scholarly journals Septo-Optic Dysplasia Diagnosed in a Newborn Infant with Normoglycemia: The Importance of Thorough Physical Examination

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Aishwarya Palorath ◽  
Ishita Kharode
Keyword(s):  
Physical Examination ◽  
Neonatal Intensive Care ◽  
Hormone Replacement ◽  
Newborn Infants ◽  
Male Infant ◽  
Plasma Cortisol Level ◽  
Pituitary Hormone ◽  
Acth Stimulation ◽  
Suspected Sepsis ◽  
Absent Septum Pellucidum

A newborn male infant was admitted to the neonatal intensive care unit due to suspected sepsis. He was clinically stable with normal electrolyte levels on admission. However, he was noted to have micropenis and bilateral nonpalpable testes. Ultrasound imaging confirmed the presence of both gonads in the inguinal canal, with no Müllerian structures visualized. Laboratory examination revealed an undetectable random plasma cortisol level; subsequent ACTH stimulation testing confirmed adrenal insufficiency. Further testing revealed additional pituitary hormone deficiencies, and the infant was started on multiple hormone replacement therapies. Magnetic resonance imaging identified absent septum pellucidum, pointing of the frontal horns, and optic nerve hypoplasia. A diagnosis of septo-optic dysplasia was made based on this combination of findings. This case highlights the importance of thorough physical examination in newborn infants, which may reveal the only sign of underlying pathology in the absence of other concerning findings.

scholarly journals SAT-241 Pituitary Stalk Interruption Syndrome Presenting as Neonatal Hypotonia

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Nordie Anne Bilbao
Keyword(s):  
Pituitary Gland ◽  
Neonatal Period ◽  
Hormone Replacement ◽  
Brain Mri ◽  
Rare Condition ◽  
Pituitary Stalk ◽  
Pituitary Hormone ◽  
Thyroid Function Tests ◽  
Acth Stimulation ◽  
Central Hypothyroidism

Abstract Pituitary stalk interruption syndrome (PSIS) is a rare condition that include congenital anatomic abnormalities of the pituitary gland and hypopituitarism. There is a wide variety of clinical presentation, with the age at presentation encompassing from neonatal period to adulthood and including one or more pituitary hormone deficiencies. In recent literature there is increasing recognition of PSIS presenting in the neonatal period, mostly involving hypoglycemia. Our patient is a full-term male infant who presented in the newborn period with hypotonia and hypothermia. He also had hypoglycemia, which was initially thought to be associated to hyperinsulinism in the context of gestational diabetes. Micropenis was noted on physical exam. As part of the study for hypotonia, serial thyroid function tests were obtained revealing central hypothyroidism. A low dose ACTH stimulation test was performed which revealed adrenal insufficiency. The patient was started on cortisol and thyroid hormone replacement. Brain MRI showed an ectopic neurohypophysis located along the floor of the hypothalamus, a small anterior pituitary gland, and a partially absent infundibulum, findings consistent with pituitary stalk interruption syndrome. The patient received testosterone injections for micropenis and is being followed for development of other pituitary hormone deficiencies. PSIS is a rare congenital condition that is increasingly recognized in neonates manifesting with signs of hypopituitarism.

BACTERIAL COLONIZATION OF NEWBORN INFANTS IN A NEONATAL INTENSIVE CARE UNIT

1982 ◽  
Vol 71 (5) ◽  
pp. 779-783 ◽  
Author(s):  
M. ERIKSSON ◽  
B. MELÉN ◽  
K.-E. MYRBÄCK ◽  
B. WINBLADH ◽  
R. ZETTERSTRÖM
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Bacterial Colonization ◽  
Newborn Infants

scholarly journals Severe Brief Resolved Unexplained Event in a Newborn Infant in Association with Maternal Sertralin Treatment during Pregnancy

Medicines ◽  
2018 ◽  
Vol 5 (4) ◽  
pp. 113
Author(s):  
Mirjam Pocivalnik ◽  
Manfred Danda ◽  
Berndt Urlesberger ◽  
Wolfgang Raith
Keyword(s):  
Drug Therapy ◽  
Newborn Infant ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Newborn Infants ◽  
Male Infant ◽  
Serotonin Reuptake Inhibitors ◽  
Neonatal Abstinence Syndrome ◽  
Selective Serotonin ◽  
Abstinence Syndrome

Background: Selective serotonin reuptake inhibitors are a very common choice of antidepressive drug-therapy during pregnancy. In up to 30% of cases, they have been found to cause neonatal abstinence syndrome in newborn infants. Although often both time-limiting and self-limiting, severe symptoms of neonatal abstinence syndrome (NAS) can occur. Methods/Results: We report a term male infant suffering from a severe brief resolved unexplained event caused by his mother’s sertraline intake during pregnancy. Conclusions: Newborn infants exposed to selective serotonine reuptake inhibitors (SSRIs) during pregnancy should be evaluated very carefully concerning NAS and monitored for NAS symptoms for a minimum of 72–96 h, or until symptoms have fully recovered using standardized protocols. There is a risk of severe NAS symptoms which might occur, and this circumstance should be discussed with the parents and taken into account before administering the drug.

