Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0243026 (sepsis)
 52,417 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To test the efficacy and safety of vitamin E in preventing retinopathy of prematurity, 287 infants with birth weights of less than 1.5 kg or gestational ages of less than 33 weeks were enrolled within 24 hours of birth in a randomized, double-masked trial of IV, followed by oral, placebo v tocopherol (adjusted to plasma levels of 3 to 3.5 mg/dL). In the 196 infants completing ophthalmic follow-up, tocopherol did not prevent retinopathy of prematurity of any stage (28% placebo treated v 26% tocopherol treated) or moderately severe retinopathy of prematurity (8% placebo treated v 11% tocopherol treated). Cicatricial sequelae were not significantly different (1/97 placebo treated v 3/99 tocopherol treated), with one placebo-treated infant and one tocopherol-treated infant having retinal detachments. Among all 232 infants examined, those treated with tocopherol had more retinal hemorrhage than placebo-treated infants (8/121 placebo treated v 16/111 tocopherol treated), and retinal hemorrhage correlated positively (P less than .01) with plasma levels of tocopherol after the first 2 weeks of age. Prospective monitoring of morbidity including late-onset sepsis, necrotizing enterocolitis, etc revealed no differences between groups except that grades 3 and 4 intraventricular hemorrhage occurred more frequently in infants weighing less than 1 kg at birth who had received tocopherol (14/42, 33%) v those who had received placebo (4/43, 9%) (P less than .02). Our data do not support the use of tocopherol for prophylaxis against retinopathy of prematurity in premature infants and suggest that IV tocopherol treatment starting on day 1 may increase the incidence of hemorrhagic complications of prematurity, particularly in infants with birth weights of less than 1 kg.
 ...
PMID:Tocopherol efficacy and safety for preventing retinopathy of prematurity: a randomized, controlled, double-masked trial. 354

796 pregnancies complicated by preeclampsia and 1,299 pregnancies without toxemia of the years 1981 to 1985 have been compared with regard to prematurity. Prematurity rates were 12.4 respectively 13.8 per cent, hypotrophy rates were 20 resp. 13 per cent, acidosis morbidity was 75 resp. 20 per cent and Apgar values below 8 were 63 resp. 24 per cent. Morbidity rate of respiratory distress syndrome was 8 resp. 12 per cent, of sepsis 2 resp. 7 per cent, intrauterine death rate 5 resp. 2 per cent, but survival rate overall was 93 resp. 90 per cent. Prematurity was influenced by severity of preeclampsia, time of onset and prenatal care. Prolongation of pregnancy by tocolysis is possible principally, but influenced in its effect by maternal and fetal symptoms and the necessity of termination of pregnancy by these factors.
 ...
PMID:[Premature labor in gestosis]. 356 53

We examined the effects of early administration of polymorphonuclear leukocyte (PMN) transfusions in neonates with sepsis by prospectively randomizing 35 consecutive critically ill infants with sepsis, 21 of whom received PMN transfusions in addition to supportive care, one transfusion every 12 hours for a total of five transfusions. Each transfusion consisted of 15 mL/kg containing 0.5 to 1.0 X 10(9) PMN with less than 10% lymphocytes, and was subjected to 1500 rads. PMNs were obtained by continuous-flow centrifugation leukopheresis. Pretreatment values that did not significantly affect survival included weight, gestational age, sex, prematurity, C-reactive protein, initial hematocrit, platelet count and absolute granulocyte count (AGC less than or equal to 1500/mm3), IgM, IgG, IgA, neutrophil supply pool depletion, hypoxia, acidosis, and hypotension. Postnatal age was significantly lower in the nontransfused group than in the transfused group; 2.3 +/- 0.6 vs 6.1 +/- 2.2, (P less than 0.001). Positive blood cultures were obtained in 80% of both groups. Low circulating levels of total hemolytic complement were associated with a poor outcome and higher mortality: 56 +/- 4.0 IU in survivors vs 31 +/- 4.4 IU in nonsurvivors (P less than 0.01). Survival was significantly greater in the PMN transfused group than in the nontransfused group: 20 (95%) of 21 vs nine (64%) of 14 (P less than or equal to 0.05). No untoward effects were attributable to PMN transfusions, either during the study or on subsequent follow-up visits. These preliminary data suggest that early treatment with PMN transfusions improves survival in neonates with overwhelming sepsis. In addition, depleted or low circulating levels of complement may influence prognosis and thus future treatment strategies for neonatal sepsis.
 ...
PMID:Role of circulating complement and polymorphonuclear leukocyte transfusion in treatment and outcome in critically ill neonates with sepsis. 358 10

