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Biomedical subjects

R C Banagale

Publications and source records attributed to R C Banagale.

17 recordsLinked to original sources
PubMed1989

The population pharmacokinetics of theophylline in neonates and young infants.

The population pharmacokinetics of theophylline were evaluated using 391 theophylline serum concentration measurements from 108 neonates and young infants (postnatal age 0-26 weeks), who received theophylline for the treatment of neonatal apnea. A one-compartment pharmacokinetic model with first-order elimination was used, with intravenous aminophylline and oral theophylline administration modeled as zero-order infusions. The effect of a variety of developmental and demographic factors on clearance (CL) and volume (V) were investigated. Hypothesis testing to evaluate potentially significant factors produced a final model in which clearance was based on weight (kg) raised to an exponential power and postnatal age (weeks), with CL (ml/hr) = 17.5 (weight)1.28 + 1.17 (postnatal age). Clearance was reduced by 12% for patients receiving parenteral nutrition. Volume of distribution in this population was adequately described using only weight, with V (L) = 0.858 L/kg. Bioavailability of orally administered drug was not significantly less than unity. Interindividual variability in clearance was modest, with a coefficient of variation for clearance of 16%. An estimate of interindividual variability in volume could not be obtained. As a measure of residual variability in theophylline serum concentrations, the coefficients of variation for theophylline serum concentrations of 5.0, 10.0, and 13.0 mg/L were found to be approximately, 25, 12, and 9%, respectively. The identification of influential patient factors and the quantification of their influence on theophylline disposition allow for a priori estimates of theophylline pharmacokinetic parameters in these patients.

Aging↗
PubMed1986

Asphyxia neonatorum.

Various biochemical and structural changes affecting the newborn's wellbeing develop as a result of perinatal asphyxia. Central nervous system abnormalities are frequent complications with high mortality and morbidity. Cardiac compromise may lead to dysrhythmias and cardiogenic shock. Coagulopathy in the form of disseminated intravascular coagulation or massive pulmonary hemorrhage are potentially lethal complications. Necrotizing enterocolitis, acute renal failure, and endocrine problems affecting fluid electrolyte balance are likely to occur. Even the adrenal glands and pancreas are vulnerable to perinatal oxygen deprivation. The best form of management appears to be anticipation, early identification, and prevention of potential obstetrical-neonatal problems. Every effort should be made to carry out effective resuscitation measures on the depressed infant at the time of delivery.

Acute Kidney Injury↗
PubMed1985

Rapid fluorometric assay of bilirubin binding parameters in newborn infants.

Using a self-calibrating, digital hematofluorometer, bilirubin binding parameters were determined for whole blood specimens from 20 premature infants from day one to day six of life. The mean gestational age of the infants was 31.0 +/- 2.7 weeks and the birth weight was 1419 +/- 713.2 grams. There was a high correlation between the total blood bilirubin as determined by the hematofluorometer and total serum bilirubin as measured by a modified Jendrassik Grof method. An agreement between the hematofluorometer and coulter counter hemoglobin values was noted. There was a high correlation between the reserve bilirubin binding capacity as determined by the hematofluorometer and modified sephadex gel adsorption. No difference in the bilirubin binding parameter values was noted among infants treated and non-treated with phototherapy. Bilirubin binding parameters could be performed on the portion of heparinized specimen collected for blood gas measurement in infants with respiratory distress. The adaptability and 24 hour utility of the hematofluorometer within the neonatal intensive care area provides a convenient, practical and objective approach in the management of neonatal hyperbilirubinemia.

Bilirubin↗
PubMed1984

Apnea in newborn infants: approach to management.

Approximately 25% of infants with birth weights less than 1800 g or infants of about 34 weeks gestational age have an apneic episode. This, and the known high incidence of apneas in infants who subsequently are victims of sudden infant death syndrome, has led to aggressive attempts at early identification of newborns with abnormal cardio-respiratory patterns. We have found the pneumocardiogram to be effective in detecting cardio-respiratory abnormality in the newborn, and a very useful tool in the assessment of the effectiveness of pharmacologic therapy of neonatal apnea. Infants who are discharged on a home apnea monitor should be managed, utilizing a coordinated multidisciplinary team approach, that includes 24 h availability of a physician, technician, community health nurse, social worker and, when possible, a member of a parent support group. This paper presents a review of neonatal apnea and our institutional approach to its evaluation and management.

Apnea↗
PubMed1983

Traumatic separation of the distal femoral epiphysis in the newborn.

A case of distal femoral epiphyseal plate separation following breech delivery is reported. The purpose of this report is to emphasize the occurrence of this birth-associated injury because it can go undiagnosed or be misdiagnosed as septic arthritis, osteomyelitis, paralysis, or lymphedema. The pathogenesis, clinical and radiological course, management, and prognosis based on this case report and literature review are presented.

Birth Injuries↗
PubMed1982

Effect of serum caffeine level on pneumocardiogram of premature infants treated for apnea with theophylline.

It is speculated that measurement of serum theophylline concentration alone, without concomitant caffeine level determination, may lead to a false negative (normal) pneumocardiogram due to possible existence of therapeutic caffeine level resulting from the methylation of theophylline. Treatment of neonatal apnea with theophylline as documented by a normal follow-up pneumocardiogram should be considered successful only when the levels of both theophylline and caffeine have been documented subtherapeutic at time of re-test.

Apnea↗
PubMed1982

Reserve bilirubin binding capacity measured by absorbance deviation at saturation of primary albumin binding sites.

The reserve bilirubin binding capacity (RBBC) of neonatal serum can be measured by adding to it increments of bilirubin and noting the absorbance change at 484 nm. A 25 mg/dl bilirubin solution is added, in 5 mul increments, to 50 mul of neonatal serum in 2 ml phosphate buffer (200 mmol/L, pH 7.4). With each such addition there is a constant increase in absorbance at 484 nm until all of the albumin primary binding sites are occupied; then the increase becomes nonlinear. RBBC measurements using the proposed method and Sephadex adsorption were performed on 54 pairs of serum samples from 25 premature, jaundiced newborns. The measurements of RBBC by the proposed method warrant further improvement and verification by other laboratories and may be useful in the management of hyperbilirubinemia in the newborn.

Bilirubin↗