ABSTRACT
La hemorragia suprarrenal neonatal es poco frecuente. Se presenta en el 0,2% de los recién nacidos. El 10% de los casos son bilaterales. Puede estar asociada a un traumatismo al nacimiento, peso alto al nacer o un curso neonatal complicado por hipoxia, asfixia, hipotensión o coagulopatía. El hematoma escrotal es una manifestación extremadamente rara de la hemorragia suprarrenal neonatal. La mayoría de los pacientes presentan tumefacción escrotal con coloración azulada. En los recién nacidos, la tumefacción escrotal, con o sin coloración azulada, puede deberse a diferentes causas. Comunicamos un caso inusual de hemorragia suprarrenal neonatal secundaria a asfixia perinatal, que se manifestó con un hematoma escrotal. El diagnóstico de hemorragia suprarrenal neonatal y hematoma escrotal fue ecográfico; el tratamiento conservador evitó la exploración quirúrgica innecesaria.
Neonatal adrenal hemorrhage is uncommon. It is present in 0,2% of newborns. Ten percent of the cases occur bilaterally. It can be associated with birth trauma, large birth weight, or neonatal course complicated by hypoxia and asphyxia, hypotension, or coagulopathy. Scrotal hematoma is an extremely rare manifestation of NAH. Most patients present scrotal swelling with bluish discolouration. Scrotal swelling with/without bluish discoloration in newborns may result from different causes. We report an unusual case of neonatal adrenal hemorrage secondary to perinatal asphyxia, associated with SH. Neonatal adrenal hemorrhage and scrotal hematoma were diagnosedby ultrasonography and treated by conservative treatment, avoiding unnecessary surgical exploration.
Subject(s)
Humans , Male , Infant, Newborn , Scrotum , Adrenal Gland Diseases/complications , Adrenal Gland Diseases/diagnosis , Genital Diseases, Male , Hematoma , Hemorrhage/complications , Hemorrhage/diagnosisABSTRACT
La taquicardia supraventricular (TSV) es el tipo de arritmia sostenida más frecuente en los recién nacidos y lactantes. En general, la presentación de la TSV en los recién nacidos es sutil y, a menudo produce insuficiencia cardíaca congestiva. A pesar del amplio uso de los agonistas p2, su toxicidad ha sido cuestionada. En varios estudios se informó un aumento de la incidencia de arritmias cardíacas en los pacientes que reciben estos agentes, y en otros estudios se hallaron tasas elevadas de muerte cardiovascular asociada con el uso de agonistas p2 nebulizados y orales, como el salbutamol, que se utilizan para tratar el broncoespasmo en los recién nacidos con diversas enfermedades. Informamos un caso de TSV después de la administración de salbutamol nebulizado a un recién nacido.
Supraventricular tachycardia (SVT) is the most common sustained arrhythmia in neonates and infants. Presentation of SVT in the neonate is usually subtle and frequently complicated by congestive heart failure. Despite the widespread use of β2-agonists, their safety has been questioned. Several studies have reported an increased incidence of cardiac arrhythmias in patients treated with these agents, and other studies have found increased rates of cardiovascular death associated with the use of oral and nebulized β2-agonists such as salbutamol, which is used to treat bronchospasm in newborns with several diseases. Herein, we report a case of SVT following administration of nebulized salbutamol in a neonate.
Subject(s)
Humans , Female , Infant, Newborn , Tachycardia, Supraventricular , Infant, Newborn , AlbuterolABSTRACT
Se informa el caso de un neonato que desarrolló encefalopatía en el transcurso de los primeros tres días de vida. Presentaba hipo persistente, que evolucionó a coma profundo 72 horas después de la admisión al hospital. Los parámetros de septicemia y el análisis del líquido cefalorraquídeo (LCR) fueron normales. Tras la evaluación metabòlica, se confirmó la presencia de hiperamoniemia e hipercitrulinemia. El índice de la concentración de LCR/glicina en plasma era normal. Esto no coincidió con nuestro diagnóstico inicial de hiperglicinemia no cetósica, que suele manifestarse con hipo. Se recomienda tener en cuenta la deficiencia de ácido argininosuccínico sintetasa (ASD por su sigla en inglés; citrulinemia) de inicio neonatal en el diagnóstico diferencial de encefalopatía asociada con hipo durante el período neonatal, lo que sugiere una enzimopatía congénita.
