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Biomedical subjects

J R Alexander

Publications and source records attributed to J R Alexander.

49 records · Page 3Linked to original sources

Respiratory infections in the first year of life in children at risk of developing atopy.

Ninety-two infants, each of whom had one parent with asthma or hay fever, were followed up from birth to age of 1 year and 72 to the age of three years. During the first year of life respiratory symptoms, eczema, and respiratory viral infections were all reported. Within the first year 24 babies developed eczema; 28 had a wheal of 1 mm in diameter or more on prick skin testing with cutaneous allergens. Forty-three children had one or both of these characteristics and formed an atopic subgroup; by the same criteria, 49 children were non-atopic. The number of respiratory infections in the two groups was not significantly different; similar viruses were isolated from both groups. These viruses were associated with both upper and lower respiratory tract infections. Wheezing was a clinical feature in 12 children during lower respiratory tract infections. Of these babies six were atopic in the first year of life. Of the six non-atopic babies, one had eczema in the second year and five children developed raised total serum IgE values within the 3 years.

Child, Preschool↗

Does joint custody work? A first look at outcome data of relitigation.

Joint custody, with both divorced parents sharing childrearing functions, is a recent and controversial phenomenon. To the authors' knowledge there have been no published quantitative outcome studies establishing its efficacy. The authors present data on 414 consecutive custody cases in a Los Angeles court over a 2-year period, comparing relitigation rates (indicative of postdivorce parental conflict) of exclusive and joint custody. In those cases which were returns to court, the proportion of relitigation for joint custody families was one-half that of exclusive custody families, suggesting that joint custody is a more beneficial arrangement in terms of reduced parental conflict.

California↗

Prolonged apnea and cardiac arrhythmias in infants discharged from neonatal intensive care units: failure to predict an increased risk for sudden infant death syndrome.

Twenty-four hour recordings of respiratory wave form and ECG were made on low-birth-weight and/or premature infants within one week of discharge from eight neonatal intensive care units. Eight infants (0.7%) had episodes of apnea greater than 30 seconds in duration, all of which were accompanied by bradycardia less than 100 beats per minute; 25 infants (2.3%) had a total of 36 apneic episodes between 20 and 30 seconds in duration, 29 of which were accompanied by bradycardia less than or equal to 100 beats per minute; and 19 infants (1.7%) had episodes of bradycardia less than or equal to 50 beats per minute without prolonged apnea (as shown by a lack of breathing movement). Five infants had ventricular premature beats (including one with ventricular tachycardia). Eleven infants had supraventricular premature beats (including two with supraventricular tachycardia and one with preexcitation). Four infants had both supraventricular and ventricular premature beats. Two infants had preexcitation. Eleven infants who underwent 24-hour recordings died. Five infants were victims of sudden infant death syndrome. One infant death was sudden and unexpected and was attributed to bronchopneumonia. Two deaths were associated with congenital heart disease and three were associated with major cerebral disorders. None of the six babies who died suddenly and unexpectedly had apnea greater than or equal to 20 seconds, bradycardia less than or equal to 50 beats per minute, or cardiac arrhythmias on their 24-hour recordings.

Apnea↗

Controlled trial of sulpiride in chronic schizophrenic patients.

In a double-blind comparative trial of sulpiride (600-1,800 mg/day) and trifluoperazine (15-45 mg/day) in 38 chronic schizophrenic patients, ratings of therapeutic results and unwanted effects were made at two-weekly interviews during the six weeks treatment period. The results show that sulpiride has neuroleptic properties and a spectrum of therapeutic activity similar to that of trifluoperazine. There was an association between plasma sulpiride levels and therapeutic response after four weeks' treatment.

Adult↗

Pulmonary function in patients with inflammatory bowel disease.

Pulmonary function has been assessed in 36 outpatients with inflammatory bowel disease. The carbon monoxide transfer factor was found to be significantly reduced in patients as compared with matched controls (P less than 0.01). The reason for this reduction is not clear but it is unlikely to be due to sulfasalazine (Salazosulphapyridine).

Adolescent↗

Characteristics of elderly people admitted to hospital, Part III homes, and sheltered housing.

Approximately 100 consecutive admissions in Southampton to sheltered housing, to Part III homes, and to long-stay geriatric hospital beds in 1975 and 1976 were selected and data were collected by interview with patients and staff. There was a total of 299 admissions in the final sample. The sheltered housing group were younger and more often married than those admitted to Part III homes, who were more often married but only slightly younger than the new geriatric patients. The three groups were separated on dependency measures with almost no overlap between the sheltered housing and the other groups, but a little more evidence of overlap and interchange between Part III and hospital admissions. The patients in hospital whose dependency scores were more typical of Part III residents were almost all special cases and this was found to be true of other apparently misplaced individuals. Most of the sheltered housing admissions were suffering from heart, chest, and musculoskeletal complaints, while new Part III residents had more psychiatric disturbance; cerebrovascular and psychiatric problems occurred most often in the hospital group. The three groups of admissions form distinct categories and it is arguable that this is a concomitant of underprovision. This also shows that there is no great measure of misplacement on the basis of the current norm, although the suitability of this norm in sheltered housing is open to question.

Activities of Daily Living↗

Hypoxaemia in infants with respiratory tract infections.

Nineteen infants who were graduates from special care baby units underwent two overnight tape recordings of oxygen saturation (SaO2) and breathing movements; one during an upper (n = 12) or lower (n = 7) respiratory tract infection and the other when free of infection. Baseline SaO2 was lower during infection (median 99.6 vs 100%, p less than 0.01), with four patients having values (84.3-95.5%) below the normal lower limit for full-term infants (97%). The median number of apnoeic pauses was also lower during respiratory tract infection (4.7 vs 15.7/h, p less than 0.02). The median number of episodic desaturations (SaO2 less than or equal to 80%) did not change significantly (1.3 vs 1.9/h, p greater than 0.05), with the exception of one patient who had extremely increased values during infection for both apnoeic pauses (63/h) and desaturations (112/h). No infant, however, was considered clinically hypoxaemic. Clinically unsuspected hypoxaemia may thus occur during respiratory tract infection in a proportion of infants graduating from special care baby units. Such hypoxaemia may have potentially deleterious effects.

Apnea↗