scholarly journals Human Herpesvirus 6 Meningitis in a Neonatal Case

2021 ◽  
Vol 28 (4) ◽  
pp. 153-156
Author(s):  
Gyu Min Yeon ◽  
Yu Jin Jung
Keyword(s):  
Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Neonatal Period ◽  
Newborn Infants ◽  
Human Herpesvirus ◽  
Human Herpesvirus 6 ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Herpesvirus 6 ◽  
Infancy And Early Childhood

Incidence of human herpesvirus-6 (HHV-6) infection in the neonatal period has been reported in few cases. HHV-6, commonly responsible for roseola, is known to establish infection during infancy and early childhood. A 14-day-old neonate, presented with a fever of 38.3℃, primarily due to an HHV-6 infection, was admitted to our neonatal intensive care unit. A polymerase chain reaction (PCR) of his cerebrospinal fluid was positive for HHV-6. Additionally, serology for HHV-6 PCR was positive. We believe that HHV-6 can cause infection in febrile newborn infants.

Growth hormone replacement for patients with adult onset growth hormone deficiency—what have we learned?

2004 ◽  
Vol 16 (4) ◽  
pp. 1-6
Author(s):  
Monique Piersanti
Keyword(s):  
Growth Hormone ◽  
Gh Deficiency ◽  
Hormone Replacement ◽  
Hormone Deficiency ◽  
Pituitary Hormone ◽  
Adult Onset ◽  
Gh Replacement ◽  
Term Benefit

Growth hormone (GH) deficiency is a condition recognized to occur in individuals who have had multiple pituitary hormone deficiencies as a result of pathological processes or neurosurgical interventions. The indications, benefits, and risks of GH replacement therapy will be reviewed with an emphasis on those patients who were adults with the deficiency first emerged. The results of this analysis indicate that, although a measurable improvement can be detected in the patient's quality of life, body composition, and some cardiovascular parameters, the larger questions of long-term benefit and patient selection currently remain unanswered.

Adverse perinatal outcomes of chlamydia infections: an ongoing challenge

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Yael Eliner ◽  
Moti Gulersen ◽  
Amos Grunebaum ◽  
Erez Lenchner ◽  
Liron Bar-El ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Neonatal Intensive Care ◽  
Low Birthweight ◽  
Perinatal Outcomes ◽  
The United States ◽  
Chlamydia Infection ◽  
Suspected Sepsis ◽  
Bonferroni Adjustment ◽  
Neonatal Ventilation ◽  
Adverse Perinatal Outcomes

Abstract Objectives Chlamydia trachomatis is one of the most common sexually transmitted diseases in the world, but there are limited data on its impact on perinatal outcomes. Our objective was to investigate the association between chlamydia infections and adverse perinatal outcomes. Methods This is a retrospective analysis of the United States Centers for Disease Control and Prevention natality live birth database for the years 2016–2019. The rates of adverse perinatal outcomes were compared between patients with a chlamydia infection during pregnancy and patients without such infection, using Pearson’s chi-square test with the Bonferroni adjustment. A multivariate logistic regression was then used to adjust outcomes for potential confounders. Results Chlamydia infections were associated with small, but statistically significant, increased odds of preterm birth (<37 weeks), early preterm birth (<32 weeks), low birthweight (<2,500 g), congenital anomalies, low 5-min Apgar score (<7), neonatal intensive care unit admission, immediate neonatal ventilation, prolonged (>6 h) neonatal ventilation, and neonatal antibiotic treatment for suspected sepsis. Conclusions Chlamydia infections during pregnancy are associated with adverse perinatal outcomes. These results call for increased education regarding the potential risks of pregnancies with a chlamydia infection, as well as for increased antenatal surveillance and post-natal pediatric assessment in these pregnancies.

Evaluation of Microbiologic and Hematologic Parameters and E-Selectin as Early Predictors for Outcome of Neonatal Sepsis

2009 ◽  
Vol 133 (8) ◽  
pp. 1291-1296 ◽  
Author(s):  
Maysaa El Sayed Zaki ◽  
Hesham El Sayed
Keyword(s):  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Newborn Infants ◽  
Prognostic Indicator ◽  
Diagnostic Value ◽  
Total Leukocyte Count ◽  
C Reactive Protein ◽  
Gram Negative ◽  
Reactive Protein ◽  
Early Predictors

