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Epidemiology of Congenital Heart Defects (CHD): Results from a Prospective,Population-Based Cohort Study (EPICARD) 先天性心脏缺陷(CHD)的流行病学:基于人群的前瞻性队列研究(EPICARD)结果
Pub Date : 2017-09-05 DOI: 10.4172/2167-0897.1000253
N. Lelong, F. Goffinet, B. Khoshnood
The purpose of this article is to provide a summary of the initial, published results of a large, prospective, population-based cohort study of children with structural congenital heart defects in France. We also discuss the current and future work to be done in this study
这篇文章的目的是对法国结构性先天性心脏缺陷儿童的一项大型、前瞻性、基于人群的队列研究的初步发表结果进行总结。最后讨论了本研究当前和未来需要做的工作
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引用次数: 1
Immigrant Newborn and Physiological Jaundice 移民新生儿与生理性黄疸
Pub Date : 2017-07-10 DOI: 10.4172/2167-0897.1000258
A. Zuppa, M. Cavani, R. Riccardi, P. Catenazzi, Alma Iafisco, G. Vento
Objective: In Italy there are a growing number of infants born to non-Italian mothers. The aim of this study is to analyze the physiological trend of bilirubin in newborns from South-east Asia and South America, compared to Italian newborns. Method: 60 newborns were enrolled: 20 Italian newborns, 20 South American newborns, 20 Southeast Asian newborns. All babies were born from normal pregnancies, delivered vaginally. There was no AB0 and Rh incompatibility. Daily total serum bilirubin (TSB) levels were the main outcome. Results: The bilirubin reached the peak on the third day of life in the Italian group (9.5 ± 2.7 mg/dL); on the fourth day of life in the Southeastern Asian group (9.9 ± 3.0 mg/dL) and on the fifth day of life in the South American group (10.9 ± 2.4 mg/dL). On the fifth, sixth and seventh day of life South American newborns had significantly higher TSB levels compared to the Italian group and to the Southeastern Asian group. Conclusion: The higher and delayed peak of bilirubin level in infants from Southeastern Asia and South America has epidemiological and health-care consequences. Dedicated nomograms should be processed to avoid the overtreatment and the discharge of newborns with a higher and later peak of bilirubin.
目的:在意大利,越来越多的婴儿是由非意大利母亲所生。本研究的目的是分析东南亚和南美新生儿与意大利新生儿胆红素的生理趋势。方法:纳入60例新生儿:意大利新生儿20例,南美新生儿20例,东南亚新生儿20例。所有的婴儿都是正常怀孕,顺产的。AB0和Rh不相容。每日血清总胆红素(TSB)水平是主要观察指标。结果:意大利组在出生第3天胆红素达到峰值(9.5±2.7 mg/dL);东南亚组为(9.9±3.0 mg/dL),南美组为(10.9±2.4 mg/dL)。在出生后的第5天、第6天和第7天,南美洲新生儿的TSB水平明显高于意大利组和东南亚组。结论:东南亚和南美地区婴儿胆红素峰值升高和峰值延迟具有流行病学和卫生保健意义。应处理专用图,以避免过度治疗和新生儿出院时胆红素峰值较高、较晚。
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引用次数: 1
Assessment of Fetal Lung Maturity by Lamellar Body Count (LBC) in Comparison to the Fluorescence Polarization TDx FLM-II and L/S Ratio Methods 用板层体计数(LBC)评价胎儿肺成熟度与荧光偏振TDx FLM-II和L/S比值法的比较
Pub Date : 2017-05-22 DOI: 10.4172/2167-0897.1000256
C. Williams, Pascale Akl, K. Blick
Respiratory distress syndrome causes morbidity and mortality of the newborn and is most often associated with premature birth. Laboratory testing can be helpful in establishing fetal lung maturity (FLM) status in situations when premature delivery may be necessary. In addition, the rising incidence of late-preterm births at >34 and =50 k/mm3.
呼吸窘迫综合征导致新生儿发病和死亡,最常与早产有关。实验室测试可以帮助建立胎儿肺成熟度(FLM)状态的情况下,早产可能是必要的。此外,晚期早产的发生率在bbb34和=50 k/mm3之间不断上升。
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引用次数: 0
Sacrococcygeal Teratoma - An Interesting Case and Infrequently seen Extension in Spinal Cord 骶尾骨畸胎瘤-一个有趣的病例和罕见的脊髓延伸
Pub Date : 2017-04-29 DOI: 10.4172/2167-0897.1000255
D. Sharma, S. Murki, T. Pratap
A male baby of 2.6 kg was born to Gravida2Para0Abortion1 mother through normal vaginal delivery at 33 weeks of gestation. Baby had normal Apgar score of 8/9/9 at one, five and ten minutes respectively. At birth baby was noticed to have large swelling in the sacrococcygeal region which was approximately having the size of 10*2 cm, with solid consistency and erythematous.
在妊娠33周时,一位孕妇通过阴道顺产产下一名体重2.6公斤的男婴。婴儿在1分钟、5分钟和10分钟时的Apgar评分为8/9/9。出生时发现婴儿骶尾骨区有大肿胀,大小约为10*2 cm,呈实性粘稠度和红斑。
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引用次数: 0
Incidence and Risk Factor of Permanent Hypothyroidism in Preterm Infants 早产儿永久性甲状腺功能减退症的发病率及危险因素
Pub Date : 2017-04-15 DOI: 10.4172/2167-0897.1000254
M. Chung
Background: To investigate the incidence and risk factors of permanent hypothyroidism in premature infants diagnosed with congenital hypothyroidism. Methods: A retrospective review of medical records of preterm infants was performed between March 2010 and December 2013. We included infants who were treated with thyroxine after being diagnosed with congenital hypothyroidism and persistent hyperthyrotropinemia. Exclusion criteria included an infants who were lost to follow up or earlier discontinuation of thyroxine medication and had proven permanent hypothyroidism. We performed trial offtherapy at 36 months of age. Results: A total of 49 infants were eligible for trial off-therapy at age 3 years. Permanent and transient hypothyroidism was diagnosed in 12 and 37 infants, respectively. Persistent hypothyroidism was more frequent in the infants with high TSH and low FT4 levels at initial screening and high incidence in abnormalities in thyroid imaging work-ups and positive anti-thyroid antibodies. Moreover, the average thyroxine dosage during follow-up was significantly higher in infants with persistent hypothyroidism (p<0.05). Conclusion: Thyroid dysfunction is common in preterm infants, and nearly 80% of infants showed transient hypothyroidism. Therefore, if there is no other risk factor for permanent hypothyroidism, it is possible to consider an earlier trail off- therapy for preterm infants.
背景:研究被诊断为先天性甲状腺功能减退症的早产儿发生永久性甲状腺功能低下的发病率和危险因素。方法:对2010年3月至2013年12月期间早产儿的医疗记录进行回顾性审查。我们纳入了在被诊断为先天性甲状腺功能减退症和持续性高甲状腺素血症后接受甲状腺素治疗的婴儿。排除标准包括一名因随访或提前停用甲状腺素药物而丢失的婴儿,该婴儿已被证明患有永久性甲状腺功能减退症。我们在36个月大时进行了非治疗试验。结果:共有49名婴儿在3岁时有资格接受非试验性治疗。分别在12名和37名婴儿中诊断出永久性和短暂性甲状腺功能减退症。持续性甲状腺功能减退在初次筛查时TSH高、FT4低的婴儿中更为常见,甲状腺成像检查异常和抗甲状腺抗体阳性的婴儿发病率较高。此外,患有持续性甲状腺功能减退症的婴儿在随访期间的平均甲状腺素剂量显著较高(p<0.05)。结论:甲状腺功能障碍在早产儿中很常见,近80%的婴儿表现为短暂性甲状腺功能低下。因此,如果没有其他导致永久性甲状腺功能减退的危险因素,可以考虑对早产儿进行早期的试验治疗。
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引用次数: 3
Reducing Adverse Effects of Antenatal Magnesium Therapy for Neuroprotection: Tailoring Treatment to the Intended Recipient 减少产前镁治疗对神经保护的不良反应:针对预期受试者的量身定制治疗
Pub Date : 2017-03-25 DOI: 10.4172/2157-7552.1000252
D. Narasimhulu, S. Rastogi
Magnesium sulfate is widely administered to pregnant women at risk of preterm delivery for neuroprotection. However, there are no uniform guidelines in the dosing protocol for magnesium use. While antenatal magnesium therapy reduces the risk of cerebral palsy and gross motor dysfunction, adverse neonatal outcomes related to magnesium have been reported by some, and are the subject of considerable debate. There may be a therapeutic window within which the neuroprotective effects of magnesium sulfate are observed, with adverse neonatal outcomes at levels outside this window. Magnesium sulfate is one of few drugs currently administered in a “one dose fits all” regimen, without taking into account maternal or fetal parameters. While the mother is monitored and her dose is adjusted as needed, the fetus is not monitored (neither in utero nor in the NICU). Inability to monitor the fetal magnesium concentration while in utero may be countered by identifying variables that influence fetal serum magnesium levels and attempting to adjust the maternal dose accordingly. Further studies with larger sample sizes are needed to determine the optimal dose of maternal magnesium to provide fetal neuroprotection or maternal seizure prophylaxis with minimal neonatal adverse outcomes. It may be possible that monitoring neonatal serum magnesium concentrations and treating neonates with high levels may impact their outcomes and this is an option that needs to be explored.
