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Biomedical subjects

O Finnström

Publications and source records attributed to O Finnström.

At least 37 records · Page 2Linked to original sources
PubMed1998

Control of an outbreak of a highly beta-lactam-resistant Enterobacter cloacae strain in a neonatal special care unit.

Two successive outbreaks of colonization and infection with Enterobacter cloacae resistant to third generation cephalosporins (cephalosporin-resistant E. cloacae, CREC) and involving 15 infants occurred within 12 months in a neonatal special care unit. Isolates of clinical significance were obtained from four infants (urine 2 cases, blood, pleural drainage). According to epidemiological typing using computerized biochemical fingerprinting and pulsed-field gel electrophoresis (PFGE) the same CREC strain was found in both outbreaks. The origin of the strain and its reservoir between the two outbreaks remained unknown. Emphasizing strict barrier nursing of the infants had little or no impact on the presence and transmission of the strain in the unit. In contrast, replacing ampicillin plus cefotaxime as standard empiric therapy with penicillin G plus netilmicin plus consequent cohorting of newborns and staff promptly halted both the outbreaks. During a 5-y follow-up after the last episode, the choice of antibiotics for empirical treatment has varied, and no further outbreaks of CREC have been seen, with the exception of two sporadic cases.

Ampicillin↗
PubMed1997

The Swedish national prospective study on extremely low birthweight (ELBW) infants. Incidence, mortality, morbidity and survival in relation to level of care.

In a 2-year (1990-92) prospective national investigation, comprising all stillborn and live-born ELBW infants with a birthweight of < or = 1000 g born at 23 completed weeks of gestation or more, we examined the incidence, neonatal mortality, major morbidity and infant survival in relation to level of care and place of residence. A total of 633 ELBW infants were live-born, i.e. 0.26% of all live-born infants, and 298 were stillborn. The average neonatal mortality was 37% and 91% at 23 weeks, 70% at 24 weeks, and 40% at 25 weeks of gestation. Of neonatal survivors, 8% had intraventricular haemorrhage grade 3, 10% retinopathy of prematurity of stage > or = 3, 2% necrotizing enterocolitis, and 28% were oxygen-dependent at a time corresponding to 36 weeks of gestation. In all, 77% were treated with mechanical ventilation, whereas 19% survived without, almost all of them being CPAP treated. Infant mortality among infants born at level III (tertiary centres) was 30%, at level IIa (with full perinatal service) 46% and at level IIb (with basic neonatal service) 55%. Only 1% was born at hospital level I. Regarding the relation to place of residence, the mortality rates among infants residing in the areas served by levels III, IIa and IIb hospitals were 36%, 45% and 41%, respectively. The referral system thus functioned well, but can be improved, and increased perinatal referral, at borderline perinatal viability, might provide a better quality of care and a better chance of survival.

Cause of Death↗
PubMed1996

[Good prognosis for very low birth weight infants].

A population-based multicentre study, comprising all very low birthweight (VLBW; < or = 1,500 g) infants born alive in the south-east region of Sweden during a 15-month period, was performed in the late 1980s. Among the VLBW infants there were 107 lifebirths (a rate of 0.72%), 86 (80.4%) neonatal survivors and no late deaths. Twenty (18.4%) had intracranial complications, two (2.3%) retinopathy of prematurity, grade 3, and six (5.6%) bronchopulmonary dysplasia. At follow-up at 18 months of uncorrected age, the VLBW infants were still lighter in weight and of shorter stature than control group infants. Of the five (5.8%) of the surviving VLBW infants who had significant neurological disorder at 18 months of age, all had weighed less than 800 g at birth, and had manifested neurological symptoms at 6 months of age. The hospitalisation rate during the first 18 months of life was greater in the VLBW than the control group.

Child Development↗
PubMed1993

Administration of vitamin K to newborn infants and childhood cancer.

