Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One year's experience with MAS in a neonatal intensive-care unit is analyzed with follow-up information. Seventeen patients or 3.7% of all admissions had MAS. Four patients (23.5%) died of acute respiratory failure. Two patients with MAS and persistence of the fetal circulation required cardiac catheterization to exclude cyanotic congenital heart disease. No survivors had persistent chronic lung disease. However, two of three patients with MAS and seizures had significant psychomotor retardation at follow-up examination.
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PMID:Meconium aspiration syndrome. Neonatal and follow-up study. 8 Jan 35

Despite the generally salutary experience in recent years of managing suppurative pleuropulmonary disease, empyemas and lung abscesses have persisted and increased in incidence in hospitals such as Queens Hospital Center that serve large numbers of the socioeconomically disadvantaged. This study documents the etiology, clinical presentation, treatment, and treatment results of suppurative pleuropulmonary disease at Queens Hospital Center, which serves a large segment of the urban poor, many of whom are black. Results indicate that contributory or antecedent etiologic factors include a history of prior disease (specifically pneumonia, lung abscess, obstructive lung disease, pulmonary neoplasia, and tuberculosis); a predisposition to constitutional or immunologic deficiencies (specifically, alcoholism, anemia/malnutrition, drug abuse, and acquired immunodeficiency syndrome [AIDS]); conditions contributing to tracheobronchial aspiration (specifically, alcoholism and seizure disorders); and a miscellaneous group such as prior surgery, cardiovascular disease, and sepsis syndrome. The patients in this study were young with maximal incidence occurring in the third to fifth decades of life. Patients were predominantly male (75%) and black (66%). There were 18 deaths (23%), with sepsis being the cause in 10 (56%). Most surgical interventions were conservative, ie, bronchoscopies (48), thoracenteses (43), and tube thoracotomies (39). Thirty-one open thoracotomies were performed for drainage, decortication, or pulmonary resection. The surgical mortality was three cases or 5% of the patients who underwent surgery. The designated incidence of proven AIDS in this series (29%) was low, undoubtedly because many patients refused testing, and the multiple gram-positive and gram-negative infections that were seen did not conform to the Centers for Disease Control criteria for diagnosis and case reporting for AIDS.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The role of surgery in treating pleuropulmonary suppurative disease--review of 77 cases managed at Queens Hospital Center between 1986 and 1989. 160 13

The use of intravenous immunoglobulins (IVIG) has provided a substantial therapeutic advance in the treatment of antibody deficiency syndromes improving the quality of life of the affected patients. Among the advantages there are the possibility to employ higher doses to reach higher serum levels, with a more efficacious prophylaxis against infections; the prevention of chronic lung disease if IVIG are prescribed early, at diagnosis or at least at the onset of symptoms; the significant improvement of pulmonary function. The IVIG which are likely to be the best choice are the "intact Fc" preparations. In these products, or at least in some preparations, all IgG subclasses are present, which are endowed with specific and differentiated functions. Another important requirement is the presence of specific antibodies (e.g. anti Mycoplasmas, anti Campylobacter, anti Echovirus, anti pyogenic bacteria). The benefits of the prophylactic use of IVIG in preterm and low birthweight infants to prevent neonatal and late-onset infections are widely accepted. Lastly, IVIG are employed successfully in some autoimmune diseases as PTI and immune cytopenias, myasthenia gravis, acute and chronic inflammatory demyelinating polyneuropathy, Kawasaki syndrome, childhood recurrent seizures, juvenile chronic arthritis.
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PMID:[Current developments in the use of intravenous immunoglobulins]. 179 93

