scholarly journals Apparent life-threatening events in neonates and infants of the first year of life

2019 ◽  
Vol 19 (5) ◽  
pp. 302-308
Author(s):  
Natalya N. Korableva
Keyword(s):  
Viral Infections ◽  
Whooping Cough ◽  
Muscle Tone ◽  
Newborn Health ◽  
First Year ◽  
Outpatient Basis ◽  
Common Causes ◽  
Life Threatening ◽  
Neonates And Infants ◽  
First Year Of Life

There are presented data on the apparent life-threatening event (ALTE) that may develop as a sudden, frightening episode with the cessation of breathing (apnea), skin discoloration (cyanosis, pallor, redness), violation of muscle tone: lowering (more often) or rigidity, with the presence of cough or breathlessness in the first year infant. ALTE incidence ranges from 0.46 to 10 per 1000 live births. Common causes of ALTE are established to be gastroesophageal reflux disease, viral infections of the lower respiratory tract, convulsions, whooping cough, sepsis and/or meningitis, arrhythmias or congenital malformations of the heart and respiratory hypoxic-ischemic brain damage, cases of child abuse. There are described history characteristics and features of the examination of ALTE survivors. Most of the ALTE babies are indicated to require hospitalization for cardiorespiratory monitoring within 24 hours after the event. A child older than 30 days suffered from first ALTE clearly associated with feeding, can be observed and examined on an outpatient basis. There is notes particular importance of the new medical and organizational technologies for the improvement of newborn health care, which will significantly promote the prevention of these conditions.

scholarly journals The Prevalence of Symptoms of Life-Threatening Events in Infants of the First Year of Life: a Cross-Sectional Population Study

2019 ◽  
Vol 18 (2) ◽  
pp. 109-117 ◽  
Author(s):  
Natalya N. Korableva ◽  
Ekaterina N. Pershina ◽  
Vladimir A. Gusev
Keyword(s):  
Risk Factors ◽  
Muscle Tone ◽  
First Year ◽  
Hospital Data ◽  
Cross Sectional ◽  
Skin Changes ◽  
Life Threatening ◽  
Second Year ◽  
First Year Of Life ◽  
Irregular Breathing

Background.The prevalence of symptoms of life-threatening events in infants was previously studied using hospital data. However, not all parents in the event of such symptoms seek medical help in the hospital.Objective.Our aim was to identify the prevalence and risk factors of life-threatening events in infants in the first year of life.Methods.In the period from November 2017 to February 2018, we interviewed mothers who have children in their second year of life who are registered at children's outpatient clinics in Syktyvkar. Respondents noted episodes of absent, infrequent or irregular breathing, blanching or cyanosis of the skin, changes in muscle tone (hypo- or hypertonia), changes in the level of responses that occurred in infancy. The prevalence of symptoms of life-threatening events was estimated based on the total number of infants in the first year of life (n = 3088) who lived in Syktyvkar as of January 1, 2018.Results.At least one symptom of life-threatening events in infancy was reported by 43 (4.3%) of the 1001 mothers surveyed. The prevalence of symptoms was 429.5 [95% confidence interval (CI) 321–574] per 10,000 children of the corresponding age. Independent predictors of life-threatening events in children of the first year of life were sudden deaths of relatives under the age of 50 years [odds ratio (OR) 2.4; 95% CI 1.1–5.3], cases of pre-syncope or syncope in relatives (OR 4.4, 95% CI 2.1–9.0), artificial feeding of infants (OR 4.0, 95% CI 1.5–11.2). The sensitivity of the model, which took into account the presence of at least one of the three predictors, was 19% (8/43), specificity — 99% (2/958).Conclusion.The issue of the occurrence of life-threatening events in an infant can impact every 25th family. In every fifth infant, the occurrence of symptoms of life-threatening events can be predicted based on risk factors.

scholarly journals The pseudo-life-threatening conditions in infants

2019 ◽  
Vol 64 (2) ◽  
pp. 13-21 ◽  
Author(s):  
N. N. Korableva ◽  
L. M. Makarov ◽  
L. A. Balykova ◽  
N. P. Kotlukova
Keyword(s):  
Respiratory Failure ◽  
High Risk ◽  
Skin Color ◽  
Muscle Tone ◽  
Low Risk ◽  
First Year ◽  
Life Threatening ◽  
Definition Of ◽  
First Year Of Life ◽  
Life Threatening Event

The article analyzes the literature on the development of views on the definition, approaches to diagnostics and tactical measures in case of suddenly manifesting conditions in children of the first year of life, accompanied by respiratory failure, changes in muscle tone and skin color. The article contains data from the clinical guidelines of theAmericanAcademyof Pediatrics 2016. The above guidelines gave introduced a new term “brief resolved unexplained event” (BRUE) and distinguished two groups of infants – with low and high risk of unfavorable outcome. The article contains a definition of a “life-threatening event”, which refers to events in children of the first year of life who have experienced a rapidly resolved unexplained condition and met the criteria of low risk. The authors describe the approaches to the diagnosis and prevention of pseudo-life-threatening events in infants. The authors call the pediatric community to discuss and present their own view on the problem of definition and tactical measures necessary for identifying quickly resolved unexplained events in children of the first year of life who meet the criteria of low risk.

scholarly journals Reconstruction of the Aortic Arch in Neonates and Infants: The Importance of Patch Material

2021 ◽  
Vol 12 (4) ◽  
pp. 487-491
Author(s):  
Ingrid M. van Beynum ◽  
Serife Kurul ◽  
Thomas Krasemann ◽  
Michiel Dalinghaus ◽  
Pieter van de Woestijne ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Important Determinant ◽  
Primary Repair ◽  
First Year ◽  
Aortic Arch Reconstruction ◽  
Study Population ◽  
Aortic Arch Repair ◽  
Neonates And Infants ◽  
Arch Reconstruction ◽  
First Year Of Life

Objectives: Restenosis after aortic arch reconstruction is a known complication in neonates and infants. Homograft is the most commonly used patch material for aortic arch reconstructions in our center. Since 2014, tissue-engineered bovine pericardium (CardioCel) has been used as an alternative. The aim of our study was to determine whether the choice of material affected the development of restenosis in these patients. Methods: Data of all neonates and infants who underwent aortic arch reconstruction with the use of any patch material between 2005 and 2016 were analyzed. Restenosis was defined by the need for reintervention, either percutaneous or surgical. Results: Forty-one patients underwent aortic arch repair. Excluding the 30-day mortality, 36 patients represented the study population. At primary repair, the aortic arch was reconstructed with homograft (n = 26) or CardioCel (n = 10). Restenosis was documented during the first year of life in 13 patients: Six (23%) patients in the homograft group and seven (70%) patients in the CardioCel group ( P = .01). In the homograft group, the median time from operation to first intervention for restenosis was 22.0 (range: 14-32) weeks, as compared to 14.0 (range: 7-21) weeks in the CardioCel group ( P = .04). Conclusion: We conclude that choice of patch material is likely to be an important determinant for the risk of restenosis needing reintervention following reconstruction of the aortic arch in neonates and infants.

Abnormal Shoulder Girdle Muscle Tone in Premature Infants During Their First 18 Months of Life

PEDIATRICS ◽  
1986 ◽  
Vol 77 (5) ◽  
pp. 664-669
Author(s):  
Michael K. Georgieff ◽  
Judy C. Bernbaum
Keyword(s):  
Premature Infants ◽  
Motor Development ◽  
Muscle Tone ◽  
Birth Asphyxia ◽  
Shoulder Girdle ◽  
First Year ◽  
First Year Of Life ◽  
Girdle Muscle ◽  
Shoulder Girdle Muscle

To document the incidence of and neonatal factors associated with abnormal shoulder girdle muscle tone in premature infants at follow-up, we studied 125 consecutively admitted infants weighing < 1,750 g treated in The Children's Hospital of Philadelphia intensive care nursery and subsequently seen in the Neonatal Follow-up Program up to 18 months of age. Fifty-seven infants (46%) displayed abnormal shoulder girdle muscle tone which presented clinically as scapular retractions. These infants had significantly lower birth weights (P < .001) and gestational age (P < .001) as well as a higher incidence of acute and chronic pulmonary disease (P < 0.01) and CNS insults (P < .05) when compared with infants without scapular retractions. The 57 infants with scapular retractions were further divided into two groups: 42 infants (74%) in whom scapular retractions were associated with generalized mild hypertonicity and 15 infants (26%) in whom scapular retractions compensated for trunk and neck hypotonicity. The infants with scapular retractions and hypotonicity had a significantly higher incidence of neonatal neurologic morbidity including seizures, major resuscitations, and birth asphyxia (P < .01) when compared with the infants with scapular retractions and hypertonicity. Shoulder girdle tone abnormalities in the first year of life inhibit crawling, sitting, and object manipulation and, therefore, may manifest as delays in motor development. Identification of infants with significant neonatal risk factors for tone abnormalities is important to allow for earlier therapeutic intervention.

scholarly journals Stridor in infant caused by subglottic hemangiome: case report

2020 ◽  
Vol 10 (3) ◽  
Author(s):  
Raquel Lot ◽  
Caroline Rosa ◽  
Camila Freitas ◽  
Gracinda Adnet ◽  
Luisa Costa ◽  
...  
Keyword(s):  
Beta Agonist ◽  
First Year ◽  
Vascular Neoplasms ◽  
Threatening Condition ◽  
Life Threatening ◽  
Diagnostic Hypothesis ◽  
Therapeutic Measures ◽  
The Right ◽  
First Year Of Life ◽  
Age Range

Subglottic hemagioma is a rare cause of stridor, but it is one of the most common vascular neoplasms of the airways in childhood. If the treatment is not promptly instituted, it becomes a life-threatening condition. The diagnosis should be suspected when infants outside the age range for acute laryngitis present with stridor associated with severe respiratory effort, without viral prodromes, with a condition that is not responsive to initial therapeutic measures considering the main diagnostic hypothesis. Infantile hemangiomas begin to proliferate during the first year of life (between the 1st and 2nd month of life). Involution usually occurs between 6 months and 12 months of life (most involution until 4 years). The case is a 5-month-old female infant, with sudden stridor associated with respiratory distress without viral prodromes or fever, with little response to inhaled short-acting beta-agonist, inhaled adrenaline, as well as corticosteroids inhalation/parenteral. Bronchoscopy showed a bulging of the submucosa to the right of the subglottis with slight vascularization, suggestive of subglottic hemangioma. Treatment with propranolol was initiated orally with the aim of regressing the hemangioma and after clinical stability, the infant was discharged with outpatient follow-up.

scholarly journals Symptomatic and Asymptomatic Respiratory Viral Infections in the First Year of Life: Association With Acute Otitis Media Development

2014 ◽  
Vol 60 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Tasnee Chonmaitree ◽  
Pedro Alvarez-Fernandez ◽  
Kristofer Jennings ◽  
Rocio Trujillo ◽  
Tal Marom ◽  
...  
Keyword(s):  
Otitis Media ◽  
Viral Infections ◽  
Acute Otitis Media ◽  
First Year ◽  
Media Development ◽  
Respiratory Viral Infections ◽  
First Year Of Life

scholarly journals Interactions of Respiratory Viruses and the Nasal Microbiota during the First Year of Life in Healthy Infants

mSphere ◽  
2016 ◽  
Vol 1 (6) ◽  
Author(s):  
Insa Korten ◽  
Moana Mika ◽  
Shkipe Klenja ◽  
Elisabeth Kieninger ◽  
Ines Mack ◽  
...  
Keyword(s):  
Microbial Diversity ◽  
Early Life ◽  
Viral Infections ◽  
Human Rhinovirus ◽  
First Year ◽  
Disease Development ◽  
Potential Marker ◽  
Acute Changes ◽  
First Year Of Life ◽  
Nasal Microbiota

