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Cranial Ultrasound (cUS) may not be sensitive enough to detect subtle white matter (WM) injuries. Our study compared serial cUS with MRI at term equivalent age (TEA) to determine if it is possible to identify an ultrasound representation of subtle diffuse WM injuries such as punctate lesions (PWMLs) and diffuse excessive high signal intensity (DEHSI). Fifty-six very preterm infants were scanned sequentially from birth to TEA, an MRI was performed at TEA. Each echodensity found on cUS was classified as absent, transient (≤7 days), or prolonged (>7 days). A transient periventricular echodensity was detected in seven infants (12.5%), and a prolonged echodensity in 15 (26.8%). MRI examinations were performed in all 56 infants. No altered signal intensity was found in 18 infants (32.1%). DEHSI was detected in 14 infants (25%), and PWMLs were detected in eight babies (14.3%). Both abnormalities were found in 16 infants (28.6%). The positive predictive values of the prolonged echodensity for DEHSI and PWMLs were 86.7% and 46.7% respectively. However, a significant statistical correspondence (p=0.002, Odds Ratio 11.9) was found comparing DEHSI with cUS abnormal echodensities. Serial cUS during the neonatal period in preterm infants is essential and cannot be replaced with MRI at TEA. MRI seems to be more reliable in detecting mild or moderate WM abnormalities. However, serial cUS performed by an experienced neonatologist can provide valuable information on early WM changes such as prolonged echodensities that could potentially lead to a diffuse injury. [ABSTRACT FROM AUTHOR]

A 2-year, cross-sectional study was conducted to identify risk factors for Cryptosporidium sp. infection in bovine farms in central Italy. Faecal samples were collected on 248 farms, from 2024 calves and analysed using ELISA and immunofluorescent assay (IFA) commercial kits. In all 101 samples confirmed to be positive with IFA, the aetiological agent was identified as Cryptosporidium parvumand a large genetic variability was detected by subtype analysis. The prevalence of farm infection ranged from 3.4% to 35.6%. Univariate analysis showed a number of putative risk factors, including the type of farm, stalling of calves, late supply of colostrum, number of heads and contact between calves and adults. However, multivariate analysis confirmed that the higher risk for calves was associated with housing calves separately from their dams, a characteristic practice of dairy herd, whereas calves being nursed by their dams, a characteristic of cow–calf herd resulted as a protective factor. [ABSTRACT FROM AUTHOR]

The article discusses the use of intrauterine growth charts, or birth weight-for-gestational age charts, for the anthropometric classification of neonates. Key issues examined include the distinction between neonatal anthropometric charts and intrauterine growth charts and the difference between the terms "small-for-gestational age" and "intrauterine growth restricted."

Interictal spiking is seen in the EEG of epileptic patients between seizures. To date, the roles played by interictal events in seizure occurrence and in epileptogenesis remain elusive. While interictal spikes may herald the onset of electrographic seizures, experimental data indicate that hippocampus-driven interictal events prevent seizure precipitation. Even less clear than the role of interictal events in seizure occurrence is whether and how interictal spikes contribute to epileptogenesis. Thus, while plastic changes within limbic neuronal networks may result from ongoing interictal activity, experimental evidence supports the view that epileptogenesis is accompanied by a decrease in hippocampus-driven interictal activity. [ABSTRACT FROM AUTHOR]

The objective was to evaluate pravastatin modulation on peripheral blood mononuclear cell (PBMC) migration across endothelial monolayers. Eleven hypercholesterolaemic patients were treated with pravastatin 20 mg/day. At baseline (T0), after 40 days (T40) and after 6 months (T6 months) of treatment total serum cholesterol, low-density lipoprotein (LDL), high-density lipoprotein, triglycerides, C-reactive protein, as well as tumour necrosis factor-α (TNF-α) and metalloproteinases-9 plasma levels were evaluated. At the same time points the effect of pravastatin on migration of PBMCs through a monolayer of murine brain endothelial cells was studied both in basal conditions and after endothelial stimulation with recombinant mouse TNF-α 10 ng/ml for 24 h. Seven volunteers were used as healthy controls. Significant decreases in total cholesterol, LDL and triglycerides as well as inhibition of transmigration were observed. PBMCs transmigration in patients prior to pravastatin therapy was higher than in healthy controls. These results suggest that pravastatin could be of benefit in a spectrum of diseases characterised by extravasation of PBMCs into the central nervous system. [ABSTRACT FROM AUTHOR]

