ABSTRACT
Fracture-separation of the distal humeral epiphysis in newborn is a rare entity, usually the result of a traumatic delivery. It can mimic elbow dislocation and, due to the absence of ossification of the epiphysis at that time, cannot be diagnosed radiographically. However, ultrasound is an important diagnostic tool for this purpose because it is able to clearly visualize the cartilaginous epiphysis. In addition, it allows the differential diagnosis with posterior elbow dislocation whose therapeutic management and prognosis are different. We report the case of a preterm newborn in which a fracture-separation of the distal humeral epiphysis was diagnosed with the help of sonography. The purpose of this report is to emphasize the utility of echography as a cheap, available, and noninvasive tool for the evaluation of the nonossified epiphysis in the newborn elbow.
Subject(s)
Elbow Joint/diagnostic imaging , Epiphyses, Slipped/diagnostic imaging , Epiphyses, Slipped/etiology , Humeral Fractures/complications , Humeral Fractures/diagnostic imaging , Humerus/diagnostic imaging , Ultrasonography/methods , Diagnosis, Differential , Humans , Infant, NewbornABSTRACT
Fundamento y objetivo: El consumo de drogas durante la gestación es una situación de riesgo. Nuestro objetivo es conocer la prevalencia actual, las características del embarazo, parto y recién nacidos (RN) de madres consumidoras de drogas. Pacientes y método: Estudio retrospectivo de los hijos de madres consumidoras de drogas entre los años 2002-2008 y comparación con los años 1982-1988, atendidos en nuestro hospital. Resultados: Actualmente hay un menor consumo de heroína y siempre asociada a otras drogas, siendo mayoritariamente inhalada o fumada. Se observa mayor edad materna (28,4 años), mejor control gestacional (60,5%) y más RN que van a centros de acogida (13,1%). Los programas de metadona proporcionan mejores resultados globales. Hay reducción de infecciones por virus de la inmunodeficiencia humana (VIH) (25%) y de la hepatitis B (VHB) (2,5%). El desprendimiento de placenta en el consumo de cocaína es muy elevado (11%). En el comparativo de los dos períodos se observan diferencias estadísticamente significativas en edad materna, control del embarazo, tipo de parto, tratamiento del síndrome de abstinencia a drogas (SAD) y destino de los RN.Conclusiones: Se observa un predominio de drogadicción en gestantes autóctonas, y disminución del consumo de heroína, con predominio del policonsumo. Actualmente se observa mejor control gestacional, menor infección por VIH y VHB. Asimismo, más niños van a centros de acogida. La edad gestacional y parámetros somatométricos se han mantenido a lo largo de los años. Los programas de metadona mejoran los aspectos nocivos del consumo de opiáceos. El desprendimiento prematuro de placenta en la gestante y las alteraciones neuroconductuales (ANC) en el RN son frecuentes en el consumo de cocaína (AU)
Background and objective: The use of illicit drugs during pregnancy becomes a high risk situation. Ourobjective is to determine the currently prevalence, pregnancy, delivery and newborns characteristics of mothers who use illicit drugs. Patients and methods: Retrospective study of children exposed prenatally to illicit drugs in the Neonatologys Unit of the Hospital del Mar during 2002-2008 and comparison with 1982-1988 data. Results: Heroin use is lower currently and it is always associated with other drugs, mainly inhaled or smoked. There is an increase of the maternal age (28.4 years), an improved gestational control (60.5%) and more newborns are attended in shelters (13.1%). Methadone programs provide better overall results. Human immunodeficiency virus (HIV) (25%) and hepatitis B (BHV) (2.5%) infections have decreased.Placental abruption rate in cocaine users is very high (11%). By comparing both periods, there were statistically significant differences in maternal age, gestational control, delivery way, neonatalwithdrawal syndrome treatment and newborn destination. Conclusions: Drug abuse remains prevalent in native pregnants. Heroin use has decreased. At present, there is a better gestational control and less HIV and HBV infections. The gestational age andsomatometric parameters have not changed over the years. Methadone programs improve thedeleterious aspects of opioid use. Placental abruption in pregnancy and neurobehavioral disorders innewborn are common in cocaine users (AU)
Subject(s)
Humans , Female , Pregnancy , Substance-Related Disorders/epidemiology , Infant, Newborn, Diseases/chemically induced , Pregnancy Complications , Pregnancy Outcome , Social ProblemsABSTRACT
BACKGROUND AND OBJECTIVE: The use of illicit drugs during pregnancy becomes a high risk situation. Our objective is to determine the currently prevalence, pregnancy, delivery and newborn's characteristics of mothers who use illicit drugs. PATIENTS AND METHODS: Retrospective study of children exposed prenatally to illicit drugs in the Neonatology's Unit of the Hospital del Mar during 2002-2008 and comparison with 1982-1988 data. RESULTS: Heroin use is lower currently and it is always associated with other drugs, mainly inhaled or smoked. There is an increase of the maternal age (28.4 years), an improved gestational control (60.5%) and more newborns are attended in shelters (13.1%). Methadone programs provide better overall results. Human immunodeficiency virus (HIV) (25%) and hepatitis B (BHV) (2.5%) infections have decreased. Placental abruption rate in cocaine users is very high (11%). By comparing both periods, there were statistically significant differences in maternal age, gestational control, delivery way, neonatal withdrawal syndrome treatment and newborn destination. CONCLUSIONS: Drug abuse remains prevalent in native pregnants. Heroin use has decreased. At present, there is a better gestational control and less HIV and HBV infections. The gestational age and somatometric parameters have not changed over the years. Methadone programs improve the deleterious aspects of opioid use. Placental abruption in pregnancy and neurobehavioral disorders in newborn are common in cocaine users.
