Newborns - continued

New impetus was given to photomedicine by development of lasers that are compatible with the clinical environment. These include HeNe, Ar ion, mby, and tunable dye lasers operating in the continuous wave (cw) mode. Prior to the advent of lasers in medicine, only the treatment of newborn jaundice, and the appHcation of long wavelength uv irradiation in conjunction with adininistration (or topical appHcation) of psoralen class sensitizers to treatment of skin diseases (86), principally psoriasis, were clinically important phototherapies. 

From the above, derives the fundamental concept that the newborn infant must be maintained in an adequate degree of hydration and in electrolyte balance in order for the infant to thrive. In some cases, where for one reason or other, the infant is not able to take fluids by mouth in the normal manner, one may need to resort to supplementary fluid therapy by vein. For a rational approach to this problem one needs to have available from the clinical chemical laboratory> rapid response in order to continuously monitor changes in electrolyte levels so that fluids can be modified so as to correct these abnormal-ities. 

Rh incompatibility may occur when an Rh negative mother carries an Rh-positive fetus. At the time of delivery, a small amount of the baby s Rh-positive blood may gain access to the maternal circulation. In response, the immune system of the mother produces anti-Rh antibodies. During the subsequent pregnancy, the fetus is exposed to these antibodies as they cross the placenta. If this fetus is also Rh-positive, then the anti-Rh antibodies attack the fetal erythrocytes and cause hemolytic disease of the newborn (erythroblastosis fetalis). This may occur in about 3% of second Rh-positive babies and about 10% of third Rh-positive babies. The incidence continues to increase with subsequent pregnancies. 

Drug dependence Administer cautiously to people who are known or suspected to be physically dependent on opioids, including newborns of mothers with narcotic dependence. Reversal of narcotic effect will precipitate acute abstinence syndrome. Repeat administration The patient who has satisfactorily responded should be kept under continued surveillance. Administer repeated doses as necessary, because the duration of action of some narcotics may exceed that of the narcotic antagonist. Respiratory depression Not effective against respiratory depression due to nonopioid drugs. 

Children When administered by continuous IV infusion (especially for more than 24 hours preceding delivery) to control convulsions in toxemic mothers, the newborn may show signs of magnesium toxicity, including neuromuscular or respiratory depression. 

The blood-CSF barrier of newborns is significantly more permeable than that of adults (F2, R5, SI 1). The albumin ratios continuously decrease during the course of the first month of life, reaching the lowest values between 1 and 3 years of age, and then slowly rise again (Table 4). It is therefore advisable to consider age when assessing the blood-CSF barrier, especially during infancy and old age. 

The incidence of STDs, by their nature, closely follow changes in sexual behaviour and practices of the population as evidenced by the decline of many, but not all, STDs in the safe sex era induced by the AIDS pandemic. However, STDs continue to be a major health problem worldwide. Apart from acute morbidity they also are a major cause of pelvic inflammatory disease and infertility among women of child-bearing age, and cause congenital infections among the newborn. 

The consequences of discontinuing medication with subsequent psychotic relapse can be grave. Continuing maintenance medications that have been effective is appropriate. If a medication change is necessary, treatment with haloperidol is recommended because this agent has been used extensively, it has not been associated with teratogenesis, and it possesses only a small risk for EPS in the newborn. 

A. Lorek, Y. Takei, E. B. Cady, J. S. Wyatt, J. Penrice, A. D. Edwards, D. Peebles, M. Wylezinska, H. Owen-Reece V. Kirkbride, et al.. Delayed (secondary) cerebral energy failure after acute hypoxia-ischemia in the newborn piglet continuous 48-hour studies by phosphorus magnetic resonance spectroscopy. Pediatr. Res., 1994, 36, 699-706. 

For new disorders, acceptance came from detecting patients with the disorder in numbers that were similar to PKU, as was the case with MCAD deficiency. When the number of newborns screened approached a half million and at least one or two very rare disorders (1 in 100,000-300, 000) could be detected, the statistics supported the continued use of the method. A comprehensive MS/MS screen that included an amino acid and acylcami-tine profile could detect a disorder in 1 infant in 2500 screened while having a false result rate equal to or less than many of the newborn screens for one disorder. 

Human populations that have experienced health effects from exposure to 2-nitrophenol or 4-nitrophenol have not been identified, but little research has been conducted on this subject. Based on results from animal studies, as described in Section 2.6, it is possible that individuals who consume ethanol may have slower rates of clearance of 4-nitrophenol. This subpopulation, if exposed to 4- nitrophenol, may be considered potentially susceptible. Furthermore, newborn infants utilize fetal hemoglobin, which has reduced oxygen-carrying capacity, and also have low levels of nicotinamide adenine dinucleotide diaphorase, which continuously reduces methemoglobin therefore, infants (as well as individuals congenitally deficient in this enzyme) may represent... 

Newborn humans have few olfactory preferences most of the wiring has to be put in place during the early years of development, though we continue to learn and acquire odor preferences throughout our lives. The cultural implications of this and its relation to perfumery are of course immense, since each of us is able to learn and respond to an enormous range of odorous materials rather than only to those dictated by a genetically predetermined system of behavioral responses. 

To understand the etiology of hypoglycemia in the newborn, it is first necessary to know the principles of fetal metabolism that form the basis for newborn physiology and pathology. A unique characteristic of the fetus is the need for the continual provision of substrates across the maternal and placental circulations for growth and energy. A second unique characteristic of the fetus is its biochemical development so that it no longer needs this constant substrate supply (i.e., is capable of independent existence) at birth. 

Depending on the probe drug used and on the experimental method, 2 or 3 acetylator types can be described slow, intermediate and rapid, the intermediate one being not always distinguished from the rapid one. Phenotype distribution has been considered as a continuous variable (Meisel 2002). Due to slow post-natal maturation of the acetylation enzymatic systems, the acetylation status is evolving in newborns and infants, and depends on the probe drug used (Rane 1999). 

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