Delia Edith Theurel Martín, Jorge Luis Alvarado Socarras
Enteroviruses (EVs) are a common cause of infection in neonates, they spread from person to person by a variety of routes and can cause severe symptoms and complications, including meningoencephalitis, myocarditis, and hepatic failure. We report the clinical and paraclinical characteristics of six patients diagnosed in a hospital cluster with late-onset sepsis, mostly preterm newborns. The most common symptoms were the same as a sepsis-like syndrome, the predominant sign of presentation was fever. The most frequent laboratory finding was elevated C-reactive protein, and later positive cerebrospinal fluid multiplex for EVs. Support treatment was given. A benign course was observed. Seizures were the only complication, with a normal electroencephalography at 6-month follow-up. In-hospital cases would benefit from a high clinician suspicion and early detection for achieving immediate isolation and containment measures to limit the spread to sick and vulnerable newborns, avoiding clusters.
肠道病毒（EV）是新生儿感染的常见病因，它们通过各种途径在人与人之间传播，可引起严重的症状和并发症，包括脑膜脑炎、心肌炎和肝功能衰竭。我们报告了在一个医院群中确诊的六名晚发型败血症患者的临床和辅助临床特征，其中大部分是早产新生儿。最常见的症状与败血症样综合征相同，主要表现为发热。最常见的实验室检查结果是 C 反应蛋白升高，随后出现脑脊液 EVs 多反应阳性。患者接受了辅助治疗。病程为良性。癫痫发作是唯一的并发症，随访6个月时脑电图正常。临床医生应高度怀疑并及早发现院内病例，以便立即采取隔离和遏制措施，限制病菌向患病和易感新生儿传播，避免病例聚集。
{"title":"Neonatal Enteroviral Meningoencephalitis: Clinical and Paraclinical Characteristics of a Nosocomial Outbreak in Colombia","authors":"Delia Edith Theurel Martín, Jorge Luis Alvarado Socarras","doi":"10.4103/jcn.jcn_19_24","DOIUrl":"https://doi.org/10.4103/jcn.jcn_19_24","url":null,"abstract":"Enteroviruses (EVs) are a common cause of infection in neonates, they spread from person to person by a variety of routes and can cause severe symptoms and complications, including meningoencephalitis, myocarditis, and hepatic failure. We report the clinical and paraclinical characteristics of six patients diagnosed in a hospital cluster with late-onset sepsis, mostly preterm newborns. The most common symptoms were the same as a sepsis-like syndrome, the predominant sign of presentation was fever. The most frequent laboratory finding was elevated C-reactive protein, and later positive cerebrospinal fluid multiplex for EVs. Support treatment was given. A benign course was observed. Seizures were the only complication, with a normal electroencephalography at 6-month follow-up. In-hospital cases would benefit from a high clinician suspicion and early detection for achieving immediate isolation and containment measures to limit the spread to sick and vulnerable newborns, avoiding clusters.","PeriodicalId":45332,"journal":{"name":"Journal of Clinical Neonatology","volume":"16 5","pages":""},"PeriodicalIF":0.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141695511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The development of artificial intelligence (AI) approaches impacted drug discovery, medical imaging, customized diagnostics, and therapeutics. Medicine will be transformed by AI. One such area of medicine where AI is significantly improving care is neonatology. The objective of this scoping review is to explore the applications of AI in neonatal critical care and its outcome. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a scoping review was conducted utilizing the Web of Science, MEDLINE (PubMed), and Scopus databases. The search was limited to full-text publications on AI applications in neonatal critical care that were published between January 1, 2019, and December 31, 2023. Articles specifically addressing the application of AI in neonatal care have been considered within the scope of this review. At least three reviewers had independently executed the screening, data abstraction, and exploration. Database searches yielded 631 articles, of which 11 met the inclusion criteria. The research encompassed extensive AI applications in neonatal critical care, employed for prognosis, diagnosis, and therapy strategizing. Artificial neural networks, machine learning, deep learning, and shallow hybrid neural networks were the commonly utilized AI techniques (neonatal critical care). These methods were applied to screen for inborn metabolic abnormalities, predict various outcomes, including death and sepsis, identify diseases such as sepsis, and assess neurodevelopmental outcomes in preterm newborns, helping plan several medical treatments. The included research demonstrated encouraging outcomes when using AI in neonatal critical care. AI-driven electronic arrangements upgrade neonatal basic care by improving risk forecast, promising critical commitments to future health care. Be that as it may, careful appraisal, evidence-based considers, and determination of safety, ethics, and information straightforwardness issues are essential before implementation. Acceptance by administrative bodies and the therapeutic community pivots on tending to these concerns.
