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

Respiratory distress syndrome (RDS) is associated with prematurity-related deficiency of surfactant. Surfactant replacement therapy has been used in premature infants to prevent RDS or reduce its severity. In this study we describe the pathology of the lungs after surfactant replacement therapy. All the neonatal autopsies during the years 1989 and 1990 (n = 235) were examined. Infants > or = 31 weeks gestation, with congenital anomalies or who lived more than 2 weeks were excluded from the study. Infants who had received intratracheal Survanta, a modified surfactant extracted from cow lung (n = 14), were compared with infants who did not receive exogenous surfactant (n = 20). The two groups were statistically comparable in terms of weight, gestational and postnatal age, gender, and clinical management. H&E-stained lung sections were examined independently by two pathologists without knowledge of surfactant treatment status; any discrepancies in histological evaluation were resolved by joint review. Nine histological features were evaluated including hyaline membranes, necrosis of the epithelium, hemorrhage, edema, inflammation, metaplasia, arteriolar muscular hyperplasia, interstitial fibrosis, and pulmonary interstitial emphysema (PIE). Histological changes were graded from 0 to 3+. When it was present, cerebral periventricular-intraventricular hemorrhage (PVH-IVH) was graded 1-4. The presence or absence of sepsis and necrotizing enterocolitis (NEC) were also determined. Comparisons between patient groups were performed using the Mann-Whitney U, Student's t and chi 2 tests. The severity of hyaline membrane disease, PIE, and epithelial necrosis was less severe in the surfactant-treated group than in the untreated group. There were no differences between the two groups in the degree of pulmonary hemorrhage or in the incidence of PVH-IVH, sepsis, or NEC.
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PMID:Pathology of the lung in surfactant-treated neonates. 797 82

A clinical analysis is presented of 85 cases of serological incompatibility in newborns hospitalized in neonatal diseases department within 7 years. In 35 newborns Rh incompatibility was diagnosed including 24 with the presence of anti-D antibodies, and in eight newborns antibodies were found against other Rh antigens. In 53 newborns AB0 incompatibility was diagnosed, and the overwhelming majority of mothers had 0 blood group and almost 70% of the newborns has A blood group. In all newborns pathological jaundice occurred. Among newborns with Rh incompatibility prematurity, birth weight below 2500 g, perinatal complications and low Apgar score were more frequently found. Almost 80% of the newborns with Rh incompatibility and over 60% of the newborns with AB0 incompatibility showed signs of infection, and bacterial sepsis was most frequently diagnosed.
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PMID:[RH and ABO incompatibility in newborns treated in a pediatric hospital]. 797 97

Case records of 68 newborns who required assisted ventilation over a 24 month period were reviewed. Fortyfour (64.7%) received intermittent mandatory ventilation, 10 (14.7%) received nasal CPAP and the remaining 14 (20.58%) received a combination of the above. Some of the indications for ventilation were infections (21), hyaline membrane disease (16), problems related to asphyxia (11), apnea of prematurity (10) and persistent pulmonary hypertension of newborn (5). The overall survival rate was 41.17%. In the CPAP group 90% (9/10) survived, while in the remaining survival was 32.7% (19/58). The best outcome was observed in persistent pulmonary hypertension of newborn (80%) followed by apnea of prematurity (70%) and hyaline membrane disease (43.75). Outcome was poor in conditions related to birth asphyxia (27.2%) and infections (19.05%). Survival rates were higher (44.4%) in babies weighing > 1500g at birth as compared to 40.9% in babies < 1500g. Babies less than 32 weeks gestation had a survival rate of 32% as compared to 46.5% in those over 32 weeks. This difference was not statistically significant. Complications were seen in 12/68 patients (17.6%). Pneumothorax was the commonest followed by sepsis, intraventricular hemorrhage and blocked endotracheal tubes. Babies with hyaline membrane disease had the highest incidence of complications. Analysis of the data with regard to the indications, outcome and complications is presented.
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PMID:Assisted ventilation in neonates: the Manipal experience. 800 67

The histologic features of liver biopsies from 20 children treated with total parenteral nutrition (TPN) are presented. All the children received TPN for no less than 2 wk. Conditions that led clinicians to use this form of treatment included prematurity, sepsis, and gastrointestinal surgical procedures. Fourteen children had a history of prematurity; in nine the birth weight was between 640 and 1300 g. Gestational age and birth weight were not available in five and 11 children, respectively. Ten of the 20 children died. Our findings suggest that the morphologic features observed in the liver can be correlated with the duration of TPN. Thus, we propose a time table of hepatic histologic findings beginning with cholestasis and culminating in cirrhosis.
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PMID:Total parenteral nutrition: a histopathologic analysis of the liver changes in 20 children. 800 42

The data were provided by a search in the National Statistical Service of Greece (NSSG), and covered the period from January 1, 1979 through December 31, 1987, for all infant deaths in Greece. Data on live births were taken from the annual statistical reports of NSSG. Statistical analysis was done by means of the Edward's method. The seasonal patterns of the number of deaths and death rates (per 1000 live-born) were almost identical for the 2 parts of the period studied, for the years 1979 and 1987. 1979-83 and 1984-87 were treated separately for the neonatal period and for the postneonatal period. The number of neonatal and early neonatal deaths did not show significant seasonality in the total period, in either the urban or the rural areas, although the peaks for early neonatal deaths in 8 out of 9 studied years were in the spring and summer. The maximum number of postneonatal deaths was observed during January-February, representing a 60-90% increase compared to the minimum number of deaths, and the difference was more evident in the rural areas of residence in 1979-83. Neonatal deaths from prematurity showed statistically significant seasonal variation with a peak in May, more prominent in urban areas. Postneonatal deaths from infections showed statistically significant seasonal variation with a peak in February more prominent in rural areas and in the 1979-83 period. Postneonatal deaths from pneumonia showed very significant seasonal variation, with a peak in February more prominent in rural areas and in the 1979-83 period. Neonatal deaths from sepsis showed increased occurrence in May, whereas postneonatal deaths from sepsis and from enteric infections did not show significant seasonality. Deaths from injuries showed a statistically significant peak during January-February, in both urban and rural areas, in the postneonatal period. Neonatal and postneonatal deaths from sudden infant death syndrome were more common during the winter (December-January-February) in urban areas.
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PMID:Seasonal variation of neonatal and infant deaths by cause in Greece. 802 71

