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Biomedical subjects

G McEnery

Publications and source records attributed to G McEnery.

18 recordsLinked to original sources
PubMed2004

The needs of physically disabled young people during transition to adult services.

OBJECTIVES: The needs and provisions for health service and housing adaptation of a cohort of school leavers with physical disabilities in two inner city London health districts are described in this cross-sectional study. METHODS: Fourteen young people were assessed by two consultant community paediatricians during their last year at school, using a structured proforma that includes the British Association of Community Child Health standards of functional levels. RESULTS: Great difficulty was encountered in identifying the subjects, partly because of inadequate information systems. Only 16 were identified out of over 12 000 school leavers. Important discrepancies were found between the needs assessed and the services provided. For the total sample, the need for 49 potential referrals to adult specialist services was identified, but 17 were not made as such services did not exist, in contrast to what had been available within paediatric services. Adult physiotherapy and occupational therapy services were particularly under-provided for young people with physical disabilities. Only a minority were eligible for housing adaptations. CONCLUSIONS: Suggestions are made for improvements in information systems, the transition process, revised provision of services and closer involvement of general practitioners.

Adolescent↗
PubMed1992

The spinal cord in neurologically stable spina bifida: a clinical and MRI study.

MRI scans of the brain and spinal cord, together with neurological and urological assessments, were carried out on 20 young people (aged between eight and 22 years) who had had surgical treatment of spina bifida in early life and in whom there had been no deterioration of spinal cord function. 19 were imaged successfully. The cord was tethered in all and it was low-lying in 18. Five had cavities within the cord; other abnormalities included cord thinning, lipomas and diastematomyelia. The relationship of these findings to subsequent deterioration and the use of MRI in these patients are discussed. These abnormalities, found in the absence of clinical deterioration, throw fresh light on the natural history of this condition.

Adolescent↗
PubMed1991

Neonatal at risk screening and the identification of deafness.

From a cohort of 10,686 live births, 322 (3%) were identified as being at risk of a hearing impairment defined as moderate, or worse. These neonates were screened by measurement of auditory brainstem responses. The neonatal at risk screening programme was effective in terms of both yield and cost. The mean age at which hearing aids were fitted was 6 months in the children identified by the neonatal screen. Such a programme is both practicable and useful in a district general hospital. The yield from the neonatal programme was, however, only 43% of the total number of deaf children eventually identified from the cohort. The need to identify more deaf children by a sensitive infant distraction test screening programme remains.

Age Factors↗
PubMed1988

Diarrhoea due to breast milk: case of fucose intolerance?

An unusual form of diarrhoea is reported that was relieved when breast feeding was stopped. Chromatography to estimate sugars in the faeces should be performed for all infants with unexplained diarrhoea before changes are made in the diet.

Breast Feeding↗
PubMed1984

Disodium cromoglycate compared with beclomethasone dipropionate in juvenile asthma.

In a double-blind controlled crossover trial of inhaled disodium cromoglycate and beclomethasone dipropionate in juvenile asthma, beclomethasone produced higher therapeutic scores but significantly so in only two indices--wheeze-free days and morning peak flow rates. Combined treatment offered no advantage over beclomethasone alone. No side-effects were noted. The findings confirm other studies of cromoglycate and a steroid aerosol (betamethasone 17-valerate) but disagree with the only other comparative trial of cromoglycate and beclomethasone, in which both were found equally effective.

Adolescent↗
PubMed1982

The content of phylloquinone (vitamin K1) in human milk, cows' milk and infant formula foods determined by high-performance liquid chromatography.

Phylloquinone (2-methyl-3-phytyl-1,4-naphthoquinone) in human and cows' milk and in infant formula foods has been assayed by a method based on high-performance liquid chromatography (HPLC). The method has three chromatographic steps consisting of a preliminary purification of lipid extracts by conventional liquid chromatography, a further fractionation by semipreparative HPLC and a final analytical step by reversed-phase HPLC in which phylloquinone was resolved from the remaining contaminants and quantified by reference to an internal standard (phylloquinone 2,3-epoxide). The identity of the chromatographic peak ascribed to phylloquinone (vitamin K1) was established by mass spectrometry. Mature human milk from 20 lactating mothers gave a mean concentration of phylloquinone of 2.1 micrograms/liter, and colostrum from 9 mothers gave a mean value of 2.3 micrograms/liter. These levels in human milk were significantly lower than those found in either Friesian (holstein) cows' milk (mean 4.9 micrograms/liter) or unsupplemented infant formula foods containing only cows' milk fat (mean 4.2 micrograms/liter). The mean phylloquinone content of two unsupplemented infant formula foods containing only vegetable oils was 11.5 micrograms/liter. After an oral dose of 20 mg phylloquinone, the concentration of K1 in the breast milk of one mother rose to 140 micrograms/liter after 12 hours and at 48 hours was still about twice the average endogenous level of human milk.

