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Biomedical subjects

C G Sia

Publications and source records attributed to C G Sia.

17 recordsLinked to original sources
PubMed1994

Oral rehydration solutions (ORS): enhancement by a soluble fiber.

OBJECTIVE: This study was designed to test the hypothesis that, in an animal model of protein-energy malnutrition (PEM), carboxymethylcellulose (CMC), a viscous additive for the World Health Organization Oral Rehydration Solution (WHO-ORS), previously found to be effective in rats with osmotic diarrhea as an enhancer of water and sodium absorption, would also improve the performance of the WHO-ORS. This hypothesis was based on the changes in fluid and electrolyte transport that could be induced by an increase in the viscosity. METHODS: We evaluated CMC in young rats fed a low-protein, low-energy diet for 3 weeks to induce PEM. Control (CTL) rats were fed a nutritionally complete diet. The ORS were tested with an in vivo perfusion procedure under anesthesia. RESULTS: CMC addition (0, 2.5, 5.0 and 10.0 g/L) sharply increased the rates of net water and sodium absorption in both groups of rats, especially in the PEM animals. Net water absorption increased from (means +/- SEM) 0.75 +/- 0.06 to 2.21 +/- 0.18, 3.35 +/- 0.20 and 8.46 +/- 0.84 microL/min x cm in the PEM rats (0, 2.5, 5.0 and 10.0 g/L CMC, respectively). For the same CMC concentrations, sodium absorption improved from 178.8 +/- 20.3 to 402.4 +/- 18.4, 486.4 +/- 29.2 and 898.4 +/- 21.4 nmol/min x cm, respectively. CTL rats also showed marked increases. Rates of lumen-to-serosa water influx improved in both groups without major changes in water efflux. Net water and sodium absorption appeared related to the log of the ORS viscosity. CONCLUSIONS: The results further support the concept that increased viscosity induced by CMC enhances the effectiveness of ORS.

Absorption↗
PubMed1994

Oral rehydration solutions: increased water and sodium absorption by addition of a viscosity-enhancing agent in a rat model of chronic osmotic diarrhea.

Viscosity-enhancing agents such as carboxymethylcellulose (CMC) can alter absorption of solutes and fluid exchange in the small intestine. We investigated whether the standard World Health Organization oral rehydration solution (WHO-ORS) with the addition of CMC would improve net water and sodium absorption in rats using an in vivo intestinal perfusion technique. Four WHO-ORS, containing either 0, 2.5, 5.0, or 10.0 g/L of CMC, were perfused in rats with a well-tested model of cathartic-induced chronic osmotic diarrhea (D) and in normal controls (C). In D rats, the ORSs with CMC improved sodium absorption at the three concentrations used (p < 0.01). The same effect was shown in C rats. Net water absorption was also enhanced in D rats given ORSs with CMC, although the changes in C animals were less marked. The improvement in sodium and water absorption in both C and D rats positively correlated with the log of relative ORS viscosity. Ultrastructural examination of tissues perfused with 10 g/L of CMC showed an extended brush border glycocalyx. This study indicates that CMC added to WHO-ORS in the perfused rat jejunum improves the effectiveness of the solution by increasing sodium and water absorption.

Animals↗
PubMed1994

Limitation of private attending pediatricians' neonatal intensive care privileges in level III institutions throughout the United States.

OBJECTIVE: To determine the privileges of Private Attending Pediatricians (PAP) in caring for newborns requiring intensive (ITC), intermediate (IMC), or continuing (CC) care in Level III neonatal intensive care units (NICUs) throughout the United States. DESIGN: A two-page mail questionnaire was sent to 429 Level III NICUs to obtain the statement best describing the PAPs' privileges, the number of PAP, and some of the PAPs' functions. Level III NICUs were classified by geographic region as Eastern, Central, or Western United States. RESULTS: Responses were received from 301 NICUs (70%) representing 48 states, the District of Columbia, and > 9000 PAP. Twenty-two institutions had no PAP. In the remaining 279 institutions, 96% (267/279) had restricted the PAPs' privileges partially or completely. In 32% (88/279), the PAP were not allowed to render any type of NICU care. In 18% (51/279) of the institutions, the PAP were allowed to render CC only. In 27% (76/279) of the institutions, the PAP were allowed to render IMC and CC only. Limitation of PAPs' privileges were reported in all geographic areas in the U.S., were more pronounced in the Eastern than the Central or Western sections of the country, and were noted in institutions with small (< or = 10) as well as large (> or = 60) numbers of PAP. Limitation of PAPs' privileges was determined by the PAP him/herself in many institutions. Proficiency in resuscitation was considered to be a needed skill. Communication with parents of an infant under the care of a neonatologist was encouraged. CONCLUSIONS: The PAPs' privileges were limited partially or completely in most Level III NICUs. Knowledge of this restricted role impacts significantly on curriculum design for pediatric house officers, number and type of health care providers required for Level III NICUs and future house officer's career choices.

