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Biomedical subjects

E John

Publications and source records attributed to E John.

At least 91 records · Page 5Linked to original sources
PubMed1984

Prevention and control of neonatal pyoderma with chlorhexidine.

The extent of staphylococcal colonisation and neonatal pyoderma was studied in 5 220 infants in two large Swedish hospitals in 1979-1982. A method for routine cord care with 4% chlorhexidine detergent solution was evaluated in one hospital. Nursery colonisation with Staph. aureus and streptococci decreased significantly. The method proved to be clinically efficient for prevention of pyoderma in the nursery as well as for controlling staphylococcal infection after discharge from hospital. The combined use of a quantitative sampling method and phage-typing showed that most post-discharge lesions were nursery-derived. In one of the hospitals, daily cord care with 70% ethanol failed to prevent streptococcal and staphylococcal omphalitis in the nursery whereas daily cord care with chlorhexidine reduced the incidence of omphalitis from 21 to 1%.

Chlorhexidine↗
PubMed1983

Urinary excretion of methylparaben and its metabolites in preterm infants.

A high-performance liquid chromatographic (HPLC) assay to quantitate methylparaben in urine was developed. Standard curves were linear and recovery of the paraben from urine averaged 82.6%. The urinary excretion of methylparaben in six preterm infants (less than or equal to 31 weeks gestational age), who were receiving intramuscular injections of a paraben-containing gentamicin formulation, ranged from 13.2 to 88.1%. Small quantities of the metabolite, p-hydroxybenzoic acid, were detected by GC-MS.

Biotransformation↗
PubMed1983

Pharmacokinetics of gentamicin in very low birth weight preterm infants.

Low birth weight preterm infants with suspected infection were administered gentamicin intramuscularly every 18 h (2.5 mg/kg) or 24 h (3.0 mg/kg). For both dosage regimens plasma gentamicin levels were monitored during a dosage interval on three separate occasions over a 10 day period. Both regimens gave satisfactory plasma concentrations and there was no important statistically significant difference between the two. The body clearance of gentamicin correlated with gestational age (r = 0.76, p less than 0.01). The results indicate either regimen may be useful in the clinical situation but from a practical standpoint administration every 24 h may be easier to comply with then every 18 h.

Drug Administration Schedule↗
PubMed1983

Evaluation of bubble clicking in gastric aspirate in the newborn.

Gastric aspirates were obtained soon after delivery from 167 babies 24 to 40 weeks gestation. Bubble clicking and foam stability tests were compared for their reliability in determining pulmonary maturity. Both tests predicted mature lungs accurately in 90-91% of babies, however their ability to predict immature lungs was less, bubble clicking predicting it accurately in 88% of babies and foam stability test predicting it in 77% of babies. Bubble clicking, foam stability tests, L/S ratio and two dimensional thin layer chromatography were done in 26 gastric aspirates obtained from 22 babies with mature lungs and 4 babies with with hyaline membrane disease. Phosphatidyl glycerol was present in 21 of the 22 babies with mature lungs. Bubble clicking demonstrated a 95% accuracy and foam stability test 100% accuracy in predicting the presence of phosphatidyl glycerol. Bubble clicking is a useful and easily preformed test in the clinical assessment of a preterm baby.

Chromatography, Thin Layer↗
PubMed1983

Cost of neonatal intensive care.

An analysis was made of the costs of provision for the intensive care of inborn babies in an inner city hospital equipped to deal with high risk obstetrics. Costs showed the expected inverse proportion to birthweight. The larger number of more mature babies nevertheless contributed almost 2/3 of the total cost. The adjusted cost/survivor ("adjusted" to reflect the fact that only the survivors benefit) was $39,845 for babies less than 801 g; $26,100 for those between 801 g and 1,000 g; $14,137 between 1,001 g and 1,500 g and $4,782 over 1,500 g. The largest single expense was in nursing salaries which constituted 60-80% of the total outlay. No data are available for precise comparison. The figures are presented as a basis on which to begin forming judgements of the cost effectiveness of newborn intensive care.

Australia↗
PubMed1983

Cardiac output and organ blood flow in young rabbits during intermittent positive-pressure ventilation.

Cardiac output and organ blood flow were measured by a microsphere technique in three groups of healthy young rabbits. In one group, animals were subjected to light sedation and intermittent positive-pressure ventilation. Control animals in a second group were sedated but not ventilated. In a third group, animals were conscious and breathing spontaneously. Cardiac output increased significantly (p less than 0.05) in conscious controls and in one measurement in anesthetized controls. It did not change in ventilated rabbits. Blood flow to the brain increased during study in all three groups and to the eye in both control groups. These elevations in cardiac output and cerebral blood flow were attributed to arousal. Blood flow to the kidney decreased in both anesthetized groups. The blood flow to skin, muscle, ileum and colon decreased significantly in the ventilated animals though not in the anesthetized controls. In both groups, similar reductions were found in the fractional distribution of cardiac output to these areas. It was concluded that ventilation at low pressure had no effect on cardiac output. The occurrence of redistribution of the circulation was deduced from the parallel reductions of regional blood flows and fractions of cardiac output received by some organs together with preservation of cerebral blood flow, though it was obscured in the two control groups by simultaneous increases in cardiac output. The circumstances suggested that this redistribution was due to disturbed homeostasis from arousal. Implications for the newborn were discussed.

Animals↗
PubMed1983

Neonatal hypotension: two years' experience in a neonatal intensive care nursery.

Routine measurement of blood pressure in high risk neonates admitted to the intensive care nursery during a 2 year period resulted in detection of 18 infants with persistent hypotension requiring definitive treatment. The perinatal events in these babies were compared to those in a control group of infants. No single well defined factor responsible for neonatal hypotension could be found in the antenatal period or during labour. However 14 of the 18 babies were asphyxiated at the time of admission compared to 6 of 18 controls (p less than 0.02). Seventeen of 18 babies were preterm. Treatment consisted of maintenance of ventilation, oxygenation and acid-base status, volume expansion when indicated and inotropic agents. Nine of the 18 hypotensive babies died compared to 1 of 18 controls. Failure to respond within a few hours of commencement of treatment indicated poor prognosis.

Adult↗
PubMed1982

Ultrastructure of the lung after ventilation.

We looked at the ultrastructure of the lung of rabbits ventilated with air moistened with nebulized water ("nebulized group"), and humidified air ("humidified group") compared to a group of controls. Both groups of ventilated rabbits had plasmalemmal vesicles that were larger than in controls. They were fewer in number (P less than 0.001) and less well defined. Early degenerative changes were noted in 6 of 9 rabbits in the nebulized group and 6 of 9 rabbits in the humidified group, while none of the rabbits in the control group were similarly affected. Interstitial oedema of varying severity was seen in 6/9 rabbits from each of the ventilated groups.

Animals↗
PubMed1980

Papillary muscle necrosis in a neonatal autopsy population: incidence and associated clinical manifestations.

Papillary muscle necrosis was found in 24 of 84 neonates without congenital heart disease who died and were autopsied during a 17-month study period. The lesion was most prevalent in infants greater than or equal to 3,000 gm birth weight (59%), but papillary muscle necrosis was also noted in 25% of the infants of medium birth weight (1,500 to 2,999 gm) and in 19% of the very low-birth-weight infants (less than 1,500 gm). Papillary muscle necrosis in the highest birth-weight group correlated with five-minute Apgar scores of 6 or less, meconium aspiration syndrome, seizures, congestive heart failure, increased cardiothoracic ratio (greater than or equal to 0.60), and ischemic changes on electrocardiogram. In the medium- and very low-birth-weight groups, however, patients with papillary muscle necrosis could seldom be differentiated clinically from their birth-weight peers without the lesion, even in retrospect.

Autopsy↗
PubMed1980

Lead intoxication during development: its late effects on kidney function and blood pressure.

Exposure to lead in early life may result in chronic renal disease in adulthood. To test this hypothesis, we gave Sprague-Dawley rats, from 3 to 9 weeks of age, either tap water or a 1% lead acetate solution, and we studied them (in pairs) 3 and 16 weeks after exposure; that is, at 12 and 25 weeks of age. Lead-intoxicated animals failed to grow. Their GFR's were lower compared with the matched controls and fell between 12 and 25 weeks of age from 4.8 +/- 0.3 to 3.3 +/- 0.4 ml/min/g dry kidney wt (P less than 0.01). Changes in RBF and single nephron GFR were proportional to changes in total kidney GFR, indicating that superficial and deep nephrons were equally affected. The blood pressure in the lead-exposed animals studied at 25 weeks of age was 143.2 +/- 3.7 mm Hg, a value significantly higher than that of 130.4 +/- 3.3 observed in controls (P less than 0.05). These results demonstrate that limited exposure to lead during development can result in progressive renal insufficiency and hypertension.

Animals↗
PubMed1980

Effects of gas temperature and particulate water on rabbit lungs during ventilation.

Anesthetized young rabbits were ventilated for 6 hr at 20 cm H2O peak airway pressure using air nebulized with water at 22 degrees C (cold nebulized group, n = 11), at 36 degrees C (warm nebulized group, n = 11) and humidified air at 36 degrees C (warm humidified group, n = 10). Their biochemical status during ventilation and pulmonary morphology at autopsy were compared to those of ten control rabbits. Both nebulized groups had particulate water in the inspired air and water of condensation in the endotracheal tube. The rabbits ventilated with warm humidified air and the control group breathing spontaneously maintained their blood pressure and pHa within physiologic range. Rabbits ventilated with air nebulized with water at 22 and 36 degrees C had a significant decline in mean blood pressure (96 mm Hg leads to 61 mm Hg in cold nebulized and 91 mm Hg leads to 61 mm Hg in warm nebulized) and mean pHa (7.43 leads to 7.23 in cold nebulized and 7.42 leads to 7.31 in warm nebulized). All rabbits in the control and warm humidified groups survived the study whereas 9 of 22 in the nebulized groups died before completion of study (P < 0.005). Morphometric analysis revealed a significant increase in the mean vascular wall thickness in both nebulized groups of rabbits when compared to that in the control and warm humidified groups (P < 0.05). The cold nebulized group also had significantly less air space and correspondingly more interstitial thickness and intraalveolar edema (P < 0.05) compared to control and warm humidified groups. These findings of pulmonary parenchymal damage in rabbits ventilated with air containing particulate water and the greater degree of both physiologic and anatomic change evident in the cold nebulized animals suggest that particulate water and low inspired air temperature may contribute to the genesis of pulmonary damage during intermittent positive pressure ventilation.

Animals↗
PubMed1980

Effects of intermittent positive-pressure ventilation on lungs of normal rabbits.

We ventilated 10 healthy young rabbits with warm moist air at 20 cm H2O peak airway pressure and compared their pulmonary histology to that of 10 controls. The histological changes were analysed using the Leitz Texture Analysis System. Four hundred high-power fields (240 micrometers X 240 micrometers) were scanned from each section and the mean proportions of air space, interstitium and oedema determined. Calculated bicarbonate decreased significantly in both groups (P < 0.05); this was accompanied by a modest decrease in pHa in the ventilated group. The PaO2 and PaCO2 were maintained within the normal range. The blood pressure decreased in both groups. Seven of 10 ventilated rabbits had interstitial widening while only 1 of 10 controls had a similar lesion (chi 2 = 5.21, P = < 0.05). The area occupied by interstitium ranged from 26 to 46% (mean 37.6%) in controls and 18 to 81% (mean 45.4%) in ventilated rabbits. There was a lack of correlation between clinical and histopathological findings. While 6 of 10 ventilated rabbits had intra-alveolar oedema and a decrease in air space to less than 50% of total area, none developed hypoxaemia. Two of these 6 rabbits also had pHa less than 7.35 by the end of the study, yet all were clinically stable. These data indicate that intermittent partial-pressure ventilation with warm moist air may result in pulmonary parenchymal damage within 6 h in healthy rabbits.

Animals↗