He or She, What Will It Be: Old Wivesʹ Tales and Foetal Sex Prediction

Aim: A myriad of myths surround pregnancy, especially regarding the prediction of the sex of the infant. Some of these myths and old wives\u27 tales are, to this day, widespread among expectant parents. The objective of this study was to examine whether common pregnancy-related statements regarding foetal sex prediction vary between mothers of female and male infants. Methods: The questionnaire-based study was conducted from September 2017 to September 2018 at a well-baby nursery. Participants were mothers of infants (n = 350) admitted to the well-baby nursery with a singleton pregnancy and at > 36 weeks of gestation at birth. Results: We investigated a number of statements regarding foetal sex prediction. With the exception of one statement, there were no other differences between mothers of male and female infants. Pregnancy with a male foetus is associated with glossier hair during pregnancy. Women with female newborns reported glossier hair during pregnancy in 39.1% of cases, while women with male newborns reported the same in 45.0% of cases (P = 0.04). Conclusion: Old wives\u27 tales regarding sex prediction of the infant during pregnancy remain myths for a reason, with the possible exception of one statement regarding glossier hair and pregnancy with a male foetus. (Kardum* D, Kardum Ž, Nađ T, Müller A. He or She, What Will It Be: Old Wivesʹ Tales and Foetal Sex Prediction. SEEMEDJ 2020; 4(1); 96-101

Preživljenje do otpusta iz bolnice novorođenčadi vrlo niske porođajne težine u dvije hrvatske perinatalne regije: retrospektivna studija vremena i uzroka smrti

We investigated mortality, causes, timing and risk factors for death until hospital discharge in very-low-birth-weight (VLBW) infants born in two Croatian perinatal care regions. This retrospective study included 252 live born VLBW infants. The mortality rate until hospital discharge was 30.5% (77/252). VLBW in-fants who died had by 4 weeks lower gestational age (GA) than surviving infants (median GA, 25 vs. 29 weeks), lower birth weight (BW) (mean BW, 756.4 vs. 1126.4 g), lower 5-minute Apgar score (median 5 vs. 8) and were more often resuscitated at birth (41.6 vs. 19.4%; p12 hours to necrotizing enterocolitis.Istraživali smo smrtnost, uzroke, vrijeme i rizične čimbenike za smrt do otpusta iz bolnice u novorođenčadi vrlo niske porođajne težine (VNPT) rođene u dvije hrvatske perinatalne regije. Ova retrospektivna studija je uključila 252 živo-rođena novorođenčeta VNPT. Smrtnost do otpusta iz bolnice bila je 30.5% (77/252). Novorođenčad VNPT koja su umrla bila su 4 tjedna manje gestacijske dobi od novorođenčadi koja je preživjela (medijan gestacijske dobi 25 prema 29 tjedana; p12 sati glavni uzrok smrti je nekrotizirajući enterokolitis

Application of peripherally inserted central catheters in children

Periferno postavljeni centralni venski kateteri (engl. peripherally inserted central catheters - PICC) često se koriste kako bi se osigurao središnji venski pristup u pacijenta tijekom akutnoga zbrinjavanja ili za vrijeme dugoročnoga liječenja. To je pouzdana metoda koja ima nisku incidenciju komplikacija u odnosu na kratkoročnu primjenu centralnih venskih katetera. Prije postavljanja PICC-a moraju se uzeti u obzir indikacije, kontraindikacije i potencijalne komplikacije. Osoblje koje nadzire pacijente s PICC-om mora biti primjereno educirano o koristima PICC-a, njegovome korištenju, nadzoru mjesta na kojemu je postavljen, održavanju katetera te vješto u prepoznavanju ranih komplikacija. U članku se daje pregled problematike periferno postavljenih centralnih venskih katetera te njihove primjene prije svega u pedijatrijskih pacijenata.Peripherally inserted central catheters (PICC) are often used to ensure central venous access during acute or long term treatment. PICC is a reliable method with low incidence of complications related to short-term application of central venous catheters. Before PICC placement, indications, contraindications, and potential complications must be considered. Medical personnel involved in treatment of patients with PICC must be properly educated on benefits of PICC, its use, oversight of insertion point, and its maintenance as well as skilled in recognition of early complications. The article gives an overview of problems with peripherally inserted central catheters with emphasis on its use in pediatric patients

The impact of early caloric intake on growth parameters in extremely preterm neonates

Introduction: Even though adequate caloric intake is essential for the promotion of growth in extremely premature infants, this is rarely achieved. We investigated how total caloric intake in the first week of life and other events during the hospitalization impact head circumference and weight at 36 weeks of corrected age in extremely preterm infants. Patients and methods: The study sample consisted of extremely preterm infants treated at Osijek University Hospital Centre, born between January 2018 and December 2020. Records were collected regarding nutritional data, sex, gestational age, birth weight and head circumference, invasive respiratory support, bacterial infection, necrotizing enterocolitis, postnatal steroids, need for supplemental oxygen at 36 weeks gestation, day of introduction of enteral nutrition, duration of parenteral nutrition, length of stay, hemodynamically significant patent ductus arteriosus, cystic periventricular leukomalacia and retinopathy of prematurity. Results: The study cohort included 30 infants. At 36 weeks gestation for weight, median Z scores were -1.63 (IQR -2.34 to -1.15; 95% CI -2.09 to -1.52), and for head circumference were -1.32 (IQR 2.37 to - 0.81; 95% CI -1.75 to -0.91). Median energy intake on the first day of life was 33.42 kcal/kg, and 80.78 kcal/kg on day 7. Early caloric intake was not correlated with changes in Z scores for head circumference and weight at 36 weeks of gestation. Other factors influenced changes in head circumference and weight Z scores, namely: gestational age, respiratory support during the first week, need for additional O2 at 36 weeks, and retinopathy of prematurity requiring intervention. Conclusion: In our cohort of premature infants at 36 weeks corrected age other factors, not primarily total caloric intake influenced growth parameters

