morphine and Respiratory-Tract-Infections

Topics: Child, Preschool; Cystic Fibrosis; Female; Genetic Carrier Screening; Genetic Counseling; Humans; Infant; Infant, Newborn; Intestinal Obstruction; Meconium; Minerals; Nutritional Physiological Phenomena; Pancreatic Extracts; Pregnancy; Respiratory Tract Diseases; Respiratory Tract Infections; Vitamins

Topics: Bronchopulmonary Dysplasia; Female; Humans; Infant, Newborn; Infant, Premature, Diseases; Inhalation; Male; Meconium; Respiratory Distress Syndrome, Newborn; Respiratory Tract Diseases; Respiratory Tract Infections

Does a delay in diagnosis exist in females with cystic fibrosis (CF) presenting with respiratory symptoms alone. Does it segregate with poorer clinical outcomes?. A set of 3,851 patients registered with the UK CF Database (diagnosed 1986-2003) were divided into four mutually exclusive categories by mode of presentation: meconium ileus or distal intestinal obstruction syndrome (MI/DIOS); positive family history; newborn screening; and symptoms excluding MI/DIOS. The last symptom category was subdivided to create a group for respiratory symptoms alone.. Females presenting with respiratory symptoms alone were diagnosed 9 months later than males (median age of diagnosis in males 22 months, n = 325; females, 31 months, n = 322; P = .028). No gender differences were observed for anthropometric, lung function, microbiological, supplemental feeding, or time since diagnosis using discriminant analysis applied to all patients (n = 461, Wilks' lambda = .97, P = .15) or to patients divided by genotype: DeltaF508/DeltaF508 (n = 168, Wilks' lambda = .97, P = .69), class I-III genotype (n = 251, Wilks' lambda = .96, P = .41), or class IV-V genotype (n = 73, Wilks' lambda = .90, P = .50) presenting with respiratory symptoms alone.. A relative delay in diagnosis exists in female patients presenting with respiratory symptoms alone compared with males. This does not, however, segregate with a significantly poorer clinical phenotype in the UK.

Topics: Child, Preschool; Cystic Fibrosis; Databases, Factual; Female; Genotype; Humans; Infant; Infant, Newborn; Male; Meconium; Medical Records, Problem-Oriented; Neonatal Screening; Respiratory Tract Infections; Risk Factors; Sex Factors; Time Factors; Treatment Outcome

To study the association between meconium and maternal infection.. This was a retrospective cohort study of 678 pregnant women. All term deliveries during a 31-month period with meconium passage were included. Each meconium delivery was matched with a consecutive delivery without meconium at the same gestational age.. The overall infection rate was 16%, with 13% of the infections directly related to the pregnancy, labor, and delivery. The endometritis rate was 5%, with 7.1% and 3% in the meconium and no-meconium group, respectively. The chorioamnionitis rate was 8.3%, with 9.5% in the meconium and 7.1% in the no-meconium group. Factors found to be associated with overall obstetric infections had the following odds ratios (ORs) and 95% confidence intervals (CIs): meconium (OR 1.8, 95% CI 1.1, 2.8), internal monitoring (OR 3.4, 95% CI 1.9, 5.9), amnioinfusion (OR 2.0, 95% CI 1.3, 3.3), number of vaginal exams (OR 4.5, 95% CI 2.8, 7.1), length of labor (OR 2.8, 95% CI 1.8, 4.4), and cesarean (OR 3.1, 95% CI 1.9, 5.1). Logistic regression analyses revealed the following ORs and 95% CIs: 1) for endometritis-cesarean (OR 4.2, 95% CI 1.9, 8.9), internal monitoring (OR 2.5, 95% CI 1.1, 5.9), and meconium (OR 2.5, 95% CI 1.1, 5.5), and 2) for chorioamnionitis-length of labor greater than 10 hours (OR 2.7, 95% CI 1.4, 5.6), number of vaginal exams greater than seven (OR 3.4, 95% CI 1.7, 6.6), and use of internal monitors (OR 2.5, 95% CI 1.2, 5.3).. Meconium passage increases the risk of postpartum endometritis but not chorioamnionitis. Length of labor, internal monitoring, and number of vaginal exams are risk factors for chorioamnionitis.

Topics: Adult; Case-Control Studies; Chorioamnionitis; Cohort Studies; Endometritis; Female; Gestational Age; Humans; Labor, Obstetric; Logistic Models; Mastitis; Meconium; Obstetric Labor Complications; Otitis Media; Pregnancy; Respiratory Tract Infections; Retrospective Studies; Risk Factors; Urinary Tract Infections

1. In order to identify potential risks for lower respiratory tract symptoms during early infancy, the concentration of cotinine was measured in meconium of 91 newborns as a parameter of prenatal exposure to tobacco, and a questionnaire was performed with parents at birth. Infants were followed up for the first year of life by monthly telephone interviews. 2. Lower respiratory tract infections during the first 6 months of life were associated with a high concentration of cotinine in meconium (cotinine higher than median vs lower than median; odds ratio 4.9, 95% confidence interval 1.2 to 20.3), while none of the other variables tested including selfreport of parental, prenatal or postnatal tobacco consumption, parents history of atopy, maternal age, presence of siblings, socio-economic status, duration of gestation, birth weight, gender, and duration of breast feeding were identified as independent risks. The occurrence of a lower respiratory tract infection during the first 6 months of life was predicted correctly in 77% of the infants by a cotinine excretion in meconium exceeding the group median. 3. In conclusion, quantification of cotinine in meconium is preferred to historical parameters as an estimate of the risk for early respiratory tract infections.

Topics: Adult; Biomarkers; Cotinine; Dose-Response Relationship, Drug; Female; Humans; Infant; Infant, Newborn; Male; Maternal-Fetal Exchange; Meconium; Pregnancy; Respiratory Tract Infections; Risk Assessment; Smoking; Surveys and Questionnaires; Time Factors

Major advances have been made in the identification and prevention of perinatal factors that lead to long-term handicap or neurologic deficits. When the infant or child exhibits a major handicap, scrutiny of the pregnancy management often occurs in an attempt to define the causal factors. The medical goal of this inquiry is to prevent injuries and, when possible, to eliminate these factors. In the litigious sense, any deviation from optimal, ideal care or any unusual observations, such as unusual or atypical fetal heart rate patterns, are often causally linked to the adverse outcome. There are at least four categories of major fetal injury that probably occur prior to labor. An awareness of, and a diligent search for, details will no doubt clarify the legitimate origins of many so-called birth injuries. Hence the common tendency to fixate on minor deviations and/or deficiencies of labor and delivery management as causing catastrophic injuries will be successfully challenged.

Topics: Adult; Cerebral Hemorrhage; Female; Fetal Diseases; Fetal Heart; Fetal Monitoring; Humans; Infant Mortality; Infant, Newborn; Lung Diseases, Obstructive; Meconium; Myocardial Infarction; Perinatology; Pregnancy; Prenatal Diagnosis; Respiratory Tract Infections

Azlocillin, an acylureido penicillin with bactericidal activity, is particularly effective against Pseudomonas, enterococci and Haemophilus influenzae. It is also very active against E. coli, various Proteus species and Bacteroides. Pharmacokinetic studies were carried out in 138 children of various ages (prematures, newborns, infants, schoolchildren) after administering 50-75-100 mg/kg/ body weight azlocillin via the i.v. or i.m. routes; The constant of elimination and the distribution volumes were calculated besides the serum levels. In prematures and newborns, therapeutically effective serum levels were obtained on administering 50 or 100 mg/kg body weight twice daily. Infants and older children required 100 or 75 mg/kg body weight t.i.d. Determination of azlocillin in the bronchial secretion after i.v. doses of 75 mg/kg body weight showed good elimination. Azlocillin was always identified up to the 5th hour post injectionem. Inspite of parenteral administration, azlocillin was identified in different concentrations in the meconium as well. 39 children were treated with azlocillin, 35 of whom had Pseudomonas infection. Very good results were obtained in infections of the urinary tract, wound infections, conjunctivitis, dacryocystitis and in one case of meningitis. Bronchopulmonary diseases did not take an equally good course, but in these cases the conditions had not been favourable. No serious side effects were revealed by testing several laboratory parameters.

Topics: Azlocillin; Child; Child, Preschool; Conjunctivitis; Dacryocystitis; Humans; Infant; Infant, Newborn; Kinetics; Meconium; Meningitis; Penicillins; Pseudomonas Infections; Respiratory Tract Infections; Surgical Wound Infection; Urinary Tract Infections

Topics: Adolescent; Adult; Child; Child, Preschool; Cystic Fibrosis; Female; Growth Disorders; Humans; Infant; Infant, Newborn; Intestinal Obstruction; Male; Meconium; Pancreatic Diseases; Respiratory Tract Infections; Sweating

Topics: Adolescent; Adult; Airway Obstruction; Child; Child, Preschool; Cystic Fibrosis; Female; Humans; Infant; Infant, Newborn; Infertility; Intestinal Obstruction; Liver; Lung; Male; Meconium; Middle Aged; Pancreas; Respiratory Tract Infections

Topics: Child; Child, Preschool; Cough; Cystic Fibrosis; Diet; Drainage; Humans; Infant; Infant, Newborn; Intestinal Absorption; Intestinal Obstruction; Liver Cirrhosis; Meconium; Psychology; Respiratory Tract Infections

Topics: Central Nervous System Diseases; Child Development; Congenital Abnormalities; Emaciation; Female; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Prospective Studies; Respiratory Tract Infections; Sleep Wake Disorders; Social Behavior; Syndrome; Thumb

Topics: Abdomen, Acute; Aerosols; Anti-Bacterial Agents; Breathing Exercises; Cough; Cystic Fibrosis; Drainage; Heat Exhaustion; Humans; Intestinal Obstruction; Lung Diseases; Meconium; Mucus; Nasal Polyps; Physical Therapy Modalities; Pneumonia, Staphylococcal; Pneumothorax; Pulmonary Atelectasis; Rectal Prolapse; Respiratory Tract Infections; Sputum

Topics: Anti-Bacterial Agents; Body Weight; Cystic Fibrosis; Female; Humans; Infant; Infant, Newborn; Male; Meconium; Respiration; Respiratory Function Tests; Respiratory Therapy; Respiratory Tract Infections

Topics: Adult; Bronchiectasis; Cystic Fibrosis; Humans; Intestinal Obstruction; Intestines; Liver Function Tests; Male; Meconium; Radiography; Respiratory Tract Infections

Two of 15 children who survived neonatal meconium ileus had "meconium ileus equivalent." They were treated with hydration, pancreatic enzyme therapy and antibiotics. One of these children died from pulmonary disease at the time of the bowel obstruction. The survival rate of infants with meconium ileus is steadily improving because of prompt operative intervention, better preoperative and postoperative care and long-term treatment with enzyme supplements and antibiotics. Late intestinal obstruction due to adhesive bands, volvulus, intussusception or "meconium ileus equivalent" may occur in children previously treated for meconium ileus of infancy. The omission of pancreatic enzyme supplementation and the occurrence of respiratory infections are frequently associated with "meconium ileus equivalent."In this series of patients four of the infants treated surgically for neonatal meconium ileus died in the early postoperative period.

Topics: Anti-Bacterial Agents; Child; Cystic Fibrosis; Fetal Diseases; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Pseudo-Obstruction; Intestinal Volvulus; Intussusception; Male; Meconium; Pancreas; Peritoneal Diseases; Postoperative Care; Respiratory Tract Infections; Surgical Procedures, Operative; Survival Rate