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Biomedical subjects

R S Pildes

Publications and source records attributed to R S Pildes.

At least 73 records · Page 4Linked to original sources
PubMed1979

Hyperglycemia in stressed small premature neonates.

The metabolic responses to a constant glucose infusion were measured in 30 premature infants, 700 to 1,550 gm. The study included 18 stressed premature infants who needed assisted ventilation, and 12 control premature infants. Metabolic measurements were similar in both groups in the cord and preinfusion samples. In the first postinfusion sample, glucose, cortisol, and glycerol values were higher in stressed than in control premature infants. Hyperglycemia was seen in 13 of stressed and in only one of control premature infants. Stressed infants who became hyperglycemic in the first postinfusion sample were then compared to stressed euglycemic infants. Insulin levels were higher, glycerol levels similar, but cortisol levels lower in stressed hyperglycemic than in stressed euglycemic premature infants. The etiology of hyperglycemia in stressed premature infants cannot be attributed to hypoinsulinemia or to hypercortisolemia, and is not associated with increased glycerol levels. There was no difference in mortality between stressed hyperglycemia and stressed euglycemic infants; stress, rather than hyperglycemia, was related to mortality.

Blood Glucose↗
PubMed1979

Effect of posture on the pattern of stomach emptying in the newborn.

To determine the effect of posture on the pattern of neonatal stomach emptying, 56 test meals of a 10% dextrose were given to 14 healthy infants over a period of two or three consecutive days. The infants, whose postnatal age ranged between 5 and 27 days, were studied in each of four positions. The emptying pattern was determined by the double-sampling dye-technique. The results indicate that there are no significant postural differences in the pattern of stomach emptying. They also indicate that neonatal and adult patterns are similar.

Gastric Emptying↗
PubMed1978

Mercury poisoning from mercurochrome therapy of an infected omphalocele.

A neonate with an infected omphalocele was treated locally with merbromin (mercurochrome) for five days. Extensive skin peeling with bullous lesions, edema, and fever developed three days after mercurochrome therapy. The infant died on the ninth day. Autopsy revealed evidence of heavy metal poisoning of the kidney, excessive mercury levels in the blood, and in tissues of the brain, kidney, and liver.

Fluoresceins↗
PubMed1978

Candida albicans meningitis in a premature neonate successfully treated with 5-fluorocytosine and amphotericin B: a case report and review of the literature.

Candida albicans meningitis was diagnosed in a 45-day-old premature infant whose birth weight was 1,616 gm. Symptoms consisted of poor weight gain and poor suckling. The combined use of amphotericin B and 5-fluorocytosine (5-FC) resulted in negative CSF cultures after 12 days of therapy. Amphotericin B was given for 45 days (total 83 mg) and 5-FC for 60 days (total 19 mg). Only one other premature infant has been reported in the literature who had similar treatment. A review of Candida meningitis diagnosed before death in 11 other infants less than 1 year of age is presented.

Amphotericin B↗
PubMed1978

Electroretinography in neonates treated with phototherapy.

Electroretinographic (ERG) studies were performed in 22 normal control newborns and 28 neonates who had had phototherapy during the first few days of life. Mean age at ERG testing was 16.8 +/- 2.9 days in the phototherapy group and 16.4 +/- 3.7 days in the control group. Results of routine funduscopy were normal in both groups. Amplitudes of a and b waves under dark- and light-adapted states were similar in both groups. Phototherapy did not appear to have deleterious effects on photopic and scotopic retinal function in infants whose eyes were adequately shielded.

Dark Adaptation↗
PubMed1977

Congenital syphilitic osteitis of scapulae and ribs.

A newborn with congenital syphilis presented radiographically with a lack of ossification of the medial portions of several ribs and massive sclerosis and decalcification of scapulae. The uniqueness of syphilitic scapular and rib involvement is discussed. The infant also went on to develop skin lesions which appeared following penicillin therapy and also developed an extrahepatic biliary atresia.

Humans↗
PubMed1977

Control of juvenile diabetes mellitus and its relationship to endogenous insulin secretion as measured by C-peptide immunoreactivity.

Proinsulin is converted to insulin and C-peptide in the pancreatic beta-cells; the latter two peptides are secreted in equimolar concentrations. Thus measurements of C-peptide immunoreactivity may provide a means of assessing residual pancreatic function in insulin-treated diabetic patients. Thirty-five patients with a mean (+/- SE) age of 13.4 +/- .6 years who had diabetes mellitus for 4.8 +/- .3 years were included in this study. Glucose and CPR were measured in the fasting state and one hour after 1 gm/kg (maximum 50 gm) of oral and glucose. Patients were assigned to one of two groups on the basis of adequate or poor control of diabetes. Twenty-five of the 35 (71%) patients had evidence of endogenous beta-cell function, i.e., CPR greater than 0.5 ng/ml. CPR levels over 0.5 ng/ml were present in a significantly (p less than 0.05) greater number of patients with diabetes of less than 5 years duration (19/21) than in those with diabetes greater than 5 years duration (6/14). Only one patient showed a rise in CPR after the glucose load. All patients with CPR greater than 2.0 ng/ml were in the adequately controlled groups, but there were patients with CPR less than 2.0 ng/ml in both adequately and poorly controlled groups. Because the CPR value includes both C-peptide and antibody-bound proinsulin, separate determination of free C-peptide was done in 30 patients. These results confirmed the conclusions based on CPR estimation. Although growth hormone values were higher in patients in the poorly controlled group, there was no correlation between hGH and CPR. We conclude that residual insulin secretion in diabetic patients may facilitate good control, but that low CPR values and hence absent beta-cell reserve is not always associated with poor control.

Adolescent↗
PubMed1977

Hydrocortisone therapy in meconium aspiration syndrome: a controlled study.

To evaluate the efficacy of glucocorticoids in the treatment of infants with meconium aspiration syndrome, a double-blind study using hydrocortisone or a lactose placebo was undertaken. Thirty-five infants were included in the study. No significant differences in arterial Po2, Pco2, pH, A-aDo2 gradients, in requirement for assisted ventilation, or in survival were domonstrated between the groups. In control infants, a significant decrease (p less than 0.01) in respiratory distress score was found at 48 to 72 hours of age; in treated infants, it was seen only after 72 hours. The infants in the treated group took a significantly longer (p less than 0.01) period of time to wean to room air than those in the control group (68.9 +/- 9.6 hours vs 36.6 +/- 6.9 hours). On the basis of these observations, hydrocortisone is not recommended for treatment of MAS.

Drug Evaluation↗
PubMed1977

Treatment of neonatal hypoglycemia with continuous intravenous glucose infusion.

The treatment of neonatal hypoglycemia by constant infusion of glucose at the rate of 8 mg/kg/minute was studied in 22 hypoglycemic neonates. In 18 neonates glucose levels rose above the hypoglycemic range within ten minutes of infusion and in three, within 30 to 50 minutes of infusion. The remaining neonate had hyperinsulinemia and responded only to diazoxide. Constant glucose infusion was found to be useful therapeutically for neonatal hypoglycemia.

Female↗
PubMed1977

Absorption of iodine in the neonate following topical use of povidone iodine.

Topical application of povidone iodine on the umbilical cord and normal intact skin of newborn infants resulted in significantly elevated plasma iodine levels. High iodine levels were also found in two neonates who had povidone iodine applied to denuded skin. No significant alteration in thyroid function was seen. The possible toxic manifestations of high plasma iodine levels are discussed.

Administration, Topical↗