, including that provided by neonatal nurses, have made a crucial and steadfast contribution to marked improvements in neonatal outcomes.

Patterns of admission and factors associated with neonatal mortality among neonates admitted to the neonatal intensive care unit of University of Gondar Hospital, Northwest Ethiopia

Directory of Open Access Journals (Sweden)

Demisse AG

2017-05-01

Full Text Available Abayneh Girma Demisse, Fentahun Alemu, Mahlet Abayneh Gizaw, Zemene Tigabu School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia Introduction: The neonatal period is a highly vulnerable time for an infant completing many of the physiologic adjustments required for life outside the uterus. As a result, there are high rates of morbidity and mortality. The three major causes of mortality in developing countries include prematurity, infection, and perinatal asphyxia. The aim of this study was to identify the patterns of neonatal admission and factors associated with mortality among neonates admitted at the Neonatal Intensive Care Unit (NICU of University of Gondar Hospital.Materials and methods: A retrospective cross-sectional study was conducted among all admitted neonates in the NICU of University of Gondar referral hospital from December 1, 2015 to August 31, 2016. Information was extracted retrospectively during admission from patient records and death certificates, using a pretested questionnaire. The data were entered and analyzed using SPSS version 20, and p-values <0.05 were considered statistically significant.Results: A total of 769 neonates was included in the study. There were 448 (58.3% male neonates, and 398 (51.8% neonates were rural residents. More than two-thirds of the 587 deliveries (76.3% were performed in tertiary hospitals. Neonatal morbidity included hypothermia 546 (71%, sepsis 522 (67.9%, prematurity 250 (34.9%, polycythemia 242 (31.5%, hypoglycemia 142 (18.5, meconium aspiration syndrome 113 (14.7%, and perinatal asphyxia 96 (12.5%. The overall mortality was 110 (14.3%; 95% confidence interval [CI]: 11.9–16.9 of which 69 (62.7% deaths occurred in the first 24 hours of age. In the multivariate analysis, mortality was associated with perinatal asphyxia (adjusted odds ratio [AOR]: 5.97; 95% CI: 3.06–11.64, instrumental delivery (AOR: 2.99; 95% CI: 1.08–8.31, and early onset

Volume and leak measurements during neonatal CPAP in neonates

OpenAIRE

Fischer, Hendrik S.

2011-01-01

As yet, little is known about the effects of air leakages during CPAP in newborns. The present doctoral dissertation investigates tidal volume and leak measurements during nasal continuous positive airway pressure in neonates using a commercial ventilatory device. Investigations include in vitro studies, modelling and computer simulation as well as a clinical randomized cross-over trial in neonates.

O CONTATO E A AMAMENTAÇÃ O PRECOCES: SIGNIFICADOS E VIVÊNCIAS

Directory of Open Access Journals (Sweden)

Eloana Ferreira D\\u2019Artibale

2014-01-01

Full Text Available Este estudio tiene como objetivo analizar los significados y las experiencias del contacto y amamantamiento precoces de las puérperas internadas en un Hospital Amigo del Niño. Se trata de un estudio descriptivo, exploratorio, con abordaje cualitativo, que se desarrolló en un hospital universitario en el Noroeste de Paraná, de noviembre de 2011 a enero de 2012, con la participación de 16 puérperas. Los datos fueron colectados por medio de la observación sistemática no participante de los partos, apuntes en diario de campo y entrevista semiestructurada. El tratamiento de los datos fue realizado por medio del análisis de contenido, modalidad temática. Los resultados revelaron que el acercamiento entre el binomio madre-hijo, en seguida al nacimiento, proporcionó una experiencia única a la mujer, desencadenando diversas sensaciones dentro del contexto biopsicosociocultural de cada una de ellas, con sentimientos y significados favorables al vínculo madre-hijo y al inicio de la amamantación.

PRODUÇÃO DE SEMENTES DE CULTIVARES PRECOCES DE SOJA EM DUAS ÉPOCAS E DOIS LOCAIS PAULISTAS: I. CARACTERÍSTICAS AGRONÔMICAS E PRODUTIVIDADE

Directory of Open Access Journals (Sweden)

MEDINA PRISCILA FRATIN

1997-01-01

Full Text Available Com o objetivo de analisar as características agronômicas e a produtividade de sementes de cultivares precoces de soja (IAC-100, IAC-16, IAC-Foscarin-31, BR-4 e IAS-5 na estação seca, sob irrigação suplementar, realizou-se o cultivo desses genótipos durante o outono-inverno, nos municípios de Campinas e Votuporanga (SP e para comparação do efeito de época de semeadura, também na época convencional. Na colheita, avaliaram-se: altura das plantas, número de nós por planta, altura da inserção das primeiras vagens, número de sementes por planta, massa de mil sementes e produtividade. Determinaram-se, também, o potencial de germinação e a produtividade de sementes viáveis, após a colheita e na época da semeadura da safra seguinte (novembro. Concluiu-se que: (a a semeadura de cultivares precoces de soja, no início do outono, é alternativa viável para a produção de sementes, especialmente em regiões como a de Votuporanga, onde a época convencional de semeação pode inviabilizar a obtenção de sementes que mantenham alta capacidade germinativa por um período satisfatório; (b o retardamento da semeadura na produção de sementes de cultivares precoces de soja deve basear-se na análise tanto da produtividade total como na de sementes viáveis, considerando-se, principalmente, a viabilidade das sementes na época de semeação da safra seguinte.

Parâmetros genéticos e análise de trilha para o florescimento precoce e características agronômicas da alface

Directory of Open Access Journals (Sweden)

Alcinei Mistico Azevedo

2014-02-01

Full Text Available O objetivo deste trabalho foi avaliar os parâmetros genéticos das características agronômicas e de tolerância ao florescimento precoce de onze cultivares de alface, bem como verificar a existência de associação entre as características. O experimento foi realizado em ambiente protegido, em delineamento de blocos ao acaso, com quatro repetições e doze plantas por parcela. Quarenta e cinco dias após o transplantio das mudas, foram mensuradas as seguintes características: massa de matéria fresca total e "comercial" da parte aérea, massa de matéria seca "comercial" da parte aérea, massa de matéria fresca e seca da raiz, diâmetro e circunferência da cabeça, altura de planta, número de folhas por planta e número de dias até a antese. Há variabilidade genética entre as cultivares, em todas as variáveis, exceto quanto à circunferência de planta e matéria fresca da raiz. As cultivares Regina 500, Lívia e Atração foram superiores quanto ao número de dias para o florescimento e também para as demais características avaliadas. A seleção contra o florescimento precoce ocasionou ganho em todas as características; porém, não interferiu na matéria seca da raiz. A matéria fresca da parte aérea e o diâmetro de cabeça são indicadas para a seleção indireta contra o florescimento precoce.

Telemedicine in Neonatal Home Care

DEFF Research Database (Denmark)

Holm, Kristina Garne; Brødsgaard, Anne; Zachariassen, Gitte

2016-01-01

participatory design and qualitative methods. Data were collected from observational studies, individual interviews, and focus group interviews. Two neonatal units participated. One unit was experienced in providing neonatal home care with home visits, and the other planned to offer neonatal home care......BACKGROUND: For the majority of preterm infants, the last weeks of hospital admission mainly concerns tube feeding and establishment of breastfeeding. Neonatal home care (NH) was developed to allow infants to remain at home for tube feeding and establishment of breastfeeding with regular home...... visits from neonatal nurses. For hospitals covering large regions, home visits may be challenging, time consuming, and expensive and alternative approaches must be explored. OBJECTIVE: To identify parental needs when wanting to provide neonatal home care supported by telemedicine. METHODS: The study used...

Early nasal continuous positive airway pressure versus INSURE in VLBW neonates

Directory of Open Access Journals (Sweden)

Ana Saianda

2010-09-01

coorte retrospectiva dos RNMBP nascidos num hospital de apoio perinatal diferenciado entre Janeiro/2002-Agosto/2008. Incluíram-se as crianças registadas na Vermont-Oxford Network com IG ≤30semanas e com uso de nCPAP logo após o nascimento (N = 96. Estabeleceu-se Grupo nCPAP – uso de nCPAP isolado (N = 40 e Grupo INSURE (N = 56. Consideraram-se outcomes precoces: síndroma de dificuldade respiratória (SDR, necessidade de administrar surfactante com intuito terapêutico ou recurso a ventilação invasiva. Compararam-se igualmente outcomes tardios: doença pulmonar crónica da prematuridade (DPC, mortalidade e o outcome composto DPC-mortalidade. Resultados: No grupo INSURE verificou-se menor IG, não se registando diferenças relativamente ao peso ao nascer e indução da maturação pulmonar. Verificou-se SDR em 21/40 (53% casos do grupo nCPAP e em 17/56 (30% casos do grupo INSURE (OR ajustado [IC 95%] – 0,2 [0,1-0,6]. No grupo nCPAP todos estes casos realizaram surfactante com intuito terapêutico, não tendo sido efectuada nenhuma dose adicional de surfactante no grupo INSURE. Verificou-se maior número de casos com necessidade de VI no grupo nCPAP do que no grupo INSURE (11/40, 28% vs 9/56, 12%. Não foram encontradas diferenças estatisticamente significativas relativamente aos outcomes tardios. Conclusão: Em RNMBP com IG ≤30sem, o uso isolado de nCPAP poderá traduzir-se numa ligeira desvantagem em outcomes precoces, sem evidentes repercussões em termos de DPC ou mortalidade. Key-words: Very low birth weight, nCPAP ventilation, INSURE, respiratory distress syndrome (newborn, chronic lung disease of prematurity, mortality, Palavras-chave: Recém-nascido muito baixo peso, nCPAP, INSURE, sindroma de dificuldade respiratória neonatal, doença pulmonar crónica da prematuridade, mortalidade

Neonatal Informatics: Transforming Neonatal Care Through Translational Bioinformatics

Science.gov (United States)

Palma, Jonathan P.; Benitz, William E.; Tarczy-Hornoch, Peter; Butte, Atul J.; Longhurst, Christopher A.

2012-01-01

The future of neonatal informatics will be driven by the availability of increasingly vast amounts of clinical and genetic data. The field of translational bioinformatics is concerned with linking and learning from these data and applying new findings to clinical care to transform the data into proactive, predictive, preventive, and participatory health. As a result of advances in translational informatics, the care of neonates will become more data driven, evidence based, and personalized. PMID:22924023

Maternal haemoglobin and short-term neonatal outcome in preterm neonates.

Directory of Open Access Journals (Sweden)

Elodie Savajols

Full Text Available To determine whether there is a significant association between maternal haemoglobin measured before delivery and short-term neonatal outcome in very preterm neonates.We included prospectively all live births occurring from 25 to 32+6 weeks of gestation in a tertiary care centre between January 1(st 2009 and December 31(st 2011. Outborn infants and infants presenting with lethal malformations were excluded. Three hundred and thirty-nine mothers and 409 infants met the inclusion criteria. For each mother-infant pair a prospective record of epidemiologic data was performed and maternal haemoglobin concentration recorded within 24 hours before delivery was retrospectively researched. Maternal haemoglobin was divided into quartiles with the second and the third one regarded as reference as they were composed of normal haemoglobin values. Short-term outcome was defined as poor in case of death during hospital stay and/or grades III/IV intraventricular haemorrhage and/or periventricular leukomalacia and/or necessity of ventriculoperitoneal shunt.The global rate of poor short-term neonatal outcome was 11.4% and was significantly associated with low maternal haemoglobin values. This association remained significant after adjustment for antenatal corticosteroids therapy, gestational age, parity, mechanism of preterm birth, mode of delivery and birth weight (aOR = 2.97 CI 95% [1.36-6.47]. There was no relation between short-term neonatal outcome and high maternal haemoglobin concentration values.We show that low maternal haemoglobin concentration at delivery is an independent risk factor for poor short-term neonatal outcome in very preterm neonates. This study is one of the first to show such an association within the preterm population.

Neonates need tailored drug formulations.

Science.gov (United States)

Allegaert, Karel

2013-02-08

Drugs are very strong tools used to improve outcome in neonates. Despite this fact and in contrast to tailored perfusion equipment, incubators or ventilators for neonates, we still commonly use drug formulations initially developed for adults. We would like to make the point that drug formulations given to neonates need to be tailored for this age group. Besides the obvious need to search for active compounds that take the pathophysiology of the newborn into account, this includes the dosage and formulation. The dosage or concentration should facilitate the administration of low amounts and be flexible since clearance is lower in neonates with additional extensive between-individual variability. Formulations need to be tailored for dosage variability in the low ranges and also to the clinical characteristics of neonates. A specific focus of interest during neonatal drug development therefore is a need to quantify and limit excipient exposure based on the available knowledge of their safety or toxicity. Until such tailored vials and formulations become available, compounding practices for drug formulations in neonates should be evaluated to guarantee the correct dosing, product stability and safety.

Gasometria arterial e inflamação pulmonar de ratos com diferentes tempos de sepse abdominal Arterial gasometry and lung inflammation in rats with different times of abdominal sepsis

Directory of Open Access Journals (Sweden)

Sérgio Luiz Rocha

2007-03-01

Full Text Available RACIONAL: Sepse é a principal causa de morbi-mortalidade nas vítimas de trauma e em pacientes cirúrgico e apesar de toda tecnologia e terapêutica disponível não há diminuição nestas estatísticas. OBJETIVOS: Avaliar as repercussões ácido-básicas e o grau de injúria pulmonar decorrentes de sepse abdominal em ratos após seis e 24 horas de peritonite fecal através da ligadura e punção do ceco. MÉTODOS: Foram utilizados 40 ratos Wistar, machos, adultos. A amostra foi dividida aleatoriamente em quatro grupos: grupo A (sham/6 h - n=5 submetidos à laparotomia mediana infra-umbilical sem nenhuma outra intervenção; grupo B (sham/24h - n=5 submetidos à laparotomia mediana infra-umbilical sem nenhuma outra intervenção; grupo C (LPC/6 h - n=15 submetidos à ligadura e punção do ceco e grupo D (LPC/24h - n=15 submetidos à ligadura e punção do ceco. Após seis ou 24 horas, conforme o grupo em estudo, os animais foram novamente anestesiados e submetidos as seguintes análises: observação clínica de sinais de sepse, laparotomia através do mesmo acesso anterior e realização de cultura do líquido peritoneal e punção cardíaca para obtenção de amostra sangüínea suficiente para gasometria arterial, hematócrito e leucometria. Procedeu-se eutanásia e os pulmões retirados para análise de edema pulmonar e o infiltrado inflamatório. RESULTADOS: Ocorreram quatro óbitos no grupo D. Verificou-se, em todos os grupos, a presença de acidose mista. Comparando os grupos experimento 6h versus controle 6h foram encontradas duas variáveis significativas - HCO3 (p=0,0015 e BE (p=0,0015 -, demonstrando acidose metabólica mais grave no grupo experimento. Nos grupos controle também se confirmou acidose mista, devido às alterações das variáveis HCO3 (p=0,0079, PO2 (p=0,0079 e SO2 (p=0,0079. A correlação entre o grau de comprometimento pulmonar e o estado metabólico confirma a existência de resposta inflamatória sist

Diagnóstico precoce do câncer infantil: responsabilidade de todos Early diagnosis of childhood cancer: a team responsibility

Directory of Open Access Journals (Sweden)

Karla Emilia Rodrigues

2003-01-01

Full Text Available OBJETIVO: Alertar para a necessidade do conhecimento e investigação dos sinais e sintomas iniciais do câncer infantil, bem como para a responsabilidade de todos envolvidos no processo do seu diagnóstico precoce a fim de melhorar os nossos índices de cura. MÉTODOS: Revisão da literatura através de consulta ao Medline. RESULTADOS: O diagnóstico do câncer infantil é um processo complexo e muitas são as variáveis que parecem influenciá-lo. A detecção precoce e o pronto início do tratamento têm importante papel na redução da mortalidade e morbidade do tratamento. O melhor entendimento da relação entre estes fatores é de fundamental importância para o desenvolvimento de estratégias de saúde pública para detecção precoce do câncer infantil. CONCLUSÃO: Muitos fatores parecem estar associados ao atraso do diagnóstico do câncer infantil. O tempo que decorre entre o primeiro sintoma e o diagnóstico depende da idade da criança e do tipo do tumor, principalmente. Determinar os sinais e sintomas que devem alertar para a possibilidade de doenças malignas ainda é um desafio.OBJECTIVES: To call attention for necessity of the knowledge of the early symptoms of childhood cancer and for the responsibility of the parents, physicians and teachers rendering health supervision to the children and to alert that the early detection and prompt treatment is of paramount importance in achieving cures in childhood cancer. SOURCES: Literature review using Medline. SUMMARY: The diagnosis of childhood cancer is complex and many variables play an important role. Early detection and prompt therapy have the potential to reduce mortality and treatment morbidity. A better understanding of the relationship between symptoms and diagnosis is important for the development of effective public health strategies. CONCLUSIONS: There are several factors that may be associated with length of time between symptoms and diagnosis. Lag time to diagnosis

Neonatal Nursing

OpenAIRE

Crawford, Doreen; Morris, Maryke

1994-01-01

"Neonatal Nursing" offers a systematic approach to the nursing care of the sick newborn baby. Nursing actions and responsibilities are the focus of the text with relevant research findings, clinical applications, anatomy, physiology and pathology provided where necessary. This comprehensive text covers all areas of neonatal nursing including ethics, continuing care in the community, intranatal care, statistics and pharmokinetics so that holistic care of the infant is described. This book shou...

Neonatal Outcomes of Rh-Negative Pregnancies in a Tertiary Level Neonatal Intensive Care Unit: A Prospective Study

Directory of Open Access Journals (Sweden)

Chacham

2016-07-01

Full Text Available Background Rhesus incompatibility is a preventable cause for severe neonatal hyperbilirubinemia, hydrops fetalis and still births. The prevalence of the Rh-negative blood group among Indian woman varies from 2% - 10%. Despite declining the incidence of Rhesus incompatibility, due to availability of anti-D immunoglobulin, and improved antenatal care of the Rh-negative pregnant woman, it still accounts for a significant proportion of neonatal hyperbilirubinemia and neuro-morbidity. The prevalence of Rh-negative women having Rh-positive neonates is 60%. Objectives This study aimed to estimate the incidence of Rh iso-immunization and evaluate the outcomes of Rh iso-immunized neonates. Methods This prospective observational study was conducted in a tertiary level neonatal intensive care unit, Princess Esra hospital, Deccan college of medical sciences, Hyderabad, Telangana, India. Consecutive intramural and extramural neonates admitted to neonatal intensive care unit with the Rh-negative mother’s blood group and hyperbilirubinemia were enrolled. Neonates born to Rh+ve mothers were excluded. Neonatal gestational age, birth weight, age at admission, duration of phototherapy, duration of hospitalization, neonatal examination and investigations were recorded in a predesigned, pretested performa. Results A total of 90 neonates were born to Rh-negative mothers, of which 70% (63 had the Rh-positive blood group and 30% had the Rh-negative blood group. Of these 63 neonates, 48 (76.2% had hyperbilirubinemia and 43 neonates (68.3% had significant hyperbilirubinemia (total serum bilirubin > 15mg/dL. Among them, 2%, 75% and 23% were born to primi, multi and grandmutli, respectively. Also, 14.5% of the neonates were large for dates (LFD, 75% appropriate for dates (AFD and 10.5% were small for dates (SFD. Premature and SFD neonates had higher incidence of hyperbilirubinemia. Significantly higher incidence of jaundice occurred within 72 hours of life. The mean

Avaliação da Introdução Precoce da Alimentação Complementar em Crianças de 0 a 24 meses Atendidas em uma Unidade Básica de Saúde

OpenAIRE

Adriana Morellato; Jussara Carnevale Almeida; Nêmora Cabistani

2009-01-01

Objetivo: Verificar a frequência, os principais alimentos e motivos da introdução precoce da alimentação complementar, além do uso de mamadeira e chupeta em crianças de 0 a 24 meses. Métodos: Estudo transversal com crianças de 0 a 24 meses de idade atendidas numa Unidade Básica de Saúde. No período de junho a agosto de 2006, aplicou-se um questionário às mães ou acompanhantes sobre a alimentação complementar das crianças. Foi considerada precoce a introdução de alimentos sólidos e/ou líqui...

SERUM SODIUM CHANGES IN NEONATES RECEIVING PHOTOTHERAPY FOR NEONATAL HYPERBILIRUBINEMIA

Directory of Open Access Journals (Sweden)

Sunil Kumar

2015-07-01

Full Text Available BACKGROUND : Neonates receiving phototherapy have side effects like hypocalcemia and electrolyte changes. Our study is hereby intended to study the serum sodium changes due to phototherapy. AIMS : To evaluate the serum sodium changes in neonates receiving phototherapy f or neonatal hyperbilirubinemia. SETTINGS AND DESIGN : A prospective hospital based comparative study conducted on neonates admitted in the Neonatal Intensive Care Unit receiving phototherapy. METHODS AND MATERIAL : A predesigned proforma has aided the enroll ment of 252 newborns into the study. Serum bilirubin and serum sodium were determined before and after termination of phototherapy. The first samples were considered as controls. A comparative study was made between before and after phototherapy groups to determine the incidence of serum sodium imbalances. STATISTICAL ANALYSIS USED : Proportions will be compared using chi - square test. All data of various groups will be tabulated and statistically analyzed using suitable statistical tests (Student's t test. RESULTS : Male to Female ratio was 1.45 : 1. Incidence of low birth weight babies was 23% and preterm was 20.2%. Mean birth weight and gestational age was 2.84±0.51 kg and 38.44±1.98 wks respectively. Mean duration of phototherapy was 37.65±11.06 hrs. The incidence of hyponatremia post phototherapy found to be 6% which was more in low birth weight (LBW babies (17.2% , p48 hrs (p<0.001. Even the decline in mean serum sodium values after phototherapy found to be statistically significant. CONCLUSION : Our study shows that neonates u nder phototherapy are at higher risk of hyponatremia. This risk is greater in premature and LBW babies and hence this group of babies should be closely monitored for changes in serum sodium and should be managed accordingly.

Neonatal Vaccination: Challenges and Intervention Strategies.

Science.gov (United States)

Morris, Matthew C; Surendran, Naveen

2016-01-01

While vaccines have been tremendously successful in reducing the incidence of serious infectious diseases, newborns remain particularly vulnerable in the first few months of their life to life-threatening infections. A number of challenges exist to neonatal vaccination. However, recent advances in the understanding of neonatal immunology offer insights to overcome many of those challenges. This review will present an overview of the features of neonatal immunity which make vaccination difficult, survey the mechanisms of action of available vaccine adjuvants with respect to the unique features of neonatal immunity, and propose a possible mechanism contributing to the inability of neonates to generate protective immune responses to vaccines. We surveyed recent published findings on the challenges to neonatal vaccination and possible intervention strategies including the use of novel vaccine adjuvants to develop efficacious neonatal vaccines. Challenges in the vaccination of neonates include interference from maternal antibody and excessive skewing towards Th2 immunity, which can be counteracted by the use of proper adjuvants. Synergistic stimulation of multiple Toll-like receptors by incorporating well-defined agonist-adjuvant combinations to vaccines is a promising strategy to ensure a protective vaccine response in neonates. © 2016 S. Karger AG, Basel.

Lesao nasal precoce pelo uso da pronga nasal em recem-nascidos prematuros de muito baixo peso: estudo piloto

Directory of Open Access Journals (Sweden)

Nathalie Tiemi Ota

2013-09-01

Full Text Available OBJETIVO: Analisar, em recém-nascidos de muito baixo peso e com indicação de ventilação não invasiva via pronga nasal, a incidência do aparecimento precoce de lesão nasal. MÉTODOS: Série de casos prospectiva de nascidos com idade gestacional <37 semanas, peso <1.500g e idade pós-natal <29 dias. Os pacientes foram avaliados desde a instalação da pronga nasal até o 3o dia de uso, três vezes ao dia. Foram analisadas as condições clínicas dos pacientes, características do dispositivo e de sua aplicação. A análise inicial foi descritiva, verificando-se a prevalência de lesão nasal bem como os fatores a ela associados. Os dados categóricos foram analisados por qui-quadrado ou exato de Fisher e os dados numéricos, por teste t ou Mann-Whitney. RESULTADOS: Dezoito recém-nascidos foram incluídos, dos quais 12 (idade gestacional de 29,8±3,1 semanas, peso ao nascer de 1.070±194g e Score for Neonatal Acute Phisiology - Perinatal Extension (SNAPPE de 15,4±17,5 evoluíram com lesão nasal (Grupo Lesão e 6 (idade gestacional de 28,0±1,9 semanas, peso de 1.003±317g e SNAPPE de 26,2±7,5 não apresentaram lesão nasal (Grupo Sem Lesão. No Grupo Lesão, houve maior frequência do gênero masculino (75% versus 17%, a lesão apareceu em média após 18 horas e predominantemente no período notur no (75%. CONCLUSÃO: A incidência de lesão nasal em prematuros submetidos à ventilação não invasiva via pronga nasal foi elevada, sendo possível planejar estudo dos fatores associados, com base neste piloto.

Prevalência de perda precoce de molares decíduos: estudo retrospectivo = Prevalence of early loss of deciduous molars: a retrospective study

Directory of Open Access Journals (Sweden)

Alessandro Leite Cavalcanti

2008-07-01

Full Text Available Este estudo retrospectivo determinou a prevalência da perda precoce demolares decíduos em pacientes atendidos na clínica de Odontopediatria da Universidade Estadual da Paraíba. Foram examinados 515 prontuários, sendo os dados registrados em um formulário. Foram analisadas as variáveis: gênero, idade, tipo de molar decíduo perdido,arcada dentária (maxilar ou mandibular e lado (direito e esquerdo. Observou-se que a prevalência de perda precoce foi de 15,1%, existindo uma distribuição similar entre os gêneros. Em relação à idade da criança, a maior freqüência de perda acometeu pacientescom sete anos (32,1%. Houve distribuição equitativa da perda dentária entre as arcadas superior e inferior, com 43,6% cada uma, sendo o lado esquerdo o mais acometido (41%. O segundo molar superior esquerdo foi o mais acometido (17,9%, seguido do primeiromolar decíduo superior direito (16,1%. Pode-se concluir que a prevalência de perda precoce foi baixa e que os molares decíduos superiores foram os dentes mais comumente perdidos.This retrospective study determined the prevalence of early loss of deciduous molars in patients enrolled at the Pediatric Dentistry clinic at the State University of Paraíba. A review of 515 patient records were analyzed, registered in a form. The following variables were analyzed: gender, age, type of deciduous molar loss, region (maxilla or mandible and side (right and left. It was observed that the prevalence of early tooth loss was 15.1% and there was a similar distribution between the genders. In regard to age, the greatest frequency of tooth loss involved patients at 7 years old (32.1%. There was a similar distribution of tooth loss between the maxilla and mandible regions, at 43.6% each, with the left side being themost involved (41%. The second upper left deciduous molar was the most commonly missing tooth (17.9%, followed by the first upper right deciduous molar (16.1%. It can be concluded that the

Placa de Castillo Morales: uso precoce e qualidade de vida da criança com Síndrome de Down

OpenAIRE

Santana, Ana Luísa Rato

2015-01-01

Dissertação para obtenção do grau de Mestre no Instituto Superior de Ciências da Saúde Egas Moniz Com este trabalho pretende-se, mostrar a importância da terapia precoce da regulação orofacial com o uso de Placa Palatina Castillo-Morales, em pacientes com Síndrome de Down, e avaliar as alterações e benefícios do uso desta placa para uma melhor Qualidade de Vida. A Placa de Castillo-Morales é utilizada como um complemento para a estimulação orofacial, sendo, especialmente usada em pacien...

Erythrocyte glucose-6-phosphate dehydrogenase deficiency in male newborn babies and its relationship with neonatal jaundice Deficiência de glicose-6-fosfato desidrogenase eritrocitária em recém-nascidos do sexo masculino e sua relação com a icterícia neonatal

Directory of Open Access Journals (Sweden)

Marli Auxiliadora C. Iglessias

2010-01-01

masculino provenientes da Maternidade Escola Januário Cicco em Natal, Rio Grande do Norte. A deficiência da glicose-6-fosfato desidrogenase foi determinada através do método qualitativo da redução da metahemoglobina (teste de Brewer e confirmada mediante determinação espectrofotométrica quantitativa da atividade da G6PD e pela eletroforese da enzima em acetato de celulose. Oito recém-nascidos apresentaram deficiência da G6PD, e quatro deles exibiram icterícia nas primeiras 48 horas depois do nascimento, com valores de bilirrubina maiores de 10 mg/dL. Todos os deficientes apresentaram a variante A-. Os dados encontrados confirmam a associação da deficiência da G6PD e a icterícia neonatal. Assim sendo, o diagnóstico precoce da deficiência logo após o nascimento é essencial ao controle do aparecimento da icterícia e para evitar o contato destes recém-nascidos com conhecidos agentes hemolíticos.

Therapies for neonates with congenital malformations admitted to a neonatal unit

Directory of Open Access Journals (Sweden)

Maria Vera Lúcia Moreira Leitão Cardoso

2015-03-01

Full Text Available The aim of this study was to characterize the treatments applied to newborns with congenital malformation hospitalized in a neonatal unit and to identify whether there is an association among the treatments used and the type of malformation. A descriptive, prospective and quantitative study was developed in a public institution in Fortaleza, Ceará, Brazil. Data were collected using the medical records of 30 neonates with congenital malformations. The incidence of malformations was higher among females, regardless of the mother’s age, gestational age or weight at birth; malformations of the central nervous and musculoskeletal systems prevailed. The treatments used varied according to the clinical evolution of the neonate. The data collected did not present statistical significance when associated with the variable of congenital malformation and the treatments used (p>0.05. The treatments are not directly related to the type of malformation, but to the clinical condition of the neonate.

Intraoperative fluid therapy in neonates

African Journals Online (AJOL)

Differences from adults and children in physiology and anatomy of neonates inform our ... is based on energy expenditure indexed to bodyweight.2 Energy ... fragile and poorly keratinised.5 ... neonates means that very conservative fluid regimes in neonates ..... I make an estimation of insensible loss from the skin, viscera,.

Neonatal Tele-Homecare

DEFF Research Database (Denmark)

Holm, Kristina Garne

Neonatal homecare (NH) implies that parents manage tube feeding and care of their preterm infant at home supported by home visits from neonatal nurses, to monitor infant growth and the well-being of the family. Home visits are costly and time consuming in rural areas. The overall aim of this study...

[Neonatal tumours and congenital malformations].

Science.gov (United States)

Berbel Tornero, O; Ortega García, J A; Ferrís i Tortajada, J; García Castell, J; Donat i Colomer, J; Soldin, O P; Fuster Soler, J L

2008-06-01

The association between pediatric cancer and congenital abnormalities is well known but, there is no exclusive data on the neonatal period and the underlying etiopathogenic mechanisms are unknown. First, to analyze the frequency of neonatal tumours associated with congenital abnormalities; and second, to comment on the likely etiopathogenic hypotheses of a relationship between neonatal tumours and congenital abnormalities. Historical series of neonatal tumours from La Fe University Children's Hospital in Valencia (Spain), from January 1990 to December 1999. Histological varieties of neonatal tumours and associated congenital abnormalities were described. A systematic review of the last 25 years was carried out using Medline, Cancerlit, Index Citation Science and Embase. The search profile used was the combination of "neonatal/congenital-tumors/cancer/neoplasms" and "congenital malformations/birth defects". 72 neonatal tumours were identified (2.8% of all pediatric cancers diagnosed in our hospital) and in 15 cases (20.8%) there was some associated malformation, disease or syndrome. The association between congenital abnormalities and neonatal tumours were: a) angiomas in three patients: two patients with congenital heart disease with a choanal stenosis, laryngomalacia; b) neuroblastomas in two patients: horseshoe kidney with vertebral anomalies and other with congenital heart disease; c) teratomas in two patients: one with cleft palate with vertebral anomalies and other with metatarsal varus; d) one tumour of the central nervous system with Bochdaleck hernia; e) heart tumours in four patients with tuberous sclerosis; f) acute leukaemia in one patient with Down syndrome and congenital heart disease; g) kidney tumour in one case with triventricular hydrocephaly, and h) adrenocortical tumour: hemihypertrophy. The publications included the tumours diagnosed in different pediatric periods and without unified criteria to classify the congenital abnormalities. Little data

Avaliação da introdução precoce da alimentação complementar em crianças de 0 a 24 meses atendidas em uma unidade básica de saúde

OpenAIRE

Morellato, Adriana; Cabistani, Nêmora Moraes; Almeida, Jussara Carnevale de

2009-01-01

Objetivo: Verificar a frequência, os principais alimentos e motivos da introdução precoce da alimentação complementar, além do uso de mamadeira e chupeta em crianças de 0 a 24 meses. Métodos: Estudo transversal com crianças de 0 a 24 meses de idade atendidas numa Unidade Básica de Saúde. No período de junho a agosto de 2006, aplicou-se um questionário às mães ou acompanhantes sobre a alimentação complementar das crianças. Foi considerada precoce a introdução de alimentos sólidos e/ou líquidos...

Diagnóstico precoce de anormalidades no desenvolvimento em prematuros: instrumentos de avaliação Early diagnosis of abnormal development of preterm newborns: assessment instruments

Directory of Open Access Journals (Sweden)

Rosana S. Santos

2008-08-01

Full Text Available OBJETIVO: Revisar criticamente os instrumentos de avaliação mais utilizados na atualidade na literatura para triagem e identificação precoce de anormalidades no desenvolvimento em crianças. FONTES DOS DADOS: Foi realizado um levantamento bibliográfico nas bases de dados no SciELO, plataforma CAPES, PubMed e Google Scholar, com os unitermos "prematuridade", "atraso no desenvolvimento", "paralisia cerebral", "diagnóstico precoce" e "testes de avaliação". SÍNTESE DOS DADOS: Foram listados 455 títulos, sendo selecionados para esta revisão 174 artigos com base em título, relevância temática e resumo. Apenas artigos originais, disponíveis em meio eletrônico, a partir de 1985, com informação sobre a construção, aplicabilidade e propriedades psicométricas dos testes foram usados. CONCLUSÕES: Os testes de triagem podem acelerar o início da intervenção precoce e facilitar o desenvolvimento futuro destas crianças. Vários instrumentos são utilizados para este fim, dentre eles destacam-se, nas pesquisas nacionais, o teste DENVER II e o Alberta Infant Motor Scale. O Movement Assessment of Infant também emerge como teste de triagem utilizado em nosso país. Além desses, dois outros testes são indicados na literatura mundial por sua alta sensibilidade e especificidade em idades precoces: Test of Infant Motor Performance e General Movements.OBJECTIVE:To review the literature regarding screening psychomotor tests for the early identification of developmental problems. SOURCES: A search on SciELO, PubMed and Google Scholar was performed using the terms "prematurity," "developmental delay," "cerebral palsy," "early diagnosis" and "evaluation tests." SUMMARY OF THE FINDINGS:A total of 455 references were listed, and 174 studies were selected for this review based on title, relevance, and abstract. Only original and electronically available material, from 1985 forward, with information on design, applicability, and psychometric

Neonatal mortality in Utah.

Science.gov (United States)

Woolley, F R; Schuman, K L; Lyon, J L

1982-09-01

A cohort study of neonatal mortality (N = 106) in white singleton births (N = 14,486) in Utah for January-June 1975 was conducted. Using membership and activity in the Church of Jesus Christ of Latter-day Saints (LDS or Mormon) as a proxy for parental health practices, i.e., tobacco and alcohol abstinence, differential neonatal mortality rates were calculated. The influence of potential confounding factors was evaluated. Low activity LDS members were found to have an excess risk of neonatal death five times greater than high activity LDS, with an upper bound of a two-sided 95% confidence interval of 7.9. The data consistently indicate a lower neonatal mortality rate for active LDS members. Non-LDS were found to have a lower rate than either medium or low activity LDS.

Predictors of positive blood culture and deaths among neonates with suspected neonatal sepsis in a tertiary hospital, Mwanza- Tanzania

Directory of Open Access Journals (Sweden)

Jeremiah Seni

2010-06-01

Full Text Available Abstract Background Neonatal sepsis is a significant cause of morbidity and mortality in neonates. Appropriate clinical diagnosis and empirical treatment in a given setting is crucial as pathogens of bacterial sepsis and antibiotic sensitivity pattern can considerably vary in different settings. This study was conducted at Bugando Medical Centre (BMC, Tanzania to determine the prevalence of neonatal sepsis, predictors of positive blood culture, deaths and antimicrobial susceptibility, thus providing essential information to formulate a policy for management of neonatal sepsis. Methods This was a prospective cross sectional study involving 300 neonates admitted at BMC neonatal unit between March and November 2009. Standard data collection form was used to collect all demographic data and clinical characteristics of neonates. Blood culture was done on Brain Heart Infusion broth followed by identification of isolates using conventional methods and testing for their susceptibility to antimicrobial agents using the disc diffusion method. Results Among 770 neonates admitted during the study period; 300 (38.9% neonates were diagnosed to have neonatal sepsis by WHO criteria. Of 300 neonates with clinical neonatal sepsis 121(40% and 179(60% had early and late onset sepsis respectively. Positive blood culture was found in 57 (47.1% and 92 (51.4% among neonates with early and late onset neonatal sepsis respectively (p = 0.466. Predictors of positive blood culture in both early and late onset neonatal sepsis were inability to feed, lethargy, cyanosis, meconium stained liquor, premature rupture of the membrane and convulsion. About 49% of gram negatives isolates were resistant to third generation cephalosporins and 28% of Staphylococcus aureus were found to be Methicillin resistant Staphylococcus aureus (MRSA. Deaths occurred in 57 (19% of neonates. Factors that predicted deaths were positive blood culture (p = 0.0001, gram negative sepsis (p = 0.0001 and

NEONATAL TOBACCO SYNDROME

Directory of Open Access Journals (Sweden)

R.A.Kireev

2008-12-01

Full Text Available The objective of the research is to study neonatal adaptation in new-born children from the tobacco abused mothers. A comparative analysis of clinical and neuroendochnal status and lipid metabolism in new-born children from smoking and non-smoking mothers was carried out Neonatal adaptation disorders were revealed in new-born children from the smoking mothers.

Pelayanan Kesehatan Ibu dan Kematian Neonatal

Directory of Open Access Journals (Sweden)

Desy Fitri Yani

2013-03-01

Full Text Available Indonesia bersama seluruh negara berkembang berupaya mencapai kesepakatan Millenium Development Goals (MDGs dengan salah satu sasaran menurunkan angka kematian neonatal dari 20 per 1.000 kelahiran hidup menjadi 15 per 1.000 kelahiran hidup. Penelitian ini bertujuan mengetahui hubungan pelayanan kesehatan ibu dengan kematian neonatal di Kabupaten Lampung Timur tahun 2011. Penelitian dengan desain studi kasus kontrol ini mengamati kasus ibu yang mengalami kematian neonatal dan kontrol ibu yang tidak mengalami kematian neonatal. Analisis multivariat menemukan pelayanan antenatal dan pertolongan persalinan berhubungan secara signifikan dengan kematian neonatal, setelah mengendalikan variabel umur ibu dan riwayat kehamilan (OR = 16,32; nilai p = 0,000; dan (OR = 18,36; nilai p = 0,31. Bayi yang dilahirkan dari Ibu dengan pelayanan antenatal tidak lengkap berisiko mengalami kematian neonatal 16,32 dan 18,36 kali lebih besar daripada bayi yang dilahirkan. Ibu dengan pelayanan antenatal lengkap dan penolong persalinan profesional. Tidak ada hubungan penolong persalinan dengan kematian neonatal, setelah mengontrol variabel pelayanan antenatal, umur ibu, riwayat kehamilan, riwayat penyakit, dan riwayat persalinan. Disarankan meningkatkan kualitas pelayanan antenatal dengan memerhatikan faktor umur ibu dan riwayat persalinan, mengembangkan kegiatan audit maternal perinatal serta meningkatkan keterampilan petugas penolong persalinan. All developing countries including Indonesia seek to reach agreement the Millennium Development Goals (MDG’s. It is objectives include reducing neonatal mortality by 25 percent from 20 per 1,000 live birth to 15 per 1,000 live births. This study aimed to determine the relationship of maternal health services with neonatal mortality in East Lampung District in 2011. This study used case control design to compare between the groups of mother whom have neonatal deaths (cases and neonatal life (control in East Lampung District in

Interpretation of neonatal chest radiography

International Nuclear Information System (INIS)

Yoon, Hye Kyung

2016-01-01

Plain radiographs for infants in the neonatal intensive care unit are obtained using the portable X-ray equipment in order to evaluate the neonatal lungs and also to check the position of the tubes and catheters used for monitoring critically-ill neonates. Neonatal respiratory distress is caused by a variety of medical or surgical disease conditions. Clinical information about the gestational week, respiratory symptoms, and any events during delivery is essential for interpretation of the neonatal chest radiographs. Awareness of common chest abnormality in the prematurely born or term babies is also very important for chest evaluation in the newborn. Furthermore, knowledge about complications such as air leaks and bronchopulmonary dysplasia following treatment are required to accurately inform the clinicians. The purpose of this article was to briefly review radiographic findings of chest diseases in newborns that are relatively common in daily practice

Interpretation of neonatal chest radiography

Energy Technology Data Exchange (ETDEWEB)

Yoon, Hye Kyung [Dept. of Radiology, Kangwon National University Hospital, Chuncheon (Korea, Republic of)

2016-05-15

Plain radiographs for infants in the neonatal intensive care unit are obtained using the portable X-ray equipment in order to evaluate the neonatal lungs and also to check the position of the tubes and catheters used for monitoring critically-ill neonates. Neonatal respiratory distress is caused by a variety of medical or surgical disease conditions. Clinical information about the gestational week, respiratory symptoms, and any events during delivery is essential for interpretation of the neonatal chest radiographs. Awareness of common chest abnormality in the prematurely born or term babies is also very important for chest evaluation in the newborn. Furthermore, knowledge about complications such as air leaks and bronchopulmonary dysplasia following treatment are required to accurately inform the clinicians. The purpose of this article was to briefly review radiographic findings of chest diseases in newborns that are relatively common in daily practice.

Radiation doses and risks to neonates undergoing common radiographic examinations in the neonatal intensive care unit

International Nuclear Information System (INIS)

McParland, B.J.; Lee, R.

1996-01-01

Neonates in the-Neonatal Intensive Care Unit (NICU) can receive large numbers of radiographs owing to the clinical conditions they may present. More neonatal radiation dosimetry data are required for three fundamental reasons: (1.) to aid in the establishment of reference dose levels for interinstitutional comparisons; (2.) to improve childhood cancer risk estimates following neonatal exposure; and (3.) to indicate appropriate directions for dose reduction. This paper describes an investigation of two different NICU radiological techniques with significantly different neonate doses. While patient-matched images taken with both techniques were assessed in a blind review, this component of the study is beyond the scope of this paper and is not discussed here. (author)

Videovigilância inteligente em ambientes aquáticos : detecção precoce de afogamento em piscinas domésticas

OpenAIRE

Peixoto, Nuno Pedro Rodrigues

2010-01-01

Tese de doutoramento (área de Informática Industrial) Neste documento, apresenta-se um conjunto de trabalhos relativos à utilização de videovigilância inteligente para a análise de comportamentos humanos em ambientes aquáticos, orientado à detecção precoce de afogamento em piscinas domésticas. Recorrendo a imagens de vídeo capturadas com uma câmara comum de videovigilância e um computador pessoal para efectuar todas as análises necessárias ao reconhecimento de pessoas e à infer...

RISK FACTORS IN NEONATAL ANAEROBIC INFECTIONS

Directory of Open Access Journals (Sweden)

M. S. Tabib

2008-06-01

Full Text Available Anaerobic bacteria are well known causes of sepsis in adults but there are few studies regarding their role in neonatal sepsis. In an attempt to define the incidence of neonatal anaerobic infections a prospective study was performed during one year period. A total number of 400 neonates under sepsis study were entered this investigation. Anaerobic as well as aerobic cultures were sent. The patients were subjected to comparison in two groups: anaerobic culture positive and anaerobic culture negative and this comparison were analyzed statistically. There were 7 neonates with positive anaerobic culture and 35 neonates with positive aerobic culture. A significant statistical relationship was found between anaerobic infections and abdominal distention and pneumonia. It is recommended for those neonates with abdominal distention and pneumonia refractory to antibiotic treatment to be started on antibiotics with anaerobic coverage.

Triagem neonatal para hemoglobinopatias no Rio de Janeiro, Brasil Neonatal screening for hemoglobinopathies in Rio de Janeiro, Brazil

Directory of Open Access Journals (Sweden)

Clarisse Lopes de Castro Lobo

2003-03-01

Full Text Available OBJETIVO: Descrever os principais resultados do programa de triagem neonatal para a doença falciforme do Estado do Rio de Janeiro em 15 meses de funcionamento (agosto de 2000 a novembro de 2001. MÉTODOS: A partir de agosto de 2000, amostras de sangue passaram a ser coletadas de todos os recém-nascidos atendidos em postos de atenção básica à saúde no Estado para triagem neonatal da doença falciforme. Essas amostras são submetidas a cromatografia líquida de alta resolução. Se o cromatograma resultante for compatível com a doença falciforme, a criança e seus pais são encaminhados para confirmação diagnóstica e tratamento. RESULTADOS: De agosto de 2000 a novembro de 2001, 99 260 recém nascidos participaram da triagem. Houve um caso de homozigose para Hb C. Um em cada 27 recém-nascidos triados pelo programa apresentou o traço falciforme (Hb AS. A doença falciforme foi constatada em 83 casos (um caso novo para cada 1 196 nascimentos: 62 Hb S, 18 Hb SC, 3 Hb SD. Uma criança não compareceu para confirmação diagnóstica. As 82 crianças acompanhadas apresentaram 15 intercorrências (infecções de vias aéreas superiores, febre, seqüestro esplênico, síndrome mão-pé e crises de vaso-oclusão, motivando sete internações. Houve necessidade de transfusão sangüínea em 15 crianças, mas nenhuma tornou-se alo-imunizada. Os demais bebês estão evoluindo satisfatoriamente com o uso de penicilina profilática. CONCLUSÕES: Nossos dados evidenciam a importância do diagnóstico precoce da doença falciforme, de forma a prevenir e evitar as freqüentes complicações infecciosas enfrentadas por esses pacientes.OBJECTIVE: To describe the main results obtained in the first 15 months of neonatal screening for sickle cell disease in the state of Rio de Janeiro, Brazil, from August 2000 to November 2001. METHODS: Starting in August 2000, blood samples began to be collected for sickle cell disease screening from all newborns

Determinants of neonatal mortality in Indonesia.

Science.gov (United States)

Titaley, Christiana R; Dibley, Michael J; Agho, Kingsley; Roberts, Christine L; Hall, John

2008-07-09

Neonatal mortality accounts for almost 40 per cent of under-five child mortality, globally. An understanding of the factors related to neonatal mortality is important to guide the development of focused and evidence-based health interventions to prevent neonatal deaths. This study aimed to identify the determinants of neonatal mortality in Indonesia, for a nationally representative sample of births from 1997 to 2002. The data source for the analysis was the 2002-2003 Indonesia Demographic and Health Survey from which survival information of 15,952 singleton live-born infants born between 1997 and 2002 was examined. Multilevel logistic regression using a hierarchical approach was performed to analyze the factors associated with neonatal deaths, using community, socio-economic status and proximate determinants. At the community level, the odds of neonatal death was significantly higher for infants from East Java (OR = 5.01, p = 0.00), and for North, Central and Southeast Sulawesi and Gorontalo combined (OR = 3.17, p = 0.03) compared to the lowest neonatal mortality regions of Bali, South Sulawesi and Jambi provinces. A progressive reduction in the odds was found as the percentage of deliveries assisted by trained delivery attendants in the cluster increased. The odds of neonatal death were higher for infants born to both mother and father who were employed (OR = 1.84, p = 0.00) and for infants born to father who were unemployed (OR = 2.99, p = 0.02). The odds were also higher for higher rank infants with a short birth interval (OR = 2.82, p = 0.00), male infants (OR = 1.49, p = 0.01), smaller than average-sized infants (OR = 2.80, p = 0.00), and infant's whose mother had a history of delivery complications (OR = 1.81, p = 0.00). Infants receiving any postnatal care were significantly protected from neonatal death (OR = 0.63, p = 0.03). Public health interventions directed at reducing neonatal death should address community, household and individual level factors

NEONATAL CONJUNCTIVITIS AND ITS DRUG SENSITIVITY PATTERN

Directory of Open Access Journals (Sweden)

Kavitha Thulukkanam

2017-05-01

Full Text Available BACKGROUND Neonatal conjunctivitis is eye discharge in neonates and it is a common infection in neonates in the first month of life. Worldwide, the incidence of neonatal conjunctivitis varies from 1% to 33% depending on the socioeconomic status of the people in the region. In India, the incidence varies from region to region from 0.9 to 35%. MATERIALS AND METHODS Single center prospective study. All neonates of age 0-30 days delivered and referred from neonatal ward of Chengalpattu Medical College and Hospital with complaints of eye swelling, redness, conjunctival discharge to the eye department for treatment are included in the study. RESULTS In this study, age group from 0-7 days were most commonly affected by neonatal conjunctivitis. Both eyes were commonly affected together. Neonates born by both LSCS and normal vaginal delivery were almost equally affected. The most common organism found in culture and Gram staining was staphylococci. CONCLUSION Neonatal conjunctivitis is more likely to be acquired postnatally. It acquires during the 1 st week and responds well to local application of antibiotics, which covers common causative bacteria.

Neonatal tetanus mortality in coastal Kenya

DEFF Research Database (Denmark)

Bjerregaard, P; Steinglass, R; Mutie, D M

1993-01-01

In a house-to-house survey in Kilifi District, Kenya, mothers of 2556 liveborn children were interviewed about neonatal mortality, especially from neonatal tetanus (NNT). The crude birth rate was 60.5 per 1000 population, the neonatal mortality rate 21.1 and the NNT mortality rate 3.1 per 1000 li...... indicates that over the past decade the surveyed area has greatly reduced neonatal and NNT mortality. Possible strategies for accelerated NNT control have been identified by the survey....

Specialist teams for neonatal transport to neonatal intensive care units for prevention of morbidity and mortality.

Science.gov (United States)

Chang, Alvin S M; Berry, Andrew; Jones, Lisa J; Sivasangari, Subramaniam

2015-10-28

Maternal antenatal transfers provide better neonatal outcomes. However, there will inevitably be some infants who require acute transport to a neonatal intensive care unit (NICU). Because of this, many institutions develop services to provide neonatal transport by specially trained health personnel. However, few studies report on relevant clinical outcomes in infants requiring transport to NICU. To determine the effects of specialist transport teams compared with non-specialist transport teams on the risk of neonatal mortality and morbidity among high-risk newborn infants requiring transport to neonatal intensive care. We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2015, Issue 7), MEDLINE (1966 to 31 July 2015), EMBASE (1980 to 31 July 2015), CINAHL (1982 to 31 July 2015), conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. randomised, quasi-randomised or cluster randomised controlled trials. neonates requiring transport to a neonatal intensive care unit. transport by a specialist team compared to a non-specialist team. any of the following outcomes - death; adverse events during transport leading to respiratory compromise; and condition on admission to the neonatal intensive care unit. The methodological quality of the trials was assessed using the information provided in the studies and by personal communication with the author. Data on relevant outcomes were extracted and the effect size estimated and reported as risk ratio (RR), risk difference (RD), number needed to treat for an additional beneficial outcome (NNTB) or number needed to treat for an additional harmful outcome (NNTH) and mean difference (MD) for continuous outcomes. Data from cluster randomised trials were not combined for analysis. One trial met the inclusion criteria of this review but was considered ineligible owing to

Correction of Neonatal Hypovolemia

Directory of Open Access Journals (Sweden)

V. V. Moskalev

2007-01-01

Full Text Available Objective: to evaluate the efficiency of hydroxyethyl starch solution (6% refortane, Berlin-Chemie versus fresh frozen plasma used to correct neonatal hypovolemia.Materials and methods. In 12 neonatal infants with hypoco-agulation, hypovolemia was corrected with fresh frozen plasma (10 ml/kg body weight. In 13 neonates, it was corrected with 6% refortane infusion in a dose of 10 ml/kg. Doppler echocardiography was used to study central hemodynamic parameters and Doppler study was employed to examine regional blood flow in the anterior cerebral and renal arteries.Results. Infusion of 6% refortane and fresh frozen plasma at a rate of 10 ml/hour during an hour was found to normalize the parameters of central hemodynamics and regional blood flow.Conclusion. Comparative analysis of the findings suggests that 6% refortane is the drug of choice in correcting neonatal hypovolemia. Fresh frozen plasma should be infused in hemostatic disorders. 

Phototherapy and exchange transfusion for neonatal ...

African Journals Online (AJOL)

The purpose of this document is to address the current lack of consensus regarding the management of hyperbilirubinaemia in neonates in South Africa. If left untreated, severe neonatal hyperbilirubinaemia may cause kernicterus and ultimately death and the severity of neonatal jaundice is often underestimated clinically.

Role of massage therapy on reduction of neonatal hyperbilirubinemia in term and preterm neonates: a review of clinical trials.

Science.gov (United States)

Garg, Bhawan Deep; Kabra, Nandkishor S; Balasubramanian, Haribalakrishna

2017-09-13

Neonatal hyperbilirubinemia (NNH) is one of the leading causes of admissions in nursery throughout the world. It affects approximately 2.4-15% of neonates during the first 2 weeks of life. To evaluate the role of massage therapy for reduction of NNH in both term and preterm neonates. The literature search was done for various randomized control trials (RCTs) by searching the Cochrane Library, PubMed, and EMBASE. This review included total of 10 RCTs (two in preterm neonates and eight in term neonates) that fulfilled inclusion criteria. In most of the trials, Field massage was given. Six out of eight trials reported reduction in bilirubin levels in term neonates. However, only one trial (out of two) reported significant reduction in bilirubin levels in preterm neonates. Both trials in preterm neonates and most of the trials in term neonates (five trials) reported increased stool frequencies. Role of massage therapy in the management of NNH is supported by the current evidence. However, due to limitations of the trials, current evidences are not sufficient to use massage therapy for the management of NNH in routine practice.

Opinions regarding neonatal resuscitation training for the obstetric physician: a survey of neonatal and obstetric training program directors.

Science.gov (United States)

Bruno, C J; Johnston, L; Lee, C; Bernstein, P S; Goffman, D

2018-04-01

Our goal was to garner opinions regarding neonatal resuscitation training for obstetric physicians. We sought to evaluate obstacles to neonatal resuscitation training for obstetric physicians and possible solutions for implementation challenges. We distributed a national survey via email to all neonatal-perinatal medicine fellowship directors and obstetrics & gynecology residency program directors in the United States. This survey was designed by a consensus method. Ninety-eight (53%) obstetric and fifty-seven (51%) neonatal program directors responded to our surveys. Eighty-eight percent of neonatologists surveyed believe that obstetricians should be neonatal resuscitation program (NRP) certified. The majority of surveyed obstetricians (>89%) believe that obstetricians should have some neonatal resuscitation training. Eighty-six percent of obstetric residents have completed training in NRP, but only 19% of obstetric attendings are NRP certified. Major barriers to NRP training that were identified include time, lack of national requirement, lack of belief it is helpful, and cost. Most obstetric attendings are not NRP certified, but the majority of respondents believe that obstetric providers should have some neonatal resuscitation training. Our study demonstrates that most respondents support a modified neonatal resuscitation course for obstetric physicians.

The effect of high risk pregnancy on duration of neonatal stay in neonatal intensive care unit.

Science.gov (United States)

Afrasiabi, Narges; Mohagheghi, Parisa; Kalani, Majid; Mohades, Gholam; Farahani, Zahra

2014-08-01

High risk pregnancies increase the risk of neonatal mortality and morbidity. In order to identify the influence of pregnancy complications on the period of neonatal stay in Neonatal Intensive Care Units (NICUs), an analysis has been carried out in our center. In a cross-sectional-descriptive analytical study, the data including NICU length of stay was gathered from 526 medical records of neonates. We also assessed their maternal complications such as premature rapture of membranes (PROM), urinary tract infection (UTI), preeclampsia, oligohydramnios, and twin/triplet pregnancy. Finally we analyzed the relation between variables by SPSS statistics software version 19. The level of significance was considered PUTI (P=0.02), multiple gestation (P=0.03), and oligohydramnios (P=0.003). We found a positive correlation between numbers of gestation and length of NICU stay (P=0.03). A positive correlation existed between neonatal complication and length of NICU stay (P<0.001). By increasing maternal health level and prenatal care services, neonatal outcome can be improved and length of stay in NICUs decreased.

The prevalence of neonatal jaundice and risk factors in healthy term neonates at National District Hospital in Bloemfontein

Science.gov (United States)

2018-01-01

Background Neonatal jaundice affects one in two infants globally. The jaundice is the result of an accumulation of bilirubin as foetal haemoglobin is metabolised by the immature liver. High serum levels of bilirubin result in lethargy, poor feeding and kernicterus of the infant. Aim The main aim of this article was to determine the prevalence of neonatal jaundice and secondly to explore its risk factors in healthy term neonates. Setting Maternity ward, National District Hospital, Bloemfontein, South Africa. Methods In this cross-sectional study, mothers and infants were conveniently sampled after delivery and before discharge. The mothers were interviewed and their case records were reviewed for risk factors for neonatal jaundice and the clinical appearance and bilirubin levels of the infants were measured with a non-invasive transcutaneous bilirubin meter. Results A total of 96 mother-infant pairs were included in the study. The prevalence of neonatal jaundice was 55.2%; however, only 10% of black babies who were diagnosed with jaundice appeared clinically jaundiced. Normal vaginal delivery was the only risk factor associated with neonatal jaundice. Black race and maternal smoking were not protective against neonatal jaundice as in some other studies. Conclusion More than half (55.2%) of healthy term neonates developed neonatal jaundice. As it is difficult to clinically diagnose neonatal jaundice in darker pigmented babies, it is recommended that the bilirubin level of all babies should be checked with a non-invasive bilirubin meter before discharge from hospital or maternity unit as well as during the first clinic visit on day 3 after birth.

Bartter syndrome: presentation in an extremely premature neonate.

Science.gov (United States)

Flores, F X; Ojeda, F J; Calhoun, D A

2013-08-01

Reports of Bartter syndrome in premature neonates are rare. We describe the presentation and clinical course of a neonate born at 25.6 weeks estimated gestational age with polyuria, hyponatremia, hypokalemia and hypercalciuria ,who was diagnosed with neonatal Bartter syndrome. The evaluation, diagnosis and management of neonatal Bartter syndrome in this premature neonate are discussed.

Neonates with reduced neonatal lung function have systemic low-grade inflammation

DEFF Research Database (Denmark)

Chawes, Bo L.K.; Stokholm, Jakob; Bønnelykke, Klaus

2015-01-01

Background: Children and adults with asthma and impaired lung function have been reported to have low-grade systemic inflammation, but it is unknown whether this inflammation starts before symptoms and in particular whether low-grade inflammation is present in asymptomatic neonates with reduced...... lung function. ObjectiveWe sought to investigate the possible association between neonatal lung function and biomarkers of systemic inflammation.  Methods: Plasma levels of high-sensitivity C-reactive protein (hs-CRP), IL-1β, IL-6, TNF-α, and CXCL8 (IL-8) were measured at age 6 months in 300 children.......  Results: The neonatal forced expiratory volume at 0.5 seconds was inversely associated with hs-CRP (β-coefficient, −0.12; 95% CI, −0.21 to −0.04; P approach, including hs-CRP, IL-6...

Analysis of In-hospital Neonatal Death in the Tertiary Neonatal Intensive Care Unit in China: A Multicenter Retrospective Study

Institute of Scientific and Technical Information of China (English)

Chen-Hong Wang; Li-Zhong Du; Xiao-Lu Ma; Li-Ping Shi; Xiao-Mei Tong; Hong Liu; Guo-Fang Ding

2016-01-01

Background:Globally,the proportion of child deaths that occur in the neonatal period remains a high level of 37-41％.Differences of cause in neonate death exist in different regions as well as in different economic development countries.The specific aim of this study was to investigate the causes,characteristics,and differences of death in neonates during hospitalization in the tertiary Neonatal Intensive Care Unit (NICU) of China.Methods:All the dead neonates admitted to 26 NICUs were included between January 1,2011,and December 31,2011.All the data were collected retrospectively from clinical records by a designed questionnaire.Data collected from each NICU were delivered to the leading institution where the results were analyzed.Results:A total of 744 newborns died during the l-year survey,accounting for 1.2％ of all the neonates admitted to 26 NICUs and 37.6％ of all the deaths in children under 5 years of age in these hospitals.Preterm neonate death accounted for 59.3％ of all the death.The leading causes of death in preterm and term infants were pulmonary disease and infection,respectively.In early neonate period,pulmonary diseases (56.5％) occupied the largest proportion ofpreterm deaths while infection (27％) and neurologic diseases (22％) were the two main causes of term deaths.In late neonate period,infection was the leading cause of both preterm and term neonate deaths.About two-thirds of neonate death occurred after medical care withdrawal.Of the cases who might survive if receiving continuing treatment,parents' concern about the long-term outcomes was the main reason of medical care withdrawal.Conclusions:Neonate death still accounts for a high proportion of all the deaths in children under 5 years of age.Our study showed the majority of neonate death occurred in preterm infants.Cause of death varied with the age of death and gestational age.Accurate and prompt evaluation of the long-term outcomes should be carried out to guide the critical

Determinants of neonatal mortality in Indonesia

Directory of Open Access Journals (Sweden)

Agho Kingsley

2008-07-01

Full Text Available Abstract Background Neonatal mortality accounts for almost 40 per cent of under-five child mortality, globally. An understanding of the factors related to neonatal mortality is important to guide the development of focused and evidence-based health interventions to prevent neonatal deaths. This study aimed to identify the determinants of neonatal mortality in Indonesia, for a nationally representative sample of births from 1997 to 2002. Methods The data source for the analysis was the 2002–2003 Indonesia Demographic and Health Survey from which survival information of 15,952 singleton live-born infants born between 1997 and 2002 was examined. Multilevel logistic regression using a hierarchical approach was performed to analyze the factors associated with neonatal deaths, using community, socio-economic status and proximate determinants. Results At the community level, the odds of neonatal death was significantly higher for infants from East Java (OR = 5.01, p = 0.00, and for North, Central and Southeast Sulawesi and Gorontalo combined (OR = 3.17, p = 0.03 compared to the lowest neonatal mortality regions of Bali, South Sulawesi and Jambi provinces. A progressive reduction in the odds was found as the percentage of deliveries assisted by trained delivery attendants in the cluster increased. The odds of neonatal death were higher for infants born to both mother and father who were employed (OR = 1.84, p = 0.00 and for infants born to father who were unemployed (OR = 2.99, p = 0.02. The odds were also higher for higher rank infants with a short birth interval (OR = 2.82, p = 0.00, male infants (OR = 1.49, p = 0.01, smaller than average-sized infants (OR = 2.80, p = 0.00, and infant's whose mother had a history of delivery complications (OR = 1.81, p = 0.00. Infants receiving any postnatal care were significantly protected from neonatal death (OR = 0.63, p = 0.03. Conclusion Public health interventions directed at reducing neonatal death should

The challenges of neonatal magnetic resonance imaging

International Nuclear Information System (INIS)

Arthurs, Owen J.; Graves, Martin J.; Lomas, David J.; Edwards, Andrea; Austin, Topun

2012-01-01

Improved neonatal survival rates and antenatal diagnostic imaging is generating a growing demand for postnatal MRI examinations. Neonatal brain MRI is now becoming standard clinical care in many settings, but with the exception of some research centres, the technique has not been optimised for imaging neonates and small children. Here, we review some of the challenges involved in neonatal MRI, including recent advances in overall MR practicality and nursing practice, to address some of the ways in which the MR experience could be made more neonate-friendly. (orig.)

Susceptibility weighted imaging of the neonatal brain

International Nuclear Information System (INIS)

Meoded, A.; Poretti, A.; Northington, F.J.; Tekes, A.; Intrapiromkul, J.; Huisman, T.A.G.M.

2012-01-01

Susceptibility weighted imaging (SWI) is a well-established magnetic resonance technique, which is highly sensitive for blood, iron, and calcium depositions in the brain and has been implemented in the routine clinical use in both children and neonates. SWI in neonates might provide valuable additional diagnostic and prognostic information for a wide spectrum of neonatal neurological disorders. To date, there are few articles available on the application of SWI in neonatal neurological disorders. The purpose of this article is to illustrate and describe the characteristic SWI findings in various typical neonatal neurological disorders.

Susceptibility weighted imaging of the neonatal brain

Energy Technology Data Exchange (ETDEWEB)

Meoded, A.; Poretti, A. [Division of Pediatric Radiology and Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD (United States); Northington, F.J. [Division of Neonatology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD (United States); Tekes, A.; Intrapiromkul, J. [Division of Pediatric Radiology and Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD (United States); Huisman, T.A.G.M., E-mail: thuisma1@jhmi.edu [Division of Pediatric Radiology and Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD (United States)

2012-08-15

Susceptibility weighted imaging (SWI) is a well-established magnetic resonance technique, which is highly sensitive for blood, iron, and calcium depositions in the brain and has been implemented in the routine clinical use in both children and neonates. SWI in neonates might provide valuable additional diagnostic and prognostic information for a wide spectrum of neonatal neurological disorders. To date, there are few articles available on the application of SWI in neonatal neurological disorders. The purpose of this article is to illustrate and describe the characteristic SWI findings in various typical neonatal neurological disorders.

Ictericia Neonatal

OpenAIRE

Blanco de la Fuente, María Isabel

2014-01-01

El motivo que ha llevado a la realización de este trabajo fin de grado sobre el tema de la ICTERICIA NEONATAL se debe a la elevada frecuencia de su aparición en la población. Un porcentaje elevado de RN la padecen al nacer siendo, en la mayor parte de los casos, un proceso fisiológico resuelto con facilidad debido a una inmadurez del sistema hepático y a una hiperproducción de bilirrubina. La ictericia neonatal es la pigmentación de color amarillo de la piel y mucosas en ...

INCIDÊNCIA E IMPORTÂNCIA DO DIAGNÓSTICO PRECOCE DE MELANOMA NO BRASIL

Directory of Open Access Journals (Sweden)

Matheus Violato Guidetti

2016-10-01

Full Text Available Embora o câncer de pele seja o mais frequente no Brasil e corresponda a 25% de todos os tumores malignos registrados no País, o melanoma representa apenas 4% das neoplasias malignas do órgão, porém é o tipo mais grave devido à sua alta possibilidade de metástase. Após uma comparação dos diversos estudos presentes nessa revisão, percebe–se determinada padronização no desenvolvimento da doença quanto ao sexo, idade, etnia e localização da lesão. No Brasil, essa neoplasia cresce anualmente e os fatores são diversos, como a pré-disposição genética e os maus cuidados com a pele, por isso, é fundamental trabalhar a conscientização sobre o risco dessa doença. Ademais, a incidência e prevalência do melanoma cutâneo carece de maior atenção das políticas públicas, pois o diagnóstico precoce é a chave-mestra para uma maior eficácia no tratamento.

Laser Photoradiation Therapy For Neonatal Jaundice

Science.gov (United States)

Hamza, Mostafa; Hamza, Mohammad

1987-04-01

This paper describes our leading experience in the clinical application of laser in the treatment of neonatal jaundice. Currently, the irradiation of jaundiced infants during neonatal life to fluorescent light is the most common treatment of neonatal hyperbilirubinemia. The authors have investigated the photodegradation of bilirubin by laser in vitro and in Gunn rats before embarking on its clinical application in the treatment of jaundice in the new born child. This work was done to study the theraputic effect of laser compared to the currently used phototherapy in the treatment of neonatal jaundice. We selected 16 full term neonates with jaundice to be the subject of this study. The neonates of the study were devided into two groups. The first group was treated with continuous phototherapy . The second group recieved photoradiation therapy with gas laser The laser used was a CW argon-ion laser tuned to oscillate at 488.0 nm wavelength. This wavelength selection was based on our previous studies on the effect of laser irradiation of Gunn rats at different wavelengths. Comparison of the results of both methods of treatment will be reported in detail. The advantages and limitations of laser photoradiation therapy for neonatal jaundice will be discussed.

Intervenção precoce em escolares de risco para a dislexia: revisão da literatura Early intervention in students at risk for dyslexia: literature review

Directory of Open Access Journals (Sweden)

Maíra Anelli Martins

2011-08-01

Full Text Available TEMA: intervenção precoce em escolares de risco para a dislexia. OBJETIVO: este estudo tem por objetivo geral mapear os artigos publicados sobre intervenção com escolares de risco para dislexia e, como objetivos específicos, analisar descritivamente aspectos específicos dos textos. CONCLUSÃO: as publicações na área em relação ao tema não são constantes, porém, os artigos científicos analisados evidenciam a preocupação dos pesquisadores em elaborar, desenvolver e validar instrumentos de avaliações e intervenções que contribuam para a identificação precoce da dislexia.BACKGROUND: early intervention in students at risk for dyslexia. PURPOSE: this study aims to map the general articles on intervention with students at risk for dyslexia and specific objectives, descriptively analyzing specific text aspects. CONCLUSION: there are few published data on this issue; however, the reviewed scientific articles highlight the concern of the researchers to elaborate, develop and validate assessments and interventions that contribute to the early identification of dyslexia.

MRI of neonatal encephalopathy

International Nuclear Information System (INIS)

Khong, P.L.; Lam, B.C.C.; Tung, H.K.S.; Wong, V.; Chan, F.L.; Ooi, G.C.

2003-01-01

We present the magnetic resonance imaging (MRI) findings in neonatal encephalopathy, including hypoxic-ischaemic encephalopathy, perinatal/neonatal stroke, metabolic encephalopathy from inborn errors of metabolism, congenital central nervous system infections and birth trauma. The applications of advanced MRI techniques, such as diffusion-weighted imaging and magnetic resonance spectroscopy are emphasized

Neonatal resuscitation: advances in training and practice

Directory of Open Access Journals (Sweden)

Sawyer T

2016-12-01

Full Text Available Taylor Sawyer, Rachel A Umoren, Megan M Gray Department of Pediatrics, Division of Neonatology, Neonatal Education and Simulation-based Training (NEST Program, University of Washington School of Medicine, Seattle, WA, USA Abstract: Each year in the US, some four hundred thousand newborns need help breathing when they are born. Due to the frequent need for resuscitation at birth, it is vital to have evidence-based care guidelines and to provide effective neonatal resuscitation training. Every five years, the International Liaison Committee on Resuscitation (ILCOR reviews the science of neonatal resuscitation. In the US, the American Heart Association (AHA develops treatment guidelines based on the ILCOR science review, and the Neonatal Resuscitation Program (NRP translates the AHA guidelines into an educational curriculum. In this report, we review recent advances in neonatal resuscitation training and practice. We begin with a review of the new 7th edition NRP training curriculum. Then, we examine key changes to the 2015 AHA neonatal resuscitation guidelines. The four components of the NRP curriculum reviewed here include eSim®, Performance Skills Stations, Integrated Skills Station, and Simulation and Debriefing. The key changes to the AHA neonatal resuscitation guidelines reviewed include initial steps of newborn care, positive-pressure ventilation, endotracheal intubation and use of laryngeal mask, chest compressions, medications, resuscitation of preterm newborns, and ethics and end-of-life care. We hope this report provides a succinct review of recent advances in neonatal resuscitation. Keywords: neonatal resuscitation, Neonatal Resuscitation Program, NRP, simulation, deliberate practice, debriefing, eSIM

Acute symptomatic neonatal seizures in preterm neonates: etiologies and treatments.

Science.gov (United States)

Pisani, Francesco; Spagnoli, Carlotta

2017-12-15

Acute symptomatic neonatal seizures in preterm newborns are a relevant clinical challenge due to the presence of many knowledge gaps. Etiology-wise, acute symptomatic seizures have an age-specific epidemiology, with intraventricular hemorrhage and its complications representing the first cause in extremely and very preterm neonates, whereas other etiologies have similar occurrence rates as in full-term infants. Specific treatment strategies for the premature neonates are not yet available. Studies suggest a similarly low response rate with even more unfavorable prognosis than in full-term infants. Pharmacodynamic and pharmacokinetic changes are likely under way during the preterm period, with the potential to affect both effectiveness and safety of antiepileptic drugs in these patients. However, due to the lack of clear evidence to guide prioritization of second-line drugs, off-label medications are frequently indicated by review papers and flow-charts, and are prescribed in clinical practice. We therefore conclude by exploring potential future lines of research. Copyright © 2017 Elsevier Ltd. All rights reserved.

Procedural pain in neonatal units in Kenya.

Science.gov (United States)

Kyololo, O'Brien Munyao; Stevens, Bonnie; Gastaldo, Denise; Gisore, Peter

2014-11-01

To determine the nature and frequency of painful procedures and procedural pain management practices in neonatal units in Kenya. Cross-sectional survey. Level I and level II neonatal units in Kenya. Ninety-five term and preterm neonates from seven neonatal units. Medical records of neonates admitted for at least 24 h were reviewed to determine the nature and frequency of painful procedures performed in the 24 h period preceding data collection (6:00 to 6:00) as well as the pain management interventions (eg, morphine, breastfeeding, skin-to-skin contact, containment, non-nutritive sucking) that accompanied each procedure. Neonates experienced a total of 404 painful procedures over a 24 h period (mean=4.3, SD 2.0; range 1-12); 270 tissue-damaging (mean=2.85, SD 1.1; range 1-6) and 134 non-tissue-damaging procedures (mean=1.41, SD 1.2; range 0-6). Peripheral cannula insertion (27%) and intramuscular injections (22%) were the most common painful procedures. Ventilated neonates and neonates admitted in level II neonatal units had a higher number of painful procedures than those admitted in level I units (mean 4.76 vs 2.96). Only one procedure had a pain intensity score documented; and none had been performed with any form of analgesia. Neonates in Kenya were exposed to numerous tissue-damaging and non-tissue-damaging procedures without any form of analgesia. Our findings suggest that education is needed on how to assess and manage procedural pain in neonatal units in Kenya. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Análise da qualidade de vida após a alta hospitalar em sobreviventes de sepse grave e choque séptico Analysis of quality of life following hospital discharge among survivors of severe sepsis and septic shock

Directory of Open Access Journals (Sweden)

Glauco Adrieno Westphal

2012-06-01

Full Text Available OBJETIVO: Descrever a repercussão da sepse grave e do choque séptico sobre a qualidade de vida após a alta hospitalar. MÉTODOS: Estudo controlado realizado em dois hospitais gerais de Joinville, Santa Catarina, Brasil, envolvendo pacientes internados com sepse grave ou choque séptico no período de agosto de 2005 a novembro de 2007. Os pacientes foram contatados por telefone entre junho e novembro de 2009. Os sobreviventes responderam ao Short Form-36, um questionário de qualidade de vida, dois anos após a alta. O questionário também foi respondido por um grupo controle composto de pessoas que habitavam o mesmo domicílio dos sobreviventes, sem internação recente e com idade mais próxima possível à do paciente. RESULTADOS: De 217 pacientes com sepse grave ou choque séptico, 112 (51,6% sobreviveram à internação. A sobrevida pós-alta hospitalar foi de 41,02% em 180 dias, 37,4% após um ano, 34¡3% em 18 meses e 32,3% em dois anos. Trinta e seis sobreviventes responderam ao Short Form-36. Houve comprometimento da qualidade de vida dos sobreviventes (No. = 36 em relação ao grupo controle (No. = 36 nos domínios: capacidade funcional (59 ± 32 versus 91 ± 18; P OBJECTIVE: Describe the impact of severe sepsis and septic shock on patients' quality of life following hospital discharge. METHODS: A controlled study conducted in two general hospitals of Joinville, Santa Catarina, Brazil, of in-patients with severe sepsis or septic shock during the period of August 2005 through November 2007. The patients were contacted by telephone between June and November 2009. The study group responded to Short Form-36, a questionnaire on the quality of life, two years after being discharged from hospital. The questionnaire was also answered by a control group composed of people who lived at the same residence as the study subjects, had no recent hospitalization, and were close in age. Results: Of 217 patients with severe sepsis or septic shock

The value of neonatal autopsy.

LENUS (Irish Health Repository)

Hickey, Leah

2012-01-01

Neonatal autopsy rates were in decline internationally at the end of the last century. Our objective was to assess the current value of neonatal autopsy in providing additional information to families and healthcare professionals.

Bupivacaine versus lidocaine analgesia for neonatal circumcision

OpenAIRE

Stolik-Dollberg, Orit C; Dollberg, Shaul

2005-01-01

Abstract Background Analgesia for neonatal circumcision was recently advocated for every male infant, and its use is considered essential by the American Academy of Pediatrics. We compared the post-operative analgesic quality of bupivacaine to that of lidocaine for achieving dorsal penile nerve block (DPNB) when performing neonatal circumcision. Methods Data were obtained from 38 neonates following neonatal circumcision. The infants had received DPNB analgesia with either lidocaine or bupivac...

Parents' experiences with neonatal home care following initial care in the neonatal intensive care unit: a phenomenological hermeneutical interview study.

Science.gov (United States)

Dellenmark-Blom, Michaela; Wigert, Helena

2014-03-01

A descriptive study of parents' experiences with neonatal home care following initial care in the neonatal intensive care unit. As survival rates improve among premature and critically ill infants with an increased risk of morbidity, parents' responsibilities for neonatal care grow in scope and degree under the banner of family-centred care. Concurrent with medical advances, new questions arise about the role of parents and the experience of being provided neonatal care at home. An interview study with a phenomenological hermeneutic approach. Parents from a Swedish neonatal (n = 22) home care setting were extensively interviewed within one year of discharge. Data were collected during 2011-2012. The main theme of the findings is that parents experience neonatal home care as an inner emotional journey, from having a child to being a parent. This finding derives from three themes: the parents' experience of leaving the hospital milieu in favour of establishing independent parenthood, maturing as a parent and processing experiences during the period of neonatal intensive care. This study suggests that neonatal home care is experienced as a care structure adjusted to incorporate parents' needs following discharge from a neonatal intensive care unit. Neonatal home care appears to bridge the gap between hospital and home, supporting the family's adaptation to life in the home setting. Parents become empowered to be primary caregivers, having nurse consultants serving the needs of the whole family. Neonatal home care may therefore be understood as the implementation of family-centred care during the transition from NICU to home. © 2013 John Wiley & Sons Ltd.

An agent based architecture for high-risk neonate management at neonatal intensive care unit.

Science.gov (United States)

Malak, Jaleh Shoshtarian; Safdari, Reza; Zeraati, Hojjat; Nayeri, Fatemeh Sadat; Mohammadzadeh, Niloofar; Farajollah, Seide Sedighe Seied

2018-01-01

In recent years, the use of new tools and technologies has decreased the neonatal mortality rate. Despite the positive effect of using these technologies, the decisions are complex and uncertain in critical conditions when the neonate is preterm or has a low birth weight or malformations. There is a need to automate the high-risk neonate management process by creating real-time and more precise decision support tools. To create a collaborative and real-time environment to manage neonates with critical conditions at the NICU (Neonatal Intensive Care Unit) and to overcome high-risk neonate management weaknesses by applying a multi agent based analysis and design methodology as a new solution for NICU management. This study was a basic research for medical informatics method development that was carried out in 2017. The requirement analysis was done by reviewing articles on NICU Decision Support Systems. PubMed, Science Direct, and IEEE databases were searched. Only English articles published after 1990 were included; also, a needs assessment was done by reviewing the extracted features and current processes at the NICU environment where the research was conducted. We analyzed the requirements and identified the main system roles (agents) and interactions by a comparative study of existing NICU decision support systems. The Universal Multi Agent Platform (UMAP) was applied to implement a prototype of our multi agent based high-risk neonate management architecture. Local environment agents interacted inside a container and each container interacted with external resources, including other NICU systems and consultation centers. In the NICU container, the main identified agents were reception, monitoring, NICU registry, and outcome prediction, which interacted with human agents including nurses and physicians. Managing patients at the NICU units requires online data collection, real-time collaboration, and management of many components. Multi agent systems are applied as

Neonatal tetanus associated with skin infection.

Science.gov (United States)

Maharaj, M; Dungwa, N

2016-08-03

A 1-week-old infant was brought to a regional hospital with a history of recurrent seizures following lower abdominal septic skin infection. She was found to have neonatal tetanus, and a spatula test was positive. The tetanus infection was associated with a superficial skin infection, common in neonates. Treatment included sedatives (diazepam, chlorpromazine, phenobarbitone and morphine), muscle relaxants, antibiotics and ventilation in the neonatal intensive care unit. Intrathecal and intramuscular immunoglobulin were given, and the wound was treated. The infant recovered, with no seizures by the 16th day from admission, and was off the ventilator by the 18th day. This was shorter than the usual 3 - 4 weeks for neonates with tetanus at the hospital. The question arises whether tetanus immunisation should be considered in infants with skin infections, which frequently occur in the neonatal period.

Perinatal pharmacology: applications for neonatal neurology.

Science.gov (United States)

Smits, Anne; Allegaert, Karel

2011-11-01

The principles of clinical pharmacology also apply to neonates, but their characteristics warrant a tailored approach. We focus on aspects of both developmental pharmacokinetics (concentration/time relationship) and developmental pharmacodynamics (concentration/effect relationship) in neonates. We hereby aimed to link concepts used in clinical pharmacology with compound-specific observations (anti-epileptics, analgosedatives) in the field of neonatal neurology. Although in part anecdotal, we subsequently illustrate the relevance of developmental pharmacology in the field of neonatal neurology by a specific intervention (e.g. whole body cooling), specific clinical presentations (e.g. short and long term outcome following fetal exposure to antidepressive agents, the development of new biomarkers for fetal alcohol syndrome) and specific clinical needs (e.g. analgosedation in neonates, excitocytosis versus neuro-apoptosis/impaired synaptogenesis). Copyright © 2011 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Geographical Accessibility to Obstetric and Neonatal Care and its Effect on Early Neonatal Mortality in Colombia, 2012-2014

Directory of Open Access Journals (Sweden)

Diego Fernando Rojas Gualdrón

2017-04-01

Full Text Available Introduction: The distribution of health resources influences early neonatal mortality, granting access to obstetric care which is a major public health problem. However, the geographical dimension of this influence has not been studied in Colombia. Objective: To describe the geographical accessibility to obstetric and neonatal care beds and its association with early neonatal mortality in Colombia and its municipalities. Method:An ecological study at municipal level was carried out. Ordinary least squares (OLS regression and a geographically weighted regression (GWR were used to explore statistical and spatial associations. Results: The municipalities in Colombia with Higher mortality tend to have lower geographical accessibility to obstetric and neonatal beds after controlling the fertility and economic characteristics of these municipalities. This association is significant only in municipalities of the west coast. The strength of this association decreases in inner municipalities. Discussion: The centralization of obstetric and neonatal beds in major municipalities around the central region leaves municipalities with high risk of mortality underserved. The decentralization of obstetric and neonatal healthcare resources is a mandatory issue in order to reduce geographical disparities in mortality and to improve neonatal survival, and a healthy beginning of life.

Clinical practice: neonatal resuscitation. A Dutch consensus

NARCIS (Netherlands)

van den Dungen, F.A.M.; van Veenendaal, M.B.; Mulder, A.L.M.

2010-01-01

The updated Dutch guidelines on Neonatal Resuscitation assimilate the latest evidence in neonatal resuscitation. Important changes with regard to the 2004 guidelines and controversial issues concerning neonatal resuscitation are reviewed, and recommendations for daily practice are provided and

Neonatal and infantile acne vulgaris: an update.

Science.gov (United States)

Serna-Tamayo, Cristian; Janniger, Camila K; Micali, Giuseppe; Schwartz, Robert A

2014-07-01

Acne may present in neonates, infants, and small children. Neonatal and infantile acne vulgaris are not considered to be rare. The presentation of acne in this patient population sometimes represents virilization and may portend later development of severe adolescent acne. Neonatal and infantile acne vulgaris must be distinguished from other cutaneous disorders seen in newborns and infants. Infantile acne tends to be more pleomorphic and inflammatory, thus requiring more vigorous therapy than neonatal acne.

Providing safe surgery for neonates in sub-Saharan Africa.

Science.gov (United States)

Ameh, Emmanuel A; Ameh, Nkeiruka

2003-07-01

Advances in neonatal intensive care, total parenteral nutrition and improvements in technology have led to a greatly improved outcome of neonatal surgery in developed countries. In many parts of sub-Saharan Africa, however, neonatal surgery continues to pose wide-ranging challenges. Delivery outside hospital, delayed referral, poor transportation, and lack of appropriate personnel and facilities continue to contribute to increased morbidity and mortality in neonates, particularly under emergency situations. Antenatal supervision and hospital delivery needs to be encouraged in our communities. Adequate attention needs to be paid to providing appropriate facilities for neonatal transport and support and training of appropriate staff for neonatal surgery. Neonates with surgical problems should be adequately resuscitated before referral where necessary but surgery should not be unduly delayed. Major neonatal surgery should as much as possible be performed by those trained to operate on neonates. Appropriate research and international collaboration is necessary to improve neonatal surgical care in the environment.

Neonatal pressure ulcers: prevention and treatment

Directory of Open Access Journals (Sweden)

García-Molina P

2017-09-01

Full Text Available Pablo García-Molina,1,2 Alba Alfaro-López,1 Sara María García-Rodríguez,1 Celia Brotons-Payá,1 Mari Carmen Rodríguez-Dolz,1,2 Evelin Balaguer-López1,2 1Department of Nursing, University of Valencia, 2Research Group of Pediatric Nutrition, INCLIVA Foundation, Valencia, Spain Abstract: Health professionals should be prepared to respond to the needs of hospitalized neonates. The health team must consider multiple situations, where the neonate is at risk of having an adverse effect. One of the main interventions that health professionals must practice when interacting with hospitalized newborns is skin care. Neonates often suffer from diaper rash or intravenous drugs extravasation. Recently, hospitalized neonates and especially those in an unstable clinical situation are also at a risk of developing pressure ulcers. The presence of a pressure ulcer in a neonate can lead to serious problems to survival (eg, sepsis, clinical instability. This is the reason why, with this literature review, we attempt to answer questions from health professionals caring for neonates about the prevention and treatment of pressure ulcers. Keywords: infant, pressure ulcer, treatment, prevention, wound, assessment

Imaging approach to persistent neonatal jaundice

International Nuclear Information System (INIS)

Kirks, D.; Coleman, R.E.; Filston, H.C.; Rosenberg, E.R.; Merten, D.F.

1984-01-01

Fifteen patients with persistent neonatal jaundice were evaluated by sonography and radionuclide scintigraphy. The sonographic features of both neonatal hepatitis and biliary atresia are nonspecific. Hepatobiliary scintigraphy after phenobarbital pretreatment in patients with neonatal hepatitis demonstrates normal hepatic extraction and delayed tracer excretion into the gastrointestinal tract. If there is neonatal hepatitis with severe hepatocellular damage, the hepatic extraction of tracer activity is decreased and excretion may be delayed or absent. Patients under 3 months of age with biliary atresia have normal hepatic extraction of tracer with no excretion into the gastrointestinal tract. Sonography in patients with a choledochal cyst shows a cystic mass in the porta hepatis with associated bile-duct dilatation. Hepatobiliary scintigraphy confirms that the choledochal cyst communicates with the biliary system. Initial sonography demonstrates hepatobiliary anatomy; subsequent phenobarbital-enhanced radionuclide scintigraphy determines hepatobiliary function. An expedient diagnostic approach is recommended for the evaluation of persistent neonatal jaundice

A PEARL Study Analysis of National Neonatal, Early Neonatal, Late Neonatal, and Corrected Neonatal Mortality Rates in the State of Qatar during 2011: A Comparison with World Health Statistics 2011 and Qatar's Historic Data over a Period of 36 Years (1975-2011).

Science.gov (United States)

Rahman, Sajjad; Al Rifai, Hilal; El Ansari, Walid; Nimeri, Nuha; El Tinay, Sarrah; Salameh, Khalil; Abbas, Tariq; Jarir, Rawia A; Said, Nawal; Taha, Samer

2012-10-01

To prospectively ascertain Qatar's national Neonatal Mortality Rate (NMR), Early Neonatal Mortality Rate (ENMR), and Late Neonatal Mortality Rate (LNMR) during 2011, compare it with recent data from high-income countries, and analyze trends in Qatar's NMR's between 1975 and 2011 using historic data. A National prospective cohort-study. National data on live births and neonatal mortality was collected from all public and private maternity facilities in Qatar (1(st) January-December 31(st) 2011) and compared with historical neonatal mortality data (1975-2010) ascertained from the database of maternity and neonatal units of Women's Hospital and annual reports of Hamad Medical Corporation. For inter country comparison, country data of 2009 was extracted from World Health Statistics 2011 (WHO) and the European Perinatal Health report (2008). A total of 20583 live births were recorded during the study period. Qatar's national NMR during 2011 was 4.95, ENMR 2.7, LNMR 2.2, and cNMR 3.33. Between 1975 and 2011, Qatar's population increased by 10-fold, number of deliveries by 7.2 folds while relative risk of NMR decreased by 87% (RR 0.13, 95% CI 0.10-0.18, P<0.001), ENMR by 91% (RR 0.09, 95% CI 0.06-0.12, P<0.001) and LNMR by 58% (RR 0.42, 95% CI 0.23-0.74, P=0.002). The comparable ranges of neonatal mortality rates from selected high-income West European countries are: NMR: 2-5.7, ENMR 1.5-3.8, and LNMR 0.5-1.9. The neonatal survival in the State of Qatar has significantly improved between 1975 and 2011. The improvement has been more marked in ENMR than LNMR. Qatar's current neonatal mortality rates are comparable to most high-income West European countries. An in-depth research to assess the correlates and determinants of neonatal mortality in Qatar is indicated.

Neonatal orbital abscess

Directory of Open Access Journals (Sweden)

Khalil M Al-Salem

2014-01-01

Full Text Available Orbital complications due to ethmoiditis are rare in neonates. A case of orbital abscess due to acute ethmoiditis in a 28-day-old girl is presented. A Successful outcome was achieved following antimicrobial therapy alone; spontaneous drainage of the abscess occurred from the lower lid without the need for surgery. From this case report, we intend to emphasize on eyelid retraction as a sign of neonatal orbital abscess, and to review all the available literature of similar cases.

Abdominal surgery in neonatal foals.

Science.gov (United States)

Bryant, James E; Gaughan, Earl M

2005-08-01

Abdominal surgery in foals under 30 days old has become more common with improved neonatal care. Early recognition of a foal at risk and better nursing care have increased the survival rates of foals that require neonatal care. The success of improved neonatal care also has increased the need for accurate diagnosis and treatment of gastrointestinal, umbilical, and bladder disorders in these foals. This chapter focuses on the early and accurate diagnosis of specific disorders that require abdominal exploratory surgery and the specific treatment considerations and prognosis for these disorders.

The study of thrombocytopenia in sick neonates

International Nuclear Information System (INIS)

Aman, I.; Hassan, K.A.; Ahmad, T.M.

2004-01-01

Objective: To determine the number of cases and manifestations of thrombocytopenia in sick neonates. Subjects and Methods: A total of 365 neonates from 0-28 days of age admitted with different clinical problems irrespective of birth weight and gestational age were evaluated for thrombocytopenia. These neonates were categorized into five different groups (A-E), which were of neonatal infections, asphyxia neonatorum, preterm and smallness for gestational age, jaundice and miscellaneous respectively. Results: Out of 365 cases, 88 were found to have thrombocytopenia (platelet counts < 150,000 per mm/sup 3/) which was 24.1% of the total. In group A (neonatal infections), out of 152 neonates, 62 had low platelet counts (40.78%). In group B (neonatal asphyxia), out of 90 only 11 had thrombocytopenia (12.2%). In group C (preterm and small for gestational age), out of 60 cases only 9 had thrombocytopenia. In group D (jaundice), all 33 cases had normal platelet counts. In group E (miscellaneous), out of 30 cases only 6 had thrombocytopenia. The common manifestations in thrombocytopenic babies were petechiae and bruises followed by gastrointestinal hemorrhages. The percentage of manifest thrombocytopenia cases was 56.8% and of occult thrombocytopenia 43.1 %. Conclusion: The leading causes of thrombocytopenia in sick neonates are infections, asphyxia, complicated pre- maturity and smallness for gestational age. Apart from the platelet counts the bleeding mainfestations also depend upon the underlying ailments. (author)

Estimation of adult and neonatal RBC lifespans in anemic neonates using RBCs labeled at several discrete biotin densities.

Science.gov (United States)

Kuruvilla, Denison J; Widness, John A; Nalbant, Demet; Schmidt, Robert L; Mock, Donald M; An, Guohua; Veng-Pedersen, Peter

2017-06-01

Prior conclusions that autologous neonatal red blood cells (RBC) have substantially shorter lifespans than allogeneic adult RBCs were not based on direct comparison of autologous neonatal vs. allogeneic adult RBCs performed concurrently in the same infant. Biotin labeling of autologous neonatal RBCs and allogeneic adult donor RBCs permits concurrent direct comparison of autologous vs. allogeneic RBC lifespan. RBCs from 15 allogeneic adult donors and from 15 very-low-birth-weight (VLBW) neonates were labeled at separate biotin densities and transfused simultaneously into the 15 neonates. Two mathematical models that account for the RBC differences were employed to estimate lifespans for the two RBC populations. Mean ± SD lifespan for adult allogeneic RBC was 70.1 ± 19.1 d, which is substantially shorter than the 120 d lifespan of both autologous and adult allogeneic RBC in healthy adults. Mean ± SD lifespan for neonatal RBC was 54.2 ± 11.3 d, which is only about 30% shorter than that of the adult allogeneic RBCs. This study provides evidence that extrinsic environmental factors primarily determine RBC survival (e.g., small bore of the capillaries of neonates, rate of oxygenation/deoxygenation cycles) rather than factors intrinsic to RBC.

