ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12597.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Autonomic and behavioral response to fear stimulation (sudden noise 80 dB) was studied in 12 sleeping infants at ages 8–50 weeks. The aim of the present study was to identify a possible passive defense response in infants. The response, which is widespread in birds and mammals, is characterized by apnea and bradycardia with circulatory changes as seen during the forced diving response. Upon stimulation, two respiratory responses were elicited: apnea preceded by irregular respiration or simple irregular respiration. Apnea was elicited in 58% of stimulations at ages 8–16 weeks compared to 14% at 28–50 weeks. The mean duration of apnea decreased from 7.8 s(± 1.8 s) at 8–13 weeks to 4.7s (± 1.1s) at 17–20 weeks. The preceding irregular respiration increased from 5.3 s (± 4.4 s) to 10.6 s (± 5.4 s) at the same ages. The heart rate response was biphasic and were interpreted as the orienting response. The mean deceleration in relation to apnea was 16% at 8–16 weeks and was reduced to 8% at 28–50 weeks. Infants of smoking mothers were more prone to respond with apnea than infants of nonsmoking mothers (73% versus 38%). REM sleep and long postprandial sleep time increased the probability of apnea response (62% versus 38% and 66% versus 35%). The responses seen may be interpreted as expressions of the passive

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12598.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12599.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

There is insufficient data on the value of absent or retrograde end‐diastolic flow (AREDF) in the fetal umbilical artery, descending aorta and aortic arch to predict perinatal outcome. In this prospective investigation, 65 pregnant women between 24 and 34 weeks' gestation with pregnancy‐induced hypertension were studied by color Doppler echocardiography. Pregnancies leading to birth at or before 34.0 gestational weeks (23 with and 19 without AREDF) were included in the outcome analysis. Fetuses with AREDF were delivered at earlier gestational ages (p =0.006). They had a higher incidence of gastrointestinal complications (p= 0.01), bronchopulmonary dysplasia (p= 0.03), intraventricular hemorrhage (p= 0.03) and vascular hypotension (p= 0.03) than those without AREDF. The presence of AREDF was associated with a mortality rate of 30%, whereas in fetuses without AREDF there was no mortality (p= 0.61). Using logistic regression and taking into consideration various perinatal factors, the presence of AREDF (p= 0.03) and early gestational age (p= 0.0001) were associated with serious neonatal diseases or death. A reverse diastolic flow in the aortic isthmus was registered in five fetuses; three died during the perinatal period and one was severely damaged. According to our results, AREDF, particularly with the appearance of reverse diastolic flow in the isthmus of the aortic arch, is a predictor of poor neonatal outc

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12600.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Asphyxiated (n = 27) and control infants (n = 25) were subjected to spinal taps. Amino acids were measured with liquid chromatography and the degree of hypoxic‐ischemic cncephalopathy was determined in each case. In asphyxiated infants, the concentrations of aspartate and glutamate were 286% and 387% (p0.01 andp0.05) of the control values. respectively. The Cerebrospinal fluid aspartate levels were significantly (p0.05) higher in the group with severe (3.4 μmol/l) compared with the group with mild hypoxic‐ischemic encephalopathy (1.0 μmol/l). Glutamate was also higher in the group with severe (12.3 μmol/l) than in the groups with mild (2.7 μmol/l) or moderate (3.2 μmol/l) hypoxic‐ischemic enccphalopathy (p0.05). High concentrations of excitatory amino acids were present in the CSF of asphyxiated infants which may exert excitotox

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12601.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Ten Swedish and 23 Turkish mothers delivering premature infants with a birth weight of less than 2000 g were investigated concerning their attitudes and feelings towards their newborn babies when the infants were treated either in an air‐heated incubator or on a heated water‐filled mattress (HWM). The first interview took place during the first few days after delivery and the second interview in the case of the Swedish study two wceks later and in the Turkish study one week later. In the first interview, feelings of fear, unreality and insecurity predominated, although significantly more so among the mothers of the incubator group. These feelings had changed strikingly by the time of the second interview among the mothers whose infants were treated on the HWM, but persisted to a large extent among the mothers whose infants rcmained in an incubator. The results of both investigations indicate that the mothers' perceptions of their infants improves when the prematurely born infant is treated on an HWM instead of in an incuba

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12602.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

