Infant death and consanguineous marriage.
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Biomedical subjects
Publications and source records attributed to J Steen.
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Perinatal and infant death are important indicators of community health. We examined the rate of stillbirth and death before the age of two years among 36,700 children with Norwegian and 2,750 children with Pakistani background. There was no difference in the rate of stillbirth and death during the second year of life, but a 2.5-3 times higher death rate during the first year of life among the Pakistani children, compared with the Norwegian children. When deaths due to single gene disorders and congenital malformations were excluded, the death rate during the first year of life was similar in the two groups. The Pakistani children had an 18 times higher death rate from autosomal recessive disorders and a ten times higher death rate from malformations of the central nervous system. The difference in death rate between the two groups was probably due to the high rate of consanguinity among the Pakistani parents.
The study concerns children born the years 1975-84. Only children in need of hearing aids are taken into account. The incidense was 1.08 per 1,000 live born children. The prevalens in January 1988 was 1.57 per 1,000 children, including 18 children moving into the city. The etiology among 75 children was 47% prenatal, 16% perinatal, 11% postnatal defects and further 26% of unknown neurogenic origin. Among the 63 impaired children living in Oslo 1988 15 or 24% had multiple handicaps. Identification of hearing loss before one year of age increased from 23% for children born 1975/79 to near 60% for children born 1980/84. At risk children should be tested before leaving hospital after delivery.
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In a retrospective survey the efficacy of a prophylactic antacid regime with aluminiumhydroxyde/magnesiumcarbonate (LINK, A.L. pharma) was investigated in 157 patients with major burns. Only 14% developed any sign of upper gastrointestinal stress ulceration, and only 5% revealed clinically significant bleeding indicating blood transfusion. No case developed haemodynamic instability, nor need for acute surgery, and no one died from haemorrhage. We found the regime economically attractive, and with few and reversible side effects. We conclude that our prophylactic regime is highly effective.
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Fasting serum gastrin (SG) concentration and the SG response to a standard protein meal were investigated in 8 women with upper gastrointestinal dyspepsia in the 36th week of pregnancy and again 8 weeks after parturition, when the dyspepsia had disappeared. The fasting SG concentration was significantly higher (p less than 0.05) during pregnancy than post partum, whereas no statistically significant difference was found between the SG response to a protein meal stimulation during pregnancy vs. post partum. The demonstrated variations in gastrin secretion during and after pregnancy offer no explanation for the upper gastrointestinal dyspepsia of our patients.
Fasting and meal-stimulated NH2-terminal gastrin concentrations in serum were significantly higher in patients with active duodenal ulcer than in control subjects and in patients with inactive duodenal ulcer (p less than 0.05). In contrast, the COOH-terminal gastrin concentrations (the bioactive gastrins) did not differ among the groups. Parallel variation in the NH2- and COOH-terminal gastrin concentrations occurred both during meal stimulation and as response to adrenaline or secretin infusion. In a longitudinal study of duodenal ulcer patients, higher NH2- than COOH-terminal gastrin concentrations were associated with the active phase of the disease, whereas this seldom occurred during the inactive phase (p less than 0.001). These data suggest that abnormally large amounts of the NH2-terminal fragment of gastrin-17 are released to the circulation during the active phase of duodenal ulcer.
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