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Biomedical subjects

E N Hey

Publications and source records attributed to E N Hey.

At least 37 records · Page 2Linked to original sources
PubMed1986

Seasonal variations in maternal serum and mammary immunity to RS virus.

We have recorded the systemic and mammary/mucosal immune responses of women following natural infection with RS virus during the second and third trimesters of pregnancy. Anti-RS virus IgG antibody levels in the sera of women collected in the first trimester of pregnancy showed a bimodal distribution with high and low antibody groups. Antibody levels increased after exposure to the winter RS virus epidemic in the second trimester of pregnancy, probably as a result of infection but only for women in the low antibody group. Despite the increases, antibody levels for these women remained well below those of the high antibody group. There was no rise in mean antibody levels after exposure in the third trimester, even among women with low antibody, suggesting a degree of immunosuppression in late pregnancy. There was no evidence that infection during pregnancy was associated with adverse consequences for the infant. Exposure to RS virus in the first two trimesters, but not the third, was associated with high colostral IgA antibody levels that were maintained in the milk throughout the first 7 weeks of lactation. There was a significant correlation between colostral and maternal nasal IgA antibody levels at delivery. Levels of blood or colostral lymphocyte transformation responses at delivery were unaffected by exposure to RS virus in pregnancy. These observations upon natural infection suggest that vaccination during pregnancy is likely to achieve only marginal effects upon serum antibody levels but boost maternal mammary/mucosal immunity.

Antibodies, Viral↗
PubMed1986

Classifying perinatal death: an obstetric approach.

Consultation between the clinicians and epidemiologists responsible for the Perinatal Mortality Surveys in Scotland and in the Northern Regional Health Authority in England showed that the classification of perinatal death introduced more than 30 years ago by Sir Dugald Baird still retained its utility, but that unintentional differences in the way cases were being classified had threatened the validity of temporal or geographical comparisons. To overcome this problem an effort has now been made to define the main terms used in this classification more precisely. To preserve continuity, the main structure of the original groupings has been retained; but the opportunity has been taken to adjust certain minor groups in conformity with recent ideas, and also to modify definitions to take into account the greatly improved prognosis for babies of very low birthweight. Otherwise, it is thought that subclassification of the main groups offers a better method of exploring new hypotheses than any radical alteration of the main groups themselves.

Data Collection↗
PubMed1986

Classifying perinatal death: fetal and neonatal factors.

It has been common practice in the United Kingdom for more than 30 years to classify perinatal deaths according to the maternal condition that initiated the events that led to death. However, such an approach tends to ignore the baby as an individual in his or her own right. The need for an additional classification that identifies the pathological processes occurring in the baby in every perinatal death has long been recognized, and the classification adopted in the 1958 British Perinatal Mortality Survey has now been revised with this need in mind.

Congenital Abnormalities↗
PubMed1985

Prognosis for babies with meningomyelocele and high lumbar paraplegia at birth.

The life expectation of babies with paralytic lumbar meningomyelocele not offered immediate surgery at birth appears to be influenced by the extent to which parents are involved in the child's early care. 8 of the 27 children offered family-centred care in one hospital in 1971-80 and not offered immediate surgery survived to school entry and none of these children has since died. All are chairbound and incontinent, but none is intellectually retarded and many are no more handicapped than the children offered immediate surgical treatment at birth. The choice before the family at birth does not have to be presented as an urgent and immediate choice between life and death.

Child, Preschool↗
PubMed1985

Creatinine and urea clearances compared to inulin clearance in preterm and mature babies.

