NEWBORN ASSESSMENT USING VIRGINIA APGAR METHODOLOGY AND ITS MODIFICATIONS

2021 ◽  
Vol 100 (3) ◽  
pp. 152-165
Author(s):  
V.Yu. Avramenko ◽  
◽  
M.V. Degtyareva ◽  
Keyword(s):  
Clinical Practice ◽  
Apgar Score ◽  
Clinical Status ◽  
Neonatal Resuscitation ◽  
Health Status Assessment ◽  
Diagnostic Efficacy ◽  
American Academy Of Pediatrics ◽  
The World ◽  
Status Assessment ◽  
Method Of Assessment

Neonatal clinical status assessment at birth has always been crucial for neonatologists, anesthesiologists-resuscitators, pediatricians, obstetricians and gynecologists. The technique proposed by Virginia Apgar in 1952 is now recognized worldwide. However, a number of shortcomings have been identified in the application of the technique. Scientists and practitioners around the world are continually searching for an alternative tool to overcome the limitations of the Apgar score. The modified score and additional score proposed by E. Saling (1968), expanded (proposed by the American Academy of Pediatrics, 2006), specified and combined Apgar score, proposed by M. Rüdiger (2010, 2012), as well as an alternative method of assessment of the condition of a child immediately after birth – the Neonatal Resuscitation and Adaptation Score (NRAS, 2015) are the most famous transformations of the Apgar score described in the literature. They have their advantages, but further research is needed to confirm their feasibility in clinical practice. The main challenges for researchers are to personalize, objectify the approach to newborn’s health status assessment and to increase diagnostic efficacy and predictive value of the technique.

scholarly journals Conservation status assessment of the highest forests in the world: Polylepis flavipila forests as a case study

2021 ◽  
Vol 7 (1) ◽  
pp. 160-169
Author(s):  
Fressia Nathalie Ames-Martínez ◽  
Harold Rusbelth Quispe-Melgar ◽  
Daniel Renison
Keyword(s):  
Conservation Status ◽  
The World ◽  
Status Assessment

Venous Thromboembolism: Genetics and Thrombophilias

2021 ◽  
Vol 42 (02) ◽  
pp. 271-283
Author(s):  
Manila Gaddh ◽  
Rachel P. Rosovsky
Keyword(s):  
Clinical Practice ◽  
Venous Thromboembolism ◽  
Family History ◽  
Morbidity And Mortality ◽  
Inherited Thrombophilia ◽  
Risks And Benefits ◽  
Hereditary Thrombophilia ◽  
The World ◽  
The Future ◽  
History Of

AbstractVenous thromboembolism (VTE) is a major cause of morbidity and mortality throughout the world. Up to one half of patients who present with VTE will have an underlying thrombophilic defect. This knowledge has led to a widespread practice of testing for such defects in patients who develop VTE. However, identifying a hereditary thrombophilia by itself does not necessarily change outcomes or dictate therapy. Furthermore, family history of VTE by itself can increase an asymptomatic person's VTE risk several-fold, independent of detecting a known inherited thrombophilia. In this article, we will describe the current validated hereditary thrombophilias including their history, prevalence, and association with VTE. With a focus on evaluating both risks and benefits of testing, we will also explore the controversies of why, who, and when to test as well as discuss contemporary societal guidelines. Lastly, we will share how these tests have been integrated into clinical practice and how to best utilize them in the future.

scholarly journals Systematic review of clinical practice guidelines for adults with fractures: identification of best evidence for rehabilitation to develop the WHO’s Package of Interventions for Rehabilitation

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Francesca Gimigliano ◽  
◽  
Sara Liguori ◽  
Antimo Moretti ◽  
Giuseppe Toro ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Hip Fracture ◽  
Distal Radius ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Adult Population ◽  
World Health ◽  
The World

