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Biomedical subjects

G Cassady

Publications and source records attributed to G Cassady.

At least 19 recordsLinked to original sources
PubMed1991

Black-white differences in newborn anthropometric measurements.

The mean birth weight of black infants is consistently less than that of white infants. In 1518 low-income multiparous women, the mean difference in singleton births was 171 g, of which 38 g was partitioned to preterm births and another 35 g reflected lower gestational ages in term births. A series of regression analyses were used to determine the effect of black race on various newborn measurements in 1205 term newborns, adjusting for other known risk factors. In this model, black race accounted for a mean decrease of 148 g in weight and 0.52 cm in length. There were also significant decreases in mean head (0.44 cm), chest (0.66 cm), and abdominal (0.56 cm) circumferences. Arm and leg lengths were not different, but black arm circumferences (0.14 cm) were significantly larger. Triceps and thigh skin fold measurements were not statistically different, but black subscapular skin fold values were significantly smaller (0.17 mm). The ponderal index in blacks was significantly less than in whites. These data suggest that in this population, intrinsic and/or extrinsic factors associated with race account for most smaller black newborn measurements and for much of the racial difference in birth weight.

Alabama↗
PubMed1991

28-day survival rates of 6676 neonates with birth weights of 1250 grams or less.

Survival rates specific for birth weight, gestational age, sex, and race are described for 6676 inborn neonates who weighed less than 1251 g at birth and were born during 1986 through 1987. Overall 28-day survival increased with gestational age and birth weight, from 36.5% at 24 weeks' gestation to 89.9% at 29 weeks' gestation, or from 30.0% for neonates of 500 through 599 g birth weight to 91.3% for neonates of 1200 through 1250 g. The expected birth weight-specific survival advantage for female neonates and black neonates diminished when the data were controlled for gestational age, showing that certain previously reported survival advantages are based on lower birth weight for a given gestational age. Multivariate analysis showed that all tested variables were significant predictors for survival, in order of descending significance: gestational age and birth weight, sex, race, single birth, and small-for-gestational-age status. The powerful effect of gestational age on survival highlights the need for an accurate neonatal tool to assess the gestational age of very low birth weight neonates after birth.

Black or African American↗
PubMed1979

Transcutaneous oxygen (tcPO2) measurements as an aid to fluid therapy in necrotizing enterocolitis.

Impaired peripheral perfusion is a major problem in necrotizing enterocolitis with delayed recognition and definite documentation being primary factors. While blood pressure and other clinical measurements may improperly estimate the severity of the problem, changes in transcutaneous oxygen measurements and their relationship to arterial oxygen (the tcPO2/PaO2 ratio) potentially afford a sensitive measurement of peripheral perfusion. Experience in our unit confirms a close relationship between tcPO2/ and PaO2 being 0.97 +/- 0.04 (SE). Ten infants with birth weights of 640 to 1380 g, who subsequently developed necrotizing enterocolitis, had strikingly lower ratios initially (0.00, 0.00, 0.00, 0.17, 0.21, 0.43, 0.44, 0.48, and 0.56). Use of the tcPO2/PaO2 ratio to monitor fluid therapy was related to outcome, suggesting that this ratio is important in managing necrotizing enterocolitis.

Enterocolitis, Pseudomembranous↗
PubMed1978

Subcutaneous fat necrosis of the newborn.

Subcutaneous fat necrosis of the newborn (SFNN) developed in a 1-week-old black boy. His mother had received numerous medications for eclampsia. Birth was by Caesarean section and complicated by meconium aspiration. There were numerous nodules over the back, buttocks and extremities that yielded a caseous-like material. Microscopically, these nodules showed crystallization and necrosis of the fat. Hypoglycemia, pneumonia, oliguria, thrombocytopenia, seizures and urinary infection were associated with the cutaneous problem and led to a fatal outcome 2 weeks after birth.

Adult↗
PubMed1977

Amniotic fluid glucose in pregnancies complicated by diabetes.

Amniotic fluid glucose (AF glu) was studied in 92 pregnancies complicated by maternal diabetes. An inverse relation between AF glu and gestational age was found: [AF glu (mg. per diciliter) = 160.9 -- 3.51 (weeks gestation); r = -0.47]. A direct relation between AF glu and severity of maternal diabetes was observed: mean AF glu (mg. per deciliter) = 24.6 +/- S.D. 12.3 in Class A, 41.2 +/- 25.5 in Class AD and 57.5 +/- 36.5 in Classes B-D. A positive correlation of AF glu with osmolality was observed [AF Osm (mOsm. per kilogram) = 250.7 + 0.22 AF glu; r = +0.50], but this relation was remarkable inconsistent in individual patients. Neither individual nor serial AF glu levels were of any prognostic value in predicting fetal condition or perinatal outcome.

Amniocentesis↗
PubMed1977

Relation between arterial blood pressure and blood volume and effect of infused albumin in sick preterm infants.

