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Biomedical subjects

O Claris

Publications and source records attributed to O Claris.

At least 55 records · Page 3Linked to original sources
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↗
PubMed1996

Incidence of ischemic-hemorrhagic cerebral lesions in premature infants of gestational age < or = 28 weeks: a prospective ultrasound study.

While it is well accepted that the incidence of intraventricular hemorrhage (IVH) increases with decreasing gestational age (GA), the majority of studies report their findings on the basis of birthweight (BW) rather than GA. Over a 5-year period, 199 infants born at or below 28 weeks of gestation were entered into a prospective cranial ultrasound study stratified according to GA. One hundred and five (53%) had normal ultrasound findings. The overall incidence of IVH, as expected, rose with decreasing GA but we were unable to show any clear influence of BW or growth retardation on its occurrence. Incidence of grades I, IIa, IIb and III IVH were 8, 10, 16 and 11%, respectively. Leukomalacia, bleeding in the posterior fossa and in the cerebellum occurred in 4, 7 and 2% of the population, respectively.

Birth Weight↗
PubMed1995

Secular changes in the outcomes to eighteen to twenty-four months of age of extremely low birth weight infants, with adjustment for changes in risk factors and severity of illness.

OBJECTIVES: To analyze secular changes in the rates of death and of major impaired outcome in surviving outborn infants who weighted < or = 800 gm at birth and were admitted in 1980 to 1989, with adjustment for changes in risk factors and severity of illness around the time of birth; and to identify changes in these factors that might explain changes in outcomes. DESIGN: Retrospective cohort study with follow-up to a minimum of 18 months of postterm age. After preliminary screening, multivariate models of association between risk/severity of illness factors and outcomes were constructed, validated, and used to adjust outcomes (death and major impairment to 18 to 24 months of age). SETTING: Regional neonatal intensive care unit for referral of "outborn" infants. PATIENTS: Two hundred eighty-seven consecutively admitted infants who weighted < or = 800 gm at birth (97% follow-up). RESULTS: The death rate during the 1980s did not fall significantly (p adjusted for risk factors = 0.115). The major impairment rate fell (odds ratio, 0.24 (95% confidence interval, 0.10, 0.60); p = 0.002, adjusted for delivery route and respiratory failure measures), mainly because of a reduced rate of blindness, not attributable to cryotherapy. The risk factors that improved and were possibly related to the reduced impairment rate were blood pH and glucose concentration, and serum sodium concentration in the first 48 hours of life. CONCLUSIONS: Despite an increasing selection for referral of less mature and more severely ill outborn babies near the "limit of viability," and despite more aggressive care, the rate of major impairment fell significantly during the 1980s. This trend was enhanced by adjustment for severity of illness. The fall was attributable to a reduced rate of blindness, and was associated with evidence of improved control of physiologic balance after birth.

Apgar Score↗
PubMed1994

Preoperative stabilization using high-frequency oscillatory ventilation in the management of congenital diaphragmatic hernia.

OBJECTIVES: a) To assess the efficiency of preoperative stabilization with the use of high-frequency oscillatory ventilation in the treatment of congenital diaphragmatic hernia; b) to determine early prognosis factors. DESIGN: Prospective, consecutive patient study. SETTING: A tertiary neonatal intensive care unit in a university hospital. PATIENTS: All patients admitted to the neonatal intensive care unit with a diagnosis of congenital diaphragmatic hernia between April 1990 and June 1993 (n = 18). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Eleven infants had an antenatal diagnosis. Ventilatory settings, blood gas values, arterial-alveolar oxygen ratio, and oxygenation index were recorded on admission and every 3 hrs thereafter until surgery. Surgery was performed if the FIO2 was < 0.3 and mean airway pressure was approximately 9 cm H2O, while the infants were ventilated with high-frequency oscillation. Mean duration of high-frequency oscillatory ventilation was 57 +/- 52 hrs before surgery and 60 +/- 104 hrs after surgery. Overall survival rate was 72%. Infants were divided into two groups, according to the time of surgery. Group 1 (n = 12) patients were operated on in the first 48 hrs of life; on admission, all group 1 patients had an arterial-alveolar oxygen ratio of > or = 0.3 and an oxygenation index of < or = 10, and all recovered. Group 2 (n = 6) consisted of patients for whom preoperative stabilization was difficult to achieve. One infant died before surgery. Four other infants had congenital malformations and subsequently died. Only one infant survived. In this group, the arterial-alveolar oxygen ratio and oxygenation index on admission were 0.08 +/- 0.05 and 33.2 +/- 14.6, respectively (p < .01 vs. group 1). CONCLUSIONS: a) This study demonstrated the efficiency of preoperative stabilization using high-frequency oscillation in the treatment of congenital diaphragmatic hernia. b) An arterial-alveolar oxygen ratio of > or = 0.3 and an oxygenation index of < or = 10 on admission are associated with a rapidly completed surgical procedure and a good outcome.

Female↗