Pub Date : 2021-10-17DOI: 10.21608/anj.2021.100450.1038
N. Gomaa, Ahmed M. EL-SHEWY
Background: Retinopathy of prematurity (ROP) and Bronchopulmonary dysplasia (BPD) share the common risk factors of perinatal inflammation and oxidative stress exposure. Moreover, both diseases have a genetic background. Aim of work: is to explore the ROP prevalence and severity among preterm infants diagnosed with BPD and to identify and examine the shared risk factors. Patients and methods: This was a retrospective case-control study consisting of 44 preterm infants with BPD and 62 gestational age-matched controls. Infants’ birth and postnatal medical records were revised. Results: BPD and ROP corresponded with the duration of administration of CPAP, oxygen blender, head box, incubator oxygen, mechanical ventilation, duration of admission, oxygenation, caffeine citrate, TPN, administration and duration of inhaled steroids, inotropic support, surfactant administration, PDA, ICH, PRBCs and plasma transfusion, LOS and infectious episodes. Severe cases of ROP occurred in BPD cases, and this connection extended to varying grades in both diseases. The use of inotropic support was the most predisposing factor to BPD. By contrast, utilizing mechanical ventilation was the most predisposing factor to ROP. Conclusions: BPD and ROP share common risk factors, and there is a connection between them in regard to the varying grades of severity. Though, hemodynamic instability, longer inotropic support, hemodynamically significant PDA, prolonged mechanical ventilation act as cofactors.
{"title":"Relationship between Retinopathy of Prematurity (ROP) and Broncho-Pulmonary Dysplasia (BPD): A Retrospective-Analytical Study","authors":"N. Gomaa, Ahmed M. EL-SHEWY","doi":"10.21608/anj.2021.100450.1038","DOIUrl":"https://doi.org/10.21608/anj.2021.100450.1038","url":null,"abstract":"Background: Retinopathy of prematurity (ROP) and Bronchopulmonary dysplasia (BPD) share the common risk factors of perinatal inflammation and oxidative stress exposure. Moreover, both diseases have a genetic background. Aim of work: is to explore the ROP prevalence and severity among preterm infants diagnosed with BPD and to identify and examine the shared risk factors. Patients and methods: This was a retrospective case-control study consisting of 44 preterm infants with BPD and 62 gestational age-matched controls. Infants’ birth and postnatal medical records were revised. Results: BPD and ROP corresponded with the duration of administration of CPAP, oxygen blender, head box, incubator oxygen, mechanical ventilation, duration of admission, oxygenation, caffeine citrate, TPN, administration and duration of inhaled steroids, inotropic support, surfactant administration, PDA, ICH, PRBCs and plasma transfusion, LOS and infectious episodes. Severe cases of ROP occurred in BPD cases, and this connection extended to varying grades in both diseases. The use of inotropic support was the most predisposing factor to BPD. By contrast, utilizing mechanical ventilation was the most predisposing factor to ROP. Conclusions: BPD and ROP share common risk factors, and there is a connection between them in regard to the varying grades of severity. Though, hemodynamic instability, longer inotropic support, hemodynamically significant PDA, prolonged mechanical ventilation act as cofactors.","PeriodicalId":8054,"journal":{"name":"Annals of Neonatology Journal","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82295178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-18DOI: 10.21608/anj.2021.94162.1036
Amr Abo Eleyon Mohamed, H. El-Masry, Alaa-eldin Hassan, M. Younis, M. Aladawy, A. M. Hashem
Background: Neonatal hypothyroidism is a serious endocrinal disorder that must be diagnosed promptly to avoid irreversible neurological deficits. Aim of work: screening of all preterm infants for thyroid dysfunction. Patients and methods: All preterm infants enrolled to this study were subjected to thorough history taking and complete physical examinations. Investigations: initially screening for hypothyroidism was done according to Egyptian screening program and serum TSH, T4, and free T4 were done within the 1st week of life and repeated at the end of 2nd and 4th week of life for those with abnormal results only. Results: Abnormal thyroid function was detected in 178 (50%) preterm infants. Twenty-two infants were excluded from the study. Mean serum levels of TSH, T4 and free T4 were higher among group II infants (more mature) than 1st group (less mature). The mean levels of T4 and free T4 were higher at the end of 4th week of life than their levels during the 1st week of life. Transient hypothyroxinemia was more frequent thyroid dysfunction disorders among both groups (52.5 % and 38 % for 1st and 2nd groups respectively). Neonatal hypothyroidism, transient primary neonatal hypothyroidism, and transient hyperthyrotropinemia were detected in 9 (11.25%), 18 (22.5%), and 11 neonates (13.75%), respectively for the 1st group and observed in 7 (9.2%), 14 (18.4%), and 9 neonates (11.8%), respectively for the second group Conclusions: Thyroid dysfunction was moderately common among preterm neonates. Protocol for thyroid function tests among preterm infants is essential.
{"title":"Screening for Thyroid Dysfunction among Preterm Infants at Manfalout General Hospital, Assiut, Egypt","authors":"Amr Abo Eleyon Mohamed, H. El-Masry, Alaa-eldin Hassan, M. Younis, M. Aladawy, A. M. Hashem","doi":"10.21608/anj.2021.94162.1036","DOIUrl":"https://doi.org/10.21608/anj.2021.94162.1036","url":null,"abstract":"Background: Neonatal hypothyroidism is a serious endocrinal disorder that must be diagnosed promptly to avoid irreversible neurological deficits. Aim of work: screening of all preterm infants for thyroid dysfunction. Patients and methods: All preterm infants enrolled to this study were subjected to thorough history taking and complete physical examinations. Investigations: initially screening for hypothyroidism was done according to Egyptian screening program and serum TSH, T4, and free T4 were done within the 1st week of life and repeated at the end of 2nd and 4th week of life for those with abnormal results only. Results: Abnormal thyroid function was detected in 178 (50%) preterm infants. Twenty-two infants were excluded from the study. Mean serum levels of TSH, T4 and free T4 were higher among group II infants (more mature) than 1st group (less mature). The mean levels of T4 and free T4 were higher at the end of 4th week of life than their levels during the 1st week of life. Transient hypothyroxinemia was more frequent thyroid dysfunction disorders among both groups (52.5 % and 38 % for 1st and 2nd groups respectively). Neonatal hypothyroidism, transient primary neonatal hypothyroidism, and transient hyperthyrotropinemia were detected in 9 (11.25%), 18 (22.5%), and 11 neonates (13.75%), respectively for the 1st group and observed in 7 (9.2%), 14 (18.4%), and 9 neonates (11.8%), respectively for the second group Conclusions: Thyroid dysfunction was moderately common among preterm neonates. Protocol for thyroid function tests among preterm infants is essential.","PeriodicalId":8054,"journal":{"name":"Annals of Neonatology Journal","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81837161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-04DOI: 10.21608/anj.2021.89757.1035
Sylvia R. Zekry, E. Hamed, F. Hassanen, Safwat M. Abdel-Aziz
Background: Thrombocytopenia is frequent hematological diseases affecting neonates hospitalized to neonatal intensive care unit (NICU). Several maternal and neonatal factors contribute to thrombocytopenia development. Aim of work: To identify the incidence and possible risk factors for neonatal thrombocytopenia. Patients and methods: This prospective observational study included all newborns aged from 1- 28 days with thrombocytopenia (platelet count <150,000 /L) either full term or preterm, inborn or outborn cases admitted to NICU in Assiut University Children's Hospital from 1 st of February 2019 to 31 st of January 2020. Thrombocytopenia frequency, as well as associated maternal risk factors as pregnancy-induced hypertension (PIH), diabetes mellitus, premature rupture of membranes (PROM), eclampsia, immunological diseases, and neonatal risk factors as sepsis, birth hypoxia, intrauterine growth retardation (IUGR), and prematurity were evaluated. Results: A total of 1590 neonates were enrolled, of them, 420 cases developed thrombocytopenia. Thrombocytopenia incidence was 26.4%. Maternal risk factors linked with neonatal thrombocytopenia were pregnancy-induced hypertensive disorders (PIH), PROM, and immune thrombocytopenia; neonatal risk factors were sepsis, prematurity, necrotizing enterocolitis (NEC), intrauterine growth retardation (IUGR), asphyxia, Toxoplasmosis, Rubella, Cytomegalovirus, and Herpes viruses infection (TORCH), and prolonged hospital stays. Among newborns with thrombocytopenia, 84.5% had late onset thrombocytopenia (> 72 hours of life). Thrombocytopenia was mild in 41.9%, moderate in 37.9%, and severe in 20.2%. Mortality rate was 20.2%. Conclusions: Thrombocytopenia frequency was 26.4% of neonates hospitalized in our NICU. The most common etiology associated with thrombocytopenia was PIH, PROM, and immune disorders, followed by neonatal sepsis, prematurity, NEC, and IUGR.
{"title":"Incidence and Risk Factors for Neonatal Thrombocytopenia among Newborns admitted to Neonatal Intensive Care Unit of Assiut University Children's Hospital-A Prospective Observational Study","authors":"Sylvia R. Zekry, E. Hamed, F. Hassanen, Safwat M. Abdel-Aziz","doi":"10.21608/anj.2021.89757.1035","DOIUrl":"https://doi.org/10.21608/anj.2021.89757.1035","url":null,"abstract":"Background: Thrombocytopenia is frequent hematological diseases affecting neonates hospitalized to neonatal intensive care unit (NICU). Several maternal and neonatal factors contribute to thrombocytopenia development. Aim of work: To identify the incidence and possible risk factors for neonatal thrombocytopenia. Patients and methods: This prospective observational study included all newborns aged from 1- 28 days with thrombocytopenia (platelet count <150,000 /L) either full term or preterm, inborn or outborn cases admitted to NICU in Assiut University Children's Hospital from 1 st of February 2019 to 31 st of January 2020. Thrombocytopenia frequency, as well as associated maternal risk factors as pregnancy-induced hypertension (PIH), diabetes mellitus, premature rupture of membranes (PROM), eclampsia, immunological diseases, and neonatal risk factors as sepsis, birth hypoxia, intrauterine growth retardation (IUGR), and prematurity were evaluated. Results: A total of 1590 neonates were enrolled, of them, 420 cases developed thrombocytopenia. Thrombocytopenia incidence was 26.4%. Maternal risk factors linked with neonatal thrombocytopenia were pregnancy-induced hypertensive disorders (PIH), PROM, and immune thrombocytopenia; neonatal risk factors were sepsis, prematurity, necrotizing enterocolitis (NEC), intrauterine growth retardation (IUGR), asphyxia, Toxoplasmosis, Rubella, Cytomegalovirus, and Herpes viruses infection (TORCH), and prolonged hospital stays. Among newborns with thrombocytopenia, 84.5% had late onset thrombocytopenia (> 72 hours of life). Thrombocytopenia was mild in 41.9%, moderate in 37.9%, and severe in 20.2%. Mortality rate was 20.2%. Conclusions: Thrombocytopenia frequency was 26.4% of neonates hospitalized in our NICU. The most common etiology associated with thrombocytopenia was PIH, PROM, and immune disorders, followed by neonatal sepsis, prematurity, NEC, and IUGR.","PeriodicalId":8054,"journal":{"name":"Annals of Neonatology Journal","volume":"124 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88001826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-01DOI: 10.21608/anj.2021.83662.1033
W. Ahmed, W. Kabiel, Dalia Mohamed
Background: The levels of transplacental transferred immunoglobulins (Ig) carry protective effect to the neonate and varies by many factors as gestational age, maturity, body weight, hemodynamics and maternal diseases. Aim: This study aimed to measure the serum levels of Ig A and Ig G in neonates in different settings and to correlate their levels with neonatal morbidities. Methods: The study conducted during the period from June 2020 to January 2021 in a tertiary level NICU and included a total number of fifty one neonates. The measurement of serum Ig G and Ig A levels were measured by mininef method. Results: The mean value of Ig G and Ig A were 898 mg g/l and 16.3 g/l respectively. Ig G was directly correlated with the maturity, weight, early starting of feeding (p-value 0.001) while they correlated inversely with respiratory and inotropic support and CRP levels (p=value 0.001). Ig G was correlated inversely with the respiratory support whether CPAP or mechanical ventilation; being higher in neonates who didn't receive assisted ventilation. A cut off level of 512 g/l of Ig G was needed to detect increased risk of neonates to sepsis. Preterm babies had lower values than full term ones (p-value 0.001). Conclusion: Transplacental transferred immunoglobulins had a protective effect for neonates and their levels were inversely correlated with neonatal morbidities either in preterm or fullterm neonates
背景:经胎盘转移免疫球蛋白(Ig)水平对新生儿具有保护作用，并受胎龄、成熟度、体重、血流动力学和母体疾病等因素的影响。目的:本研究旨在测定不同环境下新生儿血清中igg和igg的水平，并探讨其水平与新生儿发病率的关系。方法:研究于2020年6月至2021年1月在某三级新生儿重症监护室进行，共51例新生儿。采用微量法测定血清Ig、Ig A水平。结果:Ig G和Ig A的平均值分别为898 mg G /l和16.3 G /l。Ig - G与成熟度、体重、早饲呈正相关(p值0.001)，与呼吸、肌力支持及CRP水平呈负相关(p值0.001)。无论是CPAP还是机械通气，Ig G与呼吸支持呈负相关;在未接受辅助通气的新生儿中更高。检测新生儿败血症的风险增加需要达到512 g/l的临界值。早产儿的数值低于足月婴儿(p值0.001)。结论:经胎盘转移免疫球蛋白对新生儿有保护作用，其水平与早产儿和足月新生儿发病率呈负相关
{"title":"Protective Effect of Trans-placental Transferred Immunoglobulins against Neonatal Morbidities in A Tertiary Level Intensive Care Unit","authors":"W. Ahmed, W. Kabiel, Dalia Mohamed","doi":"10.21608/anj.2021.83662.1033","DOIUrl":"https://doi.org/10.21608/anj.2021.83662.1033","url":null,"abstract":"Background: The levels of transplacental transferred immunoglobulins (Ig) carry protective effect to the neonate and varies by many factors as gestational age, maturity, body weight, hemodynamics and maternal diseases. Aim: This study aimed to measure the serum levels of Ig A and Ig G in neonates in different settings and to correlate their levels with neonatal morbidities. Methods: The study conducted during the period from June 2020 to January 2021 in a tertiary level NICU and included a total number of fifty one neonates. The measurement of serum Ig G and Ig A levels were measured by mininef method. Results: The mean value of Ig G and Ig A were 898 mg g/l and 16.3 g/l respectively. Ig G was directly correlated with the maturity, weight, early starting of feeding (p-value 0.001) while they correlated inversely with respiratory and inotropic support and CRP levels (p=value 0.001). Ig G was correlated inversely with the respiratory support whether CPAP or mechanical ventilation; being higher in neonates who didn't receive assisted ventilation. A cut off level of 512 g/l of Ig G was needed to detect increased risk of neonates to sepsis. Preterm babies had lower values than full term ones (p-value 0.001). Conclusion: Transplacental transferred immunoglobulins had a protective effect for neonates and their levels were inversely correlated with neonatal morbidities either in preterm or fullterm neonates","PeriodicalId":8054,"journal":{"name":"Annals of Neonatology Journal","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83951754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.21608/ANJ.2021.183374
S. Mousa
Children cannot be considered as miniature adults regarding to hemostatic balance. There is a great difference between neonatal, pediatric, and adult hemostatic systems. The concept of developmental hemostasis is now accepted on a wide range. It ensures accurate prevention, diagnosis, and treatment of thrombotic and hemorrhagic diseases in neonates and children. Developmental hemostasis could affect multiple physiological processes within the body other than hemostasis, such as angiogenesis, inflammation, and wound repair, as well as the interaction between different drugs and the coagulation system. “The Perinatal and Pediatric Hemostasis Subcommittee of the Scientific and Standardization Committee of the International Society on Thrombosis and Hemostasis (ISTH)” recommended for each laboratory to define reference ranges which are age-adjusted using its own technical conditions. Adding to that, accurate sampling techniques are mandatory for correct interpretation of laboratory results. New assays should be developed putting into consideration the fundamentals of developmental hemostasis.
