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1.
Artigo em Inglês | MEDLINE | ID: mdl-34205660

RESUMO

Moderate to late preterm infants are at risk of developing problems later in life. To support attachment and infants' development, high quality parent-infant interaction is important. Parent-infant interaction is known to improve through intervention programs but since no such intervention program is addressed directly to moderate to late preterm infants, a tailor-made intervention was developed. The aim was to describe the rationale, development, framework and practical provision of a new early collaborative intervention program. This study has a descriptive design and the intervention is described using the Template for Intervention Description and Replication. During an intervention-session, the preterm infant's cues are made visible to the parents as they perform an everyday care-taking procedure. Instant feedback is delivered to give the parents the opportunity to notice, interpret and respond to cues immediately. The infant's response to the parent's action is discussed in a dialogue to instantly guide parents´ awareness of the preterm infant's subtle cues. This study describes a new early collaborative intervention, developed to support interaction between parents and their moderate to late preterm infants starting in the neonatal intensive care unit. Clinical studies evaluating parental experiences as well as the effects of the early intervention are ongoing, ClinicalTrials.gov NCT02034617.


Assuntos
Recém-Nascido Prematuro , Unidades de Terapia Intensiva Neonatal , Desenvolvimento Infantil , Intervenção Educacional Precoce , Humanos , Lactente , Recém-Nascido
2.
Artigo em Inglês | MEDLINE | ID: mdl-34205787

RESUMO

Developmental problems in extremely preterm (EP) infants and the associated longitudinal burden for their families are major health issues worldwide. Approaches to social-emotional support such as family-integrating Creative Music Therapy (CMT) are warranted. We aimed: (1) to explore parental perspectives on the use of CMT with EP infants in the neonatal hospitalization period and (2) to examine the possible longitudinal influence of CMT. A qualitative design was used to examine the perspective of six families from various backgrounds. Semi-structured interviews were carried out when the infants reached school age. We used an inductive-deductive thematic analysis to identify three main themes, each with three sub-themes: (1) the positive impact of CMT on the infants, the parents, and bonding; (2) the attitude toward CMT, from being open-minded to recommending it as complementary therapy; and (3) the experience of overall healthy infant development despite unique developmental delay issues. The findings elucidate the positive and formative impact of CMT on both infants and parents in the stressful NICU setting and beyond. CMT may empower positive transformation in the parents through individualized early nurturing musical interactions, capacity building, and positive reinforcement. Further research may help to identify and implement potentially modifiable factors for improving health care in this vulnerable group through early family-integrating, resource-based approaches such as CMT.


Assuntos
Musicoterapia , Música , Criança , Desenvolvimento Infantil , Seguimentos , Humanos , Lactente , Lactente Extremamente Prematuro , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Pesquisa Qualitativa
3.
Zhongguo Dang Dai Er Ke Za Zhi ; 23(7): 659-670, 2021 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-34266521

RESUMO

Neonates are easily suffering from local or systematic infections due to their vulnerable skin barrier function, which leads to the increasing risk of death. Therefore, it is important to protect neonatal skin integrity and prevent neonatal skin injury in the neonatal intensive care unit (NICU). Based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and current evidence, the guidelines for neonatal skin management in the NICU were developed to provide recommendations on routine skin care and prevention and treatment of iatrogenic skin injury of neonates for health care providers.


Assuntos
Unidades de Terapia Intensiva Neonatal , Pele , Humanos , Recém-Nascido
4.
Zhongguo Dang Dai Er Ke Za Zhi ; 23(7): 702-706, 2021 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-34266527

RESUMO

OBJECTIVE: To study whether there are differences in the resuscitation process and early outcomes between the extremely preterm infants delivered on off-hours (6 pm to 8 am of working days, weekends, and national holidays) and those delivered on working hours. METHODS: A retrospective analysis was performed on the medical data of extremely preterm infants who were born in the Peking University Third Hospital from January 1, 2010 to December 31, 2020 and transferred to the neonatal intensive care unit (NICU). According to the time of birth, they were divided into two groups:working hours (n=77) and off-hours (n=98). The resuscitation process and early outcomes were compared between the two groups. RESULTS: Compared with the working hours group, the off-hours group had a significantly lower proportion of infants with the use of full-dose dexamethasone before delivery (P < 0.05) and a significantly higher proportion of infants with a 1-minute Apgar score of < 7, positive pressure ventilation, or tracheal intubation (P < 0.05). The incidence rates of neonatal respiratory distress syndrome and intrauterine pneumonia in the off-hours group were significantly higher than those in the working hours group (P < 0.05). CONCLUSIONS: Extremely preterm infants delivered on off-hours tend to have a low Apgar score at 1 minute after birth, with a higher proportion of infants requiring positive pressure ventilation or tracheal intubation during resuscitation than those delivered on working hours, and they tend to develop neonatal respiratory distress syndrome and intrauterine pneumonia. This suggests that it is important to make adequate preparations in terms of personnel and supplies for resuscitation of extremely preterm infants after birth and that NICUs should develop a detailed management plan for extremely preterm infants at each period of time before, during, and after birth.


