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Biomedical subjects

J S Forsyth

Publications and source records attributed to J S Forsyth.

At least 37 records · Page 2Linked to original sources
PubMed1991

Cerebral pathology in the very low birthweight infant: predictive value of peripartum metabolic acidosis.

One-hundred-and-three infants with a birthweight of less than 1500 g and delivering at a gestation of less than 32 weeks were examined by serial cranial ultrasound scans. A capillary blood sample was drawn for blood gas analysis within 1 h of birth in all cases. The subsequent development of intracranial pathology was found to be significantly associated with gestation at delivery (P less than 0.01), birthweight (P less than 0.01) and base deficit within 1 h of birth (P less than 0.001). For infants with a base deficit of greater than 5.0 mmol/l within the first hour of life, the sensitivity for predicting the subsequent development of cerebral pathology was 51.5% with a specificity of 97.3%, and a positive predictive value of 97.1%. This relationship between a metabolic acidosis within 1 h of birth and the subsequent development of cerebral pathology held for both major and minor degrees of pathology, but was stronger in those infants developing major cerebral pathology. The study suggests that improved surveillance of the very preterm infant during labour and at birth with the aim of reducing the incidence of metabolic acidosis at birth, may help to reduce subsequent intracranial pathology, and thereby perinatal and long-term morbidity.

Acidosis↗
PubMed1991

The use of the objective structured clinical examination as an audit of teaching and student performance.

A four year experience of the Objective Structured Clinical Examination in Child Health of 301 students in 18 separate examination diets was analysed to determine student competence in several clinical examinations including cardiovascular and central nervous system, developmental examination, history of asthma and in answering multiple choice questions relating to factual information. Using criterion reference assessment, student performance was related to individual knowledge, quality of teaching, examination design and teacher expectation. Variable levels of expectation and achievement were noted for different clinical items. Staff expectation of student performance was found to be higher than achieved in 39%, the same in 55% and in only 6% did students perform better than was anticipated. The value of using Criterion Reference Assessment System, based on a standard comprehensive examination, is discussed in relation to influencing examination design and efficiency of teaching medical students.

Achievement↗
PubMed1990

Protective effect of breast feeding against infection.

OBJECTIVE: To assess the relations between breast feeding and infant illness in the first two years of life with particular reference to gastrointestinal disease. DESIGN: Prospective observational study of mothers and babies followed up for 24 months after birth. SETTING: Community setting in Dundee. PATIENTS: 750 pairs of mothers and infants, 76 of whom were excluded because the babies were preterm (less than 38 weeks), low birth weight (less than 2500 g), or treated in special care for more than 48 hours. Of the remaining cohort of 674, 618 were followed up for two years. INTERVENTIONS: Detailed observations of infant feeding and illness were made at two weeks, and one, two, three, four, five, six, nine, 12, 15, 18, 21, and 24 months by health visitors. MAIN OUTCOME MEASURE: The prevalence of gastrointestinal disease in infants during follow up. RESULTS: After confounding variables were corrected for babies who were breast fed for 13 weeks or more (227) had significantly less gastrointestinal illness than those who were bottle fed from birth (267) at ages 0-13 weeks (p less than 0.01; 95% confidence interval for reduction in incidence 6.6% to 16.8%), 14-26 weeks (p less than 0.01), 27-39 weeks (p less than 0.05), and 40-52 weeks (p less than 0.05). This reduction in illness was found whether or not supplements were introduced before 13 weeks, was maintained beyond the period of breast feeding itself, and was accompanied by a reduction in the rate of hospital admission. By contrast, babies who were breast fed for less than 13 weeks (180) had rates of gastrointestinal illness similar to those observed in bottle fed babies. Smaller reductions in the rates of respiratory illness were observed at ages 0-13 and 40-52 weeks (p less than 0.05) in babies who were breast fed for more than 13 weeks. There was no consistent protective effect of breast feeding against ear, eye, mouth, or skin infections, infantile colic, eczema, or nappy rash. CONCLUSION: Breast feeding during the first 13 weeks of life confers protection against gastrointestinal illness that persists beyond the period of breast feeding itself.

Bottle Feeding↗
PubMed1990

A study of the relationship between bile salts, bile salt-stimulated lipase, and free fatty acids in breast milk: normal infants and those with breast milk jaundice.