人工智能（AI）方法的发展对药物发现、医学成像、定制诊断和治疗产生了影响。人工智能将改变医学。新生儿科就是人工智能显著改善护理的医学领域之一。 本范围综述旨在探讨人工智能在新生儿重症监护中的应用及其结果。 根据《系统综述和元分析首选报告项目》指南，我们利用 Web of Science、MEDLINE (PubMed) 和 Scopus 数据库进行了范围界定综述。检索仅限于2019年1月1日至2023年12月31日期间发表的有关新生儿重症监护中人工智能应用的全文出版物。专门论述人工智能在新生儿护理中应用的文章已被纳入本综述范围。至少有三位审稿人独立完成了筛选、数据摘录和探索工作。 在数据库中搜索到 631 篇文章，其中 11 篇符合纳入标准。这些研究涵盖了人工智能在新生儿重症监护中的广泛应用，用于预后、诊断和治疗策略制定。人工神经网络、机器学习、深度学习和浅层混合神经网络是常用的人工智能技术（新生儿重症监护）。这些方法被用于筛查先天性代谢异常、预测各种结果（包括死亡和败血症）、识别疾病（如败血症）以及评估早产新生儿的神经发育结果，从而帮助规划多种医疗方法。这些研究表明，在新生儿重症监护中使用人工智能取得了令人鼓舞的成果。 人工智能驱动的电子安排通过改善风险预测提升了新生儿基础护理，有望为未来的医疗保健做出重要贡献。尽管如此，在实施之前，仔细评估、基于证据的考虑以及对安全性、伦理和信息公正性问题的确定是必不可少的。行政机构和治疗界能否接受，关键在于能否解决这些问题。
{"title":"Artificial Intelligence Applications in Neonatal Critical Care: A Scoping Review","authors":"Surekha Satish Sakore, Seeta Devi, Prachi Mahapure, Meghana Kamble, Prachi Jadhav","doi":"10.4103/jcn.jcn_13_24","DOIUrl":"https://doi.org/10.4103/jcn.jcn_13_24","url":null,"abstract":"\u0000 \u0000 The development of artificial intelligence (AI) approaches impacted drug discovery, medical imaging, customized diagnostics, and therapeutics. Medicine will be transformed by AI. One such area of medicine where AI is significantly improving care is neonatology.\u0000 \u0000 \u0000 \u0000 The objective of this scoping review is to explore the applications of AI in neonatal critical care and its outcome.\u0000 \u0000 \u0000 \u0000 Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a scoping review was conducted utilizing the Web of Science, MEDLINE (PubMed), and Scopus databases. The search was limited to full-text publications on AI applications in neonatal critical care that were published between January 1, 2019, and December 31, 2023. Articles specifically addressing the application of AI in neonatal care have been considered within the scope of this review. At least three reviewers had independently executed the screening, data abstraction, and exploration.\u0000 \u0000 \u0000 \u0000 Database searches yielded 631 articles, of which 11 met the inclusion criteria. The research encompassed extensive AI applications in neonatal critical care, employed for prognosis, diagnosis, and therapy strategizing. Artificial neural networks, machine learning, deep learning, and shallow hybrid neural networks were the commonly utilized AI techniques (neonatal critical care). These methods were applied to screen for inborn metabolic abnormalities, predict various outcomes, including death and sepsis, identify diseases such as sepsis, and assess neurodevelopmental outcomes in preterm newborns, helping plan several medical treatments. The included research demonstrated encouraging outcomes when using AI in neonatal critical care.\u0000 \u0000 \u0000 \u0000 AI-driven electronic arrangements upgrade neonatal basic care by improving risk forecast, promising critical commitments to future health care. Be that as it may, careful appraisal, evidence-based considers, and determination of safety, ethics, and information straightforwardness issues are essential before implementation. Acceptance by administrative bodies and the therapeutic community pivots on tending to these concerns.\u0000","PeriodicalId":45332,"journal":{"name":"Journal of Clinical Neonatology","volume":"40 7","pages":""},"PeriodicalIF":0.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141709793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Alsafadi, Mohammad Hakim Albaloushi, Faris Tariq Alsafadi, Shadi Jarrada, Jamal Alshoibi
Hypothermia immediately afterbirth is common, especially in preterm (PT) infants because of their skin immaturity. If it is prolonged, it can lead to mortality and morbidity. Although plastic wrap (PW) can improve neonatal hypothermia by decreasing evaporative heat loss, its effect on mortality and morbidity is uncertain. The aim of the study was to detect if PW can decrease mortality and morbidity in PT infants from 240 to 296 weeks’ gestation. The study design was a retrospective study. The study was conducted at two neonatal intensive care units (NICUs). NICUs medical records from 2021 to 2023. The data were analyzed using logistic regression analysis. A total of 187 PT infants from 240 to 296-week gestation were admitted to both NICUs during that period, 148 PT infants were included in the study. Mean gestational age (GA) was 27.2 ± 2.7 weeks and mean birth weight was 865 ± 375 g; 75 PT infants (51%) were male, and 30 PT infants (20.2%) were