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

Thirteen biochemical parameters and five enzymatic activities were determined on sera of 63 normal human fetuses sampled by direct puncture under ultrasound guidance, between the 20th and the 26th wk of gestation, and on their mothers. They were referred to us for various prenatal diagnoses but were well and confirmed healthy at birth. Some parameters were found to be very similar in both groups, mainly creatinine, calcium, creatine kinase, aspartate aminotransferase, and gamma-glutamyl transferase. Some values were significantly higher in the fetuses, such as total bilirubin, direct bilirubin, phosphorus, lactic dehydrogenase and alkaline phosphatase activities, and alpha-fetoprotein. Urea, uric acid, glucose, triglycerides, cholesterol, total protein, and albumin levels were found to be lower in fetuses. These data indicate a slower metabolism in fetuses compared to their mothers, a lower level of energy requirement, and a relative liver immaturity. These normal values of fetal biochemistry will improve our knowledge of physiology and help to determine the specific values of a test in fetal pathology.
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PMID:Blood chemistry of normal human fetuses at midtrimester of pregnancy. 243 76

Clearance experiments concerning the influence of hypophysin + (0.1 vol. unit/kg) and desoxycorticosterone-21-acetate (0.1 mg/kg) on sodium, potassium, calcium, magnesium and inorganic phosphorus excretion in urine have been carried out on 12 bulls at the age of 2-5 weeks of life. After hypophysin injection kidney purification of sodium, potassium and chloride ions has been noticed and hypophysin effect on tubular absorption processes turned out to be clearly late in relation to its influence on glomerular filtration decrease. After desoxycorticosterone-21-acetate injection, lowering of clearances of both sodium and potassium has been noticed and it may prove that kidney mechanisms responsible for potassium ion regulation show functional immaturity. Hypophysin and desoxycorticosterone-21-acetate in calves at the age 2-5 weeks have not affected kidney processes of calcium, magnesium and inorganic phosphorus excretion in urine.
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PMID:[Effect of hypophysin and desoxycorticosterone-21-acetate on renal function in calves in the neonatal period. II. Urinary excretion of electrolytes]. 248 70

As part of a randomised controlled study to assess the effect of pasteurization of breast milk on the growth of very-low-birth-weight infants, the longitudinal changes in serum calcium, phosphorus, alkaline phosphatase, 25-hydroxyvitamin D, and bone-gla-protein concentrations were investigated. Infants fed untreated own mother's milk grew more rapidly than those fed pasteurized pooled preterm milk and had higher serum alkaline phosphatase and lower phosphorus values. Serum calcium and 25-hydroxyvitamin D (25-OHD) concentrations were similar in the two groups. Despite the provision of 750 IU vitamin D daily from the 2nd week of life, serum 25-OHD values remained low in a number of infants in both groups, suggesting that either malabsorption of vitamin D or hepatic immaturity might be responsible for the persistently low values. Bone-gla-protein rose significantly after birth and was correlated with alkaline phosphatase values, but not with 25-OHD or phosphorus values. The study supports previous work that indicates that the low phosphorus content of breast milk is probably responsible for biochemical evidence of inadequate bone mineralization and that despite vitamin D supplementation, 25-OHD values do not rise adequately. Thirty-six infants were reexamined between 4 and 11 months after birth. The 25-OHD values had risen significantly in all infants except one who had vitamin D deficiency rickets.
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PMID:Mineral homeostasis in very low birth weight infants fed either own mother's milk or pooled pasteurized preterm milk. 351 33

Optimalize the feeding of low birth weight infants is a very important problem in industrial as well as in developing countries where such infants are very numerous. Water need is very important but gastric and vascular capacity is limited in LBW infants. Energy has to be absorbed at a rate of 120 to 130 Kcal/kgBW/day without raising the osmolarity of the food. Protein intake has to be higher than in term babies but due to enzyme and kidney immaturity the amino acid pattern of the protein has to be carefully adapted to the pattern of the proteins to be synthesized. Calcium, phosphorus, iron, zinc and other trace minerals as well as vitamins have to be provided in relatively large quantities but their bioavailability has also to be checked. The utilisation of breast milk and particularly of own mothers milk having delivered prematurely is also discussed.
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PMID:[New aspects in the nutrition of newborn infants with low birth weight]. 377 17