Breast milk jaundice has been reported to be associated with increased lipase activity and elevated free fatty acid (FFA) concentrations within breast milk. We have previously shown that bile salts are present in small concentrations in breast milk and the aim of this study was to examine the relationship of bile salt-stimulated lipase (BSSL) activity, FFA concentration, and bile salt concentration in milks of normal infants and the milk of infants with breast milk jaundice. Mothers of healthy newborn infants were recruited in the early newborn period and 42 provided breast milk samples at 2 weeks, 30 at 6 weeks, 16 at 10 weeks, and 13 at 14 weeks postnatally. We initially studied the effect of lactation on bile salts and found there was a significant decline in both cholate and chenodeoxycholate levels with duration of lactation (p less than 0.05). There was also a significant fall in BSSL activity with duration of lactation (p less than 0.05), but no correlation was found between BSSL activity and bile salt concentration. FFA concentrations were similar throughout lactation and were not related to either BSSL activity or bile salt concentration. There was a significant increase in the concentration of cholate and the cholate-to-chenodeoxycholate ratio in the milks of 12 infants with breast milk jaundice compared with normal milks, the BSSL activity was similar and contrary to previous reports, the FFA concentration was not increased in the milks of infants with breast milk jaundice.

Bile Acids and Salts↗
PubMed1990

Diagnosis of neonatal chlamydial conjunctivitis.

Fifty seven babies with ophthalmia neonatorum had conjunctival smears examined by microscopy and bacterial culture, and by immunofluorescence, to find out which was the best method of diagnosing chlamydial conjunctivitis. The positive (33%) and negative (70%) predictive values of microscopy and culture were too low for us to accept it as an adequate method of detecting the presence of Chlamydia trachomatis.

Bacteriological Techniques↗
PubMed1986

Diagnosis of exocrine pancreatic insufficiency in cystic fibrosis by use of fluorescein dilaurate test.

In the fluorescein dilaurate test fluorescein dilaurate is cleaved by the pancreas specific cholesterol ester hydrolase activity and the liberated fluorescein is absorbed and excreted in the urine. Fluorescein recovery is a reflection of exocrine pancreatic function. The test was evaluated in 14 patients with cystic fibrosis and 16 healthy volunteers. The test was well tolerated by patients, was easy to perform, and gave significantly lower values in the patients suffering from cystic fibrosis. The result of the pancreolauryl test was also correlated with the result of the faecal chymotrypsin test in 11 of the patients suffering from cystic fibrosis. A positive correlation was found between the two test results. The test is a practical and reliable index of pancreatic exocrine function and may have a useful role as a screening procedure.

Adolescent↗
PubMed1985

Wiedemann-Beckwith syndrome in one of monozygotic twins.

A pair of monozygotic twins discordant for Wiedemann-Beckwith syndrome is described. The probability of monozygosity is 0.995. This observation suggests that the syndrome is unlikely to be under single gene control and genetic counselling should be based on multifactorial inheritance.

Beckwith-Wiedemann Syndrome↗
PubMed1983

Bile salts in breast milk.

Breast milk was studied for the presence of bile salts. Cholate and chenodeoxycholate were found in all samples examined. In both colostrum and milk there was a predominance of cholate. Their biological activity remains to be determined.

Bile Acids and Salts↗
PubMed1982

The effect of fever on antipyrine metabolism in children.

1 The elimination of antipyrine from saliva was measured in six children aged 5 months to 5 years during fever and during a control period 2-4 weeks after the cessation of fever. 2 The mean (+/- s.d.) saliva antipyrine clearance during fever, 32 +/- 13 ml kg-1 h-1, was nearly 50% less than that when the children were afebrile, 50 +/- 22 ml kg-1 h-1 (P less than 0.02). The mean saliva antipyrine half-life during fever, 15.20 +/- 5.40 h, was almost twice as long as that found when body temperature was normal, 9.18 +/- 2.49 h (P less than 0.01). The apparent volume of distribution of antipyrine was not significantly affected by fever. 3 These findings indicate that drug metabolising ability in children is impaired during fever.

Antipyrine↗
PubMed1982

Interstitial deletion of chromosome 7: a case report and review of the literature.

A de novo deletion 7q11 leads to q21.2 was identified in a newborn with genital and other minor clinical abnormalities and some degree of psychomotor retardation. A review of the literature revealed a number of cases of deletion 7q, which can be categorized into three groups according to their breakpoints. Attempts to correlate phenotype with genotype in these cases have been only moderately successful, and as yet only deletion 7q32 leads to qter can be associated with a definite clinical syndrome, although a tentative syndrome may be postulated in association with deletion of region 7q22 leads to 7q31.

Abnormalities, Multiple↗
PubMed1982

Cystic fibrosis presenting with chronic electrolyte depletion, metabolic alkalosis and hyperaldosteronism.

A five month old infant who presented with failure to thrive and was found to have severe electrolyte depletion, metabolic alkalosis and hyperaldosteronism is described. The diagnosis of cystic fibrosis was made by demonstrating abnormal sweat electrolytes and pancreatic insufficiency. It is important to exclude cystic fibrosis in any infant presenting with this biochemical abnormality.

Alkalosis↗