hypothermic on admission. After adjusting for risk factors that potentially increased the mortality, admission temperature did not affect the mortality significantly (odds ratio [OR]: 0.8, confidence interval [CI]: 0.6–1.1). The only factor that increased the mortality significantly was GA (OR: 1.1, CI: 1.05–1.4). The other model that tested the effect of admission temperature on the morbidity showed that none of the morbidities were significantly decreased after adjusting for risk factors, necrotizing enterocolitis (OR: 1.05, CI: 0.8–1.3), intraventricular hemorrhage (OR: 0.8, CI: 0.6–1.09), bronchopulmonary dysplasia (OR: 1.1, CI: 0.8–1.3), retinopathy of prematurity (OR: 1.2, CI: 0.9–1.4), and late-onset sepsis (OR: 1.1, CI: 0.9–1.4). PW applied immediately after birth seemed to improve admission temperature in PT infants from 240 to 296-week gestation, but it did not improve neonatal mortality or morbidity.
{"title":"The Effect of Plastic Wrap Use to Prevent Hypothermia on Neonatal Mortality and Morbidity in Extreme Preterm Infants","authors":"T. Alsafadi, Mohammad Hakim Albaloushi, Faris Tariq Alsafadi, Shadi Jarrada, Jamal Alshoibi","doi":"10.4103/jcn.jcn_31_24","DOIUrl":"https://doi.org/10.4103/jcn.jcn_31_24","url":null,"abstract":"\u0000 \u0000 Hypothermia immediately afterbirth is common, especially in preterm (PT) infants because of their skin immaturity. If it is prolonged, it can lead to mortality and morbidity. Although plastic wrap (PW) can improve neonatal hypothermia by decreasing evaporative heat loss, its effect on mortality and morbidity is uncertain.\u0000 \u0000 \u0000 \u0000 The aim of the study was to detect if PW can decrease mortality and morbidity in PT infants from 240 to 296 weeks’ gestation.\u0000 \u0000 \u0000 \u0000 The study design was a retrospective study.\u0000 \u0000 \u0000 \u0000 The study was conducted at two neonatal intensive care units (NICUs).\u0000 \u0000 \u0000 \u0000 NICUs medical records from 2021 to 2023.\u0000 \u0000 \u0000 \u0000 The data were analyzed using logistic regression analysis.\u0000 \u0000 \u0000 \u0000 A total of 187 PT infants from 240 to 296-week gestation were admitted to both NICUs during that period, 148 PT infants were included in the study. Mean gestational age (GA) was 27.2 ± 2.7 weeks and mean birth weight was 865 ± 375 g; 75 PT infants (51%) were male, and 30 PT infants (20.2%) were hypothermic on admission. After adjusting for risk factors that potentially increased the mortality, admission temperature did not affect the mortality significantly (odds ratio [OR]: 0.8, confidence interval [CI]: 0.6–1.1). The only factor that increased the mortality significantly was GA (OR: 1.1, CI: 1.05–1.4). The other model that tested the effect of admission temperature on the morbidity showed that none of the morbidities were significantly decreased after adjusting for risk factors, necrotizing enterocolitis (OR: 1.05, CI: 0.8–1.3), intraventricular hemorrhage (OR: 0.8, CI: 0.6–1.09), bronchopulmonary dysplasia (OR: 1.1, CI: 0.8–1.3), retinopathy of prematurity (OR: 1.2, CI: 0.9–1.4), and late-onset sepsis (OR: 1.1, CI: 0.9–1.4).\u0000 \u0000 \u0000 \u0000 PW applied immediately after birth seemed to improve admission temperature in PT infants from 240 to 296-week gestation, but it did not improve neonatal mortality or morbidity.\u0000","PeriodicalId":45332,"journal":{"name":"Journal of Clinical Neonatology","volume":"37 4","pages":""},"PeriodicalIF":0.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141696633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Intergrowth-21st and Fenton 2013 growth charts are used for postnatal growth monitoring in preterms. There is no international consensus on which graph to refer to and why. This study is a local validation, of which graph would be plausible for the Indian population to detect small-for-gestational-age (SGA) and extra-uterine growth restriction (EUGR) babies, abetting in the settlement of this ambiguity. The primary objective was to compare the Intergrowth-21st with Fenton 2013 growth charts for birth size classification and to detect the proportion of EUGR in preterms. The secondary objective was to assess the proportion of comorbidities in SGA babies by both these graphs. The design of the study was a prospective comparative observational study. All preterm newborns (24–<37 weeks of gestation) admitted to the neonatal intensive care unit