Simultaneous clearances of inulin, urea and creatinine were compared in 41 babies of 26-40 weeks gestation on 122 occasions during the first month of life. In each case creatinine was measured by a reaction rate method, and in thirty specimens it was also measured after adsorption onto resin. Urea clearance averaged only 62% of inulin clearance (P less than 0.001), and was a poor marker of glomerular filtration. Creatinine clearance measured by resin adsorption equalled inulin clearance, but the assay is manual and not suitable for routine clinical use. Creatinine clearance measured by reaction rate analysis underestimated inulin clearance by a quarter (P less than 0.01) because this automated method overestimated plasma creatinine by an average of 22 mumol/l. Urinary creatinine excretion was 72 +/- 17 nmol/kg per min (mean +/- S.D.) during the first week of life, and 66 +/- 13 nmol/kg per min in weeks two to four, and was not influenced by gestation or body size. Using these values, glomerular filtration rate, urine flow, and the urinary excretion rates of substances may be estimated from measurements made on plasma and untimed urines. Although these estimates are imprecise, with 9% confidence limits of 62-161%, they are useful in clinical practice because they avoid the need to make accurately timed collections of urine.

Creatinine↗
PubMed1985

Increase in cerebral palsy in normal birthweight babies.

A register has been compiled of the 421 children with congenital cerebral palsy born between 1960 and 1975 from a defined geographical area of North East England (population 770 000). There was a fall in the rate of cerebral palsy among very low birthweight babies between 1964 and 1975 and also in the small group with dyskinetic cerebral palsy. The rate rose, however, among babies weighing more than 2.5 kg at birth in the second half of the study, in parallel with changes in perinatal mortality. The net effect is that the overall congenital cerebral palsy rate (mean 1.64 per 1000 livebirths) showed a gradual rise between 1968 and 1975. This conclusion is reinforced by evidence of a rise in incidence among the subgroup of patients with severe cerebral palsy (as defined by an interval measurement of handicap) during the same period.

Birth Weight↗
PubMed1985

Effect of varying water intake on renal function in healthy preterm babies.

Renal control of water and electrolyte homeostasis was studied in 10 healthy babies (gestation 29 to 34 weeks; birthweight 1.19 to 2.19 kg) while water intake was varied. Glomerular filtration rate and urine flow were estimated daily from spot plasma and urine samples for six days using a constant inulin infusion, and simultaneous sodium, potassium, osmolar, and free water clearances were calculated. The infusion was started at an average age of 14 hours. Each baby received a total fluid intake of 96 ml/kg daily on study days 1, 2, and 5, and about 200 ml/kg on study days 3, 4, and 6. Daily sodium intake was kept constant at 3 mmol/kg. At the end of the first study day the babies were undergoing a diuresis, but thereafter their estimated daily water balances remained stable regardless of intake. Glomerular filtration remained stable; alterations in urine flow reflected a change in the percentage of filtrate excreted. Plasma electrolytes and osmolality were stable throughout, and on study days 2 to 6 the urinary excretion rates of sodium, potassium, and other osmoles remained the same regardless of urine flow. The delivery of sodium to the distal tubule was estimated to be between 17 and 20% of the filtered load. Well preterm babies can cope with daily water intakes between 96 and 200 ml/kg from the third day of life.

Diuresis↗
PubMed1985

Neonatal urinary ascites.

Two neonates with spontaneous rupture of the bladder and an otherwise normal genitourinary tract are described. Conservative management resulted in complete resolution of the lesion in one but the other child died from a coliform septicaemia. Necropsy showed a discrete ischaemic lesion in the fundus of the bladder.

Ascites↗
PubMed1984

A controlled trial of hyposensitization with adsorbed tyrosine Dermatophagoides pteronyssinus antigen in childhood asthma: in vivo aspects.

Continuing study for a second year and further analysis of a double-blind placebo controlled trial, already briefly reported, of injections of tyrosine-adsorbed, glutaraldehyde-modified Dermatophagoides pteronyssinus antigen in fifty-one children with perennial asthma and positive bronchial challenge to the antigen, confirms that the patients receiving the treatment reduced their symptomatic medication more than controls, without deterioration of symptoms. Some became symptom-free, when off all treatment. A double-blind placebo controlled trial of continuing treatment for a second year gave evidence of deterioration when the treatment was stopped. Within the treatment group, the improvement was associated with loss of late (6 hr) reaction to bronchial provocation with the antigen, but was not associated with change of immediate (20 min) reaction in lungs or skin. Those who improved in the placebo group did not lose their late reaction. There was a trend for similar benefit from active treatment in the control group, during the second year, though less than in the original active group, and only one lost his late reaction. Only one of the six children with very severe early onset asthma improved. Local reactions to either active or placebo (tyrosine) were seen in half the patients; these were mild and did not influence the treatment. Systemic symptoms occurred shortly after four active injections and after two placebo injections; only one patient stopped the treatment.

