hehady

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Dear Colleagues May I invite you to the The 2nd International Neonatology Conference NEONATAL INFECTIONS: Where we stand ? organised by the Neonatal Care Unit, Mansoura University Children's Hospital In collaboration with Egyptian Association of Neonatology (EAN) & Egyptian Society for Neonatal and Preterm Care (ESNPC). 2nd-4th April 2009 Renaissance Hotel Alexandria – Egypt This year we will have 4 distinguished International speakers: Professor David Woods ( South Africa ) Professor Hany Aly (Washington DC, USA ) Professor Martin Skidmore (Toronto, Canada ) Professor Christian P. Speer (Germany ) The main topics will be: Neonatal sepsis : Egyptian Data. Congenital and perinatal infections. Infection control measures in the NICU. Emerging resistant pathogens. Procedure related infections. Neonatal Candidemia. Conference web site: WWW. nicu2009.com Address: El-Gomhorya St. El-Mansoura Mansoura University Children's Hospital Neonatal Intensive Care Unit Tel : +20 50 2238670 Fax : :+20 50 2234092 Email : Nicu_much@hotmail.com Khashabamohamed@hotmail.com International Conferences Company Address: 21 Dr.Mohamed Mandor st.,Nasr City, Cairo, Egypt. Zip Code: 11371 Tel : + (202) 24017326 , + (202) 24017327, + (202) 24021782 Fax: + (202) 24022796 Mobile : + (2) 010 666 11 72, + (2) 010 67 26 118, + (2) 010 606 77 88 + (2) 012 31 444 54 E-Mail: egyicc@link.net

Q1. Two weeks for BSI; longer courses for meningitis and arthritis Q2. 10 days Q3. We use CRP as a guidance, we rarely look at clearance of bacteria from follow up blood cultures.

Please read this article and then answer my questrions: Should we administer antenatal steroids to mothers preganat 34-37 weeks planned for elective CS? Bastek JA, Sammel MD, Paré E, Srinivas SK, Posencheg MA, Elovitz MA. Adverse neonatal outcomes: examining the risks between preterm, late preterm, and term infants. Am J Obstet Gynecol. 2008 Oct;199(4):367.e1-8.

A recent CT published in Pediatrics. 2008 Oct;122(4):693-700, demonstrated the efficacy of oral probiotics in prevention of NEC. Oral probiotics prevent necrotizing enterocolitis in very low birth weight preterm infants: a multicenter, randomized, controlled trial. Lin HC, Hsu CH, Chen HL, Chung MY, Hsu JF, Lien RI, Tsao LY, Chen CH, Su BH. OBJECTIVE: The goal was to investigate the efficacy of orally administered probiotics in preventing necrotizing enterocolitis for very low birth weight preterm infants. METHODS: A prospective, blinded, randomized, multicenter controlled trial was conducted at 7 NICUs in Taiwan, to evaluate the beneficial effects of probiotics in necrotizing enterocolitis among very low birth weight infants (birth weight: <1500 g). Very low birth weight infants who survived to start enteral feeding were eligible and were assigned randomly to 2 groups after parental informed consent was obtained. Infants in the study group were given Bifidobacterium bifidum and Lactobacillus acidophilus, added to breast milk or mixed feeding (breast milk and formula), twice daily for 6 weeks. Infants in the control group were fed with breast milk or mixed feeding. The clinicians caring for the infants were blinded to the group assignment. The primary outcome measurement was death or necrotizing enterocolitis (Bell's stage >or=2). RESULTS: Four hundred thirty-four infants were enrolled, 217 in the study group and 217 in the control group. The incidence of death or necrotizing enterocolitis (stage >or=2) was significantly lower in the study group (4 of 217 infants vs 20 of 217 infants). The incidence of necrotizing enterocolitis (stage >or=2) was lower in the study group, compared with the control group (4 of 217 infants vs 14 of 217 infants). No adverse effect, such as sepsis, flatulence, or diarrhea, was noted. CONCLUSION: Probiotics, in the form of Bifidobacterium and Lactobacillus, fed enterally to very low birth weight preterm infants for 6 weeks reduced the incidence of death or necrotizing enterocolitis.

Background In 1988, the World Health Assembly resolved to eradicate poliomyelitis. Although substantial progress toward this goal has been made, eradication remains elusive. In 2004, the World Health Organization called for the development of a potentially more immunogenic monovalent type 1 oral poliovirus vaccine. Methods We conducted a trial in Egypt to compare the immunogenicity of a newly licensed monovalent type 1 oral poliovirus vaccine with that of a trivalent oral poliovirus vaccine. Subjects were randomly assigned to receive one dose of monovalent type 1 oral poliovirus vaccine or trivalent oral poliovirus vaccine at birth. Thirty days after birth, a single challenge dose of monovalent type 1 oral poliovirus vaccine was administered in all subjects. Shedding of serotype 1 poliovirus was assessed through day 60. Results A total of 530 subjects were enrolled, and 421 fulfilled the study requirements. Thirty days after the study vaccines were administered, the rate of seroconversion to type 1 poliovirus was 55.4% in the monovalent-vaccine group, as compared with 32.1% in the trivalent-vaccine group (P<0.001). Among those with a high reciprocal titer of maternally derived antibodies against type 1 poliovirus (>64), 46.0% of the subjects in the monovalent-vaccine group underwent seroconversion, as compared with 21.3% in the trivalent-vaccine group (P<0.001). Seven days after administration of the challenge dose of monovalent type 1 vaccine, a significantly lower proportion of subjects in the monovalent-vaccine group than in the trivalent-vaccine group excreted type 1 poliovirus (25.9% vs. 41.5%, P = 0.001). None of the serious adverse events reported were attributed to the trial interventions. Conclusions When given at birth, monovalent type 1 oral poliovirus vaccine is superior to trivalent oral poliovirus vaccine in inducing humoral antibodies against type 1 poliovirus, overcoming high preexisting levels of maternally derived antibodies, and increasing the resistance to excretion of type 1 poliovirus after administration of a challenge dose. (Current Controlled Trials number, ISRCTN76316509.)

Still we have limited number of seats: Topics will include: New Mechanical Ventilation Modes High Frequency Ventilation CPAP Update Hands on Respiratory support techniques (Conventional Ventilators-CPAP-HFO) Surfactant replacement therapy Neonatal Pain management Hands on surfactant administration and ICT insertion Case Scenarios on Mechanical Ventilation Clinical Rounds in the NICU Total Parenteral Nutrition (Indications, Components, preparation and Complications) Neonatal Transport Case Scenarios on TPN Hands on Vascular access (PICC and UVC) Common cardiac problems in newborn Neonatal X ray interpretation Head US in newborn Brain CT and MRI Common surgical problems in newborn Amplitude integrated EEG Hearing screening Hands on Training on a EEG and Auditory Evoked Potentials

I P O K R a T E S Clinical Seminar Perspectives and Advances in Maternal and Neonatal Nutrition and Neonatal Gastroenterology This seminar deals with the understanding and management of gastro-intestinal disorders and nutritional care problems,mainly in prematures. LECTURERS Alasmi M King Faisal Specialist Hospital & Research Center, Riyadh, KSA Hay W University of Colorado Health Sciences Center, Denver, Colorado, USA Neu J University of Florida College of Medicine, Gainesville, Florida, USA Schanler R Schneider Children’s Hospital at North Shore, New York, USA Upperman J Children's Hospital Los Angeles, Univ. of South California, Los Angeles, USA COORDINATION EGYPT Samy, Gamal; Badrawi,Nadia; Taman, Khaled; Bashir, Moataz TARGET GROUPS Affiliates of university and non-universitarian hospitals in neonatology, pediatrics, nutrition, surgery and related fields LOCAL ORGANIZER / Prof. Khaled Taman MD, Ph.D REGISTRATION 31 El Nozha Street – Rabaa El Estethmary Buldings – Nasr City, Cairo 11371, Egypt Office Phone: (002) 02 24718737, Mobile : (002) 010 1404410, e-mail: ktaman2000@yahoo.co.uk INFORMATION/REGISTRATION IPOKRaTES Head Office c/o m:con GmbH • Rosengartenplatz 2 • D-68161 Mannheim Phone +49 (0)621 / 4106-134 • Fax +49 (0)621 / 4106-80134 E-mail: ipokrates@mcon-mannheim.de • internet: http://www.ipokrates.info PARTICIPATION FEES Single person Registration € 100 from Egypt Single person Registration € 150 from other countries This fees for attending scientific sessions, printed materials and certificate of attendance. Another € 80 for running coffee breaks and 3 days open buffee lunch. DATE December 17-19, 2008; starts 08:30 am PLACE Triumph Hotel & conference center, El Khalifa El Maamoun St. Heliopolis, LIMITED NUMBER OF PARTICIPANTS: 70 Please Note: Only registered participants, NO on site registration ! FOR FURTHER DETAILS PLEASE SEE: WWW.IPOKRaTES.INFO

Dear 99nicu friends Please give your comments on this pioneer study. J Pediatr. 2008 Jun 3. [Epub ahead of print] A Randomized Controlled Trial of Theophylline Versus CO(2) Inhalation for Treating Apnea of Prematurity. Al-Saif S, Alvaro R, Manfreda J, Kwiatkowski K, Cates D, Qurashi M, Rigatto H. Departments of Pediatrics, University of Manitoba, Winnipeg, Manitoba, Canada. OBJECTIVE: To determine whether inhalation of 0.8% CO(2) in preterm infants decreases the duration and rate of apnea as effectively as or better than theophylline with fewer adverse side effects. STUDY DESIGN: A prospective, randomized, control study of 42 preterm infants of gestational age 27 to 32 weeks assigned to receive inhaled CO(2) (n = 21) or theophylline (n = 21). The study group had a mean (+/- standard error of the mean) birth weight of 1437 +/- 57 g, gestational age of 29.4 +/- 0.3 weeks, and postnatal age of 43 +/- 4 days. After a control period, 0.8% CO(2) or theophylline was given for 2 hours, followed by a recovery period. RESULTS: In the CO(2) group, apneic time and rate decreased significantly, from 9.4 +/- 1.6 seconds/minute and 94 +/- 15 apneic episodes/hour to 3.0 +/- 0.5 seconds/minute and 34 +/- 5 apneic episodes/hour. In the theophylline group, apneic time and rate decreased significantly, from 8 +/- 1 seconds/minute and 80 +/- 8 apneic episodes/hour to 2.5 +/- 0.4 seconds/minute and 28 +/- 3 apneic episodes/hour. Cerebral blood flow velocity (CBFV) decreased only during theophylline administration. CONCLUSIONS: Our findings suggest that inhaled low (0.8%) CO(2) concentrations in preterm infants is at least as effective as theophylline in decreasing the duration and number of apneic episodes, has fewer side effects, and causes no changes in CBFV. We speculate that CO(2) may be a better treatment for apnea of prematurity than methylxanthines.

If you did not have the chance to attend Hot topics 2007, now you can download the presenters'slides of very intersting lectures from key speakers, from this link: http://www.hottopics.org/postconslides.php

TRy these sites, Gumdrop pacifiers: http://www.preemiesrus.com/catalog/product_info.php/products_id/575 Cookie Cap: http://www.hawaiimedical.com/Products/index.html Chin Strap: http://www.fphcare.com/neonatal/pdfs/185043351.pdf Also INCA CPAP accessories

In Egyptian Universities the situation is different, we have to spend 3 years general pediatircs residency and pass MsC exam and then at least 3 more years in neonatology, including thesis in a research related to neonatology, then you can be a lecturer in Pediatrics/neonatology after finnishinfg MD exam in Pediatrics. Currently we planning MD degree in neonatology after finishing 3 years residency in general pediatrics.

A series of articles published recently have indicated the danger of nCPAP on our premies' ears Surenthiran SS. Arch. Dis. Child. Fetal Neonatal Ed. 2003;88;315-318 Karam O. Arch. Dis. Child. Fetal Neonatal Ed. 2008;93;F132-F134 Trevisanuto D et al. Arch. Dis. Child. Fetal Neonatal Ed. 2008;93;F396-F397

A new article is going to be released soon on facial nerve palsy as a complication of flow driver CPAP in ELBW infants by Maffei G, et al. J Perinat Med 36 (2008). Did experinece this complication in your practice?

We use pacifier or chin strap to keep mouth closed. Non-pharmacologic sedation via nestting, incubator covers, demming of NICU lights also helps.

The study will be published soon and then I'll write the abstract in this forum once I recieve the acceptance.

No our faculty will moderate the course this time. We are expecting attendee from 5 countries at least, it will be a chance to exchange ideas and to enjoy the hospitally of mansoura as well.

The 3rd International Advanced Neonatology Workshop Mansoura University Children’s Hospital, Mansoura, Egypt 7-12 November, 2008 Main Topics: Mechanical Ventilation Necrotizing Enterocolitis Total Parenteral Nutrition Surgical Problems Cardiovascular Support Neonatal Transport X-ray Interpretation Amplitude Integrated EEG Cranial imaging Venue Mansoura University Children’s Hospital, Mansoura Egypt Instructors and Speakers Prof. Shadia El Sallab Prof. Mohamed Khashaba Prof. M Reda Basiouny Dr. Hesham Abd El Hady Dr. Basma Shouman Dr. Nehad Nasef Contact Information Address El-Gomhoria St. Mansoura, Mansoura University Children’s Hospital, Neonatology Unit Fax +20502234092 E-mail Khashabamohamed@hotmail.com Website http://www.mans.edu.eg/much/En/neonatology/index.htm

Do you have experience with antibiotic lock. We have finnished a study on antibiotic lock using amikacin-heparin for neonates with extended UVC use and it was successful.

A one day course arranged by the Universities of Tanta, Mansoura, Zagazig, Egypt. It will be conducted in Tanta University on August 1st 2008. It will cover all aspects of CPAP including physiology, indications, CPAP delivery devices, clinical evidence, complications, nursing care , how to optimize CPAP in your NICU?, and hands on training on bubble CPAP and flow driver CPAP. Course fees 150 LE. For reservation contact: Arab Organizers Co. Tel; 0101709857-040/3349714 Email:araborganizers@hotmail.com

A 1-day course will be conducted in Tanta University in August 1st 2008, this will be in collaboration with Mansoura and Zagazig Universities. Registration fees 150 LE. For more detailsplease see: WWW.deltapediatrics2008.com

The registration fees for the conference is 450 $ for full registration, including Attendance to all scientific sessions Delegate’s bag with congress material Lunches and coffee breaks during the congress Opening Ceremony and Get Together Reception Gala Dinner half board accomodation for two nights in a 5 stars hotel. For double room add 150 $

Happy New Year. We would like to see you all in Mansoura and Port-Said, in our first international Neonatology conference (Neonatal Brain Where We Stand), we have 4 ditinguished Guest Speakers this Year from USA and UK. Please send this invitation to your colleagues. The conference will be on 2nd-4th April 2008. Main topics will be: asphyxia in newborn infant, use of aEEG, drugs affecting neonatal brain, therapeutic hypothermia, Intrauterine infections infection and neonatal brain, neuroimaging, neurodevelopmental outcome, Collaborative research in neonatal neurology. The website will be active soon. WWW.NICU2008.com

Mansoura international advanced neonatalology workshop will be held in the period from 29-3-2008 to 2-4-2008, the workshop will be held in the auditorium of Mansoura University Children's Hospital, Course faculty will include Neonatology Staff memebrs from our NICU as well as distinguished speakers (Dr. Denis Azzopardi) from Hammersmith, UK and Dr. Hany Aly from Washington DC, USA. the course will cover major aspects of ventilation; topics like pulmonary physiology, basics of mechanical ventilation, modes of ventilation, CPAP, HFV, interterpretation of ABG, CXR, pulmonary graphics. Hands on practice sessions with training on ventilators like Draeger 8000 + conventional and HFV, Benett, Bearcup ventilators; Bubble CPAP, Flow-driver CPAP, chest tube insertion, interactive case scenarios on mechanical ventilatoion using simulators etc. Other topics will include: TPN, Hypoxic ischemic encephalopathy, aEEG, neonatal seizures, circulatory support of sick newborn, neonatal transport. I think it will be a major event with a lot of topics to cover for those intersted in neonatology. there will be a limited number of seats. Please reserve early. The course fees will be 1000 $ including course fees, full accomodation. with opportunities for young residents and fellows for reduced fees. Those intersted can contact our secretary or contact me personally on my e-mail

Mansoura international advanced neonatalology workshop will be held in the period from 29-3-2008 to 2-4-2008, the workshop will be held in the auditorium of Mansoura University Children's Hospital, Course faculty will include Neonatology Staff memebrs from our NICU as well as distinguished speakers (Dr. Denis Azzopardi) from Hammersmith, UK and Dr. Hany Aly from Washington DC, USA. the course will cover major aspects of ventilation; topics like pulmonary physiology, basics of mechanical ventilation, modes of ventilation, CPAP, HFV, interterpretation of ABG, CXR, pulmonary graphics. Hands on practice sessions with training on ventilators like Draeger 8000 + conventional and HFV, Benett, Bearcup ventilators; Bubble CPAP, Flow-driver CPAP, chest tube insertion, interactive case scenarios on mechanical ventilatoion using simulators etc. Other topics will include: TPN, Hypoxic ischemic encephalopathy, aEEG, neonatal seizures, circulatory support of sick newborn, neonatal transport. I think it will be a major event with a lot of topics to cover for those intersted in neonatology. there will be a limited number of seats. Please reserve early. The course fees will be very cheap with opportunities for young residents and fellows for reduced fees. Those intrseted can contact our secretary or contact me personally on my e-mail