Caracterización de recién nacidos a término con deshidratación hipernatrémica / Characterization of full term newborns with hypernatremic dehydration

INTRODUCCIÓN: La deshidratación hipernatrémica neonatal es una condición grave y su incidencia se ha incre mentado en los últimos años, repercutiendo en complicaciones que llevan a la hospitalización del recién nacido. OBJETIVO: Describir las características clínicas y de laboratorio de recién nacidos a término con diagnóstico de deshidratación hipernatremica. PACIENTES Y MÉTODO: Estudio observacional descriptivo de recién nacidos a término que se hospitalizaron por deshidratación hiperna trémica entre los años 2014 y 2016. Se incluyeron recién nacidos a término mayores de 37 semanas con signos clínicos de deshidratación (mucosas secas, fontanela deprimida, llanto sin lágrimas, signos de pliegue cutáneo) y/o pérdida excesiva de peso mayor de 7% y sodio sérico mayor a 145 mEq/L. Se registraron variables sociodemográficas y bioquímicas para su análisis. RESULTADOS: Se incluyeron 43 neonatos. El 60,5% de sus madres fueron primigestantes, el 90% de los neonatos recibieron lactancia materna exclusiva, las madres reportaron problemas en la lactancia materna en el 76,7%. La pérdida de peso al ingreso con respecto al peso de nacimiento fue de 15,3% en promedio. El 83,3% contaba con seguro de salud público. 65,1% presentó signos clínicos de deshidra tación al ingreso y 83,5% signos neurológicos transitorios. El promedio de sodio fue de 155 mEq/L al ingreso. El descenso de sodio en las primeras 24 horas de manejo fue 7,74 mEq/L (0,32mEq/L por hora). La corrección de la hipernatremia fue en el 55,8% por vía oral y la estancia hospitalaria de 4 días en promedio. CONCLUSIONES: Los problemas de alimentación se presentaron en un (76%) madres primigestantes en un (88,4%). El 90,6% de esta población administraban lactancia materna exclusiva, resultados que pueden contribuir para alertar al profesional de la salud a identificar de forma oportuna, signos de alarma y un control precoz posterior al alta del puerperio y a la toma de medidas preventivas.

INTRODUCTION: The hypernatremic neonatal dehydration is a severe condition whose incidence has increased in recent years resulting in complications leading to the hospitalization of the newborn. OBJECTIVE: Describe the clinical and laboratory characteristics of term-newborns with Hypernatremic Dehy dration diagnosis. PATIENTS AND METHOD: Descriptive observational study of hospitalized term- newborns due to hypernatremic dehydration between a period from 2014 to 2016. Term newborns over 37 weeks with clinical signs of dehydration (dry mucous membranes, depressed fontanel, tear less crying, signs of the cutaneous pleat), and/or excessive weight loss greater than 7% and serum sodium greater than 145 mEq/L were included. Sociodemographic and biochemical variables were recorded for analysis. RESULTS: 43 neonates were included. 60.5 percent of their mothers were pri- miparous, 90 percent of neonates received exclusive breastfeeding, mothers reported breastfeeding problems in 76.7 percent. Incoming neonates reported weight loss compared to birth weight at 15.3% on average. 83.3% had public health insurance. 65.1% had dehydration clinical signs at entry and 83.5% transient neurological signs. The average sodium was 155 mEq/L at revenue. The sodium decrease in the first 24 hours of handling was 7.74 mEq/L (0.32mEq/L per hour). The correction of the hypernatremia was 55.8% by oral intake and 4 days hospital stay on average. CONCLUSIONS: The feeding's problems came up in a (76%), primiparous mothers in an (88.4%). 90.6 percent of this population administered exclusive breastfeeding, results that can help to alert the health professional to timely identification, warning signs, and early post-discharge control and preventive measures.

[Characterization of full term newborns with hypernatremic dehydration]. / Caracterización de recién nacidos a término con deshidratación hipernatrémica.

INTRODUCTION: The hypernatremic neonatal dehydration is a severe condition whose incidence has increased in recent years resulting in complications leading to the hospitalization of the newborn. OBJECTIVE: Describe the clinical and laboratory characteristics of term-newborns with Hypernatremic Dehy dration diagnosis. PATIENTS AND METHOD: Descriptive observational study of hospitalized term- newborns due to hypernatremic dehydration between a period from 2014 to 2016. Term newborns over 37 weeks with clinical signs of dehydration (dry mucous membranes, depressed fontanel, tear less crying, signs of the cutaneous pleat), and/or excessive weight loss greater than 7% and serum sodium greater than 145 mEq/L were included. Sociodemographic and biochemical variables were recorded for analysis. RESULTS: 43 neonates were included. 60.5 percent of their mothers were pri- miparous, 90 percent of neonates received exclusive breastfeeding, mothers reported breastfeeding problems in 76.7 percent. Incoming neonates reported weight loss compared to birth weight at 15.3% on average. 83.3% had public health insurance. 65.1% had dehydration clinical signs at entry and 83.5% transient neurological signs. The average sodium was 155 mEq/L at revenue. The sodium decrease in the first 24 hours of handling was 7.74 mEq/L (0.32mEq/L per hour). The correction of the hypernatremia was 55.8% by oral intake and 4 days hospital stay on average. CONCLUSIONS: The feeding's problems came up in a (76%), primiparous mothers in an (88.4%). 90.6 percent of this population administered exclusive breastfeeding, results that can help to alert the health professional to timely identification, warning signs, and early post-discharge control and preventive measures.

