The prevalence of congenital and early-onset hearing loss in Jordanian and Israeli infants.

The objective of the study was to investigate the prevalence of congenital and early-onset hearing loss, and the influence of the known risk factors for hearing loss on infants in Jordan and Israel. Subjects were a total of nearly 17,000 infants from both countries, including infants with and without risk factors for hearing loss. The hearing screening protocol included distortion product otoacoustic emission, followed in case of repeated OAE referral or high risk (HR) infant by diagnostic auditory brainstem responses. The results indicate that the prevalence and severity of hearing loss amongst Jordanian infants (1.37%) is remarkably higher as compared to the Israeli infants (0.48%). The overall prevalence of bilateral SNHL was seven times more in the Jordanian infants, 18 times in non-risk, and three times in the HR infants relative to the Israeli infants. Risk factors including family history, hyperbilirubinemia, bacterial meningitis, and associated syndromes were more prevalent amongst Jordanian infants. This unique study underscores the importance of sharing and exchanging information to create empirical data to guide health-care providers in adapting protocols to the local constraints in developing countries.

Necrotizing enterocolitis: the impact of the establishment of a Department of Pediatric Surgery on the Beilinson Medical Campus.

Necrotizing enterocolitis (NEC) is the most commonly acquired gastrointestinal emergency in neonates. We retrospectively surveyed all cases of confirmed NEC treated at the Beilinson Medical Center (BMC) (now Rabin Medical Center, Beilinson Campus) during a 12 year period to determine whether the establishment of a department of pediatric surgery has influenced the treatment and outcome of NEC patients. Of the 48 patients, 23 were patients treated in the "early period", 1982-87, when surgery was performed in the Department of General Surgery by staff trained in pediatric surgery (group I), and 25 were treated in the "later period" 1988-93, in the same neonatal intensive care unit, with surgical supervision by the new Department of Pediatric Surgery (group II). We found that 32% of the group II patients were of extremely low birthweight (<1,000 g) compared with 13% of group I. They also had lower Apgar scores, and a higher percentage needed respiratory assistance (56 vs. 26%, P = 0.02). All those infants of group II who had been born in other hospitals and were transferred to BMC for treatment were in an advanced state of disease and all required surgery. Total mortality decreased from 22% in group I to 8% in group II. This decrease may be attributed to improved supportive treatment in the neonatal intensive care unit, earlier surgery for NEC based on relative rather than absolute indications, higher rates of primary resection, and better postoperative care. Our review indicates that the establishment of a Department of Pediatric Surgery at the BMC has contributed to the considerable improvement in NEC outcome in our center.