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Biomedical subjects

D Blum

Publications and source records attributed to D Blum.

At least 127 records · Page 7Linked to original sources
PubMed1984

A critical comparison of the history of sudden-death infants and infants hospitalised for near-miss for SIDS.

To determine whether significant historical differences distinguish the near-miss for Sudden Infant Death from the infants who died of SIDS, we analysed the histories and clinical data from two groups of infants seen in our University Hospital and from collaborative research group. The data were obtained with the use of a standardised questionnaire and consultation of all available medical data. Sixty-five infants were identified as near-miss for SIDS after they had suffered a severe cardiorespiratory incident during sleep for which no cause could be found despite a complete medical examination. After an autopsy had failed to reveal a cause for the unexpected death 95 cases of SIDS were retained in the study. A series of 353 variables were collected from the parents, the gynaecologists, neonatologists and attending physicians. After statistical analysis, only 15 of the 353 items studied significantly differentiated between the two groups. A step-wise discriminant analysis performed on these items led to the identification of six independent variables: the time of the incident; the circumstances leading to the observation of the child; the child's sleep position; previous minor intestinal problems; the size of the family and the mother's coffee consumption. Most variables indicate that the near-miss infants were discovered and rescued earlier than the infants who died. No other historical information appeared significantly to differentiate between the two groups of infants. These data need confirmation from a prospective epidemiological survey.

Family Characteristics↗
PubMed1984

Yellow nail syndrome.

Yellow nail syndrome was first described in 1964 by Samman and White. The full syndrome consists of the triad yellow nails, lymphedema, and pleural effusions with associated respiratory tract involvement. However, yellow nails alone or with any combination of the triad is termed yellow nail syndrome. We are describing a patient with yellow nails and pulmonary disease, whose nails cleared after resolution of his pulmonary condition. Although various therapeutic approaches have been used, the treatment of pulmonary disease was important in our patient.

Diagnosis, Differential↗
PubMed1984

Carbon dioxide laser transection of rat peripheral nerves.

Histologic, ultrastructural, and horseradish peroxidase tracing studies have shown that the carbon dioxide laser does not, as previously reported, seal transected axons in peripheral nerves that are subsequently repaired. If sealed nerve ends are the desired effect, such as in treatment of painful neuromas, this experimental animal study in rats suggests that the laser may be contraindicated because of the possible retention of proximal nerve regenerative ability. For resections of peripheral neuromas followed by neurorrhaphy, our data indicate that conventional scissor transection of the nerve may be followed by better reinnervation than that of laser transection.

Animals↗
PubMed1984

Obstructive sleep apnea syndrome in childhood.

The review of 31 records of obstructive sleep apnea syndrome in childhood allows the authors to report some characteristics of the population and the clinical picture. They explain the diagnostic plan, detailing the need of combined ENT and pediatrician evaluations and the importance of the polygraphic sleep recording. They relate their therapeutical results after adenotonsillectomy in cases with lymphoid enlargement, after section of velopharyngeal flap in plasties for velopalatal incompetence and discuss their attitude in cases of other origins. They finally give the results of complete biological investigations performed in hope to find an univocal pathway to the observed massive lymphoid hyperplasia.

Adenoidectomy↗
PubMed1983

Measuring the impact of water supply and sanitation investments on diarrhoeal diseases: problems of methodology.

A review of the published literature on the impact of water supply and/or excreta disposal facilities on diarrhoeal diseases, or on infections related to diarrhoea, reveals several methodological problems that hamper the drawing of definitive conclusions from these studies. This paper examines eight of these methodological problems: lack of adequate control, the one to one comparison, confounding variables, health indicator recall, health indicator definition, failure to analyse by age, failure to record usage, and the seasonality of impact variables. It is suggested that an evaluation of the impact on health of environmental interventions may best be undertaken by the combined efforts of engineers, social scientists and epidemiologists in 'opportunistic' settings and that the intervening behavioural processes so necessary for health impact to occur should be a primary focus of such evaluations.

Age Factors↗
PubMed1983

Oculocardiac reflex in near miss for sudden infant death syndrome infants.