Recurrent pleural effusion as manifesting feature of primitive chest wall Hodgkin's disease.

Recurrent, cytologically benign pleural effusion was, for a long time, the only clinical manifestation of Hodgkin's disease involving the inner thoracic wall in the reported case. It is the first case reported in literature.

Quadricuspid aortic valve.

A case of quadricuspid aortic valve is described. The anomaly was unexpectedly found during operation for aortic valve replacement in a 70-year-old woman. Macroscopic and histological examinations of the valve showed no sign of previous inflammatory disease. Quadricuspid aortic valve must be considered, therefore, a malformation capable of leading to severe valve failure in later life.

[Clinical and morphological findings in 2 cases of angioimmunoblastic lymphadenopathy with dysproteinemia]. / Rilievi clinici e morfologici in due casi di linfoadenopatia angioimmunoblastica con disprotidemia o LAID.

Two autopsy cases of angioimmunoblastic lymphadenopathy with dysproteinemia were examined. Clinical and morphological data did not differ greatly from those in other cases of the literature: patients died two and three months after the onset of the symptoms. The autopsy findings included moderately enlarged generalized lymph nodes, hepatosplenomegaly and lungs involvement. Microscopically the most prominent change was the vascular proliferation with pleiomorphic cellular infiltration.

Mesonephric adenocarcinoma of bladder.

Mesonephric adenocarcinoma of the bladder is an extremely rare neoplasm. The typical location in the bladder neck and trigone tends to confirm that this neoplasm probably derives from a remanent of the mesonephric duct. This case is the fourth described in the literature. The patient underwent total cystectomy with ureterosigmoidostomy and is still apparently tumor free 7 years after operation.

Struma ovarii. Observations on three cases.

The true struma ovarii is a rare teratomatous neoplasia, composed with typical thyroid tissue. Generally it is asymptomatic or only determines a mild hypogastric weighting feeling. In a few subjects this neoplasm is secreting and rise to hyperthyroidism. The Authors describe the clinical and anatomopathological characteristics of 3 cases of true struma ovarii come to their observation. No malignant histologic features in any of them was seen. In the relatively short period of post surgical observations no women showed relapses or metastases. This confirms that true struma ovarii is usually a benign tumor.

Brenner's tumor. Observations on six cases.

Brenner's tumor is a rare fibroepithelial ovarian neoplasia, histologically characterized by an epithelial component similar to the transitional epithelium of the urinary tract. The histogenesis of neoplasm, which only rarely secretes estrogens, is still controversial. The Authors describe the clinical and anatomopathological features of six cases come to their observation. Only one of these was malignant; the woman died 18 months after diagnosis. There is no strict correlation between histological picture and biological behaviour. Only this one can give assurance on the benign or malignant nature of Brenner's tumor.

Incidence of malignant ovarian neoplasms in the provinces of Pisa, Lucca, Livorno and La Spezia during the period 1976-1981.

The Authors report a critical review of all the cases of ovarian neoplasia observed in the provinces of Pisa, Livorno, Lucca and La Spezia between 1976 and 1981. This study does not take into account all the cases in which incomplete clinical and histologic data were available or the first histologic diagnosis was not confirmed by a second examination. The incidence rate and distribution characteristics of all the histologic types of ovarian neoplasia are described.

Characteristics of lymphomas in the BALB/cfRIII mouse strain.

The occurrence of 392 lymphomas in 1607 BALB/cfRIII mice from F0 to F45 is analyzed. Lymphoma incidence increased rapidly in the first 5 generations, reached a high plateau from F6 to F20 and then decreased slowly until it disappeared altogether. After F35, only sporadic cases of lymphoma have been observed. The morphologic characteristics of 350 of these lymphomas observed from F0 to F20 are described. Three main types of lymphomas have been recognized on the basis of gross morphology, histology and age: a) early, lymphocytic, with thymic involvement; b) early, lymphocytic, without thymic involvement; and c) late, histiocytic, without thymic involvement. The first 2 types are virus-induced and thymus-dependent, and the third type is both virus and thymus independent. Lymphomas without thymic involvement and histiocytic lymphomas increased with the generations. The source of causative virus, the interference with mammary tumors, and the possible cell types of origin of lymphomas are discussed.

[Sarcoid type granuloma in lymph nodes with Hodgkin's disease]. / Aspetti sarcoidosimili in corso di malattia di Hodgkin

Sarcoid type granuloma have been observed in lymph nodes with Hodgkin's disease. Several pathogenetic hypotheses have been considered, and finally the picture has been interpreted as the epithelioid form of Hodgkin's disease.