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

We performed a double-blind study in 101 preterm infants who weighed less than or equal to 1500 g at birth, who had respiratory distress, and who survived for at least four weeks, to evaluate the efficacy of oral vitamin E in preventing the development of retrolental fibroplasia. Weekly indirect ophthalmologic examinations begun when the infants were three weeks old revealed a significant decrease in the incidence of retrolental fibroplasia greater than or equal to Grade III (P less than 0.03) and greater than or equal to Grade II (P less than 0.05) (McCormick classification) in the 50 infants given 100 mg of vitamin E per kilogram of body weight per day as compared with 51 given 5 mg per kilogram per day (controls). When multivariate analysis was applied to the controls, five risk factors were identified: gestational age, level and duration of administration oxygen, intraventricular hemorrhage, sepsis, and birth weight. When multivariate analysis was applied to both control and treatment groups, the severity of retrolental fibroplasia was found to be significantly reduced in infants given 100 mg of vitamin E (P = 0.012).
 ...
PMID:Retrolental fibroplasia: efficacy of vitamin E in a double-blind clinical study of preterm infants. 702 75

Very low birth weights (VLBW) remain the major factor contributing to neonatal mortality and morbidity. The development of Neonatal Intensive Care Units (NICU) has improved the outcome for the VLBW infants. However, outborn VLBW infants may have different outcomes, and different medical costs than those born intramurally. This study compared the mortality, morbidity and costs of inborn and outborn VLBW infants cared in the NICU of a tertiary care center. A total of 176 VLBW infants (inborn 83, outborn 93) were examined over the three years period June 1990 to May 1993. The birth weights (1131 +/- 244 g vs 1133 +/- 255 g) and gestational ages (29.0 +/- 4.0 wk vs 28.9 +/- 3.0 wk) were not different between the two groups. However, the age of admission to our wards was significantly different between the inborn infants (5.0 +/- 3.2 hr.) and outborn infants (53.6 +/- 26.8 hr.). There was no difference in mortality rates between the outborn infants (35.7%) and the inborn infants (32.9%), nor in the incidence of intraventricular hemorrhage, respiratory distress syndrome, sepsis, necrotizing enterocolitis, retinopathy of prematurity or abnormal auditory brainstem response. However the incidence of patent ductus arteriosus and chronic lung disease of the outborn infants was higher than those of the inborn (47% vs 32%, 51% vs 29% respectively). The mean duration of hospitalization and cost seemed to be longer and higher in the outborn VLBW infants. It was concluded that outborn VLBW infants have higher rates of morbidity, longer hospitalization and cost more than inborn infants.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Outcome and cost of intensive care for very low birth weight infants. 757 69

With advances in neonatal intensive care survival of extremely low birth weight (< 1 kg) infants has increased significantly over the past decade. Dexamethasone is used increasingly for the prevention and treatment of chronic lung disease in these infants. The impact of dexamethasone therapy on the incidence or severity of retinopathy of prematurity (ROP) remains controversial. We conducted a retrospective study to evaluate the association between short-term dexamethasone treatment and severe ROP in extremely low birth weight infants. From October 1989 to December 1992, 309 very low birth weight infants were admitted to the neonatal intensive care unit. A total of 266 infants (86%) survived until hospital discharge. Of these, 90 weighed less than 1 kg. Thirty-eight of 90 infants received short-term dexamethasone therapy for chronic lung disease and the remaining 52 infants did not. Infants treated with dexamethasone and those not treated with dexamethasone were comparable in birth weight (820 vs 828 gm), gestational age (26.5 vs 26.9 weeks), inborn (11 vs 14), and occurrence of sepsis (13/38 vs 21/52). Infants treated with dexamethasone required longer periods of mechanical ventilation (44 +/- 23 vs 26 +/- 15 days, p < 0.001), had longer duration of supplemental oxygen (57 +/- 28 vs 29 +/- 23 days, p < 0.001), had higher incidence of patent ductus arteriosus (28/38 vs 18/52, p < 0.0003), and required surfactant therapy more often for respiratory distress syndrome (17/38 vs 11/52, p < 0.01), when compared with infants who did not receive dexamethasone. Severe ROP developed in 16 infants (stage III or higher); 12 of these were in the dexamethasone-treated group (p < 0.003). Thirteen infants required cryotherapy; nine were from the dexamethasone-treated group (p < 0.13). This study demonstrates an apparent association between the incidence of severe ROP and dexamethasone therapy. Prospective, randomized, controlled studies are needed to correct for differences in severity of cardiorespiratory illness to establish whether a causal role exists for steroid therapy in ROP. Until such studies are available, careful consideration must be given to indications, dosage, time of initiation, and duration of treatment with dexamethasone in extremely low birth weight infants.
 ...
PMID:Severe retinopathy of prematurity in extremely low birth weight infants after short-term dexamethasone therapy. 766 64