Assuntos
Lactente Extremamente Prematuro , Síndrome do Desconforto Respiratório do Recém-Nascido , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Ressuscitação , Estudos Retrospectivos
5.
Invest Educ Enferm ; 39(2)2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34214287

RESUMO

OBJECTIVES: To describe the experiences of parents of hospitalized preterm children regarding the restrictions implemented in the neonatal intensive care unit -NICU- during the COVID-19 pandemic. METHODS: Qualitative study. Semi-structured interviews were conducted between April and October 2020 with 12 parents of preterm children, whose children were hospitalized and discharged from NICU during the pandemic. The analysis was performed with tools from grounded theory through open and axial coding. RESULTS: The study identified four categories regarding the experience: 1) needing information: refers to the need for clear and close information to compensate for the physical distance; 2) limiting the interaction with the children: expressed as a painful situation, which minimizes opportunities for learning to care at home for their preterm child; 3) the pandemic: adding to the fears: in which the virus appears as a new threat for the children, who are vulnerable given their premature condition; and 4) limiting social support after discharge: identifies that the parents had less family and professional support for care after discharge during times of pandemic. CONCLUSIONS: Parents of preterm children lived a difficult experience that became complex within the context of the pandemic. The experiences of parents of preterm children during times of COVID-19 indicate that restrictions to enter neonatal units to prevent the virus transmission limited the interaction with the preterm child and with the health staff and increased the needs for information.


Assuntos
COVID-19 , Hospitalização , Unidades de Terapia Intensiva Neonatal , Pais/psicologia , Distanciamento Físico , Adulto , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Masculino , Pesquisa Qualitativa , Adulto Jovem
6.
Trials ; 22(1): 444, 2021 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-34256820

RESUMO

BACKGROUND: Infants born very preterm (< 32 weeks gestational age (GA)) are at risk for developmental language delays. Poor language outcomes in children born preterm have been linked to neurobiological factors, including impaired development of the brain's structural connectivity (white matter), and environmental factors, including decreased exposure to maternal speech in the neonatal intensive care unit (NICU). Interventions that enhance preterm infants' exposure to maternal speech show promise as potential strategies for improving short-term health outcomes. Intervention studies have yet to establish whether increased exposure to maternal speech in the NICU offers benefits beyond the newborn period for brain and language outcomes. METHODS: This randomized controlled trial assesses the long-term effects of increased maternal speech exposure on structural connectivity at 12 months of age (age adjusted for prematurity (AA)) and language outcomes between 12 and 18 months of age AA. Study participants (N = 42) will include infants born very preterm (24-31 weeks 6/7 days GA). Newborns are randomly assigned to the treatment (n = 21) or standard medical care (n = 21) group. Treatment consists of increased maternal speech exposure, accomplished by playing audio recordings of each baby's own mother reading a children's book via an iPod placed in their crib/incubator. Infants in the control group have the identical iPod setup but are not played recordings. The primary outcome will be measures of expressive and receptive language skills, obtained from a parent questionnaire collected at 12-18 months AA. The secondary outcome will be measures of white matter development, including the mean diffusivity and fractional anisotropy derived from diffusion magnetic resonance imaging scans performed at around 36 weeks postmenstrual age during the infants' routine brain imaging session before hospital discharge and 12 months AA. DISCUSSION: The proposed study is expected to establish the potential impact of increased maternal speech exposure on long-term language outcomes and white matter development in infants born very preterm. If successful, the findings of this study may help to guide NICU clinical practice for promoting language and brain development. This clinical trial has the potential to advance theoretical understanding of how early language exposure directly changes brain structure for later language learning. TRIAL REGISTRATION: NIH Clinical Trials (ClinicalTrials.gov) NCT04193579 . Retrospectively registered on 10 December 2019.