Chi-Square Distribution↗
PubMed1991

Polymorphonuclear leukocyte function in the preterm neonate: effect of chronologic age.

In this study, effect of chronologic age on polymorphonuclear leukocyte (PMN) chemiluminescence and random and chemotactic motility was evaluated in 38 stable preterm neonates of less than 32 weeks' gestation during the first month of life. Chemiluminescence and random and chemotactic motility of PMNs from preterm neonates were first evaluated at mean postnatal age of 9.8 days and then weekly for an ensuing 21-day period. For comparison, one blood sample was obtained for PMN functions from 14 healthy term neonates younger than 72 hours of age and seven normal adults. On day 1 PMN chemiluminescence and random and chemotactic motility values in preterm neonates were significantly lower (P less than .001) compared with those in term neonates and PMN function values of term neonates were significantly lower (P less than .001) than those of adults. Although initial PMN chemiluminescence and random and chemotactic motility values in preterm neonates were depressed, subsequent values on days 7, 14, and 21 increased significantly (P less than .002). On day 21 (mean postnatal age of 30.8 days) no differences existed in chemiluminescent activity and random motility between preterm and term neonates; chemotactic motility in preterm neonates, however, remained impaired. Mean cumulative age (gestational age at birth plus postnatal age) of preterm neonates on day 21 of study was 32.5 weeks, suggesting that chronologic age has more effect on maturational changes in PMN functions than gestational age.

Aging↗
PubMed1989

Nursery privileges of the private attending pediatrician in the care of critically sick neonates in New York state.

To determine the role of the private attending pediatrician in caring for newborns who require intensive, intermediate, or continuing care in New York state, a request was sent to New York state institutions to select the statement best describing private attending pediatrician privileges. Privileges were graded from 1 to 6 with category 1 allowing the private attending pediatrician to care for all newborns and category 6 not allowing the private attending pediatrician to care for any newborns. Nurseries were classified (per New York State Department of Health) as regional, nonregional intensive care, intermediate care, and continuing care centers. A total of 97% (88/90) of institutions responded, representing 2,040 private attending pediatricians. In 95% (79/83) of the New York state institutions with staff private attending pediatricians, the pediatricians' privileges were limited. In 18% (15/83), the private attending pediatrician does not supervise any newborns receiving special care, whereas in an additional 77%, pediatricians' privileges have been limited. Despite this, the majority of institutions encourage the private attending pediatrician to continue communication with the family. Limited hospital privileges coupled with continued family communication may be the future trend for private attending pediatricians in the hospital setting.

Communication↗
PubMed1986

Patterns of bilirubin staining in nonhemolytic kernicterus.

Patterns of bilirubin staining were studied in nine infants with kernicterus related to nonhemolytic hyperbilirubinemia, all weighing less than 1200 g, and nine matched controls. Three staining patterns were disclosed: a localized pattern in the central nervous system of kernicteric infants, with only the thalamus staining significantly often; staining, in extraneural tissues (adrenal, myocardial, renal, and colonic mucosa) only in kernicteric infants, despite similar bilirubin levels in both groups; and yellow staining of the alveolar hyaline membranes as a function of survival duration in both groups. Bilirubin staining of tissue is apparently a generalized phenomenon, most recognized in the central nervous system as kernicterus. Failure to maintain the impermeability of the cell membrane coupled with regional differences in blood flow would best explain bilirubin distribution. In contrast, the degree of bilirubin staining of alveolar hyaline membranes is time related in kernicteric and control infants.

