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

Extracorporeal membrane oxygenation (ECMO) is lifesaving for infants with severe respiratory distress but is complicated by severe intracranial hemorrhage in 10% to 30% of patients. Intracranial venous hypertension, as a result of ligation of the internal jugular vein (IJV), has been hypothesized as a contributing factor to cerebral edema and subsequent hemorrhage. Accessory cephalad IJV cannulation may serve as a means of additional venous drainage to the pump as well as protection against intracranial venous hypertension. Proximal and distal cannulation of the IJV were studied in a primate model. The parameters monitored included sagittal sinus, right and left ventricular pressures as well as venous pressure in the ECMO circuit. The cephalad venous cannula was clamped and unclamped at 30-minute intervals. There was no significant difference in sagittal sinus or intracranial pressures during periods of cephalad cannula clamping or unclamping. Venous return was augmented when the cephalad cannula was unclamped. Cephalad cannulation has no demonstrable protective effect on intracranial, subarachnoid or venous pressures but does improve venous return to the ECMO circuit. It is concluded that cephalad venous cannulation is not necessary in all cases and should be reserved for those patients requiring additional venous drainage to support pump flow.
 ...
PMID:Proximal and distal cannulation of the internal jugular vein for ECMO in a primate. 143 26

Women on regular dialysis are usually infertile, but contraception should not be neglected. Pregnancy is invariably complicated and poses excessive risks, with an uncertain and low chance of success. Even when therapeutic abortion is excluded, the live birth outcome at best is 19%. Renal transplantation usually reverses abnormal reproductive function and comprehensive pre-pregnancy counseling is essential, with discussion of all implications, including the harsh realities of long-term maternal survival. In this survey of 2,309 pregnancies in 1,594 women, therapeutic abortion was undertaken in 27% of conceptions and the spontaneous abortion rate was 13%. Of the conceptions that continued beyond the first trimester, 92% ended successfully. In most, renal function was augmented in pregnancy, with transient deterioration in late pregnancy (with or without proteinuria). Permanent renal impairment occurred in 15% of pregnancies. There was a 30% chance of developing hypertension, preeclampsia or both. Preterm delivery occurred in 50%, and intrauterine growth retardation in 25% of pregnancies. Despite its pelvic location, the transplanted kidney rarely produced dystocia and was not injured during vaginal delivery. Cesarean section should be reserved for obstetric reasons only. Neonatal complications include respiratory distress syndrome, leukopenia, thrombocytopenia, adrenocortical insufficiency, and infection. No predominant or frequent developmental abnormalities have been described and data on infancy and childhood are encouraging. For the future more work is needed to improve pre-pregnancy assessment criteria, to understand the mechanisms of gestational renal dysfunction and proteinuria, to assess the side effects and implications of immunosuppression in pregnancy, and to elucidate the remote effects of pregnancy on both renal prognosis and the offspring.
 ...
PMID:Dialysis, transplantation, and pregnancy. 195 48

In the absence of respiratory distress and massive visceral herniation, the diagnosis of blunt diaphragmatic disruption can be difficult. This is particularly true for diaphragmatic injuries confined to the right hemidiaphragm. Because diagnostic delay and strangulation are associated with notable increases in mortality and morbidity, it is important to identify the injury as early as possible. Victims of lateral impact motor vehicle collisions are more likely to experience rupture of the diaphragm than victims of frontal collisions. Occupants exposed to left lateral impacts are at greatest risk. The side of diaphragmatic rupture correlates with the direction of impact. The right hemidiaphragm is more resistant to rupture. Deformation shear is a more plausible mechanism for diaphragmatic rupture after lateral impacts. Knowledge of the mechanisms that produce this injury combined with information regarding the victim's seat position and direction of the impacting force should lead to a high index of clinical suspicion for diaphragmatic rupture. Chest radiography and diagnostic peritoneal lavage will establish the correct diagnosis in almost 90% of the patients with acute diaphragmatic disruption. Additional diagnostic studies are reserved for the remaining 10% of patients. Due to the pressure differential between abdomen and thorax, the natural history of these injuries is one of enlargement, and none can be expected to heal spontaneously. Once the diagnosis has been established, the treatment of every diaphragmatic disruption is surgical repair.
 ...
PMID:Blunt rupture of the diaphragm: mechanism, diagnosis, and treatment. 258 1

