Fourth Week Of Life Research Articles

Razão proteína:creatinina urinária em filhotes felinos em crescimento: nova visão

This study aimed to evaluate the urinary excretion of protein employing the urine protein:creatinine ratio in growing health kittens and included twelve clinically healthy multi-mixed-breed kittens, seven males and five females from three different litters. Urine collections started when the kittens completed the fourth week of life. The study followed a controlled longitudinal experimental model, with 14 repeated measures, one per week. A total of 168 urine samples from 12 healthy growing kittens were analyzed. UPC ratio median value was 0.56 (confidence interval 0.51 - 0.62), revealing urinary protein excretion more remarkable than is expected for healthy adult cats. Two-way repeated-measures ANOVA results indicated no statistically significant differences in urine protein:creatinine ratio values concerning the kittens’ ages and genders. Additionally, there was a striking fluctuation of urine protein: creatinine ratio values for all kittens over the 14 weeks (coefficient of variation 53.3%). Urine protein:creatinine ratio of healthy growing kittens changes unexpectedly, and most values reach magnitudes considered pathological for adult cats, suggesting a clinically irrelevant condition. Since the fluctuation of the UPC is not related to age (from the fourth to the seventeenth week of age), to interpret of UPC of growing kittens, in practice or research, it is mandatory to repeat the measures, at least three times, at one week apart, to discharge pathologic event.

The impact of iron supplementation on the preterm neonatal gut microbiome: A pilot study.

The gastrointestinal microbiome in preterm infants exhibits significant influence on optimal outcomes-with dysbiosis shown to substantially increase the risk of the life-threatening necrotizing enterocolitis. Iron is a vital nutrient especially during the perinatal window of rapid hemoglobin production, tissue growth, and foundational neurodevelopment. However, excess colonic iron exhibits potent oxidation capacity and alters the gut microbiome-potentially facilitating the proliferation of pathological bacterial strains. Breastfed preterm infants routinely receive iron supplementation starting 14 days after delivery and are highly vulnerable to morbidities associated with gastrointestinal dysbiosis. Therefore, we set out to determine if routine iron supplementation alters the preterm gut microbiome. After IRB approval, we collected stool specimens from 14 infants born <34 weeks gestation in the first, second, and fourth week of life to assess gut microbiome composition via 16S rRNA sequencing. We observed no significant differences in either phyla or key genera relative abundance between pre- and post-iron timepoints. We observed notable shifts in infant microbiome composition based on season of delivery. Though no obvious indication of iron-induced dysbiosis was observed in this unique study in the setting of prematurity, further investigation in a larger sample is warranted to fully understand iron's impact on the gastrointestinal milieu.

Use of an elevated platform with perforated surface and manure belt by fast-growing broilers on commercial farms

Like other members of the species Gallus gallus, fast-growing broilers are motivated to perch. However, broilers in the European Union are kept in unstructured barns, with no opportunity to sit elevated and rest undisturbed. A possible solution to this problem is elevated platforms. The aim of this study was to evaluate the use of an elevated platform with perforated surface and manure belt by fast-growing broilers. On 2 commercial farms, an elevated platform was installed in 1 barn per farm. Approximately 35,000 Ross 308 broilers were housed in each barn for 3 fattening periods. On 1 d per wk, the number of broilers per m² on the platform and the ramp was determined every 30 min from video recordings. Besides, focal animals were observed to analyze their behavior on the platform at different ages and during light and dark periods. Broilers used the elevated platform and the ramp from the first week until the end of the fattening period (platform: 9.92 broilers per m², ramp: 6.47 broilers per m²), with a peak in the fourth week of life (platform: 13.00 broilers per m²). In wk 2, 4, and 5, platform use was higher during the light period than during the dark period. Broilers stayed longer on the platform in the dark period (dark: 01:54:23 [hh:mm:ss], light: 00:19:54 [hh:mm:ss]). In every phase of the fattening period, broilers on the platform were inactive to a high proportion (on average 80.60%). This indicates that broilers used the platform also for resting behavior. Thus, the elevated platform with perforated surface and manure belt is a suitable option to structure broiler barns. It allows the broilers to sit elevated and provides additional space. Factors such as a shallow ramp incline of 20°, wide ramps, and appropriate material used for the surface and ramps may have contributed to its high use by broilers of all ages. Further research is needed to evaluate the design of platforms that allow broilers to rest undisturbed.

