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Biomedical subjects

T R Thompson

Publications and source records attributed to T R Thompson.

At least 73 records · Page 4Linked to original sources
PubMed1981

Furosemide use in premature infants and appearance of patent ductus arteriosus.

Furosemide is a known stimulant of the renal release of prostaglandin E2, a potent dilator of the ductus arteriosus. A possible relationship between furosemide use in infants with respiratory distress syndrome (RDS) and the incidence of patent ductus arteriosus (PDA) was investigated using two different retrospective analyses. The amount of furosemide administered prior to the day a murmur was heard in the infants with PDA was higher than the amount given to patients without PDA during the same period. In a historical analysis of patients treated for RDS in the years 1970 through 1979, furosemide use and fluid intake appeared to be independent factors contributing to the incidence of PDA. The proposed relationship between furosemide use and the occurrence of PDA in patients with RDS warrants further study.

Ductus Arteriosus↗
PubMed1981

Scoliosis in Prader-Willi syndrome.

Children with Prader-Willi syndrome frequently have musculoskeletal problems such as joint hyperlaxity, hypotonia, delayed bone age, and scoliosis. Their musculoskeletal problems are magnified by the extreme obesity most of these patients exhibit. In certain cases, such as scoliosis, the Prader-Willi patient is placed at significant risk for increased morbidity and mortality. Our paper emphasizes the accurate diagnosis of this syndrome, proper dietary management, and some guidelines regarding surgical evaluation and management of a patient with significant scoliosis.

Child↗
PubMed1981

Effect of antenatal administration of Betamethasone on hospital costs and survival of premature infants.

Prenatal administration of glucocorticoids has been shown to decrease in incidence and severity of respiratory distress syndrome in premature infants, but little is known regarding the immediate economic impact of this reduction in respiratory morbidity. This study retrospectively examined 342 infants born during 1978 and 1979 and hospitalized in the University of Minnesota Hospitals. Comparison of survival and the hospital charges for infants whose mothers had not received prenatal glucocorticoid therapy showed that administration of glucocorticoids has a significant effect in lowering mortality in infants with birth weights between 750 and 1,249 gm (27 to 29 weeks' gestation). Glucocorticoid therapy was also effective in decreasing morbidity as reflected by hospital charges of surviving infants with birth weights between 1,250 and 1,749 gm (30 to 32 weeks' gestation). In both steroid-treated and nontreated mothers, prolongation of gestation decreases hospital charges in a linear fashion. The noted decrease in hospital costs should not justify prenatal glucocorticoid administration but should stimulate examination of long-term effects of the drug on surviving infants.

Betamethasone↗
PubMed1980

The Siemens-Elema Servo Ventilator 900 B for the management of newborn infants with severe respiratory distress syndrome: a 22-month trial.

The Siemens-Elema Servo Ventilator 900 B is an electronically-controlled, volume-limited ventilator. To adapt this ventilator for use in newborns with respiratory failure, minute volume control, PEEP valves, air-oxygen blenders, and respiratory tubing circuits were modified. During a 22-month period, 161 newborn infants with severe respiratory distress syndrome (RDS) were managed with this ventilator. The overall survival rate was 66%; the incidence of barotrauma was 20%; the survival rate was 53%. Of the infants studied, 12% developed bronchopulmonary dysplasia, and 79% of these survived. Of the 19% of patients with a symptomatic intraventricular hemorrhage, 6% survived. The experience of the authors with this ventilator modified to manage newborn infants with severe RDS has been extremely encouraging. Furthermore, this ventilator is versatile because it can be readily recalibrated for use in older patients and can be easily adapted for patients requiring surgery. This ventilator has the extremely important advantage of being a volume ventilator which can effectively provide positive pressure ventilatory support to patients of all age and weight groups.

Clinical Trials as Topic↗
PubMed1980

Pulmonary alveolar proteinosis: an uncommon cause of chronic neonatal respiratory distress.

A full-term newborn infant had the onset of respiratory distress immediately after birth. She required supplemental oxygen from birth, and had pulmonary alveolar proteinosis (PAP) documented by open lung biopsies at 6 and at 12 weeks of age. Light and electron microscopy showed dense, PAS-positive granular, homogeneous material within the alveolar spaces, diagnostic of PAP. No Pneumocystic carinii organisms were demonstrated on silver staining, and bacterial and viral cultures were negative. The infant died of progressive respiratory insufficiency at 1 yr or age. Pulmonary alveolar proteinosis should considered a rare cause of chronic respiratory distress in the newborn infant.

Chronic Disease↗
PubMed1980

Preextubation ventilatory measurements in newborns and infants.

