SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Current progress in the use of vaccines against a range of infectious agents, both bacterial (pertussis, pneumococcus and group B streptococcus) and mycobacterial (bacille Calmette-Guérin), to prevent neonatal infection are reviewed by Professors Gilbert, Britton and McIntyre and Dr Peter Richmond.
We studied the effects of the presence or absence of the thyroid gland on the iodine metabolism and excretion in term Dutch newborns by performing a retrospective study of the urinary iodine excretion in 193 term newborns with abnormal congenital hypothyroidism screening results. Thirty-six euthyroid newborns with decreased thyroxine-binding globulin levels were compared with 157 hypothyroid patients, 54 due to thyroid agenesis and 103 due to thyroid dysgenesis. A significant difference in the urinary iodine excretion was observed between the agenesis group (mean: 28 micrograms/24 h) and the euthyroid newborns (mean: 46 micrograms/24 h, P=0.001). In conclusion, healthy, euthyroid, term newborns excreted more iodine in their urine than newborns with thyroid agenesis. These results strongly indicated the existence of a temporarily negative iodine balance: the excretion of iodine prevailed over the intake and the newborn's thyroidal iodine, stored during pregnancy, could be used for thyroxine synthesis in the postnatal period. Since healthy term neonates were able to maintain adequate plasma free thyroxine concentrations under normal TSH stimulation, the prenatally acquired iodine stores could be considered sufficiently high to compensate for the transient postnatal losses.
We present the case of a newborn with bacterial endocarditis with mitral valve involvement as a complication of late-onset sepsis due to Staphylococcus aureus with associated pyelonephritis and meningitis. The diagnosis was confirmed by echocardiogram and blood culture with growth of S. aureus. Treatment was medical and surgical. Neonatal bacterial endocarditis is extremely difficult to diagnose. The signs and symptoms are usually nonspecific and cannot be distinguished from those of sepsis or congenital heart disease. Consequently, a high degree of suspicion is needed for the early diagnosis of this condition. Echocardiography should be performed in children who present sepsis and heart murmur and even in those with staphylococcemia (sepsis due to S. aureus) without associated heart murmur. This investigation enables an early diagnosis of endocarditis to be made and appropriate treatment to be given without having to wait for the development of signs and symptoms that frequently go undetected.
Rats were castrated on day 2 after birth, given one injection of testosterone pronate (TP: 2.5 mg) or oil just after operation and then received TP or oil when adult. 3H-Leucine was injected intravenously 2.5 hours before killing. The incorporation of labelled amino acid into protein was investigated in the thyroid glands. Males receiving TP both neonatally and when adult incorporate twice as much labelled leucine into protein as compared to their counterparts. Grain density was highest in the thyroid gland of early hormone treated rats when challanged with testosterone in adulthood. Thyroid gland priming by early hormone treatment has been discussed.
Neonatal bacillus Calmette-Guérin (BCG) immunisation is a primary preventive measure against tuberculosis. Local health professionals expressed concern about the variability of knowledge regarding eligible infants and uptake of the vaccine. A questionnaire was sent out to health visitors for use at the routine visit to babies. Details requested included ethnic group and country of origin of the infant, eligibility for BCG vaccination, and vaccination status. BCG vaccination was indicated for 41% of newborns. In total 74% of these eligible infants received the vaccine with a range of 36-83% between the five maternity units. There were inconsistencies within maternity units in identifying high-risk groups by ethnicity and country of origin, resulting in low coverage in certain eligible groups. Confusion exists about which infants are at risk of tuberculosis and should be vaccinated. Current national guidelines are not specific enough for cases of interracial parenting and for the increasingly diverse countries of origin of the population. In the absence of clearer national guidelines there is a need for pragmatic local guidance.
Of a total of 24 newborn with neonatal bacterial infectious syndrome (NBIS), in 157 (65.12%) the infection appeared immediately at birth. In the rest of 84, the clinical manifestations appeared in the first 4 days of life followed in decreasing order by systemic manifestation without location on pneumonia and bronchopneumonia were the most frequently diagnosed, an organ, septicemias and meningitis, infectious jaundice, etc. Two antibiotics were associated in the severe forms, and antiinfectious monotherapy was used in the milder ones. In the cases with unfavourable clinical evolution, the antiinfectious treatment was used. The severe forms of NBIS were among the most cases of death at this age. NBIS manifested, therefore, under various forms, imitating other noninfectious affections. During diagnosis, mother's anamnestic data, and very often the clinician's intuition were very important, before the bacteriologic corroboration.
