Mirror covered tunnel phototherapy increases the efficacy of phototherapy for neonatal jaundice

Objective: Neonatal jaundice (NJ) is one of the most common cause of neonatal hospital admission. Phototherapy is the main therapy for hyperbilirubinemia of neonatal jaundice. The efficacy of phototherapy depends on the dose and wavelength of light used and the surface area exposed. We increased photons in mirror covered tunnel phototherapy (MCTP) by putting mirrors behind the lamps (mirror covering), without raising the temperature or risk of hyperthermia. This study evaluates the efficacy of this modification. Methods: In this randomized clinical trial study, during a 6-month period 30 neonates were treated for NJ; 60 neonates who had uncomplicated neonatal jaundice requiring only phototherapy were used as controls for the study by the convenience sampling method. The controls received single phototherapy by tunnel phototherapy while the study group underwent MCTP.In this set we put mirrors which were mercury coated 3 mm thick glass behind the bulbs of the set. Serum bilirubin was measured at admission, 24 hr and 48 hr after initiation of treatment, then daily and 24 hr after discharge. Independent sample t-test was used in SPSS version12 software for data analysis . Results: Mean duration of admission in the study group was ignificantly lower than controls (p= 0.027). Likewise the mean decrease in bilirubin level after 24 and 48 hr of phototherapy were significantly lower than controls (p= 0.005 and p= 0.036). Conclusion: Our results show that the use of mirrors behind the bulbs in tunnel phototherapy units can safely increase the efficacy of phototherapy. Keywords: Hyperbilirubinemia, Jaundice, Neonate, Phototherapy

Pediatric liver transplantation from neonatal donors

Sixteen recipients of neonatal liver grafts were compared with 114 contemporaneous pediatric recipients of grafts from older donors. Graft and patient survival were worse in the neonatal group although the differences were not statistically significant. Patients with neonatal livers who had no technical complications required a longer time postoperatively to correct jaundice and a prolonged prothrombin time. These functional differences were limited to the 1st postoperative month and the end result was the same as with liver transplantation from older donors. © 1992 Springer-Verlag

Nursing protocol for neonatal phototherapy

Objetivo: Determinar la evidencia disponible en el manejo de fototerapia para el tratamiento de ictericia neonatal para construir un protocolo de enfermería. Método: Revisión bibliográfica exhaustiva, durante el período 2011-2016, realizada a través de búsquedas bibliográficas en PubMed con las palabras clave "neonatal jaundice guidelines", "neonatal jaundice phototherapy"; en Cuiden, con las palabras clave "neonatal jaundice", "neonatal phototherapy”; y en Google Académico con “protocolo” “ictericia neonatal”, “guidelines neonatal jaundice”, “guidelines phototherapy”. No hubo límites en el idioma. Resultado: Desarrollo de un protocolo de enfermería para niños mayores de 35 semanas de edad gestacional tratados con fototerapia, basado en la evidencia de la revisión de la literatura y acordado por todo el personal de enfermería de la unidad. Conclusiones: El cuidado de enfermería es importante para el mantenimiento y el éxito del proceso de fototerapia. Un protocolo acordado, reduce la variabilidad en la práctica y puede mejorar los resultados de fototerapia en neonatos con hiperbilirrubinemia no conjugada.Objective: To determine the available evidence in the phototherapy management for the neonatal jaundice treatment to build a nursing protocol. Method: Comprehensive literature review, during period 2011-2016, conducted through literature searches in PubMed with the keywords "neonatal jaundice guidelines", "neonatal jaundice phototherapy"; in Cuiden, with the keywords "neonatal jaundice", "neonatal phototherapy", and in Google Scholar with "protocol" "neonatal jaundice.", “guidelines neonatal jaundice”, “guidelines phototherapy”. There were no limits in the language. Result: Development of a nursing protocol for infants over 35 weeks of gestational age treated with phototherapy, based on evidence from literature review and agreed by all nursing staff of the unit. Conclusions: Nursing care is important for maintenance and success of phototherapy process. A protocol agreed, reduces variability in practice and can improve phototherapy results in neonates with unconjugated hyperbilirubinemia

