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Neutrophil Chemotaxis and Respiratory Burst in Term and Preterm Newborn InfantsStålhammar, Maria January 2016 (has links)
Neutrophil activation is the most important initial immune defense against invading microbes in newborn infants. The reduced neutrophil migration and uncontrolled regulation of reactive oxygen species (ROS) production observed in neonates, could result in a diminished infectious response or in tissue damage. The aims were to study neutrophil chemotactic response towards IL-8 and fMLP in term neonates; to examine neutrophil receptor expression involved in adhesion, migration, phagocytosis and complement after stimulation with IL-8 and fMLP in term neonates; and to investigate neutrophil production of ROS, induced by PMA and E.coli, after preincubation with IL-8 and fMLP in term and preterm newborn infants. Comparisons were made to neutrophils from healthy adults. Chemotaxis was distinguished from randomly migrating neutrophils, and the neutrophil migration distance and the number of migrating neutrophils per distance was evaluated. Neutrophils were labeled with antibodies to cell surface antigens (CD11b, CD18, CD65, CD15S, CD162, CD44, CD35, CD88, CD181, CD182 and CD64) after stimulation with IL-8 and fMLP. After preincubation of neutrophils with fMLP or IL-8 and stimulation with PMA or E.coli, respiratory burst was detected. The same analyses were also made in preterm infants (median 25+3weeks GA; range 23+0–29+2) within 3 days postnatal age. Neutrophils from neonates exhibited different migratory and receptor responses to IL-8 and fMLP, with a diminished response towards IL-8 in term newborn infants in terms of reduced chemotaxis and modulation of receptors involved in adhesion, chemotaxis, complement and phagocytosis as compared to adults. fMLP reduced PMA- and E.coli-induced respiratory burst in neutrophils from term neonates and adults. The reduced respiratory burst by fMLP may be a mechanism for reducing the detrimental effects of uncontrolled inflammation. Although a similar burst reduction was observed in preterm infants born >25 weeks GA with fMLP, a diminished neutrophil respiratory burst modulation in very preterm infants cannot be excluded and requires further studies at different gestational and postnatal ages.
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Triagem auditiva neonatal com potencial evocado auditivo de tronco encefálico automático: a utilização de novas tecnologiasSena, Taise Argolo 14 February 2012 (has links)
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Previous issue date: 2012-02-14 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Introduction: The Automated Auditory Brainstem Response (AABR) is an
important tool to make Newborn Hearing Screening. However, some aspects
that make it more difficult to exam, like time and intensity of acoustic
stimulus, must be taken into consideration. Aim: Analyze the results of
Newborn Hearing Screening with Automated Auditory Brainstem Response
with new technologies that use the detection method in the frequency domain
and stimulus repetition rate at 93Hz. Methodology: The Automated Auditory
Brainstem Response was made at 200 newborns (93 female and 107 male),
at 30 and 35dBnHL. Subsequently all newborns were submitted to the
Auditory Brainstem Response (ABR) Diagnostic Mode, as golden standard
test. Results: The sensibility and specificity were calculated through Fisher
Exact Test taken into consideration the ABR Diagnostic Mode. The sensibility
found at AABR at 35dBnNA was 100% and the specificity was 100%, at the
intensity of 30dBnNA the sensibility found was 100% and the specificity was
97.23%. The average time to make the automated exam was 28.3 seconds
in the 35 dBnHL and 32.9 seconds in the 30 dBnHL. The time was analyzed
considering the state of consciousness of the newborn, based on the
Brazelton Scale classification. It was possible to notice that when the
newborn was quieter the examination time was quicker. Conclusion: The
AABR made at frequency domain with stimulus repetition rate at 93Hz shows
high sensibility and specificity, with relative short time to get the results. The
state of consciousness influences the execution time of the exam. / Introdução: O Potencial Evocado Auditivo de Tronco Encefálico Automático
(PEATE-A) é uma ferramenta importante para realização da Triagem
Auditiva Neonatal. Entretanto, alguns aspectos que dificultam a realização
do exame, como o tempo e a intensidade do estímulo acústico, devem ser
levados em consideração. Objetivos: Analisar os resultados da Triagem
Auditiva Neonatal com Potencial Evocado Auditivo de Tronco Encefálico
Automático, com novas tecnologias que utilizam método de detecção no
domínio da frequência e taxa de repetição do estímulo a 93Hz.
