PubMed Health⌕ Search

Biomedical subjects

I Kovar

Publications and source records attributed to I Kovar.

17 recordsLinked to original sources
PubMed1996

Prenatal diagnosis of amniotic band syndrome in a methadone user: review of the literature and a case report.

We present a case and review of the literature of an amniotic band causing malformation in the distal forearm in a baby born to a methadone-dependent mother. This diagnosis was made prenatally at the routine 18-20-week gestation anomaly ultrasound scan. Histology of the amniotic band postpartum revealed hair shafts within its structure. This has not previously been documented, nor has an association of this syndrome with systematic abuse of methadone. The fact that this anomaly could be detected by prenatal ultrasound scanning is of value in the counselling of high-risk pregnancies such as this.

Adult↗
PubMed1989

Is it possible to "achieve a balance" and meet the "safety net"? Paediatric Advisory Subcommittee to the North West Thames Regional Health Authority.

The government's document Hospital Medical Staffing--Achieving a Balance--Plan for Action introduced the concept of a "safety net"--that is, a minimum safe level of staffing--of junior doctors in the acute specialties. The North West Thames Paediatric Advisory Group has therefore reviewed the implications and consequences of implementing the safety net in respect of children's services. The group found that if a reasonable safety net was to be provided that enabled the services to stay within the projected junior staffing levels, maintain a balance, meet training needs, and reduce junior doctors' hours of work, then changes in the organisation of the services would be required. Examining the options available showed that to achieve a safety net within the projected numbers of junior staff at least six paediatric units in the region would have to close. It is doubtful if there is the political will to support the very radical changes that would be needed in the distribution of services if the government's recommendations in Achieving a Balance were to be implemented. The profession, the Department of Health, and the public must be made aware that the proposed changes in medical staffing will cause a fundamental change in the traditional pattern of delivery of health care.

Child↗
PubMed1989

Hypothyroidism and unusual rickets in a very preterm infant.

Two separate episodes of rickets developed in a female infant of 25 weeks gestation and birthweight 690 g, who had congenital hypothyroidism and required parenteral nutrition for more than 100 days. We speculate that there is a relationship between metabolic bone disease of prematurity and the preterm infant's thyroid status.

Congenital Hypothyroidism↗
PubMed1988

Cytomegalovirus screened blood for neonatal intensive care units.

Two infants were considered to have acquired cytomegalovirus (CMV) infection from blood transfusions screened for the presence of CMV antibody by a haemagglutination assay. Further samples from the same donors were tested by a latex agglutination test; six of 18 (33%) previously believed seronegative were found to be seropositive.

Agglutination Tests↗
PubMed1983

Chlormethiazole in the treatment of neonatal status epilepticus.

A pre-term neonate with status epilepticus resistant to conventional treatment but who responded to a chlormethiazole infusion is reported. Nineteen days of continuous infusion was required before treatment could be discontinued and oral phenytoin substituted. Chlormethiazole should be considered in the treatment of resistant convulsions in the newborn.

Chlormethiazole↗
PubMed1982

Plasma alkaline phosphatase activity: a screening test for rickets in preterm neonates.

Both rickets and raised plasma alkaline phosphatase activity are common in the preterm infant. Measurement of plasma alkaline phosphatase activity is valuable in screening for active disease and in diagnosis, but normal reference data are not available for preterm babies. In 30 consecutive preterm infants (birthweight 1580 +/- 410 g, gestational age 31 +/- 2.5 weeks) serial measurements of plasma alkaline phosphatase activity, plasma levels of calcium and inorganic phosphorus, and the pattern of alkaline phosphatase isoenzymes were made. Four patterns of changes in plasma alkaline phosphatase activity with time were seen. 4 of the 30 infants were shown to have rickets; these children and 14 of the 26 non-rachitic infants showed an increasing/peak/decreasing pattern with increasing age, but levels were much higher in the rachitic infants. The activity in all 30 was raised above the adult and childhood reference ranges at some point in time. The data suggest that an activity of five times the upper limit of the normal adult reference range is acceptable in the preterm infant but an activity higher than this may suggest rickets.