Summary. Background: Most preterm infants are still preterm and have a low birth weight when they are discharged from the hospital. An important issue is whether the long-term consequences of early growth restriction can be diminished by nutritional intervention in preterm infants after discharge from the hospital. Aim: To evaluate differences in growth and in weight gain composition of preterm infants fed standard term formula (SF) or enriched formula (PDF) after discharge from hospital during the first 2 months of life. Methods: Thirty-three healthy preterm infants, birth weight < 1750 g at gestational age < 35 weeks, were randomised to SF or PDF at the time of discharge from hospital. Anthropometric variables were studied longitudinally and body composition was measured using dual energy x-ray absorptiometry (DEXA) twice, before hospital discharge and two months later. Weight gain composition was calculated as the difference between the two determinations. Results: Seventeen infants were fed SF and 16 PDF. Anthropometric variables and whole body composition were similar at birth, at the start of the nutritional study (mean age 45 days), and at the end of the study 2 months later. Over the whole study period, weight gain and weight gain composition were similar in the two groups. Sex did not appear to influence weight gain and weight gain composition. In infants with growth restriction at discharge there was a significant reduction of weight gain, fat mass gain, and bone mineral content deposition independently of the formula provided. Conclusions: There is no immediate effect on preterm infants of a nutrient enriched formula compared with a standard formula on growth, weight gain, or weight gain composition. [ABSTRACT FROM AUTHOR]

The effects of Ni2+ were evaluated on slowly-decaying, high-voltage-activated (HVA) Ca2+ currents expressed by pyramidal neurons acutely dissociated from guinea-pig piriform cortex. Whole-cell, patch-clamp recordings were performed with Ba2+ as the charge carrier. Ni2+ blocked HVA Ba2+ currents (IBas) with an EC50 of approximately 60 μm. Additionally, after application of nonsaturating Ni2+ concentrations, residual currents activated with substantially slower kinetics than both total and Ni2+-sensitive IBas. None of the pharmacological components of slowly decaying, HVA currents activated with kinetics significantly different from that of total currents, indicating that the effect of Ni2+ on IBas kinetics cannot be attributed to the preferential inhibition of a fast-activating component. The effect of Ni2+ on IBa amplitude was voltage-independent over the potential range normally explored in our experiments (-60 to +20 mV), hence the Ni2+-dependent decrease of IBa activation rate is not due to a voltage- and time-dependent relief from block. Moreover, Ni2+ significantly reduced IBa deactivation speed upon repolarization, which also is not compatible with a depolarization-dependent unblocking mechanism. The dependence on Ni2+ concentration of the IBa activation-rate reduction was remarkably different from that found for IBa block, with an EC50 of ∼20 μm and a Hill coefficient of ∼1.73 vs.∼1.10. These results demonstrate that Ni2+, besides inhibiting the IBas under study probably by exerting a blocking action on the pore of the underlying Ca2+ channels, also interferes with Ca2+-channel gating kinetics, and strongly suggest that the two effects depend on Ni2+ occupancy of binding sites at least partly distinct. [ABSTRACT FROM AUTHOR]

The relationship of birthweight to gestational age is described. Two problems are discussed and solutions offered: the production of standard centile charts of birthweight for very early gestational ages, based on a small amount of data, and the adjustment of birthweight for gestational age in the analysis of factors associated with lower birthweight. [ABSTRACT FROM AUTHOR]

In 10 children with cystic fibrosis and persisting steatorrhoea, supplementation with taurine (30-40 mg/kg/day) was given for two months as an adjunct to the usual pancreatic enzyme treatment. A three day fat and energy balance was performed in patients with cystic fibrosis, before and after the supplementation, and in seven healthy controls who did not receive taurine. Faecal fat was measured by a gravimetric method and stool energy was determined using a bomb calorimeter. Patients with cystic fibrosis, before and after taurine, and healthy controls received the same fat and energy intake (calculated by a dietitian). In patients with cystic fibrosis taurine did not produce any improvement of steatorrhoea (mean (SD) faecal fat 8.7 (3.3) v 11.2 (7.0) g/day, respectively before and after the supplementation), of faecal energy loss (0.978 (0.468) v 1.133 (0.539) MJ/day), of faecal fat expressed as percent of fat intake (13.4 (5.6) v 15.1 (9.8)%), and of faecal energy expressed as percent of energy intake (9.9 (3.6) v 11.2 (5.7)%). Healthy controls had significant lower fat (3.5 (2.3) g/day) and energy 0.576 (0.355) MJ/day faecal losses. In conclusion, taurine failed to decrease significantly fat and energy losses. Our study does not support the use of taurine supplementation in the nutritional management of cystic fibrosis. [ABSTRACT FROM AUTHOR]

