Search PubMed⌕ Search

Biomedical subjects

I Arad

Publications and source records attributed to I Arad.

72 records · Page 4Linked to original sources

Determinants of forced expiratory flows in newborn infants.

Maximal flows at functional residual capacity (VmaxFRC) from partial expiratory flow-volume (PEFV) curves (achieved with rapid compression of the chest) were obtained on 11 healthy newborn babies. Mean VmaxFRC, size corrected by dividing absolute values by measured thoracic gas volume, was 1.90 TGV's/s. Specific upstream conductances were high, and the cross-sectional area of the flow-limiting segment was estimated to be approximately 0.30 cm2 in the three infants on whom recoil pressures at FRC were also measured. The cross-sectional area of the major bronchi in the neonate is approximately 0.26-0.30 cm2. PEFV curves were convex to the volume axis. Many of the neonates increased their flows while breathing a helium-oxygen gas mixture. These results suggest 1) size-corrected flows are higher in the neonate than in older children or adults; 2) the site of the flow-limiting segment at FRC during maximal expiratory maneuvers is in large proximal airways, similar to the adult; and 3) the relationship of airway size to parenchymal size may be similar in neonates and adults or, in fact, airways may be larger, relative to parenchyma, in neonates. These physiological data do not support the hypothesis, based on pathological studies, that peripheral airways are disproportionately smaller (when compared with central airways) in infants than in adults.

Airway Resistance↗

Vacuum extraction and neonatal jaundice.

Various fetal scalp lesions are related to the use of the vacuum extractor. Blood sequestered in these lesions could result in an increased bilirubin load on the functionally limited neonatal liver, leading to the development of hyperbilirubinemia. In the present study bilirubin levels of vacuum extracted neonates were compared with those of non-instrumentally delivered babies during the first 72 hours of life. Sixty-nine vacuum extracted neonates had higher bilirubin levels than 56 non-instrumentally delivered babies at 24 (114 mumol/l vs. 96 mumol/l), 48 (163 vs. 141) and 72 (194 vs. 144) hours of age. The p values were 0.05, less than 0.025 and less than 0.001 respectively. This trend was apparent in both oxytocin induced and non-induced deliveries and whether or not phototherapy cases were included in the analysis. The incidence of hyperbilirubinemia requiring phototherapy was higher after vacuum extraction than after non instrumental delivery (27.5% vs. 12.5%; p less than 0.04). Analysis of our results unexpectedly indicated that oxytocin induction was generally associated with an attenuation of bilirubin levels after both vacuum extraction and spontaneous delivery. The clinician attending newborn babies should be aware of the higher incidence of neonatal hyperbilirubinemia associated with vacuum extraction.

Bilirubin↗

Exchange transfusion in newborns via a peripheral artery and vein.

Exchange transfusion using a peripheral artery and vein was carried out 18 times in 17 newborn infants. The arteries use to withdraw blood were the radial [13], the ulnar [3] an the posterior tibial [2]. Infusion of blood was carried out simultaneously through a peripheral vein. There was no mortality or morbidity directly associated with the procedure. We recommend this technique for exchange transfusion in general, and especially in the very ill newborn.

Arteries↗

Umbilical care and cord separation.

Four different treatments for the care of the umbilical cord were compared in a randomised, controlled study. Triple dye was associated with a significantly earlier separation of the cord than either 1% neomycin or 1% silver sulphadiazine ointment, and it was nearly as effective as bismuth subgallate (an astringent powder) in causing rapid sloughing. If the mother is made aware that care of the umbilical cord may delay cord separation she may be spared unnecessary concern.

Clinical Trials as Topic↗

Familial Ebstein's anomaly.

A family is described in which both a father and son are affected with Ebstein's anomaly, while several other family members manifest different cardiac malformations. Five additional instances of familial Ebstein's anomaly were found in the literature and compared with our family. Inspection of possible modes of inheritance in this group of families suggests that Ebstein's anomaly is probably inherited as a polygenic character with a threshold phenomenon.

