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Biomedical subjects

H B Valman

Publications and source records attributed to H B Valman.

At least 109 records · Page 6Linked to original sources

The causes of low oestrogen excretion in pregnancy: the development of diagnostic methods for the antenatal detection of familial congenital adrenocortical hypoplasia.

A pregnancy producing a boy with congeital adrenocortical hypoplasia is described. Consistently low oestrogen excretion, less than 10 umol/24 h, was not associated with any anatomical abnormality or diminished growth of the fetus as judged by ultrasound examination. Fetoplacental steroid sulphatase definciency was excluded by finding normal maternal excretion of oestrogen precursors, the 3Beta-hydroxy-5-ene steroid sulphates. Generalized adrenocortical hypoplasia was proven in the baby boy by analysis of steroid netabolites excreted in his urine. He suffered from salt loss and progressive jaundice. Both were responsive to gluco- and mineralo-corticoid replacement therapy. It is suggested that amniocentesis may be required for the antenatal diagnosis of congenital adrenocortical hypoplasia.

Adrenal Cortex Hormones↗

Birth trauma.

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Birth Injuries↗

Role of viruses in febrile convulsions.

A disseminated viral illness was demonstrated by isolating a virus from the CSF, blood or urine in 27% of 73 children who were admitted to hospital after a first febrile convulsion. However, a viral aetiology could be implicated for 86% of the children after combining results of tissue culture, electron microscopy, mouse inoculation, complement fixation tests, and interferon assay. Parallel bacterial cultures showed a possible pathogen in 29% of children, but in only 4% was the pathogen isolated from the CSF, blood, or urine. No correlation was found between the nature of the pathogen (or evidence of its dissemination) and the severity of the convulsion, degree of fever, CSF protein, CSF white cells, or the WBC. The results suggest that a febrile convulsion could be a response to invasion of the blood stream or central nervous system by a micro-organism which is usually a virus. Invasion may be of such brief duration that successful isolation of the virus from the blood, CSF, or urine in not more commonly achieved.

Child↗

A year's experience of the rotavirus syndrome and its association with respiratory illness.

In a hospital study rotavirus was identified in 51% of 152 children with diarrhoea. These patients showed a clinical pattern that was distinct from patients in whom the diarrhoea was associated with bacteria, other viruses, or no pathogens. A respiratory illness was described in 66% of rotavirus patients and usually preceded the gastrointestinal symptoms. Vomiting lasted between one and 3 days and was curtailed by substituting the normal diet with clear fluids. Watery diarrhoes continued for 4 or 5 days, even when rehydration was by the intravenous rather than the oral route. Prolonged diarrhoea was rare. Most children infected with rotavirus were under 2 years of age, but dehydration was most severe in infants aged between 12 and 18 months. A clinician can thus recognise the rotavirus syndrome and expect spontaneous recovery if adequate rehydration is maintained for a critical few days.

Adolescent↗

Measurement of 4-hydroxyphenylacetic aciduria as a screening test for small-bowel disease.

We evaluted measurement of urinary 4-hydroxyphenyl acetic acid as a potential screening method for small-bowel disease and bacterial overgrowth syndromes in 360 unselected acutely ill infants and children. Control data were obtained on 120 healthy children, ages 1.5 to 15 years, from a general medical practice, 48 healthy infants, ages one to five years, from local day nurseries, and 150 healthy babies, ages less than one to eight days. Comparative data were from 300 acutely ill hospitalized babies and children, ranging in age from less than one day to 15 years and without clinical evidence for small-bowel disease and bacterial overgrowth syndrome. No false-negative results and only 2% false-positive results were observed. Among the 10 patients whose urinary excretion of the analyte was considered to be abnormal were patients with Giardia lamblia infestation, ileal resection with blind loop, and other diseases of the small intestine associated with bacterial overgrowth. We conclude that measurement of 4-hydroxyphenylacetic acid excretion is useful in screening for such diseases.

Adolescent↗

Increasing prevalence of breast-feeding.

Two studies were performed to gauge the prevalence of and attitudes towards breast-feeding. Mothers delivered in one month in 1975 and in one month in 1977 were sent a questionnaire one month later to determine whether they were breast-feeding their babies; those that were received a second questionnaire at three months. The prevalence of breast-feeding increased significantly between 1975 and 1977, and in both periods primiparas were more likely to breast-feed than multiparas. A survey of mothers' intentions to breast-feed showed that there were no significant racial differences, but that 82% of women in social classes I and II intended to breast-feed compared with 54% in classes IV and V. These results show that, although the level of breast-feeding was high in 1975, a campaign directed at mothers, doctors, midwives, and health visitors did increase the prevalence of breast-feeding.

Attitude↗

Group B streptococcal infection in a maternity unit.

Neonatal infection due to Group B streptococci is described in a maternity unit. Six babies were affected and two died. Three of the babies were born at term, and weighed more than 2.5 kg. Tachypnoea was the earliest clinical sign in each case, and we suggest that newborn infants with persistent tachypnoea and evidence of maternal or infant colonization with Group B streptococci should receive antibiotics. Alternative approaches to the diagnosis and management of infection with Group B streptococci are discussed and rejected.

Cross Infection↗

Bacteriostasis of Escherichia coli by milk. I. Colonization of breast-fed infants by milk resistant organisms.

Human milk has a bacteriostatic effect on Escherichia coli in vitro. The milks of 40 mothers were tested for this effect against E. coli isolated from their stools, from those of their own babies, and from those of babies not breast-fed. The milks had a direct bacteriostatic effect, not dependent on complement, on some but not all the strains of E. coli. Breast-fed babies receiving supplementary bottle feeds were colonized with milk-resistant strains, whereas bottle-fed babies and, surprisingly, babies completely breast-fed were colonized equally with milk-sensitive and milk-resistant strains, as were the mothers. These results suggest that the bacteriostatic effect of human milk, demonstrable in vitro does sometimes operate in vivo. The antibacterial activity of human milk is not infleunced by the O, H, or K antigens of E. coli and is effective against other Gram-negative organisms, e.g. Salmonella, Klebsiella, Proteus.

Actinomycetaceae↗

Aldosterone and sodium HOMEOSTASIS in preterm infants.

A specific mass spectrometric method was used for tetrahydroaldosterone determination in urine of preterm infants (26-34 weeks gestational age) up to 9 weeks of age. Hyponatraemia during the first 2 weeks of life was associated with an excretion of tetrahydroaldosterone (5-50 mug/24 h) comparable with full-term infants. Excretion of tetrahydroaldosterone was significantly elevated in all infants studied during the third week of life (80-350 mug/24 h) and this was associated with establishment of positive sodium balance. The excretion of tetrahydro aldosterone remained high for 2 or 3 weeks. The results are discussed in relation to the development of renal tubules and control mechanism for sodium homeostasis.

Aldosterone↗