Neonatology is a subspecialty of pediatrics Pediatrics is the branch of medicine that deals with the medical care of infants, children, and adolescents. The upper age limit of such patients ranges from age 12 to 21. A medical practitioner who specializes in this area is known as a pediatrician. The word pediatrics and its cognates mean healer of children; they derive from two Greek words: π that consists of the medical care of newborn infants, especially the ill or premature newborn infant. It is a hospital A hospital, in the modern sense of the word, is an institution for health care providing patient treatment by specialized staff and equipment, and often, but not always providing for longer-term patient stays. Its historical meaning, until relatively recent times, was "a place of hospitality", for example the Chelsea Royal Hospital,-based specialty, and is usually practiced in neonatal intensive care units A neonatal intensive care unit, usually shortened NICU and also called a newborn intensive care unit, intensive care nursery (ICN), and special care baby unit (SCBU [pronounced "Skiboo"], especially in Great Britain), or a humidicrib, is a unit of a hospital specializing in the care of ill or premature newborn infants. The NICU is (NICUs). The principal patients of neonatologists Neonatology is a subspecialty of pediatrics that consists of the medical care of newborn infants, especially the ill or premature newborn infant. It is a hospital-based specialty, and is usually practiced in neonatal intensive care units . The principal patients of neonatologists are newborn infants who are ill or requiring special medical care are newborn The term infant derives from the Latin word infans, meaning "unable to speak or speechless." It is typically applied to children between the ages of 1 month and 12 months; however, definitions vary between birth and 3 years of age infants who are ill or requiring special medical care due to prematurity In humans, preterm birth refers to the birth of a baby of less than 37 weeks gestational age. The cause for preterm birth is in many situations elusive and unknown; many factors appear to be associated with the development of preterm birth, making the reduction of preterm birth a challenging proposition, low birth weight, intrauterine growth retardation Birth mass is the mass of a baby at its birth. It has direct links with the gestational age at which the child was born and can be estimated during the pregnancy by measuring fundal height. A baby born within the normal range of mass for that gestational age is known as appropriate for gestational age . Those born above or below that range have, congenital malformations Congenital disorder involves defects in or damage to a developing fetus. It may be the result of genetic abnormalities, the intrauterine environment, errors of morphogenesis, or a chromosomal abnormality. The outcome of the disorder will further depend on complex interactions between the pre-natal deficit and the post-natal environment. Congenital (birth defects Congenital disorder involves defects in or damage to a developing fetus. It may be the result of genetic abnormalities, the intrauterine environment, errors of morphogenesis, or a chromosomal abnormality. The outcome of the disorder will further depend on complex interactions between the pre-natal deficit and the post-natal environment. Animal), sepsis Sepsis is a serious medical condition that is characterized by a whole-body inflammatory state and the presence of a known or suspected infection. The body may develop this inflammatory response by the immune system to microbes in the blood, urine, lungs, skin, or other tissues. A lay term for sepsis is blood poisoning, more aptly applied to, or birth asphyxias Intrauterine hypoxia occur when the fetus is deprived of an adequate supply of oxygen. IH is used to describe inadequate oxygen availability during the gestation period, birth asphyxia (also refered to as perinatal asphyxia or Asphyxia neonatorum ) can result from inadequate supply of oxygen immediately prior to, during or just after delivery.

