Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0476273 (respiratory distress)
19,632 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aim of this study was to determine whether there is a decrease in fetal cortisol levels associated with the respiratory distress syndrome (RDS). Eighteen newborn infants of less than 37 weeks' gestation who developed moderate to severe forms of RDS did have a significantly lower (P less than 0.02) mean cord plasma cortisol concentration at birth than that observed in 67 unaffected infants of similar gestational age; mean values +/- standard errors were 3.36 +/- 0.42 and 5.58 +/- 0.43 mug per 100 ml, respectively. However, whether or not RDS developed in neonates appeared to depend more upon the degree of prematurity (with a 71.5% incidence in gestations of less than 32 weeks compared to 17.1% in those of 32 to less than 37 weeks) than upon cortisol levels at delivery. Bood cortisol levels in the first days of life of four infants with RDS were considerably increased in comparison to those at birth. Mean cord plasma cortisol concentrations increased with duration of pregnancy, with the previously observed value for term infants (of 37 or more weeks) being approximately twice that for infants of less than 32 weeks' gestation. These findings appear to justify carefully controlled studied with antepartum glucocorticoid administration with the aim of reducing the incidence of RDS in premature newborn infants.
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PMID:Relationship between cortisol levels in umbilical cord plasma and development of the respiratory distress syndrome in premature newborn infants. 126 4

The neonatal outcomes in 109 pregnancies complicated by prolonged rupture of the fetal membranes were studied over a 3-year period. The overall neonatal mortality was 29 (26.6%). Nineteen of these deaths were from infections, of which 12 were pneumonia. There was also a high morbidity rate of 68.8%. Neonatal sepsis, cardiorespiratory depression at birth and prematurity were the most significant complications. Forty-eight (44%) of the infants in the study group had an infection, in contrast with three (2.9%) in the control group (p < 0.0001). No protective effect or benefit from prolonged rupture of fetal membranes in relation to the development of respiratory distress syndrome was demonstrated.
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PMID:Prolonged rupture of membranes and neonatal outcome in a developing country. 128 44

The impact of surfactant therapy on chronic lung disease remains uncertain. During the past decade (1982-91), over 300 babies with respiratory distress syndrome (RDS) weighing 501-2,500 g at birth were consecutively treated with surfactant-TA at our neonatal intensive care unit. Data on 95 RDS babies treated in the first 5 year period (Period 1, 1982-86) were compared with those on 158 RDS babies treated in the second 5 year period (Period 2, 1987-91). Overall respiratory improvement was better in Period 2 than in Period 1. In Period 2, surfactant therapy converted 98% of the babies with moderate/severe RDS to those with 'near normal' lung by 72 hr post-treatment. In Period 2, 95% of the surfactant-treated babies weighing 501-1,750 g at birth survived, 97% of which required no supplemental oxygen at 40 weeks corrected gestational age. Increased survival rate in the surfactant-treated babies during the past decade has not been followed by a parallel increase in chronic lung disease. The severity of the initial pulmonary disease per se was not the significant risk factor for chronic lung disease. Several other variables affecting the response to surfactant therapy and outcome have been identified by stepwise logistic regression analysis and include factors related to perinatal events such as birth asphyxia and infection, and other complications of prematurity.
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PMID:Surfactant replacement therapy in premature babies with respiratory distress syndrome: factors affecting the response to surfactant and comparison of outcome from 1982-86 and 1987-91. 128 9

Between 1988 and 1991 thirty-nine pregnant women suffering from HELLP-Syndrome were treated in our hospital. A retrospective analysis of clinical course and of the changes in the relevant laboratory values was performed. The incidence of the HELLP-Syndrome at Freiburg University Hospital was 0.85% for all pregnancies or 17% of the patients with toxaemia. 90% of the women were primipara, there was no prevalence of a certain group. The clinical course was characterized by the perseverance of symptoms for more than two weeks in 18% of the cases and a perinatal mortality of 25%, the latter mainly due to prematurity of the infants. This suggests that perinatal mortality due to respiratory distress syndrome can be reduced by conservative and expectative management of these patients. However on the other side a high rate of caesarean sections (77%) and sometimes even induced abortions were necessary to avoid maternal mortality and severe pre-or postpartal complications for these women.
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PMID:[Experiences with HELLP syndrome]. 129 80

