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Thermoregulation,incubator humidity,and skincare practices in appropriate for gestational age ultra-low birth weight infants:need for more evidence

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World Journal of Pediatrics 2024年第7期20卷 643-652页

作者： Umesh Mishra Deanne August Karen Walker Pranav R.Jani Mark Tracy Faculty of Medicine and Health University of SydneySydneyAustralia Department of Neonatology Westmead HospitalWestmeadNSWAustralia Grantley stable Neonatal unit Royal Brisbane and Women’s HospitalBrisbaneAustralia school of Nursing Midwifery and Social WorkUniversity of QueenslandBrisbaneAustralia Department of Newborn care Royal Prince Alfred HospitalCamperdownAustralia

Background Although not universal,active care is being offered to infants weighing<500 g at birth,referred to as ultra-low birth weight(ULBW)infants appropriate for gestational *** infants have the greatest risk of dy... 详细信息

Background Although not universal,active care is being offered to infants weighings ultra-low birth weight(ULBW)infants appropriate for gestational *** infants have the greatest risk of dying or developing major *** infants face challenges related to fluid and heat loss as well as skin injury in the initial days of life from extreme anatomical and physiological immaturity of the *** there is an emerging literature on the outcomes of ULBW infants,there is a paucity of evidence to inform practice guidelines for delivering optimal care to this cohort of *** sources A comprehensive review of the literature was performed using the PubMed and Embase *** keywords included“thermoregulation or body temperature regulation”,“incubator humidity”,“skin care”,“infant,extremely low birth weight”and“ultra-low birth weight infants”.Results Evidences for thermoregulation,incubator humidity,and skincare practices are available for preterm infants weighingspecifically for ULBW *** on thermoregulation,incubator humidity,or skincare practices had a small sample size and did not include a sub-group analysis for ULBW *** practice recommendations in ULBW infants are adopted from research in very and/or extremely low birth weight *** This narrative review focuses on challenges in thermoregulation,incubator humidity,and skincare practices in ULBW infants,highlights current research gaps and suggests potential developments for informing practices for improving health outcomes in ULBW infants.

关键词： Incubator humidity Neonatal intensive care unit skincare Thermoregulation Ultra-low birth weight

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Epidemiology and risk factors for mortality in critically ill patients with pancreatic infection

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Journal of intensive Medicine 2024年第1期4卷 81-93页

作者： Marie Dejonckheere Massimo Antonelli Kostoula Arvaniti Koen Blot Ben CreaghBrown Dylan Wde Lange Jan De Waele Mieke Deschepper Yalim Dikmen George Dimopoulos Christian Eckmann Guy Francois Massimo Girardis Despoina Koulenti sonia Labeau Jeffrey Lipman Fernando Lipovestky Emilio Maseda Philippe Montravers Adam Mikstacki JoseArtur Paiva Cecilia Pereyra Jordi Rello JeanFrancois Timsit Dirk Vogelaers stijn Blot the Abdominal sepsis study(Abses)group on behalf of the Trials Group of the European society of intensive care Medicine Department of Internal Medicine and Pediatrics Faculty of Medicine and Health SciencesGhent UniversityGhentBelgium Department of Anesthesiology Intensive Care and Emergency MedicineFondazione Policlinico Universitario A.Gemelli IRCCSRomeItaly UniversitàCattolica del sacro Cuore RomeItaly intensive care unit Papageorgiou University Affiliated HospitalThessaloníkiGreece Department of Epidemiology and Public Health SciensanoIxellesBelgium surrey Perioperative Anaesthetic Critical care Collaborative Research Group(sPACeR) Royal Surrey County HospitalGuildfordUK Department of Clinical and Experimental Medicine University of SurreyGuildfordUK Department of intensive care Medicine University Medical Center UtrechtUniversity UtrechtUtrechtthe Netherlands Department of intensive care Medicine Ghent University HospitalGhentBelgium Data science Institute Ghent University HospitalGhentBelgium Department of Anesthesiology and Reanimation Cerrahpasa School of MedicineIstanbul University-CerrahpasaIstanbulTurkey rd Department of Critical care “EVGENIDIO”HospitalNational and Kapodistrian University of AthensAthensGreece Department of General Visceral and Thoracic SurgeryKlinikum Hannoversch-MuendenGoettingen UniversityGöttingenGermany Division of scientific Affairs-Research European Society of Intensive Care MedicineBrusselsBelgium Anesthesia and intensive care Department University Hospital of ModenaModenaItaly UQ Centre for Clinical Research Faculty of MedicineThe University of QueenslandBrisbaneQLDAustralia nd Critical care Department Attikon University HospitalAthensGreece Department of Nursing Faculty of EducationHealth and Social WorkUniversity College GhentGhentBelgium Jamieson Trauma Institute The University of QueenslandBrisbaneQLDAustralia Nimes University hospital University of MontpellierNimesFrance Critical care Department Hospital of the Interamerican Open University(UAI)Buenos AiresArgentina surgical Critical care Department of AnesthesiaHospital Universitario

