Does circumcision increase neonatal jaundice?

PURPOSE: The aim of this study was to evaluate the effects of circumcision done during the early newborn period on the baby's feeding frequency and therefore a possible effect on serum bilirubin values. METHODS: Sixty consecutive male patients, of whom 30 were circumcised, were comparatively followed. Babies born between 35 and 40 gestational weeks, weighing above 3000 g and who had no antenatal and/or perinatal problems were enrolled. Changes in weight, frequency of feeds, urination, stooling and the serum bilirubin levels were compared. RESULTS: There was no statistically significant difference between the two groups. CONCLUSION: In experienced hands, newborn circumcision on the second day of life is safe, does not affect babies' feeding frequency or bowel movements on day 3, and does not increase serum bilirubin on day 4, thus does not increase the risk of neonatal jaundice.

Chest and mid-arm circumferences: identification of low birth weight newborns in Turkey.

The present study was performed to find out which anthropometric measurement(s) could efficiently be substituted for weight to detect neonates with low birth weight at birth. A total of 874 neonates, between 32 and 43 weeks of gestational age were measured within 24 h of birth to interpret the validity of anthropometric measurements. Low birth weight was observed in 10 per cent of the neonates. The study showed a significant correlation (P < 0.001) between chest circumference, mid-arm circumference, head circumference, length, and birth weight. However, the correlation was maximum for chest circumference (r = 0.855) and mid-arm circumference (r = 0.791). A chest circumference of < 30 cm and a mid-arm circumference of < 9 cm had the best sensitivity and specificity for identifying neonates with a birth weight of < 2500 g. Chest circumference and/or mid-arm circumference can be used as simple and reliable indicators for predicting low birth weight whenever weighing of newborns is not feasible.

Susceptibility to local and systemic bacterial infections in intercellular adhesion molecule 1-deficient transgenic mice.

The contribution of intercellular adhesion molecule 1 (ICAM-1) during systemic and local bacterial infections was studied in transgenic ICAM-1-deficient and control mice that were injected intraperitoneally (ip) or intradermally (id) with Escherichia coli, Pseudomonas aeruginosa, or Staphylococcus aureus. Mortality rates, blood cultures, white blood cell (WBC) counts and absolute neutrophil counts (ANCs) were obtained daily until cultures were sterile. Six and 24 h after injections, autopsies were done on randomly selected ip-inoculated mice and biopsies were done on randomly selected id-inoculated mice. Survival rates were similar. In ICAM-1-deficient mice, ip P. aeruginosa resulted in higher incidences of bacteremia at 24 h (P = .003) and 48 h (P = .002); id S. aureus resulted in larger skin lesions (P = .026). Leukocytosis persisted in ICAM-1-deficient mice 6 h after ip injection of E. coli; however, WBC counts and ANCs in peritoneal fluid did not differ. Although the inflammatory responses were similar histologically in ICAM-1-deficient and normal mice, differences in site- and stimulus-specific susceptibilities were noted.

The ability of recombinant murine granulocyte-macrophage colony-stimulating factor to protect neonatal rats from septic death due to Staphylococcus aureus.

Granulocyte-macrophage colony-stimulating factor (GM-CSF) potentiates in vitro and in vivo production of granulocytes. Also, recombinant human GM-CSF in vitro enhances functional capabilities of human granulocytes. Recombinant murine (rm) GM-CSF was administered to neonatal rats in vivo to test its ability to protect from septic death due to Staphylococcus aureus. When rmGM-CSF was given intraperitoneally 6 h before a 90% lethal dose challenge of S. aureus, peak survival was observed at a dose of 30 pg/g (54% vs. 10% in animals administered saline; P less than .001). Blood cultures were positive for S. aureus in 26 of 32 saline-treated and in 5 of 31 rmGM-CSF-treated animals (P less than .001). Numbers of blood granulocytes were significantly increased 9 h after administration of rmGM-CSF (30 pg/g) but returned to control levels by 12 h. Neither neutrophil storage nor proliferative pools were affected. Thus, rmGM-CSF significantly improved survival when given prophylactically in a neonatal rat model of infection.

Transient tachypnea of the newborn (TTN): a role for polymorphisms of surfactant protein B (SP-B) encoding gene?

BACKGROUND: Transient tachypnea of the newborn (TTN) is usually a benign self-limiting respiratory disorder in the immediate neonatal period. The lipophilic surfactant-associated protein B (SP-B) was demonstrated to be the most relevant structural component of the surfactant system for immediate postnatal pulmonary adaptation. We hypothesized genetic variations of surfactant protein B (heterozygous 121 ins 2 mutation er intron 4 polymorphisms) to be related to TTN. PATIENTS AND METHOD: We screened genomic DNA of 83 healthy term neonates (gestational age: 39 (37 - 41) completed weeks [median and range]; birth weight: 3325 +/- 541 grams [mean +/- SD]) and 75 infants presenting with TTN (gestational age: 38 (37 - 41) completed wecks [median and range]; birth weight: 3091 +/- 435 grams [mean +/- SD]) by means of PCR-amplification, fragment length and sequence analysis. TTN was diagnosed an the basis of the clinical signs with respiratory rate > 60 breaths/minute, fraction of inspired oxygen > 0.21, and characteristic radiographic findings within less than 24 hours after birth. Newborns with any infection, pulmonary or cardiac congenital malformations, postnatal asphyxia and infants born to diabetic mothers were excluded. RESULTS: In TTN-group the frequency of male infants (68.4 % versus 44.6 %, p < 0.05) and caeserian section were significantly higher (68.4 % versus 30.1 %, p < 0.05). We did not find any statistical difference in frequency of intron 4 variations between controls and TTN-group (8.4 % versus 10.7 %). None of the infants were heterozygous for the 121ins2 SP-B mutation. CONCLUSIONS: WC conclude polymorphisms of intron 4 and heterozygous 121 ins 2 mutation not to associated with TTN.