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Comparative Study 2008; 29(2): 222-229 PubMed PMID: 18404140 Citation  Keywords:  Birth Weight, Body Height, Female, Gestational Age, Humans, Infant, Newborn:blood, Infant, Newborn, Diseases:blood, Infant, Premature:blood, Infection:blood, Insulin-Like Growth Factor I:analysis, Male, Pregnancy, Pregnancy Complications, Infectious:blood.   

OBJECTIVES: IGF-I is believed to be a key factor in fetal growth dynamics It is widely known, that serious early-onset infection in the newborn is a risk factor for further developmental disturbances in a child. However, effect of congenital infection as well as an influence of infectious and non-infectious perinatal risk factors on circulating IGF-I concentrations in newborns has not been examined, yet.

DESIGN: Thus, the aim of this study was: 1) evaluation of IGF-I venous blood serum concentration in full-term and premature infants considering their sex, occurrence of intrauterine infection and perinatal risk factors; 2) establishing the relationship between IGF-I serum concentrations and chosen anthropometric parameters values in infected and healthy newborns.

SETTING: The study involved 112 newborns appropriate for gestational age. Taking into consideration occurrence of early onset infection and gestational age we divided examined children into 4 groups: I group--infected, full-term newborns; II group--infected premature newborns; III group--healthy full-term newborns; IV group--healthy premature newborns. In all infants immediately after birth anthropometric measurements were performed (birth weight, body length, circumference of head and circumference of chest) and serum IGF-I concentration was determined.

RESULTS: We demonstrated that full-term infants with intrauterine infection have statistically significantly higher concentration of IGF-I in blood serum than infected premature infants and healthy full-term infants. Analysis of correlation revealed a significant positive linear correlations between IGF-I serum concentration and gestational age and anthropometric parameters values.

CONCLUSIONS: We conclude that intrauterine infection increases serum IGF-I concentration in full-term infants, but not in preterm infants, that may be a result of immaturity. We suggest serum IGF-I concentration may be considered an additional element of developmental and nutritional state assessment in infected newborn....

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Comparative Study 2008; 29(2): 205-221 PubMed PMID: 18404134 Citation  Keywords:  Adult, Cytokines:blood, Enterococcus faecalis:isolation & purification, Female, Fetal Membranes, Premature Rupture:blood, Humans, Infant, Newborn, Lactobacillus:isolation & purification, Pregnancy, Pregnancy Complications, Infectious:blood, Risk Factors, .   

BACKGROUND: Infections are among the most frequent causes of premature delivery and premature discharges of amniotic fluid. The vaginal ecosystem significantly contributes to the development of these conditions. Premature rupture of membranes (PROM) and preterm premature rupture of membranes (pPROM) are associated with an increased risk of intra-amniotic infection. The intra-amniotic infection negatively affects perinatal morbidity and mortality of newborns.

OBJECTIVES: Finding of relationship of vaginal microflora to PROM, pPROM and the risk of early-onset neonatal sepsis.

METHODS: A prospective study was implemented in 152 women with singleton gestations with PROM (n=52) and pPROM (n=47); the control group included 53 women with physiologic pregnancy and delivery at normal term without PROM. In all the women, aerobic cultivations from the vagina and cervix for Chlamydia trachomatis were provided before initiation of antibiotic treatment, the microbial picture of vagina was examined, and the cultivation examination of urine was carried out. The placenta was subjected to histopathologic examination. For the diagnosis of early-onset sepsis, we used concentrations of cytokines IL-6, IL-8, TNF-alpha, and the adhesion molecule, ICAM-1, from the venous umbilical blood taken immediately after delivery and cutting of the umbilical cord. Demonstrated early neonatal sepsis served as a further criterion.

RESULTS: The most frequent bacteriologic findings throughout the group were coagulase-negative Staphylococci, Ureaplasma, Candida albicans, and Streptococcus viridans. Women with a diagnosis of urinary tract infection or diabetes mellitus were excluded from the study. We found no statistically significant relationship between a specific bacterial strain and PROM and pPROM. We found a statistically significant association between the risk for intra-amniotic infection and the finding of S. viridans (p<0.001). There was also a statistically significant relationship between the microbiologic picture of the vagina VI and infection risk (p<0.002).

CONCLUSIONS: Based on results of the present study, it is clear that the use of cultivation and microscopic findings in the vagina and cervix for the timely diagnosis of the risk of early-onset neonatal sepsis is restricted....

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Comparative Study 2008; 29(1): 80-86 PubMed PMID: 18283247 Citation  Keywords:  Adult, Birth Weight:drug effects, Buprenorphine:adverse effects, Female, Fetal Growth Retardation:chemically induced, Heroin:administration & dosage, Heroin Dependence:rehabilitation, Humans, Infant, Newborn, Life Style, Methadone:adverse effects, Narcoti.   

