{"title":"Vitamin D Status of Preterm Newborns at Approximately 4 Weeks of Age in Shenzhen, China: A Retrospective Observational Cohort Study Conducted Across Two Centers","authors":"Yanping Guo, Zhangbin Yu, Huiying Tu, Biying Zheng, Jiamin Li, Ying Liu","doi":"10.2147/rrn.s450403","DOIUrl":"https://doi.org/10.2147/rrn.s450403","url":null,"abstract":"","PeriodicalId":509999,"journal":{"name":"Research and Reports in Neonatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140084528","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}
: “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.
{"title":"Obstacles to the Early Diagnosis and Management of Patent Ductus Arteriosus","authors":"Sharada Gowda, Ranjit Philip, M. Weems","doi":"10.2147/rrn.s409744","DOIUrl":"https://doi.org/10.2147/rrn.s409744","url":null,"abstract":": “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.","PeriodicalId":509999,"journal":{"name":"Research and Reports in Neonatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140470326","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. 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
{"title":"Congenital Malaria in a 20-Day-Old Neonate: A Case Report and Literature Review","authors":"M. Regasa, Tesfaye Shibiru, T. Tilahun, Gedefa Bayisa, Gemechis Negari","doi":"10.2147/rrn.s452965","DOIUrl":"https://doi.org/10.2147/rrn.s452965","url":null,"abstract":"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","PeriodicalId":509999,"journal":{"name":"Research and Reports in Neonatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140464655","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}
{"title":"Prevalence, Prevention and Management of Bronchopulmonary Dysplasia","authors":"Margaret Gilfillan, Michelle J Mejia, V. Bhandari","doi":"10.2147/rrn.s405985","DOIUrl":"https://doi.org/10.2147/rrn.s405985","url":null,"abstract":"","PeriodicalId":509999,"journal":{"name":"Research and Reports in Neonatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139392334","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}