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Article: Meningomyelocele Simulation Model: Pre-surgical Management-Technical Report.

Rosen, Orna / Angert, Robert M

2018 Volume 10, Issue 2, Page(s) e2231

Abstract: This technical report describes the creation of a myelomeningocele model of a newborn baby. This is a simple, low-cost, and easy-to-assemble model that allows the medical team to practice the delivery room management of a newborn with myelomeningocele. ... ...

Abstract	This technical report describes the creation of a myelomeningocele model of a newborn baby. This is a simple, low-cost, and easy-to-assemble model that allows the medical team to practice the delivery room management of a newborn with myelomeningocele. The report includes scenarios and a suggested checklist with which the model can be employed.
Language	English
Publishing date	2018-02-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.2231
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Article ; Online: Dexmedetomidine versus intermittent morphine for sedation of neonates with encephalopathy undergoing therapeutic hypothermia.

Cosnahan, Anna S / Angert, Robert M / Jano, Eni / Wachtel, Elena V

Journal of perinatology : official journal of the California Perinatal Association

2021 Volume 41, Issue 9, Page(s) 2284–2291

Abstract: Objective: In March 2019, the sedative in the therapeutic hypothermia protocol at Bellevue Hospital Center and NYU Langone Health changed from morphine to dexmedetomidine. This study evaluated the impact of this change on efficacy and safety parameters.! ...

Abstract	Objective: In March 2019, the sedative in the therapeutic hypothermia protocol at Bellevue Hospital Center and NYU Langone Health changed from morphine to dexmedetomidine. This study evaluated the impact of this change on efficacy and safety parameters. Study design: This was a retrospective, observational cohort study including neonates with HIE undergoing therapeutic hypothermia (N = 70) at two regional perinatal medical centers. Results: Baseline demographics, pain scores, hemodynamics, and time to enteral feeds were similar between dexmedetomidine (N = 34) and morphine (N = 36) patients. Dexmedetomidine patients received more breakthrough morphine (0.13 ± 0.13 vs 0.04 ± 0.09 mg/kg, p = 0.001), but less cumulative morphine (0.13 ± 0.13 vs 1.79 ± 0.23 mg/kg, p < 0.0001). Morphine patients on invasive ventilation required increased support (0 vs 31.58%, p = 0.02). Conclusion: Dexmedetomidine is effective and safe for sedation and analgesia during therapeutic hypothermia. It reduced total opioid usage, with no increased incidence of adverse events.
MeSH term(s)	Brain Diseases ; Cohort Studies ; Dexmedetomidine ; Humans ; Hypothermia, Induced ; Infant, Newborn ; Morphine
Chemical Substances	Dexmedetomidine (67VB76HONO) ; Morphine (76I7G6D29C)
Language	English
Publishing date	2021-03-01
Publishing country	United States
Document type	Journal Article ; Observational Study
ZDB-ID	645021-0
ISSN	1476-5543 ; 0743-8346
ISSN (online)	1476-5543
ISSN	0743-8346
DOI	10.1038/s41372-021-00998-8
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Zs.A 2412: Show issues

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Article: Gastroschisis Simulation Model: Pre-surgical Management Technical Report.

Rosen, Orna / Angert, Robert M

Cureus

2017 Volume 9, Issue 3, Page(s) e1109

Abstract: This technical report describes the creation of a gastroschisis model for a newborn. This is a simple, low-cost task trainer that provides the opportunity for Neonatology providers, including fellows, residents, nurse practitioners, physician assistants, ...

Abstract	This technical report describes the creation of a gastroschisis model for a newborn. This is a simple, low-cost task trainer that provides the opportunity for Neonatology providers, including fellows, residents, nurse practitioners, physician assistants, and nurses, to practice the management of a baby with gastroschisis after birth and prior to surgery. Included is a suggested checklist with which the model can be employed. The details can be modified to suit different learning objectives.
Language	English
Publishing date	2017-03-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.1109
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Article ; Online: Non-central peripherally inserted central catheters in neonatal intensive care: complication rates and longevity of catheters relative to tip position.

Goldwasser, Bernard / Baia, Catalina / Kim, Mimi / Taragin, Benjamin H / Angert, Robert M

Pediatric radiology

2017 Volume 47, Issue 12, Page(s) 1676–1681

Abstract: Background: Peripherally inserted central catheters (PICCs) represent a mainstay of intravascular access in the neonatal intensive care setting when long-term vascular access is needed. Ideally, PICCs should be inserted and maintained in a central ... ...

