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Query: UMLS:C0728731 (prematurity)
 7,134 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Clinical and haematological findings at the nadir of the refractory, early anaemia of prematurity were compared in a study of 95 preterm infants. 53% of 30 babies less than 32 weeks' gestational age at birth had abnormal clinical features resulting from anaemia at its nadir, with a combination of tachycardia, tachypnoea, dyspnoea and feeding difficulties, diminished activity, and pallor. The expression 'available oxygen', derived from the Hb concentration and Hb-O2 affinity, correlated more closely with clinical features of anaemia that did the Hb concentration alone. A formula is presented that predicts the 'available oxygen', provided the Hb concentration and post-conceptual age are known; this avoids the need for direct measurement of Hb-O2 affinity. Clinical anaemia is common in preterm infants with Hb concentrations of up to 10.5 g/dl, consequent on the high O2 affinity of fetal Hb. This is the first description of any common clinical consequence of high Hb-O2 affinity.
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PMID:Nonphysiological anaemia of prematurity. 72 8

From June. 1987 to Dec. 1988, data was collected from 12 cases with Congenital Brain Anomalies. The cases involved 7 girls and 5 boys with ages ranging from 2 days to 15 years old. Abnormalities diagnosed were Cavum-septi pellucidi; Cavum vergae; Cystic dilated cavum; Cavum veli interpositi; Lissencephaly with dysgenesis of the corpus callosum; Dysgenesis of the corpus callosum associated the midline dorsal cyst; Holoprosencephaly, alobar type; Schizencephaly associated with Hydranencephaly; Encephaloclastic porencephaly; Severe hydrocephalus; Variant type of Dandy-Walker cyst with dysgenesis of the corpus callosum; Arnold-Chiari malformation. The patients were initially seen OPD primarily for seizures and other complaints such as nystagmus with visual impairment, hypotonia, facial anomalies, Yolk-sac tumor, prematurity, dyspnea and hydrocephalus. Among these, Holoprosencephaly was easiest to diagnose because it was combined with facial anomalies. However the others required evaluation by CT. CT offers very efficient diagnostic modality which is better than a Cranial Echo. It is also safer than the invasive angiography and not as expensive as MRI.
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PMID:[Congenital anomalies of the brain in computed tomography]. 276 27

At no other time of life is the decision to transfuse potentially as difficult as in the newborn period. Superimposed upon complex "physiologic" changes in the ability to deliver and release oxygen are varying requirements among infants in terms of oxygen need. These are compounded by changes brought about as a direct consequence of frequent phlebotomy in the most ill of preterm infants. Despite the confusion overlying many of the changes occurring at this time of life, certain principles can be applied. Unlike that of the adult, an infant's ability to make oxygen available in response to a specific demand is almost as dependent upon the modifiers of oxygen uptake and release by hemoglobin as upon the hemoglobin concentration itself. These modifiers are constantly changing, sometimes in a predictable fashion, sometimes not. As discussed, some attention to the status of a particular infant's capability in providing oxygen relative to need will assist in the decision when to transfuse. If specific parameters of these assessments can not be determined, it may be necessary to proceed with transfusion based on the clinical presentation of an infant. With regard to the above, any infant sufficiently ill to require frequent blood sampling should have such blood losses replaced, certainly before ten percent of blood volume has been exceeded. This is particularly true in infants who are unable to maintain adequate arterial oxygen tensions with or without the use of supplemental inspired oxygen. At several weeks of age, when the clinical status of a preterm infant may have stabilized, transfusion may or may not be needed during the nadir of the anemia of prematurity. Infants who had been previously transfused or who had earlier received frequent simple transfusions should be able to tolerate lower levels of hemoglobin. Infants without compromised cardiopulmonary function and in whom no unusual metabolic needs exist are unlikely to be aided by transfusions when the hemoglobin concentration is greater than 10 to 11 g/dl. At lower levels of hemoglobin, simple calculations of "available oxygen" may be helpful when it is difficult to determine whether clinical signs and symptoms of anemia exist. Such signs and symptoms may include poor feeding, dyspnea, tachycardia, tachypnea, diminished activity, and pallor. Apnea has not unequivocably been shown to improve following transfusion. Clearly, our current concepts regarding indications for transfusion, even when based upon known principles of physiology, still represent an art form that is less than completely scientific.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Anemia of prematurity. Current concepts in the issue of when to transfuse. 351 96

