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Biomedical subjects

O Claris

Publications and source records attributed to O Claris.

At least 19 recordsLinked to original sources
PubMed1998

Gastric necrosis in newborns: a report of 11 cases.

Eleven neonates ranging in gestational age from 34 to 40 weeks presented with gastric necrosis. The 4 full-term neonates showed sudden-onset hemorrage and "coffee-ground" vomiting; in the 7 premature babies the initial clinical finding was abdominal distention. The criteria for diagnosis were: perinatal distress in prematures and transient neonatal respiratory distress in full-term babies. Radiographic evidence of gastric distention was typical and preceded clinical signs of hematemesis and gastric perforation. Surgery was performed in 8 patients; 3 received medical treatment. At surgery 1 total and 3 subtotal gastrectomies and 4 segmental gastric resections were performed. Three of these patients died post-operatively as a consequence of multiorgan failure; a second look was necessary in one patient 1 week after surgery because of prepyloric perforation due to ulcers. Biopsy specimens taken from the site of perforation demonstrated extensive necrosis; ulceration was disseminated in the surrounding gastric mucosa; no signs of phlogosis were detected. The diagnosis, treatment, and physiopathologic considerations are reviewed.

Biopsy↗
PubMed1998

Multiple hormone resistance in short children born with intrauterine growth retardation?

Intrauterine growth retardation (IUGR) is encountered in 2.5% (-2 SD) of newborns. Lack of postnatal catch-up growth is found in 8-20%. If GH secretion is increased early postnatally in IUGR, then some persistently short IUGR children may present with GH insufficiency. However, the mechanism of postnatal catch-up growth is heterogenous. The response to GH treatment with regard to plasma IGF-1, GH dose and growth velocity was analyzed in persistently short idiopathic IUGR children and compared to GH-deficient (GHD) and familial short stature (FSS) children of similar age and degree of short stature. IUGR children require both a greater basal and GH-induced plasma IGF-1 in order to achieve a growth velocity of similar magnitude to that of FSS and GHD children. These data suggest a different sensitivity to GH in IUGR compared to FSS or GHD children, sustaining the hypothesis that these idiopathic IUGR children may be partially IGF-1 resistant. The recent report of partial insulin resistance in IUGR subjects raises the possibility of an IGF-1 receptor- or post-receptor-mediated defect.

Drug Resistance, Multiple↗
PubMed1997

Body composition in appropriate and in small for gestational age infants.

The body composition of 70 appropriate for gestational age newborn infants whose gestational age ranged from 32 to 41 weeks was determined by dual-energy X-ray absorptiometry during the first 48 h of life. The evolution of the bone mineral content, fat and lean mass was well correlated with gestational age (r = 0.66, r = 0.66 and r = 0.82, respectively) but even more closely with birthweight (r = 0.85, r = 0.91 and r = 0.97, respectively). The body composition of 20 symmetric small for gestational age infants (mean gestational age +/- SD = 38.1 +/- 1.2 weeks; mean birthweight +/- SD = 2117 +/- 183 g) was also studied. The total body fat, the lean mass and the bone mineral content of small for gestational age infants were decreased significantly in comparison with those of appropriate for gestational age infants with the same gestational age (p < or = 0.05, p < or = 0.0001 and p < or = 0.05) but was not significantly different from those observed in appropriate for gestational age infants of the same birthweight.

Absorptiometry, Photon↗
PubMed1997

High frequency oscillation and exogenous surfactant in the treatment of neonatal respiratory distress syndrome.

Surfactant therapy has become widely used in neonates suffering from respiratory distress syndrome. High frequency oscillation has been shown to be efficient and safe in animal models, but somewhat less convincing in human neonates. An overview is given of the experimental and clinical data assessing the combination of these two techniques. Personal preliminary data are briefly presented.

Animals↗
PubMed1997

Aetiology, morphology and body composition of infants born small for gestational age.

Infants born small for gestational age (SGA) are a heterogeneous group. Both the timing and duration of the intrauterine insult determine the physical condition and body composition of the infant at birth. Infants with symmetrical intrauterine growth retardation (IUGR) have a similar body composition at birth to weight-matched infants born appropriate for gestational age. However, these infants are more likely to remain shorter and lighter than normal infants. In contrast, infants with asymmetrical IUGR have reduced fat deposition but are more likely to exhibit catch-up growth during the first few months of life. The low mortality and morbidity rates in infants born SGA observed in recent studies are linked to their appropriate perinatal management, including adequate early nutritional support.

Body Composition↗
PubMed1997

Use of dual-energy X-ray absorptiometry for the measurements of small quantities of mineral.

