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Biomedical subjects

N Linder

Publications and source records attributed to N Linder.

At least 73 records · Page 4Linked to original sources

Adenovirus type 8 conjunctivitis outbreak in a neonatal intensive care unit.

An outbreak of adenovirus type 8 conjunctivitis occurred in seven premature infants who had undergone ophthalmological examination four to seven days previously. Three of the affected infants, treated with steroids because of bronchopulmonary dysplasia, showed systemic manifestations and deterioration of their respiratory disease. Second and third waves affected nine staff and 12 family members.

Adenovirus Infections, Human↗

Safety of vancomycin with or without gentamicin in neonates.

Short- and long-term side effects of vancomycin, or the combination of vancomycin and gentamicin, were retrospectively evaluated for 65 treatment courses in 47 premature infants who were exposed to high vancomycin serum concentrations. Thirty-five treatment courses involved treatment with the combination; 30 courses involved treatment with vancomycin alone. No immediate side effects were noted. Nephrotoxicity, defined as an increase in serum creatinine 0.5 mg/dl or more above baseline, was found in only 1 patient receiving vancomycin as the only antibiotic; that patient had pre-existing renal dysfunction. Three treatment courses involving the vancomycin-gentamicin combination resulted in nephrotoxicity; renal function returned to normal by 14 days after treatment. Thrombocytopenia was noted in 5 patients, but none exhibited clinical bleeding. Low platelet counts persisted throughout treatment, but by two weeks after treatment, this was resolved. In conclusion, the use of vancomycin or the combination of vancomycin and gentamicin in seriously ill premature infants is usually safe. The adverse effects noted were reversible, and monitoring creatinine and platelet counts during treatment is recommended.

Drug Monitoring↗

Congenital myopathy with oculo-facial abnormalities (Marden-Walker syndrome).

Marden-Walker syndrome present in the neonatal period is characterized by oculo-facial abnormalities, congenital myopathy, and contractures. A newborn infant with a similar pattern of anomalies is reported, and further evidence for autosomal recessive inheritance as well as new neuropathological findings are included.

Contracture↗

Prevalence of HBsAg carriers in native and immigrant pregnant female populations in Israel and passive/active vaccination against HBV of newborns at risk.

Israel has no official prevention policy at present against perinatal and horizontal transmission of hepatitis B virus (HBV) infection in newborns and children at risk. The present study was designed to assess the prevalence of HBV carrier state in a population of 11,123 pregnant women at term. Among this population (mean age 29.7 +/- 5.9), 98 women (0.88%) were found to be asymptomatic HBsAg+ carriers, and 97% of these carriers were anti-HBe+. Evidence for HBV replication, as determined by serum HBV-DNA, was established in 6.6% of the HBsAg+/anti-HBe+ population. The HBsAg carrier rate was strongly influenced by religion, continent, and country of birth of the carrier mothers. The highest relative carrier rate was found among women of Moslem origin (4.3%), as compared to Jewish women (0.67%). Most carrier women were born in Israel (56.1%) to mothers who had emigrated from regions with intermediate or high endemicity of HBV, such as North Africa or the Middle East. In these groups, the HBsAg carrier rate ranged between 1.2 and 3.0%. Ninety-three percent of newborns receiving passive/active vaccination against HBV developed protective levels of anti-HBs. Finally, evidence for horizontal transmission of HBV was found in 19.3% of 83 non-vaccinated children in families of HBsAg carriers. The present study therefore establishes HBsAg prevalence rates in specific risk groups of women at term and confirms the need for an official policy on immunization against HBV in Israel. Since over 50% of women at term belong to the defined risk groups, universal active vaccination of the entire newborn population each year is suggested as the most rational and needed policy in Israel.

Adolescent↗

Treatment of neonatal immune thrombocytopenia with high dose intravenous gamma-globulin.

