Neonatal Sacrococcygeal Neuroblastoma Mimicking a Teratoma.

We reported the first case of a congenital intrapelvic presacral neuroblastoma in Puerto Rico managed in the early neonatal period. The preoperative diagnosis was a sacrococcygeal teratoma Altman stage IV classification. This case confirms the importance of a comprehensive physical examination and observation of low-risk newborn infants with a history of adequate prenatal care and an unremarkable fetal ultrasonogram during pregnancy.

Loss of parental role as a cause of stress in the neonatal intensive care unit.

UNLABELLED: Having a baby in the Neonatal Intensive Care Unit (NICU) is a major source of stress for parents. The barriers to parenting and reactions to the environment may negatively influence the parent-infant relationship. OBJECTIVE: To identify NICU-related parental stress and associated factors. METHODS: Parents (N = 156) of newborns admitted to NICU completed the Parental Stressor Scale. RESULTS: Most of the parents (46%) rated the experience to be extremely stressful. The principal cause of stress was the alteration in parental role and being separated from their baby. Stress was not associated to education, marital status, infants' birth weight, gestational age, congenital anomalies or if the parents expected the baby to be in the NICU. CONCLUSION: Identification of areas associated to higher levels of stress in parents may help the NICU staff to establish strategies to help parents cope with the stress caused by being unable to start their parenting role immediately after their babies' birth.

Propionic acidemia in a male newborn with Noonan syndrome: a case report.

We report a case of preterm infant born with prenatal diagnosis of cystic hygroma in the neck and congenital heart defect. Physical exam showed a hypotonic infant with dysmorphic features. Noonan syndrome was diagnosed. This newborn presented with progressive encephalopathy leading to a workup for metabolic disorders. The findings of elevated glycine levels associated with ketosis prompted the diagnosis of propionic acidemia. This case demonstrates that metabolic disorders can co-exist with other genetic syndromes and a high index of suspicion is needed in order to make the diagnosis and determine available treatment options. Genetic counseling should be offered to the parents as these disorders may affect future.