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Biomedical subjects

D Blum

Publications and source records attributed to D Blum.

At least 91 records · Page 5Linked to original sources
PubMed1988

Noncompliance in the treatment of endocarditis. The medical staff as co-conspirators.

Intravenous drug abusers with endocarditis present difficult problems in both medical and psychiatric management. A retrospective chart survey revealed that eight of nine such patients with endocarditis signed out against medical advice before antibiotic therapy was completed. Reasons for premature discharge included the patient's underlying psychopathology as well as the emotional response of the staff to these patients. Understanding both of these factors may help to prevent these premature discharges.

Adult↗
PubMed1988

Management of an infant with an apparent life-threatening event.

Our clinical experience agrees with most of the recent literature that infants with an apparent life-threatening event (ALTE) form a heterogeneous entity. A specific medical or surgical cause for the event could be found in 61% of the cases. Only 14% of the infants with an apparently severe event entered a home monitoring program. The other infants were treated whenever appropriate. All infants survived the first year of life. Home monitoring was shown to require continuous assistance to the parents. The follow-up of the infants up to 10 years after the ALTE reveals no neurodevelopmental abnormality in most of the infants. A systematic exclusional study of the infants with an ALTE, together with appropriate treatment programs, could thus provide the possibility of a good survival for most infants.

Female↗
PubMed1988

Infant with an apparent life-threatening event and possible risk for sudden infant death syndrome.

Pediatricians may be asked by anxious parents to care for their infant who survived a possible sudden death. The child was found unresponsive, pale or cyanotic, and apparently not breathing. The accident occurred unexpectedly, and only a prompt intervention by one of the caretakers permitted a normalization of the child's behavior. The following line discuss some aspects of the prevention of a sudden infant death. There are based on articles and reviews that appeared in the recent literature [1-3], as well as on our local experience. The purpose of these notes is to give the pediatrician some information on the practical aspects of the management of such infants with an apparent life-threatening event. The manuscript ends with some comments about the possible identification of high risk infants on the basis of the available neurophysiological data.

Humans↗
PubMed1988

Polysomnographic studies of infants who subsequently died of sudden infant death syndrome.

The polygraphic findings from 11 future victims of sudden infant death syndrome (SIDS) are reported and compared with those of matched pairs of control infants. The recordings had been done to alleviate parental anxiety about sleep apnea. Four infants had siblings who were victims of SIDS. Two infants were studied 3.5 to 9.5 weeks before their deaths because of an unexplained apparent life-threatening event that had occurred during sleep. For each victim of SIDS, two control infants were selected from the 2,000 infants who had been tested in the same hospitals. They were matched for sex, gestational age, postnatal age, and weight at birth with the SIDS victims. Their polygraphic recordings had been performed within similar conditions. Each record was allocated a random code number and was analyzed without knowledge of the patient's identity by two independent scorers. Most sleep and cardiorespiratory variables studied did not differentiate SIDS victims from control infants. Only four variables significantly characterized the future SIDS victims: the maximal duration of central apneas, the number of sighs followed by a central apnea, the presence of obstructive apneas, and the presence of mixed apneas. Central apneas were longer during all sleep states in the SIDS victims compared with their matched controls, but none exceeded 14 seconds. Sighs immediately followed by an apnea were significantly less frequent in the future SIDS group. Obstructive and mixed sleep apneas were seen in eight of 11 SIDS victims and in only three of 22 control infants.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1988

[Consumption of legal and illegal drugs by school students from the region of Doubs].

Two surveys were carried out among high school students from the Doubs region in 1982 and 1985. Their objective was to determine how legal and illegal drugs were used and their importance among the target population. Alcohol was found to be more common among the male population and its consumption remained stable during the 1982-1985 period. The use of tobacco, however, increased dramatically, especially among females attending vocational schools. The surveys also revealed that the age at which smoking was attempted for the first time has lowered, family and school environment playing an important role. Of those students who smoked, 69% had parents and a close friend who smoked, whereas 16% had none in their immediate environment who smoked. It was noted that young girls used more often psycho-active medicines than boys. A noticeable increase in their use became evident especially in vocational schools. Of those students questioned, 43% of junior high school students, 10.3% of vocational school students and 14.8% of senior high school students, stated that they used illegal drugs and that their accessibility permitted a wide use of these products. Whatever the age or sex the following associations were the most significant: drugs-tobacco, drugs-alcohol, tobacco-alcohol. Health education must therefore make the promotion of preventive strategies, concerning legal and illegal drugs, a priority in the education of adolescents.

Adolescent↗
PubMed1988

[Presentation of an apparatus to measure lens opacity: Opacity Lensmeter 701. Preliminary study].

The Opacity Lensmeter is a new instrument permitting the measurement of lens opacity. This preliminary report was performed on 98 patients (195 phakic eyes). Age, sex, lens opacity and retinal sensibility (using automated perimetry with the Octopus 2000 R) were assessed. A correlation between age and lens opacity was found in a simple linear regression model on 186 eyes (available data): opacity = 0.00423 square (age) + 5.18. An another more precise correlation was found in 138 eyes, excluding those with anterior segment abnormalities and corneal opacity: opacity = 0.0035 square (age) + 5.17. No statistical differences were observed between lens opacity and sex nor were left/right differences significant. No conclusion was possible concerning retinal sensibility and measured lens opacity because of the small sample (25 eyes). This easily handled instrument may be helpful in daily practice to evaluate opacity in lens pathology. Furthermore, it should be useful for the interpretation of the respective role of cataract and retinal damage in P.O.A.G. loss of retinal sensibility.

Adolescent↗
PubMed1987

Diagnostic categories in infants referred for an acute event suggesting near-miss SIDS.

Among 857 infants admitted between 1977 and 1984 for a life-threatening apnoeic event a definite pathologic condition was found in 576 (66%). In 32 (6.5%) of the latter the polysomnogram was abnormal. The major clinical diagnostic categories were, with decreasing frequency: digestive (n = 263), vasovagal (n = 95), neurological (n = 78), respiratory obstructions (n = 33), and respiratory infections (n = 27); miscellaneous causes were found in 80 infants. No obvious cause could be traced in the remaining 281 infants. According to those caring for them the episode was severe in 77 (27%) of these infants, 57 (74%) of which had an abnormal polysomnogram, and minor in 204 (73%), 36 (18%) of which had an abnormal sleep study. Home monitoring was performed for 145 patients: all those with an abnormal polysomnogram and the 20 infants with an unexplained severe episode associated with a normal sleep study. We conclude from our experience that when an infant is referred for an acute event suggesting near-miss sudden infant death syndrome (SIDS), a large array of diagnoses can be found and that an electric monitoring device will ultimately be advocated for only 17% of all infants presented, but for all those with an unexplained severe episode, irrespective of the results of the sleep study.

Humans↗
PubMed1987

Impact of home monitoring for sudden infant death syndrome on family life. A controlled study.

As home monitoring has been advocated for the prevention of sudden infant death (SIDS) we investigated the influence of such a monitoring programme on family life. Twenty European middle and lower-class families with a child monitored at home after a near miss for SIDS event were investigated. Some psychological and social findings were compared with a group of 20 matched control families. It appears that home monitoring induces severe stress, mainly in the mothers. Fathers and siblings also manifested significant emotional stress. Poor schooling of the parents and previous marital discord seem to be predictors of bad adaptation to home monitoring.

Female↗
PubMed1987

The epidemiology of acute diarrhoea in a rural community in Imo State, Nigeria.

As part of an evaluation of a water supply and sanitation project, a baseline cross-sectional study of diarrhoea, and its putative risk factors, was conducted in 5 villages in Imo State, Nigeria. Data were collected from 4641 and 5920 persons during surveys in the dry and wet seasons, respectively. 8 d period prevalence rates for diarrhoea ranged from 5 to 50%, with the highest rates occurring in the 6 to 23 month age group. Diarrhoea was associated with up to 75% of all illnesses in young children and with about 20% in adults. Risk factors included lower socio-economic status, an unclean domestic environment, use of non-purified water, absence of soap, and feeding methods other than exclusive breast-feeding in the early months of infancy. These results suggest that the education component of water supply and sanitation projects should emphasize personal and domestic hygiene and infant feeding.

Adolescent↗
PubMed1987

The bacteriological quality of traditional water sources in north-eastern Imo State, Nigeria.

Monthly bacteriological water testing of traditional water sources (ponds, rivers, unprotected springs and traditional wells) used by five villages in northeastern Imo State, Nigeria, was conducted during the period January 1983 to August 1985. The membrane-filtration technique was used to detect faecal coliforms (FC) and faecal streptococci (FS). Evidence of faecal pollution was seen throughout the year for all water sources. During the study period, the monthly geometric mean counts per 100 ml of water (all sources combined) ranged from 760 to 17877 for FC and from 678 to 17394 for FS. The peak period of faecal pollution occurred during the transition between the dry and wet seasons and in the early wet season. During this peak pollution season (February-May), the geometric mean counts were 2.5-7.2 times higher than in the remaining part of the year for all source types except rivers, with ponds being the most heavily polluted. Preliminary findings on the sensitivity and specificity, in this tropical environment, of the standard membrane-filtration technique for enumerating FC are presented. The implications of the findings of this study for the environmental control of waterborne and hygiene-related diseases are discussed.

Developing Countries↗
PubMed1987

Transepidermal water loss during sleep in infants.

Transepidermal water evaporation rate (ER) was measured in 207 infants with a mean postnatal age of 12.7 +/- 10.6 weeks. Measurements were made from the forehead with the use of an Evaporimeter during polygraphic sleep recordings performed under standard conditions. ER values were computed in g/m2 X h. Evaporation rates were significantly lower during rapid eye movement (REM) sleep (8.5 +/- 4.4 g/m2 X h), compared to values measured during quiet wakefulness (11.6 +/- 7.4) or non-REM (NREM) sleep (11.2 +/- 7.6). The differences were not related to age, sex, weight, or rectal temperature, as shown by a covariance analysis. These data, recorded in normal infants, indicate the need to consider the state of sleep or wakefulness of the subjects when comparing results of water evaporation studies.

Humans↗
PubMed1987

Difficulty in initiating and maintaining sleep associated with cow's milk allergy in infants.

To confirm that sleeplessness in infants can be related to an undiagnosed allergy to cow's milk proteins, 71 infants were studied. Group I consisted of 20 infants referred for chronic insomnia that had appeared in the early days of life. Group II was made up of 31 infants admitted for skin or digestive symptoms attributed to cow's milk intolerance; 13 of these infants were shown to sleep as poorly as the infants of group I. Group III consisted of 20 infants with no history of sleep disturbance or milk allergy. The three groups of infants were comparable for sex and age. Laboratory tests revealed immunologic reactions to milk in all the infants in groups I and II. The sleep of the insomniac infants (group I, and the 13 "poor sleepers" in group II) became normal after cow's milk was eliminated from the diet. Insomnia reappeared when the infants in group I were challenged with milk. We conclude that infants with clinically evident milk allergy may suffer from sleeplessness and that when no evident cause for a chronic insomnia can be found in an infant the possibility of milk allergy should be given serious consideration.

Animals↗
PubMed1987

Continuous transepidermal water loss measurement in sleeping infants.

Transepidermal water evaporation rate was measured continuously in 8 infants with the use of an evaporimeter during one night of polygraphic sleep recording. Evaporation rates were significantly lower during REM than during NREM sleep. In both sleep stages it decreased during the night with the lowest values between 02.00 and 04.00 h. Evaporation values showed cyclic changes which were studied by measuring minute-by-minute differences between the maximum and the minimum values (the "amplitude variability") and the number of evaporation peaks per minute (the "peak density"). Both the "amplitude variability" and the "peak density" were smaller in REM than in NREM sleep. The "amplitude variability" decreased during the night with lowest values seen between 02.00 and 04.00 h. These changes in evaporation rates could reflect autonomic nervous system activity as well as basal metabolic activity and should be taken into account whenever such measurements are performed in sleeping infants.

Female↗