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

The effect of medium-chain triglycerides (MCT) on the "physiological" steatorrhea of prematurity was studied in 34 infants with birthweights below 2,000 gm. The infants were divided into three groups and fed three formulas identical in nutrient content except for the type of fat, as follows: group 1 (control): corn oil, oleo, and coconut oil (39:41:20); group 2: MCT, corn oil, and coconut oil (40:40:20); group 3: MCT and corn oil (80:20). The infants fed MCT-containing formulas had striking diminution in stool volume and frequency. Their total fat absorption was significantly improved when compared with controls; nitrogen absorption was slightly but significantly improved in the 80% MCT group. The results also suggest that nitrogen sparing may be enhanced in premature infants fed MCT-containing formulas.
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PMID:Medium-chain triglyceride feeding in premature infants: effects on fat and nitrogen absorption. 117 May 44

Fourteen foals less than four days of age were treated with the aminoglycoside, amikacin sulphate, and either penicillin or ampicillin for septicaemia, pneumonia, and/or failure of passive immunoglobulin transfer. Serum amikacin concentrations were determined at three times during an 8 or 12 h dosing interval. A 7.0 mg/kg bodyweight dose of amikacin every 8 h was appropriate. Prematurity did not influence mortality. All seven premature foals survived, whereas four of the seven full term foals died. Uraemia in three foals was caused by urinary bladder rupture; amikacin-induced nephrotoxicity was not recognised by clinical chemistries (elevations in serum creatinine or blood urea nitrogen concentrations) or post-mortem findings.
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PMID:Pharmacokinetics of amikacin in critically ill neonatal foals treated for presumed or confirmed sepsis. 229 86

Hepatic dysfunction is one of the frequent manifestations of multisystemic involvement in preeclampsia. This study was conducted to establish the impact of liver dysfunction on maternal and neonatal outcome in women with pregnancy-induced hypertension (PIH). The prevalence of liver dysfunction as determined by an elevated serum glutamic oxalacetic transaminase (SGOT) concentration was 21% in a population of 355 patients with PIH. Liver dysfunction was associated with the presence of severe hypertension, proteinuria, a lower platelet count, and renal compromise (elevated blood urea nitrogen, creatinine, and uric acid serum concentrations). Abdominal pain was also associated with an SGOT elevation. Liver dysfunction was associated with intrauterine growth retardation and prematurity. Furthermore, the association with these neonatal complications was independent from the severity of the hypertension and the presence of proteinuria. Thus, we conclude that liver dysfunction is a frequent complication of PIH and that it is an independent risk factor for maternal and perinatal complications.
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PMID:Clinical significance of liver dysfunction in pregnancy-induced hypertension. 334 61

Fifty-eight premature infants weighing less than 1,600 g at birth were fed a special formula. The formula contained nutrients in amounts recommended by the Committee ono Nutrition of the American Academy of Pediatrics for very low birth weight (VLBW) infants. The feeding studies were carried out at newborn nurseries in Tampa, Florida (study A, n = 25), Pittsburgh, Pennsylvania (study B, n = 20), and Oaklawn, Illinois (study C, n = 13). Study subjects were comparable in birth weight, gestational age, and in the duration of follow-up in the nurseries. All study subjects grew at rates of weight acquisition equivalent to the comparative fetal counterpart. Routine anthropometric measurements were similar to those of fetal development curves. Mean protein intake ranged from 2.3 to 3.7 g/kg/day and mean caloric intake from 105 to 150 kcal/kg/day. Late metabolic acidosis in association with prematurity was absent in all subjects studied as demonstrated by normal pH values, bicarbonate, and partial pressure of carbon dioxide. Serum sodium and serum chloride levels were normal. Serum calcium ranged from 8.3 to 10.1 mg/dl and serum phosphorus from 6.0 to 7.5 mg/dl. Total serum protein levels ranged from 4.5 to 5.1 g/dl. Blood urea nitrogen diminished progressively from 5.1 to 2 mg/dl in the course of the study. Serum glucose levels in samples taken prior to and 2 h after feeding did not demonstrate any evidence of reactive hypoglycemia.
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PMID:Results of feeding a special formula to very low birth weight infants. 718 45

