Incidence of traumatic lumbar punctures in adults: the impact of a patient's first procedure.

Introduction: Lumbar puncture (LP) is a widely used diagnostic method in patients of all ages. Blood-contaminated cerebrospinal fluid samples are frequent and may compromise diagnostic accuracy.

Objectives: We determined age-specific incidences of traumatic LPs (TLPs) in adults and examined factors that accounted for the incidence of TLPs.

Incidence of Traumatic Lumbar Punctures in Neonates and Infants.

Objectives: The objective of this study is to examine factors accounting for the incidence of traumatic lumbar puncture (TLP) in infants younger than 1 year old.

Study Design: Retrospective analysis of cerebrospinal fluid (CSF) data from 1,240 neonatal (≤28 days) and 399 infant lumbar puncture (LP) procedures was conducted. Data from two successive LP procedures were obtained from 108 patients.

NIV-NAVA versus NCPAP immediately after birth in premature infants: A randomized controlled trial.

Objective: To evaluate whether noninvasive-neurally adjusted ventilatory assist (NIV-NAVA) decrease respiratory efforts compared to nasal continuous positive airway pressure (NCPAP) during the first hours of life.

Methods: Twenty infants born between 28 and 31 weeks were randomized to NIV-NAVA or NCPAP. Positive end-expiratory pressure was constantly kept at 6 cmHO for both groups and the NAVA level was 1.

Traumatic lumbar punctures in diagnostic and intrathecal treatment punctures of pediatric hemato-oncology patients.

Successful first diagnostic lumbar puncture (LP) is crucial because intrathecal chemotherapy has not yet protected the central nervous system against cancer cells. If blood contaminates the cerebrospinal fluid (CSF) with blasts, they may enter the central neural system and compromise the patient's health. We retrospectively determined the incidence of traumatic lumbar punctures (TLP) in 2,507 LPs of 250 pediatric hemato-oncology patients aged from one to 18 years, including both diagnostic and intrathecal treatment procedures, and 2,617 LPs of 1,525 other age-matched pediatric patients.

Implementation of neurally adjusted ventilatory assist and high flow nasal cannula in very preterm infants in a tertiary level NICU.

Preterm infants treated with invasive ventilation are often affected by bronchopulmonary dysplasia, brain structure alterations, and later neurodevelopmental impairment. We studied the implementation of neurally adjusted ventilatory assist (NAVA) and high flow nasal cannula (HFNC) in a level III neonatal unit, and its effects on pulmonary and central nervous system outcomes. This retrospective cohort study included 193 surviving infants born below 32 weeks of gestation in preimplementation (2007-2008) and postimplementation (2016-2017) periods in a single study center in Finland.

Neurally adjusted ventilatory assist in ventilated very preterm infants: A crossover study.

Objective: To assess the effects of neurally adjusted ventilatory assist (NAVA) ventilation on oxygenation and respiratory parameters in preterm infants.

Study Design: An observational crossover study with a convenience sample of 19 infants born before 30 gestational weeks. Study parameters were recorded during 3-h periods of both NAVA and conventional ventilation.

Backup ventilation during neurally adjusted ventilatory assist in preterm infants.

Objective: To analyze the proportion of backup ventilation during neurally adjusted ventilatory assist (NAVA) in preterm infants at different postmenstrual ages (PMAs) and to analyze the trends in backup ventilation in relation to clinical deteriorations.

Methods: A prospective observational study was conducted in 18 preterm infants born at a median (range) 27 (23 -34 ) weeks of gestation with a median (range) birth weight of 1,100 (460-2,820) g, who received respiratory support with either invasive or noninvasive NAVA. Data on ventilator settings and respiratory variables were collected daily; the mean values of each 24-h recording were computed for each respiratory variable.

Parent-infant skin-to-skin contact reduces the electrical activity of the diaphragm and stabilizes respiratory function in preterm infants.

Background: The physiological benefit of parent-infant skin-to-skin contact (SSC) is uncertain for preterm infants with ventilatory support. We aimed to investigate whether SSC stabilizes the respiration compared to incubator care in mechanically ventilated preterm infants.

Methods: The prospective observational study was performed in Turku University Hospital, Finland.

Real-time detection of cerebrospinal fluid with bioimpedance needle in paediatric lumbar puncture.

Background: Lumbar puncture is a common clinical procedure that can occasionally be difficult. Various needle guidance methods can facilitate performing this procedure, but at the expense of special expertise, equipment and facility. In the present study, we evaluated the clinical feasibility of a novel bioimpedance needle system regarding its ability to detect cerebrospinal fluid (CSF) in paediatric lumbar punctures.

Rapid respiratory transition at birth as evaluated by electrical activity of the diaphragm in very preterm infants supported by nasal CPAP.

Objective: To investigate breathing patterns during respiratory adaptation in preterm infants using the electrical activity of the diaphragm (EAdi) signal.