OBJECTIVES: To investigate whether childhood cancer is associated with intramuscular administration of vitamin K to newborn infants. DESIGN: Routines for administration of vitamin K to infants born after normal deliveries during 1973-89 were obtained from maternity hospitals. Occurrence of cancer up to the end of 1991 was identified by comparing these records with the national cancer registry. Adherence to the routine method of administering vitamin K was checked with the medical records of a sample of 396 infants (196 who had developed childhood cancer and 200 controls). SETTING: All maternity hospitals in Sweden. SUBJECTS: 1,384,424 full term infants born after non-instrumental deliveries, 1,085,654 of whom were born in units where vitamin K was routinely given by intramuscular injection and 272,080 of whom were born where it was given orally. MAIN OUTCOME MEASURES: Odds ratios for cancer after intramuscular administration of vitamin K versus oral administration after stratification for year of birth. RESULTS: Adherence to routine method of administering vitamin K was 92% in the 235 cases where individual information could be found. The risk of cancer after intramuscular administration of vitamin K was not elevated compared with that after oral administration: odds ratios of 1.01 (95% confidence interval 0.88 to 1.17) for all childhood cancers and 0.90 (0.70 to 1.16) for childhood leukaemia. CONCLUSIONS: The alleged association between intramuscular vitamin K prophylaxis to newborn infants and childhood cancer could not be verified in the present study of full term infants born after non-instrumental delivery.

Administration, Oral↗
PubMed1992

Neurological adaptation of infants delivered by emergency or elective cesarean section.

The effects of intrapartal asphyxia on neonatal neurological condition have been studied in 17 full-term infants delivered by emergency cesarean section and in 30 full-term infants delivered by elective cesarean section used as controls. A neurological examination consisting of 31 items was performed on days 1, 2 and 5 after birth. A tonus score, an excitability score as well as the number of optimal responses were calculated. A follow-up examination was done at six months of age with a standardized neurological and developmental examination. The results showed that infants born after emergency cesarean section were significantly more hypotone the first two days after delivery than the infants in the elective cesarean section group. In regard to individual neurological items, significant differences were found between the emergency and elective cesarean section in reaction to sound, rooting, patellar, Moro and stepping reflexes with weaker reactions in the elective cesarean section group. Growth, psychomotor development and neurological status at six months did not differ significantly between the groups. Our findings indicate that full-term infants born after emergency cesarean section due to mild intrapartal asphyxia have a delayed neurological adaptation as expressed by poor muscular tonus during their first days of life compared with infants born after elective cesarean section.

Adaptation, Physiological↗
PubMed1989

Plasma ionized calcium, phosphate and magnesium in preterm and small for gestational age infants.

Blood concentrations of ionized calcium, phosphate and magnesium were determined on days 1, 3 and 5 in 32 preterm infants, appropriate for gestational age, and 25 small for gestational age infants. The results were compared with those of a reference group of 31 fullterm newborns. Preterm infants had lower mean ionized calcium levels than the reference population. Ionized calcium levels were positively correlated with gestational age and postnatal age. The sickest infants had the lowest calcium levels. Intrauterine growth retardation did not seem to influence the calcium levels. Small for gestational age infants had lower phosphate values than the reference group and the values correlated with the degree of growth retardation the first day. Magnesium concentrations increased with time and did not differ significantly between the study groups and the reference group. Magnesium values did not correlate with calcium or phosphate values.

Calcium↗
PubMed1988

Blood exchange transfusions in newborns, the effect on serum ionized calcium.

Serum levels of ionized calcium (CaF) were determined in 35 newborn infants subjected to blood exchange transfusion with citrated blood. Eleven of these were supplemented with calcium injections during and after the transfusion. No symptoms or signs accompanied the extremely low calcium levels noted during the exchange transfusion. Intravenous calcium administration often rendered transitory high serum concentrations of ionized calcium. The lowest and highest calcium levels noted during transfusion were 0.28 and 5.16 mmol/l respectively. Calcium levels normalized within 1 day after exchange transfusion without calcium therapy. Repeated exchange transfusions brought about progressively lower calcium values.

Calcium↗
PubMed1988

Neurological condition of large-for-gestational-age infants during the newborn period.

Thirty-two large-for-gestational-age (LGA) infants and 46 appropriate-for-gestational-age (AGA) infants used as controls, were investigated. LGA and AGA infants did not differ regarding instrumental deliveries or asphyxia. The infants were examined on the 1st and 5th days after birth with a standardized neurological assessment. The LGA infants showed a significantly delayed neurological adaptation with fewer optimal responses on day one as compared to the AGA infants. These differences were not observed on day five. There were no neurological differences between prenatally and postnatally detected LGA infants. No significant differences were observed regarding parity on maternal complications, neonatal course, and neurological scores of the LGA infants.

Fetal Macrosomia↗