ABSTRACT
In contrast to adults, neonates and infants with coronavirus disease 2019 (COVID-19) infection have milder symptoms and are less likely to require hospitalization. However, some neonates with COVID-19 can present with significant symptoms. Recent evidence suggests that neurologic manifestations of neonatal COVID-19 infection may be higher than initially thought. In this comprehensive review of the current literature, we summarize the clinical, laboratory, and radiologic findings, as well as potential management strategies for COVID-19-related neurologic illness in neonates. Although the growing brain may be affected by neurologic disease associated with COVID-19 infection, the few published studies on the long-term outcomes after COVID-19 infection in neonates and infants provide conflicting results. Larger collaborative clinical studies are needed to determine whether COVID-19 infection in neonates has long-term neurodevelopmental outcomes.
Subject(s)
COVID-19 , Nervous System Diseases , Infant, Newborn , Infant , Adult , Humans , COVID-19/complications , COVID-19/diagnosis , SARS-CoV-2 , Nervous System Diseases/diagnosis , Nervous System Diseases/etiology , HospitalizationSubject(s)
Brain Diseases , COVID-19 , Infant, Newborn , Humans , Brain Diseases/diagnosis , Brain Diseases/etiology , Risk FactorsABSTRACT
Albumin is the most abundant protein in human blood with distinctive functions throughout the human body. Low albumin levels are a predictor of mortality as well as disease outcome in children and adults. However, the clinical significance of hypoalbuminemia and the role of albumin infusions in NICUs remain unclear and controversial.
Subject(s)
Hypoalbuminemia , Intensive Care Units, Neonatal , Adult , Child , Humans , Hypoalbuminemia/diagnosis , Hypoalbuminemia/drug therapy , Infant, Newborn , Serum Albumin/metabolismABSTRACT
Paediatric abdominal pain continues to pose a diagnostic challenge in the acute hospital care setting. We describe an eleven-year-old boy who presented to the emergency department with acute-onset, sharp abdominal pain localised to right lower quadrant. Abdominal imaging was diagnostic for epiploic appendagitis (EA), with pathognomonic 'ring sign' and 'central dot' visualised on the axial computed tomography images. He responded well to conservative treatment, including a short course of non-steroidal anti-inflammatory drugs. EA is a lesser-known paediatric entity mimicking surgical conditions. However, steady but sharp and non-migratory characteristic of the pain in either of the lower abdominal quadrants should raise suspicion for EA. Early accurate diagnosis can prevent unnecessary surgical exploration in these patients.
ABSTRACT
OBJECTIVE: To compare neurodevelopmental outcomes of large and appropriate for gestational age (LGA, AGA) infants <29 weeks' gestation at 18-24 months of corrected age. STUDY DESIGN: Retrospective cohort study using the Canadian Neonatal Network and Canadian Neonatal Follow-Up Network databases. Primary outcome was a composite of death or significant neurodevelopmental impairment (NDI), defined as severe cerebral palsy, Bayley III cognitive, language and motor scores of <70, need for hearing aids or cochlear implant and bilateral visual impairment. Univariate and multivariable logistic analyses were applied for outcomes. RESULTS: The study cohort comprised 170 LGA and 1738 AGA infants. There was no difference in significant NDI or individual components of the Bayley III between LGA and AGA groups. LGA was associated with the increased risk of death by follow-up, 44/170 (25.9%) vs. 320/1738 (18.4%) (aOR: 1.60 95% CI: 1.00-2.54). CONCLUSIONS: Risk of NDI was similar between LGA and AGA infants.
Subject(s)
Gestational Age , Canada/epidemiology , Female , Humans , Infant , Infant, Newborn , Pregnancy , Retrospective StudiesSubject(s)
Agranulocytosis , Anemia , Lymphopenia , Thrombocytopenia , Agranulocytosis/diagnosis , Humans , Infant, Newborn , Lymphopenia/diagnosisABSTRACT
OBJECTIVE: Correlation of catch-up growth and Insulin-like Growth Factor -1 levels (IGF-I) in SGA babies. METHODS: 50 Full-term Small for Gestational Age children aged 12-18 months were analyzed for Catch-up growth (gain in weight and/or length, Standard Deviation Score/SDS >0.67). IGF-1 was measured after post-glucose load using ELISA method and correlated with catch-up growth. RESULTS: Mean (SD) birthweight and length were 2.1 (0.3) Kg and 44.4 (3.1) cm, respectively. At enrollment, mean (SD) age, weight and length were 15.0 (2.1) months, 7.7 (1.3) Kg, and 72.9 (5.6) cm, respectively. Catch-up growth was noted in 60% children. IGF-1 levels were significantly higher in children showing catch-up growth (56.6 (63.2) ng/mL) compared to those not having catch up growth (8.7 (8.3) ng/mL). IGF-1 was positively correlated with both weight and length catch-up. CONCLUSION: Majority of Small for Gestational Age showed catch-up growth by 18 months, which had good correlation with IGF-1 levels.
Subject(s)
Child Development/physiology , Infant, Small for Gestational Age/growth & development , Insulin-Like Growth Factor I/metabolism , Anthropometry/methods , Birth Weight , Cross-Sectional Studies , Enzyme-Linked Immunosorbent Assay , Female , Humans , Infant , Infant, Newborn , MaleABSTRACT
Posterior reversible encephalopathy syndrome (PRES) is a clinico- radiological syndrome characterized clinically by headache, seizures, visual disturbances, vomiting and radiologically by predominant posterior leukoencephalopathy. The authors report an 11-y-old boy with meningitis presenting with transient hypertension and visual loss and MRI finding compatible with the diagnosis of PRES and complete reversal of symptomatology within 10 d. A wide plethora of tests carried out failed to identify the cause of transient hypertension with a probability of this being due to transient autonomic dysfunction.
