Croatian medical journal
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Croatian medical journal · Oct 2005
ReviewIs neonatal intensive care justified in all preterm infants?
A proactive policy of resuscitation at birth and prompt initiation of intensive care have been shown to be associated with an improvement in the survival of very preterm infants in both institution-based and population-based studies. As a greater percentage of live births were offered intensive care, the survival rate rose progressively in all birth weight and gestation subgroups among extremely low birth weight infants, including those who were born at borderline viability between 23 weeks and 25 weeks of gestational age. Their quality-adjusted survival rate also rose progressively, since the large gains in survival over time had not been offset by significant increases in survival with disability. ⋯ National and international surveys of obstetricians and neonatologists on their perception of viability and their management decisions in extremely preterm infants have shown significant variations on the application use of intensive care in those born extremely preterm. If doctors believe that such infants have little prospect for intact survival, their management would be suboptimal or delayed, thus creating a self-fulfilling prophecy. Both developed and developing countries need to develop appropriate policies for initiating and withdrawing intensive care, taking into consideration their own cultural, social, and economic factors.
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Croatian medical journal · Oct 2005
Randomized Controlled Trial Clinical TrialUsefulness of aspirin therapy in high-risk pregnant women with abnormal uterine artery Doppler ultrasound at 14-16 weeks pregnancy: randomized controlled clinical trial.
To assess the effectiveness of low-dose aspirin in the prevention of preeclampsia and intrauterine growth restriction (IUGR) in high-risk pregnant women with abnormal findings at uterine artery Doppler velocimetry performed at 14-16 weeks. ⋯ Low-dose aspirin administered as early as 14-16 weeks of gestation to pregnant women at high risk of preeclampsia with abnormal uterine Doppler findings may reduce or modify the course of severe preeclampsia. Its effects on the prevention of IUGR need further evaluation.
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Croatian medical journal · Oct 2005
Comparative StudyRelationship between eye movement period and micturition in newborn infants differs from that of human fetuses at term.
To investigate the relationship between the onset of eye movement periods and micturition in human fetuses and in neonates with the intention of clarifying the transition in relationship during the perinatal period. ⋯ The relationship between the onset of an eye movement period and micturition is different in term human fetuses and neonates of less than 1 month of age. This suggests that the neuronal relationship among brain centers for micturition, rapid-eye-movement sleep, and awakening is dramatically altered perinatally.
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Croatian medical journal · Oct 2005
Molecular analysis in diagnostic procedure of hearing impairment in newborns.
To determine the proportion of newborns diagnosed with hearing impairment through the hearing impairment screening program in newborns, and the frequency of 35delG/GJB2 mutation as a cause of hearing impairment. The results of the study imply the integration of the mutation analysis in the neonatal screening program. ⋯ Neonatal hearing impairment screening is useful for early diagnosis of hearing impairment. It should be complemented with the 35delG/GJB2 mutation analysis, because the identification of the mutation and the etiologic diagnosis might improve the medical treatment and genetic counselling of patients and families with hearing impairment.
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This essay presents a preventive ethics to hidden aspects of the professional liability crisis, which is now affecting physicians throughout the world. It draws on the concept of fiduciary responsibility and its four professional virtues of integrity, compassion, self-effacement, and self-sacrifice to identify preventive ethics approaches to the professional liability crisis for practicing physicians and physician leaders. ⋯ Physician leaders should create organizational cultures to support physicians in this important work. Fiduciary responsibility and professional virtues should guide practicing physicians and physician leaders in creating best-practice models to improve organizational culture and influence health policy.