Bilirubin↗
PubMed1985

Upper- vs lower-limb systolic blood pressure in full-term normal newborns.

The difference between upper- vs lower-limb systolic blood pressure (BP) was investigated in 100 normal full-term newborns younger than 24 hours of age by the oscillometric method. The mean systolic BP of both upper limbs was 72.3 +/- 7.6 mm Hg (mean +/- SD). The mean +/- SD systolic BP of both lower limbs was 71.3 +/- 8.2 mm Hg. Systolic BP in the upper limb was greater than that in the lower limb in 66% of newborns by as much as 20 mm Hg (mean +/- SD, 3.5 +/- 3.1). Systolic upper-limb BP was lower than systolic lower-limb BP in 28% of newborns by as much as 21 mm Hg (mean +/- SD, 5.1 +/- 5.1). Systolic BP did not correlate with birth weight. Follow-up evaluation of BP in 25 of the infants up to 3 years of age revealed higher systolic BP in the lower extremities in 24 of the 25 infants. We conclude that (1) it is normal to have a higher systolic BP in either the upper limb or the lower limb in newborns younger than 24 hours of age, and (2) there is no correlation of systolic BP with birth weight in full-term normal neonates younger than 24 hours of age.

Arm↗
PubMed1981

Observations on maternal preference for rooming-in facilities.

To determine the length of time mothers prefer their infants with them, 1,000 mothers at North Shore University Hospital (NSUH) and 435 mothers at Kings County Hospital (KCH) were asked postpartum whether they would prefer their infants with them every four hours for 1/2 hour for feeding or rooming-in with their infants during the daytime only or 24 hours a day. Approximately one third of the mothers at NSUH preferred rooming-in whereas approximately three quarters of the mothers at KCH preferred rooming-in. Significantly more mothers at KCH preferred 24-hour rooming-in than at NSUH. Factors such as primiparity, attendance at Lamaze classes, and breast-feeding were significantly associated with the mother's preference to room-in at NSUH, but there was no such association at KCH. This study suggests that: (1) the desire to room-in is not universal; (2) each institution must individualize rooming-in facilities according to the needs of the population; (3) although the demand for rooming-in varies, more mothers prefer rooming-in than there are accommodations presently available; and (4) factors that may be associated with rooming-in are not the same in all populations. It appears that it is as inappropriate to impose rooming-in as it is to deprive mothers of rooming-in.

Black or African American↗
PubMed1980

Xiphopagus conjoined twins: a 300-year review of the obstetric, morphopathologic, neonatal, and surgical parameters.

Obstetric, morphopathologic, neonatal, and surgical features of 36 reported cases of xiphopagus conjoined twins were correlated and reveal: (1) a 6% incidence of prenatal diagnosis; (2) a 36% rate of dystocia; (3) a 19% incidence of stillbirths; (4) variation in the extent of fusion; (5) a high rate of occurrence of concurrent congenital malformations, not limited to a conjoined area, especially of the heart (25%) and gastrointestinal tract (33%); (6) the importance of diagnostic tests to elucidate conjoined or abnormal structures because of the high rate of concurrent malformations; (7) opisthotonos as the body alignment position of choice; (8) a 69% female sex bias; (9) surgical separation usually in the first year of life; and (10) a 53% survival rate. This paper correlates the world literature for xiphopagus conjoined twins for the past 300 years.

Abnormalities, Multiple↗
PubMed1980

Sequential scintiangiography of the hepato-splenic system of xiphopagus conjoined twins.

Scintiangiography of xiphopagus conjoined twins following sequential i.v. injection of Tc-99m sulfur colloid revealed the size, configuration, and anatomic point of fusion of the twins' common liver prior to surgery. Cross circulation was determined to be non-significant by this approach. The technique is presented, compared to other methods, and the benefit of sequential hepatic scintiangiography for xiphopagus conjoined twins is reviewed.

Cross Circulation↗
PubMed1975

Rentrolental fibroplasia in a full-term infant.

A 3,800-g infant, born after 40 weeks' gestation, developed retrolental fibroplasia, documented by indirect ophthalmoscopy. Elevated arterial oxygen tensions may have occurred during brief treatment for two episodes of cyanosis.

Adult↗