
Eric ShinwellBar Ilan University | BIU · Faculty of Medicine in the Galilee
Eric Shinwell
MD FRCP Edin
About
140
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Introduction
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May 1997 - June 2013
May 1997 - July 2013
Publications
Publications (140)
Objective:
To determine the effect of perinatal and neonatal risk factors on retinopathy of prematurity (ROP) and to examine the association of fertility treatments on the risk for ROP in very low birth weight (VLBW) preterm twins.
Methods:
The population-based observational study consisted of VLBW twins born at 24-29 weeks gestational age (GA)....
Importance:
The long-term effects of surfactant administration via a thin catheter (minimally invasive surfactant therapy [MIST]) in preterm infants with respiratory distress syndrome remain to be definitively clarified.
Objective:
To examine the effect of MIST on death or neurodevelopmental disability (NDD) at 2 years' corrected age.
Design, s...
Background
SUMOylation involves the attachment of small ubiquitin-like modifier (SUMO) proteins to specific lysine residues on thousands of substrates with target-specific effects on protein function. Sentrin-specific proteases (SENPs) are proteins involved in the maturation and deconjugation of SUMO. Specifically, SENP7 is responsible for processi...
Research has indicated the importance of internal motivation as a factor in reducing academic misconduct in higher education and some commentators have also cited prosocial values as buffers against the temptation to cheat. In light of this research, the goal of the present research was to study the roles of motivation and prosocial values in comba...
( JAMA . 2021;326:2478–2487)
Continuous positive airway pressure (CPAP) is recommended for newly born preterm infants. A previous meta-analysis of clinical trials compared CPAP to intubation and ventilation in terms of death or bronchopulmonary dysplasia and found CPAP had a relative risk of 0.91 [95% confidence interval (CI), 0.84-0.99]. In the st...
Importance
The benefits of surfactant administration via a thin catheter (minimally invasive surfactant therapy [MIST]) in preterm infants with respiratory distress syndrome are uncertain.
Objective
To examine the effect of selective application of MIST at a low fraction of inspired oxygen threshold on survival without bronchopulmonary dysplasia (...
We read with interest the Letter by Verd et al. commenting on our Editorial regarding vaccination of children and adolescent against severe acute respiratory syndrome corona virus 2 (SARS‐CoV‐2).1,2 Indeed, when deciding on vaccination policy against SARS‐CoV‐2 many considerations need to be examined, including the safety of vaccines, the effective...
Background
Minimally invasive surfactant therapy (MIST) is a promising mode of administration that offers the potential to limit barotrauma and prevent lung injury in preterm infants with respiratory distress syndrome (RDS).
Objective
This study assessed the effects of the implementation of MIST on safety and efficacy in infants who met criteria f...
Background:
The incidence of congenital cytomegalovirus (CMV) infection in Israel is 0.7%. Only 10-15% are symptomatic. Valganciclovir has been shown to improve hearing and neurodevelopmental outcomes in neonates with symptomatic congenital CMV infection. Targeted examination of infants who fail routine neonatal hearing screening or have clinical...
Objectives:
To assess infection rates predischarge and postdischarge in breast milk-fed newborns with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive mothers who were separated postdelivery from their mothers and discharged from the hospital. Also, we aim to evaluate breastfeeding rates predischarge and postdischarge.
Method...
Antenatal corticosteroids undoubtedly save many lives and improve the quality of many others. However, the currently accepted dosage schedule has been in place since 1972, and recent studies have suggested that beneficial effects may be seen with less. Most but not all studies of long-term outcome show no adverse effects. The use of antenatal corti...
Objectives
Recommendations for vitamin D (VitD) intake and target serum levels of 25(OH)D in preterm infants are diverse. We hypothesized that preterm infants with low birth weight (BW) have low dietary intake of VitD and therefore should be supplemented with higher amounts of VitD.
Methods
Infants with BW < 2 kg were supplemented with 600 units o...
Background: The COVID-19 pandemic disrupted medical education. Social distancing prevented students from gathering in any setting. Teaching became less effective due to lack of staff, cancellation of procedures, transition to telehealth and shortages of personal protective equipment. Medical schools’ responses to previous lockdowns are not well doc...
Interprofessional collaborative practice (ICP) offers the potential to improve patient care in comparison with disjointed care provided by a random group of individual health-care providers. Some even see collaborative care as a panacea for patient safety. At the postgraduate level, collaborative practice is now taught and well entrenched in many s...
We instituted quality improvement program. We compare the infection rate before (2011-2012) and after (2013-2015). Central line associated blood stream infection episodes decreased from 15.2 to 2.29 episodes per 1000 catheter days (P = .004). We found two major changes, 1. Hand hygiene increased mainly "before aseptic task", from 69.9% to 89.9% and...
