Mixed infection with unusual fungi and staphylococcal species in two extremely premature neonates.

Systemic fungal infections are being recognized with increasing frequency in extremely premature neonates. We report two such infants with late-onset mixed infection with Staphylococcal species and unusual fungi. These cases are of interest in view of recent reports on the interaction of Staphylococcal cell wall components and neutrophils, as damaged skin sites could form a nidus and portal of entry for saprophytic fungal pathogens.

Distinct patterns of glomerular disease in Lima, Peru.

Aim: We performed both a retrospective and prospective study to elucidate the types of glomerular diseases present in adults in Lima, Peru.

Material And Methods: In the retrospective study, we analyzed 1,263 renal biopsies over a 10-year period (1985 -1995) that were processed at a central reference renal pathology laboratory in Lima. 101 cases were examined in the prospective study.

Clinicopathologic correlations in lupus nephritis in Lima, Peru.

Background: We assessed whether immunohistologic markers for glomerular or tubulointerstitial injury might provide better correlations with ongoing renal function and disease activity as compared with the WHO classification or the NIH activity and chronicity indices in lupus nephritis.

Methods: Thirty-three patients with clinically defined systemic lupus underwent renal biopsy over a 1-year period at Hospital Loayza in Lima, Peru. Biopsy specimens were evaluated for macrophages, proliferating cells, alpha-actin expression, and type IV collagen deposition in both glomeruli and the tubulointerstitium and the results compared with the current WHO and NIH classifications in relation to the clinical presentation.

Postnatal inositol levels in preterm infants.

Objective: To measure plasma inositol levels in preterm infants fed formula containing inositol at levels close to those in human milk.

Study Design: Plasma inositol levels were measured in 72 preterm infants fed formula containing 1110 mumol/L inositol and in cord blood of 12 healthy term infants. Preterm infant plasma levels were measured four times: (1) within the first 7 days of life, (2) intermediate enteral feeding, (3) at hospital discharge, and (4) 2 months after hospital discharge.

Pharmacokinetics of continuous infusion fentanyl in newborns.

Although fentanyl administration by continuous infusion in newborns during ventilatory support has increased, pharmacokinetic data are lacking. Our objective was to determine the pharmacokinetics of fentanyl continuous infusions for sedation/analgesia in newborns who had undergone mechanical ventilation. Fentanyl was administered per routine care in seven newborns who had undergone mechanical ventilation and had normal hepatic, renal, and cardiac function.

Phenoxybenzamine placental transfer during the third trimester.

Objective: To report phenoxybenzamine placental transfer in the treatment of maternal hypertension secondary to pheochromocytoma.

Case Summary: A 22-year-old woman diagnosed with pheochromocytoma was medically managed at 33 weeks gestation with oral phenoxybenzamine and labetalol until delivery 26 days later. To determine phenoxybenzamine placental passage, at the time of cesarean section simultaneous samples were obtained from the cord blood, maternal blood, and amniotic fluid.

Threshold retinopathy of prematurity. Transition from cryopexy to laser treatment.

Purpose: The authors studied the effectiveness of laserpexy versus cryopexy for treatment of acute retinopathy of prematurity.

Methods: Seventy-six eyes in 41 patients were treated for acute retinopathy of prematurity from January 1991 to April 1994.

Results: Fifty-six eyes in 30 patients had zone 2 disease.

Guidelines for continuous infusion medications in the neonatal intensive care unit.

Objective: To present practical guidelines in tabular form for dosage, calculation, preparation, and monitoring of common medications administered by continuous infusion to neonatal intensive care patients.

Data Sources: Review articles and clinical trials were identified through a computer literature search with subsequent bibliography scanning.

Study Selection: Articles selected for review were considered important contributions.

Cocaine and indomethacin: fetal anuria, neonatal edema, and gastrointestinal bleeding.

A case is reported in which exposure to cocaine and indomethacin was associated with development of fetal anuria, anasarca, and neonatal gastrointestinal hemorrhage. Cocaine and indomethacin may act synergistically to adversely affect renal, cardiovascular, and platelet function. It may be prudent to obtain a drug history and urine screen for cocaine before instituting indomethacin therapy for preterm labor or polyhydramnios.