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A familial case of Muenke syndrome. Diverse expressivity of the FGFR3 Pro252Arg
mutation – case report and review of the literature
29 Nov 2013 09:03 am
Journal of Maternal-Fetal and Neonatal Medicine, Volume 0, Issue 0, Page 1-5, Early Online.
A multicenter cohort study of pregnancy outcomes among women with laboratory-confirmed
H1N1 influenza
26 Nov 2013 12:00 am
A multicenter cohort study of pregnancy outcomes among women with laboratory-confirmed H1N1
influenza
Journal of Perinatology 33, 939 (December 2013). doi:10.1038/jp.2013.110
Authors: A Naresh, B M Fisher, K K Hoppe, J Catov, J Xu, J Hart, A M Lynch, R Gibbs, D Eschenbach, M
Gravett & R H Beigi
A novel systematic approach to the evaluation of the fetal venous system
09 Dec 2013 11:07 am
Publication date: October 2013
Source:Seminars in Fetal and Neonatal Medicine, Volume 18, Issue 5
Author(s): Elena Sinkovskaya , Anna Klassen , Alfred Abuhamad
Sonographic evaluation of the fetal venous system in normal and abnormal conditions has drawn increasing
interest in recent years. Whereas the assessment of the fetal heart and the related arteries is standardized
using well-defined planes, the fetal venous system is still lacking a systematic approach. In this article we
present a novel sonographic algorithm for a systematic examination of the fetal venous system using six
planes of transverse and oblique views of the fetal abdomen and chest. These planes, using twodimensional and color Doppler, enable a targeted demonstration of the typical veins to include the umbilical
vein, ductus venosus, portal veins, hepatic veins, inferior vena cava, azygos vein, pulmonary veins,
coronary sinus, superior vena cava and brachiocephalic vein. We postulate that integrating such a
sequential stepwise algorithm for the evaluation of the venous system into targeted fetal cardiac imaging
may improve the detection of isolated and combined anomalies of the fetal systemic and pulmonary veins.
A randomized trial comparing perinatal outcomes using insulin detemir or neutral protamine
Hagedorn in type 1 diabetes
29 Nov 2013 03:39 pm
Journal of Maternal-Fetal and Neonatal Medicine, Volume 27, Issue 1, Page 7-13, January 2014.
A risk stratification model to predict adverse neonatal outcome in labor
26 Nov 2013 12:00 am
A risk stratification model to predict adverse neonatal outcome in labor
Journal of Perinatology 33, 914 (December 2013). doi:10.1038/jp.2013.64
Authors: C M Holmgren, M S Esplin, M Jackson, T F Porter, E Henry, B D Horne & M W Varner
A time stamp comparative analysis of frequent chromosomal abnormalities in Romanian
patients
29 Nov 2013 03:40 pm
Journal of Maternal-Fetal and Neonatal Medicine, Volume 27, Issue 1, Page 1-6, January 2014.
Access to care for women reporting postnatal complications in the occupied Palestinian
territory: a cross-sectional study
08 Dec 2013 01:45 pm
Publication date: 5 December 2013
Source:The Lancet, Volume 382, Supplement 4
Author(s): Hendia A Abu Nabaa , Ghadir A Hilal , Sbeih A Sbeih , Rula Ghandour , Rita Giacaman
Background Postnatal care is an important component of maternal health, especially for the treatment of
complications after delivery. However, only a third of women receive postnatal care in the occupied
Palestinian territory (oPt). The aim in this study was to assess the factors that contributed to women not
receiving postnatal care despite the manifestation of symptoms. Methods Data were obtained from a
nationally representative household survey (Pan-Arab Project for Family Health [PAPFAM] 2006) by the
Palestinian Central Bureau of Statistics, West Bank, oPt, and analysed. Women (aged 15–54 years) who
were married and reported one or more postnatal symptoms with fever—severe vaginal bleeding, swelling
and pain in the legs, foul-smelling vaginal discharge, lower abdominal pain, severe lower back pain, severe
upper back pain, painful micturation, or breast swelling and pain—were selected from 3334 women in the
postnatal period. For the analysis, responses about these eight symptoms were converted into a scale
(Cronbach's α=0·82). Descriptive analysis, Pearson's χ2, and binary logistic regression were done with
postnatal care as the dependent variable and selected demographic and socioeconomic variables as
possible associated factors. SPSS (version 17.0) was used for the statistical analysis. Findings 267 (46%)
of 584 women had one postnatal symptom, 217 (37%) had two or three postnatal symptoms, and 100
(17%) had four to seven. 245 (42%) women received postnatal care and 339 (58%) did not. 251 (74%) of
339 women who did not receive postnatal care reported that symptoms were not a problem. Logistic
regression analysis showed that women who were poorer were more likely to not receive postnatal care
than were those who were better off (odds ratio 2·1, 95% CI 1·1–4·0]. Women reporting normal delivery
were four times less likely to use postnatal care than were those who reported having a caesarean (4·0,
2·5–6·2). Women married to younger men (aged ≤29 years) and women living in the West Bank were
almost half as likely to receive postnatal care than were women married to older men (aged ≥30 years; 1·9,
1·1–3·3) and women in the Gaza strip (2·4, 1·5–3·6). Interpretation Poverty is an important barrier to
postnatal care for women and contributes to the inequity in the provision of services to these women. Better
accessibility of postnatal care for women in the Gaza Strip might be due to the presence of several
international humanitarian agencies that provide services to people living in this region, and the small size
of the Gaza Strip increasing accessibility to clinics for women. More efforts are needed to address women's
health needs in the postnatal period. Funding None.
Advances in interventional and hybrid therapy in neonatal congenital heart disease
09 Dec 2013 11:07 am
Publication date: October 2013
Source:Seminars in Fetal and Neonatal Medicine, Volume 18, Issue 5
Author(s): Dietmar Schranz , Ina Michel-Behnke
In addition to the considerable surgical advances in treating congenital heart diseases, hybrid and
transcatheter therapies have become a cornerstone of neonatal cardiology within the last decade.
Approaches to the care of cyanotic newborns with congenital heart disease focused on manipulations of the
inter-atrial septum, right ventricular outflow tract obstructions, and on the arterial duct as the source for
pulmonary blood flow. Currently, fewer interventional procedures are used in newborns and small infants to
treat excessive pulmonary blood flow caused by shunt lesions, but transcatheter techniques and hybrid
strategies have been developed to treat newborns suffering from inadequate systemic perfusion. However,
transcatheter techniques are still not available to treat failing systemic ventricles without obvious structural
disorders of the myocardium or dilated cardiomyopathies in newborns and infancy, despite new surgicalinterventional strategies are already developed to avoid or to delay early heart transplantation. In
conclusion, material and technical improvements have enabled transcatheter techniques to replace
medical-based therapies to solve structurally dependent cardiovascular diseases. However, evidencebased and long-term follow-up data are required.
Adverse pregnancy outcomes in women with nausea and vomiting of pregnancy*
29 Nov 2013 03:41 pm
Journal of Maternal-Fetal and Neonatal Medicine, Volume 27, Issue 1, Page 84-88, January 2014.
Amnion protective cesarean section – method for gentle delivery of preterm and/or VLBW
neonates
02 Dec 2013 09:21 am
Journal of Maternal-Fetal and Neonatal Medicine, Volume 0, Issue 0, Page 1-4, Early Online.
Amplitude-integrated EEG and range-EEG modulation associated with pneumatic
orocutaneous stimulation in preterm infants
05 Dec 2013 12:00 am
Amplitude-integrated EEG and range-EEG modulation associated with pneumatic orocutaneous
stimulation in preterm infants
Journal of Perinatology advance online publication, December 5 2013.doi:10.1038/jp.2013.150
Authors: S M Barlow, P Jegatheesan, S Weiss, B Govindaswami, J Wang, J Lee, A Oder & D Song
An Important Finding of Systemic Aspergillosis: Skin Involvement and Amphotericin B
Resistance in an Adolescent
09 Dec 2013 05:54 am
Publication date: Available online 8 December 2013
Source:Pediatrics & Neonatology
Author(s): Aslinur Ozkaya-Parlakay , Buse Ozer-Bekmez , Ates Kara , Baris Kuskonmaz , Zuhal Akcoren ,
Sevtap Arikan-Dagli , Berna Oguz
Invasive aspergillosis is a life-threatening infectious complication in immunocompromised patients,
especially with malignancy, and in some cases, it causes extensive tissue destruction and subsequent
systemic illness, leading to multiorgan failure and death. Skin involvement and amphotericin B resistance
are very rare findings of aspergillosis. Herein, we report the case of a primary hemophagocytic syndrome
patient who developed subcutaneous nodules in the 3rd month of bone marrow transplantation from which
Aspergillus fumigatus was cultivated despite the fact that she was under antifungal therapy. In
immunocompromised patients with prolonged fever, atypical presentations of invasive mycosis should be
kept in mind, and early appropriate therapy should be initiated promptly to decrease morbidity and
mortality.