Background:The Abses-classification defines specific phenotypes of patients with intra-abdominal infection based on the(1)setting of infection onset(community-acquired,early onset,or late-onset hospital-acquired),(2)presence or absence of either localized or diffuse peritonitis,and(3)severity of disease expression(infection,sepsis,or septic shock).This classification system demonstrated reliable risk stratification in intensive care unit(ICU)patients with intra-abdominal *** study aimed to describe the epidemiology of ICU patients with pancreatic infection and assess the relationship between the components of the Abses-classification and ***:This was a secondary analysis of an international observational study(“Abses”)investigating ICU patients with intra-abdominal *** patients with pancreatic infection were included in this analysis(n=165).Mortality was defined as ICU mortality within 28 days of observation for patients discharged earlier from the *** with mortality were assessed using logistic regression analysis and reported as odds ratio(OR)and 95%confidence interval(CI).Results:The overall mortality was 35.2%(n=58).The independent risk factors for mortality included older age(OR=1.03,95%CI:1.0 to 1.1 P=0.023),localized peritonitis(OR=4.4,95%CI:1.4 to 13.9 P=0.011),and persistent signs of inflammation at day 7(OR=9.5,95%CI:3.8 to 23.9,Psource control interventions within the first week(OR=4.0,95%CI:1.3 to 12.2,P=0.013).Gramnegative bacteria were most frequently isolated(n=58,49.2%)without clinically relevant differences in microbial etiology between survivors and ***:In pancreatic infection,a challenging source/damage control and ongoing pancreatic inflammation appear to be the strongest contributors to an unfavorable short-term *** this limited series,essentials of the Abses-classification,such as the setting of infection onset,diffuse

关键词： Pancreatic infection intensive care unit Mortality Intra-abdominal infection sepsis

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Low sARs-CoV-2 seroprevalence but high perception of risk among healthcare workers at children’s hospital before second pandemic wave in Germany

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World Journal of Pediatrics 2021年第5期17卷 484-494页

作者： Marietta Neumann Annette Aigner Eileen Rossow David schwarz Maria Marschallek Jorg steinmann Ralf stucker Ingo Koenigs Philippe stock Department of paediatrics Altona Children's HospitalUniversitat HamburgAltonaer KinderkrankenhausBleickenallee 3822763 HamburgGermany Corporate Member of Freie Universitat Berlin and Humboldt-Universitat Zu Berlin Institute of Biometry and Clinical Epidermiology BerlinCharite-Universitatsmedizin BerlinBerlinGermany Department of Neonatology and paediatric intensive care Medicine Altona Children's HospitalHamburgGermany Department of paediatric surgery Altona Children's HospitalHamburgGermany Labor Dr.Fenner and Colleagues Hamburg.Germany Department of paediatric Orthopaedics Altona Children's HospitalHamburgGermany Department of paediatric surgery University Medical Centre Hamburg Eppendorf(UKE)HamburgGermany Department of paediatrics Altona Children's HospitalHamburgGermany

Background Healthcare workers are considered a particularly high-risk group during the coronavirus disease 2019(COVID-19)*** workers in paediatries are a unique subgroup:they come into frequent contact with children,who often experience few or no symptoms when infected with severe acute respiratory syndrome coronavirus 2(sARs CoV-2)and,therefore,may transmit the disease to unprotected *** Germany,no studies exist evaluating the risk of COVID-19 to healthcare workers in paediatric *** We tested the staff at a large children's hospital in Germany for immunoglobulin(Ig)G antibodies against the nucle-ocapsid protein of sARs CoV-2 in a period between the first and second epidemic wave in *** used a questionnaire to assess each individual's exposure risk and his/her own perception of having already been infected with *** We recruited 619 participants from all sectors,clinical and non-clinical,constituting 70%of the entire *** seroprevalence of sARs CoV-2 antibodies was 0.325%(95%confidence interval 0.039-I.168).self-perceived risk of a previ-ous sARs-CoV-2 infection decreased with age(odds ratio,0.81;95%confidence interval,0.70-0.93).Having experienced symptoms more than doubled the odds of a high self-perceived risk(odds ratio,2.18;95%confidence interval,1.59--3.00).There was no significant difference in self perceived risk between men and *** seroprevalence was low among healtheare workers at a large children's hospital in Germany before the second epidemic wave,and it was far from a level that confers herd ***-perceived risk of infection is often overestimated.

关键词： Health personnel sARs CoV-2 seroepidemiologic studies Pediatrics

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Lemon Myrtle(Backhousia citriodora): An Alternative and Effective Treatment for Molluscum Contagiosum in children with Atopic Dermatitis

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Chinese Journal of Integrative Medicine 2023年第11期29卷 1018-1020页

作者： Konstantinos Kakleas shilpee sinha Deborah Wilson Gary stiefel paediatric Allergy Clinic Agia Sofia Children's HospitalAthens(11527)Greece paediatric Allergy Clinic Leicester Royal Infirmary HospitalLeicester(LE15WW)United Kingdom

Atopic dermatitis is a common skin disorder that affects approximately 10%-20%of the children in the united Kingdom.^((1)) children with atopic dermatitis are more prone to developing molluscum contagiosum(MC).^((2,3)) MC,a common viral cutaneous infection in childhood,is caused by poxvirus of the molluscipox genus and presents as one or more umbilicated,smooth,flesh-colored,dome-shaped *** virus is transmitted through close physical contact.

关键词： dermatitis colored shaped

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Upregulation of miR-489-3p and miR-630 inhibits oxaliplatin uptake in renal cell carcinoma by targeting OCT2

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Acta Pharmaceutica sinica B 2019年第5期9卷 1008-1020页

作者： Lu Chen Le Chen Zhiyuan Qin Jinxiu Lei sheng Ye Kui Zeng Hua Wang Meidan Ying Jianqing Gao su Zeng Lushan Yu Institute of Drug Metabolism and Pharmaceutical Analysis Zhejiang Province Key Laboratory of Anti-Cancer Drug ResearchCollege of Pharmaceutical SciencesZhejiang UniversityHangzhou310058China paediatric intensive care unit the Children's HospitalZhejiang University School of MedicineHangzhou310003China Department of Urology Cancer Hospital of Zhejiang ProvinceHangzhou310022China

