Preparation and characterization of a curcumin nanoemulsion gel for the effective treatment of mycoses.

Fungal infections of skin including mycoses are one of the most common infections in skin or skins. Mycosis is caused by dermatophytes, non-dermatophyte moulds and yeasts. Various studies show different drugs to treat mycoses, yet there is need to treat it with applied drugs delivery. This study was designed to prepare a bio curcumin (CMN) nanoemulsion (CMN-NEs) for transdermal administration to treat mycoses. The self-nanoemulsification approach was used to prepare a nanoemulsion (NE), utilizing an oil phase consisting of Cremophor EL 100 (Cre EL), glyceryl monooleate (GMO), and polyethylene glycol 5000 (PEG 5000). Particle size (PS), polydispersity index (PDI), zeta potential (ZP), Fourier transform infrared (FTIR) spectrophotometric analysis, and morphological analyses were performed to evaluate the nanoemulsion (NE). The in vitro permeation of CMN was investigated using a modified vertical diffusion cell with an activated dialysis membrane bag. Among all the formulations, a stable, spontaneously produced nanoemulsion was determined with 250 mg of CMN loaded with 10 g of the oil phase. The average droplet size, ZP, and PDI of CMN-NEs were 90.0 ± 2.1 nm, - 7.4 ± 0.4, and 0.171 ± 0.03 mV, respectively. The release kinetics of CMN differed from zero order with a Higuchi release profile as a result of nanoemulsification, which also significantly increased the flux of CMN permeating from the hydrophilic matrix gel. Overall, the prepared nanoemulsion system not only increased the permeability of CMN but also protected it against chemical deterioration. Both CMN-ME (24.0 ± 0.31 mm) and CMN-NE gel (29.6 ± 0.25 mm) had zones of inhibition against Candida albicans that were significantly larger than those of marketed Itrostred gel (21.5 ± 0.34 mm). The prepared CMN-NE improved the bioavailability, better skin penetration, and the CMN-NE gel enhanced the release of CMN from the gel matrix on mycotic patients.

Factors associated with neonatal near miss: Case of the University Hospital Center IbnSina of Rabat Morocco 2021.

OBJECTIVES: Analogous to the Near Miss Maternal approach, the concept of Near Miss Neonatal (NNM) is an approach recently developed to identify newborns who survive near-fatal complications during the first 28 days of ectopic life. The objective of this study is to shed light on the cases of Neonatal Near Miss and identify its factors associated with live births. METHODS: A prospective cross-sectional study was conducted to identify factors associated with Neonatal Near Miss in newborns admitted to the National Reference Center in Neonatology in Rabat, Morocco from January 1 to December 31, 2021. A pre-tested, structured questionnaire was used to collect the data. These data were entered using Epi Data software and exported to SPPS23 for analysis. To identify the determinants of the outcome variable, binary multivariable logistic regression was used. RESULTS: Among the 2676 selected live births, 2367 (88.5%; 95% CI: 88.3-90.7)) were cases of NNM. Factors in women which were significant predictors of NNM included being referred from other health care facilities [AOR: 1.86; 95% CI: 1.39-2.50], residing in a rural area [AOR: 2.37; 95% CI: 1.82-3.10], having less than four prenatal visits [AOR: 3.17; 95% CI: 2.06-4.86], and having gestational hypertension [AOR: 2.02; 95% CI: 1.24-3.30]. CONCLUSIONS: This study revealed a high proportion of NNM cases in the study area. The factors associated with NNM which were found to increase these cases demonstrates the primary health care program must be further improved to avoid preventable causes of neonatal mortality.

Polymeric ethosomal gel loaded with nimodipine: Optimisation, pharmacokinetic and histopathological analysis.

This study was performed with the main objective of formulating and evaluating the potential of ethosomesl gel (Etho gel) to deliver nimodipine (NiM) for cardiovascular disease, a potent water insoluble anti-hypertensive drug via skin to reach the deeper layers of skin. The Box-Behnken design (BBD) was used to optimize the NiM-Eth to determine the impact of the independent and depended variables. The effectiveness of drug entrapment, vesicle size, and cumulative drug release were assessed for the NiM loaded ethosomes and NiM-Eth gel using carbopol 934 as a gelling agent. Fourier transform infrared spectroscopy (FTIR), Differential scanning calorimetry (DSC), Power X-ray diffraction (PXRD), and scanning electron microscopy (SEM) analysis were performed and analysed their physicochemical characters. Rat abdomen skin was used to investigate drug permeability and deposition. As compared to marketed products, NiM-Eth gel produced an improved drug permeability in ex vivo experiments. The mean AUC0 to AUC0-∞ of NiM-Eth gel when compared to oral formulation (Nymalize oral preparation) was found to be increased from 4.1 to 5.9 folds which was found to be resulted from first pass effect. Histophatlogical findings revealed that the maximum amount of NiM penetrated the stratum corneum of the skin and create drug depots in the deep layer. In summary, it can be said that NiM might be successfully prepared in NiM-Eth gel for transdermal drug delivery.

A novel approach for the quantification of paclitaxel loaded in ethyl cellulose/kollicoat and ethylcellulose/eudragit colloidal particles by UPLC-PDA.

An optimized rapid reversed phase ultra-performance liquid chromatography (UPLC-PDA) method has been developed and validated for precise and accurate quantification of paclitaxel in drug delivery systems. The chromatographic separation was attained on L1 (USP) column (2.1 ×50 mm, 1.7µm) with an isocratic mobile phase comprised of acetonitrile and water (1:1; flow rate 0.6 mL/min) and detection was executed at 227 nm by PDA detector. The proposed UPLC-PDA method is found to be rapid with retention time of 1.37 min, selective with homogenous peaks and sensitive with Limit of Detection (LOD) of 0.08µg/mL and Limit of Quantification (LOQ) of 2.6µg/mL. The method showed excellent linearity (R2>0.998) over the range of 0.1 to 0.4mg/mL and applied for the paclitaxel quantification in different formulations with no inference of excipients. Thus, the proposed approach has potential for rapid estimation of drug purity, assay and release profile from pharmaceutical preparations.

Fabrication, In Vitro, and In Vivo Assessment of Eucalyptol-Loaded Nanoemulgel as a Novel Paradigm for Wound Healing.

Wounds are the most common causes of mortality all over the world. Topical drug delivery systems are more efficient in treating wounds as compared to oral delivery systems because they bypass the disadvantages of the oral route. The aim of the present study was to formulate and evaluate in vitro in vivo nanoemulgels loaded with eucalyptol for wound healing. Nanoemulsions were prepared using the solvent emulsification diffusion method by mixing an aqueous phase and an oil phase, and a nanoemulgel was then fabricated by mixing nanoemulsions with a gelling agent (Carbopol 940) in a 1:1 ratio. The nanoemulgels were evaluated regarding stability, homogeneity, pH, viscosity, Fourier-transform infrared spectroscopy (FTIR), droplet size, zeta potential, polydispersity index (PDI), spreadability, drug content, in vitro drug release, and in vivo study. The optimized formulation, F5, exhibited pH values between 5 and 6, with no significant variations at different temperatures, and acceptable homogeneity and spreadability. F5 had a droplet size of 139 ± 5.8 nm, with a low polydispersity index. FTIR studies showed the compatibility of the drug with the excipients. The drug content of F5 was 94.81%. The percentage of wound contraction of the experimental, standard, and control groups were 100% ± 0.015, 98.170% ± 0.749, and 70.846% ± 0.830, respectively. Statistically, the experimental group showed a significant difference (p < 0.03) from the other two groups. The results suggest that the formulated optimized dosage showed optimum stability, and it can be considered an effective wound healing alternative.

Utilization of Gelling Polymer to Formulate Nanoparticles Loaded with Epalrestat-Cyclodextrin Inclusion Complex: Formulation, Characterization, In-Silico Modelling and In-Vivo Toxicity Evaluation.

Epalrestat (EPL) is an aldose reductase inhibitor with poor aqueous solubility that affects its therapeutic efficacy. The research study was designed to prepare epalrestat-cyclodextrins (EPL-CDs) inclusion complexes to enhance the aqueous solubility by using beta-cyclodextrin (ß-CD) and sulfobutyl ether7 ß-CD (SBE7 ß-CD). Furthermore, polymeric nanoparticles (PNPs) of EPL-CDs were developed using chitosan (CS) and sodium tripolyphosphate (sTPP). The EPL-CDs complexed formulations were then loaded into chitosan nanoparticles (CS NPs) and further characterized for different physico-chemical properties, thermal stability, drug-excipient compatibility and acute oral toxicity studies. In-silico molecular docking of cross-linker with SBE7 ß-CD was also carried out to determine the binding site of the CDs with the cross-linker. The sizes of the prepared NPs were laid in the range of 241.5-348.4 nm, with polydispersity index (PDI) ranging from 0.302-0.578. The surface morphology of the NPs was found to be non-porous, smooth, and spherical. The cumulative percentage of drug release from EPL-CDs loaded CS NPs was found to be higher (75-88%) than that of the pure drug (25%). Acute oral toxicity on animal models showed a biochemical, histological profile with no harmful impact at the cellular level. It is concluded that epalrestat-cyclodextrin chitosan nanoparticles (EPL-CDs-CS NPs) with improved solubility are safe for oral administration since no toxicity was reported on vital organs in rabbits.

