Subject(s)
Achromobacter denitrificans/isolation & purification , Cross Infection/epidemiology , Disease Outbreaks , Drug Contamination , Gram-Negative Bacterial Infections/epidemiology , Bacteremia/epidemiology , Chlorhexidine , Cross Infection/microbiology , Female , Gram-Negative Bacterial Infections/microbiology , Humans , Infant, Newborn , MaleABSTRACT
INTRODUCTION: Vein of Galen arteriovenous malformation (VGAM) appears during the embryonic period and gives rise to a complex network of arterial and venous vessels that generates a blood shift, from the brain parenchyma towards the malformation, with haemodynamic repercussions. Heart failure is the most frequent presenting symptom during the neonatal period, yet, convulsions or other neurological signs have occasionally been reported in this stage of life. CASE REPORT: A term infant with symptoms of heart failure and convulsions that began during the first 12 hours of life. CAT and magnetic resonance angiography scans revealed a vascular malformation and areas of cerebral ischaemia. CONCLUSIONS: In the case of our patient, detecting areas of ischaemia in the cerebral hemispheres suggested that the damage could be caused by a "steal" syndrome leading the blood flow away from these areas towards the malformation. This situation can occur either before or after birth and the self-limiting nature of the seizures in cerebral infarcts could lead to them going noticed because they take place inside the uterus or when the patient is not being observed directly by his or her health care providers. We suspect that the convulsions in newborn infants with this malformation may well be more frequent than is currently believed.
Subject(s)
Cerebral Veins/abnormalities , Intracranial Arteriovenous Malformations/complications , Spasms, Infantile/etiology , Bradycardia/etiology , Brain Ischemia/etiology , Cardiomegaly/etiology , Cerebral Hemorrhage/etiology , Cerebrovascular Circulation , Embolization, Therapeutic , Female , Fetal Diseases/etiology , Humans , Hydrocephalus/etiology , Hydrocephalus/therapy , Hypoxia/etiology , Infant, Newborn , Intracranial Arteriovenous Malformations/diagnosis , Intracranial Arteriovenous Malformations/diagnostic imaging , Intracranial Arteriovenous Malformations/pathology , Intracranial Arteriovenous Malformations/therapy , Magnetic Resonance Imaging , Psychomotor Disorders/etiology , Subdural Effusion/etiology , Ultrasonography , Ventriculoperitoneal ShuntABSTRACT
Introduction. Vein of Galen arteriovenous malformation (VGAM) appears during the embryonic period and gives rise to a complex network of arterial and venous vessels that generates a blood shift, from the brain parenchyma towards the malformation, with haemodynamic repercussions. Heart failure is the most frequent presenting symptom during the neonatal period, yet, convulsions or other neurological signs have occasionally been reported in this stage of life. Case report. A term infant with symptoms of heart failure and convulsions that began during the first 12 hours of life. CAT and magnetic resonance angiography scans revealed a vascular malformation and areas of cerebral ischaemia. Conclusions. In the case of our patient, detecting areas of ischaemia in the cerebral hemispheres suggested that the damage could be caused by a steal syndrome leading the blood flow away from these areas towards the malformation. This situation can occur either before or after birth and the self-limiting nature of the seizures in cerebral infarcts could lead to them going noticed because they take place inside the uterus or when the patient is not being observed directly by his or her health care providers. We suspect that the convulsions in newborn infants with this malformation may well be more frequent than is currently believed (AU)
Introducción. La malformación arteriovenosa de la vena de Galeno (MAVG) aparece durante el período embrionario y da lugar a una compleja red de vasos arteriales y venosos que generan una derivación de sangre desde el parénquima cerebral hacia la malformación, con repercusiones hemodinámicas. La insuficiencia cardíaca es la forma de presentación más frecuente durante el período neonatal; sin embargo, las convulsiones u otros signos neurológicos se han referido raramente en esta etapa de la vida. Caso clínico. Se trata de un recién nacido a término que comenzó en las primeras 12 horas de vida con un cuadro de insuficiencia cardíaca y convulsiones. La TAC y la angiorresonancia magnética evidenciaron la malformación vascular y zonas de isquemia cerebral. Conclusiones. En nuestro paciente, la detección de áreas de isquemia en los hemisferios cerebrales sugiere que el daño podría estar ocasionado por un fenómeno de robo del flujo sanguíneo desde dichas áreas hacia la malformación. Esta situación puede acontecer antes o después del nacimiento, y el carácter autolimitado de las crisis en los infartos cerebrales podría hacer que éstas pasaran desapercibidas porque acontezcan intraútero o cuando el paciente no está siendo observado directamente por sus cuidadores. Nosotros sospechamos que las convulsiones en los neonatos con esta malformación podrían ser más frecuentes de lo que se considera en la actualidad (AU)
