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Biomedical subjects

A A Fanaroff

Publications and source records attributed to A A Fanaroff.

At least 109 records · Page 6Linked to original sources
PubMed1980

Changing trends of neonatal and postneonatal deaths in very-low-birth-weight infants.

Advances in perinatal care have resulted in a decline in mortality of very-low-birth-weight infants (< 1.5 kilograms) and also in an extension of the mortality period. To determine the current relevance of neonatal mortality results as indicators of outcome, all deaths among 427 very-low-birth-weight infants admitted during 1975-1977 were documented. A total of 145 infants died; 90 of the deaths (62%) occurred during the early neonatal period (0 to 6 days), 35 (24%) in the late neonatal period (7 to 27 days), and 20 (14%) in the postneonatal period. Death in 17 of the 20 postneonatal losses was due to neonatal complications of prematurity, and 16 of the 20 deaths occurred during the initial hospitalization. The postponement of these deaths to the postneonatal period has important epidemiologic implications and indicates a need for a reconsideration of accepted reporting mechanisms for infants of very low birth weight.

Female↗
PubMed1979

Echocardiographic abnormalities in infants of diabetic mothers.

In order to evaluate the presence of myocardial hypertrophy and/or abnormalities of postnatal cardiovascular adaptation, echocardiograms were performed on 34 infants of diabetic mothers. Based on cardiopulmonary assessment, the IDM were divided into three groups: Group I with congestive heart failure predominating: Group II with respiratory distress predominating: Group III asymptomatic. Hypertrophy of the interventricular septum and of the walls of left and right ventricles was frequently present in IDM: this change was most notable in association with clinical CHF. Six IDM, four of whom were found to have CHF, had additional echocardiographic signs of subaortic stenosis. All IDM had normal indices of left ventricular performance, despite the presence of CHE. In IDM with respiratory distress, the right ventricular pre-ejection period to ventricular ejection time ratio was elevated, suggesting an abnormality of the transitional pulmonary circulation. Poor maternal diabetes control and maternal systemic hypertension were closely correlated with evidence of myocardial hypertrophy in the infants.

Birth Weight↗
PubMed1979

Necrotizing enterocolitis in neonates fed human milk.

The incidence of necrotizing enterocolitis encountered in neonates fed only refrigerated human milk was comparable to that in infants fed milk and isotonic formula or isotonic formula alone. The infants fed human milk were significantly (P less than 0.05) smaller, less mature, had lower Apgar scores, and were fed later than the formula-fed infants. The mean age of onset and time between first feeding and onset of NEC was similar among the three groups. These data indicate that refrigerated human milk was not effective in lowering the incidence of NEC. Possible explanations for the occurrence of NEC in neonates fed human milk include: (1) the introduction of a pathogen via contaminated milk; (2) inadequate maternal antigenic stimulation by the neonatal gastrointestinal flora; and (3) adverse affects of storage on cell number and function.

Enterocolitis, Pseudomembranous↗
PubMed1977

A modern approach to management of pregnant diabetics: a two-year analysis of perinatal outcomes.

Increased understanding of maternal-fetal carbohydrate homeostasis together with modern perinatal technology now provides a more rational basis for obstetric management of the pregnant diabetic patient. These concepts were applied at MacDonald House in the care of 96 diabetic pregnant women over a two-year period. Pregnancy outcomes were compared with prior experiences with the same group of women. The perinatal mortality rate was reduced from 13.5 to 4.2%, and the rate of macrosomia (infants large for gestational age) was reduced from 30.9 to 17.7%. Patients with gestational diabetes, with a prior loss rate of 8.3%, suffered no losses in the current series. Maternal age was not found to correlate with an untoward outcome in this subgroup.

Adolescent↗
PubMed1977

Neonatal pattern vision: a predictor of future mental performance?

The visual fixation responses of 33 high-risk neonates to patterned stimuli were rated as normal, suspect, or abnormal in an attempt to predict future intellectual performance. For comparison purposes, a neurologic examination was aslo administered. Follow-up studies based on autopsies and neurologic and psychological testing agreed with the neonatal visual preference ratings in 27 cases, but with the neurologic examination ratings in only 22 cases. This preliminary study suggests that neonatal visual testing is a promising technique for evaluating brain integrity in the newborn period.

Child, Preschool↗
PubMed1977

Human tracheobronchial secretions: development of mucous glycoprotein and lysozyme-secreting systems.

Baseline rates for secretion of mucous glycoprotein were similar similar (680--830 microgram/g tissue/24 hour) for cultured tracheal epithelium from newborns of 26--32 weeks' gestation, full term newborns, and older children. Addition of methacholine to culture medium augmented secretory rates of glycoprotein from all tissue sources 3--5 fold. The overall composition of secreted mucous glycoproteins changed little with increasing age. A trend toward less sulfation and toward increased sialic acid and fucose content was noted in secreted glycoproteins from explants of older subjects. Histochemical observations of stored glycoprotein in tracheal tissue, which was subsequently used for organ culture experiments, confirmed that a modest, but consistent sulfate to sialic acid shift occurs during early life. In contrast, baseline secretory rates for lysozyme from tracheal epithelium of preterm infants were one-half as large as rates from epithelium of full term babies and were refractory to cholinergic stimulation. Stimulation of lysozyme secretion by a cholinergic agonist was achieved in all cases by 40 weeks' gestation. We conclude that basal glycoprotein secretion and the mechanism for glycoprotein response to cholinergic stimulation have developed by the earliest age of viability, but that lysozyme secretion is deficient and is unresponsive to cholinergic stimulation in tracheal tissue from preterm newborns.

Age Factors↗
PubMed1976

Neonatal respiratory distress following elective delivery. A preventable disease?

Twelve per cent of all infants with respiratory distress admitted to our neonatal intensive-care unit from November, 1973 to April, 1974, were born after elective intervention (15 cesarean sections and four vaginal inductions). All were white and 18/19 were private compared to yearly admissions of white (56 per cent) and private (57 per cent). Eighteen of 19 were admitted from the region via the transport service. Mean birth weight was 2.69 kilograms, with 18 infants over 2 kilograms. Pediatric gestational age from a physical and neurological evaluation ranged from 32 to 39 weeks (mean 36.2 weeks) in contrast to obstetric dating which ranged from 38 to 44 weeks (mean 39 weeks). The obstetric dating was 3 or more weeks greater than the pediatric age in 11 infants. Pulmonary disease included transient tachypnea (5) and respiratory distress syndrome (14). No prior documentation of pulmonary maturity had been obtained in any of these infants. Mean hospitalization was 23 days (range 1 to 140), with estimated costs of $3,421 per baby. Two infants died. Respiratory distress following elective delivery remains a potent source of on-going perinatal morbidity. Regional programs must direct increased educational efforts to eliminate this preventable disease.

Birth Weight↗
PubMed1976

Neonatal septic arthritis.

Neonatal septic arthritis of the knee was encountered in nine infants during a two-year period, representing an incidence of 16.5 per 1,000 admissions to a neonatal intensive care unit. The etiologic agents included Staphylococcus aureus (3), Klebsiella (1), Streptococcus, group B (2), and Candida albicans (3). Two infants with systemic fungal infection died. Arthritis was the presenting feature of neonatal septicemia in three of six infants with bacterial infection and was accompanied by osteomyelitis in two. In eight of the infants, the same organism was cultured from the skin of the umbilicus as was cultured from the joint. Umbilical catheters had been placed in all of these infants. Full recovery of joint function has been noted in the seven surviving infants.

Arthritis, Infectious↗
PubMed1976

Urinary biogenic amines in idiopathic apnea of prematurity.

Urinary biogenic amines were measured in 22 preterm infants of less than 36 weeks' gestational age. Fifteen of these infants had idiopathic apnea. Although levels of urinary dopa were not significantly different, dopamine, norepinephrine and epinephrine were all significantly lower in the infants with apena. It is proposed that apnea of prematurity may be related to an immaturity of catecholamine-producing pathways, leading to inadequate physiologic responses to hypoxia, with resulting accentuation of central respiratory depression. Alternatively, urinary biogenic amines may be a reflection of some unrelated process occurring elsewhere in the body or a depletion of catechol stores resulting from the apnea itself.

Apnea↗