US Database Study of Clinical Burden and Unmet Need in Recurrent Pericarditis.

Background Patients with recurrent pericarditis (RP) may develop complications, multiple recurrences, or inadequate treatment response. This study aimed to characterize disease burden and unmet needs in RP. Methods and Results This retrospective US database analysis included newly diagnosed patients with RP with ≥24 months of continuous history following their first pericarditis episode.

Performance of a Novel Molecular Method in the Diagnosis of Late-Onset Sepsis in Very Low Birth Weight Infants.

Objective: To compare the use of a generic molecular assay to 'standard' investigations used to assist the diagnosis of late onset bacterial sepsis in very low birth weight infants (VLBW, <1500 g).

Methods: VLBW infants, greater than 48 hours of age, who were clinically suspected to have sepsis were investigated using standard tests (full blood count, C-reactive protein (at presentation) and blood culture), in addition, blood was taken for a universal molecular assay (16S rRNA reverse transcriptase PCR) for comparison. Clinical data were recorded during the suspected infection episode.

Human parechovirus infection in neonatal intensive care.

Background: Approximately 5-6% of all infective episodes in neonatal intensive care unit (NICU) are of viral origin. Previous studies suggest that human parechovirus (HPeV) infection presents most commonly in term infants, as a sepsis-like syndrome in which meningoencephalitis is prominent. Our aim was to study the infection rate and associated features of HPeV.

ABCA3 Deficiency: an unusual cause of respiratory distress in the newborn.

Respiratory Distress Syndrome (RDS) is due to deficiency of surfactant and commonly occurs in preterm babies. We report the first confirmed case in Northern Ireland of ABCA3 transporter deficiency which is a rare but important cause of RDS in term babies.A 38 week gestation female infant developed respiratory distress at four hours of age.

Glutamine supplementation for young infants with severe gastrointestinal disease.

Background: Endogenous glutamine biosynthesis may be insufficient to meet the needs of infants with severe gastrointestinal disease. Studies using animal models of gastrointestinal disease and controlled trials in adult patients have suggested that glutamine supplementation improves clinical outcomes.

Objectives: To assess the evidence from randomised controlled trials that providing supplemental glutamine reduces mortality and morbidity in infants with severe gastrointestinal disease.

The emerging pattern of hydrops fetalis--incidence, aetiology and management.

Objectives: To analyse the incidence, aetiology and management of live born cases of hydrops fetalis in a Regional Perinatal Centre.

Methods: We reviewed 35 cases of hydrops delivered over a six year period.

Results: Non-immune hydrops accounted for 80% of the cases and the majority of babies required Level 1 intensive care.

Variation in [U-13C] alpha linolenic acid absorption, beta-oxidation and conversion to docosahexaenoic acid in the pre-term infant fed a DHA-enriched formula.

Docosahexaenoic acid (DHA) is an integral component of neural cell membranes and is critical to the development and function of the CNS. A premature delivery interrupts normal placental supply of DHA such that the infant is dependent on the nature of the nutritional support offered. The most abundant omega-3 fatty acid in pre-term formulas is alpha linolenic acid (ALNA), the precursor of DHA.

Readmission with respiratory syncytial virus (RSV) infection among graduates from a neonatal intensive care unit.

We evaluated the incidence of readmission with respiratory syncytial virus (RSV) infection among the graduates of a regional Neonatal Intensive Care Unit (NICU), and characterized those who were rehospitalized. These data were used as a predictive tool to estimate the number of babies likely to suffer readmission with RSV for the year 2000 cohort. Using the published efficacies of palivizumab, the costs and benefits of protecting this cohort were assessed.

Nutritional factors and visual function in premature infants.

