Pyridoxal 5'-phosphate may be curative in early-onset epileptic encephalopathy

Neonatal epileptic encephalopathy can be caused by inborn errors of metabolism. These conditions are often unresponsive to treatment with conventional antiepileptic drugs. Six children with pyridox(am)ine-5'-phosphate oxidase (PNPO) deficiency presented with neonatal epileptic encephalopathy. Two were treated with pyridoxal 5'-phosphate (PLP) within the first month of life and showed normal development or moderate psychomotor retardation thereafter. Four children with late or no treatment died or showed severe mental handicap. All of the children showed atypical biochemical findings. Prompt treatment with PLP in all neonates and infants with epileptic encephalopathy should become mandatory, permitting normal development in at least some of those affected with PNPO deficiency.

Apophysenausriss der Tuberositas tibiae und Fraktur der dorsalen Tibiakopfepiphyse

Avulsion fractures of the tibial tuberosity are rare. In general, juvenile male athletes sustain this fracture. A combination of Ogden type 3A fracture in combination with a posterior fracture of the proximal tibial epiphysis type Salter 2 is described for the first time. The necessity for immediate surgical intervention to prevent secondary soft tissue injury is stressed.

Monte Carlo results for continuum percolation in low and high dimensions

We report on Monte Carlo simulations of continuum percolation thresholds, by implementing highly efficient algorithms for very large samples. Our work, which includes percolation of hyperspheres, hypercubes, and boxes, in various dimensions, sizes, and shapes, has confirmed the expected dependence of the threshold on Vex, the total excluded volume, and on Bc, the average number of bonds per site. We have further confirmed that Vex=Bc, and that Bc is dependent on the objects shape, for which we offer a possible explanation. In particular we find that, counterintuitively, one can have Bc<1, as we have found for hyperspheres of dimension > or =12. From our many results for differently sized hyperspheres, we were also able to derive the correlation length exponent v solely from the behavior of the thresholds using finite-size scaling.

[Congenital intestinal lymphangiectasia: a rare differential diagnosis in hypoproteinemia in infants]

BACKGROUND

Congenital intestinal lymphangiectasia is a rare disease in childhood, which may already cause protein-losing enteropathy in newborns.

PATIENT, METHODS AND RESULTS

This is a case report of an infant with generalized edema and protein-losing enteropathy, in whom intestinal lymphangiectasia was diagnosed at the age of two months. Following repetitive intravenous albumin und gamma globulin infusions, the elimination of long-chain fats from the diet and the substitution with medium-chain triglycerides (MCT) led to an improvement of the protein-losing enteropathy.

CONCLUSION

In newborns with low level of serum protein and edema protein-losing enteropathy caused by congenital lymphangiectasia might be considered as a differential diagnosis.