Distortion product otoacoustic emissions in newborn babies with and without late-term maternal iron deficiency anaemia.

Background: Studies on animals have demonstrated that maternal iron deficiency anaemia (IDA) could result in decreased cochlear sensory hair cells and reduced amplitudes of distortion-product otoacoustic emissions (DPOAEs) of young guinea pigs. Thus, it is essential to study the functioning of cochlear hair cells using DPOAEs in human newborn babies with maternal IDA. The current study explores maternal IDA's effect on DPOAEs in newborn babies. Method: A total of 110 newborn babies with gestational age ≥34 weeks were considered and a 'between-subjects' design was used. The participants were divided into 3 groups- "Normal" (61 babies without maternal IDA), "Mild" (28 babies with mild maternal IDA) and "Moderate" (21 babies with moderate maternal IDA). The cord blood was collected and the DPOAEs were recorded for each baby for a range of frequencies (1 k - 8 kHz) and a range of intensities (70-40 dB SPL in 10 dB steps). Results: The analysis of both DP-gram and DP input-output (I/O) function showed that there was no significant difference (p > 0.05) across the normal, mild, and moderate groups in the overall presence of DPOAEs as well as the amplitude across frequencies or intensities (70-40 dB SPL). Also, the overall correlation of RBC indices with DPOAE amplitude across frequencies as well as the slope of the I/O function showed no relationship. Conclusion: The current study concludes that there is no effect of late-term maternal IDA on the DPOAEs of newborn babies.

Spontaneous movements in the newborns: a tool of quantitative video analysis of preterm babies.

BACKGROUND AND OBJECTIVES: The number of preterm babies is steadily growing world-wide and these neonates are at risk of neuro-motor-cognitive deficits. The observation of spontaneous movements in the first three months of age is known to predict such risk. However, the analysis by specifically trained physiotherapists is not suited for the clinical routine, motivating the development of simple computerized video analysis systems, integrated with a well-structured Biobank to make available for preterm babies a growing service with diagnostic, prognostic and epidemiological purposes. METHODS: MIMAS (Markerless Infant Movement Analysis System) is a simple, low-cost system of video analysis of spontaneous movements of newborns in their natural environment, based on a single standard RGB camera, without markers attached to the body. The original videos are transformed into binarized sequences highlighting the silhouette of the baby, in order to minimize the illumination effects and increase the robustness of the analysis; such sequences are then coded by a large set of parameters (39) related to the spatial and spectral changes of the silhouette. The parameter vectors of each baby were stored in the Biobank together with related clinical information. RESULTS: The preliminary test of the system was carried out at the Gaslini Pediatric Hospital in Genoa, where 46 preterm (PT) and 21 full-term (FT) babies (as controls) were recorded at birth (T0) and 8-12 weeks thereafter (T1). A simple statistical analysis of the data showed that the coded parameters are sensitive to the degree of maturation of the newborns (comparing T0 with T1, for both PT and FT babies), and to the conditions at birth (PT vs. FT at T0), whereas this difference tends to vanish at T1. Moreover, the coding method seems also able to detect the few 'abnormal' preterm babies in the PT populations that were analyzed as specific case studies. CONCLUSIONS: Preliminary results motivate the adoption of this tool in clinical practice allowing for a systematic accumulation of cases in the Biobank, thus for improving the accuracy of data analysis performed by MIMAS and ultimately allowing the adoption of data mining techniques.

Effect of collaborative quality improvement on stillbirths, neonatal mortality and newborn care practices in hospitals of Telangana and Andhra Pradesh, India: evidence from a quasi-experimental mixed-methods study.

