Infant premature

Secondary immunodeficiencies (9) are much more common than primary ones and frequently occur as a result of immaturity of the immune system in premature infants, immunosuppressive therapy, or surgery and trauma. Illnesses, particularly when prolonged and serious, have been associated with secondary immunodeficiencies, some of which may be reversible. Acquked immune deficiency syndrome (AIDS) (10—12) may be considered a secondary immunodeficiency disease caused by the human immunodeficiency vimses HIV-1 or HIV-2. Hitherto unknown, the disease began to spread in the United States during the latter part of the 1970s. The agent responsible for this infection has been isolated and identified as a retrovims. 

The use of oxygen in pediatric incubators is an important factor in increasing the survival rate of premature infants who develop cyanosis. However, the use of oxygen is associated with risk of developing the visual defect known as retrolental fibroplasia (38). A careflil monitoring of arterial blood oxygen partial pressure is important. 

Other specialized appHcations of cardiac arrest devices include extracorporeal membrane oxygenation (ECMO) which occurs when the lungs of a premature infant caimot function properly. The market segments for cardiopulmonary support devices are potentially significant. 

Myxedema and goiter are the main conditions for which thyroid preparations are indicated. The treatment of cretinism is difficult because it is recognized only at or after birth. Even if this disease could be diagnosed m utero, thyroid hormones do not readily cross the placental barrier. In addition, the fetus, as does a premature infant, rapidly deactivates the thyroid hormones. The halogen-free analogue DlMlT [26384-44-7] (3), which is resistant to fetal deiodinases, may prove useful for fetal hypothyroidism (cretinism). 

Vitamin Deficiency. Vitamin deficiency is uncommon in normal adults. However, when it does occur, it can be serious, particularly in pregnant women. Some vitamin deficiency can occur because of a large reduction of fat intake, which decreases absorption. Strict vegetarians also risk reduced vitamin intake. Premature infants and elderly people who are exposed to minimal sunlight and consume Htde vitamin also have a reduced capacity to metabolize and can develop vitamin deficiency. 

There is a clinical need for non-natural, functional mimics of the lung surfactant (LS) proteins B and C (SP-B and SP-C), which could be used in a biomimetic LS replacement to treat respiratory distress syndrome (RDS) in premature infants [56]. An effective surfactant replacement must meet the following performance requirements (i) rapid adsorption to the air-liquid interface, (ii) re-spreadabihty... 

The Newborn Infant, Figure 1 is a photograph showing the appearance of a 2-1/2 kilo premature infant as conqpared to a nurse s hand. This infant is not the smallest infant one has to contend with since premature infants weighing 600 grams with no genetic abnormalities are occasionally seen. 

Parenteral Fluids. During the past ten years interest has been renewed in the total alimentation of the infant by vein (2). The motivation for this is the fact that neonates may suffer from some congenital malformation of the intestinal tract which would require surgical resection. If this is done, then one needs some outside way for alimentation, bypassing the intestine, until the intestine is able to heal and recover its normal function. This may take many weeks. A second source of motivation is the small premature infant weighing less than a kilogram, whose immature central nervous system and gastrointestinal tract make it difficult to establish nutrition by oral intake soon after birth. These also require total intravenous nutrition for a substantial period of time. 

It is known that the prevalence of UTIs varies by age and gender. UTIs may occur at any age, even in the very young. Premature infants, for example, have a higher rate than full-term infants, and neonatal boys are five to eight times more likely to have... 

Hepatic steatosis usually is a result of excessive administration of carbohydrates and/or lipids, but deficiencies of carnitine, choline, and essential fatty acids also may contribute. Hepatic steatosis can be minimized or reversed by avoiding overfeeding, especially from dextrose and lipids.35,38 Carnitine is an important amine that transports long-chain triglycerides into the mitochondria for oxidation, but carnitine deficiency in adults is extremely rare and is mostly a problem in premature infants and patients receiving chronic dialysis. Choline is an essential amine required for synthesis of cell membrane components such as phospholipids. Although a true choline deficiency is rare, preliminary studies of choline supplementation to adult patients PN caused reversal of steatosis. 

