AJP Reports最新文献

{"title":"Successful Use of Neurally Adjusted Ventilatory Assist in Managing Refractory Bilateral Pneumatoceles in a Premature Neonate.","authors":"Efren Diaz, Shamaila Gil, Lisa M Scheid","doi":"10.1055/a-2945-0611","DOIUrl":"10.1055/a-2945-0611","url":null,"abstract":"<p><p><b>Background</b> Pneumatoceles are air-filled cystic lesions within the lung parenchyma, often arising from severe pneumonia or mechanical ventilation-induced lung injury, which pose significant risk, particularly in neonates requiring high positive-pressure ventilation. Traditional management includes conservative monitoring, percutaneous drainage, and/or surgical intervention. High-frequency ventilation is frequently employed to minimize barotrauma. <b>Case Summary</b> We present a neonate born at 29 ^0/7 weeks of gestation, weighing 780 g. Post-delivery, the patient developed pneumonia, leading to multiple refractory bilateral pneumatoceles and transfer to our hospital. Initial management included high-frequency jet ventilation and inhaled nitric oxide, with limited improvement over 3 weeks, after which we initiated neurally adjusted ventilatory assist (NAVA), leading to significant clinical improvement. Radiographic imaging showed rapid improvement of the pneumatoceles on NAVA, with complete resolution observed at outpatient follow-up. <b>Discussion</b> This case demonstrates successful management of refractory bilateral pneumatoceles using NAVA. Its patient-driven approach provides synchronized, gentle ventilation, crucial for treating pulmonary air leak syndromes and facilitating natural weaning. NAVA's dynamic adjustments and ability to closely match ventilatory support to the patient's neural respiratory drive using less peak inspiratory pressure offers a promising strategy for managing complex pulmonary conditions, such as pneumatoceles, in neonates.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"16 3","pages":"e154-e158"},"PeriodicalIF":0.7,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148878730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moyamoya Disease in Pregnancy: A Case Series.","authors":"Hannah Elizabeth McCool, Nick Cochran, Kerri Spontarelli Fruit, Bill Atkinson","doi":"10.1055/a-2930-3966","DOIUrl":"https://doi.org/10.1055/a-2930-3966","url":null,"abstract":"<p><p><b>Objective</b> Moyamoya disease is a rare progressive cerebrovascular disorder characterized by stenosis of the intracranial internal carotid arteries and formation of fragile collateral vessels, predisposing patients to ischemic and hemorrhagic stroke. Physiologic changes of pregnancy-including increased blood volume, systemic vasodilation, and augmented cerebral blood flow-may increase cerebrovascular vulnerability and complicate management. <b>Study Design</b> We describe three pregnancies complicated by moyamoya disease managed at a tertiary referral center in West Texas. All patients had undergone prior cerebral revascularization and were followed by neurology before conception. Antithrombotic strategies varied by individual risk factors and included aspirin or low-molecular-weight heparin. Comorbidities included pregestational diabetes with dichorionic diamniotic twins, homozygous factor V Leiden, and Chiari malformation with MTHFR mutation. <b>Results</b> Two patients underwent planned cesarean delivery with favorable maternal and neonatal outcomes following multidisciplinary management. The third developed preeclampsia with severe features at 32 weeks and experienced sudden neurologic deterioration. Despite emergent cesarean delivery, she suffered a fatal intracerebral hemorrhage. <b>Conclusion</b> These cases highlight the spectrum of pregnancy outcomes in patients with moyamoya disease and emphasize the importance of multidisciplinary care, strict blood pressure control, and careful neurologic surveillance.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"16 3","pages":"e148-e151"},"PeriodicalIF":0.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Important Limitations on the Conclusions of \"Discrepant Results on Two Different Single Gene Noninvasive Prenatal Tests for Cystic Fibrosis: A Case Report\".","authors":"Julia Wynn, Jennifer Hoskovec","doi":"10.1055/a-2913-7060","DOIUrl":"https://doi.org/10.1055/a-2913-7060","url":null,"abstract":"","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"16 3","pages":"e152-e153"},"PeriodicalIF":0.