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Biomedical subjects

C R Maddock

Publications and source records attributed to C R Maddock.

7 recordsLinked to original sources
PubMed1988

Prevention of unexpected infant death. A review of risk-related intervention in six centers.

Over seventy percent of unexpected infant deaths are registered as SIDS. Over 85,000 infants have been screened at birth and one month of age for risk of unexpected death using the Sheffield Score system. Scores range from below 400 to over 800 points. Infants with scores over 800 are at more than 16 times greater risk than infants with scores below 400. Family doctors and health visitors were alerted to high-risk infants, who were examined at home and weighed naked at home five times in the first six months. Mortality in the high-risk group was reduced by more than 50% (p less than 0.02 in one area and p less than 0.05 in another). It is concluded that with few extra resources unexpected infant mortality can be reduced by 25% by this approach.

Child Health Services↗
PubMed1987

A population-based evaluation of sustained mechanical ventilation of newborn babies.

The scope and impact of sustained assisted ventilation were investigated within a cohort of 11,061 babies born to a geographically defined community. 76 (0.7%) normally formed newborn infants and 3 with major anomalies had respiratory failure potentially treatable by mechanical ventilation. 31 (0.3%) weighed less than 1000 g. 28 infants underwent more than 8 hours' assisted ventilation, which was initiated as an emergency in 14 cases, as an elective measure to minimise the hazards of transport in 10, and as a therapeutic option for apnoea in 4. Pneumothorax requiring drainage complicated the ventilation of 10 infants, 7 of whom died and 2 were subsequently disabled. Of the 14 ventilated survivors examined at school age, 2 had serious persisting disabilities associated with the ventilation and 2 with other perinatal events; of the 10 considered normal, 5 had had emergency ventilation.

Child, Preschool↗
PubMed1984

A clicking hip in a newborn baby should never be ignored.

7864 infants were examined within 48 h of birth by junior medical staff; 5 with dislocation, 16 with dislocatable hip, and 25 with joint laxity were referred for abduction splinting. 622 of the infants (7.9%) had minor signs (clicking or grating hip). When these 622 infants underwent clinical and radiological examination at 4 months of age, 34 had serious hip pathology (5 dislocation, 5 dislocatable hip, and 24 radiological abnormalities). Of the 7196 infants considered normal in the newborn period, 7 were referred for orthopaedic opinion (3 with dislocation and 4 with subluxation) at age 2-9 months by general practitioners and community health physicians. Thus, dislocated or dislocatable hips were 39 times more frequent in infants who had minor signs on examination within 48 h of birth than in infants considered normal. The implication of these findings is that clicking and grating of the hip are important signs which require systematic follow-up, with radiological examination at 4-6 months.

Bone Diseases, Developmental↗
PubMed1980

Very low birth weight children at school age: comparison of neonatal management methods.

The outcome of 293 infants born to a geographically defined community and weighing 501-1500 g was investigated. Medical intervention in the newborn period had been avoided. Morbidity was assessed at school age. Of the infants, 236 had been live born in the labour ward of this hospital; of these, 117 (49.6%) died in the neonatal period, one (0.4%) died in the first year, four (1.7%) were untraced, 13 (5.5%) had major handicap, 29 (12.3%) had minor handicap, and 72 (30.5%) were considered to be normal. In terms of survival, handicap, and intellectual with that of infants born over the same period (1963-71) in areas where intensive methods of perinatal care were used. These results imply that postnatal survival and potential of infants of very low birth weight are by no means prejudiced when only experienced nursing care is available.

Adolescent↗