WorldWideScience

Sample records for enterocolite necrosante neonatal

  1. Fatores associados à enterocolite necrosante

    OpenAIRE

    Vieira,Maria Teresa Campos; Lopes,José Maria de Andrade

    2003-01-01

    OBJETIVO: avaliar as formas de apresentação clínica da enterocolite necrosante neonatal e os fatores associados à doença. MÉTODOS: estudo retrospectivo dos casos de enterocolite necrosante neonatal (ECN) (n = 56) ocorridos na UTI Neonatal Lagoa, entre dezembro de 1986 e julho de 1992. O diagnóstico e estadiamento da doença seguiram o critério de Bell modificado. Foram avaliados o diagnóstico e a evolução de todos os casos. Posteriormente, foram selecionados os casos de enterocolite grau II e ...

  2. Fatores associados à enterocolite necrosante Factors associated with necrotizing enterocolitis

    Directory of Open Access Journals (Sweden)

    Maria Teresa Campos Vieira

    2003-04-01

    Full Text Available OBJETIVO: avaliar as formas de apresentação clínica da enterocolite necrosante neonatal e os fatores associados à doença. MÉTODOS: estudo retrospectivo dos casos de enterocolite necrosante neonatal (ECN (n = 56 ocorridos na UTI Neonatal Lagoa, entre dezembro de 1986 e julho de 1992. O diagnóstico e estadiamento da doença seguiram o critério de Bell modificado. Foram avaliados o diagnóstico e a evolução de todos os casos. Posteriormente, foram selecionados os casos de enterocolite grau II e III (n =44 e comparados com um grupo controle (n = 44, selecionado pelo peso de nascimento (± 250g e época de internação (± 2 semanas. Para a análise estatística, foi considerado significante p OBJECTIVE: to evaluate the features of clinical presentation of neonatal necrotizing enterocolitis and its associated factors. METHODS: retrospective study of the cases of neonatal necrotizing enterocolitis (n = 56 diagnosed at Neonatal Intensive Care Unit Lagoa (NICU, between December 1986 and July 1992. Diagnosis and stages of the disease followed the modified Bell's criteria. Diagnosis and follow-up of all cases were evaluated. The cases of enterocolitis - degrees II and III (n = 44 - were subsequently selected and compared to a case-control group (n = 44, selected according to birthweight ( 250 g and hospitalization period ( 2 weeks. The statistically significant analysis was considered as p < 0.05. RESULTS: out of 2,447 newborns admitted to the NICU, 56 (2.3% presented enterocolitis. Mean weight was 1908.5 g; mean gestational age was 35 weeks and 1 day; mean period for diagnosis was 10.7 days; 51 (91.1% patients were fed before diagnosis; 18 (32.1% needed urgent surgery; nine (16.9% hemocultures were positive; 10 (17.8% patients died. Four clinical standards were observed: fulminant, acute with pneumatosis, insidious and suspect. Comparatively to the case-control group, three factors were significantly associated with enterocolitis: apnea (p = 0

  3. Aspectos radiológicos relevantes no diagnóstico da enterocolite necrosante e suas complicações

    OpenAIRE

    Alvares,Beatriz Regina; Martins,Daniel Lahan; Roma,Renato Lopes; Pereira,Inês Minniti Rodrigues

    2007-01-01

    A enterocolite necrosante representa uma das emergências gastrintestinais mais freqüentes e graves no período neonatal. Na suspeita clínica dessa doença, o exame radiológico simples de abdome é um procedimento de rotina, desempenhando um papel fundamental no diagnóstico, acompanhamento e detecção de complicações. No presente trabalho, realizamos uma revisão da literatura pertinente e descrevemos os achados radiológicos da enterocolite necrosante, ilustrados com casos do nosso serviço. Concluí...

  4. Avaliação de um modelo experimental de enterocolite necrosante neonatal em ratos Evaluation of an experimental model of necrotizing enterocolitis in rats

    Directory of Open Access Journals (Sweden)

    Karine Furtado Meyer

    2006-04-01

    Full Text Available OBJETIVO: Avaliar um modelo experimental de enterocolite necrosante em ratos proposto por Okur e colaboradores em 1995. MÉTODOS: Utilizou-se 28 ratos da raça EPM-Wistar no primeiro dia de vida, com peso entre 4 a 6 gramas. Os animais foram submetidos a hipóxia (H colocando os filhotes em uma câmara de gás CO2 para sacrifício de roedores onde receberam um fluxo de ar contendo 100% de CO2 durante 5 minutos. Após a hipóxia os animais foram reanimados (R com fluxo de ar contendo O2 a 100%, também durante 5 minutos. Os animais divididos em dois grupos: G1: controle (n=12: ratos não submetidos a H-R; G2: (n=16: ratos submetidos a H-R. Segmentos de intestino delgado e cólon foram preparados para análise histológica. O restante do intestino foi utilizado para dosagem de malondialdeído tecidual. RESULTADOS: Dosagem de malondialdeído do G1 foi em média 1,05 (0,44-2,03 e do G2 foi em média 2,60 (0,59- 6,4 nmol MDA/mg proteína. O G2 teve média significativamente maior do que a do grupo controle (pOBJECTIVE: To evaluate an experimental model of necrotizing enterocolitis in rats proposed by OKUR e col. in 1995. METHODS: On their first day of life, 28 EPM-Wistar rats weighing between 4 and 6 grams were submitted to hypoxia (H by placing them in a CO2 gas chamber for rodents' sacrifice, where they received a 100% CO2 air flow for 5 minutes. After the hypoxia the animals were reanimated (R with a 100% O2 air flow, also for 5 minutes. The animals were allocated in two groups: G1: control (n=12: rats not submitted to H-R; G2: (n=16: rats submitted to H-R. Segments of the small intestine and colon were prepared for histological analysis. The remaining intestine was used to measure tissular malondialdehyde. RESULTS: Mean malondialdehyde dosages were 1.05 (0.44-2.03 and 2.60 (0.59- 6.4 nmol MDA/mg protein for G1 and G2, respectively. G2's mean value was significantly higher than in the control group (p<0.002. Significant statistical difference

  5. Enterocolite necrosante em recém-nascidos de muito baixo peso: a influência da nutrição enteral

    OpenAIRE

    KIMAK, Karine Santos

    2013-01-01

    A enterocolite necrosante é uma importante causa de morbimortalidade neonatal em prematuros, principalmente nos recém-nascidos de muito baixo peso. Apesar de a enterocolite necrosante apresentar etiologia multifatorial, a dieta enteral tem sido implicada como um dos principais fatores associados e não há consenso sobre quando deve ser iniciada, como deve progredir, nem a sua relação com a ocorrência da doença. Assim, este estudo teve por objetivo avaliar se o padrão da nutrição enteral influe...

  6. Enterocolite Necrosante num Serviço de Cardiologia Pediátrica

    OpenAIRE

    Afonso, S.; Ferreira, S.; Macedo, A. J.; Kaku, S.

    2014-01-01

    Introdução: Os autores procuram determinar factores de risco de enterocolite necrosante, em recém-nascidos de termo com cardiopatia congénita.Métodos: Revisão retrospectiva de recém-nascidos de termo, com cardiopatia congénita, internados num serviço de Cardiologia Pediátrica, nos anos de 1998 e 1999. Classificação das enterocolites de acordo com os critérios modificados de Bell.Resultados: Foram revistos 71 recém-nascidos. Dezassete doentes tiveram NEC (24%) sendo 11 de grau I (15%) e seis d...

  7. Avanços em enterocolite necrosante Advances in necrotizing enterocolitis

    Directory of Open Access Journals (Sweden)

    Nelson Diniz de Oliveira

    2005-03-01

    Full Text Available OBJETIVO: Avaliar relatos recentes sobre a enterocolite necrosante, com especial interesse na etiopatogenia, manejo e prevenção. FONTE DOS DADOS: Os artigos utilizados nessa revisão consistem em ensaios randomizados ou semi-randomizados, estudos de caso-controle, metanálises e artigos de revisão recentemente publicados. Alguns outros artigos foram selecionados devido à sua importância para o tema. RESULTADOS: A enterocolite necrosante é uma importante causa de morbimortalidade neonatal em prematuros. Entre esses, os nascidos com retardo de crescimento intra-uterino apresentam um risco mais elevado. O processo fisiopatológico inicia-se intra-útero e continua após o nascimento. Entre outros fatores envolvidos na fisiopatologia, estão a ação da arginina na produção do óxido nítrico intestinal e a ação do fator de crescimento epidérmico na regeneração celular. A perfuração intestinal ainda é um problema cirúrgico, e evidências melhores quanto à sua abordagem precisam ser avaliadas. Após a cirurgia, a extensão da alça intestinal remanescente, a preservação da válvula ileocecal, assim como a utilização precoce de leite materno ou solução de aminoácidos, são determinantes na duração da nutrição parenteral e no sucesso da readaptação intestinal. Estratégias preventivas estão centradas nas práticas alimentares e, recentemente, na suplementação de aminoácidos. CONCLUSÃO: Com um melhor entendimento do processo fisiopatológico, do manejo clínico e cirúrgico, assim como das medidas de prevenção, importantes resultados serão alcançados em termos de redução da morbimortalidade conseqüente à enterocolite necrosante.OBJECTIVE: To evaluate recently reported findings on necrotizing enterocolitis, Paying particular attention to pathogenesis, management and preventative strategies. DATA SOURCES: The articles covered in this report consist of randomized and quasi-randomized trials, case control studies

  8. Necrotizing enterocolitis, pathogenesis and the protector effect of prenatal corticosteroids Enterocolite necrosante: resposta imflamatória x corticoterapia pré-natal

    Directory of Open Access Journals (Sweden)

    Alexander Roberto Precioso

    2002-09-01

    Full Text Available Necrotizing enterocolitis is the most frequently occurring gastrointestinal disorder in premature neonates. Animal models of necrotizing enterocolitis and prenatal administration of cortisone have demonstrated that cortisone may accelerate maturation of the mucosal barrier, therefore reducing the incidence of this gastrointestinal disorder. The authors present a review of the literature of the most important risk factors associated with necrotizing enterocolitis, such as inflammatory gastrointestinal mediators, enteral feeding and bacterial colonization, and immaturity of the gastrointestinal barrier, and we emphasize the necessity for additional studies to explore the prenatal administration of cortisone as a preventive strategy for necrotizing enterocolitis.A enterocolite necrosante é a mais freqüente patologia gastrointestinal adquirida no período neonatal, acometendo preferencialmente o recém-nascido prematuro. Estudos experimentais sugerem que a corticoterapia pré-natal acelera a maturação da mucosa gastrintestinal, levando a diminuição da incidência desta doença. Os autores apresentam uma revisão da literatura em relação aos principais fatores fisiopatológicos associados a enterocolite necrosante, tais como mediadores inflamatórios gastrintestinais, nutrição enteral e colonização bacteriana e imaturidade gastrintestinal e enfatizam a necessidade de mais estudos que avaliem a influencia da corticoterapia pré-natal com fator de prevenção da enterocolite necrosante.

  9. Aspectos radiológicos relevantes no diagnóstico da enterocolite necrosante e suas complicações Relevant radiological findings for the diagnosis of necrotizing enterocolitis and its complications

    Directory of Open Access Journals (Sweden)

    Beatriz Regina Alvares

    2007-04-01

    Full Text Available A enterocolite necrosante representa uma das emergências gastrintestinais mais freqüentes e graves no período neonatal. Na suspeita clínica dessa doença, o exame radiológico simples de abdome é um procedimento de rotina, desempenhando um papel fundamental no diagnóstico, acompanhamento e detecção de complicações. No presente trabalho, realizamos uma revisão da literatura pertinente e descrevemos os achados radiológicos da enterocolite necrosante, ilustrados com casos do nosso serviço. Concluímos que o diagnóstico radiológico da enterocolite necrosante realizado em todas as suas etapas, contribui para uma conduta terapêutica imediata, reduzindo as complicações e aumentando a sobrevida dos pacientes.Necrotizing enterocolitis is one of the most frequent and severe gastrointestinal emergencies occurring in the neonatal period. Once necrotizing enterocolitis is suspected a simple abdominal x-ray is a routine examination and this film will play an essential role in the diagnosis of the disease and the follow-up care of the patient, as well as in the detection of complications. In the present study we reviewed the pertinent literature and described the radiological findings, illustrated with cases from our institution. We concluded that the radiological diagnosis of necrotizing enterocolitis done at all stages contributes for an immediate therapeutic management, reducing the complications and improving the patient's survival.

  10. Eficácia dos probióticos na profilaxia de enterocolite necrosante em recém-nascidos prematuros: revisão sistemática e meta-análise Effectiveness of probiotics in the prophylaxis of necrotizing enterocolitis in preterm neonates: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Wanderley Marques Bernardo

    2013-02-01

    Full Text Available OBJETIVO: Elucidar os benefícios do uso de probióticos na prevenção de enterocolite necrosante (ECN e de suas complicações em recém-nascidos prematuros. MÉTODO: Revisão sistemática de ensaios clínicos randomizados, que incluiu pesquisas efetuadas em três bases de dados (MEDLINE, EMBASE e LILACS, utilizando a combinação dos termos (necrotizing enterocolitis AND (probiotics. RESULTADOS : Foram incluídos 11 ensaios clínicos randomizados, totalizando 2.887 pacientes, sendo 1.431 no grupo Probiótico e 1.456 no grupo Controle. Houve redução na incidência de ECN (NNT = 25, de morte global (NNT = 34 e sepse neonatal (NNT = 34 no grupo Probiótico em relação ao grupo Controle. Pacientes alimentados com suplementação de probióticos tiveram tempo de reintrodução alimentar (p OBJECTIVE: To elucidate the benefits of using probiotics in the prevention of necrotizing enterocolitis (NEC and its complications in preterm newborns. METHOD: This was a systematic review of randomized controlled trials, which included studies retrieved from three databases (MEDLINE, Embase, and LILACS, using a combination of the terms (necrotizing enterocolitis AND (probiotics. RESULTS: 11 randomized trials were included, totaling 2,887 patients, 1,431 in the probiotic group and 1,456 in the control group. There was a reduction in the incidence of NEC (NNT = 25, overall death (NNT = 34, and neonatal sepsis (NNT = 34 in the probiotic group compared to the control group. Patients that received probiotic supplementation had lower food reintroduction time (p < 0.001 and hospitalization time (p < 0.001 when compared to those not receiving probiotics. There was no difference in mortality caused by NEC. CONCLUSION: In premature newborns, the use of probiotics is effective as a prophylaxis for NEC and its complications.

  11. Enterocolite necrosante em recém-nascidos de muito baixo peso em uma unidade neonatal de alto risco do Nordeste do Brasil (2003-2007 Necrotizing enterocolitis in very low weight newborns at a high risk neonatal unit in the Northeast region of Brazil (2003-2007

    Directory of Open Access Journals (Sweden)

    Taciana Duque Braga

    2012-06-01

    Full Text Available OBJETIVOS: avaliar a incidência de enterocolite necrosante (ECN, no período de 2003 a 2007, em crianças nascidas com muito baixo peso e descrever as características da assistência prestada a esses recém-nascidos. MÉTODOS: estudo longitudinal retrospectivo conduzido em uma unidade neonatal de alto risco com uma amostra de 1028 recém-nascidos de muito baixo peso, excluindo-se os menores de 750 g. A frequência de ECN foi observada do primeiro até o trigésimo dia de vida, ou até a sua ocorrência ou óbito, considerando-se o que ocorresse primeiro em um período de cinco anos. ECN foi definida pelo critério de Bell (estágio ≥2. Utilizou-se o qui-quadrado de tendência para avaliar o comportamento das variáveis categóricas ao longo dos cinco anos. RESULTADOS: ECN ocorreu em 55 dos 1028 recém-nascidos (5,3%. Observou-se maior incidência de ECN no ano de 2005 (19/204 com uma significante redução no ano de 2007 (8/195, entretanto, essa variação não caracterizou uma tendência (p=0,45. Observou-se aumento significante do uso de antibióticos,de nutrição parenteral, de corticóide antenatal e do consumo de leite materno e uma redução na média da idade gestacional de 2,4 semanas entre 2003 e 2007. CONCLUSÕES: a incidência de ECN foi variável, sem tendência de ascensão ou queda. Observou-se um incremento na cobertura de corticoide antenatal, aumento na utilização de leite materno e redução no consumo de fórmula. Mais estudos são necessários para melhor avaliar a contribuição dessas medidas na não progressão da incidência da ECN, apesar de tratar-se de uma população com risco elevado para essa doença.OBJECTIVES: to assess the incidence of nectrotizing enterocolitis (NEC, between 2003 and 2007, in children born with a very low weight and to describe the care provided for these newborns. METHODS: a retrospective longitudinal study was carried out at a high-risk neonatal unit with a sample of 1028 newborns with

  12. Enterocolite necrosante: resposta imflamatória x corticoterapia pré-natal

    OpenAIRE

    Precioso, Alexander Roberto; Proença, Renata Suman Mascaretti

    2002-01-01

    Necrotizing enterocolitis is the most frequently occurring gastrointestinal disorder in premature neonates. Animal models of necrotizing enterocolitis and prenatal administration of cortisone have demonstrated that cortisone may accelerate maturation of the mucosal barrier, therefore reducing the incidence of this gastrointestinal disorder. The authors present a review of the literature of the most important risk factors associated with necrotizing enterocolitis, such as inflammatory gastroin...

  13. Associação de transfusão de concentrado de hemácias (CH e enterocolite necrosante (ECN: relato de caso

    Directory of Open Access Journals (Sweden)

    Jun Otsutsumi Junior

    2017-12-01

    Full Text Available A Enterocolite necrosante é uma síndrome clínicopatológica caracterizada por sinais e sintomas gastrintestinais e sistêmicos. De etiologia incerta, atinge um em cada 1.000 nascidos vivos. Alguns eventos levam à suspeita da síndrome, a qual pode estar associada à transfusão de hemácias. Objetivou-se relatar o caso de um recém-nascido prematuro que apresentou sinais de enterocolite necrosante após uma transfusão sanguínea com concentrado de hemácias. Recém-nascido, internado em uma Maternidade Escola de Fortaleza, Ceará, apresentava bom desenvolvimento e anemia, com hemoglobina 9,34 e hematócrito 30,1, sendo indicada transfusão. Na primeira transfusão, não apresentou reação clínica pós-transfusão; com 51 dias de vida, devido a outro quadro de anemia, foi indicada nova transfusão, apresentando hipoatividade, distensão abdominal e dois episódios de queda de saturação; após 66 dias, houve nova indicação para transfusão, a qual após infusão de 5,1ml evoluiu com novo episódio de taquidispneia, distensão abdominal e hiposaturação. O caso demonstrou evidência e clareza conforme achados na literatura. Observou-se que o uso da imagem como exame complementar para o diagnóstico identifica precocemente os achados da doença.

  14. Valor preditivo da distensão de alças intestinais em radiografias no prognóstico de enterocolite necrosante Dilatation of bowel loops on radiological images: prognostic value in necrotizing enterocolitis

    Directory of Open Access Journals (Sweden)

    Daniel Lahan Martins

    2007-10-01

    Full Text Available OBJETIVO: Avaliar o valor prognóstico da distensão de alças intestinais observada em radiografias na evolução e mortalidade de neonatos com enterocolite necrosante. MATERIAIS E MÉTODOS: Nas radiografias de abdome de 53 pacientes obtidas no momento da suspeita diagnóstica de enterocolite necrosante, foi realizada a medida do diâmetro da alça mais distendida (AD, assim como a distância entre a borda superior da primeira vértebra lombar e a borda inferior da segunda (L1-L2, a distância entre as bordas laterais dos pedículos da primeira vértebra lombar (L1, e foram estabelecidas as associações entre AD/L1-L2 e AD/L1. Esta medida foi considerada como possível determinante de potenciais complicações, intervenção cirúrgica e mortalidade. RESULTADOS: Os pacientes que necessitaram de tratamento cirúrgico, aqueles que tiveram complicações durante a evolução e aqueles que morreram da doença tiveram a relação entre AD e AD/L1-L2 maiores (p OBJECTIVE: To evaluate the prognostic value of bowel loops dilatation as a finding on radiographs in the development and mortality of neonates with necrotizing enterocolitis. MATERIALS AND METHODS: On abdominal radiographs of 53 patients for diagnostic suspicion of necrotizing enterocolitis, the major diameters of dilated bowel loops (AD were measured, as well as the distance between the upper border of the first lumbar vertebra and the lower border of the second one (L1-L2, and the distance between the lateral borders of the first lumbar vertebra (L1 pedicles, and the subsequent association between AD/L1-L2, AD/L1. This measure was considered as a possible determining factor for potential complications, surgical intervention and mortality. RESULTS: The patients who needed surgical management and who had complications during progression and died of the disease had showed increased AD and AD/L1-L2 (p < 0.05. AD/L1 values and site of the most dilated bowel loop were not different in the groups

  15. Eficácia dos probióticos na profilaxia de enterocolite necrosante em recém-nascidos prematuros: revisão sistemática e meta-análise

    Directory of Open Access Journals (Sweden)

    Wanderley Marques Bernardo

    2013-02-01

    Full Text Available OBJETIVO: Elucidar os benefícios do uso de probióticos na prevenção de enterocolite necrosante (ECN e de suas complicações em recém-nascidos prematuros. MÉTODO: Revisão sistemática de ensaios clínicos randomizados, que incluiu pesquisas efetuadas em três bases de dados (MEDLINE, EMBASE e LILACS, utilizando a combinação dos termos (necrotizing enterocolitis AND (probiotics. RESULTADOS : Foram incluídos 11 ensaios clínicos randomizados, totalizando 2.887 pacientes, sendo 1.431 no grupo Probiótico e 1.456 no grupo Controle. Houve redução na incidência de ECN (NNT = 25, de morte global (NNT = 34 e sepse neonatal (NNT = 34 no grupo Probiótico em relação ao grupo Controle. Pacientes alimentados com suplementação de probióticos tiveram tempo de reintrodução alimentar (p < 0,001 e de hospitalização (p < 0,001 menor quando comparados aos que não receberam. Não houve diferença na mortalidade causada por ECN. CONCLUSÃO: Em recém-nascidos prematuros, o uso de probióticos é eficaz na profilaxia de ECN e de suas complicações.

  16. Uso de fatores de crescimento epidérmico e estimulador de colônias de granulócitos na prevenção e tratamento da enterocolite necrosante no recém-nascido Use of epidermic and granulocyte-colony stimulating growth factors in the prevention and treatment of necrotizing enterocolitis of the newborn

    Directory of Open Access Journals (Sweden)

    Dáfne Cardoso B. da Silva

    2008-06-01

    Full Text Available OBJETIVO: Revisar os conhecimentos existentes em relação ao uso de fatores de crescimento epidérmico e estimulador de colônias de granulócitos na prevenção e/ou no tratamento da enterocolite necrosante (ECN durante o período neonatal. FONTES DE DADOS: Revisão da literatura, nas bases de dados Medline, Lilacs, SciELO e PubMed, utilizando os unitermos "recém-nascidos", "enterocolite" e "fatores de crescimento", no período de 2003 a 2007. Nesta busca, 49 artigos foram encontrados, sendo 17 pertinentes ao tema. Também foram utilizados outros artigos, independente do ano de publicação, relacionados a aspectos definidores da ECN no recém-nascido. SÍNTESE DOS DADOS: A ECN continua sendo responsável por uma elevada morbimortalidade neonatal. Os mecanismos fisiopatológicos vêm sendo elucidados e, a partir deles, são discutidas novas terapias, como o uso de fatores de crescimento, destacando-se o fator de crescimento epidérmico e o fator estimulador de colônias de granulócitos. CONCLUSÕES: O uso de fatores de crescimento no tratamento e prevenção da ECN neonatal parece promissor. É necessário maior número de ensaios clínicos para comprovar sua eficácia e segurança. Enquanto isso, a melhor prática médica continua sendo a prevenção da doença.OBJECTIVE: To review the literature regarding the use of hematopoietic and epidermic growth factors for prevention or treatment of neonatal necrotizing enterocolitis (NEC. DATA SOURCES: Literature review of Medline, Lilacs, SciELO and Pubmed databases, using the key-words "newborn", "enterocolitis" and "growth factors", from 2003 to 2007. Fourty-nine papers were retrieved, but only 17 related to the subject. Other studies that described some clinical aspects of enterocolitis were also included, regardless of the year of publication. DATA SYNTHESIS: Necrotizing and enterocolitis has been an important cause of morbidity and mortality in the neonatal period. As the knowledge about the

  17. Terapia nutricional e sepse neonatal

    OpenAIRE

    Freitas,Brunnella Alcantara Chagas de; Leão,Renata Teixeira; Gomes,Andréia Patrícia; Siqueira-Batista,Rodrigo

    2011-01-01

    O objetivo do presente artigo é revisar a literatura acerca dos conhecimentos atuais relativos à terapia nutricional - enteral e parenteral - para os recém-nascidos pré-termo, principalmente os de muito baixo peso, destacando seu efeito protetor na sepse neonatal e na enterocolite necrosante. As diferentes modalidades de alimentação do recém-nascido prematuro - especialmente para aqueles de muito baixo peso - e seu efeito protetor na diminuição de complicações (mormente as infecciosas) foram ...

  18. Terapia nutricional e sepse neonatal

    Directory of Open Access Journals (Sweden)

    Brunnella Alcantara Chagas de Freitas

    2011-12-01

    Full Text Available O objetivo do presente artigo é revisar a literatura acerca dos conhecimentos atuais relativos à terapia nutricional - enteral e parenteral - para os recém-nascidos pré-termo, principalmente os de muito baixo peso, destacando seu efeito protetor na sepse neonatal e na enterocolite necrosante. As diferentes modalidades de alimentação do recém-nascido prematuro - especialmente para aqueles de muito baixo peso - e seu efeito protetor na diminuição de complicações (mormente as infecciosas foram analisadas. A utilização preferencial do leite materno na nutrição enteral, o controle das ofertas energético-protéicas, o início precoce da nutrição enteral mínima, a introdução precoce da alimentação parenteral - nas primeiras 24 horas - e a utilização dos imunonutrientes que tenham estudos suficientes para fundamentar sua indicação podem se constituir em boas diretrizes adjuvantes na prevenção da sepse neonatal e da enterocolite necrosante. Sem embargo, percebe-se a necessidade de mais estudos - preferencialmente multicêntricos, controlados e randomizados - para esclarecer o papel protetor da nutrição no RNPT, não somente na prevenção de infecções, mas também para auxiliar o desenvolvimento neural e a prevenção de consequências deletérias futuras.

  19. Glycine reduces tissue lipid peroxidation in hypoxia-reoxygenation-induced necrotizing enterocolitis in rats Glicina reduz a peroxidação lipídica tecidual em enterocolite necrosante induzida por hipóxia-reoxigenação em ratos

    Directory of Open Access Journals (Sweden)

    Karine Furtado Meyer

    2006-06-01

    Full Text Available PURPOSE: To assess the protective effect of glycine in an experimental model of Neonatal Necrotizing Enterocolitis (NEC. METHODS: Fifty (50 neonatal Wistar rats, from a litter of six female rats and weighing 4 to 6 grams, were used. Five animals were cannibalized and the 45 remaining were distributed into three groups: the G1 normal control group (n=12; the G2 Group (n=16, of animals that underwent hypoxia-reoxygenation (HR; the G3 Group of animals (n=17 that underwent HR following a 5% intraperitoneal glycine infusion. The animals underwent hypoxia in a CO2 chamber receiving an air flow of 100% CO2 for 5 minutes and reoxygenation receiving an O2 flow at 100% for 5 minutes. One centimeter long small bowel and colon segments were prepared for histological analysis. The rest of the bowel was removed in a block and frozen at minus 80°C for homogenization and determination of tissue malondialdehyde (MDA. Tissue lesions were classified as Grade 0 to Grade 5, according to the level of damaged mucosa. RESULTS: The animals in Group G1 had levels of small bowel and colon lesion significantly smaller as compared to the animals in Groups G2 and G3. The G2 group had mean MDA values significantly higher than the animals in the G1 (p = .015 and G3 (p=0.021 groups. MDA values did not differ significantly (p = 0.992 for the animals in groups G1 and G3. CONCLUSION: Glycine reduces tissue MDA levels (a measurement of lipid peroxidation following HR in neonatal rats.OBJETIVO: Avaliar o efeito protetor da glicina, num modelo experimental de ECN. MÉTODOS: Foram utilizados 50 ratos Wistar recém-nascidos, com peso variando de 4 a 6 gramas, provenientes da ninhada de seis ratas. Cinco animais foram canibalizados e, os 45 restantes, foram distribuídos em três grupos: controle G1(n=12; G2(n=16, animais que foram submetidos à hipóxia-reoxigenação; G3(n=17, animais submetidos à hipóxia-reoxigenação após uma infusão intraperitoneal de glicina 5%. Os animais

  20. Análisis de los factores epidemiológicos y clínicos implicados en el desarrollo de la enterocolitis necrosante

    OpenAIRE

    Martínez Rodríguez, Laura

    2015-01-01

    La enterocolitis necrosante (ENC) es una de los procesos patológicos neonatales más graves por su elevada mortalidad (30%) y complicaciones. A pesar de los constantes avances en la atención neonatal su incidencia continua siendo elevada en el recién nacido pretérmino (RNPT), especialmente en los de peso al nacimiento inferior a 1500 g en los que se estima del 7-10%, tasa que ha sufrido escasas variaciones en los últimos años. La ECN es una enfermedad de origen multifactorial, y la sintomatolo...

  1. Incidencia de enterocolitis necrosante en niños prematuros alimentados precozmente

    Directory of Open Access Journals (Sweden)

    Luis Alfonso Pérez

    2011-06-01

    Conclusión. El iniciar en forma temprana la alimentación entérica en neonatos prematuros no aumenta el riesgo de enterocolitis necrosante ni el de mortalidad y sí representa grandes ventajas para estos pacientes.

  2. Esofagitis necrosante aguda: análisis retrospectivo Acute esophageal necrosis: a retrospective case series

    Directory of Open Access Journals (Sweden)

    R. Ramos

    2008-09-01

    Full Text Available Introducción: la esofagitis necrosante aguda es una entidad rara. Se reconoce por el aspecto negro difuso del esófago a la endoscopia. Su incidencia e patogénesis se desconoce. Pacientes y métodos: se analizaron retrospectivamente 11 pacientes con esofagitis necrosante aguda desde el punto de vista de los datos clínicos, de laboratorio y endoscopicos en 2 años. Resultados: se analizaron las endoscopias realizadas a 3.976 pacientes, observándose esofagitis necrosante aguda en 11 pacientes. El estado nutricional era malo en 6 pacientes. La resolución completa de la esofagitis se observó en cuatro pacientes. Durante el seguimiento se observó una estenosis en un paciente y un nuevo episodio de esofagitis necrosante aguda en otro paciente. Siete pacientes fallecieron, pero esta elevada mortalidad parece deberse a las enfermedades de base y no es atribuible a las lesiones de la esofagitis necrosante. Conclusiones: la incidencia de esofagitis necrosante aguda en nuestra serie fue 0,28%. La esofagitis necrosante aguda tiene una elevada mortalidad.Background: acute esophageal necrosis has been considered a rare event. It is defined as the presence of diffuse dark pigmentation of the esophagus on upper endoscopy. Its incidence has not yet been established. The pathogenesis remains unknown. Patients and methods: a retrospective analysis of clinical, laboratory, endoscopic, and histological data, and of the clinical course of 11 patients with acute necrotizing esophagitis was carried out over a 2-year period. Results: among 3,976 patients who underwent upper endoscopy, 11 (0.28% with acute esophageal necrosis were identified. Nutritional status was poor for 6 patients. Complete resolution of acute esophageal necrosis without further recurrence was observed in 4. One stricture appeared during follow-up and other patient developed new-onset acute esophageal necrosis. Seven patients died, but no death was directly related to acute esophageal necrosis

  3. Sepse neonatal como fator de risco para leucomalácia periventricular em pré-termos de muito baixo peso Periventricular leukomalacia in very low birth weight preterm neonates with high risk for neonatal sepsis

    Directory of Open Access Journals (Sweden)

    Rita C. Silveira

    2008-06-01

    Full Text Available OBJETIVO: Verificar a associação de leucomalácia periventricular (LPV e sepse neonatal em recém-nascidos de muito baixo peso (RNMBP. MÉTODOS: Foram incluídos RNMBP com suspeita clínica de infecção nascidos na instituição de 01/08/2005 a 31/07/2007. Foram excluídos óbitos antes dos 14 dias, malformações do sistema nervoso central e infecções congênitas. Foi realizado ultra-som cerebral no terceiro dia e semanalmente até a sexta semana de vida ou alta. LPV foi diagnosticada por hiperecogenicidade difusa periventricular persistente por mais de 7 dias, ou por cistos periventriculares. RNMBP foram divididos em grupos com e sem LPV. Sepse foi definida por manifestação clínica com cultura positiva. Os testes t, Mann-Whitney, qui-quadrado e regressão logística foram usados. RESULTADOS: Foram incluídos 88 RNMBP, sendo que 62 (70,5% sobreviveram e 51 (57,8% tiveram LPV. Os grupos foram semelhantes no peso de nascimento, idade gestacional, escore de Apgar, tipo de parto, SNAPPE-II, presenças de enterocolite necrosante, persistência de canal arterial e óbitos. Sepse e ventilação mecânica foram mais freqüentes no grupo com LPV (23,5 e 2,7%, p = 0,005; 86 e 59%, p = 0,004, respectivamente. Na regressão logística, ambos foram fatores de risco independentes para LPV (p = 0,027 e 0,015, respectivamente. CONCLUSÃO: Corioamnionite é fator de risco definido para LPV. Demonstramos que sepse neonatal também é fator de risco importante. Acreditamos que a resposta inflamatória sistêmica seja o principal fator envolvido na etiopatogenia da LPV em RNMBP.OBJECTIVE: To investigate the association between periventricular leukomalacia (PVL and neonatal sepsis in very low birth weight infants (VLBWI. METHODS: We studied VLBWI with a clinical suspicion of infection who had been born at our institution between the 1st of August, 2005 and the 31st of July, 2007. Children were excluded if they died before reaching 14 days, had malformations

  4. Peculiaridades da circulação mesentérica em recém-nascidos e suas implicações em doenças gastrintestinais do período neonatal Mesenteric circulation peculiarities in infant newborns and its implications in gastrointestinal illnesses of the neonatal period

    Directory of Open Access Journals (Sweden)

    Chang Yin Chia

    2009-06-01

    Full Text Available OBJETIVO:Descrever peculiaridades da circulação mesentérica neonatal e caracterizar fatores de suscetibilidade ao desenvolvimento de doenças gastrintestinais e alterações do fluxo sanguíneo da artéria mesentérica superior por meio da dopplerfluxometria. FONTES DE DADOS: Livros-textos e publicações indexadas no Medline e SciELO nos últimos 20 anos, utilizando-se as palavras chaves: "mesenteric artery", "superior mesenteric artery", "newborn intestinal circulation", "necrotizing enterocolitis", "doppler flow velocimetry". SÍNTESE DOS DADOS: Alterações do fluxo sanguíneo mesentérico são um dos fatores predisponentes da enterocolite necrosante, doença neonatal de alta morbimortalidade que acomete principalmente prematuros. A circulação mesentérica é peculiar no período neonatal tanto em relação ao seu estado basal, quanto à sua resposta frente a estímulos fisiológicos. Variações da irrigação mesentérica podem ser inerentes à própria fase de desenvolvimento vascular intestinal do recém-nascido pré-termo, com possíveis agravos de fatores perinatais como: insuficiência placentária, asfixia, infecção, cateterismo umbilical, drogas (indometacina e cafeína, fototerapia, alimentação artificial e progressão rápida da dieta. A dopplerfluxometria permite o estudo da irrigação de órgãos-alvo e pode quantificar o fluxo sanguíneo, a resistência vascular e predizer situações de risco para doenças do trato gastrintestinal no período neonatal. CONCLUSÕES: O recém-nascido apresenta peculiaridades de irrigação sanguínea gastrintestinal. A dopplerfluxometria da artéria mesentérica superior é um método não invasivo que determina as condições circulatórias no território intestinal.OBJECTIVE:To describe peculiarities of the neonatal mesenteric circulation and to characterize the susceptibility factors to the development of gastrointestinal illnesses and alterations of the superior mesenteric artery

  5. Fascitis necrosante bilateral: a propósito de un caso Bilateral necrotizing fasciitis: case report

    Directory of Open Access Journals (Sweden)

    F. Fernández Gómez

    2011-06-01

    Full Text Available La fascitis necrosante es una enfermedad de origen infeccioso que afecta a la fascia muscular y progresa rápidamente. Para el manejo de este tipo de pacientes es clave un diagnóstico precoz y un tratamiento adecuado que combine antibioticoterapia y cirugía. Presentamos el caso de una paciente de 77 años de edad con diagnóstico de fascitis necrosante de presentación atípica por la bilateralidad de las lesiones, la ausencia de factores predisponentes y la presencia de un único germen causal.Necrotizing fasciitis is an infectious disease that involves muscular fascia and has a quickly progress. Early diagnosis and proper treatment that consists on antibiotic therapy and surgery are the key of patient management. We report the case of a 77 years old oman with necrotizing fasciitis diagnosis with atypical presentation due to bilateral skin lesions, lack of risk factors and only one germ as causal pathogen.

  6. Fascitis necrosante por Apophysomyces elegans, moho de la familia Mucoraceae, en paciente inmunocompetente.

    Directory of Open Access Journals (Sweden)

    Carmen Elena Ruiz

    2004-09-01

    Full Text Available Se presenta la historia de un niño de 7 años de edad, politraumatizado por accidente automovilístico, que falleció a consecuencia de infección por Apophysomyces elegans, un hongo de la familia Mucoracea. La invasión fue progresiva, inicialmente se observó una lesión puntiforme en la región lumbar izquierda que progresó a fascitis necrosante y, posteriormente, afectó la zona lumbar, los glúteos y el flanco derecho. El tratamiento antimicótico resultó inefectivo y el paciente falleció 8 semanas después de su accidente. Se presenta, además, una revisión de los casos atribuidos a este hongo.

  7. Validation of protocol of experimental necrotizing enterocolitis in rats and the pitfalls during the procedure Validação do modelo de enterocolite necrotizante experimental em ratos e as armadilhas durante sua execução

    Directory of Open Access Journals (Sweden)

    Frances Lilian Lanhellas Gonçalves

    2013-01-01

    Full Text Available PURPOSE: To describe the difficulties of implementing the protocol of experimental necrotizing enterocolitis (NEC in order to obtain a larger number of newborns affected with the disease and a lower mortality. METHODS: Term Sprague-Dawley newborns rats (22 days were divided into four groups of 12 fetuses each (n = 48: EC - breastfed newborns; IH - breastfed newborns and subjected to a stress protocol by ischemia and hypothermia; ESB - formula-fed newborns (Esbilac®, PetAg, Hampshire, IL, USA and NEC - formula-fed newborns and subjected to stress protocol. The parameters set for the study protocol were: milk concentration (0.19 g ml or 0.34 g/ml, diet instilled volume (according to body weight - 200 kcal/day/Kg - or progressive, according to acceptance, weight (gain, loss or maintenance and duration of the experiment (72 hours or 96 hours. Data of body weight (BW, intestinal weight (IW and the IW/BW ratio were obtained. Samples of terminal ileum were collected and analyzed by the degree of injury to the intestinal wall. Statistically significance was set to pOBJETIVO: Relatar as dificuldades da execução do protocolo de enterocolite necrosante (ECN experimental a fim de obter um maior número de neonatos comprometidos com a doença e menor mortalidade. MÉTODOS: Neonatos de ratas Sprague-Dawley nascidos a termo (22 dias foram divididos em 4 grupos de 12 fetos cada (n=48: EC - neonatos amamentados pela mãe; IH - neonatos amamentados pela mãe e submetidos a estresse por isquemia e hipotermia, ESB - neonatos alimentados por leite artificial (Esbilac®, PetAg, Hampshire, IL, USA e NEC - neonatos alimentados com fórmula e submetidos a protocolo de estresse. Os parâmetros estabelecidos para o protocolo de estudo foram: concentração do leite (0,19 g/ml ou 0,34 g/ml, volume de dieta instilada (de acordo com ganho de peso - 200 kcal/dia/kg - ou progressivo, de acordo com aceitação, peso (ganho, perda ou manutenção e duração do experimento

  8. Incidencia y factores de riesgo para enterocolitis necrosante en una cohorte de prematuros menores de 1500 gramos

    Directory of Open Access Journals (Sweden)

    María Eulalia Tamayo

    2008-11-01

    Full Text Available INTRODUCCIÓN: la enterocolitis necrosante (ECN es la urgencia gastrointestinal más frecuente del período neonatal, y tiene una alta tasa de mortalidad. La influencia de los factores de riesgo en la aparición de ECN es aún motivo de controversia. OBJETIVO: definir la incidencia e identificar los factores de riesgo relacionados con la ECN en una cohorte retrospectiva de niños con peso al nacer menor de 1.500 gramos. MÉTODOS: estudio de cohorte en recién nacidos pretérmino menores de 1.500 gramos. Se revisaron 254 historias clínicas, seleccionadas aleatoriamente de una base de datos de los neonatos egresados del Hospital Universitario San Vicente de Paúl (HUSVP, de Medellín, Colombia, entre enero de 2001 y enero de 2006; se determinó la incidencia de ECN y se observó el comportamiento de las variables identificadas en la literatura como factores de riesgo en el grupo que padeció y en el que no padeció ECN, usando el análisis univariado y el modelo de regresión logística. RESULTADOS: se encontraron 23 casos de ECN, correspondientes al 9% de los 254 pacientes. La gravedad fue de grado II en 52,2% y de grado III en 47,8%. De los pacientes con ECN, 52% fueron hombres, el peso al nacer fue 1.031 g (± 209, y la edad gestacional, 28 semanas (± 2; la edad gestacional entre 24 y 28 semanas se comportó como un factor de riesgo independiente para la aparición de ECN (p = 0,005, OR ajustado 5,5, [95% IC: 1,6-2,0]. El diagnóstico de ECN se hizo al día 10,22 de vida (± 10. Los pacientes con ECN tuvieron con más frecuencia apneas, ductus arterioso persistente y sepsis tardía, y se les realizaron más procedimientos invasivos como catéter venoso umbilical y ventilación mecánica. El 86% recibieron vía enteral con leche de fórmula antes del diagnóstico y la administración de esta se comportó como un factor de riesgo al ajustar en el análisis multivariado (p = 0,027, OR ajustado 4,6, [95% IC: 1,193-18,4]. La tasa de mortalidad en

  9. Perfil clínico de neonatos de muito baixo peso internados em uma Unidade de Tratamento Intensivo Neonatal

    Directory of Open Access Journals (Sweden)

    Alana Piccoli

    2013-01-01

    Full Text Available Objetivo: Descrever o perfil de recém-nascidos prematuros de muito baixo peso (RNMBP internados em uma UTIN. Metodologia: Caracteriza-se como um estudo retrospectivo documental com coleta de dados nos prontuários de RNMBP. Resultados: A amostra foi composta por 153 RNMBP, os quais apresentaram peso ao nascimento (PN de 1082,92 ± 275,73 e tempo de ventilação pulmonar mecânica (VPM de 13,34 ± 17,23 dias. A incidência de displasia broncopulmonar esteve associada ao tempo de VPM, à presença de enterocolite necrosante e à persistência do canal arterial. O tempo de permanência em VPM esteve associado ao tempo de internação e ao peso de nascimento. A incidência de hemorragia intracraniana esteve associada ao tempo de VPM, à IG e ao PN. Conclusão: O baixo peso ao nascimento, isolado ou associado a outros fatores, contribui para o aparecimento de comorbidades que poderão influenciar na qualidade de vida desses bebês bem como aumentar a mortalidade.

  10. Pneumonias necrosantes em crianças previamente saudáveis

    Directory of Open Access Journals (Sweden)

    João Luís Barreira

    2002-01-01

    Full Text Available RESUMO: Introdução: As pneumonias necrosantes são uma complicação rara da pneumonia lobar, sobretudo na era pós-antibiótica. Recentemente tem-se assistido no nosso hospital ao acréscimo da incidência destas complicações não sendo claro o motivo que lhe está subjacente.Material e Métodos: Estudo retrospectivo dos casos de pneumonias necrosantes em crianças com menos de 13 anos de idade e previamente saudáveis, ocorridos num período de 2 anos num hospital terciário. Carac-terização clínica, imagiológica e microbiológica e da evolução no internamento e após alta.Resultados: Entre as 392 crianças internadas por pneumonia no período do estudo, 15 crianças (3,4–2,4 anos; 9 rapazes sem doença prévia conhecida apresentavam evidência de necrose pulmonar na TAC pulmonar. Apesar da antibioticoterapia, a febre persistiu 13–7 dias. Dez doentes desenvolveram pneumatocelos e 3 abcessos pulmonares. Doze doentes apresentavam derrames pleurais associados, tendo nove deles necessitado de drenagem torácica. Foi isolado o agente infectante em 3 doentes (2 S. aureus e 1 Enterobacter cloacae.Conclusões: Os resultados encontrados não permitem esclarecer o aumento recente das pneumonias necrosantes. A baixa taxa de isolamento do agente infeccioso implicado poderá estar relacionada com o frequente uso prévio de antibióticos. As imunodeficiências primárias deverão ser sempre pesquisadas nas pneumonias graves mesmo em crianças previamente saudáveis. Apesar da evolução clínica arrastada e da frequente necessidade de toracotomia, o resultado final foi bom na maioria dos doentes.REV PORT PNEUMOL 2002; VIII (1: ABSTRACT: Background: Necrotizing pneumonia used to be rare in the postantibiotic era. Its incidence appears to be rising in our hospital although there is no clear explanation for that.Patients and Methods: Retrospective

  11. Tratamiento de la fascitis necrosante por E. Coli mediante desbridamiento quirúrgico y terapia Vac®: a propósito de un caso

    Directory of Open Access Journals (Sweden)

    M. Silva Bueno

    Full Text Available La fascitis necrosante es una rara infección de tejidos blandos con una alta tasa de morbi-mortalidad. Presentamos el caso de una paciente de 44 años diagnosticada de fascitis necrosante por E. coli en el contexto clínico de inmunosupresión por trasplante renal. Logramos un tratamiento exitoso mediante la asociación de desbridamiento quirúrgico, antibioticoterapia intravenosa y curas con terapia de presión negativa (VAC®, seguido de injertos autólogos de piel parcial. Remarcamos las ventajas clínicas de la terapia de presión negativa en el manejo y curación de heridas complejas.

  12. Tratamiento de la fascitis necrosante por E. Coli mediante desbridamiento quirúrgico y terapia Vac®, a propósito de un caso

    Directory of Open Access Journals (Sweden)

    M. Silva Bueno

    Full Text Available La fascitis necrosante es una rara infección de tejidos blandos con una alta tasa de morbi-mortalidad. Presentamos el caso de una paciente de 44 años diagnosticada de fascitis necrosante por E. coli en el contexto clínico de inmunosupresión por trasplante renal. Logramos un tratamiento exitoso mediante la asociación de desbridamiento quirúrgico, antibioticoterapia intravenosa y curas con terapia de presión negativa (VAC®, seguido de injertos autólogos de piel parcial. Remarcamos las ventajas clínicas de la terapia de presión negativa en el manejo y curación de heridas complejas.

  13. Fasciíte necrosante: revisão com enfoque nos aspectos dermatológicos

    Directory of Open Access Journals (Sweden)

    Costa Izelda Maria Carvalho

    2004-01-01

    Full Text Available Fasciíte necrosante é infecção bacteriana destrutiva e rapidamente progressiva do tecido subcutâneo e fáscia superficial, associada a altos índices de morbimortalidade, se não tiver tratamento precoce. Recentemente, inúmeros casos publicados têm demonstrado aumento na freqüência e gravidade dessa infecção, particularmente causada pelo Streptococcus do grupo A (GAS e que acomete até mesmo pessoas jovens e saudáveis. Classifica-se em tipo I, quando causada por flora mista de anaeróbios e outras bactérias, e tipo II, quando causada pelo GAS isolado ou associado ao Staphylococcus aureus. Os fatores predisponentes incluem: doenças crônicas e malignas, abuso de álcool, uso de drogas endovenosas, lesões da pele como varicela, úlceras crônicas, psoríase, cirurgia, traumas abertos e fechados, entre outros. Clinicamente destacam-se: a dor intensa, o edema grave, a rápida progressão e a resposta pobre à antibioticoterapia. É necessário um alto índice de suspeição para o diagnóstico clínico, que é confirmado à intervenção cirúrgica, com a evidência de necrose da fáscia superficial. Os exames radiológicos são úteis, e o diagnóstico diferencial deve ser feito principalmente com celulite em seu estágio inicial. O tratamento, que deve ser precoce, é feito com antibióticos de amplo espectro, debridamento cirúrgico agressivo e medidas de suporte clínico e nutricional.

  14. Neonatal sepsis

    Science.gov (United States)

    ... 1 week and before 3 months of age. Causes Neonatal sepsis can be caused by bacteria such as Escherichia ... and Tests Lab tests can help diagnose neonatal sepsis and identify the cause of the infection. Blood tests may include: Blood ...

  15. Enterocolitis necrosante en un niño prematuro hijo de padres VIH+ Necrotizing enterocolitis observed in a premature newborn with HIV+parents

    Directory of Open Access Journals (Sweden)

    Ida González Núñez

    2009-06-01

    Full Text Available En Cuba, entre el 1ero. de enero de 1986 y el 30 de abril de 2007 nacieron 280 niños hijos de madres VIH+. De ellos solo 22 (7,8 % nacieron con edad gestacional menor de 37 semanas y solo uno (4,5 % presentó una enterocolitis necrosante. En el presente artículo se describe un episodio de esta enfermedad en un niño prematuro hijo de padres VIH+, supuestamente asociado al uso profiláctico de zidovudina en las madres seropositivas por la posibilidad de producir toxicidad mitocondrial en el feto. Con el tratamiento quirúrgico empleado, la evolución del niño fue favorable. El caso presentado constituye una evidencia que el personal médico debe tener en cuenta para el cuidado y diagnóstico de estos pacientes.In Cuba, from January 1, 1986 to April 30, 2007 were born 280 children from HIV+ mothers. Only 22 (7, 8% had a gestational age under 37 weeks and only one (4, 5% presented with a necrotizing enterocolitis. In present paper we describe an episode of this disease in a premature baby son of HIV+ parents, supposedly associated with prophylactic use of Zidovudine in seropositive mothers by possibility to produce mitochondria toxicity in fetus. This case is an evidence that family physician must to assess for care and diagnosis of these patients.

  16. Neonatal arrhythmias.

    Science.gov (United States)

    Poddar, Banani; Basu, Srikanta; Parmar, Veena R

    2006-02-01

    Neonatal arrhythmias are not uncommon; however, they rarely cause hemodynamic compromise. This paper aims to study the etiology, spectrum and outcome of neonates with arrhythmias who presented to a pediatric department. All neonates, either inborn or brought to the pediatric emergency with rhythm disorders, between August 1999 to August 2002, were included prospectively. Evaluation including a search for secondary causes of rhythm disorder and a chest X-ray, standard 12-lead electrocardiography and echocardiography in all. The management required in each and the outcomes were noted. Nine neonates were identified, of which 4 were inborn. Tachycardia was seen in 8 neonates and bradycardia in only one. Three neonates had an antenatal onset of arrhythmias; in the rest it was postnatal in onset. Five neonates had a secondary rhythm disorder, secondary to metabolic derangements in 4 and a cardiac mass in 1. Five had ventricular arrhythmias and 5 had hemodynamic compromise due to the arrhythmia. The outcome was poor in 4 and was related to the underlying illness. Tachyarrhythmia is more common than bradyarrhythmia in the neonate. Arrhythmias secondary to various metabolic causes are more common than primary rhythm disorders.

  17. Tuberculosis neonatal

    OpenAIRE

    Pastor Durán, Xavier

    1986-01-01

    PROTOCOLOS TERAPEUTICOS. TUBERCULOSIS NEONATAL 1. CONCEPTO La tuberculosis neonatal es la infección del recién nacido producida por el bacilo de Koch. Es una situación rara pero grave que requiere un diagnóstico precoz y un tratamiento enérgico..

  18. Tratamento cirúrgico de pneumonia necrosante: análise de quatro casos Surgical treatment of necrotizing pneumonia: analysis of four cases

    Directory of Open Access Journals (Sweden)

    FERNANDO LUIZ WESTPHAL

    2000-02-01

    Full Text Available A pneumonia necrosante é uma patologia grave que surge como complicação rara de pneumonia lobar. Quatro crianças na faixa etária entre dez e 28 meses foram hospitalizadas com pneumonia bacteriana aguda, evoluindo com toxemia, derrame pleural e insuficiência respiratória, respondendo insatisfatoriamente a antibioticoterapia e drenagem pleural. Todos os pacientes foram submetidos a tratamento cirúrgico para descorticação pulmonar e ressecção de tecido pulmonar necrosado. Complicações como fístulas broncopleurais ocorreram em dois pacientes, havendo óbito em um dos casos. Os autores concluem que a ressecção pulmonar de emergência é indicada quando a necrose pulmonar é diagnosticada em pacientes septicêmicos ou com fístula broncopleural de alto débito, visando a melhora do prognóstico dessas crianças, mesmo cientes de que o índice de morbimortalidade nesses casos é alto.Necrotizing pneumonia is a serious complication of lobar pneumonia. Four children aged between ten months and three years were admitted with acute bacteremic pneumonia and developed sepsis, pleural effusion, and respiratory distress despite adequate antibiotic treatment and chest tube drainage. Decortication and pulmonary resection were performed in all of them. The observed complications were bronchopleural fistula and one death. The emergency pulmonary resection is indicated when pulmonary necrosis is associated to sepsis and massive bronchopleural fistula. In such circumstances, morbidity and mortality are higher than in other conditions.

  19. Neonatal hypertension.

    Science.gov (United States)

    Sharma, Deepak; Farahbakhsh, Nazanin; Shastri, Sweta; Sharma, Pradeep

    2017-03-01

    Neonatal hypertension (HT) is a frequently under reported condition and is seen uncommonly in the intensive care unit. Neonatal HT has defined arbitrarily as blood pressure more than 2 standard deviations above the base as per the age or defined as systolic BP more than 95% for infants of similar size, gestational age and postnatal age. It has been diagnosed long back but still is the least studied field in neonatology. There is still lack of universally accepted normotensive data for neonates as per gestational age, weight and post-natal age. Neonatal HT is an important morbidity that needs timely detection and appropriate management, as it can lead to devastating short-term effect on various organs and also poor long-term adverse outcomes. There is no consensus yet about the treatment guidelines and majority of treatment protocols are based on the expert opinion. Neonate with HT should be evaluated in detail starting from antenatal, perinatal, post-natal history, and drug intake by neonate and mother. This review article covers multiple aspects of neonatal hypertension like definition, normotensive data, various etiologies and methods of BP measurement, clinical features, diagnosis and management.

  20. Tirosinemia neonatal Neonatal tyrosinemia

    Directory of Open Access Journals (Sweden)

    Rafael J. Manotas Cabarcas

    1995-04-01

    Full Text Available Mediante la técnica de Udenfriend y Cooper, se midieron los niveles de tirosina en la sangre del cordón de 26 prematuros y 31 niños de término, con el fin de comparar las concentraciones según la edad gestacional y detectar la presencia de la tirosinemia neonatal. Se encontró un caso de esta entidad en un niño de 31 semanas de edad gestacional, lo cual correspondió al 3.8% de los prematuros y al 1.8% del grupo total. La concentración de tirosina en el paciente fue de 53 JJ.M. El promedio de las concentraciones en los prematuros menores de 32 semanas fue de 16.8 :t 6.3 JJ.M; el de los niños entre 33 y 36 semanas fue de 19.3 :t 7.6 JJ.M y el de los niños de término, de 17.2 :t 9.4 JJ.M. Las pruebas estadísticas no mostraron tendencias ni diferencias significativas entre estas concentraciones. El promedio ponderado para el grupo total fue 17.7 :t 7.3 JJ.M. Se recomienda establecer programas de tamizaje para detectar este problema porque puede presentar repercusiones neurológicas posteriores.

    By means of the Udenfriend-Cooper technique, levels of tyrosine were measured in the cord blood of 26 preterm and 31 term Infants; the objective was to compare tyrosine concentrations according to gestational age and to detect the presence of neonatal tyrosinemia. A case of this disease was found In an Infant with 31 weeks of gestational age; this case represented 3.8% of preterm Infants and 1.8% of the total group. Average tyrosine concentration according to age was as follows: 16.8: ± 6.3  µM in Infants under 32 weeks of gestational age; 19.3: ±: 7.6 µM In those between 33 and 36 weeks and 17.2 : ±: 9.4 µM In the term Infants

  1. Neonatal retinoblastoma

    Directory of Open Access Journals (Sweden)

    Tero T Kivelä

    2017-01-01

    Full Text Available From 7% to 10% of all retinoblastomas and from 44% to 71% of familial retinoblastomas in developed countries are diagnosed in the neonatal period, usually through pre- or post-natal screening prompted by a positive family history and sometimes serendipitously during screening for retinopathy of prematurity or other reasons. In developing countries, neonatal diagnosis of retinoblastoma has been less common. Neonatal retinoblastoma generally develops from a germline mutation of RB1, the retinoblastoma gene, even when the family history is negative and is thus usually hereditary. At least one-half of infants with neonatal retinoblastoma have unilateral tumors when the diagnosis is made, typically the International Intraocular Retinoblastoma Classification (Murphree Group B or higher, but most germline mutation carriers will progress to bilateral involvement, typically Group A in the fellow eye. Neonatal leukokoria usually leads to the diagnosis in children without a family history of retinoblastoma, and a Group C tumor or higher is typical in the more advanced involved eye. Almost all infants with neonatal retinoblastoma have at least one eye with a tumor in proximity to the foveola, but the macula of the fellow eye is frequently spared. Consequently, loss of reading vision from both eyes is exceptional. A primary ectopic intracranial neuroblastic tumor known as trilateral retinoblastoma is no more common after neonatal than other retinoblastoma. For many reasons, neonatal retinoblastoma may be a challenge to eradicate, and the early age at diagnosis and relatively small tumors do not guarantee the preservation of both eyes of every involved child. Oncology nurses can be instrumental in contributing to better outcomes by ensuring that hereditary retinoblastoma survivors receive genetic counseling, by referring families of survivors to early screening programs when they are planning for a baby, and by providing psychological and practical support

  2. Neonatal Retinoblastoma

    Science.gov (United States)

    Kivelä, Tero T.; Hadjistilianou, Theodora

    2017-01-01

    From 7% to 10% of all retinoblastomas and from 44% to 71% of familial retinoblastomas in developed countries are diagnosed in the neonatal period, usually through pre- or post-natal screening prompted by a positive family history and sometimes serendipitously during screening for retinopathy of prematurity or other reasons. In developing countries, neonatal diagnosis of retinoblastoma has been less common. Neonatal retinoblastoma generally develops from a germline mutation of RB1, the retinoblastoma gene, even when the family history is negative and is thus usually hereditary. At least one-half of infants with neonatal retinoblastoma have unilateral tumors when the diagnosis is made, typically the International Intraocular Retinoblastoma Classification (Murphree) Group B or higher, but most germline mutation carriers will progress to bilateral involvement, typically Group A in the fellow eye. Neonatal leukokoria usually leads to the diagnosis in children without a family history of retinoblastoma, and a Group C tumor or higher is typical in the more advanced involved eye. Almost all infants with neonatal retinoblastoma have at least one eye with a tumor in proximity to the foveola, but the macula of the fellow eye is frequently spared. Consequently, loss of reading vision from both eyes is exceptional. A primary ectopic intracranial neuroblastic tumor known as trilateral retinoblastoma is no more common after neonatal than other retinoblastoma. For many reasons, neonatal retinoblastoma may be a challenge to eradicate, and the early age at diagnosis and relatively small tumors do not guarantee the preservation of both eyes of every involved child. Oncology nurses can be instrumental in contributing to better outcomes by ensuring that hereditary retinoblastoma survivors receive genetic counseling, by referring families of survivors to early screening programs when they are planning for a baby, and by providing psychological and practical support for parents when

  3. Neonatal Nursing

    OpenAIRE

    Crawford, Doreen; Morris, Maryke

    1994-01-01

    "Neonatal Nursing" offers a systematic approach to the nursing care of the sick newborn baby. Nursing actions and responsibilities are the focus of the text with relevant research findings, clinical applications, anatomy, physiology and pathology provided where necessary. This comprehensive text covers all areas of neonatal nursing including ethics, continuing care in the community, intranatal care, statistics and pharmokinetics so that holistic care of the infant is described. This book shou...

  4. Cerebral abscess caused by Serratia marcescens in a premature neonate Abscesso cerebral causado por Serratia marcescens em prematuro

    Directory of Open Access Journals (Sweden)

    Tatiana Mattos Hirooka

    2007-12-01

    Full Text Available BACKGROUND: Cerebral abscesses are extremely rare in neonates. Serratia marcescens is an unusual cause of sepsis and neurological spread is especially ominous. PURPOSE: To report the case of a 34-week neonate who developed this rare condition and to discuss diagnostic and therapeutic measures. CASE REPRT: A 34-week male neonate sequentially developed respiratory distress syndrome, early sepsis and necrotizing enterocolitis; later cultures revealed S. marcescens. After deterioration, a cerebral abscess became evident, which revealed S. marcescens. Clinical improvement ensued after high-dose amikacin and meropenem. CONCLUSION: Clinical signs are often non-specific. Proper diagnostic measures, neurosurgical consultation and aggressive antibiotic therapy are essential for these high-risk neonates.INTRODUÇÃO: Abscessos cerebrais são extremamente raros em neonatos. Serratia marcescens é causadora incomum de sepse nestes pacientes e a disseminação no sistema nervoso central é grave. OBJETIVO: Relatar um prematuro de 34 semanas que desenvolveu esta condição e discutir as medidas diagnósticas e terapêuticas. RELATO DE CASO: Prematuro masculino de 34 semanas desenvolveu síndrome do desconforto respiratório, sepse neonatal e enterocolite necrotizante; hemoculturas revelaram S. marcescens. Após deterioração clínica, evidenciou-se um abscesso cerebral cuja drenagem revelou S. marcescens. Houve melhora após introdução de amicacina e meropenem. CONCLUSÃO: Os sinais clínicos são inespecíficos. Passos diagnósticos apropriados, avaliação neurocirúrgica precoce e antibioticoterapia agressiva são essenciais para estes prematuros.

  5. Neonatal neurosonography

    Energy Technology Data Exchange (ETDEWEB)

    Riccabona, Michael, E-mail: michael.riccabona@klinikum-graz.at

    2014-09-15

    Paediatric and particularly neonatal neurosonography still remains a mainstay of imaging the neonatal brain. It can be performed at the bedside without any need for sedation or specific monitoring. There are a number of neurologic conditions that significantly influence morbidity and mortality in neonates and infants related to the brain and the spinal cord; most of them can be addressed by ultrasonography (US). However, with the introduction of first CT and then MRI, neonatal neurosonography is increasingly considered just a basic first line technique that offers only orienting information and does not deliver much relevant information. This is partially caused by inferior US performance – either by restricted availability of modern equipment or by lack of specialized expertise in performing and reading neurosonographic scans. This essay tries to highlight the value and potential of US in the neonatal brain and briefly touching also on the spinal cord imaging. The common pathologies and their US appearance as well as typical indication and applications of neurosonography are listed. The review aims at encouraging paediatric radiologists to reorient there imaging algorithms and skills towards the potential of modern neurosonography, particularly in the view of efficacy, considering growing economic pressure, and the low invasiveness as well as the good availability of US that can easily be repeated any time at the bedside.

  6. Neonatal pain

    Science.gov (United States)

    Walker, Suellen M

    2014-01-01

    Effective management of procedural and postoperative pain in neonates is required to minimize acute physiological and behavioral distress and may also improve acute and long-term outcomes. Painful stimuli activate nociceptive pathways, from the periphery to the cortex, in neonates and behavioral responses form the basis for validated pain assessment tools. However, there is an increasing awareness of the need to not only reduce acute behavioral responses to pain in neonates, but also to protect the developing nervous system from persistent sensitization of pain pathways and potential damaging effects of altered neural activity on central nervous system development. Analgesic requirements are influenced by age-related changes in both pharmacokinetic and pharmacodynamic response, and increasing data are available to guide safe and effective dosing with opioids and paracetamol. Regional analgesic techniques provide effective perioperative analgesia, but higher complication rates in neonates emphasize the importance of monitoring and choice of the most appropriate drug and dose. There have been significant improvements in the understanding and management of neonatal pain, but additional research evidence will further reduce the need to extrapolate data from older age groups. Translation into improved clinical care will continue to depend on an integrated approach to implementation that encompasses assessment and titration against individual response, education and training, and audit and feedback. PMID:24330444

  7. Histiocytic necrotizing lymphadenitis (Kikuchi lymphadenitis in an HIV-positive patient Linfadenite necrosante histiocítica (linfadenite de Kikuchi em um paciente HIV-positivo

    Directory of Open Access Journals (Sweden)

    José VASSALLO

    2002-10-01

    Full Text Available Histiocytic necrotizing lymphadenitis, or Kikuchi's lymphadenitis (KL, is an unusual form of lymphadenitis, generally with self-limited clinical course. KL has been reported in rare patients infected with the human immunodeficiency virus (HIV. Pathogenesis of the lesion is probably related to an impaired immune function. The purpose of the present article is to report on one case in which KL was diagnosed in an HIV-infected patient. Histomorphology and immunophenotype were similar to previous reports, but a focus of activated CD30+ macrophages was seen, what might be due to the immunological status of the patient. EBV was not detected on the sections using the in situ hybridization technique. Although rare, the occurrence of KL in HIV-infected subjects must be emphasized, because of the potential misdiagnosis of malignancy, especially in the presence of CD30+ cells.A linfadenite necrosante histiocítica, ou linfadenite de Kikuchi (LK, é uma forma rara de linfadenite, geralmente de curso clínico auto-limitado. Raros casos de LK associados à infecção pelo vírus da imunodeficiência humana (HIV foram relatados, sendo sua patogênese atribuída à disfunção imunológica destes pacientes. O objetivo do presente artigo é relatar um caso de associação de LK em um paciente HIV-positivo. A histomorfologia e a imunofenotipagem foram semelhantes aos casos anteriormente descritos na literatura, mas focos de macrófagos ativados positivos para o CD30 foram vistos, o que pode ser devido ao estado imune do paciente. A pesquisa de EBV por hibridização in situ foi negativa no tecido. Embora rara, a ocorrência de LK em pacientes HIV-positivos deve ser lembrada, por causa do potencial erro diagnóstico com linfoma maligno, especialmente na presença de células CD30+.

  8. Neonatal Kraniefraktur

    DEFF Research Database (Denmark)

    Johannesen, Katrine Marie Harries; Stantchev, Hristo

    2015-01-01

    During the latest decades the incidence of birth traumas has decreased significantly. Even so the traumas still contribute to an increased mortality and morbidity. We present a case of spontaneous neonatal skull fracture following a normal vaginal delivery. Abnormal facial structure was seen...

  9. Neonatal Jaundice

    DEFF Research Database (Denmark)

    Maimburg, Rikke Damkjær; Væth, Michael; Schendel, Diana

    2008-01-01

    In a previous study, we found that infants transferred to a neonatal ward after delivery had an almost twofold increased risk of being diagnosed with infantile autism later in childhood in spite of extensive controlling of obstetric risk factors. We therefore decided to investigate other reasons ...

  10. Perfil clínico da Enterocolite por Citomegalovírus (CMV na síndrome da imunodeficiência adquirida (Aids Clinical profile of Cytomegalovirus Colitis in AIDS

    Directory of Open Access Journals (Sweden)

    D.B. de Lima

    2000-03-01

    Full Text Available Múltiplos agentes estão envolvidos na etiopatogenia da diarréia em Aids. O exame de fezes e a colonoscopia são elementos decisivos para o diagnóstico específico. A enterocolite por CMV pode cursar com febre, emagrecimento, diarréia intermitente e hematoquesia. Outros agentes causadores de diarréia podem ter o mesmo espectro de apresentação. OBJETIVO: Definir o perfil clínico da enterocolite por CMV em pacientes com Aids, comparando os parâmetros clínicos, endoscópicos e de tempo de sobrevida entre dois grupos com diarréia crônica, grupo A com CMV e grupo B sem CMV. MÉTODOS: Foram acompanhados 48 pacientes com Aids e diarréia de duração maior que 30 dias, sendo 27 do grupo A e 21 do grupo B. Os parâmetros analisados foram idade, situação de risco, duração da diarréia, hematoquesia, intervalo de tempo entre diagnóstico da infecção por HIV e início de diarréia, achados endoscópicos e sobrevida. Foram realizados exames parasitológicos, culturas e colonoscopia com biópsias. Foi utilizado o teste "t-student" para amostras não pareadas e o teste Qui-Quadrado com correção de Yates para variáveis não paramétricas. Foram construídas curvas de sobrevida pelo método descrito por Kaplan-Meier e aplicado o teste de Mantel - Haenszel. Foi assumido como nível de significância estatística o valor de P menor que 0.05. RESULTADOS: O padrão endoscópico da infecção por CMV correspondeu a ulcerações associadas a hemorragia de submucosa 14 (51.8% P P > 0.001. Os outros parâmetros estudados não mostraram significância estatística. CONCLUSÕES: A presença de enterocolite por CMV em Aids é marcador de mau prognóstico e menor sobrevida. Existe um padrão endoscópico sugestivo da infecção por CMV.OBJECTIVE: To determine the clinical profile of CMV colitis in AIDS patients, comparing clinical, endoscopic parameters and survival time between 2 groups of AIDS patients having chronic diarrhea. Group A being CMV

  11. [Neonatal cholestasis

    Science.gov (United States)

    Roquete, M L

    2000-07-01

    OBJECTIVE: To warn pediatricians about the early recognition of cholestasis in newborns and infants. METHODS: A bibliographic research about cholestasis was performed using Medline, and emphasizing the most relevant publications of the last 30 years. RESULTS: The concept of cholestasis and the causes of cholestatic tendency in newborns and infants are described. Several causes of intra and extrahepatic cholestasis are reported as well. In this review, only the diseases with diagnostic, therapeutic or prognostic peculiarities are commented, including extrahepatic biliary atresia, idiopathic neonatal hepatitis, galactosemia, and Alagille s syndrome. Furthermore, several resources are discussed for the diagnosis of cholestasis. CONCLUSIONS: The establishment of the diagnosis of cholestasis through the detection of hyperbilirubinemia in newborns who present jaundice after 14 days of life is a goal that could change the prognosis of several diseases responsible for neonatal cholestasis.

  12. Neonatal Kraniefraktur

    DEFF Research Database (Denmark)

    Johannesen, Katrine Marie Harries; Stantchev, Hristo

    2015-01-01

    During the latest decades the incidence of birth traumas has decreased significantly. Even so the traumas still contribute to an increased mortality and morbidity. We present a case of spontaneous neonatal skull fracture following a normal vaginal delivery. Abnormal facial structure was seen......, and the fracture was identified with an MRI. The fractures healed without neurosurgical intervention. Case reports show that even in uncomplicated vaginal deliveries skull fractures can be seen and should be suspected in children with facial abnormalities....

  13. Neonatal Listeriosis

    Directory of Open Access Journals (Sweden)

    Shih-Yu Chen

    2007-01-01

    Full Text Available In Western developed countries, Listeria monocytogenes is not an uncommon pathogen in neonates. However, neonatal listeriosis has rarely been reported in Taiwan. We describe two cases collected from a single medical institute between 1990 and 2005. Case 1 was a male premature baby weighing 1558 g with a gestational age of 31 weeks whose mother had fever with chills 3 days prior to delivery. Generalized maculopapular rash was found after delivery and subtle seizure developed. Both blood and cerebrospinal fluid culture collected on the 1st day yielded L. monocytogenes. In addition, he had ventriculitis complicated with hydrocephalus. Neurologic development was normal over 1 year of follow-up after ventriculoperitoneal shunt operation. Case 2 was a 28-weeks' gestation male premature baby weighing 1180 g. Endotracheal intubation and ventilator support were provided after delivery due to respiratory distress. Blood culture yielded L. monocyto-genes. Cerebrospinal fluid showed pleocytosis but the culture was negative. Brain ultrasonography showed ventriculitis. Sudden deterioration with cyanosis and bradycardia developed on the 8th day and he died on the same day. Neonatal listeriosis is uncommon in Taiwan, but has significant mortality and morbidity. Early diagnosis of perinatal infection relies on high index of suspicion in perinatal health care professionals. [J Formos Med Assoc 2007;106(2:161-164

  14. Fenômeno de Lúcio (eritema necrosante na gestação The Lucio's phenomenon (necrotizing erythema in pregnancy

    Directory of Open Access Journals (Sweden)

    Karin Adriane Helmer

    2004-04-01

    Full Text Available O fenômeno de Lúcio, variante do estado reacional hansênico tipo 2, provavelmente mediado por imunocomplexos, caracteriza-se por reação cutânea necrosante grave que ocorre principalmente em doentes portadores de hanseníase virchowiana não nodular. Os autores relatam o caso de uma paciente de 27 anos, do sexo feminino, gestante de 32 semanas, com quadro de lesões eritêmato-purpúricas nos membros, bem delimitadas, confluentes, encimadas por bolhas, algumas necróticas e ulceradas, com uma semana de evolução, acompanhadas de febre e intensa dor local. A baciloscopia da linfa evidenciou bacilos álcool-acidorresistentes formando globias, e a histopatologia da pele confirmou hanseníase virchowiana, compatível com fenômeno de Lúcio. Foi iniciada prednisona e poliquimioterapia multibacilar com rifampicina, clofazimina e sulfona, com boa evolução. A gravidez tem sido associada à elevada incidência de aparecimento dos primeiros sinais ou ao agravamento da hanseníase por alterações hormonais que levam ao desequilíbrio imunológico, sendo considerado crítico o período compreendido entre o último trimestre de gestação e os primeiros três meses da lactação, quando a imunossupressão atinge seu ápice. Apesar da recomendação de se restringir a ingestão de drogas na gestação, o tratamento da hanseníase deve ser realizado, visto que seus benefícios superam os riscos.The Lucio's phenomenon, a type 2 reactional condition in leprosy probably mediated by immune complexes, is a severe necrotizing skin reaction that occurs mainly in patients with non-nodular lepromatous leprosy. This report presents a 27-year-old woman, in her 32nd week of pregnancy, with a one-week history of painful skin lesions in extremities, reddish-purple, sharply delineated, confluent, with bullae and occasional necrosis and ulceration. The patient also referred fever. Baciloscopy showed acid-fast bacilli and globi, and the histopathologic findings of a

  15. Neonatal sepsis

    Directory of Open Access Journals (Sweden)

    Angelica Dessì

    2014-06-01

    Full Text Available In this paper on neonatal sepsis, after a short presentation of etiopathogenesis and physiopathology, we will briefly present the clinical picture, the diagnosis and the therapy. Concerning diagnosis, we will focus our attention on procalcitonin (PCT, serum amyloid A (SAA, presepsin (sCD14 and metabolomics. Three practical tables complete the review. Proceedings of the International Course on Perinatal Pathology (part of the 10th International Workshop on Neonatology · October 22nd-25th, 2014 · Cagliari (Italy · October 25th, 2014 · The role of the clinical pathological dialogue in problem solving Guest Editors: Gavino Faa, Vassilios Fanos, Peter Van Eyken

  16. Neonatal hypokalemia

    Directory of Open Access Journals (Sweden)

    Sarici D

    2012-03-01

    Full Text Available Dilek Sarici1, S Umit Sarici21Kecioren Research and Education Hospital, Kecioren, Ankara, 2Chief of Division of Neonatology, Division of Neonatology, Department of Pediatrics, Gulhane Military Medical Academy, Ankara, TurkeyAbstract: In this article, distribution of potassium (K+ in body fluids, pathophysiology, causes, clinical signs and symptoms, and the evaluation and treatment of neonatal hypokalemia are reviewed. K+ is the most important intracellular cation and normal serum K+ is stabilized between 3.5 and 5.5 mEq/L. Hypokalemia may be caused by increased renal losses, increased extrarenal (gastrointestinal losses, redistribution or prolonged insufficient K+ intake. Clinical signs and symptoms occur as the result of functional changes in striated muscle, smooth muscle, and the heart. Hypokalemia is usually asymptomatic when K+ levels are between 3.0 and 3.5 mEq/L; however, there may sometimes be slight muscle weakness. Moderate hypokalemia is observed when serum K+ is between 2.5 and 3.0 mEq/L. Proximal muscle weakness is observed most commonly in lower extremities; cranial muscles are normal, but constipation and distention are prominent. Severe hypokalemia develops when serum K+ falls below 2.5 mEq/L. Rhabdomyolysis, myoglobinuria, severe muscle weakness, paralysis, respiratory distress, and respiratory arrest are observed. The clinical signs and symptoms may be unremarkable in cases of chronically developing hypokalemia; however, appropriate treatment is essential when serum K+ level falls below 2.5 mEq/L as the most dangerous complication of hypokalemia is fatal cardiac arrythmia, and changes visible with electrocardiography may not always correlate with the level of hypokalemia. Sodium (Na+, K+, chloride (Cl-, bicarbonate, creatinine, blood sugar, magnesium (Mg, plasma renin activity, aldosterone, and blood gases should be investigated by laboratory testing. Aspartate aminotransferase, alanine aminotransferase, creatinine kinase, and

  17. The neonatal brain

    International Nuclear Information System (INIS)

    Flodmark, O.

    1987-01-01

    The clinical examination of the CNS in the neonate is often difficult in cases of complex pathology. Diagnostic imaging of the neonatal brain has become extremely useful and in the last decade has developed in two main directions: CT and US. MR imaging has been used recently with varying success in the diagnosis of pathology in the neonatal brain. Despite technical difficulties, this imaging method is likely to become increasingly important in the neonate. The paper examines the normal neonatal brain anatomy as seen with the different modalities, followed by pathologic conditions. Attention is directed to the common pathology, in asphyxiated newborns, the patholphysiology of intraventicular hemorrhage and periventricular leukomalacia in the preterm neonate, and hypoxic-ischemic brain injury in the term neonate. Pitfalls, artifacts, and problems in image interpretation are illustrated. Finally, the subsequent appearance of neonatal pathology later in infancy and childhood is discussed

  18. Enterocolitis necrosante (enteropatía isquémica aguda, presente más allá de la etapa neonatal, en un hospital pediátrico de Nivel III

    Directory of Open Access Journals (Sweden)

    Jairo Echeverry Raad

    1999-10-01

    Full Text Available Objective: describe the clinic and paraclinic profile ofNecrotizing Enterocholitis (NEC cases, during two years, at infants Ward of La Misericordia Hospital, Bogotá. Measurement: sociodemograpbic variables , related with chief complaint, inicial clinical condition and evolution were obtained and processed. The data was gathered for summaries and correlations. Results: The study sample was constituted by the clinical records of 24 patients. Prolonged episodes of diarrhea (with inadequate ambulatory treatment, nutritional disorders and important dehydration were commons factors. There was indirect evidence of circulatory collapse at entry that was not detected nor treated accurately. Transient Renal damage was presento The illness was clinically evident toward 5th day ofhospitalization. The stay time was near 24 days. There was no mortality in the series. Conclusions: twelve  specific hypothesis and a general physiopathological model are proposed. If the model is certain, the subject matter of this study is asevere and potential complication of the Acute Diarrhea Syndrome. AH the efforts to aim the prevention of infants diarrhea or adequate primary treatment, can determine a decrease in the incidence of tbis severe disorder in our country.

  19. Pathophyisiology and risk factors of necrotizing enterocolitis in newborns less than 1.500g Fisiopatología y factores de riesgo para el desarrollo de enterocolitis necrosante en neonatos menores de 1.500 g

    Directory of Open Access Journals (Sweden)

    Carolina Tamayo Múnera

    2006-04-01

    Full Text Available The Necrotizing enterocolitis (NEC is a serious illness of the newborn that affects mainly the preterm infant. It corresponds to a diffuse intestinal necrosis with more affection of the ileocecal region. The pathophysiology is complex and multiple risk factors can cause the illness in a susceptible infant. Among the different theories about their appearance is observed that prematurity, intestinal isquemia, bacterial colonization and enteral feeding are the main risk factors, which can be favored by prenatal, perinatal or postnatal conditions. The aim of this article is to review the pathophysiology and the risk factors described in the current evidence. La enterocolitis necrosante (ECN es una grave enfermedad propia del recién nacido (RN que afecta principalmente a los RN pretérmino (RNPT. Corresponde a una necrosis isquémica de la mucosa intestinal con mayor afección de la región ileocecal. La fisiopatología es compleja y en ella participan múltiples factores de riesgo que pueden ocasionar la enfermedad en un RN susceptible. Entre las diferentes teorías acerca de su aparición se observa reiteradamente que la prematuridad, la isquemia intestinal, la colonización bacteriana y la alimentación enteral se repiten como los factores de riesgo principales, los cuales pueden ser favorecidos por condiciones prenatales, perinatales o posnatales. Se revisan la fisiopatología y los factores de riesgo implicados en la génesis de esta enfermedad.

  20. Vasculite granulomatosa necrosante isolada de colo uterino associada à infecção por papilomavírus humano Isolated necrotizing granulomatous vasculitis of the uterine cervix associated with human papillomavirus infection

    Directory of Open Access Journals (Sweden)

    Nilton Salles Rosa Neto

    2009-10-01

    Full Text Available Vasculites de órgão único, ou isoladas, já foram descritas em diversos órgãos e seu achado pode ser acidental. Relatamos um caso de vasculite granulomatosa necrosante isolada de colo uterino em uma paciente de meia-idade, previamente hígida, sexualmente ativa, e cuja pesquisa de DNA de papilomavírus humano (Human Papiloma Virus - HPV por captura híbrida foi positiva. Não foi identificado comprometimento sistêmico e, como houve excisão completa da lesão, optou-se pelo acompanhamento clínico. Há poucos relatos, na literatura, de acometimento do trato genital feminino de forma isolada, alguns com presença simultânea de lesões que podem ser causadas pelo HPV, postulando-se uma associação patogênica.Single organ vasculitis (SOV, or isolated vasculitis, has been described in several organs and it can be an accidental finding. We report a case of isolated necrotizing granulomatous vasculitis of the uterine cervix in a middle-aged woman, previously healthy, and sexually active, and whose human papillomavirus (HPV DNA hybrid capture assay was positive. Systemic involvement was not detected and, since the lesion was completely removed, we opted for a clinical follow-up. The literature has very few reports on the isolated involvement of the female genital tract, and some had concomitant lesions that could be caused by the HPV, indicati.

  1. Tratamiento de la fascitis necrosante por E. Coli mediante desbridamiento quirúrgico y terapia Vac®, a propósito de un caso Treatment of necrotizing fasciitis caused by E.Coli with surgical debridement and vacuum assisted therapy (Vac®, case report

    Directory of Open Access Journals (Sweden)

    M. Silva Bueno

    2011-12-01

    Full Text Available La fascitis necrosante es una rara infección de tejidos blandos con una alta tasa de morbi-mortalidad. Presentamos el caso de una paciente de 44 años diagnosticada de fascitis necrosante por E. coli en el contexto clínico de inmunosupresión por trasplante renal. Logramos un tratamiento exitoso mediante la asociación de desbridamiento quirúrgico, antibioticoterapia intravenosa y curas con terapia de presión negativa (VAC®, seguido de injertos autólogos de piel parcial. Remarcamos las ventajas clínicas de la terapia de presión negativa en el manejo y curación de heridas complejas.Necrotizing fasciitis is a rare soft tissue infection which presents a high rate of morbi-mortality. We describe the case of a 44 years old patient diagnosed with necrotizing fasciitis caused by E. coli, in the context of immunosuppression due to renal transplantation. Successful treatment was achieved by combining surgical debridement, intravenous antibiotic treatment and vacuum assisted closure therapy (VAC® completed by autologous split skin grafts. We stress the clinical benefits of subatmospheric pressure therapy in the management and healing of complex wounds.

  2. Tratamiento de la fascitis necrosante por E. Coli mediante desbridamiento quirúrgico y terapia Vac®: a propósito de un caso Treatment of necrotizing fasciitis caused by E.Coli with surgical debridement and vacuum assisted therapy (Vac®: case report

    Directory of Open Access Journals (Sweden)

    M. Silva Bueno

    2011-06-01

    Full Text Available La fascitis necrosante es una rara infección de tejidos blandos con una alta tasa de morbi-mortalidad. Presentamos el caso de una paciente de 44 años diagnosticada de fascitis necrosante por E. coli en el contexto clínico de inmunosupresión por trasplante renal. Logramos un tratamiento exitoso mediante la asociación de desbridamiento quirúrgico, antibioticoterapia intravenosa y curas con terapia de presión negativa (VAC®, seguido de injertos autólogos de piel parcial. Remarcamos las ventajas clínicas de la terapia de presión negativa en el manejo y curación de heridas complejas.Necrotizing fasciitis is a rare soft tissue infection which presents a high rate of morbi-mortality. We describe the case of a 44 years old patient diagnosed with necrotizing fasciitis caused by E. coli, in the context of immunosuppression due to renal transplantation. Successful treatment was achieved by combining surgical debridement, intravenous antibiotic treatment and vacuum assisted closure therapy (VAC® completed by autologous split skin grafts. We stress the clinical benefits of subatmospheric pressure therapy in the management and healing of complex wounds.

  3. Neonatal orbital abscess

    Directory of Open Access Journals (Sweden)

    Pratik Y Gogri

    2015-01-01

    Full Text Available Orbital abscess generally occurs in older children but it can rarely affect infants and neonates too. We report a case of community acquired methicillin resistant staphylococcus aureus (CA-MRSA neonatal orbital abscess in a 12-day-old term female neonate with no significant past medical history or risk factor for developing the infection. The case highlights the importance of consideration of CA-MRSA as a causative agent of neonatal orbital cellulitis even in a neonate without any obvious predisposing condition. Prompt initiation of appropriate medical therapy against MRSA and surgical drainage of the abscess prevents life threatening complications of orbital cellulitis which more often tend to be fatal in neonates.

  4. Congenital and neonatal pneumonia.

    Science.gov (United States)

    Nissen, Michael D

    2007-09-01

    The greatest risk of death from pneumonia in childhood is in the neonatal period. It is estimated that pneumonia contributes to between 750000-1.2 million neonatal deaths annually, accounting for 10% of global child mortality. Congenital and neonatal pneumonias are often a difficult disease to identify and treat, with clinical manifestations often being non-specific. Many of the normal lung defences are compromised in the fetus and neonate, leading to an increased susceptibility to infection. The aetiology and epidemiology of congenital and neonatal pneumonias will depend on the clinical setting and population that the baby belongs to, the stage in the perinatal period, the gestational age of the baby and the definition of pneumonia. Diagnosis, treatment and prevention strategies are therefore also dependent on these factors, and will differ depending on the clinical setting. This review summarizes the current knowledge concerning congenital and neonatal pneumonia worldwide and discusses future directions in the prevention of the disease.

  5. Neonatal Arrhythmias: Atrial Flutter

    Directory of Open Access Journals (Sweden)

    M.O. Gonchar

    2014-10-01

    Full Text Available The paper presents the current data on the diagnosis of neonatal arrhythmias, covers the prevalence, mechanisms of formation, diagnosis and treatment of one type of cardiac arrhythmias — atrial flutter. Clinical observation in terms of the diagnosis and treatment of atrial flutter in a newborn in the early neonatal period is given.

  6. Neonatal cardiac emergencies

    African Journals Online (AJOL)

    Neonatal cardiac emergencies. The neonatal period is one that fills many generalists with fear – this article will help to dispel these concerns. George A Comitis, MB ChB, DCH (SA), DA (SA), FCPaed (SA), Cert Cardiology (SA) Paed. Consultant, Paediatric Cardiology Service of the Western Cape, Red Cross War Memorial ...

  7. Predictors of early neonatal mortality at a neonatal intensive care ...

    African Journals Online (AJOL)

    admin

    Predictors of early neonatal mortality at a neonatal intensive care unit of a specialized referral teaching hospital in. Ethiopia. Bogale Worku1, Assaye Kassie2, Amha Mekasha1, Birkneh Tilahun1, Alemayehu Worku3. Abstract. Background: The larger fraction of infant mortality is that of neonatal; and early neonatal death is ...

  8. Neonatal Tele-Homecare

    DEFF Research Database (Denmark)

    Holm, Kristina Garne

    Neonatal homecare (NH) implies that parents manage tube feeding and care of their preterm infant at home supported by home visits from neonatal nurses, to monitor infant growth and the well-being of the family. Home visits are costly and time consuming in rural areas. The overall aim of this study...... was to develop a telehealth service for NH without home visits - neonatal tele-homecare (NTH) and test it in an observational study. Participatory design (PD) methods were conducted to facilitate involvement of the end-users (parent of preterm infants and clinicians) in the development of the telehealth service...

  9. The neonatal chest

    Energy Technology Data Exchange (ETDEWEB)

    Lobo, Luisa [Servico de Imagiologia Geral do Hospital de Santa Maria, Av. Prof. Egas Moniz, 1649-035 Lisbon (Portugal)]. E-mail: mluisalobo@gmail.com

    2006-11-15

    Lung diseases represent one of the most life threatening conditions in the newborn. Important progresses in modern perinatal care has resulted in a significantly improved survival and decreased morbidity, in both term and preterm infants. Most of these improvements are directly related to the better management of neonatal lung conditions, and infants of very low gestational ages are now surviving. This article reviews the common spectrum of diseases of the neonatal lung, including medical and surgical conditions, with emphasis to the radiological contribution in the evaluation and management of these infants. Imaging evaluation of the neonatal chest, including the assessment of catheters, lines and tubes are presented.

  10. Sonomammography in Neonatal Mastauxe

    Directory of Open Access Journals (Sweden)

    Sushil Ghanshyam Kachewar

    2015-03-01

    Full Text Available Prominence or even enlargement of one or both breasts is known in neonates. It is believed to be a physiological response to falling levels of maternal estrogen towards last trimester of pregnancy. This input stimulates prolactin release from the newborn's pituitary leading to transient neonatal breast enlargement. This phenomenon is independent of the gender of the neonate. It presents in the first few weeks of life and resolves subsequently. Often fluid discharge is noted from the prominent or swollen breast that resolves without treatment in subsequent weeks. Manual breast manipulation for discharge removal may lead to undesirable effects like local irritation, enhanced enlargement, prolonged tissue hypertropy or even mastitis. A case of such 7-days female neonate is presented here backed with imaging evaluation for confirmation of diagnosis. Typical sonomammographic findings are described. [Cukurova Med J 2015; 40(Suppl 1: 22-24

  11. Neonatal Cerebral Sinovenous Thrombosis

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2006-04-01

    Full Text Available The presentation, treatment, and outcome of neonatal cerebral sinovenous thrombosis (SVT were studied in 42 children, using neurology clinic records (1986-2005 at Indiana University School of Medicine.

  12. Neonatal mortality in Utah.

    Science.gov (United States)

    Woolley, F R; Schuman, K L; Lyon, J L

    1982-09-01

    A cohort study of neonatal mortality (N = 106) in white singleton births (N = 14,486) in Utah for January-June 1975 was conducted. Using membership and activity in the Church of Jesus Christ of Latter-day Saints (LDS or Mormon) as a proxy for parental health practices, i.e., tobacco and alcohol abstinence, differential neonatal mortality rates were calculated. The influence of potential confounding factors was evaluated. Low activity LDS members were found to have an excess risk of neonatal death five times greater than high activity LDS, with an upper bound of a two-sided 95% confidence interval of 7.9. The data consistently indicate a lower neonatal mortality rate for active LDS members. Non-LDS were found to have a lower rate than either medium or low activity LDS.

  13. Neonatal pain management

    Directory of Open Access Journals (Sweden)

    Tarun Bhalla

    2014-01-01

    Full Text Available The past 2-3 decades have seen dramatic changes in the approach to pain management in the neonate. These practices started with refuting previously held misconceptions regarding nociception in preterm infants. Although neonates were initially thought to have limited response to painful stimuli, it was demonstrated that the developmental immaturity of the central nervous system makes the neonate more likely to feel pain. It was further demonstrated that untreated pain can have long-lasting physiologic and neurodevelopmental consequences. These concerns have resulted in a significant emphasis on improving and optimizing the techniques of analgesia for neonates and infants. The following article will review techniques for pain assessment, prevention, and treatment in this population with a specific focus on acute pain related to medical and surgical conditions.

  14. Neonatal herpes simplex pneumonia.

    OpenAIRE

    Lissauer, T J; Shaw, P J; Underhill, G

    1984-01-01

    A neonate with herpes simplex pneumonia is described. Herpes simplex infection should be considered in the differential diagnosis of pneumonia in newborn infants, even in the absence of clinically apparent herpes in the mother.

  15. Maternal and neonatal tetanus

    Science.gov (United States)

    Thwaites, C Louise; Beeching, Nicholas J; Newton, Charles R

    2017-01-01

    Maternal and neonatal tetanus is still a substantial but preventable cause of mortality in many developing countries. Case fatality from these diseases remains high and treatment is limited by scarcity of resources and effective drug treatments. The Maternal and Neonatal Tetanus Elimination Initiative, launched by WHO and its partners, has made substantial progress in eliminating maternal and neonatal tetanus. Sustained emphasis on improvement of vaccination coverage, birth hygiene, and surveillance, with specific approaches in high-risk areas, has meant that the incidence of the disease continues to fall. Despite this progress, an estimated 58 000 neonates and an unknown number of mothers die every year from tetanus. As of June, 2014, 24 countries are still to eliminate the disease. Maintenance of elimination needs ongoing vaccination programmes and improved public health infrastructure. PMID:25149223

  16. Hiperbilirrubinemia neonatal agravada Aggravated neonatal hyperbilirubinemia

    Directory of Open Access Journals (Sweden)

    Ana Campo González

    2010-09-01

    Full Text Available INTRODUCCIÓN. La mayoría de las veces la ictericia en el recién nacido es un hecho fisiológico, causado por una hiperbilirrubinemia de predominio indirecto, secundario a inmadurez hepática e hiperproducción de bilirrubina. El objetivo de este estudio fue determinar el comportamiento de la hiperbilirrubinemia neonatal en el Hospital Docente Ginecoobstétrico de Guanabacoa en los años 2007 a 2009. MÉTODOS. Se realizó un estudio descriptivo y retrospectivo de 173 recién nacidos que ingresaron al Departamento de Neonatología con diagnóstico de hiperbilirrubinemia agravada. RESULTADOS. La incidencia de hiperbilirrubinemia neonatal agravada fue del 3,67 % y predominó en hermanos con antecedentes de ictericia (56,65 %. El tiempo de aparición fue de 48 a 72 h (76,87 % y entre los factores agravantes se hallaron el nacimiento pretérmino y el bajo peso al nacer. La mayoría de los pacientes fueron tratados con luminoterapia (90,17 %. CONCLUSIÓN. La hiperbilirrubinemia neonatal agravada constituye un problema de salud. Los factores agravantes son la prematuridad y el bajo peso al nacer. La luminoterapia es una medida terapéutica eficaz para su tratamiento.INTRODUCTION. Most of times jaundice in newborn is a physiological fact due to hyperbilirubinemia of indirect predominance, secondary to liver immaturity and to bilirubin hyperproduction. The aim of present of present study was to determine the behavior of neonatal hyperbilirubinemia in the Gynecology and Obstetrics Teaching Hospital of Guanabacoa municipality from 2007 to 2009. METHODS. A retrospective and descriptive study was conducted in 173 newborn patients admitted in the Neonatology Department diagnosed with severe hyperbilirubinemia. RESULTS. The incidence of severe neonatal hyperbilirubinemia was of 3,67% with predominance in brothers with a history of jaundice (56,65%. The time of appearance was of 48 to 72 hrs (76,87% and among the aggravating factors were the preterm birth and

  17. Neonatal orbital abscess

    Directory of Open Access Journals (Sweden)

    Khalil M Al-Salem

    2014-01-01

    Full Text Available Orbital complications due to ethmoiditis are rare in neonates. A case of orbital abscess due to acute ethmoiditis in a 28-day-old girl is presented. A Successful outcome was achieved following antimicrobial therapy alone; spontaneous drainage of the abscess occurred from the lower lid without the need for surgery. From this case report, we intend to emphasize on eyelid retraction as a sign of neonatal orbital abscess, and to review all the available literature of similar cases.

  18. [Neonatal asphyxia: neurologic outcome].

    Science.gov (United States)

    Allemand, A; Stanca, M; Sposato, M; Santoro, F; Danti, F R; Dosi, C; Allemand, F

    2013-08-01

    The neonatal asphyxia is recognized as an important cause of morbidity and mortality during the pediatric age. The objective of this study was to evaluate the correlation between some neonatal variables and neurological outcome at two years of life in infants with asphyxia, in order to produce a correct prognosis and to grant a rapid and targeted therapy. We have recruited 63 patients whose history and neuroimages suggested a neonatal asphyxia, and we have analysed their clinical- instrumental parameters every three months until two years of life. A correlation study was carried out in order to find a statistical significance indicated by p-value Neonatal seizures are not related to an increased risk to develop epilepsy. Epilepsy alone is a rare event and it usually complicates CP picture. Most subject with both epilepsy and CP are term infants with adequate weight. Preterm VLBW infants have a greater risk to develop a psychomotor delay. Clinical conditions at birth are related to CP severity (several neonatal neurological signs are the greater risk factors). Severely pathological neonatal EEG (background activity) is related to CP severity and an early symptomatic epilepsy onset is related with both epilepsy and CP severity.

  19. MENINGOENCEFALITE NECROSANTE EM BOVINOS CAUSADA POR HERPESVÍRUS BOVINO NO ESTADO DE MATO GROSSO, BRASIL NECROTIZING MENINGO-ENCEPHALITIS IN CATTLE DUE TO BOVINE HERPESVIRUS IN THE STATE OF MATO GROSSO, BRAZIL

    Directory of Open Access Journals (Sweden)

    Edson Moleta Colodel

    2002-04-01

    Full Text Available Achados epidemiológicos, clínicos, patológicos e microbiológicos de 13 casos de meningoencefalite necrosante pelo Herpesvírus Bovino (BHV, afetando 12 rebanhos bovinos ocorridos no período de março de 1999 a agosto de 2000 em 11 municípios do Estado de Mato Grosso são descritos. Onze surtos ocorreram em sistemas de criação extensiva, afetando com maior freqüência animais da raça nelore, e idade média de 24 meses com uma variação de dois a 72 meses. Os principais sinais clínicos descritos foram as alterações neurológicas, sendo relatados salivação profusa, descarga nasal e ocular serosa, depressão profunda, incoordenação, andar a esmo ou em círculo, cegueira, diminuição do tonus lingual, decúbito lateral com movimentos de pedalagem, opistótono e morte. Ausência de alterações foi o relato mais comum durante a necropsia. Em alguns casos, observou-se congestão encefálica difusa, hemorragias submeningeanas multifocais, achatamento de circunvoluções cerebrais e áreas focais de malacias. Os principais achados microscópicos foram meningoencefalite com corpúsculos de inclusão eosinofílicos, intranucleares em astrócitos. As áreas de malacia afetavam principalmente o córtex cerebral. Foi realizado isolamento e caracterização viral em três de um total de sete amostras encaminhadas Em um dos casos, dos que houve isolamento viral, o diagnóstico histopatológico foi de polioencefalomalacia não se observando meningoencefalite e corpúsculos de inclusão.The epidemiological, clinical, pathological and microbiological aspects of 13 cases of necrotizing meningo-encephalitis associated to bovine herpesvirus are described. The disease is described in 12 cattle herds from March 1999 to August 2000 at 11 counties of the State of Mato Grosso, Brazil. The outbreaks were described in cattle raised on farms in which, mostly Zebu breeds were involved. The average age of the cattle affected was 24 months, ranging from two

  20. Neonatal nonimmune hemolytic anemia.

    Science.gov (United States)

    Yaish, Hassan M; Christensen, Robert D; Lemons, Richard S

    2017-02-01

    As in adults and older children, anemia in newborn infants can be the result of erythropoietic failure, hemorrhage, or hemolysis. When hemolysis is the prime consideration, it can be challenging for physicians caring for neonates to choose from the wide variety of available diagnostic tests. This review describes the authors' opinions regarding rational, consistent, and cost-effective means of making an exact diagnosis of a neonatal hemolytic condition. Two recent advances in the diagnosis of neonatal nonimmune hemolytic disorders are highlighted in this review: introduction of flow cytometry-based Eosin-5-maleimide (EMA) uptake as a screening test to identify RBC membrane defects and next-generation sequencing (NGS)-based panels to uncover exact mutations causing hemolysis. The availability of newer tools such as EMA and NGS to diagnose specific hemolytic conditions, which might otherwise remain unknown, enables neonatal practitioners not only to identify the exact cause of hemolysis but also to discover novel mutations that can be implicated in the cause of neonatal hemolytic processes.

  1. Neonatal Sepsis in Haiti.

    Science.gov (United States)

    Boulos, Alexandre; Rand, Katherine; Johnson, Josh A; Gautier, Jacqueline; Koster, Michael

    2017-02-01

    Infections (including sepsis, meningitis, pneumonia and tetanus) stand as a major contributor to neonatal mortality in Haiti (22%). Infants acquire bacteria that cause neonatal sepsis directly from the mother's blood, skin or vaginal tract either before or during delivery. Nosocomial and environmental pathogens introduce further risk after delivery. The absence of cohesive medical systems and methods for collecting information limits the available data in countries such as Haiti. This study seeks to add more information on the burden of severe bacterial infections and their etiology in neonates of Haiti. Researchers conducted a secondary retrospective analysis of a de-identified database from the Neonatal Intensive Care Unit (NICU) at Nos Petit Frères et Soeurs-St. Damien Hospital (NPFS-SDH). Records from 1292 neonates admitted to the NICU at NPFS-SDH in Port-au-Prince Haiti from 2013 to 2015 were reviewed. Sepsis accounted for 708 of 1292 (54.8%) of all admissions to the NICU. Infants admitted for sepsis had a mortality rate of 23% (163 of 708 infants admitted for sepsis). The most common organism cultured was Streptococcus agalactiae, followed by Klebsiella pneumoniae, Pseudomonas aeroginusa, Enterobacter aerogenes, Staphylococcus aureus and Proteus mirabillis Failure to order or obtain a culture was associated with an increased fatality (odds ratio 2.4) for infants with sepsis. Resistance should be a concern when treating empirically. © The Author [2016]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. Transient neonatal diabetes or neonatal hyperglycaemia: A case ...

    African Journals Online (AJOL)

    Transient neonatal diabetes and neonatal hyperglycaemia both present in the neonatal period with features of hyperglycaemia, dehydration and weight loss. Differentiating these conditions clinically is difficult. We describe the case of a 13 day old female whom we managed recently who could have had either condition.

  3. The value of neonatal autopsy.

    LENUS (Irish Health Repository)

    Hickey, Leah

    2012-01-01

    Neonatal autopsy rates were in decline internationally at the end of the last century. Our objective was to assess the current value of neonatal autopsy in providing additional information to families and healthcare professionals.

  4. NEONATES (BIRTH – 1 MONTH)

    African Journals Online (AJOL)

    Chantel

    western Johannesburg and also at the. Donald Gordon Medical Centre. Neonatal skin, like the respiratory system, bears the brunt of the extreme change in external environment that characterises birth. NEONATES. 488 CME September 2004 Vol.22 No.9. NEONATES (BIRTH – 1 MONTH). Fig. 1. Café-au-lait macule. Fig. 2.

  5. Neonatal Malaria in the Gambia

    African Journals Online (AJOL)

    Uche

    Conclusions: These data show that neonatal malaria is not uncommon in The Gambia and that the clinical features are akin to those of neonatal septicaemia. Key words: Malaria; septicaemia; neonate: ... mechanisms such as the milk diet of the infant being deficient in p-amino-benzoic acid,. 9 haematological factors such as ...

  6. Rings in the neonate.

    LENUS (Irish Health Repository)

    Hackett, C B

    2011-02-01

    Neonatal lupus erythematosus (NLE) is an uncommon disease of the neonate. It is believed to be caused by the transplacental passage of maternal autoantibodies to the ribonucleoproteins (Ro\\/SSA, La\\/SSB or rarely U RNP) as these are almost invariably present in NLE sera. The most common clinical manifestations include cutaneous lupus lesions and congenital complete heart block. Hepatobiliary and haematologic abnormalities are reported less frequently. We describe a patient with cutaneous NLE to illustrate and raise awareness of the characteristic annular eruption of this condition. We also emphasize the need for thorough investigation for concomitant organ involvement and for maternal education regarding risk in future pregnancies.

  7. Ultrasonography of Neonatal Cholestasis

    Energy Technology Data Exchange (ETDEWEB)

    Cheon, Jung Eun [Seoul National University Hospital, Seoul (Korea, Republic of)

    2012-06-15

    Ultrasonography (US) is as an important tool for differentiation of obstructive and non-obstructive causes of jaundice in infants and children. Beyond two weeks of age, extrahepatic biliary atresia and neonatal hepatitis are the two most common causes of persistent neonatal jaundice: differentiation of extrahepatic biliary atresia, which requires early surgical intervention, is very important. Meticulous analysis should focus on size and configuration of the gallbladder and anatomical changes of the portahepatis. In order to narrow the differential diagnosis, combined approaches using hepatic scintigraphy, MR cholangiography, and, at times, percutaneous liver biopsy are necessary. US is useful for demonstrating choledochal cyst, bile plug syndrome, and spontaneous perforation of the extrahepatic bile duct

  8. Neonatal nutrition and metabolism

    National Research Council Canada - National Science Library

    Thureen, Patti J; Hay, William W

    2006-01-01

    ..., the volume highlights the important longterm effects of fetal and neonatal growth on health in later life. In addition, there are very practical chapters on methods and techniques for assessing nutritional status, body composition, and evaluating metabolic function. Written by an authoritative, international team of cont...

  9. [Recommendations for neonatal transport].

    Science.gov (United States)

    Moreno Hernando, J; Thió Lluch, M; Salguero García, E; Rite Gracia, S; Fernández Lorenzo, J R; Echaniz Urcelay, I; Botet Mussons, F; Herranz Carrillo, G; Sánchez Luna, M

    2013-08-01

    During pregnancy, it is not always possible to identify maternal or foetal risk factors. Infants requiring specialised medical care are not always born in centres providing intensive care and will need to be transferred to a referral centre where intensive care can be provided. Therefore Neonatal Transport needs to be considered as part of the organisation of perinatal health care. The aim of Neonatal Transport is to transfer a newborn infant requiring intensive care to a centre where specialised resources and experience can be provided for the appropriate assessment and continuing treatment of a sick newborn infant. Intrauterine transfer is the ideal mode of transport when the birth of an infant with risk factors is diagnosed. Unfortunately, not all problems can be detected in advance with enough time to safely transfer a pregnant woman. Around 30- 50% of risk factors will be diagnosed during labour or soon after birth. Therefore, it is important to have the knowledge and resources to resuscitate and stabilise a newborn infant, as well as a specialised neonatal transport system. With this specialised transport it is possible to transfer newly born infants with the same level of care that they would receive if they had been born in a referral hospital, without increasing their risks or affecting the wellbeing of the newborn. The Standards Committee of the Spanish Society of Neonatology reviewed and updated recommendations for intrauterine transport and indications for neonatal transfer. They also reviewed organisational and logistic factors involved with performing neonatal transport. The Committee review included the type of personnel who should be involved; communication between referral and receiving hospitals; documentation; mode of transport; equipment to stabilise newly born infants; management during transfer, and admission at the referral hospital. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  10. Necropsias de neonatos, fator da melhoria da qualidade nas UTIs neonatais Neonatal necropsies as a factor in quality improvement of the neonatal ICUs

    Directory of Open Access Journals (Sweden)

    Mônica Serapião

    2007-08-01

    Full Text Available Neste estudo foram estudados 552 casos de necropsia de neomortos provenientes de unidades de terapia intensiva neonatais (UTINs. Desses, 265 apresentaram algum tipo de enfermidade ou lesão não esperada conseqüentes (direta ou indiretamente a seu manuseio diagnóstico e/ou terapêutico. Os casos foram agrupados por tipo de enfermidade, em seus respectivos órgãos ou sistemas, que ressaltou a prevalência de lesões pulmonares, como membrana hialina, enfisema intersticial, displasia broncopulmonar e alterações graves em nível de sistema nervoso central (SNC, sinalizando o prognóstico quanto à qualidade de vida. Como parte das medidas terapêuticas, devem ser analisados os acessos arteriais e venosos dos vasos umbilicais, com suas complicações, e o acesso venoso profundo, propriamente dito, para nutrição parenteral total, com graves complicações fatais para o lado do coração, como endocardite fúngica e tamponamento cardíaco por "Intralipid". Foram discutidas as resultantes multissistêmicas dos quadros de hipotensão e choque: enterocolite necrotizante e necroses corticomedular, renal, hepática e miocárdica. Este trabalho ressalta o valor da necropsia na melhoria da qualidade das UTINs, bem como apresenta várias situações em que o diagnostico só foi conhecido devido à necropsia ou, então, o resultado modificou, de certa forma, a abordagem terapêutica futura. A consulta e a análise da literatura demonstram a virtual inexistência de metodologia adequada para desenvolver e estabelecer um comportamento que propicie o exercício sistemático de aferição do desempenho organizacional, e que reduza sensivelmente as possibilidades de efeitos indesejáveis relacionados com rotinas e procedimentos operacionais nesse campo da prática assistencial. As principais causas de insucesso parecem ser creditadas à tecnologia de máquinas e substâncias, cuja adequação à biologia dos organismos em desenvolvimento não é plenamente

  11. Occurrence of yeasts, enterococci and other enteric bacteria in subgingival biofilm of HIV-positive patients with chronic gingivitis and necrotizing periodontitis Ocorrência de leveduras, enterococos e outras bactérias entéricas no biofilme subgengival de pacientes HIV-positivos com gengivite crônica e periodontite necrosante

    Directory of Open Access Journals (Sweden)

    Elerson Gaetti-Jardim Júnior

    2008-06-01

    Full Text Available The purpose of this study was to determine the prevalence of enteric bacteria and yeasts in biofilm of 80 HIV-positive patients with plaque-associated gingivitis or necrotizing periodontitis. Patients were subjected to extra, intra oral and radiographic examinations. The oral hygiene, bleeding on probing, gingival conditions, and attachment loss were evaluated. Clinical specimens were collected from gingival crevices or periodontal pockets, transferred to VMGA III, diluted and transferred to Sabouraud Dextrose agar with 100 µg/ml of chloramphenicol, peptone water, EVA broth, EMB agar, SS agar, Bile esculin agar and Brilliant green agar. Isolation of yeasts was carried out at room temperature, for 3-7 days; and for the isolation of enteric microorganisms plates were incubated at 37ºC, for 24-48 h. The yeasts identification was performed according to the carbon and nitrogen assimilation, fermentation of carbohydrates and germ tube formation. Bacteria were identified according to their colonial and cellular morphologies and biochemical tests. Yeasts were identified as Candida albicans and its occurrence was more common in patients with CD4+ below 200/mm³ and was affected by the extension of periodontal involvement (P = 0.0345. Enteric bacteria recovered from clinical specimens were identified as Enterobacter sakazakii, Enterobacter cloacae, Serratia liquefaciens, Klebsiella oxytoca and Enterococcus sp. Enterobacteriaceae and enterococci were detected in 32.5% of clinical samples from patients with necrotizing periodontitis. In conclusion, non-oral pathogenic bacteria and C. albicans were more prevalent in periodontal sites of HIV-positive patients with necrotizing periodontitis and chronic gingivitis.O objetivo desse estudo foi avaliar a ocorrência de bactérias entéricas e leveduras no biofilme subgengival de pacientes HIV-positivos com gengivite crônica ou periodontite necrosante. Os pacientes foram submetidos a exame clínico e radiogr

  12. Diffuse neonatal gastric infarction

    International Nuclear Information System (INIS)

    Johnson, J.F.; Woisard, K.K.; Cooper, G.L.

    1988-01-01

    Diffuse neonatal gastric infarction can be a devastating complication of invasion of the gastric wall and vessels by fungi colonizing the gastric mucosa. Even in the presence of extensive transmural necrosis, however, the radiographs do not necessarily show evidence of gastric mucosal abnormality. Instead, plain films and positive contrast studies may erroneously suggest a mechanical gastric outlet obstruction. Ancillary evidence of a devitalized viscus in a baby who appears to have complete gastric outlet obstruction should suggest the diagnosis of gastric infarction. (orig.)

  13. Diffuse neonatal gastric infarction

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, J.F.; Woisard, K.K.; Cooper, G.L.

    1988-02-01

    Diffuse neonatal gastric infarction can be a devastating complication of invasion of the gastric wall and vessels by fungi colonizing the gastric mucosa. Even in the presence of extensive transmural necrosis, however, the radiographs do not necessarily show evidence of gastric mucosal abnormality. Instead, plain films and positive contrast studies may erroneously suggest a mechanical gastric outlet obstruction. Ancillary evidence of a devitalized viscus in a baby who appears to have complete gastric outlet obstruction should suggest the diagnosis of gastric infarction.

  14. Telemedicine in Neonatal Home Care

    DEFF Research Database (Denmark)

    Holm, Kristina Garne; Brødsgaard, Anne; Zachariassen, Gitte

    2016-01-01

    BACKGROUND: For the majority of preterm infants, the last weeks of hospital admission mainly concerns tube feeding and establishment of breastfeeding. Neonatal home care (NH) was developed to allow infants to remain at home for tube feeding and establishment of breastfeeding with regular home...... visits from neonatal nurses. For hospitals covering large regions, home visits may be challenging, time consuming, and expensive and alternative approaches must be explored. OBJECTIVE: To identify parental needs when wanting to provide neonatal home care supported by telemedicine. METHODS: The study used...... participatory design and qualitative methods. Data were collected from observational studies, individual interviews, and focus group interviews. Two neonatal units participated. One unit was experienced in providing neonatal home care with home visits, and the other planned to offer neonatal home care...

  15. Neonatal cystic fibrosis screening test

    Science.gov (United States)

    Cystic fibrosis screening - neonatal; Immunoreactive trypsinogen; IRT test; CF - screening ... Cystic fibrosis is a disease passed down through families. CF causes thick, sticky mucus to build up in ...

  16. Clinical practice: neonatal resuscitation. A Dutch consensus

    NARCIS (Netherlands)

    van den Dungen, F.A.M.; van Veenendaal, M.B.; Mulder, A.L.M.

    2010-01-01

    The updated Dutch guidelines on Neonatal Resuscitation assimilate the latest evidence in neonatal resuscitation. Important changes with regard to the 2004 guidelines and controversial issues concerning neonatal resuscitation are reviewed, and recommendations for daily practice are provided and

  17. Neonatal adrenal hemorrhage presenting as late onset neonatal jaundice

    OpenAIRE

    Qureshi, Umar Amin; Ahmad, Nisar; Rasool, Akhter; Choh, Suhail

    2009-01-01

    Clinical manifestations of adrenal hemorrhage vary depending on the degree and rate of hemorrhage, as well as the amount of adrenal cortex compromised by hemorrhage. We report here a case of neonatal adrenal hemorrhage that presented with late onset neonatal jaundice. The cause of adrenal hemorrhage was birth asphyxia.

  18. Neonatal respiratory distress in a reference neonatal unit in ...

    African Journals Online (AJOL)

    Acute fetal distress, elective caesarean delivery, APGAR score < 7 at the 1st minute, prematurity, male gender and macrosomia were independent predictors of NRD. The main etiologies were neonatal infections (31%) and transient tachypnea of the newborn (25%). Its neonatal mortality rate was 24.5%, mainly associated ...

  19. Feeding premature neonate

    DEFF Research Database (Denmark)

    Dam, Mie S.; Juhl, Sandra M.; Sangild, Per T.

    2017-01-01

    a novel milk diet (bovine colostrum) to model the effects of this new diet in premature infants. Our ethnographic fieldwork in an experimental pig laboratory and a neonatal intensive care unit (NICU) in 2013–2014 shows that regardless of biogenetics, daily practices of feeding, housing, and clinical care...... parents may perceive the animality of bovine colostrum, and the background information obtained in piglets, as a threat to the infants' connection to their biological parents as well as the larger human collective. Our study argues that the ‘species flexibility’ of premature beings profoundly shapes...

  20. Fetal and Neonatal Arrhythmias.

    Science.gov (United States)

    Jaeggi, Edgar; Öhman, Annika

    2016-03-01

    Cardiac arrhythmias are an important aspect of fetal and neonatal medicine. Premature complexes of atrial or ventricular origin are the main cause of an irregular heart rhythm. The finding is typically unrelated to an identifiable cause and no treatment is required. Tachyarrhythmia most commonly relates to supraventricular reentrant tachycardia, atrial flutter, and sinus tachycardia. Several antiarrhythmic agents are available for the perinatal treatment of tachyarrhythmias. Enduring bradycardia may result from sinus node dysfunction, complete heart block and nonconducted atrial bigeminy as the main arrhythmia mechanisms. The management and outcome of bradycardia depend on the underlying mechanism. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Cost of neonatal care.

    OpenAIRE

    Ryan, S; Sics, A; Congdon, P

    1988-01-01

    A six month evaluation of the costs of a regional neonatal medical and surgical unit was carried out. The total cost for six months was pounds 970,000 and this covered 4349 inpatient days and 282 admissions. For medical cases the cost ranged from pounds 132 to pounds 27,600 and the mean daily cost for different weight groups ranged from pounds 159 to pounds 274. The average daily cost for regional patients at pounds 258 was greater than for district patients who cost pounds 199. Altogether 23...

  2. Neonatal opioid withdrawal syndrome.

    Science.gov (United States)

    Sutter, Mary Beth; Leeman, Lawrence; Hsi, Andrew

    2014-06-01

    Neonatal opioid withdrawal syndrome is common due to the current opioid addiction epidemic. Infants born to women covertly abusing prescription opioids may not be identified as at risk until withdrawal signs present. Buprenorphine is a newer treatment for maternal opioid addiction and appears to result in a milder withdrawal syndrome than methadone. Initial treatment is with nonpharmacological measures including decreasing stimuli, however pharmacological treatment is commonly required. Opioid monotherapy is preferred, with phenobarbital or clonidine uncommonly needed as adjunctive therapy. Rooming-in and breastfeeding may decease the severity of withdrawal. Limited evidence is available regarding long-term effects of perinatal opioid exposure. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Intraoperative fluid therapy in neonates

    African Journals Online (AJOL)

    The evidence base for the administration of intraoperative fluids in neonates is poor and extrapolated from adults and children. Differences from adults and children in physiology and anatomy of neonates inform our practice. Keywords: fluid ..... compromise lung function and wound healing. The EGL develops early in ...

  4. Neonatal Tetanus: A Continuing Menace

    African Journals Online (AJOL)

    Alasia Datonye

    WHO/EPI/GEN/86/7 REVE 1 (ENGLISH). 27. UNICEF. Neonatal tetanus: protecting mothers and children. The State of World's Children 1994: 10. 28. WHO. EPI: Disease incidence and immunization coverage (Saudi Arabia). Weekly Epidem. Record. 1986;. 61(7): 45-46. 29. WHO. EPI. Neonatal tetanus mortality surveys.

  5. Interpretation of neonatal chest radiography

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hye Kyung [Dept. of Radiology, Kangwon National University Hospital, Chuncheon (Korea, Republic of)

    2016-05-15

    Plain radiographs for infants in the neonatal intensive care unit are obtained using the portable X-ray equipment in order to evaluate the neonatal lungs and also to check the position of the tubes and catheters used for monitoring critically-ill neonates. Neonatal respiratory distress is caused by a variety of medical or surgical disease conditions. Clinical information about the gestational week, respiratory symptoms, and any events during delivery is essential for interpretation of the neonatal chest radiographs. Awareness of common chest abnormality in the prematurely born or term babies is also very important for chest evaluation in the newborn. Furthermore, knowledge about complications such as air leaks and bronchopulmonary dysplasia following treatment are required to accurately inform the clinicians. The purpose of this article was to briefly review radiographic findings of chest diseases in newborns that are relatively common in daily practice.

  6. Interpretation of neonatal chest radiography

    International Nuclear Information System (INIS)

    Yoon, Hye Kyung

    2016-01-01

    Plain radiographs for infants in the neonatal intensive care unit are obtained using the portable X-ray equipment in order to evaluate the neonatal lungs and also to check the position of the tubes and catheters used for monitoring critically-ill neonates. Neonatal respiratory distress is caused by a variety of medical or surgical disease conditions. Clinical information about the gestational week, respiratory symptoms, and any events during delivery is essential for interpretation of the neonatal chest radiographs. Awareness of common chest abnormality in the prematurely born or term babies is also very important for chest evaluation in the newborn. Furthermore, knowledge about complications such as air leaks and bronchopulmonary dysplasia following treatment are required to accurately inform the clinicians. The purpose of this article was to briefly review radiographic findings of chest diseases in newborns that are relatively common in daily practice

  7. Neonatal gastrointestinal imaging

    International Nuclear Information System (INIS)

    Rao, Padma

    2006-01-01

    Radiological imaging is an important part of the evaluation and management of neonates with suspected anomalies of the gastrointestinal tract. Clinical presentation is often non-specific, commonly with abdominal distension and vomiting for which the underlying cause may or may not be clinically apparent. In a proportion of patients, the clinical assessment alone may suffice in providing the diagnosis and no further imaging is necessary. The reader must have an understanding of the normal radiographic appearances of the gastrointestinal tract in neonates and appreciate normal variants and differences to adults. In certain cases, the abdominal radiograph alone is diagnostic. In others, sonography and contrast studies are useful adjunct investigations and the indications for CT and MRI are few, but specific. Appropriate radiological investigation will help to establish the diagnosis and guide surgical intervention whilst also avoiding unnecessary radiation. Some of the conditions require transfer to specialist paediatric institutions for care. Thus, in some circumstances it is appropriate for imaging to be delayed and performed at the specialist centre with early referral often essential for the continued well being of the child

  8. Neonatal status of twins

    Directory of Open Access Journals (Sweden)

    Božinović Dragica

    2012-01-01

    Full Text Available Multiple pregnancy is a pregnancy where more than one fetus develops simultaneously in the womb, as a result of the ovulation and fertilization of more than one egg. It is relatively rare in humans and represents the rest of the phylogenetic stages. The most common are twins and they indicate the development of two fetuses in the womb. The frequency of twin pregnancies is about 1%. Multiple pregnancies belong to a group of high-risk pregnancies because of the many complications that occur during the pregnancy: higher number of premature deliveries, bleeding, early neonatal complications and higher perinatal morbidity and mortality. Such pregnancies and infants require greater supervision and monitoring. The aim of this study was to determine the percentage of baby twins born at the maternity ward of the General Hospital in Prokuplje and their morbidity and mortality. Data on the total number of deliveries, number of twins, parity and maternal age, gestational age, body weight of twins, method of delivery, Apgar score and perinatal mortality were collected and statistically analyzed by means of retrospective analysis of operative birth and neonatal protocol for 6 years (2005 of 2010. Out of 4527 mothers who gave birth 43 were pairs of twins, or 0.95% of women gave birth to twins. These babies are more likely born by Caesarean section, but delivered with slightly lower birth weight.

  9. Neonatal Mortality of Inborns in the Neonatal Unit of a Tertiary ...

    African Journals Online (AJOL)

    The neonatal deaths comprised of 120 early neonatal deaths and 39 late neonatal deaths. The yearly neonatal mortality rate showed a steady decline except for 1999 during which there was a slight rise. The incidence of neonatal deaths decreased with age, weight at birth and maturity. Low birth weight and birth asphyxia ...

  10. Neonate brain disorders

    International Nuclear Information System (INIS)

    Xydis, V.

    2012-01-01

    Full text: Hypoxic-Ischemic insults in the brain of neonates constitute major cause of morbidity and mortality. A wide range of motor, sensory, and cognitive disabilities are observed in this population spanning from slight motor deficits, school difficulties and behavioral problems up to cerebral palsy and mental retardation. Pathologically involved areas characterized by high metabolic demands and therefore with enhanced vulnerability to any reduction or cessation of energy and oxygen supply. Watershed areas of the brain (vascular end zones and vascular border zones) are predominately affected in any adverse event. Radiologic and pathologic appearance of these lesions depends both on the severity of the insult and the maturity of the brain. The dominant pathology observed in preterm neonates is white matter lesions. There are three basic patterns of brain destruction in this population. Periventricular leukomalacia (PVL focal fPVL, diffuse dPVL), germinal matrix haemorrhage (GMH) associated with intraventricular haemorrhage (IVH), and parenchymal haemorrhage (PH). fPVL is characterized by focal necrosis of all cellular elements in the periventricular white matter, resulting in the formation of cysts, and dPVL is characterized by diffuse destruction of the premyelinating oligodendrocytes (pre-OLs) the precursors of mature oligodendroglia cells responsible for the formation of myelin in a later stage. GMH is located beneath germinal matrix layer surrounding the lateral ventricles and can extend into the ventricular system resulting thus to IVH. Finally, PH is located within the parenchyma adjacent to the ventricles and is believed to represent haemorrhagic infarcts following venous drainage compromise. In term or near-term neonates, the top-ographic pattern of injuries involves mainly gray matter structures. Most frequent predilection sites include the cerebral cortex (paracentral lobule, Rolandic area, visual cortex and hippocampus), basal ganglia, thalamus, and

  11. The neonate in distress

    International Nuclear Information System (INIS)

    Ball, T.I. Jr.

    1987-01-01

    Respiratory distress is a very common and yet non-specific symptom in neonates and young infants. It may be manifested clinically in many ways, including tachypnea, apnea, periodic respiratory, grunting, retractions, nasal flaring, and cyanosis. In many instances, the chest radiograph is diagnostic or at least suggestive of the diagnosis. This fact is important in determining surgical or medical conditions that require emergency therapy. Even if the chest film is normal, valuable information can be gained. This initial normal radiograph can be used as a baseline film in the face of further developing symptoms which, likewise, may have developing radiographic findings. In any event, the chest radiograph gives the clinician ''direction'' in his or her search for the cause of the patient's respiratory distress

  12. Neonatal Pulmonary Hemosiderosis

    Directory of Open Access Journals (Sweden)

    Boris Limme

    2014-01-01

    Full Text Available Idiopathic pulmonary hemosiderosis (IPH is a rare complex entity characterized clinically by acute or recurrent episodes of hemoptysis secondary to diffuse alveolar hemorrhage. The radiographic features are variable, including diffuse alveolar-type infiltrates, and interstitial reticular and micronodular patterns. We describe a 3-week-old infant presenting with hemoptysis and moderate respiratory distress. Idiopathic pulmonary hemosiderosis was the first working diagnosis at the Emergency Department and was confirmed, 2 weeks later, by histological studies (bronchoalveolar lavage. The immunosuppressive therapy by 1 mg/kg/d prednisone was immediately started, the baby returned home on steroid therapy at a dose of 0,5 mg/kg/d. The diagnosis of idiopathic pulmonary hemosiderosis should be evocated at any age, even in the neonate, when the clinical presentation (hemoptysis and abnormal radiological chest images is strongly suggestive.

  13. Neonatal Pulmonary Hemosiderosis

    Science.gov (United States)

    Limme, Boris; Nicolescu, Ramona; Misson, Jean-Paul

    2014-01-01

    Idiopathic pulmonary hemosiderosis (IPH) is a rare complex entity characterized clinically by acute or recurrent episodes of hemoptysis secondary to diffuse alveolar hemorrhage. The radiographic features are variable, including diffuse alveolar-type infiltrates, and interstitial reticular and micronodular patterns. We describe a 3-week-old infant presenting with hemoptysis and moderate respiratory distress. Idiopathic pulmonary hemosiderosis was the first working diagnosis at the Emergency Department and was confirmed, 2 weeks later, by histological studies (bronchoalveolar lavage). The immunosuppressive therapy by 1 mg/kg/d prednisone was immediately started, the baby returned home on steroid therapy at a dose of 0,5 mg/kg/d. The diagnosis of idiopathic pulmonary hemosiderosis should be evocated at any age, even in the neonate, when the clinical presentation (hemoptysis and abnormal radiological chest images) is strongly suggestive. PMID:25389504

  14. Radiologic findings of neonatal sepsis

    International Nuclear Information System (INIS)

    Kim, Sam Soo; Han, Dae Hee; Choi, Guk Myeong; Jung, Hye Won; Yoon, Hye Kyung; Han, Bokyung Kim; Lee, Nam Yong

    1997-01-01

    To review the simple radiographic and sonographic findings in infants with neonatal sepsis. We retrospectively analyzed simple chest and abdominal radiographs, and brain sonograms in 36 newborn infants (preterm : term=23 :13). With neonatal sepsis diagnosed by blood culture and clinical manifestations. Pulmonary parenchymal infiltrate excluding respiratory distress syndrome and pulmonary edema or atelectasis was found in 22 infants (61%). Paralytic ileus, hepatosplenomegaly, and necrotizing enterocolitis were present in 18(50%), 9(25%), and 1(3%) infants, respectively, while skeletal changes suggesting osteomyelitis were found in three. Brain sonography was performed in 29 infants and in four, abnormalities were seen ; these comprised three germinal matrix hemorrhages and one intraparenchymal hemorrhage. In six patients(17%) radiologic examinations revealed no abnormality. In patients with neonatal sepsis, pulmonary infiltrates and paralytic ileus were common abnormalities. Although these were nonspecific, radiologic findings may be used to supplement clinical and laboratory findings in diagnosing neonatal sepsis and planning its treatment

  15. Radiologic findings of neonatal sepsis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sam Soo; Han, Dae Hee; Choi, Guk Myeong; Jung, Hye Won [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of); Yoon, Hye Kyung; Han, Bokyung Kim; Lee, Nam Yong [Sansung Medical Center, Seoul (Korea, Republic of)

    1997-06-01

    To review the simple radiographic and sonographic findings in infants with neonatal sepsis. We retrospectively analyzed simple chest and abdominal radiographs, and brain sonograms in 36 newborn infants (preterm : term=23 :13). With neonatal sepsis diagnosed by blood culture and clinical manifestations. Pulmonary parenchymal infiltrate excluding respiratory distress syndrome and pulmonary edema or atelectasis was found in 22 infants (61%). Paralytic ileus, hepatosplenomegaly, and necrotizing enterocolitis were present in 18(50%), 9(25%), and 1(3%) infants, respectively, while skeletal changes suggesting osteomyelitis were found in three. Brain sonography was performed in 29 infants and in four, abnormalities were seen ; these comprised three germinal matrix hemorrhages and one intraparenchymal hemorrhage. In six patients(17%) radiologic examinations revealed no abnormality. In patients with neonatal sepsis, pulmonary infiltrates and paralytic ileus were common abnormalities. Although these were nonspecific, radiologic findings may be used to supplement clinical and laboratory findings in diagnosing neonatal sepsis and planning its treatment.

