Cardiac surgery for children with trisomies 13 and 18: Where are we now?
The objective is to examine whether cardiac surgery should be considered for children with trisomy 13 or 18 (T13 or 18).T13 or 18 were previously referred to as “lethal” conditions due to high mortality rates and severe disability among survivors. In the last decade, investigations have revealed these conditions are heterogeneous, with increasing numbers of studies describing interventions for these children. A number of factors makes the interpretation of reported outcomes after cardiac surgery challenging: (1) dissimilarities in practice lead to a wide variation in reported outcomes after cardiac surgery; (2) cardiac...
Source: Seminars in Perinatology - February 1, 2016 Category: Perinatology & Neonatology Authors: Annie Janvier, Barbara Farlow, Keith Barrington Source Type: research
Cardiac surgery for children with trisomies 13 and 18: Where are we now?
The objective is to examine whether cardiac surgery should be considered for children with trisomy 13 or 18 (T13 or 18).T13 or 18 were previously referred to as “lethal” conditions due to high mortality rates and severe disability among survivors. In the last decade, investigations have revealed these conditions are heterogeneous, with increasing numbers of studies describing interventions for these children. A number of factors makes the interpretation of reported outcomes after cardiac surgery challenging: (1) dissimilarities in practice lead to a wide variation in reported outcomes after cardiac surgery; (2) cardia...
Source: Seminars in Perinatology - January 31, 2016 Category: Perinatology & Neonatology Authors: Annie Janvier, Barbara Farlow, Keith Barrington Source Type: research
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Source: Seminars in Perinatology - January 31, 2016 Category: Perinatology & Neonatology Source Type: research
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Source: Seminars in Perinatology - January 31, 2016 Category: Perinatology & Neonatology Source Type: research
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Source: Seminars in Perinatology - January 31, 2016 Category: Perinatology & Neonatology Source Type: research
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Source: Seminars in Perinatology - January 31, 2016 Category: Perinatology & Neonatology Source Type: research
Teaching and assessing ethics in the newborn ICU
This article reviews currently available teaching methods, pedagogy, and resources in medical ethics, professionalism, and communication, as well as assessment strategies and tools, to help medical educators and practicing clinicians ensure trainees achieve and maintain competency. (Source: Seminars in Perinatology)
Source: Seminars in Perinatology - January 29, 2016 Category: Perinatology & Neonatology Authors: Christy L. Cummings Source Type: research
Teaching and assessing ethics in the newborn ICU
This article reviews currently avail able teaching methods, pedagogy, and resources in medical ethics, professionalism, and communication, as well as assessment strategies and tools, to help medical educators and practicing clinicians ensure trainees achieve and maintain competency. (Source: Seminars in Perinatology)
Source: Seminars in Perinatology - January 28, 2016 Category: Perinatology & Neonatology Authors: Christy L. Cummings Source Type: research
Pharmacologic interventions for the prevention and treatment of retinopathy of prematurity
Retinopathy of prematurity (ROP), a significant morbidity in prematurely born infants, is the most common cause of visual impairment and blindness in children and persists till adulthood. Strict control of oxygen therapy and prevention of intermittent hypoxia are the keys in the prevention of ROP, but pharmacologic interventions have decreased risk of ROP. Various drug classes such as methylxanthines (caffeine), VEGF inhibitors, antioxidants, and others have decreased ROP occurrence. The timing of pharmacologic intervention remains unsettled, but early prevention rather than controlling disease progression may be preferred...
Source: Seminars in Perinatology - January 28, 2016 Category: Perinatology & Neonatology Authors: Kay D. Beharry, Gloria B. Valencia, Douglas R. Lazzaro, Jacob V. Aranda Source Type: research
Healthcare justice and human rights in perinatal medicine
This article describes an approach to ethics of perinatal medicine in which “women and children first” plays a central role, based on the concept of healthcare justice. Healthcare justice requires that all patients receive clinical management based on their clinical needs, which are defined by deliberative (evidence-based, rigorous, transparent, and accountable) clinical judgment. All patients in perinatal medicine includes pregnant, fetal, and neonatal patients. Healthcare justice also protects the informed consent process, which is intended to empower the exercise of patient autonomy in the decision-making process ab...
Source: Seminars in Perinatology - January 22, 2016 Category: Perinatology & Neonatology Authors: Frank A. Chervenak, Laurence B. McCullough Source Type: research
Healthcare justice and human rights in perinatal medicine
This article describes an approach to ethics of perinatal medicine in which “women and children first” plays a central role, based on the concept of healthcare justice. Healthcare justice requires that all patients receive clinical management based on their clinical needs, which are defined by deliberative (evidence-based, rigorous, transparent, and accountable) clinica l judgment. All patients in perinatal medicine includes pregnant, fetal, and neonatal patients. Healthcare justice also protects the informed consent process, which is intended to empower the exercise of patient autonomy in the decision-making process a...
Source: Seminars in Perinatology - January 21, 2016 Category: Perinatology & Neonatology Authors: Frank A. Chervenak, Laurence B. McCullough Source Type: research
The safe motherhood initiative: The development and implementation of standardized obstetric care bundles in New York
The medical literature demonstrates that inadequate hospital protocols or the lack of consistent protocols for diagnosis, management, consultation, and/or referral can lead to confusion and unnecessary variation in patient care. Incongruities in clinical settings have been repeatedly shown to compromise quality of patient outcomes. Accordingly, the development and adoption of standardized protocols as the best practice for addressing incidence of adverse events remains a top priority in health care quality and safety initiatives. (Source: Seminars in Perinatology)
Source: Seminars in Perinatology - January 21, 2016 Category: Perinatology & Neonatology Authors: Anna Burgansky, Donna Montalto, Norain A. Siddiqui Source Type: research
Ethics and professional responsibility: Essential dimensions of planned home birth
Planned home birth is a paradigmatic case study of the importance of ethics and professionalism in contemporary perinatology. In this article we provide a summary of recent analyses of the Centers for Disease Control database on attendants and birth outcomes in the United States. This summary documents the increased risks of neonatal mortality and morbidity of planned home birth as well as bias in Apgar scoring. We then describe the professional responsibility model of obstetric ethics, which is based on the professional medical ethics of two major figures in the history of medical ethics, Drs. (Source: Seminars in Perinatology)
Source: Seminars in Perinatology - January 21, 2016 Category: Perinatology & Neonatology Authors: Laurence B. McCullough, Amos Grünebaum, Birgit Arabin, Robert L. Brent, Malcolm I. Levene, Frank A. Chervenak Source Type: research
Ethical issues in neonatal research involving human subjects
This article describes some examples of historical and modern controversies in neonatal research, discusses the justification for research involving such vulnerable and fragile patients, clarifies current federal regulations that govern research involving neonates, and suggests ways that clinical investigators can develop and implement ethically grounded human subjects research. (Source: Seminars in Perinatology)
Source: Seminars in Perinatology - January 21, 2016 Category: Perinatology & Neonatology Authors: Alan R. Fleischman Source Type: research
