• Title/Summary/Keyword: Neonates

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Food protein-induced proctocolitis: Is this allergic disorder a reality or a phantom in neonates?

  • Hwang, Jin-Bok;Hong, Jeana
    • Clinical and Experimental Pediatrics
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    • v.56 no.12
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    • pp.514-518
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    • 2013
  • The etiology of small and fresh rectal bleeding in neonates who are not sick is usually unknown; the only known cause is food protein-induced proctocolitis (FPIPC). It has been recently reported that FPIPC is a rare cause of rectal bleeding in newborns, and most cases have been proved to be due to idiopathic neonatal transient colitis. A recommended strategy for diagnosing suspected FPIPC in neonates is as follows. During the early stage, the etiology of small and fresh rectal bleeding in an otherwise healthy newborn need not be studied through extensive investigations. In patients showing continued bleeding even after 4 days, sigmoidoscopy and rectal mucosal biopsy may be performed. Even if mucosal histological findings indicate a diagnosis of FPIPC, further oral food elimination and challenge tests must be performed sequentially to confirm FPIPC. Food elimination and challenge tests should be included in the diagnostic criteria of FPIPC.

Morphological studies on the uterine development of fetuses and neonates in Korean native goats (한국재래산양의 태아 및 신생아의 자궁의 발달에 관한 형태학적 연구)

  • Jung, Soon-hee;Kim, Chong-sup;Kwak, Soo-dong
    • Korean Journal of Veterinary Research
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    • v.38 no.2
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    • pp.258-264
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    • 1998
  • The morphological development of uterus in 60-, 90-, 120-day-old fetuses at gestation and neonates of Korean native goats were investigated by light microscopy. 1. In the 60-day-old fetuses, uterine walls differentiated and divided into the endometrium, myometrium and perimetrium. 2. In the 90-day-old fetuses, the blood vessels appeared in the uterine walls, in the 120-day-old fetuses the nodules (primordial caruncles) appeared first in the endometrium. 3. In the 120-day-old fetuses, the gland primordia observed on the uterine epithelium. In the neonates, the developing uterine glands were more number and deeper than those of 120-old fetuses. 4. PAS reaction of the mucosa cells in the endometrium was reacted weak, moderate and strong at 90-, 120-day-old fetuses and neonates, respectively.

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Current Status and Importance of Clinical Research Involving Neonates (신생아 임상 연구의 현황과 필요성)

  • Cho, Su-Jin
    • Neonatal Medicine
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    • v.15 no.2
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    • pp.113-118
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    • 2008
  • Clinical trials in neonates of different gestational age, birth weight, postnatal age and general health status are needed to assure safe and optimal evidence-based-therapy to this special population. Pharmacodynamic maturation must be considered in grouping the neonates for clinical trials. Informed consent from the parents, protection of the neonates participating in the clinical trials, adherence to good clinical practice guidelines, and designation of short term and long term outcomes must be taken into consideration from the beginning of the trials. Collaboration between centers will be helpful in overcoming the problem with small patient size. Many of these challenges are surmountable and an well-designed clinical trial will improve the mortality and morbidity in these very small children.

Neonatal Coagulation Disorder: Diagnostic Approaches for Bleeding Neonates (신생아 혈액 응고질환: 출혈 경향을 보이는 신생아에 대한 진단적 접근)

  • Kim, Chun-Soo
    • Neonatal Medicine
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    • v.18 no.1
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    • pp.6-13
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    • 2011
  • All newborn infants with clinically significant bleeding should be evaluated for a hemostatic deficit. Medical history should include the following data: familial bleeding disorders, maternal illness and medication, age of bleeding onset, and prophylactic administration of vitamin K. The first essential step for evaluating bleeding neonates is determining whether the baby is sick or well. The physician should also evaluate the extent of the bleeding, features of bleeding lesions, and other abnormal findings from the physical examination. Skeletal anomalies may provide diagnostic clues. Depending on the clinical features and results of screening tests, other tests including coagulation factors may be useful for determining the diagnosis. All laboratory results must be considered in the context of age-related reference values. The platelet function analyzer provides a promising alternative to bleeding time. Fibrin degradation products and D-dimers are used for screening and specially testing fibrinolytic activity, respectively. The Apt test may help to rule out factors derived from maternal blood. Radiologic imaging studies are important because asymptomatic intracranial hemorrhages are common in neonates.

