Single-leg versus double-leg hip spica casts in the management of paediatric femoral shaft fractures? A systematic review and meta-analysis.

Background: Paediatric femoral shaft fractures can be managed with single- or double-leg hip spica casting between ages six-months and six-years. The aim of this review was to determine if single-leg hip spicas reduce the impact on family life without compromising fracture stability.

Methods: The study was registered on PROSPERO (CRD42023454309).

Participatory learning and action (PLA) to improve health outcomes in high-income settings: a systematic review protocol.

Introduction: Participatory learning and action (PLA) is a form of group reflection and learning with documented efficacy in low-income countries to improve social and health outcomes. PLA represents both a learning philosophy and a practical framework that could be applied to a variety of contexts. To date, PLA has not been widely implemented within high-income countries (HICs) to improve health and health-related outcomes.

Interhospital Transfers of Maternal Patients: Cohort Analysis of Nationwide Inpatient Sample, 2011.

Objective: The objective of this study was to estimate the annual rate of interhospital transfers of pregnant and postpartum women in the United States and analyze associated patient and health system characteristics as measures of regionalized perinatal care performance.

Methods: Separate weighted univariate analyses of the 2011 Nationwide Inpatient Sample (NIS) were performed for all maternal discharges, in-hospital deaths, and transfers. Multivariable logistic regression analyses for transfer dispositions adjusted for health system characteristics, maternal demographics, and diagnoses were performed.

Neonatal Enterovirus Infection: Case Series of Clinical Sepsis and Positive Cerebrospinal Fluid Polymerase Chain Reaction Test with Myocarditis and Cerebral White Matter Injury Complications.

 We describe five neonates with enteroviral (EV) infection to demonstrate central nervous system (CNS) and cardiac complications and report successful treatment of myocarditis with immunoglobulin intravenous (IVIG) in two.  Case series identified during three enteroviral seasons in one neonatal intensive care unit (NICU) by cerebral spinal fluid (CSF) reverse transcriptase polymerase chain reaction (PCR) testing for EV in neonates suspected to have sepsis, but with sterile bacterial cultures.  Cases were identified in each of three sequential years in a NICU with 800 to 900 admissions/year.

Predictive factors and practice trends in red blood cell transfusions for very-low-birth-weight infants.

Background: Red blood cell (RBC) transfusions in very-low-birth-weight (VLBW) infants, while common, carry risk. Our objective was to determine clinical predictors of and trends in RBC transfusions among VLBW infants.

Methods: RBC transfusion practice and its clinical predictors in 1,750 VLBW (≤1,500 g) infants were analyzed in a single-center cohort across sequential epochs: 2000-2004 (Epoch 1), 2005-2009 (Epoch 2), and 2010-2013 (Epoch 3).

Surgery and neurodevelopmental outcome of very low-birth-weight infants.

Importance: Reduced death and neurodevelopmental impairment among infants is a goal of perinatal medicine.

Objective: To assess the association between surgery during the initial hospitalization and death or neurodevelopmental impairment of very low-birth-weight infants.

Design, Setting, And Participants: A retrospective cohort analysis was conducted of patients enrolled in the National Institute of Child Health and Human Development Neonatal Research Network Generic Database from 1998 through 2009 and evaluated at 18 to 22 months' corrected age.

Increased risk of death among uninsured neonates.

Objective: To estimate the contribution of health insurance status to the risk of death among hospitalized neonates.

Data Sources: Kids' Inpatient Databases (KID) for 2003, 2006, and 2009.

Study Design: KID 2006 subpopulation of neonatal discharges was analyzed by weighted frequency distribution and multivariable logistic regression analyses for the outcome of death, adjusted for insurance status and other variables.

Growth in VLBW infants fed predominantly fortified maternal and donor human milk diets: a retrospective cohort study.

Background: To determine the effect of human milk, maternal and donor, on in-hospital growth of very low birthweight (VLBW) infants. We performed a retrospective cohort study comparing in-hospital growth in VLBW infants by proportion of human milk diet, including subgroup analysis by maternal or donor milk type. Primary outcome was change in weight z-score from birth to hospital discharge.

Improving survival of extremely preterm infants born between 22 and 25 weeks of gestation.

Objective: To estimate observed compared with predicted survival rates of extremely premature infants born during 2000-2009, to identify contemporary predictors of survival, and to determine if improved survival rates occurred during the decade.

Methods: We conducted a retrospective cohort analysis of 237 inborn neonates without major congenital anomalies born from 2000 to 2009 after 22 to 25 completed weeks of gestation. Observed survival rates at each gestational age were compared with predicted survival rates based on gestational age, birth weight, sex, singleton or multiple gestation, and antenatal corticosteroid administration estimated by a Web-based calculator that was derived from 1998 to 2003 outcomes of a large national cohort.

Prediction of survival in infants with congenital diaphragmatic hernia based on stomach position, surgical timing, and oxygenation index.

Objective: To identify characteristics predictive of survival of patients with congenital diaphragmatic hernia (CDH).

Study Design: Retrospective analysis of clinical characteristics including severity of lung disease measured by oxygenation index (OI) associated with single-center survival in CDH patients (n = 81) from 1992 to 2008. Data were analyzed using univariate and multivariable logistic regression, effect plots, and receiver operating characteristic (ROC) plots.