{"title":"Evolution of Hemostasis in Neonates and Children","authors":"S. Mousa","doi":"10.21608/ANJ.2021.183374","DOIUrl":"https://doi.org/10.21608/ANJ.2021.183374","url":null,"abstract":"Children cannot be considered as miniature adults regarding to hemostatic balance. There is a great difference between neonatal, pediatric, and adult hemostatic systems. The concept of developmental hemostasis is now accepted on a wide range. It ensures accurate prevention, diagnosis, and treatment of thrombotic and hemorrhagic diseases in neonates and children. Developmental hemostasis could affect multiple physiological processes within the body other than hemostasis, such as angiogenesis, inflammation, and wound repair, as well as the interaction between different drugs and the coagulation system. “The Perinatal and Pediatric Hemostasis Subcommittee of the Scientific and Standardization Committee of the International Society on Thrombosis and Hemostasis (ISTH)” recommended for each laboratory to define reference ranges which are age-adjusted using its own technical conditions. Adding to that, accurate sampling techniques are mandatory for correct interpretation of laboratory results. New assays should be developed putting into consideration the fundamentals of developmental hemostasis.","PeriodicalId":8054,"journal":{"name":"Annals of Neonatology Journal","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83239186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.21608/ANJ.2021.183384
Mohammad Abdelmaaboud
Respiratory support in the form of mechanical ventilation is a crucial intervention in premature neonates, with respiratory problems. However, prolonged mechanical ventilation and endotracheal intubation may be associated with major adverse effects, such as ventilation-associated pneumonia (VAP), pneumothorax, bronchopulmonary dysplasia (BPD) and periventricular hemorrhage. To minimize such risks and complications, it is recommended to discontinue MV as soon as babies are able to maintain spontaneous breathing and achieve appropriate gas exchange with minimal respiratory effort. The ideal time for extubation is based on clinical and laboratory parameters assessed at the time of planned extubation. However, such parameters are not very objective, which makes extubation in NICUs a trial-and-error approach. Based on the morbidities associated with the long duration of MV in newborn babies, there is a clear need to establish objective criteria for extubation and avoid reintubation. In this editorial, we will focus on the extubation bundle (including MODIFIED SBT) prior to extubation which can independently predict successful extubation in preterm babies.
{"title":"Extubation Bundle, Is It Applicable to Reduce The Rate of Reintubation, Among Preterm Neonates?","authors":"Mohammad Abdelmaaboud","doi":"10.21608/ANJ.2021.183384","DOIUrl":"https://doi.org/10.21608/ANJ.2021.183384","url":null,"abstract":"Respiratory support in the form of mechanical ventilation is a crucial intervention in premature neonates, with respiratory problems. However, prolonged mechanical ventilation and endotracheal intubation may be associated with major adverse effects, such as ventilation-associated pneumonia (VAP), pneumothorax, bronchopulmonary dysplasia (BPD) and periventricular hemorrhage. To minimize such risks and complications, it is recommended to discontinue MV as soon as babies are able to maintain spontaneous breathing and achieve appropriate gas exchange with minimal respiratory effort. The ideal time for extubation is based on clinical and laboratory parameters assessed at the time of planned extubation. However, such parameters are not very objective, which makes extubation in NICUs a trial-and-error approach. Based on the morbidities associated with the long duration of MV in newborn babies, there is a clear need to establish objective criteria for extubation and avoid reintubation. In this editorial, we will focus on the extubation bundle (including MODIFIED SBT) prior to extubation which can independently predict successful extubation in preterm babies.","PeriodicalId":8054,"journal":{"name":"Annals of Neonatology Journal","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87523541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The effect of Fenofibrate and Antioxidant Vitamins [D, E and C] in Treatment of Uncomplicated Neonatal Hyperbilirubinemia","authors":"Sawsan M. Al-Banna, Asmaa Riad, Sozan Anis","doi":"10.21608/anj.2020.69366","DOIUrl":"https://doi.org/10.21608/anj.2020.69366","url":null,"abstract":"","PeriodicalId":8054,"journal":{"name":"Annals of Neonatology Journal","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84761474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In this issue, we represent a case which may posse special interest to many neonatologists. Apparently healthy female neonate was born by spontaneous vaginal delivery as a sixth offspring to a third-degree consanguineous Egyptian parent. No significant neonatal problems occurred necessitate NICU admission. She had come to our outpatient neurology clinic at age 15th day with episodic transient generalized stiffness, hypertonia and tonic spasms. These episodes were existed from the first days of life as a result of sudden acoustic or tactile stimulation. Both general and neurological examinations were normal. Routine laboratory workup, electroencephalography (EEG) and MRI brain were normal. Father told us about her two brothers who aged 8 and 6 years old, both have had the same story and diagnosed faultily as epileptics. On next visit, we examined her brothers and found them suffering from repeated fallings, injuries and myoclonic jerks only as a reflex to unexpected various sensory stimuli. Although normal EEG and brain imaging, anti-epileptic combinations drugs, not included oral clonazepam, were prescribed to both without improvement. Good to mention that both of them were short and cognitively impaired. The case was one of neonatal conditions mimic epilepsy (CME) called (hereditary hyperekplexia). Recognition of hyperekplexia in the neonatal period is critical to avoid erroneous diagnoses like epilepsy. In conclusion: Neonatologists should be aware of CME in neonatal period. hyperekplexia teaches us simply three unique lessons in neonatology: First, not all CME are benign as known, hyperekplexia may be fatal. Second, some CME like hyperekplexia may be inherited. Lastly, some antiepileptic medications as clonazepam may be used in treatment of non-epileptic conditions like hyperekplexia
{"title":"Familial hyperekplexia: Lessons from the other face of the coin","authors":"S. Mounir","doi":"10.21608/anj.2020.69360","DOIUrl":"https://doi.org/10.21608/anj.2020.69360","url":null,"abstract":"In this issue, we represent a case which may posse special interest to many neonatologists. Apparently healthy female neonate was born by spontaneous vaginal delivery as a sixth offspring to a third-degree consanguineous Egyptian parent. No significant neonatal problems occurred necessitate NICU admission. She had come to our outpatient neurology clinic at age 15th day with episodic transient generalized stiffness, hypertonia and tonic spasms. These episodes were existed from the first days of life as a result of sudden acoustic or tactile stimulation. Both general and neurological examinations were normal. Routine laboratory workup, electroencephalography (EEG) and MRI brain were normal. Father told us about her two brothers who aged 8 and 6 years old, both have had the same story and diagnosed faultily as epileptics. On next visit, we examined her brothers and found them suffering from repeated fallings, injuries and myoclonic jerks only as a reflex to unexpected various sensory stimuli. Although normal EEG and brain imaging, anti-epileptic combinations drugs, not included oral clonazepam, were prescribed to both without improvement. Good to mention that both of them were short and cognitively impaired. The case was one of neonatal conditions mimic epilepsy (CME) called (hereditary hyperekplexia). Recognition of hyperekplexia in the neonatal period is critical to avoid erroneous diagnoses like epilepsy. In conclusion: Neonatologists should be aware of CME in neonatal period. hyperekplexia teaches us simply three unique lessons in neonatology: First, not all CME are benign as known, hyperekplexia may be fatal. Second, some CME like hyperekplexia may be inherited. Lastly, some antiepileptic medications as clonazepam may be used in treatment of non-epileptic conditions like hyperekplexia","PeriodicalId":8054,"journal":{"name":"Annals of Neonatology Journal","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75547938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Preterm infants are more liable to suffer from anemia, as 90% of extremely low birth weight infants receive red blood cell transfusion. When to receive red blood cell transfusion is not well defined until now, even the complications and hazards resulting from the transfusion of adult red blood cell into the premature circulation is still a matter of debate. In this review, fetal erythropoiesis and the unique pathophysiology of anemia of prematurity is discussed, different meta-analysis studies are presented regarding liberal (high hemoglobin threshold) or restrictive (low hemoglobin threshold) transfusion protocols, early or late transfusion preferences. To clarify the picture of this, everyday decision neonatologists need to take, whether or not to give this premature infant a red packed cell transfusion, which may affect the life of this infant indefinitely. Until now, no fixed guidelines are present regarding when to transfuse anemia and still dependent on expert opinion and center experience.
{"title":"Red blood cell transfusion in preterm neonates: a huge debate on tiny patients","authors":"S. Mousa","doi":"10.21608/anj.2020.69361","DOIUrl":"https://doi.org/10.21608/anj.2020.69361","url":null,"abstract":"Preterm infants are more liable to suffer from anemia, as 90% of extremely low birth weight infants receive red blood cell transfusion. When to receive red blood cell transfusion is not well defined until now, even the complications and hazards resulting from the transfusion of adult red blood cell into the premature circulation is still a matter of debate. In this review, fetal erythropoiesis and the unique pathophysiology of anemia of prematurity is discussed, different meta-analysis studies are presented regarding liberal (high hemoglobin threshold) or restrictive (low hemoglobin threshold) transfusion protocols, early or late transfusion preferences. To clarify the picture of this, everyday decision neonatologists need to take, whether or not to give this premature infant a red packed cell transfusion, which may affect the life of this infant indefinitely. Until now, no fixed guidelines are present regarding when to transfuse anemia and still dependent on expert opinion and center experience.","PeriodicalId":8054,"journal":{"name":"Annals of Neonatology Journal","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84344819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In this issue, we represent a case which may posse special interest to many neonatologists. Apparently healthy female neonate was born by spontaneous vaginal delivery as a sixth offspring to a third-degree consanguineous Egyptian parent. No significant neonatal problems occurred necessitate NICU admission. She had come to our outpatient neurology clinic at age 15th day with episodic transient generalized stiffness, hypertonia and tonic spasms. These episodes were existed from the first days of life as a result of sudden acoustic or tactile stimulation. Both general and neurological examinations were normal. Routine laboratory workup, electroencephalography (EEG) and MRI brain were normal. Father told us about her two brothers who aged 8 and 6 years old, both have had the same story and diagnosed faultily as epileptics. On next visit, we examined her brothers and found them suffering from repeated fallings, injuries and myoclonic jerks only as a reflex to unexpected various sensory stimuli. Although normal EEG and brain imaging, anti-epileptic combinations drugs, not included oral clonazepam, were prescribed to both without improvement. Good to mention that both of them were short and cognitively impaired. The case was one of neonatal conditions mimic epilepsy (CME) called (hereditary hyperekplexia). Recognition of hyperekplexia in the neonatal period is critical to avoid erroneous diagnoses like epilepsy. In conclusion: Neonatologists should be aware of CME in neonatal period. hyperekplexia teaches us simply three unique lessons in neonatology: First, not all CME are benign as known, hyperekplexia may be fatal. Second, some CME like hyperekplexia may be inherited. Lastly, some antiepileptic medications as clonazepam may be used in treatment of nonepileptic conditions like hyperekplexia.
{"title":"Familial hyperekplexia: Lessons from the other face of the coin","authors":"Samir Monir","doi":"10.21608/anj.2020.68927","DOIUrl":"https://doi.org/10.21608/anj.2020.68927","url":null,"abstract":"In this issue, we represent a case which may posse special interest to many neonatologists. Apparently healthy female neonate was born by spontaneous vaginal delivery as a sixth offspring to a third-degree consanguineous Egyptian parent. No significant neonatal problems occurred necessitate NICU admission. She had come to our outpatient neurology clinic at age 15th day with episodic transient generalized stiffness, hypertonia and tonic spasms. These episodes were existed from the first days of life as a result of sudden acoustic or tactile stimulation. Both general and neurological examinations were normal. Routine laboratory workup, electroencephalography (EEG) and MRI brain were normal. Father told us about her two brothers who aged 8 and 6 years old, both have had the same story and diagnosed faultily as epileptics. On next visit, we examined her brothers and found them suffering from repeated fallings, injuries and myoclonic jerks only as a reflex to unexpected various sensory stimuli. Although normal EEG and brain imaging, anti-epileptic combinations drugs, not included oral clonazepam, were prescribed to both without improvement. Good to mention that both of them were short and cognitively impaired. The case was one of neonatal conditions mimic epilepsy (CME) called (hereditary hyperekplexia). Recognition of hyperekplexia in the neonatal period is critical to avoid erroneous diagnoses like epilepsy. In conclusion: Neonatologists should be aware of CME in neonatal period. hyperekplexia teaches us simply three unique lessons in neonatology: First, not all CME are benign as known, hyperekplexia may be fatal. Second, some CME like hyperekplexia may be inherited. Lastly, some antiepileptic medications as clonazepam may be used in treatment of nonepileptic conditions like hyperekplexia.","PeriodicalId":8054,"journal":{"name":"Annals of Neonatology Journal","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84956094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：