Metodologia: O Potencial Evocado Auditivo de Tronco Encefálico
Automático foi realizado em 200 neonatos (93 do sexo feminino e 107 do
masculino), nas intensidades de 30 e 35dBnNA. Em seguida, todos os
neonatos foram submetidos ao exame de Potencial Evocado Auditivo de
Tronco Encefálico (PEATE) Modo Diagnóstico, como teste padrão ouro.
Resultados: A sensibilidade e especificidade foram calculadas por meio do
Teste Exato de Fisher, levando em consideração o resultado do PEATE
Modo Diagnóstico. A sensibilidade encontrada para o PEATE-A na
intensidade de 35dBnNA foi de 100% e a especificidade de 100%; para a
intensidade de 30dBnNA a sensibilidade encontrada foi de 100% e a
especificidade, de 97,23%. O tempo médio de realização do exame
automático foi de 28,3 segundos para a intensidade de 35 dBnNA e de 32,9
segundos para a intensidade de 30dBnNA. O tempo também foi analisado
de acordo com o estado de consciência do neonato, conforme a
classificação da Escala de Brazelton. Foi possível observar que quanto mais
quieto o neonato, mais rápido o tempo de realização do exame. Conclusão:
O PEATE-A realizado no domínio da frequência com taxa de repetição em
93Hz apresenta alta sensibilidade e especificidade, com tempo
consideravelmente curto para a determinação da resposta. O estado de
consciência influencia no tempo de execução do exame
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Aspects of prevention and assessment of neonatal pain /Eriksson, Mats, January 2003 (has links) (PDF)
Diss. (sammanfattning) Linköping : Univ., 2004. / Härtill 5 uppsatser.
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The postpartum mandate estimated costs and benefits /Malkin, Jesse D., January 1998 (has links)
Thesis (Ph. D.)--RAND Graduate School, 1998. / Includes bibliographical references (p. 241-258).
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Young infants demonstrate a preference for infant directed talkPegg, Judith E. January 1989 (has links)
This research was designed to assess 7-week-old infants' preference for infant directed and adult directed talk. (IDT and ADT) using the infant controlled habituation/dishabituation looking procedure. Infants were presented with short audio recordings of either a female or a male speaking in IDT during habituation and ADT during dishabituation or the reverse. In the control conditions, the stimulus did not change. Infants demonstrated preference for IDT over ADT in both male and female speaker conditions. They also demonstrated preference for the female speaker used in this study over the male speaker. Interactions among the dependent variables (first three looks), and the independent variables (infant gender, and style of speaking as well as infant gender, and speaker gender), suggest that the preference might not be as robust as the preference found in infants over 4 months. Evidence for discrimination between IDT and ADT was inferred from the between group demonstration of preference, but no evidence of within infant discrimination was found. Because the evidence suggests that 7-week-old infants demonstrate weaker preference for IDT over ADT than do infants of 4 months, it is assumed that infant preferences follow a developmental sequence. Thus, it is possible that developing preferences are influenced by experiential factors. / Arts, Faculty of / Psychology, Department of / Graduate
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The impact of infant massage on the development of children with disabilities and children born at-risk for developmental delaysEscobedo, Maria Jesus 01 January 2003 (has links)
This project encompasses program evaluations of infant massage intervention and its impact in the overall development of infants and children born with disabilities or babies born at risk for developmental delays.
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Utilization of Genetics Services in the Diagnosis of Hearing Loss in Newborns in the State of OhioCara, Barnett Lorraine 24 September 2020 (has links)
No description available.
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Effekten av sockerlösning i smärtlindrande syfte till nyfödda : En litteratudstudieRingman, Lina January 2015 (has links)
Nyfödda barn som är kroniskt eller tillfälligt sjuka upplever multipla invasiva och vävnadsskadande procedurer på akutmottagningar och intensivvårdsavdelningar. Smärtsamma procedurer är en risk för hjärnskador hos den nyfödde. Den här litteraturstudien hade som syfte att beskriva den smärtlindrande effekten av sockerlösning i samband med smärtsamma procedurer hos nyfödda samt att beskriva möjliga komplement till administrering av sockerlösning. Vidare var syftet att beskriva de valda artiklarnas design. Artiklarna hämtades från databasen PubMed genom sökord i olika kombinationer. Undersökningsgruppen var tillfälligt sjuka samt friska nyfödda barn. Artiklarna bearbetades noggrant genom att läsas igenom med fokus på resultatdelen. Resultatet av de granskade artiklarna visar att sockerlösningen har en god effekt på smärta hos nyfödda när den jämförs med placebo eller sterilt vatten. I studier som jämfört sockerlösningen med metoder som att den nyfödda fick suga, fick värme eller hud mot hud så har sockerlösningen en sämre effekt på smärta hos nyfödda. Ett resultat talade helt emot att använda sig av sockerlösning till nyfödda i smärtlindrande syfte. Komplement till sockerlösning i smärtlindrande syfte, som t ex att den nyfödda fick värme, hud mot hud eller fick suga tillsammans med sockerlösning gav bättre effekter än att ge endast sockerlösning. Resultatet visade även att bröstmjölk (inte genom amning) har en sämre effekt jämfört med sockerlösning avseende smärta, men när den nyfödda fick amma visades det motsatta. Författarens tredje frågeställning beskriver ett resultat där de flesta studier har en liknande design, dock ser strukturen för hur man presenterat sin design olika ut mellan de olika studierna. / Newborn babies who are chronically or temporarily ill are experiencing multiple invasive and noxious procedures in emergency rooms and intensive care units. Painful procedures are a risk of brain damage in newborn. This literature review aims to describe the analgesic effect of the sugar solution during painful procedures in neonates and to describe possible complement to the administration of sugar solution. A further aim was to describe the selected articles design. Studies retrieved from the database PubMed by keywords in various combinations. The study group was temporarily ill and healthy babies. Articles were processed carefully by being read with a focus on results section. The results of the reviewed articles show that the sugar solution has a good effect on pain in newborns when compared with placebo or sterile water. In studies that compared the sugar solution with methods that newborn babies were sucking, got heat or skin to skin so the sugar has a worse effect on pain in neonates. One result speaks totally against the use of sugar solution to newborn for pain-relieving. Complement to the sugar solution in purpose of pain relief, such as the newborn got warmth, skin to skin or got sucking in combination with sugar solution provides better effects than giving only the sugar solution. A result also show that breast milk (not through breastfeeding) has a worse effect than sugar solution in pain, but when the newborn babies were breast-feeds the opposite was shown. The author`s third question describes a performance were most studies has a similar design, but the structure of how it has been presented differs between the different studies.
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An analysis of inter-healthcare facility transfer of neonates within the eThekwini Health District of KwaZulu-NatalAshokcoomar, Pradeep 18 January 2013 (has links)
Dissertation submitted in fulfilment of the requirements for the Degree of Master of
Technology: Emergency Medical Care, Durban University of Technology, 2012. / Introduction
The safe transfer of neonates from one healthcare facility to another is an integral
component in the process of neonatal care. Neonates, a term applying specifically to
infants during the first 28 days of life, are transferred from medical healthcare
facilities which do not have specialist care or intensive care management to more
specialised facilities in order to improve their clinical outcome and chance of survival.
The transfer system is thus an important aspect of the overall care provided to
neonates. The transfer process, however, poses a threat of aggravating the clinical
condition of the neonate. Inter-healthcare facility transfer of a neonate requires
careful planning, skilled personnel and specialised equipment to maintain the
continuum of care, as this directly impacts on the morbidity and mortality of the
neonate.
Purpose of the study
The purpose of the study was to undertake a descriptive analysis of the current
neonatal inter-healthcare facility transfer system in the eThekwini Health District of
KwaZulu-Natal (KZN). This service is provided by the public sector ambulance
service known as the Emergency Medical Rescue Service (EMRS). The study,
based on 120 consecutive transfers, assessed the clinical demographics of the
neonates, the time taken to complete the transfers, including time sub-intervals, the
equipment that was necessary for the transfers and the qualifications and
procedures performed by the transfer team. The study also identified any adverse
events that were encountered during the transfers.
