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R S Procianoy

Publications and source records attributed to R S Procianoy.

48 records · Page 3Linked to original sources
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[Assessing the efficacy of the recombinant human granulocyte colony-stimulating factor "rhG-CSF" in the treatment of early neonatal sepsis in premature neonates]

OBJECTIVE: To evaluate the efficacy of the recombinant human granulocyte colony-stimulating factor (rhG-CSF) in the treatment of early-onset neonatal sepsis among premature infants.MATERIALS AND METHODS: A double-blind, randomized, placebo-controlled trial was performed among forty-four preterm neonates who had "clinical diagnosis" of early-onset sepsis. The treatment group (n=22) received 10 micro g/kg/d of rhG-CSF, IV once daily for three consecutive days, and the placebo group (n=22) received the same volume of a visually-indistinguishable vehicle. Prior to the first dose, and prior to the second and third doses, and again 10 days after the first dose, we measured tumor necrosis factor-a, interleukin-6, granulocyte-macrophagocyte colony-stimulating factor, G-CSF, leukocyte count, absolute neutrophil count, immature/total neutrophil ratio, platelet count, and hemoglobin concentration. A bone marrow aspiration was performed seven days after the first dose, and both the neutrophil storage pool (NSP) percent and the NSP/NPP (neutrophil proliferative pool) ratios were tabulated.RESULTS: The treatment and placebo groups were of similar gestational age (29-/+ 3 vs 31-/+ 3 weeks) and birth weight (1376 -/+ 491 vs 1404 -/+ 508 grams). They had similar Apgar scores and 24 hour SNAP scores. No deaths occurred during the first week of life among the treatment group while three deaths occurred in the placebo group. RhG-CSF treatment did not alter the serum concentrations of the cytokines measured (except for G-CSF). Serum G-CSF levels, blood leukocyte counts, absolute neutrophil counts, NSP percentages, and NSP/NPP ratios were higher in the treatment group 24 hours and 72 hours after dosing. The occurrence of a subsequent infection over the two week period following dosing was significantly lower in the treatment group (n=2) than in the placebo group (n=9; p<0.02, RR 0.19 [0.05-0.78]). The overall mortality rate during the entire hospitalization was not different between treatment and placebo groups.CONCLUSIONS: Administration of rhG-CSF to premature neonates with the clinical diagnosis of early-onset sepsis was associated with lower incidence of nosocomial infection over the ensuing three weeks period, but it did not change the overall mortality rate.

Journal Article↗
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[Coagulase-negative Staphylococcus sp. in blood cultures from infants less than 60 days old: infection versus contamination].

OBJECTIVE: The aim of this study was to determine the prevalence of infection versus the prevalence of contamination in infants less than 60 days old who had blood cultures positive for CoNS. MATERIAL AND METHODS: Between February and June - 1993, a number of 45 blood cultures positive for CoNS from 41 patients were studied. Patients were classified in three groups according to their clinical and laboratorial data: I- infected patients, II- non-infected patients and III- dubious. RESULTS: The results showed that 11 patients (26.8%) were included in group I, 25 (61%) in group II (contaminated blood cultures), and 5 (12.2%) in group III. CONCLUSION: It is suggested that more than one blood culture should be requested before treatment with antimicrobials, avoiding unnecessary administration of antibiotics.

English Abstract↗
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[The influence of intrapartum antibiotic therapy on the diagnosis of early-onset neonatal sepsis].

OBJECTIVE: To determine the influence of intrapartum antibiotic therapy on blood and secretion cultures of newborn infants suspected of early-onset sepsis. MATERIAL AND METHODS: From August 1995 through July 1996, 69 sequential newborn infants with early-onset sepsis or septic syndrome were included in the study. All of them were followed for the end point: positivity of blood, urine, CSF, tracheal secretion or umbilical catheter cultures. The sample size was figured out to be 17 for each group, for a significant level of 5%. RESULTS: Seventeen mothers were treated with antibiotic. Ampicillin alone or in association with other drugs was utilized in 70% of them. Urinary tract infection occurred in 9 mothers (53%), ammonites in 6, one mother had both and another one had erysipelas. Thirteen newborn infants had positive cultures in the group whose the mothers had not received antibiotic (n=52), none of the 17 newborn infants delivered by the mothers treated with antibiotic had any positive culture (p=0.0164). The relative risk of positive culture in a septic neonate if the mother is not treated with antibiotic is 12 times higher than if the mother is treated with antibiotic. CONCLUSION: The use of intrapartum antibiotic in newborn infants with early-onset sepsis or septic syndrome may cause a negativity of cultural exams, increasing the difficulty of the diagnosis of early-onset neonatal sepsis.

English Abstract↗
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[Evaluation of umbilical cord pH and its relationship with Apgar score in term newborn infants].

