ISSN:1040-8703    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

During the past decade, new evidence has been collected regarding the fetal risks of environmental tobacco smoke. Throughout gestation, the unborn baby is exposed to increasing concentrations of nicotine through maternal blood and gastrointestinal and skin absorption of the nicotine in the amniotic fluid. Recent research shows measurable concentrations of cotinine in the hair of infants born to passively smoking mothers. This exposure has been recently associated with effects on fetal growth.

ISSN:1040-8703    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Factors contributing to brain damage and an adverse outcome are complex. Both severe hypoxia-ischemia and prolonged hypoxia of lesser severity may cause brain damage. Compromised cerebral perfusion leads to ischemia. Fetal brain damage may begin because of a redistribution rather than reduction of cerebral blood flow. Normal newborn cerebral blood flow is low; fetal asphyxia at birth causes delayed cerebral hyperperfusion in the neonate. The threshold of newborn cerebral blood flow that is associated with brain damage has not yet been established. Hypoxia-ischemia will disrupt cerebral metabolism. The fetus can compensate for hypoxia up to a point; however, decompensation will occur when acidosis becomes severe. Normal newborn cerebral oxygen consumption is low compared with that in the adult; however, asphyxia, causing brain damage, is associated with abnormal newborn cerebral metabolism. Supplementary glucose may have a protective effect in the newborn brain. Hypoxia-ischemia will cause brain damage in the human fetus and neonate. There is a threshold of fetal asphyxia at birth when brain damage may occur. Sustained neonatal hypotension and hypoxemia are associated with brain damage and an adverse outcome.

ISSN:1040-8703    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Anemia of prematurity (AOP) results from several interacting processes, including phlebotomy losses, a temporary failure to release erythropoietin in response to anemia, a short life span of erythrocytes, and rapid growth of body mass and, hence, blood volume after the first few weeks of life. Infants with AOP have erythroid progenitors that respond to erythropoietinin vitro, suggesting that treatment with recombinant erythropoietin might reduce the need for transfusions for AOP. Many pilot studies were needed to define the dose of recombinant erythropoietin (500 to 750 U/kg/wk) that stimulated the early onset of erythropoiesis in infants with AOP. Three large controlled trials have demonstrated that recombinant erythropoietin therapy reduces transfusions in AOP and is apparently safe. Unresolved issues include the ideal dose, the optimal nutrition needed during therapy, the target population, and timing of the start of treatment.

ISSN:1040-8703    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Good nutrition is of great importance for all living individuals, especially for the rapidly growing newborn infant. Nutrition is needed not only for the maintenance of physiologic functions but also for growth. Despite extensive research in this field, numerous questions remain regarding the nutrition of the term as well as the preterm infant. It should be stressed that the requirements of term infants are different from those of preterm infants, and a further distinction has to be made between very low birth weight and extremely low birth weight infants. In this review, the following issues are addressed: breastfeeding versus formula feeding, the role of polyunsaturated fatty acids, nutrition of the infant with bronchopulmonary dysplasia, and parenteral nutrition.

ISSN:1040-8703    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1040-8703    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1040-8703    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The majority of postdiarrheal hemolytic uremic syndrome is caused byEscherichia coli0157:H7. The organisms are carried in the intestines of cattle; partially cooked contaminated hamburger is the single most common vector. TheE. coliproduce a potent cytotoxin that gains access to the circulation, is taken up by glycolipid receptors on glomerular endothelial cells, is internalized, and causes cell death. Associated phenomena include the activation of platelets, leukocytes, and the coagulation cascade, as well as the production of cytokines. Although some patients experience a mild or incomplete syndrome, life-threatening multisystem involvement can occur. Treatment is supportive, but plasma exchange may be useful in selected high-risk subsets. Efforts to prevent colitis from evolving into hemolytic uremic syndrome include the oral administration of material to bind the toxin in the gut. Mortality remains at 5% to 10%; about 4% are left with end-stage renal failure, and approximately 50% suffer mild chronic kidney damage.

ISSN:1040-8703    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Urinary tract infection (UTI), vesicoureteral reflux (VUR), and certain voiding disorders result in renal damage. In the past few years, the increasing use of 99m-rC-dimercaptosuccinic acid renal scans, urodynamic testing, and antenatal sonography have helped shed light on the interrelationship of these disorders Renal parenchymal involvement during acute febrile UTI and subsequent renal scarring are quite commonly observed in the absence of VUR, suggesting that the presence of reflux is not a prerequisite for renal damage. In infants with gross VUR, renal damage is often present at birth even before the development of any UTI High intravesical pressures during bladder filling and voiding are commonly observed in infants with gross VUR, reflecting an underlying voiding dysfunction. High voiding detrusor pressures are also commonly observed in infants presenting with symptomatic UTI who do not have VUR. Children with dysfunctional voiding states are at risk for development of VUR and UTI. Renal damage in these children may occur in the absence of one or the other. This review elucidates how voiding dysfunction predisposes children to bacterial colonization of the bladder, the development or perpetuation of VUR, and renal damage.

ISSN:1040-8703    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Growth failure, sometimes of a severe nature, has been recognized for many years as a consequence of chronic renal insufficiency (CRI) in childhood. The factors associated with growth failure, including renal osteodystrophy, anorexia and malnutrition, acidosis, salt wasting, and anemia, have also been recognized for many years. Despite vigorous treatment of these factors, patients with CRI continue to grow poorly. It was hoped that, with modern dialysis and transplantation, these patients would have normal growth or even catch-up growth and therefore overcome the height deficit that accrued during the time they had CRI. Unfortunately, this has not been the case. Although normal growth may be seen after transplantation, catch-up growth is rare. In the past year, studies have been reported demonstrating that supraphysiologic doses of growth hormone will produce catch-up growth in children with CRI. These reports are encouraging and are reviewed here.

ISSN:1040-8703    

出版商:OVID    

年代:1995

数据来源: OVID