We have investigated the role of the urinary 3-methylhistidine (3MH) excretion, a measure of protein catabolism, in the evaluation of the metabolic state of premature infants. Two-hundred and twenty-two 24 hr urine collections and 3MH/Cr ratio determinations (expressed as mumoles of 3MH per mg creatinine) were carried out in 36 infants (average gestational age 32.7 +/- 0.7 wk, weight 1640 +/- 120 grams) and the relationship between the 3MH/Cr ratios and the metabolic and clinical state has been investigated. Five or more 3MH/Cr measurements were carried out on each of 19 infants and serial determinations on four of those babies are presented. The urinary 3MH/Cr ratio of healthy infants with adequate caloric intake and normal growth curve was .148 +/- .039 (S.D.) mumol/mg, about 35% higher than the 3MH/Cr ratio in healthy adults. As long as the premature infants were healthy the degree of prematurity had no effect on the 3MH/Cr ratio. The relationship between 3MH/Cr ratio and nitrogen balance was highly significant (p less than .001). 3MH/Cr ratio also correlates very well with the metabolic status of the infants: in the group with normal 3MH/Cr ratios less than or equal to .175 (.148 + 1 S.D., n = 90) there were four clinically stressed infants (4.4% false negative rate) while in the group with elevated 3MH/Cr ratios greater than .225 (.148 + 2 S.D.; n = 79) there were only three clinically well infants (3.8% false positive rate). In comparing the clinical status and 3MH/Cr ratios, we found that in the group of infants who could not be clearly defined as clinically well or stressed (n = 108) the 3MH/Cr ratio was more useful than clinical judgment in the prediction of metabolic status. It can be concluded that 3MH/Cr ratio is a potentially useful clinical tool which describes with high accuracy the clinical and metabolic status of premature infants. This conclusion is further supported by the data of serial 3MH/Cr determinations.
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PMID:Urinary 3-methylhistidine/creatinine ratio as a clinical tool: correlation between 3-methylhistidine excretion and metabolic and clinical states in healthy and stressed premature infants. 727 50

Cholestasis often occurs in infants on total parenteral nutrition (TPN) for long periods. Amino acid formulations developed specifically for infants, namely Aminosyn PF and Trophamine, may protect against cholestasis associated with total parenteral nutrition (CATPN). The development of cholestasis may also be caused by other risk factors such as prematurity, surgery, sepsis, and extracorporeal membrane oxygenation (ECMO). To evaluate the relative effectiveness of the pediatric amino acid formulations in reducing CATPN, the courses of 70 infants < 1 year of age who received TPN for at least 14 days were reviewed. Cholestasis was defined as a conjugated serum bilirubin > or = 2 mg/dl subsequent to the initiation of TPN; CATPN was considered present when other factors related to cholestasis were ruled out. Liver function tests were recorded 24 h before starting TPN and at day 7, 15, and 21 during TPN infusion. Thirty infants (42.8%) developed cholestasis. CATPN was judged to have occurred in 15 (21.4%) of 70 infants, while 15 (21.4%) developed cholestasis secondary to other factors. Of the 15 CATPN patients, 7 had received Trophamine, 6 had received Aminosyn PF, and 2 had received both solutions. Aminosyn PF and Trophamine, along with other potential risk factors for CATPN such as antecedent surgery, sepsis, ECMO, prematurity, and nitrogen/calorie intake were analyzed by regression-analysis methods. None was statistically significant except the length of TPN (p = 0.0063). In conclusion, we cannot support the view that Trophamine is more effective than Aminosyn PF in the prevention of CATPN.
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PMID:Aminosyn PF or trophamine: which provides more protection from cholestasis associated with total parenteral nutrition? 858 87

The aim of this study was to assess the possible role of gas mixing inefficiency in spontaneously breathing infants with mild chronic lung disease (CLD) of prematurity in relation to changes in other functional parameters. A simple bedside technique for recording and analysis of multiple breath nitrogen washout curves was applied together with occlusion mechanics. Fifteen preterm infants with mild or moderately severe CLD were studied at a mean postconceptional age of 35 wk, together with 15 healthy preterm infants at the same maturity. All infants breathed spontaneously, and the test was performed by a continuous bypass flow system, connected to a face mask, a pneumotachograph, and a nitrogen meter. The results showed impaired gas mixing with moment ratios above the 95th percentile of the normal group in 11/15 infants with CLD. Functional residual capacity (FRC) was low in 13/15 infants, but specific compliance and resistance of the respiratory system did not differ between the groups. As FRC and moment ratios were not correlated, it is suggested that they may reflect different aspects of the pathophysiology in CLD. It is concluded that low FRC and disturbed gas mixing are characteristic disturbances in CLD at different degrees of severity. The multiple breath nitrogen washout test, followed by moment analysis of end-tidal nitrogen concentrations, is a simple and sensitive method for detection of these disturbances and for monitoring purposes.
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PMID:Impaired gas mixing and low lung volume in preterm infants with mild chronic lung disease. 954 11

