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1. Postnatal corticosteroid use for prevention or treatment of bronchopulmonary dysplasia in England and Wales 2012–2019: a retrospective population cohort study

Author

Neena Modi, Chris Gale, Iyad Al-Muzaffar, Jonathan Cusack, Victoria Nesbitt, Sanjay Salgia, Matthew Babirecki, Aashish Gupta, L M Wong, Anita Mittal, Ahmed Hassan, Karin Schwarz, Graham Whincup, Abdul Hasib, Mehdi Garbash, David Gibson, Pauline Adiotomre, Abby Deketelaere, Stanley Zengeya, Cath Seagrave, Hilary Dixon, Narendra Aladangady, Hassan Gaili, Matthew James, M Lal, Lawrence Miall, Venkatesh Kairamkonda, J Kefas, Jennifer Birch, Gail Whitehead, I Misra, Subodh Gupta, Steven Wardle, Eleri Adams, Minesh Khashu, Charlotte Groves, Christos Zipitis, Peter De Halpert, Joanne Fedee, Stephen Jones, Kirsten Mack, Charlotte Huddy, Salim Yasin, Ngozi Edi-osagie, Carrie Heal, Jacqeline Birch, Hari Kumar, Chris Rawlingson, Delyth Webb, Sankara Narayanan, Elizabeth Eyre, Caroline Sullivan, Wynne Leith, Vimal Vasu, Katia Vamvakiti, Megan Eaton, Ambalika Das, Katharine Mcdevitt, Anna Gregory, Shu-Ling Chuang, Sabita Uthaya, Cheryl Battersby, Imran Ahmed, Chris Warren, Tristan Bate, Mark Johnson, Sunil Reddy, Rashmi Gandhi, Nitin Goel, Richard Hearn, Cheentan Singh, Faith Emery, Vineet Gupta, Yee Aung, Vennila Ponnusamy, Pinki Surana, Anand Kamalanathan, Kavi Aucharaz, Lindsay Halpern, Matt Nash, Alex Allwood, Nigel Brooke, Jennifer Holman, Geraint Lee, Sobia Balal, Poornima Pandey, Ravindra Bhat, Simon Rhodes, Savi Sivashankar, Michael Grosdenier, Ajay Reddy, Prakash Thiagarajan, Chinnappa Reddy, Lidia Tyszcuzk, Glynis Rewitzky, Bushra Abdul-Malik, Dominic Muogbo, Angela D'Amore, John McIntyre, Lucinda Winckworth, Jim Baird, Akinsola Ogundiya, Pamela Cairns, Porus Bastani, Marice Theron, Siba Paul, Giles Kendall, Puneet Nath, Ros Garr, Sundeep Sandhu, Michael Cronin, Alison Bedford Russell, Ruchika Gupta, Archana Mishra, Oluseun Tayo, Priya Muthukumar, Brendan Harrington, Victoria Sharp, Nicola Johnson, Sam Wallis, Prashanth Bhat, Lee Abbott, Raju Narasimhan, Kate Creese, Divyen Shah, Clare Cane, Ghada Ramadan, Sijia Yao, Alistair Ewing, Penelope Young, Ramona Onita, Joanne Dangerfield, Jocelyn Morris, Toria Klutse, Sonia Spathis, Sathish Krishnan, Samar Sen, Jez Jones, Geedi Farah, Prem Pitchaikani, Jonathan Filkin, Ashok Karupaiah, Richard Heaver, Mohammad Alam, Tiziana Fragapane, Jess Reynolds, Khadija Ben-Sasi, Patricia Cowley, Shilpa Ramesh, Julia Croft, Soma Sengupta, Nagendra Venkata, Anitha Vayalakkad, Ben Obi, Anjali Petkar, Arun Ramachandran, Se-Yeon Park, Sue Bird, Jageer Mohammed, and Sanjay Jaisal

Subjects
Medicine
Abstract

Objective Describe the population of babies who do and do not receive postnatal corticosteroids for prevention or treatment of bronchopulmonary dysplasia (BPD).Design Retrospective cohort study using data held in the National Neonatal Research Database.Setting National Health Service neonatal units in England and Wales.Patients Babies born less than 32 weeks gestation and admitted to neonatal units from 1 January 2012 to 31 December 2019.Main outcomes Proportion of babies given postnatal corticosteroid; type of corticosteroid; age at initiation and duration, trends over time.Secondary outcomes Survival to discharge, treatment for retinopathy of prematurity, BPD, brain injury, severe necrotising enterocolitis, gastrointestinal perforation.Results 8% (4713/62019) of babies born

Published
2022
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2. Increase in the use of inhaled nitric oxide in neonatal intensive care units in England: a retrospective population study

Author

Chris Gale, Jonathan Cusack, Sanjay Salgia, Peter Martin, Matthew Babirecki, Liza Harry, Tim Wickham, Aashish Gupta, L M Wong, Anita Mittal, Sunita Seal, Ahmed Hassan, Karin Schwarz, Graham Whincup, Stephen Brearey, John Chang, Abdul Hasib, Mehdi Garbash, David Gibson, Pauline Adiotomre, Abby Deketelaere, Ruth Shephard, Mukta Jain, Stanley Zengeya, Cath Seagrave, Hilary Dixon, Narendra Aladangady, Hassan Gaili, Matthew James, M Lal, Ambadkar, Khalid Mannan, Lawrence Miall, Venkatesh Kairamkonda, J Kefas, Jennifer Birch, Gail Whitehead, I Misra, Imdad Ali, Mark Dyke, Michael Selter, Subodh Gupta, Richard Nicholl, Steven Wardle, Eleri Adams, Minesh Khashu, P Amess, Charlotte Groves, Shameel Mattara, Christos Zipitis, Peter De Halpert, Paul Settle, Paul Munyard, Joanne Fedee, Natasha Maddock, Richa Gupta, Stephen Jones, Kirsten Mack, Charlotte Huddy, Ngozi Edi-osagie, Nick Brennan, Carrie Heal, Majd Abu-harb, Jacqeline Birch, Chris Knight, Hamudi Kisat, Hari Kumar, Chris Rawlingson, Delyth Webb, Bird, Sankara Narayanan, Ian Evans, Rekha Sanghavi, Caroline Sullivan, Wynne Leith, Vimal Vasu, Katia Vamvakiti, Megan Eaton, Vadivelam Murthy, Aiwyne Foo, Katharine Mcdevitt, Shu-Ling Chuang, Cheryl Battersby, Nimish V Subhedar, Sena Jawad, Tristan Bate, Mark Johnson, Neeraj Jain, Faith Emery, Vineet Gupta, Yee Aung, Pinki Surana, Kayleigh Oughham, Anand Kamalanathan, Kavi Aucharaz, Nicola Paul, Lindsay Halpern, Matt Nash, Jo Anderson, Alex Allwood, Nigel Brooke, K Abdul Khader, Sanghavi Rekha, Anas Olabi, Jennifer Holman, Geraint Lee, Sobia Balal, Poornima Pandey, Ravindra Bhat, Simon Rhodes, Vinay Pai, Savi Sivashankar, Michael Grosdenier, Ajay Reddy, Christopher Dewhurst, Ghada Ramadan Krishnamurthy, Rob Negrine, Prakash Thiagarajan, P Kamath, Laura Winder, Andreea Bontea, Chinnappa Reddy, Elizabeth Sleight Deshpande, Lidia Tyszcuzk, Anne Dale, Glynis Rewitzky, Olutoyin Banjoko, Bushra Abdul-Malik, Dominic Muogbo, Angela D'Amore, John McIntyre, Chrissie Oliver, Lucinda Winckworth, Jyoti Kapur, P Amess Ben Obi, Naveen Athiraman, Chandan Gupta, Jim Baird, Ralf Hartung, Akinsola Ogundiya, Pamela Cairns, Porus Bastani, Marice Theron, Siba Paul, Giles Kendall, Puneet Nath, Ozioma Obi, Yee Mon Aung, Eleanor Hulse, Ros Garr, and Sundeep Sandhu

Subjects
Pediatrics, RJ1-570
Abstract

Objective To describe temporal changes in inhaled nitric oxide (iNO) use in English neonatal units between 2010 and 2015.Design Retrospective analysis using data extracted from the National Neonatal Research Database.Setting All National Health Service neonatal units in England.Patients Infants of all gestational ages born 2010–2015 admitted to a neonatal unit and received intensive care.Main outcome measures Proportion of infants who received iNO; age at initiation and duration of iNO use.Results 4.9% (6346/129 883) of infants received iNO; 31% (1959/6346) were born 34 weeks of gestation. Between epoch 1 (2010–2011) and epoch 3 (2014–2015), there was (1) an increase in the proportion of infants receiving iNO: 34 weeks (4.5% vs 5.0%), (2) increase in postnatal age at iNO initiation:

Published
2021
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3. Progesterone as a neuroprotective agent in neonatal hypoxic-ischaemic encephalopathy - a systematic review

