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59 records – page 1 of 6.

Advanced maternal age and the outcomes of preterm neonates: a social paradox?

https://arctichealth.org/en/permalink/ahliterature131136
Source
Obstet Gynecol. 2011 Oct;118(4):872-7
Publication Type
Article
Date
Oct-2011
Author
Jaideep Kanungo
Andrew James
Douglas McMillan
Abhay Lodha
Daniel Faucher
Shoo K Lee
Prakesh S Shah
Author Affiliation
University of Toronto, Toronto, Ontario, Canada.
Source
Obstet Gynecol. 2011 Oct;118(4):872-7
Date
Oct-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Canada - epidemiology
Cesarean Section - statistics & numerical data
Chorioamnionitis - epidemiology
Female
Humans
Hypertension, Pregnancy-Induced - epidemiology
Infant, Newborn
Infant, newborn, diseases - epidemiology
Infant, Premature, Diseases - epidemiology
Infant, Small for Gestational Age
Intensive Care Units, Neonatal - statistics & numerical data
Male
Maternal Age
Middle Aged
Pregnancy
Pregnancy Outcome - epidemiology
Premature Birth - epidemiology
Retrospective Studies
Steroids - administration & dosage
Young Adult
Abstract
To estimate the effect of maternal age on survival free of major morbidity among preterm newborns younger than 33 weeks of gestation at birth.
Data from a retrospective cohort of preterm newborns younger than 33 weeks of gestation admitted to Canadian neonatal intensive care units between 2003 and 2008 were analyzed. The primary outcome was survival without major morbidity (defined as bronchopulmonary dysplasia, intraventricular hemorrhage grade 3 or 4, periventricular leukomalacia, retinopathy of prematurity stage 3, 4 or 5, or necrotizing enterocolitis stage 2 or 3). Trends in outcomes in relation to maternal age groups were examined using a multivariable analysis that controlled for confounders.
Baseline comparison for the 12,326 eligible newborns revealed no differences in sex, small-for-gestational-age status, and chorioamnionitis among different maternal age groups. Higher rates of cesarean delivery, use of prenatal steroids, maternal hypertension, and diabetes were noted as maternal age increased (P
PubMed ID
21934451 View in PubMed
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[Antibiotic treatment of newborn infants. Experiences from a neonatal department]

https://arctichealth.org/en/permalink/ahliterature59086
Source
Tidsskr Nor Laegeforen. 1997 Apr 20;117(10):1450-2
Publication Type
Article
Date
Apr-20-1997
Author
E. Kolsrud
S H Anderssen
Author Affiliation
Barneavdelingen Ostfold sentralsykehus, Fredrikstad.
Source
Tidsskr Nor Laegeforen. 1997 Apr 20;117(10):1450-2
Date
Apr-20-1997
Language
Norwegian
Publication Type
Article
Keywords
Anti-Bacterial Agents - administration & dosage
Antibiotic Prophylaxis
Bacterial Infections - microbiology - prevention & control
Drug Utilization
English Abstract
Humans
Intensive Care Units, Neonatal - statistics & numerical data
Norway
Abstract
We have studied all newborns admitted to our neonatal intensive care unit during 1993 and treated with intravenous antibiotics. Patient-files were examined for all available data at admission, focusing on factors predisposing for infection, symptoms, additional diagnoses, laboratory tests, bacteriology and antibacterial treatment. Antibiotics were given to 126 (28%) patients, of whom 90 were suspected of having an infection on admission. 57 of these were discharged with an infection-related diagnosis. 33 patients received prophylactic antibiotics, of whom three later developed infection. Retrospectively, 53 patients had proven or very probable infection. Fourteen patients tested blood culture positive. In our material the incidence of septicaemia was 0.45% of all newborn. Both the frequency of treatment and the incidence of septicaemia are consistent with the findings in earlier reports. We find that our material contains an unacceptably high frequency of false negative blood cultures. Recently published data show that the incidence of positive blood cultures is proportional to the amount of blood extracted.
PubMed ID
9198920 View in PubMed
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Babies admitted to NICU/ICU: province of birth and mode of delivery matter.