One of the aspects of prematurity in neonates is the respiratory distress syndrome. Although treatment with mechanical ventilation reduced the mortality rate, bronchopulmonary dysplasia still develops in many neonates. We have attempted to reduce intubation and mechanical ventilation by using, in the delivery room, humidified and warmed gas with fractional inspired oxygen as low as possible to obtain SaO2 between 85 and 95%. The gas was administered with a face mask using continuous positive air pressure 3-5 cm H2O. Seventeen out of 66 premature neonates born before the 35th week of gestation were ventilated immediately (n = 11) or subsequently (n = 6). Seven out of 26 infants (27%) born between 30 and 32 weeks required mechanical ventilation. In contrast, ventilation was necessary for eight out of 16 premature neonates born before the 29th week of gestation. Mortality rate was 6% (4/66) in the latter group (< 29 weeks), and only one neonate developed bronchopulmonary dysplasia.
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PMID:[Neonatal resuscitation and preventive continuous positive pressure ventilation]. 134 17

Although prenatal glucocorticoid treatment reduces neonatal respiratory morbidity, respiratory distress syndrome and chronic lung disease (CLD) develop in many very-low-birthweight infants despite therapy. To investigate the effect of additional prenatal treatment with thyrotropin-releasing hormone (TRH), we did a multicentre, blinded, randomised trial. 404 women with threatened preterm delivery at less than 32 weeks' gestation received betamethasone plus TRH (4 doses of 400 micrograms 8-hourly) or betamethasone plus placebo. 103 infants who were fully treated and of less than 1500 g birthweight were evaluated during the neonatal period. TRH treatment (55 infants) did not affect the total incidence of respiratory distress syndrome (47% vs 58% in controls) or of severe respiratory distress syndrome (13% vs 25% in controls, p = 0.11). CLD (defined as requirement for supplemental oxygen at 28 days after birth) developed in significantly fewer TRH-treated infants (18% vs 44% of controls, p less than 0.01). The unadjusted relative risk of CLD with TRH therapy was 0.40 (95% CI 0.26-0.80, p less than 0.05), and this was not materially changed after adjustment for potentially modifying variables. There were significantly fewer adverse outcomes, defined as death or continuing oxygen requirement, in the TRH group than in the steroid-alone group both at 28 days and when infants reached 36 weeks' postconceptional age. The incidence of other complications of prematurity was similar in the two groups. Prenatal TRH reduces the incidence of chronic lung disease among betamethasone-treated infants.
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PMID:Respiratory disease in very-low-birthweight infants after prenatal thyrotropin-releasing hormone and glucocorticoid. TRH Study Group. 135 Aug 27

Previous data have suggested that neonatal complications amongst preterm ventilated infants increase with decreasing gestational age and thus are likely to be greatest among ventilated infants of less than 28 weeks gestational age. The aim of this study was to test that hypothesis, thus we report the neonatal complications of 175 extremely preterm mechanically ventilated infants (gestational age less than or equal to 28 weeks). Of the infants 152 were ventilated because of respiratory distress syndrome (RDS) or respiratory distress of severe prematurity, 41% of these infants died. Amongst infants with RDS or respiratory distress of extreme prematurity, mortality was significantly increased in infants of gestational age less than or equal to 24 weeks and birth weight less than or equal to 1000 g. In this group 20% developed a pneumothorax, and mortality was inversely related to gestational age. In infants with RDS, 43% developed a periventricular haemorrhage and 37% were still oxygen-dependent at 28 days of age; neither of these complications was significantly related to birth weight or gestational age. Of infants with RDS 38% developed a patent ductus arteriosus and 16% developed retinopathy of prematurity. These data suggest that even amongst very immature infants there has been an impressive reduction in the neonatal complications of mechanical ventilation.
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PMID:Neonatal complications of extreme prematurity in mechanically ventilated infants. 139 33

