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Journal of Pediatric and Neonatal Individualized Medicine
Journal Prestige (SJR): 0.13
Number of Followers: 4  

  This is an Open Access Journal Open Access journal
ISSN (Online) 2281-0692
Published by Hygeia Press Homepage  [1 journal]
  • Risk factors for neonatal mortality in Neonatal Intensive Care Units
           (NICUs): a systematic literature review and comparison with scoring

    • Authors: Farzaneh Kermani, Abbas Sheikhtaheri, Mohammad Reza Zarkesh, Shahram Tahmasebian
      Abstract: Objective: To identify neonatal death risk factors in NICUs and compare these factors with current scoring systems. Data source: This review was conducted using Web of Science, PubMed/Medline, Scopus, and Cochrane library databases, considering papers published between 2007 and 2018. Study selection: Studies conducted on the neonatal mortality risk factors in NICUs were included. We identified 3,642 unique citations; 69 full-text articles were included in the final review. Data extraction: Data elements such as the first author, published year, country, purpose, data collection period, study design, sample size, and risk factors were extracted. Data synthesis: Ninety factors were identified in three categories: 25 maternal factors, 59 neonatal factors, and six organizational factors. In total, delivery mode, non-use of steroid or corticosteroid, birth weight, gestational age, Apgar score, hospital/NICU level, and outborn status are the most cited risk factors for neonatal death. Well-known scoring systems did not consider many of the identified factors. Conclusions: Determination of risk factors in neonatal death can help neonatologists identify sick neonates who are more likely to die in NICUs and provide on-time care at their bedsides. Researchers interested in developing predictive neonatal mortality models may also use the results of this study to develop models for predicting neonatal death.
      PubDate: 2020-10-31
      DOI: 10.7363/090226
      Issue No: Vol. 9, No. 2 (2020)
  • Selected Lectures of the Course “Take care of children”, 2nd Edition,
           Virtual Edition; Cagliari (Italy); October 31st, 2020

    • Authors: --- Various Authors
      Abstract: Selected Lectures of the Course “Take care of children”, 2nd Edition • Virtual Edition • PRENDERSI CURA DEI BAMBINI CON LA FITOTERAPIA E GLI INTEGRATORI ALIMENTARI • ISTRUZIONE PER L’USO, OPPORTUNITÀ E LIMITI • Cagliari (Italy) • October 31st, 2020   LECT 1 • Food supplements in pediatric daily clinical practice [Gli integratori alimentari nella pratica clinica quotidiana in età pediatrica] • D. Careddu (Novara, Italy) LECT 2 • Dangerous relationship between junk food, microbiota and neuro­development [Relazioni pericolose tra junk food, microbiota e neurosviluppo] • E. Lombardi Mistura (Bergamo, Italy) LECT 3 • How to read the label of a botanical food supplement [Come leggere l’etichetta di un integratore alimentare] • M. Biagi (Siena, Italy) LECT 4 • Plants extracts active on the immune system from immune modulation to allergies [Piante ed estratti vegetali attivi sul sistema immunitario dall’immuno­modulazione alle allergie] • O. Al Jamal (Cagliari, Italy) LECT 5 • Probiotics: an update [Novità in tema di probiotici] • S.A. Nervi (Milan, Italy) LECT 6 • Children and teenager’s stress: adaptogens rule [Gli adattogeni e lo stress psicofisico dal bambino all’adolescente] • G. Trapani (Sanremo, Italy)
      PubDate: 2020-10-30
      DOI: 10.7363/090244
      Issue No: Vol. 9, No. 2 (2020)
  • Selected Lectures of the 16th International Workshop on Neonatology,
           Virtual Edition; Cagliari (Italy); October 29th-30th, 2020

    • Authors: --- Various Authors
      Abstract: Selected Lectures of the 16th International Workshop on Neonatology • Virtual Edition • NEONATOLOGY: STEPS TOWARDS THE FUTURE IN THE COVID-19 ERA • Cagliari (Italy) • October 29th-30th, 2020   LECT 1 • Neonatal ventilation in the third millennium • C. Moretti, C. Gizzi (Rome, Italy) LECT 2 • COVID-19 in children: what did we learn' • M. Votto, R. Castagnoli, I. Brambilla, A. Licari, G.L. Marseglia (Pavia, Italy) LECT 3 • COVID-19, microbiota and lung-gut axis • V. Fanos, M.C. Pintus, M.A. Marcialis, R. Pintus (Cagliari, Italy) LECT 4 • Enteral nutrition for very preterm infants: the facts, the assumptions and the unknowns • B.W. Kramer (Maastricht, The Netherlands) LECT 5 • Lactoferrin in the prevention of viral infections: from molecular mechanisms to clinical implications • D. Peroni, G. Costagliola, E. Spada (Pisa, Italy) LECT 6 • Neonatal sepsis: present and future • K. Sarafidis (Thessaloniki, Greece) LECT 7 • The Neonatology after COVID-19 • F. Mosca, M. Fumagalli, P. Schiavolin, C. Pietrasanta, A. Ronchi, L. Pugni (Milan, Italy) LECT 8 • The development of immunity, from fetal life to newborn: where health begins • C. Salpietro, G. Ceravolo, C. Cuppari (Messina, Italy)
      PubDate: 2020-10-28
      DOI: 10.7363/090245
      Issue No: Vol. 9, No. 2 (2020)
  • A single-center study of the prevalence of breastfeeding at 6 months of
           previously sick neonates

    • Authors: Sudatip Kositamongkol, Kamolpun Muongsuwan, Sariya Prachukthum
      Abstract: Background: Human milk is recognized to be excellent nutrition for neonates. However, supporting breastfeeding in these hospitalized vulnerable infants entails many challenges. Data are lacking on breastfeeding duration and associated factors for breastfeeding continuation until 6 months, especially in a low-resource setting. Objectives: To determine the prevalence of breastfeeding for previously hospitalized neonates at least 6 months post-discharge and examine the factors associated with successful breastfeeding. Methods and study design: This is a prospective study. Mothers were eligible if their infant(s) had been admitted to Neonatal Units within the first 7 days of life. General demographic data and maternal perception scores were collected during admission. Telephone interviews on feeding practices were conducted every 2 months until 6 months post-discharge or at discontinuation of breastfeeding. Results: Of 87 mothers who completed follow-up, 91%, 71% and 57% were breastfeeding at 2, 4 and 6 months, respectively. The main reasons for discontinuation were maternal perceptions of insufficient milk supply and difficulty in returning to work. Mothers being the main caregivers, above-average family income and maternal perception on breastfeeding benefits and barriers were significant factors for successful breastfeeding for 6 months. Conclusions: Strategies to encourage breastfeeding are needed for all mothers who return to work and especially for low-income families.
      PubDate: 2020-10-27
      DOI: 10.7363/090208
      Issue No: Vol. 9, No. 2 (2020)
  • Conservative management of paraphimosis via telecommunication: an option
           in the COVID-19 era'

    • Authors: Ahmet Alyanak, Özer Ural Çakıcı
      Abstract: Paraphimosis is a urological emergency that is best managed by a manual reduction or incision of the narrowed band when manual reduction has failed. Facilitator options for this reduction are proposed, which are mostly involved in creating a hyperosmolar environment to decrease edema in the trapped prepuce. However, all series to date and the best of the authors’ knowledge have reported the reduction of the paraphimosis at hospital admission, either by manual maneuver or surgical interventions. In this report, we present two paraphimosis cases that were successfully managed by parent-education, close observation via telecommunication, and locally applied steroid and antihistaminic therapy.
      PubDate: 2020-10-13
      DOI: 10.7363/090235
      Issue No: Vol. 9, No. 2 (2020)
  • Stevens-Johnson Syndrome with marked mucous presentation

    • Authors: Inês Coelho, Sofia Baptista, Teresa Monteiro, Ana Cristina Fernandes, Ana Rita Pereira, Daniel Tiago, Maria João Virtuoso
      Abstract: Introduction: Stevens-Johnson Syndrome (SJS) is a rare mucocutaneous disease whose incidence increases with age and about 20% of cases occur in children and adolescents. Mortality reaches 5%. Case description: We present a male adolescent, 11 years old, admitted due to oral mucosa erosions, lips edema and erythema, enanthema, cutaneous target lesions and edemaciate, erythematous and exudative glans, treated with non-steroidal anti-inflammatory drugs one day before the onset of cutaneous symptoms. The diagnostic tests didn’t show alterations and microbiological tests and serologies were negative. The patient was admitted to the Pediatrics Department with diagnosis of SJS. He was hospitalized for 10 days with intravenous analgesia, mucositis solution and topical emollient, hydric and nutritional reinforcement. He exhibited successive improvement of lesions with complete resolution after 2 weeks. Conclusions: The diagnosis of SJS is clinical, with special emphasis to the use of drugs or the presence of previous infection. Its recognition is important so that clinical intervention can occur as early as possible, decreasing the likelihood of complications and death.
      PubDate: 2020-10-04
      DOI: 10.7363/090224
      Issue No: Vol. 9, No. 2 (2020)
  • Frequency of head and neck masses in the Iranian infants during a 21-year

    • Authors: Monir Moradzadeh Khiavi, Mohammad Taghi Haghi Ashtiani, Mohammad Javad Kharazi-Fard, Pegah Hosseinzadeh
      Abstract: Aim: Head and neck masses are common clinical findings in infants, children and adolescents. This retrospective study aimed to assess the frequency of head and neck masses in children younger than 2 years of age. Materials and methods: All medical files present in the Pathology Department of Children’s Medical Center in Tehran from 1995 to 2016 with the pathology report confirming head and neck mass in children 0-2 years of age were evaluated in this study. The masses were divided into three groups of congenital/developmental, inflammatory/reactive/infectious and neoplastic (benign/malignant) lesions. Data were analyzed using SPSS® version 22. Results: Among 15,572 children aged 0-2 years presenting to the Children’s Medical Center in Tehran, Iran, 413 patients (2.7%) showed head and neck masses with a higher frequency in males (1.2:1; p = 0.000). About half of the lesions were in the neck, and about one-third of the remaining lesions were in the oral cavity and salivary glands. Most lesions were congenital (40.7%) or inflammatory (34.9%). Hemangioma was the most common benign tumor. Among congenital lesions, dermoid cyst and branchial cleft cyst and among inflammatory lesions, lymphadenitis and lymphoid tissue hyperplasia were the most common. The overall prevalence of malignant neoplasms was 3.6%, and rhabdomyosarcoma had a high frequency. Mucocele was the most common oral inflammatory mass. Conclusion: The results showed variations in the frequency of head and neck masses, especially malignancies, in children under the age of 2 compared with older children. Since children comprise one-fourth of the population, the frequency of head and neck masses must be separately determined for each age group.
      PubDate: 2020-10-03
      DOI: 10.7363/090210
      Issue No: Vol. 9, No. 2 (2020)
  • Risk factors for neonatal sepsis: an overview

    • Authors: Beatriz C. Araújo, Hercília Guimarães
      Abstract: Neonatal sepsis is still a significant cause of mortality and morbidity at the Neonatal Intensive Care Unit (NICU) and an important cause of long hospitalization time, even though it has diminished with the improvement of neonatal care. The aim of this study was to systematically review data on the risk factors for neonatal sepsis, so that the incidence of neonatal sepsis can be minimized.
      A PubMed literature search for all relevant studies from 1999 to 2019 was conducted and after a first analysis based on titles and abstracts and a second analysis based on the full texts, a total of 35 articles were selected to review.
      Based on the evidence extracted from these articles, the risk factors for neonatal sepsis can be divided into three categories: maternal factors, neonatal factors and factors associated with the NICU. Thus, the identified maternal risk factors were premature rupture of membranes and maternal infection. In terms of neonatal risk factors, prematurity, low birth weight, low Apgar score, meconium-stained amniotic fluid, birth asphyxia, not crying immediately after birth and need for resuscitation were the primary risk factors identified. Regarding the NICU, the central venous catheter was the most isolated risk factor, both its use and duration, followed by mechanical ventilation and parenteral nutrition.
      However, some variable results were inconsistent, which reinforces the need for further multicenter studies to evaluate these risk factors in order to understand their association with neonatal sepsis, so that preventive measures can be implemented.
      PubDate: 2020-10-02
      DOI: 10.7363/090206
      Issue No: Vol. 9, No. 2 (2020)
  • Trends in respiratory management and morbidities of very preterm or very
           low birth weight infants from 2000 to 2013: results from a Portuguese
           tertiary level Neonatal Intensive Care Unit

    • Authors: Rui Pinto-Lopes, Sara Abreu-Pereira, Gustavo Rocha, Filipa Flor-de-Lima, Carina Rodrigues, Gorett Silva, M. Beatriz Guedes, Hercília Guimarães
      Abstract: Summary: Considerable progress has been made regarding children’s morbidity and mortality. Nonetheless, recent developments have been insufficient to meet set targets. This study aims to evaluate trends and outcomes in respiratory management following a 14-year collaboration with the Vermont Oxford Network (VON).
      Methods: Data were collected prospectively at a Level III NICU in the North of Portugal and submitted to the VON between 2000 and 2013. The primary outcome was bronchopulmonary dysplasia (BPD). Pneumothorax and respiratory distress syndrome were secondary outcomes.
      Results: A total of 323 very low birth weight infants hospitalised in our centre met the inclusion criteria. Significant changes were observed with supplemental oxygen use and endotracheal intubation decreasing, whilst surfactant use rose. Conventional ventilation techniques at any time were used less often. No differences in the rates of BPD were observed.
      Conclusion: A review of current practice has led to a more cautious approach, privileging less invasive ventilatory techniques and pondered oxygen supplementation, albeit with no significant improvement in the evaluated respiratory outcomes.
      PubDate: 2020-09-16
      DOI: 10.7363/090215
      Issue No: Vol. 9, No. 2 (2020)
  • Vein of Galen malformation: prenatal diagnosis, postnatal monitoring and

    • Authors: Francisca Calheiros-Trigo, Alexandra Cadilhe, João Reis, Nicole Silva, Almerinda Pereira
      Abstract: Vein of Galen aneurysmal malformation (VGAM) is a very rare congenital vascular malformation. Also known as the “median prosencephalic arteriovenous fistula”, VGAM is a subtype of dural arteriovenous fistula. It is believed that the development of VGAM occurs between weeks 6 and 11 of embryo development. Prenatal diagnosis is based on fetal ultrasound, between the second and third trimesters. Despite prenatal diagnosis, this congenital malformation is associated with high morbidity and mortality. We report the case of a 38-year-old primigravida referred at 32 weeks of gestational age to our Prenatal Diagnosis Unit for a suspected VGAM. The remaining fetal assessment was normal. At 38 weeks, a male newborn weighing 3,825 g was born. The postnatal evaluation confirmed VGAM. Endovascular treatment was performed at 4 and 5 months, without complications. The patient is currently 9 months old and has a normal neurodevelopment.
      PubDate: 2020-09-16
      DOI: 10.7363/090217
      Issue No: Vol. 9, No. 2 (2020)
  • Spontaneous depressed skull fracture in a neonate

    • Authors: Francisca Calheiros-Trigo, Maria João Machado, Rui Almeida, Nicole Silva, Almerinda Pereira
      Abstract: The most common cause of neonatal skull fracture is trauma from instruments used during an assisted birth. In the literature, there are limited reports of neonatal depressed skull fractures (DSF) in the absence of birth trauma. The diagnosis is based on clinical and radiological findings. We present the case of a female neonate, born full-term after a eutocic delivery. The pregnancy was unremarkable. There was no history of trauma during pregnancy or delivery. At birth, a congenital depression in the right parietal region was noted. Head computed tomography revealed a right parietal depressed fracture, without underlying brain lesion. Surgical elevation was performed with favourable outcome. There were no complications. The patient is currently 9 months old and has a normal neurodevelopment.
      PubDate: 2020-09-10
      DOI: 10.7363/090216
      Issue No: Vol. 9, No. 2 (2020)
  • Neonatal femoral artery thrombosis at the time of birth: a case report

