News Article | April 26, 2017
NEW YORK, April 26, 2017 (GLOBE NEWSWIRE) -- Dr. DonnaMaria E. Cortezzo, Attending Neonatologist and Pediatric Palliative Care Provider at Cincinnati Children’s Hospital Medical Center and Assistant Professor at the University of Cincinnati - Department of Pediatrics and Anesthesia has been selected to join the Physician Board at the American Health Council. She will be sharing her knowledge and expertise on Neonatology, Neonatal - Perinatal Palliative Care. and Neonatal Pain/ Sedation Management. Board Certified through the American Board of Pediatrics in Hospice and Palliative Medicine, Pediatrics, and Neonatal - Perinatal Medicine, Dr. Cortezzo utilizes her nine years of expertise in the field of Neonatology in her role as an Attending Neonatologist and Pediatric Palliative Care Provider at Cincinnati Children’s Hospital Medical Center and Assistant Professor at the University of Cincinnati - Department of Pediatrics and Anesthesia. In her current capacity, Dr. Cortezzo’s day-to-day responsibilities include clinical care in neonatology and pediatric palliative care and conducting research in neonatal and palliative pain care and neonatal pain management. Following graduation with a medical degree from the University of Connecticut in 2008, Dr. Cortezzo completed her residency in Pediatrics at the University of Connecticut in 2011 and her fellowship in Neonatal-Perinatal Medicine in 2014. In 2015, Dr. Cortezzo completed a fellowship in Hospice and Palliative Medicine at the Cincinnati Children's Hospital Medical Center. Dr. Cortezzo’s scope of clinical practice includes neonatology, perinatal palliative care, neonatal palliative care, neonatal pain management, and congenital anomalies. She has authored several peer-reviewed publications on bacillus subtilis, germination, DNA damaging chemicals, antisense ribosome inhibition of gene expression, barriers and facilitators to palliative care in the NICU, and experiences with end-of-life care in the NICU. Among her many accolades, Dr. Cortezzo is proud to have been published in bio-chem journals during her residency at the University of Connecticut and in pediatric journals addressing palliative care. A recent published article titled, “End of Life Care” draws a comparison between family and provider attitudes in pediatric palliative care. She has spoken at national conferences on neonatal-perinatal palliative care and recently spoke at an ethics conference regarding ethical challenges in conducting invasive research involving the maternal-fetal dyad. Looking back, Dr. Cortezzo pursued the field of Neonatology after being drawn to the acuity, pathophysiology, procedures, and the ability to connect with families of her patients in neonatology. Seeing the need for palliative medicine in neonatology prompted her to seek out additional training and broaden her career focus. To further develop her professional development, Dr. Cortezzo maintains a membership with The American Academy of Pediatrics, The American Medical Association, and The American Board of Pediatrics. Considering the future, Dr. Cortezzo hopes to focus on further integrating palliative care in to fetal and neonatal care, improving the approach to pain and sedation management in neonates, and utilizing simulation to teach health care professionals communication skills around difficult conversations. In her free time, Dr. Cortezzo enjoys working out, listening to music, cooking, outdoor activities, and non-traditional art.
News Article | October 28, 2016
A total of 28 Mercy Medical Center physicians were recognized in Baltimore magazine’s November 2016 “Top Docs” issue, representing 23 separate specialties, ranging from breast cancer surgery to varicose veins. They are (as listed in the magazine): Dr. Kelly Alexander, General Surgery Dr. Mark Applefeld, Cardiology: Interventional Dr. Fermin Barrueto, Urogynecology Dr. John Campbell, Orthopedic Surgery: Foot & Ankle Dr. Bernard W. Chang, Plastic Surgery: Reconstructive and Plastic Surgery: Breast Dr. Teresa Diaz-Montes, Gynecologic Oncology Dr. Susan Dulkerian, Neonatology Dr. R. Mark Ellerkmann, Gynecology: General Dr. J. Lawrence Fitzpatrick, General Surgery Dr. Neil B. Friedman, Breast Surgery and Oncology: Breast Dr. Scott Huber, Gastroenterology Dr. Dwight D. Im, Gynecologic Oncology Dr. Maria Jacobs, Radiation Oncology Dr. Clifford Jeng, Orthopedic Surgery: Foot & Ankle Dr. Peter Ledakis, Oncology: General Dr. Paul Lucas, Surgery for Chronic Venous Disease/Varicose Veins Dr. Lynn Ludmer, Rheumatology Dr. David Maine, Pain Management Dr. Andrea Marx, Rheumatology Dr. Albert Polito, Pulmonary Dr. Neil B. Rosenshein, Gynecologic Oncology Dr. John Salkeld, Radiology: Nuclear Medicine Dr. Armando Sardi, Surgical Oncology Dr. David Sill, Interventional Radiology Dr. Amish Sura, Cardiology: Interventional Dr. Thomas Swope, General Surgery Dr. Debra Vachon, ColoRectal Dr. Linda C. Wang, Dermatology (Medical) Mercy’s Dr. Maria C.E. Jacobs, Director of Radiation Oncology, was among several doctors photographed and profiled for the special edition. Dr. Jacobs works in close collaboration with the cancer surgeons, including fellow Baltimore magazine “Top Doc” honoree, Dr. Neil B. Friedman, Director, The Hoffberger Breast Center to coordinate post surgical treatment for breast cancer patients. Dr. Jacobs and Dr. Friedman were the first team of doctors in the state of Maryland to use Intraoperative Radiotherapy (IORT), a state-of-the-art technology that allows patients to get treated in one single radiation therapy session – a notable advantage over the many multiple visits required prior to IORT. Each Mercy physician was recognized as among the best in their respective fields. Other honorees including Dr. Dwight Im, Dwight D. Im, M.D., FACOG, renowned gynecologic cancer surgeon and leader of Mercy Medical Center’s prestigious gynecology and robotic surgery programs, and been named a “Top Doctor" for 2016 earlier this year by Castle Connolly Medical Ltd.; Armando Sardi, M.D., FACS, respected and renowned Surgical Oncologist who has been honored as a Top Doc in Baltimore magazine multiple times, serves as Medical Director of The Institute for Cancer Care at Mercy and as Chief of Division of Surgical Oncology at Mercy and recognized internationally for his work in the field of Hyperthermic Intraperitoneal Chemotherapy (HIPEC) to treat late stage, complex cancers of the abdominal region; and Teresa P. Diaz-Montes, M.D., MPH, FACOG, Associate Director of The Lya Segall Ovarian Cancer Institute, the first center in the region specifically designed for the treatment of ovarian cancer. Mercy Medical Center in Baltimore, MD, is a 142-year-old university affiliated medical facility named a "Top Hospital" by U.S. News and World Report with a national reputation for women's health care. For more information about Mercy, visit Mercy online at http://www.mdmercy.com; MDMercyMedia on FACEBOOK and TWITTER; or call 1-800-MD-MERCY.
News Article | October 26, 2016
Approximately one in three pregnant women in the U.S. deliver babies by cesarean delivery. While cesarean delivery may be life-saving for the mother, the baby or both, the rapid increase in cesarean birth rates over the past decade raises concerns that this type of delivery may be overused. Women & Infants Hospital of Rhode Island, a Care New England hospital, has been accepted into the American College of Nurse-Midwives (ACNM) Reducing Primary Cesareans Project. Women & Infants is working with other hospitals from across the United States and ACNM to improve healthy outcomes for mothers and families by focusing on reducing the incidence of first cesarean sections in low-risk women who have never given birth. "Our team of academic and community-based midwives is thrilled to champion this interprofessional opportunity to strengthen our current knowledge of what promotes healthy labor and birth," said Elisabeth Howard, PhD, CNM, FACNM, director of nurse midwifery in the Department of Obstetrics and Gynecology at Women & Infants Hospital and associate professor of obstetrics and gynecology (clinical) at The Warren Alpert Medical School of Brown University. "As providers, midwives possess considerable expertise in physiologic approaches to the care of women during