BACKGROUND: Improving quality of care is a key priority to reduce neonatal mortality and stillbirths. The Safe Care, Saving Lives programme aimed to improve care in newborn care units and labour wards of 60 public and private hospitals in Telangana and Andhra Pradesh, India, using a collaborative quality improvement approach. Our external evaluation of this programme aimed to evaluate programme effects on implementation of maternal and newborn care practices, and impact on stillbirths, 7- and 28-day neonatal mortality rate in labour wards and neonatal care units. We also aimed to evaluate programme implementation and mechanisms of change. METHODS: We used a quasi-experimental plausibility design with a nested process evaluation. We evaluated effects on stillbirths, mortality and secondary outcomes relating to adherence to 20 evidence-based intrapartum and newborn care practices, comparing survey data from 29 hospitals receiving the intervention to 31 hospitals expected to receive the intervention later, using a difference-in-difference analysis. We analysed programme implementation data and conducted 42 semi-structured interviews in four case studies to describe implementation and address four theory-driven questions to explain the quantitative results. RESULTS: Only 7 of the 29 intervention hospitals were engaged in the intervention for its entire duration. There was no evidence of an effect of the intervention on stillbirths [DiD - 1.3 percentage points, 95% CI - 2.6-0.1], on neonatal mortality at age 7 days [DiD - 1.6, 95% CI - 9-6.2] or 28 days [DiD - 3.0, 95% CI - 12.9-6.9] or on adherence to target evidence-based intrapartum and newborn care practices. The process evaluation identified challenges in engaging leaders; challenges in developing capacity for quality improvement; and challenges in activating mechanisms of change at the unit level, rather than for a few individuals, and in sustaining these through the creation of new social norms. CONCLUSION: Despite careful planning and substantial resources, the intervention was not feasible for implementation on a large scale. Greater focus is required on strategies to engage leadership. Quality improvement may need to be accompanied by clinical training. Further research is also needed on quality improvement using a health systems perspective.

Enterococcus faecalis Is a Better Competitor Than Other Lactic Acid Bacteria in the Initial Colonization of Colon of Healthy Newborn Babies at First Week of Their Life.

Initial colonization of human gut by bacteria is an important step in controlling its microbiota and health status. This study followed the initial colonization by lactic acid bacteria (LAB) in colon of new born babies through following its occurrence in their stool at first week of their life. The LAB occurrence in the neonates' stool was followed on MRS agar medium. The isolated LAB from male and female newborn babies of normal birth and cesarean section surgical delivery were molecular biologically identified by phylogenetic analysis of 16S rRNA gene sequence. From the 24 investigated newborn babies, three LAB taxa, Lactobacillaceae, Enterococcus, and Streptococcus, were detected in their stool at first week of their life. Lactobacillaceae represented 20.8% of total colonized LAB in newborn babies in the culture-dependent approach used in this study and included three species namely Limosilactobacillus reuteri (previously known as Lactobacillus reuteri), Lacticaseibacillus rhamnosus (previously known as Lactobacillus rhamnosus) and Ligilactobacillus agilis (previously known as Lactobacillus agilis). Enterococcus faecalis and E. faecium were detected where E. faecalis was the highest dominant, representing 62.5% of total LAB colonizing newborn babies. This result suggests that this bacterium has high potency for colonization and might be important for controlling the initial settlement of microbiota in healthy newborn babies. Only one species of Streptococcus namely Streptococcus agalactiae was detected in 8.33% total of the investigated newborn babies indicating high competency by other LAB for colonization and that this bacteria, in spite of its pathogenicity, is commensal in its low existence in healthy babies. The explored potency of natural initial colonization of the LAB species E. faecalis, E. faecium, L. reuteri, L. rhamnosus, and L. agilis of which many health beneficial strains were previously reported, would be important for future applications. Despite the controversy in evaluating its health benefits, E. faecalis as a potent competitor to other LAB refers to its importance in initial colonization of healthy babies colon at first week of their life. Further future studies, with more number of samples and characterization, would be of importance for evaluating the potential use of beneficial Enterococcus strains which could improve intestinal ecosystem.

Analysis of ocular infection in neonates / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To study the distribution, drug resistance and epidemic characteristics of pathogenic bacteria in neonatal eye infection in Cangnan County, Zhejiang Province from 2014 to 2018, and to provide the basis for the prevention, diagnosis and treatment of clinical conditions.<p>METHODS: Totally 108 strains of pathogenic bacteria isolated from 294 eyes specimens from neonatal clinic from January 2014 to December 2018 were identified, common drug sensitivity test and epidemiological characteristics were summarized and analyzed.<p>RESULTS: The detection rate of pathogenic bacteria in 294 ocular secretions was 36.7%(108/294). The main flora included 48 strains of<i> Staphylococcus epidermidis</i>(44.4%), 16 strains of<i> Staphylococcus aureus</i>(14.8%), 24 cases of <i>Escherichia coli</i>(22.2%), 12 strains of <i>Neisseria gonorrhoeae</i>(11.1%), 5 strains of <i>Corynebacterium diphtheria</i>(4.6%), 2 strains of <i>Enterococcus</i>(1.9%)and 1 case of <i>Streptococcus </i>(0.9%). The main pathogens are highly sensitive to amikacin and netilmicin, and are highly sensitive to jellithromycin and netilmicin. The activity of gentamicin is poor. It has good activity against quinolones.<p>CONCLUSION:<i>Staphylococcus</i> is the main pathogen of neonatal eye infection, and eye antibiotics commonly used in clinic have good antibacterial activity against all kinds of pathogenic bacteria.