The value of the Apgar score as an index of birth asphyxia has been recently questioned. The purpose of the present study is to evaluate the relationship between cord blood pH and Apgar score in term newborn infants.A cross-sectional study involving 76 term newborn infants was performed from March through September 1995 at the Obstetric Unit of Hospital de Clínicas de Porto Alegre. The blood samples were obtained from umbilical cord artery and vein at the moment of delivery. Infants were divided in three different groups according to the Apgar score: Group A (n=60): >or=7 at one and five minutes; Group B (n=13): < 7 at one minute and >or=7 at five minutes; Group C (n=3): < 7 at one and five minutes. The frequency of acidemia in Group A was 18.3% (11 newborn infants) considering arterial pH < 7.20 and 5% considering arterial pH or= 7.20 and nine (56.2%) had arterial pH > 7.10. None of the newborn infants in Group C had arterial pH > 7.10. The sensitivity and specificity values for Apgar score less than 7 at one minute for detection of fetal acidemia were, respectively, 54.1% and 94.1%. This study confirms a poor correlation between Apgar score and umbilical blood cord pH, even in a term newborn, and emphasizes the importance of obtaining umbilical cord pH to consider the diagnosis of perinatal asphyxia.

English Abstract↗
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[Hyperkalemia in very low birthweight infants: incidence and associated factors].

The present study evaluated the incidence of hyperkalemia in premature babies born at the Hospital de Clínicas de Porto Alegre (birthweight or=6 mEq/l) and 15.4% with potassium levels subject to cardiac arrhythmia (>or= 6.7 mEq/l). The population was divided into two groups: group KN with potassium < 6 mEq/l (n=16) and group KE with potassium >or= 6 mEq/l (n=10). The hydroelectrolyte management and maintenance of neutral thermal environment was the same for both groups. Neither group received potassium in the first 36 hours of life. The KE group presented higher potassium levels during all the study. The mean birthweights of the groups were similar (KN = 963 gr; KE = 987 gr). The KN group presented a mean gestational age (29.3 weeks x 30.8 weeks) and Apgar Score in the first minute of life (3.18 x 5.7) significantly lower (p = 0.004 and p = 0,015 respectively) than the KE group. There were no significant differences between both groups in relation to the intraventricular hemorrhage, acidosis, hialine membrane disease, insulin level, glycemia, glycemia/insulin index, glomerular filtration rate, diurese, urinary potassium level, fractional sodium excretion, fractional potassium excretion and aldosterone tubular index. The level of aldosterone was significantly higher in the KE group (p = 0.029) within 24 hours of life (212.8 ng/dl x 110.2 ng/dl). It is suggested that none of the studied factors is responsible for the non-oliguric hyperkalemia of the very low birthweight newborn infant, stressing, however, that the serum potassium level must be carefully controlled in those infants.

English Abstract↗
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[Decision making about the child in CIU--participation of the family].

This paper focuses attention on the moral and ethical principles in the treatment of a very sick newborn infant and child. Special attention is given to the risk benefit balance of the employment of sophisticated technology with the purpose of prolonging the survival of a possible handicapped child. The authors analyzed the different ways of facing this problem according to different cultural backgrounds. The concept of a terminal patient is not applied to the neonatal period. The principle of autonomy is discussed, and the familiar feelings are analyzed.

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[The influence of the mode of delivery on the umbilical cord serum aldosterone levels in preterm newborn infants].

The influence of the mode of delivery on the umbilical cord serum aldosterone levels in preterm newborn infants was studied. Sixty-four newborn infants gestational age less than 37 weeks were sequentially included in the study. Umbilical cord blood was collected just after birth and the aldosterone level was measured by radioimmunoassay. The median aldosterone level of the whole studied sample was 74.5 ng/dl (range: 22.00-280.00 ng/dl). The aldosterone level of the 31 newborn infants delivered vaginally was similar of the 33 newborn infants delivered by cesarean-section. When the cesarean group was subdivided in presence or not of labor prior to delivery, the aldosterone levels of those delivered after labor was significantly higher than those without labor. It is suggested that some event associated to the mode of delivery or the presence of labor prior to delivery may influence aldosterone levels in preterm newborn infants.

English Abstract↗
PubMedDate not supplied

[Effect of B1, B2 and B6 vitamins on gastro-pancreatic enzymes (author's transl)].

Based in a former work the authors made an "in vitro" verification about the action of pure and isolated B1, B2 and B6 on the digestive enzymes. After many experiments they came to the following conclusions: 1. Pure and isolated vitamins B1, B2 and B6 have no effect on the clotting of milk. 2. Vitamins B1 and B2 delay the action of the digestive enzymes on the clotting of milk. 3. Vitamin B6 can be considered an activator, diminishing the time enzymes takes to produce clotting of milk. Afterwards they make commentaries and relate the analogy of the results with those of other authors when studying the action of pure and isolated vitamins in other biological branches and in animals.

Animals↗