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Biomedical subjects

R Gale

Publications and source records attributed to R Gale.

At least 73 records · Page 4Linked to original sources
PubMed1990

A randomized, controlled application of the Wallaby phototherapy system compared with standard phototherapy.

The feasibility and efficacy of a fiberoptic blanket (Wallaby Phototherapy System) for the treatment of physiologic jaundice was compared with conventional phototherapy. Forty-two full-term infants with nonhemolytic jaundice were included in the study. Infants in the study group were treated with the fiberoptic blanket and the infants in the control group were placed under a standard phototherapy unit. Both the fiberoptic blanket and the standard phototherapy unit delivered an average irradiance of 7.0 +/- 0.5 muw/cm2/nm. Incremental changes in serial plasma bilirubin levels compared with the initial bilirubin concentration did not differ between the study and control groups. For infants whose initial plasma bilirubin concentration exceeded 200 mumol/L, a statistically significant difference was found in both study and control groups between the average bilirubin level at initiation of phototherapy and the average bilirubin level at termination of treatment. We conclude that phototherapy delivered by the fiberoptic blanket is safe and has efficacy comparable to that of conventional phototherapy, providing a convenient alternative phototherapy application strategy that obviates the need for eye patches and facilitates maternal handling of the infant during therapy.

Bedding and Linens↗
PubMed1990

Effect of maternal smoking and age on congenital anomalies.

The incidence of congenital anomalies was examined by the level of maternal and paternal smoking during pregnancy for 17,152 infants. A multiple regression analysis was used to control for the possible confounding effects of maternal age, formal education, ethnic origin, religion, marital status, parity, social class, and work outside the home. Neither maternal nor paternal smoking habits were significantly associated with the occurrence of congenital malformations. Maternal age was significantly (P less than .005) related to the incidence of major anomalies. Mothers aged 35 years and older who smoked were found to have a significantly (P less than .002) higher risk for minor malformations and a nonsignificantly increased rate of major malformations. Maternal cigarette smoking may be an important preventable risk factor for congenital anomalies among mothers aged 35 years or older.

Congenital Abnormalities↗
PubMed1989

A prospective study of the active management of labor in women of high parity.

High parity has been suggested as contra-indication for the use of oxytocin stimulation in labor. The aim of our study was to prospectively evaluate a protocol of oxytocin administration in 130 consecutive low-risk patients having their sixth or subsequent delivery. Induction of labor failed only in 5 cases. No adverse effect on maternal and perinatal outcome was found. We conclude that with the introduction of electronic fetal monitoring and direct recording of uterine activity, oxytocin can be safely used for low-risk grand multiparae.

Adult↗
PubMed1989

The effect of abortion on the incidence of pre-eclampsia.

The incidence of pre-eclampsia was studied in 9771 women that were pregnant for the first or second time. The protection offered by a previous pregnancy which ended in abortion was compared to that provided by a first pregnancy that proceeded to term. The rate of pre-eclampsia was 2.9% for primigravid women and was significantly lower (1.5%, p less than 0.001) for women giving birth for the second time. Adjusting by multiple regression for confounding factors (e.g., maternal age, social class, ethnic origin and smoking), the incidence of pre-eclampsia was also significantly lower (p = 0.038) following an induced abortion, but not following a spontaneous abortion.

Abortion, Induced↗
PubMed1989

The c-myc oncogene is regulated independently of differentiation in myeloid cell lines.

Human myeloid leukaemia (U-937 and HL-60) cells when incubated at low cell densities with human recombinant gamma-interferon underwent functional maturation without any loss of proliferative potential relative to uninduced cells. In addition, the proportion of cells in S,G2/M and levels of c-myc oncogene (mRNA and protein) were maintained at the same level as those of untreated control cells. However, cells grown under similar conditions but with retinoic acid matured to the same extent but became growth inhibited with concomitant reductions in the proportion of cells in S,G2/M and levels of c-myc mRNA and protein. These studies indicate firstly that c-myc levels are regulated independently from differentiation in myeloid (non lymphoid) cells, secondly that gamma-interferon can induce differentiation without growth arrest under conditions of low cell density and thirdly emphasise the close association of c-myc expression with proliferative capacity.

