Fourth Day Of Life Research Articles

Successful repair of infracardiac total anomalous pulmonary venous connection with nonconfluent bilateral pulmonary veins.

We report a rare case of an infracardiac-type total anomalous pulmonary venous connection with nonconfluent bilateral pulmonary veins in a patient diagnosed with heterotaxy syndrome with right atrial isomerism, mitral valve atresia, a single atrium, and double-outlet right ventricle. On the fourth day of life, the patient underwent successful repair using a sutureless technique. Two years after the surgery, the patient remained well without any signs of pulmonary venous obstruction.

Development of the Intestinal Microbiota of Dairy Calves and Changes Associated with Cryptosporidium spp. Infection in Brazil.

Cryptosporidium spp. is one of the most important pathogens infecting nursing calves worldwide. This study aimed to investigate the intestinal microbiota of dairy calves during the first month of life and the impact of diarrhea caused by Cryptosporidium on a Brazilian farm. Fecal samples from 30 calves were collected during the first month of life, and fecal scores were recorded. Samples from the second, third, and fourth days of life were analyzed by DNA sequencing of the 16S rRNA gene. In addition, samples of sixteen calves positive for Cryptosporidium spp. were retrospectively chosen according to the development of diarrhea: four and two days before diarrhea, at the onset of diarrhea, after four days of diarrhea, at the end of diarrhea, and after six days of diarrhea resolution. Diarrhea was observed in all calves (100%), starting at day 5 of life, and all calves tested positive for Cryptosporidium in at least one sample. The microbiota richness increased with age but was retarded by diarrhea. Compositional changes associated with Cryptosporidium infection included increases in Fusobacterium, Prevotella, and Peptostreptococcus, as well as decreases in Collinsella and Lachnospiraceae. In conclusion, Cryptosporidium infection has the potential to decrease richness and change the composition of the intestinal microbiota of dairy calves.

The Early Hematological Profile and Its Variations: A Useful Tool in the Prediction of Intraventricular Hemorrhage in Extremely Preterm Infants.

Background and Objectives: The purpose of this study to investigate if the early variations in the hematological profile could be a useful tool in the prediction and evaluation of intraventricular hemorrhage. Materials and Methods: It is a retrospective study conducted between 1 January 2017 and 31 December 2022, in a tertiary academic center. In-born infants ≤ 28 weeks of gestation (n = 134) were enrolled. The study group of infants with all grades of IVH was further divided into mild IVH subgroups (grades 1 and 2) and severe IVH subgroups (grades 3 and 4); the control group included infants without IVH. Results: The prevalence of IVH was 35.8% (n = 48 of 134 infants-study group). We identified significantly lower median values of HGB (p = 0.0312) and HCT (p = 0.0172) in all grades of the IVH group at birth as compared with control, followed by a significantly higher drop in MCV (p = 0.0146) and MCH (p = 0.0002) in the fourth day of life. Conclusions: Extremely preterm infants with IVH may have lower HTC and HGB values at birth, together with a decrease in MCH and MCHC and increase in MPV. The predictive model based on logistic regression analysis could predict the probability of the occurrence of IVH according to their values.

Coagulation assessment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infected pregnant women and their offspring by using rotational thromboelastometry (ROTEM).

During pregnancy, severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection may intensify the gestational procoagulant state. Coronavirus disease 2019 (COVID-19) associated coagulopathy (CAC) constitutes an exacerbated immunothrombosis response. There islimited data regarding the coagulation profile of SARS-CoV2-infected pregnant women, especially those with CAC, and the effect on their offspring. This prospective study aimed to compare the hemostatic profile of those women and their neonates with healthy mother-neonate pairs. Conventional coagulation tests (CCTs) and rotational thromboelastometry (ROTEM) were employed to evaluate the hemostatic profiles. Neonates were assessed at birth and on the fourth day of life. We enrolled 46 SARS-CoV2-infected pregnant women and 22 healthy controls who gave birth to 47 and 22 neonates, respectively. CAC was present in 10 participants. SARS-CoV2-infected pregnant women manifested slightly prolonged APTT and higher fibrinogen levels. Regarding ROTEM, we noted decreased FIBTEM CFT, with higher A10, A-angle, and MCF. The CAC group presented lower platelet count, increased fibrinogen levels, and higher FIBTEM A10 and MCF. PT was slightly prolonged at birth in neonates bornto SARS-CoV2-infected mothers. During the fourth day of life, D-dimers were significantly increased. Concerning ROTEM, neonates born to SARS-CoV2-infected mothers showed lower FIBTEM CT at birth. SARS-CoV2-infected pregnant women present a hypercoagulable profile. Hypercoagulability with elevated fibrinolysis and lower platelet count is observed in participants with CAC. The coagulation profile of neonates born to SARS-CoV2 mothers seems unaffected. Elevated D-dimers on the fourth day may reflect a neonatal inflammatory response to maternal SARS-CoV2.

