A5090322485- Neonatal and Maternal Infections
- Congenital Diaphragmatic Hernia Studies
- Neonatal Respiratory Health Research
- Streptococcal Infections and Treatments
- Mechanical Circulatory Support Devices
- Sepsis Diagnosis and Treatment
- Cardiac Arrest and Resuscitation
- Infant Development and Preterm Care
- Immune Response and Inflammation
- Neonatal and fetal brain pathology
- Neutrophil, Myeloperoxidase and Oxidative Mechanisms
- Neuroscience of respiration and sleep
- Infant Nutrition and Health
- Electrolyte and hormonal disorders
- Tracheal and airway disorders
- Pneumonia and Respiratory Infections
- Prenatal Screening and Diagnostics
- Infectious Encephalopathies and Encephalitis
- Congenital Anomalies and Fetal Surgery
- Cardiac Imaging and Diagnostics
- Congenital Heart Disease Studies
- Neurological disorders and treatments
- Clinical Nutrition and Gastroenterology
- Cystic Fibrosis Research Advances
- Mitochondrial Function and Pathology
University of Washington
2021-2024
Seattle Children's Hospital
2023
University of Tennessee Health Science Center
2015-2020
Le Bonheur Children's Hospital
2017-2019
Perinatal Institute
2017
Children’s Foundation
2017
Betsi Cadwaladr University Health Board
2015
Intraventricular hemorrhage prevention bundles (IVHPBs) can decrease the incidence of intraventricular (IVH) in premature infants. Our center had a high rate severe (grade III/IV) IVH (9.8%), and poor adherence (24%) to an IVHPB neonates born ≤1250 g or ≤30 gestational weeks. Improvement initiatives were planned by 30% over 2 years.A multidisciplinary team undertook interventions including in-service training, prompt initiation IVHPB, revision guidelines, process standardization. Baseline...
Abstract Background Bronchopulmonary dysplasia (BPD) is a disease that can affect preterm neonates. Infants with severe BPD may develop pulmonary hypertension (PHN) and require chronic mechanical ventilation tracheostomy. The outcomes of these infants have not been studied well. We proposed to review survival requiring tracheostomy secondary in our NICU at 24 months. Methods reviewed infants’ charts who were diagnosed underwent from January 2011 May 2016 children’s hospital NICU. Data...
Abstract Group B streptococci (GBS) are one of the leading causes life-threatening illness in neonates. Proinflammatory responses to GBS mediated through host innate immune receptors play a critical role disease manifestation. However, mechanisms involved proinflammatory against GBS, as well contribution signaling modulators defense, have not been fully elucidated. In present study, we investigated protein kinase D (PKD)1 GBS. We found that both live and antibiotic-killed induce activation...
Because of provider variability in feeding guideline application, a quality improvement (QI) initiative was begun to better standardize initiation and advancement for preterm infants. Our specific, measurable, achievable, relevant, timely aims included decreasing the time reach full feeds by 35% reducing duration central lines 30% over 12 months infants born between 25 30 weeks' gestation or with birth weight 600 1250 g.Registered dietitians tracked line days, parenteral nutrition (PN),...
Evidence suggests that β-lactam monotherapy of streptococcal infections may incite stronger inflammation and is inferior to combination therapy with macrolides. We hypothesized use macrolides alone or in a for group B (GBS) sepsis would improve outcomes by reducing inflammation.TNF-α was measured from supernatants RAW 264.7 cells stimulated GBS isolates, presence four treatment regimens: ampicillin alone, azithromycin plus ampicillin. Mouse model developed treated same regimens. Clinical...
<b>Objectives</b> Trisomy 18 is presumed to be a lethal chromosomal abnormality; medical management of infants with this aneuploidy controversial. Our objective was describe our approach and experience trisomy infants. <b>Study Design</b> We reviewed the initial hospital course, management, factors predicting discharge from two large tertiary care neonatal intensive units in southern United States over 26 years. <b>Results</b> Of 29 18, 21 (72%) died 8 (28%) were discharged home. 19 (66%)...
