Prenatal presentation of transient central diabetes insipidus.

Introduction: Nephrogenic diabetes insipidus (DI) in the foetus has been described as a rare presentation of severe polyhydramnios.

Discussion: We report a case of foetal central DI, characterised by severe polyhydramnios. Significant polyuria was noted at birth.

Oral lactoferrin for the prevention of sepsis and necrotizing enterocolitis in preterm infants.

Background: Lactoferrin, a normal component of human colostrum, milk, tears and saliva can enhance host defence and may be effective in the prevention of sepsis and necrotizing enterocolitis (NEC) in preterm neonates.

Objectives: To assess the safety and effectiveness of oral lactoferrin in the prevention of sepsis and NEC in preterm neonates.

Search Strategy: The Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), MEDLINE and PREMEDLINE (1966 to Oct 2009), EMBASE (1980 to Oct 2009) and CINAHL (1982 to Oct 2009) were searched.

Management of neonatal sepsis by Gram-negative pathogens.

For the pediatrician and neonatologist who care for term and preterm infants, the challenge remains to keep these infants free of infection after delivery in special-care nurseries and neonatal intensive care units. Studies of complications associated with term infants at risk due to maternal factors, as well as preterm infants after early delivery, have demonstrated that sepsis is a major cause of neonatal mortality and morbidity. Infections due to Gram-negative organisms are increasingly being reported from neonatal units.

Human recombinant lactoferrin acts synergistically with antimicrobials commonly used in neonatal practice against coagulase-negative staphylococci and Candida albicans causing neonatal sepsis.

Neonatal sepsis causes significant mortality and morbidity. Coagulase-negative staphylococci (CoNS) and Candida frequently cause neonatal sepsis at >72 h of age. Lactoferrin, which is present in human milk, is a component of innate immunity and has broad-spectrum antimicrobial activity.

Prophylaxis with lactoferrin, a novel antimicrobial agent, in a neonatal rat model of coinfection.

Lactoferrin has broad-spectrum antimicrobial activity, and the authors hypothesized that recombinant human lactoferrin (Talactoferrin alfa [TLF]) would reduce mortality and morbidity in a coinfection model. The MIC 50 (minimum inhibitory concentration required to inhibit the growth of 50% of organisms) of TLF against Candida albicans and Staphylococcus epidermidis was determined. Neonatal Wistar rats were infected with C albicans or S epidermidis or both, at doses of 2 x10(8) colony-forming units (CFUs) given subcutaneously.

Coagulase-negative staphylococcal infections in the neonate and child: an update.

Coagulase-negative staphylococcus (CONS) infection is the most common bloodstream infection treated in neonatal and pediatric intensive care units and significantly impacts patient mortality and morbidity. Staphylococcus epidermidis is the most common CONS species isolated clinically and investigated for its pathogenicity and virulence. Difficulties exist in the differentiation of CONS infection from culture contamination in clinical specimens, as CONS is a common skin commensal.

Prevention and treatment of respiratory syncytial virus infection in infants: an update.

Respiratory syncytial virus (RSV) is a serious pathogen causing significant mortality and morbidity, especially in premature infants and infants with chronic lung disease or significant congenital heart disease. Therapy for RSV infection is essentially supportive, although several new compounds are under investigation. Therefore, immunoprophylaxis to prevent severe RSV disease in high-risk infants assumes great significance.

Neonatal diabetes mellitus: patient reports and review of current knowledge and clinical practice.

Neonatal diabetes mellitus (NDM) is a rare disease reported to have an incidence of one in 400,000 to 500,000 live births. The disorder may be more common as it is not routinely considered a diagnostic possibility by many neonatologists who may routinely use insulin to treat neonatal hyperglycemia. NDM can be grouped into two distinct clinical entities--transient and permanent--based on certain features detailed herein; however, distinction between the two categories can only be definitely made in hindsight.