[Disorders of acid-base equilibrium in neonatal physiologic jaundice]. / Anomalie dell'equilibrio acido-base nell'ittero fisiologico neonatale.

38 healthy term jaundiced infants were tested. On 3rd day of life we obtained a blood sample from a peripheric vein to determine red blood cells and reticulocytes count, serum albumin, total, conjugated and unconjugate bilirubin. On 3rd, 4th, 5th, 6th day of life 4 standard heparinized microtubes were filled after lancing the heel: 2 microtubes to estimate the mean value of total bilirubin, 2 for the mean value of pH. The urine pH was evaluated every morning. The results of total bilirubin (T.B.), pH, pCO2 and Base Deficit were analyzed using T-test. All tested infants were free-bilirubin jaundiced. Infants treated with phototherapy had a T.B. ranging from 15.2 mg/dl on 3rd day of life to 10.5 mg/dl on 6th, while in controlled infants T.B. never exceeded 10 mg/dl. In treated infants the pH was higher than in controlled ones: p was less than 0.001 on 4th day, less than 0.005 on 5th day and less than 0.001 on 6th day. In both groups the urine pH ranged from 5 to 6.5 every day. The marked increase in respiratory rate during phototherapy is a well known side effect. But a significant decrease in pCO2 was present before starting phototherapy. A mixed disturbance of acid-base balance could be suspected: an already existing mild metabolic acidosis in phototherapy group with respiratory alkalosis due to anion gap variety, with unknown determining causes. We relate the initial metabolic acidosis to the depressed oxidative phosphorylation (with lactic acidosis) in the neonatal liver.(ABSTRACT TRUNCATED AT 250 WORDS)

[The micro-erythrosedimentation rate in low-birth-weight newborn infants]. / La microvelocità di eritrosedimentazione nei neonati di basso peso.

Several authors described the values of micro-ESR in identifying neonates with infection, but all results were referred to full-term, or full-term and LBW, or full-term and pre-term infants. Our study focused on LBW infants only. 31 of them (15 AGA preterm and 16 SGA term) were tested according to Adler's method and the mean values as well as the 95%ile of their micro-ESR were compared to Adler's group. All of them had a lower micro-ESR but in the SGA term infants it resulted to be very significant. This was in accordance with Ht and MCV increase for chronic fetal hypoxemia and acute placental-fetal transfusion during episodes of fetal hypoxia. We conclude that a micro-ESR lower than usual detects a possibly SGA septic newborn.

Macroscopic hematuria associated with neonatal adrenal hemorrhage.

We report an unusual case of right adrenal hemorrhage in which none of the clinical or familiar factors commonly associated with this situation were present. Diagnosis was made after sudden macroscopic hematuria, and was based on clinical and radiologic findings alone. The normal course of adrenal hemorrhage is also discussed.

[Asymptomatic hematuria. Features of 11 observed cases]. / L'ematuria asintomatica. Rilievi su 11 casi osservati.

The management of 11 cases of asymptomatic haematuria (E.A. in text) of which 1 macroscopic and 10 microscopic, involved a very accurate investigation on family medical history (focusing on haematuria, renal failure, deafness and atopy) as well as individual anamnesis (former events of E.A., concomitant and previous upper respiratory tract infections and allergic diseases) together with all laboratory and clinical tests on kidney functions. The first six months, the 24/hrs proteinuria, the "minute count" of urinary erythrocytes and the blood pressure were tested in all patients once a month, while, during the following 18 months, 3 tests only were carried out. All the subjects presented normal renal functions; for 2 of them the intravenous urography proved to be necessary because of a renal pain concomitant with haematuria while the audiogram was required for 1 subject only. After 2 years, the microscopic E.A. is still enduring in 3 patients: 2 of them recording haematuria in familial anamnesis and 1 suffering from similar episodes, long before we studied his case. None of them had to undergo the renal biopsy which the authors take into consideration only when E.A. is higher than 10,000.000 R.C./24 hrs and associated with high proteinuria and high complement decrease or when hereditary and concomitant to deafness (high frequences only).

[Premature rupture of the membranes: its effects on the newborn infant and the validity of antibiotic prophylaxis]. / La rottura prematura delle membrane: suoi effetti sul neonato e validità della profilassi antibiotica.

Premature Rupture of Membranes (R.P.M.) is often described in association with both amniotic fluid infections and the high risk of respiratory distress sindrome and of neonatal infections. But amniotic fluid infections, as underlined by some authors, may be a cause of R.P.M. as well as a consequence. Several attempts were made to formulate guidelines for early detection and treatment of neonatal septicaemia. In such a contest we considered 10 infants with R.P.M.: 9 treated with preventive antibiotics, 1 treated without any preventive antibiotics. We monitored the leucocyte and trombocyte counts as well as superficial swabs taken from the eyes, ears, throat, nose, umbilicus; clinical findings such as temperature, weight, gastrointestinal and breathing symptoms, jaundice were also monitorised in them all. The group treated with preventive antibiotics didn't show any compliance. The patient treated without any antibiotics showed signs and symptoms of septicemia on 7th day of life.

[Neurologic consequences of the neonatal respiratory syndrome in full-term and pre-term neonates]. / Conseguenze neurologiche della sindrome respiratoria neonatale nel neonato a termine e nel pre-termine.

Neonatal respiratory distress (N.R.D.) must be carefully dealt considering the high death risk as well as the possible neurologic damage in the survivors. Optimal perinatal management allowed a considerable reduction in neonatal mortality without involving, despite expectations, an increase in neurologic handicaps. In this contest we have considered 20 newborn infants affected by N.R.D. who revealed symptoms of neurologic distress at birth. Neurologic assessments were performed by a pediatrician immediately after birth and at regular intervals during hospitalization; special attention was paid to reflexes and neurologic behaviour. All study children were seen for neuro-development assessments at 3, 5 and 12 months from the date of delivery. Except for 2 who died, all the children we studied proved to have a normal psychomotorious development and no alterations were registered by the audiometric examinations. In order to avoid all neurologic handicaps the importance of the most qualified assistence is then stressed.