Cell Cycle↗
PubMed1989

Is teenage pregnancy a neonatal risk factor?

Maternal characteristics and neonatal outcome of 421 primiparas aged 15-19 years who delivered at Bikur Cholim Hospital in Jerusalem were examined. The study group included 190 teenage mothers from the Mea Shearim community who marry young and who receive extensive social and economic support. The control group included 231 teenage mothers from other areas of Jerusalem, characterized by a predominantly low social class, Oriental ethnic origin, and a high rate of out-of-wedlock births (28.6%). The Mea Shearim mothers had a significantly lower incidence of low birth weight (less than 2500 g) infants compared to the control group (6.3% vs. 14.7%, p less than 0.01). The differences could not be explained by maternal age distribution, ethnicity, smoking, or marital status. These results suggest that in a community that provides extensive social and economic support and good access to free prenatal care of high standard, teenage pregnancy is not a neonatal risk factor.

Adolescent↗
PubMed1989

Changing medical education.

This paper is based on one which was prepared to support the World Conference of the World Federation for Medical Education in August 1988. It is designed to provide a broad perspective on the essential elements of an educational change process. The paper covers the stages in designing a change strategy and highlights the difficulties that any change agent is likely to encounter. A review of the history of change in education and organizations is followed by discussion of the need for change and the ability to change. Reasons for resistance to change are presented and discussed. Implementation and reinforcement of change are considered before a final section on evaluation.

Curriculum↗
PubMed1989

Continuous parenteral infusion of vitamin E pharmacokinetics and bilirubin production in premature neonates.

We conclude that 5 mg/kg of vitamin E, administered intra-arterially as an 8-hour continuous infusion, significantly and predictably raises serum vitamin E levels into the supraphysiologic range with no apparent side effects. In a group of premature infants whose initial serum vitamin E levels were generally greater than or equal to 0.5 mg/dL, no decrease in bilirubin production was observed. Thus, vitamin E deficiency probably does not play a prominent role in jaundice of prematurity.

Bilirubin↗
PubMed1989

Suckling stimulation test for neonatal tremor.

The response of neonatal tremor to a suckling stimulation test was investigated in 102 healthy neonates born at full term. In 84 the tremor resolved immediately; none had hypocalcaemia and only one had mild hypoglycemia. Eighteen in whom the tremor continued had either hypocalcaemia (n = 13) or hypoglycaemia (n = 5).

Humans↗
PubMed1989

Breast-feeding of term infants. Three-hour vs. four-hour non-demand. A randomized controlled reappraisal of hospital-based feeding schedules.

On those maternity wards where "rooming in" is not practiced, infants are fed according to fixed schedules. The purpose of this study was to investigate possible differences between two common feeding regimens, three-hourly vs. four-hourly feeds during the first 3 days of life. A group of 152 singleton, full-term infants with birth weights 2,500-2,990 g, born at Bikur Cholim Hospital in Jerusalem from February 1988, to August 1988, were randomly assigned to one of two breast-feeding groups and followed prospectively. The study group (62 infants) was breast-fed every 4 hours, and the control group (90 infants) every 3 hours. The two groups were statistically similar for mean maternal age, parity, ethnic origin, social class, neonatal Apgar scores, birth percentile, and mean birth weights. Infants who breast-fed every 4 hours did not have greater transitional weight loss or higher serum bilirubin levels compared to infants fed at 3 hour intervals.

Adult↗
PubMed1989

Hyponatremia in a neonate of a cocaine abusing mother.

Neonatal hyponatremia can be caused by increased sodium losses, inadequate sodium intake, increased maternal or neonatal water load or by water retention secondary to excess of ADH release. Cocaine use by pregnant women has not as yet been reported to correlate with hyponatremia in the newborn infant. We present a case of an infant whose mother used cocaine regularly during the last stages of pregnancy and who developed hyponatremia in the first week of life. A mechanism is proposed and discussed.