Adolescent↗
PubMed1984

In vitro investigations in asthmatic children undergoing hyposensitization with tyrosine-adsorbed Dermatophagoides pteronyssinus antigen.

Successful hyposensitization to Dermatophagoides pteronyssinus in perennial childhood asthma was associated with a slight mean rise of serum IgG antibody to the mite antigen in contrast to a placebo group in whom this antibody fell slightly. No relationship was detected between the effect on asthma and the magnitude of this change. Nor was there any consistent effect on IgE or IgA antibody. There was a wide range of total serum IgE and IgE, IgG and IgA antibody to D. pteronyssinus before treatment; this level did not predict the effect of treatment. Some patients lacked IgA antibody. IgE antibody to timothy grass pollen was raised in some but not others. These levels did not change systematically during the study and improvement occurred in those who had this antibody as well as IgE antibody to D. pteronyssinus. IgG and IgE antibodies to D. pteronyssinus were significantly correlated in the pre-treatment samples. Lymphocyte thymidine uptake was lower after 8 weeks of treatment than in the control group, not only after stimulus with D. pteronyssinus antigen, in vitro, but also with antigen from Candida albicans. This was not a serum effect. The late bronchial provocation response was lost only in those with serum IgA less than the log mean for age.

Adolescent↗
PubMed1984

Weight as the best standard for glomerular filtration in the newborn.

The relation between surface area and body weight changes dramatically in infancy. In 31 healthy infants of 27 to 40 weeks' gestation, variations in glomerular filtration rate were reduced more than twofold by choosing glomerular filtration rate/kg body weight rather than glomerular filtration rate/m2. The former provides the most useful and practical index of renal function in the neonate.

Body Surface Area↗
PubMed1983

Underdiagnosis and undertreatment of asthma in childhood.

A total of 179 Tyneside children who had suffered at least one episode of wheeze since school entry were seen at the age of 7. All but 14 had visited a doctor for chest symptoms, but a diagnosis of asthma had been offered to the parents of only 21 children, including three of the 56 children experiencing four to 12 wheezy episodes a year and 11 of the 31 children experiencing more than 12 episodes a year. Bronchodilator treatment was rarely offered in the absence of such a diagnosis, and two thirds of the children had never received a bronchodilator. Of the children experiencing four or more episodes a year, only a third had received bronchodilator drugs regularly, though half had lost more than 50 days from school because of wheeze. School absenteeism fell 10-fold in the 31 children finally offered continuous prophylactic treatment. Although many doctors had feared that use of the word "asthma" would cause anxiety, parents were uniformly relieved when given an explanation of their child's recurrent wheeze. This study uncovered a disturbing amount of ill health in children that was easily rectified. Probably this same problem exists in other areas.

Absenteeism↗
PubMed1983

Prevalence and spectrum of asthma in childhood.

All the 7 year old schoolchildren in North Tyneside were screened for wheeze with a questionnaire followed by selective clinical assessment: 9.3% of the children had had episodic wheeze within the past year and all those followed up subsequently responded to one or more of the drugs used for asthma. A further 1.8% had had similar symptoms since starting school, though they had not wheezed in the past year. Frequently of symptoms in the 11% of children with features of asthma varied widely and correlated with bronchial reactivity on histamine challenge, but it was not possible to separate children with frequent wheeze from asymptomatic controls by their response to histamine. It was concluded that all these wheezy children had symptoms of a common basic disorder and that they should all be treated as asthmatic.

