Risk factors for cerebral palsy in very low-birthweight infants in the 1980s and 1990s.

One-hundred twenty-nine very low-birthweight infants were treated in Newborn and Infant Care Department of Children's Memorial Health Institute between 1985 and 1994; 89 were taken to prospective neurodevelopmental care. The newborns were divided into two groups. Group I had 38 preterm infants born from 1985 to 1989 and followed up at 7 to 11 years of age. Group II had 51 very low-birthweight infants treated from 1990 to 1994 and followed up at 2 to 5 years of age. Complicated, multiple pregnancy, normal delivery, and extremely low birthweight were significantly more frequent in group II. Very low-birthweight infants were frequently born by cesarean section in severe asphyxia. Only four (7.8%) newborns received surfactant therapy. From 1990 to 1994, respiratory distress syndrome III and IV, and a longer respiratotherapy period were significantly more frequent. From 1985 to 1994, the frequency of sepsis, periventricular leukomalacia, and normal ultrasonography was constant. Intraventricular hemorrhage I, II, and IV were frequently present in the 1990s, and intraventricular hemorrhage III was frequent in the 1980s. Cerebral palsy was diagnosed in 11 (28.9%) children in group I and 18 (35.2%) in group II (not statistically different). Multiple and complicated pregnancy, cesarean section, severe asphyxia, and respiratory distress syndrome did not increase the risk of cerebral palsy in very low-birthweight infants. Periventricular leukomalacia has a more predictive value for cerebral palsy in these infants than did intraventricular hemorrhage.

[Chronic, infantile, neurologic, cutaneous and articular syndrome (CINCA) in an infant]. / Syndrome chronique, infantile, neurologique, cutané et articulaire (CINCA) chez un nourrisson.

BACKGROUND: CINCA syndrome is a clinical syndrome of unclear etiology, characterized by a chronic multi-organ inflammatory process unsusceptible to treatment. CASE REPORT: An 18-month-old boy was admitted because he suffered, since the age of 2 months, from cutaneous, articular and neurological changes, lymphadenopathy, hepatosplenomegaly, choroiditis and psychosomatic development retardation. These clinical symptoms were unsusceptible to anti-inflammatory and antihistaminic drugs. Rehabilitation was not effective either. CONCLUSION: A long-term clinical observation is required before sustained multi-organ changes beginning in early childhood and exclusion of other chronic inflammatory diseases enable the diagnosis of CINCA syndrome.

[Estimate of clinical dynamic in periventricular leukomalacia]. / Ocena dynamiki objawów klinicznych w przypadkach okolokomorowej leukomalacji.

Clinical observations of 68 preterm and term newborns with ultrasonographically diagnosed PVL treated in the Infant Department of the Child Health Center in Warsaw from January 1985 to December 1990 are presented. The most frequent clinical sign in newborns was hypotonia of the lower extremities. Tremors were significantly more frequent in preterms. During the infant period, more clinical signs occurred in connection with cerebral atrophy (ventriculomegaly and subdural space enlargement). Observations were carried from the neonatal period to the age of 6 years. Development of 42 (61.8%) children was normal. In 26 (38.2%) infants from 6 to 12 months old, cerebral palsy (most frequently diplegia) was diagnosed. No significant differences in the frequency of cerebral palsy between terms and preterms were found. Epilepsy and minimal brain dysfunctions were also present.

[Diagnosis of Edwards syndrome in newborns]. / Diagnostyka zespolu Edwardsa u noworodków--obserwacje wlasne.

Congenital malformations most useful for the diagnosis of trisomy 18 in the first days of life were defined based on observations of newborns with Edwards syndrome treated at the Child Health Center in 1992-1994. Intrauterine growth retardation, facial skeleton dysmorphy, congenital heart malformation, mainly VSD, extremity malformations, especially of the palms and feet found in the newborn suggest a diagnosis of Edwards syndrome. The need to differentially diagnose trisomy 18 with autosomal recessive syndrome TAR, Roberts and Smith-Lemli-Opitz is stressed.

Development conditions and principles for identification of cow's milk protein hypersensitivity in infants.

The authors studied a group of 153 infants presenting pneumonia and/or bronchitis suspected to be immunized to cow's milk proteins (cow's milk allergy). The diagnosis was confirmed in 96 children (62.7%), which is 20.8% of hospitalized infants presenting respiratory tract diseases. Factors influencing the occurrence of family cow's milk intolerance and the type of infant feeding were analyzed thoroughly. Our own principles of diagnosing hypersensitivity to cow's milk proteins, considering the family history suggesting the possibility of cow's milk hypersensitivity, the occurrence of recurrent wheezy bronchitis and symptoms of the gastrointestinal tract were established. The diagnostic usefulness of LMIT with cow's milk allergens was assessed.

[Clinical characteristics of infections with cytomegalovirus in infants from personal observations]. / Charakterystyka kliniczna zakazen wirusem cytomegalii u niemowlat na podstawie wlasnych obserwacji.

An infection with cytomegaly virus had been diagnosed in 13 infants (including 4 neonates examined up to 2 weeks of life) out of 960 infants hospitalized within 3 years. Clinical examination most frequently revealed hepato- and splenomegaly, pneumonia and neurological disorders, and during a further stage of the clinical course psychomotoric retardation was noted in 7 out of 13 infants, and hearing loss in 5 out of 13 infants. A specific immunoglobulin G preparation (Cytotect) has been successfully used in all children, producing recovery or clinical improvement together with serologic improvement.

[Studies on the occurrence of systemic manifestations during first eruption of teeth in children]. / Badania nad wystepowaniem objawów ogólnoustrojowych w przebiegu pierwszego zabkowania u dzieci.

The aim of the study was establishing whether systemic symptoms and signs appearing in children during first eruption of teeth are connected with this process, and what is the correlation between the studied features and eruption of individual milk teeth. The study involved 55 generally healthy infants aged 3-4 months, and the observation was continued up to the age of 36 months. The study on the development of teeth was carried out in two Regional Paediatric Dental Clinics in Warsaw, at 6-week intervals in the first year of life, and at 10-week intervals in the 2nd and 3rd years. The systemic symptoms and signs were recorded by mothers, and the obtained data were stored on computer cards. The results were subjected to statistical analysis considering finally these systemic manifestations which were present in at least 25% of children. The manifestations connected with teeth eruption included: profuse salivation, biting of hard, things, restlessness, appetite loss and sleep disturbances. These symptoms were most pronounced at the time of milk incisors eruption, less evident during eruption of first molars, and were absent during eruption of second molars. Canine teeth eruption was connected particularly with restlessness and sleep disturbances. Such signs as raised body temperature, skin changes, gastrointestinal disturbances were only weakly connected with teeth eruption.

[Coexistence of Toxoplasma gondii and Cytomegalovirus infections in infants]. / Wspóøistnienie zarazen pierwotniakiem Toxoplasma gondii i wirusem cytomegalii u niemowlat.

Coexistence of Toxoplasma gondii and Cytomegalovirus infection in 3 dystrophic newborns is discussed. Also the not very characteristic course of the infection is stressed.

[Long-term clinical observation of children with passively acquired anti-Toxoplasma antibodies]. / Dlugotrwala obserwacja kliniczna dzieci z biernym przeniesieniem przeciwcial przeciwtoksoplazmowych.

A group of 20 children born to mothers, suspected of active toxoplasma infection during gestation, was analysed. Multispecialist examinations carried out in children for the period of 2-3 years have shown that the specific antibodies were acquired transplacentally. This enabled to exclude an active infectious process in children.