A5091029981- Neonatal and Maternal Infections
- Antibiotics Pharmacokinetics and Efficacy
- Neonatal Respiratory Health Research
- Pharmaceutical studies and practices
- Sepsis Diagnosis and Treatment
- Neonatal Health and Biochemistry
- Neonatal and fetal brain pathology
- Pneumonia and Respiratory Infections
- Antimicrobial Resistance in Staphylococcus
- Bacterial Identification and Susceptibility Testing
- Streptococcal Infections and Treatments
- Anesthesia and Sedative Agents
- Infant Nutrition and Health
- Analytical Methods in Pharmaceuticals
- Renal function and acid-base balance
- Nosocomial Infections in ICU
- Pregnancy and preeclampsia studies
- Child Abuse and Related Trauma
- Clostridium difficile and Clostridium perfringens research
- Anesthesia and Neurotoxicity Research
- Antibiotic Resistance in Bacteria
- Blood Coagulation and Thrombosis Mechanisms
- Traumatic Brain Injury and Neurovascular Disturbances
- Cardiovascular Conditions and Treatments
- Neurogenetic and Muscular Disorders Research
University of Tartu
2014-2024
Tartu University Hospital
2015-2024
PENTA Foundation
2024
Intensive Care Society
2018
European Society of Anaesthesiology
2017
Czech Academy of Sciences, Institute of Microbiology
2015
Boston Children's Museum
2010
Boston Children's Hospital
2010
Nemours Children’s Clinic
2007
There are not very many epidemiological studies on perinatal stroke, and authors suggest that this may be an underdiagnosed condition. The aim of the study was to estimate incidence arterial ischemic hemorrhagic stroke in Estonia, first clinical signs identify possible differences predisposing factors outcome between acutely retrospectively diagnosed cases stroke.A retro- prospective (within month) conducted a children population born eastern southern regions Estonia during years 1994 2003....
Antibiotic dosing in neonates varies between countries and centres, suggesting suboptimal exposures for some neonates. We aimed to describe variations factors influencing the variability of frequently used antibiotics European NICUs help define strategies improvement. A sub-analysis Study Neonatal Exposure Excipients point prevalence study was undertaken. Demographic data receiving any antibiotic on day within one three two-week periods from January June 2012, dose, interval route...
Sepsis and bacterial meningitis are major causes of mortality morbidity in neonates infants. Meropenem, a broad-spectrum antibiotic, is not licensed for use infants below 3 months age sufficient information on its plasma CSF disposition dosing lacking. To determine pharmacokinetics meropenem young the link between clinical outcomes babies with late-onset sepsis (LOS). Data were collected two recently conducted studies, i.e. NeoMero-1 (neonatal LOS) NeoMero-2 meningitis). Optimally timed...
Perinatal asphyxia and resulting hypoxic-ischemic encephalopathy is a major cause of death long-term disability in term born neonates. Up to 20,000 infants each year are affected by HIE Europe even more regions with lower level perinatal care. The only established therapy improve outcome these therapeutic hypothermia. Allopurinol xanthine oxidase inhibitor that reduces the production oxygen radicals as superoxide, which contributes secondary energy failure apoptosis neurons glial cells after...
Objectives We aimed to describe administration of eight potentially harmful excipients interest (EOI)—parabens, polysorbate 80, propylene glycol, benzoates, saccharin sodium, sorbitol, ethanol and benzalkonium chloride—to hospitalised neonates in Europe identify risk factors for exposure. Methods All medicines administered during 1 day with individual prescription demographic data were registered a web-based point prevalence study. Excipients identified from the Summaries Product...
The early use of broad-spectrum antibiotics remains the cornerstone for treatment neonatal late onset sepsis (LOS). However, which should be used is still debatable, as relevant studies were conducted more than 20 years ago, recruited in single centres or countries, evaluated not clinical anymore and had variable inclusion/exclusion criteria outcome measures. Moreover, antibiotic-resistant bacteria have become a major problem many countries worldwide. We hypothesized that efficacy meropenem...
Abstract Background Despite therapeutic hypothermia (TH) and neonatal intensive care, 45–50% of children affected by moderate-to-severe hypoxic-ischemic encephalopathy (HIE) die or suffer from long-term neurodevelopmental impairment. Additional neuroprotective therapies are sought, besides TH, to further improve the outcome infants. Allopurinol — a xanthine oxidase inhibitor reduced production oxygen radicals subsequent brain damage in pre-clinical preliminary human studies cerebral ischemia...
We aimed to compare the clinical efficacy of ampicillin (AMP) vs. penicillin (PEN) both combined with gentamicin in empirical treatment neonates at risk early onset neonatal sepsis (EOS).We performed an open label cluster randomized equivalence study Estonian intensive care units, including suspected EOS, aged less than 72 h. Primary end-point was failure rate, expressed by need for change antibiotic regimen within h and/or 7-day all cause mortality. Bowel colonization followed biweekly...
Coagulase-negative staphylococci (CoNS) are the first colonizers of gastrointestinal tract (GIT) and commonest cause late-onset sepsis (LOS) in preterm neonates. Intravascular catheters considered a major source CoNS bacteremia. However, several cases LOS remain without an identified source. To elucidate whether GIT could be potential invasive strains, we aimed to assess molecular similarity between from blood neonates with LOS.Altogether 22 53 isolates collected caused by (Staphylococcus...
Prolonged infusion of meropenem has been suggested in studies with population pharmacokinetic modeling but not tested neonates. We compared the steady-state pharmacokinetics (PK) given as a short (30-min) or prolonged (4-h) to very-low-birth-weight (gestational age, <32 weeks; birth weight, <1,200 g) neonates define appropriate dosing regimen for phase 3 efficacy study. Short (n = 9) 10) infusions were at dose 20 mg/kg every 12 h. Immediately before and 0.5, 1.5, 4, 8, h after 4th 7th doses...
Objective: An increasing number of studies that are using high-throughput molecular methods rapidly extending our knowledge gut microbial colonization in preterm infants whose immaturity and requirement for extensive treatment may result altered process. We aimed to describe the profile microbiota 50 extremely low birth weight (<1200 g) critically ill at three different time points during first two months life by 16S rRNA gene specific sequencing. Patients Methods: Stool samples were...
Aim : To evaluate the role of early (up to 12h) changes in cerebral blood‐flow (CBF) velocity predicting severity hypoxic‐ischaemic encephalopathy (HIE) and long‐term outcome asphyxiated term infants. Methods CBF velocities were investigated by colour Doppler ultrasonography 81 healthy 60 infants at least three times during first 5 d life. The psychomotor development was followed up 18 mo. Results No differences found age 2–6 h between with severe mild‐moderate HIE, mean [mean (95% CI...
Inflicted traumatic brain injury (ITBI) or shaken baby syndrome (SBS) is recognized as a major cause of disability and death in the paediatric population.To find out incidence ITBI Estonia.26 cases were recognized: four children died, 22 survived.Of 26 children, 20 (77%) boys six (23%) girls. Median age at admission to hospital was 3.9 mo, younger than girls.The overall 28.7 per 100,000 infants. In prospective group 40.5 100,000, retrospective 13.5 100,000. not rare but always form child...
Despite differences in types of infection and causative organisms, pharmacokinetic-pharmacodynamic (PKPD) targets vancomycin therapy derived from adult studies are suggested for neonates. We aimed to identify doses needed the attainment AUC/MIC > 400 300 neonates with sepsis correlate these recommended treatment outcome. Neonates who had Vancomycin therapeutic drug monitoring (TDM) performed between January 1, 2010 December 31, 2012 were studied. Clinical characteristics, episodes...
We recruited 48 neonates (50 vancomycin treatment episodes) in a prospective study to validate model-informed precision dosing (MIPD) software. The initial dose was based on population pharmacokinetic model and adjusted every 36-48 h. Compared with historical control group of 53 (65 episodes), the achievement target trough concentration 10-15 mg/L improved from 37% 62% MIPD (