Feeding of Low Birth Weight Neonates

2020 ◽  
Vol 34 (1-2) ◽  
pp. 28-51
Author(s):  
Nishanth Banait ◽  
Sriparna Basu ◽  
Prakash Desai ◽  
Sourabh Dutta ◽  
Ashok Kumar ◽  
...  

Nutrition in this critical period is essential for immediate outcomes such as changes in anthropometry (weight, length, and head circumference) as well as adverse effects like necrotizing enterocolitis. Nutrition also affects long-term adverse outcomes such as developmental delay, diplegic cerebral palsy, and death during infancy and childhood. This review has looked for the effects of nutrition in these areas. Further long-term outcomes like risk of adult onset diseases like myocardial infarction and stroke may also be related to the nutrition of the LBW neonate but have not been included in this review. The guideline has been developed using standard methods adapted by National Neonatology Forum in accordance with the process described in the World Health Organization handbook for guideline development. The detailed methods are described elsewhere in this compilation of guidelines. Table 1 summarizes the recommendations for practice questions prioritized by the guideline development group in consultation with a wider group of National Neonatology Forum members. The recommendations made by this group are summarized in Table 1 .

2021 ◽  
Vol 08 (01) ◽  
pp. 9-18
Author(s):  
Naresh Kumar ◽  

The outbreak of Coronavirus disease 19 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was declared a pandemic by World Health Organization (WHO) on 11th March, 2020. COVID-19 infection predominantly manifests as pulmonary symptoms that may progress to acute respiratory distress syndrome. The data on extra-pulmonary manifestations of acute COVID-19 are available. Most patients who have COVID-19 recover well within months. Currently, more than 50 million people have recovered globally. Many reports of patients with persistent severe symptoms and significant end-organ damage after SARS-CoV-2 infection have also been observed. As COVID-19 is a relatively new disease, future sequelae aren’t well established. Major adverse outcomes were found to affect different body systems: respiratory system (lung fibrosis and pulmonary thromboembolism), cardiovascular system (cardiomyopathy), and neurological system (sensory dysfunction and stroke). Mental health of COVID-19 patients were also found to be adversely affected. This review describes the effects of SARS-CoV-2 taking into account the previous experiences with SARS-CoV-2 and the Middle East Respiratory Syndrome (MERS) coronavirus that caused SARS in 2003 and MERS in 2012 respectively. This review aims to update on the long-term sequelae of SARS-CoV-2 infection and highlight the necessity for patient monitoring following the acute stage of infection with SARS-CoV-2 to provide ground for the prevention, diagnosis, and management of these potential long-term sequelae and to complete the natural history of COVID-19.


2020 ◽  
Vol 48 (4) ◽  
pp. 329-334
Author(s):  
Soo Jin Han ◽  
Seung Mi Lee ◽  
Sohee Oh ◽  
Subeen Hong ◽  
Jeong Won Oh ◽  
...  

AbstractBackgroundIn monochorionic twin pregnancy, placental anastomosis and inter-twin blood transfusion can result in specific complications, such as twin-twin transfusion syndrome (TTTS) and twin anemia-polycythemia sequence (TAPS). It is well established that adverse outcomes are increased in TTTS, but reports on the neonatal and long-term outcomes of TAPS are lacking. The objective of this study was to evaluate the neonatal and neurodevelopmental outcomes in spontaneous TAPS.MethodsThe study population consisted of monochorionic twin pregnancies with preterm birth (24–37 weeks of gestation) between November 2003 and December 2016 and in which cord blood was taken at the time of delivery. According to the result of hemoglobin in cord blood, the study population was divided into two groups: a spontaneous TAPS group and a control group. Neonatal and neurodevelopmental outcomes were compared between the two groups.ResultsDuring the study period, 11 cases were diagnosed as spontaneous TAPS (6.4%). The TAPS group had lower gestational age at delivery and had a higher risk for cesarean delivery. However, neonates with TAPS were not at an increased risk for neonatal mortality and significant neonatal morbidity. In addition, the frequency of severe cerebral lesion during the neonatal period and the risk of cerebral palsy at 2 years of age were not different between the two groups.ConclusionThe spontaneous TAPS diagnosed by postnatal diagnostic criteria was not associated with the increased risk of adverse neonatal and neurodevelopmental outcomes. Further studies are needed to evaluate the morbidity of antenatally diagnosed TAPS.


BMJ ◽  
2021 ◽  
pp. n526
Author(s):  
François Lamontagne ◽  
Thomas Agoritsas ◽  
Reed Siemieniuk ◽  
Bram Rochwerg ◽  
Jessica Bartoszko ◽  
...  

