Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Perinatal infections with bacteria belonging to the genus campylobacter are being increasingly recognized. We present a case of early onset neonatal sepsis with Campylobacter jejuni (previously C. Fetus ss. jejuni or Vibrio jejuni). The infant was born prematurely at 31 weeks of gestation and presented with respiratory distress and frequent apnoea from birth. The chest X-ray film demonstrated reticulogranular pattern consistent with hyaline membrane disease. The infant was successfully treated with ampicillin and gentamicin. C. jejuni infection should be considered in the differential diagnosis of early onset sepsis in the neonate and can mimic the radiological picture of hyaline membrane disease.
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PMID:Early onset neonatal sepsis with Campylobacter jejuni: a case report. 202 21

Extracorporeal membrane oxygenation (ECMO) has rescued moribund infants with respiratory failure from a variety of causes. We report the experience from 58 United States and 7 overseas ECMO centers between 1980 and 1989. Voluntarily submitted data forms provided details of diagnosis, clinical condition, ECMO indications, morbidity, and mortality. Of 3,528 infants with a predicted mortality greater than 80% treated with ECMO, 83% survived. Entry diagnoses and aggregate survival were: meconium aspiration syndrome (MAS) 1,356 (93%), persistent pulmonary hypertension of the newborn (PPHN) 480 (83%); congenital diaphragmatic hernia (CDH) 585 (62%); hyaline membrane disease (HMD) 532 (84%); sepsis 416 (77%); and other 185 (77%). ECMO indications were a-AdO2 greater than 600 for 6 to 8 hours (22%), oxygenation index greater than 40 for 4 hours (18%), acute deterioration (14%), maximal therapy failure (34%), and barotrauma (1%). Annual survival improved over 9 years except for CDH, which decreased from 70% (1987) to 56% (1989) P less than .01). Survivors differed from non-survivors (P less than .05) by birth weight (greater than 2 kg), gestational age (greater than 37 weeks), entry diagnosis (MAS, PPHN, HMD, sepsis v CDH), inborn versus outborn, pre-ECMO pH, and ECMO duration. Technical complications in 25% of patients and medical complications in 75% adversely affected survival. Annual sepsis survival improved to 75% (1989) but had significantly greater complication rates (P less than .05) than other diagnoses. Multicenter data yield information not available from single institution experience. Although entry criteria and conventional therapy continue to evolve, ECMO currently improves survival from an estimated 20% to 83% overall. Individual prognosis depends on entry diagnosis, clinical condition, and complications.
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PMID:Extracorporeal membrane oxygenation and neonatal respiratory failure: experience from the extracorporeal life support organization. 206 12

In a neonatal unit which, at that time, had no facilities for artificial ventilation, 14 newborn infants with birth weight greater than or equal to 1,500 g fulfilling the diagnostic criteria for severe hyaline membrane disease (HMD) were treated by tracheal instillation of bovine surfactant (200 mg/kg). Twelve of these babies showed increased transcutaneous PO2/FiO2 ratio within 2 min, the average therapeutic response being sustained for at least 72 h. One of the two babies who did not respond to treatment was later diagnosed as a case of group B streptococcal pneumonia. One baby with favorable initial response died from sepsis at the age of 7 days; the other patients survived without sequelae. We conclude that treatment with exogenous surfactant might be considered as an alternative to ventilator treatment in babies with severe HMD.
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PMID:Surfactant replacement in spontaneously breathing babies with hyaline membrane disease--a pilot study. 227 46

In order to detect existing problems and opportunely pinpoint failures, an evaluation was conducted to determine the most frequent causes of morbidity and mortality in a neonatal ward. A retrospective analysis was carried out on the total number of births attended per year (1,003) at the hospital and of those newborns, those transferred to the neonatal ward (213, 21.2%). Of the 213 newborns placed in the neonatal ward, 30 of them (14.08%) were transferred to a Third Level Hospital (Neonatal Intensive Care Unit) while the rest remained in the neonatal ward. The five most frequent pathologies seen at the ward were reviewed. A high percentage (28.1%) of the patients were considered as potentially infected, while the remaining pathologies encountered were found to be similar to others reported elsewhere in the literature. Of the 183 babies looked after in the neonatal ward, 176 (96.17%) were cured and later discharged from the ward while the other seven died (3.8%) due to hyaline membrane disease, intracranial hemorrhaging, ischemic hypoxic encephalopathy and hospital-acquired septicemia. We conclude that specialized prenatal care and the early detection of high risk pregnancy decreases morbidity and mortality in second level hospital wards. Recommendations are given on the management of neonatal ward.
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PMID:[Morbimortality at a second-level neonatology unit]. 233 60

