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Stefan Johansson

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    Sweden

Everything posted by Stefan Johansson

  1. Very interesting webinar organised by BAPM, 20 Dec 2:30 PM (GMT) More info here: https://www.bapm.org/events/reducing-the-rates-of-bronchopulmonary-dysplasia-bpd-a-new-bapm-toolkit
  2. Hi Natascha! We don't have a specific guideline but do allow siblings to visit, given they are well (no respiratory tract infections) and "old enough" as judged by parents. We have not seen (to my knowledge) RSV outbreaks or similar. No special hours. No formal age restriction. Same hygiene restrictions apply to all (staff, family etc), but once cleaned and disinfected, siblings can touch. In the early period (in incubator, lines, ventilatory support etc), we usually focus on the parents and avoid smaller children visiting but restrict to parents but once patients are in nursed in family rooms, we have a liberal view on siblings visiting. But they do not stay over night in the family room. My experience is that sibling visits are uncomplicated, usually the siblings are setting the boundaries themselves, and never stay long enough to cause any friction or problems for anyone
  3. We also add MCT as a fortifier to breast milk if growth is suboptimal
  4. I am very glad to share that the Society for Evidence-Based Neonatology (EBNEO) has started to share their great work also here at 99nicu. Find EBNEO's first post here, about hydrocortisone and BPD risk. We are very happy to help EBNEO promote the latest evidence, something that can really matter to our patients. In order to give EBNEO most visibility, there is now a new section in the "forum view", as indicated on the screen shot below. Naturally, those posts will also be promoted by us, as "Our picks", in our Newsletter and in our social media channels. @EBNEO many thanks for sharing your work here!
  5. We have a national guideline about this, you can find it on the link below. It is in Swedish, but I think Google translate can help Am on vacation in London (https://nicuverse.org/@stefanjohansson/111340868985434432 ) but let me know if you need help with specific info from it. https://neo.barnlakarforeningen.se/wp-content/uploads/sites/14/2017/12/Osteopeni-20-dec-2017-reviderad-slutversion.pdf
  6. Dear @Carlos Delgado, thanks for taking this initiative and starting a Club space for this large and important topic. Looking fw to see this develop and whenever you need, we within the 99nicu Team are here to facilitate from our "backoffice"
  7. This opinion article by Prof Hugo Lagercrantz, also editor-in-chief of @Acta Paediatrica , came on my radar. It is about how to approach infants born at the viability limit (i.e. 22 weeks). The article is in Swedish, but Google translate may help of you are interested to read through. https://www.svd.se/a/mQ929l/hugo-lagercrantz-hur-pass-tidigt-fodda-ska-vi-forsoka-radda Prof Lagercrantz's takehomes are: NICU care and post-NICU care of these infants requires a national strategy in addition to health care providers (doctors specifically!), philosophers, theologists, paralegals and brain researchers should contribute in writing such a national strategy I would like to add, parents should also be included in such a process! As of now in Sweden, we have a national guideline from 2016 about referral to university hospitals from 22+0 and onwards. I would argue this document is a good start, but it lacks several aspects, for example when/how to withhold or withdraw care. This document is currently being revised, hope it will be communicating a wider approach to this difficult question. Would be great to learn how you base decision at the border of viability? Who decides what and when?
  8. @Francesco Cardona lets discuss and decide something around both ideas
  9. My thoughts goes like this, that not much will change. If I may make an analogy to politics: I foresee few people shifting between the Probiotics Positive Party and the Probiotics Sceptics Party. So, the positive ones will keep being positive (thanks to strong arguments from key stakeholders), while the sceptic ones will feel they get new fuel for their position.
  10. The 99nicu.org web site is built on the Invision Power Board software. In the next version (v5) there will be a major overhaul of the user interface, allowing for an even better way of presenting and browsing content here. You can get a sneak preview in the video below (a bit techy, but still )
  11. The reason for the unusual strategy in Sweden, to give probiotics to infants at 28-31 weeks and not <28 weeks, is because the national nutrition group argued the evidence for infants <28 weeks was insufficient. The result of this discussion was to recommend in the very preterm population (28-31 weeks) and make a full-scale RCT in extremely preterm infants (<28 weeks), the PEPS trial, see link below. It is currently running and hope to present results in a few years time. The plan is ambitious, to randomise 1600 infants <28 weeks, so it might take longer. https://clinicaltrials.gov/study/NCT05604846
  12. I just wanted to share a few short words as a welcome to you who have become a Society Member. Thanks so much for joining and we in the "99nicu Team" are looking forward to engage you in discussions how the 99nicu Society can develop in the future. Ciao for now and see you around!
