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Target Concepts:
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Query: UMLS:C0728731 (
prematurity
)
7,134
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Cord blood was anonymously screened to determine the prevalence of human
immunodeficiency
virus (HIV) seropositivity in neonates admitted to the neonatal intensive care unit (NICU) at the Bronx Lebanon Hospital Center, located in the South Bronx. We speculated that factors leading to admission to the NICU such as low birth weight,
prematurity
and being small for gestational age would also be associated with an increased prevalence of HIV seropositivity. During the study period the prevalence of HIV seropositivity was 11.6% in the NICU population. There was no significant difference in maternal age, gravidity, race and sex in HIV-seropositive vs. HIV-seronegative newborns. There was a significantly increased incidence of maternal drug use (P less than 0.01), babies small for gestational age (P less than 0.005) and microcephaly (P less than 0.02) in seropositive vs. seronegative NICU babies. The results of this study suggest that the NICU population may comprise a significant number of infants of HIV-infected mothers.
...
PMID:Human immunodeficiency virus seropositivity in critically ill neonates in the south Bronx. 154 7
Erythropoietin is a glycoprotein hormone that plays a vital role in erythropoiesis. It is mainly produced in the fetal liver till the third trimester of pregnancy. At that point, the kidney interstitium takes over this function and becomes the main source of erythropoietin. Hypoxia stimulates erythropoietin production by a mechanism that may require a heme protein as a second messenger. Erythropoietin stimulates the maturation of erythroid precursors (colony-forming unit-erythroid and burst-forming unit-erythroid) via at least two types of cell surface receptors. The higher-affinity receptors appear to be more important in modulating the effects of erythropoietin in vivo. Changes in intracellular calcium may ultimately mediate the action of erythropoietin on erythroid precursors. A specific and sensitive radioimmunoassay is now available for accurately measuring erythropoietin levels. All forms of erythrocytosis except polycythemia vera are associated with elevated erythropoietin levels. Levels are also high in cord blood obtained following fetal asphyxia. Reduced levels are seen in patients with anemia due to renal diseases. The response of erythropoietin to the degree of anemia appears to be attenuated in patients with cancer, chronic diseases, and human
immunodeficiency
virus (HIV) infection. Erythropoietin has been successfully used for treating patients with anemia due to renal failure. Its use has also been approved for the treatment of anemia patients receiving zidovudine for HIV infection. Encouraging results have been observed when erythropoietin was used to treat anemia due to rheumatoid arthritis, hematological malignancies, and
prematurity
. It has also been used to increase the yield of autologous blood collected prior to an elective surgical procedure. However, it has not proved to be useful in sickle cell anemia and myelodysplastic syndromes.
...
PMID:Erythropoietin. Biology and clinical applications. 178 66
Sexually transmitted diseases (STDs) are now the most common group of identifiable infectious diseases in many countries, especially among those ages 15-50 and in infants. Their control is important considering the high incidence of acute infections, complications and sequelae, their socioeconomic impact, and their role in increasing transmission of the human
immunodeficiency
virus (HIV). THe worldwide incidence of major bacterial and viral STDs is estimated to be over 125 million cases yearly. STDs are hyperendemic in many developing countries. However, in industrialized countries, the bacterial STDs such as syphilis, gonorrhea, chancroid declined from their peak during WW II until the late 1950s, increased during the 1960s and early 1970s, and have again decreased since that time. In the industrialized world, diseases due to Chlamydia trachomatis, genital herpes virus, human papillomaviruses, and HIV are now more significant than the classical bacterial ones; both groups remain major health problems in most developing countries. Infection rates are similar in both men and women, but women and infants bear the major burden of complications and serious sequelae. Infertility and ectopic pregnancy are often a result of pelvic inflammatory disease and are preventable. STDs in pregnant women can result in
prematurity
, stillbirth, and neonatal infections. In many areas, 1-5% of newborns are at risk of gonococcal ophthalmia neonatorum, a disease that blinds and congenital syphilis causes up to 25% of perinatal mortality. Genital and anal cancers (especially cervical cancer) are associated with viral STDs (genital human papillomavirus and herpes virus infections). Urethral stricture and infertility are frequent sequelae in men. (author's modified)
...
PMID:Epidemiology of sexually transmitted diseases: the global picture. 228
Neurologic and neurodevelopmental problems were investigated in a cohort of 39 human
immunodeficiency
virus (HIV)-infected children and 164 antibody-negative children born to HIV-positive women. All children were followed from birth for between 1 month and 4 years. Serious neurologic manifestations were present in 5 of 16 children (31%) who developed acquired immunodeficiency syndrome/acquired immunodeficiency syndrome-related complex, although in 2 the neurologic signs were probably not related to HIV. This can be compared with a prevalence of 0 of 23 in children who remained asymptomatic or who had less severe HIV-related symptoms or signs and 2 of 164 (1%) in uninfected children. Neurologic signs in the uninfected group were associated with the presence of drug withdrawal at birth and
prematurity
. These findings contrast with reports of a high prevalence of neurologic findings in most studies of HIV-infected children.
