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

The results reported in this paper were obtained from 276 cases (babies and infants) with increases in intracranial pressure. In 88 cases the cause of disease was not clear, while 35 patients showed symptoms of an acute increase in intracranial pressure so that diagnosis was an urgent necessity. With subdural hygromata, clinical results obtained for acute rises of pressure usually differ greatly from those obtained for chronic increases of pressure. The diaphany of skull is usually negative. Fundal hemorrhages were observed in acute cases only. Critical cerebral pressures were most frequently observed in the case of tumors. The diagnosis is rather difficult. In the case of functional immaturity of the brain localized neurological symptoms are not usually observed. The cerebral pressure is generally counterbalanced for a long time so that an acute cerebral symptomatology is not produced until tumoral complications, shifts in cerebrospinal fluid passages, intracranial mass shifts, or tumoral hemorrhages occur. Unlike all other groups of diseases, symptoms of rises of intracranial pressure were very marked. Malformations of the posterior cranical fossa included acute occlusions in the case of Dandy-Walker syndromes and arachnoidal cysts. In the case of severe cerebral malformations, acute increases in intracranial pressure are sometimes erroneously concluded from an abnormal increase of the size of head accompanied by a complete lack of reactions on the part of children affected with them. Children with hydrocephalus caused by a disturbance of the circulation of liquor are now treated with pressure-controlled liquor drainage systems. Critical cerebral pressures may occur if the drainage system suddenly fails to operate properly.
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PMID:[Diagnosis of increases in acute intracranial pressure in infancy and early childhood]. 12 64

To focus attention on the problem of infant mortality in Lebanon, data were compiled on infant mortality from 1978 to 1986 at the American University of Beirut Medical Center. Causes of death are analyzed for 602 males and 398 females. 54.9% deaths occurred at 1 month of age and 77.4% died within the 1st year. Autopsies were performed on .7%. 37.7% of all neonatal deaths were due to neonatal diseases such as hyaline membrane disease, asphyxia neonatorum, immaturity, necrotizing enterocolitis, hemorrhage, hemolysis, meconium aspiration, and kernicterus. Better prenatal care would reduce this group, or the administration of corticosteroids to the mother 24-48 hours prior to delivery, as well as rapid resuscitation at birth and prevention of the 5 curses: hypoxemia, hypoglycemia, hypothermia, hypotension, and acidosis. Although unavailable in Lebanon, administration of surfactants through an endotracheal tube would also help. Infections constitute 25.1% of deaths; many are preventable through adequate public health measures and strict personal hygiene, i.e., diseases such as sepsis, pneumonia, meningitis, gastroenteritis, hepatitis, encephalitis, and 1-2 cases of the following: diphtheria, measles, peritonitis, tetanus, tuberculosis, cytomegalis inclusion, herpes, parathyphoid, pertussis, poliomyelitis, and shigellosis. Congenital diseases were 21.6%. In utero diagnosis could prevent some diseases and in utero treatment is possible for hydrocephalus and hydronephrosis. Screening programs postnatally could lead to treatment. 5.9% were malignancies such as leukemia, lymphoma, brain tumors, histocytosis, Wilm's tumor, Ewing sarcoma, and Hodgkin's disease. Early diagnosis is critical if mortality is to be reduced in this group, but medical advances are still needed. 2.9% are miscellaneous diseases such as poisoning, rheumatic diseases, marasmus, Reye's syndrome, nephrosis, rickets, and epilepsy. Most of these diseases are preventable, except for rheumatic inflammation of the heart. Recommended necessary steps to reduce infant mortality are: prenatal care, diagnosis and screening, intrauterine surgery; resuscitation and intensive care centers with modern equipment and trained personnel; national vaccination and screening programs; adequate public health measures and hygiene; parental education; and well-equipped hospitals to serve all regardless of income level.
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PMID:Pediatric mortality: an avoidable tragedy. 251 28

Trends are changing in the management of infants and children with indirect inguinal hernias. Advances in neonatal intensive care have resulted in the survival of many small premature infants who have a high incidence of inguinal hernia. The rate of incarceration, strangulation, and gonadal infarction in these babies is twice that of the general pediatric age group. Respiratory immaturity, apnea, bradycardia, and associated neonatal conditions require special management at the time of hernia repair, usually performed just before discharge from the neonatal intensive care unit. New information concerning volume loss and depletion of germ cells beginning at 6 months of age in boys with undescended testes has stimulated the performance of orchiopexy when the patient is 1 year of age. More than 90% of boys with cryptorchid testes at the age of 1 year have an associated hernia that requires concomitant repair at the time of orchiopexy. The use of the peritoneal cavity for fluid absorptive purposes in hydrocephalus treated by venticuloperitoneal shunts or of peritoneal dialysis for renal failure and metabolic diseases such as hyperammonemia and lactic acidosis causes increased intraabdominal pressure and results in the appearance of a previously unrecognized hernia. Recognition of these and other conditions associated with a high incidence of hernial occurrence should allow early diagnosis and treatment before the development of complications. Most elective repairs of hernias are safely performed in the outpatient setting; however, some infants and children with concurrent illnesses are best managed in a "morning admissions" program, in which hospital admission occurs postoperatively.
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PMID:Current concepts in inguinal hernia in infants and children. 257

