Severe Iron Deficiency Anemia in Infants and Young Children, Requiring Hospital Admission.

Objective. This study evaluated patient characteristics, milk intake, and associated lab findings of children 6 months to 5 years old, admitted to a children's hospital with severe iron-deficiency anemia (IDA). Methods.

Neonatal distal femoral physeal fracture requiring closed reduction and pinning.

Neonatal physeal fracture of the distal femur is often difficult to diagnose. Timely and accurate diagnosis and appropriate therapy are critical in order to avoid permanent morbidity and dysfunction of the affected limb. We describe an infant in whom closed reduction and pinning were required in order to assure a good outcome.

Professional liability in a neonatal intensive care unit: a review of 20 years' experience.

Objective: To examine neonatal intensive care unit (NICU) malpractice claims and identify common characteristics likely to result in malpractice.

Study Design: A retrospective study (1972 to 1992) at a tertiary care children's hospital examining malpractice claims involving NICU infants.

Results: A total of 31 cases of malpractice out of 9367 NICU admissions (incidence 0.

Neonatal autopsies: a 10-year experience.

Objectives: To identify trends in neonatal autopsy rates at a tertiary care hospital during the last decade, to determine the concordance between antemortem and post-mortem diagnoses, and to describe patient characteristics that influenced diagnostic yield on autopsy.

Design: Retrospective review of medical records.

Setting: Tertiary care children's hospital.

Autopsies in children: are they still useful?

Background: Autopsy has traditionally been the criterion for determining cause of death and has played a major role in medical education and quality control. With increasing use of bedside technology, however, autopsy rates have steadily declined.

Objective: To identify (1) trends in pediatric autopsy rates during the past decade, (2) concordance between antemortem and postmortem diagnoses, and (3) patient characteristics influencing autopsy rates or diagnostic yield.

Getting enough: mothers' concerns about breastfeeding a preterm infant after discharge.

Objective: To describe maternal concerns about breastfeeding a preterm infant in the postdischarge period and to delineate the strategies mothers used in managing these concerns.

Design: Naturalistic inquiry was used.

Setting: A semistructured interview was conducted with the mother in the home 1 month after discharge of the infant.

A new scale for in-home test-weighing for mothers of preterm and high risk infants.

The purposes of this research were to describe the accuracy of test-weighing with the BabyWeigh, a new infant scale suitable for use in the home, and to determine whether mothers and investigators could estimate intake accurately during breastfeeding sessions, using clinical cues that are recommended for this purpose. Within five days of projected NICU discharge, 30 preterm and/or high risk infants and their mothers were studied during a single breastfeeding session. A member of the research team performed test-weights with the Smart Model 20 infant scale, and mothers performed test-weights with the BabyWeigh scale.

Intrathrombic urokinase reverses neonatal renal artery thrombosis.

A term infant with aortic and renal artery thrombosis is described, in whom the right kidney experienced complete ischemia for 5 days. A continuous intrathrombic urokinase infusion induced complete clot lysis and reperfusion of the right kidney. Follow-up studies of renal function and renal growth have been normal.

Breastfeeding support services in the neonatal intensive-care unit.

Objective: To describe a model for providing breastfeeding support in the neonatal intensive-care unit (NICU).

Design: Naturalistic, participant observation.

Setting: Suburban Level III NICU.

Concurrent validity of a new instrument for measuring nutritive sucking in preterm infants.

The purpose of this study was to examine the concurrent validity of the Whitney strain gage for the measurement of nutritive sucking in preterm infants. Ten preterm infants were studied continuously during at least one entire bottle feeding per week, from admission into the study until discharge from the nursery. Sucking was measured simultaneously by an adapted nipple and the Whitney gage.

Pharmacokinetics of lorazepam in critically ill neonates with seizures.

Pharmacokinetic data were evaluated in 10 term neonates with seizures after intravenous administration of lorazepam, 0.05 mg/kg or 0.1 mg/kg.