Assuntos
Unidades de Terapia Intensiva Neonatal , Substância Branca , Criança , Feminino , Humanos , Lactente , Lactente Extremamente Prematuro , Recém-Nascido , Idioma , Fala
7.
Mymensingh Med J ; 30(3): 671-677, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34226454

RESUMO

Neonatal sepsis is associated with increased mortality and morbidity including prolonged hospital stay. Management of such cases is difficult, costly and need expert centers in many cases. Therefore, continued surveillance is mandatory to identify risk factors of neonatal sepsis which help optimizing its management. With the above idea, this cross-sectional descriptive study was conducted at the neonatal intensive care unit (NICU) in the department of Neonatology, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh from July 2017 to December 2017 to observe the effects of maternal and neonatal risk factors in the development of neonatal sepsis and to determine risk factors of neonatal sepsis. Ninety four neonates (0-28 days) who were admitted in NICU with suspected sepsis were included in this study by purposive sampling technique. After admission written informed consent from parents or guardians obtained and histories were obtained including perinatal history and full physical examination of the infants were done and septic screening were sent. All the relevant information was recorded in a pre-designed questionnaire and all data were compiled, tabulated and then analyzed by SPSS version 21.0. Among 94 cases, 72.3% were preterm and 27.6% were term. There was male predominance and male/ female ratio was 1.9:1. Most (76.6%) of the patient admitted within 72 hours of birth. Most (83%) had low birth weight (<2500gm). Most came from rural area 61(64.9%) and also from low income family 59(62.8%). Premature onset of labour 40(42.6%), PROM >18 hours 36(38.3%), vaginal route of delivery 52(55.3%), instrumental resuscitation 15(16%), prelacteal feeding 11(11.7%), bottle feeding 15(16%) were the antenatal, natal and postnatal risk factors in this study. Also the neonatal factors, like prematurity, resuscitation at birth and low APGAR score carried the significant risk of developing sepsis. Poor feeding, lethargy, respiratory distress, jaundice were more common presenting symptoms. Tachycardia, tachypnea, chest indrawing, cyanosis hypothermia, hyperthermia and apnoea were found as more common presenting sign of sepsis in this study. Based on result it is concluded that prolonged rupture of membrane>18 hours, vaginal route of delivery, preterm birth, instrumental resuscitation, prelacteal feeding, bottle feeding were the major perinatal risk factors in this study.


Assuntos
Sepse Neonatal , Nascimento Prematuro , Bangladesh/epidemiologia , Estudos Transversais , Feminino , Hospitais , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Masculino , Sepse Neonatal/diagnóstico , Sepse Neonatal/epidemiologia , Gravidez , Fatores de Risco
8.
Enferm. foco (Brasília) ; 12(1): 73-78, jun. 2021.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1254991

RESUMO

Objetivo: Conhecer a vivência materna na internação do filho na Unidade de Terapia Intensiva Neonatal. Método: Pesquisa qualitativa de caráter descritivo e exploratório, realizada na Unidade Pediátrica de um hospital escola de um município no Sul do Brasil, no período de março a maio de 2019, com 10 mães de recém-nascidos. A coleta de informações ocorreu por meio de entrevista semiestruturada e a análise foi temática. Resultados: Observa-se que as mães apresentam diversos sentimentos negativos, como tristeza, angústia, dor, desespero, impotência, ocasionados pelo impacto da notícia e pela adaptação com as peculiaridades da Unidade de Terapia Intensiva Neonatal, mas com a melhora clínica dos filhos são despertados sentimentos positivos de alegria e esperança. Considerações finais: Percebe-se a importância de um olhar crítico dos profissionais de saúde para a temática, oportunizando que as mães e os familiares exponham suas experiências e elaborando estratégias de cuidado com vistas a minimizar os efeitos negativos decorrentes da hospitalização do recém-nascido na Unidade de Terapia Intensiva Neonatal. (AU)


Objective: To know the maternal experience in the child's hospitalization in the Neonatal Intensive Care Unit. Method: Qualitative research of a descriptive and exploratory character, carried out in the Pediatric Unit of a teaching hospital in a municipality in southern Brazil, from March to May 2019, with 10 mothers of newborns. Information was collected through semi-structured interviews and the analysis was thematic. Results: It is observed that the mothers have several negative feeling, such as sadness, anguish, pain, despair, impotence, caused by the impact of the news and the adaptation to the peculiarities of the Neonatal Intensive Care Unit, but with the clinical improvement of their childrens, positive feelings of joy and hope are aroused. Final considerations: It is perceived the importance of a critical view of health profissionals on the theme, allowing mothers and family members to expose their experiences and devising care strategies in order to minimize the negative effects resulting from the hospitalization of the newborn in the Neonatal Intensive Care Unit. (AU)


Objetivo: Conocer la experiencia materna en la hospitalización del niño en la Unidad de Cuidados Intensivos Neonatales. Método: Investigación cualitativa de carácter descriptivo y exploratorio, realizada en la Unidad de Pediatría de un hospital universitario en un municipio del sur de Brasil, de marzo a mayo de 2019, con 10 madres de recién nacidos. La información se recopiló a través de entrevistas semiestructuradas y el análisis fue temático. Resultados: se observa que las madres tienen varios sentimientos negativos, como tristeza, angustia, dolor, deseperación, impotencia, caudados por el impacto de las noticias y la adaptación a las peculiaridades de la Unidad de Cuidados Intensivos Neonatales, pero con la mejoría clínica de sus hijos, se despiertan sentimientos positivos de alegría y esperanza. Consideraciones finales: se percibe la importancia de una visión crítica de los profesionales de la salud sobre el tema, lo que permite a las madres y los miembros de la família exponer sus experiencias e idear estrategias de atención para minimizar los efectos negativos resultantes de la hospitalización del recién nacido en la Unidad de Cuidados Intensivos Neonatales. (AU)


Assuntos
Enfermagem , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Hospitalização
9.
Invest. educ. enferm ; 39(2): [e10], 15 junio 2021. table 1
Artigo em Inglês | LILACS, BDENF - Enfermagem, COLNAL | ID: biblio-1254666

RESUMO

Objective. To describe the experiences of parents of hospitalized preterm children regarding the restrictions implemented in the neonatal intensive care unit -NICU- during the COVID-19 pandemic. Methods. Qualitative study. Semi-structured interviews were conducted between April and October 2020 with 12 parents of preterm children, whose children were hospitalized and discharged from NICU during the pandemic. The analysis was performed with tools from grounded theory through open and axial coding. Results. The study identified four categories regarding the experience: 1) needing information: refers to the need for clear and close information to compensate for the physical distance; 2) limiting the interaction with the children: expressed as a painful situation, which minimizes opportunities for learning to care at home for their preterm child; 3) the pandemic: adding to the fears: in which the virus appears as a new threat for the children, who are vulnerable given their premature condition; and 4) limiting social support after discharge: identifies that the parents had less family and professional support for care after discharge during times of pandemic. Conclusion. Parents of preterm children lived a difficult experience that became complex within the context of the pandemic. The experiences of parents of preterm children during times of COVID-19 indicate that restrictions to enter neonatal units to prevent the virus transmission limited the interaction with the preterm child and with the health staff and increased the needs for information.


Objetivo. Describir las experiencias de padres de niños prematuros hospitalizados frente a las restricciones implementadas en la Unidad de Cuidado Intensivo Neonatal -UCIN- durante la pandemia por la COVID-19. Métodos. Estudio cualitativo. Se realizaron entrevistas semiestructuradas entre abril y octubre de 2020 a 12 padres de niños prematuros; los niños estuvieron hospitalizados y dados de alta en UCIN durante la pandemia. El análisis se realizó con herramientas de la teoría fundamentada mediante codificación abierta y axial. Resultados. Se identificaron cuatro categorías en torno a la experiencia: 1) Necesitando información: se refiere a la necesidad de información clara y cercana para compensar la distancia física; 2) limitando la interacción con los hijos: se expresa como una situación dolorosa, que minimiza las oportunidades de aprendizaje para el cuidado de su hijo prematuro en casa; 3) La pandemia: sumando a los miedos, en la que el virus aparece como una nueva amenaza para los hijos, quienes son vulnerables dada su condición de prematurez; y 4) Limitando el apoyo social después del alta: se identifica que los padres tuvieron menos apoyo familiar y profesional para el cuidado después del alta en tiempos de pandemia. Conclusión. Los padres de los niños prematuros vivieron una experiencia difícil que se complejizó en el contexto de la pandemia. Sus experiencias, en tiempos de COVID 19, indican que las restricciones de ingreso a las unidades neonatales para prevenir la trasmisión del virus limitaron la interacción con el hijo prematuro y con el personal de salud e incrementaron las necesidades de información.