We observed 12 very preterm infants (10 males) with a peculiar respiratory syndrome characterized by early onset soon after birth and by a biphasic course. The severe first phase was characterized by a clinical pattern mimicking the idiopathic respiratory distress syndrome of prematurity. Gradually, respiratory symptoms decreased and assisted ventilation with oxygen therapy was reduced. In the second phase, a significant worsening of respiratory signs and the appearance of apneic spells were observed. Chest X-ray showed hypoexpansion of the lungs and the prevalence of a fine reticular pattern. Chlamydia trachomatis was identified in this second phase in conjunctival and pharyngeal swabs and/or on tracheal aspirates. Our data suggest that in the very preterm infants, chlamydial infection shows different clinical and laboratory features if compared with Chlamydia trachomatis pneumonia of infants born at term.
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PMID:Chlamydia trachomatis in neonatal respiratory distress of very preterm babies: biphasic clinical picture. 142 84

Gram-negative bacterial infections were documented in 6 neonatal New World camelids (5 Ilamas and 1 alpaca). The organisms isolated from blood before death or from multiple organs after death were Escherichia coli (n = 3), Actinobacillus sp (n = 1), and Klebsiella pneumoniae (n = 1). Only 2 crias survived, and 1 became blind secondary to retinal detachment and ocular inflammation, which developed after treatment for bacterial infection. Abnormal events during the perinatal period (prematurity, dystocia, cesarean section, weak at birth) were reported in all 6 crias. Signs of depression, convulsions, and/or coma were observed in all animals. Diarrhea and respiratory distress were also noticed in the 3 crias that died shortly after admission. Serum immunoglobulins were assessed, but without the benefit of a stall-side test specific for Ilama immunoglobulins. All crias were suspected to have poor transfer of maternal immunoglobulins. Hemograms and serum biochemical values prior to the initiation of treatment were obtained on 5 of the 6 crias. Total nucleated cells ranged from 1,400 to 23,100 cells/microliter. Four of the 5 crias has a left shift, and 2 crias had toxic neutrophils. Serum glucose concentrations, measured in 5 of 6 crias, ranged from 83 to 293 mg/dl. Serum creatinine values were high in 2 of 5 crias, 1 of which had acute tubular necrosis. Three crias with high serum electrolyte (sodium, chloride, or potassium) values subsequently died. Arterial blood gas values were assessed in 3 crias, 1 of which had respiratory alkalosis and mild hypoxemia.
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PMID:Gram-negative bacterial infection in neonatal New World camelids: six cases (1985-1991). 142 94

Of 95 infants treated with the synthetic surfactant, Exosurf, under a Treatment Investigational New Drug protocol, 17 received one dose, 40 received two, and 38 received three doses. Seventy-six (80%) of the infants were treated by rescue protocol. We retrospectively reviewed the clinical course of the 67 surviving rescue infants. We found that, compared to one- and two-dose infants, those treated with three doses of Exosurf were more premature, smaller, required a longer ventilator course, and had more frequent complications, including patent ductus arteriosus (PDA), intraventricular hemorrhage, nosocomial pneumonia, and apnea. They required higher oxygen concentrations starting 8 hr after their first dose and higher mean airway pressure (MAP) from the time of their second dose. These trends continued during all subsequent time points, as compared to infants treated with two doses. The third dose was administered an average of 17 hr after the second, resulting in little change of MAP, but some reduction in oxygen requirements. By 24 hr after the last dose, only 4% of three-dose infants were extubated compared with 30% of the two-dose and 71% of one-dose infants. In conclusion, repeated administration of Exosurf is not equally effective in every treated infant with respiratory distress syndrome (RDS) and complications of prematurity may affect or accompany poor response.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Exosurf treatment investigational new drug phase: effect of an individualized third dose in infants with respiratory distress syndrome. 143 38


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