The effect of probiotic supplements "Hydrolaktiv" and "Multibacterin" as part of the treatment and prevention regimens of gastrointestinal diseases of calves on the level of protein metabolism

The aim of the study was to establish the effect of probiotic supplements "HydroLaktiV" and "Multibacterin" as part of the treatment and prevention regimens of gastrointestinal diseases of calves on the level of protein metabolism.The study was conducted on newborn calves, of which three groups were formed according to the principle of analogues: one control (group 1) and two experimental (group 2 and group 3). Animals of all groups were kept in identical conditions. From the fourth day of life until the age of sixty, calves of all groups, according to the scheme adopted in the experimental farm, were fed kefir prepared with the use of the enzymatic feed additive "GastroVet", from the age of ten the animals began to be accustomed to coarse feeds by laying out first-class hay and starter feed (KK-62) in feeders. Additionally, the calves of the second experimental group were added to kefir with a feed additive "HydroLaktiV" at a dose of 15.0 g per head twice a day, and the calves of the third experimental group received the biocomplex "Multibacterin" at a dose of 1.0 ml per 10.0 kg of body weight twice a day.Blood collection from the studied animals was carried out from the jugular vein 30 minutes before feeding in compliance with the rules of asepsis and antiseptics. Blood serum was used for biochemical studies. The latter were performed on a Clima MC-15 semi-automatic analyzer, taking into account the following indicators: total protein, albumin, α-, β- and γglobulins.It has been established that the use of probiotic feed additives "HydroLaktiV" and "Multibacterin" as part of the treatment and prevention regimens of gastrointestinal diseases of calves has a positive effect on the normalization of protein metabolism, manifested in the maintenance of homeostasis, restoration of humoral immunity of animals after illness, as well as normalization of digestion and metabolic processes.

Growth Performance and Feed Intake Assessment of Italian Holstein Calves Fed a Hay-Based Total Mixed Ration: Preliminary Steps towards a Prediction Model.

The aim of this study was to evaluate the effects of a complete hay-based total mixed ration (TMR) for calves, focusing on their feed intake, animal growth performance, and fecal output, and to develop a preliminary estimation equation for solid feed intake and body weight in Holstein heifer calves. Twenty female Italian Holstein calves (37.14 ± 2.72 kg) born between February and July were studied from the day of birth until 77 days of age. From the fourth day of life, they were fed 3 L/day of pasteurized milk twice daily and supplemented with the same hay-based TMR. The data on feed intake, fecal characteristics, and growth performances were collected and showed that these calves had adequate parameters. Moreover, the data collected was used to create equations to predict body weight and solid feed intake using a mixed model. The goodness of fit of the developed equations was evaluated by coefficients of determinations (R2). The equation obtained shows high R2 (0.98 for solid feed intake and 0.99 for calf weight), indicating the satisfactory precision and accuracy needed to predict female calves' body weight and solid feed intake.

Trend and Predictors of Breastmilk Feeding among Very-Low-Birth-Weight Infants in NICU and at Discharge.

