Point-of-care testing and treatment of sexually transmitted and genital infections to improve birth outcomes in high-burden, low-resource settings (WANTAIM): a pragmatic cluster randomised crossover trial in Papua New Guinea.

Background: Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and bacterial vaginosis have been associated with adverse maternal and perinatal outcomes, but there is conflicting evidence on the benefits of antenatal screening and treatment for these conditions. We aimed to determine the effect of antenatal point-of-care testing and immediate treatment of C trachomatis, N gonorrhoeae, T vaginalis, and bacterial vaginosis on preterm birth, low birthweight, and other adverse maternal and perinatal outcomes compared with current standard of care, which included symptom-based treatment without laboratory confirmation.

Methods: In this pragmatic cluster randomised crossover trial, we enrolled women (aged ≥16 years) attending an antenatal clinic at 26 weeks' gestation or earlier (confirmed by obstetric ultrasound), living within approximately 1 h drive of a study clinic, and able to provide reliable contact details at ten primary health facilities and their catchment communities (clusters) in Papua New Guinea.

Being born with a single cardiac ventricle: What do we tell prospective parents.

Single ventricle cardiac disease remains one of the most extreme forms of congenital heart disease. It encompasses a wide variety of lesions characterised by the existence of one small ventricular cavity. We now realise that survival of this group is much longer than expected, well into adulthood for the majority with current techniques, albeit with a considerable burden of disease for many.

Addressing Suffering in Infants and Young Children Using the Concept of Suffering Pluralism.

Despite the central place of suffering in medical care, suffering in infants and nonverbal children remains poorly defined. There are epistemic problems in the detection and treatment of suffering in infants and normative problems in determining what is in their best interests. A lack of agreement on definitions of infant suffering leads to misunderstanding, mistrust, and even conflict amongst clinicians and parents.

Early-onset vitamin B-dependent epilepsy due to pathogenic variants in a premature infant: A case report and review of the literature.

Vitamin B-dependent epilepsies are a heterogeneous group of disorders characterized by decreased availability of the active cofactor pyridoxal-5'-phosphate (PLP). While pathogenic variants in or genes account for most cases of these disorders, biallelic pathogenic variants in have been shown to cause a form of early onset vitamin B-dependent epilepsy (EPVB6D). PLPBP is thought to play a role in the homeostatic regulation of vitamin B, by supplying PLP to apoenzymes while limiting side-reaction toxicity related to excess unbound PLP.

Point-of-care testing and treatment of sexually transmitted infections to improve birth outcomes in high-burden, low-income settings: Study protocol for a cluster randomized crossover trial (the WANTAIM Trial, Papua New Guinea).

, , and bacterial vaginosis have been associated with preterm birth and low birth weight, and are highly prevalent among pregnant women in many low- and middle-income settings. There is conflicting evidence on the potential benefits of screening and treating these infections in pregnancy. Newly available diagnostic technologies make it possible, for the first time, to conduct definitive field trials to fill this knowledge gap.

Caffeine for apnea of prematurity and brain development at 11 years of age.

Objective: Caffeine therapy for apnea of prematurity has been reported to improve brain white matter microstructure at term-equivalent age, but its long-term effects are unknown. This study aimed to investigate whether caffeine affects (1) brain structure at 11 years of age, and (2) brain development from term-equivalent age to 11 years of age, compared with placebo.

Methods: Preterm infants born ≤1250 g were randomly allocated to caffeine or placebo.

[Five years after the Spanish neonatal resuscitation survey. Are we improving?].

Introduction: An analysis is presented of delivery room (DR) neonatal resuscitation practices in Spanish hospitals.

Methods: A questionnaire was sent by e-mail to all hospitals attending deliveries in Spain.

Results: A total of 180 questionnaires were sent, of which 155 were fully completed (86%).

Childhood behavior problems and age at first sexual intercourse: a prospective birth cohort study.

Background And Objectives: Early first sexual intercourse (FSI) is a risk factor for unplanned teenage pregnancy, sexually transmitted infection, and adverse social, emotional, and physical health outcomes in adolescence and into adulthood. The aim of this study was to examine relationships between internalizing (eg, anxious/depressed, withdrawn) and externalizing (eg, delinquent, aggressive) behavior problems in childhood and age at FSI.

Methods: We used a large, population-based birth cohort (The Western Australian Pregnancy Cohort [Raine] Study) to address this question.