The Experts below are selected from a list of 165 Experts worldwide ranked by ideXlab platform
Subramaniam Sivasangari - One of the best experts on this subject based on the ideXlab platform.
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specialist teams for neonatal transport to neonatal intensive care units for prevention of morbidity and mortality
Cochrane Database of Systematic Reviews, 2015Co-Authors: Alvin Sm Chang, Andrew Berry, Lisa J Jones, Subramaniam SivasangariAbstract:Background Maternal antenatal transfers provide better neonatal outcomes. However, there will inevitably be some infants who require acute transport to a neonatal intensive care unit (NICU). Because of this, many institutions develop services to provide neonatal transport by specially trained health personnel. However, few studies report on relevant clinical outcomes in infants requiring transport to NICU. Objectives To determine the effects of specialist transport teams compared with non-specialist transport teams on the risk of neonatal mortality and morbidity among High-Risk Newborn infants requiring transport to neonatal intensive care. Search methods We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2015, Issue 7), MEDLINE (1966 to 31 July 2015), EMBASE (1980 to 31 July 2015), CINAHL (1982 to 31 July 2015), conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. Selection criteria Study design: randomised, quasi-randomised or cluster randomised controlled trials. Population: neonates requiring transport to a neonatal intensive care unit. Intervention: transport by a specialist team compared to a non-specialist team. Outcomes: any of the following outcomes — death; adverse events during transport leading to respiratory compromise; and condition on admission to the neonatal intensive care unit. Data collection and analysis The methodological quality of the trials was assessed using the information provided in the studies and by personal communication with the author. Data on relevant outcomes were extracted and the effect size estimated and reported as risk ratio (RR), risk difference (RD), number needed to treat for an additional beneficial outcome (NNTB) or number needed to treat for an additional harmful outcome (NNTH) and mean difference (MD) for continuous outcomes. Data from cluster randomised trials were not combined for analysis. Main results One trial met the inclusion criteria of this review but was considered ineligible owing to serious bias in the reporting of the results. Authors' conclusions There is no reliable evidence from randomised trials to support or refute the effects of specialist neonatal transport teams for neonatal retrieval on infant morbidity and mortality. Cluster randomised trial study designs may be best suited to provide us with answers on effectiveness and clinical outcomes.
Shimaa Fetouh Elbakly - One of the best experts on this subject based on the ideXlab platform.
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Plasma Protein Z Levels in Healthy and High-Risk Newborn Infants
American Journal of Bioscience and Bioengineering, 2014Co-Authors: Ahmed Anower Khattab, Fathia Mohamed El Nemr, Rania Salah El Zayat, Mohmmed Soliman Rizk, Shimaa Fetouh ElbaklyAbstract:Objectives: To evaluate plasma protein Z (PZ) levels in healthy and High-Risk Newborn infants. Background: Protein Z (PZ) is a vitamin K-dependent plasma protein , As is the case with other coagulation proteins and inhibitors, protein Z is consumed during disseminated intravascular coagulation (DIC), Functionally protein Z has been shown to be a direct requirement for the binding of thrombin to endothelial phospholipids , Protein Z also serves as a cofactor for the inhibition of coagulation factor Xa by a plasma serein called protein Z-dependent protease inhibitor (ZPI), The inhibitory function is exerted by the Protein Z- dependent protease inhibitor (ZPI), which circulates in the human plasma in a complex with PZ , The physiological function of protein Z is still rather ill-defined and may play role in high risk Newborn. Methods: This study was conducted on 85 Newborns divided in 4 groups ,(group I Newborns affected by respiratory distress syndrome (RDS) , group II Newborns from mothers with pre-eclampsia, group III Newborns small for gestational age (SGA) and group IV healthy term and preterm Newborns normal for gestational age. Newborns with sepsis, congenital malformation or hemorrhagic disorders were excluded, Plasma PZ levels was measured. Results: In the neonates of the study groups, protein z level was significant lower in patient group than control group, in group I ( 0.79 ±0.32), group II (0.70± 0.30), group III (0.78 ±0.32) and group IV (1.44 ±0.43) (p value
Michael Obladen - One of the best experts on this subject based on the ideXlab platform.
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Umbilical venous erythropoietin and umbilical arterial pH in relation to morphologic placental abnormalities.
