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Biomedical subjects

R S Pildes

Publications and source records attributed to R S Pildes.

At least 91 records · Page 5Linked to original sources
PubMed1977

Significance of radiographic findings in early-onset group B streptococcal infection.

Chest radiographs on 73 neonates with early-onset group B Streptococcus (GBS) infection were reviewed. Eighty-six percent of the infants were premature (less than 38 weeks); 68% weighed less than or equal to 1,500 g. In infants weighing less than or equal to 1,500 g, the predominant radiographic pattern was hyaline membrane disease (HMD) (80%). There was a significant increase in radiographic HMD in 1,000 to 1,500-g neonates with GBS infection (77%) when compared to a control group of infants without GBS infection (44%). Mortality in 1,000 to 1,500-g infants with GBS infection and radiographic HMD (95%) was also significantly higher than in the control group of infants with hmd HMD and no GBS infection (38%). In larger premature and full-term infants, the radiographic findings were not specific and also were not helpful in distinguishing GBS infection from other newborn respiratory disorders.

Female↗
PubMed1976

Transient neonatal pustular melanosis.

Newborn infants were observed with vesicopustular and pigmented macular skin lesions, which occurred more commonly in black and mature infants and which were distinct clinically and histopathologically from erythema toxicum. Histopathology of skin biopsies of the vesicopustules is characterized by polymorphonuclear infiltration. The lesions often present as, or evolve into, a pigmented macule and persist from three weeks to three months. There are no associated systemic symptoms.

Black or African American↗
PubMed1976

Exchange transfusion in the neonate: a controlled study using frozen-stored erythrocytes resuspended in plasma.

During a nine-month period 43 consecutive infants who needed exchange transfusions for the management of their hyperbilirubinemia randomly received whole blood less than 5 days old (control group) or frozen erythrocytes diluted in plasma (experimental groups). There was no different prior to and after exchange transfusions in total protein, albumin, globulin, immunoglobulins, bilirubin, and hematocrit in the control group versus the experimental group. The efficacies of bilirubin removal, as measured by delta bilirubin, were the same in the two groups. Advantages of exchange transfusion with freeze-preserved erythrocytes suspended in type-specific plasma are discussed.

Bilirubin↗
PubMed1976

Cholestasis associated with administration of L-amino acids and dextrose solutions.

Infants of very low birth weight who require prolonged assisted ventilation are unable to tolerate oral feedings. To provide and maintain nutrition in these infants, a modified form of parenteral nutrition (dextrose 10% and crystalline L-amino acids, 1.7-3.4 g%) is used in our nursery. Intrahepatic cholestasis was diagnosed at autopsy in four infants who received modified peripheral alimentation and in a fifth infant who received total parenteral alimentation (dextrose 20%, L-amino acids 3.8 g%) via a central venous catheter. These infants weighed less than 1,250 g at birth (range 943-1,247 g) and were appropriate for gestational age. They required assisted ventilation for over 2 weeks. Three infants did not receive any oral feedings. L-Amino acids were given for a mean of 36.8 +/- 10 days (range, 22-76 days). The diagnosis of cholestasis was suspected clinically in only one infant, in whom persistent elevation of direct bilirubin was detected at 4 weeks of age. Pathologic findings in four infants included the presence of bile casts in bile canaliculi and, in one case, in ductules and canaliculi. Liver architecture was well preserved. Inflammatory infiltrate in the portal tract was either absent or minimal, consisting of lymphocytes, and only in one of five cases a few eosinophils. Cholestasis may be regarded as a possible complication of parenteral alimentation even if the fluids are modified and given peripherally. High direct bilirubinemia may be the earliest clinical manifestation.

Amino Acids↗
PubMed1976

Insulin and growth-hormone responses in neonatal hyperglycemia.

Glucose, insulin, and growth hormone values were studied prospectively in 75 premature infants during the first five days after birth. Intravenous glucose was given at a mean rate of 4.7-4.9 mg./kg./min. (range 3-7). Mean birth weight was 1,394+/-47 gm. (mean+/-S.E.M.). Blood glucose values were significantly higher on days 1 and 2 than on days 3 to 5. Hypoglycemia (blood glucose less than 20 mg./100 ml.) occurred in two SGA and one AGA infants. On the other hand, hyperglycemia (greater than 125 mg./100 ml.) was found in 32 of the 75 (42.7 per cent) infants. A significantly greater number of deaths occurred in infants with hyperglycemia (19/32) than in those with normoglycemia (19/32) than in those with normoglycemia (5/43). Mean plasma insulin values were significantly higher on days 1 and 2 (15+/-3 and 18+/-4 muU./ml.) than on days 3 and 4-5 (6+/-1 and 7+/-2 muU./ml.). In addition, mean insulin levels were significantly higher during hyperglycemic than during normoglycemic glucose levels at similar postnatal age. Growth hormone values were higher during the first three days than subsequently, but the values were similar in normoglycemic and hyperglycemic groups. Significant negative correlations were seen between glucose values on the first two days of postnatal life and birth weight, gestational age, and Apgar scores, whereas positive correlations were found with FiO2 and respiratory distress score (RDS).

Acidosis, Respiratory↗
PubMed1975

Effect of maternal heroin addiction on 67 liveborn neonates. Withdrawal symptoms, small body size, and small head circumference were frequent findings.

It is apparent that maternal addiction affects the fetus and causes serious problems in the neonatal period. Whether intrauterine exposure to heroin has far-reaching, long-term residual effects remains to be determined. We believe that prospective studies are indicated in order to evaluate the incidence of small head circumference, the pattern of intrauterine growth retardation, and the correlation of these findings with later neurologic and behavioral development.

Abnormalities, Drug-Induced↗
PubMed1975

Subcutaneous calcium deposition in the neonate associated with intravenous administration of calcium gluconate.

Nine infants who had severe local manifestations following intravenous administration of calcium gluconate are presented. The lesions appeared at the intravenous sites as firm subcutaneous nodules or areas of areas of inflammation with central softening and fluctuation. The interval between appearance of the lesion and calcium administration was 13 plus or minus 2.5 (mean plus or minus SEM) days. Five infants were treated with antibiotics and three of the five had incision and drainage. Roentgenographic evidence of subcutaneous calcification was seen in all cases at the time the lesions were first noticed. In two infants the entire cephalic vein was calcified. Induration and inflammation completely subsided in six infants, four of whom had follow-up roentgenograms showing complete resolution of calcification. A conservative approach in management is recommended.

Biopsy, Needle↗
PubMed1975

Assisted ventilation in infants with meconium aspiration syndrome.

In a retrospective analysis of infants born with meconium staining over an 18-month period at Cook County Hospital, 32 infants met two of the three criteria for the diagnosis of meconium aspiration syndrome: (1) history of meconium in the oropharynx or trachea; (2) clinical evidence of respiratory distress; and (3) x-ray evidence of aspiration pneumonia. Seventeen infants developed respiratory failure; nine of these infants died. One infant without respiratory failure died of sepsis. Analysis of sequential arterial blood pH and gas tension showed that nonsurviving infants had persistently high PCO2 and A-a gradient in spite of initiation of assisted ventilation. These changes seem to be related to severe right-to-left shunting and ventilation perfusion abnormalities. The data further suggest that asphyxia and acidosis occur well before the infant is born and that intrapartum monitoring to recognize fetal asphyxia may help in improving morbidity and mortality from meconium aspiration syndrome.

Blood Gas Analysis↗