POSSIBLE EFFECTS OF KANAMYCIN AND INCUBATION IN NEWBORN CHILDREN WITH LOW BIRTH WEIGHT

ABSTRACT: In an acoustico-vestibular follow-up investigation of 91 four- to six-year-old children with birth weight below 2 000 g, the same incidence of sensorineural hearing loss (19 %) was found in 54 children treated with kanamycin in the neonatal period as in a group of 37 infants not treated with kanamycin. When comparing a group of children treated with both kanamycin and incubator (54 children) with a group treated with incubator only (16 children), no definite signs of synergism between incubator noise and kanamycin were found. However, the 5 cases of moderate or severe hearing loss all belonged to the group treated with both incubator and kanamycin. These 5 children had more severe neonatal complications, especially apnea, cyanotic spells and hyperbilirubinemia, which may increase the severity of the hearing loss.
Among 56 incubator treated children with normal hearing (ISO standards) 52% had an audiogram pattern suggesting minor noise-provoked cochlear lesions. Among 18 non-incubator treated children with normal hearing only one child (6%) had a similar pattern. It should be stressed, however, that these children had no clinical symptoms of hearing loss.     

Menkes's syndrome. Report of a patient treated from 21 days of age with parenteral copper

In an infant with Menkes's steely-hair syndrome, early treatment (from 21 days of age) with parenteral copper failed to halt the disease. In addition to urinary tract abnormalities, panlobular emphysema was present a finding not previously noted in the syndrome.     

INTERRELATION BETWEEN FATTY ACID OXIDATION AND CONTROL OF GLUCONEOGENIC SUBSTRATES IN SMALL-FOR-GESTATIONAL-AGE (SGA) INFANTS WITH HYPOGLYCEMIA AND WITH NORMOGLYCEMIA

ABSTRACT. Twelve SGA infants were studied from 4 hours after birth (day 1), before and for 4 hours after injection of 0.5 g of fat/kg b. w. (Intralipid®, IL). Eight infants were restudied after 24 hours (day 2). A positive correlation was found between initial samples of FTA and glucose on day 1 (n= 11, r 0.71, p < 0.02) and between FFA and β-hydroxybutyrate (n= 12, r 0.62, p < 0.05), suggesting low FFA mobilization and oxidation in SGA infants with low blood glucose. After IL infants with low blood glucose had a more pronounced defect of intravascular lipolysis. Four infants had initial hypoglycemia (HG), with blood glucose 0.4-1.3 mmol/l, and 8 were normoglycemic (NG). In the NG group initial levels of lactate and alanine were within normal limits, and no changes occurred after IL. An early peak of glycerol was seen. In the HG group initial lactate and alanine levels were higher than in the NG group, while glycerol did not differ. After injection of IL, glucose increased at 60 and 120 min in the HG group. A close correlation was found between mean levels of lactate and alanine and a negative correlation between lactate and glucose, while no correlation was found between glycerol and glucose levels. The infants with the lowest initial glucose and the highest lactate levels had the steepest rise in glucose and the fastest decrease in lactate per unit increase in β-hydroxybutyrate after IL. On day 2 the initial levels of lactate and alanine were lower than on day 1 and all infants were normoglycemic. A glucose peak corresponding to the glycerol peak was seen after IL, but lactate and alanine levels did not change. These data were consistent with reduced lipolytic capacity, low fatty acid oxidation and reduced gluconeogenesis in SGA infants on day 1, especially in those with HG. The glucose and β-hydroxybutyrate levels were rapidly increasing and lactate levels decreasing after IL, suggesting improving gluconeogenesis concomitantly with increasing fatty acid oxidation.