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

Water metabolism is a major problem in infants of very low birth weight. Their surface is proportionally larger, they have a relatively low intracellular water volume and a high extracellular and total body volume. Kidney function is immature compared to bigger infants, and the neuroendocrine function is also immature. Finally the large surface and the high skin permeability causes a very high insensible water loss in the early neonatal period. Water imbalance presents itself as either dehydration or overhydration. Dehydration gives poor peripheral--and renal circulation and thereby decreased renal function with acidosis. Furthermore hyperosmolar dehydration will give increased hematocrit and blood viscosity and hyperbilirubinaemia. Excessive administration of water will give oedema and congestive heart failure and possibly an increased risk for patent ductus arteriosus, bronchopulmonal dysplasia and necrotising enterocolitis. The evaporative water losses varies according to the thermal environment and air humidity and it is therefore impossible to give narrow limits for the daily water intake. Clinical examination, frequent controls of body weight (twice daily) and measurements of urine volume and osmolarity serve as guide lines. Yet inappropriate secretion of ADH may confuse the value of measuring urine osmolarity. Finally a neonatal weight loss of 5-10% may be beneficial as a decrease in extracellular water may lessen the working load of the heart and therefore possibly lessen the risk for a patent ductus. Renal immaturity in handling sodium reabsorption on the other hand, will often give an excessive dehydration. For this reason about 2 mmol Na/kg body weight should be given daily to very low birth weight infants from the fourth day of life to the 3rd-4th week if the baby is on human milk or a low salt formula.
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PMID:Water--the major nutrient. 2475 24

The clinical and urodynamic approach to enuretic children over a period of more than 20 years has allowed the authors to develop a multifactorial pathophysiological concept of this disorder. The main factors involved are psychological, familial, genetic, vesical, due to bladder immaturity, hormonal, due to a defect of nocturnal ADH secretion, hygiene and dietary habits, etc. The sleep factor is predominant in the majority of cases. Although nocturnal enuresis is apparently isolated in many cases, it is often associated with a state of bladder immaturity, sometimes latent during the day, but occurring at night with episodes of detrusor hyperactivity, occurring during various phases of sleep. In practice, the recognition, in children, of these factors, some of which require specific treatments, implies a management combining several of these therapeutic modalities.
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PMID:[Evaluation of 20 years' experience of enuresis in children]. 927 79