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Magnesium sulfate and fetal neuroprotection: overview of clinical evidence

Neural Regeneration Research 2018年第12期13卷 2044-2049页

作者： Clément Chollat Stéphane Marret Institut National de la Santé et de la Recherche Médicale U1245 Genetics and Pathophysiology of Neurodevelopmental Disorders Team 4Neovasc Institute of Research and Innovation in Biomedicine Rouen School of Medicine Normandy University Department of neonatal intensive care Port Royal University Hospital Department of neonatal Pediatrics and intensive care and Neuropediatrics Charles-Nicolle University Hospital

Antenatal administration of magnesium sulfate is an important part of the neuroprotective strategy for preterm infants. Strong evidence from five randomized controlled trials and five meta-analyses has demonstrated that magnesium sulfate, when administered before preterm delivery, significantly reduces the risk of cerebral palsy at two years. Through secondary analyses of randomized controlled trials and other original clinical studies, this state-of-the-art review highlights the absence of serious adverse effects in both pregnant women and neonates, as well as the impact of maternal body mass index and preeclamptic status on the maternal and neonatal magnesium levels, which could influence the magnitude of the neuroprotective effect. Although antenatal magnesium sulfate is a cost-effective strategy, some practice surveys have demonstrated that the use of magnesium sulfate is not sufficient and that its use is heterogeneous, differing among different maternity wards. Since 2010, an increasing number of obstetrical societies have recommended its use to improve the neurological outcomes of preterm infants, especially the International Federation of Gynecology and Obstetrics and World Health Organization in 2015, and France in 2017. Considering the neuroprotective impact of magnesium sulfate when administered before delivery, postnatal administration should be considered, and its effects should be assessed using randomized controlled trials.

关键词： magnesium sulfate preterm birth neuroprotection cerebral palsy neurodevelopment international recommendations clinical studies meta-analysis preeclampsia cost-effectiveness

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Trends in prevalence and mortality of gastroschisis and omphalocele in the united States from 2010 to 2018

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World Journal of Pediatrics 2022年第7期18卷 511-514页

作者： Parth Bhatt Frank Adusei Poku Jacob Umscheid Marian Ayensu Narendrasinh Parmar Rhythm Vasudeva Keyur Donda Harshit Doshi Fredrick Dapaah-Siakwan united Hospital Center BridgeportWVUSA University of Central Oklahoma EdmondOKUSA University of Kansas School of Medicine WichitaKSUSA Woodhull Medical Center New YorkUSA Brookdale University Hospital and Medical Center BrooklynNYUSA University of South Florida TampaFLUSA Golisano Children's Hospital of Southwest Florida FortMyersFLUSA neonatal intensive care unit Valley Children's Hospital9300 Valley Children's PlaceSE 20MaderaCA 93636USA

Gastroschisis and omphalocele are the two most common congenital defects of the anterior abdominal *** etiologies remain unclear,but while gastroschisis is associ-ated with young maternal age,maternal smoking,maternal alcohol and illicit drug use during pregnancy omphalocele is frequently associated with genetic disorders and other congenital anomalies[1].The incidence of gastroschisis in the united States(US)has increased with an estimated inci-dence of 4.6 per 10,000 live births(LB)between 2010 and 2014[2].A recent study capturing information on 20%of infants admitted to neonatal intensive care unit(NICU)in the US showed a decrease in gastroschisis hospitalizations while that of omphalocele remained stable[3].However,it lacks generalizability[3].Our aim was to provide updated trends of gastroschisis and omphalocele hospitalizations in the US between 2010 and 2018 using population-based and nationally representative databases.

关键词： admitted halo maternal

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Caffeine therapy in preterm infants

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World Journal of Clinical Pediatrics 2015年第4期4卷 81-93页

作者： Hesham Abdel-Hady Nehad Nasef Abd Elazeez Shabaan Islam Nour neonatal intensive care unit Mansoura University Children's Hospital

Caffeine is the most commonly used medication for treatment of apnea of prematurity. Its effect has been well established in reducing the frequency of apnea, intermittent hypoxemia, and extubation failure in mechanically ventilated preterm infants. Evidence for additional short-term benefits on reducing the incidence of bronchopulmonary dysplasia and patent ductus arteriosus has also been suggested. Controversies existamong various neonatal intensive care units in terms of drug efficacy compared to other methylxanthines, dosage regimen, time of initiation, duration of therapy, drug safety and value of therapeutic drug monitoring. In the current review, we will summarize the available evidence for the best practice in using caffeine therapy in preterm infants.

关键词： Apnea Caffeine Preterm Methylxanthines

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Epidemiology of carbapenem-resistant Acinetobacter baumannii colonization in neonatal intensive care units:A systematic review and meta-analysis

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World Journal of Meta-Analysis 2024年第1期12卷 1-10页

作者： Donatien Serge Mbaga Sebastien Kenmoe Seraphine Nkie Esemu Arnol Bowo-Ngandji Nene Kaah Keneh Jane-Francis Tatah Kihla Akoachere Hortense Kamga Gonsu Roland Ndip Ndip Jean Thierry Ebogo-Belobo Cyprien Kengne-Ndé Nicholas Tendongfor Jean Paul Assam Assam Lucy Mande Ndip Jacky Njiki Bikoï Sara Honorine Riwom Essama Department of Microbiology The University of Yaounde IYaounde 00237Cameroon Department of Microbiology and Parasitology University of BueaBuea 00237Cameroon Faculty of Medicine and Biomedical Sciences The University of Yaounde IYaounde 00237Cameroon Center for Research in Health and Priority Pathologies Institute of Medical Research and Medicinal Plants StudiesYaounde 00237Cameroon Epidemiological Surveillance Evaluation and Research UnitNational AIDS Control CommitteeDouala 00237Cameroon

BACKGROUND The rising prevalence of carbapenem-resistant Acinetobacter baumannii(CRAB)in neonatal intensive care units(NICUs)represents an escalating challenge in healthcare settings,particularly in managing hospital-acquired infections(HAIs).Studies across various World Health Organization regions have documented a significant incidence of CRAB-related HAIs,with rates as high as 41.7 cases per 1000 patients in ICUs,accounting for 13.6%of all *** infections pose a doubled mortality risk compared to infections with carbapenem-susceptible Acinetobacter baumannii.A particularly concerning aspect of CRAB colonization is its asymptomatic nature,enabling its transmission through healthcare workers(HCWs)or the NICU environment to vulnerable neonates with developing immune *** To explore the prevalence of CRAB colonization in NICUs,focusing on neonates,healthcare workers,and the environmental samples,to enhance epidemiological understanding and inform targeted *** We conducted according to PRISMA 2020 checklist guidelines,a comprehensive literature search across multiple databases including MEDLINE(Ovid),EMBASE(Ovid),Global Health(Ovid),Web of Science,and Global Index *** were selected based on predetermined criteria,primarily involving neonates,HCWs,and environmental swabs,using culture or molecular methods to detect CRAB *** excluded studies that did not specifically focus on NICUs,were duplicates,or lacked necessary *** study selection and quality assessment were conducted independently by two *** extraction involved collecting comprehensive details about each *** statistical analysis used a random-effects model to calculate the pooled prevalence and confidence intervals,stratifying results by regional *** assessed study heterogeneity using Cochran's Q statistic and I²statistic,with regression tests employed to evaluate potential publication *** We analyzed 737 records from f

关键词： Colonization Carbapenem-resistant Acinetobacter baumannii neonatal intensive-care unit

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Faculty of health sciences students’knowledge and attitudes toward coronavirus disease 2019 during the first wave of the pandemic:A cross-sectional survey

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Journal of Integrative Nursing 2022年第3期4卷 151-156页