[The application of the modern phototherapeutic technologies for the medical rehabilitation of the children].

This literature review is focused on the application of polychromatic and monochromatic polarized light for the treatment of various diseases of the childhood including those in the newborns and the premature babies. The analysis of the data of scientific research gives evidence of the beneficial effect of polychromatic polarized light on the clinical course of various skin diseases in the newborn children. Moreover, the improved immunological and reparative processes were revealed after the surgical interventions for congenital heart defects in the newborns. The light-induced changes in the skin contribute to the realization of therapeutic effects of polarized polychromatic light in such children's diseases as atopic dermatitis, bronchitis, bronchial asthma, neurogenic urinary bladder dysfunction, and the traumatic injuries of the limbs. The biologically positive physiological effects of monochromatic polarized light are known to contribute to the improvement of the clinical and functional status in the children presenting with bronchial asthma and in the patients frequently suffering from acute respiratory diseases. The versatility of the biological effects of polarized light taken together with the possibility of its application from the first days of the child's life, the short duration of the procedure, the absence of unpleasant sensations and contact between the damaged surface and the device as well as the simplicity of using the equipment determine the promising prospects for the use of the proposed method in the clinical pediatric practice.

Filial responses as predisposed and learned preferences: Early attachment in chicks and babies.

To what extent are filial responses the outcome of spontaneous or acquired preferences? The case of domestic chicks illustrates the connection between predisposed and learned knowledge in early social responses. In the absence of specific experience, chicks prefer to approach objects that are more similar to natural social partners (e.g. they prefer face-like configurations, biological motion, self-propelled objects and those that move at variable speed). Spontaneous preferences are complemented by filial imprinting, a powerful learning mechanism that enables chicks to quickly learn the features of specific social partners. While neurobiological studies have clarified that the substrates of spontaneous and learned preferences are at least partially distinct in chicks, evidence shows that spontaneous preferences might orient and facilitate imprinting on animate stimuli, such as the mother hen, and that hormones facilitate and strengthen preferences for predisposed stimuli. Preferences towards animate stimuli are observed in human neonates as well. The remarkable consistency between the perceptual cues attended to by newborn babies and naïve chicks suggests that the attentional biases observed in babies are unlikely to result from very rapid post-natal learning, and confirms that research on precocial species can inform and guide human infant research with regards to both typical and atypical development. This has potentially important biomedical implications, opening new possibilities for the early detection of subjects at risk for autism spectrum disorders. We show how the parallel investigation of predispositions in naïve chicks and human infants, both benefiting from contact with social partners since the beginning of life, has greatly improved our understanding of early responses to social stimuli at the behavioural and neurobiological level.

Cord blood haemoglobin and ferritin concentrations in newborns of anaemic and non-anaemic mothers in Lagos, Nigeria.

BACKGROUND: Pre-delivery haemoglobin and serum ferritin concentrations of anaemic and non-anaemic mothers were determined, and cord blood haemoglobin and serum ferritin concentrations of their newborns were compared. This is to establish the mean values for pre-delivery haemoglobin and serum ferritin concentrations of anaemic and non-anaemic mothers and the cord blood haemoglobin and serum ferritin concentrations of their newborns at term. MATERIALS AND METHODS: A case-control study was done involving 142 pregnant women and their newborns. They were divided into two groups - the anaemic group (n = 65) and the non-anaemic (n = 77) group. Five millilitres of blood was collected from each woman and 2 ml was collected from the cord of their newborns into ethylenediaminetetraacetic acid (EDTA) bottle and plain bottle for full blood count analysis and ferritin assay, respectively. RESULTS: The mean pre-delivery haemoglobin concentrations of the women in anaemic group and non-anaemic group were 9.5 ± 1.01 g/dl and 12.15 ± 1.07 g/dl, respectively, and their mean serum ferritin concentrations were 64.45 ± 138.76 µg/l and 32.83 ± 35.36 µg/l, respectively. The mean cord blood haemoglobin concentrations for anaemic and for non-anaemic groups were 12.54 ± 2.54 g/dl and 13.44 ± 2.23 g/dl (P = 0.02), respectively, and the mean cord blood serum ferritin concentrations (non-anaemic, 69.38 ± 78.88 µg/l; anaemic, 7.26 ± 115.60 µg/l) (P = 0.00) were higher in the newborns of non-anaemic than of anaemic mothers. Significant association was found between maternal anaemia and cord blood ferritin concentrations (P = 0.025). CONCLUSION: Maternal anaemia has significant effects on cord blood haemoglobin and serum ferritin concentrations.

