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Skin Disorders inNewborn Infants
KEY POINTS 1. Neonatal skin matures with gestational age with increasing thickness, less permeability, and higher density of sweat and sebaceous glands. Keratinization begins at 24 weeks and matures near term. 2. Cold stress is an important risk to preterm…
Leadership and OrganizationalCulture in Healthcare
KEY POINTS 1. All organizations, be it in healthcare or in any other sector(s) of society, strive for effective, potentially transformational leadership. 2. In any health-care system, infants receiving care in neonatal intensive care units are often the most vulnerable…
Organization of Neonatal Intensive Care
KEY POINTS 1. Neonatal intensive care units (NICUs) are organized for the clinical care of premature and critically ill newborn infants. 2. Healthcare centers require a well-considered structure to enable collaborative decision-making to provide family-centered, high-value care to the mother-infant…
Designing Clinical Trials in Neonatology—International Trials
KEY POINTS 1. Assessing therapeutic safety and efficacy of a drug/device or technology requires carefully designed trials that are sufficiently powered to detect differences in outcomes. 2. International trials can help reduce the time required for the study and improve…
Neonatal Randomized Controlled Trials
KEY POINTS 1. Neonates and infants often are treated with medicines that have not been approved by regulatory authorities for use in this age group. 2. The inclusion of infants in drug development studies and clinical trials is limited by…
Quality Improvement in Neonatal Care
KEY POINTS 1. The quality of clinical care and improvement is typically measured in six areas: safety, effectiveness, patient-centeredness, timeliness, efficiency, and equality. 2. Healthcare administered during pregnancy, labor, and childbirth continues to show considerable center-to-center variability and needs careful…
Neurodevelopmental Impairment in Specific Neonatal Disorders
KEY POINTS 1. Neonatal intensive care unit graduates are at risk of neurodevelopmental impairment (NDI). 2. NDI can occur in cognitive, motor, vision, hearing, or language domains and can seriously impair the child's social, academic, and behavioral functioning. 3. Periventricular…
Use of Neuroimaging to Predict Adverse Developmental Outcomes in High-Risk Infants
KEY POINTS 1. Nearly half of all very low birth weight infants may have had brain injury due to hypoxia-ischemia, arterial ischemic stroke(s), inflammation, infection, and intraventricular hemorrhages (IVHs). 2. Neuroimaging is increasingly seen in a “biomarker-like role,” where it…
Early Detection of Cerebral Palsy
Key Points 1. Cerebral Palsy (CP) originates from an injury or abnormality in the developing brain, resulting in abnormal muscle tone, and consequently, in altered movement, posture, and motor function. 2. Tools used to accurately detect CP in the first…