Search PubMed⌕ Search

Biomedical subjects

D Pickering

Publications and source records attributed to D Pickering.

At least 55 records · Page 3Linked to original sources

Persistent ductus arteriosus complicating the respiratory distress syndrome.

Persistent ductus arteriosus (PDA) complicated the clinical course in 45 (15%) of 299 babies with the respiratory distress syndrome (RDS) presenting over a 3-year period. The incidence of PDA complicating RDS rose with decreasing birthweight and was highest in babies with severe RDS as judged by the use of assisted ventilation. In babies with a birthweight of less than 1500 g, PDA occurred as a complication of RDS in 25% of cases. In babies who recieved intermittent positive pressure ventilation (IPPV) for management of RDS, the incidence of PDA was 35%. Overall mortality for babies with RDS was 17%; when PDA occurred as a complication mortality was 31%. In survivors, spontaneous closure of the PDA occurred in all except one infant. The development of signs of PDA in 19 babies either necessitated a renewal of IPPV or prevented "weaning" from IPPV or from continuous positive airways pressure. 9 (47%) of these babies died, 8 of them after the first week of life. The frequency of PDA complicating RDS and the relatively high mortality in this conservatively-treated group of babies is emphasized. The incidence reported here is likely to increase with the increased survival of very low birthweight infants with severe RDS. The high incidence of late deaths in babies who develop signs of PDA associated with an inability to wean from assisted ventilation suggests that early surgical ligation of the PDA in these babies should be considered. The results of a conservative approach to management of these infants are presented.

Birth Weight↗

Cystinotic rickets treated with vitamin D metabolites.

A 22-month-old girl with cystinotic rickets was given 1 microgram 1,25-dihydroxycholecalciferol (1,25-DHCC) daily in addition to standard treatment. Her rickets healed and linear growth rate appeared to increase. It is suggested that the effect of 1,25-DHCC and its metabolically active analogues on cystinotic rickets should be further studied.

Cystinosis↗

Astrovirus associated gastroenteritis in a children's ward.

During an outbreak of gastroenteritis in a paediatric ward astroviruses were found in faeces from 17 to 27 symptomatic children and from four of 14 members of the staff with diarrhoea. No viruses were found in 10 asymptomatic children. Fourteen of the 21 astrovirus excretors were free of any recognised pathogens, but in the other seven, rotaviruses or pathogenic bacteria were also present. Serological evidence of astrovirus infection was obtained in five adults and two children.

Antibodies, Viral↗

Cardiac biopsy in skeletal myopathy: report of a case with myocardial mitochondrial abnormalities.

Transvenous right ventricular endomyocardial biopsy in an 11-yr-old boy with a proximal skeletal myopathy and a cardiomyopathy, has shown a major increase in mitochondrial size and numbers on electron-microscopic morphometry, with formation of unique ring-shaped mitochondria in cardiac muscle cells. The significance of this finding and the use of cardiac biopsy in children are discussed.

Cardiomyopathies↗

Pre- and postoperative growth in persistent ductus arteriosus.

Children with a persistent ductus arteriosus requiring ligation under 6 months of age show evidence of intrauterine growth retardation. By the time of operation the weight centile of 17 (71%) of 24 such infants had fallen, but 20(84%) of the 24 gained weight postoperatively. Those who did not so were either large-for-dates infants growing towards the normal or small-for-dates infants who remained small postoperatively.

Birth Weight↗

Double outlet right ventricle with l-malposition and uncommitted ventricular septal defect.

A case is described which exhibited Double Outlet Right Ventricle (DORV) with l-malposition of the aorta in association with a ventricular septal defect of the noncommitted, atrioventricular canal variety. When the ventriculoarterial relationship of DORV is encountered, it is more usual to find the aorta to the right of the pulmonary artery. Review of the literature shows that examples of DORV and l-malposition have been described with subaortic, subpulmonary and doubly committed defects, but we are unaware of any previous example reported with a noncommitted defect. These findings indicate that DORV with l-malposition should be anticipated in association with the same accompanying defects as those described in DORV with d-malposition, and emphasize the necessity for adopting a segmental approach to nomenclature. They also have morphogenetic significance, suggesting that DORV with l-malposition is closely linked with the anomalies for anatomically corrected malposition and concordant (complete) l-transposition. The present case exhibited an electrocardiographic superior axis, which is probably related to the presence of the atrioventricular canal deformity. The coexistence of hypoplasia of the aortic isthmus is speculatively related to the presence of conal and valvar factors, which can be considered to have reduced aortic blood flow.

Adult↗