[Methods in neonatal abstinence syndrome (NAS): results of a nationwide survey in Austria]. / Vorgehen bei Neonatalem Abstinenzsyndrom (NAS): Ergebnisse einer nationalen Umfrage in Österreich.

BACKGROUND: Neonatal abstinence syndrome (NAS) occurs in neonates whose mothers have taken addictive drugs or were under substitution therapy during pregnancy. Incidence numbers of NAS are on the rise globally, even in Austria NAS is not rare anymore. The aim of our survey was to reveal the status quo of dealing with NAS in Austria. METHODS: A questionnaire was sent to 20 neonatology departments all over Austria, items included questions on scoring, therapy, breast-feeding and follow-up procedures. RESULTS: The response rate was 95%, of which 94.7% had written guidelines concerning NAS. The median number of children being treated per year for NAS was 4. Finnegan scoring system is used in 100% of the responding departments. Morphine is being used most often, in opiate abuse (100%) as well as in multiple substance abuse (44.4%). The most frequent forms of morphine preparation are morphine and diluted tincture of opium. Frequency as well as dosage of medication vary broadly. 61.1% of the departments supported breast-feeding, regulations concerned participation in a substitution programme and general contraindications (HIV, HCV, HBV). Our results revealed that there is a big west-east gradient in patients being treated per year. CONCLUSION: NAS is not a rare entity anymore in Austria (up to 50 cases per year in Vienna). Our survey showed that most neonatology departments in Austria treat their patients following written guidelines. Although all of them base these guidelines on international recommendations there is no national consensus.

[Virus infections in pregnancy--neonatal management]. / Virusinfektionen in der Schwangerschaft--neonatales Management.

We report on the most important viral infections in pregnancy. The importance of these infections is based on severe consequences for foetus, neonate and mother herself. New tests, e.g. direct virus detection assays, improved the security of diagnosis. We emphasize the management of viral infected neonates including own experiences.

Screening and diagnosis of congenital cytomegalovirus infection: a 5-y study.

Although cytomegalovirus infection is the most common infection transmitted via the placenta, there are no guidelines for routine screening to detect children congenitally infected with cytomegalovirus. From 1993 to 1997, maternal serum and cord vein blood of newborns was screened for HCMV-IgM (n = 21,183). Urine was examined for HCMV-excretion during the first postnatal week to prove HCMV infection in children who expressed HCMV-IgM in cord vein blood (n = 13) or who were born to mothers positive for HCMV-IgM in the serum (n = 234), or when both cord vein blood and maternal serum were positive for HCMV-IgM (n = 6). Congenital HCMV infection was detected in 17 newborns. To determine the incidence of congenital HCMV infection, only those mother/child pairs were selected in whom serum and cord vein blood were investigated (n = 5967 mother/child pairs). In this group 13 newborns were infected. The observed incidence for congenital HCMV infection is 0.21%. It is concluded that that this screening programme will detect those children at risk for congenital HCMV infection. These children have to be examined for virus excretion in the urine. Although the observed incidence is only 0.21%, congenital HCMV infection is a problem that can no longer be neglected because of its long-term sequelae.

Improved fatigue resistance not associated with maximum oxygen consumption in creatine-depleted rats.

Effects of feeding of either creatine or its analog beta-guanidinopropionic acid (beta-GPA) on endurance work capacity and oxygen consumption were studied in rats. Resting high-energy phosphate contents in hindlimb muscles were lower in the beta-GPA group and higher in the creatine group than in controls. The glycogen contents in resting hindlimb muscles of rats fed beta-GPA were significantly higher than those in controls. The endurance run and swimming times to exhaustion were significantly greater (32-70%) in the beta-GPA group than in the control and creatine groups. However, there were no beneficial effects on the maximum oxygen consumption (VO2max) and oxygen transport capacity of blood by the feeding of beta-GPA. None of these parameters were significantly influenced by creatine supply. Both maximum exercise time and VO2max in the beta-GPA group were not changed by normalization of glycogen levels. The activities of mitochondrial enzymes in skeletal muscles were higher in the beta-GPA group than in the controls. Thus endurance capacity is improved if the respiratory capacity of muscles is increased, even when the contents of high-energy phosphates in muscles are lower. Increased endurance capacity was not directly associated with the elevated levels of muscle glycogen, oxygen transport capacity of blood, or VO2max.