Does Urinary Tract Ultrasound Have Its Place in the Treatment of Early Neonatal Jaundice? Neonatal Bilateral Adrenal Hemorrhage: Case Report.

Adrenal hemorrhage is a rare clinical entity in the neonatal period, with an incidence of 1.7-2.1/1000 births. It is more often diagnosed on the right side, whilst bilateral hemorrhage occurs in 10%-15% of cases. Clinical presentation shows a wide range of symptoms, from the signs of adrenal insufficiency to asymptomatic course of illness with incidental finding of changes on testing. Neonatal jaundice due to hemolysis of hemorrhagic content often is an accompanying sign. We present a male neonate born at term, with early neonatal jaundice of unknown cause and without evi-dence of perinatal infection. Ultrasound of the urinary tract revealed hypoechoic formations in the upper poles of both kidneys, confirmed by magnetic resonance imaging of the abdomen. Clinical and laboratory test results showed no signs of adrenal insufficiency. There was no confirmation of em-bryonic tumor or neuroblastoma. Ultrasound of the urinary tract as an available and noninvasive test has its place in the treatment of early neonatal jaundice of unknown cause. Additional invasive treat-ment and unnecessary laparotomy can be avoided with ultrasound monitoring of the formation re-gression.

Perinatal outcome of singleton versus twin late preterm infants: do twins mature faster than singletons?

OBJECTIVE: To determine whether as a result of an assumed advanced maturation late preterm twin infants have a more favorable perinatal outcome than singleton late preterm infants. METHODS: Over a 36-month period (from September 2011 to September 2014), 277 late preterm infants (153 from singleton and 124 from twin pregnancies) were hospitalised in NICU, University Hospital Center "Sisters of Mercy" Zagreb, Croatia, and were retrospectively studied by review of maternal and neonatal charts for gestational age, sex, birth weight, mode of delivery, 5-min Apgar score and for several outcome variables expected for preterm infants, until the day of discharge. RESULTS: There was statistically no significant difference in the incidence of any of the observed and compared outcomes, except in the incidence of phototherapy which was higher in singletons group (49.01 versus 13.7%, p < 0.0001). The mean birth weight, as expected, was smaller in the twin group. CONCLUSIONS: We found no evidence to support the traditional belief that twin late preterm infants have accelerated maturation and better neonatal outcome compared with singleton late preterm infants. Our findings suggest that late preterm twins have a prognosis similar to that of singleton late preterm infants born at the same gestational age.

The most common deviations in the development of hand motoricity in children from birth to one year of age.

The early child development, from birth until the age of one year is, amongst other changes, characterized by intense motor learning. During that period, the voluntary learning patterns evolve from reflexive patterns to coordinated voluntary patterns. All of the child's voluntary movements present active forms in which the child communicates with the environment. In this communication, the hand plays an important role. Its brain representation covers one-third of the entire motor region, situated in the close proximity to the speech region. For this reason, some authors refer to hand as a "speech organ". According to numerous studies, each separate finger also has a relatively large representation in the cerebral cortex, which points to the importance of the fine motor skills development, or precise, highly differentiated movements of hand muscles following the principles of differentiation and hierarchical integration. Development of the fine motor skills in the hand is important for the overall child development, and it also serves as a predictor pointing to immaturity of the central nervous system. The aim of this paper is to present the development of hand motoricity from birth until the age of one year, as well as the most frequent deviations observed in children hospitalized at Children's Department of Rehabilitation, Clinical Department of Rheumatology, Physical Medicine and Rehabilitation, Sestre milosrdnice University Hospital Center.