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Biomedical subjects

M Stronati

Publications and source records attributed to M Stronati.

36 records · Page 2Linked to original sources
PubMed1993

Infant neurodevelopmental outcome in pregnancies complicated by gestational hypertension and intra-uterine growth retardation.

The neonatal outcome of 78 consecutive singleton pregnancies complicated by intrauterine growth retardation (IUGR) and gestational hypertension were compared with the outcome of 78 adequately matched pregnancies complicated by idiopathic IUGR. The rate of low (< 5) 1-minute Apgar scores was higher in infants born to hypertensive mothers (12.8% vs 2.6% p = .035). No differences in the prevalence of other perinatal factors such as acidosis, respiratory distress syndrome, hypoglycemia, pneumothorax, bronchopulmonary dysplasia, intracranial hemorrhage, requirement for assisted ventilation or survival were found between cases and controls. After two years' follow-up, the rate of major neurological neonatal handicaps, was 2.8% in the cases and 1.4% in the controls (p = 0.56). Mild neurodevelopmental abnormalities were more frequent in infants born to hypertensive mothers (14.3% vs 2.9% p = .025). After adjustment by multiple logistic regression, to eliminate the effect of confounding factors, the probability of normal neurodevelopmental outcome was reduced by 82% in infants born to hypertensive mothers as compared to controls (Odds Ratio = 0.18; 95% confidence interval 0.05 to 0.82 p = .028). These findings suggest that pregnancies complicated by IUGR and gestational hypertension are associated with a high prevalence of subsequent neurodevelopmental problems among infants.

Adult↗
PubMed1992

The influence of presentation and method of delivery on neonatal mortality and infant neurodevelopmental outcome in nondiscordant low-birthweight ( < 2500 g) twin gestations.

The effects of birth order, presentation and method of delivery on neonatal mortality and neurodevelopmental outcome in nondiscordant low birthweight ( < 2500 g) twin gestations were evaluated. Sixty-four sets of twins were included in the study; 29 sets were in vertex/vertex presentation (Group I), 25 sets in vertex/breech (Group II) and in 10 pregnancies the first twin was nonvertex (Group III). The rate of favorable neonatal outcome (survival and normal neurodevelopmental outcome after a 2-year follow-up) was lower in pregnancies in which at least one twin was in nonvertex presentation (50/70 vs. 52/58 P = 0.02). However, after adjustment by multiple logistic regression analysis for the effects of gestational age, birthweight, birth order and educational level of the mother, this difference was not statistically significant (odds ratio = 0.6; 95% confidence interval 0.44 to 5.9; P = 0.5). In pregnancies in which at least one of the twins was in nonvertex presentation, delivery by cesarean section did not affect the rate of favorable neonatal outcome (odds ratio = 1.8; 95% confidence interval 0.48 to 12.9; P = 0.8). The results of this study suggest that in low birthweight twin gestations, method of delivery in relation to fetal presentation has little or no effect on neonatal mortality and subsequent neonatal neurodevelopmental outcome.

Birth Order↗
PubMed1989

Congenital cystic adenomatoid malformation of the lung. Presentation of 16 cases.

Congenital cystic adenomatoid malformation (CCAM) of the lung is one of the rarest causes of neonatal distress. The principal radiological sign of CCAM is an intrapulmonary mass of soft tissue density, containing cystic areas of different sizes and shapes. The mass usually compresses the rest of the affected lung and displaces the mediastinum and heart to the opposite side, compressing the lung which is often therefore hypoplastic. If CCAM is diagnosed in utero by ultrasound, the treatment of choice is surgery as soon as possible after birth, with good survival rates. Sixteen cases of CCAM are presented, one with bilateral disease, diagnosed at different times, and one with an associated prune belly syndrome, to be added to the 405 already reported in the literature, and their clinical, radiological and pathological features are described.

Diagnosis, Differential↗
PubMed1987

Complement-dependent bactericidal activity for E. coli K12 in serum of preterm newborn infants.