Mothers' own milk (MOM) for premature babies is considered a life-saving drug for its proven protective action against the complications of prematurity and for effects on outcome in the short and long term, especially neurological ones. We studied the use of MOM for infants weighing <1500 g for a period of 5 years, evaluating the trend over time and the impact of some variables on human milk feeding performance. Statistical comparisons concerned the rate of feeding with breast milk during a stay in an NICU and at discharge with respect to two types of variables: (1) maternal and neonatal characteristics (gestational age, birth weight, type of pregnancy (whether single or twin), maternal age) and (2) feeding characteristics (time of the start of minimal enteral feeding and availability of MOM, days until the achievement of full enteral feeding). Group comparisons were performed using ANOVA or t-test for continuous variables and Pearson chi-squared test or Fisher exact test for categorical variables. We observed an increase, between 2017 and 2021, in MOM use (p = 0.003). The availability of the own mothers' milk occurred, on average, on the fourth day of life and improved over the years. The start of minimal enteral feeding (MEF) with human milk averaged 1.78 days, and 54.3% of VLBWs received MEF with donor milk on the first day of life. The average percentage of feeding with the mothers' milk at discharge was 47.6%, with 36.1% of exclusive MOM and an increase from 45.8% in 2017 (33.3% exclusive) to 58.82% (41.18% exclusive) in 2021. The mean average daily growth of the weight improved (p < 0.001) during this period, and there was no statistical difference between infants fed with maternal milk and those fed with bank milk. Older maternal age, early-start feeding with maternal milk and low gestational age had a statistically significant impact on feeding with MOM at discharge.

The Predictive Value of Lung Ultrasound Score on Hemodynamically Significant Patent Ductus Arteriosus among Neonates ≤25 Weeks.

Lung ultrasound (LU) is increasingly used to diagnose and monitor neonatal pulmonary disorders; however, its role in hemodynamically significant patent ductus arteriosus (hsPDA) has not been elucidated. This prospective study investigated the predictive value of the LU score (LUS) for hsPDA in preterm infants with gestational age (GA) ≤ 25 weeks. Preterm infants with GA ≤ 25 weeks were enrolled in this study. LU was conducted on the fourth day of life (DOL). Six lung regions in every lung were scanned, with each region rated as 0-4 points. The performance of the LUS in predicting hsPDA among infants aged ≤25 weeks was analyzed by plotting the receiver operating characteristic (ROC) curve. A total of 81 infants were included in this study. GA, birth weight (BW), gender, Apgar score, delivery mode, antenatal steroids, meconium-stained amniotic fluid, premature rapture of membrane, and early-onset sepsis were not significantly different, but infants in the hsPDA group had increased LUS (38.2 ± 2.8 vs. 30.3 ± 4.3, p < 0.001) compared with non-hsPDA group. The area under the ROC curve (AUC) value of the LUS on the fourth DOL was 0.94 (95% CI: 0.93-0.99) in predicting hsPDA. The LUS threshold at 33 achieved 89% sensitivity and 83% specificity, with the positive and negative predictive values (PPV and NPV) being 87 and 86%, respectively. The LUS can predict hsPDA in extremely preterm infants at an early stage.

Quality improvement project in a neonatal intensive care unit reduced the prevalence and duration of hypophosphatemia with significant and sustainable results.

Hypophosphatemia is associated with prolonged mechanical ventilation and may affect growth, bone mineralization, nephrocalcinosis, and mortality in preterm infants. Optimal nutrition practices may decrease risk for hypophosphatemia and improve outcome. A quality improvement project was established to improve parenteral and enteral phosphorus intake with the goal to decrease prevalence and duration of hypophosphatemia in the first 14 days in infants <32 weeks' gestation. Among 406 preterm infants, the prevalence of moderate hypophosphatemia decreased from 44% to 19% (P < 0.01) over 4 years. The median duration of moderate hypophosphatemia decreased from 72 h (48-128) to 24 (24-53) (P < 0.01). Daily intakes of parenteral calcium and phosphorus on the fourth day of life increased from 1.5 to 2.5 mEq/kg/day (P < 0.01) and 0.6 to 1.3 mmol/kg/day (P < 0.01), respectively. The median postnatal age of first serum phosphorus concentration assessment decreased from 53 h (41-64) to 32 (24-40) (P < 0.01). During this quality improvement project, reduced prevalence and duration of hypophosphatemia in infants <32 weeks' gestation in the first 14 days of life was achieved through the optimization of parenteral and enteral phosphorus intake and improved response to acute hypophosphatemia.

