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Biomedical subjects

W Rosenfeld

Publications and source records attributed to W Rosenfeld.

At least 37 records · Page 2Linked to original sources
PubMed1989

Phenytoin and phenobarbital concentrations in serum: a comparison of Ames Seralyzer with GLC, TDX, and EMIT.

A recently developed system for measuring antiepileptic drug concentrations was evaluated for phenytoin and phenobarbital. The apoenzyme reactive immunoassay system was compared with gas-liquid chromatography, EMIT, and TDX systems. Comparisons were performed with control specimens and with sera obtained from patients at three facilities. Precision for all methods was similar, with within-run and between-run coefficients of variation generally 5%. The accuracy of all methods was acceptable, but bias was present in some. However, measurements obtained by a nontechnical person (physician) in a clinical setting were sometimes inaccurate.

Chromatography, Gas↗
PubMed1986

Endogenous antioxidant defenses in neonates.

Deficiencies of antioxidant defenses have been postulated as possible mechanisms in the development of bronchopulmonary dysplasia (BPD). Neonates, especially prematures with respiratory distress syndrome (RDS), are exposed to high oxygen tensions for prolonged periods. To evaluate the neonates' ability to respond to an oxygen challenge with increased superoxide dismutase (SOD), 9 prematures were studied immediately at birth and on days 1, 3, 5, and 7. An increase in plasma levels was noted during the first week of life in the patients who were exposed to oxygen. The mean endogenous SOD level at birth was 1.28 microgram/ml. On day 1, plasma SOD rose to 1.53 microgram/ml and to 2.25 micrograms/ml on day 3 (P = .003). This trend continued into the fifth and seventh days. Whether this increase in SOD has clinical significance in the prevention of BPD requires further investigation.

Antioxidants↗
PubMed1986

Oxidant-mediated lung disease in newborn infants.

High concentrations of oxygen are administered with increased airway pressure to most preterm neonates with respiratory distress syndrome (RDS). Among 20% to 30% of survivors a form of chronic lung disease, bronchopulmonary dysplasia (BPD), develops. Its pathogenesis may include tissue damage caused by the superoxide anion (O2-) and other free oxygen radicals. Animal experiments and other data suggested a rationale for superoxide dismutase (SOD) administration in an effort to prevent or ameliorate BPD. Our preliminary studies in 19 prematures with RDS demonstrated its safety in human newborns and permitted measurement of its plasma levels. No adverse clinical findings occurred, and laboratory parameters were unchanged. Subcutaneous administration (0.25 mg/kg) of bovine SOD led to detectable levels at 1 1/2 h (mean 0.22 microgram/ml), with a slight rise to a higher peak at 2 1/2-4 h and a plateau over the remainder of the 12-h interval. Following doses 2-5, peak levels of 0.64 microgram/ml occurred at 4-8 h. With this background, a prospective double-blind controlled study of 45 neonates (mean gestational age, 29 weeks; birth weight, 1,100 g) showed a statistically significant reduction in prevalence of clinical and X-ray signs of BPD with fewer days of continuous positive airway pressure required. The safety and pharmacokinetics of bovine SOD were confirmed.

Antioxidants↗
PubMed1986

Serial trypsin inhibitory capacity and ceruloplasmin levels in prematures at risk for bronchopulmonary dysplasia.

Oxidant injury and release of proteolytic enzymes in prematures with respiratory distress syndrome (RDS), who are treated with ventilators and oxygen, have been postulated as possible causes of bronchopulmonary dysplasia (BPD). The premature may be at particular risk due to low levels of antiproteases, such as alpha-1-proteinase inhibitor (alpha 1PI), and antioxidants, such as ceruloplasmin (CER). Both alpha 1PI and CER deficiencies have been correlated with the severity of RDS. We studied serial alpha 1PI activity as measured by trypsin inhibitory capacity (TIC) and CER in the serum 27 prematures who required ventilator therapy for RDS. Serum TIC values for day 1 were significantly lower (0.34 vs. 0.92 mg inhibited/ml of sample) in the 13 patients who developed BPD compared to the 14 who did not. No significant differences were seen on succeeding days. No significant differences in CER were seen, although both groups had levels 33-50% of adult normals (11.3 vs 9.3 mg/dl). Other significant variables included birthweight (p less than 0.005), severity of RDS (p less than 0.03), and gestational age (p less than 0.03). One way analysis of variances demonstrated day 1 TIC to be the most significant variable (p less than 0.0001), followed by weight (p less than 0.007), severity RDS (p less than 0.04), and gestational age (p less than 0.03). CER levels were not a significant variable. A formula utilizing unstandardized canonical discriminant function including day 1 TIC, birthweight, severity of RDS, and gestational age was 100% sensitive and 85% specific in the prediction of BPD for the original study group. In an additional 25 consecutive admissions with severe RDS of whom 18 survived, the formula was 100% sensitive (6/6) and 75% specific (9/12).(ABSTRACT TRUNCATED AT 250 WORDS)

Birth Weight↗
PubMed1986

Phototherapy effect on the incidence of patent ductus arteriosus in premature infants: prevention with chest shielding.