  16. Microbes causing severe neonatal septicemia in a tertiary neonatal intensive care unit

    OpenAIRE

    Khashana, Abdelmoneim

    2016-01-01

    Neonatal sepsis is the most challenging neonatal disease in developing countries despite the progress in the neonatal management. The aim of the study is to demonstrate the most common organisms causing severe neonatal sepsis in a tertiary neonatal intensive care unit. The study conducted in the neonatal intensive care unit (ICU) unit of pediatric department in Suez Canal University Hospital in the period from December 2013 to November 2014.Blood cultures showed the growth of Escherichia coli...

  17. Transient pseudohypoparathyroidism and neonatal seizure.

    Science.gov (United States)

    Manzar, S

    2001-04-01

    The case of a neonate is presented who had late onset seizure associated with hypocalcemia, hyperphosphatemia, and raised parathyroid hormone. The infant did not have any stigmata of pseudohypoparathyroidism. The hypocalcemia was initially resistant to calcium therapy, but responded to vitamin D analog therapy. The diagnosis of 'transient neonatal pseudohypoparathyroidism' was entertained, as the infant remained stable and seizure-free with normal serum biochemistry during 8 months of follow-up.

  18. Necrotizing nocardial scleritis after combined penetrating keratoplasty and phacoemulsification with intraocular lens implantation: a case report and review of the literature Esclerite necrosante por Nocardia após ceratoplastia penetrante e facoemulsificação com implante de lente intra-ocular: caso clínico e revisão de literatura

    Directory of Open Access Journals (Sweden)

    Jerome Charles Ramos-Esteban

    2007-03-01

    Full Text Available We report the history and clinical presentation of an 88-year-old female with Fuchs dystrophy who developed an acute anterior necrotizing scleritis in her left eye 23 months after an uncomplicated combined penetrating keratoplasty and phacoemulsification with intraocular lens implantation which progressed to slceral perforation with uveal prolapses. The patient underwent a complete systemic work-up for both autoimmune and infectious causes of scleritis. Surgical specimens of the area of scleral perforation were sent for histology and microbiologic studies. Analysis of surgical specimens revealed the presence of culture-proven Nocardia asteroides as a causative agent for the patient's scleral perforation. Results of her systemic autoimmune work-up were not conclusive. Successful treatment with tectonic scleral reinforcement with donor corneal tissue and preserved pericardium, oral and topical trimethoprim-sulfamethoxazole and topical amikacin salvaged the globe and increased vision. The patient's final best-corrected visual acuity sixteen months after her last operation remains 20/70. Prompt surgical intervention with submission of appropriate specimens for pathological diagnosis and microbiology, along with consultation with rheumatologic and infectious disease specialists, are mandatory to minimize visual loss in cases of suspected infectious necrotizing scleritis.Relato de caso de esclerite necrosante aguda, evoluindo para perfuração escleral com prolapso uveal, 23 meses após procedimento de ceratoplastia penetrante e facoemulsificação com implante de lente intra-ocular no olho esquerdo sem intercorrências.A paciente foi submetida à avaliação completa auto-imune para esclerite. Biópsia da área de perfuração escleral foi encaminhada para avaliação patológica e microbiológica. Análise de material cirúrgico revelou presença de cultura proveniente de Nocardia asteroides como agente causal da perfuração escleral. Resultados de

  19. Porcine Neonatal Coccidiosis

    Science.gov (United States)

    Sanford, S. E.; Josephson, G. K. A.

    1981-01-01

    Coccidia were identified in intestinal sections from 82 piglets comprising 37 consignments from 34 farms, and represented a yearly increasing incidence in the three years 1978 to 1980. Piglets were primarily from medium to large farms with intensive, continuous-farrowing, confinement-rearing programs. Piglets, usually five days to 15 days old, had yellow, fluid diarrhea, became unthrifty and sometimes died. In six piglets from two farms, a green, adherent, fibrinonecrotic membrane was seen throughout most of the jejunum and ileum. Significant gross lesions were not observed in the other 76 piglets. Moderate to severe villous atrophy of jejunum and ileum was seen histologically. Various asexual and sexual stages of coccidia were seen within parasitophorous vacuoles of villar epithelial cells. Multifocal erosions with necrosis of villar tips and occasionally more diffuse mucosal necrosis with fibrinocellular exudate were seen. Isospora suis oocysts were identified in feces from several weaners from one farm. Amprolium and decoquinate mixed in the sow ration at 1 kg/tonne for three weeks prior to and postfarrowing was moderately successful in stopping outbreaks of neonatal diarrhea associated with coccidiosis. ImagesFigure 1.Figure 2.Figure 3.Figure 4.Figure 5.Figure 6. PMID:7343074

  20. Osteoarthritis in the neonate

    International Nuclear Information System (INIS)

    Weigel, W.; Hayek, W.H.; Bens, G.

    1979-01-01

    A fatally ending index case of sepsis osteoarthritis that was diagnosed retrospectively initiated this report. This patient had severe, asymmetrically distributed metaphyseal growthdisturbances, many long bones. In order to determine the features of early radiologic diagnosis we report the findings of 7 further patients with neonatal septic osteoarthritis with clinical and radiological follow-up. The most important observation for early radiologic diagnosis of osteoarthritis is the displacement of fat layers along the metaphysis. Other findings of the soft tissues have the same diagnostic value as bone destruction and subperiosteal new bone formation found one to three weeks later on roentgenfilms. Detecting early signs of osteoarthritis helps in localizing the focus for bacteriologic diagnosis, which is to be more successful than blood cultures. Diagnosing a joint empyema initiates surgical intervention for pressure relief in order to avoid necrosis of the epiphysis as seen in the femoral bone in septic arthritis of the hip joint. Early diagnosis and treatment to destruction of growing cartilage is necessary to avoid gross disturbances and length discrepancies of long bones. In cases of sepsis called 'babygram' and a repeat examination 10 to 14 days later is mandatory. (orig.) [de

  1. Hypothyroidism in Filipino neonates

    International Nuclear Information System (INIS)

    Guevarra, R.; Torres, J.F.; Estrada, F.A.; San Luis, T.O.L.

    1988-01-01

    Thyroid hormone determination (T4, T3, rT3, TSH) in cord blood of 3,897 newborns was carried out in Metro Manila (non-endemic) and central, Northern and Southern Luzon (endemic for goiter). The objective is to detect congenital hypothyroidism and establish its incidence in new born Filipinos. This was done by radioimmunoassay, using commercial kits from Abbott Laboratories. The results obtained as mean values for non-endemic regions are: T4: 10.96 +- 2.25 ug/dl; T3: 60-64 +- 13.82 ng/dl; rT3: 250.4 +- 64.9 ng/dl; and TSH 5.89 +- 2.58 uU/ml, n=200. Mean values in endemic regions (n = 205) are T4: 9.46 +- 2.18 ug/dl; T3: 67.8 +- 12.05 ng/dl; rT3: 184.3 +- 32.7 ng/dl and TSH: 6.65 +- 3.13 uU/ml. From the above data, nomograms were drawn where the values obtained from each case were plotted. From non-endemic regions 28 positive cases were recalled and in the endemic regions 16 positive cases were also recalled for re-examination but most of them turned out to be false positive. As of now, four positive cases were found in Metro Manila, i.e. 4/2, 441 births and five in endemic regions out of 1,456 births so the incidence of neonatal hypothyroidism is 9/3,897 births. This is 9 times higher than most reports abroad which is about 1/4000 births. (Auth.). 36 refs; 10 tabs; 10 figs

  2. Fetal and neonatal thyrotoxicosis

    Directory of Open Access Journals (Sweden)

    Chandar Mohan Batra

    2013-01-01

    Full Text Available Fetal thyrotoxicosis is a rare disease occurring in 1 out of 70 pregnancies with Grave′s disease or in 1 out of 4000-50,000 deliveries. The mortality is 12-20%, usually from heart failure, but other complications are tracheal compression, infections and thrombocytopenia. It results from transfer of thyroid stimulating immunoglobulins from mother to fetus through the placenta. This transplacental transfer begins around 20 th week of pregnancy and reaches its maximum by 30 th week. These autoantibodies bind to the fetal thyroid stimulating hormone (TSH receptors and increase the secretion of the thyroid hormones. The mother has an active autoimmune thyroid disease or has been treated for it in the past. She may be absolutely euthyroid due to past treatment by drugs, surgery or radioiodine ablation, but still have active TSH receptor stimulating autoantibodies, which can cause fetal thyrotoxicosis. The other features of this disease are fetal tachycardia, fetal goiter and history of spontaneous abortions and findings of goiter, ascites, craniosyntosis, fetal growth retardation, maceration and hydrops at fetal autopsy. If untreated, this disease can result in intrauterine death. The treatment for this disease consists of giving carbimazole to the mother, which is transferred through the placenta to the fetus. The dose of carbimazole is titrated with the fetal heart rate. If the mother becomes hypothyroid due to carbimazole, thyroxine is added taking advantage of the fact that very little of thyroxine is transferred across the placenta. Neonatal thyrotoxicosis patients are very sick and require emergency treatment. The goal of the treatment is to normalize thyroid functions as quickly as possible, to avoid iatrogenic hypothyroidism while providing management and supportive therapy for the infant′s specific signs and symptoms.

  3. Maternal hypotension and neonatal acidemia during Caeserean ...

    African Journals Online (AJOL)

    Objectives: To determine the incidence of neonatal acidaemia following delivery through caesarean section under spinal anaesthesia and determine the prevalence of maternal hypotension during Caesarean section under spinal anaesthesia and its correlation with neonatal acidaemia. Design: Prospective observational ...

  4. Buprenorphine During Pregnancy Reduces Neonate Distress

    Science.gov (United States)

    ... who received buprenorphine had milder symptoms of neonatal opioid withdrawal than those born to women who received methadone. ... with less neonatal distress. Buprenorphine, like methadone, reduces opioid craving and alleviates withdrawal symptoms without the safety and health risks related ...

  5. Two Neonates with Congenital Hydrocolpos

    Directory of Open Access Journals (Sweden)

    Vydehi Murthy

    2013-01-01

    Full Text Available Introduction. Neonatal hydrocolpos is a rare condition. Hydrocolpos is cystic dilatation of the vagina with fluid accumulation due to a combination of stimulation of secretary glands of the reproductive tract and vaginal obstruction. The differential for a neonatal presentation of lower abdominal mass includes urogenital anomalies, Hirschsprung’s, disease or sacrococcygeal teratoma. Prenatal diagnosis and early newborn imaging studies leads to early detection and treatment of these cases. Case. We report here two cases of neonatal hydrocolpos with prenatal diagnosis of lower abdominal mass. Postnatally, ultrasound, MRI imaging, and cystoscopy confirmed large cystic mass as hydrocolpos with distal vaginal obstruction. Both patients had enlarged renal system secondary to mass effect. Conclusion. High index of suspicion for hydrocolpos in a newborn presenting with fetal diagnosis of infraumbilical abdominal mass will facilitate timely intervention and prevention of complications.

  6. Diagnostic imaging in neonatal stroke

    International Nuclear Information System (INIS)

    Kuhle, S.; Ipsiroglu, O.; Weninger, M.

    2000-01-01

    A cerebral artery infarction is an important differential diagnosis in the newborn with neurological abnormalities. Based on clinical data, its incidence is estimated to be 1 in 4000 newborns. Since the course is often subclinical, the true incidence is probably higher. Diagnosis: Cerebral ultrasound and Doppler sonography as readily available screening tools play a central role in the initial diagnosis of neonatal cerebral infarction. Definitive diagnosis is made by computed tomography or magnetic resonance imaging. Beside symptomatic anticonvulsive therapy, treatment aims at the prevention of secondary ischemic injury. Discussion: Three term infants with different clinical courses of neonatal stroke are presented to sensitize the clinician and the radiologist for this probably underdiagnosed entity. The role of imaging modalities in the diagnosis and follow-up of neonatal cerebral infarction is discussed. (orig.) [de

  7. Neonatal hemophilia: a rare presentation

    Directory of Open Access Journals (Sweden)

    Nuno Ferreira

    2015-12-01

    Full Text Available Hemophilia A is a X-linked hereditary condition that lead to decreased factor VIII activity, occurs mainly in males. Decreased factor VIII activity leads to increased risk of bleeding events. During neonatal period, diagnosis is made after post-partum bleeding complication or unexpected bleeding after medical procedures. Subgaleal hemorrhage during neonatal period is a rare, severe extracranial bleeding with high mortality and usually related to traumatic labor or coagulation disorders. Subgaleal hemorrhage complications result from massive bleeding. We present a neonate with unremarkable family history and uneventful pregnancy with a vaginal delivery with no instrumentation, presenting with severe subgaleal bleeding at 52 hours of life. Aggressive support measures were implemented and bleeding managed. The unexpected bleeding lead to a coagulation study and the diagnosis of severe hemophilia A. There were no known sequelae. This case shows a rare hemophilia presentation reflecting the importance of coagulation studies when faced with unexplained severe bleeding.

  8. Antimicrobial therapy in neonatal intensive care unit

    OpenAIRE

    Tzialla, C.; Borghesi, A.; Serra, G.; Stronati, M.; Corsello, G.

    2015-01-01

    Severe infections represent the main cause of neonatal mortality accounting for more than one million neonatal deaths worldwide every year. Antibiotics are the most commonly prescribed medications in neonatal intensive care units (NICUs) and in industrialized countries about 1% of neonates are exposed to antibiotic therapy. Sepsis has often nonspecific signs and symptoms and empiric antimicrobial therapy is promptly initiated in high risk of sepsis or symptomatic infants. However continued us...

  9. Bupivacaine versus lidocaine analgesia for neonatal circumcision

    OpenAIRE

    Stolik-Dollberg, Orit C; Dollberg, Shaul

    2005-01-01

    Abstract Background Analgesia for neonatal circumcision was recently advocated for every male infant, and its use is considered essential by the American Academy of Pediatrics. We compared the post-operative analgesic quality of bupivacaine to that of lidocaine for achieving dorsal penile nerve block (DPNB) when performing neonatal circumcision. Methods Data were obtained from 38 neonates following neonatal circumcision. The infants had received DPNB analgesia with either lidocaine or bupivac...

  10. Neonatal and infantile acne vulgaris: an update.

    Science.gov (United States)

    Serna-Tamayo, Cristian; Janniger, Camila K; Micali, Giuseppe; Schwartz, Robert A

    2014-07-01

    Acne may present in neonates, infants, and small children. Neonatal and infantile acne vulgaris are not considered to be rare. The presentation of acne in this patient population sometimes represents virilization and may portend later development of severe adolescent acne. Neonatal and infantile acne vulgaris must be distinguished from other cutaneous disorders seen in newborns and infants. Infantile acne tends to be more pleomorphic and inflammatory, thus requiring more vigorous therapy than neonatal acne.

  11. Centralização de fluxo sanguíneo fetal: comparação entre os índices diagnósticos Brain-sparing effect: comparison of diagnostic indices

    Directory of Open Access Journals (Sweden)

    Cleide Mara Mazzotti de Oliveira Franzin

    2010-01-01

    Full Text Available OBJETIVO: descrever os resultados perinatais adversos em pacientes com centralização de fluxo sanguíneo fetal, utilizando a relação entre os índices de pulsatilidade das artérias cerebral média e umbilical (IPACM/IPAU e entre os índices de resistência das artérias cerebral média e umbilical (IRACM/IRAU, assim como comparar os dois índices diagnósticos. MÉTODOS: foram incluídas 151 gestantes com diagnóstico de centralização de fluxo sanguíneo atendidas na maternidade da Universidade Estadual de Campinas, cujo parto ocorreu até 15 dias após o diagnóstico ultrassonográfico. Foram considerados como resultados perinatais adversos: índice de Apgar inferior a sete no quinto minuto, internação em UTI neonatal, concepto pequeno para a idade gestacional, sofrimento fetal agudo, mortalidade perinatal, hipoglicemia, policitemia, enterocolite necrosante, hemorragia cerebral, hemorragia pulmonar, anemia, septicemia, doença de membrana hialina, síndromes convulsivas, síndrome de hiper-reflexia e insuficiência renal. As frequências dos resultados perinatais adversos (RPA para as relações cérebro-placentária foram comparadas utilizando-se o teste exato de Fisher ou o do χ2 de Pearson, considerando-se como estatisticamente significativo o nível de 5%. Os resultados perinatais adversos foram avaliados de acordo com a idade gestacional, utilizando-se o teste de tendência de Cochrane-Armitage. RESULTADOS: os resultados perinatais adversos para o grupo em que os dois índices apresentaram-se alterados constatou que 62,5% dos recém-natos necessitaram de internação em UTI, conceptos pequenos para a idade gestacional (PIG ocorreram em 75,2%, sofrimento fetal agudo em 35,3%, hipoglicemia em 84,4%, policitemia em 8,3%, enterocolite necrosante em 4,2% e hemorragia cerebral em 2,1%. Constatou-se associação significativa das relações IPACM/IPAU e IRACM/IRAU, no decorrer da idade gestacional, para necessidade de cuidados

  12. Neonatal lupus erythematosus in a Nigerian infant

    African Journals Online (AJOL)

    2017-06-15

    Jun 15, 2017 ... persisted unchanged after 14 days of antibiotics. A skin snip was taken for histology and a diagnosis of neonatal lupus erythematosus was made. Key words: neonatal lupsus erythematosus, infant .... anti-Rho (SSA) antibody which is present in 95% of cases of Neonatal lupus is fundamental.8,9 The signifi-.

  13. 21 CFR 880.5400 - Neonatal incubator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Neonatal incubator. 880.5400 Section 880.5400 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL... § 880.5400 Neonatal incubator. (a) Identification. A neonatal incubator is a device consisting of a...

  14. Neonatal tetanus mortality in coastal Kenya

    DEFF Research Database (Denmark)

    Bjerregaard, P; Steinglass, R; Mutie, D M

    1993-01-01

    In a house-to-house survey in Kilifi District, Kenya, mothers of 2556 liveborn children were interviewed about neonatal mortality, especially from neonatal tetanus (NNT). The crude birth rate was 60.5 per 1000 population, the neonatal mortality rate 21.1 and the NNT mortality rate 3.1 per 1000...

  15. Neonatal arrhythmias: diagnosis, treatment, and clinical outcome

    OpenAIRE

    Ban, Ji-Eun

    2017-01-01

    Arrhythmias in the neonatal period are not uncommon, and may occur in neonates with a normal heart or in those with structural heart disease. Neonatal arrhythmias are classified as either benign or nonbenign. Benign arrhythmias include sinus arrhythmia, premature atrial contraction, premature ventricular contraction, and junctional rhythm; these arrhythmias have no clinical significance and do not need therapy. Supraventricular tachycardia, ventricular tachycardia, atrioventricular conduction...

  16. Malaria parasite positivity among febrile neonates | Enyuma ...

    African Journals Online (AJOL)

    Background: Malaria, earlier considered rare in neonates, has been reported with increasing frequency in the last decade. Neonatal malaria diagnosis is challenging because the clinical features are non-specific, variable and also overlap with bacterial infection. Aim: To determine the prevalence of neonatal malaria and ...

  17. Neonatal varicella: A case report

    Directory of Open Access Journals (Sweden)

    Bhardwaj AK

    2011-06-01

    Full Text Available Chicken pox is an infectious childhood disease. It is rare ininfants and newborns due to passive immunity receivedfrom the mother. The characteristic skin eruptions inchicken pox are vesicular with erythematous base andaccompanied with pruritus. The skin of the palms and solesis typically spared. We report a case of neonatal varicellawhere the mother was having skin eruptions at the time ofdelivery and the neonate contracted it during the perinatalperiod and developed clinical disease on the day five of life.Specific anti-viral therapy was given to the mother and thebaby and the recovery was uneventful.

  18. Pain Management Perceptions of the Neonatal Nurses in NICUs and Neonatal Units in Ardebil, Iran

    OpenAIRE

    Nasrin Mehrnoush; Tahereh Ashktorab; Mohammad heidarzadeh; Sirous momenzadeh; jafar khalafi

    2016-01-01

    Background: This study aimed to determine neonatal nurses’ perceptions of knowledge and practice in pain management in NICUs & neonatal units. Methods: A cross-sectional descriptive study design was used. A total of 120 neonatal nurses who working in NICUs & neonatal units in Ardebil province, Iran were selected using the convenience sampling technique. A questionnaire of Nurses’ Perceptions of Neonatal Pain (Cong, 2013), including 36 questions with Likert scale and 2 open ended questions, wa...

  19. The challenges of neonatal magnetic resonance imaging

    International Nuclear Information System (INIS)

    Arthurs, Owen J.; Graves, Martin J.; Lomas, David J.; Edwards, Andrea; Austin, Topun

    2012-01-01

    Improved neonatal survival rates and antenatal diagnostic imaging is generating a growing demand for postnatal MRI examinations. Neonatal brain MRI is now becoming standard clinical care in many settings, but with the exception of some research centres, the technique has not been optimised for imaging neonates and small children. Here, we review some of the challenges involved in neonatal MRI, including recent advances in overall MR practicality and nursing practice, to address some of the ways in which the MR experience could be made more neonate-friendly. (orig.)

  20. The challenges of neonatal magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Arthurs, Owen J.; Graves, Martin J.; Lomas, David J. [Addenbrooke' s Hospital, Cambridge University Hospitals NHS Foundation Trust, Department of Radiology, Cambridge (United Kingdom); Edwards, Andrea [Addenbrooke' s Hospital, Cambridge University Hospitals NHS Foundation Trust, Department of Radiology, Cambridge (United Kingdom); Addenbrooke' s Hospital, Department of Neonatology, Cambridge (United Kingdom); Austin, Topun [Addenbrooke' s Hospital, Department of Neonatology, Cambridge (United Kingdom)

    2012-10-15

    Improved neonatal survival rates and antenatal diagnostic imaging is generating a growing demand for postnatal MRI examinations. Neonatal brain MRI is now becoming standard clinical care in many settings, but with the exception of some research centres, the technique has not been optimised for imaging neonates and small children. Here, we review some of the challenges involved in neonatal MRI, including recent advances in overall MR practicality and nursing practice, to address some of the ways in which the MR experience could be made more neonate-friendly. (orig.)

  1. Current Trends in Neonatal Tracheostomy.

    Science.gov (United States)

    Isaiah, Amal; Moyer, Kelly; Pereira, Kevin D

    2016-08-01

    The indications for neonatal tracheostomy may have changed with current noninvasive respiratory therapies compared with previous decades. To study the current trends in neonatal tracheostomy and identify the primary indication for the procedure and risk factors for failed extubation. This retrospective medical record review included 47 neonates who underwent tracheostomy from January 1, 2009, to December 31, 2013, at the University of Maryland Children's Hospital. Group 1 included infants undergoing tracheostomy for the primary indication of upper airway obstruction; group 2, infants with primary pulmonary disease. Data on weight, gestational age, comorbid conditions, congenital abnormalities, complications, outcomes, and indications for tracheostomy were compared statistically between groups. Differences in gestational age, birth weight, and age at tracheostomy. Among the 47 infants included in the study (30 boys; 17 girls, mean [SD] age, 113 [73] days), 31 (66%) demonstrated anatomical causes of airway obstruction, and 16 (34%) had significant pulmonary disease. Among infants with anatomical causes, subglottic stenosis represented the largest group (11 of 31 [35%]). The mean age at the time of tracheostomy was significantly lower in the group with airway obstruction (98.9 vs 146.9 days; difference, 48 [95% CI, 4.8-91.2] days; P = .04). No procedure-related morbidity or mortality was encountered. Anatomical upper airway obstruction may be returning as the most common indication for a neonatal tracheostomy, thereby supporting the belief that current respiratory therapies have lowered the burden of chronic lung disease and the need for prolonged ventilatory care.

  2. Photodegradation of riboflavin in neonates

    International Nuclear Information System (INIS)

    Sisson, T.R.

    1987-01-01

    The biologically most important flavins are riboflavin and its related nucleotides, all highly sensitive to light. It is because of its photoreactivity and its presence in almost all body fluids and tissues that riboflavin assumes importance in phototherapy of neonatal jaundice. The absorption maxima of both bilirubin and riboflavin in the body are nearly identical: 445-450 (447) nm. In consequence, blue visible light will cause photoisomerization of bilirubin accompanied by photodegradation of riboflavin. This results in diminished erythrocyte glutathione reductase, which indicates generalized tissue riboflavin deficiency and red cell lysis. Single- and double-strand breaks in intracellular DNA have occurred with phototherapy. This light exposure of neonates may result also in alterations of bilirubin-albumin binding in the presence of both riboflavin and theophylline (the latter frequently given to prevent neonatal apnea). Many newborns, especially if premature, have low stores of riboflavin at birth. The absorptive capacity of premature infants for enteral riboflavin is likewise reduced. Consequently, inherently low stores and low intake of riboflavin plus phototherapy for neonatal jaundice will cause a deficiency of riboflavin at a critical period for the newborn. Supplementation to those infants most likely to develop riboflavin deficiency is useful, but dosage, time, and mode of administration to infants undergoing phototherapy must be carefully adjusted to avoid unwanted side effects

  3. Internipple measurements in Indian neonates

    African Journals Online (AJOL)

    and transverse ocular distance are some important measurements when diagnosing dysmorphology.[4]. The internipple index (internipple distance (cm) × 100 ÷ circum ference of ... internipple distance to chest circumference compared with neonates ... first 3 days of life, and to correlate these measurements with gender,.

  4. Standardisation of neonatal clinical practice.

    Science.gov (United States)

    Bhutta, Z A; Giuliani, F; Haroon, A; Knight, H E; Albernaz, E; Batra, M; Bhat, B; Bertino, E; McCormick, K; Ochieng, R; Rajan, V; Ruyan, P; Cheikh Ismail, L; Paul, V

    2013-09-01

    The International Fetal and Newborn Growth Consortium for the 21(st) Century (INTERGROWTH-21(st) ) is a large-scale, population-based, multicentre project involving health institutions from eight geographically diverse countries, which aims to assess fetal, newborn and preterm growth under optimal conditions. Given the multicentre nature of the project and the expected number of preterm births, it is vital that all centres follow the same standardised clinical care protocols to assess and manage preterm infants, so as to ensure maximum validity of the resulting standards as indicators of growth and nutrition with minimal confounding. Moreover, it is well known that evidence-based clinical practice guidelines can reduce the delivery of inappropriate care and support the introduction of new knowledge into clinical practice. The INTERGROWTH-21(st) Neonatal Group produced an operations manual, which reflects the consensus reached by members of the group regarding standardised definitions of neonatal morbidities and the minimum standards of care to be provided by all centres taking part in the project. The operational definitions and summary management protocols were developed by consensus through a Delphi process based on systematic reviews of relevant guidelines and management protocols by authoritative bodies. This paper describes the process of developing the Basic Neonatal Care Manual, as well as the morbidity definitions and standardised neonatal care protocols applied across all the INTERGROWTH-21(st) participating centres. Finally, thoughts about implementation strategies are presented. © 2013 Royal College of Obstetricians and Gynaecologists.

  5. Pathophysiology of Equine Neonatal Septicemia

    Directory of Open Access Journals (Sweden)

    Juan Carlos Ospina Chirivi

    2014-07-01

    Full Text Available Neonatal septicemia is a major cause of mortality and morbidity in horses in their first seven days of life and within their pathophysiology. It is important to consider the extrinsic and intrinsic predisposing factors which make foals susceptible to agents of primarily bacterial etiology. However, other types of infectious etiology (viruses and fungi should be considered too, as well as noninfectious etiologies. The paper mentions a wide variety of mechanisms that produce different injuries that must be addressed with measures of critical neonatal care, so it is imperative for the veterinarian to know the pathogenic mechanisms of the disease, its clinical presentation and anatomo-pathological lesions. Thus, systemic inflammatory response syndrome (SIRS, multiple organ dysfunction syndrome (MODS, and peripheral circulatory collapse or shock are some of the elements defined as the pillars of the pathophysiology of neonatal septicemia, extensively studied in equine medicine. This paper presents a short review of the triggering mechanisms of neonatal septicemia highlighting the importance of epidemiological investigations in Colombia. It shows the need for retrospective and prospective studies and for divulgation of some of the preventive measures of the disease in horses.

  6. Time Perception during Neonatal Resuscitation.

    Science.gov (United States)

    Trevisanuto, Daniele; De Bernardo, Giuseppe; Res, Giulia; Sordino, Desiree; Doglioni, Nicoletta; Weiner, Gary; Cavallin, Francesco

    2016-10-01

    To assess the accuracy of time perception during a simulated complex neonatal resuscitation. Participants in 5 neonatal resuscitation program courses were directly involved in a complex simulation scenario. They were asked to assume the role of team leader, assistant 1, or assistant 2. At the end of the scenario, each participant completed a questionnaire on perceived time intervals for key resuscitation interventions. During the scenario, actual times were documented by an external observer and video recorded for later review. In addition, participants were asked to evaluate their self-perceived level of stress and preparation. Health care providers (68 physicians and 40 nurses) were involved in 36 scenarios. Perceived time intervals for the initiation of key resuscitation interventions were shorter than the actual time intervals, regardless of the participant's role in the scenario. Self-assessed levels of stress and preparation did not influence time perception. Health care providers underestimate the passage of time, irrespective of their role in a simulated complex neonatal resuscitation. Participant's self-assessed levels of stress and preparation were not related to the accuracy of their time perception. These findings highlight the importance of assigning a dedicated individual to document interventions and the passage of time during a neonatal resuscitation. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Neonatal blood gas sampling methods

    African Journals Online (AJOL)

    adequate collateral circulation before radial arterial puncture may not be a reliable predictor of subsequent risk of vascular injury.75. Conclusion and recommendations. Indwelling arterial catheters remain a practical, reliable and accurate method of neonatal blood gas sampling, provided they are inserted and maintained ...

  8. Caffeine impact on neonatal morbidities.

    Science.gov (United States)

    Aranda, Jacob V; Beharry, Kay; Valencia, Gloria B; Natarajan, Girija; Davis, Jonathan

    2010-10-01

    Caffeine is a silver bullet in neonatology. This ubiquitous trimethylxanthine, pervasively used in the human diet and beverages, significantly impacts on major acute neonatal morbidities including apnea of prematurity, bronchopulmonary dysplasia, patent ductus arteriousus with or without surgical ligation and post-operative apnea. Potential uses in respiratory distress syndrome as suggested by improved lung function in primate models is supported by the decreased time on mechanical ventilation and need for oxygen therapy. Improved later outcomes at 18 to 22 months include clinically significant decreases in cerebral palsy, cognitive impairment, and severe retinopathy of prematurity in those babies who received caffeine during the neonatal period compared to non-caffeine treated placebo neonates. Ongoing and future research studies focus on optimizing current dose regimens to determine whether benefits can be maximized while maintaining an impressive safety profile. Molecular pharmacologic studies focused on the molecular and the biochemical mechanisms underlying the protective effects of caffeine are also being done to optimize treatment regimes and to target potential molecular pathways leading to further decreases in acute and long term neonatal morbidities. Since its use in newborns three decades ago, caffeine is now one of the safest, most cost-beneficial and effective therapies in the newborn.

  9. Neonatal characteristics and perinatal complications in neonates with Down syndrome.

    Science.gov (United States)

    Ergaz-Shaltiel, Zivanit; Engel, Offra; Erlichman, Ira; Naveh, Yaron; Schimmel, Michael S; Tenenbaum, Ariel

    2017-05-01

    The annual rate of Down syndrome (DS) births in Jerusalem is stable, regardless of prenatal screening, and diagnostic measures. We aimed to evaluate our historical cohort for obstetrical characteristics and the neonatal course and complications. We reviewed computerized medical files of neonates with the diagnosis of DS born in the four main hospitals in Jerusalem between the years 2000 and 2010 and evaluated for maternal history and primary neonatal hospitalization. A total of 403 neonates were diagnosed with DS. The average maternal age was 35.6 years, 73% were born via spontaneous vaginal delivery. In all gestational ages, the mean birth weight and head circumference percentiles were significantly lower than the general population (P < 0.001 for both) and at each week the HC percentile was lower than the weight percentile (P < 0.0001), worse among males. Mortality during the primary hospitalization was 3.7%. The most common anomalies were cardiac (79%) with either congenital defects or functional abnormalities, neither influenced the length of hospitalization. The main reasons for prolonged hospitalization were prematurity and anomalies of other (non-cardiac) organs. Common perinatal complications included respiratory failure or need for oxygen supplementation (32%), hyperbilirubinemia (23%), sepsis (6.4%), and feeding difficulties (13%). About 84% were fed by human milk; of those, two thirds were exclusively breast-fed and one third were supplemented with infant formula. In conclusion, infants with DS were small for gestational age with relatively reduced head circumference. Despite the increased rate of congenital anomalies and perinatal complications, most infants were discharged home in good medical condition and were exclusively breastfed. © 2017 Wiley Periodicals, Inc.

  10. Diagnostic imaging in neonatal stroke; Bildgebende Diagnostik des Neonatal stroke

    Energy Technology Data Exchange (ETDEWEB)

    Kuhle, S.; Ipsiroglu, O.; Weninger, M. [Universitaetsklinik fuer Kinder- und Jugendheilkunde, Wien (Austria). Abt. fuer Neonatologie, angeborene Stoerungen und Intensivmedizin; Puig, S.; Prayer, D. [Universitaetsklinik fuer Radiodiagnostik, Wien (Austria)

    2000-01-01

    A cerebral artery infarction is an important differential diagnosis in the newborn with neurological abnormalities. Based on clinical data, its incidence is estimated to be 1 in 4000 newborns. Since the course is often subclinical, the true incidence is probably higher. Diagnosis: Cerebral ultrasound and Doppler sonography as readily available screening tools play a central role in the initial diagnosis of neonatal cerebral infarction. Definitive diagnosis is made by computed tomography or magnetic resonance imaging. Beside symptomatic anticonvulsive therapy, treatment aims at the prevention of secondary ischemic injury. Discussion: Three term infants with different clinical courses of neonatal stroke are presented to sensitize the clinician and the radiologist for this probably underdiagnosed entity. The role of imaging modalities in the diagnosis and follow-up of neonatal cerebral infarction is discussed. (orig.) [German] Ein Infarkt im Stromgebiet der Zerebralarterien stellt eine wichtige Differentialdiagnose bei neurologischen Auffaelligkeiten in der Neonatalperiode dar. Die Inzidenz wird anhand von klinischer Daten auf 1:4000 Lebendgeborene geschaetzt. Da der Verlauf oft subklinisch ist, liegt die wahre Inzidenz wahrscheinlich hoeher. Diagnose: Bei der Diagnosestellung kommen dem Schaedelultraschall und der Doppelsonographie als leicht verfuegbaren Screening-Methoden eine zentrale Rolle zu. Die definitive Diagnose wird, je nach Verfuegbarkeit, mittels Computertomographie oder Kernspintomographie gestellt. Die Behandlung ist neben der symptomatischen (antikonvulsiven) Therapie auf die Vermeidung von ischaemischen Sekundaerschaeden gerichtet. Diskussion: Wir wollen mit der vorliegenden Arbeit anhand von 3 Kindern mit verschiedenen klinischen Verlaeufen eines sog. Neonatal stroke den Stellenwert der bildgebenden Verfahren bei der Diagnostik und Verlaufskontrolle aufzeigen und die Sensibilitaet fuer dieses vermutlich unterdiagnostizierte Krankheitsbild erhoehen

  11. Colestase neonatal prolongada: estudo prospectivo

    Directory of Open Access Journals (Sweden)

    PRADO Elizabeth Teixeira Mendes Livramento

    1999-01-01

    Full Text Available Em razão da urgência de se decidir por um tratamento clínico ou por uma intervenção cirúrgica imediata, o estudo da colestase neonatal prolongada envolve dois objetivos básicos: o diagnóstico diferencial entre atresia biliar e hepatite neonatal e a pesquisa dos agentes etiológicos associados. Desta maneira, através de estudo prospectivo desenvolvido na década de 1970, foram avaliadas 77 crianças portadoras de colestase neonatal prolongada para estabelecer o diagnóstico diferencial entre atresia biliar e hepatite neonatal e, numa segunda fase, 108 crianças, visando esclarecer a etiopatogenia da colestase neonatal prolongada. Os resultados do diagnóstico diferencial revelaram que, dos 18 atributos avaliados, apenas oito mostraram-se bons indicadores de atresia biliar, em ordem decrescente: ductos proliferados (espaço-porta, fibrose (espaço-porta, colestase (espaço-porta, cor das fezes -- acolia, hepatomegalia, colestase canalicular (lóbulo, infiltrado (espaço-porta, células gigantes (lóbulo. Estes oito atributos foram então compostos, mediante uma ponderação, em um único indicador de grande poder discriminativo, capaz de decidir o diagnóstico diferencial em 99% dos casos. Quanto à etiopatogenia, registrou-se: vírus rubéola 0%, vírus herpes simples 0%, listeriose 0%, citomegalovirose 2,2%, vírus hepatite B 2,4%, toxoplasmose 2,8%, deficiência de alfa-1-antitripsina 13,1%, sífilis 21,1 %, auto-anticorpos hepáticos 58,4%. O trabalho desenvolvido mostra que as 8 variáveis mais decisivas, como indicadoras diferenciais entre atresia biliar e hepatite neonatal, permanecem como índices fundamentais, auxiliando, em conjunto com novos métodos diagnósticos, na composição de uma estratégia multifatorial cada vez menos invasiva e mais precisa. O estudo da etiopatogenia, dependente das condições epidemiológicas locais e da época, com a introdução de novos métodos diagnósticos, torna-se atualmente cada vez mais

  12. Acute symptomatic neonatal seizures in preterm neonates: etiologies and treatments.

    Science.gov (United States)

    Pisani, Francesco; Spagnoli, Carlotta

    2017-12-15

    Acute symptomatic neonatal seizures in preterm newborns are a relevant clinical challenge due to the presence of many knowledge gaps. Etiology-wise, acute symptomatic seizures have an age-specific epidemiology, with intraventricular hemorrhage and its complications representing the first cause in extremely and very preterm neonates, whereas other etiologies have similar occurrence rates as in full-term infants. Specific treatment strategies for the premature neonates are not yet available. Studies suggest a similarly low response rate with even more unfavorable prognosis than in full-term infants. Pharmacodynamic and pharmacokinetic changes are likely under way during the preterm period, with the potential to affect both effectiveness and safety of antiepileptic drugs in these patients. However, due to the lack of clear evidence to guide prioritization of second-line drugs, off-label medications are frequently indicated by review papers and flow-charts, and are prescribed in clinical practice. We therefore conclude by exploring potential future lines of research. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Neonatal erythroderma – clinical perspectives

    Directory of Open Access Journals (Sweden)

    Boull CL

    2017-06-01

    Full Text Available Christina L Boull, Kristen P Hook Department of Dermatology, Division of Pediatric Dermatology, University of Minnesota, Minneapolis, MN, USA Abstract: Neonatal erythroderma is rare, but significant as it may be the initial manifestation of an array of infectious, metabolic, and genetic conditions, some of which are life-threatening. Initial management should focus on identifying and treating life threatening etiololgies and complications, including infection, and fluid, electrolyte, and temperature disturbances. Often, the etiology of erythroderma is difficult to quickly identify in the neonate, as there is significant clinical overlap between causative entities. Furthermore, rapid definitive diagnostic tests are lacking. Herein we provide a review of the specific clinical features and diagnostic tests, which can aid in making a correct diagnosis. Skin care for the erythrodermic infant is also discussed. We encourage subspecialist consultation when appropriate to aid in the evaluation, especially when initial testing is nondiagnostic. Keywords: psoriasis, atopic dermatitis, cutaneous candidiasis

  14. Neonatal lenticulostriate vasculopathy: case reports

    International Nuclear Information System (INIS)

    Bokiniec, R.; Pawluch, R.; Majewska, U.; Krol, M.; Kornacka, M. K.

    2006-01-01

    Lenticulostriate vasculopathy (LSV) is sometimes detected as stripe-like vascular echogenicities in the region of the basal ganglia on routine brain ultrasonography in neonates. LSV is often associated with various perinatal and neonatal abnormalities. Eight infants had echogenic stripes in the basal ganglia at the location of the lenticulostriate arteries, seen by head ultrasound. One patient had infection with rubella, three had respiratory disease, one with twin to twin transfusion, two with congenital malformation, and one had a restrictive ductus arteriosus in prenatal diagnosis. Brain computed tomography in one sonographically diagnosed LSV case failed to display the lesion. Sonographic follow up of patients with LSV showed progression in one case, no change in six, and resolution of lesions in one case. Sonography is helpful in detecting early noncalcific inflammation and mineralisation in vasculitis. LSV has varied clinical associations. Although nonspecific, these findings should alert the physician to the possibility of congenital infection, chromosomal abnormality, or prenatal drug exposure. (author)

  15. Maternal Preeclampsia and Neonatal Outcomes

    Directory of Open Access Journals (Sweden)

    Carl H. Backes

    2011-01-01

    Full Text Available Preeclampsia is a multiorgan, heterogeneous disorder of pregnancy associated with significant maternal and neonatal morbidity and mortality. Optimal strategies in the care of the women with preeclampsia have not been fully elucidated, leaving physicians with incomplete data to guide their clinical decision making. Because preeclampsia is a progressive disorder, in some circumstances, delivery is needed to halt the progression to the benefit of the mother and fetus. However, the need for premature delivery has adverse effects on important neonatal outcomes not limited to the most premature infants. Late-preterm infants account for approximately two thirds of all preterm deliveries and are at significant risk for morbidity and mortality. Reviewed is the current literature in the diagnosis and obstetrical management of preeclampsia, the outcomes of late-preterm infants, and potential strategies to optimize fetal outcomes in pregnancies complicated by preeclampsia.

  16. Neonatal pustular dermatosis: An overview

    Directory of Open Access Journals (Sweden)

    Sangita Ghosh

    2015-01-01

    Full Text Available Neonatal pustular eruption is a group of disorders characterized by various forms of pustulosis seen in first 4 weeks of life. Its presentation is often similar with some subtle differences, which can be further established by few simple laboratory aids, to arrive at a definite diagnosis. Given their ubiquitous presentation, it is sometimes difficult to differentiate among self-limiting, noninfectious, pustular dermatosis such as erythema toxicum neonatorum, transient neonatal pustular melanosis, miliaria pustulosa, etc., and potentially life threatening infections such as herpes simplex virus and varicella zoster virus infections. This review article tries to address the chronological, clinical, morphological, and histological differences among the various pustular eruptions in a newborn, in order to make it easier for a practicing dermatologist to diagnose and treat these similar looking but different entities of pustulation with a clear demarcation between the physiological benign pustular rashes and the infectious pustular lesions.

  17. CT findings in neonatal hypothermia

    Energy Technology Data Exchange (ETDEWEB)

    Schulman, H.; Laufer, L.; Berginer, J.; Hertzanu, Y. [Department of Radiology, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, P. O. Box 151, Beer-Sheva 84101 (Israel); Hershkowitz, E.; Berenstein, T.; Sofer, S. [Pediatric Intensive Care Unit, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva (Israel); Maor, E. [Department of Pathology, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva (Israel)

    1998-06-01

    Background. Newborn infants are particularly prone to hypothermia, a condition with a high mortality. Objective. To study the CT brain patterns in infants with hypothermia and neurological symptoms. Materials and methods. We reviewed the brain CT of nine infants with neonatal hypothermia, multiple organ failure, seizures and coma. Results. Two infants had normal CT scans, acutely and at follow-up, and were clinically normal at follow-up. In seven infants, CT showed diffuse cerebral oedema, with reversal of the normal density relationship between grey and white matter and a relative increased density of the thalami, brainstem and cerebellum - the `reversal sign`. In six surviving infants with severe developmental delay, follow-up CT revealed cerebral atrophy with multicystic encephalomalacia. Conclusions. The `reversal sign` has been described in the abused child, birth asphyxia and anoxia due to drowning. Neonatal hypothermia is offered as a further cause. (orig.) With 6 figs., 1 tab., 13 refs.

  18. Hepatobiliary scan in neonatal Jaundice

    International Nuclear Information System (INIS)

    Nahar, Nurun; Hasan, Mizanul; Karim, M.A.

    2002-01-01

    Jaundice is more or less common in newborn babies. Through physiological jaundice is most common cause of neonatal jaundice, possibility of obstructive jaundice especially biliary atresia should be kept in mind. Early diagnosis of biliary atresia followed by surgical treatment can save baby's life. Otherwise death is inevitable due to liver failure. Hepatobiliary scan is the imaging study of choice in neonatal jaundice especially when there is persistent conjugated hyperbilirubinaemia. Total 27 newborn babies of suspected biliary atresia, aged 14 days to 4 months were referred to Institute of Nuclear Medicine for Hepatobiliary scan. All of them had high serum bilirubin ranged from 6.0 mg/dl with an average of 9.35 ng/dl serum bilirubin level. Ultrasonography of hepatobiliary system was performed in 14 cases showing normal sized liver in 4 cases and hepatomegaly in 10 cases. Hepatobiliary scan was done with 99m Tc-Mebrofenin (Br IDA) after preparing the baby with phenobarbitone for 3-5 days. 20 (67%) cases were scan positive suggesting biliary atresia (BA) and 7(27%) cases were scan negative. In BA there will be increased hepatic uptake of the radionuclide without any significant excretion even in 24 hours delayed images. Presence of radiotracer in the bowel exclude the diagnosis of BA. Early diagnosis of biliary atresia is very important because in this condition surgery should be performed early (within 60 days of life). Studies suggest that hepatobiliary scan after hepatic stimulation with phenobarbitone for a period of 3-5 days is highly accurate for differentiating biliary atresia from other causes of neonatal jaundice. It is very important to perform hepatobiliary scan in a case of neonatal jaundice to exclude biliary atresia for the sake of baby's life.(author)

  19. Therapeutic hypothermia in neonatal asphyxia

    OpenAIRE

    Cornette, L.

    2012-01-01

    Hypoxic ischemic encephalopathy is a serious condition affecting newborn infants which can result in death and disability. There is now strong clinical evidence that moderate post-asphyxial total body cooling or hypothermia in full term neonates results in long-term neuroprotection, allowing us to proclaim this innovative therapy as “standard of care.” The treatment is a time-critical emergency and should be started within 6 hours after the insult. Such requires optimal collaboration among lo...

  20. Simultaneous occurrence of foetal and neonatal alloimmune thrombocytopenia and neonatal neutropenia due to maternal neutrophilic autoantibodies

    DEFF Research Database (Denmark)

    Morling Taaning, Ellen Birkerod; Jensen, Lise; Varming, Kim

    2012-01-01

    Foetal and neonatal alloimmune thrombocytopenia (FNAIT) and neonatal neutropenia caused by maternal autoantibodies against neutrophils are rare disorders. We describe a newborn with severe thrombocytopenia and intracerebral bleeding caused by maternal anti-HPA-3a alloantibodies and mild neutropenia...

  1. Which biomarkers reveal neonatal sepsis?

    Directory of Open Access Journals (Sweden)

    Kun Wang

    Full Text Available We address the identification of optimal biomarkers for the rapid diagnosis of neonatal sepsis. We employ both canonical correlation analysis (CCA and sparse support vector machine (SSVM classifiers to select the best subset of biomarkers from a large hematological data set collected from infants with suspected sepsis from Yale-New Haven Hospital's Neonatal Intensive Care Unit (NICU. CCA is used to select sets of biomarkers of increasing size that are most highly correlated with infection. The effectiveness of these biomarkers is then validated by constructing a sparse support vector machine diagnostic classifier. We find that the following set of five biomarkers capture the essential diagnostic information (in order of importance: Bands, Platelets, neutrophil CD64, White Blood Cells, and Segs. Further, the diagnostic performance of the optimal set of biomarkers is significantly higher than that of isolated individual biomarkers. These results suggest an enhanced sepsis scoring system for neonatal sepsis that includes these five biomarkers. We demonstrate the robustness of our analysis by comparing CCA with the Forward Selection method and SSVM with LASSO Logistic Regression.

  2. RISK FACTORS IN NEONATAL ANAEROBIC INFECTIONS

    Directory of Open Access Journals (Sweden)

    M. S. Tabib

    2008-06-01

    Full Text Available Anaerobic bacteria are well known causes of sepsis in adults but there are few studies regarding their role in neonatal sepsis. In an attempt to define the incidence of neonatal anaerobic infections a prospective study was performed during one year period. A total number of 400 neonates under sepsis study were entered this investigation. Anaerobic as well as aerobic cultures were sent. The patients were subjected to comparison in two groups: anaerobic culture positive and anaerobic culture negative and this comparison were analyzed statistically. There were 7 neonates with positive anaerobic culture and 35 neonates with positive aerobic culture. A significant statistical relationship was found between anaerobic infections and abdominal distention and pneumonia. It is recommended for those neonates with abdominal distention and pneumonia refractory to antibiotic treatment to be started on antibiotics with anaerobic coverage.

  3. Neonatal and Maternal 25-OH Vitamin D Serum Levels in Neonates with Early-Onset Sepsis.

    Science.gov (United States)

    Gamal, Taha Soliman; Madiha, Abd-Allah Sayed; Hanan, Mostafa Kamel; Abdel-Azeem, Mohamed El-Mazary; Marian, Gamil S

    2017-05-09

    Vitamin D is a fat-soluble vitamin that is important for calcium metabolism and plays an important role in the immune functions. The aim of this study was to measure neonatal and maternal 25-OH vitamin D serum levels in neonates with early onset sepsis. The study included fifty neonates with early onset sepsis (25 full-term and 25 preterm infants) and thirty age and sex matched healthy neonates as controls. After history taking and clinical examination, complete blood count, C-reactive protein and 25-OH vitamin D serum levels (neonatal and maternal) were measured for all neonates. The mean gestational age for neonates with sepsis was (37.5 ± 0.98 for full term and 34.1 ± 1.26 for preterm neonates). Neonatal and maternal 25-OH vitamin D serum levels were significantly lower in patients (6.4 ± 1.8 and 24.6 ± 2.2 nmol/L) than controls (42.5 ± 20.7 and 50.4 ± 21.4 nmol/L). Significant negative correlations between neonatal and maternal 25-OH vitamin D serum levels and all sepsis markers and significant positive correlations between neonatal and maternal 25-OH vitamin D levels were present. At cut-off values <20 nmol/L for neonatal and <42 nmol/L for maternal 25-OH vitamin D for detection of neonatal sepsis, the sensitivity, specificity, positive predicted value (PPV) and negative predicted value (NPV) were 84%, 79%, 94.7% and 82.3% for neonatal and 82%, 77%, 91.4% and 80.6% for maternal 25-OH vitamin D, respectively. Positive correlations between neonatal and maternal 25-OH Vitamin D serum levels are present and they are negatively correlated with all sepsis markers. They can be sensitive early predictors for early onset sepsis in neonates.

  4. Treatment and Prevention of Neonatal Anemia

    OpenAIRE

    Widness, John A.

    2008-01-01

    Because red blood cell (RBC) transfusion therapy remains the primary treatment of anemia encountered in early life, the basis for RBC transfusion in the treatment of symptomatic anemia is discussed in this review along with several important aspects of neonatal blood banking practices. Nontransfusion approaches to the prevention and treatment of neonatal anemia also are described. Finally, this review covers the controversy surrounding whether neonatal RBC transfusion therapy should be restri...

  5. Neonatal resuscitation: a report from Oman.

    Science.gov (United States)

    Manzar, S

    2000-07-01

    There has been a considerable increase in the educational level and awareness of neonatal care in developing countries over last decade. The importance of neonatal resuscitation, however, has been ignored. This report discusses the importance of structured neonatal courses with emphasis on the need for more such courses at regional levels, especially in developing countries. The concept of basic and advanced life support of the newborn is also presented.

  6. Neonatal morbidity in term neonates is related to gestational age at birth and level of care

    NARCIS (Netherlands)

    Miltenburg, A.S.; van Elburg, R.M.; Kostense, P.J.; van Geijn, H.P.; Bolte, A.C.

    2011-01-01

    Aims: The objective of this study was to assess whether the incidence of neonatal morbidity of neonates born at term and admitted to a neonatal intensive care unit (NICU) differs by gestational age and level of care. Methods: This is a 5-year retrospective cohort study of singleton term births

  7. Neonatal morbidity in term neonates is related to gestational age at birth and level of care

    NARCIS (Netherlands)

    Miltenburg, Andrea Solnes; van Elburg, Ruurd M.; Kostense, Pieter J.; van Geijn, Herman P.; Bolte, Antoinette C.

    2011-01-01

    The objective of this study was to assess whether the incidence of neonatal morbidity of neonates born at term and admitted to a neonatal intensive care unit (NICU) differs by gestational age and level of care. This is a 5-year retrospective cohort study of singleton term births admitted to the NICU

  8. Dramatic Increases in Maternal Opioid Use and Neonatal Abstinence Syndrome

    Science.gov (United States)

    ... and Neonatal Abstinence Syndrome Dramatic Increases in Maternal Opioid Use and Neonatal Abstinence Syndrome Email Facebook Twitter Text Description of Infographic Use of opiates during pregnancy can result in a drug withdrawal syndrome in newborns called neonatal abstinence syndrome (NAS). ...

  9. Pelayanan Kesehatan Ibu dan Kematian Neonatal

    Directory of Open Access Journals (Sweden)

    Desy Fitri Yani

    2013-03-01

    Full Text Available Indonesia bersama seluruh negara berkembang berupaya mencapai kesepakatan Millenium Development Goals (MDGs dengan salah satu sasaran menurunkan angka kematian neonatal dari 20 per 1.000 kelahiran hidup menjadi 15 per 1.000 kelahiran hidup. Penelitian ini bertujuan mengetahui hubungan pelayanan kesehatan ibu dengan kematian neonatal di Kabupaten Lampung Timur tahun 2011. Penelitian dengan desain studi kasus kontrol ini mengamati kasus ibu yang mengalami kematian neonatal dan kontrol ibu yang tidak mengalami kematian neonatal. Analisis multivariat menemukan pelayanan antenatal dan pertolongan persalinan berhubungan secara signifikan dengan kematian neonatal, setelah mengendalikan variabel umur ibu dan riwayat kehamilan (OR = 16,32; nilai p = 0,000; dan (OR = 18,36; nilai p = 0,31. Bayi yang dilahirkan dari Ibu dengan pelayanan antenatal tidak lengkap berisiko mengalami kematian neonatal 16,32 dan 18,36 kali lebih besar daripada bayi yang dilahirkan. Ibu dengan pelayanan antenatal lengkap dan penolong persalinan profesional. Tidak ada hubungan penolong persalinan dengan kematian neonatal, setelah mengontrol variabel pelayanan antenatal, umur ibu, riwayat kehamilan, riwayat penyakit, dan riwayat persalinan. Disarankan meningkatkan kualitas pelayanan antenatal dengan memerhatikan faktor umur ibu dan riwayat persalinan, mengembangkan kegiatan audit maternal perinatal serta meningkatkan keterampilan petugas penolong persalinan. All developing countries including Indonesia seek to reach agreement the Millennium Development Goals (MDG’s. It is objectives include reducing neonatal mortality by 25 percent from 20 per 1,000 live birth to 15 per 1,000 live births. This study aimed to determine the relationship of maternal health services with neonatal mortality in East Lampung District in 2011. This study used case control design to compare between the groups of mother whom have neonatal deaths (cases and neonatal life (control in East Lampung District in

  10. A Neonatal Murine Model of MRSA Pneumonia.

    Science.gov (United States)

    Fitzpatrick, Elizabeth A; You, Dahui; Shrestha, Bishwas; Siefker, David; Patel, Vivek S; Yadav, Nikki; Jaligama, Sridhar; Cormier, Stephania A

    2017-01-01

    Pneumonia due to methicillin-resistant Staphylococcus aureus (MRSA) is a significant cause of morbidity and mortality in infants particularly following lower respiratory tract viral infections such as Respiratory Syncytial Virus (RSV). However, the mechanisms by which co-infection of infants by MRSA and RSV cause increased lung pathology are unknown. Because the infant immune system is qualitatively and quantitatively different from adults we developed a model of infant MRSA pneumonia which will allow us to investigate the effects of RSV co-infection on disease severity. We infected neonatal and adult mice with increasing doses of MRSA and demonstrate that neonatal mice have delayed kinetics in clearing the bacteria in comparison to adult mice. There were differences in recruitment of immune cells into the lung following infection. Adult mice exhibited an increase in neutrophil recruitment that coincided with reduced bacterial titers followed by an increase in macrophages. Neonatal mice, however, exhibited an early increase in neutrophils that did not persist despite continued presence of the bacteria. Unlike the adult mice, neonatal mice failed to exhibit an increase in macrophages. Neonates exhibited a decrease in phagocytosis of MRSA suggesting that the decrease in clearance was partially due to deficient phagocytosis of the bacteria. Both neonates and adults responded with an increase in pro-inflammatory cytokines following infection. However, in contrast to the adult mice, neonates did not express constitutive levels of the anti-microbial peptide Reg3γ in the lung. Infection of neonates did not stimulate expression of the co-stimulatory molecule CD86 by dendritic cells and neonates exhibited a diminished T cell response compared to adult mice. Overall, we have developed a neonatal model of MRSA pneumonia that displays a similar delay in bacterial clearance as is observed in the neonatal intensive care unit and will be useful for performing co

  11. Procedural pain in neonatal units in Kenya.

    Science.gov (United States)

    Kyololo, O'Brien Munyao; Stevens, Bonnie; Gastaldo, Denise; Gisore, Peter

    2014-11-01

    To determine the nature and frequency of painful procedures and procedural pain management practices in neonatal units in Kenya. Cross-sectional survey. Level I and level II neonatal units in Kenya. Ninety-five term and preterm neonates from seven neonatal units. Medical records of neonates admitted for at least 24 h were reviewed to determine the nature and frequency of painful procedures performed in the 24 h period preceding data collection (6:00 to 6:00) as well as the pain management interventions (eg, morphine, breastfeeding, skin-to-skin contact, containment, non-nutritive sucking) that accompanied each procedure. Neonates experienced a total of 404 painful procedures over a 24 h period (mean=4.3, SD 2.0; range 1-12); 270 tissue-damaging (mean=2.85, SD 1.1; range 1-6) and 134 non-tissue-damaging procedures (mean=1.41, SD 1.2; range 0-6). Peripheral cannula insertion (27%) and intramuscular injections (22%) were the most common painful procedures. Ventilated neonates and neonates admitted in level II neonatal units had a higher number of painful procedures than those admitted in level I units (mean 4.76 vs 2.96). Only one procedure had a pain intensity score documented; and none had been performed with any form of analgesia. Neonates in Kenya were exposed to numerous tissue-damaging and non-tissue-damaging procedures without any form of analgesia. Our findings suggest that education is needed on how to assess and manage procedural pain in neonatal units in Kenya. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  12. Fetal and neonatal atrial arrhythmias: an association with maternal diabetes and neonatal macrosomia.

    Science.gov (United States)

    Pike, J I; Krishnan, A; Kaltman, J; Donofrio, M T

    2013-12-01

    To determine if the incidence of maternal diabetes mellitus or neonatal macrosomia is more frequent in fetuses and neonates with atrial arrhythmias than the general population. Fetuses and neonates neonates with atrial flutter or ectopic atrial tachycardia were more likely to be macrosomic or be born to diabetic mothers than the general population. Postnatal echocardiography suggests that there may be abnormal diastolic left ventricular filling in some babies with these arrhythmias. Independent of ventricular hypertrophy, we speculate that isolated, non-recurrent fetal or neonatal atrial flutter, or ectopic atrial tachycardia may be caused by cardiac diastolic dysfunction and atrial stretch in utero. © 2013 John Wiley & Sons, Ltd.

  13. Etiologies of Prolonged Unconjugated Hyperbilirubinemia in Neonates Admitted to Neonatal Wards

    Directory of Open Access Journals (Sweden)

    Mohammad Kazem Sabzehei

    2015-12-01

    Full Text Available Background: Jaundice is a common condition among neonates. Prolonged unconjugated hyperbilirubinemia occurs when jaundice persists beyond two weeks in term neonates and three weeks in preterm neonates. This study aimed to determine the etiologies of prolonged unconjugated hyperbilirubinemia in infants admitted to the neonatal ward of Besat Hospital in Hamadan, Iran. Methods: This study was conducted on all infants diagnosed with prolonged unconjugated hyperbilirubinemia during 2007-2012 in the neonatal ward of Besat Hospital in Hamadan, Iran. Demographic characteristics of infants, physical examination and laboratory findings were collected and analyzed to determine the etiologies of neonatal hyperbilirubinemia. Results: In total, 100 infants diagnosed with neonatal hyperbilirubinemia were enrolled in this study, including 49 male and 51 female neonates with mean age of 20±1 days and mean bilirubin level of 17.5±4.0 mg/dL. Main causes of hyperbilirubinemia were urinary tract infection, ABO incompatibility, hypothyroidism and glucose-6-phosphate dehydrogenase deficiency in 14%, 5%, 6% and 5% of neonates, respectively. Moreover, unknown etiologies, such as breastfeeding, were detected in 70% of the studied infants. Conclusion: According to the results of this study, determining the main causes of prolonged unconjugated hyperbilirubinemia in neonates is of paramount importance. In the majority of cases, neonatal hyperbilirubinemia is associated with physiological factors, such as breastfeeding.

  14. Evaluation of Neonates with Ventriculitis

    Directory of Open Access Journals (Sweden)

    Ferda Ozlu

    2013-08-01

    Full Text Available Backgroud: Neonatal meningitis and ventriculitis still remain a problem with high mortality in spite of systemic and intraventricular antibiotics. Ventriculitis due to repeated taps is a serious problem of posthemorragic hydrocephalus in preterm infants. Methods: In this study, we evaluated 16 infants with ventriculitis followed at Cukurova University Faculty of Medicine Neonatal Intensive Care Unit between January 1999-December 2004. Results: Mean gestational week was 33± 5 (25-40 weeks and mean birth weight was 2096 ± 912 (980-3500 grams. Venticulitis was diagnosed at 38 ± 22 days. Eleven of the infants had intraventricular hemorrhage and 15 had hydrocephalus, 5 of whom had congenital hydrocephalus. Drainage of CSF was performed by taps in 13 infants. Gram negative microorganisms (Klebsiella pneumonia, Pseudomonas aeruginosa were predominating in cultures. Both intravenous and intraventricular antibiotic treatment was performed according to the cerebrospinal fluid cultures. Vancomycine and amicasine as intraventricular therapy were performed for 28 ±17 days. Cerebrospinal fluid protein levels increased significantly at 8 infant during intraventricular therapy. Mean cerebrospinal fluid protein at the begining of intraventricular treatment was 624.1± 429.1 (109-1330 mg/dl while on 14th day of treatment it was 993.7± 582.2 (89-1750 mg/dl. Seven of the infants were ventriculoperitoneal shunted 6 of them were reinfected. Seven of the infants were died during treatment, 1 infant with ventriculoperitoneal shunt was treated and 8 infants were discharged during treatment because of parents’ refusal of therapy. Conclusion: Despite the new treatment regimens, the ventriculitis still remains a problem because of nonstandardized practice in neonatal care. [Cukurova Med J 2013; 38(4.000: 553-558

  15. Neonatal Herpes Simplex Virus Infection.

    Science.gov (United States)

    James, Scott H; Kimberlin, David W

    2015-09-01

    Herpes simplex virus (HSV) 1 and HSV-2 infections are highly prevalent worldwide and are characterized by establishing lifelong infection with periods of latency interspersed with periodic episodes of reactivation. Acquisition of HSV by an infant during the peripartum or postpartum period results in neonatal HSV disease, a rare but significant infection that can be associated with severe morbidity and mortality, especially if there is dissemination or central nervous system involvement. Diagnostic and therapeutic advances have led to improvements in mortality and, to a lesser extent, neurodevelopmental outcomes, but room exists for further improvement. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Teamwork in the Neonatal Intensive Care Unit

    Science.gov (United States)

    Barbosa, Vanessa Maziero

    2013-01-01

    Medical and technological advances in neonatology have prompted the initiation and expansion of developmentally supportive services for newborns and have incorporated rehabilitation professionals into the neonatal intensive care unit (NICU) multidisciplinary team. Availability of therapists specialized in the care of neonates, the roles of…

  17. Outcome of neonatal surgeries in Nnewi, Nigeria

    African Journals Online (AJOL)

    Prune belly syndrome. 2 (1.4). Neonatal testicular torsion. 2 (1.4). Vaginal atresia. 1 (0.7). Musculoskeletal. Abscesses. 6 (4.1). Congenital cutis aplasia. 2 (1.4). Tumours. Sacrococcygeal teratoma. 4 (2.7). Cystic hygroma. 2 (1.4). Cervical teratoma. 2 (1.4). Total. 147 (100.0). Outcome of neonatal surgeries Ekwunife et al.