  13. I don’t need to expand on how Internet and social media have shifted the paradigm for professional discussion. You know this! Painful it is, but I wanted to share that I have decided to close my Twitter/X account. I will miss you tweeps. But... see you soon elsewhere! I started to build a network on Twitter in 2009, exploring this new channel for communication about research and medicine. Twitter was different then, compared to what X has become. In the earlier years, Twitter impersonated open, high-level and cross-professional discussions. Despite different opinions shared, the feed was a friendly gathering. If you posted something seemingly controversial (or something not at all controversial about Covid-19, liberal democracy values, suffering among immigrants, or aggressive warfare), people commented in a respectful manner. You did not get a load of automated bot replies (from "verified accounts" with like ~10 followers) telling you were a moron and should XYZ! Importantly, #NeoTwitter, #NeoEBM and #foamneo all grew into valuable resources. I am so grateful for connecting with you and other wonderful people there. It has indeed enriched my professional life, and often made me think twice. With X and the new leadership by Musk et al (btw, is there even an “al”?), I have simply taken the consequence of not compromising with my values. That’s why I will delete my X account soon, after saying good bye to comrades there. The principal reason is that I don’t want to contribute to a communication platform where hate speech, conspiracy theories, and fake news is given this much space. The world of today is complicated enough as it is. Although my own feed is still pretty OK, I feel that sharing a communication platform with the “dark side” (and don’t underestimate the force of it), implies that my presence there, as a person and as a professional, legitimate the bad stuff. In fact, this might even be an intentional business strategy of the X management team. There is certainly some “alternative cost” to rebuild a neonatal network on a new platform. But I am fine with that. For myself, this is a step worth taking to get rid off the feeling that I am also, to some symbolic extent, feeding the trolls on X. For the time being, I will stick to LinkedIn, while hoping to rebuild a network feed on our NICUVERSE Mastodon-server and/or on Bluesky. So, might see you there And of course, maybe the future holds a renaissance for 99nicu.org with its older-school web site-based discussions. Please note that this is a personal decision and about my own Tw/X account. However, within the 99nicu Team, we are also discussing an X-it strategy, but we need to make sure we have the organization's best interest in mind. And, with our upcoming conference, we may choose to keep the 99nicu account up and running to for sharing the word about our conference plans. After all, #NeoTwitter is still a great place for reaching out. Thanks to the Verge for making the graphics illustrating this post
  14. We can now proudly present 99nicu Society, a fully registered non-profit society. This is indeed a milestone. We have now a structural platform for the long-term development of 99nicu as a global community for NICU health care providers. If you share our vision and mission, we invite you to become a member of the 99nicu Society by upgrading your regular website membership. To do this, simply log in and make the change in your dashboard. When we launched this web community back in 2006, our focus was on creating a space for NICU staff to connect and discuss relevant topics. These were the days before social media as we know them today, and like-minded geeky people gathered in Bulletin Boards on the Internet for “sharing and caring”, because “information wants to be free”. (Those were indeed the days!) Our first logo was... not too bad I was a part of a Mac computer community called 99mac, which provided an excellent online space. It struck me that NICU staff should have a similar platform. As a young specialist at the time, I wanted to network more efficiently than traditional conferences allowed, especially considering the demanding shifts we worked. The internet seemed like the perfect place for this endeavor. Since 2006, 99nicu has gone through various development phases, from the early “just do it”-years, to some more quiet periods, leading up to today’s setup with a full-fledged website, our well-regarded Future of Neonatal Care conferences, popular webinars, and a strong presence on social media, including our latest NICUVERSE project on Mastodon. From the beginning and until this change, 99nicu.org was practically my personal property. Since some time, I felt that we need to secure the long-term future of 99nicu, and together with the @Francesco Cardona, @Vicky Payne, @piatkat, and @Gustaf Lernfelt, we set forth exploring options to establish 99nicu a “legal entity”. The most straightforward solution was to tax-register 99nicu.org as a non-profit organization with the Swedish Tax Authority (Swe. Ideell förening). I am very happy that we have now completed this process, marking a significant milestone in the 99nicu’s history. While we will continue to offer regular and free website memberships, we are now introducing the option to join the "99nicu Society" for 10 EUR per year. What does this change mean? In essence, non-profit organisations in Sweden are membership-based and some simple rules apply. Anyone shall be able to sign up as a member, given compliance to the organisation’s by-laws stipulating some formal points (attached). The organisation shall be managed by a Board elected by the members at an Annual Meeting. The financials need to be reported in a simple form on a yearly basis. In the spring every year, all Society members will be invited to gather at a virtual Annual Meeting, to go through some formalities, including election of the Executive Board acting on behalf of the Society members. For this Founding year, the 99nicu Board will consist of myself (chairman), @Vicky Payne (secretary), @Gustaf Lernfelt (treasurer), and @Francesco Cardona and @piatkat (board members). In practice, our current web community remains unchanged. Memberships continue to be open and free for anyone connected to the NICU context. The new option is to become a 99nicu Society member for 10 EUR, with memberships requiring annual renewal (365 days from registration). You can become a member by upgrading through your User Dashboard (click here). You may wonder why there is a fee of 10 EUR per year and what benefits come with Society Membership. Simply put, we need financial support to run this show. As the saying goes, "there's no such thing as a free lunch." By becoming a member, you declare your support for our vision and mission through 99nicu.org and can actively participate in shaping our future. Society members will gain access to a dedicated Members Club for internal communication. We also aspire to offer enticing benefits in the future, including educational activities and discounted conferences, among other opportunities. The specifics will be hashed out collaboratively with you, our valued members. I am personally very happy about this step, that 99nicu has become a properly registered non-profit organisation. Over the years, founding 99nicu has changed my professional life as a neonatal health care provider, and I feel privileged to have connected here with such a vast network of like-minded people since we opened the first version of the website in 2006. However, as time marches on, it becomes essential to plan for succession, as is the natural order of things. Apologies for this lengthy post, now I must go and contemplate the mysteries of the universe... (Just kidding!)
  15. https://x.com/plusstrial/status/1635407575142535168?s=46&t=rFToyvjB8iSdl3KsHgh2rA Hmm, forgot that embedding no longer works w twitter/X. Anyway, the surfsup trial is done and should be reporting results soon. I have no experience but the smaller studies were promising.
  16. This paper came on my radar, UK data on 83.000 very preterm infants born 2010 to 2020, and their mortality and respiratory outcomes. The short version is that mortality decreased from 10.1% to 8.5% while severe BPD increased from 12% to 17%. The composite of death/severe BPD changed from 21% to 24%. Also postdischarge respiratory support increased between 2010 and 2020, from 13% to 17%. The authors write in their conclusion that "these survivors will develop chronic respiratory diseases requiring greater healthcare resources." What's your thoughts in this paper? What shall we do?! Find the full-text paper here: https://thorax.bmj.com/content/early/2023/08/28/thorax-2023-220174
  17. Do you mean a context where no regular apnea monitors are available, like a low/middle-income context?
  18. The 2023 Neonatal Nutrition Network Study Day is coming up for the 27th of September 2023, the first F2F meeting after the pandemic. The meeting will be held in a hybrid format therefore remote access is also available. The venue will be at the UCLH Educational Centre and you will find attached here the more detailed flyer for the meeting. Overall, the programme has a range of great topics plus workshops and networking opportunities. Registration is now open and Early Bird cut off date has been extended to 14th August 2023. Registration closes on the 24th September 2023. Please note that the virtual registrations gives only access to lectures-not the workshops. Here is the link for the event page and registration: http://training.ucheducationcentre.org/home/viewcourse/723/ 9th N3 Study Day 27092023.pdf
  19. I found this more extensive writeup about methergine in LactMed, but otherwise nothing more substantial info Interesting how unpublished case reports (to the manufacturer) can have such impact. https://www.ncbi.nlm.nih.gov/books/NBK501342/
  20. @Gustaf Lernfelt missed that in the nicuverse, thanks for sharing the link! And thanks @Jose Ramon Fernandez for sharing the info!
  21. Since Tw embedding no longer works... I copy and paste the following from the user Laura Miers “The WHO confirmed at least 26 infants in Croatia, France, Italy, Spain, Sweden & the UK had been infected with a rare type of enterovirus, called echovirus-11. Eight of those babies died, with most deaths in France following organ failure & sepsis.” Read more on this WHO link: https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON474 and here frmo NBC News: https://www.nbcnews.com/health/health-news/virus-infection-newborns-doctors-warn-summer-illness-rcna92382
  22. 📢 Exciting news! We are thrilled to announce the 4th "Future of Neonatal Care" conference, AKA #99nicuMeetup, a collaboration between 99nicu and the esteemed Portuguese Neonatal Society. 🌟 Join us on 03-06 of April 2024 in Lisbon, Portugal, as we explore evidence-based practices, cutting-edge research, and practical insights to enhance newborn care worldwide. 📅 Save the date and be part of this incredible opportunity to network, learn, and shape the future of neonatal care. Stay tuned for updates and browse https://99nicu.org/meetup2024/
  23. Hi @Rao , do you mean as a test for congenital hypothyroidism?

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