Author

Ming-Te Lee, Rosin McNicholas, Lawrence Miall, Nigel Simpson, Kevin C.W. Goss, Nicola J. Robertson, and Paul Chumas

Subjects
Developmental Neuroscience, Neurology
Abstract

Hypoxic-ischaemic encephalopathy (HIE) in the newborn baby is a major contributor to neonatal mortality and morbidity across the world. Therapeutic hypothermia (HT) is the current standard treatment for moderate to severe HIE, but not all babies benefit. Potential neuroprotective actions of PROG include anti-apoptotic, anti-inflammatory and anti-oxidative effects and reduction of energy depletion, tissue/cellular oedema and excitotoxicity. In pre-clinical studies of neonatal HIE, progesterone (PROG) has neuroprotective properties, but has not been the subject of systematic review. Here our objective was to evaluate the evidence base for PROG as a potential therapeutic agent in HIE. The PICO framework was used to define the following inclusion criteria; Population: human neonates with HIE/Animal models of HIE, Intervention: PROG +/- other agents, Comparison: V.S. control, Outcome: pathological, neurobehavioural and mechanistic outcome measures. Medline, EMBASE and CINHAL were then searched between August to October 2018 using pre-defined medical subject heading and key words. Study inclusion, data extraction and risk of bias (ROB) analysis using the SYRCLE ROB tool were carried out by two authors. 14 studies were included in the review. They typically displayed a high ROB. This systematic review suggests that PROG had positive effects on neuropathology and reduced neurobehavioural deficits post-hypoxic-ischaemic (HI) injury. However, there was sex dimorphism in the effects of PROG. In addition, there are limitations and biases in these studies and there remains a need for well-designed large pre-clinical studies with greater methodological quality to further inform the efficacy, safety, dose, timing and frequency of PROG administration. With such data, large animal studies could be planned combining PROG administration with and without HT.

Published
2022
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4. Visual impairment, severe visual impairment, and blindness in children in Britain (BCVIS2): a national observational study

Author

Lucinda J Teoh, Ameenat Lola Solebo, Jugnoo S Rahi, Joe Abbott, Wajda Abdullah, Gill Adams, Louise Allen, Christopher Anderson, Karen Ansell, Samira Anwar, Isabel Ash, Jane Ashworth, Sher Aslam, Majunath Astagi, Colin Ball, Rajesh Balu, Victoria Barrett, Zahabiyah Bassi, Adam Bates, Dushyant Batra, Sarah Bell, Linda Belmour, James Benzimra, Ginny Birrell, Susmito Biswas, Andrew Blaikie, Michael Blundell, Kate Bolton, Ewoud Bos, Pamela Bowen, Richard Bowman, Natalie Boyle, John Bradbury, Maria Bredow, Marsel Bregu, Nicholas Brennan, Rosie Brennan, Paul Brittain, Charles Buchanan, Catey Bunce, Howard Bunting, Priscilla Burgess, Cathie Burke, Alexandra Kate Bush, Jeremy Butcher, Lucilla Butler, Clare Cane, Cathryn Chadwick, Ruth Charlton, Anne-Marie Childs, Jessy Choi, Vivi Choleva, Amanda Churchill, Michael Clarke, Peter Clayton, Luke Clifford, Alan Connor, Rachel Cox, Lyn Cresswell, Annegret Dahlmann-Noor, Angela D'Amore, Mehul Dattani, Fiona Dean, Anita Devlin, Luna Dhir, Cora Doherty, Suzanne Dorey, Fiona Drimmie, Tina Duke, Gordon Dutton, Fiona Eaton, Megan Eaton, Danielle Eckersley, Clive Edelsten, Rachel Elderkin, Julia Ennis, Julia Escardo-Paton, Ziad Estephen, Onajite Etuwewe, Anthony Evans, Adjoa Ezekwe, Jenny Fairfield, Kevin Falzon, Allison Ferguson, Brian Fleck, Mary Gainsborough, Alexandra Galloway, Naomi Gerson-Sofer, Caspar Gibbon, Patricia Gibson, Kevin Goss, Katherine Graham-Evans, Judith Gray, Anna Gregory, Arun Gulati, Deniz Gurtin-Zorkun, Emma Guy, Diab Haddad, Helen Haggerty, Paul Haigh, Julia Hale, Samer Hamada, Joanne Hancox, Kerry Hanna, Sian Harris, Christine Harrison, Phillip Harvey, Sophie Headland, Dominic Heath, Paul Heaton, Robert Henderson, Melanie Hingorani, Zoe Hirst, Claire Hogg, Wolfgang Hogler, Roger Holden, Janice Hoole, Karen Horridge, Delyth Howard, Rachel Howells, Vanessa Irvine, Clare Irving, Nicola Johnson, Ian Johnston, Alice Jollands, David Jones, Annie Joseph, Archana Joshi, Pugazhvendan Kandaswamy, Charles Kattakayam, Joseph Keenan, Anne Kelly, James Kersey, Awais Khan, Peng Khaw, Tina Kipioti, Sadia Kiran, Lesley Kneen, Ajay Kotagiri, Richa Kulshrestha, Rosemary Lambley, Tim Lavy, Joanna Lawson, Vicki Lee, Jane Leitch, Julie Lennon, Gabi Lipshen, Chris Lloyd, John Loftus, Tom Lomas, Vernon Long, Jane Mackinnon, Mary MacRae, Usman Mahmood, Anna Maino, Sarah Maling, David Mansfield, Elizabeth Marder, Richard Markham, Jane Marr, Catherine Marsh, Anna Maw, Eleanor McCartney, Helen McCullagh, Anna McDonald, Derek McPhee, Lawrence Miall, Shila Mistry, Benjamin Moate, Meyyammai Mohan, Helen Moore, Will Moore, Nicola Morgan, Claire Morton, Alan Mulvihill, Ranjit Nair, Bill Newman, Christiane Nitsch, Katy O'Connell, Ngozi Oluonye, Vittaldas Pai, Helen Palmer, Maria Papadopoulos, Shelagh Parkinson, Bina Parmar, Manoj Parulekar, Madhavi Parvathareddy, Dipesh Patel, Himanshu Patel, Kamal Patel, Philippa Pennefather, Flaudia Petrone, Marcus Pierrepoint, Rachel Pilling, Sally Pollard, Renata Puertas, Karen Pysden, Anthony Quinn, Philip Quinn, Diyaa Rachdan, Jyoti Raina, Saul Rajak, Laura Ramm, Catherine Rands, Tekki Rao, Mary Ray, Ashwin Reddy, Sheilla Reilly, Maralla Rekha, Greg Richardson, Andrew Riordan, Nerys Roberts, Helen Robertson, Gillian Robinson, Neil Rogers, Shakir Saeed, Caroline Salmon, Jenefer Sargent, Nagini Sarvananthan, Conrad Schmoll, James Self, P Sellar, Elaine Service, Ayad Shafiq, Shilpa Shah, Vinod Sharma, Jemima Sharp, Julia Shaw, Manjula Shenoy, Tamsin Sleep, Elisa Smit, Katherine Smyth, Lynne Speedwell, Katherine Spowart, P Standring, Paulo Stanga, Alison Stanley, Alan Stanton, David Steel, John Stephen, Catherine Stewart, Jessica Street, Sally Stucke, Shona Sutherland, Katya Tambe, Anamika Tandon, Alison Tappin, Kate Taylor, Robert Taylor, Katherine Teasdale, Maria Theodorou, Gareth Thomas, Megan Thomas, Paula Thomas, Dorothy Thompson, Stephen Thomson, Indrajit Thopte, Peter Tiffin, Angela Tillett, Heidi Traunecker, Maria Tsimpida, Vivienne Van Someren, Udupa Venkatesh, Zoe Vermaak, Michael Vincent, David Walker, Simon Walker, Deidre Walsh, Bronwyn Walters, Martin Ward Platt, Louise Watson, Patrick Watts, Siobhan West, Stephanie West, Cathy White, Joy White, Gabriel Whitlingum, Cathy Williams, Sophie Wilne, Janice Wilson, Chien Wong, Tamsin Woodbridge, Paul Wright, Martha Wyles, and Philip Wylie

Subjects
Male, medicine.medical_specialty, Pediatrics, Adolescent, genetic structures, Cross-sectional study, Visual impairment, Vision Disorders, Blindness, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Epidemiology, Health care, Ethnicity, Developmental and Educational Psychology, medicine, Humans, Cumulative incidence, 030212 general & internal medicine, Child, business.industry, Incidence, Incidence (epidemiology), Infant, Newborn, Childhood blindness, Infant, medicine.disease, United Kingdom, eye diseases, Cross-Sectional Studies, Socioeconomic Factors, Child, Preschool, Pediatrics, Perinatology and Child Health, Female, Observational study, medicine.symptom, business
Abstract

