Ulcerative tracheitis among intubated neonates--a clinicopathologic study.

OBJECTIVE: To determine frequency of ulcerative tracheitis (UT) among intubated neonates and identify groups of neonates at greater risk of UT. METHODS: Medical histories and autopsy findings from 232 neonates between 1995 and 2006 were reviewed retrospectively. All neonates were treated at the Department of Neonatology, Clinical Hospital Center Split. Autopsies and histological examinations were performed at the Clinical Department of Pathology, Forensic Medicine and Cytology. Neonates were classified into groups based on their sex, gestational age, survival time and cause of death, duration and reasons for intubation. Simplified Wigglesworth classification was used to determine cause of death. Chi-squared test and multiple logistical regression analysis were used for statistical analysis. RESULTS: UT was found in 44 cases (18.96%). The main risk factor for UT development was duration of intubation, especially if it lasted over 96 h (P=0.005). Higher frequency of UT was noted in neonates with gestational age over 37 weeks (P=0.002) and birth weight over 2500 g (P=0.115). CONCLUSION: Our study has shown that the main risk factor for UT development was intubation duration exceeding 96 h. Term-borns, and neonates with normal birth weight both have higher risk of UT. High risk groups should be observed carefully and alternative respiratory support treatment, such as continues positive airway pressure (CPAP) may be considered.

Ivemark syndrome: asplenia with kidney collecting duct cysts and polysplenia with cerebellar cyst.

Two newborns, one male and one female, from two different families, with Ivemark syndrome proven at autopsy are reported. One of them had asplenia and another had polysplenia. Both newborns had complex cardiac defects with isomerism of the lungs. The newborn with asplenia had dextrocardia, transposition of the great vessels, stenosis of the pulmonary artery, common atrioventricular canal and patent ductus arteriosus. The newborn with polysplenia had a common atrium, hypoplastic left ventricle and patent ductus arteriosus. The patient with asplenia had cystic dilated collecting ducts of the kidney and the patient with polysplenia had cerebellar cyst. These associate malformations have not been reported previously. Both cases were sporadic.

Leiomyomatosis peritonealis disseminata in a postmenopausal woman.

Leiomyomatosis peritonealis disseminata (LPD), a multifocal proliferation of smooth muscle like cells, has so far been described in 48 cases. Most of them were pregnant women or women taking the oral contraceptives, which supported the hypothesis that LPD is associated with hyperestrogenism. We report a 65-year-old women, without history of taking exogenous estrogens, which suggests that factors other than hormonal influences may contribute to pathogenesis of LPD.