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Biomedical subjects

I Arad

Publications and source records attributed to I Arad.

At least 55 records · Page 3Linked to original sources
PubMed1986

Vacuum extraction at cesarean section--neonatal outcome.

The use of the vacuum extractor at cesarean section has been advocated in order to avoid extension of the uterine incision and to facilitate the delivery of a floating head. We have evaluated, prospectively and retrospectively, the neonatal outcome of vacuum extraction at cesarean section in comparison with regular cesarean section. The interval between the final uterine incision and complete delivery (U-D interval) was significantly prolonged (P less than 0.01) in 8 cases of vacuum extraction (Group A) when prospectively compared with 10 cases of regular cesarean section (Group B). The Apgar scores, the acid-base values at delivery and the clinical course of the two groups were not significantly different. Although analysis of our prospective data suggests a trend of an association between prolongation of the U-D interval and neonatal depression, our retrospective data of 34 neonates delivered by vacuum extraction at cesarean section and 44 neonates delivered by regular cesarean section, showed no significant untoward effect when the vacuum extractor was utilized. Since prolongation of the U-D interval may have an undesireable effect on the fetus, we advocate extra caution in the use of this method.

Apgar Score↗
PubMed1986

Autopsy findings of Serratia meningoencephalitis in infants.

Serratia meningoencephalitis is often a fatal disease that causes widespread destruction of brain tissue despite aggressive antibiotic treatment. The autopsy findings of 2 cases are described. In a case caused by S. liquefaciens, previously not reported as the causative organism of meningoencephalitis, suppurative meningitis, ventriculitis, vasculitis, and extensive necrotic process of the brain matter were found. In the other case, caused by S. marcescens, the findings were those of acute and subacute abscesses with hemorrhagic necrosis.

Bacterial Infections↗
PubMed1985

A knot of the subclavian venous catheter in a premature neonate.

The percutaneous subclavian venous catheter is used in administration of total parenteral nutrition in premature neonates. Most of the complications observed include catheter-related sepsis, cracking or obstruction of the line, and accidental removal. We encountered an unusual complication when an intravascular knot in the catheter was formed upon removal of the line. If care is taken when advancing the catheter, this complication can be avoided.

Catheterization↗
PubMed1985

Percutaneous subclavian venous catheters in premature infants weighing less than 1500 gm.

Thirty-two percutaneous subclavian venous catheters were inserted in critically ill, low birthweight (less than 1500 gm) neonates. No complication occurred secondary to insertion. The total number of catheter-patient days was 754 days, with the average duration of a single catheter being 23.5 days. The incidence of primary catheter-related clinical sepsis was 3.1%. The safety and bedside feasibility of the procedure, as well as long catheter duration make it the best option for long-term venous access in this unique group of patients.

Birth Weight↗
PubMed1985

Aminophylline versus doxapram in weaning premature infants from mechanical ventilation: preliminary report.

A small, double-blind crossover study compared the efficacy of aminophylline and doxapram in ventilator weaning of eight premature infants recovering from respiratory distress syndrome (RDS). Although neither drug was significantly better than the other, four infants were weaned from mechanical ventilation after drug administration. It is suggested that drugs stimulating the respiratory center may aid in shortening the duration of mechanical ventilation in premature infants recovering from RDS.

Aminophylline↗
PubMed1985

Effect of acute hypoxia on ascorbate content of plasma, cerebral cortex, and adrenal gland.

Levels of ascorbic acid (AA) in the plasma, brain, and adrenal gland of rats were determined after 15 min of hypoxia (PaO2 less than 25 mm Hg) and following asphyxia. In rabbits, AA plasma levels were followed up to 75 min of reoxygenation following 15 min of hypoxia of the same severity. A significant increase (approximately 70%) in AA levels was found in plasma of rats and rabbits after hypoxia and asphyxia. This increase was found to be transient, with a return to normal levels within 1 h after resumption of normal oxygenation. Pretreatment with dexamethasone reduced the increase in AA level in both rabbits and rats. Adrenalectomy in rats, performed 24 h before the experiment, abolished the response to hypoxia. Ascorbate levels in the cerebral cortex, hypothalamus, and adrenal gland of awake rats subjected to hypoxia or asphyxia were found to be the same as in normoxic rats. Our results suggest that the observed changes in plasma AA levels are probably mediated through adrenocorticotropic hormone and that the adrenal gland is the major source of ascorbate efflux into the circulation during oxygen deprivation.

Adrenal Glands↗
PubMed1985

Tracheo-oesophageal anomalies in the Goldenhar anomalad.

A case of the Goldenhar anomalad is presented with a previously undescribed association with oesophageal atresia and tracheo-oesophageal fistula. This is the second instance of a tracheobronchial-oesophageal communication being found in association with the anomalad. Awareness of this combination may facilitate future diagnosis and treatment of the anomaly.

