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)

We performed clinicopathological studies on early-onset sepsis (5 infants, less than 72 hours of life, EOS) and late-onset sepsis (15 infants, greater than 72 hours, LOS) of very low birth weight, less than 1500 g (VLBW). In EOS, the clinical features mimic the respiratory distress syndrome and hematological changes were not observed. The lungs showed slight interstitial pneumonia with structural immaturity, hyaline membranes, hemorrhage, and minimal infiltration by polymorphonuclear neutrophils (PMNs). The pathogen was group B streptococcus or weakly gram-negative bacilli. In LOS, pneumonia proceeded to sepsis and neutropenia with elevated numbers of circulating immature neutrophils, and increased levels of C-reactive protein were observed at the onset of sepsis. Severe pneumonia with infiltration of numerous PMNs and bacterial colonies and polymicrobial infection by nosocomial pathogens such as Staphylococcus aureus and Pseudomonas aeruginosa were common. The thymus and spleen weights varied but retained normal structure in EOS. The thymus was depleted of lymphocytes, and the spleen was hypertrophic but poorly reactive against infection in LOS. The pathogenesis of EOS is regarded as being more closely correlated with lung immaturity and circulatory disorder in early life, whereas that of LOS is associated with immunological defenses of the host, potency of the pathogens, and terminal multiple organ failure.
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PMID:Clinicopathological differences between early-onset and late-onset sepsis and pneumonia in very low birth weight infants. 223 61

The respiratory distress syndrome (RDS) is a physiological manifestation of neonatal pulmonary immaturity and it is still the major cause of neonatal morbidity and mortality. In order to promote early fetal lung maturity when a preterm delivery is anticipated, a number of pharmacological agents have been investigated. Corticosteroids, in particular, have been extensively used and the results of several trials are reported in literature. A cohort of 246 consecutive singleton preterm infants, liveborn at the Obstetric Clinic of Ferrara University during a 5-year period, was studied to assess whether antenatal steroid therapy reduces the incidence of RDS. Respiratory distress developed in 18.6% of 102 babies who received treatment and in 15.3% of 144 controls, without difference at the statistical analysis. According to previous studies, a lower incidence of RDS was only observed in the treated females compared to non-treated controls (35% vs 46%) at the gestational age of 28-33 weeks. Since the efficacy of steroids seems to be restricted to a very small and specific group of babies, who, moreover are relatively mature by modern intensive care standards, the Authors suggest that the prevention of RDS and its related complications should rely much more on appropriate surveillance and management of the mother and infant than on specific pharmacological interventions.
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PMID:Contribution to the assessment of steroid therapy in the prevention of respiratory distress syndrome in the neonate. 229 42

The classical description of the Pierre Robin syndrome includes micrognathia, glossoptosis, airway obstruction, and usual presence of a cleft palate. The Pierre Robin syndrome is currently defined as the combination of retrognathia, cleft palate, and respiratory distress. This last is mixed, with a peripheral component due to glossoptosis and a central component due to brain stem immaturity. The main ocular manifestations found in the Pierre Robin syndrome are congenital glaucoma and severe congenital mypopia responsible for retinal detachment. Microphthalmia is infrequent. We report the case of a neonate with severe Pierre Robin syndrome and major microphthalmia documented by CT scan.
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PMID:[Ophthalmologic manifestations of the Pierre Robin syndrome. Report of a case of microphthalmia]. 231 60

