Dislocated hips showed significantly lower values for all of the evaluated parameters concerning congruency and containment. MRI is not only useful to confirm successful reduction but may also help to predict outcome by evaluating following dislocation.

ABSTRACT:The optimal thermal environment for sick preterm infants is unknown. Incubator temperature can be regulated to an abdominal wall temperature of 36.5°C [neutral temperature (NT)] or to a minimal temperature difference (Ͻ2°C) between abdominal wall and extremities [comfort temperature (CT)]. This could affect the microcirculation, particularly in infants with impaired perfusion. We assessed the microvascular perfusion with near-infrared photoplethysmography (NIRP) at these two target temperatures between d 1 and 4 of life in preterm infants with normal (NL group) or impaired (RED group) microcirculation as determined by a clinical score. Signal strength variables such as area under the curve (AUC) and the first derivate of the amplitude (FLUX) were calculated. Starting temperature was randomized to NT or to CT and then followed by the other temperature. A significant increase of FLUX and AUC in the RED group was found with NT as starting temperature (FLUX: 282 Ϯ 76 at NT versus 627 Ϯ 211 at CT; p ϭ 0.025; AUC: 73 Ϯ 47 at NT versus 234 Ϯ 112 at CT; p ϭ 0.009), but not with CT. In NL infants, both parameters did not change significantly. Increasing the incubator temperature to CT changes thermoregulatory flow to the extremities in preterm infants with impaired microvascular perfusion and might improve tissue flow. T he optimal thermal environment for nursing sick preterm infants is not known. Neutral thermal zone is traditionally defined as a range of environmental temperatures within which the metabolic rate is minimal and thermoregulation is achieved by nonevaporative means (1,2). NT corresponds to a body surface temperature of about 37°C above the liver, in accordance with a core temperature of approximately 36.5°C regardless of the temperature of the extremities (3,4). CT is defined as a minimal temperature difference between the abdominal wall and the extremities (Ͻ2°C) (3). CT corresponds to an approximate core temperature of 37°C and higher and is close to an intrauterine temperature of 38°C (2,4).Changes in body temperature of about 1°C are primarily associated with changes in total peripheral skin blood flow (5). In term infants with NL exposed to phototherapy an increase of 224% in skin blood flow has been observed using electrocapacitance plethysmography (6). The effect of incubator temperature on circulation and microcirculation of preterm infants with signs of an impaired peripheral microcirculation (e.g. mottled skin) has not yet been reported. In the present study, we compared the effect of different incubator temperatures (NT and CT) on indices of peripheral blood flow in preterm infants matched for gestational age either with infants showing clinical signs of an impaired microcirculation or those without such signs. Microcirculation was assessed noninvasively with NIRP (7).Photoplethysmography was first described by Hertzman and Spealman in 1937 (8). It is a noninvasive technique consisting of a red/infrared light-emitting diode and a photosensitive detector (9). The emitted light is eithe...

This study shows good initial results after Ponseti treatment for idiopathic as well as non-idiopathic clubfeet. Based on the good functional results all clubfeet should initially be treated with the Ponseti method regardless of the etiology.

Even though infants were transfused at very low levels of hemoglobin with significant clinical effects, microcirculation assessed by NIRP seemed not be affected. Infrared photoplethysmographs present flow not only in the nutritive capillaries but mainly in the subpapillary plexus at a greater depth. This thermoregulatory flow seems not be affected by blood transfusions of anemic infants.