ABSTRACT Respiratory viral infections are very frequent in infancy and of importance in acute and chronic disease development. Infections with human rhinovirus (HRV) are, e.g., associated with the later development of asthma. We found that only symptomatic HRV infections were associated with acute changes in the nasal microbiota, mainly characterized by a loss of microbial diversity. Infants with more frequent symptomatic HRV infections had a lower bacterial diversity at the end of the first year of life. Whether the interaction between viruses and the microbiota is one pathway contributing to asthma development will be assessed in the follow-ups of these children. Independent of that, measurements of microbial diversity might represent a potential marker for risk of later lung disease or monitoring of early life interventions. Traditional culture techniques have shown that increased bacterial colonization is associated with viral colonization; however, the influence of viral colonization on the whole microbiota composition is less clear. We thus aimed to understand the interaction of viral infections and the nasal microbiota in early life to appraise their roles in disease development. Thirty-two healthy, unselected infants were included in this prospective longitudinal cohort study within the first year of life. Biweekly nasal swabs (n = 559) were taken, and the microbiota was analyzed by 16S rRNA pyrosequencing, and 10 different viruses and 2 atypical bacteria were characterized by real-time PCR (combination of seven duplex samples). In contrast to asymptomatic human rhinovirus (HRV) colonization, symptomatic HRV infections were associated with lower alpha diversity (Shannon diversity index [SDI]), higher bacterial density (PCR concentration), and a difference in beta diversities (Jaccard and Bray-Curtis index) of the microbiota. In addition, infants with more frequent HRV infections had a lower SDI at the end of the study period. Overall, changes in the microbiota associated with symptomatic HRV infections were characterized by a loss of microbial diversity. The interaction between HRV infections and the nasal microbiota in early life might be of importance for later disease development and indicate a potential approach for future interventions. IMPORTANCE Respiratory viral infections are very frequent in infancy and of importance in acute and chronic disease development. Infections with human rhinovirus (HRV) are, e.g., associated with the later development of asthma. We found that only symptomatic HRV infections were associated with acute changes in the nasal microbiota, mainly characterized by a loss of microbial diversity. Infants with more frequent symptomatic HRV infections had a lower bacterial diversity at the end of the first year of life. Whether the interaction between viruses and the microbiota is one pathway contributing to asthma development will be assessed in the follow-ups of these children. Independent of that, measurements of microbial diversity might represent a potential marker for risk of later lung disease or monitoring of early life interventions.

Surgical ablation of a cardiac rhabdomyoma in an infant with tuberous sclerosis

1998 ◽  
Vol 8 (1) ◽  
pp. 134-135 ◽  
Author(s):  
Dagmar Henglein ◽  
Nabil-Maurice Guirgis ◽  
Gérard Bloch
Keyword(s):  
Tuberous Sclerosis ◽  
Conservative Therapy ◽  
Surgical Intervention ◽  
First Year ◽  
Rare Tumor ◽  
Surgical Ablation ◽  
Cardiac Rhabdomyoma ◽  
Mitral Valves ◽  
Life Threatening ◽  
First Year Of Life

AbstractCardiac rhabdomyoma is a rare tumor. Because of its rate of regression, mainly in the first year of life, conservative therapy is generally suggested when diagnosis occurs in infancy. We report surgical ablation of a rhabdomyoma in a 2-month-old boy in whom the tumor extended into the subaortic outflow tract. The tumor, which had a dual attachment to the aortic and mitral valves, was safely removed without any valvar damage. We suggest immediate surgical intervention for those rhabdomyomas which are life-threatening because of their size, location, or arrhythmogenicity.

scholarly journals Follow-up evaluation of children with birth weight less than or equal to 2,000 g

2004 ◽  
Vol 122 (6) ◽  
pp. 239-245 ◽  
Author(s):  
Marcia de Freitas ◽  
Arnaldo Siqueira ◽  
Conceição Aparecida de Mattos Segre
Keyword(s):  
Birth Weight ◽  
Hospital Admissions ◽  
Hyaline Membrane Disease ◽  
First Year ◽  
Outpatient Basis ◽  
Reference Curve ◽  
Low Socioeconomic ◽  
High Incidence ◽  
First Year Of Life