of Noble Hospital and Research Center, Maharashtra, were the participants. Weight, length, and head circumference were plotted on Intergrowth 21 and Fenton growth charts at birth and at 4 weeks of age or at 36 weeks of postmenstrual age whichever is later. Corresponding Z-scores and percentiles were calculated electronically from their respective online software. the reliability of Intergrowth-21st when compared to Fenton 2013 growth charts in assessing the birth size was better, and detection of the proportion of EUGR in preterm babies was better with Fenton charts. A total of 429 preterm babies with a mean gestational age of 33.3 ± 2.4 weeks were included in the study. Fenton (67.1%) overestimated the proportion of EUGR when compared to Intergrowth-21st (18.6%) which was statistically significant (P < 0.001). On the contrary, although the proportion of SGA babies detected was higher with Intergrowth-21st (29.8%) when compared to Fenton (19.6%), there was moderate-to-high statistically significant agreement observed between the two growth charts in detecting SGA babies (Kappa = 0.716, P < 0.001). The proportion of comorbidities did not vary significantly among the SGA babies between the growth charts (P > 0.05). Fenton overestimates EUGR when compared to Intergrowth-21st, whereas both the growth charts are equally good in identifying SGA babies with no differences in the comorbidities detected. Intergrowth-21st standards look more pertinent for growth monitoring in the current study setting for Indian preterm babies.
{"title":"Intergrowth 21 Versus Fenton 2013 Growth Charts: Congruence in Assessing the Birth Size and the Proportion of Extra-uterine Growth Restriction in Preterm Babies","authors":"G. Jose, Anilkumar M. Khamkar, P. Pote","doi":"10.4103/jcn.jcn_39_24","DOIUrl":"https://doi.org/10.4103/jcn.jcn_39_24","url":null,"abstract":"\u0000 \u0000 Intergrowth-21st and Fenton 2013 growth charts are used for postnatal growth monitoring in preterms. There is no international consensus on which graph to refer to and why. This study is a local validation, of which graph would be plausible for the Indian population to detect small-for-gestational-age (SGA) and extra-uterine growth restriction (EUGR) babies, abetting in the settlement of this ambiguity.\u0000 \u0000 \u0000 \u0000 The primary objective was to compare the Intergrowth-21st with Fenton 2013 growth charts for birth size classification and to detect the proportion of EUGR in preterms. The secondary objective was to assess the proportion of comorbidities in SGA babies by both these graphs.\u0000 \u0000 \u0000 \u0000 The design of the study was a prospective comparative observational study. All preterm newborns (24–<37 weeks of gestation) admitted to the neonatal intensive care unit of Noble Hospital and Research Center, Maharashtra, were the participants. Weight, length, and head circumference were plotted on Intergrowth 21 and Fenton growth charts at birth and at 4 weeks of age or at 36 weeks of postmenstrual age whichever is later. Corresponding Z-scores and percentiles were calculated electronically from their respective online software.\u0000 \u0000 \u0000 \u0000 the reliability of Intergrowth-21st when compared to Fenton 2013 growth charts in assessing the birth size was better, and detection of the proportion of EUGR in preterm babies was better with Fenton charts.\u0000 \u0000 \u0000 \u0000 A total of 429 preterm babies with a mean gestational age of 33.3 ± 2.4 weeks were included in the study. Fenton (67.1%) overestimated the proportion of EUGR when compared to Intergrowth-21st (18.6%) which was statistically significant (P < 0.001). On the contrary, although the proportion of SGA babies detected was higher with Intergrowth-21st (29.8%) when compared to Fenton (19.6%), there was moderate-to-high statistically significant agreement observed between the two growth charts in detecting SGA babies (Kappa = 0.716, P < 0.001). The proportion of comorbidities did not vary significantly among the SGA babies between the growth charts (P > 0.05).\u0000 \u0000 \u0000 \u0000 Fenton overestimates EUGR when compared to Intergrowth-21st, whereas both the growth charts are equally good in identifying SGA babies with no differences in the comorbidities detected. Intergrowth-21st standards look more pertinent for growth monitoring in the current study setting for Indian preterm babies.