    • Authors: Orestis Tsonis, Thodoris Gouvias, Fani Gkrozou, Ioanna Antonopoulou, Anastasia Giantsouli, Minas Paschopoulos, Maria Baltogianni
      Abstract: Neonatal thrombosis is a relatively common disease/condition and most often associated with predisposing genetic factors, underlying medical disorders and acquired trigger factors, such as iatrogenic interventions. Perinatal femoral artery thrombosis with no underlying risk factors has not been presented in the international literature. There has been no evidence of perinatal artery thrombosis with no underlying risk factors in the international literature.
      In this case presentation, a neonate was born via normal vaginal delivery at 39+4 weeks of gestation, in an otherwise uncomplicated pregnancy without risk factors, with marked discoloration of right lower abdomen and right lower limb, initially pale and eventually evolving to cyanotic. At the time of birth, such clinical presentation was a challenge to clinicians regarding diagnosis. The absence of right-sided palpable femoral pulses raised suspicion and led to a diagnostic approach primarily including ultrasonography.
      A right femoral blood clot blocking blood flow and resulting in the pale right lower limb was revealed via Doppler ultrasound. Screening test for thrombophilia was negative and neonatal arterial patency was achieved after administration of Low Molecular Weight Heparin (LMWH). After a 6-week course of treatment, vascular latency was fully restored and confirmed by ultrasound on day 10 post-partum. Clinicians should be aware of this unusual event that can be detrimental and endanger limb survival if immediate further action is not taken. Neonatal thrombosis can occur even at the time of birth; thus, clinicians should be alert in cases of neonates born with pale extremities. Low-risk cases could still pose a great threat to the survival of an extremity if appropriate action is not taken.
      PubDate: 2020-09-08
      DOI: 10.7363/090214
      Issue No: Vol. 9, No. 2 (2020)
  • Congenital ocular anomalies in newborns: a practical atlas

    • Authors: Federico Mecarini, Vassilios Fanos, Giangiorgio Crisponi
      Abstract: All newborns should be examined for ocular structural abnormalities, an essential part of the newborn assessment. Early detection of congenital ocular disorders is important to begin appropriate medical or surgical therapy and to prevent visual problems and blindness, which could deeply affect a child’s life. The present review aims to describe the main congenital ocular anomalies in newborns and provide images in order to help the physician in current clinical practice.
      PubDate: 2020-09-04
      DOI: 10.7363/090207
      Issue No: Vol. 9, No. 2 (2020)
  • Venous thrombosis in a 36-day-old infant with transposition of the great
           arteries and supraventricular tachycardia

    • Authors: Rand Abdul Haleem Almuhyi
      Abstract: Pediatric venous thromboembolism (VTE), although uncommon, can lead to serious morbidity and mortality. Cyanotic congenital heart diseases are one of the most common causes of VTE in children, especially when it is associated with other risk factors for thrombosis.
      We therefore report a case of right femoral vein thrombosis in a 36-day-old infant with transposition of the great arteries who had supraventricular tachycardia and bronchopneumonia.

      PubDate: 2020-05-31
      DOI: 10.7363/090204
      Issue No: Vol. 9, No. 2 (2020)
  • Impact of acute cardiovascular collapse on cerebral electrical activity:
           importance of heart-brain interaction

    • Authors: Kristin L. Riley, Heidi M. Harmon, Brady A. Thomas, Adrianne R. Bischoff, Regan E. Giesinger, Patrick J. McNamara
      Abstract: A preterm infant experienced pericardial tamponade due to a deep central line. During the event the patient was on neurological monitoring, ampli­tude integrated electroencephalogram (aEEG), which demonstrated abnormal baseline activity during the point of cardiovascular collapse with improvement once intervention occurred with pericardiocentesis. The case highlights the value of neurological monitoring in acute hemodynamic instability.
      PubDate: 2020-05-27
      DOI: 10.7363/090205
      Issue No: Vol. 9, No. 2 (2020)
  • Epidemiology of SARS-CoV-2: numbers matter!

    • Authors: Giorgia Casti, Pier Paolo Bassareo, Marco Limone, Filippo Pistolesi, Vassilios Fanos, Maria Antonietta Marcialis
      Abstract: The ongoing pandemic is the result of the spread of a recently identified Coronavirus, named SARS-CoV-2 (Severe Acute Respiratory Syndrome – Coronavirus – 2).
      Since 31th December 2019, when the first cluster was reported in Wuhan (China), the global Novel COronaVIrus Disease 2019 (COVID-19) cases significantly increased, and on 12th March 2020, the WHO Director declared the disease as pandemic.
      As of April 28th 2020, 2.982,688 cases and 210,193 deaths were reported globally.
      The aim of this article is the analysis of the main epidemiological characteristics of the current pandemic: transmission, basic reproduction number (R0), incubation period, global, European and Italian confirmed cases and deaths, focusing on the paediatric population.

