ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1991.tb11914.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACT.We studied the relationship between serum calcium and urinary calcium excretion in association with the parathyroid function in 28 neonates at birth and at five days of age. At birth, the urine calcium was low in spite of high cord serum calcium and a low parathyroid hormone level. On the fifth day of birth, urinary calcium excretion increased despite the reduction in serum calcium and an increase in the parathyroid hormone. These results suggest that the large increase in renal blood flow and the consequent increase in calcium load on the immature renal tubule occurring after birth may be the main cause for the change in this serum calcium‐urinary calcium relationship. This finding can in part explain the temporary hypocalcemia during this perio

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1991.tb11915.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACT.The case records of all neonates admitted to the neonatal unit at Aga Khan University Hospital (Karachi) in a 30 month period (Nov. 86April 89) were analysed. Of 60 neonates with confirmed sepsis, 33 (55%) had non‐nosocomial infection (NNC) whereas 27 (45 %) had nosocomial sepsis (NC). The most common organisms causing early‐onset NNC sepsis were Klebsiella species (53%) andEscherichia coli(10%), whereas the organisms causing late‐onset NNC sepsis includedSalmonella parathypi(21%), Group A Streptococcus (21%),Escherichia coli(14%) and Pseudomonas species (14%). Klebsiella was the most common organism causing NC sepsis, others beingStaphylococcus aureus(15%) and Serratia species (15%). The mortality in NC sepsis, early‐onset and late onset NNC sepsis was 44%, 26% and 43%, respectively. Risk factors associated with NNC sepsis included low birthweight, prematurity and prolonged and complicated deliveries. There was a high incidence of drug resistance to ampicillin and gentamicin among gram‐negative organisms causing sepsis (m

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1991.tb11916.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACT.Rectal cultures from Swedish and Pakistani hospital‐delivered newborn infants were analysed regarding the early aquisition of enterobacteria. Swedish infants were delivered vaginally, Pakistani infants were delivered either vaginally or by caesarean section. The Swedish infants were all breast‐fed, whereas breastfeeding was incomplete and often started late among the Pakistani infants. Both groups of Pakistani infants were more rapidly colonized with enterobacteria than were the Swedish infants. Cultures from Swedish infants seldom yielded more than one kind of enterobacteria;E. coliandKlebsieflawere most frequently isolated.E. colidominated in both Pakistani groups, but especially caesarean section delivered infants were in addition often colonized withProteus, Klebsiella, EnterobacterorCitrobacterspecies. Breastfeeding from the first day of life reduced colonization withKlebsiella/Enterobacter/Citrobucter.The results suggest that environmental exposure, delivery mode and early feeding habits all influence the early intestinal colonization with enterobacte

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1991.tb11917.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACT.The effect of therapeutic doses of indomethacin versus placebo (saline) on cerebral hemodynamics was studied in nine mechanically ventilated preterm infants. Recordings were made at rest and during endotracheal suctioning. Indomethacin at a dose of 0.2 mg/kg body weight was infused over 5 min. Compared to placebo, there was a significant decrease in Doppler mean frequency in the anterior cerebral artery within minutes of starting the indomethacin infusion during the resting period after the first (p<0.01), second (p<0.001) and third (p<0.025) doses. This effect has persisted during endotracheal suctioning. Thus, indomethacin alters cerebral hemodynamics by decreasing Doppler mean frequency. In view of these findings, and particularly because of the alteration in the resting cerebral hemodynamics, the recommendation of prophylactic treatment with indomethacin remains questionable.

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1991.tb11918.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACT.Between 1974 and 1989, 15 neonates were found, at autopsy, to have subcapsular hematoma of the liver in a retrospective clinicopathologic study of 644 neonates. The majority (75 %) of the neonates were<28 weeks gestation, male gender, and were delivered by the vaginal route following a complicated pregnancy and labor including malpresentation. The clinical course included resuscitation at birth, ventilatory support and hypovolemic shock with death occurring within 24 hours in 11 neonates. Other clinical events included air leak (n=4 infants) and infection (n=4). Intracranial hemorrhage was suspected in all but was found at autopsy in 8 neonates. The subcapsular hematoma was intact in 7 and ruptured in 8 neonates. Hence, subcapsular hemorrhage of the liver should be considered in the differential diagnosis of hypovolemic shock in very low birthweight infants.

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1991.tb11919.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACT.Relative circulating volume (CV) was determined in 31 polycythaemic newborn infants who underwent a partial plasma exchange transfusion (PPET). The infants were divided in four subgroups: appropriate for gestational age (AGA) term and preterm infants, and small for gestational age (SGA) term and preterm infants. CV was calculated using a regression line between the number of exchange steps and central venous haematocrit values obtained before the procedure and after every exchange step. The median relative CV in all polycythaemic newborn infants was 94.0 (range 69‐143) ml/kg. Irrespective of gestational age and birthweight the median relative CV in AGA infants was 86.5 (range 69‐107) ml/kg, which differed significantly from the value of 106 (range 85‐143) ml/kg found in SGA infants. If a PPET is indicated we recommend to calculate the exchange volume in AGA infants using a relative CV of 86 ml/kg and in SGA infants using a relative CV of 106

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1991.tb11920.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACT.We studied urine excretion of free and conjugated aldosterone by 12 control infants and 14 infants with hyaline membrane disease (HMD) on the first and seventh days after birth. Both groups had a mean gestational age of 29 weeks. Total urine aldosterone excretion (UAE) and percent excreted as conjugate were similar for both groups on both study days, and did not relate to the severity of respiratory failure in infants with HMD. Sodium intake was higher for infants with HMD on both study days (p<0.02), but their urine sodium excretion was only significantly (p3 nmol/kg/d, there was no significant difference between estimated sodium‐potassium exchange by control (22 ± 5 %,n=8) and HMD (31 ± 5 %,n=10) groups. These data suggest that neither the magnitude of excretion of aldosterone in the urine, the ability to conjugate aldosterone nor the degree of relative distal tubular unresponsiveness to aldosterone are related to the severity of pulmonary immaturity in preterm infa

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1991.tb11921.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACT.In order to clarify the pathogenesis of rickets in preoperative patients with extrahepatic biliary atresia, we evaluated baseline serum 25‐OHD and 1,25(OH)2D levels and correlated serum 25‐OHD levels with increase in age and season of birth in 16 preoperative patients. Further, parenteral vitamin D2tolerance tests were performed in 5 cases. Serum 25‐OHD and 1,25(OH)2D levels were significantly lower than those in 15 normal controls. There was a negative correlation between the serum 25‐OHD levels and increase in age. The patients born during the winter had lower serum 25‐OHD concentrations than those born in summer. The mean value of increased 25‐OHD levels after the parenteral vitamin D2tolerance tests did not differ from that of 6 controls. Since there was no impairment of vitamin D 25‐hydroxylation, the reduction in serum 25‐OHD may therefore be mainly due to disturbed intestinal vitamin D absorption. It was also concluded that season of birth and increase in age are pathogenic factors in the etiology of rickets in preoperative patients with extrahepatic

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1991.tb11922.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACT.Twenty consecutive patients between 9 and 18 years of age with inflammatory bowel disease (IBD) [ulcerative colitis (UC) or Crohn's disease (CD)] were assessed for the presence of psychiatric disorder. The prevalence of psychiatric disorder using the DSM‐111‐R criteria (Diagnostic and Statistical Manual 3rd ed., revised), was 60% in the IBD group compared to 15% in a matched control group (p=0.009). The psychiatric disturbances were mainly depressive or anxiety disorders. The IBD children also scored significantly higher (p=0.0028) on the Child Behaviour Checklist (CBCL) which was completed by the mothers. This indicates more behavioural problems in the IBD group than in the control group. The present study suggests that children and adolescents with IBD comprise a population at high risk for developing a psychiatric disorder that may not be overt but nevertheless plays an important interactive role in the course of the dise

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1991.tb11923.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY