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

Epilepsy is more prevalent in developing countries than in developed countries. The high incidence is assumed to be associated with poor antenatal and maternal care, prematurity, birth injuries, childhood febrile convulsions, malnutrition, and infections. Accurate diagnostic equipment, such as the computerized axial tomography, is often beyond the reach of developing countries. The 7 drugs considered essential to the management of epilepsy are phenobarbitol; phenytoin; carbamazepine; ethosuximide; sodium valproate; and diazepam and clonazepam. Surgery is indicated in symptomatic epilepsy due to a local lesion, e.g., a neoplasm. In developing countries, superstition, cultural beliefs, and ignorance add to the social morbidity of the epileptic. Although epilepsy is a chronic condition which can seldom be cured, it can be controlled to the point where it becomes a minor inconvenience.
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PMID:Epilepsy in the developing countries. 46 51

Gram-negative bacterial infections were documented in 6 neonatal New World camelids (5 Ilamas and 1 alpaca). The organisms isolated from blood before death or from multiple organs after death were Escherichia coli (n = 3), Actinobacillus sp (n = 1), and Klebsiella pneumoniae (n = 1). Only 2 crias survived, and 1 became blind secondary to retinal detachment and ocular inflammation, which developed after treatment for bacterial infection. Abnormal events during the perinatal period (prematurity, dystocia, cesarean section, weak at birth) were reported in all 6 crias. Signs of depression, convulsions, and/or coma were observed in all animals. Diarrhea and respiratory distress were also noticed in the 3 crias that died shortly after admission. Serum immunoglobulins were assessed, but without the benefit of a stall-side test specific for Ilama immunoglobulins. All crias were suspected to have poor transfer of maternal immunoglobulins. Hemograms and serum biochemical values prior to the initiation of treatment were obtained on 5 of the 6 crias. Total nucleated cells ranged from 1,400 to 23,100 cells/microliter. Four of the 5 crias has a left shift, and 2 crias had toxic neutrophils. Serum glucose concentrations, measured in 5 of 6 crias, ranged from 83 to 293 mg/dl. Serum creatinine values were high in 2 of 5 crias, 1 of which had acute tubular necrosis. Three crias with high serum electrolyte (sodium, chloride, or potassium) values subsequently died. Arterial blood gas values were assessed in 3 crias, 1 of which had respiratory alkalosis and mild hypoxemia.
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PMID:Gram-negative bacterial infection in neonatal New World camelids: six cases (1985-1991). 142 94

Renal function differs in term infants from that in adults, with lower glomerular filtration rate (GFR) and reduced proximal tubular reabsorption of sodium (Na) and water: nevertheless, it is adequate for their needs. This is not true of very preterm infants in whom hyponatraemia is common. Animal studies have shown that Na+, K(+)-ATPase and the Na+/K+ exchanger are poorly expressed at birth with rapid postnatal rises. Cell receptors for hormones that influence tubular Na transport are less numerous in the premature infant than later in life: intracellular second messenger systems may also be immature. The low GFR is due to vasoconstriction and may be necessary to prevent water and electrolyte wasting due to tubular overload. The hyponatraemia of prematurity could, in principle, be due either to Na loss or water excess and can be prevented either by giving additional Na or by restricting water intake. Na supplementation causes relative volume expansion (VE), water restriction volume contraction (VC); this is demonstrated by the effect of the two approaches on weight gain and on the levels of vasoactive hormones in the blood. We argue that moderate VE is more physiological than VC, both in attempting to simulate intrauterine conditions and in consideration of the infant's nutritional needs. The much less common complication of hypernatraemia is usually due to abnormal water loss and should be prevented by increasing water intake appropriately. The above applies to well, preterm babies: sick preterm infants are much more variable in their Na and water requirements than well infants of comparable gestation and weight and each needs an individually tailored regimen based on frequent clinical assessment and laboratory measurement.
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PMID:Salt and the newborn kidney. 202 43

In a double blind study, two comparable groups (each n = 10) of premature infants less than 34 weeks of gestational age, with idiopathic apnea were given an IV treatment of either theophylline or caffeine. The loading doses were respectively 6 and 10 mg/kg and the maintenance doses were 2 and 1.25 mg/kg every 12 hours. In both groups, apneas greater than or equal to 15 s. with or without bradycardia were similarly reduced (p less than 0.01). Both drugs increased significantly the respiratory rate. Compared to caffeine, theophylline induced a significant acceleration of heart rates, an increase in urinary sodium excretion, more frequent gastrointestinal intolerance and behavioral changes. Plasma concentrations of theophylline were less stable than those of caffeine. These data suggest that a single daily dose of caffeine should be preferentially used in the treatment of idiopathic apneas of prematurity.
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PMID:[The choice between theophylline and caffeine in the treatment of apnea in premature infants]. 220 8

In summary the following can be stated: (1) The comparable large number of premature and low birth weight infants leads in many countries to a public health problem. (2) Prematurity is an unphysiological state which causes some peculiarities in digestive and metabolic functions which in turn have implications on nutrition. (3) Under normal circumstances an intake of about 115-130 kcal/kg b.w./day meets the energy requirements. (4) For the so-called healthy low birth weight infant with a birth weight of 1.5 kg or more 2.9 to g protein/kg b.w./day seem to be adequate. Small for gestational age infants tolerate higher, severely ill low or very low birth weight infants only much smaller amounts or protein. (5) Quality of gain in weight has become a central issue in neonatal nutrition. Data available so far indicate the key role of energy and protein intake. (6) Due to the high requirements for growth the premature and low birth weight infant has greater needs for almost all other nutrients compared to term infants. (7) If human milk is fed - whether from the infant's own mother or pooled - it should at least be supplemented with protein, calcium, phosphorus and sodium as otherwise the high requirements could not be covered. (8) The scientific work done over the last decade has made available so-called premature formulas. (9) Only a very few bodies have issued guidelines on the nutrition of low birth weight infants, the most comprehensive one which has just been published by the ESPGAN. (10) Clinical trials with a premature formula which was formulated according to those guidelines confirmed the theoretical considerations of ESPGAN. (11) Final goals for nutrition of premature and low birth weight infants remain to be clarified by future scientific work. There is, however, considerable evidence that the diet fed to premature or low birth weight infants influences their future quality of life.
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PMID:New perspectives in the nutrition of premature and low birth weight infants. 268 68

Bloodspot 17 alpha-hydroxyprogesterone, plasma cortisol, plasma sodium and urinary 17 alpha-hydroxyprogesterone, cortisol, sodium and creatinine levels were determined in 24 term and 32 pre-term infants on the third, eighth and fourteenth days of life. Pre-term infants, whether 'well' or 'sick', had significantly raised bloodspot 17 alpha-hydroxyprogesterone levels (up to 158 nmol/L) compared with those found in term infants (up to 18.8 nmol/L). Urinary 17 alpha-hydroxyprogesterone creatinine ratios were also higher in pre-term infants. Plasma cortisol results showed similar ranges for term and pre-term infants, and bloodspot 17 alpha-hydroxyprogesterone/plasma cortisol ratios for day 3 specimens correlated with the degree of prematurity. These results may be due either to immature enzyme systems in the pre-term baby or to an excess of related steroids cross-reacting in the 17 alpha-hydroxyprogesterone assay. We propose the use of two distinct upper limits of normal of 20 nmol/L (term infants) and 200 nmol/L (pre-term infants), for the interpretation of bloodspot 17 alpha-hydroxyprogesterone levels at the end of the first week of life.
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PMID:The interpretation of bloodspot 17 alpha-hydroxyprogesterone levels in term and pre-term neonates. 376 91

To determine the effect of phenobarbital sodium therapy and subependymal intraventricular hemorrhage (SEp-IVH) on the theophylline requirement of premature infants suffering with apnea and seizure activity, we compared three groups of patients as follows: group 1, those with apnea of prematurity (ten patients); group 2, those with apnea and SEp-IVH (ten patients); and group 3, those with apnea, SEp-IVH, and seizure activity for which they were receiving phenobarbital therapy (nine patients). Patients in groups 1 and 2 required lower dosages and blood levels of theophylline to control their apnea than did those in group 3, who required higher dosages and blood levels of methylxanthines. Theophylline dosages and blood levels did not significantly differ between groups 1 and 2. In group 3, the theophylline requirement for control of apnea was significantly increased after initiation of phenobarbital therapy. There seems to be a direct correlation between the increased requirement for theophylline and concomitant phenobarbital administration. The data suggest that phenobarbital increases theophylline requirement when treating neonatal apnea.
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PMID:Phenobarbital increases the theophylline requirement of premature infants being treated for apnea. 378 91

Eighteen open chest dogs anesthetized with pentobarbital sodium were studied to determine the role of early cycle premature ventricular beats in the initiation of ventricular tachycardia and fibrillation during the initial 30 minutes of acute myocardial ischemia. The coupling interval and prematurity index (R-R'/R-R) of every premature beta after a sinus beat were determined during both the "immediate" (2 to 12 minutes) and "delayed" (13 to 30 minutes) phases of ventricular arrhythmias that follow acute coronary ligation. During the immediate phase, characterized by marked fractionation of local electrograms and delayed intramyocardial conduction, early cycle beats were infrequent (8 percent of extrasystoles) and initiated only 3 (4 percent) of 75 episodes of ventricular tachycardia and fibrillation. However, during the delayed phase, characterized by less fractionation and more uniform conduction, early cycle beats were both more frequent (24 percent of extrasystoles, p less than 0.001) and more successful (20 [34 percent] of 59 episodes, p less than 0.001) in initiating ventricular tachycardia and fibrillation. Thus, the underlying electrophysiologic derangements appeared to be of primary importance in determining both the frequency and relative malignancy of early cycle beats during acute myocardial ischemia.
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PMID:Role of early cycle ventricular extrasystoles in initiation of ventricular tachycardia and fibrillation: evaluation of the R on T phenomenon during acute ischemia in a canine model. 617 40

Documentation of the mechanism of sudden death is described in a patient with a prolonged QT interval. Ventricular tachycardia was initiated by a ventricular premature beat (VPB) with a prematurity index similar to previous isolated VPBs. This event occurred despite the fact that the patient was receiving phenytoin sodium, a drug known to shorten the QT interval.
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PMID:Documented sudden cardiac death in prolonged QT syndrome. 642 93

A pilot neonatal mass-screening for congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21-OHD) was performed in the western region of Shizuoka Prefecture, Japan, using a simplified radioimmunoassay method for 'Disc-17-hydroxyprogesterone (17-OHP) determination. The results obtained during a 30-month period indicated that 3 infants out of the 34314 neonates examined were proved to have 21-OHD, and the incidence of homozygotes and heterozygotes were estimated to be 1:11438 and 1:54, respectively. At the time of recall, the concentrations of plasma 17-OHP and 21-deoxycortisol and their urine metabolites as well as plasma sodium levels were quite applicable to diagnosis, while the clinical signs that may be manifest in 21-OHD were of little value in this connection. Prematurity and perinatal complications of neonates tended to give false-positive results, being secondary to the function of the residual foetal adrenal cortex and non-specific stimulatory effects of various stresses. Despite several technical and practical problems to be solved, the present study demonstrated the importance and validity of a neonatal mass-screening program for CAH.
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PMID:A neonatal mass-screening for congenital adrenal hyperplasia in Japan. 651 97


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