The purpose of this study was to evaluate the feasibility of the use oral ibuprofen suspension (OIS) in the treatment of patent ductus arteriosus (PDA) in premature infants. Premature infants (= 35 weeks) age 2 to 7 days who suffered from respiratory distress and had been diagnosed with PDA were included in this study. Color Doppler echocardiography (ECHO) was used to measure the internal ductal diameter, pressure gradient, and the ratio of left atrial to aortic root diameters (La/Ao). Infants were randomly assigned to one of two groups: group I received three doses of intravenous (IV) indomethacin (0.2 mg/kg at 12-hour intervals) and group O received an initial dose of OIS (10 mg/kg), followed by two doses of 5 mg/kg each, after 24 and 48 hours. A follow-up ECHO was done after treatment by the same pediatric cardiologist who was blinded to the assignment of the study groups. Changes in blood platelet count, hematocrit, blood urea nitrogen, and creatinine were compared between groups. In total, 78 premature infants were screened: 21 had been diagnosed with PDA. Infants in group I (n = 9) and group O (n = 12) did not differ in birthweight (1884 +/- 485 versus 1521 +/- 398 g [mean +/- SD]; P = 0.13), gestational age (32.9 +/- 1.6 versus 31.2 +/- 2.5 weeks; P = 0.07), internal diameter of PDA (2.3 +/- 0.5 versus 2.1 +/- 0.5 mm; P = 0.34), pressure gradient across PDA (12.83 +/- 6.46 versus 11.11 +/- 4.5 mm Hg; P = 0.48), and La/Ao ratio (1.26 +/- 0.21 versus 1.17 +/- 0.12; P = 0.25). Closure of PDA was achieved in 78% (seven of nine) of infants in group I and in 83% (10 of 12) of infants in group O. Comparisons of laboratory changes following treatment in group I and group O were as follows: decrease in hematocrit (-6.5 +/- 6.6 versus -1.2 +/- 4.2; P = 0.04) and in platelet count (-54 +/- 67 versus -1 +/- 53 x 10 (3)/muL; P = 0.24), and increase in blood urea nitrogen (16.4 +/- 16.4 versus 2.1 +/- 17.4 mg/dL; P = 0.06) and serum creatinine (0.12 +/- 0.22 versus -0.06 +/- 0.19 mg/dL; P = 0.13). Two infants in group I had severe pulmonary hemorrhage, whereas there were none in the group O. Oral ibuprofen could be an easy-to-administer and efficacious alternative in the treatment of PDA.
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http://dx.doi.org/10.1055/s-2007-976550 | DOI Listing |
JAMA Netw Open
January 2025
Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University Hospital, Aarhus University, Aarhus, Denmark.
Importance: Current evidence of the association between prenatal exposure to glucocorticoids and long-term mental disorders is scarce and has limitations.
Objective: To investigate the association between prenatal exposure to systemic glucocorticoids and mental disorders in offspring at the age of 15 years, comparing exposed vs unexposed offspring born to mothers with the same underlying disease (risk of preterm delivery and autoimmune or inflammatory disorders).
Design, Setting, And Participants: This nationwide population-based cohort study used data from registries in Denmark with follow-up until December 31, 2018.
Pediatr Surg Int
January 2025
Neonatal Intensive Care Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.
Purpose: To compare postoperative outcomes of bedside surgery (BS) with those of surgery performed in the operating room (ORS) in preterm and full-term neonates.
Methods: Data from neonates undergoing major surgical interventions were retrospectively evaluated. Primary outcome was the incidence of postoperative hypothermia.
Mult Scler
January 2025
Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
Background: Many common symptoms in post-acute sequelae following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC) overlap with those of multiple sclerosis (MS). We examined symptoms and performance of the PASC score, developed in the general population, in MS based on infection history.
Methods: We surveyed North American Research Committee on Multiple Sclerosis (NARCOMS) registry participants regarding infections and categorized participants based on infection history.
Mediators Inflamm
January 2025
Department of Bioinformatics, School of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, China.
The tolerance and dynamic regulation of the maternal immune system during pregnancy are pivotal for ensuring fetal health. Immune cell subsets play a complex and crucial role in this process, closely linked to the neonatal health status. Despite recognizing the significance of dysregulation in the quantity and activity of immune cells in neonatal disease occurrence, their specific roles remain elusive, resulting in a dearth of clinically viable interventions for immune-mediated neonatal diseases.
View Article and Find Full Text PDFInt Breastfeed J
January 2025
School of Health and Welfare, Dalarna University, Falun, Sweden.
Background: Emerging knowledge about supportive neurodevelopmental neonatal care shows the need for an individual approach to establish breastfeeding. However, evidence on how cue-based breastfeeding is supported in neonatal intensive care units (NICUs) is scarce. Therefore, the aim was to describe supporting practices for cue-based breastfeeding.
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