Preparation of Soluble Complex of Curcumin for the Potential Antagonistic Effects on Human Colorectal Adenocarcinoma Cells.

This study was designed to investigate the effects of curcumin (CMN) soluble complex (SC) prepared by melt casting (HM) and hot-melt extrusion (HME) technology. Phase solubility (PS) study, in silico molecular modeling, aqueous solubility, drug release, and physicochemical investigation including a novel dyeing test was performed to obtain an optimized complex by a central composite design (CCD). The results show that the HME-SC produces better improvements towards solubility (0.852 ± 0.02), dissolution (91.87 ± 0.21% at 30 min), with an ideal stability constant (309 and 377 M-1 at 25 and 37 °C, respectively) and exhibits AL type of isotherm indicating 1:1 stoichiometry. Intermolecular hydrogen bonding involves the formation of SC, which does not undergo any chemical modification, followed by the complete conversion of the amorphous form which was identified by XRD. The in vitro cytotoxicity showed that IC50 was achieved in the SW480 (72 µM.mL-1) and Caco-2 (40 µM.mL-1) cells while that of pure CMN ranged from 146 to 116 µM/mL-1. Apoptosis studies showed that cell death is primarily due to apoptosis, with a low rate of necrosis. In vivo toxicity, confirmed by the zebrafish model, exhibited the safety of the HME-SC. In conclusion, the HME-SC potentially enhances the solubility and cytotoxicity to the treatment of colorectal cancer (CRC).

Clinical predictive factors of histological chorioamnionitis: case-control study.

INTRODUCTION: Histological chorioamnionitis or "intrauterine inflammation or infection" (Triple I) it is an acute inflammation of amniotic membrane, chorionic plate and umbilical cord. SUBJECT: To assess in the event of the clinical predictive factors associated to histological chorioamnionitis. METHODS: Prospective examination of 50 placentas from aberrant pregnancies, and 50 placentas from 'normal' deliveries. The Placentas analyzed by the conventional histopathology method, and the severity of chorioamnionitis was classified histologically according to the intensity and the topography of placental inflammation.The clinical and histopathological features of the study groups were introduced into the SPSS 13 database (License University Mohammed V-Rabat). RESULTS: 36/50 placentas of aberrant pregnancies showed a histological chorioamnionitis often associated to a funisitis, and 11/50 normal placentas have shown some lesions of histological chorioamnionitis mainly grade one without funisitis.On the other hand we noted a statistically significant association between histological chorioamnionitis and premature rupture of the membranes (PROM) over than 12h (p < 0.001). CONCLUSIONS: Our study confirmed the predominance of histological chorioamnionitis lesions in clinically suspected cases of chorioamnionitis with 72% versus 22% in the controls group.Among the clinical parameters studied, only the premature rupture of the Membranes was shown a statistically significant association with the appearance of histological signs of chorioamnionitis.In conclusion, chorioamnionitis is sometimes clinically silent. Morphological placental study could be a confirmation of this pathology, which is predominantly associated to PROM over than 12 h.

Development, characterization and evaluation of anti-fungal activity of miconazole based nanogel prepared from biodegradable polymer.

