RESUMO
OBJECTIVE: To determine the incidence and factors associated with diffuse basal ganglia or thalamus hyperechogenicity (BGTH) in preterm infants. STUDY DESIGN: (1) Review of serial neurosonograms among neonates with gestational age (GA) <34 weeks born at Weiler Hospital during a 21-month period; (2) Color Doppler flow imaging; (3) Case-control study using GA group-matched controls; and (4) Blind reading of CT scans or MRIs in patients with BGTH. RESULTS: Among 289 infants, 24 (8.3%) had diffuse BGTH. Color Doppler flow imaging was normal in nine patients. The incidence of diffuse BGTH was inversely related to GA (P<0.01). Logistic regression (n=96) showed that diffuse BGTH was significantly associated with requirement of high-frequency oscillation (HFO) (P=0.031), severe intraventricular hemorrhage (IVH) (P=0.004), hypotension requiring vasopressors (P=0.040), hypoglycemia (P=0.031) and male gender (P=0.014). Most patients with diffuse BGTH had normal basal ganglia and thalamus on CT/MRI, one had a hemorrhage, and one had an ischemic infarction. CONCLUSIONS: In our series, diffuse BGTH occurred in 8.3%, and was associated with factors similar to those previously reported. In contrast, several series have reported almost exclusively linear or punctuate hyperechoic foci, corresponding to hyperechogenicity of the lenticulostriate vessels. Our data provide further evidence to suggest that diffuse BGTH and hyperechogenicity of the lenticulostriate vessels are two different entities. Additional studies are required to determine the long-term significance of diffuse BGTH.
Assuntos
Doenças dos Gânglios da Base/diagnóstico por imagem , Gânglios da Base/diagnóstico por imagem , Núcleo Caudado/diagnóstico por imagem , Ecoencefalografia , Doenças do Prematuro/diagnóstico por imagem , Doenças Talâmicas/diagnóstico por imagem , Tálamo/diagnóstico por imagem , Doenças dos Gânglios da Base/epidemiologia , Estudos Transversais , Diagnóstico Diferencial , Dominância Cerebral/fisiologia , Ecoencefalografia/estatística & dados numéricos , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Doenças do Prematuro/epidemiologia , Unidades de Terapia Intensiva Neonatal , Modelos Logísticos , Imageamento por Ressonância Magnética , Masculino , Prognóstico , Fatores de Risco , Doenças Talâmicas/epidemiologia , Tomografia Computadorizada por Raios XRESUMO
We report a full-term neonate with a left middle cerebral artery infarct, narrowing of the internal carotid artery detected by magnetic resonance angiography and B-mode ultrasonography, and a large thrombus at the origin of the internal carotid artery detected by B-mode ultrasonography. Internal carotid arterial thrombus is seldom considered the source of middle cerebral arterial embolus in neonates. We suggest that B-mode ultrasonography of the carotid artery be included in the diagnostic evaluation of middle cerebral artery infarcts in neonates.
Assuntos
Trombose das Artérias Carótidas/congênito , Artéria Carótida Interna , Infarto da Artéria Cerebral Média/congênito , Embolia Intracraniana/congênito , Trombose das Artérias Carótidas/diagnóstico , Artéria Carótida Interna/patologia , Diagnóstico Diferencial , Diagnóstico por Imagem , Humanos , Recém-Nascido , Infarto da Artéria Cerebral Média/diagnóstico , Embolia Intracraniana/diagnóstico , Masculino , Artéria Cerebral Média/patologia , Exame NeurológicoRESUMO
We report the successful management of a case of hemolytic disease and hydrops fetalis secondary to anti Rh 17 antibodies in a woman with the rare D-- phenotype. We discuss the efficacy of intravenous immunoglobulins in treating hemolytic disease of the newborn infant.
Assuntos
Eritroblastose Fetal/etiologia , Eritroblastose Fetal/genética , Hidropisia Fetal/etiologia , Hidropisia Fetal/genética , Fenótipo , Sistema do Grupo Sanguíneo Rh-Hr/efeitos adversos , Sistema do Grupo Sanguíneo Rh-Hr/genética , Adulto , Eritroblastose Fetal/terapia , Feminino , Humanos , Hidropisia Fetal/terapia , Recém-Nascido , GravidezAssuntos
Cálcio/sangue , Eritrócitos/metabolismo , Potássio/sangue , Desnutrição Proteico-Calórica/sangue , Sódio/sangue , Oligoelementos/sangue , Sangue , Água Corporal/metabolismo , Pré-Escolar , Cobre/sangue , Diarreia Infantil/sangue , Diarreia Infantil/complicações , Feminino , Humanos , Lactente , Kwashiorkor/sangue , Kwashiorkor/complicações , Magnésio/sangue , Masculino , Desnutrição Proteico-Calórica/complicações , Zinco/sangueRESUMO
Red cell and plasma lipids and their fractions were estimated in 20 cases of thalassaemia and 20 normal controls. In thalassaemia there was reduction in red cell lipids and their fractions, plasma lipids and their fractions, and derangement of liver functions. On the other hand, the intestinal fat absorption, morphology of intestinal mucosa and histochemical studies of fat absorption were normal. Hypolipidaemia may be possibly caused by deranged liver functions and is probably responsible for the diminution in erythrocyte lipids. A genetic factor producing reduction in red cell lipids may be also present.