  18. Factors infleuncing neonatal septicaemia in Maiduguri, north ...

    African Journals Online (AJOL)

    BACKGROUND: Neonatal septicaemia is a leading cause of morbidity and mortality worldwide, especially in the tropics. The risk factors vary, and the clinical features of neonatal septicaemia may be vague and nonspecific, therefore a high index of suspicion is vital to early diagnosis and treatment. The aetiological agents ...

  19. Neonatal malaria complicated by hypoglycaemia and ...

    African Journals Online (AJOL)

    There is no established and widely accepted guidelines for clinical management of severe neonatal malaria. The aim of this paper is to raise the alertness of physicians regarding the occurrence of severe malaria in the neonatal period and to describe the treatment modality we adopted (in the absence of an internationally ...

  20. Neonatal and paediatric bloodstream infections: Pathogens ...

    African Journals Online (AJOL)

    treatment for HA-BSI is piperacillin-tazobactam and amikacin, with escalation to meropenem in cases of suspected meningitis and in neonates and paediatric patients requiring transfer to tertiary care/an intensive care unit (ICU). Data extraction and analysis. We retrospectively reviewed paediatric and neonatal BSI episodes ...

  1. The Changing Spectrum of Neonatal Hepatitis

    NARCIS (Netherlands)

    Hadzic, Nedim; Verkade, Henkjan J.

    Neonatal hepatitis (NH) is a default diagnosis reached after excluding other more specific causes of prolonged neonatal cholestasis (PNC). The purpose of this brief review is to highlight the expanding spectrum of diagnoses causing PNC of infancy and to address emerging clinical dilemmas about the

  2. Rebound hyperbilirubinaemia in neonates admitted to Mofid ...

    African Journals Online (AJOL)

    Introduction and aim. Approximately 60% of term neonates and 80% of preterm neonates develop hyperbilirubinaemia in the rst week of life. Rebound hyperbilirubinaemia may occur after cessation of phototherapy, especially when the Coombs test is positive, in premature infants, and in those treated with phototherapy for ...

  3. Neurodevelopmental outcome after neonatal perforator stroke

    NARCIS (Netherlands)

    Ecury-Goossen, Ginette M; van der Haer, Marit; Smit, Liesbeth S; Feijen-Roon, Monique; Lequin, Maarten; de Jonge, Rogier C J; Govaert, Paul; Dudink, Jeroen

    AIM: To assess outcome after neonatal perforator stroke in the largest cohort to date. METHOD: Survivors from a cohort of children diagnosed with neonatal perforator stroke using cranial ultrasound or magnetic resonance imaging were eligible for inclusion. Recovery and Recurrence Questionnaire

  4. Neonatal innate immunity - A translational perspective

    NARCIS (Netherlands)

    Belderbos, M.E.

    2012-01-01

    Human newborns are highly susceptible to infections, which appears to be due to immaturity of the neonatal innate immune system. At birth, neonatal innate immune responses are characterized by decreased Th1-polarizing responses, whereas generation of Th2-polarizing and regulatory responses is

  5. The study of thrombocytopenia in sick neonates

    International Nuclear Information System (INIS)

    Aman, I.; Hassan, K.A.; Ahmad, T.M.

    2004-01-01

    Objective: To determine the number of cases and manifestations of thrombocytopenia in sick neonates. Subjects and Methods: A total of 365 neonates from 0-28 days of age admitted with different clinical problems irrespective of birth weight and gestational age were evaluated for thrombocytopenia. These neonates were categorized into five different groups (A-E), which were of neonatal infections, asphyxia neonatorum, preterm and smallness for gestational age, jaundice and miscellaneous respectively. Results: Out of 365 cases, 88 were found to have thrombocytopenia (platelet counts < 150,000 per mm/sup 3/) which was 24.1% of the total. In group A (neonatal infections), out of 152 neonates, 62 had low platelet counts (40.78%). In group B (neonatal asphyxia), out of 90 only 11 had thrombocytopenia (12.2%). In group C (preterm and small for gestational age), out of 60 cases only 9 had thrombocytopenia. In group D (jaundice), all 33 cases had normal platelet counts. In group E (miscellaneous), out of 30 cases only 6 had thrombocytopenia. The common manifestations in thrombocytopenic babies were petechiae and bruises followed by gastrointestinal hemorrhages. The percentage of manifest thrombocytopenia cases was 56.8% and of occult thrombocytopenia 43.1 %. Conclusion: The leading causes of thrombocytopenia in sick neonates are infections, asphyxia, complicated pre- maturity and smallness for gestational age. Apart from the platelet counts the bleeding mainfestations also depend upon the underlying ailments. (author)

  6. Maternal and Neonatal Care. Teacher Edition.

    Science.gov (United States)

    Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

    This curriculum guide contains the materials required to teach a course in maternal and neonatal care that will prepare students for employment as practical nurses. The course's five instructional units cover procedures for caring for the following: prenatal patients, patients in labor and delivery, postpartum patients, healthy neonates, and…

  7. Gastric perforation in neonates is ac

    African Journals Online (AJOL)

    hi-tech

    2004-01-01

    Jan 1, 2004 ... Background: Gastric perforation in neonates is a catastrophe associated with high morbidity. Most are due to underlying primary pathology. Objectives: To review the management of gastric perforation in neonates in Kwa Zulu. -Natal, South Africa. Design: Retrospective study of consecutive complete data ...

  8. Neonatal maxillary orthopedics: past to present

    NARCIS (Netherlands)

    Kuijpers-Jagtman, A.M.; Prahl, C.; Berkowitz, S.

    2013-01-01

    Neonatal maxillary orthopedics was introduced in the treatment protocol for cleft lip and palate in the 1950s of the last century. A wide range of appliances has been designed with pin-retained active appliances at one end of the spectrum and passive appliances at the other. Although neonatal

  9. Prevalence, perceptions and practices surrounding neonatal breast ...

    African Journals Online (AJOL)

    These lead to increased morbidity such as abscess formation and cellulitis. Objective: To document prevalence of, and perceptions about neonatal breast enlargement in newborns and interventions if any in south east Nigeria. Results: Neonatal breast enlargement was present in 50.8% of the target population with females ...

  10. Neonatal tetanus mortality in coastal Kenya

    DEFF Research Database (Denmark)

    Bjerregaard, P; Steinglass, R; Mutie, D M

    1993-01-01

    In a house-to-house survey in Kilifi District, Kenya, mothers of 2556 liveborn children were interviewed about neonatal mortality, especially from neonatal tetanus (NNT). The crude birth rate was 60.5 per 1000 population, the neonatal mortality rate 21.1 and the NNT mortality rate 3.1 per 1000...... livebirths. The neonatal and NNT mortality rates were higher in boys than in girls. Neonatal tetanus was not associated with mother's age, parity, or history of previous child death. The majority of the children (72%) were adequately protected at birth against NNT; in those with documented protection NNT...... mortality was 0, in those with undocumented protection 1.2 and in other children 8.5 per 1000 livebirths. Other risk factors for NNT included home delivery, untrained assistance during delivery, unhygienic cord cutting and application of potentially infectious substances on the umbilical stump. The survey...

  11. Bupivacaine versus lidocaine analgesia for neonatal circumcision

    Directory of Open Access Journals (Sweden)

    Stolik-Dollberg Orit C

    2005-05-01

    Full Text Available Abstract Background Analgesia for neonatal circumcision was recently advocated for every male infant, and its use is considered essential by the American Academy of Pediatrics. We compared the post-operative analgesic quality of bupivacaine to that of lidocaine for achieving dorsal penile nerve block (DPNB when performing neonatal circumcision. Methods Data were obtained from 38 neonates following neonatal circumcision. The infants had received DPNB analgesia with either lidocaine or bupivacaine. The outcome variable was the administration by the parents of acetaminophen during the ensuing 24 hours. Results Seventeen infants received lidocaine and 19 received bupivacaine DPNB. Ten infants in the lidocaine group (59% were given acetaminophen following circumcision compared to only 3 (16% in the bupivacaine group (P 2 = 20.6; P = 0.006. Conclusion DPNB with bupivacaine for neonatal circumcision apparently confers better analgesia than lidocaine as judged by the requirement of acetaminophen over the ensuing 24-hour period.

  12. Neonatal resuscitation: advances in training and practice

    Directory of Open Access Journals (Sweden)

    Sawyer T

    2016-12-01

    Full Text Available Taylor Sawyer, Rachel A Umoren, Megan M Gray Department of Pediatrics, Division of Neonatology, Neonatal Education and Simulation-based Training (NEST Program, University of Washington School of Medicine, Seattle, WA, USA Abstract: Each year in the US, some four hundred thousand newborns need help breathing when they are born. Due to the frequent need for resuscitation at birth, it is vital to have evidence-based care guidelines and to provide effective neonatal resuscitation training. Every five years, the International Liaison Committee on Resuscitation (ILCOR reviews the science of neonatal resuscitation. In the US, the American Heart Association (AHA develops treatment guidelines based on the ILCOR science review, and the Neonatal Resuscitation Program (NRP translates the AHA guidelines into an educational curriculum. In this report, we review recent advances in neonatal resuscitation training and practice. We begin with a review of the new 7th edition NRP training curriculum. Then, we examine key changes to the 2015 AHA neonatal resuscitation guidelines. The four components of the NRP curriculum reviewed here include eSim®, Performance Skills Stations, Integrated Skills Station, and Simulation and Debriefing. The key changes to the AHA neonatal resuscitation guidelines reviewed include initial steps of newborn care, positive-pressure ventilation, endotracheal intubation and use of laryngeal mask, chest compressions, medications, resuscitation of preterm newborns, and ethics and end-of-life care. We hope this report provides a succinct review of recent advances in neonatal resuscitation. Keywords: neonatal resuscitation, Neonatal Resuscitation Program, NRP, simulation, deliberate practice, debriefing, eSIM

  13. Neonatal periventricular leukomalacia: current perspectives

    Directory of Open Access Journals (Sweden)

    Ahya KP

    2018-01-01

    Full Text Available Kunal P Ahya,1 Pradeep Suryawanshi2 1Department of Neonatology, Maahi Newborn Care Centre, Rajkot, Gujarat, 2Department of Neonatology, BVDU Medical College, Pune, Maharashtra, India Abstract: Significant advances in the neonatal ICU have improved the survival of extreme premature neonates; with this comes the importance of intact survival. Periventricular leukomalacia (PVL is the commonest white matter brain injury in preterm infants. It has a typical distribution at the watershed areas adjacent to the lateral ventricles. PVL occurs because of ischemic injury to periventricular oligodendrocytes of the developing brain. It can be detected by cranial ultrasonography (CUS as initial periventricular echodensities, followed later by cystic formation. Recent magnetic resonance imaging studies have shown that it helps in early visualization of PVL and also detection of non-cystic form of PVL, which is not picked up by CUS. It is the commonest cause of cerebral palsy, intellectual impairment or visual disturbances. Currently, no medical treatment is available for PVL; prevention and close developmental follow-up are the only options. Keywords: periventricular leukomalacia, preterm brain injury, cranial ultrasonography

  14. Palivizumab use in preterm neonates.

    LENUS (Irish Health Repository)

    Kingston, S

    2012-01-31

    Respiratory syncytial virus (RSV) is the leading cause of bronchiolitis in infants. Palivizumab is an immunoprophylactic agent for RSV prevention in preterm infants and those with neonatal chronic lung disease. This study examines its use across neonatal units in Ireland. A questionnaire was administered to one Consultant Neonatologist or Paediatrician in each of the 20 maternity centres in Ireland about their guidelines for Palivizumab administration. There is variation in administration of Palivizumab with little consistency found between protocols reported in terms of age and presence of chronic lung disease. Ten centres have in house protocols, 3 centres use the American Academy of Paediatrics (AAP) guidelines, 2 centres prefer the UK Joint Committee on Vaccination and Immunisation (JCVI) guidelines and 3 centres do not have a set protocol. Four participants felt its use has impacted on hospital admissions and 61% believe its use is cost effective. The budgetary implication for immunoprophylaxis with Palivizumab in Ireland is estimated at 1.5 to 2 million euros annually. Given current pharmacoeconomic constraints there is a need to implement a national protocol on RSV immunoprophylaxis.

  15. Palivizumab use in preterm neonates.

    LENUS (Irish Health Repository)

    Kingston, S

    2010-05-01

    Respiratory syncytial virus (RSV) is the leading cause of bronchiolitis in infants. Palivizumab is an immunoprophylactic agent for RSV prevention in preterm infants and those with neonatal chronic lung disease. This study examines its use across neonatal units in Ireland. A questionnaire was administered to one Consultant Neonatologist or Paediatrician in each of the 20 maternity centres in Ireland about their guidelines for Palivizumab administration. There is variation in administration of Palivizumab with little consistency found between protocols reported in terms of age and presence of chronic lung disease. Ten centres have in house protocols, 3 centres use the American Academy of Paediatrics (AAP) guidelines, 2 centres prefer the UK Joint Committee on Vaccination and Immunisation (JCVI) guidelines and 3 centres do not have a set protocol. Four participants felt its use has impacted on hospital admissions and 61% believe its use is cost effective. The budgetary implication for immunoprophylaxis with Palivizumab in Ireland is estimated at 1.5 to 2 million euros annually. Given current pharmacoeconomic constraints there is a need to implement a national protocol on RSV immunoprophylaxis.

  16. Redirecting treatment during neonatal transport.

    Science.gov (United States)

    Dulkerian, Susan J; Douglas, Webra Price; Taylor, Renee McCraine

    2011-01-01

    Neonatal transport teams comprise multidisciplinary health care providers who are skilled in patient care, communication and customer service, and equipment mechanics. They are extensively trained in resuscitation and stabilization, preparing for accelerating care, and their focus is preservation of life. In any situation focused on caring for critically ill patients, ethical issues and questions may arise. For instance, is it compassionate and/or cost-effective to separate mothers and infants when continuing/accelerating care is futile, and when and how should care be redirected from acute and lifesaving care to comfort care and bereavement support for the family? The knowledge and skills required to address such situations and communicate and participate in a redirection of care may not be adequately emphasized in the preparation of the professionals responsible for stabilizing and transporting critically ill newborns. This article raises issues relating to transport and redirecting care such as eligibility for transport, parental request and consent, separation of mothers and infants, palliative and bereavement care, ethical considerations, competitive transport environment, and customer service. A shared mental model is essential. The focus of this article is not to provide answers to all of these issues, but to highlight the complexity of the topic of redirecting treatment during neonatal transport. Redirecting treatment needs to be discussed, and health care professionals should be prepared during their transport team training. Each family and situation must be approached individually, with the acceptance that there will always be more questions than answers.

  17. Patient dose in neonatal units

    International Nuclear Information System (INIS)

    Smans, K.; Struelens, L.; Smet, M.; Bosmans, H.; Vanhavere, F.

    2008-01-01

    Lung disease represents one of the most life-threatening conditions in prematurely born children. In the evaluation of the neonatal chest, the primary and most important diagnostic study is therefore the chest radiograph. Since prematurely born children are very sensitive to radiation, those radiographs may lead to a significant radiation detriment. Hence, knowledge of the patient dose is necessary to justify the exposures. A study to assess the patient doses was started at the neonatal intensive care unit (NICU) of the Univ. Hospital in Leuven. Between September 2004 and September 2005, prematurely born babies underwent on average 10 X-ray examinations in the NICU. In this sample, the maximum was 78 X-ray examinations. For chest radiographs, the median entrance skin dose was 34 μGy and the median dose area product was 7.1 mGy.cm 2 . By means of conversion coefficients, the measured values were converted to organ doses. Organ doses were calculated for three different weight classes: extremely low birth weight infants ( 2500 g). The doses to the lungs for a single chest radiograph for infants with extremely low birth weights, low birth weights and normal birth weights were 24, 25 and 32 μGy, respectively. (authors)

  18. Neonatal alloimmun trombocytopenisk purpura (NAITP

    Directory of Open Access Journals (Sweden)

    Bjørn Skogen

    2009-10-01

    Full Text Available  SAMMENDRAGNeonatal alloimmun trombocytopenisk purpura (NAITP opptrer før eller like etter fødselen, og erforårsaket av maternell alloimmunisering mot paternelle (føtale antigener som ikke er tilstede på morenstrombocytter. Incidensen er 1 pr. 2000/3000 nyfødte. Det finnes ikke noe screening-opplegg for å avsløremødre som kommer til å føde barn med NAITP. Derfor fins det heller ikke noe man kan gjøre før enkvinne føder sitt første barn med tilstanden. I påfølgende svangerskap kan moren følges, og man kanplanlegge tiltak for å redusere risikoen for skade på barnet.Skogen B. Neonatal alloimmune thrombocytopenic purpura. Nor J Epidemiol 1997; 7 (1: 69-72. ENGLISH SUMMARYNeonatal alloimmune thrombocytopenic purpura (NAITP manifests itself before or shortly after birthand is caused by maternal alloimmunization to a paternal (fetal antigen not present on the mother’splatelets. The incidence of the condition in the fetus and neonate is 1 in 2000/3000 live births. There areno screening programs for detecting mothers at risk of delivering infants affected with NAITP. Therefore,no antenatal management is possible in first pregnancies. In subsequent pregnancies there is an opportunityto detect affected fetuses and plan perinatal therapy.

  19. Arrhythmias presenting in neonatal lupus.

    Science.gov (United States)

    Brucato, A; Previtali, E; Ramoni, V; Ghidoni, S

    2010-09-01

    Perfusion of human foetal heart with anti-Ro/SSA antibodies induces transient heart block. Anti-Ro/SSA antibodies may cross-react with T- and L-type calcium channels, and anti-p200 antibodies may cause calcium to accumulate in rat heart cells. These actions may explain a direct electrophysiological effect of these antibodies. Congenital complete heart block is the more severe manifestation of so-called "Neonatal Lupus". In clinical practice, it is important to distinguish in utero complete versus incomplete atrioventricular (AV) block, as complete AV block to date is irreversible, while incomplete AV block has been shown to be potentially reversible after fluorinated steroid therapy. Another issue is the definition of congenital AV block, as cardiologists have considered congenital blocks detected months or years after birth. We propose as congenital blocks detected in utero or within the neonatal period (0-27 days after birth). The possible detection of first degree AV block in utero, with different techniques, might be a promising tool to assess the effects of these antibodies. Other arrhythmias have been described in NL or have been linked to anti-Ro/SSA antibodies: first degree AV block, in utero and after birth, second degree (i.e. incomplete block), sinus bradycardia and QT prolongation, both in infants and in adults, ventricular arrhythmias (in adults). Overall, these arrhythmias have not a clinical relevance, but are important for research purposes.

  20. Radiation therapy in the neonate

    International Nuclear Information System (INIS)

    Littman, P.; D'Angio, G.J.

    1981-01-01

    Radiation therapy (RT) is frequently used in the management of children with cancer, but neonatal neoplasms are rare. Newborns represent 1.5% of the children with malignant diseases in the Tumor Registry at the Children's Hospital of Philadelphia over the last 30 years. Thus, occasionally the pediatrics radiation therapist must consider treating the very young infant. The specific radiation effects on growth and development must be weighed in reaching a therapeutic decision. All children are vulnerable to the late effects of radiation therapy, but the neonates may be more susceptible because of the immaturity of important organs such as the brain, lung, liver, kidney, and bone. In general, radiation therapy, should be avoided during the first several weeks of life because of the potential increased sensitivity of the liver and kidneys during that period. If radiation therapy is used at all during infancy, the benefits must be weighed against the possibility of significant late effects. Increasing knowledge of pediatric neoplasms has shown that some tumors (such as mesoblastic nephroma) require no treatment except for surgical excision; and other tumors, such as Stage IV-S neuroblastoma, may require very little treatment. In those tumors that require radiation therapy, the use of chemotherapy may allow reduction of the radiation dose. Furthermore, alterations of time-dose-fractionation schemes and careful attention to tumor volume with the use of special techniques, such as ''shrinking fields,'' may decrease the late adverse effects of treatment

  1. Neonatal intracranial hemorrhages (perinatal onset)

    International Nuclear Information System (INIS)

    Ban, Sadahiko; Ogata, Masahiro; Yamamoto, Toyoshiro; Nakao, Satoshi; Mizue, Hidenari; Kobayashi, Yutaka.

    1982-01-01

    1. We have reviewed 34 cases of neonatal intracranial hemorrhages (perinatal onset, 23 mature and 11 premature infants) experienced in 10-year period from 1971 to 1980, with special reference to gestational age, birth weight, type of delivery, presence or absence of asphyxia, symptoms and cause of death. 2. Regarding 9 autopsied cases and 7 cases diagnosed by CT-scan, 10 mature infants composed of 3 subarachnoid hemorrhages, 2 intraventricular hemorrhages, 2 subdural hematomas, 2 intracerebral and 1 subependymal hemorrhage; 6 premature infants consisted of 4 subependymal hemorrhages with ventricular rupture and 2 subarachnoid hemorrhages. Most of them presented with respiratory distress, vomiting and convulsive seizures which developed within 5 days after birth. 3. Poor outcome including death amounted 49% of mature and 63% of premature infants. Along with degree of intracranial hematoma, prematurity and pulmonary complication were felt to be important prognostic factors. 4. Introduction of CT-scan led to prompt diagnosis and treatment, thus lowering mortality rate of neonatal intracranial hemorrhages. (author)

  2. Chloroquine resistant malaria in neonates.

    Science.gov (United States)

    Khichi, Qasim Khan; Channar, Mohammad Saleem; Wairraich, Mohammad Ihsan; Butt, Ahsan

    2005-01-01

    To analyze the clinical presentation, treatment given, and outcome of patients suffering from congenital and acquired malaria in neonatal period. Analytical study. Paediatrics Ward-2, QAMC/BVH, Bahawalpur for 02 years from October 2001 to October 2003. The study included 45 cases of neonatal malaria. Thirty cases of malaria, admitted during first ten days of life, diagnosed as congenital malaria, were kept in group A, while 15 cases admitted in the ward from the age of 11 to 28 days, labeled as acquired malaria, were named group B. The clinical features at the time of presentation were noted in each group from the charts having positive malarial parasite (M.P.) on thick and thin slides. The diagnosed cases were treated with the standard dose of chloroquine sulphate. Those patients who improved clinically as well as revealed no parasite on follow-up were labeled as chloroquine sensitive. On the other hand, patients showing poor clinical response with persistence of the parasites in the blood or initially disappearing but later again having a clinical disease with positive M.P. on follow-up, were labeled as chloroquine resistant. They were treated with quinine sulphate. Outcome was compared in both the groups regarding the pattern of chloroquine resistance and death/ survival. Data was collected on which Fischer's exact test of significance was performed to know the level of significance. P-value of important clinical features. Pattern of chloroquine resistance and mortality in both the groups was not statistically different.

  3. Knowledge, attitudes and practices of neonatal staff concerning neonatal pain management

    Directory of Open Access Journals (Sweden)

    Sizakele L.T. Khoza

    2014-11-01

    Full Text Available Background: Neonatal pain management has received increasing attention over the past four decades. Research into the effects of neonatal pain emphasises the professional, ethical and moral obligations of staff to manage pain for positive patient outcomes. However, evaluation studies continuously report evidence of inadequate neonate pain management and a gap between theory and practice. Objective: This study reviewed current practice in neonatal pain management to describe the knowledge, attitudes and practices of nurses and doctors regarding pain management for neonates in two academic hospitals. Method: A non-experimental, prospective quantitative survey, the modified Infant Pain Questionnaire, was used to collect data from 150 nurses and doctors working in the neonatal wards of two academic hospitals in central Gauteng. Results: The response rate was 35.33% (n = 53, most respondents being professional nurses (88.68%; n = 47 working in neonatal intensive care units (80.77%; n = 42; 24 (45.28% had less than 5 years’ and 29 respondents 6 or more years’ working experience in neonatal care. A review of pain management in the study setting indicated a preference for pharmacological interventions to relieve moderate to severe pain. An association (p < 0.05 was found between pain ratings on 5 procedures and frequency of administration of pharmacological pain management. Two-thirds of respondents (64% reported that there were no pain management guidelines in the neonatal wards in which they worked. Conclusion: The interventions to manage moderate neonatal pain are in line with international guidelines. However, neonatal pain management may not occur systematically based on prior assessment of neonatal pain, choice of most appropriate intervention and evaluation. This study recommends implementation of a guideline to standardise practice and ensure consistent and adequate pain management in neonates.

  4. Neonatal Discontinuation Syndrome in Serotonergic Antidepressant-Exposed Neonates.

    Science.gov (United States)

    Yang, Amy; Ciolino, Jody D; Pinheiro, Emily; Rasmussen-Torvik, Laura J; Sit, Dorothy K Y; Wisner, Katherine L

    2017-05-01

    To determine whether infants exposed in utero to serotonin reuptake inhibitor (SRI) antidepressants or a DSM-IV-TR-defined mood disorder have significantly more neonatal discontinuation signs compared to an unexposed group of infants at 2-4 weeks after birth. This secondary analysis was derived from 2 observational studies with enrollment from July 2000 to December 2011 in Cleveland, Ohio, and Pittsburgh, Pennsylvania. Mothers (n = 214) belonged to one of 3 groups based on exposure status during pregnancy: (1) Comparison-women who did not take psychotropics during pregnancy and had no major mood disorder; (2) SRI-exposed-women with a mood disorder who were taking an SRI but no benzodiazepines; and (3) Mood Disorder-women with depression or bipolar disorder who did not take psychotropic medications. The infants were examined for signs according to the Finnegan Scale by evaluators blind to maternal exposure status. The rates of sign presence (defined as a score ≥ 2 on the Finnegan Scale) in the SRI, Mood Disorder, and Comparison groups were similar at 34.1%, 35.1%, and 30.4%, respectively. Women in the SRI group had a significantly higher preterm birth rate (24.4%) compared to the other 2 groups (7.4% and 8.9% in the Mood Disorder and Comparison groups, respectively; P = .012). Preterm newborns had a significantly higher sign rate compared to full-term newborns (54% vs 31%, P = .020). We observed a significant relationship between Finnegan signs and preterm birth. The presence of neonatal signs at 2-4 weeks was more closely associated with prematurity than with in utero SRI or mood disorder exposure. ClinicalTrials.gov identifiers: NCT00279370 and NCT00585702. © Copyright 2017 Physicians Postgraduate Press, Inc.

  5. Dacriocistitis aguda neonatal (1996-2005 Acute neonatal dacryocystitis

    Directory of Open Access Journals (Sweden)

    Zoila del S López Díaz

    2006-12-01

    Full Text Available Se realizó un estudio longitudinal y retrospectivo en diez años (1996-2005, de todos los neonatos cuyo motivo de ingreso en nuestra Unidad de Cuidados Intensivos Neonatales fue ser portadores de dacriocistitis aguda. Se obtuvo los siguientes resultados: incidencia 0,04 c/ 100 ingresos. Predominio: edades entre 7-27días (sepsis tardía, sexo femenino 66,6 %, nacidos de embarazos a término y con buen peso al nacer 100 %. Etiología no precisada 83,3 %. Tratamiento utilizado: antibioticoterapia (penicilina + gentacina, 4 pacientes, 66,6 %, (unasyn, 1 paciente, 16,6 %, (amoxicilina + unasyn + gentamicina, 1 paciente, 16,6 %; uso de inmunoglobulina humana en 2 pacientes. Complicaciones: celulitis facial y periorbitaria 66,6 %; absceso periorbitario 33,3 %; fiebre (33,3 % y obstrucción nasal 16,6 %. Evolución satisfactoria con seguimiento por Oftalmología después del egreso hospitalario, en 100 % de los casosA retrospective longitudinal study of all neonates admitted to our Intensive Care Unit because they suffered from acute dacryocystitis was performed for 10 years (1996-2005. The results were as follows: incidence rate of 0,04 per 100 admissions; prevalence: 7-27d age groups (late sepsis, females with 66,6%; neonates born to term pregnancies and with good birthweight in 100%. Inaccurate etiology in 83,3 %. Treatment: antibiotic therapy (penicilline + gentamycin in 4 paients, 66,6%, (unasyn, one patient, 16,6 %, (amoxycillin + unasyn +gentamycin, 1 patient, 16.6 %. Use of human immunoglobulin in 2 patients. Complications: facial and periorbital cellulitis, 66,6%; periorbital abscess 33,3 %; fever (33,3 % and nasal obstruction (16,6 %. Satisfactory recovery with ophtalmological follow-up after discharge from hospital in 100 % of cases

  6. Neonatal Sepsis: past, present and future; a review article | Tripathi ...

    African Journals Online (AJOL)

    Sepsis is the most common cause of neonatal mortality. As per National Neonatal Perinatal Database (NNPD) 2002-2003, the incidence of neonatal sepsis in India was 30 per 1000 live birth. It is 3% among intramural babies and 39.7% among extramural admissions. The early manifestations of neonatal sepsis are vague ...

  7. Laser Photoradiation Therapy For Neonatal Jaundice

    Science.gov (United States)

    Hamza, Mostafa; Hamza, Mohammad

    1987-04-01

    This paper describes our leading experience in the clinical application of laser in the treatment of neonatal jaundice. Currently, the irradiation of jaundiced infants during neonatal life to fluorescent light is the most common treatment of neonatal hyperbilirubinemia. The authors have investigated the photodegradation of bilirubin by laser in vitro and in Gunn rats before embarking on its clinical application in the treatment of jaundice in the new born child. This work was done to study the theraputic effect of laser compared to the currently used phototherapy in the treatment of neonatal jaundice. We selected 16 full term neonates with jaundice to be the subject of this study. The neonates of the study were devided into two groups. The first group was treated with continuous phototherapy . The second group recieved photoradiation therapy with gas laser The laser used was a CW argon-ion laser tuned to oscillate at 488.0 nm wavelength. This wavelength selection was based on our previous studies on the effect of laser irradiation of Gunn rats at different wavelengths. Comparison of the results of both methods of treatment will be reported in detail. The advantages and limitations of laser photoradiation therapy for neonatal jaundice will be discussed.

  8. Therapeutic Hypothermia for Birth Asphyxia in Neonates.

    Science.gov (United States)

    Datta, Vikram

    2017-03-01

    India contributes to the highest neonatal mortality globally. Birth asphyxia is one of the leading causes of neonatal mortality in India. A large number of neonates who suffer from birth asphyxia progress to Hypoxic Ischemic Encephalopathy (HIE). The risk of a neonate progressing to severe form of HIE is many times higher in the low and middle income countries (LMICs) with ill developed health infrastructure. Till date LMICs have had a low institutional delivery rate, poor regionalization of care, lack of adequate transport facilities and ill equipped neonatal intensive care facilities. This has lead to a tremendous burden on the health care systems with a cohort of developmentally challenged neonates surviving into adulthood. Recently, Therapeutic Hypothermia (TH) has emerged as an evidence based intervention to reduce mortality and neurodevelopmental disability associated with asphyxia induced encephalopathy. TH has become the gold standard in the management of such cases in the western world. Extension of this knowledge to the LMICs and countries like India require a better understanding of the unique sociocultural issues associated with asphyxial brain injury in neonates. The high incidence of sepsis and presence of economic constraints make this problem more complex in such countries. The current review has tried to address these issues and looked at the basics of this complex topic from the perspective of a general pediatrician.

  9. Dosing antibiotics in neonates: review of the pharmacokinetic data.

    Science.gov (United States)

    Rivera-Chaparro, Nazario D; Cohen-Wolkowiez, Michael; Greenberg, Rachel G

    2017-09-01

    Antibiotics are often used in neonates despite the absence of relevant dosing information in drug labels. For neonatal dosing, clinicians must extrapolate data from studies for adults and older children, who have strikingly different physiologies. As a result, dosing extrapolation can lead to increased toxicity or efficacy failures in neonates. Driven by these differences and recent legislation mandating the study of drugs in children and neonates, an increasing number of pharmacokinetic studies of antibiotics are being performed in neonates. These studies have led to new dosing recommendations with particular consideration for neonate body size and maturation. Herein, we highlight the available pharmacokinetic data for commonly used systemic antibiotics in neonates.

  10. Neonatal pneumonia in sub-Saharan Africa.

    Science.gov (United States)

    Green, Robin J; Kolberg, Jessica M

    2016-01-01

    Neonatal pneumonia is a devastating condition. Most deaths in sub-Saharan Africa can be attributed to preventable diseases, including pneumonia, diarrhoea and malaria, which together killed an estimated 2.2 million children under the age of 5 years in 2012, accounting for a third of all under-five deaths in this region. Some countries are making progress in reducing mortality through community-based health schemes; however, most countries in this region are far from achieving the World Health Organization Sustainable Development Goals for reducing childhood morbidity and mortality. The microorganisms causing neonatal pneumonia are well known. Both bacteria and viruses are commonly responsible, while fungal organisms occur in the context of nosocomial disease, and parasites occur in HIV-infected children. The common bacterial pathogens are group B streptococci (and other streptococcal species) and Gram-negative organisms, most notably Escherichia coli and Klebsiella spp. The viruses that predominate are the common respiratory pathogens, namely respiratory syncytial virus, human rhinovirus, and influenza virus. Viral disease is often nosocomial and transmitted to infected neonates in the neonatal intensive care unit or other neonatal facilities by infected parents and staff. Neonatal pneumonia often presents with non-specific respiratory distress in newborns. In the premature infant it is often indistinguishable from surfactant deficiency-associated respiratory distress syndrome. Therefore, diagnostic testing that is cheap and reliable is urgently sought in this region. All neonates with pneumonia must receive broad-spectrum antibiotic cover. This usually entails the combination of penicillin and an aminoglycoside. A lack of appropriate drugs and neonatal intensive care unit facilities are hampering progress in managing neonatal pneumonia.

  11. Determinants of neonatal mortality in Indonesia.

    Science.gov (United States)

    Titaley, Christiana R; Dibley, Michael J; Agho, Kingsley; Roberts, Christine L; Hall, John

    2008-07-09

    Neonatal mortality accounts for almost 40 per cent of under-five child mortality, globally. An understanding of the factors related to neonatal mortality is important to guide the development of focused and evidence-based health interventions to prevent neonatal deaths. This study aimed to identify the determinants of neonatal mortality in Indonesia, for a nationally representative sample of births from 1997 to 2002. The data source for the analysis was the 2002-2003 Indonesia Demographic and Health Survey from which survival information of 15,952 singleton live-born infants born between 1997 and 2002 was examined. Multilevel logistic regression using a hierarchical approach was performed to analyze the factors associated with neonatal deaths, using community, socio-economic status and proximate determinants. At the community level, the odds of neonatal death was significantly higher for infants from East Java (OR = 5.01, p = 0.00), and for North, Central and Southeast Sulawesi and Gorontalo combined (OR = 3.17, p = 0.03) compared to the lowest neonatal mortality regions of Bali, South Sulawesi and Jambi provinces. A progressive reduction in the odds was found as the percentage of deliveries assisted by trained delivery attendants in the cluster increased. The odds of neonatal death were higher for infants born to both mother and father who were employed (OR = 1.84, p = 0.00) and for infants born to father who were unemployed (OR = 2.99, p = 0.02). The odds were also higher for higher rank infants with a short birth interval (OR = 2.82, p = 0.00), male infants (OR = 1.49, p = 0.01), smaller than average-sized infants (OR = 2.80, p = 0.00), and infant's whose mother had a history of delivery complications (OR = 1.81, p = 0.00). Infants receiving any postnatal care were significantly protected from neonatal death (OR = 0.63, p = 0.03). Public health interventions directed at reducing neonatal death should address community, household and individual level factors

  12. Drug binding properties of neonatal albumin

    DEFF Research Database (Denmark)

    Brodersen, R; Honoré, B

    1989-01-01

    Neonatal and adult albumin was isolated by gel chromatography on Sephacryl S-300, from adult and umbilical cord serum, respectively. Binding of monoacetyl-diamino-diphenyl sulfone, warfarin, sulfamethizole, and diazepam was studied by means of equilibrium dialysis and the binding data were analyzed...... by the method of several acceptable fitted curves. It was found that the binding affinity to neonatal albumin is less than to adult albumin for monoacetyl-diamino-diphenyl sulfone and warfarin. Sulfamethizole binding to the neonatal protein is similarly reduced when more than one molecule of the drug is bound...

  13. Monitoring Cerebral Oxygenation in Neonates: An Update

    Science.gov (United States)

    Dix, Laura Marie Louise; van Bel, Frank; Lemmers, Petra Maria Anna

    2017-01-01

    Cerebral oxygenation is not always reflected by systemic arterial oxygenation. Therefore, regional cerebral oxygen saturation (rScO2) monitoring with near-infrared spectroscopy (NIRS) is of added value in neonatal intensive care. rScO2 represents oxygen supply to the brain, while cerebral fractional tissue oxygen extraction, which is the ratio between rScO2 and systemic arterial oxygen saturation, reflects cerebral oxygen utilization. The balance between oxygen supply and utilization provides insight in neonatal cerebral (patho-)physiology. This review highlights the potential and limitations of cerebral oxygenation monitoring with NIRS in the neonatal intensive care unit. PMID:28352624

  14. Imaging findings of neonatal adrenal disorders

    International Nuclear Information System (INIS)

    Yoon, Hye Kyung; Han, Bo Kyung; Lee, Min Hee

    1999-01-01

    In newborn infants, normal adrenal glands are characterized by a relatively thin echogenic center surrounded by a thick, hypoechoic cortical rim as seen on ultrasound (US). Various disorders involving the neonatal adrenal gland include adrenal hemorrhage, hyperplasia, cyst, Wolman's disease, and congenital neuroblastoma. Adrenal hemorrhage is the most common cause of an adrenal mass in the neonate, though differentiation between adrenal hemorrhage and neuroblastoma is in many cases difficult. We describe characteristic US, CT and MR imaging findings in neonates with various adrenal disorders

  15. Imaging findings of neonatal adrenal disorders

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hye Kyung; Han, Bo Kyung; Lee, Min Hee [Sungkyunkwan Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-01-01

    In newborn infants, normal adrenal glands are characterized by a relatively thin echogenic center surrounded by a thick, hypoechoic cortical rim as seen on ultrasound (US). Various disorders involving the neonatal adrenal gland include adrenal hemorrhage, hyperplasia, cyst, Wolman's disease, and congenital neuroblastoma. Adrenal hemorrhage is the most common cause of an adrenal mass in the neonate, though differentiation between adrenal hemorrhage and neuroblastoma is in many cases difficult. We describe characteristic US, CT and MR imaging findings in neonates with various adrenal disorders.

  16. Determinants of neonatal mortality in Indonesia

    Directory of Open Access Journals (Sweden)

    Agho Kingsley

    2008-07-01

    Full Text Available Abstract Background Neonatal mortality accounts for almost 40 per cent of under-five child mortality, globally. An understanding of the factors related to neonatal mortality is important to guide the development of focused and evidence-based health interventions to prevent neonatal deaths. This study aimed to identify the determinants of neonatal mortality in Indonesia, for a nationally representative sample of births from 1997 to 2002. Methods The data source for the analysis was the 2002–2003 Indonesia Demographic and Health Survey from which survival information of 15,952 singleton live-born infants born between 1997 and 2002 was examined. Multilevel logistic regression using a hierarchical approach was performed to analyze the factors associated with neonatal deaths, using community, socio-economic status and proximate determinants. Results At the community level, the odds of neonatal death was significantly higher for infants from East Java (OR = 5.01, p = 0.00, and for North, Central and Southeast Sulawesi and Gorontalo combined (OR = 3.17, p = 0.03 compared to the lowest neonatal mortality regions of Bali, South Sulawesi and Jambi provinces. A progressive reduction in the odds was found as the percentage of deliveries assisted by trained delivery attendants in the cluster increased. The odds of neonatal death were higher for infants born to both mother and father who were employed (OR = 1.84, p = 0.00 and for infants born to father who were unemployed (OR = 2.99, p = 0.02. The odds were also higher for higher rank infants with a short birth interval (OR = 2.82, p = 0.00, male infants (OR = 1.49, p = 0.01, smaller than average-sized infants (OR = 2.80, p = 0.00, and infant's whose mother had a history of delivery complications (OR = 1.81, p = 0.00. Infants receiving any postnatal care were significantly protected from neonatal death (OR = 0.63, p = 0.03. Conclusion Public health interventions directed at reducing neonatal death should

  17. NEONATAL ABSTINENCE SYNDROME - CASE REPORT

    Directory of Open Access Journals (Sweden)

    Aleksandra Matic

    2008-01-01

    Full Text Available Neonatal abstinence syndrome (NAS refers to the constellation of signs and symptoms exhibited by a newborn of drug-abusing mother. NAS is multisystemic disorder, most frequently involving central nervous and gastrointestinal systems with irritability, high-pitched cry, hyperactive reflexes, increased muscle tone, tremors, generalized convulsions, feeding and sleeping disorders, tachycardia, tachypnea, apnea, termolability and sweating, frequent hiccups, yawning and sneezing, vomiting, diarrhea and dehydration.Intrauterine narcotic disposition can give some other adverse effects beside NAS: fetal distress, premature birth, intrauterine growth retardation, microcephaly, increased incidence of congenital anomalies (cardiac and genitourinary anomalies, cleft palate, biliar atresia. Significantly increased risks of sudden infant’s death syndrome (SIDS, abnormalities in neurocognitive and behavioral development and deficiency in motor functions have also been noticed after the long-term surveys of these children.This paper is a case report of a newborn with developed clinical signs of NAS, but it also discusses diagnostics and management of such cases

  18. Kernicterus in a neonatal foal.

    Science.gov (United States)

    Loynachan, Alan T; Williams, N M; Freestone, J F

    2007-03-01

    A 5-day-old Thoroughbred foal was submitted to the necropsy service at the University of Kentucky Livestock Disease Diagnostic Center. The foal had a clinical history of seizure activity and severe icterus. A complete blood count and serum chemistry analysis indicated that the foal was anemic (hematocrit, 16%), hyperbilirubinemic (45 mg/dl), and hypoglycemic. At necropsy, all tissues were discolored various shades of yellow. Microscopically, there was degeneration and necrosis of cerebral neurons and cerebellar Purkinje cells; severe hepatocellular degeneration and necrosis; and deposition of amorphous golden-yellow material in the cerebellar granular cell layer, pulmonary alveoli, renal tubular epithelium, splenic trabecula, and the lamina propria of the small and large intestine. The golden-yellow material in the brain, lung, spleen, and small intestine was identified as bilirubin by histochemistry. Based on the macroscopic and microscopic findings, a diagnosis of kernicterus (bilirubin encephalopathy) was made. This report describes a rare case of equine neonatal kernicterus.

  19. Neonatal doses from X ray examinations by birth weight in a neonatal intensive care unit

    Energy Technology Data Exchange (ETDEWEB)

    Ono, K.; Akahane, K.; Aota, T.; Hada, M.; Takano, Y.; Kai, M.; Kusama, T

    2003-07-01

    The aim of this study was to investigate the frequency and type of X ray examinations performed on neonates classified according to their birth weight in a neonatal intensive care unit (NICU). In this study, the radiology records of 2408 neonates who were admitted to the NICU of Oita Prefectural Hospital between January 1994 and September 1999 were investigated. This study revealed that the neonates with earlier gestational ages and lower birth weights required longer NICU stays and more frequent X ray examinations made using a mobile X ray unit. The average number of X ray examinations performed on neonates of less than 750 g birth weight was 26 films per neonate. In regard to computed tomography and fluoroscopy, no significant relationship was found between the birth weight and number of X rays. This study revealed that the entrance-surface dose per neonate was dependent upon the birth weight, while the maximum dose was not dependent upon the birth weight. The average neonatal dose in the NICU was predominantly from computed tomography and fluoroscopy. The individual dose varied widely among neonates. (author)

  20. Failure to thrive among neonates, associated factors and early neonatal outcome

    International Nuclear Information System (INIS)

    Thomas, Erica; Manji, Karim; Mpembeni Rose

    2005-01-01

    Failure to thrive or growth failure is an important feature of problems prevalent in the neonate. It remains one of the greatest challenges for the practicing pediatrician and it is a common pathway or outcome of several different underlaying infant and maternal conditions. To determine the prevalence, possible causes and early neonatal outcome of failure to thrive among young infants admitted to the Neonatal Unit in this hospital. A cross-sectional descriptive hospital based study, was carried for 10 months from April 2001 to January 2002 at the Neonatal Unit at Muhimbili National Hospital. (author)

  1. Neonatal doses from X ray examinations by birth weight in a neonatal intensive care unit

    International Nuclear Information System (INIS)

    Ono, K.; Akahane, K.; Aota, T.; Hada, M.; Takano, Y.; Kai, M.; Kusama, T.

    2003-01-01

    The aim of this study was to investigate the frequency and type of X ray examinations performed on neonates classified according to their birth weight in a neonatal intensive care unit (NICU). In this study, the radiology records of 2408 neonates who were admitted to the NICU of Oita Prefectural Hospital between January 1994 and September 1999 were investigated. This study revealed that the neonates with earlier gestational ages and lower birth weights required longer NICU stays and more frequent X ray examinations made using a mobile X ray unit. The average number of X ray examinations performed on neonates of less than 750 g birth weight was 26 films per neonate. In regard to computed tomography and fluoroscopy, no significant relationship was found between the birth weight and number of X rays. This study revealed that the entrance-surface dose per neonate was dependent upon the birth weight, while the maximum dose was not dependent upon the birth weight. The average neonatal dose in the NICU was predominantly from computed tomography and fluoroscopy. The individual dose varied widely among neonates. (author)

  2. Neonatal herpes in Denmark 1977-1991

    DEFF Research Database (Denmark)

    Fonnest, G; de la Fuente Fonnest, I; Weber, Tom

    1997-01-01

    BACKGROUND: To prevent neonatal herpes, women in labor with genital herpes infection are still delivered by Cesarean section. This policy is currently being debated. The aim of this study was to determine the incidence of neonatal herpes in Denmark and to evaluate the prevention practice. METHODS......: All newborns with perinatal herpes in Denmark 1977-1991 were identified from hospital-records. RESULTS: Of 862,298 deliveries 136 possible cases were found but only 30 (22%) fulfilled the criteria for neonatal herpes. The incidence increased from 2.36 to 4.56 per 100,000 live births during 1977......%) did not have any sequelae. Four (13%) died. Six (20%) had serious neurological sequelae. Seven (23%) only had cutaneous recurrences. In seven cases (23%) information was insufficient. CONCLUSIONS: During a 15 year period in Denmark only one neonate had serious sequelae following a recognized maternal...

  3. Potentially harmful excipients in neonatal medicines

    DEFF Research Database (Denmark)

    Nellis, Georgi; Metsvaht, Tuuli; Varendi, Heili

    2015-01-01

    OBJECTIVES: We aimed to describe administration of eight potentially harmful excipients of interest (EOI)-parabens, polysorbate 80, propylene glycol, benzoates, saccharin sodium, sorbitol, ethanol and benzalkonium chloride-to hospitalised neonates in Europe and to identify risk factors for exposure....... METHODS: All medicines administered to neonates during 1 day with individual prescription and demographic data were registered in a web-based point prevalence study. Excipients were identified from the Summaries of Product Characteristics. Determinants of EOI administration (geographical region......, gestational age (GA), active pharmaceutical ingredient, unit level and hospital teaching status) were identified using multivariable logistical regression analysis. RESULTS: Overall 89 neonatal units from 21 countries participated. Altogether 2095 prescriptions for 530 products administered to 726 neonates...

  4. Hypertension in the Neonatal Period: An Update.

    Science.gov (United States)

    Pillai, Anish; Sharma, Deepak; Kadam, Pratichi

    2016-01-01

    There has been a growing interest among neonatologists and paediatricians regarding identification and evaluation of hypertension in the neonatal period. Despite the emergent normative data on blood pressure values in term and preterm neonates over the last two decades, there is still controversy regarding correct definition and classification of hypertension. This article will discuss the current definitions, available normative data and etiology of neonatal hypertension. There is paucity of records in terms of efficacy of antihypertensive drugs in this specific population and management is usually experience based, causing considerable heterogeneity amongst different units. This review article will also cover the evaluation, management, outcomes and follow up of neonatal hypertension with latest advances in this field. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  5. Genetics Home Reference: permanent neonatal diabetes mellitus

    Science.gov (United States)

    ... is passed from the blood into cells for conversion to energy. Individuals with permanent neonatal diabetes mellitus ... Related Information What does it mean if a disorder seems to run in my family? What is ...

  6. Case report: Fibromatosis colli in a neonate

    Directory of Open Access Journals (Sweden)

    Smiti S

    2010-01-01

    Full Text Available Fibromatosis colli or pseudotumor of infancy of the sternocleidomastoid muscle is a rare cause of a benign neck mass in neonates and infants. If diagnosed correctly, it can be managed conservatively, and unnecessary investigations can be avoided.

  7. Etiology and Outcome of Neonatal Seizures

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2006-04-01

    Full Text Available The prognostic value of seizure etiology, neurologic examination, EEG, and neuroimaging in the neurodevelopmental outcome of 89 term infants with neonatal seizures was determined at the Children’s Hospital and Harvard Medical School, Boston, MA.

  8. Determination of risk factors of neonatal pneumonia.

    Science.gov (United States)

    Choudhury, A M; Nargis, S; Mollah, A H; Kabir, L M; Sarkar, R N

    2010-07-01

    Pneumonia is an important cause of neonatal infection and accounts for significant morbidity and mortality in the neonatal period. The best way to reduce the high prevalence of pneumonia at this age group is through identification and elimination of its risk factors. This case-control study was conducted in the department of Pediatrics, Dhaka Medical College & Hospital during Nov 2007 to Nov 2008 with an aim to identify the risk factors of pneumonia. Data were collected from 100 neonates, 50 cases and 50 controls who met the predefined inclusion criteria. Results shows mean birth weight (pneonatal resuscitation (ppneumonia. Multivariate analysis showed inadequate antenatal care (OR 168.9), home delivery (OR 13.8), intrapartum fever (OR 225.9), obstetric problem of mother (OR 33.4), requirement of resuscitation (OR 12.5), prolonged labour (OR 15.2) as significant risk factors of neonatal pneumonia.

  9. Neuropsychological Follow-up After Neonatal ECMO

    NARCIS (Netherlands)

    Schiller, R.M.; Madderom, M.J.; Reuser, J.J.C.M.; Steiner, K.; Gischler, S.J.; Tibboel, D.; Heijst, A.F.J. van; Ijsselstijn, H.

    2016-01-01

    OBJECTIVE: To assess the longitudinal development of intelligence and its relation to school performance in a nationwide cohort of neonatal extracorporeal membrane oxygenation (ECMO) survivors and evaluate predictors of outcome at 8 years of age. METHODS: Repeated measurements assessed intelligence

  10. Neuropsychological Follow-up After Neonatal ECMO

    NARCIS (Netherlands)

    R.M. Schiller (Raisa); M.J. Madderom (Marlous); J.J.C.M. Reuser (Jolanda); K. Steiner (Katerina); S.J. Gischler (Saskia); D. Tibboel (Dick); A.F.J. van Heijst (Arno); H. IJsselstijn (Hanneke)

    2016-01-01

    markdownabstractOBJECTIVE: To assess the longitudinal development of intelligence and its relation to school abstract performance in a nationwide cohort of neonatal extracorporeal membrane oxygenation (ECMO) survivors and evaluate predictors of outcome at 8 years of age. METHODS: Repeated

  11. Treatment of refractory neonatal seizures with topiramate.

    Science.gov (United States)

    Riesgo, Rudimar; Winckler, Maria Isabel; Ohlweiler, Lygia; Ranzan, Josiane; Becker, Michele; Salvador, Socrates; Magalhaes, Luiza; Ribeiro, Ricardo

    2012-12-01

    The objective of this study is to describe the usefulness of topiramate in refractory neonatal seizures. We reported the clinical off-label use of topiramate in three cases of refractory neonatal seizures of unclear origin with no response to conventional antiepileptic drugs. In all cases, the seizures were completely controlled with adding topiramate. All patients became seizure free during hospitalization and were followed by approximately 1 year after hospital discharge, with monotherapy with topiramate. The clinical off-label use of topiramate in neonatal seizures is still incipient. When searching publications in this matter, only one report was identified. Because of its efficacy for both seizures and neuroprotection, topiramate could be a useful choice in refractory neonatal seizures. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  12. Cranial MRI in neonatal hypernatraemic dehydration

    Energy Technology Data Exchange (ETDEWEB)

    Korkmaz, A.; Yigit, S.; Oran, O. [Neonatology Unit, University of Hacettepe, Ankara (Turkey); Firat, M. [Dept. of Radiology, University of Hacettepe, Ankara (Turkey)

    2000-05-01

    Severe neonatal hypernatraemia is a life-threatening electrolyte disorder because of its neurological complications. These are brain oedema, intracranial haemorrhages, haemorrhagic infarcts and thromboses. There are few reports concerning the radiological findings in the central nervous system in severe neonatal hypernatraemia. Cranial MRI findings in hypernatraemia have been reported in an older child, but have not been described in newborn infants. We report the cranial MRI findings in a newborn infant with acute renal failure and severe hypernatraemia. (orig.)

  13. Cranial MRI in neonatal hypernatraemic dehydration

    International Nuclear Information System (INIS)

    Korkmaz, A.; Yigit, S.; Oran, O.; Firat, M.

    2000-01-01

    Severe neonatal hypernatraemia is a life-threatening electrolyte disorder because of its neurological complications. These are brain oedema, intracranial haemorrhages, haemorrhagic infarcts and thromboses. There are few reports concerning the radiological findings in the central nervous system in severe neonatal hypernatraemia. Cranial MRI findings in hypernatraemia have been reported in an older child, but have not been described in newborn infants. We report the cranial MRI findings in a newborn infant with acute renal failure and severe hypernatraemia. (orig.)

  14. Maternal pelvic dimensions and neonatal size

    Science.gov (United States)

    Figueiroa, José N; Alves, Joao G

    2017-01-01

    Abstract Patterns of fetal growth predict non-communicable disease risk in adult life, but fetal growth variability appears to have a relatively weak association with maternal nutritional dynamics during pregnancy. This challenges the interpretation of fetal growth variability as ‘adaptation’. We hypothesized that associations of maternal size and nutritional status with neonatal size are mediated by the dimensions of the maternal pelvis. We analysed data on maternal height, body mass index (BMI) and pelvic dimensions (conjugate, inter-spinous and inter-cristal diameters) and neonatal gestational age, weight, length, thorax girth and head girth (n = 224). Multiple regression analysis was used to identify independent maternal predictors of neonatal size, and the mediating role of neonatal head girth in these associations. Pelvic dimensions displaced maternal BMI as a predictor of birth weight, explaining 11.6% of the variance. Maternal conjugate and inter-spinous diameters predicted neonatal length, thorax girth and head girth, whereas inter-cristal diameter only predicted neonatal length. Associations of pelvic dimensions with birth length, but not birth weight, were mediated by neonatal head girth. Pelvic dimensions predicted neonatal size better than maternal BMI, and these associations were mostly independent of maternal height. Sensitivity of fetal growth to pelvic dimensions reduces the risk of cephalo-pelvic disproportion, potentially a strong selective pressure during secular trends in height. Selection on fetal adaptation to relatively inflexible components of maternal phenotype, rather than directly to external ecological conditions, may help explain high levels of growth plasticity during late fetal life and early infancy. PMID:29423225

  15. Pyridoxal phosphate-dependent neonatal epileptic encephalopathy

    OpenAIRE

    Bagci, S; Zschocke, J; Hoffmann, G F; Bast, T; Klepper, J; Müller, A; Heep, A; Bartmann, P; Franz, A R

    2009-01-01

    Pyridox(am)ine-5′-phosphate oxidase converts pyridoxine phosphate and pyridoxamine phosphate to pyridoxal phosphate, a cofactor in many metabolic reactions, including neurotransmitter synthesis. A family with a mutation in the pyridox(am)ine-5′-phosphate oxidase gene presenting with neonatal seizures unresponsive to pyridoxine and anticonvulsant treatment but responsive to pyridoxal phosphate is described. Pyridoxal phosphate should be considered in neonatal epileptic encephalopathy unrespons...

  16. Neonatal pressure ulcers: prevention and treatment

    Directory of Open Access Journals (Sweden)

    García-Molina P

    2017-09-01

    Full Text Available Pablo García-Molina,1,2 Alba Alfaro-López,1 Sara María García-Rodríguez,1 Celia Brotons-Payá,1 Mari Carmen Rodríguez-Dolz,1,2 Evelin Balaguer-López1,2 1Department of Nursing, University of Valencia, 2Research Group of Pediatric Nutrition, INCLIVA Foundation, Valencia, Spain Abstract: Health professionals should be prepared to respond to the needs of hospitalized neonates. The health team must consider multiple situations, where the neonate is at risk of having an adverse effect. One of the main interventions that health professionals must practice when interacting with hospitalized newborns is skin care. Neonates often suffer from diaper rash or intravenous drugs extravasation. Recently, hospitalized neonates and especially those in an unstable clinical situation are also at a risk of developing pressure ulcers. The presence of a pressure ulcer in a neonate can lead to serious problems to survival (eg, sepsis, clinical instability. This is the reason why, with this literature review, we attempt to answer questions from health professionals caring for neonates about the prevention and treatment of pressure ulcers. Keywords: infant, pressure ulcer, treatment, prevention, wound, assessment

  17. Risk factors for hearing loss in neonates

    Directory of Open Access Journals (Sweden)

    Ni Luh Putu Maharani

    2016-11-01

    Full Text Available Background An estimated 6 of 1,000 children with live births suffer from permanent hearing loss at birth or the neonatal period. At least 90% of cases occur in developing countries. Hearing loss should be diagnosed as early as possible so that intervention can be done before the age of 6 months. Objective To determine risk factors for hearing loss in neonates. Methods We performed a case-control study involving 100 neonates with and without hearing loss who were born at Sanglah Hospital, Denpasar from November 2012 to February 2013. Subjects were consisted of 2 groups, those with hearing loss (case group of 50 subjects and without hearing loss (control group of 50 subjects. The groups were matched for gender and birth weight. We assessed the following risk factors for hearing loss: severe neonatal asphyxia, hyperbilirubinemia, meningitis, history of aminoglycoside therapy, and mechanical ventilation by Chi-square analysis. The results were presented as odds ratio and its corresponding 95% confidence intervals. Results Seventy percent of neonates with hearing loss had history of aminoglycoside therapy. Multivariable analysis revealed that aminoglycoside therapy of 14 days or more was a significant risk factor for hearing loss (OR 2.7; 95%CI 1.1 to 6.8; P=0.040. There were no statistically significant associations between hearing loss and severe asphyxia, hyperbilirubinemia, meningitis, or mechanical ventilation. Conclusion Aminoglycoside therapy for >=14 days was identified as a risk factor for hearing loss in neonates.

  18. Maternal marijuana use and neonatal morbidity.

    Science.gov (United States)

    Conner, Shayna N; Carter, Ebony B; Tuuli, Methodius G; Macones, George A; Cahill, Alison G

    2015-09-01

    Marijuana use is becoming increasingly common in the obstetric population; however, it is unknown whether it is associated with poor neonatal outcomes. We sought to determine the prevalence and risk factors for marijuana use in pregnancy and to evaluate whether marijuana use is independently associated with poor neonatal outcomes. This was a retrospective cohort study of all consecutive, nonanomalous, term deliveries at 1 institution over a 4-year study period. Women with marijuana use during pregnancy, either by self-report or positive urine drug screen, were compared with women who did not use marijuana. The primary outcome was a composite neonatal morbidity including birthweight less than 2500 g, neonatal intensive care unit admission, 5-minute Apgar score less than 7, and umbilical artery pH less than 7.10. Univariate, bivariate, and multiple logistic regression analyses were performed. Among the 8138 women in the cohort, 680 (8.4%) used marijuana during pregnancy. Women who used marijuana were younger; more likely to be of African American race; have inadequate prenatal care; and use tobacco, alcohol, and other drugs. Medical comorbidities did not differ between groups. After adjusting for smoking, other drug use, and African American race, the composite and all individual markers of poor neonatal outcome were not significantly higher among women who used marijuana during pregnancy. Marijuana use is common in pregnancy but may not be an independent risk factor for poor neonatal outcomes in term pregnancies. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Preoperative Feeding Neonates With Cardiac Disease.

    Science.gov (United States)

    Scahill, Carly J; Graham, Eric M; Atz, Andrew M; Bradley, Scott M; Kavarana, Minoo N; Zyblewski, Sinai C

    2017-01-01

    The potential for necrotizing enterocolitis (NEC) in neonates requiring cardiac surgery has contributed largely to wide feeding practice variations and a hesitation to initiate enteral feeding during the preoperative period, specifically those patients with hypoplastic left heart syndrome. A retrospective chart review of neonates undergoing cardiac surgery at a single institution between July 2011 and July 2013 was performed. The primary objective of this study was to determine if preoperative feeding was associated with NEC in neonates requiring cardiac surgery. Univariable and multivariable analyses were performed to evaluate the relationship between preoperative feeding and NEC. Secondary outcomes including growth failure, total ventilator days, total length of stay, and tube-assisted feeds at discharge were analyzed. One hundred thirty consecutive neonates who required cardiac surgery were included in the analysis. Preoperative feeding occurred in 61% (n = 79). The overall prevalence of NEC was 9% (12/130), including three neonates with surgical NEC. There was no difference in the prevalence of NEC between the preoperative feeding and nil per os (NPO) groups. Preoperative NPO status was associated with longer ventilator-dependent days ( P = .01) but was not associated with worsened growth failure, longer length of stay, or increased prevalence of tube-assisted feeds at discharge. In this study cohort, preoperative feeding was associated with a low prevalence of NEC. Larger prospective studies evaluating the safety and benefits of preoperative feeding in cardiac neonates are warranted.

  20. Neonatal morbidity associated with shoulder dystocia maneuvers.

    Science.gov (United States)

    Spain, Janine E; Frey, Heather A; Tuuli, Methodius G; Colvin, Ryan; Macones, George A; Cahill, Alison G

    2015-03-01

    We sought to examine neonatal morbidity associated with different maneuvers used among term patients who experience a shoulder dystocia. We conducted a retrospective cohort study of all women who experienced a clinically diagnosed shoulder dystocia at term requiring obstetric maneuvers at a single tertiary care hospital from 2005 through 2008. We excluded women with major fetal anomaly, intrauterine death, multiple gestation, and preterm. Women exposed to Rubin maneuver, Wood's screw maneuver, or delivery of the posterior arm were compared to women delivered by McRoberts/suprapubic pressure only, which served as the reference group. The primary outcome was a composite morbidity of neonatal injury (defined as clavicular or humeral fracture or brachial plexus injury) and neonatal depression (defined as Apgar shoulder dystocia, defined as time from delivery of fetal head to delivery of shoulders. Among the 231 women who met inclusion criteria, 135 were delivered by McRoberts/suprapubic pressure alone (57.9%), 83 women were exposed to Rubin maneuver, 53 women were exposed to Wood's screw, and 36 women were exposed to delivery of posterior arm. Individual maneuvers were not associated with composite morbidity, neonatal injury, or neonatal depression after adjusting for nulliparity and duration of shoulder dystocia. We found no association between shoulder dystocia maneuvers and neonatal morbidity after adjusting for duration, a surrogate for severity. Our results demonstrate that clinicians should utilize the maneuver most likely to result in successful delivery. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Bayesian automated cortical segmentation for neonatal MRI

    Science.gov (United States)

    Chou, Zane; Paquette, Natacha; Ganesh, Bhavana; Wang, Yalin; Ceschin, Rafael; Nelson, Marvin D.; Macyszyn, Luke; Gaonkar, Bilwaj; Panigrahy, Ashok; Lepore, Natasha

    2017-11-01

    Several attempts have been made in the past few years to develop and implement an automated segmentation of neonatal brain structural MRI. However, accurate automated MRI segmentation remains challenging in this population because of the low signal-to-noise ratio, large partial volume effects and inter-individual anatomical variability of the neonatal brain. In this paper, we propose a learning method for segmenting the whole brain cortical grey matter on neonatal T2-weighted images. We trained our algorithm using a neonatal dataset composed of 3 fullterm and 4 preterm infants scanned at term equivalent age. Our segmentation pipeline combines the FAST algorithm from the FSL library software and a Bayesian segmentation approach to create a threshold matrix that minimizes the error of mislabeling brain tissue types. Our method shows promising results with our pilot training set. In both preterm and full-term neonates, automated Bayesian segmentation generates a smoother and more consistent parcellation compared to FAST, while successfully removing the subcortical structure and cleaning the edges of the cortical grey matter. This method show promising refinement of the FAST segmentation by considerably reducing manual input and editing required from the user, and further improving reliability and processing time of neonatal MR images. Further improvement will include a larger dataset of training images acquired from different manufacturers.