Maternal intention to breast-feed and breast-feeding outcomes in term and preterm infants: Pregnancy Risk Assessment Monitoring System (PRAMS), 2000-2003.

Objective: To determine the effect of intention to breast-feed on short-term breast-feeding outcomes in women delivering term and preterm infants.

Design: Data from the US Centers for Disease Control and Prevention's Pregnancy Risk Assessment Monitoring System (PRAMS) for three states, Ohio, Michigan and Arkansas, during 2000-2003 were analysed. SAS 9·1·3 and SUDAAN 10 statistical software packages were used for analyses.

Cytochrome P450 (CYP2D6) genotype is associated with elevated systolic blood pressure in preterm infants after discharge from the neonatal intensive care unit.

Objective: To determine genetic and clinical risk factors associated with elevated systolic blood pressure (ESBP) in preterm infants after discharge from the neonatal intensive care unit (NICU).

Study Design: A convenience cohort of infants born at <32 weeks gestational age was followed after NICU discharge. We retrospectively identified a subgroup of subjects with ESBP (systolic blood pressure [SBP] >90th percentile for term infants).

Risk of adverse drug events in neonates treated with opioids and the effect of a bar-code-assisted medication administration system.

Purpose: The risk of adverse drug events (ADEs) in neonates treated with opioids and the effect of a bar-code-assisted medication administration (BCMA) system were studied.

Methods: A prospective cohort study of neonates in a neonatal intensive care unit (NICU) was conducted. A BCMA system was operative for 50% of the study period.

Impact of timing of birth and resident duty-hour restrictions on outcomes for small preterm infants.

Objective: The goal was to examine the impact of birth at night, on the weekend, and during July or August (the first months of the academic year) and the impact of resident duty-hour restrictions on mortality and morbidity rates for very low birth weight infants.

Methods: Outcomes were analyzed for 11,137 infants with birth weights of 501 to 1250 g who were enrolled in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network registry in 2001-2005. Approximately one-half were born before the introduction of resident duty-hour restrictions in 2003.

"Nurses Don't Hate Change" -- survey of nurses in a neonatal intensive care unit regarding the implementation, use and effectiveness of a bar code medication administration system.

A bar code medication administration (BCMA) system reduced preventable adverse drug events (ADEs) by 47% in our neonatal intensive care unit (NICU). However, it is often expected that providers will not welcome technological change. Two years after BCMA system implementation, we studied the perceptions of nurses in our NICU to better understand their opinions about patient safety, use, acceptance and occupational effects of the new technology.

Abortion and the risk of subsequent preterm birth: a systematic review with meta-analyses.

Objective: To conduct a systematic review and meta-analyses of studies that test the association between induced or spontaneous abortion and subsequent preterm birth.

Study Design: International databases were reviewed (1995-2007) using the terms preterm, premature, birth, labor, delivery, abortion, induced abortion, miscarriage and spontaneous abortion. Only studies that met prespecified objective criteria for methodologic design and reporting were included in the meta-analyses.

Effectiveness of a barcode medication administration system in reducing preventable adverse drug events in a neonatal intensive care unit: a prospective cohort study.

Objective: Patients are at risk of harm from medication errors. Barcode medication administration (BCMA) systems are recommended to mitigate preventable adverse drug events (ADEs). Our hypothesis was that a BCMA system would reduce preventable ADEs by 45% in a neonatal intensive care unit.

Positive effect of NICU admission on breastfeeding of preterm US infants in 2000 to 2003.

Objective: We hypothesized that neonatal intensive care unit (NICU) admission reduces breastfeeding in a recent population of US infants, adjusting for confounding factors.

Study Design: Using pregnancy risk assessment monitoring system data from 27 states for the years 2000 to 2003, we determined the relationship between breastfeeding and gestational age (GA) stratified by NICU status. We fitted a proportional odds model for breastfeeding duration as a function of NICU status adjusted for other covariates.

Feasibility of asynchronous independent lung high-frequency oscillatory ventilation in the management of acute hypoxemic respiratory failure: a case report.

Objective: To report the first case of the use of asynchronous independent lung high-frequency oscillatory ventilation (AIL-HFOV) in the management of acute hypoxemic respiratory failure in a large pediatric patient with markedly asymmetric lung disease.

Design: Case study.

Setting: Tertiary pediatric intensive care unit in a pediatric teaching hospital.

Efficacy, safety, and cost of intravenous sedation versus general anesthesia in children undergoing endoscopic procedures.

We prospectively evaluated 226 patients under 18 years of age who underwent 296 procedures, and intravenous sedation and general anesthesia were compared in regard to efficacy, safety, and cost. Children 6 to 9 years of age required the highest doses of midazolam (0.14 +/- 0.

Drowning and near-drowning.

The incidence, epidemiology, and pathophysiology of drowning and near-drowning are presented. Particular attention is paid to the neurologic and pulmonary pathophysiology indicators for monitoring and laboratory tests. Special attention to transportation of patients is given, and treatment in the field, emergency department, and pediatric intensive care unit is delineated.