To gain insight into the role of the vagus nerve in sudden infant death syndrome (SIDS), 180 infants ranging in age from 1 to 66 weeks were examined with respect to cardiac response to ocular compression. There were 35 near-miss infants, 76 normal siblings of SIDS victims, and 69 normal control infants. Asystoles within the control group ranged from 0.3 to 1.8 seconds. Ten of 35 (28%) near-miss infants and 10/76 (13%) siblings had asystoles greater than 2.0 seconds when first tested. When statistically compared, the near-miss infants were significantly different from both the control infants and the siblings (Kruskal-Wallis procedure: P less than .01, and P less than .05, respectively). It is concluded that in the first year of life a significant number of near-miss infants have an exaggerated cardiac response to ocular compression. Furthermore, the presence of prolonged asystoles in certain siblings indicates that vagal hypersensitivity, as manifested by ocular compression, may be, in part, hereditary.

Female↗
PubMed1982

Home monitoring of infants considered at risk for the sudden infant death syndrome. Four years' experience (1977-1981).

From 1977 to 1981, 500 infants had been referred to evaluate their risk for the sudden infant death syndrome (SIDS). These included 186 infants who had presented an event (prolonged apnea, hypotonia, pallor or cyanosis) initiated while asleep, 133 siblings and 181 "controls". All-night polygraphic recordings were performed in all infants, and if indicated by the history of the infants, complementary clinical investigations were done. These procedures led to the identification of 50 infants considered at risk for SIDS (10% of all referrals): 30 near-misses for SIDS, 10 siblings and 10 infants with a minor incident during sleep but with abnormal polygraphic recordings. These 50 infants (group I) were monitored at home during sleep with the help of a cardiac and respiratory monitor. Eight infants not considered at risk were monitored similarly at the request of their parents (group II). Forty of the 50 infants in group I presented with repetitive sleep apneas and bradycardias, and required stimulation by their parents to regain normal cardiorespiratory rhythm. Twelve had to be resuscitated at least once for a life-threatening event. None of the infants in group II showed alarms during sleep. Monitoring could be discontinued after a mean length of 7.2 months for the infants in group I, 4.1 months in group II. It is concluded that if identified in time through adequate investigations, some infants may be protected against SIDS through home monitoring. This approach requires expensive and well trained teams, ready, at any time, to cope with the problems that may arise in the homes of the monitored infants.

Ambulatory Care↗
PubMed1982

Pathologic findings in twelve fatal cases of toxic shock syndrome.

Pathologic changes in 12 fatal cases of toxic shock syndrome occurred in the vagina, cervix, lung, liver, and kidney. Desquamation and ulceration of the cervical and vaginal mucosa were seen in all six cases where adequate specimens were submitted. Hyaline membrane formation characteristic of "shock lung" was found in all lung tissues. Periportal inflammation was found in all liver specimens and acute tubular necrosis was seen in eight of the 12 kidney specimens. Although not specific for toxic shock syndrome, the findings are consistent with the hypothesis that the illness is caused by a staphylococcal toxin.

Adolescent↗
PubMed1982

Effects of central apneas on transcutaneous PO2 in control subjects, siblings of victims of sudden infant death syndrome, and near miss infants.

A total of 75 polysomnograms recorded during night sessions in 25 control subjects, 25 siblings of sudden infant death syndrome victims, and 25 near miss infants were studied in order to correlate the duration of central apnea to the decrease in transcutaneous oxygen pressure (tcPO2). A total of 1,650 central apneas were recorded. The three groups of infants presented the same tendency for a lower tcPO2 in indeterminate and active sleep as in quiet sleep (P greater than .10). The apneas were not preceded by a decrease in tcPO2, but were followed by a decrease in tcPO2, directly proportional to the duration of apnea. The correlation was measured in each infant individually, and proved to be significant in all cases, and comparable in the three groups. The longest apneas (greater than ten seconds) were followed by the greatest decrease in tcPO2, and were restricted to the near miss group. Apart from this observation, the near miss and sibling infants did not show lower tcPO2 than the control subjects, at any time, during sleep.

Female↗
PubMed1982

Phenothiazines and sudden infant death syndrome.

