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1.
Narayan Prabhu Iyer Amy Baumann Mark Stephen Rzeszotarski Robert Donald Ferguson Maroun Jean Mhanna 《World journal of pediatrics : WJP》2013,9(2):175-178
Background
Extremely low birth weight (ELBW <1000 g) infants may have increased sensitivity to radiation exposure. Our objective was to estimate the radiation exposure in survivors of ELBW infants during their neonatal intensive care unit (NICU) stay.Methods
In this retrospective cohort study, medical records of all ELBW infants who had been admitted to our NICU between May 1999 and October 2009 were reviewed. The infants’ total entrance skin exposure [ESE in micro-Gray (μGy)] was estimated.Results
Among 450 survivors, the mean gestational age (GA) was 26.3±2.1 weeks, and the mean birth weight (BW) was 774.2±144.4 g. Infants received a median of 32 (range: 1–159) X-rays, with an estimated ESE of 1471 μGy (range: 28–9264). Total ESE was inversely proportional to GA (r=?0.34; P<0.01), and BW (r=?0.39; P=0.01) and proportional to the severity of illness [score for neonatal acute physiology-perinatal extension (SNAPPE), r=0.39; P=0.01]. In a linear regression analysis, GA, SNAPPE and necrotizing enterocolitis were associated with radiation exposure (ESE) in ELBW infants (r2=0.133; P<0.001).Conclusions
During their NICU stay, ELBW infants were subjected to a significant number of diagnostic X-ray procedures. Our data highlight the need to closely monitor the number of X-ray procedures ordered to ELBW infants to avoid unnecessary radiation exposure. 相似文献2.
Deepak Louis Venkataseshan Sundaram Kanya Mukhopadhyay Sourabh Dutta Praveen Kumar 《Indian pediatrics》2014,51(8):637-640
Objective
To identify risk factors for mortality in neonates with meconium aspiration syndrome.Methods
All neonates (2004–2010) with meconium aspiration syndrome, irrespective of gestation were included. Risk factors were compared between those who died and survived.Results
Out of 172 included neonates, 44 (26%) died. Mean (SD) gestation and birth weight were 37.9 (2.3) weeks and 2545 (646g), respectively. Myocardial dysfunction [aOR 28.4; 95% CI (8.0–101); P<0.001] and higher initial oxygen requirement [aOR 1.04; 95% CI (1.02–1.07); P<0.001] increased odds of dying while a higher birth weight [aOR 0.998; 95% CI (0.997–1.00); P=0.005] reduced the odds of dying.Conclusions
Meconium aspiration syndrome is associated with significant mortality. Myocardial dysfunction, birth weight, and initial oxygen requirement are independent predictors of mortality. 相似文献3.
Background
To determine the characteristics and outcomes of pulmonary arterial hypertension (PAH) in extremely low birth weight (ELBW) infants.Methods
A retrospective case-control study of all ELBW infants admitted to a level III neonatal intensive care unit (NICU) between January 1, 2003 and December 31, 2010.Results
During the study period, 450 ELBW infants were admitted. 6.4% (29/450) were diagnosed with PAH and were matched to 26 controls. The mean gestational age of infants with PAH and their controls were similar [24.5±1.3 vs. 24.9±1.8 weeks (P=0.26)]; however the cases were smaller at birth than were controls [640.7±119.5 vs. 727.0±184.5 g (P=0.04)]. The diagnosis of PAH was made at a mean postnatal age of 131.8±53.7 days. Infants with PAH had a higher rate of intrauterine exposure to illicit maternal drug use [12/29 (41%) vs. 1/25 (4%); P=0.001], a longer duration of initial mechanical ventilation [74.9±28.3 vs. 59.1±27.8 days; P=0.04)], a higher incidence of severe BPD [23/29 (79%) vs. 13/26 (50%); P=0.02], and a greater NICU mortality rate [12/29 (41%) vs. 4/26 (15%); P=0.04].Conclusion
PAH in ELBW infants is associated with maternal illicit drug use in pregnancy, longer exposure to mechanical ventilation, severe bronchopulmonary dysplasia and a significant increase in early mortality. 相似文献4.
