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Biomedical subjects

F Cockburn

Publications and source records attributed to F Cockburn.

At least 55 records · Page 3Linked to original sources
PubMed1986

Determination of red-cell mass in assessment and management of anaemia in babies needing blood transfusion.

A new method for the rapid determination of red-blood-cell mass (RCM) in infants needing blood transfusion is described. RCM is estimated from the fall in the baby's fetal haemoglobin level resulting from transfusion of a known mass of adult-haemoglobin-containing red cells. In severe blood loss and refractory anaemias in preterm infants, in addition to the red-cell deficit, the plasma volume is low, leading to a falsely high haematocrit of about 0.30, which conceals a deficiency of 50-70% in circulating red cells. Red-cell transfusion in such infants based on haematocrit often fails to restore RCM to normal, leading to repeated transfusions. The frequency of transfusions may be reduced by giving enough red cells fully to correct the deficiency based on RCM estimation.

Adult↗
PubMed1986

Children intoxicated by alcohol in Nottingham and Glasgow, 1973-84.

The circumstances of ingestion, clinical course, and long term sequelae were examined retrospectively in 143 children (108 boys, 35 girls) admitted with acute alcohol intoxication in Glasgow and Nottingham over the 12 years 1973-84. Fifty three of the children were aged less than 7 years and 90 were aged 7-14. Twelve of the children were hypoglycaemic on arrival at hospital. Trauma related to intoxication occurred in 14 cases, and nine boys became drunk under duress, which in four cases was associated with sexual abuse.

Age Factors↗
PubMed1986

A comparison of energy metabolism in the new-born infant, piglet and lamb.

Characteristics of energy metabolism in the new-born infant, piglet and lamb have been compared quantitatively in order to assess how the constraints imposed by the availabilities of energy substrates in body reserves and colostrum differ between species and affect the new-born's well being during the first day after birth. Three air temperature ranges, described as thermoneutral (32-38 degrees C), moderate (18-26 degrees C) and cold (0-10 degrees C) and representing the usual birth environments of infants, piglets and lambs, respectively, have been considered. The analysis revealed the following noteworthy points. Carbohydrate and lipid are the major energy substrates for heat production because protein catabolism is minimal during the first day after birth in all three species. The availability of carbohydrate determines how long the new-born can avoid hypoglycaemia, which threatens well being because it leads to hypothermia or compromised cerebral function, but lipid availability can affect the periods for which the carbohydrate can last. Thus, in unfed piglets and lambs the available reserves of liver and skeletal muscle glycogen (g/kg body weight) are similar in normal (n.) and growth retarded (g.r.) individuals, but glycogen exhaustion occurs earlier in g.r. new-borns because a reduced lipid availability in them increases their dependence on carbohydrate. In contrast, lipid energy is plentiful in g.r., preterm (p.) and n. infants, so that the faster depletion of glycogen in g.r./p. than in n. individuals is primarily due to a restricted prenatal glycogen deposition in the former. The usual colostrum intakes of n. infants are very low during the first day, but their body reserves can supply the required energy, the major source of carbohydrate being liver glycogen. However, g.r./p. infants require supplementary feeding, the choice of feed being determined by factors such as the intakes the infants can achieve, the carbohydrate content of the feed and the need to ensure a balanced supply of minerals, electrolytes and other substances. In their usual birth environments piglets and lambs, whether growth retarded or not, require colostrum to avoid hypothermia during the first day. The colostrum of both species is rich in lipid, which corrects any deficit in the new-born and thus extends the availability of glycogen, but at the usual colostrum intakes the amounts of lactose can provide sufficient carbohydrate energy for only about half a day. Piglets and lambs, even when fed fully, are therefore obliged to call on their body glycogen reserves in order to make up the difference.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1986

Dietary copper intake in artificially fed infants.

Plasma concentrations of copper and zinc and leucocyte concentrations of zinc were measured in mothers during later pregnancy, at delivery, and 8-10 weeks after birth, and plasma concentrations of copper and zinc were measured in their infants at delivery and 8-10 weeks after birth. The 145 infants were either breast fed or fed one of two milk formulas supplying copper at different concentrations. None of the infants achieved the minimum copper intakes recommended by the World Health Organisation (WHO). At 2 months of age there were no major differences in growth or health detected in infants fed the different copper intakes. Infant birth weight correlated well with the ratio of maternal venous plasma zinc:maternal leucocyte zinc at delivery. Maternal venous plasma copper and zinc concentrations at birth correlated with umbilical venous plasma copper and zinc concentrations. Infants fed the higher copper content formulas had a low mean plasma zinc concentration without a significant increase in the mean plasma copper concentration. The present WHO recommendations regarding minimum copper intakes for infants fed formulas cannot be achieved with currently available formulas and are probably wrong.

Breast Feeding↗
PubMed1986

Ribavirin aerosol for acute bronchiolitis.

A randomised double blind placebo controlled trial of treatment with an aerosolised antiviral agent, ribavirin, was conducted in 26 infants with clinically diagnosed bronchiolitis. Nebulised ribavirin (14 infants) or normal saline aerosol (12 infants) was given for 18 hours a day for at least three days. Respiratory syncytial virus was identified in nasal secretions from 20 cases (10 from both groups). Trends in seven out of eight clinical variables favoured active treatment. Ribavirin aerosol was associated with significantly faster improvement in cough and crepitations and more rapid rate of fall in respiratory and heart rates. In the 20 infants from whose nasal secretions respiratory syncytial virus was identified most variables favoured treatment with ribavirin, with significant reduction in chest recession. No difference was found in the rate of clearance of respiratory syncytial virus. The treatment was well tolerated as judged clinically and from the results of haematological and biochemical studies. The study suggests nebulised ribavirin may have a place in the treatment of some cases of bronchiolitis.

Acute Disease↗
PubMed1986

Perinatally related wastage--a proposed classification of primary obstetric factors.

Adapting Sir Dugald Baird's concept of primary obstetric causes of perinatal mortality, a revised clinico-pathological classification has been evolved to take account of new knowledge and developments, and to direct attention to potentially avoidable deaths and to where intensified efforts and investigation are needed. Categories highlighting the importance of intrauterine growth retardation, unexplained intrauterine death and spontaneous premature labour have been introduced, intrapartum hypoxia is separated from birth trauma, and infection again has its own category. Regular perinatal audit at one obstetric hospital, since 1979, has shown that the new system provides a workable and useful means for classifying not only perinatal deaths, but also late abortions, late neonatal deaths and perinatally related infant deaths. The rate of total perinatally related wastage, defined in this way, was almost twice that for perinatal mortality (22.8 compared with 11.9 per 1000 births). The former is advocated as a more realistic index for the audit of perinatal care. The revised and extended system is put forward as a contribution to the current debate on classifying and reporting such wastage, in the hope that it may be tested as a model for regional as well as hospital surveys.

Birth Injuries↗
PubMed1985

Copper deficiency in the preterm infant of very low birthweight. Four cases and a reference range for plasma copper.

Four preterm infants of very low birthweight (less than 1500 g) developed signs of copper deficiency between age 8 and 10 weeks. All had required prolonged ventilatory support, parenteral nutrition, and nasojejunal feeding. The clinical features, which included osteoporosis, oedema, anaemia, neutropenia, and late apnoea improved when the oral copper intake was increased. Diagnosis was made more difficult because a suitable reference range for plasma copper was not available. Serial measurements of plasma copper in 39 preterm infants who had no important medical problems were used to produce a reference range for plasma copper from 30 weeks' gestation to term plus seven weeks. This information will aid recognition of hypocupraemia in the very low birthweight infant who is particularly at risk of copper deficiency.

Copper↗
PubMed1985

Effect of human colostrum and infant formula on the phagocytic activity of macrophages. I. Resident and stimulated mouse peritoneal macrophages.

