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Biomedical subjects

A R Wilkinson

Publications and source records attributed to A R Wilkinson.

At least 91 records · Page 5Linked to original sources
PubMed1985

Lack of association between barotrauma and air leak in hyaline membrane disease.

A retrospective analysis of 632 infants with hyaline membrane disease admitted to this regional intensive care nursery between 1 July 1974 and 31 December 1982 showed that 387 (61%) received mechanical ventilation. The ventilator pressures at the time the first air leak was detected were available from the records of 120 of 154 (78%) of the infants who sustained pulmonary air leak. There was a significant downward trend in both peak and end expiratory pressure used during the study period. The downward trend in peak pressure persisted when inborn and outborn infants, boys and girls, and infants more than 27, and 23 to 27 weeks' gestation were examined separately. Despite these trends there was no reduction in the incidence of pulmonary air leak in any group. These data do not support the hypothesis, implicit in the term barotrauma, that a reduction in ventilator pressures decreases the risk of air leak.

Barotrauma↗
PubMed1984

Ontogeny and neonatology of circulating endogenous inhibitor(s) of prostaglandin synthase in the human.

To further understand the mechanism by which in vivo prostaglandin synthesis may be orchestrated, plasma levels of endogenous inhibitor(s) of prostaglandin synthase (EIPS) in the human fetus, neonate and adult have been measured. In general, a reciprocal relationship was found between plasma EIPS levels and previously reported plasma prostaglandin concentrations. This result supports a role for EIPS in the control of prostaglandin biosynthesis in the human.

Adult↗
PubMed1984

Salivary estriol concentrations during normal pregnancies, and a comparison with plasma estriol.

Saliva would have advantages over plasma or urine for monitoring estriol during pregnancy. Specimen collection, after stimulation of flow by citric acid, is non-invasive and simple. We measured concentrations of unconjugated estriol in saliva and compared them with those in plasma in normal pregnancies, and found a good correlation (r = 0.79). In addition, trends of concentrations in saliva and plasma were statistically compared and found to be highly correlated. The variation among individuals in the saliva/plasma concentration ratio suggested that some inter-individual factor(s) may affect this relationship. The normal reference interval for unconjugated estriol concentration in saliva from 20 weeks of gestation to term was established.

Estriol↗
PubMed1984

Clinical usefulness of estriol assay for predicting "light-for-dates" infants.

A method was developed for determining clinical usefulness of a test for predicting "light-for-dates" infants before birth. The method was applied in a prospective study of assay of maternal estriol at 35-36 weeks of gestation as a means of identifying such infants. With the tenth centile for estriol values as the cutoff, low estriol values identified less than a third of all light-for-dates infants, and less than a third of pregnancies with low estriol values were associated with births of light-for-dates infants. Our reanalysis of data from three other published studies, using the same method of assessment, gave similar results. When laboratory tests are expected to provide clinically relevant information, we urge that data should be appropriately collected, analyzed, and reported, so clinical usefulness can be evaluated.

Estriol↗
PubMed1983

Diagnosis of neonatal seizure by continuous recording and rapid analysis of the electroencephalogram.

Clinical diagnosis of neonatal seizure is difficult and repeated seizures may be unrecognised. To assist in early diagnosis we recorded continuously the electroencephalogram (EEG) of very sick newborns while intensive care continued. In 25 babies at high risk of seizure a continuous record of two channels of EEG, ECG, and respiration was made for periods varying from 11 hours to 16 days. The method employed produced an EEG largely free of movement and electrical artefact which was analysed rapidly using a visual display unit. Electroencephalographic seizure activity was recorded in 20 babies, and continuous monitoring of the EEG allowed earlier recognition of seizure than was possible with clinical observation.

Anticonvulsants↗
PubMed1983

Influence of pre-eclampsia on concentrations of haemostatic factors in mothers and infants.

The effect of pre-eclampsia on selected maternal and neonatal coagulation factors was studied by comparing plasma concentrations in 5 severely pre-eclamptic and 5 normal pregnancies. Pre-eclampsia was associated with appreciably lower maternal values of antithrombin III, plasminogen, and platelet count in late pregnancy but umbilical cord blood values showed no notable differences from normal pregnancy.

Antithrombin III↗
PubMed1981

Electrocardiographic signs of pulmonary hypertension in children who snore.

Two children presented with sleep disturbances due to enlarged tonsils and adenoids. One child died during induction of anaesthesia, and postmortem examination showed hypertrophy of the right ventricle and atrium. As a result a prospective survey was carried out of children undergoing tonsillectomy or adenoidectomy, or both. During a nine-month period an electrocardiogram was taken in 92 children. Three electrocardiograms (3.3%) showed evidence of right heart strain. The children with abnormal electrocardiograms had symptoms of sleep disturbance with apnoea, snoring, and daytime somnolence. These symptoms and the electrocardiographic changes were reserved by adenotonsillectomy. The prevalence of pulmonary hypertension in children with enlarged tonsils and adenoids is still underestimated. When signs and symptoms of sleep disturbance, particularly snoring, are present an electrocardiogram should be obtained and a cardiologist's opinion sought before embarking on routine surgery in view of the potentially fatal consequences.

Adenoids↗
PubMed1981

Oxygen and carbon dioxide tensions, breathing and heart rate in normal infants during the first six months of life.

Daytime measurements were made of the relationship between sleep state, cardio-respiratory changes and oxygen (transcutaneous PO2) and carbon dioxide (mass spectrometer alveolar PCO2) tensions in eleven normal infants from birth to 6 months of age. Sequential records were made at 1 week, 1, 3 and 6 months. The babies were not restrained, slept in a cot, and were constantly observed. Heart rate was higher in active sleep than in quiet sleep at all ages and rose between 1 week and 1 month (P less than 0.01) in both quiet sleep and active sleep and then decreased at 3 and 6 months. Respiratory rate only changes with age in active sleep at 6 months, showing a decrease (P less than 0.05) but was higher in active sleep that in quiet sleep at 1 month (P less than 0.002) and 3 months (P less than 0.02). A fall in heart rate (less than 100 beats/min) occurred chiefly in association with apnoea. The incidence of apnoea (of greater than 3 s duration) varied widely between babies at the same age and in the same baby at different ages but was most common in the first 3 months of life. No evidence of obstructive apnoea was found and no apnoea of greater than 12 s duration was observed. Period breathing occurred in all babies at 1 month normally following sighs but was uncommon at 1 week and 3 months and absent at 6 months. A fall in transcutaneous PO2 did not precede but often resulted from an episode of periodic breathing.

Aging↗