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Biomedical subjects

H Simpson

Publications and source records attributed to H Simpson.

At least 109 records · Page 6Linked to original sources
PubMed1986

'Near-miss' or 'near-myth' for sudden infant death syndrome? Clinical observations on 57 infants.

A clinical approach to infants who may have 'nearly missed' Sudden Infant Death Syndrome (SIDS) is suggested as appropriate whether or not the eventual conclusion is that there is no connection between these surviving infants and those who die of SIDS. A non-restrictive investigative approach has been applied to 57 infants with episodes causing similar levels of alarm and recourse to medical aid but not exclusively having documented apnoea or need for cardiopulmonary resuscitation. Similarities among patients in past history, recent minor symptoms, modes of presentation and positive investigations support the concept that they may show a common response to a variety of pathophysiologic stresses. Epidemiological similarities to SIDS cases support the suggestion that SIDS may be the end-stage inadequate response to such stresses. Future studies should address the reasons for 'inappropriate' collapse, its treatment and prevention and be alert to any resultant effect upon the incidence of SIDS or further evidence of a link between the conditions.

England↗
PubMed1985

Reversibility effects on renal and hepatic gluconeogenic enzymes in rats from chronic exposure of cadmium.

The reversibility of cadmium chloride (CdCl2) effects on renal and hepatic gluconeogenic enzymes in rats was studied by removal of CdCl2 from the diet. Adult, male Sprague-Dawley rats were continuously treated with 0, 25, 50, and 75 ppm CdCl2 mixed in powdered diet for 180 d. After this period of chronic exposure, all treated rats were kept on CdCl2-free diet for another period of 180 d. The CdCl2 induced serum glucose and activities of glucose 6-phosphatase, fructose 1, 6-bisphosphatase, and phosphoenolpyruvate carboxykinase reversed to the levels of control values 120 d after the rats were fed with CdCl2-free diet. There were no significant differences in measured enzyme activities either 120 or 180 d after the cessation of CdCl2 treatment. The data indicate that CdCl2 effects on gluconeogenesis will gradually recover with time when the metal is removed from the diet.

Alanine Transaminase↗
PubMed1985

Night cough counts and diary card scores in asthma.

A tape recording system for recording night cough in asthmatics at home is described. Objective cough counts and half hour periods containing cough did not correlate with diary card scores awarded to eight children on seven nights each. Night cough diary scores may mislead in the assessment of symptom severity.

Asthma↗
PubMed1985

Sleep apnoea in infancy.

Serial polygraphic sleep studies were carried out in 86 index infants (33 'symptomatic', 24 siblings of infants with the sudden infant death syndrome (SIDS), 29 'near-miss' for SIDS) and 11 healthy controls. Brief (greater than or equal to 3 less than 6 sec) or prolonged (greater than or equal to 6 sec) obstructive apnoea was observed only in index caes, and coincided with symptoms due to associated illnesses (usually respiratory). Their prevalence was comparable in 'symptomatic' and 'near-miss' groups--39% and 35% respectively. Prolonged (greater than or equal to 20 sec) central apnoea was seen only in pre-term 'near-miss' infants. Dips in transcutaneous oxygen tension greater than or equal to 15 mmHg occurred during sleep in 17% of 'symptomatic' infants and 19% of 'near-miss' cases, usually in association with obstructive or central apnoea. Diminution or disappearance of these abnormalities following clinical recovery from 'minor' illnesses suggested that they were the result of such illnesses.

Electrocardiography↗
PubMed1984

Home monitoring for central apnoea.

Between July 1978 and December 1981, 64 infants thought to be at increased risk from sudden infant death syndrome (SIDS) were monitored at home for central apnoea. Twenty four of the infants had had a 'near miss' episode at age, median (range), 6 (1 to 33) weeks, and of these infants 22 had had 335 alarms for apnoea by age 6 months. Stimulation by shaking was carried out on 38 occasions and bag and mask resuscitation on one. The remaining 40 infants were siblings of SIDS victims and of these, 35 were monitored from age 1 week (usually after discharge home). Thirty four of the SIDS siblings had had 573 alarms for apnoea by age 6 months: stimulation by shaking was carried out on 32 occasions and bag and mask resuscitation on one. The duration of home monitoring was, median (range), 34 (8 to 87) weeks for 'near miss' infants and 45 (12 to 70) weeks for SIDS siblings. All infants survived. As part of an over all support system monitors were accepted and greatly appreciated by most parents, especially those with previous experience of SIDS. Home monitoring was practicable but the commitment in time and expertise was great and objective benefits to the infant remain unproved.

Apnea↗
PubMed1984

Symptoms, atopy, and bronchial reactivity after lower respiratory infection in infancy.

We studied the prevalence of subsequent respiratory symptoms and the relation between atopic status and bronchial reactivity in 200 index children and their controls 7 years after acute lower respiratory tract infections in infancy. Index children with recurrent symptoms differed from controls in respect of social and family characteristics and atopic background. Ventilatory function was diminished and bronchial reactivity increased. Symptom free index children also came from poorer environmental backgrounds, but did not otherwise differ from controls. 'Atopic' index children differed significantly from controls in respect of subsequent symptoms and ventilatory function and similar adverse trends were observed in 'non-atopic' index children. A comparable proportion of 'atopic' and 'non-atopic' index children showed bronchial reactivity (33.5% and 38.9% respectively). Index subgroups with and without bronchial reactivity had increased cough and wheeziness compared with respective matched controls. The former included children with 'established' asthma and the latter those with 'established' bronchitis. Atopic backgrounds were similar in both subgroups, with no differences between cases and controls. These findings suggest that atopic background and bronchial reactivity are not closely related but may contribute independently to the persistence of symptoms after respiratory infections in infancy. Bronchial reactivity may be a more useful basis than atopic status on which to separate children with episodic cough or wheeze, or both, into 'asthmatic' and 'bronchitic' subgroups.

Cough↗
PubMed1984

Outcome for acute bronchitis, bronchiolitis, and pneumonia in infancy.

The clinical and respiratory function characteristics of 200 children 7 years after their admission to hospital with acute lower respiratory tract infection in infancy have been presented. Results were subsequently analysed according to disease category (bronchitis, bronchiolitis, or pneumonia) at initial presentation. Within each diagnostic category recurrent cough and wheeze, a tendency for colds 'to go to the chest', medication, absence from school, and family doctor consultations were significantly increased. Ventilatory function was diminished and bronchial reactivity increased when compared with matched controls. Studies of a different design are required to elucidate the mechanisms whereby symptoms are increased, ventilatory function impaired, and bronchial reactivity increased after severe lower respiratory infection in infancy.

Bronchiolitis, Viral↗
PubMed1983

Gastro-oesophageal reflux in near-miss sudden infant death syndrome or suspected recurrent aspiration.

We have compared barium swallow with a radionuclide gastro-oesophageal scintigraphy (milk scan) method of detecting gastro-oesophageal reflux in 26 infants. In 17 cases, presenting as near miss sudden infant death syndrome, reflux was detected in 2 by barium swallow and in 8 by scintigraphy. In the remaining 9 infants with suspected pulmonary aspiration, reflux was demonstrated by barium swallow in 2 and by scintigraphy in four. Aspiration after gastro-oesophageal reflux was demonstrated only by the radionuclide scan. The feasibility of recording physiological variables during periods of reflux was confirmed.

Female↗
PubMed1983

Pulmonary function in severe chronic asthma in children during apparent clinical remission.

We have studied PEF, MEFV curves and the response to breathing He/O2 in 10 children (mean age 12 years) with severe steroid dependent asthma during a two year period. Abnormalities of ventilatory function were almost invariably present, with FEV1 and V50, breathing air or He/O2, the commonest indices of abnormality. FEV1 was comparable in sensitivity to V50 in detecting airflow obstruction. Clinical criteria of severity greatly underestimated the degree of functional impairment. The absolute, but not the relative response to inhalation of He/O2 was reduced at 50% VC and 25% VC. Following the inhalation of salbutamol, FEV1 V50 and V25 increased significantly in every case.

Adolescent↗
PubMed1982

Outcome of acute lower respiratory tract infection in infants: preliminary report of seven-year follow-up study.

