151
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Abstract
Twelve cases of neonates admitted to the neonatal unit of our hospital, between January 1, 2000, and December 31, 2005, because of otorrhea due to spontaneous perforation of the tympanic membrane within the first 10 days of life are presented. Data were collected retrospectively from medical records. Cultures of the middle ear exudate grew PSEUDOMONAS AERUGINOSA in 10, SERRATIA MARCENSCENS in 1, and STAPHYLOCOCCUS AUREUS in 1 neonate. Cultures of nasopharyngeal secretions grew P. AERUGINOSA in nine, S. MARCENSCENS in one, S. AUREUS in one, and STREPTOCOCCUS VIRIDANS in one neonate. Middle ear versus nasopharyngeal secretions cultures grew the same organism in 11 neonates. A 10-day course of parenteral antibiotics was administered (ampicillin-ceftazidime for all neonates except for the one neonate with the S. AUREUS otitis who received netilmicin-cloxacillin). All neonates had uneventful course and were discharged home in good clinical condition. Our findings suggest that neonates with eardrum perforation should receive antibiotics parenterally, as the most common pathogens is P. AERUGINOSA, for which there are no satisfactory antibiotics for oral use.
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Affiliation(s)
- Nicoletta Iacovidou
- NICU, 2nd Department of Paediatrics, University of Athens, Aglaia Kyriakou Children's Hospital, Athens, Greece.
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152
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Trapali C, Nika A, Papaphylactou M, Iacovidou N. A rare type of double aortic arch diagnosed by echocardiography in an asymptomatic 9-year-old patient. Pediatr Cardiol 2010; 31:728-31. [PMID: 20204347 DOI: 10.1007/s00246-010-9681-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2009] [Accepted: 02/10/2010] [Indexed: 10/19/2022]
Abstract
A case of double aortic arch with an atretic left arch distal to the origin of the left subclavian artery was suspected by echocardiography (ECHO) in an asymptomatic 9-year-old girl and confirmed by magnetic resonance imaging (MRI). The authors report their ECHO findings, which could be an important diagnostic tool for symptomatic patients because confusion exists in the literature regarding the differentiation of the aforementioned rare malformation from a right arch with mirror image branching. The authors support their ECHO proposal with an explanation based on the hypothetical double aortic arch plan set by Edwards.
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Affiliation(s)
- Christina Trapali
- Department of Cardiology, University of Athens, P & A Kyriakou Children's Hospital, Athens, Greece
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153
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Xanthos T, Iacovidou N, Pantazopoulos I, Vlachos I, Bassiakou E, Stroumpoulis K, Kouskouni E, Karabinis A, Papadimitriou L. Ischaemia-modified albumin predicts the outcome of cardiopulmonary resuscitation: An experimental study. Resuscitation 2010; 81:591-5. [DOI: 10.1016/j.resuscitation.2010.01.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Revised: 01/18/2010] [Accepted: 01/20/2010] [Indexed: 11/25/2022]
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154
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Abstract
A case of Bacillus cereus meningitis in a term neonate without identifiable risk factors or source of the organism is presented. Prompt identification of the organism and treatment resulted in a favourable outcome.
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Affiliation(s)
- Evangelia Lebessi
- Department of Microbiology, NICU Aglaia Kyriakou Children's Hospital, University of Athens, Athens, Greece
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155
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Aroni F, Iacovidou N, Dontas I, Pourzitaki C, Xanthos T. Pharmacological aspects and potential new clinical applications of ketamine: reevaluation of an old drug. J Clin Pharmacol 2009; 49:957-64. [PMID: 19546251 DOI: 10.1177/0091270009337941] [Citation(s) in RCA: 122] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Ketamine, the phencyclidine derivative described in 1965, is an intravenous anesthetic with a variety of applications. The enthusiasm following its initial release subsided due to side effects from the central nervous system. New anesthetics limited the role of ketamine in anesthetic practice. However, its hemodynamically stable profile, along with its beneficial respiratory properties and analgesic potency, rendered the drug invaluable in battlefield medicine, sedation of the uncooperative child, analgesia, and sedation in burn units. Reevaluation, though, of analgesic properties of ketamine resulted in new interest regarding its use in perioperative and chronic pain management. Moreover, recent studies in the effects of the substance on intracranial pressure and cerebral blood flow led to revising the recommendation against its use in brain injury. Furthermore, the bronchodilating effects of the substance led to increasing interest for potential use in asthma treatment. In addition, separation of the 2 enantiomers and subsequent separate studies indicated beneficial results of the S(+) one. Thus, new controlled multicentered clinical trials are to be conducted to justify approval for new uses of ketamine and take advantage of its unique range of applications.
