Improving delivery room and admission efficiency and outcomes for infants < 32 weeks: ELGAN+ (Extremely Low Gestational Age Neonate).

Objective: To evaluate the implementation of a systematic approach to improve the resuscitation, stabilization, and admission of infants < 32 weeks gestation and also to ascertain its effect on organization, efficiency, and clinical outcomes during hospitalization.

Methods: Retrospective study involving a multidisciplinary team with checklists, role assignment, equipment organization, step by step protocol, and real time documentation for the care of infants < 32 weeks gestation in the delivery room to the neonatal intensive care unit. Pre-data collection (cases) period was from Aug, 2015 to July, 2017, and post-data collection(controls) period was from Aug, 2017 to Aug, 2019.

Maternal preeclampsia as a risk factor for developing bronchopulmonary dysplasia in neonates.

Objective: To determine the effect of preeclampsia on the development of bronchopulmonary dysplasia (BPD) in preterm infants.

Methods: Retrospective cohort study of infants' ≤32 weeks' gestation admitted to a level-IV single center neonatal intensive care unit from 2014 to 2016. Infants with major congenital anomalies, death or transfer before 28 days were excluded.

Total water intake by kilogram of body weight: Analysis of the Australian 2011 to 2013 National Nutrition and Physical Activity Survey.

Aim: Water is critical for human survival, yet water intake equations may not reflect contemporary populations. This research aims to determine the total water intake of a representative Australian population, per kilogram of body weight (mL/kg) and stratified by age and sex.

Methods: A secondary analysis of the 2011 to 2013 National Nutrition and Physical Activity Survey (n = 10 146) was conducted.

Refractory Pulmonary Interstitial Emphysema in Extreme Premature Newborn.

Pulmonary interstitial emphysema (PIE) occurs when air leaks into the pulmonary interstitium due to overdistension of distal airways, it occurs mainly in neonates with respiratory distress syndrome who need positive pressure ventilation but has also been reported in spontaneously breathing infants. Herein, we report on an extremely low birth weight infant with severe persistent PIE, while on invasive mechanical ventilation (high-frequency oscillatory ventilation, high-frequency jet ventilation, and neurally adjust ventilator assist) managed successfully with 2 weeks of selective right lung ventilation after failure of more conservative measures, including shorter periods of right mainstem intubation, before the prolonged trial that was successful.

Effect of continuous positive airway pressure versus nasal cannula on late preterm and term infants with transient tachypnea of the newborn.

Objective: To compare continuous positive airway pressure (CPAP) with nasal cannula (NC) as primary noninvasive respiratory therapy in hypoxic infants for transient tachypnea of the newborn (TTN).

Study Design: Retrospective cohort study of infants born at ≥34 weeks of gestation between January 1, 2015 and December 31, 2018.

Result: After adjusting for gestational age and birth weight, the maximum fractional inspired oxygen (FiO) was significantly lower in the CPAP group with an incidence rate ratio (IRR) of 0.

Pediatric asthma pathway in the emergency room.

Asthma is one of the leading causes of hospital admission in the pediatric population. Standardization of asthma management guidelines for patients admitted to the emergency department has been suggested to improve care delivery and patient outcomes. Utilizing a multidisciplinary asthma task force at a single academic medical center, we sought to determine if a protocol-driven approach to implementation of care for patients with asthma could improve patient outcomes by reducing wait times for administration of steroids.

Variations in umbilical cord clamping practices in the United States: a national survey of neonatologists.

Objective: Since the first publication of the American College of Obstetricians and Gynecologists committee opinion in 2012, and following the update in 2017, multiple institutions in the United States (US) adopted the practice of delayed cord clamping (DCC) and/or umbilical cord milking (UCM) in preterm and term infants. However, there have been variations reported in practices with regard to method of placental transfusion, timing of cord clamping and gestational age thresholds. Furthermore, the optimal cord clamping practice in situations of depressed infants needing resuscitation or in higher-risk delivery situations, such as placental abruption, intrauterine growth restriction, multiple gestation, chorioamnionitis, maternal human immunodeficiency virus syndrome/hepatitis or maternal general anesthesia is often debated.

Short-Term Complications Associated with Surgical Ligation of Patent Ductus Arteriosus in ELBW Infants: A 25-Year Cohort Study.

Objective: This article aims to determine the incidence of short-term complications of surgical patent ductus arteriosus (PDA) ligations, the factors associated with those complications, and whether complications are associated with poor long-term outcomes.

Study Design: Retrospective cohort study of all extremely low birth weight (ELBW, < 1,000 g) infants who underwent surgical PDA ligation at a single-center neonatal intensive care unit from 1989 to 2015. Demographic, clinical, and laboratory data were reviewed.

Magnetic resonance imaging as a diagnostic modality in a child with acute lymphoblastic leukemia.

Acute lymphoblastic leukemia is the most common form of childhood cancer. It presents with nonspecific symptoms, such as bone pain, that can be easily misdiagnosed at initial presentation. We present a 2-year-old boy with bilateral foot pain that worsened over 6 months.

Role of asthma camp in improving the overall health of children with asthma.

This study sought to evaluate the benefit of asthma camp for patients who attended Baylor Scott & White McLane Children's Medical Center's Camp Wheeze Away in July 2016. Data were collected on children aged 8 to 15 years who were diagnosed with asthma and attended asthma camp. Information on body mass index, hospital admissions, and emergency department visits was collected 1 year before and 1 year after camp.

Mycobacterium Avium Complex Presenting as Pulmonary Nodules in a Child With Sickle Cell Disease.

The case of a 10-year-old child with sickle cell disease with pulmonary nodules and prolonged fevers is reported here. The child was first diagnosed with sarcoidosis based on lung biopsy, but unresponsiveness to therapy led to a second lung biopsy, which revealed the true diagnosis of mycobacterium avium complex disease. Multiple possible explanations for why the patient became infected exist.

Proteomics and Metabolomics in Pregnancy-An Overview.

Importance: Pregnancy is getting more and more complex due to increasing number of complications that may affect fetal outcomes. The introduction of newer "proteomics and metabolomics" technologies in the field of obstetrics and gynecology may allow physicians to identify possible associated etiologies that affect the mother during pregnancy and lead to associated complications affecting the offspring.

Objective: The principal objective of this review article is to provide a comprehensive evaluation of the use of proteomics and metabolomics in complicated pregnancies.

Myocardial ischemia in an adolescent secondary to nutritional thiamine deficiency.

Thiamine (vitamin B1) is an essential vitamin found in most food products in developed nations. Deficiencies in this crucial vitamin lead to diseases related to nutritional needs, metabolic demands, enzymatic function, and neurological inflammation. We present an 18-year-old patient with a history of nasopharyngeal carcinoma and total parenteral nutrition (TPN) dependence who experienced neurological manifestations and heart failure, likely due to underlying thiamine deficiency, dehydration, and vasodilation.

Morbidity and mortality of coagulase-negative staphylococcal sepsis in very-low-birth-weight infants.

Background: Coagulase-negative staphylococci (CoNS) are the most common cause of late-onset sepsis in the neonatal intensive care unit (NICU) and usually require vancomycin treatment. Our objective was to determine whether CoNS are associated with neonatal morbidity and mortality.

Methods: This was a retrospective cohort study of very-low-birth-weight (VLBW, ≤ 1500 g) infants from 1989 to 2015.

Outcomes of an Adolescent School-Based Health Initiative Needs Assessment.

Adolescent School-Based Health Initiatives (ASBHIs) are designed to increase adolescent access to medical homes and services that are not otherwise available without significant barriers. ASBHIs have been proven to increase access to care for school-aged adolescents with unique needs and limited access to these much-needed medical services. For this descriptive study we conducted a needs assessment to understand and determine the needs and desires for a school-based health initiative in a middle school in the community.

Flooding: what is the impact on pregnancy and child health?

Floods are the most common type of natural disaster in both developed and developing countries and have led to extensive morbidity and mortality throughout the world. Worldwide, over the past 30 years, flooding has claimed the lives of more than 200,000 people and affected more than 2.8 billion others.

Antibiotic Exposure and Risk for Death or Bronchopulmonary Dysplasia in Very Low Birth Weight Infants.

We assessed the association between antibiotic exposure in the first 2 weeks of life and development of bronchopulmonary dysplasia in a cohort of very low birth weight infants. After controlling for the severity of illness, each additional day of antibiotic therapy was associated with both an increased risk for and severity of bronchopulmonary dysplasia.

Chorioamnionitis and subsequent bronchopulmonary dysplasia in very-low-birth weight infants: a 25-year cohort.

Objective: To determine whether chorioamnionitis (CA) or sepsis were associated with bronchopulmonary dysplasia (BPD) in a 25-year cohort of very-low-birth weight (VLBW) infants.

Study Design: VLBW infants ⩽32 weeks gestation admitted to the neonatal intensive care unit between 1989 and 2014 were reviewed. BPD was defined using the National Institutes of Health consensus definition.

Safety and efficacy of packed red blood cell transfusions at different doses in very low birth weight infants.

This double-blinded, randomized, crossover study evaluated the safety and effectiveness of 20 mL/kg aliquots of packed red blood cell (PRBC) transfusions versus 15 mL/kg aliquot transfusions in very low birth weight (VLBW) infants with anemia. The study enrolled 22 hemodynamically stable VLBW infants requiring PRBC transfusions, with a mean gestational age of 25.7 ± 2.

Natural methods of protein stabilization: thermostable biocatalysts.

Enzymes that are naturally found in thermophilic and hyperthermophilic organisms are being used as robust biocatalysts in the fine chemical and pharmaceutical industries. They have important use in these industries due to their increased stability which is often required during commercial reaction conditions. The approach used in these studies is to learn how nature has managed to stabilize these proteins using a detailed knowledge of their biochemical properties and three-dimensional structures.

The influence of seam height on lost-time injury and fatality rates at small underground bituminous coal mines.

Due to variations in the thickness of U.S. coal seams, there is great variability in the height of the roof where underground miners work.

Controlling the pain of venous leg ulceration.

Compression therapy can often exacerbate the pain of venous leg ulceration. A pain management programme using a team approach to care can promote compliance with compression therapy. Nurses need to be sensitive and responsive to an individual's pain.