CONCENTRATION OF BILIRUBIN IN CEREBROSPINAL FLUID IN HEMOLYTIC DISEASE OF THE NEWBORN

PEDIATRICS ◽  
1955 ◽  
Vol 16 (2) ◽  
pp. 184-195
Author(s):  
Robert Stempfel ◽  
Rolf Zetterström
Keyword(s):  
Total Protein ◽  
Neonatal Period ◽  
Single Case ◽  
Newborn Infants ◽  
Spinal Fluid ◽  
Hemolytic Disease ◽  
Indirect Bilirubin ◽  
Individual Variations ◽  
Brain Barrier Permeability ◽  
Absorption Studies

1. Twenty-four full-term, newborn infants, of whom 23 were Rh-isoimmunized, were followed with serial determinations of the serum and spinal fluid bilirubin and spinal fluid total protein during the neonatal period. Of the 51 spinal fluid samples examined, measurable quantities of bilirubin were present in all cases. 2. In the presence of marked indirect hyperbilirubinemia, the spinal fluid bilirubin was predominantly indirect-reacting, though no linear relationship exists between the serum and spinal fluid bilirubin. It is suggested that this is a manifestation of individual variations in blood-brain barrier permeability within the neonatal period. A significant correlation between the spinal fluid indirect bilirubin and the spinal fluid total protein is further evidence to support this view. 3. Spectrophotometric absorption studies of 13 serum and spinal fluid samples from 8 infants with hemolytic disease of the newborn are discussed. These studies tend to confirm the observation that there is no direct correlation between the hyperbilirubinemia and the spinal fluid bilirubin concentration, though the configuration of the absorption pattern of the serum closely follows that obtained from the corresponding spinal fluid. 4. The findings in the Rh-isoimmunized group of infants were not unlike those observed in a single case of "physiologic jaundice" presented. 5. The question of indirect bilirubin neurotoxicity is briefly reviewed.

PROTEINS IN THE CEREBROSPINAL FLUID IN THE NEWBORN

PEDIATRICS ◽  
1958 ◽  
Vol 21 (2) ◽  
pp. 279-287
Author(s):  
Rainer G. Arnhold ◽  
Rolf Zetterström
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Gamma Globulin ◽  
Total Concentration ◽  
Newborn Infants ◽  
Paper Electrophoresis ◽  
Hemolytic Disease ◽  
Individual Variations ◽  
Beta Globulin ◽  
The Central Nervous System

The fractions of protein in cerebrospinal fluid of 10 infants with hemolytic disease of the newborn, and 12 newborn infants with other illnesses, have been analyzed by paper electrophoresis. Relative concentrations have been found to be almost constant, despite wide individual variations in total concentration of protein—except in inflammatory disease with involvement of the central nervous system. Relative concentrations of gamma globulin are higher in serum than in cerebrospinal fluid, while concentrations of beta globulin are greater in cerebrospinal fluid. It is suggested that the total concentration of protein in cerebrospinal fluid in newborn infants may reflect the degree of functional maturity of the blood-brain barrier system.

scholarly journals Neonatal Hypoglycaemia: A Never-Ending Story?

Neonatology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Nestor E. Vain ◽  
Florencia Chiarelli
Keyword(s):  
At Risk ◽  
Neonatal Period ◽  
Newborn Infants ◽  
Neonatal Hypoglycaemia ◽  
Rational Decision Making ◽  
Weak Evidence ◽  
Universal Approach ◽  
Definition Of ◽  
Therapeutic Alternatives ◽  
Current Guidelines

Neonatal hypoglycaemia is a common metabolic disorder presenting in the first days of life and one potentially preventable cause of brain injury. However, a universal approach to diagnosis and management is still lacking. The rapid decrease in blood glucose (BG) after birth triggers homeostatic mechanisms. Most episodes of hypoglycaemia are asymptomatic, and symptoms, when they occur, are nonspecific. Therefore, neonatologists are presented with the challenge of identifying infants at risk who might benefit from a rapid and effective therapy while sparing others unnecessary sampling and overtreatment. There is much controversy regarding the definition of hypoglycaemia, and one level does not fit all infants since postnatal age and clinical situations trigger different accepted thresholds for therapy. The concentration and duration of BG which cause neurological damage are unclear. Recognizing which newborn infants are at risk of hypoglycaemia and establishing protocols for treatment are essential to avoid possible deleterious effects on neurodevelopment. Early breastfeeding may reduce the risk of hypoglycaemia, but in some cases, the amount of breast milk available immediately after birth is insufficient or non-existent. In these situations, other therapeutic alternatives such as oral dextrose gel may lower the risk for NICU admissions. Current guidelines continue to be based on expert opinion and weak evidence. However, malpractice litigation related to neurodevelopmental disorders is frequent in children who suffered hypoglycaemia in the neonatal period even if they had other important factors contributing to the poor outcome. This review is aimed to help the practicing paediatricians and neonatologists to comprehend neonatal hypoglycaemia from physiology to therapy, hoping it will result in a rational decision-making process in an area not sufficiently supported by evidence.

Salivary Immunoglobulins: Absence of γA in Saliva Following Exchange Transfusions in Neonatal Period

PEDIATRICS ◽  
1967 ◽  
Vol 40 (3) ◽  
pp. 452-454
Author(s):  
JOHN C. SELNER ◽  
DEBORAH A. MERRILL ◽  
HENRY N. CLAMAN
Keyword(s):  
Neonatal Period ◽  
Newborn Infants ◽  
Newborn Period ◽  
Data Support ◽  
Serial Samples

The possible transport of serum γA into saliva was studied in the newborn period. Five infants with erythroblastosis fetalis and undetectable γA in serum or saliva had two-volume exchange transfusions. Serum γA rose to "adult" levels after transfusion, but no detectable γA appeared in serial samples of saliva, as measured by electroimmunodiffusion (EID). The data support the thesis that salivary γA is not transported from the serum and tends to confirm the findings of Haworth and Dilling who previously described the absence of salivary γA following exchange transfusions in newborn infants.

ACTIVITY OF GLUTAMIC-OXALOACETIC TRANSAMINASE IN THE SERUM IN THE NEONATAL PERIOD

PEDIATRICS ◽  
1957 ◽  
Vol 20 (4) ◽  
pp. 584-589
Author(s):  
Simon Kove ◽  
Stanley Goldstein ◽  
Felix Wróblewski
Keyword(s):  
Neonatal Period ◽  
Newborn Infants ◽  
Normal Range ◽  
Glutamic Oxaloacetic Transaminase ◽  
Newborn Period ◽  
Method Of Determination ◽  
Normal Term ◽  
Pathologic State ◽  
Normal Adults

The activity of glutamic oxaloacetic transaminase (GOT) in the serum was determined by the spectrophotometric method in 63 normal term newborn infants, varying from birth to 11 days of age. The normal range of activity in the newborn period varied from 13 to 105 units (with the exception of one infant in whom the level was 160 units). This is a considerably wider range than that of 5 to 45 units found in normal adults. Allowing for an error of about ±10% inherent in the method of determination of GOT, activity as great as approximately 120 units, which in adults would be indicative of some pathologic state, must be considered physiologic in the newborn infant. The activity of GOT was not related to the age of the infant within the neonatal period studied, and varied widely in different infants for each day of age, without any distinctive pattern. Variations of the activity of GOT in specimens of cord blood studied ranged below 59 units, which was lower than for any other day of the neonatal period adequately investigated. No infants were studied repeatedly. No relation was found between the concentration of bilirubin and the activity of GOT in the serum.

