Identification of BAY61-3606 Derivatives With Improved Activity in Splicing Modulation That Induces Inclusion of Cassette Exons Similar to the Splicing Factor 3B Subunit 1 Mutation.

Splicing modulation by a small compound offers therapeutic potential for diseases caused by splicing abnormality. However, only a few classes of compounds that can modulate splicing have been identified. We previously identified BAY61-3606, a multiple kinase inhibitor, as a compound that relaxes the splicing fidelity at the 3' splice site recognition.

Greater fructose consumption is associated with cardiometabolic risk markers and visceral adiposity in adolescents.

Though adolescents consume more fructose than any other age group, the relationship between fructose consumption and markers of cardiometabolic risk has not been established in this population. We determined associations of total fructose intake (free fructose plus one-half the intake of free sucrose) with cardiometabolic risk factors and type of adiposity in 559 adolescents aged 14-18 y. Fasting blood samples were measured for glucose, insulin, lipids, adiponectin, and C-reactive protein.

Use of telemedicine for children with special health care needs.

Objective: In 1995, the Children's Medical Services (CMS) of the State of Georgia contracted with the Department of Pediatrics of the Medical College of Georgia (MCG) and the MCG Telemedicine Center to develop telemedicine programs to provide subspecialty care for children with special health care needs. This article presents project statistics and results of client evaluation of services, as well as physician faculty attitudes toward telemedicine.

Design: A demonstration project using telemedicine between a tertiary center and a rural clinic serving children with special health care needs was established.

Extracorporeal membrane oxygenation. Controversies in selection of patients and management.

This article reviews controversies associated with the selection of patients for extracorporeal membrane oxygenation (ECMO) and their management. Although there has been a raging debate regarding the use of ECMO in the management of hypoxic respiratory failure in the near-term and term newborn, the authors maintain that this issue is resolved and that ECMO is now a standard of care and should be offered to every neonate who is likely to fail conventional treatment. It is the authors' contention, that there is no apparent increase in morbidity associated with the use of ECMO and that better results might be achieved if ECMO were employed earlier in the patient's course, before hypoxic-ischemia organ damage occurs.

Ventilator management of infants before extracorporeal membrane oxygenation.

The aim of this project was to review the course of infants referred for consideration of extracorporeal membrane oxygenation (ECMO) to identify maximal ventilator settings that, when exceeded, did not provide clinical benefit to the patient. These settings might then be used in defining failure of conventional mechanical ventilation. We reviewed referral records and hospital charts of all infants treated for severe respiratory failure due to meconium aspiration syndrome during the 52.

Hemidiaphragmatic paralysis as a complication of central venous catheterization in a neonate.

Central venous catheter placement has become commonplace in the care of the premature infant because of the need for long-term venous access. Although generally considered safe, there have been numerous reports of complications from the use of these catheters. We report the case of an infant in whom right hemidiaphragmatic paralysis developed after extravasation of fluid from a central venous catheter.

Clinical characteristics and outcomes of infants requiring long-term neonatal intensive care.

This study seeks to better describe the characteristics and outcomes of infants who stay for prolonged periods in the neonatal intensive care unit (NICU). Of 1174 consecutive admissions to a NICU, 73 (6%) met criteria for long-term neonatal intensive care (LTNIC). NICU care totaled 24,631 days; LTNIC infants needed 9152 days (37%).

Treatment of persistent pulmonary hypertension of the newborn without hyperventilation: an assessment of diffusion of innovation.

Objective: The treatment of neonates with persistent pulmonary hypertension of the newborn (PPHN) is controversial with no consensus on diagnostic criteria or treatments. Hyperventilation has been the therapeutic mainstay. However, two widely variant alternative approaches have been proposed: ventilation without induced alkalosis, or more aggressive therapies such as high frequency ventilation or extracorporeal membrane oxygenation.

Recognition and medical management of necrotizing enterocolitis.

The signs and symptoms associated with necrotizing enterocolitis (NEC) and the common scenarios in which NEC is observed are described to help physicians appreciate the breadth of this illness and to aid in the identification and diagnosis of those affected. An outline for medical management of infants with NEC is presented, based on the pathophysiology of this disease.

Evaluation of the SonoClot Analyzer for the measurement of platelet function in whole blood.

A viscoelastometer, the SonoClot Coagulation Analyzer, has been proposed for use in the evaluation of platelet function. The purpose of this study was to evaluate systematically this instrument when used with whole blood. Under laboratory conditions, the coefficient of variation (cv) of determinations of whole blood activated clotting time (ACT) on the instrument was approximately 7.

Significance of seizures associated with extracorporeal membrane oxygenation.

We previously reported a predominance of left focal motor seizures in infants receiving extracorporeal membrane oxygenation (ECMO), raising concerns about possible ischemia resulting from the right common carotid artery ligation. We therefore evaluated the neurologic and psychologic outcome at 2 years of age of all infants with ECMO-related seizures. Although 8 of 12 infants had left focal seizures in infancy, there was no lateralization of motor findings at 2 years of age; left hemiparesis was present in three of the infants and right hemiparesis in three.

Hidden mortality rate associated with extracorporeal membrane oxygenation.

We reviewed the outcome of all infants referred to, and accepted in, our extracorporeal membrane oxygenation (ECMO) program during a 52-month period. One hundred sixty-seven referrals, representing 158 infants and nine mothers who had not yet delivered their infants, were accepted. Eighteen infants (11.

Need for and impact on neonatal mortality of extracorporeal membrane oxygenation in infants of greater than 2500-gram birth weight.

The use of extracorporeal membrane oxygenation (ECMO) has increased significantly during the last 4 years, with more than 2400 infants now having been treated with the technique. In spite of an ill-defined role for ECMO as well as the potential for neurologic sequelae for these patients, additional centers continue to be established across the United States. To provide information regarding the number of babies who could be expected to require ECMO, the early neonatal deaths for the state of Georgia were reviewed for the 2-year period 1983-1984.

Recent experience with diaphragmatic hernia and ECMO.

In the past 4 years at the Medical College of Georgia, a total of 74 patients underwent extracorporeal membrane oxygenation (ECMO) with 62 (84%) survivors. Forty-seven of these infants had meconium aspiration syndrome and 11 had diaphragmatic hernia. The use of ECMO, when indicated, after reduction and repair of the diaphragmatic hernia, results in normal oxygen delivery, allows time for pulmonary maturation, and increases survival.

Incidence of hypertension in infants on extracorporeal membrane oxygenation.

Systemic hypertension has been associated with extracorporeal membrane oxygenation (ECMO) applied in neonatal respiratory failure. To determine the incidence of ECMO-related hypertension, we reviewed blood pressure measurements from indwelling aortic catheters in 31 infants consecutively placed on ECMO. Systemic hypertension (systolic blood pressures greater than 100 mm Hg for 4 or more consecutive hours) developed in 18 of the 31.