Abstract Context.—Early diagnosis of neonatal sepsis is mandatory. Various markers are used to diagnose the condition. Objective.—To evaluate the diagnostic value of various clinical data and hematologic parameters, such as total leukocyte count, absolute neutrophil count, immature to total neutrophil ratio, and soluble E-selectin (sE-selectin) in identification and outcome of neonatal sepsis. Design.—Newborn infants with a clinical diagnosis of sepsis in the neonatal intensive care unit at Mansoura University Children's Hospital during the period between July 2007 and December 2007 were eligible for study. In addition, 30 healthy neonates were included in the study. Complete hematologic and microbiologic laboratory investigations were performed, and serum E-selectin was measured. Results.—Plasma sE-selectin levels were significantly higher (P &lt; .001) in infected infants (mean [SD], 156.9 [77.0] ng/mL) than in noninfected (mean [SD], 88.8 [47.1] ng/mL) and healthy infants (mean [SD], 8.67 [3.74] ng/ mL). Infants with gram-negative sepsis had higher sE-selectin levels than did those with gram-positive sepsis (P = .04). C-reactive protein was the best laboratory test for diagnosis of neonatal sepsis, with an overall sensitivity and specificity of 86% and 97%, respectively. Performing sE-selectin with C-reactive protein or immature to total ratio tests increased the specificity, but reduced the sensitivity, of the tests for the determination of neonatal sepsis. Plasma sE-selectin levels were higher in nonsurvivors than in survivors (P = .01) and were higher in those with hemodynamic dysfunction than in those without hemodynamic dysfunction (P &lt; .001). Conclusions.—We conclude that plasma sE-selectin levels are elevated in neonatal sepsis. Significant elevation was associated with gram-negative sepsis. Plasma sE-selectin had low diagnostic value when used alone or in combination with other tests; however, it can be used as a prognostic indicator for the outcome of neonatal sepsis.

Shiva’s Babies

2019 ◽  
pp. 124-141
Author(s):  
Swasti Bhattacharyya
Keyword(s):  
United States ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
High Risk ◽  
Neonatal Intensive Care ◽  
Newborn Infants ◽  
Nationwide Survey ◽  
The United States ◽  
Cultural Humility ◽  
Religious Perspectives

Discussing religious views from within any tradition is challenging because they are not monolithic. However, it is worth exploring religious perspectives because they are often the foundation, whether conscious or not, of the reasoning underlying people’s decisions. Following a brief discussion on the importance of cultural humility and understanding the worldview of patients, the author focuses on Hindu perspectives regarding the care of infants in the neonatal intensive care unit. Along with applying six elements of Hindu thought (underlying unity of all life, multivalent nature of Hindu traditions, dharma, emphasis on societal good, karma, and ahimsa), the author incorporates perspectives of Hindu adults, living in the United States, who responded to a nationwide survey regarding the care of high-risk newborn infants in the hospital.

Role of N-Terminal Pro-brain Natriuretic Peptide in the Early Diagnosis of Neonatal Sepsis

2019 ◽  
Vol 14 (05) ◽  
pp. 228-234
Author(s):  
Nilufer Okur ◽  
Mehmet Buyuktiryaki ◽  
Nurdan Uras ◽  
Mehmet Yekta Oncel ◽  
Halid Halil ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Neonatal Intensive Care ◽  
Late Onset ◽  
Newborn Infants ◽  
Diagnostic Biomarker ◽  
Predictive Values ◽  
Mortality And Morbidity ◽  
Late Onset Sepsis

Objective Sepsis is one of the most significant contributors to mortality and morbidity in the neonatal population. The need to find specific biomarkers that provide meaningful information about the diagnosis of sepsis is still ongoing. This study aimed to investigate the utility of N-terminal pro-brain natriuretic peptide (NT-proBNP) as a diagnostic biomarker in newborn infants with late-onset sepsis. Methods A prospective, observational study was conducted in the neonatal intensive care unit between July 2016 and January 2017. The patients suspected of having late-onset sepsis and meeting the selection criteria were included in the study, and serial measurements of white blood cell count, serum C-reactive protein (CRP), plasma interleukin (IL) 6, and whole blood NT-proBNP levels were performed. Results The study included 87 patients diagnosed with sepsis and 35 control patients. The median NT-proBNP levels were higher in septic patients (58 [22–169] vs. 14 [7–21]; p < 0.001), showing a significant correlation with CRP and IL-6 levels (r = 0.327, p < 0.01 and r = 0.216, p < 0.05, respectively). The optimal diagnostic cutoff value for differentiating sepsis was 27.5 pg/mL. Predictive parameters of NT-proBNP, such as sensitivity (72%) and specificity (86%), were comparable to those of CRP and IL-6 for the early diagnosis of sepsis in neonates. Conclusion Plasma NT-proBNP levels were higher in septic neonates, and the predictive values were comparable to those of CRP and IL-6. However, these values were not high enough to make it a reliable diagnostic biomarker for identifying neonates in the early stages of sepsis.

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