A relationship between sudden infant death syndrome (SIDS), sleep apnea, and upper airway infections has been reported. The present observation stresses the possible influence of phenothiazine-containing medications and the occurrence of SIDS. The drug is commonly used for the treatment of infants with nasopharyngitis in Belgium and in some other European countries. In a prospective study, 52 SIDS victims, 36 near miss infants, and 175 control infants were compared for the coexistence of nasopharyngitis and phenothiazine treatment in the days preceding death or hospitalization. The incidence of nasopharyngitis was comparable in the three groups (approximately 31%), but phenothiazines were used significantly more frequently in SIDS victims (23%) and near miss infants (22%) than in control subjects (2%). It is postulated that phenothiazines, as CNS depressors, may contribute to the occurrence of SIDS.

Apnea↗
PubMed1982

Effects of obstructive sleep apneas on transcutaneous oxygen pressure in control infants, siblings of sudden infant death syndrome victims, and near miss infants: comparison with the effects of central sleep apneas.

In order to investigate the effects of obstructive sleep apneas upon transcutaneous PO2 75 polysomnograms, recorded during night sessions in 25 control infants, 25 siblings, and 25 near miss for sudden infant death syndrome (SIDS) infants were studied. These observations were compared with the decreases in transcutaneous PO2 measured during central sleep apneas in the same infants. During a total of 707.6 hours of sleep, 33 obstructive apneas and 1,650 central apneas were recorded. Obstructive apneas were seen in three control infants (three episodes), one sibling (five episodes), and six near miss for SIDS infants (25 episodes). The obstructive apneas tended to be short (less than 10 seconds). Comparatively, the central apneas were equally distributed in the three groups of infants, and only the near miss children presented apneas that lasted as long as 19 seconds. The decrease in transcutaneous PO2 was proportional to the duration of both types of apnea, but for a given duration the decrease in transcutaneous PO2 was significantly greater for the obstructive apneas than for the central apneas (with a mean difference of 7.59 +/- 0.53% PO2. It is concluded that the hypoxic effects of the obstructive apneas might have important clinical implications in infants, such as the near miss for SIDS.

Female↗
PubMed1981

Controlled fall in natremia in hypertonic dehydration: possible avoidance of rehydration seizures.

This prospective study comprises 40 infants with severe hypernatremic dehydration due to gastroenteritis. During the first 24h, natremia was closely monitored and infusion rates were adjusted so as to keep the rate of fall in natremia below 0.5 mEq/l/h. This could be achieved by giving a 70 mEq/l Na solution at the rate of 120 ml/kg/24 h. Rehydration was uneventful in all cases, and no convulsions were observed.

Dehydration↗
PubMed1981

[Mechanisms of acute pulmonary edema during meningococcal shock in children (author;s transl)].

Meningococcic shocks may induce fatal acute pulmonary edemas. Ten children, who died in this condition, have been compared to 19 others, who during the treatment of the shock, developed right heart failure, without acute pulmonary edema (8 deaths, 11 survivals). The three groups of children could not be differentiated regarding their clinical status on admission, during the shock phase, or the treatments administered. Composition, volume and speed of administration of fluids were similar in the three groups. An increase in pulmonary capillary permeability could have occurred, and lead to the development of acute pulmonary failure, as presented by the children of the first group.

Acute Disease↗
PubMed1980

Toxic-shock syndrome in menstruating women: association with tampon use and Staphylococcus aureus and clinical features in 52 cases.

To determine the risk factors associated with toxic-shock syndrome (TSS) in menstruating women, we conducted a retrospective telephone study of 52 cases and 52 age-matched and sex-matched controls. Fifty-two cases and 44 controls used tampons (P < 0.02). Moreover, in case-control pairs in which both women used tampons, cases were more likely than controls to use tampons throughout menstruation (42 of 44 vs. 34 of 44, respectively; P < 0.05). There were no significant differences in brand of tampon used, degree of absorbency specified on label, frequency of tampon change, type of contraceptive used, frequency of sexual intercourse, or sexual intercourse during menstruation. Fourteen of 44 cases had one or more definite or probable recurrences during a subsequent menstrual period. In a separate study, Staphylococcus aureus was isolated from 62 of 64 women with TSS and from seven of 71 vaginal cultures obtained from healthy controls (P < 0.001).

Adolescent↗