Patent ductus arteriosus is common among premature neonates, especially those with birth weights less than 1,500 g. In vitro, room light inhibits the contraction of immature piglet's ductal rings. Because phototherapy is used frequently from the first days of life to treat jaundice in preterm neonates, we compared the occurrence of patent ductus arteriosus among premature infants exposed to this intense light source with those whose chests were shielded. Seventy-four babies with respiratory distress syndrome were randomly assigned to either a treatment group (chest shielded with aluminum foil while on phototherapy, 36 babies) or control group (no shield, 38 babies). All were on radiant warmers, received mechanical ventilation for respiratory distress syndrome, and phototherapy (Air Shields model PTU 78-1) from day 1 of life. Irradiance was maintained at greater than 4.0 microW/cm2/nm in all cases. Although both groups had similar birth weights, gestational ages, severity of respiratory distress syndrome, intravenous fluid intake, and duration of phototherapy, the incidence of patent ductus arteriosus was significantly less in the shield group (shield 11/36 v No shield 23/38; P = .009). Patent ductus arteriosus murmurs developed in shielded patients at a later date, they required less vigorous treatment (ie, indomethacin), and they had shorter hospitalizations (74 v 85 days; P less than .05). The significant reduction of patent ductus arteriosus with shielding suggests that phototherapy may play a role in the occurrence of patent ductus arteriosus in premature infants. Shielding may be a practical method to decrease this common complication should this initial observation be confirmed.

Ductus Arteriosus, Patent↗
PubMed1985

Pharmacokinetic evaluation of cefoperazone in infants.

The pharmacokinetics of cefoperazone were evaluated in 25 infants (mean age, 26 days) after intramuscular and intravenous routes of administration. The levels in blood that were achieved were severalfold higher than those required to inhibit common pathogens. The mean half-life of 240 min was one-half of that observed in 1- to 2-day-old infants but about twice that seen in adults. Further evaluation is needed to study the efficacy of the drug in infants and children.

Cefoperazone↗
PubMed1985

A possible clinical implication of homozygous inversions of 9qh regions with Cornelia de Lange syndrome (CLS).

Several investigators have attempted to correlate chromosomal abnormalities with Cornelia de Lange Syndrome (CLS), but none of them have been conclusive. The homozygous inversion of 9qh found in the present case has not been found previously. It remains to be clarified whether the presence of this finding in CLS was simply a coincidence or whether homozygosity for such inversions may result in CLS.

Abnormalities, Multiple↗
PubMed1985

Duplication 11 (q22----qter) in an infant. A case report with review.

A male infant with partial duplication of the long arm of chromosome 11 (11q22----qter) is described with a hitherto unreported translocation. In most cases 11q trisomy is associated with 11q/22q translocation and a 3:1 meiotic disjunction with 47 chromosomes. In a few cases the 11q translocation is associated with a partial deletion of other autosomes and a total of 46 chromosomes. In the present case, translocation to 9p is involved and no apparent deletion of 9p was noted, providing an opportunity to delineate the phenotypic features due to duplication of 11q. A comparison is made between the findings of partial 11q trisomy and 11q/22q translocation.

Abnormalities, Multiple↗
PubMed1984

Cat-eye syndrome with unusual marker chromosome probably not chromosome 22.

An unusual supernumerary chromosome with a single satellite on the long arm was found in a child with manifestations of the cat-eye syndrome including apparently low-set and malformed ears, preauricular tags, micrognathia, and imperforate anus. Although G-banding suggested that this extra material was chromosome 22, this was not confirmed by several other banding techniques. After examination of the parents' chromosomes, the nature and origin of this extra chromosome remains obscure. We conclude that patients previously diagnosed as having "partial trisomy 22" with incomplete cat-eye syndrome may have a different chromosome constitution when studied by various banding techniques.

Anus, Imperforate↗
PubMed1984

Prevention of bronchopulmonary dysplasia by administration of bovine superoxide dismutase in preterm infants with respiratory distress syndrome.