To focus attention on the problem of infant mortality in Lebanon, data were compiled on infant mortality from 1978 to 1986 at the American University of Beirut Medical Center. Causes of death are analyzed for 602 males and 398 females. 54.9% deaths occurred at 1 month of age and 77.4% died within the 1st year. Autopsies were performed on .7%. 37.7% of all neonatal deaths were due to neonatal diseases such as hyaline membrane disease, asphyxia neonatorum, immaturity, necrotizing enterocolitis, hemorrhage, hemolysis, meconium aspiration, and kernicterus. Better prenatal care would reduce this group, or the administration of corticosteroids to the mother 24-48 hours prior to delivery, as well as rapid resuscitation at birth and prevention of the 5 curses: hypoxemia, hypoglycemia, hypothermia, hypotension, and acidosis. Although unavailable in Lebanon, administration of surfactants through an endotracheal tube would also help. Infections constitute 25.1% of deaths; many are preventable through adequate public health measures and strict personal hygiene, i.e., diseases such as sepsis, pneumonia, meningitis, gastroenteritis, hepatitis, encephalitis, and 1-2 cases of the following: diphtheria, measles, peritonitis, tetanus, tuberculosis, cytomegalis inclusion, herpes, parathyphoid, pertussis, poliomyelitis, and shigellosis. Congenital diseases were 21.6%. In utero diagnosis could prevent some diseases and in utero treatment is possible for hydrocephalus and hydronephrosis. Screening programs postnatally could lead to treatment. 5.9% were malignancies such as leukemia, lymphoma, brain tumors, histocytosis, Wilm's tumor, Ewing sarcoma, and Hodgkin's disease. Early diagnosis is critical if mortality is to be reduced in this group, but medical advances are still needed. 2.9% are miscellaneous diseases such as poisoning, rheumatic diseases, marasmus, Reye's syndrome, nephrosis, rickets, and epilepsy. Most of these diseases are preventable, except for rheumatic inflammation of the heart. Recommended necessary steps to reduce infant mortality are: prenatal care, diagnosis and screening, intrauterine surgery; resuscitation and intensive care centers with modern equipment and trained personnel; national vaccination and screening programs; adequate public health measures and hygiene; parental education; and well-equipped hospitals to serve all regardless of income level.
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PMID:Pediatric mortality: an avoidable tragedy. 251 28

Listeria monocytogenes is a gram positive cocco-bacillus which causes perinatal infections and also attacks immunocompromised hosts. Little is known about it in our medium. As part of a prospective study on neonatal systemic infections, its participation at the National Institute of Perinatology was researched. During a period of 18 months, 9,283 live newborns were observed, 141 of them were diagnosed with neonatal septicemia. During this period seven neonates had systemic infections due to Listeria monocytogenes: three had septicemia (two of these with meningitis) and all seven cases had pneumonia. The gestational age of the neonates was 26.1 to 41 weeks (X + DS = 35 + 4.3), with a weight of 830 g to 2,975 g (X + DS 1,958 + 773), four out of seven weighed less than 2,000 grams. The most frequent clinical manifestation was respiratory related causing a need for a differential diagnosis with hyaline membrane disease, transitory tachypnea and meconium swallowing at birth. All of the strains isolated were found to be susceptible to ampicillin, penicillin, gentamicin and amikacin; requiring high CMI levels of cephalosporins.
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PMID:[Neonatal systemic infection caused by Listeria monocytogenes]. 263 40