Maximum inspiratory pressure, inspiratory capacity, and minute ventilation were measured in a group of infants prior to extubation to determine whether these parameters predicted successful extubation. Data obtained suggested that maximum inspiratory pressure and inspiratory capacity more accurately assessed the patient's ability to tolerate extubation than minute ventilation, pH, PCO2, or respiratory rate. A maximum inspiratory pressure of greater than 33 torr and an inspiratory capacity of greater than 150 ml/m2 were predictive of successful extubation.

Female↗
PubMed1980

Neonatal transport nurses: an analysis of their role in the transport of newborn infants.

From September 1976 to March 1979, nurses selected from the newborn intensive care unit (NICU) assumed the transport team leadership role for 443 newborns. Each nurse had successfully completed an eight-week didactic and practical educational program in the assessment, management, stabilization, and transport of ill newborns including premature infants, those with various medical and surgical disorders, and those requiring assisted ventilation. Physician supervision and consultation was always available. The overall survival rate for these infants was 81%, a rate similar to that for newborns transported by physicians. The transport nurses consistently demonstrated the ability to effectively assess, manage, stabilize, and transport ill newborns. In addition, their utilization was alleviated a physician shortage on the NICU, has improved the response time to transport requests, and has enhanced educational opportunities for physicians and nurses.

Education, Nursing, Continuing↗
PubMed1979

A possible role of vitamin E in the prevention or amelioration of bronchopulmonary dysplasia.

Bronchopulmonary dysplasia (BPD) is a significant cause of chronic pulmonary disease following mechanical ventilation of newborn infants. Although the exact pathogenesis of BPD has yet to be elucidated, high concentration of supplemental oxygen delivered by positive pressure through an endotracheal tube is thought to be a major predisposing factor. The only reported clinical trial of the administration of an exogenous antioxidant as vitamin E (20 mg/kg/day I.M.) to premature infants with respiratory distress syndrome who were receiving supplemental oxygen greater than 40% showed a shorter exposure to all levels of supplemental oxygen when compared to a control group. No roentgenographic changes of BPD were noted in any vitamin-E-treated infants. Vitamin E may modify the development of BPD, but until further clinical trials demonstrate a significant reduction in the incidence and severity of BPD, efforts should be made to minimize exposure to any of the associated factors in the pathogenesis of BPD.

Humans↗
PubMed1978

Purification of the heat-stable inhibitor protein of the Ca2+-activated cyclic nucleotide phosphodiesterase by affinity chromatography.

The recently discovered heat-stable inhibitor protein of the Ca2+-activated cyclic nucleotide phosphodiesterase (Sharma, R. K., Wirch, E. & Warg, J. H. (1978) J. Biol. Chem., in press) has been purified 238 214-fold from bovine brain extract using an affinity column of the modulator protein--Sepharose 4B conjugate. The purified sample appears to be homogeneous as judged by sodium dodecyl sulphate (SDS) gel electrophoresis. The protein band has a mobility corresponding to that of a polypeptide of molecular weight 68 000. Since the heat-stable inhibitor protein has a molecular weight of 70 000 under nondenaturing conditions, it suggests that it is a monomeric protein. The protein has no inhibitory activity toward the cAMP-dependent protein kinase or protein phosphatase. The purified sample has been tested for various enzyme activities which include ATPase, GTPase, cAMP phosphodiesterase, cGMP phosphodiesterase, 5'-nucleotidase, and protein kinase. None of these activities are exhibited by the purified sample.

2',3'-Cyclic-Nucleotide Phosphodiesterases↗
PubMed1978

Central hypoventilation syndrome: experience with bilateral phrenic nerve pacing in 3 neonates.

Successful long-term phrenic nerve pacing has been reported in adults with acquired central hypoventilation syndrome. This report summarizes our experience with phrenic nerve pacing in 3 infants with congenital central hypoventilation syndrome. The electrodes were implanted in the lower thoracic portion of each phrenic nerve. In all patients. bilateral simultaneous pacing was required to maintain an adequate arterial PO2, tidal volume, and minute ventilation during quiet sleep. Case 1 died of problems primarily related to the severe cor pulmonale that had been present before pacemaker insertion; at autopsy, the pacemaker system was intact and there were no significant phrenic nerve abnormalities. Case 2 later developed failure of awake ventilatory control and died because of extensive phrenic nerve damage incurred by 19 days of continuous pacing. Case 3 has received quiet sleep pacemaker support since September 1977 and has been able to maintain normal quiet sleep ventilation in this manner. Phrenic nerve pacing can be successful in infants as long as continuous pacing is not required. Bilateral simultaneous pacing appears to be an appropriate alternative to home-based intermittent positive-pressure breathing for long-term management of children with central hypoventilation syndrome.

Electric Stimulation↗