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The aim of this study was to determine the incidence, risk factors, and outcome of acute kidney injury (AKI) in extremely low birth weight (ELBW) infants. In a case-control study, medical records of all ELBW infants who were admitted to our Neonatal Intensive Care Unit (NICU) between 1 January 2000 and 31 January 2008 were reviewed. During the study period, 12.5% (59/472) of all ELBW infants developed AKI. Forty-six infants with available medical records were matched to 46 controls. The mean gestational age and birth weight of infants with AKI and their controls were 24.7 ± 1.8 vs. 24.9 ± 1.9 weeks (p = 0.61) and 614 ± 128 vs. 616 ± 127 g (p = 0.93), respectively. Infants with AKI had a higher mean airway pressure, a lower mean arterial blood pressure, and higher exposure to cefotaxime than their controls. Infants with AKI also had an increased mortality in comparison to their controls [33/46 (70%) vs. 10/46 (22%), respectively; p < 0.0001), and oliguric patients had a higher mortality than nonoliguric patients [31/38 (81%) vs. 2/8 (25%), respectively, p = 0.003]. Based on our results, we conclude that a high mean airway pressure, low blood pressure, and the use of cefotaxime are associated with renal failure in ELBW infants. AKI in ELBW infants is also associated with an increased mortality, especially in the presence of oliguria.

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We consider distribution systems with a central warehouse and many retailers that stock a number of different products. Deterministic demand occurs at the retailers for each product. The warehouse acts as a break-bulk center and does not keep any inventory. The products are delivered from the warehouse to the retailers by vehicles that combine the deliveries to several retailers into efficient vehicle routes. The objective is to determine replenishment policies that specify the delivery quantities and the vehicle routes used for the delivery, so as to minimize the long-run average inventory and transportation costs. A new heuristic that develops a stationary nested joint replenishment policy for the problem is presented in this paper. Unlike existing methods, the proposed heuristic is capable of solving problems involving distribution systems with multiple products. Results of a computational study on randomly generated single-product problems are also presented.integrated inventory and vehicle routing, multiechelon multiproduct distribution systems, power-of-two policies

This note deals with the joint replenishment problem with stochastic demands. A new class of policies called P(s, S) policy is proposed for this problem. The proposed policy uses independent, periodic review (s, S) policies for each item. Results on test problems show that the proposed policy is superior to other classes of policies for the problem.

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MBD remains an important morbidity in ELBW infants despite advances in neonatal nutrition. Further research is needed to optimize the management of chronic lung disease and early nutrition in ELBW infants.