Heart rate (HR) and heart rate variability (HRV) in newborns is influenced by genetic determinants, gestational and postnatal age, and other variables. Premature infants have a reduced HRV. In neonatal HRV evaluated by spectral analysis, a dominant activity can be found in low frequency (LF) band (combined parasympathetic and sympathetic component). During the first postnatal days the activity in the high frequency (HF) band (parasympathetic component) rises, together with an increase in LF band and total HRV. Hypotrophy in newborn can cause less mature autonomic cardiac control with a higher contribution of sympathetic activity to HRV as demonstrated by sequence plot analysis. During quiet sleep (QS) in newborns HF oscillations increase – a phenomenon less expressed or missing in premature infants. In active sleep (AS), HRV is enhanced in contrast to reduced activity in HF band due to the rise of spectral activity in LF band. Comparison of the HR and HRV in newborns born by physiological vaginal delivery, without (VD) and with epidural anesthesia (EDA) and via sectio cesarea (SC) showed no significant differences in HR and in HRV time domain parameters. Analysis in the frequency domain revealed, that the lowest sympathetic activity in chronotropic cardiac chronotropic regulation is in the VD group. Different neonatal pathological states can be associated with a reduction of HRV and an improvement in the health conditions is followed by changes in HRV what can be use as a possible prognostic marker. Examination of heart rate variability in neonatology can provide information on the maturity of the cardiac chronotropic regulation in early postnatal life, on postnatal adaptation and in pathological conditions about the potential dysregulation of cardiac function in newborns, especially in preterm infants.

BackgroundEarly postnatal period is characterized by dramatic adaptation changes of cardiovascular and respiratory systems in newborns. There is still insufficient data regarding maturation of autonomic regulatory mechanisms in neonates early after delivery. Aim of this study was to analyze cardiac autonomic regulation in newborns within the first few postnatal days in relation to different modes of delivery using time and spectral heart rate variability analysis.MethodsEutrophic healthy term newborns (n = 46) were divided into three groups according to the delivery mode: vaginal delivery (VD group; n = 16), vaginal delivery with epidural analgesia (EDA group; n = 16), and caesarean section under general anesthesia (CS group; n = 14). Heart rate variability (HRV), blood pressure (BP), and blood oxygen saturation (SpO2) were measured within the first two hours after birth and on the third to fourth postnatal day. HRV parameters were evaluated in the time domain (RR intervals, mean square of successive differences – MSSD) and frequency domain (total spectral power – TP, absolute and relative low and high frequency powers).ResultsThe HRV spectral analysis showed significantly higher relative power of the high-frequency band (HF%) in the VD group compared to the CS group early after delivery (p = 0.002). HRV parameters and BP significantly increased on the third to fourth postnatal day in all groups (p < 0.05). No significant differences in basic characteristics, BP and SpO2 were identified between groups during both measurements.ConclusionsHRV analysis revealed higher cardiovagal modulation in spontaneously born newborns without analgesia compared to neonates born by caesarean section. It could represent a potential pathomechanism that leads to discrete abnormal neurocardiac regulation associated with higher risk for worsened postnatal adaptation of cardiovascular system in surgically delivered neonates.

A b s t r a c tSkin aging has become an area of increasing research interest in dermatovenerology. Changes in the skin associated with aging can be detected by high -frequency 20 MHz ultrasonography, which is a useful diagnostic technique allowing reliable imaging of cutaneous and superficial subcutaneous structures.Skin thickness is considered an objective parameter providing assessment of the influence of endogenous or exogenous factors, such as ultraviolet (UV) or infrared (IR) rays. Except for the changes in the skin thickness, there are also specific structural changes in the dermis of older subjects -subepidermal low echogenic band (SLEB) -that is a manifestation of photoaging severity. The main aim of this study was to identify and characterize the specific ultrasonographic changes of the cutaneous structure related to age and degree of photo exposure (the presence and measurement of SLEB).

We report a 2-year-old patient with Netherton syndrome presenting with generalized exfoliative erythroderma, ichthyosiform dermatitis, trichorrhexis invaginata, hypernatremic dehydration, failure to thrive, and recurrent respiratory infections. Molecular analysis of SPINK5 identified a novel mutation (c.1530CA). Our case report also verifies and supports the safety and efficacy of subcutaneous immunoglobulin substitution in chronic generalized skin disorders associated with primary immunodeficiencies such as Netherton syndrome.

Doppler impedance indices, such as the resistive index (RI) and pulsatility index (PI), are commonly used to characterise resistance to the flow in the vascular system. Chemical restraint can potentially affect these indices, although in some patients such restraint is necessary before ultrasonographic examination. The objective of this study was to compare ocular vascular velocity parameters, measured using Doppler imaging, in healthy conscious cats and in cats after administration of a combination of anaesthetics (butorphanol, medetomidine and ketamine). Twelve healthy cats of different breeds and both sexes were studied using Doppler imaging. The long posterior ciliary arteries in both eyes were examined. Mean comparison tests (paired and unpaired t-test) were used to determine whether any significant differences existed between right and left ocular indices and between sexes. A correlation study was applied between RI, PI and body weight. There were no significant differences in RI and PI between left and right eyes. Values also did not significantly differ among males and females. The RI and PI in long posterior ciliary arteries of cats anaesthetised with butorphanol, medetomidine and ketamine were significantly lower than those of healthy conscious cats. There was no correlation between impedance indices and body weight.