Colonic strictures following successful medical management of necrotizing enterocolitis: a prospective study evaluating early gastrointestinal contrast studies.

This is a prospective study of 50 patients with neonatal necrotizing enterocolitis (NEC) treated successfully by medical means. They were all screened with an upper gastrointestinal (GI) contrast study after 14 days of healing and prior to establishment of feeding. Thirty-six patients (72%) with normal upper GI examinations responded well to a graduated increase in feeding.

Home death and hospital follow-up of the dying infant.

As technology and medical care have improved, increasing numbers of critically ill neonatal patients are surviving the immediate neonatal period. The hectic environment of the neonatal intensive care unit often makes it difficult for personnel to attend adequately to the needs of the dying infant and his family. Accordingly, the option of home death for such infants has been offered in our neonatal intensive care unit.

The accuracy of test weighing for preterm infants.

A series of recent studies has suggested that preterm infants are capable of breast feeding at weights less than 1,500 g. However, estimating intake during breast feeding for these small infants is important for safe clinical practice and valid research. The purpose of this study was to compare the accuracy of test weighing as an estimate of intake for preterm infants using two types of scales: a mechanical scale (Toledo) commonly used in many special care nurseries, and a new electronic scale (SMART; Olympic Medical).

Nasal glioma. Presenting as neonatal respiratory distress. Definition of the tumor mass by MRI.

Nasal gliomas are benign congenital midline tumors with the potential for intracranial extension. They are most commonly seen in neonates and children but rarely in adults. The treatment of choice is surgical excision.

Grief reaction to sudden unexpected cardiorespiratory arrest in a normal newborn nursery.

The authors report two cases of sudden unexpected cardiorespiratory arrest occurring in a normal newborn nursery. They discuss the impact on the families and hospital personnel. The nursing and medical staff demonstrated many of the reactions experienced by families of sudden infant death syndrome (SIDS) victims, including shock, anger, guilt, disbelief, fear, and doubt.

Lorazepam in the treatment of refractory neonatal seizures. A pilot study.

Seven neonatal patients with severe seizures unresponsive to conventional anticonvulsant therapy were treated with lorazepam. Immediate cessation of seizure activity occurred in all patients within five minutes. Although seizures recurred in two infants eight hours later, frequency and severity diminished.

Distal ileostomy drip feedings in neonates with short bowel syndrome.

When a newborn infant presents with high intestinal atresia, the proximal segment of the bowel is usually grossly distended and atonic. The anastomosis of this segment to the smaller and unused distal segment will usually result in little or no propulsion of contents distally. Many techniques have been employed to correct this problem.

The role of RBC transfusion in the premature infant.

Fifty-six premature infants with a mean gestational age at birth of 30 weeks were randomly assigned to a transfusion group, for whom the hemoglobin level was kept above 10.0 g/dL, and a nontransfusion group, who were transfused only for specific clinical indications. The groups were followed up longitudinally with weekly determinations of reticulocyte count, the partial pressure of oxygen at which 50% of hemoglobin is saturated, and hemoglobin F percentage, as well as weight gain, length of stay, hospital cost, and frequency and severity of apnea.

Blood component transfusion in the intensive care nursery. Indications and special problems.

Increasingly, transfusions of component blood products are used in the setting of the neonatal intensive care unit. There is a need to analyze the indications and potential complications of this therapy critically. We review here the problems primarily unique to the neonatal population and suggest an approach to the transfusion requirements of this group.

Digoxin pharmacokinetics in premature infants.

An analysis of pharmacokinetic parameters of digoxin was carried out in six premature infants after the administration of a single total digitalizing dose of 20 microgram/kg. The data was analyzed using both a 2 and 3 exponential model. In the premature infant, the plasma half-life of digoxin is prolonged, while the volume of the central compartment, total body clearance, volume of distribution and volume of distribution at steady state are reduced compared to other aged patients.