A new formula for premature infants: effects on growth and nutritional status.

OBJECTIVE: Nutritional management influences immediate survival as well as subsequent growth and development of low birth weight and very low birth weight infants. Preterm infant formula (PTF) is used when there is an inadequate supply of mother's milk or when the mother is unable to breastfeed and donor breast milk is unavailable. The purpose of this prospective multicenter study was to evaluate short-term effects on nutritional status (auxological and biochemical parameters) in a population of premature infants who received a preterm infant formula. METHODS: Ninety-seven preterm infants with a birth weight between 500 g and 2000 g and a gestational age of 25-34 weeks postmenstrual age were randomly assigned to received a new preterm infant formula (Nutribèn Pre), and their nutritional status were compared to 75 fortified human milk (FHM) fed infants. RESULTS: No significant differences were observed between FHM and Nutribèn Pre fed infants in terms of growth, feeding tolerance and biochemical profiles. CONCLUSION: Nutribèn Pre is a valid, effective and safe alternative for the nutrition of preterm infants.

The chance finding of a ventricular septal defect in a 2-day-old newborn infant.

Certain congenital cardiac defects may go undetected for several years due to lack of symptoms and signs.Ventricular septal defects can occur as part of more congenital cardiac malformations or as an isolate finding. The natural history of ventricular septal defects depends on the size of the defect and on the pulmonary resistance. We present a case of the chance finding of a ventricular septal defect in a 2-day-old newborn infant with an interatrial septal aneurysm.

Dual atrioventricular nodal physiology in young child.

Dual atrioventricular nodal physiology has been reported. Atrioventricular nodal reentrant tachycardia is the most common supraventricular tachycardia associated with dual atrioventricular nodal physiology. We present a case of dual atrioventricular nodal physiology in a 12-year-old Italian boy.

Isolated tricuspid prolapse in young child.

The geometric and hemodynamic determinants of functional tricuspid regurgitation severity are mainly determined by septal leaflet tethering, septal-lateral annular dilatation, and the severity of pulmonary hypertension. Isolated significant tricuspid regurgitation can occur from isolated prolapse of valvar leaflets. Tricuspid prolapse has been found more frequently to be associated with mitral valve prolapse or with other cardiac and lung diseases and it has been rarely found as an isolated finding. Isolated primitive tricuspid prolapse appears in fact a relatively unknown anatomo-clinical entity and is of clinical importance, since this condition may be associated with significant tricuspid incompetence, a high incidence of cardiac arrhythmias, and possibly with bacterial endocarditis. We present a case of isolated prolapse of the tricuspid septal leaflet in an 11-year-old Italian boy. Also this case is illustrative of an isolated tricuspid prolapse.

Subvalvular aortic stenosis associated with valvular aortic regurgitation in young child.

Discrete subvalvar aortic stenosis is a variable and progressive disease. Recurrent obstruction may reappear despite the adequacy of surgical excision. Aortic regurgitation is associated with numerous eponymous signs, it is also a complication of discrete subvalvar aortic stenosis and its detection often triggers referral for surgery. It has also been suggested that an infant or young child with a well-defined 30 mm Hg or more peak gradient should have removal of the subvalvar obstruction. We describe a case of subvalvular aortic stenosis associated with aortic regurgitation in a 10-year-old Italian boy.

Isolated supravalvular pulmonary stenosis in a 25-day-old newborn infant: an occasional and early diagnosis.

Pulmonary stenosis comprises variable pathologic features from the right ventricular outflow tract to the peripheral pulmonary arteries. Most frequently, the obstruction occurs at the level of the pulmonary valve; however, it occurs less frequently at the infindibular level. It can occur as part of more congenital cardiac malformations such as tetralogy of Fallot, complete transposition of great arteries, or atrial septal defect. Proximal pulmonary artery stenosis has also been reported as an acquired lesion in infants treated for congenital heart disease. Primary isolated supravalvular pulmonary stenosis is less common. We present a case of primary isolated pulmonary artery stenosis in an asymptomatic 25-day-old newborn infant.