Summary Background The WHO VISION 2020 global initiative against blindness, launched in 2000, prioritised childhood visual disability by aiming to end avoidable childhood blindness by 2020. However, progress has been hampered by the global paucity of epidemiological data concerning childhood visual disability. The British Childhood Visual Impairment and Blindness Study 2 (BCVIS2) was done to address this evidence gap. Methods BCVIS2 was a prospective UK-wide, cross-sectional, observational study to establish an inception cohort of children newly diagnosed with visual impairment. Ophthalmologists and paediatricians reported cases from 89 hospitals and community centres across the UK. We included children aged 18 years or younger who were newly diagnosed with any condition causing impaired visual acuity to a level of 0·5 logMAR or worse (worse than 6/18 Snellen) in each eye, or equivalent vision as assessed by standard qualitative measures, between Oct 1, 2015, and Nov 1, 2016. Eligible children were notified simultaneously but independently by their managing ophthalmologists and paediatricians via the two national active surveillance schemes, the British Ophthalmological Surveillance Unit and the British Paediatric Surveillance Unit. Standardised detailed demographic, socioeconomic, and clinical data about detection, management, and treatment were collected at diagnosis and 1 year later. We calculated incidence estimates and relative rates by key sociodemographic factors. We did descriptive analyses of underlying ophthalmic disorders and non-ophthalmic comorbidities. Findings 61 (7%) of 845 eligible children initially notified were ineligible at follow-up because of improved vision after treatment. Thus, the study sample comprised 784 children with permanent newly-diagnosed all-cause visual impairment, severe visual impairment, or blindness. 559 (72%) of 778 children had clinically significant non-ophthalmic impairments or conditions. 28 (4%) of 784 children died within a year after diagnosis of visual disability (all had underlying systemic disorders). Incidence of visual disability in the first year of life was 5·19 per 10 000 children (95% CI 4·71–5·72), almost ten times higher than among 1-to-4-year-olds and between 20 times and 100 times higher than in the older age groups. The overall cumulative incidence (or lifetime risk) of visual impairment, severe visual impairment, or blindness was 10·03 per 10 000 children (9·35–10·76). Incidence rates were higher for those from any ethnic minority group, the lowest quintile of socioeconomic status, and those born preterm or with low birthweight. 345 (44%) of 784 children had a single affected anatomical site. Disorders of the brain and visual pathways affected 378 (48%) of 784 children. Interpretation BCVIS2 provides a contemporary snapshot of the heterogeneity, multi-morbidity, and vulnerability associated with childhood visual disability in a high-income country. These findings could facilitate developing and delivering health care and planning of interventional research. Our findings highlight the importance of including childhood visual disability as a sentinel event and metric in global child health initiatives. Funding Fight for Sight, National Institute for Health Research, and Ulverscroft Foundation.

Published
2021
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6. In neonates who have been successfully intubated can ultrasound be used to accurately confirm endotracheal tube tip position?

Author

Lawrence Miall and Shavindra Chellen

Subjects
education.field_of_study, Capnography, medicine.medical_specialty, Neonatal intensive care unit, medicine.diagnostic_test, business.industry, medicine.medical_treatment, Population, Ultrasound, Auscultation, Tracheal tube, Anesthesia, Pediatrics, Perinatology and Child Health, medicine, Intubation, Neonatology, education, business
Abstract

A neonate has just been intubated on the Neonatal Intensive Care Unit (NICU). The tube has been confirmed to be within the trachea through a combination of clinical and physiological signs. These include observing for symmetrical chest movement, listening for air leak at the mouth and auscultation of the chest and abdomen. Capnography is positive for end-tidal CO2, and the patient has shown a clinical improvement in colour, saturations and heart rate. A chest X-ray (CXR) is requested to confirm that the endotracheal tube (ET) tip sits below the upper border of the T1 vertebral body and above the lower border of the T2 vertebral body. While waiting for the radiographer to arrive you wonder whether the NICU’s ultrasound (US) machine could be used to confirm the ET tip position. In neonates who have been successfully intubated, can ultrasound accurately confirm ET tip position when compared with CXR? Embase, Medline and the Cochrane library were searched. Original human studies were included. The following search terms were used: (newborn* OR neonat*) AND (intubation OR tracheal tube* OR endotracheal tube*) AND (ultrasound OR ultrasonograph* OR sonograph*) AND (confirm* OR placement OR position*). Additionally, Medical Subject Headings (MeSH) terms of ‘newborn/’; ‘intubation/’; ‘ultrasound/’ were used in Embase. MeSH terms of ‘infant, newborn/’ and ‘intubation/’ were used in Medline. Conference abstracts, posters and letters were excluded. Studies that had a mixed population of patients from Neonatal and Paediatric intensive care were excluded. The …

Published
2021

8. Increasing use of inhaled nitric oxide in neonatal intensive care units in England: a retrospective population study

Author

Jonathan Cusack, Matthew Babirecki, Liza Harry, Tim Wickham, L M Wong, Anita Mittal, Sunita Seal, Ahmed Hassan, Karin Schwarz, Graham Whincup, Stephen Brearey, Abdul Hasib, Mehdi Garbash, David Gibson, Pauline Adiotomre, Abby Deketelaere, Ruth Shephard, Mukta Jain, Stanley Zengeya, Cath Seagrave, Hilary Dixon, Narendra Aladangady, Hassan Gaili, M Lal, Ambadkar, Khalid Mannan, Lawrence Miall, J Kefas, Jennifer Birch, Gail Whitehead, I Misra, Imdad Ali, Mark Dyke, Michael Selter, Steven Wardle, Eleri Adams, Minesh Khashu, Shameel Mattara, Peter De Halpert, Paul Settle, Paul Munyard, Joanne Fedee, Natasha Maddock, Kirsten Mack, Charlotte Huddy, Ngozi Edi-osagie, Nick Brennan, Carrie Heal, Majd Abu-harb, Jacqeline Birch, Chris Knight, Hamudi Kisat, Delyth Webb, Bird, Sankara Narayanan, Ian Evans, Caroline Sullivan, Wynne Leith, Vimal Vasu, Katia Vamvakiti, Megan Eaton, Vadivelam Murthy, Aiwyne Foo, Faith Emery, Pinki Surana, Anand Kamalanathan, Kavi Aucharaz, Nicola Paul, Lindsay Halpern, Matt Nash, Jo Anderson, Alex Allwood, Nigel Brooke, K Abdul Khader, Sanghavi Rekha, Anas Olabi, Geraint Lee, Sobia Balal, Poornima Pandey, Ravindra Bhat, Simon Rhodes, Vinay Pai, Savi Sivashankar, Michael Grosdenier, Ajay Reddy, Christopher Dewhurst, Ghada Ramadan Krishnamurthy, Rob Negrine, Prakash Thiagarajan, P Kamath, Laura Winder, Andreea Bontea, Chinnappa Reddy, Elizabeth Sleight Deshpande, Lidia Tyszcuzk, Anne Dale, Glynis Rewitzky, Olutoyin Banjoko, Bushra Abdul-Malik, Dominic Muogbo, Angela D'Amore, John McIntyre, Chrissie Oliver, Lucinda Winckworth, Jyoti Kapur, P Amess Ben Obi, Naveen Athiraman, Chandan Gupta, Jim Baird, Ralf Hartung, Akinsola Ogundiya, Pamela Cairns, Porus Bastani, Marice Theron, Siba Paul, Giles Kendall, Puneet Nath, Ozioma Obi, Yee Mon Aung, Eleanor Hulse, Ros Garr, and Sundeep Sandhu

Subjects
medicine.medical_specialty, Pediatrics, UK Neonatal Collaborative, Nitric Oxide, neonatology, RJ1-570, State Medicine, Nitric oxide, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, 030225 pediatrics, Intensive care, Intensive Care Units, Neonatal, Epidemiology, Administration, Inhalation, medicine, Humans, 030212 general & internal medicine, Neonatology, EPOCH (chemotherapy), Retrospective Studies, business.industry, Infant, Newborn, Infant, Postnatal age, chemistry, Pediatrics, Perinatology and Child Health, Population study, Gestation, epidemiology, business, Infant, Premature
Abstract

ObjectiveTo describe temporal changes in inhaled nitric oxide (iNO) use in English neonatal units between 2010 and 2015.DesignRetrospective analysis using data extracted from the National Neonatal Research Database.SettingAll National Health Service neonatal units in England.PatientsInfants of all gestational ages born 2010–2015 admitted to a neonatal unit and received intensive care.Main outcome measuresProportion of infants who received iNO; age at initiation and duration of iNO use.Results4.9% (6346/129 883) of infants received iNO; 31% (1959/6346) were born 34 weeks of gestation. Between epoch 1 (2010–2011) and epoch 3 (2014–2015), there was (1) an increase in the proportion of infants receiving iNO: 34 weeks (4.5% vs 5.0%), (2) increase in postnatal age at iNO initiation: ConclusionsBetween 2010 and 2015, there was an increase in the use of iNO among infants admitted to English neonatal units. This was most notable among the most premature infants with an almost fourfold increase. Given the cost of iNO therapy, limited evidence of efficacy in preterm infants and potential for harm, we suggest that exposure to iNO should be limited, ideally to infants included in research studies (either observational or randomised placebo-controlled trial) or within a protocolised pathway. Development of consensus guidelines may also help standardise practice.

