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Biomedical subjects

T Markestad

Publications and source records attributed to T Markestad.

At least 73 records · Page 4Linked to original sources
PubMed1994

Secular trends of sudden infant death syndrome in Norway 1967-1988: application of a method of case identification to Norwegian registry data.

In Norway, towards the end of the 1980s, sudden infant death syndrome (SIDS) was the most frequent cause of infant death. Both SIDS and the total post-perinatal mortality rates had increased. This paper presents a procedure for identifying SIDS from death certificates. Supplemented with additional information, a database was established to evaluate secular trends of SIDS and for further analytical research. The Medical Birth Registry of Norway comprises 1.3 million births from 1967 to 1988. Of these, 5447 infants died in the post-perinatal period. The cause of death was reviewed by an expert panel and 1984 cases of SIDS were retrieved. Low maternal age, higher birth order, male gender, and lower birth-weight were confirmed as risk factors for SIDS. In 1988, the rate for SIDS and for total post-perinatal deaths reached 2.69 and 5.02 per 1000 infants at risk. The incidence of SIDS increased 2.2 times from the period 1967-1971 to the period 1987-1988. Adjusted for maternal age, birth order, and birthweight, the odds ratio was 3.1. The increase is due to factors not yet accounted for. Adjusted mortality rates for the other post-perinatal deaths were not different from the crude rates.

Algorithms↗
PubMed1994

Ultrasound screening for developmental dysplasia of the hip in the neonate: the effect on treatment rate and prevalence of late cases.

OBJECTIVE: To assess the effect of ultrasound screening on primary diagnosis, management, and prevalence of late cases of developmental dysplasia of the hip (DDH). DESIGN: A randomized, controlled trial, including 11,925 newborn infants who were allocated to receive either general, or selective or no ultrasound screening in addition to the clinical examination. In the selectivity screened group only infants with risk factors or clinical findings of DDH received an ultrasound examination. The infants were at least 27 months old at the conclusion of the study. Those with risk factors for DDH had a radiograph examination of the hips at 4.5 months of age. RESULTS: The three study groups did not differ in terms of sex distribution or positive Barlow/Ortolani tests. General ultrasound screening resulted in a higher treatment rate than in either the selective or in the no ultrasound screening groups (3.4% vs 2.0% and 1.8%, P < .0001). For infants not subjected to treatment, ultrasound screening resulted in a higher follow-up rate because of nonconclusive early findings (13%, 1.8%, 0%, respectively; P < .0001). The prevalence of late subluxation or dislocation was lower for subjects assigned to general ultrasound screening than for those subjected to selective or no ultrasound screening, but the differences were not statistically significant (0.3, 0.7, 1.3 per 1000, respectively; P = .11, test for trend). CONCLUSION: The effect of ultrasound screening in reducing the prevalence of late DDH was at best marginal despite a considerable increase in diagnostic and therapeutic efforts.

Hip Dislocation, Congenital↗
PubMed1993

[Prenatal prevention of respiratory distress syndrome in newborn infants].

This article reviews the embryology, pathophysiology, clinical aspects and prophylactic treatment of respiratory distress syndrome (RDS). Prenatal prophylaxis with corticosteroids is indicated for gestational ages between 24 and 32 weeks, even if the effect of prophylaxis is uncertain before the 28th week. Prophylactic treatment is less important between the 32nd and 34th gestational week. Hypertension is not considered a contraindication, but premature rupture of the membranes is a relative contraindication. Corticosteroid treatment may be given, however, in combination with antibiotic prophylaxis.

Adrenal Cortex Hormones↗
PubMed1993

Personality and behaviour in eight-year-old, non-handicapped children with birth weight under 1500 g.

Personality and behavioural characteristics of a population-based cohort of 29 very low-birth-weight (VLBW) infants were compared with those of 29 matched, term controls at eight years of age. The VLBW infants were born to families of lower socioeconomic status (p = 0.04) and had a lower mean IQ (93 versus 104, p = 0.008) and motor abilities (p = 0.028). Based on the questionnaire personality inventory for children, the VLBW children had more learning difficulties and school coping problems, and the VLBW boys had more conduct and emotional problems than the controls. Except for conduct problems, these differences persisted after controlling for socioeconomic status. Generally, there were significant relationships between behaviour, IQ and motor abilities. In conclusion, VLBW may be a risk factor for the development of school coping and behavioural problems independent of socioeconomic status but often coexist with impaired cognitive and neuromotor function.

Case-Control Studies↗
PubMed1992

[Sleeping position and crib death in Norway].

Questionnaires to maternity hospitals in Norway in 1989 and 1991 showed that most units had changed the babies' sleeping position from the side position in the early 1970s, to predominantly prone in 1989, but back to the side position between 1989 and 1991. Parallel with these changes the incidence of sudden infant death increased steadily from 0.93 per 1,000 live births in the early 1970-74 to 2.4 per 1,000 in 1989, and dropped dramatically to 1.4 per 1,000 in 1990. It is assumed that parents adopt the sleeping position preferred in the maternity ward, and the study therefore supports the theory that the prone position significantly increases the risk of sudden infant death.

