[Problems and prospects of care for newborn babies with an extremely low body weight].

The paper is designed to discuss problems of morbidity, treatment, rehabilitation, and late follow-up development in children of extremely low birth weight (500-999 g). Despite the use of modern methods of rehabilitation and nursing, the overwhelming majority of such children develop severe combined somato-neurologic pathology leading to disability (polymorphic lesions in the nervous system, broncho-pulmonary dysplasia, retinopathy, etc.). Efficacious approach to the reduction of frequency and severity of polysystemic pathological conditions requires improvement and development of new methods of resuscitation and intensive therapy based on up-to-date neuroprotective technologies (including the use of anticytokines and stem cells) and their combination with non-medicamentous therapeutic modalities.

[Immunophenotypic characteristics of blood lymphocytes and expression of cytokine receptors in newborn infants].

Formation of the immune system during the neonatal period was studied in 88 infants aged 3 days-1 month (gestation age 28-41 weeks) with the primary diagnosis of cerebral ischemia. The patients were allocated to 4 groups based on chronological and gestational age at the moment of examination and a reference group. A total of 16 umbilical blood samples were available for analysis. Phenotype of blood lymphocyte was identified by flow cytofluorimetry with differentiation between subpopulations of T and B lymphocytes and detection of membrane receptors of IL-2, 8, and 10. T-cell subpupulation was found to be enriched in CD3+CD4+CD8+ lymphocytes. Content of B1 lymphocytes was equally high in full-term and premature infants. The latter showed enhanced expression of IL-2 receptor, CD122, by the end of the first month of life. Expression of receptors of IL-8 (chemotaxis factor) and IL-10 was high in lymphocytes of children of all groups since the onset of the neonatal period. It is concluded that comprehensive study of membrane cytokine receptors is of interest for better understanding mechanisms underlying maturation of the immune system in children of different age groups.

[Selenium contents in human milk after term and preterm labor and in breast milk substitutes]. / Soderzhanie selena v zhenskom moloke posle srochnykh i prezhdevremennykh rodov, a takzhe v adaptirovannykh molochnykh produktakh.

Selenium contents in breast milk of Russia's and Vietnam's women after term and preterm childbirth and in breast milk substitutes were studied. The concentration of selenium in breast milk of Russia's women was normal after term and preterm childbirth. The level of selenium in breast milk of Vietnam's women was decreased and could not satisfy completely the need of breasted infants. Selenium contents in babyfood "Malutka" Istra' manufacturing company were lower than those in Sybaj' company.

[The characteristics of amino acid metabolism in premature infants on different types of feeding]. / Osobennosti aminokislotnogo obmena u nedonoshennykh detei pri razlichnykh vidakh vskarmlivaniia.

Analysis of the free amino acids (AA) in a blood plasma of premature infants receiving kinds of baby food has allowed to reveal a feature of AA metabolism. A significant increasing of sum of the free AA and stable contents of aromatic AA have been found in blood of premature infants fed Prepiltti [correction of 'Prepilti'] that testified to adequacy of protein in Prepiltti [correction of 'Prepiltu'] to requirements of premature infants. Also it has been established different changes of concentration methionine and cystine in this group of the babies that confirms a hypothesis about immature of liver enzymes catabolizing a methionine.

[Rhythmic fluctuations in hemoglobin oxygen affinity in premature infants over the space of 24 hours]. / Ritmicheskie kolebaniia srodstva gemoglobina k kislorodu u nedonoshennykh detei na protiazhenii sutok.

The noninvasive method for estimating the affinity of hemoglobin for oxygen (expressed as P50, oxygen tension at 50% hemoglobin saturation) allowed the authors to follow its time variations. Significant changes of P50 during 24 hours were demonstrated to occur in 16 preterm babies (the gestational age 30-37 weeks, body weight 1850-3000 g) with perinatal encephalopathy, along with fluctuations of tcpCO2, tcpO2, and SpO2. The changes of all these variables were rhythmic; the periods of best fitting cosine curves for P50 were 3-35 hours; double amplitudes, 2.92-17.42 mm Hg; the midline estimating statistics of rhythm, 18.2-33.7 mm Hg. There was a significant correlation between tcpO2 and P50 in 10 babies; in 7 cases, the acrophases of their rhythms coincided (the mean difference was 0.06 +/- 1.1 h). Thus, P50 in preterm babies is varying during a day, it varies periodically, in some cases the variations are due to the changes in pCO2.

[Hypoxia-induced ischemic brain damage in newborns]. / Gipoksicheski-ishemicheskie povrezhdeniia mozga novorozhdennykh.

Fetal brain lesions are characterized by multifactorial genesis. Hypoxia is the central pathogenetic syndrome causing various structural changes of the brain and its malformations. A variety of morphological changes explains the polymorphism of clinical symptoms and long-term sequelae. The magnitude of the brain alterations depends on the gestational age at the moment of hypoxia and its intensity.

[Development of arterial pressure rhythm and cardiac contraction rate and effects of beta-adrenomimetic agents]. / Stanovlenie ritmov arterial'nogo davleniia i chastoty serdechnykh sokrashchenii i vliianie beta-adrenomimetikov.

