Preterm neonates remain at increased risk for adverse bilirubin-related outcomes, including acute bilirubin encephalopathy relative to term infants. Yet, most vulnerable neonates are likely benefit form the potent anti-oxidant properties of bilirubin. Evidence-based guidelines for the management of hyperbilirubinemia in preterm infants, however, are lacking. High concentrations of unconjugated bilirubin can cause permanent neurologic damage in infants, evident through magnetic resonance imaging of chronic bilirubin encephalopathy or kernicterus. There is a growing concern that exposures to even moderate concentrations of bilirubin may lead to subtle but permanent neurodevelopmental impairment referred to as bilirubin-induced neurologic dysfunction. Our current use of phototherapy to decrease bilirubin loads and its potential photo-oxidant properties is a biological conundrum that has been questioned in the use of phototherapy for very low birth weight neonates. In this issue of Clinics in Perinatology, we provide updates on the current understanding of the biology, mechanisms of increasing bilirubin load due to hemolysis, decreased bilirubin binding capacity and glucose-6-phosphate dehydrogenase deficiency, as well as clinical strategies to operationalize the thresholds for hyperbilirubinemia interventions in preterm infants.

The Year Book of Neonatal and Perinatal Medicine brings you abstracts of the articles that reported the year's breakthrough developments in perinatology, carefully selected from more than 500 journals worldwide. Expert commentaries evaluate the clinical importance of each article and discuss its application to the clinical management of your patients. There's no faster or easier way to stay informed! Chapters include The Fetus; Genetatics and Teratology; Respiratory Disorders; Infectious Diseases and Immunology; Cardiovascular System; Gastrointestinal Health and Nutrition; and Hematology, to name a few.

Bronchopulmonary dysplasia (BPD) as a chronic lung disease affecting preterm infants has been recognized for more than 45 years. However, little progress has been made in the prevention and treatment of the disease. BPD continues to be a major morbidity affecting preterm infants. Studies in pre-adolescent children demonstrate that the abnormal lung function from BPD persists well into childhood. Infants with BPD also have an increased risk for adverse neurodevelopmental outcome. Thus BPD imposes a significant burden of adverse health outcomes in preterm infants. The major risk factors for BPD are prematurity, mechanical ventilation, exposure to noxious insults such as oxygen, infections. New research data both in basic science and clinical studies have shed light on the pathogenesis, and possible new treatment or management strategies for the future. In the proposed issue of the Clinics in Perinatology, we would like to comprehensively cover BPD both from a basic science and clinical perspective. Our attempt is to balance new information along with classic topics. The proposed authors for the issue are recognized experts in the topic area/s. We hope that the issue will be of interest to a broad array of readership.

Breastfeeding Management for the Clinician: Using the Evidence is the perfect tool for busy clinicians who need a quick, accurate, and current reference. It provides the essentials of breastfeeding management to support best outcomes for breastfeeding families. Now in an updated and modernized fifth edition, this unique resource features new information on the political and social landscape of breastfeeding, LGBTQI+ families, milk sharing, exclusive pumping, new breastfeeding products, breastfeeding in emergencies, additional feeding care plans, and access to downloadable Patient Care Plan Handouts to help both patients and clinicians navigate common breastfeeding challenges and questions. Breastfeeding Management for the Clinician: Using the Evidence, Fifth Edition includes literature reviews while covering incidence, etiology, risk factors, prevention, prognosis and implications, interventions, expected outcomes, care plans, and clinical algorithms. With a focus on the practical application of evidence-based knowledge and a problem-solving approach, this reference helps busy clinicians integrate the latest research into their everyday clinical practice.

Recent advances in neonatal hematology, largely made by the authors of these chapters, are likely to generate wide spread and long-term improvements in outcomes, as well as reductions in costs of care. Publication of these advances in a single volume will facilitate dissemination of these techniques and practices. The advances include neuroprotection from erythropoietic stimulators, improved guidelines for platelet transfusions, evidence-based guidelines for FFP administration, improved diagnostic methods for genetic causes of severe neonatal jaundice, more accurate definitions of hematological perturbations in necrotizing enterocolitis and sepsis, and reduction in transfusions and in IVH rates by cord milking/delayed clamping.

In this issue the Guest Editors provide a contemporary look at the epidemiology, clinical manifestations, treatment and outcomes for neonatal-perinatal infections. Contributors include neonatologists, infectious disease, and critical care specialists with a wide variety of research interests in this arena. Readers will be exposed to the latest information on dosing of antibiotics, antivirals, and antifungals. This information is critical in the infant population given the rapid changes in physiology, metabolic pathways and renal elimination that occur over the first months of life. There is an extensive examination of infectious processes that commonly present in infants including meningitis, bloodstream infections, and urinary tract infections. Additional topics include infectious processes affecting the newborn (chorioamnionitis and TORCH infections) and premature infants (necrotizing enterocolitis). Specific pathogens are highlighted in articles on HSV, CMV/VZV, staphylococcal species, and Candida. Finally, the rationale for the most recent changes to guidelines for initiating therapy for early-onset neonatal sepsis are reviewed.

The Year Book of Neonatal and Perinatal Medicine brings you abstracts of the articles that reported the year's breakthrough developments in neonatal and perinatal medicine, carefully selected from more than 500 journals worldwide. Expert commentaries evaluate the clinical importance of each article and discuss its application to your practice. There's no faster or easier way to stay informed! Chapters in this annual cover the most current information on all aspects of neonatal and perinatal medicine from genetics to labor and delivery to issues related to many key bodily systems (heart, respiratory, nervous system, etc.) of newborns. Other topics for 2004 include neurology, gastroenterology and nutrition, medical disorders of pregnancy, fetal evaluation, and neonatal behavior.

Over the past several decades, advances in neonatal nutrition have focused on the provision of early parenteral nutrition and the development of formulas and supplements that most closely approximate maternal breast milk. The overall outcomes for infants, including premature infants, have greatly benefited from these advances, but there are still many nutritional unknowns that impact the lives of neonates. This is an exciting time in neonatal nutrition as the focus has shifted from survival and growth, which are still important goals, to effects of each micro/macronutrient on development, prevention of disease states such as ROP, the effects of neonatal nutrition on future health as an adult, and opportunities to improve long-term neurodevelopmental outcomes by optimal early nutrition. This issue focuses on aspects of enteral and parenteral nutrition that are at the forefront of neonatal care: assessing growth, parenteral nutrition components (including alternate lipid formulations), optimal storage and use of human milk (including donor milk), post-discharge nutrition, and the effects of various micro/macronutrients on long-term developmental outcomes. It is anticipated that the study and implementation of many of these novel concepts into the care of neonates, many of whom are severely premature, will be of value to practitioners, researchers, and, most of all, patients.

Neonatal intensive care unit (NICU) teams in the US and around the world receive performance reports that locate their particular value for selected process and outcome measures within the range of values from all reporting NICUs. Understandably, many providers focus primarily, if not exclusively, on their particular value. When a value appears undesirable, providers often justify it in an apparent reflex response rather than critically analysing their data. Exceedingly few reflect on the width or implications of the range within which their performance lies. Standard medical education does not include these skills, yet unwarranted practice variation necessarily compromises a population's overall quality of care. Researchers report wide variation in health care resource use with little connection to patient outcomes, challenging the belief that directing incrementally more resources at certain healthcare problems necessarily produces better results. This book provides requisite knowledge to enable readers without research expertise to understand the notion of unwarranted practice variation, how to recognize it, its ubiquity, and why it is generally undesirable - why narrowing is pervasiveness improves quality. The book begins by describing practice variation, its prevalence, and why it matters. Next, it examines alternative conceptualizations of NICU work. One view is task-oriented, while the other is aim-oriented. NICU teams rarely articulate their aims explicitly, so this book offers examples that guide thinking and action. Finally, this book asks, "Which rate is 'right'; what is the performance target?" The answer entails identifying the lowest resource use rate associated with desirable outcomes. This requires data describing efficient and predictably performing provision of current evidence-based care, along with relationships to a variety of outcomes. Provider conceptualization of healthcare quality also is often vague. The challenge lies in defining this notion operationally. This book does precisely that and gives readers tools to think critically about process, outcome, and quality measures, via some understanding of systems, risk-adjustment modelling, and discriminating signal from noise in process data.

This issue is expected to be in high demand, being extremely valuable to both neonatologists and maternal-fetal medicine physicians. The Guest Editors have put together a very comprehensive issue that looks at the premature infant. Topics include: Moderate Preterm. Late Preterm and Early Term Births: Epidemiology and Trends; Stillbirth Reduction Efforts and Impact on Early Births; Management of Indicated Early Term and Late Preterm Births; Physiological Underpinnings for Clinical Problems in Moderately Preterm, Late Preterm;Brain Maturation in the Second of Half of Pregnancy; Respiratory Disorders in Moderately Preterm, Late Preterm and Early Term Infants; Metabolic and Neurologic Issues in Moderately Preterm, Late Preterm and Early Term Infants; and Quality Initiatives Related to Moderately Preterm, Late Preterm and Early Term Births.

The 16 articles in this issue draw on the expertise of internationally recognized experts who have collectively provided cross-cutting reviews with a broad perspective on the current state of the field. The authors have provided succinct, up-to-date clinical perspectives and highlight current controversies and future challenges. As a result, this issue is a cutting-edge compendium of this complex and fast-moving field. Throughout the issue, the reader is encouraged to acquire a more comprehensive perspective by drawing connections between earlier and later articles that are thematically grouped around issues dealing with pathogenesis, diagnosis, and therapy. This issue underscores the vital importance of continued support to encourage and nurture collaboration among clinicians and scientists.

