Ischaemia-modified albumin levels in newborn jaundice before and after phototherapy.

The aim of our study was to assess the effect of phototherapy (PT) on ischaemia-modified albumin (IMA) and malondialdehyde (MDA) levels in hyperbilirubinemic full-term newborns. The study was performed on 36 full-term infants exposed to PT. The babies were aged 3 to 13 days. IMA and MDA levels of the babies were determined before and after PT, by a colorimetric assay. IMA levels before and after PT were found as 0.424 ± 0.290 and 0.531 ± 0.262 absorbance units, respectively. Although IMA levels after PT were slightly higher, the difference was not statistically significant (p > 0.131). MDA levels before and after PT were found as 8.4 ± 1.8 µmol/l and 9.4 ± 1.5 µmol/l, respectively. Serum MDA concentrations were significantly higher after PT than before PT (p < 0.000). In previous studies, conflicting findings have been reported about the effect of PT on oxidant and antioxidant systems. However, we have found no study investigating IMA levels in hyperbilirubinaemia in newborns before and after PT. Our results shows that PT does not affect IMA levels significantly. IMA increases as a result of oxidative stress. We believe that the lack of significant difference between our IMA levels before and after PT may resulted from hyperbilirubinaemia, which has antioxidant effect.

Freeman-Sheldon (whistling face) syndrome with hyperpyrexia in the newborn: case report.

Freeman Sheldon syndrome (FSS) is a rare, multiple congenital contracture syndrome that is relatively well-known, since affected children have a striking appearance. This entity was historically referred to as the "whistling-face syndrome". Malignant hyperthermia and hyperpyrexia have been documented in FSS after general anesthesia related to the neuropathy. We report a male neonate with FSS and hyperpyrexia without anesthesia. To our knowledge, our patient is the first in the literature with hyperpyrexia in the newborn period without anesthesia.

A dysmorphic newborn with 45,X,der(1)inv(1)(p13;qter)t(Y;1)(pter-->q11;p13),-Y de novo karyotype.

A dysmorphic newborn with 45,x,der(1)inv(1)(p13;qter)t(y;1)(pter-->q11;p13),-Y de novo karyotype: Y/autosome translocations are very rare chromosomal rearrangements. In most cases, the long arm of the Y chromosome is translocated onto an autosome and most patients are referred because of male infertility. Y/1 translocations are very rare, and have been reported in seven patients so far. Pericentric inversions may be seen in all chromosomes and are not associated with phenotypic abnormalities. Here we report a 6-day old male baby with prenatal growth retardation, frontal bossing, hypertelorism, micrognathia, cleft soft palate, absent uvula, hypospadias, simian line in both hands and hammer toes. Cytogenetic analysis was performed with GTG-banding, C-banding and FISH analysis containing X centromeric probe, Yq12-qter locus specific probe and whole chromosome Y probe. An unbalanced Y/1 translocation was diagnosed: 45,X,der(1)inv(1)(p13;qter)t(Y;1)(pter-->q11;p13),-Y.

Comparison of sucrose, expressed breast milk, and breast-feeding on the neonatal response to heel prick.

Newborns endure many heel pricks and other uncomfortable procedures during their first hospital stay. The aim of this study was to investigate the effectiveness of breast-feeding in reducing pain in newborns undergoing heel prick tests. One hundred thirty healthy term infants requiring a heel prick blood sampling for the Guthrie test were studied. Infants were randomly allocated to 1 of the following treatment groups: group 1, 25% sucrose (n = 35); group 2, breast milk (n = 33); group 3, sterile water (n = 34); and group 4, breast-feeding (n = 28). The median values of crying and recovery time and percent change in heart rate at 1, 2, and 3 minutes were recorded. A behavioral pain scale was applied according to the infant body coding system. The median crying time was 36, 62, 52, and 51 seconds in groups 1, 2, 3, and 4, respectively (P =.002). Similarly, there was a significant overall difference among groups for the duration of recovery time (P =.006) and the percent change in heart rate at 1 (P =.03), 2 (P =.01), and 3 (P =.009) minutes favoring the sucrose group. But when we compared the groups, the significance remained for the sucrose versus breast milk (P =.007) and water (P =.001) groups for the recovery time and sucrose versus all other groups for the percent change in heart rate at 3 minutes. The infant body coding system showed that babies in the sucrose group had significantly lower scores followed by the breast-fed and breast milk groups (P =.0001). Our study revealed that 25% sucrose is superior to breast-feeding in pain relief, which is reflected mainly in crying time and behavioral variables. The behavioral effects of breast-feeding did not provide any additional benefit.

Perineo-pelvic diaphragmatic split: anorectal exstrophy.

Anorectal malformations are among the most common congenital anomalies that require neonatal surgery. Although the headlines of anorectal malformations present with a spectrum of defects of this region, generally, imperforate anus and its fistulous or nonfistulous connections are examined. Here the authors present a boy with anorectal malformation, with sacrococcygeal teratoma and meningocele. Interestingly, the patient had neither imperforate anus nor anorectal stenosis, but had widely open anorectum. This kind of anorectal malformation has never been described previously in the English-language literature.

Superior sternal cleft and minor hemangiomas in a newborn.

The association of hemangioma and sternal cleft is rare. It may present as sternal malformation/vascular dysplasia association or PHACES syndrome when associated with other ventral developmental defects. We report on a newborn infant with superior sternal cleft and minor hemangiomas.

A case of isotretinoin embryopathy with bilateral anotia and Taussig-Bing malformation.

We report a newborn infant with multiple congenital anomalies (anotia and Taussig-Bing malformation) due to exposure to isotretinoin within the first trimester. In this paper we aim to draw to the fact that caution is needed when prescribing vitamin A-containing drugs to women of childbearing years.

Procalcitonin measurement at 24 hours of age may be helpful in the prompt diagnosis of early-onset neonatal sepsis.

BACKGROUND: The clinical signs of early-onset neonatal sepsis (EONS) are nonspecific and indistinguishable from those of noninfectious disorders. The early diagnosis of EONS is difficult, but is essential to improve outcomes. The aim of this study was to determine the diagnostic value of procalcitonin (PCT) at birth and at 24h of age in the prompt diagnosis of EONS. METHODS: The patient group consisted of neonates with a Töllner score of ≥ 10 or a Töllner score of 5-10 but with the presence of prolonged rupture of the membranes (> 18 h) or chorioamnionitis or maternal fever (n=171). The control group (n=89) comprised neonates admitted to the neonatal intensive care unit for different disease entities. Procalcitonin levels at birth (first) and at 24h of age (second) were measured for each neonate in both of the study groups. RESULTS: There was no difference between the two groups in terms of gender, birth weight, or gestational age. The mean (min-max) first PCT level was 0.48 (0.07-3.48)ng/ml in the controls and 0.51 (0.09-28.6)ng/ml in patients. The mean (min-max) second PCT level was 1.72 (0.21-18.23)ng/ml in the controls and 16.17 (0.17-100)ng/ml in patients. There was no statistically significant difference in PCT levels between the patient and control groups at birth. However, at 24h of age, PCT levels were significantly higher in the patient group than in the control group (p<0.001). Serum PCT levels in controls at 24h of age were slightly increased compared to levels at birth, but as a normal reaction. PCT thresholds for the diagnosis of sepsis were 0.59 ng/ml at birth (sensitivity 48.7%, specificity 68.6%) and 5.38 ng/ml at 24h of life (sensitivity 83.3%, specificity 88.6%). CONCLUSIONS: In EONS, PCT measurements at birth may initially be normal; a serial PCT measurement at 24h of age may be more helpful for an early diagnosis. During the first 24h of life PCT is a more sensitive marker of infection than C-reactive protein. Further studies are needed to confirm our findings.

A Wireless Sensor Network approach for distributed in-line chemical analysis of water.

In this work we propose the implementation of a distributed system based on a Wireless Sensor Network for the control of a chemical analysis system for fresh water. This implementation is presented by describing the nodes that form the distributed system, the communication system by wireless networks, control strategies, and so on. Nitrate, ammonium, and chloride are measured in-line using appropriate ion selective electrodes (ISEs), the results obtained being compared with those provided by the corresponding reference methods. Recovery analyses with ISEs and standard methods, study of interferences, and evaluation of major sensor features have also been carried out. The communication among the nodes that form the distributed system is implemented by means of the utilization of proprietary wireless networks, and secondary data transmission services (GSM or GPRS) provided by a mobile telephone operator. The information is processed, integrated and stored in a control center. These data can be retrieved--through the Internet--so as to know the real-time system status and its evolution.

The lateralization of the grasp reflex in human newborns.

The strength of the grasp reflex from the right and left hands was estimated in male and female newborns within the second day after birth. In the total sample (N = 121), the mean strength of the grasp reflex from the right hand was found to be significantly higher than that from the left hand. There was a significant positive linear correlation between reflex strengths from the right and left hands. The mean right minus left (R - L) reflex strength was found to be significantly larger than zero. There was a positive linear relationship between the R-L reflex strength and the reflex strengths from the right and left hands. This was more pronounced for the right hand than the left hand. The reflex strengths from the right and left hands were found to be positively linearly correlated with the weight of the newborn babies. These results indicated a grasp reflex lateralization in newborns. The right-bias in the grasp-reflex asymmetry established in this work would create a basis for the development of the right-hand preference in adulthood.

A case associated with Walker Warburg syndrome phenotype and homozygous pericentric inversion 9: coincidental finding or aetiological factor?

We describe a rare occurrence of pericentric inversion in homologues of chromosome 9 observed in a 2-mo-old female baby with eye and brain abnormalities. Her clinical and neuroradiological features are similar to the signs of Walker-Warburg syndrome. We found the same inversion in heterozygous condition in all metaphases of both parents, who are related, and in two grandparents and their mother. The cytogenetic abnormality alone does not explain the phenotype in this patient, but it warrants further linkage studies with emphasis on the pericentric region of chromosome 9 in patients with Walker-Warburg syndrome phenotype. This family case is unique and raises suspicions about whether the pericentric region of chromosome 9 has any connection with the phenotype of Walker-Warker syndrome.

Lateralization of the grasp reflex in male and female human newborns.

The lateralization of the grasp reflex was studied in male and female newborns. The mean grasp-reflex strength of the right hand was found to be higher than that of the left hand in males, but the difference was not significant. The mean grasp-reflex strength of the right hand was found to be significantly higher than that of the left hand in females. There was no significant difference between the mean grasp-reflex strengths of the right hand in the male and female subjects. The mean reflex strength of the left hand was found to be higher in males than females; the difference was only marginally significant. The right minus left (R - L) reflex strength showed a significant positive linear relation to the right-and left-reflex strengths in both sexes. This was, however, much more pronounced for the right-reflex than the left-reflex. There was a significantly positive linear correlation between the reflex strengths of the right and left hands and the body weight in males. The females did not show such a relationship between reflex strength and body weight. These sex-related differences in the grasp reflex in newborns were discussed in light of cerebral lateralization and its hormonal modulation.

The relationships between the degree of grasp-reflex asymmetry, grasp-reflex strength from the right and left hands, and body weight in the male and female newborn with and without familial sinistrality.

The relation of the degree of grasp-reflex asymmetry to the strength of right- and left-hand grasp-reflex strength and body weight was studied in human newborn. In the total sample (N = 103), the right minus left (R-L) reflex strength was found to be positively linearly related to the grasp-reflex strengths from the right and left hands in FS-subjects; the correlation was higher for the right hand than the left hand. In FS+ subjects (N = 17), there was not a significant correlation between R-L and right-reflex strength; left-reflex strength was found to be negatively linearly related to the R-L reflex strength. In FS- subjects, the right- and left-reflex strengths showed a positive linear correlation with body weight. In FS+ subjects, only the left-reflex showed a positive linear correlation with body weight. The R-L reflex tended to be positively correlated with body weight in FS- subjects and negatively correlated in FS+ subjects. In females (N = 58), the relation of R-L to right and left reflex was similar to that for the total sample. There was no significant correlation between grasp reflex and body weight in FS- females. In FS+ females (N = 8), there was a positive linear correlation between the right grasp-reflex and body weight; the left grasp-reflex did not show such a significant correlation. The R-L grasp-reflex strength was not correlated with body weight in females.(ABSTRACT TRUNCATED AT 250 WORDS)

Right-, left-dominance and ambidexterity in grasp reflex in human newborn: importance of left brain in cerebral lateralization.

The grasp reflex was studied in human newborn without familial sinistrality. Of 60 females, 26 (43.3%) were right-handed and 34 (56.7%) ambidextrous. Of 62 males, 20 (32.3%) were right-handed, 39 (62.9%) ambidextrous, and 3 (4.8%) left-handed. There was a nonsignificant preponderance of right-dominance in females and a significant preponderance of nonright-handedness in males. In right-handers, the mean right minus left (R-L) grasp-reflex showed a positive linear correlation with the grasp-reflex from the right and left hands, with a higher correlation for the right hand. In ambidexters, the R-L grasp reflex did not show any significant correlation with the grasp reflex from the right and left hands. The mean grasp-reflex from right and left were found to be significantly smaller in ambidextrous males and females then right-handed males and females, with a much higher significance for the right hand. It was concluded that females tended to have a more pronounced reflex lateralization than males. The results also indicated that the left brain may be more important than the right brain for the development of a spinocerebral motor lateralization in humans.