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Analgesic effect of inhaled lavender essential oil for frenotomy in healthy neonates:a randomized clinical trial

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World Journal of Pediatrics 2022年第6期18卷 398-403页

作者： Silvia Maya-Enero Montserrat Fàbregas-Mitjans Rosa Maria Llufriu-Marquès Júlia Candel-Pau Jordi Garcia-Garcia MaríaÁngeles López-Vílchez Department of neonatology Service of PediatricsHospital del MarParc de Salut MarUniversitat Pompeu FabraPasseig Marítim 25-2908003BarcelonaSpain

Background Neonatal pain may affect long-term neurodevelopment and must be treated.Frenotomy is a painful procedure wherein a common strategy to relieve pain(sucking)cannot be used because the technique is performed on the tongue.Lavender essential oil(LEO)has sedative and antispasmodic properties and has been successfully used to treat pain during heel puncture and vaccination.Our aim was to demonstrate if the use of inhaled LEO is effective in reducing pain during frenotomy in healthy,full-term neonates.Methods We conducted a randomized clinical trial in neonates who underwent a frenotomy between August 2020 and April 2021.We assessed pain using pre and post-procedure heart rate and oxygen saturation,crying time and Neonatal Infant Pain Scale(NIPS)score.Patients with type 3 tongue tie were randomized into the“experimental group”and“control group”.In both groups,we performed swaddling,administered oral sucrose,and let the newborn suck for two minutes.In the experimental group,we also placed a gauze pad with one drop of LEO under the neonate’s nose for two minutes prior to and during the frenotomy.Results We enrolled 142 patients(71 per group).The experimental group showed significantly lower NIPS scores(1.88 vs 2.92)and cried almost half the amount of time(14.8 vs.24.6 seconds,P=0.006).Comparing with the control group,we observed no side effects in either of the groups.Conclusions We observed a significant decrease in crying time and lower NIPS scores in the neonates who received inhaled LEO and underwent a frenotomy for type 3 tongue-ties.Thus,we recommend using inhaled LEO during neonatal frenotomies.

关键词： Ankyloglossia Aromatherapy Frenotomy Lavender Neonate Neonatal pain Tongue-tie

Modulation of immune response in experimental Chagas disease

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World Journal of Experimental Medicine 2013年第1期3卷 1-10页

作者： Beatriz Basso Neonatology Service School of Medical SciencesNational University of Cordoba

Trypanosoma cruzi(T. cruzi), the etiological agent of Chagas disease, affects nearly 18 million people in Latin America and 90 million are at risk of infection. The parasite presents two stages of medical importance in the host, the amastigote, intracellular replicating form, and the extracellular trypomastigote, the infective form. Thus infection by T. cruzi induces a complex immune response that involves effectors and regulatory mechanisms. That is why control of the infection requires a strong humoral and cellular immune response; hence, the outcome of host-parasite interaction in the early stages of infection is extremely important. A critical event during this period of the infection is innate immune response, in which the macrophage's role is vital. Thus, after being phagocytized, the parasite is able to develop intracellularly; however, during later periods, these cells induce its elimination by means of toxic metabolites. In turn, as the infection progresses, adaptive immune response mechanisms are triggered through the TH1 and TH2 responses. Finally, T. cruzi, like other protozoa such as Leishmania and Toxoplasma, have numerous evasive mechanisms to the immune response that make it possible to spread around the host. In our Laboratory we have developed a vaccination model in mice with Trypanosoma rangeli, nonpathogenic to humans, which modulates the immune response to infection by T. cruzi, thus protecting them. Vaccinated animals showed an important innate response(modulation of NO and other metabolites, cytokines, activation of macrophages), a strong adaptive cellular response and significant increase in specific antibodies. The modulation caused early elimination of the parasites, low parasitaemia, the absence of histological lesions and high survival rates. Even though progress has been made in the knowledge of some of these mechanisms, new studies must be conducted which could target further prophylactic and therapeutic trials against T. cruzi infection.