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Affiliation(s)
- Filippia Aroni
- Laboratory of Experimental Surgery and Surgical Research, University of Athens, Medical School, Tideos 2, 11635 Athens, Greece.
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156
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Xanthos T, Ekmektzoglou KA, Bassiakou E, Koudouna E, Barouxis D, Stroumpoulis K, Demestiha T, Marathias K, Iacovidou N, Papadimitriou L. Nurses are more efficient than doctors in teaching basic life support and automated external defibrillator in nurses. Nurse Educ Today 2009; 29:224-231. [PMID: 18829143 DOI: 10.1016/j.nedt.2008.08.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2008] [Revised: 07/23/2008] [Accepted: 08/14/2008] [Indexed: 05/26/2023]
Abstract
BACKGROUND Cardiac arrest (CA) is a leading cause of death worldwide. The European Resuscitation Council (ERC) has developed basic life support/automated external defibrillation (BLS/AED) courses for uniform training in out-of-hospital CA. OBJECTIVE The present study compares the resuscitation skills of two groups of nursing staff, one taught by newly trained ERC nurse-instructors and the other by newly trained doctor-instructors. METHOD Eighteen doctors and 18 nurses were asked to teach a total of 108 nurses in a (BLS/AED) course. One month after its completion, all 108 nurses were asked to be re-evaluated, with the use of the objective structured clinical examination. CONCLUSIONS No statistical significant difference between the two groups was noted in the written test, in contrast with data collected from the practice skills check-list. Nurses in group A could easily identify the patient in cardiac arrest but had difficulties concerning chest compressions and handling the AED. Nurses in group B were more focused during the performances, used AED more accurately and continued cardiopulmonary resuscitation with no delays. Nurses prove to be more efficient in training nurses.
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Affiliation(s)
- Theodoros Xanthos
- Department of Experimental Surgery and Surgical Research "N.S. Christeas", University of Athens, Medical School, 15B Agiou Thoma Street, 11527 Athens, Greece.
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157
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Iacovidou N, Boutsikou M, Gourgiotis D, D. Briana D, Baka S, Vraila VM, Kontara L, Hassiakos D, Malamitsi-Puchner A. Perinatal changes of cardiac troponin-I in normal and intrauterine growth-restricted pregnancies. Mediators Inflamm 2008; 2007:53921. [PMID: 17710247 PMCID: PMC1939921 DOI: 10.1155/2007/53921] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2007] [Accepted: 05/21/2007] [Indexed: 12/02/2022] Open
Abstract
Intrauterine growth restriction (IUGR) implies fetal hypoxia, resulting in blood flow redistribution and sparing of vital organs
(brain, heart). Serum cardiac Troponin-I (cTnI), a well-established marker of myocardial ischaemia, was measured in 40 mothers
prior to delivery, the doubly clamped umbilical cords (representing fetal state), and their 20 IUGR and 20 appropriate-forgestational-age (AGA) neonates on day 1 and 4 postpartum. At all time points, no differences in cTnI levels were observed between
the AGA and IUGR groups. Strong positive correlations were documented between maternal and fetal/neonatal values (r ≥ .498,
P ≤ .025 in all cases in the AGA and r ≥ .615,
P ≤ .009 in all cases in the IUGR group). These results may indicate (a) normal
heart function, due to heart sparing, in the IUGR group (b) potential crossing of the placental barrier by cTnI in both groups.
