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[Airway management in neonates and infants : Recommendations according to the ESAIC/BJA guidelines].Die Anaesthesiologie Jul 2024Securing an airway enables the oxygenation and ventilation of the lungs and is a potentially life-saving medical procedure. Adverse and critical events are common... (Review)
Review
Securing an airway enables the oxygenation and ventilation of the lungs and is a potentially life-saving medical procedure. Adverse and critical events are common during airway management, particularly in neonates and infants. The multifactorial reasons for this include patient-dependent, user-dependent and also external factors. The recently published joint ESAIC/BJA international guidelines on airway management in neonates and infants are summarized with a focus on the clinical application. The original publication of the guidelines focussed on naming formal recommendations based on systematically documented evidence, whereas this summary focusses particularly on the practicability of their implementation.
Topics: Humans; Infant, Newborn; Airway Management; Infant; Practice Guidelines as Topic; Intubation, Intratracheal; Anesthesiology
PubMed: 38958671
DOI: 10.1007/s00101-024-01424-2 -
Developmental Science Jul 2024In this study, we aimed to determine the role of parental praise and child affect in the neural processes underlying parent-child interactions, utilizing functional...
In this study, we aimed to determine the role of parental praise and child affect in the neural processes underlying parent-child interactions, utilizing functional near-infrared spectroscopy (fNIRS) hyperscanning. We characterized the dynamic changes in interpersonal neural synchrony (INS) between parents and children (4-6 years old, n = 40 dyads) during a cognitively challenging task. We then examined how changes in parent-child INS are influenced by parental feedback and child affect. Parent-child INS showed a quadratic change over time, indicating a decelerated decline during the interaction period. The relationship of parental praise, in the form of positive feedback, to change in INS was contingent upon the child's positive affect during the task. The highest levels of INS were observed when praise was present and child affect was positive. The left temporo-parietal regions of the child and the right dorsolateral prefrontal and right temporo-parietal regions of the parent demonstrated the strongest INS. The dynamic change in INS during the interaction was associated with children's independent performance on a standardized test of visuospatial processing. This research, leveraging fNIRS hyperscanning, elucidates the neural dynamics underlying the interaction between parent praise and child positive affect, thereby contributing to our broader understanding of parent-child dynamics. RESEARCH HIGHLIGHTS: The level of interpersonal neural synchrony between parents and children dynamically varies during a cognitively challenging (tangram) task. The left temporo-parietal regions of the child and the right dorsolateral prefrontal and right temporo-parietal regions of the parent demonstrate the strongest parent-child neural synchrony. The relationship between parental praise (positive feedback) and parent-child neural synchrony is contingent upon child positive affect during the task. Change in parent-child neural synchrony relates to children's performance on an independent visuospatial processing measure.
PubMed: 38958643
DOI: 10.1111/desc.13541 -
The Journal of Thoracic and... Jul 2024
PubMed: 38958632
DOI: 10.1016/j.jtcvs.2024.05.028 -
Neuromodulation : Journal of the... Jul 2024Pharmacologic pain treatments lack specific targeting and often produce unwanted side effects (eg, addiction, additional hyperalgesia). We previously established that...
OBJECTIVES
Pharmacologic pain treatments lack specific targeting and often produce unwanted side effects (eg, addiction, additional hyperalgesia). We previously established that the direct application of laser irradiation (direct photobiomodulation [PBM]) of the sural nerve reduces thermal hypersensitivity in a rodent model of chronic pain, but not mechanical hypersensitivity. These observations were consistent with a selective reduction in the small-diameter fiber contribution to electrophysiologically measured evoked response after direct PBM of a sensory nerve (saphenous). However, to our knowledge, direct application of laser irradiation has never been performed in an animal model of acute nociceptive pain or on a mixed nerve in which sensory and motor outcomes can be observed.
MATERIALS AND METHODS
In this study, we describe the effects of direct application of laser irradiation (808 nm, 60 mW, 4 minutes) on a mixed nerve (sciatic nerve) in an acute nociceptive pain model (intradermal capsaicin injection) in rats over the course of two weeks. To investigate whether laser irradiation of a mixed nerve alters motor function, in separate experiments, we applied laser irradiation to the sciatic nerve (using the same parameters as in the chronic pain experiments), and force generation of the gastrocnemius was measured.
RESULTS
Capsaicin-induced hypersensitivities to mechanical (pin prick) and thermal (Hargreaves) noxious stimuli, associated with Aδ- and C-fibers, showed a maximal reduction of 70% and 56.2%, respectively, by direct PBM, when compared with a control group (vehicle injection, no PBM) on the same day. This reduction was determined to be significant using a mixed-design analysis of variance with a p value < 0.05. Force generation remained unchanged for up to 120 minutes after laser irradiation. In summary, direct PBM selectively inhibits C- and Aδ-fiber transmission while leaving Aɑ-, Aβ-, and motor-fiber activity intact.
CONCLUSIONS
These results, in conjunction with our previous analyses of laser irradiation effects on the sural nerve in a chronic spared nerve injury pain model, suggest that direct PBM is a promising candidate for treating pain induced by small-diameter fiber activity.
PubMed: 38958630
DOI: 10.1016/j.neurom.2024.04.011 -
Echocardiography (Mount Kisco, N.Y.) Jul 2024
Topics: Humans; Echocardiography; Ultrasonography, Prenatal; Fetal Heart; Heart Defects, Congenital; Female; Pregnancy; Image Interpretation, Computer-Assisted
PubMed: 38958593
DOI: 10.1111/echo.15867 -
JPEN. Journal of Parenteral and Enteral... Jul 2024Urine sodium concentration has been suggested as a marker to guide enteral sodium supplementation in preterm infants; however, no previous data have demonstrated...
BACKGROUND
Urine sodium concentration has been suggested as a marker to guide enteral sodium supplementation in preterm infants; however, no previous data have demonstrated relationships between urine sodium concentration and postnatal growth.
METHODS
We performed a single-center retrospective cohort study on 224 preterm infants admitted to the neonatal intensive care unit at the Children's Hospital of Georgia between January 2010 and July 2022. Spot urine sodium was measured in preterm infants (<34 weeks postmenstrual age [PMA]) between days of life (DOLs) 7 and 28. Our exposure of interest was spot urine sodium concentration (milliequivalents per liter) obtained between postnatal days 7 and 28, and our primary outcome was weight velocity (grams per kilograms per day) determined at DOL 28. Statistical relationships were assessed by multivariate analysis with subgroup comparisons by Student t test and analysis of variance.
RESULTS
In 224 preterm infants (199 ± 17 days, 56% male, 71% Black), urine sodium concentration did not associate with weight velocity at DOL 28 and 36 weeks PMA. Urine sodium concentration was weakly associated with gestational age at birth, and Black preterm infants had higher urine sodium values when compared with "other," but not White preterm infants.
CONCLUSION
Spot urine sodium during the first month of life does not associate with weight velocity at DOL 28 or 36 weeks PMA.
PubMed: 38958590
DOI: 10.1002/jpen.2668 -
American Journal of Medical Genetics.... Jul 2024Inherited cardiovascular conditions are significant causes of sudden cardiac death in the young (SCDY), making their investigation using molecular autopsy and prevention...
Inherited cardiovascular conditions are significant causes of sudden cardiac death in the young (SCDY), making their investigation using molecular autopsy and prevention a public health priority. However, the molecular autopsy data in Chinese population is lacking. The 5-year result (2017-2021) of molecular autopsy services provided for victims of SCDY (age 1-40 years) was reviewed. The outcome of family cascade genetic screening and clinical evaluation was reviewed. A literature review of case series reporting results of molecular autopsy on SCDY in 2016-2023 was conducted. Among the 41 decedents, 11 were found to carry 13 sudden cardiac death (SCD)-causative genetic variants. Likely pathogenic (LP) variants were identified in the DSP, TPM1, TTN, and SCN5A genes. Cascade genetic testing identified four family members with LP variants. One family member with familial TPM1 variant was found to have hypertrophic cardiomyopathy upon clinical evaluation. This study provided insight into the genetic profile of molecular autopsy in a Chinese cohort of SCDY. The detection of important SCD-causative variants through molecular autopsy has facilitated family cascade screening by targeted genetic testing and clinical evaluation of at-risk family members. A literature review of the current landscape of molecular autopsy in the investigation of SCDY was conducted.
PubMed: 38958565
DOI: 10.1002/ajmg.a.63797 -
Paediatric Anaesthesia Jul 2024
PubMed: 38958561
DOI: 10.1111/pan.14956 -
Pediatric Critical Care Medicine : a... Jul 2024
Topics: Humans; Extracorporeal Membrane Oxygenation; Anticoagulants
PubMed: 38958551
DOI: 10.1097/PCC.0000000000003525 -
Pediatric Critical Care Medicine : a... Jul 2024
Topics: Humans; Anti-Bacterial Agents; Critical Illness; Respiratory Tract Infections; Child; Intensive Care Units, Pediatric; Child, Preschool
PubMed: 38958550
DOI: 10.1097/PCC.0000000000003517