[Paroxetine withdrawal syndrome as differential diagnosis of acute neonatal encephalopathy?].

Paroxetine, a selective serotonin reuptake inhibitor (SSRI) may be given in severe cases of maternal depression and panic disorders during pregnancy. However, it may lead to severe withdrawal symptoms: respiratory distress, jitteriness, convulsions, hypoglycaemia, an impaired muscle tone and necrotising enterocolitis. These symptoms, also called neonatal withdrawal syndrome, may last up to one month.

Plasma arginine and urinary nitrate and nitrite excretion in bronchopulmonary dysplasia.

The aim of this prospective study was to determine whether preterm infants with bronchopulmonary dysplasia (BPD) and signs of increased pulmonary artery pressure have a deficiency of plasma arginine (ARG) and systemic nitric oxide (NO) synthesis. Plasma amino acid concentrations, Doppler pulmonary systolic time intervals (ratio of acceleration time and ejection time corrected for heart rate: AT/ET(C)) and urinary nitrate and nitrite concentrations were determined at the 28th day postnatal age and at 36 weeks postmenstrual age in 73 preterm infants less than 30 weeks gestational age. The AT/ET(C) ratios were significantly lower in infants with BPD (n = 32) compared to controls.

Early decompressive craniectomy and duraplasty for refractory intracranial hypertension in children: results of a pilot study.

Introduction: Severe traumatic brain injury (TBI) in childhood is associated with a high mortality and morbidity. Decompressive craniectomy has regained therapeutic interest during past years; however, treatment guidelines consider it a last resort treatment strategy for use only after failure of conservative therapy.

Patients: We report on the clinical course of six children treated with decompressive craniectomy after TBI at a pediatric intensive care unit.

[Wilson-Mikity syndrome as a cause of respiratory insufficiency of prematurity].

The Wilson-Mikity syndrome is a differential diagnosis of chronic lung disease in the neonate and primarily related to immaturity. It is characterized by the absence of typical clinical and radiological findings of the respiratory distress syndrome (RDS). Infectious causes are being discussed.

Transient tachypnea of the newborn (TTN): a role for polymorphisms of surfactant protein B (SP-B) encoding gene?

Background: Transient tachypnea of the newborn (TTN) is usually a benign self-limiting respiratory disorder in the immediate neonatal period. The lipophilic surfactant-associated protein B (SP-B) was demonstrated to be the most relevant structural component of the surfactant system for immediate postnatal pulmonary adaptation. We hypothesized genetic variations of surfactant protein B (heterozygous 121 ins 2 mutation er intron 4 polymorphisms) to be related to TTN.

Outcome in preterm small for gestational age infants compared to appropriate for gestational age preterms at the age of 2 years: a prospective study.

Objectives: To investigate the effects of small for gestational age (SGA) in preterm infants on growth and development until the age of 22 months.

Study Design: Seventy-four preterm infants being born SGA (birth weight <10th percentile) were compared with 74 appropriate for gestational age (AGA) infants matched prospectively according to gestational age with respect to growth parameters and neurodevelopment (using Griffiths developmental scores) at the age of 22 months corrected age.

Results: Birth weight was significantly lower in SGA-infants compared to AGA-infants (1503 g (430-2205 g) versus 1995 g (680-3300 g); P<0.

Synthetic and natural surfactant differentially modulate inflammation after meconium aspiration.

Objective: Meconium aspiration syndrome remains a relevant cause of neonatal respiratory failure and is associated with severe pulmonary changes including surfactant inactivation and pronounced inflammatory changes. The present study investigated the effect of two different surfactant preparations-recombinant surfactant protein C surfactant (rSP-C Surf) and natural bovine surfactant-on pulmonary gas exchange and inflammatory response.

Design And Subjects: Twenty-three newborn piglets were intubated, mechanically ventilated, received 5 ml/kg 20% sterile meconium for induction of lung injury, and were randomized thereafter for controls ( n=7), rSP-C Surf ( n=8), or natural surfactant ( n=8).

