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Biomedical subjects

D Blum

Publications and source records attributed to D Blum.

At least 109 records · Page 6Linked to original sources
PubMed1987

Transepidermal water loss during sleep in infants at risk for sudden death.

To search for excessive sweating during sleep in infants considered at risk for sudden infant death syndrome (SIDS), we studied 258 infants during one night. There were 134 normal infants (controls), 85 siblings of SIDS victims (siblings), and 39 infants who survived an apparent life-threatening event (ALTE) with no cause found for the incident. Mean postnatal ages were between 10 and 16 weeks. Transepidermal water evaporation rate was measured from the forehead using an evaporimeter during one night's polygraphic sleep recording. Measurements were made before feedings, during the first part of the night, and evaporation rate values were expressed as grams per square meter of body surface area per hour. In the three groups of patients evaporation rates were significantly lower during rapid eye movement (REM) sleep, compared with values measured during quiet wakefulness or nonrapid eye movement (NREM) sleep. Infants with an ALTE had significantly higher evaporation rate values during NREM sleep than the two other groups (20.1 +/- 1.93, 11.3 +/- 0.68, and 11.5 +/- 0.98 for the ALTE, control, and sibling infants, respectively). The differences were not related to age, sex, weight, or rectal temperature. During NREM sleep, evaporation rate values greater than 25 mg/m2/h were seen in 10/190 (5.3%) of the asymptomatic infants and in 11/36 (30.6%) of the infants with an ALTE. The results are in agreement with reports in the literature of repeated night sweating in infants who eventually died of SIDS. Although we are unable to conclude why evaporation rate values are higher in the ALTE group than in the two other groups, we cannot exclude that it reflects differences in autonomous system activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1987

The effects of distance and season on the use of boreholes in northeastern Imo State, Nigeria.

A study was conducted in a rural area of northeastern Imo State to examine the effect of distance and season on the use of boreholes, provided at a borehole-to-population ratio of 1 to 440. The type of water source used by households varied according to season. In the water-scarce dry season, 98% of households used borehole water: 64% as their sole source, a further 26% as their main source, and 8% as a secondary source. The use of borehole water as the main source was little influenced by distance until the household-to-borehole distance reached approximately 2 km. The situation was different in the wet season when the availability of water sources was much greater. In this season, rainwater was the main water source for 64% of households. Borehole water was the main source for only 31% of households. In the rainy season, the use of borehole water as the main source showed a significant decrease with increasing household-to-borehole distance. The provision of one borehole for 400-500 people was associated with a high rate of use as the main water source only in the dry season. However, the use of boreholes as either a main or alternative source was high in both seasons and it is possible that those households that used boreholes as an alternative source used the water for drinking.(ABSTRACT TRUNCATED AT 250 WORDS)

Health Promotion↗
PubMed1986

Polysomnographic studies and home monitoring of siblings of SIDS victims and of infants with no family history of sudden infant death.

We report preliminary results of a prospective study conducted to prevent sudden death in asymptomatic infants. From 1977-1984, 3658 infants were studied polygraphically. There were 923 siblings of SIDS victims and 2735 infants with no personal of family history of SIDS. The infants were studied at 8 weeks of age. Polygraphic "risk factors" were defined by central apnoeas longer than 15 s; periodic breathing above 5% sleep time; or obstructive apnoeas above 3 s. In 937 infants "risk factors" were seen and a second study was requested 4 weeks later. Out of 891 infants re-studied at 12 weeks, 153 still presented some "risk factors" and were selected for a home monitoring programme; 150 families agreed to monitor their infants at home with a cardiorespiratory monitor with the alarms set at 20 s apnoea, and 50 beats per min bradycardia. Repeated alarms were reported for 97/150 (65%) infants; 48/150 (32%) infants were stimulated and 8/150 (5.3%) were resuscitated on at least one occasion. No death occurred during monitoring, which could be interrupted before the end of the first year of life in all infants. In the group of 3459 infants with normal results and not monitored, three siblings (0.35%) and one infant without history (0.04%) died of SIDS. Of the infants with abnormal polygraphic results, one sibling not returned for the second recording, and two out of three infants for whom the parents refused monitoring, died of SIDS. It is concluded that the programme, may prevent the death of some infants, but that the outcome of a child with normal results cannot be foreseen.