Newborn measles antibody profile in a teaching hospital: Can sex of babies determine measles IgG acquisition from their respective mothers?

Known sex specific differences in fetal, neonatal morbidity and mortality have been documented. Sex differences also exist in birth-weight centile with males being larger than females at birth. However, these sex differences are not fully explored when studying passive measles immunity acquired by babies from their mothers. Moreover, the mechanisms that confer these sex differences are to a large extent unknown. Therefore, this study assessed sex of babies as a determinant of measles immunoglobulin G acquisition from their respective mothers. One hundred and seventy four newborn babies were enrolled in this study. Enzyme linked immunosorbent assay was used to measure maternal measles antibodies (MMA) from sera collected from these babies at birth. Gestational age of the newborn babies was determined using the Nagele rule, ultrasound scan reports and the Dubowitz criteria. Sex and mean MMA of these babies was compared using the Student's t test. Significant comparison existed between mean MMA and sex of post term babies (P = 0.000), such that post term males had higher levels of MMA than females. However, overall sex and mean MMA comparison of these babies was not significant (P = 0.977). There were more MMA in male post term babies relative to their female peers; however, overall sex comparison of MMA was not significant. Therefore, there is the need for further study.

Urgência subjetiva do neonato em UTI / Subjective urgency of newborn babies in an ICU / L'urgence subjective du nouveau-né en réanimation néonatal / Urgencia subjetiva del neonato en UTI

O artigo tem por objetivo questionar alguns discursos sobre os primórdios da estruturação do sujeito para, posteriormente, construir hipóteses sobre o que estaria em jogo na experiência do neonato prematuro na UTI. Para tal, à condição do organismo biológico e às intervenções médicas oporemos as funções da fala e da linguagem como determinantes do que será constituído como trauma. Além disso,discutiremos como abordar a questão do tempo nos processos de subjetivação levados a cabo pela criança.

The objective of this article is to question certain discourses regarding the beginnings of the structuring of the subject, in order to next construct hypotheses as to what is involved in the experience of newborn babies in an ICU. For this purpose, wewill compare the condition of the biological organism and medical interventions into the functions of speech and language as determinant of what will be constituted as trauma.We will also discuss how to approach the question of time in children’s processes of subjectivation.

L’article vise à mettre en question certains discours sur les origines de lastructuration du sujet pour ensuite construire des hypothèses sur ce qui serait en jeudans l’expérience du nouveau-né prématuré en réanimation néonatale. Á cette fin, onopposera les fonctions de la parole et du langage en tant que déterminants de ce quisera constitué comme traumatisme à l’état de l’organisme biologique et auxinterventions médicales. En outre, on discutera la façon d’aborder la question du tempsdans le processus de subjectivation mené par l’enfant.

El artículo tiene como objetivo cuestionar algunos discursos sobre los albores dela estructuración del sujeto, para posteriormente, construir hipótesis sobre lo que estaría en juego en la experiencia del neonato prematuro en la UTI. Para eso. a lacondición del organismo biológico y a las intervenciones médicas o pondremos las funciones del habla y del lenguaje como determinantes de lo que se constituirá como trauma. Además, discutiremos cómo abordar la cuestión del tiempo en los procesos de subjetivación llevados a cabo por el niño.

