[Respiratory distress syndrome].
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Humans↗
Biomedical subjects
R Gale
Publications and source records attributed to R Gale.
Noninvasive validation of tobacco smoke exposure in late pregnancy using end-tidal carbon monoxide measurements.
OBJECTIVE: To determine whether exposure to tobacco smoke in late pregnancy can be reliably estimated by measuring carbon monoxide (CO) in the mother and newborn breath. STUDY DESIGN: Sixty-eight mothers and their healthy term singleton newborns, delivered at a university-affiliated community hospital in Jerusalem, were enrolled. End-tidal CO (corrected for inhaled air [ETCOc] was measured with a portable automated bedside CO analyzer. ETCOc, cotinine, and carboxyhemoglobin (COHb) levels were compared in 17 smoking, 31 passively exposed, and 20 nonsmoking mothers and their offspring. RESULTS: The mean +/- SD ETCOc was significantly higher in women who smoked than in passively exposed and nonsmoking mothers (8.42 +/- 5.65 vs 1.95 +/- 0.98 vs 1.33 +/- 0.84 ppm. p < 0.0001, respectively). Newborns whose mothers smoked had higher ETCOc levels than those of infants of passively exposed and nonsmoking mothers (10.0 +/- 7.7 vs 2.51 +/- 1.4 vs 1.74 +/- 0.98 ppm, p < 0.0001, respectively). The number of cigarettes smoked by the mother was significantly correlated with maternal ETCOc (r = 0.755, p < 0.00001), and neonatal ETCOc (r = 0.805, p < 0.00001). Maternal ETCOc was highly correlated with neonatal ETCOc (r = 0.857, p < 0.00001), cotinine (r = 0.645, p < 0.00001), and COHb (r = 0.9, p < 0.00001) levels. Birth weight was significantly associated with neonatal ETCOc (p < 0.006) and maternal ETCOc (p < 0.007). CONCLUSION: ETCOc levels in the newborn are well correlated with maternal smoking. Measurements of newborn ETCOc may be used as a noninvasive means to estimate exposure to maternal tobacco smoke immediately before delivery. These measurements will be useful for patient education and research.
Birth Weight↗
Hyperbilirubinemia and early discharge.
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Humans↗
The incubator as a chemical warfare protective device in neonatal intensive care units.
During the Persian Gulf war chemical warfare (CW) protective devices were distributed to the entire population of Israel. Neonates were to be placed in a protective infant carrier (PIC) or an improved PIC ("active PIC") to which filtered air was actively introduced by a blower. The specific needs of low birthweight babies hospitalized in intensive care units and treated in incubators were not adequately addressed. Transfer to a PIC meant disconnecting the infants from life-supporting systems and monitoring devices and exposing them to changes in ambient temperature. To overcome this difficulty the original incubator was used as a CW protective device. Its ports were sealed and low-grade positive pressure was created. This avoided transfer of the neonates from their controlled environment, reduced physiological stress, and improved medical supervision.
Air Pollution↗
Comparability of English and Welsh doctor of medicine degrees.
A comparison of the regulations required for the degree of Doctor of Medicine revealed wide variations between different universities, e.g. candidates may not receive much supervision or structured teaching. Universal reform is needed to bring this degree in line with the degree of Doctor of Philosophy.
Academic Dissertations as Topic↗
MD candidates want better training in research.
A survey of MD candidates in one teaching hospital and two postgraduate institutes was undertaken to determine their initial training needs, and their preferred methods of learning about the conduct of research. Fifty-six respondents (53% response rate) replied to a piloted questionnaire. Their replies indicated a need for intensive initial research training, offered at local level by the supervisor. The supervisor's subsequent role throughout the research period should be to provide ongoing specific critical help and support. It is concluded that teaching materials and designed teaching sessions might be provided for supervisors to assist them in their new role.
Attitude of Health Personnel↗
Effect of phototherapy for neonatal jaundice on cognitive performance.
