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Active hepatitis C virus (HCV) prevalence (i.e., HCV PCR positivity) in Israel is estimated to range from 0.1% to >5.5%, depending on risk group affiliation; seroprevalence (i.e., HCV antibody positivity) [...]

Aim of the study In preterm infants, the use of human milk is associated with unique benefits. However, successful breast feeding rates and prolonged breastfeeding duration is often reduced in preterm infants. Nevertheless, early initiation of breast expression after birth is believed to be one of the major variables that should improve the odds of successful breastfeeding. Hence, we aimed to assess correlation between timing of milk expression initiation and volume produced in regards to mode-of-delivery. Materials and methods Prospective, observational study. Mothers delivering infants weighing < 1500 g measured 24-h milk volumes on days 1–7, 14, and 21. Results Mothers delivering vaginally (N = 11) expressed milk sooner (3.82 ± 5.03 h) than mothers in the cesarean group (N = 42; 11.5 ± 9.1 h). There were no significant differences in daily number of expressions (i.e. day 1 3.6 ± 1.6 versus 2.5 ± 2.1, p = .125) or daily volume (i.e. day 1 – 7.5 ± 6.1 ml versus 11.6 ± 22.9 ml, p = .563), until day 6 from which, both were lower in the cesarean group (i.e. day 21 – number − 6.0 ± 1.3 versus 4.6 ± 1.7, p = .029; volume – 796 ± 465ml versus 435 ± 368ml, p = .018). Expressed volume initially did not correlate with earlier expression, however, latter expressed volume inversely correlated with earlier expression. In multivariate-analysis, mode of delivery, gestational age, and daily number of expressions were correlated with volumes on day 21 (p = .001). Conclusions Earlier human-milk expression is related to volumes on the second and the third week of lactation. This is overwhelmed by delivery mode, and by frequent milk expression from day 2. When early milk expression is not possible, more frequent milk expression might help increasing volumes. [ABSTRACT FROM AUTHOR]

Objective  The study aimed to assess the association of nucleated red blood cells (NRBC), a surrogate of intrauterine hypoxia, and elevated pulmonic vascular resistance (E-PVR) and oxygen requirement after minimally invasive surfactant therapy (MIST). Study Design  Retrospective study of a cohort of preterm neonates that received MIST in a single unit. Results  NRBC were measured in 65 of 75 (87%) neonates administered MIST during the period. In total, 22 of 65 (34%) infants had pre-MIST echocardiography (ECHO). Neonates with elevated NRBC (predefined as >5 × 10 9 /L, n  = 16) required higher post-MIST fraction of inspired oxygen (FiO 2) than neonates with normal NRBC (<1 × 10 9 /L, n  = 17; FiO 2  = 0.31 ± 0.10 and 0.24 ± 0.04, respectively, p  = 0.02). NRBC correlated positively with % of time in right to left ductal shunt (r = 0.51, p  = 0.052) and inversely with right ventricular stroke volume (r = −0.55, p  = 0.031) and time to peak velocity to right ventricular ejection time ratio (r = −0.62, p  < 0.001). Conclusion  Elevated NRBC are associated with elevated FiO 2 after MIST and elevated E-PVR. Intrauterine hypoxia may impact postnatal circulatory adaptations and oxygen requirement. Key Points Post-MIST FiO 2 requirements are significantly higher in infants with elevated NRBC. NRBC correlates positively with elevated PVR in neonates requiring. Intrauterine hypoxia may play a role in postnatal circulatory adaptations in neonates with RDS. [ABSTRACT FROM AUTHOR]