Application of neurally adjusted ventilatory assist in neonates
09 Dec 2013 11:07 am
Publication date: Available online 13 November 2013
Source:Seminars in Fetal and Neonatal Medicine
Author(s): Howard Stein , Kimberly Firestone
Neurally adjusted ventilatory assist (NAVA) uses the electrical activity of the diaphragm (Edi) as a neural
trigger to synchronize mechanical ventilatory breaths with the patient's neural respiratory drive. Using this
signal enables the ventilator to proportionally support the patient's instantaneous drive on a breath-bybreath basis. Synchrony can be achieved even in the presence of significant air leaks, which make this an
attractive choice for invasive and non-invasive ventilation of the neonate. This paper describes the Edi
signal, neuroventilatory coupling, and patient–ventilator synchrony including the functional concept of
NAVA. Safety features, NAVA terminology, and clinical application of NAVA to unload respiratory
musculature are presented. The use of the Edi signal as a respiratory vital sign for conventional ventilation
is discussed. The results of animal and adult studies are briefly summarized and detailed descriptions of all
NAVA-related research in pediatric and neonatal patients are provided. Further studies are needed to
determine whether NAVA will have significant impact on the overall outcomes of neonates.
Arsenic, Cadmium, Lead, and Aluminium Concentrations in Human Milk at Early Stages of
Lactation
09 Dec 2013 05:54 am
Publication date: Available online 11 November 2013
Source:Pediatrics & Neonatology
Author(s): Hai-Hsuan Chao , Chih-Hung Guo , Chung-Bin Huang , Pei-Chung Chen , Hsiu-Chuan Li , DerYun Hsiung , Yu-Kung Chou
Background Human milk is considered to be the best nutrition for all infants because it provides the optimal
source of nutritional, immunological, developmental, psychological, economic, practical, and environmental
benefits in both the short and long terms. To the best of our knowledge, few studies in Taiwan have
examined the toxicants level of breast milk and associated factors. Methods The research was carried out
over a 6-month period. Forty-five healthy lactating women, who delivered full-term newborns at our
maternity ward, were recruited, and all participants had been living in coastal urban areas of mid-Taiwan for
at least 3 years. One hundred and eighty human milk samples were collected on four occasions, which
were classified into four lactation stages as follows: colostrums, transitional milk, early mature milk, and
mature milk. Results We found that lead, cadmium, aluminium, and arsenic concentrations were the highest
in colostrums: 13.22 ± 3.58 ng/mL, 1.37 ± 0.94 ng/mL, 56.45 ± 22.77 ng/mL, and 1.50 ± 1.50 ng/mL,
respectively. The results of lead, cadmium, aluminium, and arsenic determination in human milk samples
demonstrated a trend of decline of microelement concentrations with advancing stages of lactation. We
found that the infants of smoking mothers were exposed to more cadmium than infants of nonsmoking
mothers ( p < 0.05). Conclusion According to our findings, frequent routine sampling of breast milk is
worthwhile. Prevention strategies including behavior modification and proper nutrition should be educated to
women who are at high risk of toxicant exposure. In summary, breastfeeding is still generally encouraged
and recommended.
Assessment of Childhood Overweight and Obesity: Any Better and Feasible Tool Other
than Body Mass Index?
09 Dec 2013 05:54 am
Publication date: Available online 8 December 2013
Source:Pediatrics & Neonatology
Author(s): Chun-Yan Yeung
Assessment of bone health in preterm infants through quantitative ultrasound and
biochemical markers
26 Nov 2013 02:17 pm
Journal of Maternal-Fetal and Neonatal Medicine, Volume 0, Issue 0, Page 1-5, Early Online.
Assessment of interleukin-6, interleukin-8 and interleukin-18 count in the serum of IUGR
newborns
29 Nov 2013 08:58 am
Journal of Maternal-Fetal and Neonatal Medicine, Volume 0, Issue 0, Page 1-4, Early Online.
Assessment of pregnancy-associated, within-woman change in uterine length
27 Nov 2013 01:44 pm
Journal of Maternal-Fetal and Neonatal Medicine, Volume 0, Issue 0, Page 1-5, Early Online.
Association of Umbilical Cord Plasma Acid-labile Subunit of the Insulin-like Growth Factor
Ternary Complex with Anthropometry in Term Newborns
09 Dec 2013 05:54 am
Publication date: Available online 7 November 2013
Source:Pediatrics & Neonatology
Author(s): Yen-Ming Tseng , Yea-Shwu Hwang , Chin-Li Lu , Shio-Jean Lin , Wen-Hui Tsai
Background Birth size can affect neonatal morbidity and mortality. The insulin-like growth factor (IGF)
system is the most important endocrine factor influencing fetal growth. In the circulation, IGFs (mostly IGF-I)
are bound to IGF-binding protein 3 (IGFBP-3) and an acid-labile subunit (ALS) to form a ternary complex.
The ALS protects IGFs from decay and facilitates their endocrine activity. However, the function of ALS in
fetal growth has not yet been fully determined. Methods Venous umbilical plasma samples were obtained
from 98 term neonates and analyzed using enzyme-linked immunosorbent assays. The ALS, IGF-I, and
IGFBP-3 umbilical cord plasma levels were analyzed for their association with anthropometric
measurements of the neonates. Results The ALS, IGF-I, and IGFBP-3 cord plasma levels were positively
correlated with birth weight ( r = 0.42, p < 0.001; r = 0.43, p < 0.001; and r = 0.27, p < 0.01,
respectively) and placental weight ( r = 0.37, p < 0.001; r = 0.31, p < 0.01; and r = 0.30, p < 0.01,
respectively). In addition, the ALS cord plasma levels were also positively correlated with head
circumference ( r = 0.29, p < 0.01). Multiple linear regression analyses showed that both ALS and IGF-I
cord plasma levels were independent predictive variables for birth weight ( p < 0.01 and p < 0.005,
respectively). The ALS cord plasma levels were the only independent predictive variables, however, for
head circumference and placental weight ( p < 0.01 and p < 0.05, respectively). Conclusions The ALS
umbilical cord plasma levels are one important factor, in addition to IGF-I, in the IGF system for predicting
birth anthropometry, at least for near-term gestation. Our results suggest that the influence of ALS on the
IGF system may develop prior to birth and affect fetal growth.
Association of third-trimester abdominal circumference with provider-initiated preterm
delivery
11 Nov 2013 01:05 pm
Journal of Maternal-Fetal and Neonatal Medicine, Volume 0, Issue 0, Page 1-4, Early Online.
Asthma Exacerbation in Children: A Practical Review
09 Dec 2013 05:54 am
Publication date: Available online 7 November 2013
Source:Pediatrics & Neonatology
Author(s): Lin-Shien Fu , Ming-Chin Tsai
Asthma is the most common chronic lower respiratory tract disease in childhood throughout the world.
Despite advances in asthma management, acute exacerbations continue to be a major problem in patients
and they result in a considerable burden on direct/indirect health care providers. A severe exacerbation
occurring within 1 year is an independent risk factor. Respiratory tract viruses have emerged as the most
frequent triggers of exacerbations in children. It is becoming increasingly clear that interactions may exist
between viruses and other triggers, increasing the likelihood of an exacerbation. In this study, we provide
an overview of current knowledge about asthma exacerbations, including its definition, impact on health
care providers, and associated factors. Prevention management in intermittent asthma as well as
intermittent wheeze in pre-school children and those with persistent asthma are discussed. Our review
findings support the importance of controlling persistent asthma, as indicated in current guidelines. In
addition, we found that early episodic intervention appeared to be crucial in preventing severe attacks and
future exacerbations. Besides the use of medication, timely education after an exacerbation along with a
comprehensive plan in follow up is also vitally important.
Bach music in preterm infants: no ‘Mozart effect’ on resting energy expenditure
14 Nov 2013 12:00 am
Bach music in preterm infants: no ‘Mozart effect’ on resting energy expenditure
Journal of Perinatology advance online publication, November 14 2013.doi:10.1038/jp.2013.138
Authors: H Rosenfeld Keidar, D Mandel, F B Mimouni & R Lubetzky
Biomarkers of necrotising enterocolitis
09 Dec 2013 11:07 am
Publication date: Available online 27 September 2013
Source:Seminars in Fetal and Neonatal Medicine
Author(s): Pak Cheung Ng
Different categories of biomarkers of necrotising enterocolitis (NEC), including (i) non-specific mediators of
the inflammatory cascade, e.g. acute phase reactants, chemokines, cytokines, and cell surface antigens, (ii)
enhanced non-specific biomarkers, and (iii) specific gut-associated proteins, have distinctive biochemical
characteristics and properties. The appropriateness of using these mediators in specific clinical situations,
and the pros and cons of their applications as indicators or predictors of intestinal injury and NEC are
highlighted. Many potentially new biomarkers such as micro-RNA, volatile organic compounds and gut
microbiomes are currently under investigation. A stringent protocol for biomarker discovery is revealed so
that investigators can consider this methodology as a reference for future discovery of organ-specific and/or
disease-specific biomarkers for preterm infants.
Brachial plexus injury complicating the labor: mother is the victim at this time
18 Nov 2013 02:58 pm
Journal of Maternal-Fetal and Neonatal Medicine, Volume 0, Issue 0, Page 1-3, Early Online.
Breastfeeding: Best for Babies
09 Dec 2013 05:54 am
Publication date: December 2013
Source:Pediatrics & Neonatology, Volume 54, Issue 6
Author(s): Chia-Hsiang Chu
Candidemia and Death by Candida orthopsilosis and Candida metapsilosis in Neonates
and Children
09 Dec 2013 05:54 am
Publication date: Available online 7 October 2013
Source:Pediatrics & Neonatology
Author(s): Vanessa Kummer Perinazzo Oliveira , Claudete Rodrigues Paula , Arnaldo Lopes Colombo ,
Karina Bellinghausen Merseguel , Angela Satie Nishikaku , Débora Moreira , Luciana da Silva Ruiz
Capable of identifying risk factors for placental abruption
29 Nov 2013 03:40 pm
Journal of Maternal-Fetal and Neonatal Medicine, Volume 27, Issue 1, Page 52-56, January 2014.
Cerebral palsy and developmental coordination disorder in children born preterm
09 Dec 2013 11:07 am
Publication date: Available online 2 December 2013
Source:Seminars in Fetal and Neonatal Medicine
Author(s): Alicia Jane Spittle , Jane Orton
Children born early (<37 weeks of gestation) are at high risk of a range of motor impairments due to a
variety of biological and environmental risk factors. Cerebral palsy occurs more frequently in those children
born preterm, with the risk increasing with decreasing gestational age. Mild and moderate motor
impairments, consistent with developmental coordination disorder, occur in almost half of those children
born preterm and include difficulties with balance, manual dexterity and ball skills. All forms of motor
impairment are associated with comorbidities, which may have a greater effect on quality of life, academic
achievement and participation in extracurricular activities than the motor impairment itself. Infants at risk of
motor impairment can be identified in early infancy with a combination of clinical assessment tools and
perinatal risk factors. However, the reliable diagnosis of motor impairment requires follow-up into early
childhood and it is important to ensure that the appropriate intervention is implemented.
Cervical IL-6 and pIGFBP-1 and the prediction of neonatal outcome in symptomatic preterm
labour
26 Nov 2013 02:15 pm
Journal of Maternal-Fetal and Neonatal Medicine, Volume 0, Issue 0, Page 1-7, Early Online.
Changes in delivery methods at specialty care hospitals in the United States between 2006
and 2010
26 Nov 2013 12:00 am
Changes in delivery methods at specialty care hospitals in the United States between 2006 and 2010
Journal of Perinatology 33, 919 (December 2013). doi:10.1038/jp.2013.90
Authors: V A Danilack, J J Botti, J J Roach, D A Savitz, J H Muri & D L Caldwell
Characteristics and Outcome of Liver Transplantation in Children with Alagille Syndrome: A
Single-Center Experience
09 Dec 2013 05:54 am
Publication date: Available online 8 October 2013
Source:Pediatrics & Neonatology
Author(s): Chi-Ning Lee , Mao-Meng Tiao , Hung-Jen Chen , Allan Concejero , Chao-Long Chen , YingHsien Huang
Background This study was carried out in Chang Gung Memorial Hospital-Kaohsiung Medical Center,
Taiwan, with the aim of reviewing the characteristics and the outcome of liver transplantation (LT) in
children with Alagille syndrome (AGS). Methods We performed a retrospective analysis of transplant
records of children diagnosed with AGS and undergoing LT between 1987 and 2010. Results Nine patients
underwent living donor LT. Cholestasis and characteristic facies were seen in all patients. Posterior
embryotoxon was seen in 4/9 (44.4%), butterfly vertebrae in 3/9 (33.3%), heart defect (pulmonary stenosis
in 2) in 3/9 (33.3%), and renal disease in 2/9 (22.2%) patients. Five cases had cholestasis prior to the age
of 60 days, whereas four cases had cholestasis after 60 days of age. Iminodiacetic acid scans showed no
excretion of isotope into the bowel in four cases and suggested a false diagnosis of biliary atresia. All
patients underwent diagnostic laparotomy and liver biopsy. Results of liver biopsy showed characteristic
features of paucity of interlobular bile ducts in all patients. Kasai portoenterostomy was not performed in
any patient prior to being referred for LT. The mean age at the time of LT was 4.6 years. The 5-year overall
survival rate after living donor LT was 88.9%. Conclusion Our conclusion is that the clinical features of AGS
are informative. In addition, histological confirmation is important in the diagnosis. AGS children with severe
liver disease had good prognoses with LT.
Clinical Features of Mycoplasma pneumoniae Infections in the 2010 Epidemic Season:
Report of Two Cases with Unusual Presentations
09 Dec 2013 05:54 am
Publication date: December 2013
Source:Pediatrics & Neonatology, Volume 54, Issue 6
Author(s): Tomoaki Takei , Miyuki Morozumi , Hirohiko Ozaki , Hisayo Fujita , Kimiko Ubukata , Isshi
Kobayashi , Keisuke Kadota , Takako Miyamae , Shumpei Yokota , Satoshi Iwata , Takashi Takahashi
Mycoplasma pneumoniae (Mp) is one of the main pathogens causing community-acquired pneumonia,
particularly in young individuals. Host immune response appears to play an important role in prolonged
symptoms, as well as in the recent increasing prevalence of drug-resistant Mp isolated from patients. Case
1 had a prolonged clinical course caused by drug-resistant Mp and received steroid therapy despite Mp
susceptibility to some antimicrobial agents. Serum cytokine profiles revealed elevation of interleukin-6/-10
and interferon-γ in acute phase. Case 2 had mycoplasmal myocarditis without any respiratory symptoms,
which resolved spontaneously without the administration of any antimicrobial agent. These observations
suggest that host immune response probably contributes to the etiology of Mp-associated complications.
Clinical accuracy of estimated fetal weight in term pregnancies in a teaching hospital
29 Nov 2013 03:41 pm
Journal of Maternal-Fetal and Neonatal Medicine, Volume 27, Issue 1, Page 89-93, January 2014.
Clinical advances and controversies
09 Dec 2013 11:07 am
Publication date: Available online 18 October 2013
Source:Seminars in Fetal and Neonatal Medicine
Author(s): Steven M. Donn , Sunil K. Sinha
Clinical utility of chromosomal microarray analysis in prenatal diagnosis: report of first 6
months in clinical practice*
26 Nov 2013 02:16 pm
Journal of Maternal-Fetal and Neonatal Medicine, Volume 0, Issue 0, Page 1-6, Early Online.
Clinicians’ practice environment is associated with a higher likelihood of recommending
cesarean deliveries
02 Dec 2013 01:20 pm
Journal of Maternal-Fetal and Neonatal Medicine, Volume 0, Issue 0, Page 1-8, Early Online.
Comparison of prenatal and postnatal treatments of spina bifida in Poland – a nonrandomized, single-center study
26 Nov 2013 02:19 pm
Journal of Maternal-Fetal and Neonatal Medicine, Volume 0, Issue 0, Page 1-9, Early Online.
Comparison of right ventricular measurements and SFRV in fetuses with and without
tricuspid regurgitation at 11+0 and 13+6 weeks’ gestation
04 Dec 2013 01:02 pm
Journal of Maternal-Fetal and Neonatal Medicine, Volume 0, Issue 0, Page 1-4, Early Online.
Complete Resolution of Retroperitoneal Lymphangioma with a Single Trial of OK-432 in an
Infant
09 Dec 2013 05:54 am
Publication date: Available online 16 October 2013
Source:Pediatrics & Neonatology
Author(s): Claudio Olivieri , Lorenzo Nanni , Anna Maria De Gaetano , Lucia Manganaro , Claudio Pintus
Retroperitoneal lymphangioma is extremely rare. Although these neoplasms are benign, they can grow
progressively with subsequent compression and infiltration of the adjacent structures. Surgical excision is
demanding when the lesion surrounds vital structures and it is generally fraught with a high recurrence and
morbidity rate. We report the case of a huge retroperitoneal lymphangioma in a newborn treated
successfully with intracystic injection of OK-432.
Conservative management of cervical pregnancy with embryonic heart activity by
ultrasound-guided local injection: an eight case series
13 Nov 2013 09:51 am
Journal of Maternal-Fetal and Neonatal Medicine, Volume 0, Issue 0, Page 1-4, Early Online.
Correlations between Pulmonary Function and Childhood Asthma Control Test Results in
5–11-Year-Old Children with Asthma
09 Dec 2013 05:54 am
Publication date: Available online 2 December 2013
Source:Pediatrics & Neonatology
Author(s): Ming-Sheng Lee , Jun-Kai Kao , Cheng-Han Lee , Lon-Yen Tsao , Han-Yao Chiu , Yu-Ching
Tseng , Liang-Mei Lin
Objectives We examined correlations between the two asthma assessment tools, pulmonary function tests,
and Childhood Asthma Control Test (C-ACT) scores, in 5–11-year-old children with asthma to determine if
the C-ACT scores could predict pulmonary function test results. Materials and methods A total of 172
children with asthma aged 5–11 years completed C-ACT questionnaires and underwent pulmonary function
testing. Correlations between these test results were examined. Patients were also placed into two groups,
C-ACT scores ≤19 and >19, to determine if patients with scores >19 had better pulmonary function
test results. Results Weak correlations were found between pulmonary function test results and childhood
asthma control test scores in 5–11-year-old children with asthma, with or without the use of an asthma
controller. These correlations included: 0.061 for FEV 1 [confidence interval (CI): −0.022–0.049] and 0.074
for MMEF (CI: −0.013–0.037). The proportions of children with C-ACT test scores ≤19 group and those with
scores >19 group were not significantly different. Conclusion Correlations between C-ACT scores and
pulmonary function test results were poor for children aged 5–11 years with asthma. FEV 1 , FVC, FEF 25 ,
FEF 50 , FEF 75 , MMEF, and PEFR were not significantly correlated with C-ACT scores.
Counseling women and men regarding exposures to reproductive and developmental
toxicants before conception or women during pregnancy
09 Dec 2013 11:07 am
Publication date: Available online 2 December 2013
Source:Seminars in Fetal and Neonatal Medicine
Author(s): Robert L. Brent
It should be apparent that determining the reproductive risks of an exposure during pregnancy or the cause
of a child's congenital malformations is not a simple process. It involves a careful analysis of the medical
and scientific literature pertaining to the reproductive toxic effects of exogenous agents in humans and
animals, as well as an evaluation of the exposure and the biological plausibility of the concern of an
increased risk or a causal connection between the exposure and a child's congenital malformations. It also
involves having available a detailed physical examination of the malformed infant or child and a review of
the scientific literature pertaining to genetic and environmental causes of the malformations in question.
Abridged counseling on the basis of superficial and incomplete analyses is a disservice to the family.
Experienced counselors understand that their primary task is to educate the pregnant women or family
members concerning the risk of an environmental exposure. The counselor should advise them on the
options available, but not on which option to select.
Cow's Milk Allergy with Severe Eosinophilia
09 Dec 2013 05:54 am
Publication date: Available online 2 October 2013
Source:Pediatrics & Neonatology
Author(s): Takashi Imamura , Masahiro Watanabe , Mariko Kaneko , Yasuko Shibukawa , Yutaka Fukuda ,
Katsutoshi Nagasawa
Because the role of eosinophils in neonates is not well understood, the clinical significance of eosinophilia
in neonates is unclear. We encountered a rare case of cow's milk allergy in a premature male infant with
severe eosinophilia in the neonatal period. The peripheral blood eosinophil count in this infant was 7,404/μL
at birth, and he produced stools with fresh blood immediately after birth and prior to the first feedings with
regular cow's milk. Although the patient's eosinophil count normalized without specific treatment within 6
weeks after birth, it is possible that the causes of the eosinophilia in this infant prior to the first feedings with
regular cow's milk were different from those after the first feedings. Cow's milk allergy was diagnosed on the
basis of the patient's positivity for this allergy in the challenge test and subsequent allergen-specific
lymphocyte stimulation test performed at 6 months of age.
Defining neonatal hypoglycaemia: A continuing debate
09 Dec 2013 11:07 am
Publication date: Available online 19 October 2013
Source:Seminars in Fetal and Neonatal Medicine
Author(s): Win Tin
Hypoglycaemia is one of the most frequent metabolic problems in neonatal medicine, and maintaining
glucose homeostasis is one of the important physiological events during fetal-to-neonatal transition.
Although frequently observed transient low blood glucose concentrations in the majority of healthy
newborns are the reflections of normal metabolic adaptation processes during this transition, there has
been a genuine concern that prolonged or recurrent low blood glucose levels may result in acute systemic
effects and long-term neurological and developmental consequences. Hence, it is not surprising that
neonatal hypoglycaemia remains one of the most important issues in our day-to-day practice and that we
also become obsessed with the numbers and values that we believe are a ‘cut-off’ for its definition. The aim
of this article is to critically appraise some of the available evidence either to support or refute the most
widely accepted definition of ‘neonatal hypoglycaemia’ (blood glucose concentration: <2.6 mmol/l or
47 mg/dl), to highlight our knowledge gaps in defining neonatal hypoglycaemia, and to address the
important concept of using an ‘operational threshold’, rather than focusing too much on a single blood
glucose cut-off value, which is often applied to all newborn infants.
Demographic factors determining termination of pregnancy following the detection of lethal
fetal malignancy
13 Nov 2013 09:50 am
Journal of Maternal-Fetal and Neonatal Medicine, Volume 0, Issue 0, Page 1-4, Early Online.
Diagnosis and management of life-threatening cardiac malformations in the newborn
09 Dec 2013 11:07 am
Publication date: October 2013
Source:Seminars in Fetal and Neonatal Medicine, Volume 18, Issue 5
Author(s): Mats Mellander
Approximately 1–2 per 1000 newborn babies have a cardiac defect that is potentially life-threatening usually
because either the systemic or the pulmonary blood flow is dependent on a patent ductus arteriosus. A
significant proportion of newborns with such cardiac defects are being discharged from well-baby nurseries
without a diagnosis and therefore risk circulatory collapse and death. This risk is greatest for defects with
duct-dependent systemic circulation, notably aortic arch obstruction, but is also significant in transposition of
the great arteries, for example. The solution to this problem, apart from improving prenatal detection rates,
is to introduce effective neonatal screening including routine pulse oximetry.
Different Gene Preferences of Maple Syrup Urine Disease in the Aboriginal Tribes of
Taiwan
09 Dec 2013 05:54 am
Publication date: Available online 20 November 2013
Source:Pediatrics & Neonatology
Author(s): Jia-Woei Hou , Tsann-Long Hwang
Background Maple syrup urine disease (MSUD) is a rare inborn error of metabolism caused by a deficiency
of the branched-chain α-ketoacid dehydrogenase (BCKD) complex. Mutations in any one of the three
different genes encoding for the BCKD components, namely, BCKDHA , BCKDHB , and DBT , may be
responsible for this disease. In Taiwan, few MSUD cases were diagnosed clinically, and most of these
patients are from Aboriginal tribes. Materials and methods To identify and detect the carrier frequency of
MSUD in Taiwanese Aboriginal tribes, we performed biochemical and molecular studies from peripheral
blood in MSUD patients and dried blood on filter paper in the enrolled screened populations. Results
Homozygous A208T and I281T of BCKDHA were found in two patients from Hans (non-Aboriginal
Taiwanese), respectively; compound heterozygous mutations of the DBT gene [4.7 kb deletion/c.650651insT (L217F or L217fsX223) and c.650-651insT/c.88-89delAT] were found in two patients from Amis,
respectively, after direct DNA sequencing and polymerase chain reaction-restriction fragment length
polymorphism studies. There were no cases of deleted 4.7-kb heterozygote out of 302 normal people
(Hans, n = 125; Atayal, n = 156; and Saisiyat, n = 21); by contrast, the DBT mutations c.650-651insT and
deleted 4.7-kb heterozygote were noted in 2/121 and 1/121, respectively, from the general population of the
Amis, a southeastern Taiwanese tribe. Conclusion Although the Taiwanese Austronesian Aboriginal tribes
are considered to share a common origin, different gene preferences of MSUD were noted. The novel DBT
mutation c.650-651insT was more prevalent than the deleted 4.7-kb heterozygote in the Amis population.
The reported 4.7-kb deletion indicating a possible founder mutation may be preserved in the southern and
eastern, but not in northern Aboriginal tribes of Taiwan.
Does multiple gestation impact birthweight deficit from smoking?
05 Dec 2013 12:00 am
Does multiple gestation impact birthweight deficit from smoking?
Journal of Perinatology advance online publication, December 5 2013.doi:10.1038/jp.2013.148
Authors: F A Okah, A A Oshodi, Y Liu & J Cai
Drugs during delivery room resuscitation – What, when and why?
09 Dec 2013 11:07 am
Publication date: December 2013
Source:Seminars in Fetal and Neonatal Medicine, Volume 18, Issue 6
Author(s): Vishal S. Kapadia , Myra H. Wyckoff
Although seldom needed, the short list of medications used for delivery room resuscitation of the newborn
includes epinephrine and volume expanders. Naloxone, sodium bicarbonate and the use of other
vasopressors are no longer considered helpful during acute resuscitation and are more often administered
in the post-resuscitative period under special circumstances. This review examines the existing literature for
the two commonly used medications in neonatal resuscitation and identifies the many knowledge gaps
requiring further research.
Early pregnancy exposure to feto-toxic medications among out-patients in Malawi
29 Nov 2013 09:02 am
Journal of Maternal-Fetal and Neonatal Medicine, Volume 0, Issue 0, Page 1-5, Early Online.
Early use of surfactant and nitric oxide
26 Nov 2013 12:00 am
Early use of surfactant and nitric oxide
Journal of Perinatology 33, 909 (December 2013). doi:10.1038/jp.2013.105
Author: D M Null
Efficacy of FiO2 Increase During the Initial Resuscitation of Premature Infants < 29 Weeks:
An Observational Study
09 Dec 2013 05:54 am
Publication date: December 2013
Source:Pediatrics &amp; Neonatology, Volume 54, Issue 6
Author(s): Tereza Lamberska , Jana Vaňkova , Richard Plavka
Objective To evaluate the heart rate (HR) and oxygen saturation (SpO 2 ) at 15-second intervals within 60
seconds after incremental increases of fractional inspired oxygen (FiO 2 ) during resuscitation of infants
younger than 29 weeks requiring two different forms of ventilatory support. Study design Retrospective
observational study. Methods Forty-three infants were stabilized, 14 by continuous positive airway pressure
exclusively (CPAP group), and 29 by positive pressure ventilation (PPV group). Both groups received
ventilatory support in a special bed with two cameras enabling the evaluation of all interventions including
HR, SpO 2 , FiO 2 , positive inflation pressure, and positive end-expiratory pressure values. FiO 2 was
commenced at 0.30 and titrated in 0.1–0.2 increments every 30–60 seconds. The relationships between the
incremental increases of FiO 2 and related SpO 2 and HR changes were evaluated. Results Although there
was an inverse correlation between initial FiO 2 and SpO 2 in both groups, a significant positive correlation
between the incremental increase of FiO 2 and SpO 2 changes after 30 seconds was found only in the
CPAP group. Only higher initial levels of FiO 2 had a positive effect on the improvement in SpO 2 in the
PPV group. Conclusion The efficacy of FiO 2 titration in 0.1–0.2 increments may be attenuated and delayed
in extremely preterm infants required PPV during the first 6 minutes of life.
Efficacy of clonidine versus phenobarbital in reducing neonatal morphine sulfate therapy
days for neonatal abstinence syndrome. A prospective randomized clinical trial
26 Nov 2013 12:00 am
Efficacy of clonidine versus phenobarbital in reducing neonatal morphine sulfate therapy days for
neonatal abstinence syndrome. A prospective randomized clinical trial
Journal of Perinatology 33, 954 (December 2013). doi:10.1038/jp.2013.95
Authors: B Surran, P Visintainer, S Chamberlain, K Kopcza, B Shah & R Singh
Embryology of the heart and its impact on understanding fetal and neonatal heart disease
09 Dec 2013 11:07 am
Publication date: October 2013
Source:Seminars in Fetal and Neonatal Medicine, Volume 18, Issue 5
Author(s): Adriana C. Gittenberger-de Groot , Margot M. Bartelings , Robert E. Poelmann , Monique C.
Haak , Monique R.M. Jongbloed
Heart development is a complex process during which the heart needs to transform from a single tube
towards a fully septated heart with four chambers and a separated outflow tract. Several major events
contribute to this process, that largely overlap in time. Abnormal heart development results in congenital
heart disease, which has an estimated incidence of 1% of liveborn children. Eighty percent of cases of
congenital heart disease are considered to have a multifactoral developmental background, whereas
knowledge of monogenetic causes for congenital heart disease is still limited. This review focuses on
several novel findings in cardiac development that might enhance our knowledge of aetiology and support
refinement of prenatal diagnosis of congenital heart disease.
Emergency cervical cerclage: effect on pregnancy outcome and mode of delivery
29 Nov 2013 03:40 pm
Journal of Maternal-Fetal and Neonatal Medicine, Volume 27, Issue 1, Page 80-83, January 2014.
Emotional distress in mothers of preterm hospitalized infants: a feasibility trial of nursedelivered treatment
26 Nov 2013 12:00 am
Emotional distress in mothers of preterm hospitalized infants: a feasibility trial of nurse-delivered
treatment
Journal of Perinatology 33, 924 (December 2013). doi:10.1038/jp.2013.93
Authors: L S Segre, R Chuffo-Siewert, R L Brock & M W O'Hara
Encephalocele following a periconceptional exposure to efavirenz: a case report
26 Nov 2013 12:00 am
Encephalocele following a periconceptional exposure to efavirenz: a case report
Journal of Perinatology 33, 987 (December 2013). doi:10.1038/jp.2013.121
Authors: W Gudu & D Bekele
Encouraging developments in incubator design
26 Nov 2013 12:00 am
Encouraging developments in incubator design
Journal of Perinatology 33, 990 (December 2013). doi:10.1038/jp.2013.102
Authors: T K Ferris & M M Shepley
Environmental origins of congenital heart disease: The heart–placenta connection
09 Dec 2013 11:07 am
Publication date: October 2013
Source:Seminars in Fetal and Neonatal Medicine, Volume 18, Issue 5
Author(s): James Huhta , Kersti K. Linask
Although the mammalian embryo is well protected in the uterus, environmental chemicals, drugs, and
maternal nutritional imbalances can interfere with regulatory pathways directing placental and embryonic
development early in gestation. Embryonic cells are most susceptible to environmental influences during
cellular specification and differentiation stages. Because biochemical differentiation precedes morphological
outcome often by days, the period of susceptibility to environmental chemicals expectedly precedes visible
morphogenic effects. The cellular mechanisms by which drugs and other environmental factors disrupt
embryonic development and induce cardiac abnormalities have remained undefined.
Epidemiological Features of Kawasaki Disease in Taiwan, 1976–2007: Results of Five
Nationwide Questionnaire Hospital Surveys
09 Dec 2013 05:54 am
Publication date: Available online 10 October 2013
Source:Pediatrics &amp; Neonatology
Author(s): Hung-Chi Lue , Lei-Ru Chen , Ming-Tai Lin , Luan-Yin Chang , Jou-Kou Wang , Chin-Yun Lee ,
Mei-Hwan Wu
Background Kawasaki disease (KD) affects mainly children younger than 5 years of age, leading to
coronary artery lesions, and even to life-threatening myocardial infarction. In Taiwan, KD was encountered
for the first time in 1976; then, it continued to occur in increasing numbers. Methods For the survey of
epidemiological features of KD in Taiwan, we conducted five nationwide questionnaire hospital surveys in
1987, 1992, 1994, 2001, and 2008, respectively. In each survey, a special questionnaire form, together with
a request letter and diagnostic guidelines for KD, was sent to the chairman of the Department of Pediatrics
of all hospitals with 100 or more beds in Taiwan. Results KD patients increased to a total of 14,399 patients
by 2007, with the highest number of 1018 in 2001, and the highest incidence of 66.24 per 100,000
children &lt; 5 years of age in 2006. Of the 14,399 patients, the male-to-female ratio ranged from 1.5 to 1.7.
Of these patients, 57.6–65.2% were &lt; 2 years of age, 23.3–26.6% were 2–4 years of age, and 11.4–
15.8% were ≥ 5 years of age. Coronary artery lesions were noted in 20.2–31.5% of patients. Fourteen
cases expired, documenting that the fatality rate decreased from 0.4% to 0.03% during the 31 years from
1976 to 2007. Conclusion In Taiwan, KD was encountered for the first time in 1976, and it continued to
occur, reaching the highest annual incidence of 66.24 per 100,000 children &lt; 5 years of age in 2006. In
Taiwan, the first emergence of KD came in 1976; the annual increment of the incidence rate was lower
(2.41 in Taiwan vs. 4.17 Japan), and no significant KD outbreak was observed in Taiwan.
Epidemiology of Enterovirus 71 Infections in Taiwan
09 Dec 2013 05:54 am
Publication date: Available online 10 October 2013
Source:Pediatrics &amp; Neonatology
Author(s): Min-Yuan Chia , Pai-Shan Chiang , Wan-Yu Chung , Shu-Ting Luo , Min-Shi Lee
Enterovirus 71 (EV71) was first described in USA in 1969 but retrospective studies in The Netherlands
further detected EV71 in the clinical specimens collected in 1963. EV71 has one single serotype measured
by using hyperimmune animal antisera but can be phylogenetically classified into three genogroups (A, B,
and C) including 11 genotypes (A, B1–B5, C1–C5). In Taiwan, EV71 caused a large-scale nationwide
epidemic in 1998. Retrospective studies further detected EV71 in clinical specimens collected from hand–
foot–mouth disease patients in 1980 and 1986. Therefore, EV71 may have circulated in Taiwan prior to
1980. Since 1998, EV71 has cyclically caused nationwide epidemics with different predominant genotypes
in 1998 (genotype C2), 2000–2001 (B4), 2005 (C4), 2008 (B5), and 2012 (B5). Phylogenetic analysis
revealed that C4 viruses isolated in 2005 were probably from China, B5 viruses isolated in 2008 were
probably from South Eastern Asia, and B5 viruses isolated in 2012 were probably from Xiamen, China.
Several studies have collected postinfection sera from children to measure cross-reactive neutralizing
antibody titers against different EV71 genotypes and found that antigenic differences between genogroup B
and C viruses did not have a clear pattern but that genotype A virus was antigenically different from
genogroup B and C viruses. In conclusion, EV71 cyclically caused nationwide epidemics through
international importations. EV71 surveillance in Taiwan should combine genetic and serological methods.
Erratum: Erratum
13 Nov 2013 09:54 am
Journal of Maternal-Fetal and Neonatal Medicine, Volume 0, Issue 0, Page 1, Early Online.
Establishing functional residual capacity in the non-breathing infant
09 Dec 2013 11:07 am
Publication date: December 2013
Source:Seminars in Fetal and Neonatal Medicine, Volume 18, Issue 6
Author(s): Stuart B. Hooper , Melissa L. Siew , Marcus J. Kitchen , Arjan B. te Pas
The transition to newborn life critically depends upon lung aeration and the onset of air-breathing, which
triggers major cardiovascular changes required for postnatal life, including increases in pulmonary blood
flow. Recent imaging studies indicate that lung aeration and functional residual capacity (FRC) recruitment
results from inspiratory efforts, which create transpulmonary pressure gradients. During inspiration, these
pressure gradients drive airway liquid movement through the conducting and into the distal airways where it
crosses the pulmonary epithelium and enters the surrounding tissue. Although this process can occur
rapidly (within 3–5 breaths), liquid clearance from lung tissue is much slower, resulting in oedema and
increased interstitial tissue pressures, facilitating liquid re-entry into the airways at FRC. Whereas this liquid
may be cleared during the next inspiration, liquid re-entry at FRC can be opposed by Na+reabsorption,
oncotic pressures and expiratory braking manoeuvres. Recognition that transpulmonary pressure gradients
mainly drive airway liquid clearance at birth has provided a clearer understanding of how this process may
be facilitated in very preterm infants. In particular, it underpins the rationale for providing respiratory support
that initially focuses on moving liquid through tubes (airways) rather than air. As the viscosity of liquid is
much greater than air, the resistance to moving liquid is ∼100 times greater than air, necessitating the use
of higher pressures or longer inflation times. Although it is unclear how this strategy could be safely applied
clinically, it is clear that end-expiratory pressures are required to create and maintain FRC in preterm
infants.
Estimating the quality of neonatal transport in California
26 Nov 2013 12:00 am
Estimating the quality of neonatal transport in California
Journal of Perinatology 33, 964 (December 2013). doi:10.1038/jp.2013.57
Authors: J B Gould, B H Danielsen, L Bollman, A Hackel & B Murphy
Etiology and Outcome of Hydrops Fetalis: Report of 62 Cases
09 Dec 2013 05:54 am
Publication date: Available online 2 October 2013
Source:Pediatrics &amp; Neonatology
Author(s): Sahin Takci , Mina Gharibzadeh , Murat Yurdakok , Ozgur Ozyuncu , Ayse Korkmaz , Zuhal
Akcoren , Sule Yigit
Aim We aimed to define the etiologic and prognostic factors in live-born infants with hydrops fetalis (HF) in
our tertiary neonatal intensive care unit over a 10-year period. Methods Medical records of newborn infants
with HF during 2002–2011 were reviewed retrospectively. Demographic data, prenatal interventions, clinical
and laboratory findings, outcomes, and the results of post mortem examinations were analyzed. Results
During the study period, 62 newborn infants with HF were identified from 16,200 live-born deliveries and the
incidence of HF was 3.8/1000 live births in our hospital. Twenty-eight infants (45.2%) had immune HF,
whereas 34 (54.8%) had nonimmune HF. An etiologic factor could be identified in 24 (70.5%) infants with
nonimmune HF. Lymphatic dysplasias comprised the majority (23.5%) of the infants with nonimmune HF.
Mortality rate was 50%. The presence of two or more serous cavity effusions and gestational age were
independently associated with the risk of mortality. Conclusion Despite the improvements in neonatal care,
mortality rate in infants with HF is still high. Gestational age and the extent of serous cavity determine the
risk of mortality. Timely and advanced prenatal or postnatal new therapeutic strategies may alter this fatal
outcome in appropriate patients.
Evaluating the fetus at risk for cardiopulmonary compromise
09 Dec 2013 11:07 am
Publication date: December 2013
Source:Seminars in Fetal and Neonatal Medicine, Volume 18, Issue 6
Author(s): Máximo Vento , Kari Teramo
The in-utero environment is relatively hypoxic, but fetal physiologic adaptation assures adequate tissue
oxygen supply. Fetal reactions to acute or chronic hypoxia are different and are modified by the preceding
fetal condition. Acute fetal hypoxia episodes are often not preventable. By contrast, good obstetric care
during labor may prevent poor fetal outcome in many cases of acute fetal hypoxia. The pathophysiology of
chronic fetal hypoxia caused by placental insufficiency differs from chronic fetal hypoxia seen during the last
weeks of diabetic pregnancies. The efficacy of antenatal fetal surveillance methods in preventing perinatal
complications is different in these two conditions. Electronic fetal heart rate testing and Doppler flow
assessment methods have been successful in detecting chronic fetal hypoxia caused by placental
insufficiency. However, these methods have been unable to prevent chronic fetal hypoxia complications in
diabetic pregnancies. Therefore, research to find new strategies and early and reliable biomarkers is
necessary to assess fetal well-being and to decide when to deliver the fetus.
Evaluation of the Effect of Lactobacillus paracasei (HF.A00232) in Children (6–13 years old)
with Perennial Allergic Rhinitis: A 12-week, Double-blind, Randomized, Placebo-controlled
Study
09 Dec 2013 05:54 am
Publication date: Available online 20 November 2013
Source:Pediatrics &amp; Neonatology
Author(s): Wen-Ya Lin , Lin-Shien Fu , Heng-Kuei Lin , Chian-Yin Shen , Yee-Jun Chen
Introduction Dietary supplementation with probiotics alters intestinal microflora of children and may have
immunomodulatory effects in prevention of allergic diseases. The aim of this study was to evaluate the
effects of Lactobacillus paracasei (LP), strain HF.A00232, as a supplementary agent to levocetirizine in
treating children with perennial allergic rhinitis (AR). Methods This study was a 12-week, double-blind,
randomized, placebo-controlled trial. Sixty children with AR aged 6–13 years with nasal total symptoms
score (NTSS) ≥5 who fulfilled the inclusion criteria were enrolled. Patients were randomized into two groups
with 28 participants receiving levocetirizine plus placebo and 32 participants receiving regular levocetirizine
plus LP (HF.A00232) for the first 8 weeks, with a shift to levocetirizine as rescue treatment during the
following 4 weeks. Parameters evaluated, including nasal, throat, and eye TSS (NTSS, TTSS, and ETSS,
respectively), TSS and levocetirizine use, were recorded daily. Physical examinations and Pediatric
Rhinoconjunctivitis Quality of Life Questionnaires (PRQLQs) were administered at each visit. In addition,
blood samples were obtained for evaluation of cytokines including interleukin-4, interferon-γ, interleukin-10,
and transforming growth factor-β at baseline, Week 8, and Week 12. Results The LP (HF.A00232) group
had significantly lower PRQLQ scores even after discontinuing regular levocetirizine from Week 9 to Week
12 ( p &lt; 0.01). There was more improvement in individual parameters in the PRQLQ, including sneezing (
p = 0.005), itchy nose ( p = 0.040), and swollen puffy eyes ( p = 0.038), in the LP (HF.A00232) group. No
significant differences in TSS, NTSS, TTSS, ETSS, or cytokine levels were found between the two groups.
Conclusions Dietary supplementation with LP (HF.A00232) provided no additional benefit when used with
regular levocetirizine in treating AR in the initial 8 weeks of our study, but there was a continuing decrease
in PRQLQ scores, as well as a significant improvement in individual symptoms of sneezing, itchy nose, and
swollen eyes, after discontinuing regular levocetirizine treatment.
Experience with real time continuous glucose monitoring in stabilising fluctuating glycaemia
during intensive care of the preterm infant of a diabetic mother
13 Nov 2013 09:53 am
Journal of Maternal-Fetal and Neonatal Medicine, Volume 0, Issue 0, Page 1-3, Early Online.
Face mask ventilation – the dos and don'ts
09 Dec 2013 11:07 am
Publication date: December 2013
Source:Seminars in Fetal and Neonatal Medicine, Volume 18, Issue 6
Author(s): Fiona E. Wood , Colin J. Morley
Face mask ventilation provides respiratory support to newly born or sick infants. It is a challenging
technique and difficult to ensure that an appropriate tidal volume is delivered because large and variable
leaks occur between the mask and face; airway obstruction may also occur. Technique is more important
than the mask shape although the size must appropriately fit the face. The essence of the technique is to
roll the mask on to the face from the chin while avoiding the eyes, with a finger and thumb apply a strong
even downward pressure to the top of the mask, away from the stem and sloped sides or skirt of the mask,
place the other fingers under the jaw and apply a similar upward pressure. Preterm infants require
continuous end-expiratory pressure to facilitate lung aeration and maintain lung volume. This is best done
with a T-piece device, not a self-inflating or flow-inflating bag.
Factors modulating effective chest compressions in the neonatal period
09 Dec 2013 11:07 am
Publication date: December 2013
Source:Seminars in Fetal and Neonatal Medicine, Volume 18, Issue 6
Author(s): Lindsay F.J. Mildenhall , Trang K. Huynh
The need for chest compressions in the newborn is a rare occurrence. The methods employed for delivery
of chest compressions have been poorly researched. Techniques that have been studied include
compression:ventilation ratios, thumb versus finger method of delivering compressions, depth of
compression, site on chest of compression, synchrony or asynchrony of breaths with compressions, and
modalities to improve the compression technique and consistency. Although still in its early days, an
evidence-based guideline for chest compressions is beginning to take shape.
Female fetuses are more reactive when mother eats chocolate
29 Nov 2013 03:40 pm
Journal of Maternal-Fetal and Neonatal Medicine, Volume 27, Issue 1, Page 72-74, January 2014.
Fetal and neonatal outcome in celiac disease
15 Nov 2013 02:03 pm
Journal of Maternal-Fetal and Neonatal Medicine, Volume 0, Issue 0, Page 1-5, Early Online.