Phototherapy for neonatal hyperbilirubinemia was introduced to our medical center in March 1971. To assess the influence of phototherapy on subsequent cognitive outcome, we compared the intelligence test scores at 17 years of age of subjects born 4 months before and 10 months after the introduction of phototherapy. The intelligence quotient score (mean +/- SE) at 17 years for 84 subjects with severe neonatal hyperbilirubinemia was 108 +/- 2 for those treated by phototherapy and 107 +/- 2 for controls matched for gestational age and birth weight. The confounding effect on intelligence quotient scores of perinatal factors (bilirubin concentrations, gestational age, birth weight, Apgar score) and demographic characteristics (ethnic origin, socioeconomic status, paternal education) was taken into account in a multiple logistic regression analysis by using a General Linear Models procedure. Phototherapy was found to have no independent effect on intelligence quotient scores after adjustment for the effect of confounding factors. We conclude that for full-term newborn infants with neonatal hyperbilirubinemia, phototherapy had neither a beneficial nor an adverse effect on intellectual ability in late adolescence.
Adolescent↗
Is fetal growth affected by cord entanglement?
Cord entanglement is a common occurrence during delivery. We examined the association of cord complications observed at delivery and birth weight. A retrospective survey of 12,241 births was performed, supplemented with a prospective study of an additional 456 deliveries. No adverse association was found in the retrospective data between cord coiled twice or more around the newborns' neck (8.3% of cases) and birth weight. Moreover, the incidence of cord around neck was significantly lower (p < 0.0006) in infants weighing less than 2000 gm at birth. A multiple regression analysis of the prospective data did not reveal any significant influence of cord complications on birth weight. We conclude that cord entanglement was not found to be a major cause of intrauterine disadvantage in pregnancies with a viable infant at term, as reflected by birth weight.
Adult↗
Adverse perinatal outcome in the older primipara.
Delayed childbearing has become common and has raised the awareness of the possible risks for the mother and the newborn infant. The increased maternal and neonatal risks have been attributed largely to the lack of proper prenatal care. The aim of this study was to assess whether advanced maternal age is a significant risk factor in mothers who receive good prenatal care. We matched 161 cases 1:1 according to the following criteria: maternal and paternal ethnic origin, chronic diseases, marital status, and smoking during pregnancy. Our results show that the older women had babies with a significantly higher incidence of low birth weight (< 2500 gm, p = 0.001), prematurity (< 37 weeks, p = 0.02), intrauterine growth retardation (p = 0.001), abruptio placentae (p = 0.002), and cesarean section (p < 0.001). The average hospital stay for the babies of the older mothers was longer than that for babies of the younger mothers (8.4 vs 6.1 days, p = 0.003), and the incidence of hospitalization for more than 3 days in the neonatal intensive care unit was increased (10.3% vs 2.2%). Logistic regression did not support maternal age of 35 years and older as being the single significant risk factor for adverse neonatal and maternal outcome. We conclude that maternal age older than 35 years entails a higher risk for the mother and her newborn infant, even when good prenatal care is taken.
Adult↗
Prenatal ritodrine administration and the incidence of respiratory distress syndrome in premature infants.
UNLABELLED: Prenatal exposure to ritodrine may be associated with a lower incidence of RDS in premature infants, independent of its effect on prolongation of pregnancy. OBJECTIVE: The purpose of this study was to assess the neonatal respiratory outcome of premature infants according to whether their mothers were treated prenatally with ritodrine. STUDY DESIGN: A retrospective review was done of all 247 infants born at 34 weeks of gestation or less in our hospital during a 6-year period. A multivariate logistic regression was used to adjust for possible confounding variables. RESULTS: Among the ritodrine-exposed infants respiratory distress syndrome developed in 9.5% (4/42) compared with 28% (57/205) in the unexposed group (p < 0.012; adjusted odds ratio 4.88, 95% confidence interval 1.27 to 18.70). The gestational age and birth weight were similar in the two groups. The incidence of transient tachypnea of the newborn and other neonatal complications was not statistically different between the two groups. CONCLUSION: Ritodrine was associated with a significantly lower incidence of respiratory distress syndrome in premature infants, independent of the effect of ritodrine on prolongation of pregnancy.
Female↗