Contents

History

While high infant mortality rates were recognized by the British medical community at least as early as the 1860s,[1] modern neonatal intensive care is a relatively recent advance. In 1898 Dr. Joseph B. De Lee established the first premature infant incubator station in Chicago Chicago ( /ʃɨˈkɑːɡoʊ/ or /ʃɨˈkɔːɡoʊ/) is the largest city in both Illinois and the Midwest, and the third most populous city in the United States, with over 2.8 million living within the city limits. Its metropolitan area, commonly named "Chicagoland", is the 26th most populous in the world, home to an estimated 9.7 million, Illinois United States migrant settlers began arriving from Kentucky in the 1810s; Illinois achieved statehood in 1818. The future metropolis of Chicago was founded in the 1830s on the banks of the Chicago River, one of the few natural harbors on southern Lake Michigan. Railroads and John Deere's invention of the self-scouring steel plow made central. The first American textbook on prematurity was published in 1922. In 1952 Dr. Virginia Apgar Virginia Apgar was an American physician who specialised in anesthesia and pediatrics. She was a leader in the fields of anesthesiology and teratology, and effectively founded the field of neonatology. To the public, however, she is best known as the developer of the Apgar test, a method of assessing the health of newborn babies that has described the APGAR score The Apgar score was devised in 1952 by Dr. Virginia Apgar as a simple and repeatable method to quickly and summarily assess the health of newborn children immediately after birth. Apgar was an anesthesiologist who developed the score in order to ascertain the effects of obstetric anesthesia on babies scoring system as a means of evaluating a newborn's condition. It was not until 1965 that the first American newborn intensive care unit (NICU A neonatal intensive care unit, usually shortened NICU and also called a newborn intensive care unit, intensive care nursery (ICN), and special care baby unit (SCBU [pronounced "Skiboo"], especially in Great Britain), is a unit of a hospital specializing in the care of ill or premature newborn infants. The NICU is distinct from a special) was opened in New Haven New Haven is the second-largest municipality in Connecticut and the sixth-largest municipality in New England with a core population of about 123,000 people. "New Haven" may also refer to the wider Greater New Haven area, which has nearly 600,000 inhabitants in the immediate area. It is located in New Haven County, on New Haven Harbor,, Connecticut Southwestern Connecticut is part of the New York metropolitan area; three of Connecticut's eight counties, including most of the state's population, are in the New York City combined statistical area, commonly called the Tri-State Region. Connecticut's center of population is in Cheshire, New Haven County and in 1975 the American Board of Pediatrics established sub-board certification for neonatology.[2]

The 1950s brought a rapid escalation in neonatal services with the advent of mechanical ventilation In medicine, mechanical ventilation is a method to mechanically assist or replace spontaneous breathing of the newborn. This allowed for survival of smaller and smaller newborns. In the 1980s, the development of pulmonary surfactant Surfactants are compounds that lower the surface tension of a liquid, allowing easier spreading, and lowering of the interfacial tension between two liquids, or between a liquid and a solid. Surfactants may act as: detergents, wetting agents, emulsifiers, foaming agents, and dispersants replacement therapy further improved survival of extremely premature infants and decreased chronic lung disease, one of the complications of mechanical ventilation In medicine, mechanical ventilation is a method to mechanically assist or replace spontaneous breathing, among less severely premature infants. In 2006 newborns as small as 450 grams and as early as 22 weeks gestation have a chance of survival. In modern NICUs, infants weighing more than 1000 grams and born after 27 weeks gestation have an approximately 90% chance of survival and the majority have normal neurological development.[3]

Academic training

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A neonatologist is a physician (MD or DO) practicing neonatology. To become a neonatologist Neonatology is a subspecialty of pediatrics that consists of the medical care of newborn infants, especially the ill or premature newborn infant. It is a hospital-based specialty, and is usually practiced in neonatal intensive care units . The principal patients of neonatologists are newborn infants who are ill or requiring special medical care, the physician initially receives training as a pediatrician Pediatrics is the branch of medicine that deals with the medical care of infants, children, and adolescents. The upper age limit of such patients ranges from age 12 to 21. A medical practitioner who specializes in this area is known as a pediatrician. The word pediatrics and its cognates mean healer of children; they derive from two Greek words: π, then completes an additional training called a fellowship (for 3 years in the US) in neonatology. Most, but not all neonatologists are board certified Board Certification is the process by which a physician with either a MD, MBChB, MBBS, osteopathic or dentist (DDS, BChD, BDent, BDS, or DMD), DPM) degree in the United States, documents by written, practical and/or simulator based testing a mastery of the basic knowledge and skills that define an area of medical specialization. The commonly used in the specialty of Pediatrics by the American Board of Pediatrics, and in the sub-specialty of Neonatal-Perinatal Medicine also by the American Board of Pediatrics. Most countries now run similar programs for fellowship training in Neonatology. e of Medicine in Neonatology, referred to as a D.M. (Neonatology), from India is one such highly regarded program.

Spectrum of care

Rather than focusing on a particular organ system, neonatologists focus on the care of newborns who require ICU hospitalization. They may also act as general pediatricians, providing well newborn evaluation and care in the hospital where they are based. Some neonatologists, particularly those in academic settings, may follow infants for months or even years after hospital discharge to better assess the long term effects of health problems early in life. Some neonatologists perform clinical and basic science research to further our understanding of this special population of patients.

