Basic principles of enteral feeding in premature infants

То optimize the feeding of preterm infants is now one of the priority areas in neonatology and pediatrics because neonatal malnutrition has a negative impact on the health and development of a preterm infant, including on those at a later age. Current recommendations for the enteral feeding of preterm infants are based on the knowledge of their anatomic and physiological features and the need to prevent a menacing disease, such as necrotizing enterocolitis. The feeding of preterm infants at any gestational age with their mother's native breast milk is most optimal. Recommendations for breast milk enrichment are warranted for preterm infants with higher nutrient requirements. The paper presents the differential algorithms and regimens for the feeding of preterm infants with both breast milk and milk formulas depending on many factors, such as gestational age, birth weight, and clinical status

Congenital cytomegalovirus infection: Diagnosis, treatment, and prevention

Congenital cytomegalovirus infection is an infectious disease that results from antenatal transplacental transmission of cytomegalovirus to a fetus. The above virus is the most common cause of congenital infections worldwide. Congenital cytomegalovirus infection may develop both after primary infection of a seronegative pregnant women (primary) and due to reactivation of the virus or reinfection with other virus strains during pregnancy (non-primary). In the neonatal period, 85-90% of children infected in utero are observed to have an asymptomatic or subclinical course of the disease. In other cases, the clinical picture is characterized by lesions of various organs and by frequent CNS involvement. In its severe course, the disease is treated with antiviral drugs that are so far referred to as an “off-label” group. Even in the absence of symptoms in the neonatal period, the babies infected with CMV in utero may develop late sequels, with hearing loss being most common. Preschool hearing control and ophthalmologic and neurologic monitoring are recommended for the timely treatment and rehabilitation of late manifestations of congenital cytomegalovirus infection. The important strategy to reduce the incidence of congenital cytomegalovirus infection is its prevention in pregnant women, by disseminating information about the disease in the publicly accessible sources of information and by teaching simple hygienic practices

Wilson—Mikity syndrome is a rare chronic neonatal interstitial lung disease

The Wilson—Mikity syndrome is a neonatal interstitial lung disease of unknown etiology, which occurs between 1 and 2 months of age and which is characterized by late development of oxygen dependency. The paper gives information on the possible etiological factors, pathogenesis, pathomorphology, and clinical, X-ray, and CT patterns of this rare lung disease. Analysis of 61 cases described in the literature from 1960 to 2008 established the relationship of the manifestations of the syndrome to age and degree of prematurity, as well as disease outcomes. The authors give the results of their observations of 7 patients with Wilson—Mikity syndrome, including the pattern of high-resolution computed tomography

Umbilical cord blood glucose levels in full-term newborns

The purpose of the investigation was to determine the umbilical cord venous blood level of glucose in full-term newborns and its relationship to the mode of delivery. The investigation included 102 full-term newborn infants, including 33 and 69 babies born via cesar-ean and vaginal delivery, respectively. Umbilical cord serum glucose levels were determined by the glucose oxidase test using a Sap-phire-400 biochemical analyzer. In healthy full-term newborns, the mean umbilical cord blood glucose levels were 4,29±0,88 mmol/1 (minimum, 2,9 mmol/1 and maximum, 5,9 mmol/1). In the babies born via cesarean delivery, the umbilical cord blood concentration of glucose was ascertained to be significantly lower than in those born vaginally (3,84+0,71 mmol/1 versus 4,51+0,87 mmol/1; /><0,0001). Abdominal delivery can be apparently considered to be a risk factor for hypoglycemia in neonatal infants

Microbial colonization and nosocomial infections in preterm infants in the neurosurgical hospital

Work is devoted to studying of microbial colonization and infection associated with health care in preterm infants with severe intraventricular hemorrhage (IVH) to evaluate the formation of antibiotic-resistant strains and the choice of treatment. In preterm with IVH complicated by progressive hydrocephalus revealed different variations of the colonization of hospital microorganisms, which changed over hospital treatment. The main microorganisms, which colonized mucosa of oropharynx, respiratory tract and intestines, were Gram negative bacteria multiresistant to antibiotics. In patients receiving long-term antibiotic therapy (1,5 months or more), despite the use of antifungal drugs, appeared fungal flora; in 15% of cases — types of Candida non-albicans. The cause of nosocomial ventriculitis in infants with post-hemorrhagic hydrocephalus in 70% had Gram positive organisms, in 30% — combined bacterial and fungal infection. When choosing a treatment strategy for these children must take into account the results of microbiological studies and antibiogram

Clinical case of Mitochondrial DNA Depletion

The article reports clinical case of early neonatal manifestation of a rare genetic disease – mitochondrial DNA depletion syndrome, confirmed in laboratory in Russia. Mutations of FBXL4, which encodes an orphan mitochondrial F-box protein, involved in the maintenance of mitochondrial DNA (mtDNA), ultimately leading to disruption of mtDNA replication and decreased activity of mitochondrial respiratory chain complexes. It’s a reason of abnormalities in clinically affected tissues, most of all the muscular system and the brain. In our case hydronephrosis on the right, subependimal cysts of the brain, partial intestinal obstruction accompanied by polyhydramnios were diagnosed antenatal. Baby’s condition at birth was satisfactory and worsened dramatically towards the end of the first day of life. Clinical presentation includes sepsis-like symptom complex, neonatal depression, muscular hypotonia, persistent decompensated lactic acidosis, increase in the concentration of mitochondrial markers in blood plasma and urine, and changes in the basal ganglia of the brain. Imaging of the brain by magnetic resonance imaging (MRI) demonstrated global volume loss particularly the subcortical and periventricular white matter with significant abnormal signal in bilateral basal ganglia and brainstem with associated delayed myelination. Differential diagnosis was carried out with hereditary diseases that occur as a «sepsis-like» symptom complex, accompanied by lactic acidosis: a group of metabolic disorders of amino acids, organic acids, β-oxidation defects of fatty acids, respiratory mitochondrial chain disorders and glycogen storage disease. The diagnosis was confirmed after sequencing analysis of 62 mytochondrial genes by NGS (Next Generation Sequencing). Reported disease has an unfavorable prognosis, however, accurate diagnosis is very important for genetic counseling and helps prevent the re-birth of a sick child in the family

Asymmetrical mechanical behavior of a precipitation hardened beta titanium alloy

Precipitation hardened single crystals of a beta (bcc) Ti-40 at. pct V + 1.0 at. pct Si alloy have been deformed in compression at 77 K and 298 K. The dependence of the yield stress upon aging time at 843 K for solution treated crystals shows two maxima which are caused by silicide precipitates. The orientation dependence of the yield stress and of the active macroscopic slip plane have been determined as a function of aging time. The solution treated as well as aged crystals exhibit an asymmetry of both the yield stress and the plane of slip, the degree of asymmetry being larger at 77 K than at 298 K. The asymmetry of slip and yielding is not affected by the presence of precipitation hardening. The results indicate that the effect of the dislocation core structure on dislocation motion is independent of the presence of precipitates