Fertility following change of sex: a follow-up.
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Biomedical subjects
Publications and source records attributed to R R Gordon.
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250 infants from atopic families were investigated to determine the relation between serum IgE concentrations and the development of atopic symptoms. In 44 (17.6%) atopy developed before the age of two years, 60 (24%) had doubtful symptoms, and 146 (58.4%) were clinically clear. Those who were definitely affected had higher serum IgE than those who were unaffected but 50% of them had serum IgE within the normal range. 9% of the clinically unaffected infants had raised serum IgE. Breast-feeding was in no way protective against either the development of atopy or an increase in IgE to abnormal levels.
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Neonatal and "perinatal" mortality rates by birth weight were compared for Sheffield and for England and Wales. The fall in neonatal mortality rate for Sheffield infants weighing 2500 g or less was partly due to the excessive fall in numbers in the 1000 g or less group: this effect was also present in England and Wales but was less pronounced. Perinatal mortality rates may be lowered either by reducing (a) the number of stillbirths, (b) the number of preterm live births, or (c) by salvaging a greater percentage of the latter. For liveborn births it is suggested that the second approach would be better than the third. So far there is no evidence that superintensive care for those weighing 1000 g or less reduces their mortality rate.
Since 1962 there has been a disproportionately greater fall in the number of small (less than 1000 g) live births than total live births: this has applied to Sheffield and to England and Wales but more to the former. This may have affected falling neonatal mortality rates.
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For 27 years annual figures have been kept of all infants weighing 2500 g or less born in the maternity department of the Northern General Hospital, Sheffield. The initial neonatal mortality rate (death within the first four weeks after birth) was then around 30% and is now 10%. This reduction is partly due to a decreased mortality rate among the individual weight groups but also to an increasing number of larger infants and a decreasing number of infants of low birth weight in the "high-risk" category.
A critical review of 142 intrauterine fetal transfusions performed in 99 patients during 107 pregnancies raised doubts about the absolute benefit of the procedure. Two main problems emerged: the diagnostic criteria upon which decisions were based were inadequate and the fetal mortality associated with transfusion was high, especially when this was performed before 28 weeks. We measured amniotic fluid bilirubin concentration by a biochemical method but the results following intrauterine fetal transfusion were similar to those observed by others using spectrophotometric examination of amniotic fluid.
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