...
PMID:Neurologic signs in young children with human immunodeficiency virus infection. The European Collaborative Study. 236 61
From 1974 to 1990, 336 Bacteroides isolates were obtained from 312 specimens from 274 patients. They comprised 180 (54%) B. fragilis isolates, 55 (16%) B. theta-iotaomicron, 36 (11%) B. vulgatus, 34 (10%) B. distasonis, 21 (6%) B. ovatus and 10 (3%) B. uniformis. Infections in 253 (92%) patients were polymicrobial, but in 21 (8%) children, a Bacteroides sp. was isolated in pure culture. Most Bacteroides isolates were from peritoneal fluid (114), abscesses (110), wound infections (20), blood cultures (10) and from patients with pneumonia (14) or chronic otitis media (8). Predisposing conditions were present in 145 (53%) children; these were previous surgery (46), trauma (28), malignancy (21),
prematurity
(19),
immunodeficiency
(18), steroid therapy (12) foreign body (10), diabetes (9) and sickle cell disease (7). The micro-organisms isolated most commonly mixed with Bacteroides spp. were anaerobic cocci (221), Escherichia coli (122), Fusobacterium spp. (38) and Clostridium spp. (30). All patients received antimicrobial therapy in conjunction with surgical drainage or correction of pathology in 197 (72%) cases. All but 12 (5%) patients recovered. These data illustrate the importance of Bacteroides spp. in infections in children.
...
PMID:Bacteroides infections in children. 762 59
680 Peptostreptococcus sp. (Ps) were recovered from 598 (34%) of 1,750 specimens obtained from 554 patients. They included 103 Ps asaccharolyticus, 74 Ps magnus, 56 Ps prevotii, 51 Ps micros, 46 Ps anaerobius, 11 Ps morbilorum, and 10 Ps saccharolyticus. Most infections were polymicrobial (in 553 instances or 92%) but in 45 (8%), Ps were recovered in pure culture. Most Ps were isolated from abscesses (237), ears (104), peritoneal fluid (95), lung infections (66), bone (30) and sinuses (24). Predisposing conditions were present in 224 (40%) children. These were previous surgery (54),
immunodeficiency
(43), malignancy (35), trauma (34), diabetes (23),
prematurity
(22), steroid therapy (19), foreign body (10) and sickle-cell anemia (7). The organisms most commonly isolated with Ps were Bacteroides sp. (276, including 190 B. fragilis group), Prevotella sp. (159), Fusobacterium sp. (122), Escherichia coli (114), and Staphylococcus aureus (97). Antimicrobial therapy was administered to all but 14 patients. Surgical drainage or correction of pathology was performed in 307 (56%) patients. 10 patients (2%) died of their infection. These data illustrate the importance of Ps and suggests their enhancing potentials in infection in children.
...
PMID:Peptostreptococcal infection in children. 785 47
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.
...
PMID:Severe Klebsiella infection as a cause of mortality in neonates in Harare, Zimbabwe: evidence from postmortem blood cultures. 828 21
Low birth weight,
prematurity
, and intra-uterine growth retardation (IUGR) are major determinants of child survival. Therefore, it is important to assess excess mortality due to human
immunodeficiency
virus (HIV) infection in populations where low birth weight is common. A prospective study was conducted on a total of 1385 children born to 679 HIV-seropositive and 687 seronegative women in urban Malawi. Children were regularly examined and tested for HIV. The mortality rate of children of HIV-seropositive mothers was substantiality higher (223/1000 at 12 months, 317/1000 at 24 months, and 360/1000 at 30 months, p 0.0001) than that of children of seronegative mothers (68/1000 at 12 months, 106/1000 at 24 months, and 118/1000 at 30 months). The incidence of
prematurity
and IUGR was also higher in infants of HIV-seropositive mothers than in infants of seronegative mothers (12.5% versus 3.8%, p 0.001 for premature and 7.7% versus 4.4%, p = 0.02 for IUGR infants). The mother-to-infant HIV-1 transmission rate was 35.1%. The overall incidence of low birth weight was 14.1%, but the incidence was 20.1% among children of seropositive mothers and 8.3% among those of seronegative mothers (p 0.001). After 12 months of age, HIV-infected children showed the highest mortality; however, uninfected children of HIV-seropositive and children of HIV-seronegative mothers had similar mortality. The mean birth weight of HIV-infected and uninfected children was not significantly different. In HIV-infected children the most frequent causes of death were diarrhea, pneumonia, and failure to thrive. Less common risk factors for child mortality included active maternal syphilis and cervicitis/vaginitis. A possible enrolment bias could have resulted in lower mortality estimates among babies of HIV-seronegative mothers. To decrease childhood mortality, a combination of interventions such as treatment of sexually transmitted infections during pregnancy and measures to reduce mother-to-infant transmission should be adopted.