Phagocytosis and degradation of radiolabelled human transferrin-anti-transferrin immune complexes by resident and stimulated mouse peritoneal macrophages was inhibited by liquid infant formula, particularly in the case of resident cells. Mouse peritoneal macrophages exposed to infant formula were shown by immunofluorescence to bind casein and beta-lactoglobulin, but there was little binding of alpha-lactalbumin. Comparison of various artificial milks, cow's milk and purified casein indicated that both the concentration and the degree of denaturation of casein may be important in the impairment of macrophage function by milk. It is suggested that bottle feeding of infants might result in impairment of macrophage function in the small intestine.

Animals↗
PubMed1984

Infantile type 2 sialidosis in a Pakistani family--a clinical and biochemical study.

Two siblings of consanguineous parents presented in infancy with failure to thrive, mild coarsening of facies, visceromegaly and corneal opacities. One showed reduced hepatic beta-galactosidase activity suggesting a GM1-gangliosidosis variant. Both patients developed progressive coarsening of facies, slow neurological deterioration, macular cherry-red spots and punctate cataracts over the first decade. Urine screening with thin layer chromatography revealed abnormal excretion of two slow-moving oligosaccharide bands and leukocyte and fibroblast neuraminidase activity was grossly reduced. The mother, phenotypically normal, showed levels of neuraminidase compatible with heterozygosity. These patients have primary neuraminidase deficiency. The clinical and biochemical variables are reviewed.

Adolescent↗
PubMed1984

Amoxycillin and clavulanic acid in the treatment of urinary infection.

The pharmacokinetics and clinical efficacy of amoxycillin combined with clavulanic acid in the treatment of 32 children with urinary tract infection were studied. Twenty one (80%) of 26 children with proved urinary tract infection showed a favourable clinical and bacteriological response. Fifteen of these children had amoxycillin resistant organisms and were treated successfully. In 20 children the serum and urine concentrations of amoxycillin and clavulanic acid were measured after the first oral dose.

Amoxicillin↗
PubMed1983

Alcohol and the fetus in the west of Scotland.

Forty children with the fetal alcohol syndrome were identified in the west of Scotland. All were growth retarded and had abnormal facial features, and all those who were tested were found to have neurological or developmental abnormalities. Two children died of associated physical defects. Most of the mothers were socially deprived, and all had drunk heavily while pregnant. Three women had subsequently died. These findings provide clear evidence that in the west of Scotland maternal alcohol abuse during pregnancy is a significant cause of morbidity and mortality in children.

Adult↗
PubMed1982

Epidermolysis bullosa in association with aplasia cutis congenita and pyloric atresia.

A female infant born to a mother who had an elevated serum alpha-fetoprotein during early pregnancy, presented a combination of epidermolysis bullosa and aplasia cutis congenita. She developed evidence of upper gastrointestinal obstruction and died at the age of 43 hours. Post-mortem examination showed the presence of pyloric atresia and electron microscopy of skin biopsies showed epidermolysis bullosa simplex. Examination of the placenta revealed a unique abnormality of the membranes, indicating the existence of two sacs. This case and the previously reported cases, which are reviewed, suggest an autosomal recessive inheritance. Serum alphafetoprotein estimation, ultrasonography and fetoscopy with skin biopsy are suggested as a means of pre-natal diagnosis in future pregnancies.

Abnormalities, Multiple↗
PubMed1981

Neonatal spongioform myelinopathy after restricted application of hexachlorophane skin disinfectant.

At least four out of 97 low birth weight (less than 1750 g) newborn infants who had received only limited skin disinfection with 3% hexachlorophane (HCP) emulsion developed spongioform myelinopathy in association with detectable amounts of HCP in their brains. These four cases were found in a post-mortem survey of 20 out of the 27 infants who died. Another nine of these infants had detectable amounts of HCP in the brain but no myelinopathy. It is at present not possible to define a 'safe" level of exposure to 3% HCP emulsion for small preterm infants in the first 2 weeks of life.

Brain↗
PubMed1981

A pharmacological study of cefaclor in the newborn infant.

The absorption and excretion of cefaclor were studied in 10 newborn infants. A mean peak serum concentration of 7.7 microgram/ml was achieved at 1 hour after an oral dose of 7.5 mg/kg. It is concluded that cefaclor is a well absorbed and tolerated cephalosporin for use in newborn infants.

Bacterial Infections↗