OBJECTIVE: The aim of the study was to evaluate the effect of substitution therapy in heroin addicted pregnant women on the course of pregnancy, perinatal outcomes and course of the neonatal abstinence syndrome.

DESIGN OF THE STUDY: A five-year randomised prospective comparative study

METHODS: The study was carried out in the period of 2002-2007. The group of patients included 147 i.v. heroin-addicted pregnant women. All of them were outpatients of our Perinatal Care Unit. Their daily dose of heroin was approximately lg. Later, 30 women were disqualified from the study for breaking the randomised criteria engagement. The substitution therapy in women who agreed to undergo it, started during the I. trimester of pregnancy. Finally, 47 heroin, 32 methadone and 38 buprenorphine addicted women were enrolled in the study. Birthweight of newborns was compared with the national birthweight tables. Severity and duration of neonatal abstinence syndrome (NAS) were evaluated by Finnegan s score scale.

RESULTS: None of the women delivered before the end of 34th gestational week. We did not encounter any perinatal death or developmental defect. The lowest birthweight, the highest number of newborns with IUGR and the most numerous placental changes were found in the group of heroin-addicted women. The differences compared to the two groups receiving substitution therapy were statistically significant (p < 0.05). The severity and course of NAS were the most severe (p < 0.001) in newborns of women from the methadone group.

CONCLUSION: Comparison of the groups of outpatients is in many ways questionable because of the restricted possibility of the patients' control. The lifestyle of addicted women has the same impact as the drug use alone. This is probably the main reason for differences in some of the monitored parameters between individual groups. Based on our results we can state that substitution therapy provides pregnant women with the possibility of social stabilization and adequate prenatal care. substitution therapy decreases the street heroin consumption. Methadone notably protracts the newborn's abstinence syndrome. With regard to this fact, attention has been recently focused on substitution with buprenorphine that seems to be from this viewpoint a more considerate option....

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Comparative Study 2007; 28(6): 761-764 PubMed PMID: 18063947 Citation  Keywords:  Adolescent, Adult, Antibody Formation:immunology, Biomarkers:blood, Biomarkers, Tumor:blood, Central Nervous System Neoplasms:blood, Child, Child, Preschool, Female, Humans, Immunoglobulin G:blood, Immunoglobulin M:blood, Infant, Male, Neurofibroma, Plexi.   

OBJECTIVES: The aim of the study was to investigate the relationship of serum levels of neuron-specific enolase, anti-vimentin IgG, and anti-vimentin IgM antibodies in patients with neurofibromatosis type 1 and associated tumors (optic glioma, and plexiform neurofibroma).

METHODS: Measurement of neuron-specific enolase and anti-vimentin antibodies were performed in 131 children and adolescents (67 males, mean age 10 years, range 4-19 years; 64 females, mean age 11 years, range 1-20 years) with three different forms of neurofibromatosis type 1 and in control group of 40 individuals (20 males, mean age 9 years, range 1-19 years and 20 females, mean age 12 years, range 3-18 years).

RESULTS: Anti-vimentin IgG, IgM antibodies and NSE showed similar ability to distinguish between neurofibromatosis type 1 and tumors associated with neurofibromatosis type 1. (AUC=0.57, AUC=0.52 and AUC=0.59 respectively). NSE showed better diagnostic efficiency (AUC=0.68) than the anti-vimentin IgG and anti-vimentin IgM. (AUC=0.63 and AUC=0.56 respectively). Anti-vimentin IgG and IgM antibodies showed higher sensitivity (87.5% and 87.2%) at the cut off value than the NSE (54%). On the contrary, NSE showed higher specificity at the cut off value than both the anti-vimentin IgG and IgM (71% vs. 22.5% and 16% respectively).

CONCLUSIONS: Anti-vimentin IgG and IgM and neuron-specific enolase are relevant markers in investigation of the patients with neurofibromatosis type 1 and associated tumors....

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Journal Article 2007; 28(6): 822-825 PubMed PMID: 18063938 Citation  Keywords:  Adaptation, Physiological, Age Factors, Analysis of Variance, Blood Flow Velocity:physiology, Female, Hemodynamics, Humans, Infant, Newborn, Intestines:blood supply, Male, Mesenteric Artery, Superior:diagnostic imaging, Reference Values, Regional Blood Fl.   

OBJECTIVES: After birth, the newborn intestinal circulation undergoes physiological changes. The purpose of this work was to characterize the changes in mesenteric blood flow velocity occuring during the first three days of life in healthy term infants.