A cohort of 678 consecutive very low birth weight infants, liveborn in one tertiary institution during a 63-month period, was studied to investigate whether antenatal steroid therapy had any beneficial or harmful effects on mortality or morbidity over the first 2 years of life. Comparing the 244 babies who received treatment with the 434 controls, 195 (79.9%) and 265 (61.1%), respectively, were discharged home (P less than 0.001). Mortality in the treated group remained substantially lower and was almost halved after adjustment for birth weight, extreme immaturity, lethal malformations, and confounding obstetric variables (P = 0.001). Fatal cases of respiratory distress syndrome were less common in the treated group (P = 0.044). Of in-hospital survivors, those in the treated group required less positive pressure respiratory support (P = 0.003) and fewer days in oxygen (P = 0.018), and the incidences of bronchopulmonary dysplasia (P = 0.003) and patent ductus arteriosus (P = 0.002) were lower. Two-year survivors who had received treatment were heavier (P = 0.016) and had larger head circumferences (P = 0.029). These beneficial associations in the treated group were not at the expense of increased rates of infection or adverse neurologic outcome. We did not detect any adverse effects of antenatal steroid therapy on any relevant aspect of mortality or morbidity in infancy under circumstances in which the chances of finding substantial differences were high.
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PMID:Effects of antenatal steroid therapy on mortality and morbidity in very low birth weight infants. 241 90

Radiographic-pathologic correlation of pulmonary patterns has not been performed in very small preterm infants below 28 weeks of gestation. The radiologic findings of linear interstitial densities or generalized airspace opacity coincided with histologic changes of edema and hemorrhage and indicate that this is the most frequent abnormality producing radiographic pulmonary opacification in infants of 23-27 weeks gestation. On occasion, parenchymal immaturity alone results in lung opacification, reflecting the established interpretation of diffuse atelecatasis as the histologic-radiographic finding in respiratory distress syndrome.
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PMID:Lung disease in the very immature neonate: radiographic and microscopic correlation. 260 11

Phosphatidylglycerol (PG) in amniotic fluid is recognized as a good indicator of fetal lung maturity and is unaffected by moderate amounts of blood or meconium contamination. A rapid immunologic agglutination assay, Ultrasensitive AmnioStat-FLM (FLM), was compared with two-dimensional thin-layer chromatography (TLC) and an enzymic, colorimetric procedure (E-PG). Eighty amniotic fluid specimens were analyzed. FLM results were reported as high (H), intermediate (I), or low positive (L). TLC was compared with FLM:H (n = 27), mean 0.14 (fraction of total phospholipids); I (n = 7), mean 0.11; L (n = 9), mean 0.03; negative results had no detectable PG by TLC. In 33 cases E-PG was compared with FLM:H (n = 9), mean 7.0 mumol/L; I (n = 5), mean 8.1 mumol/L; L (n = 3), mean 3.0 mumol/L; negative (n = 16), mean 3.2 mumol/L. Records were reviewed in 70 cases. Thirty cases were excluded: sample to delivery time was greater than 72 hours; steroids were given or sepsis was documented. Fetal lung immaturity was clinically present in six cases: respiratory distress syndrome in three cases and transient tachypnea of the newborn (TTN) in three cases. One false positive result was identified (TTN, FLM:H). FLM sensitivity for fetal lung maturity was 85.3%, specificity was 83.3%, and the positive predictive value for fetal lung maturity was 96.7%. FLM is a fast, reliable indicator of fetal lung maturity.
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PMID:Phosphatidylglycerol in amniotic fluid. Comparison of an "ultrasensitive" immunologic assay with TLC and enzymatic assay. 264 6

An important prerequisite for the management of high risk pregnancies is the accurate prediction of foetal lung maturity. A number of indices of foetal lung maturity based on the determination of surfactant constituents in the amniotic fluid have been proposed. Amniotic fluid contains phospholipids, including phosphatidylcholine (lecithin), sphingomyelin, phosphatidylinositol and phosphatidylglyerol (PG), some enzymes of the pathways of phospholipid synthesis, lamellar bodies, and lung specific apoproteins. The amount of these substances in amniotic fluid changes towards the end of gestation in a manner related to foetal lung maturity. Determination of the lecithin to sphingomyelin (L/S) ratio is by far the most widely used and accepted method. However, there is still controversy regarding the high incidence of false immature values, and the increased incidence of false mature values (from 1 to 15%) especially in pregnancies complicated by diabetes mellitus; an immature L/S ratio may predict respiratory distress syndrome (RDS) only in about 50% of cases. The incidence of false immature L/S ratio as well as other amniotic fluid tests depends upon patient variability, method employed, threshold taken for differentiating a normal from an abnormal condition, and on the fact that only few authors report their results in terms of sensitivity and specificity. Where laboratory facilities are minimal, it is advisable to perform the shake test or to measure the optical density of amniotic fluid. However, when these tests indicate immaturity, additional tests, such as determination of the L/S ratio or the lung profile (including PG), must be performed. The utilization of these tests is recommended for: 1) timing of delivery prior to elective caesarean section; 2) management of complicated pregnancies; and 3) recognizing indications for pharmacologic prevention of RDS in utero or at delivery.
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PMID:Assessment of foetal lung maturity. 266 95