Abstract	Background: Peripherally inserted central catheters (PICCs) represent a mainstay of intravascular access in the neonatal intensive care setting when long-term vascular access is needed. Ideally, PICCs should be inserted and maintained in a central position with the tip ending in the superior or inferior vena cava. This is not always achievable, and sometimes the tip remains in a peripheral location. Higher complication rates have been reported with non-central PICCs; however these findings have not been confirmed in a solely neonatal series and PICCs with tips in peripheral veins have not been studied. Objective: To compare complication rates and length of catheter duration related to PICC position in neonates. Materials and methods: We conducted a retrospective analysis of all PICCs inserted in term and preterm infants in a tertiary neonatal intensive care unit between May 2007 and December 2009. A single pediatric radiologist reinterpreted the catheter tip site on initial anteroposterior (AP) chest radiographs and categorized sites as central (superior vena cava, inferior vena cava, brachiocephalic vein), intermediate (subclavian, axillary, common or external iliac veins), or peripheral (veins peripheral to axillary or external iliac veins). We analyzed complication rates and length of catheter duration among the three categories. Results: We collected data on a total of 176 PICCs. Infants with PICCs in a central location had a significantly lower complication rate (18/97, 19%) than those with the PICC tip in an intermediate (24/64, 38%) or peripheral (9/15, 60%) locations (P=0.0003). Length of catheter duration was noted to be longest with central, intermediate with intermediate, and shortest with peripheral PICC tip locations (17.7±14.8 days for central vs. 11.4±10.7 days for intermediate vs. 5.4±2.5 days for peripheral, P=0.0003). Conclusion: A central location is ideal for the tip of a PICC. When this is not achievable, an intermediate location is preferable to a more peripheral position.
Language	English
Publishing date	2017-11
Publishing country	Germany
Document type	Journal Article
ZDB-ID	124459-0
ISSN	1432-1998 ; 0301-0449
ISSN (online)	1432-1998
ISSN	0301-0449
DOI	10.1007/s00247-017-3939-1
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Article ; Online: Trends in retinopathy of prematurity over a 5-year period in a racially diverse population.

Tsui, Irena / Ebani, Edward / Rosenberg, Jamie B / Angert, Robert M / Lin, Juan / Mian, Umar

Ophthalmic surgery, lasers & imaging retina

2014 Volume 45, Issue 2, Page(s) 138–142

Abstract: Background and objective: Retinopathy of prematurity presents differently in developing versus developed countries, which may be due to environmental as well as racial differences.: Patients and methods: Retrospective chart review of infants screened ...

Abstract	Background and objective: Retinopathy of prematurity presents differently in developing versus developed countries, which may be due to environmental as well as racial differences. Patients and methods: Retrospective chart review of infants screened for ROP at a single neonatal intensive care unit. Risk factors were reviewed. Main outcome measures were rates of plus disease or treatment-requiring ROP by race. Results: The study included 497 infants screened for ROP in an urban neonatal intensive care unit. Gestational age, birth weight, and bronchopulmonary dysplasia were independent risk factors for both plus disease and treatment-requiring ROP with type 3 multivariate analysis. Self-identified white race was also a risk factor for plus disease and treatment-requiring ROP. Race was significantly associated with maternal age, multiple births, and blood transfusions. Conclusion: In the study population, white race was an independent risk factor for plus disease and ROP treatment.
MeSH term(s)	Adolescent ; Adult ; Birth Weight ; Dilatation, Pathologic ; Ethnic Groups/statistics & numerical data ; Gestational Age ; Hospitals, Community ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Maternal Age ; Neonatal Screening ; New York City/epidemiology ; Retinal Vessels/pathology ; Retinopathy of Prematurity/diagnosis ; Retinopathy of Prematurity/epidemiology ; Retrospective Studies ; Risk Factors ; Vision Screening ; Young Adult
Language	English
Publishing date	2014-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	2701167-7
ISSN	2325-8179 ; 2325-8160
ISSN (online)	2325-8179
ISSN	2325-8160
DOI	10.3928/23258160-20140306-07
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Zs.A 756: Show issues

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Article ; Online: Patent ductus arteriosus and indomethacin treatment as independent risk factors for plus disease in retinopathy of prematurity.

