Monkeypox(Mpox),a zoonotic infection caused by the Mpox virus,has reemerged as a global public health concern,with unique implications for neonatal health.Although rare in newborns,cases of neonatal Mpox pose signific...Monkeypox(Mpox),a zoonotic infection caused by the Mpox virus,has reemerged as a global public health concern,with unique implications for neonatal health.Although rare in newborns,cases of neonatal Mpox pose significant diagnostic and therapeutic challenges due to limited clinical data and the vulnerability of this population.This narrative review explores the pathophysiology,clinical presentation,diagnostic barriers,and therapeutic strategies associated with Mpox in neonates.Vertical and perinatal transmission have been identified,with some cases presenting with vesicular rashes,fever,lymphadenopathy,and systemic involvement such as respiratory or neurological complications.Diagnosis often relies on polymerase chain reaction testing,yet resource limitations and symptom overlap with other neonatal infections can hinder accurate identification.Antiviral treatments like tecovirimat and cidofovir are considered in severe cases,but dosing in neonates remains uncertain due to a lack of robust safety data.Supportive care,including hydration,fever management,and prevention of secondary infections,is critical.Breastfeeding decisions require individualized assessment due to the unknown risk of viral transmission through breast milk.Preventive strategies emphasize early isolation,surveillance,and infection control measures in neonatal care settings.The review highlights significant research gaps in understanding neonatal Mpox,especially concerning long-term outcomes and optimal treatment protocols.A coordinated global effort is essential to improve diagnostics,develop safe therapeutic options,and establish evidence-based guidelines tailored to neonates.展开更多
BACKGROUND Congenital scoliosis(CS)is a spinal deformity caused by defective segmentation and development of vertebrae during early embryogenesis.It occurs in 0.5%-1%in 1000 births and may rarely occur with congenital...BACKGROUND Congenital scoliosis(CS)is a spinal deformity caused by defective segmentation and development of vertebrae during early embryogenesis.It occurs in 0.5%-1%in 1000 births and may rarely occur with congenital defects affecting the heart or genitourinary system.Truncus arteriosus(TA)is a life-threatening cardiac defect in which a single arterial trunk supplies both systemic and pulmonary circulation,leading to complications such as pulmonary hypertension,heart failure,and severe hypoxia.Although rare individually,the co-occurrence of both conditions poses unique diagnostic and therapeutic challenges,with limited documentation in medical literature.CASE SUMMARY We present a 36-week preterm neonate with CS associated with TA type 1,pre-senting with respiratory distress,cyanosis,and altered spinal curvature.This case demonstrates the complexity of managing neonates with multiple congenital de-fects.Here,the patient was managed with oxygen supplementation,heart failure medication,nasogastric feeding,and multidisciplinary care to optimize her for surgical corrections.A coordinated,interdisciplinary approach was employed to optimize outcomes,particularly in a resource-limited setting.Immediate re-spiratory and cardiovascular stabilization and long-term orthopedic and cardiac interventions were central to improving the patient’s quality of life and survival.CONCLUSION Recognizing co-existing congenital anomalies and their embryological interre-lation is critical in holistic patient care,particularly during neonatal and infancy.展开更多
Objective:To analyze the value of bedside cranial ultrasonography in the early diagnosis of neonatal brain tissue injury in intrauterine distress.Methods:128 neonates with suspected intrauterine distress admitted to t...Objective:To analyze the value of bedside cranial ultrasonography in the early diagnosis of neonatal brain tissue injury in intrauterine distress.Methods:128 neonates with suspected intrauterine distress admitted to the Yichang Central People’s Hospital from January 2023 to December 2024 were selected as study subjects based on the inclusion and exclusion criteria,and all subjects underwent bedside craniocerebral ultrasonography and MRI,and the results of MRI were used as the gold standard to divide the infants into the brain-injury group(n=31)and the no-brain-injury The children were divided into brain injury group(n=31)and no brain injury group(n=97),and the value of bedside cranial ultrasonography for early diagnosis of brain tissue injury in neonates with intrauterine distress was analyzed.Results:(1)Among the 128 cases of intrauterine distress neonates,31 cases were examined for abnormal signs,including 22 cases(70.97%)examined by bedside craniocerebral ultrasonography and 28 cases(90.32%)examined by MRI.(2)Bedside cranial ultrasound detected hypoxic-ischemic encephalopathy in 6 cases,accounting for 4.69%,ventricular widening in 2 cases,accounting for 1.56%,intracranial hemorrhage in 8 cases,accounting for 6.25%,periventricular softening of white matter in 5 cases,accounting for 3.91%,and cerebral edema in 1 case,accounting for 0.78%,while MRI detected hypoxic-ischemic encephalopathy in 9 cases,accounting for 7.03%.3 cases of ventricular widening,accounting for 2.34%,4 cases of intracranial hemorrhage,accounting for 3.13%,9 cases of periventricular-intraventricular white matter softening,accounting for 7.03%,and 3 cases of cerebral edema,accounting for 2.34%were examined.Among them,the detection rate of periventricular-intraventricular hemorrhage by bedside cranial ultrasound was significantly higher than that of MRI(P<0.05).Conclusion:The diagnostic value of bedside cranial ultrasound in periventricular-intraventricular hemorrhage is high,but the diagnostic value is not as good as that of MRI in other brain tissue injuries,and clinically appropriate examination protocols can be selected according to the specific types of craniocerebral injuries.展开更多
BACKGROUND Gastroesophageal reflux disease(GERD)is common among neonates,particularly those requiring mechanical ventilation.Pepsin,a reliable marker of gastric aspi-ration,may help detect GER episodes in ventilated n...BACKGROUND Gastroesophageal reflux disease(GERD)is common among neonates,particularly those requiring mechanical ventilation.Pepsin,a reliable marker of gastric aspi-ration,may help detect GER episodes in ventilated neonates and assess associated clinical outcomes.AIM To determine the incidence of GERD,associated risk factors,and morbidities among full-term mechanically ventilated neonates by detecting pepsin in endo-tracheal aspirates(ETA).METHODS This study included 97 full-term neonates admitted to the neonatal intensive care unit at Cairo University Hospitals from April 2023 to March 2024.ETA samples were collected at three intervals:Immediately post-intubation(Sample A),48 hours after intubation(Sample B),and just before extubation(Sample C).Pepsin concentration was measured using enzyme-linked immunosorbent assay.Clinical data,including hospital stay duration and feeding parameters,were correlated with pepsin levels.RESULTS Pepsin was detected in 76(78.4%)of Sample A,78(81.3%)of Sample B,and 47(68.1%)of Sample C.A significant positive correlation was found between pepsin levels and FiO_(2) in Sample B(r=0.203,P=0.047).Prolonged hospital stay was also associated with pepsin detection in Samples B and C(P<0.05).A negative correlation was observed between feeding amount and pepsin levels across all samples(P<0.05).CONCLUSION The incidence of GERD in full-term mechanically ventilated neonates is high,correlating with pepsin levels,FiO_(2),feeding intolerance,and hospital stay,highlighting the importance of early detection.展开更多
Introduction Congenital heart disease(CHD)is the most common birth defect with complex CHD contributing to 20%–30%of this disease[1].Overall survival rates of cCHD have improved substantially,thanks to remarkable pro...Introduction Congenital heart disease(CHD)is the most common birth defect with complex CHD contributing to 20%–30%of this disease[1].Overall survival rates of cCHD have improved substantially,thanks to remarkable progress in surgical techniques and perioperative care over the past three decades.In-hospital mortality rate during 2017–2021 for CHD-associated surgery in China is approximately 0.8%–1.0% and 2.5%–3.8% for complex CHD[2].Brain injury and later neurodevelopmental impairment(NDI)are the most enduring and detrimental complications for patients with complex CHD.As a growing number of individuals with complex CHD survive into adulthood,the impact and high incidence of NDI should be addressed.Moreover,there needs to be a research shift from improving survival to improving whole life quality,particularly in perioperative neuroprotection,persistent neurodevelopmental evaluation and early intervention.展开更多
