Ototoxic and nephrotoxic drugs in neonatal intensive care units: results of a Spanish and Italian survey.

Unlabelled: Neonates face heightened susceptibility to drug toxicity, often exposed to off-label medications with dosages extrapolated from adult or pediatric studies. Premature infants in Neonatal Intensive Care Units (NICUs) are particularly at risk due to underdeveloped pharmacokinetics and exposure to multiple drugs. The study aimed to survey commonly used medications with a higher risk of ototoxicity and nephrotoxicity in Spanish and Italian neonatal units.

Hearing Loss and Risk Factors in Very Low Birth Weight Infants.

The incidence of sensorineural hearing loss (SNHL) is still high in very low birth weight (VLBW) infants. The purpose of our study was to provide the prevalence rates of SNHL and to analyze the risk factors of hearing impairment and changes in hearing thresholds in a cohort of VLBW infants. A retrospective observational study was conducted in our neonatal intensive care unit (NICU) from 2012 to 2016.

Does the involvement of first-year residents have a negative impact on the performance of a newborn hearing screening program?

Objectives: We aimed to evaluate the efficiency of our hearing screening program, prior to hospital discharge, together with the consistency of our teamwork including first year residents by assessing a learning curve for the operators involved.

Methods: We evaluated all the data collected during the first stage of the screening program of all non-NICU neonates from March 2009 to July 2013, analyzing by means of a linear regression model, the monthly referral rate for the whole period of activity of each group of residents.

Results: performances of each group of screeners were statistically different (chi square test p < 0.

Early visual and neuro-development in preterm infants with and without retinopathy.

Background: Retinopathy of prematurity (ROP) is often associated with visual impairment and multiple developmental disabilities.

Aims: As most of the previous studies include infants with brain lesions, that can determine visual impairment per se, a cohort of low neurological risk preterm infants without ROP and with various degree of severity of ROP was assessed in order to establish visual and neurodevelopmental outcome.

Study Design: Preterm infants born at <31 weeks gestation, without major brain lesions, underwent visual function assessment at 1 year corrected age and neurodevelopmental assessment at 2 years corrected age.

Universal newborn hearing screening in the Lazio region, Italy.

Background: The introduction of Universal Newborn Hearing Screening (UNHS) programs has drastically contributed to the early diagnosis of hearing loss in children, allowing prompt intervention with significant results on speech and language development in affected children. UNHS in the Lazio region has been initially deliberated in 2012; however, the program has been performed on a universal basis only from 2015. The aim of this retrospective study is to present and discuss the preliminary results of the UNHS program in the Lazio region for the year 2016, highlighting the strengths and weaknesses of the program.

T-cell polarization: Potential serological markers in preterm and term infants.

Background: The immaturity of immune system characterizes newborn infants. Possible serological markers of Th1 and Th2 immune response are the lymphocyte activation gene-3 (CD223) and soluble CD30, respectively (sCD30).

Aims: The aim of our study was to evaluate the relationship between Th1 and Th2 immune response and gestational age (GA), comparing data in preterm and term neonates.

Longitudinal assessment of perceptual-motor abilities in pre-school preterm children.

Objective: To verify the value of early perceptual-motor assessment in preterms.

Methods: The M-ABC2 was performed below the age 3 years-4 months and 1 year later.

Results: At 4 years children showed a significant improvement in the scores and reduced rate of refusals.

Can MII-pH values predict the duration of treatment for GERD in preterm infants?

Background: Little is known regarding the prognostic role of Multichannel Intraluminal Impedance and pH monitoring (MII/pH) parameters in preterm infants with Gastro-Esophageal Reflux Disease (GERD).

Aim: Our study aimed to evaluate the relationship between MII/pH variables and the duration of pharmacological therapy for GERD, in preterm infants with gestational age (GA) ≤34weeks.

Subjects, Study Design, Outcome Measures: We retrospectively reviewed data of all newborns with GA ≤34weeks that underwent MII/pH in our Neonatal Intensive Care Unit (NICU) and pharmacological treatment for GERD.

Neurodevelopmental outcomes of premature infants with bronchopulmonary dysplasia.

Bronchopulmonary dysplasia (BPD) is a chronic lung disorder common among very preterm infants affecting significantly not only mortality and morbidity but also neurodevelopmental outcomes. This review aims to identify the short and long-term neurodevelopmental outcomes of infants with BPD, considering that the new definition of BPD allows to relate severity of BPD with greater risk of developmental delay.

Predictors of improved quality of life and claudication in patients undergoing spinal cord stimulation for critical lower limb ischemia.

Background: The aim of this study was to determine predictors of improved quality of life and claudication in patients undergoing spinal cord stimulation (SCS) for critical lower limb ischemia.

Methods: We retrospectively analyzed 101 consecutive patients with few meter claudication and nonhealing ulcer who underwent definitive SCS. These patients were selected among 274 SCS patients treated at our center from 1995 to 2012.

Perceptual-motor abilities in pre-school preterm children.