A case is reported of early-onset pre-eclampsia combined with severe malformations including holoprosencephaly and hydrocephaly caused by triploidy. By ultrasonic diagnosis, maternal risks caused by either prolonged pregnancy because of immaturity or inappropriate obstetrical management, i.e. by caesarean section, could be avoided. Ventriculocentesis of the macrocephalic fetus was performed and abortion induced.
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PMID:[Early manifestation of severe gestosis (pre-eclampsia) in fetal triploidy--diagnosis and obstetrical management]. 270 31

Neurosonography is an excellent modality for imaging a wide array of intracranial pathology in the infant and newborn. Neurosonography is also finding increasing use in other accessible regions of the central nervous system, including the adult brain during craniotomy and the spine during laminectomy. Sonography represents the primary modality for the evaluation of the preterm brain. Because of the high incidence of pathology in gestationally immature neonates, screening sonography is required in every infant. The sonographic features of intracranial hemorrhage include areas of increased echogenicity in the region of the germinal matrix, within the ventricles, or in the surrounding cerebral parenchyma. Careful follow-up of these children for sometimes severe posthemorrhagic hydrocephalus is essential. Premature neonates are also at risk for ischemic disease, particularly periventricular leukomalacia, which is accurately diagnosed sonographically and implies a poor prognosis in almost every infant so affected. Cranial sonography is also an excellent method to evaluate abnormalities that are not associated with gestational immaturity. Cranial sonography offers excellent anatomic imaging of the brain when evaluating for congenital anomalies; because sections may be obtained in a multitude of orientations, sonography is actually more versatile than computed tomographic (CT) scans. Cranial sonography is also of use when evaluating children with inflammatory processes such as ventriculitis; sonography is superior to CT scans in identifying intraventricular septae typical of the process. Intrauterine inflammatory processes, however, are frequently associated with intracranial calcifications, CT scans may be more accurate in these cases. CT scans may also be more efficacious in the diagnosis of subdural, epidural, and subarachnoid hemorrhage. Intracranial neoplasms are rare in the younger population and although they are visible with ultrasound, CT scans with contrast are essential in an effort to obtain added information and because of a greater experience using CT scans. Sonography represents an excellent modality with which to evaluate the infant and neonatal brain. In a number of diseases it may be diagnostic alone. The informed clinician, however, should keep in mind those instances where a complimentary modality such as CT scanning can add additional or even essential information.
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PMID:Pediatric neurosonography. 329 1

Infants of very low birth weights (less than 1500 g) born before the 32nd week of gestation have a high incidence of neonatal intracranial hemorrhage (ICH). Beside perinatal and postnatal asphyxia the main risk factor for ICH is the immaturity of the infant. Mild intracranial hemorrhages resolve within a few weeks. Severe ICH, which were seen in very immature babies before 30 weeks of gestation and with birth-weights below 1250 g had a fatal outcome. The mortality rate in severe ICH was 50%. The infants which survived severe ICH developed posthemorrhagic hydrocephalus (PHH). Using the open fontanelle as an acoustic window gray scale ultrasonography of children's brain is able to visualize ICH and PHH. We suggest early sonografic brain investigation within the first days of life in all prematurely born infants with perinatal asphyxia. Infants with severe ICH should have weekly sonografic controls, to detect PHH as soon as possible.
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PMID:[Diagnosis and clinical course of cerebral hemorrhage in infants based on sonography]. 670 Sep 94

The purpose of the present study is to examine the blood-brain barrier in brain of congenital hydrocephalus HTX rats. We investigated the rat brain from postnatal day 1 to 44 using light and electron microscopy and immunohistochemical methods with monoclonal anti-blood-brain barrier (BBB) antibody. HTX rats developed hydrocephalus at 1-2 days after birth. Most rats succumbed to brain changes within 4-5 weeks. Among 136 HTX rats examined, 45 rats succumbed within 1 week after birth, 29 rats between 1-2 weeks, and 4 rats 27-44 days after birth. Out of 88 hydrocephalic rats 54 showed a marked ventricular dilatation, and 34 showed a mild dilatation. Dilatation of lateral ventricles was mild in the rats at 1-2 days after birth, but 3-14-day-old rats showed moderate or marked dilatation. 15-30 days after birth the rats developed mostly marked dilatation of lateral ventricles and third ventricle. Lateral ventricles and third ventricle showed a symmetric dilatation, but ependymal cell layers were well preserved. Aqueduct exhibited no dilatation in any rat. There were spongy appearances and cystic cavities in the white matter around the lateral ventricles. There were glial fibers and capillaries across the cystic cavities. Cystic lesions were also found in the deep subcortical white matter, consisting of spongy changes with extended extracellular spaces and microcysts in the white matter. Immunohistochemically, the anti-BBB reactivity in the normal control rats was at first weak at 2 weeks after birth and increased with the course of development, prominently 4 weeks after birth. Three- and four-week-old HTX rats with hydrocephalus showed moderate positive anti-BBB reaction in the cerebral cortex, the basal ganglia, and around the aqueduct but only a very weak reaction in the deep subcortical white matter and in the subependymal area of lateral ventricles. Laminin immunoreactivity was not different in the capillaries of hydrocephalic brain as compared with normal brain. Electron microscopically, tight junctions were well formed between endothelial cells of capillaries in the subcortical white matter. Occasionally capillaries with partial defect of basal membrane could be found, where the cytoplasm of endothelial cell was protruding between pericytic cytoplasm. Swelling of astrocytic end-feet were found around the microvessels. The results suggest that at the site of the lesion there is underdevelopment or immaturity of the blood-brain barrier.
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PMID:Immunohistochemical study on blood-brain barrier in congenitally hydrocephalic HTX rat brain. 782 77

Hydrocephalus is most commonly diagnosed in the first few months of life, though cases also arise in later life. Cerebrospinal fluid shunts used to control the condition are prone to colonization particularly by Staphylococcus epidermidis. The incidence is very much higher in infancy than in older age groups, and this is probably due to prolonged hospital stay as a result of the underlying pathology, combined with the propensity for a high skin bacterial density with more adherent strains, rather than to any immune immaturity. Diagnosis of shunt colonization is often very difficult and serological tests have an important role to play even in infancy. There are several pitfalls in diagnosis, particularly in the elderly. Treatment of shunt infections should include removal of the colonized shunt, though regimens to avoid this are currently being investigated. Intraventricular therapy with vancomycin along with intravenous rifampicin offers the best changes of success at the first attempt. Shunted patients who contract purulent bacterial meningitis should not have their shunts removed but should be treated in the same way as those without shunts.
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PMID:Hydrocephalus shunt infections. 784 76

Kasabach-Merritt syndrome is characterized by thrombocytopenia and bleeding tendency leading to disseminated intravascular coagulation with giant hemangiomas. We present a very low birth weight infant with this syndrome who underwent four operations. A male baby (1179 g, 37 cm) was born at a gestational age of 28 weeks and 6 days by caesarean section. A large hemangioma, 7 x 8 cm in size, was recognized on the left thigh. As associated consumption coagulopathy (Kasabach-Merritt syndrome) was diagnosed with platelet count 5.1 +/- 10(4) mm-3 and fibrinogen 49 mg.dl-1. Despite treatment with liniac X-ray radiation, systemic steroid and component transfusion, coagulopathy became worse with extremely low platelet count of 1.1 x 10(4) mm-3. Infusion of dopamine and dobutamine was necessary for high output cardiac failure. On day 9, PDA ligation was performed. Cerebro-ventricular drainage, ventricuro-peritoneal shunt and shunt revision were required on day 15, 49 and 88, respectively, for hydrocephalus due to intraventricular hemorrhage. Main anesthetics used were fentanyl and sevoflurane. Major problems encountered by anesthetists were: bleeding tendency, water and electrolyte management, body temperature control, and immaturity and fragility of premature infant. Coagulopathy in Kasabach-Merritt syndrome must be a risk factor for intraventricular hemorrhage, which is a characteristic complication of a very low birth weight infant.
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PMID:[Anesthetic problems in a very low birth weight infant with Kasabach-Merritt syndrome]. 881 2

A 480 g, 38-day-old female infant underwent ventriculo-peritoneal shunt surgery for hydrocephalus after intra-ventricular hemorrhage. The patient was born at a gestational age of 25 weeks and 5 days, weighing 600 g, as one of twins by a cesarean section. Although respiratory distress syndrome developed, it was relieved with surfactant. The esophagus was easily perforated by a gastric tube. At the age of 7 days, PDA was closed conservatively with indomethacin. Anesthesia was induced and maintained with fentanyl (induction dose 4 micrograms.kg-1, total dose 6 micrograms.kg-1) and vecuronium. Ventilation was controlled with oxygen and air (FIO2 0.21-0.25). The main problems encountered by anesthetists in the perioperative period were; fluid management (hyperkalemia, hyponatremia, infusion volume), bradycardia due to increased intracranial pressure, body temperature control (hypothermia), and transport to the operating room. In anesthesia for extremely low birth weight (extremely premature) infants, utmost care and proficient procedure are required because of their immaturity, fragility and smallness.
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PMID:[Anesthetic problems in a 480 g infant for ventriculo-peritoneal shunt surgery]. 886 31


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