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)

Nowadays, in severe infections during the neonatal period new bacteria--group B streptococci--have to be taken into account, since in some clinics they already predominate over gramnegative rods. Septicemia and meningitis may be caused by group B streptococci. The septicemia which especially threatents prematures starts with apnoeic spells in the very first hours after birth and may be easily misdiagnosed as an idiopathic respiratory distress syndrome. The mortality is very high (about 60%). Meningitis starts later, normally during the 3rd to 4th week. Seizures are typical at the onset. Group B streptococci may be identified in the CSF by counterimmunoelectrophoresis within one hour. The prognosis is more favourable in meningitis than in septicemia (mortality about 20%). Survivors have little neurological sequelae. Penicillin G or ampicillin combination with an aminoglycoside is recommended as chemotherapy. Exchange transfusion should be considered early. Group B streptococci causing the septic form may be transfered during labour since up to 25% of pregnant women are colonized. Nosocomial transmission of group B streptococci may be the reason for meningitis. Prophylactic penicillin does not seem to help in preventing the disease, but it is possible, that meningitis of the newborn may be prevented by immunizing the mother during pregnancy.
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PMID:[Group B streptococcus infections during the neonatal period (author's transl)]. 35 54

Magnetic resonance imaging (MRI) was employed to study the rat brain in conjunction with intracerebral (ic) injection of three contrast agents: GdHAM, GdDPTA, and MnCl2. The results demonstrate several advantages of ic administration of MRI contrast agents over the other routes of injection in examining CSF dynamics and brain ventricular structure. Apparent affinity of the luminal ventricular wall of the brain for positively charged GdHAM and Mn2+ ions is observed, presumably reflecting the presence of negatively charged wall components. Respiratory distress caused by (intravenous) injection of GdHAM was found to be minimized in the case of ic injections. Time-dependent changes in observed contrast indicate that diffusive processes rather than flow of CSF play a dominant role in distributing the contrast agents. Possible applications of this approach in brain research are discussed.
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PMID:Magnetic resonance imaging study of the rat cerebral ventricular system utilizing intracerebrally administered contrast agents. 194 81

Previous study has shown that the combination of mitoxantrone (Novantrone, NO) and Ara-C (AC) (NOAC) was active in refractory non-Hodgkin's lymphoma (NHL) but myelosuppression was dose-limiting. In a pilot study, we investigated the effects of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) after NOAC chemotherapy in patients with refractory NHL. NO was applied at a dosage of 10 mg/m2/day on days 2 and 3 and AC at 3 g/m2/12h on days 1 and 2. RhGM-CSF was administered at 250 ug/m2/day as a continuous i.v. infusion from day 6 until the neutrophils were greater than 3.0/nl for 3 consecutive days. Twenty-three patients from five of the nine participating centers were treated with NOAC chemotherapy plus rhGM-CSF, whereas 14 patients from the other four centers received chemotherapy alone. With rhGM-CSF, the median duration of severe neutropenia (less than 0.5/nl) after NOAC was 8 days versus a median of 13 days without rhGM-CSF (P = 0.0058), and that of thrombocytopenia (less than 20.0/nl), 3 days versus 7 days (P greater than 0.4, NS). The rates of infections and stomatitis were 25% and 17%, respectively, for patients treated with rhGM-CSF as compared to 53% (P = 0.0547, NS) and 60% (P = 0.0078), respectively, without rhGM-CSF. The following side effects were associated with the administration of rhGM-CSF: pleural and/or pericardial effusions in five patients, thrombosis in two patients, bone pain in two patients, and respiratory distress syndrome in one patient. A complete remission was achieved in nine of the 23 patients treated with NOAC plus rhGM-CSF, and in two of the 14 patients treated with chemotherapy alone. The median survival of patients treated with rhGM-CSF was not reached at 400 days and seemed to be longer than that of patients treated with chemotherapy alone (median, 109 days; P = 0.036). RhGM-CSF after chemotherapy can be applied safely to patients with NHL, shorten the period of severe cytopenia, reduce the rates of stomatitis, and did not seem to cause adverse effects on response.
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PMID:Mitoxantrone/high-dose Ara-C and recombinant human GM-CSF in the treatment of refractory non-Hodgkin's lymphoma. A pilot study. 219 41

A retrospective study of the clinical features and management of 27 newborns with meningitis is presented. All were treated in the China Medical College Hospital between July 1981 and July 1988. Seven were premature and twenty were full term. There were 11 males and 16 females. Five infants had low birth weight (less than 2500 g) and 12 cases were diagnosed in the first week of life (early onset). E.coli was the predominant pathogen. The most common presenting manifestations were nonspecific in nature-fever, poor feeding, respiratory distress and poor activity, etc... Six patients died during the period of acute illness and the case fatality rate was 22.2%. Of the 21 patients who survived, six had sequelae (four hydrocephalus, one subdural effusion, one microcephaly), giving an over-all rate of 19 percent in the survivors. The presence of gram-negative bacterial infection and high protein content in CSF correlated significantly with the higher mortality rate.
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PMID:[Bacterial meningitis in neonates]. 227 65

The aim of the study was to overview the antibiotic treatments usually prescribed in the different neonatal units and NICU's for neonatal primary bacterial infections. Maternal or neonatal fever, shock, respiratory distress, leuconeutropenia, hyperfibrinemia as well as an increased level in C-Reactive Protein appeared to be the best clinical diagnosis criteria. Before isolation of the bacteria, the most frequently prescribed treatment was a combination of ampicillin and gentamicin. When no bacteria grew up, the treatment was usually discontinued after a few days. When a presumably pathogenic bacteria was found either in blood, or CSF or urine or peripheral cultures, the treatment lasted around 10 days. However, in proved meningitis, the treatment lasted around 20 days. In case of Streptococcus type B and Listeria monocytogenes, ampicillin (100-200 mg/kg/day) was often used in combination with gentamicin (3-4 mg/kg/day), in spite of the recent availability of new aminoglycosides. When the isolated E. coli was ampicillin-resistant, Cefotaxime was frequently used in combination.
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PMID:[Results of a national survey on the antibiotic therapy of neonatal bacterial infection due to materno-fetal contamination]. 377 24

The use of hypoxanthine measurements for quantitative monitoring of intrauterine asphyxia is generally accepted. A high level in blood or in CSF is a consequence of tissue hypoxia. Hypoxanthine and xanthine were measured by selective high pressure liquid chromatography in mature newborns, in healthy, symptom-free preterm babies, and in preterm babies affected by idiopathic respiratory distress syndrome. The measurements were carried out from peripheral venous blood within three hours after birth and at the age of 48-72 hours. In mature newborns the mean hypoxanthine level was 11.10 mumol/l in the early determinations, and 8.45 mumol/l in the second set of measurements. In unaffected prematures there were significantly higher levels, and the highest values (44.22 +/- 15.13 mumol/l) were encountered in premature babies subsequently dying of severe hypoxia. Xanthine showed a similar course. In addition to establishing normal values for prematures we desired to clarify the changes in the levels of purine metabolites during idiopathic respiratory distress and their prognostic value. Hypoxanthine and xanthine levels were found to be informative in postnatal hypoxia, especially together with other parameters.
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PMID:Plasma hypoxanthine and xanthine levels in the early newborn period in problem-free preterm babies and those with idiopathic respiratory distress syndrome. 398 48

The controlled evaluation of vidarabine as therapy of neonatal herpes implex virus (HSV) infection provided an opportunity to collect data to further assess the natural history of maternal and newborn infections. Women delivering infected babies were young, nulliprous, and infrequent aborters. Nearly 50% of the gestations ended in premature labor. Maternal infection was asymptomatic in 39 of 56 (70%) of the mothers, at the time of delivery. However, risk factors included a past history of genital herpes at any time and exposure to a sexual partner with presumed HSV lesions. Associated diseases in children born to these women were common. Premature infants had an incidence of respiratory distress of 52% (14 of 27). Eight of 29 (28%) term newborns had a bacterial infection, antedating the onset of neonatal HSV infection. Virologic studies on infected newborns confirmed that skin lesions were the most frequent site for virus retrieval. Progression of disease from isolated skin lesions was common, occurring in 70% of babies whose presenting sign was skin vesicles. CSF was virus-positive from 14 babies and more frequently in those with localized CNS disease. Importantly, brain biopsy was necessary for diagnosis in four cases. Finally, neither the presence or absence of antibodies to HSV was useful in predicting either presentation or outcome of infection. These studies further emphasize the complex nature of HSV infections of the newborn and need for tertiary care.
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PMID:The natural history of herpes simplex virus infection of mother and newborn. 625 66