An insight into the temporal dynamics in the gut microbiome, metabolite signaling, immune response, and barrier function in suckling and weaned piglets under production conditions.

Little information is available on age- and creep-feeding-related microbial and immune development in neonatal piglets. Therefore, we explored age- and gut-site-specific alterations in the microbiome, metabolites, histo-morphology, and expression of genes for microbial signaling, as well as immune and barrier function in suckling and newly weaned piglets that were receiving sow milk only or were additionally offered creep feed from day of life (DoL) 10. The experiment was conducted in two replicate batches. Creep feed intake was estimated at the litter level. Piglets were weaned on day 28 of life. Gastric and cecal digesta and jejunal and cecal tissue were collected on DoL 7, 14, 21, 28, 31, and 35 for microbial and metabolite composition, histomorphology, and gene expression. In total, results for 10 piglets (n = 5/sex) per dietary group (sow milk only versus additional creep feed) were obtained for each DoL. The creep feed intake was low at the beginning and only increased in the fourth week of life. Piglets that were fed creep feed had less lactate and acetate in gastric digesta on DoL 28 compared to piglets fed sow milk only (p < 0.05). Age mainly influenced the gastric and cecal bacteriome and cecal mycobiome composition during the suckling phase, whereas the effect of creep feeding was small. Weaning largely altered the microbial communities. For instance, it reduced gastric Lactobacillaceae and cecal Bacteroidaceae abundances and lowered lactate and short-chain fatty acid concentrations on DoL 31 (p < 0.05). Jejunal and cecal expression of genes related to microbial and metabolite signaling, and innate immunity showed age-related patterns that were highest on DoL 7 and declined until DoL 35 (p < 0.05). Weaning impaired barrier function and enhanced antimicrobial secretion by lowering the expression of tight junction proteins and stimulating goblet cell recruitment in the jejunum and cecum (p < 0.05). Results indicated that age-dependent alterations, programmed genetically and by the continuously changing gut microbiome, had a strong impact on the expression of genes for gut barrier function, integrity, innate immunity, and SCFA signaling, whereas creep feeding had little influence on the microbial and host response dynamics at the investigated gut sites.

SEXUAL DIFFERENTIATION OF AGGRESSIVE BEHAVIOR IN THE CHICKS OF THE BLACK-HEADED GULL (&lt;i&gt;LARUS RIDIBUNDUS&lt;/i&gt;, LARIDAE, CHARADRIIFORMES) IN THE NATURAL ENVIRONMENT

Sexual differentiation of social behavior in gulls and its mechanisms remain unexplored beyond the breeding season. We described the development of aggressive territorial behavior in males and females of black-headed gulls at the age of 1–4 weeks, modeling the intrusion of a peer to the nesting territory. We also hypothesized that the sex differentiation of aggressive behavior may appear as a consequence of the development of small early differences between siblings in behavioral stress response. To test this assumption, we investigated the relationship between the priority among brood in aggressive contact with the intruder, and the within-broods level of activity of a chick to stress. To measure the behavioral stress response, we used the social isolation of chicks within a small water area with an island in the middle. Longer attempts to swim outside the fenced area were regarded as a more proactive stress response. At the age of up to 3 weeks, there were no sex differences in the aggressiveness, but the stress response of males was more proactive than that of their sisters, and a more proactive chick in the brood was usually the first to attack the intruder. At the fourth week of life, the aggressiveness of males increased significantly, and in broods of two sexes, brothers began to play a leading role in protecting the nesting territory in the absence of parents. They attacked the intruder more often and made aggressive calls more frequently. Thus, we were the first to reveal sexual differentiation of territorial behavior in gull chicks in the pre-fledging period. Our results suggest that under natural conditions, where the intruder does not persist in staying in the other nest, but recedes immediately when counteracted, more proactive males use to attack the intruder earlier than sisters do. As a result, they gain experience of aggressive interactions, and develop higher abilities of aggressive responses to social challenges.