The authors analyzed the outcome of 2000 consecutive second-trimester amniocenteses. Seventy-three percent were performed for maternal age of 34 years or more. The risk of spontaneous abortion before 28 weeks' gestation was 1.3% and for stillbirth or neonatal death, 1.4%. Total fetal loss was 2.7%, compared with 2.2% in a control population. Congenital malformations were found in 1.6% of the study group and in 1.9% of controls; no increase in skeletal problems was observed. Prematurity, defined as a birth weight of less than 2500 g, was noted in 3.6%, compared with 3.7% and 3.9% in 2 control populations. Respiratory difficulties persisting for more than 24 hours were observed in 0.8% of patients, compared with 0.7% of controls. Analyses of the outcome of amniocenteses performed at a single large center do not show an increase in perinatal complications or malformations.
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PMID:Follow-up of 2000 second-trimester amniocenteses. 743 34

Subjective clinical observations have suggested that nebulized bronchodilators are helpful in the treatment of some wheezy infants. Although the role of beta 2-agonists in the management of acute asthma in infants and very young children remains controversial, the use of beta 2-adrenergic agents in this age group has been widespread. beta 2-agonists nebulization continues to be the first-line treatment for acute attack of asthma, irrespective of age, in some institutes, but their uses are not without side effect especially in young wheezy infants. We report three cases of respiratory failure occurred after treatment with nebulized beta 2 bronchodilator in infants with chronic lung disease and acute wheezing. All the 3 cases were victims of prematurity. Case 1 was a case of Wilson-Mikity syndrome; case 2 was a case of bronchopulmonary dysplasia; and case 3 was a case of repeatedly wheezing infant. All 3 cases had severely wheezy dyspnea with retraction before nebulized beta 2 bronchodilator treatment. Respiratory failure was found 5 to 10 minutes after the treatment. We suggest that it must be very careful in the treatment of severely wheezy infants with beta 2-agonist nebulization, especially in cases with histories of prematurity and chronic lung disease. It is necessary to carefully monitor the vital signs of the infants during beta 2 agonist nebulization.
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PMID:[Respiratory failure after nebulized terbutaline treatment in severely wheezy infants: report of three cases]. 804 10

In view of cytokine's effects in promoting or inhibiting inflammation, the objective of this study was to explore the characteristics of the proinflammatory cytokine, interleukin-8 (IL-8), and the inhibitory cytokine, interleukin-10 (IL-10), in the bronchoalveolar lavage (BAL) fluid of premature infants suffering from respiratory distress disease. Eighteen premature neonates with respiratory distress disease with gestational age (GA) ranging from 24 to 37 weeks were recruited for study. BAL fluids were collected following endotracheal intubation during an episode of hypoxemia or dyspnea. A series of BAL samples were obtained on day 1, 2, 4 and 7 after intubation for measuring IL-8 and IL-10 levels. The results indicate that premature infants with GA ranging from 24 to 32 weeks had a higher level of IL-8 (p = 0.029), but not level of IL-10 (p = 0.109), in the BAL obtained during the first intubation compared to premature infants with GA ranging from 33 to 37 weeks. The administration of exogenous surfactant did not influence the profiles of IL-8 and IL-10, as compared to those in-patients without treatment. Levels of IL-8 were correlated with IL-10 levels (r = 0.613, p = 0.007) in BAL fluid samples obtained on the day of intubation. The level of IL-8, but not IL-10, was significantly correlated with the duration of intubation. IL-8 and IL-10 levels in BAL fluid samples collected on the day of intubation were correlated with the development of chronic lung disease (CLD). The results suggest that extreme prematurity tends to have increased IL-8 and IL-10 levels in BAL fluid compared to premature infants with older GA, and that these increased levels are associated with the development of CLD.
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PMID:Profiles of inflammatory cytokines in bronchoalveolar lavage fluid from premature infants with respiratory distress disease. 1080 59

Neonates deaths occur the most often because of prematurity, dyspnoea and serious infections. Each of the above mentioned complications is accompanied by haemostasis, produced by a destroying effect of a heterologous stimulus on natural anticoagulation mechanism. The aim of the study was to evaluate the activation of the haemostasis system in prematurely born neonates with developing respiratory insufficiency.
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PMID:[Processes of coagulation and fibrinolysis in prematurely born neonates with developing respiratory insufficiency]. 1210 65