作者： Melek Ertürk YAVUZ Bahar CandaşALTINBAŞ Didem SARIMEHMET Ayla GÜRSOY CanselÖZEL Department of Surgical Nursing Faculty of Health SciencesArtvinÇoruh UniversityArtvinTurkey Department of Surgical Nursing Faculty of Health SciencesKaradeniz Technical UniversityTrabzonTurkey Department of Medical Services and Techniques Vocational School of Health SciencesKaradeniz Technical UniversityTrabzonTurkey Department of Surgical Nursing Faculty of Health SciencesAntalya Bilim UniversityAntalyaTurkey neonatal intensive care unit ElazığMedikalpark HospitalElazığTurkey

Objective:The study aimed to determine the faculty of the health sciences students’knowledge and attitudes regarding the coronavirus disease 2019(COVID-19)*** and Methods:This cross-sectional survey was completed with 317 undergraduate students of one health sciences faculty in *** data were collected between March 1,2020,and March 15,2020,by face-to-face interviews using a questionnaire created by the ***,percentage,mean,standard deviation,and Pearson Chi-square test were used to evaluate the ***:In this study,a high proportion of students answered questions about COVID-19 *** 55.8%of the students took partial precautions against COVID-19 to protect themselves against COVID-19 and“frequent washing of hands”was the most common *** determined that the main reasons for not taking any precautions against COVID-19 were“low number of cases in Turkey”and“getting irritated by the mask.”About 98.4%of the participants were entirely/partially following the news on COVID-19,with social media being the most commonly used *** students took more protective measures than male *** 1st-year students had more positive thoughts about vaccination compared to those in the other ***:Although the knowledge of the students about COVID-19 was good in the first wave of the pandemic,more than half of the students stated that they partially complied with the protective measures.

关键词： Attitude COVID-19 knowledge pandemic student

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Is Autonomic Nervous System Involved in the Epileptogenesis in Preterm Neonates?

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Maternal-Fetal Medicine 2023年第3期5卷 173-181页

作者： Raffaele Falsaperla Giovanna Vialiti Janette Mailo Giovanni Corsello Martino Ruggieri neonatal intensive care unit San Marco HospitalUniversity Hospital Policlinico-“G.Rodolico-San Marco”Via Azeglio CiampiCatania 95100Italy unit of Pediatrics and Pediatric Emergency University Hospital Policlinico-“G.Rodolico-San Marco”Via Azeglio CiampiCatania 95100Italy Division of Pediatric Neurology University of AlbertaStollery Children’s Hospital8440-112 St NWEdmontonAlbertaCanada Department of Maternal and Child Health University of PalermoVia del Vespro 129Palermo 90127Italy unit of Rare Diseases of the Nervous System in Childhood Department of Clinical and Experimental MedicineSection of Pediatrics and Child NeuropsychiatryUniversity of CataniaCatania 95124Italy

Autonomic nervous system dysfunction has been described with focal and generalized epileptic seizures;occurring during their ictal,interictal,or postictal *** League Against Epilepsy Seizure Classification Manual defines autonomic seizures as a distinct alteration of autonomic nervous system function involving cardiovascular,pupillary,gastrointestinal,sudomotor,vasomotor,and thermoregulatory *** seizures represent a great challenge for neonatologists and neurophysiologists;and distinguishing between ictal and non-ictal autonomic changes in neonates is rarely straightforward,especially in the premature *** avoid overdiagnosis and overtreatment,International League Against Epilepsy and the American Clinical Neurophysiology Society currently require electrographic correlation for any seizure diagnosis,including preterm *** is very little scientific evidence about the pathophysiology of autonomic *** data reporting on their incidence,clinical features,and diagnostic pathway is also *** this paper,we hypothesize that in the developing brain of preterm neonates,seizures involving deeper autonomic networks and subcortical structures might not propagate sufficiently to the cortex,and therefore the association of the seizures with specific ictal electrographic changes on surface electroencephalogram might be *** propose considering autonomic seizures in the differential diagnosis of unexplained autonomic changes in neonates,especially preterm neonates,even in the absence of clear initial electrographic *** autonomic changes could therefore be thought of as a“seizure alarm”in this population.