BACKGROUND Phocomelia is a rare congenital disorder characterized by the absence or under-development of the proximal limbs.Phocomelia can occur as a syndrome or a limb-specific deformity.While historically linked to ...BACKGROUND Phocomelia is a rare congenital disorder characterized by the absence or under-development of the proximal limbs.Phocomelia can occur as a syndrome or a limb-specific deformity.While historically linked to thalidomide,non-thalido-mide causes include genetic mutations,vascular disruptions,and teratogenic exposures.This case highlights the diagnostic and therapeutic challenges in a neonate with bilateral phocomelia,low birth weight,asphyxia and jaundice.CASE SUMMARY We report a 2-week-old term neonate with bilateral phocomelia,micrognathia,jaundice,and low birth weight.The pregnancy was unremarkable,with no tha-lidomide exposure.The mother had a history of early pregnancy losses.Clinical evaluation revealed absent humeri and radii bilaterally,with hands attached proximally to the trunk.Genetic testing was not performed,limiting the identi-fication of underlying etiology.The patient was managed with supportive care,parental counseling,and planning for long-term rehabilitation.This case un-derscores the importance of multidisciplinary care in managing congenital ano-malies.Genetic evaluation is crucial in unexplained congenital anomalies.Routine detailed ultrasounds in high-risk pregnancies aid in early diagnosis and parental preparedness.CONCLUSION Bilateral phocomelia presents significant functional challenges.Comprehensive diagnostic workups and early rehabilitation strategies are essential for optimizing patient outcomes.展开更多
BACKGROUND Congenital intestinal atresia(CIA)is a common intestinal malformation in the neonatal period,and surgery is currently the main treatment method.The choice of postoperative feeding is crucial for the recover...BACKGROUND Congenital intestinal atresia(CIA)is a common intestinal malformation in the neonatal period,and surgery is currently the main treatment method.The choice of postoperative feeding is crucial for the recovery of gastrointestinal function in children.AIM To compare and analyze the effects of different postoperative feeding methods on gastrointestinal function reconstruction in newborns with CIA.METHODS Twenty-six children diagnosed with neonatal CIA,treated with minimally invasive surgery at Shijiazhuang Maternal and Child Health Hospital between January 2021 and May 2024,were selected for this single-center prospective randomized controlled study.They were divided into two groups using envelope randomization:Enteral nutrition(EN)group(n=13)and parenteral nutrition(PN)group(n=13).Baseline and clinical characteristics were collected,and recovery time of bowel sounds and time to first defecation were used as evaluation indices for gastrointestinal functional reconstruction.Differences between the groups were analyzed using t-test,χ2 test,and Fisher’s exact test.Spearman’s correlation tests and linear regression models were employed to analyze factors influencing time to first defecation.RESULTS The time to bowel sound recovery(51.54 vs 65.85,P=0.013)and first defecation(58.15 vs 76.62,P<0.001)was shorter in the EN group compared to the PN group.Clinical improvements in the EN group,including discharge weight(P=0.044),hospital stay(P=0.027),white blood cell count(P=0.023),albumin content(P=0.013),and direct bilirubin content(P=0.018),were also better than those in the PN group.No substantial differences in postoperative complications were found between the groups.Correlation analysis indicated that abdominal infection and operation time may relate to time to first defecation.Linear regression analysis demonstrated a considerable association between EN feeding and shorter time to first defecation.Abdominal infection and an operation time>2 hours may be risk factors for prolonged time to first defecation.CONCLUSION EN substantially promotes the recovery of gastrointestinal function after CIA in neonates and can improve clinical outcomes in children.Future research should explore optimal EN practices to enhance clinical application and child health.展开更多
BACKGROUND Respiratory syncytial virus(RSV)is a leading cause of lower respiratory tract infections in neonates.While typically associated with bronchiolitis and pneumonia,RSV can rarely cause extrapulmonary complicat...BACKGROUND Respiratory syncytial virus(RSV)is a leading cause of lower respiratory tract infections in neonates.While typically associated with bronchiolitis and pneumonia,RSV can rarely cause extrapulmonary complications such as myocarditis,which may present with life-threatening symptoms if not promptly recognized.CASE SUMMARY We describe the case of a 26-day-old male neonate who presented with respiratory distress,poor feeding,and irritability.Initial evaluation revealed an RSV infection confirmed via nasopharyngeal swab.As the clinical course progressed,the infant developed cardiac arrhythmias,elevated cardiac enzymes,and echocardiographic findings consistent with myocarditis.Management included mechanical ventilation,corticosteroid therapy,L-carnitine,and vitamin D supplementation.The patient responded well to treatment and was successfully extubated and discharged in stable condition after nine days of hospitalization.CONCLUSION This case highlights the importance of early recognition and multidisciplinary management of RSV-associated myocarditis in neonates.展开更多
Objective:To explore the construction and application value of a home skin care guidance program for neonates.Methods:From February 2024 to February 2025,60 neonates were selected as samples and randomly grouped by dr...Objective:To explore the construction and application value of a home skin care guidance program for neonates.Methods:From February 2024 to February 2025,60 neonates were selected as samples and randomly grouped by drawing.Group A received the constructed home skin care program for neonates,while Group B received routine care.The mastery of skin care knowledge by parents,emotional scores of mothers,and adverse reaction rates of neonates were compared.Results:The mastery of skin care knowledge by parents in Group A was higher than that in Group B,P<0.05.The anxiety(SAS)and depression(SDS)scores of mothers in Group A were lower than those in Group B,P<0.05.The adverse reaction rate of neonates in Group A was lower than that in Group B,P<0.05.Conclusion:The construction of a home skin care program for neonates can reduce adverse reactions of mothers,improve parents’mastery of neonatal skin care knowledge,and is beneficial for reducing adverse events such as neonatal eczema,diaper dermatitis,and infection.展开更多
AIM:To explore the relationship between retinal exudative changes in neonates and perinatal toxoplasmosis,others,rubella,cytomegalovirus,and herpes simplex virus(TORCH)infections,as well as the characteristics of TORC...AIM:To explore the relationship between retinal exudative changes in neonates and perinatal toxoplasmosis,others,rubella,cytomegalovirus,and herpes simplex virus(TORCH)infections,as well as the characteristics of TORCH infection in neonates with retinal exudative changes.METHODS:Retrospective study.A total of 612 neonates with retinal exudative changes detected during ophthalmic screening in our hospital from May 2019 to March 2023 were selected.TORCH tests were performed on these neonates,and the results were subjected to statistical analysis to determine the infection characteristics.The neonates with retinal exudative changes were grouped by sex and age,the characteristics of TORCH infection were analyzed,and the positive rates were compared.RESULTS:Among the 612 neonates with retinal exudative changes,the highest positive rate was observed for cytomegalovirus(CMV-IgG)(96.7%),followed by rubella virus(RV-IgG)(73.9%).Mixed infections with two or three viruses were also observed,with the highest positive rate for mixed infection of RV-IgG and CMV-IgG reaching 71.2%.There was no statistically significant difference in TORCH infection among neonates of different sex(P>0.05).However,there were statistically significant differences in RV-IgG and CMV-IgM infections with retinal exudative changes among neonates of different age groups(P<0.05).CONCLUSION:Perinatal TORCH infection may be an important factor causing retinal exudative changes in neonates.The differences in various infections are not related to sex but are related to different age groups.展开更多
Objective:To evaluate the impact of the severe COVID-19 pandemic on neonates and develop strategies to improve their outcomes.Methods:We conducted an observational cross-sectional study at Children's Hospital 1(CH...Objective:To evaluate the impact of the severe COVID-19 pandemic on neonates and develop strategies to improve their outcomes.Methods:We conducted an observational cross-sectional study at Children's Hospital 1(CH1)from July 25,2021,to May 31,2022.All neonates who had fever or respiratory symptoms or were born from mothers with COVID-19 and had a positive RT-PCR SARS-CoV-2 result would be included.We classified neonates with COVID-19 into 2 groups:mild/moderate and severe for analysis.Differences between groups were analyzed using Fisher's exact test/Chi-square test for categorical variables and Student's t-test/Wilcoxon Rank Sum test for continuous variables.Results:This study included 88 newborns who had positive RT-PCR SARS-CoV-2 results.The severity COVID-19 rate among neonatal cases was found to be 13.6%(12/88),with a corresponding mortality rate of 1.1%(1/88).All severe cases showed lung abnormalities as evident on chest X-ray images.In addition to respiratory symptoms,a higher incidence of gastrointestinal manifestations,such as vomiting and diarrhea,was observed in the severe group,indicating a compelling association.The administration of anticoagulant and anti-inflammatory drugs in the study group resulted in a satisfactory outcome with no significant complications.Conclusions:The COVID-19 pandemic has had a substantial impact on the well-being of neonates.The management of COVID-19 in this population presents significant challenges.展开更多
Background:The optimal surgical timing and clinical outcomes of ventricular septal defect(VSD)closure in neo-nates remain unclear.We aimed to evaluate the clinical outcomes of VSD closure in neonates(age≤30 days).Met...Background:The optimal surgical timing and clinical outcomes of ventricular septal defect(VSD)closure in neo-nates remain unclear.We aimed to evaluate the clinical outcomes of VSD closure in neonates(age≤30 days).Methods:We retrospectively reviewed 50 consecutive neonates who underwent VSD closure for isolated VSDs between August 2003 and June 2021.Indications for the procedure included congestive heart failure/failure to thrive and pulmonary hypertension.Major adverse events(MAEs)were defined as the composite of all-cause mortality,reoperation,persistent atrioventricular block,and significant(≥grade 2)valvular dysfunction.Results:The median age and body weight at operation were 26.0 days(interquartile range[IQR],18.8–28.3)and 3.7 kg(IQR,3.3–4.2),respectively.The median follow-up duration was 110.4 months(IQR,56.8–165.0).Seven patients required preoperative respiratory support,andfive had significant(≥grade 2)preoperative valvular dysfunction.One early mortality occurred due to irreversible cardiogenic shock;no late mortality was observed.One reopera-tion was due to hemodynamically significant residual VSD at 103.8 months postoperatively.The overall survival,freedom from reoperation,and freedom from MAE at 15-years were 98.0%,96.3%,and 94.4%,respectively.Pre-operative mechanical ventilation was associated with a longer duration of postoperative mechanical ventilation(p<0.001)and a longer length of intensive care unit stay(p<0.001).Conclusions:VSD closure with favorable outcomes without morbidities is feasible even in neonates.However,neonates requiring preoperative respiratory support may require careful postoperative management considering the long-term postoperative risks.Overall,surgical VSD closure might be indicated earlier in neonates with respiratory compromise.展开更多
Neonates,especially admitted to neonatal intensive care unit,frequently need various medical interventions in their early days.A common procedure is the heel prick for blood sampling.Although necessary for diagnosis,t...Neonates,especially admitted to neonatal intensive care unit,frequently need various medical interventions in their early days.A common procedure is the heel prick for blood sampling.Although necessary for diagnosis,this procedure can be stressful for neonates,causing pain,extended crying,and discomfort.Reducing distress in neonates during such procedures is important for the well‐being of neonates and the satisfaction of caregivers and healthcare providers.Therefore,this review aims to identify and compare the efficacy of 25%dextrose and breast milk on pain and duration of cry among neonates during heel-lance.As part of its review process,the article examined widely used databases,including PubMed,EMBASE,Cochrane,Academia,and Google Scholar.For the meta-analysis,the authors utilized RevMan 5.4.All eligible trials were analyzed using the Cochrane Risk of Bias Tool to assess the quality of the included studies and evaluate the risk of bias.Out of 131 studies reviewed,seven studies were included in meta-analysis of pain,and four studies were included in duration of cry.The results show that 25%dextrose is more effective to reduce pain among neonates during minor invasive procedure like heel prick(P<0.00001),whereas both interventions are effective in the reduction of crying duration.This review highlights that dextrose is more effective in reducing pain in comparison to breast milk.However,additional well-designed studies with larger sample sizes and extended follow-up periods are needed to validate and build upon the current findings.Hence,this review underscores the importance of utilizing effective pain management strategies,such as 25%dextrose,to enhance neonatal care and improve the overall well-being of newborns during invasive procedures.展开更多
Introduction: Acute pain associated with caregiving is a major cause of pain among neonates. Left untreated, it can lead to long-term neurosensory and psychoaffective consequences. In Cameroon, this subject has been s...Introduction: Acute pain associated with caregiving is a major cause of pain among neonates. Left untreated, it can lead to long-term neurosensory and psychoaffective consequences. In Cameroon, this subject has been scarcely explored, thus constituting an impediment to the management of care-induced pain. Objective: Assess procedural pain in neonates in Yaoundé. Material and Methods: We conducted a cross sectional study with prospective data collection over a period of eight months (October 2022 to May 2023) in three hospitals. We included neonates who were being cared for and were not crying prior to the onset of healthcare, whose parents consented to the study. Assessments were done using the DAN scale, which is specific to care-induced pain. Data was entered and analyzed using SPSS 23.0 software. Results: A total of 161 newborns were included. The hospital prevalence of care-induced pain in neonates was 85%. Neonatal sepsis was the main cause for admission (96.6%). The most common procedures were venous blood sampling (94.4%) and insertion of peripheral venous lines (93.8%). The pain intensity for these procedures was severe (83.9%). The most painful procedure was lumbar tap, followed by venous access procedures. Conclusion: Neonates in hospitals are subjected to many painful procedures. The pain experienced during these procedures is severe. The most nociceptive procedure is a lumbar puncture.展开更多
Background: Despite a significant decline in neonatal deaths in the last 20 years (5 million in 1990 to 2.4 million in 2019), the risk of death is still high, especially in developing countries. In Tanzania, neonatal ...Background: Despite a significant decline in neonatal deaths in the last 20 years (5 million in 1990 to 2.4 million in 2019), the risk of death is still high, especially in developing countries. In Tanzania, neonatal sepsis is the third leading cause of neonatal death, accounting for 25% of all deaths. The rising global threat of antimicrobial resistance and the rising burden of neonatal death due to neonatal sepsis have been of great concern and have delayed progress toward reaching SDG goal 3.2 by 2030. This study aims to determine the bacteriological profile, antibiotic susceptibility patterns, and predictors of bacteremia among neonates with clinical sepsis at KCMC Hospital in Northern Tanzania. Methodology: This study had a cross-sectional design conducted at KCMC Hospital, Northern Tanzania. The study population was neonates admitted to the neonatal unit at KCMC Hospital. Data were collected using questionnaires and blood cultures from neonates. Frequencies and proportions were used to summarize categorical variables, while continuous variables were summarized using mean and standard deviation. The frequencies and proportions of bacteria isolated and the antimicrobial susceptibility results were analyzed and compared using Pearson’s chi-square test and Fisher’s exact test where applicable. Modified Poisson regression model was used to determine factors associated with positive blood culture. Results: Out of 411 neonates with a clinical diagnosis of neonatal sepsis, 175 (42.9%) had positive blood cultures. Gram-positive bacteria were most frequently isolated at 52.3%, and gram-negative bacteria were 47.7%. Coagulase-negative Staphylococcus (30.7%) and Staphylococcus aureus (19.9%) were the predominant gram-positive isolates. Gram-negative isolates were Klebsiella spp 47 (26.7%), E. coli 10 (5.7%), and Citrobacter spp 10 (5.1%). The gram-positive isolates were sensitive to vancomycin, piperacillin/tazobactam, and ceftazidime, whereas the gram-negative were sensitive to amikacin, meropenem, and vancomycin. The study did not find statistically significant associations between clinical factors and positive blood cultures in bacteremia. Conclusion: Gram-positive bacteria are the dominant pathogens in early-onset and late-onset neonatal sepsis. High levels of resistance to ampicillin and ceftriaxone and moderate resistance to gentamycin were observed in both gram-positive and gram-negative bacteria. Gram-positive organisms exhibit better susceptibility rates to vancomycin and ciprofloxacin, while gram-negative micro-organisms are more sensitive to amikacin and meropenem. An effective initial treatment approach for neonatal sepsis would involve a combination of drugs.展开更多
Introduction: Respiratory distress in neonates is a neonatal emergency that can lead to serious complications if not treated appropriately. The aim of this study was to describe the epidemiology, the diagnostic, and t...Introduction: Respiratory distress in neonates is a neonatal emergency that can lead to serious complications if not treated appropriately. The aim of this study was to describe the epidemiology, the diagnostic, and the outcomes of neonatal respiratory distress. Methods: This was a cross-sectional study carried out in the pediatric wards of Lomé Teaching Hospitals (CHU Sylvanus Olympio and CHU Campus), including neonates treated for respiratory distress (dyspnea associated with the use of accessory muscles of respiration, noisy breathing and with or without cyanosis) from January 1, 2021 to December 31, 2021. Data were entered using Epi Data 3.1 and SPSS software version 12.0. Results: The total number of neonates hospitalized for respiratory distress was 353, with a frequency of 12.5% and a sex ratio of 1.5. The mean age was 0.82 ± 3.20 days;the 0 - 6-day age group accounted for 92.4% of cases. Neonates had been resuscitated at birth in 46.7% of cases. Dyspnea was tachypnea in 94% of cases and bradypnea in 6%. Dyspnea was associated with cyanosis in 21.5% of cases. The severity of the respiratory distress was moderate in 64.9% of cases. Perinatal asphyxia (49.1%), inhalation pneumonitis (17.1%) and neonatal bacterial infection (14.1%) were the main etiologies. The mortality rate was 20.4%. Age greater than or equal to seven days, no neonatal resuscitation were protective factors against death. Prematurity, no antenatal consultations follow up, neonatal resuscitation, severe respiratory distress were risk factors of death. Conclusion: Neonatal respiratory distress was common in the early neonatal period and its mortality was high.展开更多
BACKGROUND Neonatal respiratory distress syndrome(NRDS)is one of the most common diseases in neonatal intensive care units,with an incidence rate of about 7%among infants.Additionally,it is a leading cause of neonatal...BACKGROUND Neonatal respiratory distress syndrome(NRDS)is one of the most common diseases in neonatal intensive care units,with an incidence rate of about 7%among infants.Additionally,it is a leading cause of neonatal death in hospitals in China.The main mechanism of the disease is hypoxemia and hypercapnia caused by lack of surfactant AIM To explore the effect of pulmonary surfactant(PS)combined with noninvasive positive pressure ventilation on keratin-14(KRT-14)and endothelin-1(ET-1)levels in peripheral blood and the effectiveness in treating NRDS.METHODS Altogether 137 neonates with respiratory distress syndrome treated in our hospital from April 2019 to July 2021 were included.Of these,64 control cases were treated with noninvasive positive pressure ventilation and 73 observation cases were treated with PS combined with noninvasive positive pressure ventilation.The expression of KRT-14 and ET-1 in the two groups was compared.The deaths,complications,and PaO_(2),PaCO_(2),and PaO_(2)/FiO_(2)blood gas indexes in the two groups were compared.Receiver operating characteristic curve(ROC)analysis was used to determine the diagnostic value of KRT-14 and ET-1 in the treatment of NRDS.RESULTS The observation group had a significantly higher effectiveness rate than the control group.There was no significant difference between the two groups in terms of neonatal mortality and adverse reactions,such as bronchial dysplasia,cyanosis,and shortness of breath.After treatment,the levels of PaO_(2)and PaO_(2)/FiO_(2)in both groups were significantly higher than before treatment,while the level of PaCO_(2)was significantly lower.After treatment,the observation group had significantly higher levels of PaO_(2)and PaO_(2)/FiO_(2)than the control group,while PaCO_(2)was notably lower in the observation group.After treatment,the KRT-14 and ET-1 levels in both groups were significantly decreased compared with the pre-treatment levels.The observation group had a reduction of KRT-14 and ET-1 levels than the control group.ROC curve analysis showed that the area under the curve(AUC)of KRT-14 was 0.791,and the AUC of ET-1 was 0.816.CONCLUSION Combining PS with noninvasive positive pressure ventilation significantly improved the effectiveness of NRDS therapy.KRT-14 and ET-1 levels may have potential as therapeutic and diagnostic indicators.展开更多
Objective:To investigate the clinical profile and risk factors of symptomatic and asymptomatic hypoglycemia in neonates admitted to a neonatal intensive care unit in a tertiary care center.Methods:The prospective obse...Objective:To investigate the clinical profile and risk factors of symptomatic and asymptomatic hypoglycemia in neonates admitted to a neonatal intensive care unit in a tertiary care center.Methods:The prospective observational study was conducted in a tertiary care center in the Specialty Department of Pediatric.196 Newborn babies with blood glucose levels<45 mg/dL were examined with a simple random sampling method between December 2019 and November 2021.Maternal and neonatal risk factors and clinical signs were recorded and compared between symptomatic and asymptomatic cases.Results:The proportion of symptomatic hypoglycemia neonates born to gestational diabetes mellitus mothers was significantly higher(23.4%vs.8.4%)(P<0.05).Small for gestational age,low birth weight,respiratory distress syndrome,hypothermia,and endocrine disorders were risk factors.The death rate in asymptomatic hypoglycemia neonates was significantly higher(58%vs.39%)(P<0.05).Conclusions:The study indicates that maternal gestational diabetes mellitus is associated with symptomatic hypoglycemia and asymptomatic hypoglycemia is associated with neonatal mortality.It is important to take vigilance and timely interventions to address associated symptoms,particularly poor feeding,in the management of neonatal hypoglycemia.展开更多
BACKGROUND： Spontaneous otoacoustic emissions （SOAEs） are regarded as a valuable audio- metric parameter that objectively reflects the function of outer hair cells （OHCs）. Many studies have reported that the inci...BACKGROUND： Spontaneous otoacoustic emissions （SOAEs） are regarded as a valuable audio- metric parameter that objectively reflects the function of outer hair cells （OHCs）. Many studies have reported that the incidence of SOAEs in adults is less than 50%. Therefore, measurement of SOAEs may be of little value to clinical examinations. However, the incidence of SOAEs in infants and neonates is higher than in adults. OBJECTIVE： To analyze the basic characteristics of SOAEs in 2–4 day old neonates, and to demonstrate the difference in OHC function between sexes and ears. DESIGN, TIME AND SETTING： Neurophysiological contrast study, performed in the Department of Neonates, Beijing Chaoyang Hospital, Capital Medical University, between December 2007 and August 2008. PARTICIPANTS： A total of 112 newborns （224 ears） consisting of 59 females and 53 males were included in this study. METHODS： The probe was adapted and embedded in the neonate external auditory canal with a foam rubber earplug after checking and clearing up the outer ear canal. The presence of SOAEs was determined when the signal amplitude had a clear peak exceeding –30 dB, or was 3 dB above the noise floor. MAIN OUTCOME MEASURES： The incidence of SOAEs, the number of SOAE signal peaks, and the maximal tension of SOAEs. RESULTS： The incidence in females （79.7%） was higher than males （76.4%） （P 〉 0.05）, and the incidence in right ears （86.6%） was higher than in left ears （69.6%） （P 〈 0.05）. There were no significant difference in the number of SOAE peaks between females and males （4.49 vs. 4.28）, or between right ears and left ears （4.62 vs. 4.12） （P 〉 0.05）. The mean maximum SOAE level per ear in females （–3.29 ± 9.28） dB sound pressure level （SPL） was slightly higher than that in males （–3.91 ± 9.14） dB SPL （P 〉 0.05）. Also, the mean maximum SOAE level in right ears （–2.03 ± 9.11） dB SPL was higher than in left ears （–5.50 ± 9.65） dB SPL （P 〈 0.05）. The maximum SOAE level showed a positive correlation with maximum SOAE number in emitting ears （r = 0.55, P 〈 0.01）. CONCLUSION： The incidence of SOAEs in neonates is high （78.1%） within 4 days of birth. The in-cidence of SOAEs and the maximum SOAE level exhibited a significant difference between right and left ears, but the difference between sexes was insignificant. Both the strongest SOAE signal peak and number of SOAEs per ear are representative of the function OHCs.展开更多
This study attempts to discuss the correlation between UGT1A1＊28 as uridine diphosphate glucuronosyltransferase gene promoter and coding region Gly71 Arg gene polymorphism with neonatal hyperbilirubinemia of neonates...This study attempts to discuss the correlation between UGT1A1＊28 as uridine diphosphate glucuronosyltransferase gene promoter and coding region Gly71 Arg gene polymorphism with neonatal hyperbilirubinemia of neonates in Wuhan. A total of 168 neonates were divided into the hyperbilirubinemia group（case group, n=108） and healthy neonates group（control group, n=60）. Their DNA was obtained through blood extraction. The gene exon mutation of UGT1A1 was detected by Sanger sequencing, which revealed the relationship between UGT1A1＊28 and Gly71 Arg polymorphism with neonatal hyperbilirubinemia of neonates. The results showed that：（1） The frequency of UGT1A1＊28 allele mutation in the case group and the control group was 9.3% and 10% respectively, with the difference being not significant between the two groups（P〉0.05）.（2） The frequency of Gly71 Arg allele mutation in the case group and the control group was 35.1% and 21.7% respectively, with the difference being significant between the two groups（P〈0.01）.（3） The serum bilirubin level of Gly71 Arg mutant homozygous and heterozygous subgroups（n=66） in the case group was 302.7±31.4 μmol/L, which was significantly higher than 267.3±28.5 μmol/L of the wild subgroup（n=42）（P〈0.01）. It was suggested that the occurrence of neonatal hyperbilirubinemia of neonates in Wuhan was not associated with UGT1A1＊28 gene polymorphism, but closely with the Gly71 Arg gene polymorphism. Meanwhile, the Arg allele mutation was related to the degree of jaundice.展开更多
文摘Monkeypox(Mpox),a zoonotic infection caused by the Mpox virus,has reemerged as a global public health concern,with unique implications for neonatal health.Although rare in newborns,cases of neonatal Mpox pose significant diagnostic and therapeutic challenges due to limited clinical data and the vulnerability of this population.This narrative review explores the pathophysiology,clinical presentation,diagnostic barriers,and therapeutic strategies associated with Mpox in neonates.Vertical and perinatal transmission have been identified,with some cases presenting with vesicular rashes,fever,lymphadenopathy,and systemic involvement such as respiratory or neurological complications.Diagnosis often relies on polymerase chain reaction testing,yet resource limitations and symptom overlap with other neonatal infections can hinder accurate identification.Antiviral treatments like tecovirimat and cidofovir are considered in severe cases,but dosing in neonates remains uncertain due to a lack of robust safety data.Supportive care,including hydration,fever management,and prevention of secondary infections,is critical.Breastfeeding decisions require individualized assessment due to the unknown risk of viral transmission through breast milk.Preventive strategies emphasize early isolation,surveillance,and infection control measures in neonatal care settings.The review highlights significant research gaps in understanding neonatal Mpox,especially concerning long-term outcomes and optimal treatment protocols.A coordinated global effort is essential to improve diagnostics,develop safe therapeutic options,and establish evidence-based guidelines tailored to neonates.
文摘BACKGROUND Congenital scoliosis(CS)is a spinal deformity caused by defective segmentation and development of vertebrae during early embryogenesis.It occurs in 0.5%-1%in 1000 births and may rarely occur with congenital defects affecting the heart or genitourinary system.Truncus arteriosus(TA)is a life-threatening cardiac defect in which a single arterial trunk supplies both systemic and pulmonary circulation,leading to complications such as pulmonary hypertension,heart failure,and severe hypoxia.Although rare individually,the co-occurrence of both conditions poses unique diagnostic and therapeutic challenges,with limited documentation in medical literature.CASE SUMMARY We present a 36-week preterm neonate with CS associated with TA type 1,pre-senting with respiratory distress,cyanosis,and altered spinal curvature.This case demonstrates the complexity of managing neonates with multiple congenital de-fects.Here,the patient was managed with oxygen supplementation,heart failure medication,nasogastric feeding,and multidisciplinary care to optimize her for surgical corrections.A coordinated,interdisciplinary approach was employed to optimize outcomes,particularly in a resource-limited setting.Immediate re-spiratory and cardiovascular stabilization and long-term orthopedic and cardiac interventions were central to improving the patient’s quality of life and survival.CONCLUSION Recognizing co-existing congenital anomalies and their embryological interre-lation is critical in holistic patient care,particularly during neonatal and infancy.
文摘Objective:To analyze the value of bedside cranial ultrasonography in the early diagnosis of neonatal brain tissue injury in intrauterine distress.Methods:128 neonates with suspected intrauterine distress admitted to the Yichang Central People’s Hospital from January 2023 to December 2024 were selected as study subjects based on the inclusion and exclusion criteria,and all subjects underwent bedside craniocerebral ultrasonography and MRI,and the results of MRI were used as the gold standard to divide the infants into the brain-injury group(n=31)and the no-brain-injury The children were divided into brain injury group(n=31)and no brain injury group(n=97),and the value of bedside cranial ultrasonography for early diagnosis of brain tissue injury in neonates with intrauterine distress was analyzed.Results:(1)Among the 128 cases of intrauterine distress neonates,31 cases were examined for abnormal signs,including 22 cases(70.97%)examined by bedside craniocerebral ultrasonography and 28 cases(90.32%)examined by MRI.(2)Bedside cranial ultrasound detected hypoxic-ischemic encephalopathy in 6 cases,accounting for 4.69%,ventricular widening in 2 cases,accounting for 1.56%,intracranial hemorrhage in 8 cases,accounting for 6.25%,periventricular softening of white matter in 5 cases,accounting for 3.91%,and cerebral edema in 1 case,accounting for 0.78%,while MRI detected hypoxic-ischemic encephalopathy in 9 cases,accounting for 7.03%.3 cases of ventricular widening,accounting for 2.34%,4 cases of intracranial hemorrhage,accounting for 3.13%,9 cases of periventricular-intraventricular white matter softening,accounting for 7.03%,and 3 cases of cerebral edema,accounting for 2.34%were examined.Among them,the detection rate of periventricular-intraventricular hemorrhage by bedside cranial ultrasound was significantly higher than that of MRI(P<0.05).Conclusion:The diagnostic value of bedside cranial ultrasound in periventricular-intraventricular hemorrhage is high,but the diagnostic value is not as good as that of MRI in other brain tissue injuries,and clinically appropriate examination protocols can be selected according to the specific types of craniocerebral injuries.
文摘BACKGROUND Gastroesophageal reflux disease(GERD)is common among neonates,particularly those requiring mechanical ventilation.Pepsin,a reliable marker of gastric aspi-ration,may help detect GER episodes in ventilated neonates and assess associated clinical outcomes.AIM To determine the incidence of GERD,associated risk factors,and morbidities among full-term mechanically ventilated neonates by detecting pepsin in endo-tracheal aspirates(ETA).METHODS This study included 97 full-term neonates admitted to the neonatal intensive care unit at Cairo University Hospitals from April 2023 to March 2024.ETA samples were collected at three intervals:Immediately post-intubation(Sample A),48 hours after intubation(Sample B),and just before extubation(Sample C).Pepsin concentration was measured using enzyme-linked immunosorbent assay.Clinical data,including hospital stay duration and feeding parameters,were correlated with pepsin levels.RESULTS Pepsin was detected in 76(78.4%)of Sample A,78(81.3%)of Sample B,and 47(68.1%)of Sample C.A significant positive correlation was found between pepsin levels and FiO_(2) in Sample B(r=0.203,P=0.047).Prolonged hospital stay was also associated with pepsin detection in Samples B and C(P<0.05).A negative correlation was observed between feeding amount and pepsin levels across all samples(P<0.05).CONCLUSION The incidence of GERD in full-term mechanically ventilated neonates is high,correlating with pepsin levels,FiO_(2),feeding intolerance,and hospital stay,highlighting the importance of early detection.
文摘Introduction Congenital heart disease(CHD)is the most common birth defect with complex CHD contributing to 20%–30%of this disease[1].Overall survival rates of cCHD have improved substantially,thanks to remarkable progress in surgical techniques and perioperative care over the past three decades.In-hospital mortality rate during 2017–2021 for CHD-associated surgery in China is approximately 0.8%–1.0% and 2.5%–3.8% for complex CHD[2].Brain injury and later neurodevelopmental impairment(NDI)are the most enduring and detrimental complications for patients with complex CHD.As a growing number of individuals with complex CHD survive into adulthood,the impact and high incidence of NDI should be addressed.Moreover,there needs to be a research shift from improving survival to improving whole life quality,particularly in perioperative neuroprotection,persistent neurodevelopmental evaluation and early intervention.
文摘BACKGROUND Phocomelia is a rare congenital disorder characterized by the absence or under-development of the proximal limbs.Phocomelia can occur as a syndrome or a limb-specific deformity.While historically linked to thalidomide,non-thalido-mide causes include genetic mutations,vascular disruptions,and teratogenic exposures.This case highlights the diagnostic and therapeutic challenges in a neonate with bilateral phocomelia,low birth weight,asphyxia and jaundice.CASE SUMMARY We report a 2-week-old term neonate with bilateral phocomelia,micrognathia,jaundice,and low birth weight.The pregnancy was unremarkable,with no tha-lidomide exposure.The mother had a history of early pregnancy losses.Clinical evaluation revealed absent humeri and radii bilaterally,with hands attached proximally to the trunk.Genetic testing was not performed,limiting the identi-fication of underlying etiology.The patient was managed with supportive care,parental counseling,and planning for long-term rehabilitation.This case un-derscores the importance of multidisciplinary care in managing congenital ano-malies.Genetic evaluation is crucial in unexplained congenital anomalies.Routine detailed ultrasounds in high-risk pregnancies aid in early diagnosis and parental preparedness.CONCLUSION Bilateral phocomelia presents significant functional challenges.Comprehensive diagnostic workups and early rehabilitation strategies are essential for optimizing patient outcomes.
文摘BACKGROUND Congenital intestinal atresia(CIA)is a common intestinal malformation in the neonatal period,and surgery is currently the main treatment method.The choice of postoperative feeding is crucial for the recovery of gastrointestinal function in children.AIM To compare and analyze the effects of different postoperative feeding methods on gastrointestinal function reconstruction in newborns with CIA.METHODS Twenty-six children diagnosed with neonatal CIA,treated with minimally invasive surgery at Shijiazhuang Maternal and Child Health Hospital between January 2021 and May 2024,were selected for this single-center prospective randomized controlled study.They were divided into two groups using envelope randomization:Enteral nutrition(EN)group(n=13)and parenteral nutrition(PN)group(n=13).Baseline and clinical characteristics were collected,and recovery time of bowel sounds and time to first defecation were used as evaluation indices for gastrointestinal functional reconstruction.Differences between the groups were analyzed using t-test,χ2 test,and Fisher’s exact test.Spearman’s correlation tests and linear regression models were employed to analyze factors influencing time to first defecation.RESULTS The time to bowel sound recovery(51.54 vs 65.85,P=0.013)and first defecation(58.15 vs 76.62,P<0.001)was shorter in the EN group compared to the PN group.Clinical improvements in the EN group,including discharge weight(P=0.044),hospital stay(P=0.027),white blood cell count(P=0.023),albumin content(P=0.013),and direct bilirubin content(P=0.018),were also better than those in the PN group.No substantial differences in postoperative complications were found between the groups.Correlation analysis indicated that abdominal infection and operation time may relate to time to first defecation.Linear regression analysis demonstrated a considerable association between EN feeding and shorter time to first defecation.Abdominal infection and an operation time>2 hours may be risk factors for prolonged time to first defecation.CONCLUSION EN substantially promotes the recovery of gastrointestinal function after CIA in neonates and can improve clinical outcomes in children.Future research should explore optimal EN practices to enhance clinical application and child health.
文摘BACKGROUND Respiratory syncytial virus(RSV)is a leading cause of lower respiratory tract infections in neonates.While typically associated with bronchiolitis and pneumonia,RSV can rarely cause extrapulmonary complications such as myocarditis,which may present with life-threatening symptoms if not promptly recognized.CASE SUMMARY We describe the case of a 26-day-old male neonate who presented with respiratory distress,poor feeding,and irritability.Initial evaluation revealed an RSV infection confirmed via nasopharyngeal swab.As the clinical course progressed,the infant developed cardiac arrhythmias,elevated cardiac enzymes,and echocardiographic findings consistent with myocarditis.Management included mechanical ventilation,corticosteroid therapy,L-carnitine,and vitamin D supplementation.The patient responded well to treatment and was successfully extubated and discharged in stable condition after nine days of hospitalization.CONCLUSION This case highlights the importance of early recognition and multidisciplinary management of RSV-associated myocarditis in neonates.
文摘Objective:To explore the construction and application value of a home skin care guidance program for neonates.Methods:From February 2024 to February 2025,60 neonates were selected as samples and randomly grouped by drawing.Group A received the constructed home skin care program for neonates,while Group B received routine care.The mastery of skin care knowledge by parents,emotional scores of mothers,and adverse reaction rates of neonates were compared.Results:The mastery of skin care knowledge by parents in Group A was higher than that in Group B,P<0.05.The anxiety(SAS)and depression(SDS)scores of mothers in Group A were lower than those in Group B,P<0.05.The adverse reaction rate of neonates in Group A was lower than that in Group B,P<0.05.Conclusion:The construction of a home skin care program for neonates can reduce adverse reactions of mothers,improve parents’mastery of neonatal skin care knowledge,and is beneficial for reducing adverse events such as neonatal eczema,diaper dermatitis,and infection.
文摘AIM:To explore the relationship between retinal exudative changes in neonates and perinatal toxoplasmosis,others,rubella,cytomegalovirus,and herpes simplex virus(TORCH)infections,as well as the characteristics of TORCH infection in neonates with retinal exudative changes.METHODS:Retrospective study.A total of 612 neonates with retinal exudative changes detected during ophthalmic screening in our hospital from May 2019 to March 2023 were selected.TORCH tests were performed on these neonates,and the results were subjected to statistical analysis to determine the infection characteristics.The neonates with retinal exudative changes were grouped by sex and age,the characteristics of TORCH infection were analyzed,and the positive rates were compared.RESULTS:Among the 612 neonates with retinal exudative changes,the highest positive rate was observed for cytomegalovirus(CMV-IgG)(96.7%),followed by rubella virus(RV-IgG)(73.9%).Mixed infections with two or three viruses were also observed,with the highest positive rate for mixed infection of RV-IgG and CMV-IgG reaching 71.2%.There was no statistically significant difference in TORCH infection among neonates of different sex(P>0.05).However,there were statistically significant differences in RV-IgG and CMV-IgM infections with retinal exudative changes among neonates of different age groups(P<0.05).CONCLUSION:Perinatal TORCH infection may be an important factor causing retinal exudative changes in neonates.The differences in various infections are not related to sex but are related to different age groups.
文摘Objective:To evaluate the impact of the severe COVID-19 pandemic on neonates and develop strategies to improve their outcomes.Methods:We conducted an observational cross-sectional study at Children's Hospital 1(CH1)from July 25,2021,to May 31,2022.All neonates who had fever or respiratory symptoms or were born from mothers with COVID-19 and had a positive RT-PCR SARS-CoV-2 result would be included.We classified neonates with COVID-19 into 2 groups:mild/moderate and severe for analysis.Differences between groups were analyzed using Fisher's exact test/Chi-square test for categorical variables and Student's t-test/Wilcoxon Rank Sum test for continuous variables.Results:This study included 88 newborns who had positive RT-PCR SARS-CoV-2 results.The severity COVID-19 rate among neonatal cases was found to be 13.6%(12/88),with a corresponding mortality rate of 1.1%(1/88).All severe cases showed lung abnormalities as evident on chest X-ray images.In addition to respiratory symptoms,a higher incidence of gastrointestinal manifestations,such as vomiting and diarrhea,was observed in the severe group,indicating a compelling association.The administration of anticoagulant and anti-inflammatory drugs in the study group resulted in a satisfactory outcome with no significant complications.Conclusions:The COVID-19 pandemic has had a substantial impact on the well-being of neonates.The management of COVID-19 in this population presents significant challenges.
