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Query: UMLS:C0243026 (sepsis)
 52,417 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Intestinal malrotation may be complicated by volvulus and intestinal necrosis. One hundred two children (64 male, 38 female) undergoing surgical abdominal exploration from 1977 to 1987 had malrotation. Fifty-two patients were less than 7 days of age, 13 from 8 to 30 days, 26 from 31 to 365 days, and 11 were older than 1 year of age. Of infants, 39 of 65 had 40-week gestations, 18 of 65 had 36- to 39-week gestations, and 8 of 65 had less than 36-week gestations. Chief symptomatology included: bilious emesis (47), intestinal obstruction (19), abdominal pain (11), and bloody stools (7). Seventy patients had congenital anomalies (50 single, 20 multiple). Diagnostic evaluations included 56 upper gastrointestinal series and 27 barium enemas. Each patient underwent correction of malrotation and appendectomy, and correction of congenital anomalies (omphalocele-9, gastroschisis-6, diaphragmatic hernia-7). Complications included short gut (2), sepsis (5), feeding difficulties (2), pneumonia (3), small bowel obstruction (2), and other (15). Nine patients (8.8%) died (trisomy 18-1, trisomy 13-1, intestinal necrosis-3, hepatic failure-1, prematurity-1, other sepsis-2). Two hundred sixteen children with intestinal malrotation have been treated from 1937 to 1987. Mortality rate has improved from 23% to 2.9%.
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PMID:Malrotation of the intestine in children. 154 4

Over a 4 year period, nine of 180 (5%) infants weighing less than 2000 G, admitted to the Aga Khan University Hospital (AKUH) developed necrotizing enterocolitis (NEC). An outbreak of NEC occurred in 1989, during which six infants developed the clinical illness. Overall incidence was 1.1%. Thirty-one birth weight and gestation matched controls were selected for comparison. Risk factors usually considered as predisposing factors, i.e., low 5 min Apgar score, rate of maternal complications, respiratory distress syndrome, mechanical ventilation, umbilical catheterisation, patient ductus arteriosus, use of antibiotics and feeding practices were found with equal frequency in both cases and controls. Six infants had positive blood and/or peritoneal fluid cultures (66%) compared to only five (16%) in the control group (P less than 0.01). Our data suggests that prematurity and sepsis are important predisposing factors for development of NEC.
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PMID:Necrotizing enterocolitis in infants weighing less than 2000 G. 157 65

High serum bilirubin levels (SBL), over 20-25 mg/dl are toxic for the Central Nervous System (CNS) of newborn infants. However, the possible toxicity on the CNS of "intermediate" SBL both in term and preterm neonates are still a matter of debate. An extensive review of the literature in this respect did not provide conclusive evidence for a dose-response pattern of toxicity for SBL 18-20 mg/dl in infants without hemolysis and/or other risk factors (such as extreme prematurity, hypoxia, hypercapnia, acidosis, sepsis, hyperosmolarity, etc.). Therefore, an aggressive approach to the treatment and/or prophylaxis of neonatal jaundice when SBL are below 20 or even 25 mg/dl is not justified on the basis of the present knowledge. This is particularly true when treatment includes phototherapy and/or exchange-transfusion which are associated with clinically significant complications and side effects. Guidelines for treatment of neonatal hyperbilirubinemia in full-term and preterm infants, with and without added complications and/or risk factors, are provided in the attempt of encouraging a more critical approach to neonatal jaundice, which is coherent with the data available in the literature and which should optimize the risk/benefit ratio.
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PMID:[Controversial aspects and rational bases of the treatment in neonatal jaundice]. 158 31