Behavioral development of a captive polar bear (Ursus maritimus) cub in the maternal den.

Two female polar bear (Ursus maritimus) cubs were born to mother Suka at the Detroit Zoo on November 17, 2020. One cub (Laerke) was hand-reared out of medical necessity, while the other cub (Astra) was mother-reared. Using audio-equipped video cameras previously installed in the maternal den, staff were able to conduct uninterrupted continuous monitoring on Suka and Astra for an unprecedented 12 weeks. Data collected during this time were analyzed descriptively. Astra spent a maximum of approximately 20% of any given 24 hperiod in nursing behaviors. Distribution of time spent nursing was relatively even across the 24 hday. In contrast to the limited data currently available, Astra spent only approximately 11% of the over 2000 h of behavioral data engaged in nursing behaviors. Astra left the nest for the first time in her fourth week of life, and time spent out of the nest gradually increased with age. Suka was observed guiding Astra back to the nest the first few times Astra ventured out. However, maintenance of maternal proximity did not appear to be a motivating factor in patterns of space use. The data presented here represent the longest uninterrupted continuous monitoring of a polar bear cub in the maternal den currently published. Publication of similar data from other institutions would establish more generalizable trends for early infancy development. These data are critical for understanding cub welfare and improving population sustainability and neonate mortality rates.

The importance of the timing of microbial signals for perinatal immune system development.

Background: Development and maturation of the immune system begin in utero and continue throughout the neonatal period. Both the maternal and neonatal gut microbiome influence immune development, but the relative importance of the prenatal and postnatal periods is unclear. Methods: In the present study, we characterized immune cell populations in mice in which the timing of microbiome colonization was strictly controlled using gnotobiotic methodology. Results: Compared to conventional (CONV) mice, germ-free (GF) mice conventionalized at birth (EC mice) showed few differences in immune cell populations in adulthood, explaining only 2.36% of the variation in immune phenotypes. In contrast, delaying conventionalization to the fourth week of life (DC mice) affected seven splenic immune cell populations in adulthood, including dendritic cells and regulatory T cells (Tregs), explaining 29.01% of the variation in immune phenotypes. Early life treatment of DC mice with Limosilactobacillus reuteri restored splenic dendritic cells and Tregs to levels observed in EC mice, and there were strain-specific effects on splenic CD4+ T cells, CD8+ T cells, and CD11c+ F4/80+ mononuclear phagocytes. Conclusion: This work demonstrates that the early postnatal period, compared to the prenatal period, is relatively more important for microbial signals to influence immune development in mice. Our findings further show that targeted microbial treatments in early life can redress adverse effects on immune development caused by the delayed acquisition of the neonatal gut microbiome.

The D-dimer reference intervals in healty term newborns

ObjectiveTo determine the D-dimer reference intervals in the neonatal period. Materials and methodsThe research had been carried out in the obstetrics and gynecology clinic and neonatal outpatient clinic of a third level hospital. Healthy term newborns aged between 1 and 28 days were enrolled in the study. Venous blood samples were collected from peripheral veins in all babies and D-dimer, prothrombin time, activated partial thromboplastin time and platelet counts were measured. Reference intervals for D-dimer in the neonatal period were determined using 2.5th and 97.5th percentile values. ResultsA hundred and thirty four newborns (71 boys, 63 girls) were enrolled in the study. Mean D-dimer levels of infants aged 1–28 days was 1.74 ± 1.88 mg/L (reference range; 0.25–2.81 mg/L). D-dimer levels were between 2.44 and 2.45 mg/L, 1.71–1.76 mg/L, 1.26–0.89 mg/L and 0.88–0.66 mg/L in the first, second, thirth and fourth week of life,respectively. D-dimer values inversely correlated with postnatal age (r:−0.3, p < 0.001). However, it remained above adult levels even in the last week. There was no statistically significant difference between the D-dimer levels of girls (1.93 ± 2.06 mg/L) and of boys (1.57 ± 1.71 mg/L). DiscussionIn this study, D-dimer levels in the neonatal period were found to be higher than adult levels stated in the literature. D-dimer levels gradually decreased overtime in the first month. It would be appropriate to use age-specific reference values in the evaluation of D dimer levels in the neonatal period.