Fetal cardiac interventions: Rationale, risk and benefit
09 Dec 2013 11:07 am
Publication date: October 2013
Source:Seminars in Fetal and Neonatal Medicine, Volume 18, Issue 5
Author(s): Gerald Tulzer , Wolfgang Arzt
Fetal congenital heart disease may progress during pregnancy and may lead to irreversible myocardial or
pulmonary damage. The rationale of fetal intracardiac interventions is to change fetal hemodynamics,
prevent secondary damage and improve long-term outcome at an acceptable risk for mother and fetus. This
review focuses on the current experience about patient selection, risks and benefits of this technique.
Fetal heart defects: Potential and pitfalls of first-trimester detection
09 Dec 2013 11:07 am
Publication date: October 2013
Source:Seminars in Fetal and Neonatal Medicine, Volume 18, Issue 5
Author(s): Asma Khalil , Kypros H. Nicolaides
Congenital heart defects (CHDs) are the leading cause of infant mortality due to birth defects. In the last 15
years, with the shift in screening for aneuploidies to the first trimester, extensive research has concentrated
on early screening and detection of CHDs. Early detailed assessment of the fetal heart requires a high level
of expertise in early anomaly scanning and fetal echocardiography. However, the detection of major CHDs
at 11–13 weeks is influenced by their association with easily detectable markers, such as the nuchal
translucency, ductus venosus blood flow and tricuspid regurgitation, and a policy decision as to the
objectives of this scan and the allocation of resources necessary to achieve them. The use of transvaginal
ultrasound and newer techniques are likely to improve the detection rate. However, the limitations of fetal
echocardiography in the first trimester must be borne in mind, and follow-up at mid-gestational
echocardiography is prudent in some cases.
Fetal surgery for neural tube defects
09 Dec 2013 11:07 am
Publication date: Available online 8 October 2013
Source:Seminars in Fetal and Neonatal Medicine
Author(s): Enrico Danzer , Mark P. Johnson
A recently completed randomized, controlled, prospective multicenter trial, the Management of
Myelomeningocele Study (MOMS), demonstrated that maternal–fetal surgery for myelomeningocele (MMC)
before 26 weeks of gestation decreases the need for ventriculoperitoneal shunting, decreases hindbrain
herniation, and preserves neurological function. However, the study also found that fetal MMC surgery is
not without significant risks, such as premature delivery or maternal complications. The primary objective of
this review is to provide a critical overview of the rationale for in-utero intervention for MMC in the context of
pathological observations, animal models, initial clinical experience with human fetal MMC surgery, and the
results of the randomized trial. The secondary objective is to briefly discuss our approach to fetal MMC.
Finally, the ongoing clinical research and the recent developments of potential alternative fetal surgical
techniques will be highlighted.
Fetal tyhmus size as a predictor of histological chorioamnionitis in preterm premature
rupture of membranes
27 Nov 2013 01:36 pm
Journal of Maternal-Fetal and Neonatal Medicine, Volume 0, Issue 0, Page 1-5, Early Online.
Fetal, amniotic and maternal inflammatory responses in early stage of ascending
intrauterine infection, inflammation restricted to chorio-decidua, in preterm gestation
29 Nov 2013 03:40 pm
Journal of Maternal-Fetal and Neonatal Medicine, Volume 27, Issue 1, Page 98-105, January 2014.
First trimester maternal lipid levels and serum markers of small- and large-for-gestational
age infants
29 Nov 2013 03:40 pm
Journal of Maternal-Fetal and Neonatal Medicine, Volume 27, Issue 1, Page 48-51, January 2014.
Frequency-modulated orocutaneous stimulation promotes non-nutritive suck development
in preterm infants with respiratory distress syndrome or chronic lung disease
05 Dec 2013 12:00 am
Frequency-modulated orocutaneous stimulation promotes non-nutritive suck development in
preterm infants with respiratory distress syndrome or chronic lung disease
Journal of Perinatology advance online publication, December 5 2013.doi:10.1038/jp.2013.149
Authors: S M Barlow, J Lee, J Wang, A Oder, S Hall, K Knox, K Weatherstone & D Thompson
Functional outcomes of very premature infants into adulthood
09 Dec 2013 11:07 am
Publication date: Available online 27 November 2013
Source:Seminars in Fetal and Neonatal Medicine
Author(s): Saroj Saigal
The outcomes of very low birth weight survivors born in the early post-neonatal intensive care era have now
been reported to young adulthood in several longitudinal cohort studies, and more recently from large
Scandinavian national databases. The latter reports corroborate the findings that despite disabilities, a
significant majority of very low birth weight survivors are leading productive lives, and are functioning better
than expected. This is reassuring, but there are still concerns about future psychopathology, cardiovascular
and metabolic problems as they approach middle age. Although these findings may not be directly
applicable to the current survivors of modern neonatal intensive care, they do provide a yardstick by which
to project the outcomes of future survivors until more contemporaneous data are available.
Gestational weight gain in insulin-resistant pregnancies
26 Nov 2013 12:00 am
Gestational weight gain in insulin-resistant pregnancies
Journal of Perinatology 33, 929 (December 2013). doi:10.1038/jp.2013.100
Authors: L M Harper, A L Shanks, A O Odibo, R Colvin, G A Macones & A G Cahill
Gestational weight gain in overweight and obese women enrolled in a healthy lifestyle and
eating habits program
25 Nov 2013 01:03 pm
Journal of Maternal-Fetal and Neonatal Medicine, Volume 0, Issue 0, Page 1-5, Early Online.
Global Maternal, Newborn, and Child Health — So Near and Yet So Far
04 Dec 2013 10:01 pm
New England Journal of Medicine, Volume 369, Issue 23, Page 2226-2235, December 2013.
Growing up after extremely preterm birth: Lifespan mental health outcomes
09 Dec 2013 11:07 am
Publication date: Available online 2 December 2013
Source:Seminars in Fetal and Neonatal Medicine
Author(s): Samantha Johnson , Neil Marlow
There is growing interest in the long-term mental health sequelae of extremely preterm birth. In this paper
we review literature relating to mental health outcomes across the lifespan. Studies conducted in the
preschool years, school age and adolescence, and adulthood show continuity in outcomes and point to an
increased risk for inattention, socio-communicative problems and emotional difficulties in individuals born
extremely preterm. Both behavioural and neuroimaging studies also provide evidence of a
neurodevelopmental origin for mental health disorders in this population. Here we summarise contemporary
evidence and highlight key methodological considerations for carrying out and interpreting studies in this
field.
Hematology, Immunology and Infectious Disease. Neonatology Questions and
Controversies Series Hematology, Immunology and Infectious Disease. Neonatology
Questions and Controversies Series, Robin K Ohls, MD and Akhil Maheshwari, MD (Eds.);
Richard A Polin, MD (Series Ed.). Elsevier, Saunders 2nd ed. (2012). p. 344 ISBN: 978-14377-2662-6 Price £49.30
09 Dec 2013 11:07 am
Publication date: December 2013
Source:Seminars in Fetal and Neonatal Medicine, Volume 18, Issue 6
Author(s): Mario Abinun
Hemodynamics and Cardiology: Neonatology Questions and Controversies Charles
S.KleinmanIstavanSeriRichard A.PolinHemodynamics and Cardiology: Neonatology
Questions and Controversies2nd2012Elsevier Saunders978-1-4377-2763-0p551£56.42
(Kindle £39.98)
09 Dec 2013 11:07 am
Publication date: December 2013
Source:Seminars in Fetal and Neonatal Medicine, Volume 18, Issue 6
Author(s): Samir Gupta
Hepcidin, iron status, and inflammation variables among healthy pregnant women in the
Turkish population
29 Nov 2013 03:40 pm
Journal of Maternal-Fetal and Neonatal Medicine, Volume 27, Issue 1, Page 75-79, January 2014.
Histological Chorioamnionitis and Neonatal Outcome in Preterm Infants
09 Dec 2013 05:54 am
Publication date: Available online 26 November 2013
Source:Pediatrics &amp; Neonatology
Author(s): Bai-Horng Su
Human-centered incubator: beyond a design concept
26 Nov 2013 12:00 am
Human-centered incubator: beyond a design concept
Journal of Perinatology 33, 989 (December 2013). doi:10.1038/jp.2013.117
Authors: R H M Goossens & H Willemsen
Hyperactivity and Impulsivity in Children with Untreated Allergic Rhinitis: Corroborated by
Rating Scale and Continuous Performance Test
09 Dec 2013 05:54 am
Publication date: Available online 7 November 2013
Source:Pediatrics &amp; Neonatology
Author(s): Ming-Tao Yang , Wang-Tso Lee , Jao-Shwann Liang , Yu-Ju Lin , Wen-Mei Fu , Chia-Chun Chen
Background Allergic rhinitis (AR) is the most common chronic allergic disease in school-age children. An
increased prevalence of attention deficit hyperactivity disorder (ADHD) in AR patients has been reported;
however, inattention and hyperactivity in AR children have not been investigated using objective and
scientific measurements. Methods We used AR symptom score, ADHD symptom scale, and computerized
continuous performance test (CPT) to study the attention and impulsivity in AR children, age-matched
controls, and ADHD children (aged 6–15 years). Univariate and multivariate linear regression analyses
were applied to identify risk factors for impulsivity and inattention in AR children. Results Twenty-nine
controls, 10 ADHD, and 105 AR children were enrolled. There were no differences in age and gender
among the three groups. The scores of Hyperactivity/Impulsivity subscales of ADHD symptoms from both
parents and teachers were significantly higher in the AR children. The CPT in AR children revealed higher
commission errors, shorter reaction times, and more perseveration. Risk factors for inattention and
impulsivity in AR children included younger age, male gender, higher AR symptom scores, persistent AR,
moderate/severe AR, multiple atopic diseases, family history of atopy, and possible comorbidity with ADHD.
