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)

Many questions are raised in this review about the role of adult donor granulocyte transfusions in the setting of overwhelming bacterial neonatal sepsis. There clearly exists a number of variables, which influence the survival and morbidity associated with bacterial sepsis. The important differences in these studies highlight the need for prospective large multicenter studies to definitely clarify these issues. Important criteria, which are yet to be established and which impact significantly, include the time of administration of adjuvant granulocytes, the number of granulocytes that need to be harvested, which group of neonates require early granulocyte transfusions, the best method for optimal and easy granulocyte collection, the frequency and intervals of granulocyte transfusions, and improved methods for the early identification of neonatal candidates who would benefit from the granulocyte transfusions. The benefits of granulocyte transfusions (ie, the improvement in morbidity and mortality) in septic neutropenic neonates must be weighed against the possible and reported side effects associated with such transfusions. Adverse reactions including graft-versus-host disease, CMV, HIV and hepatitis infection, fluid retention and pulmonary edema, blood group sensitization, and pulmonary insufficiency may all result from the use of granulocyte transfusions in a host who has evidence of developmental immaturity. All future studies must continue to evaluate these potential complications to balance and analyze the true benefits of survival with reported treatment results. Recently, a number of investigators including ourselves, have begun to examine the role of alternate adjuvant immunotherapy in enhancing neonatal host defense in the clinical setting of overwhelming bacterial sepsis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The use of granulocyte transfusion in neonatal sepsis. 213 12

Clinical apnoea in infants is defined as a pause in breathing of more than 20 s duration or a briefer pause associated with bradycardia. Such events are uncommon in term infants and usually are due to some precipitating factor. They occur more commonly in preterm infants and there is an exponential increase in incidence with decreasing gestational age at birth. Although insults such as infection or hypoxia can accentuate the problem, the major factor appears to be immaturity. Studies of brain-stem maturity using auditory evoked responses indicate that infants with immature responses have a higher incidence of apnoea. Brain-stem immaturity has also been implicated in histopathological studies of infants dying from Sudden Infant Death Syndrome (SIDS). In preterm infants, upper airway obstruction occurs commonly at the end of longer events and some infants have a predominantly obstructive pattern. These latter infants are often neurologically abnormal and have had prolonged endotracheal intubation. Both of there factors could be associated with disordered control of upper airway patency. This notion is supported by the finding of upper airway instability during nasal occlusion in these infants. A link with SIDS is uncertain, although preterm infants with chronic pulmonary insufficiency, usually following a prolonged intubation, are said to be at particularly high risk of dying suddenly and unexpectedly during infancy.
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PMID:Apnoea in the newborn infant. 353 81