Rubella immune status of neonates - a window towards seroprevalence among childbearing women.

BACKGROUND: When contracted in pregnancy, rubella may cause serious chronic infection of the fetus and development of Congenital Rubella Syndrome. Despite widespread application of rubella vaccination, periodical outbreaks are still being reported worldwide. The aim of this study was to determine rubella seroprevalence and antibody levels in neonates in Serbia as a proxy of maternal serostatus. METHODS: ELISA based serological testing for rubella was done in 599 neonates treated at the Institute of Neonatology in Belgrade, from January 2010 to December 2011. All individuals with rubella IgG concentration ≥10 IU/ml were considered seropositive for rubella. RESULTS: The mean age of enrolled neonates was 18 ± 6 days. The overall seroprevalence of rubella IgG antibodies among the tested neonates was 540/599(90.2 %, 95 % CI: 87.5-92.3). Seropositivity rate among sera of the neonates enrolled in 2010 was significantly higher than those collected in 2011 (p < 0.0001). There was no difference in average maternal age, gestational age or frequency of receiving blood products among the two study years. Significant high seropositivity rate was observed among neonates from mother aged >30 as compared to those from mothers aged <20 years (p = 0.02). Significant difference was also found between average IgG titers in the two study years (79 IU/mL in 2010 vs. 46 IU/mL in 2011, p < 0.0001). CONCLUSION: We report on high rubella seroprevalence among newborns in Serbia, as a proxy of rubella serostatus of childbearing aged women. Notably, declining trend of rubella antibodies toward diminishing titers suggest the importance of sustained rubella serosurvey and antenatal screening at the national level.

Does the gestation age of newborn babies influence the ultrasonic assessment of hip condition?

INTRODUCTION: Ultrasound represents a method of examination of hips of newborn babies capable of defining hip condition and distinguishing stable and unstable hips based on morphological elements. It is accepted in a large number of countries as a method of examination of high risk newborns, or as a method of systematic screening. OBJECTIVE: The objective of this study was to investigate correlation between ultrasonically estimated hip maturity and respective gestation maturity both in premature and term-born babies, and to investigate the influence of different delivery types on hips condition. METHODS: In our study 2045 patients, 1141 males and 904 females, were examined in at the Institute of Neonatology over a period of 5 years. The average age was 34.04 gestation weeks. There were significantly more premature (1698 or 83.03%) than term-born babies (347 or 16.97%). Ultrasound hip examination, as a screening method, was carried out according to Graf. It was followed by clinical examination. Results were analyzed by appropriate statistical methods (chi2-test, one-way ANOVA, multifactor ANOVA). RESULTS: The overall frequency of unstable hips was 3.2%, 1.88% in males and 4.87% in females (p<0.05). 96.8% babies had stable hips, out of which 35.21% were mature and 61.59% immature. In the study of the breech presentation, out of 183 babies, unstable hips were found in 1.58% of male cases, and in 10.23% of female cases. CONCLUSION: Clinical screening of developmental dysplasia of the hip is insufficient for early diagnosis and decision about the treatment of premature babies. The high frequency of unstable hip type IIc (risky) and IId (decentralized) in premature babies requires early diagnosis and therapy. Wide swaddling for prematures should be applied up to eight months of age. Gentle manipulation is necessary while nursing and conducting physiotherapy of a premature baby.

[Continuous ambulatory monitoring of blood pressure and the left ventricular mass index in children with kidney diseases]. / Kontinuirano ambulatorno merenje krvnog pritiska i indeks mase leve komore kod dece sa bubreznim oboljenjem.

INTRODUCTION: Numerous epidemiological studies have shown that blood pressure (BP) is positively related to cardiovascular morbidity and mortality. Although the relationship between BP and the incidence of morbid events is consistent and highly significant, it is difficult to predict the absolute risk. Several studies have shown that the organ damage associated with hypertension correlate to a greater degree with 24 h average BP than with clinic BP and the most of them evaluated left ventricular hypertrophy in these patients. OBJECTIVE: To evaluate the correlation between left ventricular mass index (LVMi) and BP, BP variability, pulse pressure (PP), BP load and hyperbaric index (HBI). DESIGN AND METHODS: Ambulatory blood pressure monitoring (ABPM) was performed in 30 children with renal disease aged 12.7 +/- 5.5 years. Ten of them had normal renal function, 3 had renal transplant and 17 of them had end-stage renal disease and were on chronic haemodialysis. All of the patients were submitted to an echocardiographic evaluation and LVMi was calculated according to Penn convention. Ambulatory blood pressure monitoring was performed during the 24 h period and average values of systolic and diastolic BP were evaluated. As an index of variability of BP values we used standard deviation (SD) of mean. Evaluation of average BP values has some disadvantages--it does not take into account the peaks of blood pressure and the values are lower if the circadian rhythm of BP is preserved--for this reason BP load and HBI were evaluated as well. BP load represented the percentage of BPs exceeding the upper limits of normal and HBI the integrated area under the ambulatory BP curve. For the upper limits of normal was used 95th percentile from the multicenter study of German authors. RESULTS: There was no correlation between LVMi and evaluated parameters. CONCLUSIONS: The response of myocardium to chronic increase of the afterload is highly individual, and probably the role of genetics in this is very important. Echocardiography (LVMi) could not be used with certainty for the evaluation of ventricular mass.