\u0000","PeriodicalId":45332,"journal":{"name":"Journal of Clinical Neonatology","volume":"384 3","pages":""},"PeriodicalIF":0.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141707783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aims to compare the efficacy of 10% dextrose (10%D) and expressed breast milk (EBM) in relieving heel prick pain in neonates assessed by premature infant pain profile-revised (PIPP-R). This study was done in the neonatal intensive care unit under the department of pediatrics, hospital-based prospective, randomized controlled trial. The study includes neonates born between ≥34 weeks and ≤42 weeks of gestational age. The 72 enrolled neonates were randomized into two intervention groups (EBM and 10%D). One milliliter of test solution was given to the baby 30 s before the heel prick. Pain reactions were scored using the PIPP-R scoring system, and two independent observers were chosen, who were blinded to what intervention was given. For the EBM solution, the mean PIPP-R at 0 s was 7.19 ± 2, 5.5 ± 1.5 at 30 s, and 4.28 ± 1.65 at 60 s. For the 10%D solution, the mean PIPP-R at 0 s was 4.97 ± 1.42, 2.36 ± 1.44 at 30 s, and 1.69 ± 1.53 at 60 s. The difference in the mean PIPP-R between the two groups was statistically significant, and the 10%D group majority had only minimal pain throughout the procedure. Compared to the EBM group, 10%D significantly lowered the mean PIPP-R score, giving good pain relief and less procedural discomfort.
{"title":"Efficacy of 10% Dextrose versus Expressed Breast Milk in Relieving Procedural Pain in Neonates – A Randomized Controlled Trial","authors":"Yuvasri Shanthi, Kanimozhi Thandapani, Revathi Krishnakumar, Bharath Kumar Thirunavukkarasu","doi":"10.4103/jcn.jcn_37_24","DOIUrl":"https://doi.org/10.4103/jcn.jcn_37_24","url":null,"abstract":"\u0000 \u0000 This study aims to compare the efficacy of 10% dextrose (10%D) and expressed breast milk (EBM) in relieving heel prick pain in neonates assessed by premature infant pain profile-revised (PIPP-R).\u0000 \u0000 \u0000 \u0000 This study was done in the neonatal intensive care unit under the department of pediatrics, hospital-based prospective, randomized controlled trial.\u0000 \u0000 \u0000 \u0000 The study includes neonates born between ≥34 weeks and ≤42 weeks of gestational age. The 72 enrolled neonates were randomized into two intervention groups (EBM and 10%D). One milliliter of test solution was given to the baby 30 s before the heel prick. Pain reactions were scored using the PIPP-R scoring system, and two independent observers were chosen, who were blinded to what intervention was given.\u0000 \u0000 \u0000 \u0000 For the EBM solution, the mean PIPP-R at 0 s was 7.19 ± 2, 5.5 ± 1.5 at 30 s, and 4.28 ± 1.65 at 60 s. For the 10%D solution, the mean PIPP-R at 0 s was 4.97 ± 1.42, 2.36 ± 1.44 at 30 s, and 1.69 ± 1.53 at 60 s. The difference in the mean PIPP-R between the two groups was statistically significant, and the 10%D group majority had only minimal pain throughout the procedure.\u0000 \u0000 \u0000 \u0000 Compared to the EBM group, 10%D significantly lowered the mean PIPP-R score, giving good pain relief and less procedural discomfort.\u0000","PeriodicalId":45332,"journal":{"name":"Journal of Clinical Neonatology","volume":"9 5","pages":""},"PeriodicalIF":0.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141701070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sheetal Upreti, Md. Fahim Ahmad, M. Malik, Shivani Dogra
Aphallia, an extremely rare urogenital anomaly, presents complex challenges in diagnosis and management. This anomaly, often accompanied by other congenital malformations, necessitates multidisciplinary care, and careful consideration of treatment priorities. We describe a case of a neonate diagnosed with aphallia along with anal stenosis, bilateral hydroureteronephrosis, and tetralogy of Fallot. Despite prompt intervention plans, the neonate’s condition deteriorated rapidly, highlighting the urgency and complexity of managing aphallia-associated complications. While embryological insights offer some understanding of its etiology, the clinical manifestation of aphallia underscores the need for immediate supportive measures and thoughtful decision-making regarding gender assignment and surgical interventions. Beyond medical considerations, emotional and psychological support for families navigating treatment decisions is paramount.
