Growth in the first year of life was studied prospectively, at monthly intervals, in 49 Aboriginal babies born into 6 remote communities in the tropical north-west of Australia. Birthweights, on average, were slightly lower than international (NCHS) reference values but growth velocity in the first 3 months of life exceeded international reference values. After that, growth rates in Aboriginal infants slowed and their attained weights and lengths fell behind expected values for age. By 12 months of age the Kimberley boys were 1.35 kg lighter and 4 cm shorter than the NCHS values while the Kimberley girls were 1.04 kg and 2.8 cm less than the international reference values. Environmental factors are considered dominant in determining these growth patterns in Australian Aboriginal infants.

Anthropometry↗

PubMedDate not supplied

Growth of remote Australian aborigines from birth to two years.

Lengths and weights have been measured every month from birth to two years of age in 48 Aboriginal children born into six remote communities in the Kimberley region in the far north of Western Australia. Birthweights, on average, were slightly less than international reference values but growth rates in the first 3 months of life exceeded those reference values. However, between 3 and 6 months of age rates of weight gain and linear growth fell below those expected at that age and after 9 months of age Aboriginal infants were lighter than reference values and remained so throughout the first two years of life. By 2 years of age the Kimberley children were more than 1 kg lighter and 4.5 cm (boys) and 3.6 cm (girls) shorter than the international reference values. Monthly means and standard deviations for weight and length velocities are given. Environmental factors, particularly infections and inadequate nutrition, are important contributors to impaired growth in Aboriginal infants and young children.

Australia↗

PubMedDate not supplied

Effect of magnesium on in vitro production of toxic shock syndrome toxin 1.

Batch and chemostat culture of Staphylococcus aureus strain S411 was conducted in an investigation of the role of Mg++ in the control of production of toxic shock syndrome toxin 1 (TSST-1). Under both growth conditions, Mg++ influenced bacterial growth, and TSST-1 production was correlated with bacterial growth. The specific activity of TSST-1 (ng/mg yield, ng/mg total protein) increased with increasing concentrations of Mg++ and was maximal at physiologic levels of Mg++. No production of TSST-1 was observed under anaerobic conditions. In chemostat cultures in which valine nutrient limitation was used with various levels of tryptophan in the chemically defined medium, tryptophan concentration controlled the production of TSST-1 by strain S411, regardless of the concentration of Mg++.

Aerobiosis↗

PubMedDate not supplied

Successful use of the total artificial heart as a bridge to transplantation with no mediastinitis.

UNLABELLED: High rates of infection, especially mediastinitis, have been reported with the use of the total artificial heart (TAH), thereby limiting its usefulness. We have used the TAH as a bridge to transplantation with only minor infectious complications and a zero incidence of mediastinitis. Between February 1988 and August 1990, the TAH was inserted at Loyola University Medical Center in 19 patients, ages 16 to 64 years (mean, 44 years). Seventeen patients (89%) underwent transplantation within 1 to 34 days (mean, 9.8 days). Of the patients who did not undergo transplantation, one was brain dead and the other died of bleeding diathesis. Early (30-day) deaths occurred in two patients (11.7%): acute rejection at 18 days and multiple cerebral infarcts at 14 days. Three late deaths (17.6%) occurred: one patient, cytomegalovirus and pneumocystis pneumonia at 4 months; one patient, bronchopneumonia and multisystem failure at 9 months; and one patient, chronic rejection at 14 months. Minor infectious complications during the TAH implantation included Enterobacter pneumonia treated with antibiotics and positive sputum cultures (Escherichia coli; Candida), with no clinical evidence of infection in two patients. No cases of mediastinitis occurred either while the TAH was implanted or after transplantation. All patients were on antibiotics while the device was in place. CONCLUSION: Our experience with the TAH shows this to be an excellent device for successful bridging of patients for heart transplantation. We have had minimal infectious complications and none directly attributed to the use of this device. This device should continue to be used safely as a bridge to transplantation.

Adult↗

PubMedDate not supplied

Comparison of results after heart transplantation: mechanically supported versus nonsupported patients.

Between March 1984 and July 1990 our team transplanted 168 hearts. One hundred twelve patients did not require mechanical support (group I). Fifty-six patients required mechanical support (group II). Intraaortic balloon counterpulsation was used in 37 patients (66%). The total artificial heart (TAH) was used in 16 patients (29%), and the ventricular assist device (VAD) was used in three patients (5%). The time spent on the device ranged from 1 to 35 days. No statistical difference was noted on the survival between the two groups. The 30-day and 1-year survival rate was 95% (106 patients) and 71% (79 patients) in group I and 91% (51 patients) and 68% (38 patients) in group II. As of July 31, 1990, 70% in group I and 68% in group II are alive. No significant differences were found between the two groups for the following variables (after heart transplantation): length of stay, 30-day survival, 1-year survival, and complications. The only significant difference found between the two groups was the incidence of infections: group I, 23%; group II, 51.7% (p = 0.001). Mechanical support as a bridge to transplantation provides excellent support until a donor becomes available. No difference was found in the 30-day and 1-year survival between the two groups.

Cause of Death↗

PubMedDate not supplied

Midwives' Journal. Repairing the tear.

Explore the source record for details and available documents.

Episiotomy↗

PubMedDate not supplied

High-risk heart surgery in the heart transplant candidate.

Because of the limited supply of donor hearts, transplant physicians are searching for alternative treatments for patients referred for orthotopic heart transplantation. A group of 20 patients (7% of patients accepted for heart transplantation at Loyola University Medical Center) were nonrandomly sent for conventional heart surgery. Of 20 patients, 17 survived their hospitalization, and 11 of the original 20 have avoided heart transplantation or having their names added to the transplant list. This group represents a high-risk subset of patients. Patients with poor ventricular function and ventricular arrhythmias or with poor ventricular function who underwent first-time revascularization were well served by more conventional heart surgery (all 10 patients survived surgery). Patients with poor ventricular function who required redo bypass operation had a poor result (three of six died), and such patients should be considered carefully for initial heart transplantation.

Adult↗