Serum levels of CD14 in neonatal sepsis by Gram-positive and Gram-negative bacteria.

The purpose of this study is to measure soluble CD14 (sCD14) levels in sera from newborn with sepsis, to compare it with other markers, and to study its evolution in Gram-negative and Gram-positive sepsis. Forty normal newborns were included (26 were full term and 14 were preterm infants), 20 babies had a positive blood culture (11 Gram-positive and 9 Gram-negative) and 16 cases were suspected of having sepsis based on clinical and laboratory findings, but a negative blood culture. Interleukin-6 (IL-6), sCD14, and tumour necrosis factor-alpha (TNF alpha) were measured by enzyme immunoassay, and fibronectin (FN) and C-reactive protein (CRP) by radial immunodiffusion. Neonates with a positive blood culture had increased levels of sCD14 (3.20 +/- 1.26 micrograms ml-1, p < 0.001), CRP (69 +/- 46 micrograms ml-1, p < 0.001) and IL-6 (134 +/- 150 pg ml-1, p < 0.001), and decreased values of FN (12.3 +/- 6.6 mg ml-1, p < 0.001). TNF alpha levels were also high (160 +/- 37 pg ml-1), but this increase was not statistically significant. Newborn infants suspected of having sepsis but a negative blood culture had similar but milder abnormalities. Soluble CD14 levels correlated with CRP values; however, there was no correlation between sCD14, TNF alpha and IL-6. Neonates with sepsis by Gram-positive bacteria had lower sCD14 levels than patients with Gram-negative sepsis (2.63 +/- 1.2 versus 4.04 +/- 1.0 micrograms ml-1, p < 0.05). In conclusion, the sCD14 level is increased in newborn infants with sepsis, and this is higher in infections by Gram-negative bacteria, suggesting a different contribution of monocyte and macrophage cells. In contrast, IL-6, TNF alpha, CRP and FN values are similar in infections by Gram-positive and Gram-negative bacteria.

[Mental retardation and X chromosome fragility]. / El retraso mental y la fragilidad del cromosoma X.

In four families with mental retardation as cardinal sign, authors found 11 cases of fragile chromosome X, 8 males (most with severe mental deficiency), and 3 females (mothers of affected children). Association of behavior perturbation as uneasiness, and hyperkinesia; facial dysmorphism as long or triangular face, big ears and macroorchidism, postpubertal in most of the cases, allow for clinical diagnosis. Autistic behavior is a suspicion sign too. Authors point out the necessity of a precocious diagnosis in order to treat patients with folic acid and to extend genetic counseling to the families. Prenatal identification is possible and inheritance mode in uncertain, debating recessive form linked to chromosome X and autosomic dominant controlled by sex. Incidence of 1.8/1,000 in newborn males, convert this specific form as the most frequent cause of mental retardation in this sex.

[C-reactive protein--determined by radial immunodiffusion and compared to the latex agglutination method]. / Beitrag zum Studium des C-reaktiven Proteins--bestimmt durch die radiale Immunodiffusion und verglichen mit der Latex-Agglutinations-Methode.

C-reactive protein were assayed both with immunodiffusion and precipitation on latex C-reactive protein in 216 samples of sera from newborns with suspected septicemia. Both methods correlated well (r = 0.92) rendering the second one rather useful for early diagnosis of neonatal sepsis, since it produces results within a few minutes independent of complicated apparatus or trained personal.

[C-reactive protein and orosomucoid as parameters of developmental monitoring and therapeutic effectiveness in neonatal sepsis]. / Proteína-C-reactiva y orosomucoide como parámetros de control evolutivo y eficacia terapéutica en la sepsis neonatal.

Authors develop a comparative study of two acute phase reactants behaviour, in the follow up on 27 neonates with confirmed sepsis of favourable evolution and in 15 cases with fatal evolution. Results show that sera levels C-reactive-protein follow a parallel course with clinical significance in patients reaching normal concentrations soon after favourable evolution and persisting in high level or even increasing previous ones, in cases of lethal evolution. Orosomucoid did show the same clinical-biological correlation maintaining generally in high levels independent of normalization of symptoms and C-reactive protein. They propose serial determination of C-reactive-protein and an efficient control of treatment in neonatal sepsis.

[Protracted diarrhea. Etiopathogenia and management (author's transl)]. / Diarrea prolongada. Etiopatogenia y tratamiento.

For the purpose of twelve cases on protracted diarrhea, the etiopathogenia from this illness is reviewed and the tolerance and inconvenients of treatment with intravenous feeding is assessed, being the authors addicted of employing antibiotics, cholestyramine, diets free of disaccharides and fundamental diets; in such a manner that parenteral nutrition for its inconvenients and complications should only be used in case of failing the rest of therapeutic methods.