MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Archives of Disease in Childhood - Fetal and Neonatal Edition' source. Thu, 09 Feb 2012 17:49:14 +0100 http://www.medworm.com/index.php?rid=5533603&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F1%2FF77-b%3Frss%3D1 With national reporting and benchmarking of perinatal outcomes, it is essential that the criteria used to detect cases of hypoxic ischaemic encephalopathy (HIE) are robust.The Neonatal Survey (TNS) is a validated survey collecting neonatal outcome data. Neonatal encephalopathy (NE) is used as a proxy measure of HIE; grade 2 NE cases require anticonvulsant therapy, grade 3 NE requiring either ventilation and anticonvulsant therapy (grade 3a) or ventilation following birth depression (grade 3b). Previous audits of the criteria suggest a false-positive rate of 10%.1Marked variations in the reported rates of HIE are seen in TNS, the rate in the Leeds Teaching Hospitals NHS Trust approaches six times that of other tertiary units. (Rate per 1000 live births (95% CI) 2007–2009, Leeds Hospit... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5533603 Tue, 13 Dec 2011 05:00:00 +0100 5533603 http://www.medworm.com/index.php?rid=5533602&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F1%2FF77-a%3Frss%3D1 The UK is now covered by separately commissioned neonatal transport services. This has required significant investment and it is essential that meaningful comparisons of activity levels, outcomes and value for money be made.The UK Neonatal Transport Interest Group devised a dataset in 2005 to compare transport teams. The major problem encountered was defining mutually exclusive categories of transfer. The terms ‘planned’ and ‘unplanned’ were agreed, with ‘time-critical’ added following publication of the Neonatal Toolkit.1 Unplanned/time-critical transfers are subject to scrutiny as part of the Neonatal Quality Standards.2 There is a wide variation between teams in the proportion of transfers that are classified as ‘unplanned’. In 2010, this ... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5533602 Tue, 13 Dec 2011 05:00:00 +0100 5533602 http://www.medworm.com/index.php?rid=5533601&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F1%2FF76-b%3Frss%3D1 Intravenous Ig (IVIg – polyclonal Ig) administration to neonates with Rhesus-mediated isoimmune haemolytic disease has been shown to decrease the need for exchange transfusion (number needed to treat=2.7).1 The use of IVIg as an adjuvant treatment for neonatal sepsis has been extensively studied. A 2010 Cochrane systematic review of this application in preterm (<37 weeks)/low birthweight (<2500 g) infants analysed the results of 19 studies involving 5000 infants. The authors concluded that IVIg administration resulted in a 3–4% reduction in sepsis or serious infection but was not associated with decreased morbidity or mortality.2 IVIg is postulated to interact and upregulate multiple immune function pathways. However, there is little research on neonatal immune function, ... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5533601 Tue, 13 Dec 2011 05:00:00 +0100 5533601 http://www.medworm.com/index.php?rid=5533600&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F1%2FF76-a%3Frss%3D1 Barzilay et al1 stated recently that oral ibuprofen is more effective than intravenous ibuprofen for patent ductus arteriosus (PDA) closure. They attribute this superiority to pharmacokinetics; maintaining therapeutic plasma levels over a longer time extending the drug's therapeutic effect.In an attempt to support their conclusion, they compare ibuprofen area under the curve (AUC) 0->24 generated by their study with data generated by two studies of intravenous ibuprofen.2 3 This explanation of oral ibuprofen superiority is problematic from several perspectives. First, none of the studies directly compared intravenous with oral ibuprofen. Thus, the data contrasts results obtained from different populations, using different study protocols and methodology. As such, there is no way to know... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5533600 Tue, 13 Dec 2011 05:00:00 +0100 5533600 http://www.medworm.com/index.php?rid=5533599&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F1%2FF75-c%3Frss%3D1 In responding to the article by Muller-Pebody and colleagues,1 Michael Hall and colleagues2 report that they use empiric cefotaxime monotherapy for suspected neonatal sepsis, contrary to the UK national guidelines, because they are concerned about aminoglycoside toxicity. They also state wrongly that the authors do not distinguish early- from late-onset sepsis.The concerns about aminoglycoside toxicity in neonates are largely theoretical, because there is virtually no evidence of normal aminoglycoside dosing causing significant hearing impairment in neonates.3 The recommendation against cefotaxime monotherapy is based on three factors: selection of resistant organisms, particularly extended-spectrum β-lactamase (ESBL) producing organisms, selection of organisms that are intrinsically ... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5533599 Tue, 13 Dec 2011 05:00:00 +0100 5533599 http://www.medworm.com/index.php?rid=5533598&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F1%2FF75-b%3Frss%3D1 The paper by Becher et al that analysed cases of unexpected collapse in previously healthy newborns reported to the British Paediatric Surveillance Unit over a 13 month period provides valuable information on the range of potentially lethal conditions in this age group that may remain unsuspected until collapse.1 Of concern was the high percentage (24/45; 53%) of cases identified where the episodes were attributed to airway obstruction associated with breast feeding, skin-to-skin or the prone position. While there is no denying the importance of breast feeding, it is equally important to recognise that situations may arise where certain infants may suffer lethal airway obstruction while feeding. This problem was reported a number of years ago now, not only in neonates in hospital but also ... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5533598 Tue, 13 Dec 2011 05:00:00 +0100 5533598 http://www.medworm.com/index.php?rid=5533597&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F1%2FF75-a%3Frss%3D1 ‘Empirical treatment of neonatal sepsis: are the current guidelines adequate?’1 makes recommendations for empirical antibiotic treatment of neonates based on voluntary surveillance data relating to blood culture isolates. The adverse effects of antibiotic treatment do not appear to have been considered and the recommendations do not differentiate between early and late sepsis.In 2010, the NPSA (National Patient Safety Agency) reported that, over a 1-year period, 507 incidents involving gentamicin treatment of neonates were notified,2 23 of which resulted in ‘moderate harm’ in the short term with additional possible longer-term adverse outcomes of cochlear or vestibular damage. It is also known that the m.1555A->G mutation occurs in a proportion of the population ... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5533597 Tue, 13 Dec 2011 05:00:00 +0100 5533597 http://www.medworm.com/index.php?rid=5533596&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F1%2FF70%3Frss%3D1 Does the clinical trials' evidence of benefit justify the routine use of probiotics in the preterm infant? There are many uncertainties surrounding the use of probiotics in the preterm, including the mechanism(s) of action of probiotics, knowledge of who benefits and who might not, whether it is placement of large numbers of bacteria into the small intestine or colonisation that determines efficacy, the forms of microbial adaptation(s) and ecological consequences. There is also a current lack of defined products with associated evidence of safety in the preterm infant. It is argued that one cannot assume safety because of a lack of evidence of harm and that one should take a precautionary approach to the introduction of probiotics into routine neonatal practice. One should also consider ho... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5533596 Tue, 13 Dec 2011 05:00:00 +0100 5533596 http://www.medworm.com/index.php?rid=5533595&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F1%2FF65%3Frss%3D1 Neonatal seizures are a distinct and not uncommon sign of neurological disease in the newborn, most often occurring in association with hypoxic-ischaemic encephalopathy at term. The diagnosis and monitoring of seizures in the newborn is a considerable challenge, with many suspected clinical seizures having no electrographic correlates, while many electrographic seizures have no clinical correlate. Continuous video-EEG is the gold standard for seizure monitoring, but few centres have the resources or expertise required. Amplitude-integrated EEG can be a helpful monitoring tool in experienced hands, but has potential for error when used by inexperienced staff. Automated seizure detection algorithms show much promise and some cotside systems are already available. The efficiency and accuracy ... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5533595 Tue, 13 Dec 2011 05:00:00 +0100 5533595 http://www.medworm.com/index.php?rid=5533594&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F1%2FF64%3Frss%3D1 Chlorhexidine gluconate 2.0% w/v aqueous solution (AquiHex 2%) was used to prepare the skin before umbilical catheter insertion soon after birth in a non-identical preterm twin born at 25+4 weeks gestation. Two hours later, the skin in the right iliac fossa, right flank, the periumbilical area, perineum and groin turned erythematous. Over the subsequent 6 h, the skin became pale (figure 1). The epithelium was lost in the affected areas, and the appearance was consistent with mixed-depth, partial-thickness burns. These injuries completely healed with conservative management over 4 weeks with no residual scarring. Interestingly, the other twin, who also needed umbilical catheter placement, did not develop any burns as the antiseptic solution was entirely wiped off with normal saline immediat... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5533594 Tue, 13 Dec 2011 05:00:00 +0100 5533594 http://www.medworm.com/index.php?rid=5533593&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F1%2FF62%3Frss%3D1 ConclusionsCo-infusion does not result in increased haemolysis, with total fHb significantly lower than currently accepted safe thresholds for fHb. Adherence to current guidelines may place undue restrictions on current transfusion practice in neonatal intensive care. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5533593 Tue, 13 Dec 2011 05:00:00 +0100 5533593 http://www.medworm.com/index.php?rid=5533592&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F1%2FF56%3Frss%3D1 ConclusionsThis study highlights areas of uncertainty and demonstrates marked variability in feeding practices. It provides valuable data for planning collaborative feeding trials to optimise outcome in preterm infants. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5533592 Tue, 13 Dec 2011 05:00:00 +0100 5533592 http://www.medworm.com/index.php?rid=5533591&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F1%2FF50%3Frss%3D1 ConclusionThis survey shows that diagnostic and therapeutic approaches to neonates with PHVD vary considerably. Uniform diagnostic criteria would facilitate studies to assess optimal timing and mode of intervention. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5533591 Tue, 13 Dec 2011 05:00:00 +0100 5533591 http://www.medworm.com/index.php?rid=5533590&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F1%2FF45%3Frss%3D1 ConclusionsThis retrospective study demonstrates that erythropoietin treatment is associated with an increase in the incidence of these benign vascular tumours after adjusting for all other factors. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5533590 Tue, 13 Dec 2011 05:00:00 +0100 5533590 http://www.medworm.com/index.php?rid=5533589&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F1%2FF39%3Frss%3D1 ConclusionsPDA ligation is well tolerated, with evidence of early benefit. The incidence of neurodisability or death from BPD at 1 year remains high. Increasing preoperative FiO2 and lack of prior treatment with COIs are associated with increased mortality at 1 year. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5533589 Tue, 13 Dec 2011 05:00:00 +0100 5533589 http://www.medworm.com/index.php?rid=5533588&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F1%2FF35%3Frss%3D1 ConclusionDuctal diameter and flow patterns are significantly associated, consistent with a narrowing of the ductus until closure. Overall, the two parameters are in good agreement but will result in different treatment decisions in some cases. Clinicians might consider using both methods as a cross check against each other, to assist in the management of preterm infants with a clinically detectable PDA. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5533588 Tue, 13 Dec 2011 05:00:00 +0100 5533588 http://www.medworm.com/index.php?rid=5533587&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F1%2FF30%3Frss%3D1 BackgroundSudden and unexpected postnatal collapse (SUPC) of a healthy newborn infant is a rare event, which carries a high risk of mortality and significant neurodisability in survivors. An underlying condition can be found in 60% of cases who undergo detailed postmortem but in the remainder there are important associations with prone position, breast feeding and primiparous status. The authors undertook a prospective study to ascertain the population incidence of SUPC in the UK.MethodsCases were referred through the British Paediatric Surveillance Unit reporting scheme over a 13-month period. Infants were at ≥37 weeks of gestation, had an Apgar score of ≥8 at 5 min, collapsed within 12 h in hospital requiring positive pressure ventilation and either died or received ongoing intensi... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5533587 Tue, 13 Dec 2011 05:00:00 +0100 5533587 http://www.medworm.com/index.php?rid=5533586&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F1%2FF24%3Frss%3D1 ConclusionTramadol was as effective as fentanyl for postoperative pain relief in neonates but does not appear to offer advantages over fentanyl regarding the duration of mechanical ventilation and time to reach full enteral feeding.Trial registrationNCT00713726 (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5533586 Tue, 13 Dec 2011 05:00:00 +0100 5533586 http://www.medworm.com/index.php?rid=5533585&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F1%2FF18%3Frss%3D1 ConclusionsHand expression in the early postpartum period appears to improve eventual breastfeeding rates at 2 months after birth compared with breast pumping, but further research is needed to confirm this. However, in circumstances where either pumping or hand expression would be appropriate for healthy term infants 12–36 h old feeding poorly, providers should consider recommending hand expression. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5533585 Tue, 13 Dec 2011 05:00:00 +0100 5533585 http://www.medworm.com/index.php?rid=5533584&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F1%2FF17%3Frss%3D1 A 36-year-old, gravida-3, para-2 presented with labour at the gestational age of 41 weeks. On admission, fetal monitoring was normal. It was discontinued for commodity, but after resuming (30 min later) there was significant fetal bradycardia. A rapid spontaneous vaginal delivery revealed meconium-stained amniotic fluid (grade III). No excessive fetal or placental blood loss was noted.A female baby was born with APGAR scores of 1, 2 and 4 after 1, 5 and 10 min, respectively. She was intubated and given colloids, epinephrine, bicarbonate and calcium. Placement of an umbilical vein catheter was not possible because of resistance during placement of the catheter. An umbilical arterial blood gas showed a pH of 6.8. The infant was transported to a tertiary referral centre.Upon arrival, the arte... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5533584 Tue, 13 Dec 2011 05:00:00 +0100 5533584 http://www.medworm.com/index.php?rid=5533583&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F1%2FF8%3Frss%3D1 ConclusionsUnadjusted and adjusted analyses showed that CA was significantly associated with BPD; however, the adjusted results were more conservative in the magnitude of association. The authors found strong evidence of publication bias. Despite a large body of evidence, CA cannot be definitively considered a risk factor for BPD. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5533583 Tue, 13 Dec 2011 05:00:00 +0100 5533583 http://www.medworm.com/index.php?rid=5533582&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F1%2FF4%3Frss%3D1 This article summarises both the process and changes.Changing guidelines via the ILCOR processRepresentatives of the American Heart Association, the European Resuscitation Council, the Heart and Stroke Foundation of Canada and the Resuscitation Council of South Africa founded the International Liaison Committee on Resuscitation (ILCOR) in 1992. Other organisations subsequently joined and in 1995 the task force of ILCOR established a neonatal subgroup. After the 2005 ILCOR publication,6 this subgroup became an... (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5533582 Tue, 13 Dec 2011 05:00:00 +0100 5533582 http://www.medworm.com/index.php?rid=5533581&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F1%2FF3%3Frss%3D1 Red blood cell (RBC) transfusions are an integral part of neonatal intensive care medicine.1 We recently reported that 14% of patients admitted to the Intermountain Healthcare neonatal intensive care units (NICUs) receive one or more RBC transfusions and that the average transfused neonate receives 2.4 RBC transfusions during their stay in the NICU.2When a transfusion is administered to a newborn infant, the intravenous tubing through which the donor cells are infused is temporarily dedicated to this sole purpose. Specifically, during the 3 or 4 h the donor cells are infusing, no medications or other intravenous fluids are co-infused into the same tubing. When a neonate with only one intravenous tube needs a transfusion, a concern about hypoglycaemia during the transfusion raises the quest... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5533581 Tue, 13 Dec 2011 05:00:00 +0100 5533581 http://www.medworm.com/index.php?rid=5533580&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F1%2FF2%3Frss%3D1 The routine separation of mothers and infants after delivery, a practice until recently very common in western midwifery and obstetric practice, may have significant negative effects on the establishment of normal mother–baby postnatal interactions, most importantly, the establishment of breast feeding.1 Recognition of the importance of close and direct contact between mothers and babies in the period immediately after delivery has led to the widespread adoption of the practice of ‘skin-to-skin’ care, in which the infant is placed naked and almost always prone directly onto the mother's chest very shortly after birth. The widely recognised potential benefits of early skin-to-skin contact, include improved prevalence and duration of breast feeding, improved maternal attach... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5533580 Tue, 13 Dec 2011 05:00:00 +0100 5533580 http://www.medworm.com/index.php?rid=5533579&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F97%2F1%2FF1%3Frss%3D1 Neonatal collapseIn November we published a paper on early neonatal sudden unexpected deaths1 that made reference to the anticipated publication of the British Paediatric Survey Unit (BPSU) study on unexpected collapses in neonates. We now have this report. Becher et al present the BPSU data, accompanied by both an editorial and a letter. Intriguingly, the size of the birth cohorts in each paper was very similar (828 648 and 858 466, respectively), the main differences being that Leow collated data from a relatively small area over 25 years, while Becher used the whole of the UK and Eire over 13 months; and Becher's data were on the first 12 h while Leow looked at the first week. These rare but important events need careful investigation as detailed in the guidance from the British Associa... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5533579 Tue, 13 Dec 2011 05:00:00 +0100 5533579 http://www.medworm.com/index.php?rid=5310902&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F6%2FF467%3Frss%3D1 Preterm neonates experience a large number of painful procedures during their stay in the neonatal intensive care units (NICUs) and these procedures are often not accompanied by satisfactory analgesia.1 2 Peripherally inserted central catheter (PICC) insertion is a painful intervention employed recurrently to provide a secure venous access.3–7 The aim of this study was to determine whether 25% oral glucose or EMLA cream was a better strategy for controlling pain in preterm neonates undergoing PICC insertion. A randomised, triple-masked controlled trial was conducted at two tertiary NICUs in the city of Belo Horizonte, Brazil. Participants included 30 preterm neonates (≥28 and <37 weeks of gestational age) during the first week of life with a clinical indication for PICC placeme... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5310902 Wed, 12 Oct 2011 04:00:00 +0100 5310902 http://www.medworm.com/index.php?rid=5310901&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F6%2FF461%3Frss%3D1 The breastfed infant with prolonged unconjugated hyperbilirubinaemia can present a vexing clinical dilemma. Although it is a frequently observed and usually benign finding, prolonged jaundice in the breastfed newborn requires a thoughtful evaluation that excludes possible pathological aetiologies. While recommendations for the treatment of unconjugated hyperbilirubinaemia in the first 7 days of life are straightforward, the approach to the breastfeeding infant with jaundice that persists beyond the immediate neonatal period is less clearly delineated. A sound understanding of bilirubin physiology and familiarity with current literature must guide the management of the otherwise well breastfeeding infant with prolonged unconjugated hyperbilirubinaemia. (Source: Archives of Disease in Childh... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5310901 Wed, 12 Oct 2011 04:00:00 +0100 5310901 http://www.medworm.com/index.php?rid=5310900&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F6%2FF457%3Frss%3D1 Heroin use in pregnancy is a worldwide problem. Methadone maintenance treatment has definite advantages for the mother and is currently recommended in the UK. There is, however, increasing evidence of adverse effects upon developing cortical and visual function in children of treated heroin-addicted mothers. The longer-term implications of this are not yet clear, and are confounded by poly-drug misuse and ongoing social deprivation. There is a paucity of evidence regarding outcome for infants who require pharmacological treatment for neonatal abstinence syndrome compared to those who have only mild symptoms. Well-controlled studies of the treatment of heroin misuse in pregnancy that take account of both neonatal and longer term outcomes for the child are urgently required. (Source: Archive... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5310900 Wed, 12 Oct 2011 04:00:00 +0100 5310900 http://www.medworm.com/index.php?rid=5310899&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F6%2FF453%3Frss%3D1 Defects of the NKX2-1 gene, encoding thyroid transcription factor-1, cause brain-thyroid-lung syndrome (MIM 610978), characterised by benign hereditary chorea, congenital hypothyroidism and respiratory disease. The case of a term infant with mild primary congenital hypothyroidism and neonatal persistent respiratory failure with fatal outcome at 10 months of age despite continuous ventilatory support is described. Congenital defects of genes known to disturb surfactant protein and lipid homeostasis (SFTPB, SFTPC, ABCA3) were excluded. Hypothyroidism prompted sequencing of NKX2-1, which revealed a heterozygous 29 bp deletion (c.278_306del29) disrupting the affected allele. Analysis of bronchoalveolar lavage fluid demonstrated an abnormally low amount of surfactant protein C (SP-C) in relatio... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5310899 Wed, 12 Oct 2011 04:00:00 +0100 5310899 http://www.medworm.com/index.php?rid=5310898&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F6%2FF450%3Frss%3D1 Conclusion It is possible to achieve high breastfeeding rates for very preterm infants, but rates varied widely across regions and neonatal units throughout Europe. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5310898 Wed, 12 Oct 2011 04:00:00 +0100 5310898 http://www.medworm.com/index.php?rid=5310897&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F6%2FF448%3Frss%3D1 A male infant born at 38+1 weeks' gestation by spontaneous vaginal delivery at a regional maternity hospital weighed 2860 g. No active resuscitation was required apart from gentle oropharyngeal suctioning. At 8 h of age, progressive respiratory distress with tachypnoea and subcostal retractions developed. Dyspnoea and desaturation persisted despite supplemental oxygen of 3 l/min in the incubator. Acute swelling of the upper thorax, neck and scalp were noted at 24 h of age. On arrival to the neonatal intensive care unit, there were no other significant abnormalities noted except for marked swelling and crepitus of the upper thorax, neck and scalp. The infant was placed on conventional mechanical ventilation with a fractional inspired oxygen of 60%. The initial chest anteroposterior (AP) rad... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5310897 Wed, 12 Oct 2011 04:00:00 +0100 5310897 http://www.medworm.com/index.php?rid=5310896&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F6%2FF443%3Frss%3D1 Conclusions Regional survival rates for ELBW infants have plateaued since the late 1990s, but the neurosensory outcome in survivors has improved in 2005. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5310896 Wed, 12 Oct 2011 04:00:00 +0100 5310896 http://www.medworm.com/index.php?rid=5310895&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F6%2FF440%3Frss%3D1 Early neonatal sudden unexpected unexplained deaths (for which we use the term ENSUD) have not been subject to detailed study. The authors investigated the incidence from 1983 to 2007 in the population of the North East of England and North Cumbria. The authors found 30 cases of unexplained ENSUD, giving an overall rate of 0.35/10 000 live births, with no significant change in incidence over this time, and they identified a further 19 deaths of abandoned babies. The authors conclude that unexplained ENSUD is even more rare than has been appreciated and its incidence has not been altered by the considerable changes in maternity care over the last 25 years. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5310895 Wed, 12 Oct 2011 04:00:00 +0100 5310895 http://www.medworm.com/index.php?rid=5310894&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F6%2FF434%3Frss%3D1 Conclusions This is the first trial to evaluate methods for transferring information from neonatal research into local policies and practice in England. An active approach to research dissemination is both feasible and cost-effective. Trial registration Current controlled trials ISRCTN89683698 (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5310894 Wed, 12 Oct 2011 04:00:00 +0100 5310894 http://www.medworm.com/index.php?rid=5310893&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F6%2FF429%3Frss%3D1 Conclusions A characteristic of the software algorithm reduces the frequency of saturations of 87–90% and increases the frequency of higher values returned by the Masimo SET Radical pulse oximeter. This effect, which remains within the recommended standards for accuracy, is removed by installing revised software (board firmware V4.8 or higher). Because this observation is likely to influence oxygen targeting, it should be considered in the analysis of the oxygen trial results to maximise their generalisability. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5310893 Wed, 12 Oct 2011 04:00:00 +0100 5310893 http://www.medworm.com/index.php?rid=5310892&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F6%2FF422%3Frss%3D1 Conclusion NIPPV pressure peaks only resulted in a small increase in relative tidal volumes when delivered during spontaneous inspiration. During apnoea pressure peaks occasionally resulted in chest inflation, which ameliorated oxygen desaturations. Infants did not become entrained with the NIPPV pressure changes. Synchronising every rise in applied pressure with spontaneous inspiration may increase the effectiveness of NIPPV and warrants investigation. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5310892 Wed, 12 Oct 2011 04:00:00 +0100 5310892 http://www.medworm.com/index.php?rid=5310891&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F6%2FF417%3Frss%3D1 Conclusion In neonatal pigs with asphyxia-induced cardiac arrest, the response to a C:V ratio of 15:2 is not better than the response to a C:V ratio of 3:1 despite better generation of DBP during resuscitation. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5310891 Wed, 12 Oct 2011 04:00:00 +0100 5310891 http://www.medworm.com/index.php?rid=5310890&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F6%2FF410%3Frss%3D1 Conclusion These results emphasise the importance of ongoing inflammation in the development of BPD; ETCO levels, rather than lung function test results, were the more accurate predictor of BPD development. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5310890 Wed, 12 Oct 2011 04:00:00 +0100 5310890 http://www.medworm.com/index.php?rid=5310889&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F6%2FF404%3Frss%3D1 Conclusions Preterm and full-term neonates show different patterns of associated brain lesions. Extensive white matter damage is the predominant pattern of injury in the preterm infant, while an IVH associated with a thalamic haemorrhage and punctate white matter lesions are more common in the full-term infant. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5310889 Wed, 12 Oct 2011 04:00:00 +0100 5310889 http://www.medworm.com/index.php?rid=5310888&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F6%2FF398%3Frss%3D1 Conclusions The number of confirmed cases of diagnosed congenital CMV reported in this study was lower than expected, highlighting the need for early and appropriate investigations when congenital infection is suspected. Due to the unexpectedly high proportion of preterm infants, resulting from differential case ascertainment, it was difficult to distinguish prematurity and CMV-related symptoms. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5310888 Wed, 12 Oct 2011 04:00:00 +0100 5310888 http://www.medworm.com/index.php?rid=5310887&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F6%2FF394%3Frss%3D1 Conclusions To date this is the largest study of its kind. CHD can be confidently diagnosed and excluded by remote FE. Radiographers report increased confidence and proficiency following involvement in real-time telemedicine. This application of telemedicine could improve access to fetal cardiology and support radiographers screening for CHD. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5310887 Wed, 12 Oct 2011 04:00:00 +0100 5310887 http://www.medworm.com/index.php?rid=5310886&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F6%2FF393%3Frss%3D1 Readers may have noticed that the impact factor for Fetal and Neonatal is now 3.13 – ahead of ADC on 2.6. The F&N figure has increased progressively from 2.05 in 2005. The F&N editorial team are rather pleased about this, but what does it mean, why should we care and why should our readers care? As Editors, we care because the increased impact factor means that we are publishing articles that are more frequently cited than before. This is a proxy for saying that the articles matter more to the medical/scientific community: they are in some sense more ‘important’, so the journal has become more influential among that community. We also care because authors who are employed by universities have the quality of their work assessed on the basis of the impact factors of... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5310886 Wed, 12 Oct 2011 04:00:00 +0100 5310886 http://www.medworm.com/index.php?rid=5310885&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F6%2FF392%3Frss%3D1 The recognition of congenital heart disease (CHD) during ‘routine’ obstetric anomaly scans continues to be a challenge. Recent national guidance has strengthened previous recommendations and advocated the incorporation of views of cardiac situs, four-chamber view and outflow tracts into such scans.1 An increasingly important question is how fetal cardiologists can best support district hospitals, first in terms of training and second to provide support if a cardiac abnormality is suspected. The article by McCrossan and colleagues in this month's journal2 provides an important contribution relating to the role of telemedicine in the delivery of a system for prenatal detection and management of CHD. These authors reported on several facets of the application of telemedicine in fe... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5310885 Wed, 12 Oct 2011 04:00:00 +0100 5310885 http://www.medworm.com/index.php?rid=5310884&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F6%2FF391%3Frss%3D1 Nasal intermittent positive pressure ventilation There is increasing use of non-invasive methods of respiratory support to help extremely preterm infants to be managed without endotracheal intubation and ventilation. In addition to nasal continuous positive airway pressure (CPAP), many units now use high flow nasal cannula oxygen therapy and various forms of nasal intermittent positive pressure ventilation (NIPPV). Despite their popularity there is little evidence that these modes of support offer advantages over CPAP in terms of important outcomes. Hopefully some of this uncertainty will be resolved by the large international randomised controlled trial of NIPPV that is in progress. Owen et al describe a mechanistic study of the effects of NIPPV on breathing and gas exchange. Non-synchron... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5310884 Wed, 12 Oct 2011 04:00:00 +0100 5310884 http://www.medworm.com/index.php?rid=5124452&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F5%2FF390-b%3Frss%3D1 Infection remains a major challenge in the care of sick newborn infants and its prevention through stringent hygiene measures is a cornerstone of good neonatal care. There are, however, few research data exploring the impact of infection control issues in the neonatal population. We conducted a national survey of neonatal units in England, Wales, Scotland and Northern Ireland to evaluate the impact of infection control issues. All units were contacted between July 2009 and February 2010. One hundred and ninety-eight neonatal units were identified, and 172 (87%) agreed to participate. Of these, 46 (26.7%) were network intensive care units (level 3), 83 (48.3%) were local neonatal units (level 2) and 43 (25%) were local special care units (level 1). Surgery was performed in 20 units (11.6%).... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5124452 Wed, 10 Aug 2011 23:00:00 +0100 5124452 http://www.medworm.com/index.php?rid=5124451&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F5%2FF390-a%3Frss%3D1 Measurement of accurate birth weights is essential for proper fluid management, drug dosing, growth assessment and categorisation of preterm infants. Weights measured on admission to neonatal units may include various items of attached equipment. These items have definite weights (table 1) which, if not taken into consideration, can result in a baby's recorded ‘birth weight’ being a significant overstimate of its actual birth weight. As an example, a baby of actual birth weight 982 g had an initially recorded weight on admission of 1060 g as measured in its amniotic fluid-containing polyethene bag (31 g) with attached equipment of hat (4.5 g), endotracheal tube and holder (10.5 g), SaO2 probe and wrap (26 g), nasogastric tube (3.0 g) and cord clamp (3.0 g). Failure to deduct th... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5124451 Wed, 10 Aug 2011 23:00:00 +0100 5124451 http://www.medworm.com/index.php?rid=5124450&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F5%2FF383%3Frss%3D1 Conclusions Many clinicians exhibited inadequate skills to resuscitate a newborn infant in a standard scenario. The neonatologists, as clinical experts, performed best in both technical and non-technical skills testing. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5124450 Wed, 10 Aug 2011 23:00:00 +0100 5124450 http://www.medworm.com/index.php?rid=5124449&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F5%2FF378%3Frss%3D1 In many industrialised countries, one in five women booking for antenatal care is obese. As well as affecting maternal health, maternal obesity may have important adverse consequences for fetal, neonatal and long-term health and well-being. Maternal obesity is associated with a higher risk of stillbirth, elective preterm birth and perinatal mortality. The incidence of severe birth defects, particularly neural tube and structural cardiac defects, appears to be higher in infants of obese mothers. Fetal macrosomia associated with maternal obesity and gestational diabetes predisposes infants to birth injuries, perinatal asphyxia and transitional problems such as neonatal respiratory distress and metabolic instability. Maternal obesity may also result in long-term health problems for offspring ... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5124449 Wed, 10 Aug 2011 23:00:00 +0100 5124449 http://www.medworm.com/index.php?rid=5124448&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F5%2FF377%3Frss%3D1 Subcutaneous fat necrosis (SFN) is a rare, self-limiting panniculitis mostly reported in infancy and childhood. Newborns and infants have a greater saturated to unsaturated fats ratio in their subcutaneous fat compared with older children and adults, causing an increased tendency to crystallise with cold stress.1 A full-term baby suffering hypoxic ischaemic encephalopathy (HIE) and treated with total body hypothermia is reported. SFN was first noted on physical examination at 35 h of life, presenting with a very painful erythema on the upper back area and evolving into firm erythematous nodules within a few days (figure 1). A spontaneous skin recovery was observed in the following weeks. Hypocalcaemia is the most commonly recognised metabolic complication of SFN.1 2 During the hospital sta... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5124448 Wed, 10 Aug 2011 23:00:00 +0100 5124448 http://www.medworm.com/index.php?rid=5124447&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F5%2FF374%3Frss%3D1 Whole-body deep hypothermia (DH) could be a new therapeutic strategy for asphyxiated newborn. Aim of this study was to describe how DH (core temperature 30–33°C) modifies the respiratory function if compared with mild hypothermia (MH; core temperature 33–34°C). This is an observational study. Results were obtained from a pilot study of safety of DH and topiramate in neonatal hypoxic-ischaemic encephalopathy. Fifty-seven newborns were enrolled: 29 patients in DH and 28 in MH. Recruitment criteria were moderate-severe hypoxic-ischaemic encephalopathy and gestational age ≥36 weeks. Mechanical ventilation was set to maintain SaO2 between 92% and 95%. Nineteen patients in DH and 18 in MH required mechanical ventilation. Of these patients, 10 and 12, respectively, did not ... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5124447 Wed, 10 Aug 2011 23:00:00 +0100 5124447 http://www.medworm.com/index.php?rid=5124446&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F5%2FF371%3Frss%3D1 Conclusions Early CPAP is feasible, shortens the duration of respiratory support and results in improved lung mechanics and decreased work of breathing. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5124446 Wed, 10 Aug 2011 23:00:00 +0100 5124446 http://www.medworm.com/index.php?rid=5124445&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F5%2FF365%3Frss%3D1 Conclusion Our pharmacokinetic data and bedside results suggest that a simplified schedule of vancomycin can achieve the targeted drug concentrations in most patients while avoiding secondary renal toxicity. The proposed new dosing scheme should be validated in a drug survey, but due to pharmacokinetic variability, still requires therapeutic drug monitoring. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5124445 Wed, 10 Aug 2011 23:00:00 +0100 5124445 http://www.medworm.com/index.php?rid=5124444&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F5%2FF360%3Frss%3D1 Conclusion By classifying CNS malformations according to the neuropathological analysis, the authors show that the timing and prevalence of pregnancy termination are distributed in a manner that is consistent with what is currently known on the development of brain. They are also influenced by the French prenatal screening policy and the variable expressivity of the brain malformations and associated lesions. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5124444 Wed, 10 Aug 2011 23:00:00 +0100 5124444 http://www.medworm.com/index.php?rid=5124443&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F5%2FF359%3Frss%3D1 On the fifth day of life, a 26-week male infant developed progressive abdominal and scrotal distension. Whitish discoloration of the scrotal skin raised suspicion of extravasation of lipid-containing parenteral nutrition solution (total parenteral nutrition (TPN)). A contrast study through the umbilical venous catheter (UVC) confirmed vessel perforation with intraperitoneal spill (figure 1). High-resolution ultrasonography (17 MHz transducer) showed ascites and a communicating right-sided hydrocoele. Colour Doppler revealed hyperaemia of the right spermatic cord, epididymis and testicle. Coagulase-negative staphylococci (CONS) were cultured from the UVC tip. The hydrocoele increased (figure 2) and turned out to be non-communicating. The evacuating puncture fluid was chyle-like and grew CON... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5124443 Wed, 10 Aug 2011 23:00:00 +0100 5124443 http://www.medworm.com/index.php?rid=5124442&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F5%2FF355%3Frss%3D1 Conclusions A considerable number of cerebral ultrasound abnormalities were observed in a cohort of infants born to mothers with autoimmune disease. However, no perinatal factors were significantly associated with this finding, suggesting the fetal brain impairment had a multi-factorial aetiology. Although no case of neuromotor delay was observed, long term neurological assessment of these babies is recommended in view of the cognitive impairment reported in previous studies. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5124442 Wed, 10 Aug 2011 23:00:00 +0100 5124442 http://www.medworm.com/index.php?rid=5124441&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F5%2FF348%3Frss%3D1 Conclusions Short stature at 5 years of age is common in children born preterm. The highest incidence was observed in the group with ex utero GR. Systemic steroids have a long-term impact on growth and should be used with caution. Breastfeeding at discharge appeared to be protective. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5124441 Wed, 10 Aug 2011 23:00:00 +0100 5124441 http://www.medworm.com/index.php?rid=5124440&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F5%2FF343%3Frss%3D1 Conclusions Medical history or initial blood gas values are poor predictors of subsequent nCPAP failure. A threshold FiO2 of ≥0.35–0.45 compared to ≥0.6 for intubation would shorten the time to surfactant delivery without a relevant increase in intubation rate. An individualised approach with a trial of early nCPAP and prompt intubation and surfactant treatment at low thresholds may be the best approach in very low birthweight infants. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5124440 Wed, 10 Aug 2011 23:00:00 +0100 5124440 http://www.medworm.com/index.php?rid=5124439&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F5%2FF342%3Frss%3D1 A 36-year-old primipara had previously undergone removal of the cervix for cancer. She conceived following in-vitro fertilisation. Because of her previous cervical surgery, she underwent cervical circlage. At 20 weeks' gestation, the circlage sutures became infected and the membranes ruptured. She developed increasing evidence of infection and hence a decision was made to remove the sutures at 24 weeks. The night before the planned procedure, she delivered a female infant spontaneously. The baby was resuscitated and transferred to neonatal intensive care. A laceration of the scalp was apparent on the left parieto-occipital region, measuring around 5 cm x 5 cm (figure 1). It was initially thought to be due to the baby being delivered through the sutures, but on later review was thought to h... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5124439 Wed, 10 Aug 2011 23:00:00 +0100 5124439 http://www.medworm.com/index.php?rid=5124438&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F5%2FF339%3Frss%3D1 Conclusion The SpO2 reference range can be used as an easy and practical guide to compare SpO2 profiles of infants on home oxygen therapy and guide their oxygen therapy. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5124438 Wed, 10 Aug 2011 23:00:00 +0100 5124438 http://www.medworm.com/index.php?rid=5124437&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F5%2FF335%3Frss%3D1 Conclusions Desaturation events to <80% SpO2 were rare in our sample of healthy term neonates during their first 5 days of life. Analysis of SIQ alone could be a quick and simple alternative to traditional analysis of PW. The presented reference values may be used for clinical decision making. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5124437 Wed, 10 Aug 2011 23:00:00 +0100 5124437 http://www.medworm.com/index.php?rid=5124436&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F5%2FF329%3Frss%3D1 Conclusions This study has shown an improvement in survival to discharge in babies admitted for neonatal care. However, this improved survival has been associated with an increase in the proportion of children with at least one severe disability at a corrected age of 2 years. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5124436 Wed, 10 Aug 2011 23:00:00 +0100 5124436 http://www.medworm.com/index.php?rid=5124435&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F5%2FF321%3Frss%3D1 Conclusions In this large cohort of extremely low gestational age newborns, we found little evidence that early postnatal hypotension indicators are associated with developmental delay at 24 months corrected gestational age. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5124435 Wed, 10 Aug 2011 23:00:00 +0100 5124435 http://www.medworm.com/index.php?rid=5124434&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F5%2FF318%3Frss%3D1 Twin-to-twin transfusion (TTTS) syndrome complicates approximately 10–15% of all monochorionic twin pregnancies. The pathogenesis of this condition is primarily placental in origin, with unidirectional arteriovenous anastomoses being implicated in the development of the condition and secondary fetoplacental endocrine disturbance compounding the clinical presentation. If untreated, this condition ends in pregnancy loss in over 90% of cases by 26 weeks, and survivors have high rates of neurodevelopmental delay. Fetoscopic laser ablation is the treatment of choice in severe TTTS and increases perinatal survival significantly, while reducing long-term neurodevelopmental morbidity in childhood survivors. Such monochorionic twin pregnancies though, even after ‘successful therapy&rsqu... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5124434 Wed, 10 Aug 2011 23:00:00 +0100 5124434 http://www.medworm.com/index.php?rid=5124433&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F5%2FF316%3Frss%3D1 Do extremely immature preterm infants with blood pressure which is believed to be low have reduced systemic perfusion, reduced cerebral oxygen delivery, increased cerebral injury, an increase in acute complications of prematurity and an increase in long-term disability? If so, below what value of blood pressure do these adverse outcomes increase? These unanswered questions are of vital importance; extremely preterm infants have high rates of developmental delay and disability, blood pressures are often numerically very low and many preterm infants receive treatments which are potentially toxic with the goal of increasing their blood pressure. Unfortunately, it is not at all clear whether the common treatments for low blood pressure improve systemic flow or cerebral perfusion, or among the ... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5124433 Wed, 10 Aug 2011 23:00:00 +0100 5124433 http://www.medworm.com/index.php?rid=5124432&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F5%2FF314%3Frss%3D1 The data presented by Rattihalli et al1 on the evolution of health outcomes for babies born before 26 weeks gestation in the Trent region show rising survival rates (27–46%) between 1991–1993 and 2001–2003 accompanied by a slightly increased probability of severe disability among survivors (35–39%). These results raise multiple questions: Why were there such large gains in survival but no improvement in impairment rates? Can these results be used to draw conclusions about trends in outcome in other regions of Europe or in the USA? How can these data be used to guide clinical decisions for these infants whose probability of being severely disabled is over 1 in 3? Trying to contextualise these findings using the available scientific literature is daunting. There is co... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5124432 Wed, 10 Aug 2011 23:00:00 +0100 5124432 http://www.medworm.com/index.php?rid=5124431&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F5%2FF313%3Frss%3D1 Normal blood pressure... One day we may abandon measuring blood pressure in favour of direct ascertainment of brain perfusion or oxygenation. Until that day arrives, we will need to interpret measurements of blood pressure while knowing that it does not reflect more important parameters such as cardiac output. As long as we do this, we will need thresholds at which we treat babies' hypotension, and one way of establishing these thresholds is to try to relate early blood pressure to later neurodevelopmental status. As Logan et al point out, the existing literature is contradictory on the relationship between blood pressure measured in early life and later neurodevelopmental outcome, but the authors fail to show any convincing relationship between hypotension and subsequent developmental del... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=5124431 Wed, 10 Aug 2011 23:00:00 +0100 5124431 http://www.medworm.com/index.php?rid=4932403&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F4%2FF312-b%3Frss%3D1 The letter by Kang SL, Tobin S, Kelsall W "Neonatal pulse oximetry screening: A national survey" (Arch Dis Child Fetal Neonatal Ed 2011;4:F312) is based on the same data as an article by the same authors and with the same title published in manuscript form in Acta Paediatrica on 15 February 2011 doi: 10.1111/j.1651-2227.2011.02200.x. The Acta Paediatrica paper has been retracted. The article was submitted to ADC before the paper was submitted to Acta Paediatrica. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4932403 Sat, 11 Jun 2011 23:00:00 +0100 4932403 http://www.medworm.com/index.php?rid=4932402&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F4%2FF312-a%3Frss%3D1 The newborn examination is a universally accepted method to screen for congenital heart disease (CHD); however, failure of detection has been estimated to be in excess of 25%.1 Antenatally, only 23.4% of CHD is diagnosed by obstetric ultrasound screening with variable diagnostic rates nationally.2 Recent studies have reported improved detection rates with the use of pulse oximetry (PO) and demonstrated the cost-effectiveness of such screening.3 4 We surveyed the practice of PO as a part of routine neonatal examination in hospitals across the UK. Methods All hospitals with delivery units were contacted by telephone. A standardised questionnaire was used to establish whether PO was performed on all newborns before discharge, what screening protocol was used and subsequent management if an ab... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4932402 Sat, 11 Jun 2011 23:00:00 +0100 4932402 http://www.medworm.com/index.php?rid=4932401&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F4%2FF311%3Frss%3D1 A commissioned commentary by Millar et al1 and a recent statement from the American Academy of Pediatrics2 complain about the lack of defined probiotic products that are licensed by regulatory authorities. A commercially available combination of Lactobacillus acidophilus and Bifidusbacterium infantis (Infloran), given to a total of 1725 preterm infants within the framework of two open-label and two randomised controlled trials without side effects,3 has been shown to reduce necrotising enterocolitis (NEC) and mortality in preterm infants, without negative effects in surviving infants studied at 3 years of age.4 This probiotic is licensed by SwissMedic, the Swiss Agency for Therapeutic Products of the Federal Office of Public Health in Switzerland (#00679), as a drug for use in infants with... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4932401 Sat, 11 Jun 2011 23:00:00 +0100 4932401 http://www.medworm.com/index.php?rid=4932400&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F4%2FF310-b%3Frss%3D1 We present results of a nationwide prospective study conducted in collaboration with the Swiss Federal Office for Public Health and the Swiss Paediatric Surveillance Unit (SPSU). Data for all newborn patients ≥35 0/7 weeks of gestational age (GA) born between 1 January 2007 and 31 December 2008 with at least one value of total serum bilirubin (TSB) exceeding the upper limit of exchange transfusion (ET) were included. ET limits are defined as 430 µmol/l for healthy term infants; 370 µmol/l for sick term infants or term infants with haemolysis and 320 µmol/l for preterm infants.1 A check-off form asking for neonates hospitalised with severe hyperbilirubinaemia and a detailed questionnaire were sent to all neonatal and paediatric units in Switzerland to gather clinical da... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4932400 Sat, 11 Jun 2011 23:00:00 +0100 4932400 http://www.medworm.com/index.php?rid=4932399&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F4%2FF310-a%3Frss%3D1 We thank Ahmed and colleagues for adding a substantial number of new cases of vitamin D deficiency to the literature.1 Despite earlier omissions, the 2008 version of the National Institute for Health and Clinical Excellence antenatal guideline2 suggests that all women should be informed at the booking appointment about the importance of maintaining adequate vitamin D stores during pregnancy and the breastfeeding period. Further, it specifies certain characteristics that would place women into a high-risk category for vitamin D deficiency. This guideline has been adopted by our institution (St Mary's Hospital, Manchester, UK). In addition, the Department of Health (DH) recommends supplementation of children with vitamin D to the age of 5.3 After appropriate approval, we undertook a prospect... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4932399 Sat, 11 Jun 2011 23:00:00 +0100 4932399 http://www.medworm.com/index.php?rid=4932398&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F4%2FF305%3Frss%3D1 Preterm infants in the neonatal intensive care unit (NICU) are constantly exposed to ambient noise that often exceeds recommended levels. There is a growing concern that such noise puts preterm infants at high risk for adverse health effects. This review looks at the effects of NICU noise on the cardiovascular, respiratory, auditory and nervous systems. Loud transient noise has negative short-term effects on the cardiovascular and respiratory systems of preterm infants, although direct evidence linking noise to neonatal pathology is still unclear. Further controlled trials with larger sample sizes are needed to determine the effects of more extensive exposure to NICU noise on early brain maturation and long-term developmental outcomes. (Source: Archives of Disease in Childhood - Fetal and ... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4932398 Sat, 11 Jun 2011 23:00:00 +0100 4932398 http://www.medworm.com/index.php?rid=4932397&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F4%2FF301%3Frss%3D1 Historically, the investigation of a neonate at risk of Rhesus D antigen (RhD)-associated haemolytic disease has included a direct antiglobulin test on umbilical cord blood. However, the introduction of routine antenatal anti-RhD prophylaxis has led to a significant number of false positive results and recent studies suggest that a positive cord blood direct antiglobulin test is poorly predictive of subsequent hyperbilirubinaemia. The British Committee for Standards in Haematology guidelines now recommend that a direct antiglobulin test should no longer be performed routinely on umbilical cord blood in infants born to RhD-negative mothers. We review the recent changes in antenatal management of RhD-negative mothers and their impact on the neonatal presentation of RhD-associated haemolytic ... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4932397 Sat, 11 Jun 2011 23:00:00 +0100 4932397 http://www.medworm.com/index.php?rid=4932396&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F4%2FF299%3Frss%3D1 Interleukin 18 (IL-18) is an important cytokine and involved in the pathogenesis and genetics of many diseases. The authors studied two different populations of preterm infants to test whether polymorphisms within IL-18 are in association with prematurity itself or with typical pulmonary disease or measurements seen in preterm infants, such as bronchopulmonary dysplasia, pneumothoraces and application of surfactant, inhalation or mechanical ventilation. Whereas the first population of 228 preterm infants showed strong association of IL-18 with preterm birth (p<0.001), this was not confirmed in the second population of 346 preterm infants. In addition, no association with any lung condition of prematurity was observed. The authors conclude that IL-18 does not play an important role in th... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4932396 Sat, 11 Jun 2011 23:00:00 +0100 4932396 http://www.medworm.com/index.php?rid=4932395&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F4%2FF298%3Frss%3D1 A baby girl born at 26 weeks' gestation with a birth weight of 760 g was ventilated for respiratory distress syndrome of prematurity and made good progress until day 10 postnatally, when she developed a bluish macule on her left leg with surrounding erythema which gradually developed into a necrotic lesion with yellowish discharge (figure 1). At the same time, she became clinically unwell with signs of generalised septicaemia with raised inflammatory markers. The associated knee joint was also swollen, but serial x-rays and ultrasound did not show evidence of arthritis or osteomyelitis. Blood culture and local pus swabs grew Pseudomonas. She was treated with ceftazidime for 3 weeks after which the skin lesion healed completely (figure 2). Pseudomonas aeruginosa, a non-fermentative, gram-ne... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4932395 Sat, 11 Jun 2011 23:00:00 +0100 4932395 http://www.medworm.com/index.php?rid=4932394&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F4%2FF296%3Frss%3D1 Congenital varicella syndrome (CVS) is a rare but deleterious consequence of primary varicella zoster virus (VZV) infection during pregnancy. Typical CVS stigmata are cerebral abnormalities, eye diseases and segmentally distributed, cicatricial skin lesions. In this paper the authors report on a male preterm infant, born at 30 weeks of gestation, who developed pustular skin lesions at the age of 4 weeks. The mother had suffered from chickenpox at 14 weeks of gestation. Apart from skin manifestations, critical bronchopulmonary dysplasia made the infant conspicuous. The VZV genome was detected in blood, respiratory secretions and skin lesions. At age 10 weeks he presented with extensive intestinal wall perforation, considered to be related to CVS, which finally led to death. This case shows ... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4932394 Sat, 11 Jun 2011 23:00:00 +0100 4932394 http://www.medworm.com/index.php?rid=4932393&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F4%2FF290%3Frss%3D1 Conclusions Among all drugs described as nephrotoxic in very preterm infants, ibuprofen alone proved to be nephrotoxic in this study for a 1-month span follow-up. If GFR is lower than the median reference value on day 7 after ibuprofen infusion, physicians should keep in mind that glomerular clearance of drugs may stay decreased for the first month of life. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4932393 Sat, 11 Jun 2011 23:00:00 +0100 4932393 http://www.medworm.com/index.php?rid=4932392&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F4%2FF286%3Frss%3D1 Conclusion Recommendations for intravenous vitamin A supplementation in parenterally fed preterm infants require revision. Intravenous lipid with added fat soluble vitamins should be started as soon as possible after birth, and consideration given to early oral vitamin A supplementation in those infants tolerant of enteral feeds. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4932392 Sat, 11 Jun 2011 23:00:00 +0100 4932392 http://www.medworm.com/index.php?rid=4932391&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F4%2FF281%3Frss%3D1 Conclusions Extensive CBH in preterm infants is rare and devastating. It appears to be confined to very preterm, extremely low birthweight infants and may have a male predominance. The co-existence of severe IVH and extensive CBH on routine cot-side cUS in the early neonatal period is an ominous finding. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4932391 Sat, 11 Jun 2011 23:00:00 +0100 4932391 http://www.medworm.com/index.php?rid=4932390&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F4%2FF275%3Frss%3D1 Conclusions CRIB score retains its predictive ability for mortality in VLBW babies. Early hyperlactataemia is a predictor of death in VLBW babies. The new score appears to perform as well as CRIB but requires fewer data items. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4932390 Sat, 11 Jun 2011 23:00:00 +0100 4932390 http://www.medworm.com/index.php?rid=4932389&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F4%2FF270%3Frss%3D1 Conclusion In prematurely born infants, routinely exposed to antenatal steroids and postnatal surfactant, chorioamnionitis was not associated with worse lung function or more severe BPD. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4932389 Sat, 11 Jun 2011 23:00:00 +0100 4932389 http://www.medworm.com/index.php?rid=4932388&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F4%2FF265%3Frss%3D1 Conclusion In ventilated infants, invasive and non-invasive measurements of the TTI could provide an accurate prediction of extubation outcome. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4932388 Sat, 11 Jun 2011 23:00:00 +0100 4932388 http://www.medworm.com/index.php?rid=4932387&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F4%2FF263%3Frss%3D1 A 1-month-old child was referred to our department for numerous cutaneous infantile haemangiomas (figure 1). Two weeks later, he developed a stridor during breast feeding. The laryngeal dyspnoea was investigated by an endoscopic examination (figure 2). Propranolol was then started. The cutaneous haemangiomas regressed rapidly (figure 3). Endoscopy at 2 months showed a regression of the laryngeal haemangioma (figure 4). The baby was treated for 8 months. The treatment was well tolerated and induced no side effects. At 18 months, the haemangiomas are stable. Haemangiomas are present in 10% of children under the age of 1 year. They are proliferative vascular lesions due to an accelerated turnover of endothelial cells. Angiogenesis factors, such as fibroblast growth factor-β or vascular e... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4932387 Sat, 11 Jun 2011 23:00:00 +0100 4932387 http://www.medworm.com/index.php?rid=4932386&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F4%2FF259%3Frss%3D1 Conclusion This study has implications for prevention in terms of contraception and appropriate targeting of vulnerable women. It encourages the development of case–control studies on maternal risk factors within the framework of the French birth cohort currently being established. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4932386 Sat, 11 Jun 2011 23:00:00 +0100 4932386 http://www.medworm.com/index.php?rid=4932385&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F4%2FF258%3Frss%3D1 We present a rare case of a congenital lingual teratoma found antenatally by fetal ultrasound. A 25-year-old pregnant patient was seen at our Fetal Medicine Unit at 21 weeks' gestation with a fetal anomaly. A 19 mm mass was visible in the mouth of the fetus on ultrasound. The mass consisted of two distinct cystic components (figure 1) which occupied the entire oral cavity. No other abnormalities were seen. The patient was followed up with regular ultrasound scans. The fetus was seen to have sucking movement and absence of polyhydramnios suggested intact swallowing, but there was concern about airway obstruction after birth. A female infant was delivered at 38 weeks by elective caesarean section with normal Apgar scores. An ENT surgeon was present for emergency airway management but this wa... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4932385 Sat, 11 Jun 2011 23:00:00 +0100 4932385 http://www.medworm.com/index.php?rid=4932384&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F4%2FF254%3Frss%3D1 Conclusion Airway obstruction and face-mask leak are common during the first 2 min of PPV. An RFM enables detection of important airway obstruction and mask leak. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4932384 Sat, 11 Jun 2011 23:00:00 +0100 4932384 http://www.medworm.com/index.php?rid=4932383&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F4%2FF249%3Frss%3D1 Conclusions These study's results demonstrate no acute physiological benefit of transfusion in the high haematocrit group. The fall in cardiac output with transfusion in the low haematocrit group shows that these infants had increased their cardiac output to maintain adequate tissue oxygen delivery in response to anaemia and, therefore, may have benefitted from transfusion. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4932383 Sat, 11 Jun 2011 23:00:00 +0100 4932383 http://www.medworm.com/index.php?rid=4932382&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F4%2FF243%3Frss%3D1 Conclusions Surfactant can be effectively delivered via a vascular catheter, and this method of MIST deserves further investigation. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4932382 Sat, 11 Jun 2011 23:00:00 +0100 4932382 http://www.medworm.com/index.php?rid=4932381&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F4%2FF241%3Frss%3D1 In a BBC programme, File on Four,1 the Manchester Coroner advocated a more consistent approach to the investigation of neonatal deaths and, to obtain a consistent view of what is happening, cited his own practice of requesting notification of all deaths of babies and young children in his area. However, this could only ever represent a proportion of perinatal deaths: stillbirths are only subject to coroner's investigation in exceptional circumstance (approximately 0.5%).2 So, are perinatal deaths so poorly scrutinised that they require a coroner's oversight on a routine basis? Indeed, what constitutes adequate scrutiny? Perinatal death scrutiny might be considered to occur at two levels. First, individual case review might reasonably answer questions posed by parents and clinicians. One w... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4932381 Sat, 11 Jun 2011 23:00:00 +0100 4932381 http://www.medworm.com/index.php?rid=4932380&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F4%2FF238%3Frss%3D1 Since the introduction of surfactant into the treatment of respiratory distress syndrome (RDS) in preterm infants, the immense importance of this substance has become clear. Nothing has led to a greater increase in survival and a greater decrease in long-term sequelae in preterm infants.1 Some reviews of the body of literature on this subject have demonstrated that early or prophylactic administration of surfactant is more beneficial than late (rescue) therapy.2 3 Therefore, a policy of intubation, mechanical ventilation and surfactant administration has become an accepted standard for the therapy of infants at high risk of RDS in large parts of the world. In some regions, however, especially in Scandinavia, a strategy with stabilisation of preterm infants with continuous positive airway p... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4932380 Sat, 11 Jun 2011 23:00:00 +0100 4932380 http://www.medworm.com/index.php?rid=4932379&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F4%2FF236%3Frss%3D1 In June 2010, the Royal College of Obstetricians and Gynaecologists (RCOG) published Fetal Awareness – Review of Research and Recommendations for Practice.1 The College's purpose was to update their 1997 publication2 in the light of more recent evidence, and also to provide "information for women and parents". Although they use the term ‘fetal awareness’, both publications predominantly address the issue of whether or not the fetus feels pain, and at what gestational ages this might be so. The conclusions of the summary of the evidence review are set out in box 1, and the main practice points derived from this are set out in box 2. The report caused a considerable furore in the media, where it was widely portrayed as being a political rather than a scientific document tha... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4932379 Sat, 11 Jun 2011 23:00:00 +0100 4932379 http://www.medworm.com/index.php?rid=4932378&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F4%2FF235%3Frss%3D1 Fetal awareness and fetal pain Few involved in the care of extremely preterm infants born at the limits of viability would doubt their capacity to experience discomfort in some way even though it is impossible to relate this meaningfully to all of the dimensions of pain in older children and adults. In a provocative editorial Martin Ward Platt discusses fetal pain and awareness prior to 24 weeks gestation in relation to the evidence review on the subject that was published by the Royal College of Obstetricians and Gynaecologists in 2010. See page F236 Minimally invasive surfactant therapy Following several influential randomised controlled trials, many more preterm infants are now managed with CPAPas their primary respiratory support without first being intubated and given prophylactic sur... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4932378 Sat, 11 Jun 2011 23:00:00 +0100 4932378 http://www.medworm.com/index.php?rid=4708707&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F3%2FF234%3Frss%3D1 (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4708707 Mon, 11 Apr 2011 23:00:00 +0100 4708707 http://www.medworm.com/index.php?rid=4708706&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F3%2FF233%3Frss%3D1 (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4708706 Mon, 11 Apr 2011 23:00:00 +0100 4708706 http://www.medworm.com/index.php?rid=4708705&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F3%2FF225%3Frss%3D1 Although survival rates for preterm infants have greatly improved over the last three to four decades, these infants remain at risk of developing a broad range of short-term and long-term complications. Despite the large body of work on the clinical sequelae of preterm birth, relatively little is known about its economic consequences. This paper represents a structured review of the recent scientific literature on the economic consequences of preterm birth for the health services, for other sectors of the economy, for families and carers and, more broadly, for society. A total of 2497 studies were identified by a pretested literature search strategy, 52 of which were included in the final review. Of these 52 studies, 19 reported the costs associated with the initial period of hospitalisati... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4708705 Mon, 11 Apr 2011 23:00:00 +0100 4708705 http://www.medworm.com/index.php?rid=4708704&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F3%2FF223%3Frss%3D1 We report on a preterm infant with neonatal diabetes who had profound hypoglycaemia in response to bolus subcutaneous insulin therapy, but in whom we used the combination of continuous glucose monitoring and insulin pump therapy to manage glucose control in the neonatal period, and who was discharged home on pump therapy. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4708704 Mon, 11 Apr 2011 23:00:00 +0100 4708704 http://www.medworm.com/index.php?rid=4708703&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F3%2FF217%3Frss%3D1 Conclusions The lower D3WL in formula-fed neonates, especially in neonates of obese mothers, suggests a relative overfeeding in the early days compared with breastfed neonates, which may potentially have consequences on later health. Overweight and obese mothers may need extra support to prevent early breastfeeding discontinuation. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4708703 Mon, 11 Apr 2011 23:00:00 +0100 4708703 http://www.medworm.com/index.php?rid=4708702&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F3%2FF212%3Frss%3D1 Conclusions Because the live-birth prevalence of CL±P decreased, that of all oral clefts decreased. These findings are in line with both hypotheses and may therefore have implications for prenatal counselling and folic acid policy. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4708702 Mon, 11 Apr 2011 23:00:00 +0100 4708702 http://www.medworm.com/index.php?rid=4708701&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F3%2FF206%3Frss%3D1 Conclusions Repeatability of USCOM measures is high in newborn infants. New users can be trained quickly, but with high inter-user variability. Agreement between USCOM and conventional ECHO is broad, and worse for RVO and LVO. Further studies are required to assess the ability of the device to detect clinically significant changes in infant cardiac output. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4708701 Mon, 11 Apr 2011 23:00:00 +0100 4708701 http://www.medworm.com/index.php?rid=4708700&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F3%2FF201%3Frss%3D1 Conclusion During 3-min periods of mask ventilation on a manikin, VDMV produced the least variation in delivered ventilation. SIB produced wide variation and unacceptably high TV and MV in experienced hands. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4708700 Mon, 11 Apr 2011 23:00:00 +0100 4708700 http://www.medworm.com/index.php?rid=4708699&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F3%2FF200%3Frss%3D1 (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4708699 Mon, 11 Apr 2011 23:00:00 +0100 4708699 http://www.medworm.com/index.php?rid=4708698&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F3%2FF195%3Frss%3D1 Conclusions Two-person mask ventilation technique reduces mask leak by approximately 50% compared to the standard one-person mask ventilation method. NP mask ventilation has higher mask leak than Laerdal SIB for both single- and two-person technique mask ventilation. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4708698 Mon, 11 Apr 2011 23:00:00 +0100 4708698 http://www.medworm.com/index.php?rid=4708697&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F3%2FF190%3Frss%3D1 Conclusion Minidex therapy facilitates extubation and is not associated with clinically significant short-term side effects. A randomised controlled trial is required to further assess efficacy and long-term outcomes. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4708697 Mon, 11 Apr 2011 23:00:00 +0100 4708697 http://www.medworm.com/index.php?rid=4708696&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F3%2FF186%3Frss%3D1 Conclusions The introduction of the DRG system in Germany has affected the distribution of admission weights of premature infants. Potential reasons for this effect including upcoding are discussed. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4708696 Mon, 11 Apr 2011 23:00:00 +0100 4708696 http://www.medworm.com/index.php?rid=4708695&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F3%2FF178%3Frss%3D1 Conclusion There was no evidence of an increased rate of disability despite improved survival rates over the two time periods. The rate of blindness decreased, probably reflecting earlier treatment of retinopathy of prematurity. This study demonstrates that although follow-up remains a challenge, rates of over 90% are achievable. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4708695 Mon, 11 Apr 2011 23:00:00 +0100 4708695 http://www.medworm.com/index.php?rid=4708694&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F3%2FF177%3Frss%3D1 (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4708694 Mon, 11 Apr 2011 23:00:00 +0100 4708694 http://www.medworm.com/index.php?rid=4708693&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F3%2FF169%3Frss%3D1 Conclusions Increased survival of infants with a birth weight ≤750 g coincided with more children with an impaired NDO at 2 years corrected age. SGA infants are especially at risk of impaired NDO. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4708693 Mon, 11 Apr 2011 23:00:00 +0100 4708693 http://www.medworm.com/index.php?rid=4708692&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F3%2FF164%3Frss%3D1 Conclusions Prophylactic nystatin and fluconazole reduce the incidence of colonisation and invasive fungal infection in VLBW neonates. The authors believe that nystatin is an alternative to fluconazole, because nystatin is safe, inexpensive, well tolerated and effective. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4708692 Mon, 11 Apr 2011 23:00:00 +0100 4708692 http://www.medworm.com/index.php?rid=4708691&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F3%2FF160%3Frss%3D1 (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4708691 Mon, 11 Apr 2011 23:00:00 +0100 4708691 http://www.medworm.com/index.php?rid=4708690&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F3%2FF158%3Frss%3D1 (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4708690 Mon, 11 Apr 2011 23:00:00 +0100 4708690 http://www.medworm.com/index.php?rid=4708689&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F3%2FF157%3Frss%3D1 (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4708689 Mon, 11 Apr 2011 23:00:00 +0100 4708689 http://www.medworm.com/index.php?rid=4464087&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F2%2FF156%3Frss%3D1 (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4464087 Thu, 10 Feb 2011 00:00:00 +0100 4464087 http://www.medworm.com/index.php?rid=4464086&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F2%2FF151%3Frss%3D1 The last decade has seen dramatic changes in the working arrangements and training requirements of junior medical staff employed in neonatal units. As a result, there is a need for the professional roles in service provision to be reappraised. In many neonatal services, advanced neonatal nurse practitioners (ANNPs) have been introduced and have been shown to be effective in providing an alternative option for the provision of neonatal care at both junior and middle-grade medical staffing level. One of the key factors of the success of this role is the underpinning years spent in clinical practice, a foundation that provides a valuable and unique perspective for professional functioning at a senior level. For this potential to be fully exploited, a more integrated approach to the developmen... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4464086 Thu, 10 Feb 2011 00:00:00 +0100 4464086 http://www.medworm.com/index.php?rid=4464085&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F2%2FF149%3Frss%3D1 The authors report on a rare case of neonatal scrotal oedema occurring concurrently with pain upon palpation of the spermatic cord on the first day of life. An ultrasound examination showed poor perfusion of the left testicle and a thrombosis of the left renal vein; intraoperative exploration indicated necrosis of the left testicle without signs of torsion. Gorged vessels with paravasal bleeding were found in the spermatic cord. The authors hypothesise that necrosis of the testicle may result from haemorrhagic infarction caused by renal venous thrombosis. Acute scrotal discolouration with pain upon palpation in neonates is usually attributed to testicular torsion. The authors report a case where these symptoms had a different cause. (Source: Archives of Disease in Childhood - Fetal and Neo... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4464085 Thu, 10 Feb 2011 00:00:00 +0100 4464085 http://www.medworm.com/index.php?rid=4464084&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F2%2FF146%3Frss%3D1 Conclusion Half of the units used VTV routinely, but with a considerable variation in VTV practice. More studies are required to establish best VTV practice. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4464084 Thu, 10 Feb 2011 00:00:00 +0100 4464084 http://www.medworm.com/index.php?rid=4464083&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F2%2FF144%3Frss%3D1 The aim of this study was to generate reference ranges for aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in preterm infants by describing the observed plasma concentration of these enzymes in babies born between 22 and 36 weeks' gestation. A service evaluation was conducted in babies admitted to two large neonatal intensive care units in the UK. 7006 blood samples from 1860 infants admitted to the two units between 2004 and 2008 were included. Extremely premature infants had high plasma enzyme activities when compared to babies at a later corrected gestational age. This may be due to more severe illness immediately after birth. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4464083 Thu, 10 Feb 2011 00:00:00 +0100 4464083 http://www.medworm.com/index.php?rid=4464082&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F2%2FF141%3Frss%3D1 Conclusion Maternal methadone therapy can cause transient prolongation of the QTc interval in newborn infants in the first 2 days of life. Newborns exposed to methadone are at risk of cardiac rhythm disturbances. Bradycardia, tachycardia or an irregular heart rate in an infant born to a mother on methadone treatment should prompt investigation with a 12-lead ECG. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4464082 Thu, 10 Feb 2011 00:00:00 +0100 4464082 http://www.medworm.com/index.php?rid=4464081&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F2%2FF138%3Frss%3D1 Conclusions Highly humidified incubators are frequently used to treat very low birthweight infants. Health professionals should be aware that mist and water condensation inside an incubator may significantly reduce the efficacy of treatment. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4464081 Thu, 10 Feb 2011 00:00:00 +0100 4464081 http://www.medworm.com/index.php?rid=4464080&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F2%2FF133%3Frss%3D1 Conclusion Blood cTnT, NTpBNP and a PDA scoring system at 48 h may facilitate the identification of those infants with a PDA, who are at greatest risk of poor neurodevelopmental outcome at 2 years of age. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4464080 Thu, 10 Feb 2011 00:00:00 +0100 4464080 http://www.medworm.com/index.php?rid=4464079&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F2%2FF128%3Frss%3D1 Conclusion Clinical seizure activity prior to ECMO and the duration of ECMO therapy are independently associated with SNHL. These data confirm that there is an increased incidence of SNHL in neonatal ECMO survivors at 9–13 years of age and suggest that SNHL may also present later in childhood in this patient population. Upon recovery from acute respiratory failure and after discharge from the hospital, longitudinal neurodevelopmental follow-up of infants treated with ECMO during the neonatal period is essential. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4464079 Thu, 10 Feb 2011 00:00:00 +0100 4464079 http://www.medworm.com/index.php?rid=4464078&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F2%2FF127%3Frss%3D1 (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4464078 Thu, 10 Feb 2011 00:00:00 +0100 4464078 http://www.medworm.com/index.php?rid=4464077&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F2%2FF121%3Frss%3D1 Conclusion Incidents with mechanical ventilation and intravascular catheters occur regularly in NICUs, and frequently harm patients. Multicentre, systematic analysis increases our knowledge of these events. Continuous training and education of all NICU personnel is required, together with preventive strategies aimed at the whole system – including the technical and organisational environment – rather than at human failure alone. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4464077 Thu, 10 Feb 2011 00:00:00 +0100 4464077 http://www.medworm.com/index.php?rid=4464076&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F2%2FF114%3Frss%3D1 Conclusion The likelihood of a very preterm infant developing CLD and the profile of risk factors linked with CLD are related to the infant's pattern of respiratory disease during the first 2 postnatal weeks. Among infants with little exposure to oxygen during this period, fetal growth restriction, not mechanical ventilation, is the factor with the strongest association with CLD. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4464076 Thu, 10 Feb 2011 00:00:00 +0100 4464076 http://www.medworm.com/index.php?rid=4464075&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F2%2FF108%3Frss%3D1 Conclusions Modified cot-side EEG has potential to assist with identification of extremely preterm infants at risk for adverse neurodevelopmental outcomes. However, analysis by a neurophysiologist performed better than the currently available continuity analyses. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4464075 Thu, 10 Feb 2011 00:00:00 +0100 4464075 http://www.medworm.com/index.php?rid=4464074&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F2%2FF102%3Frss%3D1 Conclusion It takes more than a minute for newly born infants <30 weeks gestation with a HR <100 bpm to achieve a HR above 100 bpm. In these infants HR does not stabilise until it reaches 120 bpm. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4464074 Thu, 10 Feb 2011 00:00:00 +0100 4464074 http://www.medworm.com/index.php?rid=4464073&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F2%2FF99%3Frss%3D1 Conclusions The two-thumb technique is superior to the two-finger technique, achieving greater depth and less variability with each compression. The two-finger technique was incorrectly applied in most cases and deviations in technique may have contributed to the significant differences in depth. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4464073 Thu, 10 Feb 2011 00:00:00 +0100 4464073 http://www.medworm.com/index.php?rid=4464072&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F2%2FF93%3Frss%3D1 Conclusions Fewer patients per nurse may be associated with improved achievement of oxygen saturation goals and may be an important modifiable factor influencing oxygen-related outcomes in premature newborns. This effect may vary with mode of respiratory support. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4464072 Thu, 10 Feb 2011 00:00:00 +0100 4464072 http://www.medworm.com/index.php?rid=4464071&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F2%2FF92%3Frss%3D1 (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4464071 Thu, 10 Feb 2011 00:00:00 +0100 4464071 http://www.medworm.com/index.php?rid=4464070&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F2%2FF86%3Frss%3D1 Conclusions Detailed magnetic resonance assessments of cardiac function and systemic perfusion are feasible in newborn infants, and provide more complete data with greater reproducibility than existing echocardiographic methods. Functional cardiac MRI could prove to be a useful research technique to study small numbers of newborn infants in specialist centres; providing insights into the pathophysiology of circulatory failure; acting as an outcome measure in clinical trials of inotropic intervention and so guiding clinical practice in the wider neonatal community. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4464070 Thu, 10 Feb 2011 00:00:00 +0100 4464070 http://www.medworm.com/index.php?rid=4464069&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F2%2FF84%3Frss%3D1 (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4464069 Thu, 10 Feb 2011 00:00:00 +0100 4464069 http://www.medworm.com/index.php?rid=4464068&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F2%2FF80%3Frss%3D1 (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4464068 Thu, 10 Feb 2011 00:00:00 +0100 4464068 http://www.medworm.com/index.php?rid=4464067&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F2%2FF79%3Frss%3D1 (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4464067 Thu, 10 Feb 2011 00:00:00 +0100 4464067 http://www.medworm.com/index.php?rid=4280736&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F1%2FF75%3Frss%3D1 In intensive care settings in the developed world, therapeutic hypothermia is established as a therapy for term infants with moderate to severe neonatal encephalopathy due to perinatal asphyxia. Several preclinical, pilot and clinical trials conducted in such settings over the last decade have demonstrated that this therapy is safe and effective. The greatest burden of birth asphyxia falls, however, in low- and middle-income countries; it is still unclear whether therapeutic hypothermia is safe and effective in this context. In this paper, the issues around treatments that may be proven safe and effective in the developed world and the caution needed in translating these into different settings and populations are explored. It is argued that there are strong scientific and ethical reasons ... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4280736 Wed, 22 Dec 2010 00:00:00 +0100 4280736 http://www.medworm.com/index.php?rid=4280735&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F1%2FF71%3Frss%3D1 More than 50 years after Silverman showed the association between temperature control and mortality, recent data again stress the importance of the thermal environment of the preterm infant. The goals of care are straightforward: maintain a normal body temperature, ensure a stable thermal environment and avoid cold stress; but the options to achieve them are many and less certain. There is a problem in defining a ‘normal’ temperature. A single measurement will tell nothing about whether the baby is using energy for thermal balance. The preterm baby should be monitored with the continuous recording and display of a central and peripheral temperature. This will give an early indication of cold stress before any change is seen in the central temperature. Reducing evaporative heat ... Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4280735 Wed, 22 Dec 2010 00:00:00 +0100 4280735 http://www.medworm.com/index.php?rid=4280734&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F1%2FF69%3Frss%3D1 Conclusions Management of severe Rhesus disease is associated with encouraging neonatal outcomes and most infants can be managed with phototherapy and a few top-up transfusions. IUT complications are rare but significantly increase neonatal mortality and morbidity. Antenatal counselling should address the likely postnatal course for these infants. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4280734 Wed, 22 Dec 2010 00:00:00 +0100 4280734 http://www.medworm.com/index.php?rid=4280733&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F1%2FF68%3Frss%3D1 (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4280733 Wed, 22 Dec 2010 00:00:00 +0100 4280733 http://www.medworm.com/index.php?rid=4280732&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F1%2FF65%3Frss%3D1 Conclusions Heel puncture is a common procedure in preterm neonates, but pain appears inadequately treated in many units and countries. Better compliance with published guidelines is needed for clinical and ethical reasons. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4280732 Wed, 22 Dec 2010 00:00:00 +0100 4280732 http://www.medworm.com/index.php?rid=4280731&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F1%2FF59%3Frss%3D1 Conclusions Persistent perinatal CMD was associated with infant diarrhoea in this low-income country setting. The observed relationship was independent of maternal health-promoting practices. Future research should further explore the mechanisms underlying the observed association to inform intervention strategies. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4280731 Wed, 22 Dec 2010 00:00:00 +0100 4280731 http://www.medworm.com/index.php?rid=4280730&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F1%2FF53%3Frss%3D1 Conclusions Normal placental histology predicted no or mild echogenicity changes, supporting the view that the latter are physiological. Placental pathology was always present in cases with grade IB PVE, presumed to represent mild or early forms of white matter injury. Both uteroplacental hypoperfusion and inflammatory features were seen in placentas from pregnancies with hypertensive disorders. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4280730 Wed, 22 Dec 2010 00:00:00 +0100 4280730 http://www.medworm.com/index.php?rid=4280729&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F1%2FF45%3Frss%3D1 Conclusions Intravenous indomethacin or ibuprofen administered to preterm infants for PDA at >24 h of life promoted ductal closure, but other short-term benefits were not seen. Treatment with intravenous ibuprofen may increase the risk of chronic lung disease. Good-quality evidence of treatment effect on morbidity, mortality and improved neurodevelopment is urgently needed. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4280729 Wed, 22 Dec 2010 00:00:00 +0100 4280729 http://www.medworm.com/index.php?rid=4280728&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F1%2FF36%3Frss%3D1 Conclusions MRI scans obtained on DOL 2–3 during hypothermia seem to predict later brain injuries in asphyxiated newborns. Brain injuries identified during this early time appear to represent irreversible changes. Early MRI scans might also be useful to demonstrate unexpected findings not related to hypoxic–ischaemic encephalopathy, which could potentially be exacerbated by induced hypothermia. Additional studies with larger numbers of patients will be useful to confirm these results. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4280728 Wed, 22 Dec 2010 00:00:00 +0100 4280728 http://www.medworm.com/index.php?rid=4280727&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F1%2FF35%3Frss%3D1 (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4280727 Wed, 22 Dec 2010 00:00:00 +0100 4280727 http://www.medworm.com/index.php?rid=4280726&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F1%2FF30%3Frss%3D1 Conclusions Differences in BPD frequency between hospitals are explained by differences in procedures, chiefly mechanical ventilation, rather than by differences in initial management or case mix. Delivery room intubation and brief mechanical ventilation did not increase BPD risk. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4280726 Wed, 22 Dec 2010 00:00:00 +0100 4280726 http://www.medworm.com/index.php?rid=4280725&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F1%2FF20%3Frss%3D1 Conclusions Combined treatment with both MV and supplemental oxygen at 36 weeks PMA strongly predicts the more common bilateral CP phenotypes. BPD without MV at 36 weeks PMA was not significantly associated with any form of CP. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4280725 Wed, 22 Dec 2010 00:00:00 +0100 4280725 http://www.medworm.com/index.php?rid=4280724&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F1%2FF19%3Frss%3D1 (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4280724 Wed, 22 Dec 2010 00:00:00 +0100 4280724 http://www.medworm.com/index.php?rid=4280723&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F1%2FF15%3Frss%3D1 Conclusions LOGNS occurs predominantly in VLBW infants. When the influence of gestational age is accounted for, the only independent risk factor found for late onset gram-negative neonatal infections is the duration of TPN. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4280723 Wed, 22 Dec 2010 00:00:00 +0100 4280723 http://www.medworm.com/index.php?rid=4280722&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F1%2FF9%3Frss%3D1 Conclusions The authors have established NeonIN in England and defined the current epidemiology of neonatal infections. These data can be used for benchmarking among units, international comparisons and as a platform for interventional studies. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4280722 Wed, 22 Dec 2010 00:00:00 +0100 4280722 http://www.medworm.com/index.php?rid=4280721&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F1%2FF4%3Frss%3D1 Conclusions Current guidelines for empirical therapy in neonates with sepsis are appropriate. However, gentamicin-based regimens should be used in preference to cefotaxime-based treatments, because of lower levels of susceptibility to cefotaxime and the need to avoid exerting selective pressure for resistance. Surveillance data linked to clinical data should further inform rational antibiotic prescribing in neonatal units. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4280721 Wed, 22 Dec 2010 00:00:00 +0100 4280721 http://www.medworm.com/index.php?rid=4280720&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F1%2FF2%3Frss%3D1 (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4280720 Wed, 22 Dec 2010 00:00:00 +0100 4280720 http://www.medworm.com/index.php?rid=4280719&cid=s_32766_69_f&fid=32766&url=http%3A%2F%2Ffn.bmj.com%2Fcgi%2Fcontent%2Fshort%2F96%2F1%2FF1%3Frss%3D1 (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition) Archives of Disease in Childhood - Fetal and Neonatal Edition journals http://www.medworm.com/rss/comments.php?id=4280719 Wed, 22 Dec 2010 00:00:00 +0100 4280719