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Biomedical subjects

A Lucas

Publications and source records attributed to A Lucas.

At least 253 records · Page 14Linked to original sources
PubMed1989

Amyloid goiter. Diagnosis by fine-needle aspiration biopsy of the thyroid.

Amyloid goiter is a rare condition. We could not find more than 90 cases from an extensive review of world literature. We report here two patients in whom that diagnosis was made, prior to surgery, by fine-needle aspiration biopsy of the thyroid. We review the major clinic and histopathologic characteristics of amyloid goiter and we stand out the usefulness of the fine-needle aspiration biopsy of the thyroid to diagnose the amyloid goiter and amyloidosis, in general.

Aged↗
PubMed1989

Quetelet's index as a measure of body fatness in young infants.

There is a dearth of body composition techniques suitable for use in young infants. We have investigated the ability of Quetelet's index (W/H2) to predict body fatness in a group of male and female infants at 5 and 11 weeks of age. Fat-free mass and hence fat mass was determined using an H2 18O dilution technique. FM/H2 and Quetelet's index were significantly correlated in all but the male, 11 week old infants. However Quetelet's index could not be used in a predictive capacity because of the poor variation accounted for by the relationships. It is possible that Quetelet's index is a poor method of predicting body fatness in young infants because of the very rapid changes that are occurring in body weight and length at that time.

Adipose Tissue↗
PubMed1989

The "cap" technique: nonmicrosurgical reattachment of fingertip amputations.

With the exception of children, amputations at the level of the lunula survive poorly by direct reattachment. Microsurgical replantation is costly and often fails because of poor venous drainage. In a series of seven adult patients the severed tip was filleted and replaced as a "cap" over the skeletonized distal phalanx of the stump. A 2 mm remnant of germinal matrix was preserved for nail regrowth. The reconstructed digits, although shortened by an average of 6 mm, give the "illusion" of a normal finger. All were successful with small areas of tip necrosis in two, healing by secondary reepithelialization. Mean static two-point discrimination was 6.5 mm (range, 3 to 10 mm) and pulp pinch was 67% of normal. The "cap" technique of nonmicrosurgical reattachment is a simple, reliable method of functional preservation of pulp tissue, as well as normal esthetic appearance of the nail complex.

Adolescent↗
PubMed1989

Energy expenditure in early infancy.

The measurement of energy expenditure has wide applications in clinical and scientific studies. Ethical and practical problems, however, have limited the acquisition of information on total energy expenditure in infancy. The doubly-labelled-water technique, recently validated for use in infants, has now been used to measure, non-invasively, total energy expenditure in a cohort of forty-one normal, full-term infants at or close to 1.5, 3 and 6 months of age. Mean total energy expenditure was 270, 280 and 330 kJ/kg per d at these ages. Centiles for total energy expenditure in early infancy are presented; it is suggested such data are most appropriately expressed as kJ/square root (kg body-weight per d). These findings will be of importance in the re-evaluation of energy requirements in infancy and in the study of lesions in energy metabolism in disease states at this age.

Aging↗
PubMed1989

Are preterm infants at risk for subsequent fractures?

In Cambridge, between 1979 and 1988, the prevalence of low gestation (less than 37 or less than 33 weeks) was not increased in 362 children under 6 years presenting to casualty with fractures compared with that in 362 children presenting without fractures or in all inborn surviving babies. These data are relevant to the assessment of suspected child abuse after preterm birth.

Child Abuse↗
PubMed1989

Early diet in preterm babies and developmental status in infancy.