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Affiliation(s)
- Nicoletta Iacovidou
- Neonatal Division, 2nd Department of Obstetrics and Gynecology, Athens University Medical School, Athens 10682, Greece
| | - Maria Boutsikou
- Neonatal Division, 2nd Department of Obstetrics and Gynecology, Athens University Medical School, Athens 10682, Greece
| | - Demetrios Gourgiotis
- Research Laboratories, 2nd Department of Paediatrics, Athens University Medical School, Athens 10682, Greece
| | - Despina D. Briana
- Neonatal Division, 2nd Department of Obstetrics and Gynecology, Athens University Medical School, Athens 10682, Greece
| | - Stavroula Baka
- Neonatal Division, 2nd Department of Obstetrics and Gynecology, Athens University Medical School, Athens 10682, Greece
| | - Venetia-Maria Vraila
- Research Laboratories, 2nd Department of Paediatrics, Athens University Medical School, Athens 10682, Greece
| | - Louiza Kontara
- Neonatal Division, 2nd Department of Obstetrics and Gynecology, Athens University Medical School, Athens 10682, Greece
| | - Demetrios Hassiakos
- Neonatal Division, 2nd Department of Obstetrics and Gynecology, Athens University Medical School, Athens 10682, Greece
| | - Ariadne Malamitsi-Puchner
- Neonatal Division, 2nd Department of Obstetrics and Gynecology, Athens University Medical School, Athens 10682, Greece
- *Ariadne Malamitsi-Puchner:
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158
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Iacovidou N, Briana DD, Boutsikou M, Gourgiotis D, Baka S, Vraila VM, Hassiakos D, Malamitsi-Puchner A. Perinatal changes of circulating N-terminal pro B-type natriuretic peptide (NT-proBNP) in normal and intrauterine-growth-restricted pregnancies. Hypertens Pregnancy 2008; 26:463-71. [PMID: 18066964 DOI: 10.1080/10641950701548414] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To investigate changes in NT-proBNP in intrauterine-growth-restricted (IUGR) and appropriate-for-gestational-age (AGA) pregnancies. METHODS NT-proBNP levels were measured in 40 mothers (MS), umbilical cords (UC), and their 20 IUGR/ 20 AGA neonates on day 1 (N1) and day 4 (N4). RESULTS UC, N1, and N4 NT-proBNP was lower in IUGR pregnancies (p <or= 0.049). In both groups, NT-proBNP levels were similar in MS and higher in N1 (p <or= 0.001). In AGA, MS NT-proBNP correlated positively with UC. CONCLUSIONS Fetal and neonatal NT-proBNP levels are lower in IUGR compared with AGA, probably due to blood flow redistribution in IUGR and NT-proBNP placental transport in AGA. NT-proBNP levels peak on N1.
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Affiliation(s)
- Nicoletta Iacovidou
- Neonatal Division, Second Department of Obstetrics and Gynecology, Athens University Medical School, Athens, Greece
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159
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Trapali C, Dellagrammaticas HD, Nika A, Iacovidou N. A unique case of reversible myocardial ischemia in a hyperthyroid neonate. Pediatr Cardiol 2008; 29:180-2. [PMID: 17912485 DOI: 10.1007/s00246-007-9060-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2007] [Accepted: 06/26/2007] [Indexed: 11/29/2022]
Abstract
A case of an 8-day-old preterm neonate with heart failure, pulmonary hypertension, and myocardial ischemia due to hyperthyroidism is reported. Treatment of the disease initially with b-blockers and, upon establishment of hyperthyroidism, with propylthiouracil reversed all cardiac abnormalities. Contrary to the rule, diagnosis of hyperthyroidism in the mother was established following the diagnosis of the condition in her baby. On long-term follow-up (10 years), the child has developed normally, remains euthyroid with normal electrocardiogram. To our knowledge, diagnosis and reversal of the above-mentioned ischemic abnormalities have not been previously reported in neonates.