CONTEXT: During the first year of life, the growth process is highly vulnerable to several impairing factors that need to be understood. OBJECTIVE: To perform follow-up evaluation on newborns weighing less than or equal to 2,000 g in a population of low socioeconomic level. TYPE OF STUDY: Retrospective. SETTING: Hospital Maternidade Escola de Vila Nova Cachoeirinha, São Paulo, Brazil. METHODS: The study included 60 children born between March 1996 and January 1998, weighing less than or equal to 2,000 g. They were divided into three subgroups, according to birth weight and adequacy for gestational age. The factors studied were maternal variables, illnesses among the newborns, hospital admissions subsequent to discharge from the nursery, and the evolution of weight from birth until 12 months of life. Statistical analyses were performed through application of the Statistical Package for Social Sciences (SPSS) V.9.0 and Curve Expert 1.3 programs. RESULTS: Previous maternal diseases occurred in 38.6% of the pregnant women and intercurrent events occurred in 100%. The prevailing neonatal diseases were sepsis (30%) and hyaline membrane disease (25%). There were 404 visits on an outpatient basis: the most frequently diagnosed complaints related to respiratory diseases (26%). Among visits to specialists, 81.7% were to the neuropediatrician. A diagnosis of normality was made for 80% of all visits, for all specialties. For each of these groups, a growth curve was established. These were shown to be below the reference curve standards, with such differences least evident with regard to the children's corrected age. DISCUSSION: The severity of the newborns'conditions may be related to the high incidence of maternal diseases prior to pregnancy as well as intercurrent events during pregnancy. The differences in growth in relation to NCHS charts show that corrected age should be used as a parameter. CONCLUSIONS: Socioeconomic conditions, clinical/obstetric events and newborn diseases during the hospital stay had repercussions on these children's progress during their first year of life. Their growth profile was found to be very far from the reference standard, thus indicating a need for constant, differentiated assessment.

SHOULD STEROIDS BE USED IN TREATING BRONCHIOLITIS?

PEDIATRICS ◽  
1970 ◽  
Vol 46 (4) ◽  
pp. 640-642
Author(s):  
Sumner J. Yaffe ◽  
Charles F. Weiss ◽  
Howard M. Cann ◽  
Arnold P. Gold ◽  
Frederic M. Kenny ◽  
...  
Keyword(s):  
Great Majority ◽  
Current Status ◽  
Influenza B ◽  
First Year ◽  
Respiratory Pathogens ◽  
Parainfluenza Viruses ◽  
Do No Harm ◽  
Life Threatening ◽  
Resistance To Infection ◽  
First Year Of Life

Since their introduction into clinical use, corticosteroids have been employed as therapeutic agents in virtually every known disease state, ranging from minor dermatologic disorders to major and serious diseases. These agents have undoubtedly altered the clinical picture and prognosis of certain diseases. However, the use of corticosteroids is always potentially associated with a variety of untoward effects, some of which may be life threatening, i.e., decreased resistance to infection, growth retardation, neurological reactions, hypertension, peptic ulcerations, and many others.1 The time honored principle—first do no harm—should always be the guideline of therapy, especially when a definite indication for a particular therapeutic agent has not been established. In recent years corticosteroids have been employed in the treatment of bronchiolitis on the hypothesis that their anti-inflammatory action would decrease swelling, inflammation, and the consequent respiratory obstruction. The opinions of different investigators on the efficacy of corticosteroids in this disorder have varied greatly; some have regarded their use as ineffective and others as lifesaving. It is the purpose of this report to review the findings from various studies and to outline the current status the use of corticosteroids in this common disorder of infants and children. Bronchiolitis is a common, acute respiratory syndrome characterized by infection of the bronchioles and respiratory distress of varying degrees due to obstructive emphysema. It is common in the first year of life and is rare in the child over 2 years of age. It frequently occurs in outbreaks. The great majority of cases are due to viruses, especially the respiratory syncitial, influenza B, and parainfluenza viruses, but it may be due to bacteria and other respiratory pathogens.

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