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Biomedical subjects

D R Harvey

Publications and source records attributed to D R Harvey.

At least 19 recordsLinked to original sources
PubMed1992

Gestational age correction for height in preterm children to seven years of age.

Correction for gestational age continues to make a difference to the height SD score (SDS) to the age of seven years in very preterm babies. The height SDS for children born at 28 weeks' gestation increased by 0.25 SDS when postconceptual age was used instead of real age. Extrapolating from these results, the effect of correction would be an increase of approximately 0.32 SDS for a seven-year-old of 24 weeks' gestation. Unsatisfactory growth may be masked by a steady or increasing real age SDS in a few children. The risks of stopping using postconceptual age at two or three years include both false confidence in genuine cases of growth retardation and misinterpretation of a decrease in height SDS as evidence of growth retardation. As the number of very preterm babies who survive increases so does the importance of these observations.

Age Factors↗
PubMed1991

Coordination of low birthweight seven-year-olds.

The coordination and laterality of a group of 171 seven-year-old children, free from major disability, with a birthweight of 2,000 g or less, were examined and compared with those of normal birthweight peers. More low birthweight children were left-handed and of mixed or undetermined hand, foot and eye dominance. Left-handedness may adversely affect some areas of performance of normal birthweight but not of low birthweight children. Low birthweight children performed significantly less well in tests of both fine and gross motor coordination. Girls tended to perform better than boys in fine motor tests. In the low birthweight group there was a correlation between IQ and coordination.

Child↗
PubMed1988

Outcome of preterm infants who suffered neonatal apnoeic attacks.

Thirty infants of less than 31 weeks post-menstrual age were monitored for apnoea using routine medical equipment and intermittent 24-h pneumocardiograms. These infants were examined again between 16 and 36 months of age. Full physical and ophthalmological examinations were carried out as well as audiometry and assessment using the Griffiths mental developmental scales. Twenty-five of these infants had suffered apnoeic attacks and two of these infants had an abnormal developmental quotient. Neither sensorineural deafness of retinopathy of prematurity were detected in the children who suffered apnoeic episodes. The poor prognosis which has been associated with neonatal apnoea may not apply to those infants without other serious neonatal problem.

Apnea↗
PubMed1987

Percutaneous absorption in preterm infants.

The skin of preterm infants varies considerably in its level of maturity. To understand skin absorption in premature infants better, we report a technique for the assessment of percutaneous absorption at various gestational and postnatal ages using stable, isotope-labeled (13C6) benzoic acid. Our results indicate that in the preterm infant, this method detects enhanced skin absorption in the first postnatal days, which declines over three weeks to that expected of a full-term infant. This approach also indicates an inverse relationship between gestational age and skin absorption, as well as postnatal age and skin absorption. The reported technique is a safe and noninvasive method using a model skin penetrant for the study of percutaneous absorption in preterm infants from which basic data may be derived to add to our understanding of skin barrier function.

Benzoates↗
PubMed1979

Vertical transmission of hepatitis B surface antigen in carrier mothers in two west London hospitals.

126 children of 102 hepatitis B surface antigen (HBsAg) carrier mothers were delivered at Hammersmith Hospital and Queen Charlotte's Maternity Hospital, between 1971 and mid-1978. Blood tests on 110 of these children showed that 8 out of the 18 with Chinese mothers, but only 6 out of the 92 other children, have become HBsAg positive. The presence of maternal hepatitis B e antigen (HBeAg) is also significantly correlated with transmission of HBsAg to the children. The management of children whose mothers are carriers is discussed.

Carrier State↗
PubMed1978

The importance of plasma lipid, glucose, insulin and fibrinogen in femoropopliteal surgery.

Fasting blood levels of cholesterol, triglyceride, glucose insulin and fibrinogen were measured preoperatively in 44 patients who had reconstructive operations for occlusive disease in the femoral and popliteal arteries. Comparison of these preoperative biochemical measurements with the results of surgery over a 4-year period indicated that failure was associated with significantly higher mean preoperative levels of both glucose (P less than 0.01) and fibrinogen (P less than 0.01). High fasting blood glucose was associated with early failure (occlusion between 3 and 12 months) and high plasma fibronogen was associated with late failure (occlusion between 1 and 4 years). The results of operation were not influenced significantly by preoperative blood levels of cholesterol, triglyceride or insulin.