Xiawei Ou Charles M. Glasier Raghu H. Ramakrishnaiah Teresita L. Angtuaco Sarah B. Mulkey Zhaohua Ding Jeffrey R. Kaiser 《Pediatric radiology》2014,44(8):980-986
Background
Permissive hypercapnia is a ventilatory strategy used to prevent lung injury in ventilated extremely low birth weight (ELBW, birth weight ≤1,000 g) infants. However, there is retrospective evidence showing that high CO2 is associated with brain injury.Objective
The objective of this study was to compare brain white matter development at term-equivalent age in ELBW infants randomized to hypercapnic vs. normocapnic ventilation during the first week of life and in healthy non-ventilated term newborns.Materials and methods
Twenty-two ELBW infants from a randomized controlled trial were included in this study; 11 received hypercapnic (transcutaneous PCO2 [tcPCO2] 50–60 mmHg) ventilation and 11 normocapnic (tcPCO2 35–45 mmHg) ventilation during the first week of life while still intubated. In addition, ten term healthy newborns served as controls. Magnetic resonance imaging (MRI) with diffusion tensor imaging (DTI) was performed at term-equivalent age for the ELBW infants and at approximately 2 weeks of age for the control infants. White matter injury on conventional MRI was graded in the ELBW and control infants using a scoring system adopted from literature. Tract-based spatial statistics (TBSS) was used to evaluate for differences in DTI measured fractional anisotropy (FA, spatially normalized to a customized template) among the ELBW and term control infants.Results
Conventional MRI white matter scores were not different (7.3?±?1.7 vs. 6.9?±?1.4, P?=?0.65) between the hypercapnic and normocapnic ELBW infants. TBSS analysis did not show significant differences (P?<?0.05, corrected) between the two ELBW infant groups, although before multiple comparisons correction, hypercapnic infants had many regions with lower FA and no regions with higher FA (P?<?0.05, uncorrected) compared to normocapnic infants. When compared to the control infants, normocapnic ELBW infants had a few small regions with significantly lower FA, while hypercapnic ELBW infants had more widespread regions with significantly lower FA (P?<?0.05, fully corrected for multiple comparisons).Conclusions
Normocapnic ventilation vs. permissive hypercapnia may be associated with improved white matter development at term-equivalent age in ELBW infants. This effect, however, was small and was not apparent on conventional MRI. Further research is needed using larger sample sizes to assess if permissive hypercapnic ventilation in ELBW infants is associated with worse white matter development. 相似文献5.
Objectives
To study post-discharge growth, mortality and morbidity of extremely low birth weight neonates at corrected age of 2 years.Methods
Weight, length and head circumference were compared on WHO growth charts at corrected ages 3 (n=54), 6, 9, 12 (n=51) and 24 months (n=37); rates of underweight, stunting, microcephaly and wasting were calculated.Results
The mean Z-score for weight, length, head circumference and weightfor-length significantly improved from 3 to 24 months (P<0.001); a significant proportion remained malnourished at 2 years. Nine infants (11%) died and 35 (44%) required readmission during first year of age.Conclusion
Extremely low birth weight neonates remain significantly growth retarded at corrected age of 2 years. 相似文献6.
Fatih Bolat Serdar Comert Guher Bolat Oznur Kucuk Emrah Can Ali Bulbul Hasan Sinan Uslu Asiye Nuhoglu 《World journal of pediatrics : WJP》2013,9(4):323-329
Background
Although advances in perinatal medicine have increased the survival rates of critically ill neonates, acute kidney injury (AKI) is still one of the major causes of mortality and morbidity in neonatal intensive care units. This study aimed to determine the prevalence of AKI and analyze demographic data and risk factors associated with the mortality or morbidity.Methods
Of 1992 neonates hospitalized between January 2009 and January 2011, 168 with AKI were reviewed in the study. The diagnosis of AKI was based on plasma creatinine level >1.5 mg/dL, which persists for more than 24 hours or increases more than 0.3 mg/dL per day after the first 48 hours of birth while showing normal maternal renal function.Results
The prevalence of AKI was 8.4%. The common cause of AKI was respiratory distress syndrome, followed by sepsis, asphyxia, dehydration, congenital anomalies of the urinary tract, congenital heart disease, and medication. The prevalence of AKI in neonates with birth weight lower than 1500 g was about three-fold higher than in those with birth weight higher than 1500 g (P<0.05). Pregnancy-induced hypertension, preterm prolonged rupture of membranes, and administration of antenatal corticosteroid were associated with increased risk of AKI (P<0.05). Umbilical vein catheterization, mechanical ventilation and ibuprofen therapy for patent ductus arteriosus closure were found to be associated with AKI (P<0.05). The overall mortality rate was 23.8%. Multivariate analysis revealed that birth weight less than 1500 g, mechanical ventilation, bronchopulmonary dysplasia, anuria, and dialysis were the risk factors for the mortality of infants with AKI.Conclusions
Prenatal factors and medical devices were significantly associated with AKI. Early detection of risk factors can reduce the mortality of AKI patients. 相似文献7.
