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Book ; Online ; E-Book: Infectious disease, immunology, and pharmacology

Benitz, William E. / Wynn, James L. / Smith, P. Brian / Polin, Richard A.

(Neonatology questions and controversies series)

2023

Abstract: Dr. Richard Polin's Neonatology Questions and Controversies series highlights the toughest challenges facing physicians and care providers in clinical practice, offering trustworthy guidance on up-to-date diagnostic and treatment options in the field. ... ...

Author's details	[edited by] William E. Benitz, James L. Wynn, P. Brian Smith ; consulting editor Richard A. Polin
Series title	Neonatology questions and controversies series
Abstract	"Dr. Richard Polin's Neonatology Questions and Controversies series highlights the toughest challenges facing physicians and care providers in clinical practice, offering trustworthy guidance on up-to-date diagnostic and treatment options in the field. In each volume, renowned experts address the clinical problems of greatest concern to today's practitioners, helping you handle difficult practice issues and provide optimal, evidence-based care to every patient."--Provided by publisher.
MeSH term(s)	Neonatology/methods ; Infant, Newborn ; Communicable Diseases ; Immune System Phenomena ; Drug Therapy ; Pharmaceutical Preparations/administration & dosage ; Infant, Newborn, Diseases
Keywords	Newborn infants ; Communicable diseases ; Immune system ; Chemotherapy ; Drugs/Dosage ; Newborn infants/Diseases
Subject code	616.33
Language	English
Dates of publication	2023-2024
Size	1 online resource (xiv, 257 pages) :, illustrations (some color)
Edition	Second edition.
Publisher	Elsevier, Inc
Publishing place	Philadelphia, PA
Document type	Book ; Online ; E-Book
Remark	Zugriff für angemeldete ZB MED-Nutzerinnen und -Nutzer
ISBN	0-323-87937-3 ; 9780323879064 ; 978-0-323-87937-8 ; 0323879063
Database	ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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Book ; Online: The Neonatal Immune System: A Unique Host-Microbial Interface

Wynn, James L. / Bliss, Joseph M.

2018

Abstract: Emerging from the protective environment of the uterus, the newborn is exposed to a myriad of microbes, and quickly establishes a complex microbiome that shapes the infant's biology in ways that are only now beginning to come to light. Among these ... ...

Abstract	Emerging from the protective environment of the uterus, the newborn is exposed to a myriad of microbes, and quickly establishes a complex microbiome that shapes the infant's biology in ways that are only now beginning to come to light. Among these exposures are a number of potential pathogens. The host responses to these pathogens in the neonatal period are unique, reflecting a developing immune system even with delivery at term. Preterm infants are delivered at a time when host defense mechanisms are even less developed and therefore face additional risk. As such, the organisms that cause disease in this period are different from the pathogens that are common in other age groups, or the disease they cause manifests in more severe fashion. Developmental alterations in both innate and adaptive immune responses in neonates have been documented among many cell types and pathways over the last several decades. Contemporary insights into the human immune system and methodologies that allow an "omics" approach to these questions have continued to provide new information regarding the mechanisms that underlie the human neonate as an "immunocompromised host." This Research Topic highlights studies related to this unique host-pathogen interface. Contributions include those related to the innate or adaptive immune system of neonates, their response to microbial colonization or infection, and/or the pathogenesis of microbes causing disease in neonates
Keywords	Medicine (General) ; Pediatrics ; Immunologic diseases. Allergy ; Science (General) ; Microbiology
Size	1 electronic resource (175 p.)
Publisher	Frontiers Media SA
Document type	Book ; Online
Note	English ; Open Access
HBZ-ID	HT020099598
ISBN	9782889454037 ; 2889454037
Database	ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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Article ; Online: Application of metabolomics to neonatal meningitis.

Wynn, James L

Pediatric research

2020 Volume 88, Issue 2, Page(s) 155–156

MeSH term(s)	Humans ; Infant ; Infant, Newborn ; Infant, Newborn, Diseases ; Meningitis ; Meningitis, Bacterial ; Metabolomics
Language	English
Publishing date	2020-05-12
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Comment
ZDB-ID	4411-8
ISSN	1530-0447 ; 0031-3998
ISSN (online)	1530-0447
ISSN	0031-3998
DOI	10.1038/s41390-020-0954-y
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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: Prolonged early antimicrobials in ELBWs: too much for too little.

