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Research and Reports in Neonatology最新文献

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Vitamin D Status of Preterm Newborns at Approximately 4 Weeks of Age in Shenzhen, China: A Retrospective Observational Cohort Study Conducted Across Two Centers 中国深圳早产新生儿约 4 周时的维生素 D 状态:在两个中心开展的回顾性观察队列研究
Pub Date : 2024-03-01 DOI: 10.2147/rrn.s450403
Yanping Guo, Zhangbin Yu, Huiying Tu, Biying Zheng, Jiamin Li, Ying Liu
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引用次数: 0
Obstacles to the Early Diagnosis and Management of Patent Ductus Arteriosus 动脉导管未闭早期诊断和管理的障碍
Pub Date : 2024-02-01 DOI: 10.2147/rrn.s409744
Sharada Gowda, Ranjit Philip, M. Weems
: “What we know is little, and what we are ignorant of is immense”; the last words of Laplace still apply to the diagnosis and management of the patent ductus arteriosus (PDA). Despite decades of research, we are searching for the right approach to care for patients with PDA. Nuances of myocardial structural changes and cardiopulmonary interactions with prolonged exposure to excess pulmonary blood flow have played an important role in decision-making. The availability of medical treatments with poor efficacy and, historically, surgical ligation as the only available definitive therapy further widened the gap between observation and definitive closure. As more extremely low birth weight neonates born at earlier gestational ages survive, we are faced with a population whose physiological immaturity and structural alignment of the myocardium predisposes them to myocardial dysfunction and dysregulated vascular tone. Therefore, it may be time to replace historical approaches with a more precise patient-centric therapeutic model. A comprehensive serial echocardiography assessment of the heart function, hemodynamic significance, and clinical context with respect to pulmonary insufficiency and gut perfusion aids the neonatologist in making PDA management decisions. A targeted approach balances risks and benefits of therapy, avoids treatment for infants likely to have early spontaneous closure, and limits prolonged exposure to the pathologic PDA shunt in high-risk infants. There is significant variability in the diagnosis and treatment of the PDA, both within and across centers. This review highlights the clinical obstacles contributing to the variability and illustrates the need for a standardized approach to PDA diagnosis and management.
:"拉普拉斯的最后一句话仍然适用于动脉导管未闭(PDA)的诊断和治疗。尽管经过几十年的研究,我们仍在寻找治疗 PDA 患者的正确方法。心肌结构变化的细微差别和长期暴露于过量肺血流的心肺相互作用在决策过程中发挥了重要作用。药物治疗疗效不佳,而手术结扎作为唯一可用的最终疗法,进一步扩大了观察和最终关闭之间的差距。随着越来越多胎龄较早的极低出生体重新生儿存活下来,我们面对的是这样一个群体,他们生理上的不成熟和心肌结构的排列使他们容易出现心肌功能障碍和血管张力失调。因此,也许是时候用一种更精确的、以患者为中心的治疗模式来取代以往的方法了。对心脏功能、血液动力学意义以及肺功能不全和肠道灌注的临床背景进行全面的连续超声心动图评估,有助于新生儿科医生做出 PDA 治疗决策。有针对性的方法可平衡治疗的风险和益处,避免对可能出现早期自发闭合的婴儿进行治疗,并限制高风险婴儿长期暴露于病理性 PDA 分流。PDA 的诊断和治疗在中心内部和中心之间都存在很大的差异。本综述强调了造成这种差异的临床障碍,并说明了对 PDA 诊断和管理采用标准化方法的必要性。
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引用次数: 0
Congenital Malaria in a 20-Day-Old Neonate: A Case Report and Literature Review 一名 20 天大新生儿的先天性疟疾:病例报告和文献综述
Pub Date : 2024-02-01 DOI: 10.2147/rrn.s452965
M. Regasa, Tesfaye Shibiru, T. Tilahun, Gedefa Bayisa, Gemechis Negari
Background: Congenital malaria is a relatively rare condition where the Plasmodium parasite is transmitted from the mother to the fetus during pregnancy. It is associated with a high fatality rate if it is not promptly diagnosed and treated. Case Summary: We report an unusual case of a 20-day-old male baby with Plasmodium vivax malaria from Western Ethiopia, suspected primarily on the basis of positive maternal history that mother had attacks of malaria in the 3 rd , 5th, and 8 th months of gestation and was cured with artemether-lumefantrine therapy. Infant presented with vomiting and a high-grade fever. The blood film of the baby showed trophozoites stage of Plasmodium vivax with a parasite density of +3. The neonate had severe thrombocytopenia (49,000/micro liter) and Splenomegaly (spleen was palpable 2cm along its line of growth). The patient was admitted to the hospital and treated with artesunate for five days and discharged on the sixth day of admission in stable condition. Conclusion: Sick neonates born to mothers in malaria-endemic areas or with a history of malaria attack(s) in the index pregnancy should be promptly investigated for malaria
背景:先天性疟疾是一种相对罕见的疾病,疟原虫会在怀孕期间从母体传染给胎儿。如果不及时诊断和治疗,死亡率很高。病例摘要:我们报告了一例不寻常的病例,一名来自埃塞俄比亚西部的 20 天大男婴患有间日疟原虫疟疾,怀疑该病的主要依据是母亲的阳性病史,即母亲在妊娠第 3 个月、第 5 个月和第 8 个月曾患过疟疾,后经蒿甲醚-本芴醇治疗治愈。婴儿出现呕吐和高烧。新生儿血小板严重减少(49,000/微升),脾肿大(沿脾脏生长线可触及 2 厘米)。患者入院后接受了为期五天的青蒿琥酯治疗,入院第六天病情稳定出院。结论疟疾流行地区的母亲所生的患病新生儿或在妊娠期有疟疾发作史的新生儿应立即接受疟疾检查。
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引用次数: 0
Prevalence, Prevention and Management of Bronchopulmonary Dysplasia 支气管肺发育不良的发病率、预防和管理
Pub Date : 2024-01-01 DOI: 10.2147/rrn.s405985
Margaret Gilfillan, Michelle J Mejia, V. Bhandari
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引用次数: 0
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Research and Reports in Neonatology
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