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本文报告了1例妊娠14周经超声发现胎儿骶尾部畸胎瘤,超声联合MRI提示肿瘤分型为Ⅰ型。妊娠26周前肿瘤囊性部分占比>60%,妊娠28周肿瘤囊性部分自行破裂。妊娠期密切监测,妊娠36周+5时,肿瘤体积增至12.8 cm×9.7 cm×12.3 cm。孕妇于妊娠37周行剖宫产术分娩。新生儿生后4 d于小儿外科行肿瘤切除术,术后随访无生理功能障碍,预后良好。  相似文献   
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目的探讨新生儿化脓性脑膜炎近期预后不良的危险因素。 方法回顾性分析2015年9月至2021年1月于河北省人民医院新生儿科诊治的76例新生儿化脓性脑膜炎患儿的相关临床资料,根据其6~12个月内转归分为预后良好组(n=46)和预后不良组(n=30),比较两组新生儿的一般情况、出生史、临床特点、实验室检测结果及病原菌类别等情况,采用多因素Logistic回归分析近期预后不良的因素,并通过绘制ROC曲线评估各个指标对于预后预测的效能。 结果预后不良组患儿男婴占比(23/30,76.67%)、低出生胎龄比例(13/30,43.33%)、低出生体重(8/30,26.67%)、合并意识障碍比例(13/30,43.33%)、电解质异常比例(9/30,30.00%)较预后良好组高[52.17%(24/46)、2.17%(1/46)、2.17%(1/46)、21.74%(10/46)、2.17%(1/46)],两组比较均差异有统计学意义(χ2=4.62,4.01,9.99;均P<0.05)。预后不良组患儿脑脊液(CSF)白细胞计数[435(165,875)×106/L]、CSF蛋白水平[1.54(0.90,2.38)g/L]均高于预后良好组[78(32,305)×106/L,0.70(0.57,1.02)g/L)],CSF葡萄糖/血糖比值[0.37(0.27,0.53)]低于预后良好组[0.54(0.46,0.68)],两组比较均差异有统计学意义(Z=-3.78,-4.72,-3.26;均P<0.01)。Logistic回归分析显示,CSF白细胞计数、CSF蛋白水平、CSF葡萄糖/血糖比值是提示预后不良的危险因素(OR=1.002,2.840,0.056;均P<0.05)。ROC曲线显示,CSF白细胞计数、CSF蛋白水平、CSF葡萄糖/血糖比值及三者联合模型曲线下面积(AUC)分别为0.800,0.822,0.769,0.879。 结论CSF白细胞计数高、CSF葡萄糖/血糖比值低、CSF蛋白水平高是提示新生儿化脓性脑膜炎近期预后不良的独立危险因素。  相似文献   
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ObjectiveThe objective of this feasibility study was to examine the implementation and usefulness of an intervention for extremely premature infant (EPI) caregivers.ResultsOne caregiver and five nurses provided feedback with a mean score of 4.4 out of 5 pertaining to helpfulness.ConclusionsImplementation of the Caregiver's Guide was feasible and was positively received by NICU nurses and caregivers. We recommend implementing a revised version of this tool based on nurse and caregiver feedback. The delivery of education should be divided between dayshift and nightshift nurses so that one nurse is not responsible for providing all the information. The education should be categorized by gestational age and day of life and only given when it is pertinent to the care of the child. A section should be added to include a quick reference guide for the medical jargon used in the NICU.  相似文献   
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Early development of the fovea has been documented by histological studies over the past few decades. However, structural distortion due to sample processing and the paucity of high-quality post-mortem tissue has limited the effectiveness of this approach. With the continuous progress in high-resolution non-invasive imaging technology, most notably optical coherence tomography (OCT) and OCT angiography (OCT-A), in vivo visualization of the developing retina has become possible. Combining the information from histologic studies with this novel imaging information has provided a more complete and accurate picture of retinal development, and in particular the developing fovea.Advances in neonatal care have increased the survival rate of extremely premature infants. However, with enhanced survival there has been an attendant increase in retinal developmental complications. Several key abnormalities, including a thickening of the inner retina at the foveal center, a shallower foveal pit, a smaller foveal avascular zone, and delayed development of the photoreceptors have been described in preterm infants when compared to full-term infants. Notably these abnormalities, which are consistent with a partial arrest of foveal development, appear to persist into later childhood and adulthood in these eyes of individuals born prematurely. Understanding normal foveal development is vital to interpreting these pathologic findings associated with prematurity.In this review, we first discuss the various advanced imaging technologies that have been adapted for imaging the infant eye. We then review the key events and steps in the development of the normal structure of the fovea and contrast structural features in normal and preterm retina from infancy to childhood. Finally, we discuss the development of the perifoveal retinal microvasculature and highlight future opportunities to expand our understanding of the developing fovea.  相似文献   
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《Vaccine》2022,40(27):3737-3745
BackgroundVaccines may induce non-specific effects on survival and health outcomes, in addition to protection against targeted pathogens or disease. Observational evidence suggests that infant Baccillus Calmette-Guérin (BCG) vaccination may provide non-specific survival benefits, while diphtheria-tetanus-pertussis (DTP) vaccination may increase the risk of mortality. Non-specific vaccine effects have been hypothesized to modify the effect of neonatal vitamin A supplementation (NVAS) on mortality.Methods22,955 newborns in Ghana and 31,999 newborns in Tanzania were enrolled in two parallel, randomized, double-blind, placebo-controlled trials of neonatal vitamin A supplementation from 2010 to 2014 and followed until 1-year of age. Cox proportional hazard models were used to estimate associations of BCG and DTP vaccination with infant survival.ResultsBCG vaccination was associated with a decreased risk of infant mortality after controlling for confounders in both countries (Ghana adjusted hazard ratio (aHR): 0.51, 95% CI: 0.38–0.68; Tanzania aHR: 0.08, 95% CI: 0.07–0.10). Receiving a DTP vaccination was associated with a decreased risk of death (Ghana aHR: 0.39, 95% CI: 0.26–0.59; Tanzania aHR: 0.19, 95% CI: 0.16–0.22). There was no evidence of interaction between BCG or DTP vaccination status and infant sex or NVAS.ConclusionWe demonstrated that BCG and DTP vaccination were associated with decreased risk of infant mortality in Ghana and Tanzania with no evidence of interaction between DTP or BCG vaccination, NVAS, and infant sex. Our study supports global recommendations on BCG and DTP vaccination and programmatic efforts to ensure all children have access to timely vaccination.Clinical trials registration: Ghana (Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12610000582055) and Tanzania (ANZCTR: ACTRN12610000636055)  相似文献   
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The pulmonary alveolocapillary dysplasia (ACD) with pulmonary vein misalignment (PVM) is a rare condition characterized by a congenital anomaly of the development of the pulmonary parenchyma. We present a case of an 8-month-old infant who died quickly from acute respiratory failure complicating an unknown ACD. We also describe its epidemiological characteristics in infants and we discuss the diagnosis's difficulties. In this case, a pulmonary arterial hypertension was decompensated by an infection. A medico-legal autopsy was performed. As for the Histological examination, it showed the features of ACD/PVM.  相似文献   
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Child benefits are typically paid from birth. This paper asks whether starting universal child benefits in pregnancy leads to improvements in infant health. Leveraging administrative birth registry and hospital microdata from England and Wales, I study the effects of the Health in Pregnancy Grant, a universal conditional cash transfer equivalent to three months of child benefit (190 GBP) as a lump sum to pregnant mothers from 2009 to 2011. I exploit quasi-experimental variation in eligibility with a regression discontinuity design in the date of birth of the baby. I find that the policy increased birth weight by 8–12 grams on average, reduced low birth weight (<2500 g) by 3-6 percent and decreased prematurity by 9–11 percent. Younger mothers, particularly those living in deprived areas, benefit the most. I present evidence that the mechanisms are unlikely to be antenatal care, nutrition or smoking, with reductions in stress remaining a possible explanation.  相似文献   
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