关键词： Premature Apnea Autonomic seizures Brain neonatal epilepsy Neonates

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Delivery room resuscitation intensity and associated neonatal outcomes of 24^(+0)-31^(+6) weeks'preterm infants in China:a retrospective cross-sectional study

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World Journal of Pediatrics 2024年第1期20卷 64-72页

作者： Si-Lu Wang Chun Chen Xin-Yue Gu Zhao-Qing Yin Le Su Si-Yuan Jiang Yun Cao Li-Zhong Du Jian-Hua Sun Jiang-Qin Liu Chuan-Zhong Yang Department of Neonatology Shanghai Key Laboratory of Maternal Fetal MedicineShanghai Institute of Maternal-Fetal Medicine and Gynecologic OncologyShanghai First Maternity and Infant HospitalSchool of MedicineTongji UniversityNo.2699Gaoke Western RoadPudong DistrictShanghai 201204China Department of Neonatology Affiliated Shenzhen Maternity and Child Healthcare HospitalSouthern Medical UniversityNo.2004Hongli RoadFutian DistrictShenzhen 518028China NHC Key Laboratory of neonatal Diseases Fudan UniversityChildren's Hospital of Fudan UniversityShanghaiChina Department of Neonatology People's Hospital of DehongKunming Medical UniversityDehongChina Department of Neonatology Children's Hospital of Fudan UniversityShanghaiChina Department of Neonatology Children's HospitalZhejiang University School of MedicineHangzhouChina Department of Neonatology Shanghai Children's Medical CenterSchool of MedicineShanghai Jiao Tong UniversityShanghaiChina

Background The aim of this study was to review current delivery room(DR)resuscitation intensity in Chinese tertiary neonatal intensive care units and to investigate the association between DR resuscitation intensity and short-term outcomes in preterm infants born at 24+0_31+6 weeks gestation age(GA).Methods This was a retrospective cross-sectional *** source population was infants born at 24+0_31+6 weeks'GA who were enrolled in the Chinese neonatal Network 2019 *** infants were categorized into five groups:(1)regular care;(2)oxygen supplementation and/or continuous positive airway pressure(O2/CPAP);(3)mask ventilation;(4)endotracheal intubation;and(5)cardiopulmonary resuscitation(CPR).The association between DR resuscitation and shortterm outcomes was evaluated by inverse propensity score-weighted logistic *** Of 7939 infants included in this cohort,2419(30.5%)received regular care,1994(25.1%)received O,/CPAP,1436(18.1%)received mask ventilation,1769(22.3%)received endotracheal intubation,and 321(4.0%)received CPR in the *** maternal age and maternal hypertension correlated with a higher need for resuscitation,and antenatal steroid use tended to be associated with a lower need for resuscitation(P<0.001).Severe brain impairment increased significantly with increasing amounts of resuscitation in DR after adjusting for perinatal *** strategies vary widely between centers,with over 50%of preterm infants in eight centers requiring higher intensity *** Increased intensity of DR interventions was associated with increased mortality and morbidities in very preterm infants in *** is wide variation in resuscitative approaches across delivery centers,and ongoing quality improvement to standardize resuscitation practices is needed.