Objetivo. Descrever as experiências de pais de crianças prematuras hospitalizadas frente às restrições implantadas na Unidade de Terapia Intensiva Neonatal -UCIN- durante a pandemia do COVID-19. Métodos. Estudo qualitativo. Entrevistas semiestruturadas foram realizadas entre abril e outubro de 2020 com 12 pais de crianças prematuras, cujos filhos foram hospitalizados e receberam alta da UTIN durante a pandemia. A análise foi realizada com ferramentas da teoria fundamentada por meio de codificação aberta e axial. Resultados. Quatro categorias foram identificadas em torno da experiência: 1) Necessidade de informação: refere-se à necessidade de informações claras e próximas para compensar a distância física; 2) limitação da interação com os filhos: expressa-se como uma situação dolorosa, que minimiza as oportunidades de aprendizagem para cuidar do filho prematuro em casa; 3) A pandemia: agravando os medos: em que o vírus surge como uma nova ameaça às crianças, vulneráveis pela prematuridade; e 4) Limitação do suporte social após a alta: identifica-se que os pais tiveram menos apoio familiar e profissional para o cuidado após a alta em momentos de pandemia. Conclusão. Os pais das crianças prematuras tiveram uma experiência difícil que se tornou mais complexa no contexto da pandemia. As experiências de pais de bebês prematuros na época do COVID 19 indicam que as restrições de admissão em unidades neonatais para prevenir a transmissão do vírus limitaram a interação com o bebê prematuro e com o pessoal de saúde e aumentaram as necessidades de informação


Assuntos
Humanos , Pais , Recém-Nascido Prematuro , Unidades de Terapia Intensiva Neonatal , Enfermagem Neonatal , Infecções por Coronavirus , Enfermagem Familiar , Pandemias
10.
Neoreviews ; 22(6): e392-e397, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34074644

RESUMO

Breast milk provides optimal nourishment for all infants and has special advantages in preterm infants. Breast milk is associated with lower rates of necrotizing enterocolitis and bronchopulmonary dysplasia and improved neurodevelopmental outcomes in the preterm population. Mothers in the NICU may experience multiple psychological, physical, and social/cultural barriers that impede successful breastfeeding. Professional lactation support is of crucial importance in this population. With the social distancing requirements of the pandemic, many clinicians have adopted novel methods of education and communication to ensure continued timely support for NICU mothers.


Assuntos
Aleitamento Materno , Unidades de Terapia Intensiva Neonatal , Lactação , Encaminhamento e Consulta , Telemedicina , Adulto , Feminino , Humanos , Recém-Nascido
11.
BMC Infect Dis ; 21(1): 546, 2021 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-34107906

RESUMO

BACKGROUND: Sepsis is an overwhelming and life-threatening response to bacteria in bloodstream and a major cause of neonatal morbidity and mortality. Understanding the etiology and potential risk factors for neonatal sepsis is urgently required, particularly in low-income countries where burden of infection is high and its epidemiology is poorly understood. METHODS: A prospective observational cohort study was conducted between April 2016 and October 2017 in a level three NICU at a tertiary care hospital in Nepal to determine the bacterial etiology and potential risk factors for neonatal sepsis. RESULTS: Among 142 NICU admitted neonates, 15% (21/142) and 32% (46/142) developed blood culture-positive and -negative neonatal sepsis respectively. Klebsiella pneumoniae (34%, 15/44) and Enterobacter spp. (25%, 11/44) were the most common isolates. The antimicrobial resistance of isolates to ampicillin (100%, 43/43), cefotaxime (74%, 31/42) and ampicillin-sulbactam (55%, 21/38) were the highest. BlaTEM (53%, 18/34) and blaKPC (46%, 13/28) were the commonest ESBL and carbapenemase genes respectively. In univariate logistic regression, the odds of sepsis increased with each additional day of use of invasive procedures such as mechanical ventilation (OR 1.086, 95% CI 1.008-1.170), umbilical artery catheter (OR 1.375, 95% CI 1.049-1.803), intravenous cannula (OR 1.140, 95% CI 1.062-1.225); blood transfusion events (OR 3.084, 95% CI 1.407-6.760); NICU stay (OR 1.109, 95% CI 1.040-1.182) and failure to breast feed (OR 1.130, 95% CI 1.060-1.205). Sepsis odds also increased with leukopenia (OR 1.790, 95% CI 1.04-3.082), increase in C-reactive protein (OR 1.028, 95% CI 1.016-1.040) and decrease in platelets count (OR 0.992, 95% CI 0.989-0.994). In multivariate analysis, increase in IV cannula insertion days (OR 1.147, 95% CI 1.039-1.267) and CRP level (OR 1.028, 95% CI 1.008-1.049) increased the odds of sepsis. CONCLUSIONS: Our study indicated various nosocomial risk factors and underscored the need to improve local infection control measures so as to reduce the existing burden of sepsis. We have highlighted certain sepsis associated laboratory parameters along with identification of antimicrobial resistance genes, which can guide for early and better therapeutic management of sepsis. These findings could be extrapolated to other low-income settings within the region.