Dietary deficiency in iron and to a lesser extent folic acid is the principle cause of anemia in the world. Reproductive aged women and growing children are the principle groups at risk of anemia. About half of nonpregnant reproductive aged women in tropical countries have hemoglobin levels lower than 12 g/100 ml, the level used by the World Health Organization to define anemia. Nutritional anemia is even more widespread among pregnant and lactating women because of the increased needs for iron during those periods. Pregnant women need almost 500 mg of iron for their increased red blood cell mass, 220 mg for routine iron loss through the urine, bile, sweat, and other routes; 290 mg for the fetus, and almost 25 mg for the placenta. In all, the pregnant women theoretically requires over 1000 mg of iron through diet or bodily reserves. Healthy, well-nourished women have total iron reserves of 2500 mg, but according to published data almost 2/3 of pregnant women even in favorable circumstances end their pregnancies with no remaining iron reserves. In tropical regions the lack of iron reserves is aggravated by parasites and infections, closely spaced pregnancies that do not allow restoration of reserves, and poor dietary availability of iron. Anemia during pregnancy is associated with elevated risks of maternal morbidity and mortality. Fatigue, dyspnea, palpitations and tachycardia, vertigo, loss of appetite and cravings for soil or other inappropriate substances are frequently observed in anemic women. The risks of prematurity and low weight are increased for infants of anemic women. Fetal malformation may be associated with folic acid deficiency. Nutrition education is needed for pregnant women. Local foods may be enriched with iron, and pregnant women may be given iron and vitamin B12 supplements directly. Iron supplements may rapidly increase iron reserves, but they are poorly tolerated by many women. The supplements should be avoided if possible early in the pregnancy because digestive intolerance is more likely in the 1st months of pregnancy. Parasitic and bacterial infections should be diagnosed and treated as a step in controlling anemia.
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PMID:[Impact of nutritional deficiencies on anemia in pregnant women]. 1228 20

The purpose of rehabilitation is to restore good physical, mental emotional, social condition and if at all possible efficiency at work in a patient with an obstructive pulmonary disease. The most important aspect of rehabilitation is an individual attitude to each patient. A patient with chronic disease and different degree of failure of the respiratory tract struggles with abnormal lung function i.e. with dyspnoea and general physical weakness. Obviously, a slight disturbance in the function of the respiratory system is almost imperceptible in daily activities, thus patients complain about slight fatigue that recedes after a short rest. The values of basic spirometric indexes FVC, FEV1 are within normal. Only disturbances of the function of peripheral air passages MEF50%VC, MEF25%VC indicate the onset of failure in the distribution of inspired gas and alveolar hypoventilation as well as violation of normal air flow in the peripheral bronchioles whose diameter is less than 2 mm. Anxiety and concern for health appear with increased dyspnoea while doing exercises and within years dyspnoea will accompany daily domestic routine activities. It is known that such factors as pollution of the environment, smoking tobacco, viral infections in childhood, bacterial infections of the respiratory system, prematurity, respiratory distress syndrome (RDS) and different degree of bronchi-pulmonary dysplasia favour the development of chronic obstructive pulmonary disease. The decrease of FEV1 more than 40 ml per year shows the increased respiratory failure. Ventilatory reserves of the respiratory system systematically diminished exceeding the predicted limit 80%. COPD is a chronic progressive disease causing irreparable obstruction of the bronchi. Then changes in the structure of the bronchial tree are seen as well as the increased tension of the smooth muscles which depend on the parasympathetic system. Does the progression of the disease indicate the lack of effective treatment? The sick patient starts doubting about the right diagnosis, medicines, rehabilitation and medical team. It is necessary to analyse and update again therapeutic treatment and rehabilitation. Movement and respiratory rehabilitation, regardless of the degree of COPD severity, has in principle five major tasks: 1. The control, alleviation, delay of pathological processes causing the increased pulmonary failure. 2. Improvement of physical condition. 3. The study of physiotherapy and coping with stress in patients with dyspnoea and progressive disease. 4. Improvement of the standard of life and prolonging lifespan. 5. The decrease of medical care expenses.
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PMID:[Movement rehabilitation, psychotherapy and respiratory rehabilitation in patients with chronic obstructive pulmonary disease]. 1500 10

Patients with orthotopic heart transplantation may have a variety of arrhythmias. There are reports of successful radiofrequency catheter ablation of some of them. Two months after orthotopic cardiac transplantation by bicaval anastomosis, a 49-year-old man developed episodes of tachycardia. The patient developed with dyspnoea and hypotension during typical atrioventricular nodal reentrant tachycardia (AVNRT) revealed by electrocardiogram. During programmed atrial stimulation with progressively increasing prematurity, dual auriculoventricular nodal physiology was observed and AVNRT was induced. This tachycardia was successfully eliminated without complications by radiofrequency catheter ablation of the slow pathway. The patient remained asymptomatic at 4-month follow-up.
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PMID:Radiofrequency catheter ablation of atrioventricular nodal reentrant tachycardia in a patient with orthotopic heart transplantation by bicaval anastomosis. 1695 61


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