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Biomedical subjects

M F Whitfield

Publications and source records attributed to M F Whitfield.

At least 37 records · Page 2Linked to original sources
PubMed1988

Brain swelling in the asphyxiated term newborn: pathogenesis and outcome.

The role of brain swelling following acute hypoxic-ischemic insult in the genesis of brain injury in the term newborn is controversial. Recent experimental animal studies suggest that it may result from prior irreversible cerebral necrosis and therefore represents a consequence as opposed to a cause of major brain injury. In this study, 32 asphyxiated term newborns were studied during the first week of life with serial intracranial pressure measurements. A total of 26 infants had CT scans during the first five days of life. Seven patients had two CT scans within this period. These investigations were correlated with outcome at 18 months of age. Seven infants had increased intracranial pressure (greater than 10 mm Hg) that reached a maximum between 36 and 72 hours of age. Cerebral perfusion pressures remained normal, which makes ongoing ischemic injury unlikely as a cause. The seven patients with increased intracranial pressure had decreased attenuation on CT that was generalized in six infants and patchy in one infant. Of the infants with increased intracranial pressure and severe CT abnormalities, three died and four had severe neurologic sequelae. In seven infants, a second CT scan at three to four days of life demonstrated progression of the decrease in tissue attenuation. Most of the infants with normal intracranial pressure (23/25) had no or had only minor neurologic abnormalities at follow-up. These data suggest that brain swelling is relatively uncommon in the asphyxiated term newborn.(ABSTRACT TRUNCATED AT 250 WORDS)

Asphyxia Neonatorum↗
PubMed1988

Changing pattern of retinopathy of prematurity: a 37-year clinic experience.

A retrospective analysis was done of multi-disciplinary neurodevelopmental assessments in 70 children who were legally blind because of cicatricial retinopathy of prematurity. The subjects lived in British Columbia and were born during a 37-year period between 1951 and 1987. The purpose of the study was to investigate changes in the perinatal characteristics and to evaluate the associated handicaps. All patients were assessed at least once in the Visually Impaired Program, British Columbia Children's Hospital. In the majority, the visual loss was profound. Since 1951, blinding retinopathy of prematurity has become a disease of progressively smaller and less mature infants. Since 1981, it has been almost entirely confined to infants of birth weight less than 1,000 g in British Columbia. The diagnosis of mild spastic diplegia was made more commonly in patients born after 1980 but, despite the progressive reduction in birth weight and gestational age during the study period, the number of patients without other associated handicaps remained constant (approximately 30%) during each successive decade.

Birth Weight↗
PubMed1987

Periventricular leukomalacia: radiologic diagnosis.

Fifteen infants and children with clinical evidence of periventricular leukomalacia (i.e., spastic diplegia or quadriplegia and premature birth) were studied. Computed tomography (CT) scans of the brain demonstrated the following characteristic abnormalities: reduction in quantity of periventricular white matter, particularly at the trigone, deep and prominent sulci that abutted the ventricles without interposed white matter, and ventriculomegaly with irregular outline of the lateral ventricles. The location and severity of abnormalities on CT scans correlated well with the neurologic abnormalities observed at follow-up and the known anatomic location of periventricular leukomalacia. These observations demonstrate the diagnostic value of CT scanning for periventricular leukomalacia during late infancy and childhood. Although serial ultrasonography during the first weeks of life may be diagnostic of periventricular leukomalacia, it is of less value later. In contrast, CT scans obtained beyond 6 months of age can demonstrate a characteristic pattern of abnormalities that may be considered diagnostic of periventricular leukomalacia.

Encephalomalacia↗
PubMed1984

Perinatal changes in a digoxin-like immunoreactive substance.