The term "pulmonary maturation" is reserved for the process of surfactant production. The term "pulmonary development" covers the overall phenomena of the growth of pulmonary structures and their differentiation. Pulmonary development is divided schematically into five stages: the embryonic stage up to the fifth to the seventh week of gestation, then the four stages of the foetal period. These four stages are: 1) The pseudo-glandular stage up to the seventeenth week during which the bronchi and the extra-acinar vessels are formed; 2) The canalicular stage characterised by the birth of the acinus, the differentiation of the cells and the beginning of surfactant synthesis to the end of this stage; 3) The saccular and alveolar stages. The saccular stage begins between the 24th and 26th week of gestation and at this stage the foetus is viable but exposed to the risk of neonatal respiratory distress on account of lack of surfactant. The alveoli are formed before the end of pregnancy. The factors controlling development and pulmonary maturation are still poorly understood. Cellular, particularly epithelial and mesenchymal interactions appear to play a major role in all the stages of development. Hormonal interactions play a determining role in pulmonary maturation. The effects on development and/or pulmonary maturation of pharmacological agents, hormones administered to the mother (e.g. opiates, glucocorticoids, aminophylline, beta-sympathomimetics, indomethacin and tobacco...) and maternal pathology are described as far as possible within the limits of our current knowledge. This information comes above all from experimental studies, thus the conclusions obtained are difficult to apply to newborn humans.
 ...
PMID:[Physiology and physiopathology in the development and maturation of the antenatal lung]. 304 96

Renal transplantation is invariably accompanied by improvements in reproductive function. The possibility of conception in women of childbearing age emphasizes the need for compassionate and comprehensive counselling. Couples who want a child should be encouraged to discuss all the implications. Therapeutic abortion is undertaken in 22% of conceptions and the spontaneous abortion rate is about 16%, the same as for the normal population. Of the conceptions that continue beyond the first trimester, over 90% end successfully. In most women, renal function is augmented during pregnancy, but permanent impairment occurs in 15% of pregnancies. In others there may be transient deterioration in late pregnancy (with or without proteinuria). There is a 30% chance of developing hypertension, pre-eclampsia or both. Preterm delivery occurs in 45-60%, and intrauterine growth retardation in at least 20% of pregnancies. Despite its pelvic location, the transplanted kidney rarely produces dystocia and is not injured during vaginal delivery. Caesarean section should be reserved for obstetric reasons only. Neonatal complications include respiratory distress syndrome, leucopaenia, thrombocytopaenia, adrenocortical insufficiency and infection. No predominant or frequent developmental abnormalities have been described and data on infancy and childhood are encouraging. For the future, clinical and laboratory research are essential in order to improve prepregnancy assessment criteria, to understand the mechanisms of gestational renal dysfunction and proteinuria, to assess the side-effects and implications of immunosuppression in pregnancy and to learn more about the remote effects of pregnancy on both renal prognosis and the offspring.
 ...
PMID:Pregnancy in renal allograft recipients: prognosis and management. 333 Apr 84

Renal transplantation is usually accompanied by an improvement in reproductive function. The possibility of conception in women of childbearing age emphasizes the need for counseling, and couples who want a child should be encouraged to discuss all implications, with the advice based on strict guidelines. If a recipient becomes pregnant, she must be monitored as a high-risk patient. Management requires particular attention to BP control, renal function, and all infection, as well as fetal surveillance. Just under 40% of conceptions do not go beyond the first trimester, but of those that do, greater than 90% end successfully. In most patients, renal hemodynamics improve during gestation, but permanent impairment occurs in 15% of pregnancies. Other patients may experience transient deterioration in late pregnancy (with or without proteinuria). Patients have a 30% chance of developing hypertension, preeclampsia, or both. Despite its pelvic location, the transplanted kidney rarely produces dystocia and experiences no apparent mechanical injury during vaginal delivery. Thus, cesarean section should be reserved for obstetric reasons only. Aseptic technique, bacterial prophylaxis even for trivial surgery, and steroid augmentation are necessary. Preterm deliveries occur in 45% to 60%, and intrauterine growth retardation in at least 20%, of gestations. Neonatal complications include respiratory distress syndrome, leukopenia, thrombocytopenia, adrenocortical insufficiency, and infection. No predominant or frequent developmental abnormalities have been described, and data on infancy and childhood are encouraging. Future goals should be to improve prepregnancy assessment criteria, to reassess the rationale and implications of immunosuppression during pregnancy, and to monitor the remote effects of pregnancy on both renal prognosis and the offspring.
 ...
PMID:Renal transplantation and pregnancy. 355 13