childbirth. We look forward to working with others both here and around the country to identify the optimal care practices that will lead to a reduction in the cesarean section rate." The Reducing Primary Cesareans (RPC) Project is part of the ACNM Healthy Birth Initiative® (HBI), a long-term effort with representatives from leading maternity care organizations. HBI focuses on preserving normalcy by promoting evidence-based practices that support a healthy birth based on a pregnant woman's own physiology. The HBI works to encourage a consistent approach to birth practices and is focused on reducing those that are not evidence-based. Funded by the Transforming Birth Fund, the RPC Project builds on the HBI by offering unique opportunities for maternity care professionals and health systems to initiate action steps known as bundles. When implemented, these bundles prompt hospital system change that is aimed at reducing the incidence of primary cesarean births in the United States, which has continued to increase without associated improvements in health outcomes for mothers and babies. Women & Infants will work with the multi-disciplinary Reducing Primary Cesareans Quality Improvement (QI) expert panel and ACNM staff to identify areas of improvement and track process and outcome measures to demonstrate improvement in readiness, assessment, reliable and appropriate care, recognition and response, and systems learning. Women & Infants will implement at least one of three bundles, based on a data-driven analysis of the major cause of first cesarean in low-risk women at that hospital: Maureen G. Phipps, MD, MPH, chair and Chace-Joukowsky Professor of Obstetrics and Gynecology and assistant dean for Teaching and Research in Women's Health at the Alpert Medical School, professor of epidemiology at the Brown University School of Public Health, and chief of obstetrics and gynecology at Women & Infants Hospital and Care New England Health System, said, "We look forward to working with ACNM and the multi-hospital quality collaborative, and feel proud of the role we will play as champions of fewer cesarean births." About the American College of Nurse-Midwives The American College of Nurse-Midwives (ACNM) is the professional association that represents certified nurse-midwives (CNMs) and certified midwives (CMs) in the United States. With roots dating to 1929, ACNM sets the standard for excellence in midwifery education and practice in the United States and strengthens the capacity of midwives in developing countries. Its members are primary care providers for women throughout the lifespan, with a special emphasis on pregnancy, childbirth, and gynecologic and reproductive health. ACNM reviews research, administers and promotes continuing education programs, and works with organizations, state and federal agencies, and members of Congress to advance the well-being of women and infants through the practice of midwifery. Women & Infants Hospital of Rhode Island, a Care New England hospital, is one of the nation's leading specialty hospitals for women and newborns. A major teaching affiliate of The Warren Alpert Medical School of Brown University for activities unique to women and newborns, Women & Infants is the 12th largest stand-alone obstetrical service in the country and the largest in New England with approximately 8,500 deliveries per year. A Designated Baby-Friendly® USA hospital, a 2015 and 2016 Women's Choice Award/America's Best Hospitals for Obstetrics and for Cancer Care, a 2015 and 2016 Women's Choice Award/Best Breast Centers, U.S.News & World Report 2014-15 Best Children's Hospital in Neonatology and a 2014 Leapfrog Top Hospital, in 2009 Women & Infants opened what was at the time the country's largest, single-family room neonatal intensive care unit. Women & Infants and Brown offer fellowship programs in gynecologic oncology, maternal-fetal medicine, urogynecology and reconstructive pelvic surgery, women's mental health, neonatal-perinatal medicine, pediatric and perinatal pathology, gynecologic pathology and cytopathology, breast disease, obstetric medicine, and reproductive endocrinology and infertility. Women & Infants has been designated as a Breast Imaging Center of Excellence by the American College of Radiography; a Center of Excellence in Minimally Invasive Gynecology; a Center of Biomedical Research Excellence for Perinatal Biology by the National Institutes of Health (NIH); and a Neonatal Resource Services Center of Excellence. It is one of the largest and most prestigious research facilities in high risk and normal obstetrics, gynecology and newborn pediatrics in the nation, and is a member of NRG Oncology, the Maternal Fetal Medicine Units Network, the Neonatal Research Network, and the Pelvic Floor Disorders Network.