Neonatal nucleated red blood cell count and postpartum complications in growth restricted fetuses.

Aims: To study relationships between nucleated red blood cell count (NRBC), persistence of NRBC count elevation and neonatal complications in growth restricted fetuses (IUGR).

Methods: Observational study of IUGR neonates (birthweight < 10th percentile). NRBC's/100 WBC were ascertained in a peripheral blood sample.

Congenital leukaemia after heavy abuse of permethrin during pregnancy.

A single case is described of congenital leukaemia with 11q23/MLL rearrangement in a preterm female newborn. Because of arachnophobia, the mother had heavily abused aerosolised permethrin, a widely used household insecticide. Permethrin is considered comparatively safe, but, in view of the mother's history, its potential to induce cleavage of the MLL gene in cell culture was tested.

Lung volume reduction surgery in bronchopulmonary dysplasia.

Unlabelled: We report on a female preterm infant of 29 wk gestational age, who developed acquired lobar emphysema after prolonged artificial ventilation secondary to respiratory disease syndrome and bronchopulmonary dysplasia. The infant underwent atypical segmentectomy at the age of 12 mo because of life-threatening hypoxaemia with pulmonary hypertension and failure of conservative treatment.

Conclusion: Lung volume reduction surgery (LVRS) dramatically improved the respiratory function and resulted in adequate weight gain and psychomotor development.

Increased risk of bronchopulmonary dysplasia and increased mortality in very preterm infants being small for gestational age.

Objective: The objective was to evaluate the impact of being born small for gestational age (SGA) on neonatal mortality and neonatal pulmonary morbidity in preterm infants <32 weeks of gestation.

Methods: We reviewed the data reported prospectively to the quality assurance program of the Federal State of Hesse, Germany, from 1990 to 1996 of infants <32 weeks of gestation. SGA was defined as birth weight below the 10th percentile.

[Small bowel intussusception in childhood].

Background: Intussusception is the most common cause of abdominal emergency in early childhood. The majority of cases are ileocolic type of intussusception. Only few reports concerning small bowel intussusception have been reported.

Treatment with bovine surfactant in severe acute respiratory distress syndrome in children: a randomized multicenter study.

Objective: To determine whether bovine surfactant given in cases of severe pediatric acute respiratory distress syndrome (ARDS) improves oxygenation.

Design: Single-center study with 19 patients, followed by a multicenter randomized comparison of surfactant with a standardized treatment algorithm. Primary endpoint PaO(2)/FIO(2) at 48 h, secondary endpoints: PaO(2)/FIO(2) at 2, 4, 12, and 24 h, survival, survival without rescue, days on ventilator, subgroups analyzed by analysis of variance to identify patients who might benefit from surfactant.

Molecular biological characterization of equine surfactant protein A.

In the following, we describe the isolation and sequencing of the equine surfactant protein A (Sp-A) as found in both the cDNA and the genomic DNA. We found a length of the cDNA sequence of 747 bp (base pairs), in translation into amino acids of 248. Compared with the known molecular biological facts about Sp-A in other species, the cDNA sequence obtained showed highest homology with that of sheep (85.

Influence of gestational age and intrauterine growth on leptin concentrations in venous cord blood of human newborns.

Background: The ob gene product leptin is involved in the regulation of body weight and energy expenditure, suggesting a potential role of leptin in embryonal and fetal development and progression of pregnancy. In term infants, leptin concentrations showed a positive correlation with birth weight. We aimed at comparing leptin cord blood levels in AGA (appropriate for gestational age) to SGA (small for gestational age) preterm and term newborns.

Changes in biochemical and biophysical surfactant properties with cardiopulmonary bypass in children.

Objective: The aim of the present study was to characterize pulmonary surfactant properties in children undergoing cardiovascular surgery with cardiopulmonary bypass.

Design: Prospective clinical trial.

Setting: University hospital pediatric intensive care unit.