关键词： Trypanosoma cruzi Chagas disease Innate and adaptive immune response

Neonatal sepsis: within and beyond China

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Chinese Medical Journal 2020年第18期133卷 2219-2228页

作者： Ying Dong Romain Basmaci Luigi Titomanlio Bo Sun Jean-Christophe Mercier Department of neonatology Children’s Hospital of Fudan UniversityShanghai 201102China Universitéde Paris IAMEINSERM75018 ParisFrance service de Pédiatrie-Urgences AP-HPHôpital Louis-Mourier92700 ColombesFrance Pediatric Emergency Department Robert Debre University Hospital75019 ParisFrance Departments of Pediatrics and neonatology Children’s Hospital of Fudan UniversityShanghai 201102China Medical University of Paris 75018 ParisFrance

Sepsis remains a significant cause of neonatal morbidity and mortality in China.A better understanding of neonatal sepsis in China as compared with other industrialized and non-industrialized countries may help optimize neonatal health care both regionally and globally.Literature cited in this review was retrieved from PubMed using the keywords"neonatal sepsis,""early-onset(EOS)"and"late-onset(LOS)"in English,with the focus set on population-based studies.This review provides an updated summary regarding the epidemiology,pathogen profile,infectious work-up,and empirical treatment of neonatal sepsis within and beyond China.The incidence of neonatal EOS and the proportion of Group B Streptococcus(GBS)within pathogens causing EOS in China seem to differ from those in developed countries,possibly due to different population characteristics and intrapartum/postnatal health care strategies.Whether to adopt GBS screening and intrapartum antibiotic prophylaxis in China remains highly debatable.The pathogen profile of LOS in China was shown to be similar to other countries.However,viruses as potential pathogens of neonatal LOS have been underappreciated.Growing antimicrobial resistance in China reflects limitations in adapting antibiotic regimen to local microbial profile and timely cessation of treatment in non-proven bacterial infections.This review stresses that the local epidemiology of neonatal sepsis should be closely monitored in each institution.A prompt and adequate infectious work-up is critically important in diagnosing neonatal sepsis.Adequate and appropriate antibiotic strategies must be overemphasized to prevent the emergence of multi-resistant bacteria in China.

关键词： Antibiotic resistance Blood culture Early-onset sepsis Late-onset sepsis Neonatal sepsis Nosocomial neonatal sepsis

Spontaneous neonatal pneumomediastinum

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Open Journal of Pediatrics 2011年第3期1卷 37-38页

作者： Kiran Kumar Balegar V Nadia Badawi Arieta Fa’asalele Kathryn Carmo Department of neonatology Royal Alexandra Hospital for Children Newborn & Paediatric Emergency Transport service

Radiolucency in the superior mediastinum may be caused by a congenital cystic mass or pneumomediastinum. Most cases of pneumomediastinum occur in preterm newborns with surfactant deficiency receiving treatment with positive pressure ventilation. Spontaneous pneumomediastinum in term neonates is also rarely reported. We report the outcome for a term neonate with respiratory distress who was transferred for surgical evaluation of a cystic superior mediastinal mass.

关键词： Spontaneous Pneumomediastinum Superior Mediastinal Mass Neonate

SARS-CoV-2 spike RBD-specific IgA and IgG antibodies in breast milk after vaccination with the protein subunit vaccine Abdala

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Infectious Medicine 2022年第4期1卷 253-261页

作者： Maylin Pérez-Bernal Carlos Hernández Rafael Ibargollín Midalis Martínez Migdiala Soria Magali Delgado Onel Valdivia DayamíDorta Andy Domínguez Enrique Pérez Yeosvany Cabreraa Research&Development Department Center for Genetic Engineering and BiotechnologyCircunvalante NorteOlivos IIISancti SpiritusCuba Neonatology Service General Hospital“Camilo Cienfuegos”128 Bartolome MasoSancti SpiritusCuba Production Department Center for Genetic Engineering and BiotechnologyCircunvalante NorteOlivos IIISancti SpiritusCuba

Background:COVID-19 vaccines that trigger a strong secretory antibody response in breast milk may achieve effective passive protection of vulnerable newborns and breastfed infants of immunized mothers.The aim of this work was to investigate the presence of SARS-CoV-2 spike RBD-specific IgA and IgG antibodies in breast milk,5 and 9 weeks after vaccination with 3 doses of the protein subunit vaccine Abdala,compared to those found in breast milk from COVID-19-recovered women,collected at least 40 days after the infection.Methods:SARS-CoV-2 spike RBD-specific IgA and IgG antibodies were semi-quantified by indirect ELISA,using a homemade standard generated by pooling twenty breast milk samples with high absorbance values according to preliminary data.The validity of the standard curves was proved following the European Medicines Agency Guideline.Two breast milk samples from 2 unvaccinated women who had not been infected with COVID-19 were included as negative controls.Potentially neutralizing antibodies was assessed by a SARS-CoV-2 surrogate virus neutralization test.Results:High levels of anti-RBD IgA antibodies were detected in breast milk samples 9 weeks after vaccination and anti-RBD IgG antibodies rise from the fifth to the ninth week.In the post-COVID-19 time that was evaluated,the IgG-type response was notably higher compared to both post-vaccination periods.Neutralizing antibody titers were similar in breast milk from vaccinated and COVID-19 recovered women.Conclusions:This is the first report about the immune response in breast milk after the administration of a COVID-19 protein subunit vaccine,which could provide analogous protection to that conferred by SARS-CoV-2 infection.This implies a potential passive immunity that breastfed infants receive from their mothers vaccinated with Abdala.