Adult↗
PubMed1978

Tuberculosis of the peritoneal cavity.

The clinical presentation and management of 30 consecutive patients with tuberculous peritonitis are reviewed. Seventy per cent of the patients were aged 40 years or less and 80 per cent were immigrants. The main clinical features of abdominal pain, loss of weight, vomiting and sweating at night had been present in a large number of patients for several months before presentation to hospital. The clinical diagnosis of tuberculous peritonitis was difficult in the absence of extraperitoneal tuberculosis. Laboratory investigations were of little value in establishing the diagnosis. An elevated ESR was found in 80 per cent of patients. At laparotomy omental biopsy was performed and was diagnostic in all cases. Laparotomy was a safe and fast method of obtaining tissue for confirmation of the diagnosis in suspected cases, particularly when presenting acutely. Ascitic fluid cultures and guinea-pig inoculations were positive in only 6 out of the 15 patients in whom they were performed. Only 1 patient died.

Adolescent↗
PubMed1977

Fatty acids of phospholipids in human neonatal lung surfactant.

The fatty acid chains of lecithin, phosphatidyl ethanolamine (PE), and phosphatidyl dimethylethanolamine (PDME) in human neonatal alveolar washes were analyzed. Both alpha- and beta-palmitic acid increased with gestational age on all phospholipids analyzed. No evidence for high concentrations of myristic acid was found on any phospholipid. Babies who were stillborn or who had died of hyaline membrane disease (HMD) had lower proportions of beta-lecithin palmitic acid when compared with babies who breathed normally before death. In the HMD group these levels were significantly lower.

Fatty Acids↗
PubMed1976

The use of dextrostix and dextrostix reflectance meters in the diagnosis of neonatal hypoglycemia.

Dextrostix is now widely used as a method of screening for hypoglycemia of the newborn. There has always been some anxiety about its accuracy for estimating very low blood sugars; this is important, since symptomatic hypoglycemia of the newborn does not usually occur until the blood glucose falls below 20 mg/dl. In 1970 a reflectance meter was introduced which would measure the colour of the strip electronically. The aim of this study was to assess the accuracy of the meter and its reliability in estimating hypoglycemia. The study was continued to investigate a new model of the reflectance meter which superseded the original one. In the pilot study using the original model, blood samples were taken from 46 babies. Readings of the Dextrostix were made by two independent observers and compared with a reading taken on the reflectance meter. These estimations were later compared with blood glucose measured by the glucose oxidase method. the meter showed a marked tendency to overestimate the blood glucose: 44 out of 46 samples were overestimated (Fig. 1, 2). In the second series 180 cord blood samples were collected. Because the intention was to study very low levels of blood glucose, the samples were allowed to stand at room temperature for several hours to allow glycolysis to occur. Again, readings were taken by two independent observers and compared with the readings taken on the new Dextrostix-Eyetone meter. The blood glucose was measured on each of the samples. There was a strong correlation (r = 0.8877, p less than 0.00005) between the blood glucose values and the readings taken from the meter, with no tendency towards overestimation (Fig. 3). A similar correlation (r = 0.8533, p less than 0.00005) was seen for the observers' readings and the chemical method, although there was a tendency to underestimate blood glucose (Fig. 4). When the meter gave an estimate of more than 20 ml/dl, in no case was the actual blood glucose in the profoundly hypoglycemic group of less than 10 mg/dl. When estimated by eye there was one case in which the blood glucose was only 7 mg/dl but the observer had estimated the result of 30 mg/dl. In order to avoid any possibility that a blood glucose was less than 20 mg/dl, it is necessary to take action on any estimate below 40 mg/dl on a Dextrostix. Despite this, Dextrostix remains a very useful method of screening for neonatal hypoglycemia, whether assessed by eye or with the new Dextrostix-Eyetone meter. the meter does give better results than estimating Dextrostix by eye, but the difference was never statistically significant.

Color↗