We performed metabolic balance studies in 77 preterm infants fed on human milk or adapted formulas, to determine the renal solute load and compared it with the potential renal solute load estimated by the composition of the diet or the urine according to Ziegler's, Bergman's, and Shaw's calculations. The renal solute load found in preterm infants was lower than that observed in young full term infants. Although all calculations predicted the renal solute load well, the equation proposed by Ziegler and Fomon from dietary protein and electrolyte load appears to be the simplest to calculate renal solute load accurately in preterm infants. [ABSTRACT FROM AUTHOR]

Thirty jaundiced neonates with diarrhoea who were being treated with phototherapy and 30 matched control infants were studied to try and find out the cause of the diarrhoea. Faecal osmolality and electrolyte concentrations were measured, which gave clear evidence that the diarrhoea arose from intestinal secretion. Rectal water and electrolyte absorption in 10 jaundiced infants receiving phototherapy, in 10 jaundiced infants not receiving phototherapy, and in 10 healthy controls was measured with a rectal dialysis bag. A further group of eight jaundiced infants was also studied both during and after phototherapy to document the reversal of ion transport changes. Absorption of water, sodium chloride, and potassium was significantly impaired in the patients receiving phototherapy compared with each of the control groups. Such impairment was transient, as it was not apparent when the jaundice faded and phototherapy was stopped. These data show that the colon plays a part in the pathogenesis of secretory diarrhoea and that both hyperbilirubinaemia and phototherapy are necessary for such an effect to develop. [ABSTRACT FROM AUTHOR]

Significant production of breath hydrogen has been shown in premature infants, suggesting limited intestinal capacity for digestion of carbohydrate. To evaluate net absorption of carbohydrate 24 three day balance studies were carried out in seven preterm infants fed pasteurised banked human milk and in 17 preterm infants fed a formula containing 75% lactose and 25% glucose polymers. Because carbohydrate reaching the colon may be converted to organic acids by bacterial flora, carbohydrate net absorption was determined by quantitating the faecal excretion of energy derived from carbohydrate. The carbohydrate derived energy content of milk and stools was calculated as the difference between the measured gross energy and the sum of energy related to nitrogen and fat. Faecal loss of carbohydrate derived energy was lower in the group fed formula (1.9 (SD 1.2) kcal/kg/day) than in the group fed human milk (4.0 (SD 1.8) kcal/kg/day). Net absorption of carbohydrate derived energy was 97.0 (SD 1.9)% as opposed to 92.6 (SD 3.9)%, respectively. Within each group there was no significant relation between carbohydrate energy absorption and fat, nitrogen, or gross energy absorption. Thus, although less complete with human milk than with formula, apparent absorption of energy derived from carbohydrate seemed quite satisfactory in these preterm infants. [ABSTRACT FROM AUTHOR]

Jaundiced babies undergoing phototherapy often develop diarrhoea. The cause of it is still uncertain. Increasing evidence supports a role of a secretory mechanism for the diarrhoea. We therefore studied the effects of bile from congenitally jaundiced rats undergoing phototherapy and of unconjugated bilirubin on rat small intestine in vivo and in vitro. Results suggest that: (1) the bile from homozygous Gunn rats under phototherapy has an anti-absorptive effect when tested in the perfused jejunum of normal Wistar rats; (2) unconjugated bilirubin has a dose dependent secretory effect on the intestinal transport of water and electrolytes, when tested in the same system. Alteration of cyclic AMP or cyclic GMP, known intracellular mediators of secretion, was not observed. We conclude that free bilirubin is an intestinal secretagogue acting by an as yet unknown mechanism, that may mediate the secretory type of diarrhoea in jaundiced neonates undergoing phototherapy. [ABSTRACT FROM PUBLISHER]

Energy and nitrogen balances were performed in 12 very low birthweight infants fed on either human milk or on a preterm formula. Energy and nitrogen retention were significantly higher in those given the formula feed (p less than 0.05). Highly significant correlations were found between nitrogen intake and nitrogen retention and between energy retention and nitrogen retention (p less than 0.001). Multiple regression analysis failed to show any effect of energy retention on the correlation between nitrogen intake and nitrogen retention in babies fed on human milk. Protein deficiency seems to be the most likely explanation of poor growth in infants fed on human milk. [ABSTRACT FROM AUTHOR]

The aim of the study was the evaluation of the relationship between chemical fat analysis and some more rapid tests proposed to estimate steatorrhoea. Stool collections (72 h) were obtained on 32 occasions in 22 patients with cystic fibrosis and in seven healthy children. A very close relationship was found between faecal fat, as measured by standard chemical methods, and faecal energy (r = 0.95, P < 0.001). We conclude that the determination of faecal energy, easier to measure than faecal fat, can provide reliable information about the extent of steatorrhoea in cystic fibrosis. [ABSTRACT FROM AUTHOR]