News Article | November 8, 2016
Barbara Stonestreet, MD, a neonatal-perinatal specialist at Women & Infants Hospital of Rhode Island, a Care New England hospital, and professor of pediatrics at The Warren Alpert Medical School of Brown University, has received a five-year, nearly $2.8 million grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development for her research into determining the most effective strategies for the treatment of perinatal brain injury in full-term and premature infants. Last month it was announced that Dr. Stonestreet received two two-year grants totaling $881,100 from the National Institutes of Health for this research. Perinatal brain injury often results in severe developmental disabilities, including neurodevelopmental delay and cerebral palsy. The resulting neurodevelopmental disabilities can place a lifelong burden on parents and society. Dr. Stonestreet explained, "We are looking at a novel approach to prevent and treat perinatal brain injury by targeting brain blood vessels with antibodies to preserve their function, to protect the brain, and to improve outcomes. This study has significant translational potential to provide new insights into novel therapies to prevent brain injury in the human fetus and/or premature and full-term infant. Women & Infants Hospital of Rhode Island, a Care New England hospital, is one of the nation's leading specialty hospitals for women and newborns. A major teaching affiliate of The Warren Alpert Medical School of Brown University for obstetrics, gynecology and newborn pediatrics, as well as a number of specialized programs in women's medicine, Women & Infants is the 12th largest stand-alone obstetrical service in the country and the largest in New England with approximately 8,500 deliveries per year. A Designated Baby-Friendly® USA hospital, U.S.News & World Report 2014-15 Best Children's Hospital in Neonatology and a 2014 Leapfrog Top Hospital, in 2009 Women & Infants opened what was at the time the country's largest, single-family room neonatal intensive care unit. Women & Infants and Brown offer fellowship programs in gynecologic oncology, maternal-fetal medicine, urogynecology and reconstructive pelvic surgery, neonatal-perinatal medicine, pediatric and perinatal pathology, gynecologic pathology and cytopathology, and reproductive endocrinology and infertility. It is home to the nation's first mother-baby perinatal psychiatric partial hospital, as well as the nation's only fellowship program in obstetric medicine. Women & Infants has been designated as a Breast Imaging Center of Excellence by the American College of Radiography; a Center of Excellence in Minimally Invasive Gynecology; a Center of Biomedical Research Excellence by the National Institutes of Health (NIH); and a Neonatal Resource Services Center of Excellence. It is one of the largest and most prestigious research facilities in high risk and normal obstetrics, gynecology and newborn pediatrics in the nation, and is a member of the National Cancer Institute's Gynecologic Oncology Group and the Pelvic Floor Disorders Network.
Fernandez-Carrocera L.A.,Neonatology |
Fernandez-Carrocera L.A.,Instituto Nacional Of Perinatologia |
Solis-Herrera A.,Neonatology |
Cabanillas-Ayon M.,Neonatology |
And 4 more authors.
Archives of Disease in Childhood: Fetal and Neonatal Edition | Year: 2013
Background: A randomised, double-blind clinical trial was undertaken in order to assess the effectiveness of probiotics in the prevention of necrotising enterocolitis (NEC) in newborns weighing <1500 g. Methods: We studied a group of 150 patients who were randomised in two groups after parental consent was obtained, to receive either a daily feeding supplementation with a multispecies probiotic (Lactobacillus acidophilus, Lactobacillus rhamnosus, Lactobacillus casei, Lactobacillus plantarum, Bifidobacteruim infantis, Streptococcus thermophillus) 1 g per day plus their regular feedings or to receive their regular feedings with nothing added (control group), over the period of January 2007 through June 2010. Clinicians in care of the infants were blinded to the group assignment. Results: The primary outcome was the development of NEC. Both groups were comparable, with no differences during hospitalisation, including the type of nutrition received. Blood cultures obtained from cases that developed sepsis did not reveal lactobacillus or Bifidobacteria growth. No differences were detected in terms of NEC risk reduction (RR: 0.54, 95% CI 0.21 to 1.39) although we did observe a clear trend in the reduction of NEC frequency in the studied cases: 6 (8%) versus 12 (16%) in the control group. When the combined risk of NEC or death was calculated as a post hoc analysis, we found a significantly lower risk (RR: 0.39, 95% CI 0.17 to 0.87) for the study group. Conclusions: Probiotics may offer potential benefits for premature infants and are a promising strategy in the reduction of the risk of NEC in preterm newborns.