Esophageal Atresia↗
PubMed1985

Aminophylline versus doxapram in idiopathic apnea of prematurity: a double-blind controlled study.

A double-blind controlled study, in two parts, was undertaken to compare the effectiveness of aminophylline and doxapram therapy in idiopathic apnea of prematurity. In the first part of this study, eight of 15 infants responded to doxapram therapy with complete cessation of apneic spells and six of 11 infants responded similarly to administration of aminophylline. These differences were statistically insignificant. In the second part of the study, assessment was made of whether the addition of doxapram to aminophylline therapy was effective in treatment of apnea of prematurity that had been unresponsive to aminophylline alone. Of ten infants who continued to have apneic spells during treatment with aminophylline, eight responded to the addition of doxapram with complete cessation of apnea. Nine infants received placebo in addition to aminophylline, and none had a reduction in frequency of apnea.

Aminophylline↗
PubMed1984

Adrenocortical reserve of neonates born of long-term, steroid-treated mothers.

Since corticosteroids have been shown to be transferred across the human placenta, prolonged administration of these drugs during gestation could be expected to suppress the response of the neonatal adrenal gland. Plasma cortisol levels, before and 30 min after the injection of ACTH (36 micrograms/kg), were determined in six neonates who were exposed in utero to prolonged maternal administration of prednisone. The basal plasma cortisol levels of these neonates (6.15 +/- 2.57 micrograms %; mean +/- SEM) were similar to values obtained in eight healthy neonates (5.19 +/- 1.36 micrograms %). The increment of cortisol levels after ACTH stimulation (16.4 +/- 2.07 micrograms %) of the study patients was larger (P less than 0.01) than the change (10.3 +/- 0.82 micrograms %) observed in six older controls. These results indicate a normal neonatal adrenal reserve after prolonged exposure to corticosteroids during fetal life.

Adolescent↗
PubMed1984

Plasma haptoglobin levels in vacuum extracted neonates.

In order to examine the pathogenesis of neonatal hyperbilirubinemia associated with vacuum extraction, we have compared plasma haptoglobin and bilirubin levels and blood hematocrits of vacuum extracted neonates with those of newborns who underwent a normal vaginal delivery. Plasma haptoglobin and blood hematocrits of the 12 vacuum patients measured on the third day of life were significantly lower (21.7 +/- 5.3 vs. 46.5 +/- 7.5 mg%; p value less than 0.01 and 52.3 +/- 1.3 vs. 59.7 +/- 1.8%; p value less than 0.005, respectively) than the 12 control patients (values are mean +/- SEM). This trend was apparent whether or not cephalhematoma was present after vacuum extraction: However, the mean bilirubin level was significantly higher than the controls only when cephalhematoma was present. Those results suggest that the higher incidence of neonatal hyperbilirubinemia previously observed after vacuum extraction, is the result of an increased hemolysis of blood sequestered in scalp lesions. Since evidence for enhanced RBC destruction has been demonstrated whether or not cephalhematoma was present, the possibility of hyperbilirubinemia should be anticipated in any case of vacuum delivery.

Bilirubin↗
PubMed1983

Flow-volume curves in infants with lung disease.

Partial expiratory flow-volume maneuvers have been performed on nine occasions on six infants with a variety of pulmonary problems using a new technique for thoracic compression. The infants were placed within an inflatable bag that was, itself, within a canvas bag. By sudden controlled inflation of the inner bag at end inspiration, partial expiratory flow-volume curves were generated and recorded by means of a face mask and pneumotachograph. By comparing these flow results with those airway resistance and lung volume measurements obtained from the infants in whole body plethysmography and by noting the effect of inhaling a helium/oxygen gas mixture, it was possible to partition the airway obstruction between large and small airways. The presence of small airway obstruction was noted in the absence of changes in airway resistance or lung volume in several instances. A complete evaluation of airway function should include this test of forced expiration for greater understanding and treatment of lung disease in infancy.

Airway Resistance↗
PubMed1982

Necrotising enterocolitis in the very low birthweight infant: expressed breast milk feeding compared with parenteral feeding.

The incidence of necrotising enterocolitis (NEC) in very low birthweight infants (VLBW less than or equal to 1500 g) was reduced by the delayed onset of enteral feeding. Eight (18%) out of 44 VLBW infants who were in hospital during the first year of the study developed NEC. During the next 12 months 85 similar infants were initially fed by parenteral nutrition only, and then from age 14-21 days with infant formula. During the second year only 3 (3%) patients developed NEC. There were no other relevant changes in management. Throughout the entire study, the onset of NEC in each infant in whom it occurred was after the start of enteral feeding. We recommend avoiding enteral feeding in VLBW infants during the period that they are particularly vulnerable--namely the first 2 or 3 weeks of life.

Enteral Nutrition↗