Published
2021

9. Variations in Neonatal Length of Stay of Babies Born Extremely Preterm: An International Comparison Between iNeo Networks

Author

Sarah E. Seaton, Elizabeth S. Draper, Mark Adams, Satoshi Kusuda, Stellan Håkansson, Kjell Helenius, Brian Reichman, Liisa Lehtonen, Dirk Bassler, Shoo K. Lee, Maximo Vento, Brian A. Darlow, Franca Rusconi, Marc Beltempo, Tetsuya Isayama, Kei Lui, Mikael Norman, Junmin Yang, Prakesh S. Shah, Neena Modi, Peter Marshall, Peter Schmidt, Anjali Dhawan, Larissa Korostenski, Javeed Travadi Travadi, Mary Sharp, Andy Gill, Jane Pillow, Jacqueline Stack, Pita Birch, Karen Nothdurft, Lucy Cooke, Dan Casalaz, Jim Holberton, Alice Stewart, Lyn Downe, Michael Stewart, Andrew Berry, Rod Hunt, Peter Morris, Tony De Paoli, Srinivas Bolisetty, Mary Paradisis, Mark Greenhalgh, Pieter Koorts, Carl Kuschel, Sue Jacobs, Lex Doyle, John Craven, Andrew Numa, Hazel Carlisle, Nadia Badawi, Himanshu Popat, Guan Koh, Jonathan Davis, Melissa Luig, Bevan Headley, Chad Andersen, Linda Ng, Georgina Chambers, Nicola Austin, Adrienne Lynn, Brian Darlow, Liza Edmonds, Lindsay Mildenhall, Mariam Buksh, Malcolm Battin, Jutta van den Boom, Vaughan Richardson, David Barker, Barbara Hammond, Victor Samuel Rajadurai, Simon Lam, Genevieve Fung, Jaideep Kanungo, Joseph Ting, Zenon Cieslak, Rebecca Sherlock, Ayman Abou Mehrem, Jennifer Toye, Khalid Aziz, Carlos Fajardo, Jaya Bodani, Lannae Strueby, Mary Seshia, Deepak Louis, Ruben Alvaro, Amit Mukerji, Orlando Da Silva, Mohammad Adie, Kyong-Soon Lee, Eugene Ng, Brigitte Lemyre, Thierry Daboval, Faiza Khurshid, Ermelinda Pelausa, Keith Barrington, Anie Lapoint, Guillaume Ethier, Christine Drolet, Bruno Piedboeuf, Martine Claveau, Marie St-Hilaire, Valerie Bertelle, Edith Masse, Roderick Canning, Hala Makary, Cecil Ojah, Luis Monterrosa, Julie Emberley, Jehier Afifi, Andrzej Kajetanowicz, Marjo Metsäranta, Outi Tammela, Ulla Sankilampi, Timo Saarela, Iris Morag, Shmuel Zangen, Tatyana Smolkin, Francis Mimouni, David Bader, Avi Rothschild, Zipora Strauss, Clari Felszer, Hussam Omari, Smadar Even Tov-Friedman, Benjamin Bar-Oz, Michael Feldman, Nizar Saad, Orna Flidel-Rimon, Meir Weisbrod, Daniel Lubin, Ita Litmanovitz, Amir Kugelman, Eric Shinwell, Gil Klinger, Yousif Nijim, Alona Bin-Nun, Agneta Golan, Dror Mandel, Vered Fleisher-Sheffer, Anat Oron, Lev Bakhrakh, Satoshi Hattori, Masaru Shirai, Toru Ishioka, Toshihiko Mori, Takasuke Amizuka, Toru Huchimukai, Hiroshi Yoshida, Ayako Sasaki, Junichi Shimizu, Toshihiko Nakamura, Mami Maruyama, Hiroshi Matsumoto, Shinichi Hosokawa, Atsuko Taki, Machiko Nakagawa, Kyone Ko, Azusa Uozumi, Setsuko Nakata, Akira Shimazaki, Tatsuya Yoda, Osamu Numata, Hiroaki Imamura, Azusa Kobayashi, Shuko Tokuriki, Yasushi Uchida, Takahiro Arai, Mitsuhiro Ito, Kuniko Ieda, Toshiyuki Ono, Masashi Hayashi, Kanemasa Maki, MieToru Yamakawa, Masahiko Kawai, Noriko Fujii, Kozue Shiomi, Koji Nozaki, Hiroshi Wada, Taho Kim, Yasuyuki Tokunaga, Akihiro Takatera, Toshio Oshima, Hiroshi Sumida, Yae Michinomae, Yoshio Kusumoto, Seiji Yoshimoto, Takeshi Morisawa, Tamaki Ohashi, Yukihiro Takahashi, Moriharu Sugimoto, Noriaki Ono, Shinichiro Miyagawa, Takahiko Saijo, Takashi Yamagami, Kosuke Koyano, Shoko Kobayashi, Takeshi Kanda, Yoshihiro Sakemi, Mikio Aoki, Koichi Iida, Mitsushi Goshi, Yuko Maruyama, Alejandro Avila-Alvarez, José Luis Fernandez-Trisac, Ma Luz Couce Pico, María José Fernández Seara, Andrés Martínez Gutiérrez, Carolina Vizcaíno, Miriam Salvador Iglesias, Honorio Sánchez Zaplana, Belén Fernández Colomer, José Enrique García López, Rafael García Mozo, M. Teresa González Martínez, Ma Dolores Muro Sebastián, Marta Balart Carbonell, Joan Badia Barnusell, Mònica Domingo Puiggròs, Josep Figueras Aloy, Francesc Botet Mussons, Israel Anquela Sanz, Gemma Ginovart Galiana, W. Coroleu, Martin Iriondo, Laura Castells Vilella, Roser Porta, Xavier Demestre, Silvia Martínez Nadal, Cristina de Frutos Martínez, María Jesús López Cuesta, Dolores Esquivel Mora, Joaquín Ortiz Tardío, Isabel Benavente, Almudena Alonso, Ramón Aguilera Olmos, Miguel A. García Cabezas, Ma Dolores Martínez Jiménez, Ma Pilar Jaraba Caballero, Ma Dolores Ordoñez Díaz, Alberto Trujillo Fagundo, Lluis Mayol Canals, Fermín García-Muñoz Rodrigo, Lourdes Urquía Martí, María Fernanda Moreno Galdo, José Antonio Hurtado Suazo, Eduardo Narbona López, José Uberos Fernández, Miguel A. Cortajarena Altuna, Oihana Muga Zuriarrain, David Mora Navarro, María Teresa Domínguez, Ma Yolanda Ruiz del Prado, Inés Esteban Díez, María Teresa Palau Benavides, Santiago Lapeña, Teresa Prada, Eduard Soler Mir, Araceli Corredera Sánchez, Enrique Criado Vega, Náyade del Prado, Cristina Fernández, Lucía Cabanillas Vilaplana, Irene Cuadrado Pérez, Luisa López Gómez, Laura Domingo Comeche, Isabel Llana Martín, Carmen González Armengod, Carmen Muñoz Labián, Ma José Santos Muñoz, Dorotea Blanco Bravo, Vicente Pérez, Ma Dolores Elorza Fernández, Celia Díaz González, Susana Ares Segura, Manuela López Azorín, Ana Belén Jimenez, Tomás Sánchez-Tamayo, Elías Tapia Moreno, María González, José Enrique Sánchez Martínez, José María Lloreda García, Concepción Goñi Orayen, Javier Vilas González, María Suárez Albo, Eva González Colmenero, Elena Pilar Gutiérrez González, Beatriz Vacas del Arco, Josefina Márquez Fernández, Laura Acosta Gordillo, Mercedes Granero Asensio, Carmen Macías Díaz, Mar Albújar, Pedro Fuster Jorge, Sabina Romero, Mónica Rivero Falero, Ana Belén Escobar Izquierdo, Javier Estañ Capell, Ma Isabel Izquierdo Macián, Ma Mar Montejo Vicente, Raquel Izquierdo Caballero, Ma Mercedes Martínez, Aintzane Euba, Amaya Rodríguez Serna, Juan María López de Heredia Goya, Alberto Pérez Legorburu, Ana Gutiérrez Amorós, Víctor Manuel Marugán Isabel, Natalio Hernández González, Segundo Rite Gracia, Ma Purificación Ventura Faci, Ma Pilar Samper Villagrasa, Jiri Kofron, Katarina Strand Brodd, Andreas Odlind, Lars Alberg, Sofia Arwehed, Ola Hafström, Anna Kasemo, Karin Nederman, Lars Åhman, Fredrik Ingemarsson, Henrik Petersson, Pernilla Thurn, Eva Albinsson, Bo Selander, Thomas Abrahamsson, Ingela Heimdahl, Kristbjorg Sveinsdottir, Erik Wejryd, Anna Hedlund, Maria Katarina Söderberg, Lars Navér, Thomas Brune, Jens Bäckström, Johan Robinson, Aijaz Farooqi, Erik Normann, Magnus Fredriksson, Anders Palm, Urban Rosenqvist, Bengt Walde, Cecilia Hagman, Andreas Ohlin, Rein Florell, Agneta Smedsaas-Löfvenberg, Philipp Meyer, Rachel Kusche, Sven Schulzke, Mathias Nelle, Bendicht Wagner, Thomas Riedel, Grégoire Kaczala, Riccardo E. Pfister, Jean-François Tolsa, Matthias Roth, Martin Stocker, Bernhard Laubscher, Andreas Malzacher, John P. Micallef, Lukas Hegi, Romaine Arlettaz, Vera Bernet, Carlo Dani, Patrizio Fiorini, Paolo Ghirri, Barbara Tomasini, Anita Mittal, Jonathan Kefas, Anand Kamalanathan, Michael Grosdenier, Christopher Dewhurst, Andreea Bontea, Delyth Webb, Ross Garr, Ahmed Hassan, Priyadarshan Ambadkar, Mark Dyke, Katharine McDevitt, Glynis Rewitzky, Angela D'Amore, P. Kamath, Paul Settle, Natasha Maddock, Ngozi Edi-Osagie, Christos Zipitis, Carrie Heal, Jacqeline Birch, Abdul Hasib, Aung Soe, Bushra Abdul-Malik, Hamudi Kisat, Vimal Vasu, Savi Sivashankar, Richa Gupta, Chris Rawlingson, Tim Wickham, Marice Theron, Giles Kendall, Aashish Gupta, Narendra Aladangady, Imdad Ali, Neeraj Jain, Khalid Mannan, Vadivelam Murthy, Caroline Sullivan, Shu-Ling Chuang, Tristan Bate, Lidia Tyszcuzk, Geraint Lee, Ozioma Obi, John Chang, Vinay Pai, Charlotte Huddy, Salim Yasin, Richard Nicholl, Poornima Pandey, Jonathan Cusack, Venkatesh Kairamkonda, Dominic Muogbo, Liza Harry, Pinki Surana, Penny Broggio, Tilly Pillay, Sanjeev Deshpande, null Mahadevan, Alison Moore, Porus Bastani, Mehdi Garbash, Mithilesh Lal, Majd Abu-Harb, Alex Allwood, Michael Selter, Paul Munyard, David Bartle, Siba Paul, Graham Whincup, Sanghavi Rekha, Philip Amess, Ben Obi, Peter Reynolds, Indranil Misra, Peter De Halpert, Sanjay Salgia, Rekha Sanghavi, Nicola Paul, Abby Deketelaere, Minesh Khashu, Mark Johnson, Charlotte Groves, Jim Baird, Nick Brennan, Katia Vamvakiti, John McIntyre, Jennifer Holman, Stephen Jones, Alison Pike, Pamela Cairns, Megan Eaton, Karin Schwarz, David Gibson, Lawrence Miall, Dr Krishnamurthy, and Sankara Narayanan

