NCT01531179.

No abstract

We prospectively evaluated the differences in clinical responses and short-term outcomes in preterm infants with respiratory distress syndrome (RDS) treated with poractant alfa or beractant. Premature infants with RDS were randomized to poractant alfa or beractant treatment between July 2008 and June 2009. Patients were followed until 40 weeks of corrected gestational age or death. The fraction of inspired oxygen (Fio(2)) after surfactant treatment, need for repeat doses, and duration of respiratory support and hospitalization were evaluated between groups. Sixty-one infants received poractant alfa and 65 received beractant. Significantly more patients in the beractant group required ≥2 doses of surfactant compared with the poractant alfa group (31% versus 12%, p = 0.023). Extubation rate within the first 3 days after surfactant administration was higher in the poractant alfa group than in the beractant group (81% versus 55.9%, p = 0.004). Posttreatment Fio(2) requirement in the poractant alfa group was significantly lower than in the beractant group on days 1, 3, and 5. Overall mortality and morbidities were similar between groups. Survival free of bronchopulmonary dysplasia (BPD) at the end of study period was 78.7% and 58.5% in poractant alfa and beractant groups, respectively (p = 0.015). Our study confirms the rapid onset of action, less need for redosing, rapid extubation, and higher survival free of BPD in preterm infants treated with poractant alfa.

AbstractsConclusion Oral probiotic administrated to VLBW infants to reduce the incidence and severity of NEC started with the first feed did not affect growth and neurodevelopmental outcomes at 18-24 months' corrected age. Objective The aim of the study is to compare the 2-year neurodevelopmental outcome of very low birth weight and/or very preterm infants followed with "medical home model" implemented in a big maternity hospital in Turkey with the primary health care. Methods We designed a prospective controlled study of infants born ≤32 week's gestation and/or ≤1500 g and hospitalized. After discharge, intervention group were followed with in the concept of medical home model and control group were followed in the concept of primary standart health care. At 18-24 months' of corrected age, the neurological examinations and the developmental assessments using the Bayley Scales of Infant Development-II were performed. THE IMPACT OF MEDICAL HOME MODEL ON NEURODEVELOPMENTAL OUTCOMES OF VERY PRETERM INFANTSResults The cerebral palsy rates in the intervention and control group were 10.6% (n=17) and 17.4% (n=27) respectively and the difference was not statistically significant (p=0.107). Whereas the rate of neurodevelopmental impairment in the intervention group was significantly lower than the control group (25% and 38, 7%; p=0.011). Conclusion We demonstrated that beginning a good follow-up process within the context of medical home model, efficient developmental support and performing guidance for early diagnose reduced the negative effects of VLBW and/or prematurity on neurodevelopmental impairment at 2 years of age. Background and Aims As revealed by several studies, a very preterm birth may affect language, executive functions, verbal short term memory and literacy. The aim of this study was to investigate these competencies in very preterms compared to full terms, thus describing how language, executive functions and verbal short-term memory observed at the end of preschool age affect literacy at school age. Methods Forty-two monolingual Italian very preterms (mean gestational age 29.7 weeks), with no history of major cerebral damage, were followed longitudinally at 6 years by investigating language (vocabulary, grammar, and phonological awareness), executive functions (syllabic and phonemic fluency) and verbal short-term memory (vowel span, non-word repetition) and again at 8 years on literacy (word and non-word reading and spelling). Two crosssectional groups of full term children were recruited as control groups (34 and 26 children at 6 and 8 years respectively). Results Preterms showed lower abilities in language at 6 years and in literacy at 8 years, while no differences between groups regarding syllabic and phonemic fluency and short-term memory were found. Linear regression analyses revealed that in the preterm sample both language and verbal short-term memory had a predictive role on PREDICTORS OF LITERACY IN VERY PRETERM INFANTS: A LONGITUDINAL STUDY

ClinicalTrials.gov under identifier NCT01741129.

Vaginal delivery is associated with higher colostrum protein content. Hormonal activity induced by labor pain and uterine contractions might account for the alterations in the protein composition of human milk to facilitate optimal development of important physiologic functions in newborns.

Abstracts microbiologic diagnosis. All 30 oropharyngeal swabs from the patients with K. kingae OAI, and 8 swabs from the 84 patients without OAI or with OAI caused by another organism, were positive. The sensitivity and specificity of oropharyngeal swab PCR for K. kingae OAI were 100% and 90.5%, respectively; positive and negative predictive values were 78.9%, and 100%, respectively. Background and Aims In the last years the world has been facing a new pandemic caused by a H1N1 influenza virus, showing particular virulence in children. Cytokines and neurotrophic factors seem to play an important role in severity and progression of this infection. In our study we evaluate cytokine (IL-1b and IL-6) and neurotrophic factor [Nerve Growth Factor (NGF), Brain Derived Neurotrophic Factor (BDNF), and Glial Derived Neurotrophic Factor (GDNF)] expression and their association with clinical-laboratory findings and outcome of children with H1N1 influenza virus infection. Methods We performed a prospective observational clinical study on 15 children with H1N1 influenza virus infection and 15 controls with lower respiratory tract infection (LRTI). Cytokines and neurotrophic factor plasma levels were measured using an immunoenzymatic assay. Results Significantly higher plasma levels of IL-1b, IL-6, NGF and BDNF were demonstrated in all patients with H1N1 infection respect to controls, while GDNF plasma levels did not undergo significant variations in the two groups. IL-6, NGF and BDNF expression was also significantly correlated with some laboratory and clinical findings, such as fever, cough, specific radiological lesions, and platelet count. No correlation was found between interleukin and neurotrophic factor expression and final outcome. Conclusions H1N1 virus infection induces an early and significantly up-regulation of both interleukins (IL1b and IL-6) and neurotrophic factors (BDNF and NGF) respect to LRTI patients. The overexpression of these molecular markers is likely to play a neuroimmunomodulatory role in H1N1 infection and may contribute to airway inflammation and disease severity and progression.

Palivizumab is currently licensed for the prevention of respiratory syncytial virus (RSV) lower respiratory tract disease in infants and children with chronic lung disease, with a history of preterm birth, or with haemodynamically significant congenital heart disease, but its routine use during outbreaks in neonatal intensive care units (NICUs) is not currently recommended. Here we report an outbreak in a NICU detected during a screening trial for RSV infection using a rapid antigen test (Respi-Strip((R))). Eleven preterm infants in our NICU tested positive for RSV during January 2009. Subsequent testing of the remaining infants in the NICU revealed two additional asymptomatic cases. In addition to precautions against cross-infection, palivizumab prophylaxis was administered to the remaining 37 premature infants. Two days after treatment, RSV was detected in two additional infants who had become symptomatic. To our knowledge this is the largest RSV outbreak in a NICU to be identified at an early stage by rapid testing and effectively controlled by infection control measures and palivizumab prophylaxis.