Pub Date : 2024-05-27DOI: 10.1101/2024.05.26.24307924
A Hutchinson, R Pais, AN Edginton, B Pilon, JM MacDonald, ME MacDonald, T Lewis, M Offringa, BT Kalish
Introduction Infants with hypoxic-ischemic encephalopathy (HIE) are at high risk for neurodevelopmental impairment, despite current standards of care. Adjunctive treatments to promote brain repair are needed. The antidiabetic drug metformin has recently been recognized as a neurorestorative agent, but, to date, has not been used in infants. Herein, we describe a clinical trial with the aim of demonstrating the safety and feasibility of metformin use to improve neurodevelopmental outcomes in infants with HIE.
导言：尽管目前的治疗标准不尽人意，但缺氧缺血性脑病（HIE）婴儿神经发育受损的风险很高。因此需要辅助治疗来促进大脑修复。抗糖尿病药物二甲双胍最近被认为是一种神经修复剂，但迄今为止尚未用于婴儿。在此，我们介绍了一项临床试验，旨在证明二甲双胍用于改善 HIE 婴儿神经发育结局的安全性和可行性。
{"title":"A Safety and Feasibility Trial Protocol of Metformin in Infants after Perinatal Brain Injury","authors":"A Hutchinson, R Pais, AN Edginton, B Pilon, JM MacDonald, ME MacDonald, T Lewis, M Offringa, BT Kalish","doi":"10.1101/2024.05.26.24307924","DOIUrl":"https://doi.org/10.1101/2024.05.26.24307924","url":null,"abstract":"<strong>Introduction</strong> Infants with hypoxic-ischemic encephalopathy (HIE) are at high risk for neurodevelopmental impairment, despite current standards of care. Adjunctive treatments to promote brain repair are needed. The antidiabetic drug metformin has recently been recognized as a neurorestorative agent, but, to date, has not been used in infants. Herein, we describe a clinical trial with the aim of demonstrating the safety and feasibility of metformin use to improve neurodevelopmental outcomes in infants with HIE.","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141167204","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}
Background: Rheumatic heart disease remains a significant public health concern, especially among children in resource-limited settings like Ethiopia. Despite effective prevention strategies, RHD persists due to factors such as poverty and limited healthcare access. Understanding the clinical characteristics and valve lesions of rheumatic heart disease is crucial for improving diagnosis and management. Objective: This study aimed to characterize the clinical features and valve lesions in children with rheumatic heart disease admitted to a tertiary teaching hospital in Eastern Ethiopia. Methods: A hospital-based cross-sectional study was conducted from September 1, 2020, to August 31, 2021, at Hiwot Fana Comprehensive Specialized Hospital. Data were collected from medical records, clinical assessments, echocardiography reports, and laboratory tests. Descriptive statistics were used for analysis. Results: A total of 39 children with rheumatic heart disease were included, predominantly females (71.8%). Shortness of breath (53.9%) and cough (38.5%) were common presenting symptoms. Acute decompensated heart failure (ADHF) was prevalent (89.7%). Mitral regurgitation (94.9%) and aortic regurgitation (66.7%) were frequent valve lesions. Other findings included mitral stenosis (56.4%) and left atrial enlargement (86.1%). Laboratory results showed mean hemoglobin of 10.29 g/dL and mean ESR of 45 mm/hr. Conclusions: This study highlights the burden of RHD in Eastern Ethiopia, with advanced disease at presentation. Mitral and aortic valve lesions were predominant, emphasizing the need for early detection and comprehensive management strategies. Collaboration among healthcare providers and policymakers is essential to address the challenges of RHD in resource-limited settings. Keywords: Rheumatic heart disease, clinical characteristics, valve lesions, Eastern Ethiopia
{"title":"Clinical characteristics and valve lesions in rheumatic heart disease among children admitted to a selected tertiary teaching hospital in eastern Ethiopia.","authors":"Temesgen Teferi Libe, Yunus Edris Kelil, Samrawit Abebaw Tegene, Faisel Abdi, Kibrom Hailemariam Mesfin","doi":"10.1101/2024.05.08.24307081","DOIUrl":"https://doi.org/10.1101/2024.05.08.24307081","url":null,"abstract":"Background: Rheumatic heart disease remains a significant public health concern, especially among children in resource-limited settings like Ethiopia. Despite effective prevention strategies, RHD persists due to factors such as poverty and limited healthcare access. Understanding the clinical characteristics and valve lesions of rheumatic heart disease is crucial for improving diagnosis and management.\u0000Objective: This study aimed to characterize the clinical features and valve lesions in children with rheumatic heart disease admitted to a tertiary teaching hospital in Eastern Ethiopia.