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Biomedical subjects

J E Baley

Publications and source records attributed to J E Baley.

22 records · Page 2Linked to original sources
PubMed1984

Disseminated fungal infections in very low-birth-weight infants: therapeutic toxicity.

The improved survival of very low-birth-weight infants, who require prolonged hospitalization and many invasive procedures, increases the risks for nosocomial illnesses, such as disseminated fungal infections. In a 2-year period, systemic fungal infections were clinically diagnosed in ten infants. This necessitated the institution of antifungal therapy in extremely premature infants (mean birth weight 788 g, mean gestational age 28 weeks) despite the paucity of knowledge about the pharmacokinetics and toxicity of these drugs in the very immature patient. Despite the absence of reported toxicity in infants and older children, severe nephrotoxicity was commonly observed with oliguria/anuria, temporally related to the administration of amphotericin B in seven of these infants. Additional evidence of nephrotoxicity included either a rise in creatinine levels (greater than or equal to 1.3 mg/dL), an increase in BUN (greater than or equal to 30 mg/dL), hypokalemia (less than or equal to 2.9 mEq/L), or hyperkalemia (greater than or equal to 6.0 mEq/L). Six of these seven drug-toxic infants died. Interruption of amphotericin B therapy, with reinstitution at a lower dose, was the most successful factor in alleviating the anuria. There is an urgent need for detailed pharmacokinetic and toxicity studies of antifungal agents in immature infants.

Acute Kidney Injury↗
PubMed1982

Effects of theophylline on the neonatal immune response.

Theophylline has recently shown to affect lymphocyte reactivity. In view of its widespread use in newborn intensive care units, the effects of both lymphocyte proliferation and immunoglobulin production at varied theophylline concentrations were measured. In 12 adults and 10 term infants lymphocyte proliferation, as assessed by a whole blood micromethod, was significantly decreased in vitro at 7.5 micrograms/ml. Immunoglobulin production in adults was decreased, by both a plaque forming cell assay and a radioimmunoassay in vitro at 12.5 micrograms/ml. Ten premature infants on theophylline, mean serum level 7.8 +/- 0.4 micrograms/ml, followed for 3-5 wk, showed a slight increase in lymphocyte proliferative responses to pokeweed mitogen. These data demonstrate no in vivo suppression of lymphocyte proliferation in theophylline-treated neonates at low theophylline levels.

Humans↗
PubMed1981

Candida endophthalmitis in the premature infant.

An attempt was made to determine the incidence and natural history of Candida endophthalmitis in the premature infant with systemic candidiasis. Each of eight premature infants were examined by indirect ophthalmoscopy within one week of their diagnosis. At this stage, four infants had multiple fluffy white lesions on both the retina and the vitreous, together with a diffuse vitreous haze. Three of the infants had interlesional and lesional-retinal vitreous strands. Three infants treated with amphotericin B and 5-fluorocytosine showed gradual disappearance of the lesions. The fourth infant died early in the course of antifungal therapy, when the eye lesions were progressing. Candida sepsis was particularly prevalent in the very low-birth-weight infant with a prolonged hospital course and treated with multiple broad-spectrum antibiotics. The course of the eye lesions indicates a good prognosis for Candida endophthalmitis, although further follow-up is necessary.

Amphotericin B↗