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1.
J Perinatol ; 44(6): 851-856, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38773215

ABSTRACT

BACKGROUND: Infants with past NICU admission have a significantly higher risk of developing neurodevelopmental disorders. Studies have demonstrated an iatrogenic effect of the NICU environment on neurodevelopmental outcomes, even while accounting for physical factors. It is, therefore, critical that an infant's LOS is driven by physical needs versus sociodemographic barriers. METHODS: We leveraged electronic health records and a backward selection regression model to explore physical and sociodemographic predictors of infant LOS. RESULTS: Our results demonstrated that physical predictors (birthweight and ventilator use) accounted for the majority of variance in our model but that a sociodemographic predictor, mean visits per day, was also significant. CONCLUSIONS: Infants who were visited more frequently experienced a shorter LOS, possibly due to increased parental involvement resulting in more individualized care and directly impacting infant stability and morbidity. By supporting visitation, we can reduce the costs of lengthy NICU hospitalizations while improving infant and parent health and well-being.


Subject(s)
Intensive Care Units, Neonatal , Length of Stay , Humans , Infant, Newborn , Length of Stay/statistics & numerical data , Female , Male , Birth Weight , Respiration, Artificial/statistics & numerical data , Respiration, Artificial/adverse effects , Infant, Premature , Electronic Health Records , Retrospective Studies , Socioeconomic Factors
2.
Cardiorenal Med ; 2(3): 234-242, 2012 Aug.
Article in English | MEDLINE | ID: mdl-22969780

ABSTRACT

BACKGROUND: Vitamin D deficiency and secondary rises in parathyroid hormone (PTH) are highly prevalent in obese African-Americans. Endothelial dysfunction related to oxidative stress is more common in African-Americans compared to whites. Currently, the association of vitamin D (25-hydroxyvitamin D, 25-OH D) and PTH to nitric oxide metabolites (NOx) - nitrate and nitrite - and oxidative stress in African-Americans is unknown. Objective: A cross-sectional design was utilized to determine the association of 25-OH D and PTH with urinary NOx (UNOx) (n = 101) and plasma isoprostanes (n = 125), an oxidative stress marker, in overweight (body mass index of 25-39.9), normotensive African-Americans aged ≥35 years. Measurements: Multivariable linear regression analysis adjusted for age, sex, body mass index, and season was used to determine the relationship of 25-OH D and PTH to UNOx and isoprostanes. General linear models, adjusted for the same covariates, contrasted UNOx across three mutually exclusive vitamin D/PTH groups: (1) normal 25-OH D (51-249 nmol/l) and normal PTH (≤65 pg/ml); (2) low 25-OH D and normal PTH, and (3) low 25-OH D and high PTH. RESULTS: 25-OH D was directly associated with UNOx before (p = 0.02) and after (p = 0.03) adjustment for PTH levels. A borderline significant association was observed between PTH and isoprostanes (p = 0.08). UNOx was 424, 290, and 270 µmol/8 h, respectively, across vitamin D/PTH groups 1-3 (p = 0.08). CONCLUSION: 25-OH D was directly associated with NO availability and PTH was positively, though borderline, associated with isoprostanes in overweight, normotensive adult African-Americans.

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