Seven years after admission to hospital for acute lower respiratory tract infection in infancy 200 children and their matched controls were assessed for respiratory state and epidemiological characteristics. The index group comprised 100 cases where respiratory syncytial virus infection had been responsible for the index illness (group 1) and 100 cases in whom this organism had not been found (group 2). There were no differences between index and control groups in birth weight or gestational age but fewer index cases were breast fed. Social indices such as class distribution and family size were more favourable in controls, though housing standards and maternal smoking habits were similar in the two groups. The prevalence of subsequent respiratory symptoms--cough, wheeze, nasal discharge, and hearing difficulties--was greater in index cases as was absence from school and family doctor consultation for respiratory illness. Bronchitis and asthma were significantly more common in the index group. Impaired ventilatory function and bronchial hyperreactivity were found in index cases when compared with controls. No differences in clinical characteristics and outcome were found in the two groups of index cases. The question whether lung "damage" during lower respiratory tract infection predisposes to subsequent respiratory problems or whether certain infants are more vulnerable than others to respiratory illnesses (including lower respiratory tract infection) from the onset is unanswered.

Acute Disease↗
PubMed1982

Atopy predisposing to acute bronchiolitis during an epidemic of respiratory syncytial virus.

Thirty-one infants admitted to hospital with acute bronchiolitis during an epidemic of respiratory syncytial virus were compared with a control group of 32 infants to establish whether the two groups differed in atopic background. Past history of respiratory illness, eczema, and present reactions to skin testing differed significantly between the two groups. Thus, infants with acute bronchiolitis had a significantly higher atopic predisposition than the controls.

Bronchiolitis, Viral↗
PubMed1982

Mortality rates and neonatal intensive care for very small babies.

Mortality rates of very small babies (those weighing 1500 g or less) born to mothers normally resident in the 11 health districts of the London portion of the North-east Thames Health Region in 1971-73 and 1975-77 were compared with admission rates to neonatal intensive care units in 1972 and 1976 in the region. There was no significant correlation between mortality and admission rates for babies weighing 1000 g or less during either period. For babies born weighing between 1001 and 1500 g this was also so in 1972. In 1976 however, mortality rates were significantly correlated negatively at 24 hours but not at 28 days with admission rates to neonatal intensive care.

Critical Care↗
PubMed1982

Sleep apnoea in acute bronchiolitis.

Three- to 4-hour polygraphic sleep studies were carried out in 16 infants aged between 1 and 6 months during and after recovery from acute bronchiolitis. During bronchiolitis 35% of total sleep time was active sleep compared with 31% after recovery. Respiration rate was increased during bronchiolitis and was higher in active sleep and quiet sleep irrespective of the stage of the illness. Apnoeic pauses were invariably shorter than 15 seconds, the mean duration for active sleep and quiet sleep being similar during infection and after recovery. Apnoeic episodes were central in type and generally initiated by a sign or body movements. Preapnoea heart rate was significantly higher than during or after apnoea. Apnoea index (the percentage of time the baby spends apnoeic), apnoea attack rate (the number of episodes of apnoea per unit time), and apnoea percentage (the distribution of episodes of apnoea while in a given sleep state) were increased significantly in quiet sleep during the index illness. Transcutaneous oxygen tension was significantly reduced during the course of infection, but comparable values were obtained in active sleep and quiet sleep during initial and recovery periods. These results show that the main changes in respiration pattern during the course of acute bronchiolitis occur in quiet sleep.

Acute Disease↗
PubMed1982

Infant diarrhoea and subsequent mortality from heart disease and cancer.

A preliminary examination of the relationship between the infant mortality of US birth cohorts and their mortality in later life suggested that infant mortality from diarrhoea and enteritis was particularly influential. In the 1917-21 birth cohorts of 17 US Registration States, infant mortality from diarrhoea and enteritis was significantly related to arteriosclerosis heart disease at ages 40-44 and 50-54 in both sexes, and to respiratory cancer at the same ages in men, after controlling for contemporary infant mortality. Hypotheses suggest by these relationships are put forward.

Adult↗