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Biomedical subjects

N Linder

Publications and source records attributed to N Linder.

At least 37 records · Page 2Linked to original sources
PubMed1998

A simple clinical test for differentiating physiological from pathological head lag in full-term newborn infants.

UNLABELLED: This prospective study was designed to assess the value of a simple clinical test, a "feeding test", on the outcome of head lag among term neonates. Of 5718 infants who were examined before their morning meal, 67 had moderate to severe head lag in the absence of predisposing risk factors for head lag. Fifteen minutes following feeding, 62 infants (92%) showed an improvement in or disappearance of head lag with concomitant rise in serum glucose. All of these infants had normal psychomotor development on follow up. In 4 infants in whom no improvement occurred after feeding, an underlying pathological cause for head lag was subsequently diagnosed. CONCLUSION: Use of the feeding test as a screening procedure in apparently healthy newborns with head lag may rule out pathological conditions in over 90% of the cases.

Blood Glucose↗
PubMed1998

Circulating xanthine oxidase and neutrophil activation during human liver transplantation.

BACKGROUND & AIMS: Oxygen free radicals, generated by xanthine oxidase (XO) and activated leukocytes, are involved in reperfusion injury in experimental liver transplantation. The roles of XO and neutrophil activation during reperfusion in clinical liver transplantation were studied. METHODS: In 10 patients undergoing liver transplantation, we assessed plasma concentrations of circulating XO by enzyme-linked immunosorbent assay (ELISA), the purine metabolites hypoxanthine, xanthine, and urate by high-performance liquid chromatography, lactoferrin by ELISA, and malondialdehyde fluorometrically up to 48 hours postoperatively. RESULTS: During reperfusion after portal vein declamping, elevated plasma concentrations of XO (52.1 ng/mL [range, 8.0-440.1]), hypoxanthine (81.62 micromol/L [48.2-108.7]), xanthine (21.01 micromol/L [8.7-22.3]), and lactoferrin (532.6 ng/mL [370.4-1326.6]) were observed compared with the preoperative levels (0 ng/mL [0-12], 1.88 micromol/L [0.62-3.15], 0.95 micromol/L [0-0.41], and 164.3 ng/mL [73.7-334.1], respectively; all P < 0.05). No changes occurred in urate or malondialdehyde. After portal vein declamping, XO, hypoxanthine, and xanthine levels were substantially greater in the hepatic than portal vein (all P < 0.05). Marginal transhepatic differences occurred in lactoferrin. CONCLUSIONS: Reperfusion during liver transplantation is associated with liberation of xanthine oxidase, hypoxanthine, and xanthine from the liver into the circulation. During reperfusion, intravascular neutrophil activation takes place in the hepatic circulation.

Adult↗
PubMed1998

Primary cutaneous mucormycosis in a premature infant: case report and review of the literature.

Mucormycosis is an uncommon infection caused by fungi of the order Mucorales, family Mucoraceae, and almost always occurs in individuals with predisposing factors such as diabetes mellitus, metabolic acidosis, or immunodeficiency states. Although mucormycosis is a rare infection in childhood, sporadic cases of skin infections have been described in young infants and older children; primary skin infection has been associated with multiple nosocomial outbreaks caused by contaminated elastic bandages. In all reported cases involving premature infants, the elimination of the infection involved surgical debridement. We report for the first time successful conservative treatment with intravenous amphotericin B in a premature infant with primary cutaneous infection caused by Rhizopus oryzae.

Amphotericin B↗
PubMed1998

Local application of honey for treatment of neonatal postoperative wound infection.

Honey has been described in ancient and modern medicine as being effective in the healing of various infected wounds. In this report we present our experience in nine infants with large, open, infected wounds that failed to heal with conventional treatment. Conventional treatment was defined as having failed if after > or = 14 d of intravenous antibiotic and cleaning the wound with chlorhexidine 0.05% W/V in aqueous solution and fusidic acid ointment the wound was still open, oozing pus, and swab cultures were positive. All infants showed marked clinical improvement after 5 d of treatment with topical application of 5-10 ml of fresh unprocessed honey twice daily. The wounds were closed, clean and sterile in all infants after 21 d of honey application. There were no adverse reactions to the treatment. We conclude that honey is useful in the treatment of post-surgical wounds that are infected and do not respond to conventional systemic and local antibiotic treatment.

Honey↗
PubMed1998

Immunogenicity of hepatitis B vaccine in preterm infants.

AIM: To assess the immunogenicity of hepatitis B vaccine in preterm and term infants, given in a sequence of three doses beginning soon after birth. METHOD: The immunogenicity of hepatitis B vaccine was assessed in 176 preterm infants (< 35 weeks of gestation), immunised soon after birth, and compared with that in 46 term infants. Titres of hepatitis B antibodies were determined one to two months after the third vaccine. The significance of the differences between the term and preterm groups was determined using Student's t test. RESULTS: A similar proportion of infants in both preterm and term groups attained protective titres of hepatitis B antibodies (88.7% vs 93.4%, respectively; p = NS). However, the term infants had a higher geometric mean titre of antibodies after the third vaccine than did the preterm infants (701.2 (745.0) vs 469.1 (486.2) mU/ml, respectively; p < 0.03). CONCLUSION: Hepatitis B vaccine is effective in most preterm infants when given soon after birth. It may be advisable to determine the immune response at 12-24 months of age to booster the non-responders.

Antibody Formation↗
PubMed1997

Topical iodine-containing antiseptics and subclinical hypothyroidism in preterm infants.

The influence of topical iodine-containing antiseptics on thyroid function test results of premature infants was determined in two separate studies. Thyroxine and thyrotropin levels were measured on blood-spotted filter paper. Samples were obtained from 128 premature infants on their tenth day of life; the infants were treated in two neonatal intensive care units. Both units used similar treatment protocols; however, one routinely used topical iodinated antiseptic agents (n = 73), whereas the other used chlorhexidine-containing antiseptics (n = 55). There was no difference in the mean T4 levels between the two groups. The mean thyrotropin levels were elevated in preterm babies exposed to iodine (15.4 vs 7.8 mIU/L, p < 0.01). Among the iodine-exposed infants, elevated thyrotropin levels (> 30 mIU/L) were found in 13.7% of infants, compared with none in the chlorhexidine-treated group (p < 0.01). We then studied an additional 46 premature infants who were treated in one neonatal intensive care unit. Iodine-containing solutions were used in 24 infants and chlorhexidine was used in 22 infants. T4 and thyrotropin levels were measured weekly during the first 28 days, one every 2 weeks until the age of 60 days, and at the age of 90 days. Among iodine-exposed infants, 20.8% had thyrotropin values > 30 mIU/L, whereas none of the infants in the chlorhexidine group had elevated thyrotropin values (p < 0.05). The elevated thyrotropin levels correlated positively with the area of disinfection. Elevated urine iodine levels were present reflecting an abnormally high iodine absorption. This study suggests that iodine absorption from topical iodine-containing antiseptics may cause disturbances in thyroid function test results in premature infants. We recommend that caution be exercised in the use of iodine-containing antiseptics in premature infants.

Anti-Infective Agents, Local↗
PubMed1997

Echovirus type 22 outbreak associated with gastro-intestinal disease in a neonatal intensive care unit.

An echovirus type 22 outbreak involving 19 neonatal intensive care unit (NICU) patients during the months of October and November 1992 is reported. Twelve infants presented with diarrhea, 7 of whom had bloody stools and x-ray findings compatible with early stages of necrotizing enterocolitis, while one infant demonstrated characteristic pneumatosis intestinalis. Outbreaks of echovirus type 22 infection in premature infants have rarely been reported. The possibility of Echovirus 22 infection should be considered in neonatal gastrointestinal disease associated with features of necrotizing enterocolitis.

Antibodies, Viral↗
PubMed1997

Iodine and hypothyroidism in neonates with congenital heart disease.

AIM: To evaluate the influence of the intravenous injection of iodine during cardiac catheterisation, and of topical iodine antiseptics during surgical procedures, on thyroid function in full term neonates. METHODS: Twenty one full term infants with major cardiac anomalies who survived for more than a month were studied. Thyroxine and thyrotropin concentrations were measured (by radioimmunoassay) before each procedure, 24 hours after the procedure, and every week thereafter until the age of 1 month or until normal. Thyroxine values less than 64.4 nmol/l were considered low, while thyrotropin values greater than 30 mU/l were considered high. RESULTS: Thyroid function tests before iodine exposure were within normal limits in all infants. Following catheterisation or surgery six infants had raised thyrotropin concentrations; three had low thyroxine concentrations. Two of those infants were treated with L-thyroxine. CONCLUSION: Iodine exposure during cardiac catheterisation or surgery may induce transient hypothyroidism in term infants.

