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The cases
Published in Chris Schelvan, Annabel Copeman, Jacky Davis, Annmarie Jeanes, Jane Young, Paediatric Radiology for MRCPCH and FRCR, 2020
Chris Schelvan, Annabel Copeman, Jacky Davis, Annmarie Jeanes, Jane Young
This 3-day-old baby was born at 27 weeks’ gestation and ventilated for severe hyaline membrane disease. He suddenly collapsed on the ventilator with hypotension, metabolic acidosis and hypotonia. A cranial USS was performed.
Fetal and neonatal medicine
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
4.19. An infant delivered at 32 weeks' gestation develops respiratory distress soon after birth with marked chest recession. At the age of 4 h he has a cyanotic episode. Chest X-ray shows ground-glass appearance with an air bronchogram. This presentation is consistent with the diagnosis ofhyaline membrane disease.meconium aspiration.wet lung.bacterial infection.tracheo-oesophageal fistula.
Iron, Oxygen Stress, and The Preterm Infant
Published in Bo Lönnerdal, Iron Metabolism in Infants, 2020
The pathologic lung changes occurring in preterm infants treated with supplemental oxygen, intubation, and positive pressure ventilation is called bronchopulmonary dysplasia (BPD).42 BPD occurs in 11 to 21% of infants with hyaline membrane disease treated in this manner.43 In addition to the high incidence of BPD in infants with hyaline membrane disease, it may also occur in similarly treated infants with congenital heart disease or other lung disease. Thus at least four important etiologic factors exist in the development of BPD: oxygen, intubation, immaturity, and pressure.
Risk factors and foetal growth restriction associated with expectant treatment of early-onset preeclampsia
Published in Annals of Medicine, 2022
Jiao Yi, Lei Chen, Xianglian Meng, Yi Chen
In early-onset preeclampsia pregnancies, an iatrogenic preterm delivery is a common consequence as delivery is the definitive treatment and the safest option for the mother, which confronts clinicians with the challenge of preterm birth at very early gestational age. Study suggested that babies whose mothers were in the subgroup of expectant treatment had lower intraventricular haemorrhage, respiratory distress caused by hyaline membrane disease and higher gestation at birth [15]. Moreover, more advanced gestational age at delivery was associated with favourable neonatal outcome [16]. Therefore, the American College of Obstetricians and Gynaecologist (ACOG) Task Force on Hypertension in Pregnancy mentioned that EP without severe features may have benefits from expectant management of inpatient or outpatient [17]. Nevertheless, factors affecting expectant management have not been adequately studied, and as one of the most common complications of EP, there is no literature concerning whether expectant treatment can improve the development of FGR. Therefore, this retrospective study is conducted to estimate the factors affecting expectant treatment of EP patients, and investigate the influence of expectant treatment on FGR.
Pulmonary toxicity induced by exposure to phthalates, an experimental study
Published in Inhalation Toxicology, 2019
Our results also showed a significant increase in the number of Type-II pneumocytes in DEHP-treated animals with disturbed lamellar bodies, which was also reported in a similar study (Rosicarelli and Stefanini 2009). Type-II Pneumocytes are responsible for the production and secretion of surfactant, which reduces alveolar surface tension and stabilizes alveolar units for effective gas exchange. Furthermore, the surfactant may be engaged in the development of the inflammatory process (Glasser and Mallampalli 2012). Surprisingly, in children affected by hyaline membrane disease, increased type-II pneumocytes have occasionally seen a pathology that contributes to DEHP leakage from PVC tubes (Lassus et al. 2001). Increased number of type-II pneumocytes may be dependent on delayed differentiation into flattened type-I pneumocytes or may be due to increased cell proliferation. In this study, however, we have noticed many mitotic figures in type-II pneumocytes that could be due to the effect of peroxisome proliferation (Stefanini et al. 1995). Additionally, the chronic inflammatory process stimulates mesenchymal stem cells in the bone marrow to differentiate into type-II pneumocytes (Wu et al. 2011), resulting in an increase in their number.
A pre-term infant of 32 weeks gestation with congenital tuberculosis treated successfully with antituberculosis chemotherapy
Published in Paediatrics and International Child Health, 2018
Xiaoyi Fang, Ruizhi Mai, Jizhong Guo, Niyang Lin
An infant girl was born by vaginal delivery in Shenzhen Kengzi Hospital at 32 weeks gestation. The Apgar scores were 9 at 1 and 10 at 5 min. Her birthweight was 1.7 kg (10th–50th percentile). She was separated from her mother and treated for prematurity and hyaline membrane disease. On day 25, she developed apnoea and poor response to stimuli. The white blood cell (WBC) count was 19.78 × 109/L with 78% neutrophils, and C-reactive protein (CRP) was 83.5 mg/L (0–8 mg/L). Chest radiograph showed bilateral patches of pulmonary infiltrates suggestive of pneumonia. She received intravenous immunoglobulin (2 g/kg) and several antibiotics (ceftazidime, piperacillin–tazobactam, meropenem, vancomycin, imipenem and linezolid in that order) because of delayed response and the symptoms eventually settled. The infant was discharged on day 44 and was cared for by her adoptive parents.