Arrhythmias, Cardiac↗
PubMed1986

Metabolism of viprostol--a synthetic vasodilator PGE2 analog.

Metabolic studies were done with 14C-Viprostol (I) administered by various routes (I.V., oral and topical) to six animal species and to man. Total radioactivity and metabolic profiles were analyzed in plasma, tissues and excreta. The main metabolites were isolated and identified by capillary GC/MS. Plasma and urinary metabolic profiles were qualitatively similar across species, with two major metabolic reactions being predominant: rapid hydrolysis to the pharmacologically active free acid (II) and oxidation of the alpha-chain to dinor and tetranor acids (III, IV). In the monkey and man, reduction of the 9-keto group lead to PGF2 type metabolites (VI-VIII). In the rat, omega oxidation of the beta-chain occurred as well, resulting in the formation of dicarboxylic acids (V).

Administration, Topical↗
PubMed1986

Auditory arousal thresholds of normal and near-miss SIDS infants.

The sleep characteristics and auditory arousal thresholds of 20 near-miss sudden infant death syndrome (SIDS) infants and 97 age- and sex-matched normal infants were studied. It was observed that spontaneous arousals occurred significantly less frequently in the near-miss SIDS infants. In both groups, induced arousals occurred at comparable stimulation intensities, and arousal thresholds decreased significantly from the 44th to the 52nd postconceptional week. This supports the notion that both groups present a similar maturational process within the auditory pathways and brainstem, and that arousal is not related to differences in behavioural response to ambient noise during sleep.

Acoustic Stimulation↗
PubMed1986

Sudden infant death syndrome in a twin: a comparison of sibling histories.

To determine possible characteristics of infant victims of sudden death, we examined 114 items related to the pre- and postnatal histories of 42 pairs of twins one of whom died of sudden infant death syndrome (SIDS) leaving a surviving sibling. Interviews with the parents were conducted after the occurrence of SIDS, and the data were checked with records held by gynecologists and pediatricians. To evaluate the specificity of any factors, we studied a control group of 42 age- and sex-matched pairs of twins, both of whom survived the first year of life. Only 11 of 114 characteristics were significantly related to SIDS: future victims had a smaller weight and height at birth, stayed longer in the nursery, and followed a moving object with their eyes, had head control, and smiled at a later age than their surviving siblings. They also fatigued more often during feeding (11/42) and had reduced arm and neck tonus (9/42). They were described as longer sleepers than their surviving siblings. During sleep, some SIDS twins, but no surviving twin, were found to be cyanotic at least once or pale (4/42) and were repeatedly covered with abundant sweat (8/42). In the control group of normal twins, the occurrence of most of these characteristics was found with a frequency comparable to that seen in the SIDS infants; the specificity of these characteristics is thus considered doubtful. The mean birth weight and height were significantly greater in the control group, and no control infant had an episode of cyanosis or pallor or repeated episodes of profuse sweating observed during their sleep.(ABSTRACT TRUNCATED AT 250 WORDS)

Body Height↗
PubMed1986

[In vitro semi-automated morphometry of preserved human corneal endothelium].

Cellular morphometry allows us to quantify the structural alterations of the corneal endothelium. Our study was a semi-automatized in vitro analysis of fresh and preserved corneal endothelium (MK medium cryopreservation). The equipment used was the Quantimeter 720 connected to a Digital PDP1123 computer. Nineteen corneas were studied and the following cellular parameters were established: perimeter, surface area, form factor and polymorphism coefficient. The computer program used was the SPSS/PC (Statistical Package for the Social Sciences) and the principal statistical tests were the Bartlett test and variance analysis. The statistical computerized study allowed us to compare the four cellular parameters and to establish the incidence rate of the conservation process on endothelial morphometry. The statistical and morphometry methods have proved to be reproducible and reliable and carry a supplementary quantitative element to analyse the influence of the conservation process.

Adult↗
PubMed1985

Familial syringoma. Case history and application of monoclonal anti-eccrine gland antibodies.

