Browsing by Author "Tapia, Jose L."
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- ItemEnteral Feeding and Necrotizing Enterocolitis: Does Time of First Feeds and Rate of Advancement Matter?(LIPPINCOTT WILLIAMS & WILKINS, 2021) Masoli, Daniela; Domínguez De Landa, María Angélica; Tapia, Jose L.; Uauy, Ricardo; Fabres, Jorge; NEOCOSUR Collaborative NetworkThe aim of the study was to determine if time to initial enteral feeding (EF) and rate of advancement are associated with necrotizing enterocolitis (NEC) or death. Methods: Secondary analysis of prospectively collected data of very-low-birth-weight infants (VLBWI: 400--1500 g) born in 26 NEOCOSUR centers between 2000 and 2014. Results: Among 12,387 VLBWI, 83.7% survived without NEC, 6.6% developed NEC and survived, and 9.6% had NEC and died or died without NEC (NEC/death). After risk adjustment, time to initial EF (median = 2 days) was not associated with NEC; however, delaying it was protective for NEC/death (odds ratio [OR] = 0.96; 95% confidence interval [CI] 0.93--0.99). A slower feeding advancement rate (FAR) was protective for NEC (OR = 0.97; 95% CI = 0.94-0.98) and for NEC/death (OR = 0.98; 95% CI = 0.96-0.99). Conclusions: In VLBWI, there was no association between an early initial EF and NEC, although delaying it was associated with less NEC/death. A slower FAR was associated with lower risk of both outcomes.
- ItemGrowth of Very Low Birth Weight Infants Who Received a Liquid Human Milk Fortifier: A Randomized, Controlled Multicenter Trial(2022) Masoli, Daniela; Mena, Patricia; Domínguez, Angélica; Ramolfo, Pamela; Vernal, Patricia; Pantoja, Miguel Angel; Esparza, Ruth; Hübner, Maria Eugenia; Ríos, Antonio; Faunes, Miriam; Uauy, Ricardo; Tapia, Jose L.; Neocosur NetworkObjectives: To evaluate growth (weight, length, head circumference, and knee–heel length [KHL]) in very low birth weight (VLBW) infants (500–1500 g) who received human milk with a liquid fortifier (LHMF) with high protein and fatty acid content versus a traditional powder fortifier (PHMF) for 45 days or until discharge. Methods: This was a multicenter, randomized, controlled trial. An intention-to-treat analysis was performed to determine adverse events and withdrawal causes. We also performed an efficacy analysis involving the infants who completed at least 2 weeks of study. Results: Of the 158 infants enrolled in the study, 146 completed at least 2 weeks, and 125 completed the entire study. The biodemographic characteristics were similar between groups, with no differences in increments of weight (22.9 vs 22.7 g kg−1 day−1), length (1.03 vs 1.09 cm/week), head circumference (0.91 vs 0.90 cm/week), or KHL (3.6 vs 3.3 mm/week). The KHL increment was greater in infants weighing >1 kg receiving LHMF (3.7 vs 3.2 mm/week, P = 0.027). Although there were no significant differences in serious adverse events, the incidence difference of the composite outcome death/necrotizing enterocolitis between groups warrants attention (1.3% with LHMF and 8.1% with PHMF). Conclusion: There were no differences in the overall growth between VLBW infants receiving either fortifier.
- ItemRandomized Trial of Early Bubble Continuous Positive Airway Pressure for Very Low Birth Weight Infants(MOSBY-ELSEVIER, 2012) Tapia, Jose L.; Urzua, Soledad; Bancalari, Aldo; Meritano, Javier; Torres, Gabriela; Fabres, Jorge; Toro, Claudia A.; Rivera, Fabiola; Cespedes, Elizabeth; Burgos, Jaime F.; Mariani, Gonzalo; Roldan, Liliana; Silvera, Fernando; Gonzalez, Agustina; Dominguez, Angelica; S Amer Neocosur NetworkObjective To determine whether very low birth weight infants (VLBWIs), initially supported with continuous positive airway pressure (CPAP) and then selectively treated with the INSURE (intubation, surfactant, and extubation to CPAP; CPAP/INSURE) protocol, need less mechanical ventilation than those supported with supplemental oxygen, surfactant, and mechanical ventilation if required (Oxygen/mechanical ventilation [MV]).
- ItemSingle vs. double phototherapy in the treatment of full-term newborns with nonhemolytic hyperbilirubinemia(SOC BRASIL PEDIATRIA, 2009) Silva, Ignacia; Luco, Matias; Tapia, Jose L.; Eugenia Perez, Maria; Antonio Salinas, Jose; Flores, Javiera; Villaroel, LuisObjectives: To compare the effectiveness of single (1 panel) vs. double (2 panels) phototherapy in reducing nonhemolytic hyperbilirubinemia in term newborns.
- ItemStroke Patterns in Neonatal Group B Streptococcal Meningitis(ELSEVIER SCIENCE INC, 2011) Hernandez, Marta I.; Sandoval, Carmen C.; Tapia, Jose L.; Mesa, Tomas; Escobar, Raul; Huete, Isidro; Wei, Xing Chang; Kirton, AdamNeonatal group B streptococcus meningitis causes neurologic morbidity and mortality. Cerebrovascular involvement is a common, poorly studied, and potentially modifiable pathologic process. We hypothesized that imaging patterns of focal brain infarction are recognizable in neonatal group B streptococcal meningitis. A consecutive case series included term neonates with the following: (1) bacterial meningitis, (2) acute group B streptococcal infection (positive cerebrospinal fluid/blood culture), (3) brain magnetic resonance imaging within 14 days, and (4) acute intraparenchymal focal infarctions (restricted diffusion). Lesions within known arterial territories were classified as arterial ischemic stroke. Clinical presentations, investigations, and neurologic outcomes were recorded. Eight newborns (50% female) with focal infarction were identified. Five presented early (<1 week), and all manifested clinical shock and elevated acute-phase reactants. Less than 50% had prenatal group B streptococcal screening, while 2 of 3 screened were negative. Two distinct patterns of focal infarction were identified: (1) deep perforator arterial stroke to basal ganglia, thalamus, and peri ventricular white matter (7/8, 88%), and (2) superficial injury with patchy, focal infarctions of the cortical surface (6/8, 75%). Outcomes (mean 23.8 months) were poor, with severe disability or death in 6/8 (75%). Recognizable stroke patterns contribute to severe neurologic outcomes and represent a potentially modifiable pathophysiologic process in neonatal group B streptococcal meningitis. (C) 2011 Elsevier Inc. All rights reserved.