An endogenous digoxin-like immunoreactive substance(s) (DLIS) exists in the serum of premature and full term infants not receiving digoxin. We followed serum changes in DLIS concentration sequentially over the first 14 postnatal days in 24 premature neonates who did not receive digoxin in the intensive care nursery. All infants had measurable levels (greater than 0.6 ng/ml) of DLIS in their serum. There was a distinct peak in DLIS concentration in 19 of 24 infants occurring at 4 +/- 1.6 (SD) days after birth (range, 1-8 days). No peak was found in five infants. The peak serum level of DLIS obtained in the first 8 days of life was negatively correlated with gestational age and birth weight. DLIS levels in amniotic fluid remained constant from 16 to 33 weeks of gestation but rose from 33 wk to term. DLIS concentrations in umbilical artery, umbilical vein, and maternal serum at normal full term delivery suggested that DLIS was of fetal origin. DLIS and digoxin concentrations are additive when present in the same serum sample if measured by standard radioimmunoassay methods.

Aging↗
PubMed1983

Seven different digoxin immunoassay kits compared with respect to interference by a digoxin-like immunoreactive substance in serum from premature and full-term infants.

Seven different digoxin immunoassay kits showed cross reactivity with an endogenous digoxin-like immunoreactive substance consistently present in serum of neonates, whether premature or full-term. The degree of interference, in decreasing order was: NML greater than New England Nuclear greater than Bio-Rad greater than Clinical Assays greater than Becton Dickinson greater than Serono greater than Syva (EMIT). More recently purchased NML kits showed less sensitivity to the substance, evidently reflecting lot-to-lot differences in antibody. A single baseline determination of the substance before digoxin is administered inadequately compensates for this interference, because the interferent concentrations can differ from day to day, with evidence that it may be most concentrated on the fourth to sixth postnatal day. Its concentration in the serum of neonates is unrelated to the concentration of dehydroepiandrostenedione sulfate, an indicator of fetal adrenal-cortical activity.

Cross Reactions↗
PubMed1982

Poor weight gain of the low birthweight infant fed nasojejunally.

Forty-four appropriately grown preterm infants of birthweight 1-1.5 kg were allocated to nasojejunal (NJ) or nasogastric (NG) feeding at birth. Infants in the NJ group were transferred to NG feeding as soon as they weighed 1.5 kg. The mean caloric intake of infants in both groups was the same, but mean incremental weight velocity during NJ feeding was significantly less than during NG feeding. At expected date of delivery mean body weight and mean occipitofrontal circumference were significantly smaller in the NJ group. During the 3 months after the expected date of delivery, when all infants were being fed orally, the infants in the NJ group had significantly greater mean weight velocity and mean occipitofrontal circumference velocity than infants in the NG group so that by 3 months after the expected date of delivery there was no significant difference in bodyweight or occipitofrontal circumference between the groups. Low birthweight infants fed by the nasojejunal route from birth should be transferred to nasogastric feeding as soon as possible.

Body Weight↗
PubMed1981

Acute hereditary tyrosinaemia type I: clinical, biochemical and haematological studies in twins.

Affected twins with acute hereditary tyrosinaemia type I are described. Attempts at therapy with a phenylalanine-tyrosine-methionine restricted diet supplemented with cysteine, vitamin E and ascorbic acid failed to influence the course of the disorder. The bleeding diathesis was due to a morbid reduction of a number of clotting factors, particularly factor VII, and this was associated with impaired platelet aggregation and release. The liver of one showed a marked reduction in fumarylacetoacetate lyase activity and her urine contained a potent inhibitor of red cell delta-aminolaevulinic acid dehydratase. Biochemical investigations of cultured fibroblasts suggest that these do not express the disorder and are unlikely to prove useful diagnostically.

Acetoacetates↗
PubMed1981

Growth and metabolic and hormonal profiles during transpyloric and nasogastric feeding in preterm infants.