Total CO2, Pco2, and pH in human spinal fluid

1961 ◽  
Vol 16 (3) ◽  
pp. 485-487 ◽  
Author(s):  
Carl R. Merril ◽  
Harry W. Seipp ◽  
Peter C. Luchsinger
Keyword(s):  
Confidence Interval ◽  
Normal Subjects ◽  
Spinal Fluid ◽  
Marked Individual ◽  
Arterial Blood ◽  
Normal Individuals ◽  
Individual Variations ◽  
Hasselbalch Equation

The relationships between pH, CO, tension and total CO2 in spinal fluid and arterial blood were explored in 12 normal individuals and 15 patients with various diseases. It was found that, in the normal subjects, the pH in the spinal fluid was constant, with a mean of 7.31 and 99 % confidence interval of 7.29–7.33. The pH in the spinal fluid was lower than that of the arterial blood in all patients studied, whereas the CO2 tension was found to average 4 mm Hg higher in the spinal fluid than in the arterial blood in most of the normal subjects studied. The pK1' was calculated for each patient's spinal fluid and arterial blood by the Henderson-Hasselbalch equation. In contrast to tonometry experiments, pK1' showed marked individual variations. The factors responsible for these variations are delineated. Submitted on November 7, 1960

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.

Early Treatment of Congenital Hypothyroidism

PEDIATRICS ◽  
1989 ◽  
Vol 83 (5) ◽  
pp. 785-789
Author(s):  
D. A. FISHER ◽  
B. L. FOLEY
Keyword(s):  
Thyroid Hormone ◽  
School Performance ◽  
Congenital Hypothyroidism ◽  
Neonatal Period ◽  
Effective Means ◽  
Newborn Infants ◽  
Motor Dysfunction ◽  
Adequate Treatment ◽  
Functional Assessments ◽  
Normal Mean

Mass population screening of newborn infants for congenital hypothyroidism was introduced in 1974 and now is a routine and effective means of early diagnosis of congenital hypothyroidism throughout most of the industrialized world. A large number of affected infants and children have been treated with replacement thyroid hormone, and several reports of IQ measurements and functional assessments of 5-to 7-year-old treated children now are available. These reports document normal mean IQ values, satisfactory school performance, and minimal motor dysfunction in treated children. However, there have been reported correlations between lower IQ values and biologic parameters of the hypothyroid state in the neonatal period among several reported studies, and it is not yet clear whether early adequate treatment will reverse all of the effects of congenital hypothyroidism.

CEREBROSPINAL FLUID LDH IN 287 CHILDREN, INCLUDING 53 CASES OF MENINGITIS OF BACTERIAL AND NON-BACTERIAL ETIOLOGY

PEDIATRICS ◽  
1968 ◽  
Vol 41 (6) ◽  
pp. 1097-1103
Author(s):  
William Neches ◽  
Martin Platt
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Dehydrogenase Activity ◽  
Newborn Infants ◽  
Central Nervous System Disease ◽  
Lactic Dehydrogenase ◽  
Spinal Fluid ◽  
Initial Examination ◽  
System Disease

Cerebrospinal fluid lactic dehydrogenase activity was determined in 287 children. Among these, 87 had no central nervous system disease and were considered to be controls. Mean lactic dehydrogenase activity in 69 controls (excluding newborn infants) was 14 units. In 18 control infants less than 1 week of age, the mean lactic dehydrogenase activity was 50 units. Thirty-two patients with bacterial meningitis had a mean cerebrospinal fluid lactic dehydrogenase of 251 units on the initial examination; 20 patients with aseptic meningoencephalitis had a mean lactic dehydrogenase activity of 23 units. The difference between the lactic dehydrogenase activity in children with bacterial and aseptic meningitis was highly significant (p < 0.005). The clinical course of the patients studied was reflected by the change in cerebrospinal fluid lactic dehydrogenase activity on serial determinations. Spinal fluid isoenzyme patterns were studied in a few patients with bacterial and non-bacterial central nervous system disorders. This study indicates that the determination of lactic dehydrogenase in spinal fluid is a useful adjunct to other cerebrospinal fluid parameters in the differential diagnosis of central nervous system infections.

