Ten days of orotracheal intubation with successful extubation in an infant with junctional epidermolysis bullosa.

OBJECTIVE: The most severe form of generalized junctional epidermolysis bullosa, the Herlitz variant, is associated with a number of extracutaneous manifestations. We report on a 45-day-old infant with laryngotracheobronchial mucosa involvement who underwent successful tracheal extubation after 10 days of orotracheal intubation and mechanical ventilatory support. Issues regarding airway management and mechanical ventilatory support in the pediatric intensive care unit are discussed.

In-utero cocaine exposure and neonatal intestinal perforation: a case report.

This article describes a case of spontaneous neonatal intestinal perforation in a preterm infant with evidence of intrauterine exposure to cocaine. Clinical, laboratory, radiological, surgical, and pathological finds were inconsistent with necrotizing enterocolitis. Three previous case reports had made the association between spontaneous focal neonatal intestinal perforation and prior intrauterine cocaine exposure; however, in each case, there were extenuating circumstances that may weaken the etiological link. The case described here appears to strengthen the association/etiological link. After all other causes of focal neonatal intestinal perforation have been excluded, the possibility of intrauterine exposure to cocaine should be considered.

Is routine episiotomy beneficial in the low birth weight delivery?

The outcome of 439 idiopathic singleton low birth weight spontaneous vertex deliveries in the university hospital of a developing country was analyzed. Any patient with a known complication of pregnancy was excluded from the study. The effects of maternal age were minimized by including only those mothers between the age of 17 and 34. The effect of maternal parity was minimized by analyzing the study in two parity groups. The birth weight distributions of the episiotomized and non-episiotomized groups were comparable. There was no significant difference in the Apgar scores and neonatal mortality rates between these neonates delivered with an episiotomy and those without. This was the case, regardless of parity. The value of an episiotomy in the delivery of the low birth weight infant is questioned.