Biomedical subjects
R H Burnell
Publications and source records attributed to R H Burnell.
Are these really sids deaths? Not by definition.
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Fever, cardiac failure and arteritis in a child with rheumatic carditis.
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An echo of the Spanish lady.
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Kawasaki disease with streptococcal infection.
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Apparent life threatening events and infant holding practices.
Two 4 week old infants are reported who suffered apparent life threatening events (ALTE) while being cradled in adult arms. The events, which could be reproduced under controlled circumstances, were not associated with any struggling by the infants. Alteration of infant holding practices in both cases resulted in cessation of the events. A case of cardiorespiratory arrest during breast feeding in an 8 week old infant that was unnoticed by her mother is also described. These cases suggest that certain infants may not respond normally to airway occlusion while being held or nursed, and show that careful study of the events surrounding ALTE may reveal contributing environmental factors. If ALTE occur around feeding time, observation of how caretakers place the infant during and after feeding may be informative.
Atlantoaxial subluxation in children with seronegative enthesopathy and arthropathy syndrome: 2 case reports and a review of the literature.
We describe 2 HLA-B27 positive children with seronegative enthesopathy and arthropathy (SEA) syndrome who developed spontaneous (nontraumatic) atlantoaxial subluxation early in their disease course. Neither child had evidence of spinal cord compression but both had progressive atlantoaxial subluxation in spite of conservative treatment. Both underwent elective posterior cervical (C1-C2) fusion.
Covert video surveillance in Munchausen syndrome by proxy. Ethical compromise or essential technique?
It has been suggested that the use of covert video surveillance in suspected cases of Munchausen syndrome by proxy should be curtailed as it represents a breach of trust between health care workers, parents and children. We present a case of asphyxia induced by a mother, which was discovered by videotaping without consent. Two previous sudden infant deaths in the family over the preceding two years, with unexplained apnoeic episodes in the third child, were considered sufficiently suspicious to justify covert surveillance. Incontrovertible evidence of parentally induced asphyxia was obtained within 24 hours of full-time covert surveillance. Despite initial denial, the mother eventually pleaded guilty to manslaughter of the first infant and to causing grievous bodily harm to the third infant. We believe that alternative techniques, such as parent-child separation, or of videotaping only after informed consent has been obtained, could have compromised the investigation and produced unacceptable delays which would have placed the surviving infant at risk of serious morbidity or of death.
Monitoring and sudden infant death.
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Ethics committees: is the tail wagging the dog?
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No association between DTP vaccination and SIDS.
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Blood pressure in schoolchildren measured under standardized conditions.
The blood pressures of 6346 children who were between the ages of seven and 17 years were measured under standardized conditions. Blood pressures were similar in prepubertal boys and girls. After puberty, the systolic blood pressures of the girls remained unchanged whereas those of the boys continued to rise. The difference between the fourth and fifth Korotkoff sounds was 2 mm at both the 50th and 95th percentiles. The systolic blood pressure was observed to fall over a 10-min period by 4-9 mmHg at the 50th percentile and 9-15 mmHg at the 95th percentile. Over the same period of time, the diastolic blood pressure was seen to fall by 2-3 mmHg and 3-6 mmHg at the 50th and 95th percentiles, respectively. There was no further fall in blood pressure after 10 min. The conditions and timing of measurement are important in blood-pressure evaluation and may explain the differences in blood pressure that have been reported for different populations.
A case of ring 20 chromosome with cardiac and renal anomalies.
A case of ring 20 chromosome is reported. In contrast to the few children documented previously with this problem who had no significant malformations the present case had major malformations of the heart and urinary tract as well as mental retardation and seizures.
Small bowel atresia, biliary atresia, and Alagille's syndrome.
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Measuring blood pressure in children.
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Small bowel atresia and biliary atresia.
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The relation between cord serum sodium levels in newborn infants and maternal intravenous therapy during labour.
A retrospective study was made of the relation between the cord serum sodium levels and the intravenous administration to the mother of 5 per cent dextrose and oxytocin. Of the 203 mothers studied, 106 received intravenous fluid before delivery. The mean sodium levels of babies of mothers who had intravenous fluid (133 +/- 4.2 (SD) mkmol/l) was significantly lower than for babies of mothers who had not (138 +/- 4.3 (SD) mmol/l).