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Biomedical subjects

A Sola

Publications and source records attributed to A Sola.

71 records · Page 4Linked to original sources
PubMed1995

Perinatal asphyxia: MR findings in the first 10 days.

PURPOSE: To determine whether one can detect hypoxic-ischemic brain injury by MR in the first 10 days of life and to identify patterns of injury in affected neonates. METHODS: Standard T1- and T2-weighted MR sequences that were performed in the first 10 days of life in 20 patients who suffered hypoxia/ischemia in the intrapartum or neonatal periods were reviewed retrospectively. Images were evaluated for patterns of signal changes. RESULTS: Four patients had normal findings and were clinically healthy. The remaining 16 patients were divided into four groups based on pattern of injury: (a) primarily deep gray matter involvement; (b) primarily cortical involvement; (c) primarily periventricular white matter injury; and (d) mixed injury pattern. Two patients had appearances that suggested prepartum injury. T1 shortening was seen in injured tissue as early as 3 days after injury. T2 shortening did not appear until 6 or 7 days after injury. CONCLUSION: MR can show brain damage in asphyxiated neonates during the first 10 days of life and shows early appearances of several patterns of brain injury.

Apgar Score↗
PubMed1992

Treatment of peripheral tissue ischemia with topical nitroglycerin ointment in neonates.

Four neonates had resolution of peripheral tissue ischemia after the application of 2% nitroglycerin ointment. A dosage of 4 mm nitroglycerin ointment per kilogram of body weight was applied to two patients with ischemia caused by vasospasm from indwelling radial artery catheterization and to two patients with ischemia resulting from dopamine extravasation. No adverse effects were noted except mild episodes of decreased blood pressure in two of the patients.

Administration, Topical↗
PubMed1992

Lack of relationship between the true airway pressure and the pressure displayed with an infant ventilator.

OBJECTIVE: To establish if the pressure indicated in the manometer of an infant ventilator (IV 100B, Sechrist, Anaheim, CA) reflects the true pressure delivered to the proximal airway during mechanical ventilation in the neonatal ICU. DESIGN: With approval of our Institutional Research Board, data were collected prospectively. Peak inspiratory pressure and end-expiratory pressure were measured at the "Y" piece of the breathing tubing. Pressure readings from the conventional ventilator's manometer were compared with simultaneously obtained measurements using an electronic monitor. SETTING: This study was conducted in a 45-bed neonatal ICU, admitting 700 to 750 newborns per year. PATIENTS: Twelve neonates who required mechanical ventilation were included in the study. INTERVENTIONS: Specific interventions were not made by study design. Measurements routinely obtained were compared. MEASUREMENTS AND MAIN RESULTS: Two hundred seventy-five simultaneous measurements of peak inspiratory pressure and positive end-expiratory pressure were compared. Peak inspiratory pressure values were higher with the electronic monitor in 273 (99%) of 275 measurements and the mean of the differences between the electronic monitor and ventilator's manometer was statistically significant (p less than .001). For positive end-expiratory pressure measurements, values indicated by the electronic monitor were lower in 152 (55%) of 275 determinations, equal in 65 (23%), and higher in 58 (21%) determinations. Percent variations between methods ranged from 0% to 140% for peak inspiratory pressures and from 0% to 500% for positive end-expiratory pressure. CONCLUSIONS: These data demonstrate that it is impossible to know the true pressure delivered to the proximal airway of a neonate during mechanical ventilation by observing the ventilator pressure manometer. The manometer readings consistently underestimate the true peak inspiratory pressure values and are very unpredictable regarding positive end-expiratory pressure values. These findings support the use of other methods to monitor the proximal airway pressure besides the ventilator's manometer in the neonatal ICU. Furthermore, mean airway pressure should not be calculated from the pressure readings obtained from the tested ventilator's manometer.

Airway Resistance↗
PubMed1992

Neonatal polycythemia in appropriately grown infants of hypertensive mothers.

Neonatal polycythemia is a frequent finding after pregnancies complicated by diabetes and by maternal hypertension with intrauterine growth retardation (IUGR). It is still unclear if the association of polycythemia with hypertension is the result of IUGR or of hypertension per se. To establish the incidence of neonatal polycythemia in populations at risk, we analyzed the results of hematocrit values obtained from 1592 neonates born consecutively at the Hospital de Clinicas, Buenos Aires. Capillary hematocrit values were obtained by heel stick before 6 h of age. When the values were 65% or greater, new samples were obtained from an antecubital vein. The risk of polycythemia in appropriately grown infants of hypertensive mothers was 12.6-fold greater than the risk in the general population. These data show that maternal hypertension poses a significant risk for polycythemia, regardless of fetal growth. We suggest that, to prevent possible sequela, hematocrit is measured routinely in all infants of hypertensive mothers for prompt diagnosis and treatment.

Chi-Square Distribution↗
PubMed1986

Brain-stem auditory response in Ondine's syndrome.

Brain-stem auditory evoked responses were measured during sleep in four infants with congenital central alveolar hypoventilation syndrome (Ondine's syndrome) and four controls matched for age and sex. Delays in peak latencies p III and interpeak latencies p I-III were consistently seen in these patients but not in the control children. These abnormalities were reproducible and suggested disruption in the normal auditory pathways at the level of the mid to upper brain stem through which fibers pass close to the area of respiratory control. These abnormalities, both electrophysiologic and metabolic, imply a functional disturbance of brain-stem control of ventilation during sleep in infants and children suffering from Ondine's syndrome.

Audiometry, Evoked Response↗
PubMed1986

New agents active against African swine fever virus.

Actinobolin, atropine, carrageenan, megalomycin C, suramin, and tetracenomycin C were tested for their activity against African swine fever virus replication. Both viral inhibitory potency and cytotoxicity were investigated. Megalomycin C, suramin, atropine, and carrageenan exhibited significant activity. Megalomycin C was the most active of the four agents with respect to the concentration of compound that blocked the formation of infectious virus by 50%. Suramin was the next most active agent in this respect, but because of its lower cytotoxicity, it had the most favorable therapeutic index.

African Swine Fever Virus↗
PubMed1981

Colloid osmotic pressure of normal newborns and premature infants.

Colloid osmotic pressure (COP) is an important regulator of fluid movement and can now be measured simply and reliably. The authors used the 4100 Wescor Colloid Osmometer to define COP values and its relation to total protein concentration (TP) in different groups of newborns. The mean COP was 19.4 +/- 2.2 (SD) torr in 99 term infants delivered vaginally and 16.0 +/- 2.1 in 40 term infants delivered by cesarean section (p less than 0.005). The COP was lower in those born operatively without preceding labor (14.9 +/- 1.8). COP correlated well with TP (r = 0.92) in term infants. In 60 sick preterm infants with 362 determinations, COP (12.5 +/- 2.5) was different from term infants (p less than 0.001) and the correlation with TP was poor (r = 0.64). Different therapeutic modalities were found to affect COP widely. Crystalloid infusion decreased COP by 22% and surgery by 32%. The authors conclude that COP varies not only with gestational age but also with mode of delivery and experience of labor. In critically ill preterm neonates, because estimations form TP are inadequate, the only way to obtain a quantitative measure of COP is by direct measurement. Repeated measurements of COP will permit precise selection of the fluids and will warn of changes that may lead to pulmonary edema.

Asphyxia Neonatorum↗
PubMed1980

Meningitis, ventriculitis, and hydrocephalus: a complication of fetal monitoring.

A case is presented of meningitis, ventriculitis, and hydrocephalus secondary to the use of fetal scalp monitoring. The most commonly reported fetal complication related to the application of the scalp electrode is the development of a scalp abscess; the incidence varies between 0.45 and 4.5%, but several other complications have also been reported and the overall incidence is not well established. Infants in whom a scalp electrode has been used should be carefully examined to detect potential serious complications.

Adolescent↗
PubMedDate not supplied

[Neonatal screening of congenital Hypothyroidism: result of the Navarra program].

The incidence of congenital Hypothyroidism is estimated at one case per 3,000-4,000 newly born. It is a proven fact that early diagnosis and treatment of this problem prevents mental retardation, which has led to the design and utilisation of methods of systematic detection in the newly born. The implantation of the screening program is relatively recent and progressive in some autonomous communities. With respect to the achievements that are being obtained by the program outstanding is the shorter time with respect to initiation of the treatment, but there still remain some shortcomings such as that of carrying out a longitudinal follow up of these infants, with respect to the evaluation of the development quotient, hence the need to have available hospital psychologists to carry out these evaluations. The expectations of achieving a mental development within normality in the children affected by congenital Hypothyroidism detected by the neonatal screening is a fact confirmed by many authors, for which reason it is highly encouraging to view the results of early detection of this neonatal screening.

English Abstract↗
PubMedDate not supplied

[Control of respiratory monitoring in the critical patient].

This study of the safety of patients undergoing mechanical ventilation was undertaken to ensure correct ventilation and to find quality-control elements for patients and nursing staff. Differences in mode programming and ventilation parameters and their registry at the change of nursing shifts, and correct programming of the sensitivity and minimum minute volume alarms and maximum airway pressure alarms were examined. In a two-month period, 8 cross-sectional studies were made of G1 prevalence in each of three nursing shifts. The status of the alarms and sensitivity were recorded when incorrect, as well as whether the ventilation mode and parameters coincided with the change of nursing shift. An analysis was made of: FiO2, PEEP, respiratory rate, minute volume, tidal volume, support pressure level, and control pressure level depending on the ventilation mode. Corrective measures were applied for a month. The effectiveness of these measures was evaluated by making 8 new G2 cross-sectional studies of the same type. Two hundred forty-eight G1 and 250 G2 recordings were made. The G2 studies revealed a generalized reduction in errors for all parameters. We concluded that the corrective measures were effective so these indicators were included in the monitoring of risk areas in the unit quality control program.

Critical Care↗