Serum ionized calcium concentrations in normal neonates

Adult serum ionized calcium (iCa) concentrations are higher when using the newer, highly sensitive, ion-selective electrodes compared with older electrodes. Currently used neonatal normative ranges were established using older electrodes and not under standardized conditions or age. Thirty term infants, carefully screened to exclude confounding factors that could affect serum iCa concentration, were studied at birth and 2 and 24 hours of age for serum iCa concentrations. Mean concentrations declined from 1.45 mmol/L (5.82 mg/dL) at birth to 1.33 mmol/L (5.34 mg/dL) at 2 hours to 1.23 mmol/L (4.92 mg/dL) at 24 hours. The 95% confidence limits at 24 hours ranged from 1.10 to 1.36 mmol/L (4.40 to 5.44 mg/dL). Using newer ion-selective electrodes, normal neonatal ranges for iCa concentrations during the first 24 hours of age are higher than published references.     

Jaundice in neonates with sickle cell disease. A case-control study

This matched, case-control study was conducted on 68 neonates with sickle cell disease (SCD) to test the hypothesis that SCD contributes to neonatal jaundice. Previous uncontrolled studies have suggested that SCD leads to a high rate of neonatal jaundice. After matching, two neonates without SCD born in the same year were selected for each patient with SCD by use of random numbers. Matching factors were gestational age, sex, birth weight, and race. Serum bilirubin concentrations and the presence or absence of clinical jaundice were recorded. Information on factors potentially influencing the rate of neonatal jaundice was obtained for the first three days of life: maternal drug, alcohol, and tobacco usage, intrauterine infection, Apgar scores, highest infant hematocrit, culture-proved sepsis, blood group incompatibilities, hemorrhages, and presence of red blood cell sickling. We found no increase in the rate of clinical jaundice and no increase in the bilirubin concentration in either the entire group of patients with SCD, or in the subgroups with either homozygous or S-hemoglobin C disease, compared with their respective controls. We conclude that SCD probably is not a significant factor predisposing to neonatal jaundice.     

Noonan's syndrome and neurofibromatosis.

A child with Noonan syndrome and multiple cafe au lait spots, compatible in size and number with von Recklinghausen''s neurofibromatosis, is presented. These features may represent a distinct genetic entity rather than the coincidence of two diseases.     

Psychogenic cough.

Psychogenic cough is croupy and explosive, never occurs during sleep, and is not affected by antitussive drugs. Physical and radiographic examinations of the respiratory tract and microbiological investigations are normal. Bronchial asthma manifested as chronic cough should be excluded in each patient by lung function testing.     

Seasonality trends of scabies in a young adult population: a 20-year follow-up

BACKGROUND: Scabies is not a notifiable disease in most countries. Therefore, its seasonality trends are usually estimated and may be inaccurate. OBJECTIVES: To determine the seasonality of scabies over the long term in a large military population, including all of the Israel Defence Forces personnel. METHODS: For the last two decades, the Israel Defence Forces have mandated the routine reportage of every case of scabies infestation in soldiers to the Epidemiology Department of the Army Health Branch. This database was used in the present study to analyse the incidence of scabies by season. Scabies was defined according to the report by a military physician based on the typical clinical presentation, relevant epidemiological data and, in most cases, microscopic visualization of the mite. RESULTS: The person-time incidence of scabies was higher in winter than summer (P < 0.001). The overall risk ratio was 1.31 (95% confidence interval 1.28-1.33). Sensitivity analysis indicated that no single year was an important source of disease heterogeneity. CONCLUSIONS: Scabies in a young adult population is more frequent in the cooler months of the year.     

Sleep-wake patterns in children with intrauterine growth retardation

The purpose of this study was to characterize the sleep patterns of children with intrauterine growth retardation, known to be at risk for neurodevelopmental disorders, and seek a possible correlation with behavior, concentration, and attention problems. The sleep patterns of 26 children with intrauterine growth retardation aged 4 to 7 years were compared with those of 47 control children using activity monitors (actigraphs). In addition, data were collected from the parents regarding sleep habits, behavior, concentration, and attention. Children with intrauterine growth retardation aged 4 to 7 years were found to have a tendency toward poorer quality of sleep than their matched controls. This inclination was statistically significant only for one sleep measure, the true sleep time. A tendency toward increased fragmentation of sleep, prolonged waking, and decreased sleep efficiency, although not statistically significant in this study, was demonstrated. Our results showed that 58% of the children with intrauterine growth retardation, compared with 40% of the children in the control group, could be defined as "poor sleepers" (sleep efficiency lower than 90% or three or more waking episodes per night). This disturbed sleep profile is probably an integral part of the neurodevelopmental profile typical of these at-risk children. No significant correlations were found between sleep quality and behavior, concentration, and attention problems.     

Normoblasts in large for gestational age infants

Thirty one term large for gestational age (LGA) infants of non-diabetic mothers were compared with 30 appropriate for gestational age controls. Median absolute nucleated red blood cell counts, lymphocyte counts, and packed cell volumes were significantly higher in the LGA infants than the controls. It is possible that LGA babies of non-diabetic mothers are exposed to relative intrauterine hypoxia.