[Psychosocial intervention model of neonatal intensive care in Modena]. / Il modello di intervento psicosociale della Terapia Intensiva Neonatale di Modena.

Many authors agree that psychosocial factors influence the psychophysical development of the infant. These factors must be taken into account in the neonatal care. At the neonatal intensive care unit (NICU) of the University Hospital of Modena, physicians, psychologist and nurses cooperate to take care of each newborn with a difficult psychosocial background. Together they individuate and select newborns with psychosocial difficulties, plan an integrated action and, eventually, address the family to the community services. We describe our experience with 106 cases from 1996 to 1999. The integrated action included observation of parental behavior within the NICU and psychological support for parents by means of psychological counselling. Many meetings among physicians, nurses, psychologist and the social worker were needed to achieve good results. The aim of the project was to define a method to provide individualized actions in order to favour psychophysical health of newborns and their families.

[A case of female pseudohermaphroditism caused by maternal androluteoma]. / Caso di pseudoermafroditismo femminile da androluteoma materno.

Female pseudohermaphroditism is a condition characterized by various degree of external genitalia virilization in a patient with female internal genitalia and karyotype (XX). External genitalia is masculinized congenitally when female fetus is exposed to excess androgenic environment. Fetal metabolic abnormalities, like congenital adrenal hyperplasia, are the most common causes of female pseudohermaphroditism, however there is a low incidence of gestational hyperandrogenism caused by maternal pathology. We report a case of female pseudohermaphroditism secondary to a maternal ovarian luteoma of pregnancy producing androgenic hormones. The newborn presented a severe degree of external genitalia virilization with high urogenital sinus (stage Prader V). Moreover we describe the main steps of diagnostic iter that are necessary both to exclude other causes of virilization and to study all anatomical aspects in view of the surgical correction. The operation consists in two phases of action: an early clitorisvulvoplasty according to Passerini-Glazel and a late vaginal pull-through with anterior saggital transanorectal approach (ASTRA).

[Sepsis caused by Corynebacterium xerosis in neonatology: report of a clinical case]. / Sepsi da Corynebacterium xerosis in neonatologia: descrizione di un caso clinico.

The pathogenicity of the nondiphtheria corynebacteria, most commonly known as coryneform bacteria in humans has been recognized in the last two decades. Corynebacterium xerosis is part of the normal flora of the skin, nasopharynx, conjunctives and it has recently been isolated from vaginal swabs. During the last few years, there has been an increased number of case reports claiming an association of C. xerosis with diseases, like septicemia, endocarditis, pleuropneumonia, peritonitis, osteomyelitis, septic arthritis, mediastinitis, meningitis, ventriculitis specially in immunocompromised patients or surgical patients. Infections due to C. xerosis have been reported rarely in newborn. We report a case of sepsis due to C. xerosis in a newborn without evident immunodeficiency. Our case further support the recognition of C. xerosis as a human pathogen and reinforces the fact that it should not be routinely considered as a contaminant.

[Up-date on the subject of neonatal convulsions]. / Attualità in tema di convulsioni neonatali.

New experimental, clinical and therapeutic results in the field of convulsive disorders of the newborn have recently come to light. Experimental studies on animals have shown that, contrary to what was assumed in the past, the immature brain is highly excitable, and during the first weeks of life excitation processes predominate over inhibitory processes. Over the last ten years, benign idiopathic convulsions in newborns, familial convulsions and benign convulsions on the fifth day of life, have been defined. Both types develop and disappear spontaneously during the first week of life and have a favourable prognosis, although they may appear at the start (especially the benign fifth-day convulsions) as status epilepticus. Recently, two types of convulsive status epilepticus in newborns have been identified: a severe idiopathic status epilepticus and focal status epilepticus. The myoclonic syndromes which occur during quiet sleep and which are not accompanied by EEG discharges should be distinguished from convulsions and do not require anti-convulsive therapy. The various EEG monitoring techniques have shown an unexpectedly high number of convulsions, especially in the form of sub-clinical convulsions and/or atypical convulsive seizures. The atypical seizures distinctly predominate in status epilepticus. The clinical evidence of the seizures in reduced by administration of anti-convulsants, which seem to block typical seizures and, viceversa, to be less active for atypical seizures and EEG seizures. In the therapeutic field, the use of phenobarbital and/or phenytoin at a high initial dosage (20 mg/kg) has been well affirmed. Drugs such as lidocaine and thiopental are currently being experimented and have given encouraging results in severe status epilepticus.

[Dietotherapy in the diseases of the gastrointestinal tract in infancy (author's transl)]. / Dietoterapia nelle malattie dell'apparato gastroenterico nell'infanzia

The AA are proposing a dietotherapy in the diseases of the gastrointestinal tract in infancy, characterized from acute diarrhoea. A slow hydrolysis product of casein is used for this purpose. The AA after description of the very good results obtained, are calling the attention on the fact that the advantage was realized only with a food product and not with drugs.