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Sample records for sepse neonatal precoce

  1. Fatores de risco para o desenvolvimento de sepse neonatal precoce em hospital da rede pública do Brasil Risk factors for early-onset neonatal sepsis in Brazilian public hospital short-title: early-onset neonatal sepsis

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    Ana Paula Goulart

    2006-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O conhecimento dos fatores de risco associados à sepse neonatal precoce em unidade de neonatologia, inserida na realidade de nosso sistema de saúde, no sentido de se detectar, prevenir e adotar medidas específicas e reduzir as taxas de mortalidade nessa faixa etária. O objetivo deste estudo foi determinar os fatores de risco associados a sepse neonatal precoce em hospital de referência em neonatologia ligado à rede pública de saúde. MÉTODO: Foi realizado um estudo observacional, prospectivo, tipo caso-controle. Foram incluídos os recém-nascidos com diagnóstico de sepse precoce e como controle, recém-nascidos sem infecção neonatal nascido na mesma data do recém-nascido considerado como caso. Foram incluídos 50 casos e três controles para cada caso, resultando em amostra total de 200 pacientes. Foi considerada estatisticamente significativa a associação quando p BACKGROUND AND OBJECTIVES: The determination of the risk factors to early-onset neonatal sepsis in our country is essential to prevent and reduce the mortality associated with this syndrome. Thus, the objective of this study was to determine the frequency and associated risk factors to early-onset neonatal sepsis in public hospital in Southern Brazil. METHODS: Observational, case-control study. Were included neonates with diagnostic of early-onset neonatal sepsis and as controls, neonates without neonatal infection. Were included 50 cases and 3 controls for each case resulting in a total sample of 200 patients. Associations were considered significant when p < 0.05. RESULTS: The sepsis frequency was 50.3 per 1000 born-alive. Risk factors associated to the development of neonatal sepsis were prematurity (OR 9.33; p < 0.001, low birth weight (OR 11.74; p < 0.001, maternal infection (OR 2.28; p = 0.009, mother with history of previous infant with neonatal sepsis (OR 6.43; p = 0.035 and rupture of the membranes more than 18 hours before delivery

  2. Terapia nutricional e sepse neonatal

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    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.

  3. Ações do enfermeiro na identificação precoce de alterações sistêmicas causadas pela sepse grave

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    Felipe Garrido

    2017-04-01

    Full Text Available Introdução: As unidades de terapia intensiva (UTIs têm sido organizadas como setores estratégicos para o suporte especializado de assistência ao paciente grave. Objetivo: Verificar as ações do enfermeiro para a identificação precoce das alterações sistêmicas causadas pela sepse grave relacionadas às alterações hemodinâmicas, neurológicas, respiratórias, renais e nutricionais dos pacientes internados em UTIs adulto. Métodos: Estudo descritivo com 24 enfermeiros. Os dados foram coletados por meio de formulário composto de questões estruturadas. Resultados: Apenas 36% dos enfermeiros possuem especialização em UTI adulto; verificou-se que os profissionais identificam parcialmente os sinais e sintomas apresentados pelo paciente séptico. Conclusão: Os enfermeiros encontram dificuldade na identificação precoce das alterações sistêmicas causadas pela sepse grave relacionada às alterações hemodinâmicas, neurológicas, respiratórias, renais e nutricionais dos pacientes internados em UTI adulto, o que pode estar relacionado com a falta de treinamento e de protocolos estabelecidos pelas instituições.

  4. Sepse tardia em pré-termos de uma unidade de terapia intensiva neonatal: análise de três anos

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    Brunnella Alcantara Chagas de Freitas

    2012-03-01

    Full Text Available OBJETIVO: Avaliar a prevalência, os fatores e os agentes etiológicos associados à sepse neonatal tardia em pré-termos de uma unidade de terapia intensiva neonatal. MÉTODOS: Estudo transversal, de dados secundários de prontuários de pré-termos admitidos em uma unidade de terapia intensiva neonatal, no triênio 2008-2010. Caracterizou-se a variável desfecho sepse neonatal tardia pelos critérios da Agência Nacional de Vigilância Sanitária. Empregaram-se os testes do Qui-quadrado de Pearson, exato de Fisher ou Qui-quadrado de tendência linear para as variáveis qualitativas. Considerou-se significante p<0,05. Realizaram-se análises bivariadas e multivariadas entre as variáveis independentes e a dependente, obtendo-se como medida de efeito as razões de prevalências, considerando-se p<0,20. RESULTADOS: Participaram do estudo 267 prematuros. Destes, 28,5% evoluíram com sepse tardia, com positividade de hemocultura em 17,1%. Evoluíram a óbito 8,2% dos pré-termos e, destes, 68,2% eram do grupo sepse. Associaram-se à hemocultura positiva três óbitos, todos com a participação de Gram-negativos. Na análise bivariada para o desfecho sepse tardia observou-se que, à medida que decresceram a idade gestacional e o peso ao nascer, houve aumento de sua prevalência. A duração de ventilação mecânica e de cateter central de inserção periférica por períodos iguais ou superiores respectivamente a 10 e 11 dias se associaram ao desfecho sepse neonatal tardia em 80,8% e 76,2% dos pré-termos. Na análise multivariada, permaneceu como fator associado à sepse tardia o tempo de cateter central de inserção periférica igual ou superior a 11 dias. Houve maior participação dos Gram-negativos como agentes etiológicos, sendo mais frequentes a Klebsiella pneumoniae e a Escherichia coli. CONCLUSÕES: A sepse tardia mantém-se uma preocupação por sua prevalência nas unidades de terapia intensiva e pela associação a procedimentos

  5. Sepse e choque séptico no período neonatal: atualização e revisão de conceitos Neonatal sepsis and septic shock: concepts update and review

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    Rita de Cássia Silveira

    2010-09-01

    Full Text Available A sepse neonatal e a síndrome da resposta inflamatória sistêmica, que antecede o choque séptico, se manifestam como um estado não específico, o que pode retardar o diagnóstico precoce do choque séptico, razão pela qual a mortalidade desta condição permanece elevada. O diagnóstico precoce envolve a suspeita de choque séptico em todo recém nascido apresentando taquicardia, desconforto respiratório, dificuldade de alimentação, tônus alterado, cor alterada, taquipnéia e perfusão reduzida, especialmente na presença de histórico materno de infecção periparto, como corioamnionite ou ruptura prolongada de membranas ovulares. O presente artigo tem como objetivo revisar o conhecimento atual a respeito das peculiaridades do período neonatal, da dinâmica da circulação fetal e da variável idade gestacional. O choque séptico no recém-nascido não é choque séptico do adulto pequeno. No recém-nascido, o choque séptico é predominantemente frio, caracterizado por redução do débito cardíaco e alta resistência vascular sistêmica (vasoconstrição. O tempo é fundamental no tratamento para reversão do choque séptico. A revisão da literatura, baseada em buscas em bases indexadas, fornece subsídios para o manejo do recém-nascido.The nonspecific presentation of neonatal sepsis and systemic inflammatory response syndrome preceding septic shock delay the early diagnosis of septic shock and increase its mortality rate. Early diagnosis involves suspecting septic shock in every newborn with tachycardia, respiratory distress, difficult feeding, altered tonus and skin coloration, tachypnea and reduced perfusion, specially in case of maternal peripartum infection, chorioamnionitis or long-term membranes rupture. This article aims to review current knowledge on neonatal period peculiarities, fetal circulation dynamics, and the pregnancy age variable. Newborn septic shock is not just a small adult shock. In the newborn, the septic

  6. Endocardite bacteriana como complicação de sepse neonatal - relato de caso Bacterial endocarditis as a complication of neonatal sepsis: a case report

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    V.L.J. Krebs

    1999-12-01

    Full Text Available Os autores relatam um paciente com 11 dias de vida, internado em Unidade de Terapia Intensiva Neonatal devido a múltiplas malformações congênitas, apresentando sepse e endocardite bacteriana. Entre os fatores de risco para endocardite foram destacados o cateterismo venoso central, hemocultura com crescimento de Staphylococcus aureus e ventilação mecânica. O diagnóstico foi realizado no 61o dia de internação devido a presença de febre persistente e aparecimento de sopro cardíaco sistólico. O ecocardiograma mostrou trombo em átrio direito, medindo 1,9 x 0,7mm sendo realizada antibioticoterapia e ressecção cirúrgica, com melhora clínica. No 125° dia de internação ocorreu óbito devido à sepse e abscesso cerebral. Na necrópsia não foram observados malformações cardíacas. Os autores concluem ser de grande importância o conhecimento das complicações potenciais das técnicas invasivas utilizadas em recém-nascidos criticamente doentes. A suspeita clínica de endocardite deve ser realizada em todos os neonatos com sepse, internados em Unidade de Terapia Intensiva Neonatal por tempo prolongadoThe authors reported on a 11 day-old child, admitted in Neonatal Intensive Care Unit for multiple congenital malformations, who had sepsis and bacterial endocarditis. Among the risk factors for endocarditis were outstanding: the central venous catheterism, hemoculture with growth of Staphylococcus aureus and mechanical ventilation. The diagnosis was made in the 61st day after admission owing to the presence of persistent fever and appearance of systolic murmur. The echocardiogram revealed a thrombus in the right atrium measuring 1.9 x 0.7mm. Antibiotic therapy and surgical resection being performed, with clinical improvement. On the 125st day after admission the patient died owing sepsis and cerebral abscess. At necropsy, heart malformations were not observed. The authors concluded to be very important the knowledge of the potential

  7. Mortalidade neonatal precoce relacionada a intervenções clínicas

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    Rossana Marchese Bittencourt

    2014-04-01

    Full Text Available Estudo descritivo, transversal, que objetivou identificar a influência das intervenções clínicas realizadas na sala de parto e UTI Neonatal no óbito neonatal precoce em Cuiabá-MT, no ano de 2010. A coleta de dados foi feita em janeiro-fevereiro/2011, com base nos dados contidos nas declarações de nascidos vivos, declarações de óbito e prontuário hospitalares, sendo arquivados e tratados no programa SPSS versão 15.0. Dos 77 óbitos analisados, 94,7% dos bebês nasceram no hospital e mais de 70% morreram precocemente. As intervenções em sala de parto que se associaram ao risco de óbito precoce foram a reanimação cardiopulmonar e intubação; durante a internação, o cateter central de inserção periférica e a hemotransfusão associaram-se como fator de proteção para o óbito precoce. O conhecimento de práticas clínicas benéficas ou maléficas para a saúde do neonato é imprescindível para alcançar a qualidade do cuidado e, consequentemente, reduzir os óbitos neonatais, especialmente os precoces.

  8. Fatores de risco para mortalidade neonatal precoce Risk factors for early neonatal mortality

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    Daniela Schoeps

    2007-12-01

    Full Text Available OBJETIVO: Avaliar os fatores de risco da mortalidade neonatal precoce. MÉTODOS: Estudo caso-controle de base populacional com 146 óbitos neonatais precoces e amostra de 313 controles obtidos entre os sobreviventes ao período neonatal, na região sul do município de São Paulo, no período de 1/8/2000 a 31/1/2001. As informações foram obtidas por meio de entrevistas domiciliares e prontuários hospitalares. Foi realizada análise hierarquizada em cinco blocos com características: 1 socioeconômicas das famílias e das mães; 2 psicossociais maternas; 3 biológicas e da história reprodutiva materna; 4 do parto; 5 do recém-nascido. RESULTADOS: Os fatores de risco para a mortalidade neonatal precoce foram: Bloco 1: baixa escolaridade do chefe da família (OR=1,6; IC 95%: 1,1;2,6; domicílio em favela (OR=2,0; IC 95%: 1,2;3,5, com até um cômodo (OR=2,2; IC 95%: 1,1;4,2; Bloco 2: mães com união recente (OR=2,0; IC 95%: 1,0;4,2 e sem companheiro (OR=1,8; IC 95%: 1,1;3,0, presença de maus tratos (OR=2,7;1,1-6,5; Bloco 3: presença de intercorrência na gravidez (OR=8,2; IC 95%: 5,0;13,5, nascimento prévio de baixo peso (OR=2,4; IC 95%: 1,2;4,5; pré-natal ausente (OR=16,1; IC 95%: 4,7;55,4 ou inadequado (OR=2,1; IC 95%: 2,0;3,5; Bloco 4: presença de problemas no parto (OR=2,9; IC 95%: 1,4;5,1, mães que foram ao hospital de ambulância (OR=3,8; IC 95%: 1,4;10,7; Bloco 5: baixo peso ao nascer (OR=17,3; IC 95%: 8,4;35,6, nascimento de pré-termo (OR=8,8; IC 95%: 4,3;17,8. CONCLUSÕES: Além dos fatores proximais (baixo peso ao nascer, gestações de pré-termo, problemas no parto e intercorrências durante a gestação, identificou-se a participação de variáveis que refletem exclusão social e de fatores psicossociais. Esse contexto pode afetar o desenvolvimento da gestação e dificultar o acesso das mulheres aos serviços de saúde. A assistência pré-natal adequada poderia minimizar parte do efeito dessas variáveis.OBJECTIVE: To

  9. 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

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    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

  10. Fatores de risco da sepse em pacientes queimados

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    Jefferson Lessa S. de Macedo

    Full Text Available OBJETIVO: Os avanços no tratamento de queimados têm reduzido as taxas de mortalidade e melhorado a qualidade de vida das vítimas de queimaduras. Entretanto, a sepse continua sendo um desafio e umas das principais causas de óbito no queimado. O objetivo deste trabalho é investigar, através de um estudo caso-controle, os fatores de risco da sepse em pacientes queimados. MÉTODO: O estudo caso-controle foi conduzido durante 12 meses, compreendendo os pacientes que foram tratados em regime de internação hospitalar na Unidade de Queimados do Hospital Regional da Asa Norte (HRAN, Brasília-DF. RESULTADOS: Quarenta e nove (19,4% pacientes tiveram sepse, de um total de 252 queimados internados na Unidade de Queimados durante o periodo do estudo. Eles tiveram um ou no maximo tres episodios de sepse durante a internacao, totalizando 62 episodios. Vinte e seis (53,1% eram homens e a media de idade foi de 21,9 ± 18,9 anos (variacao de um a 89 anos. A superficie corporal queimada dos pacientes que tiveram sepse variou de sete a 84%, com uma media de 37,7 ± 18,4%, sendo significativamente superior aos controles. As principais bacterias causadoras de sepse foram Staphylococcus aureus (46,5%, Staphylococcus coagulase negativo (20,7%, Acinetobacter baumannii (12,1% e Enterobacter cloacae (12,1%. Trinta (61,2% pacientes tiveram seu primeiro episodio de sepse na primeira semana de internacao. Quanto aos fatores de risco para a ocorrencia de sepse, destacam-se os seguintes, conforme seu poder de associacao "odds ratio": o uso de tres ou mais cateteres, a presenca de duas ou mais complicacoes, a superficie corporal queimada > 30%, o agente chama aberta e o sexo feminino. No geral, a taxa de letalidade por sepse foi de 24,5%. CONCLUSÃO: Um melhor conhecimento dos fatores de risco da sepse no paciente queimado permite o tratamento precoce dessa complicação, com antibioticoterapia sistêmica adequada, contribuindo para reduzir a morbidade e a mortalidade

  11. Diagnosis of neonatal group B Streptococcus sepsis by nested-PCR of residual urine samples Diagnóstico de sepse neonatal causada pelo estreptococo do grupo B por meio de dupla amplificação de amostras residuais de urina

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    Bruno Nicolino Cezarino

    2008-03-01

    four patients. Moreover, PCR has enabled us to use residue volumes of urine samples collected by non invasive, non sterile methods, what is technically adequate as GBS is not part of the normal urine flora, thus avoiding invasive procedures such as suprapubic bladder punction or transurethral catheterization. At the same time, the use of urine instead of blood samples could help preventing newborns blood spoliation.O estreptococo do grupo B (GBS constitui a causa mais freqüente de sepse neonatal precoce. O teste de referência continua sendo o isolamento em cultura, apesar de apresentar problemas de sensibilidade. O objetivo do presente estudo foi validar uma técnica de dupla amplificação e determinar a possibilidade do uso de amostras residuais de urina colhidas por método não invasivo, não estéril, para a confirmação da sepse por GBS em recém-nascidos. As amostras foram amplificadas com primers do principal gene de superfície do GBS. A insuficiência de volume de material biológico para a realização de exames para suporte de vida, além de outros necessários à identificação do agente etiológico de infecções é muito freqüente em recém-nascidos. Mesmo assim, decidimos definir critérios bastante rigorosos para a inclusão de pacientes na casuística: os recém-nascidos deveriam apresentar sinais e sintomas compatíveis com infecção pelo GBS; deveriam ter tido ao menos uma amostra enviada para cultura, podendo ser sangue, urina ou líquor; disponibilidade de volumes residuais dessas amostras, ou de outras colhidas no dia da hospitalização, antes da introdução da antibioticoterapia, de forma a possibilitar a análise por PCR, e evolução favorável com a antibioticoterapia empírica. Em apenas um dos quatro recém-nascidos a infecção foi confirmada por cultura, enquanto nos outros três casos a infecção foi considerada presuntiva (pacientes preencheram os critérios de inclusão, mas o GBS não foi isolado. De um total de 12 amostras

  12. Estimativa do impacto econômico da implantação de um protocolo hospitalar para detecção e tratamento precoce de sepse grave em hospitais púbicos e privados do sul do Brasil Estimate of the economic impact of implementing an in hospital protocol for the early detection and treatment of severe sepsis in public and private hospitals in southern Brazil

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    Alvaro Koenig

    2010-09-01

    Full Text Available OBJETIVO: Analisar o impacto econômico de um protocolo de detecção precoce de sepse em dois hospitais gerais. MÉTODOS: Analisamos os dados colhidos em um estudo prospectivo em pacientes sépticos antes e após a implantação do protocolo de detecção precoce de sepse grave. Realizamos uma análise de custo-efetividade comparando: taxa de mortalidade, custo do tratamento da sepse e custos indiretos atribuídos a anos de vida produtiva perdidos por óbito prematuro em ambas as fases. RESULTADOS: Foram incluídos 217 pacientes, 102 na Fase I e 115 na Fase II. Após a implantação do protocolo, em hospital privado e em hospital público, as taxas de mortalidade caíram de 50% para 32,2%, e de 68,6% para 41% (pOBJECTIVE: To analyze the economic impact of an early sepsis detection protocol in two general hospitals. METHODS: We analyzed data collected from a prospective study of septic patients before and after the implementation of a protocol for early diagnosis of severe sepsis. We conducted a cost-effectiveness analysis comparing: mortality rate, cost of sepsis treatment and indirect costs attributed to years of productive life lost to premature death in both phases. RESULTS: Two hundred seventeen patients were included, 102 in phase I and 115 in phase II. After protocol implementation, in private and public hospital, mortality rates decreased from 50% to 32.2% and from 67.6% to 41% (p < 0.05. The mean years of productive life lost due to sepsis decreased from 3.18 to 0.80 and 9.81 to 4.65 (p < 0.05, with a mean gain of 2.38 and 5.16 years of productive life, for each septic patient. Considering Brazilian gross domestic product per capita, estimated productivity loss due to sepsis decreased between 3.2 and 9.7 billion US dollars, varying based on the incidence of sepsis. Hospital costs were similar in both phases. CONCLUSION: A protocol for early detection and treatment of in-hospital septic patients is highly cost-effective from a societal

  13. A bilirrubina altera a mielinização no período neonatal precoce

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    Barateiro, Andreia Pereira, 1982-

    2012-01-01

    Tese de doutoramento, Farmácia (Biologia Celular e Molecular), Universidade de Lisboa, Faculdade de Farmácia, 2012 Oligodendrocytes (OL) are neuroglial cells present in the central nervous system responsible for myelin sheath formation, that provide an electric insulation of axons fastening the transmission of electrical signals. During the neonatal period, the brain is particularly vulnerable to toxic insults, like the one induced by hyperbilirubinemia. It has been demonstrated that in th...

  14. Avaliação do diagnóstico da sepse neonatal: uso de parâmetros laboratoriais e clínicos como fatores diagnósticos Evaluación del diagnóstico de sepsis neonatal: uso de parámetros laboratoriales y clínicos como factores diagnósticos Evaluation of the neonatal sepsis diagnosis: use of clinical and laboratory parameters as diagnosis factors

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    Luciano de Assis Meireles

    2011-03-01

    Full Text Available Objetivou-se descrever e comparar as características clínicas, laboratoriais e assistenciais de RN que apresentaram sepse comprovada tardia e de RN que apresentaram sepse não comprovada tardia. Em seguida, avaliar se houve diferença entre os grupos, além de descrever os germes prevalentes na unidade neonatal estudada. Estudo descritivo, envolvendo 168 casos. Observou-se que 33,3% tiveram sepse tardia provada. A idade no momento da sepse, o tempo total de internação, a quantidade total de neutrófilos, a quantidade de neutrófilos imaturos e o valor da PC-r mostraram bons parâmetros na diferenciação entre os dois grupos quando analisados de forma isolada. A Klebisiella pneumoniae, o Staphylococcus coagulase negativo e o S. aureus foram as bactérias mais comumente isoladas.Se objetivó describir y comparar las características clínicas, laboratoriales y asistenciales de RN que presentaron sepsis comprobada tardía y de RN que presentaron sepsis no comprobada tardía para, entonces, evaluar si hubo diferencia entre los grupos, además de describir los gérmenes prevalentes en la unidad neonatal estudiada. Estudio descriptivo, involucrando 168 casos, 33,3% tuvieron sepsis tardía probada. La edad al momento de la sepsis, el tiempo total de internación, la cantidad total de neutrófilos, la cantidad de neutrófilos inmaduros y el valor de la PC-r mostraron buenos parámetros en la diferenciación entre los dos grupos cuando fueron analizados en forma aislada. La Klebsiella pneumoniae, el Staphylococcus coagulase negativo y el S. aureus fueron las bacterias aisladas con mayor prevalencia.The purpose of this study was to describe and compare the clinical, laboratory and health care characteristics of newborns (NBs with confirmed late onset sepsis and NBs with unconfirmed late sepsis, verify if there were any differences between the groups, and describe the germs prevalent in the studied neonatal unit. This is a descriptive study, involving

  15. Perfil dos recém-nascidos submetidos à estimulação precoce em uma unidade de terapia intensiva neonatal

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    Karla Camila Lima de Souza

    2013-12-01

    Full Text Available Objetivo: Descrever o perfil dos recém-nascidos submetidos à estimulação precoce em uma unidade de terapia intensiva neonatal, caracterizando a população do estudo segundo suas variáveis neonatais e fatores de risco indicativos para o tratamento de estimulação precoce. Métodos: Estudo do tipo transversal e analítico, realizado em hospital de referência de Fortaleza, no período de fevereiro a março de 2011, cuja amostra constou de 116 prontuários de recém-nascidos indicados para o tratamento de estimulação precoce. Analisaram-se as seguintes variáveis: peso, sexo, idade gestacional, índice de Apgar, diagnóstico de síndrome do desconforto respiratório e de hemorragia intracraniana, uso de ventilação mecânica e pressão positiva contínua das vias aéreas (CPAP. As variáveis foram analisadas pelo programa Microsoft Excel® 2007 para obtenção de média e moda. Resultados: Das variáveis estudadas, houve um predomínio do baixo peso ao nascer, prematuridade e sexo masculino. Segundo o índice de Apgar, os escores do 1º e do 5º minutos mostraram valores ascendentes. Quanto às patologias estudadas, destaca-se a síndrome do desconforto respiratório como a mais prevalente, seguida da hemorragia intracraniana. Com relação à utilização do suporte ventilatório, o CPAP apresentou-se como a modalidade mais indicada, seguida da ventilação mecânica. Conclusão: O perfil dos recém-nascidos investigados no presente estudo, submetidos à estimulação precoce em uma unidade de terapia intensiva neonatal, é representado pelo sexo masculino, prematuro, com baixo peso e índice de Apgar elevado no 1º e 5º minutos, com prevalência da síndrome do desconforto respiratório e aumento do uso da pressão positiva contínua das vias aéreas.

  16. Perfis de mortalidade neonatal precoce: um estudo para uma Maternidade Pública de Belo Horizonte (MG, 2001-2006 Profiles of early neonatal deaths: a study for a Public Maternity Hospital of Belo Horizonte (MG, 2001 - 2006

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    Heloísa Maria de Assis

    2008-12-01

    Full Text Available Trata-se de estudo seccional, com base em dados secundários, com o objetivo de traçar o perfil dos óbitos neonatais precoces ocorridos em uma Maternidade Pública de referência no Estado de Minas Gerais (Maternidade Odete Valadares, Belo Horizonte, no período de 2001 a 2006. Foram utilizadas variáveis relacionadas ao recém-nascido (período de ocorrência do óbito, idade ao óbito, sexo, idade gestacional e peso ao nascer, à mãe (tipo de gravidez, tipo de parto, idade, parturição e número de nascidos mortos, bem como causas múltiplas de mortalidade categorizadas. Obtiveram-se três perfis de óbitos neonatais precoces por meio do método Grade of Membership, que possibilitou também encontrar a prevalência destes perfis. O Perfil 1 foi caracterizado por óbitos de difícil redução e teve prevalência de 41,4%; o Perfil 2, pelos óbitos passíveis de redução (prevalência de 28,3%; e o Perfil 3, pelos óbitos redutíveis (prevalência de 30,4%. Estes perfis possibilitaram a compreensão da mortalidade neonatal precoce na Maternidade Odete Valadares e a análise da sua relação com a história reprodutiva e obstétrica materna, bem como com as condições do recém-nascido. Chama a atenção a elevada prevalência de óbitos evitáveis, realidade que deve ser enfrentada pelos profissionais e pela rede pública de saúde.This is a cross-sectional study with the aim of describing the early neonatal deaths that took place at a Public Maternity Hospital, Maternidade Odete Valadares in Belo Horizonte, Minas Gerais, Brazil, from 2001 to 2006. It used variables related to the newborn (period the death took place, age at death, gender, gestational age, and birth weight, to the mother (type of pregnancy, type of delivery, age, parity, and number of stillborn children, and to the multiple causes of death. Three profiles of early neonatal death were obtained through the Grade of Membership method (GoM, which also made it possible to find

  17. Insuficiência renal aguda em pacientes com sepse grave: fatores prognósticos = Acute renal injury in patients with severe sepsis: prognostic factors

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    Okamoto, Thábata Yaedu

    2012-01-01

    Conclusões: A insuficiência renal aguda foi ocorrência comum nos pacientes com sepse, fazendo parte de um quadro de disfunção de múltiplos órgãos e sistemas, particularmente nos pacientes com diagnóstico de choque séptico, estando associada a aumento da probabilidade de morte nesses pacientes graves. O uso de drogas vasoativas foi o único fator de risco para mortalidade em pacientes com sepse e insuficiência renal aguda que se manteve na análise multivariada. Estes resultados apontam para a importância do tratamento precoce dos quadros de sepse grave a tempo de prevenir a evolução para choque séptico e para insuficiência renal

  18. Early motor outpatient service intervention for postural control in preterm neonates Intervenção motora precoce ambulatorial para neonatos prematuros no controle postural

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    Clarissa Balbão Almeida

    2008-12-01

    Full Text Available Objective: To insure the motor acquisitions related to the Axial Spontaneous Not Communicative Development, which means postural control and displacement. This was done through an early motor intervention physiotherapy program in preterm neonates born at HSL-PUCRS. Materials and Methods: the interventional program included tasks of visual harassment, toys manipulation and postural control, based on Bobath concept. All five preterms who have participated in the program were evaluated by the physiotherapy service, using The Brazilian Scale of Child behavior Development in the First Year of Life, in the beginning of the study and repeated every two months. Results: The study shows no statistical significant results in relation to postural tasks, dynamic balance and displacement. However, a progression in the preterm’s classification evaluations was demonstrated. In the first month of evaluation the median was 3 (regular classification and in the third and fifth month of evaluation the median maintained in 4 (good classification. Conclusion: The early motor intervention provided a progression in the evaluation`s classification of motor acquisitions of the preterms development, however, no statistical significant results related to postural tasks, dinamic balance and displacemen was shown.Objetivo: Verificar as aquisições motoras relacionadas ao desenvolvimento axial espontâneo não comunicativo, ou seja, controle postural e deslocamento. Isto foi feito através de um programa de intervenção motora fisioterapêutica precoce em neonatos prematuros nascidos no Hospital São Lucas - PUCRS. Materiais e Métodos: Tarefas de perseguição visual, manipulação de brinquedos e de controle postural, baseados no conceito Bobath, foram implementadas no programa interventivo. Todos os 5 prematuros que participaram deste estudo foram avaliados pelo serviço de fisioterapia por meio da Escala de Desenvolvimento do Comportamento da Criança no Primeiro Ano

  19. Fatores perinatais associados ao óbito precoce em prematuros nascidos nos centros da Rede Brasileira de Pesquisas Neonatais Perinatal factors associated with early deaths of preterm infants born in Brazilian Network on Neonatal Research centers

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    Maria Fernanda Branco de Almeida

    2008-08-01

    Full Text Available OBJETIVO: Avaliar os fatores perinatais associados ao óbito neonatal precoce em prematuros com peso ao nascer entre 400 e 1.500 g. MÉTODOS: Coorte prospectiva e multicêntrica dos nascidos vivos com idade gestacional de 23 a 33 semanas e peso de 400-1.500 g, sem malformações em oito maternidades públicas terciárias universitárias entre junho de 2004 e maio de 2005. As características maternas e neonatais e a morbidade nas primeiras 72 horas de vida foram comparadas entre os prematuros que morreram ou sobreviveram até o sexto dia de vida. As variáveis perinatais associadas ao óbito neonatal precoce foram determinadas por regressão logística. RESULTADOS: No período, 579 recém-nascidos preencheram os critérios de inclusão. O óbito precoce ocorreu em 92 (16% neonatos, variando entre as unidades de 5 a 31%, e tal diferença persistiu controlando-se por um escore de gravidade clínica (SNAPPE-II. A análise multivariada para o desfecho óbito neonatal intra-hospitalar precoce mostrou associação com: idade gestacional de 23-27 semanas (odds ratio - OR = 5,0; IC95% 2,7-9,4, ausência de hipertensão materna (OR = 1,9; IC95% 1,0-3,7, Apgar 0-6 no 5º minuto (OR = 2,8; IC95% 1,4-5,4, presença de síndrome do desconforto respiratório (OR = 3,1; IC95% 1,4-6,6 e centro em que o paciente nasceu. CONCLUSÃO: Importantes fatores associados ao óbito neonatal precoce em prematuros de muito baixo peso são passíveis de intervenção, como a melhora da vitalidade fetal ao nascer e a diminuição da incidência e gravidade da síndrome do desconforto respiratório. As diferenças de mortalidade encontradas entre os centros apontam para a necessidade de identificar as melhores práticas e adotá-las de maneira uniforme em nosso meio.OBJECTIVE:To evaluate perinatal factors associated with early neonatal death in preterm infants with birth weights (BW of 400-1,500 g. METHODS: A multicenter prospective cohort study of all infants with BW of 400

  20. Sepse Brasil: estudo epidemiológico da sepse em Unidades de Terapia Intensiva brasileiras An epidemiological study of sepsis in Intensive Care Units: Sepsis Brazil study

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    João Andrade L. Sales Júnior

    2006-03-01

    uma elevada mortalidade da sepse nas UTI em nosso país. A mortalidade no choque séptico é uma das mais elevadas no mundo. Nossos pacientes são mais graves e com tempo de internação maior. O momento é muito propício a uma reflexão ainda maior sobre esta doença que é a principal causa de morte nas UTI, haja vista o elevado impacto econômico e social. Precisa-se cada vez mais desenvolver Campanhas de Sobrevivência na Sepse e fazer uso racional, baseado em evidências, dos recursos por ora disponíveis e da forma mais precoce possível.BACKGROUND AND OBJECTIVES: Sepsis represents the major cause of death in the ICUs all over the world. Many studies have shown an increasing incidence over time and only a slight reduce in mortality. Many new treatment strategies are arising and we should define the incidence and features of sepsis in Brazil. METHODS: Prospective cohort study in sixty-five hospitals all over Brazil. The patients who were admitted or who developed sepsis during the month of September, 2003 were enrolled. They were followed until the 28th day and/or until their discharge. The diagnoses were made in accordance to the criteria proposed by ACCP/SCCM. It were evaluated demographic features, APACHE II score, SOFA (Sepsis-related Organ Failure Assessment score, mortality, sources of infections, microbiology, morbidities and length of stay (LOS. RESULTS: Seventy-five ICUs from all regions of Brazil took part in the study.3128 patients were identified and 521 (16.7% filled the criteria of sepsis, severe sepsis or septic shock. Mean age was 61.7 (IQR 39-79, 293 (55.7% were males, and the overall 28-day mortality rate was 46.6%. Average APACHE II score was 20 and SOFA score on the first day was 7 (IQR 4-10. SOFA score in the mortality group was higher on day 1 (8, IQR 5-11, and had increased on day 3 (9, IQR 6-12. The mortality rate for sepsis, severe sepsis and septic shock was 16.7%, 34.4% and 65.3%, respectively. The average LOS was 15 days (IQR 5

  1. Intervenção motora precoce ambulatorial para neonatos prematuros no controle postural = Early motor outpatient service intervention for postural control in preterm neonates

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    Almeida, Carla Skilhan de

    2008-01-01

    Full Text Available Objetivo: Verificar as aquisições motoras relacionadas ao desenvolvimento axial espontâneo não comunicativo, ou seja, controle postural e deslocamento. Isto foi feito através de um programa de intervenção motora fisioterapêutica precoce em neonatos prematuros nascidos no Hospital São Lucas - PUCRS. Materiais e Métodos: Tarefas de perseguição visual, manipulação de brinquedos e de controle postural, baseados no conceito Bobath, foram implementadas no programa interventivo. Todos os 5 prematuros que participaram deste estudo foram avaliados pelo serviço de fisioterapia por meio da Escala de Desenvolvimento do Comportamento da Criança no Primeiro Ano de Vida no ingresso do estudo e repetida a cada dois meses. Resultados: O estudo evidencia que não houve resultados estatisticamente significativos referentes às atividades posturais, de equilíbrio dinâmico e de deslocamento, mas os prematuros obtiveram progressão na classificação das avaliações. No primeiro mês da avaliação a mediana foi de 3 (classificação regular, já no terceiro e quinto mês de avaliação a mediana se manteve em 4 (classificação bom. Conclusão: A intervenção motora precoce proporcionou uma progressão na classificação da avaliação das aquisições motoras do desenvolvimento de cada prematuro, porém, não houve resultados estatisticamente significativos, referentes a atividades posturais, de equilíbrio dinâmico e de deslocamento

  2. Morte neonatal precoce segundo complexidade hospitalar e rede SUS e não-SUS na Região Metropolitana de São Paulo, Brasil Early neonatal mortality according to level of hospital complexity in Greater Metropolitan São Paulo, Brazil

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    Zilda Pereira da Silva

    2010-01-01

    Full Text Available O objetivo foi analisar o perfil dos recém-nascidos, mães e mortalidade neonatal precoce, segundo complexidade do hospital e vínculo com o Sistema Único de Saúde (SUS, na Região Metropolitana de São Paulo, Brasil. Estudo baseado em dados de nascidos vivos, óbitos e cadastro de hospitais. Para obter a tipologia de complexidade e o perfil da clientela, empregaram-se análise fatorial e de clusters. O SUS atende mais recém-nascidos de risco e mães com baixa escolaridade, pré-natal insuficiente e adolescentes. A probabilidade de morte neonatal precoce foi 5,6‰ nascidos vivos (65% maior no SUS, sem diferenças por nível de complexidade do hospital, exceto nos de altíssima (SUS e média (não-SUS complexidade. O diferencial de mortalidade neonatal precoce entre as duas redes é menor no grupo de recém-nascidos 2.500g. Há uma concentração de nascimentos de alto risco na rede SUS, contudo a diferença de mortalidade neonatal precoce entre a rede SUS e não-SUS é menor nesse grupo de recém-nascidos. Novos estudos são necessários para compreender melhor a elevada mortalidade de recém-nascidos > 2.500g no SUS.The aim of this study was to analyze the profile of newborns, mothers, and early neonatal mortality according to the hospital's complexity and affiliation (or lack thereof with the Unified National Health System (SUS in Greater Metropolitan São Paulo, Brazil. The study was based on data for live births, deaths, and hospital registries. Factor and cluster analysis were used to obtain the typology of hospital complexity and user profile. The SUS treats more high-risk newborns and mothers with low schooling, insufficient prenatal care, and teenage mothers. The probability of early neonatal death was 5.6‰ live births (65% higher in the SUS, with no significant differences by level of hospital complexity, except those with extremely high (SUS and medium (non-SUS complexity. The difference in early neonatal mortality between the

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

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    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.

  4. Procalcitonina como biomarcador de prognóstico da sepse grave e choque séptico

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    José Raimundo Araujo de Azevedo

    Full Text Available OBJETIVO: Avaliar a tendência da concentração plasmática e do clearance de procalcitonina (PCT-c como biomarcadores de prognóstico de pacientes com sepse grave e choque séptico, comparado a um outro marcador precoce de prognóstico representado pelo número de critérios de SIRS no momento do diagnóstico da sepse. MÉTODOS: Estudo de coorte prospectivo observacional onde foram incluídos pacientes com sepse grave e choque séptico. A concentração sérica de procalcitonina foi determinada no momento do diagnóstico da sepse e após 24 e 48 horas. Foram coletados dados demográficos, escore APACHE IV, escore SOFA na chegada, número de critérios de SIRS no momento do diagnóstico, sitio da infecção e resultados microbiológicos. RESULTADOS: Vinte e oito pacientes foram incluídos, 19 clínicos e nove cirúrgicos. Em 13 (46,4% a fonte da sepse foi pulmonar, em sete abdominal (25,0%, em cinco urinária (17,9% e de partes moles em três casos (10,7%. Quinze pacientes tinham sepse grave e 13 choque séptico. A mortalidade global foi cinco pacientes (17,9%, três deles com choque séptico. Vinte e oito determinações de PCT foram realizadas no momento do diagnóstico da sepse, 27 após 24 horas e 26 após 48 horas. A concentração inicial não se mostrou expressivamente diferente entre os grupos sobreviventes e não sobreviventes, mas as diferenças entre os dois grupos após 24 e 48 horas alcançaram significância estatística expressiva. Não se observou diferença em relação ao número de critérios de SIRS. O clearance de procalcitonina de 24 horas mostrou-se expressivamente mais elevado no grupo de sobreviventes (-3,0 versus -300,0, p=0,028. Embora o clearance de procalcitonina de 48 horas tenha mostrado resultado mais elevado no grupo de sobreviventes comparado aos não sobreviventes, a diferença não alcançou significância estatística. CONCLUSÃO: Concentrações persistentemente elevadas de procalcitonina no plasma, assim

  5. Implantação do Protocolo de Manejo de Sepse no Pronto Atendimento do Hospital Universitário Regional dos Campos Gerais

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    Susan Natielli Scheidt

    2018-01-01

    Full Text Available Justificativa e Objetivo: A sepse é um desafio para a saúde pública, sendo os protocolos fundamentais para seu manejo. Objetivou-se avaliar a implantação de um protocolo assistencial de manejo de sepse e caracterizar os pacientes submetidos a avaliação clínica. Método: Estudo descritivo, do tipo transversal realizado na unidade de Pronto Atendimento (PA do Hospital Universitário Regional dos Campos Gerais. O protocolo foi elaborado a partir da literatura, com foco nos pacientes adultos com critérios de síndrome da resposta inflamatória sistêmica (SIRS, sepse, sepse grave e choque séptico, sendo descrito por meio de fluxograma. Fizeram parte do estudo os pacientes atendidos no PA entre julho a setembro de 2016 submetidos ao protocolo (n=50, sendo os dados coletados por meio dos prontuários eletrônicos e analisados descritivamente. Resultados: Para implantação do protocolo realizou-se capacitações da equipe atuante no PA, para aceitação e alinhamento de conhecimentos quanto os aspectos conceituais, técnicos e logísticos. O protocolo é composto por 3 etapas: abordagem inicial ao paciente com sepse; pacote 3/6 horas – otimização hemodinâmica e pacote opcional -otimização de Saturação venosa central de oxigênio/ pressão venosa central. Os pacientes submetidos ao protocolo tinham idade média de 66 anos (dp=±13,71, a maioria era 56% mulheres, apresentaram hipotensão (96%, elevação da creatinina (76% e leucocitose (70% entre as SIRS, realização imediata de exames (100%, início da antibioticoterapia (74% e óbito (72%. Conclusão: a implantação do protocolo subsidiou a identificação precoce dos pacientes, qualificação do cuidado, ganho operacional e as características dos pacientes condizentes com quadros graves de sepse.

  6. Asfixia perinatal associada à mortalidade neonatal precoce: estudo populacional dos óbitos evitáveis Asfixia perinatal asociada a la mortalidad neonatal temprana: estudio de población de los óbitos evitables Perinatal asphyxia associated with early neonatal mortality: populational study of avoidable deaths

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    Mandira Daripa

    2013-03-01

    Full Text Available OBJETIVO: Comparar o perfil epidemiológico dos óbitos neonatais precoces evitáveis associados à asfixia perinatal conforme a região de ocorrência do óbito no Estado de São Paulo. MÉTODOS: Coorte populacional constituída por 2.873 óbitos evitáveis até seis dias de vida associados à asfixia perinatal ocorridos entre janeiro de 2001 e dezembro de 2003. Considerou-se como asfixia perinatal a presença de hipóxia intraútero, asfixia ao nascer ou síndrome de aspiração de mecônio em qualquer linha da Declaração de Óbito original. Variáveis epidemiológicas também foram extraídas das Declarações de Nascido Vivo. RESULTADOS: No triênio, 1,71 mortes por 1.000 nascidos vivos estavam associadas à asfixia perinatal, correspondendo a 22% dos óbitos neonatais precoces. Dos 2.873 óbitos evitáveis, 761 (27% ocorreram em São Paulo, capital; 640 (22%, na região metropolitana da capital; e 1.472 (51%, no interior do estado. Nas duas primeiras regiões predominaram as mortes em hospitais públicos, recém-nascidos com idade gestacional inferior a 37 semanas e peso abaixo de 2500g. No interior, os óbitos foram mais frequentes em entidades beneficentes, recém-nascidos a termo e com peso superior a 2500g. A maioria dos bebês nasceu durante o dia no município de residência materna e evoluiu para óbito no hospital de nascimento até 24 horas após o parto. A síndrome de aspiração de mecônio esteve presente em 18% dos óbitos. CONCLUSÕES: A asfixia perinatal é um contribuinte frequente para a morte neonatal precoce evitável no estado com o maior produto interno bruto per capita do Brasil, evidenciando a necessidade de intervenções específicas com enfoque regionalizado na assistência ao parto e ao nascimento.OBJETIVO: Comparar el perfil epidemiológico de los óbitos neonatales tempranos evitables asociados a la asfixia perinatal conforme a la región de ocurrencia del óbito en la provincia de São Paulo (Brasil. M

  7. Crescimento intra-uterino restrito diagnosticado pelo índice ponderal de Rohrer e sua associação com morbidade e mortalidade neonatal precoce Intrauterine growth retardation diagnosed by Rohrer's ponderal index and its association with morbidity and early neonatal mortality

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    Adehilde Maria Martins Santos

    2005-06-01

    Full Text Available OBJETIVO: diagnosticar o crescimento intra-uterino restrito (CIUR por meio do índice ponderal de Rohrer e sua associação com morbidade e mortalidade neonatal precoce. MÉTODOS: estudo retrospectivo, descritivo e de coorte transversal, no qual foram incluídos 2741 recém-nascidos (RN, sendo 2053 casos de grávidas hígidas, 228 de pré-eclâmpsia leve (PE, 52 com PE grave, 25 com PE que evoluiu para eclâmpsia, 136 de ruptura prematura das membranas (RPM e 247 de tabagistas. O índice ponderal (IP de Rohrer foi calculado segundo a equação: IP = peso/estatura³ x 100 e se utilizaram os valores 2,25 e 3,10 dos percentis 10 e 90 de Lubchenco. Classificou-se como CIUR assimétrico aquele RN com IP PURPOSE: to diagnose intrauterine growth restriction (IGR and its connection with early neonatal morbidity and mortality, through Roher's ponderal index (PI. METHODS: this was a retrospective, descriptive study of transversal cohort, in which 2741 newborns (NB were included, 2053 of them from healthy pregnant women, 228 from women with mild pregnancy-related hypertension, 52 from those with severe pregnancy-related hypertension, 25 from those with mild pregnancy-related hypertension that evolved to eclampsia, 136 from those with premature membrane rupture, and 247 from women who smoked along gestation. Roher's PI was calculated by the equation: PI = weight/height ³ x 100 and the values 2.25 and 3.10 of Lubchenco's 10 and 90 percentiles were used to classify the types of IGR. IGR was classified as asymmetric for NB with PI < 2.25 and weight lower than percentile 10, as symmetric, with PI from 2.25 to 3.10 and weight lower than percentile 10, and adequate for gestational age with PI from 2.25 to 3.10, and weight from 10 to 90 percentiles. Statistical analysis was performed using the non-paired t test, the non-parametric chi2 test and Fisher's exact test, with significance set at a value of p<0.05. RESULTS: low birth weight (< 2,500 g was present in 3

  8. Avanços no diagnóstico e tratamento da sepse Advances in sepsis diagnosis and treatment

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    Paulo R.A. Carvalho

    2003-11-01

    Full Text Available OBJETIVO: Apresentar uma revisão crítica e atualizada sobre a sepse, principalmente os aspectos diagnósticos e terapêuticos. FONTES DOS DADOS: Pesquisa bibliográfica em periódicos indexados em base Medline, tanto de revisão como ensaios clínicos e pesquisa laboratorial. SÍNTESE DOS DADOS: A Conferência Internacional sobre Definição de Sepse ampliou a relação de possíveis sinais clínicos e laboratoriais de sepse, o que poderá permitir a suspeição e manejo iniciais mais eficazes. Na avaliação laboratorial, além da pesquisa do agente infectante, vários marcadores da resposta inflamatória tais como as citoquinas inflamatórias e a procalcitonina, têm sido identificados, mas ainda sem sensibilidade e especificidade suficientes para diagnóstico seguro. Quanto ao tratamento, as intervenções precoces sobre os distúrbios hemodinâmicos continuam sendo primordiais para o desfecho, assim como o uso racional de antimicrobianos. Terapias de remoção de toxinas e de aumento da resposta imune inata ainda não provaram definitivamente seu valor. O uso de bloqueadores da resposta inflamatória isolados, em qualquer fase do seu estágio, falhou em reduzir a mortalidade. O corticóide ressurge com resultados animadores, mesmo em pacientes sem insuficiência adrenal relacionada à sepse. A proteína C ativada (drotrecogina-alfa, em um grande estudo, mostrou redução de 6% de mortalidade em uma amostragem selecionada, oferecendo uma possibilidade de melhor prognóstico na sepse. CONCLUSÕES: Comparativamente aos avanços dos últimos anos, pouco se obteve com relação à diminuição de mortalidade por sepse, pela complexidade das relações patógeno-hospedeiro. A regulação individual de cada reação do hospedeiro não mostrou o efeito esperado. Algumas estratégias, já conhecidas, foram reafirmadas como benéficas, e outras, como o uso de corticóide e a proteína C ativada, estão surgindo como terapias promissoras. As

  9. Uso da peritoneostomia na sepse abdominal Laparostomy in abdominal sepsis

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    Juvenal da Rocha Torres Neto

    2007-09-01

    Full Text Available Dentre as modalidades terapêuticas da sepse abdominal, a peritoneostomia tem papel decisivo permitindo explorações e lavagens da cavidade de forma facilitada. Observamos pacientes com diagnóstico clínico de sepse abdominal internados no Serviço de Coloproctologia do Hospital Universitário da Universidade Federal de Sergipe, e que foram submetidos a peritoneostomia de janeiro de 2004 a janeiro de 2006. Foram avaliados quanto ao diagnóstico primário e secundário, tipo de peritonite secundária, antibioticoterapia, esquema de lavagens, tempo de peritoneostomia, complicações e desfecho. Estudamos 12 pacientes, com idade de 15 a 57, média de 39,3 anos. Diagnóstico primário: abdome agudo inflamatório em 6(50%, abdome agudo obstrutivo em 2(16,7%, abdome agudo perfurativo em 2(16,7%, fístula enterocutânea em 1(8,3% e abscesso intra-cavitário em 1(8,3%. Diagnóstico secundário: perfuração de cólon em 4(33,3%, abscessos intra-cavitários em 3(25%, deiscências de anastomoses em 3(25%, 1(8,3% com tumor perfurado de sigmóide e 1(8,3% com necrose de cólon abaixado. Peritonite fecal em 10(83,3% e purulenta em 2(16,7%. A antibioticoterapia teve duração média de 19 dias. Lavagens de demanda em 6(50%, programadas em 4(33,3% e regime misto em 2(16,7%. O tempo médio de peritoneostomia foi de 10,9 dias (1-36. Como complicações: evisceração em 2(16,7% e fistulização em 1(8,3%. Quatro pacientes evoluíram com óbito.Among the therapeutics approach form of abdominal sepsis, the laparostomy has a decisive role allowing cavity explorations and lavages in an easier way. We study patients with abdominal sepsis diagnoses admitted to our surgical service of Coloproctology form Sergipe´s Federal University Hospital who underwent a Bogotá Bag laparostomy associated or not with polypropylene mesh from January 2004 to January 2006. These patients were assessed as: first and second diagnosis; secondary peritonitis type; antibiotic

  10. Prognostic value of non-reactive burst suppression EEG pattern associated to early neonatal seizures Valor prognóstico do EEG com padrão de surto-supressão não reativo associado a convulsões neonatais precoces

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    Magda Lahorgue Nunes

    2005-03-01

    como objetivo correlacionar aspectos clínicos e eletroencefalográficos associados a prognóstico em longo prazo de recém - nascidos (RN com padrão de surto - supressão não reativo no EEG. MÉTODO: Foram selecionados para este estudo RN com EEG neonatal realizado no Laboratório de Neurofisiologia Clínica do Hospital São Lucas da PUCRS e acompanhados na mesma instituição, com idade concepcional superior a 37 semanas (na data do EEG, cujos registros estivessem disponíveis para revisão. RESULTADOS: Foram incluídos 12 RN, 50% apresentaram crises convulsivas a partir do primeiro dia de vida. Em todos as convulsões eram refratárias ao tratamento medicamentoso. Em 50% a etiologia foi considerada criptogênica, 33% apresentavam erros inatos do metabolismo e 17% tinham história clínica e achados de neuroimagem sugestivos de encefalopatia hipóxico - isquêmica. O seguimento clínico demonstrou que 7/12 evoluíram para óbito, sendo 3 durante o primeiro ano de vida e um no período neonatal. Os sobreviventes apresentavam grave comprometimento do desenvolvimento neuropsicomotor e déficits neurológicos múltiplos, 92% seguiram com epilepsia refratária e 58% evoluíram para síndrome de West. CONCLUSÃO: O reconhecimento de padrão de surto - supressão não reativo no EEG neonatal pode ser relacionado a diversas doenças neurológicas e é associado a convulsões precoces e refratárias. Existe também definida associação entre este padrão e elevada morbi-mortalidade neonatal além do desenvolvimento de epilepsia pós-neonatal.

