[The magnetic resonance imaging of the cerebral lesions in a newborn infant with tuberous sclerosis]. / Imagen por resonancia magnética de lesiones cerebrales en un recién nacido con esclerosis tuberosa.

Tuberous sclerosis is a neurocutaneous disease characterized of mental retardation, facial fibroangiomas, hypochromic stain and seizures. Is presented a case of a newborn that in the third day of life presenting seizures and in the physical exam show hypochromic CT scans irregular of 3-10 mm in thorax and limbs. The seizures presented during hospitalization were tonics, it was need treatment with three anticonvulsants for the control; the parents studies were normal. Magnetic resonance showed characteristic images of this pathology like nodular subependymal lesions, hyperintense, in lateral ventricles and a cortical tuberous lesion in the right frontal region. Tuberous sclerosis has a dominant autosomic transmission; the defect is in the chromosome 9, the prenatal diagnosis is not possible and 50-80% the of case are mutations. Affect a different organs as skin, eyes, heart, brain, kidney, bone and lung. The prognostic is variable and death is caused for epileptic state, brain tumor, heart failure, renal or intercurrent infection. The magnetic resonance imaging is the landmark study for diagnosis of this pathology of ample use in the present.

[Comparison of 2 methods of partial exchange transfusion in newborns with polycythemia: peripheral-peripheral and central-peripheral]. / Comparación de dos métodos para realizar exanguinotransfusión parcial en recién nacidos con policitemia: periférica-periférica y central-periférica.

Oneself presents the result of the prospective study from evaluate the morbility of the partial exchange-transfusion (exchange-dilution) to effect in two forms in newborn with polycythemia. The A group was newborn in the which extraction of blood volume was on peripheric vein is oneself administration crystalloid solution for another periphery vein; the B group was utilized umbilical vein to remove blood volume for another periphery vein is administration the crystalloid. To have 20 newborn in each group; to predisponent prenatal factors global were toxemic (12%); the plethora was the more frequent sing (55%) and nausea in (37%). Were not encountered difference in both groups for: gestational age, weight, birth rate, trophism, polycythemia type (asymptomatic vs symptomatic); neither to have difference in the seric electrolytes, protein and vital signs before and after procedure. Were encountered more infections process in the B group (P < 0.05). Were concluded what the exchange-dilution for polycythemia in newborn of term must be for periphery vein exclusive with security of not production metabolic and hemodynamic changes and without risk for sepsis and/or enterocolitis for manipulation of umbilical vessels.

[Variation in the blood lipids in premature newborns during the use of the "all-in-one" total nutritional mixture]. / Variación de los lípidos sanguíneos en recién nacidos prematuros durante la mezcla nutricional total "todo en uno".

This prospective study was performed for the evaluation of the lipids in serum; the metabolic and other effects related with septicaemia, stability and compatibility of the parenteral nutrition combining in one continent amino acids, carbohydrates and fats; this system is called nutritional total mixture, "all in one" or three in one. Twenty prematures neonates were included in the study. The variables analyzed were: weight, gestational age; the laboratory exams taken before the installation of the system and seven days after were: total lipids, triglycerides, phospholipids, cholesterol, sodium, potassium, chloride, glucose, urea nitrogen, creatinine, hepatic enzymes and proteins, cellular blood count and coagulations tests. We obtained the next results: the mean gestational age and weight were 34 +/- 5 weeks and 1327 +/- 172 g, have been observed rise of lipids (P < 0.001), declination of potassium levels (P < 0.001), increment of calcium levels (P < 0.001), increment of albumin (P < 0.001) and platelets (P < 0.01). It is concluded that nutritional total mixture is a sure method in management of premature newborn with good stability, compatibility, with a increment of fats in serum physiological levels, with metabolic tolerance without repercussion renal, hepatic, hematological and without infections.

[Acute gastric distension due to sepsis in a newborn infant]. / Distensión gástrica aguda por sepsis en un recién nacido.

The acute distention of stomach in the newborn is conditional by metabolic alterations like hypocalcemia or by septic states. We present the case of a newborn with antecedents of membrane rupture for 12 hours obtained by cesarean procedure, of 38 weeks by Capurro, score without perinatal asphyxia and 3320 g of birth weight, which evolutioned with respiratory distress and its first exams showed leukopenia, low platelet count and the cerebrospinal fluid showed 390 cells with polymorphonuclear predominium considering the diagnosis of neonatal sepsis and meningitis. At the second day he presented abdominal distention secondary to gastric camera dilatation, were made a laparotomy to descart congenital obstruction and only found gastric distention. In all newborn with acute gastric distention its important for first instance descart congenital intestinal obstruction and is on sidered this entity by exclusion. We recommend in this patients sepsis worshop. The treatment is drainage by orogastric tube and antibiotics. The prognosis is good once upon treating the basic problem.

[Diaphragmatic hernia, secondary to a phrenic nerve lesion, in a newborn infant]. / Eventración diafragmática en un neonato secundaria a lesión del nervio frénico.

The diaphragmatic eventration will be congenital or acquired; the damage to the phrenic nerve its for elongenest, cruch, gun ball or iatrogenic; this last one could be during cardiac surgery, birth trauma, venodissection and colocation of one thorax drill. We presented the case of one premature newborn of 32 weeks with 1374g of weight, with respiratory distress syndrome which evolutioned to bilateral pneumothorax and posteriorly left diaphragmatic eventration secondary to a phrenic nerve damage by the thorax drill which one reach to mediastinum. The diagnosis of these entity will suspect by abnormal elevation of the affected hemidiaphragm and confirmed by fluoroscopy. The treatment its a early diaphragmatic pleat.

[A giant follicular cyst of the ovary in a newborn infant]. / Quiste folicular gigante de ovario en una recién nacida.

The tumoral lesions proceeding of ovary in the newborns are the 3-6% of all abdominal tumors. The most frequent tumor is ovarian follicular cyst which will be diagnosed prenatally. As a result of ovarian stimulation by fetal gonadotrophins, maternal estrogen and placenta + gonadotrophins. Maternal antecedents reported diabetes, toxemia and isoimmunization. The most frequent complication is torsion. We present the case of one female newborn, with abdominal mass present by abdominal palpation referred of the first gestation of mother with 27 years of age, with primary sterility of 11 years without treatment, with toxemia during the pregnancy. The abdominal x-film show a intraperitoneal mass the ultrasound show cystic and solid mass, without determined origin, and the scan magnetic resonance (MR) a tumoral mass with origin in the pelvic hole with extension to the infrahepatic zone. The surgical finding was left ovarian cyst with left oophorectomy and salpingectomy.