METHODS: 30 healthy term newborns were studied repeatedly at the age of 2, 24 and 70 hours. Blood flow velocity in superior mesenteric artery (SMA) was measured by Doppler ultrasound, peak systolic velocity (PSV), end-diastolic velocity (EDV) and time-averaged mean velocity (TAV) were recorded at each time point. Resistance index (RI) and pulsatility index (PI) were calculated.

RESULTS: SMA EDV increased from 2 h [-5.2+/-6.8 cm/s (mean +/- SD)] to 24 h (12.9+/-3.8 cm/s, p<0.001) with further insignificant increase to 70 h (14.9+/-4.7 cm/s). At 2 h of age the mean EDV was negative in 23 of 30 cases (76.7%). PSV did not change between 2 h (58.0+/-21.8 cm/s) and 24 h (58.5+/-15.0 cm/s) but it increased to 70 h (79.6+/-17.7 cm/s). TAV showed a significant increase with time. RI decreased from 2 h (1.09+/-0.11) to 24 h (0.78+/-0.06, p<0.001) with further insignificant increase to 70 h (0.81+/-0.06).

CONCLUSIONS: The blood flow velocity in SMA increases during the early neonatal period in term infants. The most remarkable changes occur within the first 24 hours of life. At 2 h of age a reversed blood flow is present in majority of infants....

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Journal Article 2007; 28(6): 895-900 PubMed PMID: 18063924 Citation  Keywords:  Adolescent, Adult, Age Factors, Autistic Disorder:classification, Child, Child, Preschool, Diagnostic Errors:statistics & numerical data, Early Diagnosis, Early Intervention (Education):standards, Female, Humans, Infant, Male, Parents, Quality of Health C.   

: The primary aim of the research was to find the delay between the first symptoms of an autistic disorder being recognized by parents and diagnosis in our centre. A secondary objective was to evaluate the number of contacts with professionals (physicians, teachers, and speech therapists) in which parents pointed out special manifestations seen in children and, in spite of that, the children were not referred to a specialist. A retrospective study assessed 204 children (59 girls, 145 boys) in total; 126 children (39 girls, 87 boys) with childhood autism (CHA), 57 (17 girls, 40 boys) with atypical autism (AA), and 21 (3 girls, 18 boys) with Asperger's syndrome (AS). The mean age at appearance of the first signs was 29.7 months (range 0-70, median 30+/-17.0) in N=201, and the average age at diagnosis was 81.5 months (range 13-276, median 69.5+/-45.2) in N=204. The mean delay in making a diagnosis was 51.3 months (range 0-246, median 39+/-40.9) in N=201. The delay in diagnosis is shortest in patients with AA (a mean period of 44.4 months = 3 years and 8 months), longer in CHA patients (49.5 months = 4 years and 2 months), and longest in patients with AS (80.8 months = 6 years and 9 months). A statistically significant difference in the period to diagnosis was found between CHA and AS patients (p=0.023) and between AA and AS patients (p=0.019). The mean number of visits to physicians and other specialists before referring to a specialized centre for diagnosis in N=133 was 2.4 (range 1-5, median 2+/-0.9). The diagnosis of autism is made late and early educational and behavioural interventions cannot be initiated....

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Journal Article 2007; 28(Suppl 3): 30-31 PubMed PMID: 18030275 Citation  Keywords:  Child, Child, Preschool, Community-Acquired Infections:epidemiology, Haemophilus influenzae type b, Humans, Immunization Programs, Infant, Meningitis, Haemophilus:epidemiology, Outcome Assessment (Health Care), Slovakia:epidemiology,.   

: Despite of 10 years vaccination of all children within 1st year in Slovakia against H. influenzae, this severe infection still occurs. Among 201 cases of community acquired bacterial meningitis, 14 (7%) were caused by H. influenzae serotype B. Outcome however, after early institution of treatment was fortunately positive - only 1 patient died (7.1% mortality) and in 2 other neurologic sequellae occurred (14.3%), which were transient and mild....

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Comparative Study 2007; 28(Suppl 3): 28-29 PubMed PMID: 18030273 Citation  Keywords:  Age Factors, Community-Acquired Infections:mortality, Humans, Infant, Newborn, Malnutrition:complications, Meningitis, Bacterial:ethnology, Outcome Assessment (Health Care), Risk Factors, Roma:statistics & numerical data, Slovakia:epidemiology, Statistics.   

: Etiology and risk factors such as malnutrition, diabetes, otitis/sinusitis, alcohol abuse, tuberculosis, low birth weigh as well as mortality and neurologic sequellea in Roma ethnic minority with community acquired bacterial meningitis (CBM) was assessed and compared to all CBM cases....

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