Renal insufficiency in the neonatal period

The fatty acid composition of plasma membranes in the placenta of induced-pregnancy females with ovarian hypofunction was studied Palmitic, stearic, and oleic acids were prevalent in the placental membranes. The content of arachidonic acid was higher that of linoleic acid which was in greater qualities in the membranous lipids of other tissues than arachidonic acid. The changes found in the fatty acid composition of placental membranous phospholipids were associated with the deviations in the levels of this organ-specific hormones progesterone and placental lactogen.     

Vocal dialogues in the neonatal period.

63 mothers and their 3-day-old infants were observed during breast feeding. The analysis of dyadic vocal interaction suggested that during the neonatal period, the infant's vocalization is already responsive to both presence and absence of maternal vocalization. Maternal vocalization was shown to be responsive to antecedent vocal behavior of the newborn. No sex differences were found in the patterns of sequential vocal exchanges at this period. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interventricular communication in the neonatal period]

Fe(II)-tetrakis-N,N,N',N'(2-pyridylmethyl) ethylenediamine (Fe-TPEN) catalyzes the dismutation of superoxide, and blocks the toxic effect of paraquat on Escherichia coli growth and survival. We examined antioxidative effects of Fe-TPEN on lipid peroxidation and t-butyl hydroperoxide induced cell damage. Fe-TPEN inhibited the FeSO4/H2O2 induced lipid peroxidation in the rat liver homogenates with an IC50 value of 30.2 microM, and protected Ac2F cell damage by t-butyl hydroperoxide in a dose-dependent manner (EC50 value is 2.6 microM). Also, hepatoprotective effect of Fe-TPEN (5 mg/kg, i.p.) was investigated using CCl4 induced liver injury in rats. This complex inhibited the elevation of serum alanine aminotransferase (AST) and aspartate aminotransferase (ALT) levels in CCl4 induced liver injuries, and improved submassive necrosis and fatty degeneration of the hepatocytes. Fe-TPEN also prevented the loss of total and nonprotein SH contents, glutathione peroxidase and glutathione-S-transferase activity in cytosol of rat liver. Although the exact mechanism of action is not clear, antioxidative properties as well as attenuation of hepatocellular defense systems by Fe-TPEN seem to be important on its potent hepatoprotective effect in CCl4-intoxicated rat.     

Prevalence of gallstones in the neonatal period]

The prevalence of infection with Mycobacterium avium complex (MAC) has increased since the outbreak of the HIV pandemic. This complex comprises two organisms: M. avium (mostly) and M. intracellulare (rarely). The source of MAC infection is not known. The principal risk factors for disseminated MAC infection in a patient with HIV infection are a low CD4 count and a previous opportunistic infection. The symptoms of disseminated MAC infection resemble those of HIV wasting; a positive culture of normally sterile tissue confirms a MAC infection. There is reserve with regard to routine prophylaxis in HIV-infected persons because of the possible development of resistance, interaction with other drugs used in AIDS, toxicity and possible absorption disorders which might cause prophylaxis to fail. For the treatment of disseminated MAC infection, a combination of at least two medicaments (macrolides and ethambutol) is recommended.     

Etiology of convulsions in neonatal and infantile period

The toxicity of pentobarbital was examined in male Wistar rats pretreated with a non-toxic dose of imipramine (10 mg/kg, po). Pentobarbital (70 mg/kg, ip) lethality was enhanced up to 6 hr after imipramine administration, and pentobarbital (45 mg/kg, ip) sleeping time was prolonged up to 12 hr after imipramine. Physiological measurements showed that imipramine pretreatment 2 hr prior to pentobarbital (70 mg/kg, ip) enhanced barbiturate depression in mean blood pressure, oxygen consumption and respiration rate, but not in heart rate or back skin temperature. Analysis of brain radioactivity after [14C] pentobarbital indicated that these effects of imipramine were not solely the result of inhibition of liver metabolism.     

