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Biomedical subjects

H Simpson

Publications and source records attributed to H Simpson.

15 recordsLinked to original sources

Mycoplasma pneumoniae infection. A retrospective review of 103 hospitalised children.

The clinical aspects of Mycoplasma pneumoniae infection in 103 children under 12 years admitted to hospital over an eight-year period were reviewed retrospectively. Respiratory illnesses occurred in 87 (85%) cases. The prevalence of lower respiratory tract involvement was similar in both pre-school and school children. Cough was the commonest symptom at all ages. Coryzal symptoms and wheeze were common in pre-school children. Most infants had signs of pharyngitis or otitis media. Non-specific symptoms--fever, lethargy, malaise, anorexia and vomiting--were common accompaniments in children older than one year of age. Non-respiratory illnesses in 16 (15%) patients included gastroenteritis, convulsions, non-specific skin rashes and limb pains. The duration of stay in hospital ranged from two to 30 days (median five days) with apparent clinical recovery and resolution of chest X-ray abnormalities within three months in 78 (76%) patients seen for review.

Age Factors

Mycoplasma pneuminia infection. A follow-up study of 50 children with respiratory illness.

Fifty children with a previous history of Mycoplasma pneumoniae respiratory tract infection were assessed clinically, and pulmonary function tests carried out after an interval ranging from 1 1/2 to 9 1/2 years (median 2 1/2). 23 suffered from recurrent wheezy bronchitis or asthma, and in 5 the index illness appeared to precipitate the wheezing tendency. All were symptom-free when respiratory function tests were performed. Simple tests of ventilatory function (PEFR, FEV, and FVC) were within normal limits. Increased bronchial reactivity after exercise (a fall in PEFR greater than 15% resting value) was demonstrated only in children known to have asthma. Maximum expiratory flow rates in air at 50% of vital capacity (V mas50) were within the normal range in all patients with the exception of two. The response in flow rate at 50% of vital capacity after inalation of an 80% helium and 20% oxygen mixture delta V max50) was reduced (P less than 0.001) in asymptomatic patients with a history of M. pneumoniae respiratory infection, when compared with normal data from 48 healthy schoolchildren without a background of significant respiratory illnesses. These findings indicate impairment of small airways function, even in totally symptom-free children in the study group.

Child

Viral infection as a precipitant of wheeze in children. Combined home and hospital study.

Sixteen children with asthma were studied for one year and viral isolation attempted during all episodes of wheezing. In 91 episodes investigated, 13 viruses were isolated (isolation rate 14%); whereas only one virus was isolated from 120 specimens taken when the children were symptom free. Rhinovirus was the commonest isolate and most were obtained during August, September, October. Episodes of wheezing associated with virus infection were not clinically different not more severe than those due to other precipitants.

Child

Severe ventilatory failure in asthma in children. Experience of 13 episodes over 6 years.

During the 6-year period from 1 October 1971 to 30 September 1977, 13 (about 1%) of 1225 admissions to hospital with asthma developed severe ventilatory failure (peak arterial PCO 2 greater than 8 kPa). Mean age was 4.1 years (2.3--7.9), and on average each patient had been admitted to hospital on 5 occasions during the preceding year. 11 gave a family history of asthma or a personal history of associated allergies. A viral upper respiratory tract infection was the commonest precipitant of wheeze, and in 7 patients the duration of wheeziness before admission to hospital was 12 hours or less. Six (0.5%) patients were treated by mechanical ventilation and all survived. The changing patterns of management during the study period are reviewed.

Acid-Base Equilibrium

Season of birth among the sibs of schizophrenics.

The season of birth distribution of 1,039 sibs of Canadian schizophrenic patients was compared with that of births in the Canadian general population over the same time period. The excess of winter births observed among the schizophrenics was not found among their sibs.

Canada

Cerebrospinal fluid acid-base status and lactate and pyruvate concentrations after short (less than 30 minutes) first febrile convulsions in children.

Twenty-nine infants and children with short (less than 30 minutes) first febrile convulsions were studied between 3 and 22 hours after convulsive episodes. Arterial and CSF acid-base variables, lactate and pyruvate concentrations, and lactate/pyruvate ratios were measured. Biochemical signs of cerebral hypoxia were found in only 2 patients, one of whom had short, repeated convulsions. Our findings indicate that hypoxic damage is unlikely to result from a short-duration febrile convulsion.

Acid-Base Equilibrium

Cerebrospinal fluid acid-base status and lactate and pyruvate concentrations after convulsions of varied duration and aetiology in children.

Twenty-two infants and children were studied after convulsions of varied cause and duration. Arterial and CSF acid-base variables, lactate and pyruvate concentrations, and lactate/pyruvate ratios were measured between 3 and 18 hours after convulsive episodes. Biochemical signs of cerebral hypoxia were found in 7 patients with prolonged (greater than 30 minutes) or recurrent short convulsions. These signs were absent in patients with single short convulsions. These findings indicate that cerebral hypoxia and possible brain damage is a hazard of prolonged or rapidly recurring short convulsions.

Acid-Base Equilibrium

Osmolar relation between cerebrospinal fluid and serum in hyperosmolar hypernatraemic dehydration.

The relation between cerebrospinal fluid (CSF) and serum osmolality was studied in 16 patients with hyperosmolar hypernatraemic dehydration before treatment. After correcting shock and acidosis, 0-45% saline in 2-5 or 5% dextrose was infused in each patient over a 48- to 72-hour period. During rehydration, serum osmolality, electrolyte concentrations, urea nitrogen, and blood pH were measured sequentially. Five patients developed severe neurological abnormalities within 48 hours of addmission (convulsions 2, convulsions with hemiplegia 2, hemiplegia 1). Of these, 3 had residual defects on follow-up at least one year later. This group was indistinguishable from the 11 without significant neurological abnormality, both on clinical grounds before rehydration, and after analysis of admission and subsequent serum biochemical variables. A significant osmolar gap (greater than 4 mmol/kg H2O) between serum and CSF was found in 13 patients. Severe neurological disturbance only occurred when CSF osmolality exceeded that of serum by 7 or more mmol/kg H2O. Discriminant analysis of the paired osmolar data showed that D = -117+1-74 X(CSF osmolality) -1-41 X (serum osmolality), and that severe neurological abnormality was predicted when D was positive.

Blood Glucose

Viral infection in wheezy bronchitis and asthma in children.

Virus isolation was attempted on 267 out of 360 patients with wheezy bronchitis or asthma admitted to hospital during a 3-year period. Viruses were isolated on 39 occasions, the most common being respiratory syncytial virus and rhinovirus. The peak months for virus isolation were February and August. Virus isolation was significantly more common in readmissions than in first admissions (P less than 0-01). Viruses were isolated in both sexes throughout childhood and though the admission rate fell with increasing age, the isolation rate was unaffected. The possible significance of viral infection as a cause of acute attacks of wheezing in children is discussed.

Asthma