Early onset sepsis (EOS) incidence has decreased since national guidelines and intrapartum prophylaxis were introduced. However, there been a rising concern in antibiotic overtreatment for suspicion of EOS. A web-based EOS calculator recently used to evaluate the risk newborns ≥34 weeks. Our purpose was compare local strategies with our setting an 2/1000 live births. retrospective review all born weeks from 1 January 2016 31 December 2017 completed after receiving IRB approval. We applied...
We describe a case of severe congenital myotonic dystrophy (CDM). A 38-year-old primigravida, who was known to suffer from mild (DM), conceived spontaneously and booked for confinement at 11 weeks in our unit. The couple had been fully counseled about the risks transmission this condition their offspring before embarking on pregnancy. Despite being aware risks, they declined prenatal diagnosis. pregnancy monitored by serial ultrasound scans. diagnosis CDM suspected markers borderline...
Objective A significant variability exists for diagnosis and treatment of hypotension in extremely preterm infants. Benefits the use vasopressors remain unclear. We wanted to identify risk factors associated with first week life their impact on outcomes Study Design Retrospective review all newborns ≤28 weeks gestational age (GA) admitted neonatal intensive care unit from October 1, 2012, 31, 2015, done. Data regarding antenatal characteristics were recorded. infants divided into two cohorts...
Abstract Background Use of prophylactic platelet transfusions in the neonatal setting is a common practice due to concerns about bleeding despite evidence developmental mismatch with transfusion adult platelets. The Platelets for Neonatal Transfusion-Study 2 (PlaNeT-2) published January 2019 showed that using higher thresholds (50 x 109/L) was associated more adverse outcomes and no improvement events compared lower (25 109/L). Following this trial, implementation threshold provider...
The aim of this study was to review all the cases fetal exomphalos reported CARIS (Congenital Anomaly Register and Information Service for Wales) during period 1998 2012. All congenital anomalies diagnosed pregnancy or after birth are notified in Wales. This database used identify 1998–2012. searched find total number reported, gestation at which diagnosed, karyotype fetus, associated structural outcome neonates. A 236 were 14 year period. Of these, 183 (77.5%) antenatally. 111 (47%) mothers...
Abstract Group B streptococci (GBS) are one of the leading causes life-threatening sepsis in neonates. Despite intervention with antibiotic therapy, incidence lethality is high among GBS-infected infants. The clinical symptoms related to host-pathogen interaction and exaggerated proinflammatory cytokine production during process via pathways dependent on Toll-like receptors (TLRs). Over last few years, it has become evident that protein kinase D1 (PKD1) plays a significant role inflammatory...
Abstract Group B streptococcus (GBS) still remains an important cause of neonatal sepsis in spite various preventive strategies. The immune response a neonate varies from adult human system and makes newborn more vulnerable to illness not typically manifested by adults. Microbial virulence, bacterial load, immaturity may explain the variation severity term preterm neonates. In this review, mechanisms GBS invasion infection are described. We also try identify host components possible future...
Abstract Group B streptococcus (GBS) causes life-threatening diseases, like pneumonia, septicemia and meningitis, in neonates. It has been reported that the pathogen-associated molecular patterns GBS are recognized by pattern-recognition receptors, including Toll-like receptors (TLR), host innate immune cells. This recognition results cascades of inflammatory reactions. However, basis GBS-induced proinflammatory responses not yet completely elucidated. Protein kinase D1 (PKD1) identified as...
Background: Hypoxic ischemic encephalopathy (HIE) in its moderate to severe form is treated with therapeutic hypothermia (TH) trials showing significant improvement the mortality and neuro-outcomes. Pulmonary hypertension complicates clinical course of up to10-25% these patients HIE. Extracorporeal membrane oxygenation (ECMO) improves survival pulmonary but use controversial HIE as “irreversible brain damage” a contraindication per Extra corporeal life support organization (ELSO) guidelines....
Background: Congenital diaphragmatic hernia (CDH), in its severe form has poor outcome due to associated pulmonary hypertension. ECMO is used for respiratory failure with CDH survival between 55-80%. The presence of hypoxic ischemic encephalopathy (HIE) patients can lead worse outcomes the complications HIE and treatments. Therapeutic Hypothermia (TH) widely treatment from 2009 onwards improvement mortality long term clinical trials. We hypothesized …