Publications by authors named "Ita Litmanovitz"
Article Synopsis
- Competency-based medical education (CBME) is becoming popular in post-graduate medical training, but implementing it sustainably is challenging due to various paradoxes.
- A qualitative study using in-depth interviews uncovered three major paradoxes: the balance between standardized and flexible assessment tools, the need for uniform implementation vs. tailored protocols for different wards, and the contrast between a common definition of competency and individual indicators of achievement.
- Addressing these paradoxes is crucial for successfully navigating the implementation challenges of CBME programs in medical education.
Ultrasound assessment of endotracheal tube depth in neonates: a prospective feasibility study.
Arch Dis Child Fetal Neonatal Ed
December 2023
Article Synopsis
- A study was conducted to evaluate a new ultrasound method for checking the position of endotracheal tubes in newborns, comparing it to traditional chest X-rays (CXR).
- The results showed that ultrasound accurately identified correct tube placements 100% of the time, indicating strong agreement with chest X-ray findings, and provided good sensitivity and specificity metrics.
- While the ultrasound method was effective for assessing endotracheal tube position, further research is needed to confirm its practical use in hospitals.
Article Synopsis
- - Vitamin D is crucial for calcium and phosphate regulation, but its impact on fetal bone strength remains uncertain; this study examined the connection between maternal 25(OH)D levels and neonatal bone strength in 81 mother-infant pairs using quantitative ultrasound.
- - The research found that while maternal and cord blood 25(OH)D levels were strongly correlated, with cord blood levels being higher, there was no significant link between maternal vitamin D levels and neonatal bone strength or growth indicators.
- - Additionally, certain demographic factors influenced maternal vitamin D levels, with Jewish mothers having higher levels than Muslim mothers; however, bone strength (measured as speed of sound in tibial bones) remained similar across different maternal vitamin D status groups.
Article Synopsis
- * Using near-infrared spectroscopy, researchers measured regional oxygen saturation (rSOS) before and after each feeding method in 21 infants under 32 weeks gestation.
- * Results show that continuous feeding lowers rSOS compared to bolus feeding, but it does not significantly affect the oxygen extraction by the intestines; there was also a slight trend towards reduced systemic oxygen levels after bolus feeding.
Article Synopsis
- Neonatal nutritional supplements are used to improve growth in premature or small-for-gestational-age infants, but their long-term effects on cognitive and metabolic health are unclear.
- Analysis of various trials showed that while these supplements did not significantly impact cognitive impairment or metabolic risk after 3 years, they reduced motor impairment in toddlers and had better outcomes for girls.
- Additionally, while supplementation lowered triglyceride levels, it didn't change other metabolic factors, suggesting potential benefits in early motor skills without major risks to cognitive or long-term metabolic health.
Article Synopsis
- Neonatal nutritional supplements can boost early growth in infants who are small for their gestational age, but their impact on long-term growth remains uncertain.
- A review of various studies found that while these supplements improved infant length and bone mineral content, they did not significantly affect childhood BMI.
- Additionally, the benefits in height growth appeared to be present in male toddlers but were not observed in females, indicating that results may vary by sex.
Article Synopsis
- This study examined the impact of COVID-19 on family-centered care for hospitalized infants, utilizing a 49-item online survey sent to 96 healthcare professionals across 22 countries.
- Before the pandemic, most healthcare units actively welcomed families and supported skin-to-skin care; however, during the pandemic, 83% of units restricted family presence and 32% limited parental participation in infant care.
- Additionally, smaller units faced stricter regulations compared to medium-sized ones, and units with single-family rooms generally had fewer restrictions, indicating that family separation increased during the pandemic regardless of local infection rates.
Article Synopsis
- Preterm infants with severe brain injury are at risk for poor health outcomes and may benefit from interventions like music therapy (MT) combined with skin-to-skin contact (SSC).
- A study evaluated 35 affected infants, finding that SSC with maternal singing improved physiological measurements, such as heart rate and behavioral state, compared to SSC alone.
- However, maternal singing during MT led to increased instability in the infants and heightened anxiety in mothers, suggesting a need for tailored music therapy interventions for this vulnerable population.
