Efficacy of short-term intravenous antibiotic in neonates with urinary tract infection.

Background: Recent studies have questioned the use of prolonged intravenous treatment in neonates with urinary tract infection (UTI). The aim of the present study was to examine the clinical course of neonates with UTI with special attention paid to the rates of bacteremia and meningitis and to determine the efficacy of short-term intravenous antibiotic.

Methods: Retrospective review of clinical charts of neonates admitted for UTI.

Beta2-microglobulin concentrations in cerebrospinal fluid correlate with neuroimaging findings in newborns with symptomatic congenital cytomegalovirus infection.

Overview: In newborns with symptomatic congenital cytomegalovirus (CMV) infection, neuroimaging is the best available predictor of neurodevelopmental outcome. Cerebrospinal fluid (CSF) findings in congenital CMV infection have seldom been described. Neonates with central nervous system infections present high CSF Beta(2)-microglobulin (beta(2)-m) levels.

Myofibroblastic tumor causing severe neonatal distress. Successful surgical resection after embolization.

This report describes a case of a term male 3.1 kg, normal delivery, 38 weeks of gestation with a record of hydramnios by prenatal sonography. He had fetal acute suffering and respiratory distress.

Comparative study between isolated intestinal perforation and necrotizing enterocolitis.

Introduction: Intestinal perforations in the neonatal period are usually related to necrotizing enterocolitis (NEC) or intestinal occlusion. Intestinal perforation in the absence of these conditions is called isolated perforation (IP). Several risk factors and pathogenic mechanisms have been suggested, and most of them are common to those classically attributed to NEC.

[Ectopic ureter as cause of urinary incontinence in girls].

Continuous urine dripping together with normal micturition is the classical picture of ectopic ureter in girls. During the years 1982 to 1996, eleven girls with such abnormality have been treated at our department. The diagnostic work-up included: intravenous pyelogram (IP), ultrasonography (US), renal scintiscan, cystogram, cystoscopy and/or vaginoscopy, as well as a thorough exam of the external genitalia under general anesthesia.

[West's syndrome. Analysis, aetiological factors and therapeutic options].

West's syndrome (WS), which is also known as infantile myoclonic encephalopathy with hypsarrhythmia, is one of the generalized epileptic syndromes with a cryptogenic or symptomatic origin. It is an age-dependent epileptic syndrome. The latest neuroimaging techniques have enabled us to gain a better understanding of its physiopathology and to identify new aetiological factors responsible for the clinical symptoms.

Congenital epigastric evisceration: a case report.

A rare case of abdominal wall defect at the epigastric midline is presented. This newborn boy had only the greater omentum eviscerated, and no other abnormalities could be detected. This case does not seem to relate to the abdominal wall defects reported so far in the literature.

Morphology and mucosal biochemistry of gastroschisis intestine in urine-free amniotic fluid.

Background/purpose: The aim of this study was to determine the role of urine exposure in gastroschisis on the pathologic and biochemical aspects.

Methods: The intestines of fetal rabbits with gastroschisis (group G), gastroschisis and urethral ligation (group GL), and normal controls (group C) were studied by measuring weigh and length, intestinal diameter and wall thickness, and thickness of each intestinal layer. Number and length of villi and villi edema were evaluated.

[Orally administered drugs in the treatment of spasticity].

Spasticity is a common problem in paediatric neurology and its management constitutes a real professional challenge. There are numerous therapeutic options available and their advantages and disadvantages should be carefully weighed up for each individual patient. It is true that we do not have one single final option, but experience and knowledge of the therapeutic possibilities favour the functional improvement of patients suffering from spasticity.

Bisphosphonates, a new treatment for glucocorticoid-induced osteoporosis in children.

Background: Long-term corticoids used as a treatment for rheumatic diseases are the most frequent cause of osteoporosis in the pediatric population. Bisphosphonates have been proved to be useful in treating osteoporosis.

Objective: To investigate the efficacy of pamidronate in corticoid-induced osteoporosis in children.

[Is laparoscopic surgery the technique of choice in nephrectomy?].

Laparoscopic is performed in adults for the treatment of benign renal diseases. It is widely accepted that laparoscopic surgery has more advantages than open surgery in many procedures such as nephrectomy, but there is no further experience in this technique. In pediatric urology laparoscopy has become an accepted approach for varicocele, non palpable testis, bladder augmentation, adrenalectomy and urinary diversion.

[Fractures of the orbit floor].

Fractures of the floor are not common during childhood, their main cause being trauma. The mechanism is an increased pressure in the orbital cavity, which breaks at is weakest point, the floor, where soft tissue may be trapped- periorbitary fat, inferior rectus muscle, and inferior oblique muscle. Symptoms are diplopia, enoftalmos, eyelid ptosis and soft tissue haematoma.