Suvarna Shinde Nandkishor S. Kabra Shobha R. Sharma Bhupendra S. Avasthi Javed Ahmed 《Indian pediatrics》2014,51(5):367-370
Objective
To compare the efficacy of glycerin suppository versus no suppository in preterm very-low-birthweight neonates for improving feeding tolerance.Design
Randomized controlled trial.Setting
Level III neonatal unit from Mumbai, India.Participants
50 very-low-birthweight (birth weight between 1000 to 1500 grams) preterm (gestational age between 28 to 32 weeks) neonates randomized to glycerine suppository (n=25) or no intervention (n=26).Intervention
Glycerin suppository (1g) once a day from day-2 to day-14 of life or no suppository, along with intermittent oral feeds and standardized care.Primary outcome
Time required to achieve full enteral feeds (180 mL/kg/d).Results
Baseline characteristics of neonates like gestational age, birth-weight, gender and age at the time of introduction of feeds were comparable in both groups. The mean (SD) duration to reach full enteral feed was 11.90 (3.1) days in glycerin suppository group and was not significantly different (P=0.58) from control group, [11.33 (3.57) days]. Glycerin suppository group regained birth weight 2 days earlier than control group but this difference was not significant (P=0.16). There was no significant difference in duration of hospital stay or occurrence of necrotizing enterocolitis amongst the two study groups.Conclusion
Once daily application of glycerin suppository does not accelerate the achievement of full feeds in preterm very-low-birthweight neonates. 相似文献8.
Jyoti Singh Dharmendra Soni Devendra Mishra H. P. Singh S. Bijesh 《Indian pediatrics》2014,51(4):285-288
Objective
Primary: To determine the incidence of congenital malaria in a cohort of pregnant women in a hyper-endemic area of central India. Secondary: (1) To find out the placental weight and placental malaria positivity, and to assess fetal and neonatal outcome in terms of survival, mean hemoglobin and mean birth weight.Design
Prospective observational study.Setting
Maternity and neonatal ward of a tertiary level hospital attached to a medical college located in Rewa, Madhya Pradesh, India.Participants
Near term and term pregnant women admitted in the maternity ward with a singleton pregnancy, whose neonates were available for examination till at least 6 hours after birth.Methods
Thick and thin blood smear were examined for malarial parasites from mothers prior to delivery. Based on the results of peripheral smear they were divided into ‘exposed group’ (peripheral smear positive for malaria parasite) and unexposed group’ (smear negative for malaria parasite). These groups were then followed prospectively till delivery and subsequently till the mother and the neonates were discharged from the hospital.Outcome variables
Primary: Presence of asexual parasite in neonate. Secondary: Placental weight, presence of asexual malarial parasite in placenta, still births, early neonatal deaths, mean birth weight and mean hemoglobin.Results
Seventy-two (35.5%) of 203 blood smears of near term and term pregnant women were found positive for malaria parasite (60 P. vivax and 12 P. falciparum); rest 131 comprised the unexposed group. Six (2.95%) neonates had parasitemia (4 P. vivax and 2 P. falciparum). Of the 203 smears made from placental blood, 24 (11.8%) were positive for malaria parasite. The mean (SD) birth weight [2300 (472) g vs 2430 (322) g; P=0.98], proportion of preterm babies (6.9% vs 8.4%, P=0.71), incidence of still birth (4.2% vs 3.0%, P=1.0) and early neonatal death (2.8% vs 3.0%, P=1.0) were not significantly different between the exposed and unexposed group.Conclusions
The incidence of congenital malaria is low despite high maternal smear positivity for malaria. 相似文献9.
Amit Tagare Sudha Chaudhari Sandeep Kadam Umesh Vaidya Anand Pandit Mehmood G. Sayyad 《Indian journal of pediatrics》2013,80(1):16-20
Objective
To determine the morbidity and mortality in ELBW babies till discharge from a Neonatal Intensive Care Unit (NICU).Methods
This study was a prospective observational study conducted in a 40 bed well equipped level III care NICU between 01.12.2006 and 30.04.2008. All ELBW babies admitted during this period were assessed for morbidities and interventions required during NICU stay and for their outcome like survival or death.Results
The survival rate of 87 ELBW babies admitted during this period was 56.1 %. Pulmonary hemorrhage was the commonest cause of death (25 %) followed by respiratory distress syndrome (22.5 %), intraventricular hemorrhage (22.5 %) and sepsis (20 %). Significantly higher number of non-survivors were <750 g at birth (p?=?0.0001) and <28 wk gestation (p?=?0.0001). Small for gestational babies had better chances of survival compared to those appropriate for gestational age (p?=?0.005). RDS (67.8 %), probable sepsis (62.1 %) and hyperbilirubinemia (59.8 %) were the most frequent morbidities. Conventional ventilation (72.4 %) and nasal CPAP(48.3 %) were the commonest respiratory interventions. Surfactant replacement therapy was required in 47.1 % babies.Conclusions
ELBW babies have a major contribution to mortality in a NICU. Babies with birth weight <750 g and gestation <28 wk have poor survival. RDS, pulmonary hemorrhage, IVH and sepsis are the common causes of death while RDS, sepsis and hyperbilirubinemia are the most common morbidities. 相似文献10.
Hendrik Stefan Fischer Charles Christoph Roehr Hans Proquitté Gerd Schmalisch 《World journal of pediatrics : WJP》2013,9(4):318-322
Background
Nose and mouth leaks impair effective pressure transmission during neonatal continuous positive airway pressure (CPAP), but little is known about how these leaks affect physiological parameters. This study investigated the influence of nose leaks and spontaneous mouth opening on peripheral oxygen saturation (SpO2) and respiratory rate (RR) using nasopharyngeal CPAP.Methods
In 32 neonates with a gestational age of 30 (24–38) weeks and a birth weight of 1435 (710–2730) g, SpO2 and RR measurements were taken with and without occlusion of the contralateral nostril in a randomized cross-over trial in 1-minute intervals over a 10-minute period during each condition. Mouth opening and newborn activity were documented.Results
SpO2 with open nostril was comparable to that with occluded nostril [93 (78.5–99.5)% vs. 94 (80–100)%, P=0.20]. RR decreased from 51 (26–82)/min to 48 (32–85)/min (P=0.027). In infants with an SpO2≤93% during open nostril (n=17), SpO2 increased after nostril occlusion [91 (80–96)% vs. 89.5 (78.5–93)%, P=0.036]. The mouth was open in 78.5% of measurements with open nostril, and in 87.4% of measurements after nostril occlusion (P=0.005). No significant influence of mouth opening or closure on SpO2 or RR was detected.Conclusions
In neonates on unilateral nasopharyngeal CPAP with an SpO2 ≤93%, occlusion of the contralateral nostril significantly increased SpO2 and reduced RR. The beneficial physiological effects further support using binasal prongs to minimize nose leaks in this population. Future studies should investigate the beneficial effects of reducing mouth leaks when applying CPAP to these infants. 相似文献11.
Gaurav Ameta Amit Upadhyay Sunil Gothwal Kuldeep Singh Kirti Dubey Abhilasha Gupta 《Indian journal of pediatrics》2013,80(3):195-198
Objective
To compare reduction in incidence of feed intolerance in neonates born with meconium stained amniotic fluid (MSAF) by use of gastric lavage to those who did not receive lavage.Methods
This Randomized controlled trial was conducted in all vigorous newborns delivered through MSAF, with birth weight ≥1800 g and gestation ≥34 wk. In the lavage group, gastric lavage with 10 ml/kg of normal saline was done.Results
Twelve neonates in the lavage group (n?=?124) developed feed intolerance compared to 16 neonates in control group (n?=?120), (p?=?.309; OR 0.69; 95%CI 0.27–1.58). No difference in any other morbidity was noted.Conclusions
Gastric lavage in neonates with MSAF does not reduce feed intolerance, irrespective of thickness of MSAF and it confers no advantages. 相似文献12.
N. M. El Raggal Soha Mohamed Khafagy N. H. Mahmoud S. A. El Beltagy 《Indian pediatrics》2013,50(5):459-462
Objective
To determine the clinical utility of serum neutrophil gelatinase-associated lipocalin (NGAL) as an early marker of acute kidney injury in asphyxiated neonates with hypoxic ischemic encephalopathy (HIE).Design
Cohort study.Settings
National Intensive Care Unit of Maternity Hospital, Ain Shams University, Cairo, Egypt.Patients
The study included 30 term asphyxiated neonates (8 with mild, 13 with moderate and 9 with severe HIE) and 20 control neonates.Intervention
Serum NGAL level was measured within 6 hours after birth using an enzyme linked immunosorbent assay.Main outcome measures
Patients were subsequently discriminated into AKI (n=12) and no-AKI (n=18) groups.Results
The median (Interquartile range) serum NGAL concentration was 95.0 (70.75–180.00) ng/mL in asphyxiated neonates, and 39.75 (6.0–48.0) ng/mL in control neonates; (P<0.001). Serum NGAL correlated with HIE severity: mean (SD) was 65.50 (3.77) ng/mL in infants with mild HIE, 115.07 (45.83) ng/mL in infants with moderate HIE and 229.66 (79.50) ng/mL in infants with severe HIE; (P<0.01). The median (Interquartiles) serum NGAL level was 182.50 (166.25–301.75) ng/mL in patients with AKI, 74.00 (66.00–78.75) ng/mL in those without AKI; (P<0.001). A cutoff value 157 ng/mL for serum NGAL could detect AKI in asphyxiated neonates with a sensitivity of 83.3% and a specificity of 94.4%.Conclusion
Elevated serum NGAL measured within 6 hours after birth reliably indicates acute kidney injury in asphyxiated neonates. 相似文献13.
Irena Ulanovsky Tatiana Smolkin Shlomo Almashanu Tatiana Mashiach Imad R. Makhoul 《World journal of pediatrics : WJP》2018,14(3):247-253
Background
Some neonates develop idiopathic hyperbilirubinemia (INHB) requiring phototherapy, yet with no identifiable causes. We searched for an association between abnormal thyroid levels after birth and INHB.Methods
Of 5188 neonates, 1681 (32.4%) were excluded due to one or more risk factors for hyperbilirubinemia. Total thyroxine (TT4) and thyroid stimulating hormone values were sampled routinely at 40–48 hours of age and measured in the National Newborn Screening Program.Results
Of the 3507 neonates without known causes for hyperbilirubinemia, 61 (1.7%) developed INHB and received phototherapy. Univariate analyses found no significant association between mode of delivery and INHB (vacuum-delivered neonates were a priori excluded). Nonetheless, in cesarean-delivered (CD) neonates, two variables had significant association with INHB: TT4 ≥ 13 µg/dL and birth at 38–38.6 weeks. In vaginally delivered (VD) born neonates, INHB was associated with weight loss > 7.5% up to 48 hours of age. Multivariate logistic regression analysis showed a strong effect of mode of delivery on possible significant association with INHB. In CD neonates, such variables included: TT4 ≥ 13 µg/dL [P = 0.025, odds ratio (OR) 5.49, 95% confidence interval (CI) 1.23–24.4] and birth at 38–38.6 weeks (P = 0.023, OR 3.44, 95% CI 1.19–9.97). In VD neonates, weight loss > 7.5% (P = 0.019, OR 2.1, 95% CI 1.13–3.83) and 1-min Apgar score < 9 (P < 0.001, OR 3.8, 95% CI 1.83–7.9), but not TT4, showed such an association.Conclusions
INHB was significantly associated with birth on 38–38.6 week and TT4 (≥ 13 µg/dL) in CD neonates, and with a weight loss > 7.5% in VD neonates. We herein highlight some acknowledged risk factors for neonatal hyperbilirubinemia, and thus minimize the rate of INHB.14.