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Affiliation(s)
- Christina Trapali
- Department of Cardiology, University of Athens, P. and A. Kyriakou Children's Hospital, Athens, Greece
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160
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Briana DD, Boutsikou M, Gourgiotis D, Kontara L, Baka S, Iacovidou N, Hassiakos D, Malamitsi-Puchner A. Role of visfatin, insulin-like growth factor-I and insulin in fetal growth. J Perinat Med 2007; 35:326-9. [PMID: 17511597 DOI: 10.1515/jpm.2007.071] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE IGF-I and insulin are the main regulators of intrauterine and postnatal growth. Adipose tissue secreted cytokines are implicated in intrauterine growth. The relevant function of the adipocytokine visfatin is unknown. MATERIALS AND METHODS Serum visfatin, IGF-I and insulin levels were measured by enzyme immunoassays in 40 singleton full-term fetuses and neonates on postnatal days 1(N1) and 4 (N4). RESULTS No significant correlations exist between visfatin and IGF-I or insulin. N1 and N4 visfatin positively correlated with customized (adjusted) birth weight centiles (r=0.511, P=0.021, and r=0.597, P=0.005, respectively). Fetal and N1 IGF-I positively correlated with customized centiles (r=0.608, P<0.001 and r=0.485, P=0.006, respectively). Fetal insulin positively correlated with customized centiles (r=0.654, P=0.021). CONCLUSIONS Potential implication of visfatin in fetal growth is probably not mediated by IGF-I or insulin. Although a more active role cannot be excluded, visfatin may simply represent a marker of fat accumulation.
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Affiliation(s)
- Despina D Briana
- 2nd Department of Obstetrics and Gynecology, Neonatal Division, Athens University Medical School, Athens, Greece
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161
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Briana DD, Boutsikou M, Baka S, Hassiakos D, Gourgiotis D, Marmarinos A, Iacovidou N, Malamitsi-Puchner A. N-terminal parathyroid hormone-related protein levels in human intrauterine growth restricted pregnancies. Acta Obstet Gynecol Scand 2007; 86:945-9. [PMID: 17653879 DOI: 10.1080/00016340701417497] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND N-terminal parathyroid hormone-related protein has a vital role in regulating cell growth and differentiation, uteroplacental vasodilatation, uterine muscle relaxation, and placental transport. These functions are compromised in intrauterine growth restriction. We aimed to investigate N-terminal parathyroid hormone-related protein concentrations in maternal, fetal, and neonatal plasma of intrauterine-growth-restricted and appropriate for gestational age pregnancies. METHODS Plasma N-terminal parathyroid hormone-related protein levels were determined in 40 mothers and their 20 intrauterine-growth-restricted and 20 appropriate for gestational age singleton full-term fetuses and neonates on postnatal days 1 and 4. RESULTS Fetal N-terminal parathyroid hormone-related protein levels were significantly lower in the intrauterine growth restriction group (b=1.166, 95%CI: 0.430-1.902, p=0.003) and correlated with the customized centiles of the infants (r=0.407, p=0.009). In the appropriate for gestational age group, neonatal day 1 N-terminal parathyroid hormone-related protein levels were significantly lower compared to maternal (p<0.001) and fetal (p=0.022) ones. Fetal and neonatal day 1 levels were significantly lower in males (b=-1.303, 95%CI: -2.508 to -0.097, p=0.036, and b=-0.802, 95%CI: -1.5 to -0.105, p=0.027, respectively). In the intrauterine growth restriction group, maternal N-terminal parathyroid hormone-related protein levels were significantly increased compared to fetal (p<0.001) and neonatal day 1 (p=0.001) levels. CONCLUSIONS The reduced fetal N-terminal parathyroid hormone-related protein concentrations in intrauterine growth restriction may reflect compromised placental function and impaired fetal growth, suggesting that N-terminal parathyroid hormone-related protein may be involved in the pathogenesis of intrauterine growth restriction.