  2. Acute renal failure in asphyxiated term neonates

    Directory of Open Access Journals (Sweden)

    Pejović Biljana

    2002-01-01

    Full Text Available INTRODUCTION Acute renal failure (ARF is a frequent clinical condition in neonatal intensive care units (NICU. The leading cause of neonatal ARF is perinatal asphyxia (PS. The aim of this study was to examine the relationship between the degree of PS and the severity of ARF in term neonates. METHODS A prospective survey of 31 term neonates with Ps and but without congenital malformations or sepsis was performed in NICU of the regional Hospital of Gynaecology and Obstetrics in Belgrade (average number of deliveries about 6000 per year. ARF was diagnosed in the first 7 days of life when plasma creatinine was above 133 μmοΙ/L for at least 48 hours while maternal renal function was normal. The degree of PS was determined according to Apgar score (AS at 1 min. The severe PS was defined as AS < 3 and moderate PS as AS 4-6. RESULTS Twenty neonates (64% had oliguric ARF with urine output of 0.37 ±0.16 ml/kg/h while the others had nonoliguric ARF with urine output of 2.4 ± 0.7 ml/kg/h. Most of neonates with oliguric ARF (65% had severe perinatal asphuxia while in those with nonoliguric ARF moderate perinatal asphyxia predominated (73%. DISCUSSION During hypoxic-ischaemic events many organs are injured, and the most vulnerable ones are kidneys and central nervous system. Our results showed a strong connection between perinatal asphyxia and A, which was in accordance with the results of other studies. Neonates with severe perinatal asphyxia had serious impairment of renal function, which was confirmed with strong correlation between Apgar score and plasma creatinine. In neonates with oliguric ARF, but not in those with nonoliguric ARF, the highly positive linear correlations were found between AS and urinary output (r = 0.77; p < 0.01, plasma creatinine (r = 0.78; p < 0.01, fractional excretion of sodium (r = 0.76; p < 0.01, and index of renal failure (r = 0.80; p < 0.01. Only in oliguric neonates with severe perinatal asphyxia (31 % the outcome was

  3. Pantoea dispersa: an unusual cause of neonatal sepsis

    Directory of Open Access Journals (Sweden)

    Veerendra Mehar

    Full Text Available Neonatal septicemia is the most important cause of neonatal mortality. A wide variety of bacteria both aerobic and anaerobic can cause neonatal sepsis. Genus Pantoea is a member of Enterobacteriaceae family that inhabits plants, soil and water and rarely causes human infections, however, Pantoea dispersa has not been reported as a causative organism for neonatal sepsis. We hereby report two neonates with early onset sepsis caused by Pantoea dispersa. Early detection and appropriate antibiotic therapy can improve overall outcome of this rare infection in neonates.

  4. A survey on hypothermia incidence in transported neonates to neonatal ward Ali Asghar hospital

    Directory of Open Access Journals (Sweden)

    SayeadMohammadsaleh Tabib

    2015-05-01

    Full Text Available Background: Hypothermia is very prevalent in neonatal transport and can increase morbidity and mortality in this age group. Materials and Methods: In this study, all neonates transported from different parts of Bushehr province to Ali Asghar hospital during the second half (2007 were checked for axillary temperature on admission. Results: 328 neonates were entered to the study. The incidence of hypothermia was 47.6 percent. There was a significant relationship between hypothermia and transfer method (with or without incubator, gestational age, chronological age on admission, birth weight, Apgar score (P<0.0001 and neonatal outcome (P=0.001. Conclusion: Hypothermia leads to increased mortality in neonates and is related to prematurity and low birth weight and low Apgar score. Kangaroo mother care (KMC is recommended instead of incubator care to prevent hypothermia during transfer.

  5. Memory in the neonate brain.

    Directory of Open Access Journals (Sweden)

    Silvia Benavides-Varela

    Full Text Available BACKGROUND: The capacity to memorize speech sounds is crucial for language acquisition. Newborn human infants can discriminate phonetic contrasts and extract rhythm, prosodic information, and simple regularities from speech. Yet, there is scarce evidence that infants can recognize common words from the surrounding language before four months of age. METHODOLOGY/PRINCIPAL FINDINGS: We studied one hundred and twelve 1-5 day-old infants, using functional near-infrared spectroscopy (fNIRS. We found that newborns tested with a novel bisyllabic word show greater hemodynamic brain response than newborns tested with a familiar bisyllabic word. We showed that newborns recognize the familiar word after two minutes of silence or after hearing music, but not after hearing a different word. CONCLUSIONS/SIGNIFICANCE: The data show that retroactive interference is an important cause of forgetting in the early stages of language acquisition. Moreover, because neonates forget words in the presence of some--but not all--sounds, the results indicate that the interference phenomenon that causes forgetting is selective.

  6. Memory in the Neonate Brain

    Science.gov (United States)

    Benavides-Varela, Silvia; Gómez, David M.; Macagno, Francesco; Bion, Ricardo A. H.; Peretz, Isabelle; Mehler, Jacques

    2011-01-01

    Background The capacity to memorize speech sounds is crucial for language acquisition. Newborn human infants can discriminate phonetic contrasts and extract rhythm, prosodic information, and simple regularities from speech. Yet, there is scarce evidence that infants can recognize common words from the surrounding language before four months of age. Methodology/Principal Findings We studied one hundred and twelve 1-5 day-old infants, using functional near-infrared spectroscopy (fNIRS). We found that newborns tested with a novel bisyllabic word show greater hemodynamic brain response than newborns tested with a familiar bisyllabic word. We showed that newborns recognize the familiar word after two minutes of silence or after hearing music, but not after hearing a different word. Conclusions/Significance The data show that retroactive interference is an important cause of forgetting in the early stages of language acquisition. Moreover, because neonates forget words in the presence of some –but not all– sounds, the results indicate that the interference phenomenon that causes forgetting is selective. PMID:22087327

  7. National neonatal weight policy survey.

    LENUS (Irish Health Repository)

    Walsh, B

    2009-06-01

    This survey was conducted to review the current practice regarding frequency of weight measurement in neonatal units in the Republic of Ireland, and whether these practices are in keeping with best practice as described in the literature. There was an 88.5% (23 of 26) response rate to this survey. 6 (26%) units had a written policy, and 16 (70%) had an unwritten agreed practice. In the Vermont Oxford Network\\'s potentially better practices daily weight measurements on newborn infants are recommended until the infant is stable and growing and then alternate day measurements The most common practices in this survey were to weigh infants on alternate days, this occurred in 9 (39%) units, and twice weekly in 6 (26%). Less than 31% of units had a separate policy for those less than 30 weeks, on assisted ventilation, or transitioning to enteral feeds. Most weigh infants on alternate days, and plot weights weekly, which is in keeping with best practice. Few units have separate policies for specific subgroups as is recommended in the limited literature. Consensus guidelines should be developed and promoted nationally.

  8. National neonatal weight policy survey.

    LENUS (Irish Health Repository)

    Walsh, B

    2012-02-01

    This survey was conducted to review the current practice regarding frequency of weight measurement in neonatal units in the Republic of Ireland, and whether these practices are in keeping with best practice as described in the literature. There was an 88.5% (23 of 26) response rate to this survey. 6 (26%) units had a written policy, and 16 (70%) had an unwritten agreed practice. In the Vermont Oxford Network\\'s potentially better practices daily weight measurements on newborn infants are recommended until the infant is stable and growing and then alternate day measurements The most common practices in this survey were to weigh infants on alternate days, this occurred in 9 (39%) units, and twice weekly in 6 (26%). Less than 31% of units had a separate policy for those less than 30 weeks, on assisted ventilation, or transitioning to enteral feeds. Most weigh infants on alternate days, and plot weights weekly, which is in keeping with best practice. Few units have separate policies for specific subgroups as is recommended in the limited literature. Consensus guidelines should be developed and promoted nationally.

  9. Fetal and neonatal endocrine disruptors.

    Science.gov (United States)

    Unüvar, Tolga; Büyükgebiz, Atilla

    2012-06-01

    Endocrine disruptors are substances commonly encountered in every setting and condition in the modern world. It is virtually impossible to avoid the contact with these chemical compounds in our daily life. Molecules defined as endocrine disruptors constitute an extremely heterogeneous group and include synthetic chemicals used as industrial solvents/lubricants and their by-products. Natural chemicals found in human and animal food (phytoestrogens) also act as endocrine disruptors. Different from adults, children are not exposed only to chemical toxins in the environment but may also be exposed during their intrauterine life. Hundreds of toxic substances, which include neuro-immune and endocrine toxic chemical components that may influence the critical steps of hormonal, neurological and immunological development, may affect the fetus via the placental cord and these substances may be excreted in the meconium. Children and especially newborns are more sensitive to environmental toxins compared to adults. Metabolic pathways are immature, especially in the first months of life. The ability of the newborn to metabolize, detoxify and eliminate many toxins is different from that of the adults. Although exposures occur during fetal or neonatal period, their effects may sometimes be observed in later years. Further studies are needed to clarify the effects of these substances on the endocrine system and to provide evidence for preventive measures.

  10. Managing neonatal bowel obstruction: clinical perspectives

    Directory of Open Access Journals (Sweden)

    Desoky SM

    2018-02-01

    Full Text Available Sarah M Desoky,1 Ranjit I Kylat,2 Unni Udayasankar,1 Dorothy Gilbertson-Dahdal1 1Department of Medical Imaging, University of Arizona College of Medicine, Tucson, AZ, USA; 2Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Arizona College of Medicine, Tucson, AZ, USA Abstract: Neonatal intestinal obstruction is a common surgical emergency and occurs in approximately 1 in 2,000 live births. The causes of obstruction are diverse with varied embryological origins, and some underlying etiologies are not yet well described. Some findings of neonatal bowel obstruction can be detected prenatally on ultrasound imaging. The obstruction is classified as “high” when the level of obstruction is proximal to the ileum, and “low” when the level of obstruction is at the ileum or colon. Early diagnosis of the type of intestinal obstruction and localization of the obstructive bowel segment guides timely and appropriate management of the underlying pathologic entity. Neonatal bowel obstructions are ideally managed at specialized centers with a large volume of neonatal surgery and dedicated pediatric surgical and anesthesia expertise. Although surgical intervention is necessary in most cases, initial management strategies often target underlying metabolic, cardiac, or respiratory abnormalities. Imaging plays a key role in early and accurate diagnosis of the abnormalities. When bowel obstruction is suspected clinically, initial imaging workup usually involves abdominal radiography, which may direct further evaluation with fluoroscopic examination such as upper gastrointestinal (UGI contrast study or contrast enema. This article provides a comprehensive review of clinical and radiological features of common and less common causes of intestinal obstruction in the neonatal age group, including esophageal atresia, enteric duplication cysts, gastric volvulus, congenital microgastria, hypertrophic pyloric stenosis, duodenal atresia

  11. Neonatal paracetamol treatment reduces long-term nociceptive behaviour after neonatal procedural pain in rats.

    Science.gov (United States)

    van den Hoogen, N J; Tibboel, D; Honig, W M M; Hermes, D; Patijn, J; Joosten, E A

    2016-09-01

    Pain from skin penetrating procedures (procedural pain) during infancy in the neonatal intensive care unit (NICU) may result in changes of nociceptive sensitivity in later life. This supports the need for pain management during such vulnerable periods in life. This study, therefore, analyses the short- and long-term consequences of neonatal paracetamol (acetaminophen) treatment on pain behaviour in an experimental rat model of neonatal procedural pain. A repetitive needle-prick model was used, in which neonatal rats received four needle pricks into the left hind paw per day from postnatal day 0 to day 7 (P0-P7). Paracetamol (50 mg/kg/day s.c.) was administered daily (P0-P7), and sensitivity to mechanical stimuli was compared with a needle-prick/saline-treated group and to a tactile control group. At 8 weeks of age, all animals underwent an ipsilateral paw-incision, modelling postoperative pain, and the duration of hypersensitivity was assessed. Neonatal paracetamol administration had no effect upon short-term mechanical hypersensitivity during the first postnatal week or upon long-term baseline sensitivity from 3 to 8 weeks. However, neonatal paracetamol administration significantly reduced the postoperative mechanical hypersensitivity in young adults, caused by repetitive needle pricking. Paracetamol administration during neonatal procedural pain does not alter short-term or long-term effects on mechanical sensitivity, but does reduce the duration of increased postoperative mechanical hypersensitivity in a clinically relevant neonatal procedural pain model. Paracetamol can be used safely in neonatal rats. Neonatal paracetamol treatment had no effect upon short-term mechanical hypersensitivity during the first postnatal week, nor upon long-term baseline sensitivity from 3 to 8 weeks. Paracetamol treatment during the first postnatal week significantly reduced the postoperative mechanical hypersensitivity in young adult rats. © 2016 European Pain Federation

  12. Socioeconomic factors and adolescent pregnancy outcomes: distinctions between neonatal and post-neonatal deaths?

    Directory of Open Access Journals (Sweden)

    Flick Louise H

    2005-07-01

    Full Text Available Abstract Background Young maternal age has long been associated with higher infant mortality rates, but the role of socioeconomic factors in this association has been controversial. We sought to investigate the relationships between infant mortality (distinguishing neonatal from post-neonatal deaths, socioeconomic status and maternal age in a large, retrospective cohort study. Methods We conducted a population-based cohort study using linked birth-death certificate data for Missouri residents during 1997–1999. Infant mortality rates for all singleton births to adolescent women (12–17 years, n = 10,131; 18–19 years, n = 18,954 were compared to those for older women (20–35 years, n = 28,899. Logistic regression was used to estimate adjusted odds ratios (OR and 95% confidence intervals (CI for all potential associations. Results The risk of infant (OR 1.95, CI 1.54–2.48, neonatal (1.69, 1.24–2.31 and post-neonatal mortality (2.47, 1.70–3.59 were significantly higher for younger adolescent (12–17 years than older (20–34 years mothers. After adjusting for race, marital status, age-appropriate education level, parity, smoking status, prenatal care utilization, and poverty status (indicated by participation in WIC, food stamps or Medicaid, the risk of post-neonatal mortality (1.73, 1.14–2.64 but not neonatal mortality (1.43, 0.98–2.08 remained significant for younger adolescent mothers. There were no differences in neonatal or post-neonatal mortality risks for older adolescent (18–19 years mothers. Conclusion Socioeconomic factors may largely explain the increased neonatal mortality risk among younger adolescent mothers but not the increase in post-neonatal mortality risk.

  13. A case series of neonatal arrhythmias.

    Science.gov (United States)

    Isik, Dilek Ulubas; Celik, Istemi Han; Kavurt, Sumru; Aydemir, Ozge; Kibar, Ayse Esin; Bas, Ahmet Yagmur; Demirel, Nihal

    2016-01-01

    Neonatal arrhythmias (NAs) are defined as abnormal heart rates in the neonatal period. They may occur as a result of various cardiovascular, systemic and metabolic problems. A retrospective chart review was performed on newborns who were diagnosed with NA during hospitalization in a neonatal intensive care unit (NICU), or who were admitted to the NICU because of an arrhythmia diagnosis in two NICUs in Turkey from May 2011 to June 2013. Seventeen neonates with arrhythmias were identified. The incidence of NA was 0.4% and 0.3% in the two NICUs, and was 0.37% in the study population as a whole. Mean gestational age was 37 (29-40) weeks. Nine of the infants (53%) were diagnosed with fetal arrhythmia (FA) during the last week of gestation. The distribution of NA types was as follows: six (35%) supraventricular tachycardia (SVT), six (35%) premature atrial contractions (PACs), two (11%) premature ventricular contractions (PVCs), two (11%) multiple arrhythmias such as SVT + PAC and AV block + PVC, and one (5%) AV block. Wolff-Parkinson-White syndrome was present in one patient. An association of NA with congenital heart malformations was identified in five cases. Cardiac arrhythmias are important causes of infant morbidity, and an occasional cause of infant mortality if undiagnosed and untreated. It is important for the physician to be aware of the etiology, development and natural history of arrhythmias in the fetal and neonatal period.

  14. Rescuer fatigue during simulated neonatal cardiopulmonary resuscitation.

    Science.gov (United States)

    Li, E S; Cheung, P-Y; O'Reilly, M; Aziz, K; Schmölzer, G M

    2015-02-01

    To assess development of fatigue during chest compressions (CCs) in simulated neonatal cardiopulmonary resuscitation (CPR). Prospective randomized manikin crossover study. Thirty neonatal healthcare professionals who successfully completed the Neonatal Resuscitation Program performed CPR using (i) 3:1 compression:ventilation (C:V) ratio, (ii) continuous CC with asynchronous ventilation (CCaV) at a rate of 90 CC per min and (iii) CCaV at 120 CC per min for a duration of 10 min on a neonatal manikin. Changes in peak pressure (a surrogate of fatigue) and CC rate were continuously recorded and fatigue among groups was compared. Participants were blinded to pressure tracings and asked to rate their level of comfort and fatigue for each CPR trial. Compared with baseline, a significant decrease in peak pressure was observed after 72, 96 and 156 s in group CCaV-120, CCaV-90 and 3:1 C:V, respectively. CC depth decreased by 50% within the first 3 min during CCaV-120, 30% during CCaV-90 and 20% during 3:1 C:V. Moreover, 3:1 C:V and CCaV were similarly preferred by healthcare professionals. Similarly, 3:1 C:V and CCaV CPR were also fatiguing. We recommend that rescuers should switch after every second cycle of heart rate assessment during neonatal CPR.

  15. Evaluation and Management of Neonatal Supraventricular Tachycardia

    Directory of Open Access Journals (Sweden)

    Malekian

    2016-07-01

    Full Text Available Background Supraventricular Tachycardia (SVT is the most frequent arrhythmia requiring a medical treatment in neonates. Objectives The aim of our study was to evaluate and manage neonatal supraventricular tachycardia. Methods This study was performed on 22 newborns that were diagnosed with SVT at two neonatal intensive care units (NICU in south west of Iran from October 2012 to October 2015. Data on gender, age, weight, maternal age, gestational age, presence of congenital heart disease, blood pressure in admission, duration of hospitalization period, duration of SVT, medicine for the control of SVT, list of medicine administered at releasing time were collected. Echocardiography was performed for all patients. Data was analyzed by the SPSS version 18 software. Results Twelve neonates were male (54.5% and ten (45.5% were female. The mean age was 11.68 ± 8.17 days. Three neonates (13.6% had congenital heart disease. The mean duration of hospitalization was 6.54 ± 3.98 days. Nine patients (41% only had responded adenosine. One patient had hypotensive that received D/C shock. Conclusions We concluded that in most SVT patients, conventional treatment can be helpful and an only minor percentage of patients need to receive flecainide as the last line of treatment.

  16. The Neonatal Connectome During Preterm Brain Development.

    Science.gov (United States)

    van den Heuvel, Martijn P; Kersbergen, Karina J; de Reus, Marcel A; Keunen, Kristin; Kahn, René S; Groenendaal, Floris; de Vries, Linda S; Benders, Manon J N L

    2015-09-01

    The human connectome is the result of an elaborate developmental trajectory. Acquiring diffusion-weighted imaging and resting-state fMRI, we studied connectome formation during the preterm phase of macroscopic connectome genesis. In total, 27 neonates were scanned at week 30 and/or week 40 gestational age (GA). Examining the architecture of the neonatal anatomical brain network revealed a clear presence of a small-world modular organization before term birth. Analysis of neonatal functional connectivity (FC) showed the early formation of resting-state networks, suggesting that functional networks are present in the preterm brain, albeit being in an immature state. Moreover, structural and FC patterns of the neonatal brain network showed strong overlap with connectome architecture of the adult brain (85 and 81%, respectively). Analysis of brain development between week 30 and week 40 GA revealed clear developmental effects in neonatal connectome architecture, including a significant increase in white matter microstructure (P development. © The Author 2014. Published by Oxford University Press.

  17. Arrhythmia in the neonatal intensive care unit.

    Science.gov (United States)

    Badrawi, Nadia; Hegazy, Ranya A; Tokovic, Edisa; Lotfy, Wael; Mahmoud, Fadia; Aly, Hany

    2009-04-01

    A random sample of 457 neonates was prospectively studied in order to identify the incidence, common types, and risk factors for arrhythmias in the neonatal intensive care unit (NICU). A 12-lead EKG was studied in all neonates (n = 457). A total of 139 Holter studies was done in every fourth baby with a normal EKG (n = 100) and in all babies with an abnormal EKG (n = 39). Of the 100 infants who were thought to be arrhythmia-free by EKG, nine infants demonstrated an arrhythmia on Holter studies. When we correlated screening results with maternal, obstetrical, and neonatal risk factors; arrhythmias were significantly associated with male gender, more mature gestational age, lower glucose levels, maternal smoking, high umbilical artery lines, and the use of the nebulized beta-2 adrenergic treatment, whereas umbilical venous lines and dopamine infusion did not relate to arrhythmia. We conclude that arrhythmias are more common in the NICU than in the general neonatal population. Compared to Holter monitoring, the sensitivity of the EKG was only 89%.

  18. Longterm follow-up of neonatal septicemia.

    Science.gov (United States)

    Alfvén, G; Bergqvist, G; Bolme, P; Eriksson, M

    1978-11-01

    The longterm prognosis of neonatal septicemia during the first four weeks of life has been estimated. Of 90 infants with the diagnosis of neonatal septicemia during a five-year period, 1969--1973, 65 infants survived the initial treatment. Another two infants died with complications of their main disease, intestinal atresia, at the age of two months. Thus the total mortality in neonatal septicemia in this series was 30%. The remaining 63 children have been investigated between ages of 2 1/2 and 6 1/2 years. Of these 63 children we have found 14 children (22% of the surviving) with handicaps where the septicemia can be regarded as a possible cause of the handicap. Of these 14 children only six had an "uncomplicated" septicemia while four of them had meningitis and four had osteomyelitis. Furthermore, of the 14 handicapped children nine were delivered preterm (28--36 weeks) and all of them had one or more additional neonatal diagnoses than septicemia. The prognosis, both immediate and longterm, of neonatal septicemia in the present series compares favourably to most international studies. The importance of early detection together with an aggresive treatment of the septicemia is stressed and is considered as the main reason for the good prognosis.

  19. Neonatal asphyxia: A study of 210 cases

    Directory of Open Access Journals (Sweden)

    Hülya Üzel

    2012-06-01

    Full Text Available Objectives: Perinatal asphyxia remains an importantcause of neonatal morbidity and mortality. The aim of thisstudy was to investigate antenatal, natal, and postnatalrisk factors of neonatal asphyxia, relationship with knownrisk factors and stage of Sarnat and Sarnat scores, theeffect of risk factors on hospital discharge and survival forneonates with perinatal asphyxia.Materials and methods: In this study, we retrospectivelyanalyzed the hospital records of 210 patients diagnosedas perinatal asphyxia. The patients’ demographic characteristics,antepartum, intrapartum, and postpartum riskfactors and Sarnat and Sarnat clinical staging criteria ofnewborns were analyzed.Results: The risk factors for asphyxia were detectedantepartum period in 67.7% of newborns, intrapartum in91% and potpartum in of 29.5% of neonates. When caseswere examined according to the studied years, perinatalasphyxia ratio was the most frequent in 2007 as 28.1%.With a decline over the years, frequency dropped to %21in 2010. The number of patients with stage 3 and mortalityrate were significantly decreased over the years (p<0.05.Conclusions: Less preventable intrapartum causes ofbirth asphyxia are seen more frequently. Early detectionof risk factors together with appropriate prenatal, nataland postnatal care provision, reduced emergency caesareansections and will decrease considerably decreasefrequency of perinatal asphyxia. We think that followingup neonates who needed intensive care in neonatal unitssufficiently equipped will decrease complications due toasphyxia. J Clin Exp Invest 2012; 3(2: 194-198

  20. Pain management for neonatal circumcision.

    Science.gov (United States)

    Taddio, A

    2001-01-01

    Circumcision is the most common surgical procedure performed in the neonatal period in North America. If untreated, the pain of circumcision causes both short and long term changes in infant behaviours. The most widely studied pharmacological intervention for pain management during circumcision is dorsal penile nerve block (DPNB) by injected lidocaine (lignocaine). Randomised controlled trials have demonstrated its efficacy; infants premedicated with lidocaine have significantly smaller changes in physiological and pain-related behaviours compared with infants who are not given analgesics. A meta-analysis of injection-related adverse effects (bruising/haematoma) yielded a risk of 6.7% (95% confidence interval, 0.5 to 12.9%). Systemic toxicity from injected local anaesthesia has not been reported. Less effective modalities include topical anaesthesia with lidocaine-prilocaine cream [Eutectic Mixture of Local Anaesthetics (EMLA)], lidocaine cream and oral administration of sucrose. The good tolerability of lidocaine-prilocaine cream has been demonstrated by a lack of clinically significant methaemoglobinaemia when used appropriately. Nonpharmacological interventions (pacifier, specially designed restraint chair) reduce distress during the procedure, and paracetamol (acetaminophen) may provide postoperative analgesia. No single agent has been demonstrated to ameliorate pain for all infants undergoing circumcision. A multimodal approach of pharmacotherapy is currently recommended. Studies evaluating the efficacy of combined analgesia have demonstrated significant benefits for combinations of 2 or more forms of treatment (such as DPNB and sucrose-dipped pacifier) compared with single interventions. The instrument used to perform the circumcision is also important. The Mogen clamp has been shown to be associated with a shorter procedure time and less pain compared with the Gomco clamp. If circumcision is to be performed on infants, it is, therefore, recommended that

  1. Sensorial saturation for neonatal analgesia.

    Science.gov (United States)

    Bellieni, Carlo V; Cordelli, Duccio M; Marchi, Simonetta; Ceccarelli, Simona; Perrone, Serafina; Maffei, Marianna; Buonocore, Giuseppe

    2007-01-01

    Sensorial saturation (SS) is a procedure in which touch, massage, taste, voice, smell, and sight compete with pain, producing almost complete analgesia during heel prick in neonates. SS is an apparently complex maneuvre, but when correctly explained it is easily learnt. In the present paper, we studied its feasibility, assessing whether a long training is really needed to achieve good results. We enrolled 66 consecutive babies and divided them randomly into 3 groups which received the following forms of analgesia: glucose plus sucking (A), SS performed by nurses (B), SS performed by mothers (C). We did not use perfume on the caregivers' hands, so that babies could smell the natural scent of the hands. We assessed pain level by the ABC scale. Median scores of groups A, B, and C were: 1 (0 to 6), 0 (0 to 4), and 0 (0 to 6), respectively. Mean scores were: 0.6, 0.6, and 1.7 and standard errors were 0.38, 0.22, and 0.32, respectively. Scores of groups B and C were significantly lower than that of A (P=0.03 and 0.006, respectively). No significant difference was found between values of scores of groups B and C. Even without the use of perfume on the hands, SS was effective as an analgesic maneuvre. It made no difference whether SS was performed by mothers who applied it for the first time or experienced nurses. SS is rapid to learn and any caregiver (mother, pediatrician or nurse) can effectively use it.

  2. An audit of morbidity and mortality of hospitalised neonates in neonatal care unit of a tertiary care hospital in Abbottabad.

    Science.gov (United States)

    Anis-ur-Rehman; Qureshi, Azhar Munir; Najeeb, Shehzad; Siddiqui, Tahir Saeed; Idris, Muhammad; Ahmad, Tausif

    2011-01-01

    Perinatal as well as neonatal mortality record in our country is one of the highest in the world. Home deliveries, lack of adequate facilities, poverty and lack of education are sonme of the important known causes. The present study was planned to determine neonatal mortality in Hazara. Hospital records of neonatal admissions at Ayub Teaching Hospital (ATH) Abbottabad from 1st January 2007-31st December 2007 were analysed retrospectively. Percent neonatal mortality was calculated from the record, along with the causes of neonatal mortality. A total of 1705 neonates were admitted in the study period at the department of neonatology Ayub Teaching Hospital Abbottabad. Out of 1,705 neonates 947 (56%) were males while 857 (44%) were females with a male to female ratio of 1.24:1 . Majority, 1,411 out of 1,705 (83%), of the neonates was admitted during the 1st week of their life, mean age 6 days. Asphyxia, sepsis and prematurity were the three most common causes of neonatal admissions contributing 27%, 26% and 24% respectively. Overall mortality was 11%. Neonatal mortality is an important contributing factor to infant mortality in Hazara Division. Majority of patients was admitted in the first week of life which indicates that good antenatal and natal care can reduce the mortality and morbidity of our neonates. Improvement in the prenatal, natal and nursery care as a whole can reduce the neonatal mortality in preterm as well as full term neonates.

  3. Neonatal bloodstream infections in a Ghanaian Tertiary Hospital

    DEFF Research Database (Denmark)

    Labi, Appiah-Korang; Obeng-Nkrumah, Noah; Bjerrrum, Stephanie

    2016-01-01

    Background: Diagnosis of bloodstream infections (BSI) in neonates is usually difficult due to minimal symptoms at presentation; thus early empirical therapy guided by local antibiotic susceptibility profile is necessary to improve therapeutic outcomes. Methods: A review of neonatal blood cultures...

  4. Hypertensive encephalopathy in a patient with neonatal thyrotoxicosis

    NARCIS (Netherlands)

    Pijnenburg, MWH; Zweens, MJ; Bink, MTE; Odink, RJ

    1999-01-01

    Neonatal hyperthyroidism may give rise to serious cardiovascular complications. A girl with severe thyrotoxicosis in whom hypertensive encephalopathy developed is described. Conclusion Neonatal thyrotoxicosis can give rise to hypertension and may lead to hypertensive encephalopathy.

  5. Ornithine aminotransferase deficiency: Diagnostic difficulties in neonatal presentation

    NARCIS (Netherlands)

    Cleary, M. A.; Dorland, L.; de Koning, T. J.; Poll-The, B. T.; Duran, M.; Mandell, R.; Shih, V. E.; Berger, R.; Olpin, S. E.; Besley, G. T. N.

    2005-01-01

    We describe two unrelated cases of ornithine aminotransferase (OAT) deficiency with rare neonatal presentation of hyperammonaemia. The diagnosis in the neonatal presentation of OAT deficiency is hampered as hyperornithinaemia is absent. Enzyme and mutation studies confirmed the diagnosis. OAT

  6. Short-acting sulfonamides near term and neonatal jaundice

    DEFF Research Database (Denmark)

    Klarskov, Pia; Andersen, Jon Trærup; Jimenez-Solem, Espen

    2013-01-01

    To investigate the association between maternal use of sulfamethizole near term and the risk of neonatal jaundice.......To investigate the association between maternal use of sulfamethizole near term and the risk of neonatal jaundice....

  7. Magnetic resonance appearance of adrenal hemorrhage in a neonate

    International Nuclear Information System (INIS)

    Willemse, A.P.P.; Feldberg, M.A.M.; Witkamp, T.D.; Coppes, M.J.; Kramer, P.P.G.

    1989-01-01

    The Magnetic Resonance (MR) appearance of adrenal hemorrhage in a neonate is described and compared with Ultrasound (US). The value of US studies in adrenal neonatal hemorrhage is well known. We present the MR appearance of this common condition. (orig.)

  8. Cerebral aspects of neonatal extracorporeal membrane oxygenation: a review.

    NARCIS (Netherlands)

    Mol, A.C. de; Liem, K.D.; Heijst, A.F.J. van

    2013-01-01

    Background: Neonatal extracorporeal membrane oxygenation (ECMO) is a lifesaving therapeutic approach in newborns suffering from severe, but potentially reversible, respiratory insufficiency, mostly complicated by neonatal persistent pulmonary hypertension. However, cerebral damage, intracerebral

  9. Motor performance after neonatal extracorporeal membrane oxygenation: a longitudinal evaluation

    NARCIS (Netherlands)

    Cammen-Zijp, M.H. van der; Janssen, A.J.W.M.; Raets, M.M.; Rosmalen, J. van; Govaert, P.; Steiner, K.; Gischler, S.J.; Tibboel, D.; Heijst, A.F.J. van; Ijsselstijn, H.; et al.,

    2014-01-01

    OBJECTIVE: To assess longitudinally children's motor performance 5 to 12 years after neonatal extracorporeal membrane oxygenation (ECMO) and to evaluate associations between clinical characteristics and motor performance. METHODS: Two hundred fifty-four neonatal ECMO survivors in the Netherlands

  10. Severe Neonatal Epileptic Encephalopathy and KCNQ2 Mutation: Neuropathological Substrate?

    NARCIS (Netherlands)

    Dalen Meurs-van der Schoor, Charlotte; van Weissenbruch, Mirjam; van Kempen, Marjan; Bugiani, Marianna; Aronica, Eleonora; Ronner, Hanneke; Vermeulen, R. Jeroen

    2014-01-01

    Background: Neonatal convulsions are clinical manifestations in a heterogeneous group of disorders with different etiology and outcome. They are attributed to several genetic causes. Methods: We describe a patient with intractable neonatal seizures who died from respiratory compromise during a

  11. Causes of Neonatal Mortality in the Neonatal Intensive Care Unit of Taleghani Hospital

    Directory of Open Access Journals (Sweden)

    Ali Hossein Zeinalzadeh

    2017-09-01

    Full Text Available Background: Neonatal survival is one of the most important challenges today. Over 99% of neonatal mortalities occur in the developing countries, and epidemiologic studies emphasize on this issue in the developed countries, as well. In this study, we attempted to investigate the causes of neonatal mortality in Taleghani Hospital, Tabriz, Iran.Methods: In this cross-sectional study, we studied causes of neonatal mortality in neonatal intensive care unit (NICU of Taleghani Hospital, Tabriz, Iran, during 2013-2014. Data collection was performed by the head nurse and treating physician using a pre-designed questionnaire. Most of the data were extracted from the neonatal records. Information regarding maternal underlying diseases and health care during pregnancy was extracted from mothers' records.Results: A total of 891 neonates were admitted to NICU of Taleghani Hospital of Tabriz, Iran, during 2013-2014, 68 (7.5% of whom died. Among these cases, 37 (%54.4 were male, 29 (29.4% were extremely low birth weight, and 16 (23.5% weighed more than 2.5 kg. The main causes of mortality were congenital anomalies (35.3%, prematurity (26.5%, and sepsis (10.3%, respectively.Conclusion: Congenital anomaly is the most common cause of mortality, and the pattern of death is changing from preventable diseases to unavoidable mortalities

  12. Risk Factors for Neonatal Mortality Among Very Low Birth Weight Neonates

    Directory of Open Access Journals (Sweden)

    Fatemeh Nayeri

    2013-05-01

    Full Text Available The objective of this study is to determine risk factors causing increase in very low birth way (VLBW neonatal mortality. The medical files of all neonates weighing ≤1500 g, born in Vali-e-Asr hospital (2001-2004 were studied. Two groups of neonates (living and dead were compared up to the time of hospital discharge or death. A total of 317 neonates were enrolled. A meaningful relationship existed between occurrence of death and low gestational age (P=0.02, low birth weight, lower than 1000 g (P=0.001, Apgar score <6 at 5th minutes (P=0.001, resuscitation at birth (P=0.001, respiratory distress syndrome (P=0.001 need for mechanical ventilation (P=0.001, neurological complications (P=0.001 and intraventricular hemorrhage (P=0.001. Regression analysis indicated that each 250 g weight increase up to 1250 g had protective effect, and reduced mortality rate. The causes of death of those neonates weighting over 1250 g should be sought in factors other than weight. Survival rate was calculated to be 80.4% for neonates weighing more than 1000 g. The most important high risk factors affecting mortality of neonates are: low birth weight, need for resuscitation at birth, need for ventilator use and intraventricular hemorrhage.

  13. Season of birth shapes neonatal immune function

    DEFF Research Database (Denmark)

    Thysen, Anna Hammerich; Rasmussen, Morten Arendt; Kreiner-Møller, Eskil

    2016-01-01

    Birth season has been reported to be a risk factor for several immune-mediated diseases. We hypothesized that this association is mediated by differential changes in neonatal immune phenotype and function with birth season. We sought to investigate the influence of season of birth on cord blood...... immune cell subsets and inflammatory mediators in neonatal airways. Cord blood was phenotyped for 26 different immune cell subsets, and at 1 month of age, 20 cytokines and chemokines were quantified in airway mucosal lining fluid. Multivariate partial least squares discriminant analyses were applied...... to determine whether certain immune profiles dominate by birth season, and correlations between individual cord blood immune cells and early airway immune mediators were defined. We found a birth season-related fluctuation in neonatal immune cell subsets and in early-life airway mucosal immune function...

  14. Digital radiography in intensive neonatal care

    International Nuclear Information System (INIS)

    Merlo, L.; Bighi, S.; Cervi, P.N.; Lupi, L.; Vita, G.

    1991-01-01

    The authors report their experience with the routinary use of a computerized digital radiography system in Intensive Neonatal Care department. The conventional screen-film system is replaced by photostimulable imaging plates, which are scanned during processing by a laser providing the digital image. The latter is subsequently processable on high-resolution monitors. Over a 6-month period 86 examinations were performed with this method in Intensive Neonatal Care; good technical results were obtained. The use of digital radiography in intensive neonatal care is extremely promising for it allows high-quality images to be obtained, and radiation dose and number of acquisitions to be reduced. Finally, work stations allow both selective visualization of different body structures and their magnification

  15. Drug binding properties of neonatal albumin

    DEFF Research Database (Denmark)

    Brodersen, R; Honoré, B

    1989-01-01

    Neonatal and adult albumin was isolated by gel chromatography on Sephacryl S-300, from adult and umbilical cord serum, respectively. Binding of monoacetyl-diamino-diphenyl sulfone, warfarin, sulfamethizole, and diazepam was studied by means of equilibrium dialysis and the binding data were analyzed...... by the method of several acceptable fitted curves. It was found that the binding affinity to neonatal albumin is less than to adult albumin for monoacetyl-diamino-diphenyl sulfone and warfarin. Sulfamethizole binding to the neonatal protein is similarly reduced when more than one molecule of the drug is bound...... per albumin molecule, and binding of the first sulfamethizole molecule is possibly reduced as well. Diazepam binds with equal affinity to the fetal and adult proteins. Among the two main albumin drug-binding functions, for warfarin and diazepam, the former is thus compromised in the newborn infant...

  16. Endocardial Pacemaker Implantation in Neonates and Infants

    Directory of Open Access Journals (Sweden)

    Canan Ayabakan

    2006-04-01

    Full Text Available Transvenous pacemaker lead implantation is the preferred method of pacing in adult patients. Lead performance and longevity are superior and the implantation approach can be performed under local anaesthetic with a very low morbidity. In children, and especially in neonates and infants, the epicardial route was traditionally chosen until the advent of smaller generators and lead implantation techniques that allowed growth of the child without lead displacement. Endocardial implantation is not universally accepted, however, as there is an incidence of venous occlusion of the smaller veins of neonates and infants with concerns for loss of venous access in the future. Growing experience with lower profile leads, however, reveals that endocardial pacing too can be performed with low morbidity and good long-term results in neonates and infants.

  17. Neonatal herpes in Denmark 1977-1991

    DEFF Research Database (Denmark)

    Fonnest, G; de la Fuente Fonnest, I; Weber, Tom

    1997-01-01

    BACKGROUND: To prevent neonatal herpes, women in labor with genital herpes infection are still delivered by Cesarean section. This policy is currently being debated. The aim of this study was to determine the incidence of neonatal herpes in Denmark and to evaluate the prevention practice. METHODS......: All newborns with perinatal herpes in Denmark 1977-1991 were identified from hospital-records. RESULTS: Of 862,298 deliveries 136 possible cases were found but only 30 (22%) fulfilled the criteria for neonatal herpes. The incidence increased from 2.36 to 4.56 per 100,000 live births during 1977......-1984 through 1984-1991. Three mothers (10%) had recurrent herpes at delivery, three (10%) had primary herpes, and five (17%) had oral herpes. Seven infants (23%) were delivered by Cesarean section. Nine (30%) only had cutaneous herpes, four (13%) had CNS herpes, nine (30%) had disseminated disease. Six (20...

  18. [Neonatal adrenal hematoma: various modes of presentation].

    Science.gov (United States)

    Fadil, F-Z; Lehlimi, M; Chemsi, M; Habzi, A; Benomar, S

    2014-09-01

    Neonatal adrenal hematoma is a rare condition, most frequently caused by trauma. We report three cases of adrenal hematoma admitted to the Neonatology and Neonatal Intensive Care Unit in the A. Harouchi Children's Hospital, the Ibn Rushd University Hospital in Casablanca, Morocco, over a 2-year period from January 2011 to December 2012. The average age of these patients was 5 days. The clinical presentations were diverse; the most common manifestations were intense jaundice in one case, acute adrenal insufficiency in one case, and severe anemia in the other case. Abdominal ultrasonography was used to confirm the diagnosis and monitor adrenal hemorrhage in all the patients. Analysis of clinical, laboratory, and ultrasonography data showed a favorable prognosis in all the patients. Based on these observations, we discuss the risk factors, clinical presentations, progression and management of neonatal adrenal hemorrhage. Copyright © 2014. Published by Elsevier SAS.

  19. Neonatal listeriosis followed by nosocomial infection

    Directory of Open Access Journals (Sweden)

    M Dinic

    2013-01-01

    Full Text Available Neonatal listeriosis is widely reported, but this is the first case reported in Serbia. A newborn developed respiratory distress syndrome 2 hours after delivery and was admitted to the neonatal intensive care unit. Initial empirical therapy was inappropriate. Consequently, on the second day, the patient developed meningitis. Listeria monocytogenes was isolated from the tracheal aspirate, blood, periumbilical swab, and cerebrospinal fluid. After bacteriology results, the therapy was changed to ampicillin and meropenem. On day 11 of hospitalization, the patient developed nosocomial infection due to multidrug-resistant Stenotrophomonas maltophilia. Since therapeutic options were limited, the patient was treated with ciprofloxacin. After 26 days of hospitalization the patient showed complete recovery and was discharged with no apparent sequelae. This case showed the importance of bacteriological examination in cases of infections caused by uncommon organisms. Pediatricians should be aware of the neonatal infection caused by Stenotrophomonas maltophilia.

  20. The Neurodevelopmental Impact of Neonatal Morphine Administration

    Directory of Open Access Journals (Sweden)

    Stephanie Attarian

    2014-04-01

    Full Text Available Medical management of newborn infants often necessitates recurrent painful procedures, which may alter nociceptive pathways during a critical developmental period and adversely effect neuropsychological outcomes. To mitigate the effects of repeated painful stimuli, opioid administration for peri-procedural analgesia and ICU (intensive care unit sedation is common in the NICU (neonatal intensive care unit. A growing body of basic and animal evidence suggests potential long-term harm associated with neonatal opioid therapy. Morphine increases apoptosis in human microglial cells, and animal studies demonstrate long-term changes in behavior, brain function, and spatial recognition memory following morphine exposure. This comprehensive review examines existing preclinical and clinical evidence on the long-term impacts of neonatal pain and opioid therapy.

  1. Thymic size in preterm neonates: a sonographic study

    DEFF Research Database (Denmark)

    Jeppesen, Dorthe Lisbeth; Hasselbalch, H; Poulsen, Susanne Dam

    2003-01-01

    AIM: To assess the variation in size of the thymus in vivo in preterm neonates and to identify relations between thymic size and gestational age (GA), birthweight, occurrence of postnatal infections and maternal alcohol and tobacco intake during pregnancy. METHODS: Eighty preterm neonates with a GA...... neonates. A normal range for Ti in preterm neonates has been established. The sonographic method is a safe and effective technique for measuring the size of the thymus in preterm infants....

  2. Two cases of neonatal adrenal hemorrhage presenting with persistent jaundice.

    Science.gov (United States)

    Ruffini, E; De Petris, L; Zorzi, G; Paoletti, P; Mambelli, G; Carlucci, A

    2013-01-01

    The adrenal hemorrhage is a relatively rare event in newborns but must be considered in the presence of a persistent unexplained jaundice, especially in presence of predisposing factors. Serial ultrasonography is the modality of choice for initial diagnosis and follow-up of neonatal adrenal hemorrhage. We report two cases of neonatal adrenal hemorrhage presenting with persistent jaundice. The causes of the neonatal adrenal hemorrhages were a difficult vaginal delivery in macrosomic infant and a neonatal infection.

  3. Factors associated with hospitalization during neonatal period.

    Science.gov (United States)

    Quaresma, Maria Emília; Almeida, Ana Claudia; Méio, Maria Dalva B; Lopes, José Maria A; Peixoto, Maria Virgínia M

    2017-09-22

    Neonatal mortality rate remains high in Brazil. The aim of the study was to evaluate the factors associated with hospitalization during the neonatal period. Cross-sectional study conducted in ten randomly-selected Brazilian municipalities. Mothers of children under the age of 6 who were carrying the child's health booklet were interviewed in basic health units. Hierarchical modeling of sociodemographic factors (distal level), maternal variables (intermediate level), and features of the newborns (proximal level) was performed. The variables that presented a value of p≤0.20 in the univariate analysis were included in the multivariate hierarchical modeling process, with block input according to their hierarchical level. The variables with a value of p≤0.05 were considered statistically significant. 2022 mothers were included, allowing 258 (12.8%) cases of hospitalization during the neonatal period to be identified, of which 49.7% were male, 8.9% were premature, and 8.4% had low birth weight (<2500g). After analysis by hierarchical approach, factors associated with neonatal hospitalization (prevalence ratio [95% CI]) included: history of prematurity (2.03 [1.25-3.30], p=0.004), gestational risk (2.02 [1.46-2.79], p<0.001); intrapartum risk (3.73 [2.33-5.99], p<0.001); gestational age (32-37 weeks: 13.83 [1.74-110.09], p=0.01; and<32 weeks: 25.03 [3.03-207.12], p=0.003); low birth weight (3.95 [2.56-6.09], p<0.001), and male gender (1.44 [1.09-1.98], p=0.01). Factors associated with maternal and neonatal history are associated with neonatal hospitalization. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  4. Neonates with reduced neonatal lung function have systemic low-grade inflammation

    DEFF Research Database (Denmark)

    Chawes, Bo L.K.; Stokholm, Jakob; Bønnelykke, Klaus

    2015-01-01

    , TNF-α, and CXCL8, confirmed a uniform upregulated inflammatory profile in children with reduced forced expiratory volume at 0.5 seconds (P = .02). Adjusting for body mass index at birth, maternal smoking, older children in the home, neonatal bacterial airway colonization, infections 14 days before...... of the Copenhagen Prospective Study on Asthma in Childhood2000 birth cohort who had completed neonatal lung function testing at age 4 weeks. Associations between neonatal lung function indices and inflammatory biomarkers were investigated by conventional statistics and unsupervised principal component analysis...

  5. The Tuning of Human Neonates' Preference for Speech

    Science.gov (United States)

    Vouloumanos, Athena; Hauser, Marc D.; Werker, Janet F.; Martin, Alia

    2010-01-01

    Human neonates prefer listening to speech compared to many nonspeech sounds, suggesting that humans are born with a bias for speech. However, neonates' preference may derive from properties of speech that are not unique but instead are shared with the vocalizations of other species. To test this, thirty neonates and sixteen 3-month-olds were…

  6. Short Report: Neonatal cleft lip repair in babies with breastfeeding ...

    African Journals Online (AJOL)

    Non-syndromic term neonates referred to Polokwane Mankweng Hospital Complex (PMHC) from primary and secondary hospitals with CLP and difficulties in breastfeeding were prospectively admitted to the neonatal unit. Our breastfeeding team supervised and assisted them with breastfeeding. The neonates whose ...

  7. Neonatal transport practices in Ibadan, Nigeria | Abdulraheem | Pan ...

    African Journals Online (AJOL)

    Introduction: Neonatal transport involves moving sick neonates in optimal conditions to ensure good outcomes. It is well organized in most developed countries but receives little attention in developing countries where the highest burden of neonatal mortality exists and a large number of newborns require referrals daily for ...

  8. Prevalence of neonatal septicaemia in the University of Port ...

    African Journals Online (AJOL)

    PROF. EZECHUKWU

    2013-04-30

    Apr 30, 2013 ... Abstract. Background: Septicaemia is a major cause of morbidity and mortality in the neonatal period. Early detection of neonatal septicaemia is often hampered by its subtle and non- specific symptoms and signs thus a high index of suspicion is needed. Objectives: To determine the prevalence of neonatal.

  9. Delivery practices, hygiene, birth attendance and neonatal infections ...

    African Journals Online (AJOL)

    Background: Drawing attention to home birth conditions and subsequent neonatal infections is a key starting point to reducing neonatal morbidity which are a main cause of mortality in sub-Saharan Africa. Objectives: To determine the proportion of respiratory, ophthalmic, and diarrhoeal infections in neonates; the proportion ...

  10. Neonatal sepsis: Highlighting the principles of diagnosis and ...

    African Journals Online (AJOL)

    Neonatal sepsis is a clinical syndrome consisting of nonspecific symptoms and signs of infection, accompanied by a bacteraemia in the first 28 days of life. The risk of neonatal sepsis and death increases with decreasing birth weight and gestational age. South African data have reported the overall incidence of neonatal ...

  11. An audit of some health facilities and equipment for neonatal ...

    African Journals Online (AJOL)

    Background: Neonatal Mortality rates continue to be high in spite of the general decline in under-5 mortality rates in Nigeria. Available evidence has shown that the availability of a skilled birth attendant and equipment for basic neonatal resuscitation is necessary for the prevention of early neonatal death which accounts for ...

  12. Prevalence of neonatal septicaemia in the University of Port ...

    African Journals Online (AJOL)

    Background : Septicaemia is a major cause of morbidity and mortality in the neonatal period. Early detection of neonatal septicaemia is often hampered by its subtle and nonspecific symptoms and signs thus a high index of suspicion is needed. Objectives: To determine the prevalence of neonatal sept ic a emia , ident i fy ...

  13. Severe hyperglycaemia due to neonatal sepsis - A case report ...

    African Journals Online (AJOL)

    Neonatal sepsis is a clinical syndrome characterized by signs and symptoms of infection with or without accompanying bacteremia in the first month of life. The clinical signs of neonatal sepsis are neither specific nor uniform. Neonatal sepsis may present with fever, hypotonia, respiratory distress, apnea and hyperglycaemia.

  14. Prevalence and factors associated with neonatal sepsis among ...

    African Journals Online (AJOL)

    TOSHIBA

    Abstract. Background: Neonatal sepsis contributes significantly to neonatal mortality. This study was carried out to determine the prevalence and factors associated with neonatal sepsis in Dar es Salaam, Tanzania. Methods: A hospital based cross-sectional study was conducted at Mwananyamala and Temeke hospitals in.

  15. Trends in profiles of bacteria causing neonatal sepsis in Central ...

    African Journals Online (AJOL)

    Developing countries suffer from a huge burden of neonatal sepsis. Neonatal mortality and long term sequelae or morbidity portends huge costs for the poor Nigerian economy. We identified trends in bacterial agents implicated in neonatal sepsis and their antibiotic susceptibility profiles at the National Hospital Abuja over ...

  16. Effect of fetal brainsparing on the early neonatal cerebral circulation

    NARCIS (Netherlands)

    Scherjon, S. A.; Oosting, H.; Kok, J. H.; Zondervan, H. A.

    1994-01-01

    The effect of antenatal brainsparing on subsequent neonatal cerebral blood flow velocity (CBFV) was studied in very preterm infants. CBFV was determined, using a pulsed Doppler technique, both in the fetal and neonatal period. Neonatally, blood pressure and transcutaneous carbon dioxide tension

  17. Phototherapy and DNA changes in full term neonates with ...

    African Journals Online (AJOL)

    Objectives: Assess the effect(s) of phototherapy on DNA and on the rate of apoptosis in full term neonates with hyperbilirubinemia. It comprised 35 neonates with indirect hyperbilirubinemia who received phototherapy for 48h, and 20 apparently healthy full term neonates with normal serum bilirubin level, as a control group.

  18. Upper GI bleeding among neonates admitted to Mulago Hospital ...

    African Journals Online (AJOL)

    These conditions are risk factors for upper GI bleeding (UGIB) in sick neonates. UGIB is associated with poor neonatal outcomes such as prolonged hospitalisation and poor weight gain. The magnitude of UGIB and its contribution to neonatal morbidity has not been described in most low income countries. Objective: To ...

  19. Neutrophil CD64 in early-onset neonatal sepsis

    African Journals Online (AJOL)

    EL-HAKIM

    new generation of tests to detect early systemic infections measures the up ... culture. Results: Neutrophil CD64 expression was increased significantly in neonates with neonatal sepsis than controls (p=0.001). Cases with history of premature rupture of ..... Khader Y, Amarin Z, Daoud A. Diagnostic markers for neonatal ...

  20. Mannose-binding lectin deficiency in preterm neonates

    African Journals Online (AJOL)

    EL-HAKIM

    deficiency and neonatal sepsis and whether measuring MBL levels might be used to identify which neonates are prone to infections. Keywords: Mannose binding lectin, neonates, preterm, sepsis. Mohamed S. El-. Shimi,. Soha M. .... sepsis or pneumonia, even after correction for birth- weight, because of an insufficient ...

  1. 21 CFR 880.5410 - Neonatal transport incubator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Neonatal transport incubator. 880.5410 Section 880.5410 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Devices § 880.5410 Neonatal transport incubator. (a) Identification. A neonatal transport incubator is a...

  2. Causes of neonatal mortality two years before and after the ...

    African Journals Online (AJOL)

    Results: The highest proportion of neonatal deaths pre and post policy implementation were preterm delivery and low birth weight complications, birth asphyxia and trauma, neonatal infections and congenital anomalies. Conclusion: There are no significant changes in the avoidable causes of neonatal deaths in Kenyan ...

  3. Neonatal Mortality and Perinatal Risk Factors in Rural Southwestern ...

    African Journals Online (AJOL)

    Asphyxia accounted for 3(9.4%) deaths; neonatal tetanus, congenital abnormality and diarrhoea were responsible for one (3.1%) death each. Cause of death was unclassified in many early neonatal deaths particularly those which occurred at home. Predictors of neonatal death included LBW {RR=4.7 (1.7-13.1) p=0.03}, ...

  4. Morbidity and mortality pattern of neonates admitted into the Special ...

    African Journals Online (AJOL)

    Background: The neonatal mortality rate in Nigeria is amongst the highest globally and is mainly due to preventable causes such as neonatal sepsis, perinatal asphyxia and prematurity. Objective: To determine the morbidity and mortality pattern of neonates admitted into the Special Care Baby Unit (SCBU) of the University ...

  5. Serum procalcitonin as an early marker of neonatal sepsis | Ballot ...

    African Journals Online (AJOL)

    Background. It has recently been suggested that procalcitonin (PCT) is of value in the diagnosis of neonatal sepsis, with varying results. This study was to evaluate the role of PCT as a single early marker of neonatal sepsis. Setting. Neonatal Unit, Johannesburg Hospital, and Microbiology Laboratory, National Health ...

  6. pattern, indications and review of complications of neonatal blood ...

    African Journals Online (AJOL)

    newborns. This study evaluates the blood transfusion indications and patterns in neonates admitted to neonatal wards of University College Hospital, Ibadan,. Nigeria. ... in the newborn particularly due to the reduced marrow activity in the neonatal period. Despite .... increasing the risk or transfusion-induced arrhythmias.

  7. Neonatal perforated Amyand's hernia presenting as an enterocutaneous scrotal fistula

    Directory of Open Access Journals (Sweden)

    Antonios Panagidis

    2015-07-01

    Full Text Available Perforation of the vermiform appendix in a septic neonate with an Amyand's hernia resulted in the formation of a scrotal enterocutaneous fistula. In conclusion from this exceptional complication, active parental awareness for any neonatal scrotal swelling is required, and an early operative policy for the neonatal inguinal hernia is significant.

  8. Gardnerella vaginalis bacteremia in a premature neonate.

    Science.gov (United States)

    Amaya, Rene A; Al-Dossary, Fahad; Demmler, Gail J

    2002-01-01

    Gardnerella vaginalis is a normal component of the human vaginal flora and commonly associated with bacterial vaginosis. Invasive infection in obstetrical patients due to G. vaginalis has also been reported. In the pediatric age range, infection due to G. vaginalis is extremely rare and limited to neonates. We describe a 23-week premature infant with G. vaginalis bacteremia and review the characteristics of neonatal G. vaginalis infection reported in the literature. Antibiotic susceptibility testing of G. vaginalis isolates has shown that penicillin, ampicillin, erthromycin, clindamycin, and vancomycin are effective in vitro.

  9. Water immersion in neonatal bereavement photography.

    Science.gov (United States)

    Duffey, Heather

    2014-01-01

    Water immersion in neonatal bereavement photography is a new technique intended to enhance the quality of the photographs provided to families following their loss. Water immersion appears to be most helpful following a second trimester fetal demise. This technique can be used by nurses, professional photographers and others in addition to more traditional neonatal bereavement photography. It does not require special skills or equipment and can be implemented in virtually any perinatal setting. The enhanced quality of photographs produced with this method can potentially provide a source of comfort to grieving families. © 2014 AWHONN.

  10. A case report of neonatal scabies

    Directory of Open Access Journals (Sweden)

    Anil Kumar Singhal

    2017-01-01

    Full Text Available Scabies is commonly seen worldwide, in its usual classic form when afflicting older children and adults. However, neonatal scabies is described as its own entity in the literature. We present a case of a 4-week old infant with a generalized papulopustular, vesicular, and crusted rash who was diagnosed with scabies. We contrast the differing clinical features of neonatal and classic scabies, describe possible mimickers of this diagnostic dilemma, and review current treatment options available for scabies in this very young age group.

  11. Acute suppurative neonatal parotitis: Case report.

    LENUS (Irish Health Repository)

    Khan, Sardar U

    2012-02-01

    Neonatal suppurative parotitis is very rare. One review of the English-language literature spanning 35 years found only 32 cases. Most cases are managed conservatively with antibiotic therapy; early antibiotic treatment reduces the need for surgery. The predominant organism is Staphylococcus aureus. We report a new case of neonatal suppurative parotitis in a 3-week-old boy. The patient was diagnosed on the basis of parotid swelling, a purulent exudate from a Stensen duct, and the growth of pathogenic bacteria in culture. He responded well to 9 days of intravenous antibiotic therapy. We also discuss the microbiologic and clinical patterns of this disease.

  12. NOMID - a neonatal syndrome of multisystem inflammation

    Energy Technology Data Exchange (ETDEWEB)

    Torbiak, R.P.; Cockshott, W.P. (Chedoke-McMaster Hospitals, Hamilton, ON (Canada). Dept. of Radiology); Dent, P.B. (Chedoke-McMaster Hospitals, Hamilton, ON (Canada). Dept. of Pediatrics)

    1989-08-01

    Neonatal onset multisystem inflammatory disease is a rare disorder first described by Lorber in 1973. An additional 29 cases have been recorded. Two patients are described here, one with a 17 year follow-up. The typical features are a rash, fever, adenopathy, hepatosplenomegaly, and a severe, deforming arthropathy predominantly affecting large joints. The most striking feature is the onset in the neonatal period. Other associated features include inflammation, chronic meningitis, anemia, and persistent leukocytosis. Most, if not all, patients develop bizarre epiphyseal radiographic findings that are virtually pathognomonic. This disease is distinct from Still disease. (orig.).

  13. Staphylococcal bullous impetigo in a neonate.

    Science.gov (United States)

    Duggal, Shalini Dewan; Bharara, Tanisha; Jena, Pragnya Paramita; Kumar, Avinash; Sharma, Abha; Gur, Renu; Chaudhary, Sanjay

    2016-07-16

    An otherwise healthy, full-term neonate presented at day 15 of life to the pediatric emergency with generalized papulo-pustular rash for 2 d. This was finally diagnosed as bullous impetigo caused by Staphylococcus aureus (S. aureus). The skin lesions decreased significantly after starting antibiotic therapy and drainage of blister fluid. There was no recurrence of the lesions on follow-up. This case of generalized pustular eruption due to S. aureus in a neonate is reported, as it poses a diagnostic dilemma and can have serious consequences if left untreated.

  14. Radiologic evaluation of neonatal and childhood hypertension

    International Nuclear Information System (INIS)

    Amour, T.S.; Siegel, M.J.

    1986-01-01

    The authors reviewed the radiographic findings in 40 neonates and 90 children and adolescents with hypertension. In neonates the common causes of secondary hypertension were renal vascular thrombosis (33%), polycystic kidney disease (25%), and obstructive uropathy (17%). US and renal scans were the most useful studies and yielded diagnostic information in approximately 70% of cases. Surgically correctable hypertension was found in almost half the patients. In patients over 1 year of age, the common causes of hypertension were medical renal disease (50%) and renovascular hypetension (15%). Urography, scintigraphy, and arteriography played a crucial role in their evaluation

  15. Congenital anomalies of the neonatal head

    International Nuclear Information System (INIS)

    Benson, C.B.; Teele, R.L.; Dobkin, G.R.; Fine, C.; Bundy, A.L.; Doubilet, P.M.

    1987-01-01

    US is a noninvasive modality that has proved highly valuable in the assessment of congenital intracranial anomalies in the neonate. The patterns of malformation must be familiar to those who obtain and interpret neonatal cranial sonograms. The authors present a variety of cases of congenital anomalies studied with US, including agenesis of the corpus callosum, Dandy-Walker malformation, occipital enecphalocele, congenital hydrocephalus, vein of Galen aneurysm, hydranencephaly, holoprosencephaly, absence of the septum pellucidum, schizencephaly, and hypoplastic cerebellum. Correlation with other radiographic modalities and pathologic follow-up, available in a majority of cases, is included

  16. Is neonatal group B streptococcal infection preventable?

    LENUS (Irish Health Repository)

    Azam, M

    2011-05-01

    Early onset group B streptococcal (EOGBS) infection causes significant neonatal morbidity and mortality. We determined the incidence of EOGBS at Galway University Hospital (GUH) and examined any "missed opportunities" for preventing neonatal infection between 2004 and 2009. Our obstetric approach is risk-based. The incidence was 0.45\\/1,000 live-births; one death and one with neurological sequelae. A single mother received IAP; however we could not determine any potential for reducing cases of EOGBS by improving current IAP usage.

  17. Genes and environment in neonatal intraventricular hemorrhage.

    Science.gov (United States)

    Ment, Laura R; Ådén, Ulrika; Bauer, Charles R; Bada, Henrietta S; Carlo, Waldemar A; Kaiser, Jeffrey R; Lin, Aiping; Cotten, Charles Michael; Murray, Jeffrey; Page, Grier; Hallman, Mikko; Lifton, Richard P; Zhang, Heping

    2015-12-01

    Emerging data suggest intraventricular hemorrhage (IVH) of the preterm neonate is a complex disorder with contributions from both the environment and the genome. Environmental analyses suggest factors mediating both cerebral blood flow and angiogenesis contribute to IVH, while candidate gene studies report variants in angiogenesis, inflammation, and vascular pathways. Gene-by-environment interactions demonstrate the interaction between the environment and the genome, and a non-replicated genome-wide association study suggests that both environmental and genetic factors contribute to the risk for severe IVH in very low-birth weight preterm neonates. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. EVALUATION OF CARDIAC MURMURS IN NEONATES

    Directory of Open Access Journals (Sweden)

    Chakravathy

    2015-10-01

    Full Text Available BACKGROUND: Cardio vascular malformations are the most common congenital malformations. Early recognition of congenital heart disease is important in the neonatal period, as many of them may be fatal if undiagnosed. AIM : To study the epidemiology of neonatal cardiac murmurs. To identify clinical characteristics which differentiates pathological murmur from functional murmurs to assess the reliability of clinical evaluation in diagnosing congenital heart diseas e? METHODS : The study population included all neonates admitted in a Hospital in Visakhapatnam to the NICU, postnatal ward, attending pediatric OPD and were detected to have cardiac murmurs. It was a cross sectional study over a period of 16 months. A clinical diagnosis was made based on history and clinical examination. Then Chest X ray and ECG were done in symptomatic infants. Echo cardiography was done in all neonates for confirmation of diagnosis, the neonates were again examined daily till they were in hospital and during the follow up visit at 6 weeks. RESULTS : A total of 61 neonates were included and was conducted over a period of 16 months . T he incidence of cardiac murmurs among intramural neonates was 13.5 for 1000 live births. Most frequent symptom was fast breathing in 10[16.4%] cases. VSD was the most common diagnosis clinically in 19[31.47%] babies. The most frequent diagnosis was acyanotic complex congenital heart disease, Only intra mural neonates were considered for the incidence of murmurs and the incidence of cardiac murmurs among them babies was 13.5 for 1000 live in 23[37.7%] cases followed by 10[16.4%] cases each of VSD and ASD respectively. Overall in our study 73.77% [45 cases] of the murmurs were diagnosed correctly and confirmed by Echocardiography. INTERPRETATIONS & CONCLUSIONS: 1. It is possible to make clinical diagnosis in many cases of congenital heart diseases. 2. The functional murmurs could be differentiated from those arising from structural heart

  19. The Neonatal Pain, Agitation and Sedation Scale and the bedside nurse's assessment of neonates.

    Science.gov (United States)

    Hillman, B A; Tabrizi, M N; Gauda, E B; Carson, K A; Aucott, S W

    2015-02-01

    To determine the reliability of an objective measure of pain, agitation and sedation using the Neonatal Pain, Agitation and Sedation Scale (N-PASS) compared with nursing bedside assessment. Neonates admitted in neonatal intensive care unit over a 6-month period were eligible. Pain and sedation were assessed with N-PASS, and a subjective questionnaire was administered to the bedside nurse. A total of 218 neonates were eligible (median: gestational age 34.6 weeks, age at assessment 7 days). N-PASS pain score correlated significantly with both nurses' pain score (Spearman coefficient (r)=0.37; Ppain, agitation and sedation in this broad population and provides a quantitative assessment of subjective descriptions that often drives patient therapy.