The aim of the study was to assess the precision and the accuracy of whole-body dual-energy X-ray absorptiometry (DXA) measurements of low quantities of mineral. Six stillborn infants were measured three times in order to assess the precision in vivo. Powdered bone tablets were also measured three times separately or in compact groups (0.32-41.7 g of hydroxyapatite) by whole-body DXA. Mean correlation coefficients were 6.85 +/- 5.99 and 6.74 +/- 6.58% in vivo and in vitro, respectively. DXA-based estimates of the tablets were highly correlated with the actual bone mineral content (BMC; r = 0.99, p = 0.0001). The mean difference between DXA values and the reference values was 2.55 +/- 10.93%, but the agreement between DXA results and reference values rose to 3.99 +/- 3.49% for BMC above 10 g. Very small amounts of mineral can be measured by whole-body DXA, but assessment of an infant with a BMC less than 10 g should be made with care.

Absorptiometry, Photon↗
PubMed1997

Diabetes during pregnancy does not alter whole body bone mineral content in infants.

A previous study using single photon absorptiometry has reported low bone mineral density of the radius in infants of diabetic mothers. The aim of this study was to assess by dual x-ray absorptiometry the whole body bone mineral content (WbBMC) and the body composition of 40 infants of diabetic mothers at birth (mean gestational age +/- SD, 37.5 +/- 1.3 weeks; mean birth weight +/- SD, 3815 +/- 641 g). WbBMC was not correlated with gestational age, but was well correlated with birth weight (r = 0.73; P = 0.0001) and also with fat mass (r = 0.87; P = 0.0001) and lean mass (r = 0.42; P = 0.008). The z-scores +/- SD adjusted for weight for WbBMC and fat mass were significantly increased (1.3 +/- 0.9 and 2.6 +/- 1.3, respectively (P < 0.0001), but were not significantly influenced either by in utero growth or by the type of the diabetes mellitus of the mother. Bone mineralization and fat mass studied by whole body dual x-ray absorptiometry are increased at birth in these infants compared with reference curves.

Absorptiometry, Photon↗
PubMed1996

[Outcome of blood gas parameters during the first 24 years after Exosurf administration].

BACKGROUND: There is now good evidence that the clinical course of infants with respiratory distress syndrome can be improved by treatment with exogenous surfactant. However, optimal methods of giving such a treatment are still debated. POPULATION AND METHODS: The arterial blood gases and the arterial/alveolar oxygen tension ratio (a/A) were recorded during the 24 hours following artificial surfactant (Exosurf) treatment in 400 newborns aged 25 to 42 gestational weeks. A positive response was defined by an a/A ratio > 0.22 or an increase in a/A ratio up to 25%. RESULTS: After administration of the first dose, a positive response was obtained in 63% of cases during the first 6 hours and 11% during the 6 following hours. The response after the second dose was favourable in 75% of cases. At 24 hours after treatment, 36% of the infants had obtained an a/A ratio > 0.22. CONCLUSION: Because of the 18% of infants who responded positively only after the second dose, administration of this dose seems justifiable even in case of non-response to the first dose. The quality of the response is related to the severity of the pulmonary illness but is independent of the gestational age.

Analysis of Variance↗
PubMed1996

[New technique of nasal continuous positive pressure in neonatology].

BACKGROUND: Early treatment with nasal continuous positive airway pressure (CPAP) in newborns with respiratory distress syndrome is useful, by recruiting alveoli and restoring the functional residual capacity. POPULATION AND METHODS: Nasal CPAP was supplied by the Infant Flow Driver (Electro Medical Equipment). From 15 June 1994 to 15 December 1994, 42 neonates received nasal CPAP. Their mean birthweight and gestational age were 1511 +/- 411 g and 30.9 +/- 2.5 weeks, respectively. Fifteen infants had been ventilated for hyaline membrane disease and nasal CPAP was applied immediately after extubation. In the other 27 infants, nasal CPAP was given soon after birth (respiratory distress syndrome: 20 neonates; apneic spells: seven neonates). RESULTS: Three infants needed subsequent mechanical ventilation because of the severity of the disease (one had spontaneous pneumothorax); four infants received exogenous surfactant (Curosurf, one single dose) within a brief period of mechanical ventilation (30-45 min). There were no failure of extubation, and no intracranial lesions. Excess of pharyngeal secretion and abdominal distension were common. CONCLUSION: Early treatment with nasal CPAP reduces the need for mechanical ventilation. Furthermore, surfactant therapy required by a moderate to severe disease is possible with a rather short period of artificial ventilation.

Apnea↗