During January 1989-September 1991, in India, neonatologists prescribed assisted ventilation (intermittent positive pressure ventilation [IPPV] and continuous positive airway pressure [CPAP]) for 90 neonates born and treated at a tertiary hospital in Delhi. All neonates requiring more than 168 hours of ventilation received IPPV. The smallest surviving neonate weighed 830 g at birth and was born at 26 weeks' gestation. This neonate received 510 hours of ventilation. One neonate received 48 days of ventilation (gestational age at birth, 28 weeks; birth weight, 800 g). This neonate eventually died due to necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD), and sepsis. This infant was the only infant to develop NEC. A total of two newborns developed BPD. One infant developed retinopathy of prematurity (ROP). Indications for ventilation were hyaline membrane disease (HMD) (45/90), apnea (13/90), and transient tachypnea of the newborn (TTNB) (11/90). Almost all HMD cases who weighed more than 1.5 kg at birth on CPAP survived. CPAP successfully treated all TTNB cases. Nine neonates developed pneumothorax. Three of them survived. 34 neonates developed sepsis, the most common complication. 20 sepsis cases also had underlying pneumonia. Sepsis was responsible for 35% of deaths (14/40). Five infants on IPPV developed persistent pulmonary hypertension (persistent fetal circulation). 35 infants developed infection during ventilation, 34 of whom had a nosocomial infection. The nosocomial infection rate was 37.7%. Nosocomial infection was responsible for 35% of deaths. 12 babies (13%) developed pulmonary air leaks, 50% of whom died. 25 of the 33 infants on CPAP survived. Few CPAP cases developed pulmonary air leak, BPD, and ROP. Six of 22 very low birth weight (VLBW) infants (1 kg) survived. These findings led the researchers to recommend that medical centers with basic facilities for level II care should provide neonatal ventilation. They proposed that ventilation may not be cost effective for VLBW newborns, however.
 ...
PMID:Three-year experience with neonatal ventilation from a tertiary care hospital in Delhi. 788 27

One hundred and seventy-seven infants of birth weight less than 1500 grams admitted to the neonatal intensive care unit of Mackay Memorial Hospital in 1987 were studied. The sex distribution, male to female ratio was 100:77, inborn 78 cases, outborn 99 cases. At one year follow-up, the mortality rate of these weighed between 500 gm and 799 gm was 100%, between 800 gm and 999 gm 54%, between 1000 gm and 1249 gm 17%, between 1250 gm and 1499 gm 19% respectively. The mortality rate of outborns was higher than that of inborns (X2 = 6.03, P < .05). The most common cause of mortality of these infants was intracranial hemorrhage, it accounts for 55% of the mortality. Seventy-three percent of the deceased cases expired during the first three hospitalization days. Of these 177 cases, 94 were put on respirator with IPPB initially, another 47 cases were on nasal CPAP. Only 36 cases didn't require respiratory therapy. Complications of the extreme prematurity and management including intraventricular hemorrhage, pulmonary hemorrhage, sepsis, pneumothorax, persistent pulmonary hypertension, disseminated intravascular coagulopathy, electrolyte imbalance, bronchopulmonary dysplasia and retinopathy of prematurity were discussed. In order to improve survival and reduce complications of these extreme prematurity, advanced monitoring system, early detection and prevention of intracranial hemorrhage, establishment of the transport system are essential.
 ...
PMID:[Clinical study of infants with birth weight less than 1500 grams]. 823 56

This study attempted to identify predictors for mortality, morbidity, disability, and educational handicap at age 4 years in a cohort of 194 infants born at 23 to 28 weeks' gestation at one regionalized tertiary center from 1983 to 1986. Forty-one infants died (21%); standardized neurodevelopmental and functional assessments were conducted on 149 of 153 (97%) survivors at a mean age of 52 months. Five significant predictors of death were identified with logistic regression analysis: gestational age 23 to 26 weeks, intraventricular hemorrhage grades 3 or 4, male gender, five-minute Apgar < or = 3, and absence of prophylactic calf lung surfactant extract. Significant predictors of neurodevelopmental morbidity included sepsis, male gender, and nonwhite race. Significant predictors of disability at age four included neurodevelopmental impairment and severe retinopathy of prematurity. Low socioeconomic status, nonwhite race and male gender were predictive of educational handicap. These findings suggest that outcomes may have distinct pathophysiologies. The role of biomedical events appears strongest for death.
 ...
PMID:Predictors of mortality, morbidity, and disability in a cohort of infants < or = 28 weeks' gestation. 825 4

Neonates of 34 triplet pregnancies were admitted to our neonatal unit over a twelve-year period (1983 to 1995), with an incidence of 1 out of 812 deliveries. Thirty (88%) of the pregnancies were the result of ovulation induction and artificial fertilization: artificial insemination from husband (n = 3), in vitro fertilization (n = 9), and gamete intra-fallopian transfer (n = 6). All except one had antenatal sonographic diagnosis, 79% in the first trimester. The most common pregnancy-related complication was preterm labor (56%). Twenty-seven (79%) were delivered by cesarean section. There were 101 live births (one stillborn). Mean gestation age was 33.6 +/- 2.94 weeks, mean birthweight 1809 +/- 485 g, with 7 extremely low birthweight (< 1000 g [6.8%]). Neonatal complications included respiratory distress syndrome (12%), intraventricular hemorrhage (8.8%), retinopathy of prematurity (8%), sepsis (3%), severe asphyxia (3%), and omphalopagus conjoined twins (1%). The perinatal and neonatal mortality was 49 per 1000 and 59 per 1000, respectively. The introduction of advanced artificial fertilization techniques and ovulation induction agents resulted in a major increase in multifetal gestations. Early prenatal diagnosis, judicious prolongation of gestation, and planned delivery by cesarean section combined with major improvement in neonatal care by experienced neonatologists has improved survival of triplet neonates.
 ...
PMID:Changing epidemiology of triplet pregnancy: etiology and outcome over twelve years. 886 45