Abstract Clinical question What is the role of drugs in preventing covid-19? Why does this matter? There is widespread interest in whether drug interventions can be used for the prevention of covid-19, but there is uncertainty about which drugs, if any, are effective. The first version of this living guideline focuses on the evidence for hydroxychloroquine. Subsequent updates will cover other drugs being investigated for their role in the prevention of covid-19. Recommendation The guideline development panel made a strong recommendation against the use of hydroxychloroquine for individuals who do not have covid-19 (high certainty). How this guideline was created This living guideline is from the World Health Organization (WHO) and provides up to date covid-19 guidance to inform policy and practice worldwide. Magic Evidence Ecosystem Foundation (MAGIC) provided methodological support. A living systematic review with network analysis informed the recommendations. An international guideline development panel of content experts, clinicians, patients, an ethicist and methodologists produced recommendations following standards for trustworthy guideline development using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Understanding the new recommendation The linked systematic review and network meta-analysis (6 trials and 6059 participants) found that hydroxychloroquine had a small or no effect on mortality and admission to hospital (high certainty evidence). There was a small or no effect on laboratory confirmed SARS-CoV-2 infection (moderate certainty evidence) but probably increased adverse events leading to discontinuation (moderate certainty evidence). The panel judged that almost all people would not consider this drug worthwhile. In addition, the panel decided that contextual factors such as resources, feasibility, acceptability, and equity for countries and healthcare systems were unlikely to alter the recommendation. The panel considers that this drug is no longer a research priority and that resources should rather be oriented to evaluate other more promising drugs to prevent covid-19. Updates This is a living guideline. New recommendations will be published in this article and signposted by update notices to this guideline. Readers note This is the first version of the living guideline for drugs to prevent covid-19. It complements the WHO living guideline on drugs to treat covid-19. When citing this article, please consider adding the update number and date of access for clarity.


2021 ◽  
Vol 10 (8) ◽  
pp. 1730
Author(s):  
Hiroshi Miyama ◽  
Yasuyuki Shiraishi ◽  
Shun Kohsaka ◽  
Ayumi Goda ◽  
Yosuke Nishihata ◽  
...  

Abnormal liver function tests (LFTs) are known to be associated with impaired clinical outcomes in heart failure (HF) patients. However, this implication varies with each single LFT panel. We aim to evaluate the long-term outcomes of acute HF (AHF) patients by assessing multiple LFT panels in combination. From a prospective multicenter registry in Japan, 1158 AHF patients who were successfully discharged were analyzed (mean age, 73.9 ± 13.5 years; men, 58%). LFTs (i.e., total bilirubin, aspartate aminotransferase or alanine aminotransferase, and alkaline phosphatase) at discharge were assessed; borderline and abnormal LFTs were defined as 1 and ≥2 parameter values above the normal range, respectively. The primary endpoint was composite of all-cause death or HF readmission. At the time of discharge, 28.7% and 8.6% of patients showed borderline and abnormal LFTs, respectively. There were 196 (16.9%) deaths and 298 (25.7%) HF readmissions during a median 12.4-month follow-up period. The abnormal LFTs group had a significantly higher risk of experiencing the composite outcome (adjusted hazard ratio: 1.51, 95% confidence interval: 1.08–2.12, p = 0.017), whereas the borderline LFTs group was not associated with higher risk of adverse events when referenced to the normal LFTs group. Among AHF patients, the combined elevation of ≥2 LFT panels at discharge was associated with long-term adverse outcomes.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yi-chang Chen ◽  
Keh-chung Lin ◽  
Chen-Jung Chen ◽  
Shu-Hui Yeh ◽  
Ay-Woan Pan ◽  
...  

Abstract Background Joint contractures, which affect activity, participation, and quality of life, are common complications of neurological conditions among elderly residents in long-term care facilities. This study examined the reliability and validity of the Chinese version of the PaArticular Scales in a population with joint contractures. Methods A cross-sectional study design was used. The sample included elderly residents older than 64 years with joint contractures in an important joint who had lived at one of 12 long-term care facilities in Taiwan for more than 6 months (N = 243). The Chinese version of the PaArticular Scales for joint contractures was generated from the English version through five stages: translation, review, back-translation, review by a panel of specialists, and a pretest. Test-retest reliability, internal consistency reliability, construct validity, and criterion validity were evaluated, and the results were compared with those for the World Health Organization Quality of Life scale and the World Health Organization Disability Assessment Schedule. Results The Chinese version of the PaArticular Scales had excellent reliability, with a Cronbach α coefficient of 0.975 (mean score, 28.98; standard deviation, 17.34). An exploratory factor analysis showed three factors and one factor with an eigenvalue > 1 that explained 75.176 and 62.83 % of the total variance in the Activity subscale and Participation subscale, respectively. The subscale-to-total scale correlation analysis showed Pearson correlation coefficients of 0.881 for the Activity subscale and 0.843 for the Participation subscale. Pearson’s product-moment correlation revealed that the correlation coefficient (r) between the Chinese version of the PaArticular Scales and the World Health Organization Disability Assessment Schedule was 0.770, whereas that for the World Health Organization Quality of Life scale was − 0.553; these values were interpreted as large coefficients. Conclusions The underlying theoretical model of the Chinese version of the PaArticular Scales functions well in Taiwan and has acceptable levels of reliability and validity. However, the Chinese version must be further tested for applicability and generalizability in future studies, preferably with a larger sample and in different clinical domains.