Subjects
Male, medicine.medical_specialty, Birth weight, Standard score, Care provision, 03 medical and health sciences, 0302 clinical medicine, Sex Factors, Pregnancy, 030225 pediatrics, Intensive Care Units, Neonatal, Infant Mortality, Medicine, Humans, 030212 general & internal medicine, International network, business.industry, Obstetrics, Extremely preterm, Infant, Newborn, Gestational age, Infant, Length of Stay, medicine.disease, Infant mortality, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, Linear Models, Female, Pregnancy, Multiple, business
Abstract

Objective To compare length of stay (LOS) in neonatal care for babies born extremely preterm admitted to networks participating in the International Network for Evaluating Outcomes of Neonates (iNeo). Study design Data were extracted for babies admitted from 2014 to 2016 and born at 24 to 28 weeks of gestational age (n = 28 204). Median LOS was calculated for each network for babies who survived and those who died while in neonatal care. A linear regression model was used to investigate differences in LOS between networks after adjusting for gestational age, birth weight z score, sex, and multiplicity. A sensitivity analysis was conducted for babies who were discharged home directly. Results Observed median LOS for babies who survived was longest in Japan (107 days); this result persisted after adjustment (20.7 days more than reference, 95% CI 19.3-22.1). Finland had the shortest adjusted LOS (−4.8 days less than reference, 95% CI –7.3 to −2.3). For each week's increase in gestational age at birth, LOS decreased by 12.1 days (95% CI –12.3 to −11.9). Multiplicity and male sex predicted mean increases in LOS of 2.6 (95% CI 2.0-3.2) and 2.1 (95% CI 1.6-2.6) days, respectively. Conclusions We identified between-network differences in LOS of up to 3 weeks for babies born extremely preterm. Some of these may be partly explained by differences in mortality, but unexplained variations also may be related to differences in clinical care practices and healthcare systems between countries.

Published
2020

10. G216(P) A 5-year experience of using levetiracetam, (keppra) to control neonatal seizures in a regional neuroscience nicu

Author

Lawrence Miall, G Venkatachalam, and VA Harikrishnan

Subjects
Phenytoin, Pediatrics, medicine.medical_specialty, medicine.diagnostic_test, business.industry, Cerebral infarction, Incidence (epidemiology), Neonatal hypoglycemia, Electroencephalography, medicine.disease, Meconium, medicine, Levetiracetam, Neonatal seizure, business, medicine.drug
Abstract

Introduction Neonatal seizures are relatively common and are predictors of long-term neurocognitive and developmental impairment. The incidence of seizures in term infants is 1–3 per 1000 live births and is higher in preterm infants at 1%–13%. Aim To study the efficacy of Levetiracetam when used as part of a treatment protocol for neonatal seizures. Methods We reviewed electronic and patient care records of all neonates admitted to our NICU with seizures between 1 st January 2013 and 1 st 2018 January. Seizures were confirmed by single-channel amplitude integrated EEG and/or 12 channel [modified 10–20 system] l EEG in all cases. Results Over a 5 year period we had 5732 admissions to the neonatal unit and 134 patients with seizures. Of these 30 babies were treated with Levetiracetam. The local neonatal seizure treatment protocol includes, in ascending order, first: Phenobarbital® Midazolam® Levetiracetam ® Phenytoin. In babies, clinical seizure activity resolved within 3–48 hours. Levetiracetam used as the first line in 1 patient (no effect), as the second line in 3 patients (2 resolved, 1 later diagnosed with Pyridoxine-dependent seizures). Levetiracetam used as the third line in 21 patients of which 17 patient had good resolution. The four babies who did not respond had the following aetiologies: cerebral infarction, mitochondrial disorder, neonatal hypoglycemia, HIE grade 3 and meconium aspiration. Levetiracetam was used as a fourth line in 5 neonates and had good resolution in all cases. Levetiracetam was not started on one baby who had a diagnosis of pyridoxine-dependent seizure and this baby responded well to pyridoxine. 30 babies treated with Levetiracetam seizure control attained soon after its use in 24 babies (80%). See table 1. Conclusion Based on our single centre experience Levetiracetam achieves good seizure control in neonatal babies and there were no reported side effects noted. Levetiracetam might be considered as a first line treatment in neonatal seizure management when it is appropriate.1 Reference J Pediatr Neurosci. 2017 Jan-Mar;12(1):24–28.

Published
2019
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11. Neonatology at a Glance

Author

Tom Lissauer, Avroy A. Fanaroff, Lawrence Miall, Jonathan Fanaroff, Tom Lissauer, Avroy A. Fanaroff, Lawrence Miall, and Jonathan Fanaroff

Subjects
Infants--Diseases--Treatment, Newborn infants, Newborn infants--Diseases, Neonatology, Newborn infants--Care, Infants--Care
Abstract

Written by a team of leading international experts, Neonatology at a Glance provides a concise and easy-to-read overview of neonatal medicine. Each topic is clearly explained over a two-page spread, aided by numerous diagrams and illustrations. It has been extensively updated to include recent advances in perinatal medicine, genetics, respiratory support, therapeutic hypothermia, antimicrobial stewardship, and family integrated care. The book covers the wide range of problems encountered in looking after newborn babies, from normal newborn infants to the complexities of neonatal intensive care. Neonatology at a Glance: Provides up-to-date coverage of the important conditions you will encounter, including neonatal resuscitation and care of preterm infants Covers challenging topics including pain, ethical issues, patient safety, evidence-based medicine, and palliative and end of life care Includes details of a wide range of practical procedures, including less invasive surfactant administration, cranial ultrasound, brain monitoring and neuroimaging, and neonatal transport Neonatology at a Glance is the perfect guide for all health professionals looking after newborn infants, including pediatric trainees, medical students, neonatal nurse practitioners and neonatal nurses, therapists, and midwives. For neonatologists, pediatricians, and neonatal lecturers, it is a valuable resource to assist with teaching.

