Does the type of sleep surface influence infant wellbeing in the NICU?

PURPOSE: To evaluate whether different mattress surfaces (standard vinyl-covered foam mattress [SFM] versus viscoelastic polyurethane mattress [VPM]) are associated with differences in nurses' perceptions of infant sleep/restfulness, nurses' assessment of infant pain, parents' perceptions of infant comfort/crying, infant weight, and vital signs among babies with birthweights <1,700 grams or gestational ages <35 weeks in a NICU. STUDY DESIGN AND METHODS: A quasi-experiment was conducted in which a control group of 40 babies admitted to the NICU over a 7-month period were placed on SFMs and an experimental group of 40 babies admitted in the next 7 months were placed on VPMs. Data were collected in 72 hours immediately following infant placement on the mattresses. RESULTS: There were no differences between groups based on gender, gestational age, and birthweight. Babies in the SFM group were an average of 15 hours older when placed on the mattress and had lower Day 1 acuity. There were no differences between groups on nurses' perceptions of infant sleep/restfulness, nurses' assessment of infant pain, parents' perceptions of comfort/crying, and infant vital signs. Weight loss for babies in the VPM group was more than twice that of infants on the SFM; however, the loss was clinically within normal limits. Vital signs of babies in both groups were largely within normal ranges and perceptions of sleep/restfulness and comfort/crying levels were positive. CLINICAL IMPLICATIONS: Both mattresses seem to be effective for babies in the NICU. More data are needed on the potential relationships between the VPM mattress and neonatal weight loss.

Infantile mixed phenotype acute leukemia (bilineal and biphenotypic) with t(10;11)(p12;q23);MLL-MLLT10.

We report a case of a 6-month-old boy with a mixed phenotype acute leukemia (MPAL), bilineal and biphenotypic immunophenotype (B-lymphoid lineage and combined B-lymphoid and monocytic lineage) with t(10;11)(p12;q23);MLL-MLLT10. He was treated with acute myeloid leukemia protocol and in complete remission at 7-month follow-up. To the best of our knowledge, this is the first reported MLL-MLLT10 rearranged case presenting as MPAL in an infant. From a clinical practice standpoint, this case illustrates the importance of detection of MLL rearrangement due to its prognostic implication and the effectiveness of flow cytometry immunophenotyping in diagnosing MPAL and monitoring minimal residual disease.