硫酸镁被广泛用于有早产风险的孕妇,用于神经保护。然而,在镁使用的给药方案中没有统一的指导方针。虽然产前镁治疗可以降低脑瘫和严重运动功能障碍的风险,但一些人报告了与镁相关的新生儿不良结局,这也是一个值得争论的话题。可能存在一个治疗窗口,在该窗口内可以观察到硫酸镁的神经保护作用,而新生儿的不良结局则处于该窗口外的水平。硫酸镁是目前为数不多的在不考虑母体或胎儿参数的情况下以“一刀切”方案给药的药物之一。在监测母亲并根据需要调整剂量的同时,不监测胎儿(无论是在子宫内还是在新生儿重症监护室)。无法在子宫内监测胎儿镁浓度可以通过识别影响胎儿血清镁水平的变量并尝试相应地调整母体剂量来解决。需要进行更大样本量的进一步研究,以确定母体镁的最佳剂量,从而在新生儿不良后果最小的情况下提供胎儿神经保护或母体癫痫预防。监测新生儿血清镁浓度和治疗高水平的新生儿可能会影响他们的结果,这是一个需要探索的选择。
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引用次数: 1
Mastitis Neonatorum: An Interesting and Uncommon Condition Seen in Infants 新生儿乳房炎:一种有趣而罕见的婴儿疾病
Pub Date : 2017-03-17 DOI: 10.4172/2157-7552.1000251
D. Sharma, S. Murki, T. Pratap
A 21 day old male infant was admitted to NICU with swelling of right breast and fever from last 3 days. Baby had documented fever of 101oF at the time of admission. Baby was exclusively breast feed with no history of decrease acceptance of feed.
1例21日龄男婴因右乳肿胀及近3天发热入住新生儿重症监护病房。入院时,婴儿高烧101华氏度。婴儿是纯母乳喂养,没有接受饲料减少的历史。
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引用次数: 4
Incidence and Magnetic Resonance Imaging 发病率和磁共振成像
Pub Date : 2017-02-28 DOI: 10.4172/2167-0897.1000250
I. Markovic, Z. Milenkovic
Holoprocencephaly (HPE) is a developmental anomaly featured by a failure in differentiation and cleavage of the prosencephaly resulting in incomplete separation of the two hemispheres. In almost 80% of individuals it is accompanied by specific craniofacial anomalies. Both genetic and teratogen factors are responsible for the development of HPE [1]. Rare in absolute terms, HPE is the most common brain abnormality and is seen in 1 per 8000-16,000 live births [2-4]. In an analysis of 21 HPE epidemiologic articles Orioli IM and Castilla EE [5] found that the pregnancy outcomes had relevant impact on the incident rate of HPE, being lower than 1 per 10,000 in live and stillbirth and between 40-50 per 10000 in aborted embryos. In a large series of 4,157,224 births, the same authors observed 370 infants with suspected holoprosencephaly (0,009%) stressing that isolated HPE was homogeneous among the 11 sampled countries, increasing from 0.5/10,000 births to 1/10,000 births between 1967 and 2000% [6]. The early embryonic occurrence may be even higher with prevalence of 1:250 in embryos [7] but may not be detected due to most fetuses aborting in early gestation [2]. In our small series of 4000 MRI explorations in children of different ages (from newborns to 15 years old) only three cases harboring HPE were diagnosed, accounting for almost 0.05%. Even though, the holoprosencephaly has been divided into three categories (alobar, semilobar and lobar) and a clear distinction between them does not exist. However, another two categories have been added to the previous one: the middle interhemispheric fusion variant (MIHF/MIHV or syntelencephaly [8] and a septopreoptic type [9]. Alobar HPE is a rare and the most severe congenital malformation, usually diagnosed by prenatal ultrasound, rarely postnattally by CT or MRI, because the infant is most often stillborn. There is no separation of cerebral hemisphere with only one large ventricle and failure of transverse cleavage into diencephalon and telencephalon. Semilobar HPE, less dysmorphic then alobar (HPE), has both the frontal and parietal lobes completely fused and interhemispheric fissure exist posteriorly. The concomitant anomalies might be microcephaly, macrocephaly, motor abnormalities such as choreoathetosis or lower extremity spasticity.
全前脑畸形(HPE)是一种发育异常,其特征是前脑分化和切割失败,导致两个半球不完全分离。在几乎80%的个体中,它伴有特定的颅面异常。遗传和致畸因素都是HPE发生的原因[1]。HPE绝对罕见,是最常见的大脑异常,每8000-16000例活产中就有1例出现[2-4]。在对21篇HPE流行病学文章的分析中,Orioli IM和Castilla EE[5]发现,妊娠结局对HPE的发生率有相关影响,在活产和死产中低于1/10000,在流产胚胎中低于40-50/10000。在一系列4157224名新生儿中,同一作者观察到370名疑似无前脑畸形的婴儿(0009%),强调在11个抽样国家中,孤立的HPE是同质的,在1967年至2000%之间,从0.5/100000名新生儿增加到1/10000名新生儿[6]。早期胚胎的发生率可能更高,胚胎中的发生率为1:250[7],但由于大多数胎儿在妊娠早期流产,可能无法检测到[2]。在我们对不同年龄(从新生儿到15岁)的儿童进行的4000次MRI小系列检查中,只有三例被诊断为HPE,几乎占0.05%。尽管如此,前脑无裂被分为三类(alobar、semilobar和lobar),它们之间并没有明确的区别。然而另外两个类别被添加到前一个类别中:中间半球间融合变体(MIHF/MIHV或同脑[8]和隔视类型[9]Alobar HPE是一种罕见且最严重的先天性畸形,通常通过产前超声诊断,很少通过产后CT或MRI诊断,因为婴儿通常是死产。大脑半球没有分离,只有一个大心室,间脑和端脑的横向切割失败。半叶HPE,比alobar(HPE)变形更小,额叶和顶叶完全融合,半球间裂存在于后方。伴随的异常可能是小头畸形、大头畸形、运动异常,如舞蹈异常或下肢痉挛。
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引用次数: 0
Arthrogryposis Multiplex Congenital: Case Report 先天性多发性关节炎1例
Pub Date : 2017-02-11 DOI: 10.4172/2167-0897.1000249
R. Achour, Sarra Amari, N. B. Jamaa, I. Ksibi, S. Kacem, K. Néji
Arthrogryposis is a syndrome that can be, seen in different diseases that have in common the existence of multiple joint stiffness. Once the diagnosis poses, the prognosis will depend on the severity of the clinical presentation and its precocity of installation. Management depends on the etiology, which makes the treatment different from one case to another. In cases of suspected Arthrogryposis, practitioners should have attention to amniotic fluid quantity, fetal motricity, swallowing movements and research an amyotrophy or abnormalities of the extremities. We report a particular case of antenatal diagnosis of Arthrogryposis with excess amniotic fluid.
关节强直是一种可在不同疾病中发现的综合征,这些疾病共同存在多发性关节强直。一旦诊断出来,预后将取决于临床表现的严重程度及其安装的早熟性。治疗取决于病因,这使得不同病例的治疗方法不同。在疑似关节炎的情况下,从业者应注意羊水量、胎儿运动、吞咽运动,并研究四肢肌萎缩或异常。我们报告了一例羊水过多的关节炎产前诊断的特殊病例。
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引用次数: 1
Umbilical Cord Clamping Time in Premature Infants 早产儿脐带夹紧时间
Pub Date : 2017-02-05 DOI: 10.4172/2167-0897.1000248
A. Gökalp, A. Günlemez, D. Oğuz
This paper provides a brief overview of benefits of delayed cord clamping according to the early clamping after birth. Introduction: Optimal timing of cord clamping has long been a controversial issue. Recently many studies have shown that delayed cord clamping leads to remarkable decreases in risks of morbidity such as intraventricular haemorrhage, necrotising enterocolitis, hypoperfusion, need for transfusion and optimal haemoglobin haematocrit levels in preterm infants. Conclusion: Delayed clamping of the umbilical cord will ensure more positive outcomes in preterm neonates.
本文简要介绍了根据出生后早期夹紧延迟脐带夹紧的好处。长期以来,脐带夹紧的最佳时机一直是一个有争议的问题。最近许多研究表明,延迟脐带夹紧可显著降低发病率的风险,如脑室内出血、坏死性小肠结肠炎、灌注不足、需要输血和早产儿最佳血红蛋白红细胞压积水平。结论:延迟脐带夹紧可以保证早产儿更多的积极结果。
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引用次数: 1
期刊
Journal of neonatal biology
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