Objectives: To examine the association between mortality or neurodevelopmental impairment at 18-24 months of corrected age and the Transport Risk Index of Physiologic Stability (TRIPS) score on admission to the neonatal intensive care unit (NICU) in extremely premature infants.
Study Design: Retrospective cohort study of extremely premature infants (inborn and outborn) born at 22-28 weeks of gestational age and admitted to NICUs in the Canadian Neonatal Network between April 2009 and September 2011. TRIPS scores and clinical data were collected from the Canadian Neonatal Network database. Follow-up data at 18-24 months of corrected age were retrieved from the Canadian Neonatal Follow-Up Network database. Neurodevelopment was assessed using the Bayley Scales of Infant and Toddler Development, Edition III. The primary outcome was death or significant neurodevelopmental impairment at 18-24 months of corrected age. The secondary outcomes were individual components of the Bayley Scales of Infant and Toddler Development, Edition III assessment.
Results: A total of 1686 eligible infants were included. A TRIPS score of ≥20 on admission to the NICU was significantly associated with mortality (aOR 2.71 [95% CI, 2.02-3.62]) and mortality or significant neurodevelopmental impairment (aOR 1.91 [95% CI, 1.52-2.41]) at 18-24 months of corrected age across all gestational age groups of extremely premature infants.
Conclusion: The TRIPS score on admission to the NICU can be used as an adjunctive, objective tool for counselling the parents of extremely premature infants early after their admission to the NICU.
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http://dx.doi.org/10.1016/j.jpeds.2020.05.019 | DOI Listing |
J Clin Lipidol
December 2024
Internal Medicine Department, Coimbra's Healthcare Integrated Delivery System, Praceta Professor Mota Pinto, 3004-561, Coimbra, Portugal.
Tangier disease is an extremely rare autosomal recessive monogenic disorder caused by mutations in the ATP binding cassette transporter A1 gene (ABCA1). It is characterized by severe deficiency or absence of high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A-1 (ApoA1), with highly variable clinical presentations depending on cholesterol accumulation in macrophages across different tissues. We report a case of a 47-year-old man with very low HDL-C and very high triglyceride levels, initially attributed to the patient's metabolic syndrome, alcohol abuse, and splenomegaly.
View Article and Find Full Text PDFPaediatr Respir Rev
January 2025
Department of Respiratory Medicine, The Children's Hospital at Westmead, Westmead, Sydney, New South Wales 2145, Australia; Discipline of Paediatrics and Child Health, Faculty of Medicine, University of Sydney, Camperdown, Sydney, New South Wales 2006, Australia.
Physical activity is crucial for children's physical, cognitive, and social development, reducing the risk of non-communicable diseases and improving overall well-being. A major legacy of extremely preterm delivery is respiratory limitation with reduced lung function and decreased exercise capacity which can be further exacerbated by inactivity and deconditioning. Strategies to increase incidental physical activities in early childhood and participation in sport and more formal exercise programmes in middle childhood have the potential to optimize cardiopulmonary function, improve quality of life, and foster social interactions in childhood and beyond, thereby providing benefits that extend far beyond the physical domain.
View Article and Find Full Text PDFAntibiotics (Basel)
January 2025
Adelaide Medical School, Robinson Research Institute, The University of Adelaide, Adelaide 5005, Australia.
Effective gentamicin dosing is crucial to the survival of neonates with suspected sepsis but requires a careful balance between attaining both effective peak and safe trough concentrations. We aimed to systematically compare existing gentamicin dosing guidelines for neonates in Australia to determine the extent to which they reach therapeutic targets. Simulations of a single gentamicin dose to a virtual representative neonatal population according to each Australian guideline were performed using population pharmacokinetic modelling.
View Article and Find Full Text PDFInt J Environ Res Public Health
January 2025
Healthcare Analysis and Forecasting, Wantage OX12 0NE, UK.
This study investigates the process of planning for future inpatient resources (beds, staff and costs) for maternity (pregnancy and childbirth) services. The process of planning is approached from a patient-centered philosophy; hence, how do we discharge a suitably rested healthy mother who is fully capable of caring for the newborn baby back into the community? This demonstrates some of the difficulties in predicting future births and investigates trends in the average length of stay. While it is relatively easy to document longer-term (past) trends in births and the conditions relating to pregnancy and birth, it is exceedingly difficult to predict the future nature of such trends.
View Article and Find Full Text PDFBMC Public Health
January 2025
Department of Emergency, Hainan Clinical Research Center for Acute and Critical Diseases, The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan, 570100, China.
Background: Due to climate change, the frequency and intensity of heat waves and other extreme weather events are rapidly increasing. Compared to the general population, pregnant women and fetuses are increasingly vulnerable to the effects of extreme temperatures and are associated with the occurrence of adverse birth outcomes, including preterm birth (PTB). However, its risk of preterm birth is currently uncertain.
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