ABSTRACT
BACKGROUND: The quality of general movements (GMs) is a widely used criterion to assess neurological dysfunction in young infants. It is unknown, however, whether the birth process influences the motor repertoire of healthy full term infants during the first week after birth. AIMS: To assess the quality of GMs and to determine the motor optimality score (OS) in healthy full term infants during the first week after birth and to evaluate the influence of the mode of delivery on GM quality. STUDY DESIGN: Thirty-three healthy full term infants born either vaginally or after caesarean section (CS) under spinal anaesthesia were video recorded in the first week after birth in order to assess GM quality and to determine OS with Prechtl's method. RESULTS: Abnormal GMs were observed mainly on the early recordings: 86% on the day of birth (day 0), 94% on day 1, and 68% on day 2. On days 5 to 7 (day 5-7) all GMs were normal (P<.001). The OSs increased significantly from median 12 on day 0 to 18 on day 5-7 (P<.001). Monotonously slow movements were frequently seen during the first days but not on day 5-7 (P<.001). GM quality and OS did not differ between infants born by vaginal delivery or after CS under spinal anaesthesia. CONCLUSIONS: Healthy full term infants often showed abnormal GM quality and lower OSs during the first week after birth, irrespective of the mode of delivery. GM quality normalised during subsequent days and was normal on day 5-7.
Subject(s)
Movement , Child Development , Female , Humans , Infant, Newborn , MaleABSTRACT
We describe the case of a 10-year-old boy who presented with high fever, vomiting and diarrhoea. There were no respiratory symptoms and auscultation and percussion of the lungs were normal. The combination of the clinical picture with a high C reactive protein value prompted us to perform a diagnostic work-up. A chest radiograph showed abscess formation in a lobar pneumonia in the right upper lobe and intravenous antibiotic therapy was started. The patient recovered and treatment was continued with oral antibiotics. Radiologically confirmed pneumonia in a febrile patient without respiratory symptoms is described as occult pneumonia. An increased number of leucocytes and/or an increased C reactive protein value can predict occult pneumonia in febrile children. This case highlights the diagnostic challenge of pneumonia in febrile children without respiratory symptoms and reminds clinicians to consider occult pneumonia in the differential diagnosis of fever without source.
Subject(s)
Fever/etiology , Pneumonia, Pneumococcal/diagnosis , Anti-Bacterial Agents/therapeutic use , Auscultation , Child , Diagnosis, Differential , Fever/diagnosis , Fever/drug therapy , Follow-Up Studies , Humans , Male , Pneumonia, Pneumococcal/complications , Pneumonia, Pneumococcal/drug therapy , Radiography, Thoracic , Streptococcus pneumoniae/isolation & purificationABSTRACT
A 15-year-old white girl with autoimmune thyroiditis developed arthritis 3 weeks after starting therapy with the antithyroid drug thiamazole. Because an adverse drug reaction of thionamide therapy was suspected, thiamazole was withdrawn, and symptoms disappeared rapidly. Thionamide therapy is indicated for hyperthyroidism and has been widely used since 1948. Reported adverse drug reactions range from mild to potentially life threatening. Arthritis is an uncommon but serious side effect and can develop as a part of the antithyroid arthritis syndrome or as a part of antineutrophil cytoplasmic antibody-associated vasculitis that is induced by antithyroid drugs. Little is known about the exact pathogenesis. Therapy consists of prompt discontinuation of the drug, where upon symptoms rapidly disappear. Because of possible cross-reactivity with alternative thionamides, another form of treatment for hyperthyroidism is recommended. Clinical awareness is important, and prompt withdrawal of the antithyroid drug is necessary when serious side effects occur.