Evaluation of function and disorders of the adrenal gland in neonates (신생아에서의 부신기능 평가와 질환)

  • Hwang, Il Tae
    • Clinical and Experimental Pediatrics
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    • v.50 no.3
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    • pp.236-240
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    • 2007
  • Majority of sick full term newborns have adequate adrenal cortical function in response to stress. Acutely ill neonates with a basal cortisol level less than $15{\mu}g/dL$ (414 nmol/L) suggest adrenal insufficiency and require function testing of adrenal function. In premature infant, immaturity of hypothalamic-pituitary adrenal axis (HPA axis), may limit the ability to increase cortisol production in response to stress. The response to low dose ACTH and CRH appears to be useful as an additional test of adrenal function. CRH stimulation has been used increasingly in neonates. The ACTH and CRH stimulated cortisol response of more than $17{\mu}g/dL$ (469 nmol/L) indicates a normal response.

Renal replacement therapy in neonates with an inborn error of metabolism

  • Cho, Heeyeon
    • Clinical and Experimental Pediatrics
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    • v.62 no.2
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    • pp.43-47
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    • 2019
  • Hyperammonemia can be caused by several genetic inborn errors of metabolism including urea cycle defects, organic acidemias, fatty acid oxidation defects, and certain disorders of amino acid metabolism. High levels of ammonia are extremely neurotoxic, leading to astrocyte swelling, brain edema, coma, severe disability, and even death. Thus, emergency treatment for hyperammonemia must be initiated before a precise diagnosis is established. In neonates with hyperammonemia caused by an inborn error of metabolism, a few studies have suggested that peritoneal dialysis, intermittent hemodialysis, and continuous renal replacement therapy (RRT) are effective modalities for decreasing the plasma level of ammonia. In this review, we discuss the current literature related to the use of RRT for treating neonates with hyperammonemia caused by an inborn error of metabolism, including optimal prescriptions, prognosis, and outcomes. We also review the literature on new technologies and instrumentation for RRT in neonates.

Applying the Bacterial Meningitis Score in Neonates Diagnosed Meningitis: A Single Center's Experience

  • Park, Sun Young;Seo, Kyoo Hyun;Lee, Jae Min;Lee, Eun Sil;Kim, Saeyoon
    • Neonatal Medicine
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    • v.24 no.1
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    • pp.26-31
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    • 2017
  • Purpose: To identify the factors associated with differential diagnosis of neonatal bacterial meningitis at the earliest opportunities possible and to evaluate the value of the bacterial meningitis score especially in neonates. Methods: We conducted a single-center, retrospective study of neonates diagnosed meningitis at our hospital between January 2000 and March 2014. We compared the general characteristics, clinical manifestations, laboratory findings, bacterial meningitis scores between the bacterial group and the aseptic group. Results: Bacterial meningitis differs significantly from aseptic meningitis in platelet count, the cerebrospinal fluid polymorphonuclear leukocyte count, and the serum protein including also the albumin (P<0.05). Except two infants, the bacterial meningitis score over 2 accurately predict bacterial meningitis in the other 11 infants. Conclusion: The bacterial meningitis score appears highly useful to identify neonatal infants with bacterial meningitis. However, its diagnostic and prognostic value is just 'adjunctive', because low score cannot rule out bacterial meningitis.

White matter injury following rotavirus infection in neonates: new aspects to a forgotten entity, 'fifth day fits'?

  • Yeom, Jung Sook;Park, Chan-Hoo
    • Clinical and Experimental Pediatrics
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    • v.59 no.7
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    • pp.285-291
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    • 2016
  • That rotavirus infection can cause neurological symptoms in young children has been well established. However, it is surprising why rotavirus infection has been overlooked as a cause of neonatal seizures for many years, despite significant research interest in neonatal rotavirus infection. Neonates are the age group most vulnerable to seizures, which are typically attributed to a wide range of causes. By contrast, because rotavirus infection is usually asymptomatic, it has been difficult to identify an association between this virus and neonatal seizures. The conventional wisdom has been that, although neonates are commonly infected with rotavirus, neurological complications are rare in this age. However, recent studies using diffusion-weighted imaging (DWI) have suggested a connection between rotavirus infection and neonatal seizures and that rotavirus infection can induce diffuse white matter injury without direct invasion of the central nervous system. The clinical features of white matter injury in rotavirus-infected neonates include the onset of seizures at days 4-6 of life in apparently healthy term infants. The recent findings seem to contradict the conventional wisdom. However, white matter injury might not be a completely new aspect of rotavirus infection in neonates, considering the forgotten clinical entity of neonatal seizures, 'fifth day fits'. With increased use of DWI in neonatal seizures, we are just starting to understand connection between viral infection and white matter injury in neonates. In this review, we discuss the historical aspects of rotavirus infection and neonatal seizures. We also present the clinical features of white matter injury in neonatal rotavirus infection.