Renal cell carcinoma(RCC) is one of the most common malignant tumors affecting the urogenital system, accounting for 90% of renal malignancies. Traditional chemotherapy options are often the front-line choice of regimen in the treatment of patients with RCC, but responses may be modest or limited due to resistance of the tumor to anticarcinogen. Downregulated expression of organic cation transporter OCT2 is a possible mechanism underlying oxaliplatin resistance in RCC treatment. In this study, we observed that mi R-489-3 p and mi R-630 suppress OCT2 expression by directly binding to the OCT2 30-UTR. Meanwhile, via 786-O-OCT2-mi RNAs stable expression cell models, we found that mi RNAs could repress the classic substrate 1-methyl-4-phenylpyridinium(MPP+), fluorogenic substrate N,N-dimethyl-4-(2-pyridin-4-ylethenyl) aniline(AsP+), and oxaliplatin uptake by OCT2 both in vitro and in xenografts. In 33 clinical samples, mi R-489-3 p and mi R-630 were significantly upregulated in RCC, negatively correlating with the OCT2 expression level compared to that in adjacent normal tissues, using tissue microarray analysis and q PCR validation. The increased binding of c-Myc to the promoter of pri-mi R-630, responsible for the upregulation of mi R-630 in RCC, was further evidenced by chromatin immunoprecipitation and dual-luciferase reporter assay. Overall, this study indicated that mi R-489-3 p and mi R-630 function as oncotherapy-obstructing micro RNAs by directly targeting OCT2 in RCC.

关键词： OCT2 mi RNA Renal cell carcinoma Epigenetic regulation Oxaliplatin

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The ketogenic diet for paediatric patients with super-refractory status epilepticus in febrile infection-related epilepsy syndrome

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Acta Epileptologica 2020年第1期2卷 25-31页

作者： Xinhua Wang Xuan Gao Guoping Lu Zhongying Lu shuizhen Zhou Yi Wang Yuanfeng Zhou Department of Neurology Children’s Hospital of Fudan UniversityShanghai 201102China. Department of intensive care unit Children’s Hospital of Fudan UniversityShanghai 201102China. Department of Clinical Nutrition Children’s Hospital of Fudan UniversityShanghai 201102China.

Objective:To investigate the effect and safety of ketogenic diet(KD)for the treatment of paediatric patients with super-refractory status epilepticus(sRsE)in febrile infection-related epilepsy syndrome(FIREs).Method:From January 1,2015 to October 31,2017,ten critically ill paediatric patients with sRsE in FIREs were included in this study and treated with *** treatment effects of KD were evaluated by using continuous encephalography(CEEG)and amplitude-integrated electro-encephalography(aEEG).Results:All 10 patients fulfilled the diagnostic criteria of sRsE in FIREs and achieved ketosis within 24–72 h following the administration of *** and aEEG were monitored for several weeks to assess the efficacy of KD on status epilepticus(sE).sE was contained in 8 patients within 2 to 19 days after initiation of KD,and KD was discontinued in the other 2 *** of the 10 patients demonstrated severe adverse ***:KD may be an alternative and safe treatment option in critical paediatric patients with sRsE in FIREs.

关键词： Ketogenic diet paediatric super-refractory status epilepticus Febrile infection-related epilepsy syndrome

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Childhood obesity in New Zealand

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World Journal of Pediatrics 2019年第4期15卷 322-331页

作者： Valentina Chiavaroli John D.Gibbins Wayne s.Cutfield JoséG.B.Derraik Neonatal intensive care unit Pescara Public HospitalPescaraItaly Liggins Institute University of AucklandAucklandNew Zealand A Better start-National science Challenge University of AucklandAucklandNew Zealand Endocrinology Department Children's Hospital of Zhejiang University School of MedicineHangzhouChina Department of Women's and children's Health Uppsala UniversityUppsalaSweden

Background paediatric obesity has reached epidemic proportions globally,resulting in significant adverse effects on health and *** life events,including those that happen before,during,and after pregnancy can predispose children to later *** purpose of this review is to examine the magnitude of obesity among New Zealand children and adolescents,and to determine their underlying risk factors and associated *** sources PubMed,Web of science,and Google scholar searches were performed using the key terms 'obesity','overweight','children','adolescents',and 'New Zealand'.Results Obesity is a major public health concern in New Zealand,with more than 33% of children and adolescents aged 2-14 years being overweight or *** disproportionately affects Māori (New Zealand's indigenous population) and Pacific children and adolescents,as well as those of lower socioeconomic *** Zealand's obesity epidemic is associated with numerous health issues,including cardiometabolic,gastrointestinal,and psychological problems,which also disproportionately affect Māori and Pacific children and ***,a number of factors may be useful to identify those at increased risk (such as demographic and anthropometric characteristics) and inform possible *** The prevalence of overweight and obese children and adolescents in New Zealand is markedly high,with a greater impact on particular ethnicities and those of lower socioeconomic *** the current burden of pediatric obesity should be a key priority for New Zealand,for the benefit of both current and subsequent *** strategies should focus on obesity prevention,particularly starting at a young age and targeting those at greatest risk.

关键词： Obesity children Adolescents New Zealand Pacific Islands

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Ventricular Arrhythmia in the Fontan Circulation:Prevalence,Risk Factors and Clinical Implications

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Congenital Heart Disease 2023年第5期18卷 507-523页

作者： Charis Tan Diana Zannino Carley Clendenning sophie Offen Thomas LGentles Julian Ayer David Tanous Vishva Wijesekera Leeanne Grigg David Celermajer Mark McGuire Yves d’Udekem Rachael Cordina Department of Cardiothoracic surgery Royal Prince Alfred HospitalCamperdownAustralia sydney Medical school University of SydneyCamperdownAustralia Clinical Epidemiology and Biostatistics unit Murdoch Children’s Research InstituteParkvilleAustralia Department of Cardiology Royal Prince Alfred HospitalCamperdownAustralia Department of paediatric Cardiology Starship HospitalAucklandNew Zealand Department of paediatric Cardiology The Children’s Hospital at WestmeadWestmeadAustralia Department of Cardiology Westmead HospitalWestmeadAustralia Adult Congenital Heart Disease unit The Prince Charles HospitalBrisbaneAustralia Department of Cardiology The Royal Melbourne HospitalMelbourneAustralia Heart Research Institute CamperdownAustralia Department of Cardiac surgery The Royal Children’s Hospital MelbourneParkvilleAustralia Department of paediatrics The University of MelbourneParkvilleAustralia

Objective:sudden cardiac death(sCD)and malignant ventricular arrhythmia(VA)are increasingly recognized as important issues for people living with a Fontan circulation,but data are *** sought to characterize the cohort who had sudden cardiac death,most likely related to VA and/or documented VA in the Australia and New Zealand Fontan Registry including risk factors and clinical ***:A retrospective cohort study was *** criteria were documented non-sustained ventricular tachycardia,sustained ventricular tachycardia,ventricular fibrillation,resuscitated cardiac arrest or sCD>30 days post-Fontan ***:Of 1611 patients,20(1.2%)had VA;14(1.0%)had VA without sCD and 6(sCD(6%of all deaths recorded in Registry;5 of those had documented VA at the time of arrest and 1 was presumed to be VA-associated).The median age at first VA was 20.5(14–32)years,10(50%)were females,and the median age at Fontan operation was 8(4–17)*** univariable analysis,hypoplastic left heart syndrome(p=0.03)and older age Fontan operation(pssociated with *** Fontan era(pst-Fontan atrial arrhythmia(p=0.010)were associated with *** with VA had a 3 times higher risk of death or heart transplant(HR 3.27(1.19,8.98),p=0.02).Conclusions:A proportion of people living with a Fontan circulation have malignant *** VA screening in this cohort is *** data are needed to aid risk stratification.

