A nurse-driven algorithm to screen for congenital heart defects in asymptomatic newborns.

Routine pulse oximetry screening (POS) performed on asymptomatic newborns after 24 hours of life, but before hospital discharge, may detect critical congenital heart defects (cCHD) when used as an adjunct to physical examination. Timely identification of this small percentage of newborns prompts early intervention and improves outcomes. New-generation, highly accurate pulse oximeters provide a simple, low-risk, low-cost tool to improve detection of potentially lethal cardiac lesions. The purpose of this study was to develop, implement, and test the utility of a nurse-driven algorithm that would support and serve as a guide for detection of cCHD in asymptomatic newborns using POS prior to discharge home from the hospital. Results showed that this collaborative protocol was easily implemented in a community hospital. The universal algorithm enhances POS and clinical examination to identify asymptomatic infants with undiagnosed cCHD prior to discharge from the hospital.

Staphylococcus aureus Septicemia with a fatal transmural myocardial infarction in a 27-week-gestation twin infant: a case study.

Septicemia, one of the major causes of morbidity and mortality in the neonatal period, often has a rapid and fulminant course. Low-birth-weight infants with persistent Staphylococcus aureus septicemia, possibly associated with percutaneous central venous catheters, may develop metastatic infections including endocarditis with large vegetations. This article describes a neonate with S. aureus bacteremia that resolved with treatment who died secondary to decreased left ventricular function. At autopsy, organizing microthrombi were seen within both atria, the left ventricle, and the left coronary arterial system. Extensive infarcts were noted throughout the entire myocardium of the left ventricle. It was suspected, but not proven, that the thrombotic sequelae from septicemia caused this neonate's death.

Coping with prostate cancer: a meta-analytic review.

The present meta-analytic review assessed the relations between coping categories and indices of adjustment in men with prostate cancer. Relevant methodological and statistical information was extracted from 33 target studies (n = 3,133 men with prostate cancer). Men with prostate cancer who used approach, problem-focused, and emotion-focused coping were healthier both psychologically and physically, although the effect sizes for problem-focused coping and emotion-focused coping were more modest. For approach coping these effect sizes were particularly strong for measures of self-esteem, positive affect, depression, and anxiety. Conversely, men with prostate cancer who used avoidance coping experienced heightened negative psychological adjustment and physical health, and particularly for measures of positive mood and physical functioning. The findings of this study suggest that active approaches to coping with prostate cancer are beneficial psychologically, physically, and are positively associated with a return to pre-cancer activities.