  11. Codificação da sepse pulmonar e o perfil de mortalidade no Rio de Janeiro, RJ

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    Bruno Baptista Cardoso

    Full Text Available RESUMO: Objetivo: Descrever os óbitos com menção de sepse pulmonar, medir a associação entre sepse pulmonar e pneumonia, assim como avaliar o impacto da regra de codificação no perfil de mortalidade, com a inclusão simulada do diagnóstico de pneumonia, nas declarações de óbito (DO com menção de sepse pulmonar, no Rio de Janeiro, em 2011. Métodos: Foram identificados os óbitos com menção de sepse pulmonar independentemente da causa básica. Aos médicos atestantes, aplicou-se questionário medindo a associação entre sepse pulmonar e pneumonia. O registro de pneumonia nos prontuários dos óbitos com menção de sepse pulmonar e sem menção de pneumonia na DO foi investigado. Foi descrito o perfil de mortalidade após a inclusão simulada do código de pneumonia nas declarações com sepse pulmonar. Resultados: Sepse pulmonar correspondeu a 30,9% das menções de sepse e a menção de pneumonia estava ausente em 51,3% dessas declarações. Pneumonia constava em 82,8% da amostra de prontuários investigados. Dos médicos entrevistados, 93,3% relataram pneumonia como a mais frequente causa de sepse pulmonar. A simulação revelou que a inclusão da pneumonia alterou a causa básica de 7,8% dos óbitos com menção de sepse e 2,4% de todos os óbitos, independentemente da causa original. Conclusão: Sepse pulmonar está associada à pneumonia e a simples inclusão do código de pneumonia nas declarações de óbito com menção de sepse pulmonar impactaria o perfil de mortalidade, apontando necessidade de aprimoramento das regras de codificação na Classificação Internacional de Doenças (CID-10.

  12. Triagem auditiva neonatal: motivos da evasão das famílias no processo de detecção precoce Newborn hearing screening: reasons for the evasion of families in the process of early detection

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    Kátia de Feitas Alvarenga

    2012-01-01

    Full Text Available OBJETIVO: Analisar os motivos da evasão familiar no programa de triagem auditiva neonatal realizado em um hospital público e correlacioná-los com a distribuição demográfica das famílias e as características do programa. MÉTODOS: Participaram 132 famílias, de um total de 739 contatadas, cujos filhos nasceram em uma maternidade no interior do estado de São Paulo de outubro/2003 a dezembro/2005 e que não haviam comparecido para a realização do teste ou reteste da triagem auditiva neonatal. Foi aplicado um questionário de levantamento das causas de evasão, contendo perguntas relacionadas à triagem auditiva, nível de escolaridade e profissão dos pais e também sobre a audição e o desenvolvimento de linguagem da criança. RESULTADOS: Realizou-se a aplicação do questionário com 132 famílias (17,86%; com as demais não foi obtido contato. Deste total, 82 haviam faltado na primeira etapa da triagem auditiva (teste e 50 não haviam retornado para realização do reteste. Os motivos mais frequentes para justificar a evasão foram o desinteresse e a dificuldade em conciliar o agendamento com a rotina familiar. Não houve associação entre os motivos da evasão e o nível de escolaridade e ocupação dos pais, nem com o profissional que realizou a orientação acerca da triagem auditiva. Não foi referido nenhum caso de alteração auditiva, nem de atraso significativo no desenvolvimento da linguagem. CONCLUSÃO: Os motivos da evasão familiar independem de variáveis voltadas à família e à dinâmica do programa de triagem auditiva.PURPOSE: To analyze the reasons for evasion of the families from the newborn hearing screening program conducted at a public hospital, and to correlate them with the demographic distribution of the families and the characteristics of the program. METHODS: Participants were 132 families, from a total of 739 contacted, whose children had been born in a maternity hospital in the interior of the state of

  13. Uso de biomarcadores na sepse pediátrica: revisão de literatura

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    Vanessa Soares Lanziotti

    Full Text Available RESUMO A despeito dos avanços nos últimos anos, a sepse ainda é uma das principais causas de internação e mortalidade em lactentes e crianças. A presença de biomarcadores na resposta a um insulto infeccioso resulta em seu uso na triagem, no diagnóstico, no prognóstico (estratificação de risco, na monitorização da resposta terapêutica e no uso racional de antibióticos (duração adequada, por exemplo. Os estudos sobre biomarcadores na sepse em crianças são ainda relativamente escassos. Esta revisão aborda o uso de biomarcadores na sepse em pacientes pediátricos, com ênfase em proteína C-reativa, procalcitonina, interleucinas 6, 8 e 18, gelatinase dos neutrófilos humanos e proadrenomedulina, que podem ser úteis na abordagem da sepse pediátrica.

  14. Contribuição ao entendimento da patogenia da sepse

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    J. F. Fracasso

    2009-02-01

    Full Text Available

    O choque vasodilatador mais freqüente resulta de sepse, uma inflamação sistêmica em resposta a uma infecção que se caracteriza por hipotensão, hiporreatividade às catecolaminas e coagulação intravascular disseminada. A causa mais comum de sepse é a infecção por bactérias Gram-negativas, principalmente de Escherichia coli, resultando na liberação de lipopolissacarídeos (endotoxinas da parede celular, quando da morte ou lise do microrganismo, com o envolvimento de muitos mediadores, incluindo o óxido nítrico. Mais tarde descobriu-se que os níveis sanguíneos de vasopressina, em pacientes com sepse, eram anormalmente baixos, e observou-se que alguns destes pacientes, com choque séptico avançado, eram extremamente sensíveis às ações pressóricas da vasopressina exógena. Palavras-chave: endotoxina; vasopressina; choque séptico; sepse; hiporreatividade; choque vasodilatador.

  15. Efeito da sinvastatina na sepse abdominal de ratos diabéticos

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    Irami Araújo-Filho

    Full Text Available OBJETIVO: Analisar se o pré-tratamento com sinvastatina em modelo experimental de sepse abdominal é benéfico em ratos diabéticos. MÉTODOS: Cinquenta e seis ratos Wistar foram aleatoriamente distribuídos em: grupo não diabético (n-28 e grupo diabetes induzido por estreptozotocina (n=28. Sepse abdominal por ligadura e punção do ceco foi induzida em 14 ratos diabéticos e em 14 não diabéticos. Os demais 28 animais foram alocados em grupo sham. Os grupos de ratos com sepse e os sham (cada com sete animais foram tratados com microemulsão oral de simvastatina (20 mg kg-1 day-1 e solução salina 0,9%, respectivamente. Sangue periférico foi usado para dosagem de TNFα, IL-1β, IL-6, proteína C reativa, procalcitonina, contagem de leucócitos e neutrófilos em todos os animais. A análise estatística foi realizada pela ANOVA e teste de Tukey, com p<0,05. RESULTADOS: A sinvastatina reduziu a mortalidade nos ratos diabéticos. Os valores séricos de TNF-α, IL-1β, IL-6, proteína C reativa, procalcitonina, leucócitos e neutrófilos mostraram-se mais baixos nos ratos diabéticos e não diabéticos com sepse, tratados com sinvastatina, do que nos tratados com solução salina. CONCLUSÃO: A sinvastatina teve efeito antiinflamatório, que pode ter resultado em proteção contra a sepse em ratos diabéticos.

  16. A sepse como causa de lesão renal aguda: modelo experimental

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    Carolina Ferreira Pinto

    2012-10-01

    Full Text Available A sepse associada à falência de múltiplos órgãos como a lesão renal aguda (LRA demonstra alta taxa de mortalidade no paciente crítico. Este estudo investigou a LRA induzida pela sepse em modelo experimental. Foram utilizados ratos da raça Wistar, adultos e machos divididos nos seguintes grupos: Controle - controle cirúrgico e Sepse - indução da sepse pela ligadura e punção do cécon (LPC. Foram avaliados os parâmetros fisiológicos (temperatura retal, pressão arterial média - PAM, glicemia sérica e fluxo urinário; a função renal (clearance de creatinina; o estresse oxidativo (peróxidos urinários e substâncias reativas com ácido tiobarbitúrico - TBARS e realizada a análise histológica renal. O estudo conclui que a LRA induzida pela sepse caracteriza-se por lesão endotelial com disfunção hemodinâmica, liberação de mediadores inflamatórios e geração de espécies reativas de oxigênio (EROs por células tubulares, caracterizando-se como uma associação de vasoconstrição renal de origem hemodinâmica e inflamatória.

  17. Gas tonometry for evaluation of gastrointestinal mucosal perfusion: experimental and clinical sepsis¹. part 2 Tonometria a gás para a avaliação da perfusão da mucosa gastrointestinal: sepse clínica e experimental. Parte 2

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    Eliezer Silva

    2002-09-01

    Full Text Available Substantial clinical and animal evidences indicate that the mesenteric circulatory bed, particularly the gut mucosa, is highly vulnerable to reductions in oxygen supply and prone to early injury in the course of hemodynamic changes induced by sepsis and septic shock. Gut hypoxia or ischemia is one possible contributing factor to gastrointestinal tract barrier dysfunction that may be associated with the development of systemic inflammatory response and multiple organ dysfunction syndrome, the principal cause of death after sepsis. Monitoring gut perfusion during experimental and clinical sepsis may provide valuable insights over new interventions and therapies highly needed to reduce multiple organ dysfunction and sepsis-related morbidity and mortality. We present our experience with gas tonometry as a monitor of the adequacy of gastrointestinal mucosal perfusion in experimental models sepsis and with the use of vasoactive agents for hemodynamic management in patients with septic shock.Evidências clínicas e experimentais substanciais indicam que o território circulatório mesentérico, principalmente na mucosa intestinal, é altamente vulnerável a redução na oferta de oxigênio e predisposto a lesão precoce na presença de alterações hemodinâmicas induzidas pela sepse e choque séptico. A hipóxia ou isquemia intestinal é um dos possíveis mecanismos contribuintes para a disfunção da barreira gastrointestinal que pode estar associada com o desenvolvimento da resposta inflamatória sistêmica e com a síndrome da disfunção de múltiplos órgãos, a principal causa comum de morte na sepse. Monitorar a perfusão intestinal na sepse experimental e clínica pode fornecer dados valiosos quanto a novas intervenções e tratamentos altamente necessários para reduzir disfunção de múltiplos órgãos e mortalidade extremamente elevadas na sepse. Apresentamos nossa experiência com a tonometria a gás como monitor da adequação da perfus

  18. Fatores de risco associados à mortalidade em pacientes com sepse em unidade de terapia intensiva de hospital privado de Pernambuco Risk factors associated to mortality on septic patients in an intensive care unit of a general private hospital from Pernambuco

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    Joana Corrêa de A. Koury

    2007-03-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Verificar a associação entre as características clínicas, epidemiológicas e laboratoriais com a mortalidade de pacientes com sepse, internados em UTI de hospital privado do estado de Pernambuco (Nordeste do Brasil, a fim de melhorar o atendimento a essa população, através da identificação precoce dos pacientes com risco de desenvolver falência de órgãos. MÉTODO: Estudo de caso-controle aninhado a uma coorte prospectiva e observacional que incluiu os pacientes adultos admitidos na UTI com sepse ou que a desenvolveram durante a internação. Foram colhidos os dados epidemiológicos, avaliados os escores clínicos e exames laboratoriais como: D-dímero, antitrombina III, INR, contagem de plaquetas, sódio, albumina, lactato e creatinina, sendo analisada sua associação com a mortalidade. Os pacientes foram acompanhados até a alta da UTI ou óbito. RESULTADOS: Foram incluídos no estudo 199 pacientes. Após regressão logística, apenas o tempo de internação na UTI maior que 72h, a presença de doença crônica associada, o número de órgãos acometidos superior a três e o lactato maior que 4 mmol/L estiveram associados com a mortalidade. Com relação à associação com o intervalo de tempo para o óbito, apenas o escore SOFA foi significativo, pois um terço dos pacientes com pontuação superior a 12 foram a óbito em menos de 72h. CONCLUSÕES: Os pacientes admitidos com sepse na UTI provenientes da comunidade (tempo de internação hospitalar BACKGROUND AND OBJECTIVES: Verify the association between clinical, epidemiological and laboratorial characteristics with mortality of septic patient in an Intensive Care Unit (ICU from Pernambuco, northeast of Brazil, to improve the attention for patients with sepse which are in risk of developing organ dysfunction. METHODS: Case-control study, without intervention, that included adults' patients admitted in ICU with sepsis or that developed it during ICU

  19. Transient sexual precocity and ovarian cysts.

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    Lyon, A J; De Bruyn, R; Grant, D B

    1985-01-01

    Nine girls presenting under the age of 7 years with unsustained sexual precocity are described. Large ovarian cysts were detected by ultrasound in three and laparotomy in one. In two girls the symptoms resolved after surgical removal of the cyst; the other seven had spontaneous remission of symptoms, but in two of these transient breast development and bleeding recurred: further ovarian cyst formation was found in one of these patients. Endocrine studies performed before resolution of the cys...

  20. Behavioral aggressiveness in boys with sexual precocity

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    Bindu Kulshreshtha

    2012-01-01

    Full Text Available Background: Some boys with sexual precocity are known to have behavioral problems like increased physical and verbal aggression and school and social maladjustments. It is believed to be due to premature androgen exposure. However, it is not clear why only some develop this problem, difference in etiology could be one explanation. Aim: The aim of the study is to assess behavioral aggression in boys with sexual precocity due to different disorders. Materials and Methods: Seven children, ages three to seven years, were enrolled for this study. Two were diagnosed to have congenital adrenal hyperplasia (CAH, three had testotoxicosis, while two had central precocious puberty. Parents of children with precocious puberty underwent the (CASP questionnaire (children′s aggression scale-parent version. Results: Testosterone levels were high in all patients. Parents denied any history of physical or verbal aggression in the two boys with CAH. Their CASP rating was 0. In contrast, the CASP ratings in the two boys with testotoxicosis and the two with precocious puberty for five domains ranged from 3.1 - 24.2, 2.6 - 8.3,1-5.6,0 - 7.1, and 0 - 1, respectively. In the present study, increased aggression was seen among all the patients with testotoxicosis and both with precocious puberty. In contrast, there were no symptoms of either increased verbal or physical aggression in either of the two patients with CAH. Conclusions: The hormonal milieu in the boys with CAH versus those with sexual precocity due to other causes differed in terms of cortisol and androgen precursors. The androgen excess in CAH children was a consequence of cortisol deficiency. It is possible that cortisol sufficiency is required for androgen-mediated behavioral effects.

  1. Dopamina e o rim na sepse: uma revisão sistemática

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    Katz Denise Varella

    2003-01-01

    Full Text Available A insuficiência renal aguda (IRA tem uma alta morbi-mortalidade em pacientes de terapia intensiva. A sepse grave e choque séptico são fatores de risco importantes para o desenvolvimento de IRA. A dopamina em dose baixa (0,5 a 3 mg/kg/min vem sendo empregada durante várias décadas como opção terapêutica para a proteção da função renal nestes pacientes, ainda que na ausência de estudos bem controlados. OBJETIVOS: Verificar evidências na literatura que justifiquem o uso rotineiro da dopamina em dose baixa nos pacientes com sepse grave e choque séptico. MÉTODOS: Busca sistemática da literatura, abrangendo bancos de dados eletrônicos (MEDLINE, EMBASE, LILACS e a busca manual de artigos. RESULTADOS: Dos cinco estudos clínicos randomizados encontrados, nenhum se enquadrou nos critérios de inclusão, pois não avaliavam a função renal. Dentre os estudos do tipo séries de casos, apenas oito foram passíveis de avaliação qualitativa. Foram descritos alguns efeitos adversos associados à dopamina, tais como aumento do shunt pulmonar, taquiarritmias, aumento na pressão de artéria pulmonar, que não foram estatisticamente significantes. A mortalidade também não se alterou com o uso da dopamina. CONCLUSÕES: Não existem evidências suficientes na literatura que suportem o uso rotineiro da dopamina em dose baixa como opção terapêutica para proteção da função renal na sepse grave e choque séptico.

  2. Interleucina 6 e proteína c reativa no diagnóstico de sepse tardia no recém-nascido Interleukins 6 and c - reactive protein for the diagnosis of late onset sepsis in the newborn infant

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    Maria Esther J. R. Ceccon

    2006-04-01

    Full Text Available OBJETIVO: Verificar a acurácia da interleucina 6 (IL-6 e da proteína C reativa (PCR para o diagnóstico de sepse tardia no recém-nascido (RN. MÉTODOS: Trata-se de estudo de coorte prospectivo com 43 RNs internados com suspeita de sepse tardia na UTIN. Foram dosados no dia da suspeita diagnóstica (dia 0 e nos dias 1, 3 e 7 de evolução os níveis séricos da IL-6 e da PCR e calculado o melhor valor de coorte para o diagnóstico de sepse. Também foram calculados os índices de sensibilidade (S, especificidade (E, valor preditivo positivo e negativo (VPP, VPN para cada um dos testes, assim como para a combinação entre eles. RESULTADOS: Os níveis séricos da IL-6 e da PCR estiveram acima do ponto de coorte nos RN com sepse e com sepse presumível com diferenças significantes entre ambos os grupos, nos quais a única diferença foi hemocultura positiva no primeiro. Foi possível afastar esse diagnóstico em seis RNs. Para o diagnóstico de sepse, a IL-6 obteve os melhores índices no dia da suspeita diagnóstica, dia 0 (S: 88,9%, E: 80%, VPP: 76,2%, VPN: 90,9%, seguida da proteína C reativa (S: 94%, E: 78,3%, VPP: 77,3%, VPN: 94,7% 24 horas após. A combinação dos dois (IL 6/PCR mostrou-se mais adequada para o diagnóstico precoce no dia 0 e até 24 horas de evolução com S e VPN de 100%. CONCLUSÃO: A combinação de IL6/PCR apresentou acurácia para o diagnóstico de sepse. A evolução destes testes ao longo dos dias refletiu a evolução clínica dos RN.BACKGROUND: Verify the accuracy of interleukin 6 (IL-6 and C-reactive protein (CRP for diagnosis of late onset sepsis in newborn (NB infants. METHODS: a prospective cohort study with 43 NB infants hospitalized at the NICU with suspicion of late onset sepsis was carried out. Levels of IL-6 and of CRP were dosed with suspicion diagnoses; day (0 and sequentially on day 1, 3, and 7 of the evolution and the best cut-off values were calculated for the diagnoses. Indices of sensibility (S

  3. Proteômica na sepse: estudo piloto Proteomics in sepsis: a pilot study

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    Rita Azevedo de Paiva

    2010-12-01

    Full Text Available Na sepse ocorre desregulação da expressão gênica. Os marcadores genéticos revelam apenas o genótipo do indivíduo, não sendo afetados pelos processos biológicos decorrentes da ação do ambiente, estes expressos nas proteínas. Este estudo teve como objetivo alcançar maior compreensão sobre as bases moleculares da sepse. Para tal realizou a identificação e análise da expressão diferencial de proteínas no soro de paciente séptico em diferentes estágios de gravidade (sepse, sepse grave e choque séptico através de técnicas proteômicas. Amostras de soro referentes a cada estágio da sepse foram colhidas e submetidas à eletroforese unidimensional em fitas com gradiente de pH imobilizado seguida de eletroforese bidimensional em gel de poliacrilamida 12,5%. Os géis obtidos foram corados, escaneados e analisados através do programa ImageMasterPlatinum. As proteínas expressas diferencialmente nos géis foram excisadas, digeridas com tripsina e identificadas através de espectrometria de massa. Foram identificadas 14 proteínas expressas diferencialmente entre os estágios da sepse, assim como uma proteína não expressa em todos os estágios, sugerindo a existência de um possível biomarcador. Foram elas: amilóide sérico A, apolipoproteína A-1 (2 isoformas, proteína dedo de zinco 222, albumina humana, PRO 2619, imunoglobulina de cadeia leve kappa região VLJ, imunoglobulina M monoclonal de aglutinação a frio e 7 inibidoras de proteases - alfa-1 antitripsina. Os resultados obtidos neste estudo piloto demonstram a participação das vias do complemento e coagulação, do metabolismo lipídico e da informação genética na sepse. A grande maioria de proteínas identificadas está envolvida no sistema imune com predomínio das proteínas inibidoras de proteases.Gene expression is disrupted by sepsis. Genetic markers can only reveal a patient's genotype, and they are not affected by environmental biological processes. These

  4. Atualidades proteômicas na sepse Proteomic updates on sepsis

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    Rodrigo Siqueira-Batista

    2012-06-01

    Full Text Available A ampliação do conhecimento das técnicas de análise proteômica tem permitido maior compreensão das bases moleculares relacionadas à identificação de vias de sinalização celular, de proteínas modificadoras, de modificações pós-traducionais, além de caracterizar marcadores biológicos específicos. Desta feita, a documentação de determinadas proteínas expressas na sepse constitui uma promissora abordagem para elucidação dos aspectos fisiopatológicos, diagnósticos, terapêuticos e prognósticos dessa condição, com a finalidade de aplicação na prática clínica. Embora os resultados sejam ainda preliminares, a proteômica poderá oferecer bons subsídios para o melhor manejo dos pacientes sépticos. Dessa feita, o objetivo do presente artigo é apresentar uma breve revisão das aplicações dos estudos proteômicos na sepse.The increased knowledge regarding proteomic analysis techniques has allowed for better understanding of the molecular bases related to the identification of cell signaling, modifying protein, and post-translational modification pathways, in addition to the characterization of specific biological markers. Thus, documenting certain proteins expressed in sepsis is a promising approach to elucidate pathophysiological, diagnostic, therapeutic, and prognostic aspects in this condition with a purpose of applying them to clinical practice. Although the studies are still preliminary, proteomics may offer good benefits for the better management of septic patients. Thus, this article aims to introduce a short review of the applications of proteomic studies to sepsis.

  5. Interleucina-12 em crianças com sepse e choque séptico

    Directory of Open Access Journals (Sweden)

    Joelma Gonçalves Martin

    2012-06-01

    Full Text Available OBJETIVO: Examinar o comportamento da interleucina-12 e verificar se pode ser utilizada para diferenciar condições sépticas em crianças. MÉTODOS: Foram inscritas, de forma prospectiva, entre janeiro de 2004 e dezembro de 2005, crianças com idades de 28 dias a 14 anos, subdivididas nos grupos sepse (SG; n=47 e choque séptico (SSG; n=43. A interleucina-12 foi avaliada quando da admissão (T0 e 12 horas mais tarde (T12. A gravidade da doença foi avaliada utilizando o escore PRISM. RESULTADOS: A interleucina-12 não diferenciou crianças com sepse das com choque séptico quando da admissão [SSG: 0,24 (0-22,64=SG: 1,23 (0-511,6; p=0,135] e na avaliação T12 [SG: 6,11 (0-230,5=SSG: 1,32 (0-61,0; p=0,1239]. Na comparação entre os momentos, não foi observada diferença estatística para SG [SG, T0: 1,23 (0-511,6=T12: 6,11 (0-230,5; p=0,075]. Entretanto, em casos de SSG, a interleucina-12 aumentou entre as avaliações T0 e T12 [SSG, T0: 0,24 (0-226,40,05. Para ambos os grupos, não houve correlação entre interleucina-12 na admissão e o escore PRISM. CONCLUSÃO: A interleucina-12 não diferencia as condições sépticas e não se relaciona com a gravidade da doença por ocasião da admissão. Em pacientes com choque séptico, a interleucina-12 aumenta com o tempo.

  6. Colonização materna e neonatal por estreptococo do grupo B em situações de ruptura pré-termo de membranas e no trabalho de parto prematuro Group B streptococcus maternal and neonatal colonization in preterm rupture of membranes and preterm labor

    Directory of Open Access Journals (Sweden)

    Marcelo Luís Nomura

    2009-08-01

    dois casos de sepse precoce por EGB nesta amostra, com prevalência de 10,8 casos por mil nascidos vivos e mortalidade de 50%. CONCLUSÕES: a amostra avaliada apresenta altas taxas de colonização materna por Streptococcus agalactiae. São necessários o uso de meio de cultura seletivo e a associação de culturas ano-retais e vaginais para aumentar a taxa de detecção do EGB. A incidência de sepse neonatal precoce foi elevada nesta população.PURPOSE: to indentify the prevalence and risk factors of maternal colonization by group B streptococcus (GBS in pregnant women with premature labor (PL and/or premature membrane rupture (PMR. METHODS: two anal and two vaginal swabs were collected from 203 pregnant women with diagnosis of PL or PMR assisted at the practice along one year. Pregnant women with imminent labor at admission were excluded. One swab of each source was placed in a transfer milieu and sent for culture in blood-agar plates; the two remaining swabs were incubated for 24 hours in Todd-Hewitt milieu for further sowing in blood-agar plates. Risk factors were analyzed by the chi-square test, Student's t-test (p-value set at 0.05 and 95% confidence interval and logistic regression. The following variables were analyzed: age, race, parity and mother schooling; culture results by source and type of culture; admission diagnosis; gestational age at admission; asymptomatic bacteriuria; gestational age at delivery; type of delivery; neonatal GBS colonization rate and immediate neonatal condition. RESULTS: prevalence of maternal GBS colonization was 27.6% (56 cases. The colonization rates according to gestational complications were 30% for PMR, 25.2% for PL and 17.8% for PL + PMR. Univariate analysis has shown that the variables Caucasian race, low level of schooling and bacteriuria were associated with higher colonization rates. Multivariate analysis showed that the presence of urinary infection was the only variable associated with maternal colonization. The GBS

  7. Prognostički značaj određivanja koncentracija citokina članova superfamilije tumor nekrozis faktora alfa kod obolelih od sepse

    OpenAIRE

    Lendak, Dajana

    2015-01-01

    Uvod: Nespecifičnost kliničke slike sepse, velike individualne razlike u odgovoru organizma na infekciju kao i neophodnost adekvatne inicijalne procene težine kliničke slike, toka i ishoda bolesti, čine istraživanja biomarkera koji bi doprineli pravovremenom postavljanju dijagnoze i adekvatnoj prognozi bolesti izuzetno značajnim. Do sada je ispitivano preko 200 biomarkera od kojih ni jedan nije pokazao zadovoljavajuću senzitivnost i specifičnost. Uloga B limfocita u patogenezi sepse pri tome ...

  8. Neonatal Death

    Science.gov (United States)

    ... Home > Complications & Loss > Loss & grief > Neonatal death Neonatal death E-mail to a friend Please fill in ... cope with your baby’s death. What is neonatal death? Neonatal death is when a baby dies in ...

  9. Efeitos da castração pós-natal sobre o tecido pulmonar após sepse experimental de origem abdominal em ratos

    Directory of Open Access Journals (Sweden)

    d'Acampora Armando José

    2004-01-01

    Full Text Available OBJETIVO: Avaliar os efeitos da castração pós-natal sobre o tecido pulmonar na sepse de origem abdominal induzida em ratos. MÉTODOS: Foram utilizados 33 ratos Wistar distribuídos em dois grupos: Grupo Controle (GC = 5 machos adultos normais sem desafio séptico. Grupo Experimento (GE: 28 ratos submetidos a sepse por ligadura e perfuração de ceco (LPC e distribuídos em três subgrupos: Subgrupo Macho (SgM: nove ratos machos adultos, sem castracão e submetidos a sepse por LPC. Subgrupo Fêmea (SgF: nove ratos fêmeas adultos normais submetidas a sepse por LPC. Subgrupo Castrado (SgC: dez ratos machos que no quarto dia de vida foram submetidos a orquiectomia bilateral e quando adultos à sepse por LPC. Após a LPC os animais foram observados até o óbito, realizada análise histomorfométrica do pulmão, observando-se o número de polimorfonucleares e mononucleares. RESULTADOS: 50% dos animais do SgC sobreviveram 24 horas, contra 33% do SgF e 0% do SgM, mostrando uma nítida influência da castração na resposta ao desafio séptico. O número de polimorfonucleares e mononucleares não foi diferente estatisticamente entre o SgC e CG, estando estatisticamente aumentados no SgM e SgF. CONCLUSÃO: Os animais castrados apresentaram uma maior tendência à sobrevida e menor alteração pulmonar.

  10. Sepsis: emerging role of nitric oxide and selectins Sepse: o papel das selectinas e do óxido nítrico

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    Abhijit Chandra

    2006-02-01

    Full Text Available Sepsis-a state of systemic bacterial infection-often leads to multiorgan failure and is associated with high mortality despite the recent advances achieved in intensive care treatment. Many of the ill effects of sepsis are attributed to an abnormally enhanced host inflammatory response that leads to neutrophil recruitment and activation involving selectins, a class of adhesion molecules, in the initial stages. Nitric oxide and its various isoforms have also been implicated in various vascular alterations and directly participate in the cellular toxicity in sepsis. This review briefly describes the role of selectins and nitric oxide in experimental and clinical sepsis as well as the therapeutic outcomes of blocking therapies.Sepse - um estado de infecção bacteriana sistêmica - frequentemente leva à falência múltipla de órgãos e associa-se a altos índices de mortalidade, apesar de progressos recentes no manejo de pacientes em unidades de terapia intensiva. Muitos dos efeitos maléficos associados à sepse são atribuídos a uma resposta inflamatória patologicamente ampliada que leva a recrutamento neutrofílico e ativação das moléculas de adesão do grupo das selectinas, durante as fases iniciais do processo . O óxido nítrico e sua diversas isoformas também foram implicados nas diversas manifestações vasculares da sepse como participantes diretos da toxicidade celular. Esta revisão descreve o papel das selectinas e do óxido nítrico em situações clínicas e experimentais de sepse, bem como os respectivos efeitos de processos terapêuticos de bloqueio.

  11. Sepse por Staphylococus aureus resistente à meticilina adquirida na comunidade no sul do Brasil Sepsis due to community-acquired methicillin-resistant Staphylococcus aureus in southern Brazil

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    Luciane Cristina Gelatti

    2009-08-01

    Full Text Available Staphylococcus aureus resistente à meticilina foi inicialmente descrito como um típico microrganismo adquirido em infecções nosocomiais. No entanto, nos últimos anos Staphylococcus aureus resistente à meticilina adquirido na comunidade é causa de infecções de pele e tecidos moles, mas infecções graves como pneumonia e sepse podem ocorrer. Este relato descreve um caso de sepse em criança, complicado com pneumonia secundária a lesão em partes moles por Staphylococcus aureus resistente à meticilina adquirido na comunidade no Sul do Brasil. O paciente foi atendido em Unidade de Emergência com história de ferimento provocado por trauma em membro inferior que evoluiu para celulite, pneumonia e sepse.Methicillin-resistant Staphylococcus aureus was initially described as a typical microorganism acquired in nosocomial infections. However, over recent years, community-acquired methicillin-resistant Staphylococcus aureus has been a cause of skin and soft-tissue infections. Serious infections such as pneumonia and sepsis can also occur. This report describes a case of sepsis in a child that was complicated by pneumonia secondary to soft tissue lesions that were due to community-acquired methicillin-resistant Staphylococcus aureus in southern Brazil. The patient was attended at the Emergency Unit with a history of injury caused by lower-limb trauma that evolved to cellulitis, pneumonia and sepsis.

  12. ser precoce na intervenção

    OpenAIRE

    Bernardo, Ana Carolina Couto

    2013-01-01

    Dissertação apresentada à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Ciências da Educação: Educação Especial, área de especialização em Domínio da Intervenção Precoce na Infância Este estudo centra-se na implementação de uma Escola de Mães, programa de educação parental realizado em seis sessões na freguesia de Calhetas, ilha de S. Miguel, e na avaliação comparativa, anterior e posterior ao programa, das três mães participantes no que...

  13. Estatinas na sepse: nova arma terapêutica no arsenal da medicina intensiva? Statins on sepsis: a new therapeutic gun in intensive care medicine?

    Directory of Open Access Journals (Sweden)

    Luiz Eduardo Fonteles Ritt

    2006-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Sepse é uma síndrome de base inflamatória; diversos fármacos que -atuam sobre as vias de ativação da inflamação vêm sendo observados. As estatinas, além do conhecido efeito hipolipemiante detêm capacidades antiinflamatórias chamados pleiotrópicas. Essa ação pode ser benéfica no tratamento da sepse. O objetivo deste estudo foi revisar as principais publicações abordando o seu uso na sepse. MÉTODO: Busca por artigos originais cruzando os unitermos sepse e estatina no MedLine entre 1990 e 2006. RESULTADOS: Diversos estudos experimentais e retrospectivos investigaram o uso de estatinas em sepse, até o momento, em sua maioria mostraram melhora de mortalidade e morbidade. Não existem estudos prospectivos, aleatórios, placebo-controlados ou metanálises, o que demonstrou que a falta de evidências sólidas e comprovadas para indicação de uso desta conduta ainda é prevalente. Portanto ainda com seu beneficio questionável, são necessários estudos clínicos aleatórios que possam comprovar a teoria em questão. CONCLUSÕES: Diversos estudos experimentais e retrospectivos têm investigado o uso de estatinas em pacientes sépticos, porém, apesar da literatura demonstrar ser esta teoria promissora, ainda necessita-se de estudos clínicos abordando maior número de pacientes, de forma aleatória, para estar-se apto a entender e, possivelmente, recomendar o uso desta medicação no tratamento de pacientes com sepse.BACKGROUND AND OBJECTIVES: Sepsis is a syndrome with an important inflammatory component in its pathophysiology. Some drugs that act on the activation of inflammatory cascade have been tested in septic patients. Statins, beyond hypolipemic effects, have anti-inflammatory capacities, known as pleiotropic effects. That action may be of value on sepsis treatment. Review of publications who discuss the use of statins. This article has the objective to review the mainly papers about statins and

  14. Proteína C ativada no tratamento de recém-nascido com sepse, choque e disfunção de múltiplos órgãos e sistemas: relato de caso e revisão de literatura Activated C protein in the treatment of a newborn with sepsis, shock and multiple organ dysfunction systems: case report and literature review

    Directory of Open Access Journals (Sweden)

    Flávia Carolina Davini Georgetti

    2006-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A sepse grave representa a síndrome de resposta inflamatória sistêmica resultante de uma infecção, na presença de disfunção cardiovascular, síndrome do desconforto respiratório agudo ou duas ou mais disfunções orgânicas. Embora a mortalidade atribuída à sepse em crianças tenha sido reduzida de maneira significativa nas últimas décadas, a incidência de óbitos em recém-nascidos permanece elevada (20% a 40%, a despeito dos avanços em cuidados intensivos. O objetivo deste estudo foi descrever o caso de um recém-nascido com sepse, choque e disfunção de múltiplos órgãos e sistemas (DMOS que se beneficiou do uso da proteína C ativada. RELATO DO CASO: Recém-nascido prematuro, do sexo masculino, nascido de cesariana em decorrência de ruptura prematura de membranas e sofrimento fetal agudo. Internado na UTI-Neonatal por insuficiência respiratória aguda secundária à pneumonia intra-útero. Recebeu assistência ventilatória, surfactante pulmonar exógeno e antibioticoterapia precocemente, evoluindo, no entanto, com hipertensão pulmonar persistente e choque. Houve difícil controle do quadro infeccioso, a despeito de ajustes no esquema de antibioticoterapia, evoluindo com DMOS. No 28º dia, foi iniciado o uso da proteína C ativada. O paciente evoluiu favoravelmente à medicação, com resolução das disfunções orgânicas e ausência de sangramentos. CONCLUSÕES: A proteína C ativada não pode ser prescrita de maneira rotineira no tratamento de recém-nascidos com sepse grave. No caso relatado, no entanto, acredita-se que ela tenha contribuído para a resolução das disfunções orgânicas apresentadas pelo paciente.BACKGROUND AND OBJECTIVES: Severe sepsis represents the systemic inflammatory response resulting from an infection, associated with one of the following: cardiovascular organ dysfunction, acute respiratory distress syndrome or two or more organ dysfunctions. Although the

  15. Reposição de volume na sepse com solução salina hipertônica Sepsis volume reposition with hypertonic saline solution

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    Gilberto Friedman

    2008-09-01

    Full Text Available Esta revisão discute os efeitos hemodinâmicos e imunomoduladores da solução hipertônica em choque experimental e em pacientes com sepse. Comentamos sobre os mecanismos de ação da solução hipertônica, recorrendo a dados sobre choque hemorrágico e séptico. Atuações específicas da solução salina hipertônica aplicáveis a sepse grave e choque séptico são enfatizadas. Os dados disponíveis corroboram os benefícios em potencial da infusão de solução salina hipertônica em vários aspetos da fisiopatologia da sepse, inclusive hipoperfusão dos tecidos, consumo reduzido de oxigênio, disfunção endotelial, depressão miocárdica e presença de um amplo elenco de citocinas próinflamatórias e várias espécies de oxidantes. Uma terapia que, ao mesmo tempo, bloqueie os componentes prejudiciais da sepse terá um impacto no seu tratamento. Estudos prospectivos adequadamente desenhados poderão no futuro comprovar o papel benéfico da solução salina hipertônica.The present review discusses the hemodynamic and immune-modulatory effects of hypertonic saline in experimental shock and in patients with sepsis. We comment on the mechanisms of action of hypertonic saline, calling upon data in hemorrhagic and septic shock. Specific actions of hypertonic saline applicable to severe sepsis and septic shock are highlighted. Data available support potential benefits of hypertonic saline infusion in various aspects of the pathophysiology of sepsis, including tissue hypoperfusion, decreased oxygen consumption, endothelial dysfunction, cardiac depression, and the presence of a broad array of pro-inflammatory cytokines and various oxidant species. A therapy that simultaneously blocks the damaging components of sepsis will have an impact on the management of sepsis. Proper designed prospective studies may prove a beneficial role for hypertonic saline solution in the future.

  16. Novas diretrizes na abordagem clínica da neutropenia febril e da sepse em oncologia pediátrica New guidelines for the clinical management of febrile neutropenia and sepsis in pediatric oncology patients

    Directory of Open Access Journals (Sweden)

    Ana Verena Almeida Mendes

    2007-05-01

    Full Text Available OBJETIVOS: Fornecer subsídios à abordagem diagnóstica, profilática e terapêutica da neutropenia febril e da sepse em criança com doença oncológica, dando especial atenção aos novos protocolos e diretrizes. FONTES DE DADOS: Revisão de literatura científica utilizando uma busca bibliográfica eletrônica nas páginas do MEDLINE, Medscape, SciELO, Google, Cochrane e PubMED com as palavras-chave febrile, neutropenic, cancer, children, sepse, intensive, care. Foram selecionados artigos publicados entre 1987 e 2007, preferencialmente artigos de revisão, protocolos, revisões sistemáticas, estudos epidemiológicos, recomendações de força-tarefa e ensaios clínicos fase III. Foram revistos os consensos publicados pela Infectious Diseases Society of America, Center for Diseases Control e Infectious Diseases Working Party da German Society of Hematology and Oncology, além de recomendações da World Federation of Pediatric Intensive and Critical Care Societies e da Society of Critical Care Medicine. SÍNTESE DOS DADOS: A utilização de esquemas quimioterápicos agressivos, transplante de medula óssea e recursos de terapia intensiva aumentaram a sobrevida nas crianças com câncer e também a morbidade infecciosa, sendo as complicações sépticas a principal causa de mortalidade. Diversos fatores de risco têm sido identificados, como neutropenia, tipo oncológico, sinais clínicos e marcadores de resposta inflamatória (reação em cadeia da polimerase, procalcitonina, assim como a maior resistência aos antimicrobianos e antifúngicos. Protocolos de classificação de risco, de diagnóstico e tratamento devem ser estabelecidos em cada serviço, respeitando a flora microbiológica da população estudada. A terapia intensiva pediátrica tem aumentado a sobrevida a curto e longo prazo nestes pacientes. CONCLUSÕES: Pacientes oncológicos são particularmente vulneráveis a complicações infecciosas. A identificação e o tratamento

  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. 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.

  19. 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

  20. The timing of normal puberty and the age limits of sexual precocity

    DEFF Research Database (Denmark)

    Parent, Anne-Simone; Teilmann, Grete; Juul, Anders

    2003-01-01

    During the past decade, possible advancement in timing of puberty has been reported in the United States. In addition, early pubertal development and an increased incidence of sexual precocity have been noticed in children, primarily girls, migrating for foreign adoption in several Western European...

  1. The timing of normal puberty and the age limits of sexual precocity

    DEFF Research Database (Denmark)

    Parent, Anne-Simone; Teilmann, Grete; Juul, Anders

    2003-01-01

    During the past decade, possible advancement in timing of puberty has been reported in the United States. In addition, early pubertal development and an increased incidence of sexual precocity have been noticed in children, primarily girls, migrating for foreign adoption in several Western Europe...

  2. 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...

  3. Estudo de associação genética entre fator de necrose tumoral alfa e sepse e choque séptico em pacientes pediátricos tailandeses

    Directory of Open Access Journals (Sweden)

    Suwannee Phumeetham

    2012-10-01

    Full Text Available OBJETIVOS: Avaliar a associação entre o polimorfismo genético do fator de necrose tumoral alfa (TNF-α e o desenvolvimento de sepse e choque séptico em pacientes pediátricos tailandeses e investigar o impacto clínico de polimorfismos do TNF-α nessa população. MÉTODOS: Para a realização deste estudo de associação genética, foram analisados prospectivamente pacientes pediátricos (idade < 18 anos com sepse clínica/choque séptico. Todos os dados foram coletados por especialistas em terapia intensiva pediátrica e as análises genéticas foram realizadas em um laboratório central. Um polimorfismo de nucleotídeo único [single nucleotide polymorphism (SNP], localizado na região promotora 5' na posição -308, foi genotipado e os resultados foram associados a fenótipos clínicos. RESULTADOS: Foram investigados 167 indivíduos tailandeses, dos quais 66 eram pacientes pediátricos com sepse/choque séptico e 101 eram controles saudáveis. Curiosamente, não foi possível identificar associação entre sepse e o polimorfismo -308 (G→A, um dos principais SNPs anteriormente associado à sepse em várias populações caucasianas, visto que não houve diferença de frequência entre casos e controles. CONCLUSÕES: Neste estudo, o principal polimorfismo do TNF-α -308 não esteve associado à sepse clínica/choque séptico na população tailandesa. Essa informação é importante para futuras análises que busquem identificar a função do TNF-α como risco genético para o desenvolvimento de imunopatologia subjacente a várias doenças no continente asiático.

  4. 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.

  5. 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

  6. The roles of talent, physical precocity and practice in the development of soccer expertise.

    Science.gov (United States)

    Helsen, W F; Hodges, N J; Van Winckel, J; Starkes, J L

    2000-09-01

    Here we consider the potential contributions of talent, physical precocity and deliberate practice in the development of soccer expertise. After presenting a working definition of 'talent', we examine how coaches perceive and select potential talent. Our findings suggest that much of what coaches see as early talent may be explained by physical precocity associated with a relative age advantage. Finally, as a test of the model of Deliberate Practice, we review the results of studies that assessed the progress of international, national and provincial players based on accumulated practice, amount of practice per week and relative importance and demands of various practice and everyday activities. A positive linear relationship was found between accumulated individual plus team practice and skill. Various practical suggestions can be made to improve talent detection and selection and to optimize career practice patterns in soccer.

  7. Ictericia Neonatal

    OpenAIRE

    Blanco de la Fuente, María Isabel

    2014-01-01

    El motivo que ha llevado a la realización de este trabajo fin de grado sobre el tema de la ICTERICIA NEONATAL se debe a la elevada frecuencia de su aparición en la población. Un porcentaje elevado de RN la padecen al nacer siendo, en la mayor parte de los casos, un proceso fisiológico resuelto con facilidad debido a una inmadurez del sistema hepático y a una hiperproducción de bilirrubina. La ictericia neonatal es la pigmentación de color amarillo de la piel y mucosas en ...

  8. The timing of normal puberty and the age limits of sexual precocity

    DEFF Research Database (Denmark)

    Parent, Anne-Simone; Teilmann, Grete; Juul, Anders

    2003-01-01

    During the past decade, possible advancement in timing of puberty has been reported in the United States. In addition, early pubertal development and an increased incidence of sexual precocity have been noticed in children, primarily girls, migrating for foreign adoption in several Western European...... the environment has been considered. These observations urge further study of the onset of puberty as a possible sensitive and early marker of the interactions between environmental conditions and genetic susceptibility that can influence physiological and pathological processes....

  9. PÚRPURA DE HENOCH-SCHONLEIN – O ENVOLVIMENTO RENAL PRECOCE

    Directory of Open Access Journals (Sweden)

    Inês Medeiros

    2016-07-01

    Comentários: O caso descrito ilustra um acometimento renal precoce e pouco frequente na PHS, de acordo com o descrito na literatura. A presença de proteinúria nefrótica e de síndrome nefrótica, secundárias à PHS, está associada a um prognóstico menos favorável, pelo que se ressalva a importância do seguimento a longo prazo.

  10. 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 ...

  11. Função adrenal na sepse e choque séptico Adrenal function in sepsis and septic shock

    Directory of Open Access Journals (Sweden)

    Cristiane Freitas Pizarro

    2007-11-01

    Full Text Available OBJETIVO: Rever os critérios diagnósticos e o tratamento de insuficiência adrenal, em pacientes da faixa etária pediátrica, com sepse grave e choque séptico. FONTES DOS DADOS: Os artigos foram selecionados através das bases de dados MEDLINE (1966-junho 2007, Embase (1994-2007 e Cochrane Library (2000-2007. As seguintes palavras-chave foram utilizadas: choque séptico, sepse, corticosteróides, insuficiência adrenal e crianças. SÍNTESE DOS DADOS: Não existe um critério bem estabelecido e aceito para definir insuficiência adrenal em pacientes criticamente enfermos. A incidência de insuficiência adrenal varia de acordo com o critério utilizado, podendo alcançar desde valores inferiores a 15% até superiores a 61%. O teste rápido de estímulo com hormônio adrenocorticotrófico (ACTH é largamente utilizado como um teste simples para a identificação de não responsividade adrenocortical, mas existe muita discussão quanto à dose de corticotropina a ser utilizada. A dose de 250 µg é a dose padrão. Recentemente, baixas doses de corticotropina (1 µg têm sido propostas, com a sugestão de que elas possam ter uma maior sensibilidade. Dúvidas ainda persistem quanto à eficácia da reposição com baixas doses de corticosteróides em crianças com choque refratário às catecolaminas. Mais estudos são necessários para determinar se o tratamento de tais pacientes alteraria morbidade e/ou mortalidade. CONCLUSÃO: Insuficiência adrenal é comum em crianças com sepse grave e choque séptico e pode contribuir para o desenvolvimento de choque refratário às catecolaminas. Contudo, dúvidas ainda persistem em relação à eficácia da terapêutica com baixas doses de corticosteróides.OBJECTIVE:To review diagnostic criteria and treatment of adrenal insufficiency in pediatric patients with severe sepsis and septic shock. SOURCES: Articles were selected using MEDLINE (1966-June 2007, Embase (1994-2007 and Cochrane Library (2000

  12. Aplicação de protocolo proposto pela Agência Nacional de Vigilância Sanitária para uso de antibióticos em recém-nascidos de muito baixo peso

    Directory of Open Access Journals (Sweden)

    Maria Cristina F. Guedes Pinto

    2013-10-01

    Full Text Available OBJETIVO: Analisar a aplicação de um protocolo proposto pela Agência Nacional de Vigilância Sanitária (ANVISA para aprimorar o diagnóstico de sepse em recém-nascidos de muito baixo peso. MÉTODOS: Estudo prospectivo que avaliou a aplicação de protocolo envolvendo critérios clínicos e laboratoriais (escore hematológico de Rodwell e dosagem seriada da proteína C-reativa, recomendado pela ANVISA, para aprimorar o diagnóstico de sepse neonatal em recém-nascidos de muito baixo peso. Participaram do estudo todos os pacientes que nasceram e permaneceram na Unidade Neonatal até a alta ou óbito, e foram excluídos aqueles com doenças congênitas. Os principais desfechos analisados entre os recém-nascidos antes da aplicação do protocolo (2006-2007 e após a aplicação do mesmo (2008 foram as taxas de sepses precoce e tardia, o uso de antimicrobianos e a mortalidade. As médias foram comparadas por meio de teste t e as variáveis categóricas pelo teste Qui-quadrado (χ2; o nível de significância para todos eles foi fixado em 95%. RESULTADOS: Foram incluídos no estudo 136 recém-nascidos de muito baixo peso. Não houve diferença entre os grupos em relação às características clínicas gerais nos períodos estudados. Houve, no entanto, redução na quantidade de diagnóstico de sepse precoce provável (p < 0,001, de uso de esquemas antimicrobianos (p < 0,001 e da mortalidade geral e associada à sepse (p = 0,009 e p = 0,049, respectivamente. CONCLUSÃO: A utilização do protocolo permitiu aprimorar o diagnóstico de sepse, reduzindo o diagnóstico de sepse precoce provável, promovendo, desta forma, o uso racional de antimicrobianos na população estudada.

  13. [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.

  14. 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......, 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....

  15. 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

  16. Quality of Life of Severe Sepsis Survivors After Hospital Discharge Calidad de vida de sobrevivientes de sepsis grave después del alta hospitalar Qualidade de vida de sobreviventes de sepse grave após alta hospitalar

    Directory of Open Access Journals (Sweden)

    Ligia Marcia Contrin

    2013-06-01

    ño comparado con los pacientes en estado crítico pero sin sepsis en el grupo control. Los pacientes ancianos (>60 años con sepsis tuvieron una prevalencia significativamente mayor de problemas. No hubo diferencias en EQ-VAS entre los entrevistados de ambos grupos. CONCLUSIONES: Después del alta de la UCI, los pacientes que sobrevivieron a la sepsis tuvieron una tasa de mortalidad más alta que los pacientes sin enfermedad crítica. Pacientes ancianos con sepsis tuvieron problemas moderados y graves en todas las cinco dimensiones de calidad de vida evaluadas. OBJETIVOS: avaliar a qualidade de vida em sobreviventes de sepse grave, utilizando os instrumentos EuroQol-5 Dimensions e Escala Analógica Visual. MÉTODO: caso controle aninhado, realizado em pacientes que receberam alta da unidade de terapia intensiva de um hospital de ensino, após admissão com sepse grave. A seleção foi feita a partir do cadastro sepse, contendo 349 prontuários. Cada paciente com sepse foi considerado como um sujeito e o paciente internado após foi considerado controle, desde que não tivesse sepse e tivesse sobrevivido à internação, totalizando 100 sujeitos. RESULTADOS: o grupo sepse apresentou mortalidade mais elevada em 1 ano comparado com pacientes críticos, porém, sem sepse no grupo controle. Pacientes mais velhos (>60 anos de idade no grupo sepse tiveram prevalência significativamente maior de problemas. Não houve diferença na Escala Visual Análoga entre os entrevistados de ambos os grupos. CONCLUSÕES: após alta da unidade de terapia intensiva, os pacientes que sobreviveram à sepse tiveram taxa de mortalidade mais elevada do que os pacientes críticos sem a doença. Pacientes idosos com sepse tiveram problemas variando de moderado a grave, em todas as cinco dimensões de qualidade de vida avaliadas.

