cardiovascular-agents and Intestinal-Perforation

Extremely preterm infants are peculiar in regard to their risk of retinopathy of prematurity (ROP). In this study, we aim to study insults that may affect extremely preterm infants, including prenatal, at birth, and postnatal insults and their effect on the development of ROP.. This study used the data from Prematurity and Respiratory Outcomes Program (PROP). All included infants with a gestational age of 23 0/7 to 28 6/7 weeks using best obstetrical estimate. We included stressful events and/or modifiable variables that may affect the normal development. We used multiple regression analysis in our statistical analysis.. We included a total of 751 infants in our study. The mean birth weight for the included sample was 915.1 (±232.94) grams. 391 (52.1%) Infants were diagnosed with ROP. We found a significant negative correlation between ROP development and birth weight (p < 0.001), with a correlation coefficient of - 0.374. We found that the need for prophylactic indomethacin (OR 1.67), the occurrence of air leaks (OR: 2.35), ventilator-associated pneumonia (OR: 2.01), isolated bowel perforations (OR: 3.7), blood culture-proven sepsis (OR: 1.5), other infections (OR: 1.44), and receiving ventricular shunt (OR: 2.9) are significantly associated with the development of ROP.. We believe this study included the largest number of factors studied in the largest sample of extremely premature infants. We recommend a screening program for extremely preterm infants that takes into account a scoring system with higher scores for complicated condition.

Topics: Birth Weight; Cardiovascular Agents; Cellulitis; Cerebrospinal Fluid Shunts; Continuous Positive Airway Pressure; Ductus Arteriosus, Patent; Embolism, Air; Female; Humans; Indomethacin; Infant, Extremely Low Birth Weight; Infant, Extremely Premature; Infant, Newborn; Infant, Very Low Birth Weight; Intestinal Perforation; Male; Mediastinal Emphysema; Meningitis; Neonatal Sepsis; Pneumonia, Ventilator-Associated; Pneumopericardium; Pneumoperitoneum; Pneumothorax; Protective Factors; Retinopathy of Prematurity; Subcutaneous Emphysema; Urinary Tract Infections

To determine the risk of diverticular perforation associated with current and ever use of corticosteroids, opiate analgesics, non-steroidal anti-inflammatory drugs, aspirin, cyclo-oxygenase-2 inhibitors, statins and calcium antagonists.. Case-control analysis using conditional logistic regression analysis of data from the UK General Practice Research Database. The study involved 899 cases of incident diverticular perforation and 8980 population controls from 1990 to 2005.. Odds ratios (ORs) are presented for perforation associated with use of corticosteroids, opiate analgesics, non-steroidal anti-inflammatory drugs, aspirin, cyclo-oxygenase-2 inhibitors, statins and calcium antagonists. Data were adjusted for smoking, comorbidity, prior abdominal pain and body mass index.. A total of 899 patients with an incident diagnosis of perforated diverticular disease were identified. Current use of opiate analgesics (OR=2.16; 95% CI 1.55 to 3.01) and oral corticosteroids (OR=2.74; 95% CI 1.63 to 4.61) was associated with a two- and threefold increase in the risk of diverticular perforation, respectively. Current use of a calcium antagonist and aspirin were not associated with an increased risk of diverticular perforation. Current statin use was associated with a reduction in the risk of perforation (OR=0.44; 95% CI 0.20 to 0.95).. Perforated diverticular disease is a serious surgical emergency with current opiate analgesics and oral corticosteroids being strongly associated with an increased risk of diverticular perforation.

Topics: Aged; Aged, 80 and over; Analgesics; Anti-Inflammatory Agents, Non-Steroidal; Cardiovascular Agents; Comorbidity; Confounding Factors, Epidemiologic; Diverticulum, Colon; Drug-Related Side Effects and Adverse Reactions; Epidemiologic Methods; Female; Glucocorticoids; Humans; Intestinal Perforation; Male; Middle Aged; United Kingdom

To describe factors associated with failure of patent ductus arteriosus closure and development of gastrointestinal complications in subjects treated with indomethacin.. Infants

Topics: Cardiovascular Agents; Ductus Arteriosus, Patent; Enterocolitis, Necrotizing; Female; Humans; Indomethacin; Infant, Low Birth Weight; Infant, Newborn; Intestinal Perforation; Logistic Models; Male; Multivariate Analysis; Predictive Value of Tests; Retrospective Studies; Risk Factors; Severity of Illness Index; Treatment Outcome

Indomethacin is the most frequently used pharmacological agent for closure of a patent ductus arteriosus (PDA) in premature infants. However, reports of complications, particularly, necrotizing enterocolitis (NEC) and isolated gastrointestinal perforation have generated concerns about the use of this medication.. A retrospective study to compare the incidence of NEC, NEC-related gastrointestinal complications and isolated gastrointestinal perforation among premature infants treated for a PDA with either, indomethacin alone (I), surgical ligation alone (L), or indomethacin followed by surgical ligation (I-L).. The medical records of 224 infants that underwent treatment, either pharmacological or surgical, for a PDA, confirmed by echocardiography, over a 4-year period (1995 to 1998) were analyzed. Treatment history and gastrointestinal complications were reviewed.. Of the 224 infants, 108 (48.2%) were treated with I, 50 (22.3%) by L, 66 (29.5%) with I-L. The clinical characteristics of the three treatment groups were similar and no differences in the incidence of NEC were observed between groups. NEC occurred in 14 (13%) of the I group, seven (14%) of the L group, and eight (12%) of the I-L group. The rate of NEC related gastrointestinal complications and isolated gastrointestinal perforation were also similar among groups.. In this large retrospective study, indomethacin treatment for a significant PDA in premature infants was not associated with a greater risk for NEC or NEC-related gastrointestinal complications than surgical ligation.

Topics: Birth Weight; Cardiac Surgical Procedures; Cardiovascular Agents; Ductus Arteriosus, Patent; Enterocolitis, Necrotizing; Gastrointestinal Diseases; Gestational Age; Humans; Indomethacin; Infant, Newborn; Infant, Premature; Intestinal Perforation; Ligation; Retrospective Studies

The intake of anti-inflammatory drugs by 268 patients with colonic or small bowel perforation or haemorrhage was compared with that by a group of patients, matched for age and sex, with uncomplicated lower bowel disease. Patients with perforation or haemorrhage were more than twice as likely to be takers of anti-inflammatory drugs, but no association was detected with the intake of other types of drugs, particularly cardiovascular drugs. The association between complicated lower bowel disease and intake of anti-inflammatory drugs may be causal.

Topics: Adrenal Cortex Hormones; Adult; Anti-Inflammatory Agents; Cardiovascular Agents; Colonic Diseases; Gastrointestinal Hemorrhage; Humans; Intestinal Perforation; Intestine, Small