scholarly journals Glucose Variations in the First Day of Life of Newborns under Observational Surveillance

2020 ◽  
Vol 26 (2) ◽  
pp. 212-221
Author(s):  
Jung Ae Cho ◽  
Kyoung Hee Son ◽  
Hyun Young Eom ◽  
Seo Hae Lim ◽  
Yong Hoon Jun ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Clinical Symptoms ◽  
Multiple Gestation ◽  
Hypoglycemic Episode ◽  
Potential Health ◽  
Abnormal Growth ◽  
Glucose Levels ◽  
Level Ii ◽  
Term Newborns ◽  
Glucose Management

Purpose: Nursing protocols for glucose management are well known for both healthy term newborns and high-risk newborns. However, for less risky newborns who are under only observation surveillance, hypoglycemia could be overlooked unless clinical symptoms develop. Methods: A retrospective study was performed to explore factors influencing variations in glucose levels in 91 newborns who did not require any interventions, but were under nursing surveillance, at a level II neonatal intensive care unit. Data were retrieved from electrical medical records on glucose levels, demographic characteristics, and other clinical characteristics of newborns in their first day of life from January 2016 to May 2019. Results: Glucose levels tended to stabilize within the normal range (60~80 mg/dL) as time passed during the first day of life. Cesarean section, multiple gestation, abnormal growth, and later preterm birth were associated with low glucose levels in the first 2 hours of life. Thirty-one newborns experienced a hypoglycemic episode (< 45 mg/dL) during the first 24 hours of life. Conclusion: The findings of this study support the active encouragement of early feeding within 2 hours of birth and urgent adoption of a structural protocol for glucose surveillance in newborns with potential health problems immediately after birth.

scholarly journals Self-Care IoT Platform for Diabetic Mellitus

2021 ◽  
Vol 11 (5) ◽  
pp. 2006
Author(s):  
Jai-Chang Park ◽  
Seongbeom Kim ◽  
Je-Hoon Lee
Keyword(s):  
Blood Glucose ◽  
Self Care ◽  
Target Range ◽  
Process Data ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Iot Platform ◽  
Number Of Patients ◽  
Glucose Management ◽  
The Relationship

Diabetes mellitus is a severe chronic disease, and the number of patients has increased. To manage blood glucose levels, patients should frequently measure their blood glucose and analyze which lifestyle habits affect blood glucose levels. However, it is hard to record and analyze the relationship between their blood glucose levels and lifestyle. The internet of things (IoT) is useful to interconnect, monitor, obtain, and process data between various devices used in everyday life to fulfill a common objective. This paper proposes an intelligent self-care platform using IoT technology that helps patients with chronic diabetes manage their blood glucose levels in their target range. In particular, we developed various devices called the self-care IoT pack. It consists of five different types of devices to obtain blood glucose levels, physical activities, food intake, medication, sleeping, and so on. They can collect blood glucose levels with lifestyles that automatically impact the patient’s blood glucose level. We also devised a self-care application to display and analyze the data obtained from the IoT pack. Consequently, the proposed self-care IoT platform collects the blood glucose levels and the lifestyles without any burden of record. By reviewing the accumulated information, the patients can find bad habits in blood glucose management and improve their lifestyle.

scholarly journals Bilateral scapulothoracic osteochondromas in a patient with hereditary multiple exostosis: a case report and review of the literature

2016 ◽  
Vol 8 (3) ◽  
Author(s):  
Markus Rupp ◽  
Jendrik Hardes ◽  
Michael J. Raschke ◽  
Adrian Skwara
Keyword(s):  
Malignant Transformation ◽  
Clinical Symptoms ◽  
Diagnostic Testing ◽  
Femoral Fractures ◽  
Diagnostic Procedures ◽  
Hereditary Multiple Exostosis ◽  
Autosomal Dominant Disorder ◽  
Abnormal Growth ◽  
Adolescents And Adults ◽  
Rule Out

Hereditary multiple exostosis (HME) is an autosomal dominant disorder characterized by two or more benign growing, cartilage capped tumors of long bones called osteochondromas. If abnormal growth and clinical symptoms of osteochondromas newly appear in adults, malignant transformation of the usually benign growing tumors should be suspected and diagnostic testing should be initiated. Against the background of hypothesized higher malignant transformation of osteochondromas into chondrosarcoma in individuals with shoulder exostoses, we report a case of bilateral scapulothoracic osteochondromas in a patient suffering from HME. A 60-year-old female with HME complained of chest pain while being hospitalized for bilateral femoral fractures. A computed tomography scan of the chest was performed to rule out pulmonary embolism. However, bilateral osteochondromas in the scapulothoracic spaces were detected. Due to absence of radiographic evidences for malignant transformation in the patient, invasive diagnostic procedures such as biopsy and histological examination were recommended in order to exclude malignant transformation of both osteochondromas. Physicians should be aware that patients with HME who present with shoulder pain should be examined for osteochondromas in the scapulothoracic space. Due to possible sarcomatous transformation, regular follow-ups are necessary for adolescents and adults.

