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Fungal infection with Candida has become increasingly common in the neonatal intensive care unit. Candida infection causes many deaths and significantly increases health care costs. Candida spreads among babies by contact, generally by health care staff and sometimes by family members. In addition to routine steps to control infection, keeping babies who have candida in separate rooms (single room isolation) or cared for together (cohorting) may decrease the spread of candida. In this review, the authors sought studies that evaluated these measures, but could not find any. Therefore, the authors recommend that appropriate studies be performed in the future to answer this important question that may save lives and costs.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: November 9, 2011

Background: Infants in the neonatal intensive care unit (NICU) are subjected to stress, including high intensity sound. The sound environment in the NICU is louder than most home or office environments and contains disturbing noises of short duration and at irregular intervals. There are competing sound signals that frequently challenge preterm infants, staff, and parents. The sound levels in NICUs range from 7 dB to 120 dB, often exceeding the maximum acceptable level of 45 dB, recommended by the American Academy of Pediatrics. Hearing impairment is diagnosed in 2% to 10% of preterm infants versus 0.1% of the general paediatric population. Noise may cause apnoea, hypoxaemia, alternation in oxygen saturation, and increased oxygen consumption secondary to elevated heart and respiratory rates and may, therefore, decrease the amount of calories available for growth. Elevated levels of speech are needed to overcome the noisy environment in the NICU, thereby increasing the negative impacts on staff, newborns, and their families. High noise levels are associated with an increased rate of errors and accidents, leading to decreased performance among staff. The aim of all interventions considered for inclusion in this review is to reduce the sound levels that reach the individual neonate to 45 dB or less. This can be achieved by lowering the sound levels in an entire unit, treating the infant in a section of a NICU or in a 'private' room, or in incubators in which the sound levels are controlled, or reducing the sound levels that reaches the individual infant by using earmuffs or earplugs. By lowering the sound levels that reach the neonate, the resulting stress can be diminished, thereby promoting growth and reducing adverse neonatal outcomes.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: January 30, 2015

Newborn nurseries and neonatal intensive care units often require staff and visitors to wear overgowns with the intention of preventing the spread of infection. It has also been thought that putting on an overgown will remind people to wash their hands, which is of proven importance in preventing infection. A review of the medical literature identified eight clinical trials on gowning in these settings, involving 3811 newborns. Infection rates, death rates, or the length of stay of infants were not significantly affected by wearing gowns. Only two of the trials were considered to be of good quality, and there was variation between trials regarding gowning policies. Gowning did not increase the rate of handwashing. There is no evidence to support the use of gowning by staff to prevent the spread of infection. Based on these studies, gowning may not be a cost effective policy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: April 22, 2003

Telemedicine uses information technology so that doctors or nurses can communicate with their patients when they are not in the same room. The parents of sick infants who are treated in neonatal intensive care units require a lot of support when their child is ill and when they are taking their baby home. Telemedicine may be able to help the doctors and nurses to improve provision of support to the parents. This review identified one trial which did not show that telemedicine alters the time these infants stay in hospital. However, there was some imprecision of the published data in this study that makes it difficult to make firm recommendations either way with telemedicine.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: June 13, 2012

Progress in early labour may be slow. Women identify onset of labour from various signs including painful contractions and blood‐stained vaginal loss and may seek advice from health professionals about progress of their labour and for reassurance. Women may be advised to stay at home for as long as possible, or be sent home from hospital because their labour is not established. However, if progress in labour is more rapid than expected, delayed admission may result in an unplanned home birth.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: April 20, 2017

Cervical intra‐epithelial neoplasia (CIN) is a pre‐cancerous lesion of the cervix uteri (neck of the womb) caused by human papillomavirus (HPV), which may develop into cervical cancer, if not treated. Local treatment involves destroying or removing the abnormal area of the cervix, leaving most of the cervix, and the uterus in place maintaining the ability to become pregnant in the future, if desired. Certain types of local treatment may also be suitable for very early cervical cancer (stage IA1) if the tumour is very small and very unlikely to have spread beyond the cervix. There are many studies investigating whether the local treatment for CIN and early cervical cancer increases the risk of preterm birth (PTB) in subsequent pregnancies. However, there is no definite conclusion and this creates confusion for both the medical staff and women who may be recommended treatment, but also want to have children in the future.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Women who have high blood pressure (hypertension) during pregnancy or who develop pre‐eclampsia (high blood pressure with protein in the urine or other organ systems involvement, or both) can develop serious complications. Potential complications for the mother are worsening of pre‐eclampsia, development of seizures and eclampsia, HELLP syndrome (haemolysis, elevated liver enzymes and low platelet count), detachment of the placenta, liver failure, renal failure, and difficulty breathing because of fluid in the lungs.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: January 15, 2017

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