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Biomedical subjects

T G Matthews

Publications and source records attributed to T G Matthews.

65 records · Page 4Linked to original sources

Relevance of the gestational age distribution of meconium passage in utero.

The incidence of meconium staining of the amniotic fluid among the admissions to a newborn special care unit was determined. Meconium staining of the amniotic fluid was present in 251 (7.5%) of 3,374 admissions. The majority of those with meconium staining (98.4%) was of 37 weeks gestation or greater and none was less than 34 weeks gestation. The possible relevance of this gestational age distribution is discussed.

Amniotic Fluid↗

The anatomy of a smile.

The anatomy of the smile is an integral part of dentistry. Its understanding involves close scrutiny of all elements of the oral region. It is not enough to establish the size of teeth based on the high and low lip lines, size of the mouth, and a shade to blend with the age and complexion. To create a harmonious smile the dentist must maintain or create the normal curvature of the lips, proper exposure of the red zone of the lips, an undistorted philtrum, and undisturbed nasolabial grooves. These entities, maintained in harmony with the exposed teeth, constitute the anatomy of a smile. In order that patients may be served properly, the smile must be understood, recorded, and analyzed so that desirable aspects may be preserved and graceless components returned to attractiveness.

Age Factors↗

Significance of raised immunoglobulin M levels in cord blood of small-for-gestational-age infants.

Cord IgM values were determined in small-for-gestational-age infants born at Hammersmith Hospital during a 5 1/2-year period. 121 (12.5%) infants had levels more than 0.2 g/l; in 92 these were between 0.21 and 0.3 g/l. In only 18 (14.8%) was a level of 0.4 g/l exceeded, and 5 proved cases of intrauterine infection--rubella (2), syphilis (2), and toxoplasmosis (1)--were in this group. The factor most often associated with cord IgM more than 0.4 g/l was prolonged rupture of the membranes. There was an increased incidence of blood group B among the mothers, probably reflecting the greater number of nonCaucasian women giving birth to small-for-gestational-age infants. Determination of cord IgM did not help significantly indiagnosis.

ABO Blood-Group System↗

Strategies for reduction of neonatal mortality.

Infant mortality rates in developed countries have shown significant decreases in recent years. Two-thirds of infant mortality still occurs in the neonatal period and our aim in this study was to review the causes of these neonatal deaths and see where further improvements may be possible. A 6-yr review of all neonatal deaths of live-born infants over 500 g birthweight from 1991 to 1996 was made. The 1989 amended Wigglesworth classification was used to categorize cause of death and other perinatal variables were also recorded. Results show there were 34,375 births and 153 neonatal deaths. Classification of these deaths by Wigglesworth found 78 (51 per cent) due to congenital malformations, 58 (38 per cent) due to prematurity, 6 (4 per cent) due to asphyxia and 11 (7 per cent) due to specific other causes. The corrected neonatal mortality was 2.18. Neural tube defects alone accounted for 10 per cent of the total neonatal mortality. Fifty-five out of 58 infants who died due to prematurity had birthweight < 1000 g and survival rates in this group compared well to international standards. We conclude that a reduction in neonatal mortality is possible but is most likely to result from community focused measures such as increased use of pre- and peri-conceptional folate.

Asphyxia Neonatorum↗

Sudden infant death syndrome--are parents getting the message?

BACKGROUND: Factors that place an infant at increased risk of sudden infant death include the prone sleep position, overheating and parental smoking, while practices such as bottle-feeding, co-sleeping and the use of pacifiers remain controversial. Major publicity campaigns have been undertaken, which have included the distribution of printed material and extensive media coverage. AIMS: To examine if Irish parents follow the currently recommended childcare guidelines to reduce the risk of sudden infant death and to examine factors that may have impact on their acceptance. METHODS: A random selection of 197 infants from the Birth Register of the Eastern Health Board. Parents were interviewed and a semi-structured survey questionnaire was completed. RESULTS: Forty one per cent of infants are still placed on their side to sleep, an inherently unstable position. First time parents are more likely to place their infants on their backs. Over 60% of infants are exposed to one or more adults smoking in the home despite parental knowledge of its association with sudden infant death syndrome (SIDS). Sixty eight per cent of infants are overwrapped at night and parental understanding of what constitutes overwrapping is poor. Thirteen per cent of infants regularly co-sleep with their parents and 20% of these parents smoke. Pacifier use is common. CONCLUSION: Future programmes should target first time parents, should provide clear information regarding appropriate infant thermal environment, and should ensure regular updating of medical personnel so that they can instruct families on best current practice. Smoking remains a significant health issue with an impact on sudden infant death.

Adult↗

Sleep position and SIDS in Irish infants.

A retrospective case-controlled study has compared the frequency of different sleeping positions in a group of 97 SIDS infants and a group of 98 control infants. The results show a clear excess of SIDS deaths among Irish infants sleeping in the prone (lying on abdomen) position with the risk of a SIDS increased 2.3 fold comparing prone to side and 10.5 fold comparing prone to back positions. Among the SIDS group 79% of infants were lying prone when found dead compared to 25% of the control group (chi square = 64.3, p < 0.001) with only 7% and 9% sleeping on their sides and backs respectively (control group 48% and 27% respectively). Irish parents should be advised to avoid placing infants in the prone position (on abdomen) to sleep as this position is associated with a significantly increased risk of the Sudden Infant Death Syndrome.

Case-Control Studies↗

Expensive triplets.

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Costs and Cost Analysis↗