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Gain a solid understanding of neonatal and pediatric diseases as you explore real-world patient experiences with this unique resource.

Inside, you'll find everything you need to know about perinatal lung diseases - common neonatal complications - congenital diseases - pediatric pulmonary and upper airway diseases - and neuromuscular disorders. A streamlined presentation helps you easily grasp the background, pathophysiology, clinical manifestations, management and treatment, and the course and prognosis of each disease. In every chapter, unfolding case studies with full-color illustrations and photographs enhance your critical-thinking skills, making it easy to connect theory with practice. Plus, multiple-choice review questions help you assess your progress. Explore MORE online at DavisPlus Access your complete text online with the Davis Digital Version and gain additional practice with Student Questions and Interactive Case Studies. Redeem the Plus Code, inside new, printed texts, to access these DavisPlus Premium Resources.

The Guest Editors have assembled well published authors to present state-of-the-art clinical reviews devoted to resuscitation of the newborn and fetus. Articles are devoted to the following topics: fetal/intrauterine compromise; Cellular biology of end organ injury and strategies to prevent end organ injury; Role of oxygen in the DR; DR management of meconium stained infant; Role of medications in neonatal resuscitation; Delayed cord clamping; Post-resuscitation management; HIE and novel strategies for neuroprotection; Physiology of transition from intrauterine to extrauterine life; Resuscitation of preterm infants: Special considerations; Chest compressions and dysrhythmias in neonates; Resuscitation of infants with prenatally diagnosed anomalies; Ethical issues in neonatal resuscitation; Training programs in neonatal resuscitation: The Neonatal Resuscitation Program and Helping Babies Breathe; and Future of neonatal resuscitation.

The Year Book of Neonatal and Perinatal Medicine brings you abstracts of the articles that reported the year's breakthrough developments in neonatal and perinatal medicine, carefully selected from more than 500 journals worldwide. Expert commentaries evaluate the clinical importance of each article and discuss its application to your practice. There's no faster or easier way to stay informed Chapters in this annual cover the most current information on all aspects of neonatal and perinatal medicine from genetics to labor and delivery to issues related to many key bodily systems (heart, respiratory, nervous system, etc.) of newborns. Other topics for 2004 include neurology, gastroenterology and nutrition, medical disorders of pregnancy, fetal evaluation, and neonatal behavior.

Dr. Spitzer has created an issue devoted to the evidence-based pharmacologic care of the neonate. The issue opens with an important article on? A Quality Improvement Approach to Modifying Medication Use in the NICU. The expert authors he has secured have contributed articles in the areas of therapeutic drug monitoring, off-label use of medications in the NICU, antenatal and post-natal corticosteroids, antibiotics, antifungals, and antivirals, as well as bronchodilators and nitric oxide. Other articles also present evidence-based use of oxygen, dopamine, anesthetics and analgesics, and erythropoetin.

More than half a million babies in the US are born prematurely every year - preterm birth is the leading cause of infant mortality and those who survive may face lifelong problems.? This issue of the Obstetrics and Gynecology Clinics discusses the epidemiology, outcomes and clinical prediction of preterm birth, and offers information on various therapies.

The guest editors thoroughly examine prematurity for the perinatologist by supplying state-of-the art reviews on this topic.? Articles include: The integrated development of sensory organization; The normal sequence of sensory development in the fetus and newborn; The role of the limbic system in early development; The role of the olfactory system in early maternal orientation and feeding outcomes; Olfactory contributions to attachment and learning; The gustatory system in the newborn: implications for development of eating; The role of auditory development in early communication and attachment;?
The role of vision and state organization in early development; Epigenetic contributions to early developmental care; Supporting successful eating and growth; The scientific foundations for Kangaroo care;
The practice of individualized developmental care; and Designing environments for developmental care.

The Year Book of Neonatal and Perinatal Medicine brings you abstracts of the articles that reported the year's breakthrough developments in neontatology and perinatology, carefully selected from more than 500 journals worldwide. Dr. Avroy Fanaroff, Emeritus Professor as Case Western Reserve University, is a key opinion leader who has been a driving force in the field for many years. He authors many commentaries himself and has assembled top experts to select the most important journal articles and write commentaries that evaluate the clinical importance of each article and discuss its application to patient care. There's no faster or easier way to stay informed! This annual covers all aspects of care from the fetus, postnatal growth, labor and delivery, infectious diseases, respiratory disorders, cardiovascular health, and gastrointestinal health to name a few. The Year Book of Neonatal and Perinatal Medicine publishes annually in November.

