Archives of disease in childhood
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One hundred and two cases of neonatal cancers, representing 2% of all paediatric malignancies, were seen during a 60 year period at The Hospital for Sick Children, Toronto, Canada. The neonatal cancers included neuroblastoma (47%), retinoblastoma (17%), soft tissue sarcoma (12%), central nervous system tumours (9%), leukaemia (8%), and a few cases of Wilms' tumour, liver tumour, and miscellaneous tumours. The overall mortality from disease was 41%. ⋯ There was one instance of second malignancy of the thyroid gland induced by radiation. We conclude that although neonatal cancers are difficult management problems, many patients can be cured. Physicians should discuss with parents the possible risks associated with treatment before treatment is begun.
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We describe a simple technique of neonatal ventilation that induces the neonate to breathe in synchrony with the ventilator. This preserves the beneficial effects of spontaneous respiration (unlike therapeutic paralysis) and reduces potentially harmful interactions between baby and ventilator. The technique uses measurements of the neonate's own respiratory timing.
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Randomized Controlled Trial Clinical Trial
Breast milk jaundice in premature infants.
In randomised study of 186 preterm infants those fed on maternal or banked breast milk had a significantly higher peak bilirubin concentration and a more prolonged jaundice than infants fed an artificial preterm formula and were over four times more likely to achieve plasma bilirubin values above 200 mumol/l (11.7 mg/100 ml). This dietary effect was seen even in a high risk subgroup of sick ventilated infants below 1500 g who were receiving restricted enteral intakes. We suggest that breast milk jaundice in preterm infants may increase clinical intervention. Our findings are discussed in the light of epidemiological data suggesting an association between moderate hyperbilirubinaemia (greater than 170 mumol/l) and neurodevelopmental outcome.
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A case of ampicillin and chloramphenicol resistant Haemophilus influenzae meningitis successfully treated with cefotaxime is described.
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We report two cases of meningitis due to Haemophilus influenzae type b resistant to ampicillin and chloramphenicol. In one child the meningitis was preceded by pneumonia and pleural effusion. Both children responded to treatment with cefotaxime.