Mean birth weights and percentile charts are given for 161 singleton infants born between 24 and 30 weeks' gestation at the 2nd School of Medicine of Naples. This chart is the first for a Mediterranean population. Our data are similar to those reported from a United Kingdom population and from Japan, suggesting that ethnic differences in birth weight at this gestational age are unimportant. [ABSTRACT FROM AUTHOR]

The perinatal histories of 27 newborn infants with NEC were compared to those of 54 infants of equivalent birth weight who did not have NEC during an 8-year study period to see if possible predisposing factors were independent of the confounding effect of birth weight. No differences were observed in gestational age, degree of intrauterine growth retardation, premature rupture of membranes, perinatal asphyxia, skin temperature at admission, haematocrit, presence or absence of respiratory distress syndrome, umbilical catheter placement, start and type of feeding or presence of positive blood cultures. Prematurity is the greatest risk factor predisposing to the development of NEC and the perinatal problems which precede the onset of NEC are common among all premature infants. [ABSTRACT FROM AUTHOR]

Healthy term breast- and adapted formula-fed infants show similar weight gain and weight gain composition during the first months of life. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the effect of fortification on the osmolality of human milk.Methods: The osmolality of 47 samples of human milk was determined at baseline, just after, and 24 hours after supplementation with five different human milk fortifiers (HMF) at 4 degrees C.Results: Ten minutes after HMF supplementation the osmolality of human milk was significantly higher than the sum of the respective values of HMF dissolved in water and human milk, measured separately at baseline (p<0.0001), with the exception of the HMF containing only proteins. After 24 hours a further increase in osmolality was observed. Linear regression analysis showed that total dextrin content (r=0.84) was the main determinant of the increase.Conclusions: Human milk and HMF interact to induce a rapid increase in osmolality higher than would be expected from composition alone. This rise could be explained by the amylase activity of human milk, inducing hydrolysis of the dextrin content of HMF, leading to small osmotically active molecules of oligosaccharides. The high osmolality of fortified human milk should be considered in the nutritional management of preterm infants. [ABSTRACT FROM AUTHOR]

This paper reports on a preterm infant with meconium peritonitis in which prenatal sonography demonstrated calcified peritoneal meconium associated with fetal ascites. His spontaneous and favorable outcome is described and other causes of neonatal abdominal calcifications are discussed. [ABSTRACT FROM AUTHOR]

This paper describes two cases of gangrene in the buttock secondary to infusion of a hyperosmolar solution into the umbilical artery at birth. Because of the frequent dilatation of the umbilical arteries in asphyxiated infants, needle puncture should not be used to infuse fluids into the umbilical vein. Moreover, hypertonic solutions that can produce vascular thrombosis should be avoided in metabolic resuscitation in the delivery room. [ABSTRACT FROM AUTHOR]

The article describes the case of a male infant who vomited while being fed breast milk by gavage. His chest radiography revealed massive milk inhalation. Because of severe respiratory distress, the infant required intubation and assisted ventilation. His clinical condition was continuing to improve after the beginning of surfactant therapy.

Abstract The processing of olfactory inputs by the parahippocampal region has a central role in the organization of memory in mammals. The olfactory input is relayed to the hippocampus via interposed synapses located in the piriform and entorhinal cortices. Whether olfactory afferents directly or indirectly project to other areas of the parahippocampal region beside the entorhinal cortex (EC) is uncertain. We performed an electrophysiological and imaging study of the propagation pattern of the olfactory input carried by the fibres that form the lateral olfactory tract (LOT) into the parahippocampal region of the in vitro isolated guinea pig preparation. Laminar analysis was performed on field potential depth profiles recorded with 16-channel silicon probes at different sites of the insular–parahippocampal cortex. The LOT input induced a large amplitude polysynaptic response in the lateral EC. Following appropriate LOT stimulation, a late response generated by the interposed activation of the hippocampus was observed in the medial EC. LOT stimulation did not induce any local response in area 36 of the perirhinal cortex (PRC), while a small amplitude potential with a delay similar to the lateral EC response was inconsistently observed in PRC area 35. No PRC potentials were observed following the responses evoked by LOT stimulation in either the lateral or the medial EC. These findings were substantiated by current source density analysis of PRC laminar profiles. To further verify the absence of EC-to–PRC field interactions after LOT stimulation, high-resolution optical imaging of neuronal activity was performed after perfusion of the isolated brain with the voltage-sensitive dye RH-795. The optical recordings confirmed that olfactory-induced activity in the EC does not induce massive PRC activation. The present findings suggest that the olfactory input into the parahippocampal region is confined to the entorhinal cortex. The results also imply that,... [ABSTRACT FROM AUTHOR]