  17. Lesao nasal precoce pelo uso da pronga nasal em recem-nascidos prematuros de muito baixo peso: estudo piloto

    Directory of Open Access Journals (Sweden)

    Nathalie Tiemi Ota

    2013-09-01

    Full Text Available OBJETIVO: Analisar, em recém-nascidos de muito baixo peso e com indicação de ventilação não invasiva via pronga nasal, a incidência do aparecimento precoce de lesão nasal. MÉTODOS: Série de casos prospectiva de nascidos com idade gestacional <37 semanas, peso <1.500g e idade pós-natal <29 dias. Os pacientes foram avaliados desde a instalação da pronga nasal até o 3o dia de uso, três vezes ao dia. Foram analisadas as condições clínicas dos pacientes, características do dispositivo e de sua aplicação. A análise inicial foi descritiva, verificando-se a prevalência de lesão nasal bem como os fatores a ela associados. Os dados categóricos foram analisados por qui-quadrado ou exato de Fisher e os dados numéricos, por teste t ou Mann-Whitney. RESULTADOS: Dezoito recém-nascidos foram incluídos, dos quais 12 (idade gestacional de 29,8±3,1 semanas, peso ao nascer de 1.070±194g e Score for Neonatal Acute Phisiology - Perinatal Extension (SNAPPE de 15,4±17,5 evoluíram com lesão nasal (Grupo Lesão e 6 (idade gestacional de 28,0±1,9 semanas, peso de 1.003±317g e SNAPPE de 26,2±7,5 não apresentaram lesão nasal (Grupo Sem Lesão. No Grupo Lesão, houve maior frequência do gênero masculino (75% versus 17%, a lesão apareceu em média após 18 horas e predominantemente no período notur no (75%. CONCLUSÃO: A incidência de lesão nasal em prematuros submetidos à ventilação não invasiva via pronga nasal foi elevada, sendo possível planejar estudo dos fatores associados, com base neste piloto.

  18. O CONTATO E A AMAMENTAÇÃ O PRECOCES: SIGNIFICADOS E VIVÊNCIAS

    OpenAIRE

    Eloana Ferreira D\\u2019Artibale; Luciana Olga Bercini

    2014-01-01

    Este estudio tiene como objetivo analizar los significados y las experiencias del contacto y amamantamiento precoces de las puérperas internadas en un Hospital Amigo del Niño. Se trata de un estudio descriptivo, exploratorio, con abordaje cualitativo, que se desarrolló en un hospital universitario en el Noroeste de Paraná, de noviembre de 2011 a enero de 2012, con la participación de 16 puérperas. Los datos fueron colectados por medio de la observación sistemática no participante de los parto...

  19. Imunodeficiência Combinada Grave – O Diagnóstico Precoce é Importante?

    OpenAIRE

    Simão, I; Valente, R; Farela Neves, J; Neves, C

    2011-01-01

    Introdução: Os doentes com Imunodeficiência Combinada Grave (SCID) não diagnosticados evoluem inexoravelmente para a morte no primeiro ano de vida. Um elevado índice de suspeição é fundamental para o diagnóstico precoce, o factor mais importante para a sobrevida destas crianças. Objectivo: Apresentam-se três casos clínicos ilustrativos da importância da precocidade diagnóstica no prognóstico final. Casos clínicos: Caso clínico 1: Lactente do sexo masculino, com antecedentes de inf...

  20. Influence of laparoscopy and laparotomy on gasometry, leukocytes and cytokines in a rat abdominal sepsis model Influência da laparoscopia e laparotomia na gasometria, leucócitos e citocinas em modelo de sepse abdominal em ratos

    Directory of Open Access Journals (Sweden)

    Irami Araújo Filho

    2006-04-01

    Full Text Available PURPOSE: Laparoscopic surgery is associated with reduced surgical trauma, and less acute phase response, as compared with open surgery. Cytokines are important regulators of the biological response to surgical and anesthetic stress. The aim of this study was to determine if CO2 pneumoperitoneum would change cytokine expression, gas parameters and leukocyte count in septic rats. METHODS: Wistar rats were randomly assigned to five groups: control (anesthesia only, laparotomy, CO2 pneumoperitoneum, cecum ligation and puncture by laparotomy, and laparoscopic cecum ligation and puncture. After 30 min of the procedures, arterial blood samples were obtained to determine leukocytes subpopulations by hemocytometer. TNFalpha, IL-1beta, IL-6 were determined in intraperitoneal fluid (by ELISA. Gas parameters were measured on arterial blood, intraperitoneal and subperitoneal exsudates. RESULTS: Peritoneal TNFalpha, IL-1beta and IL-6 concentrations were lower in pneumoperitoneum rats than in all other groups (pOBJETIVO: A cirurgia laparoscópica está associada com trauma reduzido e baixa resposta na fase aguda do trauma, quando comparada com a cirurgia aberta. As citocinas e o balanço ácido-base são fatores importantes da resposta biológica ao trauma cirúrgico-anestésico. O objetivo deste estudo foi determinar se o pneumoperitôneo com CO2 altera a expressão das citocinas, a gasometria e a contagem diferencial de leucócitos em ratos com sepse abdominal. MÉTODOS: Ratos Wistar foram aleatoriamente distribuídos em 5 grupos: controle (somente anestesia, laparotomia, pneumoperitôneo com CO2, ligadura e punção do ceco por laparotomia, ligadura e punção do ceco por laparoscopia. Após 30 minutos dos procedimentos, sangue arterial foi colhido para leucometria diferencial em hemocitômetro. TNFalfa, IL-1beta e IL-6 foram dosadas no líquido intraperitoneal (por ELISA. Os parâmetros gasosos foram medidos no sangue arterial e nos exsudatos

  1. STUDY OF CLINICAL PROFILE OF PATIENTS PRESENTING WITH SEXUAL PRECOCITY TO A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Binoy Kumar Mohanty

    2016-07-01

    Full Text Available BACKGROUND Precocious puberty is a common paediatric endocrine disorder seen in clinical practice. OBJECTIVE To study the various aetiologies and clinical presentations of patients presenting with sexual precocity to a tertiary care hospital. DESIGN Cross sectional study. MATERIAL AND METHODS We collected and analysed the clinical data including hormonal status of 24 consecutive patients who presented to our department from January 2014 to December 2015 for evaluation of sexual precocity. RESULTS Most of the patients presenting to us had evidence of precocious puberty (n=16, followed by premature adrenarche (n=5 and premature thelarche (n=3 respectively. The females outnumbered males in our study (68.75% of total cases. Females presenting with central precocious puberty had no appreciable cause (idiopathic in majority (85.72% of cases. While, males presenting with central precocious puberty had an organic cause (60% in majority of cases. CONCLUSIONS Precocious puberty is more common among females as compared to males. Organic lesion must be ruled out in all patients presenting with central precocious puberty especially in males.

  2. Neonatal hypoglycemia.

    Science.gov (United States)

    Straussman, Sharon; Levitsky, Lynne L

    2010-02-01

    Hypoglycemia in the newborn may be associated with both acute decompensation and long-term neuronal loss. Studies of the cause of hypoglycemic brain damage and the relationship of hypoglycemia to disorders associated with hyperinsulinism have aided in our understanding of this common clinical finding. A recent consensus workshop concluded that there has been little progress toward a precise numerical definition of neonatal hypoglycemia. Nonetheless, newer brain imaging modalities have provided insight into the relationship between neuronal energy deficiency and central nervous system damage. Laboratory studies have begun to reveal the mechanism of hypoglycemic damage. In addition, there is new information about hyperinsulinemic hypoglycemia of genetic, environmental, and iatrogenic origin. The quantitative definition of hypoglycemia in the newborn remains elusive because it is a surrogate marker for central nervous system energy deficiency. Nonetheless, the recognition that hyperinsulinemic hypoglycemia, which produces profound central nervous system energy deficiency, is most likely to lead to long-term central nervous system damage, has altered management of children with hypoglycemia. In addition, imaging studies on neonates and laboratory evaluation in animal models have provided insight into the mechanism of neuronal damage.

  3. Identificação das bactérias envolvidas na sepse grave de fêmeas caninas com piometra submetidas a ovário-histerectomia terapêutica

    Directory of Open Access Journals (Sweden)

    Tabatha do Amaral Kalenski

    2012-04-01

    Full Text Available A piometra é uma afecção reprodutiva comum que acomete fêmeas caninas, podendo se agravar e progredir para o quadro de sepse grave e choque séptico. A precocidade da instituição da antibioticoterapia é determinante para um melhor prognóstico. O objetivo deste estudo foi avaliar os principais microrganismos envolvidos nos casos de sepse grave em cadelas acometidas por piometra e submetidas à ovário-histerectomia terapêutica, por meio de realização de hemocultura e cultura da secreção uterina e antibiograma. Foram avaliadas 33 fêmeas caninas e o principal agente envolvido com a sepse grave secundária à piometra foi a Escherichia coli, identificada em 57,57% dos casos. Também foram identificados Staphylococcus sp., com incidência de 9,09%, Citrobacter koseri, Enterobacter cloacae, Enterobacter faecalis, Eduardsiella sp., Klebsiella pneumoniae e Streptococcus sp., com 3,03% de frequência cada. Após a realização do antibiograma pelo método de difusão, os antimicrobianos que apresentaram maior eficácia contra as cepas de Escherichia coli foram a gentamicina, a enrofloxacina, a cefalexina e a associação de amoxicilina com ácido clavulânico, nesta ordem. A cultura da secreção uterina foi mais sensível que a hemocultura para identificação do agente microbiano (p<0,0001. A identificação bacteriana é útil para direcionar a antibioticoterapia empírica mais específica, de acordo com o perfil de sensibilidade, minimizando assim o desenvolvimento de resistência, o custo do tratamento e o risco de reações adversas aos antimicrobianos utilizados.

  4. 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

  5. Seleção precoce para a produtividade de grãos no feijoeiro

    Directory of Open Access Journals (Sweden)

    ROSAL CARLOTA JOAQUINA DE SOUSA

    2000-01-01

    Full Text Available O objetivo do presente trabalho foi avaliar a eficiência da seleção precoce para o caráter produtividade de grãos na cultura do feijão (Phaseolus vulgaris L.. Para tanto foi utilizado o cruzamento entre os cultivares Carioca (P1 e FT- Tarumã (P2. Foram avaliadas 192 famílias, 64 das quais derivadas de plantas F2, outras 64 de plantas F2 do RC1 (F1 x P1 e 64, ainda, de plantas F2 de RC2 (F1 x P2. As famílias foram conduzidas empregando-se o método Bulk dentro de famílias F2 e avaliadas nas gerações F2:3 (fevereiro de 1997, F2:4 (julho de 1997, F2:5 (novembro de 1997, F2:6 (fevereiro de 1998, na área experimental do Departamento de Biologia da Universidade Federal de Lavras (MG. Utilizou-se o delineamento látice simples 14 x 14 na avaliação das 192 famílias juntamente com os pais e duas testemunhas. A partir das análises de variância dos dados da produtividade de grãos, foram estimados os componentes da variância genética e fenotípica, a herdabilidade realizada, as estimativas de correlações entre as famílias nas sucessivas gerações e o ganho observado com a seleção divergente. Constatou-se que: as famílias de melhor desempenho foram observadas no RC2; a interação genótipos x ambientes afetou a seleção precoce, valendo destacar que, para melhorar sua eficiência, as famílias devem ser avaliadas no mínimo durante duas gerações; a seleção precoce foi eficiente principalmente para a eliminação das famílias com pior desempenho, reduzindo, dessa forma, o trabalho dos melhoristas em gerações avançadas.

  6. High risk pregnancies and factors associated with neonatal death.

    Science.gov (United States)

    Demitto, Marcela de Oliveira; Gravena, Angela Andréia França; Dell'Agnolo, Cátia Millene; Antunes, Marcos Benatti; Pelloso, Sandra Marisa

    2017-04-03

    To identify the factors associated with intra-hospital neonatal mortality based on the individual characteristics of at-risk pregnant mothers, delivery and newborns. This was a cross-sectional epidemiological study of live newborns delivered by women attended at the high-risk outpatient unit of a philanthropic hospital in Maringá, Paraná, Brazil between September 2012 and September 2013. Six hundred and eighty-eight women participated in the study. The neonatal mortality coefficient found was 17.7/1,000 live births, most in the early neonatal phase. Premature labor, fetal malformation and multiple gestations were associated with neonatal death. Premature, very low birth weight newborns and those with an Apgar score of less than seven, five minutes after birth were at high risk of death. Identifying risk factors can help plan actions to consolidate the perinatal network. Specific programs should be incentivized in other countries, in the search for significant perinatal results such as reducing neonatal mortality. Identificar os fatores associados à mortalidade neonatal intra-hospitalar com base nas características individuais de gestantes de risco, do parto e do recém-nascido. Estudo epidemiológico do tipo transversal, realizado com crianças nascidas vivas de partos hospitalares de mulheres acompanhadas pelo ambulatório de alto risco de um hospital filantrópico de Maringá, Paraná, Brasil, no período de setembro de 2012 a setembro de 2013.RESULTADOS Fizeram parte da pesquisa 688 mulheres. O coeficiente de mortalidade neonatal foi de 17,7 óbitos/1.000 nascidos vivos, sendo sua maioria no período neonatal precoce. Trabalho de parto prematuro, malformação fetal e gestação múltipla foram as intercorrências associadas ao óbito neonatal. Recém-nascidos prematuros, com muito baixo peso ao nascer e Índice de Apgar menor que sete no quinto minuto de vida apresentaram risco elevado de morte. A identificação de fatores de risco pode auxiliar no

  7. The timing of normal puberty and the age limits of sexual precocity

    DEFF Research Database (Denmark)

    Parent, Anne-Simone; Teilmann, Grete; Juul, Anders

    2003-01-01

    During the past decade, possible advancement in timing of puberty has been reported in the United States. In addition, early pubertal development and an increased incidence of sexual precocity have been noticed in children, primarily girls, migrating for foreign adoption in several Western European...... countries. These observations are raising the issues of current differences and secular trends in timing of puberty in relation to ethnic, geographical, and socioeconomic background. None of these factors provide an unequivocal explanation for the earlier onset of puberty seen in the United States....... In the formerly deprived migrating children, refeeding and catch-up growth may prime maturation. However, precocious puberty is seen also in some nondeprived migrating children. Attention has been paid to the changing milieu after migration, and recently, the possible role of endocrine- disrupting chemicals from...

  8. Neonatal euthanasia.

    Science.gov (United States)

    Kon, Alexander A

    2009-12-01

    Despite advances in the care of infants, there remain many newborns whose medical conditions are incompatible with sustained life. At times, healthcare providers and parents may agree that prolonging life is not an appropriate goal of care, and they may redirect treatment to alleviate suffering. While pediatric palliative treatment protocols are gaining greater acceptance, there remain some children whose suffering is unrelenting despite maximal efforts. Due to the realization that some infants suffer unbearably (ie, the burdens of suffering outweigh the benefits of life), the Dutch have developed a protocol for euthanizing these newborns. In this review, I examine the ethical aspects of 6 forms of end of life care, explain the ethical arguments in support of euthanasia, review the history and verbiage of the United States regulations governing limiting and withdrawing life-prolonging interventions in infants, describe the 3 categories of neonates for whom the Dutch provide euthanasia, review the published analyses of the Dutch protocol, and finally present some practical considerations should some form of euthanasia ever be deemed appropriate.

  9. 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

  10. 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

  11. A mortalidade neonatal em 1998, no município de Botucatu - SP La mortalidad neonatal en 1998, en el município de Botucatu-SP The neonatal mortality in 1998 at the municipality of Botucatu-SP

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    Kátia Poles

    2000-07-01

    Full Text Available Considerando que a mortalidade neonatal é indicador da qualidade da assistência prestada à gestante, ao parto e ao recém-nascido, realizamos o presente trabalho, cujo objetivo foi identificar as causas e o índice de mortalidade neonatal durante o ano de 1998 em Botucatu-SP. O coeficiente de mortalidade neonatal obtido foi de 8,3/1000 nascidos vivos e o coeficiente de mortalidade neonatal precoce foi de 7,3/1000 nascidos vivos, confirmando a importância dos óbitos na primeira semana de vida. Aproximadamente três quartos dos óbitos puderam ser classificados como reduzíveis por diagnóstico e tratamento precoces, reduzíveis por adequada atenção ao parto ou parcialmente reduzíveis por adequado controle da gravidez, evidenciando que para se reduzir os índices de morte neonatal, deveremos investir na melhoria da qualidade da assistência prestada à gestante, à parturiente e ao neonato.Considerando que la mortalidad neonatal es un indicador de la calidad de la asistencia ofrecida en la gestación, al parto y al recién- nacido, realizamos el presente trabajo, con el objetivo de estudiar la mortalidad neonatal durante el año de 1998 en Botucatu-SP. El coeficiente de mortalidad neonatal encontrado fue 8,3/1000 nacidos vivos y el coeficiente de mortalidad neonatal precoz fue de 7,3/1000 nacidos vivos, confirmando la importancia de las defunciones en la primera semana de vida. Los resultados mostraron que aproximadamente tres cuartos de las defunciones pueden ser reducidas con el control del embarazo, con el diagnóstico y tratamiento precoz o con la adecuada atención al parto, evidenciando que para reducir los índices de mortalidad neonatal, deberemos invertir en la mejoría de la calidad de la asistencia ofrecida en la gestación, en el parto y al recién-nacido.Considering that neonatal mortality is an indicator of the quality of the care provided to pregnant women, at childbirth as well as to the new born, authors developed the

  12. INCIDÊNCIA E IMPORTÂNCIA DO DIAGNÓSTICO PRECOCE DE MELANOMA NO BRASIL

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    Matheus Violato Guidetti

    2016-10-01

    Full Text Available Embora o câncer de pele seja o mais frequente no Brasil e corresponda a 25% de todos os tumores malignos registrados no País, o melanoma representa apenas 4% das neoplasias malignas do órgão, porém é o tipo mais grave devido à sua alta possibilidade de metástase. Após uma comparação dos diversos estudos presentes nessa revisão, percebe–se determinada padronização no desenvolvimento da doença quanto ao sexo, idade, etnia e localização da lesão. No Brasil, essa neoplasia cresce anualmente e os fatores são diversos, como a pré-disposição genética e os maus cuidados com a pele, por isso, é fundamental trabalhar a conscientização sobre o risco dessa doença. Ademais, a incidência e prevalência do melanoma cutâneo carece de maior atenção das políticas públicas, pois o diagnóstico precoce é a chave-mestra para uma maior eficácia no tratamento.

  13. O CONTATO E A AMAMENTAÇÃ O PRECOCES: SIGNIFICADOS E VIVÊNCIAS

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    Eloana Ferreira D\\u2019Artibale

    2014-01-01

    Full Text Available Este estudio tiene como objetivo analizar los significados y las experiencias del contacto y amamantamiento precoces de las puérperas internadas en un Hospital Amigo del Niño. Se trata de un estudio descriptivo, exploratorio, con abordaje cualitativo, que se desarrolló en un hospital universitario en el Noroeste de Paraná, de noviembre de 2011 a enero de 2012, con la participación de 16 puérperas. Los datos fueron colectados por medio de la observación sistemática no participante de los partos, apuntes en diario de campo y entrevista semiestructurada. El tratamiento de los datos fue realizado por medio del análisis de contenido, modalidad temática. Los resultados revelaron que el acercamiento entre el binomio madre-hijo, en seguida al nacimiento, proporcionó una experiencia única a la mujer, desencadenando diversas sensaciones dentro del contexto biopsicosociocultural de cada una de ellas, con sentimientos y significados favorables al vínculo madre-hijo y al inicio de la amamantación.

  14. Amamentação e as intercorrências que contribuem para o desmame precoce

    Directory of Open Access Journals (Sweden)

    Carolina Sampaio de Oliveira

    Full Text Available RESUMO Objetivo Conhecer a vivência de mães em relação à amamentação e as intercorrências que contribuem para o desmame precoce. Método Pesquisa do tipo descritiva-exploratória, com abordagem qualitativa realizado em uma unidade de Estratégia da Saúde da Família, no município de Cáceres-MT, por meio de entrevista semi-estruturada com 21 mulheres que tiveram filhos de janeiro/2012 a janeiro/2014. Resultados Os dados apontaram que ao término dos 6 meses das crianças, somente 19,1%, continuavam em Aleitamento Materno Exclusivo e as principais alegações para sua ocorrência foram: Déficit de conhecimentos inexperiência/insegurança; Banalização das angústias maternas; Intercorrências da mama puerperal; Interferências familiares; Leite fraco/insuficiente; trabalho materno. Conclusão O estudo reforçou a necessidade de ajustes no modelo de atenção vigente, ultrapassando aplicabilidade de técnicas pré-definidas, incentivando a criticidade perceptiva dos profissionais de saúde na construção de novos saberes e condutas.

  15. Contato precoce pele a pele entre mãe e filho: significado para mães e contribuições para a enfermagem

    Directory of Open Access Journals (Sweden)

    Thaís Alves Matos

    2010-12-01

    Full Text Available Tratou-se de uma pesquisa convergente-assistencial, realizada numa maternidade da Região Sul do Brasil entre abril e maio de 2009, objetivando compreender o significado do contato precoce pele-a-pele mãe-filho para o ser-mãe, identificar características do estabelecimento desse contato e contribuições da enfermagem. Os dados foram coletados pela observação participante e entrevista, com nove mães, identificando-se quatro categorias: a orientações acerca do contato pele-a-pele precoce mãe-filho antes do nascimento; b estabelecimento do contato precoce pele-a-pele mãe-filho; c significado do contato pele-a-pele precoce mãe-filho para o ser-mãe; e d contribuições da enfermagem no estabelecimento do contato precoce pele-a-pele mãe-filho. Conclui-se que o significado do contato precoce mãe-filho atribuído pelas mães é positivo, e a contribuição da enfermagem no estabelecimento desse contato é significativa.

  16. Atrofia mucosa/translocação bacteriana na sepse experimental em ratos Wistar Mucosal atrophy/bacterial translocation in experimental sepsis in Wistar rats

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    Armando José d'Acampora

    2004-10-01

    Full Text Available OBJETIVO: Avalizar a relação entre lesão mucosa e translocação bacteriana. MÉTODO: Utilizou-se 50 ratos distribuídos em 5 grupos: 1.Controle: injeção de inóculo padrão de Pseudomonas aeruginosa, 2.Dreno: injeção do inóculo padrão e drenagem da cavidade abdominal, após 6 horas, 3.Lavado: injeção do inóculo padrão e lavagem da cavidade abdominal, após 6 horas, 4.Lavado + dreno: injeção do inóculo padrão e após 6 horas, drenagem e lavagem da cavidade, 5.Normal: avaliação histológica da parede intestinal normal. Após o óbito, realizou-se hemocultura e cultura peritoneal. Realizou-se medida da espessura total da parede do jejuno e da camada mucosa em vilosidades seccionadas de forma longitudinal. RESULTADOS: Na hemocultura, houve crescimento de Pseudomonas aeruginosa e Escherichia coli em 90% e 52,5% dos animais. Na cultura peritoneal, houve crescimento de P. aeruginosa, E. coli e Klebsiella sp em 87,5%, 85% e 5% dos animais. Quanto a altura da camada mucosa e da parede intestinal, não houve alteração estatisticamente significativa entre os 5 grupos. CONCLUSÃO: A sepse aguda não causou alteração na camada mucosa do intestino delgado e a translocação ocorrida não pode ser considerada como decorrente de uma lesão da mucosa intestinal.PURPOSE: Observe the relation between small intestine's mucosal injury and bacterial translocation. METHODS: 50 adult female rats were distributed in 5 groups: 1. Control: intraperitoneal injection of Pseudomonas aeruginosa, 2. Drainage: intraperitoneal injection of P. aeruginosa and drainage of the abdominal cavity, after 6 hours, 3. Washed: intraperitoneal injection of P. aeruginosa and washing of the abdominal cavity, after 6 hours, 4. Washed + drainage: intraperitoneal injection of P. aeruginosa plus drainage and washing of the cavity, after 6 hours, 5. Normal: evaluation of the normal intestinal wall. After death, blood and peritoneal cultures were performed. Fragments of

  17. Estudo epidemiológico das infecções neonatais no Hospital Universitário de Londrina, Estado do Paraná = Epidemiological study of neonatal infections at the University Hospital of Londrina, Paraná State

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    Gilselena Kerbauy Lopes

    2008-01-01

    Full Text Available A maior suscetibilidade dos neonatos às infecções resulta em taxas de infecção hospitalar (IH superiores às outras populações de pacientes. O objetivo deste trabalho foi determinar a frequência e o perfil das IH para os neonatos associando os principais fatoresde risco e óbito. Foi realizado estudo epidemiológico, retrospectivo, em registros de notificação de infecções neonatais da Comissão de Controle de Infecção Hospitalar do Hospital Universitário de Londrina, no período entre 2001 e 2005. A taxa média anual deIH neonatal foi 18,3% ao longo dos cinco anos. As infecções mais frequentes foram pneumonia (46,0% e sepse (49,1%, as quais estiveram relacionadas ao tempo de hospitalização superior a 60 dias e aos procedimentos invasivos como intubação orotraqueale o cateterismo vascular, que aumentaram três vezes o risco para sepse e respectivamente 3,26 e 2,50 vezes o risco para óbito. A IH contribuiu com 85,7% dos óbitos. O coeficiente de letalidade foi 15,8%.The greater susceptibility of neonates to infections results in higher rates of nosocomial infection (NIs than in other patient populations. The objective of this work was to determine the frequency and profile of NIs in neonates associated to the main risk and death factors. A retrospective epidemiological study wasconducted on neonates with NIs admitted to the neonatal sector at the University Hospital of Londrina, between 2001 and 2005. The mean annual rate of neonatal NI was 18.3% over the course of five years. The most frequent infections were pneumonia (46.0% and sepsis(49.1%, which were related to a hospitalization period of over 60 days. The use of tracheal tubes and vascular catheters increased threefold the risk of sepsis. The tracheal tubes and vascular catheters increased the risk of death by 3.26 and 2.50 times, respectively. NIs contributed to 85.7% of deaths. The mortality coefficient was 15.8%.

  18. Avanços na abordagem do carcinoma precoce de esôfago

    Directory of Open Access Journals (Sweden)

    Vitor Arantes

    Full Text Available Nos países ocidentais, o carcinoma de células escamosas de esôfago (CCE geralmente é detectado em estágio avançado, quando as possibilidades de cura são remotas e o prognóstico reservado. Entretanto, nos anos recentes, ocorreu uma série de avanços na abordagem do CCE de esôfago, tais como a identificação dos grupos de risco para o surgimento desta neoplasia; o uso da endoscopia de alta resolução e cromoendoscopia com lugol favorecendo o diagnóstico do CCE em estágios iniciais; e o desenvolvimento de técnicas endoscópicas de ressecção tumoral endoluminal em monobloco denominada dissecção endoscópica de submucosa. Este progresso tem possibilitado a aplicação do tratamento endoscópico minimamente invasivo com potencial curativo em pacientes selecionados com CCE superficial de esôfago. O presente artigo de revisão, elaborado por um grupo multicêntrico internacional, tem como objetivo primário contribuir para o entendimento dos principais avanços recentes ocorridos no manejo do CCE precoce de esôfago. Como objetivo secundário, pretende propiciar uma revisão detalhada e minuciosa da estratégia técnica de DES desenvolvida pelos experts japoneses, de forma a colaborar para a difusão deste conceito e a incorporação destas tecnologias na Medicina Brasileira e Latino-americana.

  19. 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...

  20. MRI of neonatal encephalopathy

    International Nuclear Information System (INIS)

    Khong, P.L.; Lam, B.C.C.; Tung, H.K.S.; Wong, V.; Chan, F.L.; Ooi, G.C.

    2003-01-01

    We present the magnetic resonance imaging (MRI) findings in neonatal encephalopathy, including hypoxic-ischaemic encephalopathy, perinatal/neonatal stroke, metabolic encephalopathy from inborn errors of metabolism, congenital central nervous system infections and birth trauma. The applications of advanced MRI techniques, such as diffusion-weighted imaging and magnetic resonance spectroscopy are emphasized

  1. NEONATAL TOBACCO SYNDROME

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    R.A.Kireev

    2008-12-01

    Full Text Available The objective of the research is to study neonatal adaptation in new-born children from the tobacco abused mothers. A comparative analysis of clinical and neuroendochnal status and lipid metabolism in new-born children from smoking and non-smoking mothers was carried out Neonatal adaptation disorders were revealed in new-born children from the smoking mothers.

  2. Inibição da atividade da citrato sintase cerebral em um modelo animal de sepse Inhibition of brain citrate synthase activity in an animal model of sepsis

    Directory of Open Access Journals (Sweden)

    Giselli Scaini

    2011-06-01

    Full Text Available OBJETIVO: Um amplo corpo de evidência oriundo de estudos experimentais indica que a sepse se associa com um aumento da produção de espécies de oxigênio reativo, depleção de antioxidantes, e acúmulo de marcadores de estresse oxidativo. Além disto, a disfunção mitocondrial foi implicada na patogênese da síndrome de disfunção de múltiplos órgãos. A citrato sintase é uma enzima que se localiza no interior das células, na matriz mitocondrial, sendo uma etapa importante do ciclo de Krebs; esta enzima foi utilizada como um marcador enzimático quantitativo da presença de mitocôndrias intactas. Assim, investigamos a atividade da citrato sintase no cérebro de ratos submetidos ao modelo sepse com de ligadura e punção do ceco. MÉTODOS: Em diferentes horários (3, 6, 12, 24 e 48 horas após cirurgia de ligadura e punção do ceco, seis ratos foram sacrificados por decapitação, sendo seus cérebros removidos e dissecados o hipocampo, estriato, cerebelo, córtex cerebral e córtex pré-frontal, e utilizados para determinação da atividade de citrato sintase. RESULTADOS: Verificamos que a atividade de citrato sintase no córtex pré-frontal estava inibida após 12, 24 e 48 horas da ligadura e punção do ceco. No córtex cerebral, esta atividade estava inibida após 3, 12, 24 e 48 horas da ligadura e punção do ceco. Por outro lado a citrato sintase não foi afetada no hipocampo, estriato e cerebelo até 48 horas após a ligadura e punção do ceco. CONCLUSÃO: Considerando-se que é bem descrito o comprometimento da energia decorrente da disfunção mitocondrial na sepse, e que o estresse oxidativo desempenha um papel essencial no desenvolvimento da sepse, acreditamos que o comprometimento da energia pode também estar evolvido nestes processos. Se a inibição da citrato sintase também ocorre em um modelo de sepse, é tentador especular que a redução do metabolismo cerebral pode provavelmente estar relacionada com a

  3. Sepse no pós-operatório de cirurgia cardíaca: descrição do problema Sepsis in the postoperative period of cardiac surgery: problem description

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    Dinaldo Cavalcanti de Oliveira

    2010-03-01

    Full Text Available FUNDAMENTOS: A despeito do avanço no diagnóstico e na terapêutica da sepse nos últimos anos, a morbidade e mortalidade são elevadas. OBJETIVO: Avaliar a prevalência, a evolução hospitalar e o prognóstico de pacientes que apresentaram sepse no pós- operatório de cirurgia cardíaca. MÉTODOS: Trata-se de um registro prospectivo que incluiu pacientes (n = 7.332 submetidos à cirurgia cardíaca (valvar ou coronariana entre janeiro de 1995 e dezembro de 2007. Utilizamos os critérios clássicos de diagnóstico de sepse para identificar os pacientes que evoluíram com tal enfermidade e avaliamos as comorbidades pré-operatórias, a evolução hospitalar e o prognóstico. RESULTADOS: A sepse ocorreu em 29 pacientes (prevalência = 0,39%. O sexo masculino predominou sobre o feminino (79% vs. 21%. A idade média foi de 69 ± 6,5 anos. As principais comorbidades pré-operatórias eram: hipertensão arterial sistêmica (79%, dislipidemia (48% e antecedente familiar de doença arterial coronariana (38%. O índice Apache médio foi de 18 ± 7, enquanto o Sofa indicou 14,2 ± 3,8. O foco infeccioso primário foi pulmonar em 19 pacientes (55%. Houve 19 culturas positivas, e a média de hidratação endovenosa nas primeiras 24 horas foi de 1.016 ± 803 ml. As principais complicações foram: insuficiência renal aguda (65%, síndrome de baixo débito cardíaco (55% e arritmia ventricular maligna (55%. A mortalidade foi de 79% (23 pacientes. CONCLUSÃO: A sepse após cirurgia cardíaca foi um evento raro, porém com desfechos clínicos catastróficos. O índice elevado de morbidade e mortalidade revelou a necessidade de um aprimoramento no tratamento, visando melhorar a evolução clínica dos pacientes.BACKGROUND: In spite of the advances in sepsis diagnosis and treatment in the last years, the morbidity and mortality are still high. OBJECTIVE: To assess the prevalence, in-hospital evolution and prognosis of patients that presented sepsis in the

  4. Heterose em cajueiro anão precoce Heterosis in precocious dwarf cashew

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    José Jaime Vasconcelos Cavalcanti

    2003-06-01

    Full Text Available Esse trabalho foi conduzido com o objetivo de avaliar a heterose no cajueiro (Anacardium occidentale L. anão precoce. O experimento foi composto por seis clones parentais (CCP 06, CCP 09, CCP 76, CCP 1001, C1P3 e P399E e 18 combinações híbridas. Utilizou-se delineamento de blocos casualizados, com duas repetições e cinco plantas por parcela. A heterose média foi de 12,09%, 19,38%, 98,01%, 96,97% e -2,11%, respectivamente, para altura da planta, diâmetro da copa, número de castanha por planta, produtividade de castanha e peso médio de castanha, indicando presença de vigor híbrido nos cruzamentos, para todos os caracteres, exceto para peso médio de castanha, demonstrando a importância de sua exploração, com perspectivas de avanços genéticos sobre caracteres da cultura do caju. A conseqüência seria a obtenção de clones comerciais com características de produção desejáveis e a formação de populações-base para o programa de melhoramento populacional. Os híbridos CCP 06 x C1P3, CCP 09 x P399E e CCP 09 x CCP 06 são os mais promissores.The objective of this work was to evaluate the heterosis in dwarf cashew (Anacardium occidentale L.. The experiment had six parent clones (CCP 06, CCP 09, CCP 76, CCP 1001, C1P3, and P399E and 18 hybrid plants. A randomized complete block experimental design with two replications and five plants per plot was used. The average heterosis was 12%, 19%, 98%, 97%, and -2%, for the parent clones, based on the traits plant height, canopy diameter, number of nuts per plant, nut yield, and nut weight. It should be pointed out the presence of hybrid vigor in all crosses for all traits, except nut weight. This stresses the importance of hybrid vigor exploration, with perspectives of significant genetic improvement of the cashew culture, by obtaining superior commercial clones and establishing base-populations for the population breeding program. The hybrid combinations CCP 06 x C1P3, CCP 09 x P399E

  5. Third World adversity: African infant precocity and the role of environment.

    Science.gov (United States)

    Saugstad, Letten F

    2002-01-01

    The war against illiteracy has not been won. The number of illiterates approaches a billion. Most reside in Third World countries--former colonies--where they are caught in a poverty trap of disease, low agricultural production and environmental adversity requiring technology beyond their means. I argue against the commonly held view that this is mainly attributable to the four hundred years of traffic in men. According to the late K.O. Dike, middle men along the African coast barred foreign merchants from the hinterland, and because of this the social, political structure and sovereignty of the African states remained fundamentally unchanged during the period 1400-1807, whereas a few decades after colonisation the socio-political system collapsed and was replaced by a small rich elite and many poor, while resources were taken out of Africa. Present poverty and underdevelopment represent as great a challenge as the trade in slaves. As did the African Middle-Men of that time, African leaders now must unite in an ambitious and confident Pan-African Union demonstrating strength. Western countries should focus on reducing poverty and improving nutrition. This also makes terrorism and legal and illegal migration less likely. Education is important, but the West should not limit its effort to fighting illiteracy but should also support the establishment of institutions for higher education. Africa possessed optimal conditions and an enriched environment for human evolution. African Infant Precocity is a persistent example. The human brain, like other brains, consists 60% of poly-unsaturated fatty acids (Marine-Fat), the rest being water. A sufficient amount is required to secure optimal brain growth. It normalizes brain function, and prevents sudden cardiac and infant death, which have been increasing in Western societies. Humans are unique in having a mismatch between the need for brain food--marine fat--and our common high protein diet. Nowhere is the neglect of the

  6. Effects of bromopride on the healing of left colonic anastomoses in rats with induced abdominal sepsis Efeitos da bromoprida na cicatrização de anastomoses no cólon esquerdo de ratos sob sepse abdominal induzida

    Directory of Open Access Journals (Sweden)

    Silvana Marques e Silva

    2012-06-01

    Full Text Available PURPOSE: To evaluate the effects of bromopride on the healing of left colonic anastomoses in rats with induced abdominal sepsis. METHODS: Forty rats were divided into two groups to receive either bromopride (experimental group- E or saline (control group- C. Each group was divided into subgroups of ten animals each to be euthanized on third (E3 and C3 or seventh day (E7 and C7 after surgery. Sepsis was induced by cecal ligation and puncture. The rats underwent segmental left colon resection and end-to-end anastomosis. Adhesion formation, tensile strength and hydroxyproline concentration were assessed. Histomorphometry of collagen and histopathological analysis were also performed. RESULTS: On postoperative third day, anastomoses in bromopride-treated animals showed lower tensile strength (p=0.02 and greater reduction in hydroxyproline concentration (p=0.04 than in control animals. There was no statistical difference in these parameters on seventh day, and the remaining parameters were similar across subgroups. Collagen content was also similar across subgroups. CONCLUSION: In the presence of abdominal sepsis, the administration of bromopride was associated with decreased tensile strength and hydroxyproline concentration in left colonic anastomoses in rats three days after surgery.OBJETIVO: Avaliar os efeitos da bromoprida sobre a cicatrização de anastomoses de cólon esquerdo de ratos na presença de sepse abdominal. MÉTODOS: Quarenta ratos distribuídos em grupos contendo 20 animais para administração de bromoprida ou salina. Cada grupo foi dividido em subgrupos contendo dez animais, para eutanásia no terceiro ou no sétimo dia de pós-operatório. A indução da sepse foi realizada pelo método de ligadura e punção do ceco. Foi realizada ressecção de um segmento do cólon esquerdo e anastomose término-terminal. À re-laparotomia, foi avaliada a quantidade total de aderências e removido um segmento colônico contendo a anastomose

  7. Early neonatal deaths associated with perinatal asphyxia in infants ≥2500 g in Brazil

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    Maria Fernanda Branco de Almeida

    2017-11-01

    Full Text Available Objective: To assess the annual burden of early neonatal deaths associated with perinatal asphyxia in infants weighing ≥2500 g in Brazil from 2005 to 2010. Methods: The population study enrolled all live births of infants with birth weight ≥2500 g and without malformations who died up to six days after birth with perinatal asphyxia, defined as intrauterine hypoxia, asphyxia at birth, or meconium aspiration syndrome. The cause of death was written in any field of the death certificate, according to International Classification of Diseases, 10th Revision (P20.0, P21.0, and P24.0. An active search was performed in 27 Brazilian federative units. The chi-squared test for trend was applied to analyze early neonatal mortality ratios associated with perinatal asphyxia by study year. Results: A total of 10,675 infants weighing ≥2500 g without malformations died within six days after birth with perinatal asphyxia. Deaths occurred in the first 24 h after birth in 71% of the infants. Meconium aspiration syndrome was reported in 4076 (38% of these deaths. The asphyxia-specific early neonatal mortality ratio decreased from 0.81 in 2005 to 0.65 per 1000 live births in 2010 in Brazil (p < 0.001; the meconium aspiration syndrome-specific early neonatal mortality ratio remained between 0.20 and 0.29 per 1000 live births during the study period. Conclusions: Despite the decreasing rates in Brazil from 2005 to 2010, early neonatal mortality rates associated with perinatal asphyxia in infants in the better spectrum of birth weight and without congenital malformations are still high, and meconium aspiration syndrome plays a major role. Resumo: Objetivo: Avaliar a taxa anual de óbitos neonatais precoces associados à asfixia perinatal em neonatos de peso ≥2.500 g no Brasil de 2005 a 2010. Métodos: A população do estudo envolveu todos os nascidos vivos de neonatos com peso ao nascer ≥2.500 g e sem malformações que morreram até seis dias ap

  8. Contato precoce pele a pele entre mãe e filho: significado para mães e contribuições para a enfermagem

    OpenAIRE

    Matos, Thaís Alves; Souza, Morgana Stefani de; Santos, Evanguelia Kotzias Atherino dos; Velho, Manuela Beatriz; Seibert, Eli Rodrigues Camargo; Martins, Nezi Maria

    2010-01-01

    Tratou-se de uma pesquisa convergente-assistencial, realizada numa maternidade da Região Sul do Brasil entre abril e maio de 2009, objetivando compreender o significado do contato precoce pele-a-pele mãe-filho para o ser-mãe, identificar características do estabelecimento desse contato e contribuições da enfermagem. Os dados foram coletados pela observação participante e entrevista, com nove mães, identificando-se quatro categorias: a) orientações acerca do contato pele-a-pele precoce mãe-fil...

  9. Correction of Neonatal Hypovolemia

    Directory of Open Access Journals (Sweden)

    V. V. Moskalev

    2007-01-01

    Full Text Available Objective: to evaluate the efficiency of hydroxyethyl starch solution (6% refortane, Berlin-Chemie versus fresh frozen plasma used to correct neonatal hypovolemia.Materials and methods. In 12 neonatal infants with hypoco-agulation, hypovolemia was corrected with fresh frozen plasma (10 ml/kg body weight. In 13 neonates, it was corrected with 6% refortane infusion in a dose of 10 ml/kg. Doppler echocardiography was used to study central hemodynamic parameters and Doppler study was employed to examine regional blood flow in the anterior cerebral and renal arteries.Results. Infusion of 6% refortane and fresh frozen plasma at a rate of 10 ml/hour during an hour was found to normalize the parameters of central hemodynamics and regional blood flow.Conclusion. Comparative analysis of the findings suggests that 6% refortane is the drug of choice in correcting neonatal hypovolemia. Fresh frozen plasma should be infused in hemostatic disorders. 

  10. Neonatal abstinence syndrome

    Science.gov (United States)

    ... in a newborn who was exposed to addictive opiate drugs while in the mother’s womb. Causes Neonatal ... Increased muscle tone Irritability Poor feeding Rapid breathing Seizures Sleep problems Slow weight gain Stuffy nose, sneezing ...

  11. 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.

  12. 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.

  13. Estudo epidemiológico das infecções neonatais no Hospital Universitário de Londrina, Estado do Paraná - DOI: 10.4025/actascihealthsci.v30i1.4386 Epidemiological study of neonatal infections at the University Hospital of Londrina, Paraná - DOI: 10.4025/actascihealthsci.v30i1.4386

    Directory of Open Access Journals (Sweden)

    Renata Aparecida Belei

    2008-07-01

    Full Text Available A maior suscetibilidade dos neonatos às infecções resulta em taxas de infecção hospitalar (IH superiores às outras populações de pacientes. O objetivo deste trabalho foi determinar a frequência e o perfil das IH para os neonatos associando os principais fatores de risco e óbito. Foi realizado estudo epidemiológico, retrospectivo, em registros de notificação de infecções neonatais da Comissão de Controle de Infecção Hospitalar do Hospital Universitário de Londrina, no período entre 2001 e 2005. A taxa média anual de IH neonatal foi 18,3% ao longo dos cinco anos. As infecções mais frequentes foram pneumonia (46,0% e sepse (49,1%, as quais estiveram relacionadas ao tempo de hospitalização superior a 60 dias e aos procedimentos invasivos como intubação orotraqueal e o cateterismo vascular, que aumentaram três vezes o risco para sepse e respectivamente 3,26 e 2,50 vezes o risco para óbito. A IH contribuiu com 85,7% dos óbitos. O coeficiente de letalidade foi 15,8%.The greater susceptibility of neonates to infections results in higher rates of nosocomial infection (NIs than in other patient populations. The objective of this work was to determine the frequency and profile of NIs in neonates associated to the main risk and death factors. A retrospective epidemiological study was conducted on neonates with NIs admitted to the neonatal sector at the University Hospital of Londrina, between 2001 and 2005. The mean annual rate of neonatal NI was 18.3% over the course of five years. The most frequent infections were pneumonia (46.0% and sepsis (49.1%, which were related to a hospitalization period of over 60 days. The use of tracheal tubes and vascular catheters increased threefold the risk of sepsis. The tracheal tubes and vascular catheters increased the risk of death by 3.26 and 2.50 times, respectively. NIs contributed to 85.7% of deaths. The mortality coefficient was 15.8%.

  14. 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

  15. 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.

  16. Gasometria arterial e inflamação pulmonar de ratos com diferentes tempos de sepse abdominal Arterial gasometry and lung inflammation in rats with different times of abdominal sepsis

    Directory of Open Access Journals (Sweden)

    Sérgio Luiz Rocha

    2007-03-01

    Full Text Available RACIONAL: Sepse é a principal causa de morbi-mortalidade nas vítimas de trauma e em pacientes cirúrgico e apesar de toda tecnologia e terapêutica disponível não há diminuição nestas estatísticas. OBJETIVOS: Avaliar as repercussões ácido-básicas e o grau de injúria pulmonar decorrentes de sepse abdominal em ratos após seis e 24 horas de peritonite fecal através da ligadura e punção do ceco. MÉTODOS: Foram utilizados 40 ratos Wistar, machos, adultos. A amostra foi dividida aleatoriamente em quatro grupos: grupo A (sham/6 h - n=5 submetidos à laparotomia mediana infra-umbilical sem nenhuma outra intervenção; grupo B (sham/24h - n=5 submetidos à laparotomia mediana infra-umbilical sem nenhuma outra intervenção; grupo C (LPC/6 h - n=15 submetidos à ligadura e punção do ceco e grupo D (LPC/24h - n=15 submetidos à ligadura e punção do ceco. Após seis ou 24 horas, conforme o grupo em estudo, os animais foram novamente anestesiados e submetidos as seguintes análises: observação clínica de sinais de sepse, laparotomia através do mesmo acesso anterior e realização de cultura do líquido peritoneal e punção cardíaca para obtenção de amostra sangüínea suficiente para gasometria arterial, hematócrito e leucometria. Procedeu-se eutanásia e os pulmões retirados para análise de edema pulmonar e o infiltrado inflamatório. RESULTADOS: Ocorreram quatro óbitos no grupo D. Verificou-se, em todos os grupos, a presença de acidose mista. Comparando os grupos experimento 6h versus controle 6h foram encontradas duas variáveis significativas - HCO3 (p=0,0015 e BE (p=0,0015 -, demonstrando acidose metabólica mais grave no grupo experimento. Nos grupos controle também se confirmou acidose mista, devido às alterações das variáveis HCO3 (p=0,0079, PO2 (p=0,0079 e SO2 (p=0,0079. A correlação entre o grau de comprometimento pulmonar e o estado metabólico confirma a existência de resposta inflamatória sist

  17. Impacto das malformações congênitas na mortalidade perinatal e neonatal em uma maternidade-escola do Recife Impact of congenital malformations on perinatal and neonatal mortality in an university maternity hospital in Recife

    Directory of Open Access Journals (Sweden)

    Melania Maria Ramos de Amorim

    2006-05-01

    Full Text Available OBJETIVOS: determinar a incidência de malformações congênitas em recém-nascidos assistidos em uma maternidade-escola de Recife e avaliar o impacto destas malformações na mortalidade perinatal e neonatal. MÉTODOS: realizou-se um estudo longitudinal durante os meses de setembro de 2004 a maio de 2005, analisando-se todos os partos assistidos no Instituto Materno Infantil Prof. Fernando Figueira, IMIP. Determinou-se a freqüência e o tipo de malformações congênitas e foram calculados os coeficientes de mortalidade fetal, mortalidade perinatal, mortalidade neonatal precoce e tardia. RESULTADOS: a freqüência de malformações foi de 2,8% (em 4043 nascimentos. O percentual de malformações entre os nativivos foi de 2,7%, e entre os natimortos foi de 6,7%. Dentre as malformações, as mais freqüentes foram as do sistema nervoso central (principalmente hidrocefalia e meningomielocele, as do sistema osteomuscular e as cardiopatias. Não houve associação entre malformações e sexo, porém a freqüência de prematuridade e baixo peso foi maior entre os casos de malformações. Constatou-se, entre os malformados, mortalidade neonatal precoce de 32,7% e tardia de 10,6%. Os casos de malformações representaram 6,7% dos natimortos, 24,2% das mortes neonatais precoces e 25,8% do total de mortes neonatais. CONCLUSÕES: a freqüência de malformações correspondeu a 2,8% dos nascimentos. As malformações representaram a segunda causa mais freqüente de mortes neonatais, depois da prematuridade.OBJECTIVES: to determine the incidence of congenital malformations in newborns in a university maternity hospital in Recife and assess the impact of malformation in perinatal and neonatal mortality. METHODS: a longitudinal study was performed from September 2004 to May 2005 with all deliveries at the Instituto Materno Infantil Prof. Fernando Figueira, IMIP analyzed. The type and incidence of congenital malformations were determined, and fetal mortality

  18. Evolução funcional de pacientes graves submetidos a um protocolo de reabilitação precoce

    Directory of Open Access Journals (Sweden)

    Fernanda Murata Murakami

    2015-06-01

    Full Text Available RESUMO Objetivo: Avaliar a evolução funcional dos pacientes submetidos a um protocolo de reabilitação precoce do paciente grave da admissão até a alta da unidade de terapia intensiva. Métodos: Foi conduzido um estudo transversal retrospectivo, incluindo 463 pacientes adultos com diagnóstico clínico e/ou cirúrgico, submetidos a um protocolo de reabilitação precoce. A força muscular global foi avaliada na admissão da unidade de terapia intensiva por meio da escala Medical Research Council. De acordo com a pontuação da Medical Research Council os pacientes foram alocados em um dos quatro planos de intervenção, de acordo com a adequação ou não desses parâmetros, com a escala crescente do plano significando melhor status funcional. Os pacientes não colaborativos foram alocados nos planos de intervenção, conforme seu status funcional. A força muscular global e/ou o status funcional foram reavaliados na alta da unidade de terapia. Por meio do comparativo entre o plano de Intervenção na admissão (Planoinicial e na alta (Planofinal. Os pacientes foram categorizados em três grupos, de acordo com a melhora ou não do status funcional: respondedores 1 (Planofinal > Planoinicial, respondedores 2 (Planofinal = Planoinicial e não respondedores (Planofinal < Planoinicial. Resultados: Dos 463 pacientes submetidos ao protocolo, 432 (93,3% pacientes responderam positivamente à estratégia de intervenção, apresentando manutenção e/ou melhora do status funcional inicial. Os pacientes clínicos classificados como não respondedores apresentaram idade superior (74,3 ± 15,1 anos; p = 0,03 e maior tempo de internação na unidade de terapia intensiva (11,6 ± 14,2 dias; p = 0,047 e no hospital (34,5 ± 34,1 dias; p = 0,002. Conclusão: A manutenção e/ou melhora do status funcional admissional esteve associada com menor tempo de internação na unidade de terapia intensiva e hospitalar. Os resultados sugerem que o tipo de diagn

  19. Genomic association for sexual precocity in beef heifers using pre-selection of genes and haplotype reconstruction.

    Directory of Open Access Journals (Sweden)

    Luciana Takada

    Full Text Available Reproductive traits are of the utmost importance for any livestock farming, but are difficult to measure and to interpret since they are influenced by various factors. The objective of this study was to detect associations between known polymorphisms in candidate genes related to sexual precocity in Nellore heifers, which could be used in breeding programs. Records of 1,689 precocious and non-precocious heifers from farms participating in the Conexão Delta G breeding program were analyzed. A subset of single nucleotide polymorphisms (SNP located in the region of the candidate genes at a distance of up to 5 kb from the boundaries of each gene, were selected from the panel of 777,000 SNPs of the High-Density Bovine SNP BeadChip. Linear mixed models were used for statistical analysis of early heifer pregnancy, relating the trait with isolated SNPs or with haplotype groups. The model included the contemporary group (year and month of birth as fixed effect and parent of the animal (sire effect as random effect. The fastPHASE® and GenomeStudio® were used for reconstruction of the haplotypes and for analysis of linkage disequilibrium based on r2 statistics. A total of 125 candidate genes and 2,024 SNPs forming haplotypes were analyzed. Statistical analysis after Bonferroni correction showed that nine haplotypes exerted a significant effect (p<0.05 on sexual precocity. Four of these haplotypes were located in the Pregnancy-associated plasma protein-A2 gene (PAPP-A2, two in the Estrogen-related receptor gamma gene (ESRRG, and one each in the Pregnancy-associated plasma protein-A gene (PAPP-A, Kell blood group complex subunit-related family (XKR4 and mannose-binding lectin genes (MBL-1 genes. Although the present results indicate that the PAPP-A2, PAPP-A, XKR4, MBL-1 and ESRRG genes influence sexual precocity in Nellore heifers, further studies are needed to evaluate their possible use in breeding programs.

