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A case of 7q21.3q31.1 deletion in a preterm boy with feeding intolerance and cyanotic episodes 一例7q21.3q31.1缺失的早产儿出现喂养不耐受和发绀症状
IF 0.2 Pub Date : 2022-04-01 DOI: 10.4103/jcn.jcn_119_21
A. Jones
This report describes a preterm male infant with phenotypic features of mild facial dysmorphism, congenital abnormalities of the hands and feet, corneal clouding, hypertonia, bilateral sensorineural hearing loss, and bilateral ventriculomegaly. His clinical course was significant for severe cyanotic episodes associated with the advancement of feed volume. Microarray analysis identified a large constitutional de novo deletion of 7q21.3q31.1. This rare deletion has never been reported in a preterm infant, and the management of this patient will help offer clinical guidance for this genetic condition.
本报告描述了一名早产儿,其表型特征为轻度面部畸形、先天性手脚异常、角膜混浊、张力过大、双侧感觉神经性听力损失和双侧心室肥大。他的临床病程对于与进食量增加相关的严重发绀发作具有重要意义。微阵列分析确定了7q21.3q31.1的大的组成性从头缺失。这种罕见的缺失从未在早产儿中报道过,对该患者的管理将有助于为这种遗传疾病提供临床指导。
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引用次数: 0
Umbilical cord with two umbilical veins: A report of two cases 带两条脐静脉的脐带:附2例报告
IF 0.2 Pub Date : 2022-01-01 DOI: 10.4103/jcn.jcn_100_21
Bhoojata Gondi, S. Laxman, Venkata Rao Paturi, K. Maram
Umbilical cord with two umbilical veins is a rarely reported anomaly. Four-vessel cord is known to be associated with other congenital anomalies. Second umbilical vein is usually due to persistence of right umbilical vein. We report two cases of two umbilical veins; one newborn with four-vessel umbilical cord with two umbilical veins, who presented with severe pulmonary arterial hypertension, and another newborn with three-vessel umbilical cord with two umbilical veins, diagnosed to have transposition of great arteries. The presence of two umbilical veins mandates comprehensive workup to rule out other congenital anomalies. However, as highlighted by our first case, the presence of two umbilical veins is not always an ominous sign but could be seen in otherwise normal baby.
带两条脐静脉的脐带是一种罕见的异常报道。四血管脊髓已知与其他先天性异常有关。第二脐静脉通常是由于右脐静脉的延续。我们报告两例两脐静脉;一名新生儿四支脐带二静脉,表现为严重肺动脉高压,另一名新生儿三支脐带二静脉,诊断为大动脉转位。存在两个脐静脉需要全面的检查,以排除其他先天性异常。然而,正如我们的第一个病例所强调的那样,两条脐静脉的存在并不总是一个不祥的迹象,但在其他正常的婴儿中可以看到。
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引用次数: 0
>Early initiation of breastfeeding: Antenatal, peripartum, and neonatal correlates 早期开始母乳喂养:产前、围产期和新生儿相关
IF 0.2 Pub Date : 2022-01-01 DOI: 10.4103/jcn.jcn_25_21
I. Mahfouz, F. Asali, Tasneem Khalfieh, H. Saleem, Sereen Diab, Batool Samara, H. Jaber
Introduction: The World Health Organization recommends early initiation of breastfeeding (EIBF). This is because breastfeeding is important for the child's development and has maternal benefits. Current literature has focused on sociodemographic factors, and the evidence supporting antenatal, peripartum, and neonatal variables is limited and contradicting. The main aim of this study is to report the rates of early breastfeeding initiation and their antenatal, peripartum, and neonatal correlates. Materials and Methods: A prospective observational study of pregnant women who attended the labor ward of the Specialty Hospital in Amman, Jordan between September 1, 2019, and June 1, 2020, was conducted. Inclusion criteria required women to be 18 years of age or more. Demographic, antenatal, peripartum, and neonatal data were collected. The timing of breastfeeding initiation was recorded in the 1st h and between 1 and 24 h and then data were analyzed. Results: A total of 300 women were recruited with mean age of 29.5 years and mean gestational age being 38.6 weeks. In addition, breastfeeding initiation rates were 26.3% and 65.5% within the 1st h and between 1 and 24 h, respectively. Antenatal, peripartum, and neonatal variables that were associated with lower rates of EIBF (P < 0.05) include antenatal obstetrics complications, induction of labor, assisted vaginal delivery, caesarean section (CS), CS performed on maternal request, CS under general anesthesia, surgical site pain, mother's perception of inadequate pain management, preterm delivery, low Apgar scores, low birth weight, neonatal intensive care unit admission, and less frequent rooming-in. Conclusion: Rates of breastfeeding initiation within the first hour and between 1 and 24 h of delivery were 26.3% and 65.5%, respectively. Compared to antenatal variables, the peripartum and neonatal variables are more likely to have significant effects on EIBF. Therefore, more obstetric attention should focus on these factors to improve rates of initiating breastfeeding early.
简介:世界卫生组织建议尽早开始母乳喂养。这是因为母乳喂养对孩子的发育很重要,对母亲也有好处。目前的文献主要关注社会人口因素,支持产前、围产期和新生儿变量的证据有限且相互矛盾。本研究的主要目的是报告早期母乳喂养的开始率及其产前、围产期和新生儿的相关性。材料和方法:对2019年9月1日至2020年6月1日期间在约旦安曼专科医院分娩病房就诊的孕妇进行了一项前瞻性观察性研究。纳入标准要求女性年满18岁或以上。收集人口统计学、产前、围产期和新生儿数据。母乳喂养开始的时间记录在第1小时和1至24小时之间,然后分析数据。结果:共招募了300名女性,平均年龄29.5岁,平均胎龄38.6周。此外,母乳喂养开始率在1小时内和1至24小时内分别为26.3%和65.5%。与较低EIBF发生率相关的产前、围产期和新生儿变量(P<0.05)包括产前产科并发症、引产、辅助阴道分娩、剖腹产(CS)、应产妇要求进行的CS、全身麻醉下的CS、手术部位疼痛、母亲对疼痛管理不足的感知、早产、Apgar评分低,出生体重低,新生儿重症监护室入院,入住频率较低。结论:分娩后1小时内和1至24小时内开始母乳喂养的比率分别为26.3%和65.5%。与产前变量相比,围产期和新生儿变量更有可能对EIBF产生显著影响。因此,产科应更多地关注这些因素,以提高早期开始母乳喂养的比率。
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引用次数: 0
A bullous purpura triggered by warming in a newborn with congenital cytomegalovirus infection 先天性巨细胞病毒感染新生儿因体温升高引起的大疱性紫癜
IF 0.2 Pub Date : 2022-01-01 DOI: 10.4103/jcn.jcn_37_21
Luca Bonadies, N. Doglioni, E. Cuppini, C. Minotti, Eugenio Baraldi
A newborn with microcephaly presented hemorrhagic bullous purpura triggered by heat in the 1st h of life. Doppler arterial and venous ultrasound excluded vascular complications. Cytomegalovirus was detected in blood, urine, and serum of the lesions. The final diagnosis was cytomegalovirus congenital infection due to reactivation in an immune mother, with associated purpuric rash, confirmed by cerebral magnetic resonance imaging.