https://arctichealth.org/en/permalink/ahliterature132200
Source
Healthc Q. 2011;14(2):16-20
Publication Type
Article
Date
2011
Author
Shafagh Fallah
Xi-Kuan Chen
Derek Lefebvre
Jacqueline Kurji
Joanne Hader
Kira Leeb
Author Affiliation
Canadian Institute for Health Information (CIHI), Toronto, Ontario, Canada.
Source
Healthc Q. 2011;14(2):16-20
Date
2011
Language
English
Publication Type
Article
Keywords
Birth weight
Canada - epidemiology
Cesarean Section - statistics & numerical data
Delivery, obstetric - statistics & numerical data
Female
Gestational Age
Humans
Infant, Low Birth Weight
Infant, Newborn
Intensive Care Units - statistics & numerical data
Intensive Care Units, Neonatal - statistics & numerical data
Length of Stay - statistics & numerical data
Male
Multiple Birth Offspring - statistics & numerical data
Premature Birth - epidemiology
Abstract
Neonatal intensive care units (NICUs) and intensive care units (ICUs) provide care for newborns in need of specialized medical attention. Across Canada, rates of NICU/ICU admission vary. Due to the high cost of monitoring and interventions these admissions cost more than general newborn stays - whether the newborn is in a specialized NICU or in an ICU in those facilities without specialized units for newborns. This study explores the variation in NICU/ICU admissions and the characteristics of mothers and newborns associated with an increased likelihood of NICU/ICU admission. We focus further on the association between NICU/ICU admission and Caesarean section (C-section). After excluding multiple births, preterm births, small for gestational age births and those delivered by women with select complications, we find an increased risk for NICU/ICU admission for babies born by C-section as their only indication. NICU/ICU admission following C-section alone may not represent the most desirable pathway of care for these newborns.
PubMed ID
21841387 View in PubMed
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Bacteremia due to persistent strains of coagulase-negative staphylococci in a neonatal intensive-care unit.

https://arctichealth.org/en/permalink/ahliterature201968
Source
Infect Control Hosp Epidemiol. 1999 May;20(5):349-51
Publication Type
Article
Date
May-1999
Author
L. Sung
K. Ramotar
L M Samson
B. Toye
Author Affiliation
Department of Pediatrics, University of Ottawa, Ontario, Canada.
Source
Infect Control Hosp Epidemiol. 1999 May;20(5):349-51
Date
May-1999
Language
English
Publication Type
Article
Keywords
Bacteremia - epidemiology - microbiology
Case-Control Studies
Coagulase - analysis
Cross Infection - epidemiology - microbiology
Disease Reservoirs - statistics & numerical data
Female
Humans
Infant, Newborn
Intensive Care Units, Neonatal - statistics & numerical data
Male
Ontario - epidemiology
Retrospective Studies
Risk factors
Staphylococcal Infections - enzymology - epidemiology - microbiology
Staphylococcus - classification - enzymology - isolation & purification
Statistics, nonparametric
Abstract
This retrospective case-control study was performed to determine risk factors for bacteremia due to persistent coagulase-negative staphylococci in our neonatal intensive-care unit. Enteral nutrition and the presence of a nasogastric tube were identified as possible risk factors for coagulase-negative staphylococcal bacteremia involving one of the persistent strains.
PubMed ID
10349955 View in PubMed
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Central line-associated bloodstream infection in neonatal intensive care units.

