Biomedical subjects
Publications and source records attributed to A Zipursky.
The occurrence of vitamin E deficiency in newborn infants has come into question in light of recent findings. This article examines the available data concerning this condition and addresses the need for vitamin E therapy.
Thrombosis in newborn infants is probably more common that at any other period of life. This article highlights the neonate's tendency to develop thrombotic lesions, both in the absence and presence of indwelling catheters. Thrombosis associated with indwelling catheters is discussed in detail. Non-catheter-induced thrombosis is discussed along with its predisposing factors and the major sites of neonatal thrombi and their sequelae. An outline is then offered for a reasonable diagnostic and therapeutic approach.
In this article a practical approach to the assessment of anemia in newborn infants is developed using the classic pathophysiologic approach with special emphasis on factors such as growth and blood sampling that must be considered if an accurate assessment of anemia in this age group is to be made.
While antepartum prophylaxis of Rh immunization is much more costly and the postpartum program is much more cost-effective, the question is whether the antepartum program is sufficiently cost-effective to warrant its use. How, in any given region, should the issue be tackled? This article addresses that question.
The three-dimensional shape of erythrocytes is assessed by light microscopy using a simple technique to view glutaraldehyde-fixed erythrocytes. The technique and its standardization is described. Using this method the erythrocytes of adults have been compared to those of full-term and premature infants. In adults, the majority of erythrocytes are bowl-shaped at 37 degrees C and disc-shaped at room temperature. Newborn infants have significantly more bowl-shaped cells as well as significantly more irregularly shaped cells. Erythrocyte differential counts have been performed on a large series of patients to determine the normal range for each cell shape in adults, full-term, and premature infants. It is suggested that the study of erythrocyte morphology in haematologic disease in newborn infants requires three-dimensional assessment and quantitative data of normal values.
I have reviewed hemolytic disease of the newborn to discuss with you the mechanisms by which red cell destruction occurs in the newborn and how such a process may be detected. I have introduced the concept of "minimal hemolytic disease" that manifests in ABO incompatibility disease and have suggested that this process may contribute significantly to the problem of idiopathic hyperbilirubinemia. There are many potential causes for this condition and they deserve study. The diagnosis of hemolytic disease in the newborn includes careful assessment of anemia and of all the factors unique to the newborn that affect its appearance and interpretation, as well as careful assessment of the erythrocytes themselves.
Five children with 'paroxysmal cold haemoglobinuria' are described. In all of them an upper respiratory tract infection preceded the episode of acute intravascular haemolysis and potentially pathogenic organisms were recovered from four. The haematological features are presented and the importance of technique in the detection of the pathognomonic antibody is stressed and discussed in detail. Although the clinical manifestations are usually self-limiting and of short duration, it may be necessary, because of the rapidity and severity of anaemia, to provide interim support with appropriate blood transfusion. Since the disease is not usually recurrent and not clearly related to exposure to cold, it is suggested that it be re-named Donath-Landsteiner haemolytic anaemia.
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A double-blind randomized trial of vitamin E therapy was conducted in premature infants whose birth weight was less than 1,500 gm. Treated infants received 25 mg of vitamin E daily by mouth for the first six weeks of life. Detailed studies of plasma coagulation factors were performed prior to therapy and at days 7 and 42. None of the factors differed significantly between the treated and control groups. Although vitamin E therapy has been reported to affect the blood levels of vitamin K dependent coagulation factors, no such effect was noted in this group of premature infants.
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A series of 1,704 infants of blood group O mothers have been studied to determine the relation between the degree of red cell sensitization and the cord hemoglobin and bilirubin concentrations. The infants with blood group A or B had significantly higher cord bilirubin and lower cord hemoglobin concentrations than the group O babies. Those infants whose red cells had the greatest evidence of sensitization had the highest bilirubin and lowest hemoglobin levels. The infants in whom no antibody was demonstrable on the red cells or in the red cell eluate also had significantly higher cord bilirubin and lower cord hemoglobin levels than the ABO compatible group; it is suggested that these infants had sufficient erythrocyte sensitization to produce mild hemolysis. ABO incompatibility represents a spectrum of hemolytic disease extending from those in which there is little laboratory evidence of erythrocyte sensitization, but evidence of hemolysis, to severe hemolytic disease in which erythrocyte sensitization is usually easily demonstrable.
We describe a microtechnology for the study of the coagulation system in newborn infants. Interpretation of results demands an understanding of the techniques used and the nature of the control population from which normal values are drawn. We have examined two syndromes which represent the majority of hemostatic disorders of sick newborn infants. The first is thrombocytopenia resulting from bacterial infections in which there are minimal changes in the levels of blood coagulation factors and little tendency to bleed. The second is a syndrome of disseminated intravascular coagulation in which there is a profound disturbance in the coagulation mechanism, relatively little change in platelet counts, a severe hemorrhagic diathesis, and widespread ischemic necrosis.
The absorption of vitamin E, given by orogastric tube, was studied in premature infants who weighed less than 1.5 kg at birth. After the administration of either dl-alpha tocopherol or the acetate form, plasma tocopherol levels increased. In a second blind trial, 28 infants received either 25 units of dl-alpha tocopherol or placebo during the first six weeks of life. Plasma tocopherol levels in all treated infants were sustained in the normal adult range. The vitamin E-deficient state of premature infants can be corrected by oral therapy alone.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.