The aim of this study was to evaluate the effectiveness of different oral carbohydrate solutions for alleviation of pain in healthy preterm babies. Thirty-one preterm infants who were having blood drawn by heel prick were given 2 ml of solution A (20% sucrose), solution B (20% glucose) or solution C (placebo, sterile water) into the mouth, 2 min before lancing. Behavioural responses to this painful stimulus were measured by duration of crying and facial expressions (Neonatal Facial Coding System, NFCS) and physiological responses were measured by heart rate (HR), respiratory rate (RR), and oxygen saturation changes (SaO 2 ).
A prenatally diagnosed patient was referred to our hospital at 35 weeks of gestation. Antenatal ultrasonography demonstrated cardiomegaly and aneurysm of the vein of Galen. A 3,290 g male baby was delivered by elective cesarean section at 37 weeks of gestation. Physical examination was remarkable for tachypnea, hyperdynamic precordium with a continuous murmur, cranial bruit and bounding carotid pulses. Magnetic resonance angiography confirmed vein of Galen aneurysmal malformation and demonstrated the vessels feeding the aneurysm. Postnatal management included aggressive medical treatment of cardiac failure and transarterial embolization of the vessels feeding the aneurysm at 3 days of age. Posthemorrhagic hydrocephalus developed after embolization, and a ventriculo-peritoneal shunt was placed at 29 days of age. Presently, the patient is 4 years of age and has no neurological abnormality at follow-up. Vein of Galen aneurysmal malformations can cause severe morbidity and mortality in neonates. However, careful obstetric follow-up and early postnatal endovascular treatment of these malformations may lead to a favorable outcome.
SUMMARY Sixty low birthweight infants (1000-2000 g) admitted to a neonatal care unit in Turkey were studied. Those not requiring intensive care were randomly assigned for treatment either in a cot on a heated, water filled mattress kept at 37°C (n=28) or in air heated incubators with a mean air temperature of 35°C (n=32). On admission 53 (88-3%) of the infants had body temperatures between 300 and 36°C. There was good correlation between axillary and rectal temperatures in the infants while they were hypothermic. Normal temperatures were achieved within the first day and remained within this range during the subsequent days after admission in all the infants treated on the heated, water filled mattress, whereas they were not achieved until three days later in the incubator group. The neonatal mortality among those treated on the heated, water filled mattress was 21%, and among those treated in the incubator 34%. The heated, water filled mattress provides a good alternative to skin to skin contact with the mother, and to the use of a complex and expensive incubator for rapidly attaining and maintaining normal temperatures in the low birthweight newborn.Hypothermia and cold injuries were among the main causes of neonatal death in the early 19th century.' The influence of thermal environment on
Breast milk samples from mothers of breast‐fed, healthy, term newborns with unexplained prolonged jaundice were analyzed for β‐glucuronidase activity. Mean enzyme activity was 75.7 ± 34.5 modified Sigma units/ml in the breast milk samples ingested by the study group of jaundiced babies (n= 25) and 82.2 ± 40.1 modified Sigma units/ml in the samples ingested by the control group of non‐jaundiced babies (n = 20) (p > 0.05). Enzyme activities at 2, 3 and 4 postnatal weeks were 101.0 ±39.9, 66.0 ± 20.7 and 57.0 ± 22.4 modified Sigma units/ml in the study group and 87.9 ±36.1, 58.5 ± 15.0 and 88.3 ±49.1 modified Sigma units/ml in the controls. The differences were not statistically significant (p > 0.05). We conclude that breast milk β‐glucuronidase activity may be a contributory factor, in the presence of other variables, in hyperbilirubinemia but it is neither the main nor the only cause of prolonged jaundice in neonates.
Our results suggest that G71R mutation of UGT1A1 is not rare; however, an association between G71R mutation and hyperbilirubinemia of unexplained cause has not been shown in Turkish newborns.
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