A Study on the Sleep pattern of normal neonates in Seoul and Kyungki area (서울.경기지역 신샌아의 수면/활동 양상에 관한 연구)

  • Kim, Il-Ok;Yang, Eun-Young;Lee, Ja-Hyung
    • Korean Parent-Child Health Journal
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    • v.3 no.2
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    • pp.41-48
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    • 2000
  • The sleep is the most important problem for new parents. However, there were very rare the study about sleep of normal neonates and early infants in Korea. So we attempted pilot survey study of neonates' sleep pattern. The purpose of this study was to investigate the sleep pattern of normal neonates in Seoul and Kyungki area and to provide for basis for nursing intervention for parents of them. The subjects of this study were 37 normal full-term neonates of 2~3weeks of age who were visited by researcher or assistant at postpartum care unit, health care clinic, outpatient clinic located in Seoul and Kyungki area from April 20, 1999 to March 15, 2000. This study was descriptive survey study under the convenient sampling method. The instrument of this study was the NCASA translated by Korean Parent Child Health Academic Association. The collected data were coded as 1/4hour unit, and analyzed by MS Office Excel program. The result of this study were as followed: 1. The mean amount of total sleep was 15.1hours. The mean amount of daytime sleep was 9.5hours. The mean amount of nighttime sleep was 5.7 hours. The mean amount of longest sleep was 2.9hours. The mean amount of shortest sleep was 0.6hour. 2. The mean amount of total activity was 8.9hours. The mean amount of daytime activity was 6.5 hours. The mean amount of nighttime activity was 2.3hours. The frequency of feeding was 10.4 times a day. The frequency of daytime feeding was 7.3 times. The frequency of nighttime feeding was 3.1 times. It is suggested that various subjects and more data according to age, and comparative study among different cultures are needed for further study in the future.

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A Clinical Study for Rota Virus Infection of Neonates in Oriental Medicine Hospital Postpartum Care Center (한방병원 산후조리센터 내 신생아의 Rota Virus 감염증에 대한 임상적 고찰)

  • Lee, Jeong-Lim;Ha, Kwang-Su;Ha, Su-Yun;Song, In-Sun;Kim, Sun-Mi
    • The Journal of Pediatrics of Korean Medicine
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    • v.19 no.2
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    • pp.115-126
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    • 2005
  • Objective : The aim of this study is to investigate rota virus infection of neonates In the Postpartum care center. Methods : This clinical study was carried out with the 205 neonates who admitted to the Postpartum Care Center of ${\bigcirc}{\bigcirc}$ Oriental Medicine Hospital, from July, 2004 to July, 2005. Stools were examined daily with Rotazyme ELISA tests(Bio Line Rota Virus, SD Standard Diagnostics, INC.) for 3 days from the day of admission. Supplementary test was examined when change was found in stools. Results : Among 205 newborn babies, 58 cases turned out to be positive. The positive rate of rota virus was not significantly related to sex, birth weight, gestation age. But, it was significantly related to delivery method and it was higher in caesarean section group. The manifestation rates of symptoms were 51.7% in Rotazyme positive neonates. In the Rotazyme positive 58 cases, 30 cases(51.7%) had diarrhea, 8 cases had fever(13.8%), 1 case(1.7%) had vomiting. The positive rate of rota virus was higher during from october to march. There were 190 cases(92.2%) of mixed feeding and 15 cases(7.8%) of artificial feeding. There was significance between breast feeding and the positive rate of rota virus. There was no significance between hospital of birth and the rate of positive rotazyme test. Conclusions : A further study of neonates in postpartum care center is necessary as preference of postpartum care center was increased. And the oriental medicine treatment of rota virus IS expected to be effective, so a further study is necessary.

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