Necrotizing enterocolitis in infants with esophageal atresia awaiting delayed primary repair

Of 149 infants with esophageal atresia treated during a 13-year period, 5 (3%) developed postoperative necrotizing enterocolitis (NEC). Four of the 5 were premature with birth weights below 1.8 kg (Waterston group C), and all were from a group of 17 awaiting delayed primary esophageal anastomosis. In each case, NEC occurred suddenly and death ensued within 5 days. NEC should be included in the list of complications resulting from, or associated with, delayed primary repair of esophageal atresia.     

新生儿坏死性小肠结肠炎早期诊断及手术选择

目的：探讨新生儿坏死性小肠结肠炎的早期诊断及手术时机选择。方法：对收治的128例患儿进行回顾性研究，分析临床表现，X线征象与病情发展之间的关系，结合文献进行探讨，找到早期诊断指标及选择手术时机。结果：128例患儿保守治疗70例，存活49例，手术58例，存活41例。结论：早期诊断及适时手术对该病的治疗十分关键。     

The effects of early postnatal stimulation on Morris water-maze acquisition in adult mice: genetic and maternal factors

 Following stressor exposure BALB/cByJ mice exhibit hypersecretion of corticosterone and marked brain catecholamine alterations. In addition, mice of this strain exhibit impairments of performance in a Morris water-maze, which may be exacerbated by footshock application. In the present investigation it was demonstrated that early-life handling of mouse pups (coupled with brief separation periods from the dam over the course of 21 days postpartum) reduced the learning impairments seen when mice were tested in the Morris water-maze at 120 days of age and also prevented stress-induced disturbances in this task. Likewise, cross-fostering BALB/cByJ mice with a C57BL/6ByJ dam prevented the performance deficits. In contrast, C57BL/6ByJ mice cross-fostered to a BALB/cByJ dam exhibited proficient performance. Thus, maternal factors may be important in determining the Morris water-maze disturbances, provided that this was applied on the BALB/cByJ genetic background. Stressor exposure exacerbated the performance disturbances in BALB/cByJ mice, while diazepam treatment disrupted Morris water-maze performance in both BALB/cByJ and C57BL/6ByJ mice. Paralleling the behavioral changes associated with handling, the stress-induced hypercorticosterone secretion characteristic of the BALB/cByJ mouse was attenuated by the early handling procedure. Stressor exposure also produced strain-dependent variations of NE and 5-HT, but these effects were not appreciably influenced by the handling procedure. These data are consistent with the proposition that performance disturbances of BALB/cByJ mice tested in the Morris water-maze task are associated with excessive hypothalamic-pituitary-adrenal reactivity. Moreover, it appears that the influence of early-life stimulation may interact with genetic factors in determining endocrine and behavioral stress responses. Received: 11 October 1995 / Final version: 22 June 1996     

Ⅰ期修补腹裂的早期转归(附18例报告)

目的 :评价Ⅰ期修补腹裂的早期转归。方法 :回顾分析我院小儿外科 17年间收治的腹裂病历 18份。结果 :产前诊断 16例 (89% )。全部病婴I期修补腹壁缺损。出生至手术的平均时间 5h(0 .5h～ 17h)。 4例合并肠道畸形和 1例并发肠坏死者需要更多的手术和更长的时间达到完全喂养 (P<0 .0 1)。 3例死亡 (16 .6 % ) ,其中 2例死于感染。结论 :我们的经验提示腹裂的死亡率不超过 16 .6 % ,降低死亡率主要是防治感染并发症 ,Ⅰ期修补可改善早期转归。     

26752名新生儿先天性甲状腺功能低下筛查

对１９９３～１９９４年天津农村２６７５２名新生儿筛查情况进行了初步分析。结果显示，１９９４年筛查率较１９９３年显著提高。５７例初筛阳性，其中７例确诊为先天性甲状腺功能低下，发病率为１／３８２２．７例病儿有５例早期出现临床症状，２例误诊为其它疾病，３例被漏诊。７例病儿均通过儿保医生追访后给予明确的诊断及治疗。本文提示开展新生儿筛查，特别是在医疗水平较低的农村，无疑是至关重要的。     

Risk factor for neonatal tetanus in West Burkina Faso: A case control study

A case-control study was carried out to identify risk factors for neonatal tetanus in rural Burkina Faso. Each of the 31 cases identified prospectively were matched with two controls. Risk factors such as the instrument used to cut the umbilical cord and the qualification of the midwives were only identified in the univariate analysis. The multifactorial analysis identified factors commonly believed to be associated with neonatal tetanus: lack of mother's immunization and place of birth other than maternity clinics. However, applying karite nut butter on the umbilical cord was found to be a strong independent factor associated with neonatal tetanus. Immunization of mothers against tetanus should be enforced. Health education must take into consideration sociocultural realities of these populations.     

Changing aspects of psychiatric inpatient treatment

This paper presents data obtained in a one-day census investigation in five European countries (Austria, Hungary, Romania, Slovakia, Slovenia). The census forms were filled in for 4191 psychiatric inpatients. Concerning legal status, 11.2% were hospitalised against their will (committed) and 21.4% were treated in a ward with locked doors. There was only a small correlation between commitment and treatment in a locked ward. More frequent than treatment of committed patients in locked wards was treatment of committed patients in open wards (Austria, Hungary) and treatment of voluntary patients in closed wards (Slovakia, Slovenia). Concerning employment, 27.7% of patients aged 18-60 held a job before admission. The vast majority of patients (84.8%) had a length of stay of less than 3 months. A comparison of these data with the results of a study performed in 1996 and using the same method shows a decrease of rates of long-stay patients. In 1996 the rates of employment were significantly higher in Romania (39.3%) and Slovakia (42.5%) compared to Austria (30.7%). These differences disappeared in 1999 due to decreasing rates of employment in Romania and Slovakia. The numbers of mental health personnel varies between types of institution (university or non-university) and countries, being highest in Austria and lowest in Romania. A considerable increase in the numbers of staff was found in Slovakia.