摘要一例新生儿小头畸形,在出生后1小时出现热致出血性大疱性紫癜。多普勒动脉和静脉超声排除血管并发症。在病变的血液、尿液和血清中检测到巨细胞病毒。最终诊断为巨细胞病毒先天性感染,由于免疫母亲的再激活,并伴有紫癜疹,经脑磁共振成像证实。
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引用次数: 0
Respiratory patterns in neonates hospitalized with brief resolved unexplained events 因短暂原因不明事件住院的新生儿的呼吸模式
IF 0.2 Pub Date : 2022-01-01 DOI: 10.4103/jcn.jcn_69_21
K. Mirnia, M. Kadivar, Razieh Sangsari, M. Saeedi, M. Kaveh, M. Maleki, Rangarirai Makuku
Objective: The objective of this study is aimed at investigating and evaluating respiratory patterns between infants hospitalized with brief resolved unexplained event (BRUE) and the control group. Methods: A convenient sampling method was used to select 52 patients presented at an urban, tertiary, and teaching pediatric hospital fitting the American Academy of Pediatrics' criteria of a lower-risk BRUE from December 2019 to December 2020. A random probability sampling method was used to select 52 patients as a control group. A NINIX apnea monitoring device was used to record respiratory time patterns and analyzed with SPSS 25. Results: A total of 104 participants participated in the study. Our study found that inspiration time (0.31 ± 0.04), expiratory time (0.93 ± 0.14), respiratory rate (38.48 ± 4.38), body temperature (37.11 ± 0.20), and heart rate (137.90 ± 6.60) were not statistically different between both groups. Mean birth weight in the control group and BRUE were respectively (3.43 ± 0.39, 3.23 ± 0.35). Mean gestational age in the control and BRUE groups were respectively (38.94 ± 1.01, 39.0 ± 1.04). Mean postnatal age in the control and BRUE groups were respectively (17.19 ± 6.07, 17.32 ± 7.35). Birth weight (P = 0.08) was statistically significant between both groups. In one patient, we recorded breath arrest for more than 20 s. Conclusion: There were no significant differences in respiratory patterns between infants hospitalized with BRUE and the control group. Low birth weight and low APGAR score are possible risk factors for infants experiencing BRUE, and more investigations are required to establish underlying causes.
目的:本研究的目的是调查和评估短期解决不明原因事件(BRUE)住院婴儿与对照组的呼吸模式。方法:采用方便的抽样方法,选择2019年12月至2020年12月在符合美国儿科学会低风险布鲁尔标准的城市、三级和教学儿科医院就诊的52例患者。采用随机概率抽样方法,选取52例患者作为对照组。采用NINIX呼吸暂停监护仪记录呼吸时间模式,并用SPSS 25进行分析。结果:共104名受试者参与研究。两组患者吸气时间(0.31±0.04)次、呼气时间(0.93±0.14)次、呼吸频率(38.48±4.38)次、体温(37.11±0.20)次、心率(137.90±6.60)次差异无统计学意义。对照组平均出生体重为(3.43±0.39),BRUE为(3.23±0.35)。对照组和BRUE组的平均胎龄分别为(38.94±1.01,39.0±1.04)。对照组和BRUE组的平均出生年龄分别为(17.19±6.07)、(17.32±7.35)。两组出生体重差异有统计学意义(P = 0.08)。在一个病人中,我们记录到呼吸停止超过20秒。结论:BRUE住院患儿的呼吸方式与对照组无显著差异。低出生体重和低APGAR评分可能是婴儿发生BRUE的危险因素,需要更多的调查来确定根本原因。
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引用次数: 0
Minimally or less invasive surfactant replacement therapy in neonates: A narrative review 微创或微创表面活性剂替代治疗在新生儿:叙述回顾
IF 0.2 Pub Date : 2022-01-01 DOI: 10.4103/jcn.jcn_2_21
Gengaimuthu Karthikeyan
Surfactant replacement therapy is a major cornerstone in the successful management of neonates with respiratory distress syndrome. Until recently, the INtubate, SURfactant, Extubate protocol was the best a trade-off achieved to deliver the surfactant to the air exchanging respiratory epithelium against the barotrauma of prolonged intubation and ventilation. Minimal or Less Invasive Surfactant Therapy (MIST or LISA) was adapted in clinical practice as a gentler and a gentler way of delivering surfactant. LISA or MIST is associated with a significant reduction in the oxygen days and chronic lung disease, intraventricular hemorrhage of grade 2 or above, retinopathy of prematurity and other key neonatal outcomes. This translates into shortened neonatal intensive care unit stay and a significant reduction in the stress levels of neonatal nurses, parents, and caregivers. This procedure needs to be performed by skilled professionals with appropriate training to achieve the desired results.
