Showing papers by "Primary Children's Hospital published in 1982"

Blood and Marrow Neutrophils during Experimental Group B Streptococcal Infection: Quantification of the Stem Cell, Proliferative, Storage and Circulating Pools

Abstract: Blood and Marrow Neutrophils during Experimental Group B Streptococcal Infection: Quantification of the Stem Cell, Proliferative, Storage and Circulating Pools

Calcium and phosphorus compatibility in parental nutrition solutions for neonates.

Abstract: Factors affecting calcium-phosphate solubility in parenteral nutrition solutions used in neonates were studied. Six neonatal parenteral nutrition solutions were prepared using either Aminosyn or FreAmine III and various amino acid and dextrose concentrations. Phosphorus (as mono- and dibasic potassium phosphate) and calcium (as 10% calcium gluconate) were added in concentrations of calcium 2.5-100 meq/liter and phosphorus 2.5-100 mmol/liter. Duplicate samples were prepared and analyzed either after they were heated in a water bath (37 degrees C) for 20 minutes or after 18 hours at 25 degrees C followed by 30 minutes in a water bath (37 degrees C). Precipitation was detected visually and spectrophotometrically, and pH was measured. Lipid emulsion was added to two Fre-Amine III solutions in a ratio of 7.5:1 (parenteral nutrition solution:lipid) and the resulting pH was measured. Time and temperature affected calcium-phosphate solubility in all solutions tested. Precipitation curves of amount of calcium versus amount of phosphate added were prepared for each solution. Amino acid and dextrose concentrations affected the pH of the solutions, and when a lipid emulsion was added, the pH rose more in the 1% than in the 2% FreAmine III solution. In selected solutions, as much as 120 mg/kg/day calcium and 55 mg/kg/day phosphate can be administered, approximating daily third-trimester accumulation of these minerals. Use of the precipitation curves in this paper, with attention to their limitations, should aid in the safe delivery of calcium and phosphorus intravenously to neonates.

Percutaneous Insertion of Silastic Central Venous Catheters in Newborn Infants

Abstract: Percutaneous insertion of a very narrow (0.635-nm outside diameter) Silastic catheter for delivery of central hyperalimentation was performed on infants in the Newborn Intensive Care Center. Insertion of the catheter into the external jugular or basilic vein was successful in 15/17 (88%) infants, including four weighing less than 1,000 gm. Catheters remained in place for 446 patient-days (mean 24.8 +/- 15.9 days). Culture-proven infection, thrombophlebitis, or caval obstruction did not occur. Percutaneously placed central Silastic catheters proved to be a safe and effective alternative to surgically placed catheters.

Spinal dysraphia as an autosomal dominant defect in four families

Abstract: Four families were selected randomly on the basis of the occurrence of spina bifida cystica and/or spina bifida occulta in one or more family members. Sixty-three relatives were studied clinically and roentgenologically; their roentgenograms were evaluated blindly. Twenty-eight were clinically and roentgenologically normal; 35 were diagnosed as having spina bifida occulta (SBO), spina bifida cystica (SBC), vertebral anomalies, and/or external defects usually interpreted as evidence for SBO. Excluding one proband we found the frequency of SBO to be 19/51 (37%) and the frequency of all types of spinal/vertebral defects (excluding five probands) to be 30/58 (52%). The distribution of these defects in the four families was analyzed using likelihood methods corrected for random ascertainment. The log likelihood values for sporadic, recessive, and dominant models were −26.69, −20.95, and −18.90, respectively, indicating a higher likelihood of autosomal dominant inheritance than sporadic occurrence or recessive inheritance. The penetrance probability in this dominant model, estimated by maximum likelihood, is 0.749 ± 0.100. Further examination of these data suggests that SBO and SBC represent different expressions of the same dominant gene in these kindreds.

Granulocyte transfusion in septic canine neonates.

Abstract: Summary: Newborn dogs were inoculated intratracheally with 0.5–1.0 x 108 Staphylococcus aureus/g body weight. Neutropenia (490 ± 280 neutrophils/mm3 versus 8,390 ± 490 control, ± S.E., P< 0.001), and depletion of the marrow neutrophil storage pool (3 ± 1% versus 27 ± 2% storage neutrophils P < 0.001) occurred 5–6 h following the inoculation. All animals died at 6–10 h. Additional inoculated pups were selected at random to receive transfusions of either granulocytes, plasma or red blood cells. Granulocyte transfusions (3x109 neutrophils/kg) improved survival (P < 0.005), but plasma and red blood cells did not. Speculation: Previous reports have shown that certain neonates with bacterial sepsis utilize neutrophils more rapidly than they are replaced by the marrow mitotic neutrophil pool. The quantitative neutrophil deficiency thus produced, results in blood neutropenia, reduced neutrophil availability to affected tissues and high mortality. In this study, neonatal dogs were infected experimentally and found to develop neutropenia, depletion of neutrophil reserves, and death. Granulocyte transfusions improved the survival of these animals while plasma or packed red blood cell transfusions did not. Thus, granulocyte transfusion may present a useful therapeutic modality in those septic neonates who are found to have neutropenia and a depleted neutrophil supply.

Tourette's disorder and the use of clonidine.

Abstract: This paper discusses the use of clonidine in a severe case of Tourette's disorder refractory to treatment with haloperidol. Clonidine was effective in ameliorating symptoms and reducing the frequency of severe tics. This suggests that clonidine may have value in refractory cases of Tourette's disorder. Amelioration of symptoms also occurred with intensive psychiatric treatment focusing on improving coping skills and reducing anxiety associated with conflict. This would support the need for thorough psychiatric evaluation and treatment which gives attention to both biological and psychiatric issues.