In this study, we compared three different therapy modes (150,000 IU, 300,000 IU, and 600,000 IU vitamin D p.o.) in infants with nutritional vitamin D deficiency rickets (VDR). Our purpose was to determine the most effective dosage of vitamin D with least side effects for treating VDR. The study included 56 patients, 3-36 months of age, with nutritional VDR and 20 age-matched control infants. In all infants, serum calcium, phosphorus, alkaline phosphatase, magnesium, serum 25-hydroxycholecalciferol, plasma intact parathormone levels and urinary Ca/creatine ratio were determined. Of 56 patients, 52 were able to be followed long-term. These patients were reexamined on the 3rd day, 7-10th day, and 25-30th day after treatment. On the 30th day post-treatment, we did not find any difference between the doses in the improvement of rickets. However, hypercalcemia was present in eight infants who had been administered 300,000 IU (two infants) and 600,000 IU (six infants) of vitamin D. In conclusion, our findings showed that 150,000 IU or 300,000 IU of vitamin D was adequate in the treatment of VDR, but 600,000 IU of vitamin D may carry the risk of hypercalcemia.
A residual AFI < 50 mm after preterm PROM between 24 and 34 weeks of gestation, which is mostly seen in grand multiparous women in Eastern Turkey, may be a valuable prognostic variable for anticipating adverse maternal and neonatal outcomes.
The aim of this study was to evaluate the etiology, clinical, and laboratory findings and prognostic features of life-threatening hypernatremic newborns secondary to salting. Ten severely hypernatremic newborns (four females) with a mean age of 6.5 +/- 2.6 days were followed up. Nine of them were full term, and one was preterm. It was noticeable that 60% of them were small for gestational age. In the laboratory investigation, five uremias were detected. It was interesting to find in the etiologic history that 40% of the patients had been salted just after birth. Twenty percent of them had also hyperbilirubinemia and kernicterus, 20% had neonatal convulsion, and 50% had dehydration. Two of the hypernatremic newborns died during the study; the others were followed up. One case had spasticity and developmental disability at the 3rd month, and another one had developmental disability at the 6th month of ages. As a conclusion, although salting of newborns is not so frequent, it could be seen in rural places of our country, and this may be one of the reasons for serious hypernatremia in newborns whose skin integrity have not been formed completely. These cases should be treated carefully.
The cerebral blood flow velocities (CBFV) of infants with perinatal asphyxia and hypoxic ischemic encephalopathy (HIE) in the first 12 hours of their lives have been the chief focus of our concern in this study. Cerebral ischemia which can develop in the earlier hours of HIE, and the detection and diagnosis of this condition with color Doppler ultrasonography (cD-USG) will be put into discussion. Twenty-three full-term newborn infants who had perinatal asphyxia and HIE together with a control group constituting twenty full-term newborn infants who produced no problems, were included in our study. All of the infants underwent cD-USG in the postpartum period of the first 12 hours (mean 8.4 hours). Measurements being based upon peak systolic velocity (PSV), end diastolic velocity (EDV) and Pouecelout's resistive index (RI) in anterior and middle cerebral arteries were conducted. The infants, having been discharged from the unit they were followed up for mean 9.8 months in the outpatient clinic. PSV and EDV counts in the postpartum first 12 hours of 23 infants who were detected to have HIE were found to be significantly lower compared to the control group, whereas RI counts were found to be significantly higher (p < 0.05). The counts obtained from the right and left cerebral arteries of the infants with HIE were found to be corraleted with each others. The neonates in the patient group were observed to have gone through this prognosis: Three of them died, three of them had cerebral palsy, one of them had infantile spasms, and three of them had developmental retardation. When we compared the CBFV of the 10 neonates who had poor prognosis, retrospectively with the other 13 neonates who had good prognosis, PSV and EDV were found to be significantly lower and RI significantly higher (p < 0.05). In the light of the data we have obtained, cD-USG can be considered to be a highly practical device in evaluating CBVF of the infants with HIE. A skillful detection of the decrease in cerebral blood flow which can develop in the postasphyxial first 12 hours and the prospective treatments being based upon this approach would contribute to the diagnosis, treatment and prognosis of such cases.
In this case report the authors present an extremely low birth weight premature infant with neonatal brucellosis whose mother had been treated for brucellosis during pregnancy. Infant developed mild respiratory distress syndrome soon after birth. At 2nd wk of postnatal age findings of bronchopulmonary dysplasia were evident and she and her mother were diagnosed to have brucellosis at the same time. After commencement of antibrucellosis therapy and nonspesific treatment for bronchopulmonary dysplasia, infant was completely cured of the symptoms related to both brucellosis and bronchopulmonary dysplasia. The results of the present case and a review of the literature have let to conclude that Brucella might have role in development of prematurity and bronchoplumonary dysplasia. Since discovery of brucella bacilli in early periods of 20th century, fetotoxicity of brucella bacilli seems to increase gradually suggesting an increasing virulance of the bacilli or vanishing host defense of human beings.
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