Drs. Fleischman and Iams present comprehensive review articles on the current state of science and medicine on the premature infant.The issue is divided into sections devoted to epidemiology, causes, outcomes, and controversies. Specific articles address stress, infection, inflammation, antenatal steroids, and ethical issues surrounding care at the edge of viability.

Delivery After Prior Cesarean is examined in the issue of Clinics in Perinatology, guest edited Drs. Mark Landon and Caroline Signore. Authorities in the field have come together to pen articles on topics such as Rising primary cesarean rates: VBAC vital statistics, Access to TOLAC, Medicolegal aspects of VBAC/TOL, Ethics, Midwifery and VBAC, Success rates and factors, Intrapartum management: induction, labor progression and monitoring, Uterine rupture: rates and prediction, Multiple repeat cesareans and the threat of placenta accrete, Maternal morbidity and mortality, Perinatal morbidity and mortality, and Long-term infant outcomes.

Topics include: MRI of the preterm and term neonate with hypoxic ischemic injury; MRI of neonatal infections; MRI of neonatal stroke; Neonates with seizures: What to consider, How to image?;? Metabolic diseases of the newborn; Fetal MRI: Imaging versus imagining?; Postmortum MRI: An alternative to autopsy?; MRI of spinal dysraphia: What to consider?; Diffusion Tensor Imaging of the neonatal spinal cord; How to prepare and care for a critical sick neonate in a MRI environment; Functional (BOLD) imaging of the newborn; Advanced functional MRI; Dedicated MR antennae for neonatal imaging; Shaken infant syndrome/ Imaging of child abuse; Congenital Cardiac Defects and MR guided planning of surgery; Congenital Cardiovascular Malformation: Non-invasive imaging; MR guided cardiovascular interventions in noenates and infants; Musculoskeletal imaging of the newborn.

This issue of Clinics in Perinatology reviews Healthcare Associated Infections in the Neonatal Intensive Care Unit. Guest Editors Drs. Karen Fairchild and Richard Polin have assembled a panel of expert contributors to pen articles on Epidemiology and Risk Factors for NICU HAI: Genes and Environment; Strategies to Reduce NICU HAI: Line, Tube, and Hand Hygiene;? Candida in the NICU: Pros and Cons of Prophylaxis; MRSA in the NICU; New Concepts of Microbial Translocation in the Neonatal Intestine: Mechanisms and Prevention; Antibiotic Resistance in NICU Pathogens: Mechanisms, Clinical Impact, and Prevention; Biomarkers for LONS: Cytokines and Beyond; Heart Rate Variability: A Novel Physiomarker for Sepsis Detection in the NICU; Ventilator-Associated Pneumonia; Perinatal Infection and Prematurity; and Meningitis in Neonates: Bench to Bedside.

This issue of Clinics in Perinatology, guest edited by Drs. Alan Spitzer and Dan Ellsbury, examines Quality Improvement in Neonatal and Perinatal Medicine. The first part of the issue addresses Tools of Quality Improvement and includes articles on The Quality Chasm in Neonatal and Perinatal Medicine; Evaluating the Medical Evidence; The Vermont Oxford Network Database; The Pediatrix Clinical Data Warehouse; Role of Regional Collaboratives: The California Perinatal Quality Care Collaborative Model; A Primer on Quality Improvement Methodology; Using Statistical Process Control Methodology; Human Factors in Quality Improvement, Random Safety Audits, Root Cause Analysis, and Failure Mode and Effects Analysis; Collaboration Between Obstetricians and Neonatologists: Perinatal Safety Programs and Improved Clinical Outcomes; and Pay for Performance: A Business Strategy for Quality Improvement in Neonatal-Perinatal Medicine. The second part of this issue addresses Specific Applications of Documented Quality Improvement Methodology in Neonatal and Perinatal Medicine and includes articles on Delivery Room Intervention-Improving the Outcome, Reducing Retinopathy of Prematurity, Improving Breast Milk Use During and After the NICU Stay, Decreasing Catheter Related Bloodstream Infection, and Decreasing Bronchopulmonary Dysplasia.

Early Onset Neonatal Sepsis is covered in this issue of Clinics in Perinatology, guest edited by Drs. Karen Fairchild and Richard Polin. Authorities in the field have come together to pen articles on Innate host defenses and risk for EONS, Group B streptococcus, Diagnosis and management of clinical chorioamnionitis, Molecular diagnostics of sepsis, Use of proteomics in the diagnosis of chorioamnionitis and neonatal sepsis, Adjunct laboratory tests in the diagnosis of EONS, Ureaplasma: role in diseases of prematurity, Meningitis in neonates, Adjunct immunologic therapies in neonatal sepsis, Pathophysiology and treatment of septic shock in neonates, and International perspective on EONS.