Complement-dependent serum bactericidal activity for E. coli K12 was assessed in 12 term infants and in 16 preterm infants. In both groups of newborns, at birth, bactericidal reaction by the classical pathway of complement activation was impaired with respect to normal controls at less than 0.001 level of significance (as estimated by Student's t-test). The serum bactericidal reaction by the alternative pathway of complement activation was significantly impaired only in preterm newborns, being normal in term infants. At a time corresponding to 40 weeks' gestational age also in preterm newborns alternative pathway mediated bactericidal activity for E. coli K12 was found normal. Classical pathway mediated bactericidal activity became normal only at an age corresponding to 52 weeks' gestational age.

Blood Bactericidal Activity↗
PubMedDate not supplied

[Neuropsychologic development of small for gestational age preterm infants: follow up at 12-36 months of age].

We followed 94 preterm infants (G.A. < 37 weeks) small for gestational age (SGA) born from 1980 to 1987 in Pavia and admitted to the Neonatal Intensive Care Unit of S. Matteo Hospital (Pavia). A control group matched for gestational age of 94 preterm appropriate for gestational age (AGA) was also studied. Neurological examination was carried out at 40 weeks postmenstrual age and at 3, 6, 9, 12, 24, 36 months of age with the method of Amiel-Tison and Grenier (1986). Psychomotor development was assessed using Brunet-Lezine's Scale until 1985 and after Bayley Scales of Infant Development. Intrauterine mortality was 23.40% in the SGA group and 5.32% in the AGA group (p = 0.0003); neonatal mortality was 18% in the SGA group and 6.62% in the AGA group (p < 0.01). 42 SGA (80.8%) and 58 AGA (79.5%) were completely normal (group A) at 36 months, but SGA infants showed transient neurological abnormalities (TNA) more frequently than the control group (30.7% vs 6.8% - p < 0.001). 5 SGA (9.6%) and 10 AGA (13.7%) had minor abnormalities (group B); no SGA children and only one AGA had diplegia (group C); 3 SGA (5.8%) and 4 AGA (5.5%) were considered to have severe handicap (group D) SGA children had a higher incidence of epilepsy (3.8% vs 0) than AGA (group E). These results show that in our group of SGA preterm infants the union of intrauterine growth retardation and prematurity compromise the possibility of survival.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMedDate not supplied

[Pharmacokinetics of ceftriaxone in the first three month of life].

The purpose of the study was to define more precisely ceftriaxone kinetic variations in neonates and infants during the first three months of life. Ceftriaxone pharmacokinetics were studied in 14 newborns and infants with gestational age ranging from 31 to 42 weeks and younger than three months of postnatal age. Ceftriaxone was administered as an intravenous bolus injection over 15 min at a dose of 50 mg/Kg every 24 hours, for a period of 7 to 28 days according to the bacterial diseases. 13 patients had normal renal function and one had a chronic renal insufficiency. Plasma and urine concentrations were measured by a specific HPLC assay. The mean plasma concentration was 180.7 +/- 19.9 ug/ml (mean +/- SD) 30 min after the beginning of the infusion. After 24 h the plasma value was 29.9 +/- 10.0 ug/ml. The mean elimination half-life (t1/2) was 19.9 h, the total clearance (CL) of the drug was 0.38 ml/min/Kg and the volume of distribution (Vd) was 0.32 l/Kg. About 52% of the administered dose was excreted unchanged in urine. In the patient with renal insufficiency we observed t1/2 = 38.9 h and CL = 0.10 ml/min/Kg. Only a slight accumulation of the drug (from 180.7 +/- 19.9 ug/ml to 223 +/- 15.5 ug/ml) was observed during multiple dosing. The volume of distribution and the plasma half-life were significantly correlated (negative correlation) to the postnatal age. There was no correlation between clearance and postnatal age. No side effects were observed in newborns and infants after administration of ceftriaxone.

Bacterial Infections↗