Neonatology
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Sepsis continues to be a leading cause of morbidity and mortality in newborns. ⋯ We conclude that p38 MAPK phosphorylation is crucially involved in LPS activation and could explain the differences in early cytokine response between neonatal and adult blood.
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Increased survival rates for extremely low birth weight infants have been reported. However, survival rates and prognoses of extremely preterm infants, such as infants born at 22 weeks of gestation, are still poor. ⋯ In our study, all infants admitted to the NICU at a gestational age of 22 weeks were discharged from the hospital alive. This might suggest that infants after 22 weeks' gestation be considered eligible for active treatment in Japan, though considering the size of the material, generalizibility of the results cannot be considered guaranteed.
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Most pediatric cardiologists believe that pulse oximetry helps to diagnose critical congenital heart disease in neonates who might otherwise be discharged from the newborn nursery undiagnosed. Some of these patients develop catastrophic cardiac and multi-system failure after the ductus closes and die or suffer severe morbidity. Nevertheless, pulse oximetry is not universally used in the newborn nursery. ⋯ Recent studies, however, show that even cardiologists miss critical congenital heart defects, modern oximeters are stable and reliable, and that the false positive rate is very low, lower than the false positive rate based on physical examination. The benefits probably exceed the cost, and evidence is provided to confirm this. There is no reason not to use pulse oximetry routinely in the newborn nursery.