Approximately 5-7% of all infants are born prematurely, and birth before 37 weeks is the most common cause of neonatal mortality, morbidity and long-term disability. Premature infants are poorly equipped for life outside the womb, and oxidant stress has been implicated in the aetiology of visual impairment in these infants, who are often exposed to increased O2 concentrations and high light intensity in neonatal units. The carotenoids lutein and zeaxanthin, which give the macular area of the eye its yellow colour, are located in the retinal pigment epithelium of the eye, and are believed to play a role in protecting it against oxidative and light damage.

Cord blood transferrin receptors to assess fetal iron status.

Objective: To study iron status at different gestational ages using cord blood serum transferrin receptors (STfRs).

Methods: STfRs, iron, ferritin, total iron binding capacity, haemoglobin, and reticulocytes were measured in 144 cord blood samples. The babies were divided into three groups according to gestation (26 very preterm (24-29 weeks); 50 preterm (30-36 weeks); 68 term (37-41 weeks)).

First clinical case of small de novo duplication of 19q (13.3-13.4) confirmed by FISH.

Partial trisomy of 19q has been reported in only 13 patients, of which all but one have been due to unbalanced translocations. Only one previous report of a de novo duplication of distal 19q has been described in a fetal chorionic villus sample. There was no description of clinical phenotype in this report.

[Effect of 2 different dosages of a porcine surfactant on pulmonary gas exchange of premature infants with severe respiratory distress syndrome].

Background: Doses between 20 and 200 mg/kg body weight (bw) of different surfactant preparations have been recommended in clinical trials for the treatment of neonatal RDS; an optimal dose regimen of surfactant replacement therapy has not yet been defined. Aim of the present pilot study was the evaluation of pulmonary gas exchange in infants with severe RDS following the application of either a high (200 mg/kg bw) or a low (100 mg/kg bw) dose of a natural porcine surfactant (Curosurf).

Methods: 15 neonates were randomized to a high dose regimen, 17 infants to a low dose of surfactant.

Comparison of clinical responses to natural and synthetic surfactants.

The clinical responses to both natural and synthetic surfactants were observed in two District General Hospital Neonatal Units who were centrally randomised as part of two separate multicentre trials (OSIRIS and Curosurf 4). Forty five infants were enrolled consecutively in the OSIRIS trial using synthetic surfactant (Exosurf), while 21 infants were subsequently enrolled in the Curosurf 4 trial using natural surfactant (Curosurf). There were no significant differences between the groups for mean birth weight, gestational age, inspired oxygen (FiO2), or arterial: alveolar oxygen ratio (a/A) prior to surfactant administration.

A 2-year follow up of babies enrolled in a European multicentre trial of porcine surfactant replacement for severe neonatal respiratory distress syndrome. Collaborative European Multicentre Study Group.

The postnatal growth, respiratory status and neurodevelopmental outcome of surviving babies enrolled in the first European multicentre trial of porcine surfactant (Curosurf) replacement for severe neonatal respiratory distress syndrome, were assessed at corrected ages of 1 and 2 years. Follow up rates of survivors were 93% at 1 year and 89% at 2 years. Treated and control groups were similar at both 1 and 2 years in terms of physical growth, the prevalence of persistent respiratory symptoms and the occurrence of major and minor disability.

Plasma manganese, selenium and glutathione peroxidase levels in the mother and newborn infant.

Manganese (Mn), selenium (Se) and glutathione peroxidase (GPX) levels were determined in 56 paired samples of maternal and cord blood plasma at birth in both term and preterm pregnancies. Correlations existed between maternal and newborn plasma levels for Se, but not for Mn or GPX. Values of Mn, Se and GPX were all greater in the term than the preterm infant.

Surfactant replacement therapy for severe neonatal respiratory distress syndrome: implications for nursing care.

This study, which was part of a European multicentre randomised controlled trial of surfactant administration for severe respiratory distress syndrome, monitored the progress and nursing care of the group of babies enrolled in Belfast. In total 33 preterm babies with birth weights between 700-2000 g were studied. Nineteen babies were treated with surfactant and fourteen acted as controls, receiving conventional therapy with mechanical ventilation alone.