{"title":"Aphallia with Anal Stenosis and Congenital Cyanotic Heart Disease: A Rare Case Report","authors":"Sheetal Upreti, Md. Fahim Ahmad, M. Malik, Shivani Dogra","doi":"10.4103/jcn.jcn_34_24","DOIUrl":"https://doi.org/10.4103/jcn.jcn_34_24","url":null,"abstract":"Aphallia, an extremely rare urogenital anomaly, presents complex challenges in diagnosis and management. This anomaly, often accompanied by other congenital malformations, necessitates multidisciplinary care, and careful consideration of treatment priorities. We describe a case of a neonate diagnosed with aphallia along with anal stenosis, bilateral hydroureteronephrosis, and tetralogy of Fallot. Despite prompt intervention plans, the neonate’s condition deteriorated rapidly, highlighting the urgency and complexity of managing aphallia-associated complications. While embryological insights offer some understanding of its etiology, the clinical manifestation of aphallia underscores the need for immediate supportive measures and thoughtful decision-making regarding gender assignment and surgical interventions. Beyond medical considerations, emotional and psychological support for families navigating treatment decisions is paramount.","PeriodicalId":45332,"journal":{"name":"Journal of Clinical Neonatology","volume":"57 8","pages":""},"PeriodicalIF":0.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141696313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The use of creatinine as an endogenous marker of estimated glomerular filtration rate (eGFR) is well-established in clinical practice, despite its limitations. As a step toward limiting this drawback, cystatin C and various biomarkers came into use in determining renal function. In sick neonates, various pathologies may impair renal function thus, underscoring the need for accurate estimation of glomerular filtration rate (GFR). This study aimed at evaluating the use of cystatin C in estimating the GFR of sick neonates in comparison to creatinine. A hospital-based descriptive study was conducted at a tertiary center in North Central, Nigeria, for 4 months. One hundred and seventy-three sick neonates admitted into the special care baby unit were recruited. Blood was sampled at admission for determination of serum creatinine and cystatin C levels, while a repeat sample for creatinine was taken 48 hours after. GFR was estimated using the Schwartz formula for creatinine and the Zappitelli equation for cystatin C and compared with an inulin reference. The median (interquartile range [IQR]) eGFR derived from cystatin C was 48.8 (21.0) mL/min/1.73 m2, it was higher than the median creatinine-derived GFR at admission and was of statistical significance. It is also approximated closer to the inulin reference. The median (IQR) eGFR derived from creatinine at admission was 21.2 (21.4) mL/min/1.73 m2. Creatinine-derived eGFR was significantly lower in babies with asphyxia and neonatal sepsis compared to those who did not have these diagnoses. Cystatin C-derived eGFR showed no variation between the various diagnoses. In conclusion, cystatin C is a useful and unbiased determinant of eGFR in sick neonates as compared to creatinine.
肌酐作为估算肾小球滤过率（eGFR）的内源性标志物，尽管有其局限性，但在临床实践中已得到广泛认可。为了限制这一缺陷，胱抑素 C 和各种生物标记物开始用于确定肾功能。在患病的新生儿中，各种病变都可能损害肾功能，因此更需要对肾小球滤过率（GFR）进行准确评估。 本研究旨在评估胱抑素 C 与肌酐相比在估测患病新生儿肾小球滤过率中的应用。 这项以医院为基础的描述性研究在尼日利亚中北部的一家三级医疗中心进行，为期 4 个月。研究招募了 173 名在婴儿特别护理病房住院的患病新生儿。入院时抽血测定血清肌酐和胱抑素 C 水平，48 小时后再次抽血测定肌酐。血肌酐采用施瓦茨公式估算，胱抑素C采用扎皮特利公式估算，并与菊粉参考值进行比较。 根据胱抑素 C 得出的 eGFR 中位数（四分位数间距 [IQR]）为 48.8 (21.0) mL/min/1.73 m2，高于入院时肌酐得出的 GFR 中位数，具有统计学意义。其近似值也更接近菊粉参考值。入院时根据肌酐得出的 eGFR 中位数（IQR）为 21.2 (21.4) mL/min/1.73 m2。与未确诊窒息和新生儿败血症的婴儿相比，肌酐得出的 eGFR 明显较低。胱抑素 C 衍生的 eGFR 在不同诊断之间没有差异。 总之，与肌酐相比，胱抑素 C 是决定患病新生儿 eGFR 的有用且无偏见的指标。
{"title":"Glomerular Filtration Rate in Sick Neonates: A Focus on Cystatin C","authors":"Olusola Avong, Isa Abdulkadir, Mairo Bugaje","doi":"10.4103/jcn.jcn_33_24","DOIUrl":"https://doi.org/10.4103/jcn.jcn_33_24","url":null,"abstract":"\u0000 \u0000 The use of creatinine as an endogenous marker of estimated glomerular filtration rate (eGFR) is well-established in clinical practice, despite its limitations. As a step toward limiting this drawback, cystatin C and various biomarkers came into use in determining renal function. In sick neonates, various pathologies may impair renal function thus, underscoring the need for accurate estimation of glomerular filtration rate (GFR).\u0000 \u0000 \u0000 \u0000 This study aimed at evaluating the use of cystatin C in estimating the GFR of sick neonates in comparison to creatinine.\u0000 \u0000 \u0000 \u0000 A hospital-based descriptive study was conducted at a tertiary center in North Central, Nigeria, for 4 months. One hundred and seventy-three sick neonates admitted into the special care baby unit were recruited. Blood was sampled at admission for determination of serum creatinine and cystatin C levels, while a repeat sample for creatinine was taken 48 hours after. GFR was estimated using the Schwartz formula for creatinine and the Zappitelli equation for cystatin C and compared with an inulin reference.