Neonate Health Dictionary

An antibiotic derived from a soil organism, Streptomyces venezuelae. It is also prepared synthetically. A potent broad-spectrum antibiotic, chloramphenicol may, however, cause serious side-effects such as aplastic ANAEMIA, peripheral NEURITIS, optic neuritis and, in neonates, abdominal distension and circulatory collapse. The drug should therefore be reserved for the treatment of life-threatening infections such as Haemophilus in?uenzae, SEPTICAEMIA or MENINGITIS, typhoid fever (see ENTERIC FEVER) and TYPHUS FEVER, when the causative organism proves resistant to other drugs. However, because it is inexpensive, it is used widely in developing countries. This antibiotic is available as drops for use in eye and ear infection, where safety is not a problem.... chloramphenicol

A commonly occurring virus of the herpes virus group – the name derived from the swollen appearance of infected cells (‘cytomegalo’ = large cell). The infection is usually asymptomatic (or like mild in?uenza), but it can cause an illness similar to infectious MONONUCLEOSIS. Most people (80 per cent) will have had CMV infection by the time they are adults, but the virus can remain latent in the body and cause recurrent infections. During an acute infection the virus is excreted in saliva, breast milk and urine as well as from the vagina, and this may continue for years. CMV is transmitted naturally by saliva or during sexual contact, but blood transfusions and organ transplantations are also infection routes. Although CMV rarely causes its host any problems, when it is passed from an infected mother to her fetus in utero or to an infant during birth (from vaginal secretions) or via breast milk postnatally, the virus causes a generalised severe infection in the infant. This can involve the central nervous system and liver, causing death of the fetus or neonate. If the infant survives it may be mentally retarded, with motor disabilities, deafness and chronic liver disease. In England and Wales about 400 babies a year are born with CMV-induced disabilities. If an adult is immunode?cient (see IMMUNODEFICIENCY) because of HIV infection/AIDS or as a result of immunosuppressive treatment after an organ transplant, he or she may become seriously ill.... cytomegalovirus (cmv)

A disorder in which the skin is permanently dry and scaly. It is usually genetically determined and several di?erent forms are recognised:

Ichthyosis vulgaris Common and inherited as a dominant trait. Beginning in early childhood, it is often associated with atopic eczema (see DERMATITIS). The limb ?exures and face are spared.

X-linked ichthyosis is much less common, more severe and appears earlier than ichthyosis vulgaris. The ?sh-like scales are larger and darker and do not spare the ?exures and face.

Ichthyosiform erythroderma Of two types and very rare: in the recessive form, the appearance at birth is of the so-called ‘collodion baby’; in the dominant form the baby is born with universally red, moist and eroded skin with an unpleasant smell. Gradually, over several months, thick scales replace the ERYTHEMA.

Treatment Minor forms are helped by constant use of EMOLLIENTS and moisturising applications. Cream containing UREA can be valuable. The rare erythrodermic patterns in the neonate require skilled intensive care as thermoregulation is disturbed and massive ?uid loss occurs through the skin. Later in childhood, oral RETINOIDS are useful.... ichthyosis

Body proteins that act as antibodies. 1. IgG: The immunoglobulin that can be measured in the serum approximately two weeks after a challenge by an antigen. Can cross the placenta from mother to foetus. 2. IgM: The immunoglobulin that can be measured very soon after a challenge by an antigen. The level returns to a non-measurable level very quickly and so this measurement is useful as a test for recent envenomation (or illness). Cannot cross the placenta from mother to foetus. Presence in a neonate therefore indicates infection of the body. 3. IgE: Reaginic antibody; immunoglobulin found in association with allergic or homocytotrophic responses. 4. IgA: Secretory antibody; immunoglobulin found in nonvascular fluids, such as the saliva, bile, aqueous humor, synovial fluide etc.... immunoglobulins

A rare disease, although the causal organism, Listeria monocytogenes, is widely distributed in soil, silage, water, and various animals, with consequent risk of food contamination – for example, from unpasteurised soft cheese. Neonates are mainly affected – often as a result of a mild or inapparent infection in the pregnant mother. The disease presents in two main forms: MENINGOENCEPHALITIS, or SEPTICAEMIA with enlarged LYMPH glands. Elderly adults occasionally develop the ?rst form, while younger adults are more likely to develop a mild or even inapparent form. The disease is treated with ANTIBIOTICS such as ampicillin (see PENICILLIN) or CHLORAMPHENICOL.... listeriosis

OXYGEN toxicity in human lungs causes an acute OEDEMA followed by ?brosis and PULMONARY HYPERTENSION. In the neonate, retrolental ?broplasia occurs and centralnervous-system damage may result in the infant having ?ts. Several factors are involved in toxicity and there is no absolute relationship to time or concentration, although inspired concentrations of under 50 per cent are probably safe for long periods.... oxygen toxicity

adj. capable of living a separate existence. The legal age of viability of a fetus is 24 weeks, by virtue of the Abortion Act 1967 (as amended), but some fetuses now survive birth at an even earlier gestational age due to advances in neonatal medicine and technologies. The treatment of very premature neonates can raise issues of *personhood, *quality of life, and resource allocation. —viability n.... viable

Linn. var. piperascens Holmes.

Family: Labiatae; Lamiaceae.

Habitat: Cultivated in Jammu and Kashmir.

English: Japanese Mint.

Unani: Naanaa.

Action: Carminative, chola- gogue, expectorant, antibacterial, antifungal.

