Biomedical subjects

Brigid Jordan

Publications and source records attributed to Brigid Jordan.

4 recordsLinked to original sources

PubMed2006

Rescue intracytoplasmic sperm injection and preimplantation genetic diagnosis in combination can result in pregnancy.

OBJECTIVE: To report the birth of a baby from the transfer of one embryo after rescue intracytoplasmic sperm injection (ICSI) and preimplantation genetic diagnosis (PGD). DESIGN: Case report. SETTING: IVF center. PATIENT(S): A 42-year-old G2P0020 woman with unexplained infertility. INTERVENTION(S): Rescue ICSI followed by PGD. MAIN OUTCOME MEASURE(S): Pregnancy. RESULT(S): Rescue ICSI was performed on seven unfertilized oocytes, which resulted in three embryos. The PGD analysis revealed one normal embryo, which was transferred and resulted in pregnancy and delivery. CONCLUSION(S): Rescue ICSI in combination with PGD can result in a successful pregnancy.

Adult↗

PubMed2006

Clinical predictors of pathological gastro-oesophageal reflux in infants with persistent distress.

BACKGROUND: Gastro-oesophageal reflux (GOR) is common in infants with persistent crying. Empirical treatment with antireflux medications is common practice, although on clinical grounds it may be difficult to determine whether GOR is abnormal. AIMS: To examine the diagnostic accuracy of clinical predictors of pathological GOR in infants with persistent crying. METHODS: One hundred and fifty-one infants (82 male; median age 2.5 months, range 0.5-8.2 months) with persistent crying were prospectively studied. Crying and fussing were charted for 24 h, and parents completed a validated questionnaire on reflux symptoms. All infants underwent oesophageal 24-h pH monitoring. RESULTS: Twenty-seven (17.9%) infants had pathological GOR with a fractional reflux time (FRT) >10%. There was no significant association between total crying duration per 24 and FRT (P = 0.84) or the number of reflux episodes (P = 0.68). Pathological GOR was more common in infants under 3 months, compared to older infants (P = 0.04). Feeding difficulties were significantly associated with pathological GOR (P = 0.02). Backarching was not increased in infants with GOR (P = 0.30). Pathological GOR was significantly associated with the frequency of regurgitation (P = 0.04), but not with vomitus volume (P = 0.62). Regurgitation more than 5 times daily was the most specific reflux symptom (specificity 70.9%), but was a poor predictor of pathological GOR (positive predictive value 22.2%). In the absence of frequent regurgitation or feeding difficulties, pathological GOR was unlikely (negative predictive value 87-90%). CONCLUSIONS: Investigation and treatment of GOR in infants with persistent crying should be primarily directed at infants presenting with frequent regurgitation or feeding difficulties.

Age Factors↗

PubMed2004

1. Problem crying in infancy.

Up to 20% of parents report a problem with infant crying or irritability in the first 3 months of life. Crying usually peaks at 6 weeks and abates by 12-16 weeks. For most irritable infants, there is no underlying medical cause. In a minority, the cause is cow's milk and other food allergy. Only if frequent vomiting (about five times a day) occurs is gastro-oesophageal reflux a likely cause. It is important to assess the mother-infant relationship and maternal fatigue, anxiety and depression. Management of excessive crying includes: explaining babies' normal crying and sleeping patterns; helping parents help their baby deal with discomfort and distress through a baby-centred approach; helping parents recognise when their baby is tired and apply a consistent approach to settling their baby; encouraging parents to accept help from friends and family, and to simplify household tasks. If they are unable to manage their baby's crying, admission to a parenting centre (day stay or overnight stay) or local hospital should be arranged.

Algorithms↗

PubMedDate not supplied

Effect of antireflux medication, placebo and infant mental health intervention on persistent crying: a randomized clinical trial.

OBJECTIVE: To assess the effect of medical antireflux treatment, and of an infant mental health consultation (IMHC), on persistent crying in infants and maternal distress. METHODS: Infants under 9 months of age with persistent crying, and their mothers, were enrolled in a randomized placebo-controlled trial. At enrollment, a questionnaire on demographic and clinical details was completed by mothers, and maternal distress was measured (Experience of Motherhood Questionnaire; EMQ). Oesophageal 24-h pH monitoring was performed in all infants on day 2. At week 4, the cry chart and EMQ were repeated in conjunction with a final interview. RESULTS: One hundred and three infants (56 under 3 months of age; 55 male) who were randomized to active medication (ranitidine plus cisapride; n = 34), placebo (n = 29) or IMHC (n = 40) completed the trial. There was a significant reduction in crying duration from baseline to week 4 (253 +/- 96.5 min vs 159 +/- 92.3 min per 24 h; P < 0.001), without differences between treatment groups (AVOVA: F = 0.75; P = 0.48). There was a modest improvement in EMQ scores from 44.9 +/- 8.6 at day 1 to 42.8 +/- 9.4 at week 4; P = 0.006. The improvement in maternal stress was similar in all treatment groups (Kruskal-Wallis chi2 = 0.354; P = 0.84), but subsequent admission to a mother-infant unit was significantly less frequent in the IMHC group (P < 0.05). CONCLUSION: Antireflux medications and IMHC were not superior to placebo in treating infants with persistent crying. Although the reduction in maternal distress was similar in all treatment groups, the individualized IMHC reduced the need for subsequent admission to a mother-infant unit.

Crying↗