Alkaline Phosphatase↗
PubMed1981

Plasma alkaline phosphatase activity in the preterm neonate.

Rickets was diagnosed clinically and confirmed radiologically in a preterm infant at 12 weeks of age, who despite therapy with vitamin D died. Four preterm infants who were subsequently admitted to the nursery had their biochemistry followed serially as controls. All infants demonstrated a marked increase and then subsequent decrease in plasma alkaline phosphatase activity; the peak value occurring near to what should have been gestationally term. The plasma alkaline phosphatase was of bony origin. Rickets was confirmed radiologically in only one of these four infants. Rising and markedly elevated plasma alkaline phosphatase activity appears to be common in this group of infants and may represent a physiological increase in osteoblastic activity and increasing bone mineralisation in what would have been the infants' 3rd trimester of pregnancy and immediate newborn period.

Alkaline Phosphatase↗
PubMed1979

Laryngeal chemoreflex in newborn lambs: respiratory and swallowing response to salts, acids, and sugars.

The laryngeal chemoreflex was tested in a standardized manner in eighteen 1- to 6-day-old lambs. The respiratory and swallowing components of the reflex response to chemical solutions introduced to the larynx were quantified to characterize the function of the receptors and to elucidate what kind of receptors most likely are involved. A relationship between the strength of the stimulus and the respiratory response was found. The response was suppressed with the addition of small amounts of CaCl2, NaCl, and LiCl. NaCl, 0.3--0.6 M, 0.15 M NaCl titrated to a pH of 3--5 with hydrochloric or acetic acid, and 0.25--1.0 M glucose in 0.15 M NaCl elicited the reflex response. A quantitative separation was seen in the respiratory response to equimolar concentrations of the salt solutions as well as to the acid solutions in normal saline with equal pH. The response to glucose was significantly reduced after application of potassium gymnemate (P less than 0.001). A direct relationship between the amount of swallowing and the respiratory response was found (r = 0.83). The laryngeal chemoreflex responses to the stimuli used have certain functional characteristics that are similar to taste receptor responses. This would suggest that the taste bud-like structures present in the laryngeal area are likely receptors for mediation of the reflex.

Acetates↗
PubMed1978

Medical management of small preterm infants with symptomatic patent ductus arteriosus.

During 1975, 38 of 44 infants with a birth weight of less than or equal to 1,500 gm who developed pulmonary edema and congestive heart failure due to a patent ductus arteriosus were managed medically until the ductus closed spontaneously days or weeks later. Overall survival was 71%, and there were no deaths among 11 infants weighing more than 1,250 gm. Pulmonary complications were prevalent and were attributed to the extensive use of mechanical ventilation required to control pulmonary edema. The results of this study document the results to be expected when small preterm infants with a symptomatic patent ductus arteriosus are managed without surgical or pharmacologic intervention and provide a basis for the rational design of clinical trials evaluating other management approaches.

Blood Transfusion↗
PubMed1978

Randomized trial of early closure of symptomatic patent ductus arteriosus in small preterm infants.

As a result of randomized assignment, 15 preterm infants weighing 1,500 gm or less at birth and who had a symptomatic PDA were treated according to a medical management protocol, and ten according to an early surgical closure protocol. All infants required mechanical ventilation at the time of study entry, which was one week after birth. Birth weight, gestational age, age at onset of congestive failure, age at study entry, and the initial morbidity of members of the two groups were similar. The nine surviving infants managed according to the surgical closure protocol were weaned from mechanical ventilation sooner, had a decreased need for digoxin and furosemide, achieved gastrointestinal function sooner, and had a smaller hospital bill than the 12 survivors of the medical management group. These results indicate that infants with a symptomatic PDA still requiring mechanical ventilation at one week after birth will benefit from surgical closure of the ductus at that time.

Digoxin↗