The diagnosis of ovarian torsion remains challenging. Clinical characteristics lack sensitivity and specificity and ultrasound diagnosis is not definitive. Laparoscopy remains the investigation of choice. Despite delays in diagnosis this study demonstrates relatively high ovarian salvage rates compared with most published data.

No abstract

Breastfeeding is the gold standard when it comes to infant feeding due to the significant health benefits it offers infants. The advantages of breast milk are even greater for infants with Down syndrome because of their increased risk for infections and gastrointestinal issues. However, because babies with Down syndrome often experience unique challenges that can compromise successful breastfeeding, the hospital uses special techniques in the nursery to ensure the mothers have the necessary education to initiate breastfeeding and to troubleshoot should problems arise. The techniques outlined are designed to address issues of hypotonia, sleepiness, and tongue thrusting, which are common in babies with Down syndrome.

Background: Low birth-weight infants' survival continues to improve and there is increased need to provide secure vascular access. This study examines safety of larger peripherally inserted central catheters (PICCs) that offer greater utility. Purpose: To determine feasibility of 2.6-French (Fr) double-lumen PICCs in newborns and compare noninfectious complications such as thrombus formation, catheter breakage, infiltration, and accidental dislodgment and central line–associated bloodstream infection (CLABSI) rate with that of newborn infants treated with 1.9-Fr single- and double-lumen PICCs. Methods: Infants requiring PICCs were admitted in our 69-bed level IV neonatal intensive care unit from September 2006 to May 2015. Two distinct groups were compared: the 1.9-Fr—(single-lumen [n = 105] and double-lumen [n = 27])—and 2.6-Fr double-lumen PICCs (n = 111). Data obtained included birth weight and weight at insertion, gestational age at birth and corrected gestation age at insertion, indication, catheter days, indication for removal, and complications: noninfectious and infectious. Univariate and multivariate statistical analysis evaluated data. Results: There were no differences regarding gestational age at birth and insertion and indications for placement of 2.6-Fr double-lumen (n =111) and 1.9-Fr both single- and double-lumen (n = 132) PICCs. The same was noted between the groups' complications. Noninfectious complications were more common in PICCs with peripheral tip location in all groups. Implications for Practice: Consider use of 2.6-Fr PICCs in a neonatal intensive care unit when the utility of blood administration and sampling is required. Implications for Research: Examine line migration and CLABSI associated with sampling and blood administration.

No abstract