Adult↗

Application of the cilia dyskinesis test in the diagnosis of cystic fibrosis in an adolescent.

In certain cases of obscure chronic lung disease, the possibility of a genetic disorder, such as cystic fibrosis of the pancreas, should be considered. When the genetic defect fails to cause pancreatic involvement, the partial expression of cystic fibrosis is encountered. Elevation of sweat electrolyte levels is not sufficient to confirm the diagnosis of cystic fibrosis in adults since normal levels vary widely in both adolescents and adults. Other tests should, therefore, be utilized. The cilia dyskinesis test is positive in both homozygous and heterozygous patients with cystic fibrosis. Utilization of this technique in a family study confirmed the diagnosis of partial expression of cystic fibrosis in an adolescent female.

Acid-Base Equilibrium↗

Lung function in infancy and childhood following neonatal intensive care.

Pulmonary function studies were performed in 11 neonatal intensive care survivors both during infancy and later in childhood. Lung function was compared with the respiratory support given in the neonatal period. The mean +/- SE thoracic gas volume was 96 +/- 4% predicted in infancy and rose to 122 +/- 8% predicted during childhood (P less than 0.005). The specific airway conductance (SGaw) in infancy was 57 +/- 7% predicted and rose to 90 +/- 8% predicted in childhood (P less than 0.0025). Abnormalities in SGaw were found only in ventilated infants, and there was a negative logarithmic correlation between the treatment score in the neonatal period and the SGaw in both infancy and childhood. The data indicate a long-term improvement in airway conductance of moderately affected infants with the development of mild hyperinflation in childhood possibly resulting from residual small airway abnormalities despite a symptomless clinical course. The residual abnormalities in prematurely born infants were in proportion to the intensity of treatment required in the neonatal period.

Child↗

Serum-growth hormone and free-fatty-acids levels following angiocardiography in children.

Blood-free-fatty acids (F.F.A.) and growth-hormone levels were determined in 9 children subjected to cardiac catheterization and angiography. A significant rise of growth-hormone level was recorded immediately after angiocardiography, followed by a marked increase of F.F.A. levels 2--4 hours after termination of the catheterization. These results may indicate that the high levels of F.F.A. sustained after cardiac catheterization and angiography are probably due to the increase of growth -hormone secretion during the procedure.

Adolescent↗

Evaluation of human fetal urine as a source of amniotic fluid phospholipids.

The accumulation of surface active material in amniotic fluid during gestation is assumed to result from lung fluid secretion through the trachea. Some animal studies, however, have indicated that virtually all of the tracheal fluid is swallowed, whereas little if any enters the amniotic cavity. Following these observations fetal urine has been considered by some authors as an alternative source of amniotic fluid phospholipids. However, the phospholipid content of human fetal urine has not yet been determined. We have determined the L/S ratio and lamellar body concentration in human amniotic fluid and fetal urine obtained during 3 term cesarean deliveries. While both the L/S ratio and lamellar body particle concentration in the amniotic fluid samples were equivalent to values reported in term pregnancies, no measurable lecithin or sphingomyelin peaks were demonstrated in the urine samples and very few, if any, particles were counted. The lack of similarity between determinants of surface activity in human amniotic fluid and fetal urine does not support a major contribution of fetal urine to the phospholipid content of amniotic fluid.

Amniotic Fluid↗

Ocular findings in arthrogryposis multiplex congenita.

Close ophthalmological follow-up of a case of arthrogryposis multiplex congenita disclosed a progressing paresis of the lateral recti, a gradual decrease in the corneal blinking reflex by the age of eight weeks and a clear deterioration of the visual evoked responses by the first 16 weeks of life along with preservation of normal ERG responses. These observations are believed to represent the gradual affection of the motor and sensorial cranial nerves occurring post-natally in this case of AMC.

Adult↗