Differential effects of maternal hypoxia or nutrient restriction on carotid and femoral vascular function in neonatal rats.

In our study population, PDA closure was gestation dependant, with a cumulative closure rate of 65%. A similar proportion of infants closed their PDA following the first and second courses regardless of gestation. These data suggest that a second course of ibuprofen may be effective in closing a PDA in even the most preterm infant.

The harlequin color change is an unusual cutaneous phenomenon observed in newborn infants as transient, benign episodes of a sharply demarcated erythema on half of the infant, with simultaneous contralateral blanching. In this report, two newborns with congenital heart anomalies demonstrated the harlequin color change, one whose skin findings showed a course related to the dose of systemic prostaglandin E1, suggesting a possible association. The benign, self-limited nature of the color change mandates that prostaglandin E1 not be discontinued for this reason. The entity is likely more common than the paucity of reports in the world literature suggests, and all physicians should recognize its graphic appearance to avoid unnecessary exposure to agents in an effort to treat it.

The expired tidal volume, inflation pressures and times during the first five inflations during resuscitation were variable. The expired tidal volumes were significantly greater if the infant inspired during the inflation.

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Respiratory syncytial virus (RSV) infection is associated with chronic respiratory morbidity in infants born very prematurely. Our aims were to determine if infants born moderately prematurely (32--35 weeks of gestation) who had had an RSV hospitalisation, compared to those who had not, had greater healthcare utilisation and related cost of care in the first 2 years. Two thousand and sixty-six eligible infants' records were examined to identify three groups: 20 infants admitted for an RSV lower respiratory tract infection (RSV), 30 admitted for another respiratory problem (other respiratory) and 108 admitted for a nonrespiratory problem/never admitted (non-respiratory).Healthcare utilisation was assessed by examining hospital and general practitioner records and cost of care calculated using the National Scheme of Reference costs and the British National Formulary prices. The mean cost of care in the RSV group (£12,505) was greater than the non-respiratory(£1,178) (95% CI for difference £5,015 to £17,639, p=00.002) and the other respiratory (£3,356) groups (95% CI for difference £2,963 to £15,606, p<0.001). The adjusted mean differences in the cost of care were £11,186 between the RSV and non-respiratory groups (95% CI £4,763 to £17,609) and £9,076 (95% CI £2,515 to £15,637) between the RSV and the other respiratory groups. Forty-two of 2,066 eligible infants had an RSV hospitalisation (2%);thus, assuming prophylaxis would reduce the hospitalisation rate by 50%, the number needed to treat was 98. In conclusion,RSV hospitalisation in moderately prematurely born infants is associated with increased health-related cost of care. Nevertheless, if RSV prophylaxis is to be cost effective,a high risk group of moderately prematurely born infants needs to be identified.

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