This is a report of our experience with 22 cases of large unruptured omphaloceles treated by amnion inversion during the period 1973 through 1990. The method is characterized by three stages: (1) a silastic sheet is sutured directly to the skin around the amniotic membrane, under local anaesthesia, without dissection between the skin and the amnion; (2) the reduction of herniated viscera into the abdominal cavity is achieved by squeezing the sheeting using a specially modified stapler; and (3) the amniotic membrane is preserved intact, and inverted into the abdominal cavity at the time of abdominal wall closure. Of the 22 infants, 19 survived with satisfactory results. Two patients died of multiple associated anomalies, and the remaining patient died of sepsis arising at the time of the final abdominal closure. This procedure has proved to be effective and safe for high-risk patients with congenital heart diseases, anal atresia, tracheoesophageal fistula, or bronchial stenosis and prematurity. The practical aspects of the procedure, as well as its advantages and pitfalls, are illustrated.
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PMID:Advantages and pitfalls of amnion inversion repair for the treatment of large unruptured omphalocele: results of 22 cases. 164 Mar 38

Neutropenia in the newborn is often associated with sepsis, maternal hypertension, or prematurity. We describe a 654-g infant born at 30 weeks' gestation by cesarean section due to severe maternal hypertension. His course was complicated by five episodes of sepsis, including three with group B streptococcus. The results of hematologic and immunologic studies were normal except that absolute neutrophil counts were low (less than 1 x 10(9)/L) with intermittent increases during sepsis. Human recombinant granulocyte colony-stimulating factor administered subcutaneously (10 micrograms/kg per day initially) resulted in an absolute neutrophil count of greater than 30 x 10(9)/L within 2 weeks. The dosage was lowered and the absolute neutrophil counts were maintained at 8 to 12 x 10(9)/L with no further septic episodes. The human recombinant granulocyte colony-stimulating factor therapy was discontinued after 7 months, and the patient remained healthy with an absolute neutrophil count of greater than 2 x 10(9)/L. Thus, treatment with human recombinant granulocyte colony-stimulating factor may be useful as a temporary measure for neonatal neutropenia associated with sepsis. A controlled, clinical trial is warranted.
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PMID:Neutropenia in an extremely premature infant treated with recombinant human granulocyte colony-stimulating factor. 171 73

Risk factors, clinical syndromes and the case-fatality rates associated with Group B Streptococcus (GBS) infections in infants managed at the University of Rochester Medical Center during 1979 to 1989 were reviewed. Overall 92 episodes of early onset disease (EOD) and 54 of late onset disease (LOD) were diagnosed in 143 infants (3 infants with EOD presented later with LOD). About one-third of patients with EOD and controls were non-white compared with two-thirds of patients with LOD that occurred in racial minority groups. Prematurity and low birth weight were significantly more common in patients with invasive GBS disease than in controls. Eighty-three of 92 (90%) cases of EOD were detected during the first day of life and 10 of 54 (19%) cases of LOD occurred in infants older than 3 months of age. At the time of diagnosis 4% of infants with EOD were asymptomatic, 54% had respiratory disease, 27% had sepsis without a focus, 15% had meningitis and 1% had urinary tract infection or omphalitis. Among infants with LOD 46% had sepsis, 37% meningitis, 7% urinary tract infection, 6% osteomyelitis and/or septic arthritis and 4% cellulitis or pneumonia. Leukopenia and shift to the left were observed in 43 and 61% of episodes of EOD and in 28 and 57% of episodes of LOD, respectively. All infants were promptly treated with antibiotics and vigorous supportive therapy. The case-fatality rate was 13% in EOD and 0 in LOD.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The changing spectrum of group B streptococcal disease in infants: an eleven-year experience in a tertiary care hospital. 174 91