Anti-Infective Agents, Local↗
PubMed1997

Urine samples from disposable diapers: an accurate method for urine cultures.

BACKGROUND: The method of collection of the urine sample is of paramount importance in making a diagnosis of urinary tract infection in infants and children. Squeezing urine out of disposable diapers can provide a urine sample that can be used to detect chemical abnormalities as well as a specimen suitable for microscopic examination. To date there have been no reported studies on the use of this technique for urine culture as compared with samples collected by suprapubic aspiration and catheterization. METHODS: Urine was obtained from 38 infants aged under 2 years who presented with fever with no obvious cause. All infants had urine collected either by catheterization or suprapubic aspiration and by extraction from a disposable diaper. The urine samples were cultured using standard bacteriologic techniques. RESULTS: Five infants had a urinary tract infection, as shown by a pure growth of more than 10(5) colonies/mL of a single species of bacterium. In all the cases the same result was obtained from both the diaper urine sample and the sample obtained by suprapubic aspiration or catheter. In 31 infants the urine samples collected by both techniques (diaper and catheter or suprapubic aspiration) were negative, and in only 2 infants did the diaper specimen yield a positive result, while the urine obtained by suprapubic aspiration or catheter was sterile. CONCLUSIONS: Urine obtained from a disposable diaper can provide a valid sample for diagnosing urinary tract infection. The technique is simple, and can be carried out readily in ambulatory settings with minimal equipment and expense.

Disposable Equipment↗
PubMed1996

Hypoxemia associated with cimetidine therapy in a newborn infant.

Cimetidine therapy used for the treatment of gastric bleeding due to tolazoline therapy in a newborn infant was temporally associated with episodes of severe hypoxemia. It appears likely that the histamine H2 receptor blocked by cimetidine obviated the pulmonary vasodilator effect of tolazoline therapy.

Adrenergic alpha-Antagonists↗
PubMed1996

Organ distribution and molecular forms of human xanthine dehydrogenase/xanthine oxidase protein.

Xanthine dehydrogenase/xanthine oxidase (XDH/XO) is a major cytoplasmic source of superoxide radicals and hydrogen peroxide, and it is considered important in the pathogenesis of ischemia-reperfusion damage. Because little is known about the enzyme in human tissues, the aims of this study were to purify human XDH/XO and to produce Ab for detection of the protein in Western blots and for quantification by ELISA. We purified human milk XDH/XO, produced Ab for Western blotting and ELISA of the protein, and evaluated the molecular forms and activity-protein relationships in human tissues. The molecular size of the purified protein under nondenaturing conditions was approximately 300 kd. On SDS-PAGE, it was fragmented into four main bands of 143, 125, 87, and 59 kd. Ab recognized bands of similar size in Western blots of the purified preparation and human milk. In fresh liver homogenates treated with anti-proteases, the three largest bands were observed; in the intestine, only the two largest were observed. Serum, brain, heart, and skeletal muscle were negative, whereas some lung and kidney samples showed one faint band of 143 kd. Trypsin treatment of the enzyme converted the large molecular-weight bands into smaller bands, as did incubation of a liver homogenate without anti-proteases. XDH/XO protein concentrations (ng/mg total protein) were 146 +/- 70 in liver and 556 +/- 320 in intestine and less than 5 ng/ml in serum. The relationship of activity to protein (2.7-3.0 mumol/min/mg XDH/XO protein) was constant in liver and intestine during development. We conclude that 1) human XDH/XO has molecular size and subunit structure similar to other mammalian enzymes; 2) the polypeptide chain is unstable, also in the intact cell, despite retained activity; and 3) the amount of inactive XDH/XO in human liver and intestine is apparently small.

Adult↗
PubMed1996

Metastasis of chondrosarcoma.

This study was undertaken to analyse metastases of patients with intermediate- or high-grade chondrosarcomas. Out of 24 intermediate-grade tumours, 5 (21%) developed metastases, as did 6 of 10 high-grade tumors (60%) (P = 0.04). Four patients developed pulmonary metastasis only, 5 developed both pulmonary metastasis and metastases of the other sites. Two patients showed a rare metastatic pattern: bone metastases only. The metastasis rate in the primary chondrosarcoma (42%) was higher than that in the secondary chondrosarcomas (0%) (P = 0.03). The metastasis rate was higher in patients with local recurrence (86%) than in those without local recurrence (19%) (P = 0.01). In 5 of 6 patients who had a local relapse and metastasis, the interval between the two relapses was a few months.

Cytomegalovirus↗