Hemolytic disease of the newborn due to anti-Di(a): report of one case.

In the Diego blood group, the frequency of the Di(a + b +) or Di(a + b -) phenotype among Chinese in Taiwan is estimated to be 3.2%. Here we report a case of severe hemolytic disease caused by anti-Di(a). The baby's total bilirubin elevated to 23 mg/dl at the age of 72 hours. A blood exchange transfusion and phototherapy were performed. We suggest to include Diego positive cell panels in testing antibody specificities that are likely to be encountered in this population.

The efficacy of different umbilical cord care regimens: an in vitro study on their drying and antimicrobial effect.

BACKGROUND: Topical regimens have been used for umbilical cord care for different purposes, but their drying efficacy has rarely been statistically analyzed. We designed an in vitro study with six regimens to determine which one can achieve the best drying and antimicrobial effects in umbilical cord care. METHODS: Twenty-seven umbilical cords were resected when babies were born. Each cord was cut into seven segments in appropriate length and randomly labeled to seven groups. Six regimens including 75% alcohol, 90% alcohol, tincture povidone-iodine, aqua povidone-iodine, Chinese herbs, and one powder agent (M) were used topically on six groups of umbilical cords once daily. The control group received no treatment. Daily weight of the cords was recorded for 7 days, and bacterial culture was performed on the sixth day. RESULTS: All study groups presented similar algebraic functional relationship between weight change and time. The drying effect occurred mostly within the first 3 days (weight loss 88.6%), especially on the first day (62.1%). Mean ratio of the final weight/initial weight was 10.2%. Significant day-by-day weight loss was noted from day 1 to day 5 (p < 0.001). Both aqua and tincture povidone-iodine groups showed not only satisfied drying effect but also significantly better antimicrobial effect than other groups. CONCLUSIONS: Povidone-iodine has both good drying and antimicrobial effects in umbilical cord care. As the topical use of povidone-iodine has been reported to relate to transient neonatal hypothyroidism, we suggest it to be used only as a good substitute if there are signs of umbilical cord infection.

[Effect of light on total micro-bilirubin values in vitro].

In order to elucidate the effect of light on total bilirubin values in vitro, 616 capillary blood samples were collected from jaundiced newborn infants at the nursery of Veterans General Hospital-Taipei. Samples were divided into 3 groups: 1. Phototherapy light group-133 samples were irradiated with blue fluorescent light (spectral irradiance 425-475 nm = 4 mu watt/cm2/nm); 2. Room light group-202 samples were irradiated with white fluorescent light (spectral irradiance 425-475 nm = 0.2 mu watt/cm2/nm); 3. Dark group-the last 215 samples were placed in the dark. Total bilirubin values were checked with spectrophotometry, at 0, 2, 4, 6, 24 and 48 hours after being placed in different environments. Total bilirubin values varied significantly in different light source and time groups (p less than 0.0001), plus both had statistical interactions (p less than 0.0001). There were significant decreases in the bilirubin values of the phototherapy group beginning at 2 hours (p less than 0.05), and in the room light group beginning at 6 hours (p less than 0.05), but there was no change in the dark group. We conclude that blood samples for total bilirubin values should not be placed under the light of phototherapy even 2 hours. If blood samples are exposed to room light inevitably, it is safe to be checked within 4 hours. If immediate measurements are unavailable, the samples can be placed in a dark environment allowing the values to remain unchanged for 48 hours.

New therapy for hydrocarbon pneumonitis--nasal prongs continuous positive airway pressure (NPCPAP).

Respiratory failure and conscious disturbance developed in a 18-month-old girl following ingestion of an unknown quantity of spot remover solution, a petroleum distillate product. Rapid deterioration was noted within 2 hours after ingestion. The patient became stable in condition and dramatically improved through intensive care with respiratory support by using nasal prongs continuous positive airway pressure (NPCPAP). To our knowledge, this may be the first case being successfully managed with this technique.