http://jama.ama-assn.org/cgi/content/abstract/304/8/859
JAMA. 2010;304(8):859-866. doi:10.1001/jama.2010.1206
Among 1804 pregnancies exposed to acyclovir, valacyclovir, or famciclovir in the first trimester, 40 infants (2.2%) were diagnosed with a major birth defect compared with 19 920 (2.4%) among the unexposed (adjusted POR, 0.89; 95% confidence interval [CI], 0.65-1.22).
It seems quite safe.
Friday, August 27, 2010
Friday, August 20, 2010
AUA Recommendations for Prenatal Hydronephrosis
These are published recently
Recommendation: Voiding cystourethrogram is recommended for children with high-grade (Society of Fetal Urology grade 3 and 4) hydronephrosis, hydroureter or an abnormal bladder on ultrasound (late term prenatal or postnatal), or who develop a urinary tract infection on observation.
Option: An observational approach without screening for VUR, with prompt treatment of any urinary tract infection, may be taken for children with prenatally detected hydronephrosis (SFU grade 1 or 2), given the unproven value of identifying and treating VUR. It is also considered an option to perform a voiding cystourethrogram in these patients to screen for VUR.
http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines/main-reports/vur2010/ScreenNeonateinfantWithPrenatalHydronephrosis.pdf (for complete article).
Summary:In screened populations with prenatal hydronephrosis the prevalence of vesicoureteral reflux is 16.2%. Reflux in the contralateral nondilated kidney accounted for a mean of 25.2% of detected cases for a mean prevalence of 4.1%. In patients with a normal postnatal renal ultrasound the prevalence of reflux is 17%. The prenatal anteroposterior renal pelvic diameter was not predictive of reflux prevalence.
Recommendation: Voiding cystourethrogram is recommended for children with high-grade (Society of Fetal Urology grade 3 and 4) hydronephrosis, hydroureter or an abnormal bladder on ultrasound (late term prenatal or postnatal), or who develop a urinary tract infection on observation.
Option: An observational approach without screening for VUR, with prompt treatment of any urinary tract infection, may be taken for children with prenatally detected hydronephrosis (SFU grade 1 or 2), given the unproven value of identifying and treating VUR. It is also considered an option to perform a voiding cystourethrogram in these patients to screen for VUR.
http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines/main-reports/vur2010/ScreenNeonateinfantWithPrenatalHydronephrosis.pdf (for complete article).
Summary:In screened populations with prenatal hydronephrosis the prevalence of vesicoureteral reflux is 16.2%. Reflux in the contralateral nondilated kidney accounted for a mean of 25.2% of detected cases for a mean prevalence of 4.1%. In patients with a normal postnatal renal ultrasound the prevalence of reflux is 17%. The prenatal anteroposterior renal pelvic diameter was not predictive of reflux prevalence.
Wednesday, August 18, 2010
Unilateral Lung Intubation for Pulmonary Air Leak Syndrome in Neonates: A Case Series and a Review of the Literature
https://www.thieme-connect.com/ejournals/abstract/ajp/doi/10.1055/s-0030-1263298
In view of our experience and the review of the literature, we suggest that unilateral intubation is an efficient and relatively safe therapy in cases of neonatal air leak syndrome. It is also suggested that appropriate treatment duration should be at least 48 hours.
Amer J Perinatol :
DOI: 10.1055/s-0030-1263298
In view of our experience and the review of the literature, we suggest that unilateral intubation is an efficient and relatively safe therapy in cases of neonatal air leak syndrome. It is also suggested that appropriate treatment duration should be at least 48 hours.
Amer J Perinatol :
DOI: 10.1055/s-0030-1263298
Tuesday, August 3, 2010
Predictive value of signs and CRP for a positive blood culture
http://www3.interscience.wiley.com/journal/123531601/abstract?CRETRY=1&SRETRY=0
401 newborns were prospectively followed and clinical signs and CRP values were recorded and blood culture results were compared.
Conclusion: In this selected population of infants with suspected sepsis, apnoea and hypotension are independently predictive of a confirmed diagnosis, while bradycardia is more predictive among preterm infants and tachypnea among term infants.
Apnea, hypotension and CRP were independently predictive of positive blood culture.
401 newborns were prospectively followed and clinical signs and CRP values were recorded and blood culture results were compared.
Conclusion: In this selected population of infants with suspected sepsis, apnoea and hypotension are independently predictive of a confirmed diagnosis, while bradycardia is more predictive among preterm infants and tachypnea among term infants.
Apnea, hypotension and CRP were independently predictive of positive blood culture.
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