Cerebrotendinous xanthomatosis (CTX) is a progressive metabolic leukodystrophy. Early identification and treatment from birth onward effectively provides a functional cure, but diagnosis is often delayed. We conducted a pilot study using a two-tier test for CTX to screen archived newborn dried bloodspots (DBS) or samples prospectively collected fro...
Background
The long-term effects on neurodevelopment of the use of inhaled glucocorticoids in extremely preterm infants for the prevention or treatment of bronchopulmonary dysplasia are uncertain.
Methods
We randomly assigned 863 infants (gestational age, 23 weeks 0 days to 27 weeks 6 days) to receive early (within 24 hours after birth) inhaled bu...
Bronchopulmonary Dysplasia (BPD) represents a major threat to the short and long-term health and development of very preterm infants. Unfortunately, despite much study and progress in neonatology in recent years and some modest improvements in survival, both the incidence and severity of BPD remain frustratingly stable (1). This article is protecte...
Aim:
It is unclear whether maternal intra-partum antibiotic treatment (IAT) continues to exert a bactericidal effect on common pathogens in neonates. We studied the in vitro bactericidal effect of IAT on the cord and peripheral venous blood of newborn infants.
Methods:
Umbilical cord and peripheral venous blood from newborn infants born at Kapla...
Objective
To evaluate the impact of major neonatal morbidities on the risks for rehospitalization in children and adolescents born of very low birth weight.
Study design
An observational study was performed on data of the Israel Neonatal Network linked together with the Maccabi Healthcare Services medical records. After discharge from the neonatal...
Background: Transcutaneous bilirubinometry (TcB) is routinely used to monitor jaundice in term and near term infants. However, before 35 weeks gestation the technique has not been widely adopted.
Aim: To study the correlation between TcB and Total Serum Bilirubin (TsB) before, during and after phototherapy in preterm infants born before 35 weeks’ g...
Context:
Bronchopulmonary dysplasia (BPD) in preterm infants remains a major health burden despite many therapeutic interventions. Inhaled corticosteroids (IC) may be a safe and effective therapy.
Objective:
To assess the safety and efficacy of IC for prevention or treatment of BPD or death in preterm infants.
Data sources:
PubMed, the Cochran...
Objective: To study the effect of plurality on refractive status in former preterm infants at age 8-12 years.
Methods: Refraction was compared in singletons and multiples, in Very Low Birth Weight infants (VLBW, <1500 grams) at age 6 months and 8-12 years. Preterm infants were compared with a group of term infants.
Results: 37 of 104 (36%) VLBW inf...
Methods:
Daily data regarding nutrition and growth were collected from the medical record of VLBW infants born during 1995-2010. The infants were grouped by year of birth in order to compare infants from before, during and after the policy change. Evaluation of growth included age in days at return to birth weight and the proportion of infants wit...
Background:
Systemic glucocorticoids reduce the incidence of bronchopulmonary dysplasia among extremely preterm infants, but they may compromise brain development. The effects of inhaled glucocorticoids on outcomes in these infants are unclear.
Methods:
We randomly assigned 863 infants (gestational age, 23 weeks 0 days to 27 weeks 6 days) to ear...
Background
Inhaled steroids have been studied for both prevention and treatment of bronchopulmonary dysplasia (BPD). Results have been inconsistent. Recently, a large randomized controlled trial (RCT) has been reported.
Methods/design
We will perform a comprehensive systematic literature search for randomized and quasi-randomized controlled trials...
Infants born at the limits of viability present neonatologists in particular and society in general with difficult challenges. Ethical and legal considerations establish a framework for action, although this varies between countries, departments and individuals and shows dynamic changes over time. This brief review includes a vignette telling a fam...
Background Survival of extremely low birth weight (ELBW) infants has improved in recent decades but bronchopulmonary dysplasia (BPD) remains a major problem. The effect of early inhalation of corticosteroids on survival without BPD in these infants is unclear.
Objective To determine the effect of early use of inhaled budesonide in infants with gest...
Neonatal group B streptococcal disease has become less common but still constitutes a major cause ofmorbidity andmortality. Around the world, a variety of preventive strategies are in place with varying degrees of implementation and success. This article reviews these approaches and looks to the future. © 2014 by the American Academy of Pediatrics....
Aim: To investigate the correlation between transcutaneous bilirubinometry (TcB) and total serum bilirubin (TsB) in jaundiced infants before and after, but not during phototherapy.
Methods: This study prospectively investigated the correlation between TcB and TsB in term and near term infants before and after phototherapy.