Tsui, Irena / Ebani, Edward / Rosenberg, Jamie B / Lin, Juan / Angert, Robert M / Mian, Umar

Journal of pediatric ophthalmology and strabismus

2013 Volume 50, Issue 2, Page(s) 88–92

Abstract: Purpose: To examine whether clinically significant patent ductus arteriosus (PDA) or indomethacin treatment are associated with plus disease or retinopathy of prematurity (ROP) requiring treatment.: Methods: Retrospective, cross-sectional study. ... ...

Abstract	Purpose: To examine whether clinically significant patent ductus arteriosus (PDA) or indomethacin treatment are associated with plus disease or retinopathy of prematurity (ROP) requiring treatment. Methods: Retrospective, cross-sectional study. Charts were reviewed for gestational age, birth weight, birth head circumference, birth length, maternal characteristics, gender, bronchopulmonary dysplasia, neurologic comorbidities, PDA and its treatments, gastrointestinal comorbidities, blood transfusions, and sepsis. Main outcome measures were increased rates of plus disease or ROP requiring treatment. Results: A total of 450 premature infants screened for ROP in a mid-sized, urban neonatal intensive care unit were included. On univariate analysis, gestational age, birth weight, birth head circumference, birth length, bronchopulmonary dysplasia, neurologic comorbidities, PDA and its treatments, gastrointestinal comorbidities, and sepsis were significantly correlated to plus disease and ROP requiring treatment. PDA was significantly associated with bronchopulmonary dysplasia, neurologic comorbidities, sepsis, and blood transfusions (P < .0001). With type 3 multivariate analysis, only gestational age and bronchopulmonary dysplasia were independent risk factors for ROP. Conclusion: PDA and indomethacin were associated with plus disease and ROP requiring treatment on univariate analysis but this was not significant after adjusting for other risk factors. PDA was also strongly related to bronchopulmonary dysplasia and blood transfusions, which may explain its effect on ROP.
MeSH term(s)	Birth Weight ; Cross-Sectional Studies ; Cyclooxygenase Inhibitors/adverse effects ; Cyclooxygenase Inhibitors/therapeutic use ; Ductus Arteriosus, Patent/complications ; Ductus Arteriosus, Patent/drug therapy ; Female ; Gestational Age ; Humans ; Indomethacin/adverse effects ; Indomethacin/therapeutic use ; Infant, Newborn ; Intensive Care Units, Neonatal ; Male ; Retinal Neovascularization/etiology ; Retinal Vessels/pathology ; Retinopathy of Prematurity/etiology ; Retrospective Studies ; Risk Factors
Chemical Substances	Cyclooxygenase Inhibitors ; Indomethacin (XXE1CET956)
Language	English
Publishing date	2013-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	800921-1
ISSN	1938-2405 ; 0191-3913
ISSN (online)	1938-2405
ISSN	0191-3913
DOI	10.3928/01913913-20130108-03
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Zs.B 333: Show issues

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Article ; Online: Babyboy/Babygirl: A National Survey on the Use of Temporary, Nondistinct Naming Conventions for Newborns in Neonatal Intensive Care Units.

Adelman, Jason S / Aschner, Judy L / Schechter, Clyde B / Angert, Robert M / Weiss, Jeffrey M / Rai, Amisha / Parakkattu, Vibin / Goffman, Dena / Applebaum, Jo R / Racine, Andrew D / Southern, William N

Clinical pediatrics

2017 Volume 56, Issue 12, Page(s) 1157–1159

MeSH term(s)	Electronic Health Records/statistics & numerical data ; Female ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal/statistics & numerical data ; Male ; Medical Errors/statistics & numerical data ; Names ; Surveys and Questionnaires ; United States
Language	English
Publishing date	2017-04-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	207678-0
ISSN	1938-2707 ; 0009-9228
ISSN (online)	1938-2707
ISSN	0009-9228
DOI	10.1177/0009922817701178
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Article: CC10 reduces inflammation in meconium aspiration syndrome in newborn piglets.

Angert, Robert M / Pilon, Aprile L / Chester, Darrin / Davis, Jonathan M

Pediatric research

2007 Volume 62, Issue 6, Page(s) 684–688

Abstract: Complications from meconium aspiration syndrome (MAS) remain significant despite a variety of therapeutic interventions. Clara cell protein (CC10) is a novel anti-inflammatory agent that can also inhibit phospholipase A2 (PLA2) (an important component of ...

