[Impediments to incubator home care in The Netherlands]. / Belemmeringen voor couveuse-thuiszorg in Nederland.

OBJECTIVE: To determine whether incubator home care is desirable and feasible. DESIGN: Inventory. SETTING: Four neonatal units representative of the type of care in general hospitals in the Netherlands. METHOD: The relevant data on all infants with a birth weight < or = 2000 g admitted in the last 3 months of 1996 to one of four hospitals were analysed. Conditions for incubator home care were determined (e.g. absence of need for special care, vital function monitoring or nasogastric tube feeding). RESULTS: Forty-nine infants were enrolled. Mean hospital stay was 28.7 days in an incubator plus 19.7 days in a cot. When infants were placed in a cot they usually still needed tube feeding and monitoring of vital functions and sometimes parenteral nutrition, medication or extra oxygen which made home discharge impossible. Therefore a pilot study of actual home care could not be carried out. CONCLUSION: Although early home discharge is very desirable for newborn infants, the number of infants eligible for incubator home care is so small that further attempts to organise it are not useful.

Influence of long chain unsaturated fatty acids in formula feeds on lipid peroxidation and antioxidants in preterm infants.

The influence of long chain polyunsaturated fatty acids (LCP) in formula feeds on lipid peroxidation and antioxidants was studied in 35 healthy preterm infants (gestational age 30-35 wk) during the first 6 postnatal weeks. Infants received a preterm formula supplemented with n-3 LCP (LCP group, n = 13), or standard preterm formula (NO-LCP group, n = 15); 7 infants fed human milk served as a reference group. With LCP supplementation, erythrocyte C22:6n-3 levels were stable; without supplementation, the levels declined (difference p < 0.001). LCP supplementation did not decrease vitamin E or C levels, or increase lipid peroxidation products (thiobarbituric acid-reactive substances) in plasma. In erythrocytes, LCP supplementation did not markedly influence the reduced/oxidized glutathione ratio; however, the susceptibility to H2O2-induced oxidative stress was reduced. Our results suggest that healthy preterm infants are able to cope with any extra peroxidative stress produced by n-3 LCP supplementation. However, these findings might not be generally applicable to other formulas containing LCP supplements.

Cerebellar and brainstem hypoplasia in a child with a partial monosomy for the short arm of chromosome 5 and partial trisomy for the short arm of chromosome 10.

A child with hypoplasia of the cerebellum and brainstem in association with an unbalanced translocation, resulting in a partial deletion of the short arm of chromosome 5 and a partial trisomy of the short arm of chromosome 10, is described. A balanced translocation was present in his mother and maternal grandmother. A maternal uncle had died at the age of 4 years with the same clinical picture. After reviewing the literature, we conclude that the monosomy 5p is the most likely cause for this malformation. We suggest that the possible existence of chromosomal anomalies should always be considered in the differential diagnosis of hypoplasia of the cerebellum and/or brainstem.

[Hemolytic disease in a newborn infant caused by rare maternal anti-erythrocyte antibodies and exchange transfusion with maternal blood frozen earlier]. / Hemolytische ziekte bij een pasgeborene door zeldzame maternale anti-erytrocyten-antistoffen, en wisseltransfusie met eerder ingevroren maternaal bloed.

After a pregnancy of 31 weeks and 4 days a pale baby girl was born with mild oedema, severe anaemia (4.2 mmol/l), increased normoblast count and hyperbilirubinaemia, indicating a blood group antagonism. This was caused by very rare irregular antibodies with the specificity anti-U. These antibodies had been demonstrated in the mother before, after earlier transfusions with erythrocytes. At that time autologous blood was stored at -70 degrees C in the Central Laboratory of the Dutch Red Cross in Amsterdam, because U negative donors are hard to find. One of these units was used for an exchange transfusion given to the baby, who recovered well. This case study underlines the necessity of screening for presence of irregular antibodies during pregnancy. A national registration of patients with antibodies against erythrocytes is recommended.

Community-based evaluation survey of immunizations in Burkina Faso.

A cluster sample survey was conducted in January 1989 in 3 provinces of Burkina Faso to evaluate an immunization programme (based on two contacts, providing inactivated poliomyelitis vaccine plus DPT) that had been launched in 1982-84. The objectives were to estimate neonatal tetanus (NNT) mortality and poliomyelitis prevalence in the study area. The target population (using the same sample of households comprised 2107 live infants born during the preceding year for the NNT survey, and 17,154 children aged 0-9 years for the poliomyelitis survey. The NNT mortality rate was 3.3 per 1000 live births, and the poliomyelitis prevalence rate was 2.8 per 1000 children aged 5-9 years. Dates of onset of poliomyelitis cases among children aged 0-9 years and the numbers of children at risk during the 10-year recall period, reconstituted with demographic indicators taken from standardized life-tables, were used to calculate the incidence rates of poliomyelitis. These rates could be compared in the 5-year period preceding the survey, and showed a decreasing trend consistent with routine surveillance data.

PIP: A cluster sample survey was conducted in January 1989 in 3 provinces of Burkina Faso to evaluate an immunization program (based on 2 contacts, providing inactivated poliomyelitis vaccine plus DPT) that had been launched in 1982-84. The objectives were to estimate neonatal tetanus (NNT) mortality and poliomyelitis prevalence in the study area. The target population (using the same sample of households) comprised 2107 live infants born during the preceding year for the NNT survey, and 17,154 children aged 0-9 years for the poliomyelitis survey. The NNT mortality rate was 3.3/1000 live births, and the poliomyelitis prevalence rate was 2.8/1000 children aged 5-9 years. Dates of onset of poliomyelitis case among children aged 0-9 years and the number of children at risk during the 10-year recall period, reconstituted with demographic indicators taken from standardized life tables, were used to calculate the incidence rates of poliomyelitis. These rates could be compared in the 5-year period preceding the survey, and showed a decreasing trend consistent with routine surveillance data. (author's)