Carboxyhemoglobin as biomarker of prematurity complications

BackgroundCarboxyhemoglobin (COHb) is considered a biomarker of oxidative stress and previous studies suggest a correlation between its blood level and prematurity complications. Our aim in this study was to assess the correlation between COHb levels and the risk for bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH), and retinopathy of prematurity (ROP). MethodsWe retrospectively studied 178 preterm infants with gestational age of 27.0 ± 1.5 weeks, among which 121 (68 %) had BPD, 43 (24 %) IVH, and 33 (19 %) ROP. COHb levels measured during the first seven days of life were recorded. ResultsLogistic regression analysis showed that higher levels of COHb on the seventh day of life increases the risk for moderate-to-severe BPD (OR 4.552, 95 % Cl 1.220–16.997; P = 0.024), while higher levels of COHb on the fourth day of life increases the risk for grade 2–4 IVH (OR 5.537, 95 % Cl 1.602–19.134; P = 0.007). ConclusionsCOHb measured in the first week of life can contribute to predicting the risk for BPD and IVH, but not for ROP, in very preterm infants. Since COHb can be readily measured, its assessment can be useful in clinical practice for early identification of preterm infants at high risk for oxidative stress related complications.

THE CLINICAL CASE OF GENERALIZED CONGENITAL HERPESVIRUS INFECTION IN NEWBORNS, AS A RESULT OF PRIMARY ASYMPTOMATIC INFECTION OF THE MOTHER WITH HSV TYPE 2 DURING PREGNANCY

The article presents a clinical case of generalized congenital herpesvirus infection with manifestation on the fourth day of life due to asymptomatic primary infection of the mother with HSV type 2 during pregnancy, complicated by early neonatal bacterial sepsis. The features of the clinic, diagnostics, principles of treatment and follow-up data of the child are presented. Clinical manifestation of congenital herpes infection took place on the 4th day of life. Laboratory confirmed by the detection of DNA of the herpes simplex virus type 2 in the blood, followed by determination of the quantitative level of this indicator and subsequent clinical and laboratory dynamics. Cancellation of specific therapy after 21 days due to the end of the course. Continuation up to 1 year 2 months of a course of specific mmunosuppressive therapy with acyclovir with increased therapy in case of recurrence of local manifestations. At the age of 1 year and 2 months, the withdrawal of specific immunosuppressive therapy. During the next year of life, 4 episodes of recurrence of herpes infection, in the form of local skin lesions. The child was vaccinated according to the calendar, additional vaccination against chickenpox, hepatitis A, pneumococcus, rotavirus infection, seasonal flu. Now the child is 2.4 years old. The child's condition is satisfactory. Development by age. The publication of materials was agreed with the Bioethics Commission of the National Bohomolets Medical University. All anamnestic data, examination results and photo materials were published upon written consent of the parents of the newborn child.Conclusions. Neonatal herpes infection can lead to significant morbidity, mortality, and adverse long-term outcomes. Despiteadequate therapy, vesicular rash recurrences in the first years of life are very common. Given the high rate of herpes simplex virus infection in the population, especially in pregnant women, all children should be considered potentially prone to herpes infection. Determination of maternal immune status, early diagnosis of clinical signs with verification of the causative agent, and timely and adequate specific antiviral therapy are essential to improve prognosis and reduce disability in later years of life.

Tricuspid Valve Blood Cysts Mimicking Thrombus or Vegetation on Echocardiogram in a Neonate.

A 2-month-old male infant, born premature with a birth weight of 865g, was found to have a tricuspid valve mass mimicking thrombus and vegetation by echocardiogram on the fourth day of life. The patient was treated with antibiotics and anticoagulation with no change in the size of the mass on serial follow-up echocardiography. The patient died of severe pulmonary vein stenosis and complex neurological disability. Postmortem cardiac examination revealed numerous cardiac blood cysts with two dominant ones (1.6 and 1.5mm) on the septal leaflet of the tricuspid valve, which based on the location and position corresponded to the suspected vegetation and thrombus on imaging. Cardiac blood cysts on valve leaflets are a common incidental finding during autopsy within the first 6months of life; however, they are rarely detected on imaging because of their minute size, often < 0.5mm. In this case, the sizable blood cysts were thought to represent thrombus or vegetation on echocardiogram, which influenced the patient management.

