Thyroid abnormalities in term infants with fungal sepsis

Summary Objective: To describe thyroid alterations in term newborns (TNB) with fungal sepsis during NICU hospitalization. Method: The study included six TNB that during the clinical and laboratory manifestations of sepsis with positive cultures for fungus showed changes in thyroid hormones, called low T3 syndrome and low T3-T4 syndrome. TNB that could present hormonal changes caused by disease as those born to mothers with thyroid disease, or who had perinatal asphyxia and major surgeries were excluded. Results: Of six TNB with fungal sepsis, five had positive culture for Candida albicans and one had positive culture for Candida tropicalis. Low T3 syndrome was observed in two TNB (50%), while T3-T4 syndrome was observed in other two (100%). The four children progressed to septic shock. Conclusion: Fungal sepsis is becoming more common among newborns admitted to NICU. Thyroid insufficiency could be a marker of disease severity with possible need for hormone supplementation.

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POS-342 HIGH PREVALENCE OF THYROID ABNORMALITIES AND LOW T3 SYNDROME IN MEXICAN SUBJECTS WITH CKD

Kidney International Reports ◽

10.1016/j.ekir.2021.03.358 ◽

2021 ◽

Vol 6 (4) ◽

pp. S148-S149

Author(s):

E. Sabath ◽

L. Cárdenas-Rodríguez ◽

M.L. Robles-Osorio

Keyword(s):

Low T3 Syndrome ◽

Low T3 ◽

High Prevalence ◽

Thyroid Abnormalities

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Clinical Investigations: Somatosensory Evoked Potentials in Full-Term Neonates With Perinatal Asphyxia

Folia Medica ◽

10.2478/folmed-2014-0013 ◽

2014 ◽

Vol 56 (2) ◽

pp. 88-95 ◽

Cited By ~ 1

Author(s):

Ina E. Geneva ◽

Maya B. Krasteva ◽

Stefan S. Kostianev

Keyword(s):

Evoked Potentials ◽

Somatosensory Evoked Potentials ◽

Amplitude Ratio ◽

Perinatal Asphyxia ◽

Nerve Fibers ◽

Full Term ◽

Healthy Children ◽

Term Infants ◽

Healthy Infants ◽

Term Newborns

Abstract OBJECTIVE: To explore the capacity of somatosensory evoked potentials (SEP) to assess maturation processes in the development of the nervous system, and the characteristics of SEP in healthy full-term infants and full-term newborns with perinatal asphyxia and their follow up until the age of 14 months. MATERIALS AND METHODS: SEP were studied in 21 healthy full-term infants and 38 full-term newborns with perinatal asphyxia. The children with asphyxia were studied longitudinally until they were 14 months old. To assess the SEP we measured the latency of the P15, N20 and P25 components, the amplitude ratio N20/ P25 and inter-peak intervals P15-N20 and N20-P25. RESULTS: The component that was most typically always found in the SEP recordings of both healthy infants and those with perinatal asphyxia was N20. The mean latency values of P15, N20 and P25 were higher in the children with perinatal asphyxia (p ⋋ 0.001). The SEP amplitude was highly variable (CoV% = 76.6%). The latencies became shorter with age in asphyxia patients aged 0 to 14 months, the shortening being the greatest in the first trimester, while they showed no statistically significant differences in infants aged 6 to 12 months. CONCLUSIONS: SEPs in the neonatal period differ considerably from those of adults and older children in the morphology and longer potential latency, which can be accounted for by the incomplete myelination of nerve fibers. The changes in SEP latency in patients with HIE stages I and II follow the same pattern found in healthy children - latency became shorter with increasing age, which was most pronounced in the first 3 months. SEP latency was found to be correlated with height and age. No differences were found in the latency of potentials between healthy infants and infants with brain hemorrhage. Recording SEP is a sensitive method to assess the CNS in children with perinatal asphyxia and to monitor the maturation of the somatosensory pathway.

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Thyroid function during prolonged exposure to fluorides

Problems of Endocrinology ◽

10.14341/probl11890 ◽

1996 ◽

Vol 42 (1) ◽

pp. 6-9 ◽

Cited By ~ 3

Author(s):

N. D. Mikhailets ◽

M. I. Balabolkin ◽

V. A. Rakitin ◽

I. P. Danilov

Keyword(s):