Caffeine stimulates respiration and has been used in apneic spells in premature infants. 

M. Boutroy, P. Vert, R. Royer, P. Monin, and M. Royer-Morrot, Caffeine, a metabolite of theophylline during treatment of apnea in the premature infant, J. Pediatr., 94, 996 (1979). 

Infant respiratory distress syndrome (IRDS), also known as hyaline membrane disease, is one of the most common causes of respiratory disease in premature infants. In fact, it occurs in 30,000 to 50,000 newborns per year in the U.S. — most commonly in neonates bom before week 25 of gestation. IRDS is characterized by areas of atelectasis, hemorrhagic edema, and the formation of hyaline membranes within the alveoli. IRDS is caused by a deficiency of pulmonary surfactant. Alveolar type II cells, which produce surfactant, do not begin to mature until weeks 25 to 28 of... 

Antioxidant therapy might be promising medication for the treatment of some lung disorders. For example, lecithinized phosphatidylcholine-CuZnSOD suppressed the development of bleomycin-induced pulmonary fibrosis in mice [284] these findings could be of relevance for the treatment of bleomycin-stimulated pulmonary fibrosis in humans. Davis et al. [285] recently demonstrated that the treatment of premature infants with recombinant human CuZnSOD may reduce early pulmonary injury. 

A jaundiced one-day-old premature infant with an elevated free bilirubin is seen in the premature-baby nursery The mother received an antibiotic combination preparation containing sulfamethizole for a urinary tract infection (UTI) one week before deliver)1 You suspect that the infant s findings are caused by the sulfonamide because of the following mechanism ... 

Etteldorf, J.N. 1951. Methylene blue in the treatment of methemoglobinemia in premature infants caused by marking ink. J. Pediat. 38 24-27. 

Kagan, B.M., B.Mirman, J.Calvin, and E.Lundeen. 1949. Cyanosis in premature infants due to aniline dye intoxication. J. Pediat. 34 574-578. 

Carnitine can be synthesized from lysine and methionine, but synthesis is decreased in premature infants. Low carnitine levels can occur in premature infants receiving parenteral nutrition or carnitine-free diets. 

In premature infants, feedings are started at lower rates or volumes, usually 10 to 20 mL/kg/day. 

Whether LSD causes dysmorphogenesis is also difficult to evaluate. A third case of multiple ocular abnormalities was reported in a premature infant of a mother who had used LSD sporadically, as well as other drugs, such as cocaine and heroin. No definite cause-effect relationship could be drawn (14). 

In the same way as volatiles from the whole breast, odorants carried in human colostrum/milk are arousing and attractive to newborns (Mizuno, Mizuno, Shino-hara and Noda 2004 Marlier and Schaal 2005). Interestingly, neonatal responsiveness to these milk cues does not seem to depend on breastfeeding experience as term-born infants exclusively fed formula (Marlier and Schaal 2005), and premature infants (Bingham et al. 2003), react to them in the same way as regularly breast-fed infants. 

Meza, C.V., Powell, N.J. and Covington, C. (1998) The influence of olfactory intervention on non-nutritive sucking skills in a premature infant. Occup. Ther. J. Res. 18, 71-83. 

Our data from premature infants indicate that if both the urine calcium and the urine phosphate are between 2 and 10 mg/dl, the ratio of these elements in the alimentation solution is appropriate. 

Antiviral antibodies Preventing respiratory syncytial virus infections in premature infants Synagis... 

Artificial surfactant, which contains dipalmitoylphosphati-dyl choline and some palmitic acid to provide for spreadability, is now commercially available for instillation into the lung. Adminishation of steroids to the mother prior to birth of the premature infant is also carried out. 

Benzyl alcohol This product contains benzyl alcohol, which has been associated with a fatal gasping syndrome in premature infants. 

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