Publications by authors named "Riskin A"

Article Synopsis
  • The study aimed to determine if using a continuous non-invasive pCO monitor in extremely low birth weight (ELBW) infants during their first week of life could reduce rates of severe brain injuries (IVH or PVL) and related mortality.
  • A total of 132 ELBW infants were observed, divided into a study group monitored by the TCpCO and a smaller control group due to monitor availability, showing no significant difference in rates of IVH/PVL or combined outcomes between the two groups.
  • The research highlighted difficulties in conducting controlled trials in fast-evolving medical practices, as changes in standard care complicated the study's findings and limited the ability to make strong conclusions.
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A growing body of research shows that rudeness negatively affects individual functioning and performance. Considerably less is known about how rudeness affects team processes and outcomes. In a series of five studies aimed at extending theories of the social-cognitive implications of rudeness to the team level, we show that rudeness is detrimental to team functioning.

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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.
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Objective: This study aims to examine the perspectives of neonatologists in Israel regarding resuscitation of preterm infants born at 22-24 weeks gestation and their consideration of parental preferences. The factors that influence physicians' decisions on the verge of viability were investigated, and the extent to which their decisions align with the national clinical guidelines were determined.

Study Design: Descriptive and correlative study using a 47-questions online questionnaire.

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To explore the influence of religious beliefs and faith on breastfeeding initiation among mothers in Israel. The study, conducted from February 2022 to July 2023 at Bnai Zion Medical Center (located in Haifa district) and Laniado hospital (located in Netanya, Sharon plain), included mothers and their partners who voluntarily completed questionnaires. The survey, comprising 26 questions, delves into religion, faith, religiosity, and infant feeding approaches, while considering various socioeconomic and health-related factors.

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Article Synopsis
  • Rapid trio genome sequencing (rtGS) is being implemented in Israeli neonatal intensive care units (NICUs) to provide advanced care for critically ill newborns suspected of having genetic issues.
  • A study conducted from October 2021 to December 2022 involved 130 neonates, leading to a diagnostic rate of 50% for disease-causing genetic variants and 11% for variants of unknown significance (VUS).
  • Results showed a mean turnaround time for rapid reports of 7 days, with high engagement from medical staff regarding the clinical utility of the results (82% response rate to questionnaires).
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Neonatal hyperbilirubinemia is an extremely common metabolic complication of the neonatal period which may be associated with bilirubin encephalopathy and even death. Adverse neurological consequences are preventable if a timely diagnosis and treatment are provided. Phototherapy is usually the preferred option to decrease hyperbilirubinemia.

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Article Synopsis
  • Extremely low birth weight (ELBW) premature infants are at high risk for both low and high carbon dioxide levels, which can lead to serious health issues.
  • A study was conducted to compare CO levels from non-invasive transcutaneous monitors (TcCO) with traditional blood gas measurements (bgCO) in ELBW infants, finding a moderate correlation and good agreement between the two methods.
  • Results indicate that while TcCO can effectively monitor CO levels in these infants, it should be used alongside blood gas sampling for a comprehensive assessment due to variability in readings.
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Unlabelled: Glucose-6-phosphate dehydrogenase (G6PD) deficiency and polymorphism in uridine diphosphate glucuronosyl transferase 1A1 (UGT1A1) were associated with significant neonatal hyperbilirubinemia (NHB) and increased risk for kernicterus. However, quantitative screening tests for G6PD enzyme activity proved unsatisfactory in estimating the risk for significant NHB, especially in heterozygous females that could present phenotype overlap between normal homozygotes, heterozygotes, and deficient homozygotes, resulting in a continuum of intermediate G6PD activity.

Objective: To examine the association of genotype and phenotype in newborns with decreased G6PD activity and its relation to NHB.

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Objective: This study aimed to compare oxygenation instability, as documented by the oxygen saturation (SpO) histograms, during bolus (over 30 minutes) versus continuous (over 2 hours) feeding among very low birth weight (VLBW) premature infants, supported with noninvasive ventilation (NIV).

Study Design: This was a randomized prospective study. VLBW infants supported with NIV received three consecutive feeds in a random order of bolus-continuous-bolus or continuous-bolus-continuous.

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Intrapartum antibiotics are widely used and may potentially affect bilirubin levels and neurotoxicity in the newborn. The aim of this study was to examine the effect of intrapartum antibiotic exposure on neonatal jaundice. We retrospectively collected data from 972 neonates born to 963 mothers.

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Selective serotonin reuptake inhibitors (SSRIs) are increasingly used for maternal depression during pregnancy; however, their use has been linked to adverse effects in newborns. Respiratory and feeding problems, jaundice, metabolic and temperature dysregulation and hypoglycemia have been described in term infants. However, scarce data exists on early neonatal adaptation in exposed infants born prematurely.

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Intracardiac thrombi in preterm infants are not common but may lead to fatal outcomes. Predisposing and risk factors include small vessel size, hemodynamic instability, immaturity of the fibrinolytic system, indwelling central catheters and sepsis. In this paper, we present our own experience with a case of a catheter-related right atrial thrombus in a preterm infant, which was successfully treated with an aspiration thrombectomy.

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Objective: To compare adverse perinatal outcome among coronavirus disease 2019 (COVID-19)-vaccinated and -unvaccinated pregnant women.

Method: Retrospective equivalence cohort study comparing 930 women who received at least one BNT162b2 (Pfizer/BioNTech) COVID-19 vaccine during the second or third trimester of pregnancy and 964 unvaccinated women. The primary outcome was a composite adverse perinatal outcome including at least one of the following: preterm delivery <35 weeks of gestation, intrauterine fetal death >23 weeks of gestation, intrauterine growth restriction defined as birth weight < 10th percentile, 5-min APGAR score ≤ 7, and neonatal care unit admission.

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Background: Communication with parents of sick premature and term infants in the NICU is complicated and challenging. Multiple efforts have been made to improve it, including the introduction of new electronic-based measures.

Aim: We aimed to study the influence of implementation of a new communication technology on parents' satisfaction with care in the NICU during the COVID-19 pandemic.

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Background: Group decision-making can be placed on a continuum of group dynamics, between Groupthink and Polythink.

Objective: To present a new assessment tool for the characterization of medical teams' decision-making group dynamics, and test it to study the effects of exposure to rudeness on various types of group dynamics.

Methods: Three judges who watched videotapes of critical care simulations evaluated 24 neonatal intensive care unit teams' decision-making processes.

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Background And Objectives: There is a debate regarding the preferred intravenous (IV) access for newborns. Our aim was to study practices regarding the choice of vascular access and outcomes.

Methods: A seven-month prospective observational study on IV lines used in all newborns admitted to Bnai Zion Medical Center's neonatal intensive care unit (NICU).

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Objectives: This study aimed to compare time to full feeding (TFF) between continuous gastric feeding (CGF) and bolus feeding (BF) in very low birth weight (VLBW) infants supported with noninvasive ventilation (NIV) and to evaluate feasibility and identify methodological pitfalls for future large-scale studies.

Study Design: This study is a randomized controlled, prospective, pilot study. VLBW premature infants, supported with NIV, were randomized while still on trophic feeding <20 mL/kg/day to receive feeding over 2 hours of CGF or over 15- to 30-minute BF.

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Type 2 diabetes mellitus (T2DM) is believed to cause hypogonadism through increasing pro-inflammatory cytokines. Tumour necrosis factor-α (TNF-α) is a primary cytokine associated with T2DM. The study explored the association between total testosterone (TT) level and cytokines status in 53 adult males, 27 T2DM (T2DM group) and 26 non-T2DM (control group).

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Background: Transthyretin (TTR), also known as prealbumin, has been suggested as an indicator of protein and nutritional status.

Objective: The aim of this study was to examine the maternal and umbilical cord (UC) TTR in relation to intrauterine growth, and the serum TTR of preterm infants in relation to nutritional status and growth.

Methods: After application of exclusion criteria, 49 preterm infants (mean gestational age and birth-weight 32.

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Background: Exposure to pain in early life was associated with long term consequences, therefore strategies for minimizing painful procedures in newborns should be employed. The utility and reliability of cord blood CBC was demonstrated before, however data regarding use of cord blood in healthy infants at risk for polycythemia are lacking.

Methods: A single-center, paired-sampling prospective laboratory study including all healthy asymptomatic infants born after 36 weeks gestation who were SGA (<2500 g), LGA (>4000 g), or born to mothers with diabetes in pregnancy.

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Background: Interpeak latencies (IPL), as measured by the auditory brainstem-evoked responses (ABR) test, represent the conduction time, and therefore the maturation of the brainstem auditory pathway. We aimed to study the effect of various risk factors for the neurodevelopmental delay on the conduction time in the auditory pathway among normal hearing premature infants, at term postmenstrual age (PMA).

Methods: Retrospective analysis of 239 premature infants (gestational age 32.

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Parenteral nutrition is used to treat children that cannot be fully fed by the enteral route. While the revised ESPGHAN/ESPEN/ESPR/CSPEN pediatric parenteral nutrition guidelines provide clear guidance on the use of parenteral nutrition in neonates, infants, and children based on current available evidence, they have helped to crystallize areas where research is lacking or more studies are needed in order to refine recommendations. This paper collates and discusses the research gaps identified by the authors of each section of the guidelines and considers each nutrient or group of nutrients in turn, together with aspects around delivery and organization.

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Background: Infants born very prematurely have functionally and structurally immature gastrointestinal tracts.

Objectives: To assess the safety and tolerability of administration of enteral recombinant human (rh) insulin on formula fed preterm infants and to assess whether enteral administration of rh-insulin enhances gastrointestinal tract maturation by reducing the time to reach full enteral feeding.

Methods: A phase 2, multicenter, double-blind, placebo-controlled, randomized study was conducted.

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