Neonatal tetanus with good outcomes at a regional referral hospital in Eastern Uganda: a case report

BackgroundNeonatal tetanus, though now rare in developed countries, is still a significant cause of mortality in developing countries. Mortality, which can be as high as 100% without medical intervention, can be reduced to less than 10% with intensive care. Low-resource settings still lack sophisticated intensive care that has been shown to improve outcomes in high-income countries. However, there are low-cost interventions that have been shown to improve outcomes such as the use of magnesium sulfate in the management of severe tetanus.Case presentationA 9-day-old term Itesot neonate presented to our facility with inability to breast feed, excessive crying, and stiffening of the body when touched that started on the fourth day of life. On admission, she had signs of respiratory distress, fever, and labile heart rate. A diagnosis of neonatal tetanus with autonomic dysfunction was made, and the neonate was started on diazepam and magnesium sulfate infusion. She showed remarkable improvement and was discharged after 24 days of inpatient care.ConclusionThere is still need to improve case management modalities for neonatal tetanus in low-income settings to improve outcomes. This case report summarizes how adopting a low-cost treatment modality for neonatal tetanus resulted in good outcomes at a regional referral hospital in Eastern Uganda.

VP12.11: Fetal hydronephrosis and a atypical genital tract malformation

Congenital renal diseases are significant causes of morbid mortality in children. There is a strong association between malformations of the urinary system and the genital tract. In the traditional Potter classification, the type IV is characterised by cystic kidneys in association with lower obstruction. However, the anomalies of the vagina generally do not influence urinary system development. We describe a 23-year-old lady, low risk pregnancy, 22 weeks of gestation. The ultrasound revealed oligohydramnios (amniotic fluid index 4.8 centimetres), adequate fetal growth, normal placenta and Doppler. In the morphology was identify bilateral hydronephrosis. The patient was followed up and counselling by the neonatal risks. She refused any intrautero intervention. On 31 week's gestation the amniotic fluid has become normal (AFI =15.0 cm), but the kidneys findings were the same. In this time, the lower abdominal evaluation was identified an unspecific hypoechoic cyst located posterior to bladder. On 40 week's gestation Caesarean delivery was performed at and the newborn weighed 4.3kg. The postnatal ultrasound findings were bilateral hydronephrosis and hiperechogenic parenchymal texture of the kidneys, normal bladder and abdominal hipoechogenic cyst. This cyst was located in topography of the vagina and was suggestive of hydrocolpos. The exam showed an imperforate hymen. The prompt surgical treatment was performed in the fourth day of life by abdominal section. The surgical findings confirmed the hypothesis of hydrocolpos. The newborn went to home and we are following the case closely. The importance of this case is in calling attention to different etiology to fetal hydronephrosis. The congenital malformation of the genital tract must be remembered, since other causes investigated so far have been negative. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

Overwhelming sepsis in a neonate affected by Zellweger syndrome due to a compound heterozygosis in PEX 6 gene: a case report

BackgroundPeroxisome biogenesis disorders (PBDs) are a group of metabolic diseases caused by dysfunction of peroxisomes. Different forms of PBDs are described; the most severe one is the Zellweger syndrome (ZS). We report on an unusual presentation of Zellweger syndrome manifesting in a newborn with severe and fulminant sepsis, causing death during the neonatal period.Case presentationA term male Caucasian neonate presented at birth with hypotonia and poor feeding associated with dysmorphic craniofacial features and skeletal abnormalities. Blood tests showed progressive leukopenia; ultrasounds revealed cerebral and renal abnormalities. He died on the fourth day of life because of an irreversible Gram-negative sepsis. Post-mortem tests on blood and urine samples showed biochemical alterations suggestive of ZS confirmed by genetic test.ConclusionsZS is an early and severe forms of PBDs. Peroxisomes are known to be involved in lipid metabolism, but recent studies suggest their fundamental role in modulating immune response and inflammation. In case of clinical suspicion of ZS it is important to focus the attention on the prevention and management of infections that can rapidly progress to death.