Current Practices of Antiseptic Use in Canadian Neonatal Intensive Care Units

2018 ◽  
Vol 36 (02) ◽  
pp. 141-147 ◽  
Author(s):  
Helen McCord ◽  
Elise Fieldhouse ◽  
Walid El-Naggar
Keyword(s):  
Intensive Care ◽  
Adverse Effects ◽  
Intensive Care Units ◽  
Health Care Providers ◽  
Neonatal Intensive Care ◽  
Chlorhexidine Gluconate ◽  
Neonatal Intensive Care Units ◽  
Care Providers ◽  
Level Ii ◽  
Canadian Provinces

Objective This article assesses the degree of variability in the current practice of skin antiseptics used in Canadian neonatal intensive care units (NICUs) and different experiences related to each antiseptic used. Methods An anonymous survey was distributed to a clinical representative of each of the 124 Canadian level II and level III NICUs. Results One hundred and two respondents (82.2%), representing all Canadian provinces, completed the survey. Chlorhexidine gluconate with/without alcohol was the antiseptic most used (96%) and the antiseptic with the highest reported adverse effects (68% reported skin burns/breakdown). Other antiseptics used include povidone-iodine (35%) and isopropyl alcohol (22%). Specific guidelines for antiseptic use were available in only 50% of the units with many NICUs lacking gestational and/or chronological age restrictions. Only 23% of responders believed that there was awareness among health care providers of the adverse effects of antiseptics used. Less than half (43%) were completely satisfied with the antiseptics used in their units. Conclusion Chlorhexidine gluconate is the most commonly used antiseptic in Canadian NICUs. The high number of associated adverse effects and the lack of guidelines regulating antiseptic use are of concern. Large clinical trials are urgently needed to guide practice and improve the safety of antiseptics.

Provider Perspectives on the Acceptability, Appropriateness, and Feasibility of Teleneonatology

2021 ◽  
Author(s):  
Jennifer L. Fang ◽  
Rachel Umoren ◽  
Hilary Whyte ◽  
Jamie Limjoco ◽  
Abhishek Makkar ◽  
...  
Keyword(s):  
Rural Communities ◽  
Neonatal Intensive Care ◽  
Linear Models ◽  
Neonatal Care ◽  
Community Hospitals ◽  
Provider Perspectives ◽  
Level Ii ◽  
Survey Results ◽  
Level I ◽  
Strongly Agree

Objective We aimed to measure provider perspectives on the acceptability, appropriateness, and feasibility of teleneonatology in neonatal intensive care units (NICUs) and community hospitals. Study Design Providers from five academic tertiary NICUs and 27 community hospitals were surveyed using validated implementation measures to assess the acceptability, appropriateness, and feasibility of teleneonatology. For each of the 12 statements, scale values ranged from 1 to 5 (1 = strongly disagree; 5 = strongly agree), with higher scores indicating greater positive perceptions. Survey results were summarized, and differences across respondents assessed using generalized linear models. Results The survey response rate was 56% (203/365). Respondents found teleneonatology to be acceptable, appropriate, and feasible. The percent of respondents who agreed with each of the twelve statements ranged from 88.6 to 99.0%, with mean scores of 4.4 to 4.7 and median scores of 4.0 to 5.0. There was no difference in the acceptability, appropriateness, and feasibility of teleneonatology when analyzed by professional role, years of experience in neonatal care, or years of teleneonatology experience. Respondents from Level I well newborn nurseries had greater positive perceptions of teleneonatology than those from Level II special care nurseries. Conclusion Providers in tertiary NICUs and community hospitals perceive teleneonatology to be highly acceptable, appropriate, and feasible for their practices. The wide acceptance by providers of all roles and levels of experience likely demonstrates a broad receptiveness to telemedicine as a tool to deliver neonatal care, particularly in rural communities where specialists are unavailable. Key Points