\u0000 \u0000 \u0000 \u0000 The median (interquartile range [IQR]) eGFR derived from cystatin C was 48.8 (21.0) mL/min/1.73 m2, it was higher than the median creatinine-derived GFR at admission and was of statistical significance. It is also approximated closer to the inulin reference. The median (IQR) eGFR derived from creatinine at admission was 21.2 (21.4) mL/min/1.73 m2. Creatinine-derived eGFR was significantly lower in babies with asphyxia and neonatal sepsis compared to those who did not have these diagnoses. Cystatin C-derived eGFR showed no variation between the various diagnoses.\u0000 \u0000 \u0000 \u0000 In conclusion, cystatin C is a useful and unbiased determinant of eGFR in sick neonates as compared to creatinine.\u0000","PeriodicalId":45332,"journal":{"name":"Journal of Clinical Neonatology","volume":"7 8","pages":""},"PeriodicalIF":0.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141690581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Elfarargy, T. A. Alruwaili, D. H. Elbadry, A. R. Ahmad
Neonatal transport program (NTP) is a specialized service for neonatal transport for those who require transfer between hospitals for intensive care. NTP is indicated in any transportation of neonates from place to place, but it is specially indicated in unstable or high-risk neonates. The aim of this review is to discuss the importance of NTP, indication, and contraindication of NTP. In addition, we demonstrate the items of the transport system, methods for the preparation for transportation, as well as all the items of the transportation pathway. We also discuss the predeparture checklist, in addition to the illustration of the NTP telephone referral template. This review will demonstrate the predeparture checklist. Our main goal is to show the importance of NTP in providing the best place for the treatment of needed neonates with safe and adequate scientific transportation from the referring hospital to the receiving hospital.
{"title":"Neonatal Transport Program Overview","authors":"M. Elfarargy, T. A. Alruwaili, D. H. Elbadry, A. R. Ahmad","doi":"10.4103/jcn.jcn_23_24","DOIUrl":"https://doi.org/10.4103/jcn.jcn_23_24","url":null,"abstract":"Neonatal transport program (NTP) is a specialized service for neonatal transport for those who require transfer between hospitals for intensive care. NTP is indicated in any transportation of neonates from place to place, but it is specially indicated in unstable or high-risk neonates. The aim of this review is to discuss the importance of NTP, indication, and contraindication of NTP. In addition, we demonstrate the items of the transport system, methods for the preparation for transportation, as well as all the items of the transportation pathway. We also discuss the predeparture checklist, in addition to the illustration of the NTP telephone referral template. This review will demonstrate the predeparture checklist. Our main goal is to show the importance of NTP in providing the best place for the treatment of needed neonates with safe and adequate scientific transportation from the referring hospital to the receiving hospital.","PeriodicalId":45332,"journal":{"name":"Journal of Clinical Neonatology","volume":"27 2","pages":""},"PeriodicalIF":0.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141711649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Almalki, Jana Abdulnaser Algithmi, Haitham Mohammed Alghamdi, Malek Adeeb Alhnaidi, Hammam Kandil
Breastfeeding practices in Saudi Arabia may vary between working and non-working mothers. Working hours and work-related responsibilities may be obstacles to exclusive breastfeeding (EBF). This study aims to investigate the prevalence of breastfeeding among working versus non-working mothers in Jeddah, Saudi Arabia and to investigate barriers to EBF among working mothers. This was a cross-sectional survey-based study, in which 507 women were surveyed, predominantly aged 26–33 years. The data were collected through an online self-administered questionnaire sent randomly through social media. The Chi-squared test was employed to assess the prevalence and the factors influencing the choice of breastfeeding methods in these groups. EBF rate was 82% and 85.5% in non-working and working mothers, respectively. Exclusively breastfeeding mothers favored direct breastfeeding (54%) and mostly breastfed for over 6 months of their infants’ age (92%), whereas non-EBF mothers favored a combination of milk pumps and direct breastfeeding (P ≤ 0.001). The majority of working mothers strongly agree with the continuation of breastfeeding for the first 6 months of the child’s life if the workplace provides special breastfeeding facilities, provides paid maternity leave, or if they get help with housework. There was no difference in the duration of breastfeeding in working mothers compared to nonworking mothers. Working mothers report many barriers to breastfeeding, and those strategies should be targeted by governmental programs to enhance EBF practices.