表面活性剂替代疗法是成功治疗新生儿呼吸窘迫综合征的主要基石。直到最近,INtubate、SURfactant、Extubate方案是将表面活性剂输送到空气交换呼吸上皮以对抗长期插管和通气带来的压力创伤的最佳折衷方案。微创或微创表面活性剂治疗(MIST或LISA)在临床实践中被认为是一种更温和、更温和的表面活性剂输送方式。LISA或MIST与氧气天数和慢性肺病、2级或以上脑室出血、早产视网膜病变和其他关键新生儿结局的显著减少有关。这意味着缩短了新生儿重症监护室的住院时间,并显著降低了新生儿护士、父母和护理人员的压力水平。该程序需要由受过适当培训的熟练专业人员执行,以达到预期效果。
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引用次数: 0
Recurrent, persistent pneumothorax in a neonate: A cryptic cause 新生儿复发性持续性肺气肿:一个神秘原因
IF 0.2 Pub Date : 2022-01-01 DOI: 10.4103/jcn.jcn_133_21
S. Hegde, S. Mohanty, Bharathi Balachander, A. Shubha
Newborns, especially preterms, have a higher risk of developing pneumothorax. We report a 33-week preemie who presented with recurrent, persistent right pneumothorax, which failed to resolve with standard treatment. The child underwent surgical removal of a suspect nonexpanding upper lobe of the right lung with clinical improvement. Histopathology was atypical but nearly consistent with congenital pulmonary airway malformation (CPAM). This report highlights the clinicopathological discordance noted and aims to draw an embryological explanation toward the atypical histomorphology of CPAM in preemies.
新生儿,尤其是学龄前儿童,患上肺气肿的风险更高。我们报告了一例33周的早产儿,其表现为复发性、持续性的右侧肺气肿,但未能通过标准治疗解决。这名儿童接受了可疑的右肺上叶切除手术,临床情况有所改善。组织病理学不典型,但与先天性肺气道畸形(CPAM)几乎一致。本报告强调了注意到的临床病理不一致,旨在对早产儿CPAM的非典型组织形态学做出胚胎学解释。
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引用次数: 0
Spontaneous skull fracture in a term infant 足月婴儿自发性颅骨骨折
IF 0.2 Pub Date : 2022-01-01 DOI: 10.4103/jcn.jcn_109_21
Wegdan Mawlana, M. Gharib, A. Osman
Instrumental delivery is the most common cause of skull fracture in neonates. We report a depressed fracture with massive intracranial hemorrhage in a term female infant born by unassisted cesarean section after unremarkable pregnancy.
器械分娩是新生儿颅骨骨折最常见的原因。我们报告一例凹陷性骨折伴大量颅内出血的足月女婴儿,在妊娠后无辅助剖宫产。
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引用次数: 0
Assessment of gestational age by new-born joint angles 新生儿关节角度对胎龄的评估
IF 0.2 Pub Date : 2022-01-01 DOI: 10.4103/jcn.jcn_116_21
A. Nandy, T. Mondal, Divyoshanu M Ivan, Tapti Sengupta, Sanjusree Das, D. Goldar, A. Hazra, R. Mondal
Objective: We aimed to measure the joint angles of major joints in newborn babies to explore their association with gestational age (GA). Materials and Methods: This observational study was conducted to evaluate joint angles in healthy newborn infants, born between 28 and 41 completed weeks of gestation. Healthy and hemodynamically stable babies were selected by purposive sampling up to the 2nd day of life. Six major joints of upper and lower limbs (shoulder, elbow, wrist, hip, knee, and ankle) were assessed on either side. The joint angles and range of motion (ROM) achieved through predefined passive movements were measured by a single observer using a manual acrylic goniometer. The positioning of the joints during measurement was standardized. Results: A total of 433 newborn babies, belonging to different GA, were evaluated. The joint angles and ROM did not show any significant differences between right and left sides and between male and female babies. The ROM of flexion-extension and adduction-abduction movement at shoulder, angle of palmer-flexion at wrist, and angle of dorsiflexion at ankle, were observed to correlate strongly with GA (correlation coefficient r of –0.75, –0.74, –0.73, and –0.73, respectively). The relationships were inverse. A mathematical model based upon multiple regression analysis is proposed to predict GA from these four measurements. Conclusions: Structured clinical assessment of major joint angles in newborn babies has the potential to provide relatively precise estimation of GA, which may be used to add accuracy to modified New Ballard Score.
