The premature infant as a compromised host.
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Biomedical subjects
Publications and source records attributed to J C Rowe.
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On Day 1 of life (Day 0 = birth), the sleep-wake behavioral states of rabbits were measured for 2 hr, after which half the animals received 10 mg/kg of theophylline by intubation (N = 16), whereas the remainder received normal saline (N = 17). Behavioral states were then measured on Days 2, 3, 5, 7, 15, 20, 30 and 40. Theophylline sharply reduced active sleep starting on Day 2 and continuing through Day 20. The development of quiet sleep was delayed for 10 days in the drug-treated group. Paralleling the loss of active sleep was a major increase in wake between Days 2 to 20. The drug also affected the intermediate states of sleep-wake transition and active-quiet sleep transition. The data raise major questions about the safety of a drug widely used in the newborn intensive care setting.
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Very low birth weight infants require greater intakes of calcium and phosphate than can be supplied simultaneously in parenteral nutrition. We investigated the biochemical effects and retention of calcium and phosphate when each was administered for 24 h on an alternate day schedule as part of total parenteral nutrition. Serum and urine were collected during a 24 h basal period and during randomly ordered 24 h infusions of either calcium or phosphate in 14 infants during the first week of life. In general, the urinary excretion of the infused mineral (calcium or phosphorus) increased during the 24 h period of its infusion. The serum phosphorus level fluctuated widely from day to day while the serum calcium level did not change. During the 24 h infusion of phosphate, phosphate retention was 67.9 +/- 7.4% and, during the 24 h infusion of calcium, calcium retention was 72.5 +/- 4.3%. However, ongoing excretion of each mineral on the day it was not infused meant that 48.3% of the 48 h phosphate intake and 42.2% of the 48 h calcium intake were lost in the urine. We conclude that excessive amounts of the administered mineral were excreted and that alternate day infusion of calcium and phosphate is an unsatisfactory method for providing these minerals. Attainment of sufficient retentions of calcium and phosphate will require development of novel methods of simultaneous administration which provide calcium and phosphate in high concentrations.
OBJECTIVE: The C-propeptide of cartilage type II procollagen, together with the N-propeptide, are removed from newly synthesized procollagen during collagen fibril assembly in cartilage matrix. The presence and content of the C-propeptide reflect the synthesis of this molecule. Recently, we showed that serum levels of the C-propeptide are increased in adults with rheumatoid arthritis, pointing to increased synthesis of this molecule. In this study we examined its content in the sera of children to determine whether it changes during development. METHODS: Sera were obtained from 44 premature infants (cord blood), 75 children (0-18 years), 14 young adults (18-22 years) and 47 adults (35-60 years). The concentration of serum C-propeptide of type II procollagen was determined by a solution phase competitive inhibition radioimmunoassay which uses a polyclonal antiserum specific for the bovine and human C-propeptide. RESULTS: Compared with adults, concentrations of the C-propeptide of type II procollagen were significantly elevated in children of ages 0-14 years. Concentrations were constant until 10 years of age (premature infants: 14.5 +/- 1.4 ng/ml, mean +/- SE; 0-10 years: 13.6 +/- 1 ng/ml). In children of ages 10-14 years, during which the pubertal growth spurt is ordinarily observed, the mean concentration increased (10-14 years: 21.6 +/- 0.7 ng/ml) although not significantly due to the variation between individuals. Concentrations at all ages younger than 14 were significantly greater than those in older adolescents ages 14-18 (6.3 +/- 0.7 ng/ml), young adults (8.4 +/- 2.0 ng/ml) and adults (5.7 +/- 0.4 ng/ml). Serum concentrations did not show significant differences with respect to sex, but varied from child to child at any given age. CONCLUSIONS: The measurement of this circulating C-propeptide may be of use in studying the biochemical and physiological bases of changes in cartilage turnover in children, and abnormalities thereof.