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Biomedical subjects

H B Valman

Publications and source records attributed to H B Valman.

At least 19 recordsLinked to original sources

Adrenal function in preterm infants.

The adrenal function of 10 preterm infants of gestational age 27-34 weeks was assessed longitudinally from measurements of excretion rates of steroid metabolites in 24-hour urine samples collected at frequent intervals for up to 80 days after delivery. The changes in steroid excretion with time in preterm infants of gestation over 28 weeks reflect involution of the fetal adrenal zone at a similar rate to term infants. These findings are consistent with the removal at birth of the inhibitory effects of oestrogen on the 3 beta-hydroxysteroid dehydrogenase enzyme. The continued function of the adrenal fetal zone beyond the first month in preterm infants of less than 28 weeks gestation may however be due to persistence of some other fetal regulatory adrenal mechanism.

Adrenal Cortex Hormones

Microcytosis, iron deficiency, and thalassaemia in preschool children.

To investigate the possible causes of an increased incidence of red cell microcytosis in Asian children, 204 Gujarati Asian children and 88 European children attending community infant welfare clinics underwent initial screening tests for determination of red cell indices. Seventy six Asian (37%) and nine European (12%) children had microcytic red cells (mean corpuscular volume less than 74 fl). Further investigation showed that 16 of the Asian children (21%) with microcytosis had thalassaemia trait (eight were heterozygous for alpha thalassaemia and eight for beta thalassaemia), and 50 (66%) had suspected iron deficiency (confirmed by a response to oral iron in 41 cases): the remaining 'microcytic' children were aged less than 2 years, when mean corpuscular volume between 70 and 74 fl may be normal. Increased values for serum total iron binding capacity were more sensitive in detecting iron deficiency than reduced serum ferritin concentrations. Enthusiastic screening for microcytic anaemia in young children may mean that a substantial minority with thalassaemia genes are given unnecessary iron supplements. The response to a short course of oral iron should therefore be carefully monitored, and the possibility of thalassaemia trait as well as non-compliance with treatment should be reconsidered in all those in whom there is little or no response.

Asia

A major role for viruses in acute childhood encephalopathy.

29 children and 3 adults with acute depression of conscious level or acute onset of focal neurological signs were studied prospectively. 3 were found to have a non-infectious cause for their illness. The presence of interferon or specific antibodies in the serum and/or cerebrospinal fluid provided evidence of active virus infection in 25 of the remaining 29 patients. There was laboratory evidence that a virus had invaded the central nervous system in 11 patients. Early investigation gave the highest diagnostic yield. Since several common viruses were identified, it appears that the nature of the illness is due more to the host response than to the nature of the infective agent.

Acute Disease

Birth trauma.

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Birth Injuries

Role of viruses in febrile convulsions.

A disseminated viral illness was demonstrated by isolating a virus from the CSF, blood or urine in 27% of 73 children who were admitted to hospital after a first febrile convulsion. However, a viral aetiology could be implicated for 86% of the children after combining results of tissue culture, electron microscopy, mouse inoculation, complement fixation tests, and interferon assay. Parallel bacterial cultures showed a possible pathogen in 29% of children, but in only 4% was the pathogen isolated from the CSF, blood, or urine. No correlation was found between the nature of the pathogen (or evidence of its dissemination) and the severity of the convulsion, degree of fever, CSF protein, CSF white cells, or the WBC. The results suggest that a febrile convulsion could be a response to invasion of the blood stream or central nervous system by a micro-organism which is usually a virus. Invasion may be of such brief duration that successful isolation of the virus from the blood, CSF, or urine in not more commonly achieved.

Child

A year's experience of the rotavirus syndrome and its association with respiratory illness.

In a hospital study rotavirus was identified in 51% of 152 children with diarrhoea. These patients showed a clinical pattern that was distinct from patients in whom the diarrhoea was associated with bacteria, other viruses, or no pathogens. A respiratory illness was described in 66% of rotavirus patients and usually preceded the gastrointestinal symptoms. Vomiting lasted between one and 3 days and was curtailed by substituting the normal diet with clear fluids. Watery diarrhoes continued for 4 or 5 days, even when rehydration was by the intravenous rather than the oral route. Prolonged diarrhoea was rare. Most children infected with rotavirus were under 2 years of age, but dehydration was most severe in infants aged between 12 and 18 months. A clinician can thus recognise the rotavirus syndrome and expect spontaneous recovery if adequate rehydration is maintained for a critical few days.

Adolescent