Results: Overall 673 pair...
Abstract Group B streptococcus (GBS) remains worldwide a leading cause of severe neonatal disease. Since the end of the 1990s, various strategies for prevention of the early onset neonatal disease have been implemented and have evolved. When a universal antenatal GBS screening-based strategy is used to identify women who are given an intrapartum an...
Premature infants at the limits of viability raise difficult ethical, legal, social and economic questions. Neonatologists attending an international Collegium were surveyed about delivery room behaviour, and the approach taken by selected countries practicing 'modern' medicine was explored.
There were strong preferences for comfort care at 22 week...
In this issue of the journal, Williams et al provide both good and potentially not so good news on the contribution that infections make to neonatal and infant mortality (1). The good news is that the absolute numbers of neonates and infants dying of infectious causes in the north of England fell significantly during the 21 years between 1988 and 2...
Abstract Objective: Evaluation of a neonate for suspected early neonatal sepsis routinely includes blood tests such as complete blood count, CRP and culture. In order to obviate the need for venepuncture, we prospectively compared these tests in paired samples from umbilical cord and peripheral venous blood drawn during the first hours after birth...
Airway medications are frequently used in the care of the sick neonate. The most prominent airway medication, surfactant for respiratory distress syndrome, will be discussed elsewhere in this issue of Neonatology. Other indications for airway medications have included the prevention and treatment of bronchopulmonary dysplasia, pulmonary hypertensio...
In Israel, an average of 37 children are born each year with sepsis and another four with meningitis as a result of Group B Streptococcal (GBS) disease. Israel currently only screens mothers with defined risk factors (around 15% of all pregnancies) in order to identify candidates for Intrapartum Antiobiotic Prophyhlaxis (IAP) of GBS. This paper pre...
Multi-fetal pregnancy is associated with a higher rate of complications and specific conditions, both during pregnancy and labor, that are not seen with singletons. All these make the twin fetus more vulnerable and put him at higher risk. We describe the types of twins, the complications that are unique to them, and the conditions they may face dur...
Aim: Guidelines for detection of early neonatal sepsis employ a risk factor approach combined with laboratory parameters. In an era of increasing intrapartum antibiotic prophylaxis (IAP), we re-assessed the approach as a whole and each of the risk factors individually.
Method: This retrospective study included infants with risk factors for sepsis o...
The objective of our study was to assess factors associated with iatrogenic events in Neonatal Intensive Care Units (NICUs). This was a retrospective analysis based on a cohort of patients who participated in our previous prospective study (Pediatrics 122:550-555, 2008), conducted in four tertiary university-affiliated NICUs in Israel, that include...
To determine the correlation between specific fetal heart rate (FHR) abnormalities and the incidence of death, severe (grade 3-4) intraventricular hemorrhage (IVH) and periventricular echogenicity (PVE) in extremely low birth weight infants (ELBW) within the first 4 days after birth.
The study included live-born ELBW infants ≤ 30 weeks' gestation w...
Flexible fiberoptic bronchoscopy (FFB) is an under-used technology in neonates, mostly performed by external consultants from either pulmonology or otolaryngology. Modern ultra-thin scopes offer the neonatologist new diagnostic and therapeutic opportunities at the bedside.
To describe the diagnostic value, therapeutic potential, and safety profile...
The American Academy of Pediatrics recently published recommendations for the red reflex assessment in the newborn period to detect and treat ocular disorders as early as possible, and to prevent lifelong visual impairment and even save lives. The test is technically simple to perform, non-invasive, requires minimal equipment and can detect a varie...
The inability to appropriately ventilate neonates shortly after their birth could be related in rare cases to chest-wall rigidity caused by the placental transfer of fentanyl. Although this adverse effect is recognized when fentanyl is administered to neonates after their birth, the prenatal phenomenon is less known. Treatment with either naloxone...
OBJECTIVE: Palivizumab reduces respiratory syncytial virus (RSV) hospitalization in children at high risk by 50% compared with placebo. We compared the efficacy and safety of motavizumab, an investigational monoclonal antibody with enhanced anti-RSV activity in preclinical studies, with palivizumab. METHODS: This randomized, double-blind, multinati...
In rare cases, severe fetal vitamin K deficiency bleeding may occur in utero as a result of insufficient vitamin K placental transfer. We present a case of a 32-week-preterm infant born with severe intracranial hemorrhage to a pregnant woman who suffered from hyperemesis gravidarum. Neonatal hematologic status was compatible with vitamin K deficien...
