Children of short stature: Part 1.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to D Harvey.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A group of small-for-dates full-term babies whose intra-uterine growth was followed by serial ultrasonic cephalometry were examined at a mean age of 4 years. Those children whose skull growth had begun to slow in utero before 34 weeks' menstrual age were more likely to have a height and weight less than the 10th centile. When the onset of growth failure had occurred before 26 weeks there was a lower developmental quotient at follow-up using the Griffiths extended scales. Prolonged slow growth in utero therefore seems to be followed by slow growth and development after birth.
The newborn rabbit responds to acute anoxia, as a result of breathing nitrogen, with successive periods of dyspnoea, primary apnoea, gasping and terminal apnoea. Pethidine caused an increase in the period of primary apnoea and a decrease in the duration and rate of gasping. When nalorphine was combined with pethidine the period of primary apnoea was still increased although the duration and number of gasps were restored to control values. Naloxone, in contrast, acted as a mild respiratory stimulant, shown as a longer phase of dyspnoea. Also it completely abolished the respiratory depression produced by pethidine. Naloxone may be preferable to nalorphine as a drug to reverse the effects of pethidine immediately after birth.
A child with acute lymphoblastic leukaemia complicated by prolonged gastrointestinal and skin haemorrhages due to profound thrombocytopenia finally died of thrombotic occlusions of major cerebral arteries due to mucormycosis. Biopsy of any suspect lesion is needed urgently before prolonged therapy with amphotericin B is started. So far there have been no cures in childhood.
Cooling is known to prolong survival in newborn animals when used before the onset of asphyxia. It has therefore been advocated as a treatment for birth asphyxia in humans. Since it is not possible to cool a human baby before the onset of birth asphyxia, experiments were designed to test the effect of cooling after asphyxia had already started. Newborn rabbits were asphyxiated in 100% nitrogen and were cooled either quickly (drop of 1 degree C in 45 s) or slowly (drop of 1 degree C in 2 min) at varying intervals after asphyxia had started. When compared with controls, there was an increase in survival only when fast cooling was used early in asphyxia. This fast rate of cooling is impossible to obtain in a human baby weighing from 30 to 60 times more than a newborn rabbit. Further litters of rabbits were asphyxiated in utero. After deliver they were placed in environmental temperatures of either 37 degrees C, 20 degrees C, or 0 degrees C and observed for spontaneous recovery. The animals who were cooled survived less often than those kept at 37 degrees C. The results of these experiments suggest that hypothermia has little to offer in the treatment of birth asphyxia in humans.
The frequency of "significant" jaundice of the newborn at this hospital increased from 8-1% of all live births in 1971 to 12-1% in 1972 and 15-4% in 1973. This coincided with an increased use of oxytocic agents and epidural anaesthetics in labour, and a change in the artificial feed given to normal infants. A retrospective study of jaundiced infants born in 1972 failed to explain the increase in jaundice. Though the use of oxytocic agents was not the direct cause, since their use results in the delivery of more infants before 40 weeks of gestation it may be a contributory factor. The use of epidural anaesthetics was sastically related to the development of jaundice but the nature of the association was not clear. Mothers of infants who became jaundiced has a significantly higher frequency of poor past obstetric histories, but once again the association was not clear. The change in artificial feeds was excluded as a possible cause.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.