Congenital malformations presenting during the neonatal period

Discharge of the newborn within 24 to 48 hours after birth makes it more difficult to detect some congenital malformations and increases the need for careful examination and review of the history of the pregnancy, delivery, and nursery course. Progressive physiologic changes after birth, especially in the cardiovascular system, precede the development of signs indicative of disease for certain congenital malformations. Discharge before these changes occur may delay their detection because the newborn is not being monitored by medical or nursing caregivers. The AAP Committee on the Fetus and Newborn has published guidelines for criteria for safe discharge and follow-up evaluation to help create a safe situation for such early discharges. Some specific observations at birth may lead to earlier diagnosis. Careful attention to subtle differences between the initial and follow-up examination, such as a changing cardiac murmur or quality of pulses or abdominal fullness, may provide clues to the diagnosis of congenital malformations. Coordinated suck and swallow with successful feeding and passage of stool and urine within 24 hours after birth should occur before discharge. Reports of feeding difficulties should be reviewed. Although a thorough examination is facilitated by a sleeping infant, documentation of a normal pitched cry helps in the evaluation of the upper airway. Parents should be counseled about signs of illness that warrant medical attention, and early follow-up is needed to detect problems early enough to intervene effectively. In addition, although passage of a feeding tube through each nare and to the stomach with aspiration and measurement of gastric volume is not a routine procedure in the well, term newborn, this may be a useful early diagnostic tool in infants with signs or a maternal or nursery history suggestive of nasal or GI obstruction.     

Mucoviscidosis with respiratory symptomatology in the neonatal period]

A case of cystic fibrosis presented in the neonatal period with respiratory symptomatology associated with early pancreatic insufficiency is reported. The CFTR gene molecular analysis was found to be a compound heterozygotes for delta F508 and G542X. The rarity of this mode of presentation and the inclusion of this entity in the differential diagnosis for neonatal respiratory distress syndrome is emphasised. The pathogenesis and some therapeutic aspects carried out in our patient, which might have improved the life expectancy of patients with this disease, are discussed.     

Development of a cavernous malformation of the brain

We report the appearance of a cavernous malformation associated with a developmental venous anomaly in a young boy 3 years after radiation therapy for a posterior fossa medulloblastoma. The presence of a stenosis of the venous drainage of the anomaly led us to postulate that venous restrictive disease, induced by radiation therapy, resulted in increased venous pressure and caused the formation of the cavernous malformation.     

Gelastic Epilepsy. Onset in neonatal period

The phenomenon of gelastic epilepsy was first described in 1873, yet fewer than 100 patients with this disorder have been reported on to date. The purpose of this article is to report on the first two patients to our knowledge with the onset of these seizures in the immediate neonatal period. Both patients have been shown to have posterior hypothalamic mass lesions presumably of congenital origin, and have remained free of neurologic progression of the disease with conservative treatment.     

Temperament stability between the neonatal period and 24 months.

The predictive relation between neonatal behavior and temperament at 24 months was examined for 67 infants. Behaviors rated by trained examiners at both ages were aggregated into composite scores to provide a more reliable indicator of individual differences than single-item scores. Longitudinal analyses revealed several significant relations between the two ages, most notably that irritable neonates were rated as more upset, less attentive to stimuli, and less responsive to the staff at 24 months. The common variable describing behavior at both ages was related to emotionality. Examination of extreme groups on ratings of emotional tone indicated that the distressed toddler had high irritability ratings as a neonate, but the more pleasant toddler was not different from the average group in neonatal irritability scores. It was concluded that a modest predictive relation between temperament variables was demonstrated from the neonatal period to 24 months. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changes in the activation markers of blood coagulation and fibrinolysis in the neonatal period

BACKGROUND: Activation markers of the clotting and fibrinolytic systems are elevated immediately after birth and decline to near adult levels during the first 24 hours of life. The aims of this study were to investigate, whether the activation of both clotting and fibrinolysis is dependent on the mode of delivery, and to measure activation markers in newborns with infection beyond the first days of life. PATIENTS: We have studied activation markers thrombin-antithrombin III complex, prothrombin fragment 1 + 2, D-dimer and plasmin-antiplasmin complex by use of commercially available ELISA techniques in 20 newborns after elective Cesarean sections because of previous sections, in 20 newborns after Cesarean sections and a trial of labor with uterine contractions over a period of > 20 hours and in 20 newborns (34.-41. gestational week) aged 10-25 days with infection. 20 healthy adults served as controls. RESULTS: A significant elevation of all activation markers was observed both in the newborns after Cesarean sections and in the 10-25 days old children with infection. There were no differences among newborns after elective sections compared to newborns after section and a trial of labor with uterine contractions over a period of > 20 hours. CONCLUSIONS: The clotting and fibrinolytic systems reveal increased activation immediately after delivery, but uterine contractions over a period of > 20 hours seem not to make a difference. During infection, the activation markers of the hemostatic system in newborns aged 10-25 days behaves similarly to the mature adult system.     

Sleep and breathing disorders in patients with brain stem lesions

Most information about the structures within the brain stem that modulate respiration and sleep are gathered from animal experiments. Therefore we examined 10 patients several weeks after an infarction of the brain stem by means of polysomnography and tested the chemosensitive drives of respiration. None of these patients complained about symptoms of sleep disordered breathing. In each case polysomnographic measurements and ventilatory response curves revealed pathologic findings. The respiratory response to CO2 was diminished or completely abolished in each patient. In some cases hypoventilation or disturbances of the respiratory rhythmicity could be seen. In several cases missing REM sleep, sleep fragmentation or the reduction of slow wave sleep were observed. The study indicates that on the base of results from animal research the comparison of morphological and pathophysiological data is helpful to gain a better understanding on the coupling of the respiratory system with sleep at the brain stem level as well as on the pathomechanism of sleep related breathing disorder.     

Metabolic consequences of different perioperative fluid therapies in the neonatal period

The rat CNS has been previously shown to synthesize pregnenolone (PREG) and to convert it into progesterone (PROG) and some of its 5 alpha-reduced metabolites. However, the brain cell types involved in the metabolic conversions of PREG are poorly known. Selective conditions were used to obtain purified cultures of neurons and astrocytes from mouse or rat fetal striatum and cerebral cortex. Neurons converted PREG to only one identified metabolite, 20 alpha-dihydro PREG, whereas astrocytes converted PREG also to PROG, 5 alpha-dihydro PROG, and 3 alpha (3 beta)-5 alpha-tetrahydro PROG. Therefore, astrocytes can convert the neurosteroid PREG into the steroid hormone PROG and the neuromodulatory steroid 3 alpha, 5 alpha-tetrahydro PROG, whereas neurons lack the delta 5-3 beta-hydroxysteroid dehydrogenase isomerase activity (and cholesterol side-chain cleavage activity), necessary for the biosynthesis of PROG. Provision of steroid substrates is another example of cross-talk between glial cells and neurons.     

Prenatal tobacco exposure: Developmental outcomes in the neonatal period.

Smoking during pregnancy is a persistent public health problem that has been linked to later adverse outcomes. The neonatal period—the first month of life—carries substantial developmental change in regulatory skills and is the period when tobacco metabolites are cleared physiologically. Studies to date mostly have used cross-sectional designs that limit characterizing potential impacts of prenatal tobacco exposure on the development of key self-regulatory processes and cannot disentangle short-term withdrawal effects from residual exposure-related impacts. In this study, pregnant participants (N = 304) were recruited prospectively during pregnancy, and smoking was measured at multiple time points, with both self-report and biochemical measures. Neonatal attention, irritable reactivity, and stress dysregulation were examined longitudinally at three time points during the first month of life, and physical growth indices were measured at birth. Tobacco-exposed infants showed significantly poorer attention skills after birth, and the magnitude of the difference between exposed and nonexposed groups attenuated across the neonatal period. In contrast, exposure-related differences in irritable reactivity largely were not evident across the 1st month of life, differing marginally at 4 weeks of age only. Third-trimester smoking was associated with pervasive, deleterious, dose–response impacts on physical growth measured at birth, whereas nearly all smoking indicators throughout pregnancy predicted level and growth rates of early attention. The observed neonatal pattern is consistent with the neurobiology of tobacco on the developing nervous system and fits with developmental vulnerabilities observed later in life. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sleep deprivation induces brain region-specific decreases in glutathione levels

Rats were deprived of sleep for 96 h by the platform technique and total glutathione (GSHtau) levels were measured in seven different brain areas. Glutathione levels were found to be significantly reduced in the hypothalamus of sleep-deprived animals when compared with large platform (-18%) or home cage (-31%) controls. Deprived rats also had reduced GSHtau levels in thalamus compared with home cage controls only. Glutathione levels did not differ among the three groups in any of the other brain areas examined. These results indicate that specific brain areas may be differentially susceptible to oxidative stress after sleep deprivation. The apparent vulnerability of the hypothalamus to these effects may contribute to some of the functional effects of sleep deprivation.