Article Synopsis
- Cortisol levels in newborns can be influenced by the type of delivery, with vacuum extraction deliveries showing the highest levels compared to other methods like unplanned cesareans and vaginal births.
- The study aimed to explore the relationship between umbilical cord cortisol levels and 17-hydroxyprogesterone (17-OHP) levels in newborns to assess any potential misinterpretations in screening tests.
- Despite observing higher cortisol levels in stressful deliveries, the findings showed no correlation between umbilical cord cortisol levels and 17-OHP levels in newborns, indicating that stressful deliveries do not lead to false positives in newborn screening tests.
Article Synopsis
- Music therapy (MT) and skin-to-skin care (SSC) are both interventions designed to help preterm infants with issues like sensory regulation, stress reduction, and enhancing parent-infant attachment.
- The study aims to compare the effects of combining MT with SSC against SSC alone on preterm infants’ autonomic nervous system stability, parental anxiety, and parent-infant attachment.
- A total of 72 preterm infants and their parents will participate in the trial, which includes two sessions in the hospital and a follow-up, with ethical approval obtained and the trial registered on ClinicalTrials.gov.
Article Synopsis
- The study investigates whether conservative antibiotic treatment (CAT) is a viable alternative to appendectomy for children with uncomplicated acute appendicitis.
- Data was collected from 362 children treated with CAT, showing that most (86.8%) did not require surgery, but some still needed appendectomies later due to recurrences.
- The findings indicate that CAT can be a safe and effective treatment strategy, provided strict diagnostic criteria are followed, though it doesn’t replace surgery for all cases.
The Role of Exercise in Prevention and Treatment of Osteopenia of Prematurity: An Update.
Pediatr Exerc Sci
November 2017
Article Synopsis
- Premature infants are at higher risk for osteopenia due to low bone mass accumulation before birth and a higher requirement for bone nutrients.
- Recent studies suggest that engaging in passive range-of-motion exercises may improve weight gain, bone mineralization, and bone health markers in these infants.
- This review highlights the potential importance of exercise as a preventive and therapeutic measure for osteopenia in premature infants, alongside traditional nutritional interventions.*
Article Synopsis
- - A study evaluated conservative treatment for 197 children with uncomplicated appendicitis, finding an 87% success rate using intravenous antibiotics followed by oral antibiotics, which resulted in shorter hospital stays compared to those needing surgery.
- - Prognostic markers for treatment failure included symptoms of vomiting/nausea and the presence of intraluminal fluid on sonography, with intraluminal fluid being a significant risk factor after multi-regression analysis.
- - The research concludes that conservative treatment can be effective for uncomplicated appendicitis, and those who require surgery typically have a straightforward recovery with no serious complications, emphasizing the need to monitor intraluminal fluid as a contraindication for conservative treatment.
Article Synopsis
- The study aimed to assess how blood transfusions affect iron status and other related parameters in stable preterm infants.
- Researchers analyzed data from 63 preterm infants before and within 24 hours after receiving red blood cell transfusions, measuring factors like hemoglobin, ferritin, hepcidin, and erythropoietin.
- Results showed an increase in hemoglobin and ferritin post-transfusion, while hepcidin levels also rose, indicating that preterm infants can regulate their iron levels influenced by their age.
Article Synopsis
- The study aimed to investigate the link between major neonatal health issues and poor head growth in very-low-birthweight (VLBW) infants born preterm, analyzing a sample of nearly 13,000 infants.
- Results showed that 4.5% of infants experienced severe head growth failure (HGF) and 20.9% had moderate HGF; both were significantly associated with conditions like respiratory distress syndrome and necrotizing enterocolitis.
- Understanding if these neonatal morbidities directly affect head growth or influence it through nutrition could lead to better interventions for improving growth outcomes in preterm infants.
Article Synopsis
- The study examined the impact of a twice daily exercise program on bone strength in very low birth weight (VLBW) preterm infants compared to once daily and no exercise interventions.
- Thirty-four VLBW infants were randomly placed into three groups for a four-week period, where they underwent assisted range-of-motion exercises starting shortly after birth.