In a group of 236 very low birth weight (VLBW) surviving infants, 60 had developed bronchopulmonary dysplasia (BPD) in the nursery. When compared with the 176 infants without BPD, infants with BPD were smaller, more immature, with lower one- and five-minute Apgar scores. Infants with BPD had a greater incidence of cardio-pulmonary and central nervous system (CNS) complications in the nursery. On follow-up, 25 (42%) of these infants were abnormal developmentally compared to 7% of infants without BPD (p less than .001). When comparisons were made within the group of infants with BPD, very few differences were found in maternal or infant risk factors between the normal and abnormal infants. The infants with BPD who had poor outcome more often had seizures and severe intraventricular hemorrhage (IVH). The infants with BPD who had good outcome were more often small for gestational age (SGA) and resuscitated with intubation at birth. They had apnea in the nursery more frequently than did abnormal infants with BPD. We conclude that VLBW infants with BPD are at greater risk for poor neurodevelopmental outcome than those without BPD. The risk for the infant with BPD relates to CNS complications rather than to chronic lung disease.
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PMID:Prediction of neurodevelopmental outcome in infants with and without bronchopulmonary dysplasia. 203 22

We studied the importance of exposure to an elevated partial pressure of carbon dioxide (PCO2) in the development of scarring retinopathy of prematurity (SROP) in a cohort of 92 neonates with chronic lung disease (greater than or equal to 14 days of respiratory therapy, greater than or equal to 30 days of oxygen therapy, and greater than or equal to 70 days in the hospital), 31 of whom had SROP. This cohort was chosen to avoid confounding prolonged respiratory failure with the presence of SROP and because such a cohort was expected to contain approximately 85% of all patients with SROP. Patients with SROP had a lower PCO2 and spent more time on a respirator at higher respirator pressures during the first 70 days of life. In addition, infants with SROP had a lower mean arterial pressure and had a higher prevalence of seizures (97% vs 43%) and intraventricular hemorrhage (52% vs 26%). We conclude that an elevated PCO2 is not associated with SROP in this group of critically ill premature neonates but that the presence of a seizure disorder or an intraventricular hemorrhage is strongly associated with SROP.
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PMID:Retinopathy of prematurity. Risk factors in a five-year cohort of critically ill premature neonates. 310 83

Heterotopic gray matter, which previously had been associated with severe congenital malformations of the brain and developmental delay, was found without these associated conditions. The authors found ten cases of heterotopic gray matter on magnetic resonance (MR) images. The lesions had a signal intensity that was isointense compared with that of gray matter on T1, spin-density, and T2-weighted images. Nine of the ten cases were associated with a seizure disorder. The tenth case, discovered during a workup for metastatic lung disease, was confirmed with pathologic studies. Heterotopic gray matter is the presence of cortical neurons in an abnormal location, which may be periventricular (nodular) or within the white matter (laminar). A knowledge of heterotopic gray matter and its association with seizures may prevent the misinterpretation of findings on MR images.
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PMID:Association of heterotopic gray matter with seizures: MR imaging. Work in progress. 313 31

A retrospective study of nine sick premature infants with chronic lung disease who received captopril for control of systemic hypertension (systolic blood pressure (BP) greater than 113 mm Hg) was carried out to determine efficacy of therapy and associated complications. All nine infants had markedly elevated peripheral renin values, 134.3 +/- 128.1 ng/mL/hr (mean +/- SD). Five infants had abnormal renal sonographic and perfusion scans with evidence of renal artery thrombosis, parenchymal disease, or both. Captopril therapy (0.3 mg/kg) was instituted at a postnatal age of 123 +/- 108 days. After the initial dose, the systolic BP decreased significantly in all infants, the decrease ranging from 21% to 58% of the pretreatment value. Dosage was subsequently halved in all infants. Seventeen episodes of unpredictable decreases in BP more than 40% from baseline occurred during the reduced maintenance therapy. Four infants had a total of seven episodes during which the BP decreased by 57 +/- 10% from baseline; this decrease persisted for 17 +/- 6 hours and was unresponsive to volume reexpansion and inotropic therapy. All seven episodes were accompanied by oliguria (urine output less than 1 mL/kg/hr) that persisted for 18 +/- 12 hours. These episodes were accompanied by neurologic signs (subtle seizures, lethargy, and/or apnea) within 18 +/- 6 hours after the onset of oliguria. The remaining five infants had a total of 13 episodes of decreased BP of 50 +/- 8% of baseline, which were of significantly shorter duration and responded to volume reexpanders, inotropic therapy, or both and were unaccompanied by oliguria. These data suggest the need for close observation of BP in infants receiving maintenance captopril therapy.
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PMID:Renal failure in sick hypertensive premature infants receiving captopril therapy. 328 14

