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Biomedical subjects

J Mancilla-Ramírez

Publications and source records attributed to J Mancilla-Ramírez.

15 recordsLinked to original sources
PubMed1992

[Intravenous immunoglobulin in the treatment of neonatal septicemia].

Thirty-seven neonates with confirmed septicemia through hemoculture were studied. Of them, 18 were treated with antibiotic and the other 19 were given 500 mg/kg of intravenous immunoglobin with a pH of 4.25 (IGIV). The greater part of the neonates in this study were full-term or near full-term. There were no differences in age, gestational age and weight, nor in mortality, the bacterias found and the clinical manifestations which were seen in both groups. Yet, the hospitalary stay was shorter for those in the group treated with IGIV (13.9 +/- 5.7 days) than in the trial group (24.4 +/- 10.3 days); as well as some clinical manifestations like diarrhea and splenomegalia (P < 0.05). The serum of the neonates from the IGIV group showed a greater capacity of opsonization and inhibition of bacterial growth than those in the trial group (P < 0.001), coinciding with an increase of 300 mg/dL in the serum levels of IgG of the group treated with IGIV from the 3rd day of the study and the C4 and B-Properdine factor serum levels from the 7th day of the study, while in the trial group, there were no changes in these factors (P < 0.001). Even though no differences were seen in the mortality rate due to septicemia, the results suggest a much shorter evolution of the illness in patients treated with IGIV. In addition, the serum of those patients treated with IGIV showed in in vitro studies, a better bacteriostatic activity and a better capacity to opsonize the bacterias isolated in the hemocultures.(ABSTRACT TRUNCATED AT 250 WORDS)

Bacteremia↗
PubMed1992

[Septic shock in newborn infants].

Systemic bacterial infections continue to be a main cause of death in newborns at neonatal intensive care units (NICU), worldwide. Bacteria causing neonatal septicemia are mainly the gram-negative, which possess endotoxin and are responsible for endotoxic shock. However, gram-positive bacteria are also able to induce septic shock, especially in immunocompromised hosts, like the newborns. Diagnosis and treatment of neonatal septic shock are quite difficult. Furthermore, there is not sufficient knowledge about its real frequency in Latin-american countries. The hyperdynamic phase of septic shock in newborns can be short and the hypodynamic phase is rapidly established, which increases the mortality. Since few years ago, some important aspects of physiopathology in septic shock have been studied and, at the same time that our knowledge about immunologic soluble mediators is increasing, new therapeutic modalities have been discovered. Such is the case of the therapeutic potentialities of cytokines, receptor antagonists and monoclonal antibodies, which is very encouraging at the present time.

Adrenal Cortex Hormones↗
PubMed1990

[Neonatal septicemia: differences in full-term and pre-term newborn infants].

Neonatal septicemia was assessed by blood cultures in 115 newborns (NB) during a two years study in a pediatric hospital of reference in Mexico City. The studied patients were divided in two groups of gestational age, and the differences of etiologic agents, clinical signs, laboratory findings and clinical outcome were compared at term and preterm neonates. We observed Staphylococcus epidermidis became the first cause of septicemia in at term NB (P less than 0.001), while Escherichia coli and Klebsiella pneumoniae (P less than 0.01) were more frequent in the preterm neonates. The clinical manifestations of fever (P less than 0.001), hepatomegaly (P less than 0.01), splenomegaly (P less than 0.05), and rejection to feeding (P less than 0.05) were more common in at term NB. On the other hand, apneas (P less than 0.01), hypothermia (P less than 0.02), and abdominal distension (P less than 0.05) were more frequent in the preterm NB. The altered white blood cell counts were more commonly observed in the preterm group, as leukopenia (P less than 0.05), neutropenia (P less than 0.01), and high I/T ratio (P less than 0.05). There were not significant differences in complications or sequels between the two groups; however, the mortality ratio was higher in the preterm NB group (P less than 0.02). Changing etiology of neonatal septicemia is discussed, and we propose these kind of data are very useful for purpose of detection, diagnostic and treatment of septic neonates.

Humans↗
PubMed1989

[Therapeutic effectiveness of an intravenous immunoglobulin with pH 4.25 in experimental neonatal sepsis caused by Klebsiella pneumoniae].

The in vitro opsonic activity and in vivo therapeutic effect of an intravenous immunoglobulin (IGIV) pH 4.25 against Klebsiella pneumoniae were evaluated in this study. By an opsonophagocytic assay in microtiter plates, bacteria were opsonized with IGIV pH 4.25, 10% rabbit serum, or 10% rabbit serum heated at 56 degrees C for 30 minutes. Opsonized bacteria were challenged with polymorphonuclear leukocytes (PMNs) from normal adults and bacterial killing was measured at 60 and 150 minutes. Forty-four newborn Wistar rats were infected subcutaneously with a 75% lethal dose of Klebsiella pneumoniae, and 90 minutes after, 24 rats were assigned to receive 500 mg/kg of IGIV pH 4.25 by intraperitoneal route and the remaining 20 animals received an equal volume injection of PBS. Animal survival was observed during a ten-day period. The best bacterial killing index was reached when bacteria were previously opsonized with IGIV pH 4.25 at 60 minutes (p less than 0.001), as well as at 150 minutes (p less than 0.0001) of challenge with PMNs. Newborn rat survival was better in the IGIV group (17/24), than PBS group (5/20), with significant statistical difference (p = 0.0029). These data suggest IGIV pH 4.25 can be a useful adjunct in the treatment of Klebsiella pneumoniae newborn sepsis.

