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Background: The study aims to describe the lingual laser frenotomy perioperative protocol for newborns with ankyloglossia with or without breastfeeding difficulties developed by Odontostomatology and Neonatology and Neonatal Intensive Care Units of the Aldo Moro University of Bari. Methods: Authors carried out a prospective observational cohort study. Newborns with ankyloglossia (classified by using both Coryllos' and Hazelbaker's criteria) with or without difficult breastfeeding (according to Infant Breastfeeding Assessment Tool) underwent diode laser frenotomy (800 ± 10 nm; 5 W; continuous wave mode; contact technique; under topical anesthesia) and follow-up visits after seven and thirty days postoperatively. The authors analyzed as main outcomes the perioperative pain intensity measured by the C.R.I.E.S. scale, the occurrence of complications and quality of healing, the quality of breastfeeding, newborn's postoperative weight gain, maternal nipple pain, and the presence of lesions as secondary outcomes. Results: Fifty-six newborns were included in the current study. Intraoperative mean pain intensity was 5.7 ± 0.5 points, resolved within thirty postoperative minutes. Observed complications were mild punctuating bleeding, carbonization of the irradiated site, and transitory restlessness. All wounds were completely healed within the thirtieth postoperative day. During follow-up, a significant breastfeeding improvement was evident with satisfactory newborns' weight gain and a significant reduction of nipple pain and lesions (p <.05). Conclusion: Our lingual laser frenotomy protocol provided significant breastfeeding improvement in the mother-newborn dyads with low intraoperative pain and no significant complications. [ABSTRACT FROM AUTHOR]

Pneumothorax in newborns can be life-threatening. The traditional treatment of pneumothorax is chest drain placement. Recently, modified pigtail catheter has been proposed as a less traumatic approach despite limited experience in infants. To compare the effectiveness and safety of pigtail catheters versus traditional straight chest drains in term and preterm infants with pneumothorax, in two tertiary neonatal units: Policlinico Hospital in Bari, IT and John Radcliffe Hospital in Oxford, UK. We retrospectively reviewed medical records of 47 newborns with pneumothorax admitted to the two units between October 2009 and June 2017, and treated with either pigtail catheters or straight chest drains. Three newborns (6.7%) were excluded from the study because they were treated with both types of drains. The remaining 44 neonates were included in the analysis. Overall, 56.8% (n = 25/44) of pneumothoraces were drained with pigtail catheters and 43.2% (n = 19/44) with straight drains. No differences in gestational age and birth weight were found. The success rate, defined as complete radiological resolution of the pneumothorax after drainage, was significantly higher in the pigtail group (96.0% versus 73.7%; p < 0.05). Days of drainage, length of hospital stay and duration of respiratory support were not significantly different. Subcutaneous emphysema and drain dislodgement/malfunction occurred only in the straight drain group (0.0% versus 11.1%; p = 0.181). No significant differences in mortality between the two groups were found (28.0% pigtail group versus 26.3% straight drain group; p > 0.05).Conclusion: Pigtail catheters are a safe and effective alternative to traditional chest drains for infants with pneumothorax. What is Known:• Air leaks in newborns can represent an emergency, especially among preterms;• The first treatment in a life-threatening pneumothorax is thoracentesis with needle aspiration or placement of a chest drain.What is New:• Pigtail catheter have been described as an alternative to traditional chest drains;• Pigtail catheters are a safe and effective alternative to traditional chest drains for infants with pneumothorax. [ABSTRACT FROM AUTHOR]

Kasabach-Merritt Syndrome (KMS) is a rare clinical entity, found in 1% of angiomatous lesions, characterized by severe consumption coagulopathy/thrombocytopenia in association with highly aggressive neonatal vascular lesions. We describe a case of prenatally diagnosed vascular neoformation of the neck, revealed by obstetric ultrasound and then confirmed by fetal Magnetic Resonance, with subsequent onset of KMS at birth. The newborn was treated with Propanolol and Prednisone, without any benefit; Magnetic Resonance (MRI) at day 14 of life confirmed the hypervascularized lesion of about 6x7x6 cm on the right laterocervical site. Sirolimus therapy was then initiated leading to rapid improvement in thrombocytopenia and a volumetric reduction of the vascular lesion on MRI. After 12 months of treatment, MRI scan showed a further reduction in volume of the vascular lesion; also, the KMS-related thrombocytopenia was completely resolved: Sirolimus could represent the first line of treatment of vascular lesions in the neonatal age. [ABSTRACT FROM AUTHOR]

Chromosome 14q11-q22 deletion syndrome (OMIM 613457) is a rare genomic disorder whose associated phenotype is heterogeneous, depending on the size, and, mostly, on the deleted region. We report the clinical and molecular characterization of a female newborn, whose phenotype was characterized by poor growth, dysmorphic facial features, subclinical hypothyroidism, and mild reduction of CD3CD8 Lymphocytes with increased CD4/CD8 ratio. By array-CGH, we identified a 4.08 de novo interstitial deletion of the 14q13.2q21.1 region, which includes 16 OMIM genes.Our patient phenotype is compared with other published cases, for a better classification of the 14q11-q22 deletion syndrome. We demonstrated that the 14q13.2q21.1 deletion, which encompasses NKX2-1, but not FOXG1 gene and HPE8 region, identifies a well defined, more benign, microdeletion syndrome. This report confirms that an early identification with accurate characterization of the genomic disorders is of great relevance, enabling proper genetic counseling of the reproductive risk, as well as disease prognosis, and patient management. © 2016 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

The relationship between serum uric acid (UA) and cardiovascular risk profile was investigated in 557 outpatients (415 women) aged 60 years and older. Patients were grouped according to a UA cutoff level of 5.5 mg/dL. Prevalence of obesity, hypertension, and impaired glucose metabolism was increased in women with higher UA, who had higher body mass index (37.7±6.9 vs 33.1±5.9 kg/m(2) , P<.001), waist circumference, and serum glucose and triglyceride concentrations than women with lower UA levels. Conversely, men with higher UA levels showed lower high-density lipoprotein cholesterol and higher left ventricular mass than men with lower UA levels. Estimated glomerular filtration rate was reduced in patients with high UA levels of both sexes (65±17 vs 72±16 mL/min/1.73 m(2) , P<.001, for women; 70±16 vs 76±15 mL/min/1.73 m(2) , P<.03, for men). Grouping patients by sex-specific median UA concentrations produced similar results. These data indicate that, even in the elderly, UA clusters in a sex-specific fashion with features of metabolic syndrome and signs of target organ damage. [ABSTRACT FROM AUTHOR]

Congenital third-degree (complete) atrioventricular block requires pacemaker implanta-tion where prenatal hydrops, low ventricular rate (<45 bpm) non-response to inotropes, and/or left ventricular dysfunction is present. A permanent pacemaker was implanted in a 1200g 9 day old preterm: the smallest newborn successfully subjected to this procedure, according to literature. [ABSTRACT FROM AUTHOR]

Cystic hygroma and lymphangioma, currently defined as 'lymphatic malformations', are developmental abnormalities of the lymphoid system with potential for rapid expansion. The management of these abnormalities depends on the site and extent of the lesion. A different disease is diffuse lymphangiomatosis. It is very rare at birth and its treatment remains controversial. A lymphatic malformation (cystic hygroma) of the neck of a newborn girl as the first sign of diffuse lymphangiomatosis and treatment of the latter condition with sirolimus are presented. A newborn girl with a presumed isolated lymphatic malformation of the neck and significant respiratory involvement was diagnosed via total-body nuclear magnetic resonance imaging to be affected by diffuse lymphangiomatosis; she was treated with sirolimus. The treatment with sirolimus was found to be very effective, with complete resolution of the disease, good tolerability, and no side effects. This report suggests the need to explore the possibility of diffuse lymphangiomatosis in neonates with apparently isolated lymphatic malformations. In the presence of clinical deterioration, sirolimus treatment may achieve excellent results with no adverse events., (© 2015 S. Karger AG, Basel.)