Usage of glutamine in children

Glutamin je neesencijalna aminokiselina čija endogena sinteza u stresnim i kataboličkim stanjima često nije dovoljna za zadovoljavanje potreba organizma. Budući da glutamin sudjeluje u brojnim procesima poput dijeljenja stanica, sinteze proteina i popravka oštećenih proteina, a ima i protuupalno i imunomodulatorno djelovanje, kliničke studije bavile su se učinkom dodavanja glutamina parenteralnoj ili enteralnoj prehrani na tijek bolesti, trajanje hospitalizacije i konačni ishod u odraslih i pedijatrijskih gastroenteroloških, onkoloških, kirurških, traumatoloških, septičnih i kritično bolesnih pacijenata. Premda su početna istraživanja bila ohrabrujuća, novije studije nisu potvrdile početne rezultate. Radovi koji se odnose na dječju dob malobrojniji su i uključuju manji broj ispitanika. Oni do sada nisu pokazali negativne pojave vezane uz primjenu glutamina. Zamijećen je povoljan učinak u nedonoščadi i onkoloških pacijenata, dok u većine nije pronađena razlika između skupina ispitanika koje su primale glutaminom obogaćenu parenteralnu ili enteralnu prehranu i kontrolnih skupina koje su bile na standardnoj parenteralnoj ili enteralnoj prehrani.Glutamine is a nonessential amino acid whose endogenous synthesis under stress and in catabolic states is often not sufficient to meet the body’s needs. Since glutamine plays a role in cell division, protein synthesis and repair of damaged proteins, and also has anti-inflammatory and immunomodulatory effects, clinical studies have addressed the effect that adding glutamine to parenteral or enteral nutrition could have on the course of the disease, duration of hospitalization and mortality in adult and pediatric patients. Although the initial studies were encouraging, recent studies so far have not confirmed these initial results. Studies relating to children’s age are less numerous and include smaller number of respondents. These studies have not demonstrated adverse effects of glutamine supplementation and have found a beneficial effect in preterm neonates and patients undergoing chemotherapy. In most studies, however, no difference was found between the patients receiving glutamine-enriched parenteral or enteral feeding, and control groups that were on standard parenteral or enteral nutrition

Readmission of late preterm and term neonates in the neonatal period

Objective: To determine the incidence of hospital readmissions in late preterm and term neonates, the most common reasons for readmission, and analyze the risk factors for readmission in the neonatal period. Methods: Newborn infants admitted to a well-baby nursery ≥ 36 weeks gestation were included in this retrospective cohort study. Data for all infants born in a 3-year period and readmitted in the first 28 days of life were analyzed. Indication for readmission was one diagnosed during initial workup in the pediatric emergency room visit before readmission. Results: The final cohort consisted of 5408 infants. The readmission rate was 4.0% (219/5408). Leading readmission causes were respiratory tract infection (29.58%), jaundice (13.70%), and urinary tract infection (9.59%). The mean ± SD age of readmitted infants was 13.3 ± 7.1 days. The mean ± SD treatment duration of treatment was 5.5 ± 3.0 days. In the multivariate regression analysis, infants that were during the initial hospitalization transferred to special care/NICU had a lower chance of readmission during the neonatal period (p = 0.04, OR = 0.23, 95% CI 0.06–0.93). Infants with mothers aged from 19–24 years had a higher risk of readmission (p = 0.005, OR = 1.62, 95% CI 1.16–2.26). Conclusions: Finding that infants that were during the initial hospitalization transferred to special care or a NICU setting were less likely to require hospitalization in the neonatal period is an interesting one. Further research into how different approach in these settings reduce the risk of readmission is necessary

Intubation and basics of mechanical ventilation

Intubacija i mehanička ventilacija agresivni su medicinski postupci, ali u određenim stanjima spašavaju život djeteta. Zadatak je liječnika provesti postupke što nježnije i stručnije, u što kraćem vremenu, kako dijete ne bi imalo akutne ili kronične komplikacije. Svi načini intubacije imaju svoje prednosti i nedostatke te su za pojedini način intubacije indikacije donekle različite. Postoje različiti načini mehaničke ventilacije djeteta, različiti putovi (modovi) za „prevođenje” djeteta preko životno ugrožavajućega stanja. U svakom centru provode se oni načini ventilacije koji daju najbolje rezultate i s kojima tim koji ih provodi ima najviše iskustva.Intubation and mechanical ventilation are very aggressive medical treatments, but in certain situations they can save the life of a child. Physicians must perform medical procedures as gently, quickly and professionally as they can to prevent acute and chronic complications. Different intubation methods have their advantages and disadvantages; therefore, indications for a particular intubation procedure are different to a certain extent. There are various types of mechanical ventilation in children; different modes to overcome a life-threatening condition of a child. The type of ventilation chosen to be implemented in a particular medical center is the one the team is most experienced in, therefore providing the best results