Key application: Mint oil— internally for flatulence, functional gastrointestinal and gallbladder disorders; catarrhs of the upper respiratory tract. Externally, for myalgia and neuralgia. (German Commission E.)

Major components of the essential oil are menthol (up to 95%) and men- thone. Others are alpha-and beta- pinene, alpha-thujene, l-limonene, beta-phellandrene, furfural, methyl- cyclohexanone and camphene. The essential oil possesses both antibacterial and antifungal properties.

The leaves show anti-implantation effect. Seeds showed abortifacient activity (29%) in albino rats with marked malformations in neonates where pregnancy was not terminated.... mentha arvensis

Sleep is a state which alternates with wakefulness, and in which awareness and responsiveness to the environment are reduced. It is not, however, uniform and can be divided into two main states di?erentiated according to electrical recordings of brain activity (EEG), of the muscles (EMG), and of the eye movements (EOG).

Non-rapid-eye-movement (NREM) sleep This is subdivided into four stages, of which stage 1 is the lightest and stage 4 the deepest. The activity of the cerebral cortex (see BRAIN) is diminished and the body’s functions are mainly regulated by brain-stem activity. The metabolic rate is reduced; in keeping with this the temperature falls, respiration is reduced, cardiac output, heart rate, and blood pressure fall, and activity of the sympathetic nervous system is reduced. NREM sleep normally occurs at the onset of sleep except in neonates. During adult life, the duration – particularly of stages 3 and 4 – of NREM sleep becomes less, and very little of this deep sleep occurs after the age of 60 years.

NREM sleep has been thought to have several functions, such as energy conservation and growth. Growth hormone is produced in bursts during stages 3 and 4, and more cell division occurs during this type of sleep than during wakefulness. A controversial proposal has been that processing of information acquired during wakefulness occurs during NREM sleep.... sleep

Whooping-cough, or pertussis, is a respiratory-tract infection caused by Bordetella pertussis and spread by droplets. It may occur at all ages, but around 90 per cent of cases are children aged under ?ve. Most common during the winter months, it tends to occur in epidemics (see EPIDEMIC), with periods of increased prevalence occurring every three to four years. It is a noti?able disease (see NOTIFIABLE DISEASES). The routine vaccination of infants with TRIPLE VACCINE (see also VACCINE; IMMUNISATION), which includes the vaccine against whooping-cough, has drastically reduced the incidence of this potentially dangerous infection. In the 1990s over 90 per cent of children in England had been vaccinated against whooping-cough by their second birthday. In an epidemic of whooping-cough, which extended from the last quarter of 1977 to mid-1979, 102,500 cases of whooping-cough were noti?ed in the United Kingdom, with 36 deaths. This was the biggest outbreak since 1957 and its size was partly attributed to the fall in vaccination acceptance rates because of media reports suggesting that pertussis vaccination was potentially dangerous and ine?ective. In 2002, 105 cases were noti?ed in England.

Symptoms The ?rst, or catarrhal, stage is characterised by mild, but non-speci?c, symptoms of sneezing, conjunctivitis (see under EYE, DISORDERS OF), sore throat, mild fever and cough. Lasting 10–14 days, this stage is the most infectious; unfortunately it is almost impossible to make a de?nite clinical diagnosis, although analysis of a nasal swab may con?rm a suspected case. This is followed by the second, or paroxysmal, stage with irregular bouts of coughing, often prolonged, and typically more severe at night. Each paroxysm consists of a succession of short sharp coughs, increasing in speed and duration, and ending in a deep, crowing inspiration, often with a characteristic ‘whoop’. Vomiting is common after the last paroxysm of a series. Lasting 2–4 weeks, this stage is the most dangerous, with the greatest risk of complications. These may include PNEUMONIA and partial collapse of the lungs, and ?ts may be induced by cerebral ANOXIA. Less severe complications caused by the stress of coughing include minor bleeding around the eyes, ulceration under the tongue, HERNIA and PROLAPSE of the rectum. Mortality is greatest in the ?rst year of life, particularly among neonates – infants up to four weeks old. Nearly all patients with whooping-cough recover after a few weeks, with a lasting IMMUNITY. Very severe cases may leave structural changes in the lungs, such as EMPHYSEMA, with a permanent shortness of breath or liability to ASTHMA.

Treatment Antibiotics, such as ERYTHROMYCIN or TETRACYCLINES, may be helpful if given during the catarrhal stage – largely in preventing spread to brothers and sisters – but are of no use during the paroxysmal stage. Cough suppressants are not always helpful unless given in high (and therefore potentially narcotic) doses, and skilled nursing may be required to maintain nutrition, particularly if the disease is prolonged, with frequent vomiting.... whooping-cough

(NAS) symptoms and signs exhibited by a newborn baby (neonate) due to drug withdrawal (see dependence). This results when the fetus has been exposed to addictive drugs through maternal substance abuse or misuse. Symptoms tend to occur in the first few days of life (in the case of methadone, which is a long-acting opioid, symptom onset may be delayed). They include tremors and jerking, high-pitched crying, sneezing, sucking of fists, feeding difficulties, shortened periods of sleep between feeds, rapid breathing, sweating, loose stools, nasal stuffiness, and frequent yawning. Treatment includes swaddling or snugly wrapping in a blanket, as babies with NAS are often difficult to comfort. Other nonpharmacological measures include frequent small feeds using high-calorie formula and intravenous fluids if babies become dehydrated. Drug therapy may be used for seizures and withdrawal symptoms.... neonatal abstinence syndrome