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Biomedical subjects

H L Halliday

Publications and source records attributed to H L Halliday.

At least 145 records · Page 8Linked to original sources
PubMed1981

Hypertrophic cardiomyopathy in infants of poorly-controlled diabetic mothers.

Twelve newborn infants of poorly-controlled diabetic mothers were transferred from outlying maternity hospitals for neonatal intensive care. Respiratory distress and cardiomegaly were the presenting signs. Ten infants were large for dates (macrosomic) and had echocardiographic evidence of myocardial hypertrophy, reduced ejection time, and systolic anterior movement of the mitral valve (in 6 infants). These findings are similar to those of adults with idiopathic hypertrophic subaortic stenosis. Two infants died. In survivors the myocardial hypertrophy persisted for at least 2 weeks but the evidence of functional subaortic stenosis had disappeared by 4-7 days. The 2 infants who were appropriately grown had cardiomegaly as a result of ventricular dilatation. This was associated with hypoglycaemia and acidosis, and disappeared when these metabolic disturbances were corrected.

Birth Weight↗
PubMed1981

Transient tachypnoea of the newborn: two distinct clinical entities?

Twenty-five infants with transient tachypnoea of the newborn (TTN) were examined by serial echocardiography during the first 4 days of life. The infants could be divided clinically into two groups: group 1 (n = 19) babies with mild classical TTN requiring less than 40% oxygen, and group 2 (n = 6) babies with severe TTN needing greater than 60% oxygen. Apart from amount of oxygen these two groups differed in that those with severe TTN had lower Apgar scores and arterial pH soon after birth. Echocardiography showed that the babies with classical TTN had increased left ventricular pre-ejection period to ejection times (LPEP/LVET) during the first day of life. Initial LPEP/LVET ratio correlated with duration of treatment with oxygen. The babies with severe TTN increased LPEP/LVET and right ventricular pre-ejection period to ejection times ratios (RPEP/ RVET) during the first 3 days of life. There was no correlation between systolic time intervals and duration of oxygen treatment. These findings suggest that there may be two distinct types of TTN: mild or classical type resulting from mild left ventricular failure, and a severe type associated with generalised myocardial failure, pulmonary hypertension, and right-to-left shunting.

Echocardiography↗
PubMed1980

Evaluation of television consultations between a large neonatal care hospital and a community hospital.

Two-way television consultations between community hospital nurses and neonatologists at a nearby teaching hospital were conducted over a two- and one-half year period of time and were evaluated with respect to a baseline time period in which the television was not available. Screening for illness and prematurity in neonates occurred in a high risk population residing in a black, economically deprived, innercity area. Outcomes including transfer of sick babies from the community hospital to the large teaching hospital are analyzed in relation to prenatal maternal risk characteristics. Apgar scores, birth weight and gestational age. Evidence available suggests that television consultations facilitated formation of appropriate criteria for interhospital transfer and that routine clinical screening tests were performed more consistently following initiation of interhospital consultations.

Age Factors↗
PubMed1980

Method of screening obstetric patients to prevent reproductive wastage.

Data from 1268 deliveries were analyzed and infant outcome was followed using the 2-way television link between a small community hospital and a university neonatal center. Scoring based on 36 prenatal risk characteristics found 26% of the mothers to be at high risk. This high-risk group accounted for 64% of the infant transfers and 67% of the neonatal deaths. Screening of obstetric patients using a prenatal risk score is advised.

Female↗
PubMed1979

Perinatal listeriosis--a review of twelve patients.

From July, 1974 to February, 1978, we managed 12 infants with listeriosis. This infection presented in two distinct forms: an early-onset type (nine patients), often representing a congenital infection following maternal illness, and a late-onset type in which the patient presented with meningitis (three patients). Of our nine infants with early-onset disease, three died, three developed permanent sequelae, and only three were normal at follow-up. Appropriate early management in the perinatal period may improve the outlook in this condition. Affected infants were often premature and had pneumonia, rash, and hepatosplenomegaly at birth. Prenatal clues to the diagnosis included maternal fever, abdominal pains, and leukocytosis with meconium staining of the preterm amniotic fluid. Examination of gastric aspirate at birth showed gram-positive coccobacilli. Antibiotic therapy should be started prenatally and continue for three weeks after birth to prevent recurrences of the late-onset type. This late-onset disease presented as meningitis after the second week of life and responded well to antibiotics. Our three patients recovered without sequelae.

Female↗
PubMed1979

Prediction of neonatal death or need for interhospital transfer by prenatal risk characteristics of mother.

A closed-circuit television system is implemented between neonatal specialists at a large neonatal care hospital and nurses caring for infants in the newborn nursery in a small community hospital located in an inner city, predominantly black, economically deprived area. Data are systematically collected relating prenatal risk characteristics of mothers to outcome measures, including selected intrapartum maternal complications, neonatal morbidity and mortality, neonatal therapeutic interventions, and transfer of neonates from the small hospital to the larger hospital. To our knowledge, study of factors predicting transfer has received little attention in the literature. A log linear model is used to identify specific groups of prenatal risk characteristics capable of predicting maternal and neonatal outcomes.

Adult↗
PubMed1979

Echocardiographic findings of large patent ductus arteriosus in the very low birthweight infant before and after treatment with indomethacin.

17 very low birthweight infants (mean birthweight 850 g) with large patent ductus arteriosus (PDA) were studied by echocardiography before and after treatment with indomethacin. Before treatment left heart dimensions were increased suggesting large left-to-right shunt. Echographic measurements of augmented left ventricular (LV) contraction could be attributed to increase in preload, and reduction in afterload in PDA. After indomethacin, in infants showing clinical response, left heart dimensions returned rapidly to normal and LV contraction became normal or reduced. Two infants had reduced LV contraction with persistent pulmonary oedema suggesting LV failure. In contrast, infants showing no clinical response to the drug also had no significant changes in echographic measurements. Right ventricular systolic time intervals (RPEP/RVET) did not alter after indomethacin treatment in either group, suggesting that the drug does not increase pulmonary vascular resistance.

Blood Pressure↗
PubMedDate not supplied

Current perspectives on the drug treatment of neonatal respiratory distress syndrome.

Respiratory distress syndrome (RDS) in preterm neonates is caused by a lack of alveolar surfactant, which leads to decreased pulmonary compliance and increased work of breathing. Effective therapy for RDS has reduced mortality at the expense of increasing the number of preterm survivors with chronic lung disease. Drugs such as corticosteroids, proterelin (thyrotropin-releasing hormone) and ambroxol have all been administered to mothers to promote fetal lung maturation, but of these only corticosteroids have been proven to be of benefit. The management of RDS includes assisted ventilation and surfactant replacement therapy. There are several surfactant preparations, some synthetic and others derived from animal lungs, and recent research has been directed at finding which, if any, is superior. The timing of the first dose has also been studied. Prophylactic surfactant administration within the first 15 minutes of life appears to be more efficacious than later treatment for very preterm babies, but could lead to some neonates being treated unnecessarily and perhaps being exposed to adverse effects. Newer treatments for neonates with RDS are aimed at reducing the pulmonary inflammation that occurs as a result of ventilatory barotrauma and oxygen toxicity. Superoxide dismutase, along with other antioxidants, may be beneficial as a free radical scavenger to reduce oxygen toxicity. Inhaled nitric oxide may reduce oxygen requirements by reducing ventilation-perfusion mismatching, and early treatment with corticosteroids may reduce pulmonary inflammation. All of these treatments are currently undergoing clinical trials.

Humans↗