  20. Experiências de adversidade precoce e sintomas medicamente não explicados : o caso particular da fibromialgia

    OpenAIRE

    Campos, Ana Catarina da Costa

    2013-01-01

    Trabalho final do mestrado em medicina do desporto com vista à atribuição do Grau de Mestre (área científica de psiquiatria), apresentado à Faculdade de Medicina da Universidade de Coimbra Vários estudos têm tornado aparente de como as experiências de adversidade precoce podem influenciar a vida das suas vítimas, nomeadamente no que diz respeito às suas consequências a nível da saúde tanto física como mental dos indivíduos. O objetivo deste trabalho é o de efetuar uma revisão bibliográfica...

  1. Diabetes gestacional - Otimização do controlo materno e morbilidade neonatal

    OpenAIRE

    Mimoso, Maria Gabriela

    2018-01-01

    Introdução - A diabetes gestacional (DG) é uma das complicações médicas mais frequentes na gravidez. O diagnóstico mais precoce e o rigor do controlo metabólico é fundamental para diminuir a morbilidade perinatal.A hiperglicémia materna ao induzir hiperglicémia fetal e consequente hiperinsulinismo, é responsável pela maioria das complicações do feto e no recém-nascido (RN).Objetivo - Avaliar a evolução da morbilidade neonatal de filhos de mães com DG explorando as possíveis correlações entre ...

  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. Intraoperative fluid therapy in neonates

    African Journals Online (AJOL)

    Differences from adults and children in physiology and anatomy of neonates inform our ... is based on energy expenditure indexed to bodyweight.2 Energy ... fragile and poorly keratinised.5 ... neonates means that very conservative fluid regimes in neonates ..... I make an estimation of insensible loss from the skin, viscera,.

  5. 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

  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. Síndrome do desconforto respiratório agudo relacionada à sepse em crianças com câncer: dinâmica respiratória de uma condição devastadora

    Directory of Open Access Journals (Sweden)

    Rodrigo Genaro Arduini

    Full Text Available RESUMO Objetivo: Avaliar a evolução clínica e os parâmetros respiratórios de crianças com câncer submetidas à ventilação mecânica que apresentavam síndrome do desconforto respiratório agudo relacionada à sepse. Métodos: Este estudo longitudinal, prospectivo e observacional de coorte com duração de 2 anos incluiu 29 crianças e adolescentes. Dados clínicos, avaliações de gasometria sanguínea e parâmetros ventilatórios foram coletados em quatro momentos diferentes. As flutuações entre as avaliações e as diferenças entre as médias estimadas foram analisadas por meio de modelos lineares mistos, tendo como parâmetro primário (endpoint a ocorrência de óbito dentro de 28 dias após o início da síndrome do desconforto respiratório agudo. Resultados: Ocorreram 17 óbitos dentro de 28 dias após o início da síndrome do desconforto respiratório agudo, e outros 7 entre 29 e 60 dias. Apenas cinco pacientes sobreviveram por mais de 60 dias. Nove (31% pacientes faleceram como consequência direta de hipoxemia refratária, e os demais em razão de falência de múltiplos órgãos e choque refratário a catecolaminas. Em 66% das avaliações, o volume corrente demandado para obter saturação de oxigênio igual ou acima de 90% foi superior a 7mL/kg. As médias estimadas de complacência dinâmica foram baixas e similares para sobreviventes e não sobreviventes, porém com inclinação negativa da reta entre a primeira e última avaliações, acompanhada por uma inclinação negativa da reta para volume corrente nos não sobreviventes. Os não sobreviventes tiveram significantemente mais hipoxemia, com relações PaO2/FiO2 que demonstravam médias mais baixas e inclinação negativa da reta nas quatro avaliações. As pressões pico, expiratória e média das vias aéreas demonstraram inclinações positivas na reta para os não sobreviventes, que também apresentaram mais acidose metabólica. Conclusões: Na maioria de

  8. Análise exploratória dos fatores relacionados ao prognóstico em idosos com sepse grave e choque séptico Related prognostic factors in elderly patients with severe sepsis and septic shock

    Directory of Open Access Journals (Sweden)

    Roberta de Lima Machado

    2009-03-01

    Full Text Available OBJETIVOS: O objetivo deste estudo foi avaliar variáveis relacionadas à mortalidade intra-hospitalar em 28 dias, de idosos com diagnóstico de sepse grave ou choque séptico em unidade de terapia intensiva clínica. MÉTODOS: Cento e cinqüenta e dois pacientes, com idade > 65 anos internados com sepse grave ou choque séptico foram acompanhados durante 28 dias e as variáveis foram coletadas nos dias 1, 3, 5, 7, 14 e 28 de internação. Para a comparação das variáveis categóricas, empregaram-se os testes Qui-quadrado e para as variáveis contínuas o teste de Mann-Whitney ou teste T, quando apropriado. Todos os testes foram bicaudais com erro alfa de 0,05. RESULTADOS: A média da idade foi de 82,0 �� 9,0 anos, com 64,5% de mulheres, sendo a mortalidade de 47,4%. Foram relacionados ao óbito: índice Acute Physiologic and Chronic Heatlh Evaluation II (p OBJECTIVES: The objective of this study was to evaluate variables related to intra hospital mortality at 28 days, of aged persons with severe sepsis and septic shock in a clinical ICU. METHODS: One hundred and fifty-two patients aged > 65 years with severe sepsis and septic shock were followed for 28 days and the variables were collected on days 1, 3, 5, 7, 14 and 28 of stay. To compare categorical variables the Chi-square test was used and the Mann-Whitney or t test for continuous variables. All tests were double-tailed, alpha error of 0.05. RESULTS: Mean age was 82.0 ± 9.0 years and 64.5% were female. Mortality was of 47.4%. Related to death were the following: Acute Physiological and Chronic Heath Evaluation II score (p < 0.001, Sequential Organ Failure Assessment score on days 1, 3, 5, 7 (p < 0.001, length of stay in intensive care (p < 0.001, number of organ failures (p < 0.001, high serum lactate on day 3 (p = 0.05, positive troponin I (p < 0.01, echocardiographic variables (systolic diameter p = 0.005; diastolic diameter p = 0.05; shortening fraction p = 0.02, previous renal

  9. 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...

  10. Approach to neonatal sepsis

    Directory of Open Access Journals (Sweden)

    Shankar Narayan

    2015-01-01

    The treatment includes supportive care along with administration of appropriate antibiotics. Adjuvant treatment includes IVIG, GCSF, exchange transfusion and pentoxifylline administration. This paper aims to present an algorithmic approach to neonatal sepsis to expedite the diagnosis along with providing appropriate and adequate treatment.

  11. Manifestações precoces dos transtornos do comportamento na criança e no adolescente Early manifestations of behavioral disorders in children and adolescents

    Directory of Open Access Journals (Sweden)

    Eugênio Grillo

    2004-04-01

    Full Text Available OBJETIVO: Revisão sobre o diagnóstico precoce dos principais transtornos do comportamento na criança e no adolescente, fornecendo informações práticas relativas às primeiras manifestações clínicas e à importância do diagnóstico precoce. FONTES DOS DADOS: Revisão narrativa, com levantamento na PubMed das publicações que contêm aspectos do diagnóstico precoce, especialmente na última década. SÍNTESE DOS DADOS: Os pediatras devem estar preparados e atentos para detectar precocemente um transtorno do comportamento, já que, em alguns desses transtornos, intervenções precoces podem melhorar a evolução. Além disso, essas intervenções podem levar ao diagnóstico de doenças de herança mendeliana, passíveis de aconselhamento genético. São enfocadas as manifestações precoces dos transtornos invasivos do desenvolvimento, do transtorno do déficit de atenção/hiperatividade, do transtorno de ansiedade de separação, do transtorno de ansiedade generalizada, da depressão, da esquizofrenia, dos principais transtornos alimentares da criança maior ou adolescente (anorexia nervosa e bulimia nervosa e do uso e abuso de substâncias. CONCLUSÕES: As manifestações precoces dos principais transtornos do comportamento na criança e no adolescente podem ser observadas antes da idade na qual o diagnóstico tem sido habitualmente estabelecido. O diagnóstico precoce implica intervenções precoces e orientação dos pais a respeito do prognóstico ou, em algumas situações, aconselhamento genético. A comorbidade entre esses transtornos é muito freqüente, e a manifestação de uma delas pode ser a pista para o diagnóstico de outra.OBJECTIVE: To discuss the early diagnosis of behavioral disorders in childhood and adolescence and to provide the pediatrician with practical knowledge about the first symptoms of the main behavioral disorders at this age. SOURCES OF DATA: PubMed (emphasis on the past decade. SUMMARY OF THE FINDINGS

  12. Tendências da mortalidade neonatal em São Luís, Maranhão, Brasil, de 1979 a 1996 Neonatal mortality trends in São Luís, Maranhão, Brazil, from 1979 to 1996

    Directory of Open Access Journals (Sweden)

    Valdinar Sousa Ribeiro

    2000-06-01

    Full Text Available O propósito do presente trabalho é avaliar a evolução da mortalidade neonatal em São Luís nos últimos 18 anos, classificá-la de acordo com os dias de vida e pelo critério de evitabilidade de óbitos da Fundação SEADE, a partir de dados do IBGE e do Ministério da Saúde. Detectou-se aumento da mortalidade neonatal, às custas de aumento expressivo do seu componente precoce, especialmente pelas causas reduzíveis por diagnóstico e tratamento precoce, e parcialmente reduzíveis por adequado controle da gravidez. A mortalidade infantil, desse modo, manteve-se inalterada, apesar do decréscimo do seu componente pós-neonatal. O aumento expressivo no coeficiente de mortalidade neonatal a partir de 1995 aponta para a queda na qualidade da assistência obstétrica e neonatal, talvez motivada pelo elevado percentual de cesáreas e pela superlotação dos berçários. A tendência de estabilidade ou aumento da mortalidade neonatal é semelhante à observada recentemente no Brasil como um todo e difere da observada em outras cidades brasileiras, nas quais foi descrita queda lenta, mas persistente, da mortalidade neonatal, em oposição a uma redução mais dramática em países desenvolvidos.This study examined neonatal mortality trends in São Luís in the last 18 years. The early and late components were assessed and causes were classified according to SEADE Foundation criteria based on reducibility of deaths and timing of prevention (during prenatal care, childbirth, or neonatal care. Data were derived from official live birth and death records. We detected an unexpected increase in the neonatal mortality rate, due primarily to a steep rise in early neonatal deaths. Causes reducible by early diagnosis and treatment (other specific infections and other neonatal respiratory causes and those partially reducible by adequate monitoring of pregnancy (preterm births, low birth weight, and respiratory distress syndrome showed the largest increase

  13. Neonatal Hyperglycemia due to Transient Neonatal Diabetes Mellitus in Puerto Rico

    OpenAIRE

    Fargas-Berríos, N.; García-Fragoso, L.; García-García, I.; Valcárcel, M.

    2015-01-01

    Neonatal hyperglycemia is a metabolic disorder found in the neonatal intensive care units. Neonatal diabetes mellitus (NDM) is a very uncommon cause of hyperglycemia in the newborn, occurring in 1 in every 400,000 births. There are two subtypes of neonatal diabetes mellitus: permanent neonatal diabetes mellitus (PNDM) and transient neonatal diabetes mellitus (TNDM). We describe a term, small for gestational age, female neonate with transient neonatal diabetes mellitus who presented with poor ...

  14. Reflexões sobre precoces, prodígios, gênios e as altas habilidades, com base na neurociência cognitiva

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo Paulino

    2011-10-01

    Full Text Available Em Educação Especial, altas habilidades designam pessoas que demonstram capacidades, potenciais ou desempenho, em atividades humanas, bem acima da média. Objetivamos, utilizando-se da neurociência, entender os precoces, prodígios, gênios e altas habilidades como resultantes de um processo único das formações da memória. Trata-se de uma pesquisa bibliográfica, em que as obras foram identificadas, localizadas, compiladas, fichadas e analisadas. O material foi localizado a partir de palavras-chave em bases de dados. Para a compilação, foram utilizados, como critério de inclusão, a intersecção dos unitermos adotados, bem como os trabalhos de pesquisadores da educação, psicologia e neurociência, publicados entre 1966 e 2009. Analisamos qualitativamente 40 referências, sendo 18 artigos e 22 outros textos. A trajetória de análise foi desenvolvida tendo a questão norteadora: há necessidade de se explicar diferentemente os precoces, prodígios, gênios e as AH? Chegamos a três proposições lógicas. Procuramos demonstrar, por meio desse exercício lógico, que não haveria necessidade de se explicar diferentemente os precoces, prodígios, gênios e as AH, mas concluímos que há necessidade de tais diferenciações, mesmo dentro da área da neurociência, no entanto, a demonstração acima aponta para a teoria de Renzulli como válida para gênios e AH, com ressalvas para precoces e prodígios, que merecem um olhar mais aprofundado.Palavras-chave: Altas habilidades. Memória. Neurociência cognitiva. Neurotransmissores.

  15. Ocorrência precoce da mosca das frutas em ameixas Incidence of the southamerican fruit fly on plums

    Directory of Open Access Journals (Sweden)

    Luiz Antonio Salles

    1999-06-01

    Full Text Available O objetivo deste estudo foi verificar qual o estágio fenológico mais precoce da fruta de ameixeira em que ocorreria o ataque de mosca das frutas Anastrepha fraterculus. Os estudos foram conduzidos em plantas adultas de ameixeira, expondo-se fêmeas grávidas da mosca das frutas, confinadas em gaiolas com frutos protegidos do ataque natural. Cinco cultivares de ameixeira foram estudados (Amarelinha, Pluma 7, Reubennel, Santa Rosa e Wade. Essa praga ataca frutos de qualquer um dos cultivares logo nos primeiros estádios do desenvolvimento, quando os mesmos têm somente cerca de 2 a 3cm de diâmetro.The incidence of the southamerican fruit fly, Anastrepha fraterculus, on plum cultivars is reported. The objective of this study was to know the earliest fruit phase that fly attack could occur. Fertilized females were confined with fruits in plum trees in an orchard. Five plums cultivars were studied: Amarelinha; Pluma 7; Reubennel; Santa Rosa and Wade. This pest attack fruits during first stages of their development, mainly they have only from 2 to 3 centimeters of diameter.

  16. Puberdade precoce causada por tumores intracranianos: relato de 4 casos Pubertas praecox due to intracranial tumors: report of 4 cases

    Directory of Open Access Journals (Sweden)

    Reynaldo A. Brandt

    1974-12-01

    Full Text Available São relatados 4 casos de puberdade precoce conseqüentes a tumores intracranianos: um teratoma adulto do ventrículo lateral, um astrocitoma protoplasmático do terceiro ventrículo e diencéfalo, um astroblastoma do ter- ceiro ventrículo e diencéfalo e um hamartoma hipotalâmico. São apresentadas teorias que tentam explicar os mecanismos hormonais envolvidos e é salientada a importância do diagnóstico neuroradiológico preciso, pela possibilidade de cura em alguns casos e de tratamento satisfatório nos demais.Four cases of precocious puberty secondary to intracranial tumors are reported. A 3 year and 11 month old boy had a teratoma in the left lateral ventricle and total surgical excision was followed by recovery. An 8 year old girl with a protoplasmic astrocytoma of the third ventricle diagnosed by biopsy, followed by shunting and cobalt therapy was discharged improved. A five year old boy with an extensive astroblastoma of the diencephalon died following biopsy and shunting of cerebrospinal fluid. A posterior hypothalamic hamartoma totally excised from a 3 year old girl was followed by remission of the precocious puberty. The theories of hormonal mechanisms leading to precocious puberty are presented. It is stressed the importance of pneumoencephalography in the diagnosis of intracranial hamartomas, for they lack neurological signs.

  17. Considerações sobre o diagnóstico precoce na clínica do autismo e das psicoses infantis

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    Paola Visani

    2012-06-01

    Full Text Available Este artigo se refere a uma pesquisa de Iniciação Científica. Esta se baseou na teoria de Marie-Christine Laznik para investigar, por meio do estudo de prontuários, como aconteceu em um Centro de Atenção Psicossocial Infantil, localizado no município de São Paulo, o diagnóstico precoce do autismo e das psicoses infantis e como se deu a trajetória destas famílias até a chegada à instituição. A pesquisa revelou que o início do tratamento de crianças autistas e psicóticas se dá de maneira tardia em consequência da não realização da detecção precoce, da demora por parte de profissionais e/ou instituições de saúde em dar um diagnóstico formal e realizar um encaminhamento e da insegurança dos profissionais da saúde para lidar com estas psicopatologias graves. Os resultados desse trabalho ajudam a pensar ações futuras e necessidades de maior concentração de esforços para que o tratamento do autismo e das psicoses infantis possa acontecer de maneira cada vez mais precoce, frente a quadros não cronificados.

  18. Congenital hypothyroidism in neonates

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    Aneela Anjum

    2014-01-01

    Full Text Available Context: Congenital hypothyroidism (CH is one of the most common preventable causes of mental retardation in children and it occurs in approximately 1:2,000-1:4,000 newborns. Aims and Objectives: The aim of this study is to determine the frequency of CH in neonates. Settings and Design: This cross-sectional study was conducted in neonatal units of the Department of Pediatrics Unit-I, King Edward Medical University/Mayo Hospital, Lahore and Lady Willington Hospital Lahore in 6 months (January-June 2011. Materials and Methods: Sample was collected by non-probability purposive sampling. After consent, 550 newborn were registered for the study. Demographic data and relevant history was recorded. After aseptic measures, 2-3 ml venous blood analyzed for thyroid-stimulating hormone (TSH level by immunoradiometric assay. Treatment was started according to the individual merit as per protocol. Statistical Analysis Used: Data was analyzed by SPSS 17 and Chi-square test was applied to find out the association of CH with different variables. Results: The study population consisted of 550 newborns. Among 550 newborns, 4 (0.8% newborns had elevated TSH level. CH had statistically significant association with mother′s hypothyroidism (P value 0.000 and mother′s drug intake during the pregnancy period (P value 0.013. Conclusion: CH is 0.8% in neonates. It has statistically significant association with mother′s hypothyroidism and mother′s drug intake during pregnancy.

  19. Telemedicine in Neonatal Home Care

    DEFF Research Database (Denmark)

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

    2016-01-01

    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......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...

  20. 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 ...

  1. 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

  2. REVISÃO SISTEMÁTICA INTEGRATIVA DA LITERATURA SOBRE MODELOS E PRÁTICAS DE INTERVENÇÃO PRECOCE NO BRASIL

    Directory of Open Access Journals (Sweden)

    Bruna Pereira Ricci Marini

    2017-09-01

    Full Text Available RESUMO Objetivo: Identificar quais práticas e modelos de Intervenção Precoce na Infância estão descritos na literatura científica brasileira. Fontes de dados: Realizou-se uma revisão sistemática integrativa da literatura indexada entre 2005 e 2015 nas bases Biblioteca Virtual em Saúde, Bielefeld Academic Search Engine, Education Resources Information Center e Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Ensino Superior. Foram incluídos artigos publicados em língua inglesa ou portuguesa, na íntegra e disponibilizados online que: contivessem os termos “Intervenção Precoce” ou “Estimulação Precoce” ou “Estimulação Essencial” no título, resumo ou palavras-chave; contassem como participantes crianças de 0 a 6 anos, seus cuidadores ou profissionais de serviços de Intervenção Precoce; estivessem indexados em uma revista com classificação igual ou superior a B2, segundo avaliação do WebQualis (Qualis 2014, para as áreas de Educação ou Educação Física; e descrevessem práticas de Intervenção Precoce. Síntese dos dados: Verifica-se que a Intervenção Precoce parece desenvolver-se exclusivamente aliada ao setor da saúde, com prevalência de práticas voltadas à estimulação de habilidades, com enfoque centrado na criança, estruturadas a partir de um modelo reabilitativo de cuidado e do emprego de abordagens clínicas. Conclusões: Os resultados apontam para a adoção de práticas e modelos de Intervenção Precoce distantes daqueles recomendados e reconhecidos como boas práticas pela literatura internacional. Nesse sentido, aponta-se a necessidade da atualização dos profissionais que atuam nessa área, bem como do investimento em pesquisas que incidam sobre a temática.

  3. Nutrição precoce de neonatos prematuros estáveis e pequenos para a idade gestacional: um ensaio clínico randomizado

    Directory of Open Access Journals (Sweden)

    Shmuel Arnon

    2013-08-01

    Full Text Available OBJETIVO: Examinar o efeito da nutrição precoce sobre o tempo para atingir a nutrição completa em neonatos prematuros (PIG estáveis pequenos para a idade gestacional. MÉTODO: Os neonatos prematuros com idade gestacional inferior a 37 semanas e peso ao nascer inferior a 10% foram alocados aleatoriamente para um regime de nutrição precoce (nas primeiras 24 horas de vida ou tardia (após as primeiras 24 horas de vida. Todos os neonatos apresentaram uma evidência intrauterina de fluxo diastólico reverso ou ausente. Os neonatos incapazes de iniciar uma nutrição precoce foram excluídos. O tempo para a alimentação completa, a progressão da nutrição e morbidez correspondente foram comparados. A eletrogastrografia (EGG foi utilizada para mensurar a motilidade gástrica pré e pós-prandial no segundo e no sétimo dias após o início da nutrição. RESULTADOS: Foram incluídos 60 neonatos no estudo, sendo 30 em cada grupo. Os neonatos incluídos no regime de nutrição precoce atingiram a nutrição enteral completa antes dos neonatos do grupo de controle (98±80-157 em comparação a 172±1 23-261 horas de idade, respectivamente; p = 0,004 e recebiam alta hospitalar antes (p = 0,04. Nenhuma enterocolite necrosante (ECN foi comprovada em ambos os grupos de estudo. A motilidade gástrica melhorou no sétimo dia após o início da nutrição em ambos os grupos de estudo, sem diferença entre eles. CONCLUSÕES: Os neonatos prematuros PIG estáveis em regime de nutrição precoce atingiram alimentação enteral completa e receberam alta hospitalar significativamente antes que aqueles em regime de nutrição tardio, sem morbidez excedente.

  4. Uso de drogas entre trabalhadores precoces na atividade de malabares Uso de drogas entre trabajadores precoces en la actividad de malabarista Use of drugs between precocious workers in the activity of jugglers

    Directory of Open Access Journals (Sweden)

    Daniele Cristine da Silva Cirino

    2009-09-01

    Full Text Available O presente estudo objetiva identificar os fatores que motivam o uso de drogas entre meninos trabalhadores em condição de rua na cidade de João Pessoa - PB, caracterizar a atividade de trabalho de malabares e relacionar o trabalho precoce e o uso de drogas com as perspectivas de futuro destes sujeitos. A pesquisa desenvolveu-se através da territorialização, observação e registro assistemático e entrevistas semiestruturadas, com dados analisados a partir da análise de conteúdo de Bardin (1979. Foram entrevistados seis sujeitos, entre 11 e 16 anos, todos do sexo masculino. As drogas utilizadas por eles foram bebidas alcoólicas, cigarro, cola e maconha. Os motivos para o uso foram a imposição do grupo e o desconhecimento dos reais efeitos das drogas. Constatamos ainda que, para os trabalhadores precoces no setor informal urbano, há construção de perspectivas de futuro, vislumbradas através da inserção profissional quando adultos, possível de se concretizar a partir da escola.Esta investigación trata de identificar los factores que motivan el uso de drogas entre niños trabajadores en condición de calle de la ciudad de João Pessoa - PB; caracterizar la actividad de trabajo de malabaristas y relacionar trabajo precoz y uso de drogas con las perspectivas de futuro de estos niños. Se utilizó como técnicas: "territorialización" (conocimiento previo del sitio, observación y registro no sistemáticos y entrevistas semidirigidas, con datos analizados por medio del análisis de contenido de Bardin (1979. Fueron entrevistados 06 niños, entre 11 y 16 años, del sexo masculino. Las drogas utilizadas por ellos fueron bebidas alcohólicas, cigarrillo, inhalantes y marihuana. Los motivos para el uso fueron: imposición del grupo y desconocimiento de los efectos reales de las drogas. Constatamos, todavía, que existe construcción de perspectivas de futuro para estos trabajadores a partir de la inserción profesional cuando adultos

  5. Gestantes colonizadas pelo Streptococcus do grupo B e seus recém-nascidos: análise crítica da conduta adotada no Instituto Fernandes Figueira, Fundação Oswaldo Cruz Beta-hemolytic streptococcus in pregnant women and their newborn infants: a critical analysis of the protocol used at Fernandes Figueira Institute, Oswaldo Cruz Foundation, in Brazil

    Directory of Open Access Journals (Sweden)

    Natalie Del-Vecchio L. Costa

    2010-06-01

    Full Text Available OBJETIVO: Avaliar a aplicação do protocolo do Centers of Disease Control (CDC, 2002 quanto à profilaxia da sepse neonatal precoce por Streptococcus do grupo B (SGB. MÉTODOS: Estudo retrospectivo com revisão de prontuários de 125 gestantes colonizadas pelo SGB e 133 recém-nascidos, no período de janeiro/2003 a dezembro/2006. A conduta intraparto foi considerada correta quando a gestante recebia antibioticoprofilaxia pelo menos quatro horas antes do parto, ou quando não recebia, mas era submetida a parto cesáreo eletivo. A conduta intraparto foi considerada incorreta quando a gestante recebia antibioticoprofilaxia menos de quatro horas antes do parto, a prescrição antibiótica estava incorreta ou quando não havia profilaxia prescrita. RESULTADOS: A prevalência de colonização materna pelo SGB foi de 4,7%. A época de coleta do swab vaginal/retal variou entre 14 e 40 semanas de gestação, com média de 32 semanas. Das gestantes colonizadas, 54 (43% receberam conduta intraparto correta. Dos 133 recém-nascidos estudados, 95 (71% receberam avaliação diagnóstica corretamente, 17 (13% evoluíram com sepse clínica e um (0,75% apresentou sepse comprovada. A incidência de sepse foi maior em recém-nascidos cujas mães não receberam profilaxia intraparto corretamente, porém esta associação não apresentou diferença estatística significativa (18 versus 7%, p>0,05. CONCLUSÕES: Apesar de o protocolo para prevenção de sepse precoce pelo SGB estar implementado na instituição, ainda é possível observar falhas na profilaxia intraparto materna. Essas falhas representam oportunidades perdidas na prevenção da sepse precoce pelo SGB.OBJECTIVE: To evaluate the use of the guidelines of the Centers of Disease Control (CDC, 2002 regarding the prophylaxes of group B Streptococcus (GBS early onset neonatal sepsis. METHODS: We conducted a retrospective study by chart review of 125 pregnant women colonized by GBS and 133 neonates born at a

  6. Volume and leak measurements during neonatal CPAP in neonates

    OpenAIRE

    Fischer, Hendrik S.

    2011-01-01

    As yet, little is known about the effects of air leakages during CPAP in newborns. The present doctoral dissertation investigates tidal volume and leak measurements during nasal continuous positive airway pressure in neonates using a commercial ventilatory device. Investigations include in vitro studies, modelling and computer simulation as well as a clinical randomized cross-over trial in neonates.

  7. 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.

  8. Análise de desempenho do Programa de Triagem Neonatal do Estado do Rio de Janeiro, Brasil, de 2005 a 2007 Performance analysis of the Rio de Janeiro State Neonatal Screening Program, 2005-2007

    Directory of Open Access Journals (Sweden)

    Judy Botler

    2011-12-01

    Full Text Available As diretrizes enfatizam o momento adequado para a coleta do teste de triagem neonatal entre o 3º e o 7º dias de vida, em 100% dos recém-natos. O tratamento do hipotireoidismo congênito e da fenilcetonúria iniciado até 2 semanas de vida é capaz de evitar as sequelas neurológicas dessas doenças. O programa de triagem neonatal do Estado do Rio de Janeiro foi credenciado para Fase II do Programa Nacional de Triagem Neonatal com dois modelos de programa - modelo A e modelo B. Foi realizada análise de desempenho do PTN de 2005 a 2007. Entre 2002 e 2007, a cobertura foi crescente e chegou a 80,4%, com 33,8% das coletas realizadas até 7 dias. Ambos os modelos tiveram desempenhos semelhantes e aquém das metas preconizadas, com 50% dos casos confirmados obtendo diagnóstico com mais de 48 dias de vida. Os atrasos acumulados nas diversas etapas do processo podem anular os benefícios da detecção precoce, fundamento da triagem neonatal. Os efeitos deletérios de longo prazo transcendem a esfera individual acarretando impacto no sistema de saúde e grande ônus social.Guidelines emphasize that the appropriate time frame for neonatal screening with the heel stick test is from the 3rd to 7th day of life, in 100% of newborns. Treatment for congenital hypothyroidism and phenylketonuria, when initiated in the first two weeks of life, is capable of preventing the neurological sequelae of these diseases. The Rio de Janeiro State Neonatal Screening Program was accredited for Phase 2 of the National Neonatal Screening Program, with two program models (A and B. A performance analysis was conducted for the Neonatal Screening Program, for the years 2005 to 2007. Coverage increased from 2002 to 2007, reaching 80.4%, with 33.8% of the blood samples drawn in the first 7 days of life. The two models showed similar performance, short of the targets, with 50% of the confirmed cases receiving their diagnosis at more than 48 days of life. The delays accumulated in

  9. Release to farmers of ''Carioca Arbustivo Precoce 1070'' (CAP-1070), a bushy bean mutant induced by gamma rays in Brazil

    International Nuclear Information System (INIS)

    Tulmann Neto, A.; Albertini, J.

    1989-01-01

    Full text: Seeds of the indeterminate growth type bean cultivar ''Carioca'' have been treated with 32 krad gamma rays. In M 2 , a mutant showing bushy growth type has been selected. The mutant also shows earlier maturity (5-14 days) and therefore was called ''Carioca Arbustivo Precoce 1070'' (CAP-1070). The determinate (bushy) growth habit is due to one recessive gene and earliness is associated with this habit. CAP-1070 maintained the same response to diseases as the original cultivar. In trials carried out in several states of Brazil, yield was lower, similar or greater than ''Carioca'' depending on conditions. The short flowering period of CAP-1070, resulting from the bushy growth habit may reduce grain yields but under favourable circumstances, CAP-1070 may yield more than other varieties. CAP-1070 raised great interest among farmers visiting experimental fields of F.T. Pesquisa e Sementes, a private plant breeding firm at Ponta Grossa, Parana. Therefore, the firm decided to multiply the seeds and distribute them to farmers, who have now been cultivating CAP-1070 since 1986 between coffee rows. The CAP-1070 is the first induced bean mutant cultivated by farmers in Brazil. However, like the original cultivar ''Carioca'', CAP-1070 became susceptible to diseases. Therefore, we crossed the mutant and have obtained promising lines with bushy habits, disease resistance and higher yield. CAP-1070 is also used in cross-breeding programmes of Government research institutes in Brazil. Research was supported by IAEA under Research Contract No. 2195/SD, EMBRAPA, CNEN and CNPQ. (author)

  10. Distrofia oftalmoplégica progressiva. Forma de inicio ocular precoce e comprometimento muscular universal tardio Progressive ophthalmoplegic dystrophy

    Directory of Open Access Journals (Sweden)

    João P. Rodrigues

    1968-03-01

    Full Text Available É estudada uma forma particular de distrofia muscular progressiva — forma óculo-faríngea — cujo diagnóstico foi comprovado mediante traçados eletromiográficos e biópsia do músculo orbicular da pálpebra. São analisadas as duas formas de distrofias oftalmoplégicas: 1 miopatia ocular; 2 miopatia óculo-faríngea. A forma óculo-faríngea é mais rara, incide em idades mais avançadas (média de 40 anos em comparação com a forma ocular pura (média de 23 anos; além disso, é ressaltada a alta incidência familiar daquela forma de miopatia. O caso ora registrado parece ser um élo entre as duas formas, pois o início foi precoce, sem incidência familiar e com comprometimento da deglutição e de músculos da face, pescoço, tronco, cintura escapular, pélvica e dos membros.A case of peculiar form of progressive muscular dystrophy — the oculopharyngeal one — is reported. The diagnosis was ascertained by electromiography and biopsy of orbicularis palpebrae muscle. Two forms of ophthalmoplegic dystrophy are analysed: 1 ocular myopathy and 2 oculopharyngeal miopathy. The latter is less frequent, occurring on patients in the fourth decade, in comparison with the pure ocular form affecting patients in the second decade. Besides this, the high familial incidence of the oculo-pharyngeal form is stressed. The reported case seems to be an intermediate form between them. The onset occurred at 11 years of age; there was no other case in the family, the disease involving swallowing, face, neck, trunk, shoulder, pelvic and members muscles.

  11. 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.

  12. NEONATES (BIRTH – 1 MONTH)

    African Journals Online (AJOL)

    Chantel

    Major defects in neonatal skin have serious consequences for the health of the baby, but fortunately these are very rare. Early diagnosis of the genodermatoses can be life-saving. Birthmarks, also known as naevi, are usually first noted in neonates, and can be very alarming for parents. A variety of infections can.

  13. Developments in neonatal care and nursing responses.

    Science.gov (United States)

    Healy, Patricia; Fallon, Anne

    This article reviews the origins and evolution of neonatology and considers the role of the neonatal nurse within this specialty. Neonatal nurses are a vital part of the neonatal team that provides care for sick babies. The nursing care required by sick babies and their families on a neonatal unit can be variable and complex. The past century has seen significant changes in the role of the neonatal nurse. This has come about through dramatic technological developments on neonatal units, an increased understanding of neonatal physiology and pathology, changes in the education of neonatal nurses, and active and ongoing clinical research within the specialty. The resulting significant advances in neonatal care, including that provided by neonatal nurses, have made a crucial and steadfast contribution to marked improvements in neonatal outcomes.

  14. 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.

  15. 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

  16. Update on neonatal hypoglycemia.

    Science.gov (United States)

    Rozance, Paul J

    2014-02-01

    Neonatal hypoglycemia is one of the most common biochemical abnormalities encountered in the newborn. However, controversy remains surrounding its definition and management especially in asymptomatic patients. New information has been published that describes the incidence and timing of low glucose concentrations in the groups most at risk for asymptomatic neonatal hypoglycemia. Furthermore, one large prospective study failed to find an association between repetitive low glucose concentrations and poor neurodevelopmental outcomes in preterm infants. But hypoglycemia due to hyperinsulinism, especially genetic causes, continued to be associated with brain injury. New advances were made in the diagnosis and management of hyperinsulinism, including acquired hyperinsulinism in small for gestational age infants and others. Continuous glucose monitoring remains an attractive strategy for future research in this area. The fundamental question of how best to manage asymptomatic newborns with low glucose concentrations remains unanswered. Balancing the risks of overtreating newborns with low glucose concentrations who are undergoing a normal transition following birth against the risks of undertreating those in whom low glucose concentrations are pathological, dangerous, and/or a harbinger of serious metabolic disease remains a challenge.

  17. 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.

  18. Neonatal sigmoid volvulus.

    Science.gov (United States)

    Khalayleh, Harbi; Koplewitz, Benjamin Z; Kapuller, Vadim; Armon, Yaron; Abu-Leil, Sinan; Arbell, Dan

    2016-11-01

    Neonatal sigmoid volvulus is a rare entity. It is associated with Hirschsprung's disease. Presentation is acute abdominal distention, vomiting and obstipation. Abdominal radiograph will show the "coffee bean" sign, but this is frequently missed and the diagnosis requires a high index of suspicion. Treatment options include contrast enema, colonoscopy or laparotomy, depending on the condition of the baby and local availability. During the last 6years, 6 infants with sigmoid volvulus were treated in our department. Four presented during the first 48h since birth, and 2 presented at the age of 2 and 7weeks of age. One child was operated and 5 had primary contrast enema with radiologic de-volvulus. Rectal biopsy was performed in all cases; three children had Hirschsprung's disease. Those with normal biopsies responded well to rectal washouts. Two patients had early one stage transanal pullthrough and one had 2 further occasions of sigmoid volvulus prior to definitive surgery. All three recovered with an uneventful course. Neonatal sigmoid volvulus requires a high level of suspicion. Contrast enema is efficient for primary de-volvulus. Rectal biopsy should be performed and if positive for Hirschsprung's disease, surgery should be performed sooner rather than later. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Neonates need tailored drug formulations.

    Science.gov (United States)

    Allegaert, Karel

    2013-02-08

    Drugs are very strong tools used to improve outcome in neonates. Despite this fact and in contrast to tailored perfusion equipment, incubators or ventilators for neonates, we still commonly use drug formulations initially developed for adults. We would like to make the point that drug formulations given to neonates need to be tailored for this age group. Besides the obvious need to search for active compounds that take the pathophysiology of the newborn into account, this includes the dosage and formulation. The dosage or concentration should facilitate the administration of low amounts and be flexible since clearance is lower in neonates with additional extensive between-individual variability. Formulations need to be tailored for dosage variability in the low ranges and also to the clinical characteristics of neonates. A specific focus of interest during neonatal drug development therefore is a need to quantify and limit excipient exposure based on the available knowledge of their safety or toxicity. Until such tailored vials and formulations become available, compounding practices for drug formulations in neonates should be evaluated to guarantee the correct dosing, product stability and safety.

  20. 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

  1. Placa de Castillo Morales: uso precoce e qualidade de vida da criança com Síndrome de Down

    OpenAIRE

    Santana, Ana Luísa Rato

    2015-01-01

    Dissertação para obtenção do grau de Mestre no Instituto Superior de Ciências da Saúde Egas Moniz Com este trabalho pretende-se, mostrar a importância da terapia precoce da regulação orofacial com o uso de Placa Palatina Castillo-Morales, em pacientes com Síndrome de Down, e avaliar as alterações e benefícios do uso desta placa para uma melhor Qualidade de Vida. A Placa de Castillo-Morales é utilizada como um complemento para a estimulação orofacial, sendo, especialmente usada em pacien...

  2. REVISÃO SISTEMÁTICA INTEGRATIVA DA LITERATURA SOBRE MODELOS E PRÁTICAS DE INTERVENÇÃO PRECOCE NO BRASIL

    OpenAIRE

    Bruna Pereira Ricci Marini; Mariane Cristina Lourenço; Patrícia Carla de Souza Della Barba

    2017-01-01

    RESUMO Objetivo: Identificar quais práticas e modelos de Intervenção Precoce na Infância estão descritos na literatura científica brasileira. Fontes de dados: Realizou-se uma revisão sistemática integrativa da literatura indexada entre 2005 e 2015 nas bases Biblioteca Virtual em Saúde, Bielefeld Academic Search Engine, Education Resources Information Center e Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Ensino Superior. Foram incluídos artigos publicados em língua ...

  3. Videovigilância inteligente em ambientes aquáticos : detecção precoce de afogamento em piscinas domésticas

    OpenAIRE

    Peixoto, Nuno Pedro Rodrigues

    2010-01-01

    Tese de doutoramento (área de Informática Industrial) Neste documento, apresenta-se um conjunto de trabalhos relativos à utilização de videovigilância inteligente para a análise de comportamentos humanos em ambientes aquáticos, orientado à detecção precoce de afogamento em piscinas domésticas. Recorrendo a imagens de vídeo capturadas com uma câmara comum de videovigilância e um computador pessoal para efectuar todas as análises necessárias ao reconhecimento de pessoas e à infer...

  4. Influência regional no consumo precoce de alimentos diferentes do leite materno em menores de seis meses residentes nas capitais brasileiras e Distrito Federal

    OpenAIRE

    Saldiva,Silvia Regina Dias Medici; Venancio,Sonia Isoyama; Gouveia,Ana Gabriela Cepeda; Castro,Ana Lucia da Silva; Escuder,Maria Mercedes Loureiro; Giugliani,Elsa Regina Justo

    2011-01-01

    Objetivou-se avaliar a influência regional no consumo precoce de alimentos diferentes do leite materno em menores de seis meses residentes nas capitais brasileiras. Analisaram-se dados de 18.929 crianças da II Pesquisa de Prevalência de Aleitamento Materno nas Capitais Brasileiras - 2008. As frequências do consumo de chá, sucos, leite artificial e mingau/papa foram calculadas para as capitais das cinco regiões brasileiras. Curvas do consumo foram obtidas pela análise de logitos e estimativas ...

  5. [Neonatal tumours and congenital malformations].

    Science.gov (United States)

    Berbel Tornero, O; Ortega García, J A; Ferrís i Tortajada, J; García Castell, J; Donat i Colomer, J; Soldin, O P; Fuster Soler, J L

    2008-06-01

    The association between pediatric cancer and congenital abnormalities is well known but, there is no exclusive data on the neonatal period and the underlying etiopathogenic mechanisms are unknown. First, to analyze the frequency of neonatal tumours associated with congenital abnormalities; and second, to comment on the likely etiopathogenic hypotheses of a relationship between neonatal tumours and congenital abnormalities. Historical series of neonatal tumours from La Fe University Children's Hospital in Valencia (Spain), from January 1990 to December 1999. Histological varieties of neonatal tumours and associated congenital abnormalities were described. A systematic review of the last 25 years was carried out using Medline, Cancerlit, Index Citation Science and Embase. The search profile used was the combination of "neonatal/congenital-tumors/cancer/neoplasms" and "congenital malformations/birth defects". 72 neonatal tumours were identified (2.8% of all pediatric cancers diagnosed in our hospital) and in 15 cases (20.8%) there was some associated malformation, disease or syndrome. The association between congenital abnormalities and neonatal tumours were: a) angiomas in three patients: two patients with congenital heart disease with a choanal stenosis, laryngomalacia; b) neuroblastomas in two patients: horseshoe kidney with vertebral anomalies and other with congenital heart disease; c) teratomas in two patients: one with cleft palate with vertebral anomalies and other with metatarsal varus; d) one tumour of the central nervous system with Bochdaleck hernia; e) heart tumours in four patients with tuberous sclerosis; f) acute leukaemia in one patient with Down syndrome and congenital heart disease; g) kidney tumour in one case with triventricular hydrocephaly, and h) adrenocortical tumour: hemihypertrophy. The publications included the tumours diagnosed in different pediatric periods and without unified criteria to classify the congenital abnormalities. Little data

  6. Abdominal surgery in neonatal foals.

    Science.gov (United States)

    Bryant, James E; Gaughan, Earl M

    2005-08-01

    Abdominal surgery in foals under 30 days old has become more common with improved neonatal care. Early recognition of a foal at risk and better nursing care have increased the survival rates of foals that require neonatal care. The success of improved neonatal care also has increased the need for accurate diagnosis and treatment of gastrointestinal, umbilical, and bladder disorders in these foals. This chapter focuses on the early and accurate diagnosis of specific disorders that require abdominal exploratory surgery and the specific treatment considerations and prognosis for these disorders.

  7. Maternal or neonatal infection: association with neonatal encephalopathy outcomes.

    Science.gov (United States)

    Jenster, Meike; Bonifacio, Sonia L; Ruel, Theodore; Rogers, Elizabeth E; Tam, Emily W; Partridge, John Colin; Barkovich, Anthony James; Ferriero, Donna M; Glass, Hannah C

    2014-07-01

    Perinatal infection may potentiate brain injury among children born preterm. The objective of this study was to examine whether maternal and/or neonatal infection are associated with adverse outcomes among term neonates with encephalopathy. This study is a cohort study of 258 term newborns with encephalopathy whose clinical records were examined for signs of maternal infection (chorioamnionitis) and infant infection (sepsis). Multivariate regression was used to assess associations between infection, pattern, and severity of injury on neonatal magnetic resonance imaging, as well as neurodevelopment at 30 mo (neuromotor examination, or Bayley Scales of Infant Development, second edition mental development index encephalopathy, chorioamnionitis was associated with a lower risk of brain injury and adverse outcomes, whereas signs of neonatal sepsis carried an elevated risk. The etiology of encephalopathy and timing of infection and its associated inflammatory response may influence whether infection potentiates or mitigates injury in term newborns.

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

    African Journals Online (AJOL)

    admin

    mortality and they have been the reasons for the wide variation in mortality rates among the health facilities reporting. Objective: ... A study in Indonesia about determinants of neonatal ..... antenatal visit, frequency of visits and administration of.

  9. Does early career achievement lead to earlier death? Assessment of the precocity-longevity effect in professional basketball players

    Directory of Open Access Journals (Sweden)

    Nick Wattie

    2016-11-01

    Full Text Available Objectives: To examine the precocity-longevity (P-L effect in North American professional basketball players who debuted between 1946 and 1979, and to determine whether playing position and decade of play influenced the relationship between age of career achievements and lifespan. Methods: 1852 players were evaluated from a recognized sports archive (i.e., sports-reference.com, which provided information on date of birth, death, and career debut, playing position, and indicators of achievement (i.e., All-Star team and/or All-League team selection. Athletes were categorized as above or below the median age of professional debut, and median age of selection to first All-Star team and/or All-League team. Analyses of deceased players (n = 598 were comprised of bivariate correlations between age of achievement (age of debut, age of first All-Star game and age of first All-League team selection and age of death, and t-tests to compared the average age of death of early and late achievers (p < .05. Survival analyses, using the entire sample (living and deceased players, compared the lifespans between those who debuted above and below the median age of achievement for each indicator of achievement. Results: Only the correlation between age of professional debut and age of death (r = .33, p < .001 and age of first all-star game and age of death (r = .29, p < .05 and the t-test comparing the average death age of early (66.4 y and later (69.3 y debut age groups (p =.01, reached statistical significance. However, survival analyses demonstrated a trend for lower risk of death for early achievers, with one exception (i.e., age of debut this trend was not statistically significant. Conclusions: Results did not support the P-L hypothesis, suggesting that sample characteristics (i.e., physical fitness of high performance athletes, and measurement methodologies, may influence support for the proposed hypothesis in sport. However, future research would benefit

  10. Anormalidades de membros na trissomia do cromossomo 18: evidência para o diagnóstico precoce

    Directory of Open Access Journals (Sweden)

    Rafael F. M. Rosa

    2012-10-01

    Full Text Available OBJETIVO: Verificar a frequência e os tipos de anormalidades de membros observadas entre pacientes com trissomia do cromossomo 18, ou síndrome de Edwards (SE. MÉTODO: A amostra foi constituída de pacientes consecutivos avaliados por um serviço de genética clínica no período entre 1975 e 2008. O resultado da análise citogenética, bem como os dados clínicos, foram coletados a partir dos prontuários médicos, dando-se ênfase aos seus achados de membros. Todos foram submetidos ao exame de cariótipo no mesmo laboratório. RESULTADOS: No período de avaliação, foram identificados 50 pacientes, 33 deles (66% do sexo feminino, com idade na primeira avaliação variando de 1 dia a 16 anos (mediana de 14 dias. A linhagem única com trissomia livre do cromossomo 18 foi a alteração cromossômica predominante (90%. Mosaicismo foi verificado em 10% dos casos. A anormalidade predominante de membros superiores observada na amostra (n = 50 foi o punho cerrado com sobreposição dos dedos (70%. Outras alterações frequentes incluíram a prega palmar única (42% e a hipoplasia das unhas (36%. Anormalidades radiais foram observadas em 11 pacientes (22%. Quanto aos membros inferiores, a hipoplasia de unhas foi a alteração mais comum (58%, seguida do pé em mata-borrão com calcâneo proeminente (50%. Um dos pacientes possuía ainda ectrodactilia unilateral. CONCLUSÕES: Apesar da descrição clássica, as anormalidades de membros podem ser bastante variáveis na SE. Alguns pacientes podem ainda apresentar alterações não usuais, como defeitos radiais e ectrodactilia. Esses achados são de extrema importância para a suspeita e a identificação clínica precoce dos pacientes com a SE.

  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 mucosal immunology.

    Science.gov (United States)

    Torow, N; Marsland, B J; Hornef, M W; Gollwitzer, E S

    2017-01-01

    Although largely deprived from exogenous stimuli in utero, the mucosal barriers of the neonate after birth are bombarded by environmental, nutritional, and microbial exposures. The microbiome is established concurrently with the developing immune system. The nature and timing of discrete interactions between these two factors underpins the long-term immune characteristics of these organs, and can set an individual on a trajectory towards or away from disease. Microbial exposures in the gastrointestinal and respiratory tracts are some of the key determinants of the overall immune tone at these mucosal barriers and represent a leading target for future intervention strategies. In this review, we discuss immune maturation in the gut and lung and how microbes have a central role in this process.

  14. Feeding premature neonate

    DEFF Research Database (Denmark)

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

    2017-01-01

    Kinship, understood as biogenetic proximity, between a chosen animal model and a human patient counterpart, is considered essential to the process of ‘translating’ research from the experimental animal laboratory to the human clinic. In the Danish research centre, NEOMUNE, premature piglets are fed...... 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...... the researchers refer to as the ‘translatability’ of the results. In the NICU, parents of premature infants likewise imagine a kind of interspecies kinship when presented with the option to supplement mother's own milk with bovine colostrum for the first weeks after birth. However, in this setting the NICU...

  15. Neonatal heart rate prediction.

    Science.gov (United States)

    Abdel-Rahman, Yumna; Jeremic, Aleksander; Tan, Kenneth

    2009-01-01

    Technological advances have caused a decrease in the number of infant deaths. Pre-term infants now have a substantially increased chance of survival. One of the mechanisms that is vital to saving the lives of these infants is continuous monitoring and early diagnosis. With continuous monitoring huge amounts of data are collected with so much information embedded in them. By using statistical analysis this information can be extracted and used to aid diagnosis and to understand development. In this study we have a large dataset containing over 180 pre-term infants whose heart rates were recorded over the length of their stay in the Neonatal Intensive Care Unit (NICU). We test two types of models, empirical bayesian and autoregressive moving average. We then attempt to predict future values. The autoregressive moving average model showed better results but required more computation.

  16. Neonatal bartter syndrome

    International Nuclear Information System (INIS)

    Parkash, J.; Salat, S. M.; Khan, I.A.

    2006-01-01

    A pre-term baby girl was born following a pregnancy complicated by severe polyhydramnios at a gestational age of 36 weeks. She was initially suffering from respiratory distress consistent with idiopathic respiratory distress syndrome, and altered electrolyte imbalance with hyponatremia, hypokalemia and hypochloremic metabolic alkalosis. However, during the third week of life when she had dehydration along with significant electrolyte imbalance, Bartter's syndrome was considered which was supported by findings of high renin and aldosterone levels. Treatment was done by correction of electrolytes and dehydration along with indomethacin. The drug was well tolerated. The infant showed correction of electrolyte imbalance. The features of this case suggest an extreme form of Bartter's syndrome presenting from the early days of life. The syndrome is reported because of it's rarity and alerts pediatricians to the antenatal and neonatal variant of Bartter's syndrome. (author)

  17. Neonatal Informatics: Transforming Neonatal Care Through Translational Bioinformatics

    Science.gov (United States)

    Palma, Jonathan P.; Benitz, William E.; Tarczy-Hornoch, Peter; Butte, Atul J.; Longhurst, Christopher A.

    2012-01-01

    The future of neonatal informatics will be driven by the availability of increasingly vast amounts of clinical and genetic data. The field of translational bioinformatics is concerned with linking and learning from these data and applying new findings to clinical care to transform the data into proactive, predictive, preventive, and participatory health. As a result of advances in translational informatics, the care of neonates will become more data driven, evidence based, and personalized. PMID:22924023

  18. Neonatal mortality at Leratong Hospital

    African Journals Online (AJOL)

    unit lacked sufficient NICU equipment. The aims of the ... staff on duty, admission room care for all neonates from the Leratong .... home (29%) or from another facility (4%). ..... The work load, coupled with shortage of trained nurses during.

  19. 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

  20. 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.

  1. Aspectos clínicos da fenilcetonúria em serviço de referência em triagem neonatal da Bahia Clinical aspects of phenylketonuria in a reference service for neonatal screening in Bahia

    Directory of Open Access Journals (Sweden)

    Tatiana Amorim

    2005-12-01

    Full Text Available OBJETIVOS: descrever as características clínicas dos pacientes com hiperfenilalaninemia acompanhados no Serviço de Referência em Triagem Neonatal (SRTN do estado da Bahia. MÉTODOS: estudo descritivo transversal, tendo como amostra todos os pacientes com diagnóstico conhecido de Hiperfenilalaninemia residentes no estado da Bahia e acompanhados no SRTN até setembro de 2005. Tal população é composta de 46 famílias, num total de 51 pacientes. A análise dos dados foi descritiva, incluindo medidas de tendência central e dispersão. RESULTADOS: houve discreto predomínio do gênero feminino (52,9%. A maioria dos pacientes (78,4% teve seu diagnóstico estabelecido através da triagem neonatal, tendo, portanto, tratamento precoce. Consangüinidade foi registrada em 32,6% das famílias. A média de início do tratamento entre os pacientes diagnosticados pela triagem neonatal foi de 56,6 37,8 dias, enquanto que entre os pacientes com diagnóstico tardio, foi de 7,1 anos. CONCLUSÕES: o estudo descreve um grupo de pacientes representativo de uma patologia incluída no Programa Nacional de Triagem Neonatal (PNTN, sendo, portanto, de relevância para a saúde pública. Entre os dados clínicos, chama a atenção a média de idade do início do tratamento, superior ao recomendado na literatura, alertando para a necessidade de um maior enfoque no diagnóstico precoce.OBJECTIVES: to describe clinical aspects of hyper-phenylalaninemia in patients followed up on the Reference Service for Neonatal Screening (SRTN in the state of Bahia. METHODS: cross-sectional study that enrolled all patients living in the state of Bahia and followed up on the SRTN who had a definite diagnosis of hyper-phenylalaninemia prior to September, 2005. That population was made up of 46 families, with 51 patients. The analysis of data was descriptive, using measures of central tendency and dispersion. RESULTS: a discrete predominance of females was found (52.9%. Most patients

  2. Neonatal hypoglycaemia: learning from claims

    OpenAIRE

    Hawdon, Jane M; Beer, Jeanette; Sharp, Deborah; Upton, Michele

    2016-01-01

    Objectives Neonatal hypoglycaemia is a potential cause of neonatal morbidity, and on rare but tragic occasions causes long-term neurodevelopmental harm with consequent emotional and practical costs for the family. The organisational cost to the NHS includes the cost of successful litigation claims. The purpose of the review was to identify themes that could alert clinicians to common pitfalls and thus improve patient safety. Design The NHS Litigation Authority (NHS LA) Claims Management Syste...

  3. PRODUÇÃO DE SEMENTES DE CULTIVARES PRECOCES DE SOJA EM DUAS ÉPOCAS E DOIS LOCAIS PAULISTAS: II. QUALIDADE FISIOLÓGICA

    Directory of Open Access Journals (Sweden)

    MEDINA PRISCILA FRATIN

    1997-01-01

    Full Text Available Tendo em vista os sérios problemas encontrados na qualidade de sementes de soja, principalmente de cultivares precoces produzidas na época de cultivo tradicional no Estado de São Paulo (com semeadura em novembro, este trabalho foi realizado com o objetivo de reunir informações sobre a qualidade fisiológica de sementes de cinco cultivares de ciclo precoce, semeados em duas épocas e regiões distintas do Estado. Assim, sementes dos cultivares IAC-100, IAC-16, IAC-Foscarin-31, BR-4 e IAS-5 foram obtidas de semeaduras realizadas em novembro de 1989 e março/abril de 1990, nos municípios de Campinas e de Votuporanga. A avaliação da qualidade fisiológica, realizada por meio de diferentes testes, após as colheitas e na época de semeadura da safra seguinte, demonstrou que o retardamento da semeadura para o final do verão/início de outono proporcionou a obtenção de sementes com maiores níveis de viabilidade e de vigor em ambas as localidades, sendo que, em Votuporanga, as vantagens foram ainda maiores.

  4. Formação em comunicação aumentativa e alternativa dos profissionais de intervenção precoce: um estudo qualitativo na região norte de Portugal

    OpenAIRE

    Fernandes, Hugo André da Silva Martins

    2014-01-01

    Dissertação de mestrado em Educação Especial (área de especialização em Intervenção Precoce) A capacidade de comunicar permite criar oportunidades de interação, influenciar o comportamento de outros e através disso exercer controlo sobre o meio ambiente da pessoa. Este facto, requere da parte dos profissionais de Intervenção Precoce (IP) um conjunto de competências para intervir junto de crianças com perturbações da comunicação. Este estudo tem por finalidade conhecer as per...

  5. Fatores que contribuem para o desmame precoce Factores que contribuyen para el destete precoz Factors that contribute to early weaning

    Directory of Open Access Journals (Sweden)

    Mirella Teixeira Joca

    2005-12-01

    Full Text Available A interrupção prematura da amamentação pode acarretar perigos, pois os alimentos a serem utilizados são inadequados do ponto de vista nutricional, além de expor a criança a organismos infecciosos. Torna-se relevante investigar os fatores relacionados ao desmame precoce. Pesquisa exploratória e quantitativa, realizada no Centro de Desenvolvimento da Família (CEDEFAM, no período de maio a junho/2003, com 20 nutrizes, no qual foi aplicado um questionário contendo 12 questões sobre os motivos que as levaram a desmamarem precocemente. Os resultados foram agrupados em três segmentos: fatores de desmame relacionados com o perfil; a assistência pré-natal e o parto; e prática do aleitamento materno, e apresentados em forma de tabelas. Concluímos que os profissionais e a sociedade podem não estar preparados para favorecer a mulher no exercício da amamentação. Enquanto isso, a política de saúde não cria condições para que todos tenham acesso à educação, melhoria de renda e conscientização do planejamento familiar.La interrupción precoz del destete puede resultar en peligros, pues los alimentos utilizados son considerados por los nuticionistas como inadecuados, además de exponer al niño a organismos infecciosos. Es muy importante investigar los factores relacionados al desmame. Investigación exploratoria y cuantitativa, realizada en una Unidad de Desarrollo de la Família (CEDEFAM, en el período de mayo hasta junio/2003, con 20 nutrices, cuando fue aplicado un cuestionardo com 12 cuestiones sobre los motivos que que las llevaron al destete precoz. Los resultados fueron agrupados en tres segmentos: factores de destete relacionados con el perfil; la asistencia prenatal y el parto; y práctica de la amamantación materna, y presentados en forma de tabelas. Concluimos que los profesionales y la sociedad pueden no estar preparados para faborecer la mujer en amamantación. Mientras eso ocurre, la política de salud no crea

  6. INVISIBLE MURDERER: NEONATAL TETANUS

    Directory of Open Access Journals (Sweden)

    Yonca SONMEZ

    2006-06-01

    Full Text Available Neonatal tetanus (NNT has been secondary in the whole world in the death list of diseases which can be protected by the help of vaccine. It’s an important community health problem in the less-developed countries in which pre-birth care services are limited, assisting a mother at childbirth by uneducated people in dirty atmosphere and the immunity against tetanus is not enough. Studies have shown that minor part of the cases have been expressed in most of the countries. Because of that NNT have been called as “silent/invisible murderer”. In Turkey, in the year of 2003 it has been seen 15 cases, and 12 of them have been resulted in death. The methods which will be applied to carry out the elimination of NNT are; the vaccination of pregnant women with at least two doses tetanus toxoid and providing clean birth conditions for all of the pregnant women. However, in Turkey the proportion of the women who have two doses of tetanus vaccine is 41%. To eliminate NNT in our country, all the pregnant women must be attained, the ones who are attained must be presented with qualified pre-birth care service which also includes tetanus immunity and the births must be carried out under healty conditions. As smallpox and polio eradication, NNT elimination will also be accomplished by self-sacrificing works of personnel in primary health care. [TAF Prev Med Bull 2006; 5(3.000: 229-233

  7. Neonatal cerebral infarction

    International Nuclear Information System (INIS)

    Fujimoto, Shinji; Togari, Hajime; Sobajima, Hisanori; Suzuki, Shigesumi; Wada, Yoshiro; Yokochi, Kenji; Nishimura, Yutaka; Inukai, Kazuhisa; Futamura, Masahide.

    1992-01-01

    In a retrospective multi-center study, we investigated eighteen infants with unilateral cerebral infarctions confirmed by computed tomography (CT) scans. The initial symptoms were observed in all the patients between 0 and 3 days of age. Convulsions or apneic attacks were the initial symptoms in all but one. Only 4 patients had complicated obstetric histories and none showed polycythemia or electrolyte abnormalities. All of the initial CT scans revealed unilaterally localized hypodense areas. In 10, the initial CT scans were performed within 24 hours after the clinical onset. In 16, the lesions were within the territory of the middle cerebral artery, 9 of which also involved the cortico-spinal tract (CST). In the remaining 2 patients, the lesions were located whithin the territory of the posterior cerebral artery. None of the 9 patients without CST involvement developed hemiplegia, whereas 5 (56%) of the 9 with CST involvement had hemiplegia, which is a fairly low incidence compared with that in adult cases. This difference was thought to be related to neonatal brain plasticity. (author)

  8. Neonatal aortic stenosis.

    Science.gov (United States)

    Drury, Nigel E; Veldtman, Gruschen R; Benson, Lee N

    2005-09-01

    Neonatal aortic stenosis is a complex and heterogeneous condition, defined as left ventricular outflow tract obstruction at valvular level, presenting and often requiring treatment in the first month of life. Initial presentation may be catastrophic, necessitating hemodynamic, respiratory and metabolic resuscitation. Subsequent management is focused on maintaining systemic blood flow, either via a univentricular Norwood palliation or a biventricular route, in which the effective aortic valve area is increased by balloon dilation or surgical valvotomy. In infants with aortic annular hypoplasia but adequately sized left ventricle, the Ross-Konno procedure is also an attractive option. Outcomes after biventricular management have improved in recent years as a consequence of better patient selection, perioperative management and advances in catheter technology. Exciting new developments are likely to significantly modify the natural history of this disorder, including fetal intervention for the salvage of the hypoplastic left ventricle; 3D echocardiography providing better definition of valve morphology and aiding patient selection for a surgical or catheter-based intervention; and new transcutaneous approaches, such as duel beam echo, to perforate the valve.

  9. 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

  10. Sistema hospitalar como fonte de informações para estimar a mortalidade neonatal e a natimortalidade The Brazilian hospital system as a source of information to estimate stillbirth and neonatal mortality rates

    Directory of Open Access Journals (Sweden)

    Joyce MA Schramm

    2000-06-01

    Full Text Available OBJETIVO: Apesar da reconhecida importância em acompanhar a evolução temporal da mortalidade infantil precoce, a deficiência das estatísticas vitais no Brasil ainda permanece na agenda atual dos problemas que impedem o seu acompanhamento espaço-temporal. Realizou-se estudo com o objetivo de investigar o Sistema de Informações Hospitalares (SIH/SUS como fonte de informações, para estimar a natimortalidade e a mortalidade neonatal. MÉTODOS: Propõe-se um método para estimar a natimortalidade e a mortalidade neonatal, o qual foi aplicado para todos os Estados das regiões Nordeste, Sul e Sudeste e para o Pará, no ano de 1995. Para fins comparativos, o Sistema de Informações sobre Mortalidade (SIM/MS foi utilizado para estimar as taxas sob estudo, após a correção do número de nascidos vivos por um método demográfico. RESULTADOS: O SIH/SUS forneceu mais óbitos fetais e neonatais precoces do que o SIM/MS em grande parte das unidades federadas da região Nordeste. Adicionalmente para os Estados localizados nas regiões Sul e Sudeste, que apresentam, em geral, boa cobertura do registro de óbitos, as taxas calculadas pelos dois sistemas de informação tiveram valores semelhantes. CONCLUSÕES: Considerando a cobertura incompleta das estatísticas vitais no Brasil e a agilidade do SIH/SUS em disponibilizar as informações em meio magnético, conclui-se que o uso do SIH/SUS poderá trazer inúmeras contribuições para análise do comportamento espaço-temporal do componente neonatal da mortalidade infantil no território brasileiro, em anos recentes.OBJECTIVE: Studies on the evolution of infant mortality rate are very relevant. Nevertheless, lack of vital statistics in Brazil limits the temporal and spatial analysis of this indicator. This study aims to investigate the possible use of the Brazilian Hospital Information System as an alternative information source for stillbirth and neonatal mortality rates by age group. METHODS: A

  11. SERUM SODIUM CHANGES IN NEONATES RECEIVING PHOTOTHERAPY FOR NEONATAL HYPERBILIRUBINEMIA

    Directory of Open Access Journals (Sweden)

    Sunil Kumar

    2015-07-01

    Full Text Available BACKGROUND : Neonates receiving phototherapy have side effects like hypocalcemia and electrolyte changes. Our study is hereby intended to study the serum sodium changes due to phototherapy. AIMS : To evaluate the serum sodium changes in neonates receiving phototherapy f or neonatal hyperbilirubinemia. SETTINGS AND DESIGN : A prospective hospital based comparative study conducted on neonates admitted in the Neonatal Intensive Care Unit receiving phototherapy. METHODS AND MATERIAL : A predesigned proforma has aided the enroll ment of 252 newborns into the study. Serum bilirubin and serum sodium were determined before and after termination of phototherapy. The first samples were considered as controls. A comparative study was made between before and after phototherapy groups to determine the incidence of serum sodium imbalances. STATISTICAL ANALYSIS USED : Proportions will be compared using chi - square test. All data of various groups will be tabulated and statistically analyzed using suitable statistical tests (Student's t test. RESULTS : Male to Female ratio was 1.45 : 1. Incidence of low birth weight babies was 23% and preterm was 20.2%. Mean birth weight and gestational age was 2.84±0.51 kg and 38.44±1.98 wks respectively. Mean duration of phototherapy was 37.65±11.06 hrs. The incidence of hyponatremia post phototherapy found to be 6% which was more in low birth weight (LBW babies (17.2% , p48 hrs (p<0.001. Even the decline in mean serum sodium values after phototherapy found to be statistically significant. CONCLUSION : Our study shows that neonates u nder phototherapy are at higher risk of hyponatremia. This risk is greater in premature and LBW babies and hence this group of babies should be closely monitored for changes in serum sodium and should be managed accordingly.

  12. Diagnóstico precoce do câncer infantil: responsabilidade de todos Early diagnosis of childhood cancer: a team responsibility

    Directory of Open Access Journals (Sweden)

    Karla Emilia Rodrigues

    2003-01-01

    Full Text Available OBJETIVO: Alertar para a necessidade do conhecimento e investigação dos sinais e sintomas iniciais do câncer infantil, bem como para a responsabilidade de todos envolvidos no processo do seu diagnóstico precoce a fim de melhorar os nossos índices de cura. MÉTODOS: Revisão da literatura através de consulta ao Medline. RESULTADOS: O diagnóstico do câncer infantil é um processo complexo e muitas são as variáveis que parecem influenciá-lo. A detecção precoce e o pronto início do tratamento têm importante papel na redução da mortalidade e morbidade do tratamento. O melhor entendimento da relação entre estes fatores é de fundamental importância para o desenvolvimento de estratégias de saúde pública para detecção precoce do câncer infantil. CONCLUSÃO: Muitos fatores parecem estar associados ao atraso do diagnóstico do câncer infantil. O tempo que decorre entre o primeiro sintoma e o diagnóstico depende da idade da criança e do tipo do tumor, principalmente. Determinar os sinais e sintomas que devem alertar para a possibilidade de doenças malignas ainda é um desafio.OBJECTIVES: To call attention for necessity of the knowledge of the early symptoms of childhood cancer and for the responsibility of the parents, physicians and teachers rendering health supervision to the children and to alert that the early detection and prompt treatment is of paramount importance in achieving cures in childhood cancer. SOURCES: Literature review using Medline. SUMMARY: The diagnosis of childhood cancer is complex and many variables play an important role. Early detection and prompt therapy have the potential to reduce mortality and treatment morbidity. A better understanding of the relationship between symptoms and diagnosis is important for the development of effective public health strategies. CONCLUSIONS: There are several factors that may be associated with length of time between symptoms and diagnosis. Lag time to diagnosis

  13. Prevalência de perda precoce de molares decíduos: estudo retrospectivo = Prevalence of early loss of deciduous molars: a retrospective study

    Directory of Open Access Journals (Sweden)

    Alessandro Leite Cavalcanti

    2008-07-01

    Full Text Available Este estudo retrospectivo determinou a prevalência da perda precoce demolares decíduos em pacientes atendidos na clínica de Odontopediatria da Universidade Estadual da Paraíba. Foram examinados 515 prontuários, sendo os dados registrados em um formulário. Foram analisadas as variáveis: gênero, idade, tipo de molar decíduo perdido,arcada dentária (maxilar ou mandibular e lado (direito e esquerdo. Observou-se que a prevalência de perda precoce foi de 15,1%, existindo uma distribuição similar entre os gêneros. Em relação à idade da criança, a maior freqüência de perda acometeu pacientescom sete anos (32,1%. Houve distribuição equitativa da perda dentária entre as arcadas superior e inferior, com 43,6% cada uma, sendo o lado esquerdo o mais acometido (41%. O segundo molar superior esquerdo foi o mais acometido (17,9%, seguido do primeiromolar decíduo superior direito (16,1%. Pode-se concluir que a prevalência de perda precoce foi baixa e que os molares decíduos superiores foram os dentes mais comumente perdidos.This retrospective study determined the prevalence of early loss of deciduous molars in patients enrolled at the Pediatric Dentistry clinic at the State University of Paraíba. A review of 515 patient records were analyzed, registered in a form. The following variables were analyzed: gender, age, type of deciduous molar loss, region (maxilla or mandible and side (right and left. It was observed that the prevalence of early tooth loss was 15.1% and there was a similar distribution between the genders. In regard to age, the greatest frequency of tooth loss involved patients at 7 years old (32.1%. There was a similar distribution of tooth loss between the maxilla and mandible regions, at 43.6% each, with the left side being themost involved (41%. The second upper left deciduous molar was the most commonly missing tooth (17.9%, followed by the first upper right deciduous molar (16.1%. It can be concluded that the

  14. 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

  15. Fetal and neonatal thyrotoxicosis

    Science.gov (United States)

    Batra, Chandar Mohan

    2013-01-01

    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 20th week of pregnancy and reaches its maximum by 30th 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. PMID:24251220

  16. 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.

  17. CT of the neonatal head

    International Nuclear Information System (INIS)

    Mohan, S.; Rogan, E.A.; Batty, R.; Raghavan, A.; Whitby, E.H.; Hart, A.R.; Connolly, D.J.A.

    2013-01-01

    Computed tomography (CT) is used less often than other techniques on neonatal units. However, in the acute setting, CT can be invaluable in diagnosing or excluding potentially life-threatening conditions and guiding initial management in neonates. Common indications for scanning include trauma, suspected non-accidental injury, infection, or an acute hypoxic or metabolic event. The aim of this review is to provide an overview of the normal neonatal head at CT and compare this to the common pathological abnormalities. Several key features of each condition will be highlighted. It is important to note that some pathological conditions can have overlapping features at CT and, therefore, the clinical history and additional investigations are also of key importance in determining the diagnosis

  18. 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

  19. 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.

  20. 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 li...... indicates that over the past decade the surveyed area has greatly reduced neonatal and NNT mortality. Possible strategies for accelerated NNT control have been identified by the survey....

  1. 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.

  2. 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...

  3. Diffusion Weighted Imaging of the Neonatal Brain

    NARCIS (Netherlands)

    J. Dudink (Jeroen)

    2010-01-01

    textabstractAlthough in the last decades advances in fetal and neonatal medicine have reduced mortality in neonatal intensive care units in the Western world, the morbidity due to brain injury remains high. Patterns of neonatal brain injury can be roughly divided in (1) term and (2) preterm

  4. Phototherapy and exchange transfusion for neonatal ...

    African Journals Online (AJOL)

    The purpose of this document is to address the current lack of consensus regarding the management of hyperbilirubinaemia in neonates in South Africa. If left untreated, severe neonatal hyperbilirubinaemia may cause kernicterus and ultimately death and the severity of neonatal jaundice is often underestimated clinically.

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

    African Journals Online (AJOL)

    U.O. Ezomike

    Abstract. The clinical presentation of neonatal paratesticular abscess may closely resemble that of, neonatal testicular torsion and the use of scrotal ultrasonography to differentiate the two has low, sensitivity. We propose early operative treatment of suspected neonatal testicular torsion to salvage, the testicle in cases of ...

  6. 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 ...

  7. Neonatal herpes simplex virus infections.

    Science.gov (United States)

    Pinninti, Swetha G; Kimberlin, David W

    2018-04-01

    Neonatal herpes simplex virus (HSV) is an uncommon but devastating infection in the newborn, associated with significant morbidity and mortality. The use of PCR for identification of infected infants and acyclovir for treatment has significantly improved the prognosis for affected infants. The subsequent use of suppressive therapy with oral acyclovir following completion of parenteral treatment of acute disease has further enhanced the long-term prognosis for these infants. This review article will discuss the epidemiology, risk factors and routes of acquisition, clinical presentation, and evaluation of an infant suspected to have the infection, and treatment of proven neonatal HSV disease. Copyright © 2018 Elsevier Inc. All rights reserved.

  8. Diagnóstico precoce de anormalidades no desenvolvimento em prematuros: instrumentos de avaliação Early diagnosis of abnormal development of preterm newborns: assessment instruments

    Directory of Open Access Journals (Sweden)

    Rosana S. Santos

    2008-08-01

    Full Text Available OBJETIVO: Revisar criticamente os instrumentos de avaliação mais utilizados na atualidade na literatura para triagem e identificação precoce de anormalidades no desenvolvimento em crianças. FONTES DOS DADOS: Foi realizado um levantamento bibliográfico nas bases de dados no SciELO, plataforma CAPES, PubMed e Google Scholar, com os unitermos "prematuridade", "atraso no desenvolvimento", "paralisia cerebral", "diagnóstico precoce" e "testes de avaliação". SÍNTESE DOS DADOS: Foram listados 455 títulos, sendo selecionados para esta revisão 174 artigos com base em título, relevância temática e resumo. Apenas artigos originais, disponíveis em meio eletrônico, a partir de 1985, com informação sobre a construção, aplicabilidade e propriedades psicométricas dos testes foram usados. CONCLUSÕES: Os testes de triagem podem acelerar o início da intervenção precoce e facilitar o desenvolvimento futuro destas crianças. Vários instrumentos são utilizados para este fim, dentre eles destacam-se, nas pesquisas nacionais, o teste DENVER II e o Alberta Infant Motor Scale. O Movement Assessment of Infant também emerge como teste de triagem utilizado em nosso país. Além desses, dois outros testes são indicados na literatura mundial por sua alta sensibilidade e especificidade em idades precoces: Test of Infant Motor Performance e General Movements.OBJECTIVE:To review the literature regarding screening psychomotor tests for the early identification of developmental problems. SOURCES: A search on SciELO, PubMed and Google Scholar was performed using the terms "prematurity," "developmental delay," "cerebral palsy," "early diagnosis" and "evaluation tests." SUMMARY OF THE FINDINGS:A total of 455 references were listed, and 174 studies were selected for this review based on title, relevance, and abstract. Only original and electronically available material, from 1985 forward, with information on design, applicability, and psychometric

  9. Identificação precoce do risco para transtornos da atenção e da leitura em sala de aula

    Directory of Open Access Journals (Sweden)

    Olga Valéria Andrade

    Full Text Available Testou-se a acurácia de atividades pedagógicas coletivas, baseadas em julgamentos fonológicos por meio do pareamento entre figuras e de figuras com palavras faladas, na identificação de escolares de risco para transtornos da atenção e da leitura em sala de aula. Quarenta e cinco escolares do 2º ano (idade média de 7 anos, 29 do gênero masculino, foram divididos em grupo controle, sem dificuldade de leitura-escrita (n=32, e grupo de risco, com dificuldade de leitura (n=13. O baixo desempenho nessas atividades, definido como os escores acima de 1,65 DP abaixo da média do grupo controle, apresentou boa sensitividade (verdadeiros positivos e especificidade (verdadeiros negativos na identificação precoce dos escolares de risco.

  10. INTERVENÇÃO PRECOCE NA PSICOSE: DE ESTRATÉGIA CLÍNICA A POSSÍVEL CATEGORIA DIAGNÓSTICA

    Directory of Open Access Journals (Sweden)

    Luna Rodrigues Freitas-Silva

    2014-12-01

    Full Text Available No campo psiquiátrico, as possibilidades de prevenir o risco de desenvolver transtornos mentais começam a reunir interesse, motivar pesquisas e provocar controvérsias. Entre as diversas investigações sobre risco e categorias psiquiátricas que vêm sendo conduzidas no cenário internacional destacam-se as propostas destinadas a detectar e intervir precocemente no desenvolvimento da psicose. Os programas de detecção precoce da psicose têm como objetivo atingir duas categorias de pacientes: os que vivem o primeiro surto psicótico e aqueles considerados em estado mental de risco ou pré-psicóticos. Apesar da controvérsia em torno do estado mental de risco, com a elaboração de uma nova versão do DSM aventou-se a possibilidade de criar uma categoria específica que identificasse o risco para a psicose. Neste artigo analisamos as propostas de intervenção precoce na psicose de estratégia clínica dividindo essa análise em três etapas: 1- a do surgimento das ações no contexto de refinamento da clínica do primeiro surto; 2- a da sistematização controversa da noção de estado mental de risco; 3- a da formalização da proposta de nova categoria diagnóstica durante a elaboração do DMS-5.

  11. Análise da qualidade de vida após a alta hospitalar em sobreviventes de sepse grave e choque séptico Analysis of quality of life following hospital discharge among survivors of severe sepsis and septic shock

    Directory of Open Access Journals (Sweden)

    Glauco Adrieno Westphal

    2012-06-01

    Full Text Available OBJETIVO: Descrever a repercussão da sepse grave e do choque séptico sobre a qualidade de vida após a alta hospitalar. MÉTODOS: Estudo controlado realizado em dois hospitais gerais de Joinville, Santa Catarina, Brasil, envolvendo pacientes internados com sepse grave ou choque séptico no período de agosto de 2005 a novembro de 2007. Os pacientes foram contatados por telefone entre junho e novembro de 2009. Os sobreviventes responderam ao Short Form-36, um questionário de qualidade de vida, dois anos após a alta. O questionário também foi respondido por um grupo controle composto de pessoas que habitavam o mesmo domicílio dos sobreviventes, sem internação recente e com idade mais próxima possível à do paciente. RESULTADOS: De 217 pacientes com sepse grave ou choque séptico, 112 (51,6% sobreviveram à internação. A sobrevida pós-alta hospitalar foi de 41,02% em 180 dias, 37,4% após um ano, 34¡3% em 18 meses e 32,3% em dois anos. Trinta e seis sobreviventes responderam ao Short Form-36. Houve comprometimento da qualidade de vida dos sobreviventes (No. = 36 em relação ao grupo controle (No. = 36 nos domínios: capacidade funcional (59 ± 32 versus 91 ± 18; P OBJECTIVE: Describe the impact of severe sepsis and septic shock on patients' quality of life following hospital discharge. METHODS: A controlled study conducted in two general hospitals of Joinville, Santa Catarina, Brazil, of in-patients with severe sepsis or septic shock during the period of August 2005 through November 2007. The patients were contacted by telephone between June and November 2009. The study group responded to Short Form-36, a questionnaire on the quality of life, two years after being discharged from hospital. The questionnaire was also answered by a control group composed of people who lived at the same residence as the study subjects, had no recent hospitalization, and were close in age. Results: Of 217 patients with severe sepsis or septic shock

  12. Susceptibility weighted imaging of the neonatal brain

    International Nuclear Information System (INIS)

    Meoded, A.; Poretti, A.; Northington, F.J.; Tekes, A.; Intrapiromkul, J.; Huisman, T.A.G.M.

    2012-01-01

    Susceptibility weighted imaging (SWI) is a well-established magnetic resonance technique, which is highly sensitive for blood, iron, and calcium depositions in the brain and has been implemented in the routine clinical use in both children and neonates. SWI in neonates might provide valuable additional diagnostic and prognostic information for a wide spectrum of neonatal neurological disorders. To date, there are few articles available on the application of SWI in neonatal neurological disorders. The purpose of this article is to illustrate and describe the characteristic SWI findings in various typical neonatal neurological disorders.

  13. 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.)

  14. Susceptibility weighted imaging of the neonatal brain

    Energy Technology Data Exchange (ETDEWEB)

    Meoded, A.; Poretti, A. [Division of Pediatric Radiology and Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD (United States); Northington, F.J. [Division of Neonatology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD (United States); Tekes, A.; Intrapiromkul, J. [Division of Pediatric Radiology and Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD (United States); Huisman, T.A.G.M., E-mail: thuisma1@jhmi.edu [Division of Pediatric Radiology and Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD (United States)

    2012-08-15

    Susceptibility weighted imaging (SWI) is a well-established magnetic resonance technique, which is highly sensitive for blood, iron, and calcium depositions in the brain and has been implemented in the routine clinical use in both children and neonates. SWI in neonates might provide valuable additional diagnostic and prognostic information for a wide spectrum of neonatal neurological disorders. To date, there are few articles available on the application of SWI in neonatal neurological disorders. The purpose of this article is to illustrate and describe the characteristic SWI findings in various typical neonatal neurological disorders.

  15. 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,.

  16. 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.

  17. 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

  18. 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.

  19. Neonatal blood gas sampling methods

    African Journals Online (AJOL)

    You work in a regional neonatal intensive care unit. An 8-day-old ... The baby was born at 28 weeks' gestation with a birth weight of 1. 100 g. ... and arterial blood taken from indwelling arterial lines.2-4 However, even ... tal age of 48 - 72 hours.

  20. Human Parechovirus and Neonatal Encephalitis

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2008-10-01

    Full Text Available Clinical presentation, cranial ultrasound (cUS and MRi findings, and neurodevelopmental outcome of 10 neonates (70% term with human parechovirus (HPeV encephalitis are described by researchers at University Medical Center, Utrecht, The Netherlands; University of Toronto, Ontario, Canada; and Universitaire de Quebec, Canada.

  1. Neonatal umbilical inflammatory myofibroblastic tumor

    African Journals Online (AJOL)

    antenatal scan. The preferred treatment option is resection of the tumor. Spontaneous regression has been described. Ann Pediatr Surg 13:160–162 c 2017 Annals of Pediatric. Surgery. ... Keywords: inflammatory myofibroblastic tumor, neonatal tumor, surgical resection ... Other anatomical regions were the brain, the.

  2. Triagem neonatal para hemoglobinopatias no Rio de Janeiro, Brasil Neonatal screening for hemoglobinopathies in Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    Clarisse Lopes de Castro Lobo

    2003-03-01

    Full Text Available OBJETIVO: Descrever os principais resultados do programa de triagem neonatal para a doença falciforme do Estado do Rio de Janeiro em 15 meses de funcionamento (agosto de 2000 a novembro de 2001. MÉTODOS: A partir de agosto de 2000, amostras de sangue passaram a ser coletadas de todos os recém-nascidos atendidos em postos de atenção básica à saúde no Estado para triagem neonatal da doença falciforme. Essas amostras são submetidas a cromatografia líquida de alta resolução. Se o cromatograma resultante for compatível com a doença falciforme, a criança e seus pais são encaminhados para confirmação diagnóstica e tratamento. RESULTADOS: De agosto de 2000 a novembro de 2001, 99 260 recém nascidos participaram da triagem. Houve um caso de homozigose para Hb C. Um em cada 27 recém-nascidos triados pelo programa apresentou o traço falciforme (Hb AS. A doença falciforme foi constatada em 83 casos (um caso novo para cada 1 196 nascimentos: 62 Hb S, 18 Hb SC, 3 Hb SD. Uma criança não compareceu para confirmação diagnóstica. As 82 crianças acompanhadas apresentaram 15 intercorrências (infecções de vias aéreas superiores, febre, seqüestro esplênico, síndrome mão-pé e crises de vaso-oclusão, motivando sete internações. Houve necessidade de transfusão sangüínea em 15 crianças, mas nenhuma tornou-se alo-imunizada. Os demais bebês estão evoluindo satisfatoriamente com o uso de penicilina profilática. CONCLUSÕES: Nossos dados evidenciam a importância do diagnóstico precoce da doença falciforme, de forma a prevenir e evitar as freqüentes complicações infecciosas enfrentadas por esses pacientes.OBJECTIVE: To describe the main results obtained in the first 15 months of neonatal screening for sickle cell disease in the state of Rio de Janeiro, Brazil, from August 2000 to November 2001. METHODS: Starting in August 2000, blood samples began to be collected for sickle cell disease screening from all newborns

  3. Advancing Neurologic Care in the Neonatal Intensive Care Unit with a Neonatal Neurologist

    Science.gov (United States)

    Mulkey, Sarah B.; Swearingen, Christopher J.

    2014-01-01

    Neonatal neurology is a growing sub-specialty area. Given the considerable amount of neurologic problems present in the neonatal intensive care unit, a neurologist with expertise in neonates is becoming more important. We sought to evaluate the change in neurologic care in the neonatal intensive care unit at our tertiary care hospital by having a dedicated neonatal neurologist. The period post-neonatal neurologist showed a greater number of neurology consultations (Pneurology encounters per patient (Pneurology became part of the multi-disciplinary team providing focused neurologic care to newborns. PMID:23271754

  4. 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

  5. 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

  6. 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.

  7. Neonatal Hyperglycemia due to Transient Neonatal Diabetes Mellitus in Puerto Rico.

    Science.gov (United States)

    Fargas-Berríos, N; García-Fragoso, L; García-García, I; Valcárcel, M

    2015-01-01

    Neonatal hyperglycemia is a metabolic disorder found in the neonatal intensive care units. Neonatal diabetes mellitus (NDM) is a very uncommon cause of hyperglycemia in the newborn, occurring in 1 in every 400,000 births. There are two subtypes of neonatal diabetes mellitus: permanent neonatal diabetes mellitus (PNDM) and transient neonatal diabetes mellitus (TNDM). We describe a term, small for gestational age, female neonate with transient neonatal diabetes mellitus who presented with poor feeding tolerance and vomiting associated with hyperglycemia (385 mg/dL), glycosuria, and metabolic acidosis within the first 12 hours of life. The neonate was treated with intravenous insulin, obtaining a slight control of hyperglycemia. An adequate glycemia was achieved at 5 weeks of life. The molecular studies showed complete loss of maternal methylation at the TND differentially methylated region on chromosome 6q24. The etiology of this neonate's hyperglycemia was a hypomethylation of the maternal TND locus. A rare cause of neonatal diabetes mellitus must be considered if a neonate presents refractory hyperglycemia. To our knowledge, this is the first case reported in Puerto Rico of transient neonatal mellitus due to the uncommon mechanism of maternal hypomethylation of the TND locus. Its prevalence in Puerto Rico is unknown.

  8. Neonatal hypocalcemia, neonatal seizures, and intellectual disability in 22q11.2 deletion syndrome

    Science.gov (United States)

    Cheung, Evelyn Ning Man; George, Susan R.; Andrade, Danielle M.; Chow, Eva W. C.; Silversides, Candice K.; Bassett, Anne S.

    2015-01-01

    Purpose Hypocalcemia is a common endocrinological condition in 22q11.2 deletion syndrome. Neonatal hypocalcemia may affect neurodevelopment. We hypothesized that neonatal hypocalcemia would be associated with rare, more severe forms of intellectual disability in 22q11.2 deletion syndrome. Methods We used a logistic regression model to investigate potential predictors of intellectual disability severity, including neonatal hypocalcemia, neonatal seizures, and complex congenital heart disease, e.g., interrupted aortic arch, in 149 adults with 22q11.2 deletion syndrome. Ten subjects had moderate-to-severe intellectual disability. Results The model was highly significant (P < 0.0001), showing neonatal seizures (P = 0.0018) and neonatal hypocalcemia (P = 0.047) to be significant predictors of a more severe level of intellectual disability. Neonatal seizures were significantly associated with neonatal hypocalcemia in the entire sample (P < 0.0001), regardless of intellectual level. There was no evidence for the association of moderate- to-severe intellectual disability with other factors such as major structural brain malformations in this sample. Conclusion The results suggest that neonatal seizures may increase the risk for more severe intellectual deficits in 22q11.2 deletion syndrome, likely mediated by neonatal hypocalcemia. Neonatal hypocalcemia often remains unrecognized until the postseizure period, when damage to neurons may already have occurred. These findings support the importance of early recognition and treatment of neonatal hypocalcemia and potentially neonatal screening for 22q11.2 deletions. PMID:23765047

  9. Bartter syndrome: presentation in an extremely premature neonate.

    Science.gov (United States)

    Flores, F X; Ojeda, F J; Calhoun, D A

    2013-08-01

    Reports of Bartter syndrome in premature neonates are rare. We describe the presentation and clinical course of a neonate born at 25.6 weeks estimated gestational age with polyuria, hyponatremia, hypokalemia and hypercalciuria ,who was diagnosed with neonatal Bartter syndrome. The evaluation, diagnosis and management of neonatal Bartter syndrome in this premature neonate are discussed.

  10. Flowering induction in radicchio (cichorium intybus l.var silvestre bischoff:the influence of vernalization in different types and classes of precocity

    Directory of Open Access Journals (Sweden)

    Ferdinando Pimpini

    2008-07-01

    Full Text Available All experiments were carried out at the Experimental Station “L. Toniolo” of the University of Padova (45°21’ N; 11°58’ E. Experiment 1. This research was undertaken to study the effect of increasing duration of cold periods (0-5-10-15- 20 and 30 days on three classes of “Rosso di Chioggia” with different precocity: “Perseo” (Precocious, “Leo” (Medium and “Virgo” (Late. Seeds were sown on different dates (V30-V20-V15-V10-V5 and V0, i.e. May 10th- 20th-25th and 30th, June 5th and 10th 2004 respectively and placed in pre-formed polystyrene multiple trays. Treatments with low temperatures (5 °C started on the 1st June for V30 and for the others (V5-V10-V15 and V20 25-20-15 and 10 days later in controlled growth chambers, while plants that did not require vernalization stayed in the greenhouse. After vernalization and its stabilisation for 15 days, plants were transplanted in open field (July 24th. Moreover, on the 30th of August the number of leaves in rosette and elongated stem on five flowered plants for each group was determined, to verify the possible existing relation between flowering and the number of leaves on plant. Experiment 2. This experiment was undertaken to compare the effect of vernalization on flowering of 8 cultivars of radicchio to assess their membership of annual or biennial species. The 8 cultivars were Rosso di Treviso tardivo “Sile tardivo”, Rosso di Treviso precoce “Mesola precoce”, Rosso di Chioggia “Perseo” (P, “Leo” (M and “Virgo” (L, Rosso di Verona “Cologna medio”, Variegato di Lusia “Adige tardivo” e Variegato di Castelfranco “Castellano medio”. All types were vernalized for 0-5 and 15 days (V0-V5 and V15. Seeds were placed (January 15th-25th and 30th 2005 for V15, V5 and V0 respectively in pre-formed polystyrene multiple trays. Vernalization (5 °C started on February 14th in controlled growth chambers and, at the end, was stabilized for 15 days. After

  11. Aspectos de biologia floral de cajueiros anão precoce e comum Floral biology aspects of the early dwarf and common cashew

    Directory of Open Access Journals (Sweden)

    Larissa Barbosa de Sousa

    2007-06-01

    Full Text Available O conhecimento da biologia floral é de suma importância para o desenvolvimento da cultura do cajueiro (Anacardium occidentale L.. Com relação aos aspectos botânicos, as características morfológicas das flores contribuíram efetivamente para a determinação das espécies do gênero Anacarduim conhecidas. No presente trabalho, objetivou-se estudar a biologia floral dos cajueiros anão precoce e comum. A pesquisa foi desenvolvida na área experimental do Departamento de Fitotecnia, Centro de Ciências Agrárias, Universidade Federal do Piauí, em Teresina, PI, avaliando-se nove clones de cajueiro anão ("CAP 14", "Embrapa 09", "Embrapa 50", "Embrapa 51", "Embrapa 76", "Embrapa 183", "Embrapa 189", "FAGA 01", "FAGA 11" e um clone de cajueiro comum ("CCA", utilizando-se quatro panículas por planta, cada uma com orientação norte, sul, leste e oeste. Os tipos varietais, cajueiro comum e anão precoce, apresentam pouca variação para a maioria dos caracteres avaliados. A proporção entre flores hermafroditas e o total de flores, em cajueiro comum, pode levá-lo a uma maior produção de frutos por panícula do que nos clones de cajueiro anão precoce analisados. O número de frutos desenvolvidos é bastante reduzido nos dois tipos varietais. As panículas situadas em diferentes orientações cardeais são semelhantes em todos os clones estudados quanto aos aspectos relacionados à biologia floral do cajueiro.The knowledge of the floral biology is very important for the development of the cashew's culture (Anacardium occidentale L.. In relation to botanical aspects, the morphological characteristics of flowers contributed effective to determination of the well-known species of Anacardium. It was aimed at studing the floral biology of the early dwarf and common cashew. The research was developed in the experimental area of the Department of Fitotecnia, Centro de Ciências Agrárias, Universidade Federal do Piauí, in Teresina, PI, and nine

  12. 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.

  13. Maternal Preeclampsia and Neonatal Outcomes

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    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.

  14. 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

  15. CT findings in neonatal hypothermia

    International Nuclear Information System (INIS)

    Schulman, H.; Laufer, L.; Berginer, J.; Hertzanu, Y.; Hershkowitz, E.; Berenstein, T.; Sofer, S.; Maor, E.

    1998-01-01

    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.)

  16. 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.

  17. 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)

  18. Systemic fungal infections in neonates

    Directory of Open Access Journals (Sweden)

    Rao S

    2005-01-01

    Full Text Available Advances in neonatal management have led to considerable improvement in newborn survival. However, early (72hours onset systemic infections, both bacterial and fungal, remain a devastating complication and an important cause of morbidity and mortality in these babies. Most neonatal fungal infections are due to Candida species, particularly Candida albicans. The sources of candidiasis in NICU are often endogenous following colonization of the babies with fungi. About 10% of these babies get colonized in first week of life and up to 64% babies get colonized by 4 weeks of hospital stay. Disseminated candidiasis presents like bacterial sepsis and can involve multiple organs such as the kidneys, brain, eye, liver, spleen, bone, joints, meninges and heart. Confirming the diagnosis by laboratory tests is difficult and a high index of suspicion is required. The diagnosis of fungemia can be made definitely only by recovering the organism from blood or other sterile bodily fluid. Amphotericin B continues to be the mainstay of therapy for systemic fungal infections but its use is limited by the risks of nephrotoxicity and hypokalemia. Newer formulations of amphotericin B, namely the liposomal and the lipid complex forms, have recently become available and have been reported to have lesser toxicity. More recently Indian liposomal Amphotericin B derived from neutral lipids (L-Amp -LRC-1 has shown good response with less toxicity. A clinical trial with this preparation has shown to be safe and efficacious in neonatal fungal infections. Compared to other liposomal preparations, L-Amp-LRC-1 is effective at lower dose and is less expensive drug for the treatment of neonatal candidiasis.

  19. Simultaneous occurrence of fetal and neonatal alloimmune thrombocytopenia and neonatal neutropenia due to maternal neutrophilic autoantibodies

    DEFF Research Database (Denmark)

    Taaning, Ellen; 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...

  20. CRESCIMENTO DE MUDAS DE CAJUEIRO-ANÃO-PRECOCE 'CCP¾ 76' SUBMETIDAS À ADUBAÇÃO ORGÂNICA E MINERAL

    Directory of Open Access Journals (Sweden)

    LIMA ROSIANE DE LOURDES SILVA DE

    2001-01-01

    Full Text Available A adição de doses de matéria orgânica e fertilizante mineral ao substrato, para a produção de mudas em recipientes é uma técnica bastante utilizada nos sistemas modernos de produção de mudas. Contudo, para a cultura do cajueiro são poucas as informações que definam passíveis doses de matéria orgânica e fertilizantes minerais capazes de produzirem mudas vigorosas a curtos intervalos de tempo. Durante a fase de produção de mudas de cajueiro-anão-precoce 'CCP 76', conduziu-se um ensaio na área experimental do Departamento de Irrigação e Drenagem da Universidade Federal do Ceará em Fortaleza, Ceará, no período de abril a junho de 1995. Utilizou-se como substrato à camada arável (0-30cm de um Podzólico Vermelho-Amarelo Distrófico, textura média. Para o plantio, utilizaram-se sementes oriundas de um único genótipo de cajueiro- anão-precoce progênie 'CCP 76'. Os tratamentos constaram da aplicação de quatro doses de matéria orgânica (0; 100; 200 e 300 cm³/2,5 Kg solo e quatro doses da mistura mineral (0; 1,92; 3,34 e 6,18 g contendo uréia, superfosfato triplo, cloreto de potássio, gesso, calcário e fritas tipo MIB-3. O delineamento experimental utilizado foi o inteiramente casualizado, com 16 tratamentos, em 4 repetições, seguindo o modelo fatorial 4². Foram realizadas as seguintes determinações: altura de planta (cm, diâmetro do caule (mm, número de folha/planta, comprimento da raiz principal (cm, peso da matéria seca da parte aérea e do sistema radicular (g/planta. Os resultados enfatizam que a aplicação de doses combinadas de matéria orgânica e fertilizante mineral promoveu acréscimos significativos sobre a altura da planta, peso da matéria seca da parte aérea e número de folhas.

  1. CRESCIMENTO DE MUDAS DE CAJUEIRO-ANÃO-PRECOCE 'CCP¾ 76' SUBMETIDAS À ADUBAÇÃO ORGÂNICA E MINERAL

    Directory of Open Access Journals (Sweden)

    ROSIANE DE LOURDES SILVA DE LIMA

    2001-08-01

    Full Text Available A adição de doses de matéria orgânica e fertilizante mineral ao substrato, para a produção de mudas em recipientes é uma técnica bastante utilizada nos sistemas modernos de produção de mudas. Contudo, para a cultura do cajueiro são poucas as informações que definam passíveis doses de matéria orgânica e fertilizantes minerais capazes de produzirem mudas vigorosas a curtos intervalos de tempo. Durante a fase de produção de mudas de cajueiro-anão-precoce 'CCP 76', conduziu-se um ensaio na área experimental do Departamento de Irrigação e Drenagem da Universidade Federal do Ceará em Fortaleza, Ceará, no período de abril a junho de 1995. Utilizou-se como substrato à camada arável (0-30cm de um Podzólico Vermelho-Amarelo Distrófico, textura média. Para o plantio, utilizaram-se sementes oriundas de um único genótipo de cajueiro- anão-precoce progênie 'CCP 76'. Os tratamentos constaram da aplicação de quatro doses de matéria orgânica (0; 100; 200 e 300 cm³/2,5 Kg solo e quatro doses da mistura mineral (0; 1,92; 3,34 e 6,18 g contendo uréia, superfosfato triplo, cloreto de potássio, gesso, calcário e fritas tipo MIB-3. O delineamento experimental utilizado foi o inteiramente casualizado, com 16 tratamentos, em 4 repetições, seguindo o modelo fatorial 4². Foram realizadas as seguintes determinações: altura de planta (cm, diâmetro do caule (mm, número de folha/planta, comprimento da raiz principal (cm, peso da matéria seca da parte aérea e do sistema radicular (g/planta. Os resultados enfatizam que a aplicação de doses combinadas de matéria orgânica e fertilizante mineral promoveu acréscimos significativos sobre a altura da planta, peso da matéria seca da parte aérea e número de folhas.

  2. Neonatal Hearing screening in tafila

    International Nuclear Information System (INIS)

    Rashed, K.A.

    2007-01-01

    To measure the true prevalence of hearing impairment in neonates in Tafila, Jordan. This retrospective study was carried out at Prince Zeid Hospital, Taflia, Jordan through analysis of data of all births from January 2005 and January 2006. Transient evoked otoacoustic emissions (TEOAE) were measured via the application of echoprobe to both ears. There were two groups of births that were analysed statistically. Hearing impaired neonates were those with two fails or more in each ear. Normal ones were those with 3 pass or more. Of the 1788 babies in the study group, 1622 (90.7%) were enrolled in the study with 9.3% loss rate. 1512 babies were examined on the 2 day of birth, 2 of them had hearing impairment with a rate of 1.2/1000. 110 babies were screened on the day of discharge from the nursery, one of them with hearing defect with a rate of 5.9/1000. Thus, true prevalence of hearing impaiment or failure was 1.7/1000. We conclude that screening for hearing impairment in the neonatal period is easy, informative and the true prevalence of hearing impairment in Tafila is similar to that in different parts of the world. (author)

  3. 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.