Wynn, James L

Pediatric research

2019 Volume 85, Issue 7, Page(s) 929–930

MeSH term(s)	Anti-Bacterial Agents ; Anti-Infective Agents ; Humans ; Infant ; Infant, Extremely Low Birth Weight ; Infant, Extremely Premature ; Infant, Newborn
Chemical Substances	Anti-Bacterial Agents ; Anti-Infective Agents
Language	English
Publishing date	2019-03-05
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Comment
ZDB-ID	4411-8
ISSN	1530-0447 ; 0031-3998
ISSN (online)	1530-0447
ISSN	0031-3998
DOI	10.1038/s41390-019-0360-5
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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)
Zs.MO 373: Show issues

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Article ; Online: Early onset and hospital acquired neonatal sepsis associated with high mortality.

Wynn, James L

The Journal of pediatrics

2018 Volume 204, Page(s) 320–323

MeSH term(s)	Child ; Cohort Studies ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Neonatal Sepsis ; Prospective Studies ; Sepsis
Language	English
Publishing date	2018-12-20
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	3102-1
ISSN	1097-6833 ; 0022-3476
ISSN (online)	1097-6833
ISSN	0022-3476
DOI	10.1016/j.jpeds.2018.10.075
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Article: The frequency and timing of sepsis-associated coagulopathy in the neonatal intensive care unit.

Aziz, Khyzer B / Saxonhouse, Matthew / Mahesh, Divya / Wheeler, Kathryn E / Wynn, James L

Frontiers in pediatrics

2024 Volume 12, Page(s) 1364725

Abstract: Introduction: Sepsis is a common cause of morbidity and mortality in the neonatal intensive care unit (NICU). The frequency and severity of sepsis-associated coagulopathy as well as its relationship to illness severity are unclear.: Methods: We ... ...

Abstract	Introduction: Sepsis is a common cause of morbidity and mortality in the neonatal intensive care unit (NICU). The frequency and severity of sepsis-associated coagulopathy as well as its relationship to illness severity are unclear. Methods: We performed a single-center, retrospective, observational cohort study of all infants admitted to the University of Florida Health (UF Health), level IV NICU between January 1st 2012 to March 1st 2020 to measure the frequency of sepsis-associated coagulopathy as well as its temporal relationship to critical illness in the NICU population. All clinical data in the electronic health record were extracted and deposited into an integrated data repository that was used for this work. Results: We identified 225 new sepsis episodes in 216 patients. An evaluation for sepsis-associated coagulopathy was performed in 96 (43%) episodes. Gram-negative pathogen, nSOFA score at evaluation, and mortality were greater among episodes that included a coagulopathy evaluation compared with those that did not. Abnormal coagulation results were common (271/339 evaluations; 80%) and were predominantly prothrombin times. Intervention (plasma or cryoprecipitate) followed a minority (84/271; 31%) of abnormal results, occurred in 40/96 (42%) episodes that were often associated with >1 intervention (29/40; 73%), and coincided with thrombocytopenia in 37/40 (93%) and platelet transfusion in 27/40 (68%). Shapley Additive Explanations modeling demonstrated strong predictive performance for the composite outcome of death and/or treatment for coagulopathy in neonates (f1 score 0.8, area under receiver operating characteristic curve 0.83 for those with abnormal coagulation values). The three most important features influencing the composite outcome of death or treatment for coagulopathy included administration of vasoactive medications, hematologic dysfunction assessed by the maximum nSOFA platelet score, and early sepsis (≤72 h after birth). Conclusions: A coagulopathy evaluation was performed in a minority of NICU patients with sepsis and was associated with greater illness severity and mortality. Abnormal results were common but infrequently associated with intervention, and intervention was contemporaneous with thrombocytopenia. The most important feature that influenced the composite outcome of death or treatment for coagulopathy was the administration of vasoactive-inotropic medications. These data help to identify NICU patients at risk of sepsis-associated coagulopathy.
Language	English
Publishing date	2024-03-05
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2711999-3
ISSN	2296-2360
ISSN	2296-2360
DOI	10.3389/fped.2024.1364725
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Article ; Online: Defining neonatal sepsis.

Wynn, James L

Current opinion in pediatrics

2016 Volume 28, Issue 2, Page(s) 135–140

Abstract: Purpose of review: Although infection rates have modestly decreased in the neonatal intensive care unit (NICU) as a result of ongoing quality improvement measures, neonatal sepsis remains a frequent and devastating problem among hospitalized preterm ... ...

Abstract	Purpose of review: Although infection rates have modestly decreased in the neonatal intensive care unit (NICU) as a result of ongoing quality improvement measures, neonatal sepsis remains a frequent and devastating problem among hospitalized preterm neonates. Despite multiple attempts to address this unmet need, there have been minimal advances in clinical management, outcomes, and accuracy of diagnostic testing options over the last 3 decades. One strong contributor to a lack of medical progress is a variable case definition of disease. The inability to agree on a precise definition greatly reduces the likelihood of aligning findings from epidemiologists, clinicians, and researchers, which, in turn, severely hinders progress toward improving outcomes. Recent findings: Pediatric consensus definitions for sepsis are not accurate in term infants and are not appropriate for preterm infants. In contrast to the defined multistage criteria for other devastating diseases encountered in the NICU (e.g., bronchopulmonary dysplasia), there is significant variability in the criteria used by investigators to substantiate the diagnosis of neonatal sepsis. Summary: The lack of an accepted consensus definition for neonatal sepsis impedes our efforts toward improved diagnostic and prognostic options, and accurate outcomes information for this vulnerable population.
MeSH term(s)	Consensus ; Humans ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases/diagnosis ; Neonatal Sepsis/diagnosis ; Terminology as Topic
Keywords	covid19
Language	English
Publishing date	2016-04
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	1049374-8
ISSN	1531-698X ; 1040-8703
ISSN (online)	1531-698X
ISSN	1040-8703
DOI	10.1097/MOP.0000000000000315
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Zs.A 3049: Show issues

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Article ; Online: Frequency of Acute Kidney Injury and Association With Mortality Among Extremely Preterm Infants.

Aziz, Khyzer B / Schles, Eric M / Makker, Kartikeya / Wynn, James L

JAMA network open

2022 Volume 5, Issue 12, Page(s) e2246327

Abstract: Importance: Neonatal acute kidney injury (AKI) is common and associated with morbidity and mortality. The temporal relationship between AKI and critical illness, as well as the frequency of AKI definition components (urine output and serum creatinine [ ... ...

Abstract	Importance: Neonatal acute kidney injury (AKI) is common and associated with morbidity and mortality. The temporal relationship between AKI and critical illness, as well as the frequency of AKI definition components (urine output and serum creatinine [sCr] concentration change), are unknown in extremely low-birth-weight (ELBW) (<1000 g), extremely preterm (<29 weeks' completed gestational age [GA]) infants. Objective: To measure the frequency of AKI from birth to death or discharge with attention to the definition components as well as the temporal relationship of AKI to critical illness and death. Design, setting, and participants: A single-center, multiyear, retrospective cohort study was conducted at an academic level IV neonatal intensive care unit between January 1, 2012, and January 1, 2020. Participants included inborn ELBW and infants at 22 to 28 weeks' completed GA with confirmed congenital anomalies who survived 12 hours or more. Exposures: Extremely preterm birth and ELBW. Main outcomes and measures: The primary outcome was AKI frequency. The timing, severity, and criteria for AKI were measured. The temporal relationship between AKI, organ dysfunction, and outcomes were quantified using odds ratios (ORs), logistic regression, and Shapley Additive Explanations. Acute kidney injury recognition, imaging, pediatric nephrology consultation, and follow-up were determined. Results: A total of 436 infants (52% male; 44% Black) met the inclusion criteria (median BW, 725 g; median GA, 25.7 wk). Acute kidney injury was common in the first week of life (44%), primarily based on the change in the sCr concentration criterion (88%), and negatively associated with GA (OR, 0.69; 95% CI, 0.60-0.78), but positively associated with antecedent critical illness (OR, 1.17; 95% CI, 1.12-1.23), severe intraventricular hemorrhage (OR, 1.86; 95% CI, 1.12-3.08), late-onset sepsis (OR, 1.03; 95% CI, 1.02-1.03), and mortality (OR, 2.77; 95% CI, 1.63-4.72). Acute kidney injury had negligible clinical contribution to death within the model (Shapley Additive Explanation, <0.5% change to outcome) relative to antecedent patient-concentration organ dysfunction (6%-15% change). Among infants with severe AKI, recognition (32%), nephrology inpatient consultation (16%), and outpatient follow-up (9%) were not common. Conclusions and relevance: In this cohort study of ELBW infants, AKI was common in the first week of life, inversely associated with GA, and followed organ (primarily cardiovascular) dysfunction. Acute kidney injury considered as the primary pathway to mortality was rare, and amelioration of AKI to modify death was not well supported.
MeSH term(s)	Infant ; Child ; Female ; Infant, Newborn ; Male ; Humans ; Infant, Extremely Premature ; Retrospective Studies ; Critical Illness ; Cohort Studies ; Multiple Organ Failure ; Premature Birth ; Acute Kidney Injury/epidemiology ; Acute Kidney Injury/complications
Language	English
Publishing date	2022-12-01
Publishing country	United States
Document type	Journal Article
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2022.46327
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Article ; Online: NRBC concentrations over time in neonates with moderate to severe neonatal encephalopathy with and without sentinel events.