"COMPARATIVE STUDY OF EARLY NEONATAL MORBIDITIES OF LATE PRETERM AND TERM NEONATES"

2021 ◽  
pp. 23-25
Author(s):  
Jatin Manocha ◽  
Kusum Mahajan ◽  
Anuj Kumar
Keyword(s):  
Preterm Infants ◽  
Prospective Observational Study ◽  
Neonatal Period ◽  
Newborn Infants ◽  
Late Preterm ◽  
Preterm Neonates ◽  
Feeding Problems ◽  
Term Neonates ◽  
Late Preterm Infants ◽  
Study Results

Background- Newborn infants are unique in their physiology and the health problems that they experience. Neonatal period is dened from birth to under four weeks of age. Late preterm infants may physiologically and physically appear like infants born at term, but most late preterm infants may undergo complications like respiratory distress, apnea, hypothermia, feeding problems, hypoglycemia, hyperbilirubinemia, sepsis, and mortality. AIM-To compare the clinical prole of late preterm neonates with term neonates. MATERIALAND METHODS: This prospective observational study was carried out in neonatal division of department of pediatrics MMIMSR, Mullana. Eligible neonates delivered at MMIMSR, Mullana born from 34 weeks up to 42 weeks gestation were included. All infants enrolled in the study was followed daily till rst 7 days of life for any morbidity by clinical evaluation and review of hospital records.104 preterms included in the study and 226 term neonates were included in the study. Results- Preterms born via LSCS and NVD were(58%vs.42%).Morbidities in late preterms were Hypoglycemia (21.2% vs. 9.3%), Hypothermia (15.4%vs5.7%), hypocalcaemia (38.4% vs. 5.3%), neonatal hyperbilirubinemia(67.3% vs. 30.5%), feeding difculties(44.2% vs. 14.6%), sepsis(40.4% vs. 19.5%), respiratory support(53% vs. 47%)

Metabolic Fuel and Hormone Responses to Fasting in Newborn Infants

PEDIATRICS ◽  
1979 ◽  
Vol 64 (5) ◽  
pp. 613-619
Author(s):  
Charles A. Stanley ◽  
Endla K. Anday ◽  
Lester Baker ◽  
Maria Delivoria-Papadopolous
Keyword(s):  
Gestational Age ◽  
Plasma Glucose ◽  
Neonatal Period ◽  
Newborn Infants ◽  
Older Children ◽  
Glucose Levels ◽  
Metabolic Fuel ◽  
Healthy Infants ◽  
Lower Plasma Glucose ◽  
Appropriate For Gestational Age

To examine why newborn infants frequently cannot maintain adequate levels of plasma glucose in the interval between delivery and the time they are first fed, circulating metabolic fuel and regulatory hormone concentrations were determined in 44 healthy infants at the end of an eight-hour postnatal fast. Plasma glucose fell below 40 mg/100 ml prior to eight hours in four of 24 term-appropriate-for-gestational-age (AGA), two of nine preterm-AGA, five of six term-small-for-gestational-age (SGA), and three of five preterm-SGA infants. Fuel and hormone patterns in the premature and SGA infants were not different from those found in term-AGA infants. Results in these neonates differed in two areas from the response to fasting seen later in life. In fasted term-AGA infants, ketones were low (β-hydroxybutyrate 0.29 ± 0.04 mM/liter) despite elevated concentrations of fatty acid precursors (1.4 ± 0.07 mM/liter), and the group of infants studied failed to demonstrate the increase in plasma ketones with lower glucose levels (r = +.23, P = .07) which is found in older children. Levels of glucose precursors were two to three times higher in term-AGA infants (lactate 2.9 ± 0.2 mM/liter; alanine 0.48 ± 0.02 mM/liter) than levels found beyond the neonatal period and, in contrast to older children and adults, were not diminished in infants with lower plasma glucose (lactate, r = -.28, P = .035; alanine, r = -.33, P = .02). These differences between the responses to postnatal fasting and those seen beyond the neonatal period suggest that the capacity for both hepatic ketone synthesis and gluconeogenesis is not fully developed at birth.

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