- Results showed that while bone strength declined in all groups, those in the twice daily intervention experienced a significantly reduced decrease in bone strength, suggesting benefits for preventing osteopenia and fractures.
Article Synopsis
- Preterm infants in the NICU experience critical brain development stages that can be negatively impacted by injuries and complications from prematurity, as well as stress factors in the environment.
- *The NICU setting presents various stressors, such as maternal absence and sensory overload, which can hinder proper brain growth and development.
- *Developmental care, particularly through the NIDCAP program, aims to minimize these stressors and supports both the infant's development and the formation of early parent-infant connections during hospitalization.*
Article Synopsis
- The study explored how combining kangaroo care (KC) with maternal singing affects preterm infants and their mothers.
- It involved 86 stable preterm infants, measuring heart rate variability and maternal anxiety during different phases of KC, with and without singing.
- Findings showed that maternal singing during KC lowered maternal anxiety and improved heart rate variability in infants, though no changes were noted in infants' behavior or physiological parameters.
Article Synopsis
- Beta-palmitate in infant formula may enhance digestion, leading researchers to hypothesize that high beta-palmitate (HBP) formula would result in more frequent, softer stools and less crying compared to low beta-palmitate (LBP) formula.
- In a study with 63 infants, they were fed either HBP or LBP formula, while a group of breastfed infants served as a control; data on crying and stool characteristics were collected over several days.
- Results showed that HBP formula significantly reduced crying duration and frequency compared to LBP, suggesting it may enhance comfort for formula-fed infants and ease parental stress, similar to the benefits seen with breastfeeding.
Article Synopsis
- Pregnancy-induced hypertension (PIH) was examined to see if it affects mortality and major health issues in preterm, small for gestational age (SGA) infants.
- The study analyzed over 2,100 singleton SGA infants born between 1995 and 2010, using data to evaluate the impact of PIH compared to no PIH, considering acute pregnancy complications.
- Results indicated that PIH did not lead to better outcomes regarding mortality or severe health issues in preterm SGA infants, regardless of the presence of pregnancy complications.
Article Synopsis
- A study was conducted to see if very early feeding (within 24 hours of birth) helps small for gestational age (SGA) preterm infants reach full feeding faster compared to delayed feeding (after 24 hours).
- The research involved 60 preterm infants divided into two groups, with results showing that those fed early reached full feeding and were discharged home significantly sooner without increased health issues like necrotizing enterocolitis.
- Both groups showed improved gastric motility by the seventh day after feeding began, but there were no significant differences in motility between the early and delayed feeding groups.
Effect of high β-palmitate content in infant formula on the intestinal microbiota of term infants.
J Pediatr Gastroenterol Nutr
April 2013
Article Synopsis
- Palmitic acid (PA) in human milk is primarily in the sn-2 position, allowing for better absorption, while palm oil used in formulas has PA in sn-1 and sn-3 positions, which is less efficiently absorbed.
- A study with 36 infants (14 breast-fed and 22 formula-fed) tested the effects of high β-palmitate (HBP) vs. low β-palmitate (LBP) formulas on gut bacteria over 6 weeks.
- Results showed that HBP formula led to higher levels of beneficial bacteria, Lactobacillus and bifidobacteria, in the infants' stools compared to those on LBP formula, indicating a positive impact on gut microbiota.
Article Synopsis
- The study compared the effects of different infant formulas on bone strength in term infants over 12 weeks, focusing on palmitic acid levels.
- Eighty-three healthy infants participated, with those formula-fed divided into high beta-palmitate (HBP) and low beta-palmitate (LBP) groups, alongside a breast-fed reference group.
- Results showed that infants on HBP formula had significantly higher bone speed of sound (SOS) than those on LBP formula, indicating improved bone strength similar to breast-fed infants.
Article Synopsis
- Music therapy, specifically using live harp music, is recommended for preterm infants and their mothers in the NICU to enhance care.
- The study focused on the effects of combining live harp music therapy with kangaroo care on the well-being of both mothers and infants, measuring heart rates, oxygen levels, and anxiety.
- Results showed that this combination significantly reduced maternal anxiety but did not impact the infants' physiological or behavioral responses.