HIE-Prophylactic Phenobarbital!

In a small study, researchers have found improved outcomes at 18 months. 17 in prophylactic group (40mg/kg) 21 in the control group were followed up for neurological outcomes with whole body cooling.
Three infants in the prophylaxis group (15%) and 18 in the control group (82%) had seizures while they were in the NICU (p < 0.0001).
There was a trend towards other benefits. But it is a small study with no EEG in all patients. Hence, take it with a pinch of salt.
The study is in Jour. Pediatrics.

Topiramate-Neuroprotective in HIE?

Oral Topiramate in Neonates with Hypoxic Ischemic Encephalopathy Treated with Hypothermia: A Safety Study

http://www.jpeds.com/article/PIIS0022347610003197/abstract?rss=yes

Conclusion

Although the number of newborns in this study was limited, the short-term outcome and the safety data appear to support the evaluation of topiramate in clinical trials to explore its possible additive neuroprotective action.

Interesting. What is the mechanism of action? I will try and find out.

B-Type Natriuretic Peptide Predicts Responses to Indomethacin in Premature Neonates with Patent Ductus Arteriosus. Journal of Pediatrics - Volume 157, Issue 1 (July 2010)

Mean baseline BNP levels were higher in neonates who were non-responders (2234 ± 991 pg/mL) than neonates who were responders (983 ± 814 pg/mL; P = .001). A baseline BNP level >1805 pg/mL had a sensitivity rate of 88% and a specificity rate of 87% for predicting indomethacin non-responsiveness (P = .003).

This was an interesting study shedding some light on the response of PDA to indomethacin.

Smoking-neurodevelopmental outcome

Smoking in pregnancy: a risk factor for adverse neurodevelopmental
outcome in preterm infants?
U Kiechl-Kohlendorfer (ursula.kohlendorfer@i-med.ac.at), E Ralser, U Pupp Peglow, G Reiter, E Griesmaier, R Trawöger
Acta Paediatrica/Acta Paediatrica 2010 99, pp. 1016–1019
prospectively enrolled 181 infants
born alive between 23 and 32 weeks of gestation; 142 infants (78.5%) completed the follow-up visit. Smoking in pregnancy, small for gestational age and chronic lung
disease maintained significance in a multivariable analysis.

White matter susceptibility to blood pressure!

Acta Paediatrica latest issue has one interesting article.

http://www3.interscience.wiley.com/journal/123415876/abstract
Gestational age was 26–32 weeks. Transcutaneous carbon dioxide was between 4.7 and 8.5 kPa and mean arterial blood pressure between 22 and 55 mmHg.
a plateau over a certain blood pressure threshold and a positive slope below this threshold, the relation to white matter flow percentage was statistically significant (p = 0.02). The threshold was 29 mmHg (95% confidence limits 26–33).

Blood Glucose-Type of Birth-does it matter?

Acta paediatrica http://www3.interscience.wiley.com/journal/123476689/abstract?CRETRY=1&SRETRY=0
published an interesting study about the effect of delivery on blood sugar levels. The C/s infants though had lower sugar comparatively at birth, had their blood sugars increased in two hours.
Cord blood glucose concentration was higher in VD (81.3 ± 16.9 mg/dL) than CS infants (70.3 ± 9.7 mg/dL, p = 0.039). The change in blood glucose concentration over the first 2-h of life differed significantly between the two groups, being an increase in CS versus a decrease in VD infants (−3.5 ± 15.2 vs. −15.4 ± 24.6 mg/dL, p = 0.013).

Ultrasound to Determine PICC lines

http://www.ejradiology.com/article/PIIS0720048X09001272/abstract?rss=yes

The correlation between positioning by US and plain radiography was very good (r=0.97, r2=0.94, p<0.0001). The time needed to verify LL placement by US was shorter by a mean 15min compared to plain radiography.
Conclusions: US can accurately guide LL tip positioning. We believe that because of the potential gain of time it offers and its lack of ionising radiation, it to be considered as an interesting tool for the positioning of LL in neonates. Yet more accurate results could be obtained with a better-trained staff.

Diagnose Diseases Early With Your Phone!!

I am copying the statement from the web site
"Mobilife introduces innovative application technologies into the market
of mobile medicine by pairing the widely-available Windows Mobile platform
with computer-assisted intravital microscopy to provide in-field analysis of
the human microcirculation to detect microangiopathy in children. The project
offers a scientifically-validated approach that cost-effectively provides
accurate microcirculatory information to diagnose vascular diseases to ultimately
reduce child mortality rates throughout the world."
here is the link
http://mobilife.us/learn.html
I am not sure where they validated this application. I will try and find out.