Chest radiographs and clinical records of 58 newborns with pulmonary interstitial emphysema (PIE) were reviewed to determine the diagnostic and prognostic significance of this finding in the first 24 hours of life. Thirty-nine infants developed PIE before 1 day of age (early PIE). In the absence of infection, early PIE was associated with younger gestational age, lower birth weight, lower 1 and 5 minute Apgar scores, and higher mortality, as compared with patients in whom air leak occurred later. Survival in infants with PIE seemed to be influenced mainly by coexisting risk factors such as extreme prematurity, birth asphyxia, and perinatal infection. Most cases of early PIE in newborns less than 30 weeks gestational age occurred at peak ventilation pressures less than 25 cm H2O, and probably reflect increased sensitivity of the underdeveloped lung to barotrauma. In infants older than 30 weeks gestational age, early PIE was strongly associated with bacterial sepsis. These data indicate that the occurrence of PIE in the first 24 hours of life is a particularly ominous sign, and is frequently associated with clinical conditions which carry a poor prognosis.
 ...
PMID:Early pulmonary interstitial emphysema in the newborn: a grave prognostic sign. 359 42

We treated eight children, aged 7 weeks to 17 years, for lung abscess. Each abscess followed an episode of aspiration or a bacterial pneumonia. Associated conditions were leukemia, congenital immune deficiency, endocarditis, cerebral palsy, and prematurity. Seven of the 8 children had polymicrobial infections, usually containing both aerobic and anaerobic bacteria. The success of medical treatment by antibiotics and chest physiotherapy was age related; 3 of the 8 children, aged 10 to 17 years, recovered on this regimen, whereas five children, aged 7 weeks to 7 years, required catheter drainage or resection for cure. Drainage by catheter pneumonostomy was performed for solitary peripheral bacterial abscesses. A large intercostal catheter was inserted into the cavity, either operatively or percutaneously. Wedge resection was performed for multiple, central, or fungal abscesses. Pneumonostomy was curative in 3 of 4 children. One chronic abscess recurred after pneumonostomy and required resection. Wedge resection was curative in the two children who came to thoracotomy; lobectomy was not necessary. Although all eight children recovered from their lung abscesses, three of them died within a year of sepsis. Lung abscess today occurs in immunocompromised children who are vulnerable to fatal infections. Chest physiotherapy is unlikely to achieve good drainage in children under 7 years of age. Medical failures can be identified within the first week of treatment. Early and aggressive surgical treatment is indicated in such children, and may be lifesaving.
 ...
PMID:Drainage of pediatric lung abscess by cough, catheter, or complete resection. 373 40

This retrospective review of 83 infants undergoing CPR in the neonatal ICU of a teaching hospital found that 12 (14%) patients were discharged from the hospital and seven (8%) were alive at least 1 yr after discharge. Of these seven, five appeared neurologically intact. From another perspective, 41% (12/29) of the patients who survived at least 24 h after CPR were discharged alive. Factors significantly (p less than .05) associated with poor outcome included sepsis, oliguria 24 h before and/or after arrest, prematurity, and intraventricular hemorrhage. Variables significantly (p less than .05) related to good outcome were the need for intubation during resuscitation and the diagnosis of major congenital anomalies. Intraventricular hemorrhage was the single most powerful variable in the regression analysis. Outcome statistics from this study were strikingly similar to currently available adult data.
 ...
PMID:Outcome of cardiopulmonary resuscitation in the neonatal intensive care unit. 374 95

