Background: Congenital brain tumors are very rare. We review these tumors in patients younger than 2 months diagnosed in our Department. Methods: Seven congenital brain tumors were diagnosed during 5 years. Clinical and radiological findings and prognosis were analyzed. Results: The study included 5 female and two male infants. Two cases were diagnosed antenatally by means of ultrasonography. All patients presented with intracranial hypertension. All neuroimaging studies revealed nonhomogenous tumors with cystic and solid components, except for the case with choroid plexus papilloma (CPP). Hydrocephalus was evident in all of them. Most were infratentorial lesions. There were three teratomas, one primitive neuroectodermal tumor, one ependymoblastoma and one CPP. Six patients were operated on, with one intraoperative death. Two passed away postoperatively with aspiration pneumonia. One patient died due to complications of chemotherapy and another one due to tumor recurrence 1 year after surgery. Only the patient with CPP is alive after 2 years. Conclusions: Today, the availability of noninvasive imaging procedures such as computerized tomography scan and magnetic resonance imaging has improved the diagnosis of congenital brain tumors. In spite of development in prenatal diagnosis, appropriate pre- and postoperative management, the mortality associated with these tumors still remains high. The final prognosis in these patients is still discouraging despite early surgery and operative and anesthetic improvements. CPP is accompanied by the best prognosis, whereas teratoma and primitive neuroectodermal tumors have the worst prognosis.

BackgroundThe existing therapeutic methods for neonatal jaundice are costly, time-consuming and potentially risky. Zinc salts can reduce phototherapy duration by precipitating unconjugated bilirubin in the intestine (bilirubin and zinc can form a complex in physiologic pH); however, zinc toxicity is an issue that must be considered since theoretically bilirubin reduction by phototherapy may increase serum zinc levels, making additional zinc supplementation the potential cause of zinc toxicity.ObjectivesSo, our purpose was evaluating the serum zinc level alterations before and after phototherapy, in hyperbilirubinemic newborns.Materials and MethodsA prospective cohort study was performed at the children’s medical center of Tehran University of Medical Sciences from 2012 to 2014. Healthy, full-term exclusively breast fed newborns with non-hemolytic jaundice were enrolled in the study. Participants were divided into two groups based on serum bilirubin levels (TSB < 18 mg/dL and TSB ≥ 18 mg/dL) at admission. Pre- and post-phototherapy total serum zinc level was measured before and 12 - 24 hours after termination of phototherapy.ResultsPhototherapy was associated with a significant increase in the serum zinc level in neonates with severe hyperbilirubinemia (TSB ≥ 18 mg/dL) but not in those with mild-moderate hyperbilirubinemia (TSB < 18 mg/dL). In addition, phototherapy caused a significant increase in the rate of zinc with potentially toxic levels (zinc > 200) in only neonates with severe hyperbilirubinemia.ConclusionsPhototherapy increases serum zinc level by reducing bilirubin level so that additional supplementation of this element can lead potentially to zinc toxicity.

A case of purulent spinal epidural abscess in a 20-day-old girl is presented. The patient had symptoms of fever, localized back pain and swelling over the interscapular area. The diagnosis was made by magnetic resonance imaging. Purulent material grew Staphylococcus aureus from the lesion. Because of severe cord compression surgical laminotomy and drainage were performed, and antibiotics were administered. One year later she was doing well without neurologic sequelae.

Background: Infections include an important cause of neonatal death. The gold standard of diagnosis is a culture that should be obtained from suspected sites. The basis of treatment is antibiotic therapy. It should start as soon as possible for preventing any subsequent complications. Choosing the appropriate antibiotic for empirical treatment is important. Methods: In this study, patients who were admitted to the neonatal wards of a Children's Hospital Medical Center for infections with positive blood, CSF, or urine culture were studied during a two-year period. Results: Ninety-two newborns that had positive cultures were included in the study. Concerning the site of infection, 27.9% of positive blood cultures and 54.1% of urinary tract infections were sensitive to aminoglycosides (P value = 0.026). However, there was no significant relationship between the infection site and sensitivity to cephalosporins. Based on the bacterial species, 76.1% of Gram-negative infections were sensitive to aminoglycosides but 40.4% to cephalosporins (P value = 0.052). Conclusions: According to the relationship found in the study, aminoglycosides can safely start in case of a higher probability of urinary tract infections and Gram-negative infections as empirical treatment.