Animals↗
PubMed1989

[Diarrhea associated with Trichomonas hominis in a newborn infant].

One female newborn infant with protracted diarrhea in whom associated Trichomonas homonis trophozoites were identified, is presented. Diarrhea in the infant persisted more than 30 days while in the hospital. Another causes of diarrhea, such as metabolic disorders, and bacterial, parasitic or viral infections were not identified. When furazolidone treatment was administered, the therapeutic response was very good, diarrhea disappeared and normal weight increase rate was recovered. It is pointed out that T. hominis might be a potential intestinal pathogen on human beings, specially on immunocompromised hosts, as newborn and malnourished infants are.

Diarrhea, Infantile↗
PubMed1989

[Frequency of neonatal necrotizing enterocolitis at a pediatric hospital].

A revision study of 322 cases of neonatal necrotizing enterocolitis (NEC) in a six year period at a pediatric hospital is presented. The frequency of NEC was 7.2% of the newborn (NB) admitted to the hospital. Fifty two percent corresponded to grade I on Bell's classification, 37% to grade II and 11% to grade III. Most of the cases were seen in at term newborn (51.3%) even though the proportional frequency in relation to the admissions was 38% in at term newborn and 62% in premature. The main clinical manifestations were abdominal distention, vomiting, and blood in feces. The frequency and intensity of other clinical signs as well as other signs as acidosis, anemia, hyponatremia and hypoprothrombinemia were directly proportional to the severity of the NEC. The radiological data of portal pneumatosis were more frequent in grade III NEC, and several cases of gastric pneumatosis were seen in the grade II NEC. Thirty four patients (10.6%) underwent surgery. The global mortality was 29.5% and in those who underwent surgery 79.4%.

Cross Infection↗
PubMedDate not supplied

Amniotic fluid interleukin-6 and the risk of early-onset sepsis among preterm infants.

BACKGROUND: High concentrations of interleukin-6 (IL-6) have been demonstrated in amniotic fluid (AF) from women with intra-amniotic infection. Recent studies have reported that IL-6 levels in AF were related to an increase in neonatal morbidity; moreover, higher IL-6 plasma levels have been observed in neonates with sepsis. METHODS: A cohort study was carried out at the National Institute of Perinatology in Mexico City. Inclusion criteria were the following: 1) preterm singleton pregnancy; 2) intact membranes at time of enrollment, and 3) written informed consent. Women with other complications of pregnancy were excluded. Newborn sepsis during the first 72 h was defined as early-onset sepsis. Amniotic fluid was obtained at the moment of delivery. Amniotic fluid IL-6 (AF IL-6) was determined by enzyme-linked immunoassays. RESULTS: Ninety-three women met the criteria for enrollment in the study and 31 (33%) of their newborns had early-onset neonatal sepsis. The mean AF IL-6 in mothers of septic newborns was 5779 +/- 2804 pg/ml compared to 729 +/- 382 pg/ml in mothers with non-infected neonates (p < 0.001). AF IL-6 concentrations higher than 1250 pg/ml were significantly associated with early-onset sepsis (OR 33.3; 95% CI 9.4-117.3) (p < 0.001). Gestational age under 32 weeks was also associated with neonatal sepsis (OR 2.56; 95% CI 1.2-9) (p = 0.002). Women whose infants developed neonatal sepsis had a higher frequency of clinical chorioamnionitis (p = 0.02). CONCLUSIONS: IL-6 determination in AF may be a useful indicator to identify neonates with higher risk of in utero bacterial infection.

Age of Onset↗
PubMedDate not supplied

[Phosphatidylcholine induces an increase in the production of interleukin-6 and improves survival of rats with neonatal sepsis caused by Klebsiella pneumoniae].

Infections by gram-negative bacteria are one of the major causes of death in newborns. Bacterial clearance is deficient in septic neonates, which seems to increase their susceptibility to infections. In this study, we observed a significant improvement in clearance of Klebsiella pneumoniae in newborn wistar rats inoculated by intraperitoneal via with 800 mg k soybean phosphatidylcholine (PC), compared to the control group injected with PBS (p 0.05). The overall survival rate was improved (p 0.05) and the white blood cell counts showed a greater leukocytosis and neutrophilia during the peak of bacteremia in the PC treated animals. Circulating levels of interleukin-6 were greater in the PC group, which developed an intense splenic hematopoiesis of the granulocyte (p 0.05) and megakariocyte series (p 0.01). No significant changes were observed in bone marrow granulocyte deposits in both study groups. The improvement in survival rate, the changes in leukocyte counts and the splenic hematopoiesis may be associated with the increased production of IL-6. These results suggest that IL-6 plays a role in the protection mechanism induced by PC in this experimental model of newborn septicemia. PC seems to be an immunomodulator of the acute response to gram-negative bacterial infection.

Animals↗