In a cohort study with historical controls of non‐asphyxiated very low‐birth‐weight infants (birth weight 1500 g and gestational age<33 completed weeks), we evaluated the use of a “minitouch” regime for stabilization after birth and treatment of respiratory distress. This combination of early (prophylactic) treatment with nasal continuous positive airway pressure and minimal handling was introduced as a routine in our Department in 1986. We compared infants born in 1987 and in 1985, when ventilator treatment was used initially in all infants with progressing respiratory distress. The frequency of mechanical ventilation was reduced significantly from 76% in 1985 to 35% in 1987 (p =0.00001). This reduction reflected the smaller number of infants who received ventilator treatment for less than one week, whereas the frequency of long‐term ventilator treatment remained unchanged. Intracranial haemorrhage grade 11‐IV was reduced from 49% in 1985 to 25%) in 1987 (p =0.01). Mortality rate, average duration of hospitalization, numbcr of infants with pneumothorax, patent ductus arteriosus, need for oxygen at 28 days and number of surviving infants with handicap did not differ significantly between the two study periods. Septicaemia was diagnosed in 16%) of the infants in 1987 versus 7% in 1985 (p = 0.045). This difference coincided with an increased use of total parented nutrition (18% in 1987 versus 3%) in 1985,p= 0.007). We conclude that the minitouch regime prevents progression of respiratory distrcss, reduces the need for ventilator treatment and is a safe and convenient alternative to mechanical ventilation in preterm infants with mild respiratory problems. The infants need to be monitored continuously to recognize respiratory insufficiency demanding ventila

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12603.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Depletion neutropenia caused by overwhelming bacterial infection is associated with fatal outcome and is an objective indicator of the severity of sepsis. Studies on controlled evaluation of exchange transfusion in the management of severe neonatal sepsis have not considered neutropenia as an inclusion critcrion, and randomized, controlled trials on evaluation of ncutrophil functions after exchange transfusion are scarce. This prompted us to carry out the present study. Septicemic neonates were enrolled if they had neutropenia and were randomized to undergo exchange transfusion (study group,n= 20) or not (controls,n=10). Granulocyte functions were assessed using the nitro blue tetrazolium (NBT) reduction test and the staphylococcicidal index. Blood was drawn for granulocyte function tests once from controls and donors, and before, immediately after and 6 h after exchange transfusion in the study group. Mortality was 35% in the study group and 70% in controls. Gram‐negative organisms accounted for 80%, in the study group and 90% in controls. Mean total leukocyte count and neutrophil count increased significantly immediately after exchange transfusion and 6 h later. Absolute band count decreased significantly immediately after exchange transfusion and incrcased 6 h later. NBT reduction in septicemic neonates in the study group, as wclras in controls. was significantly decreascd as compared to donor cells. NBT reduction improved significantly immediately after exchange transfusion and 6 h later. The valucs of the perccntage of viable staphylococci recovered from neutrophils also improved significantly immediately after exchange transfusion and 6 h later. We conclude that exchange transfusion with fresh whole blood in severe neonatal septicemia with neutropenia improves survival, increases the neutrophil count and cnhances neutrophil functio

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12604.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The aim of this study was to assess if the chest radiograph appearance at seven days of age could be used to predict chronic lung disease (oxygen dependency at 28 days of age). Sixty preterm infants (median gestational age 28 weeks), who were ventilated and/or had supplementary oxygen at seven days of age and had a chest radiograph performed at that postnatal age, were prospectively recruited. These chest radiographs were scored according to lung volume, presence of opacification, haziness, interstitial changes and cystic elements (maximum scorc 18). Twenty‐eight infants subsequently developed chronic lung disease; their median chest radiograph score was 5.5 (range 2–14) which was significantly higher than that of the non‐chronic lung disease incants (median 3; range 0–6). A chest radiograph score of 4 had a 71%, sensitivity and 88% specificity in predicting chronic lung disease. We conclude that chest radiograph appearance at seven days of age is a sensitive and specific predictor of chronic lung disease and thus could be used to indicate the need for preventive

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12605.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Lipid profile was evaluated prospectively in 23 consecutive children, aged 3.2–14.9 years, admitted to the hospital with a febrile illness (pneumonia, upper respiratory tract infection, diarrhea, pyelonephritis, mononucleosis, appendicitis). The degree of dyslipidemia associated with fever was assessed using each child as his/her own control and by comparison with 93 non‐febrile children who had no evidence of fever during the past six months. Total cholesterol decreased during the symptomatic phase of the disease. The magnitude and duration of its decrease appeared to be related to the degree and duration of fever. Low HDL‐cholesterol and hypertriglyceridemia were observed during the late stage of the febrile disease and were still detected in the convalescent phase. This study suggests that in children, transient and sometimes prolonged lipid changes may occur in association with an infectious febrile disease. This effect is important for defining the appropriate timing for screening for dyslipid

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12606.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY