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Latest & greatest articles for infants
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Transcatheter atrial septal defect closure in an infant (body weight 6.4Â kg) using the GORE CARDIOFORM septal occluder (GCSO) 29101573 2018 11 13 2194-7791 4 1 2017 Nov 03 Molecular and cellular pediatrics Mol Cell Pediatr Transcatheter atrial septal defect closure in an infant (body weight 6.4 kg) using the GORE CARDIOFORM septal occluder (GCSO). 9 10.1186/s40348-017-0077-7 Transcatheter closure has become the treatment of choice for secundum atrial septal defects (ASD II), but particularly (...) in small children, there is concern regarding procedure-related complications. We report on a 10-month-old infant, body weight of 6.4 kg, with a large ASD who was referred for failure to thrive and dyspnea on exertion. Echocardiography showed two neighboring ASDs centrally located within an atrial septum with a length of 27 mm resulting in significant left-to-right shunting. During cardiac catheterization, hemodynamic significance of the defect as well as normal pulmonary vascular resistance
Continuous Glucose Monitoring in Very Preterm Infants: A Randomized Controlled Trial 28916591 2017 09 16 2017 10 12 2017 10 12 1098-4275 140 4 2017 Oct Pediatrics Pediatrics Continuous Glucose Monitoring in Very Preterm Infants: A Randomized Controlled Trial. e20171162 10.1542/peds.2017-1162 Impaired glucose control in very preterm infants is associated with increased morbidity, mortality, and poor neurologic outcome. Strategies based on insulin titration have been unsuccessful in achieving (...) euglycemia in absence of an increase in hypoglycemia and mortality. We sought to assess whether glucose administration guided by continuous glucose monitoring (CGM) is more effective than standard of care blood glucose monitoring in maintaining euglycemia in very preterm infants. Fifty newborns ≤32 weeks' gestation or with birth weight ≤1500 g were randomly assigned (1:1) within 48-hours from birth to receive computer-guided glucose infusion rate (GIR) with or without CGM. In the unblinded CGM group
Early-life exposure to indoor air pollution or tobacco smoke and lower respiratory tract illness and wheezing in African infants: a longitudinal birth cohort study 29167839 2018 11 13 2542-5196 1 8 2017 Nov The Lancet. Planetary health Lancet Planet Health Early-life exposure to indoor air pollution or tobacco smoke and lower respiratory tract illness and wheezing in African infants: a longitudinal birth cohort study. e328-e336 10.1016/S2542-5196(17)30134-1 Indoor air pollution (IAP (...) ) and environmental tobacco smoke (ETS) are associated with lower respiratory tract illness (LRTI) or wheezing in children. However, the effect of the timing of these exposures, specifically antenatal versus postnatal, and of alternate fuel sources such as the increasingly used volatile organic compounds have not been well studied. We longitudinally investigated the effect of antenatal or postnatal IAP and ETS on LRTI or wheezing prevalence and severity in African infants. Mother and infant pairs enrolled over
Delayed versus Immediate Cord Clamping in Preterm Infants. Background The preferred timing of umbilical-cord clamping in preterm infants is unclear. Methods We randomly assigned fetuses from women who were expected to deliver before 30 weeks of gestation to either immediate clamping of the umbilical cord (≤10 seconds after delivery) or delayed clamping (≥60 seconds after delivery). The primary composite outcome was death or major morbidity (defined as severe brain injury on postnatal (...) groups. Complete data on the primary outcome were available for 1497 infants (95.6%). There was no significant difference in the incidence of the primary outcome between infants assigned to delayed clamping (37.0%) and those assigned to immediate clamping (37.2%) (relative risk, 1.00; 95% confidence interval, 0.88 to 1.13; P=0.96). The mortality was 6.4% in the delayed-clamping group and 9.0% in the immediate-clamping group (P=0.03 in unadjusted analyses; P=0.39 after post hoc adjustment for multiple
Early (< 8 days) systemic postnatal corticosteroids for prevention of bronchopulmonary dysplasia in preterm infants. BACKGROUND: Bronchopulmonary dysplasia remains a major problem in neonatal intensive care units. Persistent inflammation in the lungs is the most likely underlying pathogenesis. Corticosteroids have been used to prevent or treat bronchopulmonary dysplasia because of their potent anti-inflammatory effects. OBJECTIVES: To examine the relative benefits and adverse effects (...) of systemic postnatal corticosteroids commenced within the first seven days of life for preterm infants at risk of developing bronchopulmonary dysplasia. SEARCH METHODS: For the 2017 update, we used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 1); MEDLINE via PubMed (January 2013 to 21 February 2017); Embase (January 2013 to 21 February 2017); and the Cumulative Index to Nursing and Allied Health Literature (CINAHL
Late (> 7 days) systemic postnatal corticosteroids for prevention of bronchopulmonary dysplasia in preterm infants. BACKGROUND: Many preterm infants who survive go on to develop bronchopulmonary dysplasia, probably as the result of persistent inflammation in the lungs. Corticosteroids have powerful anti-inflammatory effects and have been used to treat individuals with established bronchopulmonary dysplasia. However, it is unclear whether any beneficial effects outweigh the adverse effects (...) of these drugs. OBJECTIVES: To examine the relative benefits and adverse effects of late systemic postnatal corticosteroid treatment (> 7 days) for preterm infants with evolving or established bronchopulmonary dysplasia. SEARCH METHODS: For the 2017 update, we used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 1); MEDLINE via PubMed (January 2013 to 21 February 2017); Embase (January 2013 to 21 February 2017
Influenza vaccines for preventing acute otitis media in infants and children. BACKGROUND: Acute otitis media (AOM) is one of the most common infectious diseases in children. It has been reported that 64% of infants have an episode of AOM by the age of six months and 86% by one year. Although most cases of AOM are due to bacterial infection, it is commonly triggered by a viral infection. In most children AOM is self limiting, but it does carry a risk of complications. Since antibiotic treatment (...) increases the risk of antibiotic resistance, influenza vaccines might be an effective way of reducing this risk by preventing the development of AOM. OBJECTIVES: To assess the effectiveness of influenza vaccine in reducing the occurrence of acute otitis media in infants and children. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, LILACS, Web of Science, the WHO International Clinical Trials Registry Platform, and ClinicalTrials.gov (15
Inhaled versus systemic corticosteroids for the treatment of bronchopulmonary dysplasia in ventilated very low birth weight preterm infants. BACKGROUND: This is an update of a review published in 2012. A related review "Inhaled versus systemic corticosteroids for preventing bronchopulmonary dysplasia in ventilated very low birth weight preterm neonates" has been updated as well. Bronchopulmonary dysplasia (BPD) is a serious and common problem among very low birth weight infants, despite the use (...) (1980 to 23 February 2017), and CINAHL (1982 to 23 February 2017). We also searched clinical trials registers, conference proceedings and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. SELECTION CRITERIA: Randomised or quasi-randomised controlled trials comparing inhaled versus systemic corticosteroid therapy (irrespective of dose and duration) starting after the first week of life in ventilator-dependent very low birth weight infants. DATA
Early planned removal of umbilical venous catheters to prevent infection in newborn infants. BACKGROUND: Lengthy duration of use may be a risk factor for umbilical venous catheter-associated bloodstream infection in newborn infants. Early planned removal of umbilical venous catheters (UVCs) is recommended to reduce the incidence of infection and associated morbidity and mortality. OBJECTIVES: To compare the effectiveness of early planned removal of UVCs (up to two weeks after insertion) versus (...) , and the Maternity & Infant Care Database (until May 2017), as well as conference proceedings and previous reviews. SELECTION CRITERIA: Randomised and quasi-randomised controlled trials that compared effects of early planned removal of UVCs (up to two weeks after insertion) versus an expectant approach or a longer fixed duration in preventing bloodstream infection and other complications in newborn infants. DATA COLLECTION AND ANALYSIS: Two review authors assessed trial eligibility and risk of bias
Protein hydrolysate versus standard formula for preterm infants. BACKGROUND: When human milk is not available for feeding preterm infants, protein hydrolysate rather than standard cow's milk formulas (with intact proteins) are often used because they are perceived as being tolerated better and less likely to lead to complications. However, protein hydrolysate formulas are more expensive than standard formulas, and concern exists that their use in practice is not supported by high-quality (...) evidence. OBJECTIVES: To assess the effect of feeding preterm infants with hydrolysed formula (versus standard cow's milk formulas) on the risk of feed intolerance, necrotising enterocolitis, and other morbidity and mortality in preterm infants. SEARCH METHODS: We used the standard Cochrane Neonatal search strategy including electronic searches of the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 4), Ovid MEDLINE, Ovid Embase, and the Cumulative Index to Nursing and Allied Health
Maternal and Infant Outcomes After Human Papillomavirus Vaccination in the Periconceptional Period or During Pregnancy 28796684 2017 08 10 2017 09 08 2017 09 08 1873-233X 130 3 2017 Sep Obstetrics and gynecology Obstet Gynecol Maternal and Infant Outcomes After Human Papillomavirus Vaccination in the Periconceptional Period or During Pregnancy. 599-608 10.1097/AOG.0000000000002191 To evaluate whether quadrivalent human papillomavirus vaccine (4vHPV) administered during the periconceptional (...) , Spontaneous epidemiology Adolescent Adult Adverse Drug Reaction Reporting Systems Cohort Studies Congenital Abnormalities epidemiology Female Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18 adverse effects Humans Infant, Newborn Papillomavirus Infections prevention & control Preconception Care Pregnancy Pregnancy Complications, Infectious prevention & control Pregnancy Outcome Premature Birth epidemiology Prenatal Care Retrospective Studies Stillbirth epidemiology United States
Comparative effectiveness of fiberoptic phototherapy for hyperbilirubinemia in term infants Comparative effectiveness of fiberoptic phototherapy for hyperbilirubinemia in term infants Comparative effectiveness of fiberoptic phototherapy for hyperbilirubinemia in term infants HAYES, Inc Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation HAYES, Inc. Comparative (...) effectiveness of fiberoptic phototherapy for hyperbilirubinemia in term infants. Lansdale: HAYES, Inc. Directory Publication. 2017 Authors' conclusions Phototherapy is used to treat jaundice in newborns, and to prevent severe hyperbilirubinemia, and its complications. The lights in phototherapy units emit photons that alter the structure of the bilirubin molecule, which can then be excreted in bile or urine. Fiberoptic phototherapy (FPT) systems are light-emitting pads or blankets that are placed under
Effects of Inorganic Iodine Therapy Administered to Lactating Mothers With Graves Disease on Infant Thyroid Function 29264454 2018 11 13 2472-1972 1 10 2017 Oct 01 Journal of the Endocrine Society J Endocr Soc Effects of Inorganic Iodine Therapy Administered to Lactating Mothers With Graves Disease on Infant Thyroid Function. 1293-1300 10.1210/js.2017-00297 The effects of maternal inorganic iodine therapy on infant thyroid function are not well known. This study investigated the effects (...) on infant thyroid function of maternal inorganic iodine therapy when administered to lactating mothers with Graves disease. This study was a prospective case series performed at the Tajiri Thyroid Clinic, Kumamoto, Japan. Subjects were 26 infants of lactating mothers with Graves disease treated with potassium iodide (KI) for postpartum thyrotoxicosis. Infant blood levels of thyroid-stimulating hormone (TSH) and free thyroxine were measured using the dried filter-paper method. Iodine concentrations
High versus standard volume enteral feeds to promote growth in preterm or low birth weight infants. BACKGROUND: Breast milk alone, given at standard recommended volumes (150 to 180 mL/kg/d), is not adequate to meet the protein, energy, and other nutrient requirements of growing preterm or low birth weight infants. One strategy that may be used to address these potential nutrient deficits is to give infants enteral feeds in excess of 200 mL/kg/d ('high-volume' feeds). This approach may increase (...) nutrient uptake and growth rates, but concerns include that high-volume enteral feeds may cause feed intolerance, gastro-oesophageal reflux, aspiration pneumonia, necrotising enterocolitis, or complications related to fluid overload, including patent ductus arteriosus and bronchopulmonary dysplasia. OBJECTIVES: To assess the effect on growth and safety of feeding preterm or low birth weight infants with high (> 200 mL/kg/d) versus standard (≤ 200 mL/kg/d) volume of enteral feeds. Infants
Cerebral near-infrared spectroscopy monitoring for prevention of brain injury in very preterm infants. BACKGROUND: Cerebral injury and long-term neurodevelopmental impairment is common in extremely preterm infants. Cerebral near-infrared spectroscopy (NIRS) enables continuous estimation of cerebral oxygenation. This diagnostic method coupled with appropriate interventions if NIRS is out of normal range (that is cerebral oxygenation within the 55% to 85% range) may offer benefits without causing (...) more harms. Therefore, NIRS coupled with appropriate responses to abnormal findings on NIRS needs assessment in a systematic review of randomised clinical trials and quasi-randomised studies. OBJECTIVES: To evaluate the benefits and harms of interventions that attempt to alter cerebral oxygenation guided by cerebral NIRS monitoring in order to prevent cerebral injury, improve neurological outcome, and increase survival in preterm infants born more than 8 weeks preterm. SEARCH METHODS: We used
Early Mortality and Morbidity in Infants with Birth Weight of 500?Grams or Less in Japan 28746032 2017 07 26 2017 07 26 1097-6833 2017 Jun 01 The Journal of pediatrics J. Pediatr. Early Mortality and Morbidity in Infants with Birth Weight of 500?Grams or Less in Japan. S0022-3476(17)30638-8 10.1016/j.jpeds.2017.05.017 To assess the short-term prognosis of Japanese infants with a birth weight (BW) of ?500?g. Demographic and clinical data were reviewed for 1473 live born infants with a BW ?500?g (...) at gestational age ?22 weeks who were treated in the 204 affiliated hospitals of the Neonatal Research Network of Japan between 2003 and 2012. Survival to hospital discharge occurred in 811 of 1473 infants (55%; 95% CI 53%-58%). The survival rates of BW ?300?g, 301-400?g, and 401-500?g were 18% (95% CI 10%-31%), 41% (95% CI 36%-47%), and 60% (95% CI 57%-63%), respectively. In a multivariable Cox proportional hazards analysis, antenatal corticosteroid use (adjusted hazard ratio: 0.68; 95% CI 0.58-0.81; P
Prebiotic galacto-oligosaccharides mitigate the adverse effects of iron fortification on the gut microbiome: a randomised controlled study in Kenyan infants 28774885 2017 08 04 2017 08 04 1468-3288 2017 Aug 03 Gut Gut Prebiotic galacto-oligosaccharides mitigate the adverse effects of iron fortification on the gut microbiome: a randomised controlled study in Kenyan infants. gutjnl-2017-314418 10.1136/gutjnl-2017-314418 Iron-containing micronutrient powders (MNPs) reduce anaemia in African (...) infants, but the current high iron dose (12.5 mg/day) may decrease gut Bifidobacteriaceae and Lactobacillaceae, and increase enteropathogens, diarrhoea and respiratory tract infections (RTIs). We evaluated the efficacy and safety of a new MNP formula with prebiotic galacto-oligosaccharides (GOS) combined with a low dose (5 mg/day) of highly bioavailable iron. In a 4-month, controlled, double-blind trial, we randomised Kenyan infants aged 6.5-9.5 months (n=155) to receive daily (1) a MNP without iron
Respiratory viruses in healthy infants and infants with cystic fibrosis: a prospective cohort study 28778921 2017 08 05 2017 08 05 1468-3296 2017 Aug 04 Thorax Thorax Respiratory viruses in healthy infants and infants with cystic fibrosis: a prospective cohort study. thoraxjnl-2016-209553 10.1136/thoraxjnl-2016-209553 Acute viral respiratory tract infections in children with cystic fibrosis (CF) are known causes of disease exacerbation. The role of viral infections during infancy is, however (...) , less known, although early infancy is thought to be a crucial period for CF disease development.We prospectively assessed symptomatic and asymptomatic viral detection in the first year of life in infants with CF and healthy controls. In a prospective cohort study, we included 31 infants with CF from the Swiss Cystic Fibrosis Infant Lung Development Cohort and 32 unselected, healthy infants from the Basel Bern Infant Lung Development Cohort and followed them throughout the first year of life
Effect of a Baby-Led Approach to Complementary Feeding on Infant Growth and Overweight: A Randomized Clinical Trial 28692728 2017 07 10 2017 09 05 2168-6211 171 9 2017 Sep 01 JAMA pediatrics JAMA Pediatr Effect of a Baby-Led Approach to Complementary Feeding on Infant Growth and Overweight: A Randomized Clinical Trial. 838-846 10.1001/jamapediatrics.2017.1284 Baby-led approaches to complementary feeding, which promote self-feeding of all nonliquid foods are proposed to improve energy self (...) -regulation and lower obesity risk. However, to date, no randomized clinical trials have studied this proposition. To determine whether a baby-led approach to complementary feeding results in a lower body mass index (BMI) than traditional spoon-feeding. The 2-year Baby-Led Introduction to Solids (BLISS) randomized clinical trial recruited 206 women (168 [81.6%] of European ancestry; 85 [41.3%] primiparous) in late pregnancy from December 19, 2012, through March 17, 2014, as part of a community