Bioclimatic zoning for quails in the dry period in the state of Paraíba, Brazil

Based on the temperature and humidity index, for quails from the 3rd to the 5th week of life, in the dry period in Paraíba state, Brazil, the objective was to carry out a bioclimatic zoning, identifying as regions suitable for the reproduction of quails and, when necessary, mitigating measures for greater animal comfort. The bioclimatic zoning was carried out for the mesoregions of the state, the climatic data used are from meteorological stations in the period from 1961 - 2015, from them maps were elaborated with the spatial distribution of the index, identifying as regions with ideal thermal comfort conditions for the animals. For quails in the third week, the Agreste mesoregion presents the best situation in the dry season, not requiring corrective measures to maintain the comfort of these animals. In the fourth week of life of the quails, the mesoregions that would provide THI values ​​within the ZCT in the dry period would be the Zona da Mata paraibana and Sertão, while the ZCT for quails in the fifth week of life, could be found throughout the state of Paraíba.

Acne in the newborn.

Neonatal acne (NA) is a transitory dermatosis that occurs between the second and fourth weeks of life in 20% of children. This condition is more frequent in males, with a male-female ratio of 4.5:1. Present primary skin lesions are open and closed comedones which can evolve into papules, erythematous pustules and, in rare cases, nodules and cysts. NA topography includes the forehead, cheeks, chin, and eyelids, but occasionally it spreads to the scalp, neck, and trunk. NA occurs due to an elevated production of placental and neonatal androgens (of adrenal origin in both sexes and of testicular origin in males) which cause enlargement of the sebaceous glands and increases the production of sebum. Most cases are mild and transient, but if NA is severe and long-lasting, clinical and paraclinical examination will be necessary to find congenital adrenal hyperplasia or a virilizing tumor of adrenal or gonadal origin. The diagnosis of NA is clinical; its main differential -diagnoses are neonatal cephalic pustulosis, other neonatal vesiculopustular dermatoses, infectious diseases, and acneiform reactions. The resolution of NA is spontaneous. In most cases, the use of a mild dermal cleanser and water will be sufficient. For comedogenic lesions (open and closed comedones), topical retinoids or 20% azelaic acid may be used, as well as some topical antibiotics for inflammatory lesions.

Evaluation of radiologic evidence of metabolic bone disease in very low birth weight infants at fourth week of life.

AimThe aim of this study is to determine the incidence of metabolic bone disease (MBD) and assess the risk factors for development radiologic evidence of MBD.MethodsPreterm infants with gestational age ≤32 weeks and birth weight ≤1500 g were included in this prospective study. Metabolic bone disease was defined as hypophosphatemia (phosphorus levels <4 mg/dl), ALP levels >450 U/L, or radiologic findings of MBD at four weeks of age.ResultsThe study included 254 infants (gestational age: 29 (27–30) weeks, birth weight: 1130 g (960–1300)). Metabolic bone disease was diagnosed in 96 patients (37%); 48 infants had only radiologic evidence of MBD, 24 infants had only biochemical diagnosis of MBD, and 24 infants had both radiologic evidence of MBD and biochemical diagnosis of MBD.ConclusionsOur results showed that radiologic evidence of MBD existed in some infants with normal biochemical results. That finding may guide further development of screening programs for MBD.

Temporal characterization of the insulin resistance during puberty in mice.

Objectives. The onset of puberty in humans is followed by an increase in insulin resistance and this transient phenomenon decreases at the end of the puberty. However, the insulin resistance during puberty has not been described in mice. Thus, in the present study we performed a temporal characterization of the development of insulin resistance during puberty in male and female C57BL/6 mice.Methods. From the fourth week of life male (n=18) and female (n=32) C57BL/6 wild-type mice were weekly subjected to insulin tolerance tests until the seventh week of life. Blood glucose levels were determined using a glucose meter through samples collected from the tail tip. Vaginal opening was assessed daily in female mice. Preputial separation was determined in a subgroup of males.Results. We observed a transient increase in the area under the curve of the insulin tolerance tests and in basal glycemia in female mice at the time of vaginal opening (between the fourth and fifth week of life) compared with previous and subsequent weeks of pubertal development. In contrast, male mice show no changes in insulin sensitivity during puberty.Conclusions. Our findings demonstrate that the insulin resistance at puberty can also be observed in female mice and this peak occurs at the time of vaginal opening. Our temporal characterization can be used as a reference for future studies that aim to study glucose homeostasis during puberty in rodents.

Can 5-minute Apgar score be considered as an additional independent risk factor for screening of retinopathy of prematurity?

Introduction: Because of increasing the population of premature infants due to improving neonatal care we try to find other independent criteria in addition to birth weight and gestational age to reduce the number of infants who need a retinopathy of prematurity (ROP) screening examination. Methods: This is a retrospective cross-sectional study, included 150 preterm infants with gestational age of ≤ 32 weeks or birth weight ≤ 1500 g or receives oxygen therapy for more than 2 days, who were examined from the fourth week of life for ROP in Tabriz Al-Zahra hospital’s neonatal intensive care unit (NICU), from March 2017 to January 2018. All infants with other risk factors such as multi gestational pregnancy, blood transfusion or exchange, phototherapy, underlying disease, cerebral hemorrhage, chronic lung disease and sepsis were excluded from the study. Infants divided to two group ROP (n=47) and non-ROP (n=133) and their 5-minute Apgar score was Apgar score was compared as an independent risk factor. Exploratory data analysis was performed using descriptive measures with independent samples t tests. Kolmogorov-Smirnov tests were used to test the normality of data distribution. Results: The mean 5-minute Apgar scores were statistically lower in ROP group (5.4±2.3) than non-ROP group 6.2±2.1 (P value=0.041). Conclusion: Apgar score was statistically significant, but in light of the very close results obtained, it seems prudent to consider an independent risk factor.

Effect of Early-Onset Preeclampsia on Offspring's Blood Pressure during the First Month of Life

To explore the effect of early-onset preeclampsia on the blood pressure of offspring during the first month of life. This prospective case-control study included 106 neonates of mothers with early-onset preeclampsia (developing at <34weeks of gestation) and 106 infants of normotensive mothers, matched 1-to-1 for sex and gestational age. Serial blood pressure measurements were obtained on admission, daily for the first postnatal week, and then weekly up to the fourth week of life. There were no differences in blood pressure values on admission and the first day of life between cases and controls. Conversely, infants exposed to preeclampsia had significantly higher systolic (SBP), diastolic (DBP), and mean blood pressure (MBP) on the subsequent days up to the fourth postnatal week (P<.001-.033). Multiple regression analyses with adjustment for sex, gestational age, antenatal corticosteroid use, and maternal antihypertensive medication use confirmed the foregoing findings (P<.001-.048). Repeated-measures ANOVA also identified preeclampsia as a significant determinant of trends in SBP, DBP, and MBP during the first month of life (F=16.2, P<.001; F=16.4, P<.001; and F=17.7, P<.001, respectively). Infants of mothers with early-onset preeclampsia have elevated blood pressure values throughout the neonatal period compared with infants born to normotensive mothers.

Abstract 466: Myopathy Causing Bag3 P209L Protein Leads to Restrictive Cardiomyopathy Caused by Aggregate Formation and Sarcomere Disruption in Cardiomyocytes

The co-chaperone BAG3 (Bcl-2 associated athanogene 3) is strongly expressed in cross-striated muscles and plays a key role in the turnover of muscle-proteins as a member of the CASA (chaperone-assisted selected autophagy) complex. An amino acid exchange (P209L) in the human BAG3 gene, caused by a single base mutation, gives rise to a severe dominant childhood muscular dystrophy, restrictive cardiomyopathy, and respiratory insufficiency. To get deeper insights into the pathophysiological mechanisms of the disease, we generated a transgenic mouse model of the human mutation BAG3 P209L , in which a fusion protein consisting of the human BAG3 P209L and the green fluorescent protein eGFP can be conditionally overexpressed. Ubiquitous overexpression of BAG3 P209L -eGFP leads to a severe phenotype between the second and fourth week of life, including decreased body weight, skeletal muscle weakness, and heart failure. Echocardiography revealed that the BAG3 P209L -mice suffer from restrictive cardiomyopathy and Sirius-red-staining of heart tissue showed extensive fibrosis. In cardiomyocytes, isolated from hearts of transgenic mice overexpressing BAG3 wt -eGFP or BAG3 P209L -eGFP, BAG3 wt -eGFP stringently localizes to sarcomeres and intercalated discs, whereas cardiomyocytes from BAG3 P209L -eGFP mice displayed formation of BAG3 containing aggregates and disruption of sarcomeres in vivo . While BAG3 P209L -eGFP binding to á-Hsp70, Filamin C and á-HspB8 was unchanged it was less soluble than BAG3 and had a tendency to aggregate, thereby sequestering BAG3 and its clients. Depletion of the BAG3 pool leads to an impairment of CASA and accumulation of damaged proteins, causing sarcomere disintegration leading to restrictive cardiomyopathy.

Reference intervals for serum 17α-hydroxyprogesterone and ultrasonographic adrenal gland sizes in healthy newborns

Background and objectives: Serum 17α- hydroxyprogesterone (17OHP) and bilateral adrenal sizes are pivotal for clinical practice in both diagnosis and treatment of congenital adrenal disorders during the first month of life. Our aims were to determine the reference ranges for serum 17OHP and bilateral adrenal gland sizes according to sex and age groups in healthy term newborns.Materials and methods: A total of 156 healthy newborns, aged 4–7 days (Group 1) or 26–30 days old (Group 2) were included in the study. Serum 17OHP concentration was measured in the morning by radioimmunoassay. The right and left adrenal glands’ width, length, and depth were measured with ultrasonography by the same radiologist and the volumes were calculated.Results: The clinical characteristics and serum 17OHP concentrations were similar in male and female newborns. Percentiles for serum 17OHP concentration and the volume of adrenal glands according to age groups and sexes were obtained. Mean 17OHP concentration was 4.67 ± 2.6 ng/ml and 4.49 ± 2.7 ng/ml at the first and fourth week of life, respectively (p > .05). There was a significant decrease in adrenal sizes during the fourth week of life. There was no significant correlation between serum 17OHP concentration and adrenal gland sizes.Conclusions: We have determined reference intervals for serum 17OHP concentration and bilateral adrenal gland sizes for healthy newborns. Although serum concentrations of 17OHP did not change significantly through the first month of life, our reference intervals for serum 17OHP concentration and adrenal sizes may improve clinical approach toward newborns who are suspected of adrenal disorder. We conclude that our reference intervals can guide for congenital adrenal screening regarding serum 17OHP concentration besides diagnosis of adrenal hypoplasia or hyperplasia with ultrasonographic adrenal gland sizes.

The earliest timing of ultrasound in screening for developmental dysplasia of the hips.

PurposeThe current study aimed to evaluate the results of ultrasound screening for developmental dysplasia of the hips (DDH) done at various weeks of life, to determine the earliest time that ultrasound screening can be performed reliably.MethodsIn this 17-year cohort study, all neonates who underwent ultrasound screening prior to the 12th week of life with subsequent follow-up radiography done at 1 year of life were included. The ultrasound images were evaluated according to the Graf classification, Harcke’s dynamic ultrasound screening method, and Terjesen’s femoral head coverage method. The radiographic images were evaluated according to the acetabular index and the femoral head position. The accuracy and correlation between the ultrasound findings from various weeks of life with the radiographic findings at 1 year of life were evaluated.ResultsA total of 348 neonates were included in the study, of whom 92 had abnormal ultrasound findings and 42 had abnormal radiographic findings at 1 year. Significant differences were identified between the findings of ultrasound screening examinations performed prior to the fourth week of life (day 21 and before) and the radiographic findings at 1 year of life (P<0.05). In contrast, no significant differences were identified when ultrasound screening was performed between the fourth and 12th weeks of life (day 22 and beyond) (P>0.05). The accuracy of ultrasound screening was 79.2% or higher when performed during or after the fourth week of life (day 22 and beyond).ConclusionThe earliest that ultrasound screening for DDH can be performed reliably is during the fourth week of life (day 22 and beyond).