https://arctichealth.org/en/permalink/ahliterature106771
Source
Infect Control Hosp Epidemiol. 2013 Nov;34(11):1167-73
Publication Type
Article
Date
Nov-2013
Author
Ana C Blanchard
Elise Fortin
Isabelle Rocher
Dorothy L Moore
Charles Frenette
Claude Tremblay
Caroline Quach
Author Affiliation
Division of Infectious Diseases, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada.
Source
Infect Control Hosp Epidemiol. 2013 Nov;34(11):1167-73
Date
Nov-2013
Language
English
Publication Type
Article
Keywords
Bacteremia - epidemiology - microbiology - mortality
Birth weight
Candidemia - epidemiology
Candidiasis - epidemiology
Catheter-Related Infections - epidemiology - microbiology - mortality
Catheterization, Central Venous - adverse effects
Central Venous Catheters - adverse effects - microbiology
Comorbidity
Escherichia coli Infections - epidemiology
Female
Gastrointestinal Diseases - epidemiology
Humans
Incidence
Infant
Infant, Newborn
Intensive Care Units, Neonatal - statistics & numerical data
Klebsiella Infections - epidemiology
Lung Diseases - epidemiology
Male
Methicillin-Resistant Staphylococcus aureus
Quebec - epidemiology
Retrospective Studies
Staphylococcal Infections - epidemiology - microbiology
Abstract
Describe the epidemiology of central line-associated bloodstream infections (CLABSIs) in neonatal intensive care units (NICUs) participating in a standardized and mandatory CLABSI surveillance program.
Retrospective cohort. Setting. We included patients admitted (April 2007-March 2011) to 7 level II/III NICUs who developed a CLABSI (as defined by the National Healthcare Safety Network).
CLABSIs/1,000 central line-days and device utilization ratio were calculated; ?(2) test, Student t test, Kruskal-Wallis, and Poisson regression were used.
Overall, 191 patients had 202 CLABSI episodes for a pooled mean rate of 4.0 CLABSIs/1,000 central line-days and a device utilization ratio of 0.20. Annual pooled mean CLABSI rates increased from 3.6 in 2007-2008 to 5.1 CLABSIs/1,000 central line-days in 2010-2011 (P - .01). The all-cause 30-day case fatality proportion was 8.9% (n = 17) and occurred a median of 8 days after CLABSI. Coagulase-negative Staphylococcus was identified in 112 (50.5%) cases. Staphylococcus aureus was identified in 22 cases, and 3 (13.6%) were resistant to methicillin. An underlying intra-abdominal pathology was found in 20% (40/202) of CLABSI cases, 50% of which were reported in the last year of study. When adjusted for mean birth weight, annual CLABSI incidence rates were independently associated with the proportion of intra-abdominal pathology (P = .007) and the proportion of pulmonary pathology (P = .016) reported.
The increase in CLABSI rates in Quebec NICUs seems to be associated with an increased proportion of cases with underlying intra-abdominal and pulmonary pathologies, which needs further investigation.
PubMed ID
24113600 View in PubMed
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The changing epidemiology of preterm twins and triplets admitted to neonatal intensive care units in Canada, 2003 to 2008.

https://arctichealth.org/en/permalink/ahliterature132550
Source
Am J Perinatol. 2012 Apr;29(4):237-44
Publication Type
Article
Date
Apr-2012
Author
Kate L Bassil
Prakesh S Shah
Keith J Barrington
Adele Harrison
Orlando P da Silva
Shoo K Lee
Author Affiliation
Dalla Lana School of Public Health, University of Toronto, Ontario, Canada. kbassil@mtsinai.on.ca
Source
Am J Perinatol. 2012 Apr;29(4):237-44
Date
Apr-2012
Language
English
Publication Type
Article
Keywords
Canada - epidemiology
Female
Humans
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases - epidemiology
Intensive Care Units, Neonatal - statistics & numerical data - trends
Outcome Assessment (Health Care)
Patient Admission - statistics & numerical data - trends
Pregnancy
Triplets
Twins
Abstract
We describe trends in the rates of admission of preterm twin and triplet infants to neonatal intensive care units (NICUs) across Canada and compare their neonatal outcomes over a 6-year period. Temporal trends of admission rates for 5193 twins and triplets
PubMed ID
21809267 View in PubMed
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Characteristics and outcome of infants with candiduria in neonatal intensive care - a Paediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study.