Methodology
The study was conducted from 19 December 2011 to 30 January 2012. It used
quantitative methodology and a non-experimental prospective design to undertake a
descriptive analysis of 120 inter-healthcare facility transfers of neonates within the
eThekwini Health District of KwaZulu-Natal. Data collection relied upon two types of
questionnaires. A descriptive survey method incorporated logistic and deductive
reasoning to evaluate the objectives of this study. Frequency distributions were
generated to describe data categories. Bivariate analysis was conducted using chi-
square.
Results
During the study period there were a total of 120 neonatal inter-healthcare facility
transfers. All referrals were undertaken by road ambulances. Eighty-three (62.2%),
transfers were undertaken by the operational ambulance units, 35 (29.2%) by the
obstetric unit and 2 (1.7%) by the planned patient transport units. Thirty one (28.5%)
transfers were on Fridays, followed by 24 (20.8%) on Mondays and 20 (16.6%) on
weekends. Ninety seven (80.8%) were during the hours of dayshift (07h00-19h00)
and 23 (19.2%) were during nightshift (19h00-07h00). Of the 120 neonatal transfers,
29 (24.2%) were specialised transfers, of which 22 (75.9%) were ventilated.
With reference to the gestational ages of the neonates being transferred 90 (76.7%),
were pre-term, 26 (21.7%) were term and 2 (1.7%) were post-term. There were 11
(9.2%) newborns (from birth to 4 hours), 56 (46.7%) early neonates (from 4 hours to
7 days) and 53 (44.2%) late neonates (from 7 days to 28 days). Of the 120 neonatal
transfers, 90 (75.0%) were pre-term having associated co-morbidities and 49
(40.8%) had respiratory problems.
The mean time ± standard deviation (SD), taken by EMRS eThekwini to complete an
inter-healthcare facility transfer was 3h 49min ± 1h 57min. The minimum time to
complete a transfer was 55min and the maximum time was 10h 34min. The mean
time ± SD from requests to dispatch was 1h 20min ± 1h 36min. The delays in
dispatch were associated with no ambulances being available 70 (58.3%), no ALS
personnel available 48 (40.0%), no equipment available 23 (19.2%) and no ILS
personnel available 7 (5.8%) to undertake the transfers. Junior or inexperienced
personnel in the communication centre also contributed to the time delays by
dispatching ALS personnel for non-specialised transfers and requesting neonatal
equipment when it had not been requested by the referring personnel for the
transfer. The mean time ± SD from the referring hospital to the time mobile to the
receiving hospital was 43min ± 26min. Six (5.0%) neonates were clinically unstable
at the referring facility for transfer. For 15 (12.5%) transfers, neonates had been
inappropriately packaged for transport by the hospital staff, which added to the
delays, p. value = 0.018.
The necessary equipment was unavailable for 37 (30.8%) of the transfers. The lack
of equipment was due to problems such as poor resource allocation, and
malfunctioning, inappropriate, insufficient and unsterile equipment. The pre-
departure checklist had not been completed in 50 (41.67%) of the transfers.
The study identified 10 (8.3%) adverse events related to the physiological state of
the neonate and included 1 (0.8%) mortality. Nine (7.5%) neonates suffered serious
life threating complications during transportation, 8 (6.7%) of which were due to
desaturation, 6 (5.0%) due to respiratory deterioration, 3 (2.5%) due to cardiac
deterioration and 1 (0.8%) due to temperature related problems. Eighteen (15.0%) of
120 transfers experienced equipment related adverse events of which 9 (7.5%) were
associated with ventilators, 9 (7.5%) with incubators, 3 (2.5%) with the ambulance, 2
(1.7%) with the oxygen supply and 1 (0.8%) with arterial cannulation. Five (33.3%) of
the 15 equipment related adverse events contributed directly to life threatening
physiologically related adverse events, p. value = 0.007.
Conclusion and recommendation
The Emergency Medical Rescue Service (EMRS) is involved in the transportation of
a significant number of neonates between various healthcare facilities in the
eThekwini Health District, some requiring intensive care and some not. This
descriptive, prospective study has identified numerous shortfalls in the service
provided by the EMRS in the eThekwini District.
Inter-healthcare facility transfer of neonates can be safely performed by the transport
services if the operations are well co-ordinated and there are dedicated, specialised
and trained transport teams armed with appropriate equipment and medication,
together with the guidance of policies and quality assurance. Transport teams must
be trained to provide this specialised care in various environments, including ground
and air ambulances and understand the multiphase neonatal transfer processes.