A female black rhinoceros calf developed significant hypoglycemia (blood glucose, 30 mg/dL) and hypothermia (97 degrees F) within 48 hours of birth and refused to nurse. Normal gestation of the black rhinoceros is 15 months, but elongated hoof slippers and low birth weight (30 kg) suggested prematurity in this calf. Clinical symptoms of neonatal sepsis including lassitude and poor sucking continued in spite of the aggressive use of antibiotics, and the calf required mechanical ventilatory support on day 7. Nutritional support including enteral gavage feedings (Pedialyte/4 ounces of SMA [Wyeth Ayerst] with sucraflox) had been instituted and was supplemented with total parenteral nutrition on day 5. Central venous access was obtained via a jugular cutdown. The total parenteral nutrition included appropriate electrolytes and vitamins for the neonatal calf but did not include trace elements. The use of total parenteral nutrition by our zoos for therapeutic purposes is increasing. Experience with total parenteral nutrition in exotic animals such as the black rhinoceros is limited, yet this may be an important therapeutic modality in these animals, particularly those in danger of extinction.
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PMID:Total parenteral nutrition in a premature rhinoceros calf. 177 15

In the present study, brainstorm auditory evoked responses (BAER) were recorded in 68 at risk neonates discharged from the neonatal ICU of Safdarjung Hospital. The high risk group of 35 neonates included 13 neonates with multiple (3-4) risk factors and 22 neonates with single risk factors, viz., prematurity (less than 32 weeks) low birth weight (LBW) (less than 1500 g), hyperbilirubinemia requiring exchange transfusion, severe birth asphyxia, craniofacial malformations and sepsis with meningitis treated with amikacin for 3 weeks. The remaining 33 neonates were grouped in the low risk category who had only one of the following factors: prematurity (33-36 weeks)/LBW (1500-2000 g), hyperbilirubinemia requiring phototherapy, mild/moderate birth asphyxia, or sepsis treated with amikacin for 2 weeks. The test was performed at the mean conceptional age of 40.2 weeks (range 34-44 weeks) and involved determination of threshold of hearing as per presence of wave V. A normal response had wave V at 30 dB hearing level click stimulus at 50/sec from both ears or to 30 dB hearing level from one ear and 45 dB hearing level from the other ear. Thirteen neonates of the high risk group failed to produce a normal response (5 failed at 30 dB, 6 failed at 45 dB, and 2 failed at 75 dB hearing level). Forty six per cent of them had multiple high risk factors. All the low risk group neonates had normal threshold of 30 dB hearing level in the initial screening.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Hearing assessment by brainstem auditory evoked responses (BAER) in neonates at risk. 179 70

The premature rupture of the membranes is still a cause of concern due to the related risk of infection and respiratory disorders. The study included sixty-two neonates whose mothers had ruptured their membranes for at least 48 hours (group A) and 42 neonates with a high risk of infection (low birth weight, prematurity) (group B) in order to assess whether antibiotic prophylaxis used in pregnant women with premature rupture of the membranes is sufficient to reduce the risk of severe neonatal infection. The results obtained show that there is an increased frequency of RDS, jaundice and mortality in group A, whereas in group B there was a greater frequency of sepsis and urinary tract infections. Antibiotic prophylaxis therefore allows the frequency of neonatal infections following the rupture of membranes to be reduced, thus enabling the birth to be delayed in order to induce pulmonary maturity.
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PMID:[Neonatal infections and premature rupture of fetal membranes]. 179 5

Neonatal sepsis was studied among one hundred neonates (50 hospital born and 50 outborn babies) over one year period. The incidence of neonatal septicaemia was 15.5 per 1000 live births in the hospital. Among outborn babies it accounted for 6.1% of total pediatric admissions and 43.7% of sick neonates referred from outside. Low birth weight and prematurity were important predisposing factors in both the groups. Blood culture was positive among 32% of outborn and 34% of inborn babies. Coagulase-negative Staphylococcus, Klebsiella and Acinetobacter were the common causative organisms. All isolated organisms were sensitive to Gentamicin whereas 75% of them were resistant to Ampicillin. Mortality among outborn neonates (32%) was much higher in comparison to (10%) hospital born babies. Early identification of high risk antenatal cases and neonates and appropriate referral can bring down mortality and morbidity from neonatal sepsis.
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PMID:Neonatal septicaemia among inborn and outborn babies in a referral hospital. 180 Mar 36


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