Aim:To evaluate if a complete urological screening is justified by potential urological anomalies in newborns or infants with asymptomatic renal ectopia (RE). Methods: The database records of 60 consecutive neonatal cases of RE diagnosed at the authors' hospital from 1990 to 2004 were retrospectively reviewed. Results: At diagnosis, mean patient age was 1.6 months. In 58 of 60 patients, the suspected diagnosis of RE was made during prenatal or postnatal screening ultrasonography, including two newborns with anorectal malformation. There were 24 patients with crossed RE (C-RE) and 36 patients with simple RE (S-RE). A solitary RE was present in two patients. The most frequent associated urological abnormality was vesicoureteral reflux (37.5% of C-RE and 16.6% of S-RE). Hydronephrosis was detected in seven RE and five contralateral kidneys. An obstructive megaureter was present in one patient with C-RE. In 40% of S-RE and 92.9% of C-RE, the 99m Tc DMSA documented reduction of function of RE. The longitudinal diameter of the ectopic kidney was significantly smaller than the contralateral one. Other non-renal diseases were present in 15% of patients, of which the most frequent was cryptorchidism (6.6%). Conclusions: A complete urological evaluation is necessary in newborns with C-RE for the high incidence of associated urological anomalies, of which VUR is the most frequent. A complete urological evaluation is also reasonable in patients with S-RE who have a pelvic dilatation. No diagnosis or treatment of the associated urological diseases, in consideration of congenital decreased function of the ectopic kidney, might predispose these children to improvement of renal function impairment.
The aim of this study was to evaluate the incidence and outcome of isolated moderate renal pelvis dilatation (RPD) [anterior-posterior diameter (APD) 10-15 mm] in an unselected population of 2-month-old infants prospectively followed for up to 12-14 months of life. Isolated moderate renal pelvis dilatation was detected in 282 of the 11,801 (2.4%), infants screened; 240 infants with normal renal ultrasound were enrolled as the control group. Resolution of RPD was considered when an APD
Elevated breast milk (BM) Na concentration is regarded as responsible for elevated Na intake. To verify the clinical significance of milk Na concentration, we studied the relationship between BM Na þ concentration and infants' daily Na þ intake, infants' daily BM intake (DBMI) and percentage weight loss (%WL) in healthy newborn infants. All mothers who gave birth to a single healthy infant, between February and March 2004 at the Obstetric Clinic of University of Messina (Italy), were invited to participate if they were willing to attempt to breastfeed exclusively. BM Na þ concentration, DBMI, Na þ intake and %WL were determined on the third day after delivery. Statistical analysis was performed by Spearman's correlation test, classification and regression trees and the generalised linear model. Of the 270 eligible mothers, 208 participated in the study. The results showed that on the third day postpartum BM Na þ concentration was 23·05 (SD 1·10) mmol/l, mean DBMI was 202 (SD 68·9) g/d, and mean Na þ intake was 4·36 (SD 0·22) mmol/d and 1·36 (SD 0·07) mmol/kg per d. BM Na þ concentration was inversely related to infant DBMI, and Na þ intake was directly related to infant DBMI and not to BM Na þ concentration. %WL was significantly correlated only to DBMI. In conclusion, the present data demonstrate, for the first time, that when lactogenesis is suboptimal, BM Na þ concentration is higher, but infants' Na þ intake is lower. Finally, the present data probably suggest that for the clinical assessment of breast-feeding, evaluation of milk intake remains the best method.Breast milk sodium: Infant sodium intake: Infant weight loss
The delivery room management of infants born through meconium stained amniotic fluid (MSAF) remains controversial. The aim of this prospective study was to evaluate maternal and neonatal characteristics of MSAF infants and the incidence of meconium aspiration syndrome (MAS) in routine delivery room management which reserved selective intubation for depressed/asphyxiated babies. Between October 1993 and September 1997, a consecutive sample of 3745 full-term infants was analyzed. Of these, 361 were MSAF infants. No significant difference in maternal age, parity, gestational age, sex, low 1 and 5 minute Apgar scores, metabolic acidemia, or need for endotracheal intubation was found between MSAF and non-MSAF infants. Only one of the MSAF infants (0.28%), who needed intubation, developed MAS. Identification of postterm pregnancy and prenatal asphyxia is the best prevention of MAS.
The aim of this study was to evaluate the incidence and outcome of isolated severe renal pelvis dilatation (RPD; APD>15
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