Neonates definitions

Infants with salt-losing crisis and adrenal insufficiency in infancy may have adrenal hypoplasia congenita. This can be of two types recessive, for which the cause has not been defined and which affects mostly the fetal zone, and X-linked, which is caused by mutations in the DAX-1 gene, which (with steroidogenic factor-1) controls definitive zone development and steroidogenesis [71]. GC-MS analysis of patients with the disorder show variant patterns from absence of neonatal A5 steroids, appropriate for the recessive form [81], to extremely low cortisol production and transient 11/Lhy-droxylase deficiency, as evidenced through increased THS excretion (Malunowicz, personal communication). 

Definition and causes of jaundice Jaundice (icterus) refers to the yellow color of the skin, nail beds, and sclerae caused by deposition of bilirubin, secondary to increased bilirubin levels in the blood. There are three major forms of jaundice hemolytic jaundice, caused by massive lysis of red blood cells, releasing more heme than can be handled by the reticuloendothelial system obstructive jaundice, resulting from obstruction of the bile duct and hepatocellular jaundice, caused by damage to liver cells that decreases the liver s ability to take up and conjugate bilirubin. In addition, neonatal jaundice is caused by the low activity of hepatic glucuronylation of bilirubin, especially in premature infants. 

A second, cytosolic CPS activity (CPSII) occurs in mammals as part of the CAD trifunctional protein that catalyzes the first three steps of pyrimidine synthesis (CPSII, asparate tran-scarbamoylase, and dihydroorotase). The activities of these three enzymes—CPSII, aspartate transcarbamoylase, and dihydroorotase—result in the production of orotic acid from ammonium, bicarbonate, and ATP. CPSII has no role in ureagenesis, but orotic aciduria results from hepatocellular accumulation of carbamyl phosphate and helps distinguish CPSI deficiency from other UCDs. Defects in CPSI classically present with neonatal acute hyperammonemic encephalopathy. The plasma citrulline and urine orotic acid concentrations are both low. A definitive diagnosis can be established by enzyme assay of biopsied liver tissue or by mutation analysis. 

The survival of all species depends on the integrity of its reproductive system. Reproductive toxicology may be defined as the study of the effects of physical and chemical agents on the reproductive and neuroendocrine systems of adult males and females, as well as those of the embryo, fetus, neonate, and prepubertal animal. This chapter focuses primarily on the potential sites of toxic insult in the reproductive systems of adult mammals, the biochemical mechanisms of such toxicants, and the manifestations that may result. The latter part of the above definition is a subspecialty of developmental toxicology (Chapter 34) and is discussed only in brief. 

Toxicological screening of hair of neonates, when clinical features suggest an intake of definite medications or drugs of abuse by the mother during pregnancy ... 

The reference interval for the activity of ALD in adults is 2.5 to lOU/L, measured at 37 °C. However, there is a definite sex difference with men having higher values. Serum ALD in the neonate is fourfold the adult activity and in children is twice that of the adult. Adult values are attained by the time the child reaches puberty. ... 

NAG, along with other urinary enzymes, has been used to evaluate drug induced tubular damage as in the case of acetaminophen [113], 5-aminosalicyate/ sulfasalazine in patients being treated for inflammatory bowel disease [114], and the relative nephrotoxicity of differing aminoglycoside dose schedules in neonates [115]. Assess of the urinary excretion of NAG have also been reported in hypertensive patients [116] and in patients with chronic renal failure due to various causes [117]. However, to date, it is considered to be an ancillary but non-definitive marker of renal disease. 

The ductus arteriosus in neonates is highly sensitive to vasodilation by PGEj. Maintenance of a patent ductus may be important hemodynamically in some neonates with congenital heart disease. PGEj (alprostadil, prostin vr pediatric) is highly effective for palliative, but not definitive, therapy to maintain temporary patency until surgery can be performed. Apnea is observed in —10% of neonates so treated, particularly those who weigh <2 kg at birth. 

The variation in the error rates was probably due to the differences in the definitions of medication errors, the methodologies used and the settings. For example, the error rate in a neonatal intensive care unit is much higher than that in a general paediatric ward. Furthermore, the systems of prescribing, dispensing and drug administration vary... 

Barberry is contraindicated or cautioned against in pregnancy in several contemporary texts on herbal safety (Brinker 2001 Mills and Bone 2005). These contraindications are based primarily on the uterine stimulant activity of the isolated compound berberine in excised mouse uteri (Furuya 1957 Imaseki et al. 1961) and the potential ability of berberine to displace bilirubin and cause neonatal jaundice (Chan 1993). Although definitive data confirming the safety of barberry during pregnancy is lacking, several... 

It is now believed that neonatal jaundice is largely due to failure of the liver glucuronidase, but a shortened mean survival of fetal cells has been postulated as a contributory cause. Thus Hollingsworth (1955), Mollison (1956), Schulman et al. (1954) by different methods considered that the mean cell life was definitely shortened, whereas Seelemann (1954) and Gairdner et al. (1952) believed that the mean cell survival time might be slightly reduced. 

The first 3 cases (serial nos 604, 638, 515) in the table had hormonal profiles entirely consistent with severe hypothyroidism although these women did not exhibit the clinical features of hypothyroidism In all three cases the pregnancy outcome was a stillblrth/early neonatal death In the succeeding 3 cases (serial nos 568, 245, 430) the maternal total and free thyroxine values were low but triiodothyronine values were within the normal range In one of these the outcome was a stillbirth/early neonatal death and one child has a hearing/speech defect but no other abnormality and, by our definition, cannot be labelled as an endemic cretin ... 

Condorelli, G., Morisco, C., Latronico, M.V., Claudio, P.P., Dent, P., Tsichlis, P., Condorelli, G., Frati, G., Drnsco, A., Croce, C.M., Napoli, C. (2002). TNF-alpha signal transduction in rat neonatal cardiac myocytes definition of pathways generating from the TNF-alpha receptor. FASEB J. 16(13) 1732-1737. 

In contrast, in a retrospective analysis of 292 neonates who received parenteral nutrition with lipid emulsions containing omega-3 fatty acids for more than 1 day, 104 (36%) developed cholestasis after a mean of 22 days, with a conjugated bilirubin concentration over 34 pmol/l 31 had a serum conjugated bilirubin concentration over 100 pmoUl and 13 developed liver failure 4 underwent transplantation and 5 died of hepatic disease [385]. The authors suggested that in the absence of definitive evidence of efficacy, as well as increased costs, it is difficult to justify the routine use of lipid... 

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