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Biomedical subjects

R Paludetto

Publications and source records attributed to R Paludetto.

At least 19 recordsLinked to original sources
PubMed2003

"Safe" hyperbilirubinemia is associated with altered neonatal behavior.

Treatment of neonatal jaundice is currently recommended for higher bilirubinemia levels than before. Using the Brazelton Neonatal Behavior Assessment Scale, we found that a series of 28 healthy, untreated, term neonates with moderate bilirubinemia scored significantly less than an equal number of appropriately matched controls with low bilirubinemia for visual and auditory items, both inanimate and animate. Also, a greater lability of state, a lower self-quieting ability and more frequent tremors were found in the jaundiced group. We conclude that hyperbilirubinemia per se, even in the concentration range where phototherapy is not currently recommended, can give rise to alterations in neonatal behavior.

Acoustic Stimulation↗
PubMed2000

Nonnutritive sucking during heelstick procedures decreases behavioral distress in the newborn infant.

We investigated if nonnutritive sucking (NNS) during heelstick procedures alleviates behavioral distress in neonates. In our NICU, 26 neonates without severe complications (mean Minde score 0.8, range 0-3), undergoing heelstick procedures at least twice a day, in the first 2 weeks of life, were enrolled in the trial (mean gestational age 33.9 weeks, range 26-39 weeks, mean birth weight 1, 988.5 g, range 1,200-4,010 g, mean Apgar score at the first minute 6. 7, range 4-10, at the fifth minute 8.5, range 6-10). Two heelpricks were performed in each neonate with NNS randomly assigned. Behavioral states, transcutaneous oxygen tension (TcPO(2)), heart rate, and respiratory rate were monitored before, during and after the heelstick procedures. Heelstick procedures lasted for a mean of 109 s (range 50-230 s) with NNS, and a mean of 128.8 s (range 20-420 s) without NNS. Compared with baseline, heart rate and behavioral distress increased and respiratory rate decreased during heelstick and after heelstick. Oxygen tension did not change. Nonnutritive sucking had no effect on respiratory rate or transcutaneous oxygen tension, but reduced the time of crying and the heart rate increase during the procedure. In conclusion, NNS can be recommended to reduce distress in newborns undergoing invasive routine procedures. Further studies are needed to evaluate the effects of NNS on respiratory rate and blood gas levels.

Blood Specimen Collection↗
PubMed1997

Clinical approach to the analysis of causes of death in the first two years of life of very-low-birthweight infants in a multicentre setting.

Mortality in the first 2 years of 634 very-low-birthweight infants admitted to eight neonatal intensive care units in Italy, and the factors associated with the net probability of death from each cause, were studied by means of the Cox proportional hazard model. A clinical classification of the causes of death was used. Overall mortality was 33.7% (intercentre range 12.6-52.9%). The highest cause-specific mortality rates were observed for respiratory problems, intra-ventricular haemorrhage (IVH) and infections (14.5%, 6.3% and 5.7% respectively). The leading causes of death were respiratory problems and IVH in the first week of life, infections from the second week up to the end of the first month, and bronchopulmonary dysplasia (BPD) afterwards. Birthweight < 1000 g, gestational age < 30 weeks, absence of spontaneous respiratory activity, unknown body temperature and pH < 7.20 at admission were associated with death from respiratory problems and IVH. Male sex, birthweight < 1000 g and unknown body temperature at admission were associated with death from BPD. Mortality from infections was higher in one centre; no other differences emerged among the eight NICUs. The classification of the causes of death employed and the use of the net probabilities of death appear as practical and useful instruments to study the relationship between specific aspects of medical care and mortality, and to investigate the reasons for differences in performance between neonatal units.

Cause of Death↗
PubMed1997

Cholestasis in newborn infants with perinatal asphyxia.

OBJECTIVE: The aim of this study was to characterize the liver involvement in infants who have both neonatal asphyxia and neonatal cholestasis. METHODS: We describe four asphyctic newborn infants (three born at term) who developed early (age 3.8 +/- 2.1 days) intrahepatic neonatal cholestasis and in whom tests for causes of neonatal liver damage were negative. RESULTS: The clinical picture and course were benign and similar to that of sporadic "idiopathic" neonatal hepatitis. Clinical signs and abnormal liver function tests tended to normalize within the first year of life in all. Conjugated bilirubin became normal at 6 months after the onset of cholestasis, while liver enzymes tended towards normal values thereafter, within 1 year of follow-up. Liver biopsy (taken in one patient) showed a typical picture of giant cell hepatitis; ultrastructure was nonspecific. SIGNIFICANCE: Our results suggest that isolated asphyxia should be taken into account as a potential causal factor in term or pre-term asphyctic newborns who develop early "idiopathic" neonatal cholestasis.

Asphyxia Neonatorum↗
PubMed1994

Rubella embryopathy after maternal reinfection.

Reinfection with rubella is possible. The real risk for fetus and newborn is not known, as are the incidences of rubella reinfection during pregnancy and congenital rubella infection after maternal reinfection.

Antibodies, Viral↗
PubMed1990

Pulsatile weight increases in very low birthweight babies appropriate for gestational age.

The weight increment profiles of 20 low birthweight babies measured during the first two months of extrauterine life were analysed. The babies were weighed daily, and the weight profiles showed minor irregularities when compared with an interpolated linear trend. When increments were plotted at two week intervals a linear increase in weight velocity was seen, but when increments were computed every three days, the velocity profile was non-linear and pulsatile. All cases studied showed regular pulsatile patterns of weight velocity during the first two months of life. A mean profile of the 20 babies permitted estimation of the periodicity of the pulsing: the cycle alternated every nine to 11 days. A non-linear pattern was found in the published series of unsmoothed data that have been widely adopted as standards for growth in low birthweight babies.

Female↗
PubMed1988

Birth weight of Italian infants of 30 weeks' gestation or less.

Mean birth weights and percentile charts are given for 161 singleton infants born between 24 and 30 weeks' gestation at the 2nd School of Medicine of Naples. This chart is the first for a Mediterranean population. Our data are similar to those reported from a United Kingdom population and from Japan, suggesting that ethnic differences in birth weight at this gestational age are unimportant.

Birth Weight↗
PubMed1987

A case control study of necrotizing enterocolitis occurring over 8 years in a neonatal intensive care unit.

The perinatal histories of 27 newborn infants with NEC were compared to those of 54 infants of equivalent birth weight who did not have NEC during an 8-year study period to see if possible predisposing factors were independent of the confounding effect of birth weight. No differences were observed in gestational age, degree of intrauterine growth retardation, premature rupture of membranes, perinatal asphyxia, skin temperature at admission, haematocrit, presence or absence of respiratory distress syndrome, umbilical catheter placement, start and type of feeding or presence of positive blood cultures. Prematurity is the greatest risk factor predisposing to the development of NEC and the perinatal problems which precede the onset of NEC are common among all premature infants.

Birth Weight↗
PubMed1986

Interaction between nonnutritive sucking and respiration in preterm infants.

The effect of nonnutritive sucking bursts (NNSBs) on respiratory frequency was sequentially evaluated in 12 healthy preterm infants. Studies were performed during active sleep in infants between 32 and 37 weeks postconceptional age. The duration of NNSBs was classified as follows: (a) less than 3 s, (b) between 3 and 6 s, and (c) greater than 6 s. NNSBs of each duration were found at all ages, although NNSBs greater than 6 s were the least frequently observed. Respiratory rate increased significantly during NNSBs of less than 3 s, and also in those of 3-6 s duration. There was no significant effect on respiratory frequency of sucking bursts longer than 6 s. Our results document an early interaction between these two motor rhythms, which is influenced by the length of the NNSB. Moreover, they indicate that the decrease in respiratory frequency reported in a similar group of preterm infants during feeding should not be interpreted as an effect of sucking per se.

Aging↗
PubMed1986

Moderate hyperbilirubinemia does not influence the behavior of jaundiced infants.

