1,721,175 research outputs found
MOTAVIZUMAB FOR PROPHYLAXIS OF RESPIRATORY SYNCIYTIAL VIRUS IN HIGH-RISK CHILDREN: A NON INFERIORITY TRIAL
No full textOBJECTIVE: Palivizumab reduces respiratory syncytial virus (RSV) hospitalization in children at high risk by approximately 50% compared with placebo. We compared the efficacy and safety of motavizumab, an investigational monoclonal antibody with enhanced anti-RSV activity in preclinical studies, with palivizumab.
METHODS: This randomized, double-blind, multinational, phase 3, noninferiority trial assessed safety and RSV hospitalization in 6635 preterm infants aged <or=6 months at enrollment or children aged <or=24 months with chronic lung disease of prematurity who received 15 mg/kg palivizumab or motavizumab monthly. Secondary end points included outpatient medically attended lower respiratory tract infections (MALRIs), RSV-specific LRIs, otitis media, antibiotic use, development of antimotavizumab antibodies, and motavizumab serum concentrations.
RESULTS: Motavizumab recipients had a 26% relative reduction in RSV hospitalization compared with palivizumab recipients, achieving noninferiority. Motavizumab was superior to palivizumab for reduction of RSV-specific outpatient MALRIs (50% relative reduction). Overall, adverse events (AEs) were not significantly different between groups. Cutaneous events were reported in 2 percentage points more motavizumab recipients (7.2% vs 5.1%); most were mild, but 0.3% resulted in dosing discontinuation. Antidrug antibodies (ADA) were detected in 1.8% of motavizumab recipients. Patients with anti-drug antibody reported 6 RSV events and 17 cutaneous events.
CONCLUSIONS: Children receiving prophylaxis with motavizumab or palivizumab had low rates of RSV hospitalization; motavizumab recipients experienced 50% fewer RSV MALRIs than palivizumab recipients. AEs were similar in both groups, although cutaneous AEs were higher for motavizumab recipients. Motavizumab may offer an improved alternative in prophylaxis for serious RSV disease in infants and children at high risk
[Neonatological emergencies in delivery room] [Article in Italian] • Il neonatologo ed alcune emergenze in sala parto
No full textIntroduction: In the delivery room the neonatologist may deal with emergencies, not always predictable by pre-natal diagnosis. Among these dangerous situations, we include: i) extremely preterm birth of a newborn very/extremely low birth weight and ii) shoulder dystocia in term newborns. We will discuss in details these two clinical scenarios.
Methods: We reviewed the main recent papers about resuscitation of very/extremely low birth weight preterm newborns and about dystocia of shoulder reported in PubMed database. After that, we compared reported results with practice in our Unit and discussed the topics considering strategies to optimize the results and minimizing possible errors.
Discussion and conclusions: In our opinion the optimization of clinical practice in Neonatology should be based on: i) national or international recommendations drawn up by commissions or study groups of experts, on the basis of scientific evidence, ii) local department protocols, in order to standardize staff interventions within the same unit; iii) ongoing training of doctors, nurses and midwives, through simulation sessions and CRM (Crisis Resources Management). As regards shoulder dystocia, The Tuscan Group for Clinical Risk Management drawn a poster to be showed in every delivery room, in order to allow the staff to rapidly remember the correct clinical interventions. On the other hand, as regards ventilatory preterm newborns strategies, the Centro di Formazione e Simulazione NINA is working on a project of a mechatronich simulator for staff training (MERESSINA).
Articoli Selezionati del “3° Convegno Pediatrico del Medio Campidano” · Guspini · 25 Maggio 2013
Guest Editor: Roberto Antonucci
Keywords
preterm newborn; Delivery Room Intensive Care Unit (DRICU); alveolar recruitment; functional residual capacity (FRC); shoulder dystocia; simulatio
Babies born to mothers with thyroid disease
No full textThyroid dysfunctions are the second most common endocrine disorders complicating pregnancy after diabetes mellitus. Mater- nal thyroid dysfunctions are associated with miscarriage, pre- eclampsia, eclampsia, placental abruption and preterm delivery. As maternal thyroxine is essential for fetal neurodevelopment, until the foetal thyroid gland starts to produce thyroid hormones in the second trimester of gestation, reduced availability of maternal thy- roid hormones may impair neurogical development of the foetus. It has been reported decreased IQ in infants born to mothers with hypothyroidism or hypothyroxinemia
Rhythmical leg movements in low-risk and brain-damaged preterm infants
No full textThe characteristics of rhythmical kicking movements of preterm infants with documented brain damage (BD), who later showed a severe motor impairment, are described and compared with those of low-risk (LR) preterm infants. Spontaneous movements were videotaped for 60 min in the incubator or in a warmer. A first group of 6 BD and 6 LR infants was observed at 31-35 weeks of postmenstrual age (PMA) and a second group (6 BD, 6 LR) at 37-39 weeks. Bouts of rhythmical kicks, defined as leg movements repeated in the same form at least three times at regular short intervals, were analysed during periods of activity. The results indicated non-significant differences between BD and LR infants at 31-35 weeks of PMA. In contrast, some differences were observed at 37-39 weeks. These differences were not due to leg movement frequency, but to inter-leg coordination and to temporal organisation of the kicking cycles. LR infants exhibited more alternate-leg movements and fewer semi-both-leg movements (simultaneous flexion and non-simultaneous extension) than BD infants. In LR cases the duration of the pause between flexion and extension was shorter, whereas flexion and extension periods were similar for all infants. Although there were significant differences, quantitative analysis of kicking characteristics was not clinically useful because of the large overlap in findings between the two groups. On the other hand Gestalt evaluation of general movements of the same videorecordings showed a closer correlation with the presence of brain lesions and with neurological outcome
Linfoadeniti da germi piogeni, mycobatteri atipici,da Mycobacterium tubercolosis, graffio di gatto, toxoplasma condii.
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Improved efficacy of econazole in a murine model of vaginal candidiasis by the mucoadhesive polymer polycarbophil
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PROPHYLAXIS AND TREATMENT OF NEONATAL ISOIMMUNE THROMBOCYTOPENIA - DESCRIPTION OF 2 CASES
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