  4. Structural Connectivity Asymmetry in the Neonatal Brain

    OpenAIRE

    Ratnarajah, Nagulan; Rifkin-Graboi, Anne; Fortier, Marielle V.; Chong, Yap Seng; Kwek, Kenneth; Saw, Seang-Mei; Godfrey, Keith M; Gluckman, Peter D.; Meaney, Michael J.; Qiu, Anqi

    2013-01-01

    Asymmetry of the neonatal brain is not yet understood at the level of structural connectivity. We utilized DTI deterministic tractography and structural network analysis based on graph theory to determine the pattern of structural connectivity asymmetry in 124 normal neonates. We tracted white matter axonal pathways characterizing interregional connections among brain regions and inferred asymmetry in left and right anatomical network properties. Our findings revealed that in neonates, small-...

  5. Avaliação da Introdução Precoce da Alimentação Complementar em Crianças de 0 a 24 meses Atendidas em uma Unidade Básica de Saúde

    OpenAIRE

    Adriana Morellato; Jussara Carnevale Almeida; Nêmora Cabistani

    2009-01-01

    Objetivo: Verificar a frequência, os principais alimentos e motivos da introdução precoce da alimentação complementar, além do uso de mamadeira e chupeta em crianças de 0 a 24 meses. Métodos: Estudo transversal com crianças de 0 a 24 meses de idade atendidas numa Unidade Básica de Saúde. No período de junho a agosto de 2006, aplicou-se um questionário às mães ou acompanhantes sobre a alimentação complementar das crianças. Foi considerada precoce a introdução de alimentos sólidos e/ou líqui...

  6. Neonatal Hyperglycemia due to Transient Neonatal Diabetes Mellitus in Puerto Rico

    Directory of Open Access Journals (Sweden)

    N. Fargas-Berríos

    2015-01-01

    Full Text Available Neonatal hyperglycemia is a metabolic disorder found in the neonatal intensive care units. Neonatal diabetes mellitus (NDM is a very uncommon cause of hyperglycemia in the newborn, occurring in 1 in every 400,000 births. There are two subtypes of neonatal diabetes mellitus: permanent neonatal diabetes mellitus (PNDM and transient neonatal diabetes mellitus (TNDM. We describe a term, small for gestational age, female neonate with transient neonatal diabetes mellitus who presented with poor feeding tolerance and vomiting associated with hyperglycemia (385 mg/dL, glycosuria, and metabolic acidosis within the first 12 hours of life. The neonate was treated with intravenous insulin, obtaining a slight control of hyperglycemia. An adequate glycemia was achieved at 5 weeks of life. The molecular studies showed complete loss of maternal methylation at the TND differentially methylated region on chromosome 6q24. The etiology of this neonate’s hyperglycemia was a hypomethylation of the maternal TND locus. A rare cause of neonatal diabetes mellitus must be considered if a neonate presents refractory hyperglycemia. To our knowledge, this is the first case reported in Puerto Rico of transient neonatal mellitus due to the uncommon mechanism of maternal hypomethylation of the TND locus. Its prevalence in Puerto Rico is unknown.

  7. NEONATAL CONJUNCTIVITIS AND ITS DRUG SENSITIVITY PATTERN

    Directory of Open Access Journals (Sweden)

    Kavitha Thulukkanam

    2017-05-01

    Full Text Available BACKGROUND Neonatal conjunctivitis is eye discharge in neonates and it is a common infection in neonates in the first month of life. Worldwide, the incidence of neonatal conjunctivitis varies from 1% to 33% depending on the socioeconomic status of the people in the region. In India, the incidence varies from region to region from 0.9 to 35%. MATERIALS AND METHODS Single center prospective study. All neonates of age 0-30 days delivered and referred from neonatal ward of Chengalpattu Medical College and Hospital with complaints of eye swelling, redness, conjunctival discharge to the eye department for treatment are included in the study. RESULTS In this study, age group from 0-7 days were most commonly affected by neonatal conjunctivitis. Both eyes were commonly affected together. Neonates born by both LSCS and normal vaginal delivery were almost equally affected. The most common organism found in culture and Gram staining was staphylococci. CONCLUSION Neonatal conjunctivitis is more likely to be acquired postnatally. It acquires during the 1 st week and responds well to local application of antibiotics, which covers common causative bacteria.

  8. Neonatal Vaccination: Challenges and Intervention Strategies.

    Science.gov (United States)

    Morris, Matthew C; Surendran, Naveen

    2016-01-01

    While vaccines have been tremendously successful in reducing the incidence of serious infectious diseases, newborns remain particularly vulnerable in the first few months of their life to life-threatening infections. A number of challenges exist to neonatal vaccination. However, recent advances in the understanding of neonatal immunology offer insights to overcome many of those challenges. This review will present an overview of the features of neonatal immunity which make vaccination difficult, survey the mechanisms of action of available vaccine adjuvants with respect to the unique features of neonatal immunity, and propose a possible mechanism contributing to the inability of neonates to generate protective immune responses to vaccines. We surveyed recent published findings on the challenges to neonatal vaccination and possible intervention strategies including the use of novel vaccine adjuvants to develop efficacious neonatal vaccines. Challenges in the vaccination of neonates include interference from maternal antibody and excessive skewing towards Th2 immunity, which can be counteracted by the use of proper adjuvants. Synergistic stimulation of multiple Toll-like receptors by incorporating well-defined agonist-adjuvant combinations to vaccines is a promising strategy to ensure a protective vaccine response in neonates. © 2016 S. Karger AG, Basel.

  9. Foetal and neonatal thyroid disorders.

    Science.gov (United States)

    Radetti, G; Zavallone, A; Gentili, L; Beck-Peccoz, P; Bona, G

    2002-10-01

    Thyroid hormones have been shown to be absolutely necessary for early brain development. During pregnancy, both maternal and foetal thyroid hormones contribute to foetal brain development and maternal supply explains why most of the athyreotic newborns usually do not show any signs of hypothyroidism at birth. Foetal and/or neonatal hypothyroidism is a rare disorder. Its incidence, as indicated by neonatal screening, is about 1:4000. Abnormal thyroid development (i.e. agenesia, ectopic gland, hypoplasia) or inborn errors in thyroid hormone biosynthesis are the most common causes of permanent congenital hypothyroidism. Recent studies reported that mutations involving Thyroid Transcriptor Factors (TTF) such as TTF-1, TTF-2, PAX-8 play an important role in altered foetal thyroid development. Deficiency of transcriptor factor (Pit-1, Prop-1, LHX-3) both in mother and in the foetus represents another rare cause of foetal hypothyroidism. At birth clinical picture may be not always so obvious and typical signs appear only after several weeks but a delayed diagnosis could have severe consequences consisting of delayed physical and mental development. Even if substitutive therapy is promptly started some learning difficulties might still arise suggesting that intrauterine adequate levels of thyroid hormones are absolutely necessary for a normal neurological development. Placental transfer of maternal antithyroid antibodies inhibiting fetal thyroid function can cause transient hypothyroidism at birth. If the mother with thyroid autoimmune disease is also hypothyroid during pregnancy and she doesn't receive substitutive therapy, a worse neurological outcome may be expected for her foetus. Foetal and/or neonatal hyperthyroidism is a rare condition and its incidence has been estimated around 1:4000-40000, according to various authors. The most common causes are maternal thyroid autoimmune disorders, such as Graves' disease and Hashimoto's thyroiditis. Rarer non autoimmune causes

  10. Fatores de risco para óbito em unidade de terapia intensiva neonatal, utilizando a técnica de análise de sobrevida Risk factors for neonatal death in neonatal intensive care unit according to survival analysis

    Directory of Open Access Journals (Sweden)

    Susana de Paula Risso

    2010-03-01

    Full Text Available OBJETIVO: Identificar fatores de risco associados ao óbito de recém-nascidos internados na unidade de terapia intensiva neonatal do Hospital Universitário de Taubaté, SP. MÉTODOS: É um estudo longitudinal com informações obtidas dos prontuários dos recém-nascidos internados na unidade de terapia intensiva neonatal, do Hospital Universitário da Universidade de Taubaté. A variável dependente foi o tipo de desfecho: alta ou óbito. As variáveis independentes foram variáveis maternas e gestacionais: idade materna, hipertensão, diabetes, terapia com corticóide e parto; variáveis do recém-nascido: peso ao nascer, duração da gestação, escore de Apgar no primeiro e quinto minutos de vida, nascimento múltiplo, malformações congênitas e sexo; variáveis relativas à internação: relato de ventilação mecânica, ventilação pressão positiva, relato de nutrição parenteral prolongada, sepse, entubação, massagem cardíaca, fototerapia, doença da membrana hialina, oxigênioterapia, tempo de internação e fração inspirada de oxigênio. Foi construído um modelo de forma hierarquizada em três níveis para análise de sobrevida, através do modelo de Cox; o programa computacional utilizado foi o Stata v9 e permaneceram no modelo final as variáveis com pOBJECTIVE: To identify risk factors associated with death of infants admitted to neonatal intensive care unit of Taubaté University Hospital. METHODS: It is a longitudinal study with information obtained from medical records of newborns admitted to the neonatal intensive care unit of Taubaté University Hospital. Type of outcome, discharge or death, was dependent variable. The independent variables were maternal and gestational variables: maternal age, hypertension, diabetes, corticosteroid therapy and delivery; variables of the newborn: birth weight, gestation length, Apgar score in the first and fifth minutes of life, multiple birth, congenital malformations and sex

  11. Predição de pré-eclâmpsia em suas formas tardia e precoce pela dilatação fluxo-mediada da artéria braquial

    Directory of Open Access Journals (Sweden)

    Augusto Henriques Fulgêncio Brandão

    2014-08-01

    Full Text Available Objetivo:Avaliar a capacidade de predição das formas precoce e tardia da pré-eclâmpsia pela dilatação fluxo-mediada da artéria braquial (FMD, marcador biofísico de disfunção endotelial.Materiais e Métodos:Um total de 91 pacientes de alto risco para desenvolvimento de pré-eclâmpsia foi submetido a FMD entre 24 e 28 semanas de gestação.Resultados:Das pacientes selecionadas, 19 desenvolveram pré-eclâmpsia, sendo 8 em sua forma precoce e 11 em sua forma tardia. Usando-se um valor de corte de 6,5%, a sensibilidade (S da FMD para predição de pré-eclâmpsia precoce foi 75,0%, com especificidade (E de 73,3%, valor preditivo positivo (VPP de 32,4% e valor preditivo negativo (VPN de 91,9%. Para predição de pré-eclâmpsia tardia, encontrou-se valor de S de 83,3%, E de 73,2%, VPP de 34,4% e VPN de 96,2%. Para a predição de todas as formas associadas de pré-eclâmpsia, encontrou-se valor de S de 84,2%, E de 73,6%, VPP de 45,7% e VPN de 94,6%.Conclusão:A FMD se mostrou uma ferramenta com boa capacidade de predição de pré-eclâmpsia, nas suas formas tardia e precoce, o que pode representar um impacto positivo no acompanhamento de gestantes de alto risco para desenvolvimento dessa síndrome.

  12. The timing of normal puberty and the age limits of sexual precocity: variations around the world, secular trends, and changes after migration.

    Science.gov (United States)

    Parent, Anne-Simone; Teilmann, Grete; Juul, Anders; Skakkebaek, Niels E; Toppari, Jorma; Bourguignon, Jean-Pierre

    2003-10-01

    During the past decade, possible advancement in timing of puberty has been reported in the United States. In addition, early pubertal development and an increased incidence of sexual precocity have been noticed in children, primarily girls, migrating for foreign adoption in several Western European countries. These observations are raising the issues of current differences and secular trends in timing of puberty in relation to ethnic, geographical, and socioeconomic background. None of these factors provide an unequivocal explanation for the earlier onset of puberty seen in the United States. In the formerly deprived migrating children, refeeding and catch-up growth may prime maturation. However, precocious puberty is seen also in some nondeprived migrating children. Attention has been paid to the changing milieu after migration, and recently, the possible role of endocrine- disrupting chemicals from the environment has been considered. These observations urge further study of the onset of puberty as a possible sensitive and early marker of the interactions between environmental conditions and genetic susceptibility that can influence physiological and pathological processes.

  13. Programa de atenção a alunos precoces com comportamento de superdotação: identificação e proposta de enriquecimento musical

    Directory of Open Access Journals (Sweden)

    Fabiana Oliveira Koga

    2017-04-01

    Full Text Available O presente artigo tem por objetivo abordar os processos de identificação e enriquecimento musicais que orientam os trabalhos desenvolvidos pela oficina de música do Programa de Atenção a Alunos Precoces com Comportamento de Superdotação (PAPCS. O PAPCS ocorre uma vez por semana, nos períodos matutino e vespertino, nas dependências da Faculdade de Filosofia e Ciências da Universidade Estadual Paulista (UNESP, Campus de Marília/SP. Participaram dessa coleta 17 alunos, com faixa etária compreendida entre cinco e 12 anos de idade. A identificação musical foi realizada por meio dos seguintes testes psicométricos: Primary Measures of Music Audition (PMMA (GORDON, 1986a, Intermediate Measures of Music Audition (IMMA (GORDON, 1986b. O trabalho de enriquecimento musical foi desenvolvido a partir do modelo de Renzulli (2004 e os resultados que serão contemplados aqui fizeram parte das oficinas musicais que ocorreram no PAPCS nos anos de 2014 e 2015. Os resultados obtidos permitiram concluir que, em meio aos 17 estudantes, 10 apresentaram acuidade auditiva elevada, ou seja, demonstraram um dos indicadores de precocidade e comportamento de superdotação.

  14. Doença de Alzheimer esporádica de início precoce Sporadic early onset Alzheimer´s disease

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    Annibal Truzzi

    2005-01-01

    Full Text Available A doença de Alzheimer (DA é a principal causa de demência. Um subgrupo de pacientes apresenta sua forma familiar ou precoce (Alzheimer's disease (AD is the main cause of dementia. A subgroup of patients has the familial or early-onset (<65 years form of AD, with rapid course and a dominant genetic transmission through many generations. We report a case of a patient without a positive familiar history for AD, who presented early memory problems and progressive functional and cognitive (speech, praxis, executive functions e viso-spatial habilities decline. Behavioural (imnsonia, psychomotor agitation and hypersexuality and psychological (depression symptoms of AD were noticed in different stages of the disease. Structural and functional neuroimaging techniques showed impairment of posterior cortical areas. Early onset AD can be confounded with psychiatric disorders especially when there is no familiar history for AD. The presenile impact on both patient and family is intense and treatment in the early stages is very important to reduce patient and caregivers' burden.

  15. O processo de subjetivação na clínica psicanalítica com diagnóstico precoce do câncer

    Directory of Open Access Journals (Sweden)

    Cristina Lindenmeyer Saint-Martin

    Full Text Available Este artigo dedica-se a trabalhar a problemática do efeito do diagnóstico de câncer em pessoas submetidas às técnicas de detecção precoce dessa doença. Ressalta uma especificidade no trabalho clínico psicanalítico, onde a autora introduz uma reflexão a partir do discurso de Freud após os anos 20. Através de algumas noções, tais como o traumatismo, o masoquismo, a repetição, também coloca no centro de sua experiência clínica os conceitos de trauma e clivagem propostos nos últimos textos de Ferenczi. Estes conceitos apóiam a reflexão do autor sobre a complexidade transferencial e contratransferencial do trabalho psicanalítico desenvolvido com o paciente canceroso.

  16. Fósforo na produtividade e qualidade de sementes de feijão Carioca Precoce cultivado no período das águas Phosphorus on the productivity and seed quality of bean Carioca Precoce cultivated during the rainy season

    Directory of Open Access Journals (Sweden)

    Claudemir Zucareli

    2011-03-01

    Full Text Available O fósforo é o nutriente que mais limita a produtividade do feijoeiro em solos brasileiros, podendo influenciar na qualidade fisiológica de sementes. Objetivou-se com o trabalho avaliar a produtividade e a qualidade de sementes de feijão (Phaseolus vulgaris L. do cultivar Carioca Precoce cultivado no período das águas em resposta à adubação fosfatada. Foram avaliadas seis doses de P (0; 30; 60; 90; 120 e 150 kg de P2O5 ha-1, aplicados no sulco da semeadura na forma de superfosfato triplo, com cinco repetições. A produtividade de sementes foi determinada com base na massa das sementes produzidas na área útil da parcela experimental. A qualidade das sementes foi avaliada por meio das seguintes determinações: massa de 100 sementes, teor de água, germinação, primeira contagem, teor de água após o envelhecimento acelerado, germinação após o envelhecimento acelerado, condutividade elétrica, emergência de plântulas no campo e massa de matéria seca de plântulas. A produtividade de sementes do feijão Carioca Precoce, cultivado no período das águas, aumentou linearmente em função do suprimento de P. A massa de 100 sementes e a qualidade fisiológica das sementes não foram alteradas pelo incremento das doses de P.Common bean is an important crop in Brazilian agriculture and phosphorus (P deficiency is one of the most yield limiting factors for this crop, thus plant P-deficiency can hamper the seed physiological quality. The objective of this study was to evaluate the productivity and quality of common bean seeds cv. Carioca Precoce cultivated during the rainy season in response to phosphate fertilizer. Six levels of P (0; 30; 60; 90; 120 and 150 kg of P2O5 ha-1, with five replications, were applied in the groove of sowing as triple superphosphate. The seeds yield, at the experimental plot, was determined by the dry weight. Seed quality was evaluated through the following determinations: 100-seed mass, seed moisture content

  17. 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

  18. 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.

  19. 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.

  20. Evaluation of Neonates with Ventriculitis

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    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

  1. Imaging of the neonatal CNS

    International Nuclear Information System (INIS)

    Simbrunner, J; Riccabona, M

    2006-01-01

    Imaging of the central nervous system is one of the major tasks of Paediatric Radiology, particularly in newborns, who present with a variety of conditions that need more or less urgent imaging. Imaging is usually performed primarily by bedside US, in rare cases supplemented by a skull or spine radiograph. For more detailed information and preoperatively, MRI has become the neuroimaging tool. Thus, CT today is only used for acute trauma assessment, for assessment of potential cerebral calcifications or when MRI is not available. In cases with vascular anomalies or unsuccessful punctures, image guided interventions (embolisation) or image guidance for access (lumbar puncture, puncture of skull collections ...) may become necessary. This article tries to give a brief overview on the common disease entities, their typical imaging features in the major modalities applied and the implications of imaging potential for indication and choice of imaging method. In general, acute assessment may become everywhere and major features of important diseases should be recognised not to miss conditions which need urgent treatment or referral to a dedicated paediatric unit. Many other conditions will only be seen at centres with a dedicated neonatal care unit and dedicated paediatric radiologist who then also will be able to provide proper imaging with adapted protocols and methods for these partially severely sick babies. As these specific features and adapted capabilities as well as dedicated training and clinical experience are necessary for providing best results and proper handling in neonates, many neonatal conditions will not be imaged at a peripheral site, but primarily should be referred to a paediatric (radiology) centre

  2. Foetal and neonatal alloimmune thrombocytopaenia

    Directory of Open Access Journals (Sweden)

    Kaplan Cecile

    2006-10-01

    Full Text Available Abstract Foetal/neonatal alloimmune thrombocytopaenia (NAIT results from maternal alloimmunisation against foetal platelet antigens inherited from the father and different from those present in the mother, and usually presents as a severe isolated thrombocytopaenia in otherwise healthy newborns. The incidence has been estimated at 1/800 to 1/1 000 live births. NAIT has been considered to be the platelet counterpart of Rh Haemolytic Disease of the Newborn (RHD. Unlike RHD, NAIT can occur during a first pregnancy. The spectrum of the disease may range from sub-clinical moderate thrombocytopaenia to life-threatening bleeding in the neonatal period. Mildly affected infants may be asymptomatic. In those with severe thrombocytopaenia, the most common presentations are petechiae, purpura or cephalohaematoma at birth, associated with major risk of intracranial haemorrhage (up to 20% of reported cases, which leads to death or neurological sequelae. Alloimmune thrombocytopaenia is more often unexpected and is usually diagnosed after birth. Once suspected, the diagnosis is confirmed by demonstration of maternal antiplatelet alloantibodies directed against a paternal antigen inherited by the foetus/neonate. Post-natal management involves transfusion of platelets devoid of this antigen, and should not be delayed by biological confirmation of the diagnosis (once the diagnosis is suspected, especially in case of severe thrombocytopaenia. Prompt diagnosis and treatment are essential to reduce the chances of death and disability due to haemorrhage. Due to the high rate of recurrence and increased severity of the foetal thrombocytopaenia in successive pregnancies, antenatal therapy should be offered. However, management of high-risk pregnancies is still a matter of discussion.

  3. 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.

  4. Sepsis neonatal por Chryseobacterium meningosepticum

    Directory of Open Access Journals (Sweden)

    Carlos Velásquez

    2008-10-01

    Full Text Available El Chrysobacterium meningosepticum conocido también como Flavobacterium meningosepticum, es una bacteria Gram negativa distribuida en la naturaleza, pero cuya variedad patógena es raramente diagnosticada. Su importancia radica en su alta resistencia antibiótica, que cuando es causa de infecciones en prematuros y adultos inmunocomprometidos conlleva a una alta mortalidad. Se realiza una revisión acerca de esta bacteria, la importancia de su diagnóstico y la vigilancia de las infecciones intrahospitalarias, a raíz de un caso presentado en una unidad de cuidados intensivos neonatal de Lima, Perú.

  5. Clinical significance of neonatal menstruation.

    Science.gov (United States)

    Brosens, Ivo; Benagiano, Giuseppe

    2016-01-01

    Past studies have clearly shown the existence of a spectrum of endometrial progesterone responses in neonatal endometrium, varying from proliferation to full decidualization with menstrual-like shedding. The bleedings represent, similar to what occurs in adult menstruation, a progesterone withdrawal bleeding. Today, the bleeding is completely neglected and considered an uneventful episode of no clinical significance. Yet clinical studies have linked the risk of bleeding to a series of events indicating fetal distress. The potential link between the progesterone response and major adolescent disorders requires to be investigated by prospective studies. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. Neuropathic bladder in the neonate.

    Science.gov (United States)

    Carr, Michael C

    2014-09-01

    The management of infants born with myelomeningocele depends on understanding how their bladder stores and empties urine. Storage at low pressure with effective emptying periodically throughout the day is the goal. Intervention is designed to impact on one or both of these processes so that infants can remain infection-free and at the same time allow for appropriate renal growth over time. Urodynamic evaluation plays an important role, so that neonates can be stratified according to their risk. Most patients require intermittent catheterization and pharmacotherapy to achieve these goals at some point in their lives. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Neonate with Mycoplasma hominis meningoencephalitis given moxifloxacin

    NARCIS (Netherlands)

    Wildenbeest, Joanne G.; Said, Ines; Jaeger, Bregje; van Hest, Reinier M.; van de Beek, Diederik; Pajkrt, Dasja

    2016-01-01

    Mycoplasma hominis is a commensal organism in the genitourinary tract that can cause life-threatening CNS infections in neonates after intrauterine infection or through vertical transmission during birth. We present a case of an 11-day-old neonate presenting with fever and supporting laboratory

  8. Neurological status in severely jaundiced Zimbabwean neonates

    NARCIS (Netherlands)

    Wolf, M. J.; Beunen, G.; Casaer, P.; Wolf, B.

    1998-01-01

    Neurological status was studied in 50 jaundiced infants with a total serum bilirubin of > 400 mumol/l (23.4 mg/dl). Infants were assessed in the neonatal period with the Neonatal Neurological Examination and 4 months of age with the Infant Motor Screen. Twenty-six (52 per cent) infants were

  9. 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.

  10. 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

  11. 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…

  12. 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 ...

  13. 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 ...

  14. 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)

  15. 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

  16. Perinatal pharmacology: applications for neonatal neurology.

    Science.gov (United States)

    Smits, Anne; Allegaert, Karel

    2011-11-01

    The principles of clinical pharmacology also apply to neonates, but their characteristics warrant a tailored approach. We focus on aspects of both developmental pharmacokinetics (concentration/time relationship) and developmental pharmacodynamics (concentration/effect relationship) in neonates. We hereby aimed to link concepts used in clinical pharmacology with compound-specific observations (anti-epileptics, analgosedatives) in the field of neonatal neurology. Although in part anecdotal, we subsequently illustrate the relevance of developmental pharmacology in the field of neonatal neurology by a specific intervention (e.g. whole body cooling), specific clinical presentations (e.g. short and long term outcome following fetal exposure to antidepressive agents, the development of new biomarkers for fetal alcohol syndrome) and specific clinical needs (e.g. analgosedation in neonates, excitocytosis versus neuro-apoptosis/impaired synaptogenesis). Copyright © 2011 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  17. Neonatal tetanus associated with skin infection.

    Science.gov (United States)

    Maharaj, M; Dungwa, N

    2016-08-03

    A 1-week-old infant was brought to a regional hospital with a history of recurrent seizures following lower abdominal septic skin infection. She was found to have neonatal tetanus, and a spatula test was positive. The tetanus infection was associated with a superficial skin infection, common in neonates. Treatment included sedatives (diazepam, chlorpromazine, phenobarbitone and morphine), muscle relaxants, antibiotics and ventilation in the neonatal intensive care unit. Intrathecal and intramuscular immunoglobulin were given, and the wound was treated. The infant recovered, with no seizures by the 16th day from admission, and was off the ventilator by the 18th day. This was shorter than the usual 3 - 4 weeks for neonates with tetanus at the hospital. The question arises whether tetanus immunisation should be considered in infants with skin infections, which frequently occur in the neonatal period.

  18. Imaging approach to persistent neonatal jaundice

    International Nuclear Information System (INIS)

    Kirks, D.; Coleman, R.E.; Filston, H.C.; Rosenberg, E.R.; Merten, D.F.

    1984-01-01

    Fifteen patients with persistent neonatal jaundice were evaluated by sonography and radionuclide scintigraphy. The sonographic features of both neonatal hepatitis and biliary atresia are nonspecific. Hepatobiliary scintigraphy after phenobarbital pretreatment in patients with neonatal hepatitis demonstrates normal hepatic extraction and delayed tracer excretion into the gastrointestinal tract. If there is neonatal hepatitis with severe hepatocellular damage, the hepatic extraction of tracer activity is decreased and excretion may be delayed or absent. Patients under 3 months of age with biliary atresia have normal hepatic extraction of tracer with no excretion into the gastrointestinal tract. Sonography in patients with a choledochal cyst shows a cystic mass in the porta hepatis with associated bile-duct dilatation. Hepatobiliary scintigraphy confirms that the choledochal cyst communicates with the biliary system. Initial sonography demonstrates hepatobiliary anatomy; subsequent phenobarbital-enhanced radionuclide scintigraphy determines hepatobiliary function. An expedient diagnostic approach is recommended for the evaluation of persistent neonatal jaundice

  19. 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.

  20. 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

  1. 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)

  2. 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)

  3. 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.

  4. 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.

  5. 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.

  6. Pediatric and neonatal cardiovascular pharmacology.

    Science.gov (United States)

    Miller-Hoover, Suzan R

    2003-01-01

    Advances in cardiology, surgical techniques, postoperative care, and medications have improved the chances of long-term survival of the neonatal and pediatric patient with complex congenital cardiac anomalies. Rather than undergoing palliative repair, these children are now frequently taken to the operating room for complete repair. As complete repair becomes the norm, collaborative management and a thorough understanding of the pre and postoperative medications used become essential to the care of these patients. The nurse's ability to understand preop, postop, and management medications is enhanced by an understanding of the principles of cardiac anatomy and physiology, as well as developmental changes in cardiac function. All of these are reviewed. In addition, since the safe and effective administration of these drugs depends on the pediatric intensive care unit (PICU) and neonatal intensive care unit (NICU) nurse's thorough knowledge of these medications and their effects on the cardiovascular system, a brief review of these medications is presented. While new technology and techniques are improving survival rates for children with congenital heart anomalies, it is the postoperative care that these children receive that enhances the patient's survival even more.

  7. Contaminação bacteriana em concentrados plaquetários: identificação, perfil de sensibilidade aos antimicrobianos e sepse associada à transfusão Bacterial contamination on platelet concentrates: identification, antimicrobial susceptibility profile and transfusion-related sepsis

    Directory of Open Access Journals (Sweden)

    Rosiéli Martini

    2010-12-01

    Full Text Available INTRODUÇÃO: Devido à sepse bacteriana associada à transfusão de concentrados plaquetários (CPs ter sérias consequências clínicas para os pacientes, alguns procedimentos têm sido incorporados na preparação e no controle de qualidade dos componentes sanguíneos para reduzir o risco da contaminação bacteriana. Este artigo descreve a prevalência da contaminação bacteriana dos CPs que foram transfundidos, o espectro bacteriano detectado com seu perfil de sensibilidade aos antimicrobianos e as reações transfusionais nos receptores. MÉTODOS: Um total de 292 CPs (278 randômicos e 14 por aférese, proveniente do Hemocentro do Estado do Rio Grande do Sul (HEMORGS de Santa Maria foi testado. As quantidades de 100μL e 200μL foram coletadas da porção tubular da bolsa de plaquetas e semeadas utilizando dois tipos de metodologias. RESULTADOS: Em cinco unidades(1,7%; 5/292 foram isoladas bactérias pela metodologia qualitativa e apenas uma pela quantitativa. Staphylococcus epidermidis foi o microrganismo identificado em todas as amostras. Dois pacientes apresentaram sepse associada à transfusão com desfecho fatal. CONCLUSÕES: A contaminação bacteriana pelas transfusões de CPs constitui-se num importante problema de saúde pública devido a sua associação com altas taxas de morbidade e mortalidade. Neste estudo, somente microrganismos gram-positivos foram isolados sendo que nenhuma amostra obtida por aférese apresentou contaminação.INTRODUCTION: Bacterial sepsis associated with the transfusion of platelet concentrates (PCs results in serious clinical implications for patients. Given these implications, certain procedures have been integrated into the preparation and quality control of blood components to reduce the risk of bacterial contamination. This article describes the prevalence of bacterial contamination on transfused PCs, the bacterial spectrum detected and their antimicrobial susceptibility profile and transfusion

  8. Effects of bromopride on abdominal wall healing with induced peritoneal sepsis after segmental colectomy and colonic anastomosis in rats Efeitos da bromoprida na cicatrização da parede abdominal com sepse peritoneal induzida e submetidos à ressecção segmentar e anastomose do cólon esquerdo em ratos

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    Marcos Vinícius Melo de Oliveira

    2011-12-01

    Full Text Available PURPOSE: Evaluate the effects of bromopride on abdominal wall healing of rats with induced peritoneal sepsis after segmental colectomy and colonic anastomosis. METHODS: Forty rats underwent sectioning of the left colon and end-to-end anastomosis and were divided into two groups of 20 animals for the administration of bromopride (bromopride group - B or saline solution (control group - C. Each group was divided into subgroups of 10 animals each to be killed on the third (GB3 and GC3 or seventh postoperative day (GB7 and GC7. It was analyzed the following characteristics: breaking strength of the abdominal wall's wound; surgical and histopathological features of the abdominal wall; and clinical features of the rats. RESULTS: There was no difference between the groups in relation to the weight of the rats and the breaking strength of the abdominal wall's wound. The GB7 group presented less edema and less quantity of fibrin during histopathological evaluation compared to the GC7 group. CONCLUSION: Bromopride did not have harmful effects on the healing of abdominal wall in rats.OBJETIVO: Avaliar o efeito da bromoprida, na cicatrização da ferida operatória da parede abdominal de ratos com sepse peritoneal experimentalmente induzida e submetidos a ressecção segmentar e anastomose de cólon esquerdo. MÉTODOS: 40 ratos distribuídos em dois grupos contendo 20 animais, para administração de bromoprida (grupo bromoprida- B ou solução de NaCl 0,9% (grupo controle - C. Cada grupo foi dividido em subgrupos contendo 10 animais, para eutanásia no terceiro (GB3 e GC3 ou sétimo dia (GB7 e GE7 de pós-operatório. Os ratos foram submetidos à secção do cólon esquerdo e anastomose término-terminal. No dia da eutanásia foram avaliadas as características cirúrgicas da cavidade abdominal e clínicas dos ratos. Foram coletados segmentos da parede para a avaliação histopatológica e de resistência tênsil da ferida operatória. RESULTADOS: N

  9. Cárie precoce e severa na infância: uma abordagem integral Severe early childhood caries: an integral approach

    Directory of Open Access Journals (Sweden)

    Estela M. Losso

    2009-08-01

    Full Text Available OBJETIVO: Fornecer informações para auxiliar o médico pediatra a reconhecer os fatores de risco para o início da cárie precoce na infância e da cárie severa na infância (CSI, possibilitando a intervenção precoce de tais fatores, e, assim, evitar a instalação dessa doença prevenível e as suas consequências. FONTES DOS DADOS: As informações foram coletadas a partir de artigos científicos publicados nas bases de dados SciELO, MEDLINE e PUBMED nos últimos 25 anos, livros técnicos e publicações de consenso de organismos internacionais. As palavras-chave utilizadas foram: early childhood caries, severe early childhood caries, dental caries e children. SÍNTESE DOS DADOS: A CSI é uma forma de cárie dentária que afeta bebês e crianças. É infecciosa, de etiologia multifatorial e de desenvolvimento rápido, iniciando logo após a erupção dos dentes. Por apresentar fatores de risco local e sociocultural, deve ser considerada como sintoma de uma alteração na criança e de falta de cuidados adequados. Suas manifestações incluem dor, abscessos e dificuldades mastigatórias, afetando a alimentação e o sono da criança. Além disso, afeta também sua saúde geral, fala e autoestima. CONCLUSÕES: A CSI é uma doença com métodos preventivos estabelecidos, que devem ser introduzidos o mais precocemente possível, por meio de programas preventivos na comunidade e no núcleo familiar. Os profissionais que atendem bebês e crianças devem estar atentos aos casos com risco para o desenvolvimento da doença cárie e interceder a fim de se obter saúde.OBJECTIVE: To provide information with the purpose of helping pediatricians to recognize the risk factors for the onset of severe early childhood caries, allowing for early intervention and thus avoiding this preventable disease and its consequences. SOURCES: Information was collected from scientific articles published on the databases SciELO, MEDLINE and PUBMED in last 25 years, as

  10. Efeitos do envelhecimento precoce no vigor de sementes de Chorisia speciosa St. Hil. - Bombacaceae Effects of accelerating aging on the seed vigor of Chorisia speciosa St. Hil. - Bombacaceae

    Directory of Open Access Journals (Sweden)

    Silmara Cristina Fanti

    2005-06-01

    Full Text Available O objetivo deste trabalho foi avaliar a influência do envelhecimento precoce no vigor de sementes de paineira (Chorisia speciosa St. Hil. - Bombacaceae. Adotou-se o método da câmara de envelhecimento (45ºC e 100% de umidade relativa, sendo utilizadas para cada período de envelhecimento (0, 24, 48, 72, 96, 120 e 144 horas quatro subamostras de 50 sementes, distribuídas em caixas tipo ";gerbox";. Decorridos os períodos de envelhecimento, as sementes foram submetidas às seguintes avaliações: teste de germinação (27 ºC, teste de condutividade elétrica e avaliação de plântulas. Os resultados foram submetidos à análise de variância e ao teste de Tukey. Nos períodos de 48, 72, 96 e 120 horas de envelhecimento, foram obtidos valores estatisticamente inferiores de porcentagem de germinação em relação ao experimento-controle. A permanência das sementes por 144 horas em câmara de envelhecimento levou à perda total da viabilidade. O decréscimo na germinação foi diretamente proporcional ao aumento na lixiviação eletrolítica dos solutos celulares das sementes. A partir de 72 horas de envelhecimento precoce, detectou-se redução significativa na porcentagem de plântulas emergidas. O período de 72 horas de envelhecimento mostrou-se adequado para ser utilizado em trabalhos futuros de avaliação de vigor de sementes de paineira, pois é possível detectar diferenças significativas, em relação ao experimento-controle (sementes não envelhecidas, dos parâmetros porcentagem de germinação, porcentagem de plântulas emergidas e condutividade elétrica.The aim of this work was to evaluate the effects of accelerated aging on the seed vigor of paineira (Chorisia speciosa St. Hil.- Bombacaceae. The aging chamber technique was used (45ºC and 100% R.U. and four replications of 50 seeds were distributed on gerbox for each aging time (0, 24, 48, 72, 96, 120 and 144h. After the aging periods, the seeds were submitted to germination

  11. 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.

  12. Desempenho vegetativo e produtivo de cultivares e linhagens de soja de ciclo precoce no município de Piracicaba-SP

    Directory of Open Access Journals (Sweden)

    CÂMARA G.M.S.

    1998-01-01

    Full Text Available Como parte da rede oficial do Estado de São Paulo relativa à competição de linhagens de soja, desenvolveu-se no município de Piracicaba-SP, durante o ano agrícola 1996/97, experimento de campo visando avaliar o desempenho vegetativo e produtivo de linhagens e cultivares de soja (Glycine max L. Merrill pertencentes ao ciclo de maturação precoce. Delineado em blocos ao acaso com 20 tratamentos (linhagens e cultivares e 4 repetições, o experimento foi instalado em Terra Roxa Estruturada eutrófica. As parcelas foram constituídas por 4 linhas espaçadas entre si de 0,50 m com 5,0 m de comprimento. Como padrões de comparação das novas linhagens, foram utilizados os cultivares IAS-5 (atualmente o mais cultivado no Estado de São Paulo e IAC-17 (com elevada produtividade nos últimos ensaios no Estado de São Paulo. Foram avaliadas as seguintes características: estande inicial; época de florescimento; época de maturação; altura de planta no florescimento e na maturação; altura de inserção da primeira vagem; grau de acamamento e rendimento em grãos. Concluiu-se que: a baixo estande de plantas promoveu menor altura final, menor altura de inserção de vagem e menor rendimento em grãos; b as linhagens BR 92-4428, BR 92-6528, IAC 93-680, IAC 90-938, IDS 413-F4, IAC 93-598 e IAC 90-1000, foram as mais produtivas, superando ambos os padrões; c as linhagens FT 90-2687 e BR 92-5261, apresentaram os piores rendimentos.

  13. Lack of significant associations with early career performance suggest no link between the DMRT3 "Gait Keeper" mutation and precocity in Coldblooded trotters.

    Directory of Open Access Journals (Sweden)

    Kim Jäderkvist Fegraeus

    Full Text Available The Swedish-Norwegian Coldblooded trotter (CBT is a local breed in Sweden and Norway mainly used for harness racing. Previous studies have shown that a mutation from cytosine (C to adenine (A in the doublesex and mab-3 related transcription factor 3 (DMRT3 gene has a major impact on harness racing performance of different breeds. An association of the DMRT3 mutation with early career performance has also been suggested. The aim of the current study was to investigate this proposed association in a randomly selected group of CBTs. 769 CBTs (485 raced, 284 unraced were genotyped for the DMRT3 mutation. The association with racing performance was investigated for 13 performance traits and three different age intervals: 3 years, 3 to 6 years, and 7 to 10 years of age, using the statistical software R. Each performance trait was analyzed for association with DMRT3 using linear models. The results suggest no association of the DMRT3 mutation with precocity (i.e. performance at 3 years of age. Only two traits (race time and number of disqualifications were significantly different between the genotypes, with AA horses having the fastest times and CC horses having the highest number of disqualifications at 3 years of age. The frequency of the AA genotype was significantly lower in the raced CBT sample compared with the unraced sample and less than 50% of the AA horses participated in a race. For the age intervals 3 to 6 and 7 to 10 years the AA horses also failed to demonstrate significantly better performance than the other genotypes. Although suggested as the most favorable genotype for racing performance in Standardbreds and Finnhorses across all ages, the AA genotype does not appear to be associated with superior performance, early or late, in the racing career of CBTs.

  14. Teste de envelhecimento precoce para sementes de azevém, aveia preta e milheto Accelerated aging test for ryegrass black oat grass and pearl millet seeds

    Directory of Open Access Journals (Sweden)

    Danton Camacho Garcia

    1999-06-01

    Full Text Available A viabilidade da aplicação e da padronização do teste de envelhecimento precoce em sementes de azevém, aveia preta e milheto foi verificada em três lotes, para cada espécie, com valores iniciais de germinação semelhantes. As sementes de cada lote foram submetidas ao teste por períodos de 24, 48, 72, 96 e 120 horas, à temperatura de 41°C e 100% de umidade relativa do ar. Em aveia preta, o período de 24 horas estratifica lotes de sementes pelo vigor. Para milheto e azevém, o período de envelhecimento para estratificar lotes de sementes pelo vigor pode ser de 24 a 48 horas. Períodos de 72 a 120 horas são muito drásticos para as três espécies e impedem a estratificação de lotes de sementes pelo vigor.Accelerated aging test standardization for seeds of ryegrass, black oat grass and pearl millet was cheked in three lots, of each specie, with similar initial values of germination. The seeds of each lot were submited to periods of 24, 48, 96 and 120 hours of temperature of 41°C and air relative humidity of 100%. In black oat grass the 24h period stratifies seed vigor among lots. However, for pearl millet and ryegrass the period can be of 24 to 48h. Periods of 72 to 120 hours are very severe to the three species and prevent the seed vigor lots stratification.

  15. Uso precoce e tardio de dopamina após isquemia miocárdica Early and late use of dopamine after myocardial ischemia

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    Ademar R. Souza

    2004-09-01

    Full Text Available OBJETIVO: Avaliar os efeitos na função ventricular esquerda do uso precoce e tardio de dopamina, em modelo experimental de coração isolado. MÉTODO: Foram utilizados 60 coelhos em modelo de coração isolado mantido por animal suporte. Um balão intraventricular foi locado no ventrículo esquerdo. Três grupos foram constituídos: grupo controle (GC; grupo que recebeu dopamina precoce (Dopa P e grupo que recebeu dopamina tardia (após 20 minutos (Dopa T. Foram realizadas leituras hemodinâmicas diretas e indiretas. RESULTADOS: Fluxo sangüíneo coronariano: GC(7,196 ± 1,275ml/min; Dopa P (9,477 ± 1,160ml/min; Dopa T (14,316 ± 2,308ml/min, com GC=Dopa P, GC ¹Dopa T e Dopa P¹Dopa T. Primeira derivada temporal da pressão intraventricular (dp/dt+: GC (719,61 ± 127,53ml/min; Dopa P (719,61 ± 127,53ml/min; Dopa T (1431,60 ± 230,87ml/min, p0,05, Dopa P=Dopa T=GC. Estresse sistólico desenvolvido: GC (27,273 ± 10,276g/cm²; Dopa P (55,219 ± 24,625g/cm²; Dopa T (79,152 ± 12,166g/cm², Dopa P=Dopa T, Dopa P=GC e GC ¹ Dopa T.Dialdeído Malônico (MDA: GC (4,5 ± 0,527mmol/L; Dopa P (4,7 ± 1,16mmol/L; Dopa T (4,1 ± 0,7379mmol/L, p>0,05, Dopa P=Dopa T=GC. CONCLUSÕES: Concluiu-se que, no modelo experimental delineado, o uso precoce da dopamina foi deletério, segundo algumas variáveis hemodinâmicas.OBJECTIVE: To evaluate the effect on the left ventricular function of the early and late use of dopamine in an experimental model of an isolated heart. METHOD: Were used 60 rabbits in an isolated heart model sustained by animal support. An intraventricular balloon was placed in the left ventricle. Three groups were constituted: a control group (CG; a group that received dopamine precociously (Dopa P and a group that received dopamine after 20 minutes (Dopa T. Direct and indirect hemodynamic readings were taken. RESULTS: Coronary artery flow: CG (7.196 ± 1.275 mL/min; Dopa P (9.477 ± 1.160 mL/min; Dopa T (14.316 ± 2.308 mL/min, with CG

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

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    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

  17. 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 ...

  18. 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.

  19. 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.

  20. Providing safe surgery for neonates in sub-Saharan Africa.

    Science.gov (United States)

    Ameh, Emmanuel A; Ameh, Nkeiruka

    2003-07-01

    Advances in neonatal intensive care, total parenteral nutrition and improvements in technology have led to a greatly improved outcome of neonatal surgery in developed countries. In many parts of sub-Saharan Africa, however, neonatal surgery continues to pose wide-ranging challenges. Delivery outside hospital, delayed referral, poor transportation, and lack of appropriate personnel and facilities continue to contribute to increased morbidity and mortality in neonates, particularly under emergency situations. Antenatal supervision and hospital delivery needs to be encouraged in our communities. Adequate attention needs to be paid to providing appropriate facilities for neonatal transport and support and training of appropriate staff for neonatal surgery. Neonates with surgical problems should be adequately resuscitated before referral where necessary but surgery should not be unduly delayed. Major neonatal surgery should as much as possible be performed by those trained to operate on neonates. Appropriate research and international collaboration is necessary to improve neonatal surgical care in the environment.

  1. 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

  2. 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

  3. 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...

  4. 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

  5. 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.

  6. Neonatal Intrathoracic Stomach without Gastric Volvulus.

    Science.gov (United States)

    Bokka, Sriharsha; Mohanty, Manoj Kumar

    2016-10-01

    Intrathoracic stomach is a rare and serious congenital abnormality. The anomaly may be complicated by gastric volvulus and can lead to ischemic gastric infarction in the neonate. If diagnosed antenatally, neonatal management can be planned in advance so as to reduce morbidity. This anomaly must be differentiated from the more common congenital diaphragmatic hernia, as associated pulmonary hypoplasia is common in the latter and rare with gastric herniation. We report a case of intrathoracic stomach in a neonate without volvulus, fortunately a rare entity which was managed operatively, and the child has been under regular follow-up.

  7. [Studies of flomoxef in neonates].

    Science.gov (United States)

    Sato, H; Narita, A; Matsumoto, K; Nakazawa, S; Suzuki, H; Nakanishi, Y; Nagao, K; Nakazawa, S; Niinou, K

    1991-11-01

    Studies on pharmacokinetics and clinical effects of flomoxef (FMOX), a parenteral oxacephem antibiotic, were carried out in neonates. The results obtained are summarized as follows. 1. Mean peak serum concentrations of FMOX upon single administrations at doses of 20 mg/kg and 40 mg/kg were 33.3 +/- 7.33 micrograms/ml and 68.9 micrograms/ml, respectively. 2. Mean urinary recovery rates of FMOX in the first 6 hours after administration of the above doses were 35.2% and 48.3%, respectively. 3. FMOX was administered to 4 cases including 1 prophylactic case, 1 case each with aspiration pneumonia and sepsis, hypodermic abscess of the head, and itrauterine infection, at a dose of 20-30 mg/kg 2 or 3 times a day. Clinically, excellent results were obtained in 3 cases including an methicillin-resistant Staphylococcus aureus case. 4. No side effects nor abnormal laboratory test results were observed.

  8. Neonatal brucellosis and breast milk.

    Science.gov (United States)

    Ceylan, Abdullah; Köstü, Murat; Tuncer, Oğuz; Peker, Erdal; Kırımi, Ercan

    2012-03-01

    In this case report the authors present an extremely low birth weight premature infant with neonatal brucellosis whose mother had been treated for brucellosis during pregnancy. Infant developed mild respiratory distress syndrome soon after birth. At 2nd wk of postnatal age findings of bronchopulmonary dysplasia were evident and she and her mother were diagnosed to have brucellosis at the same time. After commencement of antibrucellosis therapy and nonspesific treatment for bronchopulmonary dysplasia, infant was completely cured of the symptoms related to both brucellosis and bronchopulmonary dysplasia. The results of the present case and a review of the literature have let to conclude that Brucella might have role in development of prematurity and bronchoplumonary dysplasia. Since discovery of brucella bacilli in early periods of 20th century, fetotoxicity of brucella bacilli seems to increase gradually suggesting an increasing virulance of the bacilli or vanishing host defense of human beings.

  9. Miliary pattern in neonatal pneumonia

    International Nuclear Information System (INIS)

    Flores, J.A.M.

    1988-01-01

    We have seen 10 newborn babies who developed respiratory distress and whose chest radiographs showed a miliary nodular pattern of disease. Of these infants only 3 had blood cultures that were positive for staphylococcus aureus. Of the remaining 7, 2 had conjunctivitis from which staphylococcus aureus was cultured, 4 had negative cultures and 1 did not have a blood culture done. All patients were diagnosed as having bacterial pneumonia and appeared to respond favourably to antibiotic therapy. The pulmonary abnormalities resolved. The children were clinically well in less than 3 weeks. The author suggests that the miliary pattern is one of the radiological patterns of neonatal pneumonia possibly produced by hematogenous bacterial dissemination. (orig.)

  10. Group B streptococcal neonatal parotitis.

    Science.gov (United States)

    Dias Costa, Filipa; Ramos Andrade, Daniel; Cunha, Filipa Inês; Fernandes, Agostinho

    2015-06-10

    Acute neonatal parotitis (ANP) is a rare condition, characterised by parotid swelling and other local inflammatory signs. The most common pathogen is Staphylococcus aureus, but other organisms can be implicated. We describe the case of a 13-day-old term newborn, previously healthy, with late-onset group B Streptococcus (GBS) bacteraemia with ANP, who presented with irritability, reduced feeding and tender swelling of the right parotid. Laboratory evaluation showed neutrophilia, elevated C reactive protein and procalcitonin, with normal serum amylase concentration. Ultrasound findings were suggestive of acute parotitis. Empiric antibiotic therapy was immediately started and adjusted when culture results became available. The newborn was discharged after 10 days, with clinical improvement within the first 72 h. Although S. aureus is the most common pathogen implicated in ANP, GBS should be included in the differential diagnosis. 2015 BMJ Publishing Group Ltd.

  11. 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

  12. Thyroid function in neonatal hypothyroidism.

    Science.gov (United States)

    Dussault, J H; Letarte, J; Guyda, H; Laberge, C

    1976-10-01

    Various aspects of the thyroid function have been measured in 28 cases of neonatal hypothyroidism detected by means of the Quebec Screening Program for Metabolic Diseases. In all instances the T4 value in the blood of filter paper spot was below 2 SD of the mean of the day, averaging 0.39 +/- 0.04 ng/40 mul (mean +/- SEM) of eluted blood. The T4 value of a second similar sample averaged 0.22 +/- 0.04 ng/mul of eluted blood; this value was significantly lower than the first one. The serum T4 concentration was decreased in all the infants, whereas three of them had a normal serum TSH concentration. At least three groups of patients could be identified: (1) patients with primary thyroid failure, (2) those with secondary or tertiary hypothyrodism, and (3) those with abnormal synthesis of thyroid hormone.

  13. 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)

  14. 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)

  15. 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)

  16. PRODUÇÃO DE SEMENTES DE CULTIVARES PRECOCES DE SOJA EM DUAS ÉPOCAS E DOIS LOCAIS PAULISTAS: I. CARACTERÍSTICAS AGRONÔMICAS E PRODUTIVIDADE

    Directory of Open Access Journals (Sweden)

    MEDINA PRISCILA FRATIN

    1997-01-01

    Full Text Available Com o objetivo de analisar as características agronômicas e a produtividade de sementes de cultivares precoces de soja (IAC-100, IAC-16, IAC-Foscarin-31, BR-4 e IAS-5 na estação seca, sob irrigação suplementar, realizou-se o cultivo desses genótipos durante o outono-inverno, nos municípios de Campinas e Votuporanga (SP e para comparação do efeito de época de semeadura, também na época convencional. Na colheita, avaliaram-se: altura das plantas, número de nós por planta, altura da inserção das primeiras vagens, número de sementes por planta, massa de mil sementes e produtividade. Determinaram-se, também, o potencial de germinação e a produtividade de sementes viáveis, após a colheita e na época da semeadura da safra seguinte (novembro. Concluiu-se que: (a a semeadura de cultivares precoces de soja, no início do outono, é alternativa viável para a produção de sementes, especialmente em regiões como a de Votuporanga, onde a época convencional de semeação pode inviabilizar a obtenção de sementes que mantenham alta capacidade germinativa por um período satisfatório; (b o retardamento da semeadura na produção de sementes de cultivares precoces de soja deve basear-se na análise tanto da produtividade total como na de sementes viáveis, considerando-se, principalmente, a viabilidade das sementes na época de semeação da safra seguinte.