This report describes outcomes for all infants with birth weight 501-1750 grams born in the three major maternity hospitals in Dublin between 1.1.90 to 31.12.91. 37,958 mothers delivered 38,498 infants during this period, consisting of approximately 36% of all deliveries in Ireland. 633 (1.6%) of all infants born weighed 501-1750 grms. 102 (16%) were stillborn and 28 of the 531 live born infants had lethal malformations. 30% of women received two or more doses of antenatal steroids before delivery and a highly significant negative correlation occurred between the need for ventilation after birth and antenatal steroids. 56.4% of babies were delivered by caesarean section as compared with 10.8% of the hospital population. Of 503 liveborn infants without lethal malformation. 426 (85%) survived to 28 days and 419 (83%) to discharge home. 15% were growth retarded. 46% of infants were ventilated, mean duration of ventilation was 7 days. 25% of infants had an intraventricular haemorrhage, 10% necrotising enterocolitis and 19% culture proven sepsis. 15% of survivors developed broncho pulmonary dysplasia and 12% retinopathy of prematurity. This paper describes important information for mortality, morbidity and interventions among a large population of low birth weight infants in Ireland and can be used as a basis against which to compare future alterations in practice. It demonstrates a clear benefit for antenatal steroids in decreasing the need for ventilation and the importance of ensuring their utilisation antenatally where possible.
 ...
PMID:The Dublin outcome for low birth-weight infants. 893 44

In a prospective study at Sultan Qaboos University Hospital, out of 73 premature infants screened for retinopathy of prematurity (ROP), 25 (34 per cent) developed the disease. Nine significant risk factors were found to be associated with the development of ROP. These factors were lower birth weight, shorter gestational age, apnoea, top-up blood transfusion, mechanical ventilation, receiving sodium bicarbonate for correction of metabolic acidosis, total parenteral nutrition, intraventricular haemorrhage, and sepsis. However, with stepwise logistic regression analysis, only birth weight, gestational age, and total parenteral nutrition were found to be independently associated with the development of ROP. The severity of ROP was significantly inversely proportional to both birth weight and gestational age. The tendency for the association of some risk factors to disappear when subjected to more stringent analysis (logistic regression) suggests that this association is more likely to be due to the length of treatment (particularly oxygen exposure and mechanical ventilation) and the overall severity of initial illness.
 ...
PMID:Risk factors associated with retinopathy of prematurity: a study from Oman. 900 63

This study was designed to evaluate neonatal morbidity and mortality following preterm delivery in the setting of mature amniotic fluid pulmonary studies. We performed a retrospective analysis of all pregnancies resulting in preterm deliveries (< 37 weeks) from 1/1/88 to 5/31/92 in which there was a "mature" phospholipid profile, defined as positive phosphatidylglycerol (PG) or lecithin/sphyngomyelin (L/S) ratio > or = 2 determined within 1 week of delivery. Excluded were multiple gestations, diabetic pregnancies, and fetal or neonatal abnormalities involving the cardiovascular, renal, or pulmonary tract. Main outcome measures were incidence of significant neonatal morbidity, including respiratory distress requiring respiratory support, sepsis, patent ductus arteriosus, grade 3-4 intraventricular hemorrhage, necrotizing enterocolitis, retinopathy of prematurity, meningitis, and pneumonia. A total of 153 patients fulfilled the inclusion criteria. Mean (SD) gestational age at delivery and birth weight were 33.8 (2.1) weeks and 2298 (561) g, respectively. There were no neonatal deaths, but significant morbidity was present in 20% (31/153) of cases. The most common major neonatal complications were respiratory distress (12%) and suspected or documented sepsis (16%). Univariate analysis showed that frequency of major neonatal morbidity was related to gestational age at delivery (p < 0.001), birth weight (p < 0.001), Apgar score at 5 minutes < 7 (p = 0.008) and method of lung maturity assessment (complications were ore frequent when lung maturity was defined by L/S > or = 2 than by PG positivity) (p = 0.02). Multivariate analysis demonstrated a significant association between the presence of a neonatal complication and method of lung maturity assessment after adjustment for gestational age at delivery (p = 0.04). The incidence of major neonatal complications among preterm infants is high even in the presence of mature fetal lung studies; this incidence is related primarily to the gestational age at birth, and secondarily to the method of lung maturity testing (complications are less common in the presence of PG positivity than of L/S > or = 2).
 ...
PMID:Morbidity in the preterm infant with mature lung indices. 925 2


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>