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Newborn babies have been vaccinated orally on five consecutive days, with 5 droplets of a vaccine containing 10(11) killed Bordetella pertussis. Eight out of twelve subjects showed antibody titres varying between 1:20 and 1:80.
Newborns with the ileus caused by developmental defects of the digestive tract have, as a rule, suprastenotic dilatations of all the intestine or a considerable part of it higher than the ileus zone and a great difference in the width of the lumen of the intestine portions left after resection of the injured area. In the Center of Developmental Defects of Newborns 190 patients with ileus have been treated for the recent 10 years. In 37 cases T-shaped bypass anastomosis was used which has considerable advantages over "dead" anastomosis. T-shaped ileostomy allows unloading the dilated adducting part of the intestine overfilled with the contents in early terms after operation and simultaneously fulfilling "the feeding" into the abducting part of the intestine.
15 newborn infants with the hyperviscosity syndrome due to polycythaemia i.e. a central haematocrit of at least 65% and a raised whole blood viscosity, were examined for changes in their coagulation and fibrinolytic systems. 5 were thrombocytopenic but showed no other signs of activated coagulation. Neither did the only patient with positive ethanol gelation test measuring circulating fibrin/fibrinogen degradation products (FDP) appeared in only two and, with only one exception, an assay for fibrinolytic activity in plasma was negative. No defects were found in the coagulation system. Thus, in most of the patients there was no demonstrable abnormal proteolysis in the circulation. However, in such infants the normally low levels of antithrombin III (heparin cofactor activity) in combination with the impairment of the microcirculation might increase the risk of thrombotic complications. Haemodilution, preferably with plasma, is therefore advocated in the symptomatic patients.
A newborn infant presented with hepatosplenomegaly, rash, anemia, and leukocytosis at one day of age and manifested characteristic myeloid metaplasia by one mouth of life. Vitamin B12 and leukocyte alkaline phosphatase were elevated and platelet aggregation was impaired. Myelofibrosis was not present and neutrophil function was preserved. An unidentified high isoelectric point hemoglobin with unusual chromatographic and electrophoretic behaviors was found to comprise 12% of the total hemoglobin. The myeloid metaplasia and mutant hemoglobin disappeared over the subsequent months without biochemical or clinical residual. The available evidence was consistent with the mutant hemoglobin representing either a gamma chain or clonal embryonic chain variant. The inability to clarify prognostic factors in these unusual myeloproliferative syndromes suggests caution in the initiation of cytotoxic therapy.
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34 newborn infants who had been bathed in a standard manner with Hibiscrub were studied to find out whether it was absorbed percutaneously. Low levels of chlorhexidine were found in the blood of all 10 babies sampled by heel prick, and 5 of 24 from whom venous blood was taken. The detection of chlorhexidine varied greatly with the method and timing of sampling, and no correlation was found between gestational or postnatal age and chlorhexidine levels.
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Hypoxia in newborn infants is becoming much easier to prevent, detect and treat. Nevertheless the successful management of potentially hypoxic fetuses and newborn infants remains the major challenge to all physicians concerned with perinatal care. What is at stake is not only that sick infants should survive, but equally or more importantly that the survivors should be normal children. Recent follow-up studies show that this aim can, with few exceptions, now be achieved (Stewart and Reynolds, 1974; Davies and Stewart, 1975; Durbin et al, 1976).
The contribution (Qo/Qt) of gas-filled air spaces with reduced ventilation-perfusion ratio (VA/Qc) to the production of total venous admixture in nondistressed premature infant and newborn infants with transient tachypnea was assessed by the aADN2 and AaDo2. The mean value for Qo/Qt in both nondistressed prematures and infants with transient tachypnea was 0.08. In both groups this represented about 30% of total venous admixutre.
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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 (beta-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 less than .035; alanine, r = -33, P less than .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.
Two newborn infants were infected with Salmonella originating from their mothers. After infection of a newborn infant with Salmonella typhi from a mother, known for a long time to be a chronic carrier, no pathological findings were observed but the child continued to secrete typhoid bacilli for three years. The infection of the second child with S. panama, from a mother recognized as a carrier post-partum, caused a fulminating diarrhoea accompanied by septicaemia which had a fetal outcome.
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The authors have studied the pancreas of a premature female infant born to a diabetic mother. The findings included a peri-insular eosinophilic leucocyte infiltration, macropolinesia and a marked increase in B cells. In the exocrime parenchyma small B cells aggregates were also observed. B cells contained voluminous hypercromatic muclei and degranulated cytoplasm. Morphometric data demonstrated an increase in islet tissue. These morphological findings are indicative of excessive insulin secretion. The presence of eosinophilic leucocytes in pancreatic tissue and the pathogenic mechanism involved are discussed.
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