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Biomedical subjects

E Griffin

Publications and source records attributed to E Griffin.

36 records · Page 2Linked to original sources
PubMed1990

Narcotic addiction: the expectant mother and her baby.

In a retrospective study of the period 1982-1985, the records of 29 narcotic-addicted mothers and their 42 babies were reviewed. All mothers were from socially deprived backgrounds, had a poor record of ante-natal attendance and had frequent admissions to hospital. Thirteen mothers had a past history of hepatitis B and four were HBsAg positive. The babies had significantly lower mean gestational age and mean birth weight than the control group. Features of withdrawal were recorded in 84% of babies where a history was available. A high incidence of twins (10.5%) was also observed. Testing for HIV antibody in more recent cases has revealed positive results in seven mothers and three babies; one infant has since died from acquired immune deficiency syndrome.

Adolescent↗
PubMed1990

Transportation of newborn infants.

The benefit of an organized neonatal transport system is well established. Over a 30 month period, January 1987 to June 1989, 172 babies were transported to the Dublin maternity hospitals. Birth weights ranged from 640 to 5,180g 106 (62%) were less than 37 weeks gestation. Indications for transport included respiratory distress syndrome (54), prematurity only (43), convulsions and/or neurologic dysfunction (23), jaundice (11) and apnoea (11). One hundred and sixty-eight were transferred by ambulance and four by helicopter. Twenty travelled more than 100 miles. Forty (23%) received assisted ventilation during transport. On arrival 37 (21%) had temperature less than 36 degrees C; 22 (13%) had blood sugar less than 2.2 m mol/l and 34 (20%) had arterial ph less than 7.25. Fifty per cent of referral letters had incomplete information. Treatment and care given en route was recorded in only 28 babies. Twenty-four babies (14%) died. Infants who died were more likely to have been of low birth weight, travelled a long distance, been hypothermic, had poor arterial gases, had blood sugars less than 2.2 m mol/l, and had poor referral letters. This review indicates that death and morbidity continue to be associated with the present system of postnatal transfer of newborn infants. The urgent need for an organized neonatal transport service remains unmet.

Emergency Medical Services↗
PubMed1989

Motor slowing in asymptomatic HIV infection.

To examine neuropsychological deficits associated with the human immunodeficiency virus (HIV), 25 asymptomatic homosexual men and sexual partners of intravenous drug users and 25 seronegative homosexual men and nonhigh-risk heterosexuals were assessed on measures of fine motor control, visual scanning, attention, depression, and global psychological functioning. Analysis suggested that HIV infection is associated with reduced fine motor control. Seropositivity is associated with elevated depression and global psychological maladjustment. When depression and global adjustment were analyzed as covariates, motor slowing was evident in the seropositive group. These findings suggest an association between motor slowing and HIV infection in asymptomatic subjects and point to the necessity of measuring affect at least as a control variable. Further study is needed to determine whether the fine motor deficit evident in this sample is limited to distinct subgrouping of the over-all sample.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Neonatal seizures: the Dublin Collaborative Study.

Asphyxial seizures occurred in 89 of 101,829 infants born alive at term (0.87/1000) in three large maternity hospitals from January 1980 to December 1984. These seizures were significantly associated with antenatal complications, primiparity, and prolonged pregnancy. Meconium staining of the amniotic fluid was also associated with asphyxial seizures, but there were high false positive (11%) and false negative (50%) rates. Fifteen of the infants who had seizures died (18%) and 21 (25%) were handicapped at 1 year. Outcome was most successfully predicted by the way the infant was feeding at 1-2 weeks. All infants taking more than half their estimated requirements by mouth at 1 week were normal, and those still being fed by tube at 2 weeks were handicapped.

Asphyxia Neonatorum↗
PubMed1979

Appearance and characterization of lipoprotein X during continuous intralipid infusions in the neonate.

The development of hyperphospholipidemia and hypercholesterolemia was studied in infants that required total parenteral nutrition and given a continuous infusion of Intralipid, (1-4 g/kg body wt per 24 h. Detailed studies were carried out on infusion periods lasting 1-10 d. After 24 h there was a marked increase in plasma free cholesterol (68%) and phospholipid (77%) concentrations. Based on the amount of cholesterol in Intralipid, and the rate of infusion, it was estimated that at least 50% of the plasma cholesterol increment during 64-h infusions was derived from endogenous sources. By contrast, the hyperphospholipidemia could be attributed to the Intralipid as the rise in plasma was calculated to be equivalent to only 16% of the exogenous phospholipid infused. Approximately 10% of the phospholipid in Intralipid was in a triglyceride-free mesophase form with a free cholesterol:phospholipid molar ratio of 0.063. There were no systematic changes in plasma concentrations of cholesterol ester or triglyceride during Intralipid infusions. The increase in free cholesterol and phospholipid was localized in the low density lipoproteins (d = 1.006-1.063 g/ml). The presence of lipoprotein X (Lp-X) in the low density lipoprotein fraction was demonstrated by electrophoresis in agar and by isolation and chemical characterization with hydroxylapatite chromatography. Isoelectric focusing of urea-soluble protein of Lp-X revealed that albumin and apolipoproteins CII and CIII were major components, whereas apolipoprotein E and AI were minor constituents. The abnormal lipoprotein was apparent by 16 h during 64 h of infusion. After 6 d of continuous infusions the free cholesterol in Lp-X was 30+/-10 mg/dl (mean+/-SD), which represents a total Lp-X mass of 90 mg/dl. After cessation of the infusion, Lp-X, as monitored by electrophoresis in agar, disappeared within 72-96 h. Thus, during infusion of Intralipid in infants at rates commonly employed, the capacity of the clearance mechanisms for phospholipid are exceeded, which causes the accumulation of phospholipid and free cholesterol in the form of Lp-X particles. It is suggested that mesophase phospholipids in Intralipid may play a significant role in this process.

Apolipoproteins↗
PubMedDate not supplied

Neonatal transportation: the effects of a national neonatal transportation programme.

BACKGROUND: The transport of critically ill newborns by specialised transport teams has been shown to be associated with a significant improvement in their clinical condition on arrival at the receiving hospital. AIM: To determine if the National Neonatal Transport Programme introduced in 2001 improved clinical condition of newborns at the end of transfer. METHODS: A retrospective study of all 176 patients transported by the National Neonatal Transport Programme between March 2001 and March 2002. RESULTS: Before transfer, 17% of patients were hypothermic, 2% hypoglycaemic and 11% acidotic as were 7%, 3% and 5% respectively at the end of transfer. A review of 172 neonatal transports between 1987 and 1989 revealed that 21% of patients were hypothermic, 13% hypoglycaemic and 20% acidotic at the end of transfer. CONCLUSIONS: The National Neonatal Transport Programme has resulted in improved clinical condition of newborns at the end of transfer when compared to their condition before transfer and compared to outcomes prior to the introduction of the programme.

Critical Illness↗
PubMedDate not supplied

Mother-to-child transmission of human immunodeficiency virus (HIV) in Ireland: a prospective study.

Symptomatic HIV infection was first diagnosed in an Irish child in 1985. A prospective study was initiated to determine the vertical transmission rate (VTR) of HIV and the average age of infant seroreversion and to monitor clinical, immunologic and virologic evidence for HIV infection in seroreverters. Ninety three HIV positive infants have been prospectively identified since 1985. The predominant underlying maternal risk factor for HIV infection is intravenous drug use (IVDU) (96 per cent). Of 93 infants, median gestational age was 40 weeks and median birth weight 3125 grams. Ninety-four per cent of infants were bottle fed. Currently 72 (77 per cent) infants are uninfected, 12 (13 per cent) are infected, 4 (4.5 per cent) are indeterminate and 5 (5.5 per cent) have been lost to follow up. The intermediate estimate of vertical transmission rate (VTR) is 14.3 per cent. The median age at documented seroreversion was 12 months. There are no significant differences between infected and non-infected children in male/female ratio, gestational age, mode of delivery or birth weight. Strategies to reduce the transmission of HIV among drug users in combination with routine antenatal screening and antiretroviral prophylaxis of vertical transmission are all measures which can reduce HIV infection in our children.

AIDS Serodiagnosis↗
PubMedDate not supplied

Effective systems documentation: essential for safety management.

The rapid pace of change in healthcare has caused critical engineering systems in hospitals and other healthcare facilities systems to be altered and upgraded on a virtually continuous basis. Changes to these systems, which include heating, ventilating, and air conditioning (HVAC), medical gases, normal and emergency electrical systems, plumbing, and fire protection systems, often are not properly documented. As a result, healthcare facilities may, over time, be exposed to increased risk. Such a situation compromises an organization's high level of patient and staff safety; it also may cause problems during a Joint Commission on Accreditation of Healthcare Organizations review of environment of care. This article outlines seven specific questions safety officers should review to determine if their facility needs a thorough systems assessment.

Documentation↗
PubMedDate not supplied

The human side of reengineering.

This article on the human side of reengineering describes the issues and concerns faced by healthcare executives who are considering or who already are involved in a reengineering project. It offers a practical approach to understanding issues such as the importance of assessing the culture and its readiness for change, the importance of human resource policy development prior to initiating a reengineering project, and how to ensure buy-in and support from the healthcare organization and its community.

Chief Executive Officers, Hospital↗
PubMedDate not supplied

The Dublin outcome for low birth-weight infants.

This report describes outcomes for all infants with birth weight 501-1750 grams born in the three major maternity hospitals in Dublin between 1.1.90 to 31.12.91. 37,958 mothers delivered 38,498 infants during this period, consisting of approximately 36% of all deliveries in Ireland. 633 (1.6%) of all infants born weighed 501-1750 grms. 102 (16%) were stillborn and 28 of the 531 live born infants had lethal malformations. 30% of women received two or more doses of antenatal steroids before delivery and a highly significant negative correlation occurred between the need for ventilation after birth and antenatal steroids. 56.4% of babies were delivered by caesarean section as compared with 10.8% of the hospital population. Of 503 liveborn infants without lethal malformation. 426 (85%) survived to 28 days and 419 (83%) to discharge home. 15% were growth retarded. 46% of infants were ventilated, mean duration of ventilation was 7 days. 25% of infants had an intraventricular haemorrhage, 10% necrotising enterocolitis and 19% culture proven sepsis. 15% of survivors developed broncho pulmonary dysplasia and 12% retinopathy of prematurity. This paper describes important information for mortality, morbidity and interventions among a large population of low birth weight infants in Ireland and can be used as a basis against which to compare future alterations in practice. It demonstrates a clear benefit for antenatal steroids in decreasing the need for ventilation and the importance of ensuring their utilisation antenatally where possible.

Female↗