Hypocalcemia is common in the first 48 h of life in ELBW infants

BACKGROUND: The incidence of early hypocalcemia in extremely low birthweight (ELBW) infants is unknown because the distribution of serum calcium values in this population is not defined. OBJECTIVE: To determine the range of serum calcium values in ELBW infants during the first 48 h of life and the risks associated with low values. DESIGN/METHODS: Retrospective analysis of all ELBW infants admitted on day 1 of life from April 2004 to October 2006. Demographic variables, therapy, serum calcium (Ca), pH, albumin, and blood ionized Ca were recorded. RESULTS: There were 381 Ca levels obtained from 111 patients. Mean Ca was 6.90 mg/dL (1.73 mmol/L) (5(th)-95(th) percentile: 5.16-8.80). Ca levels rose after 24 h of life. Almost one quarter (23.1%) of the Ca levels were low by current standards. The majority of subjects (59.9%) had at least one hypocalcemic value. CONCLUSIONS: Serum Ca values are lower in ELBW infants and inconsequential. Thus, hypocalcemia should be re-defined for ELBW infants.     

SPOTTED FEVER : II. AN EXPERIMENTAL STUDY OF FIéVRE BOUTONNEUSE

Several methods for the experimental study of the rickettsial diseases have been applied to fièvre boutonneuse. An analysis of the results has indicated that fièvre boutonneuse is a variety of spotted fever and that the etiologic agent is a rickettsia which belongs to the genus Dermacentroxenus and to the species rickettsi (Wolbach (6)). The distinctive morphology of the organism and its characteristic intranuclear clustering in ticks and in tissue cultures are the important criteria upon which this conclusion is based. Immunological, histological, and cytological observations of a confirmatory nature are also reported.     

TYPHUS FEVER : IV. FURTHER OBSERVATIONS ON THE BEHAVIOR OF RICKETTSIA PROWAZEKI IN TISSUE CULTURES

In tissue cultures grown at 32°C., typhus Rickettsiae increase rapidly within the cytoplasm of infected cells up to about the 14th day. At this time practically every cell is infected and the majority of cells are distended with organisms. This condition remains constant as long as successful cultures of the cells can be maintained (up to 52 days). Loss in virulence does not take place during this period in vitro. The number of Rickettsia-filled cells found in sections and the incubation period of the infection resulting from inoculation of cultures from each age group are definitely correlated. The behavior of typhus Rickettsiae in dividing cells is described and methods of spread of the infection other than by mitosis of cells are discussed. Normal tissues do not become infected in vitroto any considerable extent in spite of prolonged proximity to heavily infected cultures of scrotal sac exudate. Complete anaerobiosis and alterations in pH do not alter the intracellular location of the organism in tissue cultures. The organisms are not seen within nuclei of infected cells. They remain intact and infective for several weeks in cells which are kept alive but not multiplying. They disappear in less than 1 week, however, when the cells undergo degeneration.