The effectiveness of bovine superoxide dismutase (SOD) in the prevention of bronchopulmonary dysplasia was evaluated in a prospective double-blind controlled study in 45 neonates (mean gestational age 28.7 weeks, mean weight 1154 gm) with severe respiratory distress syndrome. All were ventilator dependent with FiO2 greater than or equal to 0.7 at 24 hours of age. Either bovine SOD (0.25 mg/kg) or saline solution was administered subcutaneously every 12 hours according to random selection until patients could be maintained in room air without ventilatory or continuous positive airway pressure (CPAP) support. SOD levels were detected in all patients given treatment. Mean peak values at 4 hours after dose ranged from 0.15 micrograms/ml (dose 1) to 0.45 micrograms/ml (dose 10). The drug was well tolerated, and no side effects were detected. Among the 31 survivors (SOD 14, placebo 17) radiologic evidence of BPD was significantly less in patients given SOD (3/14 vs 12/17, P = 0.008). Clinical signs of bronchopulmonary dysplasia (wheezing, pneumonia) were less in patients given SOD (3/14 vs 11/17, P = 0.019). Patients given SOD required fewer days of CPAP (P less than 0.003). There were no differences in days of O2 therapy, intermittent positive pressure breathing, or incidence and severity of patent ductus arteriosus or intraventricular hemorrhage. This preliminary study suggests that SOD may be helpful in reducing the severity of bronchopulmonary dysplasia in infants with respiratory distress syndrome.

Animals↗
PubMed1983

Pemoline in attention deficit disorder and alcoholism: a case study.

Diagnosis of attention deficit disorder in a 35-year-old man and treatment with pemoline substantially improved his response to alcoholism treatment and aftercare. The authors conclude that treatment of attention deficit disorder may aid in rehabilitation of alcoholic patients.

Adult↗
PubMed1982

Partial duplication for the short arm of chromosome 2 : the 2p23 to pter syndrome.

A 32 week, small for gestational age neonate was found to have partial duplication of the short arm of chromosome 2 (2p23 to pter). This duplication was due to a paternal balanced translocation [46,XY,t(2;20)(p23;q13)]. Peculiar facies with prominent eyes, low set ears and anteverted nostrils was apparent. A PDA with congestive heart failure occurred in the first weeks of life. The patient also had a marked diastasis recti, hemivertebrae, long tapering fingers and rocker bottom feet. The propositus was similar to the 14 cases of 2p duplication previously reported. It appears that duplication of the distal end of 2p (2p23 to pter), with or without deletion, should be classified as duplication (2p) syndrome.

Abnormalities, Multiple↗
PubMed1982

Safety and plasma concentrations of bovine superoxide dismutase administered to human premature infants.

The safety and plasma concentrations of bovine superoxide dismutase (SOD), potentially useful in prevention of bronchopulmonary dysplasia, were evaluated in 19 prematures with severe IRDS. All were respirator dependent and required FiO2 greater than 0.7 at 24 h of age. Subcutaneous tests (0.1 mg/kg) and treatment doses (0.25 mg/kg) did not induce wheal and flare or systemic reactions. No abnormalities in serum electrolytes, calcium, glucose, creatinine concentrations, complete blood and platelet counts were noted. Following dose 1, SOD was detectable in all patients at 1 1/2 h and rose slowly to a peak at 4-8 h. Mean levels remained between 0.2 and 0.36 micrograms/ml during the 12-hour interval between doses. Similar responses resulted following doses 2-5 with mean levels between 0.36 and 0.68 micrograms/ml. SOD levels varied directly with serum creatinine levels obtained at the time of SOD administration but other factors such as skin perfusion were not controlled. The present study demonstrates that SOD at a dose of 0.25 mg/kg s.c. can be administered safely to prematures with severe IRDS and resulted in levels associated with therapeutic effects in adults.

Animals↗
PubMed1981

Evaluation of modified gowning procedures in a neonatal intensive care unit.

The effect of modified gowning techniques in a neonatal intensive care unit was evaluated. During alternate two-month intervals, no gowns were worn over street clothes in patient care areas by staff or visitors. Mortality and infections rates during these "modified" gowning intervals were the same as during the gowning periods. However, the incidence of necrotizing enterocolitis was significantly greater in the modified gowning periods (7/353) than in the gowning periods (1/371). An expansion of this one-year study to include another year showed an even greater effect. The prevalence of bacteria at three anatomic sites (nares, umbilicus, and groin) on days 2, 4, 7, 10, 14, 21, and 28 of hospitalization was comparable between those studied during modified gowning and gowning intervals. Exceptions were the significantly increased prevalence of Staphylococcus epidermidis in the groin (days 21 and 28) during gowning and S aureus in the nares (day 28) during modified gowning periods.

Bacterial Infections↗
PubMed1981

Double trisomy 48,XXX,+ 18 in a newborn.

We report the 6th case of double trisomy X and 18 ie, 48,XXX,+ 18. The infant lacked overlapping fingers, simian creases, and structural heart disease and is alive at 275 days. Two X chromosomes were late replicating. Anomalies of the hands and kidneys involved only the right side in the present case; review of the five previous cases of 48,XXX, +18 also showed that anomalies of kidneys, hands, and ears affected predominantly the right side in three patients.

Chromosome Banding↗