Avaliação auditiva no recém-nascido e suas implicações éticas: [revisão] / Hearing evaluation on newborn babies and its ethical implications: [review]r

O estudo tem por finalidade examinar a produção bibliográfica que investigou o uso do teste das emissões otoacústicas em recém-nascidos realizado em hospitais, dando ênfase à aprovação do referido artigo junto ao Comitê de Ética em Pesquisa. O método constitui-se numa revisão bibliográfica de artigos nacionais publicados em revistas brasileiras. A busca se deu por meio de bancos de dados da Biblioteca Virtual em Saúde (BVS) (http://www.bireme.br), e site de busca (http://www.google.com.br), referentes aos anos de 2004 a 2006, usando os descritores emissões otoacústicas e triagem auditiva ou expressões equivalentes em neonatos, em hospitais. Outro meio foi a busca manual nas listas de referências dos artigos selecionados. Após aplicação dos critérios de inclusão, foram selecionados nove artigos em cinco tipos de revistas. A citação da aprovação do Comitê de Ética e assinatura do termo de consentimento livre e esclarecido pelo responsável estiveram presentes na grande maioria dos artigos, demonstrando a preocupação e respeito dos pesquisadores da área para com o sujeito participante no estudo.

The study has as purpose to examine the bibliographic production that investigates the use of the test of otoacoustic emissions in newborn babies done in hospitals. It gives emphasis in the approval of the mentioned article along the Research Ethics Committee. The method consists on bibliographic revision of national articles published in Brazilian journals. The research was realized in databases of the virtual library in health (http://www.bireme.br) and at the search engine Google (http://www.google.com.br), considering the period of 2004 to 2006. The key words used were: otoacoustic emissions and hearing triage or equivalent expressions in newborn babies in hospitals. Another source was the manual search in reference lists of the selected articles. After the application of the inclusion rules, nine articles were selected in five different journals. The citation of the approval of the Ethics Committee and the signature of the Free Consent Term, which were cleared by the responsible, were present in the majority of the articles and it demonstrates the concern and respect of the researchers of this area with the participant citizen on the study.

Percepção das mães sobre o cuidado do bebê de baixo peso antes e após implantação do Método Mãe-Canguru em hospital público da cidade de São Paulo, Brasil / Maternal perception of low birth weight babies before and following the implementation of the Kangaroo Mother Care in a public hospital, in the city of São Paulo, Brazil

OBJETIVOS: aumentar a compreensão sobre os diferentes modos que as famílias de baixa renda lidam com o nascimento de um bebê pré-termo, com vistas a aprimorar a implantação do Método Mãe-Canguru (MMC). MÉTODO: estudo qualitativo realizado em São Paulo, estado de São Paulo, em 2004, no qual foram entrevistadas 19 mães antes e 22 mães após implantação do MMC. O roteiro de entrevistas incluía questões abertas, das quais emergiram as informações sobre como as mães cuidaram de seus bebês de baixo peso, os arranjos domésticos e outras medidas a que recorreram. Para análise utilizou-se a abordagem da Grounded Theory. RESULTADOS: a necessidade de cuidar de outros filhos parece ser um dos principais limitadores para a opção ao MMC. Em comparação às mães entrevistadas antes da implantação do programa, as mães-cangurus eram mais jovens, mais escolarizadas, sem outros filhos, recebiam mais ajuda nas tarefas domésticas e relataram menos dificuldades na amamentação. CONCLUSÕES: a oferta do MMC em uma maternidade da periferia de São Paulo sugere efeitos positivos sobre a amamentação. A tendência à conformação de famílias nucleares dificulta a participação das mulheres no programa. Conhecer as limitações e possibilidades de cada família pode contribuir para o aperfeiçoamento do processo de implantação.

OBJECTIVES: increase the understanding of the different ways low income families deal with a preterm baby aiming at the improvement of the Kangaroo Mother Care (KMC). METHOD: qualitative study performed in the city of São Paulo, State of São Paulo, in 2004 with the interview of 19 mothers before and 22 mothers following the implementation of the KMC. The design of the interviews included open questions to obtain information on how mothers tended their low weight babies, household arrangements and other measures they resorted to. The Grounded Theory Method Approach was used for analysis. RESULTS: the need to care for other children seems to be one of the main KMC constraints. In comparison to mothers interviewed before the program's implementation, the mothers using the KMC were younger, had more schooling, no other children and reported less difficulty in breastfeeding their babies. CONCLUSIONS: the KMC offer in a maternity in the outskirts of São Paulo reflects positive effects on breastfeeding. The tendency of nuclear families hinders women's participation in the program. Awareness of the limitations and possibilities of each family may contribute to improve the program's implementation.