Acta paediatrica
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To determine the relation between the level of initial neonatal care and in-hospital mortality of infants born before 33 wk of gestation in the era of surfactant therapy. ⋯ In-hospital mortality in non-teaching level III units was similar to that in a teaching unit, but significantly higher in level I-level II units. Neonatal care of newborns delivered before 33 wk of gestation should initially occur in level III units.
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To investigate whether the serum levels of interleukin-1beta, 6, 8, tumour necrosis factor-alpha and the soluble receptor of IL-2 are useful in the diagnosis of neonatal sepsis, and whether their diagnostic power is increased when in combination with classical markers such as C-reactive protein and white blood cell count. ⋯ Our study suggests that no individual test can on its own identify infected neonates, and that although the combination of C-reactive protein, interleukin-8 and the soluble receptor of interleukin-2 exhibits a high specificity, its sensitivity is limited.
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Comparative Study
Effect of perinatal asphyxia on thyroid-stimulating hormone and thyroid hormone levels.
To compare serum concentrations of thyroid hormones--T4, T3, free T4 (FT4) and reverse T3 (rT3)--and thyroid-stimulating hormone (TSH) found in the umbilical cord blood of term newborns with and without asphyxia and those found in their arterial blood collected between 18 and 24 h after birth. A further aim of the study was to assess the association between severity of hypoxic-ischemic encephalopathy and altered thyroid hormone and TSH levels, and between mortality and FT4 levels in the arterial blood of newborns between 18 and 24 h of life. ⋯ Serum concentrations of TSH, T4, T3 and FT4 are lower in asphyxiated newborns than in normal newborns between 18 and 24 h of life; this suggests central hypothyroidism secondary to asphyxia. Asphyxiated newborns with moderate/severe hypoxic-ischemic encephalopathy present a greater involvement of the thyroid function and consequently a greater risk of death.
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Comparative Study
Procalcitonin and interleukin-6 in the diagnosis of early-onset sepsis of the neonate.
The reliability of procalcitonin (PCT) and interleukin-6 (IL-6) was determined and compared with that of C-reactive protein (CRP) in the diagnosis of early-onset sepsis of the neonate within the first 12 h of life. ROC analysis of values of 41 neonates with blood-cultures-positive and clinical sepsis compared with those of 27 uninfected neonates revealed sensitivities for PCT (> or = 6 ng/mL), IL-6 (> or = 60 pg/mL), and CRP (> or = 2.5 mg/L) of 77%, 54%, and 69% and specificities of 91%, 100% and 96%, respectively. Sensitivity of CRP at > or = 8 mg/L was 49% (p = 0.012 compared to PCT). ⋯ PCT was the most sensitive diagnostic parameter in the diagnosis of early-onset sepsis within 12 h of life.
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To assess whether axillary temperature measurements reliably reflect oral/rectal temperature measurements. ⋯ Axillary temperatures in young children do not reliably reflect oral/rectal temperatures and should therefore be interpreted with caution.