关键词： Fontan congenital cardiac arrhythmia sudden cardiac death ventricular tachyarrhythmia

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Venous thromboembolism prophylaxis in hospitalized elderly patients： Time to consider a ＇MUsT＇ strategy

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Journal of Geriatric Cardiology 2011年第2期8卷 114-120页

作者： Kwok M Ho Edward Litton Department of intensive care Medicine Royal Perth Hospital and School of Population Health University of Western Australia Perth WA 6000 Australia

Venous thromboembolism （VTE） is the commonest cause of preventable death in hospitalized patients. Elderly patients have higher risk of VTE because of the high prevalence of predisposing co-morbidities and acute illnesses. Clinical diagnosis of VTE in the elderly patient is particularly difficult and, as such, adequate VTE prophylaxis is of pivotal importance in reducing the mortality and morbidities of VTE. Omission of VTE prophylaxis is, however, very common despite continuous education. A simple way to overcome this problem is to implement universal VTE prophylaxis for all hospitalized elderly patients instead of selective prophylaxis for some patients only according to individual＇ s risk of VTE. Although pharmacological VTE prophylaxis is effective for most patients, a high prevalence of renal impairment and drug interactions in the hospitalized elderly patients suggests that a multimodality approach may be more appropriate. Mechanical VTE prophylaxis, including calf and thigh compression devices and/or an inferior vena cava filter, are often underutilized in hospitalized elderly patients who are at high-risk of bleeding and VTE. Because pneumatic compression devices and thigh length stockings are virtually risk free, mechanical VTE prophylaxis may allow early or immediate implementation of VTE prophylaxis for all hospitalized elderly patients, regardless of their bleeding and VTE risk. Although the cost-effectiveness of this Multimodality Universal sTat （＇MUsT＇） VTE prophylaxis approach for hospitalized elderly patients remains uncertain, this strategy appears to offer some advantages over the traditional ＇selective and single-modal＇ VTE prophylaxis approach, which often becomes ＇hit or miss＇ or not implemented promptly in many hospitalized elderly patients. A large clustered randomized controlled trial is, however, needed to assess whether early, multimodality, universal VTE prophylaxis can improve important clinical outcomes of hospitalized elderly patients.

关键词： age bundle of care deep vein thrombosis prevention pulmonary embolism

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Recovery rates of combination antibiotic therapy using in vitro microdialysis simulating in vivo conditions

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Journal of Pharmaceutical Analysis 2018年第6期8卷 407-412页

作者： Jayesh A.Dhanani suzanne L.Parker Jeffrey Lipman steven C.Wallis Jeremy Cohen John Fraser Adrian Barnett Michelle Chew Jason A.Roberts Burns Trauma and Critical Care Research Centre The University of Queensland UQ Centre for Clinical Research Department of intensive care Medicine Royal Brisbane & Women's Hospital Faculty of Health Queensland University of Technology Critical care Research Group The University of Queensland Institute of Health and Biomedical Innovation & school of Public Health and social Work Queensland University of Technology Department of Anaesthesiology and intensive care and Department of Medical and Health Sciences Link?ping University school of Pharmacy The University of Queensland Department of Pharmacy Royal Brisbane & Women's Hospital

Microdialysis is a technique used to measure the unbound antibiotic concentration in the interstitial spaces, the target site of action. In vitro recovery studies are essential to calibrating the microdialysis system for in vivo studies. The effect of a combination of antibiotics on recovery into microdialysate requires investigation. In vitro microdialysis recovery studies were conducted on a combination of vancomycin and tobramycin, in a simulated in vivo model. Comparison was made between recoveries for three different concentrations and three different perfusate flow rates. The overall relative recovery for vancomycin was lower than that of tobramycin. For tobramycin, a concentration of 20μg/mL and flow rate of 1.0μL/min had the best recovery. A concentration of 5.0μg/mL and flow rate of 1.0μL/min yielded maximal recovery for vancomycin. Large molecular size and higher protein binding resulted in lower relative recoveries for vancomycin. Perfusate flow rates and drug concentrations affected the relative recovery when a combination of vancomycin and tobramycin was tested. Low perfusate flow rates were associated with higher recovery rates. For combination antibiotic measurement which includes agents that are highly protein bound, in vitro studies performed prior to in vivo studies may ensure the reliable measurement of unbound concentrations.

关键词： Microdialysis Combination antibiotic therapy Relative recovery rate Pharmacokinetics Anti-infectives Protein binding

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