The preterm newborn infant for his very high growth rate is especially vulnerable to any deficiency or excess of the nutritional intake. Moreover he differs from the older infant because of the immaturity of many biological function. Such immaturity is temporary in the term newborn, while lasts longer in the preterm newborn infant. In this paper needs for energy, proteins, lipids, carbohydrates and minerals in the preterm newborn are reported. They are based on metabolic balance studies carried out in preterm newborn infants fed either human milk or different formulas. The own mother fresh milk, supplemented with phosphorus, appears to be the best feeding for the preterm infant. Formulas conveniently adapted in carbohydrates, proteins, lipids and minerals content may be used as reasonable substitutes. On the contrary the pooled pasteurized human milk is not advisable.
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PMID:[Nutritional requirements of the low birth-weight newborn infant]. 391 50

Myocardial calcification has been rarely described in premature infants after myocardial infarction and myocarditis with coxsackievirus B1. In adults and older children, metastatic myocardial calcification has been reported in chronic renal failure. We report a case of myocardial calcification in a 680-gm preterm infant after a prolonged course of renal failure complicated by secondary hyperparathyroidism. Subclinical myocardial injury was evidenced by a high serum creatine phosphokinase MB band concentration, which probably provided a susceptible substrate for the deposition of calcium crystals, because the multiplication product of serum calcium and inorganic phosphorus levels transiently exceeded 75 mg x mg/100 ml, indicating serum saturation during the course of secondary hyperparathyroidism. We report this case as an unusual complication of renal immaturity in extremely low birth weight infants and an indication of a relatively intact parathyroid glandular function in them. Hypoxia, myocardial dysfunction, and renal failure are common complications in such infants, and in the presence of renal failure, the serum levels of calcium and inorganic phosphorus should be maintained below the pathologic level to avoid ectopic calcification of the tissues, including the myocardium.
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PMID:Myocardial calcification in an extremely low birth weight infant with chronic renal failure and secondary hyperparathyroidism. 851 2

African teenagers with slipped capital femoral epiphysis (SCFE) not infrequently also have genu valgum (knock-knee). Because we had previously demonstrated metabolic bone disease attributable to dietary calcium deficiency in black teenagers with genu valgum, we examined 29 black teenagers (15 male, 14 female) with SCFE for metabolic bone disease. Each patient had an iliac crest bone biopsy taken (after double tetracycline labeling) for routine histomorphometry, and blood and urine samples for bone biochemistry. Spinal bone mineral density was measured in 13 patients. Compared to reported data, we found our patients to be sexually more immature, older, at least as obese, and to have more severe and more frequently bilateral hip disease. Eighty percent of the children took dairy products only once or twice a week or less frequently, and 37.9% had genu valgum. Compared with race- and age-matched South Africans, bone biopsies in our patients showed lower bone volume (BV/TV, p = 0.0003), wall thickness (p = 0.0002), and trabecular thickness (Tb.Th, p = 0.0002), and a tendency to greater trabecular spacing (Tb.Sp, p = 0.053). Lower osteoid volume (OV/BV, p = 0.0001), osteoid surface (OS/BS, p = 0.0001), osteoid thickness (O.Th, p = 0.0002), double labeled surface (dLS/BS, p = 0.029), and bone formation rate (BFR/BS, p = 0.037) suggested poorer bone forming capacity in our patients. No evidence of hyperparathyroid bone disease or osteomalacia was found. BV/TV was below the reference range (14.2%) in 65.5% of cases; these patients had lower values for Tb.Th (p = 0.037) and Tb.N (p = 0.0003), greater Tb.Sp (p = 0.0002), a tendency to lower adjusted apposition rate (Aj.AR, p = 0.057), and had had less frequent intake of dairy products than those with normal BV/TV (p = 0.024). Furthermore, months since menarche correlated with histomorphometric variables BV/TV (r = 0.667, p = 0.009), Tb.Th (r = 0.745, p = 0.002), Tb.Sp (r = -0.549, p = 0.042), O.Th (r = 0.784, p = 0.0009), and Aj.AR (r = 0.549, p = 0.042). The correlation between Tb.Th and spinal bone mineral content (r = 0.656, p = 0.015) suggests that the reduced trabecular thickness reflected a generalized bone condition. A greater than normal proportion of patients had spinal bone mineral density values below -1 standard deviation (SD) of the mean (osteopenia) (p = 0.001). Patients tested for parathyroid hormone and 25-hydroxyvitamin D levels were found to have normal values. Parathyroid hormone correlated with Aj.AR (r = 0.661, p = 0.038) and serum phosphorus (r = -0.764, p = 0.010). We conclude that sexual immaturity and possibly past dietary calcium deficiency contributed to osteopenia, and that this, together with obesity, led to the development of more severe and more frequently bilateral SCFE in our patients than in reported series of black and white children.
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PMID:Bone disease in African children with slipped capital femoral epiphysis: histomorphometry of iliac crest biopsies. 951 18

