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Aim: This descriptive study was conducted to evaluate chronic pain in premature infants on invasive and noninvasive mechanical ventilation. Material and Methods: The sample of this study consisted of 110 premature infants with a gestational age of ≥25 weeks and ≤36 weeks in the Neonatal Intensive Care Unit. Data were collected between February 2018 and April 2019 with the Descriptive Information Form to determine the infants' characteristics and the Newborn Pain and Discomfort Scale (EDIN). The data were analyzed with tests suitable for normal distribution, and the significance level was accepted as p <.05. Results: It was determined that the average total pain score of premature infants from the EDIN scale was 5.43 ± 1.86, and 35.5% of them experienced pain (> 6 points). It was found that the chronic pain scores increased as the length of hospital stay and the duration of mechanical ventilation increased in premature infants who were applied mechanical ventilation (p <.05). It was determined that the average chronic pain score was higher in infants with a risk of impaired skin integrity (p <.01). Conclusions: It has been recommended to give importance to skin assessment of premature infants receiving mechanical ventilation, to perform routine pain assessment, and to take measures to reduce pain in infants whose duration of stay on mechanical ventilation exceeds five days. [ABSTRACT FROM AUTHOR]

Apnea of prematurity is a frequently encountered condition in premature infants in the neonatal-intensive-care-units and is defined as respiratory arrest for more than 15-20 seconds or short-term respiratory interruption accompanied by low oxygen-saturation and/or bradycardia. While apnea is observed in almost all babies born below 28 weeks of gestation, the frequency of apnea decreases as the gestational week gets older. Hypoxemia and bradycardia attacks intervening due to apnea together with the neurological immaturity caused by premature-birth increase the risk of neurological damage in these babies and in the long term; it can cause significant morbidities such as cerebral palsy, developmental coordination disorder, cognitive and behavioral disorders, bronchopulmonary dysplasia, and retinopathy of prematurity. For this reason, the diagnosis and treatment of apnea in premature infants is important, and caffeine, a methylxanthine derivative, is the first choice in the pharmacological treatment of apnea. Caffeine is structurally similar to adenosine and its effect is dose-dependent mainly on adenosine receptors. Caffeine eliminates the inhibition of the medullary-respiratory-center suppressed by adenosine in apnea of prematurity, increases neural excitation by preventing gamma-aminobutyric acid release, increases the sensitivity of the central nervous system to blood carbon-dioxide levels, thus it stimulates and maintains respiration in infants with apnea. In this review, the effect of caffeine, which is the first choice in the treatment of apnea in premature infants, information about who, when, in which dose, and for how long we should use it, has been tried to be given in the light of the recent literature data. [ABSTRACT FROM AUTHOR]

Copyright of Online Turkish Journal of Health Sciences (OTJHS) / Online Türk Sağlık Bilimleri Dergisi is the property of Oguz KARABAY and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective:Our aim is to evaluate the closure of patent ductus arteriosus through surgery at an early stage, commonly seen in premature infants and a leading cause of left-to-right shunt and mortality/morbidity, as a safe modality to prevent complications that may develop in postnatal preiod in patients with bronchopulmonary displasia or respiratory distress syndrome followed up in mechanical ventilation, and whose ductus arteriosus can not be closed despite medical treatment. Material and Methods:Thirty two cases of patent ductus arteriosus with premature birth history and no additional cardiac pathology, performed in the Department of Cardiovascular Medical School, Necmettin Erbakan University between 2006-2015 were included into the study. Results:Of the 32 patients, 14 (43,7%) were females and 18 (56,3%) were males. The most frequently seen preoperative disorder was respiratory distress syndrome(n=20). Twenty-two (68%) of the patients were following as intubated in newborn intensive care unit. Surgical procedure was performed in patients whose ductus were not closed via medical treatmentorin whom medical treatment was contraindicated for problems such as intracranial hemorrhage, renal failure or thrombocytopenia. Excitus rate was 15,6% (n=5) in our series. Removal time of mechanical ventilation was average 6,2 days. Postoperative echocardiography showed no recurrence of patent ductus arteriosus. Conclusion:Prevention of postnatal mortality and morbidity due to patent ductus arteriosus in premature infants can be achieved by early surgical closure during postnatal early period before secondary organ failure due to shunting develops and infants with critical general status-dependent on mechanical vantilation-,and for whom medical treatment is unsuccessful. [ABSTRACT FROM AUTHOR]

