Serum glutamic-oxaloacetic transaminase and glutamic-pyruvic transaminase activity in premature and full-term asphyxiated newborns

The serum activity of SGOT and SGPT is one of the more specific parameters of liver cell injury both in adults and in the pediatric age-group. The determination of serum transaminase activity could offer a routine and rapid laboratory test for establishing the presence of hepatic cellular damage following intrauterine or perinatal asphyxia. In fact, it appears that there is a correlation between hypoxia and the increase in serum activity of transaminases in full-term and premature asphyxiated newborns. However, this increase is reversible up to the 30th day of life. The behavior of transaminase enzymatic activity in premature asphyxiated newborns compared to full-term asphyxiated newborns suggests a higher resistance of membranes to hypoxic-ischemic injuries and a lower enzymatic pool of cellular metabolism in premature newborns. Therefore, knowledge of the behavior of SGOT and SGPT activity may have important implications in the diagnosis and early treatment of perinatal asphyxia.     

The pattern of major serum apolipoproteins during the early neonatal period

Serum triglycerides, total cholesterol, lipoproteins and apolipoprotein A-I, B and C-III were investigated in 24 normal newborns at birth (umbilical cord blood) and again 4 days after birth (venous blood). Blood samples from 95 fasted normolipidemic male and female subjects aged between 20 to 60 years were also analysed. Immunochemical studies of serum from umbilical cord blood have shown that all investigated apolipoproteins were present although at lower levels than found in adults. The concentration of lipids, lipoproteins and apolipoprotein B and C-III in the serum from blood collected 4 days after birth did not practically differ from that of adult.     

Chylothorax in the neonatal period

Chylothorax is defined as an effusion of lymph in the pleural cavity. In the nconate both congenital and traumatic (iatrogenic) forms exist. Birth asphyxia and respiratory insufficiency are major symptoms of congenital chylothorax, requiring resuscitation and artificial ventilation. Antenatal diagnosis by ultrasound allows carly therapeutic intervention such as ventilatory support and drainage of chylous fluid immediately after birth. Traumatic chylothorax is mainly seen after intrathoracic surgery. Treatment primarily consists of continuous or intermittent drainage of chyle with replacement of fluid-, electrolyte-, and protein losses and parenteral nutrition. Introduction of oral feeding is considered only after a substantial period without chyle production in the pleural cavity and consists of a medium-chain triglyceride containing formula. In a minority of cases surgical intervention is necessary.     

Seizures in the neonatal period

OBJECTIVE: To characterize and differentiate neonatal seizures from those that occur at different ages, based on a critical assessment of the available literature and also on the author? clinical experience. SOURCES: Literature review, including up-to-date and classical studies that helped us to better understand clinical, neurophysiological and physiopathological aspects related to seizures in the newborn. SUMMARY OF THE FINDINGS: The authors present clinical and electroencephalographic characteristics of neonatal seizures, discuss their classification, treatment and prognosis. CONCLUSIONS: Neonatal seizures have a distinct clinical pattern, which justifies the necessity of an appropriate classification. The etiology is predominantly symptomatic and multifactorial; the treatment should follow a routine protocol, and the prognosis seems to be closely related to etiology.     

血清总胆汁酸测定及新生儿期胆汁淤积状况分析

目的 探讨新生儿期生理及常见疾病时胆汁淤积情况。方法 用酶法测定健康早产儿、足月新生儿各20例血清总胆汁酸（TBA）水平,并与63例正常儿童比较;测定生理性黄疸及消退后TBA水平变化及新生儿窒息（28例）、感染（41例）、溶血（14例）TBA水平与健康新生儿比较。结果 新生儿期血TBA水平增高（P＜0．01）,以早产儿为最高,生理性黄疸消退后血TBA水平无变化;新生儿窒息、感染、溶血时血TBA明显升高。结论 新生儿期存在生理性胆汁淤积,多种病理因素可加重淤积;诊断胆汁淤积,血TBA较胆红素更准确。     

Renal ultrasound in the neonatal period

Ultrasound was used for imaging the kidneys in 55 neonates. The normal kidney in a neonate is characterized by prominent medulla and fetal lobulation, the main renal vessels are frequently demonstrated. Of 29 infants with normal kidneys by ultrasound, 4 had renal disease (3 acute tubular necrosis, one partial renal artery thrombosis) and one had a pelvic kidney. In 24 infants congenital abnormalities or acquired renal disease was diagnosed. Multicystic dysplastic kidney and hydronephrosis were the most frequently observed abnormalities. Polycystic kidneys at the early stage (both adult type and infantile) appeared as enlarged hyperechoic kidneys. In 2 neonates the kidneys were normal but they had adrenal mass lesions.Based on the paper presented at the 50th Annual Meeting of the American Academy of Pediatrics, Detroit, Michigan, October 1980     

Developmental hemostasis in the neonatal period

Background The hemostatic system is complex and evolves continuously since gestation and well into the adult years,in a process known as“developmental hemostasis.”Data sources A comprehensive review was performed after an extensive literature search on PubMed/MEDLINE concerning developmental hemostasis during the neonatal period.Relevant cross references were also included.Results Although part of a system,each component of the hemostatic system evolves differently,with many displaying both quantitative and qualitative age-related differences.This leads to drastic disparities between the coagulation system of neonates and both other children’s and adults’,while still maintaining a generally balanced and physiological hemostasis.The motives behind this process remain to be fully elucidated but may be,at least in part,related to non-hemostatic factors.Conclusions Knowledge regarding“developmental hemostasis”is essential for everyone caring for newborns or even children in general and in this review,we describe each hemostatic system component’s neonatal characteristics and age-related progression as well as explore some of the possible physiological motives behind the process.     

Brain abscess in the neonatal period

Cerebral abscess is considered as a rare lesion with severe prognosis in neonates. The present means of cerebral imaging allow for a better estimation of its frequency, a more precise diagnosis of the evolutive stage and the estimation of the efficacy of the treatments. Incision-drainage associated with antibiotic treatment was successful in children. Two cases of neonatal cerebral abscesses treated and cured according to this protocol are reported.