Biliblanket Utilization for Outpatient Treatment of Newborn Jaundice.

Hyperbilirubinemia is a common neonatal diagnosis. Biliblankets have the potential to reduce readmission for hyperbilirubinemia. The study purpose was to characterize home biliblanket treatment for hyperbilirubinemia using retrospective medical record review of newborns with total serum bilirubin of 0.1 to 3 mg/dL below inpatient threshold seen at 9 pediatric clinics (N = 359). The main outcomes were whether a biliblanket was used and whether the usage impacted readmissions. Home biliblankets were used for 44% of newborns. Nine percent of newborns were readmitted for hyperbilirubinemia. Four percent of newborns treated with a biliblanket were readmitted compared with 13% of those not treated with a biliblanket (P = .002). Newborns treated with a biliblanket (odds ratio [OR] = 0.16; 95% confidence interval [CI] = 0.06-0.44) and newborns 3 days or older (OR = 0.16; 95% CI = 0.06-0.43) were less likely to be readmitted than newborns not treated with a biliblanket and 2-day-old newborns. We found that home biliblanket use was associated with lower odds of hospital readmission for newborn jaundice.

Cancer Care at Times of Crisis and War: The Syrian Example.

PURPOSE: As Syria enters its fifth year of conflict, the number of civilians killed and injured continues to rise sharply. Along with this conflict comes the rapid decline of medical care, specifically cancer care. To determine physician and equipment availability, cancer screening and management, and possible solutions relative to various major cities, a survey was distributed to physicians inside Syria through the help of the humanitarian organization Syrian American Medical Society. METHODS: Online surveys were distributed to both certified oncologists who work in cancer clinics and general physicians who work in rural and mobile clinics inside Syria. Variables assessed were physician specialty, location, population, cost, regional situation (besieged versus government controlled), and resource availability and access. Results were stratified by location and physician specialty. RESULTS: Survey results revealed a large shortage of specialized physicians and inhibited accessibility to screening and management options in besieged areas compared with government-controlled regions. Physicians within both government-controlled and besieged cities reported limited or no targeted agents, radiation therapy, clinical trials, bone marrow transplantation, positron emission tomography scans, magnetic resonance imaging, and genetic testing. CONCLUSION: The Syrian civil war has resulted in suboptimal oncology care in the majority of the region. In consideration of specific deficiencies in cancer care, we recommend several solutions that may better the level of care in Syria: patient education on medical documentation and self-examination; online consultation; and cheap, effective screening methods. The implementation of these recommendations may change the course of cancer care in a country that has deteriorated into the worst humanitarian crisis of the century.