Published
2020

12. Essential Neonatal Medicine

Author

Sunil Sinha, Lawrence Miall, Luke Jardine, Sunil Sinha, Lawrence Miall, and Luke Jardine

Subjects
Newborn infants--Diseases, Neonatology, Newborn infants
Abstract

Providing a comprehensive yet concise guide for trainee doctors, neonatal nurses and midwives, Essential Neonatal Medicine continues to be an indispensable resource that combines the depth and breadth of a textbook with the efficiency of a revision guide. Extensively updated and full-colour throughout, this edition includes new chapters on neonatal transport and palliative care, as well as further content on pathophysiology and embryology, quality improvement and risk management, infection control, and non-invasive ventilation. With an improved artwork programme and a new glossary of terms, Essential Neonatal Medicine is ideal for all trainee health professionals new to neonatology, or looking for a comprehensive aid to support them.

Published
2018

13. Paediatrics at a Glance

Author

Lawrence Miall, Mary Rudolf, Dominic Smith, Lawrence Miall, Mary Rudolf, and Dominic Smith

Subjects
Pediatrics--Handbooks, manuals, etc
Abstract

Paediatrics at a Glance provides an introduction to paediatrics and the problems encountered in child health as they present in primary, community and secondary care, from birth through to adolescence. Thoroughly updated to reflect changes in understanding of childhood illness over the last 5 years, the 4th edition of this best-selling textbook diagrammatically summarises the main differential diagnoses for each presenting symptom, while accompanying text covers important disorders and conditions as well as management information.Paediatrics at a Glance:• Is an accessible, user-friendly guide to the entire paediatric curriculum• Features expanded coverage of psychological issues and ethics in child health• Includes more on advances in genetics, screening and therapy of childhood illness• Contains new videos of procedures and concepts on the companion website• Includes a brand new chapter on Palliative Care - an emerging area in the specialty• Features full colour artwork throughout• Includes a companion website at www.ataglanceseries.com/paediatrics featuring interactive self-assessment case studies, MCQs, videos of the procedures and concepts covered in the book, and links to online resourcesPaediatrics at a Glance is the ideal companion for anyone about to start a paediatric attachment or module and will appeal to medical students, junior doctors and GP trainees as well as nursing students and other health professionals.

Published
2016

14. Neonatology at a Glance

Author

Tom Lissauer, Avroy A. Fanaroff, Lawrence Miall, Jonathan Fanaroff, Tom Lissauer, Avroy A. Fanaroff, Lawrence Miall, and Jonathan Fanaroff

Subjects
Infants--Care, Infants--Diseases--Treatment, Neonatology--Outlines, syllabi, etc, Neonatology--Methods, Newborn infants
Abstract

Neonatology at a Glance provides a concise, illustrated overview of neonatal medicine. Written by leading international experts, it provides essential information on perinatal medicine, delivery, the normal newborn infant and neonatal problems encountered in neonatal intensive care units and their management. Each topic is supported by excellent illustrations, diagrams, and, for the first time, video clips to show neonatal resuscitation and stabilizing the sick newborn, normal examination, the baby with hypoxic-ischemic encephalopathy, recognition of seizures and practical procedures. Neonatology at a Glance: • Provides up to date coverage of the important conditions you will encounter • Covers challenging topics including pain, ethical issues, quality improvement, evidence based medicine and palliative care • Features new sections on fetal medicine, respiratory support, therapeutic hypothermia, amplified EEG and perinatal neuroimaging • Integrates invaluable details about practical procedures including neonatal resuscitation and transport • Supplemented by video materials and artwork which can be viewed via the companion website at www.ataglanceseries.com/neonatology Neonatology at a Glance is the perfect guide for all health professionals looking after newborn infants, including pediatric trainees, medical students, neonatal nurse practitioners and neonatal nurses, therapists and midwives. For neonatologists, pediatricians and nurse tutors it is a valuable resource to assist with teaching.