      PubDate: 2020-05-20
      DOI: 10.7363/090203
      Issue No: Vol. 9, No. 2 (2020)
  • The importance of laboratory medicine in the era of COVID-19 pandemic: a
           challenge for patients, pediatricians, obstetricians, and clinical

    • Authors: Michele Mussap
      Abstract: The dramatic and rapid widespread of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection is causing millions of infected subjects and thousand of deaths worldwide. The current global goal is to mitigate or suppress the burden of COronaVIrus Disease 2019 (COVID-19) and to adopt effective targeted therapies. Laboratory tests include molecular diagnostics and viral antigens recognition for the identification of SARS-CoV-2 in human biological materials, serologic methods for detecting serum antibodies against SARS-CoV-2 and routine blood and urine tests. Many molecular tests, mainly based on real-time polymerase chain reaction (RT-PCR), have been developed after the publication of the SARS-CoV-2 full-length genome sequence; several factors may affect their accuracy, including inadequate sample collection, thermal inactivation, viral load, and cross-reactivity. In-vitro diagnostic (IVD) companies have developed serologic methods optimized on high throughput analytical platforms; however very few methods currently detect IgM and the accurate quantitative measurement of antibodies are not still ready. Sensitivity and specificity require robust validation; point of care (POC) lateral flow immunochromatographic assays are far to be highly sensitive and specific and data obtained by these methods should be evaluated with caution. The effectiveness of serologic tests depends on the appropriateness of test request too. Routine biochemical data in adults with COVID-19 reveal alterations of various tests, including lymphopenia, thrombocytopenia, hypoalbuminemia, and serum elevation of several biomarkers, including D-dimer, ferritin, C-reative protein (CRP), cytokines. Cardiac troponins and N-terminal pro-brain natriuretic peptide (NT-pro BNP) are predictors of adverse outcome and death. Vertical transmission of SARS-CoV-2 has been not yet demonstrated exhaustively. Regrettably, in pregnant women, newborns and children with COVID-19, very limited and confusing data hamper a definitive conclusion on the value of routine laboratory tests. Emerging opportunities arise from the introduction of microbiomics, metabolomics, and pharmacometabolomics for improving patient’s care and outcome.

      PubDate: 2020-05-16
      DOI: 10.7363/090201
      Issue No: Vol. 9, No. 2 (2020)
  • MEDNIK syndrome: a new entry in the spectrum of inborn errors of copper

    • Authors: Gavino Faa, Clara Gerosa, Massimo Castagnola
      Abstract: Copper homeostasis, including intestinal absorption, blood transport, uptake, trafficking and excretion, is regulated by multiple genes encoding for specific copper transporters, which coordinate copper bioavailability. Mutations in genes coding for copper pumps or copper chaperons are responsible for copper overload or deficiency, with relevant consequences on cell structure and human health. The spectrum of genetic disorders of copper metabolism includes multiple entities, characterized by different clinical presentation, with liver and brain as target organs.
      In recent years, a new autosomal recessive muco-cutaneous syndrome characterized by Mental retardation, Enteropathy, Deafness, peripheral Neuropathy, Icthiosis and Keratodermia (MEDNIK) has been described in several French-Canadian families.
      Regarding the molecular pathways involved in MEDNIK syndrome, AP1S1 has been identified as the pivotal gene involved in the correct functioning of AP-1 complex, which is responsible for the crosstalk between the trans-Golgi network and the other endosomes.
      MEDNIK syndrome opens a new field of human pathology, that has been called “adaptinopathies” including all congenital diseases associated with mutations in genes coding for adaptor complexes subunits. Moreover, the report of MEDNIK syndrome induces to focus on the developing spectrum of inborn errors of copper metabolism, where at least eight diseases may be included.
      PubDate: 2020-05-14
      DOI: 10.7363/090202
      Issue No: Vol. 9, No. 2 (2020)
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