The prognostic value of serial EEG recordings following acute neonatal asphyxia in full-term infants.

Perinatal asphyxia is one of the major causes of non-progressive neurological deficits seen in children. It is reported that currently no set of parameters allowing for accurate prediction of prognosis following severe perinatal asphyxia is available. Even electroencephalogram (EEG) recordings, which are known to give a fairly good prediction of long-term outcome, have their flaws. The aim of this prospective study was to evaluate the additional value of serial EEGs in full-term infants. In all, 36 infants were enrolled. All met strict entrance criteria, received standard treatment and underwent two EEGs according to a pre-set protocol: the first between 12 and 36 hours post-partum, the second between 7 and 9 days post-partum. It is clearly demonstrated that serial EEG recordings do enhance the prognostic value of the EEG. Moreover, distinct progression seen in serial EEGs is highly prognostic for a normal outcome and has even more prognostic value than one single severely abnormal EEG. A better indication of future outcome is obtained from serial EEGs.

Spontaneous motility in preterm infants treated with indomethacin.

OBJECTIVE: To determine in preterm infants with a patent ductus arteriosus (PDA) the effect of indomethacin treatment on spontaneous motor activity. STUDY DESIGN: Motor activity was assessed from repeated videotape recordings in 32 preterm infants (

Hypertensive encephalopathy in a patient with neonatal thyrotoxicosis.

UNLABELLED: Neonatal hyperthyroidism may give rise to serious cardiovascular complications. A girl with severe thyrotoxicosis in whom hypertensive encephalopathy developed is described. CONCLUSION: Neonatal thyrotoxicosis can give rise to hypertension and may lead to hypertensive encephalopathy.

Bacterial contamination of growth hormone solution and injection equipment during use by growth hormone deficient children.

The frequency of bacterial contamination of growth hormone solution and injection equipment use by 20 growth hormone deficient children was studied. In a cross-over study the children were randomized to begin using, for their growth hormone injections, either the recently developed growth hormone injection pen or the conventional syringe method. A comparison was then made of these two methods of injection over a 6-week period and the vials, pen-cartridges, syringes and needles were cultured. When the pen was used 5.3% of the 114 vials, 15.5% of the 110 cartridges and 11.2% of the 98 needles were found to be contaminated; when the syringe was used 3.5% of the 113 vials, 7.1% of the 98 syringes and 9.1% of the 99 needles were contaminated. To ensure microbiological safety during the preparation and injection of the growth hormone solution, regular instruction and reassessment of the injection technique for patients on long-term treatment are advocated. This applies even when disposable items are used. As no statistically significant difference was noted between the number of contaminated items used with either the pen or the syringe method, we conclude that the growth hormone pen is suitable for growth hormone administration.

Very large peroxisomes in distinct peroxisomal disorders (rhizomelic chondrodysplasia punctata and acyl-CoA oxidase deficiency): novel data.

We report very large hepatic peroxisomes (d-circle greater than 1 micron) in a patient with rhizomelic chondrodysplasia punctata and a patient with acyl-CoA oxidase deficiency. The effects of peroxisomal enlargement on the enzymatic activity are discussed. As increase in peroxisomal size is also reported in at least 12 other patients with peroxisomal disorders, we propose a relationship between the enlargement of the organelles and their functional deficiency.