Few data from randomised prospective studies address whether early diet influences later neurodevelopment in man. As part of a larger multicentre trial, 502 low birthweight infants were assigned randomly, for a median of 30 days, to receive a preterm formula or unfortified donor breast milk as sole diets or as supplements to their mothers' expressed milk. Surviving infants were assessed at nine months after their expected date of delivery without knowledge of their feeding regimen. The mean developmental quotient was 0.25 standard deviations lower in those fed donor breast milk rather than preterm formula. In infants fed their mother's expressed milk, however, the disadvantage of receiving banked milk compared with preterm formula as a supplement, was greater when the supplement was over half the total intake, and approached five points, representing 0.5 standard deviations for developmental quotient. Infants fed donor breast milk were at particular disadvantage following fetal growth retardation, with developmental quotients 5.3 points lower. We suggest that the diet used for low birthweight babies over a brief, but perhaps critical, postnatal period has developmental consequences that persist into infancy; infants who are small for gestational age are especially vulnerable to suboptimal postnatal nutrition.

Child Development↗
PubMed1989

Comforters and night waking.

Among 320 low birthweight infants seen at nine months post term those using a soft object, thumb, or fingers as comforter were significantly less likely to wake at night (9/96, 9%) than those with no comforter or using a dummy (66/224, 29%). Dummy users were as likely to wake (27/93, 29%) as those without a comforter (39/131, 30%).

Bedding and Linens↗
PubMed1989

Does dexamethasone suppress the ACTH response in preterm babies?

Tests of adrenal stimulation with adrenocorticotrophic hormone (ACTH) were performed before and after commencing dexamethasone treatment in 12 infants. All except one of the tests performed showed the expected twofold rise in serum cortisol, suggesting that in this group of premature babies dexamethasone did not suppress the adrenal response.

Adrenocorticotropic Hormone↗
PubMed1989

Growth and development in premature twins.

A total of 476 infants (386 singletons and 90 twins) born before 32 weeks' gestation were studied to compare long term growth and development in twins and singletons. At 18 months, after adjusting for confounding social, obstetric, and neonatal factors, twins were not disadvantaged in their neurodevelopmental status, but were 1.6 cm shorter than singletons and had thicker triceps and subscapular skinfolds. No significant differences were found between first and second born twins in later growth or development at 18 months post-term. While preterm twins may have an inherent disadvantage in linear growth it is suggested that in other respects twinning is not a risk factor in preterm infants.

Anthropometry↗
PubMed1989

High alkaline phosphatase activity and growth in preterm neonates.

In a study on 857 infants born preterm, high peak plasma alkaline phosphatase activity was independently related to slower growth rate in the neonatal period, and to a highly significant reduction in attained length at 9 months and 18 months post term. At 18 months the deficit in body length associated with peak neonatal plasma alkaline phosphase activity of 1200 IU/l or more was 1.6 cm (95% confidence interval 0.9 to 2.3 cm) after adjusting for confounding factors. The strength and magnitude of this association between high plasma alkaline phosphase activity and body length was greater than that for any other factor identified, including the infant's sex and the presence of fetal growth retardation. Data are presented that support the view that the high plasma alkaline phosphatase activity reflected early bone mineral substrate deficiency resulting in metabolic bone disease. We speculate that even silent early bone disease may interfere with the control of subsequent linear growth and emphasise the potential importance of providing preterm infants, especially those fed human milk, with adequate substrate for bone mineralisation.

Alkaline Phosphatase↗
PubMed1989

Functional modifications of the CD4+ and the CD8+ subset due to maternal serum.

Numerous experiments have been performed to try to explain the successful gestation of the semiallogeneic mammalian fetus in the immuno-competent mother. A popular hypothesis is that localized intra uterine suppression mediates the immune response and contributes directly to the survival of the fetus. Suppressive factors synthesized at the fetomaternal interface may be transported by the bloodstream and be found in the retroplacental and peripheral blood circulation. In this report we aim to study these modulating factors by exposing a proteinaceous antigen (Candidine or human mono nuclear cells) to unrelated human lymphocytes in the presence of a pool of maternal serum, retroplacental (MAT SR) or peripheral (MAT SP), or to a pool of male or calf serum (MALS or CS). A significant downregulation of the candidine mediated lymphocytic stimulation was observed in the case of the maternal serum. In order to further characterize this inhibition, a quantitative evaluation of the expression of the CD4 and CD8 positive subpopulations was performed. A selective inhibition of the CD4 positive subset was observed. In the PHA stimulation assay in the presence of maternal serum there was an inhibition of the thymidine uptake of unrelated lymphocytes. When studying the different subsets which were stimulated in the presence of maternal serum and control media it was shown that the CD4 positive subpopulation remained unchanged while there was a slight inhibition of the CD8 positive subset in the first case (maternal serum treated). The same CD4 positive inhibitive property of maternal serum was observed when a neoplastic cell line (HUT cells) was used as target for candidine in a stimulation test. This CD4 inhibited expression remained constant as long as the maternal serum was renewed. Maternal lymphocytes however remained resistant to the inhibitive action of maternal serum and did not show any change in their CD4 and CD8 positive subpopulation. By investigating the different blood components, it was shown that the suppressive factor was included in the IgG fraction and synthesized at the placental level. Appearing quite early during the gestation (at the 5-6th week), this factor was vanishing 2 weeks after the delivery.

Antigens, Differentiation, T-Lymphocyte↗
PubMed1989

Adjusting energy expenditure for body weight in early infancy.

The most appropriate method of expressing energy expenditure relative to body weight was investigated in 50 normal, full-term infants at 6 weeks, 12 weeks and 6 months of age. Regression analysis revealed that the relationship between body weight and energy expenditure at each age could be adjusted for by expressing energy expenditure per kg0.65, per kg0.43 and per kg0.55 body weight at the three age points studied. These powers were not significantly different and a pooled estimate was per kg0.56. This is very close to kg0.5 or the square root of body weight. It is suggested that in studies on energy, metabolism in early infancy the expression of total energy expenditure per kg0.5 body weight should be used as the most appropriate adjustment for removing the influence of body weight upon energy expenditure.

Body Weight↗
PubMed1988

Adverse neurodevelopmental outcome of moderate neonatal hypoglycaemia.

There has been considerable debate over whether asymptomatic neonatal hypoglycaemia results in neurological damage. In a detailed multicentre study of 661 preterm infants hypoglycaemia was found to be common. Moderate hypoglycaemia (plasma glucose concentration less than 2.6 mmol/l) occurred in 433 of the infants and in 104 was found on three to 30 separate days. There was considerable variation among the centres, implying differences in decisions to intervene. The number of days on which moderate hypoglycaemia occurred was strongly related to reduced mental and motor development scores at 18 months (corrected age), even after adjustment for a wide range of factors known to influence development. When hypoglycaemia was recorded on five or more separate days adjusted mental and motor developmental scores at 18 months (corrected age) were significantly reduced by 14 and 13 points respectively, and the incidence of neurodevelopmental impairment (cerebral palsy or developmental delay) was increased by a factor of 3.5 (95% confidence interval 1.3 to 9.4). These data suggest that, contrary to general belief, moderate hypoglycaemia may have serious neurodevelopmental consequences, and reappraisal of current management is urgently required.

Cerebral Palsy↗
PubMed1988

Are current dietary guidelines for young children a prescription for overfeeding?

New estimates for the energy requirements of young children have been derived by combining the energy deposited during growth with measurements of total energy expenditure obtained by use of the new doubly-labelled water (2H2(18)O) method in 355 healthy infants aged 0-3 years. The resultant values of 110, 95, 85, 83, 83, 84, and 85 kcal/kg/day at 1, 3, 6, 9, 12, 24, and 36 months, respectively, are substantially lower than current Department of Health and Social Security and FAO/WHO/UNU recommended dietary allowances. Evidence from diet surveys suggests that changes in infant feeding practices are largely responsible for the apparent reduction in energy requirements. Dietary guidelines may need to be reappraised, to avoid overfeeding of infants.

Age Factors↗