There must be good communication and co-ordination by all role players, which is
underpinned by good team work to improve the standards of neonatal care and
monitoring. Only then can clinical excellence be achieved when transporting
neonates between healthcare facilities.
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Étude des réflexes cardiorespiratoires d'origine oesophagienne chez l'agneau nouveau-né sans sédation / Cardiorespiratory reflexes originating from stimulation of the esophagus in non sedated newborn lambsNault, Stéphanie January 2016 (has links)
Résumé : Introduction : La relation entre les réflexes vagaux à point de départ œsophagien et les événements cardiorespiratoires des nouveau-nés (apnées, bradycardies, désaturations en O[indice inférieur 2]) reste un sujet discuté. Des études antérieures ont montré que la stimulation des chémo- ou mécanorécepteurs de l’œsophage chez l’animal adulte anesthésié peut être la cause de différents réflexes (Jadcherla, 2012). De plus, l’implication des terminaisons nerveuses des fibres C (FCs) dans certains réflexes d’origine œsophagienne a été suggérée (Lang et al., 2001). Considérant qu’il reste beaucoup d’inconnues sur ces réflexes, en particulier en période néonatale, les objectifs de cette étude sont de i) caractériser les réflexes cardiorespiratoires lorsqu’un reflux gastro-œsophagien (RGO) est mimé; ii) déterminer l’effet du site de la stimulation sur la sévérité des réflexes; iii) déterminer le niveau d’implication des FCs. Méthodes : Huit agneaux nouveau-nés ont été instrumentés chirurgicalement; 48h plus tard, deux enregistrements polysomnographiques distincts ont été effectués sans sédation, avant et après blocage permanent des FCs (Diaz et al., 2000). Cinq stimulations randomisées ont été effectuées permettant de mimer un RGO à différents niveaux de l’œsophage. Résultats : Les stimulations œsophagiennes (RGO) entrainent des réflexes d’inhibition cardiorespiratoire. Les stimulations doubles provoquent des réflexes de plus grande amplitude. Cette inhibition cardiorespiratoire est moins marquée suite au blocage permanent et sélectif des FCs par la capsaïcine. Conclusion : Mes résultats expérimentaux montrent, pour la première fois, une relation entre les réflexes vagaux œsophagiens et des événements cardiorespiratoires chez un animal nouveau-né en l’absence de sédation et suggèrent aussi une certaine implication des FCs. Les reflux proximaux, quant à eux, sont ceux pouvant potentiellement conduire à un RGO pathologique étant donné qu’ils engendrent des réflexes de plus grande amplitude. / Abstract : Introduction : The relationship between vagal reflexes originating from the esophagus and cardiorespiratory events in neonates (apneas, bradycardias, O[subscript 2] desaturations) remains a controversial subject. Previous studies in an a esthetized adult animals have shown that stimulation of esophagal chemo- or mechanoreceptors may cause various reflexes (Jadcherla, 2012). In addition, the involvement of C-fiber endings in some of those reflexes has been suggested (Lang et al., 2001). Considering that many uncertainties remain about these reflexes, especially in the neonatal period, the goals of this study were to i) characterize the cardiorespiratory reflexes observed when a gastroesophageal reflux is mimicked; ii) determine the effect of the stimulation site on the amplitude of those reflexes; iii) determine whe ther C-fibers are involved. Methods: Eight newborn lambs were surgically instrumented; 48 hours later, two separate polysomnographic recordings were performed without sedation before and after permanent C-fiber blockade (Diaz et al., 2000). Five randomized stimulations were performed to mimic a gastroesophageal reflux at different levels of the esophagus. Results: Esophageal stimulations cause cardiorespiratory inhibitory reflexes. Double stimulation causes more important reflexes, including bradycardia and apnea. The cardiorespiratory inhibition response was less marked after permanent and selective blockade of C-fibers by capsaicïne. Conclusion: My experimental results show, for the first time, a relationship between esophageal vagal reflexes and cardiorespiratory events in a neonatal, non-sedated animal and suggest some involvement of C-fiber endings. Results also suggest that proximal gastroesophageal refluxes generate more important reflexes.
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