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  • Blog Entries

    • By Stefan Johansson in Department of Brilliant Ideas
         0
      The Dept of Brilliant Ideas proudly presents this 90 sec video about Neobiomics and the vision and mission of ProPrems®.
      I am grateful and also proud that what the network of people around Neobiomics has achieved.
      It has been a journey and now is the time to "arrive" at the point we headed for.
      If you want more info - send me a DM or email stefan@neobiomics.eu.
      Please note that we only deliver ProPrems® in Europe.
       
    • By Stefan Johansson in Department of Brilliant Ideas
         0
      The new buzz word in health care is “innovation”. Which is a good thing! 
      I have been in the ecosystem of innovation since 2016 with the startup company Neobiomics and the ProPrems® product, in the Innovation Incubator at Karolinska Institutet (KI DRIVE). There we meet with other startup companies, and we share several of the challenges of operating in the interface between innovation and “traditional” health care.
      Here's a few thoughts.
      Innovation can only benefit patients through implementation
      For innovations to reach out and bring value, implementation is key. No matter how brilliant an idea, it needs to be brought to life in an open-minded culture, where learning and change are core values. Health care can be conservative and resistive to change, and that may slow down, discourage or even hinder implementation.
      Eminence-based medicine vs evidence-based medicine
      I am a strong advocate of evidence-based medicine myself, but health care is still influenced a fair bit by “eminence-based medicine”. High-profile people may tell how they “feel” or “believe”. While feelings and beliefs are essential parts of the human nature, they are (IMHO) insufficient arguments in discussions about evidence. Innovations backed by evidence may not “feel right” if they change current practice. But we need to trust data, or else there is little point of doing research.
      (Too?) many stakeholders
      Health care is a complex structure, with a lot of stakeholders. While patients are more empowered now than ever before, there are a lot of “layers” between an innovation and a patient. Implementation involves staff, informal leaders, heads of departments, pharmacies, management teams, professional bodies, policymakers etc. As a consequence, implementation takes time. It can take more time than patients should need to tolerate.
      What to do?
      To take words to action, health care needs to embrace a culture of learning and change, or else “innovation” will be no more than a buzz word Research data is a valid starting point for change Innovators travel with light luggage, and need a complementary decision-making process in health care, not to delay the benefits and value that innovation bring patients With best regards from the Department of Brilliant Ideas
    • By AllThingsNeonatal in All Things Neonatal
         0
      The Ortolani and Barlow manouvers are probably the two most requested parts of the physical exam that students ask to be shown. We line up several medical students who take turns applying the steps of abduction and then adduction, testing the stability of the hips. We routinely give oral sucrose, position in kangaroo care or breastfeed while performing other noxious stimuli such as heel lancing but at least in my centre give nothing for manipulating the hips in such a fashion.
      How can we determine if a newborn feels pain?
      In a recent paper entitled Neurophysiological and behavioral measures of pain during neonatal hip examination by Pettersson M et al they used three methods to assess pain during the newborn hip exam. These were the Premature Infant Pain Profile‐Revised (PIPP‐R) scale which is generally used for such assessment as well as two relatively novel ways in the use of near‐infrared spectroscopy (NIRS) and galvanic skin response (GSR). In essence if the a region of the brain becomes more active during a painful experience more oxygen will be extracted during that time. By using auscultation of heart rate with a stethoscope as a control procedure which should not elicit pain the authors were able to compare in a controlled fashion 28 newborns undergoing both activities. The use of NIRS was previously demonstrated as valid in the paper Pain activates cortical areas in the preterm newborn brain. Galvanic skin response has also been demonstrated to correlate with pain and measures changes in skin conductance in the paper Skin conductance compared to a combined behavioural and physiological pain measure in newborn infants.
      So the authors set out to compare findings in these 28 infants and standardized the study as much as they could by having one Neonatologist perform all hip exams and having a video recording of the infant’s face during the procedure assessed by two independent reviewers in order to assign the PIPP-R scores. While not a randomized trial, for the type of intervention being studied this was the right approach to take to determine the answer to their question.
      The Findings
      Interesting findings indeed. Statistically significant differences were noted in bilateral changes in oxygen extraction during hip examination as well as for the GSR small peaks. The PIPP-R scores as well were vastly different between the two groups suggesting that the areas of the brain responsible for perception of pain were indeed activated more so with manipulation of the hip than with auscultation of the heart.
      What can we take from this?
      The hip exam may elicit responses indicating pain but there remains the question of how much is actually elicited. Nonetheless, the authors findings are intriguing as they certainly challenge the notion that this is a quick exam that should be just done and gotten over with. Clearly bundling or Kangaroo Care are not an option here due to the nature of what is being done. The next time you are planning on doing such tests though should you at least consider non-nutritive sucking on a pacifier or sucrose solution if readily available? If not readily available then should it be?
    • By Jelli KA in Bubbly Girl in NICU
         2
      After watching a documentary in ARTE about bacteriophages it made me think about how else is antibiotic resistance in NICU.? It available french / German
      Here the story phages was told. First discovered use by  Felix Derrel to combat infections in the pre-antibiotics era and was later discredited and forget about in the western world
      Historically they worked rather well, so there is an attempt to bring them back in the light of increasing antibiotics resistance.
      This rediscovery started  with lab study that showed  that the phages were effective at clearing infection in rats population sample.
      Phagoburn
      Recently, a French team took it to human and show it feasible despite the many challenges.  This study was a RCT which a specific process approval and protocols were established. The aim in *Phagoburn*was to see if phages could be useful using to fight infection in burn victims. It was lead by Dr. Patrick Jault and large team .Jerôme Gabbard head Start up tells Pherecydes provided the synthesis of phages.
      control got standard treatment {silver salts +antiobiotics}  and othe got phages.This got published in nature. The was a reduction in the infection rate in phage group, a  loading dosing issue among other practical things.
         Researchers in france say that there a scaling issue to produce larger amounts, as well a regulatory framework. From bioethical point of view it is possible, a more detail informed consent will be necessary.These days research still going a la Croix de Lion Hospital, France. University Hospital ~CHU Lyon~.
      ( initial used - discovered @pasteur Institute)
      https://www.arte.tv/fr/videos/078693-000-A/l-incroyable-histoire-des-tueurs-de-bacteries/
      Thus what do think any future of phage in NICU?
  • Upcoming Events

    • 19 March 2020
      0  
      Stockholm Conference on Ultra-Early Intervention is a scientific conference on Infant and Family Centered Developmental Care (IFCDC) organized by Karolinska NIDCAP Training and Research Center.
      In 2020, the 11th conference is scheduled for 19 March 2020.
      Check out the web site: https://www.karolinska.se/ultraearly

      the-2020-stockholm-conference-on-ultra-early-intervention_191120.pdf
    • 15 April 2020 Until 19 April 2020
      0  
      Welcome to Vienna and the 4th Future of Neonatal Care conference AKA the 99nicu Meetup!
      Find all info here: https://99nicu.org/meetup/ 
    • 26 April 2020 Until 28 April 2020
      0  
      First announcement of 
      Recent advances in neonatal medicine
      IXth International symposium honoring prof. Richard B. Johnston, MD, Denver, US
      26-28 April 2020, in Würzburg, Germany
      Find more information in the attached folder.
      First_Announcement_01.2020.pdf
    • 25 June 2020 Until 26 June 2020
      0  
      Visit Conference website: http://www.lutonneocon.co.uk
    • 17 November 2020
      1  
      The 17th of November each year is the World Prematurity Day. Originally started by parent organisations in Europe in 2008, the World Prematurity Day is an international event aiming at high-lighting the ~15 million infants born preterm each year.
      Read more about this day on the March of Dimes web site, and on Facebook.
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