Provider Perspectives on the Acceptability, Appropriateness, and Feasibility of Teleneonatology

2021 ◽  
Author(s):  
Jennifer L. Fang ◽  
Rachel A Umoren ◽  
Hilary Whyte ◽  
Jamie Limjoco ◽  
Abhishek Makkar ◽  
...  
Keyword(s):  
Rural Communities ◽  
Neonatal Intensive Care ◽  
Linear Models ◽  
Neonatal Care ◽  
Community Hospitals ◽  
Provider Perspectives ◽  
Level Ii ◽  
Survey Results ◽  
Level I ◽  
Strongly Agree

Objective: We aimed to measure provider perspectives on the acceptability, appropriateness, and feasibility of teleneonatology in neonatal intensive care units (NICU) and community hospitals. Study Design: Providers from five academic tertiary NICUs and 27 community hospitals were surveyed using validated implementation measures to assess the acceptability, appropriateness, and feasibility of teleneonatology. For each of the twelve statements, scale values ranged from 1 to 5 (1=strongly disagree; 5=strongly agree), with higher scores indicating greater positive perceptions. Survey results were summarized, and differences across respondents assessed using generalized linear models. Results: The survey response rate was 56% (203/365). Respondents found teleneonatology to be acceptable, appropriate, and feasible. The percent of respondents who agreed with each of the twelve statements ranged from 88.6-99.0%, with mean scores of 4.4-4.7 and median scores of 4.0-5.0. There was no difference in the acceptability, appropriateness, and feasibility of teleneonatology when analyzed by professional role, years of experience in neonatal care, or years of teleneonatology experience. Respondents from Level I well newborn nurseries had greater positive perceptions of teleneonatology than those from Level II special care nurseries. Conclusion: Providers in tertiary NICUs and community hospitals perceive teleneonatology to be highly acceptable, appropriate, and feasible for their practices. The wide acceptance by providers of all roles and levels of experience likely demonstrates a broad receptiveness to telemedicine as a tool to deliver neonatal care, particularly in rural communities where specialists are unavailable.

Serum d ‐ and l ‐lactate, pyruvate and glucose levels in individuals with at‐risk mental state and correlations with clinical symptoms

2019 ◽  
Vol 14 (4) ◽  
pp. 410-417 ◽  
Author(s):  
Mayu Onozato ◽  
Maho Umino ◽  
Ayako Shoji ◽  
Hideaki Ichiba ◽  
Naohisa Tsujino ◽  
...  
Keyword(s):  
At Risk ◽  
Mental State ◽  
Clinical Symptoms ◽  
Glucose Levels ◽  
At Risk Mental State

Narcolepsy and Hypoglycaemia

1959 ◽  
Vol 105 (438) ◽  
pp. 163-170 ◽  
Author(s):  
Colin M. Smith ◽  
R. A. Schneider
Keyword(s):  
Blood Glucose ◽  
Clinical Symptoms ◽  
Sleep Patterns ◽  
Glucose Levels ◽  
Intravenous Insulin ◽  
Blood Glucose Levels ◽  
Eeg Changes ◽  
Clinical Description ◽  
Eeg Pattern ◽  
Light Sleep

For some years now it has been recognized that the symptoms induced by hypoglycaemia may resemble narcolepsy. Cases of islet-celled pancreatic adenomas simulating narcolepsy have been described by Harris (7), Delay (4) and Wyke (18). The resemblance may be a superficial one, however, and Wyke observed in his case during a “sleepy attack” that “the EEG pattern bore no resemblance to that of natural or artificial sleep”. In a more recent paper Ziegler and Presthus (19) described thirteen patients who showed normal EEGs at blood glucose levels (induced by fasting and intravenous insulin) of from under 15 mg. per cent. to 54 mg. per cent. In eight of these patients there were no clinical symptoms; in the remaining five patients the symptoms were described as follows: “feel like a ton of lead”, “warm and sleepy”, “tired”, “drowsy and sweaty” and “dizzy and tired”. It seems, in fact, that the clinical description of drowsiness in hypoglycaemia may correspond either to no EEG changes or to various degrees of slowing rather than to the typical recurrent light sleep patterns characteristic of narcolepsy. It will be recalled that hypnosis too is ushered in by a sense of drowsiness but that the EEG changes are not those of sleep (1, 2, 5). Many hysterical trance states—often loosely, and unfortunately, described as narcolepsy—come into this category. In short, it is apparent that all that sleeps is not narcolepsy (6, 12, 13, 14).

scholarly journals Oral Dextrose Gel Reduces the Need for Intravenous Dextrose Therapy in Neonatal Hypoglycemia

2016 ◽  
Vol 1 (3) ◽  
pp. 1-9 ◽  
Author(s):  
Munmun Rawat ◽  
Praveen Chandrasekharan ◽  
Stephen Turkovich ◽  
Nancy Barclay ◽  
Katherine Perry ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Neonatal Intensive Care ◽  
Newborn Infants ◽  
Large For Gestational Age ◽  
Term Infants ◽  
Glucose Levels ◽  
Lower Baseline ◽  
Before And After

Background: Newborn infants with risk factors may require intravenous (IV) dextrose for asymptomatic hypoglycemia. Administration of IV dextrose and transfer to the neonatal intensive care unit (NICU) may interfere with parent-infant bonding. Objective: To study the effect of implementing dextrose gel supplement with feeds in late preterm/term infants affected by asymptomatic hypoglycemia on reducing IV dextrose therapy. Method: A retrospective study was conducted before and after dextrose gel use: 05/01/2014 to 10/31/2014 and 11/01/2014 to 04/30/2015, respectively. Asymptomatic hypoglycemic (blood glucose level <45 mg/dl) infants in the newborn nursery (NBN) were given a maximum of 3 doses of dextrose gel (200 mg/kg of 40% dextrose) along with feeds. Transfer to the NICU for IV dextrose was considered treatment failure. Results: Dextrose gel with feeds increased the blood glucose level in 184/250 (74%) of asymptomatic hypoglycemic infants compared to 144/248 (58%) with feeds only (p < 0.01). Transfer from the NBN to the NICU for IV dextrose decreased from 35/1,000 to 25/1,000 live births (p < 0.01). Exclusive breastfeeding improved from 19 to 28% (p = 0.03). Conclusions: Use of dextrose gel with feeds reduced the need for IV fluids, avoided separation from the mother and promoted breastfeeding. Neonates who failed dextrose gel therapy were more likely to be large for gestational age, delivered by cesarean section and had lower baseline blood glucose levels.

Facilitated tucking on pain in pre-term newborns during neonatal intensive care: A single blinded randomized controlled cross-over pilot trial

2013 ◽  
Vol 6 (1) ◽  
pp. 19-27 ◽  
Author(s):  
Balasubramanian Sundaram ◽  
Sonali Shrivastava ◽  
Joseley Sunderraj Pandian ◽  
Vijay Pratap Singh
Keyword(s):  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Pilot Trial ◽  
Randomized Controlled ◽  
Term Newborns

Universal Electrocardiographic Screening for Long QT Syndrome in Hospitalized Neonates

2019 ◽  
Vol 37 (03) ◽  
pp. 322-325
Author(s):  
Bethany D. Kaemingk ◽  
Timothy J. Ulrich ◽  
Man Li ◽  
William A. Carey ◽  
Marc A. Ellsworth
Keyword(s):  
Long Qt Syndrome ◽  
Neonatal Intensive Care ◽  
Electronic Monitoring ◽  
Screening Method ◽  
Unexpected Death ◽  
Long Qt ◽  
Level Ii ◽  
Qt Syndrome ◽  
Unnecessary Testing

Objective Long QT syndrome (LQTS) is a known cause of unexpected death, leading some to recommend routine neonatal electrocardiographic (ECG) screening. We used continuous electronic heart rate corrected QT interval (QTc) monitoring to screen for interval prolongation in a cohort of hospitalized neonates to identify those at a risk of having LQTS. We hypothesized that this screening method would yield an acceptable positive predictive value (PPV). Study Design A cohort of 589 infants hospitalized in a level II neonatal intensive care unit were screened through continuous electronic QTc monitoring linked to an investigator-designed, computerized data sniffer. Screening was conducted from days-of-life 3 through 7 or until hospital discharge. The data sniffer alerted investigators for a 24-hour average QTc of ≥475 ms. Positively screened patients were further evaluated with 12-lead ECG. Results Positive screens were obtained in 5.6% of patients, all of whom had negative follow-up ECG testing (PPV = 0%). Furthermore, one-quarter of positively screened neonates underwent echocardiography based on ECG findings, none of which identified clinically relevant pathology. Conclusion Electronic monitoring of QTc in hospitalized neonates during the first week of life was not an efficient way to identify those at a risk of having LQTS. Conversely, screening triggered unnecessary testing.

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