The charts of all newborns at the University of the East Medical Center in the Philippines were obtained and were matched with the mother's charts in a study designed to identify the causes of perinatal morbidity and mortality and to analyze the factors that lead to such results. There were 4219 deliveries of 28 weeks and later or 1000 grams and more during 1980-82; only 4057 were available for study. There were 39 neonatal deaths from 4015 live births giving a neonatal death rate of 9.7/1000 live births. Late fetal deaths or stillbirths occurred in 42 fetuses out of 4057 total births with a stillbirth rate of 10.3. There were in all 81 perinatal deaths from 4057 total births with a perinatal mortality of 19.99. There were 250 morbid babies out of 4015 live births giving a morbidity rate of 62.3/1000 live births. Compared to national statistics, the results at this institution are expectedly lower, due to fewer patients with more facilities and personnel. The most common cause of neonatal mortality in the 39 cases was sepsis, which occurred in 21 cases or 53.8%. This was followed by prematurity with hyaline membrane disease in 13/39 or 33.3% of cases and asphyxia in 4/39 or 10.3%. Lethal congenital anomalies occurred in only 1/39 or 2.6% of cases. Stillbirth or late fetal deaths occurred in 42 cases or over 1/2 of total perinatal mortality cases. In 23 of the 42 cases or 54.8%, the cause was cord accidents. In 11/42 or 26.2% of cases, the cause of fetal death was severe asphyxia due to abruptio placenta, severe toxemia giving rise to placental insufficiency, or obstructed labor. In 3/42 or 7.1%, lethal anomalies was the cause; in 5/42 or 11.9% the cause was unknown. Of the total causes of fetal deaths, only those due to asphyxia may be preventable to some extent; these cases comprise only 26.2% of the whole group. Perinatal morbidity was identified in 250 live births. Review of the maternal conditions giving rise to a 25% or more rate of neonatal morbidity shows that multiple pregnancy was foremost with a 60% rate, fetal distress with a 43% rate, premature rupture of membranes with a 38% rate, chronic toxemia with a 31% rate, and placenta previa with a 28% rate. Morbidity and mortality can be lowered markedly with improved prenatal care and early detection and treatment of complications which interact with socioeconomic status and other social differentials.
 ...
PMID:Perinatal morbidity and mortality in the Philippines. 377 13

Amniocentesis has recently been advocated as a useful diagnostic adjunct in the management of the patient with preterm premature rupture of membranes (PROM). Although studies are limited, transabdominal inspection of amniotic fluid for a mature phospholipid lung profile or evidence of incipient sepsis appears helpful in reducing the risk of prematurity and infection in the gravida and neonate. In addition, amniocentesis in this group of patients is technically feasible if ultrasound is used concomitantly. Limitations to this procedure include the inability to identify neonates at risk for nonpulmonary complications of prematurity such as intraventricular hemorrhage. Physicians should be aware of their individual laboratory and nursery limitations along with current infectious morbidity statistics before initiating this management protocol.
 ...
PMID:The use of amniocentesis in preterm premature rupture of membranes. 388 66

Assessment of placental pathology and its relationship to historical data, initial laboratory parameters, and outcome was undertaken in 22 cases of early-onset group B streptococcal sepsis of the neonate. Fourteen (64%) of the placentas demonstrated chorioamnionitis, six (27%) funisitis, and in nine (41%) gram stain demonstrated organisms within the membranes. Focal villous edema was observed in five (23%) cases and diffuse villous edema in four (18%). No placenta demonstrated chorangiosis. Placental inflammation was significantly (p less than 0.05) associated with prematurity, prolonged rupture of membranes, and onset of symptoms at less than 3 hours of age. No placental change was significantly associated with outcome or with neutropenia, which was the only parameter assessed that appeared to have prognostic value.
 ...
PMID:Significance of placental findings in early-onset group B streptococcal neonatal sepsis. 388 54

A 14-month-girl presented with an asymptomatic posterior mediastinal mass. She had a history of prematurity, umbilical artery catheterization, and sepsis. The diagnosis of aortic aneurysm was made by dynamic computed tomography. The aneurysm was successfully resected.
 ...
PMID:Aortic aneurysm secondary to umbilical artery catheterization. 388 16


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