Health science There are two approaches to health science: the study and research of the food that we eat; and the study and research of health-related issues to understand how humans and other animals function, and the application of that knowledge to improve health and to prevent and cure diseases > Medicine Medicine is the science and art of healing. It encompasses a range of health care practices evolved to maintain and restore health by the prevention and treatment of illness. Before scientific medicine, healing arts were practised in accordance with alchemical treatments and ritual practices that developed out of religious and cultural traditions
Specialties A specialty in medicine is a branch of medical science. After completing medical school, physicians or surgeons usually further their medical education in a specific specialty of medicine by completing a multiple year residency. Medical practitioners who engage in a medical specialty are known as medical specialists and subspecialties A subspecialty is narrow field within a specialty such as forensic pathology, which is a subspecialty of anatomical pathology. A subspecialist is a specialist of a subspeciality
Surgery Surgery is a medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, to help improve bodily function or appearance, and sometimes for religious reasons. An act of performing surgery may be called a surgical procedure, operation, or simply

Cardiac surgery Cardiac surgery is a surgery on the heart and/or great vessels performed by a cardiac surgeon. Frequently, it is done to treat complications of ischemic heart disease , correct congenital heart disease, or treat valvular heart disease caused by various causes including endocarditis. It also includes heart transplantation · Cardiothoracic surgery Cardiothoracic surgery is the field of medicine involved in surgical treatment of diseases affecting organs inside the thorax . Generally treatment of conditions of the heart (heart disease) and lungs (lung disease) · Colorectal surgery Colorectal surgery is a field in medicine, dealing with disorders of the rectum, anus, and colon. The field is also known as proctology, but the term is outdated in the more traditional areas of medicine. The word proctology is derived from the Greek words Proktos, meaning anus or hindparts, and Logos meaning science or study · General surgery General surgery, despite its name, is a surgical specialty that focuses on abdominal organs, e.g., intestines including esophagus, stomach, small bowel, colon, liver, pancreas, gallbladder and bile ducts, and often the thyroid gland . They also deal with diseases involving the skin, breast, and hernias. These surgeons deal mainly in the Torso · Neurosurgery Neurosurgery is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the entire nervous system including the brain, spinal column, spinal cord, peripheral nerves, and extra-cranial cerbrovascular system · Ophthalmology Ophthalmology is the branch of medicine which deals with the anatomy, functions, and diseases of the eye. The term ophthalmologist refers to a specialist in medical and surgical eye problems. Since ophthalmologists perform operations on eyes, they are considered to be both a surgical and medical specialty · Oral and maxillofacial surgery · Orthopedic surgery Orthopedic surgery or orthopedics (orthopaedic doctors above the rank of SHO/FY2 are also called orthopods) is the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopedic surgeons use both surgical and nonsurgical means to treat musculoskeletal trauma, sports injuries, degenerative diseases, infections, tumors, (Hand surgery The field of hand surgery deals with both surgical and non-surgical treatment of conditions and problems that may take place in the hand or upper extremity . Hand surgery may be practiced by graduates of general surgery, orthopedic surgery and plastic surgery. Plastic surgeons and orthopedic surgeons receive significant training in hand surgery) · Otolaryngology Otolaryngology or ENT is the branch of medicine that specializes in the diagnosis and treatment of ear, nose, throat, and head and neck disorders. The full name of the specialty is otolaryngology-head and neck surgery. Practitioners are called otolaryngologists-head and neck surgeons, or sometimes otorhinolaryngologists (ORL). Otolaryngology is (ENT) · Pediatric surgery Pediatric surgery or paediatric surgery (BE) is a subspecialty of surgery involving the surgery of fetuses, infants, children, adolescents, and young adults. Many pediatric surgeons practice at children's hospitals · Plastic surgery Plastic surgery is a medical specialty concerned with the correction or restoration of form and function. While famous for aesthetic surgery, plastic surgery also includes many types of reconstructive surgery, hand surgery, microsurgery, and the treatment of burns. The word "plastic" derives from the Greek plastikos meaning to mould or · Surgical oncology The specialty of surgical oncology has evolved in steps similar to medical oncology, which grew out of hematology, and radiation oncology, which grew out of radiology. The Ewing Society known today as the Society of Surgical Oncology was started by surgeons interested in promoting the field of oncology. Though is not blessed by a specialty Board · Thoracic surgery Thoracic surgery is the field of medicine involved in the surgical treatment of diseases affecting organs inside the thorax . Generally treatment of conditions of the lungs, chest wall, and diaphragm · Transplant surgery Organ transplantation is the moving of an organ from one body to another, or from a donor site on the patient's own body, for the purpose of replacing the recipient's damaged or absent organ. The emerging field of Regenerative medicine is allowing scientists and engineers to create organs to be re-grown from the patient's own cells Organs and/or · Trauma surgery Trauma surgery is a surgical specialty involved in the invasive treatment of physical injuries, typically in an emergency setting. Trauma surgeons generally complete residency training in general surgery and often fellowship training in trauma or surgical critical care. The trauma surgeon is responsible for the initial resuscitation and · Urology Urology is the surgical specialty that focuses on the urinary tracts of males and females, and on the reproductive system of males. Medical professionals specializing in the field of urology are called urologists and are trained to diagnose, treat, and manage patients with urological disorders. The organs covered by urology include the kidneys, · Vascular surgery Vascular surgery is a specialty of surgery in which diseases of the vascular system, or arteries and veins, are managed by medical therapy, minimally-invasive catheter procedures, and surgical reconstruction. The specialty evolved from general and cardiac surgery. Early pioneers of the field include Russian surgeon Nikolai Korotkov, noted for

Internal medicine Internal medicine is the medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. Doctors of Internal Medicine, also known as internists, are sometimes referred to as the "doctor's doctor," because they are often called upon to act as consultants to other physicians to help solve puzzling diagnostic

Allergy Allergy is a disorder of the immune system which is a form of hypersensitivity. Allergic reactions occur to normally harmless environmental substances known as allergens; these reactions are acquired, predictable, and rapid. Strictly, allergy is one of four forms of hypersensitivity and is called type I hypersensitivity. It is characterized by/Immunology Immunology is a broad branch of biomedical science that covers the study of all aspects of the immune system in all organisms. It deals with the physiological functioning of the immune system in states of both health and disease; malfunctions of the immune system in immunological disorders ; the physical, chemical and physiological characteristics · Andrology Male-specific medical and surgical procedures include vasectomy and vasovasostomy as well as intervention to deal with male genitourinary disorders such as: · Angiology (Vascular Medicine) · Cardiology · Endocrinology · Gastroenterology (Hepatology) · Geriatrics · Hematology · Infectious disease · Nephrology · Oncology · Pulmonology · Rheumatology

Diagnostic

Clinical laboratory sciences (Clinical chemistry, Clinical immunology, Cytopathology, Medical microbiology, Transfusion medicine) · Radiology (Interventional radiology, Nuclear medicine) · Pathology (Anatomical, Clinical) · Clinical neurophysiology

Other specialties

Addiction medicine · Adolescent medicine · Anesthesiology · Dermatology · Disaster medicine · Emergency medicine · Family medicine · General practice · Gynaecology · Hospital medicine · Intensive-care medicine · Medical genetics · Neurology · Obstetrics · Occupational medicine · Ophthalmology · Pain management (Algiatry) · Palliative care · Pediatrics (Neonatology) · Physical medicine and rehabilitation (Physiatry) · Preventive medicine · Psychiatry · Reproductive medicine (Reproductive endocrinology and infertility, Reproductive surgery) · Sexual medicine · Sleep medicine · Sports medicine · Transplantation medicine · Tropical medicine (Travel medicine)

Others

Physician (MD/MBBS and DO) · Physician assistant

Biomedical research · Clinical psychology · Dentistry · Epidemiology · Optometry · Pharmacy · Podiatry · Public health · Veterinary medicine

History of medicine · Medical education · Medical school · Personalized medicine

References

  1. ^ Baines, M.A. (1862). Excessive Infant-Mortality: How Can It Be Stayed?. http://www.neonatology.org/classics/baines.html#note1. Retrieved 2007-02-18.
  2. ^ American Academy of Pediatrics (2001). "Committee Report: American Pediatrics: Milestones at the Millennium". Pediatrics 107 (6): 1482–1491. doi:10.1542/peds.107.6.1482. PMID 11389283.
  3. ^ Lemmons, J.A., et al. (2001). "Very Low Birth Weight Outcomes of the National Institute of Child Health and Human Development Neonatal Research Network, January 1995 Through December 1996". Pediatrics 107(1) (1): 1–8. doi:10.1542/peds.107.1.e1. PMID 11134465.

Categories: Pediatrics

 

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