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Biomedical subjects

A G Philip

Publications and source records attributed to A G Philip.

At least 37 records · Page 2Linked to original sources
PubMed1985

Neonatal cerebral pathology diagnosed by ultrasound.

This article discusses cranial ultrasonography in various clinical settings. Since 1979, the authors have screened all preterm infants for intracranial hemorrhage, and here they present their experience with hemorrhage and its sequel, ventricular dilatation. Also discussed is the use of cranial ultrasonography in infants with seizures and encephalopathy and in infants with abnormal head growth or suspected cerebral malformations.

Cerebral Hemorrhage↗
PubMed1983

Alpha 1-acid glycoprotein in the neonate with and without infection.

In a study of early neonatal infection, 278 babies had a blood culture and an alpha 1-acid glycoprotein (alpha 1-AGP) determination. There were significant differences between the mean (+/- SEM) levels of alpha 1-AGP in infants who were noninfected (26 +/- 1.3 mg/dl, n = 244), infected (81 +/- 11 mg/dl, n = 12) and proved to have sepsis (66 +/- 10 mg/dl, n = 22). In the 'noninfected' group, alpha 1-AGP levels increased with postnatal age. Increasing levels were seen on the 1st day with both increasing gestational age (15-34 mg/dl from less than 30 to greater than or equal to 38 weeks) and birth weight (17-42 mg/dl from less than 1,000 to greater than or equal to 4,000 g), irrespective of the infant's sex. Among the sepsis group, infants who died had lower levels than those who survived (19 mg/dl vs. 90 mg/dl).

Age Factors↗
PubMed1982

Neonatal sepsis resulting from possible amniotic fluid infection: risk and detection.

Antibiotics are frequently prescribed "prophylactically" when the neonate is considered to be at risk for infection. The risk factors of prolonged rupture of membranes (greater than 24 hours), maternal fever/infection, and/or unexplained preterm labor (suggesting possible anmiotic fluid infection) were investigated in 276 babies. Only two of 150 babies investigated for a single factor proved to have sepsis, while of the 126 babies who had multiple factors, 13 had sepsis. Several laboratory tests, used singly or in combination, were more helpful than clinical manifestations in predicting which babies were likely to be infected. Neonatal sepsis was present in 6 per cent of the total, in 10 per cent of neonates with clinical signs, in 21 per cent with an increased immature/total neutrophil ratio (I/T ratio greater than or equal to 0.2), and in 36 per cent of infants with a positive "sepsis screen." The incidence of "infection" (sepsis and "very probable" infection) was 12 per cent overall, but was 14 per cent with neonatal signs, 44 per cent with I/T ratio greater than or equal to 0.2, and 74 per cent in those with a positive sepsis screen. A leukocyte count less than 5,000/cu mm and/or an I/T ratio greater than or equal to 0.2 was 100 per cent sensitive for sepsis, but the sepsis screen was most "efficient" at detecting "infection." Starting antibiotics on the basis of risk factors alone does not seem appropriate. In situations where amniotic fluid infection is possible, evaluation with the leukocyte count and differential (with or without other tests) could decrease the indiscriminate use of antibiotics, particularly when a single risk factor is the reason for suspecting infection.

Amniotic Fluid↗
PubMed1981

Decreased use of antibiotics using a neonatal sepsis screening technique.

Antibiotic use was evaluated in an intensive care nursery before (1975-77, Group 1) and after 1978-80, Group 2) a "sepsis screen" was used at the bedside. All babies were evaluated prospectively, but the sepsis screen was available within an hour to influence decisions about antibiotics only in Group 2. The screen was positive if two or more of five simple tests were positive when investigation for possible sepsis was initiated. Group 1 and Group 2 had similar numbers of babies with proven sepsis and positive sepsis screens, and similar reasons for investigation, but there was a marked decrease (P less than 0.0001) in antibiotic use in Group 2. When only those babies with a negative sepsis screen were evaluated, the result was even more striking. This study demonstrates that antibiotic use can be decreased with the help of simple, rapid, and inexpensive tests.

Adult↗
PubMed1981

Term twins with discordant birth weights: observations at birth and one year.

Sixteen pairs of term discordant twins (weight discrepancy of more than 20% when the lighter twin was compared to the heavier) were evaluated at birth. Weight, length, head circumference, anterior fontanel area, and combined ossification of the knee epiphyses were measured, and ponderal index (weight/length ratio) calculated. The most severely growth retarded infants had markedly decreased ossification and larger anterior fontanels. Eleven pairs had physical measurements at one year of age. With individual exceptions, the lighter twins at birth remained smaller in all dimensions. Despite these persistent differences between twin pairs, the values for length at one year of age were within normal limits for both the heavier and lighter twins. Infants without ossification at birth had a greater incremental linear growth by one year than those infants with ossification.

Birth Weight↗
PubMed1981

Intracranial pressure. Sequential measurements in full-term and preterm infants.

Intracranial pressure (ICP) was measured sequentially using a pressure-activated fiberoptic device that is placed over the anterior fontanel in 120 full-term and 53 preterm infants during the first week after birth. Mean birth weight in full-term infants was 3,527 g (range, 2,720 to 4,620 g) and in preterm infants was 1,695 g (range 1,130 to 2,440 g). Mean ICP was 12.6, 12.1, and 11.4 cm H2O on days 1,2, and 3 in full-term infants, and was 10.2, 17.0, 11.0, 8.9, 7.3 cm H20 on days 1, 2, 3, 5, 7 in preterm infants. The values in preterm infants did not seem to be related to differences in Apgar scores, but higher values were seen in infants treated with continuous positive airway pressure administered by nasal prongs (before the method of fixation was changed). More stable values have been seen recently in preterm infants, which may reflect changes in care (eg, less hypoxemia).

Analysis of Variance↗
PubMed1981

Neonatal mortality risk for the eighties: the importance of birth weight/gestational age groups.

Since 1976 a computerized data base has been used to store information on babies admitted to two intensive care nurseries serving the Vermont/New Hampshire region. The data base now allows reporting "neonatal" mortality by birth weight/gestational age (BW/GA) groupings for 1976--1979. For all BW/GA groups, except the most immature infants, there has been marked improvement compared to data gathered in the sixties (ie, mortality has decreased). These data are probably applicable to most other centers providing neonatal intensive care. The use of BW/GA categories provides the most reliable way of objectively comparing statistics from one center to another. Differences between two centers were observed when birth weight specific rates were used, but were largely abolished by using BW/GA groups. Data gathered in this way will be increasingly important for comparisons between centers and across years and when evaluating the effectiveness of new therapeutic interventions.

Birth Weight↗