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Medications that reduce gastric acid secretion are commonly prescribed for treating gastroesophageal reflux disease. However,several studies have shown that these medications are not very effective, and are associated with adverse effects. This articlediscusses the physiology of gastric acid secretion, clinical indications and pharmacology of acid suppressing medications, andpossible adverse effects of these medications
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In utero sensory stimuli and interaction with the environment strongly influence early phases of fetal and infant development. Extremelypremature infants are subjected to noxious procedures and routine monitoring, in addition to exposure to excessive light and noise, whichdisturb the natural sleep cycle and induce stress. Non-invasive ventilation, measures to prevent sepsis, and human milk feeding improveshort-term and long-term neurodevelopmental outcomes in premature infants. To preserve brain function, and to improve quality of lifeand long-term neurodevelopmental outcomes, the focus now is on the neonatal intensive care unit (NICU) environment and its impact onthe infant during hospital stay. The objectives of this write-up are to understand the effects of environmental factors, including lighting andnoise in the NICU, on sensory development of the infant, the need to decrease parental and caregiver stress, and to review existingliterature, local policies and recommendations
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Apnea in a premature infant is not always due to immaturity and caffeine is not always the answer. We report a case of apnea in a preterm infant who presented at two weeks of life with increase in frequency of apnea that did not respond to caffeine. Family history was significant for diarrhea in a sibling. Stool PCR was positive for Norovirus Genogroup II. Enteric isolation was instituted and the apnea resolved spontaneously with conservative management. Re-emergence of apnea or persistent apnea necessitates further investigation to elucidate the etiology.