Endogenous formation of thromboxane A2 and prostacyclin were evaluated in seven neonatates with persistent pulmonary hypertension by serial gas chromatographic mass spectrometric determination of their urinary metabolites dinor-thromboxane B2 and dinor-6-keto-prostaglandin F1 alpha, respectively. The patients were studied until their hypertension had resolved on clinical criteria. Urinary excretion of dinor-thromboxane B2 and dinor-6-keto-prostaglandin F1 alpha was increased when the persistent pulmonary hypertension was associated with group B streptococcal (n = 2) and pneumococcal (n = 1) sepsis. Based on urinary metabolite excretion, endogenous formation of thromboxane A2 and prostacyclin did not consistently differ from normal neonates in four patients with non-septic persistent pulmonary hypertension (hyaline membrane disease (n = 2), asphyxia, and meconium aspiration). These data suggest that thromboxane A2 is not a universal mediator of persistent pulmonary hypertension. It may, however, have a role in the pathophysiology of early onset group B streptococcal disease, and persistent pulmonary hypertension of other infectious aetiology. If these findings are confirmed by further studies, thromboxane synthetase inhibition or receptor antagonism may offer a potential therapeutic approach in neonates with persistent pulmonary hypertension associated with sepsis.
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PMID:Endogenous formation of prostanoids in neonates with persistent pulmonary hypertension. 267 60

Extracorporeal membrane oxygenation (ECMO) is an approved therapy for some neonates who have respiratory failure that is due to hyaline membrane disease, meconium aspiration, persistent pulmonary hypertension, congenital diaphragmatic hernia, or sepsis. The major complication of this therapy is hemorrhage, with intracranial hemorrhage having the highest morbidity and mortality. Seizures, incisional bleeding and bleeding in the pleural space, hypoxic-ischemic encephalopathy, renal failure, and cardiovascular complications account for most of the other complications. Cranial sonography provides an ideal imaging modality for baseline evaluation and daily follow-up; however, computed tomography and magnetic resonance imaging, because of better sensitivity, are important for assessment after ECMO. The changes in intracranial blood flow related to ECMO can be noninvasively evaluated by Doppler ultrasound modalities.
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PMID:Neurosonographic findings in infants treated by extracorporeal membrane oxygenation (ECMO). 268 79

Elastase, a neutral protease stored in the azurophilic granules of neutrophils, is immediately released during the process of phagocytosis and rapidly bound and inactivated by alpha 1-proteinase inhibitor. This complex (E-alpha 1-PI) is highly stable and can be identified by ELISA-technique. In our study 95% of all infants with neonatal septicemia and/or meningitis had significantly increased plasma levels of E-alpha 1-PI at the time of diagnosis (n = 37). After initiation of therapy normalization of E-alpha 1-PI levels was observed in all neonates who recovered from infection. These data suggest that E-alpha 1-PI is a sensitive and rapidly responsive indicator of neonatal septicemia. In addition E-alpha 1-PI may be helpful in monitoring the course of the disease. However, the specificity of E-alpha 1-PI is rather low: in patients with local infections and inflammatory processes such as neonatal pneumonia, enterocolitis and meconium aspiration E-alpha 1-PI levels were also shown to be increased. In contrast, all patients with hyaline membrane disease had E-alpha 1-PI levels within the normal range.
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PMID:[Elastase-alpha 1-proteinase inhibitor in diseases of the neonatal period]. 304 7

Using 1984 perinatal mortality rates as indicators of the level of maternal and newborn health care service quality and efficiency, Libya's high perinatal loss is compared to perinatal losses of 9 other developing countries. Timely antenatal care is identified as the essential component needed to reduce perinatal loss. Libyan perinatal, still birth, and early neonatal death rates were 26.3, 11.4, and 14.9/100, respectively. Perinatal death rates of other countries in the study ranged from 18.8 to 100/thousand. The major causes of still births in Libya included antepartum hemorrhage, cord accidents, maternal diabetes mellitus, and fetal malformations. The effect of timely obstetric care in reducing still birth rates (SBR) is evidenced by comparing SBRs of 16.8 to 63.8 in pregnant women receiving or not receiving minimal antenatal care at a peripheral health center, respectively. The clinical causes of early neonatal death were major congenital malformation (24.9%), hyaline membrane disease and aspiration syndrome (26.1%), birth asphyxia and injury (17.9%), very low birth weight (17.2%), and sepsis/meningitis (13.1%). High general fertility rates of developing countries leads to increased proportions of women under 20 and over 35 years of age bearing children. These women are prone to bearing offspring comparatively more vulnerable to early neonatal death. Consanguineous marriages leading to congenital malformation, and lack of maternal immunization with tetanus toxoid are also cited as factors contributing to high perinatal mortality. In closing, the authors call for future community-based studies, and recognize socioeconomic level as a main determinant in obtaining obstetric care.
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PMID:Perinatal outcome at Benghazi and implications for perinatal care in developing countries. 316 32


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