In Malaysia, obstetricians compared 1989 and 1991 perinatal deaths at the Hospital University Sains Malaysia in Kelantan State, the state referral hospital and the only hospital in the state with a neonatal intensive care unit (NICU). There were 46.98% more deliveries in 1991 than in 1989 (7114 vs. 4840). Almost all neonatal deaths took place in the NICU. The perinatal mortality rate fell considerably from 41.32 to 24.88/1000 births, largely due to the declines in the early neonatal mortality rate (10.02-5.45) and the stillbirth rate (31.61-19.53). The rate of very low birth weight (VLBW) infants born increased 11.44% (6.82 vs. 7.5/1000 live births). Their survival rate increased only slightly (54.54-59.37%). Ventilation for VLBW infants suffering from birth asphyxia and meconium aspiration contributed greatly to improvements in survival (31.7% vs. 61.5%). A greater proportion of VLBW infants survived beyond 5 days in 1991 than in 1989 (61.4% vs. 80.2%). In 1991, sepsis was the most frequent cause of death (31.15%). Prematurity also contributed considerably to neonatal mortality. The cause of fetal death was unknown in most cases (51.08%). These findings suggest that better obstetrical management and better ventilatory management of meconium aspiration and birth asphyxia contributed largely to the marked improvement in neonatal survival.
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PMID:Changes of perinatal statistics in a semiurban setup between two time periods in Malaysia. 813 73

In this retrospective study carried out covering the period, 1978-1991, 62 neonates were seen, diagnosed and treated for intestinal atresia which included: duodenal atresia and stenosis, small bowel atresia and atresia of large bowel. Locations of obstruction were duodenal in 17 patients, jejunal in 25 patients, jejuno-ileal in 5 and colon in two. Duodenal atresia was noted in 9 infants and duodenal stenosis due to annular pancreas, Ladd's bands with malrotation of bowel in 8. Associated anomalies which were observed were anorectal malformations in 2 and malrotation in 2 infants. Birth weights ranged from 1450 gm to 3000 gm. Prematurity was recorded in 11 infants. Diagnosis of intestinal atresia in our patients was made clinically and radiologically. Intestinal atresia in neonates was differentiated from other causes of obstruction such as Meconium Ileus, Hirschsprung's disease, neonatal volvulus, rectal atresia in anorectal malformations. Treatment of infants with intestinal atresia was surgical. Surgical techniques used depended on pathological findings. In 36 patients, complications such as functional obstructions with vomiting and failure to thrive, malabsorption, aspiration, bronchopneumonia, sepsis were observed. Overall mortality rate in our cases was 25 (41.9%) out of 62 patients.
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PMID:Intestinal atresia and stenosis as seen and treated at Kenyatta National Hospital, Nairobi. 818 36

Premature rupture of the membranes is associated with considerable neonatal and maternal morbidity when it leads to premature birth. In most cases, this condition occurs at term, does not require medical intervention and has a benign course. Although few effective preventive measures are available, the family physician should screen pregnant patients for remediable risk factors, including smoking and certain vaginal infections, such as trichomoniasis. Diagnostic strategies include assessment of the amniotic fluid and laboratory tests to evaluate fetal and maternal welfare. Management options include expectant treatment, induction of labor or initiation of corticosteroids, antibiotics and/or tocolytics. These options must be carefully evaluated because of the morbidity associated with prematurity and the increased incidence of sepsis in prolonged rupture of the membranes.
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PMID:Premature rupture of the membranes: diagnostic and management strategies. 819 74

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.
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PMID:[Clinical study of infants with birth weight less than 1500 grams]. 823 56

Postmortem blood cultures were taken from 105 neonates dying at Harare Hospital during a 1-year period. The infants were characterized by prematurity (63% < 37 weeks gestation), low birth weight (60% < 2500 g) and low Apgar score at 1 min (43% < 3). More than one-half of the infants died within 48 hours of admission. Positive blood cultures within 10 minutes of death occurred in 44% of infants, and Klebsiella sp. were by far the most common isolates. Positive blood cultures were associated with very low birth weight (< 1500 g), and with babies who survived for > 48 hours. Antibodies to human immunodeficiency virus type 1 were found in 40% of the infants, and a high proportion of these had Klebsiella bacteremia. Nearly all the infants had received antibiotic therapy, usually penicillin and gentamicin. Very few babies who had received a cephalosporin had a positive blood culture, and in vitro tests showed that although many organisms were resistant to penicillin and the aminoglycosides, very few showed resistance to the cephalosporins. Our findings suggest that cephalosporins may be useful in treating severe neonatal sepsis, particularly when there is no response to more standard therapy.
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PMID:Severe Klebsiella infection as a cause of mortality in neonates in Harare, Zimbabwe: evidence from postmortem blood cultures. 828 21


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