目的:测量新生儿主要关节的关节角度,探讨其与胎龄(GA)的关系。材料和方法:本观察性研究旨在评估健康新生儿的关节角度,这些新生儿出生于孕28至41周。通过有针对性的采样选择健康且血流动力学稳定的婴儿,直到出生第2天。对两侧上肢和下肢的六个主要关节(肩、肘、腕、髋、膝和踝)进行了评估。通过预定义的被动运动实现的关节角度和运动范围(ROM)由单个观察者使用手动丙烯酸测角仪测量。测量过程中接头的定位是标准化的。结果:共对433名新生儿进行了评估,他们属于不同的GA。关节角度和ROM在左右两侧以及男性和女性婴儿之间没有显示出任何显著差异。肩部屈伸和内收外展运动的ROM、手腕手掌屈曲角度和脚踝背屈角度与GA密切相关(相关系数r分别为-0.75、-0.74、-0.73和-0.73)。这种关系是相反的。提出了一个基于多元回归分析的数学模型来预测这四个测量值的遗传算法。结论:新生儿主要关节角度的结构化临床评估有可能提供相对精确的GA估计,这可用于提高改良的New Ballard评分的准确性。
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引用次数: 0
Vitamin D supplementation in the prevention of neonatal bronchopulmonary dysplasia: Is it beneficial? 补充维生素D预防新生儿支气管肺发育不良:有益吗?
IF 0.2 Pub Date : 2022-01-01 DOI: 10.4103/jcn.jcn_114_21
M. Elfarargy, G. Al-Ashmawy, Hany El Hady
Background: Neonatal bronchopulmonary dysplasia (BPD) is a chronic neonatal respiratory disease that is precipitated by prolonged oxygenation and mechanical ventilation (MV), leading to respiratory distress (RD). Aim of Study: The aim of the study is to assess the role of Vitamin D as adjuvant treatment in the prevention and management of BPD in neonates. Patients and Methods: Prospective randomized controlled trial with identification number TCTR20210622001 on 100 premature neonates who had RD and were put on MV. The examined neonates were classified into 2 groups: Group 1, which received Vitamin D (Vit D), and Group 2, which had placebo. Urinary β2-microglobulin (B2M) in addition to plasma Krebs von den Lungen-6 (KL-6) levels were measured on the 1st and the 14th day of hospitalization. Results: There was a decrease in urinary B2M and plasma KL-6 levels in Group 1, if compared with Group 2 neonates (P < 0.05). There was a decrease in hospitalization in Group 1 neonates (P < 0.05). Group 1 neonates showed a decrease of the developed BPD cases (P < 0.05). Conclusion: Vit D supplementation may help in the prevention of BPD in neonates, but further studies with larger number of neonates should be done. Recommendation: Routine Vit D supplementation in a dose of 800 IU to preterm who are susceptible to develop BPD.
背景:新生儿支气管肺发育不良(BPD)是一种慢性新生儿呼吸系统疾病,由长期氧合和机械通气(MV)引起,导致呼吸窘迫(RD)。研究目的:本研究的目的是评估维生素D作为辅助治疗在新生儿BPD预防和管理中的作用。患者和方法:识别号为TCTR20210622001的前瞻性随机对照试验,对100名患有RD并接受MV的早产儿进行研究。受试新生儿分为2组:第1组接受维生素D(Vit D)治疗,第2组接受安慰剂治疗。在住院第1天和第14天测量尿β2-微球蛋白(B2M)和血浆Krebs-von den Lungen-6(KL-6)水平。结果:与2组新生儿相比,1组新生儿尿B2M和血浆KL-6水平下降(P<0.05)。1组新生儿住院率下降(P>0.05),但还需要对更多新生儿进行进一步的研究。建议:对易患BPD的早产儿常规补充维生素D,剂量为800IU。
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引用次数: 0
期刊
Journal of Clinical Neonatology
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