CSF cytokine levels in preterm infants may reflect systemic inflammation and are independent of gestation.

Background: Among preterm infants, high concentrations of inflammatory mediators in cerebrospinal fluid (CSF) are associated with poor outcome. Previous studies have not indicated whether CSF concentrations of inflammatory mediators are associated with important confounders such as gestational age.

Aims: To examine associations between CSF concentrations of inflammatory mediators and gestational age, maternal features suggestive of inflammation, characteristics of the CSF sample or the presence of a systemic inflammatory response.

Negative exploration for pyloric stenosis--is it preventable?

Background: The diagnosis of infantile hypertrophic pyloric stenosis (IHPS), although traditionally clinical, is now increasingly dependent on radiological corroboration. The rate of negative exploration in IHPS has been reported as 4%. The purpose of our study was to look at elements of supportive clinical evidence leading to positive diagnosis, and to review these with respect to misdiagnosed cases undergoing negative exploration.

Pontomedullary disconnection: fetal and neonatal considerations.

The cerebellar and pontocerebellar hypoplasias present a unique challenge when detected in the developing fetus. A diverse aetiology and prognosis make counselling of these families difficult. Advances in fetal imaging allow for more accurate diagnosis and counselling, but postnatal MRI is still required.

Patients' perceptions of "uncertainty" in nurse practitioner consultations.

The aim of this qualitative study was to explore patients' perceptions of consulting with a nurse practitioner in situations of clinical uncertainty. Uncertainty in this context is defined as one where there is no obvious diagnosis, treatment or where the outcome of the consultation is not definite. Three general practice sites were recruited to participate.

Isochromosome 20p associated with multiple congenital abnormalities.

A second case of tetrasomy 20p due to an additional isochromosome 20p is reported. This resulted in a spontaneous intrauterine death with multiple congenital abnormalities. In keeping with the previous report, the foetus had poor ossification resulting in multiple long bone fractures.

Congenital cystic adenomatoid malformation: is there a difference between the antenatally and postnatally diagnosed cases?

Background: The majority of congenital cystic adenomatoid malformation (CCAM) lesions are diagnosed antenatally. A few cases however may not be recognised antenatally and present in infancy or later childhood with chest symptoms, including chest infection.

Objective: To review the clinical and radiological spectrum of CCAM, comparing the antenatally with the postnatally diagnosed cases.

Atypical chronic lung disease in preterm infants.

An atypical pattern of chronic lung disease (CLD) has been described in preterm infants and a potential association with intrauterine inflammation has been proposed. We aimed to describe patterns of CLD, to determine the incidence of atypical CLD, and to compare the distribution of various perinatal factors in infants with classic and atypical CLD. Information about demographics, respiratory status and various perinatal variables was collected for all neonatal admissions <1250 g.

Left pulmonary artery sling presenting as unilateral echogenic lung on 20-week detailed antenatal ultrasound examination.

Background: We report the first case of left pulmonary artery sling (LPAS) presenting as unilateral echogenic lung at a routine 20-week antenatal US examination. The infant had minimal symptoms at delivery, but developed an oxygen requirement and respiratory distress from day 10 of postnatal life. Antenatal US and antenatal MRI indicated an intrathoracic anomaly, so permitting definitive investigations in the neonatal period using CT, MRI and helical-CT-acquired virtual bronchoscopy.

Neonatal brain abscess--potential pitfalls of CT scanning.

CASE REPORT. A 6-day-old preterm infant collapsed on the neonatal unit and was found to have enterobacter meningitis. Cranial ultrasounds had been normal in the first few days of life, but an ultrasound on day 9 of life showed a well-defined lesion, which was thought to be an abscess in view of his underlying illness.