Early human development
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Invasive candidiasis is associated with high morbidity and mortality in neonates and children. The incidence of invasive candidiasis is greater in children than in adults and is particularly high in neonates. Main risk factors are multiple antibiotics, central venous catheters, parenteral nutrition, immunodepression, low birth weight, fungal colonization, and necrotizing enterocolitis. Successful management of IFIs relies on early recognition and rapid initiation of effective treatment.
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Neonatal renal tumours are rare, with only 7% of all neonatal tumours arising from the kidney. Presentation is usually as a flank mass or as a coincidental finding on either antenatal or postnatal ultrasound. Mesoblastic nephroma is the most common tumour to be found at this age, but Wilms' tumour and other malignant and benign tumours occur. ⋯ Given the low malignant potential of these tumours, treatment is by radical nephroureterctomy, except in cases with bilateral disease or syndromic patients with a high incidence of metachronous tumours. Chemotherapy is rarely indicated. Survival is generally excellent for all tumour types in this age group, the exception being malignant rhabdoid tumour of the kidney which may have metastases at presentation.
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Early human development · Jul 2010
ReviewRisk factors and prevention of late-onset sepsis in premature infants.
Late-onset sepsis in premature infants is a major cause of morbidity, mortality, and increased medical costs. Risk factors include low birth weight, low gestational age, previous antimicrobial exposure, poor hand hygiene, and central venous catheters. Methods studied to prevent late-onset sepsis include early feedings, immune globulin administration, prophylactic antimicrobial administration, and improved hand hygiene. In this review, we will outline the risk factors for development of late-onset sepsis and evidence supporting methods for prevention of late-onset sepsis in premature infants.
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Early human development · Oct 2009
ReviewNeonatal end-of-life decisions and bioethical perspectives.
In the nineties the EURONIC project documented the staff views and practices regarding ethical decision-making in neonatal intensive care units of eight Western Europe countries: France, Germany, Great Britain, Italy, Luxembourg, Netherlands, Spain and Sweden. This paper reviews the changes occurred in the ethical and legal background of these countries, and discusses possible influences on neonatal care practices. To a certain extent, many of these changes appear to be in line with the neonatal physicians' views and attitudes previously documented by the EURONIC project, while some are not. Large differences persist within Western Europe on what constitutes appropriate neonatal end-of-life care.