The relation between directly measured arterial blood pressure and blood volume was studied in 61 sick preterm infants. Mean blood volume (derived from plasma volume [T1824 ten-minute albumin space] and hematocrit value) of 26 hypotensive infants (89.1 +/- 17.26 ml/kg) was not significantly different from that of 35 normotensive, but otherwise comparable, infants (91.4 +/- 14.57 ml/kg). There was no relation between arterial mean blood pressure and blood volume. Twenty-one infants with arterial mean blood pressure less than 30 mm Hg were given 1.0 g/kg of 10% salt-poor albumin. Significant increases in blood pressure occurred but were small in magnitude; more than one half of infants had arterial mean blood pressures persistently less than 30 mm Hg. Arterial/alveolar PO2 ratio decreased significantly with albumin infusion in six infants with hyaline membrane disease not receiving continuous distending-airway pressure, suggesting an association between infused albumin and impaired oxygen exchange.

Albumins↗
PubMed1976

Amniotic fluid osmolality in pregnancies complicated by diabetes.

Amniotic fluid osmolality (AF Osm) was studied in 247 patients whose pregnancies were complicated by maternal diabetes. Significant increases in mean AF Osm accompanied pre-existing fetal as well as subsequent perinatal death. Abnormal increases in AF Osm were associated with a significant increase in risk of perinatal compromise with cumulative morbidity and mortality rates of 54 per cent. These data suggest that serial evaluation of AF Osm enables detection of a "higher risk" group of diabetic pregnancies in which perinatal death is more than doubled.

Adolescent↗
PubMed1976

Neonatal pneumopericardium.

Six cases of pneumopericardium in neonates with hyaline membrane disease were observed during a six-month period. Five babies were receiving positive inspiratory or expiratory pressure or both. All but one had other extra-alveolar air collections. In three cases, sudden decrease in PaO2 was the only recorded sign that led to diagnosis. Pericardial aspiration was performed in four babies; one died and three either survived or died later of unrelated disease. One neonate was not treated and died of other causes. Treatment was delayed in the sixth infant; the pneumopericardium disappeared spontaneously but soon reappeared and contributed to a fatal outcome, although a drainage catheter was inserted. This experience and review of other authors' observations suggest that prompt drainage by catheter and continuous suction is indicated.

Drainage↗
PubMed1976

Impact of intensive newborn care on neonatal mortality in a community hospital.

Development of a Perinatal Center delivering Level 3 intensive care in a community hospital is described. The inborn neonatal mortality at the hospital in which the Center is located, as well as that of the 13 surrounding counties, has diminished more rapidly than the state neonatal mortality. This has coincided with an almost constant delivery rate, increased proportion of staff patients, relatively constant rate of low birth weight, and declining total perinatal mortality. Our experience suggests that appropriately trained and motivated people, not equipment or geographic location, represent the key factor in the development of such a center.

Child Health Services↗
PubMed1976

Congenital tuberculosis.

Congenital tuberculosis is a rare and often fatal disease. This report concerned a premature infant in whom the disease was found after postpartum diagnosis in the mother. Use of endotracheal tube aspirates to diagnose tuberculosis in the infant is a unique feature of this case.

Adult↗
PubMed1976

Reye's syndrome in a neonate.

This case substantiates the fact that Reye's syndrome can occur in newborns. The clinical features appear to be slightly different in the neonate, in that respiratory distress was the presenting sign in this case and in the one other reported case in a newborn, with no mild preceding illness or vomiting. Thus, Reye's syndrome must be considered when a newborn presents with respiratory distress and evidence of central nervous system and hepatic involvement.

Female↗
PubMed1976

Nasal continuous positive airway pressure. Improvement in arterial oxygenation in hyaline membrane disease.

Continuous positive airway pressure (CPAP) was employed using nasal prongs in 30 neonates with hyaline membrane disease (HMD). There was a significant improvement in mean PaO2 (from 47 to 80 mmHg;p less than 0.001) with no significant change in PaCO2 or pH within a mean 36 min of therapy. Use of the technique allowed reduction of FiO2 to less than 0.60 in less than 20 h in 18 infants. Infants treated within 24 h of birth had significantly greater improvements in PaO2. Complications were infrequent and only 3 of 30 babies developed a pneumothorax while on nasal CPAP. Only 1 of the 23 survivors required mechanical ventilation in addition to nasal CPAP.

Carbon Dioxide↗
PubMed1976

Use of Limulus lysate for detecting gram-negative neonatal meningitis.

The Limulus lysate test was evaluated as a method for rapid detection of neonatal gram-negative bacterial meningitis. A total of 208 CSF samples were collected from 145 newborn infants suspected of having meningitis. Initial samples from all six babies with culture-proven gram-negative bacterial meningitis had positive Limulus tests within 30 minutes of incubation. Samples from 14 infants with gram-negative organisms isolated only in blood and/or urine as well as from four neonates with gram-positive organisms in CSF cultures and from 13 with gram-positive organisms in blood cultures all yielded negative Limulus tests. Thus, of 37 newborn infants with bacteria demonstrated in systemic cultures, only those six with gram-negative organisms in CSF had positive CSF Limulus tests. The CSF Limulus test was shown to be a rapid, reliable, and specific test for the detection on neonatal gram-negative bacterial meningitis.

Arachnida↗