Paralytic ileus in the neonate as a rare complication of maternal methadone treatment-a case report.

Narcotic bowel syndrome is defined as worsening abdominal bloating and cramping with chronic opiate use, leading to paralytic ileus. This syndrome is common yet underreported in adults. However, there is no current evidence of such conditions in the newborn after exposure to high doses of opiates.

Are Ketamine Infusions a Viable Therapeutic Option for Refractory Neonatal Seizures?

Ketamine is an N-methyl-d-aspartate (NMDA) receptor antagonist that works by binding to the phencyclidine-binding site, thereby blocking influx of cations through the NMDA receptor channel. The use of ketamine to treat refractory status epilepticus in adults and older children is well documented. Maturational changes in neonatal NMDA and γ-aminobutyric acid receptor expression and function make NMDA receptor antagonists, like ketamine, attractive potential therapeutic agents for treatment of refractory seizures in the newborn.

Household income and subjective well-being after spinal cord injury: a longitudinal study.

Background: Studies regarding subjective well-being (SWB) after spinal cord injury (SCI) are increasing in recent years, but little has been contributed to the relationship between income and SWB.

Objective: By using longitudinal data, we want to identify (1) the overall trend in SWB over a 10-year period; (2) the association between household income and SWB at baseline; (3) the variation of the trajectory of SWB over 10 years among different household income groups; and (4) the variation of change rates of SWB over 10 years among different household income groups.

Methods: We conducted a cohort study, including 434 participants who completed 3 measurements in 1998, 2003, and 2008.

Nontraumatic coma in children and adolescents: diagnosis and management.

The causes of nontraumatic coma (NTC) vary by country, season and period of data collection. Infective diseases are among the major worldwide causes of NTC. Nonaccidental head injury must be in the differential diagnosis.

Decreased urine albumin:creatinine ratios in infants of diabetic mothers: does exposure to diabetic pregnancies alter fetal renal development?

Offspring of diabetic mothers experience an increased risk for type 2 diabetes but it is not known whether diabetic pregnancies also confer a higher inter-generational risk for diabetic complications. Because microalbuminuria is a sensitive indicator of glomerular damage, we compared the urine albumin:creatinine ratios (ACRs) between 65 infants of diabetic mothers (InfDM+) and 59 infants of non-diabetic mothers (InfDM-), and repeated the comparisons in 21 InfDM+ and 19 InfDM- when children were 5-19 months old. ACRs were higher among neonates compared with normal reference values for adults, but declined with increasing age.

Efficacy of auditory enrichment in a prosimian primate (Otolemur garnettii).

Research suggests that auditory environmental enrichment might reduce abnormal behavior in certain primate species. The authors evaluated the behavioral effects of exposure to music in a prosimian primate (Garnett's bushbaby; Otolemur garnettii). They exposed bushbabies to a Mozart concerto for 15 min per day for 20 d (5 h exposure total), video-recorded them and subsequently analyzed the frequency of subjects' grooming and stereotypic behaviors.

Fatal yersiniosis in farmed deer caused by Yersinia pseudotuberculosis serotype O:3 encoding a mannosyltransferase-like protein WbyK.

Sudden death of 9 deer occurred in a large enclosed deer farm with approximately 400 heads of cervids. Fatal yersiniosis was diagnosed in 2 deer that were submitted for laboratory diagnosis. Histopathologically, the disease was characterized by multifocal pulmonary hemorrhage and mild interstitial pneumonia, marked diffuse cholangiohepatitis, minimal myocarditis with mild myocardial degeneration, and mild multifocal suppurative cystic colitis.

Gleason score and pretreatment prostate-specific antigen in survival among patients with stage D2 prostate cancer.

Although multiple studies have addressed the prognostic importance of tumor differentiation in patients with clinically localized prostate cancer, few data are available in patients with metastatic disease. We evaluated and compared survival data in two groups of men with Whitmore stage D2 metastatic prostate cancer initially treated with hormonal therapy. A series of 76 patients with D2 metastatic disease were evaluated and treated at the National Cancer Institute (NCI) in conjunction with an additional cohort of 141 patients from the Louisiana State University School of Medicine (LSU).

One-year outcome in 232 premature infants with birth weights of 750 to 1249 grams and respiratory distress syndrome randomized to rescue treatment with two doses of synthetic surfactant or air placebo. Canadian Exosurf Neonatal Study Group.

A randomized, double-blind, placebo-controlled trial was performed in 13 hospitals in Canada to assess whether two rescue doses of a synthetic surfactant (Exosurf Neonatal) would reduce mortality and morbidity rates in neonates with respiratory distress syndrome who weighed from 750 to 1249 gm. As part of the original trial design, double-blind follow-up evaluations were performed at 1-year adjusted age. A total of 118 patients who received air placebo and 114 patients who received synthetic surfactant were evaluated at 1 year.

One-year follow-up of 89 infants with birth weights of 500 to 749 grams and respiratory distress syndrome randomized to two rescue doses of synthetic surfactant or air placebo. Canadian Exosurf Neonatal Study Group. Canadian Exosurf Neonatal Follow-Up Group.