\u0000Methods: A hospital-based cross-sectional study was conducted from September 1, 2020, to August 31, 2021, at Hiwot Fana Comprehensive Specialized Hospital. Data were collected from medical records, clinical assessments, echocardiography reports, and laboratory tests. Descriptive statistics were used for analysis.\u0000Results: A total of 39 children with rheumatic heart disease were included, predominantly females (71.8%). Shortness of breath (53.9%) and cough (38.5%) were common presenting symptoms. Acute decompensated heart failure (ADHF) was prevalent (89.7%). Mitral regurgitation (94.9%) and aortic regurgitation (66.7%) were frequent valve lesions. Other findings included mitral stenosis (56.4%) and left atrial enlargement (86.1%). Laboratory results showed mean hemoglobin of 10.29 g/dL and mean ESR of 45 mm/hr.\u0000Conclusions: This study highlights the burden of RHD in Eastern Ethiopia, with advanced disease at presentation. Mitral and aortic valve lesions were predominant, emphasizing the need for early detection and comprehensive management strategies. Collaboration among healthcare providers and policymakers is essential to address the challenges of RHD in resource-limited settings.\u0000Keywords: Rheumatic heart disease, clinical characteristics, valve lesions, Eastern Ethiopia","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140938594","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}
Background Invasive mechanical ventilation in very-low-birth-weight infants (VLBWI) was associated with immediate and long-term complications. Nasal high-frequency oscillation (nHFO) has recently become a new non-invasive ventilation (NIV) mode for treating respiratory failure in VLBWI. This study aimed to investigate the safety and efficacy of nHFO as an alternative respiratory support to prevent intubation in VLBWI who have failed other NIV modes.
{"title":"Efficacy and Safety of Nasal High-Frequency Oscillation in Preventing Intubation in Very-Low-Birth-Weight Infants with Respiratory Distress Syndrome","authors":"Buu Quoc Dang, Tam Thi Thanh Pham, Duc Ninh Nguyen, Nguyen Phuoc Long, Tinh Thu Nguyen","doi":"10.1101/2024.05.10.24307155","DOIUrl":"https://doi.org/10.1101/2024.05.10.24307155","url":null,"abstract":"<strong>Background</strong> Invasive mechanical ventilation in very-low-birth-weight infants (VLBWI) was associated with immediate and long-term complications. Nasal high-frequency oscillation (nHFO) has recently become a new non-invasive ventilation (NIV) mode for treating respiratory failure in VLBWI. This study aimed to investigate the safety and efficacy of nHFO as an alternative respiratory support to prevent intubation in VLBWI who have failed other NIV modes.","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"138 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140938637","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}
Pub Date : 2024-05-08DOI: 10.1101/2024.05.07.24306996
John D. Lewis, Atiyeh A. Miran, Michelle Stoopler, Helen M. Branson, Ashley Danguecan, Krishna Raghu, Linh G. Ly, Mehmet N. Cizmeci, Brian T. Kalish
Objectives Neonatal hypoxic-ischemic encephalopathy is a serious neurologic condition associated with death or neurodevelopmental impairments. Magnetic resonance imaging (MRI) is routinely used for neuroprognostication, but there is substantial subjectivity and uncertainty about neurodevelopmental outcome prediction. We sought to develop an objective and automated approach for the analysis of newborn brain MRI to improve the accuracy of prognostication.
{"title":"Automated Neuroprognostication via Machine Learning in Neonates with Hypoxic-Ischemic Encephalopathy","authors":"John D. Lewis, Atiyeh A. Miran, Michelle Stoopler, Helen M. Branson, Ashley Danguecan, Krishna Raghu, Linh G. Ly, Mehmet N. Cizmeci, Brian T. Kalish","doi":"10.1101/2024.05.07.24306996","DOIUrl":"https://doi.org/10.1101/2024.05.07.24306996","url":null,"abstract":"<strong>Objectives</strong> Neonatal hypoxic-ischemic encephalopathy is a serious neurologic condition associated with death or neurodevelopmental impairments. Magnetic resonance imaging (MRI) is routinely used for neuroprognostication, but there is substantial subjectivity and uncertainty about neurodevelopmental outcome prediction. We sought to develop an objective and automated approach for the analysis of newborn brain MRI to improve the accuracy of prognostication.","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140938312","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}
Pub Date : 2024-05-08DOI: 10.1101/2024.05.06.24306917
Germana Bancone, Mary Ellen Gilder, Elsie Win, Gornpan Gornsawun, Paw Khu Moo, Laypaw Archasuksan, Nan San Wai, Sylverine Win, Borimas Hanboonkunupakarn, Francois Nosten, Verena I Carrara, Rose McGready
Background Neonatal hyperbilirubinaemia (NH) is a common problem worldwide and causes morbidity and mortality especially in low-resource settings.