  20. Intracranial complications of Serratia marcescens infection in neonates.

    Science.gov (United States)

    Madide, Ayanda; Smith, Johan

    2016-03-15

    Even though Serratia marcescens is not one of the most common causes of infection in neonates, it is associated with grave morbidity and mortality. We describe the evolution of brain parenchymal affectation observed in association with S. marcescens infection in neonates. This retrospective case series details brain ultrasound findings of five neonates with hospital-acquired S. marcescens infection. Neonatal S. marcescens infection with or without associated meningitis can be complicated by brain parenchymal affectation, leading to cerebral abscess formation. It is recommended that all neonates with this infection should undergo neuro-imaging more than once before discharge from hospital; this can be achieved using bedside ultrasonography.

  1. Neonatal Sepsis”: Bacteria & their Susceptibility Pattern towards Antibiotics in Neonatal Intensive Care Unit

    OpenAIRE

    Sharma, Chandra Madhur; Agrawal, Ravi Prakash; Sharan, Hariom; Kumar, Bijay; Sharma, Deepti; Bhatia, Santokh Singh

    2013-01-01

    Background: Neonatal sepsis is one of the most common causes of neonatal mortality and morbidity, particularly in the developing countries. Its causative bacteria and their respective sensitivity patterns are different in each hospital and region. The objective of this study was to determine the causative bacteria and pattern of susceptibility to antibiotics in NICU of a tertiary care centre, which in turn may help in implementation of empirical therapy.

  2. Association of early caffeine administration and neonatal outcomes in very preterm neonates.

    Science.gov (United States)

    Lodha, Abhay; Seshia, Mary; McMillan, Douglas D; Barrington, Keith; Yang, Junmin; Lee, Shoo K; Shah, Prakesh S

    2015-01-01

    Advantages of caffeine for apnea of prematurity have prompted clinicians to use it prophylactically even before apnea. To determine the effect of early initiation of caffeine therapy on neonatal outcomes in very preterm infants born in Canada. A retrospective cohort study was conducted. Patients included preterm neonates born at less than 31 weeks' gestation admitted to 29 participating Canadian Neonatal Network neonatal intensive care units between January 1, 2010, and December 31, 2012. Neonates who received caffeine were divided into 2 groups based on the following timing of caffeine initiation: within the first 2 days after birth (early) and on or after the third day following birth (late). A composite of death or bronchopulmonary dysplasia. Of 5517 eligible neonates, 5101 (92.5%) received caffeine (early: 3806 [74.6%]; late: 1295 [25.4%]). There was no difference in weight or gestational age at birth between the groups. Neonates in the early group had decreased odds of a composite outcome of death or bronchopulmonary dysplasia (adjusted odds ratio [AOR], 0.81; 95% CI, 0.67-0.98) and patent ductus arteriosus (AOR, 0.74; 95% CI, 0.62-0.89). There was no difference between the groups in mortality (AOR, 0.98; 95% CI, 0.70-1.37), necrotizing enterocolitis (AOR, 0.88; 95% CI, 0.65-1.20), severe neurological injury (AOR, 0.80; 95% CI, 0.63-1.01), or severe retinopathy of prematurity (AOR, 0.78; 95% CI, 0.56-1.10). In very preterm neonates, early (prophylactic) caffeine use was associated with a reduction in the rates of death or bronchopulmonary dysplasia and patent ductus arteriosus. No adverse impact on any other outcomes was observed.

  3. neonatal bacterial meningitis in Cape Town children

    African Journals Online (AJOL)

    neonatal bacterial meningitis in Cape Town children. Bacterial meningitis is a major cause of childhood morbidity and mortality in South Africa. However, comprehensive regional or national epidemiological data, essential for rational public health interventions, are lacking. The purpose of this 1-year prospective study, from.

  4. State of the art. Neonatal respiratory failure.

    Science.gov (United States)

    Parker, L A

    1999-12-01

    Advances in ventilatory management of respiratory distress in the newborn have made dramatic strides during the last decade. Innovative treatments such as PTV, HFV, liquid ventilation, and NO therapy are just beginning to have an impact on the care of neonates in the NICU. These treatment modalities should continue to have an effect on the care of the newborn infant well into the future.

  5. Resuscitation of the Newborn: AN IMPROVED NEONATAL ...

    African Journals Online (AJOL)

    This places a unique demand on a resuscitator which can be used safely at birth. It must be able to achieve such pressures without injuring the lungs; yet once the FRC has been established, it must be able to adapt itself to the differing ventilatory requirements, without altering the blood chemistry of the neonate. S. Afr. Med.

  6. Nursing clinical handover in neonatal care.

    Science.gov (United States)

    Brown, Janie; Sims, Shanette

    2014-01-01

    Clinical handover ensures continuity of care, providing the opportunity to transfer responsibility and accountability for the care of a patient from nurse to nurse. The aim of this study was to examine afternoon nursing clinical handover from the perspective of nurses, exploring the quality of information, the interactions and support, the efficiency and the involvement of parents in a private neonatal unit. An exploratory, descriptive, prospective quantitative survey with qualitative elements was undertaken using The Handover Evaluation Scale (O'Connell, MacDonald, & Kelly, 2008). All nurses working in the Neonatal unit who attend afternoon handover, were invited to participate in the study (N = 22), with N = 16 responses received. The quantitative and qualitative results indicate that the quality of the information handed over in neonatal care units can be maintained despite intrinsic limitations. Additionally, high levels of support and interaction between nursing staff in this stressful practice environment occur during the handover period. Given the vulnerability of neonates it is important that accurate information is efficiently handed over. In order to do this distractions should be minimised. Finally, parental involvement in handover should be actively encouraged whenever feasible.

  7. Nosocomial infections in neonatal intensive care units

    African Journals Online (AJOL)

    owner

    2012-08-24

    Aug 24, 2012 ... hospitalization, as well as increased cost of treatment in both developed and resource-poor countries.2 .... searchers- who conducted logistic regression analysis of identified risk factors associated with ... A historical perspective of the epidemiology of patho- gens responsible for neonatal nosocomial ...

  8. Neonatal hypoglycaemia: prevalence and clinical manifestations in ...

    African Journals Online (AJOL)

    Background: Neonatal hypoglycaemia is associated with significant long term neuro-developmental sequelae. The signs and symptoms are often non-specific. Some are completely asymptomatic. Many cases therefore remain undiagnosed. This study was therefore designed to determine the prevalence, obstetric and ...

  9. Prolonged parenteral nutrition after neonatal gastrointestinal surgery

    DEFF Research Database (Denmark)

    Estmann, Anne; Qvist, Niels; Husby, Steffen

    2002-01-01

    INTRODUCTION: Long-term treatment with parenteral nutrition (PN) may be essential for survival in infants after neonatal gastrointestinal surgery. It seemed well indicated in a population-based study to estimate the need for long-term PN and to characterize the infants that received TPN with regard...

  10. Predictors of Severe Neonatal Compromise Following Caesarean ...

    African Journals Online (AJOL)

    BACKGROUND: The potential harm to a mother and baby from caesarean delivery for clinically diagnosed foetal distress may not always be justified by the degree of neonatal depression at birth. OBJECTIVE: To assess the accuracy of clinical diagnosis of foetal distress indicating caesarean section and identify antepartum ...

  11. Cesarean section changes neonatal gut colonization

    DEFF Research Database (Denmark)

    Stokholm, Jakob; Thorsen, Jonathan; Chawes, Bo L

    2016-01-01

    -driven partial least squares analyses. The initial airway microbiota was unaffected by birth method. CONCLUSION: Delivery by means of cesarean section was associated with early colonization patterns of the neonatal gut but not of the airways. The differences normalized within the first year of life. We speculate...

  12. Unusual cause of neonatal intestinal obstruction | Zikavska ...

    African Journals Online (AJOL)

    There are many causes of intestinal obstruction in the neonatal age. The most common types are mechanical and result from congenital malformations of the gastrointestinal tract. However, functional disorders also occur. In some cases, diagnosis can be made prenatally but in others manifestation occurs after birth. The aim ...

  13. Humidity control tool for neonatal incubator.

    Science.gov (United States)

    Abdiche, M; Farges, G; Delanaud, S; Bach, V; Villon, P; Libert, J P

    1998-03-01

    In the first days of life, the daily evaporative loss from premature neonates can reach up to 20% of body mass. Such loss can be reduced by increasing the air humidity inside the incubator. Neither passive humidification nor open loop systems allow high humidity rates to be maintained or easily controlled: at 34 degrees C, the maximum levels vary with the system from 40% to 77% of relative humidity. The skin evaporative exchanges between the neonate and the environment are directly proportional to the water vapour partial pressure difference between the neonate's skin and the air. An active closed loop system has been designed, which permits reliable and accurate control of humidity according to the water vapour partial pressure set, between 1 and 6 kPa, in an air temperature range of 28-39 degrees C. It is characterised by variations of about 0.05 kPa around the set value and a maximum humidification speed of 0.25 kPa min-1. The algorithm is based on optimal control and the dynamic programming principles. Test results place this active system above usual systems for its power, precision and adaptability. It is an exploitable tool in fundamental and clinical research, to precisely study the humidity effects on neonatal comfort and thermo-regulation evolution.

  14. Cultural Competence of Obstetric and Neonatal Nurses.

    Science.gov (United States)

    Heitzler, Ella T

    To measure the cultural competence level of obstetric and neonatal nurses, explore relationships among cultural competence and selected sociodemographic variables, and identify factors related to cultural competence. Descriptive correlational study. Online survey. A convenience sample of 132 obstetric and neonatal registered nurses practicing in the United States. Nurse participants completed the Cultural Competence Assessment (CCA) instrument, which included Cultural Awareness and Sensitivity (CAS) and Cultural Competence Behaviors (CCB) subscales, and a sociodemographic questionnaire. Correlation and regression analyses were conducted. The average CCA score was 5.38 (possible range = 1.00-7.00). CCA scores were negatively correlated with age and positively correlated with self-ranked cultural competence, years of nursing experience, years of experience within the specialty area, and number of types of previous cultural diversity training. CCB subscale scores were correlated positively with age, years of nursing experience, years of experience within the specialty area, and number of types of previous diversity training. CAS subscale scores were positively correlated with number of types of previous diversity training. Standard multiple linear regression explained approximately 10%, 12%, and 11% of the variance in CCA, CAS, and CCB scores, respectively. Obstetric and neonatal registered nurses should continue to work toward greater cultural competence. Exposing nurses to more types of cultural diversity training may help achieve greater cultural competence. Copyright © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  15. Right paratesticular abscess mimicking neonatal testicular torsion ...

    African Journals Online (AJOL)

    U.O. Ezomike

    Right paratesticular abscess mimicking neonatal testicular torsion and caused by Proteus mirabilis. U.O. Ezomikea,∗. , M.A. Ituena, S.C. Ekpemoa, S.O. Ekenzeb a Department of Surgery, Federal Medical Centre Umuahia, Abia State, Nigeria b Sub-Department of Pediatric Surgery, University of Nigeria Teaching Hospital, ...

  16. An MR-compatible neonatal incubator.

    Science.gov (United States)

    Paley, M N J; Hart, A R; Lait, M; Griffiths, P D

    2012-07-01

    To develop a neonatal MR-compatible incubator for transporting babies between a neonatal intensive care unit and an MRI unit that is within the same hospital but geographically separate. The system was strapped to a standard MR-compatible patient trolley, which provides space for resuscitation outside the incubator. A constant-temperature exothermic heat pad was used to maintain temperature together with a logging fluoro-optic temperature monitor and alarm system. The system has been designed to accommodate standard knee-sized coils from the major MR manufacturers. The original incubator was constructed from carbon fibre, but this required modification to prevent radiofrequency shading artefacts due to the conducting properties of the carbon fibre. A high-tensile polyester material was used, which combined light weight with high impact strength. The system could be moved onto the patient bed with the coils and infant in place by one technologist. Studies in eight neonatal patients produced high quality 1.5 T MR images with low motion artefacts. The incubator should also be compatible with imaging in 3 T MR systems, although further work is required to establish this. Images were acquired using both rapid and high-resolution sequences, including three-dimensional volumes, proton spectra and diffusion weighting. The incubator provides a safe, quiet environment for neonates during transport and imaging, at low cost.

  17. Rebound hyperbilirubinaemia in neonates admitted to Mofid ...

    African Journals Online (AJOL)

    Total serum bilirubin. (TSB) was checked in the neonates 24 and 48 hours after cessation of phototherapy. We included patients in whom follow-up tests were completed at 24 and 48 hours after discharge. Chi-square and Student's t-tests were used for data analysis using SPSS version 13.0 (SPSS. Inc., Chicago, IL, USA).

  18. Maternal drugs and neonatal renal failure

    Directory of Open Access Journals (Sweden)

    M Sahay

    2014-01-01

    Full Text Available Maternal use of drugs during pregnancy may cause irreversible renal failure in the newborn. This report highlights the adverse effect of telmisartan during the last trimester of pregnancy. The neonate presented with oliguric renal failure and the renal histology showed proximal tubular dysgenesis.

  19. Cerebral oxygenation in the preterm neonate

    NARCIS (Netherlands)

    Dix, L.M.L.

    2017-01-01

    Although survival rates of preterm infants are improving, preterm birth is still associated with significant morbidity.The brain is one of the most vulnerable organs in preterm infants. Neonatal brain injury can have a large impact on the quality of life. Monitoring the immature brain is therefore

  20. Neonatal Bacterial Meningitis And Dexamethasone Adjunctive ...

    African Journals Online (AJOL)

    Objective: Neonatal bacterial meningitis is devastating, with attendant high mortality and neurological sequelae. We, therefore, aimed to delineate its current incidence, etiologic, clinical, laboratory spectra, and the effect of steroid therapy on the outcome. Methodology: Babies admitted from1992 to 1995 in the Special Care ...

  1. Neonatal cholinergic syndrome – organophosphate poisoning or ...

    African Journals Online (AJOL)

    A single case of neonatal organophosphate-like poisoning is presented, presumed to have been caused by traditional medicine intake. The dangers of traditional medications and naturally occurring anticholinergics are discussed. South African Journal of Child Health Vol. 2 (1) 2008: pp. 26-27 ...

  2. A Neonate with persistent hypoglycemia and seizures.

    African Journals Online (AJOL)

    MBY

    disorder was diagnosed and managed with limited success as the episodes hydroglycemic seizures persisted. ... the presence of hyperinsulinemia as the cause of the hypoglycemic dependent seizures. Case Presentation. A three day old girl was admitted to the neonatal .... the Prader-Willi syndrome, has been reported.

  3. Case Report - Neonatal progeroid syndrome (Wiedemann ...

    African Journals Online (AJOL)

    Case Report - Neonatal progeroid syndrome (Wiedemann-Rautenstrauch syndrome) in an Egyptian child with premature loss of teeth, and café au lait skin ... pads in the suprabuttock areas, triangular face, pseudohydrocephalous, sparse scalp hair and eyebrows, prominent scalp veins, greatly widened anterior fontanels, ...

  4. Pemberian Antitrombin III pada Sepsis Neonatal

    Directory of Open Access Journals (Sweden)

    Nathanne Septhiandi

    2016-11-01

    Kesimpulan. Secara statistik penggunaan AT III apabila dibandingkan dengan plasebo pada keadaan sepsis neonatal tidak memperbaiki prognosis dalam hal menurunkan tingkat mortalitas selama 28-30 hari. Walaupun demikian, tingkat mortalitas kelompok AT III lebih rendah dibandingkan dengan placebo.

  5. Total Body Opacification 'Technique Neonatal Adrenal Haemorrhage

    African Journals Online (AJOL)

    1971-12-11

    Dec 11, 1971 ... A case is reported illustrating the possible usefulness of total body opacification in the diagnosis of neonatal adrenal haemorrhage. To derive maximum benefit from this principle, the routine use of an early film coupled with high dosage is urged whenever an intravenous pyelogram is performed for ...

  6. Intravenous immunoglobulin prophylaxis in neonates on artificial ...

    African Journals Online (AJOL)

    The efficacy of the prophylactic use of intravenous immunoglobulin (Ig) was evaluated in a double-blind placebo-controlled trial of 21 pairs of ventilated neonates weighing more than 1 500 g, Each infant received 0.4 g/kglday of intravenous Ig or a similar volume of placebo daily for 5 days. Criteria used to assess the ...

  7. Neonatal Staphylococcus lugdunensis urinary tract infection.

    Science.gov (United States)

    Hayakawa, Itaru; Hataya, Hiroshi; Yamanouchi, Hanako; Sakakibara, Hiroshi; Terakawa, Toshiro

    2015-08-01

    Staphylococcus lugdunensis is a known pathogen of infective endocarditis, but not of urinary tract infection. We report a previously healthy neonate without congenital anomalies of the kidney and urinary tract who developed urinary tract infection due to Staphylococcus lugdunensis, illustrating that Staphylococcus lugdunensis can cause urinary tract infection even in those with no urinary tract complications. © 2015 Japan Pediatric Society.

  8. Neonatal adrenal hemorrhage presenting as acute scrotum

    African Journals Online (AJOL)

    Introduction. In newborns, adrenal hemorrhage is not an uncommon event. The large size of the adrenal cortex contributes to an increased vulnerability to trauma during a difficult delivery [1]. However, the neonatal adrenal hemorrhage may rarely present as inguinoscrotal swelling [2,3]. This condition can simulate torsion of ...

  9. Neonatal acute megakaryoblastic leukemia mimicking congenital neuroblastoma

    OpenAIRE

    Kawasaki, Yukako; Makimoto, Masami; Nomura, Keiko; Hoshino, Akihiro; Hamashima, Takeru; Hiwatari, Mitsuteru; Nakazawa, Atsuko; Takita, Junko; Yoshida, Taketoshi; Kanegane, Hirokazu

    2014-01-01

    Key Clinical Message We describe a neonate with abdominal distension, massive hepatomegaly, and high serum neuron-specific enolase level suggestive of congenital neuroblastoma. The patient died of pulmonary hemorrhage after therapy. Autopsy revealed that the tumor cells in the liver indicated acute megakaryocytic leukemia with the RBM15-MKL1 fusion gene.

  10. Effect of antenatal tocolysis on neonatal outcomes.

    Science.gov (United States)

    Klauser, Chad K; Briery, Christian M; Keiser, Sharon D; Martin, Rick W; Kosek, Mary A; Morrison, John C

    2012-12-01

    Detail adverse neonatal effects in pregnancies treated with indomethacin (I), magnesium sulfate (M) or nifedipine (N). Women in acute preterm labor with cervical dilatation 1-6 cm were randomized to receive one of three first-line tocolytic drugs. There were 317 neonates (I = 103, M = 95, N = 119) whose mothers were treated with tocolytic therapy. There was no difference in gestational age at randomization (average 28.6 weeks' gestation) or at delivery (31.6 weeks' gestation, p = 0.551), birth weight (p = 0.871) or ventilator days (p = 0.089) between the three groups. Neonatal morbidity was not different between the three groups; respiratory distress syndrome (p = 0.086), patent ductus arteriosus (p = 0.592), sepsis (p = 0.590), necrotizing enterocolitis (p = 0.770), intraventricular hemorrhage (p = 0.669) and periventricular leukomalacia (p = 0.124). There were no statistically significant differences between the three tocolytics as far as composite neonatal morbidity or mortality was concerned.

  11. Neonatal adrenal hemorrhage mimicking an acute scrotum.

    Science.gov (United States)

    Adorisio, O; Mattei, R; Ciardini, E; Centonze, N; Noccioli, B

    2007-02-01

    Twenty-two cases of scrotal hematoma caused by neonatal adrenal hemorrhage are reported in the literature and unnecessary surgical exploration was performed in nine (41%), suspecting testicular torsion. In this paper, we present a newborn male with right adrenal gland hemorrhage causing right scrotal swelling and discoloration of groin managed conservatively.

  12. fetal survival and neonatal growth with intramuscular

    African Journals Online (AJOL)

    FETAL SURVIVAL AND NEONATAL GROWTH WITH INTRAMUSCULAR. INJECTIONS OF FOLATE DURING GESTATION IN THE RAT. 1s. c. lkpo, 1e. o. Agu* and 22M. Ofuya. DEPARTMENT OF ANIMAL AND ENVIRONMENTAL BIOLOGY,. 20EPARTMENT or HUMAN PHYSIOLOGY. UNIVERSITY or PORT HARCOURT, ...

  13. maternal hypotension and neonatal acidaemia during caeserean ...

    African Journals Online (AJOL)

    2012-10-01

    Oct 1, 2012 ... VpH = Umbilical Venous Blood pH. Twenty eight patients (17.7%) developed maternal hypotension (systolic Blood Pressure less than. 100mmHg) but there was no statistically significant difference in the prevalence of neonatal acidaemia and low Apgar scores among babies born to normotensive and ...

  14. Intravenous immunoglobulin prophylaxis in neonates on artificial ...

    African Journals Online (AJOL)

    of ventilation therapy and time to clinical recovery. There were no significant differences in the treated and ... shown in vitro in neonatal animals.3 When this study commenced in 1987, the majority of patients ..... and M. Pather, who assisted us with the clinical investigations. REFERENCES. 1 Chmco G. Rondinl G. O,ebani A.

  15. Intestinal microcirculatory dysfunction and neonatal necrotizing enterocolitis.

    Science.gov (United States)

    Zhang, Hong-yi; Wang, Fang; Feng, Jie-xiong

    2013-01-01

    Based on the observation that coagulation necrosis occurs in the majority of neonatal necrotizing enterocolitis (NEC) patients, it is clear that intestinal ischemia is a contributing factor to the pathogenesis of NEC. However, the published studies regarding the role of intestinal ischemia in NEC are controversial. The aim of this paper is to review the current studies regarding intestinal microcirculatory dysfunction and NEC, and try to elucidate the exact role of intestinal microcirculatory dysfunction in NEC. The studies cited in this review were mainly obtained from articles listed in Medline and PubMed. The search terms used were "intestinal microcirculatory dysfunction" and "neonatal necrotizing enterocolitis". Mainly original milestone articles and critical reviews written by major pioneer investigators in the field were selected. Immature regulatory control of mesentery circulation makes the neonatal intestinal microvasculature vulnerable. When neonates are subjected to stress, endothelial cell dysfunction occurs and results in vasoconstriction of arterioles, inflammatory cell infiltration and activation in venules, and endothelial barrier disruption in capillaries. The compromised vasculature increases circulation resistance and therefore decreases intestinal perfusion, and may eventually progress to intestinal necrosis. Intestinal ischemia plays an important role through the whole course of NEC. New therapeutic agents targeting intestinal ischemia, like HB-EGF, are promising therapeutic agents for the treatment of NEC.

  16. Auditory Evoked Responses in Neonates by MEG

    International Nuclear Information System (INIS)

    Hernandez-Pavon, J. C.; Sosa, M.; Lutter, W. J.; Maier, M.; Wakai, R. T.

    2008-01-01

    Magnetoencephalography is a biomagnetic technique with outstanding potential for neurodevelopmental studies. In this work, we have used MEG to determinate if newborns can discriminate between different stimuli during the first few months of life. Five neonates were stimulated during several minutes with auditory stimulation. The results suggest that the newborns are able to discriminate between different stimuli despite their early age

  17. Neonatal euthanasia : Lessons from the Groningen Protocol

    NARCIS (Netherlands)

    Verhagen, A. A. Eduard

    2014-01-01

    Decisions about neonatal end-of-life care have been studied intensely over the last 20 years in The Netherlands. Nationwide surveys were done to quantify these decisions, provide details and monitor the effect of guidelines, new regulations and other interventions. One of those interventions was the

  18. CSF Cultures and Bacteremia in Neonatal Meningitis

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2006-04-01

    Full Text Available Cerebrospinal (CSF culture results were compared with results of blood cultures and CSF parameters (WBC, glucose, and protein in 9111 neonates with culture-proven meningitis and a first lumbar puncture at >34 weeks’ gestational age from 150 NICU’s managed by the Pediatrix Medical Group.

  19. Maternal and neonatal outcomes of macrosomic pregnancies

    Science.gov (United States)

    Weissmann-Brenner, Alina; Simchen, Michal J.; Zilberberg, Eran; Kalter, Anat; Weisz, Boaz; Achiron, Reuven; Dulitzky, Mordechai

    2012-01-01

    Summary Background To compare maternal and neonatal outcomes of term macrosomic and adequate for gestational age (AGA) pregnancies. Material/Methods A retrospective analysis was performed on all term singleton macrosomic (birth weight ≥4000 g) and AGA (birth weight >10th percentile and shoulder dystocia, neonatal hypoglycemia, and had longer hospitalization period (both in vaginal and cesarean deliveries). Specifically, the odds ratio (OR) relative to AGA pregnancies for each macrosomic category (4000–4250 g, 4250–4500 g and ≥4500 g) of shoulder dystocia was 2.37, 2.24, 7.61, respectively, and for neonatal hypoglycemia 4.24, 4.41, 4.15, respectively. The risk of post partum hemorrhage was statistically increased when birth weight was >4500 g (OR=5.23) but not for birth weight between 4000–4500 g. No differences were found in the rates of extensive perineal lacerations between AGA and the different macrosomic groups. Conclusions Macrosomia is associated with increased rate of cesarean section, shoulder dystocia, neonatal hypoglycemia, and longer hospitalization, but not associated with excessive perineal tears. Increased risk of PPH was found in the >4500g group. PMID:22936200

  20. Studies on Hepatitis B vaccination in neonates

    NARCIS (Netherlands)

    R. del Canho (Riwka)

    1993-01-01

    textabstractFrom 1982-1989, 705 infants born to HBsAg positive mothers entered the Dutch neonatal hepatitis B vaccination program and received passive-active hepatitis B immunization, according to 6 schedules, varying in time of onset vaccination, dose of hepatitis B immunoglobulin (HBlg) and type

  1. Idiopathic neonatal pneumoperitoneum, a case report

    Directory of Open Access Journals (Sweden)

    Sarah Magdy Abdelmohsen

    2017-01-01

    Conclusion: This case demonstrated that laparotomy is not a true routine in neonates with idiopathic pneumoperitoneum if a timely diagnosis is established. Future research is still necessary to understand the source of the free gas in the abdomen, as well as the underlying causes of delayed postoperative gas underdiaphragm and postoperative abdominal drain bag gas expansion.

  2. Neonatal anthropometry: thin-fat phenotype in fourth to fifth generation South Asian neonates in Surinam.

    Science.gov (United States)

    van Steijn, L; Karamali, N S; Kanhai, H H H; Ariëns, G A M; Fall, C H D; Yajnik, C S; Middelkoop, B J C; Tamsma, J T

    2009-11-01

    We assessed whether the earlier described 'thin-fat phenotype' is present in Surinam South Asian babies of the fourth to fifth generation after migration from India. In this observational study we collected data from 39 South Asian term neonates and their mothers in Paramaribo, Surinam. We compared the following data with data from an earlier study in Southampton, UK (338 neonates) and in Pune, India (631 neonates): maternal body mass index, neonatal weight, length, head, mid-upper arm and abdominal circumferences and subscapular skinfold thickness. The mothers in Paramaribo were older than the Southampton mothers; their body mass index was comparable. Mean birth weight was 3159 g (Southampton: 3494 g; Pune: 2666 g). Compared with Southampton babies, the Paramaribo babies were smaller in nearly all body measurements, the smallest being abdominal circumference at the umbilicus level (s.d. score: -1.62; 95% confidence interval (CI): -2.07 to -1.16) and mid-upper arm circumference (s.d. score: -1.08; 95% CI: -1.46 to -0.69). In contrast, subscapular skinfold thickness was similar (s.d. score: +0.08; 95% CI: -0.24 to +0.55). Except for subscapular skinfold thickness and length, all neonatal measurements were intermediate between those from Southampton and Pune. The thin-fat phenotype is preserved in Surinam South Asian neonates of the fourth to fifth generation after migration from India.

  3. Acute renal failure in premature neonates

    Directory of Open Access Journals (Sweden)

    Doronjski Aleksandra

    2009-01-01

    Full Text Available Background/Aim. Hemodynamic stress is the leading cause of acute renal failure (ARF in premature neonates. Incidence of ARF in this population is between 8 and 24%. The aim of this study was to determine the frequency of presence of ARF in premature neonates, as well as its impact on their survival. Methods. A retrospective study of 114 premature neonates [(gestational age, GA less than 37 gestation weeks (gw] admitted to the Intensive Care Unit (ICU at the Pediatric Clinic, Institute of Child and Youth Healthcare of Vojvodina in 2007 was conducted. Serum creatinine, urea and bilirubine were determined on the 3rd day of life in 65 newborns who met inclusion criteria. ARF was diagnosed in 16 newborns (n=16/65; 25%. Results. The premature neonates with ARF had significantly lower GA [<28 gw - 8/16 (50% vs. 5/49 (10%; p < 0.05], birth weight (BW (1 265 g vs. 1615 g; p < 0.05 and systolic blood pressure (43.37 mm Hg vs. 52.7 mmHg; p < 0.05 than ones without ARF. Non-olyguric ARF was diagnosed in 62% of newborns with ARF (n=10/16, while the rest had the olyguric type (n = 6/16; 38%. Twenty-five percent of premature neonates with ARF (n = 4/16 died in contrast to 10% of premature neonates without ARF (n = 5/49. ARF was treated conservatively in all but 3 cases when peritoneal dialysis was performed. Renal function has recovered completely in all of the survivors. In order to determine their predictivity in relation to ARF, following parameters were analyzed: GA, BW < 1 500 g, presence of concomitant sepsis and intracranial hemorrhage grade III/IV. BW < 1 500 g demonstrated the highest sensitivity (se 0.75, while GA < 28 gw, sepsis and intracranial hemorrhage grade III/IV showed high specificity (sp = 0.90, 0.89 0.88, respectively. Conclusion. Acute renal failure frequently occurs in population of premature neonates and requires meticulous fluid and electrolyte balance, especially in the case of low birth weight and extreme immaturity.

  4. Convulsiones neonatales refractarias Neonatal refractory seizures

    Directory of Open Access Journals (Sweden)

    Jaume Campistol

    2009-01-01

    Full Text Available Las convulsiones del período neonatal y del primer año de vida pueden tener un origen, un tratamiento y un pronóstico muy distintos y serán el neonatólogo y el neuropediatra quienes mejor las conozcan y manejen con mayor experiencia. Existen formas graves de encefalopatía epiléptica del período neonatal como el Sídrome Ohtahara o la encefalopatía mioclónica de Aicardi, con un pronóstico muy reservado y una elevada morbimortalidad. Además existen algunas formas de convulsiones y epilepsias del período neonatal y del lactante joven que no responden al empleo de fármacos antiepilépticos (FAEs. En esta situación el iniciar precozmente otro tipo de terapia puede evitar el deterioro neurológico que, sin duda debido a las crisis convulsivas, se producirá y podrá permitir al paciente llevar una vida normal con la única obligación de tomar de por vida una medicación distinta de los FAEs. Revisamos el grupo de defectos metabólicos que dan lugar a convulsiones y epilepsias y cuyo tratamiento es muy distinto al de una epilepsia. Incluimos en esta revisión algunas formas de convulsiones y epilepsias del lactante joven que tienen en la actualidad tratamiento efectivo mediante sustancias totalmente distintas de los FAEs.Convulsions appearing in the neonatal or first year of life can have a very different origin, treatment or prognosis and it shall be up to the neonatologist or neuropediatrician to resolve the problem since they are the ones who know their patients best. There are severe forms of epileptic encephalopathy in the neonatal period such as Ohtahara syndrome or Aicardi myoclonic encephalopathy with poor prognosis and high morbimortality. Furthermore, there are forms of convulsions and epilepsies during the neonatal and infant period which do not respond to AED. In such cases, it is important to initiate as soon as possible another type of treatment to prevent a neurological deterioration due to repeated convulsion crises and

  5. Maternal depression and anxiety and fetal-neonatal growth.

    Science.gov (United States)

    Pinto, Tiago Miguel; Caldas, Filipa; Nogueira-Silva, Cristina; Figueiredo, Bárbara

    Maternal depression and anxiety have been found to negatively affect fetal and neonatal growth. However, the independent effects of maternal depression and anxiety on fetal-neonatal growth outcomes and trajectories remain unclear. This study aimed to analyze simultaneously the effects of maternal prenatal depression and anxiety on (1) neonatal growth outcomes, and (2), on fetal-neonatal growth trajectories, from the 2nd trimester of pregnancy to childbirth. A sample of 172 women was recruited and completed self-reported measures of depression and anxiety during the 2nd and 3rd trimesters of pregnancy, and at childbirth. Fetal and neonatal biometrical data were collected from clinical reports at the same assessment moments. Neonates of prenatally anxious mothers showed lower weight (p=0.006), length (p=0.025), and ponderal index (p=0.049) at birth than neonates of prenatally non-anxious mothers. Moreover, fetuses-neonates of high-anxiety mothers showed a lower increase of weight from the 2nd trimester of pregnancy to childbirth than fetuses-neonates of low-anxiety mothers (p<0.001). Considering maternal depression and anxiety simultaneously, only the effect of maternal anxiety was found on these markers of fetal-neonatal growth outcomes and trajectories. This study demonstrates the independent longitudinal effect of maternal anxiety on major markers of fetal-neonatal growth outcomes and trajectories, simultaneously considering the effect of maternal depression and anxiety. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  6. Vaccines for women for preventing neonatal tetanus.

    Science.gov (United States)

    Demicheli, Vittorio; Barale, Antonella; Rivetti, Alessandro

    2015-07-06

    Tetanus is an acute, often fatal, disease caused by an exotoxin produced by Clostridium tetani. It occurs in newborn infants born to mothers who do not have sufficient circulating antibodies to protect the infant passively, by transplacental transfer. Prevention may be possible by the vaccination of pregnant or non-pregnant women, or both, with tetanus toxoid, and the provision of clean delivery services. Tetanus toxoid consists of a formaldehyde-treated toxin that stimulates the production of antitoxin. To assess the effectiveness of tetanus toxoid, administered to women of reproductive age or pregnant women, to prevent cases of, and deaths from, neonatal tetanus. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 January 2015), CENTRAL (The Cochrane Library 2015, Issue 1), PubMed (1966 to 28 January 2015), EMBASE (1974 to 28 January 2015) and reference lists of retrieved studies. Randomised or quasi-randomised trials evaluating the effects of tetanus toxoid in pregnant women or women of reproductive age on numbers of neonatal tetanus cases and deaths. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. Two effectiveness trials (9823 infants) and one safety trial (48 mothers) were included. The main outcomes were measured on infants born to a subset of those randomised women who became pregnant during the course of the studies. For our primary outcomes, there was no high-quality evidence according to GRADE assessments.One study (1182 infants) assessed the effectiveness of tetanus toxoid in comparison with influenza vaccine in preventing neonatal tetanus deaths. A single dose did not provide significant protection against neonatal tetanus deaths, (risk ratio (RR) 0.57, 95% confidence interval (CI) 0.26 to 1.24; 494 infants; GRADE: low-quality evidence). However, a two- or three-dose course did provide protection against neonatal deaths, (RR 0.02, 95% CI 0.00 to 0

  7. Risk Factors of Neonatal Anemia in Placenta Previa

    Science.gov (United States)

    Jang, Dong Gyu; Jo, Yun Sung; Lee, Sung Jong; Lee, Gui Se Ra

    2011-01-01

    Objectives: Placenta previa is a major cause of neonatal anemia. The purpose of this study was to elucidate the risk factors of neonatal anemia in placenta previa. Methods: The study was conducted on 158 placenta previa patients at 3 hospitals in affiliation with the Catholic Medical Center, Seoul, Korea from May 1999 through December 2009. The subjects were divided in to 2 groups: 47 placenta previa patients with neonatal anemia, and 113 placenta previa patients without neonatal anemia. The subjects' characteristics were compared. Logistic regression was used to control for confounding factors. Results: Anterior placental location (OR 2.48; 95% CI: 1.20-5.11) was an independent risk factor of neonatal anemia after controlling for potential confounders. Conclusion: To manage neonatal anemia in placenta previa patients, obstetricians should do their best to detect placental location. Pediatricians should consider the high possibility of neonatal anemia in cases involving anterior placental location. PMID:21960747

  8. Correção cirúrgica da doença de Hirschprung pela técnica de de la Torre-Mondragon

    Directory of Open Access Journals (Sweden)

    Gabriela Teixeira Araujo

    2015-10-01

    Full Text Available A Aganglionose Intestinal Congênita (AIC, ou Doença de Hirschprung, é uma má formação caracterizada pela ausência de células ganglionares nos plexos mioentérico e submucoso da porção distal do trato gastrointestinal. Assim, o segmento aganglionar é aperistáltico e espástico, constituindo um obstáculo ao transito intestinal e gerando a dilatação do segmento saudável. A doença costuma manifestar-se no período neonatal com obstrução intestinal, distensão abdominal e vômitos. O tratamento é cirúrgico, pela técnica de De La Torre-Mondragon, realizada em um tempo cirúrgico e sem colostomia prévia. Relato do caso: P.R.D., masculino, 33 dias de vida, foi encaminhado ao serviço com quadro de distensão abdominal e parada da eliminação de fezes há 22 horas. Foi internado primeiramente aos cinco dias de vida com quadro de obstrução intestinal, aliviada após limpeza mecânica. Encontrava-se com abdômen distendido, flácido, sem sinais de desconforto à palpação e ruídos hidroaéreos presentes. O enema opaco evidenciou progressão do contraste com dilatação do retossigmoide. A manometria retal demonstrou reflexo inibitório anorretal não desencadeado, com inúmeras evacuações do lactente durante o exame. Foi indicada correção cirúrgica feita pela técnica de De La Torre-Mondragon, sem intercorrências. Anatomopatológico da peça cirúrgica confirmou ausência de células ganglionares no segmento. O diagnóstico preciso e o manejo cirúrgico precoce foi fundamental para evitar a principal complicação desta doença, a enterocolite necrosante. A técnica de De La Torre-Mondragon consiste no rebaixamento transanal endorretal do cólon e permitiu a recuperação do transito intestinal precocemente, sem a necessidade de colostomia. O reestabelecimento precoce do transito intestinal melhorou a qualidade de vida do paciente e diminuiu custos e o tempo de hospitalização.

  9. Neonatal nursing: an unmet challenge in India.

    Science.gov (United States)

    Kalyan, Geetanjli; Vatsa, Manju

    2014-11-01

    Nurses comprise a key component to maternal and newborn health care delivery, including the care of 'at-risk' or sick newborns. However, the efficiency and effectiveness of services rely heavily on adequate numbers of highly skilled neonatal nurses. Currently, in India, a significant shortage of trained nurses in the field of newborn care is contributing to poor neonatal outcomes. Specifically, nurses caring for newborns lack the competency and experience needed to ensure optimal care. This deficiency has been linked to a lack of expert faculty, standardized training and minimal or no exposures to newborn clinical care areas during pre service education. Moreover, in addition to a lack of operational research in the area, nurses who provide care for newborns are often faced with numerous system related issues that impede their ability to provide optimal care. Most notably, frequent changes of work place, poor wages, and lack of continuing education, skill maintenance, recognition, and collaborative team culture further compromise the nursing care. All these lead to poor motivation and competency. To meet this challenge, it is essential that emphasis be placed on the identification and support of nursing faculty with expertise in newborn and neonatal care who are able to ensure that nurses receive standardized education for pre-service, in-service and ongoing care. In addition, importance should be placed on encouraging newborn nursing research as well as on governmental increases in salary compensation. Lastly, given the shortage of physicians to take care of sick neonates in remote areas, the creation of a cadre of Neonatal nurse practitioner/ advanced practice nurses would be an invaluable solution in developing countries. Furthermore, centralized oversight of newborn education and training would be best served, if responsibility was placed with Reproductive maternal newborn child health (RMNCH) workers and district level officers.

  10. Early neonatal lamb mortality: postmortem findings.

    Science.gov (United States)

    Holmøy, I H; Waage, S; Granquist, E G; L'Abée-Lund, T M; Ersdal, C; Hektoen, L; Sørby, R

    2017-02-01

    An investigation of stillbirth and early neonatal lamb mortality was conducted in sheep flocks in Norway. Knowledge of actual causes of death are important to aid the interpretation of results obtained during studies assessing the risk factors for lamb mortality, and when tailoring preventive measures at the flock, ewe and individual lamb level. This paper reports on the postmortem findings in 270 liveborn lambs that died during the first 5 days after birth. The lambs were from 17 flocks in six counties. A total of 27% died within 3 h after birth, 41% within 24 h and 80% within 2 days. Most lambs (62%) were from triplet or higher order litters. In 81% of twin and larger litters, only one lamb died. The most frequently identified cause of neonatal death was infectious disease (n=97, 36%); 48% (n=47) of these died from septicaemia, 25% (n=24) from pneumonia, 22% (n=21) from gastrointestinal infections and 5% (n=5) from other infections. Escherichia coli accounted for 65% of the septicaemic cases, and were the most common causal agent obtained from all cases of infection (41%). In total, 14% of neonatal deaths resulted from infection by this bacterium. Traumatic lesions were the primary cause of death in 20% (n=53) of the lambs. A total of 46% of these died within 3 h after birth and 66% within 24 h. Severe congenital malformations were found in 10% (n=27) of the lambs, whereas starvation with no concurrent lesions was the cause of death in 6% (n=17). In 16% (n=43) of the lambs, no specific cause of death was identified, lambs from triplet and higher order litters being overrepresented among these cases. In this study, the main causes of neonatal lamb mortality were infection and traumatic lesions. Most neonatal deaths occurred shortly after birth, suggesting that events related to lambing and the immediate post-lambing period are critical for lamb survival.

  11. HIV and pregnancy: Maternal and neonatal evolution

    Directory of Open Access Journals (Sweden)

    Diego Cecchini

    2011-10-01

    Full Text Available Data regarding epidemiological aspects, antiretroviral drug safety, and outcomes of HIV-infected pregnant women and their newborns are limited in Argentina. We underwent a retrospective analysis of registries of HIV-infected pregnant women assisted at Helios Salud, Buenos Aires, Argentina (1997-2006. Variables associated with preterm delivery and neonatal complications were analyzed by univariate and logistic regression analyses. A total of 204 mother-child binomium were included. Maternal age (median: 29 years; 32.5% without prior diagnosis of HIV-infection. Baseline median CD4 T-cell count: 417 cell/μl; 98% received antiretroviral drugs during pregnancy [2 nucleoside analogs plus either nevirapine (55% or a protease inhibitor (32%]. Overall incidence of toxicity was 12.5%: rash (8%, anemia (3.5% and hepatotoxicity (1%. Rash was associated with exposure to nevirapine. Eighty one percent and 50% reached HIV-viral loads <1000 and <50 copies/ml at the end of pregnancy, respectively. Twenty six percent had obstetric complications and 16% had preterm delivery. Of the newborns, 1.6% had congenital defects and 9% had neonatal complications. Overall neonatal mortality was 1% and perinatal transmission was 0.7%. Protease inhibitor use and obstetric complications were associated to preterm delivery while obstetric complications were associated with neonatal complications. In our population, hepatotoxicity was low despite frequent use of nevirapine. Protease inhibitor use was associated to preterm delivery. A favorable virological response and a low rate of perinatal transmission was observed, what supports the consensus that antiretroviral therapy benefits during pregnancy outweigh risks of maternal and neonatal adverse events.

  12. [Prolonged pain in neonates: retrospective analysis].

    Science.gov (United States)

    Lilla, Michèle; Stadelman-Diaw, Corinne; Ramelet, Anne-Sylvie

    2013-12-01

    Infants hospitalised in neonatology are inevitably exposed to pain repeatedly. Premature infants are particularly vulnerable, because they are hypersensitive to pain and demonstrate diminished behavioural responses to pain. They are therefore at risk of developing short and long-term complications if pain remains untreated. Compared to acute pain, there is limited evidence in the literature on prolonged pain in infants. However, the prevalence is reported between 20 and 40 %. This single case study aimed to identify the bio-contextual characteristics of neonates who experienced prolonged pain. This study was carried out in the neonatal unit of a tertiary referral centre in Western Switzerland. A retrospective data analysis of seven infants' profile, who experienced prolonged pain ,was performed using five different data sources. The mean gestational age of the seven infants was 32weeks. The main diagnosis included prematurity and respiratory distress syndrome. The total observations (N=55) showed that the participants had in average 21.8 (SD 6.9) painful procedures that were estimated to be of moderate to severe intensity each day. Out of the 164 recorded pain scores (2.9 pain assessment/day/infant), 14.6 % confirmed acute pain. Out of those experiencing acute pain, analgesia was given in 16.6 % of them and 79.1 % received no analgesia. This study highlighted the difficulty in managing pain in neonates who are exposed to numerous painful procedures. Pain in this population remains underevaluated and as a result undertreated.Results of this study showed that nursing documentation related to pain assessment is not systematic.Regular assessment and documentation of acute and prolonged pain are recommended. This could be achieved with clear guidelines on the Assessment Intervention Reassessment (AIR) cyclewith validated measures adapted to neonates. The adequacy of pain assessment is a pre-requisite for appropriate pain relief in neonates.

  13. Neonatal intestinal obstruction in Benin, Nigeria

    Directory of Open Access Journals (Sweden)

    Osifo Osarumwense

    2009-01-01

    Full Text Available Background: Intestinal obstruction is a life threatening condition in the newborn, with attendant high mortality rate especially in underserved subregion. This study reports the aetiology, presentation, and outcome of intestinal obstruction management in neonates. Materials and Methods: A prospective study of neonatal intestinal obstruction at the University of Benin Teaching Hospital, Benin, Nigeria, between January 2006-June 2008. Data were collated on a structured proforma and analysed for age, sex, weight, presentation, type/date of gestation/delivery, aetiology, clinical presentation, associated anomaly, treatment, and outcome. Results: There were 71 neonates, 52 were males and 19 were females (2.7:1. Their age range was between 12 hours and 28 days (mean, 7.9 ± 2.7 days and they weighed between 1.8 and 5.2 kg (average, 3.2 kg. The causes of intestinal obstruction were: Anorectal anomaly, 28 (39.4%; Hirschsprung′s disease, 8 (11.3%′ prematurity, 3 (4.2%; meconeum plug, 2 (2.8%; malrotation, 6 (8.5%; intestinal atresia, 8 (11.3%; necrotising enterocolitis (NEC, 4 (5.6%; obstructed hernia, 4 (5.6%; and spontaneous gut perforation, 3 (4.2%. Also, 27 (38% children had colostomy, 24 (33.8% had laparotomy, 9 (12.8% had anoplasty, while 11 (15.4% were managed nonoperatively. A total of 41 (57.7% neonates required incubator, 26 (36.6% needed total parenteral nutrition, while 15 (21.1% require d paediatric ventilator. Financial constraint, late presentation, presence of multiple anomalies, aspiration, sepsis, gut perforation, and bowel gangrene were the main contributors to death. Neonates with lower obstructions had a better outcome compared to those having upper intestinal obstruction ( P < 0.0001. Conclusion: Outcomes of intestinal obstruction are still poor in our setting; late presentation, financial constraints, poor parental motivation and lack of basic facilities were the major determinants of mortality.

  14. Neonatal varicella pneumonia, surfactant replacement therapy

    Directory of Open Access Journals (Sweden)

    Mousa Ahmadpour-kacho

    2015-12-01

    Full Text Available Background: Chickenpox is a very contagious viral disease that caused by varicella-zoster virus, which appears in the first week of life secondary to transplacental transmission of infection from the affected mother. When mother catches the disease five days before and up to two days after the delivery, the chance of varicella in neonate in first week of life is 17%. A generalized papulovesicular lesion is the most common clinical feature. Respiratory involvement may lead to giant cell pneumonia and respiratory failure. The mortality rate is up to 30% in the case of no treatment, often due to pneumonia. Treatment includes hospitalization, isolation and administration of intravenous acyclovir. The aim of this case report is to introduce the exogenous surfactant replacement therapy after intubation and mechanical ventilation for respiratory failure in neonatal chickenpox pneumonia and respiratory distress. Case Presentation: A seven-day-old neonate boy was admitted to the Neonatal Intensive Care Unit at Amirkola Children’s Hospital, Babol, north of Iran, with generalized papulovesicular lesions and respiratory distress. His mother has had a history of Varicella 4 days before delivery. He was isolated and given supportive care, intravenous acyclovir and antibiotics. On the second day, he was intubated and connected to mechanical ventilator due to severe pneumonia and respiratory failure. Because of sever pulmonary involvement evidenced by Chest X-Ray and high ventilators set-up requirement, intratracheal surfactant was administered in two doses separated by 12 hours. He was discharged after 14 days without any complication with good general condition. Conclusion: Exogenous surfactant replacement therapy can be useful as an adjunctive therapy for the treatment of respiratory failure due to neonatal chickenpox.

  15. Radiological evaluation of surgical emergencies in neonate

    Energy Technology Data Exchange (ETDEWEB)

    Suh, C. O.; Oh, K. K.; Park, C. Y. [Yonsei University, Medical College, Seoul (Korea, Republic of)

    1980-12-15

    Most pathologic conditions requiring emergent operation in neonate are congenital anomalies and delayed diagnosis and associated anomaly are important factors which have contributed to the high mortality rate of congenital anomalies. To prevent this delay, early recognition of the danger signals, adequate roentagenologic examination and accurate diagnosis should be made. Furthermore radiologists should be aware of developing mechanism, clinical manifestations and roentgenographic findings of those neonatal emergencies. 135 cases of neonatal emergencies were analyzed at this point of view, which verified by surgery and pathologic examination at Yonsei University College of Medicine, Severance Hospital since 1968. Embryology and characteristic roentgenographic pictures of each disease were discussed. The conclusions are as follows; 1. Most cases (110/135) presented intestinal obstruction. Imperforate anus (29 cases) was most common disease which followed by infantile hypertrophic pyloric stenosis (25 cases), small bowel atresia and stenosis (18 cases), congenital megacolon (15 cases) and esophageal atresia (14 cases). 2. Clinical Type and time of occurrence of symptoms and signs were so characteristic that these were helpful for differential diagnosis. 3. In infantile hypertrophic pyloric stenosis, confirmative diagnosis could be made in plain abdominal film, when 'Caterpillar sign' was seen. 4. When small bowel obstruction was suspected in plain abdominal film, barium enema examination was more helpful than upper G-I study. When microcolon was found, lower small bowel obstruction was highly suggested. 5. Diagnosis of midgut malrotation was possible in larger cases (4/7). Upper G-I examination was more valuable than barium enema study, because duodenal obstruction due to Ladd's band was common problem in neonate. 6. In neonatal period, diagnosis of aganglionosis could be made with the finding of barium stasis on 24-48 hours delay film, even though no

  16. Neonatal Outcomes Associated With Placental Abruption.

    Science.gov (United States)

    Downes, Katheryne L; Shenassa, Edmond D; Grantz, Katherine L

    2017-12-15

    Placental abruption (early separation of the placenta) is associated with preterm birth and perinatal mortality, but associations with other neonatal morbidities remain understudied. We examined the association between abruption and newborn outcomes. We analyzed 223,341 singleton deliveries from the Consortium on Safe Labor study, a retrospective, multisite, observational study (2002-2008) of electronic medical records in the United States. Adjusted relative risks, incidence rate ratios, and 99% confidence intervals were estimated. Direct effects attributable to abruption were examined by conditioning on intermediates (preterm birth and small for gestational age) with sensitivity analyses. Incidence of abruption was 1.6% (n = 3,619). Abruption was associated with an elevated risk of newborn resuscitation (relative risk (RR) = 1.5, 99% confidence interval (CI): 1.5, 1.6), apnea (RR = 5.8, 99% CI: 5.1, 6.5), asphyxia (RR = 8.5, 99% CI: 5.7, 11.3), respiratory distress syndrome (RR = 6.5, 99% CI: 5.9, 7.1), neonatal intensive care unit admission (RR = 3.4, 99% CI: 3.2, 3.6), longer intensive care length of stay (incidence rate ratio = 2.0, 99% CI: 1.9, 2.2), stillbirth (RR = 6.3, 99% CI: 4.7, 7.9), and neonatal mortality (RR = 7.6, 99% CI: 5.2, 10.1). In sensitivity analyses, there was a direct effect of abruption associated with increased neonatal risks. These findings expand our knowledge of the association between abruption and perinatal and neonatal outcomes. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. Modeling birth weight neonates and associated factors

    Directory of Open Access Journals (Sweden)

    Mansour Rezaei

    2017-01-01

    Full Text Available Background: Neonate with abnormal weight is at risk of increased mortality and morbidity. Many factors affect pregnancy outcome. Because of the importance and vital role in birth weight, in this study, some of the factors associated with birth weight in a sample of Iranians neonates were investigated. Materials and Methods: In this cross-sectional study, 245 newborns in a sample of Iranians neonates in the year 2013 were selected, and characteristics of neonate and their mothers were derived. Birth weights were registered by the neonatal scale. To identify the direct and indirect factors affecting birth weight, we used path analysis (PA and IBM AMOS and SPSS software. Results: The mean ± standard deviation of weight in girls (3200 ± 421 g less than boys (3310 ± 444 g significantly (P = 0.04. Gestational age (P < 0.001, birth rank (P = 0.012, distance from a previous pregnancy (P = 0.028, and mother weight (P = 0.04 had a statistical significant relationship with birth weight. In the final PA model, gestational age has a highest total effect, type of delivery with gestational age-mediated had the highest indirect effect and type of delivery, and gestational age had the greatest total impact on the birth weight. Conclusion: Gestational age, sex, distance from a previous pregnancy, maternal weight, type of delivery, number of abortion, and birth rank were related with birth weight. Due to the termination of pregnancy and avoid unnecessary deliveries through cesarean section and other related factors should be further consideration by childbirth experts. In addition, factors affecting these variables are carefully identified and prevented as much as possible.

  18. Exchange Transfusion in the Treatment of Neonatal Septic Shock: A Ten-Year Experience in a Neonatal Intensive Care Unit

    OpenAIRE

    Pugni, Lorenza; Ronchi, Andrea; Bizzarri, Bianca; Consonni, Dario; Pietrasanta, Carlo; Ghirardi, Beatrice; Fumagalli, Monica; Ghirardello, Stefano; Mosca, Fabio

    2016-01-01

    Septic shock, occurring in about 1% of neonates hospitalized in neonatal intensive care unit (NICU), is a major cause of death in the neonatal period. In the 1980s and 90s, exchange transfusion (ET) was reported by some authors to be effective in the treatment of neonatal sepsis and septic shock. The main aim of this retrospective study was to compare the mortality rate of neonates with septic shock treated only with standard care therapy (ScT group) with the mortality rate of those treated w...

  19. Multidrug-resistant organisms in neonatal sepsis in two tertiary neonatal ICUs, Egypt.

    Science.gov (United States)

    Awad, Hesham A; Mohamed, Maha H; Badran, Nabil F; Mohsen, Manal; Abd-Elrhman, Al-Sayed A

    2016-03-01

    Neonatal sepsis remains a serious problem in any neonatal intensive care unit (NICU). Bacterial organisms have developed increased resistance to commonly used antibiotics. Because not enough data are available from Egypt, the aim of the present study was to determine the causative bacteria and the level of their resistance to commonly used antibiotics in tertiary NICUs in Cairo, Egypt. A 3.5-year retrospective study was carried out at NICUs of the Children's Hospital of Ain Shams University and that of El-Hussein Hospital, Al-Azhar University, Egypt. Records of neonates were reviewed. All neonates with culture-proven sepsis were included in the study. Almost one-third of the admitted neonates (33.4%) were diagnosed as having neonatal sepsis, 32.25% of them culture-proven. Early/late onset sepsis was found in 35.4 and 64.6%, respectively. Gram-negative/gram-positive bacteria was found in 68 to 25.6%. Fungal infection was detected in 9% of the isolates. Escherichia coli was the main pathogen isolated in both early-onset sepsis (41.2%) and late-onset sepsis (24.5%). Overall, 77% of the isolates were multidrug-resistant (60% of gram-positive bacteria and 83.4% of gram-negative bacteria). Nearly 80% (79%) of mortality was caused by multidrug-resistant organisms. Gram-positive and gram-negative bacteria showed high resistance against commonly used antibiotics such as ampicillin, amoxicillin, cefotaxime, ceftriaxone, and gentamicin. There is an alarming increase in antibiotic resistance to the commonly used antibiotics. Continuous surveillance for antibiotic susceptibility is needed to ensure proper empirical therapy. Improvement of infection control practices, avoidance of irrational use of antibiotics, and revision of the protocols are mandatory in the prevention of neonatal sepsis.

  20. Incidence of congenital heart disease among neonates in a neonatal unit of a tertiary care hospital

    International Nuclear Information System (INIS)

    Hussain, S.; Sabir, M.U.

    2014-01-01

    Objectives: To determine the incidence and pattern of various congenital heart disease in a neonatal unit of a tertiary care hospital. Methods: The prospective study was carried out in the neonatal unit of Combined Military Hospital, Rawalpindi, from September 2008 to August 2011. All 5800 neonates admitted with gestational age of >28 weeks irrespective of birthweight were included in the study. Neonatologist/Paediatrician carried out the neonatal examination during the first 12 hours of life. Neonates suspected of having congenital heart disease were further evaluated by pulse oxymetry, X-ray chest and echocardiography to ascertain final diagnosis and type of lesion. Data was collected on a predesigned proforma containing information regarding gender, mode of delivery, gestational age, weight at birth, family history, and associated malformations. SPSS 16 was used for statistical analysis. Results: Of the 5800 neonates, 87 (1.5%) were found to have congenital heart disease with an incidence of 15/1000. There was a male preponderance. Most common lesion was ventricular septal defect 27(31.3%), followed by atrial septal defect 20 (22.9%), patent ductus arteriosus 13 (14.94%), tetralogy of fallot 06 (6.89%), transposition of great arteries 04 (4.59%), Pulmonary stenosis 05 (5.79%) and 03(3.44%) had atrioventricular canal defects. Conclusion: Congenital heart disease is a common congenital anomaly. Its incidence varies from centre to centre due to different factors like nature of the sample, method of detection and early examination by a neonatologist/paediatrician. In this study a higher incidence is reported because it was carried out in a tertiary care unit, which is a referral hospital and all the neonates admitted in the unit were included in the study. (author)

  1. Genetic polymorphisms and sepsis in premature neonates.

    Directory of Open Access Journals (Sweden)

    Susanna Esposito

    Full Text Available Identifying single nucleotide polymorphisms (SNPs in the genes involved in sepsis may help to clarify the pathophysiology of neonatal sepsis. The aim of this study was to evaluate the relationships between sepsis in pre-term neonates and genes potentially involved in the response to invasion by infectious agents. The study involved 101 pre-term neonates born between June 2008 and May 2012 with a diagnosis of microbiologically confirmed sepsis, 98 pre-term neonates with clinical sepsis and 100 randomly selected, otherwise healthy pre-term neonates born during the study period. During the study, 47 SNPs in 18 candidate genes were genotyped on Guthrie cards using an ABI PRISM 7900 HT Fast real-time and MAssARRAY for nucleic acids instruments. Genotypes CT and TT of rs1143643 (the IL1β gene and genotype GG of rs2664349GG (the MMP-16 gene were associated with a significantly increased overall risk of developing sepsis (p = 0.03, p = 0.05 and p = 0.03, whereas genotypes AG of rs4358188 (the BPI gene and CT of rs1799946 (the DEFβ1 gene were associated with a significantly reduced risk of developing sepsis (p = 0.05 for both. Among the patients with bacteriologically confirmed sepsis, only genotype GG of rs2664349 (the MMP-16 gene showed a significant association with an increased risk (p = 0.02. Genotypes GG of rs2569190 (the CD14 gene and AT of rs4073 (the IL8 gene were associated with a significantly increased risk of developing severe sepsis (p = 0.05 and p = 0.01. Genotype AG of rs1800629 (the LTA gene and genotypes CC and CT of rs1341023 (the BPI gene were associated with a significantly increased risk of developing Gram-negative sepsis (p = 0.04, p = 0.04 and p = 0.03. These results show that genetic variability seems to play a role in sepsis in pre-term neonates by influencing susceptibility to and the severity of the disease, as well as the risk of having disease due to specific pathogens.

  2. NEONATAL COMPLICATIONS OF PREMATURE RUPTURE OF MEMBRANES

    Directory of Open Access Journals (Sweden)

    F. Nili AA. Shams Ansari

    2003-07-01

    Full Text Available Premature rupture of membranes (PROM is one of the most common complications of pregnancy that has a major impact on neonatal outcomes. With respect to racial, nutritional and cultural differences between developed and developing countries, this study was conducted to detect the prevalence of neonatal complications following PROM and the role of the duration of rupture of membranes in producing morbidities and mortalities in these neonates in our hospital. Among 2357 pregnant women, we found 163 (6.91% cases of premature rupture of the fetal membranes in Tehran Vali-e-Asr Hospital during April 2001 to April 2002. Route of delivery was cesarean section in 65.6% of women. Urinary tract infection occured in 1.8%, maternal leukocytosis and fever in 20.2% and 5.5%, chorioamnionitis in 6.1%, fetal tachycardia in 1.2% and olygohydramnios in 4.9%. Gestational age in 138 (86% of neonates was less than 37 completed weeks. Thirty five infants (21.47% had respiratory distress syndrome and 33 (20.245% had clinical sepsis. Pneumonia in 6 (3.7% and skeletal deformity in 7 (4.294% were seen. Rupture of membrane of more than 24 hours duration occurred in 71 (43.6% of the patients. Comparison of morbidities between two groups of neonates and their mothers according to the duration of PROM (less and more than 24 hours showed significant differences in NICU admission, olygohydramnios, maternal fever, leukocytosis and chorioamnionitis rates (p24 hr of PROM with an odds ratio of 2.68 and 2.73, respectively. Positive blood and eye cultures were detected in 16 cases during 72 hours of age. Staphylococcus species, klebsiella, E.coli and streptococcus were the predominant organisms among positive blood cultures. Mortality was seen in 18 (11% of neonates because of respiratory failure, disseminated intravascular coagulation, septic shock, and a single case of congenital toxoplasmosis. In this study, the prevalence of prematurity, sepsis and prolonged rupture of membrane

  3. Neonatal respiratory depression associated with epidural analgesia

    Directory of Open Access Journals (Sweden)

    Alberto Gálvez Toro

    2013-06-01

    Full Text Available Background: Epidural analgesia is the most effective analgesics used during childbirth but is not without its problems.In the Hospital San Juan de la Cruz of Ubeda from November 2011 we have detected 3 cases of newborn infants with signs of respiratory depression. Appeared in them: normal cardiotocographic records during childbirth, use of epidural associated with fentanyl, termination by vacuum and elevated temperature in one case.ObjectivesKnow if the neonatal adaptation to extrauterine life may be influenced by the use of epidural analgesia in childbirth. Review what role can have the rise in maternal temperature and the use of epidural fentanyl with the appearance of newborn respiratory distress.MethodsLiterature Review conducted in February of 2012 in Pubmed and the Cochrane Library, using the key words: childbirth, epidural analgesia, neonatal respiratory depression.ResultsOn the respiratory depression associated with fentanyl, a Cochrane review found indicating that newborns of mothers with an epidural, had a lower pH and were less need for administration of naloxone.On PubMed we find a review study that indicates that the respiratory depression caused by the administration of opioids via neuroaxial is rare, placing it below 1 per 1000, and a clinical case that concluded that doses of fentanyl exceeding 300 µg (approx. 5 µg/kg for 4 hours previous to childbirth, have a high risk of neonatal respiratory depression at birth.The same Cochrane review indicates that the women with epidural analgesia had increased risk of maternal fever of at least 38 ° C and a recent cohort study relates this increase in temperature with a greater likelihood of neonatal adverse events (from 37.5 ° C.ConclusionsThe studies found considered safe epidurals to the neonate and the mother, except when certain conditions are met. The literature and our clinical experience have been reports linking neonatal respiratory depression with increasing temperature (37

  4. Patterns of admission and factors associated with neonatal mortality among neonates admitted to the neonatal intensive care unit of University of Gondar Hospital, Northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Demisse AG

    2017-05-01

    Full Text Available Abayneh Girma Demisse, Fentahun Alemu, Mahlet Abayneh Gizaw, Zemene Tigabu School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia Introduction: The neonatal period is a highly vulnerable time for an infant completing many of the physiologic adjustments required for life outside the uterus. As a result, there are high rates of morbidity and mortality. The three major causes of mortality in developing countries include prematurity, infection, and perinatal asphyxia. The aim of this study was to identify the patterns of neonatal admission and factors associated with mortality among neonates admitted at the Neonatal Intensive Care Unit (NICU of University of Gondar Hospital.Materials and methods: A retrospective cross-sectional study was conducted among all admitted neonates in the NICU of University of Gondar referral hospital from December 1, 2015 to August 31, 2016. Information was extracted retrospectively during admission from patient records and death certificates, using a pretested questionnaire. The data were entered and analyzed using SPSS version 20, and p-values <0.05 were considered statistically significant.Results: A total of 769 neonates was included in the study. There were 448 (58.3% male neonates, and 398 (51.8% neonates were rural residents. More than two-thirds of the 587 deliveries (76.3% were performed in tertiary hospitals. Neonatal morbidity included hypothermia 546 (71%, sepsis 522 (67.9%, prematurity 250 (34.9%, polycythemia 242 (31.5%, hypoglycemia 142 (18.5, meconium aspiration syndrome 113 (14.7%, and perinatal asphyxia 96 (12.5%. The overall mortality was 110 (14.3%; 95% confidence interval [CI]: 11.9–16.9 of which 69 (62.7% deaths occurred in the first 24 hours of age. In the multivariate analysis, mortality was associated with perinatal asphyxia (adjusted odds ratio [AOR]: 5.97; 95% CI: 3.06–11.64, instrumental delivery (AOR: 2.99; 95% CI: 1.08–8.31, and early onset

  5. Use and safety of azithromycin in neonates: a systematic review.

    Science.gov (United States)

    Smith, Coral; Egunsola, Oluwaseun; Choonara, Imti; Kotecha, Sailesh; Jacqz-Aigrain, Evelyne; Sammons, Helen

    2015-12-09

    To identify the use and adverse drug reactions associated with azithromycin in neonates. Databases MEDLINE (1948-August 2015), EMBASE (1980-August 2015) and Pubmed (August 2015) were searched for studies on azithromycin in neonates. All studies involving neonates (azithromycin for which safety was evaluated. The primary outcome was adverse event (AE) associated with use of azithromycin. Use of azithromycin in neonates was the secondary outcome. A total of 11 articles involving 473 neonates were identified. 371 AEs were reported. Adverse events were mainly respiratory (358/1000 neonate), neurological (273/1000 neonates) and gastrointestinal (196/1000 neonates) in origin. Azithromycin significantly reduced the risk of bronchopulmonary dysplasia (BPD) in extremely premature neonates (RR=0.83, 95% CI 0.71 to 0.98, p=0.02). There was no significant difference in the incidence of elevated liver enzymes between the azithromycin and placebo group (p=0.76). There were four cases of infantile hypertrophic pyloric stenosis (IHPS). Azithromycin significantly reduces the risk of BPD in preterm neonates. The relationship between azithromycin and IHPS requires further investigation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  6. Audit of a clinical guideline for neonatal hypoglycaemia screening.