Patent ductus arteriosus (PDA) may be associated with increased morbidityin premature infants. Diagnosis and treatment of hemodynamically significant ductus arteriosus is important. In this study, we investigated the predictive role of carina angle on chest X-ray in the diagnosis of PDA. Twenty-two premature infants with gestational age of less than 32 weeks were enrolled into this study during the period from October 2009 to June 2010 at the Neonatal Intensive Care Unit of Başkent University Hospital. We compared the carina angle of 10 patients who had hemodynamically significant PDA with 12 patients who had no PDA. Carina angle measurement was repeated after PDA treatment. The hemodynamically significant PDA group had a significantly wider carina angle (94.6±6.0°) compared to the no ductus group(81.1+9.1°; p<0.05). The predictive role of carina angle in the diagnosis of PDA was assessed by receiver operating characteristic (ROC) curve (area under the curve (AUC) =0.096; p=0.001). The cut-off value of carina angle was 91°, with a sensitivity of 83% and specificity of 80%. We observed significant reduction in the carina angle measurement after the treatment(p=0.001). Measurement of carina angle is a quite simple and effective method of assessing PDA. Carina angle may provide information about PDA when echocardiography cannot be done for the diagnosis. [ABSTRACT FROM AUTHOR]

Objective: Aim of study was to evaluate both ductal diameter (Dd) and pulsed wave Doppler (PWD) patterns of patent ductus arteriosus (PDA), the treatment requirement of different patterns. Methods: In this retropective study evaluation and classification of PDA of 139 preterms born before 34 weeks gestation was performed by color Doppler and PWD. Ratio of left atrium/aortic root were evaluated in parasternal long axis. Ductal patterns were compared with both Dd and left atrium/aortic root ratio. PDA was treated by ibuprofen. The treatment requirement and thrombocyte count of patterns was evaluated. Kesulls: 85,5% of preterms were very low birth weight (<1500 g). Median gestational age was 28,5 (23-34) weeks. Median birth weight was 1050 (750-1850) g. 39 (17,3%) pulmonal ·y hypertension (PH), 43 (19,1%) growing, 68 (30,3%) pulsatile, 75 (33.3%) closing pattern were observed. PI! pattern was more often in first three days (p<0,001). There was significantly difference among patterns in term of Dd (p<0,001). The largest Dd was observed in PII pattern the smallest Dd was observed in closing pattern. The need for treatment was higher in pulsatile pattern (52,4% of patients). There was a positive corelation between left atrium/aortic root and ductal diameter in pulsátil, growing and closing pattern except I'll pattern. There was no relation between platelet count and flow patents (p>0,05). Conclusion: We determined significant relationship between Dd and flow pattern. There was no relationship between ductal pattern and thrombocyte count. Pulsatile pattern were hemodynainically significant. Despite greater Dd, treatment requirement in PII pattern was less due to low left-right shunt. Both ductal diameter and pattern together is important to identify hemodynantically of hemodynamically significant PDA. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Research & Development in Nursing / Hemşirelikte Araştırma Geliştirme Dergisi is the property of Association for Research & Development in Nursing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: To assess the effect of early parenteral amino acids, on growth and neurodevelopment of very low birth weight infants at 36 weeks' postmenstrual age and 18 months' corrected age. Material and Method: Infants who received =3 gr/kg per day of parenteral amino acids within the first 5 days of life were considered early group; infants who receive <3 gr/kg per day of parenteral amino acids within the first 5 days of life were considered late group. Infants' weight, length and head circumference were measured et 36 weeks' of postmenstrual age and 18 months' of corrected age. Nerodevelopmental index was evaluated by "Bayley Scales of Infant Development". Results: There were no statistically differences between the early and late amino acid groups in baseline characteristics; except birth weight. At 36 weeks' postmenstrual age and 18 months' corrected age, there were no statistically differences in weight, length and head circumference between the two groups. In the early group, female babies had bigger head circumference than male babies at 36 weeks' postmenstrual age and 18 months' corrected age. There were no other observed differences between boys or girls. There were no differences between two groups for neurodevelopmental impairment by Bayley mental and psychomotor developmental index. Conclusions: On evaluation of head circumferences at 36 weeks' postmenstrual age and 18 months' corrected age, it is shown that the low birth weight early group catch-up with the late group and girls in the early group have bigger head circumference therefore it is suggested that early aminoacid supplementation may have positive effect on growth and neurodevelopmental impact. [ABSTRACT FROM AUTHOR]