背景新生儿高胆红素血症（NH）是全球普遍存在的问题，会导致发病和死亡，尤其是在资源匮乏的地区。
{"title":"Non-invasive detection of bilirubin concentrations during the first week of life in a low-resource setting along the Thailand-Myanmar border","authors":"Germana Bancone, Mary Ellen Gilder, Elsie Win, Gornpan Gornsawun, Paw Khu Moo, Laypaw Archasuksan, Nan San Wai, Sylverine Win, Borimas Hanboonkunupakarn, Francois Nosten, Verena I Carrara, Rose McGready","doi":"10.1101/2024.05.06.24306917","DOIUrl":"https://doi.org/10.1101/2024.05.06.24306917","url":null,"abstract":"<strong>Background</strong> Neonatal hyperbilirubinaemia (NH) is a common problem worldwide and causes morbidity and mortality especially in low-resource settings.","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140938408","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}
Pub Date : 2024-05-07DOI: 10.1101/2024.05.07.24306981
Lin Yang, Yan Hui, Per Torp Sangild, Witold Piotr Kot, Lise Aunsholt, Gitte Zachariassen, Ping-Ping Jiang, Dennis Sandris Nielsen
Background Very preterm infants (VPIs) are born with an immature gut, being sensitive to gut microbiota dysbiosis-related disease like necrotizing enterocolitis. While human milk is the best source of nutrition for VPIs, it requires fortification to meet their nutrient requirements for optimal growth. However, the optimal type of fortifier remains uncertain. Bovine colostrum (BC), rich in protein and bioactive components, may be an alternative to conventional fortifiers (CF). We aimed to investigate the distinct impacts of different bovine fortifiers, BC and CF, on the gut microbiota of VPIs. The gut microbiota of 225 VPIs who were fed human milk fortified with either BC or CF, were profiled by 16S rRNA gene amplicon sequencing of fecal samples collected before, one and two weeks of fortification.
{"title":"Gut microbiota development in very preterm infants following fortification of human milk","authors":"Lin Yang, Yan Hui, Per Torp Sangild, Witold Piotr Kot, Lise Aunsholt, Gitte Zachariassen, Ping-Ping Jiang, Dennis Sandris Nielsen","doi":"10.1101/2024.05.07.24306981","DOIUrl":"https://doi.org/10.1101/2024.05.07.24306981","url":null,"abstract":"<strong>Background</strong> Very preterm infants (VPIs) are born with an immature gut, being sensitive to gut microbiota dysbiosis-related disease like necrotizing enterocolitis. While human milk is the best source of nutrition for VPIs, it requires fortification to meet their nutrient requirements for optimal growth. However, the optimal type of fortifier remains uncertain. Bovine colostrum (BC), rich in protein and bioactive components, may be an alternative to conventional fortifiers (CF). We aimed to investigate the distinct impacts of different bovine fortifiers, BC and CF, on the gut microbiota of VPIs. The gut microbiota of 225 VPIs who were fed human milk fortified with either BC or CF, were profiled by 16S rRNA gene amplicon sequencing of fecal samples collected before, one and two weeks of fortification.","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140938595","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}
Background Due to high risks of feeding intolerance, preterm infants often receive parenteral nutrition (PN) to ensure sufficient nutrition and energy intake. However, there is a lack of data on the status of clinical PN practice and barriers among neonatal care units in low to middle-income countries like Vietnam. This extensive survey explores the status and barriers of PN practice for preterm infants in neonatal units across Vietnam and identifies the practical implications of enhancing nutritional outcomes in preterm infants.
