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Unlabelled: We assessed the specificity of squamous metaplasia in tracheal aspirates of 69 ventilated newborns (gestational age 25-41 weeks) between days 3 and 7 of life for prediction of chronic lung disease (CLD). CLD was diagnosed when the patient was still requiring ventilation or supplementary oxygen at the postconceptional age of 36 weeks (or postnatal age of 28 days for babies born after 32 weeks gestation) and showed X-ray changes compatible with CLD. In the total population the presence of squamous metaplasia had a sensitivity of 59% and a specificity of 74% for the early diagnosis of CLD. The combination of squamous metaplasia and very low birth weight (VLBW) had a much higher specificity (94%), but a lower sensitivity (45%). Our results show that the presence of squamous metaplasia in VLBW babies during the 1st week of life predicts development of CLD with a specificity of 94% and may be helpful for entering patients into early treatment protocols or trials when a high risk population needs to be identified. As sensitivity of this approach is only 45%, further studies are needed to evaluate the predictive value of the combination of cytology with other markers in tracheal aspirate specimens.Conclusion: The presence of squamous metaplasia in tracheal aspirates of VLBW babies between days 3 and 7 of life is significantly associated with the development of chronic lung disease. Simple microscopic evaluation of fresh tracheal aspirates enables us to identify patients at high risk of CLD at a very early stage. [ABSTRACT FROM AUTHOR]

Unlabelled: Blueberry muffin lesions are associated with prenatal infections, severe and chronic anemia and neoplastic infiltrative diseases. In the first two instances they represent postnatal re-expression of cutaneous haematopoiesis, in the latter they are cutaneous localizations of a neoplastic disease. Chronic prenatal anaemia leading to blueberry muffin lesions in the neonate has been reported in association with severe haemolytic anaemia such as congenital spherocytosis, Rhesus haemolytic disease and ABO incompatibility, or in anaemia caused by twin-to-twin transfusion. We present two more causes of prenatal anaemia leading to blueberry muffin lesions: chronic fetomaternal haemorrhage and severe intracranial bleeding.Conclusion: In any blueberry muffin baby with profound anaemia, chronic fetomaternal haemorrhage and severe internal bleeding should be included in the differential diagnosis. Skin biopsy must be performed to rule out neoplastic infiltrative diseases. [ABSTRACT FROM AUTHOR]

Unlabelled: To assess the role of dexamethasone treatment as a cause of systemic hypertension and associated complications, blood pressure was registered prospectively before, during and after a 4-week dexamethasone course in 22 neonates with chronic lung disease. In all patients systolic blood pressure rose significantly during treatment (median rise 34 mm Hg, range 4-->59 mm Hg), without complications attributable to hypertension. In all but one patient blood pressure returned to pretreatment values within 2 weeks after stopping dexamethasone treatment.Conclusion: Dexamethasone induced hypertension is transient, even after a 4-week course, and is not associated with hypertensive complications, so treatment is not necessary. When hypertension persists after dexamethasone withdrawal other causes should be considered. [ABSTRACT FROM AUTHOR]

Holt-Oram syndrome is an autosomal dominant condition characterized by skeletal and cardiac defects. Pulmonary malformation is not reported to belong to the spectrum of this condition. We report a second case of a newborn with Holt-Oram syndrome who developed severe respiratory insufficiency shortly after birth. We discuss possible genetic links between abnormal pulmonary morphogenesis and Holt-Oram syndrome. [ABSTRACT FROM AUTHOR]