Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0728731 (prematurity)
 7,134 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Seven children born prematurely who survived the respiratory distress syndrome, seven children born prematurely who had no neonatal lung disease, and seven normal children born at term were studied by comparison of flow volume curves obtained while breathing air to those obtained while breathing 80% helium and 20% oxygen. Expiratory flow rates in air both groups of prematurely born children were lower than flow rates of the children born at term, and the volumes of iso-flow were higher in the survivors of RDS than those of the children born at term. The differences in flow rates in air suggest an increase in large airway resistance in both groups of prematurely born children. It is speculated that this may be secondary to growth retardation related to prematurity. The elevated Viso V in the RDS group suggests an increase in small airway resistance secondary to the disease or to its therapy.
 ...
PMID:Long-term pulmonary sequelae of premature birth with and without idiopathic respiratory distress syndrome. 83 78

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.
 ...
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

To construct standard growth curves for Japanese infants of very low birthweight, longitudinal data provided by 47 neonatal centers in Japan were reviewed. Data were collected on the growth of infants admitted to those units during 1986 and 1987 and who survived beyond 3 years of age. A total of 379 singleton infants, who were free of neurological sequelae and appropriate for gestational age, were enrolled. Those whose birthweights were more than 600 g and less than 1,500 g were grouped into nine weight categories separated by increments of 100 g. Data on the increase in weight and head circumference were compiled and analyzed until more than half the infants in each weight category had been discharged from each site. Growth curves of bodyweight and head circumference in the nine groups were constructed using polynomial regression analysis to define the curve of best fit. With increasing prematurity, significant trends of greater weight loss (P < 0.05), longer time to reach the lowest weight (P < 0.01) and a longer time to regain birthweight (P < 0.01) were observed. In addition, there was a significantly higher incidence of chronic lung disease in such groups (P < 0.0001). Growth curves were characterized by the average clinical profiles in each of the nine groups. We believe that these data will be useful in evaluating the growth of very low birthweight infants being cared for in modern neonatal intensive care units in Japan.
 ...
PMID:Postnatal growth curves of very low birthweight Japanese infants. 128 13

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.
 ...
PMID:Respiratory disease in very-low-birthweight infants after prenatal thyrotropin-releasing hormone and glucocorticoid. TRH Study Group. 135 Aug 27

We performed a randomized, double-blind, controlled trial to determine whether vitamin A supplementation in a group of very low birth weight infants would reduce the incidence of bronchopulmonary dysplasia. Forty-nine infants (birth weight 700 to 1100 gm) requiring mechanical ventilation and supplemental oxygen at 96 hours age were randomly assigned to receive either 2000 IU retinyl palmitate (n = 27) or saline placebo (n = 22) intramuscularly every other day for up to 14 doses. There were no differences between treatment groups in the incidences of bronchopulmonary dysplasia at 31 days of postnatal age (vitamin A group 48%, placebo group 55%; p = 0.776), supplemental oxygen requirement at 34 weeks of postconceptional age, or other complications of prematurity. The vitamin A group had higher mean plasma vitamin A concentrations than the placebo group, but mean plasma vitamin A concentrations were greater than 20 micrograms/dl (suggesting sufficiency) in both groups after the first study week. By study day 28, only one fourth of the infants in either group had plasma vitamin A concentrations less than 20 micrograms/dl. In contrast to an earlier report, we found no change in the incidence of BPD with vitamin A supplementation. Our findings may reflect a low baseline incidence of vitamin A deficiency in the study population and recent changes in the respiratory care of very low birth weight infants. The latter may have lessened the potential impact of vitamin A deficiency on lung disease.
 ...
PMID:Trial of vitamin A supplementation in very low birth weight infants at risk for bronchopulmonary dysplasia. 830 48

Bronchopulmonary dysplasia (BPD) and chronic lung disease remain common complications of prematurity. This article addresses the evolution of BPD since its description in 1967, and the impact of surfactant replacement therapy on the incidence and characteristics of BPD. It also addresses the emergence of a form of chronic lung disease now seen in surfactant-treated premature infants who had no acute lung disease.
 ...
PMID:Impact of lung surfactant therapy on chronic lung diseases in premature infants. 152 73

