Frequency analysis of air and skin temperature in neonates in servo-controlled incubators.

OBJECTIVE: To test a new system designed for digital recording of skin and air temperature, thereby allowing analysis of cyclic changes in temperature in neonates in servo-controlled incubators. METHODS: Analysis of cyclic changes of serial skin and air temperature in asymptomatic infants in servo-controlled incubators adjusting heat output to the patient's temperature. RESULTS: In nine asymptomatic neonates ranging from 25 to 40 weeks of gestational age, analysis showed peaks of coherence (squared correlation) between skin and air temperature measurements at periods ranging between 1.5 and 3 h. CONCLUSION: We have established a new system to study cyclic changes in skin and air temperature in neonates in servo-controlled incubators. The analysis of this pilot study suggests that the most important changes in skin and air temperature in asymptomatic neonates occur at a periodicity of 1.5 to 3 h, which is similar to that previously described for neonatal temperature. Additional data are required to determine whether this new system may be useful in neonatal care.

Gonorrhoea in a south London genitourinary medicine department.

The management and outcome of all cases of gonorrhoea which presented to a south London genitourinary medicine clinic during 1999 were assessed and compared with published national guidelines. The incidence of penicillin resistance was calculated, as was the rate of co-infection with chlamydia and trichomonas. Information regarding demographic data, microscopy, culture results, test of cure, antibiotic use, sensitivity and health adviser contact was examined. A total of 257 cases of gonorrhoea were diagnosed in 238 patients. Heterosexual men constituted 52.9% of cases, 6.6% were in homosexual men and 40.5% in women. Direct microscopy was positive in 88.8% of men and in 40.5% of women. In women, the rate of gonorrhoea co-infection with chlamydia was 34.7% and with trichomonas was 11.5%. In men the rate of chlamydia co-infection was only 3.3%, however, we do not believe this to be an accurate figure as we are unable to routinely screen all men for chlamydia due to financial restrictions. Amoxicillin with probenecid were the most commonly used antibiotics in line with local guidelines. Penicillin resistance was demonstrated in 4.6% of infected cases. Health advisers saw 73.2% of patients.

Thrombolysis of a neonatal brachial artery thrombosis with tissue plasminogen activator.

OBJECTIVE: A case report is presented describing the use of tissue plasminogen activator (TPA) to dissolve a thrombosis in the brachial artery of a critically ill premature neonate. A short review of the literature is included. DESIGN: A premature infant with pulmonary hypertension is discovered to have a concomitant right brachial artery thrombosis. A debate ensued concerning the choice of medical management to pursue after surgical extirpation was ruled out. After review of the various alternatives both traditional and novel, a decision was made to utilize TPA. RESULTS: After a continuous infusion of 0.1 mg/kg per hour for 15 hours, blood flow was established distal to the previously occluded right brachial artery. No untoward side-effects occurred during or subsequent to the treatment. CONCLUSION: TPA proved to be an extremely useful medication for the relief of a brachial artery thrombosis in this patient. The theoretical advantages, as well as several anecdotal reports of its successful use, should hopefully stimulate a large multicenter study of its use in the neonatal population.

Colony-stimulating factor 1 in the human response to neonatal listeriosis.

Immunity to Listeria monocytogenes, an important pathogen in human neonatal sepsis, is mediated by mononuclear phagocytes, which are regulated by the hematopoietic growth factor colony-stimulating factor 1. Neonates with listeriosis had higher circulating colony-stimulating factor 1 levels and subsequent monocyte counts than those of both noninfected newborns and newborns infected with nonlisterial organisms.