ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Perinatal asphyxia at term remains a significant cause of infant death and neurodevelopmental impairment, probably causing 20% of all cases of cerebral palsy. This review examines indicators that can help determine the prognosis after suspected asphyxia in term infants, including obstetric information, clinical examination, and diagnostic methods based on neurophysiology, neuroimaging, and biochemistry. New data confirm that many frequently used indicators are generally not specific predictors, while simple electroencephalographic methods, magnetic resonance spectroscopy, and magnetic resonance imaging can have high positive predictive values even when used quite soon after birth.

ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Neonatal infections range from early-onset vertically acquired infections to nosocomial bacterial sepsis, and they account for significant morbidity and mortality globally. The recent emergence of perinatally acquired HIV-1 infection has also placed an enormous burden on existing meager health resources in developing countries. The risk of early-onset group B streptococci sepsis may be related to heavy genital tract colonization at term. Perinatally acquired HIV-1 infection also occurs at birth, with higher rates of infection after vaginal delivery. Detection of circulation HIV-1 viral DNA by polymerase chain reaction offers an extremely sensitive screening method in the neonatal period. In contrast, rapid confirmation of bacterial sepsis in the newborn still poses considerable problems. A review of data on antimicrobial prophylaxis of preterm premature rupture of membranes does reveal improved neonatal outcome. However, the rapid and widespread emergence of multidrug resistance among bacterial pathogens dictates the need for judicious use of antibiotics, as well as close attention to preventive strategies.

ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

There are currently a large number of ongoing gene therapy trials in North America and Europe. These trials have almost exclusively involved patients with inherited lethal disorders or malignancies. Although there are significant ethical and safety issues that remain unresolved, it seems inevitable that this technology will soon be adapted for use in lethal, or potentially lethal, fetal and neonatal diseases. If ethical and safety issues can be resolved, a wide spectrum of nonlethal acute and chronic diseases could also benefit from this form of therapy. The purpose of this brief review is to provide an overview of current approaches to gene delivery, their successes, and their limitations. Where possible, the discussion has focused on conditions that are recognized in fetal or neonatal life, to give the reader some sense of the potential scope for this form of therapy.

ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

In this review, the recent literature pertaining to the nephrology of the fetus and neonate is reviewed. Some papers of interest are described, and an overview of active areas of research is given. One of these areas is early development, studies of which are giving new insight into patterns of normal and abnormal kidney morphogenesis. Preterm newborn infants may suffer from electrolyte imbalance and poor growth as a result of tubular dysfunction, and this subject is discussed. Also addressed are some advances in genetics that are elucidating the genetic defects of cystic kidney diseases and providing clues about the pathogenesis of renal dysplasia. Other areas discussed in this review are the assessment of renal function in the fetus and neonate, blood pressure and hypertension in the neonate, renal failure in the term and preterm infant, and the causes and the consequences of fetal urinary obstruction.

ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Safer renal biopsy techniques have led to increased recognition of the various forms of glomerulonephritis in the pediatric population. Our understanding of their natural history and progression has improved, and we now know that there is significant morbidity associated with diseases such as IgA nephropathy and membranoproliferative glomerulonephritis. Knowledge of the pathophysiology of progressive renal disease has also expanded, but specific treatment modalities, especially for children, are lacking and continue to be areas for future clinical research. This article reviews four types of glomerulonephritis that occur in childhood: acute poststreptococcal glomerulonephritis, IgA nephropathy, Alport's syndrome, and membranoproliferative glomerulonephritis. The clinical and pathologic features of each are reviewed, and the current literature covering new developments in their prognosis, genetics, or therapies are summarized.

ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The routine use of ultrasonography has resulted in an explosion in the number of conditions reported to be associated with nephrocalcinosis. It has also been increasingly recognized that urolithiasis and nephrocalcinosis can coexist in the same patient. The two conditions most commonly associated with nephrocalcinosis in childhood are the use of furosemide in infancy and the treatment of patients with hypophosphatemic rickets with phosphate and vitamin D preparations. Although originally thought to be related to hypercalciuria, more recent studies in humans and research animals indicate a multifactorial etiology for furosemide-related nephrocalcinosis. In patients with hypophosphatemic rickets, it seems that the dose of phosphate and in particular the development of secondary hyperparathyroidism play a central role in the development of nephrocalcinosis. Among the entities recently reported to be associated with nephrocalcinosis are some that characteristically include Fanconi's syndrome. These findings dispute the previous teaching of lack of renal calcifications in this syndrome, which involves proximal renal tubular acidosis. The diagnosis of nephrocalcinosis requires a metabolic work-up to identify the offending factor. When identified, appropriate intervention should be instituted.

ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

A variety of medications can adversely affect the kidney. Awareness of these potential nephrotoxic effects is crucial to prevention of serious sequelae. This review discusses renal injury caused by the chemotherapeutic agent ifosfamide, the problem of analgesic nephropathy, and the newly identified complication of trimethoprim-induced hyperkalemia. In addition, recent information about the classic nephrotoxins (cisplatin, amphotericin B, and aminoglycosides) is presented.

ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID