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Biomedical subjects

F B Mimouni

Publications and source records attributed to F B Mimouni.

29 records · Page 2Linked to original sources
PubMed1998

Intravenous correction of neonatal hypomagnesemia: effect on ionized magnesium.

OBJECTIVES: Neonatal hypomagnesemia is defined as total magnesium (TMg) < or = 0.65 mmol/L (1.6 mg/dl). However, magnesium (Mg) deficiency and sufficiency overlap at serum values of 0.57 to 0.74 mmol/L (1.4 to 1.8 mg/dl). We hypothesized that (1) some infants with TMg < or = 0.65 mmol/L (1.6 mg/dl) have normal ionized Mg values (normal neonatal range 0.40 to 0.56 mmol/L (0.97 to 1.36 mg/dl)); (2) the dose (6.0 mg of elemental Mg/kg) used to correct hypomagnesemia does not lead to elevation of ionized Mg; (3) after intravenous magnesium sulfate infusion, ionized calcium increases in patients with low baseline ionized Mg and decreases in patients with normal baseline ionized Mg. STUDY DESIGN: We recruited 22 neonates with TMg < or = 1.6 mg/dl. They received intravenous sulfate (6 mg elemental Mg/kg) over a 1-hour period. Serum TMg, ionized Mg, and ionized Ca were measured before and after magnesium sulfate infusion. An ion-selective electrode was used to allow direct measurement of ionized Mg and ionized Ca. RESULTS: Thirteen (59%) of 22 neonates with TMg < or = 0.65 mmol/L (1.6 mg/dl) had normal IMg. In 7 (31%) of 22 cases ionized Mg increased slightly above 0.56 mmol/L (1.36 mg/dl); the maximum value was 0.61 mmol/L (1.48 mg/dl). The change in ionized Ca concentrations and the baseline ionized Mg value were inversely correlated (r = -0.79; p < 0.0001). CONCLUSIONS: (1) Measurement of ionized Mg should prevent overdiagnosis and treatment of hypomagnesemia. (2) The dose used in this study is safe. (3) Ionized Mg concentrations are inversely correlated to the response of ionized Ca concentrations to an Mg load.

Calcium↗
PubMed1998

The epidemiologic trends of scabies among Israeli soldiers: a 28-year follow-up.

BACKGROUND: Scabies is not a notifiable disease in most countries. Thus, the reported rates of the disease in large populations are usually inaccurate and based on estimations. Scabies is usually reported only when large outbreaks occur. OBJECTIVE: This article describes the global epidemiology of scabies in the Israel Defense Force. The data used in this study are based on the routine and mandatory reporting of every individual case of scabies to the Army Health Branch Epidemiology Department since 1968. RESULTS: There was a period of 13 years of quiescence from the implementation of reporting in 1968 until 1981. This period was followed by an epidemic of 15 years, peaking in 1985 and 1986, and returning to the baseline rates of the quiescent period by 1996. This prospectively observed pattern of at least 13 years of quiescence followed by a peak of 15 years is consistent with other, mostly retrospective, reports. Although the peak may have been triggered by the "Lebanon" war of 1982, it is noticeable that no peak was observed during the "Yom Kippur" war (1973). CONCLUSIONS: Prospective, mandatory reporting of the kind described here should help to better understand the epidemiology of scabies.

Adolescent↗
PubMed1997

Whole blood ionized magnesium in the healthy neonate.

OBJECTIVE: We aimed to determine the normal range of ionized magnesium (IMg2+) concentration at birth and 24 hours of life in the healthy, term (37 to 41 weeks old) neonate. METHODS: Cord blood was obtained from the umbilical vein of 30 patients. In addition, blood was obtained from 32 infants at 24 hours of life. Whole blood was analyzed to determine IMg2+ concentration, ionized calcium concentration, and pH. RESULTS: The normal range of IMg2+ concentration (mean +/- 2 SD) was found to be 0.40 to 0.56 mmol/L (0.97 to 1.36 mg/dL) at both birth and 24 hours of life. CONCLUSIONS: The normal range of IMg2+ concentration (mean +/- 2 SD) in the healthy neonate at birth and 24 hours of life is 0.40 to 0.56 mmol/L (0.97 to 1.36 mg/dL). This range can serve as a reference value for future studies regarding the clinical usefulness of IMg2+ concentration determination in neonatal disease states.

Humans↗
PubMed1996

Effect of rice cereal feedings on bone mineralization and calcium homeostasis in cow milk formula fed infants.

OBJECTIVE: We conducted a prospective randomized, single-blinded clinical trial to test the hypothesis that intake of formula plus cereals between the ages of 16 and 26 weeks postnatally (as compared to formula alone) would lead to lower bone mineral content (BMC), higher parathyroid hormone (PTH) concentration, lower serum calcium (Ca), magnesium (Mg) and osteocalcin (OC); and increased continuous night sleep. METHODS: At 16 weeks postnatally, 41 healthy, term infants were randomized to formula alone or formula and cereal. RESULTS: We found no significant differences in growth or sleep pattern, nor in BMC between groups. Serum PTH concentration was significantly increased in the cereal group at 26 weeks. CONCLUSION: We speculate that the increase in PTH is due to relative Ca deficiency or is responsive to increased phosphate load in the cereal group.

Animals↗
PubMed1995

Effect of pulse dexamethasone therapy on the incidence and severity of chronic lung disease in the very low birth weight infant.

We conducted a prospective, randomized, double-blind trial to assess the efficacy and safety of pulse doses of dexamethasone on survival without supplemental oxygen in very low birth weight infants at high risk of having chronic lung disease. Seventy-eight infants with birth weights < or = 1500 gm who were ventilator dependent at 7 days of postnatal age were randomly assigned to receive pulse doses of dexamethasone, 0.5 mg/kg per day, divided twice daily (n = 39), or an equivalent volume of saline solution placebo (n = 39), for 3 days at 10-day intervals until they no longer required supplemental oxygen or assisted ventilation, or reached 36 weeks of postmenstrual age. At study entry, the groups did not differ by birth weight, gestational age, or severity of lung disease. At 36 weeks of postmenstrual age, there was both a significant increase in survival rates without oxygen supplementation (p = 0.03) and a significant decrease in the incidence of chronic lung disease (p = 0.047) in the group that received pulse therapy. Supplemental oxygen requirements were less throughout the study period in the group that received repeated pulse doses of dexamethasone (p = 0.013). The total numbers of deaths and the durations of supplemental oxygen, ventilator support, and hospital stay did not differ between groups. Recorded side effects in the pulse therapy group were minimal and included an increase in the use of insulin therapy for hyperglycemia (p < 0.05). We conclude that in this population of very low birth weight infants, treatment with pulse doses of dexamethasone resulted in improvement in pulmonary outcome without clinically significant side effects.

Adult↗
PubMed1995

Pulse dexamethasone does not impair growth and body composition of very low birth weight infants.

OBJECTIVE: Evaluation of repeated pulses of dexamethasone (PDEX), given to improve cardiopulmonary outcome, on growth of very low birth weight (VLBW, < 1500 g) infants. METHODS: In this prospective, double-blind, randomized clinical trial, VLBW infants mechanically ventilated at 1 week of age received intravenous PDEX or saline placebo (P) for 3 days, every 10 days, until no supplemental oxygen or ventilation was required or 36 weeks postmenstrual age (PMA). Weight gain, fluid intake, caloric intake, and serum glucose were monitored throughout the study. Nutritional assessment at 36 weeks PMA consisted of weight, length, head circumference, skinfold thickness measures, body composition by total body electrical conductance, and bone mineral content (BMC) by single beam photon absorptiometry. RESULTS: 37 PDEX and 31 P infants survived at least 36 days and completed the protocol. Average daily weight gain, fluid intake and caloric intake were not different between groups. The pattern of weight gain (g/kg/day, mean +/- SD) was different: PDEX infants showed significant growth delay during (3.0 +/- 11.4) and immediately after (7.8 +/- 8.7) each pulse, with subsequent growth acceleration (18.3 +/- 8.2) until the next steroid pulse. In contrast, growth rate of P infants was constant (12.6 +/- 3.7) (p = 0.04). Hyperglycemia requiring insulin therapy occurred only in the PDEX group (10/37). The catch-up growth noted between pulses in the PDEX group was explained only in part by insulin therapy. At 36 weeks PMA, there were no differences between groups in body size, composition, or BMC. CONCLUSION: PDEX negatively affected glucose metabolism and growth patterns during and immediately after drug exposure. However, assessment near term gestational age showed similar body composition and size in both groups.

Body Composition↗
PubMed1995

Nucleated erythrocytes and intraventricular hemorrhage in preterm neonates.

OBJECTIVES: Increased circulating nucleated erythrocytes (NRBCs) in the newborn period can be markers of chronic fetal hypoxia, which in turn may be a risk factor for intracranial hemorrhage (IVH). To evaluate the relation between chronic intrauterine hypoxia and IVH, we compared the courses of the absolute NRBC (ANRBC) count in preterm newborns with and without intracranial hemorrhage. METHODS: We measured ANRBC counts in the first 6 days of life in appropriate for gestational age newborns at 32 weeks' gestation or earlier with (n = 46) and without (n = 103) IVH, who were not at risk for altered erythropoiesis. RESULTS: The ANRBC counts at birth were higher in infants who developed severe IVH than in control infants without IVH (P < .03). The ANRBC counts peaked on day 2 or 3 in newborns with IVH, but declined continuously from a peak on day 1 in the control group. Stepwise regression analysis of multiple variables revealed that the grade of IVH had the greatest impact on ANRBC counts. An ANRBC count of at least 2.0 x 10(9)/L on day 1 of life had a sensitivity of 63% and a specificity of 79% in predicting grade III or IV IVH: CONCLUSION: An elevated or increasing ANRBC count in a preterm newborn is a potential marker for an impending or present severe IVH, respectively, and may reflect a state of altered prenatal or postnatal erythropoiesis.

Biomarkers↗
PubMedDate not supplied

Feeding tolerance in preterm infants: randomized trial of bolus and continuous feeding.

OBJECTIVE: To test the hypothesis that continuous gastric infusion (CGI) is better tolerated than intermittent gastric bolus (IGB) in small very low birth weight (VLBW) infants. DESIGN: Two-center, prospective, randomized, unmasked clinical trial. PATIENTS: 28 VLBW infants (birth weight <1250 g). A strict feeding protocol was followed. INTERVENTION: Patients were randomized to IGB or CGI. MAIN OUTCOME MEASURES: Time to reach full feeds (160 cc/kg/d)(by design and real), daily weight, caloric intake, residual gastric volume and type of feeding (formula vs. human milk vs. both). RESULTS: Five infants failed to complete the study because of death (n = 4) or protocol violation (n = 1). The two groups did not differ by birth weight or gestational age; infants fed via IGB reached full feeds earlier (p = 0.03) and had less delay in reaching full feeds than infants fed via CGI. CONCLUSION: Contrary to our hypothesis, gravity IGB is more effective than CGI in improving feeding tolerance in small VLBW infants.

Enteral Nutrition↗