Five term neonates diagnosed with immune thrombocytopenia were treated with 1 g/kg/day intravenous gamma-globulin. Clinical and laboratory evidence of thrombocytopenia resolved completely in 4 of the 5 patients after a single dose. Only 1 patient received a second dose of the drug. This treatment protocol requires less gamma-globulin than other protocols to safely reduce length of hospitalization.

Autoimmune Diseases↗

Suckling stimulation test for neonatal tremor.

The response of neonatal tremor to a suckling stimulation test was investigated in 102 healthy neonates born at full term. In 84 the tremor resolved immediately; none had hypocalcaemia and only one had mild hypoglycemia. Eighteen in whom the tremor continued had either hypocalcaemia (n = 13) or hypoglycaemia (n = 5).

Humans↗

Auditory nerve and brain stem evoked response thresholds in infants treated with gentamicin as neonates.

Thirty-two infants (18 full-term and 14 premature) who had been treated with gentamicin as neonates were examined to ascertain whether this drug induced hearing loss, even of low severity. Objective thresholds to clicks were obtained using auditory nerve and brain stem evoked responses. In addition, behavioral audiometry was performed. Serum concentrations before and after gentamicin treatment were at therapeutic levels. All infants were examined at least 1 1/4 months after cessation of therapy. Normal thresholds were obtained in all ears, with the exception of two with demonstrable middle ear effusion. It appears that gentamicin in therapeutic doses and serum concentrations, in the absence of renal insufficiency, does not cause hearing loss in neonates.

Evoked Potentials, Auditory↗

An oral zinc loading test in psoriasis.

Changes of zinc in body fluids were evaluated in 12 patients with extensive psoriasis and compared with those of 11 healthy volunteers, using an oral zinc loading test. Plasma zinc levels and urinary zinc excretion were measured by atomic absorption spectrophotometry. No significant difference was found between plasma zinc levels and urinary zinc excretion following an overnight fast. Both groups showed extensive increases in urinary zinc excretion following the loading test. The peak levels of plasma zinc were significantly lower in the psoriatic patients two and four hours after zinc ingestion (P less than .01 and P less than .02, respectively).

Administration, Oral↗

Need for endotracheal intubation and suction in meconium-stained neonates.

In a prospective study, we determined whether routine immediate tracheal aspiration at birth is necessary in meconium-stained but otherwise normal infants delivered vaginally and having a 1-minute Apgar score greater than 8. A total of 572 newborn infants who met these criteria were randomly allocated to one of two groups. All infants underwent oropharyngeal suctioning with a DeLee catheter while the head was still on the perineum. In group I (n = 308) suctioning of the trachea under direct vision was performed instantly at birth; in group II (n = 264) this procedure was not done. There was no mortality among infants in the study, but morbidity, mainly pulmonary and laryngeal disorders, occurred in six of 308 group I infants and in none of the group II infants (P less than 0.025). Immediate tracheal suction is not a harmless intervention, and should be considered superfluous in a vigorous term neonate born with meconium-stained amniotic fluid.

Apgar Score↗

Serum ferritin levels in preterm infants after multiple blood transfusions.

We have examined the effect on iron stores of blood transfusions given to premature neonates during hospitalization in the neonatal intensive care unit as reflected by serum ferritin levels measured for 6 months after discharge. Premature infants who were transfused with more than 100 ml packed cells (group D; n = 11) had higher ferritin levels for a longer period than premature infants who were transfused with smaller volumes (group c; n = 9) or premature and mature infants who were not transfused at all (group B; n = 24 and group A; n = 21, respectively). At 4-5 months the serum ferritin levels in group D (489.8 +/- 132.1 micrograms/L; mean +/- SEM) were significantly higher (P less than 0.001) than those of the other groups. The level of group A term infants (77.5 +/- 12.5 micrograms/L) was higher than those of group B premature infants who did not receive a blood transfusion (33.0 +/- 7.1 micrograms/L) or group C who received less than 100 ml (36.5 +/- 8.8 micrograms/L packed red blood cells. However, these differences were not statistically significant. Our data demonstrate that very-low-birthweight infants who receive a large volume of packed cells during hospitalization may accumulate iron stores sufficient for red cell production during the first 6 months of life. Administration of large amounts of supplemental iron, in such cases, may be curtailed.