Assuntos
Sepse Neonatal/epidemiologia , Sepse Neonatal/microbiologia , Estudos de Coortes , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Nepal/epidemiologia , Estudos Prospectivos , Fatores de Risco , Centros de Atenção Terciária
13.
BMJ Case Rep ; 14(6)2021 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-34099451

RESUMO

A late preterm infant was born to a diabetic mother on a background of reduced fetal movements and a poor CTG. It was noted immediately at birth that there was pathology in both upper limbs. Targeted investigation led to the diagnosis of bilateral upper limb arterial thromboses. Prompt assessment and multidisciplinary discussion led to an individualised management plan resulting in a positive outcome.


Assuntos
Nascimento Prematuro , Trombose , Feminino , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Unidades de Terapia Intensiva Neonatal , Parto , Gravidez
14.
Neonatal Netw ; 40(3): 183-186, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-34088864

RESUMO

COVID-19's first wave created chaos for new NICU families as they struggled to cope with the challenge of a fragile infant along with a pandemic. Safety was paramount due to a lack of understanding around how the virus transmits, but much has been learned since then. The next wave of the virus needs to have a rethink around family separation. World leader organization European Foundation for the Care of Newborn Infants (EFCNI) provides insight into the challenges with the first wave and suggests ideas around rethinking how families interact with their baby in the subsequent waves.


Assuntos
COVID-19/psicologia , Unidades de Terapia Intensiva Neonatal/normas , Terapia Intensiva Neonatal/psicologia , Terapia Intensiva Neonatal/normas , Relações Mãe-Filho/psicologia , Guias de Prática Clínica como Assunto , Adulto , Separação da Família , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Masculino , SARS-CoV-2
15.
Int J Pediatr Otorhinolaryngol ; 147: 110800, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34147905

RESUMO

OBJECTIVES: We identified the neonatal and maternal risk factors for hearing loss (HL) in children using National Health Insurance Service data of Korea. METHODS: We retrospectively analyzed data from the National Health Insurance Service. Infants born from 2007 to 2013 were tracked to 2015. Those diagnosed with hearing disabilities or who underwent cochlear implant surgery were included in the hearing disability group. We compared the incidence of any diagnosed disability other than a hearing disability; any maternal disability at delivery; maternal age at delivery; prenatal and neonatal Toxoplasma, syphilis, rubella, cytomegalovirus, and herpes simplex infections; craniofacial anomaly; low birth weight, hyperbilirubinemia, and bacterial meningitis; neonatal intensive care unit (NICU) admission for > 5 days; exchange transfusion; and ototoxic drug use (aminoglycosides or loop diuretics), between the hearing disability and control groups. RESULTS: The total number of newborns came to 3,164,825. Risk factors were sought in a hearing disability group (n = 847) compared to a control group (n = 2508). A diagnosed disability other than a hearing disability, which was commonly a brain lesion, the use of ototoxic drugs, NICU admission for >5 days, and a maternal disability at delivery, which was commonly a hearing disability, were significant neonatal and maternal risk factors for HL in children. CONCLUSIONS: Accompanying brain lesions, maternal hearing disabilities at delivery, use of ototoxic drugs during the neonatal period, and hospitalization in NICU for >5 days were significant risk factors for HL in children, as revealed by analysis of population-based data.