Application of luminescence spectral assay for assessment of the functional state of birds’ gastrointestinal tract by nucleic acids content in cells

The method of functional state evaluation of chickens’ glandular stomach mucous membrane epithelium, using luminescence spectral analysis with fluorescent dye “Ethidium bromide” was proposed. The dynamics of nucleic acids content in in cells of chickens’ glandular stomach under experimental escherichiosis and in intact poultry was established using this method. A gradual increase in the nucleic acids content in epithelium of glandular stomach of intact chickens was revealed from 1th to 30th days. The nucleic acids content in cells of chickens under experimental escherichiosis was gradually increased from the fourth day of life (second day after infection). The minimal index of nucleic acids content was recorded at the 7th day of chickens’ life. From 8th to 30th days of life, periods of increase / decrease in nucleic acids quantity in the cells were noted. By the 30th day, nucleic acids content in the chickens glandular stomach epithelial cells of the experimental groups was less by 40.1% than in control group poultry.

Study of cord blood albumin as a predictor of neonatal jaundice

Background: Neonatal jaundice is a commonly encountered condition in the neonates during first week of life. Early discharge of healthy term newborns is a common practice, because of the risk of nosocomial infections, social causes like in early naming ceremony, and also due to economical constrains. In significant number of newborns, neonatal hyperbilirubinemiais the most common cause for readmission. There is concern regarding early discharge of healthy term newborns due to reports of bilirubin induced brain damage resulting in sequel like kernicterus .There are reports of bilirubin induced brain damage which occurred in healthy term neonates even without hemolysis and the clinical outcome could be serious. The need for early detection of hyperbilirubinemia in the newborns is therefore important.&#x0D; Aims and Objective: The objective of the study was to find whether cord blood albumin can be considered as a predictor of neonatal jaundice. The study also explored for any possible associations of different factors like gender, birth weight and mode of delivery with the occurrence of neonatal jaundice.&#x0D; Materials and Methods: The hospital based cross sectional study enrolled 100 healthy term newborns from August 2016-July 2017. Cord blood was sent for albumin level and blood group estimation. All babies were assessed for clinical jaundice using Krammer criteria and confirmed by estimation of total serum bilirubin level on the fourth day of life.&#x0D; Results: Correlation of cord blood albumin with the fourth day bilirubin level revealed negative correlation (r value of - 0.455) with p value of 0.000 which was highly significant. However, there was no correlation between cord blood albumin level with total serum bilirubin level of more than 17mg/dl (neonatal hyperbilirubinemia) that required phototherapy or exchange transfusion (p value of &gt;0.005). Similarly, the study found no statistically significant association of neonatal jaundice with gender, weight and mode of delivery of the neonates.&#x0D; Conclusion: Cord blood albumin can be a risk factor rather than a diagnostic tool which can give a clue to possibility of high bilirubin level during neonatal period. There was no statistical significance seen between cord blood albumin level with total serum bilirubin level of ≥ 17mg/dl (neonatal hyperbilirubinemia) that required phototherapy or exchange transfusion.

ELECTROENCEPHALOGRAPHIC EXAMINATION AND ASSESSMENT OF THE PROGNOSIS OF FULL-TERM INFANTS WHO HAD SEVERE ASPHYXIA AT BIRTH