Anemia, Hypochromic↗

Unexplained neonatal jaundice as an early diagnostic sign of septicemia in the newborn.

This prospective study was performed to determine the frequency of unexplained unconjugated hyperbilirubinemia associated with bacterial infection during the first week of life. Of 5805 infants delivered between September 1984 and December 1986, 93 jaundiced newborns without evidence of septicemia fulfilled the following criteria to be enrolled in the study: weight greater than 2500 g, gestational age greater than 38 weeks, age less than 7 days, and unexplained unconjugated bilirubin greater than 170 mumol/L (greater than 10 mg/dL) during the first 48 hours of life and/or greater than 255 mumol/L (greater than 15 mg/dL) thereafter. Evaluation for septicemia included blood and urine cultures, and white cell and thrombocyte counts. The study disclosed three (3.2%) infants who developed septicemia before any clinical suspicion had been aroused. It is concluded that bacterial infections should be considered a possible cause of neonatal unconjugated hyperbilirubinemia during the first week of life, regardless of the clinical condition of the infant.

Female↗

Neonatal auditory acuity following in utero vibratory acoustic stimulation.

The fetal heart rate response to externally applied vibratory acoustic stimulation is currently being evaluated as a test of fetal well-being. We have examined the safety of this procedure by subsequent testing of the auditory nerve and brain stem evoked responses in the neonates. The results demonstrated no differences in auditory acuity when control infants were compared with infants previously exposed to antenatal vibratory acoustic stimulation.

Acoustic Stimulation↗

Excretion of dipyrone metabolites in human breast milk.

Breast milk and plasma levels of dipyrone metabolites in 8 mothers given a single oral dose of the drug were determined by HPLC. Four metabolites were demonstrated by the analytical method: 4-methylaminoantipyrine (MAA), 4-aminoantipyrine (AA), 4-formylaminoantipyrine (FAA) and 4-acetylaminoantipyrine (AAA). A good correlation was found between the plasma and milk concentrations of the metabolites. The mean (+/- SD) milk to plasma concentration ratios were: MAA = 1.37 +/- 0.28, AA = 1.15 +/- 0.40, FAA = 1.03 +/- 0.09, AAA = 0.97 +/- 0.24. The disposition pattern of the dipyrone metabolites in milk was studied in two mothers. None of the metabolites was detectable 48 h after drug administration.

Adult↗

L-deamino-8-d-arginine vasopressin treatment in pregnancy and neonatal outcome. A report of three cases.

Three women with neurohypophyseal diabetes insipidus, treated for prolonged periods, including pregnancy, with L-deamino-8-d-arginine vasopressin, gave birth in our hospital. Two of the infants had severe congenital heart disease, one of which was associated with trisomy 21. The third baby, born prematurely, presented with mild intrauterine growth retardation; at the age of 21 months, the boy had severe failure to thrive, hypotonia, and motor retardation. These three cases raise doubts as to the safety of diabetes insipidus or its treatment in pregnancy.

Abnormalities, Drug-Induced↗

Anencephaly and the nature of fetal response to vibroacoustic stimulation.

The fetal response to vibroacoustic stimulation has been used in recent years as a measure of well being. Vibroacoustic stimulation theoretically may evoke both tactile and auditory responses in the fetus. In clinical practice, it is important to distinguish which type of response is actually activated. An answer may be suggested through observation of two anencephalic fetuses who demonstrated no response to such stimulation. Neuroanatomic considerations are discussed that suggest which auditory mechanisms are involved in the fetal response to vibroacoustic stimulation.

Acoustic Stimulation↗