Energy expenditure, growth, and nutritional therapy in appropriate and small for gestational age preterm infants

ObjectiveTo evaluate the resting energy expenditure, growth, and quantity of energy and macronutrients intake in a group of preterm newborns. MethodsThe cohort study was performed with appropriate and small for gestational age preterm infants (birth weight lower than 1500g or gestational age<32 weeks). Resting energy expenditure was measured using indirect calorimetry on the 7th, 14th, 21st, and 28th days of life, and at discharge. Length, head circumference and body weight were assessed weekly. Nutritional therapy was calculated during the hospital stay and the information for each type of food was recorded in software that calculates the total amount of energy and macronutrients. Results61 preterm infants were followed; 43 appropriate and 18 small for gestational age infants. There was no statistical difference for resting energy expenditure between the groups, and it increased from the first to the fourth week of life (appropriate: 26.3% and small: 21.8%). Energy intake in the first two weeks of life was well below the energy requirement. ConclusionConsidering that the results demonstrate high energy expenditure during the first weeks of life, there is an evident need to provide the best quality of nutrition for each child in the first weeks of life so that preterm infants with or without intrauterine growth restriction can achieve their maximum potential for growth and development.

Lamellar ichthyosis in a female neonate without a collodion membrane

The term, autosomal recessive congenital ichthyosis (ARCI), describes a group of rare genetic skin diseases of cornification involving hyperkeratotic scaling at birth. The defective skin barrier function may lead to dehydration, body temperature instability, and high susceptibility to infections. In most cases of ARCI, neonates are born with a collodion membrane covering the body, often presenting with ectropion and eclabium. We report a premature female neonate presenting with hyperkeratotic scaling at birth without a collodion membrane. She was managed with placement in a humidified isolette, prophylactic antibiotics, dilute bleach baths, petrolatum ointment, and artificial eye drops. By the fourth week of life, there was marked improvement in her skin with the large, brown, plate-like scales on the trunk and extremities becoming lighter in color and finer in appearance. The ichthyosis genetic panel showed mutations in the ABCA12 gene resulting in the lamellar ichthyosis phenotype of ARCI. Our literature review revealed at least 28 patients with ARCI who were not born as collodion babies. Although collodion babies are a hallmark of most ARCI cases, clinicians should be aware of neonates with ARCI born without a collodion membrane and expedite appropriate workup and treatment.

Clinical assessment of infantile haemangioma among patients attending the dermatology department of Rapareen teaching hospital in Erbil city

Background and objectives: Strawberry (capillary) haemangiomas are the most commonbenign tumors of childhood;they are present at birth in one thirdof cases. The remainder appears shortly thereafter. Sixty percentare on the head and neck, but they may occur anywhere. The aim of this study is to have a clinical evaluation of infants and children with haemangiomaand to identify risk factors associated with infantile haemangioma. Methods: A case control study involved 38 patients with infantile haemangioma and 38 controls matched by age and gender. Data were collected by direct interview with the patient’s guardians through a questionnaire including age, gender, birth weight, any complication during pregnancy or labor and the type of complication, gestational age (full term, premature, postdate), mode of delivery (normal vaginal delivery or caesarean section), duration of the lesion, age at onset, site (head, neck, trunk, groin, upper extremity, lower extremity), size, number of the lesions, any complications and type of it, interventions and type of intervention; pharmacological, surgical or laser and family history of haemangioma. Results:From a total of 76 patients and controls, 71.1% were females and 28.9% were males.Their age ranged from 1108- months.Sixty and a half percent of our patients were less than one-year age. Full term infants made 81.6% of our patients while premature infants were only18.4% of the patients. Mode of delivery was normal vaginal delivery in 55.3% of patients and 65.8% of controls while 44.7% of patients and 34.2% of controls were born by caesarean section. Hemangiomas were present since birth in 73.7%, 13.2% had their lesion in their first week, 5.3% developed the lesion during their second and fourth week of life and 2.6% developed lesion during their third week. Lesion werepresent on the head and neck in 47.4%. Minimum lesion size was 0.3cm and maximum diameter was 10.5cm. Conclusions: Infantile haemangioma are common in female babies, risk factors are prematurity and maternal anemia. Lesions were noticed at birth or appeared within few weeks and the majority had single lesion.