Assuntos
Potenciais Evocados Auditivos do Tronco Encefálico , Perda Auditiva , Criança , Feminino , Perda Auditiva/epidemiologia , Perda Auditiva/etiologia , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Triagem Neonatal , Gravidez , República da Coreia/epidemiologia , Estudos Retrospectivos , Fatores de Risco
16.
Sci Rep ; 11(1): 13535, 2021 06 29.
Artigo em Inglês | MEDLINE | ID: mdl-34188137

RESUMO

As the novel coronavirus (COVID-19) has spread globally, a significant portion of pregnant and delivering women were infected with COVID-19. While emerging studies examined birth outcomes in COVID-19 positive women, knowledge of the psychological experience of childbirth and maternal wellness remains lacking. This matched-control survey-based study included a sample of women recruited during the first wave of the pandemic in the US who gave birth in the previous six months. Women reporting confirmed/suspected COVID-19 (n = 68) during pregnancy or childbirth were matched on background factors with women reporting COVID-19 negativity (n = 2,276). We found nearly 50% of COVID positive women endorsed acute traumatic stress symptoms at a clinical level in response to childbirth. This group was more than twice as likely to endorse acute stress and to have no visitors during maternity hospitalization than COVID negative women; they were also less likely to room-in with newborns. The COVID positive group reported higher levels of pain in delivery, lower newborn weights, and more infant admission to neonatal intensive care units. Our findings suggest COVID-19 affected populations are at increased risk for traumatic childbirth and associated risk for psychiatric morbidity. Attention to delivering women's wellbeing is warranted during the pandemic.


Assuntos
COVID-19/psicologia , Parto/psicologia , Gestantes/psicologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Adulto , Ansiedade/diagnóstico , Peso ao Nascer , COVID-19/diagnóstico , COVID-19/virologia , Feminino , Hospitais , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Dor/patologia , Admissão do Paciente/estatística & dados numéricos , Gravidez , SARS-CoV-2/isolamento & purificação , Estresse Psicológico , Inquéritos e Questionários
17.
Pediatr Surg Int ; 37(8): 1069-1078, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34059928

RESUMO

PURPOSE: To describe the epidemiology and referral patterns of gastroschisis patients in northern Ghana. METHODS: A hospital-based retrospective review was undertaken at Tamale Teaching Hospital (TTH) Neonatal Intensive Care Unit (NICU) between 2014 and 2019. Data from gastroschisis patients were compared to patients with other surgical diagnoses. Descriptive and inferential statistics were performed with SAS. Referral flow maps were made with ArcGIS. RESULTS: From a total of 360 neonates admitted with surgical conditions, 12 (3%) were diagnosed with gastroschisis. Around 91% (n = 10) of gastroschisis patients were referred from other hospitals, traveling 4 h, on average. Referral patterns showed gastroschisis patients were admitted from three regions, whereas patients with other surgical diagnoses were admitted from eight regions. Only 6% (12/201) of expected gastroschisis cases were reported during the 6-year period in all regions. All gastroschisis deaths occurred within the first week of life. CONCLUSIONS: Improving access to surgical care and reducing neonatal mortality related to gastroschisis in northern Ghana is critical. This study provides a baseline to inform future gastroschisis interventions at TTH. Priority areas may include special management of low birth weight newborns, better referral systems, empowerment of community health workers, and increasing access to timely, affordable, and safe neonatal transport.


Assuntos
Gastrosquise/mortalidade , Acesso aos Serviços de Saúde/normas , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Encaminhamento e Consulta/normas , Estudos de Casos e Controles , Feminino , Gastrosquise/cirurgia , Gana/epidemiologia , Mortalidade Hospitalar , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido de Baixo Peso , Recém-Nascido , Masculino , Estudos Retrospectivos
18.
Comput Biol Med ; 134: 104521, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34111664

RESUMO

Premature birth is the primary risk factor in neonatal deaths, with the majority of extremely premature babies cared for in neonatal intensive care units (NICUs). Mortality risk prediction in this setting can greatly improve patient outcomes and resource utilization. However, existing schemes often require laborious medical testing and calculation, and are typically only calculated once at admission. In this work, we propose a shallow hybrid neural network for the prediction of mortality risk in 3-day, 7-day, and 14-day risk windows using only birthweight, gestational age, sex, and heart rate (HR) and respiratory rate (RR) information from a 12-h window. As such, this scheme is capable of continuously updating mortality risk assessment, enabling analysis of health trends and responses to treatment. The highest performing scheme was the network that considered mortality risk within 3 days, with this scheme outperforming state-of-the-art works in the literature and achieving an area under the receiver-operator curve (AUROC) of 0.9336 with standard deviation of 0.0337 across 5 folds of cross-validation. As such, we conclude that our proposed scheme could readily be used for continuously-updating mortality risk prediction in NICU environments.


Assuntos
Unidades de Terapia Intensiva Neonatal , Redes Neurais de Computação , Peso ao Nascer , Feminino , Idade Gestacional , Humanos , Lactente , Recém-Nascido , Gravidez , Medição de Risco , Fatores de Risco
19.
Sci Rep ; 11(1): 12999, 2021 06 21.
Artigo em Inglês | MEDLINE | ID: mdl-34155278

RESUMO

An ever-increasing number of medical staff use mobile phones as a work aid, yet this may pose nosocomial diseases. To assess and report via a survey the handling practices and the use of phones by paediatric wards healthcare workers. 165 paediatric healthcare workers and staff filled in a questionnaire consisting of 14 questions (including categorical, ordinal and numerical data). Analysis of categorical data used non-parametric techniques such as the Chi-squared test. Although 98% of respondents (165 in total) report that their phones may be contaminated, 56% have never cleaned their devices. Of the respondents that clean their devices, 10% (17/165) had done so with alcohol swabs or disinfectant within that day or week; and an additional 12% respondents (20/165) within that month. Of concern, 52% (86/165) of the respondents use their phones in the bathroom, emphasising the unhygienic environments in which mobile phones/smartphones are constantly used. Disinfecting phones is a practice that only a minority of healthcare workers undertake appropriately. Mobile phones, present in billions globally, are therefore Trojan Horses if contaminated with microbes and potentially contributing to the spread and propagation of micro-organisms as per the rapid spread of SARS-CoV-2 virus in the world.


Assuntos
Aparelho Sanitário/virologia , COVID-19/prevenção & controle , Telefone Celular/instrumentação , Infecção Hospitalar/prevenção & controle , Atenção à Saúde/métodos , Desinfecção/métodos , Hospitais Pediátricos , Recursos Humanos em Hospital , SARS-CoV-2 , COVID-19/virologia , Infecção Hospitalar/virologia , Serviço Hospitalar de Emergência , Feminino , Higiene das Mãos , Humanos , Unidades de Terapia Intensiva Neonatal , Masculino , Fatores de Risco , Autorrelato
20.
BMC Infect Dis ; 21(1): 620, 2021 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-34187390

RESUMO

BACKGROUND: Candida pelliculosa is an ecological fungal species that can cause infections in immunocompromised individuals. Numerous studies globally have shown that C. pelliculosa infects neonates. An outbreak recently occurred in our neonatal intensive care unit; therefore, we aimed to evaluate the risk factors in this hospital-acquired fungal infection. METHODS: We performed a case-control study, analysing the potential risk factors for neonatal infections of C. pelliculosa so that infection prevention and control could be implemented in our units. Isolated strains were tested for drug resistance and biofilm formation, important factors for fungal transmission that give rise to hospital-acquired infections. RESULTS: The use of three or more broad-spectrum antimicrobials or long hospital stays were associated with higher likelihoods of infection with C. pelliculosa. The fungus was not identified on the hands of healthcare workers or in the environment. All fungal isolates were susceptible to anti-fungal medications, and after anti-fungal treatment, all infected patients recovered. Strict infection prevention and control procedures efficiently suppressed infection transmission. Intact adhesin-encoding genes, shown by genome analysis, indicated possible routes for fungal transmission. CONCLUSIONS: The use of three or more broad-spectrum antimicrobials or a lengthy hospital stay is theoretically associated with the risk of infection with C. pelliculosa. Strains that we isolated are susceptible to anti-fungal medications, and these were eliminated by treating all patients with an antifungal. Transmission is likely via adhesion to the cell surface and biofilm formation.


Assuntos
Biofilmes , Candidíase/epidemiologia , Candidíase/prevenção & controle , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/prevenção & controle , Surtos de Doenças/prevenção & controle , Equipamentos e Provisões/microbiologia , Unidades de Terapia Intensiva Neonatal , Saccharomycetales/genética , Antifúngicos/uso terapêutico , Candidíase/tratamento farmacológico , Candidíase/microbiologia , Estudos de Casos e Controles , China/epidemiologia , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/microbiologia , Feminino , Pessoal de Saúde , Humanos , Recém-Nascido , Controle de Infecções/métodos , Tempo de Internação , Masculino , Testes de Sensibilidade Microbiana , RNA Fúngico/genética , Fatores de Risco , Saccharomycetales/isolamento & purificação
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