Adult↗
PubMed1989

Sinusoidal heart rate pattern and an normal biophysical profile in a severely compromised fetus.

A case is described in which a woman complained of weakened fetal movements, and a persistent sinusoidal heart rate pattern was demonstrated in the presence of normal fetal breathing movements, normal fetal tone, and normal amount of amniotic fluid. In view of the subjective complaints and disregarding the normal biophysical profile, termination of pregnancy was performed. A compromised, severely anemic fetus was delivered by cesarean section. The role of sinusoidal heart rate pattern and the limitations of biophysical scores as a single determinant of fetal well being are discussed.

Adult↗
PubMed1989

Carbon monoxide excretion as an index of bilirubin production in rhesus monkeys.

The role of increased heme catabolism in neonatal hyperbilirubinemia was investigated in rhesus (Macaca mulatta) neonates through the measurement of carbon monoxide excretion rates (VECO), blood carboxyhemoglobin content (HbCO), and plasma bilirubin concentrations. Neonatal values were compared to those of adult rhesus monkeys. These indices of bilirubin production responded appropriately to administration of NEM-damaged erythrocytes and tin protoporphyrin. Our results indicate that VECO measurements are a valid index of changes in bilirubin production in the newborn rhesus monkey.

Animals↗
PubMed1989

The effect of maternal weight gain in pregnancy on birth weight.

The association between maternal weight gain during pregnancy and the infant's birth weight was studied in 14,121 term singleton births. The parturients were stratified into four body-mass categories, three age groups, four parity groups, and three levels of educational attainment. A separate multiple regression analysis was performed for each category to control for the confounding effect of gestational age, maternal social class, ethnicity, cigarette consumption, marital status, age, parity, education, and weight for height. A significant positive influence of prenatal weight gain on birth weight was found for all subgroups. The effect varied depending on maternal pre-pregnancy body mass, age, parity, and the level of formal education.

Adult↗
PubMed1988

Grand multiparity: an obstetric or neonatal risk factor?

Grand multiparity has been considered to be a factor in maternal and neonatal morbidity. In addition, families with seven or more children have been associated with low socioeconomic status. To minimize the confounding effect of the socioeconomic status, the outcome of grand multiparity has been investigated in a mostly homogeneous, ultraorthodox Jewish community in Jerusalem, Israel. A total of 5916 deliveries in one community hospital (Bikur Cholim) were studied, of which 893 (13%) occurred in mothers who had given birth to seven or more infants. There was a significant decrease in the incidence of small for gestational age infants among the grand multiparous women (3.6% as opposed to 5.8% in the control population). This difference was independent of maternal age. Moreover, grand multiparous women gave birth to significantly more large for gestational age infants. No increase in obstetric complications or neonatal morbidity and mortality was found among the offspring of the grand multiparous mothers. Having taken socioeconomic status into account, we conclude that grand multiparity does not carry an increased risk of perinatal morbidity or mortality.

Delivery, Obstetric↗
PubMed1988

Chronic benzodiazepine treatment increases the effects of the inverse agonist FG7142.

A schedule of treatment with the benzodiazepine, flurazepam, in mice for 7 days caused a significant enhancement of the convulsive effects of the partial inverse agonist FG7142. Full convulsions were seen with FG7142 after the chronic administration of flurazepam, although this compound does not cause convulsions in normal mice of the strain used. The change appeared to be maximal at 24 hr after the last dose of flurazepam and lasted for up to a week. The chronic treatment with flurazepam caused tolerance to the effects of flurazepam, but the tolerance was of shorter duration than the increase in the effects of FG7142. When the benzodiazepine antagonist, Ro 15-1788, was given with the flurazepam, the incidence of convulsions induced by FG7142 was no longer significant. Repeated administration of midazolam also slightly increased the effects of FG7142. Single doses of flurazepam or midazolam did not significantly alter the effects of FG7142, although some convulsions were seen.

Animals↗