Universal newborn hearing screening in the Lazio region, Italy

Background: The introduction of Universal Newborn Hearing Screening (UNHS) programs has drastically contributed to the early diagnosis of hearing loss in children, allowing prompt intervention with significant results on speech and language development in affected children. UNHS in the Lazio region has been initially deliberated in 2012; however, the program has been performed on a universal basis only from 2015. The aim of this retrospective study is to present and discuss the preliminary results of the UNHS program in the Lazio region for the year 2016, highlighting the strengths and weaknesses of the program. Methods: Data from screening facilities in the Lazio region for year 2016 were retrospectively analyzed. Data for Level I centers were supplied by the Lazio regional offices; data for Level II and III centers were provided by units that participated to the study. Results: During 2016, a total of 44,805 babies were born in the Lazio region. First stage screening was performed on 41,821 children in 37 different birth centers, with a coverage rate of 93.3%. Of these, 38.977 (93.2%) obtained a "pass" response; children with a "refer" result in at least one ear were 2844 (6.8%). Data from Level II facilities are incomplete due to missing reporting, one of the key issues in Lazio UNHS. Third stage evaluation was performed on 365 children in the three level III centers of the region, allowing identification of 70 children with unilateral (40%) or bilateral (60%) hearing loss, with a prevalence of 1.6/1000. Conclusions: The analysis of 2016 UNHS in the Lazio region allowed identification of several strengths and weaknesses of the initial phase of the program. The strengths include a correct spread and monitoring of UNHS among Level I facilities, with an adequate coverage rate, and the proper execution of audiological monitoring and diagnosis among Level III facilities. Weakness, instead, mainly consisted in lack of an efficient and automated central process for collecting, monitoring and reporting of data and information

Eziopatogenesi delle sordità preverbali

Abstrac

Professione Comunicatore. Tecniche e problemi della comunicazione giornalistica, di fiction e d'impresa

Tecniche e problemi della comunicazione giornalistica, di fiction e d'impres

Eziopatogenesi delle sordità preverbali

Abstrac

Neurodevelopmental outcomes of premature infants with bronchopulmonary dysplasia

Bronchopulmonary dysplasia (BPD) is a chronic lung disorder common among very preterm infants affecting significantly not only mortality and morbidity but also neurodevelopmental outcomes. This review aims to identify the short and long-term neurodevelopmental outcomes of infants with BPD, considering that the new definition of BPD allows to relate severity of BPD with greater risk of developmental delay

Neurodevelopmental outcomes of premature infants with bronchopulmonary dysplasia

Bronchopulmonary dysplasia (BPD) is a chronic lung disorder common among very preterm infants affecting significantly not only mortality and morbidity but also neurodevelopmental outcomes. This review aims to identify the short and long-term neurodevelopmental outcomes of infants with BPD, considering that the new definition of BPD allows to relate severity of BPD with greater risk of developmental delay

fototerapia precoce o tardiva nel neonato gravemente pretermine?

Fototerapia precoce o tardiva nel neonato gravemente pretermine

Risk factors for pulmonary candidiasis in preterm infants with birth weight less than 1250 grams

To evaluate the epidemiology of pulmonary candidiasis (PC) and to identify risk factors in premature infants during the 1st month of life, all infants with a birth weight <1250 g admitted to our neonatal intensive care unit with PC between January 1994 and December 2001 were retrospectively reviewed. Infants with PC ( n =20) were compared with a control group ( n =20), matched for gestational age and birth weight, with regard to possible perinatal and postnatal risk factors. Among 325 infants with a birth weight <1250 g, 20 out of 233 ventilated infants (8.6%) developed PC. Candida albicans ( n =12) and C. parapsilosis ( n =4) were the predominant isolates. Neonates with PC were significantly different from controls with regard to male prevalence ( P =0.002), rates of preterm premature rupture of membranes (PPROM) ( P =0.02), longer duration of antibiotic therapy ( P =0.01) and of ventilation ( P =0.02). The difference between groups did not attain significance with regard to postnatal dexamethasone administration, duration of central vein catheterisation and duration of parenteral nutrition. Multivariate logistic regression analysis indicated as significant predictors of PC, among perinatal data, the male gender (OR =26.3; 95%CI 2.44 to 284) and PPROM (OR =12.3; 95%CI 1.16 to 130) and, among postnatal data, the duration of ventilation (OR =1.54; 95%CI 1.01 to 2.34). Conclusion:The presence of preterm premature rupture of membranes and the duration of ventilation are significant risk factors for developing pulmonary candidiasis and should be considered in the preventive efforts to reduce this disease in infants with a birth weight <1250 g

Caloric intake in parenteral nutrition of very low weight infants

To evaluate the efficacy of a measure able to compare energy intake from parenteral and enteral nutrition we documented growth patterns in a group of VLBW infants treated with parenteral nutrition (PN). To analyze comparative energy intake from the two sources we expressed a percentage of both parenteral and enteral calories: the former (RCP%) related to an optimal value of 85 non protein calories and the latter (RCE%) to an optimal value of 150 total calories. Total energy intake was planned on the RCT% (RCP% + RCE%). We studied 75 VLBW infants with a mean BW of 1040 g and a mean GA of 29.5 weeks. The mean duration of PN was 25.8 +/- 10.4 days. The initial weight loss (10.2 +/- 5.3%), the time to regain BW (5.5 +/- 4 days) and the day of lowest weight (5.2 +/- 1.6 day of life) were in the normal range; the subsequent growth rate resulted 25.9 +/- 9.2 g/kg/die and did not change for different GA or BW. Growth pattern about head circumference and length were above the third percentile. The mean age of RCT% = 100% was 11.4 +/- 4.8 days of PN; this value was higher for the more premature infants. Severe metabolic abnormalities were not detected. Our observations show the efficacy of the RCT% as index of energy from both enteral and parenteral source during PN: the growth pattern seems to be quite satisfactory without any severe metabolic complication

E\u2019 attendibile il monitoraggio transcutaneo dei gas ematici a bassa temperatura nel neonato.

E\u2019 attendibile il monitoraggio transcutaneo dei gas ematici a bassa temperatura nel neonato