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Query: UMLS:C0029713 (immaturity)
 4,335 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In 1989 E. Gluckman reported the successful cord blood transplantation in a boy with Fanconi anemia. Since then more than 1500 allogeneic cord blood transplantations have been performed worldwide. This has been possible because non-profit cord blood banks have been established that provide cryopreserved cord blood products from unrelated donors. However, cord blood transplantation is associated with specific risks that have sofar limited its more widespread use. Its main problem is the limited stem cell dose that is associated with a long aplasia and a high rate of engraftment failure. Therefore, cord blood is used as the stem cell source in only about 1 - 2 % of stem cell transplantations in childhood. The main advantage of cord blood transplantation lies in its low risk for graft-versus-host-disease (GvHD), one of the major causes for posttransplant morbidity and mortality particularly with unrelated stem cell donors. The low risk for GvHD is attributed to the low number of transplanted T cells and their functional immaturity. Another advantage of cord blood transplantation lies in the immediate availability of the cord blood units. Based on the experiences with allogeneic cord blood transplantation the indications for cord blood donation will be discussed.
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PMID:[Current state of cord blood transplantation in childhood]. 1216 1

This paper presents a study of adolescent pregnancy in which different age groups were compared to establish which age group had the greatest incidence of risk factors. Primiparous adolescents who delivered at the Obstetric Clinic of the Medical School of the University of Sao Paulo, Brazil, between January 1975 and June 1980 were studied. During this period, 13,961 births occurred, of which 105 were to 9-15 year olds (0.7%), 137 were to 16 year olds (0.9%) and 106 were to 17 year olds (0.7%). A large majority of the adolescents in each age group were unmarried; similarly, a lack of adequate prenatal care was observed in all 3 groups. A gestational age of less than 38 weeks was encountered in 30.5% (30 cases), and 16.9% (18 cases), respectively, in the 9-15, 16, and 17 year age groups. Among pregnancy complications, there was an elevated incidence of arterial hypertension in all 3 groups, as well as an increased occurrence of eclampsia among the 9-15 year olds. Urinary infections and anemia were also evident during pregnancy. Analgesia was required in 22 cases (20.9%) of the 9-15 year old age group, in 3 cases (2.2%) of the 16 year age group, and in 2 cases (1.9%) of the 17 year age group. Fetal presentation, duration of labor, type of birth (normal, forceps, or cesarean), puerperal morbidity, birth weight, and perinatal mortality for each of the 3 groups are presented in tables. Neonatal deaths were determined to be the consequence of prematurity and its complications except in 1 case of congenital heart disease which occurred in the 17 year old group. Neonatal jaundice was the most frequent cause of morbidity in the newborns. The results of this study agree with those of similar studies appearing in the literature. The authors attribute the greater frequency of premature births among 9-16 year olds to immaturtity of uterine muscle fiber, deficient prenatal care, and the emotional tensions to which the adolescents were subjected, as well as to medical complications of pregnancy and general maternal physical immaturity. The 17 year olds presented behavior closer to that of the adult population.
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PMID:[Pregnancy in the adolescent. II. Comparative study between primigravida from 9 to 15, 16 and 17 years old]. 1226 72

In India, there has been a declining trend in teenage pregnancy between 1977-79 and 1981-84. Teenage pregnancy tends to occur within marriages, often arranged by parents, and few pregnancies occur among unmarried teenagers. There are nevertheless concerns about the higher rates of nutritional and obstetric problems associated with adolescent pregnancy and the ignorance and immaturity which can result in higher morbidity and mortality among mothers and babies. The change to a minimum age of 18 years for marriage has been suggested as a means of reducing the number of adolescent pregnancies. The study sample included 5994 deliveries in the rural health district area of Sirur, Maharashtra state, India, between 1981 and 1984. Adolescent pregnancies (to women under 20 years old) amounted to 598 deliveries, or 10% of deliveries. The perinatal mortality rate among teenage first births to high-risk mothers (238) under 18 years old was 67.2 per 100 births; the neonatal mortality rate was 61.4. Risk factors such as prolonged labor, short stature, and anemia were associated more with women under 18 years old. Statistically significant differences were found in the rate of low birth weight infants, stillbirths, and late neonatal deaths among women aged under 18 years compared to other women. The perinatal mortality rate was 7-16 times greater when associated risk factors, except anemia, were present. The neonatal mortality rate was 2.5-18 times greater when associated risk factors, except anemia and edema, were present. Late neonatal mortality was 2.2 times higher among infants with mothers under 18 years old. Recommendations were to provide general health education about risks of teenage pregnancy, strictly enforce the minimum age at marriage law, screen all pregnant mothers for risk factors, and provide at-risk mothers with education about child bearing and rearing and referral to a hospital for safe delivery. Referrals are particularly important among first pregnancies among women under 18 years old with multiple risk factors.
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PMID:Risk of teen-age pregnancy in a rural community of India. 1234 28

Transient hyperinsulinism (HI) occurs in infants born to diabetic mothers, in infants experiencing perinatal asphyxia and in infants with intrauterine growth retardation. The precise mechanism of transient HI in these different aetiologies is not fully understood. Lactic acidosis is commonly seen in neonates as a secondary phenomenon due to hypoxia, hypovolaemia, anaemia and infection. The combination of transient HI and lactic acidosis is rare. We present the clinical and biochemical features of five infants presenting with transient HI associated with hyperlactataemia in the absence of markers of perinatal stress. This combination lasted for 3-4 weeks with complete resolution except in one patient in whom the hyperinsulinism lasted until 6 months before resolution. The precise mechanism of this association is not clear but may be related either to immaturity of the pyruvate dehydrogenase complex or to the accumulation of abnormal intramitochondrial intermediary metabolites. Infants presenting with HI should have a free flowing blood sample drawn for the measurement of plasma lactate levels.
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PMID:Severe transient neonatal hyperinsulinism associated with hyperlactataemia in non-asphyxiated infants. 1505 55

In newborn and premature infants whose lung immaturity entails a limited capacity for O2 detoxification, the use of supplemental oxygen should be continuously and non-invasively monitored. Pulse oximetry and transcutaneous O2 monitoring are the systems most used in the NICU. Major limitations of pulse oximetry are motion artifact, sensitivity to excessive light, cutaneous hypoperfusion, hypothermia, venous congestion, arterio-venous shunting, strong skin pigmentation, anemia and high percentage of abnormal hemoglobin. Alarm habituation is a further major risk. New oxymeters show less motion, artifact and higher accuracy during low oxygen saturation. The accuracy during high oxygen saturation is very dependent on the specific oxymeter model used. Transcutaneous O2 monitoring is usually combined with transcutaneous PCO2 monitoring, hence enabling evaluation of oxygenation as well as ventilation. A major risk of this method is related to the heated electrode sensor, which can induce skin burns. A combined ear sensor for pulse oximetry and PCO2 monitoring seems promising.
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PMID:[Oxygen therapy in newborn: equipments for non-invasive monitoring]. 1576 30

The first cord blood (CB) transplant was performed in 1988 in a patient with Fanconi anemia. The donor was his HLA-identical sister who was known by pre-natal diagnosis to be HLA identical and not affected by the Fanconi mutation. The CB was collected and cryopreserved at birth. The transplant was successful without GvHD and the patient is currently alive and free of disease more than 15 years after transplant, with full hematologic and immunologic donor reconstitution. At the time of the first transplant, little was known about the biologic properties of CB cells and it was thanks to the pioneering work of H. E. Broxmeyer and E. A. Boyse, who studied the progenitor cell content of CB, and of A. D. Auerbach, who realized the pre-natal diagnosis of Fanconi anemia, that this transplant was possible. Since this first transplant, many questions have been answered but others are still open for further research. For example: would a single CB unit contain enough stem cells to permanently engraft children and adults? Would maternal cell contamination in fetal blood engraft and give severe GvHD? What are the immunologic properties of CB cells? How does it interfere with GvHD, GvL and immune reconstitution? Is the immune immaturity of CB lymphocytes able to overcome the HLA barrier and authorize HLA-mismatched transplants? Is it possible to establish CB banks for unrelated and related transplants? What would be the criteria for collection, quality control and cryopreservation?
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PMID:History of the clinical use of umbilical cord blood hematopoietic cells. 1608 48

Incidence, hazards and structural variants of pneumopathies according to the findings of 826 autopsies of neonates were studied. Anthropometrical, histological, bacteriological, virusological methods were applied. 17 important elements content in hair and lungs were detected. It was established that incidences of pneumopathies, according to the findings of the autopsies in Tashkent, constitute in total 47,1%. Pulmonary atelectases amount to 57% of all pneumopathies, edematouse-hemorrhagic syndrome--23,5%, aspiration syndrome--10,7%, hyaline membranes--8,8%. The highest lethality from pneumopathies was observed among neonates born from I-III pregnancies with males prevailing. Premature babies were found to have pneumopathies in 77,5%, mature--19%, overmature--3,5%. Risk factors coming from maternal side are the following: extragenital diseases, anemia, chronic pyelonephritis, acute respiratory viral infections, aggravated obstetric anamnesis, placental separation, prolonged early rupture of amniotic fluid sac, delivery by cesarean section. Risk factors coming from the neonate's side are the following: immaturity, intrauterine chronic hypoxia, intrauterine hypotrophy. Deficiency in copper and zinc leading to structural abnormality of pulmonary tissue is of great importance for pathogenesis of separate forms of pneumopathies (pulmonary and hyaline membranes' atelectases).
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PMID:[Incidence, risk factors, and structural variants of pneumopathies in newborns in Tashkent]. 1705 5

Retinopathy of prematurity (ROP) is a complex disease of the developing retinal vasculature in premature infants. Clinical manifestations range from mild, usually transient changes of the peripheral retina to severe progressive vasoproliferation, and potentally blinding retinal detachment. With better standards in premature units and with increased survival rate of low gestational age and low birth weight infants the incidence of ROP also increased. The incidence of ROP has been decreasing in developed countries over the past decade, and ROP has become potentially confined to immature neonates with birth weights less than 1000 grams in these countries. Prematurity and retinal immaturity are the major risk factors. Oxygenation, respiratory distress, apnea, bradycardia, hearth disease, infection, hypercarbia, acidosis, anemia, and the need for transfusion are thought by some to be contributory factors. All of the preterm babies with a birth weight under 1500 grams and a gestational age under 32 weeks should be followed for ROP.
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PMID:[Retinopathy of prematurity]. 1940 50

Apnea of prematurity (AOP) is a common problem affecting premature infants, likely secondary to a "physiologic" immaturity of respiratory control that may be exacerbated by neonatal disease. These include altered ventilatory responses to hypoxia, hypercapnia, and altered sleep states, while the roles of gastroesophageal reflux and anemia remain controversial. Standard clinical management of the obstructive subtype of AOP includes prone positioning and continuous positive or nasal intermittent positive pressure ventilation to prevent pharyngeal collapse and alveolar atelectasis, while methylxanthine therapy is a mainstay of treatment of central apnea by stimulating the central nervous system and respiratory muscle function. Other therapies, including kangaroo care, red blood cell transfusions, and CO(2) inhalation, require further study. The physiology and pathophysiology behind AOP are discussed, including the laryngeal chemoreflex and sensitivity to inhibitory neurotransmitters, as are the mechanisms by which different therapies may work and the potential long-term neurodevelopmental consequences of AOP and its treatment.
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PMID:Apnea of prematurity: from cause to treatment. 2130 66

Necrotizing enterocolitis (NEC) is one of the most critical morbidities in preterm infants. The incidence of NEC is 7% in very-low-birth-weight infants, and its mortality is 15 to 30%. Infants who survive NEC have various complications, such as nosocomial infection, malnutrition, growth failure, bronchopulmonary dysplasia, retinopathy of prematurity, and neurodevelopmental delays. The most important etiology in the pathogenesis of NEC is structural and immunological intestinal immaturity. In preterm infants with immature gastrointestinal tracts, development of NEC may be associated with a variety of factors, such as colonization with pathogenic bacteria, secondary ischemia, genetic polymorphisms conferring NEC susceptibility, anemia with red blood cell transfusion, and sensitization to cow milk proteins. To date, a variety of preventive strategies has been accepted or attempted in clinical practice with regard to the pathogenesis of NEC. These strategies include the use of breast feeding, various feeding strategies, probiotics, prebiotics, glutamine and arginine, and lactoferrin. There is substantial evidence for the efficacy of breast feeding and the use of probiotics in infants with birth weights above 1,000 g, and these strategies are commonly used in clinical practice. Other preventive strategies, however, require further research to establish their effect on NEC.
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PMID:An update on necrotizing enterocolitis: pathogenesis and preventive strategies. 2223 29


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