摘要:

AbstractThere is increasing evidence that overheating is a contributing factor for some cot deaths. The authors' hypothesis is that infant thermoregulation is closely related to respiratory control. HomeLog is a system built to investigate the developing thermal, respiratory and cardiac behaviour of infants in the home environment over several weeks. HomeLong is based on a modified laptop computer. Signals recorded include body temperature (from rectal and various skin sites), ambient temperature, thoracic impedance, abdominal movement and electrocardiogram (ECG). Continuous night‐time recordings have been made for up to 6 weeks from infants between 1 and 4 months of age, in their own cots, in their own homes. Various time and frequency domain analyses of the breathing and temperature data have been developed. Analysis of breath rate variability and of body temperature fluctuations has confirmed sleep/weke changes. In addition, a periodic oscillation of body temperature every 1–2 h has been found, which closely matches oscillations of breath rate variabil

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1992.tb02728.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractInjury surveillance provides an opportunity to determine non‐intentional injury rates for those injuries which are treated in hospital accident and emergency departments. The first full calendar year of injury surveillance in north‐western greater Melbourne was used to calculate incidence rates of a wide range of injury types and causes for 1989. In a population at risk estimated to number 150604 children aged 0–14 years, the all‐cause injury mortality was 10.6/100000 per year (95% confidence interval [Cl], 5.4–15.8). There were 8207 attendances by children from the denominator area for non‐intentional injury at the three hospitals participating in surveillance, representing rates of 6437/100000 per year (95% Cl, 6258–6616) and 4406/100000 per year (95% Cl, 4254–4558) for boys and girls respectively, while the rates for admission to hospital were 957/100000 per year (95% Cl, 888–1025) and 649/100000 per year (95% Cl, 590–707). The leading causes of hospital attendance were related to injuries involving sports, play equipment, bicycles and poisoning. These rates are substantially lower than those reported from other countries. The possible reasons for this include differences in health care utilization, under‐ascertainment of cases, and a real difference in injury risk. Injury Surveillance Information System codes are defined for a standard set of injuries and injury causes which may be used for future comparative studies. Problems related to assessing the reliability of injury ascertainment are discussed, and the importance of integrating injury surveillance into routine hospital information

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1992.tb02613.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractThere is increasing evidence that hyperthermia can occur in cool climates because of overwrapping and that this practice precedes many deaths labelled as SIDS. We have attempted to test the hypothesis that the interaction of a cold face and a hot body might lead to further hyperthermia in a piglet model. Twelve non‐sedated newborn piglets were studied over the first 10 days of development. Oxygen consumption was measured continuously during sleep. Animals were exposed to cold face conditions initially while the animal's body was kept warm and then while the body was hyperthermic. The results show that stimulation of the face with cool ambient air during conditions of raised metabolic activity (hot body) causes a fall in oxygen consumption towards basal levels. These studies do not, therefore, support the hypothesis that a further increase in metabolic rate occurs during combined cold face and hot body exposure in the piglet mode

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1992.tb02730.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractThis report examines the thermal environment during last sleep of a control population to investigate how the thermal environment of the infant's bedroom varies by season, external temperature and by certain maternal and infant characteristics. Two age‐matched control infants were chosen for each case, one of which was also matched on birthweight. The home visits were not pre‐arranged and were matched on climatic conditions, time of year and time period of day for the index case. The initial response rate for controls (n= 108) was 86%. Although there was a large amount of variation in the infant thermal environment, thermal insulation correlated with room temperature (r=−0.44,P= 0.0001) and external temperature (r=− 0.30,P= 0.002). The thermal environment of the infant, as defined by excess thermal insulation for room temperature, did not vary by indoor or outdoor temperature, but higher average values were observed in teenage mothers (mean difference = 2.7 tog [95% Cl = 0.3, 5.2]), infants who slept in an adult bed (mean difference = 2.6 tog [− 0.1, 5.4]) and infants with an illness (mean difference = 0.8 tog [− 0.3,1.9]). There was a tendency for the thermal environment of infants to be higher and more variable during winter, supporting previous hypotheses that paradoxical overheating may occur in some infants during winter. Further work is required to provide a set of recommendations on the optimal thermal conditions for post‐neo

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1992.tb02731.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractPulse oximeters are programmed with a calibration curve derived from studies done in adults. Whether fetal haemoglobin levels affect their reliability is unclear. This study reports the accuracy of pulse oximetry in 22 preterm infants (mean 31 weeks, range 25–36 weeks gestation) between 1 h and 73 days of age. Oxygen saturation obtained from a Nellcor N‐200 pulse oximeter (SpO2) was compared with simultaneous arterial values (functional SaO2) measured by a Radiometer OSM3 Hemoximeter over a SpO2range of 83–99%. Fetal haemoglobin (HbF), carboxyhaemoglobin (HbCO) and methaemoglobin (HbMet) measured by the hemoximeter ranged between 0–100%, 0–3.5% and 0–0.8% respectively. Linear regression analysis revealed a close correlation between SpO2and functional SaO2(SpO2= 0.75 SaO2+ 24.43, r = 0.88, (P<0.001) over a wide range of values for PCV, heart rate, blood pressure, PaO2. PaCO2and pH. The mean SpO2‐SaO2difference of 1.3, (s.d. 2.5%, P(0.001) was unaffected by HgF, HbCO or HbMet but was increased in infants receiving inotropic support. We conclude that the Nellcor N‐200 pulse oximeter gives reliable oxygen saturation measurements unaffected by the HbF level in