Polymorphisms of surfactant protein B encoding gene: modifiers of the course of neonatal respiratory distress syndrome?

Unlabelled: Surfactant protein B (SP-B) is a lipophilic protein and plays a major role in lung mechanics. Polymorphisms of surfactant protein A, another component of the surfactant system, have been previously described to be a risk factor for respiratory distress syndrome (RDS) and bronchopulmonary dysplasia (BPD) in preterms. The aim of this prospective study was to determine whether polymorphisms within intron 4 of the SP-B gene are related to the incidence, severity and complications of RDS in Caucasian newborns.

[Colonisation of the airways with ureaplasma urealyticum as a risk factor for bronchopulmonary dysplasia in VLBW infants?].

Background: Chronic inflammatory processes contribute to the pathogenesis of bronchopulmonary dysplasia (BPD). We hypothesized colonisation with Ureaplasma urealyticum (Uu) as a possible reason for an increased risk of developing prolonged oxygen dependency > 28 days in very low birth weight (VLBW) infants.

Patients And Methods: From January 1998 to November 1999 pharyngeal swabs were prospectively obtained and tested for Uu at birth and then weekly in VLBW infants.

[Hemiconvulsion-Hemiplegia-Epilepsy-Syndrome (HHE)].

The pathogenesis of HHE is likely to be caused by prolonged focal convulsions responsible for a hypoxic cerebral edema. The decreased frequency of the syndrome could be explained by usually immediate drug-induced interruption of the seizure nowadays.

Prenatal diagnosis and management of fetuses with liver hemangiomata.

Objectives: To study the relationship between prenatal appearance and perinatal outcome of fetuses with hepatic hemangiomata with special emphasis on criteria that may help to improve perinatal management.

Methods: In a tertiary referral center six fetuses with hepatic hemangiomata were evaluated by gray-scale, color, and pulsed wave Doppler ultrasound between 1994 and 2000. Fetal blood sampling was performed in four cases.

[Acute Renal Failure in Twin-to-Twin Transfusion Syndrome: Differential Diagnosis].

In the differential diagnosis of acute renal failure in Newborns prerenal, renal and postrenal causes must be considered. Additionally, in twin-to-twin transfusion syndrome especially the donor can suffer from acute renal failure caused by longterm intrauterine hypoperfusion of the kidneys resulting in severe retardation of renal development.

Antenatal prediction of intraventricular hemorrhage in fetal growth restriction: what is the role of Doppler?

Objective: To evaluate relationships between neonatal intraventricular hemorrhage and altered brain blood flow in preterm growth-restricted fetuses.

Methods: One hundred and thirteen growth-restricted fetuses (birth weight < 10th centile and umbilical artery pulsatility index > two standard deviations above gestational age mean) which delivered prematurely (< 34.0 weeks) were studied.

[Hereditary deficiency of C1-esterase inhibitor presenting with recurrent abdominal pain].

Hereditary deficiency of C1-esterase inhibitor (C1-INH) which clinically manifests as hereditary angioedema is a rare disorder. In previously not diagnosed cases, a fatality rate of up to 30 % has been reported. The diagnosis of C1-esterase inhibitor deficiency should not be missed in patients presenting with angioedema in the face, stem or extremities.

Protein content and biophysical properties of tracheal aspirates form neonates with respiratory failure.

Background: We aimed at assessing the quality and quantity of protein-leakage across the alveolar-capillary membrane and its influence on surfactant function during the early neonatal period in preterm infants compared to newborns both with respiratory failure.

Patients And Methods: We therefore prospectively analyzed total protein, elastase-alpha1-proteinase inhibitor complex (E-alpha1-PI) and alpha2-macroglobulin concentrations in tracheal aspirates from 31 infants < or = 32 weeks gestational age (group 1 : 29.3 +/- 2 weeks, 1214 +/- 410 g [means +/- SEM]) and from 21 neonates > 32 weeks (group 2 : 37.