We studied a family with dominantly inherited eruptive syringoma. The father and the older daughter had chest and neck as well as eyelid lesions. The chest lesions seemed to develop continuously by new formation of eccrine germlike budding from the epidermis. Monoclonal antikeratin antibody EKH4, which predominantly labels the basal layers of the epidermis, stained positively in the cordlike epithelial structure and peripheral cells of the walls of cystic lesions. Staining with EKH6, which recognizes normal eccrine secretory and ductal structures--particularly luminal borders--was positive along the luminal borders of the cystic lesions; staining with EKH5, which labels eccrine secretory portion, was entirely negative in the lesions. These findings further supported the theory that syringoma of the eyelids and eruptive syringoma, which mainly involves the anterior neck and upper chest, are essentially the same tumor and that these appendage tumors are of eccrine ductal differentiation.

Adenoma↗
PubMed1985

Obstructive sleep apnea induced by a parapharyngeal cystic hygroma in an infant.

A 7-week-old infant with severe sleep apnea underwent polysomnography that revealed as many as 455 obstructive apneas per night; the apneic episodes had a mean duration of 34 s. A growing tumor in the neck, a parapharyngeal cystic hygroma, was discovered and surgically removed. The infant's condition improved dramatically, and a follow-up polygraphic recording was normal. During the following 10 months the child's condition remained stable. The case reported illustrates a rare cause of severe sleep obstructive apnea. It also reinforces the need for a complete medical approach to the diagnosis and treatment of obstructive sleep apnea in infants.

Head and Neck Neoplasms↗
PubMed1985

Phenothiazine-induced sleep apneas in normal infants.

A relationship between sudden infant death syndrome and the use of phenothiazine-containing medications is suspected. In order to investigate the influence of phenothiazines upon cardiorespiratory and sleep characteristics, four normal infants (mean age 15.8 weeks) had polygraphic recordings made for one night. The recordings were repeated three nights later, after the daily administration of a usual therapeutic dose of a standard phenothiazine syrup (promethazine, 1 mg/kg of body weight per day). The infants were monitored for six days after the first treatment. Findings from the first polygraphic recordings were normal for each infant. The second recordings disclosed an increase in sleep time, a reduction in the number and duration of awakenings, an increase in non-rapid eye movement (NREM) III sleep state, and a reduction in body movements. During the second night, each infant showed an increase in the number of central apneas, and each infant also had several episodes of obstructive apneas (median duration four seconds). It is concluded that promethazine depresses the arousal and respiratory mechanisms in normal infants during sleep. This observation reinforces the opinion that CNS depressants should be avoided in infants less than 1 year of age; CNS depressants could result in sudden death in apnea-prone infants.

Arousal↗
PubMed1985

Insomnia and cow's milk allergy in infants.

A group of eight infants (six boys and two girls, 7 to 46 weeks of age) is reported, in whom a causal relationship between cow's milk allergy and chronic sleeplessness was suspected. They were referred because of waking and crying episodes that had occurred since the early days of life during sleep hours. During an average night, they slept about 4.5 hours and woke their parents about five times. They cried a lot during the day and were described as fussy. Two infants had been treated with phenothiazine without improvement. No cause for chronic insomnia was found during a standard medical and psychologic workup. An all-night polygraphic recording confirmed the disrupted sleep pattern of these infants, as compared with that of normal infants, and excluded further causes of arousals. Due to a clinical suspicion of atopy, the infants were further subjected to a series of allergy tests. IgE levels were shown to be elevated in each child, and radioallergosorbent tests were positive for cow's milk protein. The infants were than fed exclusively with a hydrolyzed milk protein mixture for 4 weeks. Sleep normalized within 2 weeks in every infant: night sleep increased to a median of 10 hours, and the awakenings only occurred occasionally. In four infants less than 6 months of age, cow's milk was reintroduced in the diet, and within 1 week all four became severely sleepless. Cow's milk was again excluded from the diet and the babies' sleep behaviors were again normalized. It is concluded that, when no evident cause for sleeplessness can be found in an infant, the possibility of milk allergy should be given serious consideration.

Animals↗
PubMed1984

[Interaction between tiapride and alcohol in man].

Results of a study in nine alcoholic patients designed to investigate the effects on wakefulness of tiapride combined with alcohol are presented. Each patient was given successively alcohol, tiapride, and both. Changes in certain psychomotor performances during each of these three periods are described. In the study patients, the tiapride-alcohol combination produced no detrimental effect on wakefulness; on the contrary, results of one of the tests were improved.

Arousal↗