Asthma↗
PubMed1982

Wheezing, asthma, and pulmonary dysfunction 10 years after infection with respiratory syncytial virus in infancy.

Of the 180 children admitted to hospitals in Tyneside in the first year of life with proved respiratory syncytial virus lower respiratory tract infection, 130 were seen for review 10 years later and 34 of the remaining 50 children accounted for. Skin tests, lung function tests, and histamine-challenge and exercise tests for bronchial lability were undertaken in over 100 of the index children and a similar number of control children. A total of 55 (42%) of the 130 index children had had further episodes of wheeze, while only 21 (19%) out of 111 controls had ever wheezed; but few (6.2% v 4.5%) had troublesome symptoms at the age of 10. There was a threefold increase in the incidence of bronchial lability in the index children but no excess of atopy. Maximum expiratory air flow was reduced throughout the vital capacity manoeuvre in the index children, even when those with a history of recurrent wheeze were excluded. Results of single-breath nitrogen washout tests were normal, however, suggesting that ventilation was not appreciably uneven, even though expiratory flow was restricted. These differences might have been caused by infection damaging the growing lung but might also be explained by pre-existing differences in the airway, rendering certain children more susceptible to symptomatic infection when first challenged by the virus in infancy.

Asthma↗
PubMed1982

Nasal conductance and effective airway diameter.

1. Transnasal pressure (delta p) in Pa and gas flow in cm3 s-1 were measured in men breathing gases of different density, assuming flow through each nostril (f) to be half the measured total flow. Measurements were also made in children with allergic rhinitis before and after nasal antigen challenge. 2. Flow always showed evidence of turbulence when transnasal pressure exceeded 40-80 Pa breathing air and Reynolds number exceeded 2400 (1800 in the presence of nasal obstruction). 3. Changes in effective mean nasal airway diameter (D) after nasal challenge can be determined at points of similar pressure from the relation log (D2/D1) = 0.368 log (f2/f1) when flow is turbulent. 4. Absolute estimates of airway diameter in cm can be obtained from the relation 4.75 log D = 1.75 log f--log delta p+log L--4.756 breathing air when flow is turbulent (since the relation between pressure and flow approximates to that found in a long cylinder) and these estimates are only marginally affected by differing assumptions about nasal airway length (L). 5. Because pressure and flow are non-linearly related, and changing nasal dimensions have a profound effect on the flow at which turbulence occurs, it is suggested that measures of nasal conductance at delta p greater than or equal to 0.1 kPa are preferable to the more conventional measures of nasal resistance at a specified flow rate.

Airway Resistance↗
PubMed1982

Antigen provocation to the skin, nose and lung, in children with asthma; immediate and dual hypersensitivity reactions.

Most (18/21) children with perennial asthma gave dual (immediate and late) responses to bronchial provocation with two of Dermatophagoides pteronyssinus, and either timothy grass pollen or cat fur. Most (19/21) also showed dual responses to skin prick tests, only half (11/21) gave dual responses in the nose, mainly with timothy grass pollen, and these were associated with allergic rhinitis. Only two children gave dual responses in lung, skin and nose to both antigens, and only two gave immediate reactions without late reactions in all positive tests; most showed different patterns of response according to the organ tested or the antigen used for provocation. Our results suggest that local factors may be important in determining the pattern of allergic response in a 'target' organ, and that dual responses are strongly associated with the patient's symptoms.

Adolescent↗
PubMed1980

Osteogenesis imperfecta (lethal) bones contain types III and V collagens.

Lethal osteogenesis imperfecta (OI-L) and normal fetal bones contain types I and V collagen with relatively more type V in OI-L bones. The latter, unlike normal fetal bone, also contain some type III collagen. Such altered collagen ratios could directly produce the bony fragility and radiotranslucency of OI-L bones. Since this is an inherited osteoporosis similar alterations in acquired osteoporoses are also possible.

Collagen↗