Thyroid Function ◽

Prolonged Exposure ◽

Liver Parenchyma ◽

Aluminum Production ◽

Enzymatic System ◽

Low T3 Syndrome ◽

Low T3 ◽

Diagnostic Signs ◽

Peripheral Conversion ◽

Thyroid Abnormalities

Thyroid function was examined in 165 workers of electrolysis shops of aluminum production with more or less expressed signs of chronic fluoride intoxication (fluorosis) by radioimmunoassay of hormones and the test of 13II absorption by the thyroid. The detected thyroid abnormalities were characterized by a moderate reduction of iodine-absorbing function of the thyroid, low T3 with normal T4 level, and a slight increase of TTH concentration. These changes augmented with longer service and fluorosis progress. Hence, the syndrome of low T3 and reduced absorption of 1311 may be considered as diagnostic signs of fluorosis. In case of toxic involvement of the liver in fluorosis patients, low T3 syndrome is observed much more frequently: in 75.6% cases. Liver abnormalities evidently lead to disorders in the peripheral conversion of T4 in T3, occurring primarily in liver parenchyma. Indirect effect of fluorine on the enzymatic system of deiodination cannot be ruled out as well.

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Thyroid hormones as a marker to diagnose the severity of fungal sepsis in neonates

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20195170 ◽

2019 ◽

Vol 7 (1) ◽

pp. 14

Author(s):

Vatti Rajeswari ◽

Selvendran C.

Keyword(s):

Thyroid Hormone ◽

Prospective Observational Study ◽

Case Series ◽

Hormone Deficiency ◽

Low T3 Syndrome ◽

Medical College ◽

Low T3 ◽

Group A ◽

Fungal Sepsis ◽

Thyroid Profile

Background: Sepsis due to fungi in the neonatal period occurs in infants admitted to the ICU for long periods of time, especially affecting infants with a birth weight <1500 g. In this case series thyroid insufficiencies have been used as a marker to diagnose the severity of fungal sepsis and outcome of those babies. Objectives of this study was to describe thyroid hormone variations in new-borns with fungal sepsis and to find the correlation between thyroid hormone deficiency and severity of fungal sepsisMethods: It is a prospective observational study of 100 infants done in Sree Balaji Medical College, chrompet. Thyroid profile was done to all patients. Patients with Low T3 syndrome and Low T3, T4 syndrome were divided into group A and B and statistical analysis was done to find the correlation between thyroid insufficiency and severity of the fungal sepsis.Results: Significant correlation was noted between low T3, low T4 levels and fungal sepsis.Conclusions: Thyroid insufficiency, with the variables described, could be a marker of disease severity with the possible need for hormone supplementation to decrease the mortality.

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The Controversy Persists: Is There a Qualification Criterion to Utilize Inhaled Nitric Oxide in Pre-term Newborns?

Frontiers in Pediatrics ◽

10.3389/fped.2021.631765 ◽

2021 ◽

Vol 9 ◽

Author(s):

Frederico Vieira ◽

Marjorie Makoni ◽

Edgardo Szyld ◽

Krishnamurthy Sekar

Keyword(s):

Nitric Oxide ◽

Perinatal Asphyxia ◽

Cochrane Review ◽

Neonatal Resuscitation ◽

Inhaled Nitric Oxide ◽

Hypoxemic Respiratory Failure ◽

Term Infants ◽

American Academy Of Pediatrics ◽

Antenatal Steroid ◽

Term Newborns

Inhaled nitric oxide (iNO) use in premature newborns remains controversial among clinicians. In 2014, the American Academy of Pediatrics, Committee on Fetus and Newborn released a statement that the available data do not support routine iNO use in pre-term newborns. Despite the absence of significant benefits, 2016 California data showed that clinicians continue to utilize iNO in pre-term infants. With studies as recent as January 2017, the Cochrane review confirmed no major advantages of iNO in pre-term newborns. Still, it recognized that a subset of pre-term infants with pulmonary hypertension (PHTN) had not been separately investigated. Furthermore, recent non-randomized controlled trials have suggested that iNO may benefit specific subgroups of pre-term newborns, especially those with PHTN, prolonged rupture of membranes, and antenatal steroid exposure. Those pre-term infants who showed a clinical response to iNO had increased survival without disability. These findings underscore the need for future studies in pre-term newborns with hypoxemic respiratory failure and PHTN. This review will discuss the rationale for using iNO, controversies regarding the diagnosis of PHTN, and additional novel approaches of iNO treatment in perinatal asphyxia and neonatal resuscitation in the pre-term population < 34 weeks gestation.

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Chronic liothyronine (T3) treatment in stable heart failure patients with low T3 syndrome: A randomised, double-blind, cross-over, placebo-controlled intervention study (The LIHFA study)

Endocrine Abstracts ◽

10.1530/endoabs.35.oc1.3 ◽

2014 ◽

Author(s):

Pernille Holmager ◽

Ulla Schmidt ◽

Mark Peter Dall ◽

Helena Dominguez ◽

Bo Zerahn ◽

...

