Early human development
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Early human development · May 2013
Measurement of systemic oxygen delivery and inotropy in healthy term neonates with the Ultrasonic Cardiac Output Monitor (USCOM).
The aim of this study was to assess the normal values for Smith-Madigan inotropy (SMI), Smith-Madigan inotropy index (SMII), oxygen delivery (DO2) and oxygen delivery index DO2I in healthy term neonates on the first day of life and during circulatory adaptation over the first three days of life. ⋯ Normal inotropy of the left heart and systemic DO2 values in healthy full-term neonates over the first three days of life were assessed using the USCOM. Subjects showed stable myocardial contractility over the first three days with decreasing DO2 and DO2I in line with the decrease in cardiac output (CO). DO2 and DO2I showed small but significant reductions during the first 24 h. USCOM proved to be a feasible and convenient non-invasive bedside tool to assess inotropy and oxygen delivery in neonates.
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Early human development · Mar 2013
Analysis of acute pain scores and skin conductance measurements in infants.
Skin conductance (SC) has been previously used to measure acute post-operative pain in adults and older children (>1year old).We have investigated the ability of SC to predict the severity of post-operative pain scores in the exclusively infant population. ⋯ Peak SC values may serve as indicators of unmitigated pain. Further studies are needed to fully investigate the effect of MOR A118G SNP on the post operative pain scores and SC values in the larger infant population in order to validate both the clinical significance of the skin conductance for routine pain assessment in infants and the observed genetic effect.
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Early human development · Feb 2013
Digit ratio (2D:4D) in newborns: influences of prenatal testosterone and maternal environment.
The 2D:4D digit ratio is sexually-dimorphic, probably due to testosterone action through the perinatal period. We characterize the 2D:4D ratio in newborn (NB) infants, in between the pre- and postnatal surges of testosterone, and relate it to the mother's 2D:4D and to testosterone levels in the amniotic fluid (AF). ⋯ Sexual dimorphism at birth was only significant for the left hand, in contrast with reports of greater right hand dimorphism, suggesting that postnatal testosterone is determinant for 2D:4D stabilization. The lower 2D:4D ratios in mothers who had sons support claims that hormone levels in parents are influential for determining their children's sex. NB female's digit ratio, but not males', was associated to the level of AF testosterone. The mother's 2D:4D ratios were positively correlated with their daughters' 2D:4D, but the same was not observed for male NBs, suggesting that prenatal testosterone levels in male fetus lead their 2D:4D ratios to stray from their mothers' with high individual variability.
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Early human development · Dec 2012
How to develop a business case to establish a neonatal pulse oximetry programme for screening of congenital heart defects.
Pulse oximetry screening for critical congenital heart defects (CCHDs) is a highly specific, moderately sensitive test which is cost effective, acceptable to both clinical staff and parents and meets the criteria for universal screening. Pulse oximetry screening is gaining considerable worldwide support and last year was added to the recommended uniform screening panel in the USA following endorsement by the Health and Human Services Secretary. There is significant heterogeneity in published screening protocols and it is important to consider all available evidence and also take local factors into account when developing a screening programme, whether it is within an individual hospital, neonatal network or even at a national level. This paper presents available options based both on the published evidence and personal practice experience which will aid those considering the introduction of screening to make the right decisions both from a clinical and financial perspective.
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Early human development · Nov 2012
Very low birth weight neonates who survive early-onset sepsis do not have an increased risk of developing late-onset sepsis.
Very low birth weight neonates (≤ 1500 g, VLBWs) have a high rate of infection and distinct baseline immune function compared with more mature populations. In critically ill children and adults, sepsis increases subsequent infection risk. It is unknown whether sepsis modifies the risk of subsequent infection in VLBWs. ⋯ In contrast to findings in children and adults, EOS was not associated with an increased risk of LOS in this cohort. Age-specific investigations are needed to determine if post-sepsis immunologic alterations are present.