Baquero H.,Universidad del Norte, Colombia |
Alviz R.,Medicina Alta Complejidad S.A. |
Castillo A.,Northeast Georgia Medical Center |
Neira F.,Medicina Alta Complejidad S.A. |
Acta Paediatrica, International Journal of Paediatrics | Year: 2011
Aim: To assess the time to obtain reliable oxygen saturation readings by different pulse oximeters during neonatal resuscitation in the delivery room or NICU. Methods: Prospective study comparing three different pulse oximeters: Masimo Radical-7 compared simultaneously with Ohmeda Biox 3700 or with Nellcor N395, in newborn infants who required resuscitation. Members of the research team placed the sensors for each of the pulse oximeters being compared simultaneously, one sensor on each foot of the same baby. Care provided routinely, without interference by the research team. The time elapsed until a reliable SpO2 was obtained was recorded using a digital chronometer. Statistical comparisons included chi-square and student's T-test. Results: Thirty-two infants were enrolled; median gestational age 32 weeks. Seventeen paired measurements were made with the Radical-7 and Biox 3700; mean time to a stable reading was 20.2 ± 7 sec for the Radical-7 and 74.2 ± 12 sec for the Biox 3700 (p = 0.02). The Radical-7 and the N- 395 were paired on 15 infants; the times to obtain a stable reading were 20.9 ± 4 sec and 67.3 ± 12 sec, respectively (p = 0.03). Conclusion: The time to a reliable reading obtained simultaneously in neonatal critical situations differs by the type of the pulse oximeter used, being significantly faster with Masimo Signal Extraction Technology. This may permit for better adjustments of inspired oxygen, aiding in the prevention of damage caused by unnecessary exposure to high or low oxygen. ©2011 The Author(s)/Acta Pædiatrica ©2011 Foundation Acta Pædiatrica.
Manzoni P.,S Anna Hospital |
De Luca D.,Catholic University of the Sacred Heart |
Stronati M.,Neonatology |
Jacqz-Aigrain E.,Clinical Investigation Center |
And 7 more authors.
American Journal of Perinatology | Year: 2013
Neonatal sepsis causes a huge burden of morbidity and mortality and includes bloodstream, urine, cerebrospinal, peritoneal, and lung infections as well as infections starting from burns and wounds, or from any other usually sterile sites. It is associated with cytokine - and biomediator-induced disorders of respiratory, hemodynamic, and metabolic processes. Neonates in the neonatal intensive care unit feature many specific risk factors for bacterial and fungal sepsis. Loss of gut commensals such as Bifidobacteria and Lactobacilli spp., as occurs with prolonged antibiotic treatments, delayed enteral feeding, or nursing in incubators, translates into proliferation of pathogenic microflora and abnormal gut colonization. Prompt diagnosis and effective treatment do not protect septic neonates form the risk of late neurodevelopmental impairment in the survivors. Thus prevention of bacterial and fungal infection is crucial in these settings of unique patients. In this view, improving neonatal management is a key step, and this includes promotion of breast-feeding and hygiene measures, adoption of a cautious central venous catheter policy, enhancement of the enteric microbiota composition with the supplementation of probiotics, and medical stewardship concerning H2 blockers with restriction of their use. Additional measures may include the use of lactoferrin, fluconazole, and nystatin and specific measures to prevent ventilator associated pneumonia.Copyright © 2013 by Thieme MedicalPublishers, Inc.