We report an infant who developed encephalopathy within the first 3 days of life. He had persistent hiccups that progressed to deep coma 72 hours after admission. The sepsis parameters and cerebrospinal fluid examination (CSF) were normal. The metabolic evaluation confirmed hyperammonemia, and hypercitrullinemia. The ratio of CSF/plasma glycine concentration was normal. This did not agree with our initial diagnosis of nonketotic hyperglycinemia where hiccups is present more often. Neonatal onset of argininosuccinic acid synthetase deficiency (ASD; citrullinemia) should be brought in mind in the differential diagnosis of encephalopathy in association with hiccups in the neonatal period suggesting inborn errors of metabolism.
Subject(s)
Humans , Infant, Newborn , Male , Citrullinemia/diagnosis , Citrullinemia/complications , Hiccup/etiologyABSTRACT
Objective: To perform neurodevelopmental evaluation at 18 to 24 months’ corrected age in very low birth infants (VLBW) with transient hypothyroxinemia. Design: Cohort study. Setting: Maternity teaching hospital. Patients: Premature infants who were previously evaluated for thyroid hormone values in the first weeks of life were included. Intervention: Data of these infants who weighed ≤1500 g and ≤32 weeks of gestation were retrieved for the current study. Available subjects (n=56) were evaluated for neurodevelopmental status at 18 to 24 months of corrected age. Bayley Scales of Infant Development –Second Edition (BSID-II) was performed to define Mental developmental index (MDI) and Psychomotor developmental index (PDI). Results: The mean MDI and PDI scores were similar between the infants with and without transient hypothyroxinemia of prematurity (THOP) [79.9 ± 14.9 vs 70 ± 20.7, respectively (P=0.54); and 92.2 ± 16.4 vs 85.6 ± 18.9, respectively (P=0.68)]. After adjustment for gestational age and multiple prenatal, perinatal, and early and late neonatal variables, THOP was not associated with an increased risk of disabling cerebral palsy, or a reduction of MDI and PDI scores. Conclusions: THOP may not be an important cause of problems in neurologic and mental development detected at the age of 18 to 24 months’ corrected age.
ABSTRACT
La separación de las madres de sus bebés prematuros durante su internación en cuidados intensivos neonatales interrumpe la continuidad de la atención y disminuye su calidad, debido al aumento de la ansiedad y el estrés, y origina problemas en el neurodesarrollo y en la conducta a largo plazo. La atención centrada en la familia es un enfoque para la planificación, ejecución y evaluación de la asistencia sanitaria que se basa en la colaboración entre los profesionales de la salud y las familias de los pacientes. Luego de observar que el enfoque clásico no logra fomentar el desarrollo neurológico de los niños y la interacción madre-hijo, este método modifica el diseño de unidades, y propone nuevas disposiciones para satisfacer las necesidades de los neonatos, sus familias y los profesionales de la salud. En esta revisión se discuten la importancia de la atención centrada en la familia en la unidad de cuidados intensivos neonatales y los efectos de este enfoque sobre los diseños de dichas unidades
Subject(s)
Humans , Female , Infant, Newborn , Patients' Rooms , Patient-Centered Care/methods , Patient-Centered Care/organization & administration , Intensive Care, Neonatal/methods , Intensive Care, Neonatal/trends , Intensive Care, NeonatalABSTRACT
Neu-Laxova syndrome is a rare lethal congenital disorder involving multiple systems. Intrauterine growth retardation, ichthyosis, microcephaly, abnormal facial findings, and limb contractures are its key features. We present a case of Neu-Laxova syndrome in a male appropriate for gestational age (AGA) newborn with characteristic features including ichthyosis, microcephaly, severe ectropion, rudimentary ears, eclabion, limb contractures, and hypoplastic genitalia. The patient was born at 38 weeks of gestation to consanguinous Turkish parents. The mother was a 20-year-old primi gravida with lack of prenatal follow-up. Therefore, the case was diagnosed postnatally, and he died 5 days later. Because of the autosomal recessive inheritance of Neu-Laxova syndrome, in countries with high rates of consanguineous marriage, such as Turkey, physicians have to know this syndrome, and serial prenatal ultrasound examinations with genetic counseling should be performed on pregnant women at high risk. To the best of our knowledge, this is the first case described in an AGA newborn.