[Premature rupture of membranes, fetal immunoglobulins and perinatal infections ].
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Biomedical subjects
Publications and source records attributed to I Csaba.
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The authors examined the effect of prednisolone-salium succinate administered on the 17th or 18th day of pregnancy on the adrenal function of newborn rats. They found that in doses of 1.0 or 2.0 mg/kg it does not affect physiological development or, respectively, the extent of the circadian rhythm or the stress response. However, the adrenal function of newborn animals was significantly inhibited by 30.0 mg/kg as regards its adaptability to extra-uterine life. The authors point out the importance of investigations to determine the adrenal function of newborns following steroid therapy to prevent RDS.
In the course of investigations in pregnant rats the authors established that the effect of prednisolone-sodium succinate on the maturation of the fetal lung depends on the dose administered and/or on the time at which it was given. The prednisolone only increased the surface-active lecithin concentration - thus accelerating the functional maturation of the lung - if it was given on the 17th or 18th day of gestation, in a dose of 1.0 mg/kg or 2.0 mg/kg. A dose of 0.5 mg/kg had no effect, while a high dose not only inhibited lecithin synthesis but also caused significant side-effects. The authors point out that the glucocorticoids only have a favorable effect on lung maturation if administered during a certain period in their development, and link this to the maturation process of the specific cortisol receptors in the lung. They also point out the potential danger of glucocorticoids administered to prevent dyspnea and emphasize the importance of determining the lowest effective dose of the various synthetic preparations and/or the optimum time for giving them. They raise the question of whether there is also an ideal time for glucocorticoid treatment in human pregnancies.
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In an attempt to provide information about the role of RAAS in development of late hyponatremia in low-birthweight neonates, simultaneous measurement of plasma renin activity, (PRA), plasma aldosterone concentration (PA), and urinary aldosterone excretion (UAE) was made using RIA methods along with determination of Na and K balance weekly up to the 6th week of life. Seven healthy male infants with mean birthweight of 1580 g, range: 1160-1850 g, and mean gestational age of 31 weeks, range: 30-32 weeks, were selected for the study. Due to the increased urinary Na loss, negative Na balance developed in the first 2 weeks followed positive balance thereafter. PRA, PA, and UAE increased tremendously from the initially high values of 18.2 +/- 4.1 ng/ml/hr, 1.7 +/- 0.5 ng/ml, and 2.6 +/- 0.4 microgram/day, mean and SEM, to their maximum of 78.6 +/- 18.1 ng/ml/hr, p less than 0.01, 6.8 +/- 3.7 ng/ml, p less than 0.05, and 26.4 +/- 2.9 microgram/dayp less than 0.01, in the 3rd week, respectively. Later on, gradual declines occurred, however, PRA, PA, and UAE remained highly elevated even at the 6th week with values of 45.5 +/- 15 ng/ml/hr, 1.6 +/- 0.5 ng/ml, and 14.5 +/- 1.4 microgram/day, respectively. It is suggested that late hyponatremia of premature infants is due to tubular unresponsiveness to aldosterone and not to inadequate response of RAAS to stimulation.
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