Obstetrics and gynecology, 1994Co-Authors: Rolf F Maier, Günther A, Martin Vogel, Joachim W. Dudenhausen, Michael ObladenAbstract:OBJECTIVE To investigate the relation between the biochemical markers of umbilical venous erythropoietin and umbilical arterial pH and morphologic placental abnormalities in fetal hypoxia. METHODS Placentas from 300 High-Risk Newborn infants (gestational age 24-42 weeks) were examined macroscopically and microscopically following standardized criteria. The morphologic findings were correlated with the erythropoietin concentration in umbilical venous blood and with umbilical arterial pH at birth. Venous hematocrit and circulating nucleated red blood cells were measured in 112 of these infants during the first 6 hours of life. RESULTS The umbilical venous erythropoietin concentration correlated significantly (r = 0.74) with the number of circulating nucleated red blood cells. In 26 placentas without morphologic abnormalities, the median (and 25th and 75th percentiles) erythropoietin concentration was 35.2 mU/mL (19.2-48.7) and umbilical arterial pH was 7.30 (7.20-7.33). The erythropoietin concentration was elevated significantly when placental examination showed evidence of acute villous circulatory disturbance (61.3 mU/mL; 24.2-125.1), fetal vasculopathy (85.6 mU/mL; 23.7-119.7), or chorioamnionitis with fetal reaction (51.3 mU/mL; 27.7-118.7). The erythropoietin concentration varied significantly with the stage of placental meconium phagocytosis; it was 62.7 mU/mL (16.3-125.9) if meconium phagocytosis was classified as recent, 128.2 mU/mL (44.4-1483.2) if it was classified as a few hours old, and 66.2 mU/mL (46.3-140.1) if it was classified as a few days old. Umbilical arterial pH was not altered significantly with different morphologic placental abnormalities. CONCLUSIONS Fetal erythropoietin production is stimulated by hypoxia after a few hours' delay and leads to increased erythropoiesis. Placental examination combined with measurement of umbilical venous erythropoietin and umbilical arterial pH provides information about earlier fetal hypoxia.
Alvin Sm Chang - One of the best experts on this subject based on the ideXlab platform.
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specialist teams for neonatal transport to neonatal intensive care units for prevention of morbidity and mortality
Cochrane Database of Systematic Reviews, 2015Co-Authors: Alvin Sm Chang, Andrew Berry, Lisa J Jones, Subramaniam SivasangariAbstract:Background Maternal antenatal transfers provide better neonatal outcomes. However, there will inevitably be some infants who require acute transport to a neonatal intensive care unit (NICU). Because of this, many institutions develop services to provide neonatal transport by specially trained health personnel. However, few studies report on relevant clinical outcomes in infants requiring transport to NICU. Objectives To determine the effects of specialist transport teams compared with non-specialist transport teams on the risk of neonatal mortality and morbidity among High-Risk Newborn infants requiring transport to neonatal intensive care. Search methods We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2015, Issue 7), MEDLINE (1966 to 31 July 2015), EMBASE (1980 to 31 July 2015), CINAHL (1982 to 31 July 2015), conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. Selection criteria Study design: randomised, quasi-randomised or cluster randomised controlled trials. Population: neonates requiring transport to a neonatal intensive care unit. Intervention: transport by a specialist team compared to a non-specialist team. Outcomes: any of the following outcomes — death; adverse events during transport leading to respiratory compromise; and condition on admission to the neonatal intensive care unit. Data collection and analysis The methodological quality of the trials was assessed using the information provided in the studies and by personal communication with the author. Data on relevant outcomes were extracted and the effect size estimated and reported as risk ratio (RR), risk difference (RD), number needed to treat for an additional beneficial outcome (NNTB) or number needed to treat for an additional harmful outcome (NNTH) and mean difference (MD) for continuous outcomes. Data from cluster randomised trials were not combined for analysis. Main results One trial met the inclusion criteria of this review but was considered ineligible owing to serious bias in the reporting of the results. Authors' conclusions There is no reliable evidence from randomised trials to support or refute the effects of specialist neonatal transport teams for neonatal retrieval on infant morbidity and mortality. Cluster randomised trial study designs may be best suited to provide us with answers on effectiveness and clinical outcomes.
Candi Jump - One of the best experts on this subject based on the ideXlab platform.
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growth in the high risk Newborn infant post discharge results from a neonatal intensive care unit nutrition follow up clinic
Nutrition in Clinical Practice, 2020Co-Authors: Xiaoyi Zhang, Brynn Donnelly, Jessina Thomas, Lauren Sams, Karen Obrien, Sarah N Taylor, Candi JumpAbstract:Growth and nutrition in preterm infants have long-term implications for neurodevelopmental and cardiometabolic outcomes. Many infants are discharged from the neonatal intensive care unit (NICU) with growth restriction, but often without a specialized team to monitor postdischarge growth. At our institution, we addressed our ongoing concerns for the health and growth of these infants post-discharge by creating a Nutrition NICU Graduate Clinic. This clinic serves infants discharged from our NICU who were born with very low birth weight, had difficulty growing or feeding while inpatient, had a gastrostomy tube placed during hospitalization, or were deemed high risk for other reasons by our neonatal team, with the first clinic visit within 5 weeks of discharge. Data from our first 227 patients at time of discharge, first clinic visit, and any available second clinic visits are described. Anthropometrics show a high rate of extrauterine growth restriction at time of discharge with continued growth restriction at follow-up. Feeding regimens prescribed at discharge and variations from the prescribed regimen at time of follow-up are described. At time of first clinic visit, most patients (92.2%) required a medical or dietary intervention by our team. Our findings illustrate the need for early and specialized nutrition follow-up in this patient population to improve growth trajectory post-discharge.