Perinatal corticosteroids are like a double-edged sword. On the one hand, they reduce risk for major morbidity and even mortality; on the other hand, they modify growth and development of body systems, with short- and long-term consequences. The relationship between corticosteroids and neurodevelopmental outcome has been extensively studied in rand...
Background: The rare congenital combination of microcephaly, lymphedema and chorioretinopathy (MLCD) has been described. Recently, three cases with these clinical characteristics have been diagnosed as having, in addition, various congenital cardiac anomalies, which may be part of this genetic entity that presents with variable expression.
Clinical...
Outcomes, both short and long term, differ between singletons and multiplets. Recently, a number of large, well-designed studies have clarified these differences, particularly in light of major changes in perinatal and neonatal care that have influenced changing outcomes. Accordingly, this article will review risks for singletons, twins and higher-...
Judaism offers a clear set of laws that aid the patient and family from sickness through death and into a structured mourning process.
The goals were to determine the incidence of iatrogenic events in NICUs and to determine whether awareness of iatrogenic events could influence their occurrence.
We performed a prospective, observational, interventional, multicenter study including all consecutive infants hospitalized in 4 NICUs. In the first 3 months (observation period), the medi...
Few therapies in perinatal medicine have created as much controversy as corticosteroids. Despite five decades of extensive research and practice, major areas of uncertainty remain. In this article, we review the most current evidence on both antenatal and postnatal therapy.
Conclusion: Overall, it is clear that we must continue to investigate the m...
We describe a previously unreported neonatal presentation of an anomalous origin of the left coronary artery arising from the pulmonary artery. This is a full-term female infant after normal pregnancy and delivery. The baby was diagnosed at 2 days of age due to weak femoral pulses noted on the routine nursery discharge examination. The cardiac exam...
Prolonged mechanical ventilation (MV) with O2-rich gas inhibits lung growth and causes excess, disordered accumulation of lung elastin in preterm infants, often resulting in chronic lung disease (CLD). Using newborn mice, in which alveolarization occurs postnatally, we designed studies to determine how MV with either 40% O2 or air might lead to dys...
Advances in perinatal and neonatal care in recent years have resulted in dramatic improvements in the rate of intact survival of preterm infants. As a result, neonatologists have focused on the new challenge of bringing about similar advances for the tiniest infants who are born at or near the current limits of viability. Although these tiny infant...
Mechanical ventilation with 40% oxygen reduces pulmonary expression of genes that regulate lung development and impairs alveolar septation in newborn mice. Am J Physiol Lung Cell Mol Physiol 293: , 2007. First published August 17, 2007; - Mechanical ventilation (MV) with O(2)-rich gas offers life-saving treatment for extremely premature infants wit...
Preterm male infants are at a disadvantage when compared with female infants regarding the incidence of respiratory and neurologic morbidity and mortality. At term, female infants from unlike-sex twin pairs have birth weights that are closer to their male co-twins than to girls from like-sex twin pairs. We hypothesized that if the male disadvantage...
Recent years have witnessed an international, multisource effort to define and progressively improve evidence-based criteria for defining the relationship between perinatal events and the subsequent development of cerebral palsy. The neonatal components of these criteria include neonatal encephalopathy, Apgar score, multisystem organ dysfunction, a...
To conduct a single-centre "look-back" study of the prevalence of hepatitis C in teenagers who had received blood products as newborns, prior to hepatitis C virus (HCV) blood donor screening.
Using blood bank records, we identified 732 surviving teenagers aged 14-18 years who had received blood products as neonates during 1986-1990. Letters recomme...
The purpose of this document is to expand the 1995 ISTS/COMBO Declaration of Rights which was initially produced to promote awareness of the special needs of multiple birth infants, children, and adults. It addresses the clinical and ethical dimensions of perinatal care of multiple pregnancy. The ad hoc committee was chaired by Isaac Blickstein. Th...
To study the association between reduced use of postnatal steroids for bronchopulmonary dysplasia (BPD) in very low birthweight (VLBW) infants and oxygen (O(2))-dependency at 28 days of age and at 36 weeks postmenstrual age.
Large national database study.
The Israel National VLBW Neonatal Database.
The sample included infants born between 1997 and...
Unlabelled:
Very-low-birthweight (VLBW) infants suffer marked growth delay despite well-intentioned efforts at combining enteral and parenteral nutrition. Fear of necrotizing enterocolitis (NEC) has traditionally influenced neonatologists toward delaying and progressing slowly with enteral feeding, while supporting the infant with parenteral nutri...
To examine if the recommended weight gain of >680 g/week during the first 24 weeks of pregnancy decreases the frequency of adverse birth weight outcomes in triplet mothers with a normal pregravid BMI.
