ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1987.tb02166.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1987.tb02167.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1987.tb02168.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractEpidural anaesthesia is now a widely used method for pain relief in childbirth, particularly using the drug Bupivacaine. There are nevertheless differing opinions in the research literature about the advisability of its routine use. While it is clearly very effective in relieving labour pain, there are some consistent, troublesome patterns; for example, a strong association between epidural use and other interventions, such as instrumental delivery. Further, there are no clear answers from the research to date concerning the risks and benefits of epidural anaesthesia for infant and mother. Answers could be provided by randomized clinical trials, but meanwhile a conservative approach to its use is recommended for uncomplicated labours.

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1987.tb02169.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractA prospective study on 150 infants with a birthweight of 1250 g or less was carried out to investigate the effects of patent ductus arteriosus (PDA), haemorrhagic pulmonary oedema (HPO), Indomethacin therapy and surgical ligation on the development of periventricular haemorrhage (PVH) or the extension of pre‐existing PVH. The incidence of PVH, diagnosed by serial cerebral ultrasonography was 44% and the incidence of PDA, diagnosed by serial M‐mode and contrast echocardiography, was 45%. During the first 8 days after birth when the infants were vulnerable to PVH, the development of PDA did not lead to the development or extension of PVH in 85% of infants. Haemorrhagic pulmonary oedema also had no effect on PVH in 71% of infants. Compared with infants whose PDA or HPO had no effect on PVH, those who had development or extension of haemorrhage had significantly more severe hypercapnia, blood gas instability and hypotension associated with the occurrence of PDA or HPO. Early Indomethacin therapy was not associated with the development or extension of PVH in 93% of infants. Although an elevation of arterial blood pressure was demonstrated after ductal ligation, surgery was performed after 1 week of age in all infants and in no instance was there an effect on PVH. This study suggests that PDA leads to PVH only if it causes significant blood gas and blood pressure disturbances which are known to affect cerebral blood flow advers

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1987.tb02170.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractThe records of all 91 neonates with asphyxia who were referred to the Royal Children's Hospital in 1982 and 1983 were reviewed and information was obtained on their subsequent neurological outcome. Thirty children had been extubated after their initial resuscitation, before transfer to the Royal Children's Hospital; 21 of these children had been extubated despite the fact that they had taken more than 5 min to take their first breath, and 11 (52%) of them died (while none of the nine infants who breathed within 5 min died). A paediatrician was involved with two‐thirds of the 21 children who were extubated despite having more than 5 min to breathe. Twelve children required cardiac massage; seven of them were extubated and then reintubated before transfer, and six of the seven infants died. These findings suggest that many paediatricians are not aware of the importance of continuing ventilatory support in neonates who have suffered a severe asphyxial insult. Asphyxiated babies who require cardiac massage, and babies who do not start breathing within 5 min of birth, should not be extubated as soon as they have established regular respiration; they should remain intubated and be transferred to an intensive care uni

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1987.tb02171.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractA cranial ultrasound examination was performed between 48 and 96 h of age on 580 neonates of 25–42 weeks gestation. The incidence of cerebroventricular haemorrhage (CVH) in infants less than 32 weeks gestation was 37%, compared with an incidence of 2.7% in infants of 32 weeks or more. The incidence of CVH in unselected healthy term infants (between 37 and 42 weeks) was only 1.1%.Of the 13 infants of 32 weeks or more who were found to have a haemorrhage, nine had a small (Grade I) haemorrhage (69%) and none of these infants had abnormal neurological signs in the neonatal period. The remaining four infants with Grade II, III or IV haemorrhage developed either seizures or episodes of apnoea. Two of the 13 infants of 32 weeks or more with a haemorrhage died, one during the newborn period and the other at 5.5 months of age.CVH in asymptomatic infants of 32 weeks or more gestation is uncommon and does not justify routine cranial ultrasound scannin

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1987.tb02172.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractFrom a sample of 803 children, 307 were involved in 413 separate incidents which resulted in injuries requiring medical attention. The most common injuries were lacerations, fractures, abrasions, and sprains. The majority of injuries were of minor severity. The most common incident resulting in an injury was a fall, followed by incidents where a child was struck by a person or object. A fifth of all falls was from bicycles. Sporting and playground equipment were associated with a large number of injuries, particularly at school. The study serves to highlight shortcomings in national injury data bases, in particular the absence of injury severity indices, codes for sports and recreation, and inadequate codes for falls. A case is made for integrating injury prevention within the school syllabus. The importance of bicycle injuries and the need for an injury surveillance based on accident and emergency centres is stressed.

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1987.tb02173.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractThe values for macro‐ and micronutrients and food energy intake are reported from a sample of 154 healthy children aged 6 years who have been prospectively studied since birth. The daily food energy intake in absolute terms and adjusted for body mass was lower than reported previously, and lower than the current recommended daily intake (RDI) but consistent with values derived from predictive equations based on other studies of preschool children. The carbohydrate intake was similar, but the protein intake was slightly lower and the fat intake also less than that reported in previous studies of children of a similar age. Micronutrient intake was greater than the RDI for each. The intake of potassium was adequate, but that of sodium was high in relation to the recommended K:Na ratio of>1, resulting in a value of 0.66.Stature was positively correlated with energy and fat intake, but there was an inverse correlation between fatness and energy intake, and intake of unrefined carbohydrate. These results are discussed in relation to the effect of different nutritional planes on growth rat

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1987.tb02174.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractThe respiratory impairment of asphyxiating thoracic dystrophy previously has been attributed to slower growth of the ribs which reduces chest size and limits chest expansion during breathing. Two siblings with this condition are described. One was found to have an abnormally low crying vital capacity; in the other the peak flow rate was reduced markedly. Chest X‐rays and ventilation‐perfusion nuclear scans were suggestive of hypoplastic lungs. Nasopharyngeal aspirates of airway secretions were found to contain significantly less total phospholipids and differences in phospholipid composition in comparison with a normal control group. These findings raise the possibility that the lungs are hypoplastic and have an abnormal phospholipid content in asphyxiating thoracic dystro

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1987.tb02175.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY