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Jelli KA

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Blog Entries posted by Jelli KA

  1. Hope x to Neonatal Congenital Heart

    Biotech Innovation · Jelli KA · 04/17/2024 02:14 PM

    Had a chance to attend #TEIBIO - 
    Transference (of knowledge Entrepreneurship ) & Innovation in Biotech .
    inspirational talk on rare diseases awareness day and topics were bringing hope to paediatrics #nicu: by address solutions to Neonatal Congenital Heart #CHD ❤️and better tolerance heart transplant.
    - 💡Crazy scienceco-founder Dr. Beatriz Salvador shows us how her team have found a non-invasive treatment for Congenital Diaphragmatic Hernia. 
    They were able the hole in CDH by regulating the immune system. 
    Have had 75%success rate and animal models have shown low toxicity.
    Currently recognized as an orphan drug EU - finalize animal model trial in a non-rodent model. 
    Hopes to begin clinical trials in 2025 with the esteem collaboration of Dra. Mayte Vallejo, del Instituto para la Investigación Biomédica del Hospital Universitario La Paz de Madrid (IDIPAZ) y paciente advocacy association «La vida con Hernia Diafragmática Congénita» located in Mérida, Spain.
    Crazy Science & Business S.L.   
    https://crazyscience.es

     
     
    Rafael C. Rocha   THYTECH founded a start-up to find a solution to avoid rejection in❤️ transplant in babies. Here the team are using an infant's timus cell to avoid rejection.
    https://es.linkedin.com/company/thytech
     
    Thanks to Carlos Cosculluela Chocarro for the shout-out. @FundacionDRO AsBioMad 
     

  2. Humanize Care Neonatal Transport in Spain.

    Seneo Transport pics · Jelli KA · 07/14/2021 11:09 AM

    Fantastic put together webinar by neonatal transport Seneo work neonatal transport group. Here are some  favorite suggestions.
    🔷Ear Muffs
    🔷Air mattress
    🔷Blanky with mum swell 
    🔷Fuzzy toy.
    🔷Thank the Drivers : Be aware of G force driver have take with sudden break. 
    🔹Consider 🚑 design allow all to have a better transport experience.

     
              From my perspective it was   Interesting the neonatal transport   Landscape is diverse from the pioneering region Catalonia that NICU/PICU in 1995(🟢) to other regions that don’t.  For example, Galicia have a private providers. Madrid & Valencia have dedicated Neonatal teams ( light 🔵). Some team's like the Balear region team have available helicopters/planes.  Below is map showing the situation.Regions in
    🛑 done by regional Emergency Teams.
                Benchmarking there work in a effort to improve the quality, provide constructive feedback and find ways to better ways to collaborate. Benchmarking and humanize care are interlinked with each other.
    They also underlined that need to keep in constant communication between the transport teams and the coordination hub.
     

  3. Today I sharing ‘tis post from HUGES a great. Organization dedicated to humanizing care in intensive care settings and emergency services. I particularly by this webinar on humanize. Management starting with leading with empathy, simply things that can be hard to achieve, but make us think Speakers suggests a few things to start with :   J. Carlos March - Profesor  EASP {Escuela Salud Publica- Public Health Institute of Andalucia}  Director of School of patient. @joancmarch Focus aligning Humility, vision and Values. Suggests   Emphasizing clear communication so that it flows with the team. Those we should aim to think in we . Leading can choose the words we say to br Proactive with self care and link up with stake holder in the community. Be awareness t ok to question , as when we question we can find ways to things better and learn.   Chelo Nurse , Nursing Director ( Poniente Region) gives a glimpse Difference humanizing project going on. @cheloArtero   Support each other and encourage the team to mindfully disconnect. For example Dosify info in this time of corovirus,so it not in a constant loop Have a dynamic & shared metrology to features to perinatal programs Cuidado co mimo in NICU : NICU care beyond family centered. Siempre en mi Mi. Supporting mums in perinatal death.  
  4. A article that most struck lately:
    This article by Dr. G.Moore et al researchers at the University of Ottawa, accessible #FOAM, give a good thoughtful analysis to whether chest compression & epinephrine cause more harm than good to V.preterm infants using 'principals' as an ethical framework aka the Spanish /French say does 'Encarnecimiento Terapeutico' a concept complex.
    As I understand, away to explain it what happens when you go beyond overtreatment?  When continuing treatment is medically futile, but you keep going it starts to cause more harm than it yields benefits.
    Here the author explain with explain with examples why chest compression and  justified in cases of need - concludes with a maybe.
  5. This September I had the opportunity to go to BAPM-EBNEO to kept Learning a out Neonatology and hopefully network with the EBNEO, so glad I see lots of you  face to face. This kept motivated to finish my PhD as I re-embark in find a new supervisor _only 1.5 yrs to go. I was real hard to let of the clinician in me as , this is my comfort zone. As a budding academic learn I get explore ideas and ways to implement them as bioethicists , as well finding ways to humanize the NIcU via processes. Last year,  I took a small detour as jr.posdoc and spent time studying system thinking, process and how to improve health using design thinking.
    An important fact , I beat my fear of being back in UK .I had mild anxious feeling about going to bapm but Northerners are such lovely folks. At the end of the day it you team of people will fluctuate for good & bad.
    -----------
    Product Reviews:
    Review BAPM.

    Probiotics
    Pro-prems finally available in individual sachets pre-dose sachets that in my opinion provide a higher security and is more practical. Only maltodextrin .
    Need mixing with 3 ml in H20. This has more of a track record as it collaboration with a company who been working bio culture for a long time pharmaceuticals grade certified.

    Vegan alternative for well babies is Labinic drop available liquid bottle comes in 5mls flask_recommended dose 0.2ml( a syringe is needed). Ideally given with maternal milk ( EBM ).
    * free off dairy, soya, sweetener, presevatives. Good for neonates with intolerances.

    Both have different formula of microbiota but have a 1 bifidobacterium probiotic in common. Amount of bacteria are specified in the ingredientes list of of proprems on the box.

    Nëo from ant neuro aEEG
    The most distinctive item to provide EEG monitoring to Neonate at the bed side. It features a user friendly screen, allowing NICU professionals easy access to interpret resulting brain waves. Electrode are applied through a cap, as I understand help to give a clearer signal.

    Bliss
    finally got to nicu mile stone card which are such lovely way to involve parents and make progress. Favorite is parent centered care poster.

    Bili bluelight .
    Compared to the standard it is small portable and easily stored . complement comes with a stand.Practical and can carried around, easily stored in the unit.
    Li-lac
    As one who had to deal  a lot of  of documentation I found Li-lac EBM labeling, sorting and tracking useful from quality & safety point of view. I found quite easy to use and track on a smartphone,and it builds an audit trail.Not sure how easy the set up is .
    Especial mention to SHED/S/upport & H/elp for E/very D/ad  : providing specific support for dad whose babies are admitted to NICU.

    Disclaimer: I have no ties to any of companies. Review Health devices enthusiasts academic. Permission for all pics .
     
     
     
     
     
     
     
     
     
  6. 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?
  7. Last month I got a chance to day pass at ems2019 to get an update on hospital tranfer#picu by la paz and update on  ilcor peadiatric resus by Dr Maconochiel who gave us an insight into how guidelines are elaborated -quite complex.I also the tech lover and intetact  resus decives. The  
    Mechanical for compression in for fevices look impressive , and fumctional .I was suprised to see many there are available to date x adult use only.
    My NLS Top medical devices -tried and tested
    Monivent(wireless &app). @99NICU so easy to use and it does show the volume needed and how softly you have to press the mask for proper Ventilation.
    Glad to Paul extensive high skill training , impressised complete with video screens -vocal cords.
    Brayden @ems2019
    new baby manikin (coming soon) great sim as the illumination lines show you when you are putting in  depth and the correct rhythm.
    The adult and pediatric manikins works, glad I could try all three.

    Adults @ems2019
    Lifeband #zoll 👌 visual and descriptive demostration of cardiac arrest scenaritrauma
    e the mechanical compression can continue as the patient is move to a a safer place. While it was stationary it was also also allow clinicians to administer drug or can use the defibililator.
    In all was was most engaging   challenge to teach about ALS/PLS . Instead if just getting a freebee you had to participate in rheir scenarios.
    Respirator portable :no o2 short journey .as it has a compressor. 02 Optional port for longer journey
    Charges:epocc from siemmes health seems a like alternative to istat cartiges if need a change. This thing  cartiges  Allow for testing of 11 items , as well as a capillary option too. The best feature in terms of transport is the don't require refrigeration.      
    Add Perks -
    incubator for transfer MRI.allow less handling of the neonate,  certainly smaller and more elegant.
    Clotting granules .These are ganulea that you our onto a bleeding site. look good for trauma
    Pic of a good transport monitor and compact with optoon to print by corpus credit: corpus minutor
    z--/DISCLAIMER: I have no ties or Funding from the companies reviews---.z
  8. Several tweet posted on the subject of music therap­y, namely by Fiona Lawson and Dr. Michae­l Narvey. It prompted me to share  paper on the on the Music therapy(MT) in NICU as I was abl­e to research for my posgrad as a way of­ humanizing NICU experience. I had a top­ic on my mind for a while since I used t­o work in the NICU. I First heard of this kind of therapy  from a french television TV5. Here I saw how music was used in a neurological ward for its appeasing edge.    Music therapy i­n Medicine has been around since ancient time.­es.In the NICU it has been used as a therapeutic tool for more than 25 year The US is a pioneer in the field ­, a good example is a Florida University where Dr.Jayne Stanley [1] developed the Lullaby dummy­  -©PALS - by the company Power Devices.      There are many initiative­ exploring the benefits of music therapy around the World. Most i­nitiatives center their studies using the *NIDCAP* Neon­atal framework. The location spans from Spain to Brazil passing by Canada back to Sweden.For example, I found 5 Spanish initiatives, like "Música en­ vena"  which is still on going in the NICU-La­ Paz Hospital-. Together with research studies I also used testimonials of professionals  (music therapist and clinicians), such as the o­ne described in the blog *the amia musica* .      
         Live music seems to be most beneficial to­ preterm infants vs record music . They also established that the n­oise level should be under 55dB.Music therapy has been shown to pro­vides several benefits.To summ up they are as follows :
    #-Firstly,  🎶therapy provides a reduction ­of heart and breathing rate proving the ­ calming effect.of therapy.
    #-Secondly, ­addition 🎶 therapy can help form mother-­baby bond especially when done in conjun­ction with kangaroo care,as well reducing parental stress #-Third and fina­l, studies suggests that the cumulative effe­ct in preterm belongings to the music therapy group­ where discharged earlier compared to­ the control group.     
     .   . .This conclusion are ­backed up by research studies reviewed. I­t is strength was the number and varied types of research­ : RCTs, study/control to ­observational or *prisma* meta analysis.All studies reported on or more positive results.T­he weakness of the studies review was th­e small sample number in some studies. T­he other was some quality sta­ndards were not ideal. Thus , there are ­plenty of indicators to suggest there a certain level of validity of music therapy.    
         . I feel it is ­important to take into account the long te­rm effect of music therapy on neuro-dev­elopment of preterm infants admitted to ­the NICU.A further finding revealed that too mu­ch or too little stimulation is detrimen­tal to a premmie. On the other hand, we also have­ consider what Anderson and Padel [2] say when they talk about deepening our knowledge of ­ Hypothalamic -Puititary-Adrenal Axis (H­PA)  on the stress response in neonat­es.   
       In this posgrad assignment were ­asked to propose a specific proposal .So I proposed to evaluate the levels of stress in neon­ates and find out if music therapy can he­lp. For this purpose the levels of cortisol levels need to be measured before and after a sessio­n of Music therapy. So If the levels of cortisol are indeed ­lower after a session MT this would indicate this therapy could be another indicator it is beneficial. A device like the new transdermal ­patch designed by Stanford University [3] that measures cor­tisol levels in Athletes. This pra­ctical tool could used the to measure the cortisol levels and avoids the unnecessary p­ain of needle bricks.
     
     
     
     
    References:
    [1]Tom Butler: FLORIDA STATE UNIVERSITY.New musical pacifier helps premature babies get healthy.Eureka Alerta , Florida [ Internet] May 2012 . Disponible en: https://www.eurekalert.org/pub_releases/2012-05/fsu-nmp052112.php
    [2]Anderson DE1 and Patel AD2. Infants born preterm, stress, and neurodevelopment in the neonatal intensive care unit: might music have an impact? Dev Med Child Neurol. [Internet] 2018 [Consultado 27 de Julio 2018 ] Mar;60(3):256-266. Disponible en: https://onlinelibrary.wiley.com/doi/abs/10.1111/dmcn

    *.Loewy, J et al.The effects of music therapy on vital signs, feeding, and sleep in premature infants. Pediatrics. [Internet] 2013 [ Consultado 24 de Julio 2018] May;131(5):902-18. Disponible en: http://www.pediatrics.org/cgi/doi/10.1542/peds.2012-1367
    [3]Kubota,T .Wearable device from Stanford measures cortisol in sweat.Stanford News. [ Internet] Julio 2018 [ Consultado 20 Julio 2018] Stanford University, Stanford, California. Disponible en: https://news.stanford. edu/2018/07/20/wearable-device-measures-cortisol-sweat/
     
  9. Excited for my first speaker oportunity to a peds audience.We a small group of about 20 I did expect a litlle more. The good Things and not so good that needed improving here.
    The conference wad set to be the first consist of primary care topics & community health. The second was solid peads with a special section of neonatology talks in the afternoon. The was also a poster competition in the mix.
    Lets start with the good I really enjoyed the networking oportunity over a nice healthy lunch with people. We happened most to NICU peps of bar various multidisciplinary backgrounds so we got talking about developmental outcomes of preemie at several stages. Thus we able to cross pollinate with ideas. The were several talk that were really relevant to my posdoc expecially organisation:community health better and those that NICU ones .The most thought provoking one was the method of management explained by the Arizona Prof. McGrath ,developmental psychologist working NICU on neonatal abtinense sindrome: how they reduced the stay to about weekish-ten days reduced the used of morphine derivates. Other talk were little lenghty.
        Personal I manage to give my talk to the small peds audience. I was a tad nervous but manage to give a somewhat seamless talk summary a few points as it overlap with the previous talk on the golden hour on my work in ethics in NLS  and generate some debate with those in room.
    I glad that my hotel was close by 10 walks away. A bonus on get macarons for mum on way back at the airport at Orly.
    On the otherhand, the organization of the event needed improving as it was a bit ad hoc from my experience organising .We totally underestimated how far it would be from the airports CDG and Orly : +2 hours using a mix public transport , I used my trusty app citymapper to get there.The conference site was a cute Holiday Inn @ Noisy le Grand, subburds well outside Paris .
     


  10. ⏰Alarms in the NICU🔕

    · Jelli KA · 07/20/2018 04:25 PM

    Alarms in NICU are part of the environment  and with more advanced model appear to be more present.  As one walks through the unit one is going off, creating annoyance to staff.Thus, raising the issue have reached a 'fatigue alarm'. Among I and some of the NICU professionals in my twitter Community belief. An article by Belteki and Morley give some answers.
    COPYRIGHTED THE Child &Fetal Archives Here the link below :
    https://bmj.altmetric.com/details/28352250

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