Adult↗
PubMed1979

Prolonged QT interval and cardiac arrhythmias in two neonates: sudden infant death syndrome in one case.

Two neonates with arrhythmias and the long QT syndrome are described. The arrhythmias were detected in utero and both infants were apparently well after birth. The first infant, although well, had a bradycardia for the first 9 days of life. A normal heart rate was documented at 10 days but a prolonged QT interval was not appreciated on the ECG. He was discharged from hospital but died suddenly and unexpectedly 3 days later. A post-mortem examination failed to find a cause for his death which therefore fell into the category of the sudden infant death syndrome (SIDS). A retrospective analysis of the perinatal electrocardiogram showed a probable junctional rhythm with 2:1 conduction to the ventricle; the QT interval was prolonged at 0.52 seconds (QTC = 0.63). The second infant had a QT interval of 0.52 seconds (QTC = 0.54) and frequent ventricular premature beats on a 24-hour electrocardiogram. She was treated with propranolol and remains well 2 years later. Sudden infant death has often been described in the siblings of children with the long QT syndrome and one other report described a case of SIDS which was said to have had a prolonged QT interval on the perinatal ECG. This report, however, provides unquestionable evidence, in one case, of an association between the long QT syndrome and SIDS.

Arrhythmias, Cardiac↗
PubMed1978

Human milk bank in a district general hospital.

A human milk bank was organised in the special care baby unit of a district general hospital. The staff of the unit and members of a voluntary organisation helped to contact donors and arrange collection of milk samples. Over two years 2093 samples of expressed breast milk were collected from 187 donors and examined bacteriologically. Of these samples, 1171 (56%) grew no bacteria. If the organism count exceeded 2.5 X 10(6)/1 but was less than 1 X 10(9)/1 samples were subjected to mild heat treatment. If the count exceeded 1 X 10(9)/1 the milk was not fed to babies. Sixty-five babies received milk from the bank during the second year. Although these infants were vulnerable, mortality and morbidity were not adversely affected by the banked milk they received. The cost of establishing and running a human milk bank need not be high. Extensive resources such as extra staff and laboratory and transport facilities were not needed. Enthusiastic co-operation and good will between hospital staff, voluntary helpers, and donors contributed greatly to the success of the scheme.

Costs and Cost Analysis↗
PubMed1977

Giant cell arteritis with gangrene in a child.

After an episode of abacterial meningitis in a 5-year-old boy there developed splenomegaly, uveitis, and a granulomatous arteritis of the lower limbs requiring amputation of one leg. Immune complexes persist in the blood, but the precise antigenic stimulus remains conjectural.

Age Factors↗
PubMedDate not supplied

The effectiveness of antenatal education of Pakistani and Indian women living in this country.

Eighty-two Asian women (mostly Muslims) living in East London were prospectively studied through their pregnancy and delivery. Their infants were assessed during the second year of life for growth, nutrition, morbidity, development and vaccination history. There was no increase in perinatal or infant mortality over the general population in the same borough, though there was increased infant morbidity, most commonly iron deficiency (in 25%), and one child with subclinical rickets. One child had a genetic neurodegenerative disorder. The incidence of low birth weight babies was only slightly greater than that of the district as a whole, but after 1 year of age they were less well grown than the population studied by Tanner & Whitehouse. Sixty-four per cent of the women started to breast feed, but many also gave artificial milk and they usually ceased to breast feed earlier than most women in the same district. When half of the women were randomly allocated to receive specialized education, with the others acting as controls, very few attended and little benefit was detected. Though the significance is doubtful, the infants of those educated did tend to be better grown (especially in length), be less likely to have development well below average, have reduced morbidity and have more complete immunization schedules than those of the women not receiving education. This study shows no benefit due to antenatal education, but suggests that the children have advantages when their mothers have the drive to attend the education sessions.

Breast Feeding↗