Clinical treatment outcomes and their changes in extremely preterm twins: a multicenter retrospective study in Guangdong Province, China / 中国当代儿科杂志

OBJECTIVES@#To investigate the clinical treatment outcomes and the changes of the outcomes over time in extremely preterm twins in Guangdong Province, China.@*METHODS@#A retrospective analysis was performed for 269 pairs of extremely preterm twins with a gestational age of <28 weeks who were admitted to the department of neonatology in 26 grade A tertiary hospitals in Guangdong Province from January 2008 to December 2017. According to the admission time, they were divided into two groups: 2008-2012 and 2013-2017. Besides, each pair of twins was divided into the heavier infant and the lighter infant subgroups according to birth weight. The perinatal data of mothers and hospitalization data of neonates were collected. The survival rate of twins and the incidence rate of complications were compared between the 2008-2012 and 2013-2017 groups.@*RESULTS@#Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of severe asphyxia and smaller head circumference at birth (P<0.05). The mortality rates of both of the twins, the heavier infant of the twins, and the lighter infant of the twins were lower in the 2013-2017 group compared with the 2008-2012 group (P<0.05). Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of pulmonary hemorrhage, patent ductus arteriosus (PDA), periventricular-intraventricular hemorrhage (P-IVH), and neonatal respiratory distress syndrome (NRDS) and a higher incidence rate of bronchopulmonary dysplasia (P<0.05).@*CONCLUSIONS@#There is a significant increase in the survival rate over time in extremely preterm twins with a gestational age of <28 weeks in the 26 grade A tertiary hospitals in Guangdong Province. The incidences of severe asphyxia, pulmonary hemorrhage, PDA, P-IVH, and NRDS decrease in both the heavier and lighter infants of the twins, but the incidence of bronchopulmonary dysplasia increases. With the improvement of diagnosis and treatment, the multidisciplinary collaboration between different fields of fetal medicine including prenatal diagnosis, obstetrics, and neonatology is needed in the future to jointly develop management strategies for twin pregnancy.

[Spiral CT findings of pulmonary infection induced by intravenous injection of heroin].

OBJECTIVE: To investigate spiral CT findings of pulmonary infection induced by intravenous injection of heroin. METHODS: The clinical data and spiral CT findings of 21 patients with pulmonary infection due to intravenous injection of heroin were analyzed retrospectively. RESULTS: Pulmonary lesions were detected in all these cases in the initial examination by spiral CT plain scan, including pneumatocele in 13 (61.9%), pulmonary cavity in 13 (61.9%), pulmonary consolidation in 15 (71.4%), and plural lesions in 8 cases (38.1%) of which 7 (33.3%) had plural effusion and 1 (0.48%) had encapsulated hydropneumothorax. Three cases had only one of the lesions and 18 had at least 2 of them. The CT images in each case were compared with X-ray film, and the latter displayed abnormalities in 20 cases (95.2%). X-ray failed to detect the lesions in 1 case (4.8%), in which pneumatocele was found in CT images. CONCLUSION: The pulmonary lesions of pulmonary pneumatocele, cavity, consolidation, and plural lesions are specific CT manifestations of hematogenous pulmonary suppurative infection induced by intravenous injection of heroin.