Two-dimensional echocardiography is a useful noninvasive tool for diagnosing intrapericardial tumors as a cause of respiratory distress or abnormal cardiomediastinal shadow on chest x-ray. Early recognition of these tumors within the pericardium is important since surgical removal is often curative. Cardiac cineangiography is unnecessary to delineate further the tumor and should be reserved for those in which associated intracardiac defects are suspected.
 ...
PMID:Diagnosis of intrapericardial tumor in an infant by two-dimensional echocardiography. 370 96

To determine the extent and consequences of penetrating trauma to the head and neck in children, as well as the safety and efficacy of selective management of penetrating wounds of the face and neck, we reviewed our experience with these injuries since 1970. During this interval, 45 children aged 2 to 17 years were admitted for treatment of 37 missile wounds (MW) and eight stab wounds (SW). Most patients reached the hospital within 30 minutes of injury. The greatest single number of these injuries were due to accidents; violent crimes accounted for the remainder of injuries in which a motive for attack was known. Craniotomy was performed in neurologically viable patients only; neck exploration was reserved for those patients who presented with profuse hemorrhage, an expanding or pulsatile hematoma, respiratory distress, or violation of the esophagus, trachea, or great vessels seen on fluoroscopy, endoscopy, or angiography. Overall survival was 87% (MW 84%, SW 100%). Three of the nonsurvivors presented in extremis with gunshot (GSW) wounds to the head, and died shortly thereafter, while two who presented with similar injuries survived craniotomy but died subsequently from irreversible brain damage; one presented in shock due to massive hemorrhage (internal jugular vein transection flush with the base of the skull) and exsanguinated during attempted repair. Among the 39 survivors, 15 sustained multiple wounds, but only two presented in shock, due in both instances to tension pneumothorax. Soft tissue injuries of the scalp, face, and neck accounted for 36 of the 39 nonfatal wounds; five of these involved major cervical structures, but only four required immediate exploration.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Fifteen years' experience with penetrating trauma to the head and neck in children. 381 88

In this study all deliveries with premature rupture of the membranes (VBS) between 1978 and the midst of 1981 were compared and statistically analysed using a control collective, which consisted of the sum of the respective following delivery. A premature rupture of the membranes was found in 18.1 per cent. We observed a VBS more often in case of increasing age of the mother and significantly more often for primiparae. An infection of the urinary tract seemed to increase the risk of an VBS. The latent period is longer, if the VBS occurred in the early pregnancy. There was no difference between both groups according to the course of birth, the frequency of KPDA, the pressing period and the period of dilatation. Complications with the umbilical cord could not be found more often in the collective of premature rupture of the membranes than in the control group. The umbilical cord prolapse even was rarer in case of premature rupture of the membranes. Difficulties in adaptation and the respiratory distress syndrome could be found significantly more often in the group of VBS, according to the higher rate of premature children in this collective. The possible stimulating effect of the VBS on the induction of the fetal lung maturity was reserved by the higher rate of neonatal infections in case of longer latent periods. We found the amnion infection syndrome in 2.1 per cent if the latent period was less than 24 hours, 10.7 per cent if it was longer than 48 hours and more than 15 per cent if it was 72 hours and more.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Clinical aspects of premature rupture of the membranes]. 404 80

Careful management of fluid and electrolytes may require the rational use of diuretic agents in some neonatal pathological conditions. High efficacy diuretics include "loop" diuretics--furosemide, bumetanide and ethacrynic acid. The elimination half-life and renal effects of furosemide are prolonged in newborn infants as compared with adults. In congestive heart failure, the mean net losses associated with a 1 mg i.v. dose of furosemide, are 28 ml/kg, 3.6 mmol/kg and 0.3 mmol/kg respectively for water, sodium and potassium. The furosemide--dopamine (2 micrograms/kg/min) combination may improve renal insufficiency in the course of respiratory distress syndrome (RDS). Furosemide also decreases the deleterious renal effects of indomethacin. Beneficial effect of furosemide has not been clearly demonstrated in RDS and bronchopulmonary dysplasia (BPD). Metabolic alkalosis, hypokalemia, renal calcifications, cholelithiasis and worsening in BPD outcome have been related to long-term administrations of furosemide. The risk of furosemide induced-ototoxicity has not been clearly assessed in newborn infants. Medium efficacy diuretics (thiazides) act primarily in the early distal tubule. Chlorothiazide may reduce calcium urinary excretion in neonates receiving long-term furosemide therapy. Weak diuretics (potassium-sparing diuretics and carbonic anhydrase inhibitors) cause excretion of less than 5% of the filtered sodium. Potassium-sparing diuretics are usually reserved for neonates with congestive heart failure and are always used in combination.
 ...
PMID:[Diuretics in the neonatal period]. 756 38


1 2 3 4 5 Next >>