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abeluchin

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abeluchin last won the day on November 26 2017

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About abeluchin

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  • First name
    abel
  • Last name
    guerra
  • Occupation
    Neonatology Fellow
  • Affiliation
    WHMC
  • Location
    San Antonio, TX

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  1. Hi colleagues, In the past few years the assessment of growth in the newborn has been updated significantly. In the US, we use Fenton for preterm < 35weeks, CDC and WHO for late-preterm and term babies. I have . WHO for uses growth charts for 0-24 months and does not consider GA at birth, , so babies could easily be over-classified by SGA, or LGA if GA at birth is not used. For example: using medcal interactive growth charts (CDC-based); a newly born male at 37weeks who weight 2600grams is classify as AGA between 25th and 50th%tile. A baby with same BW, but with a GA at birth of 41 wee
  2. I just had a LGA term baby born through shoulder dystocia; noted with respiratory distress shortly after birth. Placed on HFNC, need ~35% FiO2 on 2 LPM. Xray with right hemidiapragm elevation. Question: How long is prudent to wait for surgical intervention in these babies? Thanks
  3. Thanks to you all for your response. The baby was transfered for neuro eval and expectant management was carried out.
  4. Dr. Vijayashankara, would you please, explain a bit more why your practice was change from multiple to a single dose of surfactant? Thanks
  5. It has recently been brought to my attention that the suture of the pedunculated vestigial digit in post-axial polydactilly has been associated with development of painful neuroma over time! I have always ligated these vestigial non-bonny digits and have them follow up with their PCP.Here is some of the articles: Pediatr Dermatol. 2010 Jan-Feb;27(1):39-42. doi: 10.1111/j.1525-1470.2009.01071.x. A selective approach to treatment of ulnar polydactyly: preventing painful neuroma and incomplete excision. Mullick S1, Borschel GH. Pediatr Dermatol. 2009 Jan-Feb;26(1):100-2. doi: 10.1111/j.152
  6. Hi, I recently care of a couple of 34 weeks Mono-Di twin male infants, one of them with a Hct of 37% and the other 47%. The BW was very similar in both twins at 1890g and 1900g and no h/o olygo was recorded in any of them. I ordered a retic count in the anemic boy, as well as a CUS and a KB test on the mother. KB test was reported as 0.15; with an estimated of fetal blood loss of 12ml. Retic count was 16% and came down nicely over three days to 8%. Hct remained stable in the low 30%. Both kids were asymptomatic since birth and are feeding and growing well. Questions: is this presentati
  7. What is your experience with this condition and performing frenotomy? Thanks
  8. I would love to hear your local practice in regards to repeated doses of surfactant in neonates with respiratory distress? The study publish by Soll in cochrane showed benefits of multiple vs single dose, but the RCT were done in the 90's when gentle ventilation and antenatal steroids were not standard in the NICU! What do Neos across the world do in this regard? If you do repeat the treatment, what is your criteria? GA, time after birth, degree of respiratory distress or respiratory modality? Thanks for you feedback on this interesting topic. I am a neo neo trained in the post surfactant
  9. Hi colleagues, I had the pleasure recently to manage a premature infant (30wks EGA), who was born by precipitously vaginal delivery after mother arriving at the hospital with abdominal pain and vaginal bleeding, (later confirmed to be placental abruption). Good prenatal care, GBS positive in mother's urine 3wks PTD. The female infant was born lifeless, required PPV and chest compression by the bedside nurse and was intubated quickly when the neonatology arrived at the bedside at 2 MOL. Apgars 1,3 and 7. Infant was brought to the NICU placed on CMV initially at 20/5, then increased to 25/5, R
  10. Hi colleagues, We use PICC in the NICU all the times and seldon have complications. There several emntioned complication from PICC lines, particularly the malpositioned ones. PICC lines at times, as you all know are critical in the management of preemies and it is very improtant to understand risk and benfits of keeping a line when it is placed. I recently seen a couple of radiology report requesting to remove PICC lines because project into the liver. I though understand that the hepatic vein are very difficult to catheterize with a PICC line (as opposed to umbilical catheter), especially o
  11. Hi coleagues, I recently came across to a baby in the newborn nursery with what appears clinically as a subgaleal hemorrage (SH). The infant was born at term 2800gram BW, required internal cephalic eversion x3, but no vaccum or forcepts were used. Initial exam was normal except for some scalp bruises. At ~ 8HOl, a significant scalp swelling was noted, concerning for SH( given the boggy sentation of palpation and that is covered all the occiput bilaterally), serial exam showed no significant progression of the swelling, and no extension into the neck. Head Circumsference initially was 33cm and
  12. Thanks. Any one depicting weight/HC by GA?
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