The objective of this investigation was to measure the bronchodilator effect of aerosolized albuterol on infants with respiratory syncytial virus (RSV)-induced respiratory failure. Infants who required intubation and mechanical ventilator support for RSV disease were eligible for this prospective, nonrandomized study. Pulmonary function tests, including respiratory mechanics by least mean square analysis, small airway function by rapid thoraco-abdominal compression, and functional residual capacity by nitrogen washout were performed before and 20 min after inhalation of 20-40 breaths of undiluted (0.5%) albuterol solution via a small-volume nebulizer. Analysis of maximum expiratory flow at functional residual capacity (V'maxFRC) before and after albuterol administration was performed using a t-test for paired comparisons. A two-tailed P-value of less than 0.05 was considered statistically significant. Twenty-five infants (mean +/-SD postconceptional age = 45 +/- 5 weeks) were enrolled. Thirteen of the 25 infants had a prior history of prematurity and/or cardiorespiratory disease. After aerosolized albuterol, mean V'maxFRC increased significantly from 48 +/- 46 ml/sec to 65 +/- 59 ml/sec (P = 0.03); however, only three patients had an increase into the normal range. Three patients had a substantial (40-50%) decrease in V'maxFRC. These findings suggest that during the acute phase of severe RSV respiratory infection some of this group of very young infants had airway reactivity that improved in response to inhaled albuterol.
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PMID:Aerosolized albuterol improves airway reactivity in infants with acute respiratory failure from respiratory syncytial virus. 971 Feb 73

Inhaled nitric oxide is a targeted pulmonary vasodilator that improves clinical outcomes for newborn patients with persistent pulmonary hypertension of the newborn, and may be effective in treating some premature patients with acute respiratory distress syndrome or lung disease of prematurity. Nitric oxide is now recognized as playing an important role in the regulation of diverse physiological processes. However, the pharmacological properties of inhaled nitric oxide are not easy to separate from its toxicological effects. For example, the intended effect of inhaled nitric oxide, vasodilation in the lung, is mediated, in part, by increased cellular cyclic GMP (cGMP). However, increased cGMP can also interfere with normal cellular proliferation. Nitric oxide has also been shown to cause DNA strand breaks and/or base alterations that are potentially mutagenic. Inhaled nitric oxide can rapidly react with oxygen in the lung to form nitrogen dioxide, which is a potent pulmonary irritant. Nitric oxide also reacts with superoxide anion to form peroxynitrite, a cytotoxic oxidant that can interfere with surfactant functioning. The overall effect of inhaled nitric oxide in potentiating or attenuating inflammation and oxidative damage in diseased lung is dependent on the dose administered. Furthermore, despite rapid inactivation by circulating hemoglobin, inhaled nitric oxide exerts effects outside the lung, including blocking platelet aggregation, causing methemoglobinemia, and possibly inducing extrapulmonary vasodilation. The toxicology of inhaled nitric oxide is not completely understood and must be considered in the design of protocols for its safe and effective clinical use.
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PMID:The toxicology of inhaled nitric oxide. 1113 40

Various factors can influence the metabolism of surgical neonates. These include prematurity, operative stress, critical illness, and sepsis. The nutritional management of surgical infants with congenital or acquired intestinal abnormalities has improved after the introduction of parenteral nutrition. This article is focused on the energy and protein metabolism of surgical neonates with particular reference to the metabolic response to operative trauma and sepsis. The metabolic utilization of intravenous nutrients also is discussed. The metabolic response to operative trauma is different between neonates and adults. Infants have high rates of protein turnover and are avid retainers of nitrogen. Energy expenditure increases only transiently (4 to 6 hours) after major surgery in neonates. Protein turnover and catabolism seems not to be affected by major operative procedures in neonates. In neonates on parenteral nutrition, carbohydrate and fat have an equivalent effect on protein metabolism. The main determinants of fat utilization are carbohydrate intake and resting energy expenditure. Parenteral nutrition in surgical neonates is associated with increased production of oxygen-free radicals. This seems to be related to intravenous fat administration. Promoting fat utilization by reducing the carbohydrate to fat ratio in the intravenous diet reduces free radical activity to a similar extent as fat exclusion. Glutamine appears to be safe for use in neonates and infants and is "conditionally essential" in very-low birth weight infants and in septic neonates. Enteral glutamine supplementation in very-low birth weight infants reduces the risk of sepsis. The metabolism of surgical neonates is affected by operative trauma, critical illness, and sepsis. Nutritional support in surgical neonates has a profound impact on outcome. Exogenous glutamine can modulate immune, metabolic, and inflammatory responses. Further investigations are needed to clarify the clinical benefit of parenteral or enteral glutamine administration in surgical neonates.
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PMID:Metabolism and nutritional support in the surgical neonate. 1203 42


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