https://arctichealth.org/en/permalink/ahliterature147226
Source
BMC Infect Dis. 2009;9:183
Publication Type
Article
Date
2009
Author
Joan L Robinson
H Dele Davies
Michelle Barton
Karel O'Brien
Kim Simpson
Elizabeth Asztalos
Anne Synnes
Earl Rubin
Nicole Le Saux
Charles Hui
Joanne M Langley
Reg Sauve
Louis de Repentigny
Lajos Kovacs
Ben Tan
Susan E Richardson
Author Affiliation
Department of Pediatrics, Alberta Children's Hospital Calgary, Alberta, Canada. jr3@ualberta.ca
Source
BMC Infect Dis. 2009;9:183
Date
2009
Language
English
Publication Type
Article
Keywords
Antifungal Agents - therapeutic use
Canada - epidemiology
Candidiasis - diagnosis - drug therapy - epidemiology
Cross Infection - diagnosis - drug therapy - epidemiology
Female
Humans
Infant, Newborn
Intensive Care Units, Neonatal - statistics & numerical data
Male
Prognosis
Prospective Studies
Urinary Tract Infections - diagnosis - drug therapy - epidemiology
Abstract
There is limited information in the literature on the presentation and prognosis of candidal urinary tract infection (UTI) in infants in the neonatal intensive care unit (NICU).
This was a prospective cohort study performed in 13 Canadian NICUs. Infants with candidal UTI without extra-renal candidal infection at presentation were enrolled.
Thirty infants fit the study criteria. Median birth weight and gestational age were 2595 grams (range 575-4255) and 35 weeks (range 24-41) with 10 infants being
Notes
Cites: Pediatr Infect Dis J. 1999 Nov;18(11):959-6310571429
Cites: Clin Infect Dis. 2001 Apr 1;32(7):1018-2311264029
Cites: Pediatrics. 2003 Sep;112(3 Pt 1):634-4012949295
Cites: Semin Perinatol. 2003 Oct;27(5):393-40014626503
Cites: Arch Dis Child Fetal Neonatal Ed. 2006 May;91(3):F188-9216332924
Cites: Pediatr Infect Dis J. 1997 Feb;16(2):190-49041599
Cites: Pediatr Crit Care Med. 2005 May;6(3 Suppl):S25-915857553
Cites: Mycopathologia. 2005 Apr;159(3):331-715883715
Cites: Pediatr Infect Dis J. 1996 Apr;15(4):348-528866806
PubMed ID
19930662 View in PubMed
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Colonization with coagulase-negative staphylococci in two neonatal units.

https://arctichealth.org/en/permalink/ahliterature36530
Source
J Hosp Infect. 1992 Dec;22(4):287-98
Publication Type
Article
Date
Dec-1992
Author
B. Nyström
U. Ransjö
S. Ringertz
G. Faxelius
R. Tunell
G. Ohman
J. Wilton
M A Pfaller
Author Affiliation
Department of Clinical Microbiology, Huddinge Hospital, Sweden.
Source
J Hosp Infect. 1992 Dec;22(4):287-98
Date
Dec-1992
Language
English
Publication Type
Article
Keywords
Anti-Bacterial Agents - pharmacology
Coagulase
Colony Count, Microbial
Drug Resistance, Microbial - genetics
Drug Utilization
Hospitals, Teaching - statistics & numerical data
Humans
Infant, Newborn - microbiology
Intensive Care Units, Neonatal - statistics & numerical data
Microbial Sensitivity Tests
Nurseries, Hospital - statistics & numerical data
Staphylococcus - genetics - growth & development
Sweden - epidemiology
Abstract
Episodes of septicaemia due to coagulase-negative staphylococci (CNS) were more frequent in a level III than in a level II neonatal unit in Stockholm, Sweden. Colonization with CNS during the first 2 weeks of life was investigated in 10 infants from each unit. As the use of antibiotics differed between the two units, the aim was to correlate colonization and antimicrobial resistance patterns to antibiotic usage. Antimicrobial susceptibility of CNS to isoxazolylpenicillins, co-trimoxazole, erythromycin, clindamycin, chloramphenicol and gentamicin was determined. Selected isolates were typed with restriction endonuclease analysis of plasmid DNA and of genomic DNA. Infants were frequently colonized with multiple strains and species of CNS, and transmission of strains from patient to patient occurred within the unit. Qualitative and quantitative differences in antibiotic use were not correlated with colonization. The prevalence of resistant isolates, mostly of Staphylococcus haemolyticus, was higher in the level II unit with lower use of antibiotics. Staphylococcus epidermidis, which is generally more virulent, prevailed in the level III unit, where there were more severely ill children and invasive procedures were more frequently performed.
PubMed ID
1363108 View in PubMed
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Comparison of singleton and multiple-birth outcomes of infants born at or before 32 weeks of gestation.

