Maternal Body Mass Index and Risk of Bronchopulmonary Dysplasia in Extremely Preterm Infants.

OBJECTIVE: We evaluated the relationship between maternal body mass index (BMI) and death or bronchopulmonary dysplasia (BPD). We hypothesized that in extremely low birth weight (ELBW; BW < 1,000 g) infants, the risk of death or BPD would be greater if the maternal BMI deviated further from the ideal BMI of 24. STUDY DESIGN: ELBW infants admitted to AdventHealth Neonatal Intensive Care Unit (NICU) between calendar years 2012 and 2017 were included in this retrospective observational study. BPD was defined as continuous supplemental oxygen use at 36 weeks post-menstrual age. RESULT: There was no association between the deviation of maternal BMI from the ideal of 24 and the composite outcome of death or BPD (6.9 ± 6.7 vs. 7.06 ± 6.6, pp = 0.966). However, there was a lower risk of death with a higher maternal BMI (p = 0.024). BPD was also associated with a higher maternal BMI (p = 0.045). CONCLUSION: Maternal BMI was not associated with the composite variable of death or BPD in ELBW infants. The lack of association was due to the contrast between high BMI and a lower risk of death and a higher risk for BPD. KEY POINTS: · Maternal BMI was not associated with the composite outcome of death or BPD.. · Elevated BMI was associated with a higher risk of BPD.. · Elevated BMI was associated with a lower risk of death..

Lactulose-associated lithium toxicity: a case series.

BACKGROUND: Lactulose is commonly used for constipation and hepatic encephalopathy. Its adverse effects of dehydration and serum electrolyte imbalances are widely known. OBJECTIVE: This study aimed to describe a case series of 3 patients receiving lactulose who developed lithium toxicity. METHODS: The authors described a case series of 3 patients admitted to a large county psychiatric hospital who developed lithium toxicity while taking lactulose for constipation or hyperammonemia. RESULTS: In all 3 cases of lithium toxicity, the patients were prescribed with lithium for acute mania and lactulose for constipation or hyperammonemia. One case required the patient to be transferred to a local emergency department for further treatment. CONCLUSIONS: This case series shows the interaction between lithium and lactulose. It is postulated that lactulose's effects of volume depletion can lead to poor renal excretion of lithium.

Reducing perinatal HIV transmission among HIV-infected pregnant women.

BACKGROUND: In 1995, Help Understand and Guide-Me (HUG-Me) began planning the implementation of Protocol 076, a treatment that aids in the reduction of perinatal transmission of human immunodeficiency virus (HIV). A program coordinator and a social worker worked with a 1572 bed-hospital system to successfully implement the protocol. METHODS: Program effectiveness was tracked through monitoring of client outcomes. HIV test results of infants born to HIV-infected mothers were tracked for nine years. In addition, chart audits were conducted on all patients to ensure that testing and counseling were documented for every pregnant woman who delivered at the hospital. RESULTS: From 1996 to 2005, among 434 births to HIV-infected women enrolled in the clinic, only one HIV-infected infant was born. Chart audits revealed that HIV testing and counseling were not being performed and/or documented by all physicians. Therefore, in-service training was initiated for providers on a regular basis. In addition, other factors were addressed to aid patient adherence to treatment. DISCUSSION: The initiative's success in virtually eliminating perinatal transmission has had a major impact in reducing rates of pediatric HIV/AIDS for the community.