Topical candidiasis is a known skin fungal infection which is usually treated by conventional dosage forms such as cream, gel, emulgel which are having numerous adverse effects on skin. To overcome such disadvantages, different novel drug delivery systems have been considered. Polymer based nano-particulate systems have shown good skin penetration after topical application. Therefore, in the present study the main focus was on the pathology, pathogenesis, and consequently topical treatment of candidiasis. Nanogel containing miconazole have been prepared from the natural polymers i.e. gelatin and chitosan. The nanogel of miconazole (100 mg) nitrate was formulated by modified emulsification-diffusion technique and characterized for different parameters. From all the seven nanogel formulations named as F1 to F7, F1 (Gelatin and Chitosan in the percentage of 82.85 and 17.15 respectively) have been selected as model formulations. The reason behind that was as per ICH stability guideline, the formulations F1 was found optimum and stable. Miconazole nanogel formulations F1 also showed the maximum release i.e. 78 % approximately. XRD showed the formulated nanogel was in crystalline shape. In summary, the miconazole nanogel drug delivery systems have two main advantages i.e. they are topical preparation as well as nano sized. It can be postulated that nanogel may be a best approach to treat the fungal skin diseases.

A Newly Isolated Carboxymethyl-Glucan (CM-G) Restores Depressed Baroreflex Sensitivity in Renovascular Hypertensive Rats.

This study was designed to investigate the effects of a newly synthesized carboxymethyl-glucan (CM-G) on blood pressure (BP), baroreflex sensitivity (BRS) and sympathetic vascular modulation in renovascular hypertensive rats. Male Wistar rats were divided into four groups: Sham (n = 10); 2K1C (subjected to renal artery clipping to induce renovascular hypertension, n = 10); Sham + CM-G (treated with CM-G, n = 7) and 2K1C + CM-G (treated with CM-G, n = 7). The daily treatment with CM-G (40 mg/kg) was performed for 2 weeks. Blood pressure, heart rate (HR), systolic BP variability, baroreflex sensitivity (BRS) and sympathetic vascular tone were evaluated. After six weeks of renal artery clipping, 2K1C rats exhibited arterial hypertension (171 ± 11 vs. 118 ± 4 mmHg, p < 0.05), impaired BRS (-1.30 ± 0.10 vs. -2.59 ± 0.17 bpm.mmHg-1, p < 0.05) and enhanced sympathetic activity as shown by the hexamethonium test (-60 ± 5 vs. -33 ± 2 ΔmmHg, p < 0.05) when compared to sham rats. Oral administration of CM-G in renovascular hypertensive rats reduced hypertension (126 ± 4 vs. 171 ± 11 mmHg, p < 0.05) and improved the BRS (-2.03 ± 0.16 vs. -1.30 ± 0.10 bpm.mmHg-1, p < 0.05) in 2K1C rats when compared to placebo. Those effects seem to be caused by a reduction in sympathetic activity. The present study revealed for the first time that CM-G treatment reduces arterial hypertension and restores arterial baroreflex sensitivity via a reduction in the sympathetic tone in conscious renovascular hypertensive rats.

Phosphodiesterases (PDEs) from Snake Venoms: Therapeutic Applications.

BACKGROUND: Snake venom, a highly poisonous and active venomous snake's secretion, is a complex mixture of inorganic cations, carbohydrates, lipids, proteins, peptides, toxins and hydrolytic enzymes of importance including Phosphodiesterases (PDEs). These snake venom hydrolytic enzymes interfere in different physiological processes. Snake venom PDEs have several roles to metabolize extracellular nucleotides and to regulate nucleotide based intercellular signalling mechanisms including platelet aggregation, which can lead to death and debilitation in cardiac arrest and strokes in patients having cerebro-vascular and cardiovascular diseases, hypertension and atherosclerosis which is the primary cause of life-threatening diseases such as, stroke and myocardial- infarction. CONCLUSION: PDEs are used to synthesize modified oligonucleotides, which are useful in potential therapeutic applications. Characterization of PDEs from different snake venoms has potential in identifying new anticoagulants that target specific active sites, which leads to the treatment of haemostatic disorders. Here, we review the snake venom PDEs potential therapeutic activity against platelet aggregation which could provide ideal platforms to design drugs for treatment or to fight against unwanted clots formation.

[Spontaneous neonatal aortic thrombosis revealing protein S deficiency]. / Thrombose aortique néonatale spontanée révélant un déficit en protéine S.

Arterial thrombosis of the newborn is rare and associated with poor prognosis, often attributed to umbilical arterial catheterization. The aortic and spontaneous forms are exceptional. Its severity requires fast and effective treatment. Although therapeutic means are numerous, no consensus has been established to date although thrombolysis and heparin therapy appear to give good results depending on the site and extent of thrombosis. We report a case of extensive thrombosis of the abdominal aorta in a 5-day-old newborn, revealed by acute hypernatremic dehydration. Thrombosis was not related to umbilical catheterization. The diagnosis was confirmed by Doppler ultrasound with discovery during the etiologic assessment of an authentic protein S deficiency. This observation was the occasion for a review of the literature concerning the evolutionary and therapeutic clinical aspects of neonatal arterial thrombosis.

