Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0029713 (immaturity)
 4,335 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The normal verbal and motor responses embodied in the standard Glasgow Coma Scale (GCS) are not achievable during the first few years of life. The recent literature contains numerous reports of attempts to devise scales of responses quantitating the conscious level in infants and young children, both for research purposes and as clinical guides; some of these scales incorporate items, e.g. brainstem reflexes, that are not included in the GCS. We have reported on a simple paediatric version of the GCS, which uses the standard scale with minor modifications in the verbal component, and sets realistic age-related normal responses. This has been tested prospectively in a series of 60 head-injured infants and children (age range 0-72 months). Of 6 cases recorded as comatose 6 h after injury, 4 have confirmed or suspected residual disabilities. Of 35 cases considered to be fully conscious at 6 h, 31 have made good recoveries and only 1 has suspected residual disabilities. The study suggests that the scale accords with the realities of neurological immaturity, and confirms that it can be used in routine paediatric practice. For comparative therapeutic trials, the conscious level in infants has limited value as an index of brain injury, and should be complemented by other indices, such as brainstem reflexes.
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PMID:Head injuries in infants and young children: the value of the Paediatric Coma Scale. Review of literature and report on a study. 193 14

Animal experimental studies conducted at the turn of the century resulted in the use of magnesium sulphate as an anticonvulsant in humans. In U.S. clinics, parenteral administration of magnesium sulphate became a routine procedure in the treatment of eclampsia and pre-eclampsia. This treatment has proved very effective in treating convulsions in pregnancy provided an adequate dosage was given amounting to up to 60 g daily. Mother and infant mortality were largely eliminated. Numerous clinical studies showed a negligible side effect rate. Side effects in the foetus: These are due to penetration of magnesium into the foetal blood circulation. Reports on an inhibition of cardiac rate fluctuation and changes in calcium levels have been contradictory, and hence not generally accepted. It is claimed that the parathormone level may drop slightly. Isolated reports on foetal magnesium intoxications associated with depression of breathing, slackness and hyporeflexia often prompt the conclusion that this disease pattern had been due to immaturity and asphyxia. Generally, foetal magnesium blood levels do not correlate well with signs of magnesium intoxication. Urine excretion is greatly slowed down in foetal immaturity. Side effects in the mother: Short-term relaxing action on the uterus has been described frequently. High dosages have been successfully used in arresting labour if there is a tendency to premature birth. Increase in uterine blood flow was seen after administration of magnesium sulphate in animal experiments. Magnesium is said to reduce blood coagulation by influencing fibrinolysis and thrombocyte resistance. However, a somewhat enhanced loss of blood during birth is said to be more likely due to relaxation of the uterus than to a disturbance of blood coagulation. Rapid intravenous injection causes short-term flushing, nausea and vomiting. Short-acting drops in blood pressure are possible. The cardiac output is said to increase at the conventional dosage level whereas the peripheral resistance drops due to vasodilation. Increases and decreases in heart rate have been reported, but in most cases no changes were seen. Changes in ventricular action time occur with toxic doses only, which can lead to cardiac arrest in the diastole. Other toxic signs are hyporeflexia, depressed breathing and CNS depressions which may result in coma. Hyporeflexia always occurs before the other toxic signs appear, so that it can be used as a clinical control criterion. Calcium gluconate, given via the IV route, is a good and rapid-acting antidote.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Use of magnesium sulfate as an anticonvulsant in severe pregnancy toxemia and eclampsia]. 655 75

Head injuries are a significant cause of morbidity and mortality in children. A descriptive multiple-case study was used to compare the accuracy of two assessment scales in children aged under 5 years. The study emphasised the importance of prompt and accurate assessment of children with head injuries. The Glasgow Coma Scale (GCS) is inappropriate for use in young children. The Adelaide Coma Scale (ACS) is a more appropriate tool for those aged under 5 years because it takes the child's age, and, therefore, neurological immaturity, into account. However, the ACS still does not give enough scope for assessment. If the ACS is used, therefore, additional information must be considered, including specific paediatric indicators, and an assessment of each child's behaviour according to the main care giver.
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PMID:The use of a paediatric coma scale for monitoring infants and young children with head injuries. 987 5

Apparent increase of the incidence of childhood diabetes mellitus has been observed in many countries over the last decades. Data of seasonality are not consistent, especially in younger group. The triggering of the autoimmune process in genetically susceptible individuals may be the result of a variety of environmental factors including viral infections, specific nutrients, early introduction of cow's milk proteins and ingestion of nitrosamines, stress-inducing events, early perinatal lesions. Clinical studies of the last decade have confirmed that diabetes mellitus in young children is specific type of type 1 diabetes. At presentation, children in preschool age group, who have type 1 diabetes, have higher incidence of ketoacidosis with coma because of immaturity of the central nervous system. Delays in diagnosis in small children often lead to more severe dehydration and ketoacidosis. Chi dren in the young age group who have type 1 diabetes represent unique set of problems for their families and health care team.
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PMID:[New aspects of etiopathogenesis and clinical characteristics of diabetes mellitus type 1 in children]. 1561 86

Neonatal encephalopathy is a significant cause of infant mortality and morbidity with risk of neurological sequelae in the survivors of neonates admitted to Neonatal (N) Intensive Care Unit (ICU). The EEG and Evoked Potentials (EPs) are very informative in the ICU. In particular, it is known that the SomatoSensory (SS) EPs are the best single indicator of early prognosis in adults and children patients with traumatic and/or hypoxic-ischemic coma compared to the Glasgow Coma Scale (GCS) and CTscan. Most paediatric studies excluded newborns in an attempt to eliminate the age effects, because of the structural and functional immaturity of somatosensory system. In fact, newborns differ from adults and paediatric patients for many aspects: hypoxic-ischemic aetiology, SSEPs normative data, grading and predictive values, timing and techniques recording, clinical scales of evaluation. Recently a diagnostic and predictive role of early SSEPs has been established in perinatal hypoxic-ischemic. We reported a literature review of early diagnostic/prognostic role of SSEPs and our preliminary neurophysiological data of prospective study in mild or severe perinatal hypoxic-ischemic insult.
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PMID:The prognostic role of evoked potentials in neonatal hypoxic-ischemic insult. 2187 35