[Temporomandibular joint ankylosis (TMA) in children].

Temporomandibular joint (TMJ) ankylosis is a degenerative disease that produces a limitation of mouth opening. In children, TMJ ankylosis usually presents with facial asymmetry, difficulty in feeding and rarely upper way obstruction. Ankylosis is commonly associated with trauma, infections, systemic and congenital diseases.

[Progressive bone elongation of the maxillo-facial area: mandibular distraction].

Thanks to the distraction osteogenesis technique, it is nowadays possible to create new bone in the facial area. Between january 1997 and march 1999 we have performed 20 such procedures, from which 15 were mandibular. We present our experience in 10 patients with this new technique, 5 unilateral and 5 bilateral.

[Advantages of primary rhinoplasty in the treatment of lip fissure].

Congenital cleft lip is always associated to nasal deformity. The classical approach has been not to treat the severe nose defects during childhood, in the fear that early surgery would interfere with nasal growth. However, long term follow-up in patients with early conservative rhinoplasty has shown the nose to hold its new shape and its growth to be normal.

[Neurofibromatosis type 2 as a result of a de novo mutation: a case report].

Introduction: Neurofibromatosis type 2 is a dominant autosomic hereditary disease which courses with distinct tumours of the central nervous system and scant cutaneous manifestations. The increased knowledge of the natural history and the genetics of NF 2 acquired over the past few years has shown that clinical onset possibly occurs during the paediatric age and an early diagnosis of these patients can be decisive in the final outcome.

Clinical Case: A 12 year old girl who visited the clinic because of a month old presentation of cervical tumour, otalgia and dysphonia.

[Teratogenic effects of epilepsy and anti epileptic drugs].

Objective: In this paper we review the main studies on teratogenicity related to epilepsy and especially use of anti epileptic drugs (AED), with special emphasis on recently acquired knowledge regarding the new AED.

Development: When considering the teratogenic effects of epilepsy and the anti epileptic drugs it should be remembered that there are a series of premises and considerations which undoubtedly play an important part in causing possible damage to the foetus. These factors include changes caused during pregnancy, the passage of drugs across the placenta barrier , malformations occurring in the children and relations of women with epilepsy and finally the effect of seizures on the foetus.

[Congenital errors of metabolism with epileptic seizures during the first years of life].

Objective: In this paper we review the main aetiologies of metabolic origin which cause epilepsy in children aged between 1 and 10 years.

Development: There are many aetiological causes of convulsive seizures. Seizures and epilepsies due to congenital errors of metabolism are a minority but should be known.

[Magnetic Resonance in children with dyskinetic cerebral palsy secondary to perinatal injury].

Introduction: The incidence of perinatal factors in the dyskinetic cerebral palsy (DCP) is high. The introduction of the magnetic resonance (MR) has improved our understanding of the pathophysiology and early diagnosis of injury.

Objective: Review the clinical characteristics of a group of patients with DCP and the appearance of their MR.

Upper lip fistulas: three new cases.

Objective: We present three new cases of congenital upper lip fistula. Two of them were located in the philtrum midline, one of which was associated to a double maxillary frenulum, a medial lip cleft, and a medial cleft of the primitive palate. The other was located in the left side of the vermilion.

Pontocerebellar hypoplasia type 2 and Reye-like syndrome.

Pontocerebellar hypoplasia is an autosomal recessive syndrome with onset during the fetal period. Two subtypes of pontocerebellar hypoplasia have been described on the basis of clinical and neuropathologic criteria. Pontocerebellar hypoplasia type 2 is characterized by progressive microcephaly, early onset of extrapyramidal dyskinesia, and near absence of motor and cognitive development, without signs of either spinal or peripheral involvement.

[Group B streptococcus cellulitis-adenitis syndrome in neonates. Is it a marker of bacteremia?].

We report the case of an infant in whom facial cellulitis was the only initial sign of a group B streptococcal bacteriemia. Adenitis-cellulitis syndrome is a rare clinical manifestation of group B streptococcal infection in infants. Local infection together with the onset of fever can be the only signs of bacteriemia in newborns and infants.

Is there a relationship between plasma phenylalanine and cholesterol in phenylketonuric patients under dietary treatment?

Objectives: To study the lipid profile in a group of treated phenylketonuric patients (PKU; n = 61) compared with a group of inborn error of intermediary metabolism patients (IEM; n = 22), a group of hyperphenylalaninemic children (HPA; n = 37), and a control group without dietary restriction (n = 41).

Design And Methods: Phenylalanine was analyzed by ion exchange chromatography and triglycerides, cholesterol and HDL were determined by standard procedures with the Cobas Integra analyzer.

Results: Serum total cholesterol concentrations were significantly lower in PKU patients compared with IEM patients (whose cholesterol daily intake was similar to those of PKU patients), HPA children and the control group.