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and Temperature Stability of Low-Complexity Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy: A Retrospective Case Series.","authors":"Milagros F Bermudez-Pelaez, Veronica F Rojas-Osorio, Cristian M Matos-Inocente, Marina A Bustamante-Ordoñez, Maria L Rospigliosi-Lopez","doi":"10.1055/a-2924-5385","DOIUrl":"https://doi.org/10.1055/a-2924-5385","url":null,"abstract":"<p><p><b>Objective</b> This study aimed to evaluate the feasibility and temperature stability of low-complexity therapeutic hypothermia (TH) in neonates with moderate-to-severe hypoxic-ischemic encephalopathy (HIE). <b>Study Design</b> Retrospective case series of neonates born at ≥36 weeks of gestation with moderate-to-severe HIE treated with low-complexity TH in a tertiary-level hospital in Peru (2018-2024). Variables included timing of initiation, achievement and maintenance of the target core temperature, duration of hypothermia, and clinical outcomes. Descriptive statistics were used. <b>Results</b> A total of 13 neonates were included (77% male; median gestational age 38 weeks). TH was initiated at a median of 103 min after birth. Within the first 6 hours, 84.6% reached 34°C; however, only 31% maintained a stable core temperature within the target range (33.5-34.5°C) throughout treatment. Median duration of hypothermia was 75 hours. Complications occurred in 23.1% of cases, and overall mortality was 15.4%. <b>Conclusion</b> Low-complexity TH is feasible and allows timely initiation within the neuroprotective window. However, maintaining stable therapeutic temperatures remains a major challenge, which may compromise its potential neuroprotective effectiveness.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"16 3","pages":"e134-e140"},"PeriodicalIF":0.7,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to Parental Engagement in NICU Infants with Congenital Anomalies: An Exploratory Pilot Study in Fetal Center Mother-Infant Dyads.","authors":"Jaclyn Ruggiero, Aditi Chunduru, Wen Li, Thomas Cunningham, Elisa Garcia, Alexandra Patch, Jerrie S Refuerzo, Allison Davidson","doi":"10.1055/a-2920-8381","DOIUrl":"10.1055/a-2920-8381","url":null,"abstract":"<p><p><b>Objective</b> This study aimed to explore potential medical, sociodemographic, and maternal mental health (MMH) factors associated with parental engagement in the neonatal intensive care unit (NICU) among mother-infant dyads, followed through a fetal center (FC). <b>Study Design</b> This exploratory pilot study used mixed retrospective and prospective data collection at a Level IV NICU and affiliated FC between June and August 2023. The primary outcome was cumulative parental bedside presence during the first postnatal month. Secondary outcomes included time to first parental visitation, skin-to-skin (STS) care, expressed breast milk (EBM) provision, and MMH indicators. Maternal and infant clinical and sociodemographic variables were retrospectively abstracted from the electronic medical record, while parental visitation patterns were prospectively tracked using bedside documentation tools. <b>Results</b> Sixteen mother-infant dyads were included. Mean time to the first parental visitation was 7.6 h, and mean time to first STS contact was 8.3 days. Exploratory analysis identified patterns suggesting differences in parental engagement by language, insurance status, and MMH indicators. African American parents visited earlier than Caucasian and Hispanic parents ( <i>p</i> = 0.05). Descriptively, English-speaking and privately insured families initiated STS earlier than Spanish-speaking and publicly insured families. Earlier parental visitation was also observed among mothers providing EBM at postnatal day 14 ( <i>p</i> = 0.016). Mothers prescribed psychotropic medications experienced longer delays to first visitation ( <i>p</i> = 0.046). Given the small sample size and exploratory design, findings should be interpreted cautiously. <b>Conclusion</b> In this exploratory pilot cohort of FC mother-infant dyads, parental engagement patterns appeared to vary across sociodemographic and MMH-related factors. These preliminary findings support the feasibility and importance of larger prospective studies examining structural and psychosocial barriers to early parental participation in high-risk NICU populations.