Hassan Boskabadi Abbas Navaee Boroujeni Hesam Mostafavi-Toroghi Golkoo Hosseini Majid Ghayour-Mobarhan Dariush Hamidi Alamdari Mahtab Biranvandi Hamidreza Saber Gordon A. Ferns 《Indian journal of pediatrics》2014,81(3):248-253
Objective
To determine the prooxidant-antioxidant balance (PAB) in neonatal asphyxia and compare it with values for PAB in healthy neonates.Methods
In a prospective observational study, serum PAB of umbilical cord blood of 30 neonates with asphyxia [pH <?7.2, low Apgar score, signs of respiratory distress syndrome (RDS)] as the case group and 35 healthy neonates (without an abnormal clinical event at birth and after the first week) as the control group were compared.Results
Among the 35 neonates in the control group, the average level of serum PAB was 20.00 HK units, which was significantly lower than for the 30 neonates within the case group (40.46 HK units; p?=?0.019). The blood pH in the case group was significantly lower than for control group (P?<?0.001). In controls, HCO3 - and pCO2 were 18.6 mmol/L and 38.5 mmHg respectively, whilst in the case group these values were 15.5 mmol/L and 45.7 mmHg respectively (p?<?0.05).Conclusions
Determination of PAB may be useful in the early diagnosis of perinatal asphyxia and is consistent with HCO3 -, pCO2 and Apgar score. 相似文献15.
Seyyed-Abolfazl Afjeh Mohammad-Kazem Sabzehei Minoo Fallahi Fatemeh Esmaili 《Iranian journal of pediatrics.》2013,23(5):579-587
Objective
Very low birth weight (VLBW) infants are at high risk for morbidity and mortality. This article determines the frequency of disease, rate od survival, complications and risk factors for morbidity and mortality in VLBW neonates admitted to a level III neonatal intensive care unit (NICU) at Mahdieh Hospital in Tehran.Methods
This cross-sectional retrospective study was performed from April 2007 to March 2010 on all hospitalized VLBW neonates. Relevant pre- and peri-natal data up to the time of discharge from the hospital or death, including complications during the course of hospitalization, were collected from the case notes, documented on a pre-designed questionnaire and analyzed.Findings
Out of 13197 neonates, 564 (4.3%) were VLBW with 51.4% males. Mean gestational age was 29.6±2.5 weeks; mean birth weight 1179±257 grams. Mean birth weight, gestational age and Apgar scores were significantly higher in babies who survived than in those who died, (1275±189 vs. 944±253 grams; 30.5±2.2 vs. 27.5±2 weeks and 6.9±1.7 vs. 5±2.1 respectively, P<0.001 in all instances). Overall survival was 70.9%; in extremely low birth weight (ELBW) newborns this figure was 33.3% rising to 84.1% in infants weighing between 1001-1500 grams. Respiratory failure resulting from RDS in ELBW babies was the major factor leading to death. Need for mechanical ventilation, pulmonary hemorrhage and gastro-intestinal bleeding were also significant predictive factors for mortality.Conclusion
Birth weight and mechanical ventilation are the major factors predicting VLBW survival. 相似文献16.
Hamid Amoozgar Monirosadat Barekati Nahal Farhani Narjes Pishva 《Indian journal of pediatrics》2014,81(3):238-242
Objectives
To evaluate the cardiac conduction system using P wave dispersion on electrocardiogram and its relationship with the short term mortality and development of arrhythmia in asphyxiated neonates.Methods
Thirty term babies with evidence of asphyxia and without any congenital abnormalities were consecutively evaluated as cases. They were compared with thirty healthy term babies without asphyxia. Twelve-lead surface electrocardiography was obtained from all the patients and the controls, and P wave dispersion was calculated according to its definition as the difference between P maximum duration and P minimum duration in 12-lead electrocardiogram.Results
A statically significant difference of P wave dispersion was observed between the patients and the control group (0.027?±?0.011 mm/s and 0.016?±?0.006 mm/s, respectively; P value?=?0.0001). The P wave dispersion had a statistically significant correlation with the grade of asphyxia (P?=?0.004, r?=?0.62), the P wave dispersion had no statistically significant correlation with Apgar scores, short term arrhythmia, and troponin I level in asphyxiated neonates (P?<?0.05).Conclusions
The P wave dispersion increased in asphyxiated neonates and correlated with grade of asphyxia; however, the increased P wave dispersion was not correlated with the short term mortality, arrhythmia and troponin I level of the asphyxiated neonates. 相似文献17.