Abstract Background The identification of existing rehabilitation interventions and related evidence represents a crucial step along the development of the World Health Organization’s (WHO) Package of Interventions for Rehabilitation (PIR). The methods for such identification have been developed by the WHO Rehabilitation Programme and Cochrane Rehabilitation under the guidance of the WHO’s Guideline Review Committee secretariat. The aim of this paper is to report on the results of the systematic search for clinical practice guidelines (CPGs) relevant to the rehabilitation of adults with fractures and to present the current state of evidence available from the identified CPGs. Methods This paper is part of the Best Evidence for Rehabilitation (be4rehab) series, developed according to the methodology presented in the World Health Organization’s (WHO) Package of Interventions for Rehabilitation (PIR) introductory paper. It is a systematic review of existing CPGs on fractures in adult population published from 2009 to 2019. Results We identified 23 relevant CPGs after title and abstract screening. According to inclusion/exclusion criteria, we selected 13 CPGs. After checking for quality, publication time, multiprofessionality, and comprehensiveness, we finally included five CPGs dealing with rehabilitative management of fractures in adult population, two CPGs addressing treatment of distal radius fracture and three the treatment of femoral/hip fracture. Conclusion The selected CPGs on management of distal radius and femoral/hip fracture include few recommendations regarding rehabilitation, with overall low to very low quality of evidence and weak/conditional strength of recommendation. Moreover, several gaps in specific rehabilitative topics occur. Further high-quality trials are required to upgrade the quality of the available evidence. Level of evidence Level 1.

Cardiopulmonary Resuscitation of the Newborn

1990 ◽  
Vol 12 (5) ◽  
pp. 136-141
Author(s):  
Robert A. Sinkin ◽  
Jonathan M. Davis
Keyword(s):  
United States ◽  
American Academy ◽  
American Heart Association ◽  
Life Support ◽  
American Heart ◽  
Neonatal Resuscitation ◽  
Heart Association ◽  
The United States ◽  
Delivery Room ◽  
American Academy Of Pediatrics

Approximately 3.5 million babies are born each year in approximately 5000 hospitals in the United States. Only 15% of these hospitals have neonatal intensive care facilities. Six percent of all newborns require life support in the delivery room or nursery, and this need for resuscitation rises to 80% in neonates weighing less than 1500 g at birth. Personnel who are skilled in neonatal resuscitation and capable of functioning as a team and an appropriately equipped delivery room must always be readily available. At least one person skilled in neonatal resuscitation should be in attendance at every delivery. Currently, a joint effort by the American Academy of Pediatrics and the American Heart Association has resulted in the development of a comprehensive course to train appropriate personnel in neonatal resuscitation throughout the United States. Neonatal resuscitation is also taught as part of a Pediatric Advanced Life Support course offered by the American Heart Association. In concert with the goals of the American Academy of Pediatrics and the American Heart Association, we strongly urge all personnel responsible for care of the newborn in the delivery room to become certified in neonatal resuscitation. The practical approach to neonatal resuscitation is the focus of this article.

scholarly journals UK neonatal resuscitation survey

2018 ◽  
Vol 104 (3) ◽  
pp. F324-F325 ◽  
Author(s):  
Elinor Charles ◽  
Katie Hunt ◽  
Vadivelam Murthy ◽  
Christopher Harris ◽  
Anne Greenough
Keyword(s):  
Carbon Dioxide ◽  
Clinical Practice ◽  
Neonatal Resuscitation ◽  
Neonatal Care ◽  
Initial Resuscitation ◽  
Carbon Dioxide Monitoring ◽  
Different Levels

BackgroundPrevious surveys have demonstrated that neonatal resuscitation practices on the delivery suite vary between UK units, particularly according to the hospital’s neonatal unit’s level. Our aim was to determine if recent changes to the Resuscitation Council guidelines had influenced clinical practice.MethodsSurveys of resuscitation practices at UK delivery units carried out in 2012 and 2017 were compared.ResultsComparing 2017 with 2012, initial resuscitation using air was more commonly used in both term (98% vs 75%, p<0.001) and preterm (84% vs 34%, p<0.001) born infants. Exhaled carbon dioxide monitoring was more frequently employed in 2017 (84% vs 19%, p<0.001). There were no statistically significant differences in practices according to the level of neonatal care provided by the hospital.ConclusionThere have been significant changes in neonatal resuscitation practices in the delivery suite since 2012 regardless of the different levels of neonatal care offered.

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