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"16 3","pages":"e141-e147"},"PeriodicalIF":0.7,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13461298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148722428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alignment between Published Performance Metrics and Clinical Reporting in sgNIPT: Implications from a Recent Case.","authors":"Laura G Hendon","doi":"10.1055/a-2918-5666","DOIUrl":"10.1055/a-2918-5666","url":null,"abstract":"","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"16 3","pages":"e132-e133"},"PeriodicalIF":0.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148676840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early-Onset Neonatal Sepsis Caused by <i>Globicatella sanguinis/sulfidifaciens</i> : Case Report.","authors":"Fredrick Odhiambo Otieno, Rafael Fonseca, Lemuel Aigbibvalu","doi":"10.1055/a-2913-6821","DOIUrl":"10.1055/a-2913-6821","url":null,"abstract":"<p><p><b>Background</b> <i>Globicatella sanguinis</i> is a rare α-hemolytic gram-positive coccus increasingly recognized as a human pathogen but remains an uncommon cause of neonatal invasive infection. Reported neonatal cases are limited, and optimal antimicrobial therapy is uncertain because Clinical and Laboratory Standards Institute (CLSI) susceptibility breakpoints are unavailable. <b>Case Presentation</b> A term female neonate born at 39 ^3/7 weeks via vacuum-assisted vaginal delivery after an in vitro fertilization pregnancy developed respiratory distress and lethargy shortly after birth. Delivery was complicated by umbilical cord avulsion, causing acute blood loss and hypovolemia. Initial evaluation demonstrated metabolic acidosis, leukocytosis, bandemia, and a rapid hematocrit decline requiring packed red blood cell transfusion. Blood culture obtained at birth grew <i>Globicatella sanguinis/sulfidifaciens</i> within 12 hours, whereas cerebrospinal fluid culture remained sterile. Empiric ampicillin and gentamicin were initiated; repeat blood cultures were negative. Susceptibility testing yielded minimum inhibitory concentration values without CLSI interpretation. Following infectious disease consultation, the infant completed a 10-day course of intravenous ampicillin from the first negative blood culture and recovered without complications. <b>Conclusion</b> This case highlights the diagnostic overlap between hemorrhagic shock and early-onset neonatal sepsis and emphasizes the management challenges posed by rare pathogens lacking standardized susceptibility criteria and evidence-based neonatal treatment recommendations.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"16 3","pages":"e128-e131"},"PeriodicalIF":0.7,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148652939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-Sectional Survey of Obstetrical Providers' Knowledge, Attitudes, and Use of Noninvasive Prenatal Testing for 22q11.2 Deletion.","authors":"Juliana Simon, James W Van Hook, Nabila Azeem, Madeline Allen, Hind N Moussa","doi":"10.1055/a-2884-8604","DOIUrl":"10.1055/a-2884-8604","url":null,"abstract":"<p><p><b>Objective</b> This study's primary objective was to characterize obstetrical providers' knowledge and utilization of noninvasive prenatal testing (NIPT) for 22q11.2 deletion screening. <b>Study Design</b> A one-time survey was distributed to physicians, nurse practitioners, and midwives. Participants answered 18 multiple-choice questions pertaining to demographic information, clinical use of carrier and NIPT, and knowledge regarding use of NIPT for 22q11.2 deletion syndrome. Responses were descriptively analyzed based on years of clinical experience and provider subspecialty. <b>Results</b> Twenty-two providers responded to the survey: six Obstetrics and Gynecology (OB/GYN) resident physicians, 10 OB/GYN generalist physicians, three Maternal-Fetal Medicine physicians, two nurse practitioners, and one midwife. All resident physicians reported never ordering 22q11.2 deletion NIPT, despite using a Trisomy screening panel, which includes 22q11.2 deletion as an opt out. Conversely, all experienced physicians ( <i>n</i> = 13) reported using expanded panels and screening for 22q11.2 deletion. Only half of our sample who completed the survey ( <i>n</i> = 10) felt adequately informed to counsel patients on screening results and procedures. <b>Conclusion</b> Our findings demonstrate an association between years in practice and the utilization of 22q11.2 deletion NIPT screening. Enhanced educational initiatives beginning during residency are necessary to improve provider knowledge on 22q11.2 deletion screening, information regarding test ordering, and counseling procedures.