2018 ◽  
Vol 5 (2) ◽  
pp. 29-33
Author(s):  
Robson de Sousa ◽  
Maria do Socorro Rocha Sarmento Nobre

RESUMO Estratégia usada internacionalmente a busca ativa de sintomáticos respiratórios permite identificar precocemente pessoas com tosse por tempo igual ou superior a três semanas consideradas com suspeita de tuberculose pulmonar visando à descoberta dos casos bacilíferos. É uma atividade de saúde pública e deve ser realizada por todos os serviços de saúde de forma permanente. Com o objetivo de identificar os casos, interromper a cadeia de transmissão e reduzir a incidência da doença a longo prazo.  Objetivo: Conhecer os números de casos notificados de tuberculose e realizar um comparativo com os indicadores de sintomático respiratório no município de Palmas/TO entre os anos de 2015 e 2016. Método: O estudo é do tipo descritivo, de corte transversal e documental direta. Conclusão: Verifica-se que o número confirmado de TB da pesquisa do SR tanto para o ano de 2015 quanto para o ano de 2016 está muito aquém dos casos novos notificados, foi possível perceber a descontinuidade dos pacientes que são encaminhados para avaliação e que não há segmentos principalmente em relação ao resultado dos exames.   Palavras-chave: Tuberculose. Vigilância Epidemiológica. Organização Mundial da Saúde. ABSTRACT A strategy used internationally for the active search of respiratory symptomatic patients allows early identification of people with cough for a time equal to or greater than three weeks considered with suspicion of pulmonary tuberculosis in order to discover the bacilliferous cases. It is a public health activity and must be performed by all health services on an ongoing basis. In order to identify the cases, interrupt the transmission chain and reduce the incidence of the disease in the long term. Objective: To know the numbers of reported cases of tuberculosis and to carry out a comparison with the indicators of respiratory symptomatology in the municipality of Palmas / TO between the years 2015 and 2016. Method: The study is descriptive, cross-sectional and direct documentary. Conclusion: It is verified that the confirmed number of TB of the RS research for both the year 2015 and the year 2016 is well below the new cases reported, it was possible to perceive the discontinuity of the patients that are referred for evaluation and which are not mainly related to the results of the exams. Keywords: Tuberculosis. Epidemiological surveillance. World Health Organization.


2009 ◽  
Vol 37 (4) ◽  
pp. 1191-1201 ◽  
Author(s):  
Y Ma ◽  
X Wang ◽  
X Xu ◽  
G Lin

This study investigated the complete remission (CR) rate and survival of 623 newly diagnosed patients with acute myeloid leukaemia (AML) in Shanghai, China, classified according to World Health Organization and French–American–British criteria, and compared the differences in treatment effect with those reported in developed countries and those reported in Shanghai from 1984 to 1994. Total CR rate was 66.5%, median survival was 18 months and estimated survival at 3 years was 30.8%. The 3-year relapse rate was 55.1%. These data showed that the CR rate was similar to that achieved in studies from developed countries, but long-term survival was worse. The CR rate and survival were increased markedly compared with data previously collected in Shanghai (1984-1994). Induction chemotherapeutic regimens based on idarubicin, daunorubicin or homoharringtonine all had similar CR rates and survivals. Karyotype was the most important prognostic factor. Multilineage dysplasia in de novo AML was not an independent prognostic factor. Improvement in the long-term treatment effect in China is an important challenge for the future.


2020 ◽  
pp. 07-19
Author(s):  
Hiba Takieddine ◽  
Samaa AL Tabbah

Coronavirus disease 2019 (COVID-19) is a highly infectious disease that has rapidly swept across the world, inducing a considerable degree of fear, worry and concern in the population at large and among certain groups in particular, such as older adults, healthcare providers and people with underlying health conditions. Authorities around the world tried to prevent the virus spread by imposing social distancing measures, quarantining citizens and isolating infected persons. Apart from its physical impact, COVID-19 pandemic has brought numerous changes to people’s lives. It changed daily routines, caused worldwide economic crisis, increased unemployment, and placed people under emotional and financial pressures. It affected people psychologically and mentally especially in terms of emotions and cognition. During the acute crisis, everyone to varying degrees experienced fear of infection, somatic concerns, worries about the pandemic’s consequences, loneliness, depression, stress, as well as increased alcohol and drug use. As part of its public health response, the World Health Organization (WHO) has worked with partners to develop a set of new guidelines and messages that can be used to prevent, manage, and support mental and psychological well-being in different vulnerable target groups during the outbreak. Whether people like it or not, the psychological sequela of this pandemic will emerge and persist for months and years to come leading to long-term consequences. New lifestyles and “New Normals” will surely emerge. The main purpose of this review is to summarize the impact of coronavirus pandemic on the psychological and mental health of people around the world especially vulnerable groups. It also presents the relevant intervention actions and recommendations to cope efficiently and effectively with the psychological short-term and long-term outcomes, mental changes, and the “New Normal” during and after COVID-19. Keywords: COVID-19; Coronavirus, Psychological; Mental; New Normal


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