Neonatal assessment in the delivery room--Trial to Evaluate a Specified Type of Apgar (TEST-Apgar).

Background: Since an objective description is essential to determine infant's postnatal condition and efficacy of interventions, two scores were suggested in the past but weren't tested yet: The Specified-Apgar uses the 5 items of the conventional Apgar score; however describes the condition regardless of gestational age (GA) or resuscitative interventions. The Expanded-Apgar measures interventions needed to achieve this condition. We hypothesized that the combination of both (Combined-Apgar) describes postnatal condition of preterm infants better than either of the scores alone.

Delayed meconium passage in small vs. appropriate for gestational age preterm infants: management and short-term outcome.

Objective: Delayed passage of stool is a result of both gestational immaturity and illness severity. Small for gestational age (SGA) preterm infants are at high risk of gastrointestinal (GI) complications. We aimed to analyse the effects of a strict nutrition and stool protocol on GI problems in SGA compared to appropriate for gestational age (AGA) preterm infants.

aEEG and NIRS during transition and resuscitation after birth: promising additional tools; an observational study.

Aim Of The Study: During resuscitation no routine cerebral monitoring is available. We aimed at monitoring cerebral activity and oxygenation continuously during neonatal transition and resuscitation.

Methods: Neonates ≥34 weeks of gestation born via cesarean section were included.

How to dress as a paediatrician?

Aim: Do different clothing styles have an influence on the doctor-patient-parent relationship and which kind of outfit is preferred by children and parents.

Methods: One hundred and seven children and 72 parents were visited by a paediatrician randomly wearing one of the three different outfits (casual, semiformal, formal) during a hospital stay. Parents and children between 6 and 18 years were then interviewed about their opinion by use of a semi-structured questionnaire, while children between 0 and 6 years were observed concerning their behaviour during the examination.

C reactive protein: impact on peripheral tissue oxygenation and perfusion in neonates.

Objective: C reactive protein (CRP) is a sensitive marker of acute inflammation of infectious and non-infectious origin. Aim was to use near-infrared spectroscopy (NIRS) to analyse peripheral oxygenation and perfusion in term and preterm neonates with elevated CRP levels, at a time when routine haemodynamic variables are still normal.

Design: Prospective observational study.

Prematurity: influence on mother's locus of control.

The aim of the present study was to compare the beliefs of mothers of term infants with the beliefs of mothers of preterm infants in regards to their locus of control mainly influencing their personal health and well-being. Mother's beliefs regarding the level of internal (self), social external (other individuals) and fatalistic external control (e.g.

Tilting the head changes cerebral haemodynamics in neonates.

Background: Tilting only the head influences cerebral haemodynamics in term and preterm neonates.

Objective: To evaluate near-infrared spectroscopy (NIRS) as a method to detect changes of cerebral oxygenated (HbO(2)) and deoxygenated haemoglobin (Hb) and 'cerebral tissue-oxygenation-index' (cTOI) while tilting. Furthermore to investigate whether the comparison of cTOI and 'cerebral mixed venous oxygen saturation' (tiltSvO(2)), calculated out of the increase of HbO(2) and Hb, improves reproducibility.

'Multi-associations': predisposed to misinterpretation of peripheral tissue oxygenation and circulation in neonates.

Interpretation of peripheral circulation in ill neonates is crucial but difficult. The aim was to analyse parameters potentially influencing peripheral oxygenation and circulation. In a prospective observational cohort study in 116 cardio-circulatory stable neonates, peripheral muscle near-infrared spectroscopy (NIRS) with venous occlusion was performed.

Regional tissue oxygen saturation: comparability and reproducibility of different devices.

Unlabelled: Comparability and reproducibility of different near-infrared spectroscopy devices measuring regional tissue oxygen saturation remain poor. Aim of the present study was to compare values and reproducibility of cerebral∕peripheral "tissue-oxygenation-index" (TOI; NIRO 300, Hamamatsu(®), Japan) with cerebral∕peripheral "regional-oxygen-saturation" (rSO; INVOS5100, Somanetics(®), USA), and to analyze the influence of quality criteria.

Methods: cTOI and crSO2 were measured on the left forehead, pTOI and prSO2 were measured on the left calf.

Baby sleeping bag and conventional bedding conditions--comparative investigations by infrared thermography.

Background: Thermal stress is a risk factor for sudden infant death syndrome (SIDS). Recently, baby sleeping bags have been recommended as a preventive measure against SIDS. The aim of this study was to describe in which way the use of baby sleeping bags might influence thermoregulation of sleeping infants and maybe the incidence of SIDS.

Acylated ghrelin increases after controlled short-time exercise in school-aged children.

Ghrelin is a peptide hormone, which plays an important role in appetite regulation. The effects of exercise on ghrelin plasma concentrations are still not clear, especially in children and adolescents. The aim of this study was to investigate the response of acylated and total ghrelin concentrations to controlled exercise in school-aged children.

Non-nutritive sucking habits in sleeping infants.

Background: Pacifier use has been postulated to decrease the risk of sudden infant death syndrome (SIDS). The responsible mechanisms are, however, unclear.

Objectives: Since little is known about the non-nutritive sucking (NNS) habits of infants during sleep, we investigated NNS patterns and changes of physiological parameters during NNS in sleeping infants.

Combination of different noninvasive measuring techniques: a new approach to increase accuracy of peripheral near infrared spectroscopy.

One of the problems of near-infrared-spectroscopy (NIRS) measurements is low reproducibility. The aim of the present study was to introduce quality criteria to increase reproducibility of peripheral NIRS measurements. In a prospective cohort study in 40 neonates, repeated NIRS measurements were performed on the calf.

Unchanged heart rate-respiratory frequency ratio in preterm infants during spontaneous arousals.

Aim: To find out whether a correlation of heart rate (HR) and respiratory frequency (RF) defined as HR-RF-ratio (HRR) may be helpful to identify arousals in term and preterm infants.

Methods: Polygraphic recordings were performed in 25 term infants (gestational age 40.1 +/- 1.

Pacifier use does not alter the frequency or duration of spontaneous arousals in sleeping infants.

Objective: It has been reported that pacifiers might reduce the risk of SIDS by favouring infants' arousability from sleep. We evaluated the influence of a pacifier on the frequency and duration of spontaneous arousals in healthy infants.

Methods: Polygraphic recordings were performed in 14 infants with an age of 51.

Pacifier use: what makes mothers change their mind?

Aim: To find out the reasons for mothers to either use or not use a pacifier and to find out the mother's reasons for changing their mind.

Method: We analysed the data of 174 mother-infant pairs by means of a semistructured questionnaire performed shortly after birth, and at the age of 7 weeks and 5 months, respectively.

Results: The main reason for mothers primarily refusing a pacifier was their concern about malformation of the teeth or jaw.

Forearm and calf tissue oxygenation in term neonates measured with near-infrared spectroscopy.

Peripheral tissue oxygenation has been studied with near-infrared spectroscopy (NIRS) on either the forearm or calf with questionable comparability. The aim was to compare forearm and calf tissue oxygenation in healthy term neonates measured with NIRS. Fractional oxygen extraction, tissue oxygenation index, and mixed venous oxygenation were similar in both extremities, whereas oxygen delivery and oxygen consumption of calf tissue were higher.

Impact of smoking during pregnancy on peripheral tissue oxygenation in term neonates.

Background: Smoking during pregnancy is associated with higher blood pressure in neonates.

Objective: To analyze whether smoking during pregnancy has an influence on peripheral tissue oxygenation in healthy term neonates within the first days after delivery.

Methods: In a prospective cohort study, 15 healthy term neonates of mothers who had smoked during pregnancy (smoking group) were matched for gestational age, actual weight and postnatal age to 15 healthy term neonates of mothers who had not smoked during pregnancy (non-smoking group).

Ghrelin--an indicator for fat oxidation in obese children and adolescents during a weight reduction program.

The aim of this study was to investigate the effect of short-term energy restriction combined with physical activity on changes in substrate oxidation and changes in plasma concentrations of ghrelin. We designed a longitudinal intervention study of 4.2 MJ (= 1,000 kcal) daily with exercise.

Is bladder voiding in sleeping preterm infants accompanied by arousals?

Background: As it has been reported that bladder voiding in sleeping full-term infants is consistently accompanied by a cortical arousal, it was the aim of the present study to find out whether this could also hold true for preterm infants.

Methods: Polygraphic recordings were performed in 21 healthy preterm infants (10 female). The infants' gestational age at birth was 31+/-2.

Do wet diapers induce arousals in sleeping infants?

Aim: To find out whether simulated bladder voiding was able to induce arousals in sleeping infants.

Methods: Polygraphic recordings were performed in 34 infants and voiding was simulated by administering water into the diaper.

Results: Heart rate, respiratory frequency and electroencephalogram frequency did not change significantly during this procedure.

Peripheral oxygenation in term neonates.

The aim of this study was to analyse changes in peripheral oxygenation in healthy term neonates within the first week of life with near-infrared spectroscopy and venous occlusion. Oxygen delivery did not change with increasing age. Oxygen consumption and fractional oxygen extraction increased, whereas tissue oxygenation index decreased with increasing age.