PubMed | Experimental Cardiology, Experimental Cardiology and Neonatology and Neonatology
Type: | Journal: Journal of visualized experiments : JoVE | Year: 2016
This protocol describes the surgical procedure to chronically instrument swine and the procedure to exercise swine on a motor-driven treadmill. Early cardiopulmonary dysfunction is difficult to diagnose, particularly in animal models, as cardiopulmonary function is often measured invasively, requiring anesthesia. As many anesthetic agents are cardiodepressive, subtle changes in cardiovascular function may be masked. In contrast, chronic instrumentation allows for measurement of cardiopulmonary function in the awake state, so that measurements can be obtained under quiet resting conditions, without the effects of anesthesia and acute surgical trauma. Furthermore, when animals are properly trained, measurements can also be obtained during graded treadmill exercise. Flow probes are placed around the aorta or pulmonary artery for measurement of cardiac output and around the left anterior descending coronary artery for measurement of coronary blood flow. Fluid-filled catheters are implanted in the aorta, pulmonary artery, left atrium, left ventricle and right ventricle for pressure measurement and blood sampling. In addition, a 20 Gcatheter is positioned in the anterior interventricular vein to allow coronary venous blood sampling. After a week of recovery, swine are placed on a motor-driven treadmill, the catheters are connected to pressure and flow meters, and swine are subjected to a five-stage progressive exercise protocol, with each stage lasting 3 min. Hemodynamic signals are continuously recorded and blood samples are taken during the last 30 sec of each exercise stage. The major advantage of studying chronically instrumented animals is that it allows serial assessment of cardiopulmonary function, not only at rest but also during physical stress such as exercise. Moreover, cardiopulmonary function can be assessed repeatedly during disease development and during chronic treatment, thereby increasing statistical power and hence limiting the number of animals required for a study.
PubMed | Fetal Medicine, Lutheran University of Brazil, Pediatric Radiology, Grupo Hospitalar Conceicao GHC and 3 more.
Type: Case Reports | Journal: Birth defects research. Part A, Clinical and molecular teratology | Year: 2016
Gastroschisis is the most common abdominal wall defect. It is characterized by herniation of the intestine and other abdominal organs through a defect in the abdominal wall. Neuroblastoma is the most common malignant tumor observed during the neonatal period. It is a neuroendocrine tumor derived from neural crest cells that develops into the adrenal gland.We report on the undescribed association between gastrochisis and congenital neuroblastoma, diagnosised during the prenatal period. The mother was a 20-year-old healthy pregnant woman in her second pregnancy. Obstetric ultrasound examination showed a fetus presenting an abdominal wall defect on the right side of the umbilical cord, compatible with gastroschisis, and a hyperechogenic and spherical solid lesion on the left adrenal gland. Fetal magnetic resonance imaging disclosed similar features associated to a heterogeneous aspect of the liver. The diagnosis of metastatic neuroblastoma was confirmed after birth through liver biopsy. At 2 days of life, the prothrombrin time was abnormal, and the patient needed vitamin K.We cannot rule out the possibility that a clotting defect, commonly observed in disseminated malignancies such as a metastatic neuroblastoma may be associated with the etiology of the gastroschisis, as this defect may result from a thrombosis occurring around 3 to 4 weeks of gestation, a period when neuroblasts development occurs into the adrenal medulla. However, we cannot exclude the possibility that both events may have occurred simultaneously by chance.
PubMed | McMaster University and Neonatology
Type: Journal Article | Journal: Journal of neonatal-perinatal medicine | Year: 2016
Non-availability of an established validated tool to assess and monitor the severity of visible blood in a stool (VBS) specimen over time, prevents effective decision making about discontinuation of contact precautions and hospital discharge.To determine the impact of implementing a VBS investigation, parent apprisal template and Visible Blood in the Stool -Assessment Tool (VBS-AT) on standardized reporting and the evaluation of clinical improvement.A prospective quality improvement cohort study was conducted in a tertiary, neonatal unit. All infants with isolated VBS without clinical signs, radiological pneumatosis and abnormal laboratory results were included. The template and VBS-AT instrument were implemented at the bedside. Criteria for discontinuation of contact precautions and readiness for discharge home were defined apriori.Eight infants developed VBS during the cluster lasting ten days. Seventy-four (78%) of the 98 episodes were graded by the VBS-AT. Five of the six infants had a maximum VBS grade of 3. The duration of VBS and contact precautions ranged from 4-38 days. All six infants with a VBS grade 2 for 4 consecutive days did not deteriorate beyond grade 3 or develop gastrointestinal complications during the ten week period following the end of the cluster. Consistent objective reporting of the severity of VBS and consistent evaluation of infants progress over time contained the cluster effectively and facilitated discharge of stable infants.Implementation of a tool to standardize, investigate and objectively monitor the severity of VBS is feasible and improves effectiveness of care at no extra cost.