Double-blind neurodevelopmental and physical evaluations were conducted at 1-year adjusted age in 89 infants with birth weights of 500 to 749 gm who had respiratory distress syndrome in the neonatal period and were randomized to receive two rescue doses of a synthetic surfactant (Exosurf Neonatal, Burroughs Wellcome Co., Research Triangle Park, N.C.

Neonatal Campylobacter fetus meningitis: a report of an unusual case.

Campylobacter fetus is a rare cause of meningitis in the pediatric age group and, in particular, among neonates. The clinical presentation of campylobacter meningitis in high-risk neonates is not well-described. A review of campylobacter meningitis by Lee et al in 1985 reported nine cases occurring in neonates, of which only one case was caused by C.

Nutritional consequences and therapy in Crohn's disease.

Since low intakes of energy and other nutrients are significant factors leading to malnutrition in Crohn's disease, increased attention should be paid to assessing the nutritional status and intake of these patients in the hospital and on an outpatient basis. If nutritional intervention can be instituted early, some of the numerous and serious nutritional consequences of Crohn's disease may be lessened. For this condition where no therapy, surgical or medical, has proven to be more than partially effective, nutritional therapy may be a crucial factor.

Apparent life-threatening prolonged infant apnea in Saskatchewan.

Life-threatening events such as prolonged apnea and severe bradycardia are uncommon in infants. When such events occur in a family, however, the results may be disastrous. Over a period of 3 years ending June 1986, we have looked after 111 such infants aged 4 weeks to 40 weeks with a mean age of 14 weeks (male-female ratio 1.

Bacterial tracheitis in children.

We examined the records of 14 patients aged 7 months to 10 1/4 years who were treated for bacterial tracheitis from May 1982 to December 1987; the management protocol for 13 of the patients included the use of nasotracheal intubation. The infection was caused by Staphylococcus aureus in seven, Haemophilus influenzae in three, Branhamella catarrhalis in one and Streptococcus pneumoniae in one. Both H.

Treatment of pulmonary hypertension with diltiazem in a child with bronchopulmonary dysplasia.

A two-year-old child dying of pulmonary hypertension and cor pulmonale secondary to bronchopulmonary dysplasia, was demonstrated to have reactive pulmonary hypertension in response to 100% oxygen and isoproterenol infusion. In an attempt to find an oral medication to maintain pulmonary vasodilatation, experimental trials were done using hydralazine, salbutamol, nifedipine and diltiazem. Cardiac index, pulmonary and systemic vascular resistances and intrapulmonary shunts were monitored during the trials.

The neonatal airway: problems and management.

Altered, distressed, and noisy breathing during the neonatal period may indicate problems of the upper airway. Typically, a neonate with upper airway obstruction will present with stridor, which may be inspiratory and/or expiratory, and which may represent either a minor or a life-threatening illness. Evaluation of stridor will require a systematic history and physical examination, laboratory and radiologic studies, and possible endoscopic examination of the airway.

W. W. Keen and the dawn of American neurosurgery.

Before the turn of the century, W. W. Keen was the most celebrated neurosurgeon in the United States.

The limits of cerebral dehydration in the treatment of head injury.

Eighteen patients with fatal head injury were matched with survivors for age, sex, and nature and severity of injury. All were treated with cerebral dehydration. Only four patients survived whose peak serum osmolality exceeded 340 mosm/kg; none survived above 378 mosm/kg.

Congenital tracheal occlusion in neonates--a minireview.

Congenital tracheal occlusion, though seemingly rare, is generally fatal if not attended to immediately. A high index of suspicion should help to make the diagnosis in a neonate when there are respiratory distress at birth and no audible cry and an endotracheal tube cannot be advanced beyond the vocal cords. We present our experience with cases of congenital tracheal obstruction due to various causes during a period of four years.

Serum levels of C-reactive protein in neonatal respiratory distress syndrome.

Serum levels of C-reactive protein (CRP) were measured within 96 hours of birth in 55 neonates with respiratory distress syndrome (RDS), 19 neonates with no significant medical illness other than an unstable cardiovascular state, and 13 neonates with a variety of pulmonary and extra-pulmonary problems either alone or in combination with RDS. The median serum CRP level in patients with RDS (2 micrograms/ml) was neither elevated nor different from CRP levels in infants with unstable cardiovascular systems (median CRP level, 2 micrograms/ml); however, neonates with other problems including pneumonia, aspiration, and extrapulmonary sepsis had significantly elevated serum CRP values (median 24 micrograms/ml). CRP levels are not elevated in neonatal RDS.

Complex transposition with interrupted right aortic arch and partial Di George syndrome: successful palliation with combined medical and surgical therapy.

A five-day-old infant with transposition of the great arteries, ventricular septal defect, and an interrupted right aortic arch underwent successful balloon septostomy, pulmonary artery banding, and aortic arch repair. The infant also had abnormal facies with severe refractory hypocalcemia and depressed T-lymphocyte number and function believed to represent a partial Di George syndrome. The hypocalcemia resolved following treatment with a vitamin-D analogue, T-cell number increased, and T-cell function improved, but both remained subnormal.