关键词： Cardiopulmonary resuscitation Delivery room Endotracheal intubation neonatal resuscitation Preterm

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Clinical pharmacological studies in children: From exploratory towards confirmation driven methodology

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World Journal of Clinical Pediatrics 2012年第2期1卷 3-7页

作者： Karel Allegaert Division of Woman and Child Neonatal Intensive Care Unit University Hospital 3000 Leuven Belgium

Just like children are not small adults, pediatric studies are not just subgroup-adult studies. Clinical pharmacology aims to predict these effects based on drug, population and/or patient-specific pharmacokinetics(concentration-time profiles) and-dynamics(concentration-effect profile). The most essential characteristics of childhood are growth and maturation. Both phenomena are most prominent during infancy making the claim that "an infant is not just a small child" as relevant compared to the paradigm that "a child is not just a small adult". From a clinical pharmacology perspective, the consequence of such a dynamic setting is extensive variability throughout childhood in both the pharmacokinetics and pharmacodynamics. Trial design probably has impact on recruitment to an even greater extent compared to adult studies. In general, if a study is designed well, with a clear clinical question with which parents and children can identify, they are likely to consider participation. Open communication with all stakeholders involved will most likely result in ethically correct, practically feasible, scientifically sound, and economical reasonable studies to provide children with the appropriate treatment. From an academic perspective, feasibility, relevance, applicability and costs of clinical pharmacological studies in children can be signifi cantly improved by new sampling concepts(e.g., saliva, urine, dried spot blood) and the systematic introduction of already known information into the trial design through model based pediatric drug development, that mainly affect feasibility of pharmacokinetic studies. In contrast, for the pharmacodynamic part of pediatric studies, development and validation of population specifi c biomarkers or robust outcome variables is urgently needed.

关键词： Infant Child Developmental pharmacology Trial design Pharmacokinetics Pharmacodynamics

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Aluminum exposure and toxicity in neonates:a practical guide to halt aluminum overload in the prenatal and perinatal periods

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World Journal of Pediatrics 2014年第2期10卷 101-107页

作者： Daniela Fanni Rossano Ambu Clara Gerosa Sonia Nemolato Nicoletta Iacovidou Peter Van Eyken Vassilios Fanos Marco Zaffanello Gavino Faa Department of Pathology University Hospital San Giovanni di DioAOU Cagliari and University of CagliariItaly National and Kapodistrian University of Athens Medical SchoolAthensGreece Department of Pathology K.U.LeuvenLeuvenBelgium neonatal intensive care unit Puericulture Institute and Neonatal SectionAOU Cagliari and University of CagliariItaly Department of Pediatrics University of VeronaItaly

Background:During the last years,human newborns have been overexposed to biologically reactive aluminum,with possible relevant consequences on their future health and on their susceptibility to a variety of ***,newborns and particularly preterm neonates are at an increased risk of aluminum toxicity because of their relative *** sources:Based on recent original publications and classical data of the literatures,we reviewed the aluminum content in mother's food during the intrauterine life as well as in breast milk and infant formula during *** also determined the possible role of aluminum in parenteral nutrition solutions,in adjuvants of vaccines and in pharmaceutical products.A special focus is placed on the relationship between aluminum overexposure and the insurgence of bone ***:Practical points of management and prevention are *** sources that infants may receive during the fi rst 6 months of life are *** the context of prevention of possible adverse effects of aluminum overload in fetal tissues during development,simple suggestions to pregnant women are ***,practical points of management and prevention are ***:Pediatricians and neonatologists must be more concerned about aluminum content in all products our newborns are exposed to,starting from monitoring aluminum concentrations in milk-and soybased formulas in which,on the basis of recent studies,there is still too much aluminum.

关键词： aluminum fetus newborn toxicity

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Changes in intestinal flora and metabolites in neonates with breast milk jaundice

Changes in intestinal flora and metabolites in neonates with...

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2019长三角围产医学学术会议暨浙江省围产医学学术大会

作者： Yaxuan Li Nan Shen Jing Li Rui Hu Xi Mo Liqing Xu Department of neonatal intensive care unit Shanghai Children’s Medical Center

Objectives:Breast milk jaundice (BMJ) is a common cause of neonatal jaundice, but its mechanism is *** may affect bilirubin enterohepatic circulation by acting on intestinal flora of newborns. We conducted a study to illuminate the characteristics of intestinal flora in neonates with BMJ and used metabolomics to discover the possible mechanisms by which intestinal flora affects jaundice.

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