Retrospective observational study of a large sample of triplet mothers with a normal (19.8-26) pregravid BMI. Adequate, average, and inadequate weigh...
Breast feeding offers major health advantages for all infants, whether born singleton or from multiple pregnancy. Adequate quantity and quality of milk production has been documented even for high multiples. Combined efforts of parents, close family, friends, and the medical team can help to make either full or partial breast feeding of multiples p...
This study was undertaken to compare the effect of antenatal corticosteroid therapy on the risk for severe intraventricular hemorrhage (IVH grade III-IV) in preterm singleton and multiple very low birth weight (VLBW) infants.
The occurrence of severe IVH was recorded in 5022 singleton, 2032 twin, and 582 triplet infants, delivered at 24 to 32 weeks...
Promoting breastfeeding is a central aim of child health care. It is critical to develop approaches that are inexpensive, effective, and suitable across cultural and socioeconomic groups.
To study the effect of training perinatal-neonatal nursing and medical staff in breastfeeding guidance on the duration of breastfeeding in a middle-income urban p...
Piperacillin/tazobactam (P/T) has been used in NICU since 1999 as part of the empirical treatment for presumed sepsis. We studied the microbiological and clinical efficacy and safety of P/T use in newborns with sepsis, using a retrospective analysis of medical records of all newborns treated with P/T (in association with amikacin) during 1999-2003....
This study aims to clarify the relationship between indomethacin tocolysis and neonatal white matter injury (WMI) in preterm infants.
We conducted a retrospective review of preterm infants born at 24-32 weeks who had sufficient cranial ultrasound examinations (CUS) to determine the incidence and severity of abnormalities. Infants with normal CUS we...
The epidemic of multiple births has translated into a marked rise in very low birth weight infants, who are at risk for major neonatal morbidity and mortality. Gestational age-adjusted comparisons of outcome between singletons and multiples have shown conflicting results. Comparisons that corrected for relevant confounding variables show that twins...
The purpose of this study was to determine the effect of antenatal corticosteroids on the incidence of respiratory distress syndrome in singleton infants and multiple infants who weigh <1500 g and are delivered at 24 to 32 weeks of gestation.
The incidence of respiratory distress syndrome was established in 4754 singleton infants, 2460 twin infants...
To examine whether the recommended weight gain during the first 24 weeks reduces the frequency of SGA triplets.
We used data collected by the Women's Health Division of Matria Healthcare, Inc (Marietta, GA). We studied the frequency of SGA triplets (birth weight <10th percentile by triplet standards) by weight gain, parity, and pregravid BMI catego...
In recent years, scientific evidence has accumulated on the potential neuro-toxic effects of perinatal steroid therapy on the incompletely developed brain; therefore, much effort has been directed toward finding the optimal regimen that may reduce lung disease without incurring significant brain injury in fetuses and preterm infants. Current recomm...
The interrelations between early enteral feeding, necrotising enterocolitis (NEC), and nosocomial sepsis (NS) remain unclear.
To evaluate the effect of age at the introduction of enteral feeding on the incidence of NS and NEC in very low birthweight (VLBW< 1500 g) infants.
Data were collected on the pattern of enteral feeding and perinatal and neon...
To study the effect of prenatal consultation (PC) with a neonatologist on the incidence and duration of human milk feeding (HMF) in preterm infants.
A retrospective matched case-control study was preformed at a perinatal centre. Study infants were preterm infants (23-35 wk) whose mothers had received PC emphasizing the importance of HMF. Control in...
Unlabelled:
We describe a case of isolated ischemic necrosis of the epididymis in a premature newborn with aortic steal syndrome, secondary to a large patent ductus arteriosus (PDA). Neither this finding nor the possible underlying pathogenesis has been previously described.
Conclusion:
In this report our knowledge of the potential complications...
Objective: To study the effect of birth order on the risk for respiratory distress syndrome (RDS), chronic lung disease (CLD), adverse neurological findings, and death in very low birthweight (VLBW; < 1500 g) twins. Methods: A population based study of VLBW infants from the Israel National VLBW Infant Database. The sample included all complete sets...
To study the effect of birth order on the risk for respiratory distress syndrome (RDS), chronic lung disease (CLD), adverse neurological findings, and death in very low birthweight (VLBW; < 1500 g) twins.
A population based study of VLBW infants from the Israel National VLBW Infant Database. The sample included all complete sets of VLBW twin pairs...
We compare three methods which can be used to analyse the influence of birth order and other factors on health outcomes in multiple birth data. We consider marginal models based on generalized estimating equations (GEE) and two kinds of conditional models; conditional logistic regression (CLR) and mixed effects models (MEM). Although the models may...