Pediatrics
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Randomized Controlled Trial Multicenter Study
Probiotic effects on late-onset sepsis in very preterm infants: a randomized controlled trial.
Late-onset sepsis frequently complicates prematurity, contributing to morbidity and mortality. Probiotics may reduce mortality and necrotizing enterocolitis (NEC) in preterm infants, with unclear effect on late-onset sepsis. This study aimed to determine the effect of administering a specific combination of probiotics to very preterm infants on culture-proven late-onset sepsis. ⋯ The probiotics B infantis, S thermophilus, and B lactis significantly reduced NEC of Bell stage 2 or more in very preterm infants, but not definite late-onset sepsis or mortality. Treatment with this combination of probiotics appears to be safe.
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Randomized Controlled Trial
Resuscitation of preterm neonates with limited versus high oxygen strategy.
To determine whether a limited oxygen strategy (LOX) versus a high oxygen strategy (HOX) during delivery room resuscitation decreases oxidative stress in preterm neonates. ⋯ LOX is feasible and results in less oxygen exposure, lower oxidative stress, and decreased respiratory morbidities and thus is a reasonable alternative for resuscitation of preterm neonates in the delivery room.
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Epigenetics, the study of functionally relevant chemical modifications to DNA that do not involve a change in the DNA nucleotide sequence, is at the interface between research and clinical medicine. Research on epigenetic marks, which regulate gene expression independently of the underlying genetic code, has dramatically changed our understanding of the interplay between genes and the environment. ⋯ In addition, epigenetic marks are potentially heritable. In this article, we discuss the underlying concepts of epigenetics and address its current and potential applicability for primary care providers.
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Randomized Controlled Trial
Reducing children's exposure to secondhand smoke at home: a randomized trial.
To develop and test an intervention to reduce children's exposure to secondhand smoke (SHS) at homes in Yerevan, Armenia. ⋯ Intensive intervention is effective in decreasing children's exposure to SHS through educating mothers and promoting smoking restrictions at home. However, superiority over minimal intervention to decrease children's exposure was not statistically significant.
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Multicenter Study Clinical Trial
Reducing central line-associated bloodstream infections in North Carolina NICUs.
Central lines in NICUs have long dwell times. Success in reducing central line-associated bloodstream infections (CLABSIs) requires a multidisciplinary team approach to line maintenance and insertion. The Perinatal Quality Collaborative of North Carolina (PQCNC) CLABSI project supported the development of NICU teams including parents, the implementation of an action plan with unique bundle elements and a rigorous reporting schedule. The goal was to reduce CLABSI rates by 75%. ⋯ A collaborative structure targeting team development, family partnership, unique bundle elements and strict reporting on line care produced the largest reduction in CLABSI rates for any multiinstitutional NICU collaborative.