Gaulee, Pratima / Bliznyuk, Nikolay / Rajderkar, Dhanashree / Graham, Georgia / Sura, Livia / Harris, Jamie / Wynn, James L / Weiss, Michael D

Journal of perinatology : official journal of the California Perinatal Association

2024

Abstract: Objective: To study the serum concentrations of nucleated red blood cells (NRBC) over time in neonates with moderate to severe neonatal encephalopathy (NE).: Study design: A retrospective cohort study with subjects subdivided into three groups: ... ...

Abstract	Objective: To study the serum concentrations of nucleated red blood cells (NRBC) over time in neonates with moderate to severe neonatal encephalopathy (NE). Study design: A retrospective cohort study with subjects subdivided into three groups: definite sentinel events (n = 52), probable sentinel events (n = 20) and no history of sentinel events (n = 63). Peak absolute NRBC and NRBC/100 WBC were compared between groups and with MRI Injury score, cord and admission pH/base deficit. Results: Absolute NRBC peaked at 24.05 h after birth (CI: 15.30-32.79), 17.56 h after birth (CI: 7.35-27.77), and 39.81 h after birth (CI: 28.73-50.89) in each respective group. The peak in absolute NRBC correlated with the severity of injury in the grey matter in group 2 and white matter in groups 1 and 2. Higher peak absolute NRBC value correlated to a lower admission ABG pH. Conclusion: NRBC peak at 24 h after birth in neonates with sentinel events.
Language	English
Publishing date	2024-01-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	645021-0
ISSN	1476-5543 ; 0743-8346
ISSN (online)	1476-5543
ISSN	0743-8346
DOI	10.1038/s41372-024-01887-6
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Zs.A 2412: Show issues

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Article ; Online: Evaluation of the Neonatal Sequential Organ Failure Assessment and Mortality Risk in Neonates with Early-Onset Infection.

Yeo, Kee Thai / Goh, Guan Lin / Park, Woo Yeon / Wynn, James L / Aziz, Khyzer B

Neonatology

2023 Volume 120, Issue 6, Page(s) 796–800

Abstract: Background: The discriminative utility of the neonatal sequential organ failure assessment (nSOFA) for early-onset sepsis (EOS) mortality in the neonatal intensive care unit (NICU) is unknown.: Objectives: The objective of the study was to determine ... ...

Abstract	Background: The discriminative utility of the neonatal sequential organ failure assessment (nSOFA) for early-onset sepsis (EOS) mortality in the neonatal intensive care unit (NICU) is unknown. Objectives: The objective of the study was to determine the utility of nSOFA for EOS mortality. Methods: Multicenter, retrospective cohort study of NICU patients with EOS between 2012 and 2023. nSOFA scores of survivors and non-survivors were compared, and area under the receiver operating characteristics curve (AUROC) for mortality was calculated. Results: 104 subjects were identified (88 lived, 16 died). AUROC at blood culture collection (T0), 6 h after collection (T6), and the maximum nSOFA at T0 or T6 (T0-6max) were 0.76 (95% CI: 0.62, 0.91), 0.89 (0.80, 0.99), and 0.87 (0.77, 0.97), respectively. Analyses restricted to birthweight (<1.5, <1 kg) or gestational age (<32, <29 week) cutoffs revealed AUROC ranges of 0.86-0.92 for T6 and 0.82-0.84 for T0-6max. Conclusions: The nSOFA showed good-to-excellent discrimination of mortality among infants with EOS in the NICU.
MeSH term(s)	Humans ; Infant, Newborn ; Hospital Mortality ; Intensive Care Units, Neonatal ; Organ Dysfunction Scores ; Retrospective Studies ; Sepsis
Language	English
Publishing date	2023-09-27
Publishing country	Switzerland
Document type	Multicenter Study ; News
ZDB-ID	2266911-5
ISSN	1661-7819 ; 1661-7800
ISSN (online)	1661-7819
ISSN	1661-7800
DOI	10.1159/000533467
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Zs.A 391: Show issues

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