关键词： Abdala vaccine IgA IgG Neutralizing antibody titers SARS-CoV-2

Cervical Cancer in Women with Inflammatory Pap Smears

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Journal of Cancer Therapy 2014年第1期5卷 82-90页

作者： Mongia Achour Dorra Zeghal Center of Maternity and neonatology Service of Gynecology and Obstetrics Tunis Tunisia IMEC (Immuno-Microbiology Environmental and Carcinogenesis) UNIT Faculty of Sciences Bizerta Tunisia

In spite of preventive measures such as Papanicolaou cervical cytological analysis and, more recently, vaccination against HPV infection, cancer of the uterine cervix continues to be one of the most frequent causes of mortality among women worldwide, particularly in developing countries. In this prospective study, sixty patients with inflammatory Pap smears had a colposcopy with directed biopsies. The average age of our patients was 42 years. Results showed that colposcopy is normal in 10% of women. It showed normal transformations, ectropion, a colpotis and polyp at 8.33%, 21.66%, 13.33% and 5% respectively. It was able to detect changes with Grade I atypical transformations (28.33%), and Grade II atypical transformations in 13.33% of cases. The biopsies were objectified dysplasia and carcinoma in 24.13% of cases with carcinoma in situ, micro invasive squamous cell carcinoma and invasive carcinoma glandular. Moreover, we detected HPV-specific antibodies in sera of these patients. Results showed that six patients (10%) showed a positive reactivity to at least one of the HPV-16 or HPV-18 antigens and sera showed different reactivity to the different antigens with the following percentages: 5%, 3%, 2%, 3% and 3% for L1 HPV-16, E6 HPV-16, E7 HPV-16, E6 HPV-18 and E7 HPV-18 respectively. Among patients having positive antibody response, 83.33% were cases of dysplasia and carcinoma. We concluded that the Pap smear, examination of key screening for cervical cancer, is a screening test without diagnostic value and more specifically any inflammatory Pap smear should be considered a positive test and led to further investigations. Moreover, colposcopy is an exam that is performed on an outpatient basis;it allows a detailed study of the cervix and reduces the negative rate of cytology. In addition, early detection of HPV antibodies could help the follow-up of patients.

关键词： Pap Smear Inflammatory Cervical Cancer Human Papillomavirus

护士关于早产儿疼痛的护理体验:质性研究系统综述

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International Journal of Nursing Sciences 2022年第4期9卷 533-541页

作者： Tingting Zhao Angela R.Starkweather Adam Matson Shabnam Lainwala Wanli Xu Xiaomei Cong School of Nursing University of ConnecticutStorrsCTUSA College of Nursing University of FloridaGainesvilleFLUSA Division of neonatology Connecticut Children’s Medical CenterHartfordCTUSA Department of Pediatrics University of Connecticut School of MedicineFarmingtonCTUSA School of Nursing Yale UniversityOrangeCTUSA

目的通过系统文献综述整合与揭示护士在护理早产儿疼痛过程中的体验。方法研究检索了近10年发表的文献,检索数据库包括:PubMed,CINAHL,PsycINFO,Scopus,BIOSIS和ProQuest Dissertation and Theses Database。纳入标准:对重症监护室护理... 详细信息

目的通过系统文献综述整合与揭示护士在护理早产儿疼痛过程中的体验。方法研究检索了近10年发表的文献,检索数据库包括:PubMed,CINAHL,PsycINFO,Scopus,BIOSIS和ProQuest Dissertation and Theses Database。纳入标准:对重症监护室护理早产儿护士的质性研究。排除标准:非英文文献,文献不包括质性研究数据或质性数据无法从文章中提取,以及文章不包含护士体验的内容。文献质量评价采用英国牛津循证医学中心文献评价项目方案(Critical Appraisal Skills Programme,CASP)。结果经过比较纳入和排除标准,研究者最终筛选出8篇文献,共包括205名护士,分别来自伊朗、加拿大、美国、芬兰、瑞典、瑞士和澳大利亚。共归纳出5个关于早产儿疼痛护理体验的主题:1)护士可以觉察早产儿疼痛;2)早产儿疼痛未缓解导致的不良后果;3)疼痛管理的障碍;4)对现有疼痛管理方式的担忧;5)与家长合作困难。结论这篇质性研究系统综述揭示了护士对早产儿疼痛未缓解会导致新生儿发育障碍的理解。改善工作环境、降低工作负荷,研制适应不同年龄组的疼痛评估和干预方法,为护士提供有效的情感支持和培训,建立与家长的良好合作关系,均为重症监护室护士为早产儿疼痛提供更好护理的迫切需要。

