Pediatrics
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The use of pulse-oximetry screening to detect critical congenital heart defects in newborns has gained national and international momentum in the past decade. Our hospital system began screening in 2008. Since then, our program has undergone leadership changes and multiple quality improvement interventions. The aims of this study are to evaluate the evolution of our pulse-oximetry program and to provide insights from lessons learned over the course of a long-standing program. ⋯ We established a sustainable pulse-oximetry screening program in our community hospital system, and the screening has now become routine. The quality of our screening was influenced by choice of screening protocol, rigor of quality assurance reviews, and the process used to interpret screening results.
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Young adults born preterm at very low birth weight start families later. Whether less severe immaturity affects adult social outcomes is poorly known. ⋯ Young adults born preterm experience more social challenges, which may affect their romantic relationships and future family planning.
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Tapentadol (Nucynta) is indicated for the treatment of moderate to severe pain in adults. Tapentadol's mechanism of action consists of acting as an agonist on the μ-opioid receptor and by inhibiting the reuptake of norepinephrine. There are no published reports on the toxicity of tapentadol in pediatric patients. The goals of this study are to describe the incidence, medical outcomes, clinical effects, and treatment secondary to tapentadol exposure. ⋯ This is the first study examining the toxic effects of tapentadol in a pediatric population. Although a majority of the patients in this review developed no effect from their exposure, two had life-threatening events. The most common effects reported were opioidlike.
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Observational Study
Breastfeeding duration and weight gain trajectory in infancy.
Short breastfeeding duration may exacerbate accelerated early growth, which is linked to higher obesity risk in later life. This study tested the hypothesis that infants at higher risk for obesity were more likely to be members of a rising weight-for-length (WFL) z score trajectory if breastfed for shorter durations. ⋯ Infants at the highest risk for rising weight patterns appear to benefit the most from longer breastfeeding duration. Targeting mothers of high-risk infants for breastfeeding promotion and support may be protective against overweight and obesity during a critical window of development.