HSOA journal neonatology & clinical pediatrics最新文献

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Descriptive Longitudinal Pilot Study: Behaviors Surrounding Feeding of Preterm Infants Who Received Extended Tube Feedings. 描述性纵向试点研究:接受延长管饲的早产儿喂养行为。

HSOA journal neonatology & clinical pediatrics

Pub Date : 2022-01-01 DOI: 10.24966/ncp-878x/100092

Rosemary White-Traut, Thao Griffith, Cheng Zheng, Joanne Lagatta, Christina Rigby-McCotter, Claire Walsh, Karen Gralton

Purpose: Seventy percent of preterm infants experience challenges with oral feeding and commonly require tube feedings. Yet it is not well understood how these behaviors change over time while infants are receiving tube feedings only and through the transition to oral feedings. The purpose of this pilot study was to describe the change in behaviors surrounding feeding and with respect to advancing Post Menstrual Age (PMA) for preterm infants who received extended tube feedings during hospitalization in the Neonatal Intensive Care Unit (NICU).

Methods and measures: A prospective pilot study was conducted in a NICU. We recruited thirty-five infants who were born between 28 to 32 weeks gestational age and expected to have at least two weeks of tube feedings. Infant health status and feeding progression were obtained from the medical record. Behaviors surrounding feeding included infant state, social interactive behaviors, orally directed behaviors, and hunger/satiation cues were evaluated via weekly recorded videos.

Results: During the pre-feeding segment, we noted an increase over time for awake, facial gaze, gaze aversion, tongue protrusion, fussing, mouthing, vocalization, and interest in the pacifier. During the intra-feeding segment, we found an increase over time for fussing, and a decrease for eye widening, eye searching, and vocalization.

Conclusion: To our knowledge, this was the first pilot study to comprehensively describe the changes in behaviors surrounding feeding over time and with respect to advancing PMA for preterm infants who received extended tube feedings during the NICU hospitalization. Infants demonstrated distinct behaviors surrounding feeding as young as 28 weeks post menstrual age. These behaviors may vary among infants and change significantly with advancing post-menstrual age. Assessment of subtle behaviors surrounding feeding is important to ensure oral feeding readiness.

目的:70%的早产儿在口服喂养方面遇到困难，通常需要管饲。然而，当婴儿只接受管饲和过渡到口服喂养时，这些行为是如何随着时间的推移而改变的，目前还不清楚。本初步研究的目的是描述在新生儿重症监护病房(NICU)住院期间接受延长管饲的早产儿在喂养和月经后年龄(PMA)提前方面的行为变化。方法和措施:在新生儿重症监护病房进行前瞻性先导研究。我们招募了35名出生在28至32周孕龄之间的婴儿，预计至少要进行两周的管饲。从医疗记录中获取婴儿健康状况和喂养进展。喂养行为包括婴儿状态、社会互动行为、口头指导行为和饥饿/饱食线索，通过每周录制的视频进行评估。结果:在喂食前，我们注意到，随着时间的推移，醒着、面部凝视、凝视厌恶、舌头突出、大惊小怪、嘴动、发声和对安抚奶嘴的兴趣都有所增加。在喂食过程中，我们发现随着时间的推移，大惊小怪的行为增加了，而睁大眼睛、寻找眼睛和发声的行为减少了。结论:据我们所知，这是第一个全面描述在NICU住院期间接受延长管饲的早产儿喂养行为随时间变化的试点研究。婴儿在月经后28周就表现出明显的喂养行为。这些行为可能在婴儿中有所不同，并随着月经后年龄的增长而显著改变。评估喂养周围的细微行为对于确保口腔喂养准备是重要的。

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引用次数: 0

Patent Foramen Ovale And Stroke In Adolescents - To Close Or Not To Close? 青少年卵圆孔未闭与中风——闭合还是不闭合?

HSOA journal neonatology & clinical pediatrics

Pub Date : 2019-12-27 DOI: 10.24966/ncp-878x/100041

Sónia Silva

Stroke is a rare condition in childhood and about half of the cases are due to an arterial ischemic event. Although the long list of known causes, many cases remain undetermined, so-called cryptogenic strokes. However, increasing evidence indicates that some of these cryptogenic cases can be a result of a paradoxical embolism via a Patent Foramen Ovale (PFO) with a right-to-left intracardiac shunt, but the exact contribution of PFO to stroke or stroke recurrence in childhood remains unclear. Considering this, as a second line of study, a transthoracic and transoesophageal echocardiogram should be done in all cases to rule out a possible right-to-left shunt, such as PFO. Optimal treatment for acute ischemic strokes in children is con-troversial, with lacking studies. Closure of PFO should be considered as a preventive measure depending on individual risk factors and anatomic features. We present two cases of a 16-year-old boy and a 17-year-old girl who had an event of cerebral ischemia documented on MRI, and in whom was found a PFO with a shunt, with the remaining exhaustive etiologic investigation all negative. Both of them underwent percutaneous closure of the PFO.

中风在儿童时期是一种罕见的情况，大约一半的病例是由于动脉缺血性事件引起的。尽管已知的病因很长，但许多病例仍未确定，即所谓的隐源性中风。然而，越来越多的证据表明，这些隐性病例中的一些可能是通过具有从右到左心内分流的Foramen Ovale专利（PFO）引起的反常栓塞的结果，但PFO对儿童中风或中风复发的确切影响尚不清楚。考虑到这一点，作为第二项研究，在所有情况下都应进行经胸和经食管超声心动图检查，以排除可能的左右分流，如PFO。儿童急性缺血性中风的最佳治疗是可逆的，缺乏研究。PFO的闭合应视为一种预防措施，具体取决于个体风险因素和解剖特征。我们报告了两例病例，一名16岁男孩和一名17岁女孩，他们在MRI上记录了脑缺血事件，其中发现了PFO伴分流，其余详尽的病因调查均为阴性。两人均接受了经皮PFO封堵术。

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引用次数: 0

A Drug Reaction Mimics Perinatal Sepsis 药物反应模拟围产期败血症

HSOA journal neonatology & clinical pediatrics

Pub Date : 2019-11-13 DOI: 10.24966/ncp-878x/100033

D. Wilson-Costello

引用次数: 1

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全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

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