Nutritional insufficiency, leading to early growth deficits has long-lasting effects, including short stature and poor neurodevelopmental outcomes. Early enteral feeding is commonly limited by immaturity of gastrointestinal motor function in preterm neonates. To ensure that a stressed premature infant receives an adequate but not excessive amount of glucose, the amount of carbohydrate delivered in the form of dextrose is commonly initiated at the endogenous hepatic glucose production and utilization rate of 4 to 6 mg/kg/min; and 8 to 10 mg/kg/min in ELBW infants. The early provision of protein is critical to attain positive nitrogen balance and accretion as premature babies lose approximately 1% of their protein stores daily. Aminoacid can be used at concentrations of 3-3.5 g/kg/day and lipid at 3.5-4 g/kg/day as long as the fat intake remains less than 60% of nonprotein calories. Sodium, potassium, chloride, calcium, magnesium and phosphorus need to be provided in PN solution as per their daily needs. Hospital-acquired infection (HAI) is a major complication of PN. All efforts should be made to avoid it.
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PMID:Parenteral nutrition. 1853 94

The low birth weight infant's (LBW) nutrition needs special attention. Energy requirements are increased due to a high metabolic rate and a low thermogenesis. Increased protein requirements are, easy to be absorbed (from lacto-serum). Lipids, as important energetic source requires an appropriate content in essential fatty acids and medium chain triglycerides (TGM) which are easy absorbed in absence of lipase and deficit of bile salt secretion. The carbohydrates should be represented by lactose or equivalents like di-, oligo or polysaccharides. The addition of maltodextrin avoid an exaggerate supply and incomplete digestion of lactose. Sodium requirement are increased due to exaggerated loss consequence of renal immaturity. The rapid rate of growth impose the addition of Calcium, Phosphorus, Iron, Copper, and vitamins, especially Vitamin D, E and Folic acid. The appropriate nutrition of LBW must cover his special needs to maintain the homeostasis and rapid growth. Precise nutrient requirements are, however, difficult to establish.
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PMID:[Nutrition of low birth weight infants]. 1867 1

Metabolic bone disease (MBD) of prematurity remains a significant comorbid condition in preterm, low birth weight infants. As the majority of in utero calcium (Ca) and phosphorus (Phos) accretion occurs during the third trimester, many of these children have inadequate mineral stores and are at risk for deficiencies of Ca and Phos. While fortification of formula has allowed for increased mineral delivery to premature infants, intestinal immaturity prevents optimal absorption. This is compounded by immobilization, delayed establishment of enteral feeds, long term parenteral nutrition and medications that may alter mineral levels. Over time, biochemical changes occur and accompany MBD, with poor bone mineralization during this period increasing the risk for complications such as osteopenia, rickets and fractures. Screening is largely based on risk factors, but despite the 2013 AAP Consensus Statement, there remains significant variation in screening practices across institutions. A combination of laboratory and radiologic testing is often used to diagnose and manage MBD of prematurity, but there exists a lack of consensus on which screening tests and thresholds to use. This is in part related to a lack of normative data and clinical trials for preterm infants, and a result, a lack of evidence-based guidelines on the diagnosis and timing of potential treatment. Biochemical markers, such as serum Phos, alkaline phosphatase (ALP) and parathyroid hormone (PTH), have shown some benefit in the diagnosis of MBD in some studies, but have not always been reproducible. Radiographs may identify different degrees of skeletal changes, but these changes may not be detected until later in MBD development. Other modalities, such as DXA and ultrasound, have also been used, but these may be limited by lack of standards in preterm infants or lack of availability in some centers. Further research, more specifically clinical trials, are needed to determine which combination of tests can detect MBD at its earliest, in order to promote early treatment and prevent short- and long-term complications of MBD.
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PMID:Screening for Metabolic Bone Disease of prematurity. 3208 92


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