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"16 2","pages":"e117-e122"},"PeriodicalIF":0.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13309258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148343767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antenatal Testing Education: Assessing Health Education and Health Knowledge in a High-Risk Pregnant Population.","authors":"Jessica Shaker, Marina Feffer, Abigail Winder, Mirelle M Dawoud, Jameela Media, Mary J Murphy, Hannah Pope, Ann K Lal","doi":"10.1055/a-2891-4451","DOIUrl":"10.1055/a-2891-4451","url":null,"abstract":"<p><p><b>Objective</b> This study aimed to assess health knowledge and patient satisfaction in patients undergoing antenatal surveillance. <b>Study Design</b> This is a cross-sectional study that invited patients >18 years old, English-speaking, presenting for antenatal testing via biophysical profile. Patients completed a survey consisting of questions about health knowledge, demographic information, and patient satisfaction. <b>Results</b> A total of 219 pregnant patients completed the survey. The average score on the health knowledge survey was 71.5% (standard deviation [SD] = 16.5). About 25% replied that coming to the weekly ultrasounds was difficult for them, 4% considered the test invasive, and 7% considered the test stressful to their mental health. Approximately 89% stated they felt the doctors explained the reason for the weekly ultrasound, and 92% of respondents stated they enjoyed the weekly ultrasounds. Among patients who identified as Hispanic/Latino, total antenatal knowledge scores were lower (68%, SD = 17.0) than those who identified as non-Hispanic/Latino (76%, SD = 14.7), <i>p</i> -value < 0.001. As education level increased, the total score increased significantly ( <i>p</i> -value < 0.001). No significant difference in total score was seen between varying racial groups nor between varying provider types. <b>Conclusion</b> We found potential modifiable areas for improving health knowledge due to the different ethnic and educational backgrounds. We found an overall high satisfaction rate among the patients.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"16 2","pages":"e123-e127"},"PeriodicalIF":0.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13309257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148343727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obligate Funic Presentation: A Case Report of Velamentous Cord Insertion in a Normally Implanted Placenta.","authors":"Amberly Lao, Gabrielle Shuman, Julia Kim, Erin Conroy, Martin Chavez, Patricia Rekawek","doi":"10.1055/a-2848-3148","DOIUrl":"10.1055/a-2848-3148","url":null,"abstract":"<p><p>Funic presentation refers to umbilical cord loops positioned between the presenting fetal part and the internal cervical os. While often transient, persistent positioning due to anatomic predisposition represents a high-risk variant and a potential precursor to cord prolapse. We report the case of a 39-year-old pregnant woman with a velamentous cord insertion in whom the umbilical cord remained persistently positioned over the cervical os, a presentation we term \"obligate funic presentation.\" The patient's prenatal care was uncomplicated, and an ultrasound at 36 weeks identified umbilical cord loops over the internal os. She was admitted for close monitoring and subsequently developed regular preterm contractions with cervical change and recurrent variable decelerations that persisted despite resuscitative efforts. A cesarean delivery was performed at 36 weeks without evidence of cord prolapse at the time of delivery. A healthy male infant was delivered, who did not require neonatal intensive care unit (NICU) admission. Placental pathology revealed a marginal cord insertion. This case highlights an obligate funic presentation occurring in the absence of placenta previa when the cord insertion is velamentous or marginal. Early recognition is critical, as this uncommon but high-risk condition may predispose to cord compression or prolapse, necessitating heightened surveillance and individualized delivery planning and patient counseling.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"16 2","pages":"e114-e116"},"PeriodicalIF":0.7,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13293635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148325388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}