The optimal intravenous solution for rehydration of infants and children with severe dehydration is debated. AIM: The aim was to compare the efficacy of a polyelectrolyte solution (group PS) with sodium chloride 0.9% solution (group NS) in rapid parenteral rehydration of severely dehydrated infants with acute diarrhoea. METHODS: Primary outcomes ...

Predictors of tubular proteinuria (alpha 1-M/crea ratio >10 mg/mmol) were sought in 100 infants of 24-32 weeks' (group 1) and 69 of 34-42 weeks' gestation (group 2). Random spot urine samples were obtained in the former group at the ages of 0-3 days, at 1-2 weeks and thereafter at 2-week ...

OBJECTIVE: Assess in vivo O-demethylation activity in the first months of life. METHODS: Time-concentration profiles of tramadol (M) and O-demethyl tramadol (M1) in plasma and urine were simultaneously collected in the first 24 h of continuous intravenous tramadol administration in neonates and young infants. M and M1 were determined by ...

CONTEXT AND OBJECTIVE: Very low birth weight (VLBW) infants have special nutritional needs. There is a current tendency to individualize their protein needs. The objective of this study was to determine the suitability of serum and urinary urea as indicators for protein intake in adequate-for-gestational-age (AGA) and small-for-gestational-age (SGA) VLBW ...

OBJECTIVES: To test the hypothesis that the administration of 2.4 g amino acids (AA)/(kg.d) to very low birth weight infants is safe and results in a positive nitrogen balance. STUDY DESIGN: We conducted a randomized, clinical trial. Preterm infants with birth weights <1500 g received either glucose and 2.4 g ...

The metabolic fate of substrates in humans can be examined by the use of stable isotopes, one of which, [13C]bicarbonate, may serve to estimate CO2 production rate. In view of minimizing the burden of metabolic studies for preterm infants, the authors determined whether intragastric and intravenous infusions of [13C]bicarbonate would ...

OBJECTIVES: The gastric emptying breath test (GEBT) is now routinely used in many centers. Validation studies in adults have shown that although there is a linear correlation between the GEBT and scintigraphy, the GEBT overestimates gastric half emptying time (GEt1/2) by a constant of approximately 60 minutes because of postgastric ...

OBJECTIVE: Glutamine depletion has negative effects on the functional integrity of the gut and leads to immunosuppression. Very low birth weight (VLBW) infants are susceptible to glutamine depletion, as enteral nutrition is limited in the first weeks of life. Enteral glutamine supplementation may have a positive effect on feeding tolerance, ...

BACKGROUND: The pharmacokinetics of oxycodone (13-hydroxy-7,8-dihydrocodeinone) has been studied in adults and in children who are older than 6 months but there is no information on the disposition of oxycodone in neonates and young infants. The aim of this study was to study the pharmacokinetics of oxycodone in infants varying ...

Newborn infants cared for in neonatal intensive care units may develop nosocomial infections. Cefepime, a "fourth-generation" cephalosporin (i.e., with activity against virtually all of the chromosomal-beta-lactamase-producing and many extended-spectrum-beta-lactamase-producing organisms), provides excellent activity against many gram-negative pathogens resistant to expanded-spectrum cephalosporins currently used to treat neonatal infections. The purpose of ...

Sonographic findings of renal medullary hyperechogenicity have been observed in the neonate in association with severe perinatal renal injury, kidney malformations or nephrocalcinosis, and, rarely, in newborn infants with transient renal failure. The aim of the study was to describe the entity of neonatal transient renal failure with renal medullary ...

OBJECTIVES: To examine the effect of supplemental glutamine (0.6 g.kg -1 .d -1 ) on whole body protein/nitrogen and glutamine kinetics in low birth weight (LBW) infants receiving parenteral nutrition in the immediate neonatal period. STUDY DESIGN: Premature infants < or =32 weeks gestation with a birth weight from 694 ...

Sodium loss in infants with salt wasting (SW) congenital adrenal hyperplasia (CAH) does usually not occur within the first week of life. We hypothesized that sufficient mineralocorticoid activity might by temporarily maintained by still appropriate concentrations of cortisol. Plasma samples were obtained from 15 infants with SW-CAH before the onset ...

Biotin deficiency is rarely encountered in an infant on weaning from breast and formula feeding. It is characterized by alopecia and scaly, erythematous dermatitis distributed around the body orifices. We report a 5-month-old Japanese infant with typical skin lesions who had been diagnosed as a neonate with dyspepsia and fed ...

OBJECTIVE: To assess the effect of isocaloric isonitrogenous parenteral glutamine supplementation on intestinal permeability and nitrogen loss in newborns and infants after major digestive-tract surgery. SUMMARY BACKGROUND DATA: Glutamine supplementation in critically ill and surgical adults may normalize intestinal permeability, attenuate nitrogen loss, improve survival, and lower the incidence of ...

We report the presence of iopromide in the bowel and urine of a preterm infant, born 10 days after intravenous administration of the nonionic monomer to his mother. Excessive urinary iodine excretion and borderline hyperthyrotropinaemia were observed in the infant. Moreover, crossing of the fetal blood-brain barrier was demonstrated by ...

The aim of this investigation was to evaluate whether the relative change in renal clearance due to ibuprofen administration depends on the gestational age (GA). Clearance of amikacin was used as a surrogate marker for renal clearance in preterm infants (GA 24-34 weeks, day 1) on respiratory support. Clearance in ...

The aim of the present work was to study the presence of aflatoxins in blood and urine of infants with protein-energy malnutrition (PEM). The study was conducted on 60 infants, 30 with kwashiorkor and 30 with marasmus, with 10 age-matched healthy infants studied as a control group. Complete blood count, ...

OBJECTIVE: Currently blood urea nitrogen (BUN) is commonly used as a marker of protein intolerance in very preterm infants. The purpose of this study was to evaluate the relationship between amino-acid intakes and BUN concentrations during the early neonatal period in preterm neonates. STUDY DESIGN: Retrospective review of BUN concentration ...

BACKGROUND: Antenatal carnitine administration has been shown to induce fetal lung maturity by increasing pulmonary surfactant in animal and human studies. In this study, the aim was to investigate the status of carnitine in maternal and neonatal plasma of preterm infants with respiratory distress syndrome (RDS) in the first hours ...

BACKGROUND: The aim of this study is to determine carnitine levels in hypoxic-ischemiac neonates. METHODS: Total and free carnitine levels were measured in 20 normal term neonates and 20 term neonates who were diagnosed as hypoxia-ischemia. RESULTS: Both total carnitine levels (43.7 +/- 10.0 microg/dl vice 27.8 +/- 11.8 microg/dl, ...

The aim of this study was to develop a practical approach allowing a reliable and noninvasive assessment of cortisol production rates in premature infants. To measure daily urinary excretion rates of glucocorticoids, we developed a procedure using a hydraulic compression method to collect urine from cellulose nappies (diapers). Glucocorticoid metabolites ...

The objective of this study was to determine the specific reference values for urinary calcium/creatinine (UCA/Cr) (mg/mg) in healthy breast-fed newborns, and to evaluate the relationship between UCa/Cr, urinary sodium/creatinine (UNa/Cr), urinary potassium/creatinine (UK/Cr) and UNa/UK ratios in the same group. A total of 88 infants aged between 0-28 days ...

OBJECTIVE: To assess the effect of two different parenteral amino acid mixtures, Trophamine and Primene, on leucine turnover in preterm infants. METHOD: Leucine kinetics were measured with [5,5,5 D3]leucine tracer in 15 infants receiving Trophamine (group 'T') (mean birth weight 1,263 g) and 22 who received Primene (group 'P') (mean ...

OBJECTIVES: To assess excretion kinetics of free and total (free + conjugated) 2-butoxyacetic acid (BAA) following dermal and inhalation exposure to butoxyethanol (BE). METHODS: Six male volunteers were dermally exposed for 4 h to a 50% aqueous solution of BE on an area of 40 cm(2) of the volar forearm. ...

The aims of this study were to determine reference ranges for the urinary calcium (UCa/Cr) and phosphate (UPO(4)/Cr) creatinine ratios and to study factors influencing these ratios in a representative population of preterm infants managed according to current nutritional guidelines. Spot urine samples were obtained from 186 preterm infants (gestation ...

Two premature infants received 10-fold overdoses of vancomycin with resulting peak plasma concentrations > 300 microg/mL. Discontinuation of vancomycin and watchful waiting were employed, with no specific intervention to accelerate vancomycin clearance. Plasma vancomycin concentration < 40 microg/mL was attained at < 48 hours in one infant and < 72 ...

OBJECTIVE: The purpose of this study was to determine the ability of young hospitalized premature (born < or =30 weeks' gestational age) infants to achieve serum levels of palivizumab that are protective against RSV infection. METHODS: Palivizumab, 15 mg/kg per dose intramuscularly, was administered every 28 days to stable premature ...

The prevention of osteopenia of prematurity is an important issue in the care of preterm infants. Fetal bone mineral accretion has been achieved in preterm infants by establishing and maintaining a simultaneous slight excretion of calcium (Ca) and phosphorus (P) (urine concentrations of 1-2 mmol/l) by means of an individual ...

Background and aim Previous data indicate that the urinary losartan/E-3174 ratio is a marker for cytochrome P450 (CYP) 2C9 activity in vivo. The functional impact of CYP2C9*5, *6, *8, and *11 polymorphisms in vivo has not been investigated previously in humans. METHODS: A single oral dose of losartan (25 mg) ...

OBJECTIVE: This study aimed to compare nitrogen balance and biochemical tolerance of early aggressive versus late total parenteral nutrition in very-low-birth-weight (VLBW) infants over the first week of life. STUDY DESIGN: In all, 32 ventilator-dependent preterm infants were prospectively randomized into two groups. The Early Total Parenteral Nutrition (ETPN) group ...

OBJECTIVE: In the process of sampling blood through an umbilical arterial catheter (UAC), infant blood comes into stagnant contact with infusion solution in the "waste syringe" before being reinfused. We have previously demonstrated in vitro that this process is associated with less hemolysis of red blood cells (RBCs) with use ...

AIMS: To test the suitability of a simple once daily (OD) gentamicin regimen for use in young infants where routine therapeutic drug monitoring is not possible. METHODS: In an open, randomised, controlled trial, infants with suspected severe sepsis admitted to a Kenyan, rural district hospital received a novel, OD gentamicin ...

We describe three neonates with hyperkalemia and renal salt wasting during the 1st week of life. Endocrinological evaluation led to the diagnosis of selective hypoaldosteronism (HA) in two neonates and secondary pseudohypoaldosteronism (PHA) in one. The infant with PHA developed a urinary tract infection, and radiological investigation demonstrated a small ...

OBJECTIVE: Greater use of invasive procedures and aggressive antimicrobial therapy predispose extremely low birth weight (ELBW) infants to systemic fungal sepsis. Despite its adverse effects (including renal and electrolyte disturbances), amphotericin B (amphoB) remains the preferred drug for fungal therapy. Multiple studies have indicated that sodium loading may prevent renal ...

Growing infants must maintain a state of positive K+ balance, a task accomplished, in large part, by the kidney. The distal nephron is uniquely adapted to retain total body K+ early in life. The magnitude and direction of net K+ transport in the cortical collecting duct (CCD), the segment responsible ...

4-(Methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) is reduced to its main metabolite, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) in a reaction that is both stereoselective and reversible. (S)-NNAL has been shown to be equivalent to NNK in carcinogenic potency, and significantly more potent than (R)-NNAL. It was hypothesized that stereoselective differences in metabolism or tissue distribution contributed to ...

Nephrocalcinosis and/or urinary calculi are rare in infants. Furosemide treatment during the neonatal period, vitamin D intoxication, hereditary diseases such as hyperoxaluria or distal tubular acidosis are among the most common aetiologies. We report the case of a 6-month-old boy with an extra-hepatic biliary duct atresia treated by the Kasai ...

Conventional interval dosing (CID) and extended interval dosing (EID) of gentamicin were compared in preterm infants. Gentamicin peak and trough levels, serum creatinine, urine output, and hearing screens were obtained in 40 preterm infants. Results suggest that EID is safe, provides gentamicin levels in desirable ranges (peak, 5 to 12 ...

BACKGROUND: Urinary tract infections and/or urinary tract anomalies are very frequent among children. Especially in newborns/infants they represent additional factors in the development of secondary pseudohypoaldosteronism. CASE HISTORY: We present an 8-week-old infant who developed hyponatremia and hyperkalemia secondary to acute pyelonephritis. The boy presented with non-specific signs, including poor ...

This study was designed to improve the definition of acute renal failure (ARF) in very preterm infants. Twenty-eight newborn infants with gestational age < or =32 weeks were prospectively studied in the first 5 days of life and made up a control group as they did not present risk factors ...

OBJECTIVE: To analyze, in an existing cohort of infants, whether antenatal administered corticosteroids influence protein metabolism in preterm infants on the first day of life. Study design Three groups of infants were studied. The mothers of 25 infants had received 2 or more doses of corticosteroids, the mothers of 5 ...

BACKGROUND: Oxidative stress is implicated in the pathogenesis of several complications of prematurity. The glutathione cycle is one of the most important intracellular antioxidant systems. The synthesis of glutathione may not be adequate in preterm neonates because of the low levels of cysteine available. The aim of this study was ...

Increase in vascular permeability and multiorgan dysfunction after cardiopulmonary bypass (CPB) are barriers to successful cardiac surgery in infants. Complement inhibition with TP10, a C3/C5 convertase inhibitor (AVANT Immunotherapeutics, Needham, Mass), blunts post-CPB organ dysfunction in the neonatal pig. Methods and results The pharmacokinetics and safety of TP10 in infants ...

The aim of this study was to determine whether the administration of a lipid emulsion containing less polyunsaturated fatty acids but rich in monounsaturated fatty acids causes less in vivo lipid peroxidation in preterm infants. The prospective intervention study included 13 infants with birth weights and gestational ages ranging between ...

OBJECTIVE: Based on recent safety and efficacy data, combined with the known pharmacokinetic parameters of aminoglycosides in the newborn, once-daily gentamicin should be preferable to the many other dosing regimens currently in use. Although there are growing data to support its use in term newborns, experience with preterm infants is ...

Urinary steroid profile analysis using gas chromatography/mass spectrometry (GC/MS) has been reported for the diagnosis of abnormal steroidogenesis in newborn infants with some success. We tried to establish the reference values of 63 urinary steroids in Japanese newborn infant, using GC/MS in selected ion monitoring (SIM) that utilizes two characteristic ...

Optimized bumetanide extended (ER) and immediate release (IR) formulations were developed using fluid bed layering and coating techniques. We postulated that the ER bumetanide formulation would have more effective and sustained diuretic and saluretic effects than IR. The diuretic/saluretic effects of both formulations were measured in rabbits (n=8) for two ...

INTRODUCTION: Premature infants are highly susceptible to 'oxygen radical diseases' (ORD), including bronchopulmonary dysplasia, intraventricular hemorrhage/white matter injury, retinopathy of prematurity, and necrotizing enterocolitis. The incidence of ORD is reduced following antenatal treatment with betamethasone. Oxidant-mediated injury is characterized at the cellular level by peroxidation of lipid membranes. This results ...

OBJECTIVE: To evaluate the difference in nutrient intakes and biochemical responses in newborn infants <33 weeks gestation who received standardized versus individualized total parenteral nutrition (TPN) regimes. METHOD: Comparison of nutrient intakes and daily biochemical responses in newborn infants <33 weeks gestation who received standardized regime versus those who received ...