...
PMID:The effect of human immunodeficiency virus infection on birthweight, and infant and child mortality in urban Malawi. 855 35
Malaria infection due to Plasmodium falciparum has been widely recognized as associated with important adverse consequences in pregnant women, particularly in areas of high transmission. Although strategies using antimalarial drugs for prevention had been recommended, even by the late 1980s, few studies had been carried out to examine the efficacy of these prevention efforts. The objectives of the Mangochi Malaria Research Project investigation were to determine the comparative efficacy of regimens containing chloroquine (CQ) or mefloquine (MQ) antimalarial treatment and chemoprophylaxis in an area of CQ-resistant P. falciparum on the following outcomes: 1) the frequency of placental malaria infection; 2) the frequency of low birth weight; 3) the frequency of
prematurity
or intrauterine growth retardation; 4) the frequency of maternal fever illness and severe anemia; and 5) the likelihood of infant acquisition of malaria infection. Although the investigation was not designed to evaluate the role of antimalarial chemoprophylaxis and treatment on infant mortality reduction, because babies born to study women were scheduled to be followed for up to two years of life, the study allowed for an examination of mortality and morbidity in this population. The sample size was insufficient to provide more than descriptive analysis of mortality and morbidity in the fetal, perinatal, neonatal, postneonatal, and infant time intervals. The study design allowed for the evaluation of two additional aspects of maternal and infant health: other determinants of the above-listed outcomes in addition to malaria prevention (e.g., maternal age, gravidity, socioeconomic status, infection with human
immunodeficiency
virus or syphilis) and reported cause-specific mortality in the fetal-to-infant intervals. The study design included 22 months of enrollment of pregnant women at their first antenatal clinic visit from four clinic sites in Mangochi District, Malawi, with assignment to one of four antimalarial regimens and prospective follow-up through pregnancy, at delivery, and during infancy. All drug dosing was performed under supervision by the study team, making this an evaluation of intervention efficacy (excluding the role of patient compliance).
...
PMID:Objectives and methodology in a study of malaria treatment and prevention in pregnancy in rural Malawi: The Mangochi Malaria Research Project. 870 43
Developing nations in sub-Saharan Africa experience childhood mortality rates that are much higher than any other region of the world. In a rural Malawian community we investigated risk factors for deaths occurring during the neonatal (birth-28 days), postneonatal (29-365 days), infant (birth-365 days), and second-year (366-730 days) periods among a cohort of 3,724 infants monitored from birth. The neonatal mortality rate in this cohort was 48.6 per 1,000 live births (LB); the postneonatal mortality rate was 108.7/1,000 LB. The overall infant mortality rate was 157.3 deaths/1,000 LB and the mortality rate for the first two years of life was 223.7 deaths/1,000 LB. The predominate risk factors for neonatal deaths identified in multivariate analysis were low (hazard ratio [HR] = 2.3) and very low birth weight (HR = 12.7), first pregnancy (HR = 1.8) and maternal syphilis infection (HR = 2.4). Maternal infection with human
immunodeficiency
virus (HIV) (HR = 1.5) predominated for postneonatal deaths. Low (HR = 1.4) and very low (HR = 5.0) birth weight, first pregnancy (HR = 1.6), maternal HIV infection (HR = 2.4), and the combination of low education and low socioeconomic status (SES) of the mother (HR = 2.0) were the most important factors during the infant period. Maternal HIV infection (HR = 3.3) and the combination of low education and low SES of the mother (HR = 2.6) were the predominate risk factors for mortality occurring during the second year. Factors that were significant in univariate analysis but not significant in the final multivariate models included
prematurity
, previous adverse reproductive outcome, dying during high malaria transmission season, and being born at home. Interventions to prevent maternal HIV infection and low birth weight and treatment of syphilis infection would have a great impact on reducing early childhood deaths. Improving the delivery of health care and education to women during their first pregnancy and to the most socially disadvantaged women may also help reduce the burden of early childhood mortality in communities such as the one studied in Malawi.
...
PMID:Rates and risk factors for mortality during the first two years of life in rural Malawi. 870 44
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