Lenticulostriate vasculopathy (LSV) is a relatively common fi nding in routine cranial ultrasound examination that has been associated with many infectious and non-infectious conditions. The aim of this review was to provide a better understanding of LSV ultrasound fi nding, as well as the need for further laboratory and imaging examinations in infants. The most of the published studies represented small series, with few prospective long-term studies involving the control groups. Authors have mostly found an association between LSV, especially higher-grade (although there is no universally accepted classifi cation) with congenital cytomegalovirus (CMV) infection, classifying those children as at risk for sensorineural hearing loss. In contrast, some authors pointed out that LSV could be found relatively often, and believe that isolated LSV, especially lower-grade, is not predictive for an unfavourable outcome and a long-term prognosis. Therefore, although 35 years have passed since the first publication of LSV, there is still no consensus among experts on the clinical signifi cance of isolated LSV, but caution is certainly needed given the fact that most infants with congenital CMV are asymptomatic.

Prematurity is a risk factor for respiratory syncytial virus (RSV)-associated lower respiratory tract infections (LRTIs), due to immature humoral and cell-mediated immune system in preterm newborns, as well as their incomplete lung development. Palivizumab, a humanized monoclonal antibody against the F glycoprotein of RSV, is licensed for the prevention of severe RSV LRTI in children at high risk for the disease. This study is a part of a larger observational, retrospective-prospective epidemiological study (PONI) conducted at 72 sites across 23 countries in the northern temperate zone. The aim of our non-interventional study was to identify common predictors and factors associated with RSV LRTI hospitalization in non-prophylaxed, moderate-to-late preterm infants, born between 33 weeks and 0 days and 35 weeks and 6 days of gestation, and less than 6 months prior to or during the RSV season in Bosnia and Herzegovina (B&H). A total of 160 moderate-to-late preterm infants were included from four sites in B&H (Sarajevo, Tuzla, Mostar, and Banja Luka). We identified several significant intrinsic and extrinsic factors to be associated with the risk of RSV LRTI hospitalization in the preterm infants, including: comorbidities after birth, shorter hospital stay, admission to NICU/PICU while in the maternity ward, household smoking, low maternal age, breast feeding, number of family members, and history of family/paternal atopy. Overall, our results indicated that the risk of RSV LRTI in preterm newborns can be associated with different environmental and social/cultural factors, and further research is needed to comprehensively evaluate these associations.

Objective: To assess predictive value of blood lactate measurements in infants during therapeutic hypothermia due to moderate to severe asphyxia in relation to early outcome. Patients and methods: We retrospectively evaluated records of 47 full-term newborns that underwent therapeutic hypothermia after moderate to severe perinatal asphyxia from January 2011 to December 2015. Criteria for whole body cooling were established according to Bristol Cooling Protocol UK, including clinical signs of HIE using Sarnat&Sarnat scale and aEEG. Blood samples were taken from venous catheter in recommended intervals (3, 6, 12, 24, 48, 72 hours). Early outcome is evaluated on the base of survival rate, neurologic status at discharge and presence of post hypoxic lesions confirmed with brain MRI. All investigated infants were categorized into 3 groups 1) Infants with normal brain MRI finding and normal neurologic examination at the discharge; 2) Infants with abnormal brain MRI finding at the discharge (with 2 subgroups depending of neurological status at the discharge); 3) Newborns with lethal outcome. Results: Mean value of blood lactate at admission for all subjects was 11.87 ± 5.41 (3.224.0), without statistical difference between groups. Three hours after beginning of cooling mean value was 8.36 ± 3.70 (2.2-17.0) with statistical difference between all groups of survived infants compared to infants who died. After 6 and 12 hours mean values were 6.311 ± 3.69 and 6.269 ± 3.37 respectively with statistical difference between neurologically asymptomatic infants (including those with MRI finding interpreted as a mild lesion) compared to infants with abnormal neurological examination at the discharge and infants who died. Values of blood lactate after 24h, 48h and 72 h were 4.46 ± 2.00 (1.0–11.7), 3.60 ± 1.36 (1.6–6.9), 3.36 ± 1.93 (1.29.3) respectively. After 24 h we did not find statistical difference between groups. Conclusion: Serial measurements of blood lactate during therapeutic hypothermia in asphyxiated infants are important. Initial value of lactate is not proved to be predictive, but prompt decreasing of lactate values within 24 hours of cooling is associated with better early outcome. *Correspondence to: Suada Heljić, MD, PhD, NICU, Pediatric Clinic, Clinical University Center Sarajevo, Bosnia and Herzegovina, Tel: +387 61 865 285 (M), +38733566439 (W); E-mail: heljicsuada@hotmail.com

Objective: The aim of this study was to analyze prognostic indicators for mortality in neonates with seizures in a level III Neonatal Intensive Care Unit (NICU). Patients and methods: A cohort of 100 neonates with clinically manifested seizures hospitalized in the NICU during 4 years period was prospectively monitored for the first year of life. The cohort consisted of 33 preterm and 67 full-term babies with 60 male and 40 female infants. Results: The mortality rate in the first year of life of infants with seizures in the neonatal period was 23%. The most common cause of seizures was birth asphyxia for full-term infants and intra-periventricular hemorrhage for preterm infants. Death was more common in pre-term than term infants (p <0,005). Simple regression demonstrated statistically significant associations between death in the first year of life and a cluster of highly associated variables: resuscitation (p<0, 01), mechanical ventilation (p<0,01) and asphyxia (p<0,05). This cluster of variables significantly correlates with: gestational age (p<0, 05), birth weight (p<0, 05) and intracranial hemorrhage (p<0, 05). Conclusion: In this cohort of neonates with seizures asphyxia requiring neonatal resuscitation was the primary risk factor for death.

Background: necrotizing enterocolitis is a serious condition that affects mostly preterm infants, with high mortality rate. Aim: to estimate the influence of potentially contributing factors of this multifactorial disease. Methods: the study group included 51 necrotizing enterocolitis infants who were less than 37 week gestation who were hospitalized in NICU during a five year period. The control group consisted of 71 patients with approximately the same gestational age and birth weight. Average gestational age in the study group was 30.2 weeks (SD 3.7), average birth weight 1502g (SD 781.5). Average postnatal age in the time of the presenting NEC was 18.2 days (SD 12.8). Results: Logistic regression estimates the influence of risk factors, which in our study related to the treatment of preterm infants on the likelihood of NEC development. Our regression model consisted of seven independent variables (nosocomial infections, mechanical ventilation, nasal continuous positive pressure, morphine, inotropes, blood transfusions, and H2 blockers), which were shown to have a statistically significant impact, X2 (7, n=1222) = 49.522, p<0.0001; two independent variables (nosocomial infection and H2 blockers use) were statistically significant. Preterm infants with nosocomial infection had a three times greater chance of developing NEC, and infants who received H2 blockers had a 1.5 higher risk. Conclusions: Underlying pathology of very low birth weight infants and their treatment in NICU contribute to NEC development. Identifying risk factors can be crucial for the early diagnosis and outcome of disease. Awareness of risk factors should influence changes in practice to reduce the risk of NEC.