Antiasthma drug development, for the most part, seems based on three classes of therapeutic agents. Many new sympathomimetic and corticosteroid drugs with increased specificity for the lung have been introduced. The third class of drugs, the xanthines, is still best represented by the prototype drug theophylline. After a brief review of the chemical history of antiasthma xanthines (the first limited attempts to develop novel derivatives 30 to 40 years ago), and some recent structure-activity findings, this article discusses the pharmacology of a selected xanthine derivative, enprofylline (3-propylxanthine). In various experimental systems and in patients, enprofylline shares antiasthmatic effects with theophylline; however, enprofylline is the more potent of the two (greater than 1 to 2 micrograms/ml plasma are effective concentrations of enprofylline). At present, enprofylline, which lacks diaphragmatic and central nervous system stimulatory actions, has been shown to be at least as clinically efficacious as theophylline in obstructive lung disease. Further work is needed to elucidate the target cells and mechanism(s) of action involved in bronchodilatory and anti-inflammatory effects of the xanthines. Growing numbers of animal and human pharmacologic studies show that enprofylline is without many of theophylline's extrapulmonary effects--in particular the excitatory ones. Perhaps most significantly, enprofylline does not produce central nervous system stimulant behavioral effects, including seizures. If and when enprofylline becomes available as an alternative drug, increased attention will probably be focused on the significance of other theophylline actions (gastric secretion, release of free fatty acids, vasoconstriction, diuresis, etc.) that are not shared by enprofylline.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Development of safer xanthine drugs for treatment of obstructive airways disease. 353 62

To evaluate empiric dosing guidelines for aminophylline and phenytoin in the management of acute exacerbations of obstructive lung disease and seizure disorders, we utilized an emergency department (ED)-based EMIT system to measure stat plasma theophylline and phenytoin levels in patients intended to receive these drugs. Plasma drug level results were available prior to initiation of therapy. Of the patients evaluated, 45 of 163 (27.6%) aminophylline patients and 21 of 73 (28.7%) phenytoin patients were projected to have plasma concentrations below the recommended therapeutic range if empiric dosing schedules were employed. In addition, 39 of 163 (23.9%) aminophylline and 10 of 73 (13.7%) phenytoin patients, had they received these drugs empirically, would have had plasma theophylline and phenytoin levels in excess of the recommended therapeutic range using empiric dosing. We conclude that the use of empiric dosing guidelines for aminophylline and phenytoin in the ED do not reliably produce therapeutic plasma concentrations. The development of a stat drug analysis laboratory in the hospital or within the ED would improve the effectiveness and safety of these acutely used drugs with narrow therapeutic ranges.
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PMID:Effect of empiric dosing on blood levels of theophylline and phenytoin. 388 56

The eyes of infants who were premature or had exposure to increased ambient oxygen from 1979 to 1981 were examined. Of 1012 neonates, 19 were found to have acute retrolental fibroplasia (RLF) grade III or worse in at least one eye. Sixteen also had chronic lung disease (CLD), and when compared to 25 control patients who had CLD but not grade III or more RLF, they were found to consistently have lower blood CO2 tensions (PCO2), lower pH values, higher inspired oxygen concentrations (FIO2S) and a higher incidence of seizure disorders (100% vs. 48%). We could not show that an elevated PCO2 increased the risk for developing RLF. Infants with either chronic lung disease or chronic lung disease and seizures had a high risk for developing RLF grade III (39% and 57%, respectively).
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PMID:Risk factors associated with retrolental fibroplasia. 644 Nov 33


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