Arginine is an essential amino acid in the fetus and neonate and is a conditionally essential nutrient for adults. As a precursor for the synthesis of nitric oxide (NO) and other molecules that have enormous biologic importance and as a stimulant to the production of growth hormone, L-arginine plays versatile key roles in nutrition, immunodefense and metabolism. The objectives of this study were to investigate whether there is a relationship between morbidity, mortality, and plasma arginine levels, and to determine whether long-term arginine-supplemented enteral nutrition affects morbidity, mortality, hospital stay, and growth parameters in premature infants with birth weight ≤1500 g and gestational age ≤34 weeks. In this placebo-controlled study, 53 preterm infants with a birth weight of ≤1500 g and gestational age ≤34 weeks were prospectively, randomly assigned to receive enterally supplemental L-arginine (250 mg/kg per day, study group; n=27) or sterile water (placebo) (control group; n=26). Nine infants from the study group and nine infants from the control group were lost to follow-up; 18 infants from the study group and 17 infants from the control group completed the study. Blood samples for plasma arginine levels on the 1st and 15th days of life and at the postconceptional 40th week were collected. Growth parameters (weight, length, head circumference, right upper arm mid-circumference and right thigh mid-circumference) were measured on the 1st and 15th days of life and at the postconceptional 40th week. Arginine supplementation was discontinued at the end of the postconceptional 40th week. There were no significant differences in growth parameters on the 15th day and at the postconceptional 40th week between the study and control groups. There was no relationship between plasma arginine levels on the 1st day, 15th day, and at the postconceptional 40th week and either synchronized growth parameters or morbidity and mortality in all infants. There was also no difference between the supplemented group and control group in terms of incidence of morbidity and mortality. We concluded that arginine supplementation by enteral route alone in premature infants does not affect the growth parameters, morbidity or mortality. [ABSTRACT FROM AUTHOR]

Congenital cystic adenomatoid malformations (CCAMs) are hamartomatous lesions of pulmonary airway which are characterized by proliferations of terminal brochioles. They are usually infiltrated to one lobe. These patients are during the postnatal period at a level of 80% and adult patients are rare. We report a case of Stocker type 3 CCAM which caused respiratory distress in a premature born infant weighing 1940 g who was delivered by emergency caesarean section. Radiological imaging results revealed CCAM. He subsequently underwent right lobectomy. Pathological examination showed immature airspaces and interstitium, including bronchioles and cartilage as type 3 CCAM. CCAM should be considered in newborns with respiratory distress [ABSTRACT FROM AUTHOR]

Central diabetes insipidus is characterized by polydipsia, polyuria, dehydration, irritability, poor feeding, failure to thrive and hypernatremia. This disease is caused by lack of antidiuretic hormone. Here, a very low birth weight premature infant who developed central diabetes insipidus secondary to pituitary hemorrhage in the newborn period and was treated successfully with intranasal desmopressin acetate was presented. It was emphasized that desmopressin acetate might be an effective method also in the treatment of very low birth weight premature infants. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Exercise Therapy & Rehabilitation is the property of Yavuz Yakut and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)