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Biomedical subjects

R Dinwiddie

Publications and source records attributed to R Dinwiddie.

At least 73 records · Page 4Linked to original sources
PubMed1983

Haemorrhagic shock and encephalopathy: a new syndrome with a high mortality in young children.

In the past year, ten infants have been admitted to hospital with a new or previously unrecognised disorder, characterised by an acute onset of encephalopathy, fever, shock, watery diarrhoea, severe disseminated intravascular coagulation, and renal and hepatic dysfunction. Seven of the infants died. No specific causative agent has been identified, but preliminary studies suggest that the pathophysiology of the disease may involve release of proteolytic enzymes (such as trypsin) into the circulation, with destruction of the microcirculation.

Acute Disease↗
PubMed1983

Survival rates in cystic fibrosis.

Life tables were calculated for 273 British children with cystic fibrosis for the period 1974-9. There was a marked improvement in survival rates in the meconium ileus group compared with the 1969-73 data, but there was little improvement in patients presenting later with other symptoms.

Adolescent↗
PubMed1983

Plasma terbutaline levels in asthma.

Plasma terbutaline levels and peak expiratory flow rates were measured in 5 asthmatic children using doses of 0.25 and 0.075 mg/kg. The higher dose resulted in safe, non-toxic plasma levels and returned the peak expiratory flow rate to normal. This dose (maximum 5 mg) is safe in children.

Asthma↗
PubMed1983

Desquamative interstitial pneumonia and antigen-antibody complexes in two infants with congenital rubella.

Desquamative interstitial pneumonia was observed in two infants with the late-onset congenital rubella syndrome. In both infants this unusual lung disease was associated with circulating immunoglobulin M complexes and interstitial pulmonary deposits of IgM by immunofluorescence. Both infants had IgG deficiency. The first child recovered with a reduction in IgM complex levels and synthesis of rubella-specific IgG. The second infant died during the acute phase of his illness at which time there were high serum concentrations of IgM complexes and slightly increased levels of IgG complexes. Delayed maturation of the immune response in congenital rubella may predispose to persistent antigenemia and pulmonary deposition of rubella antigen-containing IgM complexes resulting in an acute form of interstitial pneumonia.

Antigen-Antibody Complex↗
PubMed1982

Nasopharyngeal airways in Pierre Robin Syndrome.

Nasopharyngeal airways have been assessed in the management of infants with severe Pierre Robin syndrome. In 12 such infants the positioning and subsequent maintenance of these tubes were found to be important in ensuring adequate relief of the airway obstruction. In five infants measurements of lung mechanics demonstrated the benefits of NP tube placement and confirmed the observed improvements in cyanotic episodes, heart failure, electrocardiograms, and arterial gas tensions. In a retrospective survey of 40 infants with PRS, failure to thrive was found to be significantly correlated with the severity of the airflow obstruction. This failure to thrive was reversed in the infants managed with NP tubes in comparison with an age-matched groups nursed while prone. The lack of significant complications with the NP airway and its acceptability to nursing staff, patients, and their parents suggest that this method deserves more widespread use in PRS and perhaps in other situations in which high upper respiratory tract obstruction is predominant.

Airway Obstruction↗
PubMed1982

Milk antigen absorption in the preterm and term neonate.

The concentrations of beta-lactoglobulin was measured in the sera of 47 preterm an term neonates during the first few days of life under standardised conditions after feeding with a cows' milk'based formula. Preterm neonates, particularly those of less than 33 weeks' gestation, had higher serum concentrations of beta-lactoglobulin than term neonates given an equivalent mild feed. Prior feeding with breast milk did not diminish the amount of beta-lactoglobulin absorbed. Our results suggest tha te ability of the gastrointestinal tract to exclude antigenically intact food proteins increases with gestational age and that gut closure occurs normally before birth in man.

Breast Feeding↗
PubMed1979

Mycoplasma hominis. A cause of neonatal meningitis.

Two cases of Mycoplasma hominis meningitis in the newborn are described. These infants demonstrate the need to consider M. hominis as a cause of neonatal meningitis, especially if the Gram stain is negative, conventional cultures yield no growth, and there is a history of maternal infection. CSF cultures on appropriate medium can quickly confirm the diagnosis.

Adult↗
PubMed1979

Cardiopulmonary changes in the crying neonate.

To determine hemodynamic effects of crying, 12 newborn infants recovering from the respiratory distress syndrome (RDS) were studied. When crying, the range of inspiratory esophageal pressure was -18.8 to -32.5 cm H2O and the range of espiratory pressure was +6.2 to 34.4 cm H2O. The esophageal pressure remained positive for a mean value of 66% of the respiratory cycle. There was a mean significant increase in heart rate of 19 beats/min. The systolic and diastolic blood pressures increased significantly at the beginning of strain to 115 and 135% of the respective control values. There was a progressive decrease in systolic and diastolic pressures during the period of strain and the systolic pressures reached values significantly less than control. With the decrease in systolic and diastolic pressures, there were pronounced reductions in pulse pressures. Three infants reached pulse pressure values less than 1% of control when cries were sustained for nine cardiac cycles. There was a significant mean decrease in arterial oxygen tension (PaO2) of 16.8 mm Hg. There were no changes in arterial carbon dioxide tension (PaCO2), pH, or base excess.

Blood Pressure↗
PubMed1977

The effects of feeding on arterial blood gases and lung mechanics in newborn infants recovering from respiratory disease.

Fifteen infants recovering from neonatal respiratory disease had arterial blood gases and lung mechanics measured 5 minutes before bolus feeds and at 5, 10, 20, and 30 minutes after feeding to determine physiologic effects of feeding. PaO2 fell significantly from prefeeding values at 5, 10, and 20 minutes after feeds. Mean prefeeding pH and base excess values were significantly different from mean postfeeding values at 5, 10, 20, and 30 minutes, respectively. PaCO2 remained unchanged before and after feeding. Heart rate and systolic and diastolic blood pressure did not change throughout the study. Dynamic lung compliance, respiratory, rate, and tidal volume did not change significantly but there was a trend toward increase in tidal volume. Mean minute volume rose with time as a consequence of the increased tidal volume. Work of breathing remained unchanged at 10 and 20 minutes postfeed and increased slightly at 30 minutes; this was due to a small increase in both elastic and viscous work components at this time.

Carbon Dioxide↗
PubMed1977

Tracheal extubation of the neonate at 2 to 3 cm H2O continuous positive airway pressure.

To investigate the efficacy of extubation at higher levels of continuous positive airway pressure (CPAP), 49 newborns (0.95 to 4.0 kg) were extubated at 2 to 3 cm H2O following 1 to 47 days of CPAP therapy. Pre- and postextubation measurements of Po2, PCO2, pH, FiO2, and CPAP were made in all infants. No significant differences (P less than.05) were found between pre- and post-extubation arterial blood gas values for all patients. Comparison of pre- and post-extubation blood gas data with respect to birthweight (less than 2.0 kg vs greater than 2.0 kg) and intubation time (less than 8 days vs. greater than 8 days) also indicated no statistical differences. Mean alveolar-arterial oxygen differences and FiO2 for 41 infants showed progressive decreases following extubation. Six of the 49 infants required reintubation within 72 hours following extubation. The results of this study indicate that newborns with respiratory disease requiring CPAP may be extubated at 2 to 3 cm H2O with no significant changes in arterial blood gas values, thus preventing prolonged intubation associated with weaning to 0 cm H2O CPAP.

Birth Weight↗