Ismail Mohamed Elhawary Eman Abdel Ghany Abdel Ghany Walaa Alsharany Aboelhamed Shahinaz Gamal Eldin Ibrahim 《World journal of pediatrics : WJP》2018,14(4):350-356
Background
To determine the incidence and risk factors of post-phototherapy rebound hyperbilirubinemia because data about bilirubin rebound in neonates are lacking and few studies have concerned this condition.Methods
A prospective observational study was conducted on 500 neonates with indirect hyperbilirubinemia who were treated according to standard guidelines. Total serum bilirubin (TSB) was measured at 24–36 h after phototherapy; significant bilirubin rebound (SBR) is considered as increasing TSB that needs reinstitution of phototherapy.Results
A total of 124 (24.9%) neonates developed SBR with TSB increased by 3.4 (2.4–11.2) mg/dL after stopping phototherapy. Multiple logistic regression model revealed the following significant risk factors for rebound: low birth weight (B = 1.3, P < ?0.001, OR 3.5), suspected sepsis (B = 2.5, P < ?0.001, OR 12.6), exposure to intensive phototherapy (B = ?0.83, P = ?0.03, OR 2.3), hemolysis (B = ?1.2, P < ?0.001, OR 3.1), high discharge bilirubin level (B = ?0.3, P = ?0.001, OR 1.3), and short duration of conventional phototherapy (B = ?? 1.2, P < ?0.001, OR 0.3).Conclusions
SBR should be considered in neonates with hemolysis, low birth weight, suspected sepsis, short duration of conventional phototherapy, exposure to intensive phototherapy, and relatively high discharge TSB. These risk factors should be taken into account when planning post-phototherapy follow-up.18.
Rakesh Mondal Sumantra Sarkar Niloy Kumar Das Swati Chakravorti Avijit Hazra Tapas Sabui Madhumita Nandi Biman Ray Anjan Das Sushas Ganguli 《Indian pediatrics》2014,51(3):199-202
Objective
To evaluate the growth pattern in children with juvenile idiopathic arthritis and its subtypes in comparison with age, sex and temporally matched controls.Study design
Prospective study.Setting
Pediatric rheumatology clinic of a tertiary care hospital in Eastern part of India.Participants
Seventy-five children (2–12 years) diagnosed as juvenile idiopathic erthritis by International League of Associations for Rheumatology criteria and 75 age- and sexmatched controls.Intervention
Weight, height and body mass index were recorded at six monthly interval in both groups over a period of 3 years.Main outcome measures
weight, height and body mass index.Results
Subtype distribution of juvenile idiopathic arthritis was: oligoarthritis (49%, n=37), rheumatoid factor negative polyarthritis (27%, n=20), rheumatoid factor positive polyarthritis (8%, n=6), systemic onset (15%, n=11) and enthesitis related arthritis (1.3%, n=1). Anthropometric parameters in children with juvenile idiopathic arthritis were not significant different from controls. Comparison between the subtypes showed significant differences in height (P=0.011), weight (P=0.005), and growth velocity (P=0.005), but not in body mass index. Systemic onset disease led to significant restriction in height (P=0.018; 95% CI 2.13–33.77) and weight (P=0.008; 95% CI 1.47–14.43) compared to controls. Growth velocity was significantly affected in rheumatoid factor positive polyarthritis (P=0.003; 95% CIO. 46–3.14).Conclusions
Children with juvenile idiopathic arthritis do not have significantly lower values of anthropometric parameters compared to controls. Significant restriction in height and weight is seen in systemic onset disease, and growth velocity is significantly reduced in rheumatoid factor positive subjects. 相似文献19.
Objectives
To evaluate arylesterase and lactonase activity of paraoxonase (PON)1 in cord blood of neonates in relation to their birth weight. The authors hypothesized that cord blood PON1 arylesterase and lactonase activities will be compromised in neonates having low birth weight.Methods
Eighty neonates born in authors’ hospital, irrespective of mode of delivery were included. Forty children with low birth weight were included in case group and 40 with normal birth weight were included as controls. PON1 arylesterase and lactonase activities were measured.Results
Serum arylesterase activity decreased significantly in low birth weight babies (p?<?0.05). Linear regression analysis (R?=?0.728) indicated significant correlation between arylesterase and birth weight. Serum lactonase activity was also reduced in low birth weight babies. Its linear regression analysis (R?=?0.727) indicated significant correlation between lactonase and birth weight.Conclusions
PON 1 activity is significantly reduced among low birth weight babies in comparison to normal weight babies. 相似文献20.