The Pierre Robin Syndrome is characterized by three defects (8,9): micrognathia, cleft palate and glossoptosis responsible for respiratory failure. The new definition of this syndrome associates retrognathia, cleft palate and respiratory distress. This respiratory distress is mixed: obstructive due to glossoptosis, and central, secondary to brainstem immaturity (1,2). The main ocular manifestations associated with the syndrome are congenital glaucoma, high congenital myopia and retinal detachment. Microphtalmia has already been reported, but is infrequent. We present a clinical case of a major microphthalmia in a Pierre Robin Syndrome, confirmed by CT scan exploration.
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PMID:[Microphthalmos in Pierre Robin syndrome. Clinical and x-ray computed tomographic study]. 269 74

In 46 newborn calves with and without respiratory distress syndrome which had been delivered prematurely by caesarean section a blood coagulation profile was established. These animals were compared with 26 healthy, 5- to 8-day-old calves. Prematurely delivered calves showed a lower average plasma fibrinogen concentration than animals delivered in due time. Calves which developed a respiratory distress syndrome had a slightly prolonged prothrombin time and partial thromboplastin time as well as a lower antithrombin III activity already immediately postnatum compared with healthy prematures and some-day-old calves. It has to be assumed that in calves with respiratory distress syndrome--in analogy to pulmonary immaturity--the blood clotting mechanism is not yet fully developed. In healthy prematures and surviving asphyctic calves hemostasis remains largely stable during the first day of life, whereas plasma fibrinogen concentration increases. In the calves not surviving the examination period prothrombin time and partial thromboplastin time postnatum became significantly longer. Only in these severely asphyctic calves the presence of a consumption coagulopathy seems likely. A secondary reactive fibrinolysis was not observed.
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PMID:[Changes in the blood coagulation potential of premature calves with and without respiratory distress syndrome]. 271 60

2216 newborns and prematures with respiratory distress of different underlying diseases were treated with long term respiratory therapy from 1. Jan. 1975 to 31. Dec. 1985. One part of the patients were born in our hospital, the other part of them were transported from outside. The rate of prematures was 81.2%. The respiratory therapy was applied in 1813 cases because of pulmonary diseases (group 1.), while in 403 cases the respiratory troubles were extrapulmonary in origin (group 2.). The diseases in the first group were as follows: hyaline membrane disease in 482 cases (27.30%), intrauterine pneumonia in 634 cases (34.64%), postnatal pneumonia in 291 cases (15.90%), meconium aspiration syndrome in 110 cases (6.01%), severe RDS-II in 158 cases (8.63%), pulmonary immaturity in 116 cases (6.35%), persistent fetal circulation in 21 cases (1.15%) and pulmonary aplasia on the left in 1 case (0.021%). In the second group the greatest part of the cases were treated for neurological disturbances. We discuss the indications of different types of respiratory therapy and the complications as well. The survival rate was in the first group 59.3%, while in the second only 16.9%. Therefore the respiratory therapy seems to be more effective in the pulmonary diseases of the newborns. The mortality rate and the rate of severe complications were lower among inborn babies because of the early application of the respiratory therapy.
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PMID:[Continuous respiratory therapy of newborn and premature infants with respiratory disorders]. 277 89


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