Published
2015

15. Neonatal Outcomes of Very Low Birth Weight and Very Preterm Neonates: An International Comparison

Author

Prakesh S. Shah, Kei Lui, Gunnar Sjörs, Lucia Mirea, Brian Reichman, Mark Adams, Neena Modi, Brian A. Darlow, Satoshi Kusuda, Laura San Feliciano, Junmin Yang, Stellan Håkansson, Rintaro Mori, Dirk Bassler, Josep Figueras-Aloy, Shoo K. Lee, Nadia Badawi, Peter Marshall, Paul Craven, Karen Simmer, Jacqueline Stack, Dan Casalaz, Elizabeth Carse, Lucy Cooke, Vijay Shingde, David Cartwright, Rod Hunt, Charles Kilburn, Peter Dargaville, Mary Paradisis, Ingrid Rieger, Carl Kuschel, Andrew Numa, Hazel Carlisle, Guan Koh, Chad Andersen, Melissa Luig, Nicola Austin, Roland Broadbent, Lindsay Mildenhall, Malcolm Battin, David Bourchier, Vaughan Richardson, Anne Synnes, Nicole Rouvinez-Bouali, Bruno Piedboeuf, Barbara Bulleid, Wendy Yee, Nalini Singhal, Adele Harrison, Cherrie Tan-Dy, Sandesh Shivananda, Kenneth Tan, Andrew James, Molly Seshia, Keith Barrington, Francine Lefebvre, Doug McMillan, Wayne Andrews, Lajos Kovacs, Kimberly Dow, Maxine Clarke, Patricia Riley, Prakesh Shah, Arne Ohlsson, Khalid Aziz, Abraham Peliowski, Zenon Cieslak, Todd Sorokan, Zarin Kalapesi, Abraham Ninan, Koravangattu Sankaran, Daniel Faucher, Gerarda Cronin, Roderick Canning, Orlando da Silva, David Lee, Cecil Ojah, Michael Dunn, Eli Heymann, Shmuel Zangen, Amir Kushnir, Francis Mimouni, David Bader, Avi Rothschild, Zipora Strauss, Clari Felszer, Jamalia Jeryes, Smadar Even Tov-Friedman, Benjamin Bar-Oz, Michael Feldman, Nizar Saad, Orna Flidel-Rimon, Meir Weisbrod, Daniel Lubin, Ita Litmanovitz, Shraga Blazer, Eric Shinwell, Leah Sirota, Yousif Nijim, Agneta Golan, Dror Mandel, Vered Fleisher-Sheffer, David Kohelet, Lev Bakhrakh, Satoshi Hattori, Shohei Konishi, Takasuke Amizuka, Takeo Kasai, Ritsuko Takahasi, Hirokazu Arai, Maki Sato, Yayoi Miyazono, Junichi Shimizu, Hiroshi Suzumura, Yumi Kono, Takahiro Inoue, Hiroshi Miyabayashi, Hisanori Sobajima, Rika Ishiguro, Hiroyuki Sato, Satsuki Totsu, Nozomi Ishii, Shigeharu Hosono, Mika Shiraishi, Humihiro Miura, Atsushi Nakao, Hitoshi Yoda, Mitsumasa Shimizu, Kazuo Seki, Yasuhumi Itani, Keiji Suzuki, Atsushi Nemoto, Tomohiko Nakamura, Masaki Wada, Yoshihisa Nagayama, Osamu Numata, Takeshi Futatani, Yasuhisa Ueno, Kazuyuki Iwai, Yoshinori Kono, Shigeru Ooki, Yusuke Nakazawa, Chizuko Suzuki, Taihei Tanaka, Motoki Bonno, Kenji Nakamura, Minako Kihara, Hiroyuki Sano, Atsushi Shiraishi, Atsushi Ohashi, Hiroyuki Ichiba, Kiyoaki Sumi, Seiji Yoshimoto, Yukihiro Takahashi, Takahiro Okutani, Masumi Miura, Fumihide Kato, Shinichi Watabe, Misao Kageyama, Rie Fukuhara, Michiko Hayashitani, Keiko Hasegawa, Kosuke Koyano, Shoko Kobayashi, Shinosuke Akiyoshi, Yusei Nakata, Takeshi Kanda, Hisano Tadashi, Hiroshi Kanda, Masaki Nakamura, Naoko Matsumoto, Masayuki Ochiai, Mikihiro Aoki, Akihiko Kawase, Koichi Iida, Chie Ishihara, Moriyasu Kohama, Ma José Fernández Seara, José Ma Fraga Bermúdez, Andrés Martínez Gutiérrez, María Mercedes Martínez Ayúcar, Carolina Vizcaíno Díaz, José Luis Quiles Durá, María González Santacruz, Ma Anne Feret Siguile, Adela Rodríguez Fernández, Belén Fernández Colomer, Enrique García López, Josep Figuera Aloy, Francesc Botet Mussons, Israel Anquela Sanz, Gemma Ginovart Galiana, Elisenda Moliner Calderon, Antonio Natal Pujol, Alicia Mirada Vives, Martín Iriondo Sanz, Roser Porta, Eva Capdevila Cogul, Laura Castells Vilella, Bruno Alonso Álvarez, José María Montero Macarro, Ana R. Barrio Sacristán, Ma Jesús López Cuesta, Ortiz Tardío, Eugenia Valls Sánchez Puerta, Isabel Benavente Fernández, Juan Mena Romero, María Dolores Martinez Gimenez, Ramón Aguilera Olmos, Ricardo Tosca Segura, Juana Ma Guzmán Cabañas, Ma Dolores Huertas Muñoz, Alberto Trujillo, Luis Fidel Moltó Ripoll, José Antonio Hurtado Suazo, Ana Elena Aldea Romero, Luis Paisán Grisolía, Ana Isabel Garrido Ocana, Eduardo Garcia Soblechero, Ma Yolanda Ruiz del Prado, Inés Esteba Díez, Gema E. González-Luis, Fermín García-Muñoz Rodrigo, Emilio Álvaro Iglesias, Fernando Fernandez Calvo, Eduard Solé Mir, Jordi Garcia Martí, Roberto Ortiz Movilla, Lucía Cabanillas Vilaplana, Marta García San Miguel, Isabel Llana Martín, María Fernández Díaz, Jesús Pérez Rodríguez, Sofía Salas, Carmen Muñoz Labian, Carmen González Armengod, Laura Domingo Comeche, Tomás Sánchez Tamayo, Manuel García del Río, José Ángel Alonso Gallego, José María Lloreda Garcia, Javier Vilas González, null Ocampo, Nieves Balado Insunza, Pilar García González, Mercedes Granero Asencio, Antonia López Sanz, Carmen Macías Díaz, Araceli Ferrari Cortés, Pedro Amadeo Fuster Jorge, Santiago López Mendoza, Sabina Romero Ramírez, Ma del Mar Albújar Font, Alicia de Ureta Huertas, Antonio Arroyos Plana, Javier Estañ Capell, Vicente Roqués, F. Morcillo, Sara Marín, María Fernanda Omaña, Gabriel Saitua Iturriaga, Jiri Kofron, Katarina Strand Brodd, Andreas Odlind, Lars Alberg, Sofia Arwehed, Eva Engström, Anna Kasemo, Charlotte Ekelund, Lars Åhman, Fredrik Ingemarsson, Laura Österdahl, Pernilla Thurn, Eva Albinsson, Bo Selander, Fredrik Lundberg, Ingela Heimdahl, Ola Hafström, Erik Wejryd, Johanna Kuusima-Löfbom, Ellen-Elisabeth Lund, Annelie Thorén, Boubou Hallberg, Eva Berggren Broström, Torbjörn Hertzberg, Björn Stjernstedt, Johan Robinson, Aijaz Farooqi, Erik Normann, Magnus Fredriksson, Anders Palm, Åsa Hedblom, Kenneth Sjöberg, Leif Thorbjörnsson, Andreas Ohlin, Rein Florell, Agneta Smedsaas-Löfvenberg, Philipp Meyer, Claudia Anderegg, Sven Schulzke, Mathias Nelle, Bendicht Wagner, Walter Bär, Grégoire Kaczala, Riccardo E. Pfister, Jean-François Tolsa, Matthias Roth, Thomas M. Berger, Bernhard Laubscher, Andreas Malzacher, John P. Micallef, Lukas Hegi, Romaine Arlettaz, Vera Bernet, Santanu Bag, Jonathan Kefas, Oliver Rackham, Arumugavelu Thirumurgan, Bill Yoxall, Tim McBride, Delyth Webb, Laweh Amegavie, Ahmed Hassan, Priyadarshan Ambadkar, Mark Dyke, Seif Babiker, Susan Rubin, Amanda Ogilvy-Stuart, Nagesh Panasa, Paul Settle, Jonathan Moise, Ngozi Edi-Osagie, Carrie Heal, Jacqeline Birch, Abdul Hasib, Aung Soe, Niraj Kumar, Hamudi Kisat, Vimal Vasu, Meera Lama, Richa Gupta, Chris Rawlingson, Tim Wickham, Karin Schwarz, Van Sommen, Sara Watkin, Aashish Gupta, Narendra Aladangady, Imdad Ali, Lesley Alsford, Khalid Mannan, Ebel Rainer, Nicholas Wilson, Mark Thomas, Ramnik Mathur, Michele Cruwys, Sunit Godambe, Timothy Watts, Jauro Kuna, John Chang, Jon Filkin, Charlotte Huddy, Ruth Shephard, Krzystof Zieba, Patti Rao, Andrew Currie, Azhar Manzoor, Munir Ahmed, Phil Simmons, Julie Nycyk, Andrew Gallagher, Chrisantha Halahakoon, Sanjeev Deshpande, Anand Mohite, Kate Palmer, Alan Gibson, Mehdi Garbash, Mithilesh Lal, Majd Abu-Harb, Róisín McKeon-Carter, Michael Selter, Paul Munyard, Vaughan Lewis, Mala Raman, Graham Whincup, Abdus Mallik, Philip Amess, Charles Godden, Peter Reynolds, Indranil Misra, Naveen Shettihalli, Peter De Halpert, Sanjay Salgia, Rekha Sanghavi, Ruth Wigfield, Abby Deketelaere, Minesh Khashu, Michael Hall, Charlotte Groves, Nick Brown, Nick Brennan, Katia Vamvakiti, Mal Ratnayaka, Simon Pirie, Stephen Jones, Paul Mannix, David Harding, Megan Eaton, David Gibson, and Lawrence Miall

Subjects
Male, Pediatrics, medicine.medical_specialty, Population, Infant, Premature, Diseases, Logistic regression, Global Health, Odds, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, medicine, Humans, Infant, Very Low Birth Weight, 030212 general & internal medicine, education, Retrospective Studies, education.field_of_study, business.industry, Mortality rate, Infant, Newborn, Retrospective cohort study, Retinopathy of prematurity, medicine.disease, Low birth weight, Bronchopulmonary dysplasia, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, Female, medicine.symptom, business, Demography
Abstract

OBJECTIVE To compare rates of a composite outcome of mortality or major morbidity in very-preterm/very low birth weight infants between 8 members of the International Network for Evaluating Outcomes. STUDY DESIGN We included 58 004 infants born weighing

Published
2016

16. The management of respiratory distress in the moderately preterm newborn infant

Author

Sam Wallis and Lawrence Miall

Subjects
Respiratory Distress Syndrome, Newborn, Pediatrics, medicine.medical_specialty, education.field_of_study, Evidence-based practice, Respiratory distress, business.industry, Extremely preterm, Population, Infant, Newborn, Acute respiratory distress, Infant newborn, Diagnosis, Differential, Intervention (counseling), Pediatrics, Perinatology and Child Health, medicine, Humans, Intensive care medicine, education, business, Infant, Premature, Research evidence
Abstract

Respiratory distress in a moderately preterm baby often presents diagnostic and management challenges to the attending paediatrician. Many of these babies will require little or no intervention, but it is known that early intervention in babies with acute respiratory distress often prevents further complications. Most current research evidence relates to extremely preterm newborns, yet moderately preterm infants are numerically far more common. This article explores the differential diagnosis of respiratory distress in this population and presents an evidence based approach to treatment.

Published
2011
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17. Posterior Fossa Abnormalities Seen on Magnetic Resonance Brain Imaging in a Cohort of Newborn Infants

Author

Lawrence Miall, Steven F. Tanner, Rosemary J. Arthur, Luc Cornette, and Malcolm I. Levene

Subjects
Male, medicine.medical_specialty, Developmental Disabilities, Gestational Age, Risk Assessment, Sensitivity and Specificity, Cohort Studies, Child Development, Atrophy, Neuroimaging, Birth Weight, Humans, Medicine, Survival rate, Cerebral Hemorrhage, Retrospective Studies, Brain Diseases, medicine.diagnostic_test, business.industry, Incidence, Infant, Newborn, Obstetrics and Gynecology, Gestational age, Retrospective cohort study, Magnetic resonance imaging, Prognosis, medicine.disease, Magnetic Resonance Imaging, Survival Rate, Cranial Fossa, Posterior, Pediatrics, Perinatology and Child Health, Female, Radiology, Cerebellar hypoplasia (non-human), Abnormality, business, Infant, Premature
Abstract

OBJECTIVE: To describe the nature and frequency of posterior fossa (PF) lesions in infants who underwent magnetic resonance (MR) brain imaging in the neonatal period and to correlate with cranial ultrasound (CUS) findings and clinical outcome. STUDY DESIGN: A retrospective review of all neonatal MR brain imaging from 1996 to 2001 (n=558). MR images, CUS and case notes were reviewed in infants with PF abnormality. RESULTS: A total of 20 infants had abnormalities in the PF, which represents 4.7% of abnormalities seen on MR. Out of 10, six term infants had PF extra-axial hemorrhage, three had cerebellar hypoplasia, while one had cerebellar hemorrhage. In the preterm, 8/10 lesions were unilateral; focal cerebellar hemorrhage was seen in 5/10 and extensive hemorrhage with secondary atrophy in 3/10. Out of 20, 17 infants also had supratentorial lesions. Out of 20, 19 had CUS performed, of which 7/19 showed PF abnormality. CONCLUSION: Intracerebellar hemorrhage was more common in preterm infants than in term infants. These hemorrhages tended to be focal, unilateral and were associated with atrophy.

