Transient neonatal pustular melanosis.
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Biomedical subjects
Publications and source records attributed to S H Reisner.
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The purpose of this study was to establish normal anthropometric standards for eye measurements in newborn infants born between 27 and 41 weeks of gestation. In 198 term and preterm newborn infants, palpebral fissure size and inner and outer canthal distances were measured and the interpupillary distance was calculated. The mean and 2 SD from the mean for each gestational week was determined, and the normal values are presented as intrauterine growth curves of these parameters for gestational age.
Aspartic acid concentration in CSF was markedly elevated in a newborn infant with severe, intractable seizures. The levels of all other amino acids in blood, urine, and CSF were within the normal range. Two of the six other siblings in this consanguineous family died in early infancy of a similar condition. Since aspartic acid is a putative excitatory neurotransmitter, a possible causal relationship is suggested between its increased CSF concentration and the occurrence of neonatal convulsions in this family.
A newborn infant with craniofacial dysmorphism and polysndactyly (Greig's Syndrome) is reported. This syndrome is manifested by postaxial polydactyly of the fingers and preaxial polydactyly of the toes, with syndactyly. The craniofacial dysmorphism is characterized by frontal bossing and other variable manifestations. X-ray examination revealed markedly advanced bone age. The mode of inheritance appears to be autosomal dominant.
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The syndrome of inappropriate antidiuretic hormone secretion (SIADH) has not often been described in newborn infants. Of 61 infants with respiratory problems who were admitted to our neonatal intensive care unit over a six-month period from July 1978, three had SIADH, diagnosed on the basis of hyponatremia, weight gain and the excretion of highly concentrated urine. In one infant the onset of marked hyponatremia was very rapid and resulted in deep coma. The occurrence of this syndrome in 5% of infants under intensive care for neonatal respiratory problems makes it essential to monitor these infants closely for deviations in fluid and electrolyte balance.
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A combination of propranolol and hydrallazine was administered to 13 patients with longstanding hypertension during 15 pregnancies. Hydrallazine was continued through labour and delivery in all patients, while in eight patients propranolol was discontinued 2 to 15 days before delivery. Blood pressure control was uniformly good and superimposed pre-eclampsia did not occur during combined therapy. There were 14 livebirths and one unexplained stillbirth. Except for two cases of milk hypoglycemia, there were no neonatal complications.
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This report makes use of a recent developed method with stable isotope and gas chromatography-mass spectrometry to determine the disappearance of labeled amino acids from plasma samples after iv administration of a single dose (93.3-mumoles/kg body weight) of [15N]glycine (92% N) in neonates. [15N]Glycine measurements were studied three times in each of six preterm infants at different gestational age and twice in two full-term infants. The first study was carried out in all infants 5 to 32 hr after delivery, the second study was performed on the third day of life, and the third study, included only the preterm infants, was at the age of 25 to 29 days. The isotope disappearance curves were linear within the first hr after [15N]glycine administration and represent mainly the hepatic uptake of glycine from the extracellular pool. The volume of glycine pool varied from the day of birth to 4 wk of life. Turnover rate constants of glycine ranging from 1.35 to 2.19 hr-1 were observed in preterm and term infants during the first 32 hr. Significant increases in turnover rate constants were noted on the third day of life in most infants. At 3 to 4 wk of life, statistically significant differences in pool size and turnover rate constants were obtained. An increase of 2- to 3-fold in turnover rate constants was observed as compared to day of birth. Pool sizes declined by 50%, but the resulted fluxes remained almost unchanged during the neonatal period. At the age of 3 to 4 wk, all these infants showed similar kinetic data as in adults.
A 3-day-old baby girl developed septicaemia, meningitis, and necrotising fasciitis due to group A beta-haemolytic streptococcus, type M52, which was also cultured from the mother's cervix. Necrotising fasciitis is a severe infection of the skin and subcutaneous tissues with infarction, necrosis, and sloughing of the affected areas. Early recognition of this condition is essential so that appropriate treatment can be given.
Nineteen cases of cysts of the external female genitalia were diagnosed over a two-year period, giving an incidence of six per 1,000 female infants. The embryology, morphology, and differential diagnosis are discussed. No treatment was given and follow-up at two months of age revealed complete resolution of the cysts, thereby establishing their benign course in the newborn period.
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