Effectiveness and Safety of Nadroparin Therapy in Preterm and Term Neonates with Venous Thromboembolism

Introduction: Optimal neonatal nadroparin dosages to treat venous thromboembolism (VTE) are unknown. Objective: To evaluate therapeutic nadroparin dosages to reach therapeutic target ranges (TTR: 0.5–1.0 International Unit (IU)/mL) and the effectiveness and safety of nadroparin in neonatal VTE. Methods: Retrospective study including neonates with VTE on nadroparin in a tertiary center between 2007 and 2018. Two groups were distinguished: neonates before (group 1) and after (group 2) switch to higher starting dosages in 2014. Results: Sixty-one neonates (44 preterm, 17 term) with 64 VTEs were included. TTR was reached in 32/64 (50%) VTEs (group 1: 35.7%; group 2: 61.1%). Median nadroparin dosage to reach TTR was 197 (97.9–330.3) IU/kg/12 h. No therapy-related deaths occurred. Recurrent VTE developed in 6 (9.8%) neonates. Complete clot resolution was observed in 31/41 (75.6%) VTEs. TTR was reached in 58.1% VTEs with complete clot resolution. No major bleeding occurred. Non-major clinically relevant bleedings occurred in 3/64 (4.7%) VTEs, consisting of large hematomas due to the use of subcutaneous catheters. Conclusions: High nadroparin dosages are needed to reach TTR in neonates, which seem to be safe. Clot resolution may occur without reaching TTR. Subcutaneous catheters may cause important bleeding complications.

Program Penerapan Mitigasi Bencana Gempa Bumi Di Ponpes Nurul Wathan Lombok Tengah NTB Berorientasi Pada Penurunan Magnet Bumi Akibat Pergerakan Sesar Patahan

The program that was implemented at Nurul Wathan (NW) was the result of research at the Rembitan Observatory to measure the earth's magnetism using a device called Proton. The international unit for measuring the earth's magnetism is the Tesla, specifically the nTesla earth magnet (Nano Tesla). The stages of implementing the solution are adjusted to the characteristics of the stages of the disaster cycle. During a disaster, full of activities in an emergency situation, post-disaster, reduce the complexity of the problems in reconstruction and rehabilitation. Pre-disaster requires thorough planning. Communities that are exposed to disasters are very diverse. For those who have been educated or those who have not received formal education, they need to understand the importance of disaster risk reduction (DRR).