Published
2003
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18. Essential Neonatal Medicine

Author

Sunil Sinha, Lawrence Miall, Luke Jardine, Sunil Sinha, Lawrence Miall, and Luke Jardine

Subjects
Newborn infants--Diseases, Neonatology
Abstract

Essential Neonatal Medicine combines the depth and breadth of a textbook with the clarity and efficiency of a learning consolidator. Providing a solid reference for trainee doctors, neonatal nurses and midwives, this full colour edition has been extensively updated with a range of new illustrations, clinical tips, cross-references to Wiley title Nursing the Neonate (2010, 9781405149747), and end-of-chapter summaries for quick study or revision. Essential Neonatal Medicine is ideal for all trainee health professionals experiencing neonatology for the first time and looking for a readable and comprehensive resource to support them. It is now accompanied by the enhanced Wiley Desktop Edition (the interactive digital version of the book featuring downloadable text and images, highlighting and note-taking facilities, book-marking, cross-referencing, in-text searching, and linking to references and glossary terms), and a companion website at www.essentialneonatalmed.com featuring figures from the book to download in PowerPoint, further reading, and self-test questions for each chapter. This title is also available as a mobile App from MedHand Mobile Libraries. Buy it now from iTunes, Google Play or the MedHand Store.

Published
2012

19. Paediatrics at a Glance

Author

Lawrence Miall, Mary Rudolf, Dominic Smith, Lawrence Miall, Mary Rudolf, and Dominic Smith

Subjects
Pediatrics--Handbooks, manuals, etc
Abstract

Paediatrics at a Glance provides an introduction to paediatrics and the problems encountered in child health as they present in primary, community and secondary care, from birth through to adolescence. Each concise chapter diagrammatically summarises the main differential diagnoses for each presenting symptom, with accompanying text which covers important disorders and conditions as well as management information. Updates and new features for this edition include: New chapters on'Ethical Issues in Paediatrics'and'Screening and Genetics'Fully updated content on autism and adolescent issues Most likely or serious diagnoses are indicated using a new quick reference icon A brand new companion website featuring self-assessment questions and further reference web links at www.ataglanceseries.com/paediatrics Paediatrics at a Glance is the ideal companion for anyone about to start a paediatric attachment or module and will appeal to medical students, junior doctors and GP trainees as well as nursing students and other health professionals.

Published
2012

21. Park’s The Pediatric Cardiology Handbook

Author

Lawrence Miall

Subjects
medicine.medical_specialty, business.industry, Pediatrics, Perinatology and Child Health, medicine, Medical emergency, medicine.disease, business, Intensive care medicine, Pediatric cardiology
Published
2015
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22. Fetal outcome following preterm delivery

Author

Lawrence Miall and Malcom Levene

Subjects
medicine.medical_specialty, Pediatrics, Fetus, business.industry, Reproductive medicine, Gestational age, Retinopathy of prematurity, medicine.disease, Surfactant therapy, medicine.disease_cause, Cerebral palsy, Respiratory syncytial virus (RSV), Obstetrics and gynaecology, medicine, business
Published
2005
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23. Peripherally inserted central catheters in children with cystic fibrosis. Eight cases of difficult removal

Author

Keith G. Brownlee, Abhi Das, Lawrence Miall, and Steve Conway

Subjects
medicine.medical_specialty, Catheterization, Central Venous, Adolescent, Cystic Fibrosis, business.industry, MEDLINE, medicine.disease, Cystic fibrosis, United Kingdom, Surgery, Anti-Bacterial Agents, Equipment failure, Surgical removal, Child, Preschool, medicine, Etiology, Humans, Catheter removal, Equipment Failure, business, Child, General Nursing
Abstract

Peripherally inserted central catheters (PICCs) are widely used in the management of cystic fibrosis (CF) in children and adults. The authors present a collection of eight case reports of patients with CF in whom removal of PICCs was difficult, including two PICCs that required surgical removal. The cases were observed in a regional pediatric CF unit in the United Kingdom. Possible etiology and strategies that can be used to achieve catheter removal are discussed.

Published
2001

24. A rare cause of upper airway obstruction in neonates

Author

Vernon W Long, Irfan Jeeva, Rana Alia, and Lawrence Miall

Subjects
medicine.medical_specialty, Normal delivery, business.industry, Infant, Newborn, Teratoma, General Medicine, Airway obstruction, medicine.disease, Magnetic Resonance Imaging, Infant newborn, Article, Surgery, Airway Obstruction, Diagnosis, Differential, Oropharyngeal Neoplasms, Laser therapy, medicine, Humans, Female, Canthus, Laser Therapy, Neonatal health, Differential diagnosis, business
Abstract

A full-term baby girl weighing 2.9 kg was born by normal delivery. The anomaly scan at 20 weeks (including a 3D facial scan) was normal. She was born in good condition, but was noticed to have bilateral purple-coloured tense mobile, non-pulsatile masses below the medial canthus (figure 1). Figure 1 Bilateral masses below …

Published
2012
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26. Pocket Neonatology

Author

Lawrence Miall

Subjects
medicine.medical_specialty, business.industry, Family medicine, Pediatrics, Perinatology and Child Health, medicine, Neonatology, business
Published
2001
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27. Plasma Creatinine Rises Dramatically in the First 48 Hours of Life in Preterm Infants

Author

J. Trevor Brocklebank, Keith G. Brownlee, Vicki L. Allgar, Michael J. Henderson, Simon J. Newell, Lawrence Miall, and Alison J. Turner

Subjects
medicine.medical_specialty, Pediatrics, Neonatal intensive care unit, Birth weight, Gestational Age, Infant, Premature, Diseases, Severity of Illness Index, chemistry.chemical_compound, Severity of illness, medicine, Birth Weight, Humans, Urea, Prospective Studies, Prospective cohort study, Creatinine, Obstetrics, business.industry, Infant, Newborn, Gestational age, Fetal Blood, Confidence interval, chemistry, Pediatrics, Perinatology and Child Health, Gestation, business, Infant, Premature
Abstract

Objective. Published data show that plasma creatinine falls steadily during the first 28 days of life and that creatinine levels in the neonatal period are higher in more premature infants. However, the best reference data commence on day 2 of life. The objective of this study was to document how plasma creatinine changes in the first 48 hours of life and to examine the reason for the apparently high levels of creatinine in preterm infants, compared with maternal levels. Design. A prospective observational study on a regional neonatal intensive care unit. Patients. A total of 42 preterm infants, mean gestational age of 29.4 weeks (range: 23–35), mean birth weight of 1.42 kg (.55–2.77), divided into 4 gestation groups: 23 to 26 weeks (n = 9), 27 to 29 weeks (n = 13), 30 to 32 weeks (n = 12), and 33 to 35 weeks (n = 8). Interventions. Measurement of plasma creatinine and urea concentration in cord blood and in serial samples taken for routine arterial blood gas analysis. Outcome Measurements. Changes in creatinine concentration with time and relationship to gestational age, birth weight, and illness severity. Results. Mean creatinine at birth was 73 μmol/L (95% confidence interval [CI]: 68–79 μmol/L). Plasma creatinine rose significantly over the first 48 hours. Mean peak creatinine in the most preterm infants (23–26 weeks) was 221 μmol/L (CI: 195–247 μmol/L). Peak plasma creatinine was inversely related to gestation (Spearman's coefficient: −.73) and birth weight (Spearman's coefficient: −.76). Significant differences in creatinine concentration were seen among different gestational groups at 24 and 48 hours of life. Peak creatinine correlated with a high Clinical Risk Index for Babies score (Spearman's coefficient: .64). The fall in creatinine began later in more premature infants. All 38 surviving infants had normal renal function; their mean plasma creatinine at discharge was 52 μmol/L (CI: 46–58 μmol/L). Conclusions. Rather than falling steadily from birth, creatinine rises dramatically in the first 48 hours of life, especially in infants of

Published
1999
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