Abstract	Complications from meconium aspiration syndrome (MAS) remain significant despite a variety of therapeutic interventions. Clara cell protein (CC10) is a novel anti-inflammatory agent that can also inhibit phospholipase A2 (PLA2) (an important component of meconium). The present study examined whether administration of recombinant human CC10 (rhCC10) would reduce inflammation and improve lung function in a piglet model of MAS. Following meconium instillation, piglets exhibited significant physiologic dysfunction that improved significantly after surfactant administration. Analysis of tracheal aspirates revealed significant increases in both tumor necrosis factor (TNF) alpha and interleukin (IL)-8 after meconium instillation. rhCC10-treated animals had significantly lower TNF-alpha levels at 24 h (561 +/- 321 versus 1357 +/- 675 pg/mL, p < 0.05) compared with saline controls. There were no differences between rhCC10-treated and untreated groups with respect to other measured physiologic variables or inflammatory markers, including secretory PLA2 activity. Histologic analyses revealed marked inflammatory infiltrates and thickened alveolar walls, but no significant differences among rhCC10 and control animals. Newborn piglets with MAS have significant physiologic dysfunction, marked inflammatory changes and histologic abnormalities, which was partially counteracted by a single dose of exogenous surfactant and rhCC10.
MeSH term(s)	Animals ; Animals, Newborn ; Anti-Inflammatory Agents/administration & dosage ; Anti-Inflammatory Agents/pharmacology ; Anti-Inflammatory Agents/therapeutic use ; Bronchoalveolar Lavage Fluid/chemistry ; Bronchoalveolar Lavage Fluid/cytology ; Disease Models, Animal ; Drug Therapy, Combination ; Enzyme Inhibitors/pharmacology ; Humans ; Infant, Newborn ; Interleukin-8/blood ; Interleukin-8/metabolism ; Lung/drug effects ; Lung/enzymology ; Lung/metabolism ; Lung/pathology ; Lung/physiopathology ; Meconium/metabolism ; Meconium Aspiration Syndrome/drug therapy ; Meconium Aspiration Syndrome/metabolism ; Meconium Aspiration Syndrome/pathology ; Meconium Aspiration Syndrome/physiopathology ; Phospholipases A2, Secretory/antagonists & inhibitors ; Phospholipases A2, Secretory/metabolism ; Pulmonary Surfactants/pharmacology ; Recombinant Proteins/pharmacology ; Swine ; Time Factors ; Tumor Necrosis Factor-alpha/blood ; Tumor Necrosis Factor-alpha/metabolism ; Uteroglobin/administration & dosage ; Uteroglobin/pharmacology ; Uteroglobin/therapeutic use
Chemical Substances	Anti-Inflammatory Agents ; Enzyme Inhibitors ; Interleukin-8 ; Pulmonary Surfactants ; Recombinant Proteins ; SCGB1A1 protein, human ; Tumor Necrosis Factor-alpha ; Uteroglobin (9060-09-7) ; Phospholipases A2, Secretory (EC 3.1.1.4)
Language	English
Publishing date	2007-12
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	4411-8
ISSN	1530-0447 ; 0031-3998
ISSN (online)	1530-0447
ISSN	0031-3998
DOI	10.1203/PDR.0b013e31815a5632
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Zs.A 564: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Identification of a µ opiate receptor signaling mechanism in human placenta.

Mantione, Kirk J / Angert, Robert M / Cadet, Patrick / Kream, Richard M / Stefano, George B

Medical science monitor : international medical journal of experimental and clinical research

2010 Volume 16, Issue 11, Page(s) BR347–52

Abstract: Background: Previous studies report that genes in the morphine biosynthetic pathway have been found in placental tissue. Prior researchers have shown that kappa opioid receptors are present in human placenta. We determined if a µ opiate receptor was ... ...