{"title":"Vietnam National Survey on Parenteral Nutrition Practice in Preterm Neonates: Status, Barriers, and Implications","authors":"Thu Tinh Nguyen, Phan Minh Nhat Nguyen, Thanh Thien Nguyen, Thi Hieu Vu, Pham Minh Tri Nguyen, Duc Ninh Nguyen","doi":"10.1101/2024.04.30.24306616","DOIUrl":"https://doi.org/10.1101/2024.04.30.24306616","url":null,"abstract":"<strong>Background</strong> Due to high risks of feeding intolerance, preterm infants often receive parenteral nutrition (PN) to ensure sufficient nutrition and energy intake. However, there is a lack of data on the status of clinical PN practice and barriers among neonatal care units in low to middle-income countries like Vietnam. This extensive survey explores the status and barriers of PN practice for preterm infants in neonatal units across Vietnam and identifies the practical implications of enhancing nutritional outcomes in preterm infants.","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"91 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140883095","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}
Pub Date : 2024-05-01DOI: 10.1101/2024.04.30.24306628
Uyen Le Tran, Linh Tran Phuong Giang, Tinh Thu Nguyen
Introduction Early-onset neonatal infection (EONI) poses significant risks to neonatal health, necessitating reliable diagnostic markers for early detection. This study aims to evaluate the diagnostic validity of procalcitonin (PCT) concentration in umbilical cord blood as a biomarker for EONI.
{"title":"Validity of Umbilical Cord Blood Procalcitonin in the Diagnosis of Early-Onset Neonatal Infection","authors":"Uyen Le Tran, Linh Tran Phuong Giang, Tinh Thu Nguyen","doi":"10.1101/2024.04.30.24306628","DOIUrl":"https://doi.org/10.1101/2024.04.30.24306628","url":null,"abstract":"<strong>Introduction</strong> Early-onset neonatal infection (EONI) poses significant risks to neonatal health, necessitating reliable diagnostic markers for early detection. This study aims to evaluate the diagnostic validity of procalcitonin (PCT) concentration in umbilical cord blood as a biomarker for EONI.","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"83 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140883155","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}
Pub Date : 2024-05-01DOI: 10.1101/2024.04.29.24306579
Sofia Cuevas-Asturias, Will Tremlett, Hannah Mitchell, Padmanabhan Ramnarayan, Natalie Pattison
Paediatric Critical Care (PCC) supports the recovery of children with severe illness. Nationally, there are 30 PCC units with a total of approximately 400 beds. There is constant demand for these beds with an average five-day length of stay and admissions increasing at a greater rate than age-specific population growth[1, 2]. Prolonged stay patients account for approximately half of all PCC patient bed days[3].
{"title":"Protocol on an Integrative review on nomenclature and outcomes in paediatric complex critical illness - The basis for consensus definition","authors":"Sofia Cuevas-Asturias, Will Tremlett, Hannah Mitchell, Padmanabhan Ramnarayan, Natalie Pattison","doi":"10.1101/2024.04.29.24306579","DOIUrl":"https://doi.org/10.1101/2024.04.29.24306579","url":null,"abstract":"Paediatric Critical Care (PCC) supports the recovery of children with severe illness. Nationally, there are 30 PCC units with a total of approximately 400 beds. There is constant demand for these beds with an average five-day length of stay and admissions increasing at a greater rate than age-specific population growth[1, 2]. Prolonged stay patients account for approximately half of all PCC patient bed days[3].","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"151 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140883159","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}
Pub Date : 2024-04-16DOI: 10.1101/2024.04.15.24305767
Ying Tang, Brittany P. Boribong, Zoe N. Swank, Melina Demokritou, Maria A.F. Luban, Alessio Fasano, Michelle Du, Rebecca L. Wolf, Joseph Griffiths, John Shultz, Ella Borberg, Sujata Chalise, Wanda I. Gonzalez, David R. Walt, Lael M. Yonker, Bruce H. Horwitz
Key points
要点
{"title":"COVID-19 mRNA vaccines induce robust levels of IgG but limited amounts of IgA within the oronasopharynx of young children","authors":"Ying Tang, Brittany P. Boribong, Zoe N. Swank, Melina Demokritou, Maria A.F. Luban, Alessio Fasano, Michelle Du, Rebecca L. Wolf, Joseph Griffiths, John Shultz, Ella Borberg, Sujata Chalise, Wanda I. Gonzalez, David R. Walt, Lael M. Yonker, Bruce H. Horwitz","doi":"10.1101/2024.04.15.24305767","DOIUrl":"https://doi.org/10.1101/2024.04.15.24305767","url":null,"abstract":"<strong>Key points</strong>","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140617841","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}
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