Acta paediatrica
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Most analyses of end of life decisions in Neonatal Intensive Care Units (NICUs) have come from Europe/English-speaking countries. Would decisions be different in Latin American NICUs? Therefore, we aim to evaluate the approach to dying infants/families in NICUs in Latin America. ⋯ Latin American NICUs differ from those in Northern Europe/English-speaking countries. More deaths are accompanied by full life support and CPR. DNR orders are rare. Withdrawal of life support is virtually non-existent. Latin American's doctors are more likely to make decisions without the objections of family about withholding life-sustaining treatment.
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Multicenter Study
Hypothermia for neonatal encephalopathy: Nationwide Survey of Clinical Practice in Japan as of August 2010.
Therapeutic hypothermia is now recommended as a standard of care for neonatal encephalopathy. Although adherence to standard cooling protocols used in the phase-III trials is essential, empiric approaches have prevailed in Japan. ⋯ Only 43.8% of the units provided therapeutic hypothermia. Even in centres where hypothermia was offered, adherence to the standard protocols was extremely poor. To secure the safety and efficacy, further promotion of the standard cooling protocols is required; an efficient cooling centre network has to be established by optimizing the work forth distribution and transportation system.
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The purpose of the study was to investigate serum concentrations of the monocyte chemoattractant protein-1 (MCP-1) and high-sensitivity CRP (hs-CRP) in children with hyperuricemia and to evaluate its association with obesity. ⋯ Serum MCP-1 and hs-CRP are elevated in hyperuricemic patients, but the role of obesity in inflammation markers needs further investigation.
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To assess the reliability of fluid balance charts in neonates. ⋯ Fluid balance charts both over- and underestimate body weight changes in an unpredictable pattern and are therefore unreliable as a single measure of fluid status in neonates.