Blood pressure (BP) and heart rate (HR) rhythms were studied in premature infants (299 profiles ranged 24-106 h at 20--min intervals) and 11-13-year-old children (19 profiles for 48 h at 15-min intervals) to explore ultradian-to-circannual rhythm characteristics in BP and HR in preterm human infant and to elucidate the influence of antenatal betamimetic (BM) exposure on adolescent BP and HR rhythms. A circannual modulation of the 3-h amplitude (A) or MESOR of systolic BP (SBP) and diastolic BP (DBP) was seen mainly in prematures with a positive family history of high BP on the father's (f+) side or with both a patro linous and matro-linous history (f+m+), the circannual modulation of HR ultradian A was statistically significant only in "f- m-" infants. In urine collected at 3 h intervals for 24-h spans from 21 premature infants Na+,K+ and 11-oxycorticosteroids had a significant circadian rhythm. 9 adolescents (BM+), which were exposed in utero to different BM doses, had a significantly higher SBP and DBP MESOR and numerically higher circadian A as compared to 10 controls (BM-); correlation (P less than 0.05) between BM dose and HR circadian A was found. DBP led SBP in 8 or 10 "BM-" but in 4 of 9 "BM+" (acrophase difference 17 min and 3 min correspondingly).(ABSTRACT TRUNCATED AT 250 WORDS)

[Enzyme status of blood cells in premature children during the treatment of omphalitis by helium-neon laser radiation]. / Fermentnyi status kletok krovi u nedonoshennykh detei pri lechenii omfalitov gelii-neonovym lazernym izlucheniem.

Helium-neon laser radiation was employed in the treatment of 27 premature children suffering from omphalitis. It has been established that helium-neon laser radiation produces a favourable effect on the healing and epithelization of the umbilical wound, activates lymphocyte succinate dehydrogenase in premature children. The rate of wound healing correlates with the initial enzymic status, with the number of sessions of laser therapy and the general estimation of the previous development of the child in accordance with the prognostic coefficient of sepsis development.

[Reserves for lowering the neonatal mortality of premature children]. / Rezervy snizheniia neonatal'noi smertnosti nedonoshennykh detei.

A tendency for a decrease in the rate of neonatal mortality among preterm babies could be followed up in industrialized countries for the current decade. This tendency is less pronounced in the USSR. Therefore newer diagnostic and therapeutic approaches developed in the clinical department of the Scientific and Research Institute of Pediatrics, the USSR Academy of Medical Sciences, could be regarded as reserves for the reduction of neonatal mortality in preterm children. They include the analysis of etiological structure of present-day pyo-septic diseases (monitoring of intrahospital flora, target-oriented treatment-the use of anti-klebsiella plasma); consideration of new aspects of pathogenesis (population structure and the receptor function of the blood defensive cells); metabolite therapy; individualization of antibacterial treatment on the basis of pharmacokinetic assessment; optimized breeding techniques (prolonged probe nutrition); background correction (perinatal encephalopathy, the syndrome of respiratory distress); newer socio-medical approaches (psychotherapy of nursing mothers, "kangaroo" method).

[The role of congenital Enterovirus infection in the pathogenesis of suppurative and inflammatory diseases in newborn infants]. / Uchastie vrozhdennoi énterovirusnoi infektsii v patogeneze gnoino-vospalitel'nykh zabolevanii u novorozhdennykh.

Newborns with suppurative-inflammatory disease were found to be at high risk of intrauterine infection with Coxsackie enteroviruses from mothers with persistent enterovirus infection; in 54.9%, congenital Coxsackie virus infection was confirmed by virus antigen identification in the urine sediment cells and autopsy material. Coxsackie A viruses were identified in 68.7% of sepsis cases, 42.6% with local purulent infection foci, and in only 6.7% of practically healthy neonates. Specific features of the clinical course are analysed together with the pathohistological picture of congenital enterovirus infection associated with the vertical virus transmission from the mother having a persistent form of this infection. A suggestion is proposed that the severe course of suppurative-inflammatory conditions and the general character of neonatal bacterial infection are largely determined by the immunodeficient states which are etiologically related to congenital enterovirus infections.

[Suppurative-inflammatory diseases in newborn infants]. / Gnoino-vospalitel'nye zabolevaniia u novorozhdennykh detei.

Changes in the etiological patterns of suppurative-inflammatory diseases of neonates during 1978-1988 were analysed. Basic trends in the etiological structure changes, growing numbers of individual microorganism families or species, and changes in the clinical manifestations corresponding to the etiology variation were demonstrated. Preventive antibiotic therapy administered to neonates in the maternity hospital is proved ineffective, and its deleterious effect on the postnatal microbial colonization is shown.

[Use of constant negative pressure around the chest for rehabilitation of external respiration in premature infants with respiratory disorders]. / Primenenie postoiannogo otritsatel'nogo davleniia vokrug grudnoi kletki dlia reabilitatsii vneshnego dykhaniia u nedonoshennykh novorozhdennykh s respiratornymi narusheniiami.

A study was of the effect produced by constant negative pressure around the chest on the clinical course and external respiratory function in premature infants with respiratory disorders. Application of constant negative pressure around the chest was followed by rapid elimination of the clinical manifestations of respiratory disorders, by the improvement of the characteristics of external respiratory function and blood gases.