关键词：新生儿重症监护病房早产儿疼痛测量父母疼痛护理护士

Production and stability study of a hospital parenteral nutrition solution for neonates

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Journal of Pharmaceutical Analysis 2019年第2期9卷 83-90页

作者： Anne-Laure Yailian Céline Serre Justine Fayard Marina Faucon Patrick Thomaré Samira Filali Christine Pivot Florence Vételé Fabrice Pirot Emmanuelle Olivier service Pharmaceutique Plateforme FripharmGroupe Hospitalier Centre Edouard HerriotHospices Civils de Lyon Laboratoire de Recherche et Développement de Pharmacie Galénique Industrielle UMR 5305Plateforme FripharmFaculté de PharmacieUniversité Claude Bernard Lyon 18 service Pharmaceutique Site H?tel-DieuCentre Hospitalo-Universitaire de Nantes1place Alexis Ricordeau service pharmaceutique Groupement Hospitalier EstHospices Civils de Lyon

Standard parenteral nutrition solutions are mixtures comprising interacting components that may degrade themselves over time. The objective of this study was to investigate the physicochemical and microbiological stability of a hospital preparation for parenteral nutrition in neonatology. The analyses were performed throughout the storage of the preparations at 2–8 °C(up to 4 months). The extent of stability was based on the determination of amino acids dosage, visual and physicochemical properties(glucose and electrolytes concentrations, pH and osmolality measurements, particle counting) and microbiological analysis(sterility test). A thermal degradation of ascorbic acid was conducted to evaluate the antioxidant properties of the parenteral mixture. Physicochemical and microbiological controls were found to comply with the specifications. Amino acids showed a good stability throughout the 4 months storage except for cysteine, which was progressively degraded to cystine, conferring a yellow coloration to parenteral solutions. Parenteral nutrition standards solutions remain stable for 4 months at 2–8 °C,ensuring safe administration in preterm infants.

关键词： Stability-indicating method study Parenteral nutrition neonatology Amino acids High-performance liquid chromatographic

High-risk phenotypes of genetic disease in a Neonatal Intensive Care Unit population

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Chinese Medical Journal 2022年第5期135卷 625-627页

作者： Tiantian Xiao Qi Ni Huiyao Chen Huijun Wang Lin Yang Bingbing Wu Yun Cao Guoqiang Cheng Laishuan Wang Liyuan Hu Hongfang Mei Yulan Lu Mengchun Gong Xinran Dong Wenhao Zhou Department of neonatology Key Laboratory of Neonatal DiseasesMinistry of HealthChildren’s Hospital of Fudan UniversityNational Children’s Medical CenterShanghai 201102China Center for Molecular Medicine Children’s Hospital of Fudan UniversityNational Children’s Medical CenterShanghai 201102China Institute of Health Management Southern Medical UniversityGuangzhouGuangdong 510515China

To the Editor: Genetic diseases contribute to 35% of deaths during the first year of life and are a significant cause of intensive care.[1] A previous study based on the China Neonatal Genomes Project investigated the genetic causes of early infant deaths and found that >25% of deceased neonates with genetic diagnoses can be cured if diagnosed in time.[2] Therefore, it is crucial to target and diagnose neonates with genetic diseases as early as possible. According to our experience, the typical phenotypes, such as special facial features or multiple congenital anomalies (MCAs), indicate a high risk of genetic disease and lead physicians to perform genetic testing in neonates as early as possible. However, in practice, infants without typical phenotypes typically undergo a long and costly diagnostic process before genetic diagnoses are confirmed. Moreover, a recent survey by the American College of Medical Genetics and Genomics (ACMG) and other national professional organizations indicated that there are insufficient numbers of qualified geneticists to fulfil genetic service needs.[3] The ACMG published the general clinical features for genetic testing indications. For example, patients with phenotypes or family history data that strongly implicate a genetic cause may undergo genetic testing.[1] However, the study indicated that many genetic conditions arise de novo or are inherited with no family history.[1] A previous study attempted to apply the non-phenotype-driven panel approach in neonates admitted to the neonate intensive care unit (NICU).[4] However, at present, the diagnostic yield is only 3.45% (1/29).[4] In addition, the economic and ethical issues associated with genomic screening remain challenging. Therefore, the available indications for genetic testing may improve the management of genetic diseases.

关键词： admitted apply fir