  17. Parâmetros genéticos e análise de trilha para o florescimento precoce e características agronômicas da alface

    Directory of Open Access Journals (Sweden)

    Alcinei Mistico Azevedo

    2014-02-01

    Full Text Available O objetivo deste trabalho foi avaliar os parâmetros genéticos das características agronômicas e de tolerância ao florescimento precoce de onze cultivares de alface, bem como verificar a existência de associação entre as características. O experimento foi realizado em ambiente protegido, em delineamento de blocos ao acaso, com quatro repetições e doze plantas por parcela. Quarenta e cinco dias após o transplantio das mudas, foram mensuradas as seguintes características: massa de matéria fresca total e "comercial" da parte aérea, massa de matéria seca "comercial" da parte aérea, massa de matéria fresca e seca da raiz, diâmetro e circunferência da cabeça, altura de planta, número de folhas por planta e número de dias até a antese. Há variabilidade genética entre as cultivares, em todas as variáveis, exceto quanto à circunferência de planta e matéria fresca da raiz. As cultivares Regina 500, Lívia e Atração foram superiores quanto ao número de dias para o florescimento e também para as demais características avaliadas. A seleção contra o florescimento precoce ocasionou ganho em todas as características; porém, não interferiu na matéria seca da raiz. A matéria fresca da parte aérea e o diâmetro de cabeça são indicadas para a seleção indireta contra o florescimento precoce.

  18. 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.

  19. Spontaneous neonatal gastrointestinal perforation: surgical or ...

    African Journals Online (AJOL)

    ... cases of spontaneous gastrointestinal perforation in neonates at the University of Benin Teaching Hospital, Benin City. The perinatal stress factors were caesarian delivery, prematurity and fetal distress due to prolonged obstructed labour.

  20. 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.

  1. Intensive care of the neonatal foal.

    Science.gov (United States)

    Koterba, A M; Drummond, W H; Kosch, P

    1985-04-01

    The basic concepts of diagnosis and treatment in the abnormal neonatal foal are presented. Methods of restraint, sedation, and general nursing care are discussed, as well as more specific techniques of respiratory and circulatory system support.

  2. [Epidemiology of nosocomial infections in neonates].

    Science.gov (United States)

    Lachassinne, E; Letamendia-Richard, E; Gaudelus, J

    2004-03-01

    Epidemiology of nosocomial infections in neonates has to be described according to our definitions (early onset GBS diseases excluded) and according to levels of care. Nosocomial risk exists in maternity departments (3% in postnatal beds), incidence rates are 7.5-12.7% or 1.3-8.5 per 1000 days in neonatal care units and 14.2% or 11.7 per 1000 days in neonatal intensive care units (NICU). Gram-positive cocci bloodstream infections are the most common nosocomial infections in NICU but viral gastroenteritis are more frequent in neonatal care units. Risk factors are low birthweight, small gestational age and intravascular catheter in NICU, and for viral nosocomial infections, visits and winter outbreaks.

  3. Genetics Home Reference: permanent neonatal diabetes mellitus

    Science.gov (United States)

    ... AL. Update on mutations in glucokinase (GCK), which cause maturity-onset diabetes of the young, permanent neonatal diabetes, and hyperinsulinemic hypoglycemia. Hum Mutat. 2009 Nov;30(11):1512-26. ...

  4. Neonatal death dwarfism - a new form

    Energy Technology Data Exchange (ETDEWEB)

    Colavita, N.; Kozlowski, K.

    1984-09-01

    A new type of neonatal death dwarfism is reported. Although it resembles superficially the metatropic dysplasia group of diseases it has some distinctive radiographic features which help to delineate it as a separate entity.

  5. Neonatal death dwarfism - a new form

    International Nuclear Information System (INIS)

    Colavita, N.; Kozlowski, K.; Universita Cattolica del Sacro Cuore di Milano, Rome

    1984-01-01

    A new type of neonatal death dwarfism is reported. Although it resembles superficially the metatropic dysplasia group of diseases it has some distinctive radiographic features which help to delineate it as a separate entity. (orig.)

  6. Fetal neonatal hyperthyroidism: diagnostic and therapeutic approachment

    Science.gov (United States)

    Kurtoğlu, Selim; Özdemir, Ahmet

    2017-01-01

    Fetal and neonatal hyperthyroidism may occur in mothers with Graves’ disease. Fetal thyrotoxicosis manifestation is observed with the transition of TSH receptor stimulating antibodies to the fetus from the 17th–20th weeks of pregnancy and with the fetal TSH receptors becoming responsive after 20 weeks. The diagnosis is confirmed by fetal tachycardia, goiter and bone age advancement in pregnancy and maternal treatment is conducted in accordance. The probability of neonatal hyperthyroidism is high in the babies of mothers that have ongoing antithyroid requirement and higher antibody levels in the last months of pregnancy. Clinical manifestation may be delayed by 7–17 days because of the antithyroid drugs taken by the mother. Neonatal hyperthyroidism symptoms can be confused with sepsis and congenital viral infections. Herein, the diagnosis and therapeutic approach are reviewed in cases of fetal neonatal hyperthyroidism. PMID:28439194

  7. Retrospective review of neonates with persistent pulmonary ...

    African Journals Online (AJOL)

    Children's Hospital[7] and 48% at Chris Hani Baragwanath Academic. Hospital. ... pulmonary pathology, although primary or idiopathic PPHN also occurs. ..... Baquero H, Soliz A, Neira F, Venegas ME, Sola A. Oral sildenafil in Neonates with.

  8. 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...

  9. Clinical pharmacokinetics of phenobarbital in neonates

    NARCIS (Netherlands)

    Touw, D J; Graafland, O; Cranendonk, A; Vermeulen, R J; van Weissenbruch, M M

    2000-01-01

    Demographic and clinical pharmacokinetic data collected from term and preterm neonates who were treated with intravenous phenobarbital have been analysed to evaluate the role of patient characteristics in pharmacokinetic parameters. Significant relationships between total body weight (TBW) or body

  10. 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.

  11. NEONATAL TERATOMA PRESENTING AS HYGROMA-COLLI

    NARCIS (Netherlands)

    JAARSMA, AS; TAMMINGA, RYJ; DELANGEN, ZJ; NIKKELS, PGJ; KIMPEN, JLL

    We describe a neonate with a large tumour involving cranial, cervical and upper mediastinal regions, which presented clinically as hygroma colli. Radiological and pathological investigations showed characteristics of a mature teratoma and prominent cystic components within the tumour. These findings

  12. Fiberoptic laryngoscopy under general anesthesia in neonates

    NARCIS (Netherlands)

    L.J. Hoeve (Hans); R.H.M. van Poppelen

    1990-01-01

    textabstractAbstract In the Sophia Children's Hospital we perform fiberoptic laryngoscopy in neonates under general anesthesia without the use of muscle relaxants in the diagnostics of functional laryngeal disorders. The necessary diagnostic and anesthetic equipment is described. Special attention

  13. Therapeutic effects of probiotics on neonatal jaundice

    OpenAIRE

    Liu, Wenbin; Liu, Huajun; Wang, Taisen; Tang, Xueqing

    2015-01-01

    Objective: To evaluate the therapeutic effects of probiotics on neonatal jaundice and the safety. Methods: Sixty-eight neonates with jaundice were divided into a control group and a treatment group (n=34) randomly, and treated by blue light phototherapy and that in combination with probiotics. The serum bilirubin levels were detected before and 1, 4, 7 days after treatment. The time when therapy showed effects and jaundice faded, clinical outcomes as well as adverse reactions were recorded. T...

  14. [Clinical studies on flomoxef in neonates].

    Science.gov (United States)

    Tabuki, K; Nishimura, T

    1993-07-01

    Clinical studies on flomoxef (FMOX) were performed in neonates and the results obtained are summarized as follows. Treatment with FMOX was made in 4 cases of neonatal bacterial infections; 2 cases of sepsis (suspected) and 1 case each of infection of umbilicus and staphylococcal scalded skin syndrome. Results obtained were excellent in 1 case, good in 3 cases. No significant side effects due to the drug were observed in any cases.

  15. Year in Review 2015: Neonatal Respiratory Care.

    Science.gov (United States)

    Courtney, Sherry E

    2016-04-01

    Neonatal respiratory care practices have changed with breathtaking speed in the past few years. It is critical for the respiratory therapist and others caring for neonates to be up to date with current recommendations and evolving care practices. The purpose of this article is to review papers of particular note that were published in 2015 and address important aspects of newborn respiratory care. Copyright © 2016 by Daedalus Enterprises.

  16. [Sensorineural hearing loss due to neonatal hyperbilirubinemia].

    Science.gov (United States)

    Clarós, P; Turcanu, D; Caballero, M; Costa, C; Clavería, M A; Clarós, A; Clarós, A

    2003-01-01

    In this article, the sensorineural hearing loss is presented as a possible sequelae of neonatal hyperbilirubinemia. In our program of early hipoacusia detection, 241 babies were examined from January 1996 until November 1999; 7 cases had a history of hyperbilirubinemia in the neonatal period and 2 of them were diagnosed of sensorineural hearing loss. We discuss how the bilirubin or any other associated factor might have been the cause and this could explain the selective affectation of some children.

  17. Diagnóstico bucal precoce no SUS : análise individual, vigilância à saúde e trabalho em equipe como possibilidade (re)estruturante

    OpenAIRE

    Melo, Nilce Santos de; Figueiredo, Paulo Tadeu de Souza; Leite, André Ferreira; Souza, Tiago Araújo Coelho de; Lucena, Edson Hilan Gomes de; Zanetti, Carlo Henrique Goretti

    2011-01-01

    O artigo se estrutura em dois estudos exploratórios sobre o exercício do diagnóstico clínico de lesões bucais no SUS. Os dados foram obtidos por meio de questionários, aplicados durante atividades de educação continuada. Aproximadamente 300 cirurgiões-dentistas que atuam na atenção básica responderam. Para a maioria (79,5%), há tempo, infraestrutura e intenção de realizar diagnóstico precoce. Por outro lado, os profissionais manifestaram dificuldades em realiz...

  18. 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 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.

  19. Serum zinc status of neonates with seizure

    Directory of Open Access Journals (Sweden)

    Olia Sharmeen

    2016-08-01

    Full Text Available Background: Seizure is a common neurological disorder in neonatal age group!. Primary metabolic derangement is one of the important reason behind this convulsion during this period. Among primary metabolic derangement hypoglycemia, is most common followed by bypocalcaemia, hypomagnesaemia, low zinc status etc. As causes of many cases of convul­sion remain unknown in neonate. Objectives: To see the zinc status in the sera of neonate with convulsion. So that if needed early intervention can be taken up and thereby prevent complications. Method: A total of 50 neonates (1-28 days who had convulsion with no apparent reasons of convulsion were enrolled as cases and 50 healthy age and sex matched neonates were enrolled as controls. After a quick clinical evaluation serum zinc status was estimated from venous blood by atomic absorption method in Chemistry Division, Atomic Energy Centre. Low zinc was considered if serum value was <0.7mg/L. Results: Among a total of 50 cases 6% had low zinc value & 2% of controls also had low zinc level. The mean serwu zinc level of cases and controls were 1.57±0.95 and 2.37±1.06 mmol/1 respectively (p<0.01. Conclusion: From the study it is seen that low zinc value is an important cause of neonatal seizure due to primary metabolic abnormalities. So early recognition and treatment could save these babies from long term neurological sequelies.

  20. Risk factors for hearing loss in neonates

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    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.

  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. Maternal Risk Factors for Neonatal Necrotizing Enterocolitis

    Science.gov (United States)

    March, Melissa I.; Gupta, Munish; Modest, Anna M.; Wu, Lily; Hacker, Michele R.; Martin, Camilia R.; Rana, Sarosh

    2015-01-01

    Objective This study aimed to investigate the relationship between maternal hypertensive disease and other risk factors and the neonatal development of necrotizing enterocolitis (NEC). Methods This was a retrospective case control study of infants with NEC from 2008 to 2012. The primary exposure of interest was maternal hypertensive disease, which has been hypothesized to put infants at risk for NEC. Other variables collected included demographics, pregnancy complications, medications, and neonatal hospital course. Data was abstracted from medical records. Results 28 cases of singleton neonates with NEC and 81 matched controls were identified and analyzed. There was no significant difference in the primary outcome. Fetuses with an antenatal diagnosis of growth restriction were more likely to develop NEC (p=0.008). Infants with NEC had lower median birth weight than infants without NEC (p=0.009). Infants with NEC had more late-onset sepsis (p=0.01) and mortality before discharge (p=0.001). Conclusions The factors identified by this case-control study that increased the risk of neonatal NEC included intrauterine growth restriction and lower neonatal birth weight. The primary exposure, hypertensive disease, did not show a significantly increased risk of neonatal NEC, however there was a nearly two-fold difference observed. Our study was underpowered to detect the observed difference. PMID:25162307

  3. 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

  4. Early impairment of cognitive functions in Parkinson's disease Comprometimento precoce das funções cognitivas na doença de Parkinson

    Directory of Open Access Journals (Sweden)

    Florindo Stella

    2007-06-01

    identificar o comprometimento cognitivo precoce nesses indivíduos.

  5. Determinant factors on children in sport Um estudo sobre os fatores influenciadores na iniciação esportiva precoce da criança

    Directory of Open Access Journals (Sweden)

    Arli Ramos de Oliveira

    1994-08-01

    Full Text Available This study has the purpose of analyzing the possible factors that early sport practice can develop on children especially without pedagogical and scientific based. The lack of a specific subject concentrated on child development studies in most physical education courses in Parana l according to Sports and Tourism Secretary. Presents different degrees of competency levels in the field. The more meaningful the Physical Education teaching is the greater the respect to the principles of age, growth, maturation and development. It is necessary to improve sport skills, and to respect children's individual differences. The child learns when he/she is ready to learn, and excessive emphasis on winning should be avoided before the age of twelve, especially for injuries prevention. The awareness of child development changes and the modification of the curriculum in the Physical Education Schools are suggested. Physical activities for children should be meaningful, according to children age level and motivation, stimulating an active and healthy freestyle. Este estudo tem o objetivo de analisar os possíveis fatores que a prática desportiva precoce pode desenvolver nas crianças, especialmente sem base pedagógica e científica. A falta de um assunto específico concentrou-se em estudos do desenvolvimento infantil na maioria dos cursos de educação física no Estado do Paraná. l de acordo com a Secretaria de Turismo e Desporto. Apresenta diferentes graus de níveis de competência no campo. O mais significativo o ensino de Educação Física é o maior do respeito aos princípios de idade, o crescimento, maturação e desenvolvimento. É necessário melhorar habilidades esportivas, e de respeitar as diferenças individuais das crianças. A criança aprende quando ele / ela está pronta para aprender, e uma ênfase excessiva na conquista deve ser evitado antes da idade de doze anos, especialmente para a prevenção de lesões. A consciência das mudan

  6. Capnografia volumétrica como meio de detectar obstrução pulmonar periférica precoce em pacientes com fibrose cística

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    Maria Ângela G. O. Ribeiro

    2012-12-01

    Full Text Available OBJETIVO: Comparar a espirometria e a capnografia volumétrica (CapV para determinar se os valores amostrados pela capnografia acrescentam informações sobre doenças pulmonares precoces em pacientes com fibrose cística (FC. MÉTODOS: Este foi um estudo do tipo corte transversal envolvendo pacientes com FC: Grupo I (42 pacientes, 6-12 anos de idade e Grupo II (22 pacientes, 13-20 anos de idade. Os grupos controle correspondentes eram formados por 30 e 50 indivíduos saudáveis, respectivamente. A capacidade vital forçada (CVF, o volume expiratório forçado no primeiro segundo (VEF1 e a relação VEF1/CVF foram determinados pela espirometria. Através da CapV, medimos a saturação periférica de oxigênio (SpO2, a frequência respiratória (FR, o tempo inspiratório (TI, o tempo expiratório (TE e o slope da fase III normalizado pelo volume corrente (slope da fase III/Vc. RESULTADOS: Em comparação com os grupos controle, todos os pacientes com FC apresentaram valores de slope da fase III/Vc (p < 0,001 mais altos independentemente do estágio de doença pulmonar. O slope da fase III/Vc foi significantemente mais alto nos 24 pacientes que tiveram resultados normais de espirometria (p = 0,018. Os pacientes do Grupo II apresentaram valores de CVF, VEF1, VEF1/CVF (p < 0,05 e SpO2 (p < 0,001 mais baixos que os pacientes do Grupo I. Os pacientes do Grupo II, comparados com os do Grupo Controle II, apresentaram FR (p < 0,001 mais alta e valores de TI e TE (p < 0,001 mais baixos. CONCLUSÕES: Todos os pacientes com FC mostraram ter valores mais altos de slope da fase III/Vc quando comparados com os pacientes dos grupos controle. A CapV identificou a heterogeneidade da distribuição da ventilação nas vias aéreas periféricas dos pacientes com FC que apresentaram espirometria normal.

  7. Repetibilidade de caracteres de produção e porte da planta em clones de cajueiro-anão precoce

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    CAVALCANTI JOSÉ JAIME VASCONCELOS

    2000-01-01

    Full Text Available Os objetivos deste trabalho foram estimar coeficientes de repetibilidade (r, comparar a eficiência das metodologias utilizadas no processo de estimação, e determinar o número de avaliações necessárias à seleção clonal de cajueiro-anão (Anacardium occidentale L. precoce. As metodologias aplicadas para estimação do coeficiente de repetibilidade constaram da análise de variância, na qual o efeito temporário do ambiente é removido do erro (ANOVA; de análise dos componentes principais obtidos da matriz de correlações (CPCOR e da matriz de variâncias e covariâncias fenotípicas (CPCOV; e da análise estrutural, com base no autovalor teórico da matriz de correlações ou correlação média (AECOR. Foram avaliados, em trinta clones, os caracteres altura da planta (AP, diâmetro da copa (DC e produção de castanha (PC, durante cinco anos. Verificou-se que em relação aos caracteres AP e DC os valores de r variaram de 0,85 (ANOVA a 0,96 (CPCOV. Quanto à produção, os valores de r foram de 0,51 (ANOVA a 0,88 (CPCOV. Desta forma, constatou-se que o método de componentes principais utilizando a matriz de variâncias e covariâncias fenotípicas é mais eficiente para estimação do coeficiente de repetibilidade, sobretudo no que se refere ao carácter produção de castanha. Observou-se que são suficientes duas medições da AP e do DC, e três medições da PC no processo seletivo.

  8. Lipodistrofia parcial familiar do tipo Dunnigan: atenção ao diagnóstico precoce Dunnigan-type familial partial lipodystrophy: attention to precocious diagnosis

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    Lenora Maria Camarate Silveira Martins Leão

    2011-02-01

    Full Text Available A lipodistrofia parcial familiar tipo Dunnigan é uma doença autossômica dominante rara. Em sua forma clássica, é resultante de uma mutação missense heterozigótica no gene LMNA, que codifica a proteína nuclear denominada lâmina tipo A/C. Caracteriza-se pelo desaparecimento progressivo do tecido adiposo subcutâneo nos membros, região glútea, abdome e tronco, que se inicia na puberdade, acompanhado de acúmulo de gordura em outras áreas, como a face, queixo, grandes lábios e região intra-abdominal, conferindo o aspecto de hipertrofia muscular e simulando o fenótipo de síndrome de Cushing. Mulheres afetadas são particularmente predispostas à resistência à insulina e suas complicações, incluindo sinais da síndrome dos ovários policísticos. Com o objetivo de alertar para o diagnóstico precoce, que possibilita a adoção de medidas que minimizam os graves distúrbios metabólicos vinculados à desordem, relatamos o caso de uma paciente em que a investigação foi realizada somente ao final da quinta década de vida. A aparente hipertrofia muscular e o acentuado depósito de gordura nos grandes lábios possibilitam aos médicos ginecologistas a suspeita diagnóstica.Dunnigan-type familial partial lipodystrophy (FPLD is an autosomal dominant disease that results from heterozygous missense mutations in LMNA, the gene that encodes nuclear lamin A/C. FPLD is characterized by a progressive disappearance of subcutaneous adipose tissue in the limbs, gluteal region, abdomen and trunk, beginning at the time of or after puberty, and excessive amount of fat in the face, chin, labia majora, and intra-abdominal region, leading to a Cushingoid appearance and increased muscularity phenotype. Affected women are particularly predisposed to insulin resistance and its complications, including features of polycystic ovary syndrome. To emphasize the importance of an early FPLD diagnosis, which is necessary to prevent serious metabolic

  9. Fatores associados ao consumo precoce de leite de vaca integral por crianças menores de um ano de idade

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    Luciano Pamplona de Goes Cavalcanti

    2015-12-01

    Full Text Available Objetivo: Avaliar a frequência e fatores associados ao uso do leite de vaca integral nas crianças menores de um ano na cidade de Fortaleza, Ceará. Métodos: Realizou-se estudo transversal e analítico envolvendo 575 mães de crianças menores de um ano de idade residentes em Fortaleza, Ceará. Aplicou-se questionário semiestruturado para coleta de dados sociodemográficos, história reprodutiva da mãe, dados referentes ao parto e à criança. Resultados: A mediana de idade das mães foi de 26,5 anos, tendo 80,5% (n=463 renda familiar de 1 a 5 salários mínimos. A maior parte (83,2%, n=475 realizou mais de seis consultas de pré-natal, mas apenas 86,2% (n=494 declararam ter recebido informações sobre aleitamento materno. Entre as crianças que receberam outro tipo de leite, 53,8% (n=191 consumiram leite de vaca integral, e destas, 31,7% (n=113 referem ter recebido orientação do pediatra. O consumo do leite de vaca foi relacionado à idade materna (menores de 18 anos de idade, (p=0,015, renda inferior a cinco salários mínimos (p<0,001, baixa escolaridade (p<0,001, mães que não trabalhavam (p<0,001, baixo número de consultas de pré-natal (p=0,019, ter nascido em hospital público (p<0,001, não ter amamentado antes de sair da maternidade (p<0,001 e não ter plano de saúde (p<0,001. Conclusão: O consumo precoce do leite de vaca integral por crianças menores de um ano apresentou alta prevalência e sofreu influência de fatores como renda, escolaridade e pouca idade da mãe. Portanto, é preciso sensibilizar os profissionais de saúde para que qualifiquem melhor as orientações prestadas durante as consultas de pré-natal e puerpério.

  10. A Study On Neonatal Mortality In Jamnagar District Of Gujarat

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    Yadav Sudha

    1998-01-01

    Full Text Available Research question: Which are the maternal, socio-demographic and neonatal attributes responsible for neonatal mortality in rural areas of Gujarat? Objectives: (i To know various maternal, socio-demographic and neonatal factors responsible for neonatal mortality in rural areas of Gujarat (ii To estimate neonatal mortality rate in the area. Setting: Rural areas of six Primary Health Centers of Jamnagar district of Gujarat State. Study design: Community based cohort study. Sample size: Population of 40512 Participants: Members of the family in which neonatal deaths occurred. Outcome variable: Neonatal mortality Analysis: Sample proportions. Results: Neonatal mortality rate on the basis of follow-up of births during one year was found to be 47.27 per thousand live births. The major maternal and socio-demographic factors responsible for neonatal mortality were; maternal age, illiteracy, lack of antenatal care, closely spaced pregnancies, delivery conducted at home, delivery conducted untrained personnel and delayed initiation of breast feeding. The major neonatal factors responsible for mortality in neonates were; low birth weight, prematurity, first order of birth, early phase of neonatal period, male gender of the child. The leading causes of neonatal mortality were found to be prematurity, birth asphyxia, neonatal infections and congenital anomalies.

  11. Acute renal failure in asphyxiated term neonates

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    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

  12. Management of neonatal abstinence syndrome in neonates born to opioid maintained women.

    Science.gov (United States)

    Ebner, Nina; Rohrmeister, Klaudia; Winklbaur, Bernadette; Baewert, Andjela; Jagsch, Reinhold; Peternell, Alexandra; Thau, Kenneth; Fischer, Gabriele

    2007-03-16

    Neonates born to opioid-maintained mothers are at risk of developing neonatal abstinence syndrome (NAS), which often requires pharmacological treatment. This study examined the effect of opioid maintenance treatment on the incidence and timing of NAS, and compared two different NAS treatments (phenobarbital versus morphine hydrochloride). Fifty-three neonates born to opioid-maintained mothers were included in this study. The mothers received methadone (n=22), slow-release oral morphine (n=17) or buprenorphine (n=14) throughout pregnancy. Irrespective of maintenance treatment, all neonates showed APGAR scores comparable to infants of non-opioid dependent mothers. No difference was found between the three maintenance groups regarding neonatal weight, length or head circumference. Sixty percent (n=32) of neonates required treatment for NAS [68% in the methadone-maintained group (n=15), 82% in the morphine-maintained group (n=14), and 21% in the buprenorphine-maintained group (n=3)]. The mean duration from birth to requirement of NAS treatment was 33 h for the morphine-maintained group, 34 h for the buprenorphine-maintained group and 58 h for the methadone-maintained group. In neonates requiring NAS treatment, those receiving morphine required a significantly shorter mean duration of treatment (9.9 days) versus those treated with phenobarbital (17.7 days). Results suggest that morphine hydrochloride is preferable for neonates suffering NAS due to opioid withdrawal.

  13. Amadurecimento precoce da placenta avaliada pela ultra-sonografia e prognóstico perinatal Early placental maturation evaluated by ultrasound and perinatal prognosis

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    Ana Patrícia Santos de Queiroz

    2006-03-01

    Full Text Available OBJETIVO: descrever os resultados maternos e perinatais das gestações com amadurecimento precoce da placenta detectado pela ultra-sonografia. MÉTODOS: realizou-se estudo retrospectivo, descritivo, tipo série de casos, com comparação de grupos. Foram incluídas 146 gestantes, internadas entre janeiro de 2000 e dezembro de 2002 e em cujo prontuário constavam diagnóstico de amadurecimento precoce da placenta (presença de placenta grau II antes da 32ª semana de gestação ou grau III, antes da 35ª semana de gestação e descrição das condições materno-fetais. Foram excluídas gestantes com diagnóstico de: amniorrexe prematura, gravidez múltipla, forma aguda de descolamento prematuro de placenta normoinserida e malformação fetal. As complicações clínico-obstétricas foram: doenças hipertensivas, redução do crescimento intra-uterino, alterações do volume de líquido amniótico, infecções, diabete materno, anemia falciforme, soropositividade para HIV, drogadição, litíase renal, epilepsia e asma brônquica. Pelos prontuários, foram identificadas 106 gestantes com complicações clínico-obstétricas (Gcom e 40, sem essas complicações (Gsem. Para comparação entre os grupos, empregaram-se os testes de chi2 e exato de Fisher, ao nível de significância de 0,05. RESULTADOS: o grupo Gcom apresentou maior freqüência de oligoâmnio (27,3%, restrição de crescimento intra-uterino (44,3% e cesárea antecedente ao trabalho de parto (36,8%. Comparado ao grupo Gsem, o Gcom caracterizou-se por maior incidência de óbitos fetais, prematuros (58,8 versus 40%, menor índice de Apgar de 5º minuto, peso ao nascer PURPOSE: to describe perinatal and obstetric characteristics of pregnant women with ultrasonographic early placental aging. METHODS: using a retrospective, descriptive, series of cases, with group comparison, the authors analyzed the data of 146 pregnant women, whose diagnosis of placental early aging (presence of grade

  14. Efeitos da desnutrição precoce e reabilitação nutricional em ratos Effects of early malnutrition and nutritional rehabilitation in rats

    Directory of Open Access Journals (Sweden)

    Magda Lahorgue Nunes

    2002-02-01

    Full Text Available Objetivos: verificar os efeitos da desnutrição precoce e da reabilitação nutricional em ratos em desenvolvimento, em relação ao limiar para crises convulsivas, peso corporal e peso cerebral.Métodos: foram utilizadas ratas prenhas do tipo Wistar e suas ninhadas. Parte da ninhada foi submetida ao paradigma da desnutrição, e os animais restantes utilizados como controle. Em P15, animais desnutridos e do grupo controle foram submetidos a estado de mal convulsivo e, após recuperação das crises, iniciavam em período de reabilitação nutricional. Em P30, os ratos foram novamente submetidos a crise convulsiva induzida por flurothyl para determinação do limiar convulsivante. Após as crises, os ratos eram sacrificados, tendo o cérebro removido e pesado. A ninhada era pesada diariamente de P2 a P30. Resultados: observamos, a partir de P5, diferença estatisticamente significativa entre o peso corporal dos animais do grupo desnutrido em comparação ao grupo nutrido. O processo de reabilitação nutricional iniciado em P16 foi associado a ascendente ganho ponderal, entretanto a diferença de peso permaneceu até P30. O peso cerebral foi discretamente superior em animais nutridos (média 1,47 g ± 0,17 e do sexo masculino (média 1,47 g ± 0,16, entretanto a diferença não foi estatisticamente significativa em relação aos desnutridos (média 1,42 g ± 0,17 ou ao sexo feminino (1,38 g ± 0,12. O limiar (tempo em segundos para o início da primeira crise clônica e da primeira crise tônico-clônica avaliado em P15 e P30 não apresentou diferença significativa entre os grupos. Conclusões: nossos resultados sugerem que a desnutrição precoce não aumenta a susceptibilidade a crises convulsivas em ratos, no período de desenvolvimento, submetidos ao modelo do flurothyl. A reabilitação nutricional iniciada precocemente teria efeito protetor na susceptibilidade a crises convulsivas dos animais previamente desnutridos.Objective: to verify

  15. 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.

  16. 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.

  17. Eruption Cyst in the Neonate.

    Science.gov (United States)

    de Oliveira, Alline J; Silveira, Maria Lg; Duarte, Danilo A; Diniz, Michele B

    2018-01-01

    The pediatric dental approach to the oral cavity of newborns requires special attention, as many aspects are unique and peculiar to this period of life. It is important that pediatricians and pediatric dentists be aware of the characteristics within normal newborn patterns and prepared to make a correct diagnosis of abnormalities at early stages. Congenital eruption cysts (ECs) are rarely observed in newborns, as at this stage of a child's life, tooth eruption is unusual. This study reports a case of EC treated successfully by monitoring of the lesion, without any surgical procedure. In the 4th month, the lesion had completely regressed, and the deciduous central incisors had erupted without problems. The clinical and radiographic monitoring of ECs in newborns seems to be a satisfactory management procedure, similar to what is recommended for older children. How to cite this article: de Oliveira AJ, Silveira MLG, Duarte DA, Diniz MB. Eruption Cyst in the Neonate. Int J Clin Pediatr Dent 2018;11(1):58-60.

  18. Radiation doses and risks to neonates undergoing common radiographic examinations in the neonatal intensive care unit

    International Nuclear Information System (INIS)

    McParland, B.J.; Lee, R.

    1996-01-01

    Neonates in the-Neonatal Intensive Care Unit (NICU) can receive large numbers of radiographs owing to the clinical conditions they may present. More neonatal radiation dosimetry data are required for three fundamental reasons: (1.) to aid in the establishment of reference dose levels for interinstitutional comparisons; (2.) to improve childhood cancer risk estimates following neonatal exposure; and (3.) to indicate appropriate directions for dose reduction. This paper describes an investigation of two different NICU radiological techniques with significantly different neonate doses. While patient-matched images taken with both techniques were assessed in a blind review, this component of the study is beyond the scope of this paper and is not discussed here. (author)

  19. 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

  20. 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.

  1. Aspectos histomorfológicos e respiratórios em modelo de lesão pulmonar aguda por sepse em ratos tratados com pentoxifilina Histomorphologic and respiratory aspects of acute lung injury in rats induced by experimental sepsis and under pentoxifylline treatment

    Directory of Open Access Journals (Sweden)

    Wagner Rogerio Souza de Oliveira

    2009-01-01

    Full Text Available OBJETIVO: Analisar as alterações histomorfológicas e respiratórias em modelo de lesão pulmonar aguda por sepse em ratos tratados com pentoxifilina. MÉTODOS: Foram utilizados 15 ratos adultos distribuídos em três grupos (n=5, por grupo, assim constituídos: GC - receberam apenas ventilação mecânica; GS - Animais sépticos tratados com solução salina e mecanicamente ventilados; GS+PTX - Animais sépticos, com infusão de pentoxifilina e mecanicamente ventilados. Todos os animais foram ventilados por um período de 180 minutos. Ao final deste período, foram avaliadas variáveis gasométricas (gasometria arterial, gravimétricas (relação peso úmido/peso seco, concentração de proteínas totais no lavado broncoalveolar e histomorfométricas (espessura dos septos alveolares. Os dados obtidos foram submetidos a análise estatística (P OBJECTIVE: Respiratory repercussion on acute lung injury in a model of induced sepsis intraperitoneally. METHODS: Fifteen animals taken at random were submitted to adult male Wistar rats. The rats were randomly divided into 3 groups (n=15: Group C - control group received only mechanical ventilation; Group S - rats received live Escherichia coli (E. coli intraperitoneally (septic and after 6 hours they were treated with normal saline infusion and ventilated with a low tidal volume. Group S+PTX - rats received live Escherichia coli intraperitoneally (septic and after 6 hours they were treated with pentoxifylline (PTX infusion and ventilated with a low tidal volume. All animals were ventilated during 180 minutes. We analyzed the arterial blood gases, gravimetric indices and histomorphometric analysis. RESULTS: Blood gases, wet to dry ratios, and total protein concentrations in the bronchoalveolar lavage were analyzed in all experimental groups. In the end of the experiment the partial pressure of oxygen was higher in the GS+PTX (460,0 ± 38,2 mmHg compared with GS (336,0 ± 14,6 mmHg. Pentoxifylline with

  2. Intervenção precoce em escolares de risco para a dislexia: revisão da literatura Early intervention in students at risk for dyslexia: literature review

    Directory of Open Access Journals (Sweden)

    Maíra Anelli Martins

    2011-08-01

    Full Text Available TEMA: intervenção precoce em escolares de risco para a dislexia. OBJETIVO: este estudo tem por objetivo geral mapear os artigos publicados sobre intervenção com escolares de risco para dislexia e, como objetivos específicos, analisar descritivamente aspectos específicos dos textos. CONCLUSÃO: as publicações na área em relação ao tema não são constantes, porém, os artigos científicos analisados evidenciam a preocupação dos pesquisadores em elaborar, desenvolver e validar instrumentos de avaliações e intervenções que contribuam para a identificação precoce da dislexia.BACKGROUND: early intervention in students at risk for dyslexia. PURPOSE: this study aims to map the general articles on intervention with students at risk for dyslexia and specific objectives, descriptively analyzing specific text aspects. CONCLUSION: there are few published data on this issue; however, the reviewed scientific articles highlight the concern of the researchers to elaborate, develop and validate assessments and interventions that contribute to the early identification of dyslexia.

  3. Influência da irrigação e do genótipo na produção de castanha em cajueiro-anão-precoce

    Directory of Open Access Journals (Sweden)

    Oliveira Vitor Hugo de

    2003-01-01

    Full Text Available Avaliou-se a influência da irrigação e do genótipo na produção de castanha em cajueiro-anão-precoce (Anacardium occidentale L. durante três anos. Foram estudados três clones (CP 09, CP 76 e CP 1001 e quatro regimes hídricos (testemunha sem irrigação e intervalos de irrigação de um, três e cinco dias. O delineamento experimental foi em blocos ao acaso, em parcelas subsubdivididas, com quatro repetições, com os regimes hídricos nas parcelas, os clones nas subparcelas, cada uma com quatro plantas, e os anos de produção nas subsubparcelas. A quantidade de água aplicada nos três tratamentos irrigados baseou-se na evaporação do tanque classe A. Em relação à produção de castanha, os clones de cajueiro-anão-precoce não apresentaram comportamento diferencial em resposta à irrigação; os clones CP 09 e CP 76 mostraram-se superiores ao CP 1001 quanto à estabilidade de safra; independentemente do regime hídrico estudado, o clone CP 76 mostrou-se menos produtivo do que os clones CP 09 e CP 1001.

  4. 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...... herpes recurrence. Four infants had a serious infection in spite of Cesarean section. This study does not support a policy of Cesarean section in case of maternal recurrent herpes simplex infection at delivery.......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...

  5. Quantitative topographic differentiation of the neonatal EEG.

    Science.gov (United States)

    Paul, Karel; Krajca, Vladimír; Roth, Zdenek; Melichar, Jan; Petránek, Svojmil

    2006-09-01

    To test the discriminatory topographic potential of a new method of the automatic EEG analysis in neonates. A quantitative description of the neonatal EEG can contribute to the objective assessment of the functional state of the brain, and may improve the precision of diagnosing cerebral dysfunctions manifested by 'disorganization', 'dysrhythmia' or 'dysmaturity'. 21 healthy, full-term newborns were examined polygraphically during sleep (EEG-8 referential derivations, respiration, ECG, EOG, EMG). From each EEG record, two 5-min samples (one from the middle of quiet sleep, the other from the middle of active sleep) were subject to subsequent automatic analysis and were described by 13 variables: spectral features and features describing shape and variability of the signal. The data from individual infants were averaged and the number of variables was reduced by factor analysis. All factors identified by factor analysis were statistically significantly influenced by the location of derivation. A large number of statistically significant differences were also established when comparing the effects of individual derivations on each of the 13 measured variables. Both spectral features and features describing shape and variability of the signal are largely accountable for the topographic differentiation of the neonatal EEG. The presented method of the automatic EEG analysis is capable to assess the topographic characteristics of the neonatal EEG, and it is adequately sensitive and describes the neonatal electroencephalogram with sufficient precision. The discriminatory capability of the used method represents a promise for their application in the clinical practice.

  6. 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.

  7. 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

  8. Structural connectivity asymmetry in the neonatal brain.

    Science.gov (United States)

    Ratnarajah, Nagulan; Rifkin-Graboi, Anne; Fortier, Marielle V; Chong, Yap Seng; Kwek, Kenneth; Saw, Seang-Mei; Godfrey, Keith M; Gluckman, Peter D; Meaney, Michael J; Qiu, Anqi

    2013-07-15

    Asymmetry of the neonatal brain is not yet understood at the level of structural connectivity. We utilized DTI deterministic tractography and structural network analysis based on graph theory to determine the pattern of structural connectivity asymmetry in 124 normal neonates. We tracted white matter axonal pathways characterizing interregional connections among brain regions and inferred asymmetry in left and right anatomical network properties. Our findings revealed that in neonates, small-world characteristics were exhibited, but did not differ between the two hemispheres, suggesting that neighboring brain regions connect tightly with each other, and that one region is only a few paths away from any other region within each hemisphere. Moreover, the neonatal brain showed greater structural efficiency in the left hemisphere than that in the right. In neonates, brain regions involved in motor, language, and memory functions play crucial roles in efficient communication in the left hemisphere, while brain regions involved in emotional processes play crucial roles in efficient communication in the right hemisphere. These findings suggest that even at birth, the topology of each cerebral hemisphere is organized in an efficient and compact manner that maps onto asymmetric functional specializations seen in adults, implying lateralized brain functions in infancy. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Practice patterns in neonatal hyperbilirubinemia.

    Science.gov (United States)

    Gartner, L M; Herrarias, C T; Sebring, R H

    1998-01-01

    To determine practice patterns of office-based pediatricians and neonatologists in the treatment of neonatal hyperbilirubinemia in healthy, term newborns during 1992, before the publication of the practice guideline for treatment of neonatal jaundice by the American Academy of Pediatrics (AAP). The survey was undertaken to inform the AAP's Subcommittee on Hyperbilirubinemia on current practices and to aid it in its preparation of the guidelines. It was also anticipated that this survey would serve as a basis for comparison for a second survey to be performed several years after the publication of the practice guidelines. A self-administered questionnaire describing a single case of a jaundiced, breastfed 36-hour-old healthy, full-term infant with a total serum bilirubin concentration of 11.0 mg/dL (188 microM/L) was sent to a random sample of 600 office-based pediatricians and 606 neonatologists who were members of the AAP. The final response rate was 74%. Respondents were asked to answer questions regarding treatment of the case based on their actual practices. Ranges of total serum bilirubin concentration were provided as possible answers to questions on initiation of phototherapy and exchange transfusion, and interruption of breastfeeding. Respondents were also queried about frequency of serum bilirubin testing, locations of phototherapy administration, and factors influencing their therapeutic decisions. Four hundred forty-two office-based pediatricians and 444 neonatologists completed the survey. There was a tendency for neonatologists to initiate both phototherapy and exchange transfusions at lower serum bilirubin concentrations than office-based general pediatricians. At a serum bilirubin of 13 to 19 mg/dL (222 to 325 microM/L), 54% of office-based pediatricians stated they would initiate phototherapy whereas 76% of neonatologists would do so. Forty percent of office-based practitioners said they would perform exchange transfusions at serum bilirubin levels

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

    African Journals Online (AJOL)

    TOSHIBA

    Relationship between outcome variable and exposure variable was done using Chi ... A recent study in Ethiopia indicates that neonatal sepsis in the major newborn ... Neonatal sepsis was defined as infection that had occurred during the.

  11. 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....

  12. 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

  13. Placental malaria and neonatal anti-tetanus antibody status: Any ...

    African Journals Online (AJOL)

    Globally, neonatal tetanus accounts for 7% of neonatal mortality,[1] ... There was a statistically significant association between type of placental malaria .... Also excluded were mothers with diabetes ..... Tetanus Vaccine: WHO Position Paper.

  14. 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.

  15. 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.)

  16. 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

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

    African Journals Online (AJOL)

    count has a poor positive predictive value for neonatal sepsis and is ... Division of Neonatology, Department of Paediatrics and Child Health, School of Medicine, University ... infections (UTIs) in neonates,[18] many clinicians use the following.

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

    African Journals Online (AJOL)

    PROF. EZECHUKWU

    2013-04-30

    Apr 30, 2013 ... preterm.4 Neonatal septicaemia accounts for 13%-15% of all neonatal deaths globally.2 .... Small for gestational age. LGA = Large for gestational age .... note that the predominant organisms showed very high sensitivity to the ...

  19. Early nasal continuous positive airway pressure versus INSURE in VLBW neonates

    Directory of Open Access Journals (Sweden)

    Ana Saianda

    2010-09-01

    coorte retrospectiva dos RNMBP nascidos num hospital de apoio perinatal diferenciado entre Janeiro/2002-Agosto/2008. Incluíram-se as crianças registadas na Vermont-Oxford Network com IG ≤30semanas e com uso de nCPAP logo após o nascimento (N = 96. Estabeleceu-se Grupo nCPAP – uso de nCPAP isolado (N = 40 e Grupo INSURE (N = 56. Consideraram-se outcomes precoces: síndroma de dificuldade respiratória (SDR, necessidade de administrar surfactante com intuito terapêutico ou recurso a ventilação invasiva. Compararam-se igualmente outcomes tardios: doença pulmonar crónica da prematuridade (DPC, mortalidade e o outcome composto DPC-mortalidade. Resultados: No grupo INSURE verificou-se menor IG, não se registando diferenças relativamente ao peso ao nascer e indução da maturação pulmonar. Verificou-se SDR em 21/40 (53% casos do grupo nCPAP e em 17/56 (30% casos do grupo INSURE (OR ajustado [IC 95%] – 0,2 [0,1-0,6]. No grupo nCPAP todos estes casos realizaram surfactante com intuito terapêutico, não tendo sido efectuada nenhuma dose adicional de surfactante no grupo INSURE. Verificou-se maior número de casos com necessidade de VI no grupo nCPAP do que no grupo INSURE (11/40, 28% vs 9/56, 12%. Não foram encontradas diferenças estatisticamente significativas relativamente aos outcomes tardios. Conclusão: Em RNMBP com IG ≤30sem, o uso isolado de nCPAP poderá traduzir-se numa ligeira desvantagem em outcomes precoces, sem evidentes repercussões em termos de DPC ou mortalidade. Key-words: Very low birth weight, nCPAP ventilation, INSURE, respiratory distress syndrome (newborn, chronic lung disease of prematurity, mortality, Palavras-chave: Recém-nascido muito baixo peso, nCPAP, INSURE, sindroma de dificuldade respiratória neonatal, doença pulmonar crónica da prematuridade, mortalidade

  20. 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.

  1. 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

  2. Seleção recorrente fenotípica para florescimento precoce de feijoeiro 'Carioca' Phenotypic recurrent selection for early flowering of 'Carioca' common bean

    Directory of Open Access Journals (Sweden)

    Flávia Barbosa Silva

    2007-10-01

    Full Text Available O objetivo deste trabalho foi avaliar a eficiência da seleção recorrente fenotípica em relação ao número de dias para o início do florescimento em feijoeiro e verificar se a seleção afeta outros caracteres. Utilizou-se uma população proveniente da mistura das populações F2 (S0 de 11 combinações híbridas, avaliadas para a precocidade. As plantas S0 (ciclo 0, que floresceram mais precocemente, foram intercruzadas para a obtenção do ciclo I. As sementes obtidas foram utilizadas para a continuidade da seleção, e o processo foi repetido até o quinto ciclo seletivo. O progresso genético foi avaliado com cinqüenta e três progênies, provenientes da mistura das sementes das plantas S0 após uma autofecundação (S1:2 de cada ciclo. Os caracteres avaliados foram: número de dias para o florescimento, severidade da mancha-angular (Phaeoisariopsis griseola, número de dias para a maturação, produtividade e tipo de grãos. Constatou-se que o progresso com a seleção foi de 2,2% ao ano, o que indica que a seleção recorrente fenotípica foi efetiva em reduzir o número de dias para o florescimento. Não houve resposta correlacionada à seleção quanto ao número de dias para o florescimento nos demais caracteres avaliados, do que se depreende ser possível a seleção de progênies que associem florescimento precoce à expressão fenotípica dos demais caracteres, conforme o interesse dos melhoristas.The objective of this work was to evaluate the efficiency of phenotypic recurrent selection for the number of days until blooming in common bean, and to verify if this selection affected other traits. One S0 population derived from the mixture of the F2 populations of 11 hybrid combinations evaluated for earliness was used. The plants of the S0 (cycle 0 which bloomed first were crossed to obtain cycle I. To go on with the selection the obtained seeds were used. The process was repeated until the fifth selection cycle. Fifty-three S1

  3. Estudo genético da precocidade sexual de novilhas em um rebanho Nelore Genetic studies of sexual precocity of heifers in a Nellore herd

    Directory of Open Access Journals (Sweden)

    Josineudson Augusto II de Vasconcelos Silva

    2005-10-01

    - heifers calving until 46 months of age (including Pr16 received 1 and those which fail 0; and heifer pregnancy (PrN - was attributed the classification 2 for those calving before 31 months, 1 for those calving from 31 to 46 months and 0 for failure. The data-set, including 30,802 weaned heifers, was analyzed by method R and Bayesian Inference. The heritability estimates were 0.52, 0.12 and 0.16 for Pr16, Pr24 and PrN, respectively, by method R. The mean value obtained by Bayesian Inference was of 0.45 for Pr16. The estimate of rg between Pr16 and AFC was -0.32. The results indicate that to select for sexual precocity is necessary to expose all females to breeding at a young age. Moreover, the pregnancy rate evaluated by Pr16 is indicated, since this trait presents high genetic variability and efficient response to selection. The analysis also indicates that Pr16 and AFC are determined by different genes.

  4. Crescimento de plantas de cajueiro anão precoce influenciado pela compactação e temperatura do solo

    Directory of Open Access Journals (Sweden)

    P. K. B. Oliveira

    2003-02-01

    Full Text Available Atribui-se ao uso de práticas culturais inadequadas uma das causas da redução drástica dos níveis de produtividade e produção da cultura do caju no nordeste brasileiro. A eliminação periódica da cobertura vegetal e o tráfego de máquinas e implementos condicionam temperaturas e densidade de solo que podem comprometer o crescimento e desenvolvimento das plantas, o que é mais preocupante ainda, considerando a textura arenosa dos solos cultivados e as condições climáticas da região. A partir destas constatações, desenvolveu-se o presente trabalho, com vistas em fornecer indicativos capazes de permitir uma avaliação dos efeitos das condições de solo e clima, objetivando identificar o comportamento de plantas de cajueiro anão precoce, submetidas a diferentes níveis de compactação e temperatura de solo, como meio de testar a hipótese de que níveis crescentes destes fatores podem reduzir seu crescimento. O presente trabalho foi desenvolvido em condições controladas, utilizando colunas de solo em tubos de PVC, nas quais se adicionou o Argissolo Vermelho-Amarelo eutrófico típico. Submeteram-se estas colunas a dois níveis de temperatura do solo, um com as colunas de solo isoladas com folhas de isopor pintadas na cor alumínio (tratamento isolado-TI, e o outro, com colunas não isoladas, mas com os tubos de PVC pintados na cor preta, para maior absorção de luz (tratamento não isolado-TNI. Os níveis de densidade a que foram ajustadas as camadas compactadas da coluna de solo foram 1,2; 1,3; 1,4; 1,5; 1,6 e 1,7 Mg m-3, sendo o restante da coluna a 1,3 Mg m-3. Os tratamentos foram distribuídos em delineamento inteiramente casualizado, com arranjo fatorial 6 x 2 (seis níveis de compactação e dois níveis de temperatura, com três repetições. Após o período de 12 meses de cultivo das plantas, a parte aérea foi colhida, determinando-se matéria seca da parte aérea, altura da planta, diâmetro do caule e número de

  5. Alteração precoce da matriz extracelular e parâmetros diastólicos na síndrome metabólica

    Directory of Open Access Journals (Sweden)

    Angela B. S. Santos

    2013-10-01

    Full Text Available FUNDAMENTOS: Síndrome Metabólica (SM está associada com maior risco cardiovascular, porém não está claro se as alterações miocárdicas presentes nessa condição, como a disfunção diastólica, são consequência de mecanismos sistêmicos ou de efeitos diretos no miocárdio. OBJETIVOS: Comparar função diastólica, biomarcadores de atividade da Matriz Extracelular (MEC, inflamação e estresse hemodinâmico, em pacientes com SM e controles saudáveis. MÉTODOS: Pacientes com SM (n = 76 e controles saudáveis (n = 30 foram avaliados clinicamente e submetidos a exame ecocardiográfico e mensuração dos níveis plasmáticos de metaloproteinase-9 (MMP9, inibidor tecidual da metaloproteinase-1 (TIMP1, proteína C reativa ultrassensível (PCR-us, resistência insulínica (HOMA-RI e NT-proBNP. RESULTADOS: O grupo SM apresentou menor onda E' (10,1 ± 3,0 cm/s vs. 11,9 ± 2,6 cm/s, p = 0,005, maiores valores para onda A (63,4 ± 14,1 vs. 53,1 ± 8,9 cm/s, p < 0,001, razão E/E'(8,0 ± 2,2 vs. 6,3 ± 1,2; p < 0,001, MMP9 (502,9 ± 237,1 vs. 330,4 ± 162,7 ng/mL, p < 0,001, PCR-us (p = 0,001 e HOMA-RI (p < 0,001, sem diferença nos níveis de TIMP1 e NT-proBNP. Na análise multivariada, apenas MMP9 foi independentemente associada a SM. CONCLUSÃO: Pacientes com SM apresentaram diferenças em medidas ecocardiográficas de função diastólica, na atividade da MEC, PCR-us e HOMA-RI em relação aos controles. Porém, somente MMP9 foi independentemente associada com SM. Esses achados sugerem que os efeitos precoces da SM sobre a atividade da MEC podem não ser detectados nas medidas ecocardiográficas de função diastólica usuais.