https://arctichealth.org/en/permalink/ahliterature159043
Source
Obstet Gynecol. 2008 Feb;111(2 Pt 1):365-71
Publication Type
Article
Date
Feb-2008
Author
Xiangming Qiu
Shoo K Lee
Kenneth Tan
Bruno Piedboeuf
Rody Canning
Author Affiliation
Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
Source
Obstet Gynecol. 2008 Feb;111(2 Pt 1):365-71
Date
Feb-2008
Language
English
Publication Type
Article
Keywords
Adult
Apgar score
Canada - epidemiology
Female
Gestational Age
Humans
Infant, Newborn
Infant, Premature - growth & development - physiology
Infant, Very Low Birth Weight - growth & development - physiology
Intensive Care Units, Neonatal - statistics & numerical data
Linear Models
Pregnancy
Pregnancy outcome
Pregnancy, Multiple
Respiratory Distress Syndrome, Newborn - epidemiology
Retinopathy of Prematurity - epidemiology
Risk assessment
Abstract
To compare the outcomes of multiple-birth and singleton very preterm infants who were admitted to neonatal intensive care units (NICUs).
Three-level hierarchical generalized linear and hierarchical linear model analyses were used to compare the risk-adjusted outcomes of 3,242 infants born at or before 32 weeks of gestational age who were admitted to 24 Canadian NICUs in 2005.
With the exception of respiratory distress syndrome (RDS), multiple-birth infants were not at a higher risk than singleton birth infants for death, patent ductus arteriosus, necrotizing enterocolitis, chronic lung disease, severe intraventricular hemorrhage, severe (stages 3 or higher) retinopathy of prematurity, or nosocomial infection, after adjusting for perinatal risks and neonatal illness severity. In addition, multiple-birth infants did not have a more prolonged duration of neonatal intensive care unit stay, duration of length of continuous positive airway pressure use, duration of ventilation, or duration of oxygen use than did singletons. Multiple-birth infants had a higher incidence of RDS (adjusted odds ratio 1.3, 95% confidence interval 1.0-1.6) and a lower incidence of severe retinopathy of prematurity (adjusted odds ratio 0.5, 95% confidence interval 0.3-0.9) than did singletons.
Multiple-birth and singleton very preterm infants had similar outcomes, except for a higher incidence of RDS among multiple-birth infants.
II.
Notes
Erratum In: Obstet Gynecol. 2008 May;111(5):1217
PubMed ID
18238974 View in PubMed
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Current trends in paediatric and neonatal ventilatory care -- a nationwide survey.

https://arctichealth.org/en/permalink/ahliterature120915
Source
Acta Paediatr. 2013 Feb;102(2):123-8
Publication Type
Article
Date
Feb-2013
Author
Merja Ålander
Outi Peltoniemi
Timo Saarela
Eija Anttila
Tytti Pokka
Tero Kontiokari
Author Affiliation
Department of Pediatrics, Oulu University Hospital, Oulu, Finland. merja.alander@oulu.fi
Source
Acta Paediatr. 2013 Feb;102(2):123-8
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Child
Child, Preschool
Finland
Follow-Up Studies
Guideline Adherence - statistics & numerical data
Health Care Surveys
Humans
Infant
Infant, Newborn
Intensive Care - methods - statistics & numerical data - trends
Intensive Care Units, Neonatal - statistics & numerical data - trends
Intensive Care Units, Pediatric - statistics & numerical data - trends
Outcome and Process Assessment (Health Care)
Physician's Practice Patterns - statistics & numerical data - trends
Practice Guidelines as Topic
Prospective Studies
Questionnaires
Respiration, Artificial - adverse effects - methods - statistics & numerical data - trends
Ventilator-Induced Lung Injury - prevention & control
Abstract
To assess daily practices in paediatric and neonatal ventilatory care in Finland.
All neonatal and paediatric intensive care units in Finland were sent a questionnaire on ventilatory strategies and were offered a 3-month prospective survey.
A total of 96% of units returned the questionnaire, and clinicians agreed on most of the principles of lung-protective ventilation. Seventeen hospitals (94%) joined the prospective survey. On average, 2.3 new ventilation episodes were started daily, and totally 211 episodes were monitored. Pulmonary problems (64%) were the main cause of treatment in neonates and postoperative care (68%) in older children. Synchronized intermittent mandatory ventilation with pressure support was the primary mode in 42% of episodes. Hypocapnia was observed repeatedly in all units. In adult intensive care units, children often received high oxygen fraction, leading to hyperoxia, and they were frequently sedated with propofol, which is not licensed for that purpose. A large proportion of children had only light sedation or no sedation at all. Despite the different strategies and practices, most episodes resulted in a favourable outcome.
Most of the principles of lung-protective ventilation have been well accepted by clinicians. More attention should be paid to achieving normocapnia and normoxia and to the correct use of sedatives, especially in units that only occasionally provide paediatric ventilation.
PubMed ID
22957736 View in PubMed
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59 records – page 1 of 6.