We compared the normal values of white blood counts in premature infants and full-term neonates, as described in part one of this paper, with blood counts of 31 infants with suspected infections and 81 infants with sepsis and/or meningitis. The half of these infected infants had leucocyte and neutrophil counts beyond the reference limits. The values tended to leucopenia in diseases beginning within the first five days of life and to leucocytosis later on. More than 80% of the patients had a left shift. One is able to predict a sepsis with a probability of 16.3%, according to our experiences, with leucocyte counts below 5 or above 20 Gpt/l. In the case of left shift the probability is about 25%. Combining these parameters the predictive value is even mounting to 56.1%. We were able to make a prognosis too referring to the blood count of infants with sepsis.
By means of 522 singles in breech presentation the pH of umbilical artery (pH u. a.) and Apgar score in comparison to the mode of delivery, duration of pregnancy and weight of neonates have been analysed. The frequency of deliveries by cesarean section in breech presentation was 28.3%, the rate of preterms in these cases amounts to 14.6% and the perinatal mortality to 42.1%. The average value of pH u.a. after vaginal delivery (7.25) was significantly different to the value after cesarean section (7.28). 25% of the pH-values were below 7.20, 10% below 7.10. Mixed acidoses dominated, metabolic ones after vaginal and abdominal deliveries equalled each other. Vaginal deliveries were frequently followed by respiratory acidoses. In 81% of one-minute-Apgar and in 93% of five-minute-Apgar, the score was above 7. According to our experiences the only determination of the pH u.a. after breech deliveries is not sufficient, because of being at risk for the fetus it demands the measurement of the complete acid-base-status. A critical comparison of these data with the clinical status of the newborn is necessary.
Thirty-five isolated hearts from newborn rabbits (aged birth to 2 days) were subjected to 120 minutes of ischemia at 15 degrees C with high potassium crystalloid cardioplegia. They were divided into four groups according to the method of cardioplegic administration: group C (preischemic control, n = 9), group S (single dose, n = 10), group M-1 (multiple dose, infused every 40 minutes, n = 7), and group M-2 (multiple dose, infused every 20 minutes, n = 9). After 30 minutes of reperfusion, the heart rate, coronary flow, creatine kinase release, percent water content, and myocardial ultrastructural scores for mitochondrial damage and intracellular edema were compared among the four groups. All of these parameters except coronary flow were significantly poorer in group M-2 than in groups C and S (p less than 0.05). The mitochondrial damage and intracellular edema scores were significantly poorer in group M-1 than in group C (p less than 0.05). No significant differences in these two scores were seen between group S and group C and between group S and group M-1. These results indicate that the single dose method of administering crystalloid cardioplegia may provide better myocardial protection than the multiple dose method in the neonate.
The authors report a case of acute fetal distress and immediate respiratory distress in a neonate presenting with large hydrometrocolpos. This diagnosis, infrequently concerned in such a situation, should be suggested in cases with abdominal tumors.
21,013 newborns were screened on the first year of a neonatal screening program on congenital hypothyroidism in the Basque Community. The evaluation of the results showed some points of interest. One of them, would be the high analytical retesting rate needed in the screening of very low-birth weight children. The rate decreased with increasing birth-weight. Forty per cent of the children with a birth-weight lower than 1,000 gr needed retesting. The rate decreased to 7.7% at birth-weights between 1,001 and 1,500 gr, to 2% at birth weights between 1,501 and 2,500 gr and only to 0,42% at birth-weights higher than 2,501 gr. The consequences of these results are discussed.
A prospective study of premature infants admitted to an intensive care neonatal unit was undertaken to evaluate the relative role of blood transfusions and maternal exposure in infections caused by cytomegalovirus (CMV), varicella zoster virus (VZV) and herpes simplex virus (HSV). During the first year of life, 13.7%, 4.8% and 4% of the infants became infected with CMV, VZV and HSV, respectively, as determined by virus isolation or seroconversion. Transfusion in the newborn period did not influence the rates of VZV or HSV infections. A higher rate of CMV infections occurred in transfused (18.8%) than in non-transfused (11%) infants but the difference was not statistically significant. A significant correlation was found between maternal antibody titers and the rate of CMV infection in infants whether or not transfusion occurred. An even stronger association was found between breast feeding and CMV infections. The risk of alloimmunization to erythrocyte and leucocyte antigens was also assessed; no evidence of increased alloimmunization to these antigens was associated with transfusion.
