Acta paediatrica
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To study delivery outcome including presence of infant congenital malformations after maternal use of loperamide in early pregnancy. ⋯ Maternal use of loperamide in early pregnancy may be associated with a moderate risk increase for a malformation in the infant. The finding should be evaluated from other large studies.
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Patients with septic shock may develop refractory hypotension despite maximal inotropic support with impairment of clinical outcome. Terlipressin, a long-acting vasopressin analogue, is reported to be effective as rescue treatment of refractory septic shock in adult and paediatric patients, while clinical experience in neonates is definitely scarce. We report a neonate with systemic inflammatory response syndrome after surgery for abdominal neuroblastoma who received terlipressin as rescue treatment after failure of volume load and catecholamines. Terlipressin promptly reversed hypotension and improved tissue perfusion without adverse effects. ⋯ Terlipressin appears an effective rescue treatment in patients with refractory vasodilatory septic shock. Further studies are required to assess its efficacy and safety in neonatal population.
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Recommendations from national bodies regarding extremely preterm infants have focussed almost exclusively on thresholds for intervention based upon estimated gestational age (GA) alone. ⋯ Simplistic policies based on GA alone should be avoided. Decision making for extremely preterm infants should recognize that they are each unique and must be individualized, taking into account all relevant prognostic factors and the values and wishes of the families.
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Low- and middle-income countries bear far higher road traffic injury mortality rates than high-income countries. This paper considers the changing picture of child traffic injury mortality in Lithuania over a 35-year period. ⋯ Road traffic injury remains a serious public health problem in children and young people in Lithuania, which requires a high priority.
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To determine the effects of noradrenaline in full-term newborns with refractory septic shock. ⋯ Noradrenaline was effective in increasing systemic blood pressure. An increase in urine output and a decrease in blood lactate concentration suggest that noradrenaline may have improved cardiac function and tissue perfusion.