Introduction. Early and accurate identification of newborns with the highestrisk of severe hypoxic-ischemic nervous system lesions and their adverse effects areessential for determining optimal therapeutic strategies, proper use of resources, andcounseling for families. It has been shown that electroencephalographic examination(multichannel EEG) can be used to assess the severity and predict the effects of hypoxicischemic encephalopathy in newborns.Purpose of our workwas to evaluate the data of the multichannel electroencephalographicexamination (visual EEG patterns) of full-term infants after therapeutic hypothermiawith different severity of the effects of hypoxic-ischemic lesions.Material and methods. 33 full-term newborn infants who underwent therapeutichypothermia in the post-asphyxed period were examuned. Clinical-instrumentalexaminations were performed during the observation period, including measurementsof regional saturation of brain tissues with oxygen, neurosonographic examinationand Doppler ultrasound examination of brain vessels, and multichannelelectroencephalography in the state of physiological sleep.Results. Adverse short-term effects in the form of the formation of destructive hypoxicischemic lesions were observed in 13 children. Signs of moderate and markedlyabnormal EEG were found in 5 (25%) children of the group without destructive lesionsand 11 (84.6%) children with destructive lesions (p&lt;0,05; relative risk - 5.84; 95%confidence interval - 1.53-22.4 sensitivity is 0.846; specificity is 0.750).In the general observation group, significant correlation (p &lt;0.05) was recordedbetween assessment of sleep spindles formation and data of Doppler ultrasound indicesof the anterior cerebral artery indices for the second (R=-0.58) and fourth day of life(R=-0,58). In children without destructive lesions, significant (p&lt;0.05) correlationsbetween assessment of sleep spindle formation and anterior cerebral artery indices forthe second (R=-0.53) and fourth day of life (R= -0,76), data for measuring regionalbrain tissue oxygen saturation: medians of left (R=-0.56) and right (R=-0.58) wereregistered.Conclusions. The existence of significant differences in visual patterns of EEG in terminfants after therapeutic hypothermia with different severity of the effects of hypoxicischemic lesions has been proved.

Cortisol, leptin and free leptin index (FLI) in newborns in the first days of life and their importance for body weight programming

BackgroundBirth weight and leptin seem to be the factors responsible for early programming of body weight in later life. A marker for leptin action is free leptin index (FLI), which depends on soluble leptin receptor (Ob-Re) (FLI = leptin/Ob-Re). In the present article, we suggest that FLI is modulated partly by cortisol variations observed in newborns in the first days of life and is connected with their postnatal weight loss.MethodsThe study group consisted of 44 full-term newborns. Leptin, cortisol and Ob-Re concentrations were determined in the umbilical cord blood (UCB) and in the newborns’ blood (NB) on the fourth day of life, free leptin index (FLI = leptin/Ob-Re) was calculated. Correlations between the assessed parameters and the somatic features of the newborns were examined.ResultsBirth weight, length and chest circumference of newborns were positively correlated with leptin concentration in the UCB but not with FLI in the UCB. Cortisol and leptin concentrations, as well as FLI values declined concomitantly with body weight, and were lower on the fourth day of life than on the first one; however, Ob-Re concentration increased (p < 0.0001). There was a positive correlation between the newborns’ birth weight loss percentage evaluated on the fourth day of life and FLI in newborns (R = 0.39; p < 0.01). Positive correlations between cortisol and Ob-Re in UCB (R = 0.35; p < 0.02) and in NB (R = 0.36; p < 0.01), as well as a negative correlation between cortisol and FLI (R = -0.32; p < 0.03) in NB were noted.ConclusionsOur data suggest a possible relationship between cortisol and a soluble leptin receptor (Ob-Re), which changes free leptin index (FLI) and is connected with birth weight loss in newborns. Whether these observations are important for programming of future body weight of children requires further research.

Segmental absence of intestinal musculature in an extremely low birthweight preterm infant

Abstract Background The segmental absence of intestinal musculature is a rare clinical entity, usually manifested in the neonatal period. It is more frequent in preterm infants, particularly in very low birthweight infants. Typically, there are intestinal perforation or intestinal obstruction symptoms. Case presentation The authors report a case of a 30-week-gestational age extremely low birthweight newborn who presented, on the fourth day of life, with a progressively acute abdomen and radiological findings suggestive of intestinal perforation. An emergency laparotomy with segmental ileal resection was performed; intestinal perforation was not confirmed. The histopathological examination of the resected distended bowel revealed an area of severe hypoplastic muscularis propria (with remaining layers intact). Conclusion Preoperative diagnosis of segmental absence of intestinal musculature is extremely difficult; its definitive diagnosis relies solely on the histopathological examination. The clinicians and pathologists should be aware of this rare condition, the treatment and prognosis of which differs from the more common necrotising enterocolitis.