The kidney is structurally and biochemically immature at birth. As a consequence, renal function is low (3;10;ll;18). Glomerular filtration rate (related to body surface area or to body weight) is approximately 25% of that in adults. The capacity of several different tubular transport systems is lower in the infant than in the adult (2;5;13;21;28). A low transporting capacity of the neonatal kidney will sometimes result in undesired losses of electrolytes, amino acids, and peptides. The capacity to concentrate urine is low (7;29), and disturbances of serum tonicity, therefore, are common. The low concentrating capacity can be attributed to renal immaturity. The capacity of the newborn fullterm as well as preterm infant to release antidiuretic hormone is normal 7;31).

Methods of meta-analysis, computer modeling, and issue analysis are used to answer four key questions related to efficacy, cost, and political feasibility of legislating insurance coverage for mammography. The findings are presented, and the strengths and weaknesses of the combined use of these methods to inform policy debate at the regional level are discussed.

In a review of the literature concerning the nutritional needs of newborn infants in intensive care, one surprisingly finds that only a few studies on this subject have been performed. This is in contrast to the extensive literature regarding the nutritional needs of healthy, growing newborn infants. It is astonishing, further, to find that there are many reports on the metabolic effects of illness in adults but hardly any on those in children and newborn infants. In fact, in a recent textbook of pediatric intensive care, in the chapter on nutrition and metabolism in the critically ill child, the authors state, “the metabolic derangements that occur in children have not been well delineated during critical illness, so that data and findings discussed have been taken mostly from the adult literature.”

The introduction of noninvasive imaging techniques allowed diagnosis of intracranial pathology in the newborn infant during life, which previously was only possible at postmortem. This has stimulated new interest in correlating pathology with the pathophysiological changes that lead to these events, the neurological signs associated with them, and their ultimate effect on the neurological state of the survivors.

In spite of major developments in prenatal supervision, perinatal asphyxia remains an important reason for the development of brain damage (18). Epidemiological investigations suggest that perinatal asphyxia actually represents a factor of increasing frequency as a cause of severe cerebral injury (9).