Background: Several studies report a high percentage of premature infants presenting perceptual motor difficulties at school age. The new version of the Movement Assessment Battery for Children allows the assessment of perceptual-motor abilities in children from the age of 3years.

Aims: To evaluate early perceptual-motor abilities in prematurely born children below the age of 4years.

Surface layer proteins from Clostridium difficile induce inflammatory and regulatory cytokines in human monocytes and dendritic cells.

Clostridium difficile, an etiological agent of most cases of antibiotic-associated diarrhea, exerts its pathological action mainly by the activity of toxin A and toxin B. Less known is the role that S-layer proteins (SLPs), predominant surface components of the bacterium, may play in pathogenesis. Here, we evaluate the ability of SLPs to modulate the function of human monocytes and dendritic cells (DC) and to induce inflammatory and regulatory cytokines, influencing the natural and adaptive immune response.

Serum levels of seven cytokines in premature ventilated newborns: correlations with old and new forms of bronchopulmonary dysplasia.

Objective: In addition to the previous classification of chronic lung disease (CLD) O2 dependency at 36 weeks of postmenstrual age, a new definition of CLD has recently been proposed: new bronchopulmonary-dysplasia (BPD). This uses total duration of O2 supplementation and positive pressure requirements to delineate three degrees of severity (mild, moderate, and severe) according to the respiratory status at 36 weeks postmenstrual age. We analyzed the balance of serum proinflammatory and profibrotic/angiogenic cytokine concentrations in relation to CLD and the new BPD definition.

Risk factors for pulmonary candidiasis in preterm infants with a birth weight of less than 1250 g.

Unlabelled: To evaluate the epidemiology of pulmonary candidiasis (PC) and to identify risk factors in premature infants during the 1st month of life, all infants with a birth weight <1250 g admitted to our neonatal intensive care unit with PC between January 1994 and December 2001 were retrospectively reviewed. Infants with PC ( n =20) were compared with a control group ( n =20), matched for gestational age and birth weight, with regard to possible perinatal and postnatal risk factors. Among 325 infants with a birth weight <1250 g, 20 out of 233 ventilated infants (8.

Cerebral ultrasound findings in neonatal lupus syndrome.

A prospective study was performed enrolling 11 newborns with neonatal lupus syndrome (NLS) and 22 control newborns to investigate cerebral ultrasound (US) anomalies and their relationship with clinical neurological signs and laboratory findings. Cerebral US detected a significantly higher incidence in the study group of both subependymal pseudocysts (SEPC) and subependymal hemorrhage (SEH), neither of which correlated to autoantibody levels. All infants had completely normal neurological examinations both at birth and follow-up.

Plasma levels of interleukin-6 and interleukin-10 in preterm neonates evaluated for sepsis.

Unlabelled: In a prospective study, plasma interleukin-6 (IL-6) and interleukin-10 (IL-10) levels were measured by enzyme-linked immunosorbent assay in 45 premature neonates (25-34 weeks gestational age) with signs and symptoms of suspected sepsis at 0, 12 and 24 h; C-reactive protein (CRP) was measured at 0-24 h after enrolment. Six subjects were excluded due to insufficient blood sampling. The remaining 39 neonates were assigned to one of three groups: 25 newborns with sepsis (blood culture positive), seven with pneumonia (positive results on broncho-alveolar lavage fluid culture and characteristic chest radiography) and seven with necrotising enterocolitis (NEC) (characteristic intestinal and radiological signs according to the criteria of Bell et al.

[Caloric intake in parenteral nutrition of very low weight infants].

To evaluate the efficacy of a measure able to compare energy intake from parenteral and enteral nutrition we documented growth patterns in a group of VLBW infants treated with parenteral nutrition (PN). To analyze comparative energy intake from the two sources we expressed a percentage of both parenteral and enteral calories: the former (RCP%) related to an optimal value of 85 non protein calories and the latter (RCE%) to an optimal value of 150 total calories. Total energy intake was planned on the RCT% (RCP% + RCE%).

[A new device for phototherapy of neonatal jaundice].

The effectiveness of a new device for phototherapy in the treatment of nonhemolytic hyperbilirubinemia (Wallaby Phototherapy System) was evaluated. 46 healthy term infants, appropriate for gestational age and with serum bilirubin > 12 mg/dl in the first 3 days of life or > 15 mg/dl after 3rd day were randomly assigned to a treatment group (24 hours of light exposure with Wallaby Phototherapy System) and to a control group (any treatment for hyperbilirubinemia). Body temperature, weight, feeding and hydration were recorded during the study period.

Placental transfer of phenobarbital: what is new?

The placental transfer of phenobarbital was investigated in 35 mother-infant pairs at birth. The drug was administered prenatally to the mothers for maternal epilepsy (group 1, n = 5), gestational hypertension and preeclampsia (group 2, n = 20) and prophylaxis of intraventricular hemorrhage in premature deliveries (group 3, n = 10). The phenobarbital levels in arterial cord blood were 100 +/- 2.