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1992.tb02615.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractThirty‐five neonates developed radiologically proven necrotizing enterocolitis (NEC) over a 40 month period. They were 28∖pm2 weeks gestation, and weighed 1094∖pm411 g at birth. Eighteen infants (51%) required surgery and three (8.5%) died. The incidence was 6.7% in the very low birthweight (VLBW) infants. A large proportion of NEC (60%) presented beyond 10 days of life. An inverse relationship between gestation and age of onset was observed. The age of presentation was 22 ∖pm 13 days (range 10–53 days) for the 18 infants 28 weeks compared with 7 ∖pm 5 days for those over 28 weeks (P<0.01). Five NEC infants had bacteraemia which occurred 2–7 days prior to gastrointestinal symptoms of NEC, and four were staphylococcal. Compared with infants controlled for gestation, there was no significant differences observed in perinatal events or feeding history. We concluded that an immature gastrointestinal system is vulnerable to NEC even beyond the early ne

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1992.tb02616.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractThe role of transplacental transfer of maternal thyrotrophin (TSH)‐blocking antibodies causing congenital hypothyroidism in Southern Chinese children was examined in this study. Twenty‐two mothers of 24 patients with congenital hypothyroidism were studied 3–5 years after delivery. None of them had thyroid dysfunction at delivery or at the time of study. None had antithyroglobulin or antimicrosomal antibody. Only one mother was found to have TSH‐binding inhibitory immunoglobulin (TBII), and her child had agenesis of the thyroid. This women had Graves disease in remission for 2 years before delivery. None had TSH‐stimulated cAMP response inhibitory immunoglobulin (TSII). Ten of the 24 congenital hypothyroid children had transient neonatal hypothyroidism, seven had agenesis of the thyroid, six had dyshormonogenesis and one had a sublingual thyroid. As none of the mothers who had children with transient neonatal hypothyroidism had blocking antibodies at the time of study, the aetiology of the transient neonatal hypothyroidism remains unclear. These data suggest that maternal TSH‐blocking antibodies do not play a role in most cases of sporadic congenital hyp

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1992.tb02617.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractThe aim of this study was to determine whether the severity of symptoms associated with rotavirus infection was related to the serotype of the infecting virus. Severity of clinical symptoms in 108 children admitted to hospital for treatment of rotavirus diarrhoea was retrospectively assessed using a scoring system for frequency and duration of vomiting and diarrhoea, degree of fever, acidosis and dehydration, and presence of electrolyte imbalance. Children were 6–30 months old and were fully weaned at onset of symptoms prior to admission to hospital. No other enteric pathogens were detected during the course of the illness. Serotypes and monotypes were identified using a panel of monoclonal antibodies. Gel electrophoresis of rotavirus RNA was performed to determine electropherotypes. Children surveyed were infected with serotype 1 (47), serotype 2 (15) or serotype 4 (46) rotaviruses. Comparisons of severity of clinical symptoms according to infecting serotype revealed no statistically significant differences between serotype 1,2 or 4 infections. In addition, no differences were detected between different rotavirus strains within each serotype (as judged by electropherotype) including monotypes 1a or 1c. This study failed to reveal differences in virulence between rotavirus strains of different VP7serotypes infecting young childre

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1992.tb02618.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractTumour samples from 38 patients with neuroblastoma were analysed for the presence of N‐mycamplification. N‐mycgene copy number in tumour DNA was determined by Southern blotting, and by dilution analysis where appropriate. Available clinical data, obtained at tissue collection and by subsequent questionnaire included patient age at diagnosis, catecholamine, ferritin and neuron‐specific enolase levels, treatment and disease status. This study was designed to investigate the use of N‐mycamplification data as an additional indicator for determination of prognosis. Patients with amplified N‐mychad more rapid disease progression than those without amplification (P<0.005). Stratification of Stage III and IV patients using N‐mycamplification permitted identification of a subgroup with poorer prognosis. The results demonstrate that determination of N‐mycamplification is important in assessment of prognosis and subsequent treatment in patients with

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1992.tb02619.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractThe infant mortality rate (IMR) at Cherbourg Aboriginal Community in south‐eastern Queensland remained high from 1906 to about 1955–60, but since then has dropped from over 200/1000 live births in 1956–60 to 16/1000 live births in 1986–90, compared with the 1987 rate for Queensland (9.2/1000) and Australia (8.6/1000). The rapid improvement in the IMR was associated with the installation of a piped and chlorinated water supply, sewerage and an intensive campaign to eradicate intestinal worms. There has also been a change in community attitudes towards routine health practices and it is likely that this has been a major factor in the

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1992.tb02620.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY