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Biomedical subjects

A J Rudolph

Publications and source records attributed to A J Rudolph.

At least 37 records · Page 2Linked to original sources
PubMed1982

A prospective study of free bilirubin and other risk factors in the development of kernicterus in premature infants.

To assess the value of free bilirubin (FB) measurements in predicting kernicterus (KI) in sick premature infants, 91 newborns weighing less than 1,500 gm at birth were observed during the first week of like with twice daily FB and total bilirubin determinations. Autopsies were performed on 30 of the 53 infants who died. Seven had KI and 23 did not. There were no differences between infants with and with out KI in the maximum FB level (KI 18.2 +/- 4.5 [SEM] nm/liter, no KI 11.1 +/- 0.9 nm/liter, P not significant) or the total bilirubin level (KI 7.3 +/- 1.3 mg/100 ml, no KI 6.1 +/- 0.5 mg/100 ml, P not significant). In fact, three kernicteric infants had very low maximum FB levels (less than 10 nm/liter). These three infants had prolonged episodes of acidosis, hypoxemia, or hypothermia during the 24 hours preceding their maximum level of FB. Although elevated levels of FB may be predictive of KI in some infants, other factors may make the blood-brain barrier more permeable to low levels of FB. This may limit the clinical applicability of FB measurements.

Bilirubin↗
PubMed1981

Retrolental fibroplasia: efficacy of vitamin E in a double-blind clinical study of preterm infants.

We performed a double-blind study in 101 preterm infants who weighed less than or equal to 1500 g at birth, who had respiratory distress, and who survived for at least four weeks, to evaluate the efficacy of oral vitamin E in preventing the development of retrolental fibroplasia. Weekly indirect ophthalmologic examinations begun when the infants were three weeks old revealed a significant decrease in the incidence of retrolental fibroplasia greater than or equal to Grade III (P less than 0.03) and greater than or equal to Grade II (P less than 0.05) (McCormick classification) in the 50 infants given 100 mg of vitamin E per kilogram of body weight per day as compared with 51 given 5 mg per kilogram per day (controls). When multivariate analysis was applied to the controls, five risk factors were identified: gestational age, level and duration of administration oxygen, intraventricular hemorrhage, sepsis, and birth weight. When multivariate analysis was applied to both control and treatment groups, the severity of retrolental fibroplasia was found to be significantly reduced in infants given 100 mg of vitamin E (P = 0.012).

Administration, Oral↗
PubMed1981

An association between retinopathy of prematurity and intraventricular hemorrhage in very low birth weight infants.

An association between cicatricial retinopathy of prematurity and intraventricular hemorrhage in very low birth weight infants was investigated retrospectively. Newborns were studied who weighed less than or equal to 1500 g at birth, who were less than or equal to 32 weeks gestational age and appropriate by weight, and admitted in the first 24 hours of life to our Neonatal Intensive Care Unit. Diagnosis of retinopathy of prematurity was made by retinal examination at approximately 4 weeks of age. Diagnosis of intraventricular hemorrhage was made by computerized tomography and clinical findings. A total of 138 infants were studied and divided into two groups: (A) birth weight less than or equal to 1000 g (31); (B) birth weight 1001--1500 g (107). There was a statistically significant association between cicatricial retinopathy of prematurity and intraventricular hemorrhage in both groups. There were no statistical differences between birth weight, gestational age, duration of oxygen therapy, highest oxygen concentration received, Apgar scores, incidence of hyaline membrane disease and patent ductus arteriosus between cicatricial retinopathy of prematurity and no retinopathy of prematurity patients in either group. This association may be an important consideration in the pathogenesis of both vascular diseases.

Cerebral Hemorrhage↗
PubMed1980

Use of indomethacin and its relationship to retinopathy of prematurity in very low birthweight infants.

The relationship between the use of indomethacin, a prostaglandin inhibitor, for closure of patent ductus arteriosus (PDA) and the occurrence of retinopathy of prematurity was investigated retrospectively. 63 preterm infants less than or equal to 1500 g who were less than or equal to 32 weeks' gestational age, appropriate weight for gestational age, with a diagnosis of PDA, and admitted during the first 24 hours of life were studied. Diagnosis of retinopathy was made by retinal examination when each infant was about 4 weeks. Diagnosis of PDA was made by clinical, radiological, and echocardiographic findings. 15 patients were treated with indomethacin because of severe congestive heart failure. There were no differences between gestational ages, birthweights, duration of oxygen therapy, or incidence of retinopathy in treated and untreated patients. We suggest that the use of indomethacin for PDA closure does not increase the incidence of retinopathy in very low birthweight infants.

Ductus Arteriosus, Patent↗
PubMed1980

Hyaline membrane disease and intraventricular haemorrhage in small for gestational age infants.

19 small for gestational age (SGA) infants with gestational ages less than or equal to 32 weeks were matched with 19 appropriate for gestational age (AGA) preterm neonates with similar risk factors for intraventricular haemorrhage and hyaline membrane disease. Gestational age, 1- and 5-minute Apgar scores, type of delivery, survival rate, use of corticosteroids before delivery, sex, twinning, presence of premature rupture of membranes, and birth date were comparable in the two groups. Gestational age of both groups was 30 (+/- 1.8) weeks, and birthweights were 919 (+/- 202) g (SGA group) and 1268 (+/- 212) g (AGA group). The incidences of hyaline membrane disease and intraventricular haemorrhage were different: 74 and 42% respectively for AGA neonates, 5 and 11% respectively for SGA infants. We suggest that a stressful environment in utero may enhance maturation and prevent hyaline membrane disease and intraventricular haemorrhage.

Cerebral Hemorrhage↗
PubMed1980

Bacterial colonization of radial artery catheters.

In 147 radial artery catheterizations performed, blanching or embolization was noted in 10.8% of the patients. Only a single episode of catheter-related septicemia was observed (0.6%) Mean duration of catheterization was 48 +/- 6 hours. Of 110 catheters cultured 25.4% grew bacteria; most organisms cultured were nonpathogenic. Duration of catheterization and intravascular infusion did not alter the incidence of catheter colonization.

Arteries↗
PubMed1980

Hypochloremic metabolic alkalosis following tolazoline-induced gastric hypersecretion.

Gastric hypersecretion following administration of tolazoline resulted in severe hypochloremic alkalosis in an infant with persistent fetal circulation. An initial bolus injection of 2 mg/kg was followed by an infusion of 5 mg/kg/hr for 24 hours. The infusion was then maintained at 2 mg/kg/hr for the next four days. Volume of gastric secretions exceeded 25 ml/kg/24 hr. Weaning from tolazoline and replacement of chloride and potassium corrected the metabolic alkalosis.

Alkalosis↗
PubMed1980

Candida endophthalmitis: a manifestation of candidiasis in the neonate.

Candida endophthalmitis is a frequent complication of systemic candidiasis. The case reported emphasizes the usefulness of indirect ophthalmoscopy in evaluating infants suspected of having disseminated candidal infection and describes the pathologic findings of Candida endophthalmitis in the neonate.

Candidiasis↗
PubMed1979

Modern management of tetanus neonatorum.

Five infants with neonatal tetanus were managed with neuromuscular blockade and positive pressure ventilation. All survived. Tetanus was frequently confused with neonatal seizures at time of presentation. All infants were delivered at home. Mean age of onset of symptoms of poor suck, hypertonicity, and generalized spasms was 5.4 days with hospital admission at 6.4 days. Mean duration of mechanical ventilation was 34 days. Although hospital management of tetanus neonatorum may be expected to have a satisfactory outcome, it represents a costly and complex approach to a preventable disease.

Female↗
PubMed1978

Effect of aminophyllin and dexamethasone on secretion of pulmonary surfactant in fetal rabbits.

Aminophyllin, dexamethasone, or saline was injected into 27.5-day fetal rabbits 2.5 hr before sacrifice, after which static pressure-volume curves with air were performed. In further similar experiments the lungs were lavaged with physiologic saline which was analysed for total phospholipid content. There were no changes in total lung capacity (TLC) induced with either aminophyllin or dexamethasone. The lungs of fetal rabbits injected with saline retained 44% TLC (+/-3 SE) after deflation to 10 cm H2O trans-pulmonary pressure compared with 48% TLC (+/-3 SE) in those injected with dexamethasone, a difference which was not statistically significant. In contrast, the lungs of fetal rabbits injected with aminophyllin retained 53% TLC (+/-2 SE) after deflation to 10 cm H2O pressure, a significant increase when compared with saline controls (P less than 0.01). There were no changes in lung weight or lung water. These results were interpreted to mean that aminophyllin decreased surface tension and augmented secretion of pulmonary surfactant. This was supported by finding significantly increased total phospholipid recovered in the lung lavage fluid of fetal rabbits injected with aminophyllin, 62 microgram/g dry lung weight (+/-6 SE) compared with 32 microgram/g dry lung weight (+/-3 SE) in saline controls (P less than 0.05). Phospholipid recovered from dexamethasone-injected fetal rabbits was not significantly increased, 38 microgram/g dry lung weight (+/-4 SE).

Aminophylline↗
PubMed1978

Hypercarbia at birth: a possible role in the pathogenesis of intraventricular hemorrhage.

To test the hypothesis that birth asphyxia has a role in the etiology of intraventricular hemorrhage (IVH), blood was collected from the umbilical artery (UA) at birth in 28 premature infants of 26 to 29 weeks gestation and analyzed for hydrogen ion concentration [H+], PCO2, standard bicarbonate level, and lactic acid level. The infants were followed up throughout their nursery stay until a diagnosis of IVH could be made or excluded, either by autopsy or clinical findings. Infants with IVH had lower Apgar scores. There were no differences in UA [H+] or bicarbonate or lactic acid levels. However, infants with IVH had a significantly higher UA PCO2. Although the difference appeared relatively small, the increase in PCO2 during labor may have been relatively large. It is concluded that hypercarbia, possibly by increasing cerebral blood flow, may be one important factor in the genesis of IVH.

Acid-Base Equilibrium↗