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Biomedical subjects

H D Dellagrammaticas

Publications and source records attributed to H D Dellagrammaticas.

13 recordsLinked to original sources
PubMed2002

Effect of low-dose oral erythromycin on gastric aspirates in ventilated neonates less than 32 weeks of gestation. Preliminary results.

In this prospective study, the 24-hour gastric aspirate volume was carefully recorded before, 24 and 48 h after administering 1.7 mg/kg/8-hourly of oral erythromycin to 16 ventilated neonates less than 32 weeks of gestation. Their median gestational age was 28.5 weeks (range 23-31 weeks), their median birthweight was 1,045 g (range 690-1,560 g) and the median day of life at which erythromycin was commenced was 9.5 days (range 4-16 days). Prior to administering erythromycin median 24-hour gastric aspirate volume, expressed as a percentage of the milk volume given over the same period, was 38.5% (range 20.0-100%). It was significantly lower 24 h (median 12%, range 0-41%, p = 0.0004) and 48 h (median 5%, range 0-21%, p = 0.0004) after commencing erythromycin. There was also significant reduction of gastric aspirate volume between 24 and 48 h after commencing erythromycin (p = 0.0024). Milk volume increment over the same period was not significant (p = 0.1022). These preliminary results warrant further evaluation through a randomised controlled trial.

Administration, Oral↗
PubMed2001

Mild dilatation of renal pelvis in term neonates with urinary tract infection.

The purpose of this study was to assess the incidence and evolution of mild dilatation confined to the renal pelvis in term neonates with urinary tract infection developing within 2 weeks from birth. Twenty-two neonates with mild dilatation of the renal pelvis out of 180 neonates with urinary tract infection were identified giving an incidence of 12.2% for this finding. Male to female ratio was 6.3:1. The left kidney was twice as frequently involved (68 vs. 32%). At follow-up, the dilatation had disappeared in 20 neonates (90.9%) by a mean age of 2.7 years with only one neonate developing two further episodes of urinary tract infection in the infantile period. No other morbidity was noted.

Dilatation, Pathologic↗
PubMed2000

Treatment of gram-negative bacterial meningitis in term neonates with third generation cephalosporins plus amikacin.

The aim of this retrospective study was to evaluate the clinical efficacy in terms of mortality and long-term morbidity of third generation cephalosporins and amikacin in combination for the treatment of gram-negative bacterial meningitis in a homogeneous group of neonates. A 15-year experience (1983-1997) with 72 term neonates without central nervous system anomalies and with gram-negative organisms grown in their cerebrospinal fluid treated with the above combination of antibiotics is presented. All isolated organisms were sensitive to cefotaxime or ceftazidime and to amikacin but 80% were resistant to ampicillin. The predominant infecting organism was Escherichia coli (68.0%) which was sensitive to both cefotaxime and amikacin in all cases but resistant to ampicillin in 48% of cases. Survival at discharge was 97.2% but ultimate survival was reduced to 94.4%, as 2 patients died a few months following discharge of conditions unrelated to meningitis. Ventriculitis was diagnosed in 10 neonates (13.8%). Among survivors, 1 neonate (1.3%) developed hydrocephalus needing shunting and 1 neonate (1.3%) with Proteus mirabilis developed a brain abscess with relapse of meningitis which was successfully treated with a 6-week course of chloramphenicol. At follow-up at an age greater than 6 months, 91.1% of the surviving infants were normal, while 92.3% of survivors at an age greater than 6 years were normal and attended normal school. These results, despite any reservations due to the nature of the study (retrospective, uncontrolled study), strongly support the use of third generation cephalosporins and amikacin in combination for the treatment of neonatal gram-negative bacterial meningitis.

Amikacin↗
PubMed1991

Effect of body tilting on physiological functions in stable very low birthweight neonates.

In babies of very low birth weight (less than 1500 g) we studied the effect of head up tilting on oxygenation, respiratory rate, heart rate and blood pressure (n = 23), on gastric emptying (n = 10), and on weight gain (n = 6). Head up tilting to 45 degrees achieved the best oxygenation at the angles studied, and decreased the respiratory and heart rates; there was no significant change in blood pressure. Residue in the stomach was also significantly less at 45 degrees, and the neonates' weight gain was higher. We conclude that nursing stable very low birthweight infants with a higher head up tilt than is conventional may have some advantages.

Blood Pressure↗
PubMed1983

Upper intestinal bacterial flora during transpyloric feeding.

Samples from the pharynx, stomach, duodenum or jejunum, and faeces were collected on 7 days between 1st and 28th day from neonates weighing less than 1.5 kg at birth who were fed by transpyloric tube. These were cultured on selective and non-selective media, and the results were expressed in a semi-quantitative manner. The number of bacterial species and the density of their growth increased with the patient's age; this was particularly noticeable with Gram-negative bacteria and the ratio of Gram-negative to Gram-positive organisms increased steadily in specimens from all sites with increasing age. The upper small intestine was more heavily colonised than the stomach early in life and the microflora present was predominantly faecal in nature. The species isolated from all sites were mainly aerobes or facultative anaerobes; strict anaerobes did not form a significant proportion of the microflora in these infants. Necrotising enterocolitis developed only after heavy jejunal colonisation with Gram-negative bacilli.

Bacteria↗
PubMed1983

Unusual ocular findings in an infant with cri-du-chat syndrome.

A newborn male with cri-du-chat syndrome, congenital nuclear cataracts, microspherophakia, and probably ectopic lenses is reported. Microspherophakia in cri-du-chat syndrome has not been previously described. The congenital cataracts were inherited from his mother who had a balanced 5;13 translocation; the two events are considered to be coincidental and a possible 'position effect' was excluded, since the other members of her family with congenital cataracts, were chromosomally normal. This is the fourth case reported where familial cri-du-chat syndrome involves chromosomes 5p and 13q.

Cataract↗
PubMed1983

Radiation doses to neonates requiring intensive care.

Radiological investigations have become accepted as an important part of the range of facilities required to support severely ill newborn babies. Increasing numbers of these very small premature babies now survive although they may undergo a considerable number of diagnostic X-ray examinations within the first few weeks of life. Since the infants are so small, many of the examinations are virtually "whole-body" irradiations and it was thought that the total doses received might be appreciable. A group of such babies admitted to the Neonatal Intensive Care Unit in Sheffield over a six-month period have been studied. X-ray exposure factors used for each examination have been noted and total skin, gonad and bone marrow doses calculated, supplemented by measurements on phantoms. It is concluded that in most cases the doses received are of the same order as those received over the same period from natural background radiation and probably less than those received from prenatal obstetric radiography, so that the additional risks from the diagnostic exposure are small. The highest doses are received in CT scans and barium examinations and it is recommended that the need for these should be carefully considered and requests for such examinations only made by experienced staff.

Birth Weight↗
PubMed1981

Clinical evaluation of the Dinamap non-invasive blood pressure monitor in pre-term neonates.

The performance of the Dinamap 847 non-invasive blood pressure monitor was evaluated in a group of 10 severely ill pre-term newborn babies. The mean gestational age was 30 weeks and mean birthweight of 1610 gm. The values of systolic, diastolic and mean arterial pressure obtained by the Dinamap were compared with the corresponding values of actual pressure through a right radial artery catheter. All these values showed a high degree of correlation. No complications were noted. It was concluded that the Dinamap 847 should be considered as an alternative for monitoring the arterial blood pressure in pre-term neonates where arterial catheterisation is either not justified or impossible.

Blood Pressure Monitors↗