[Assessment of employment's impact on breastfeeding practices]. / Évaluation de l'effet du travail sur la pratique de l'allaitement maternel.

OBJECTIVE: Employment is recognized as a weaning factor in many studies. Our aim was to evaluate the impact of employment on women's breastfeeding (BF) with a duration longer than 6 months in a Moroccan population. METHOD: A cross-sectional study was conducted between November 2015 and April 2016 in four hospitals in the region of Rabat-Salé, Morocco. All ages were included with the condition that the woman had at least one living child. A questionnaire-based interview collected data on the duration of BF for each child, breast milk storage practices, woman's opinion on BF, and the perception of work conditions during BF. Factors associated with BF lasting longer than 6 months were analyzed using logistic regression carried out in SPSS 13.0 software. RESULTS: A total of 502 surveyed women were analyzed. The median duration of breastfeeding (exclusive or mixed) in working women was 8 months versus 15 months for those without employment (P<0.001). Only 26 % stored breast milk. For working women, BF practiced due to religious conviction or perceived as mandatory were higher than for unemployed women (18% vs 15% and 11% vs. 7%, respectively; P<0.001). Working conditions during BF were perceived as daunting in 61% of cases. In multivariate analysis, factors correlated with prolonged BF longer than 6 months were: (i) early baby initiation to BF (OR=3; 95% CI [1.9-4.6]), (ii) education level: middle and high school (OR=0.1; 95% CI [0.01-0.5]), and (iii) the social status of working women (OR=0.3; 95% CI [0.1-0.6]). CONCLUSION: Employment has a negative impact on the duration of breastfeeding, work perception, and practices of breastfeeding women.

[Splenic hamartoma, severe thrombocytopenia, and macrocrania in a neonate: A case study]. / Hamartome splénique, thrombopénie sévère et macrocrânie chez un nouveau-né.

We report a case of splenic hamartoma associated with neonatal macrocrania diagnosed in a newborn. The diagnosis was made in the first 2 days of life upon the existence of an abdominal mass in the newborn infant. Abdominal ultrasound and abdominal computed tomography supported the diagnosis, but the histological study was inconclusive. The indication for surgery is still controversial. Through a literature review, the clinical, histological, and radiological aspects are discussed. The combination of neonatal hamartoma, thrombocytopenia, and macrocrania has never been reported.

[Deep vein thrombosis due to protein C deficiency in a neonate]. / Thrombose veineuse profonde par déficit en protéine C chez un nouveau-né.

INTRODUCTION: Venous thromboembolic disease is increasingly recognized as an important cause of morbidity and mortality in children. In the neonatal period, thrombotic accidents suggest constitutional abnormalities of homeostasis, including congenital protein C deficiency. We report on a clinical case that helps review all the diagnostic elements and discuss actions to be taken in the neonatal period. OBSERVATION: A newborn infant was admitted for transient neonatal respiratory distress. The physical examination revealed a facial dysmorphism and a bilateral lumbar contact. Abdominal Doppler ultrasounds showed a thrombosis of the vena cava inferior and of the left renal vein. Investigations searching for a thrombophilic state revealed severe congenital protein C deficiency. The maternal level of protein C at 50% argues in favor of a heterozygote deficit, the rate being normal in the father. Therapeutic management was based on low-molecular-weight heparin. The ultrasound check showed regression and then disappearance of thrombosis. Genetic counseling was planned. DISCUSSION AND CONCLUSION: In cases of neonatal thrombosis, seeking a deficiency anticoagulant factor, in particular of protein C, is essential in the newborn and in both parents. Therapeutic management is not codified. An individualized approach is appropriate in this very rare clinical situation.

Organic nitrates: past, present and future.

Nitric oxide (NO) is one of the most important vasodilator molecules produced by the endothelium. It has already been established that NO/cGMP signaling pathway deficiencies are involved in the pathophysiological mechanisms of many cardiovascular diseases. In this context, the development of NO-releasing drugs for therapeutic use appears to be an effective alternative to replace the deficient endogenous NO and mimic the role of this molecule in the body. Organic nitrates represent the oldest class of NO donors that have been clinically used. Considering that tolerance can occur when these drugs are applied chronically, the search for new compounds of this class with lower tolerance potential is increasing. Here, we briefly discuss the mechanisms involved in nitrate tolerance and highlight some achievements from our group in the development of new organic nitrates and their preclinical application in cardiovascular disorders.