    Science.gov (United States)

    Sundercombe, Samantha L; Raynes-Greenow, Camille H; Carberry, Angela E; Turner, Robin M; Jeffery, Heather E

    2013-10-01

    This study aims to evaluate adherence to a clinical guideline for screening and prevention of neonatal hypoglycaemia on the post-natal wards. Retrospective chart review of 581 healthy term neonates born at a tertiary maternity hospital. Indications for hypoglycaemia screening included small for gestational age (SGA), infants of diabetic mothers (IDM; gestational, Type 1 or 2), symptomatic hypoglycaemia, macrosomia and wasted (undernourished) appearance. Outcomes were protocol entry and adherence with hypoglycaemia prevention strategies including early and frequent feeding and timely blood glucose measurement. Of 115 neonates screened for hypoglycaemia, 67 were IDM, 19 were SGA (including two both IDM and SGA), and two were macrosomic. One IDM and one SGA were not screened. Twenty-two neonates were screened for a reason not identifiable from the medical record, and 13 neonates were SGA by a definition different to the guideline definition, including five who were also IDM. Guideline adherence was variable. Few neonates (41 of 106, 39%) were fed in the first post-natal hour, and blood glucose measurement occurred later than recommended for 41 of 106 (39%) of neonates. Most IDM and SGA neonates were screened. While guideline adherence overall was comparable with other studies, neonates were fed late. We recommend staff education about benefits of early (within the first hour) frequent breastfeeding for neonates at risk. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  7. Maternal and Fetal Determinants of Neonatal Body Composition.

    Science.gov (United States)

    Breij, Laura M; Steegers-Theunissen, Régine P M; Briceno, Daniela; Hokken-Koelega, Anita C S

    2015-01-01

    Body composition in early life influences the development of obesity during childhood and beyond. It is, therefore, important to adequately determine neonatal body composition. Fetal growth and maternal factors might influence neonatal fat mass percentage (FM%), independent of birth weight. In 194 healthy neonates, we investigated neonatal body composition, measured by air-displacement plethysmography (PEAPOD), and its associations with estimated fetal weight (EFW), neonatal anthropometric data, maternal preconceptional body mass index (BMI) and maternal weight gain during pregnancy. There was a large variation in neonatal FM%, even in case of a similar birth weight, corrected for gender and gestational age. Neonatal FM% was associated with EFW at 30 and 36 weeks of gestation and with catch-up in weight between 30 and 36 weeks of gestation, but not with EFW at 20 weeks (p Neonatal FM% was also associated with preconceptional BMI of the mother (p maternal weight gain. Our study shows that term neonates have a large variation in FM%. Neonatal FM% is associated with EFW at 30 and 36 weeks, catch-up in weight between 30 and 36 weeks of gestation and preconceptional BMI of the mother. © 2015 S. Karger AG, Basel.

  8. The Role of Laparoscopy in the Acute Neonatal Abdomen.

    Science.gov (United States)

    Burgmeier, Christine; Schier, Felix

    2016-12-01

    IntroductionThe surgical treatment of the acute neonatal abdomen still poses a challenge in pediatric surgery. Various underlying etiologies require different surgical procedures. Until today the role of laparoscopy in the surgical treatment of the acute neonatal abdomen is controversial. The aim of this study was to analyze our experiences with laparoscopy and to perform a review of the literature. Methods Retrospective, single-institution study including all term and preterm neonates initially undergoing laparoscopy due to an acute abdomen. Results Altogether, 17 neonates presenting with an acute neonatal abdomen initially underwent laparoscopy. Unnecessary laparotomy could be avoided in 9 of 17 (53%) neonates. After diagnostic laparoscopy, 2 patients did not require any further surgical intervention. Eight neonates presented midgut atresia intraoperatively, 5 of them underwent laparoscopic-assisted correction. Successful laparoscopic derotation of an acute volvulus (n = 1) and laparoscopic appendectomy (n = 1) could be performed. Conversion to open surgery was necessary in 8 neonates (47%) due to creation of a stoma (n = 5), multiple intestinal bands causing poor visualization (n = 2), and bowel necrosis (n = 1). Conclusions Laparoscopy is a useful diagnostic tool to evaluate the need for further surgical intervention in the acute neonatal abdomen and enables immediate surgical treatment of acute volvulus, appendicitis, or intestinal atresia. In case of conversion to laparotomy, precise localization of the incision is guaranteed. Minimization of the surgical trauma and avoidance of unnecessary laparotomy are the most important benefits of the minimal-invasive approach for the critically ill neonate. © The Author(s) 2016.

  9. Contribution of Congenital Anomalies to Neonatal Mortality Rates in Malta.

    Science.gov (United States)

    Gatt, Miriam; England, Kathleen; Grech, Victor; Calleja, Neville

    2015-09-01

    Neonatal mortality is a public health concern, and congenital anomalies contribute significantly to this mortality. This paper describes trends in neonatal mortality in Malta separately for congenital anomaly and non-congenital anomaly causes. Data for neonatal deaths of 22-week gestation onwards registered between 1994-2013 were obtained from the National Mortality Register. Chi-square tests were used to analyse 5-year time trends and differences in proportions of causes of neonatal deaths. Neonatal mortality was compared with other European countries. Between 1994 and 2013, 441 neonatal deaths and 84 821 livebirths were registered, giving a neonatal mortality of 5.2 per 1000 livebirths. Congenital anomalies accounted for 36.7% (n = 162) of the neonatal deaths, while the remaining 63.3% (n = 279) were attributed to non-congenital causes. During the 20-year period, neonatal mortality due to non-congenital causes decreased from 4.6 per 1000 livebirths in 1994-98 to 2.5 per 1000 in 2009-13, while that due to congenital anomalies remained stable (2.0 per 1000 livebirths in 1994-98 and 2.2 per 1000 in 2009-13). This has resulted in comparatively higher proportions of neonatal deaths attributed to congenital anomalies in recent years (45.9% in 2009-13 vs. 29.9% in 1994-98). Comparing neonatal mortality reported from European countries, Malta has a high rate most marked for deaths due to congenital anomalies. During 1994-2013, neonatal mortality has decreased due to a decline of non-congenital causes of death, possibly related to improved health care. The proportionate neonatal mortality attributed to congenital anomalies has increased and is the highest reported from Europe. This may be explained by the fact that termination of pregnancy is illegal in Malta. © 2015 John Wiley & Sons Ltd.

  10. Neonatal Outcomes of Rh-Negative Pregnancies in a Tertiary Level Neonatal Intensive Care Unit: A Prospective Study

    Directory of Open Access Journals (Sweden)

    Chacham

    2016-07-01

    Full Text Available Background Rhesus incompatibility is a preventable cause for severe neonatal hyperbilirubinemia, hydrops fetalis and still births. The prevalence of the Rh-negative blood group among Indian woman varies from 2% - 10%. Despite declining the incidence of Rhesus incompatibility, due to availability of anti-D immunoglobulin, and improved antenatal care of the Rh-negative pregnant woman, it still accounts for a significant proportion of neonatal hyperbilirubinemia and neuro-morbidity. The prevalence of Rh-negative women having Rh-positive neonates is 60%. Objectives This study aimed to estimate the incidence of Rh iso-immunization and evaluate the outcomes of Rh iso-immunized neonates. Methods This prospective observational study was conducted in a tertiary level neonatal intensive care unit, Princess Esra hospital, Deccan college of medical sciences, Hyderabad, Telangana, India. Consecutive intramural and extramural neonates admitted to neonatal intensive care unit with the Rh-negative mother’s blood group and hyperbilirubinemia were enrolled. Neonates born to Rh+ve mothers were excluded. Neonatal gestational age, birth weight, age at admission, duration of phototherapy, duration of hospitalization, neonatal examination and investigations were recorded in a predesigned, pretested performa. Results A total of 90 neonates were born to Rh-negative mothers, of which 70% (63 had the Rh-positive blood group and 30% had the Rh-negative blood group. Of these 63 neonates, 48 (76.2% had hyperbilirubinemia and 43 neonates (68.3% had significant hyperbilirubinemia (total serum bilirubin > 15mg/dL. Among them, 2%, 75% and 23% were born to primi, multi and grandmutli, respectively. Also, 14.5% of the neonates were large for dates (LFD, 75% appropriate for dates (AFD and 10.5% were small for dates (SFD. Premature and SFD neonates had higher incidence of hyperbilirubinemia. Significantly higher incidence of jaundice occurred within 72 hours of life. The mean

  11. Neonatal Body Composition: Measuring Lean Mass as a Tool to Guide Nutrition Management in the Neonate.

    Science.gov (United States)

    Rice, Melissa S; Valentine, Christina J

    2015-10-01

    Neonatal nutrition adequacy is often determined by infant weight gain. The aim of this review is to summarize what is currently known about neonatal body composition and the use of body composition as a measure for adequate neonatal nutrition. Unlike traditional anthropometric measures of height and weight, body composition measurements account for fat vs nonfat mass gains. This provides a more accurate picture of neonatal composition of weight gain. Providing adequate neonatal nutrition in the form of quantity and composition can be a challenge, especially when considering the delicate balance of providing adequate nutrition to preterm infants for catch-up growth. Monitoring weight gain as fat mass and nonfat mass while documenting dietary intake of fat, protein, and carbohydrate in formulas may help provide the medical community the tools to provide optimal nutrition for catch-up growth and for improved neurodevelopmental outcomes. Tracking body composition in term and preterm infants may also provide critical future information concerning the nutritional state of infants who go on to develop future disease such as obesity, hypertension, and hyperlipidemia as adolescents or adults. © 2015 American Society for Parenteral and Enteral Nutrition.

  12. Relationship between neonatal dacryocystitis and cesarean section and the treatment of neonatal dacryocystitis

    Directory of Open Access Journals (Sweden)

    Yun-Qi Ai

    2013-10-01

    Full Text Available AIM: To explore the treatment of neonatal dacryocystitis of different ages and the relationship between caesarean section and neonatal dacryocystitis.METHODS: A total of 260 cases(260 eyesof children with neonatal dacryocystitis were divided into 1-3 months group, 4-6 months group, 7-12 months group and 13-24 months group, Each group was respectively given the lacrimal sac massage, lacrimal passage irrigation and probing of lacrimal passage method. Curative effect of each method was observed in different groups. Analysis was made to determine whether caesarean section was the cause of neonatal dacryocystitis.RESULTS: The comparison between 1-3 months group and 4-6 months group showed significant difference(χ2=19.89, Pχ2=54.95, Pχ2=0.00003, P>0.05, lacrimal passage irrigation of these two groups showed no significant difference in efficacy. The comparison result between the other two groups showed no significant difference(Pχ2=10.29, PCONCLUSION:Lacrimal sac massage can exert very good therapeutic effects in infants less than 3 months. The curative effects of irrigation of lacrimal passage are quite good in babies under 12 months. Probing of lacrimal passage has a good curative effect in 7-12 months infants, but a poor curative effect in babies over 12 months. Caesarean section is an important cause for neonatal dacryocystitis.

  13. Chest X-ray of the neonate

    International Nuclear Information System (INIS)

    Puig, S.; Hoermann, M.; Rand, T.; Schaefer-Prokop, C.; Ponhold, W.; Kuhle, S.; Rebhandl, W.

    2000-01-01

    In diagnostic imaging of thoracic pathologies in mature and especially immature neonates, chest X-ray has a leading position. Profound knowledge of the normal chest X-ray and the potential physiological perinatal changes is the basic requirement for interpretation of the X-ray of a neonate. Childhood pathologie: Many congenital and acquired diseases that the radiologist is faced with in neonatology are unknown in the imaging of adults. Many of these changes are life-threatening or may have an impact on the patient's future quality of life. Therefore, early diagnosis in close cooperation with the paediatrician is essential. We give here an overview of the most important pathologic changes that the radiologist may be confronted with in daily routine. (orig.) [de

  14. The management of neonatal pulmonary hypertension.

    Science.gov (United States)

    Dhillon, Rami

    2012-05-01

    Most neonates with clinically significant pulmonary hypertension (PH) will have either persistent PH of the newborn (PPHN) or bronchopulmonary dysplasia. Cyanotic congenital heart disease must be actively ruled out as part of the differential diagnosis of PPHN. The maintenance of ductal patency with prostaglandins E1 or E2 in cases of doubt is safe and potentially beneficial given their pulmonary vasorelaxant properties. Specific tools in the treatment of PPHN include modern ventilatory strategies, inhaled nitric oxide, sildenafil, prostacyclin and extracorporeal membrane oxygenation. Rarely will a cardiac lesion be primarily responsible for neonatal PH although pulmonary vein stenosis and the persistence of an arterial duct must be considered, particularly in the older preterm baby with bronchopulmonary dysplasia.

  15. Teaching antenatal counseling skills to neonatal providers.

    Science.gov (United States)

    Stokes, Theophil A; Watson, Katie L; Boss, Renee D

    2014-02-01

    Counseling a family confronted with the birth of a periviable neonate is one of the most difficult tasks that a neonatologist must perform. The neonatologist's goal is to facilitate an informed, collaborative decision about whether life-sustaining therapies are in the best interest of this baby. Neonatologists are trained to provide families with a detailed account of the morbidity and mortality data they believe are necessary to facilitate a truly informed decision. Yet these complicated and intensely emotional conversations require advanced communication and counseling skills that our current fellowship-training strategies are not adequately providing. We review educational models for training neonatology fellows to provide antenatal counseling at the threshold of viability. We believe that training aimed at teaching these skills should be incorporated into the neonatal-perinatal medicine fellowship. The optimal approaches for teaching these skills remain uncertain, and there is a need for continued innovation and outcomes-based research. Published by Elsevier Inc.

  16. Molecular Mechanisms of Neonatal Brain Injury

    Directory of Open Access Journals (Sweden)

    Claire Thornton

    2012-01-01

    Full Text Available Fetal/neonatal brain injury is an important cause of neurological disability. Hypoxia-ischemia and excitotoxicity are considered important insults, and, in spite of their acute nature, brain injury develops over a protracted time period during the primary, secondary, and tertiary phases. The concept that most of the injury develops with a delay after the insult makes it possible to provide effective neuroprotective treatment after the insult. Indeed, hypothermia applied within 6 hours after birth in neonatal encephalopathy reduces neurological disability in clinical trials. In order to develop the next generation of treatment, we need to know more about the pathophysiological mechanism during the secondary and tertiary phases of injury. We review some of the critical molecular events related to mitochondrial dysfunction and apoptosis during the secondary phase and report some recent evidence that intervention may be feasible also days-weeks after the insult.

  17. Neonatal appendicitis: a survival case study

    Directory of Open Access Journals (Sweden)

    Izabela Linha Secco

    Full Text Available ABSTRACT Objective: To report a case of neonatal appendicitis in a children’s hospital in southern Brazil, demonstrating the impact on neonatal survival. Method: Case study with data collection from medical records, approved by the Institution and Ethics Committee for Research with Human Beings. Results: The clinical picture is initially characterized by food intolerance, evolving to hypoactivity, alteration of vital signs and septicemia due to intestinal perforation. Management is exclusively surgical, since no case described in the literature was diagnosed preoperatively and the findings usually point to acute abdomen. Conclusion: A focused clinical surveillance should be established when the infant presents peritoneal irritation. Follow-up of the evolution and the worsening of the symptoms by nurses, as part of the care team in partnership with the medical team, enables an early surgical intervention, thereby avoiding complications such as septicemia and death.

  18. [Neonatal listeriosis. Apropos of 53 cases].

    Science.gov (United States)

    Relier, J P; Amiel-Tison, C; Krauel, J; Helffer, L; Larroche, J C; Minkowski, A

    1977-01-01

    53 cases of neonatal listeriosis were seen during the last five years at the Intensive Care Unit for newborn infants (Pr Minkowski) and the Neonatal Center (P. Varangot) of the Port-Royal Maternity Hospital. The significant decline in mortality to 22 p. 100, when compared with previous years, was attributed to improvements in the diagnosis during the first hours of life and the contribution of artificial ventilation. The most frequent initial clinical sign was respiratory distress (58 p. 100) whereas meningitis was relatively rare (11 p. 100). Discoloration of the amniotic fluid and a fever in the mother at the time of delivery, were also important diagnostic clues. The macroscopic examination of the placenta and particularly placental smears containing listeria monocytogenes (15 of the specimens) as well as the hematological alterations, particularly an increase of the fibrinogen level above 3-4 g/1 during the first 48 hous of life (72 p. 100 of the cases) contributed to an early diagnosis.

  19. Water balance in the fetus and neonate.

    Science.gov (United States)

    Lindower, Julie B

    2017-04-01

    Fetal water balance is dependent prenatally on the placental transfer of water from maternal to fetal circulation. Adequate amniotic fluid volume is one indicator of stable fetal status and development. Excessive or less than expected amniotic fluid volume may be a precursor to postnatal morbidity and mortality. Postnatal transition is marked by predictable changes in body water including contraction of extracellular volume and insensible fluid loss, primarily across the skin barrier. The degree to which these occur is determined by gestational and postnatal age. Neonatal complications and clinical conditions associated with either retention or excessive loss of body water can occur. Fluid therapy in the neonatal intensive care unit may be guided using three clinical indicators: change in body weight, serum sodium concentration, and urine output. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Spectrum of cardiac involvement in neonatal lupus.

    Science.gov (United States)

    Hornberger, L K; Al Rajaa, N

    2010-09-01

    'Neonatal' lupus erythematosus (NLE) describes a clinical spectrum of cardiac and non-cardiac abnormalities observed in neonates and foetuses whose mothers have the auto-antibodies anti-SSA/Ro (anti-Ro) and anti-SSB/La (anti-La). Of the cardiac abnormalities, congenital AVB is the most common cardiovascular abnormality found in affected foetuses and infants. Many other cardiovascular manifestations of NLE have been more recently recognized including atrial and ventricular arrhythmias and other conduction abnormalities, myocarditis, cardiomyopathy often with endocardiofibroelastosis and structural heart disease, particularly valvar lesions. In this report, the spectrum of cardiovascular manifestations observed in foetuses and infants with NLE are reviewed and the pathogenesis, diagnosis and clinical outcomes are briefly discussed.

  1. Neonatal pertussis, cocooning and maternal immunization.

    Science.gov (United States)

    Swamy, Geeta K; Wheeler, Sarahn M

    2014-09-01

    The rising incidence of whooping cough, a highly contagious infection caused by Bordetella pertussis, is particularly significant for young infants who have the highest risk for morbidity and mortality. The pertussis resurgence has led to a shift in primary prevention relying on childhood vaccination to a cocooning strategy, that is, vaccination of close contacts of newborn infants (new mothers, fathers, grandparents, siblings, caretakers, etc.), thereby reducing pertussis exposure. Immunization of women during pregnancy rather than during the immediate postpartum period (the initial cocooning recommendation) appears to be a better approach by directly providing protection through transplacental transfer of maternal vaccine-induced antibodies. This article describes neonatal pertussis, cocooning as a means of reducing neonatal exposure to pertussis and maternal immunization as a means of protecting young infants against pertussis infection.

  2. Neonatal abstinence syndrome: a never ending story!

    Directory of Open Access Journals (Sweden)

    Johannes N. van den Anker

    2013-06-01

    Full Text Available Neonatal Abstinence syndrome (NAS is the result of fetal exposure to illicit or prescription drugs (for example opioids, benzodiazepines, and selective serotonin reuptake inhibitors taken by the mother prenatally. NAS is a complex of symptoms, caused by acute withdrawal of the illicit drug(s used by their mothers during pregnancy, seen in neonates hours or days after being born. In the United States of America around 16% of teenagers and 7% of women between the ages of 18 and 25 use illicit drugs during their pregnancies. In this paper the treatment of opioid dependence during pregnancy and treatment of NAS are presented. Proceedings of the 9th International Workshop on Neonatology · Cagliari (Italy · October 23rd-26th, 2013 · Learned lessons, changing practice and cutting-edge research

  3. Gastrointestinal ultrasound in neonates, infants and children

    International Nuclear Information System (INIS)

    Lobo, Maria Luisa; Roque, Mariana

    2014-01-01

    Today US plays an important and increasing role in the assessment of many, partially age-specific conditions in the GI tract in neonates, infants and children. Knowledge of the potential capabilities of US and its restrictions together with a skillful performance of GI US examination can provide essential anatomic and functional diagnostic information in many pediatric GI disorders. The aim of this review is to highlight the potential of ultrasound (US) in the evaluation of the gastrointestinal (GI) tract in neonates, infants and children. Basic and potential applications of modern US tools in pediatric GI tract are addressed, the GI US examination technique is discussed – including some common and/or typical clinical applications of and indications for US

  4. Symptomatic aneurysm of ductus arteriosus in neonates

    Directory of Open Access Journals (Sweden)

    Nageswara R Koneti

    2011-01-01

    Full Text Available Four neonates presented within 24 hours of birth with stridor, respiratory distress and a weak cry. Clinical examination of the cardiovascular system revealed no abnormality. The transthoracic echocardiogram showed large aneurysm of ductus arteriosus at the aortic isthmus, tapering to a small tortuous channel at the site of pulmonary artery insertion. Computerized tomography scan performed in two of the neonates demonstrated considerable compression of adjacent thoracic structures. One required surgical excision due to persistence of symptoms. Serial echocardiograms in the remaining three babies showed transition through various stages of resolution over a period of 6 weeks to 3 months, resulting in the obliteration of the aneurysm. All babies are doing well during the follow-up.

  5. Symptomatic aneurysm of ductus arteriosus in neonates

    International Nuclear Information System (INIS)

    Koneti, Nageswara R; Kanchi, Vasudevan; Kandraju, Hemasree; Jaishankar, S

    2011-01-01

    Four neonates presented within 24 hours of birth with stridor, respiratory distress and a weak cry. Clinical examination of the cardiovascular system revealed no abnormality. The transthoracic echocardiogram showed large aneurysm of ductus arteriosus at the aortic isthmus, tapering to a small tortuous channel at the site of pulmonary artery insertion. Computerized tomography scan performed in two of the neonates demonstrated considerable compression of adjacent thoracic structures. One required surgical excision due to persistence of symptoms. Serial echocardiograms in the remaining three babies showed transition through various stages of resolution over a period of 6 weeks to 3 months, resulting in the obliteration of the aneurysm. All babies are doing well during the follow-up

  6. [Neonatal complications related to shoulder dystocia].

    Science.gov (United States)

    Lopez, E; de Courtivron, B; Saliba, E

    2015-12-01

    To describe neonatal complications related to shoulder dystocia. This systematic evidence review is based on PubMed search, Cochrane library and experts' recommendations. The risks of brachial plexus birth injury, clavicle and humeral fracture, perinatal asphyxia, hypoxic-ischemic encephalopathy and perinatal mortality are increased after shoulder dystocia. The medical team should be able to provide neonatal resuscitation in the delivery room in case of perinatal asphyxia following shoulder dystocia, according to national and international guidelines. The initial clinical examination should search for complications such as brachial plexus birth injury or clavicle fracture. The risk of perinatal complications is increased in newborn after shoulder dystocia. The medical team should be able to manage these complications. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  7. Iodine status in neonates in Denmark

    DEFF Research Database (Denmark)

    Nøhr, S B; Laurberg, Peter; Børlum, K G

    1994-01-01

    Iodine status of 147 neonates born in five different regions of Denmark was evaluated in relation to the iodine content of breast milk and iodine supplementation taken by the mother. Approximately two-thirds of the women had not received iodine supplementation. They had low iodine concentrations...... in breast milk and urinary iodine concentrations of the neonates at day 5 were low. The median values (milk/urine) were 33.6/31.7 micrograms/l (Randers 22/26, Ringkøbing 29/16, Aalborg 36/31. Arhus 54/41 and Copenhagen 55/59 micrograms/l). Higher values were found in the group where tablets containing...... iodine had been taken (milk/urine: 57.0/61.0 micrograms/l). In general, the values are low compared with internationally recommended levels. We suggest that mothers without autoimmune thyroid disease should receive iodine supplementation in the form of vitamin/mineral tablets containing iodine (150...

  8. Vitamin D and neonatal immune function.

    LENUS (Irish Health Repository)

    Clancy, N

    2013-05-01

    Vitamin D deficiency is widespread in the neonatal and paediatric population of northern latitudes, particularly in children of African, Middle Eastern and Asian ethnicity. This is associated with diminished immune function and increases the risk of Th1 autoimmune diseases like type 1 diabetes. Epidermiological studies have also shown a link between vitamin D deficiency in children and a more severe course of illness with lower respiratory tract infection or Respiratory Syncitial Virus (RSV) bronchiolitis. The mechanism by which vitamin D enhances immunity is complex. It acts through the innate immune system by inducing antimicrobial peptides in epithelial cells, neutrophils and macrophages. The role of Vitamin D in neonatal and paediatric immunomodulation requires further study.

  9. Neonatal mortality and morbidity in the post-implementation period of a neonatal teaching program in provincial hospitals in Laos.

    Science.gov (United States)

    Schmidt, S; Bounnack, S; Hoehn, T

    2018-01-01

    Aim of this study was to analyze neonatal mortality and morbidity in the post-implementation period of a neonatal teaching program to examine a possible impact on neonatal outcomes. This study is a retrospective data analysis of all neonatal patients treated in five provincial hospitals in Laos after implementation of a neonatal teaching program. A simulation-based teaching program aims to have positive impact on the theoretical and practical skill of hospital staff in the field of newborn care. A comparison between pre-implementation and post-implementation data of newborns admitted to provincial hospitals in Laos was used to quantify the effect of repetitive teaching on neonatal outcomes. Neonatal mortality and morbidity as well as case fatality rates of infections and asphyxia decreased in the post-implementation period. In contrast, neonatal mortality rate as well as case fatality rate of prematurity increased. The total neonatal mortality rate increased in the post-implementation period. The pre-implementation and post-implementation data enable longitudinal comparisons between hospitals and highlight the differences between hospitals concerning neonatal mortality and morbidity in provincial hospitals in Laos. These data can serve as a basis for an individual adaption of the teaching program to the unique requirements of each single hospital. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  10. Validation of Greek Versions of the Neonatal Infant Pain Scale and Premature Infant Pain Profile in Neonatal Intensive Care Unit.

    Science.gov (United States)

    Dionysakopoulou, Christina; Giannakopoulou, Margarita; Lianou, Loukia; Bozas, Evangelos; Zannikos, Kirikas; Matziou, Vasiliki

    2017-09-22

    The Neonatal Infant Pain Scale and the Premature Infant Pain Profile have been used widely in neonatal intensive care units for pain assessment. This study reports the evaluation and validation of these scales in full-term newborns who were hospitalized in two Greek neonatal intensive care units. Evaluation and validation of the Neonatal Infant Pain Scale and the Premature Infant Pain Profile in full-term newborns who were hospitalized in two Greek neonatal intensive care units. A cross-sectional study. Two neonatal intensive care units at a large General Children's Hospital in Greece. A total of 81 full-term newborns. This cross-sectional study was conducted in two neonatal intensive care units at a large General Children's Hospital in Greece. We studied 81 full-term newborns, who were exposed to various painful routine procedures. A single measurement was taken from each neonate. Two observers were present during each procedure and evaluated pain using both the Neonatal Infant Pain Scale and Premature Infant Pain Profile. Internal consistency coefficient Cronbach's α, internal class agreement coefficient, and κ factor were appropriately measured. The weighting of the Neonatal Infant Pain Scale and Premature Infant Pain Profile pointed out an excellent coherence between the two scales and agreement among the researchers. The internal consistency coefficient Cronbach's α was >.8 and the internal class agreement coefficient was >.98 for both scales, which indicates an excellent consistency between scales. The κ factor for Neonatal Infant Pain Scale was >.73 and for the Premature Infant Pain Profile it was >.6, which indicates a significant agreement among investigators. The Neonatal Infant Pain Scale and Premature Infant Pain Profile were successfully adjusted in Greek standards with reliability between the scales and among the researchers. Moreover, they constitute reliable tools for the evaluation of neonatal procedural pain in full-term newborns in Greece

  11. Genetic disorders associated with neonatal jaundice

    OpenAIRE

    Morioka, Ichiro; Morikawa, Satoru; Yusoff, Surini; Harahap, Indra Sari Kusuma; Nishimura, Noriyuki; Yokoyama, Naoki; Matsuo, Masafumi; Rostenberghe, Hans Van; Nishio, Hisahide

    2013-01-01

    Abstract. Neonatal jaundice is very common in newborn infants. Although it is often a natural and transitional condition, some infants develop severe hyperbilirubinemia, in which unconjugated bilirubin in the serum may cross the blood-brain-barrier and cause bilirubin encephalopathy (acute bilirubin intoxication) or kernicterus (chronic bilirubin intoxication). To avoid these hazardous conditions, it is important to identify the infants at risk for developing severe hyperbilirubinemia. There ...

  12. Early-onset neonatal infection in Lithuania

    Directory of Open Access Journals (Sweden)

    Rasa Tamelienė

    2015-01-01

    Full Text Available Aim: The aim of the study was to analyze the etiology of early-onset neonatal infection (EONI, the risk factors, the forms and the time of its manifestation, and the tactics and outcomes of antibacterial treatment. Methods: During the prospective investigation, cases of newborns with diagnosed EONI and initial treatment in 2011 were analyzed. Four in-patient departments of Lithuania took part in the investigation. Results: In total, 18,778 newborns were included in the investigation. During the studied period, 209 cases of EONI were diagnosed: unspecified EONI in 168 (80.4% neonates, pneumonia in 20 (9.6%, and early-onset sepsis (EOS in 21 (10% neonates. Group B Streptococcus (GBS was responsible for 40% of microbiologically confirmed cases of sepsis. A negative blood culture was found in 11 newborns (52.4% treated for sepsis. In all the cases, EONI was empirically treated with penicillin and gentamycin. The duration of antibacterial treatment varied between in-patient departments in Lithuania. During the studied period, 51.7% of women were screened for GBS colonization during pregnancy, and 21% of them had a positive vaginal culture for GBS; 78% of GBS carriers received intrapartum prophylactic antibiotics. Conclusions: The incidence of culture-confirmed early neonatal sepsis in Lithuania is similar to that indicated in the scientific literature, and is decreasing. Routine antenatal screening for GBS vaginal carriage in pregnant women is not universally performed in Lithuania. The duration of antibacterial treatment for EONI should be standardized in Lithuania.

  13. COVERS Neonatal Pain Scale: Development and Validation

    OpenAIRE

    Hand, Ivan L.; Noble, Lawrence; Geiss, Donna; Wozniak, Laura; Hall, Charles

    2010-01-01

    Newborns and infants are often exposed to painful procedures during hospitalization. Several different scales have been validated to assess pain in specific populations of pediatric patients, but no single scale can easily and accurately assess pain in all newborns and infants regardless of gestational age and disease state. A new pain scale was developed, the COVERS scale, which incorporates 6 physiological and behavioral measures for scoring. Newborns admitted to the Neonatal Intensive Ca...

  14. Toll-like receptors in neonatal sepsis.

    LENUS (Irish Health Repository)

    O'Hare, Fiona M

    2013-06-01

    Toll-like receptors are vital transmembrane receptors that initiate the innate immune response to many micro-organisms. The discovery of these receptors has improved our understanding of host-pathogen interactions, and these receptors play an important role in the pathogenesis of multiple neonatal conditions such as sepsis and brain injury. Toll-like receptors, especially TLRs 2 and 4, are associated with necrotizing enterocolitis, periventricular leukomalacia and sepsis.

  15. Ethical challenges in neonatal intensive care nursing.

    Science.gov (United States)

    Strandås, Maria; Fredriksen, Sven-Tore D

    2015-12-01

    Neonatal nurses report a great deal of ethical challenges in their everyday work. Seemingly trivial everyday choices nurses make are no more value-neutral than life-and-death choices. Everyday ethical challenges should also be recognized as ethical dilemmas in clinical practice. The purpose of this study is to investigate which types of ethical challenges neonatal nurses experience in their day-to-day care for critically ill newborns. Data were collected through semi-structured qualitative in-depth interviews. Phenomenological-hermeneutic analysis was applied to interpret the data. Six nurses from neonatal intensive care units at two Norwegian hospitals were interviewed on-site. The study is designed to comply with Ethical Guidelines for Nursing Research in the Nordic Countries and the Helsinki declaration. Findings suggest that nurses experience a diverse range of everyday ethical challenges related to challenging interactions with parents and colleagues, emotional strain, protecting the vulnerable infant, finding the balance between sensitivity and authority, ensuring continuity of treatment, and miscommunication and professional disagreement. A major finding in this study is how different agents involved in caring for the newborn experience their realities differently. When these realities collide, ethical challenges arise. Findings suggest that acting in the best interests of the child becomes more difficult in situations involving many agents with different perceptions of reality. The study presents new aspects which increases knowledge and understanding of the reality of nursing in a neonatal intensive care unit, while also demanding increased research in this field of care. © The Author(s) 2014.

  16. Neonatal skull depression unassociated with birth trauma

    International Nuclear Information System (INIS)

    Eisenberg, D.; Kirchner, S.G.; Perrin, E.C.

    1984-01-01

    With few exceptions, a depression of the calvaria in a neonate is caused by birth trauma and often is associated with fracture. Localized depression of the skull without trauma is rare, and such a case is reported here. The cause, complications, and treatment of this condition are briefly discussed. Computed tomography (CT) was useful in clinical management. Although sizable, the depression was not associated with neurologic features and disappeared spontaneously

  17. [Treatment of neonatal jaundice by efficient phototherapy].

    Science.gov (United States)

    Wiese, G

    1985-01-01

    Idiopathic neonatal jaundice derives from an initial insufficiency of all processes which metabolize hydrophobic bilirubin into diglucuronide excretable in bile. The term 'neonatal hyperbilirubinemia' should only be used when there is a potential risk of bilirubin intoxication. Thus, the concept hyperbilirubinemia is not necessarily linked to the exceeding of a certain threshold value, but rather to the maturity of the child and its clinical condition. In this sense, hyperbilirubinemia is, therefore, always a syndrome requiring treatment. Besides substitution transfusion, which is highly effective per se, but risky and costly, enzyme induction (e.g., by administration of phenobarbital) represents an elegant causal therapy; however, because of its slow onset of action, it has to be given prophylactically to almost all newborns. In addition, this method requires a general induction of all microsomal enzyme systems, and is hence a major intervention in the process of maturation of the neonatal enzyme systems. Therefore, phototherapy must be regarded as the treatment of choice in cases of idiopathic neonatal hyperbilirubinemia. It leads to a bypassing of the hepatic enzyme insufficiency in that by interaction between light with a wavelength of around 460 nm and the bilirubin molecules in the skin, an isomeric, water-soluble, renally secretable bilirubin is produced. The effect of phototherapy, i.e., the reduction in the serum bilirubin concentration under phototherapy, may be described as a simple e-function. The evaluation of this regular occurrence provides important information applicable to the phototherapy procedure: it should not be initiated prematurely, the duration of radiation should be as short as possible, the irradiated surface as large as possible, the radiation source should be exploited to a maximum by keeping the distance from the light source short and using lateral reflectors. As supporting measures intestinal lavage, early oral administration of

  18. Caspofungin therapy of neonates with invasive candidiasis.

    Science.gov (United States)

    Odio, Carla M; Araya, Roberto; Pinto, Luis E; Castro, Carlos E; Vasquez, Sergio; Alfaro, Braulio; Sàenz, Alberto; Herrera, Marco L; Walsh, Thomas J

    2004-12-01

    Invasive candidiasis is an increasing problem in neonatal intensive care units worldwide and is an important cause of morbidity, mortality and prolongation of hospital stay. Despite administration of amphotericin B, invasive candidiasis in neonates is sometimes complicated by persistent fungemia and refractory invasive candidiasis. The problem has been augmented by the increasing prevalence of non-albicans species that often are resistant to fluconazole and to amphotericin B. The population consisted of 1 term and 9 premature neonates with invasive candidiasis caused by Candida albicans (n = 4), Candida parapsilosis (n = 3), Candida tropicalis (n = 2) and Candida glabrata (n = 1). Despite initial therapy with deoxycholate amphotericin B, blood cultures remained positive in all patients for 13-49 days. Invasive candidiasis progressed to meningitis and enlarging renal Candida bezoars in the kidney of one patient and an enlarging atrial vegetation in another. Another patient developed severe hypokalemia refractory to potassium supplementation. Two of the C. albicans and all of the non-albicans Candida isolates were resistant to fluconazole; the C. glabrata isolate was resistant to amphotericin B. Amphotericin B was discontinued and caspofungin initiated in all patients in a dosage of 1 mg/kg/d for 2 days followed by 2 mg/kg/d. All positive blood cultures cleared between 3 and 7 days after initiation of caspofungin, the atrial vegetation resolved and the renal Candida bezoars disappeared. Renal and hepatic function tests did not show any values above normal throughout caspofungin therapy. There were no attributable clinical adverse events during the administration of caspofungin in any of the patients. Caspofungin was effective, safe and well-tolerated as an alternative therapy for persistent and progressive candidiasis in those neonates who were unresponsive to or intolerant of deoxycholate amphotericin B.

  19. Progressive liver calcifications in neonatal coxsackievirus infection

    Energy Technology Data Exchange (ETDEWEB)

    Konen, O.; Rathaus, V.; Shapiro, M. [Dept. of Diagnostic Imaging, Sapir Medical Center, Meir General Hospital, Kfar Saba (Israel); Bauer, S.; Dolfin, T. [Neonatal Dept. Neonatal intensive Care, Sapir Medical Center, Meir General Hospital Affiliated with the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv (Israel)

    2000-05-01

    Coxsackievirus group B can cause a severe systemic disease in the perinatal period. Severe manifestations like meningitis, encephalitis, hepatitis, and myocarditis have been previously reported. A case of a twin neonate infected by coxsackievirus group B is described, who developed progressive extensive hepatic calcifications demonstrated by ultrasound and computed tomography with follow-up. Hepatic calcifications in coxsackievirus infection have not been previously reported. (orig.)

  20. Congenital lobar emphysema in neonates: Anaesthetic challenges

    Directory of Open Access Journals (Sweden)

    Mridu Paban Nath

    2011-01-01

    Full Text Available Congenital lobar emphysema (CLE is a potentially reversible, though possibly life-threatening, cause of respiratory distress in the neonate. It poses dilemma in diagnosis and management. We are presenting a 6-week-old baby who presented with a sudden onset of respiratory distress related to CLE affecting the left upper lobe. Lobectomy was performed under general anaesthesia with one lung ventilation. The details of anaesthetic challenges and management are described here.

  1. Risk factors of neonatal mortality in Ethiopia

    African Journals Online (AJOL)

    admin

    (HR=3.73, 95% CI: 2.81-4.94), first order birth (HR=1.68, 95% CI: 1.25-2.24), male sex (HR=1.26, 95% CI: 1.06-. 1.50), birth interval ..... Table 2: Results of the Kaplan-Meier estimates of neonatal survival function. Days. Total. Fail. Net. Lost. Survival function. Std. error. 95% confidence interval. 1. 8651. 223. 63. 0.9742.

  2. Neonatal cholestasis due to primary sclerosing cholangitis

    Directory of Open Access Journals (Sweden)

    Naman Sadanand Shetty

    2016-01-01

    Full Text Available Neonatal cholestasis is rarely caused due to primary sclerosing cholangitis, which is an inflammatory disease of the bile ducts, which results in obstructive fibrosis of the ducts. A 7-month-old male child presented with jaundice along with high-colored urine and clay-colored stools since birth. Liver biopsy showed mild bile duct proliferation with cholangioles showing bile and thrombi suggestive of primary sclerosing cholangitis.

  3. Multifocal atrial tachycardia in two neonates.

    Science.gov (United States)

    Farooki, Z Q; Green, E W

    1977-01-01

    Two neonates with rapid and irregular pulse rate had an uncommon form of atrial tachycardia. The irregular heart rate was first detected during fetal monitoring. Postnatal electrocardiograms were compatible with the diagnosis of multifocal atrial tachycardia or chaotic atrial rhythm. Both patients were treated with digoxin and the rhythm gradually reverted to sinus. This may represent the first description of multifocal atrial tachycardia in the newborn. Images PMID:901681

  4. The Neurodevelopmental Impact of Neonatal Morphine Administration

    OpenAIRE

    Attarian, Stephanie; Tran, Lan Chi; Moore, Aimee; Stanton, George; Meyer, Eric; Moore, Robert P.

    2014-01-01

    Medical management of newborn infants often necessitates recurrent painful procedures, which may alter nociceptive pathways during a critical developmental period and adversely effect neuropsychological outcomes. To mitigate the effects of repeated painful stimuli, opioid administration for peri-procedural analgesia and ICU (intensive care unit) sedation is common in the NICU (neonatal intensive care unit). A growing body of basic and animal evidence suggests potential long-term harm associat...

  5. Immunity to rotavirus in conventional neonatal calves.

    OpenAIRE

    Vonderfecht, S L; Osburn, B I

    1982-01-01

    The local and systemic humoral immune responses to rotavirus were studied in six conventional neonatal calves. Attenuated bovine rotavirus was administered either orally or directly into an isolated intestinal loop. The parameters monitored were neutralizing rotavirus antibody in serum, immunofluorescent and neutralizing rotavirus antibody in intestinal loop washings, and rotavirus antibody-producing cells in intestinal mucosa. An antibody response was observed in the serum and intestinal sec...

  6. Pediatric Palliative Care in Infants and Neonates

    Directory of Open Access Journals (Sweden)

    Brian S. Carter

    2018-02-01

    Full Text Available The application of palliative and hospice care to newborns in the neonatal intensive care unit (NICU has been evident for over 30 years. This article addresses the history, current considerations, and anticipated future needs for palliative and hospice care in the NICU, and is based on recent literature review. Neonatologists have long managed the entirety of many newborns’ short lives, given the relatively high mortality rates associated with prematurity and birth defects, but their ability or willingness to comprehensively address of the continuum of interdisciplinary palliative, end of life, and bereavement care has varied widely. While neonatology service capacity has grown worldwide during this time, so has attention to pediatric palliative care generally, and neonatal-perinatal palliative care specifically. Improvements have occurred in family-centered care, communication, pain assessment and management, and bereavement. There remains a need to integrate palliative care with intensive care rather than await its application solely at the terminal phase of a young infant’s life—when s/he is imminently dying. Future considerations for applying neonatal palliative care include its integration into fetal diagnostic management, the developing era of genomic medicine, and expanding research into palliative care models and practices in the NICU.

  7. COVERS Neonatal Pain Scale: Development and Validation

    Directory of Open Access Journals (Sweden)

    Ivan L. Hand

    2010-01-01

    Full Text Available Newborns and infants are often exposed to painful procedures during hospitalization. Several different scales have been validated to assess pain in specific populations of pediatric patients, but no single scale can easily and accurately assess pain in all newborns and infants regardless of gestational age and disease state. A new pain scale was developed, the COVERS scale, which incorporates 6 physiological and behavioral measures for scoring. Newborns admitted to the Neonatal Intensive Care Unit or Well Baby Nursery were evaluated for pain/discomfort during two procedures, a heel prick and a diaper change. Pain was assessed using indicators from three previously established scales (CRIES, the Premature Infant Pain Profile, and the Neonatal Infant Pain Scale, as well as the COVERS Scale, depending upon gestational age. Premature infant testing resulted in similar pain assessments using the COVERS and PIPP scales with an r=0.84. For the full-term infants, the COVERS scale and NIPS scale resulted in similar pain assessments with an r=0.95. The COVERS scale is a valid pain scale that can be used in the clinical setting to assess pain in newborns and infants and is universally applicable to all neonates, regardless of their age or physiological state.

  8. [Perforated neonatal appendicitis in a preterm newborn].

    Science.gov (United States)

    Vakrilova, L; Georgiev, Tz; Hitrova, St; Slancheva, B

    2014-01-01

    Abstract: Appendicitis is common in paediatric surgical praxis, but extremely rare in newborn infants. We report a premature male newborn from a twin pregnancy with gestational age of 31(+4) weeks, birth-weight 1580g, who underwent a laparotomy because of perforation. The baby was admitted to NICU after birth with transitory respiratory failure and early onset neonatal sepsis. MS-Staphylococcus epidermidis was isolated from blood culture, gastric contents and all peripheral specimens, C-reactive protein values were elevated after birth and significantly increased before surgery; thrombocytopenia and mild anemia were found. The control blood culture showed Candida albicans. At day 25 after birth life threatening deterioration occurred: feculent vomiting, progressing distension and palpable rigidity of the abdomen, absence of peristalsis, respiratory distress. Abdominal radiograph showed significantly distension of the intestines, air liquid levels, and discrete signs of pneumoperitoneum. The baby was transferred to the surgery with the diagnosis NEC with perforation. Appendicitis acuta gangrenosa perforativa and peritonitis fibrinopurulenta totalis were found intra-operatively but without signs of NEC. Appendectomy and sanitation of the abdominal cavity were carried out. The histological result confirmed gangrenous perforative appendicitis and purulent necrotic peritonitis. The postoperative course was unremarkable. The boy was transferred to the neonatology on day 33 of life and discharged home 12 days later. Despite of the low incidence of neonatal appendicitis, it should be taken into consideration if unclear abdominal symptoms occur in the neonatal period. Early surgical intervention contribute to a reduction of potential complications.

  9. Brain death in neonates: a case report

    Directory of Open Access Journals (Sweden)

    Georgios Mitsiakos

    2014-06-01

    Full Text Available Brain death (BD is the permanent and complete loss of cerebral and brainstem function. It is relatively uncommon in newborns with its percentage among deaths being 1-6.3%. BD leads to debate for medical, ethical and philosophical issues. It is a challenging condition in neonatal intensive care units (NICUs since difficulties for BD diagnosis in neonates and ever more so in preterm neonates do arise. Revised guidelines for BD diagnosis definition include history with known etiology, clinical examination, apnea testing and neurological evaluation often assisted by ancillary tests. We present the case of a near term female baby that was born with brain death due to hypoxic ischemic encephalopathy. We conclude that BD in newborns is a challenge to NICUs and there is a need for establishing and implementing new guidelines and checklists on national basis. Proceedings of the 10th International Workshop on Neonatology · Cagliari (Italy · October 22nd-25th, 2014 · The last ten years, the next ten years in Neonatology Guest Editors: Vassilios Fanos, Michele Mussap, Gavino Faa, Apostolos Papageorgiou

  10. Adverse consequences of neonatal antibiotic exposure.

    Science.gov (United States)

    Cotten, Charles M

    2016-04-01

    Antibiotics have not only saved lives and improved outcomes, but they also influence the evolving microbiome. This review summarizes reports on neonatal infections and variation in antibiotic utilization, discusses the emergence of resistant organisms, and presents data from human neonates and animal models demonstrating the impact of antibiotics on the microbiome, and how microbiome alterations impact health. The importance of antibiotic stewardship is also discussed. Infections increase neonatal morbidity and mortality. Furthermore, the clinical presentation of infections can be subtle, prompting clinicians to empirically start antibiotics when infection is a possibility. Antibiotic-resistant infections are a growing problem. Cohort studies have identified extensive center variations in antibiotic usage and associations between antibiotic exposures and outcomes. Studies of antibiotic-induced microbiome alterations and downstream effects on the developing immune system have increased our understanding of the mechanisms underlying the associations between antibiotics and adverse outcomes. The emergence of resistant microorganisms and recent evidence linking antibiotic practice variations with health outcomes has led to the initiation of antibiotic stewardship programs. The review encourages practitioners to assess local antibiotic use with regard to local microbiology, and to adopt steps to reduce infections and use antibiotics wisely.

  11. Neonatal Rectal Colonization with Malassezia furfur

    Directory of Open Access Journals (Sweden)

    Gil J Gross

    1992-01-01

    Full Text Available Malassezia furfur and Candida albicans are fungal pathogens which have been recognized with increasing frequency as agents of mortality and serious morbidity in neonatal intensive care unit patients. A longitudinal study of oral, rectal and umbilical colonization by these organisms of newborns admitted to a neonatal intensive care unit within 24 h of birth was undertaken. Of 71 infants followed for a minimum of 10 days, 24 were colonized with M furfur and 12 with C albicans during the first 10 days of life. The lower gastrointestinal tract was found to be the most common colonization site for both organisms. Statistically significant (P<0.05 inverse associations were demonstrated between gestational age and risk of colonization with either organism at any site, and between birthweight or gestational age and risk of rectal colonization with either organism. Antibiotics were associated with a relative risk colonization of 4.06 (P=0.06 with either organism at any site. It is concluded that M furfur and C albicans are common colonizing organisms in a neonatal intensive care unit setting and are most frequently harboured in the lower gastrointestinal tract. M furfur, recently implicated as a systemic pathogen in this population, has not been previously recognized as a gastrointestinal commensal organism. The relationship between colonization and invasive fungal disease, and potential roles for preventive strategies, remain to be elucidated.

  12. Neonatal rectal colonization with Malassezia furfur

    Science.gov (United States)

    Gross, Gil J; MacDonald, Noni E; Mackenzie, Andrew MR

    1992-01-01

    Malassezia furfur and Candida albicans are fungal pathogens which have been recognized with increasing frequency as agents of mortality and serious morbidity in neonatal intensive care unit patients. A longitudinal study of oral, rectal and umbilical colonization by these organisms of newborns admitted to a neonatal intensive care unit within 24 h of birth was undertaken. Of 71 infants followed for a minimum of 10 days, 24 were colonized with M furfur and 12 with C albicans during the first 10 days of life. The lower gastrointestinal tract was found to be the most common colonization site for both organisms. Statistically significant (Pfurfur and C albicans are common colonizing organisms in a neonatal intensive care unit setting and are most frequently harboured in the lower gastrointestinal tract. M furfur, recently implicated as a systemic pathogen in this population, has not been previously recognized as a gastrointestinal commensal organism. The relationship between colonization and invasive fungal disease, and potential roles for preventive strategies, remain to be elucidated. PMID:22451755

  13. Parental determinants of neonatal body composition.

    Science.gov (United States)

    Harvey, N C; Poole, J R; Javaid, M K; Dennison, E M; Robinson, S; Inskip, H M; Godfrey, K M; Cooper, C; Sayer, A Aihie

    2007-02-01

    The prevalence of both childhood and adult obesity is rising in the developed world, and there is increasing interest in its underlying causes. A number of studies suggest a positive relationship between birth weight and childhood body mass index, but less is known about specific prenatal environmental influences on more direct measures of obesity. We used data from the Southampton Women's Survey to investigate parental influences on neonatal body composition ascertained by dual x-ray absorptiometry. Participating mothers were characterized in detail (anthropometry, lifestyle, diet) before and during pregnancy; information was also obtained on their partners. The offspring underwent assessment of fat and lean body mass by dual x-ray absorptiometry within 2 wk of birth. Linear regression methods were used to explore the parental determinants of neonatal body composition. Complete data were available for 448 mother-offspring pairs. Taller women and those with higher parity had offspring with increased birth weight, fat, and lean mass (P body fat at birth (all P Maternal size, parity, smoking history, walking speed, and fat stores are independent determinants of neonatal body composition. If these influences are shown to have persisting effects on body composition through to adulthood, they point to novel public health interventions early in life to prevent later obesity.

  14. Neonatal management of symptomatic transplacental cryoglobulinaemia.

    Science.gov (United States)

    Laugel, V; Goetz, J; Wolff, S; Beladdale, J; Sibilia, J; Messer, J

    2004-04-01

    This study reports the first case of symptomatic placental transfer of cryoglobulins and discusses the potential pathogenic processes and the basic guidelines for neonatal management. A 32-y-old woman was affected by essential type I cryoglobulinaemia and displayed the cold-triggered cutaneous symptoms of the disease due to a monoclonal immunoglobulin G (IgG) cryoglobulin. She gave birth to healthy dizygotic twins who were placed in incubators immediately after birth and did not show any cutaneous or visceral lesion in the first 2 d. Cyanotic macules appeared on the hand and foot of one of the newborns when they were removed from the incubators. The same monoclonal IgG-lambda cryoglobulin was identified in the two newborns' cord blood and in the mother's serum. The skin lesions disappeared within 1 wk as both twins were transiently replaced in incubators. No recurrence of skin lesions was observed even at room temperature and, 6 mo later, both twins were healthy and their clinical examination was normal. To the authors' knowledge, this is the first report of placental transfer of cryoglobulins and the first description of any neonatal effect. Neonates born to mothers suffering from IgG cryoglobulinaemia should be protected against cold to avoid precipitation of the pathogenic cryoglobulins, until spontaneous resolution.

  15. Immunity to rotavirus in conventional neonatal calves.

    Science.gov (United States)

    Vonderfecht, S L; Osburn, B I

    1982-11-01

    The local and systemic humoral immune responses to rotavirus were studied in six conventional neonatal calves. Attenuated bovine rotavirus was administered either orally or directly into an isolated intestinal loop. The parameters monitored were neutralizing rotavirus antibody in serum, immunofluorescent and neutralizing rotavirus antibody in intestinal loop washings, and rotavirus antibody-producing cells in intestinal mucosa. An antibody response was observed in the serum and intestinal secretions from one calf only. Viral replication was not detected in the isolated intestinal loop. Rotavirus antibody-producing cells were found in the intestinal mucosa of five calves. Double staining revealed that most of these cells produced antibody of the immunoglobulin A class. The conclusions were: (i) a previously described system to detect rotavirus antibody-producing cells can be used to study immune responses in neonatal calves, (ii) the class or subclass of antibody in rotavirus antibody-producing cells can be determined by double immunofluorescent staining, (iii) neonatal calves respond to rotavirus inoculation with a local immunoglobulin A response, and (iv) most of the rotavirus antibody-producing cells are located in the mucosa of the proximal small intestine.

  16. MR imaging in the neonatal period

    International Nuclear Information System (INIS)

    Aida, Noriko; Inuzuka, Michiko; Odagiri, Kunio

    1994-01-01

    We reviewed 118 MR examinations in the neonatal period to define its indication, problem, and usefulness. The patients were 58 term infants under 28 days of age and 46 preterm infants under 46 week of their post conceptional age. Almost all patients were examined under sedation. We used pulse wave monitoring and respiration was monitored only by observing the chest motion. Hot water bags were used in some cases to keep the patient warm. No serious accidents or sequelae occurred, although a very few patients had a brief apnea attacks during sedation and some developed hypothermia after the examination. The MR provided many useful information such as basal ganglial lesions after perinatal asphyxia and multiplaner demonstration of the CN5 anomalies which no other modality could. The detection rate of abnormality in the study was about 65%. Although MR studies in the neonatal period have many difficulties to be overcome including sedation, maintenance of body temperature and monitoring, they can demonstrate useful information that are helpful for their early treatment and care. Thus we believe that the MR study should be performed in a more positive manner in a variety of clinical setting in the neonatal period. (author)

  17. Carotid chemoreceptor development and neonatal apnea.

    Science.gov (United States)

    MacFarlane, Peter M; Ribeiro, Ana P; Martin, Richard J

    2013-01-01

    The premature transition from fetal to neonatal life is accompanied by an immature respiratory neural control system. Most preterm infants exhibit recurrent apnea, resulting in repetitive oscillations in O(2) saturation (intermittent hypoxia, IH). Numerous factors are likely to play a role in the etiology of apnea including inputs from the carotid chemoreceptors. Despite major advances in our understanding of carotid chemoreceptor function in the early neonatal period, however, their contribution to the initiation of an apneic event and its eventual termination are still largely speculative. Recent findings have provided a detailed account of the postnatal changes in the incidence of hypoxemic events associated with apnea, and there is anecdotal evidence for a positive correlation with carotid chemoreceptor maturation. Furthermore, studies on non-human animal models have shown that chronic IH sensitizes the carotid chemoreceptors, which has been proposed to perpetuate the occurrence of apnea. An alternative hypothesis is that sensitization of the carotid chemoreceptors could represent an important protective mechanism to defend against severe hypoxemia. The purpose of this review, therefore, is to discuss how the carotid chemoreceptors may contribute to the initiation and termination of an apneic event in the neonate and the use of xanthine therapy in the prevention of apnea. Published by Elsevier B.V.

  18. MR imaging in the neonatal period

    Energy Technology Data Exchange (ETDEWEB)

    Aida, Noriko; Inuzuka, Michiko; Odagiri, Kunio (Kanagawa Children' s Medical Center (Japan))

    1994-01-01

    We reviewed 118 MR examinations in the neonatal period to define its indication, problem, and usefulness. The patients were 58 term infants under 28 days of age and 46 preterm infants under 46 week of their post conceptional age. Almost all patients were examined under sedation. We used pulse wave monitoring and respiration was monitored only by observing the chest motion. Hot water bags were used in some cases to keep the patient warm. No serious accidents or sequelae occurred, although a very few patients had a brief apnea attacks during sedation and some developed hypothermia after the examination. The MR provided many useful information such as basal ganglial lesions after perinatal asphyxia and multiplaner demonstration of the CN5 anomalies which no other modality could. The detection rate of abnormality in the study was about 65%. Although MR studies in the neonatal period have many difficulties to be overcome including sedation, maintenance of body temperature and monitoring, they can demonstrate useful information that are helpful for their early treatment and care. Thus we believe that the MR study should be performed in a more positive manner in a variety of clinical setting in the neonatal period. (author).

  19. Biochemical markers of neonatal myocardial dysfunction.

    Science.gov (United States)

    Almeida, Cristina Maria; Carrapato, Manuel R G; Pinto, Fernando; Pinto, Mariana; Ferreira, Sofia; Schmitt, Denise; Marinho, Luis

    2011-04-01

    Cardiac ultrasounds (US) are not always available at the bedside. Cardiac Troponin I (cTnI), CK-MB and NT-proBNP may be an alternative or complementary to influence evaluation and treatment. To determine reference ranges of biochemical markers cTnI, CK-MB and NT-proBNP in normal neonates. Cord and blood samples were collected from neonates and the above biochemical markers were determined. Ultrasounds were performed blindly. CK-MB remains constant from cord blood to the first day, declining thereafter to almost half the values (81.5 vs 52.0 U/l); cTnI increases from 0.004 to 0.058 ng/ml by 72 h falling to 0.030 by day 10; NT-proBNP peaks by 24 h (5085.5 pg/ml), subsiding to 3388.5 pg/ml by day 3, falling to 1316.0 pg/ml by day 10. CK-MB, mostly of muscle origin and reflecting labor stress or injury, is not to recommend as a measure of myocardial damage in the neonate. The rise in cTnI may be explained by a degree of myocardial involvement, albeit physiological. The initial rise and subsequent fall of NT-proBNP represents the physiological ventricular overload of transient birth adaptation.

  20. The sonographic features of neonatal appendicitis: A case report.

    Science.gov (United States)

    Si, Shu-Yu; Guo, Yi-Yi; Mu, Jian-Feng; Yan, Chao-Ying

    2017-11-01

    Neonatal appendicitis is extremely rare, and preoperative diagnosis is challenging. This study aimed to investigate the utility of ultrasound for the diagnosis of neonatal appendicitis. Four cases of neonatal appendicitis were included in this case series. One was a female infant and the other 3 were male infants; they were aged from 10 to 17 days. Neonatal appendicitis. Four newborns in our hospital were diagnosed with neonatal appendicitis by abdominal ultrasound. Their sonographic features were summarized and compared with surgical and pathological findings. In these infants, abdominal ultrasound demonstrated ileocecal bowel dilatation, intestinal and bowel wall thickening, and localized encapsulated effusion in the right lower quadrant and the abscess area, which was assumed to surround the appendix. Ultrasound is helpful for the diagnosis of neonatal appendicitis.

  1. Probiotics in neonatal intensive care - back to the future.

    Science.gov (United States)

    Deshpande, Girish; Rao, Shripada; Patole, Sanjay

    2015-06-01

    Survival of extremely preterm and critically ill neonates has improved significantly over the last few decades following advances in neonatal intensive care. These include antenatal glucocorticoids, surfactant, continuous positive airway pressure support, advanced gentle modes of ventilation and inhaled nitric oxide. Probiotic supplementation is a recent significant milestone in the history of neonatal intensive care. Very few, if any, interventions match the ability of probiotics to significantly reduce the risk of death and definite necrotising enterocolitis while facilitating enteral feeds in high-risk preterm neonates. Probiotics also have a potential to benefit neonates with surgical conditions with significant gastrointestinal morbidity. Current evidence for the benefits of probiotic supplementation for neonates in an intensive care unit is reviewed. The mechanisms for the benefits of probiotics in this population are discussed, and guidelines for clinicians are provided in the context of the regulatory framework in Australia. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  2. Experimental Neonatal Sepsis Causes Long-Term Cognitive Impairment.

    Science.gov (United States)

    Comim, Clarissa M; Bussmann, Regina M; Simão, Silvia R; Ventura, Letícia; Freiberger, Viviane; Patrício, Janini J; Palmas, Daphne; Mendonça, Bruna P; Cassol, Omar J; Quevedo, João

    2016-11-01

    Neonatal sepsis is a major cause of morbidity and mortality in neonatal intensive care units. Treatment with antibiotics reduces mortality and morbidity, but neonatal sepsis remains a serious life-threatening condition. The objective of this study was to evaluate cognitive impairment in adult mice submitted to sepsis in the neonatal period. To this aim, 2-day-old male C57BL/6 mice were submitted to sepsis by injection of 25 μg of LPS. Sixty days after, the learning and memory were evaluated. It was observed that the mice submitted to neonatal sepsis presented impairment of habituation, aversive, and object recognition memories, and had an increase of immobility time in forced swimming test in adulthood. In conclusion, this study shows that the neonatal sepsis causes long-term brain alterations. These alterations can persist to adulthood in an animal model due to a vulnerability of the developing brain.

  3. Time to positivity of blood cultures in neonates.

    Science.gov (United States)

    Vamsi, Sivarama Raju; Bhat, Ramesh Y; Lewis, Leslie E; Vandana, Kalwaje E

    2014-02-01

    Blood culture reports in neonatal sepsis aid physician in either optimizing therapy or discontinuing antibiotics. We determined the time taken for neonatal blood cultures to become positive using the aerobic BacT/Alert system. Of 944 blood cultures from 816 neonates, 139 (14.7%) were positive. Growth of all definitive bacteria, 95% of possible bacteria and 84% of fungi were detected within 48 hours of incubation.

  4. Congenital mesenteric hernia in neonates: Still a dilemma

    Directory of Open Access Journals (Sweden)

    Parkash Mandhan

    2015-01-01

    Full Text Available Congenital transmesenteric hernia in neonates is a rare cause of intestinal obstruction with devastating outcomes and still remains a challenge to diagnose pre-operatively. Patients are often managed with emergency surgical exploration and may need bowel resection. We present 2 neonates with small bowel obstruction secondary to strangulated transmesenteric hernia through a congenital defect in the small bowel mesentery, which were managed successfully. We have also reviewed the literature about congenital transmesenteric hernia in neonates.

