A longitudinal 1H-NMR metabolomics analysis of urine from newborns with hypoxic-ischemic encephalopathy undergoing hypothermia therapy. Clinical and medical legal insights.

Perinatal asphyxia is an event affecting around four million newborns worldwide. The 0.5 to 2 per 1000 of full term asphyxiated newborns suffer from hypoxic-ischemic encephalopathy (HIE), which is a frequent cause of death or severe disability and, as consequence, the most common birth injury claim for obstetrics, gynaecologists, and paediatricians.

Urinary gas chromatography mass spectrometry metabolomics in asphyxiated newborns undergoing hypothermia: from the birth to the first month of life.

Background: Perinatal asphyxia is a severe clinical condition affecting around four million newborns worldwide. It consists of an impaired gas exchange leading to three biochemical components: hypoxemia, hypercapnia and metabolic acidosis.

Methods: The aim of this longitudinal experimental study was to identify the urine metabolome of newborns with perinatal asphyxia and to follow changes in urine metabolic profile over time.

Cutis marmorata telangiectatica congenita in a preterm female newborn: case report and review of the literature.

Cutis Marmorata Telangiectatica Congenita (CMTC) is a rare, sporadic condition usually present at birth characterized by localized or generalized persistent cutis marmorata, telangiectasia and phlebectasia. We report a preterm female newborn, the third child of non-related caucasian parents, with CMTC at birth who showed typical cutaneous features and monolateral congenital glaucoma. The pathogenesis of this disorder is unknown and the cause is probably multifactorial.

Ureaplasma and bronchopulmonary dysplasia.

Advances in neonatal intensive care have greatly improved survival rates for children born in a very early stage of lung development (i.e. less than 26 weeks of gestation).

Therapeutic hypothermia in the prevention of hypoxic-ischaemic encephalopathy: new categories to be enrolled.

Unlabelled: Therapeutic hypothermia is now the standard of care for brain injury control in term infants with perinatal hypoxic ischemic encephalopathy (HIE). Accumulated evidence shows a reduction in mortality and long-term neurodevelopmental disability at 12-24 months of age, with more favourable effects in the less severe forms of HIE. Only few trials recruited newborns <36 weeks gestational age, or mild-to-moderate encephalopathy with base deficit (BD) <16.

EEG findings in cooled asphyxiated newborns and correlation with site and severity of brain damage.

Objective: EEG and MRI are useful tools to evaluate the severity of brain damage and to provide prognostic indications in asphyxiated neonates. Aim of our study is to analyze the relationship between serial neonatal EEGs and severity and sites of brain lesions on MRI in neonates undergoing hypothermia, following a hypoxic-ischemic injury.

Patients And Methods: Forty-eight term newborns underwent hypothermia.

A rare case of neonatal sepsis/meningitis caused by Pasteurella multocida complicated with status epilepticus and focal cerebritis.

Pasteurella multocida is normally present in respiratory and digestive tract of many domestic and wild animals, but is a rare pathogen in neonatal infection. Here we describe for the first time a case of meningitis complicated by status epilepticus and right parietal lobe cerebritis. The patient showed a dramatic clinical onset characterized by septic appearance and prolonged seizures.

Brain cooling and eligible newborns: should we extend the indications?

Therapeutic hypothermia (whole body or selective head cooling) is recognized as standard of care for brain injury control in term infants with perinatal hypoxic ischemic encephalopathy (HIE). Recent metanalyses and systematic reviews in human newborns have shown a reduction in mortality and long-term neurodevelopmental disability at 12-24 months of age, with more favourable effects in the less severe forms of HIE. HIE is most often noted in term newborns.

Brain cooling therapy.

Therapeutic hypothermia (whole body or selective head cooling) is becoming standard of care for brain injury in infants with perinatal hypoxic ischemic encephalopathy (HIE). Brain cooling reduces the rate of apoptosis and early necrosis, reduces cerebral metabolic rate and the release of nitric oxide and free radicals. Animal models of perinatal brain injury show histological and functional improvement due to of early hypothermia.

The Effects of helium/oxygen mixture (heliox) before and after extubation in long-term mechanically ventilated very low birth weight infants.

Objectives: Our goal was to evaluate the effects of a helium/oxygen mixture (heliox) on pulmonary mechanics and gas exchange in preterm infants during both conventional and noninvasive ventilation.

Patients And Methods: Ten preterm infants, ventilated from birth, were enrolled. Resistive work of breathing, pulmonary compliance, static compliance, respiratory rate, minute ventilation, ventilatory support, and gas exchange were measured before and during treatment.

[Neonatal group B Streptococcus infection: an integrated approach (of clinical pathologists, gynecologists, midwives, pediatricians-neonatologists) of the functional area of Cuneo (Italy)].

The frequency of early-onset neonatal sepsis without prophylaxis is 1-5/1.000 live births. Since year '70 the most frequent causative microorganism is the group B Streptococcus (S.

[Ethics in perinatology].

The perinatal phase coincides, at its onset (22nd-23rd week of gestation, according to common acknowledgment), with the possible beginning of a extrauterine life susceptible of protraction. The 1st, for some the 4th, week of neonatal life marks the conclusion of the perinatal phase. There are several reasons to burden this period, to which a complex World Health Organization (WHO) document for Europe was dedicated in November 2000, with ethical issues.

Prophylactic nasal continuous positive airways pressure in newborns of 28-31 weeks gestation: multicentre randomised controlled clinical trial.

Background: The role of nasal continuous positive airways pressure (nCPAP) in the management of respiratory distress syndrome in preterm infants is not completely defined.

Objective: To evaluate the benefits and risks of prophylactic nCPAP in infants of 28-31 weeks gestation.

Design: Multicentre randomised controlled clinical trial.

Complement-dependent bactericidal activity for E. coli K12 in serum of preterm newborn infants.

Complement-dependent serum bactericidal activity for E. coli K12 was assessed in 12 term infants and in 16 preterm infants. In both groups of newborns, at birth, bactericidal reaction by the classical pathway of complement activation was impaired with respect to normal controls at less than 0.