  6. Avaliação e seleção precoce para crescimento de Pinus taeda Early evaluation and selection for growth in Pinus taeda

    Directory of Open Access Journals (Sweden)

    Estefano Paludzyszyn Filho

    2002-12-01

    Full Text Available O objetivo deste trabalho foi avaliar a eficiência de diferentes métodos de seleção quanto aos caracteres ligados ao crescimento do fuste e o potencial da seleção precoce de genitores. Em 48 progênies de meios-irmãos de Pinus taeda L., foi medido o diâmetro do fuste a 30 cm e a 1,30 m do solo, aos 16 e 84 meses de idade, além da altura total. As progênies foram cultivadas em espaçamento tradicional e reduzido. Os componentes de variância, parâmetros e valores genéticos aditivos foram obtidos a partir de um modelo de análise individual. A seleção indireta foi de eficiência similar à direta quanto ao diâmetro (93% e menor quanto à altura (78%. A seleção seqüencial foi 16% (altura e 28% (diâmetro mais eficiente que a seleção única. A eficiência da seleção combinada foi maior em relação a direta para diâmetro. Vinte genitores selecionados por valores genéticos aditivos quanto ao diâmetro, aos 16 e 84 meses, aumentaram a média em 7,6% e 8,1%, respectivamente. A alta magnitude da correlação genética no que diz respeito ao diâmetro entre idades revelou que esse caráter, avaliado aos 16 meses de idade, prediz o crescimento aos 84 meses. Isso reduz custos de avaliação de progênies, antecipa o desbaste de genitores e a oferta de sementes melhoradas.The objective of this work was to evaluate the efficiency of different methods of selection in growth traits and early selection. Individual total height and stem diameter at 30 cm above the ground in close-spaced early genetic evaluation at 16 months were assessed. In a 84 month sib cohort, as a comparison, height and diameter at breast height were evaluated. Phenotypic and genetic parameters for height and diameter were estimated for 48 open-pollinated families of loblolly pine (Pinus taeda L. planted in Southern Brazil using an individual tree model. In this retrospective study, the indirect selection was of similar effectiveness as direct selection in stem

  7. 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.

  8. [Neonatal hyperthyroidism and maternal Graves disease].

    Science.gov (United States)

    Ben Ameur, K; Chioukh, F Z; Marmouch, H; Ben Hamida, H; Bizid, M; Monastiri, K

    2015-04-01

    The onset of Graves disease during pregnancy exposes the neonate to the risk of hyperthyroidism. The newborn must be monitored and treatment modalities known to ensure early treatment of the newborn. We report on the case of an infant born at term of a mother with Graves disease discovered during pregnancy. He was asymptomatic during the first days of life, before declaring the disease. Neonatal hyperthyroidism was confirmed by hormonal assays. Hyperthyroidism was treated with antithyroid drugs and propranolol with a satisfactory clinical and biological course. Neonatal hyperthyroidism should be systematically sought in infants born to a mother with Graves disease. The absence of clinical signs during the first days of life does not exclude the diagnosis. The duration of monitoring should be decided according to the results of the first hormonal balance tests. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  9. Neonatal Graves' Disease with Maternal Hypothyroidism.

    Science.gov (United States)

    Akangire, Gangaram; Cuna, Alain; Lachica, Charisse; Fischer, Ryan; Raman, Sripriya; Sampath, Venkatesh

    2017-07-01

    Neonatal Graves' disease presenting as conjugated hyperbilirubinemia is a diagnostic challenge because the differential includes a gamut of liver and systemic diseases. We present a unique case of neonatal Graves' disease in a premature infant with conjugated hyperbilirubinemia born to a mother with hypothyroidism during pregnancy and remote history of Graves' disease. Infant was treated with a combination of methimazole, propranolol, and potassium iodide for 4 weeks. Thyroid function improved after 8 weeks of treatment with full recovery of thyroid function, disappearance of thyroid-stimulating antibodies, and resolution of failure to thrive and conjugated hyperbilirubinemia. This case provides several clinical vignettes as it is a rare, severe, presentation of an uncommon neonatal disease, signs, symptoms, and clinical history presented a diagnostic challenge for neonatologists and endocrinologists, normal newborn screen was misleading, and yet timely treatment led to a full recovery.

  10. Neonatal herpes in Denmark 1977-1991

    DEFF Research Database (Denmark)

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

    1997-01-01

    : 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...... herpes recurrence. Four infants had a serious infection in spite of Cesarean section. This study does not support a policy of Cesarean section in case of maternal recurrent herpes simplex infection at delivery.......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...

  11. 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...

  12. Prevalence and underlying etiologies of neonatal hypoglycemia.

    Science.gov (United States)

    Najati, N; Saboktakin, L

    2010-08-01

    This study aims at determining the prevalence of neonatal hypoglycemia and its underlying causes. In this prospective study 14168 newborns delivered in Tabriz Alzahra Hospital during 2 years were evaluated in regard to blood glucose level at first 24 h of life. Glucose oxidase method with 4-aminophenazone with a Greiner G-300 was the used method for determining the blood glucose level. Cases with blood glucose causes of this condition, as well as the short-term mortality rate were determined. Prevalence of neonatal hypoglycemia was 0.4% (52 newborns). Underlying causes of hypoglycemia were prematurity (61.5%), diabetic mother (13.6%), septicemia (9.6%), perinatal asphyxia (9.6%), stress (3.8%) and neonatal hyperinsulinism (1.9%). The mortality rate was 53.8%, with prematurity as the leading cause of death.

  13. 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.

  14. [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.

  15. 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...

  16. An overview of medical ECMO for neonates.

    Science.gov (United States)

    Fletcher, Kathryn; Chapman, Rachel; Keene, Sarah

    2018-03-01

    Extracorporeal membrane oxygenation (ECMO), a life-saving therapy for respiratory and cardiac failure, was first used in neonates in the 1970s. The indications and criteria for ECMO have changed over the years, but it continues to be an important option for those who have failed other medical therapies. Since the Extracorporeal Life Support Organization (ELSO) Registry was established in 1989, more than 29,900 neonates have been placed on ECMO for respiratory failure, with 84% surviving their ECMO course, and 73% surviving to discharge or transfer. In this chapter, we will review the basics of ECMO, patient characteristics and criteria, patient management, ECMO complications, special uses of neonatal ECMO, and patient outcomes. Copyright © 2018 Elsevier Inc. All rights reserved.

  17. Computed radiography in neonatal intensive care

    International Nuclear Information System (INIS)

    Merlo, L.; Bighi, S.; Cervi, P.M.; Lupi, L.

    1991-01-01

    The Authors report their experience in the employment of a computerized digital radiographic system in Neonatal Intensive Care. The analog screen-film system is replaced by photosensitive imaging plates, scanned after X-ray exposure by a laser that releases the digital image, which can then be manipulated on computer work-stations. In a period of twelve months about 200 chest-abdomen X-ray examinations in Neonatal Intensive Care have been performed using this method with good technical and diagnostic results. The use of digital radiography in the neonatal area is of high interest: this system produces good quality images, there is a reduction in radiation dose and 'retakes', the system allows selective enhancement of different structures and their magnification. (orig.)

  18. Design of a light stimulator for fetal and neonatal magnetoencephalography

    International Nuclear Information System (INIS)

    Wilson, J D; Adams, A J; Murphy, P; Eswaran, H; Preissl, H

    2009-01-01

    The design, safety analysis and performance of a fetal visual stimulation system suitable for fetal and neonatal magnetoencephalography studies are presented. The issue of fetal, neonatal and maternal safety is considered and the maximum permissible exposure is computed for the maternal skin and the adult eye. The risk for neonatal eye exposure is examined. It is demonstrated that the fetus, neonate and mother are not at risk. (note)

  19. 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.

  20. Tei index in neonatal respiratory distress and perinatal asphyxia

    OpenAIRE

    Ahmed Anwer Attia Khattab

    2015-01-01

    Cardiovascular compromise is a common complication of neonatal respiratory distress and perinatal asphyxia. Tei index is a Doppler-derived index for the assessment of overall left ventricular function that combines systolic and diastolic time intervals. Aim: Assess the role of MPI versus cardiac troponin I as early indicator of hypoxic cardiac damage in neonates with respiratory distress or perinatal asphyxia. The present work was conducted on forty neonates, 15 with neonatal respiratory dist...

  1. The prevalence and challenges of abandoned dead neonates in an ...

    African Journals Online (AJOL)

    parents/caregivers' attitudes toward dead neonates. Hospital-based postbereavement programs should be organized to ... Dead neonates at the Neonatal Intensive Care Units,. Pediatric Emergency Department, Pediatric Surgical .... interventions and newborn survival. Niger J Med 2006; 15:108–114. 3 Kalkofen RW. After a ...

  2. Severe combined immunodeficiency (SCID) presenting with neonatal aplastic anemia.

    Science.gov (United States)

    Scott, Angela; Glover, Jason; Skoda-Smith, Suzanne; Torgerson, Troy R; Xu, Min; Burroughs, Lauri M; Woolfrey, Ann E; Fleming, Mark D; Shimamura, Akiko

    2015-11-01

    Aplastic anemia in the neonate is rare. We report a case of severe combined immunodeficiency (SCID) presenting with neonatal aplastic anemia. This report highlights the importance of considering SCID early in the evaluation of neonatal aplastic anemia prior to the development of infectious complications. © 2015 Wiley Periodicals, Inc.

  3. 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 ...

  4. 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 ...

  5. Causes and Clinical Outcomes in Neonates with Acute Abdomen ...

    African Journals Online (AJOL)

    Causes and Clinical Outcomes in Neonates with Acute Abdomen Requiring Surgery at ... Neonatal surgery is challenging, particularly in the emergency setting whereby ... Other causes included peritonitis (6.9%) and abdominal wall defects (4.7%). ... accounting for 13 cases (30.2%) and mortality was 34.9 % ( 15 neonates).

  6. 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…

  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. Effects of maternal hypertension on the neonatal haemogram in ...

    African Journals Online (AJOL)

    Haematocrit and white blood cell differentials were done manually. Data were analysed using SPSS version 16. Results A total of 200 neonates were recruited, comprising 100 neonates of mothers with hypertensive disorders of pregnancy and 100 neonates of normotensive mothers. The mean haematocrit was significantly ...

  9. Motion based Segmentation of Chest and Abdomen Region of Neonates

    NARCIS (Netherlands)

    Venkitaraman, A.; Makkapati, V.V.

    2015-01-01

    Respiration rate (RR) is one of the important vital signs used for clinical monitoring of neonates in intensive care units. Due to thefragile skin of the neonates, it is preferable to have monitoring systems with minimal contact with the neonate. Recently, several methods have been proposed for

  10. 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 ...

  11. 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 ...

  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. 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 ...

  15. Infections in Neonatal Intensive Care: Prevalence, Prevention and Antibiotic use

    NARCIS (Netherlands)

    van den Hoogen, A.

    2009-01-01

    Neonatal infections are an important cause of morbidity in neonatal intensive care units (NICUs). Prematurity or very low birth weight is an important predisposing factor for neonatal infection. In addition, preterm infants have a compromized immune system and they often require invasive procedures

  16. 21 CFR 880.5270 - Neonatal eye pad.

    Science.gov (United States)

    2010-04-01

    ... DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Therapeutic Devices § 880.5270 Neonatal eye pad. (a) Identification. A neonatal eye pad is an opaque device used to cover... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Neonatal eye pad. 880.5270 Section 880.5270 Food...

  17. 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.

  18. 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.

  19. 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

  20. Probable nosocomial transmission of listeriosis in neonates.

    Science.gov (United States)

    Lazarus, C; Leclercq, A; Lecuit, M; Vaillant, V; Coignard, B; Blanchard, H; Novakova, I; Astagneau, P

    2013-10-01

    Listeria monocytogenes was isolated in two neonates born consecutively in the same hospital in France. The isolates had indistinguishable pulsed-field electrophoresis profiles. Retrospective epidemiological investigations found no evidence of a food-borne or environmental source. Infection control protocols and decontamination processes were in accordance with standard recommendations. The timing of onset of these infections within the same maternity unit, and the similarity of pulsed-field gel electrophoresis profiles suggests cross-infection of L. monocytogenes between the two neonates. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  1. 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.).

  2. Neonatal marfan syndrome: report of two cases.

    Science.gov (United States)

    Ghandi, Yazdan; Zanjani, Keyhan S; Mazhari-Mousavi, Seyed-Eshagh; Parvaneh, Nima

    2013-02-01

    Neonatal Marfan syndrome is a rare and severe phenotype of this disease. A poor prognosis is anticipated due to the high probability of congestive heart failure, and mitral and tricuspid regurgitations with suboptimal response to medical therapy and difficulties in surgical management at an early age. We present two consecutive patients with this disease who are the first reported cases from Iran to the best of our knowledge. Unfortunately both of them died shortly after diagnosis. Neonatal Marfan syndrome is reported from Iran and has a poor prognosis like the patients reported from elsewhere.

  3. Biomarkers of multiorgan injury in neonatal encephalopathy.

    Science.gov (United States)

    Aslam, Saima; Molloy, Eleanor J

    2015-01-01

    Neonatal encephalopathy (NE) is a major contributor to neurodevelopmental deficits including cerebral palsy in term and near-term infants. The long-term neurodevelopmental outcome is difficult to predict with certainty in first few days of life. Multiorgan involvement is common but not part of the diagnostic criteria for NE. The most frequently involved organs are the heart, liver, kidneys and hematological system. Cerebral and organ involvement is associated with the release of organ specific biomarkers in cerebrospinal fluid, urine and blood. These biomarkers may have a role in the assessment of the severity of asphyxia and long-term outcome in neonates with NE.

  4. 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.

  5. 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.

  6. 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

  7. 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.

  8. 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.

  9. Neonatal thyrotoxicosis caused by maternal autoimmune hyperthyroidism.

    Science.gov (United States)

    Correia, Miguel Fragata; Maria, Ana Teresa; Prado, Sara; Limbert, Catarina

    2015-03-06

    Neonatal immune hyperthyroidism is a rare but potentially fatal condition. It occurs in 1-5% of infants born to women with Graves' disease (GD). In most of the cases it is due to maternal antibodies transferred from the mother into the fetal compartment, stimulating the fetal thyroid by binding thyrotropin (thyroid-stimulating hormone, TSH) receptor. We present a case of neonatal thyrotoxicosis due to maternal GD detected at 25 days of age and discuss the potential pitfalls in the diagnosis. 2015 BMJ Publishing Group Ltd.

  10. Neonatal thyrotoxicosis presenting as persistent pulmonary hypertension

    Science.gov (United States)

    Obeid, Rawad; Kalra, Vaneet Kumar; Arora, Prem; Quist, Felix; Moltz, Kathleen C; Chouthai, Nitin Shashikant

    2012-01-01

    Neonatal hyperthyroidism is a rare condition caused either by transplacental passage of thyroid-stimulating immunoglobulins from a mother with Graves’ disease or by activating mutations of the thyrotropin receptors and α-subunit of G-protein. The clinical features may vary. We report a case of neonatal thyrotoxicosis in an infant born to a mother with Graves’ disease, who presented with cardiorespiratory failure and persistent pulmonary hypertension (PPHN). PPHN resolved with specific antithyroid treatment and extracorporeal membrane oxygenation was not required. PMID:22669869

  11. Chlamydial Pneumonitis: A Creepy Neonatal Disease

    Directory of Open Access Journals (Sweden)

    Kam Lun Hon

    2013-01-01

    Full Text Available We present a case of neonatal chlamydial pneumonitis to illustrate that a high index of suspicion is necessary to make the diagnosis so that treatment can be promptly instituted. The child was afebrile and the only symptom was a cough. The respiratory equations are calculated to understand the respiratory physiology. There was no overt abnormality with ventilation, oxygenation, compliance, resistance, or ventilation-perfusion mismatch despite radiographic abnormality. The literature is searched to review if treatment with a systemic macrolide antibiotic is needed in an otherwise asymptomatic neonate with chlamydial pneumonitis.

  12. Therapies for neonates with congenital malformations admitted to a neonatal unit

    Directory of Open Access Journals (Sweden)

    Maria Vera Lúcia Moreira Leitão Cardoso

    2015-03-01

    Full Text Available The aim of this study was to characterize the treatments applied to newborns with congenital malformation hospitalized in a neonatal unit and to identify whether there is an association among the treatments used and the type of malformation. A descriptive, prospective and quantitative study was developed in a public institution in Fortaleza, Ceará, Brazil. Data were collected using the medical records of 30 neonates with congenital malformations. The incidence of malformations was higher among females, regardless of the mother’s age, gestational age or weight at birth; malformations of the central nervous and musculoskeletal systems prevailed. The treatments used varied according to the clinical evolution of the neonate. The data collected did not present statistical significance when associated with the variable of congenital malformation and the treatments used (p>0.05. The treatments are not directly related to the type of malformation, but to the clinical condition of the neonate.

  13. Neonatal Bartter Syndrome in association with congenital adrenal hyperplasia in a neonate - a rare combination.

    Science.gov (United States)

    Hussain, Shabbir

    2016-05-01

    Neonatal Bartter syndrome (NBS) is an autosomal recessive renal tubulopathy characterized by hypokalaemic, hypochloraemic metabolic alkalosis associated with increased urinary loss of sodium, potassium, calcium and chloride. There is hyperreninaemia and hyperaldosteronaemia but normotension. Congenital adrenal hyperplasia (CAH), another autosomal recessive condition, may present in the neonatal period with vomiting, hypovolaemia, failure to gain weight or ambiguous genitalia. We report a case of NBS and CAH combination in a neonate. A male neonate born at term was admitted with history of recurrent vomiting and dehydration episodes. Investigations revealed electrolytes imbalance, metabolic alkalosis, raised aldosterone and renin levels suggestive of NBS. He was treated successfully and discharged. He was re-admitted with the same symptoms. Further evaluation confirmed the presence of CAH as well. We report this case because of the rarity of this combination (NBS plus CAH) and to the best of our knowledge this is the first such case report from Pakistan.

  14. Specialist teams for neonatal transport to neonatal intensive care units for prevention of morbidity and mortality.

    Science.gov (United States)

    Chang, Alvin S M; Berry, Andrew; Jones, Lisa J; Sivasangari, Subramaniam

    2015-10-28

    Maternal antenatal transfers provide better neonatal outcomes. However, there will inevitably be some infants who require acute transport to a neonatal intensive care unit (NICU). Because of this, many institutions develop services to provide neonatal transport by specially trained health personnel. However, few studies report on relevant clinical outcomes in infants requiring transport to NICU. To determine the effects of specialist transport teams compared with non-specialist transport teams on the risk of neonatal mortality and morbidity among high-risk newborn infants requiring transport to neonatal intensive care. We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2015, Issue 7), MEDLINE (1966 to 31 July 2015), EMBASE (1980 to 31 July 2015), CINAHL (1982 to 31 July 2015), conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. randomised, quasi-randomised or cluster randomised controlled trials. neonates requiring transport to a neonatal intensive care unit. transport by a specialist team compared to a non-specialist team. any of the following outcomes - death; adverse events during transport leading to respiratory compromise; and condition on admission to the neonatal intensive care unit. The methodological quality of the trials was assessed using the information provided in the studies and by personal communication with the author. Data on relevant outcomes were extracted and the effect size estimated and reported as risk ratio (RR), risk difference (RD), number needed to treat for an additional beneficial outcome (NNTB) or number needed to treat for an additional harmful outcome (NNTH) and mean difference (MD) for continuous outcomes. Data from cluster randomised trials were not combined for analysis. One trial met the inclusion criteria of this review but was considered ineligible owing to

  15. 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.

  16. Hypothermia for neonatal hypoxic-ischemic encephalopathy: NICHD Neonatal Research Network contribution to the field.

    Science.gov (United States)

    Shankaran, Seetha; Natarajan, Girija; Chalak, Lina; Pappas, Athina; McDonald, Scott A; Laptook, Abbot R

    2016-10-01

    In this article, we summarize the NICHD Neonatal Research Network (NRN) trial of whole-body hypothermia for neonates with hypoxic-ischemic encephalopathy in relation to other randomized controlled trials (RCTs) of hypothermia neuroprotection. We describe the NRN secondary studies that have been published in the past 10 years evaluating clinical, genetic, biochemical, and imaging biomarkers of outcome. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Thoracic Ectopia Cordis in an Ethiopian Neonate

    African Journals Online (AJOL)

    GB

    2017-03-01

    Mar 1, 2017 ... Thoracic Ectopia Cordis in an Ethiopian Neonate. Henok Tadele*. 1 ... the chest wall. Initial treatment included covering the heart with sterile-saline soaked dressing, starting systemic antibiotics and supportive care. A staged ... of thoracoabdominal EC, anterior diaphragmatic hernia, lower sternal defect and ...

  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. Antiretroviral therapy during the neonatal period

    African Journals Online (AJOL)

    2015-05-04

    May 4, 2015 ... until clinical or CD4 criteria were met.1 In the landmark Children with HIV Early ... to cART regimens aimed at long-term treatment requires further investigation. ... therefore be a consideration for short-term use in neonatal ...... of memory B cells and the longevity of humoral responses in HIV-1 vertically-.

  20. 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 ...

  1. 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, ...

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

    African Journals Online (AJOL)

    term neonates without a positive Coombs test were included, and only 1 patient was readmitted with rebound hyperbilirubinaemia. (this was thought to be due to breastmilk jaundice). Our ndings are therefore similar to those of Del Vecchio et al.,[8] who reported that 1 in 48 newborns required readmission for phototherapy.

  3. News or innovations in neonatal surgery

    Directory of Open Access Journals (Sweden)

    Giorgia Totonelli

    2015-10-01

    Full Text Available Over the last decades, because of the development of several clinical and technological advances, there has been a revolution in the management of neonatal and pediatric patients. These progresses reported an improvement in the survival rate of extremely ill neonates, who now have the chance to survive into adulthood. The intent of this review is to highlight not only the advances obtained in the neonatal surgery, but also the results of a multidisciplinary work focused on the fetus, preterm and newborn baby with a surgical anomaly or disease.Attention is also paid to the recent tendency to share knowledge, protocols and database out of the single Institution or country and to follow these delicate and fragile neonatal patients to the adulthood, developing the transitional care. Proceedings of the 11th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy · October 26th-31st, 2015 · From the womb to the adultGuest Editors: Vassilios Fanos (Cagliari, Italy, Michele Mussap (Genoa, Italy, Antonio Del Vecchio (Bari, Italy, Bo Sun (Shanghai, China, Dorret I. Boomsma (Amsterdam, the Netherlands, Gavino Faa (Cagliari, Italy, Antonio Giordano (Philadelphia, USA

  4. Neonatal Bacterial Meningitis And Dexamethasone Adjunctive ...

    African Journals Online (AJOL)

    Methodology: Babies admitted from1992 to 1995 in the Special Care Baby Unit of the University of Maiduguri Teaching Hospital, Maduguri, Nigeria, with bacterial meningitis were studied prospectively. Neonatal bacterial meningitis was confirmed if the cerebrospinal fluid (CSF) microbiological, chemical, immunological and ...

  5. 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.

  6. 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

  7. 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.

  8. 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.

  9. 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

  10. 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 ...

  11. Diagnostic value of procalcitonin in neonatal sepsis

    African Journals Online (AJOL)

    2015-04-27

    Apr 27, 2015 ... Abstract: Introduction: Neonatal sepsis is a major cause of mortal- ity in developing countries. Accu- rate and quick diagnosis are diffi- cult because clinical presentation are non-specific, bacterial cultures are time-consuming and other laboratory tests lack sensitivity and specificity. Serum procalci-.

  12. 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 ...

  13. 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.

  14. 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 ...

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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

  1. Neonatal Seizure Models to Study Epileptogenesis

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    Yuka Kasahara

    2018-04-01

    Full Text Available Current therapeutic strategies for epilepsy include anti-epileptic drugs and surgical treatments that are mainly focused on the suppression of existing seizures rather than the occurrence of the first spontaneous seizure. These symptomatic treatments help a certain proportion of patients, but these strategies are not intended to clarify the cellular and molecular mechanisms underlying the primary process of epilepsy development, i.e., epileptogenesis. Epileptogenic changes include reorganization of neural and glial circuits, resulting in the formation of an epileptogenic focus. To achieve the goal of developing “anti-epileptogenic” drugs, we need to clarify the step-by-step mechanisms underlying epileptogenesis for patients whose seizures are not controllable with existing “anti-epileptic” drugs. Epileptogenesis has been studied using animal models of neonatal seizures because such models are useful for studying the latent period before the occurrence of spontaneous seizures and the lowering of the seizure threshold. Further, neonatal seizure models are generally easy to handle and can be applied for in vitro studies because cells in the neonatal brain are suitable for culture. Here, we review two animal models of neonatal seizures for studying epileptogenesis and discuss their features, specifically focusing on hypoxia-ischemia (HI-induced seizures and febrile seizures (FSs. Studying these models will contribute to identifying the potential therapeutic targets and biomarkers of epileptogenesis.

  2. 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 ...

  3. 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 ...

  4. The effect of high risk pregnancy on duration of neonatal stay in neonatal intensive care unit.

    Science.gov (United States)

    Afrasiabi, Narges; Mohagheghi, Parisa; Kalani, Majid; Mohades, Gholam; Farahani, Zahra

    2014-08-01

    High risk pregnancies increase the risk of neonatal mortality and morbidity. In order to identify the influence of pregnancy complications on the period of neonatal stay in Neonatal Intensive Care Units (NICUs), an analysis has been carried out in our center. In a cross-sectional-descriptive analytical study, the data including NICU length of stay was gathered from 526 medical records of neonates. We also assessed their maternal complications such as premature rapture of membranes (PROM), urinary tract infection (UTI), preeclampsia, oligohydramnios, and twin/triplet pregnancy. Finally we analyzed the relation between variables by SPSS statistics software version 19. The level of significance was considered PUTI (P=0.02), multiple gestation (P=0.03), and oligohydramnios (P=0.003). We found a positive correlation between numbers of gestation and length of NICU stay (P=0.03). A positive correlation existed between neonatal complication and length of NICU stay (P<0.001). By increasing maternal health level and prenatal care services, neonatal outcome can be improved and length of stay in NICUs decreased.

  5. Neonatal Intestinal Obstruction-Four Year Experience

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    D. Rathore

    2015-06-01

    Full Text Available Aim of study: To study the aetiology and frequency, sex incidence, age of presentation, management and outcome of neonatal intestinal obstruction. Material and Methods: This prospective study of 316 neonates with intestinal obstruction was conducted over a period of 4 years from November 2009 to October 2013 at single institute. These cases were managed by various surgical procedures. Their epidemiology, day of presentation, associated anomalies and outcomes were studied. Results: A total of 316 neonates (277 males and 39 females were operated for intestinal obstruction. 268(84.81% neonates presented in the 1st week of life. Imperforate anus occurred in 206 (65.19%.Small bowel atresia accounted for23 (7.27% cases while duodenal atresia was seen in19 (6.01% patients. Infantile hypertrophic pyloric stenosis and Malrotation each occurred in 14 (4.43% patients; Hirschsprung’s disease in 18(5.69%, Necrotising Enterocolitis in 12(3.79%, Meconium disease of newborn in 9(2.85% while colonic atresia was seen in one (0.3% patient. Colostomy was performed in 145(45.88%, Pouchostomy in 15(4.74% and Cutback anoplasty in 56(17.72% patients. Ramsted’s Pyloromyotomy in 13(4.11%% neonates, Laparoscopic Pyloromyotomy in 1(0.3%,Kimura’s Duodenoduodenostomy in 19(6.01% ,End to Back anastomosis in 24(7.59% , End to End anastomosis in 7(2.21% , Multiple anastomosis in 2(0.6% , Enterotomy with irrigation in 7(2.21% , Ladd’s procedure in 14(4.43% , ,Single stage transanal pull through in 8(2.53% , Ileostomy in 2(0.6% , Single stage Abdominoperineal pull through in 2(0.6%, Levelling colostomy in 6(1.89% ,Peritoneal drain insertion under Local anaesthesia in 5(1.58% . Overall mortality was 13.60%. Conclusion: Intestinal Obstruction is the most common surgical emergency in neonatal period. Early and accurate diagnosis is paramount for proper patient management. The etiology, mode of presentation, morbidity and outcome of surgery of intestinal obstruction in

  6. Reduced nephron endowment in the neonates of Indigenous Australian peoples.

    Science.gov (United States)

    Kandasamy, Y; Smith, R; Wright, I M R; Lumbers, E R

    2014-02-01

    Rates of chronic kidney disease (CKD) among Indigenous groups in Australia exceed non-Indigenous rates eight-fold. Using kidney volume as a surrogate for nephron number, we carried out a study to determine if Indigenous neonates have a smaller kidney volume (and thus a reduced nephron number) from birth compared with non-Indigenous neonates. We recruited term and preterm neonates (Indigenous) and 39 term (13 Indigenous) neonates. TKV of Indigenous neonates was significantly lower at 32 weeks [12.0 (2.0) v. 15.4 (5.1) ml; P=0.03] and 38 weeks CA [18.6 (4.0) v. 22.6 (5.9) ml; P=0.04] respectively. Term Indigenous neonates also had smaller kidney volumes compared with non-Indigenous neonates. Despite a smaller kidney volume (and reduced nephron number), Indigenous neonates did not have a significantly lower eGFR. Indigenous neonates achieve similar eGFRs to Non-Indigenous neonates, presumably through a higher single nephron filtration rate. This places Indigenous neonates at a greater risk of long-term kidney damage later in life.

  7. Home delivery and neonatal mortality in North Carolina.

    Science.gov (United States)

    Burnett, C A; Jones, J A; Rooks, J; Chen, C H; Tyler, C W; Miller, C A

    1980-12-19

    Neonatal mortality examined by place and circumstances of delivery in North Carolina during 1974 through 1976 with attention given to home delivery. Planned home deliveries by lay-midwives resulted in three neonatal deaths per 1,000 live births; planned home deliveries without a lay-midwife, 30 neonatal deaths per 1,000 live births; and unplanned home deliveries, 120 neonatal deaths per 1,000 live births. The women babies were delivered by lay-midwives were screened in county health departments and found to be medically at low risk of complication, despite having demographic characteristics associated with high-risk of neonatal mortality. Conversely, the women delivered at home without known prenatal screening or a trained attendant had low-risk demographic characteristics but experienced a high rate of neonatal mortality. Planning, prenatal screening, and attendant-training were important in differentiating the risk of neonatal mortality in this uncontrolled, observational study.

  8. Avaliação da perviedade precoce das fístulas arteriovenosas para hemodiálise Evaluation of early patency of the arteriovenous fistulas for hemodialysis

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    Milton Alves das Neves Junior

    2011-06-01

    Full Text Available CONTEXTO: A insuficiência renal crônica é uma doença de alta prevalência e morbidade, o que determina queda da qualidade de vida. Pacientes em hemodiálise necessitam de um acesso vascular que permita a conexão da circulação do paciente ao circuito externo de hemodiálise. Dentre os acessos disponíveis, as fístulas arteriovenosas (FAV são as que mais se aproximam do acesso ideal. OBJETIVO: Avaliar a perviedade precoce das FAV, identificando os fatores relacionados ao insucesso destas. MÉTODOS: Foram acompanhados todos os pacientes submetidos à confecção das FAV no Hospital do Servidor Público Municipal de São Paulo, no período de agosto de 2008 a janeiro de 2009, avaliando-se a perviedade destas no 1º, 10º e 30º pós-operatório. Foram realizadas 31 FAV no período, apresentando-se média de idade de 63,06 anos, sendo 18 pacientes do sexo masculino e 13 do feminino. RESULTADOS: Vinte e seis FAV foram distais, todas radiocefálicas; quatro foram proximais, das quais duas braquiocefálicas e duas braquiobasílicas superficializadas; uma FAV confeccionada com alça de politetrafluoretileno (PTFE fêmoro-femoral esquerda. A taxa de perviedade no primeiro mês foi de 71% dos casos. O uso de cateteres venosos centrais apresentou-se como fator de risco para oclusão da FAV (p=0,01. As FAV continuam sendo o acesso vascular para hemodiálise mais aceito e mais seguro. A indicação precoce para confecção das FAV é de fundamental importância, evitando-se, assim, o uso de cateteres e suas complicações. CONCLUSÕES: A perviedade precoce encontrada neste estudo é semelhante à da literatura, e o uso prévio de cateteres é o fator de risco mais significativo para oclusão precoce desta.BACKGROUND: Chronic renal failure is a disease of high prevalence and high morbidity, which impairs the patients' quality of life. Patients on hemodialysis need a vascular access for connection with the hemodialysis equipment. Arteriovenous fistulas

  9. Trabalho precoce e processo de escolarização de crianças e adolescentes Trabajo precoz y proceso de escolarizacion de niños y adolescentes Early work and children's and adolescents' schooling process

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    Olívia Maria Costa Grangeiro de Sousa

    2008-12-01

    Full Text Available Este estudo enfocou a relação do trabalho precoce com o processo de escolarização de crianças e adolescentes, analisando a subjetividade forjada com o trabalho e o estudo no processo de escolarização. A amostra compreendeu vinte e um estudantes trabalhadores precoces nas atividades informais em condição de rua, de 10 a 14 anos de idade, dos gêneros masculino e feminino. Observou-se prevalência de sujeitos do sexo masculino nas atividades do setor de serviços. Necessidade, satisfação pessoal e ocupação do tempo constituíram os principais motivos do ingresso precoce no trabalho. Em trabalhar e estudar há implicações psicossociais, tais como: participação restrita nas atividades sociais, de estudo e de lazer; vivências subjetivas de responsabilidades prematuras; incertezas sobre as perspectivas de futuro e, sobretudo, danos ao processo de escolarização, uma vez que contribui para reprovações, repetências, defasagens, e não raro, para a evasão escolar.Este estudio enfocó la relación del trabajo precoz con el proceso de escolarización de niños y adolescentes, analizando la subjetividad fragada sobre el trabajo y el estudio en proceso de escolarización. La muestra comprendió veintiún estudiantes trabajadores precoces en las actividades informales en condición de calle, de 10 hasta 14 años y ambos los sexos. Se ha observado la prevalencia de sujetos del sexo masculino en las actividades del sector de servicios. Necesidad, satisfacción personal y ocupación del tempo constituíran los principales motivos del ingreso precoz en el trabajo. Trabajar y estudiar presenta implicaciones psicosociales, tales como: participación restricta en las actividades sociales de estudio y de ocio; experiencias subjetivas de responsabilidades prematuras; incertidumbre sobre las perspectivas de futuro y, sobretodo, daños al proceso de escolarización, una vez que aporta para reprobaciones, repetencias, desfase, y no raro, para la

  10. Neonatal intestinal obstruction in Benin, Nigeria

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    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.

  11. Radiological evaluation of surgical emergencies in neonate

    International Nuclear Information System (INIS)

    Suh, C. O.; Oh, K. K.; Park, C. Y.

    1980-01-01

    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 demonstration of

  12. HIV and pregnancy: Maternal and neonatal evolution

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    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.

  13. Neonatal varicella pneumonia, surfactant replacement therapy

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    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.

  14. Influência da irrigação na produção de pedúnculo e de castanha em clones de cajueiro-anão-precoce

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    Oliveira Vitor Hugo de

    2002-01-01

    Full Text Available Este trabalho teve por objetivo avaliar a influência da irrigação na produção de pedúnculo e na relação peso de pedúnculo:peso de castanha em cajueiro-anão-precoce (Anacardium occidentale L.. Foram avaliados três clones (CP 09, CP 76 e CP 1001, submetidos a quatro regimes hídricos (A: testemunha sem irrigação; B: intervalo de irrigação de 1 dia; C: intervalo de irrigação de 3 dias; e D: intervalo de irrigação de 5 dias. O delineamento experimental foi em blocos ao acaso, em parcelas subdivididas, com quatro repetições, tendo-se os regimes hídricos nas parcelas e os clones nas subparcelas, cada uma com 4 plantase 3 anos de avaliação. A quantidade de água aplicada nos três tratamentos irrigados baseou-se na evaporação do tanque classe A. Os resultados levaram às seguintes conclusões: a resposta do cajueiro-anão-precoce à irrigação é genótipo-dependente; o CP 76 apresenta a maior relação peso de pedúnculo:peso de castanha, constituindo-se num clone mais apto para o consumo in natura; o CP 1001 apresenta-se como o mais promissor para o cultivo sob condições de sequeiro.

  15. Surgical procedures performed in the neonatal intensive care unit on critically ill neonates: feasibility and safety

    International Nuclear Information System (INIS)

    Mallick, M.S.; Jado, A.M.; Al-Bassam, A.R.

    2008-01-01

    Transferring unstable, ill neonates to and from the operating rooms carries significant risks and can lead to morbidity. We report on our experience in performing certain procedures in critically ill neonates in the neonatal intensive care unit (NICU). We examined the feasibility and safety for such an approach. All surgical procedures performed in the NICU between January 1999 and December 2005 were analyzed in terms of demographic data, diagnosis, preoperative stability of the patient, procedures performed, complications and outcome. Operations were performed at beside in the NICU in critically ill, unstable neonates who needed emergency surgery, in neonates of low birth weight (<1000 gm) and in neonates on special equipments like higher frequency ventilators and nitrous oxide. Thirty-seven surgical procedures were performed including 12 laparotomies, bowel resection and stomies, 7 repairs of congenital diaphragmatic hernias, 4 ligations of patent ductus arteriosus and various others. Birth weights ranged between 850 gm and 3500 gm (mean 2000 gm). Gestational age ranged between 25 to 42 weeks (mean, 33 weeks). Age at surgery was between 1 to 30 days (mean, 30 days). Preoperatively, 19 patients (51.3%) were on inotropic support and all were intubated and mechanically ventilated. There was no mortality related to surgical procedures. Postoperatively, one patient developed wound infection and disruption. Performing major surgical procedures in the NICU is both feasible and safe. It is useful in very low birth weight, critically ill neonates who have definite risk attached to transfer to the operating room. No special area is needed in the NICU to perform complication-free surgery, but designing an operating room within the NICU will be ideal. (author)

  16. 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)

  17. NEONATAL COMPLICATIONS OF PREMATURE RUPTURE OF MEMBRANES

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    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

  18. Neonatal respiratory depression associated with epidural analgesia

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    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

  19. Erythrocyte glucose-6-phosphate dehydrogenase deficiency in male newborn babies and its relationship with neonatal jaundice Deficiência de glicose-6-fosfato desidrogenase eritrocitária em recém-nascidos do sexo masculino e sua relação com a icterícia neonatal

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    Marli Auxiliadora C. Iglessias

    2010-01-01

    masculino provenientes da Maternidade Escola Januário Cicco em Natal, Rio Grande do Norte. A deficiência da glicose-6-fosfato desidrogenase foi determinada através do método qualitativo da redução da metahemoglobina (teste de Brewer e confirmada mediante determinação espectrofotométrica quantitativa da atividade da G6PD e pela eletroforese da enzima em acetato de celulose. Oito recém-nascidos apresentaram deficiência da G6PD, e quatro deles exibiram icterícia nas primeiras 48 horas depois do nascimento, com valores de bilirrubina maiores de 10 mg/dL. Todos os deficientes apresentaram a variante A-. Os dados encontrados confirmam a associação da deficiência da G6PD e a icterícia neonatal. Assim sendo, o diagnóstico precoce da deficiência logo após o nascimento é essencial ao controle do aparecimento da icterícia e para evitar o contato destes recém-nascidos com conhecidos agentes hemolíticos.

  20. 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

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    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

  1. Programa de Triagem Neonatal do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Brasil Neonatal Screening Program at the University Hospital of the Ribeirao Preto School of Medicine, São Paulo University, Brazil

    Directory of Open Access Journals (Sweden)

    Patrícia Künzle Ribeiro Magalhães

    2009-02-01

    Full Text Available O Programa de Triagem Neonatal do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Brasil, instituído em 1994 diagnosticou, até 2005, 76 crianças com hipotireoidismo congênito, 10 com fenilcetonúria e 25 com hemoglobinopatias, o que representou uma incidência de 1:2.595, 1:19.409, 1:4.120, respectivamente. Foram diagnosticadas 2.747 crianças com traço falciforme (1:37,5 nascidos vivos. A cobertura média do programa foi de 94,5%. Houve uma considerável melhora nos parâmetros de avaliação da qualidade do programa no período, porém, sem atingir os índices ideais. Campanhas visando à maior divulgação da importância da triagem neonatal são necessárias para aumentar a cobertura e a instituição do 3º dia de vida do recém-nascido como sendo o Dia do Teste do Pezinho poderia contribuir para que idades mais precoces de tratamento fossem atingidas, melhorando o prognóstico das crianças acometidas.The Neonatal Screening Program at the University Hospital of the Ribeirao Preto School of Medicine, São Paulo University, Brazil, was introduced in 1994. As of December 2005, congenital hypothyroidism had been diagnosed in 76 infants, phenylketonuria in 10, and hemoglobinopathies in 25, representing incidence rates of 1:2,595, 1:19,409, and 1:4,120, respectively. A total of 2,747 newborns had the sickle cell trait, i.e., were heterozygous for the sickle mutation (1:37.5 live births. The program's mean coverage during this period was 94.5%. There was major improvement in the parameters for evaluating the program's quality, although they were still far from ideal. Public-awareness campaigns on the importance of neonatal screening are needed to increase the program's coverage. Setting postnatal day 3 as the standard Day for the Heel Stick Test would help ensure treatment at earlier ages, thus improving prognosis for affected infants.

  2. Cardiopulmonary exercise testing in the early-phase of myocardial infarction Teste de exercício cardiopulmonar na fase precoce do infarto do miocárdio

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    Vandeni C. Kunz

    2012-10-01

    áveis cardiorrespiratórias e metabólicas no nível do limiar de anaerobiose ventilatório (LAV e no pico do teste de exercício cardiopulmonar (TECP submáximo em voluntários saudáveis e em pacientes na fase precoce após o infarto agudo do miocárdio (IAM. MÉTODO: Vinte e seis voluntários realizaram TECP submáximo ou sintoma limitante em cicloergômetro e foram divididos em grupo IAM (G-IAM=12, 56,33±8,65 anos e grupo saudável (GC=14, 53,33±3,28 anos. As medidas dos desfechos principais foram as variáveis cardiorrespiratórias e metabólicas obtidas no pico e no LAV do TECP. Teste estatístico: t-Student não pareado, α=5%. RESULTADOS: O G-IAM apresentou menores valores no LAV e no pico do TECP que o GC (p<0,05: potência em Watts (91,06±30,10 e 64,88±19,92; 154,93±34,65 e 120,40±29,60; VO2mL.kg-1.min-1 (17,26±2,71 e 12,19±2,51; 25,39±5,73 e 19,41±5,63; VCO2L/min-1 (1,43±0,31 e 0,93±0,23; 2,07±0,43 e 1,42±0,36, VO2L/min-1 (1,33±0,32 e 1,00±0,23; 1,97±0,39 e 1,49±0,36; VEL/min-1 (42,13±8,32 e 27,51±5,86; 63,07±20,83 e 40,82±11,96; FC (bpm (122,96±14,02 e 103,46±13,38; 149,67±13,77 e 127,60±10,04; duplo produto (DP (bpm.mmHg.min-1 (21835,86±3245,93 e 17333,25±2716,51; 27302,33±3053,08 e 21864,00±2051,48, respectivamente. A variável Oxygen Uptake Efficiency Slope (OUES L/min do G-IAM foi 1,79±0,51 e do GC 2,26±0,37, p<0.05. O G-IAM não apresentou alterações eletrocardiográficas ou sintomas que limitassem o TECP. CONCLUSÃO: Os resultados mostram que os pacientes com IAM Killip I apresentaram menor capacidade funcional e DP em relação ao GC, sem apresentar alterações isquêmicas. Assim, o estudo sugere que o TECP submáximo pode ser aplicado precocemente para a avaliação cardiorrespiratória por apresentar alta sensibilidade para detectar alterações de forma segura.

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

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    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

  4. Neurodevelopmental Reflex Testing in Neonatal Rat Pups.

    Science.gov (United States)

    Nguyen, Antoinette T; Armstrong, Edward A; Yager, Jerome Y

    2017-04-24

    Neurodevelopmental reflex testing is commonly used in clinical practice to assess the maturation of the nervous system. Neurodevelopmental reflexes are also referred to as primitive reflexes. They are sensitive and consistent with later outcomes. Abnormal reflexes are described as an absence, persistence, reappearance, or latency of reflexes, which are predictive indices of infants that are at high risk for neurodevelopmental disorders. Animal models of neurodevelopmental disabilities, such as cerebral palsy, often display aberrant developmental reflexes, as would be observed in human infants. The techniques described assess a variety of neurodevelopmental reflexes in neonatal rats. Neurodevelopmental reflex testing offers the investigator a testing method that is not otherwise available in such young animals. The methodology presented here aims to assist investigators in examining developmental milestones in neonatal rats as a method of detecting early-onset brain injury and/or determining the effectiveness of therapeutic interventions. The methodology presented here aims to provide a general guideline for investigators.

  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. Neonatal appendicitis: a survival case study

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    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.

  8. 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

  9. 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.

  10. Management of neonatal jaundice in primary care

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    Angeline Wan Seng Lian

    2016-02-01

    Full Text Available The Clinical Practice Guidelines on Management of Neonatal Jaundice 2003 was updated by a multidisciplinary development group and approved by the Ministry of Health Malaysia in 2014. A systematic review of 13 clinical questions was conducted using evidence retrieved mainly from Medline and Cochrane databases. Critical appraisal was done using the Critical Appraisal Skills Programme checklist. Recommendations were formulated based on the accepted 103 evidences and tailored to local setting as stated below. Neonatal jaundice (NNJ is a common condition seen in primary care. Multiple risk factors contribute to severe NNJ, which if untreated can lead to adverse neurological outcomes. Visual assessment, transcutaneous bilirubinometer (TcB and total serum bilirubin (TSB are the methods used for the detection of NNJ. Phototherapy remains the mainstay of the treatment. Babies with severe NNJ should be followed-up to detect and manage sequelae. Strategies to prevent severe NNJ include health education, identification of risk factors, proper assessment and early referral.

  11. [In utero thrombosis of neonates: inherited thrombophilia?].

    Science.gov (United States)

    Nagy, Andrea; Mogyorósy, Gábor; Kiss, Csongor; Pataki, István; Amir Houshang, Shemirani; Oláh, Eva

    2009-04-19

    Thromboembolic events are relatively uncommon in childhood. It involves mainly children under one year of age and adolescents, with an incidence is 5.1/10000 live births. Authors present a course of disease of seven cases with neonatal thromboembolic events (2.5/admissions), diagnosed and treated at the Neonatal Division of Department of Pediatrics. In three of seven cases thrombosis proved to be of intrauterine origin. In each of the latter cases, inherited thrombophilia of the mothers was detected. Additional risk factors including infection could be revealed only in one case. Using in vivo and post mortem DNA analysis, mother-like-thrombophilia could not be confirmed in any of the newborns. Based on their experiences, authors suppose that undetected predisposing factors added to maternal thrombophilia can be considered as etiological factor. Authors suggest the intensive follow-up of pregnant women with thrombophilia and also their fetuses.

  12. Molecular Mechanisms of Neonatal Brain Injury

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    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.

  13. 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.

  14. Reducing nosocomial infections in neonatal intensive care.

    Science.gov (United States)

    Rogers, Eileen; Alderdice, Fiona; McCall, Emma; Jenkins, John; Craig, Stanley

    2010-09-01

    Nosocomial infection is a common problem in neonatal intensive care. A pilot quality improvement initiative focussing on hand hygiene and aimed at reducing nosocomial infection in very low birth weight (VLBW) infants was introduced in five Neonatal Intensive Care Units. Line associated laboratory confirmed bloodstream infection (LCBSI) and ventilator associated pneumonia (VAP) were chosen as main outcome measures. In VLBW infants, the rate of line associated LCBSI per 1000 central venous catheter days fell by 24%. The rate of VAP per 1000 ventilator days in VLBW infants fell by 38%. Pre- and post-intervention questionnaires showed a statistically significant increase in use of alcohol-based gels and increased knowledge of hand hygiene.

  15. 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

  16. 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.

  17. Metabolic neural mapping in neonatal rats

    International Nuclear Information System (INIS)

    DiRocco, R.J.; Hall, W.G.

    1981-01-01

    Functional neural mapping by 14 C-deoxyglucose autoradiography in adult rats has shown that increases in neural metabolic rate that are coupled to increased neurophysiological activity are more evident in axon terminals and dendrites than neuron cell bodies. Regions containing architectonically well-defined concentrations of terminals and dendrites (neuropil) have high metabolic rates when the neuropil is physiologically active. In neonatal rats, however, we find that regions containing well-defined groupings of neuron cell bodies have high metabolic rates in 14 C-deoxyglucose autoradiograms. The striking difference between the morphological appearance of 14 C-deoxyglucose autoradiograms obtained from neonatal and adult rats is probably related to developmental changes in morphometric features of differentiating neurons, as well as associated changes in type and locus of neural work performed

  18. 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...

  19. [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

  20. Effect of Bilineaster Drop on Neonatal Hyperbilirubinemia

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    Zahra Ameli

    2017-01-01

    Full Text Available Background: Hyperbilirubinemia is considered one of the most prevalent problems in newborns. Phototherapy, exchange transfusion, and herbal medicine are common therapeutic approaches for preventing any neurologic damage in infants with neonatal jaundice. However, herbal medicine is less commonly used. Aim: This study aimed to investigate the effect of bilineaster drop on neonatal hyperbilirubinemia. Method: This study was a randomized clinical trial conducted on 98 term neonates (aged 2-14 days with neonatal jaundice admitted to Ghaem Hospital of Mashhad, Iran, during 2015. These newborns were randomly assigned into intervention (phototherapy and bilineaster drop and control (only phototherapy groups. Total and direct serum bilirubin levels were measured at the time of admission and then 12, 24, 36, and 48 h after treatment. Data were analyzed using independent t-test and repeated measures ANOVA through Stata software (Version 12. Results: The mean ages of the newborns at the time of admission were 6.2 ±2.5 and 6.04 ±2.4 days in the intervention and control groups, respectively. The intervention group showed higher reduction in mean duration of hospital stay, readmission rate, and bilirubin levels 12 and 24 h after the intervention, compared to the control group (P>0.001. However, the two groups demonstrated no statistically significant difference 36 h and 48 h after the intervention (P=0.06, P=0.22, respectively. Repeated measures ANOVA indicated that the intervention had no significant effect on the reduction trend of bilirubin levels (P=0.10 [total], P=0.06 [indirect] in both groups. Nonetheless, bilirubin levels significantly diminished in both groups over time (P