Relation between Maternal and Neonatal Serum Lipid Profile and Their Impact on Birth Weight.

OBJECTIVE: Maternal malnutrition with disturbed lipid metabolism during pregnancy may affect the fetal lipid profile. We aimed to detect the relation between maternal and neonatal serum lipid profile, as well as to detect the serum lipid profile difference between small for gestational age (SGA) infants and appropriate for gestational age (AGA) infants to disclose the impact of maternal malnutrition on birth weight. STUDY DESIGN: A cross-sectional study was conducted on 150 pregnant women coming to the labor room. Before delivery, maternal serum levels of high-density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides (TGs), and total cholesterol were assessed, then after delivery, cord blood samples were taken for assessment of the neonatal lipid profile. Birth weights were measured, then the neonates were divided into SGA and AGA groups. RESULTS: Serum levels of LDL, TGs, and total cholesterol in the SGA infants were lower than that in the AGA infants. A positive correlation between maternal and neonatal serum TGs levels was found. Besides, there was a positive correlation between birth weight and maternal serum levels of LDL, TGs, and total cholesterol. CONCLUSION: Maternal serum lipid profile could be an indicator of the neonatal serum lipid profile and birth weight. KEY POINTS: · SGA neonates have lower levels of serum lipids compared to AGA neonates.. · There is a positive correlation between maternal and neonatal triglycerides.. · There is a positive correlation between birth weight and maternal serum lipids..

The cirrhosis care Alberta (CCAB) protocol: implementing an evidence-based best practice order set for the management of liver cirrhosis - a hybrid type I effectiveness-implementation trial.

BACKGROUND: Liver cirrhosis is a leading cause of morbidity, premature mortality and acute care utilization in patients with digestive disease. In the province of Alberta, hospital readmission rates for patients with cirrhosis are estimated at 44% at 90 days. For hospitalized patients, multiple care gaps exist, the most notable stemming from i) the lack of a structured approach to best practice care for cirrhosis complications, ii) the lack of a structured approach to broader health needs and iii) suboptimal preparation for transition of care into the community. Cirrhosis Care Alberta (CCAB) is a 4-year multi-component pragmatic trial which aims to address these gaps. The proposed intervention is initiated at the time of hospitalization through implementation of a clinical information system embedded electronic order set for delivering evidence-based best practices under real-world conditions. The overarching objective of the CCAB trial is to demonstrate effectiveness and implementation feasibility for use of the order set in routine patient care within eight hospital sites in Alberta. METHODS: A mixed methods hybrid type I effectiveness-implementation design will be used to evaluate the effectiveness of the order set intervention. The primary outcome is a reduction in 90-day cumulative length of stay. Implementation outcomes such as reach, adoption, fidelity and maintenance will also be evaluated alongside other patient and service outcomes such as readmission rates, quality of care and cost-effectiveness. This theory-based trial will be guided by Normalization Process Theory, Consolidated Framework on Implementation Research (CFIR) and the Reach-Effectiveness-Adoption-Implementation-Maintenance (RE-AIM) Framework. DISCUSSION: The CCAB project is unique in its breadth, both in the comprehensiveness of the multi-component order set and also for the breadth of its roll-out. Lessons learned will ultimately inform the feasibility and effectiveness of this approach in "real-world" conditions as well as adoption and adaptation of these best practices within the rest of Alberta, other provinces in Canada, and beyond. TRIAL REGISTRATION: ClinicalTrials.gov: NCT04149223, November 4, 2019.

Pneumothorax in the neonatal intensive care unit in Cairo University Hospital.

Pneumothorax is more frequent in the neonatal period than at any other time in life and the incidence increases in neonates who have concurrent underlying lung disease or who require mechanical ventilation. This cross sectional study was performed in the inborn NICU in Cairo University Hospitals over one year from September 2010 to August 2011. All neonates admitted were included; their data were collected and observed for pneumothorax occurrence. A total of 59 neonates (9.1%) developed pneumothorax with highest incidence in ELBW and gestational ages less than 32 weeks. RDS and MAS were the most common coexisting lung pathologies. 89.83% of the cases with pneumothorax were on mechanical ventilation. Pneumothorax occurred on the right side in 64.4% of cases, on the left in 18.6% and bilateral in 16.95% of the cases. The mortality was higher (62.7%) in the neonates with pneumothorax than the mortality of the total admissions. The mortality was significantly higher with lower birth weights and gestational ages. Apgar score at one and five minutes and the associated medical diagnosis showed no significant differences between the neonates who died and those who survived.