  5. Delayed Diagnosis of Iatrogenic Bladder Perforation in a Neonate

    Directory of Open Access Journals (Sweden)

    Antoinette S. Birs

    2016-01-01

    Full Text Available Iatrogenic bladder injuries have been reported in the neonate during umbilical artery/vein catheterization, voiding cystourethrogram, urinary catheterizations, and overwhelming hypoxic conditions. Patients with iatrogenic bladder perforations can present with acute abdomen indicating urinary peritonitis, septic-uremic shock, or subtle symptoms like abdominal distension, pain, hematuria, uremia, electrolyte imbalances, and/or difficulty urinating. The following neonatal case report of perforated bladder includes a review of the signs, symptoms, diagnostic tools, and management of bladder injury in neonates.

  6. Pneumonia in neonates: can it be managed in the community?

    OpenAIRE

    Bang, A T; Bang, R A; Morankar, V P; Sontakke, P G; Solanki, J M

    1993-01-01

    Neonatal pneumonia kills about two million children a year worldwide. The World Health Organisation recommends hospitalisation of all cases of pneumonia in the first two months of infancy. In a field trial of community based management of childhood pneumonia in Gadchiroli, India, neonatal pneumonia contributed more than half of the pneumonia deaths. Parents refused referral even when advised therefore community based health workers and traditional birth attendants managed cases of neonatal pn...

  7. Sizing of Staff of Neonatal Units in a University Hospital

    OpenAIRE

    Gabriela Ramos Ferreira Curan; Amanda Beraldo; Sarah Nancy Deggau Hegeto de Souza; Edilaine Giovanini Rossetto

    2015-01-01

    The aim was to evaluate the size of the nursing neonatal units of a university hospital regarding the education and professional experience of the nursing staff and the adequacy of existing legislation professional staff. Descriptive, quantitative study, conducted at the Intensive Care Unit and Neonatal Intermediate Care. We used two instruments to collect data with the nursing staff and the professional relationship and bed occupancy. Employees had an average experience in neonatal units of ...

  8. Predictors of positive blood culture and deaths among neonates with suspected neonatal sepsis in a tertiary hospital, Mwanza- Tanzania

    Directory of Open Access Journals (Sweden)

    Jeremiah Seni

    2010-06-01

    Full Text Available Abstract Background Neonatal sepsis is a significant cause of morbidity and mortality in neonates. Appropriate clinical diagnosis and empirical treatment in a given setting is crucial as pathogens of bacterial sepsis and antibiotic sensitivity pattern can considerably vary in different settings. This study was conducted at Bugando Medical Centre (BMC, Tanzania to determine the prevalence of neonatal sepsis, predictors of positive blood culture, deaths and antimicrobial susceptibility, thus providing essential information to formulate a policy for management of neonatal sepsis. Methods This was a prospective cross sectional study involving 300 neonates admitted at BMC neonatal unit between March and November 2009. Standard data collection form was used to collect all demographic data and clinical characteristics of neonates. Blood culture was done on Brain Heart Infusion broth followed by identification of isolates using conventional methods and testing for their susceptibility to antimicrobial agents using the disc diffusion method. Results Among 770 neonates admitted during the study period; 300 (38.9% neonates were diagnosed to have neonatal sepsis by WHO criteria. Of 300 neonates with clinical neonatal sepsis 121(40% and 179(60% had early and late onset sepsis respectively. Positive blood culture was found in 57 (47.1% and 92 (51.4% among neonates with early and late onset neonatal sepsis respectively (p = 0.466. Predictors of positive blood culture in both early and late onset neonatal sepsis were inability to feed, lethargy, cyanosis, meconium stained liquor, premature rupture of the membrane and convulsion. About 49% of gram negatives isolates were resistant to third generation cephalosporins and 28% of Staphylococcus aureus were found to be Methicillin resistant Staphylococcus aureus (MRSA. Deaths occurred in 57 (19% of neonates. Factors that predicted deaths were positive blood culture (p = 0.0001, gram negative sepsis (p = 0.0001 and

  9. Pain Management Perceptions of the Neonatal Nurses in NICUs and Neonatal Units in Ardebil, Iran

    Directory of Open Access Journals (Sweden)

    Nasrin Mehrnoush

    2016-12-01

    Full Text Available Background: This study aimed to determine neonatal nurses’ perceptions of knowledge and practice in pain management in NICUs & neonatal units. Methods: A cross-sectional descriptive study design was used. A total of 120 neonatal nurses who working in NICUs & neonatal units in Ardebil province, Iran were selected using the convenience sampling technique. A questionnaire of Nurses’ Perceptions of Neonatal Pain (Cong, 2013, including 36 questions with Likert scale and 2 open ended questions, was used. Data collected were analyzed with descriptive statistics of frequencies and percentages.Results: Nurses had Appropriate knowledge of neonatal pain management , but less than 50% felt that they received adequate training and continuing education on pain. Participants reported that they don’t use of pain assessment tools (65%. Less than half felt that the pain tool used in their unit was an accurate measure (44.2%. Fewer than half reported that pain was well managed (28.3% , that their pain protocols were research evidence based (34.2% and more than half reported that parents should be involve with the care and comfort of their infant during painful procedures (71.6%. Barriers to effective pain management emerged as high workload, shortage of personnel, lack of knowledge, absence of pain protocols, lack of time, and lack of trust in the pain assessment tools.Conclusions: proper pain management was significantly correlated with adequate training, use of proper and accurate pain tools, and clear and research-based protocols and parental involvement. It can be improved by developing guidelines and support of nurses, develop of clinically feasible pain tools, adequate training and proper supervision.

  10. Maternal haemoglobin and short-term neonatal outcome in preterm neonates.

    Directory of Open Access Journals (Sweden)

    Elodie Savajols

    Full Text Available To determine whether there is a significant association between maternal haemoglobin measured before delivery and short-term neonatal outcome in very preterm neonates.We included prospectively all live births occurring from 25 to 32+6 weeks of gestation in a tertiary care centre between January 1(st 2009 and December 31(st 2011. Outborn infants and infants presenting with lethal malformations were excluded. Three hundred and thirty-nine mothers and 409 infants met the inclusion criteria. For each mother-infant pair a prospective record of epidemiologic data was performed and maternal haemoglobin concentration recorded within 24 hours before delivery was retrospectively researched. Maternal haemoglobin was divided into quartiles with the second and the third one regarded as reference as they were composed of normal haemoglobin values. Short-term outcome was defined as poor in case of death during hospital stay and/or grades III/IV intraventricular haemorrhage and/or periventricular leukomalacia and/or necessity of ventriculoperitoneal shunt.The global rate of poor short-term neonatal outcome was 11.4% and was significantly associated with low maternal haemoglobin values. This association remained significant after adjustment for antenatal corticosteroids therapy, gestational age, parity, mechanism of preterm birth, mode of delivery and birth weight (aOR = 2.97 CI 95% [1.36-6.47]. There was no relation between short-term neonatal outcome and high maternal haemoglobin concentration values.We show that low maternal haemoglobin concentration at delivery is an independent risk factor for poor short-term neonatal outcome in very preterm neonates. This study is one of the first to show such an association within the preterm population.

  11. iNICU - Integrated Neonatal Care Unit: Capturing Neonatal Journey in an Intelligent Data Way.

    Science.gov (United States)

    Singh, Harpreet; Yadav, Gautam; Mallaiah, Raghuram; Joshi, Preetha; Joshi, Vinay; Kaur, Ravneet; Bansal, Suneyna; Brahmachari, Samir K

    2017-08-01

    Neonatal period represents first 28 days of life, which is the most vulnerable time for a child's survival especially for the preterm babies. High neonatal mortality is a prominent and persistent problem across the globe. Non-availability of trained staff and infrastructure are the major recognized hurdles in the quality care of these neonates. Hourly progress growth charts and reports are still maintained manually by nurses along with continuous calculation of drug dosage and nutrition as per the changing weight of the baby. iNICU (integrated Neonatology Intensive Care Unit) leverages Beaglebone and Intel Edison based IoT integration with biomedical devices in NICU i.e. monitor, ventilator and blood gas machine. iNICU is hosted on IBM Softlayer based cloud computing infrastructure and map NICU workflow in Java based responsive web application to provide translational research informatics support to the clinicians. iNICU captures real time vital parameters i.e. respiration rate, heart rate, lab data and PACS amounting for millions of data points per day per child. Stream of data is sent to Apache Kafka layer which stores the same in Apache Cassandra NoSQL. iNICU also captures clinical data like feed intake, urine output, and daily assessment of child in PostgreSQL database. It acts as first Big Data hub (of both structured and unstructured data) of neonates across India offering temporal (longitudinal) data of their stay in NICU and allow clinicians in evaluating efficacy of their interventions. iNICU leverages drools based clinical rule based engine and deep learning based big data analytical model coded in R and PMML. iNICU solution aims to improve care time, fills skill gap, enable remote monitoring of neonates in rural regions, assists in identifying the early onset of disease, and reduction in neonatal mortality.

  12. Exposure assessment of neonates in israel to x-ray radiation during hospitalization at neonatal intensive care unit

    International Nuclear Information System (INIS)

    Datz, H.

    2005-03-01

    Nowadays nearly 10% of all births in western countries are premature. In the last decade, there has been an increase of 45% in the number of neonates that were born in Israel. At the same time, the survival of neonates, especially those with very low birth weight, VLBW, (less than 1,500 gr), has increased dramatically. Diagnostic radiology plays an important role in the assessment and treatment of neonates requiring intensive care. During their prolonged and complex hospitalization, these infants are exposed to multiple radiographic examinations involving X-ray radiation. The extent of the examinations that the infant undergoes depends on its birth weight, gestational age and its medical problems, where most of the treatment effort is focused especially on VLBW neonates. Most of the diagnostic X-ray examinations taken during the hospitalization of neonates in the neonatal intensive care unit (NICU) consist of imaging of the respiratory and gastrointestinal systems, namely, the chest and abdomen. The imaging process is done using mobile X-ray units located at the NICUs. Due to their long hospitalization periods and complex medical condition, all neonates, and neonates with VLBW in particular, are exposed to a much higher level of diagnostic radiation, compared to normal newborns. The goal of this research was to assess the extent of the exposure of neonates in Israel to X-ray radiation during their hospitalization at the neonatal intensive care unit. Five NICUs, located at different geographical zones in Israel and treating 20% of all newborns in Israel every year, participated in this research. The research was conducted in three phases: Phase I: Collection of information on radiographic techniques and exposure parameters (e.g. kV, mAs, focus to skin distance (FSD), examination borders). 499 X-ray examinations (from 157 neonates) were evaluated for necessary and unnecessary exposure of the neonate's organs to X-ray radiation during these examinations. Phase II

  13. Birth Tourism and Neonatal Intensive Care: A Children's Hospital Experience.

    Science.gov (United States)

    Mikhael, Michel; Cleary, John P; Dhar, Vijay; Chen, Yanjun; Nguyen, Danh V; Chang, Anthony C

    2016-12-01

    Objective  The aim of this article is to examine characteristics of birth tourism (BT) neonates admitted to a neonatal intensive care unit (NICU). Methods  This was a retrospective review over 3 years; BT cases were identified, and relevant perinatal, medical, social, and financial data were collected and compared with 100 randomly selected non-birth tourism neonates. Results  A total of 46 BT neonates were identified. They were more likely to be born to older women (34 vs. 29 years; p  impacts on families, health care system, and society. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  14. Neonatal bloodstream infections in a pediatric hospital in Vietnam

    DEFF Research Database (Denmark)

    Kruse, Alexandra Yasmin; Thieu Chuong, Do Huu; Phuong, Cam Ngoc

    2013-01-01

    Septicemia and bloodstream infections (BSIs) are major causes of neonatal morbidity and mortality in developing countries. We prospectively recorded all positive blood cultures (BSI) among neonates admitted consecutively to a tertiary pediatric hospital in Vietnam during a 12-month period. Among...... 5763 neonates, 2202 blood cultures were performed, of which 399 were positive in 385 neonates. Among these, 64 died, 62 in relation to septicemia. Of the BSI isolates, 56% was known pathogenic and 48% was gram-negative bacteria, most frequently Klebsiella spp. (n = 78), Acinetobacter spp. (n = 58...

  15. Haemophilus influenzae: a forgotten cause of neonatal sepsis?

    Science.gov (United States)

    Dobbelaere, A; Jeannin, P; Bovyn, T; Ide, L

    2015-06-01

    Due to the introduction of the conjugate vaccine against serotype b, neonatal sepsis caused by Haemophilus influenzae became very rare. There is little data in Belgium concerning the prevalence of H. influenzae early onset neonatal sepsis and articles about neonatal sepsis and H. influenzae published in the last decade are scarce. We report two invasive infections with a non-typeable H. influenzae. These cases show that neonatal sepsis caused by non-typeable H. influenzae may be underestimated and we believe that there is need for a better registration of this kind of infection.

  16. Factors Affecting the Weaning from Nasal CPAP in Preterm Neonates

    Directory of Open Access Journals (Sweden)

    Shantanu Rastogi

    2012-01-01

    Full Text Available Objective. Identification of the weight and postmenstrual age (PMA at successful weaning of NCPAP in preterm neonates and the factors influencing the successful wean. Study Design. Retrospective review of 454 neonates ≤32 weeks of gestational age (GA who were placed on NCPAP and successfully weaned to room air was performed. Results. Neonates had a mean birth weight (BW of 1357±392 grams with a mean GA of 29.3±2.2 weeks. Neonates were weaned off NCPAP at mean weight of 1611±432 grams and mean PMA of 32.9±2.4 weeks. Univariate analysis showed that chorioamnionitis, intubation, surfactant use, PDA, sepsis/NEC, anemia, apnea, GER and IVH were significantly associated with the time to NCPAP wean. On multivariate analysis, among neonates that were intubated, BW was the only significant factor (<0.001 that was inversely related to time to successful NCPAP wean. Amongst non-intubated neonates, along with BW (<0.01, chorioamnionitis (<0.01, anemia (<0.0001, and GER (<0.02 played a significant role in weaning from NCPAP. Conclusion. Neonates were weaned off NCPAP at mean weight of 1611±432 grams and mean PMA of 32.9±2.4 weeks. BW significantly affects weaning among intubated and non-intubated neonates, though in neonates who were never intubated chorioamnionitis, anemia and GER also significantly affected the duration on NCPAP.

  17. Neonatal Meningitis: Risk Factors, Causes, and Neurologic Complications

    OpenAIRE

    KHALESSI, Nasrin; AFSHARKHAS, Ladan

    2014-01-01

    How to Cite This Article: Khalessi N, Afsharkhas L. Neonatal Meningitis: Risk Factors, Causes and Neurologic Complications.Iran J Child Neurol. 2014 Autumn;8(4): 46-50.AbstractObjectiveNeonates are at greater risk for sepsis and meningitis than other ages and in spite of rapid diagnoses of pathogens and treatments, they still contribute to complications and mortality. This study determines risk factors, causes, andneurologic complications of neonatal meningitis in  ospitalized neonates.Materi...

  18. An agent based architecture for high-risk neonate management at neonatal intensive care unit.

    Science.gov (United States)

    Malak, Jaleh Shoshtarian; Safdari, Reza; Zeraati, Hojjat; Nayeri, Fatemeh Sadat; Mohammadzadeh, Niloofar; Farajollah, Seide Sedighe Seied

    2018-01-01

    In recent years, the use of new tools and technologies has decreased the neonatal mortality rate. Despite the positive effect of using these technologies, the decisions are complex and uncertain in critical conditions when the neonate is preterm or has a low birth weight or malformations. There is a need to automate the high-risk neonate management process by creating real-time and more precise decision support tools. To create a collaborative and real-time environment to manage neonates with critical conditions at the NICU (Neonatal Intensive Care Unit) and to overcome high-risk neonate management weaknesses by applying a multi agent based analysis and design methodology as a new solution for NICU management. This study was a basic research for medical informatics method development that was carried out in 2017. The requirement analysis was done by reviewing articles on NICU Decision Support Systems. PubMed, Science Direct, and IEEE databases were searched. Only English articles published after 1990 were included; also, a needs assessment was done by reviewing the extracted features and current processes at the NICU environment where the research was conducted. We analyzed the requirements and identified the main system roles (agents) and interactions by a comparative study of existing NICU decision support systems. The Universal Multi Agent Platform (UMAP) was applied to implement a prototype of our multi agent based high-risk neonate management architecture. Local environment agents interacted inside a container and each container interacted with external resources, including other NICU systems and consultation centers. In the NICU container, the main identified agents were reception, monitoring, NICU registry, and outcome prediction, which interacted with human agents including nurses and physicians. Managing patients at the NICU units requires online data collection, real-time collaboration, and management of many components. Multi agent systems are applied as

  19. The Effect of Mother's Voice on Arterial Blood Sampling Induced Pain in Neonates Hospitalized in Neonate Intensive Care Unit.

    Science.gov (United States)

    Azarmnejad, Elham; Sarhangi, Forogh; Javadi, Mahrooz; Rejeh, Nahid

    2015-04-19

    Due to devastating effects of pain in neonates, it is very important to ease it though safe and feasible methods. This study was to determine the effect of familiar auditory stimuli on the arterial blood sampling (ABS) induced pain in term neonates. This study was done on 30 newborns hospitalized in neonate intensive care unit (NICU) of a hospital in Tehran. Research samples were selected by using convenience sampling and randomly divided into two groups of control and test. In the test group, the recorded mothers' voices were played for the newborns before and after blood sampling procedure. Then, pain measures were recorded 10 minutes before, during and 10 minutes after blood collection based on Neonatal Infant Pain Scale (NIPS); then the pain level changes were reviewed and studied. The findings showed significant differences between the control and test groups that indicating the effect of mother's voice on reducing the pain of neonates during the ABS (ppain in the term neonates.

  20. Association between congenital malformation and neonatal and maternal variables in neonatal units of a Northeast Brazilian city

    OpenAIRE

    Fontoura, Fabíola Chaves; Cardoso, Maria Vera Lúcia Moreira Leitão

    2014-01-01

    Congenital malformations occur due to genetic, environmental, and mixed factors or unknown causes. This study aimed to investigate the existence of a relationship between the type of congenital malformation and maternal and neonatal variables. This prospective, quantitative study was conducted in three public neonatal units in Fortaleza, Ceará, Brazil. Data were collected from the medical records of 159 malformed neonates and analyzed using the Chi-square test (χ2), significance level of 5% (p

  1. Risk of early onset pneumonia in neonates with abnormal gastric aspirate

    OpenAIRE

    IB. Mahendra; I Wayan Retayasa; I Made Kardana

    2008-01-01

    Background Early onset neonatal pneumonia is the risk factor for neonatal sepsis that increases risk for neonatal deaths. Recognition, prevention, and treatment of this problem is major factors in the managemant of high risk neonates. Analysis of gastric aspirate, collected soon after birth is a useful screening test for predicting pneumonia. Objective To evaluate the risk of early onset of neonatal pneumonia in neonates with abnormal gastric aspirate. Methods A case c...

  2. Lung Ultrasound in Early Diagnosis of Neonatal Ventilator Associated Pneumonia before Any Radiographic or Laboratory Changes

    OpenAIRE

    Mohammed Ibrahim; Ahmed Omran; Mostafa Ibrahim; Nouran Bioumy; Sonya El-Sharkawy

    2016-01-01

    Neonatal pneumonia is reported to be the primary cause of neonatal respiratory failure and one of the common causes of neonatal hospitalization and death in developing countries. Chest X-ray was considered the gold standard for diagnosis of neonatal pneumonia. Lung ultrasonography has been described as a valuable noninvasive tool for the diagnosis of many neonatal pulmonary diseases. We report a case of ventilation associated neonatal pneumonia with very early diagnosis using lung ultrasound ...

  3. Interventions to reduce neonatal mortality from neonatal tetanus in low and middle income countries - a systematic review

    Science.gov (United States)

    2013-01-01

    Background In 1988, WHO estimated around 787,000 newborns deaths due to neonatal tetanus. Despite few success stories majority of the Low and Middle Income Countries (LMICs) are still struggling to reduce neonatal mortality due to neonatal tetanus. We conducted a systematic review to understand the interventions that have had a substantial effect on reducing neonatal mortality rate due to neonatal tetanus in LMICs and come up with feasible recommendations for decreasing neonatal tetanus in the Pakistani setting. Methods We systemically reviewed the published literature (Pubmed and Pubget databases) to identify appropriate interventions for reducing tetanus related neonatal mortality. A total of 26 out of 30 studies were shortlisted for preliminary screening after removing overlapping information. Key words used were “neonatal tetanus, neonatal mortality, tetanus toxoid women”. Of these twenty-six studies, 20 were excluded. The pre-defined exclusion criteria was (i) strategies and interventions to reduce mortality among neonates not described (ii) no abstract/author (4 studies) (iii) not freely accessible online (1 study) (iv) conducted in high income countries (2 studies) and (v) not directly related to neonatal tetanus mortality and tetanus toxoid immunization (5). Finally six studies which met the eligibility criteria were entered in the pre-designed data extraction form and five were selected for commentary as they were directly linked with neonatal tetanus reduction. Results Interventions that were identified to reduce neonatal mortality in LMICs were: a) vaccination of women of child bearing age (married and unmarried both) with tetanus toxoid b) community based interventions i.e. tetanus toxoid immunization for all mothers; clean and skilled care at delivery; newborn resuscitation; exclusive breastfeeding; umbilical cord care and management of infections in newborns c) supplementary immunization (in addition to regular EPI program) d) safer delivery

  4. Pattern and prevalence of neonatal thrombocytopenia in Port Harcourt, Nigeria

    Directory of Open Access Journals (Sweden)

    Zaccheaus A Jeremiah

    2010-04-01

    Full Text Available Zaccheaus A Jeremiah1, Justina E Oburu21Hematology and Blood Transfusion Science Unit, Department of Medical Laboratory Sciences, College of Health Sciences, Niger Delta University, Wilberforce Island, Bayelsa State, Nigeria; 2Department of Hematology and Blood Transfusion University of Port Harcourt Teaching Hospital, Port Harcourt, NigeriaBackground: In Port Harcourt, evidence-based guidelines for platelet transfusion therapy in neonatal patients are yet to be defined and the prevalence and pattern of neonatal thrombocytopenia has not yet been reported.Methods: Platelet counts of 132 neonatal patients admitted into the special care baby unit (SCBU at the University of Port Harcourt Teaching Hospital in Nigeria were assessed using the International Committee on Standards in Hematology (ICSH approved manual procedures for hemocytometry.6Study design: This is a cross sectional study carried out on neonates to determine the prevalence and pattern of neonatal thrombocytopenia.Results: The median platelet count of the neonates was 97.0 × 109/L (interquartile range [IQR] 50–152 while the mean age was 61.7 hours (range 1–336 hours. The overall prevalence of neonatal thrombocytopenia was 53.0%. Mild thrombocytopenia (platelet count 51–100 × 109/L was found in 39.4% of the neonates, 12.1% had moderate thrombocytopenia (platelet count 30–50 × 109/L, while severe thrombocytopenia (platelet count <30 × 109/L was detected in 1.5% of the neonates. Of these, 84.84% of the cases occurred within 72 hours (early onset. The most common clinical diagnosis among the neonates was severe birth asphyxia (33.3%, followed by neonatal jaundice (19.7%, neonatal sepsis (16.7%, low birth weight (13.6%, anemia and bleeding (6.1%, and other clinical conditions (10.6%. There was no association between clinical diagnosis and thrombocytopenia (Fisher’s exact test = 10.643; P = 0.923.Conclusion: There is a high prevalence of early onset neonatal thrombocytopenia

  5. [Lactose intolerance in neonates with non-infectious diarrhea].

    Science.gov (United States)

    Su, Hui-Min; Jiang, Yi; Hu, Yu-Lian; Yang, Hui; Dong, Tian-Jin

    2016-04-01

    To investigate the development of lactose intolerance in neonates with non-infectious diarrhea and its association with diarrhea, and to evaluate the diagnostic values of fecal pH value and urine galactose determination for neonatal lactase deficiency. Seventy hospitalized neonates who developed non-infectious diarrhea between October 2012 and June 2015 were enrolled as the diarrhea group, and 162 hospitalized neonates without non-infectious diarrhea were enrolled as the non-diarrhea group. Test paper was used to determine fecal pH value. The galactose oxidase method was used to detect urine galactose. The neonates with positive galactose oxidase were diagnosed with lactase deficiency, and those with lactase deficiency and diarrhea were diagnosed with lactose intolerance. According to the results of urine galactose detection, 69 neonates in the diarrhea group who underwent urine galactose detection were classified into lactose intolerance group (45 neonates) and lactose tolerance group (24 neonates), and their conditions after treatment were compared between the two groups. The follow-up visits were performed for neonates with diarrhea at 3 months after discharge. Fecal pH value and positive rate of urine galactose (65% vs 54%) showed no significant differences between the diarrhea and non-diarrhea groups (P>0.05). Fecal pH value showed no significant difference between the lactose intolerance and lactose tolerance groups (P>0.05), while the neonates in the lactose intolerance group had a significantly longer time to recovery of defecation than those in the lactose tolerance group (Pintolerance tends to occur. Determination of fecal pH value has no significance in the diagnosis of lactose intolerance in neonates with diarrhea.

  6. Economic burden of neonatal sepsis in sub-Saharan Africa.

    Science.gov (United States)

    Ranjeva, Sylvia L; Warf, Benjamin C; Schiff, Steven J

    2018-01-01

    The third Sustainable Development Goal for child health, which aims to end preventable deaths of newborns and children less than 5 years of age by 2030, cannot be met without substantial reduction of infection-specific neonatal mortality in the developing world. Neonatal infections are estimated to account for 26% of annual neonatal deaths, with mortality rates highest in sub-Saharan Africa (SSA). Reliable and comprehensive estimates of the incidence and aetiology surrounding neonatal sepsis in SSA remain incompletely available. We estimate the economic burden of neonatal sepsis in SSA. Data available through global health agencies and in the medical literature were used to determine population demographics in SSA, as well as to determine the incidence, disease burden, mortality and resulting disabilities associated with neonatal sepsis. The disability-adjusted life years (DALY) associated with successful treatment or prevention of neonatal sepsis in SSA for 1 year were calculated. The value of a statistical life (VSL) methodology was estimated to evaluate the economic burden of untreated neonatal sepsis in SSA. We conservatively estimate that 5.29-8.73 million DALYs are lost annually in SSA due to neonatal sepsis. Corresponding VSL estimates predict an annual economic burden ranging from $10 billion to $469 billion. Our results highlight and quantify the scope of the public health and economic burden posed by neonatal sepsis in SSA. We quantify the substantial potential impact of more successful treatment and prevention strategies, and we highlight the need for greater investment in strategies to characterise, diagnose, prevent and manage neonatal sepsis and its long-term sequelae in SSA.

  7. Economic burden of neonatal sepsis in sub-Saharan Africa

    Science.gov (United States)

    Ranjeva, Sylvia L; Warf, Benjamin C

    2018-01-01

    Background and significance The third Sustainable Development Goal for child health, which aims to end preventable deaths of newborns and children less than 5 years of age by 2030, cannot be met without substantial reduction of infection-specific neonatal mortality in the developing world. Neonatal infections are estimated to account for 26% of annual neonatal deaths, with mortality rates highest in sub-Saharan Africa (SSA). Reliable and comprehensive estimates of the incidence and aetiology surrounding neonatal sepsis in SSA remain incompletely available. We estimate the economic burden of neonatal sepsis in SSA. Methods Data available through global health agencies and in the medical literature were used to determine population demographics in SSA, as well as to determine the incidence, disease burden, mortality and resulting disabilities associated with neonatal sepsis. The disability-adjusted life years (DALY) associated with successful treatment or prevention of neonatal sepsis in SSA for 1 year were calculated. The value of a statistical life (VSL) methodology was estimated to evaluate the economic burden of untreated neonatal sepsis in SSA. Results We conservatively estimate that 5.29–8.73 million DALYs are lost annually in SSA due to neonatal sepsis. Corresponding VSL estimates predict an annual economic burden ranging from $10 billion to $469 billion. Conclusions Our results highlight and quantify the scope of the public health and economic burden posed by neonatal sepsis in SSA. We quantify the substantial potential impact of more successful treatment and prevention strategies, and we highlight the need for greater investment in strategies to characterise, diagnose, prevent and manage neonatal sepsis and its long-term sequelae in SSA. PMID:29564153

  8. Lupus eritematoso neonatal: reporte de cuatro casos Neonatal lupus erythematosus: a report of four cases

    Directory of Open Access Journals (Sweden)

    Maria Fernanda Perez

    2011-04-01

    Full Text Available El lupus eritematoso neonatal es una enfermedad poco frecuente, caracterizada clínica mente por alteraciones cutáneas semejantes al lupus subagudo o discoide y/o bloqueo cardíaco congénito. Generalmente, cuando los pacientes presentan manifestaciones cutáneas, no tienen anormalidades cardiológicas y viceversa, aunque en un 10% de los casos ambas manifestaciones pueden coexistir. Puede acompañarse también de alteraciones hematológicas, hepáticas y neurológicas. Es causado por el pasaje trasplacentario de anticuerpos maternos anti Ro (95%, anti La y menos frecuentemente anti U1RNP. Presentamos cuatro pacientes con hallazgos clínicos, histopatológicos e inmunológicos compatibles con lupus eritematoso neonatal, su tratamiento y evolución.Neonatal lupus erythematosus is a very rare disease, clinically characterized by skin lesions that resemble those of subacute or discoid lupus erythematosus and/or congenital heart block. Generally, when patients have skin manifestations, they have no cardiac defects and vice-versa; however, in 10% of cases these manifestations may coexist. Other findings may include hematologic, hepatic and neurological abnormalities. This condition is caused by the transplacental passage of maternal autoantibodies against Ro (95%, La and, less frequently, U1-ribonucleoprotein (U1-RNP. The present case report describes four patients with clinical, histopathological and immunological findings compatible with neonatal lupus erythematosus, their treatment and progress.

  9. Weight loss percentage prediction of subsequent neonatal hyperbilirubinemia in exclusively breastfed neonates.

    Science.gov (United States)

    Chang, Rui-Jane; Chou, Hung-Chieh; Chang, Yu-Hsun; Chen, Mei-Huei; Chen, Chien-Yi; Hsieh, Wu-Shiun; Tsao, Po-Nien

    2012-02-01

    The incidence of neonatal hyperbilirubinemia in our hospital has increased since the implementation of breastfeeding promotion. Inadequate breastfeeding results in reduced calorie intake, weight loss and neonatal hyperbilirubinemia. Supplementary feeding is required if breastfeeding proves inadequate. However, the optimal weight loss cut-off value for supplementary feeding is unknown. We collected records for all healthy neonates with a gestational age ≥35 weeks and birth body weight (BBW) above 2500 g, born between March 2002 and July 2005, from our nursery. A total of 1979 neonates were reviewed, 874 of whom were exclusively breastfed and subsequently enrolled in this study. Only infants who were breastfed exclusively were enrolled; 219 of these infants (25.1%) presented significant hyperbilirubinemia after 72 hours of age. Infants with early-onset (BBW after 48 hours and weight loss ≥11% of BBW after 72 hours as the cut-off values for the prediction of subsequent hyperbilirubinemia, negative predictive values were 77.7% and 76.8%, respectively. This study documented the relationship between weight loss percentage and subsequent hyperbilirubinemia incidence. Our data provide a basis for determination of an optimal weight loss percentage cut-off value that indicates supplementary feeding. Copyright © 2012. Published by Elsevier B.V.

  10. Determination of Noise Level and Its Sources in the Neonatal Intensive Care Unit and Neonatal Ward

    Directory of Open Access Journals (Sweden)

    Mahdi Jahangir Blourchian

    2015-12-01

    Full Text Available Background: In Neonatal intensive care units (NICU different sound intensities and frequencies are produced from different sources, which may exert undesirable physiological effects on the infants. The aim of this study was to determine the noise level and its sources in the NICU and neonatal ward of Al-Zahra Hospital of Rasht, Iran. Methods: In this descriptive cross-sectional study, the intensity of the sounds generated by the internal and external sources in the NICU and neonatal ward was measured using a sound level meter device. The sound produced by each of the sources was individually calculated. Data were analyzed performing descriptive and analytical statistics, using SPSS version 19. Results: The mean noise levels in six rooms and a hallway during morning, afternoon and night shifts with the electromechanical devices turned on were 61.67±4.5, 61.32±4.32 and 60.71±4.56 dB, respectively. Moreover, with the devices tuned off the mean noise levels during morning, afternoon and evening shifts were 64.97±2.6, 60.6±1.29 and 57.91±4.73 dB, respectively. The differences between the mean noise levels in the neonatal wards (standard noise level=45 dB during each shift with the electromechanical devices turned on and off were statistically significant (P=0.002 and P

  11. [Risk factors for neonatal pulmonary hemorrhage in the neonatal intensive care unit of a municipal hospital].

    Science.gov (United States)

    Fan, Jie; Hei, Ming-Yan; Huang, Xi-Lin; Li, Xiao-Ping

    2017-03-01

    To investigate the risk factors for neonatal pulmonary hemorrhage (NPH) in the neonatal intensive care unit (NICU) of a municipal hospital, and to provide a basis for the early identification and treatment of NPH. A total of 112 neonates who were admitted to the NICU of Shaoyang Central Hospital of Hunan Province and diagnosed with NPH were enrolled as the case group. A nested case-control method was used to select, as a control group (n=224), the neonates who underwent the treatment with an assisted mechanical ventilator and did not experience pulmonary hemorrhage. Univariate analysis and unconditional logistic regression analysis were used to identify the high risk factors for NPH. The univariate analysis showed that compared with the control group, the case group had significantly higher incidence rates of gestational diabetes and cholestasis in mothers, cesarean delivery, gestational age <34 weeks, 5-minute Apgar score ≤5, birth weight <2 500 g, heart failure and disseminated intravascular coagulation (DIC) before the development of NPH, partial pressure of oxygen/fraction of inspired oxygen (oxygenation index, OI) ≤100, and a reduction in mean platelet volume. The multivariate logistic regression analysis showed that DIC, heart failure, and OI ≤100 were independent risk factors for NPH (OR=33.975, 3.975, 1.818 respectively; P<0.05). Heart failure, OI ≤100, and DIC are risk factors for the development of NPH in the NICU of the municipal hospital.

  12. Neonatal Klebsiella Septicaemia in Ibadan: Implications for Neonatal Care in Developing Countries.

    Science.gov (United States)

    Omokhodion, S. I.; And Others

    1993-01-01

    The antecedent events, clinical features, prevalence, and complications of neonatal Klebsiella septicaemia in 73 infants admitted to a special care baby unit in Nigeria are retrospectively reviewed and compared with those of 72 infants who had no risk factors for sepsis admitted to the same unit during the same period. A nosocomial acquisition of…

  13. Fellowship Training in the Emerging Fields of Fetal-Neonatal Neurology and Neonatal Neurocritical Care.

    Science.gov (United States)

    Smyser, Christopher D; Tam, Emily W Y; Chang, Taeun; Soul, Janet S; Miller, Steven P; Glass, Hannah C

    2016-10-01

    Neonatal neurocritical care is a growing and rapidly evolving medical subspecialty, with increasing numbers of dedicated multidisciplinary clinical, educational, and research programs established at academic institutions. The growth of these programs has provided trainees in neurology, neonatology, and pediatrics with increased exposure to the field, sparking interest in dedicated fellowship training in fetal-neonatal neurology. To meet this rising demand, increasing numbers of training programs are being established to provide trainees with the requisite knowledge and skills to independently deliver care for infants with neurological injury or impairment from the fetal care center and neonatal intensive care unit to the outpatient clinic. This article provides an initial framework for standardization of training across these programs. Recommendations include goals and objectives for training in the field; core areas where clinical competency must be demonstrated; training activities and neuroimaging and neurodiagnostic modalities which require proficiency; and programmatic requirements necessary to support a comprehensive and well-rounded training program. With consistent implementation, the proposed model has the potential to establish recognized standards of professional excellence for training in the field, provide a pathway toward Accreditation Council for Graduate Medical Education certification for program graduates, and lead to continued improvements in medical and neurological care provided to patients in the neonatal intensive care unit. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Vaccines for women to prevent neonatal tetanus.

    Science.gov (United States)

    Demicheli, Vittorio; Barale, Antonella; Rivetti, Alessandro

    2013-05-31

    Tetanus is an acute, often fatal, disease caused by an exotoxin produced by Clostridium tetani. It occurs in newborn infants born to mothers who do not have sufficient circulating antibodies to protect the infant passively, by transplacental transfer. Prevention may be possible by the vaccination of pregnant or non-pregnant women, or both, with tetanus toxoid, and the provision of clean delivery services. Tetanus toxoid consists of a formaldehyde-treated toxin which stimulates the production of antitoxin. To assess the effectiveness of tetanus toxoid, administered to women of childbearing age or pregnant women, to prevent cases of, and deaths from, neonatal tetanus. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 October 2012), The Cochrane Library (2012, Issue 10), PubMed (1966 to 31 October 2012), EMBASE (1974 to 31 October 2012). We also used the results from handsearching and consultations with manufacturers and authors. Randomised or quasi-randomised trials evaluating the effects of tetanus toxoid in pregnant women or women of childbearing age on numbers of neonatal tetanus cases and deaths. Three review authors independently assessed trials for inclusion and trial quality, and extracted data. Two trials (10,560 infants) were included. It should be noted that these trials are very old,1966 and 1980 respectively, and one trial randomised exclusively non-pregnant women. The main outcomes were measured on infants born to a subset of those randomised women who became pregnant during the course of the studies. One study (1919 infants) assessed the effectiveness of tetanus toxoid in comparison with influenza vaccine in preventing neonatal tetanus deaths. After a single dose, the risk ratio (RR) was 0.57 (95% confidence interval (CI) 0.26 to 1.24), and the vaccine effectiveness was 43%. With a two- or three-dose course, the RR was 0.02 (95% CI 0.00 to 0.30); vaccine effectiveness was 98%. No effect was detected on causes of death other

  15. Inspired gas temperature in ventilated neonates.

    Science.gov (United States)

    Davies, Mark William; Dunster, Kimble Robert; Cartwright, David William

    2004-07-01

    The warming and humidification of inspired gases for ventilated neonates are routine. There are no data on the temperature of the gas at the airway opening in ventilated neonates. Is the inspired gas temperature at the airway opening, as expected and set on the humidifier, around 37 degrees C? We aimed to measure temperature at the airway opening and compare this with the circuit temperature. This was an observational study in a neonatal intensive care unit. Twenty-five mechanically ventilated infants were studied. All had humidifiers with chamber temperature set at 36 degrees C and the circuit temperature set at 37 degrees C. Two temperature probes were inserted and rested at the circuit-exit and at the airway opening, and temperatures were measured for 2 min in each infant. At this time, the circuit temperature was also noted. The mean (SD) temperature at the airway opening in infants nursed in incubators was 34.9 (1.2) degrees C, compared with radiant warmers where the mean (SD) was 33.1 (0.5) degrees C. The mean (SD) difference in temperature from the circuit temperature probe to the airway opening was greater under radiant warmers, with a mean (SD) drop of 3.9 (0.6) degrees C compared with a mean (SD) drop of 2.0 (1.3) degrees C in the incubators. In conclusion, the temperature at the circuit temperature probe does not reflect the temperature at the airway opening. Inspired gas temperatures are lower than the expected 37 degrees C with the normal circuits and usual humidifier settings. Copyright 2004 Wiley-Liss, Inc.

  16. MR determination of neonatal spinal canal depth

    Energy Technology Data Exchange (ETDEWEB)

    Arthurs, Owen, E-mail: owenarthurs@uk2.net [Centre for Cardiovascular MR, Great Ormond Street Hospital for Children, London WC1N 3JH (United Kingdom); Thayyil, Sudhin, E-mail: s.thayyil@ucl.ac.uk [Academic Neonatology, Institute for Women' s Health, London WC1E 6AU (United Kingdom); Wade, Angie, E-mail: a.wade@ucl.ac.uk [Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London (United Kingdom); Chong, W.K., E-mail: Kling.Chong@gosh.nhs.uk [Paediatric Neuroradiology, Great Ormond Street Hospital for Children, London (United Kingdom); Sebire, Neil J., E-mail: Neil.Sebire@gosh.nhs.uk [Histopathology, Great Ormond Street Hospital for Children, London WC1E 6AU (United Kingdom); Taylor, Andrew M., E-mail: a.taylor76@ucl.ac.uk [Centre for Cardiovascular MR, Cardiorespiratory Unit, Great Ormond Street Hospital for Children and UCL Institute of Cardiovascular Science, London WC1E 6AU (United Kingdom)

    2012-08-15

    Objectives: Lumbar punctures (LPs) are frequently performed in neonates and often result in traumatic haemorrhagic taps. Knowledge of the distance from the skin to the middle of the spinal canal (mid-spinal canal depth - MSCD) may reduce the incidence of traumatic taps, but there is little data in extremely premature or low birth weight neonates. Here, we determined the spinal canal depth at post-mortem in perinatal deaths using magnetic resonance imaging (MRI). Patients and methods: Spinal canal depth was measured in 78 post-mortem foetuses and perinatal cases (mean gestation 26 weeks; mean weight 1.04 kg) at the L3/L4 inter-vertebral space at post-mortem MRI. Both anterior (ASCD) and posterior (PSCD) spinal canal depth were measured; MSCD was calculated and modelled against weight and gestational age. Results: ASCD and PSCD (mm) correlated significantly with weight and gestational age (all r > 0.8). A simple linear model MSCD (mm) = 3 Multiplication-Sign Weight (kg) + 5 was the best fit, identifying an SCD value within the correct range for 87.2% (68/78) (95% CI (78.0, 92.9%)) cases. Gestational age did not add significantly to the predictive value of the model. Conclusion: There is a significant correlation between MSCD and body weight at post-mortem MRI in foetuses and perinatal deaths. If this association holds in preterm neonates, use of the formula MSCD (mm) = 3 Multiplication-Sign Weight (kg) + 5 could result in fewer traumatic LPs in this population.

  17. Prenatal buprenorphine exposure and neonatal neurobehavioral functioning.

    Science.gov (United States)

    Velez, Martha L; McConnell, Krystle; Spencer, Nancy; Montoya, Lina; Tuten, Michelle; Jansson, Lauren M

    2017-12-07

    Assessments of effects of prenatal opioid exposure on the neonate have consisted principally of evaluations of neonatal abstinence syndrome (NAS) to determine the need for pharmacotherapy. The purpose of this study was to comprehensively evaluate the effects of gestational maternal buprenorphine maintenance on newborn neurobehavioral functioning. Maternal substance use history and psychosocial demographics that can contribute to the neurobehavioral functioning of the infant were explored. Infants were assessed using the NICU Network Neurobehavioral Scale (NNNS) to measure their neurologic and behavioral functioning and signs of stress/abstinence on days 3, 14 and 30 of life. Participants were 41 pregnant buprenorphine-maintained women and their infants. Maternal buprenorphine dose at delivery was negatively correlated with infant quality of movement and self-regulation, and positively correlated with the central nervous system parameters of stress/abstinence at day 3 of life. As maternal buprenorphine dose increased, the mean morphine dose that the infant required for NAS treatment significantly increased. No differences were found when comparing the NNNS domain scores between infants who required pharmacotherapy for NAS versus those who did not at day 3 of life. Buprenorphine exposure during pregnancy can alter neonatal neurobehavioral and physiological responses to stimuli. A systematic evaluation of the newborn's functional domains above NAS assessment alone is crucial to address the challenges created by neurobehavioral dysregulation associated with substance exposure, improve caregiver/infant interaction and developmental trajectory. Comprehensive pre/postnatal treatment of buprenorphine-maintained mothers can lead to healthier outcomes for the dyad. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Neonatal opaque right lung: delayed fluid resorption

    International Nuclear Information System (INIS)

    Swischuk, L.E.; Hayden, K.; Richardson, J.

    1981-01-01

    Eight newborn infants with opaque right lungs were examined. Clinically, the main problem associated with the opaque right lung is mild respiratory distress, and radiographyically, the findings consist of (a) a totally opaque right lung, (b) a semiopaque right lung, or (c) an opaque right upper lobe only. These findings are usually interpreted as representing pneumonia, empyema, or hydrochlothorax, but the fact that they clear within 24 to 48 hours indicates that none of these diseases is the cause. It is thought that neonatal opaque right lung results from the transient retention of normal fetal fluid in the right lung

  19. Ventilatory management in neonates. Science or art?

    Science.gov (United States)

    Mariani, G L; Carlo, W A

    1998-03-01

    Conventional mechanical ventilation continues to be the standard mode of support for neonates with respiratory failure. Controversies regarding the selection of optimal ventilatory strategies still abound. A deep understanding of physiologic concepts as well as a critical appraisal of the literature is needed to optimize the ventilatory management of the newborn. Principles of gas exchange, pulmonary mechanics and control of breathing are reviewed in the context of their relevance during mechanical ventilation. The application of these concepts to the ventilatory strategies for the management of infants with respiratory distress is presented, and current controversies are emphasized.

  20. Diabetes mellitus neonatal en Costa Rica

    OpenAIRE

    Francis Ruiz-Salazar; Erick Richmond-Padilla; Roberto Bogarín-Solano; Fred Cavallo-Aita; Orlando Jaramillo-Lines

    2014-01-01

    La diabetes mellitus neonatal es un raro desorden metabólico usualmente desarrollado en las primeras 6 semanas de vida, secundario a un grupo de mutaciones y defectos del desarrollo pancreático que puede desembocar en una catástrofe clínica si no se identifica tempranamente; se divide en una variante transitoria y una permanente, siendo la primera la más frecuente, con cerca de un 60% de los casos. El manejo inicial de ambas variantes es la insulinoterapia intensiva, que en la variante transi...

  1. Early continuous video electroencephalography in neonatal stroke.

    LENUS (Irish Health Repository)

    Walsh, Brian H

    2011-01-01

    Perinatal stroke is the second most common cause of neonatal seizures, and can result in long-term neurological impairment. Diagnosis is often delayed until after seizure onset, owing to the subtle nature of associated signs. We report the early electroencephalographic (EEG) findings in a female infant with a perinatal infarction, born at 41 weeks 2 days and weighing 3.42 kg. Before the onset of seizures, the EEG from 3 hours after delivery demonstrated occasional focal sharp waves over the affected region. After electroclinical seizures, focal sharp waves became more frequent, complex, and of higher amplitude, particularly in \\'quiet sleep\\'. In \\'active sleep\\

  2. Early continuous video electroencephalography in neonatal stroke.

    LENUS (Irish Health Repository)

    Walsh, Brian H

    2012-01-31

    Perinatal stroke is the second most common cause of neonatal seizures, and can result in long-term neurological impairment. Diagnosis is often delayed until after seizure onset, owing to the subtle nature of associated signs. We report the early electroencephalographic (EEG) findings in a female infant with a perinatal infarction, born at 41 weeks 2 days and weighing 3.42 kg. Before the onset of seizures, the EEG from 3 hours after delivery demonstrated occasional focal sharp waves over the affected region. After electroclinical seizures, focal sharp waves became more frequent, complex, and of higher amplitude, particularly in \\'quiet sleep\\'. In \\'active sleep\\

  3. Hospital Infections in Neonatal Intensive Therapy Units

    Directory of Open Access Journals (Sweden)

    L. Cancio

    2013-11-01

    Full Text Available Hospital infections are the most frequent and important complications occurring in hospitalized patients. The concern is greater when the affected hospital infection are neonates admitted to intensive care units where the risk increases due to factors such as prematurity, low birth weight, types of procedures adopted and susceptibility due to their immature immune system. The prevention and control measures involve detection of hospital infection, development of norms of standardization, collaboration with the training of all health professionals, achieving control of antibiotic prescription and technical support for hospital administration. 

  4. Special Considerations in Neonatal Mechanical Ventilation.

    Science.gov (United States)

    Dalgleish, Stacey; Kostecky, Linda; Charania, Irina

    2016-12-01

    Care of infants supported with mechanical ventilation is complex, time intensive, and requires constant vigilance by an expertly prepared health care team. Current evidence must guide nursing practice regarding ventilated neonates. This article highlights the importance of common language to establish a shared mental model and enhance clear communication among the interprofessional team. Knowledge regarding the underpinnings of an open lung strategy and the interplay between the pathophysiology and individual infant's response to a specific ventilator strategy is most likely to result in a positive clinical outcome. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Congenital Zika Virus Infection: Beyond Neonatal Microcephaly.

    Science.gov (United States)

    Melo, Adriana Suely de Oliveira; Aguiar, Renato Santana; Amorim, Melania Maria Ramos; Arruda, Monica B; Melo, Fabiana de Oliveira; Ribeiro, Suelem Taís Clementino; Batista, Alba Gean Medeiros; Ferreira, Thales; Dos Santos, Mayra Pereira; Sampaio, Virgínia Vilar; Moura, Sarah Rogéria Martins; Rabello, Luciana Portela; Gonzaga, Clarissa Emanuelle; Malinger, Gustavo; Ximenes, Renato; de Oliveira-Szejnfeld, Patricia Soares; Tovar-Moll, Fernanda; Chimelli, Leila; Silveira, Paola Paz; Delvechio, Rodrigo; Higa, Luiza; Campanati, Loraine; Nogueira, Rita M R; Filippis, Ana Maria Bispo; Szejnfeld, Jacob; Voloch, Carolina Moreira; Ferreira, Orlando C; Brindeiro, Rodrigo M; Tanuri, Amilcar

    2016-12-01

    Recent studies have reported an increase in the number of fetuses and neonates with microcephaly whose mothers were infected with the Zika virus (ZIKV) during pregnancy. To our knowledge, most reports to date have focused on select aspects of the maternal or fetal infection and fetal effects. To describe the prenatal evolution and perinatal outcomes of 11 neonates who had developmental abnormalities and neurological damage associated with ZIKV infection in Brazil. We observed 11 infants with congenital ZIKV infection from gestation to 6 months in the state of Paraíba, Brazil. Ten of 11 women included in this study presented with symptoms of ZIKV infection during the first half of pregnancy, and all 11 had laboratory evidence of the infection in several tissues by serology or polymerase chain reaction. Brain damage was confirmed through intrauterine ultrasonography and was complemented by magnetic resonance imaging. Histopathological analysis was performed on the placenta and brain tissue from infants who died. The ZIKV genome was investigated in several tissues and sequenced for further phylogenetic analysis. Description of the major lesions caused by ZIKV congenital infection. Of the 11 infants, 7 (63.6%) were female, and the median (SD) maternal age at delivery was 25 (6) years. Three of 11 neonates died, giving a perinatal mortality rate of 27.3%. The median (SD) cephalic perimeter at birth was 31 (3) cm, a value lower than the limit to consider a microcephaly case. In all patients, neurological impairments were identified, including microcephaly, a reduction in cerebral volume, ventriculomegaly, cerebellar hypoplasia, lissencephaly with hydrocephalus, and fetal akinesia deformation sequence (ie, arthrogryposis). Results of limited testing for other causes of microcephaly, such as genetic disorders and viral and bacterial infections, were negative, and the ZIKV genome was found in both maternal and neonatal tissues (eg, amniotic fluid, cord blood, placenta, and

  6. Cardiac biomarkers in neonatal hypoxic ischaemia.

    LENUS (Irish Health Repository)

    Sweetman, D

    2012-04-01

    Following a perinatal hypoxic-ischaemic insult, term infants commonly develop cardiovascular dysfunction. Troponin-T, troponin-I and brain natriuretic peptide are sensitive indicators of myocardial compromise. The long-term effects of cardiovascular dysfunction on neurodevelopmental outcome following perinatal hypoxic ischaemia remain controversial. Follow-up studies are warranted to ensure optimal cardiac function in adulthood. CONCLUSION: Cardiac biomarkers may improve the diagnosis of myocardial injury, help guide management, estimate mortality risk and may also aid in longterm neurodevelopmental outcome prediction following neonatal hypoxic-ischaemia.

  7. Neonatal hepatic haemangioendothelioma: treatment options and dilemmas

    International Nuclear Information System (INIS)

    Meijs, Bram B. van der; Merks, Johannes H.M.; Haan, Timo R. de; Tabbers, Merit M.; Rijn, Rick R. van

    2009-01-01

    We describe a case of rapidly progressive neonatal diffuse hepatic haemangioendotheliomas. The clinical picture was characterized by respiratory insufficiency due to gross abdominal enlargement, coagulopathy, and the development of cardiovascular insufficiency during the course of disease. Pharmacological, radiotherapeutic and endovascular treatment options all proved ineffective. We describe our own experience and the steps taken to treat this child. Unfortunately, the child died as a consequence of the disease. As cases like this are rare and are associated with severe morbidity and high mortality, more knowledge needs to be gained on infantile hepatic haemangioendotheliomas and their optimal treatment. The use of a web-based data registry could be beneficial. (orig.)

  8. [Neonatal consequences of vacuum-assisted delivery].

    Science.gov (United States)

    Maagaard, Mathilde; Sørensen, Jette Led; Lando, Ane; Ottesen, Bent

    2010-08-30

    About 5000 babies annually, or 1/12 of all births, are the result of vacuum-assisted delivery in Denmark. Towards the end of the 1990'ies, the US FDA published a national warning concerning increasing complications and mortality after vacuum-assisted delivery, and other countries followed. One explanation is that training is no longer given the needed focus. Recent introduction of new requirements on Danish specialist training and the fact that vacuum-assisted delivery is an important procedure in obstetrics provides the basis for this article which systematically reviews the neonate consequences for the termed baby following vacuum-assisted delivery.

  9. A swine model of neonatal asphyxia.

    Science.gov (United States)

    Cheung, Po-Yin; Gill, Richdeep S; Bigam, David L

    2011-10-11

    Annually more than 1 million neonates die worldwide as related to asphyxia. Asphyxiated neonates commonly have multi-organ failure including hypotension, perfusion deficit, hypoxic-ischemic encephalopathy, pulmonary hypertension, vasculopathic enterocolitis, renal failure and thrombo-embolic complications. Animal models are developed to help us understand the patho-physiology and pharmacology of neonatal asphyxia. In comparison to rodents and newborn lambs, the newborn piglet has been proven to be a valuable model. The newborn piglet has several advantages including similar development as that of 36-38 weeks human fetus with comparable body systems, large body size (~1.5-2 kg at birth) that allows the instrumentation and monitoring of the animal and controls the confounding variables of hypoxia and hemodynamic derangements. We here describe an experimental protocol to simulate neonatal asphyxia and allow us to examine the systemic and regional hemodynamic changes during the asphyxiating and reoxygenation process as well as the respective effects of interventions. Further, the model has the advantage of studying multi-organ failure or dysfunction simultaneously and the interaction with various body systems. The experimental model is a non-survival procedure that involves the surgical instrumentation of newborn piglets (1-3 day-old and 1.5-2.5 kg weight, mixed breed) to allow the establishment of mechanical ventilation, vascular (arterial and central venous) access and the placement of catheters and flow probes (Transonic Inc.) for the continuously monitoring of intra-vascular pressure and blood flow across different arteries including main pulmonary, common carotid, superior mesenteric and left renal arteries. Using these surgically instrumented piglets, after stabilization for 30-60 minutes as defined by Zasphyxia with severe metabolic acidosis, systemic hypotension and cardiogenic shock with hypoperfusion to vital organs. The hypoxia is followed by reoxygenation

  10. Nursing staff requirements for neonatal intensive care.

    OpenAIRE

    Williams, S; Whelan, A; Weindling, A M; Cooke, R W

    1993-01-01

    A study to estimate the number of nursing staff required for neonatal nursing was undertaken. Certain nursing tasks, such as transporting any infant, caring for the dying infant, and looking after the very unstable infant required continuous attention by one nurse (5.5 whole time equivalent (wte) nurses for each cot). The stable ventilated infant required 10.5 nursing hours each day-that is, 2.4 wte/cot. Infants with intravenous infusions, but not ventilated, required only slightly less nursi...

  11. Ischemia-reperfusion and neonatal intestinal injury.

    Science.gov (United States)

    Young, Christopher M; Kingma, Sandra D K; Neu, Josef

    2011-02-01

    We review research relating ischemia/reperfusion to injury in the neonatal intestine. Epidemiologic evidence suggests that the most common form of necrotizing enterocolitis is not triggered by a primary hypoxic-ischemic event. Its late occurrence, lack of preceding ischemic events, and evidence for microbial and inflammatory processes preclude a major role for primary hypoxic ischemia as the sentinel pathogenic event. However, term infants, especially those with congenital heart disease who have development of intestinal necrosis, and those preterm infants with spontaneous intestinal perforations, are more likely to have intestinal ischemia as a primary component of their disease pathogenesis. Copyright © 2011 Mosby, Inc. All rights reserved.

  12. Lupus eritematoso neonatal: reporte de cuatro casos

    OpenAIRE

    Perez,Maria Fernanda; Torres,Maria Eugenia de; Buján,María Marta; Lanoël,Agustina; Cervini,Andrea Bettina; Pierini,Adrián Martín

    2011-01-01

    El lupus eritematoso neonatal es una enfermedad poco frecuente, caracterizada clínica mente por alteraciones cutáneas semejantes al lupus subagudo o discoide y/o bloqueo cardíaco congénito. Generalmente, cuando los pacientes presentan manifestaciones cutáneas, no tienen anormalidades cardiológicas y viceversa, aunque en un 10% de los casos ambas manifestaciones pueden coexistir. Puede acompañarse también de alteraciones hematológicas, hepáticas y neurológicas. Es causado por el pasaje traspla...

  13. Hemangiomatosis neonatal difusa e insuficiencia cardiaca congestiva

    OpenAIRE

    Charles Augusto Huamaní Saldaña; Violeta López-Naváez; Eloy Saravia-Sandoval

    2007-01-01

    La hemangiomatosis neonatal difusa es un trastorno raro que consiste en la aparición de múltiples hemangiomas que comprometen; piel y vísceras como hígado, intestinos o el sistema nervioso central, pudiendo llegar a causar una insuficiencia cardiaca congestiva; entre otras complicaciones. Presentamos el caso de una niña de tres meses con angiomas múltiples en la piel e hígado, asociados con; cardiomegalia y dificultad respiratoria; con diagnóstico de insuficiencia cardiaca congestiva...

  14. Intrapartum maternal fever and neonatal outcome.

    Science.gov (United States)

    Lieberman, E; Lang, J; Richardson, D K; Frigoletto, F D; Heffner, L J; Cohen, A

    2000-01-01

    Much of fever during term labor may not be infectious but rather a consequence of the use of epidural analgesia. Therefore, we investigated the association of elevated maternal intrapartum temperature with neonatal outcome when the infant does not develop an infection. We studied 1218 nulliparous women with singleton, term pregnancies in a vertex presentation and spontaneous labor. Women were excluded if their temperature was >99.5 degrees F at admission for delivery, if they were diabetic or had an active genital herpes infection or if their infant developed a neonatal infection, had a congenital infection, or had a major malformation. Maximum intrapartum temperature was categorized as: 101 degrees F. During labor, 123 women (10.1%) developed a fever >100.4 degrees F; 62 (5.1%) women had a maximum temperature of 100.5 degrees F to 101 degrees F and 61 (5.0%) women had a maximum temperature >101 degrees F. Of febrile women, 97.6% had received epidural analgesia for pain relief. Infants of women developing a fever >100.4 degrees F were more likely to have a 1-minute Apgar score 100.4 degrees F vs 8.0% for afebrile) and to be hypotonic after delivery (4.8% for >100.4 degrees F vs.5% for afebrile). Compared with infants of afebrile women, infants whose mothers' maximum temperature was >101 degrees F were more likely to require bag and mask resuscitation (11.5% vs 3.0%) and to be given oxygen therapy in the nursery (8.2% vs 1.3%). We also found a higher rate of neonatal seizure with fever (3.3% vs.2%), but the number of infants with seizure was small (n = 4). All associations remained essentially the same after controlling for confounding in logistic regression analyses. Intrapartum maternal fever, particularly if >101 degrees F, was associated with a number of apparently transient adverse effects in the newborn. Larger studies are needed to investigate the association of intrapartum fever with neonatal seizures and to determine whether any lasting injury to the fetus

  15. Neurosonography of the pre-term neonate

    International Nuclear Information System (INIS)

    Grant, E.G.

    1986-01-01

    This book provides a description of our present understanding of the premature brain as seen through the eyes of the sonogram. Neurosonography of the Pre-Term Neonate ties the pathophysiology, anatomy and the all important clinical follow-up data to the sonogram. The book is divided into five sections: Scanning Techniques and Normal Anatomy, Pathophysiology of Germinal Matrix Related Hemorrhage and Ischemia, Neurosonography - Germinal Matrix Related Hemorrhage - Periventricular Leukomalacia, Incidence and Outcome - Germinal Matrix Related Hemorrhage - Periventricular Leukomalacia and Comparison of Two Modalities: Ultrasound versus Computed Tomography

  16. Prevalence and pattern of congenital malformations among neonates in the neonatal unit of a teaching hospital

    International Nuclear Information System (INIS)

    Hussain, S.; Sabir, M.; Tarar, S. H.; Mushtaq, R.; Asghar, I.; Chattha, M. N.

    2014-01-01

    Objective: To determine the prevalence and pattern of congenital malformations among neonates in a teaching hospital. Methods: The prospective hospital-based study was conducted over a period of 18 months in the neonatal unit of Combined Military Hospital, Kharian, from September 2011 to February 2013. All neonates from newborn to 28 days of age admitted to the unit irrespective of their condition comprised the study population. Neonatal examination was done by the Registrar at the time of admission followed by neonatologist/paediatrician. Information regarding gender, weight, gestational age, mode of delivery, consanguinity, maternal age, antenatal visit record and family history were recorded on a predesigned proforma. After clinical examination, if required, relevant investigations like ultrasonography, radiology, echocardiography, laboratory and genetic studies were done to confirm diagnosis. Data was statistically analysed by using SPSS 20. Results: Out of 3,210 total admissions, 226 (7%) neonates were congenitally malformed. Of them, 130 (57.52 %) were male and 96 (42.47 %) females. Among different body systems affected, anomalies related to the central nervous system were 46(20.35%) musculoskeletal 42(18.58%), genitourinary 34 (15.04%), cardiovascular system 30 (13.27%), ear, eye, face, neck 27(11.94%), digestive system 19 (8.40%), syndromes and skin 14 (6.19%) each. Conclusion: Congenital Malformations are not rare in our community and central nervous system is the most commonly affected system. Healthcare managers must stress upon primary prevention in the form of vaccination, nutrition and drugs to decrease preventable share of congenital malformations. (author)

  17. Maternal booking status as a criterion for admission for neonatal ...

    African Journals Online (AJOL)

    1994-08-08

    Aug 8, 1994 ... Given this strain on resources, neonatal intensive care unit (NICU) staff are under pressure to admit only those patients with the best prognosis or, conversely, to deny access to those with a worse prognosis. Because neonates born to unbooked mothers who have received inadequate or no antenatal care.

  18. Evaluation of an auditory brainstem response in icteric neonates

    Directory of Open Access Journals (Sweden)

    Ahmad Talebian

    2017-08-01

    Full Text Available Background: Neonatal hyperbilirubinemia is a common and preventable cause of sensory-neural hearing impairment, which can cause difficulties in the development of speech and communication. This study was conducted to detect the toxic effect of hyperbilirubinemia on the brain stem and auditory tract in neonates with icterus admitted to Shahid Beheshti Hospital in Kashan, Iran. Materials and Methods: This cross-sectional study was conducted on 98 neonates with increased indirect bilirubin admitted to Shahid Beheshti Hospital in Kashan during 2014-2015. The patients were referred to Matini Hospital for the assessment of the auditory brainstem response (ABR; wave latency and interpeak intervals of the waves were also evaluated. According to the serum bilirubin level, the neonates were allocated into two groups; one group had a serum bilirubin level of 13-20 mg/d and another group had a bilirubin level more than 20 mg/d. Results: From 98 neonates, 26 (26.5% had a bilirubin level more than 20 mg/d and 72 (73.5% had a bilirubin level of 13-20 mg/d. Also, 46.1% of the neonates in the first group (bilirubin20 mg/d can cause an auditory processing disorder in neonates. So, performing ABR for screening and early detection of bilirubin toxicity can be recommended as a necessary audiologic intervention in all cases of severe neonatal hyperbilirubinemia.

  19. Patterns of neonatal hypoxic-ischaemic brain injury

    International Nuclear Information System (INIS)

    Vries, Linda S. de; Groenendaal, Floris

    2010-01-01

    Enormous progress has been made in assessing the neonatal brain, using magnetic resonance imaging (MRI). In this review, we will describe the use of MRI and proton magnetic resonance spectroscopy in detecting different patterns of brain injury in (full-term) human neonates following hypoxic-ischaemic brain injury and indicate the relevance of these findings in predicting neurodevelopmental outcome. (orig.)

  20. Approach to seizures in the neonatal period: a European perspective

    DEFF Research Database (Denmark)

    Vento, M; de Vries, Lisbeth Elvira; Alberola, A

    2010-01-01

    In the neonatal period, seizures rank among the most common neurological symptoms, often indicating an underlying serious neurological condition. It is remarkable that although new tools have been incorporated into the diagnosis of neonatal seizures, there is no consensus about the therapeutic ap...