In contrast to observations in other species, neither enteric mucosal weight, protein content, nor DNA content of either the suckled or artificially fed guinea pig changes over the first 24 h following term birth. In guinea pigs delivered 5 days prematurely, however, statistically significant increases in proximal enteric mucosal mass (38%), protein content (51%), and DNA content (35%) occur in suckled animals over the first 24 h of life but not in artificially fed animals. These observations illustrate that the enteric mucosal hyperplasia secondary to natural feeding, quantitatively and temporally, is species-specific and suggest that this effect is manifested only during a finite period of intestinal development. They raise doubts, therefore, concerning the importance of early enteric mucosal hyperplasia in adaptation of all species to extrauterine life.

Adaptation, Physiological↗

PubMedDate not supplied

Management of fever in patients with central vein catheters.

We have evaluated a standardized prospective system for managing episodes of fever in pediatric patients with indwelling central vein catheters being used primarily for delivery of parenteral nutrients. Over an 18-month period 72 such patients, accounting for 4347 "catheter days," were followed. Thirty-two patients experienced a total of 88 episodes of fever. An infection unrelated to the presence of the catheter (e.g. otitis media, pneumonia, urinary tract infection) was found to be the cause of fever in 27 episodes (31.7%); in all the infection responded to appropriate antibiotic therapy. Ten of the episodes of fever (11.4%) lasted for less than 2 hours and were not evaluated further. Two episodes occurred in patients who no longer required the catheter; these resolved with elective catheter removal. The cause of the remaining 49 episodes of fever was assumed to be catheter-related sepsis; these were treated empirically with an intravenous antibiotic regimen of vancomycin (40 mg/kg/day) and gentamicin (7.5 mg/kg/day). In 16 of these cases blood cultures were negative and the antibiotic regimen was either stopped or continued for other indications. The remaining 33 episodes of fever were associated with positive blood cultures, i.e. documented episodes of catheter-related sepsis. In 10 of these the catheters were removed. The remaining 23 episodes of catheter-related sepsis were treated for 14 days with antibiotics given through the central vein catheter. In 5 of these episodes blood cultures remained positive after 48 hours of specific antibiotic therapy at which time the catheter was removed.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Bacterial Agents↗

PubMedDate not supplied

Interpretation of the plasma amino acid pattern of low birth weight infants.

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Amino Acids↗