Conclusion Care for AR children should not only involve treating their allergy, but also monitoring the
possible comorbidities of impulsivity and inattention. In children with impulsivity, AR should be considered in
addition to ADHD.
IADPSG criteria for diagnosing gestational diabetes mellitus and predicting adverse
pregnancy outcomes
14 Nov 2013 12:00 am
IADPSG criteria for diagnosing gestational diabetes mellitus and predicting adverse pregnancy
outcomes
Journal of Perinatology advance online publication, November 14 2013.doi:10.1038/jp.2013.143
Authors: M Shang & L Lin
Immunogenicity of Heptavalent Conjugate Vaccine Against Streptococcus pneumoniae in
Premature Babies with Low Birth Weight
09 Dec 2013 05:54 am
Publication date: Available online 12 October 2013
Source:Pediatrics &amp; Neonatology
Author(s): Ewa Szynczewska , Danuta Chlebna-Sokół
Background There are few studies about immunogenicity and safety of heptavalent pneumococcal-CRM197
conjugate vaccine (PCV7) in low birth weight infants. Objective Assessment of immunogenicity following
administration of PCV7 in low birth weight children. Methods The PCV7 vaccine was administered to 60
infants divided into two groups: 23 children with birth weight &lt;1000 g (Group I); and 37 children with birth
weight ≥1000 g (Group II). Serum was collected four times. Results Birth weight of children included in the
study ranged from 480 g to 2450 g. The primary immunization caused an increase in the average
concentration of antibodies for all serotypes in most of the participants, with no significant differences
between the groups. However, there were some differences between various serotypes. Group serotypes
6B and 23F were the least immunogenic (≥0.35 μg/mL, Group I vs. Group II – 6B: 78.3% vs. 67,6% p
= 0.371 and 23F: 87% vs. 83.8% p = 0.738). Prior to the administration of a booster dose, a significant
decrease in antibody titer was observed in all children. The last vaccination resulted in an increased
concentration of antibodies in all children in both groups, and the results were significantly higher compared
to those measured following administration of three doses of the vaccine. Conclusions PCV7 is
immunogenic in children with low, very low, and extremely low birth weight. Serotypes 6B and 23F were the
least immunogenic, and serotype 14 proved to be the most immunogenic.
Impact of early surfactant and inhaled nitric oxide therapies on outcomes in term/late
preterm neonates with moderate hypoxic respiratory failure
26 Nov 2013 12:00 am
Impact of early surfactant and inhaled nitric oxide therapies on outcomes in term/late preterm
neonates with moderate hypoxic respiratory failure
Journal of Perinatology 33, 944 (December 2013). doi:10.1038/jp.2013.83
Authors: G G Konduri, G M Sokol, K P Van Meurs, J Singer, N Ambalavanan, T Lee & A Solimano
Implications of a possible route of vertical transmission of dengue virus by breast milk
13 Nov 2013 09:53 am
Journal of Maternal-Fetal and Neonatal Medicine, Volume 0, Issue 0, Page 1-2, Early Online.
Importance of maintaining the newly born temperature in the normal range from delivery to
admission
09 Dec 2013 11:07 am
Publication date: December 2013
Source:Seminars in Fetal and Neonatal Medicine, Volume 18, Issue 6
Author(s): Helen Chitty , Jonathan Wyllie
Over the last 50 years an increasing amount of evidence on neonatal resuscitation and stabilisation
practices has led to written recommendations on all aspects of newborn care in the first few minutes of life.
Much evidence for thermoregulatory management of both term and preterm infants has existed for decades
and more recently research has identified new techniques to maintain normothermia in newly born infants.
The use of increased environmental temperatures, skin-to-skin care, radiant warmers, plastic coverings and
hats, exothermic mattresses and heated humidified gases have or are undergoing evaluation. However,
despite the apparent acceptance of these techniques, a substantial number of infants continue to become
hypothermic soon after delivery, leading to an increased risk of comorbidities and of death. Gaps in our
knowledge remain and further research opportunities are available. However, we must also ensure that
established thermoregulatory methods for which the evidence already exists are given as much emphasis
as other aspects of newborn care and are implemented meticulously in all healthcare settings.
Incidence, predictors and outcomes of congenital diaphragmatic hernia: a population-based
study of 32 million births in the United States
29 Nov 2013 09:01 am
Journal of Maternal-Fetal and Neonatal Medicine, Volume 0, Issue 0, Page 1-7, Early Online.
Influence of Prolonged Storage Process, Pasteurization, and Heat Treatment on
Biologically-active Human Milk Proteins
09 Dec 2013 05:54 am
Publication date: December 2013
Source:Pediatrics &amp; Neonatology, Volume 54, Issue 6
Author(s): Jih-Chin Chang , Chao-Huei Chen , Li-Jung Fang , Chi-Ren Tsai , Yu-Chuan Chang , Teh-Ming
Wang
Objectives The bioactive proteins in human milk may be influenced by prolonged storage process,
pasteurization, and heat treatment. This study was conducted to evaluate the effects of these procedures.
Materials and methods Three forms of human milk – freshly expressed, frozen at −20°C for a prolonged
duration, and pasteurized milk – were collected from 14 healthy lactating mothers and a milk bank. The
concentrations of major bioactive proteins (secretory immunoglobulin A, lactoferrin, lysozyme, and leptin)
were quantified using enzyme-linked immunosorbent assay kits. Changes in these proteins by heat
treatment at 40°C or 60°C for 30 minutes were further evaluated. Results The mean concentrations of
lactoferrin and secretory immunoglobulin A were significantly reduced by 66% and 25.9%, respectively, in
pasteurized milk compared with those in freshly-expressed milk. Heat treatment at 40°C or 60°C did not
cause significant changes in lactoferrin and secretory immunoglobulin A, but there was an apparent
increase in lysozyme ( p = 0.016). There were no significant differences in leptin level among these three
forms of milk prior to ( p = 0.153) or after heat treatment ( p = 0.053). Conclusion Various
freezing/heating/pasteurization processes applied to human milk prior to delivery to neonates could affect
the concentration of immunomodulatory proteins, especially lactoferrin, secretory immunoglobulin A, and
lysozyme. Leptin was unaffected by the various handling processes tested. Fresh milk was found to be the
best food for neonates. Further studies are warranted to evaluate the functional activity of these proteins
and their effects on infants' immunological status.
Influenza B Virus-Associated Pneumonia in Pediatric Patients: Clinical Features, Laboratory
Data, and Chest X-ray Findings
09 Dec 2013 05:54 am
Publication date: Available online 7 October 2013
Source:Pediatrics &amp; Neonatology
Author(s): Chi-Yu Liu , Jiaan-Der Wang , Jen-Ta Yu , Li-Ching Wang , Ming-Chih Lin , Hsiu-Fen Lee , PoYen Chen , Hsin-Yang Hsieh , Po-Yu Wang
Background The clinical significance of influenza B is frequently overlooked, and reports on influenza B
pneumonia in children are limited. Therefore, the clinical features of associated complications have rarely
been reported. The aim of this study is to evaluate the clinical characteristics in pediatric patients with
influenza B virus-associated pneumonia. Methods From January 2009 to February 2012, 389 consecutive
patients under 18 years old with influenza B virus infection were enrolled into the study. Thirty-four patients
were defined as the pneumonia group by clinical symptoms and chest X-ray (CXR) findings, and 90 patients
who had laboratory data and normal CXR findings were recruited to form the nonpneumonia group. Results
The age of the patients in the pneumonia group was significantly younger (median of 5.3 vs. 6.6 years). The
white blood cell count (median of 7.5 vs. 5.7 × 109 cells/L) and C-reactive protein level (median of 21.1 vs.
5.7 mg/L) were higher, but the hemoglobin level was lower (median of 12.6 vs. 13.2 g/dL) in the pneumonia
group. The CXR findings revealed that 29.4% of patients had alveolar consolidation, 32.4% had interstitial
infiltration, and 38.2% had ground glass opacity. Two of four patients with pleural effusion had a positive
bacteria culture, and both of them died. Conclusion Pneumonia should be considered in pediatric patients
with influenza B virus infection presenting with younger age, higher white blood cell count, lower
hemoglobin, and higher C-reactive protein level. The CXR findings were varied. Patients with pleural
effusion and positive bacterial culture may have more severity of clinical outcome.
Intermittent Dyspnea and Cyanosis in a Newborn Caused by a Hairy Polyp
09 Dec 2013 05:54 am
Publication date: Available online 5 November 2013
Source:Pediatrics &amp; Neonatology
Author(s): Sarah Lignitz , Verena Haug , Britta Siegmund , Wolf Jürgen Mann , Wiltrud Coerdt , Eva
Mildenberger
Intermittent absent end diastolic velocity of the umbilical artery: antenatal and neonatal
characteristics and indications for delivery
29 Nov 2013 03:41 pm
Journal of Maternal-Fetal and Neonatal Medicine, Volume 27, Issue 1, Page 94-97, January 2014.
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