Subject(s)
Humans , Female , Infant, Newborn , Seizures/etiology , Vein of Galen Malformations/diagnosis , Cerebral Infarction/physiopathology , Heart Failure/physiopathology , Intracranial Arteriovenous Malformations/diagnosis , Epilepsy, Benign Neonatal/diagnosisABSTRACT
AIM: To investigate whether the serum levels of interleukin-1beta, 6, 8, tumour necrosis factor-alpha and the soluble receptor of IL-2 are useful in the diagnosis of neonatal sepsis, and whether their diagnostic power is increased when in combination with classical markers such as C-reactive protein and white blood cell count. METHODS: Blood samples were collected at admission from 40 neonates with suspected infection. Patients were included in different groups according to the bacteriological and laboratory results: Group I consisted of 20 newborns with positive blood cultures and other biological tests suggestive of infection. Group II included 20 neonates with negative blood cultures and biological tests not suggestive of infection. The control group included 20 healthy neonates with no clinical or biological data of infection. RESULTS: Mean values of C-reactive protein were significantly higher in Group I. No differences were found between the groups for white blood cell count, with the exception of the presence of leucocytosis in Group II. Levels of interleukin-1beta, 6, 8, tumour necrosis factor-alpha, soluble receptor of interleukin-2, and C-reactive protein were significantly higher in infected neonates than in the control groups. Detection sensitivity and specificity were 80 and 92% for C-reactive protein, 60 and 87% for interleukin-1beta, 61 and 80% for interleukin-6, 62 and 96% for interleukin-8, 54 and 92% for tumour necrosis factor-alpha and 63 and 94% for soluble receptor of interleukin-2. The discriminant analysis showed that the best combination for sepsis diagnosis was C-reactive protein + interleukin-8 + soluble receptor of interleukin-2, with a sensitivity of 85% and a specificity of 97.1%. CONCLUSION: Our study suggests that no individual test can on its own identify infected neonates, and that although the combination of C-reactive protein, interleukin-8 and the soluble receptor of interleukin-2 exhibits a high specificity, its sensitivity is limited.
Subject(s)
Antineoplastic Agents/blood , C-Reactive Protein/analysis , Interleukin-1/blood , Interleukin-6/blood , Interleukin-8/blood , Receptors, Interleukin-2/blood , Sepsis/blood , Sepsis/diagnosis , Tumor Necrosis Factor-alpha/analysis , Female , Humans , Infant, Newborn , Leukocyte Count , Male , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
El diagnóstico de miastenia grave en el periodo neonatal es un hecho infrecuente. Los antecedentes familiares y el examen clínico deben orientar a la realización de un test farmacológico anticolinesterasa, mediante el cual se consiguen cambios en la expresión facial y la conducta motora del paciente que permiten establecer finalmente el diagnóstico. Este tipo de iconografía no es frecuente en la bibliografía (AU)
Subject(s)
Female , Humans , Infant, Newborn , Myasthenia Gravis, Neonatal/diagnosis , Neostigmine , FaciesABSTRACT
OBJECTIVES: We have studied the quantitative differences in the percent fatty acid composition of human milk throughout its maturational process. MATERIAL AND METHODS: We analyzed milk, obtained by an electrical milk extractor (EGNELL LACT-E AMEDA), from 24 women at 3 days (colostrum) and 7 (transitional milk) after delivery. A Varian 3300 chromatograph was used for fatty acid evaluation. At 48 hours after delivery, the lipid status of the maternal blood was also evaluated. RESULTS: The mean age of the mothers was 27.4 +/- 3.7 years, with 54% primiparous and the mean weight of the newborns was 3117.5 +/- 678.6 g. Comparing colostrum with transitional milk showed a statistically significant difference between saturated fatty acids (C8, C13, and C15) and polyunsaturated fats (C18:3 and C20:4). The concentration of C13, C15, C17, C18, C16:1 and C18:1 obtained in colostrum correlated with those in transitional milk. Serum maternal lipid concentrations of cholesterol and LDL influenced milk levels of C18:2, C18:3 and C20:4. On the contrary, we could not demonstrate a similar influence on triglycerides, apoprotein A or B.