Two female infants with nonketotic hyperglycinemia (NKH) were treated with diazepam for the control of seizures. The first infant had seizures, lethargy, and respiratory distress in the first 24 hours of life. The diagnosis of NKH was made at 3 weeks of age and she was then placed on a regimen of strychnine and a low-protein diet. Strychnine therapy was discontinued after three months of treatment because there was no improvement in the seizure control or in the patient's condition. At 5 months of age the patient was referred to our clinic for further work-up. The second infant had seizures, hypotonia, and respiratory distress shortly after birth. She was treated with phenobarbital and diphenylhydantoin, which had no effect on her seizures. The baby was referred to our clinic at 8 months of age and diagnostic studies revealed NKH. All previous medications were stopped and both infants were placed on diazepam, a competitor for glycine receptors in the CNS. Choline and folic acid were added for one-carbon unit transfer and sodium benzoate to bind excessive glycine. Both infants responded to this treatment with cessation of seizures; they became more responsive and alert, and their EEGs showed remarkable improvement despite the persistence of elevated glycine levels in plasma, CSF, and urine. Diazepam as a competitor for the receptors of glycine may prove helpful in controlling the intractable seizures associated with NKH.
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PMID:Nonketotic hyperglycinemia: treatment with diazepam--a competitor for glycine receptors. 630 Jul 46

38 cases of neonatal group B streptococcal (GBS) sepsis (31 with early onset and 7 with late onset) were observed during the years 1976-1982. Early onset disease showed the following clinical characteristics: 1. frequent lack of risk factors for infection in obstetric history, 2. very early onset of symptoms of respiratory distress, 3. rapid development of shock after only minor or missing clinical signs of infection, and 4. unspecific findings on chest radiography. Neutropenia or marked leukocyte left shift as well as the presence of gram-positive cocci in gastric or tracheal aspirate proved to be useful diagnostic clues. The latex agglutination test for the detection of GBS-antigen in urine yielded in our hands many false positive results and unspecific reactions. Given the big difficulties of early diagnosis of early onset GBS-sepsis, the relatively liberal use of antibiotics in newborns with respiratory distress is probably unavoidable. Hereby prior culturing of blood and early termination of antibiotic therapy with negative cultures (of blood, CSF, tracheal aspirate) seems essential to us. The clinical significance of newer therapeutic (granulocyte transfusions, exchange transfusions, immunoglobulins) and prophylactic (intra-partum antibiotics, vaccination) modalities is according to the current literature still not clear in many respects.
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PMID:[Neonatal Streptococcus group B sepsis: problems of early diagnosis, therapy and prevention]. 639 17

High-resolution proton nuclear magnetic resonance spectroscopy was used to study human urine obtained from 10 normal babies and twenty babies with various degrees of neonatal asphyxia, respiratory distress syndrome (RDS), and meconium aspiration syndrome (MAS). All sick babies showed different degrees of oxygen deficiency, indicated by an obvious increase of the lactate signal level in the urine spectra. Changes in the concentration of other urinary metabolites produced from the citric acid cycle were also observed. In extremely serious cases, the signals of some of the major components, including citrate, alpha-ketoglutarate, and succinate, simply disappeared. The spectra of urine, serum, and CSF of an infant suffering from SIDS showed common characteristics of the metabolites.
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PMID:High-resolution proton nuclear magnetic resonance studies of urine from asphyxiated newborn infants. 762 24


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