Reanimación neonatal: actualización Neonatal resuscitation: up-date

OpenAIRE

E. Burón Martínez; A. Pino Vázquez

2009-01-01

Las últimas recomendaciones en reanimación neonatal fueron publicadas en el año 2005 por el ERC (European Resuscitation Council), el grupo ILCOR (International Liaison Committee on Resuscitation) y la AHA (American Heart Association). En nuestro país estas normas fueron difundidas por el grupo de RCP Neonatal de la Sociedad Española de Neonatología, introduciendo algunas adaptaciones y ampliando algunos capítulos como la reanimación del recién naci...

Pentraxin 3 concentrations of the mothers with preterm premature rupture of membranes and their neonates, and early neonatal outcome.

Science.gov (United States)

Akin, Mustafa Ali; Gunes, Tamer; Coban, Dilek; Ozgun, Mahmut Tuncay; Akgun, Hulya; Kurtoglu, Selim

2015-07-01

Pentraxin 3 (PTX3) is an acute phase reactant which has been used to detect intra-amniotic infections (IAI) in pregnancy, but the prognostic value of PTX3 concentrations on neonates has not been studied. We aimed to investigate the relationship between maternal PTX3-neonatal PTX3 concentrations and early neonatal outcome. The mothers diagnosed with preterm prelabor rupture of membranes (PPROM) (n = 28) and their preterm infants (n = 28) were included in the study. PTX3 concentrations were studied in plasma in the maternal peripheral blood and umbilical/peripheral vein in the neonates. The relationship between the mPTX3-nPTX3 concentrations and neonatal outcome were investigated using non-parametric tests and binary logistic regression analysis. The mean mPTX3 concentration was 10.35 ± 7.82 μg/L. Ten (35.7%) of all mothers were within the normal range and 18 (64.3%) in high percentile (≥ 97.5 percentile). There was no relation between mPTX3 concentrations and clinical or histologic chorioamnionitis, latency of PPROM, and early neonatal outcome. Mean nPTX3 concentrations was 9.18 ± 7.83 μg/L and high nPTX3 concentrations were detected in five (17.8%) neonates. nPTX3 concentrations were inversely correlated with gestational age and correlated with rate of intraventricular hemorrhage (IVH) and mortality. Neonates with high nPTX3 concentrations also have lowered APGAR scores, increased rate of respiratory distress syndrome, clinical sepsis, IVH, necrotizing enterocolitis and prolonged NICU stay. High PTX3 concentrations of the newborns are associated with some worsened early neonatal outcome including lower gestational age at delivery, increased rate of IVH and mortality. Maternal PTX3 concentrations are not an adequate marker in defining clinical or histologic chorioamnionitis and early neonatal outcome.

Associação da presença de DNA genômico de diferentes bactérias em sangue de recém-nascidos pré-termo e termo com ruptura prematura de membrana

OpenAIRE

Appel, Kelly Lopes de Araújo

2015-01-01

A associação de ruptura prematura de membranas (RPM) e infecção neonatal precoce tem sido alvo de vários estudos, pois os microrganismos responsáveis pela infecção neonatal relacionada com RPM são aqueles encontrados na microbiota vaginal normal e patogênica das gestantes. Assim, para avaliar a associação da RPM com a presença do DNA genômico de diferentes bactérias em recém-nascidos (RNs) pré-termo e a termo foi realizado um estudo observacional, transversal, com RNs provenientes de mães com...

Influência da irrigação e do genótipo na produção de castanha em cajueiro-anão-precoce

Directory of Open Access Journals (Sweden)

Oliveira Vitor Hugo de

2003-01-01

Full Text Available Avaliou-se a influência da irrigação e do genótipo na produção de castanha em cajueiro-anão-precoce (Anacardium occidentale L. durante três anos. Foram estudados três clones (CP 09, CP 76 e CP 1001 e quatro regimes hídricos (testemunha sem irrigação e intervalos de irrigação de um, três e cinco dias. O delineamento experimental foi em blocos ao acaso, em parcelas subsubdivididas, com quatro repetições, com os regimes hídricos nas parcelas, os clones nas subparcelas, cada uma com quatro plantas, e os anos de produção nas subsubparcelas. A quantidade de água aplicada nos três tratamentos irrigados baseou-se na evaporação do tanque classe A. Em relação à produção de castanha, os clones de cajueiro-anão-precoce não apresentaram comportamento diferencial em resposta à irrigação; os clones CP 09 e CP 76 mostraram-se superiores ao CP 1001 quanto à estabilidade de safra; independentemente do regime hídrico estudado, o clone CP 76 mostrou-se menos produtivo do que os clones CP 09 e CP 1001.

Influência regional no consumo precoce de alimentos diferentes do leite materno em menores de seis meses residentes nas capitais brasileiras e Distrito Federal

OpenAIRE

Saldiva,Silvia Regina Dias Medici; Venancio,Sonia Isoyama; Gouveia,Ana Gabriela Cepeda; Castro,Ana Lucia da Silva; Escuder,Maria Mercedes Loureiro; Giugliani,Elsa Regina Justo

2011-01-01

Objetivou-se avaliar a influência regional no consumo precoce de alimentos diferentes do leite materno em menores de seis meses residentes nas capitais brasileiras. Analisaram-se dados de 18.929 crianças da II Pesquisa de Prevalência de Aleitamento Materno nas Capitais Brasileiras - 2008. As frequências do consumo de chá, sucos, leite artificial e mingau/papa foram calculadas para as capitais das cinco regiões brasileiras. Curvas do consumo foram obtidas pela análise de logitos e estimativas ...

Diffusion Weighted Imaging of the Neonatal Brain

NARCIS (Netherlands)

J. Dudink (Jeroen)

2010-01-01

textabstractAlthough in the last decades advances in fetal and neonatal medicine have reduced mortality in neonatal intensive care units in the Western world, the morbidity due to brain injury remains high. Patterns of neonatal brain injury can be roughly divided in (1) term and (2) preterm

Right paratesticular abscess mimicking neonatal testicular torsion ...

African Journals Online (AJOL)

U.O. Ezomike

Abstract. The clinical presentation of neonatal paratesticular abscess may closely resemble that of, neonatal testicular torsion and the use of scrotal ultrasonography to differentiate the two has low, sensitivity. We propose early operative treatment of suspected neonatal testicular torsion to salvage, the testicle in cases of ...

Malaria parasite positivity among febrile neonates | Enyuma ...

African Journals Online (AJOL)

Background: Malaria, earlier considered rare in neonates, has been reported with increasing frequency in the last decade. Neonatal malaria diagnosis is challenging because the clinical features are non-specific, variable and also overlap with bacterial infection. Aim: To determine the prevalence of neonatal malaria and ...

Dosing antibiotics in neonates: review of the pharmacokinetic data.

Science.gov (United States)

Rivera-Chaparro, Nazario D; Cohen-Wolkowiez, Michael; Greenberg, Rachel G

2017-09-01

Antibiotics are often used in neonates despite the absence of relevant dosing information in drug labels. For neonatal dosing, clinicians must extrapolate data from studies for adults and older children, who have strikingly different physiologies. As a result, dosing extrapolation can lead to increased toxicity or efficacy failures in neonates. Driven by these differences and recent legislation mandating the study of drugs in children and neonates, an increasing number of pharmacokinetic studies of antibiotics are being performed in neonates. These studies have led to new dosing recommendations with particular consideration for neonate body size and maturation. Herein, we highlight the available pharmacokinetic data for commonly used systemic antibiotics in neonates.

Home delivery and neonatal mortality in North Carolina.

Science.gov (United States)

Burnett, C A; Jones, J A; Rooks, J; Chen, C H; Tyler, C W; Miller, C A

1980-12-19

Neonatal mortality examined by place and circumstances of delivery in North Carolina during 1974 through 1976 with attention given to home delivery. Planned home deliveries by lay-midwives resulted in three neonatal deaths per 1,000 live births; planned home deliveries without a lay-midwife, 30 neonatal deaths per 1,000 live births; and unplanned home deliveries, 120 neonatal deaths per 1,000 live births. The women babies were delivered by lay-midwives were screened in county health departments and found to be medically at low risk of complication, despite having demographic characteristics associated with high-risk of neonatal mortality. Conversely, the women delivered at home without known prenatal screening or a trained attendant had low-risk demographic characteristics but experienced a high rate of neonatal mortality. Planning, prenatal screening, and attendant-training were important in differentiating the risk of neonatal mortality in this uncontrolled, observational study.

Diagnostic imaging in neonatal stroke; Bildgebende Diagnostik des Neonatal stroke

Energy Technology Data Exchange (ETDEWEB)

Kuhle, S.; Ipsiroglu, O.; Weninger, M. [Universitaetsklinik fuer Kinder- und Jugendheilkunde, Wien (Austria). Abt. fuer Neonatologie, angeborene Stoerungen und Intensivmedizin; Puig, S.; Prayer, D. [Universitaetsklinik fuer Radiodiagnostik, Wien (Austria)

2000-01-01

A cerebral artery infarction is an important differential diagnosis in the newborn with neurological abnormalities. Based on clinical data, its incidence is estimated to be 1 in 4000 newborns. Since the course is often subclinical, the true incidence is probably higher. Diagnosis: Cerebral ultrasound and Doppler sonography as readily available screening tools play a central role in the initial diagnosis of neonatal cerebral infarction. Definitive diagnosis is made by computed tomography or magnetic resonance imaging. Beside symptomatic anticonvulsive therapy, treatment aims at the prevention of secondary ischemic injury. Discussion: Three term infants with different clinical courses of neonatal stroke are presented to sensitize the clinician and the radiologist for this probably underdiagnosed entity. The role of imaging modalities in the diagnosis and follow-up of neonatal cerebral infarction is discussed. (orig.) [German] Ein Infarkt im Stromgebiet der Zerebralarterien stellt eine wichtige Differentialdiagnose bei neurologischen Auffaelligkeiten in der Neonatalperiode dar. Die Inzidenz wird anhand von klinischer Daten auf 1:4000 Lebendgeborene geschaetzt. Da der Verlauf oft subklinisch ist, liegt die wahre Inzidenz wahrscheinlich hoeher. Diagnose: Bei der Diagnosestellung kommen dem Schaedelultraschall und der Doppelsonographie als leicht verfuegbaren Screening-Methoden eine zentrale Rolle zu. Die definitive Diagnose wird, je nach Verfuegbarkeit, mittels Computertomographie oder Kernspintomographie gestellt. Die Behandlung ist neben der symptomatischen (antikonvulsiven) Therapie auf die Vermeidung von ischaemischen Sekundaerschaeden gerichtet. Diskussion: Wir wollen mit der vorliegenden Arbeit anhand von 3 Kindern mit verschiedenen klinischen Verlaeufen eines sog. Neonatal stroke den Stellenwert der bildgebenden Verfahren bei der Diagnostik und Verlaufskontrolle aufzeigen und die Sensibilitaet fuer dieses vermutlich unterdiagnostizierte Krankheitsbild erhoehen

A Study On Neonatal Mortality In Jamnagar District Of Gujarat

Directory of Open Access Journals (Sweden)

Yadav Sudha

1998-01-01

Full Text Available Research question: Which are the maternal, socio-demographic and neonatal attributes responsible for neonatal mortality in rural areas of Gujarat? Objectives: (i To know various maternal, socio-demographic and neonatal factors responsible for neonatal mortality in rural areas of Gujarat (ii To estimate neonatal mortality rate in the area. Setting: Rural areas of six Primary Health Centers of Jamnagar district of Gujarat State. Study design: Community based cohort study. Sample size: Population of 40512 Participants: Members of the family in which neonatal deaths occurred. Outcome variable: Neonatal mortality Analysis: Sample proportions. Results: Neonatal mortality rate on the basis of follow-up of births during one year was found to be 47.27 per thousand live births. The major maternal and socio-demographic factors responsible for neonatal mortality were; maternal age, illiteracy, lack of antenatal care, closely spaced pregnancies, delivery conducted at home, delivery conducted untrained personnel and delayed initiation of breast feeding. The major neonatal factors responsible for mortality in neonates were; low birth weight, prematurity, first order of birth, early phase of neonatal period, male gender of the child. The leading causes of neonatal mortality were found to be prematurity, birth asphyxia, neonatal infections and congenital anomalies.

[Epidemiology of nosocomial infections in neonates].

Science.gov (United States)

Lachassinne, E; Letamendia-Richard, E; Gaudelus, J

2004-03-01

Epidemiology of nosocomial infections in neonates has to be described according to our definitions (early onset GBS diseases excluded) and according to levels of care. Nosocomial risk exists in maternity departments (3% in postnatal beds), incidence rates are 7.5-12.7% or 1.3-8.5 per 1000 days in neonatal care units and 14.2% or 11.7 per 1000 days in neonatal intensive care units (NICU). Gram-positive cocci bloodstream infections are the most common nosocomial infections in NICU but viral gastroenteritis are more frequent in neonatal care units. Risk factors are low birthweight, small gestational age and intravascular catheter in NICU, and for viral nosocomial infections, visits and winter outbreaks.

Potentially harmful excipients in neonatal medicines

DEFF Research Database (Denmark)

Nellis, Georgi; Metsvaht, Tuuli; Varendi, Heili

2015-01-01

OBJECTIVES: We aimed to describe administration of eight potentially harmful excipients of interest (EOI)-parabens, polysorbate 80, propylene glycol, benzoates, saccharin sodium, sorbitol, ethanol and benzalkonium chloride-to hospitalised neonates in Europe and to identify risk factors for exposure....... METHODS: All medicines administered to neonates during 1 day with individual prescription and demographic data were registered in a web-based point prevalence study. Excipients were identified from the Summaries of Product Characteristics. Determinants of EOI administration (geographical region......, gestational age (GA), active pharmaceutical ingredient, unit level and hospital teaching status) were identified using multivariable logistical regression analysis. RESULTS: Overall 89 neonatal units from 21 countries participated. Altogether 2095 prescriptions for 530 products administered to 726 neonates...

[Lactose intolerance in neonates with non-infectious diarrhea].

Science.gov (United States)

Su, Hui-Min; Jiang, Yi; Hu, Yu-Lian; Yang, Hui; Dong, Tian-Jin

2016-04-01

To investigate the development of lactose intolerance in neonates with non-infectious diarrhea and its association with diarrhea, and to evaluate the diagnostic values of fecal pH value and urine galactose determination for neonatal lactase deficiency. Seventy hospitalized neonates who developed non-infectious diarrhea between October 2012 and June 2015 were enrolled as the diarrhea group, and 162 hospitalized neonates without non-infectious diarrhea were enrolled as the non-diarrhea group. Test paper was used to determine fecal pH value. The galactose oxidase method was used to detect urine galactose. The neonates with positive galactose oxidase were diagnosed with lactase deficiency, and those with lactase deficiency and diarrhea were diagnosed with lactose intolerance. According to the results of urine galactose detection, 69 neonates in the diarrhea group who underwent urine galactose detection were classified into lactose intolerance group (45 neonates) and lactose tolerance group (24 neonates), and their conditions after treatment were compared between the two groups. The follow-up visits were performed for neonates with diarrhea at 3 months after discharge. Fecal pH value and positive rate of urine galactose (65% vs 54%) showed no significant differences between the diarrhea and non-diarrhea groups (P>0.05). Fecal pH value showed no significant difference between the lactose intolerance and lactose tolerance groups (P>0.05), while the neonates in the lactose intolerance group had a significantly longer time to recovery of defecation than those in the lactose tolerance group (Plactose intolerance tends to occur. Determination of fecal pH value has no significance in the diagnosis of lactose intolerance in neonates with diarrhea.

Surgical procedures performed in the neonatal intensive care unit on critically ill neonates: feasibility and safety

International Nuclear Information System (INIS)

Mallick, M.S.; Jado, A.M.; Al-Bassam, A.R.

2008-01-01

Transferring unstable, ill neonates to and from the operating rooms carries significant risks and can lead to morbidity. We report on our experience in performing certain procedures in critically ill neonates in the neonatal intensive care unit (NICU). We examined the feasibility and safety for such an approach. All surgical procedures performed in the NICU between January 1999 and December 2005 were analyzed in terms of demographic data, diagnosis, preoperative stability of the patient, procedures performed, complications and outcome. Operations were performed at beside in the NICU in critically ill, unstable neonates who needed emergency surgery, in neonates of low birth weight (<1000 gm) and in neonates on special equipments like higher frequency ventilators and nitrous oxide. Thirty-seven surgical procedures were performed including 12 laparotomies, bowel resection and stomies, 7 repairs of congenital diaphragmatic hernias, 4 ligations of patent ductus arteriosus and various others. Birth weights ranged between 850 gm and 3500 gm (mean 2000 gm). Gestational age ranged between 25 to 42 weeks (mean, 33 weeks). Age at surgery was between 1 to 30 days (mean, 30 days). Preoperatively, 19 patients (51.3%) were on inotropic support and all were intubated and mechanically ventilated. There was no mortality related to surgical procedures. Postoperatively, one patient developed wound infection and disruption. Performing major surgical procedures in the NICU is both feasible and safe. It is useful in very low birth weight, critically ill neonates who have definite risk attached to transfer to the operating room. No special area is needed in the NICU to perform complication-free surgery, but designing an operating room within the NICU will be ideal. (author)

Partos domiciliares acidentais na região sul do Município de São Paulo Accidental home deliveries in southern São Paulo, Brazil

Directory of Open Access Journals (Sweden)

Márcia Furquim de Almeida

2005-06-01

Full Text Available OBJETIVO: Identificar a freqüência, o risco de mortalidade fetal e neonatal precoce e os determinantes do parto domiciliar acidental. MÉTODOS: Estudo caso-controle de base populacional sobre mortes fetais e neonatais precoces realizado na região sul do Município de São Paulo. Foram coletados dados em entrevistas domiciliares e de prontuários hospitalares. Os motivos referidos pelas mães para a ocorrência de partos domiciliares foram obtidos nas entrevistas. Os fatores de risco para o parto domiciliar foram obtidos comparando-se com os partos hospitalares. Os dados foram analisados separadamente para perdas fetais, óbitos neonatais e sobreviventes. Foram utilizadas odds ratio, intervalo de confiança de 95% e o teste exato de Fisher para avaliar os fatores de risco e estimar o risco de morte. RESULTADOS: A freqüência de partos domiciliares de 0,2% no Sistema de Informações de Nascidos Vivos está sub-notificada. Quando ajustada, passa a ser de 0,4%, compatível com a encontrada em algumas cidades da Europa. Todos os partos domiciliares identificados foram acidentais. O parto domiciliar acidental está associado ao aumento da mortalidade fetal e neonatal precoce. Características sociais das mães e da gestação estão associadas à ocorrência de partos domiciliares acidentais, e não são sempre as mesmas para os três tipos de desfecho (óbito fetal, óbito neo-natal precoce e sobreviventes. A falta de transporte para o hospital foi indicada como motivo para os partos domiciliares por 30% das mães. Falhas do sistema de saúde em reconhecer a iminência do parto e a não disponibilidade de atendimento de urgência contribuíram para a ocorrência de alguns partos domiciliares. CONCLUSÕES: Apesar de serem eventos raros, pelo menos em área urbana, os partos domiciliares acidentais devem merecer atenção específica, já que acarretam aumento do risco de morte e parecem ser evitáveis.OBJECTIVE: To identify the frequency, risks

Screening for group B Streptococcus in pregnant women: a systematic review and meta-analysis Rastreo de Streptococcus del grupo B en gestantes: revisión sistemática y metanálisis Rastreamento de Streptococcus do grupo B em gestantes: revisão sistemática e metanálise

Directory of Open Access Journals (Sweden)

Mônica Taminato

2011-12-01

para la reducción de la incidencia de sepsis neonatal. Las evidencias obtenidas en el estudio sugieren que la estrategia de screening universal para las gestantes asociado al uso de antibióticos profilácticos es segura y efectiva.A infecção por Streptococcus do grupo B (GBS é considerada importante problema de saúde pública. Está associada à sepse neonatal, meningite, pneumonia, óbito neonatal, aborto séptico, coriomnionite, endometrite e outras infecções perinatais. O objetivo deste estudo foi determinar a melhor estratégia de rastreamento de GBS em gestantes. Como método usou-se a revisão sistemática com metanálise. A pesquisa foi realizada no Departamento de Enfermagem/Universidade Federal de São Paulo/Centro Cochrane do Brasil. Para a busca usaram-se as fontes Embase, LILACS, MEDLINE, lista de referências bibliográficas, comunicação pessoal e Cochrane Library. Usaram-se, como critério de seleção, os estudos que analisaram algum tipo de rastreamento para GBS em gestantes. Independente do comparador, os resultados apontam que todas as análises foram favoráveis ao programa de screening universal para a redução da incidência de sepse neonatal. Pode-se concluir que evidências obtidas no estudo são sugestivas de que a estratégia de screening universal para as gestantes, associada ao uso de antibiótico profilático, é segura e efetiva.

Amamentação e as intercorrências que contribuem para o desmame precoce

Directory of Open Access Journals (Sweden)

Carolina Sampaio de Oliveira

Full Text Available RESUMO Objetivo Conhecer a vivência de mães em relação à amamentação e as intercorrências que contribuem para o desmame precoce. Método Pesquisa do tipo descritiva-exploratória, com abordagem qualitativa realizado em uma unidade de Estratégia da Saúde da Família, no município de Cáceres-MT, por meio de entrevista semi-estruturada com 21 mulheres que tiveram filhos de janeiro/2012 a janeiro/2014. Resultados Os dados apontaram que ao término dos 6 meses das crianças, somente 19,1%, continuavam em Aleitamento Materno Exclusivo e as principais alegações para sua ocorrência foram: Déficit de conhecimentos inexperiência/insegurança; Banalização das angústias maternas; Intercorrências da mama puerperal; Interferências familiares; Leite fraco/insuficiente; trabalho materno. Conclusão O estudo reforçou a necessidade de ajustes no modelo de atenção vigente, ultrapassando aplicabilidade de técnicas pré-definidas, incentivando a criticidade perceptiva dos profissionais de saúde na construção de novos saberes e condutas.

Radiologic findings of neonatal sepsis

International Nuclear Information System (INIS)

Kim, Sam Soo; Han, Dae Hee; Choi, Guk Myeong; Jung, Hye Won; Yoon, Hye Kyung; Han, Bokyung Kim; Lee, Nam Yong

1997-01-01

To review the simple radiographic and sonographic findings in infants with neonatal sepsis. We retrospectively analyzed simple chest and abdominal radiographs, and brain sonograms in 36 newborn infants (preterm : term=23 :13). With neonatal sepsis diagnosed by blood culture and clinical manifestations. Pulmonary parenchymal infiltrate excluding respiratory distress syndrome and pulmonary edema or atelectasis was found in 22 infants (61%). Paralytic ileus, hepatosplenomegaly, and necrotizing enterocolitis were present in 18(50%), 9(25%), and 1(3%) infants, respectively, while skeletal changes suggesting osteomyelitis were found in three. Brain sonography was performed in 29 infants and in four, abnormalities were seen ; these comprised three germinal matrix hemorrhages and one intraparenchymal hemorrhage. In six patients(17%) radiologic examinations revealed no abnormality. In patients with neonatal sepsis, pulmonary infiltrates and paralytic ileus were common abnormalities. Although these were nonspecific, radiologic findings may be used to supplement clinical and laboratory findings in diagnosing neonatal sepsis and planning its treatment

Radiologic findings of neonatal sepsis

Energy Technology Data Exchange (ETDEWEB)

Kim, Sam Soo; Han, Dae Hee; Choi, Guk Myeong; Jung, Hye Won [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of); Yoon, Hye Kyung; Han, Bokyung Kim; Lee, Nam Yong [Sansung Medical Center, Seoul (Korea, Republic of)

1997-06-01

To review the simple radiographic and sonographic findings in infants with neonatal sepsis. We retrospectively analyzed simple chest and abdominal radiographs, and brain sonograms in 36 newborn infants (preterm : term=23 :13). With neonatal sepsis diagnosed by blood culture and clinical manifestations. Pulmonary parenchymal infiltrate excluding respiratory distress syndrome and pulmonary edema or atelectasis was found in 22 infants (61%). Paralytic ileus, hepatosplenomegaly, and necrotizing enterocolitis were present in 18(50%), 9(25%), and 1(3%) infants, respectively, while skeletal changes suggesting osteomyelitis were found in three. Brain sonography was performed in 29 infants and in four, abnormalities were seen ; these comprised three germinal matrix hemorrhages and one intraparenchymal hemorrhage. In six patients(17%) radiologic examinations revealed no abnormality. In patients with neonatal sepsis, pulmonary infiltrates and paralytic ileus were common abnormalities. Although these were nonspecific, radiologic findings may be used to supplement clinical and laboratory findings in diagnosing neonatal sepsis and planning its treatment.

Neonatal hypothermia in sub-Saharan Africa: a review.

Science.gov (United States)

Onalo, R

2013-01-01

Hypothermia is a major factor in neonatal morbidity and mortality in developing countries. High prevalence of hypothermia has been reported widely even from warmer tropical countries. In spite of the World Health Organization's recommendation of maintenance of warm chain in newborn care, hypothermia continues to be a common neonatal condition which has remained under-recognized, under-documented, and poorly-managed. This review aims at providing the incidence of and risk factors for neonatal hypothermia as well as provides a pathophysiological overview and management options for neonates with the condition in sub-Saharan Africa. All available published literature on neonatal hypothermia was searched electronically and manually. The principal electronic reference libraries and sites searched were PubMed, Embase, Ajol, Cochrane Reference Libraries and Google Scholar. The search terms used included 'neonatal hypothermia,' 'Cold stress in newborn' 'thermal care of the newborn,' 'neonatal thermogenesis,' 'neonatal cold injury,' among others. Pertinent books and monographs were accessed. Data in formats inaccessible to the reviewer were excluded. Neonatal hypothermia is a major condition of public health importance in countries of sub- Saharan Africa. Awareness of the burden of the disease is still low in some communities. Risk factors for neonatal hypothermia in the region include poverty, home delivery, low birthweight, early bathing of babies, delayed initiation of breastfeeding and inadequate knowledge among health workers. Low-tech facilities to prevent heat losses and provide warmth are available in sub-Saharan Africa and are thus recommended as well as continuous efforts at sensitizing caregivers on the thermal needs of newborns.

iNICU - Integrated Neonatal Care Unit: Capturing Neonatal Journey in an Intelligent Data Way.

Science.gov (United States)

Singh, Harpreet; Yadav, Gautam; Mallaiah, Raghuram; Joshi, Preetha; Joshi, Vinay; Kaur, Ravneet; Bansal, Suneyna; Brahmachari, Samir K

2017-08-01

Neonatal period represents first 28 days of life, which is the most vulnerable time for a child's survival especially for the preterm babies. High neonatal mortality is a prominent and persistent problem across the globe. Non-availability of trained staff and infrastructure are the major recognized hurdles in the quality care of these neonates. Hourly progress growth charts and reports are still maintained manually by nurses along with continuous calculation of drug dosage and nutrition as per the changing weight of the baby. iNICU (integrated Neonatology Intensive Care Unit) leverages Beaglebone and Intel Edison based IoT integration with biomedical devices in NICU i.e. monitor, ventilator and blood gas machine. iNICU is hosted on IBM Softlayer based cloud computing infrastructure and map NICU workflow in Java based responsive web application to provide translational research informatics support to the clinicians. iNICU captures real time vital parameters i.e. respiration rate, heart rate, lab data and PACS amounting for millions of data points per day per child. Stream of data is sent to Apache Kafka layer which stores the same in Apache Cassandra NoSQL. iNICU also captures clinical data like feed intake, urine output, and daily assessment of child in PostgreSQL database. It acts as first Big Data hub (of both structured and unstructured data) of neonates across India offering temporal (longitudinal) data of their stay in NICU and allow clinicians in evaluating efficacy of their interventions. iNICU leverages drools based clinical rule based engine and deep learning based big data analytical model coded in R and PMML. iNICU solution aims to improve care time, fills skill gap, enable remote monitoring of neonates in rural regions, assists in identifying the early onset of disease, and reduction in neonatal mortality.

Mediastinite por perfuração e ruptura do esôfago torácico

Directory of Open Access Journals (Sweden)

Geraldo Roger Normando Jr.

Full Text Available OBJETIVO: Avaliar a mortalidade por mediastinite e sepse originadas por perfuração e ruptura do esôfago torácico, de acordo o tempo de evolução da doença. MÉTODO: Estudo retrospectivo de 14 anos (1992 a 2006, com pacientes portadores de ruptura e perfuração do esôfago. Foi avaliado sexo, idade, mecanismo de lesão, evolução ( 24 horas e tratamento. RESULTADOS: Foram analisados 44 pacientes, sendo 10 do sexo feminino (22,73% e 34 do sexo masculino (77,27%. A variação da idade foi de dois meses a 77 anos e a média de 33,2. Os ferimentos estiveram presentes em 19 casos (43,18%: Arma branca em cinco e projétil de arma de fogo 14. A instrumentação endoscópica foi detectada em nove casos (20,45%. Nos pacientes submetidos à esofagorrafia (diagnóstico precoce, menos de 24 horas a mortalidade esteve presente três casos (20%. Em pacientes submetidos à esofagectomia (diagnóstico tardio, mais de 24 horas a mortalidade ocorreu em oito casos (36,36%, e essa diferença não foi estatisticamente significante (p 0,05. No tratamento conservador, a mortalidade foi em cinco de sete casos a a diferença foi estatisticamente significativa quando comparado com o tratamento cirúrgico. CONCLUSÕES: O tratamento conservador para mediastinite por ruptura e perfuração do esôfago mostrou mortalidade alta quando comparada com tratamento cirúrgico. Entre os pacientes operados, a diferença não foi estatisticamente significante, confirmando a indicação de esofagectomia para casos de infecção avançada e a esofagorrafia para casos precoces.

Symptoms of postpartum depression and early interruption of exclusive breastfeeding in the first two months of life Sintomas de depressão pós-parto e interrupção precoce do aleitamento materno exclusivo nos dois primeiros meses de vida

Directory of Open Access Journals (Sweden)

Maria Helena Hasselmann

2008-01-01

Full Text Available This study evaluates the association between postpartum depression and interruption of exclusive breastfeeding in the first two months of life. Cohort study of 429 infants Avaliou-se a associação entre depressão pós-parto e interrupção precoce do aleitamento materno exclusivo nos dois primeiros meses de vida. Estudo de coorte com 429 crianças < 20 dias de idade em quatro unidades de saúde no Rio de Janeiro, Brasil. Considerou-se como interrupção precoce do aleitamento materno exclusivo a introdução de chá, água, suco, leite artificial ou qualquer outro alimento. Na avaliação da depressão pós-parto utilizou-se a Edinburgh Post-natal Depression Scale. Associações foram expressas como razões de prevalências (linha de base e riscos relativos (primeiro e segundo meses de vida e respectivos intervalos de 95% de confiança estimados via regressão de Poisson com variância robusta. Filhos de mulheres com sintomas de depressão pós-parto apresentam maior risco de interrupção precoce do aleitamento materno exclusivo nos dois meses de seguimento (RR = 1,46; IC95%: 0,98-2,17 e RR = 1,21; IC95%: 1,02-1,45, respectivamente. Entre mães que amamentam exclusivamente até o primeiro mês de vida, depressão pós-parto não se associou à interrupção precoce do aleitamento materno exclusivo (RR = 1,44; IC95%: 0,68-3,06. Esses achados apontam para a importância da saúde mental materna no sucesso do aleitamento materno exclusivo.

21 CFR 880.5270 - Neonatal eye pad.

Science.gov (United States)

2010-04-01

... DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Therapeutic Devices § 880.5270 Neonatal eye pad. (a) Identification. A neonatal eye pad is an opaque device used to cover... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Neonatal eye pad. 880.5270 Section 880.5270 Food...

Neonatal bacteriemia isolates and their antibiotic resistance pattern in neonatal insensitive care unit (NICU at Beasat Hospital, Sanandaj, Iran.

Directory of Open Access Journals (Sweden)

Parvin Mohammadi

2014-05-01

Full Text Available Bacteremia continues to result in significant morbidity and mortality, particularly among neonates. There is scarce data on neonatal bacteremia in among Iranian neonates. In this study, we determined neonatal bacteremia isolates and their antibiotic resistance pattern in neonatal insensitive care unit at Beasat hospital, Sanandaj, Iran. During one year, all neonates admitted to the NICU were evaluated. Staphylococcal isolates were subjected to determine the prevalence of MRS and mecA gene. A total of 355 blood cultures from suspected cases of sepsis were processed, of which 27 (7.6% were positive for bacterial growth. Of the 27 isolates, 20 (74% were Staphylococcus spp as the leading cause of bacteremia. The incidence of Gram negative bacteria was 04 (14.8%. The isolated bacteria were resistant to commonly used antibiotics. Maximum resistance among Staphylococcus spp was against Penicillin, and Ampicillin. In our study, the isolated bacteria were 7.5 % Vancomycin and Ciprofloxacin sensitive. Oxacillin disk diffusion and PCR screened 35% and 30% mec a positive Staphylococcus spp. The spectrum of neonatal bacteremia as seen in NICU at Beasat hospital confirmed the importance of pathogens such as Staphylococcus spp. Penicillin, Ampicillin and Cotrimoxazol resistance was high in theses isolates with high mecA gene carriage, probably due to antibiotic selection.

Reduced nephron endowment in the neonates of Indigenous Australian peoples.

Science.gov (United States)

Kandasamy, Y; Smith, R; Wright, I M R; Lumbers, E R

2014-02-01

Rates of chronic kidney disease (CKD) among Indigenous groups in Australia exceed non-Indigenous rates eight-fold. Using kidney volume as a surrogate for nephron number, we carried out a study to determine if Indigenous neonates have a smaller kidney volume (and thus a reduced nephron number) from birth compared with non-Indigenous neonates. We recruited term and preterm neonates (Indigenous) and 39 term (13 Indigenous) neonates. TKV of Indigenous neonates was significantly lower at 32 weeks [12.0 (2.0) v. 15.4 (5.1) ml; P=0.03] and 38 weeks CA [18.6 (4.0) v. 22.6 (5.9) ml; P=0.04] respectively. Term Indigenous neonates also had smaller kidney volumes compared with non-Indigenous neonates. Despite a smaller kidney volume (and reduced nephron number), Indigenous neonates did not have a significantly lower eGFR. Indigenous neonates achieve similar eGFRs to Non-Indigenous neonates, presumably through a higher single nephron filtration rate. This places Indigenous neonates at a greater risk of long-term kidney damage later in life.

Neonatal herpes in Denmark 1977-1991

DEFF Research Database (Denmark)

Fonnest, G; de la Fuente Fonnest, I; Weber, Tom

1997-01-01

BACKGROUND: To prevent neonatal herpes, women in labor with genital herpes infection are still delivered by Cesarean section. This policy is currently being debated. The aim of this study was to determine the incidence of neonatal herpes in Denmark and to evaluate the prevention practice. METHODS...... herpes recurrence. Four infants had a serious infection in spite of Cesarean section. This study does not support a policy of Cesarean section in case of maternal recurrent herpes simplex infection at delivery.......BACKGROUND: To prevent neonatal herpes, women in labor with genital herpes infection are still delivered by Cesarean section. This policy is currently being debated. The aim of this study was to determine the incidence of neonatal herpes in Denmark and to evaluate the prevention practice. METHODS......: All newborns with perinatal herpes in Denmark 1977-1991 were identified from hospital-records. RESULTS: Of 862,298 deliveries 136 possible cases were found but only 30 (22%) fulfilled the criteria for neonatal herpes. The incidence increased from 2.36 to 4.56 per 100,000 live births during 1977...

Incidence of congenital heart disease among neonates in a neonatal unit of a tertiary care hospital

International Nuclear Information System (INIS)

Hussain, S.; Sabir, M.U.

2014-01-01

Objectives: To determine the incidence and pattern of various congenital heart disease in a neonatal unit of a tertiary care hospital. Methods: The prospective study was carried out in the neonatal unit of Combined Military Hospital, Rawalpindi, from September 2008 to August 2011. All 5800 neonates admitted with gestational age of >28 weeks irrespective of birthweight were included in the study. Neonatologist/Paediatrician carried out the neonatal examination during the first 12 hours of life. Neonates suspected of having congenital heart disease were further evaluated by pulse oxymetry, X-ray chest and echocardiography to ascertain final diagnosis and type of lesion. Data was collected on a predesigned proforma containing information regarding gender, mode of delivery, gestational age, weight at birth, family history, and associated malformations. SPSS 16 was used for statistical analysis. Results: Of the 5800 neonates, 87 (1.5%) were found to have congenital heart disease with an incidence of 15/1000. There was a male preponderance. Most common lesion was ventricular septal defect 27(31.3%), followed by atrial septal defect 20 (22.9%), patent ductus arteriosus 13 (14.94%), tetralogy of fallot 06 (6.89%), transposition of great arteries 04 (4.59%), Pulmonary stenosis 05 (5.79%) and 03(3.44%) had atrioventricular canal defects. Conclusion: Congenital heart disease is a common congenital anomaly. Its incidence varies from centre to centre due to different factors like nature of the sample, method of detection and early examination by a neonatologist/paediatrician. In this study a higher incidence is reported because it was carried out in a tertiary care unit, which is a referral hospital and all the neonates admitted in the unit were included in the study. (author)

Neonatal Bartter Syndrome in association with congenital adrenal hyperplasia in a neonate - a rare combination.

Science.gov (United States)

Hussain, Shabbir

2016-05-01

Neonatal Bartter syndrome (NBS) is an autosomal recessive renal tubulopathy characterized by hypokalaemic, hypochloraemic metabolic alkalosis associated with increased urinary loss of sodium, potassium, calcium and chloride. There is hyperreninaemia and hyperaldosteronaemia but normotension. Congenital adrenal hyperplasia (CAH), another autosomal recessive condition, may present in the neonatal period with vomiting, hypovolaemia, failure to gain weight or ambiguous genitalia. We report a case of NBS and CAH combination in a neonate. A male neonate born at term was admitted with history of recurrent vomiting and dehydration episodes. Investigations revealed electrolytes imbalance, metabolic alkalosis, raised aldosterone and renin levels suggestive of NBS. He was treated successfully and discharged. He was re-admitted with the same symptoms. Further evaluation confirmed the presence of CAH as well. We report this case because of the rarity of this combination (NBS plus CAH) and to the best of our knowledge this is the first such case report from Pakistan.

Simultaneous occurrence of fetal and neonatal alloimmune thrombocytopenia and neonatal neutropenia due to maternal neutrophilic autoantibodies

DEFF Research Database (Denmark)

Taaning, Ellen; Jensen, Lise; Varming, Kim

2012-01-01

Foetal and neonatal alloimmune thrombocytopenia (FNAIT) and neonatal neutropenia caused by maternal autoantibodies against neutrophils are rare disorders. We describe a newborn with severe thrombocytopenia and intracerebral bleeding caused by maternal anti-HPA-3a alloantibodies and mild neutropenia...

Acute renal failure: Nephrosonographic findings in asphyxiated neonates

Directory of Open Access Journals (Sweden)

Mohd. Ashraf

2011-01-01

Full Text Available To determine the incidence of acute renal failure (ARF and nephrosonographic findings among asphyxiated neonates, and to correlate this with uric acid levels and the severity of hypoxic encephalopathy, we studied 80 full-term appropriate-for-date singleton neonates with perinatal asphyxia, and 30 healthy full-term neonates as controls from March 2006 to February 2007. A detailed history, thorough clinical examination along with investigations, including urine examination, 24-h urine collection, ultrasonography of abdomen and cranium, serum electrolytes, blood urea nitrogen, serum creatinine, and serum uric acid were obtained. ARF developed in 45% (36/80 of the asphyxiated neonates. Forty-eight (60% neonates showed significant elevation of blood urea and 41 (51.3% neonates had significant elevation of serum creatinine than the control group (P < 0.001. Sixty-two (77.5% neonates developed significant elevation of serum uric acid levels, and nephrosonography revealed hyperechogenicity in all of them, while only two among the healthy neonates showed the raised uric acid levels (P < 0.001. Nonoliguric renal failure was seen 28/36 (77.8% of the neonates with ARF, whereas eight (22.2% neonates had oliguric renal failure. Eight (27.8% patients among ARF patients maintained abnormal biochemical parameters after 2 weeks, and of whom four patients died after variable lengths of time with a mortality rate of 11.11%. Kidneys are the most common organs involved in perinatal asphyxia, and uric acid might be a causative factor for failure in addition to hypoxic insult. Routine use of kidney function test, along with abdominal ultrasonography form an important screening tool to detect any additional morbidity in these patients.

A double-blinded randomized trial on growth and feeding tolerance with Saccharomyces boulardii CNCM I-745 in formula-fed preterm infants

Directory of Open Access Journals (Sweden)

Lingfen Xu

2016-05-01

Full Text Available Objective: The use of probiotics is increasingly popular in preterm neonates, as they may prevent necrotizing enterocolitis sepsis and improve growth and feeding tolerance. There is only limited literature on Saccharomyces boulardii CNCM I-745 (S. boulardii in preterm infants. Method: A prospective, randomized, case-controlled trial with the probiotic S. boulardii (50 mg/kg twice daily was conducted in newborns with a gestational age of 30–37 weeks and a birth weight between 1500 and 2500 g. Results: 125 neonates were enrolled; 63 in the treatment and 62 in the control group. Weight gain (16.14 ± 1.96 vs. 10.73 ± 1.77 g/kg/day, p 30 weeks old. Resumo: Objetivo: O uso de probióticos está cada vez mais popular em neonatos prematuros, já que podem prevenir a enterocolite necrosante (ECN e a sepse e aumentar o crescimento e a tolerância de alimentação. Há apenas uma literatura limitada sobre a Saccharomyces boulardii CNCM I-745 (S. boulardii em neonatos prematuros. Método: Um ensaio de caso-controle prospectivo randomizado com o probiótico S. boulardii (50 mg/kg duas vezes por dia foi realizado com recém-nascidos com idade gestacional de 30 a 37 semanas e peso ao nascer entre 1500 e 2500 g. Resultados: Foram incluídos 125 neonatos, 63 no grupo de tratamento e 62 no de controle. O ganho de peso (16,14 ± 1,96 em comparação a 10,73 ± 1,77 g/kg/dia, p 30 semanas de idade. Keywords: Feeding (intolerance, Growth, Necrotizing enterocolitis, Preterm infant, Probiotic, Sepsis, Palavras-chave: (InTolerância de alimentação, Crescimento, Enterocolite necrosante, Neonato prematuro, Probiótico, Sepse

Intracranial complications of Serratia marcescens infection in neonates.

Science.gov (United States)

Madide, Ayanda; Smith, Johan

2016-03-15

Even though Serratia marcescens is not one of the most common causes of infection in neonates, it is associated with grave morbidity and mortality. We describe the evolution of brain parenchymal affectation observed in association with S. marcescens infection in neonates. This retrospective case series details brain ultrasound findings of five neonates with hospital-acquired S. marcescens infection. Neonatal S. marcescens infection with or without associated meningitis can be complicated by brain parenchymal affectation, leading to cerebral abscess formation. It is recommended that all neonates with this infection should undergo neuro-imaging more than once before discharge from hospital; this can be achieved using bedside ultrasonography.

Status of Neonatal Pain Assessment and Management in Jordan.

Science.gov (United States)

Abdel Razeq, Nadin M; Akuma, Akuma O; Jordan, Sue

2016-08-01

Current pain assessment and management in neonates need to be fully described before neonatal pain care can be optimized. This study's purpose was to report neonatal nurses' knowledge, existing pain assessment practice, and pharmacological pain management of neonates in Jordan. A cross-sectional descriptive study was conducted. Eighteen neonatal intensive care units in Jordan were included in the study. One hundred eighty-four neonatal nurses participated. Questionnaires were distributed by and returned to the neonatal intensive care units' managers between June and August 2014. Descriptive and inferential statistics were used to present study results. Of 240 questionnaires distributed, 184 useable responses were returned. Nurses' knowledge regarding neonates' neurological development, nociception, and need for neonatal pain management was suboptimal. The analgesics most commonly used to treat neonatal pain were acetaminophen (52%) and lidocaine (45%). Benzodiazepines, phenobarbitone, and muscles relaxants were also used. Most nurses (54%-97%) reported that pain emanating from most painful procedures was never or rarely treated. Circumcision, lumbar punctures, and chest tube insertion were assigned the highest pain scores (≥9), but were rarely accompanied by analgesia. Pain assessment scales were more likely to be used, and procedural pain was more likely to be treated, in private hospitals than public hospitals. Neonates who require special care still suffer unnecessary pain that could be avoided and managed by following best practice recommendations. Disparities between developed and developing countries in quality of neonatal pain care appear to exist. Resources for education and routine care are needed to address these discrepancies. Copyright © 2016 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

NEONATES (BIRTH – 1 MONTH)

African Journals Online (AJOL)

Chantel

Major defects in neonatal skin have serious consequences for the health of the baby, but fortunately these are very rare. Early diagnosis of the genodermatoses can be life-saving. Birthmarks, also known as naevi, are usually first noted in neonates, and can be very alarming for parents. A variety of infections can.

Neonatal Listeriosis

Directory of Open Access Journals (Sweden)

Shih-Yu Chen

2007-01-01

Full Text Available In Western developed countries, Listeria monocytogenes is not an uncommon pathogen in neonates. However, neonatal listeriosis has rarely been reported in Taiwan. We describe two cases collected from a single medical institute between 1990 and 2005. Case 1 was a male premature baby weighing 1558 g with a gestational age of 31 weeks whose mother had fever with chills 3 days prior to delivery. Generalized maculopapular rash was found after delivery and subtle seizure developed. Both blood and cerebrospinal fluid culture collected on the 1st day yielded L. monocytogenes. In addition, he had ventriculitis complicated with hydrocephalus. Neurologic development was normal over 1 year of follow-up after ventriculoperitoneal shunt operation. Case 2 was a 28-weeks' gestation male premature baby weighing 1180 g. Endotracheal intubation and ventilator support were provided after delivery due to respiratory distress. Blood culture yielded L. monocyto-genes. Cerebrospinal fluid showed pleocytosis but the culture was negative. Brain ultrasonography showed ventriculitis. Sudden deterioration with cyanosis and bradycardia developed on the 8th day and he died on the same day. Neonatal listeriosis is uncommon in Taiwan, but has significant mortality and morbidity. Early diagnosis of perinatal infection relies on high index of suspicion in perinatal health care professionals. [J Formos Med Assoc 2007;106(2:161-164

Imaging findings of neonatal adrenal disorders

International Nuclear Information System (INIS)

Yoon, Hye Kyung; Han, Bo Kyung; Lee, Min Hee

1999-01-01

In newborn infants, normal adrenal glands are characterized by a relatively thin echogenic center surrounded by a thick, hypoechoic cortical rim as seen on ultrasound (US). Various disorders involving the neonatal adrenal gland include adrenal hemorrhage, hyperplasia, cyst, Wolman's disease, and congenital neuroblastoma. Adrenal hemorrhage is the most common cause of an adrenal mass in the neonate, though differentiation between adrenal hemorrhage and neuroblastoma is in many cases difficult. We describe characteristic US, CT and MR imaging findings in neonates with various adrenal disorders

Imaging findings of neonatal adrenal disorders

Energy Technology Data Exchange (ETDEWEB)

Yoon, Hye Kyung; Han, Bo Kyung; Lee, Min Hee [Sungkyunkwan Univ. College of Medicine, Seoul (Korea, Republic of)

1999-01-01

In newborn infants, normal adrenal glands are characterized by a relatively thin echogenic center surrounded by a thick, hypoechoic cortical rim as seen on ultrasound (US). Various disorders involving the neonatal adrenal gland include adrenal hemorrhage, hyperplasia, cyst, Wolman's disease, and congenital neuroblastoma. Adrenal hemorrhage is the most common cause of an adrenal mass in the neonate, though differentiation between adrenal hemorrhage and neuroblastoma is in many cases difficult. We describe characteristic US, CT and MR imaging findings in neonates with various adrenal disorders.

Triagem auditiva neonatal: incidência de deficiência auditiva neonatal sob a perspectiva da nova legislação paulista Neonatal auditory screening: the incidence of neonatal hearing impairment in the context of the new São Paulo legislation

Directory of Open Access Journals (Sweden)

Khalil Fouad Hanna

2010-06-01

Full Text Available OBJETIVOS: identificar a incidência de recém-nascidos com deficiência auditiva, em maternidade particular da cidade de São Paulo. MÉTODOS: estudo de coorte transversal, realizado no período de 2004 a 2008, em maternidade localizada na zona sul da cidade de São Paulo, com 20.615 recém-nascidos de ambos os sexos, sem indicadores de risco para deficiência auditiva e submetidos à triagem auditiva neonatal. O teste foi realizado por intermédio das Emissões Otoacústicas Evocadas Transientes (EOAET. Os pacientes que falharam nas EOAET nas duas fases foram encaminhados para a realização do Potencial Evocado Auditivo do Tronco Encefálico (PEATE para a confirmação da deficiência auditiva neonatal. Empregou-se o Teste Exato de Fischer e o nível de significância adotado foi de 0,05 oupOBJECTIVES: to determine the incidence of hearing impairment in newborns, at a private maternity hospital in the city of São Paulo. METHODS: a cross-sectional cohort study was carried out covering the period between 2004 and 2008, at a maternity hospital located in the southern zone of the city of São Paulo, including 20,615 newborns of both sexes, with no risk factors for hearing impairment and who had undergone neonatal auditory screening. The test was carried out using the Evoked Transient Otoacoustic Emissions test. Patients who failed both phases of this test were referred to do a Brainstem Auditory Evoked Potential test to confirm the presence of neonatal auditory deficiency. Fischer 's exact test was used with a level of significance of 0.05 orp<0.05. RESULTS: the incidence of neonatal hearing impairment found in this study was 1.2/1000. CONCLUSION: state legislation allows neonatal auditory screening to be more effective in achieving early detection of neonatal hearing impairment. Neonatal auditory screening prevents future impairment of oral development and language acquisition in a social, professional and educational context.

Clinical Pharmacology of Paracetamol in Neonates: A Review

Directory of Open Access Journals (Sweden)

Gian Maria Pacifici, MD, PhD

2015-12-01

Paracetamol clearance is lower in neonates than in children and adults. After metabolic conversion, paracetamol is subsequently eliminated by the renal route. The main metabolic conversions are conjugation with glucuronic acid and with sulphate. In the urine of neonates sulphated paracetamol concentration is higher than the glucuronidated paracetamol level, suggesting that sulfation prevails over glucuronidation in neonates. A loading dose of 20 mg/kg followed by 10 mg/kg every 6 hours of intravenous paracetamol is suggested to achieve a compartment concentration of 11 mg/L in late preterm and term neonates. Aiming for the same target concentration, oral doses are similar with rectal administration of 25 to 30 mg/kg/d in preterm neonates of 30 weeks’ gestation, 45 mg/kg/d in preterm infants of 34 weeks’ gestation, and 60 mg/kg/d in term neonates are suggested. The above-mentioned paracetamol doses for these indications (pain, fever are well tolerated in neonates, but do not result in a significant increase in liver enzymes, and do not affect blood pressure and have limited effects on heart rate. In contrast, the higher doses suggested in extreme preterm neonates to induce closure of the patent ductus arteriosus have not yet been sufficiently evaluated regarding efficacy or safety. Moreover, focussed pharmacovigilance to explore the potential causal association between paracetamol exposure during perinatal life and infancy and subsequent atopy is warranted.

Clinical pharmacokinetics of aminoglycosides in the neonate: a review.

Science.gov (United States)

Pacifici, Gian Maria

2009-04-01

Sepsis is common in neonates and is a major cause of morbidity and mortality. Sixty percent of preterm neonates receive at least one antibiotic, and 43% of the antibiotics administered to these neonates are aminoglycosides. The clearance (Cl), serum half-life (t(1/2)), and volume of distribution (Vd) of aminoglycosides change during the neonatal life, and the pharmacokinetics of aminoglycosides need to be studied in neonates in order to optimise therapy with these drugs. The aim of this work is to review the published data on the pharmacokinetics of aminoglycosides in order to provide a critical analysis of the literature that can be a useful tool in the hands of physicians. The bibliographic search was performed electronically using PubMed, as the search engine, through July 11th, 2008. Firstly, a Medline search was performed with the keywords "pharmacokinetics of aminoglycosides in neonates" with the limit of "human". Other Medline searches were performed with the keywords "pharmacokinetics of ... in neonates" followed by the name of the aminoglycosides: amikacin, gentamicin, netilmicin and tobramycin. In addition, the book Neofax: A Manual of Drugs Used in Neonatal Care by Young and Mangum (Thomson Healthcare, 2007) was consulted. The aminoglycosides are mainly eliminated by the kidney, and their elimination rates are reduced at birth. As a consequence Cl is reduced and t(1/2) is prolonged in the neonate as compared to more mature infants. The high body-water content of the neonate results in a large Vd of aminoglycosides as these drugs are fairly water soluble. Postnatal development is an important factor in the maturation of the neonate, and as postnatal age proceeds, Cl of aminoglycosides increases. The maturation of the kidney governs the pharmacokinetics of aminoglycosides in the infant. Cl and t(1/2) are influenced by development, and this must be taken into consideration when planning a dosage regimen with aminoglycosides in the neonate. Aminoglycosides

Influence of iron status on risk of maternal or neonatal infection and on neonatal mortality with an emphasis on developing countries

NARCIS (Netherlands)

Brabin, Loretta; Brabin, Bernard J.; Gies, Sabine

2013-01-01

Infection is a major cause of neonatal death in developing countries. This review investigates whether host iron status affects the risk of maternal and/or neonatal infection, potentially contributing to neonatal death, and summarizes the iron acquisition mechanisms described for pathogens causing

Neonatal follow-up program: Where do we stand?

Science.gov (United States)

2012-01-01

Neonatal follow-up program (NFP) is becoming the corner stone of standard, high quality care provided to newborns at risk of future neuorodevelopmental delay. Most of the recognized neonatal intensive care units in the developed countries are adopting NFP as part of their mandatory care for the best long term outcome of high risk infants, especially very low birth weight (VLBW) infants. Unfortunately, in the developing and in underdeveloped countries, such early detection and intervention programs are rarely existing, mainly because of the lack of awareness of and exposure to such programs in spite of the increasing numbers of surviving sick newborns due to advancement in neonatal care in these countries. This is a review article to explore the Neonatal follow-up programs looking at historical development, benefts and aims, and standard requirements for successful program development that can be adopted in our countries. In conclusion, proper Neonatal follow-up programs are needed to improve neonatal outcome. Therefore all professionals working in the feld of neonatal care in developing countries should cooperate to create such programs for early detection and hence early intervention for any adverse long term outcome in high-risk newborn infants PMID:27493326

Intrapartum FHR monitoring and neonatal CT brain scan

International Nuclear Information System (INIS)

Takahashi, Yoshiki; Ukita, Masahiko; Nakada, Eizo

1982-01-01

The effect of fetal distress on the neonatal brain was investigated by neonatal CT brain scan, FHR monitoring and mode of delivery. This study involved 11 cases of full term vertex delivery in which FHR was recorded by fetal direct ECG during the second stage labor. All infants weighed 2,500 g or more. FHR monitoring was evaluated by Hon's classification. Neonatal brain edema was evaluated by cranial CT histgraphic analysis (Nakada's method). 1) Subdural hemorrhage was noted in 6 of 7 infants delivered by vacuum extraction or fundal pressure (Kristeller's method). 2) Intracranial hemorrhage was demonstrated in all of 3 infants with 5-min. Apgar score 7 or less. 3) Two cases with prolonged bradycardia and no variability had intraventricular or intracerebral hemorrhage which resulted in severe central nervous system damage. 4) The degree of neonatal brain edema correlated with 5-min. Apgar score. 5) One case with prolonged bradycardia and no variability resulted in severe neonatal brain edema. Four cases with variable deceleration and increased variability resulted in mild neonatal brain edema. Two cases with late deceleration and decreased variability resulted in no neonatal brain edema. (author)

Drug binding properties of neonatal albumin

DEFF Research Database (Denmark)

Brodersen, R; Honoré, B

1989-01-01

Neonatal and adult albumin was isolated by gel chromatography on Sephacryl S-300, from adult and umbilical cord serum, respectively. Binding of monoacetyl-diamino-diphenyl sulfone, warfarin, sulfamethizole, and diazepam was studied by means of equilibrium dialysis and the binding data were analyzed...... by the method of several acceptable fitted curves. It was found that the binding affinity to neonatal albumin is less than to adult albumin for monoacetyl-diamino-diphenyl sulfone and warfarin. Sulfamethizole binding to the neonatal protein is similarly reduced when more than one molecule of the drug is bound...

Hypothermia for neonatal hypoxic-ischemic encephalopathy: NICHD Neonatal Research Network contribution to the field.

Science.gov (United States)

Shankaran, Seetha; Natarajan, Girija; Chalak, Lina; Pappas, Athina; McDonald, Scott A; Laptook, Abbot R

2016-10-01

In this article, we summarize the NICHD Neonatal Research Network (NRN) trial of whole-body hypothermia for neonates with hypoxic-ischemic encephalopathy in relation to other randomized controlled trials (RCTs) of hypothermia neuroprotection. We describe the NRN secondary studies that have been published in the past 10 years evaluating clinical, genetic, biochemical, and imaging biomarkers of outcome. Copyright © 2016 Elsevier Inc. All rights reserved.

Delivery practices, hygiene, birth attendance and neonatal infections ...

African Journals Online (AJOL)

Background: Drawing attention to home birth conditions and subsequent neonatal infections is a key starting point to reducing neonatal morbidity which are a main cause of mortality in sub-Saharan Africa. Objectives: To determine the proportion of respiratory, ophthalmic, and diarrhoeal infections in neonates; the proportion ...

Incidence, risk factors, and mortality of neonatal and late-onset dilated cardiomyopathy associated with cardiac neonatal lupus.

Science.gov (United States)

Morel, Nathalie; Lévesque, Kateri; Maltret, Alice; Baron, Gabriel; Hamidou, Mohamed; Orquevaux, Pauline; Piette, Jean-Charles; Barriere, François; Le Bidois, Jérôme; Fermont, Laurent; Fain, Olivier; Theulin, Arnaud; Sassolas, François; Hauet, Quentin; Guettrot-Imbert, Gaëlle; Georgin-Lavialle, Sophie; Deligny, Christophe; Hachulla, Eric; Mouthon, Luc; Le Jeunne, Claire; Ravaud, Philippe; Le Mercier, Delphine; Romefort, Bénédicte; Villain, Elisabeth; Bonnet, Damien; Costedoat-Chalumeau, Nathalie

2017-12-01

Dilated cardiomyopathy (DCM), a well-known complication of cardiac neonatal lupus, is associated with high mortality rate. Its risk factors remain unclear. We analyzed occurrence of postnatal DCM among children with high-degree congenital heart block (CHB) and mothers with anti-SSA and/or anti-SSB antibodies. Among 187 neonates with CHB, 35 (18.8%, one missing data) had DCM and 22 (11.8%) died during a median follow-up of 7years [range: birth-36years]. On multivariate analysis, factors associated with postnatal DCM were in utero DCM (P=0.0199; HR=3.13 [95% CI: 1.20-8.16]), non-European origin (P=0.0052; HR=4.10 [95% CI: 1.81-9.28]) and pacemaker implantation (P=0.0013; HR=5.48 [95% CI: 1.94-15.47]). Postnatal DCM could be categorized in two subgroups: neonatal DCM (n=13, diagnosed at a median age of 0day [birth-4days]) and late-onset DCM (n=22, diagnosed at a median age of 15.2months [3.6months-22.8years]). Factors associated with neonatal DCM were in utero DCM, hydrops, endocardial fibroelastosis and pericardial effusion, whereas those associated with late-onset DCM were non-European origin, in utero mitral valve insufficiency, and pacemaker implantation. Fluorinated steroids showed no protective effect against late-onset DCM (P=0.27; HR=1.65 [95% CI: 0.63-4.25]). Probability of survival at 10years was 23.1% for newborns diagnosed neonatally with DCM, 53.9% for those who developed late-onset DCM, and 98.6% for those without DCM. Neonatal and late-onset DCM appear to be two different entities. None of the known risk factors associated with neonatal DCM predicted late-onset DCM. Long-term follow-up of cardiac function is warranted in all children with CHB. Copyright © 2017 Elsevier B.V. All rights reserved.

Análise exploratória dos fatores relacionados ao prognóstico em idosos com sepse grave e choque séptico Related prognostic factors in elderly patients with severe sepsis and septic shock

Directory of Open Access Journals (Sweden)

Roberta de Lima Machado

2009-03-01

Full Text Available OBJETIVOS: O objetivo deste estudo foi avaliar variáveis relacionadas à mortalidade intra-hospitalar em 28 dias, de idosos com diagnóstico de sepse grave ou choque séptico em unidade de terapia intensiva clínica. MÉTODOS: Cento e cinqüenta e dois pacientes, com idade > 65 anos internados com sepse grave ou choque séptico foram acompanhados durante 28 dias e as variáveis foram coletadas nos dias 1, 3, 5, 7, 14 e 28 de internação. Para a comparação das variáveis categóricas, empregaram-se os testes Qui-quadrado e para as variáveis contínuas o teste de Mann-Whitney ou teste T, quando apropriado. Todos os testes foram bicaudais com erro alfa de 0,05. RESULTADOS: A média da idade foi de 82,0 �� 9,0 anos, com 64,5% de mulheres, sendo a mortalidade de 47,4%. Foram relacionados ao óbito: índice Acute Physiologic and Chronic Heatlh Evaluation II (p OBJECTIVES: The objective of this study was to evaluate variables related to intra hospital mortality at 28 days, of aged persons with severe sepsis and septic shock in a clinical ICU. METHODS: One hundred and fifty-two patients aged > 65 years with severe sepsis and septic shock were followed for 28 days and the variables were collected on days 1, 3, 5, 7, 14 and 28 of stay. To compare categorical variables the Chi-square test was used and the Mann-Whitney or t test for continuous variables. All tests were double-tailed, alpha error of 0.05. RESULTS: Mean age was 82.0 ± 9.0 years and 64.5% were female. Mortality was of 47.4%. Related to death were the following: Acute Physiological and Chronic Heath Evaluation II score (p < 0.001, Sequential Organ Failure Assessment score on days 1, 3, 5, 7 (p < 0.001, length of stay in intensive care (p < 0.001, number of organ failures (p < 0.001, high serum lactate on day 3 (p = 0.05, positive troponin I (p < 0.01, echocardiographic variables (systolic diameter p = 0.005; diastolic diameter p = 0.05; shortening fraction p = 0.02, previous renal

Neurodevelopmental outcome after neonatal perforator stroke

NARCIS (Netherlands)

Ecury-Goossen, Ginette M; van der Haer, Marit; Smit, Liesbeth S; Feijen-Roon, Monique; Lequin, Maarten; de Jonge, Rogier C J; Govaert, Paul; Dudink, Jeroen

AIM: To assess outcome after neonatal perforator stroke in the largest cohort to date. METHOD: Survivors from a cohort of children diagnosed with neonatal perforator stroke using cranial ultrasound or magnetic resonance imaging were eligible for inclusion. Recovery and Recurrence Questionnaire

Diagnóstico bucal precoce no SUS : análise individual, vigilância à saúde e trabalho em equipe como possibilidade (re)estruturante

OpenAIRE

Melo, Nilce Santos de; Figueiredo, Paulo Tadeu de Souza; Leite, André Ferreira; Souza, Tiago Araújo Coelho de; Lucena, Edson Hilan Gomes de; Zanetti, Carlo Henrique Goretti

2011-01-01

O artigo se estrutura em dois estudos exploratórios sobre o exercício do diagnóstico clínico de lesões bucais no SUS. Os dados foram obtidos por meio de questionários, aplicados durante atividades de educação continuada. Aproximadamente 300 cirurgiões-dentistas que atuam na atenção básica responderam. Para a maioria (79,5%), há tempo, infraestrutura e intenção de realizar diagnóstico precoce. Por outro lado, os profissionais manifestaram dificuldades em realiz...

Bupivacaine versus lidocaine analgesia for neonatal circumcision

Directory of Open Access Journals (Sweden)

Stolik-Dollberg Orit C

2005-05-01

Full Text Available Abstract Background Analgesia for neonatal circumcision was recently advocated for every male infant, and its use is considered essential by the American Academy of Pediatrics. We compared the post-operative analgesic quality of bupivacaine to that of lidocaine for achieving dorsal penile nerve block (DPNB when performing neonatal circumcision. Methods Data were obtained from 38 neonates following neonatal circumcision. The infants had received DPNB analgesia with either lidocaine or bupivacaine. The outcome variable was the administration by the parents of acetaminophen during the ensuing 24 hours. Results Seventeen infants received lidocaine and 19 received bupivacaine DPNB. Ten infants in the lidocaine group (59% were given acetaminophen following circumcision compared to only 3 (16% in the bupivacaine group (P 2 = 20.6; P = 0.006. Conclusion DPNB with bupivacaine for neonatal circumcision apparently confers better analgesia than lidocaine as judged by the requirement of acetaminophen over the ensuing 24-hour period.

Structural Connectivity Asymmetry in the Neonatal Brain

OpenAIRE

Ratnarajah, Nagulan; Rifkin-Graboi, Anne; Fortier, Marielle V.; Chong, Yap Seng; Kwek, Kenneth; Saw, Seang-Mei; Godfrey, Keith M; Gluckman, Peter D.; Meaney, Michael J.; Qiu, Anqi

2013-01-01

Asymmetry of the neonatal brain is not yet understood at the level of structural connectivity. We utilized DTI deterministic tractography and structural network analysis based on graph theory to determine the pattern of structural connectivity asymmetry in 124 normal neonates. We tracted white matter axonal pathways characterizing interregional connections among brain regions and inferred asymmetry in left and right anatomical network properties. Our findings revealed that in neonates, small-...

Neonatal transport practices in Ibadan, Nigeria | Abdulraheem | Pan ...

African Journals Online (AJOL)

Introduction: Neonatal transport involves moving sick neonates in optimal conditions to ensure good outcomes. It is well organized in most developed countries but receives little attention in developing countries where the highest burden of neonatal mortality exists and a large number of newborns require referrals daily for ...

Comparison of blood lead levels of mothers and cord blood in intrauterine growth retarded neonates and normal term neonates

International Nuclear Information System (INIS)

Iranpour, R.; Besharati, Amir A.; Nasseri, F.; Hashemipour, M.; Kelishadi, R.; Balali-Mood, M.

2007-01-01

Objective was to compare the blood lead levels of mothers and cord blood in intrauterine growth retarded (IUGR) neonates and normal term neonates. From April 2005, we carried out a cross-sectional, prospective study in Isfahan University of Medical Sciences, Isfahan, Iran. Blood lead levels were measured in the umbilical cord and maternal venous blood samples in the 32 mother-infant pairs with IUGR full term neonates and 34 mother-infant pairs with normal full term neonates. Blood-lead levels were analyzed by atomic absorption spectrometry. The mean lead concentration in neonates of IUGR and normal groups was not significantly different (107.47+- 16.75 versus 113.08+-19.08 ug/L, p=0.2). The mean lead concentration in mothers of IUGR group was lower than normal groups, but this difference was not significant (124.56+-19.71 versus 135.26+-26.91 ug/L, p=0.07). Maternal lead levels were strongly related with related with cord blood in both IUGR and normal groups (r=0.8, p 100ug/L by the centers for disease control; however, this was not statistically different between the groups. Our results indicate that the mean lead level was not higher in IUGR neonates, and the whole blood lead was not related to the birth weight. In addition, maternal and cord blood lead levels were strongly correlated, and there were remarkable lead burdens on both the mothers and their neonates in this industrial area. (author)

Ethical issues in neonatal research involving human subjects.

Science.gov (United States)

Fleischman, Alan R

2016-06-01

Research involving critically ill neonates creates many ethical challenges. Neonatal clinical research has always been hard to perform, is very expensive, and may generate some unique ethical concerns. This article describes some examples of historical and modern controversies in neonatal research, discusses the justification for research involving such vulnerable and fragile patients, clarifies current federal regulations that govern research involving neonates, and suggests ways that clinical investigators can develop and implement ethically grounded human subjects research. Copyright © 2016 Elsevier Inc. All rights reserved.

The sonographic features of neonatal appendicitis: A case report.

Science.gov (United States)

Si, Shu-Yu; Guo, Yi-Yi; Mu, Jian-Feng; Yan, Chao-Ying

2017-11-01

Neonatal appendicitis is extremely rare, and preoperative diagnosis is challenging. This study aimed to investigate the utility of ultrasound for the diagnosis of neonatal appendicitis. Four cases of neonatal appendicitis were included in this case series. One was a female infant and the other 3 were male infants; they were aged from 10 to 17 days. Neonatal appendicitis. Four newborns in our hospital were diagnosed with neonatal appendicitis by abdominal ultrasound. Their sonographic features were summarized and compared with surgical and pathological findings. In these infants, abdominal ultrasound demonstrated ileocecal bowel dilatation, intestinal and bowel wall thickening, and localized encapsulated effusion in the right lower quadrant and the abscess area, which was assumed to surround the appendix. Ultrasound is helpful for the diagnosis of neonatal appendicitis.

Involvement of parents in care. Telemedicin neonatal homecare

DEFF Research Database (Denmark)

Holm, K. G.; Brødsgaard, Anne; Zachariassen, G.

2015-01-01

INTRODUCTION Neonatal homecare (NH) is an alternative to hospitalization for healthy preterm infants dependent only on tube feeding. NH implies parents managing tube feeding while establishing breastfeeding at home with support from neonatal nurses offering home visits regularly, until breastfeed......INTRODUCTION Neonatal homecare (NH) is an alternative to hospitalization for healthy preterm infants dependent only on tube feeding. NH implies parents managing tube feeding while establishing breastfeeding at home with support from neonatal nurses offering home visits regularly, until...... breastfeeding is established. Home visits are time consuming and challenging for neonatal units covering big geographical areas and therefore replacements for home visits should be considered. The aim of this study is to identify parent’s needs when receiving NH and thereby identify requirements...

Prenatal cocaine exposure and neonatal/infant outcomes.

Science.gov (United States)

Cambell, Shelly

2003-01-01

Illegal drug use throughout the nation is a problem of epidemic proportion. Of particular concern is drug use among pregnant women. In most cases, these women have little hope of achieving a better life for themselves or their children. Illegal drugs, cocaine in particular, can have devastating effects on the neonate. These effects can last well into childhood and can exhibit themselves in academic, social, and family situations. Challenges for the neonatal nurse include early identification of these infants and use of available resources. This article addresses prenatal cocaine use and support services for drug-dependent women, effects of cocaine during the neonatal period, possible neonatal and infant outcomes, and implications for nursing practice.

Time for a neonatal-specific consensus definition for sepsis.

Science.gov (United States)

Wynn, James L; Wong, Hector R; Shanley, Thomas P; Bizzarro, Matthew J; Saiman, Lisa; Polin, Richard A

2014-07-01

To review the accuracy of the pediatric consensus definition of sepsis in term neonates and to determine the definition of neonatal sepsis used. The review focused primarily on pediatric literature relevant to the topic of interest. Neonatal sepsis is variably defined based on a number of clinical and laboratory criteria that make the study of this common and devastating condition very difficult. Diagnostic challenges and uncertain disease epidemiology necessarily result from a variable definition of disease. In 2005, intensivists caring for children recognized that as new drugs became available, children would be increasingly studied and thus, pediatric-specific consensus definitions were needed. Pediatric sepsis criteria are not accurate for term neonates and have not been examined in preterm neonates for whom the developmental stage influences aberrations associated with host immune response. Thus, specific consensus definitions for both term and preterm neonates are needed. Such definitions are critical for the interpretation of observational studies, future training of scientists and practitioners, and implementation of clinical trials in neonates.

CT of the neonatal head

International Nuclear Information System (INIS)

Mohan, S.; Rogan, E.A.; Batty, R.; Raghavan, A.; Whitby, E.H.; Hart, A.R.; Connolly, D.J.A.

2013-01-01

Computed tomography (CT) is used less often than other techniques on neonatal units. However, in the acute setting, CT can be invaluable in diagnosing or excluding potentially life-threatening conditions and guiding initial management in neonates. Common indications for scanning include trauma, suspected non-accidental injury, infection, or an acute hypoxic or metabolic event. The aim of this review is to provide an overview of the normal neonatal head at CT and compare this to the common pathological abnormalities. Several key features of each condition will be highlighted. It is important to note that some pathological conditions can have overlapping features at CT and, therefore, the clinical history and additional investigations are also of key importance in determining the diagnosis

Neonatal sepsis: Highlighting the principles of diagnosis and ...

African Journals Online (AJOL)

Neonatal sepsis is a clinical syndrome consisting of nonspecific symptoms and signs of infection, accompanied by a bacteraemia in the first 28 days of life. The risk of neonatal sepsis and death increases with decreasing birth weight and gestational age. South African data have reported the overall incidence of neonatal ...

Maternal Risk Factors for Neonatal Necrotizing Enterocolitis

Science.gov (United States)

March, Melissa I.; Gupta, Munish; Modest, Anna M.; Wu, Lily; Hacker, Michele R.; Martin, Camilia R.; Rana, Sarosh

2015-01-01

Objective This study aimed to investigate the relationship between maternal hypertensive disease and other risk factors and the neonatal development of necrotizing enterocolitis (NEC). Methods This was a retrospective case control study of infants with NEC from 2008 to 2012. The primary exposure of interest was maternal hypertensive disease, which has been hypothesized to put infants at risk for NEC. Other variables collected included demographics, pregnancy complications, medications, and neonatal hospital course. Data was abstracted from medical records. Results 28 cases of singleton neonates with NEC and 81 matched controls were identified and analyzed. There was no significant difference in the primary outcome. Fetuses with an antenatal diagnosis of growth restriction were more likely to develop NEC (p=0.008). Infants with NEC had lower median birth weight than infants without NEC (p=0.009). Infants with NEC had more late-onset sepsis (p=0.01) and mortality before discharge (p=0.001). Conclusions The factors identified by this case-control study that increased the risk of neonatal NEC included intrauterine growth restriction and lower neonatal birth weight. The primary exposure, hypertensive disease, did not show a significantly increased risk of neonatal NEC, however there was a nearly two-fold difference observed. Our study was underpowered to detect the observed difference. PMID:25162307

[Neonatal cholestasis

Science.gov (United States)

Roquete, M L

2000-07-01

OBJECTIVE: To warn pediatricians about the early recognition of cholestasis in newborns and infants. METHODS: A bibliographic research about cholestasis was performed using Medline, and emphasizing the most relevant publications of the last 30 years. RESULTS: The concept of cholestasis and the causes of cholestatic tendency in newborns and infants are described. Several causes of intra and extrahepatic cholestasis are reported as well. In this review, only the diseases with diagnostic, therapeutic or prognostic peculiarities are commented, including extrahepatic biliary atresia, idiopathic neonatal hepatitis, galactosemia, and Alagille s syndrome. Furthermore, several resources are discussed for the diagnosis of cholestasis. CONCLUSIONS: The establishment of the diagnosis of cholestasis through the detection of hyperbilirubinemia in newborns who present jaundice after 14 days of life is a goal that could change the prognosis of several diseases responsible for neonatal cholestasis.

Study on the relationship between enkephalin and neonatal asphyxia

International Nuclear Information System (INIS)

Hu Dian; Jin Zhijun; Xiong Ying; Cao Liping; Gu Hang; Hong Xinru; Wang Chenghai

2003-01-01

Objective: To evaluate the role of enkephalin in the neonatal asphyxia. Methods: Near-term pregnant rabbits were asphyxiated. The rabbit fetuses were delivered by cesarean section and were asphyxiated with the 1 min Apgar scores ranging at 2 to 7. All the neonatal rabbits delivered by asphyxiated mother rabbits were randomized into four groups: neonatal asphyxia untreated (asphyxia group), neonatal asphyxia treated with ICI 174864 ( ICI group), neonatal asphyxia treated with enkephalin anti-serum (anti-serum group), neonatal asphyxia treated with normal rabbit serum (serum group). A group of intact neonatal rabbits delivered by nonasphyxiated mother rabbits were used as control group. All the study neonatal rabbits were scored according to the respiration, heart beat, skin color, muscle tone, reflexes at 1, 5, 10, 15 and 30 min after cesarean delivery. The concentration of enkephalin was measured by radioimmunoassay. Results: 1) The levels of enkephalin in hypothalamus, pituitary and peripheral blood in asphyxia group were (635.2±57.6), (452.7±37.5) and (297.6±28.4) ng/L, respectively; in the control group, (185.7±29.6), (150.9±21.4) and (121.5±19.9) ng/L, respectively. The levels of enkephalin in asphyxia group were significantly higher than that in the control group (P 0.05). Conclusions: The neonatal asphyxia was associated with enkephalin. The changes of enkephalin levels may play an important role in the pathophysiological changes in neonatal asphyxia; delta-receptors may play certain role in conducting the enkephalin effect

Acute renal failure in asphyxiated term neonates

Directory of Open Access Journals (Sweden)

Pejović Biljana

2002-01-01

Full Text Available INTRODUCTION Acute renal failure (ARF is a frequent clinical condition in neonatal intensive care units (NICU. The leading cause of neonatal ARF is perinatal asphyxia (PS. The aim of this study was to examine the relationship between the degree of PS and the severity of ARF in term neonates. METHODS A prospective survey of 31 term neonates with Ps and but without congenital malformations or sepsis was performed in NICU of the regional Hospital of Gynaecology and Obstetrics in Belgrade (average number of deliveries about 6000 per year. ARF was diagnosed in the first 7 days of life when plasma creatinine was above 133 μmοΙ/L for at least 48 hours while maternal renal function was normal. The degree of PS was determined according to Apgar score (AS at 1 min. The severe PS was defined as AS < 3 and moderate PS as AS 4-6. RESULTS Twenty neonates (64% had oliguric ARF with urine output of 0.37 ±0.16 ml/kg/h while the others had nonoliguric ARF with urine output of 2.4 ± 0.7 ml/kg/h. Most of neonates with oliguric ARF (65% had severe perinatal asphuxia while in those with nonoliguric ARF moderate perinatal asphyxia predominated (73%. DISCUSSION During hypoxic-ischaemic events many organs are injured, and the most vulnerable ones are kidneys and central nervous system. Our results showed a strong connection between perinatal asphyxia and A, which was in accordance with the results of other studies. Neonates with severe perinatal asphyxia had serious impairment of renal function, which was confirmed with strong correlation between Apgar score and plasma creatinine. In neonates with oliguric ARF, but not in those with nonoliguric ARF, the highly positive linear correlations were found between AS and urinary output (r = 0.77; p < 0.01, plasma creatinine (r = 0.78; p < 0.01, fractional excretion of sodium (r = 0.76; p < 0.01, and index of renal failure (r = 0.80; p < 0.01. Only in oliguric neonates with severe perinatal asphyxia (31 % the outcome was

Length of stay and cost analysis of neonates undergoing surgery at a tertiary neonatal unit in England.

Science.gov (United States)

Shetty, S; Kennea, N; Desai, P; Giuliani, S; Richards, J

2016-01-01

Introduction There is a lack of knowledge on the average length of stay (LOS) in neonatal units after surgical repair of common congenital anomalies. There are few if any publications reporting the activity performed by units undertaking neonatal surgery. Such activity is important for contracting arrangements, commissioning specialist services and counselling parents. The aim of this study was to describe postnatal LOS for infants admitted to a single tertiary referral neonatal unit with congenital malformations requiring surgery. Methods Data on nine conditions were collected prospectively for babies on the neonatal unit over a five-year period (2006-2011). For those transferred back to their local unit following surgery, the local unit was contacted to determine the total LOS. Only those babies who had surgery during their first admission to our unit and who survived to discharge were included in the study. Cost estimates were based on the tariffs agreed for neonatal care between our trust and the London specialised commissioning group in 2011-2012. Results The median LOS for the conditions studied was: gastroschisis 35 days (range: 19-154 days), oesophageal atresia 33 days (range: 9-133 days), congenital diaphragmatic hernia 28 days (range: 7-99 days), intestinal atresia 24 days (range: 6-168 days), Hirschsprung's disease 21 days (range: 15-36 days), sacrococcygeal teratoma 17 days (range: 12-55 days), myelomeningocoele 15.5 days (range: 8-24 days), anorectal malformation 15 days (range: 6-90 days) and exomphalos 12 days (range: 3-228 days). The total neonatal bed day costs for the median LOS ranged from £8,701 (myelomeningocoele) to £23,874 (gastroschisis). The cost of surgery was not included. Conclusions There is wide variation in LOS for the same conditions in a single neonatal unit. This can be explained by different types and severity within the same congenital anomalies, different surgeons and other clinical confounders (eg sepsis, surgical

[Clinical efficacy of flomoxef in neonatal bacterial infection].

Science.gov (United States)

Sakata, H; Hirano, Y; Maruyama, S

1993-03-01

One hundred and seventy one neonates were treated with flomoxef (FMOX) and the clinical efficacy and safety were evaluated. The ages of the patients ranged from 0 to 28 days, and their body weights from 450 to 4300 g. Dose levels were 12.4 to 24.9 mg/kg every 8 or 12 hours for 1 to 10 days. Fifty two patients who responded to the FMOX treatment included 5 neonates with sepsis, 17 with suspected sepsis, 9 with urinary tract infections, 12 with pneumonia, 8 with intrauterine infections, and 1 with omphalitis. The other neonates could not be retrospectively diagnosed as bacterial infections. Of 52 patients, clinical results were excellent in 15, good in 34, fair in 1, and poor in 2. And the FMOX treatment was effective in 13 out of 14 patients in which causative bacteria were identified. The drug was well tolerated, but 6 neonates out of 33 over 5 days old had diarrhea. From these results, empiric treatment with FMOX against neonatal bacterial infection was as clinically useful as that of combination with ampicillin and gentamicin or cefotaxime and ampicillin in our neonatal intensive care unit. But, as this study did not include neonate with meningitis, efficacy to meningitis was not evaluated.

Flowering induction in radicchio (cichorium intybus l.var silvestre bischoff:the influence of vernalization in different types and classes of precocity

Directory of Open Access Journals (Sweden)

Ferdinando Pimpini

2008-07-01

Full Text Available All experiments were carried out at the Experimental Station “L. Toniolo” of the University of Padova (45°21’ N; 11°58’ E. Experiment 1. This research was undertaken to study the effect of increasing duration of cold periods (0-5-10-15- 20 and 30 days on three classes of “Rosso di Chioggia” with different precocity: “Perseo” (Precocious, “Leo” (Medium and “Virgo” (Late. Seeds were sown on different dates (V30-V20-V15-V10-V5 and V0, i.e. May 10th- 20th-25th and 30th, June 5th and 10th 2004 respectively and placed in pre-formed polystyrene multiple trays. Treatments with low temperatures (5 °C started on the 1st June for V30 and for the others (V5-V10-V15 and V20 25-20-15 and 10 days later in controlled growth chambers, while plants that did not require vernalization stayed in the greenhouse. After vernalization and its stabilisation for 15 days, plants were transplanted in open field (July 24th. Moreover, on the 30th of August the number of leaves in rosette and elongated stem on five flowered plants for each group was determined, to verify the possible existing relation between flowering and the number of leaves on plant. Experiment 2. This experiment was undertaken to compare the effect of vernalization on flowering of 8 cultivars of radicchio to assess their membership of annual or biennial species. The 8 cultivars were Rosso di Treviso tardivo “Sile tardivo”, Rosso di Treviso precoce “Mesola precoce”, Rosso di Chioggia “Perseo” (P, “Leo” (M and “Virgo” (L, Rosso di Verona “Cologna medio”, Variegato di Lusia “Adige tardivo” e Variegato di Castelfranco “Castellano medio”. All types were vernalized for 0-5 and 15 days (V0-V5 and V15. Seeds were placed (January 15th-25th and 30th 2005 for V15, V5 and V0 respectively in pre-formed polystyrene multiple trays. Vernalization (5 °C started on February 14th in controlled growth chambers and, at the end, was stabilized for 15 days. After

Neonatal Intrathoracic Stomach without Gastric Volvulus.

Science.gov (United States)

Bokka, Sriharsha; Mohanty, Manoj Kumar

2016-10-01

Intrathoracic stomach is a rare and serious congenital abnormality. The anomaly may be complicated by gastric volvulus and can lead to ischemic gastric infarction in the neonate. If diagnosed antenatally, neonatal management can be planned in advance so as to reduce morbidity. This anomaly must be differentiated from the more common congenital diaphragmatic hernia, as associated pulmonary hypoplasia is common in the latter and rare with gastric herniation. We report a case of intrathoracic stomach in a neonate without volvulus, fortunately a rare entity which was managed operatively, and the child has been under regular follow-up.

Clinical spectrum of early onset cerebellar ataxia with retained tendon reflexes: an autosomal recessive ataxia not to be missed Espectro clínico da ataxia cerebelar de início precoce com reflexos mantidos: uma ataxia autossômica recessiva para não ser esquecida

Directory of Open Access Journals (Sweden)

José Luiz Pedroso

2013-06-01

Full Text Available Autosomal recessive cerebellar ataxias are a heterogeneous group of neurological disorders. In 1981, a neurological entity comprised by early onset progressive cerebellar ataxia, dysarthria, pyramidal weakness of the limbs and retained or increased upper limb reflexes and knee jerks was described. This disorder is known as early onset cerebellar ataxia with retained tendon reflexes. In this article, we aimed to call attention for the diagnosis of early onset cerebellar ataxia with retained tendon reflexes as the second most common cause of autosomal recessive cerebellar ataxias, after Friedreich ataxia, and also to perform a clinical spectrum study of this syndrome. In this data, 12 patients from different families met all clinical features for early onset cerebellar ataxia with retained tendon reflexes. Dysarthria and cerebellar atrophy were the most common features in our sample. It is uncertain, however, whether early onset cerebellar ataxia with retained tendon reflexes is a homogeneous disease or a group of phenotypically similar syndromes represented by different genetic entities. Further molecular studies are required to provide definitive answers to the questions that remain regarding early onset cerebellar ataxia with retained tendon reflexes.As ataxias cerebelares autossômicas recessivas são um grupo heterogêneo de doenças neurológicas. Em 1981, foi descrita uma entidade neurológica incluindo ataxia cerebelar progressiva de início precoce, disartria, liberação piramidal e manutenção ou aumento dos reflexos tendíneos nos membros superiores e inferiores. Essa síndrome é conhecida como ataxia cerebelar de início precoce com reflexos mantidos. Neste artigo, o objetivo foi chamar a atenção para o diagnóstico de ataxia cerebelar de início precoce com reflexos mantidos como a segunda causa mais comum de ataxia cerebelar autossômica recessiva, após a ataxia de Friedreich, e também realizar um estudo do espectro cl

Magnetic resonance imaging of neonatal brain. Assessment of normal and abnormal findings

International Nuclear Information System (INIS)

Hasegawa, Koh; Kadono, Naoko; Kawase, Shohji; Kihara, Minako; Matsuo, Yasutaka; Yoshioka, Hiroshi; Kinugasa, Akihiko; Sawada, Tadashi

1994-01-01

To establish the normal MRI appearance of the neonatal brain, magnetic resonance imaging (MRI) was performed on 124 neonates who admitted to our neonatal intensive care unit. Degree of myelination, ventricular size, width of the extracerebral space and focal lesion in the brain were evaluated to investigate the relationship between MRI findings of neonatal brain and the neurological prognosis. 85 neonates underwent MRI both at neonatal period and at the corrected age of one year. The change of abnormal MRI findings was evaluated. 19 neonates had abnormal neurological outcome on subsequent examinations. Delayed myelination, ventriculomegaly and large extracerebral space were seen in 13, 7 and 9 neonates respectively. 4, 3 and 5 neonates out of them showed abnormal neurological prognosis respectively. Of the 19 neonates with focal lesion in MRI, 2 had parenchymal hematoma in the brain, 2 had subdural hematoma, 5 had chronic hematoma following subependymal hemorrhage, 6 had cystic formation following subependymal hemorrhage, 2 had subcortical leukomalacia, one had periventricular leukomalacia and one had cyst in the parenchyma of cerebellum. 4 neonates of 19 with focal lesion in MRI showed abnormal development. Of the neonates who had abnormal neurological prognosis, 7 neonates showed no abnormal finding in MRI at neonatal period. 3 of them had mild mental retardation. MRI shows promise in the neonatal period. It facilitates recognition of abnormalities of neonatal brain and may be used to predict abnormal neurologic outcome. However physiological change in the brain of neonates, especially of premature neonates, should be considered on interpreting these findings. Awareness of developmental features should help to minimize misinterpretation of normal changes in the neonatal brain. (author)

Magnetic resonance imaging of neonatal brain. Assessment of normal and abnormal findings

Energy Technology Data Exchange (ETDEWEB)

Hasegawa, Koh; Kadono, Naoko; Kawase, Shohji; Kihara, Minako; Matsuo, Yasutaka; Yoshioka, Hiroshi; Kinugasa, Akihiko; Sawada, Tadashi (Kyoto Prefectural Univ. of Medicine (Japan))

1994-11-01

To establish the normal MRI appearance of the neonatal brain, magnetic resonance imaging (MRI) was performed on 124 neonates who admitted to our neonatal intensive care unit. Degree of myelination, ventricular size, width of the extracerebral space and focal lesion in the brain were evaluated to investigate the relationship between MRI findings of neonatal brain and the neurological prognosis. 85 neonates underwent MRI both at neonatal period and at the corrected age of one year. The change of abnormal MRI findings was evaluated. 19 neonates had abnormal neurological outcome on subsequent examinations. Delayed myelination, ventriculomegaly and large extracerebral space were seen in 13, 7 and 9 neonates respectively. 4, 3 and 5 neonates out of them showed abnormal neurological prognosis respectively. Of the 19 neonates with focal lesion in MRI, 2 had parenchymal hematoma in the brain, 2 had subdural hematoma, 5 had chronic hematoma following subependymal hemorrhage, 6 had cystic formation following subependymal hemorrhage, 2 had subcortical leukomalacia, one had periventricular leukomalacia and one had cyst in the parenchyma of cerebellum. 4 neonates of 19 with focal lesion in MRI showed abnormal development. Of the neonates who had abnormal neurological prognosis, 7 neonates showed no abnormal finding in MRI at neonatal period. 3 of them had mild mental retardation. MRI shows promise in the neonatal period. It facilitates recognition of abnormalities of neonatal brain and may be used to predict abnormal neurologic outcome. However physiological change in the brain of neonates, especially of premature neonates, should be considered on interpreting these findings. Awareness of developmental features should help to minimize misinterpretation of normal changes in the neonatal brain. (author).

Maternal education and age: inequalities in neonatal death.

Science.gov (United States)

Fonseca, Sandra Costa; Flores, Patricia Viana Guimarães; Camargo, Kenneth Rochel; Pinheiro, Rejane Sobrino; Coeli, Claudia Medina

2017-11-17

Evaluate the interaction between maternal age and education level in neonatal mortality, as well as investigate the temporal evolution of neonatal mortality in each stratum formed by the combination of these two risk factors. A nonconcurrent cohort study, resulting from a probabilistic relationship between the Mortality Information System and the Live Birth Information System. To investigate the risk of neonatal death we performed a logistic regression, with an odds ratio estimate for the combined variable of maternal education and age, as well as the evaluation of additive and multiplicative interaction. The neonatal mortality rate time series, according to maternal education and age, was estimated by the Joinpoint Regression program. The neonatal mortality rate in the period was 8.09‰ and it was higher in newborns of mothers with low education levels: 12.7‰ (adolescent mothers) and 12.4‰ (mother 35 years old or older). Low level of education, without the age effect, increased the chance of neonatal death by 25% (OR = 1.25, 95%CI 1.14-1.36). The isolated effect of age on neonatal death was higher for adolescent mothers (OR = 1.39, 95%CI 1.33-1.46) than for mothers aged ≥ 35 years (OR = 1.16, 95%CI 1.09-1.23). In the time-trend analysis, no age group of women with low education levels presented a reduction in the neonatal mortality rate for the period, as opposed to women with intermediate or high levels of education, where the reduction was significant, around 4% annually. Two more vulnerable groups - adolescents with low levels of education and older women with low levels of education - were identified in relation to the risk of neonatal death and inequality in reducing the mortality rate.

The Tuning of Human Neonates' Preference for Speech

Science.gov (United States)

Vouloumanos, Athena; Hauser, Marc D.; Werker, Janet F.; Martin, Alia

2010-01-01

Human neonates prefer listening to speech compared to many nonspeech sounds, suggesting that humans are born with a bias for speech. However, neonates' preference may derive from properties of speech that are not unique but instead are shared with the vocalizations of other species. To test this, thirty neonates and sixteen 3-month-olds were…

Influência da irrigação na produção de pedúnculo e de castanha em clones de cajueiro-anão-precoce

Directory of Open Access Journals (Sweden)

Oliveira Vitor Hugo de

2002-01-01

Full Text Available Este trabalho teve por objetivo avaliar a influência da irrigação na produção de pedúnculo e na relação peso de pedúnculo:peso de castanha em cajueiro-anão-precoce (Anacardium occidentale L.. Foram avaliados três clones (CP 09, CP 76 e CP 1001, submetidos a quatro regimes hídricos (A: testemunha sem irrigação; B: intervalo de irrigação de 1 dia; C: intervalo de irrigação de 3 dias; e D: intervalo de irrigação de 5 dias. O delineamento experimental foi em blocos ao acaso, em parcelas subdivididas, com quatro repetições, tendo-se os regimes hídricos nas parcelas e os clones nas subparcelas, cada uma com 4 plantase 3 anos de avaliação. A quantidade de água aplicada nos três tratamentos irrigados baseou-se na evaporação do tanque classe A. Os resultados levaram às seguintes conclusões: a resposta do cajueiro-anão-precoce à irrigação é genótipo-dependente; o CP 76 apresenta a maior relação peso de pedúnculo:peso de castanha, constituindo-se num clone mais apto para o consumo in natura; o CP 1001 apresenta-se como o mais promissor para o cultivo sob condições de sequeiro.

Neonatal Intestinal Obstruction-Four Year Experience

Directory of Open Access Journals (Sweden)

D. Rathore

2015-06-01

Full Text Available Aim of study: To study the aetiology and frequency, sex incidence, age of presentation, management and outcome of neonatal intestinal obstruction. Material and Methods: This prospective study of 316 neonates with intestinal obstruction was conducted over a period of 4 years from November 2009 to October 2013 at single institute. These cases were managed by various surgical procedures. Their epidemiology, day of presentation, associated anomalies and outcomes were studied. Results: A total of 316 neonates (277 males and 39 females were operated for intestinal obstruction. 268(84.81% neonates presented in the 1st week of life. Imperforate anus occurred in 206 (65.19%.Small bowel atresia accounted for23 (7.27% cases while duodenal atresia was seen in19 (6.01% patients. Infantile hypertrophic pyloric stenosis and Malrotation each occurred in 14 (4.43% patients; Hirschsprung’s disease in 18(5.69%, Necrotising Enterocolitis in 12(3.79%, Meconium disease of newborn in 9(2.85% while colonic atresia was seen in one (0.3% patient. Colostomy was performed in 145(45.88%, Pouchostomy in 15(4.74% and Cutback anoplasty in 56(17.72% patients. Ramsted’s Pyloromyotomy in 13(4.11%% neonates, Laparoscopic Pyloromyotomy in 1(0.3%,Kimura’s Duodenoduodenostomy in 19(6.01% ,End to Back anastomosis in 24(7.59% , End to End anastomosis in 7(2.21% , Multiple anastomosis in 2(0.6% , Enterotomy with irrigation in 7(2.21% , Ladd’s procedure in 14(4.43% , ,Single stage transanal pull through in 8(2.53% , Ileostomy in 2(0.6% , Single stage Abdominoperineal pull through in 2(0.6%, Levelling colostomy in 6(1.89% ,Peritoneal drain insertion under Local anaesthesia in 5(1.58% . Overall mortality was 13.60%. Conclusion: Intestinal Obstruction is the most common surgical emergency in neonatal period. Early and accurate diagnosis is paramount for proper patient management. The etiology, mode of presentation, morbidity and outcome of surgery of intestinal obstruction in

Managing neonatal bowel obstruction: clinical perspectives

Directory of Open Access Journals (Sweden)

Desoky SM

2018-02-01

Full Text Available Sarah M Desoky,1 Ranjit I Kylat,2 Unni Udayasankar,1 Dorothy Gilbertson-Dahdal1 1Department of Medical Imaging, University of Arizona College of Medicine, Tucson, AZ, USA; 2Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Arizona College of Medicine, Tucson, AZ, USA Abstract: Neonatal intestinal obstruction is a common surgical emergency and occurs in approximately 1 in 2,000 live births. The causes of obstruction are diverse with varied embryological origins, and some underlying etiologies are not yet well described. Some findings of neonatal bowel obstruction can be detected prenatally on ultrasound imaging. The obstruction is classified as “high” when the level of obstruction is proximal to the ileum, and “low” when the level of obstruction is at the ileum or colon. Early diagnosis of the type of intestinal obstruction and localization of the obstructive bowel segment guides timely and appropriate management of the underlying pathologic entity. Neonatal bowel obstructions are ideally managed at specialized centers with a large volume of neonatal surgery and dedicated pediatric surgical and anesthesia expertise. Although surgical intervention is necessary in most cases, initial management strategies often target underlying metabolic, cardiac, or respiratory abnormalities. Imaging plays a key role in early and accurate diagnosis of the abnormalities. When bowel obstruction is suspected clinically, initial imaging workup usually involves abdominal radiography, which may direct further evaluation with fluoroscopic examination such as upper gastrointestinal (UGI contrast study or contrast enema. This article provides a comprehensive review of clinical and radiological features of common and less common causes of intestinal obstruction in the neonatal age group, including esophageal atresia, enteric duplication cysts, gastric volvulus, congenital microgastria, hypertrophic pyloric stenosis, duodenal atresia

Pattern and prevalence of neonatal thrombocytopenia in Port Harcourt, Nigeria

Directory of Open Access Journals (Sweden)

Zaccheaus A Jeremiah

2010-04-01

Full Text Available Zaccheaus A Jeremiah1, Justina E Oburu21Hematology and Blood Transfusion Science Unit, Department of Medical Laboratory Sciences, College of Health Sciences, Niger Delta University, Wilberforce Island, Bayelsa State, Nigeria; 2Department of Hematology and Blood Transfusion University of Port Harcourt Teaching Hospital, Port Harcourt, NigeriaBackground: In Port Harcourt, evidence-based guidelines for platelet transfusion therapy in neonatal patients are yet to be defined and the prevalence and pattern of neonatal thrombocytopenia has not yet been reported.Methods: Platelet counts of 132 neonatal patients admitted into the special care baby unit (SCBU at the University of Port Harcourt Teaching Hospital in Nigeria were assessed using the International Committee on Standards in Hematology (ICSH approved manual procedures for hemocytometry.6Study design: This is a cross sectional study carried out on neonates to determine the prevalence and pattern of neonatal thrombocytopenia.Results: The median platelet count of the neonates was 97.0 × 109/L (interquartile range [IQR] 50–152 while the mean age was 61.7 hours (range 1–336 hours. The overall prevalence of neonatal thrombocytopenia was 53.0%. Mild thrombocytopenia (platelet count 51–100 × 109/L was found in 39.4% of the neonates, 12.1% had moderate thrombocytopenia (platelet count 30–50 × 109/L, while severe thrombocytopenia (platelet count <30 × 109/L was detected in 1.5% of the neonates. Of these, 84.84% of the cases occurred within 72 hours (early onset. The most common clinical diagnosis among the neonates was severe birth asphyxia (33.3%, followed by neonatal jaundice (19.7%, neonatal sepsis (16.7%, low birth weight (13.6%, anemia and bleeding (6.1%, and other clinical conditions (10.6%. There was no association between clinical diagnosis and thrombocytopenia (Fisher’s exact test = 10.643; P = 0.923.Conclusion: There is a high prevalence of early onset neonatal thrombocytopenia

Diagnostic imaging in neonatal stroke

International Nuclear Information System (INIS)

Kuhle, S.; Ipsiroglu, O.; Weninger, M.

2000-01-01

A cerebral artery infarction is an important differential diagnosis in the newborn with neurological abnormalities. Based on clinical data, its incidence is estimated to be 1 in 4000 newborns. Since the course is often subclinical, the true incidence is probably higher. Diagnosis: Cerebral ultrasound and Doppler sonography as readily available screening tools play a central role in the initial diagnosis of neonatal cerebral infarction. Definitive diagnosis is made by computed tomography or magnetic resonance imaging. Beside symptomatic anticonvulsive therapy, treatment aims at the prevention of secondary ischemic injury. Discussion: Three term infants with different clinical courses of neonatal stroke are presented to sensitize the clinician and the radiologist for this probably underdiagnosed entity. The role of imaging modalities in the diagnosis and follow-up of neonatal cerebral infarction is discussed. (orig.) [de

Neonatal maxillary orthopedics: past to present

NARCIS (Netherlands)

Kuijpers-Jagtman, A.M.; Prahl, C.; Berkowitz, S.

2013-01-01

Neonatal maxillary orthopedics was introduced in the treatment protocol for cleft lip and palate in the 1950s of the last century. A wide range of appliances has been designed with pin-retained active appliances at one end of the spectrum and passive appliances at the other. Although neonatal

Neonatal seizures : Aetiology by means of a standardized work-up

NARCIS (Netherlands)

Loman, Annemiek M. W.; ter Horst, Henk J.; Lambrechtsen, Florise A. C. P.; Lunsing, Roelineke J.

Neonatal seizures are an alarming symptom and are frequent in neonates. It is important to find the cause of neonatal seizures to start a specific treatment and to give a meaningful prognosis. The aim of this study is to investigate the incidence of different aetiologies of neonatal seizures in our

Tei index in neonatal respiratory distress and perinatal asphyxia

OpenAIRE

Ahmed Anwer Attia Khattab

2015-01-01

Cardiovascular compromise is a common complication of neonatal respiratory distress and perinatal asphyxia. Tei index is a Doppler-derived index for the assessment of overall left ventricular function that combines systolic and diastolic time intervals. Aim: Assess the role of MPI versus cardiac troponin I as early indicator of hypoxic cardiac damage in neonates with respiratory distress or perinatal asphyxia. The present work was conducted on forty neonates, 15 with neonatal respiratory dist...

Bayesian automated cortical segmentation for neonatal MRI

Science.gov (United States)

Chou, Zane; Paquette, Natacha; Ganesh, Bhavana; Wang, Yalin; Ceschin, Rafael; Nelson, Marvin D.; Macyszyn, Luke; Gaonkar, Bilwaj; Panigrahy, Ashok; Lepore, Natasha

2017-11-01

Several attempts have been made in the past few years to develop and implement an automated segmentation of neonatal brain structural MRI. However, accurate automated MRI segmentation remains challenging in this population because of the low signal-to-noise ratio, large partial volume effects and inter-individual anatomical variability of the neonatal brain. In this paper, we propose a learning method for segmenting the whole brain cortical grey matter on neonatal T2-weighted images. We trained our algorithm using a neonatal dataset composed of 3 fullterm and 4 preterm infants scanned at term equivalent age. Our segmentation pipeline combines the FAST algorithm from the FSL library software and a Bayesian segmentation approach to create a threshold matrix that minimizes the error of mislabeling brain tissue types. Our method shows promising results with our pilot training set. In both preterm and full-term neonates, automated Bayesian segmentation generates a smoother and more consistent parcellation compared to FAST, while successfully removing the subcortical structure and cleaning the edges of the cortical grey matter. This method show promising refinement of the FAST segmentation by considerably reducing manual input and editing required from the user, and further improving reliability and processing time of neonatal MR images. Further improvement will include a larger dataset of training images acquired from different manufacturers.

Neonatal Sepsis: past, present and future; a review article | Tripathi ...

African Journals Online (AJOL)

Sepsis is the most common cause of neonatal mortality. As per National Neonatal Perinatal Database (NNPD) 2002-2003, the incidence of neonatal sepsis in India was 30 per 1000 live birth. It is 3% among intramural babies and 39.7% among extramural admissions. The early manifestations of neonatal sepsis are vague ...

Long-term use of neonatal helmet-CPAP: a case report.

Science.gov (United States)

Doglioni, N; Micaglio, M; Zanardo, V; Trevisanuto, D

2009-12-01

In a recent short-term physiological study, we demonstrated a new continuous positive airway pressure (CPAP) system (neonatal helmet-CPAP) that could be a feasible device for managing preterm infants needing continuous distending pressure with better tolerability than nasal-CPAP. However, its application for a long-term period has never been reported in neonates. Here, we describe the use of neonatal helmet-CPAP in a neonate with persistent pulmonary hypertension of the newborn. Twenty minutes after neonatal helmet-CPAP placement, the baseline post-ductal tcSaO2 (66%) and alveolar-arterial gradient O2 improved from 66% and 648 mmHg to 100% and 465 mmHg, respectively. The neonatal helmet-CPAP was applied for 48 hours and was well-tolerated by the patient without complications. Long-term use of neonatal helmet-CPAP appears feasible and well-tolerated. Comparative trials are needed.

Two denominators for one numerator: the example of neonatal mortality.

Science.gov (United States)

Harmon, Quaker E; Basso, Olga; Weinberg, Clarice R; Wilcox, Allen J

2018-06-01

Preterm delivery is one of the strongest predictors of neonatal mortality. A given exposure may increase neonatal mortality directly, or indirectly by increasing the risk of preterm birth. Efforts to assess these direct and indirect effects are complicated by the fact that neonatal mortality arises from two distinct denominators (i.e. two risk sets). One risk set comprises fetuses, susceptible to intrauterine pathologies (such as malformations or infection), which can result in neonatal death. The other risk set comprises live births, who (unlike fetuses) are susceptible to problems of immaturity and complications of delivery. In practice, fetal and neonatal sources of neonatal mortality cannot be separated-not only because of incomplete information, but because risks from both sources can act on the same newborn. We use simulations to assess the repercussions of this structural problem. We first construct a scenario in which fetal and neonatal factors contribute separately to neonatal mortality. We introduce an exposure that increases risk of preterm birth (and thus neonatal mortality) without affecting the two baseline sets of neonatal mortality risk. We then calculate the apparent gestational-age-specific mortality for exposed and unexposed newborns, using as the denominator either fetuses or live births at a given gestational age. If conditioning on gestational age successfully blocked the mediating effect of preterm delivery, then exposure would have no effect on gestational-age-specific risk. Instead, we find apparent exposure effects with either denominator. Except for prediction, neither denominator provides a meaningful way to define gestational-age-specific neonatal mortality.

Avanços na abordagem do carcinoma precoce de esôfago

Directory of Open Access Journals (Sweden)

Vitor Arantes

Full Text Available Nos países ocidentais, o carcinoma de células escamosas de esôfago (CCE geralmente é detectado em estágio avançado, quando as possibilidades de cura são remotas e o prognóstico reservado. Entretanto, nos anos recentes, ocorreu uma série de avanços na abordagem do CCE de esôfago, tais como a identificação dos grupos de risco para o surgimento desta neoplasia; o uso da endoscopia de alta resolução e cromoendoscopia com lugol favorecendo o diagnóstico do CCE em estágios iniciais; e o desenvolvimento de técnicas endoscópicas de ressecção tumoral endoluminal em monobloco denominada dissecção endoscópica de submucosa. Este progresso tem possibilitado a aplicação do tratamento endoscópico minimamente invasivo com potencial curativo em pacientes selecionados com CCE superficial de esôfago. O presente artigo de revisão, elaborado por um grupo multicêntrico internacional, tem como objetivo primário contribuir para o entendimento dos principais avanços recentes ocorridos no manejo do CCE precoce de esôfago. Como objetivo secundário, pretende propiciar uma revisão detalhada e minuciosa da estratégia técnica de DES desenvolvida pelos experts japoneses, de forma a colaborar para a difusão deste conceito e a incorporação destas tecnologias na Medicina Brasileira e Latino-americana.

Hypertension in the Neonatal Period: An Update.

Science.gov (United States)

Pillai, Anish; Sharma, Deepak; Kadam, Pratichi

2016-01-01

There has been a growing interest among neonatologists and paediatricians regarding identification and evaluation of hypertension in the neonatal period. Despite the emergent normative data on blood pressure values in term and preterm neonates over the last two decades, there is still controversy regarding correct definition and classification of hypertension. This article will discuss the current definitions, available normative data and etiology of neonatal hypertension. There is paucity of records in terms of efficacy of antihypertensive drugs in this specific population and management is usually experience based, causing considerable heterogeneity amongst different units. This review article will also cover the evaluation, management, outcomes and follow up of neonatal hypertension with latest advances in this field. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

May maternal lifestyle have an impact on neonatal glucose levels?

Science.gov (United States)

Hoirisch-Clapauch, Silvia; Porto, Maria Amelia S; Nardi, Antonio E

2016-02-01

Neonatal glucose levels correlate negatively with umbilical cord levels of C-peptide, a polypeptide secreted with insulin. In other words, neonatal hypoglycemia results from excessive insulin secretion from fetal/neonatal beta cells. Given that insulin causes fat to be stored rather than to be used for energy, one would expect that chronic hyperinsulinemia would result in large-for-gestational-age neonates. The finding that many small-for-gestational-age neonates have hypoglycemia suggests that the stimulus for insulin production occurs close to delivery. We postulated that a potent stimulation of maternal insulin production close to delivery would also provide a potent stimulus for fetal and neonatal insulin production, causing neonatal hypoglycemia. This study has evaluated 155 mothers with markers of excessive insulin production (such as acanthosis or grade III obesity), or with situations characterized by increased insulin requirements (such as an invasive bacterial infection or use of systemic corticosteroid within a week before delivery; or sedentariness or high-carbohydrate intake within 24h before delivery) and their 158 neonates who were screened for glycemic levels at 1, 2 and 4h after birth. The minimum glucose level was correlated to the maternal parameters, and to classical predictors of neonatal hypoglycemia, such as low-birth weight and preterm delivery. The only independent predictors were sedentariness and high-carbohydrate intake within 24h before delivery. The risk of neonatal hypoglycemia increased five-fold with sedentariness, 11-fold with high-carbohydrate intake, and 329-fold with both risk factors. The risk of neonatal hypoglycemia seems to be highly influenced by maternal lifestyle within 24h before delivery. Controlled randomized trials may help determine whether a controlled carbohydrate diet combined with regular physical activity close to delivery can prevent neonatal hypoglycemia and all its severe complications to the newborn

Avaliação da perviedade precoce das fístulas arteriovenosas para hemodiálise Evaluation of early patency of the arteriovenous fistulas for hemodialysis

Directory of Open Access Journals (Sweden)

Milton Alves das Neves Junior

2011-06-01

Full Text Available CONTEXTO: A insuficiência renal crônica é uma doença de alta prevalência e morbidade, o que determina queda da qualidade de vida. Pacientes em hemodiálise necessitam de um acesso vascular que permita a conexão da circulação do paciente ao circuito externo de hemodiálise. Dentre os acessos disponíveis, as fístulas arteriovenosas (FAV são as que mais se aproximam do acesso ideal. OBJETIVO: Avaliar a perviedade precoce das FAV, identificando os fatores relacionados ao insucesso destas. MÉTODOS: Foram acompanhados todos os pacientes submetidos à confecção das FAV no Hospital do Servidor Público Municipal de São Paulo, no período de agosto de 2008 a janeiro de 2009, avaliando-se a perviedade destas no 1º, 10º e 30º pós-operatório. Foram realizadas 31 FAV no período, apresentando-se média de idade de 63,06 anos, sendo 18 pacientes do sexo masculino e 13 do feminino. RESULTADOS: Vinte e seis FAV foram distais, todas radiocefálicas; quatro foram proximais, das quais duas braquiocefálicas e duas braquiobasílicas superficializadas; uma FAV confeccionada com alça de politetrafluoretileno (PTFE fêmoro-femoral esquerda. A taxa de perviedade no primeiro mês foi de 71% dos casos. O uso de cateteres venosos centrais apresentou-se como fator de risco para oclusão da FAV (p=0,01. As FAV continuam sendo o acesso vascular para hemodiálise mais aceito e mais seguro. A indicação precoce para confecção das FAV é de fundamental importância, evitando-se, assim, o uso de cateteres e suas complicações. CONCLUSÕES: A perviedade precoce encontrada neste estudo é semelhante à da literatura, e o uso prévio de cateteres é o fator de risco mais significativo para oclusão precoce desta.BACKGROUND: Chronic renal failure is a disease of high prevalence and high morbidity, which impairs the patients' quality of life. Patients on hemodialysis need a vascular access for connection with the hemodialysis equipment. Arteriovenous fistulas

Neonatal Platelet Transfusions and Future Areas of Research.

Science.gov (United States)

Sola-Visner, Martha; Bercovitz, Rachel S

2016-10-01

Thrombocytopenia affects approximately one fourth of neonates admitted to neonatal intensive care units, and prophylactic platelet transfusions are commonly administered to reduce bleeding risk. However, there are few evidence-based guidelines to inform clinicians' decision-making process. Developmental differences in hemostasis and differences in underlying disease processes make it difficult to apply platelet transfusion practices from other patient populations to neonates. Thrombocytopenia is a risk factor for common preterm complications such as intraventricular hemorrhage; however, a causal link has not been established, and platelet transfusions have not been shown to reduce risk of developing intraventricular hemorrhage. Platelet count frequently drives the decision of whether to transfuse platelets, although there is little evidence to demonstrate what a safe platelet nadir is in preterm neonates. Current clinical assays of platelet function often require large sample volumes and are not valid in the setting of thrombocytopenia; however, evaluation of platelet function and/or global hemostasis may aid in the identification of neonates who are at the highest risk of bleeding. Although platelets' primary role is in establishing hemostasis, platelets also carry pro- and antiangiogenic factors in their granules. Aberrant angiogenesis underpins common complications of prematurity including intraventricular hemorrhage and retinopathy of prematurity. In addition, platelets play an important role in host immune defenses. Infectious and inflammatory conditions such as sepsis and necrotizing enterocolitis are commonly associated with late-onset thrombocytopenia in neonates. Severity of thrombocytopenia is correlated with mortality risk. The nature of this association is unclear, but preclinical data suggest that thrombocytopenia contributes to mortality rather than simply being a proxy for disease severity. Neonates are a distinct patient population in whom

Normal lactate concentration range in the neonatal brain.

Science.gov (United States)

Tomiyasu, Moyoko; Aida, Noriko; Shibasaki, Jun; Tachibana, Yasuhiko; Endo, Mamiko; Nozawa, Kumiko; Shimizu, Eiji; Tsuji, Hiroshi; Obata, Takayuki

2016-11-01

Lactate peaks are occasionally observed during in vivo magnetic resonance spectroscopy (MRS) scans of the neonatal brain, even in healthy patients. The purpose of this study was to investigate the normal range of neonatal brain lactate concentration, as a definitive normal range would be clinically valuable. Using a clinical 3T scanner (echo/repetition times, 30/5000ms), single-voxel MRS data were obtained from the basal ganglia (BG) and centrum semiovale (CS) in 48 healthy neonates (postconceptional age (PCA), 30-43weeks), nine infants (age, 1-12months old), and 20 children (age, 4-15years). Lactate concentrations were calculated using an MRS signal quantification program, LCModel. Correlations between regional lactate concentration and PCA (neonates), or age (all subjects) were investigated. Absolute lactate concentrations of the BG and CS were as follows: neonates, 0.77mM (0-2.02) [median (range)] and 0.77 (0-1.42), respectively; infants, 0.38 (0-0.79) and 0.49 (0.17-1.17); and children, 0.17 (0-0.76) and 0.22 (0-0.80). Overall, subjects' lactate concentrations decreased significantly with age (Spearman: BG, n=61, ρ=-0.38, p=0.003; CS, n=68, ρ=-0.57, p<0.001). However, during the neonatal period no correlations were detected between lactate concentration in either region and PCA. We determined normal ranges of neonatal lactate concentration, which may prove useful for diagnostic purposes. Further studies regarding changes in brain lactate concentration during development would help clarify the reasons for higher concentrations observed during the neonatal period, and contribute to improvements in diagnoses. Copyright © 2016 Elsevier Inc. All rights reserved.

Estudo comparativo do desenvolvimento sensório-motor de recém-nascidos prematuros da unidade de terapia intensiva neonatal e do método canguru - doi:10.5020/18061230.2005.p191

Directory of Open Access Journals (Sweden)

Luciana Andrade da Mota

2012-01-01

Full Text Available O Método Canguru é uma alternativa ao método tradicional de assistência a bebês prematuros de baixo peso, que preconiza o contato pele a pele precoce, entre mãe e filho, 24 horas por dia, garantindo-lhes estímulos sensoriais e motores e maior participação dos pais no cuidado de seu bebê. A Unidade de Terapia Intensiva (UTI Neonatal é destinada ao tratamento de recém-nascidos prematuros com algum problema ao nascer. Objetivou-se comparar o desenvolvimento sensório-motor de recém-nascidos prematuros (RNPt da UTI Neonatal e do Método Canguru. Realizou-se um estudo comparativo, prospectivo e observacional, no Hospital Geral Dr. César Cals, em Fortaleza – CE, de agosto a outubro de 2004, com 14 RNPt, sendo 07 de cada grupo, com peso inferior a 2000g e idade gestacional entre 30 e 37 semanas. A avaliação foi semanal até a alta hospitalar ou até completarem a idade corrigida de 40 semanas, pelo método Dubowitz e Amiel-Tison, com análise de tônus muscular, respostas sensório-motoras, ganho de peso e tempo de internação. Como resultado, observou-se que os bebês do Método Canguru apresentaram melhores respostas sensório-motoras, comprovadas a partir da constatação de um menor grau de estresse, melhores respostas reflexas, movimentação espontânea e tônus muscular, e menor tempo de internação, permanecendo mais tempo em estado de alerta e interagindo bem com o ambiente e a mãe. Conclui-se que o Método Canguru mostrou-se uma alternativa mais eficaz de assistência a RNPt de baixo peso, pois proporcionou melhores resultados quanto às atividades sensório-motor dos bebês, se comparados à UTI Neonatal.

Sonographic features of neonatal mastitis and breast abscess.

Science.gov (United States)

Borders, Heather; Mychaliska, George; Gebarski, K Stiennon

2009-09-01

Neonatal mastitis and neonatal breast abscess are uncommon. Although well described in the pediatric and surgical literature, there is a paucity of reports describing their sonographic features. To describe and illustrate the sonographic features of neonatal mastitis and neonatal breast abscess. We reviewed the medical database of a large children's health-care center from 2000 through 2008 for patients presenting in the first 8 weeks of life with mastitis. The findings were correlated with clinical presentation and course, laboratory findings and clinical outcome. Four neonates (three girls and one boy) presented with mastitis. They all had prominent breast buds on the affected side with poorly defined margins, slightly more echogenic focally or diffusely compared to normal with hyperemia on color flow Doppler US. The surrounding subcutaneous tissue was thick and echogenic. Two abscesses presented as avascular areas without color flow on Doppler US, subtly increased through-transmission and surrounding hyperemia. One abscess was of increased echogenicity while the other was anechoic. Neonatal mastitis and breast abscess are unusual diseases that should be appropriately treated with antibiotics and drainage to avoid generalized sepsis, breast hypoplasia, and scarring. US is useful in distinguishing mastitis from breast abscess and guiding treatment options.

Perinatal transport: problems in neonatal intensive care capacity.

Science.gov (United States)

Gill, A B; Bottomley, L; Chatfield, S; Wood, C

2004-05-01

To assess the quantity and nature of transfers within the Yorkshire perinatal service, with the aim of identifying suitable outcome measures for the assessment of future service improvements. Collection of data on perinatal transfers from all neonatal and maternity units located in the Yorkshire region of the United Kingdom from May to November 2000. Expectant mothers (in utero transfers) and neonates (ex utero transfers). None Quantification of in utero and ex utero transfers; the reasons for and resources required to support transfers; the nature of each transfer (acute, specialist, non-acute, into or out of region). In the period studied, there were 800 transfers (337 in utero; 463 ex utero); 306 transfers were "acute" (80% of transfers in utero), 214 because of specialist need, and 280 "non-acute". Some 37% of capacity transfers occurred from the two level 3 units in the region. Of 254 transfers out of the 14 neonatal units for intensive care, 44 (17.3%) were transferred to hospitals outside the normal neonatal commissioning boundaries. The study highlights a continuing apparent lack of capacity within the neonatal service in the Yorkshire region, resulting in considerable numbers of neonatal and maternal transfers.

Pharmacokinetics of cephalosporins in the neonate: a review

Directory of Open Access Journals (Sweden)

Gian Maria Pacifici

2011-01-01

Full Text Available The aim of this work was to review the published data on the pharmacokinetics of cephalosporins in neonates to provide a critical analysis of the literature as a useful tool for physicians. The bibliographic search was performed for articles published up to December 3, 2010, using PubMed. In addition, the book Neofax: A Manual of Drugs Used in Neonatal Care by Young and Mangum was consulted. The cephalosporins are mainly eliminated by the kidneys, and their elimination rates are reduced at birth. As a consequence, clearance is reduced and t1/2 is more prolonged in the neonate than in more mature infants. The neonate's substantial body water content creates a large volume of distribution (Vd of cephalosporins, as these drugs are fairly water soluble. Postnatal development is an important factor in the maturation of the neonate, and as postnatal age proceeds, the clearance of cephalosporins increases. The maturation of the kidney governs the pharmacokinetics of cephalosporins in the infant. Clearance and t1/2 are influenced by development, and this must be taken into consideration when planning a cephalosporin dosage regimen for the neonate.

Neonatal malaria complicated by hypoglycaemia and ...

African Journals Online (AJOL)

There is no established and widely accepted guidelines for clinical management of severe neonatal malaria. The aim of this paper is to raise the alertness of physicians regarding the occurrence of severe malaria in the neonatal period and to describe the treatment modality we adopted (in the absence of an internationally ...

Cost Analysis of Treating Neonatal Hypoglycemia with Dextrose Gel.

Science.gov (United States)

Glasgow, Matthew J; Harding, Jane E; Edlin, Richard

2018-04-03

To evaluate the costs of using dextrose gel as a primary treatment for neonatal hypoglycemia in the first 48 hours after birth compared with standard care. We used a decision tree to model overall costs, including those specific to hypoglycemia monitoring and treatment and those related to the infant's length of stay in the postnatal ward or neonatal intensive care unit, comparing the use of dextrose gel for treatment of neonatal hypoglycemia with placebo, using data from the Sugar Babies randomized trial. Sensitivity analyses assessed the impact of dextrose gel cost, neonatal intensive care cost, cesarean delivery rate, and costs of glucose monitoring. In the primary analysis, treating neonatal hypoglycemia using dextrose gel had an overall cost of NZ$6863.81 and standard care (placebo) cost NZ$8178.25; a saving of NZ$1314.44 per infant treated. Sensitivity analyses showed that dextrose gel remained cost saving with wide variations in dextrose gel costs, neonatal intensive care unit costs, cesarean delivery rates, and costs of monitoring. Use of buccal dextrose gel reduces hospital costs for management of neonatal hypoglycemia. Because it is also noninvasive, well tolerated, safe, and associated with improved breastfeeding, buccal dextrose gel should be routinely used for initial treatment of neonatal hypoglycemia. Australian New Zealand Clinical Trials Registry: ACTRN12608000623392. Copyright © 2018 Elsevier Inc. All rights reserved.

Fellowship Training in the Emerging Fields of Fetal-Neonatal Neurology and Neonatal Neurocritical Care.

Science.gov (United States)

Smyser, Christopher D; Tam, Emily W Y; Chang, Taeun; Soul, Janet S; Miller, Steven P; Glass, Hannah C

2016-10-01

Neonatal neurocritical care is a growing and rapidly evolving medical subspecialty, with increasing numbers of dedicated multidisciplinary clinical, educational, and research programs established at academic institutions. The growth of these programs has provided trainees in neurology, neonatology, and pediatrics with increased exposure to the field, sparking interest in dedicated fellowship training in fetal-neonatal neurology. To meet this rising demand, increasing numbers of training programs are being established to provide trainees with the requisite knowledge and skills to independently deliver care for infants with neurological injury or impairment from the fetal care center and neonatal intensive care unit to the outpatient clinic. This article provides an initial framework for standardization of training across these programs. Recommendations include goals and objectives for training in the field; core areas where clinical competency must be demonstrated; training activities and neuroimaging and neurodiagnostic modalities which require proficiency; and programmatic requirements necessary to support a comprehensive and well-rounded training program. With consistent implementation, the proposed model has the potential to establish recognized standards of professional excellence for training in the field, provide a pathway toward Accreditation Council for Graduate Medical Education certification for program graduates, and lead to continued improvements in medical and neurological care provided to patients in the neonatal intensive care unit. Copyright © 2016 Elsevier Inc. All rights reserved.

Tratamento cirúrgico da escoliose em pacientes com amiotrofia espinhal com parafusos pediculares (instrumental de 3ª geração e complicações precoces Tratamiento quirúrgico de la escoliosis en pacientes con amiotrofia espinal con tornillos pediculares (instrumental de 3ª generación y complicaciones precoces Surgical treatment of scoliosis in spinal muscular atrophy with pedicle screws (third generation instrumentation and early complications

Directory of Open Access Journals (Sweden)

Daniel Cantarelli dos Santos

2010-06-01

Full Text Available OBJETIVO: avaliar a utilização de artrodese via posterior com parafusos pediculares para correção da escoliose em pacientes com amiotrofia espinhal. MÉTODOS: realizou-se um estudo retrospectivo de 16 pacientes com amiotrofia espinhal submetidos à artrodese via posterior exclusiva, com parafusos pediculares. Foi avaliado o perfil geral dos pacientes e o potencial de correção do ângulo de Cobb e da obliquidade pélvica, além das complicações precoces. RESULTADOS: o ângulo de Cobb pré-operatório foi em média de 94,6º (65 a 132º, no pós-operatório de 40,4º (2 a 70º, percentual de correção de 57,2%. A obliquidade pélvica pré-operatória foi em média 34,7º (25 a 56º, no pós-operatório foi para 11,3º (0 a 20º, com percentual de correção de 67,4%. Cinco pacientes tiveram complicações precoces (31,2% com boa resolução. CONCLUSÕES: o tratamento cirúrgico da escoliose em pacientes com amiotrofia espinhal por meio de artrodese via posterior utilizando parafusos pediculares tem grande potencial de correção da deformidade coronal e da obliquidade pélvica, sem grandes complicações no pós-operatório precoce.OBJETIVO: evaluar la utilización de la artrodesis vía posterior con tornillos pediculares para la corrección de la escoliosis en pacientes con amiotrofia espinal. MÉTODOS: fue realizado un estudio retrospectivo de 16 pacientes con amiotrofia espinal sometidos a la artrodesis vía posterior exclusiva, con tornillos pediculares. Fue evaluado el perfil general de los pacientes, y el potencial de corrección del ángulo de Cobb y de la oblicuidad pélvica, además de las complicaciones precoces. RESULTADOS: el ángulo de Cobb preoperatorio fue en promedio 94.6º (65 a 132º, en el postoperatorio 40.4º (2 a 70, porcentual de corrección de 57.2%. La oblicuidad pélvica preoperatoria fue en media 34.7º (25 a 56º, en el postoperatorio fue para 11.3º (0 a 20º, porcentual de corrección de 67.4%. Cinco

Two Neonates with Congenital Hydrocolpos

Directory of Open Access Journals (Sweden)

Vydehi Murthy

2013-01-01

Full Text Available Introduction. Neonatal hydrocolpos is a rare condition. Hydrocolpos is cystic dilatation of the vagina with fluid accumulation due to a combination of stimulation of secretary glands of the reproductive tract and vaginal obstruction. The differential for a neonatal presentation of lower abdominal mass includes urogenital anomalies, Hirschsprung’s, disease or sacrococcygeal teratoma. Prenatal diagnosis and early newborn imaging studies leads to early detection and treatment of these cases. Case. We report here two cases of neonatal hydrocolpos with prenatal diagnosis of lower abdominal mass. Postnatally, ultrasound, MRI imaging, and cystoscopy confirmed large cystic mass as hydrocolpos with distal vaginal obstruction. Both patients had enlarged renal system secondary to mass effect. Conclusion. High index of suspicion for hydrocolpos in a newborn presenting with fetal diagnosis of infraumbilical abdominal mass will facilitate timely intervention and prevention of complications.

CRESCIMENTO DE MUDAS DE CAJUEIRO-ANÃO-PRECOCE 'CCP¾ 76' SUBMETIDAS À ADUBAÇÃO ORGÂNICA E MINERAL

Directory of Open Access Journals (Sweden)

LIMA ROSIANE DE LOURDES SILVA DE

2001-01-01

Full Text Available A adição de doses de matéria orgânica e fertilizante mineral ao substrato, para a produção de mudas em recipientes é uma técnica bastante utilizada nos sistemas modernos de produção de mudas. Contudo, para a cultura do cajueiro são poucas as informações que definam passíveis doses de matéria orgânica e fertilizantes minerais capazes de produzirem mudas vigorosas a curtos intervalos de tempo. Durante a fase de produção de mudas de cajueiro-anão-precoce 'CCP 76', conduziu-se um ensaio na área experimental do Departamento de Irrigação e Drenagem da Universidade Federal do Ceará em Fortaleza, Ceará, no período de abril a junho de 1995. Utilizou-se como substrato à camada arável (0-30cm de um Podzólico Vermelho-Amarelo Distrófico, textura média. Para o plantio, utilizaram-se sementes oriundas de um único genótipo de cajueiro- anão-precoce progênie 'CCP 76'. Os tratamentos constaram da aplicação de quatro doses de matéria orgânica (0; 100; 200 e 300 cm³/2,5 Kg solo e quatro doses da mistura mineral (0; 1,92; 3,34 e 6,18 g contendo uréia, superfosfato triplo, cloreto de potássio, gesso, calcário e fritas tipo MIB-3. O delineamento experimental utilizado foi o inteiramente casualizado, com 16 tratamentos, em 4 repetições, seguindo o modelo fatorial 4². Foram realizadas as seguintes determinações: altura de planta (cm, diâmetro do caule (mm, número de folha/planta, comprimento da raiz principal (cm, peso da matéria seca da parte aérea e do sistema radicular (g/planta. Os resultados enfatizam que a aplicação de doses combinadas de matéria orgânica e fertilizante mineral promoveu acréscimos significativos sobre a altura da planta, peso da matéria seca da parte aérea e número de folhas.

CRESCIMENTO DE MUDAS DE CAJUEIRO-ANÃO-PRECOCE 'CCP¾ 76' SUBMETIDAS À ADUBAÇÃO ORGÂNICA E MINERAL

Directory of Open Access Journals (Sweden)

ROSIANE DE LOURDES SILVA DE LIMA

2001-08-01

Full Text Available A adição de doses de matéria orgânica e fertilizante mineral ao substrato, para a produção de mudas em recipientes é uma técnica bastante utilizada nos sistemas modernos de produção de mudas. Contudo, para a cultura do cajueiro são poucas as informações que definam passíveis doses de matéria orgânica e fertilizantes minerais capazes de produzirem mudas vigorosas a curtos intervalos de tempo. Durante a fase de produção de mudas de cajueiro-anão-precoce 'CCP 76', conduziu-se um ensaio na área experimental do Departamento de Irrigação e Drenagem da Universidade Federal do Ceará em Fortaleza, Ceará, no período de abril a junho de 1995. Utilizou-se como substrato à camada arável (0-30cm de um Podzólico Vermelho-Amarelo Distrófico, textura média. Para o plantio, utilizaram-se sementes oriundas de um único genótipo de cajueiro- anão-precoce progênie 'CCP 76'. Os tratamentos constaram da aplicação de quatro doses de matéria orgânica (0; 100; 200 e 300 cm³/2,5 Kg solo e quatro doses da mistura mineral (0; 1,92; 3,34 e 6,18 g contendo uréia, superfosfato triplo, cloreto de potássio, gesso, calcário e fritas tipo MIB-3. O delineamento experimental utilizado foi o inteiramente casualizado, com 16 tratamentos, em 4 repetições, seguindo o modelo fatorial 4². Foram realizadas as seguintes determinações: altura de planta (cm, diâmetro do caule (mm, número de folha/planta, comprimento da raiz principal (cm, peso da matéria seca da parte aérea e do sistema radicular (g/planta. Os resultados enfatizam que a aplicação de doses combinadas de matéria orgânica e fertilizante mineral promoveu acréscimos significativos sobre a altura da planta, peso da matéria seca da parte aérea e número de folhas.

[Spectrum of congenital malformations observed in neonates of consanguineous parents].

Science.gov (United States)

Pinto Escalante, D; Castillo Zapata, I; Ruiz Allec, D; Ceballos Quintal, J M

2006-01-01

Consanguineous unions occur in all populations around the world. Couples related as second cousins or closer have been observed with deleterious effect. Among the clinical effects of parental consanguinity, the incidence of offspring with congenital malformations (CM) increases approximately two-fold. A hospital database of neonates with CM was searched to select neonates with parental consanguinity and two control groups. One control group consisted of healthy neonates and the other control group consisted of neonates with CM but without parental consanguinity. Both control groups consisted of the first neonate of the same sex to be born after a consanguineous neonate with CM. Family, sociodemographic and anthropometric variables, as well as the severity of the malformations, were compared between the two groups with CM. Neonates with CM were grouped into five categories: Major multiple CM, minor multiple CM, isolated major CM, isolated minor CM, and specific diseases. The indigenous Mayan subpopulation was also analyzed. Among 1117 neonates with CM, parental consanguinity was found in 21. Parental consanguinity was also found in 8 neonates in the group of healthy controls (OR 2.4 [1.05-5.95]). The most common form of consanguinity was between second cousins and was more frequent in the Mayan subpopulation. Major multiple CM were more frequent among consanguineous than among nonconsanguineous couples. No association was found between the severity of CM and the degree of relationship. The prevalence of consanguinity found in neonates with CM and healthy controls (1.9 % and 0.8 %) was similar to that found in other Latin populations. A higher prevalence was found in the Mayan population. Mayor multiple CM were more frequent among the neonates of consanguineous than among nonconsanguineous couples.

Neonatal hypoglycaemia: learning from claims

OpenAIRE

Hawdon, Jane M; Beer, Jeanette; Sharp, Deborah; Upton, Michele

2016-01-01

Objectives Neonatal hypoglycaemia is a potential cause of neonatal morbidity, and on rare but tragic occasions causes long-term neurodevelopmental harm with consequent emotional and practical costs for the family. The organisational cost to the NHS includes the cost of successful litigation claims. The purpose of the review was to identify themes that could alert clinicians to common pitfalls and thus improve patient safety. Design The NHS Litigation Authority (NHS LA) Claims Management Syste...

Effects of maternal hypertension on the neonatal haemogram in ...

African Journals Online (AJOL)

Haematocrit and white blood cell differentials were done manually. Data were analysed using SPSS version 16. Results A total of 200 neonates were recruited, comprising 100 neonates of mothers with hypertensive disorders of pregnancy and 100 neonates of normotensive mothers. The mean haematocrit was significantly ...

Causes and Clinical Outcomes in Neonates with Acute Abdomen ...

African Journals Online (AJOL)

Causes and Clinical Outcomes in Neonates with Acute Abdomen Requiring Surgery at ... Neonatal surgery is challenging, particularly in the emergency setting whereby ... Other causes included peritonitis (6.9%) and abdominal wall defects (4.7%). ... accounting for 13 cases (30.2%) and mortality was 34.9 % ( 15 neonates).

Severe hyperglycaemia due to neonatal sepsis - A case report ...

African Journals Online (AJOL)

Neonatal sepsis is a clinical syndrome characterized by signs and symptoms of infection with or without accompanying bacteremia in the first month of life. The clinical signs of neonatal sepsis are neither specific nor uniform. Neonatal sepsis may present with fever, hypotonia, respiratory distress, apnea and hyperglycaemia.

Neonatal Jaundice

DEFF Research Database (Denmark)

Maimburg, Rikke Damkjær; Væth, Michael; Schendel, Diana

2008-01-01

In a previous study, we found that infants transferred to a neonatal ward after delivery had an almost twofold increased risk of being diagnosed with infantile autism later in childhood in spite of extensive controlling of obstetric risk factors. We therefore decided to investigate other reasons ...

Predictors of early neonatal mortality at a neonatal intensive care ...

African Journals Online (AJOL)

admin

mortality and they have been the reasons for the wide variation in mortality rates among the health facilities reporting. Objective: ... A study in Indonesia about determinants of neonatal ..... antenatal visit, frequency of visits and administration of.

Design of a Functional Training Prototype for Neonatal Resuscitation

Directory of Open Access Journals (Sweden)

Sivaramakrishnan Rajaraman

2014-11-01

Full Text Available Birth Asphyxia is considered to be one of the leading causes of neonatal mortality around the world. Asphyxiated neonates require skilled resuscitation to survive the neonatal period. The project aims to train health professionals in a basic newborn care using a prototype with an ultimate objective to have one person at every delivery trained in neonatal resuscitation. This prototype will be a user-friendly device with which one can get trained in performing neonatal resuscitation in resource-limited settings. The prototype consists of a Force Sensing Resistor (FSR that measures the pressure applied and is interfaced with Arduino® which controls the Liquid Crystal Display (LCD and Light Emitting Diode (LED indication for pressure and compression counts. With the increase in population and absence of proper medical care, the need for neonatal resuscitation program is not well addressed. The proposed work aims at offering a promising solution for training health care individuals on resuscitating newborn babies under low resource settings.

Neonatal morbidity associated with shoulder dystocia maneuvers.

Science.gov (United States)

Spain, Janine E; Frey, Heather A; Tuuli, Methodius G; Colvin, Ryan; Macones, George A; Cahill, Alison G

2015-03-01

We sought to examine neonatal morbidity associated with different maneuvers used among term patients who experience a shoulder dystocia. We conducted a retrospective cohort study of all women who experienced a clinically diagnosed shoulder dystocia at term requiring obstetric maneuvers at a single tertiary care hospital from 2005 through 2008. We excluded women with major fetal anomaly, intrauterine death, multiple gestation, and preterm. Women exposed to Rubin maneuver, Wood's screw maneuver, or delivery of the posterior arm were compared to women delivered by McRoberts/suprapubic pressure only, which served as the reference group. The primary outcome was a composite morbidity of neonatal injury (defined as clavicular or humeral fracture or brachial plexus injury) and neonatal depression (defined as Apgar dystocia, defined as time from delivery of fetal head to delivery of shoulders. Among the 231 women who met inclusion criteria, 135 were delivered by McRoberts/suprapubic pressure alone (57.9%), 83 women were exposed to Rubin maneuver, 53 women were exposed to Wood's screw, and 36 women were exposed to delivery of posterior arm. Individual maneuvers were not associated with composite morbidity, neonatal injury, or neonatal depression after adjusting for nulliparity and duration of shoulder dystocia. We found no association between shoulder dystocia maneuvers and neonatal morbidity after adjusting for duration, a surrogate for severity. Our results demonstrate that clinicians should utilize the maneuver most likely to result in successful delivery. Copyright © 2015 Elsevier Inc. All rights reserved.

Serum zinc status of neonates with seizure

Directory of Open Access Journals (Sweden)

Olia Sharmeen

2016-08-01

Full Text Available Background: Seizure is a common neurological disorder in neonatal age group!. Primary metabolic derangement is one of the important reason behind this convulsion during this period. Among primary metabolic derangement hypoglycemia, is most common followed by bypocalcaemia, hypomagnesaemia, low zinc status etc. As causes of many cases of convul­sion remain unknown in neonate. Objectives: To see the zinc status in the sera of neonate with convulsion. So that if needed early intervention can be taken up and thereby prevent complications. Method: A total of 50 neonates (1-28 days who had convulsion with no apparent reasons of convulsion were enrolled as cases and 50 healthy age and sex matched neonates were enrolled as controls. After a quick clinical evaluation serum zinc status was estimated from venous blood by atomic absorption method in Chemistry Division, Atomic Energy Centre. Low zinc was considered if serum value was <0.7mg/L. Results: Among a total of 50 cases 6% had low zinc value & 2% of controls also had low zinc level. The mean serwu zinc level of cases and controls were 1.57±0.95 and 2.37±1.06 mmol/1 respectively (p<0.01. Conclusion: From the study it is seen that low zinc value is an important cause of neonatal seizure due to primary metabolic abnormalities. So early recognition and treatment could save these babies from long term neurological sequelies.

Risk factors for hearing loss in neonates

Directory of Open Access Journals (Sweden)

Ni Luh Putu Maharani

2016-11-01

Full Text Available Background An estimated 6 of 1,000 children with live births suffer from permanent hearing loss at birth or the neonatal period. At least 90% of cases occur in developing countries. Hearing loss should be diagnosed as early as possible so that intervention can be done before the age of 6 months. Objective To determine risk factors for hearing loss in neonates. Methods We performed a case-control study involving 100 neonates with and without hearing loss who were born at Sanglah Hospital, Denpasar from November 2012 to February 2013. Subjects were consisted of 2 groups, those with hearing loss (case group of 50 subjects and without hearing loss (control group of 50 subjects. The groups were matched for gender and birth weight. We assessed the following risk factors for hearing loss: severe neonatal asphyxia, hyperbilirubinemia, meningitis, history of aminoglycoside therapy, and mechanical ventilation by Chi-square analysis. The results were presented as odds ratio and its corresponding 95% confidence intervals. Results Seventy percent of neonates with hearing loss had history of aminoglycoside therapy. Multivariable analysis revealed that aminoglycoside therapy of 14 days or more was a significant risk factor for hearing loss (OR 2.7; 95%CI 1.1 to 6.8; P=0.040. There were no statistically significant associations between hearing loss and severe asphyxia, hyperbilirubinemia, meningitis, or mechanical ventilation. Conclusion Aminoglycoside therapy for >=14 days was identified as a risk factor for hearing loss in neonates.

Opiate v CNS depressant therapy in neonatal drug abstinence syndrome.

Science.gov (United States)

Kandall, S R; Doberczak, T M; Mauer, K R; Strashun, R H; Korts, D C

1983-04-01

Paregoric and phenobarbital, administered randomly in 153 passively addicted neonates, initially appeared to control neonatal abstinence signs equally well. However, seven of the 62 phenobarbital-treated newborns had abstinence-associated seizures within the first month of life, while none of 49 paregoric-treated neonates had seizures. Forty-two neonates initially requiring no specific pharmacotherapy for abstinence signs were born to mothers taking less methadone hydrochloride just before delivery. Five of those 42 neonates, however, had seizures within the first 14 days of life. Seizure occurrence could not be predicted from analysis of early abstinence patterns. We consider paregoric to be the treatment of choice for the neonatal abstinence syndrome. Phenobarbital use should be monitored with serum drug levels and modification of recommended dosage regimens considered.

Fetal neonatal hyperthyroidism: diagnostic and therapeutic approachment

Science.gov (United States)

Kurtoğlu, Selim; Özdemir, Ahmet

2017-01-01

Fetal and neonatal hyperthyroidism may occur in mothers with Graves’ disease. Fetal thyrotoxicosis manifestation is observed with the transition of TSH receptor stimulating antibodies to the fetus from the 17th–20th weeks of pregnancy and with the fetal TSH receptors becoming responsive after 20 weeks. The diagnosis is confirmed by fetal tachycardia, goiter and bone age advancement in pregnancy and maternal treatment is conducted in accordance. The probability of neonatal hyperthyroidism is high in the babies of mothers that have ongoing antithyroid requirement and higher antibody levels in the last months of pregnancy. Clinical manifestation may be delayed by 7–17 days because of the antithyroid drugs taken by the mother. Neonatal hyperthyroidism symptoms can be confused with sepsis and congenital viral infections. Herein, the diagnosis and therapeutic approach are reviewed in cases of fetal neonatal hyperthyroidism. PMID:28439194

Colonization with hospital flora and its associated risk factors in neonates hospitalized in neonatal ward of a teaching center in Isfahan, Iran.

Science.gov (United States)

Shirani, Kiana; Mostafavizadeh, Kamyar; Ataei, Behrouz; Akhani, Khatere

2018-01-01

Due to the high incidence and prevalence of infection in neonatal ward, especially Neonatal Intensive Care Units (NICUs) reported by different studies and the important role of colonization with hospital germs in the development of nosocomial infections, we intended to evaluate the risk of colonization with hospital germs in neonates and its associated risk factors. This cross-sectional, descriptive-analytical study was conducted in 2016 in a Teaching Center in Iran. In total, 51 neonates were selected based on the inclusion criteria, and after recording their information in a checklist, samples were taken by swab from outer ear, axilla, and groin for culture. Neonates with negative culture from mentioned regions were enrolled in the study. The swab samples again were taken and sent for culture from mentioned regions in at least 3 days after hospitalization. Culture results from first and second sampling were collected and analyzed statistically. This study was conducted on 51 neonates. The mean gestational age among the neonates ranged from 35.25 (Week) ± 2.98. 22 girls (43.1%) and 29 boys (56.9%), most of them were born by cesarean. Based on the results of logistic regression, a significant association was found between the occurrence of colonization of hospital flora and the place hospitalization of the newborns (odds ratio (OR): 4.750; 95% confidence interval (CI): 1.26-17.85). This study revealed that the only risk factors of colonization with hospital flora in neonates are the type of delivery and place of hospitalization. Based on findings of the study, it is recommended to focus on efforts in increasing the rate of natural birth as well as improving conditions of infection control in NICUs to reduce the number of incidences of colonization with hospital flora in neonates.

Aspectos de biologia floral de cajueiros anão precoce e comum Floral biology aspects of the early dwarf and common cashew

Directory of Open Access Journals (Sweden)

Larissa Barbosa de Sousa

2007-06-01

Full Text Available O conhecimento da biologia floral é de suma importância para o desenvolvimento da cultura do cajueiro (Anacardium occidentale L.. Com relação aos aspectos botânicos, as características morfológicas das flores contribuíram efetivamente para a determinação das espécies do gênero Anacarduim conhecidas. No presente trabalho, objetivou-se estudar a biologia floral dos cajueiros anão precoce e comum. A pesquisa foi desenvolvida na área experimental do Departamento de Fitotecnia, Centro de Ciências Agrárias, Universidade Federal do Piauí, em Teresina, PI, avaliando-se nove clones de cajueiro anão ("CAP 14", "Embrapa 09", "Embrapa 50", "Embrapa 51", "Embrapa 76", "Embrapa 183", "Embrapa 189", "FAGA 01", "FAGA 11" e um clone de cajueiro comum ("CCA", utilizando-se quatro panículas por planta, cada uma com orientação norte, sul, leste e oeste. Os tipos varietais, cajueiro comum e anão precoce, apresentam pouca variação para a maioria dos caracteres avaliados. A proporção entre flores hermafroditas e o total de flores, em cajueiro comum, pode levá-lo a uma maior produção de frutos por panícula do que nos clones de cajueiro anão precoce analisados. O número de frutos desenvolvidos é bastante reduzido nos dois tipos varietais. As panículas situadas em diferentes orientações cardeais são semelhantes em todos os clones estudados quanto aos aspectos relacionados à biologia floral do cajueiro.The knowledge of the floral biology is very important for the development of the cashew's culture (Anacardium occidentale L.. In relation to botanical aspects, the morphological characteristics of flowers contributed effective to determination of the well-known species of Anacardium. It was aimed at studing the floral biology of the early dwarf and common cashew. The research was developed in the experimental area of the Department of Fitotecnia, Centro de Ciências Agrárias, Universidade Federal do Piauí, in Teresina, PI, and nine

Aplicação clínica da ultrassonografia craniana com Doppler em neonatos prematuros de muito baixo peso Clinical application of transcranial Doppler ultrasonography in premature, very-low-birth-weight neonates

Directory of Open Access Journals (Sweden)

Marta Lúcia Gabriel

2010-08-01

Full Text Available OBJETIVO: Analisar o valor do diagnóstico precoce de alterações hemodinâmicas em hemorragias e eventos hipóxico-isquêmicos pela avaliação de imagens e mensuração do índice de resistência por meio da ultrassonografia craniana com Doppler em neonatos prematuros de muito baixo peso. MATERIAIS E MÉTODOS: Cinquenta neonatos prematuros de muito baixo peso foram submetidos a ultrassonografia craniana com Doppler com a técnica transfontanela anterior e transtemporal sequenciais. RESULTADOS: Foram detectadas alterações cerebrais em 32% dos prematuros, sendo 22% com hemorragia intracraniana, 8% com leucomalácia periventricular e 2% com toxoplasmose. Dentre os 34 casos (68%, do total de neonatos, nos quais não foram detectadas lesões cerebrais pela ultrassonografia craniana, 18 (53% apresentaram alterações no índice de resistência. O índice de resistência variou conforme a época do exame. CONCLUSÃO: Existe correlação entre a presença de alterações na hemodinâmica cerebral e subsequente desenvolvimento de hemorragias e lesões hipóxico-isquêmicas, pela mensuração do índice de resistência. Alterações do índice de resistência, embora não preditoras de morte, estão relacionadas com a gravidade do quadro clínico em neonatos prematuros de muito baixo peso.OBJECTIVE: The present study was aimed at analyzing the value of the early diagnosis of hemodynamic changes in hemorrhages and hypoxic-ischemic events in premature, very-low-birth-weight neonates through the evaluation of images and resistance index measurement by means of transcranial Doppler ultrasonography. MATERIALS AND METHODS: Fifty premature, very-low-birth-weight neonates were submitted to transcranial Doppler ultrasonography with sequential transfontanellar and transtemporal techniques. RESULTS: Cerebral abnormalities were detected in 32% of the neonates (22% with intracranial hemorrhage, 8% with periventricular leukomalacia, and 2% with toxoplasmosis

Severe combined immunodeficiency (SCID) presenting with neonatal aplastic anemia.

Science.gov (United States)

Scott, Angela; Glover, Jason; Skoda-Smith, Suzanne; Torgerson, Troy R; Xu, Min; Burroughs, Lauri M; Woolfrey, Ann E; Fleming, Mark D; Shimamura, Akiko

2015-11-01

Aplastic anemia in the neonate is rare. We report a case of severe combined immunodeficiency (SCID) presenting with neonatal aplastic anemia. This report highlights the importance of considering SCID early in the evaluation of neonatal aplastic anemia prior to the development of infectious complications. © 2015 Wiley Periodicals, Inc.

Pattern of neonatal septicemia in a Malaysian maternity hospital.

Science.gov (United States)

Boo, N Y; Wong, Y H; Lim, V K

1989-09-01

Over a 12 months period, out of 25,411 livebirths, 155 neonates (6.1 per 1000 livebirths) had proven septicemia by blood culture. The mortality rate was 26.5%. Septicemia was more common among the very low birthweight and preterm neonates of gestation of 30 weeks or less. 45.8% of the septicemia occurred during the first 48 hours of life. Staphylococcus epidermidis was the most common causative organism. However, mortality was highest among neonates who acquired multiresistant nosocomial infection during the later part of neonatal life.

Neonatal hypocalcemia and its relation to vitamin D and calcium supplementation.

Science.gov (United States)

Elsary, Asmaa Y; Elgameel, Alkassem A; Mohammed, Wael S; Zaki, Osman M; Taha, Shaimaa A

2018-03-01

To assess the prevalence of hypocalcemia in outpatient clinic neonates and its relation to vitamin D and calcium supplementation.  Methods: This cross-sectional analytical study was conducted at the University Teaching Hospital from May to October 2016. Data were collected from 100 neonates by interviewing mothers using a structured questionnaire; which included socio-demographic information, maternal and neonatal history; in addition to investigations of serum calcium total and ionized and serum vitamin D level. Results: The prevalence of hypocalcemia was 76%, late hypocalcemia represent 52% of hypocalcemic neonates. The prevalence of hypovitaminosis D was 38%. Hypocalcemia was found more prevalent among neonates with no history of vitamin D supplementation (98.7%), no history of maternal calcium supplementation (57.9%), while they had a history of neonatal jaundice on phototherapy (46.1%) which increased to 53.8% with late hypocalcemia. Conclusion: Neonatal hypocalcemia is widely prevalent in Fayoum governorate with significant association with a history of neonatal jaundice on phototherapy, not receiving maternal calcium or neonatal vitamin D supplementation.

Palliative care in the neonatal unit: neonatal nursing staff perceptions of facilitators and barriers in a regional tertiary nursery.

Science.gov (United States)

Kilcullen, Meegan; Ireland, Susan

2017-05-11

Neonatology has made significant advances in the last 30 years. Despite the advances in treatments, not all neonates survive and a palliative care model is required within the neonatal context. Previous research has focused on the barriers of palliative care provision. A holistic approach to enhancing palliative care provision should include identifying both facilitators and barriers. A strengths-based approach would allow barriers to be addressed while also enhancing facilitators. The current study qualitatively explored perceptions of neonatal nurses about facilitators and barriers to delivery of palliative care and also the impact of the regional location of the unit. The study was conducted at the Townsville Hospital, which is the only regional tertiary neonatal unit in Australia. Semi-structured interviews were conducted with a purposive sample of eight neonatal nurses. Thematic analysis of the data was conducted within a phenomenological framework. Six themes emerged regarding family support and staff factors that were perceived to support the provision of palliative care of a high quality. Staff factors included leadership, clinical knowledge, and morals, values, and beliefs. Family support factors included emotional support, communication, and practices within the unit. Five themes emerged from the data that were perceived to be barriers to providing quality palliative care. Staff perceived education, lack of privacy, isolation, staff characteristics and systemic (policy, and procedure) factors to impact upon palliative care provision. The regional location of the unit also presented unique facilitators and barriers to care. This study identified and explored facilitators and barriers in the delivery of quality palliative care for neonates in a regional tertiary setting. Themes identified suggested that a strengths-approach, which engages and amplifies facilitating factors while identified barriers are addressed or minimized, would be successful in

Colestase neonatal prolongada: estudo prospectivo

Directory of Open Access Journals (Sweden)

PRADO Elizabeth Teixeira Mendes Livramento

1999-01-01

Full Text Available Em razão da urgência de se decidir por um tratamento clínico ou por uma intervenção cirúrgica imediata, o estudo da colestase neonatal prolongada envolve dois objetivos básicos: o diagnóstico diferencial entre atresia biliar e hepatite neonatal e a pesquisa dos agentes etiológicos associados. Desta maneira, através de estudo prospectivo desenvolvido na década de 1970, foram avaliadas 77 crianças portadoras de colestase neonatal prolongada para estabelecer o diagnóstico diferencial entre atresia biliar e hepatite neonatal e, numa segunda fase, 108 crianças, visando esclarecer a etiopatogenia da colestase neonatal prolongada. Os resultados do diagnóstico diferencial revelaram que, dos 18 atributos avaliados, apenas oito mostraram-se bons indicadores de atresia biliar, em ordem decrescente: ductos proliferados (espaço-porta, fibrose (espaço-porta, colestase (espaço-porta, cor das fezes -- acolia, hepatomegalia, colestase canalicular (lóbulo, infiltrado (espaço-porta, células gigantes (lóbulo. Estes oito atributos foram então compostos, mediante uma ponderação, em um único indicador de grande poder discriminativo, capaz de decidir o diagnóstico diferencial em 99% dos casos. Quanto à etiopatogenia, registrou-se: vírus rubéola 0%, vírus herpes simples 0%, listeriose 0%, citomegalovirose 2,2%, vírus hepatite B 2,4%, toxoplasmose 2,8%, deficiência de alfa-1-antitripsina 13,1%, sífilis 21,1 %, auto-anticorpos hepáticos 58,4%. O trabalho desenvolvido mostra que as 8 variáveis mais decisivas, como indicadoras diferenciais entre atresia biliar e hepatite neonatal, permanecem como índices fundamentais, auxiliando, em conjunto com novos métodos diagnósticos, na composição de uma estratégia multifatorial cada vez menos invasiva e mais precisa. O estudo da etiopatogenia, dependente das condições epidemiológicas locais e da época, com a introdução de novos métodos diagnósticos, torna-se atualmente cada vez mais

Frequency of neonatal abstinence syndrome (NAS and type of the narcotic substance in neonates born from drug addicted mothers

Directory of Open Access Journals (Sweden)

Fatemeh Nayeri

2015-02-01

Full Text Available Abstract Background and objective: NAS is a combination of signs and symptoms that due to physical and mental dependency, develops in neonates born from drug addicted mothers. The onset of NAS varies in accordance with the type, amount, frequency and duration of substance used. Because of diverse and unclear pattern of substance abuse in Iranian addicted pregnant mothers in comparison with western countries, this multi-center study has been designed to evaluate NAS in neonates born from drug addicted mothers. Material and method: A cross sectional study was carried out on newborns of narcotic addicted mothers during the first six months of 2008. The newborn’s status and clinical signs were checked by physical examination and scored by the Finnegan scoring system. Results: In this study 100 neonates born from narcotic addicted mothers were examined; the most used narcotic was crack (36%. 60% of neonates showed signs of NAS. The most prevalent signs of NAS were increased muscle tonicity (60%/7, irritability (59%/6 and increased moro reflex (51%/8. Neonates born from crack abusers, in comparison with other drugs, were significantly at risk of NAS (100% vs.87%, p

Síndrome do desconforto respiratório agudo relacionada à sepse em crianças com câncer: dinâmica respiratória de uma condição devastadora

Directory of Open Access Journals (Sweden)

Rodrigo Genaro Arduini

Full Text Available RESUMO Objetivo: Avaliar a evolução clínica e os parâmetros respiratórios de crianças com câncer submetidas à ventilação mecânica que apresentavam síndrome do desconforto respiratório agudo relacionada à sepse. Métodos: Este estudo longitudinal, prospectivo e observacional de coorte com duração de 2 anos incluiu 29 crianças e adolescentes. Dados clínicos, avaliações de gasometria sanguínea e parâmetros ventilatórios foram coletados em quatro momentos diferentes. As flutuações entre as avaliações e as diferenças entre as médias estimadas foram analisadas por meio de modelos lineares mistos, tendo como parâmetro primário (endpoint a ocorrência de óbito dentro de 28 dias após o início da síndrome do desconforto respiratório agudo. Resultados: Ocorreram 17 óbitos dentro de 28 dias após o início da síndrome do desconforto respiratório agudo, e outros 7 entre 29 e 60 dias. Apenas cinco pacientes sobreviveram por mais de 60 dias. Nove (31% pacientes faleceram como consequência direta de hipoxemia refratária, e os demais em razão de falência de múltiplos órgãos e choque refratário a catecolaminas. Em 66% das avaliações, o volume corrente demandado para obter saturação de oxigênio igual ou acima de 90% foi superior a 7mL/kg. As médias estimadas de complacência dinâmica foram baixas e similares para sobreviventes e não sobreviventes, porém com inclinação negativa da reta entre a primeira e última avaliações, acompanhada por uma inclinação negativa da reta para volume corrente nos não sobreviventes. Os não sobreviventes tiveram significantemente mais hipoxemia, com relações PaO2/FiO2 que demonstravam médias mais baixas e inclinação negativa da reta nas quatro avaliações. As pressões pico, expiratória e média das vias aéreas demonstraram inclinações positivas na reta para os não sobreviventes, que também apresentaram mais acidose metabólica. Conclusões: Na maioria de

Development and validation of Neonatal Satisfaction Survey--NSS-13.

Science.gov (United States)

Hagen, Inger H; Vadset, Tove B; Barstad, Johan; Svindseth, Marit F

2015-06-01

The purpose of this study was to develop and validate a survey to investigate parents' satisfaction with neonatal wards in a population of parents of children with a gestation age of ≥24 weeks to 3 months after full-term birth. We explored the literature and conducted three focus groups: two with expert health personnel and one with parents. We tested the survey in a parent population (N = 105) and report the different stages in the validation process along with the full survey, the Neonatal Satisfaction Survey - 13 categories (NSS-13). We found 13 subcategories in the Neonatal Satisfaction Survey. The subcategories measure parents' satisfaction with neonatal units based on staff, admission, nurses, anxiety, siblings (parents' perceptions of caring for the siblings of the newborn), information, timeout, doctors, facilities, nutrition, preparation for discharge, trust and visitors. Each subcategory showed acceptable internal consistency. The full version of the Neonatal Satisfaction Survey presents 69 items, and each subcategory contains two to eleven items. The Neonatal Satisfaction Survey seems suitable to measure parents' satisfaction with neonatal units and can be used in full, but it can also measure subcategories. Parents' satisfaction with neonatal units can be used to improve the quality in such wards. We consider this study as the first in a series to validate the NSS-13. The full survey with subcategories is presented in this paper. © 2014 Nordic College of Caring Science.

Prevalence and pattern of congenital malformations among neonates in the neonatal unit of a teaching hospital

International Nuclear Information System (INIS)

Hussain, S.; Sabir, M.; Tarar, S. H.; Mushtaq, R.; Asghar, I.; Chattha, M. N.

2014-01-01

Objective: To determine the prevalence and pattern of congenital malformations among neonates in a teaching hospital. Methods: The prospective hospital-based study was conducted over a period of 18 months in the neonatal unit of Combined Military Hospital, Kharian, from September 2011 to February 2013. All neonates from newborn to 28 days of age admitted to the unit irrespective of their condition comprised the study population. Neonatal examination was done by the Registrar at the time of admission followed by neonatologist/paediatrician. Information regarding gender, weight, gestational age, mode of delivery, consanguinity, maternal age, antenatal visit record and family history were recorded on a predesigned proforma. After clinical examination, if required, relevant investigations like ultrasonography, radiology, echocardiography, laboratory and genetic studies were done to confirm diagnosis. Data was statistically analysed by using SPSS 20. Results: Out of 3,210 total admissions, 226 (7%) neonates were congenitally malformed. Of them, 130 (57.52 %) were male and 96 (42.47 %) females. Among different body systems affected, anomalies related to the central nervous system were 46(20.35%) musculoskeletal 42(18.58%), genitourinary 34 (15.04%), cardiovascular system 30 (13.27%), ear, eye, face, neck 27(11.94%), digestive system 19 (8.40%), syndromes and skin 14 (6.19%) each. Conclusion: Congenital Malformations are not rare in our community and central nervous system is the most commonly affected system. Healthcare managers must stress upon primary prevention in the form of vaccination, nutrition and drugs to decrease preventable share of congenital malformations. (author)

Brain injuries due to neonatal hypoglycemia: case report

International Nuclear Information System (INIS)

Kim, Dae Bong; Song, Chang Joon; Chang, Mae Young; Youn, Hyae Won

2003-01-01

Although hypoglycemia may be common among neonates, brain injuries resulting from isolated neonatal hypoglycemia are rare. The condition may cause neurological symptoms such as stupor, jitteriness, and seizures, though in their absence, diagnosis delayed or difficult. Hypoglycemia was diagnosed in a three-day-old neonate after he visited the emergency department with loose stool, poor oral intake, and decreased activity, first experienced two days earlier. Two days after his visity, several episodes of seizure occurred. T2 and diffusion-weighted magnetic resonance (MR) scanning, performed at 11 days of age, revealed bilateral and symmetrical high signal intensity lesions in occipital, parietal, and temporal lobes. We report the MR findings of hypoglycemic encephalopathy in a neonate

Uso de drogas entre trabalhadores precoces na atividade de malabares Uso de drogas entre trabajadores precoces en la actividad de malabarista Use of drugs between precocious workers in the activity of jugglers

Directory of Open Access Journals (Sweden)

Daniele Cristine da Silva Cirino

2009-09-01

Full Text Available O presente estudo objetiva identificar os fatores que motivam o uso de drogas entre meninos trabalhadores em condição de rua na cidade de João Pessoa - PB, caracterizar a atividade de trabalho de malabares e relacionar o trabalho precoce e o uso de drogas com as perspectivas de futuro destes sujeitos. A pesquisa desenvolveu-se através da territorialização, observação e registro assistemático e entrevistas semiestruturadas, com dados analisados a partir da análise de conteúdo de Bardin (1979. Foram entrevistados seis sujeitos, entre 11 e 16 anos, todos do sexo masculino. As drogas utilizadas por eles foram bebidas alcoólicas, cigarro, cola e maconha. Os motivos para o uso foram a imposição do grupo e o desconhecimento dos reais efeitos das drogas. Constatamos ainda que, para os trabalhadores precoces no setor informal urbano, há construção de perspectivas de futuro, vislumbradas através da inserção profissional quando adultos, possível de se concretizar a partir da escola.Esta investigación trata de identificar los factores que motivan el uso de drogas entre niños trabajadores en condición de calle de la ciudad de João Pessoa - PB; caracterizar la actividad de trabajo de malabaristas y relacionar trabajo precoz y uso de drogas con las perspectivas de futuro de estos niños. Se utilizó como técnicas: "territorialización" (conocimiento previo del sitio, observación y registro no sistemáticos y entrevistas semidirigidas, con datos analizados por medio del análisis de contenido de Bardin (1979. Fueron entrevistados 06 niños, entre 11 y 16 años, del sexo masculino. Las drogas utilizadas por ellos fueron bebidas alcohólicas, cigarrillo, inhalantes y marihuana. Los motivos para el uso fueron: imposición del grupo y desconocimiento de los efectos reales de las drogas. Constatamos, todavía, que existe construcción de perspectivas de futuro para estos trabajadores a partir de la inserción profesional cuando adultos

Quantifying Neonatal Sucking Performance: Promise of New Methods.

Science.gov (United States)

Capilouto, Gilson J; Cunningham, Tommy J; Mullineaux, David R; Tamilia, Eleonora; Papadelis, Christos; Giannone, Peter J

2017-04-01

Neonatal feeding has been traditionally understudied so guidelines and evidence-based support for common feeding practices are limited. A major contributing factor to the paucity of evidence-based practice in this area has been the lack of simple-to-use, low-cost tools for monitoring sucking performance. We describe new methods for quantifying neonatal sucking performance that hold significant clinical and research promise. We present early results from an ongoing study investigating neonatal sucking as a marker of risk for adverse neurodevelopmental outcomes. We include quantitative measures of sucking performance to better understand how movement variability evolves during skill acquisition. Results showed the coefficient of variation of suck duration was significantly different between preterm neonates at high risk for developmental concerns (HRPT) and preterm neonates at low risk for developmental concerns (LRPT). For HRPT, results indicated the coefficient of variation of suck smoothness increased from initial feeding to discharge and remained significantly greater than healthy full-term newborns (FT) at discharge. There was no significant difference in our measures between FT and LRPT at discharge. Our findings highlight the need to include neonatal sucking assessment as part of routine clinical care in order to capture the relative risk of adverse neurodevelopmental outcomes at discharge. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Efferent inhibition of otoacoustic emissions in preterm neonates

Directory of Open Access Journals (Sweden)

Renata Mota Mamede Carvallo

2015-10-01

Full Text Available ABSTRACT INTRODUCTION: Abnormalities in auditory function of newborns may occur not only because of preterm birth, but also from the use of medications and from diseases related to prematurity. OBJECTIVE: To analyze the inhibitory effect from stimulation of the olivocochlear efferent system on transient evoked otoacoustic emissions in preterm neonates, comparing these data with those from full-term neonates. METHODS: This was a prospective, cross-sectional, contemporary cohort study with 125 neonates, pooled into two groups: full-term (72 full-term neonates, 36 females and 36 males, born at 37-41 weeks of gestational age; and preterm (53 neonates, 28 males and 25 females, born at ≤36 weeks of gestational age, evaluated at the corrected gestational age of 37-41 weeks. Otoacoustic emissions were recorded using linear and nonlinear click-evoked stimuli, with and without contralateral stimulation. RESULTS: The inhibitory effect of the efferent pathway in otoacoustic emissions was different (p = 0.012 between groups, and a mean reduction of 1.48 dB SPL in full-term births and of 1.02 dB SPL in preterm births was observed for the non-linear click-evoked stimulus. CONCLUSION: The results suggest a reduced inhibitory effect of the olivocochlear efferent system on otoacoustic emissions in preterm neonates.

Inflammatory and vascular placental lesions are associated with neonatal amplitude integrated EEG recording in early premature neonates.

Directory of Open Access Journals (Sweden)

Dorit Paz-Levy

Full Text Available Placental histologic examination can assist in revealing the mechanism leading to preterm birth. Accumulating evidence suggests an association between intrauterine pathological processes, morbidity and mortality of premature infants, and their long term outcome. Neonatal brain activity is increasingly monitored in neonatal intensive care units by amplitude integrated EEG (aEEG and indices of background activity and sleep cycling patterns were correlated with long term outcome. We hypothesized an association between types of placental lesions and abnormal neonatal aEEG patterns.To determine the association between the placental lesions observed in extreme preterm deliveries, and their neonatal aEEG patterns and survival.This prospective cohort study included extreme premature infants, who were born ≤ 28 weeks of gestation, their placentas were available for histologic examination, and had a continues aEEG, soon after birthn = 34. Infants and maternal clinical data were collected. aEEG data was assessed for percentage of depressed daily activity in the first 3 days of life and for sleep cycling. Associations of placental histology with clinical findings and aEEG activity were explored using parametric and non-parametric statistics.Twenty two out of the 34 newborns survived to discharge. Preterm prelabor rupture of membranes (PPROM or chorioamnionitis were associated with placental lesions consistent with fetal amniotic fluid infection (AFI or maternal under perfusion (MUP (P < 0.05. Lesions consistent with fetal response to AFI were associated with absence of SWC pattern during the 1st day of life. Fetal-vascular-thrombo-occlusive lesions of inflammatory type were negatively associated with depressed cerebral activity during the 1st day of life, and with aEEG cycling during the 2nd day of life (P<0.05. Placental lesions associated with MUP were associated with depressed neonatal cerebral activity during the first 3 days of life (P = 0

Prevalence of neonatal septicaemia in the University of Port ...

African Journals Online (AJOL)

Background : Septicaemia is a major cause of morbidity and mortality in the neonatal period. Early detection of neonatal septicaemia is often hampered by its subtle and nonspecific symptoms and signs thus a high index of suspicion is needed. Objectives: To determine the prevalence of neonatal sept ic a emia , ident i fy ...

The first occurrence of a CTX-M ESBL-producing Escherichia coli outbreak mediated by mother to neonate transmission in an Irish neonatal intensive care unit.

LENUS (Irish Health Repository)

O'Connor, Ciara

2017-01-05

Escherichia coli (E. coli) comprise part of the normal vaginal microflora. Transfer from mother to neonate can occur during delivery resulting, sometimes, in neonatal bacterial disease. Here, we aim to report the first outbreak of CTX-M ESBL-producing E. coli with evidence of mother-to-neonate transmission in an Irish neonatal intensive care unit (NICU) followed by patient-to-patient transmission.

Bloodstream Infections in a Neonatal Intensive Care Unit

OpenAIRE

Mehmet Sah Ipek

2016-01-01

Aim: To determine the pattern of bloodstream infections (BSIs) and antimicrobial susceptibility of pathogens in a neonatal intensive care unit (NICU).Material and Method: Positive hemoculture of neonates diagnosed with nosocomial sepsis from March 2011 to March 2014 in the NICU of Diyarbakir Maternity and Children%u2019s Hospital, in the southeastern region of Anatolia, Turkey, were retrospectively reviewed. Results: A total of 148 pathogens were isolated in 142 neonates. The most common micr...

Photodegradation of riboflavin in neonates

International Nuclear Information System (INIS)

Sisson, T.R.

1987-01-01

The biologically most important flavins are riboflavin and its related nucleotides, all highly sensitive to light. It is because of its photoreactivity and its presence in almost all body fluids and tissues that riboflavin assumes importance in phototherapy of neonatal jaundice. The absorption maxima of both bilirubin and riboflavin in the body are nearly identical: 445-450 (447) nm. In consequence, blue visible light will cause photoisomerization of bilirubin accompanied by photodegradation of riboflavin. This results in diminished erythrocyte glutathione reductase, which indicates generalized tissue riboflavin deficiency and red cell lysis. Single- and double-strand breaks in intracellular DNA have occurred with phototherapy. This light exposure of neonates may result also in alterations of bilirubin-albumin binding in the presence of both riboflavin and theophylline (the latter frequently given to prevent neonatal apnea). Many newborns, especially if premature, have low stores of riboflavin at birth. The absorptive capacity of premature infants for enteral riboflavin is likewise reduced. Consequently, inherently low stores and low intake of riboflavin plus phototherapy for neonatal jaundice will cause a deficiency of riboflavin at a critical period for the newborn. Supplementation to those infants most likely to develop riboflavin deficiency is useful, but dosage, time, and mode of administration to infants undergoing phototherapy must be carefully adjusted to avoid unwanted side effects

An MR-compatible neonatal incubator.

Science.gov (United States)

Paley, M N J; Hart, A R; Lait, M; Griffiths, P D

2012-07-01

To develop a neonatal MR-compatible incubator for transporting babies between a neonatal intensive care unit and an MRI unit that is within the same hospital but geographically separate. The system was strapped to a standard MR-compatible patient trolley, which provides space for resuscitation outside the incubator. A constant-temperature exothermic heat pad was used to maintain temperature together with a logging fluoro-optic temperature monitor and alarm system. The system has been designed to accommodate standard knee-sized coils from the major MR manufacturers. The original incubator was constructed from carbon fibre, but this required modification to prevent radiofrequency shading artefacts due to the conducting properties of the carbon fibre. A high-tensile polyester material was used, which combined light weight with high impact strength. The system could be moved onto the patient bed with the coils and infant in place by one technologist. Studies in eight neonatal patients produced high quality 1.5 T MR images with low motion artefacts. The incubator should also be compatible with imaging in 3 T MR systems, although further work is required to establish this. Images were acquired using both rapid and high-resolution sequences, including three-dimensional volumes, proton spectra and diffusion weighting. The incubator provides a safe, quiet environment for neonates during transport and imaging, at low cost.

Design of a light stimulator for fetal and neonatal magnetoencephalography

International Nuclear Information System (INIS)

Wilson, J D; Adams, A J; Murphy, P; Eswaran, H; Preissl, H

2009-01-01

The design, safety analysis and performance of a fetal visual stimulation system suitable for fetal and neonatal magnetoencephalography studies are presented. The issue of fetal, neonatal and maternal safety is considered and the maximum permissible exposure is computed for the maternal skin and the adult eye. The risk for neonatal eye exposure is examined. It is demonstrated that the fetus, neonate and mother are not at risk. (note)

Possible Prevention of Neonatal Death: A Regional Population-Based Study in Japan.

Science.gov (United States)

Koshida, Shigeki; Yanagi, Takahide; Ono, Tetsuo; Tsuji, Shunichiro; Takahashi, Kentaro

2016-03-01

The neonatal mortality rate in Japan has currently been at the lowest level in the world. However, it is unclear whether there are still some potentially preventable neonatal deaths. We, therefore, aimed to examine the backgrounds of neonatal death and the possibilities of prevention in a region of Japan. This is a population-based study of neonatal death in Shiga Prefecture of Japan. The 103 neonatal deaths in our prefecture between 2007 and 2011 were included. After reviewing by a peer-review team, we classified the backgrounds of these neonatal deaths and analyzed end-of-life care approaches associated with prenatal diagnosis. Furthermore, we evaluated the possibilities of preventable neonatal death, suggesting specific recommendations for its prevention. We analyzed 102 (99%) of the neonatal deaths. Congenital malformations and extreme prematurity were the first and the second most common causes of death, respectively. More than half of the congenital abnormalities (59%) including malformations and chromosome abnormality had been diagnosed before births. We had 22 neonates with non-intensive care including eighteen cases with congenital abnormality and four with extreme prematurity. Twenty three cases were judged to have had some possibility of prevention with one having had a strong possibility of prevention. Among specific recommendations of preventable neonatal death, more than half of them were for obstetricians. There is room to reduce neonatal deaths in Japan. Prevention of neonatal death requires grater prenatal care by obstetricians before birth rather than improved neonatal care by neonatologists after birth.

Computed radiography in neonatal intensive care

International Nuclear Information System (INIS)

Merlo, L.; Bighi, S.; Cervi, P.M.; Lupi, L.

1991-01-01

The Authors report their experience in the employment of a computerized digital radiographic system in Neonatal Intensive Care. The analog screen-film system is replaced by photosensitive imaging plates, scanned after X-ray exposure by a laser that releases the digital image, which can then be manipulated on computer work-stations. In a period of twelve months about 200 chest-abdomen X-ray examinations in Neonatal Intensive Care have been performed using this method with good technical and diagnostic results. The use of digital radiography in the neonatal area is of high interest: this system produces good quality images, there is a reduction in radiation dose and 'retakes', the system allows selective enhancement of different structures and their magnification. (orig.)

Plasma-mediated immune suppression : a neonatal perspective

NARCIS (Netherlands)

Belderbos, Mirjam E.; Levy, Ofer; Meyaard, Linde; Bont, Louis

Plasma is a rich mixture of immune regulatory factors that shape immune cell function. This immunomodulatory role of plasma is especially important in neonates. To maintain in utero feto-maternal tolerance and to allow for microbial colonization after birth, the neonatal immune system is biased

Neonate with Mycoplasma hominis meningoencephalitis given moxifloxacin

NARCIS (Netherlands)

Wildenbeest, Joanne G.; Said, Ines; Jaeger, Bregje; van Hest, Reinier M.; van de Beek, Diederik; Pajkrt, Dasja

2016-01-01

Mycoplasma hominis is a commensal organism in the genitourinary tract that can cause life-threatening CNS infections in neonates after intrauterine infection or through vertical transmission during birth. We present a case of an 11-day-old neonate presenting with fever and supporting laboratory

Teamwork in the Neonatal Intensive Care Unit

Science.gov (United States)

Barbosa, Vanessa Maziero

2013-01-01

Medical and technological advances in neonatology have prompted the initiation and expansion of developmentally supportive services for newborns and have incorporated rehabilitation professionals into the neonatal intensive care unit (NICU) multidisciplinary team. Availability of therapists specialized in the care of neonates, the roles of…

Maternal Super Obesity and Neonatal Morbidity after Term Cesarean Delivery.

Science.gov (United States)

Smid, Marcela C; Vladutiu, Catherine J; Dotters-Katz, Sarah K; Manuck, Tracy A; Boggess, Kim A; Stamilio, David M

2016-10-01

Objective To estimate the association between maternal super obesity (body mass index [BMI] ≥ 50 kg/m(2)) and neonatal morbidity among neonates born via cesarean delivery (CD). Methods Retrospective cohort of singleton neonates delivered via CD ≥ 37 weeks in the Maternal-Fetal Medicine Unit Cesarean Registry. Maternal BMI at delivery was stratified as 18.5 to 29.9 kg/m(2), 30 to 39.9 kg/m(2), 40 to 49.9 kg/m(2), and ≥ 50 kg/m(2). Primary outcomes included acute (5-minute Apgar score neonatal injury, and/or transient tachypnea of the newborn) and severe (grade 3 or 4 intraventricular hemorrhage, necrotizing enterocolitis, seizure, respiratory distress syndrome, hypoxic ischemic encephalopathy, meconium aspiration, ventilator support ≥ 2 days, sepsis and/or neonatal death) neonatal morbidity. Odds of neonatal morbidity were estimated for each BMI category adjusting for clinical and operative characteristics. Results Of 41,262 maternal-neonatal dyads, 36% of women were nonobese, 49% had BMI of 30 to 39.9 kg/m(2), 12% had BMI of 40 to 49.9 kg/m(2), and 3% were super obese. Compared with nonobese women, super obese women had twofold odds of acute (5 vs. 10%; adjusted odds ratio [aOR]: 1.81, 95% confidence interval [CI]: 1.59-2.73) and severe (3 vs. 6%; aOR: 2.08; 95% CI: 1.59-2.73) neonatal morbidity. Conclusion Among term infants delivered via CD, maternal super obesity is associated with increased risk of neonatal morbidity. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Vertical mother-neonate transfer of maternal gut bacteria via breastfeeding.

Science.gov (United States)

Jost, Ted; Lacroix, Christophe; Braegger, Christian P; Rochat, Florence; Chassard, Christophe

2014-09-01

Breast milk has recently been recognized as source of commensal and potential probiotic bacteria. The present study investigated whether viable strains of gut-associated obligate anaerobes are shared between the maternal and neonatal gut ecosystem via breastfeeding. Maternal faeces, breast milk and corresponding neonatal faeces collected from seven mothers-neonate pairs at three neonatal sampling points were analyzed by culture-independent (pyrosequencing) and culture-dependent methods (16S rRNA gene sequencing, pulsed field gel electrophoresis, random amplified polymorphic DNA and repetitive extragenic palindromic polymerase chain reaction. Pyrosequencing allowed identifying gut-associated obligate anaerobic genera, like Bifidobacterium, Bacteroides, Parabacteroides and members of the Clostridia (Blautia, Clostridium, Collinsella and Veillonella) shared between maternal faeces, breast milk and neonatal faeces. Using culture, a viable strain of Bifidobacterium breve was shown to be shared between all three ecosystems within one mother-neonate pair. Furthermore, pyrosequencing revealed that several butyrate-producing members of the Clostridia (Coprococcus, Faecalibacterium, Roseburia and Subdoligranulum) were shared between maternal faeces and breast milk. This study shows that (viable) obligate gut-associated anaerobes may be vertically transferred from mother to neonate via breastfeeding. Thus, our data support the recently suggested hypothesis of a novel way of mother-neonate communication, in which maternal gut bacteria reach breast milk via an entero-mammary pathway to influence neonatal gut colonization and maturation of the immune system. © 2013 Society for Applied Microbiology and John Wiley & Sons Ltd.

Bilirubin-Induced Neurotoxicity in the Preterm Neonate.

Science.gov (United States)

Watchko, Jon F

2016-06-01

Bilirubin-induced neurotoxicity in preterm neonates remains a clinical concern. Multiple cellular and molecular cascades likely underlie bilirubin-induced neuronal injury, including plasma membrane perturbations, excitotoxicity, neuroinflammation, oxidative stress, and cell cycle arrest. Preterm newborns are particularly vulnerable secondary to central nervous system immaturity and concurrent adverse clinical conditions that may potentiate bilirubin toxicity. Acute bilirubin encephalopathy in preterm neonates may be subtle and manifest primarily as recurrent symptomatic apneic events. Low-bilirubin kernicterus continues to be reported in preterm neonates, and although multifactorial in nature, is often associated with marked hypoalbuminemia. Copyright © 2016 Elsevier Inc. All rights reserved.

Neonatal abstinence syndrome

Science.gov (United States)

... in a newborn who was exposed to addictive opiate drugs while in the mother’s womb. Causes Neonatal ... Increased muscle tone Irritability Poor feeding Rapid breathing Seizures Sleep problems Slow weight gain Stuffy nose, sneezing ...

Early onset neonatal sepsis in preterm premature rupture of membranes

International Nuclear Information System (INIS)

Ashraf, M.N.

2015-01-01

To determine the frequency of early onset neonatal sepsis in newborn with various duration of preterm premature rupture of membranes (PPROM). Study Design: Cross sectional study. Place and Duration of Study: Neonatal Intensive Care Unit Combined Military Hospital, Lahore from November 2009 to November 2010. Material and Methods: Neonates of singleton pregnancies complicated by preterm premature rupture of the membranes (PPROM) with delivery between 30 and 36 weeks gestation were included in the study. The overall frequency of neonatal sepsis was calculated on clinical and serological basis. Comparison of the frequency of sepsis among groups with varying duration of rupture of membranes was done. Results: Out of 164 babies, 84 (51.2%) were female and 80 (48.8%) were male. Mean maternal age was 23 years (range: 18-36 years). Mean gestational age was 33 weeks (range: 30-36 weeks). Sepsis was suspected in 41(25%) babies on clinical grounds. C-reactive protein was raised in 36 (22%) neonates. There was statistically insignificant difference between clinical versus serological diagnosis (p=0.515). Frequency of neonatal sepsis was significantly higher in mothers with longer duration of rupture of membrane (p < 0.001). Conclusion: Frequency of neonatal sepsis was observed to be 22%. PPROM is an important risk factor for early onset neonatal sepsis. (author)

The implementation of neonatal peritoneal dialysis in a clinical setting.

Science.gov (United States)

Unal, Sevim; Bilgin, Leyla; Gunduz, Mehmet; Uncu, Nermin; Azili, Mujdem Nur; Tiryaki, Tugrul

2012-10-01

To investigate etiology, outcome and complications related to neonatal peritoneal dialysis (PD). Neonates treated with PD in our neonatal intensive care unit during 2007-2010 were analyzed retrospectively. Among 4036 hospitalized neonates; 20 neonates (0.5%) who underwent 21 cycles of PD [7 preterm, 13 term; 13 female, 7 male] were included. The mean birth weight was 2930.2 ± 720.6 g (1120-4570), mean gestational age was 37.5 ± 3.5 weeks (27-41). The etiologic disorders included inborn errors of metabolism (propionic acidemia, methylmalonic acidemia, citrullinemia, glutaric aciduria type 2, maple syrup urine disease, 10), or acute renal failure secondary to perinatal asphyxia (4), sepsis (2), prematurity (2), hypoplastic left heart syndrome (1), kernicterus (1). The complications included peritonitis (2), early leakage (4), hemorrhage (1), catheter removal (3) and occlusion (2). The mortality rate was 50%. The gestational ages and birth weights of surviving neonates were higher (p neonates, chronic renal failure (1), severe (4) and moderate neuromotor impairment (2) developed within 4-43 months. PD, although invasive, is an effective therapy in neonates. The complexity and invasiveness of the procedure is probably responsible for high rate of complications and mortality. If appropriate catheter selection and technique in the placement should be done, PD might improve outcome.

Structural connectivity asymmetry in the neonatal brain.

Science.gov (United States)

Ratnarajah, Nagulan; Rifkin-Graboi, Anne; Fortier, Marielle V; Chong, Yap Seng; Kwek, Kenneth; Saw, Seang-Mei; Godfrey, Keith M; Gluckman, Peter D; Meaney, Michael J; Qiu, Anqi

2013-07-15

Asymmetry of the neonatal brain is not yet understood at the level of structural connectivity. We utilized DTI deterministic tractography and structural network analysis based on graph theory to determine the pattern of structural connectivity asymmetry in 124 normal neonates. We tracted white matter axonal pathways characterizing interregional connections among brain regions and inferred asymmetry in left and right anatomical network properties. Our findings revealed that in neonates, small-world characteristics were exhibited, but did not differ between the two hemispheres, suggesting that neighboring brain regions connect tightly with each other, and that one region is only a few paths away from any other region within each hemisphere. Moreover, the neonatal brain showed greater structural efficiency in the left hemisphere than that in the right. In neonates, brain regions involved in motor, language, and memory functions play crucial roles in efficient communication in the left hemisphere, while brain regions involved in emotional processes play crucial roles in efficient communication in the right hemisphere. These findings suggest that even at birth, the topology of each cerebral hemisphere is organized in an efficient and compact manner that maps onto asymmetric functional specializations seen in adults, implying lateralized brain functions in infancy. Copyright © 2013 Elsevier Inc. All rights reserved.

Reducing neonatal mortality in India: critical role of access to emergency obstetric care.

Directory of Open Access Journals (Sweden)

Anu Rammohan

Full Text Available BACKGROUND: Neonatal mortality currently accounts for 41% of all global deaths among children below five years. Despite recording a 33% decline in neonatal deaths between 2000 and 2009, about 900,000 neonates died in India in 2009. The decline in neonatal mortality is slower than in the post-neonatal period, and neonatal mortality rates have increased as a proportion of under-five mortality rates. Neonatal mortality rates are higher among rural dwellers of India, who make up at least two-thirds of India's population. Identifying the factors influencing neonatal mortality will significantly improve child survival outcomes in India. METHODS: Our analysis is based on household data from the nationally representative 2008 Indian District Level Household Survey (DLHS-3. We use probit regression techniques to analyse the links between neonatal mortality at the household level and households' access to health facilities. The probability of the child dying in the first month of birth is our dependent variable. RESULTS: We found that 80% of neonatal deaths occurred within the first week of birth, and that the probability of neonatal mortality is significantly lower when the child's village is closer to the district hospital (DH, suggesting the critical importance of specialist hospital care in the prevention of newborn deaths. Neonatal deaths were lower in regions where emergency obstetric care was available at the District Hospitals. We also found that parental schooling and household wealth status improved neonatal survival outcomes. CONCLUSIONS: Addressing the main causes of neonatal deaths in India--preterm deliveries, asphyxia, and sepsis--requires adequacy of specialised workforce and facilities for delivery and neonatal intensive care and easy access by mothers and neonates. The slow decline in neonatal death rates reflects a limited attention to factors which contribute to neonatal deaths. The suboptimal quality and coverage of Emergency

Treating Hypotension in Preterm Neonates With Vasoactive Medications

Directory of Open Access Journals (Sweden)

Chloe Joynt

2018-04-01

Full Text Available Preterm neonates often have hypotension which may be due to various etiologies. While it is controversial to define hypotension in preterm neonates, various vasoactive medications are commonly used to provide the cardiovascular support to improve the blood pressure, cardiac output, or to treat shock. However, the literature on the systemic and regional hemodynamic effects of these antihypotensive medications in neonates is deficient and incomplete, and cautious translation of findings from other clinical populations and animal studies is required. Based on a literature search on published reports, meta-analytic reviews, and selected abstracts, this review discusses the current available information on pharmacologic actions, clinical effects, and side effects of commonly used antihypotensive medications including dopamine, dobutamine, epinephrine, norepinephrine, vasopressin, and milrinone in preterm neonates.

Rings in the neonate.

LENUS (Irish Health Repository)

Hackett, C B

2011-02-01

Neonatal lupus erythematosus (NLE) is an uncommon disease of the neonate. It is believed to be caused by the transplacental passage of maternal autoantibodies to the ribonucleoproteins (Ro\\/SSA, La\\/SSB or rarely U RNP) as these are almost invariably present in NLE sera. The most common clinical manifestations include cutaneous lupus lesions and congenital complete heart block. Hepatobiliary and haematologic abnormalities are reported less frequently. We describe a patient with cutaneous NLE to illustrate and raise awareness of the characteristic annular eruption of this condition. We also emphasize the need for thorough investigation for concomitant organ involvement and for maternal education regarding risk in future pregnancies.

Neonatal hemophilia: a rare presentation

Directory of Open Access Journals (Sweden)

Nuno Ferreira

2015-12-01

Full Text Available Hemophilia A is a X-linked hereditary condition that lead to decreased factor VIII activity, occurs mainly in males. Decreased factor VIII activity leads to increased risk of bleeding events. During neonatal period, diagnosis is made after post-partum bleeding complication or unexpected bleeding after medical procedures. Subgaleal hemorrhage during neonatal period is a rare, severe extracranial bleeding with high mortality and usually related to traumatic labor or coagulation disorders. Subgaleal hemorrhage complications result from massive bleeding. We present a neonate with unremarkable family history and uneventful pregnancy with a vaginal delivery with no instrumentation, presenting with severe subgaleal bleeding at 52 hours of life. Aggressive support measures were implemented and bleeding managed. The unexpected bleeding lead to a coagulation study and the diagnosis of severe hemophilia A. There were no known sequelae. This case shows a rare hemophilia presentation reflecting the importance of coagulation studies when faced with unexplained severe bleeding.

News or innovations in neonatal surgery

Directory of Open Access Journals (Sweden)

Giorgia Totonelli

2015-10-01

Full Text Available Over the last decades, because of the development of several clinical and technological advances, there has been a revolution in the management of neonatal and pediatric patients. These progresses reported an improvement in the survival rate of extremely ill neonates, who now have the chance to survive into adulthood. The intent of this review is to highlight not only the advances obtained in the neonatal surgery, but also the results of a multidisciplinary work focused on the fetus, preterm and newborn baby with a surgical anomaly or disease.Attention is also paid to the recent tendency to share knowledge, protocols and database out of the single Institution or country and to follow these delicate and fragile neonatal patients to the adulthood, developing the transitional care. Proceedings of the 11th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy · October 26th-31st, 2015 · From the womb to the adultGuest Editors: Vassilios Fanos (Cagliari, Italy, Michele Mussap (Genoa, Italy, Antonio Del Vecchio (Bari, Italy, Bo Sun (Shanghai, China, Dorret I. Boomsma (Amsterdam, the Netherlands, Gavino Faa (Cagliari, Italy, Antonio Giordano (Philadelphia, USA

Cause of neonatal deaths in Northern Ethiopia: a prospective cohort study

Directory of Open Access Journals (Sweden)

Hayelom Gebrekirstos Mengesha

2017-01-01

Full Text Available Abstract Background Despite the significant reduction in childhood mortality, neonatal mortality has shown little or no concomitant decline worldwide. The dilemma arises in that the lack of documentation of cause of death in developing countries, where registration of vital events is virtually nonexistent. Understanding of the causes of death in neonates is important to guide public health interventions. The present study identifies the common causes of neonatal death in Ethiopia. Methods A prospective cohort study was conducted among neonates born between April 2014 and July 2014 in seven hospitals, in Tigray region, Ethiopia. Mothers were interviewed by midwifes respecting risk factors and infant survival. For neonates who died in hospital, causes of death were extracted from medical records, whereas a verbal autopsy method provided presumptive assignment of cause of death for those infants who died at home. Results Of the1152 live births, there were 68 deaths (63 per 1000 live births. Two thirds of deaths were attributable to prematurity 23 (34% or asphyxia 21 (31%. Slight variance was seen between the morality patterns in early and late neonatal periods. In the early neonatal period, 37% were due to prematurity, while asphyxia (35% was more common in the late neonatal period. All infection-related deaths occurred in neonate-mother dyads from rural areas. Conclusion Prematurity, asphyxia, and infections were the leading causes of neonatal deaths in Tigray region during the study period. Causes of deaths identified during early and late neonatal mortality differed, which clearly indicates the need for responsive and evidence-based interventions and policies.

Eficácia dos probióticos na profilaxia de enterocolite necrosante em recém-nascidos prematuros: revisão sistemática e meta-análise Effectiveness of probiotics in the prophylaxis of necrotizing enterocolitis in preterm neonates: a systematic review and meta-analysis

Directory of Open Access Journals (Sweden)

Wanderley Marques Bernardo

2013-02-01

Full Text Available OBJETIVO: Elucidar os benefícios do uso de probióticos na prevenção de enterocolite necrosante (ECN e de suas complicações em recém-nascidos prematuros. MÉTODO: Revisão sistemática de ensaios clínicos randomizados, que incluiu pesquisas efetuadas em três bases de dados (MEDLINE, EMBASE e LILACS, utilizando a combinação dos termos (necrotizing enterocolitis AND (probiotics. RESULTADOS : Foram incluídos 11 ensaios clínicos randomizados, totalizando 2.887 pacientes, sendo 1.431 no grupo Probiótico e 1.456 no grupo Controle. Houve redução na incidência de ECN (NNT = 25, de morte global (NNT = 34 e sepse neonatal (NNT = 34 no grupo Probiótico em relação ao grupo Controle. Pacientes alimentados com suplementação de probióticos tiveram tempo de reintrodução alimentar (p OBJECTIVE: To elucidate the benefits of using probiotics in the prevention of necrotizing enterocolitis (NEC and its complications in preterm newborns. METHOD: This was a systematic review of randomized controlled trials, which included studies retrieved from three databases (MEDLINE, Embase, and LILACS, using a combination of the terms (necrotizing enterocolitis AND (probiotics. RESULTS: 11 randomized trials were included, totaling 2,887 patients, 1,431 in the probiotic group and 1,456 in the control group. There was a reduction in the incidence of NEC (NNT = 25, overall death (NNT = 34, and neonatal sepsis (NNT = 34 in the probiotic group compared to the control group. Patients that received probiotic supplementation had lower food reintroduction time (p < 0.001 and hospitalization time (p < 0.001 when compared to those not receiving probiotics. There was no difference in mortality caused by NEC. CONCLUSION: In premature newborns, the use of probiotics is effective as a prophylaxis for NEC and its complications.

Low birth weights and risk of neonatal mortality in Indonesia

Directory of Open Access Journals (Sweden)

Suparmi Suparmi

2016-12-01

Full Text Available Latar Belakang: Angka kematian neonatal di Indonesia mengalami stagnansi sejak sepuluh tahun terakhir. Dalam rangka mengakselerasi penurunan angka kematian neonatal di Indonesia, intervensi spesifik diperlukan pada faktor utama penyebab kematian. Penelitian ini bertujuan untuk mengetahui kontribusi berat badan lahir rendah terhadap kematian neonatal di Indonesia. Metode: Data Survei Demografi dan Kesehatan Indonesia tahun 2012 digunakan untuk analisis. Sejumlah 18021 kelahiran hidup dalam periode lima tahun terakhir telah dilaporkan oleh responden. Terdapat 14837 anak memiliki informasi lengkap untuk analisis. Adjusted relative risk dengan analisis survival digunakan untuk mengukur hubungan antara variable dengan kematian neonatal. Hasil: Anak yang lahir dengan berat badan rendah memiliki risiko 9.89 kali lebih tinggi untuk kematian neonatal bila dibandingkan dengan anak yang lahir dengan berat badan normal [adjusted relative risk (aRR = 9.89; 95% confidence interval (CI: 7.41 – 13.19; P = < 0.0001]. Anak yang lahir dari ibu berumur muda (15 - 19 tahun memiliki risiko 94% lebih tinggi bila dibandingkan dengan anak yang lahir dari ibu dengan umur antara 20-35 years. Anak dari ibu yang bekerja 81% memiliki risiko kematian neonatal lebih tinggi bila dibandingkan dengan anak yang lahir dari ibu tidak bekerja. Kesimpulan: Anak yang lahir dengan berat badan rendah dan lahir dari ibu muda memiliki risiko kematian neonatal lebih tinggi. Bayi yang lahir dengan berat badan rendah membutuhkan perawatan yang tepat untuk memperpanjang ketahanan hidup anak. (Health Science Journal of Indonesia 2016;7(2:113-117 Kata kunci: Berat badan lahir rendah, kematian neonatal, Indonesia Abstract Background: Neonatal mortality rates in Indonesia remain steady in the past decades (20 in 2002 to 19 per 1000 live births in 2012. In order to accelerate the decline in neonatal mortality rate in Indonesia, specific interventions would have to target key factors causing

Effect of antenatal tocolysis on neonatal outcomes.

Science.gov (United States)

Klauser, Chad K; Briery, Christian M; Keiser, Sharon D; Martin, Rick W; Kosek, Mary A; Morrison, John C

2012-12-01

Detail adverse neonatal effects in pregnancies treated with indomethacin (I), magnesium sulfate (M) or nifedipine (N). Women in acute preterm labor with cervical dilatation 1-6 cm were randomized to receive one of three first-line tocolytic drugs. There were 317 neonates (I = 103, M = 95, N = 119) whose mothers were treated with tocolytic therapy. There was no difference in gestational age at randomization (average 28.6 weeks' gestation) or at delivery (31.6 weeks' gestation, p = 0.551), birth weight (p = 0.871) or ventilator days (p = 0.089) between the three groups. Neonatal morbidity was not different between the three groups; respiratory distress syndrome (p = 0.086), patent ductus arteriosus (p = 0.592), sepsis (p = 0.590), necrotizing enterocolitis (p = 0.770), intraventricular hemorrhage (p = 0.669) and periventricular leukomalacia (p = 0.124). There were no statistically significant differences between the three tocolytics as far as composite neonatal morbidity or mortality was concerned.

Mortalidade neonatal em Taubaté: um estudo caso-controle Neonatal mortality in Taubaté, São Paulo, Brazil: a case-control study

Directory of Open Access Journals (Sweden)

Ruth Sampaio Paulucci

2007-12-01

Full Text Available OBJETIVO: Identificar e quantificar os fatores de risco para óbito neonatal em Taubaté, São Paulo. MÉTODOS: Trata-se de estudo caso-controle com dados de nascidos vivos e de óbitos neonatais de Taubaté, em 2003, obtidos da Secretaria Estadual da Saúde de São Paulo. Os casos (óbitos neonatais e os controles (recém-nascidos nos mesmos dias daqueles que faleceram foram reunidos num banco por meio da técnica de linkage. As variáveis independentes foram: variáveis sociodemográficas e assistenciais (idade e escolaridade maternas, paridade, consultas no pré-natal, tipo de parto e relato de natimorto e variáveis biológicas (peso ao nascer, idade gestacional, escore de Apgar, presença de defeito congênito e sexo. Utilizou-se a regressão logística para identificar e quantificar os efeitos destas variáveis em relação ao óbito neonatal pelo programa SPSS 10.0. Foram introduzidas no modelo as variáveis que apresentaram pOBJECTIVE: To identify and to estimate the risk factors associated to neonatal mortality in Taubaté, São Paulo, Brazil. METHODS: This case-control study enrolled live births in the city of Taubaté during 2003. Live birth data and death records were obtained from São Paulo Health Department. Neonatal deaths were cases and babies born alive in the same day of cases were the controls. A single data file was created by linkage approach. Dependent variable was neonatal death. Independent variables were those related to socio-demographic characteristics and prenatal care (maternal age, years in school, parity, previous stillbirths, prenatal care, as well as the biological ones (birthweight, gender, gestational age, congenital defects and Apgar score. Logistic regression was used to identify and to estimate the risk factors associated to neonatal death. The variables with p<0.20 were introduced in the model and maintained if p<0.05, by SPSS 10.0. RESULTS: 392newborns with 34 neonatal deaths were studied. There were 198

[Epidemiological characteristics of neonatal mortality in Peru, 2011-2012].

Science.gov (United States)

Ávila, Jeannette; Tavera, Mario; Carrasco, Marco

2015-01-01

Describe the epidemiological characteristics of neonatal deaths in Peru. Descriptive study based on notifications to the Perinatal and Neonatal National Epidemiological Surveillance Subsystem (PNNESS) made in 2011-2012. The capture-recapture method was used to calculate the registration of the notification and estimate the neonatal mortality rate (NMR) nationally and by regions. Responses were made to the questions: where, when, who and why the newborns died. 6,748 neonatal deaths were reported to PNNESS, underreport 52.9%. A national NMR of 12.8 deaths/1,000 live births was estimated. 16% of deaths occurred at home and 74.2% of these were in the highlands region, predominantly in rural areas and poor districts. 30% died in the first 24 hours and 42% between 1 and 7 days of life. 60.6% were preterm infants and 39.4% were term infants. 37% had normal weight, 29.4% low weight, and 33.6% very low weight. Preventable neonatal mortality was 33%, being higher in urban and highland areas. 25.1% died of causes related with prematurity-immaturity; 23.5% by infections; 14.1% by asphyxiation and causes related to care during childbirth and 11% by lethal congenital malformation. Neonatal mortality in Peru is differentiated by setting; harms related to prematurity-immaturity dominated on the coast, while the highlands and jungle recorded more preventable neonatal mortality with a predominance of asphyxia and infections.

Infections in Neonatal Intensive Care: Prevalence, Prevention and Antibiotic use

NARCIS (Netherlands)

van den Hoogen, A.

2009-01-01

Neonatal infections are an important cause of morbidity in neonatal intensive care units (NICUs). Prematurity or very low birth weight is an important predisposing factor for neonatal infection. In addition, preterm infants have a compromized immune system and they often require invasive procedures

Two cases of neonatal adrenal hemorrhage presenting with persistent jaundice.

Science.gov (United States)

Ruffini, E; De Petris, L; Zorzi, G; Paoletti, P; Mambelli, G; Carlucci, A

2013-01-01

The adrenal hemorrhage is a relatively rare event in newborns but must be considered in the presence of a persistent unexplained jaundice, especially in presence of predisposing factors. Serial ultrasonography is the modality of choice for initial diagnosis and follow-up of neonatal adrenal hemorrhage. We report two cases of neonatal adrenal hemorrhage presenting with persistent jaundice. The causes of the neonatal adrenal hemorrhages were a difficult vaginal delivery in macrosomic infant and a neonatal infection.

Factors infleuncing neonatal septicaemia in Maiduguri, north ...

African Journals Online (AJOL)

BACKGROUND: Neonatal septicaemia is a leading cause of morbidity and mortality worldwide, especially in the tropics. The risk factors vary, and the clinical features of neonatal septicaemia may be vague and nonspecific, therefore a high index of suspicion is vital to early diagnosis and treatment. The aetiological agents ...

Hematopoietic growth factors in neonatal medicine: the use of enterally administered hematopoietic growth factors in the neonatal intensive care unit.

Science.gov (United States)

Calhoun, Darlene A; Christensen, Robert D

2004-03-01

The practice of complete bowel rest in prematurely delivered neonates and those who have undergone surgery for congenital anomalies of the gastrointestinal (GI) tract is common in neonatal intensive care units (NICU). However, increased recognition of the critical role of growth factors in GI development suggests that this practice might be modified to include the administration of synthetic amniotic fluid-like solutions designed to bridge the neonate between their intra-uterine environment and that of the NICU. This article reviews advances in administering synthetic amniotic fluid-like solutions in the NICU.

An Infant With Transient Neonatal Pustular Melanosis Presenting as Pustules

Directory of Open Access Journals (Sweden)

Pei-San Chia

2010-12-01

Full Text Available Transient neonatal pustular melanosis is mostly found in full-term black infants. It is a benign and self-limited disease, and the etiology is still unknown. We present a full-term female neonate with multiple vesiculopustular and pigmented macular lesions found immediately after her birth. A skin biopsy showed vesicles consisting of intracorneal and subcorneal aggregates of neutrophils, which is compatible with transient neonatal pustular melanosis. Although it is rare in Taiwan and Asian countries, transient neonatal pustular melanosis should always be considered when pustulosis is found in the neonatal period to prevent the use of unnecessary antibiotics. Dermatological consultation and histological confirmation are sometimes required for the final diagnosis.

Relationships between maternal malaria and malarial immune responses in mothers and neonates

DEFF Research Database (Denmark)

Rasheed, F N; Bulmer, J N; De Francisco, A

1995-01-01

and schizonts (190L and 190N) were higher in neonates than mothers. There was no clear relationship between maternal malaria and neonatal mean lymphoproliferation to malarial antigens, although fewer neonates responded when mothers were actively infected. Matched maternal and neonatal lymphoproliferation...... responses did not correlate. However, first born neonatal lymphoproliferation to PPD and malarial antigens appeared lower than other neonates, in agreement with lower lymphoproliferation in primigravidae compared with multigravidae. Also in common with mothers, autologous plasma suppressed neonatal...... lymphoproliferation to PPD and malarial antigens, suggesting common immunoregulation. Higher cortisol or other circulating factors in first pregnancies may be implicated. The relevance of cell-mediated malarial immune responses detected at birth remains to be established....

Neonatal herpes in Denmark 1977-1991

DEFF Research Database (Denmark)

Fonnest, G; de la Fuente Fonnest, I; Weber, Tom

1997-01-01

: All newborns with perinatal herpes in Denmark 1977-1991 were identified from hospital-records. RESULTS: Of 862,298 deliveries 136 possible cases were found but only 30 (22%) fulfilled the criteria for neonatal herpes. The incidence increased from 2.36 to 4.56 per 100,000 live births during 1977...... herpes recurrence. Four infants had a serious infection in spite of Cesarean section. This study does not support a policy of Cesarean section in case of maternal recurrent herpes simplex infection at delivery.......BACKGROUND: To prevent neonatal herpes, women in labor with genital herpes infection are still delivered by Cesarean section. This policy is currently being debated. The aim of this study was to determine the incidence of neonatal herpes in Denmark and to evaluate the prevention practice. METHODS...

Reference intervals of citrated-native whole blood thromboelastography in premature neonates.

Science.gov (United States)

Motta, Mario; Guaragni, Brunetta; Pezzotti, Elena; Rodriguez-Perez, Carmen; Chirico, Gaetano

2017-12-01

Bleeding due to acquired coagulation disorders is a common complication in premature neonates. In this clinical setting, standard coagulation laboratory tests might be unsuitable to investigate the hemostatic function as they reflect the concentration of pro-coagulant proteins but not of anti-coagulant proteins. Thromboelastography (TEG), providing a more complete assessment of hemostasis, may be able to overcome some of these limitations. Unfortunately, experience on the use of TEG in premature neonates is very limited and, in particular in this population, reference ranges of TEG parameters have not been yet evaluated. To evaluate TEG in preterm neonates, and to assess their reference ranges. One hundred and eighteen preterm neonates were analyzed for TEG in a retrospective cohort study. Double-sided 95% reference intervals were calculated using a bootstrap method after Box-Cox transformation. TEG parameters were compared between early-preterm and moderate-/late-preterm neonates and between bleeding and non-bleeding preterm neonates. Comparing early-preterm with moderate-/late-preterm neonates, TEG parameters were not statistically different, except for fibrinolysis which was significantly higher in early preterm neonates. Platelet count significantly correlated with α angle and MA parameters. Bleeding and non-bleeding neonates had similar TEG values. These results reinforce the concept that in stable preterm neonates, in spite of lower concentration of pro- and anti-coagulants proteins, the hemostasis is normally balanced and well functioning. Copyright © 2017 Elsevier B.V. All rights reserved.

Short-acting sulfonamides near term and neonatal jaundice

DEFF Research Database (Denmark)

Klarskov, Pia; Andersen, Jon Trærup; Jimenez-Solem, Espen

2013-01-01

To investigate the association between maternal use of sulfamethizole near term and the risk of neonatal jaundice.......To investigate the association between maternal use of sulfamethizole near term and the risk of neonatal jaundice....

A simple high-dose gentamicin regimen showed no side effects among neonates

DEFF Research Database (Denmark)

Blaabjerg, Anne Sofie; Kofoed, Poul-Erik; Dalegaard, Mette Correll

2017-01-01

INTRODUCTION: Treatment of infections in neonates with gentamicin is a balance between optimising bactericidal effect and minimising adverse effects. Previously, at the Neonatal Intensive Care Unit (NICU) at Kolding Hospital, Denmark, neonates suspected of having infections were treated daily...... and 2012 and treated with gentamicin were included retrospectively in the study. Neonates with trough serum (S)-gentamicin level ≥ 2.0 mg/l before the third dose were reviewed in detail. RESULTS: In total, S-gentamicin level was measured in 253 treated neonates of whom 7% displayed elevated trough values....... Neonates elevated S...

The prevalence and challenges of abandoned dead neonates in an ...

African Journals Online (AJOL)

parents/caregivers' attitudes toward dead neonates. Hospital-based postbereavement programs should be organized to ... Dead neonates at the Neonatal Intensive Care Units,. Pediatric Emergency Department, Pediatric Surgical .... interventions and newborn survival. Niger J Med 2006; 15:108–114. 3 Kalkofen RW. After a ...

The Patterns and Causes of Neonatal Mortality at a Tertiary Hospital in Oman

Directory of Open Access Journals (Sweden)

Mohamed Abdellatif

2013-11-01

Full Text Available Objective: To report the patterns and causes of neonatal death from a tertiary care neonatal intensive care unit over a period of four years.Methods: This is a retrospective cohort study where four years data (January 2006 - December 2009 of all inborn neonatal admissions and deaths were collected from the neonatal intensive care unit at Sultan Qaboos University hospital on predesigned forms. All out born admissions and deaths were excluded. The causes of neonatal death were classified using Wigglesworth's classification.Results: The number of inborn live births during the study period was 10064 and the total number of inborn neonatal admissions was 1475. The total deaths (neonatal and post neonatal at the neonatal intensive care unit was 73 (63 inborn and 10 out born. Among the inborn, five deaths were post neonatal deaths and hence, excluded from analysis. Among the remaining inborn neonatal deaths (n=58, 34 (59% were males and 24 (41% were females. The number of neonatal admissions increased over the years during the study period from 248 to 356, while the number of deaths also increased from 10 deaths in 2006, to 20 deaths in 2009. The primary causes of neonatal deaths were prematurity and its complications 52% (n=30. Lethal congenital malformations lead to 17 (29% newborn deaths, specific diagnosis in 7 newborns (12%, and birth asphyxia in four (7% of cases.Conclusion: There was an increasing trend of neonatal admissions and deaths among inborn babies. Prematurity, with sepsis as its major complication and congenital malformations were the leading cause of neonatal mortality.

The patterns and causes of neonatal mortality at a tertiary hospital in oman.

Science.gov (United States)

Abdellatif, Mohamed; Ahmed, Masood; Bataclan, Maria Flordeliz; Khan, Ashfaq Ahmed; Al Battashi, Abeer; Al Maniri, Abdullah

2013-11-01

To report the patterns and causes of neonatal death from a tertiary care neonatal intensive care unit over a period of four years. This is a retrospective cohort study where four years data (January 2006 - December 2009) of all inborn neonatal admissions and deaths were collected from the neonatal intensive care unit at Sultan Qaboos University hospital on predesigned forms. All out born admissions and deaths were excluded. The causes of neonatal death were classified using Wigglesworth's classification. The number of inborn live births during the study period was 10064 and the total number of inborn neonatal admissions was 1475. The total deaths (neonatal and post neonatal) at the neonatal intensive care unit was 73 (63 inborn and 10 out born). Among the inborn, five deaths were post neonatal deaths and hence, excluded from analysis. Among the remaining inborn neonatal deaths (n=58), 34 (59%) were males and 24 (41%) were females. The number of neonatal admissions increased over the years during the study period from 248 to 356, while the number of deaths also increased from 10 deaths in 2006, to 20 deaths in 2009. The primary causes of neonatal deaths were prematurity and its complications 52% (n=30). Lethal congenital malformations lead to 17 (29%) newborn deaths, specific diagnosis in 7 newborns (12%), and birth asphyxia in four (7%) of cases. There was an increasing trend of neonatal admissions and deaths among inborn babies. Prematurity, with sepsis as its major complication and congenital malformations were the leading cause of neonatal mortality.

Tei index in neonatal respiratory distress and perinatal asphyxia

Directory of Open Access Journals (Sweden)

Ahmed Anwer Attia Khattab

2015-09-01

Full Text Available Cardiovascular compromise is a common complication of neonatal respiratory distress and perinatal asphyxia. Tei index is a Doppler-derived index for the assessment of overall left ventricular function that combines systolic and diastolic time intervals. Aim: Assess the role of MPI versus cardiac troponin I as early indicator of hypoxic cardiac damage in neonates with respiratory distress or perinatal asphyxia. The present work was conducted on forty neonates, 15 with neonatal respiratory distress (group I, 15 with perinatal asphyxia (group II, and 10 apparently healthy neonates as a control (group III. All have: Detailed history-thorough clinical examination-Plain X-ray-ECG-Two dimensional, M-mode and Doppler echocardiographic examination with the measurement of both myocardial performance index (MPI of the right and left ventricle-Serum cardiac troponin I. Results: There was statistically significant increase in serum cardiac troponin I in groups I and II than group III. Left and right ventricular myocardial performance index (MPI were increased in group I and II than the control group. No correlation between Tei index and each of postnatal age, apgar score at 5-min, heart rate, serum cardiac troponin I, ejection fraction and fractional shortening, but there was direct relationship between MPI and LVEDD and inverse relationship between MPI and each of EF% and FS%. But there was significant correlation between L.V. MPI and gestational age. Conclusion: Tei index was higher in neonates with respiratory distress and neonates with perinatal asphyxia than in normal neonates despite normal or even increased ejection fraction which indicates that these patients may have subclinical ventricular dysfunction which should be followed up carefully.

Current Trends in Neonatal Tracheostomy.

Science.gov (United States)

Isaiah, Amal; Moyer, Kelly; Pereira, Kevin D

2016-08-01

The indications for neonatal tracheostomy may have changed with current noninvasive respiratory therapies compared with previous decades. To study the current trends in neonatal tracheostomy and identify the primary indication for the procedure and risk factors for failed extubation. This retrospective medical record review included 47 neonates who underwent tracheostomy from January 1, 2009, to December 31, 2013, at the University of Maryland Children's Hospital. Group 1 included infants undergoing tracheostomy for the primary indication of upper airway obstruction; group 2, infants with primary pulmonary disease. Data on weight, gestational age, comorbid conditions, congenital abnormalities, complications, outcomes, and indications for tracheostomy were compared statistically between groups. Differences in gestational age, birth weight, and age at tracheostomy. Among the 47 infants included in the study (30 boys; 17 girls, mean [SD] age, 113 [73] days), 31 (66%) demonstrated anatomical causes of airway obstruction, and 16 (34%) had significant pulmonary disease. Among infants with anatomical causes, subglottic stenosis represented the largest group (11 of 31 [35%]). The mean age at the time of tracheostomy was significantly lower in the group with airway obstruction (98.9 vs 146.9 days; difference, 48 [95% CI, 4.8-91.2] days; P = .04). No procedure-related morbidity or mortality was encountered. Anatomical upper airway obstruction may be returning as the most common indication for a neonatal tracheostomy, thereby supporting the belief that current respiratory therapies have lowered the burden of chronic lung disease and the need for prolonged ventilatory care.

Standardisation of neonatal clinical practice.

Science.gov (United States)

Bhutta, Z A; Giuliani, F; Haroon, A; Knight, H E; Albernaz, E; Batra, M; Bhat, B; Bertino, E; McCormick, K; Ochieng, R; Rajan, V; Ruyan, P; Cheikh Ismail, L; Paul, V

2013-09-01

The International Fetal and Newborn Growth Consortium for the 21(st) Century (INTERGROWTH-21(st) ) is a large-scale, population-based, multicentre project involving health institutions from eight geographically diverse countries, which aims to assess fetal, newborn and preterm growth under optimal conditions. Given the multicentre nature of the project and the expected number of preterm births, it is vital that all centres follow the same standardised clinical care protocols to assess and manage preterm infants, so as to ensure maximum validity of the resulting standards as indicators of growth and nutrition with minimal confounding. Moreover, it is well known that evidence-based clinical practice guidelines can reduce the delivery of inappropriate care and support the introduction of new knowledge into clinical practice. The INTERGROWTH-21(st) Neonatal Group produced an operations manual, which reflects the consensus reached by members of the group regarding standardised definitions of neonatal morbidities and the minimum standards of care to be provided by all centres taking part in the project. The operational definitions and summary management protocols were developed by consensus through a Delphi process based on systematic reviews of relevant guidelines and management protocols by authoritative bodies. This paper describes the process of developing the Basic Neonatal Care Manual, as well as the morbidity definitions and standardised neonatal care protocols applied across all the INTERGROWTH-21(st) participating centres. Finally, thoughts about implementation strategies are presented. © 2013 Royal College of Obstetricians and Gynaecologists.

Design of smart neonatal health monitoring system using SMCC.

Science.gov (United States)

De, Debashis; Mukherjee, Anwesha; Sau, Arkaprabha; Bhakta, Ishita

2017-02-01

Automated health monitoring and alert system development is a demanding research area today. Most of the currently available monitoring and controlling medical devices are wired which limits freeness of working environment. Wireless sensor network (WSN) is a better alternative in such an environment. Neonatal intensive care unit is used to take care of sick and premature neonates. Hypothermia is an independent risk factor for neonatal mortality and morbidity. To prevent it an automated monitoring system is required. In this Letter, an automated neonatal health monitoring system is designed using sensor mobile cloud computing (SMCC). SMCC is based on WSN and MCC. In the authors' system temperature sensor, acceleration sensor and heart rate measurement sensor are used to monitor body temperature, acceleration due to body movement and heart rate of neonates. The sensor data are stored inside the cloud. The health person continuously monitors and accesses these data through the mobile device using an Android Application for neonatal monitoring. When an abnormal situation arises, an alert is generated in the mobile device of the health person. By alerting health professional using such an automated system, early care is provided to the affected babies and the probability of recovery is increased.

Reducing neonatal deaths in South Africa: Progress and challenges

Directory of Open Access Journals (Sweden)

N Rhoda

2018-03-01

Full Text Available Although current levels of the neonatal mortality rate (NMR are within reach of the Sustainable Development Goal (SDG target of 12 per 1 000 live births, the absolute number of deaths is unacceptably high for a lower-middle-income country such as South Africa (SA. Neonatal mortality over the last decade has declined very slowly, and is not commensurate with the level of government investment in healthcare. The recent neonatal mortality rate of 21 per 1 000 live births reported by the SA Demographic Health Survey is of major concern. This paper reviews recent efforts to reduce the neonatal mortality rate, including support for the implementation of neonatal policies and plans, and strengthening programmes to deliver low-cost, high-impact interventions. We review recent estimates of the NMR and causes of neonatal deaths, and discuss how the mortality from preventable causes of death could be reduced. If SA is to meet the SDG target, special attention should be given to the availability of high-impact interventions, providing an adequate number of appropriately trained healthcare providers and a more active role played by ward-based community health workers and district clinical specialist teams.

Risk factors of neonatal mortality and child mortality in Bangladesh.

Science.gov (United States)

Maniruzzaman, Md; Suri, Harman S; Kumar, Nishith; Abedin, Md Menhazul; Rahman, Md Jahanur; El-Baz, Ayman; Bhoot, Makrand; Teji, Jagjit S; Suri, Jasjit S

2018-06-01

Child and neonatal mortality is a serious problem in Bangladesh. The main objective of this study was to determine the most significant socio-economic factors (covariates) between the years 2011 and 2014 that influences on neonatal and child mortality and to further suggest the plausible policy proposals. We modeled the neonatal and child mortality as categorical dependent variable (alive vs death of the child) while 16 covariates are used as independent variables using χ 2 statistic and multiple logistic regression (MLR) based on maximum likelihood estimate. Using the MLR, for neonatal mortality, diarrhea showed the highest positive coefficient (β = 1.130; P  economic conditions for neonatal mortality. For child mortality, birth order between 2-6 years and 7 and above years showed the highest positive coefficients (β = 1.042; P  economic conditions for child mortality. This study allows policy makers to make appropriate decisions to reduce neonatal and child mortality in Bangladesh. In 2014, mother's age and father's education were also still significant covariates for child mortality. This study allows policy makers to make appropriate decisions to reduce neonatal and child mortality in Bangladesh.

Sugammadex-Enhanced Neuronal Apoptosis following Neonatal Sevoflurane Exposure in Mice

Directory of Open Access Journals (Sweden)

Maiko Satomoto

2016-01-01

Full Text Available In rodents, neonatal sevoflurane exposure induces neonatal apoptosis in the brain and results in learning deficits. Sugammadex is a new selective neuromuscular blockade (NMB binding agent that anesthesiologists can use to achieve immediate reversal of an NMB with few side effects. Given its molecular weight of 2178, sugammadex is thought to be unable to pass through the blood brain barrier (BBB. Volatile anesthetics can influence BBB opening and integrity. Therefore, we investigated whether the intraperitoneal administration of sugammadex could exacerbate neuronal damage following neonatal 2% sevoflurane exposure via changes in BBB integrity. Cleaved caspase-3 immunoblotting was used to detect apoptosis, and the ultrastructure of the BBB was examined by transmission electron microscopy. Exposure to 2% sevoflurane for 6 h resulted in BBB ultrastructural abnormalities in the hippocampus of neonatal mice. Sugammadex alone without sevoflurane did not induce apoptosis. The coadministration of sugammadex with sevoflurane to neonatal mice caused a significant increase (150% in neuroapoptosis in the brain compared with 2% sevoflurane. In neonatal anesthesia, sugammadex could influence neurotoxicity together with sevoflurane. Exposure to 2% sevoflurane for 6 h resulted in BBB ultrastructural abnormalities in the hippocampus of neonatal mice.

Prevalence and factors associated with neonatal sepsis among ...

African Journals Online (AJOL)

TOSHIBA

Relationship between outcome variable and exposure variable was done using Chi ... A recent study in Ethiopia indicates that neonatal sepsis in the major newborn ... Neonatal sepsis was defined as infection that had occurred during the.

Hypertensive encephalopathy in a patient with neonatal thyrotoxicosis

NARCIS (Netherlands)

Pijnenburg, MWH; Zweens, MJ; Bink, MTE; Odink, RJ

1999-01-01

Neonatal hyperthyroidism may give rise to serious cardiovascular complications. A girl with severe thyrotoxicosis in whom hypertensive encephalopathy developed is described. Conclusion Neonatal thyrotoxicosis can give rise to hypertension and may lead to hypertensive encephalopathy.

Neonatal sepsis: Highlighting the principles of diagnosis and ...

African Journals Online (AJOL)

count has a poor positive predictive value for neonatal sepsis and is ... Division of Neonatology, Department of Paediatrics and Child Health, School of Medicine, University ... infections (UTIs) in neonates,[18] many clinicians use the following.

Neurological status in severely jaundiced Zimbabwean neonates

NARCIS (Netherlands)

Wolf, M. J.; Beunen, G.; Casaer, P.; Wolf, B.

1998-01-01

Neurological status was studied in 50 jaundiced infants with a total serum bilirubin of > 400 mumol/l (23.4 mg/dl). Infants were assessed in the neonatal period with the Neonatal Neurological Examination and 4 months of age with the Infant Motor Screen. Twenty-six (52 per cent) infants were

Neonatal mortality at Leratong Hospital | Moundzika-Kibamba ...

African Journals Online (AJOL)

Background. There has been a high demand for delivery services at Leratong Hospital; however, no study on the causes of neonatal mortality has been conducted. It was therefore essential to identify the causes of newborn deaths so as to implement policies that would advance neonatal care. Objectives. To determine the ...

Neonatal Hemoperitoneum Secondary to Hemorrhage from Omental Venous Malformation

Directory of Open Access Journals (Sweden)

So-Hyun Nam

2015-12-01

Full Text Available Hemoperitoneum in the neonate is uncommon. We report our experience with a neonate who suddenly developed hemoperitoneum in late gestation. Ascites with right pleural effusion initially suggested fetal hydrops. However, a decrease in hemoglobin with bloody ascites from the paracentesis gave the impression of hemoperitoneum. Ultrasonography and computed tomography showed no abnormality in the solid organs. Using 3-mm laparoscopic exploration, we found the omental mass and excised it. It was histologically confirmed as a venous malformation. Venous malformation of the omentum with significant bleeding requiring exploration is a very rare condition in the neonate, but it should be considered as a cause of neonatal hemoperitoneum.

Neonatal and adult ICU ventilators to provide ventilation in neonates, infants, and children: a bench model study.

Science.gov (United States)

Vignaux, Laurence; Piquilloud, Lise; Tourneux, Pierre; Jolliet, Philippe; Rimensberger, Peter C

2014-10-01

Using a bench test model, we investigated the hypothesis that neonatal and/or adult ventilators equipped with neonatal/pediatric modes currently do not reliably administer pressure support (PS) in neonatal or pediatric patient groups in either the absence or presence of air leaks. PS was evaluated in 4 neonatal and 6 adult ventilators using a bench model to evaluate triggering, pressurization, and cycling in both the absence and presence of leaks. Delivered tidal volumes were also assessed. Three patients were simulated: a preterm infant (resistance 100 cm H2O/L/s, compliance 2 mL/cm H2O, inspiratory time of the patient [TI] 400 ms, inspiratory effort 1 and 2 cm H2O), a full-term infant (resistance 50 cm H2O/L/s, compliance 5 mL/cm H2O, TI 500 ms, inspiratory effort 2 and 4 cm H2O), and a child (resistance 30 cm H2O/L/s, compliance 10 mL/cm H2O, TI 600 ms, inspiratory effort 5 and 10 cm H2O). Two PS levels were tested (10 and 15 cm H2O) with and without leaks and with and without the leak compensation algorithm activated. Without leaks, only 2 neonatal ventilators and one adult ventilator had trigger delays under a given predefined acceptable limit (1/8 TI). Pressurization showed high variability between ventilators. Most ventilators showed TI in excess high enough to seriously impair patient-ventilator synchronization (> 50% of the TI of the subject). In some ventilators, leaks led to autotriggering and impairment of ventilation performance, but the influence of leaks was generally lower in neonatal ventilators. When a noninvasive ventilation algorithm was available, this was partially corrected. In general, tidal volume was calculated too low by the ventilators in the presence of leaks; the noninvasive ventilation algorithm was able to correct this difference in only 2 adult ventilators. No ventilator performed equally well under all tested conditions for all explored parameters. However, neonatal ventilators tended to perform better in the presence of leaks

Three cases of neonatal tetanus in Papua New Guinea lead to development of national action plan for maternal and neonatal tetanus elimination.

Science.gov (United States)

Datta, Siddharta Sankar; Barnabas, Roland; Sitther, Adeline; Guarenti, Laura; Toikilik, Steven; Kariwiga, Grace; Sui, Gerard Pai

2013-01-01

Maternal or neonatal tetanus causes deaths primarily in Asia and Africa and is usually the result of poor hygiene during delivery. In 2011, three neonatal tetanus cases were investigated in Papua New Guinea, and all three cases were delivered at home by untrained assistants. The babies were normal at birth but subsequently developed spasms. A neonatal tetanus case must be viewed as a sentinel event indicating a failure of public health services including immunization, antenatal care and delivery care. The confirmation of these cases led to the drafting of the Papua New Guinea National Action Plan for Maternal and Neonatal Tetanus Elimination. This included three rounds of a tetanus toxoid supplementary immunization campaign targeting women of childbearing age (WBCA) and strengthening of other clean delivery practices. The first immunization round was conducted in April and May 2012, targeting 1.6 million WBCA and achieved coverage of 77%. The government of Papua New Guinea should ensure detailed investigation of all neonatal tetanus cases reported in the health information system and perform subprovincial analysis of tetanus toxoid coverage following completion of all three immunization rounds. Efforts also should be made to strengthen clean delivery practices to help eliminate maternal and neonatal tetanus in Papua New Guinea.

Three cases of neonatal tetanus in Papua New Guinea lead to development of national action plan for maternal and neonatal tetanus elimination

Directory of Open Access Journals (Sweden)

Grace Kariwiga

2013-06-01

Full Text Available Maternal or neonatal tetanus causes deaths primarily in Asia and Africa and is usually the result of poor hygiene during delivery. In 2011, three neonatal tetanus cases were investigated in Papua New Guinea, and all three cases were delivered at home by untrained assistants. The babies were normal at birth but subsequently developed spasms. A neonatal tetanus case must be viewed as a sentinel event indicating a failure of public health services including immunization, antenatal care and delivery care. The confirmation of these cases led to the drafting of the Papua New Guinea National Action Plan for Maternal and Neonatal Tetanus Elimination. This included three rounds of a tetanus toxoid supplementary immunization campaign targeting women of childbearing age (WBCA and strengthening of other clean delivery practices. The first immunization round was conducted in April and May 2012, targeting 1.6 million WBCA and achieved coverage of 77%. The government of Papua New Guinea should ensure detailed investigation of all neonatal tetanus cases reported in the health information system and perform sub-provincial analysis of tetanus toxoid coverage following completion of all three immunization rounds. Efforts also should be made to strengthen clean delivery practices to help eliminate maternal and neonatal tetanus in Papua New Guinea.

Motion based Segmentation of Chest and Abdomen Region of Neonates

NARCIS (Netherlands)

Venkitaraman, A.; Makkapati, V.V.

2015-01-01

Respiration rate (RR) is one of the important vital signs used for clinical monitoring of neonates in intensive care units. Due to thefragile skin of the neonates, it is preferable to have monitoring systems with minimal contact with the neonate. Recently, several methods have been proposed for

Rescuer fatigue during simulated neonatal cardiopulmonary resuscitation.

Science.gov (United States)

Li, E S; Cheung, P-Y; O'Reilly, M; Aziz, K; Schmölzer, G M

2015-02-01

To assess development of fatigue during chest compressions (CCs) in simulated neonatal cardiopulmonary resuscitation (CPR). Prospective randomized manikin crossover study. Thirty neonatal healthcare professionals who successfully completed the Neonatal Resuscitation Program performed CPR using (i) 3:1 compression:ventilation (C:V) ratio, (ii) continuous CC with asynchronous ventilation (CCaV) at a rate of 90 CC per min and (iii) CCaV at 120 CC per min for a duration of 10 min on a neonatal manikin. Changes in peak pressure (a surrogate of fatigue) and CC rate were continuously recorded and fatigue among groups was compared. Participants were blinded to pressure tracings and asked to rate their level of comfort and fatigue for each CPR trial. Compared with baseline, a significant decrease in peak pressure was observed after 72, 96 and 156 s in group CCaV-120, CCaV-90 and 3:1 C:V, respectively. CC depth decreased by 50% within the first 3 min during CCaV-120, 30% during CCaV-90 and 20% during 3:1 C:V. Moreover, 3:1 C:V and CCaV were similarly preferred by healthcare professionals. Similarly, 3:1 C:V and CCaV CPR were also fatiguing. We recommend that rescuers should switch after every second cycle of heart rate assessment during neonatal CPR.

Neonatal asphyxia: A study of 210 cases

Directory of Open Access Journals (Sweden)

Hülya Üzel

2012-06-01

Full Text Available Objectives: Perinatal asphyxia remains an importantcause of neonatal morbidity and mortality. The aim of thisstudy was to investigate antenatal, natal, and postnatalrisk factors of neonatal asphyxia, relationship with knownrisk factors and stage of Sarnat and Sarnat scores, theeffect of risk factors on hospital discharge and survival forneonates with perinatal asphyxia.Materials and methods: In this study, we retrospectivelyanalyzed the hospital records of 210 patients diagnosedas perinatal asphyxia. The patients’ demographic characteristics,antepartum, intrapartum, and postpartum riskfactors and Sarnat and Sarnat clinical staging criteria ofnewborns were analyzed.Results: The risk factors for asphyxia were detectedantepartum period in 67.7% of newborns, intrapartum in91% and potpartum in of 29.5% of neonates. When caseswere examined according to the studied years, perinatalasphyxia ratio was the most frequent in 2007 as 28.1%.With a decline over the years, frequency dropped to %21in 2010. The number of patients with stage 3 and mortalityrate were significantly decreased over the years (p<0.05.Conclusions: Less preventable intrapartum causes ofbirth asphyxia are seen more frequently. Early detectionof risk factors together with appropriate prenatal, nataland postnatal care provision, reduced emergency caesareansections and will decrease considerably decreasefrequency of perinatal asphyxia. We think that followingup neonates who needed intensive care in neonatal unitssufficiently equipped will decrease complications due toasphyxia. J Clin Exp Invest 2012; 3(2: 194-198

[Clinical studies on flomoxef in neonates].

Science.gov (United States)

Tabuki, K; Nishimura, T

1993-07-01

Clinical studies on flomoxef (FMOX) were performed in neonates and the results obtained are summarized as follows. Treatment with FMOX was made in 4 cases of neonatal bacterial infections; 2 cases of sepsis (suspected) and 1 case each of infection of umbilicus and staphylococcal scalded skin syndrome. Results obtained were excellent in 1 case, good in 3 cases. No significant side effects due to the drug were observed in any cases.

Identificação precoce do risco para transtornos da atenção e da leitura em sala de aula

Directory of Open Access Journals (Sweden)

Olga Valéria Andrade

Full Text Available Testou-se a acurácia de atividades pedagógicas coletivas, baseadas em julgamentos fonológicos por meio do pareamento entre figuras e de figuras com palavras faladas, na identificação de escolares de risco para transtornos da atenção e da leitura em sala de aula. Quarenta e cinco escolares do 2º ano (idade média de 7 anos, 29 do gênero masculino, foram divididos em grupo controle, sem dificuldade de leitura-escrita (n=32, e grupo de risco, com dificuldade de leitura (n=13. O baixo desempenho nessas atividades, definido como os escores acima de 1,65 DP abaixo da média do grupo controle, apresentou boa sensitividade (verdadeiros positivos e especificidade (verdadeiros negativos na identificação precoce dos escolares de risco.

