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A 15-month-old girl with rhinopharyngitis was treated with a nasal solution containing the imidazoline derivative naphazoline. She rapidly developed profound CNS depression with stupor, hypothermia, hypoventilation and bradycardia. All symptoms disappeared within 24 h. The symptomatology of 18 other paediatric cases of naphthylimidazoline exposure reported to the Belgian National Poison Centre, is also discussed. Imidazoline intoxication due to overdose or accidental ingestion but also after normal therapeutic usage is frequent in children. It can cause severe CNS depression, especially in very young children. For these reasons vasoconstrictor imidazoline containing solutions should be prescribed with caution and kept out of reach of children.

The simple bedside scoring system NOSEP-1 composed of C-reactive protein, neutrophil fraction, thrombocytopenia, fever, and prolonged parenteral nutrition exposure provides a valuable tool for early identification of nosocomial sepsis. Its predictive power can be improved by adding central vascular catheter insertion site and hub colonization to the score.

Histologic results of the placenta are usually not available within the first days of life. We identified inflammatory variables in tracheal aspirates and blood that were associated with histologic chorioamnionitis (HC). A derivation cohort consisted of 62 neonates and a validation cohort of 57 neonates with a gestational age Ͻ 31 wk and ventilated on d 1. Tracheal aspirates were taken on d 1 and on d 3, if the patient was still ventilated. HC was diagnosed by light microscopy. Logistic regression was used to identify independent factors in the derivation cohort associated with HC at d 1, 2, and 3. Model performance was studied using receiver operating characteristic curve analysis. Independent factors associated with HC were, at d 1, tracheal aspirate IL-8 Ն 917 pg/mL (odds ratio, 60.7; 95% confidence interval, 11-328); at d 2, blood C-reactive protein Ն 14 mg/L (odds ratio, 9.2; 95% confidence interval, 2-38), blood white blood cell count Ն 10,400/mm 3 (odds ratio, 7.4; 95% confidence interval, 2-28); and at d 3, blood neutrophil count Ն 4968/mm Chorioamnionitis is considered to be one of the main causes of preterm labor and has been associated with an adverse perinatal outcome (e.g. cerebral palsy and chronic lung disease) in preterm infants (1, 2). Histologic results of the examination of the placenta are usually not available within the first days of life, and prenatal diagnosis of chorioamnionitis remains difficult. An early diagnosis is difficult and can only be made in 6% to 24% of these patients by amniotic fluid culture (3). As a result of the "chronic inflammation" of fetal or maternal membranes, elevated proinflammatory cytokine levels are found in the amniotic fluid and ultimately in the fetus. These cytokines are associated with preterm labor and delivery, a fetal inflammatory response, and the associated negative outcomes (4, 5).The objective of the present study was to identify variables in the TA and blood of preterm infants, measured within the first 3 d of life, that are associated with HC in the placenta. These factors would allow us to identify infants with the highest risk of suffering from the adverse consequences of chorioamnionitis. METHODS Study population.

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Many aspects of the pathogenesis of the inflammatory response in the development of chronic lung disease remain to be elucidated. Further research to identify preterm infants at highest risk for the development of this multifactorial and complex disease is needed.

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