Biomedical subjects
Publications and source records attributed to J J Ferlauto.
Alcohol is a well known teratogen. Its role in causing fetal alcohol syndrome/fetal alcohol effects is well documented. A vast amount of study over the past several decades has finally provided insight into many aspects of its effect. The only effective treatment is complete abstinence from the drug during pregnancy.
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Explore the source record for details and available documents.
We have described a term newborn infant who developed Flavobacterium meningosepticum meningitis at 9 days of age. The case demonstrates the tenacity and changing antibiotic sensitivity of this organism. We used trimethoprim-sulfamethoxazole (Bactrim) intravenously to obtain CSF sterilization. On follow-up this child was neurologically intact.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Nutrition is of critical importance to very low birth weight (VLBW) survival. Intravenous (iv) lipid tolerance has been studied using a soybean or safflower-based lipid emulsion. We studied lipid levels in a group of VLBW infants on both intravenous lipids (soybean-safflower emulsion) and on enteral feedings (24 cal/oz premature formula). Levels were obtained on 1, 2, and 3 g/kg/day of iv lipid and after 3 and 10 days of feeding. Triglyceride (TG) and free fatty acid (FFA) proved the most sensitive indicator of both iv and enteral tolerance. The higher the lipid dose, the more likely there would be elevated lipid levels, especially FFA. Mean lipid levels for the group of enteral-fed infants were normal. Comparison of lipid levels on iv to those on enteral feedings showed significant differences in trough iv levels of TG compared to preprandial TG. FFAs tended to be significantly higher on iv feedings. Monitoring lipid levels on iv and enteral feedings is appropriate to document tolerance.
OBJECTIVE: The principal objective of this retrospective, cohort study was to determine if clinically significant gastroesophageal reflux (GER) would impair the long-term cognitive and motor development of preterm infants. An additional objective was to determine the effects of clinically significant GER on the length of hospital stay and total hospital charges in preterm infants. STUDY DESIGN: The design was a retrospective, cohort study of 66 preterm infants, followed in the Neonatal Developmental Follow-Up Clinic of The Children's Hospital in Greenville, SC. Thirty-three premature infants with clinically significant GER met the following study criteria: birth dates, 1988 through 1994; lack of gastrointestinal anatomic defects; and lack of acute neurologic injury (defined as no intraventricular hemorrhage greater than Papile's grade I, no periventricular leukomalacia, no seizures, and no history of birth asphyxia). Clinically significant GER was defined as GER associated with moderate to severe apnea (n=29) or GER associated with moderate to severe feeding intolerance (n=4). The study patients were matched as closely as possible with 33 control premature infants for sex (except when twins were used), ethnicity, social risk, gestational age, birth weight, and Apgar scores at 1 and 5 minutes. Social risk was categorized using Hack's Social Risk Scale. Important covariates included apnea, home monitoring, and nasal continuous positive airway pressure. RESULTS: Neurodevelopmental test scores from 7 months of age through 2 years of age did not show any significant differences between premature infants with clinically significant GER and premature infants with no evidence of clinically significant GER. Total hospital charges were statistically different for the clinically significant GER infants and the nonclinically significant GER infants (median $112,916 versus median $63,928, p=0.01). Total neonatal intensive care unit length of stay measures were statistically different between the two groups (median 53 days versus median 40.5 days, p=0.01). CONCLUSION: Even though clinically significant GER may pose a substantial medical risk in premature infants, the long-term cognitive consequences appear to be negligible. Nevertheless, those premature infants with clinically significant GER do consume significantly more hospital resources than matched controls. Early diagnosis and intervention may possibly lessen the impact of medical costs and reduce length of hospital stay.