Roles of microRNA in the immature immune system of neonates.

Science.gov (United States)

Yu, Hong-Ren; Huang, Lien-Hung; Li, Sung-Chou

2018-06-13

Neonates have an immature immune system; therefore, their immune activities are different from the activities of adult immune systems. Such differences between neonates and adults are reflected by cell population constitutions, immune responses, cytokine production, and the expression of cellular/humoral molecules, which contribute to the specific neonatal microbial susceptibility and atopic properties. MicroRNAs (miRNAs) have been discovered to modulate many aspects of immune responses. Herein, we summarize the distinct manifestations of the neonatal immune system, including cellular and non-cellular components. We also review the current findings on the modulatory effects of miRNAs on the neonatal immune system. These findings suggest that miRNAs have the potential to be useful therapeutic targets for certain infection or inflammatory conditions by modulating the neonatal immune system. In the future, we need a more comprehensive understanding in regard to miRNAs and how they modulate specific immune cells in neonates. Copyright © 2018. Published by Elsevier B.V.

Neonatal Respiratory Distress Syndrome: Early Diagnosis, Prevention, and Treatment

Directory of Open Access Journals (Sweden)

S. A. Perepelitsa

2012-01-01

Full Text Available to improve treatment results in premature infants with neonatal respiratory distress syndrome (NRDS, by establishing developmental mechanisms and elaborating methods for its early diagnosis, treatment, and prevention. Material and methods. The paper analyzes the results of a clinical observation and laboratory, instrumental, immunological, morphological, and radiological studies of 320 premature neonates at 26—35 weeks gestational age. The following groups of neonates were identified: 1 40 premature neonatal infants without NRDS and with the physiological course of an early neonatal period (a comparison group; 2 190 premature neonates with severe NRDS in whom the efficiency of therapy with exogenous surfactants, such as surfactant BL versus curosurf, was evaluated; 3 90 premature newborn infants who had died from NRDS at its different stages. Results. The poor maternal somatic, obstetric, and gynecological histories in the early periods of the current pregnancy create prerequisites for its termination, favor the development of severe acute gestosis, and cause abnormal placental changes. Each gestational age is marked by certain placental changes that promote impaired uterineplacentalfetal blood flow and premature birth. Alveolar and bronchial epithelial damages, including those ante and intranatally, microcircula tory disorders play a leading role in the tanatogenesis of NRDS. Intranatal hypoxia and amniotic fluid aspiration are one of the important factors contributing to alveolar epithelial damage and NRDS in premature neonates. Exogenous surfactants prevent the development of hyaline membranes and are useful in the normalization of ventilation-perfusion relationships and lung biomechanical properties. Conclusion. This study could improve the diagnosis and treatment of NRDS, which assisted in reducing the duration of mechanical ventilation from 130±7.6 to 65±11.6 hours, the number of complications (the incidence of intragastric

Variation in rates of severe retinopathy of prematurity among neonatal intensive care units in the Australian and New Zealand Neonatal Network

OpenAIRE

Darlow, B A; Hutchinson, J L; Simpson, J M; Henderson-Smart, D J; Donoghue, D A; Evans, N J

2005-01-01

Aim: To analyse variations in rates of severe retinopathy of prematurity (ROP) among neonatal intensive care units (NICUs) in the Australian and New Zealand Neonatal Network (ANZNN), adjusting for sampling variability and for case mix.

Ultrasonography of Neonatal Cholestasis

Energy Technology Data Exchange (ETDEWEB)

Cheon, Jung Eun [Seoul National University Hospital, Seoul (Korea, Republic of)

2012-06-15

Ultrasonography (US) is as an important tool for differentiation of obstructive and non-obstructive causes of jaundice in infants and children. Beyond two weeks of age, extrahepatic biliary atresia and neonatal hepatitis are the two most common causes of persistent neonatal jaundice: differentiation of extrahepatic biliary atresia, which requires early surgical intervention, is very important. Meticulous analysis should focus on size and configuration of the gallbladder and anatomical changes of the portahepatis. In order to narrow the differential diagnosis, combined approaches using hepatic scintigraphy, MR cholangiography, and, at times, percutaneous liver biopsy are necessary. US is useful for demonstrating choledochal cyst, bile plug syndrome, and spontaneous perforation of the extrahepatic bile duct

Intrauterine Growth Restriction Impairs Small Intestinal Mucosal Immunity in Neonatal Piglets

Science.gov (United States)

Dong, Li; Zhong, Xiang; Ahmad, Hussain; Li, Wei; Wang, Yuanxiao; Zhang, Lili

2014-01-01

Intrauterine growth restriction (IUGR) is a very common problem in both piglet and human neonate populations. We hypothesized that IUGR neonates have impaired intestinal mucosal immunity from birth. Using neonatal piglets as IUGR models, immune organ weights, the weight and length of the small intestine (SI), intestinal morphology, intraepithelial immune cell numbers, levels of cytokines and immunoglobulins, and the relative gene expression of cytokines in the SI were investigated. IUGR neonatal piglets were observed to have lower absolute immune organ weight and SI length, decreased relative weights of the thymus, spleen, mesenteric lymph node, and thinner but longer SIs. Damaged and jagged villi, shorter microvilli, presence of autophagosomes, swelled mitochondria, and decreased villus surface areas were also found in the SIs of IUGR neonatal piglets. We also found a smaller number of epithelial goblet cells and lymphocytes in the SIs of IUGR neonates. In addition, we detected reduced levels of the cytokines TNF-α and IFN-γ and decreased gene expression of cytokines in IUGR neonates. In conclusion, IUGR was shown to impair the mucosal immunity of the SI in neonatal piglets, and the ileum was the major site of impairment. PMID:24710659

Análise da implantação de programa de triagem auditiva neonatal em um hospital universitário Newborn hearing screening program implantation analysis at a university hospital

Directory of Open Access Journals (Sweden)

Wilian Maduell de Mattos

2009-04-01

Full Text Available Aperda auditiva é mais prevalente que outros distúrbios já rastreados ao nascimento. Esforços têm sido feitos para identificação e tratamento precoces de perdas auditivas por meio de programas de triagem auditiva neonatal. OBJETIVO: Estudo prospectivo com objetivo caracterizar o processo de implantação do Programa de Triagem Auditiva Neonatal (PTAN num Hospital Universitário. Analisar a investigação diagnóstica de perda auditiva em recém-nascidos. Apresentar propostas para aprimoramento do PTAN. MATERIAIS E MÉTODOS: Foram estudados recém-nascidos (RNs submetidos à TAN por emissões otoacústicas transientes (EOAT, reflexo cócleo-palpebral (RCP e Potencial Evocado Auditivo de Tronco Encefálico (PEATE. RESULTADOS: Foram testadas 625 crianças. Na primeira etapa passaram 458 RNs e falharam 155. Retornaram na segunda etapa 122 RNs, sendo que 8 o fizeram por apresentar fator de alto risco para PA. Encaminhados para investigação diagnóstica 12 RNs (1,9%. Dos 5 que retornaram para PEATE, observou-se PA em dois RNs. CONCLUSÃO: O programa testou 81,7% dos candidatos. O índice de adesão ao programa foi 68,2%. Na primeira etapa falharam 26,7% dos RNs. A implantação do programa está em andamento e necessita constantemente de análise das dificuldades, visando solucioná-las a fim de tornar a Triagem Auditiva Neonatal Universal uma realidade.Hearing loss is more prevalent than other disorders found at birth. Efforts have been put up towards the early identification and treatment of hearing loss by means of neonatal hearing screening programs. AIM: prospective study with the goal of characterizing the process of implementing a Neonatal Auditory Screening Program (NASP at a University Hospital. To analyze hearing loss diagnostic investigations in newborns, and to present proposals for NASP improvement. MATERIALS AND METHODS: we studied newborns (NB submitted to Newborn Auditory Screening (NAS by transient evoked otoacoustic

Serum procalcitonin as an early marker of neonatal sepsis | Ballot ...

African Journals Online (AJOL)

Background. It has recently been suggested that procalcitonin (PCT) is of value in the diagnosis of neonatal sepsis, with varying results. This study was to evaluate the role of PCT as a single early marker of neonatal sepsis. Setting. Neonatal Unit, Johannesburg Hospital, and Microbiology Laboratory, National Health ...

Trends in profiles of bacteria causing neonatal sepsis in Central ...

African Journals Online (AJOL)

Developing countries suffer from a huge burden of neonatal sepsis. Neonatal mortality and long term sequelae or morbidity portends huge costs for the poor Nigerian economy. We identified trends in bacterial agents implicated in neonatal sepsis and their antibiotic susceptibility profiles at the National Hospital Abuja over ...

Surfactant Apoprotein D in Preterm Neonates with Acute Respiratory Distress Syndrome

Directory of Open Access Journals (Sweden)

S. A. Perepelitsa

2009-01-01

Full Text Available Objective: to study the production of surfactant apoprotein D in preterm neonates with acute respiratory distress syndrome (ARDS during artificial ventilation (AV. Subjects and methods. The paper presents the results of studying the production of surfactant protein D (SP-D in various biological fluids in 44 preterm neonates. Two groups of newborn infants were identified according to the clinical manifestations of ARDS. The study group comprised 25 infants with the severe course of the disease, in this connection the preventive administration of the exogenous surfactant Curosurf and AV were made in all the neonates at birth. The control group included 19 preterm babies without signs of ARDS. Results. The study has demonstrated that in parturients and preterm neonatal infants, surfactant apoprotein D is detectable in various biological fluids: amniotic fluid, the gastric aspirate obtained just after birth, residual umbilical cord blood, serum following 8 hours of birth, and bronchoalveolar fluid. Despite the low gestational age of the neonates, the lung surfactant system is able to produce SP-D, as evidenced by its high content in the amniotic fluid and residual umbilical cord blood of preterm neonates. The production of apoprotein D in preterm neonates considerably reduces in the next few hours after birth. Conclusion. The findings suggest that fetal tissues generate SP-D, which improves pulmonary gas exchange in preterm neonates in the first hours after birth and that alveolar-capillary membrane dysfunctions are transient in the neonates on AV. Key words: preterm neonates, acute respiratory distress syndrome, surfactant, surfactant apoprotein D.

Computed tomography and intracranial hemorrhages in the neonate

International Nuclear Information System (INIS)

Shibata, Iekado; Kushida, Yoshimasa; Shishido, Masaru; Nagasawa, Sadatsugu; Seiki, Yoshikatsu

1983-01-01

Thirty-two of 290 neonates admitted to the Perinatal Intensive Care Unit, Toho University Medical School, were examined by CT scan because of tentative clinical diagnosis of intracranial hemorrhage. CT scanner employed in this study was TCT-60 A from the Toshiba The Electric Co., Ltd. Fourteen cases (44%) were confirmed by the CT scan to have intracranial hemorrhage. Four cases had hemorrhage in the ventricle, while the remaining ten cases had subarachnoid hemorrhage. Subdural hemorrhage was not revealed in our series. Three of the four cases with intraventricular hemorrhage showed a typical subependymal germinal matrix hemorrhage. The prognosis of intraventricular hemorrhage in neonates seemed to be poor; two of the four cases died within a week. Their body weight at birth was apparently under the standard, and their Apgar score was 3 points. The subarachnoid hemorrhage was the main type of intracranial neonatal hemorrhages. In our series, it was constituted approximately 70% of the intracranial hemorrhages. The CT images of the subarachnoid hemorrhage in neonate were greatly different from those in adults. An irregular, wide high-density area around the falxtentorial junction was characteristic of the CT in many neonatal subarachnoid hemorrhages. In severe subarachnoid hemorrhages, a characteristic Y-shaped, high-density figure was demonstrated. In cases of subarachnoid hemorrhage from the deep venous system, high-density spreading immediately ventral to the falx-tentrium junction was demonstrated. These high-density areas due to blood in the subarachnoid space rapidly disappeared with the lapse of time. On the other hand, high-density areas in cerebral cisterns and/or fissures were rarely demonstrated in neonatal subarachnoid hemorrhages. The prognosis of subarachnoid hemorrhage in neonates was fairly good in the sense of life and cerebral functions. (author)

Neonatal varicella pneumonia, surfactant replacement therapy

Directory of Open Access Journals (Sweden)

Mousa Ahmadpour-kacho

2015-12-01

Full Text Available Background: Chickenpox is a very contagious viral disease that caused by varicella-zoster virus, which appears in the first week of life secondary to transplacental transmission of infection from the affected mother. When mother catches the disease five days before and up to two days after the delivery, the chance of varicella in neonate in first week of life is 17%. A generalized papulovesicular lesion is the most common clinical feature. Respiratory involvement may lead to giant cell pneumonia and respiratory failure. The mortality rate is up to 30% in the case of no treatment, often due to pneumonia. Treatment includes hospitalization, isolation and administration of intravenous acyclovir. The aim of this case report is to introduce the exogenous surfactant replacement therapy after intubation and mechanical ventilation for respiratory failure in neonatal chickenpox pneumonia and respiratory distress. Case Presentation: A seven-day-old neonate boy was admitted to the Neonatal Intensive Care Unit at Amirkola Children’s Hospital, Babol, north of Iran, with generalized papulovesicular lesions and respiratory distress. His mother has had a history of Varicella 4 days before delivery. He was isolated and given supportive care, intravenous acyclovir and antibiotics. On the second day, he was intubated and connected to mechanical ventilator due to severe pneumonia and respiratory failure. Because of sever pulmonary involvement evidenced by Chest X-Ray and high ventilators set-up requirement, intratracheal surfactant was administered in two doses separated by 12 hours. He was discharged after 14 days without any complication with good general condition. Conclusion: Exogenous surfactant replacement therapy can be useful as an adjunctive therapy for the treatment of respiratory failure due to neonatal chickenpox.

Pathway cross-talk network analysis identifies critical pathways in neonatal sepsis.

Science.gov (United States)

Meng, Yu-Xiu; Liu, Quan-Hong; Chen, Deng-Hong; Meng, Ying

2017-06-01

Despite advances in neonatal care, sepsis remains a major cause of morbidity and mortality in neonates worldwide. Pathway cross-talk analysis might contribute to the inference of the driving forces in bacterial sepsis and facilitate a better understanding of underlying pathogenesis of neonatal sepsis. This study aimed to explore the critical pathways associated with the progression of neonatal sepsis by the pathway cross-talk analysis. By integrating neonatal transcriptome data with known pathway data and protein-protein interaction data, we systematically uncovered the disease pathway cross-talks and constructed a disease pathway cross-talk network for neonatal sepsis. Then, attract method was employed to explore the dysregulated pathways associated with neonatal sepsis. To determine the critical pathways in neonatal sepsis, rank product (RP) algorithm, centrality analysis and impact factor (IF) were introduced sequentially, which synthetically considered the differential expression of genes and pathways, pathways cross-talks and pathway parameters in the network. The dysregulated pathways with the highest IF values as well as RPpathways in neonatal sepsis. By integrating three kinds of data, only 6919 common genes were included to perform the pathway cross-talk analysis. By statistic analysis, a total of 1249 significant pathway cross-talks were selected to construct the pathway cross-talk network. Moreover, 47 dys-regulated pathways were identified via attract method, 20 pathways were identified under RPpathways with the highest IF were also screened from the pathway cross-talk network. Among them, we selected 8 common pathways, i.e. critical pathways. In this study, we systematically tracked 8 critical pathways involved in neonatal sepsis by integrating attract method and pathway cross-talk network. These pathways might be responsible for the host response in infection, and of great value for advancing diagnosis and therapy of neonatal sepsis. Copyright © 2017

Telemedicine in Neonatal Home Care: Identifying Parental Needs Through Participatory Design.

Science.gov (United States)

Garne, Kristina; Brødsgaard, Anne; Zachariassen, Gitte; Clemensen, Jane

2016-07-08

For the majority of preterm infants, the last weeks of hospital admission mainly concerns tube feeding and establishment of breastfeeding. Neonatal home care (NH) was developed to allow infants to remain at home for tube feeding and establishment of breastfeeding with regular home visits from neonatal nurses. For hospitals covering large regions, home visits may be challenging, time consuming, and expensive and alternative approaches must be explored. To identify parental needs when wanting to provide neonatal home care supported by telemedicine. The study used participatory design and qualitative methods. Data were collected from observational studies, individual interviews, and focus group interviews. Two neonatal units participated. One unit was experienced in providing neonatal home care with home visits, and the other planned to offer neonatal home care with telemedicine support. A total of 9 parents with preterm infants assigned to a neonatal home care program and 10 parents with preterm infants admitted to a neonatal unit participated in individual interviews and focus group interviews, respectively. Three overall themes were identified: being a family, parent self-efficacy, and nurse-provided security. Parents expressed desire for the following: (1) a telemedicine device to serve as a "bell cord" to the neonatal unit, giving 24-hour access to nurses, (2) video-conferencing to provide security at home, (3) timely written email communication with the neonatal unit, and (4) an online knowledge base on preterm infant care, breastfeeding, and nutrition. Our findings highlight the importance of neonatal home care. NH provides parents with a feeling of being a family, supports their self-efficacy, and gives them a feeling of security when combined with nursing guidance. Parents did not request hands-on support for infant care, but instead expressed a need for communication and guidance, which could be met using telemedicine.

Criteria for radiologic diagnosis of hypochondroplasia in neonates

Energy Technology Data Exchange (ETDEWEB)

Saito, Tomoko; Nagasaki, Keisuke; Wada, Masaki; Nyuzuki, Hiromi; Saitoh, Akihiko [Niigata University Graduate School of Medical and Dental Sciences, Division of Pediatrics, Department of Homeostatic Regulation and Development (Japan); Nishimura, Gen [Tokyo Metropolitan Children' s Medical Center, Department of Radiology, Tokyo (Japan); Takagi, Masaki [Tokyo Metropolitan Children' s Medical Center, Department of Endocrinology, Tokyo (Japan); Keio University School of Medicine, Department of Pediatrics, Tokyo (Japan); Hasegawa, Tomonobu; Amano, Naoko [Keio University School of Medicine, Department of Pediatrics, Tokyo (Japan); Murotsuki, Jun [Tohoku University Graduate School of Medicine, Miyagi Children' s Hospital, Department of Maternal and Fetal Medicine, Sendai (Japan); Sawai, Hideaki [Hyogo College of Medicine, Departments of Obstetrics and Gynecology, Hyogo (Japan); Yamada, Takahiro [Hokkaido University Hospital, Departments of Obstetrics and Gynecology, Hokkaido (Japan); Sato, Shuhei [Aomori Rosai Hospital, Department of Obstetrics and Gynecology, Aomori (Japan)

2016-04-15

A radiologic diagnosis of hypochondroplasia is hampered by the absence of age-dependent radiologic criteria, particularly in the neonatal period. To establish radiologic criteria and scoring system for identifying neonates with fibroblast growth factor receptor 3 (FGFR3)-associated hypochondroplasia. This retrospective study included 7 hypochondroplastic neonates and 30 controls. All subjects underwent radiologic examination within 28 days after birth. We evaluated parameters reflecting the presence of (1) short ilia, (2) squared ilia, (3) short greater sciatic notch, (4) horizontal acetabula, (5) short femora, (6) broad femora, (7) metaphyseal flaring, (8) lumbosacral interpedicular distance narrowing and (9) ovoid radiolucency of the proximal femora. Only parameters 1, 3, 4, 5 and 6 were statistically different between the two groups. Parameters 3, 5 and 6 did not overlap between the groups, while parameters 1 and 4 did. Based on these results, we propose a scoring system for hypochondroplasia. Two major criteria (parameters 3 and 6) were assigned scores of 2, whereas 4 minor criteria (parameters 1, 4, 5 and 9) were assigned scores of 1. All neonates with hypochondroplasia in our material scored ≥6. Our set of diagnostic radiologic criteria might be useful for early identification of hypochondroplastic neonates. (orig.)

Criteria for radiologic diagnosis of hypochondroplasia in neonates

International Nuclear Information System (INIS)

Saito, Tomoko; Nagasaki, Keisuke; Wada, Masaki; Nyuzuki, Hiromi; Saitoh, Akihiko; Nishimura, Gen; Takagi, Masaki; Hasegawa, Tomonobu; Amano, Naoko; Murotsuki, Jun; Sawai, Hideaki; Yamada, Takahiro; Sato, Shuhei

2016-01-01

A radiologic diagnosis of hypochondroplasia is hampered by the absence of age-dependent radiologic criteria, particularly in the neonatal period. To establish radiologic criteria and scoring system for identifying neonates with fibroblast growth factor receptor 3 (FGFR3)-associated hypochondroplasia. This retrospective study included 7 hypochondroplastic neonates and 30 controls. All subjects underwent radiologic examination within 28 days after birth. We evaluated parameters reflecting the presence of (1) short ilia, (2) squared ilia, (3) short greater sciatic notch, (4) horizontal acetabula, (5) short femora, (6) broad femora, (7) metaphyseal flaring, (8) lumbosacral interpedicular distance narrowing and (9) ovoid radiolucency of the proximal femora. Only parameters 1, 3, 4, 5 and 6 were statistically different between the two groups. Parameters 3, 5 and 6 did not overlap between the groups, while parameters 1 and 4 did. Based on these results, we propose a scoring system for hypochondroplasia. Two major criteria (parameters 3 and 6) were assigned scores of 2, whereas 4 minor criteria (parameters 1, 4, 5 and 9) were assigned scores of 1. All neonates with hypochondroplasia in our material scored ≥6. Our set of diagnostic radiologic criteria might be useful for early identification of hypochondroplastic neonates. (orig.)

Risk factors of intracranial hemorrhage in premature neonates.

Directory of Open Access Journals (Sweden)

Nasrin Khalessi

2014-09-01

Full Text Available Intraventricular hemorrhage (IVH is an important cause of brain injury in premature neonates. Current study tries to define associated risk factors of IVH in preterm neonates in Aliasghar Children Hospital during 2008 to 2011. In this study, the risk factors have been evaluated in premature neonates with IVH, who had at least one brain sonography since their admission in NICU. A total of 63 premature neonates with IVH were assessed. Mean gestational age was 29.81 (24-34 weeks and mean birth weight was 1290.83±382.96 gr. Other risk factors such as sex, mode of delivery, history of using infertility drugs, maternal disease, maternal hypertension and preeclampsia, lumbar puncture, ventilator therapy and pneumothorax were considered. Because no absolute treatment for IVH is available, identifying risk factors is important in prevention and management of IVH.

Neonatal Graves' Disease with Maternal Hypothyroidism.

Science.gov (United States)

Akangire, Gangaram; Cuna, Alain; Lachica, Charisse; Fischer, Ryan; Raman, Sripriya; Sampath, Venkatesh

2017-07-01

Neonatal Graves' disease presenting as conjugated hyperbilirubinemia is a diagnostic challenge because the differential includes a gamut of liver and systemic diseases. We present a unique case of neonatal Graves' disease in a premature infant with conjugated hyperbilirubinemia born to a mother with hypothyroidism during pregnancy and remote history of Graves' disease. Infant was treated with a combination of methimazole, propranolol, and potassium iodide for 4 weeks. Thyroid function improved after 8 weeks of treatment with full recovery of thyroid function, disappearance of thyroid-stimulating antibodies, and resolution of failure to thrive and conjugated hyperbilirubinemia. This case provides several clinical vignettes as it is a rare, severe, presentation of an uncommon neonatal disease, signs, symptoms, and clinical history presented a diagnostic challenge for neonatologists and endocrinologists, normal newborn screen was misleading, and yet timely treatment led to a full recovery.

[Neonatal hyperthyroidism and maternal Graves disease].

Science.gov (United States)

Ben Ameur, K; Chioukh, F Z; Marmouch, H; Ben Hamida, H; Bizid, M; Monastiri, K

2015-04-01

The onset of Graves disease during pregnancy exposes the neonate to the risk of hyperthyroidism. The newborn must be monitored and treatment modalities known to ensure early treatment of the newborn. We report on the case of an infant born at term of a mother with Graves disease discovered during pregnancy. He was asymptomatic during the first days of life, before declaring the disease. Neonatal hyperthyroidism was confirmed by hormonal assays. Hyperthyroidism was treated with antithyroid drugs and propranolol with a satisfactory clinical and biological course. Neonatal hyperthyroidism should be systematically sought in infants born to a mother with Graves disease. The absence of clinical signs during the first days of life does not exclude the diagnosis. The duration of monitoring should be decided according to the results of the first hormonal balance tests. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Procalcitonin: A Reliable Marker for the Diagnosis of Neonatal Sepsis

Science.gov (United States)

Adib, Minoo; Bakhshiani, Zahra; Navaei, Fakhri; Saheb Fosoul, Fereshteh; Fouladi, Salomeh; Kazemzadeh, Hamidreza

2012-01-01

Objective(s) In the last few years, serum procalcitonin has been proposed as an early marker of infections in neonates, with varying results. In this study, we aimed to investigate the value of procalcitonin, and C- reactive protein in establishing the diagnosis of neonatal sepsis. Materials and Methods Blood samples were collected at admission from 69 neonates with suspected infection (admitted to the Neonatal Intensive Care Units at Alzahra and Dr Beheshti Hospital in and Fatema-Zahra in Najafabad from May 2005 to April 2006). Patients were categorized in different groups according to clinical symptoms of sepsis, bacteriological and laboratory results. Group I consisted of 20 newborns with positive blood cultures and other biological tests which suggested infection. Group II consisted of 49 neonates with negative blood cultures but had two or three of clinical signs of sepsis. The control group included 18 healthy neonates with physiological hyperbilirubinemia and no clinical and biological data of infection, referred to the hospital for bilirubin determination. Procalcitonin and C-reactive protein (CRP) were determined by immunoluminometric assay and nephlometry method respectively. Results Mean levels of procalcitonin and CRP in septic neonates (group I) were significantly higher than the other two groups (P< 0.005). Sensitivity, specificity, positive predictive value and negative predictive value were determined for all markers and compared with each other. Conclusion We conclude that procalcitonin is a better marker than CRP in the diagnosis of neonatal sepsis. PMID:23493845

A amamentação na primeira hora de vida e mortalidade neonatal Breastfeeding during the first hour of life and neonatal mortality

Directory of Open Access Journals (Sweden)

Cristiano Siqueira Boccolini

2013-04-01

Full Text Available OBJETIVO: Analisar a correlação entre o percentual de amamentação na primeira hora de vida e as taxas de mortalidade neonatal. MÉTODOS: Foram utilizados dados secundários de 67 países obtidos das pesquisas realizadas com a metodologia do Demographic and Health Surveys. Inicialmente, para a análise dos dados, foram empregadas a Correlação de Spearman (IC 95% e a análise gráfica com modificação de Kernel, seguidas de regressão de Poisson Binomial Negativa, ajustando para possíveis fatores de confundimento. RESULTADOS: O percentual de aleitamento materno na primeira hora de vida esteve negativamente associado com as taxas de mortalidade neonatal (Rho = -0,245, p = 0,046, e esta correlação foi mais forte entre os países com mortalidade neonatal superior a 29 mortes/1.000 nascidos vivos (Rho = -0,327, p = 0,048. Os países com os menores tercis de aleitamento materno na primeira hora de vida tiveram uma taxa 24% maior de mortalidade neonatal (razão de taxa = 1,24, IC 95% = 1,07-1,44, mesmo ajustando para fatores de confundimento. CONCLUSÃO: O efeito protetor da amamentação na primeira hora de vida sobre a mortalidade neonatal encontrado nesse estudo ecológico é consistente com o de estudos observacionais, e aponta para a importância de se adotar a amamentação na primeira hora de vida como prática de atenção neonatal.OBJECTIVE: To analyze the correlation between breastfeeding in the first hour of life with neonatal mortality rates. METHODS: The present study used secondary data from 67 countries, obtained from the Demographic and Health Surveys. Initially, for data analysis, Spearman Correlation (95% CI and Kernel graphical analysis were employed, followed by a Negative Binomial Poisson regression model, adjusted for potential confounders. RESULTS: Breastfeeding within the first hour of life was negatively correlated with neonatal mortality (Spearman's Rho = -0.245, p = 0.046, and this correlation was stronger among

Gender Differences in Mother-Neonate Twin Interaction.

Science.gov (United States)

Riese, Marilyn L.

To investigate differences in mothers' interaction patterns with their neonate twins based on birth order, relative size at birth, or gender, 37 neonate twins and their mothers were observed during the first 10 minutes of a feeding in a hospital nursery. Time-sampling recordings were made of maternal behaviors related to proximal stimulation,…

Outcome of neonatal surgeries in Nnewi, Nigeria

African Journals Online (AJOL)

Prune belly syndrome. 2 (1.4). Neonatal testicular torsion. 2 (1.4). Vaginal atresia. 1 (0.7). Musculoskeletal. Abscesses. 6 (4.1). Congenital cutis aplasia. 2 (1.4). Tumours. Sacrococcygeal teratoma. 4 (2.7). Cystic hygroma. 2 (1.4). Cervical teratoma. 2 (1.4). Total. 147 (100.0). Outcome of neonatal surgeries Ekwunife et al.

Determination of Noise Level and Its Sources in the Neonatal Intensive Care Unit and Neonatal Ward

Directory of Open Access Journals (Sweden)

Mahdi Jahangir Blourchian

2015-12-01

Full Text Available Background: In Neonatal intensive care units (NICU different sound intensities and frequencies are produced from different sources, which may exert undesirable physiological effects on the infants. The aim of this study was to determine the noise level and its sources in the NICU and neonatal ward of Al-Zahra Hospital of Rasht, Iran. Methods: In this descriptive cross-sectional study, the intensity of the sounds generated by the internal and external sources in the NICU and neonatal ward was measured using a sound level meter device. The sound produced by each of the sources was individually calculated. Data were analyzed performing descriptive and analytical statistics, using SPSS version 19. Results: The mean noise levels in six rooms and a hallway during morning, afternoon and night shifts with the electromechanical devices turned on were 61.67±4.5, 61.32±4.32 and 60.71±4.56 dB, respectively. Moreover, with the devices tuned off the mean noise levels during morning, afternoon and evening shifts were 64.97±2.6, 60.6±1.29 and 57.91±4.73 dB, respectively. The differences between the mean noise levels in the neonatal wards (standard noise level=45 dB during each shift with the electromechanical devices turned on and off were statistically significant (P=0.002 and P

Ornithine aminotransferase deficiency: Diagnostic difficulties in neonatal presentation

NARCIS (Netherlands)

Cleary, M. A.; Dorland, L.; de Koning, T. J.; Poll-The, B. T.; Duran, M.; Mandell, R.; Shih, V. E.; Berger, R.; Olpin, S. E.; Besley, G. T. N.

2005-01-01

We describe two unrelated cases of ornithine aminotransferase (OAT) deficiency with rare neonatal presentation of hyperammonaemia. The diagnosis in the neonatal presentation of OAT deficiency is hampered as hyperornithinaemia is absent. Enzyme and mutation studies confirmed the diagnosis. OAT

SURVEI KEMATIAN NEONATAL (STUDI AUTOPSI VERBAL DI KABUPATEN CIREBON, 2004

Directory of Open Access Journals (Sweden)

Sarimawar Djaja

2012-09-01

Full Text Available In its attempt to realize the intervention program to saving newborn babies with asphyxia, the Ministry of Health will initiate to train midwives in the village in order to that they know how to operate resuscitation equipment to save neonatal baby with asphyxia. The intervention program his dubbed successful if the mortality proportion due if asphyxia decreased to half as targeted. The survey was conducted in the rural area of Cirebon district. The sample was 200 neonatal death babies, calculated using the hypothesis test with different proportion; p1 0.3 (30% neonatal death cause of asphyxia, according household health survey 2001, p2 0.15, α 0.05, β 0.2, (l-β 0.8. Neonatal dead cases happened within 12 months prior to the survey were identified by rural midwives out of their personal records. The death cases were followed up by interviewing the mother of the neonatal baby concerning its birth, illness or disorder histories before death. The diagnosis of the diseases were based on the International Classification of Diseases 10 and Wigglesworth classification, determined in union by NIHRD researchers and neonatologists. The neonatal mortality rate was 13 out of 1,000 live births. The major cause of early neonatal mortality was respiration disorder mainly caused by birth asphyxia (45%, of which 90 percent could be intervened by doing resuscitation (for babies weighed more than 1.000 gram. The second and third order of the mortality causes was infection (22% and congenital disorders (11% respectively. The major cause of late neonatal mortality was infection (56%, followed by low birth weight and prematurely born, as well as neonatal jaundice (14 percent each, and congenital disorder comes in the third place. The option to handle asphyxia with the early neonatal babies is the right effort to decrease the neonatal mortality rate. And to achieve the utmost result, it is necessary that the rural midwives maintain their standard performance (in

Neonatal seizures in a rural Iranian district hospital: etiologies, incidence and predicting factors.

Science.gov (United States)

Sadeghian, Afsaneh; Damghanian, Maryam; Shariati, Mohammad

2012-01-01

Current study determined the overall incidence, common causes as well as main predictors of this final diagnosis among neonates admitted to a rural district hospital in Iran. This study was conducted on 699 neonates who were candidate for admission to the NICU. Study population was categorized in the case group, including patients exposed to final diagnosis of neonatal seizures and the control group without this diagnosis. Neonatal seizure was reported as final diagnosis in 25 (3.6%) of neonates. The most frequent discharge diagnosis in the seizure group was neonatal sepsis and in the non-seizure group was respiratory problems. No significant difference was found in early fatality rate between neonates with and without seizures (8.0% vs. 10.1%). Only gestational age <38 week had a relationship with the appearance of neonatal seizure. Low gestational age has a crucial role for predicting appearance of seizure in Iranian neonates.

GM-CSF augments the immunosuppressive capacity of neonatal spleen cells in vitro

International Nuclear Information System (INIS)

Morrissey, P.J.; Ireland, R.

1991-01-01

Addition of exogenous granulocyte-macrophage colony stimulating factor (GM-CSF) to cultures of adult murine spleen cells with sheep red blood cells (SRBC) results in an augmented plaque forming cell (PFC) response. The influence of GM-CSF on the ability of neonatal spleen cells to suppress the anti-SRBC plaque forming response of adult spleen cells was tested by adding GM-CSF to cultures of neonatal and adult spleen cells. The suppressive capacity of the neonatal spleen cells was augmented by exogenous GM-CSF. The augmented suppression of the neonatal spleen cells was dependent on a G-10 adherent population since the addition of GM-CSF to cultures containing G-10 passed neonatal spleen cells resulted in an augmented PFC response and not suppression. Neonatal splenic glass adherent cells were also capable of suppressing the response. Neonatal spleen cells or purified neonatal glass adherent spleen cells cultured in the presence of GM-CSF had markedly increased levels of PGE2 in the culture supernatant. Neonatal spleen cells cultured with GM-CSF had increased numbers of morphologically identifiable macrophages after 48 hr of culture. Both irradiation and G-10 passage of the neonatal spleen diminished the numbers of macrophages formed in response to GM-CSF, and both of these manipulations resulted in reversal of suppression in response to GM-CSF. Thus, the augmented suppressive capacity of neonatal spleen cells in response to GM-CSF is probably mediated by its ability to drive monocyte to macrophage differentiation as well as increase the suppressive capacity of the existing neonatal splenic macrophages by increasing their production of PGE2

Foetal and neonatal thyroid disorders.

Science.gov (United States)

Radetti, G; Zavallone, A; Gentili, L; Beck-Peccoz, P; Bona, G

2002-10-01

Thyroid hormones have been shown to be absolutely necessary for early brain development. During pregnancy, both maternal and foetal thyroid hormones contribute to foetal brain development and maternal supply explains why most of the athyreotic newborns usually do not show any signs of hypothyroidism at birth. Foetal and/or neonatal hypothyroidism is a rare disorder. Its incidence, as indicated by neonatal screening, is about 1:4000. Abnormal thyroid development (i.e. agenesia, ectopic gland, hypoplasia) or inborn errors in thyroid hormone biosynthesis are the most common causes of permanent congenital hypothyroidism. Recent studies reported that mutations involving Thyroid Transcriptor Factors (TTF) such as TTF-1, TTF-2, PAX-8 play an important role in altered foetal thyroid development. Deficiency of transcriptor factor (Pit-1, Prop-1, LHX-3) both in mother and in the foetus represents another rare cause of foetal hypothyroidism. At birth clinical picture may be not always so obvious and typical signs appear only after several weeks but a delayed diagnosis could have severe consequences consisting of delayed physical and mental development. Even if substitutive therapy is promptly started some learning difficulties might still arise suggesting that intrauterine adequate levels of thyroid hormones are absolutely necessary for a normal neurological development. Placental transfer of maternal antithyroid antibodies inhibiting fetal thyroid function can cause transient hypothyroidism at birth. If the mother with thyroid autoimmune disease is also hypothyroid during pregnancy and she doesn't receive substitutive therapy, a worse neurological outcome may be expected for her foetus. Foetal and/or neonatal hyperthyroidism is a rare condition and its incidence has been estimated around 1:4000-40000, according to various authors. The most common causes are maternal thyroid autoimmune disorders, such as Graves' disease and Hashimoto's thyroiditis. Rarer non autoimmune causes

Dietary-induced hyperthyroidism marginally affects neonatal testicular development

NARCIS (Netherlands)

Rijntjes, Eddy; Wientjes, Anna T.; Swarts, Hans J. M.; de Rooij, Dirk G.; Teerds, Katja J.

2008-01-01

The objective of this study was to determine whether dietary-induced mild fetal/neonatal hyperthyroidism influenced the initiation of spermatogenesis and the development of the adult-type Leydig cell population. Previously, the effects of neonatally induced hyperthyroidism have been investigated in

Treatment of neonatal sepsis with intravenous immune globulin

DEFF Research Database (Denmark)

Brocklehurst, Peter; Farrell, Barbara; King, Andrew

2011-01-01

Neonatal sepsis is a major cause of death and complications despite antibiotic treatment. Effective adjunctive treatments are needed. Newborn infants are relatively deficient in endogenous immunoglobulin. Meta-analyses of trials of intravenous immune globulin for suspected or proven neonatal sepsis...

An audit of some health facilities and equipment for neonatal ...

African Journals Online (AJOL)

Background: Neonatal Mortality rates continue to be high in spite of the general decline in under-5 mortality rates in Nigeria. Available evidence has shown that the availability of a skilled birth attendant and equipment for basic neonatal resuscitation is necessary for the prevention of early neonatal death which accounts for ...

Neonatal perforated Amyand's hernia presenting as an enterocutaneous scrotal fistula

Directory of Open Access Journals (Sweden)

Antonios Panagidis

2015-07-01

Full Text Available Perforation of the vermiform appendix in a septic neonate with an Amyand's hernia resulted in the formation of a scrotal enterocutaneous fistula. In conclusion from this exceptional complication, active parental awareness for any neonatal scrotal swelling is required, and an early operative policy for the neonatal inguinal hernia is significant.

Neonatal Outcomes in the Birth Center Setting: A Systematic Review.

Science.gov (United States)

Phillippi, Julia C; Danhausen, Kathleen; Alliman, Jill; Phillippi, R David

2018-01-01

This systematic review investigates the effect of the birth center setting on neonatal mortality in economically developed countries to aid women and clinicians in decision making. We searched the Google Scholar, CINAHL, and PubMed databases using key terms birth/birthing center or out of hospital with perinatal/neonatal outcomes. Ancestry searches identified additional studies, and an alert was set for new publications. We included primary source studies in English, published after 1980, conducted in a developed country, and researching planned birth in centers with guidelines similar to American Association of Birth Centers standards. After initial review, we conducted a preliminary analysis, assessing which measures of neonatal health, morbidity, and mortality were included across studies. Neonatal mortality was selected as the sole summary measure as other measures were sporadically reported or inconsistently defined. Seventeen studies were included, representing at least 84,500 women admitted to a birth center in labor. There were substantial differences of study design, sampling techniques, and definitions of neonatal outcomes across studies, limiting conclusive statements of the effect of intrapartum care in a birth center. No reviewed study found a statistically increased rate of neonatal mortality in birth centers compared to low-risk women giving birth in hospitals, nor did data suggest a trend toward higher neonatal mortality in birth centers. As in all birth settings, nulliparous women, women aged greater than 35 years, and women with pregnancies of more than 42 weeks' gestation may have an increased risk of neonatal mortality. There are substantial flaws in the literature concerning the effect of birth center care on neonatal outcomes. More research is needed on subgroups at risk of poor outcomes in the birth center environment. To expedite research, consistent use of national and international definitions of perinatal and neonatal mortality within

Comparison of Neonatal Pain, Agitation, and Sedation Scale with Premature Infant Pain Profile for the assessment of acute prolonged pain in neonates on assisted ventilation: A prospective observational study

Directory of Open Access Journals (Sweden)

Saumil Ashvin Desai

2017-01-01

Full Text Available Aim: This study aimed to compare Neonatal Pain, Agitation, and Sedation Scale (N-PASS with Premature Infant Pain Profile (PIPP for the assessment of acute prolonged pain in ventilated neonates. Methods: This study was conducted in two phases. In phase 1 of the study, we assessed whether neonates on assisted ventilation experienced acute prolonged pain. In phase 2, the aim was to compare N-PASS with PIPP for the assessment of acute prolonged pain in neonates on assisted ventilation.. Design: This is a prospective observational study. Study Setting and Duration: This study was conducted at a tertiary care neonatal intensive care unit for 6 months. Inclusion Criteria: Neonates on assisted ventilation for >48 h were selected for this study. Exclusion Criteria: Neonates with lethal congenital anomalies and severe encephalopathy were excluded from the study. N-PASS and PIPP tools were used to assess acute prolonged pain in ventilated neonates. Taking PIPP as gold standard and N-PASS as a new test, the correlation coefficient was calculated. The sensitivity, specificity, positive predictive value, and negative predictive value were also computed. The time taken to administer the tools was also computed. Results: The average PIPP score for ventilated neonates was 8.33. The correlation coefficient of N-PASS when compared to PIPP was 0.62. The average time taken to apply the N-PASS scale was 4.42 min as compared to 8.20 min for PIPP scale. In term neonates, the sensitivity, specificity, positive predictive value, and negative predictive value of N-PASS were 75%, 100%, 100%, and 60%, respectively. The corresponding values in preterm neonates were lesser. Conclusions: The study proves that neonates on assisted ventilation experience acute prolonged pain. N-PASS is clinically reliable and valid to assess acute prolonged pain in ventilated term neonates. The N-PASS is quicker than PIPP in assessing acute prolonged pain in ventilated neonates. Future

The Frequency and Severity of Magnetic Resonance Imaging Abnormalities in Infants with Mild Neonatal Encephalopathy.

Science.gov (United States)

Walsh, Brian H; Neil, Jeffrey; Morey, JoAnn; Yang, Edward; Silvera, Michelle V; Inder, Terrie E; Ortinau, Cynthia

2017-08-01

To assess and contrast the incidence and severity of abnormalities on cerebral magnetic resonance imaging (MRI) between infants with mild, moderate, and severe neonatal encephalopathy who received therapeutic hypothermia. This retrospective cohort studied infants with mild, moderate, and severe neonatal encephalopathy who received therapeutic hypothermia at a single tertiary neonatal intensive care unit between 2013 and 2015. Two neuroradiologists masked to the clinical condition evaluated brain MRIs for cerebral injury after therapeutic hypothermia using the Barkovich classification system. Additional abnormalities not included in this classification system were also noted. The rate, pattern, and severity of abnormalities/injury were compared across the grades of neonatal encephalopathy. Eighty-nine infants received therapeutic hypothermia and met study criteria, 48 with mild neonatal encephalopathy, 35 with moderate neonatal encephalopathy, and 6 with severe neonatal encephalopathy. Forty-eight infants (54%) had an abnormality on MRI. There was no difference in the rate of overall MRI abnormalities by grade of neonatal encephalopathy (mild neonatal encephalopathy 54%, moderate neonatal encephalopathy 54%, and severe neonatal encephalopathy 50%; P= .89). Basal ganglia/thalamic injury was more common in those with severe neonatal encephalopathy (mild neonatal encephalopathy 4%, moderate neonatal encephalopathy 9%, severe neonatal encephalopathy 34%; P = .03). In contrast, watershed injury did not differ between neonatal encephalopathy grades (mild neonatal encephalopathy 36%, moderate neonatal encephalopathy 32%, severe neonatal encephalopathy 50%; P = .3). Mild neonatal encephalopathy is commonly associated with MRI abnormalities after therapeutic hypothermia. The grade of neonatal encephalopathy during the first hours of life may not discriminate adequately between infants with and without cerebral injury noted on MRI after therapeutic hypothermia

Ocorrência precoce da mosca das frutas em ameixas Incidence of the southamerican fruit fly on plums

Directory of Open Access Journals (Sweden)

Luiz Antonio Salles

1999-06-01

Full Text Available O objetivo deste estudo foi verificar qual o estágio fenológico mais precoce da fruta de ameixeira em que ocorreria o ataque de mosca das frutas Anastrepha fraterculus. Os estudos foram conduzidos em plantas adultas de ameixeira, expondo-se fêmeas grávidas da mosca das frutas, confinadas em gaiolas com frutos protegidos do ataque natural. Cinco cultivares de ameixeira foram estudados (Amarelinha, Pluma 7, Reubennel, Santa Rosa e Wade. Essa praga ataca frutos de qualquer um dos cultivares logo nos primeiros estádios do desenvolvimento, quando os mesmos têm somente cerca de 2 a 3cm de diâmetro.The incidence of the southamerican fruit fly, Anastrepha fraterculus, on plum cultivars is reported. The objective of this study was to know the earliest fruit phase that fly attack could occur. Fertilized females were confined with fruits in plum trees in an orchard. Five plums cultivars were studied: Amarelinha; Pluma 7; Reubennel; Santa Rosa and Wade. This pest attack fruits during first stages of their development, mainly they have only from 2 to 3 centimeters of diameter.

Patterns of neonatal hypoxic-ischaemic brain injury

International Nuclear Information System (INIS)

Vries, Linda S. de; Groenendaal, Floris

2010-01-01

Enormous progress has been made in assessing the neonatal brain, using magnetic resonance imaging (MRI). In this review, we will describe the use of MRI and proton magnetic resonance spectroscopy in detecting different patterns of brain injury in (full-term) human neonates following hypoxic-ischaemic brain injury and indicate the relevance of these findings in predicting neurodevelopmental outcome. (orig.)

Patterns of neonatal hypoxic-ischaemic brain injury

Energy Technology Data Exchange (ETDEWEB)

Vries, Linda S. de [University Medical Centre, Department of Neonatology, Wilhelmina Children' s Hospital, Utrecht (Netherlands); Wilhelmina Children' s Hospital, University Medical Centre, Department of Neonatology, KE 04.123.1, P.O. Box 85090, Utrecht (Netherlands); Groenendaal, Floris [University Medical Centre, Department of Neonatology, Wilhelmina Children' s Hospital, Utrecht (Netherlands)

2010-06-15

Enormous progress has been made in assessing the neonatal brain, using magnetic resonance imaging (MRI). In this review, we will describe the use of MRI and proton magnetic resonance spectroscopy in detecting different patterns of brain injury in (full-term) human neonates following hypoxic-ischaemic brain injury and indicate the relevance of these findings in predicting neurodevelopmental outcome. (orig.)

Risk factors associated with neonatal deaths: a matched case-control study in Indonesia.

Science.gov (United States)