European journal of pediatrics
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Limbs ischaemia represents a rare event during the neonatal period. The present paper reports an unusual case of precocious arm ischemia that occurred immediately after birth and successfully treated with a peripheral nerve blockade. ⋯ Peripheral nerve blockade resulted in an effective and safe therapeutic approach able to allow the salvaging of the limbs.
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Reticulocyte indices are easy to obtain, low cost parameters and have gained interest in the field of diagnosing anaemias of childhood. ⋯ Age, IDA and beta-thal significantly affect reticulocyte indices. CHr and micro_r may have a role as screening tools in discriminating between IDA and beta-thal heterozygosity.
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Congenital cytomegalovirus infection is the most common cause of nonhereditary sensorineural hearing loss and an important cause of psychomotor retardation. Earlier studies showed that 6-weeks' treatment with ganciclovir, starting in the neonatal period, prevented hearing deterioration at 6 months, but in one-fifth of the infants, the effect was not sustained at age 12 months. The aim of this preliminary retrospective study was to investigate the effectiveness and safety of long-term treatment with ganciclovir/valganciclovir for congenital cytomegalovirus infection. ⋯ Four of the children (18%) had mental retardation. The main side effect of treatment was transient neutropenia. In conclusion, prolonged therapy of symptomatic congenital CMV infection with intravenous ganciclovir followed by oral valganciclovir is safe, and it appears to lead to a better auditory outcome than short-term treatment.
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Case Reports
Cushing's syndrome and adrenal insufficiency after intradermal triamcinolone acetonide for keloid scars.
A 6-year-old girl was admitted to our hospital for excessive weight gain. On presentation, she had a typical Cushingoid appearance and hypertension. ⋯ Recovery of intrinsic cortisol production occurred 12 months after the last steroid dose. Intradermal triamcinolone acetonide for keloid scars in children should be used with care taking into account the here reported complication.
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Pulse oximetry screening (POS) has been proposed as an effective, noninvasive, inexpensive tool allowing earlier diagnosis of critical congenital heart disease (cCHD). Our aim was to test the hypothesis that POS can reduce the diagnostic gap in cCHD in daily clinical routine in the setting of tertiary, secondary and primary care centres. We conducted a prospective multicenter trial in Saxony, Germany. ⋯ With POS as an adjunct to prenatal diagnosis, physical examination and clinical observation, the percentage of newborns with late diagnosis of cCHD was 4.4%. POS can substantially reduce the postnatal diagnostic gap in cCHD, and false-positive results leading to unnecessary examinations of healthy newborns are rare. POS should be implemented in routine postnatal care.