The phosphatidylcholine (PC) content of the initial endotracheal tube aspirate was measured in 105 infants intubated for resuscitation or for ventilation for respiratory distress syndrome, using high performance liquid chromatography and postcolumn fluorescence derivitization with diphenyl-1,3,5-hexatriene. Sixty eight had measurable PC. Of the infants who developed respiratory distress syndrome, with or without subsequent chronic lung disease, neither the percentage of dipalmitoylphosphatidylcholine (DPPC) nor the ratio of DPPC to palmitoyloleoylphosphatidylcholine (POPC), showed any correlation with gestational age. However, both parameters were significantly lower overall in this group than in the group of infants who did not develop respiratory distress syndrome. Infants with a ratio of DPPC:POPC less than 3.0 developed respiratory distress syndrome irrespective of gestational age, but there was considerable overlap between groups for values greater than this. The infants with respiratory distress syndrome who went on to develop chronic lung disease had the same initial PC profile as those with respiratory distress syndrome who did not develop chronic lung disease, but differed as a group by being lighter and more premature. The development of chronic lung disease was not associated with a particular initial PC composition. Other factors related to increasing prematurity must therefore be involved in rendering infants vulnerable to developing chronic lung disease.
 ...
PMID:Phosphatidylcholine composition of endotracheal tube aspirates of neonates and subsequent respiratory disease. 158 74

1. Research into the pathogenesis of acute and chronic neonatal lung disease has been hampered by the lack of a suitable small-animal model of prematurity. We describe such a model that has been developed and validated in the guinea-pig. 2. Pre-term guinea-pigs delivered by Caesarian section at 65 days gestation (normal gestation 68 days) exhibited transient respiratory distress. The survival of pre-term animals was lower than that of term animals after exposure to 95% O2 (pre-term 42% versus term 79% at 96 h, P less than 0.05). 3. Pulmonary histology in pre-term animals exposed to both 21% O2 and 95% O2 revealed evidence of acute lung injury with atelectasis, pulmonary oedema, fibrin deposition and inflammatory cell infiltration. No evidence of lung injury was observed in term animals exposed to 21% O2, whereas those exposed to 95% O2 showed a similar, but less pronounced, injury to that seen in pre-term pups. 4. The protein concentration in bronchoalveolar lavage fluid was similar in pre-term and term animals exposed to 95% O2, but neutrophil numbers in bronchoalveolar lavage fluid tended to be greater in pre-term pups. 5. Elastase-like activity, measured against succinyl-1-trialanine p-nitroanilide, was higher in bronchoalveolar lavage fluid from control pre-term animals compared with that from control term animals. Exposure to 95% O2 increased the elastase-like activity significantly in both groups. The majority of the elastase-like activity was EDTA-sensitive and thus is possibly due to metallo-elastase. Fractionation of bronchoalveolar lavage fluid indicated that the elastase-like activity was associated with a high-molecular-mass complex.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:The pre-term guinea-pig: a model for the study of neonatal lung disease. 165 47

To determine observer agreement for a clinical score and oximetry in lower respiratory infection in children less than 2 yr of age, a convenience sample of 56 infants hospitalized with bronchiolitis or pneumonia was assessed independently by two observers. A total of 12 infants had chronic lung disease of prematurity or congenital heart disease. Infants in whom oxygen supplementation could not be discontinued for at least 5 min were excluded. A severity score was assigned for each of four categories (respiratory rate, retractions, wheeze, and general appearance). A total for each patient was obtained by summing the score for each category. Oxygen saturation was measured using a Nellcor oximeter. Agreement beyond chance was measured using the kappa statistic. The relationship between observers for total score and oximetry and the mean total score and mean oximetry value for each patient was expressed as a Pearson correlation coefficient. A total of 56 infants and children were studied: 2 had pneumonia, 11 had an exacerbation of pulmonary signs and symptoms with their underlying cardiac or pulmonary disease, and 43 had bronchiolitis. Kappa was 0.48 for general assessment, 0.38 for respiratory rate, 0.31 for wheeze, and 0.25 for retractions. All values were statistically significantly greater than 0 at p less than 0.01. Correlations for total score and for oximetry were 0.68 and 0.88, respectively. The median difference between oximetry readings was 1. The correlation coefficient between total score and oximetry was -0.04. The limited agreement for clinical signs makes comparison of patient illness severity between studies difficult.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Observer agreement for respiratory signs and oximetry in infants hospitalized with lower respiratory infections. 173 71

Bronchopulmonary dysplasia (BPD) is one of the most serious complications of neonatal intensive care. This chronic lung disease usually follows early pulmonary injuries. Surfactant defect, oxygen toxicity and barotrauma are three major factors leading to diffuse alveolar and bronchiolar damage, first step of BPD. BPD usually appears in preterm infants and correlates with degree of prematurity and the severity of neonatal distress syndrome. Infants with BPD frequently have poor outcome; the mortality rate is near 30%. The long-term survival prognosis is uncertain with a risk of bronchopathy in adulthood. Until date, current management of BDP is unsuccessful. New strategies are required to prevent neonatal respiratory distress syndrome and decrease its severity.
 ...
PMID:[Bronchopulmonary dysplasia]. 192 71


1 2 3 4 5 6 7 8 9 10 Next >>