Arterial blood pressure and cerebral hemorrhage in the critically ill premature infants.
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Biomedical subjects
Publications and source records attributed to M Soliani.
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Four unrelated cases of congenital diaphragmatic hernia associated with ipsilateral upper limb reduction defects were reported by McCredie and Reid in 1978 (J Pediatr 92: 762-765). As contiguous segments of the cervical neural crest are involved in the development of diaphragm and arms, the authors suggested that an early injury to the cervical neural crest might be the common underlying pathogenesis. We describe here a further example of this malformation complex: a newborn with a left posterolateral diaphragmatic hernia associated with ipsilateral thumb hypoplasia.
Fifty eight premature infants, all needing intensive care and mechanical ventilation, were randomly allocated to two groups. Intravenous immunoglobulins (IVIG, 500 mg/kg Sandoglobulin) were administered to Group 1 while Group 2 received saline as placebo. IgG subclass serum levels were evaluated in both groups on admission, after two hours from the end of IVIG or saline infusion and from day 3 to 7 from birth. IgG subclasses were also measured in 10 healthy term neonates during the first day of life. Results show that after 2 hours from the end of IVIG administration all IgG subclasses reach levels comparable to term neonates. Comparing IgG values between treated and untreated preterm neonates it was observed that on day 3 only IgG1 and IgG3 subclasses were significantly higher in Group 1 than in Group 2. At day 5 no differences were observed between the two groups. IgG2 subclass rose reaching a significant difference between the two groups ad day 5 and 7. Our data show that IVIG single dose (500 mg/kg) administration doesn't produce a constant elevation in all IgG subclasses during the first week of life in the critically ill preterm infant.
The Authors refer some diagnostic and therapeutic observations about pelvic-perineal recurrence after abdominal-perineal excision of rectum (AAP). They analyze new possibilities of diagnostic instrumentation, in particularly TC and RM scanner, comparing the results and valuing the sensibility and specificity in a selected group of patients.
Surgical closure of patent ductus arteriosus (PDA) and perioperative time have been proposed as conditions of increased risk of peri-intraventricular hemorrhage (PVH-IVH) in preterm infants. We examined by pre- and postoperative ultrasound (US) scan 15 low birth-weight neonates who underwent PDA ligation within the first two weeks of life. They were assessed with regard to clinical state, perioperative management and development of PVH-IVH. Fourteen did not show onset or extension of intracranial hemorrhage in the immediate postoperative period. One patient developed a wide III grade IVH in the 24 perioperative hours. His conditions were particularly severe, suggesting that many factors such as acidosis, hypoxia, hypercapnia and hypotension might have combined to lead to hemorrhage. We conclude that PDA ligation is not likely to increase the risk of PVH-IVH per se.
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On the basis of previous reports on a possible correlation between phlebographic patterns and diseases of the prostatic gland, indications of the pelvic phlebography in the staging of the prostatic cancer are discussed, in order to carry out informations according to TNM system.
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