Humans↗
PubMed1992

Ultrasound in the early diagnosis of congenital dislocation of the hip: the significance of hip stability versus acetabular morphology.

Recent studies have suggested that ultrasound examinations may improve diagnostic accuracy in congenital dislocation of the hip, but there is differing opinion whether ultrasound diagnosis should be based on morphology or stability. Ultrasound was added to the routine clinical screening in 1503 newborns (1291 girls and 212 boys). Hip morphology was classified according to Graf (type 1-4), while sonographic stability was based on a modified Barlow maneuver, and classified as stable, elastic deflection (normal finding), unstable (provocating a gap between the femoral head and the acetabulum) and dislocated. Among 80 morphologically dysplastic hips, 73 (91%) were sonographically unstable or dislocated, while seven dysplastic hips were stable. On the other hand, in 49% of the sonographic unstable hips (69 out of 142) the acetabulum was either normal or just physiologically immature. 38 of these hips were left untreated and normalized spontaneously. There was a close correlation between sonographically and clinically determined hip stability (gamma = 0.95). Our study shows that the majority of morphologically dysplastic hips is sonographically unstable or dislocated, but also that morphologically dysplastic hips may be stable. Morphologically normal hips showing minor sonographic instability do probably not require treatment, and thus morphology seems to be an important diagnostic criterion.

Acetabulum↗
PubMed1992

Congenital dislocation of the hip: a prospective study comparing ultrasound and clinical examination.

Screening for congenital dislocation of the hip by standard clinical methods and ultrasound was compared prospectively in 1503 newborns (1291 girls and 212 boys). A total of 82.8% of the hips (78.8% of the infants) had well developed acetabulae, 14.5% (17.2% of the infants) were shallow (immature) and 2.7% (4.1% of the infants) were dysplastic. Within 1-3 months 96.7% of the infants with clinically stable, but immature hips normalized, while 3.3% did not improve or worsened, and therapy was therefore initiated. Indications for treatment included dysplastic and/or clinically unstable hips, and a higher number of newborns were treated during the study period than in 1982-85 (31.2 vs 19.7 per 1000, p = 0.0002). Thirty-seven percent of the patients had both clinical and ultrasound findings compatible with congenital dislocation of the hip, while the decision to treat was based on clinical findings alone in 25.0% and on ultrasound findings in 38.0%. Infants born during the study period of nine months had a low incidence of late congenital dislocation of the hip compared with our earlier reported results from 1982-85 (0.9 vs 3.5 per 1000, p = 0.012). The study demonstrated major discrepancies between clinical and ultrasound evaluation of hips in the newborn, and the role of ultrasound in the screening for congenital dislocation of the hip requires further evaluation.

Acetabulum↗
PubMed1992

Ganciclovir therapy of congenital cytomegalovirus disease.

A newborn with cytomegalovirus disease with cerebral involvement was treated with ganciclovir for 21 days. The treatment resulted in only temporary cessation of virus shedding in the urine and probably had no ameliorating effect on the long-term clinical outcome.

Cytomegalovirus Infections↗
PubMed1991

[Limits for treatment of children].

The combination of medical innovations, media focusing and ambivalence on part of the medical profession has created unrealistic expectations and difficulties in accepting limited treatment. At the same time the application of controversial, poorly documented and painful treatment modalities raises severe ethical dilemmas when treating infants and young children. This dilemma is discussed with regard to surgical treatment of hypoplastic left heart syndrome, aggressive physical therapy for severely disabled children, and treatment of extremely premature infants.

Child↗
PubMed1990

[Arterial catheters in newborn infants].

The article summarizes one year's experience of arterial lines in at third-level department for newborn children. We successfully placed an arterial line in 69 out of 71 children. 13 out of 84 arterial lines were umbilical catheters, the others were introduced percutaneously in the radial or posterior tibial arteries. Both umbilical arterial and peripheral arterial lines were functioning satisfactorily, with very few complications, and no serious ones. An arterial line is a relatively simple and a safe method for good monitoring of newborn children in need of intensive care.

Blood Pressure Monitors↗
PubMed1990

[Genital herpes in pregnancy. Time for new advice?].

This article surveys recent literature on genital herpes. In cases of active primary genital herpes, Caesarean section should be performed if delivery is possible within 4 to 6 hours after rupture of the membranes. There is no indication for repeated viral cultures or Caesarean section in patients with recurrent herpes or asymptomatic disease if there are no lesions at the time of delivery and the patient is without symptoms. With recurrent infections the risk of neonatal infection is low after vaginal delivery even if the mother is shedding virus at the time of birth, and vaginal delivery can be allowed even if the mother has lesions. In such instances, however, the neonate must be observed closely. Virus cultures must be prepared, and, if the virus is isolated, treatment with acyclovir should be started.

Female↗