To determine the incidence of hospital readmissions in late preterm and term neonates, the most common reasons for readmission, and analyze the risk factors for readmission in the neonatal period. Newborn infants admitted to a well-baby nursery ≥ 36 weeks gestation were included in this retrospective cohort study. Data for all infants born in a 3-year period and readmitted in the first 28 days of life were analyzed. Indication for readmission was one diagnosed during initial workup in the pediatric emergency room visit before readmission. The final cohort consisted of 5408 infants. The readmission rate was 4.0% (219/5408). Leading readmission causes were respiratory tract infection (29.58%), jaundice (13.70%), and urinary tract infection (9.59%). The mean ± SD age of readmitted infants was 13.3 ± 7.1 days. The mean ± SD treatment duration of treatment was 5.5 ± 3.0 days. In the multivariate regression analysis, infants that were during the initial hospitalization transferred to special care/NICU had a lower chance of readmission during the neonatal period (p = 0.04, OR = 0.23, 95% CI 0.06–0.93). Infants with mothers aged from 19–24 years had a higher risk of readmission (p = 0.005, OR = 1.62, 95% CI 1.16–2.26). Finding that infants that were during the initial hospitalization transferred to special care or a NICU setting were less likely to require hospitalization in the neonatal period is an interesting one. Further research into how different approach in these settings reduce the risk of readmission is necessary.

Objective: To assess the accuracy of umbilical cord bilirubin values to predict jaundice in the first 48 h of life and neonatal infection. Method: Newborn infants treated at a regional well-baby nursery born at ≥36 weeks of gestation were included in this retrospective cohort study. All infants born in a 3-year period from mothers with O blood type and/or Rh-negative were included and had the umbilical cord bilirubin levels measured. Hyperbilirubinemia in the first 48 h was defined as bilirubin levels above the phototherapy threshold. Neonatal infection was defined as any antibiotic treatment before discharge. Results: A total of 1360 newborn infants were included. Two hundred and three (14.9%) newborn infants developed hyperbilirubinemia in the first 48 h of life. Hyperbilirubinemic infants had smaller birth weight, higher levels of umbilical cord bilirubin, a higher rate of infection and were more often direct antiglobulin test positive. Umbilical cord bilirubin had a sensitivity of 76.85% and a specificity of 69.58% in detecting hyperbilirubinemia in the first 48 h, with the cut-off value at 34 μmol/L. The area under the receiver operating characteristic (ROC) curve was 0.80 (95% CI: 0.78–0.82). Umbilical cord bilirubin had a sensitivity of 27.03% and specificity of 91.31% in detecting perinatal infection. The area under the receiver operating characteristic (ROC) curve was 0.59 (95% CI: 0.57–0.63). Conclusions: A positive correlation was found between umbilical cord bilirubin and hyperbilirubinemia in the first 48 h of life. Umbilical cord bilirubin is a poor marker for predicting neonatal infection.

Introduction: Saul Wilson syndrome (SWS) is a rare congenital syndrome characterized by a variety of symptoms, mostly skeletal changes. Saul and Wilson were the first to describe children with extremely short stature and craniofacial dysmorphism. Case report: We present a case of a 15-years-old boy with clinical and radiological characteristics of SWS. Genetic examination identified a pathogenic heterozygous variant in the COG4 gene. Magnetic resonance imaging revealed a critical stenosis of the cranio-cervical junction (CCJ) which required surgical treatment to attempt sufficient neurological decompression. The patient underwent decompression of CCJ under general anesthesia. There was no significant radiological and clinical improvement during the postoperative period. Conclusions: SWS is presented as an extremely rare congenital disease in children. The clinical condition of our patient confined surgical possibilities, therefore further treatment in such patients should be appropriately evaluated.

To analyse placental changes in infants’ gestational age < 34 weeks and its correlation to short-term respiratory outcomes or death until hospital discharge. Information regarding all in-house born preterm infants born before 34 weeks gestation and born from January 2009 until December 2014 were collected and included among others, placental pathology and relevant data on demographics and outcomes of infants. Placental abnormalities was found in 157/253 (65.05%) cases. Acute placental inflammation was found to be the most common in both groups of premature neonates, followed by maternal vascular underperfusion. Maternal vascular underperfusion was significantly more common in GA ≤ 27 weeks compared to infants GA 28–33 weeks (35.2% vs. 13.7%; p = 0.018). Similarly, chronic placental inflammation was more common in infants GA ≤ 27 weeks compared to infants GA 28–33 weeks (14.3% vs. 3.3%; p = 0.014). Infants with placental pathology had a lower median birth weight (1460g vs. 1754g; p = 0.001, and were of shorter median GA at birth (31 vs. 32; p = 0.001). Infants with any placental disease had higher rates of death until hospital discharge (10.2% vs. 3.1%; p = 0.039) and higher rates of any stage of bronchopulmonary dysplasia (41.4% vs. 26.0%; p = 0.013). There were no significant differences in mechanical ventilation rates, duration of mechanical ventilation and duration of supplemental oxygen therapy. Identifiable placental abnormalities were found in most infants born < 34 weeks gestation. Placental pathology is associated with increased rates of bronchopulmonary dysplasia and death until hospital discharge.

Fetal hydrops is an accumulation of fluid in more than one extravascular space. Congenital chylothorax is a rare cause of non-immune fetal hydrops, and the prognosis is generally very poor. There is no consensus on the optional treatment of congenital chylothorax. Conservative treatments (low-fat high-protein diets with medium-chain triglycerides, total parenteral nutrition) and surgical interventions are performed. There is mounting evidence for the use of octreotide (a somatostatin analog) in cases nonresponsive to conservative treatment, but no specific recommendation as to the dose and the length of therapy exist so far. We report a male, late preterm newborn, with a birth weight of 3600 grams, born to a Caucasian 28-year-old secundigravida via cesarean section because of poor fetal biometric markers at 35 3/7 week gestation. Neonate was born with congenital chylothorax and severe non-immune hydrops. After the therapeutic failure of enteral low long-chain triglyceride formula and full parenteral nutrition in reducing chyle leak, the patient was treated with octreotide and shown rapid improvement. We conclude that octreotide treatment is a plausible therapeutic option before surgical treatment in patients with congenital chylothorax.

Background: The stigmatization of viral patients is primarily a negative attitude and a common opinion about people suffering from various infectious diseases of the viral etiology and their consequences. The belief and the attitude that individuals are not socially acceptable because potentially spreading contagion for the outcome has negative discrimination in our society. Often such persons are excommunicated, which extends through all the social layers and ages. Methods: The PubMed, ScienceDirect, and SpringerLink databases were used for the research. Keywords stigma, viral infection, infected patient, discrimination, isolation were entered to identify papers dealing with a viral infection, and stigmatization. Results: After screening available databases in the last five years according to the selected keywords, the PubMed database yielded nine articles, the ScienceDirect identified initially 87 articles, SpringerLink identified 42 articles. Viral infection and stigmatization are of interest to numerous scientists. Conclusion: The availability of information should create empathy and ensure openness to diversity. Following the available literature, we understand that the biggest problem today is the social exclusion of people due to their viral illness, but equally the self-isolation of those infected due to the fear of being rejected and the misunderstanding of people from the environment.