ABSTRACT
BACKGROUND: The aim of this study was to determine the characteristics of the cognitive function in very-low-birth-weight infants (VLBWI) at 6 years of age and investigate significant factors during neonatal intensive care unit admission that affect cognitive outcomes. METHODS: One hundred and eighty-nine VLBWI (28.4 weeks, 1024 g), including 93 extremely low-birthweight (EL) infants whose birthweight was <1000 g (26.8 weeks, 759 g) and 96 very low-birthweight (VL) infants whose birthweight was 1000-1499 g (30.0 weeks, 1281 g), were enrolled. The cognitive function was measured using the Wechsler Intelligence Scale for Children version 3, three IQ tests, four factor indices and 13 subtest scores. Regression analyses were performed to analyze the cognitive indices and clinical variables during neonatal intensive care unit admission. RESULTS: The full-scale IQ (FIQ) in the EL infants was 85.3 ± 13.4, which was significantly lower than the 91.8 ± 9.7 observed in the VL infants. The verbal IQ and performance IQ in the EL infants were also lower than those observed in the VL infants. The rate of difference between verbal IQ and performance IQ >14 was 20% in the EL infants and 22% in the VL infants. A multiple linear regression analysis revealed a significant relation between FIQ and HC (P = 0.002) and FIQ and dexamethasone (P = 0.012). CONCLUSION: In comparison with that observed in the VL infants, the intelligence quotient of the EL infants was inferior and exhibited more inter-individual variation. Intra-individual imbalances of the cognitive function were highly observed irrespective of the EL or VL status. Restriction of intrauterine brain growth and greater doses of dexamethasone may be harmful for subsequent cognitive outcomes.
Subject(s)
Cognition Disorders/physiopathology , Cognition/physiology , Infant, Very Low Birth Weight , Intelligence/physiology , Child , Cognition Disorders/etiology , Female , Follow-Up Studies , Humans , Intensive Care Units, Neonatal , Male , Prognosis , Retrospective Studies , Wechsler ScalesSubject(s)
Abnormalities, Multiple/diagnostic imaging , Abnormalities, Multiple/genetics , Craniofacial Abnormalities/genetics , Genes, ras , Mutation, Missense , Polyhydramnios/diagnostic imaging , Polyhydramnios/genetics , Amniocentesis , Base Sequence , Craniofacial Abnormalities/diagnostic imaging , DNA Mutational Analysis , Female , Humans , Infant, Newborn , Male , Phenotype , Pregnancy , Syndrome , Ultrasonography, PrenatalSubject(s)
Chromosome Aberrations , Chromosomes, Human, Pair 21 , Down Syndrome/genetics , Adult , Child, Preschool , Female , Humans , Male , PhenotypeABSTRACT
This report describes a case of giant cystic meconium peritonitis (GCMP) associated with a cloacal anomaly. Antenatal ultrasonography and magnetic resonance imaging demonstrated persistent fetal ascites, bilateral hydronephrosis, and 3 pelvic cystic structures. The baby girl showed duplicated hydrocolpos and a single orifice of the cloaca with a long common channel inducing a urinary outflow obstruction. After constructing a diversion colostomy, a cutaneous vesicostomy was necessary to prevent recurrent urinary tract infections. These findings are consistent with a prenatal diagnosis of cloacal anomalies, thus suggesting an association with severe obstruction of lower urinary tract and meconium peritonitis. Most of reported cases of meconium peritonitis associated with the cloaca show fibroadhesive types with scattered intraperitoneal calcifications and adhesions. However, the present case showed a rare GCMP suggesting continuous urinary influx via the fallopian tubes until the later stage of intrauterine life.
Subject(s)
Cloaca/abnormalities , Hydrocolpos/diagnosis , Meconium , Peritonitis/diagnosis , Prenatal Diagnosis/methods , Abnormalities, Multiple/diagnosis , Abnormalities, Multiple/surgery , Adult , Cesarean Section , Cloaca/surgery , Female , Follow-Up Studies , Humans , Hydrocolpos/surgery , Laparotomy/methods , Magnetic Resonance Imaging , Pregnancy , Pregnancy Outcome , Pregnancy Trimester, First , Risk Assessment , Treatment OutcomeABSTRACT
We report two consecutive cases of staphylococcal scalded skin syndrome (SSSS) in our neonatal intensive care unit (NICU). Methicillin-resistant Staphylococcus aureus (MRSA) was isolated from skin swabs. An epidemiological survey conducted on the NICU staff, isolated MRSA from nasal swabs of three personnel. Gene analysis of these five isolates using pulsed-field gel electrophoresis (PFGE) of the bacterial genome and polymerase chain reaction (PCR) for a panel of toxin genes encoded two patient-derived isolates of exfoliative toxin B (ETB) considered to be identical based on the spectrum of toxin genes encoded and PFGE patterns. Three staff-derived isolates did not, however, encode ETB and showed different repertoires of toxin genes and PFGE patterns from those of the two patient-derived isolates. Nasal application of mupirocin to all carriers successfully eradicated MRSA. Horizontal transmission of ETB-producing MRSA between the two patients in the NICU was confirmed, but no NICU personnel carried the same isolate. We therefore wish to emphasize the importance of strict standard and contact precautionary measures and the monitoring of MRSA in the NICU, together with the usefulness of gene analysis using PFGE and PCR as epidemiological tools.