{"title":"Prevalence of Breastfeeding among Working versus Nonworking Mothers in Saudi Arabia: A Regional Cross-sectional Study","authors":"F. Almalki, Jana Abdulnaser Algithmi, Haitham Mohammed Alghamdi, Malek Adeeb Alhnaidi, Hammam Kandil","doi":"10.4103/jcn.jcn_30_24","DOIUrl":"https://doi.org/10.4103/jcn.jcn_30_24","url":null,"abstract":"\u0000 \u0000 Breastfeeding practices in Saudi Arabia may vary between working and non-working mothers. Working hours and work-related responsibilities may be obstacles to exclusive breastfeeding (EBF).\u0000 \u0000 \u0000 \u0000 This study aims to investigate the prevalence of breastfeeding among working versus non-working mothers in Jeddah, Saudi Arabia and to investigate barriers to EBF among working mothers.\u0000 \u0000 \u0000 \u0000 This was a cross-sectional survey-based study, in which 507 women were surveyed, predominantly aged 26–33 years. The data were collected through an online self-administered questionnaire sent randomly through social media. The Chi-squared test was employed to assess the prevalence and the factors influencing the choice of breastfeeding methods in these groups.\u0000 \u0000 \u0000 \u0000 EBF rate was 82% and 85.5% in non-working and working mothers, respectively. Exclusively breastfeeding mothers favored direct breastfeeding (54%) and mostly breastfed for over 6 months of their infants’ age (92%), whereas non-EBF mothers favored a combination of milk pumps and direct breastfeeding (P ≤ 0.001). The majority of working mothers strongly agree with the continuation of breastfeeding for the first 6 months of the child’s life if the workplace provides special breastfeeding facilities, provides paid maternity leave, or if they get help with housework.\u0000 \u0000 \u0000 \u0000 There was no difference in the duration of breastfeeding in working mothers compared to nonworking mothers. Working mothers report many barriers to breastfeeding, and those strategies should be targeted by governmental programs to enhance EBF practices.\u0000","PeriodicalId":45332,"journal":{"name":"Journal of Clinical Neonatology","volume":"50 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141699278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Faisal Khan, Hassan Sallam, Moamen Taha Gad, Omar Khalil, M. Alsayady
Megalourethra is a rare congenital disorder of male penile tissue and urethra, characterized by nonobstructive dilatation of the urethra, mainly classified into scaphoid and fusiform types. It is commonly associated with multisystem involvement including hydronephrosis, hydroureter, posterior urethral valves, and vertebral, anal, and cardiac anomalies. The isolated entity is rarely found. Urethroplasty is a management modality to treat megalourethra with the treatment of other associated anomalies. In this article, we are presenting a case of megalourethra associated with right hydronephrosis, Grade 3–4 vesicoureteral reflux, small left kidney, and posterior urethral valve.
{"title":"Congenital Megalourethra Presented with Renal Anomalies","authors":"Faisal Khan, Hassan Sallam, Moamen Taha Gad, Omar Khalil, M. Alsayady","doi":"10.4103/jcn.jcn_42_24","DOIUrl":"https://doi.org/10.4103/jcn.jcn_42_24","url":null,"abstract":"Megalourethra is a rare congenital disorder of male penile tissue and urethra, characterized by nonobstructive dilatation of the urethra, mainly classified into scaphoid and fusiform types. It is commonly associated with multisystem involvement including hydronephrosis, hydroureter, posterior urethral valves, and vertebral, anal, and cardiac anomalies. The isolated entity is rarely found. Urethroplasty is a management modality to treat megalourethra with the treatment of other associated anomalies. In this article, we are presenting a case of megalourethra associated with right hydronephrosis, Grade 3–4 vesicoureteral reflux, small left kidney, and posterior urethral valve.","PeriodicalId":45332,"journal":{"name":"Journal of Clinical Neonatology","volume":"48 18","pages":""},"PeriodicalIF":0.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141689829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：