A new neonatal maintenance solution (Neonatalyte; Sabax) was administered to 12 newborn infants with respiratory distress. Under closely controlled conditions, the infusion was commenced at a mean age of 12 +/- 10 hours. The mean serum potassium level increased from 4,6 +/- 0,6 mmol/l to 5,6 +/- 1,4 mmol/l (P less than 0,02), while in 5 infants (42%) hyperkalaemia (greater than or equal to 6,5 mmol/l) occurred within 8 hours of commencement of Neonatalyte infusion. The mean serum calcium level decreased from 2,1 mmol/l on day 1 to 1,7 mmol/l on day 2 (P less than 0,001) and was 1,8 mmol/l on day 3 (P less than 0,01), despite mean calcium intakes of 18,33 and 45 mg on days 1, 2 and 3 respectively. The early hypocalcaemia may be related to the phosphate content of Neonatalyte. We conclude that Neonatalyte is not an ideal solution for sick newborn infants who cannot be fed orally for the first few days of life.
To determine the ability of the neonate to metabolize Intralipid, it was infused in a dose of 1 gm/kg of body weight over a 4-hour period to 27 infants in the first 48 hours of life. Differences in the metabolism of this lipid were related to gestational age and to weight for gestational age. Premature AGA infants of less than 33 week's gestation hydrolyzed the triglyceride to FFA more slowly than did AGA infants whose gestation was greater than 33 weeks. The SGA infants achieved very high plasma levels of triglycerides and free fatty acids during the infusion and cleared the lipid very slowly in the postinfusion period. This suggested impaired hydrolysis of the triglyceride and deficient uptake and/or utilization at a cellular level of the resulting free fatty acids in SGA infants.
A group of 433 neonates with pneumonia were studied through the monitoring of audiology on the basis of epidemiology in perineonatal hearing impairment and applied auditory evoked potentials. The results showed that 29 cases had a threshold of more than 30 dBnHL in primary auditory brainstem response test (6.7%), and 19 cases with threshold, more than 40 dBnHL in primary 40Hz-auditory event related potential (40Hz-AERP) test (4.4%). The follow-up between the 3rd and 12th month after the initial test demonstrated that 12 cases had hearing impairment to various degrees.
Early in ontogeny, Ig, TCR-alpha beta, and TCR-gamma delta lack N regions. In addition, Ig and TCR-gamma delta junctions preferentially occur at regions of short sequence homology, thus limiting junctional diversity for these neonatal lymphocyte populations. Here, we analyze the extent of heterogeneity in TCR-beta chain junctions made early in ontogeny. DNA and cDNA from fetal/neonatal thymocytes were amplified by polymerase chain reaction, and the V-D and D-J junctions from these randomly generated sequences were analyzed. The D-J junctions were very heterogeneous, and displayed little evidence of homology-directed recombination. The V beta 8-D and V beta 5-D junctions that we analyzed each had a particular junctional sequence that was created at the site of a two-nucleotide homology, but in each case that sequence only comprised 10 to 17% of the total sequences. This junctional heterogeneity of N region lacking TCR-beta chains can be partially explained by a relative paucity of homologies at the appropriate locations near the coding ends, particularly at the D-J junction, but other factors such as the sequence surrounding the homology may also contribute. Thus, TCR-beta chains have extensive junctional heterogeneity early in ontogeny before N regions begin to be added. Since TCR-alpha beta CDR3 plays a major role in binding antigenic peptides, this junctional heterogeneity is likely to be advantageous for establishing a diverse TCR repertoire. We suggest that the sequences of the coding ends of the TCR-alpha beta have been selected through evolution to avoid the restricted junctional diversity resulting from homology-directed recombination.
Neonatal sucking blisters appears as unilateral or bilaterally symmetrical bullae or erosions involving the distal upper extremities at birth. They represent minor self-inflicted trauma, presumably the result of a vigorous intrauterine sucking reflex. Recognizing this benign self-limited condition avoids unnecessary tests and alleviates anxiety on the part of the infant's family and physicians.
Explore the source record for details and available documents.