[Spasmus nutans and vermian agenesis: case report]. / Spasmus nutans et agénésie vermienne : à propos d'un cas.

UNLABELLED: Spasmus nutans is a syndrome occurring in infants comprising a symptomatic triad: torticollis, head nodding and nystagmus. Neuropediatric and ophthalmologic investigation are normal. No case of association with non-evolutive encephalopathy has been reported to date. We report on a case of spasmus nutans-associated agenesis of the median vermian cerebellum. OBSERVATION: A 3-month-old female infant was hospitalized for head nodding lasting 1 week and nystagmus of the left eye with no other signs. A lung infection had preceded the clinical signs. The ophthalmologic examination and electroencephalography (EEG) were normal. The cerebral MRI showed an objective partial agenesis of the median vermian cerebellum. The diagnosis of spasmus nutans-associated brain malformation was retained. CONCLUSION: The discovery of non-evolutive encephalopathy was associated with spasmus nutans. A genetic study is required.

Development and validation of bioelectrical impedance analysis equations for predicting total body water and fat-free mass in North-African adults.

BACKGROUND/OBJECTIVES: Accuracy of the bioelectrical impedance analysis (BIA) depends on population-specific prediction equations. The aim of our study was to develop prediction equations for assessing total body water (TBW) and fat-free mass (FFM) in healthy North-African adults. SUBJECTS/METHODS: In all, 250 participants (194 women, 56 men) aged 18-64 years were included in the analysis. BIA variables were measured by a tetra-polar device. TBW and FFM were assessed by the dilution of deuterium (D2O). The participants were sorted by gender and randomly split into development and validation subgroups. The validity of other published equations was also tested using Bland and Altman procedure, proportional bias and pure error. RESULTS: The prediction equations derived were: TBW (l)=5.68+0.267 height(2)/resistance+4.42 sex (male=1, female=0) + 0.225 weight-0.052 age (R(2)=0.92, root mean square error (RMSE)=1.75 l, RMSE%=5.65); and FFM (kg)=7.47 + 0.366 height(2)/resistance+6.04 sex + 0.306 weight-0.063 age (R(2)=0.92, RMSE=2.38 kg, RMSE%=5.61). The new equations provided nonsignificant proportional bias values, and better agreement than other tested equations. Bias and pure error values were 0.36 and 1.88 l for men and 0.00 and 1.82 l for women, for TBW equation. For FFM equation, bias values were 0.43 and -0.04 kg, and pure errors were 2.57 and 2.46 kg for men and women, respectively. CONCLUSIONS: The new prediction equations provide reliable estimates of TBW and FFM in North-African adults and are recommended for use in these populations.

[Neonatal liver abscess after umbilical venous catheter]. / Abcès hépatique néonatal lié à un cathéter veineux ombilical.

INTRODUCTION: The use of an umbilical venous catheter (UVC) is common practice in neonatal units and is subjected to strict rules of insertion and monitoring to detect potential complications. Hepatic abscess is one of these rare complications. OBSERVATION: We report the observation of a 15-day-old female newborn admitted for a hepatic abscess. The patient had been hospitalized at birth in a neonatal intensive care unit. With the appearance of hemodynamic instability on the 4th day of life, a nosocomial infection was suspected and was treated with ceftazidime, vancomycin and amikacin. Later, as the need for O(2) increased and plasma C-reactive protein (CRP) was 190 mg/L, the patient received imipenem and vancomycin, while an abdominal ultrasound examination showed a hepatic abscess. A triple antibiotic treatment was initiated with imipenem, vancomycin, and metronidazole, while the initial examination showed a clinically stable patient with a CRP at 208 mg/L. Abdominal ultrasounds showed a hepatic abscess measuring 53.4×24.9 mm on day 21 and 51.4 mg/L CRP. Then the abscess dimensions decreased to 35.7×14 mm. The antibiotic therapy was maintained for 4 weeks. CONCLUSION: Hepatic abscess should be suspected in neonates with UVC with sepsis and persistent signs of inflammation in spite of adequate antibiotic treatment.