We postulate that the increase in plasma and consequently urinary inositol may constitute a marker of altered glucose metabolism during fetal development in both IUGR and LGA newborns.

Osteoarticular infections, although uncommon, represent a severe condition in neonates. Infections in newborns are largely of an acute nature, transmitted by hematogenous means. The most frequently observed etiological agents are: Staphylococcus aureus, Gram negative and group B Streptococcus spp. In the majority of cases the metaphyses of the long bone are the most commonly implicated sites, although infection may spread to the contiguous epiphysis and joint in neonates. Diagnosis of acute septic arthritis and osteomyelitis may be hindered, especially in neonates, due to the manifestation of less clear-cut characteristic symptoms and signs compared to in children. When osteomyelitis is suspected, imaging techniques used in association with blood and tissue cultures are the most reliable diagnostic tests. Antimicrobial treatment should be administered for 3-4 weeks, initially intravenously, later switching to oral medication. Surgery is indicated to drain acute abscesses or when no improvement is achieved following antibiotic treatment.

KEYWORDSDysplasia of the hip; Ultrasound; Newborn; Screening; DDH.Abstract Introduction: Developmental dysplasia of the hip (DDH) is the most frequent inborn deformity of the locomotor apparatus. Ultrasound screening is frequently used to identify DDH in view of the brevity of the preclinical period during which diagnosis is possible. Appropriate therapeutic intervention during this period can positively affects the evolution of the disorder. Methods: An unselected population of 1158 Sardinian neonates underwent ultrasound examinations of both hips, and findings were classified according to the method described by Graf. Patients were assessed by means of retrospective analysis to reveal cases of congenital dislocation of the hip joint. All cases were classified and treatment outcomes determined. Results: A total of 145 hips requiring treatment were observed in 122 children. Hip dysplasia and/or dislocation were diagnosed between the ages of 14 days and 3 months. One month after diagnosis ultrasound findings were normal in 94% of the infants with at least one hip classified as type 2a. The remaining 6% were classified as types 2b, 2c, D, and 3. All were treated with abduction splints, and normal hip development was observed after one or two months of treatment. Type 4 hips were referred to an orthopedic surgeon for specialist treatment. Conclusions: When performed by skilled operators, ultrasonographic techniques are of considerable value in prescribing treatment for DDH. The satisfactory prognosis associated with early treatment of severe congenital dislocation of the hip joint underlines the advisability of scheduling routine hip screening programs to ensure early diagnosis and effective treatment of the disorder.Sommario Introduzione: La displasia evolutiva dell'anca (DDH) costituisce la deformità più frequente dell'apparato locomotore. Lo screening ecografico è la metodica più utilizzata nell'identificazione della DDH, considerando la brevità del periodo in cui la diagnosi è possibile prima della comparsa dei sintomi clinici. Un intervento terapeutico appropriato precoce può avere un effetto positivo in relazione all'evoluzione di tale patologia. Metodi: L'esame ecografico, la sua valutazione, la classificazione e la tipizzazione delle anche sono stati effettuati secondo il metodo descritto dal Graf. I pazienti sono stati valutati per mezzo di un'analisi retrospettiva volta a identificare i casi di DDH. Tutti i casi sono stati classificati e in base a ciò si è deciso il tipo di trattamento da attuare. Risultati: Complessivamente sono state osservate 145 anche in 122 bambini che presentavano un certo grado di displasia. L'età alla diagnosi variava da 14 a 90 giorni con una media di 52 giorni di vita. Un mese dopo la diagnosi ecografica le anche di tipo 2a, sia bilaterali che unilaterali, sono risultate normali nel 94%. Il restante 6% così come i tipi 2b, 2c, D e 3 sono stati trattati con un divaricatore e la guarigione completa è stata ottenuta dopo due mesi di trattamento. Il tipo 4 è stato monitorato esclusi...

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