4,687 research outputs found
Serum cortisol concentrations during induced hypothermia for perinatal asphyxia are associated with neurological outcome in human infants
No full textAbstract Birth asphyxia is a cause of neonatal death or adverse neurological sequelae. Biomarkers can be useful to clinicians in order to optimize intensive care management and communication of prognosis to parents. During perinatal adverse events, increased cortisol secretion is due to hypothalamo-pituitary-adrenal axis activation. We aimed to investigate if cortisol variations during therapeutic hypothermia are associated with neurodevelopmental outcome. We compared 18 cases (neonates with birth asphyxia) with 18 controls (healthy term newborns) and confirmed increased serum cortisol concentrations following the peri-partum adverse event. Among cases, we stratified patients according to neurological outcome at 18 months (group A - good; group B - adverse) and found that after 24 h of therapeutic hypothermia serum cortisol concentration was significantly lower in group A vs group B (28.7 ng/mL vs 344 ng/mL, *p = 0.01). In group B serum, cortisol concentration decreased more gradually during therapeutic hypothermia. We conclude that monitoring serum cortisol concentration during neonatal therapeutic hypothermia can add information to clinical evaluation of neonates with birth asphyxia; cortisol values after the first 24 h of hypothermia can be a biomarker associated with neurodevelopmental outcome at 18 months of age
Kangaroo mother care: four years of experience in very low birth weight and preterm infants.
No full textAbstract
AIM: Kangaroo Mother Care (KMC) is a method of providing care for preterm infants through skin-to-skin contact with the mother and, preferably, exclusive breastfeeding. The growing interest in KMC at the Neonatology Unit of Pisa has provided the occasion for a retrospective analysis of the last four years, comparing the clinical effects of the kangaroo method vs. those obtained with conventional care (CNC) with respect to indicators of the general health of the infants (indices of growth, and duration of breastfeeding and hospitalization).
METHODS: A total of 213 infants, aged <37 gestational weeks and weighing ≤1500 g were enrolled for the study; these were divided into two groups for the purpose of comparison (91 in KMC vs. 71 in CNC).
RESULTS: The indices of growth and the duration of the infants in hospital were not significantly different in the two groups. Nevertheless, it is worth noting how KMC is more efficacious in the very tiny VLBW infants, and that the means of the growth parameters in the KMC infants are greater than those referring to the CNC subjects, body temperatures taken at the beginning and end of a KMC session are higher, and that the mother-child relationship facilitates better sucking-feeding.
CONCLUSION: While KMC is equivalent to CNC in terms of safety, thermal protection, morbidity and auxologic development, it appears to promote humanisation of infant care and mother-child bond more quickly
A proposito di un caso di sindrome adreno-genitale con epatite gigantocellulare associata ad anemia emolitica. Diagnosi e terapia prenatale nella secondogenita affetta
No full textEducation in neonatology by simulation: between reality and declaration of intent
No full textAn unexpected event is not rare in Neonatology and can be dramatic: the operators must act with the right skills and abilities in the shortest time. Often it is a team effort and each member must be trained adequately. According to the "Swiss cheese" model by J. Reason, an accident is never the consequence of a single error, but the very final result of a chain of misunderstandings, irregularities or negligence (cheese holes): several holes allow the final medical error. Therefore, we should avoid those holes in our work. The clinical risk is always around the corner. The legal issues are becoming more and more relevant and lead to a defensive medicine, which is definitely not the best practice. For this reason, raising the safety standards is mandatory. With this purpose, after a decade of experience in "traditional" training courses, we started testing a new strategy of continuous education in Neonatology by means of high-fidelity simulation. Since 2008, we have arranged and managed a Center for Neonatal Simulation and Advanced Training in the Neonatology Unit of the University Hospital of Pisa. We have already delivered courses to pediatricians, neonatologists, anesthesiologists, gynecologists, emergency doctors, midwives and nurses, using an advanced Laerdal SimNewB simulator to teach diagnostic and therapeutic skills or communication strategies. The model has been proposed to the Italian Society of Neonatology and it has been decided to create a Task Force to discuss our model and encourage to use it in other Italian areas
Low testosterone levels in pre-term newborns born small for gestational age
No full textPrevious studies showed that small for gestational age (SGA) newborns have an increased prevalence of hypospadias and other congenital defects of external genitalia. We observed that in the first days of life, SGA male pre-term newborns have reduced testosterone levels compared with adequate for gestational age pre-term newborns, independently from the presence of abnormalities of the external genitalia. (J. Endocrinol. Invest. 33: 215-217, 2010) (C) 2010, Editrice Kurti
Agenesia renale unilaterale associata a malformazioni genitali e dismorfie faciali in un neonato maschio
No full textMEchatronic REspiratory System SImulator for Neonatal Applications (MERESSINA) project: a novel bioengineering goal
No full textRosa T Scaramuzzo,1,2 Massimiliano Ciantelli,1 Ilaria Baldoli,3 Lisa Bellanti,3 Marzia Gentile,1 Francesca Cecchi,3 Emilio Sigali,1 Selene Tognarelli,3 Paolo Ghirri,1–4 Stefano Mazzoleni,3 Arianna Menciassi,3 Armando Cuttano,1 Antonio Boldrini,1–4 Cecilia Laschi,3 Paolo Dario3 1Centro di Formazione e Simulazione Neonatale "NINA," UO Neonatologia, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy; 2Istituto di Scienze della Vita, 3The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy; 4Università di Pisa, Pisa, Italy Abstract: Respiratory function is mandatory for extrauterine life, but is sometimes impaired in newborns due to prematurity, congenital malformations, or acquired pathologies. Mechanical ventilation is standard care, but long-term complications, such as bronchopulmonary dysplasia, are still largely reported. Therefore, continuous medical education is mandatory to correctly manage devices for assistance. Commercially available breathing function simulators are rarely suitable for the anatomical and physiological realities. The aim of this study is to develop a high-fidelity mechatronic simulator of neonatal airways and lungs for staff training and mechanical ventilator testing. The project is divided into three different phases: (1) a review study on respiratory physiology and pathophysiology and on already available single and multi-compartment models; (2) the prototyping phase; and (3) the on-field system validation. Keywords: simulation, lung, newborn, continuous medical education, respiratory syste
Epidemiologia ambientale e molecolare delle malformazioni congenite dei genitali esterni: valutazione anamnestica dell’esposizione a endocrine disruptors e ricerca di polimorfismi genetici in un campione di pazienti con difetti minori
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