The effect of transpyloric and nasogastric feeding on the blood concentration of glucose, lactate, pyruvate, glycerol, hydroxybutyrate, acetoacetate, alanine, insulin, pancreatic and total glucagon was determined in 20 preterm infants. The babies were studied on the last day of transpyloric feeding and the first and fifth days of ensuing nasogastric feeding. In 9 infants hourly measurements of hormones and metabolites were made at 1000, 1100, 1200, 1300 and 1400 hours. The blood concentrations of glucose, alanine, pancreatic and total glucagon were stable, the concentration of the other metabolites and insulin, less so. No significant difference in mean metabolite or hormone concentration was noted by time of day or type of feeding. Measurements made on the fifth day of nasogastric feeding showed no significant differences from those at the time of changeover. The infants were clinically well and growing normally at the time of study, but had low plasma insulin and high plasma glucagon concentrations. We conclude (i) the site of presentation of milk in the gastrointestinal tract has no effect on the circulating concentration of selected metabolites and hormones in the preterm infants, (ii) the preterm infant grows at a normal rate with a plasma insulin/glucagon ratio that in the adult would be expected to favour catabolism.

Alanine↗
PubMed1981

Validity of routine clinical test weighing as a measure of the intake of breast-fed infants.

Routine clinical test weighing was carried out on 100 bottle-fed infants to assess the accuracy of the procedure; the feed intake was measured by weighing the feeding bottles before and after feeding. Test weight was found to be an unreliable indication of feed weight, underestimating the amount of feed actually taken at test weight values below 60 g, and overestimating the amount of feed taken at test weights over 60 g. The errors were largest in infants having test weights at the extremes of the range. Test weighing with clinical baby scales is an unreliable and inaccurate indication of feed intake in breast-fed infants.

Body Weight↗
PubMed1980

Accidental administration of Syntometrine in adult dosage to the newborn.

The clinical course is described of an infant who accidentally received an adult dose of Syntometrine (synthetic oxytocin + ergometrine) at delivery. The infant soon became ill with convulsions and ventilatory failure, and later with water intoxication. Similar reported cases are reviewed and recommendations are given for the management of future cases.

Accidents↗
PubMed1980

Chondrodysplasia punctata after warfarin in early pregnancy. Case report and summary of the literature.

A third case of chondrodysplasia punctata after exposure to warfarin alone in early pregnancy is described. The clinical course of the child during the first 18 months is outlined. The use of warfarin in early pregnancy must be avoided because of its established teratogenic effects in causing this syndrome, in addition to an overall increase in perinatal mortality.

Chondrodysplasia Punctata↗
PubMed1980

C-trisomy in a case of neonatal leukaemia.

A case of neonatal leukaemia of acute myeloid cell type was diagnosed at age 8 weeks and the patient died shortly afterwards with evidence of disseminated intravascular coagulation. An aneuploid malignant cell line 47, XY+C was found, in addition to the infant's normal constitutional karyotype. Eight other cases of congenital or neonatal leukaemia with aneuploid malignant cell lines are reviewed. C-trisomy is a commonly acquired chromosomal abnormality in a wide range of malignant and premalignant haematological disorders, and its possible significance in relation to leukaemogenesis in this case is discussed.

Chromosomes, Human, 6-12 and X↗
PubMed1976

Cows' milk allergy in the syndrome of thrombocytopenia with absent radius.

A girl with the syndrome of thrombocytopenia with absent radius had severe diarrhoea and dehydration relieved by withdrawal of cows' milk and aggravated by its reintroduction on three occasions. Deterioration in gastrointestinal symptoms was associated with haematological relapse with thrombocytopenia, leucocytosis, anaemia, and eosinophilia. There appeared to be a correlation between milk exposure and the haematological and gastrointestinal disturbances. Supporting evidence from published reports for such a correlation is reviewed. Cows' milk protein intolerance may be a factor in precipitating haematological relapse in susceptible infants with radius aplasia. Early withdrawal of cow's milk protein should be tried in thrombocytopenia with absent radius, especially in cases with prominent gastrointestinal upset.

Animals↗