Patients: Infants born between 28 + 0 and 31 + 6 gestational weeks and supported by early nasal continuous positive airway pressure (nCPAP) were studied. The EAdi signal was recorded for 120 min after birth.

Nasal high-flow therapy decreased electrical activity of the diaphragm in preterm infants during the weaning phase.

Aim: We evaluated whether nasal high-flow therapy was better than no respiratory support during the weaning phase in preterm infants.

Methods: The study was conducted in the neonatal intensive care unit of the Turku University Hospital between September 2014 and August 2015. Preterm infants who were alternating between nasal high-flow therapy and unassisted breathing were enrolled.

Two cases of low birth weight infant survival by prehospital emergency hysterotomy.

Background: During maternal cardiac arrest, emergency hysterotomy (EH) is recommended after four minutes of resuscitation, if no signs of spontaneous circulation are detected. This extreme procedure is believed to be potentially beneficial for both the mother and the infant. Both maternal and neonatal survivals seem to be associated to the time delay between the cardiac arrest and the delivery and in-hospital resuscitation location.

Gestational hyperglycemia reprograms cardiac gene expression in rat offspring.

BackgroundRat fetuses with maternal pregestational hyperglycemia develop cardiac dysfunction, and their cardiac gene expression differs from that of healthy control fetuses near term. We hypothesized that cardiac gene expression and morphologic abnormalities of rat fetuses with maternal pregestational hyperglycemia become normal after birth.MethodsNine rats were preconceptually injected with streptozotocin to induce maternal hyperglycemia and nine rats served as controls.

Ascites in newborns - a diagnostic challenge.

Isolated fetal ascites is a rare finding in prenatal ultrasound examination. The finding is always aberrant and requires further exploration. More than half of fetal ascites findings are associated with structural anomalies.

The effect of caffeine citrate on neural breathing pattern in preterm infants.

Background: Caffeine citrate is widely used to prevent and treat prematurity-associated apnea.

Aims: The aim of this study was to characterize the effect of caffeine citrate on the neural control of breathing, especially central apnea, in premature infants.

Study Design: Preterm infants were evaluated for 30min before and 30min after caffeine citrate loading (20mg/kg).

The effects of skin-to-skin care on the diaphragmatic electrical activity in preterm infants.

Background: Skin-to-skin care (SSC) is widely used in neonatal intensive care units due to its positive effects on infant physiology and parent-infant interaction.

Aims: We investigated the safety and the effect of SSC on the diaphragm electrical activity (EAdi) in premature infants recovering from respiratory distress syndrome treated on noninvasive neurally adjusted respiratory assist.

Study Design: An observational cross-over study design was used.

Maternal hyperglycemia leads to fetal cardiac hyperplasia and dysfunction in a rat model.

Accelerated fetal myocardial growth with altered cardiac function is a well-documented complication of human diabetic pregnancy, but its pathophysiology is still largely unknown. Our aim was to explore the mechanisms of fetal cardiac remodeling and cardiovascular hemodynamics in a rat model of maternal pregestational streptozotocin-induced hyperglycemia. The hyperglycemic group comprised 107 fetuses (10 dams) and the control group 219 fetuses (20 dams).

Delay in rat lung alveolarization after the combined exposure of maternal hyperglycemia and postnatal hyperoxia.

Background: Maternal diabetes interferes with fetal lung development and postnatal treatments may further disturb pulmonary growth. Therefore, we investigated the effect of postnatal oxygen exposure on alveolar development in neonatal rat lungs pre-exposed to intrauterine hyperglycemia.

Methods: Diabetes was induced in Sprague-Dawley rats with streptozotocin injection before pregnancy.

Fetal hyperglycemia alters lung structural development in neonatal rat.

Maternal diabetes is associated with increased risk for abnormal fetal organogenesis, but its effects on the developing lungs are still insufficiently known. To determine the effect of maternal hyperglycemia on postnatal lung development, we studied lung structural and cellular changes in newborn rats exposed to intrauterine hyperglycemia. We induced hyperglycemia in Sprague-Dawley rats with i.

Maternal hyperglycemia modifies extracellular matrix signaling pathways in neonatal rat lung.

Background: Maternal diabetes is associated with numerous adverse effects in fetal and neonatal organs, including the lungs.

Objective: To investigate the effects of intrauterine hyperglycemia on neonatal lung biological signaling, we performed a microarray analysis in the lungs of four 14-day-old rat pups born to a hyperglycemic dam and in four age mate control pup lungs.

Methods: Total RNA was isolated and cDNA was hybridized to the Illumina Sentrix® RatRef-12 BeadChip.

Three distinct episodes of GBS septicemia in a healthy newborn during the first month of life.

In neonates, recurrent group B streptococcal infection is uncommon, and two relapses are extremely rare. We report a case of three distinct episodes of Streptococcus agalactiae bacteremia in a healthy full-term infant over a 4-week period. The newborn had no apparent predisposing condition or infectious focus, and the recurrences occurred after adequate antimicrobial treatment, the second occurring after withdrawal of colonized breast milk.