Keyword(s):

Heart Failure ◽

Intervention Study ◽

Low T3 Syndrome ◽

Double Blind ◽

Heart Failure Patients ◽

Low T3

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Levels of Predominant Intestinal Microorganisms in 1 Month-Old Full-Term Babies and Weight Gain During the First Year of Life

Nutrients ◽

10.3390/nu13072412 ◽

2021 ◽

Vol 13 (7) ◽

pp. 2412

Author(s):

Sonia González ◽

Marta Selma-Royo ◽

Silvia Arboleya ◽

Cecilia Martínez-Costa ◽

Gonzalo Solís ◽

...

Keyword(s):

Weight Gain ◽

Gut Microbiota ◽

Early Life ◽

Later Life ◽

Full Term ◽

First Year ◽

Term Infants ◽

Term Newborns ◽

Infant Weight Gain ◽

First Year Of Life

The early life gut microbiota has been reported to be involved in neonatal weight gain and later infant growth. Therefore, this early microbiota may constitute a target for the promotion of healthy neonatal growth and development with potential consequences for later life. Unfortunately, we are still far from understanding the association between neonatal microbiota and weight gain and growth. In this context, we evaluated the relationship between early microbiota and weight in a cohort of full-term infants. The absolute levels of specific fecal microorganisms were determined in 88 vaginally delivered and 36 C-section-delivered full-term newborns at 1 month of age and their growth up to 12 months of age. We observed statistically significant associations between the levels of some early life gut microbes and infant weight gain during the first year of life. Classifying the infants into tertiles according to their Staphylococcus levels at 1 month of age allowed us to observe a significantly lower weight at 12 months of life in the C-section-delivered infants from the highest tertile. Univariate and multivariate models pointed out associations between the levels of some fecal microorganisms at 1 month of age and weight gain at 6 and 12 months. Interestingly, these associations were different in vaginally and C-section-delivered babies. A significant direct association between Staphylococcus and weight gain at 1 month of life was observed in vaginally delivered babies, whereas in C-section-delivered infants, lower Bacteroides levels at 1 month were associated with higher later weight gain (at 6 and 12 months). Our results indicate an association between the gut microbiota and weight gain in early life and highlight potential microbial predictors for later weight gain.

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Outcomes of full-term infants with bilious vomiting: observational study of a retrieved cohort

Archives of Disease in Childhood ◽

10.1136/archdischild-2013-305724 ◽

2014 ◽

Vol 100 (1) ◽

pp. 14-17 ◽

Cited By ~ 9

Author(s):

Syed Mohinuddin ◽

Pankaj Sakhuja ◽

Benjie Bermundo ◽

Nandiran Ratnavel ◽

Stephen Kempley ◽

...

Keyword(s):

Posterior Probability ◽

Abdominal Distension ◽

Clinical Findings ◽

Likelihood Ratios ◽

Term Infants ◽

X Ray ◽

Bilious Vomiting ◽

Term Newborns ◽

Time Critical ◽

Surgical Condition

Bilious vomiting in a neonate may be a sign of intestinal obstruction often resulting in transfer requests to surgical centres. The aim of this study was to assess the use of clinical findings at referral in predicting outcomes and to determine how often such patients have a time-critical surgical condition (eg, volvulus, where a delay in treatment is likely to compromise gut viability).Methods4-year data and outcomes of all term newborns aged ≤7 days with bilious vomiting transferred by a regional transfer service were analysed. Specificity, sensitivity, likelihood ratios, correlations, prior and posterior probability of clinical findings in predicting newborns with surgical diagnosis were calculated.ResultsOf 163 neonates with bilious vomiting, 75 (46%) had a surgical diagnosis and 23 (14.1%) had a time-critical surgical condition. The diagnosis of a surgical condition in neonates with bilious vomiting was significantly associated with abdominal distension (χ2=5.17, p=0.023), abdominal tenderness (χ2=5.90, p=0.015) and abnormal abdominal X-ray findings (χ2=5.68, p=0.017) but not with palpation findings of a soft as compared with a tense abdomen (χ2=3.21, p=0.073). Abnormal abdominal X-ray, abdominal distension and tenderness had 97%, 74% and 62% sensitivity, respectively, with regard to association with an underlying surgical diagnosis. Normal abdominal X-ray reduced the posterior probability of surgical diagnosis from 50% to 16%. Overall, clinical findings at referral did not differentiate between infants with or without surgical or time-critical condition.ConclusionsWe recommend that term neonates with bilious vomiting referred for transfer are prioritised as time critical.

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