摘要:

ABSTRACT.During the last decade it has become increasingly clear that severe hypoglycemia may be caused by specific enzymatic defects of amino acid and fatty acid metabolism. Several reports have presented hypoglycemic syndromes with reduced fatty acid transport or oxidation, decreased ketogenesis, or abnormalities of the Krebs cycle and electron transport chain. It is of particular interest that several enzymatic defects here discussed may present as Reye's syndrome. An intriguing fact is a highly variable clinical presentation, even in the presence of well‐defined enzyme deficiencies. Some patients are desperately ill in the newborn period, whereas in other cases there are symptoms only during catabolic phases later in childhood. The presence of hypoglycemia may be related to low levels of acetyl Co A, with consequently reduced gluconeogenesis; alternatively the glucose‐sparing effect of ketones is lost in states of reduced ketone body production. Treatment with pharmacological doses of vitamins may be attempted, depending upon the established or suspected diagnoses. With manifest hypoglycemia i.v. glucose infusion is the treatment of choice. By such means convulsions, and brain damage may be preven

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1989.tb11052.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT.Accurate quantitation of the protein content of human milk (HM) is clinically important for both determining protein and energy intakes of HM‐fed infants. Protein can be determined by Kjeldahl analysis or colorimetric assays. Colorimetric assays are rapid and convenient, but usually overestimate the protein content when compared to Kjeldahl protein (KP). In this study a protein standard based on human milk protein (HMPS) was isolated by size exclusion column chromatography. Purity and composition of the standard was determined by gel electrophoresis, Kjeldahl and amino acid analyses. The protein content of 20 mature milk samples was determined by the Lowry, BCA and BioRad colorimetric assays, using bovine serum albumin, human serum albumin/IgG, and HMPS as standards. These results were compared with KP results using Student's f‐test. All colorimetric assays overestimated milk protein content; however, the Lowry assay gave the lowest protein levels, with our protein standard yielding values closest to the KP va

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1989.tb11053.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT.In a regional population of 32120 liveborn newborn infants 65 (0.2%) had a birthweight ≤900 g (extremely small low birthweight = ESLBW) with mean gestational age 26.4 (range 22–31) completed weeks of gestation. The total 0–1 year survival rate was 48%. For the 42 infants treated in the Level III regional neonatal intensive care unit (NICU) the 0–1 year survival rate was 55% versus 34% for 23 infants not transferred to the Level III unit. In the ESLBW infants treated in the regional NICU the major complications were respiratory disorders requiring artificial ventilation (73%), bronchopulmonary dysplasia (26%), intracranial haemorrhages (40%), symptomatic persistent ductus arteriosus (36%) and sepsis (14%), persistent retinopathy of prematurity (8%). Duration of NICU treatment was 51 days (range 10–95) for survivors. Mode of delivery and rate of perinatal complications did not differ between survivors and non‐survivors. Previous legal abortion occurred in 24%, fertility problems in 29% and 21% of the mothers, were immigrants. Otherwise no significant abnormalities were found in maternal or socioeconomic conditions. Factors deciding neonatal outcome in the tiniest babies seem to be a combination of prenatal circumstances and neonatal minute fine care

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1989.tb11054.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT.Fourteen very low birthweight infants were studied positioned either prone horizontal or skin‐to‐skin at 60 degree tilt between the mother's breasts. Heart rate, skin temperature and oxygenation by transcutaneous Po2and pulse oximetry were measured. Nine of the infants had normal lungs when studied. These infants showed no change in tcPo2, or oxygen saturation but heart rate increased significantly by a mean of 6.5 beats per min during skin‐to‐skin contact. Five infants with chronic lung disease, including two on nasal catheter oxygen, showed a significant 1.0 kPa rise in tcPo2during skin‐to‐skin contact. Back skin temperature was well maintained during skin‐to‐skin contact with the room temperature at 26 to 29°C. None of the infants had a significant apnoea or bradycardia during the study. Stable very low birthweight infants can enjoy such close contact with their mothers and the tilted position may improve pulmonary functi

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1989.tb11055.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT.A new method has been evaluated for measuring ventilation and lung mechanics in spontaneously breathing infants by means of a face chamber. Airway flow is measured with a pneumotachograph inserted between the face chamber and a stable pressure source. Oesophageal pressure is measured via a water‐filled oesophageal catheter. The method is suitable for use in conjunction with continuous positive airway pressure (CPAP) treatment in neonatal intensive care. A flat frequency response curve up to 15 Hz for the two measuring systems (i.e., airway flow and oesophageal pressure), and a time shift between the two respective signals of less than 2 msec are prerequisites for correct evaluation of respiratory mechanics. In preterm infants with chest distortion, the inhomogeneity of pleural pressure affects the significance of resistance and compliance values, as calculated from oesophageal pressure. Supra‐diaphragmatic pressure variations reflect the resistive and elastic load on the diaphragm exerted by the lungs and thorax. Thus, oesophageal pressure is still useful in studies of respiratory mechanics in preterm infa

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1989.tb11056.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT.Caffeine, used for treatment of idiopathic apnea in preterm infants, may have a vasoconstrictive effect on cerebral vessels. The ensuing reduction in cerebral blood flow may play a role in the pathogenesis of ischemic brain damage. In 25 preterm infants possible changes in cerebral blood flow due to caffeine administration were assessed using Doppler ultrasound. During caffeine treatment PaCO2was reduced. However, no changes were found in cerebral blood flow velocity suggesting absence of major changes in cerebrovascular resistance and actual cerebral blood flow following caffeine medication.

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1989.tb11057.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT.We describe the evolution of a simplified method for the interpretation of serial EEG in preterm enonates which was tested in a first sample and revised and unproved in a second sample of preterm neonates. There were 185 EEGs in the first sample and 206 EEGs in the second sample. The interpretation of the EEGs was related to mental, motor and neurological outcome in late infancy. Serial EEG is an excellent indicator of brain function in the preterm neonate.

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1989.tb11058.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT.Umbilical cord serum bilirubin concentration as a predictor of subsequent jaundice was studied in 291 newborns. It was possible to define subgroups of infants with significantly higher or lower risks of developing jaundice. If cord bilirubin was below 20 |imol/l, 2.9% became jaundiced as opposed to 85% if cord bilirubin was above 40 μmol/l. Furthermore, 57% of jaundiced infants with cord bilirubin above 40 nmol/1 required phototherapy, but only 9% if cord bilirubin was 40 μmol/1 or lower (p<0.003). Knowledge of infants at risk of developing jaundice allows simple bilirubin reducing methods to be implemented before jaundice is present and could influence a decision regarding early discharge from hospital. Since the ability of plasma to bind bilirubin in cord blood from jaundiced and non‐jaundiced infants showed no significant differences, the increased cord bilirubin among infants who later became jaundiced is presumably caused by increased fetal bilirubin production or decreased removal of bilirubin from the fetal circulat

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1989.tb11059.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT.Forty‐five cases of neonatal subcutaneous gangrene were admitted between Nov. 1985 and Feb. 1987, with a mortality of 6.6%. This paper presents the first epidemiologic study of 20 cases of this disease caused by multi‐resistantStaphylococcus aureus.Eight of 20 cases were caused by an epidemic strain belonging to phage 29 (group I) and carrying 2.8, 3.3, 4.2 and 28.5–34.0 kb plasmid DNA. The restriction endonudease analysis confirmed that the plas‐mid DNA of approximately similar size in different isolates were identical or highly homologous. According to the results of an epidemiologic study the source of infection of one patient who died was her grandmother and the other one was her mother, so the family members can also be the source of neonatal infection caused by multi‐resistant

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1989.tb11060.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT.Lack of positive diagnostic criteria and increasing professional concern, probably causing increasing ascertainment, have rendered reported increases in SIDS‐rates controversial. However, these problems related to cause specific mortality do not apply to the total mortality. Due to the exceptional age‐at‐death distribution of SIDS cases, the SIDS fraction of all deaths increases during the first year of life to reach a maximum, in the present study of 56%, from the 105th through the 125th day of life. During these days, the total mortality rate in Norway increased from 0.24 per 1000 in 1971–72 to 0.46 in 1983–84. Thus, the observed trend, with an increase in the SIDS rate from 1.02 per 1000 in 1971–72 to 2.34 in 1983–84, is considered true. Observed in a country where perinatal and neonatal mortality have decreased for a long period of time and still remain very low in a global perspective, the increasing SIDS rate is a matter of

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1989.tb11061.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY