Cardiovascular malformations and brain growth

Cerebral development may be impaired in fetuses with congenital heart defects, particularly hypoplastic left heart syndrome and aortopulmonary transposition. In his Integrated Mechanism Review, Rudolph proposes that cerebral development might be adversely impacted by reduced glucose delivery instead of reduced oxygen. Impaired cerebral development in fetuses with congenital cardiovascular malformations: Is it the result of inadequate glucose supply?

Ultrasound-guided CVC insertion

Literature regarding ultrasound (US)-guided central venous catheter (CVC) placement in children remains limited and conflicting. Lau and Chamberlain’s meta-analysis examined the efficacy and safety of US-guided CVC placement among pediatric patients. Eight randomized clinical trials involving 760 patients were analyzed. US guidance of CVC insertion increased success rates by 31.8% and decreased the mean number of attempts required. A trend toward a decrease in the risk of accidental arterial puncture with the use of US-guided CVC insertion was also observed. Ultrasound-guided central venous catheter placement increases success rates in pediatric patients: a meta-analysis

Brain imaging in encephalopathy

Tann and colleagues evaluated cranial ultrasound (cUS) scans of term infants with and without neonatal encephalopathy from a national referral hospital in Kampala, Uganda. Major evolving brain injury was reported in 21.2% of cases vs 1.0% of controls, and a major abnormality seen on early cUS indicated a significantly higher risk of neonatal death; the case fatality among those with a major abnormality was 53.9%. In this low-resource setting, there was no evidence of established antepartum insult, but in a high proportion of encephalopathic infants, early cUS imaging showed evidence of evolving brain injury. Early cranial ultrasound findings among infants with neonatal encephalopathy in Uganda: an observational study

Genetics of opiate addiction and ADHD

Polymorphisms in certain genes have been linked to attention deficit hyperactivity disorder (ADHD) and susceptibility to opiate addiction. Ornoy et al. investigated genetic markers that might predict susceptibility to ADHD and/or opiate addiction in opiate-addicted parents and their children. They examined the DNA of 64 heroin-addicted parents taking methadone and that of their children who had or had not been exposed to opiates prenatally. The results showed that serotonergic and dopaminergic risk alleles seem to be related mainly to opiate dependence, with no influence on the occurrence of ADHD. ADHD risk alleles associated with opiate addiction: study of addicted parents and their children

Local anesthetics and fetal neutrophils

Whether local anesthetics exert anti-inflammatory effects in fetal and newborn systemic neutrophils is unclear. Billert and coauthors assessed the effects of bupivacaine and lidocaine on the respiratory burst of cord blood neutrophils in vitro compared with adult cells. Whole cord blood and control adult blood samples were incubated with bupivacaine and lidocaine. After one hour of incubation, the anesthetics decreased the respiratory burst in whole cord blood and adult neutrophils in a similar manner. Effects of local anesthetics on the respiratory burst of cord blood neutrophils in vitro

Paneth cells in the developing gut

Little is known about the perinatal development of Paneth cells (PCs) during gestation and its relationship to necrotizing enterocolitis (NEC). Heida and colleagues investigated when PCs arise and when they become immune-competent during gestation. They performed semiquantitative assessments of PC numbers in samples of ileum tissue of fetuses and infants. The number of immune-competent PCs increased significantly starting at 29 weeks of gestation, which corresponds to the peak incidence of NEC at a postmenstrual age of 29–33 weeks. Paneth cells in the developing gut: when do they arise and when are they immune competent?