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Affiliation(s)
- Despina D Briana
- Second Department of Obstetrics and Gynecology, Athens University Medical School, Athens, Greece
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162
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Dellagrammaticas HD, Iacovidou N, Megaloyanni E, Papadimitriou M, Kapetanakis J. Effect of low-dose oral erythromycin on gastric aspirates in ventilated neonates less than 32 weeks of gestation. Preliminary results. Neonatology 2002; 81:213-6. [PMID: 11937729 DOI: 10.1159/000051537] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In this prospective study, the 24-hour gastric aspirate volume was carefully recorded before, 24 and 48 h after administering 1.7 mg/kg/8-hourly of oral erythromycin to 16 ventilated neonates less than 32 weeks of gestation. Their median gestational age was 28.5 weeks (range 23-31 weeks), their median birthweight was 1,045 g (range 690-1,560 g) and the median day of life at which erythromycin was commenced was 9.5 days (range 4-16 days). Prior to administering erythromycin median 24-hour gastric aspirate volume, expressed as a percentage of the milk volume given over the same period, was 38.5% (range 20.0-100%). It was significantly lower 24 h (median 12%, range 0-41%, p = 0.0004) and 48 h (median 5%, range 0-21%, p = 0.0004) after commencing erythromycin. There was also significant reduction of gastric aspirate volume between 24 and 48 h after commencing erythromycin (p = 0.0024). Milk volume increment over the same period was not significant (p = 0.1022). These preliminary results warrant further evaluation through a randomised controlled trial.
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MESH Headings
- Administration, Oral
- Dose-Response Relationship, Drug
- Enteral Nutrition/adverse effects
- Erythromycin/administration & dosage
- Erythromycin/therapeutic use
- Gastrointestinal Agents/administration & dosage
- Gastrointestinal Agents/therapeutic use
- Gestational Age
- Humans
- Infant, Newborn
- Infant, Premature
- Infant, Premature, Diseases/etiology
- Infant, Premature, Diseases/therapy
- Motilin/agonists
- Prospective Studies
- Respiration, Artificial
- Respiratory Distress Syndrome, Newborn/therapy
- Stomach
- Suction
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Affiliation(s)
- H D Dellagrammaticas
- NICU, 2nd Department of Paediatrics, University of Athens, Aglaia Kyriakou Children's Hospital, Greece.
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163
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Dellagrammaticas HD, Iacovidou N, Papadimitriou M, Daskalaki A, Papadoyannis M. Mild dilatation of renal pelvis in term neonates with urinary tract infection. Biol Neonate 2001; 79:1-4. [PMID: 11150822 DOI: 10.1159/000047057] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The purpose of this study was to assess the incidence and evolution of mild dilatation confined to the renal pelvis in term neonates with urinary tract infection developing within 2 weeks from birth. Twenty-two neonates with mild dilatation of the renal pelvis out of 180 neonates with urinary tract infection were identified giving an incidence of 12.2% for this finding. Male to female ratio was 6.3:1. The left kidney was twice as frequently involved (68 vs. 32%). At follow-up, the dilatation had disappeared in 20 neonates (90.9%) by a mean age of 2.7 years with only one neonate developing two further episodes of urinary tract infection in the infantile period. No other morbidity was noted.
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Affiliation(s)
- H D Dellagrammaticas
- NICU, 2nd Department of Paediatrics, University of Athens, Aglaia Kyriakou Children's Hospital, Athens, Greece
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164
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Dellagrammaticas HD, Iacovidou N. Parental visiting in neonatal units. Arch Dis Child Fetal Neonatal Ed 2000; 83:F163-4. [PMID: 11012278 PMCID: PMC1721162 DOI: 10.1136/fn.83.2.f160h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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165
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Abstract
A case of herpes simplex encephalitis in a previously healthy 17-month-old girl relapsing 1 week after completion of a 10-day acyclovir therapy is described. The child responded favourably to a second 10-day course with acyclovir. The time of relapse and the satisfactory response to a second course of acyclovir treatment indicate that the first course of therapy was inadequate for eradication of herpes simplex virus infection.
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Affiliation(s)
- P Nicolaidou
- First Department of Paediatrics, University of Athens, St. Sophie, Children's Hospital, Greece
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