Flexural strength of concrete prism strengthened using CFRP with modified mortar

Reinforced concrete (RC) is a good durable material that commonly used in construction compared to others. However, reinforced concrete structures may be damaged and are suffering from various deteriorations because of overloading and an inadequacy of design which may be attributed to cracks, spalling, large deflection, and more. Hence, it is essential to find repair and strengthening techniques of deteriorated concrete structures not only suitable in terms of the economy, but also to use them for their intended service life

Adaptive response of neonatal sepsis-derived Group B Streptococcus to bilirubin

This work was funded by the Neonatal Unit Endowment Fund, Aberdeen Maternity Hospital. RH is funded by a career researcher fellowship from NHS Research Scotland. SG was funded by the MRC Flagship PhD programme. We are grateful for the support of Dr Phil Cash and Aberdeen Proteomics, at University of Aberdeen, in completing this project. Supplementary information accompanies this paper at https://doi.org/10.1038/s41598-018-24811-3.Peer reviewedPublisher PD

Factores predisponentes para ictericia neonatal en los pacientes egresados de la UCI neonatal, Hospital Infantil los Ángeles de Pasto

Introduction: Neonatal jaundice is one of the most common conditions in newborns; however, improper treatment can be harmful to the patient, despite being benign. Objective: To determine the predisposing factors of neonatal jaundice in patients discharged from the neonatal ICU of Los Angeles children's Hospital in the city of Pasto (Nariño) between January 2007and August 2011. Materials and methods: An observational, descriptive, retrospective and quantitative study was conducted. 608 clinical histories of discharged infants diagnosed with neonatal jaundice were studied. The variables studied were analyzed with the complement of Excel, XLSTAT-Pro 7.5.2. Results: The main predisposing factors found in the population were exclusive breastfeeding and male gender in 87%, and 57.40% respectively; besides, 90.79% were newborns at term, 92.93% had adequate weight for their gestational age and 54.93% presented neonatal jaundice between 2 and 7 days of extrauterine life. Conclusions: Neonatal jaundice is associated with both modifiable and non-modifiable maternal and neonatal factors that can be addressed with appropriate strategies to reduce the burden of disease

Antenatal atazanavir: a retrospective analysis of pregnancies exposed to atazanavir.

INTRODUCTION: There are few data regarding the tolerability, safety, or efficacy of antenatal atazanavir. We report our clinical experience of atazanavir use in pregnancy. METHODS: A retrospective medical records review of atazanavir-exposed pregnancies in 12 London centres between 2004 and 2010. RESULTS: There were 145 pregnancies in 135 women: 89 conceived whilst taking atazanavir-based combination antiretroviral therapy (cART), "preconception" atazanavir exposure; 27 started atazanavir-based cART as "first-line" during the pregnancy; and 29 "switched" to an atazanavir-based regimen from another cART regimen during pregnancy. Gastrointestinal intolerance requiring atazanavir cessation occurred in five pregnancies. Self-limiting, new-onset transaminitis was most common in first-line use, occurring in 11.0%. Atazanavir was commenced in five switch pregnancies in the presence of transaminitis, two of which discontinued atazanavir with persistent transaminitis. HIV-VL < 50 copies/mL was achieved in 89.3% preconception, 56.5% first-line, and 72.0% switch exposures. Singleton preterm delivery (<37 weeks) occurred in 11.7% preconception, 9.1% first-line, and 7.7% switch exposures. Four infants required phototherapy. There was one mother-to-child transmission in a poorly adherent woman. CONCLUSIONS: These data suggest that atazanavir is well tolerated and can be safely prescribed as a component of combination antiretroviral therapy in pregnancy