Several recent reports have described short-term effects of moderate hyperbilirubinemia, and have questioned the treatment protocols of neonatal jaundice. However, most of these studies were not designed to investigate the effects of hyperbilirubinemia per se and could have been influenced by phototherapy. We have evaluated with the Brazelton Neonatal Behavioral Scale 17 moderately jaundiced term 3-day-old infants (mean bilirubin level 10.6 mg/100 ml, range 8.4-14.3) not treated with phototherapy and 17 not jaundiced matched subjects; 14 jaundiced 4-day-old subjects (mean bilirubin level 10.4 mg/100 ml, range 8.4-12.9) and 14 not jaundiced matched subjects; 10 ex-jaundiced 1-month-old infants (mean bilirubin level 11.5 mg/100 ml, range 9.1-15.9) and 10 matched not jaundiced infants. No differences were found between jaundiced infants and not jaundiced infants. Our data indicate that moderate levels of hyperbilirubinemia not treated with phototherapy do not influence neonatal behavior. Hence, more aggressive treatment is not justified, at least in term infants.

Child Behavior↗
PubMed1985

Gangrene of the buttock: a devastating complication of the infusion of hyperosmolar solutions in the umbilical artery at birth.

This paper describes two cases of gangrene in the buttock secondary to infusion of a hyperosmolar solution into the umbilical artery at birth. Because of the frequent dilatation of the umbilical arteries in asphyxiated infants, needle puncture should not be used to infuse fluids into the umbilical vein. Moreover, hypertonic solutions that can produce vascular thrombosis should be avoided in metabolic resuscitation in the delivery room.

Buttocks↗
PubMed1985

Effects of different ways of covering the eyes on behavior of jaundiced infants treated with phototherapy.

This study was performed to determine whether covering the eyes with an opaque screen over the head end of the bassinet instead of the normal patch would improve the behavioral organization of jaundiced, but otherwise healthy, term infants treated with phototherapy. 38 matched infants were randomly assigned to have a patch or a screen. Serum bilirubin at the time of observation was 11.2-17.5 mg/100 ml (mean = 13.7, patch) and 9.4-16.4 mg/100 ml (mean = 13.4, screen). 19 infants, of whom 11 were jaundiced (6.2-14.3 mg/100 ml, mean = 10.3), served as control subjects. The infants were examined with the Brazelton scale on the 3rd day after birth, when the patch subjects had been under blue light from 6 to 45 h (mean = 23.9), and the screen subjects from 6 to 61.5 h (mean = 22.6). The control subjects scored better (all differences, p less than 0.05) than the patch subjects on inanimate visual, animate visual, visual and auditory, alertness. The control subjects also did better than the screen subjects on inanimate visual, animate visual, animate auditory, visual and auditory, alertness, but poorer on motor maturity and consolability. The screen subjects did poorer than the patch subjects only on skin color lability. At 1 month of age, 9 sets of matched infants were examined. The only difference was that the control subjects did better than the patch subjects on animate visual and lability of state. Our data confirm the poorer short-term orientation performance of jaundiced infants treated with phototherapy but do not indicate that covering the eyes with an opaque screen improves behavioral organization.

Child Behavior↗
PubMed1984

Early behavioural development of preterm infants.

In this study 17 male and 13 female infants with gestational ages between 27 and 34 weeks (mean 30.7) and birthweights between 750 and 2020g (mean 1545) were evaluated with the Brazelton Neonatal Behavioral Assessment Scale at 35, 38, 40 and 44 weeks postconceptional age. All were in room air at the time of observation and none was being treated with mechanical ventilation. In the motor performance cluster, all five items improved with advancing postconceptional age and in the orientation cluster four of six items improved with age: these show better behavioural evolution compared with other clusters. There was no change in auditory response, with good response from 35 weeks onward. Behavioural development did not proceed evenly in all areas, and within the same cluster certain features developed earlier than others. From 35 to 44 weeks, auditory responsiveness was similar to that of previously evaluated healthy term infants.

Birth Weight↗
PubMed1984

Transcutaneous oxygen tension during nonnutritive sucking in preterm infants.

The effects of nonnutritive sucking on transcutaneous oxygen tension, heart rate, and respiratory rate were studied sequentially in 14 sleeping preterm infants breathing room air. Transcutaneous oxygen tension increased during nonnutritive sucking in infants between 32 and 35 weeks postconceptional age, but not in those between 36 and 39 weeks. This response was not associated with a change in respiratory rate or sleep state, although heart rate tended to increase. These data offer further support for the beneficial effects of nonnutritive sucking in preterm infants.

Female↗