Abstract	Background: Previous studies report that genes in the morphine biosynthetic pathway have been found in placental tissue. Prior researchers have shown that kappa opioid receptors are present in human placenta. We determined if a µ opiate receptor was present and which subtype was expressed in human placenta. We also sought to demonstrate a functional µ opiate receptor in human placenta. Material/methods: Polymerase chain reactions as well as DNA sequencing were performed to identify the µ opiate receptor subtypes present in human placenta. The functionality of the receptor was demonstrated by real time amperometric measurements of morphine induced NO release. Results: The µ4 opiate receptor sequence was present as well as the µ1 opioid receptor transcript. The addition of morphine to placental tissue resulted in immediate nitric oxide release and this effect was blocked by naloxone. Conclusions: In the present study, an intact morphine signaling system has been demonstrated in human placenta. Morphine signaling in human placenta probably functions to regulate the immune, vascular, and endocrine functions of this organ via NO.
MeSH term(s)	Female ; Humans ; Morphine/pharmacology ; Naloxone/pharmacology ; Narcotic Antagonists/pharmacology ; Narcotics/pharmacology ; Nitric Oxide/secretion ; Nitric Oxide Synthase/genetics ; Nitric Oxide Synthase/metabolism ; Placenta/drug effects ; Placenta/metabolism ; Pregnancy ; Protein Isoforms/chemistry ; Protein Isoforms/genetics ; Protein Isoforms/metabolism ; Receptors, Opioid, mu/chemistry ; Receptors, Opioid, mu/genetics ; Receptors, Opioid, mu/metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Signal Transduction/physiology
Chemical Substances	Narcotic Antagonists ; Narcotics ; Protein Isoforms ; Receptors, Opioid, mu ; Nitric Oxide (31C4KY9ESH) ; Naloxone (36B82AMQ7N) ; Morphine (76I7G6D29C) ; Nitric Oxide Synthase (EC 1.14.13.39)
Language	English
Publishing date	2010-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	1439041-3
ISSN	1643-3750 ; 1234-1010
ISSN (online)	1643-3750
ISSN	1234-1010
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Zs.A 4924: Show issues

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Article ; Online: Evaluating Serial Strategies for Preventing Wrong-Patient Orders in the NICU.

Adelman, Jason S / Aschner, Judy L / Schechter, Clyde B / Angert, Robert M / Weiss, Jeffrey M / Rai, Amisha / Berger, Matthew A / Reissman, Stan H / Yongue, Camille / Chacko, Bejoy / Dadlez, Nina M / Applebaum, Jo R / Racine, Andrew D / Southern, William N

Pediatrics

2017 Volume 139, Issue 5

Abstract: Background: NICU patients have characteristics believed to increase their risk for wrong-patient errors; however, little is known about the frequency of wrong-patient errors in the NICU or about effective interventions for preventing these errors. We ... ...

Abstract	Background: NICU patients have characteristics believed to increase their risk for wrong-patient errors; however, little is known about the frequency of wrong-patient errors in the NICU or about effective interventions for preventing these errors. We conducted a quality improvement study to evaluate the frequency of wrong-patient orders in the NICU and to assess the effectiveness of an ID reentry intervention and a distinct naming convention (eg, "Wendysgirl") for reducing these errors, using non-NICU pediatric units as a comparator. Methods: Using a validated measure, we examined the rate of wrong-patient orders in NICU and non-NICU pediatric units during 3 periods: baseline (before implementing interventions), ID reentry intervention (reentry of patient identifiers before placing orders), and combined intervention (addition of a distinct naming convention for newborns). Results: We reviewed >850 000 NICU orders and >3.5 million non-NICU pediatric orders during the 7-year study period. At baseline, wrong-patient orders were more frequent in NICU than in non-NICU pediatric units (117.2 vs 74.9 per 100 000 orders, respectively; odds ratio 1.56; 95% confidence interval, 1.34-1.82). The ID reentry intervention reduced the frequency of errors in the NICU to 60.2 per 100 000 (48.7% reduction; Conclusions: The risk of wrong-patient orders in the NICU was significantly higher than in non-NICU pediatric units. Implementation of a combined ID reentry intervention and distinct naming convention greatly reduced this risk.
MeSH term(s)	Female ; Humans ; Infant, Newborn ; Intensive Care Units, Pediatric/standards ; Male ; Medication Errors/prevention & control ; Quality Improvement ; United States
Language	English
Publishing date	2017-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	207677-9
ISSN	1098-4275 ; 0031-4005
ISSN (online)	1098-4275
ISSN	0031-4005
DOI	10.1542/peds.2016-2863
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