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E Heyman

Publications and source records attributed to E Heyman.

12 recordsLinked to original sources

The effect of aminophylline on the excursions of the diaphragm in preterm neonates. A randomized double-blind controlled study.

Aminophylline is used to treat apnoea and to facilitate weaning from assisted ventilation in preterm infants. Aminophylline is thought to increase respiratory drive centrally. We performed a randomized controlled double-blind study to determine if aminophylline increases the excursions of the diaphragm indicating a possible direct peripheral effect. Twenty-two neonates were randomized to treatment with intravenous aminophylline (n = 11) or to no treatment (n = 11). An ultrasonographer, who was blinded to the group assignment, studied the diaphragmatic excursions using a real time sector scanner. The posterior one-third of the right hemidiaphragm was localized and M-mode was used to record the diaphragmatic excursions on paper. The neonates were studied in an awake but quiet state. Aminophylline resulted in an increase (43%) in the excursions of the diaphragm (p = 0.012) with no change in respiratory rate or pCO2. These findings indicate that aminophylline had a measurable effect on the diaphragmatic motion. Further studies combining this technique with other techniques are needed to determine if the main effect of aminophylline in the prevention of apnoea is mainly central or peripheral.

Aminophylline

Is the hospital setting the place for teaching breast self-examination?

The purpose of this study was to investigate the effects of an instructional program for nurses educating them to teach breast self-examination (BSE) to hospitalized patients. Nurses' knowledge, attitudes, self-practice, and practice of teaching breast self-examination to patients were measured in a group who attended such a program and compared with those of a control group who did not attend. The researchers found that the instructional program increased nurses' teaching of BSE to their patients, but did not affect their own self-practice. Nurses' attitudes to teaching BSE were less favorable than for self-practice. Issues related to environments for teaching BSE are discussed.

Breast

The outcome of triplet, quadruplet, and quintuplet pregnancies managed in a perinatal unit: obstetric, neonatal, and follow-up data.

Multifetal gestation is associated with increased frequency of maternal complications and higher perinatal morbidity and mortality. The need for contemporary data on the outcome of multifetal gestations is further underscored when selective reduction is considered. The present study details the obstetric management, neonatal outcome, and follow-up data of 24 triplet, five quadruplet, and one quintuplet pregnancies delivered in a perinatal center. The early neonatal mortality rate was 31.6, the late neonatal mortality rate was 21, and the perinatal mortality rate was 51.5. Survival to discharge was 93%. The incidence of respiratory distress syndrome was 43%, bronchopulmonary dysplasia 6%, retinopathy of prematurity 3%, intraventricular hemorrhage 4%, and cerebral palsy 2%. Follow-up from 1 to 10 years shows that only one child is moderately handicapped, whereas 99% have no significant medical problem. Early diagnosis by ultrasonography, meticulous antenatal care, early hospitalization, delivery by cesarean section, and on-site availability of a neonatologist for each baby at the time of delivery are the probable major determinants of improved outcome.

Child Development

The outcome of triplet gestations complicated by fetal death.

Intrauterine death in twin pregnancies has been reported to be associated with a very high incidence of morbidity and mortality in the surviving co-twin, mostly attributed to vascular disruption when vascular anastomosis exists between the twins' circulations. The present study describes the obstetric, neonatal, and follow-up data of five triplet gestations complicated by intrauterine death of one or two fetuses, compared with a control group of triplets matched for gestational age. Delivery occurred an average of 30 +/- 26 days after the diagnosis of intrauterine fetal death. Four of the five placentas were monochorionic. All nine infants survived, but four were small for gestational age (SGA). A comparison of study cases and controls revealed that monochorionic placentation was found only in the study group, that SGA infants were more likely (but not significantly so) to be in the study group, and that study infants required significantly less ventilatory support. Although the only case of long-term morbidity was in the study group, the cause of this complication was consistent with prematurity.

Embryonic and Fetal Development

Elevated serum creatine kinase. Following febrile seizures.

Serum creatine kinase (CK) was determined in 52 children admitted following an episode of febrile convulsions. Enzyme levels correlated with the estimated duration of the seizure. Twenty-four hour values were significantly higher than those observed 1 hour after the convulsive episode. Serum CK levels are frequently used for diagnostic purposes, so the questionable validity of this test when drawn after a convulsive episode must be considered.

Age Factors

Seclusion.

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Attitude

Partial arthroscopic meniscectomy versus total open meniscectomy.

One hundred sixteen patients who had undergone partial arthroscopic meniscectomy were reviewed in a short-term follow-up study (mean follow-up: 16 months). Their results were compared with those of a group of 402 patients who had been treated previously by conventional open meniscectomy in the same hospital. Average age in the arthroscopic group was 40 years, in the open group 34. Average sick leave was 4 weeks in the arthroscopic group, 10 weeks in the arthrotomy group. In the endoscopic group, there was virtually no sick leave for self-employed people, but 7 weeks if the lesion was sustained at work. Top-class sportsmen resumed competition 5 weeks after arthroscopy, 8 weeks after conventional meniscectomy. Still, most of them complained of prolonged synovial reaction resulting in a period of poor physical condition and performance. Of the patients treated by arthroscopy, 7.5% presented minor problems related to the approach (anteromedial-transpatellar), while 21.5% had similar problems after routine anteromedial incision in the open meniscectomy group. The overall results after arthroscopy were excellent in 49 cases (41.5%), good in 51 (43%), fair in 14 (12%), and poor in four (3.5%). These short-term results are comparable to those of the open meniscectomy group. The short-term results in the older patients confirm our belief that (partial) meniscectomy is useful for the older patient with a history of mechanical meniscal problems, with or without cartilage degeneration, provided one is not dealing with frank osteoarthrosis and secondary varus or valgus deformity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

A quaternary anti-cholinesterase probe for determining the integrity of the blood--brain barrier.

7-(Methylethoxyphosphinyloxy)-1-methyl quinolinium iodide (MEPQ), a new quaternary anti-cholinesterase (anti-ChE) compound was prepared and evaluated as a potential probe for assessing changes in the blood-brain barrier (B-BB) permeability. MEPQ was found to be 170 times more potent in its cholinesterase inhibitory activity than phospholine iodide, a previously reported anti-ChE probe in B-BB research. In rats and mice with impaired B-BB induced by osmotic opening, MEPQ readily penetrated through the damaged site as demonstrated by considerable reduction of ChE activity. In controls, brain ChE activity remained unaffected. It is suggested that MEPQ is a useful probe for both qualitative (histological staining) and quantitative (brain homogenated) assessment of permeability changes in the B-BB.

Animals