基金This retrospective study was approved by the Seoul National University Hospital Institutional Review Board(approval number:H-2106-179-1230).The requirement for informed consent was waived.
文摘Background:The optimal surgical timing and clinical outcomes of ventricular septal defect(VSD)closure in neo-nates remain unclear.We aimed to evaluate the clinical outcomes of VSD closure in neonates(age≤30 days).Methods:We retrospectively reviewed 50 consecutive neonates who underwent VSD closure for isolated VSDs between August 2003 and June 2021.Indications for the procedure included congestive heart failure/failure to thrive and pulmonary hypertension.Major adverse events(MAEs)were defined as the composite of all-cause mortality,reoperation,persistent atrioventricular block,and significant(≥grade 2)valvular dysfunction.Results:The median age and body weight at operation were 26.0 days(interquartile range[IQR],18.8–28.3)and 3.7 kg(IQR,3.3–4.2),respectively.The median follow-up duration was 110.4 months(IQR,56.8–165.0).Seven patients required preoperative respiratory support,andfive had significant(≥grade 2)preoperative valvular dysfunction.One early mortality occurred due to irreversible cardiogenic shock;no late mortality was observed.One reopera-tion was due to hemodynamically significant residual VSD at 103.8 months postoperatively.The overall survival,freedom from reoperation,and freedom from MAE at 15-years were 98.0%,96.3%,and 94.4%,respectively.Pre-operative mechanical ventilation was associated with a longer duration of postoperative mechanical ventilation(p<0.001)and a longer length of intensive care unit stay(p<0.001).Conclusions:VSD closure with favorable outcomes without morbidities is feasible even in neonates.However,neonates requiring preoperative respiratory support may require careful postoperative management considering the long-term postoperative risks.Overall,surgical VSD closure might be indicated earlier in neonates with respiratory compromise.
文摘Neonates,especially admitted to neonatal intensive care unit,frequently need various medical interventions in their early days.A common procedure is the heel prick for blood sampling.Although necessary for diagnosis,this procedure can be stressful for neonates,causing pain,extended crying,and discomfort.Reducing distress in neonates during such procedures is important for the well‐being of neonates and the satisfaction of caregivers and healthcare providers.Therefore,this review aims to identify and compare the efficacy of 25%dextrose and breast milk on pain and duration of cry among neonates during heel-lance.As part of its review process,the article examined widely used databases,including PubMed,EMBASE,Cochrane,Academia,and Google Scholar.For the meta-analysis,the authors utilized RevMan 5.4.All eligible trials were analyzed using the Cochrane Risk of Bias Tool to assess the quality of the included studies and evaluate the risk of bias.Out of 131 studies reviewed,seven studies were included in meta-analysis of pain,and four studies were included in duration of cry.The results show that 25%dextrose is more effective to reduce pain among neonates during minor invasive procedure like heel prick(P<0.00001),whereas both interventions are effective in the reduction of crying duration.This review highlights that dextrose is more effective in reducing pain in comparison to breast milk.However,additional well-designed studies with larger sample sizes and extended follow-up periods are needed to validate and build upon the current findings.Hence,this review underscores the importance of utilizing effective pain management strategies,such as 25%dextrose,to enhance neonatal care and improve the overall well-being of newborns during invasive procedures.
文摘Introduction: Acute pain associated with caregiving is a major cause of pain among neonates. Left untreated, it can lead to long-term neurosensory and psychoaffective consequences. In Cameroon, this subject has been scarcely explored, thus constituting an impediment to the management of care-induced pain. Objective: Assess procedural pain in neonates in Yaoundé. Material and Methods: We conducted a cross sectional study with prospective data collection over a period of eight months (October 2022 to May 2023) in three hospitals. We included neonates who were being cared for and were not crying prior to the onset of healthcare, whose parents consented to the study. Assessments were done using the DAN scale, which is specific to care-induced pain. Data was entered and analyzed using SPSS 23.0 software. Results: A total of 161 newborns were included. The hospital prevalence of care-induced pain in neonates was 85%. Neonatal sepsis was the main cause for admission (96.6%). The most common procedures were venous blood sampling (94.4%) and insertion of peripheral venous lines (93.8%). The pain intensity for these procedures was severe (83.9%). The most painful procedure was lumbar tap, followed by venous access procedures. Conclusion: Neonates in hospitals are subjected to many painful procedures. The pain experienced during these procedures is severe. The most nociceptive procedure is a lumbar puncture.
文摘Background: Despite a significant decline in neonatal deaths in the last 20 years (5 million in 1990 to 2.4 million in 2019), the risk of death is still high, especially in developing countries. In Tanzania, neonatal sepsis is the third leading cause of neonatal death, accounting for 25% of all deaths. The rising global threat of antimicrobial resistance and the rising burden of neonatal death due to neonatal sepsis have been of great concern and have delayed progress toward reaching SDG goal 3.2 by 2030. This study aims to determine the bacteriological profile, antibiotic susceptibility patterns, and predictors of bacteremia among neonates with clinical sepsis at KCMC Hospital in Northern Tanzania. Methodology: This study had a cross-sectional design conducted at KCMC Hospital, Northern Tanzania. The study population was neonates admitted to the neonatal unit at KCMC Hospital. Data were collected using questionnaires and blood cultures from neonates. Frequencies and proportions were used to summarize categorical variables, while continuous variables were summarized using mean and standard deviation. The frequencies and proportions of bacteria isolated and the antimicrobial susceptibility results were analyzed and compared using Pearson’s chi-square test and Fisher’s exact test where applicable. Modified Poisson regression model was used to determine factors associated with positive blood culture. Results: Out of 411 neonates with a clinical diagnosis of neonatal sepsis, 175 (42.9%) had positive blood cultures. Gram-positive bacteria were most frequently isolated at 52.3%, and gram-negative bacteria were 47.7%. Coagulase-negative Staphylococcus (30.7%) and Staphylococcus aureus (19.9%) were the predominant gram-positive isolates. Gram-negative isolates were Klebsiella spp 47 (26.7%), E. coli 10 (5.7%), and Citrobacter spp 10 (5.1%). The gram-positive isolates were sensitive to vancomycin, piperacillin/tazobactam, and ceftazidime, whereas the gram-negative were sensitive to amikacin, meropenem, and vancomycin. The study did not find statistically significant associations between clinical factors and positive blood cultures in bacteremia. Conclusion: Gram-positive bacteria are the dominant pathogens in early-onset and late-onset neonatal sepsis. High levels of resistance to ampicillin and ceftriaxone and moderate resistance to gentamycin were observed in both gram-positive and gram-negative bacteria. Gram-positive organisms exhibit better susceptibility rates to vancomycin and ciprofloxacin, while gram-negative micro-organisms are more sensitive to amikacin and meropenem. An effective initial treatment approach for neonatal sepsis would involve a combination of drugs.
文摘Introduction: Respiratory distress in neonates is a neonatal emergency that can lead to serious complications if not treated appropriately. The aim of this study was to describe the epidemiology, the diagnostic, and the outcomes of neonatal respiratory distress. Methods: This was a cross-sectional study carried out in the pediatric wards of Lomé Teaching Hospitals (CHU Sylvanus Olympio and CHU Campus), including neonates treated for respiratory distress (dyspnea associated with the use of accessory muscles of respiration, noisy breathing and with or without cyanosis) from January 1, 2021 to December 31, 2021. Data were entered using Epi Data 3.1 and SPSS software version 12.0. Results: The total number of neonates hospitalized for respiratory distress was 353, with a frequency of 12.5% and a sex ratio of 1.5. The mean age was 0.82 ± 3.20 days;the 0 - 6-day age group accounted for 92.4% of cases. Neonates had been resuscitated at birth in 46.7% of cases. Dyspnea was tachypnea in 94% of cases and bradypnea in 6%. Dyspnea was associated with cyanosis in 21.5% of cases. The severity of the respiratory distress was moderate in 64.9% of cases. Perinatal asphyxia (49.1%), inhalation pneumonitis (17.1%) and neonatal bacterial infection (14.1%) were the main etiologies. The mortality rate was 20.4%. Age greater than or equal to seven days, no neonatal resuscitation were protective factors against death. Prematurity, no antenatal consultations follow up, neonatal resuscitation, severe respiratory distress were risk factors of death. Conclusion: Neonatal respiratory distress was common in the early neonatal period and its mortality was high.
文摘BACKGROUND Neonatal respiratory distress syndrome(NRDS)is one of the most common diseases in neonatal intensive care units,with an incidence rate of about 7%among infants.Additionally,it is a leading cause of neonatal death in hospitals in China.The main mechanism of the disease is hypoxemia and hypercapnia caused by lack of surfactant AIM To explore the effect of pulmonary surfactant(PS)combined with noninvasive positive pressure ventilation on keratin-14(KRT-14)and endothelin-1(ET-1)levels in peripheral blood and the effectiveness in treating NRDS.METHODS Altogether 137 neonates with respiratory distress syndrome treated in our hospital from April 2019 to July 2021 were included.Of these,64 control cases were treated with noninvasive positive pressure ventilation and 73 observation cases were treated with PS combined with noninvasive positive pressure ventilation.The expression of KRT-14 and ET-1 in the two groups was compared.The deaths,complications,and PaO_(2),PaCO_(2),and PaO_(2)/FiO_(2)blood gas indexes in the two groups were compared.Receiver operating characteristic curve(ROC)analysis was used to determine the diagnostic value of KRT-14 and ET-1 in the treatment of NRDS.RESULTS The observation group had a significantly higher effectiveness rate than the control group.There was no significant difference between the two groups in terms of neonatal mortality and adverse reactions,such as bronchial dysplasia,cyanosis,and shortness of breath.After treatment,the levels of PaO_(2)and PaO_(2)/FiO_(2)in both groups were significantly higher than before treatment,while the level of PaCO_(2)was significantly lower.After treatment,the observation group had significantly higher levels of PaO_(2)and PaO_(2)/FiO_(2)than the control group,while PaCO_(2)was notably lower in the observation group.After treatment,the KRT-14 and ET-1 levels in both groups were significantly decreased compared with the pre-treatment levels.The observation group had a reduction of KRT-14 and ET-1 levels than the control group.ROC curve analysis showed that the area under the curve(AUC)of KRT-14 was 0.791,and the AUC of ET-1 was 0.816.CONCLUSION Combining PS with noninvasive positive pressure ventilation significantly improved the effectiveness of NRDS therapy.KRT-14 and ET-1 levels may have potential as therapeutic and diagnostic indicators.
文摘Objective:To investigate the clinical profile and risk factors of symptomatic and asymptomatic hypoglycemia in neonates admitted to a neonatal intensive care unit in a tertiary care center.Methods:The prospective observational study was conducted in a tertiary care center in the Specialty Department of Pediatric.196 Newborn babies with blood glucose levels<45 mg/dL were examined with a simple random sampling method between December 2019 and November 2021.Maternal and neonatal risk factors and clinical signs were recorded and compared between symptomatic and asymptomatic cases.Results:The proportion of symptomatic hypoglycemia neonates born to gestational diabetes mellitus mothers was significantly higher(23.4%vs.8.4%)(P<0.05).Small for gestational age,low birth weight,respiratory distress syndrome,hypothermia,and endocrine disorders were risk factors.The death rate in asymptomatic hypoglycemia neonates was significantly higher(58%vs.39%)(P<0.05).Conclusions:The study indicates that maternal gestational diabetes mellitus is associated with symptomatic hypoglycemia and asymptomatic hypoglycemia is associated with neonatal mortality.It is important to take vigilance and timely interventions to address associated symptoms,particularly poor feeding,in the management of neonatal hypoglycemia.
基金the Science and Technology Planning Project of Beijing, China, No. Z080507030808018
文摘BACKGROUND： Spontaneous otoacoustic emissions （SOAEs） are regarded as a valuable audio- metric parameter that objectively reflects the function of outer hair cells （OHCs）. Many studies have reported that the incidence of SOAEs in adults is less than 50%. Therefore, measurement of SOAEs may be of little value to clinical examinations. However, the incidence of SOAEs in infants and neonates is higher than in adults. OBJECTIVE： To analyze the basic characteristics of SOAEs in 2–4 day old neonates, and to demonstrate the difference in OHC function between sexes and ears. DESIGN, TIME AND SETTING： Neurophysiological contrast study, performed in the Department of Neonates, Beijing Chaoyang Hospital, Capital Medical University, between December 2007 and August 2008. PARTICIPANTS： A total of 112 newborns （224 ears） consisting of 59 females and 53 males were included in this study. METHODS： The probe was adapted and embedded in the neonate external auditory canal with a foam rubber earplug after checking and clearing up the outer ear canal. The presence of SOAEs was determined when the signal amplitude had a clear peak exceeding –30 dB, or was 3 dB above the noise floor. MAIN OUTCOME MEASURES： The incidence of SOAEs, the number of SOAE signal peaks, and the maximal tension of SOAEs. RESULTS： The incidence in females （79.7%） was higher than males （76.4%） （P 〉 0.05）, and the incidence in right ears （86.6%） was higher than in left ears （69.6%） （P 〈 0.05）. There were no significant difference in the number of SOAE peaks between females and males （4.49 vs. 4.28）, or between right ears and left ears （4.62 vs. 4.12） （P 〉 0.05）. The mean maximum SOAE level per ear in females （–3.29 ± 9.28） dB sound pressure level （SPL） was slightly higher than that in males （–3.91 ± 9.14） dB SPL （P 〉 0.05）. Also, the mean maximum SOAE level in right ears （–2.03 ± 9.11） dB SPL was higher than in left ears （–5.50 ± 9.65） dB SPL （P 〈 0.05）. The maximum SOAE level showed a positive correlation with maximum SOAE number in emitting ears （r = 0.55, P 〈 0.01）. CONCLUSION： The incidence of SOAEs in neonates is high （78.1%） within 4 days of birth. The in-cidence of SOAEs and the maximum SOAE level exhibited a significant difference between right and left ears, but the difference between sexes was insignificant. Both the strongest SOAE signal peak and number of SOAEs per ear are representative of the function OHCs.
基金supported by the National Natural Science Foundation of China(No.81370099)
文摘This study attempts to discuss the correlation between UGT1A1＊28 as uridine diphosphate glucuronosyltransferase gene promoter and coding region Gly71 Arg gene polymorphism with neonatal hyperbilirubinemia of neonates in Wuhan. A total of 168 neonates were divided into the hyperbilirubinemia group（case group, n=108） and healthy neonates group（control group, n=60）. Their DNA was obtained through blood extraction. The gene exon mutation of UGT1A1 was detected by Sanger sequencing, which revealed the relationship between UGT1A1＊28 and Gly71 Arg polymorphism with neonatal hyperbilirubinemia of neonates. The results showed that：（1） The frequency of UGT1A1＊28 allele mutation in the case group and the control group was 9.3% and 10% respectively, with the difference being not significant between the two groups（P〉0.05）.（2） The frequency of Gly71 Arg allele mutation in the case group and the control group was 35.1% and 21.7% respectively, with the difference being significant between the two groups（P〈0.01）.（3） The serum bilirubin level of Gly71 Arg mutant homozygous and heterozygous subgroups（n=66） in the case group was 302.7±31.4 μmol/L, which was significantly higher than 267.3±28.5 μmol/L of the wild subgroup（n=42）（P〈0.01）. It was suggested that the occurrence of neonatal hyperbilirubinemia of neonates in Wuhan was not associated with UGT1A1＊28 gene polymorphism, but closely with the Gly71 Arg gene polymorphism. Meanwhile, the Arg allele mutation was related to the degree of jaundice.
