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Biomedical subjects

M Hack

Publications and source records attributed to M Hack.

At least 55 records · Page 3Linked to original sources
PubMed1983

The very low birth weight infant: the broader spectrum of morbidity during infancy and early childhood.

Neonatal intensive care has improved very low birth weight (less than 1.5 kg) outcome. To evaluate the spectrum of morbidity related to this care, 505 survivors born between 1975 and 1979 were followed during the first three years of life. Transient neurological abnormalities of muscle tone which resolved by two years of age were seen in 40% of children. The incidence of chronic physical disease (lung disease, sequelae of necrotizing enterocolitis, and cholestatic jaundice) was 23% at term, 12% by 8 months, and 3.3% by 20 months. Subnormal weight for age at three years was found in 17% of infants born appropriate for gestational age and 46% of those born small for gestational age. Thirty-three percent of children were rehospitalized during infancy, 10% during their second year, and 10% during their third year of life. Mean IQ was 92.0. In the total population 80.6% were considered normal, 1.7% had major congenital malformations, 10.1% had neurosensory abnormalities, and 7.6% had developmental delay (DQ or IQ less than 80). Close followup care is essential to ensure the eventual adaptation and functional normalization which occurs in the majority of these high-risk infants.

Body Height↗
PubMed1982

The prognostic significance of postnatal growth in very low--birth weight infants.

To examine the relative importance of intrauterine growth failure, extrauterine growth failure before or after term, and the prognostic significance of catch-up growth, 192 very low--birth weight infants (less than 1.5 kg) were followed prospectively to 8 months corrected age. One hundred fifty-four appropriate--for--gestational age (AGA) and 38 small--for--gestational age (SGA) infants were categorized into normal and subnormal (less than -2 SD) weight for age groups at term (40 weeks) and at 8 months corrected age. By term, 71 AGA infants had subnormal weight; 41 of these caught up by 8 months, and an additional 13 AGA infants failed to thrive between term and 8 months. Of the SGA infants, three caught up in weight by term, and an additional 16 caught up by 8 months. Significant correlates of subnormal weight included neonatal risk score, incidence of chronic disease, and extended hospitalization. The AGA and SGA infants who failed to thrive or failed to catch up in weight by 8 months had lower mean Bayley developmental quotients (p less than 0.005), smaller head circumferences (p less than 0.005), and a higher rate of neurosensory impairment (p less than 0.01) than the AGA infants with normal fetal and postnatal growth. Intrauterine and/or postnatal growth failure prior to term was not of sinister prognostic significance if catch up occurred thereafter.

Adult↗
PubMed1982

Longitudinal ABR in the NICU infant.

To assess the reliability of ABR testing of NICU infants, longitudinal ABR testing was accomplished on 50 NICU infants while hospitalized and subsequently at 4 and at 20-24 months of age. The results indicate that ABR testing in the NICU may be a poor predictor of subsequent permanent hearing loss. The implications of these findings are discussed with the recommendation that ABR testing in the NICU be used in concert with follow-up testing.

Adult↗
PubMed1982

Epidemiologic study of necrotizing enterocolitis among low-birth-weight infants. Absence of identifiable risk factors.

Necrotizing enterocolitis has been associated with a variety of perinatal problems which have been purported to be risk factors predisposing the neonate to NEC. The present investigation compares the perinatal histories of 48 low-birth-weight infants (less than 1,500 gm) with NEC to those of 553 high-risk infants of equivalent birth weight who did not have NEC but who were present in the nursery during a four-year observation period. The two populations were equivalent with regard to maternal factors such as socioeconomic status, education, race, and age. Both the antenatal and intrapartum risk scores were similar, as were the position of presentation and mode of delivery. The incidence of pre-eclampsia, prolonged rupture of the membranes, and placenta previa was also equivalent. Birth weight and gestational age were identical, as well as intrauterine growth retardation and low Apgar scores. The placement of umbilical artery catheters or the performance of exchange transfusions were not more frequent among patients with NEC. Infants who developed NEC demonstrated significantly different incidences of only three variables. Mothers of these infants were usually married, and their infants had less respiratory distress syndrome; the only adverse factor present more frequently was abruptio placenta. These data raise further questions concerning the significance of previously reported risk factors of NEC.

Adult↗
PubMed1981

Rehospitalization of the very-low-birth-weight infant. A continuum of perinatal and environmental morbidity.

To evaluate ongoing morbidity, a prospective follow-up study was undertaken of the frequency and causes of rehospitalization of very-low-birth-weight infants (less than 1,500 g) during the first year of life. In 1977, 90 very-low-birth-weight infants were discharged after an average of 62 days' hospitalization. Thirty required rehospitalization on 51 occasions during the first year, for reasons including continuing care of chronic conditions related to the initial neonatal hospitalization (16), respiratory and other infections (14), inguinal herniorrhaphy (13), caretaking disorders (five), and other causes (three). Infants at highest risk for rehospitalization included those with chronic conditions and/or those with poor neurodevelopmental outcomes. These data reconfirm the continuing toll of perinatal morbidity among very-low-birth-weight infants and emphasize the medical and social responsibility for a systematic program of follow-up for these high-risk infants.

Adolescent↗
PubMed1981

Brainstem evoked response audiometry in the premature infant population.

Auditory brainstem response (ABR) audiometry was performed on 76 non-selected premature infants from 32 to 40 weeks conceptional age. Follow-up ABR was completed on 45 infants at 4 months of age. The results were compared to data from selected, relatively low risk infants of comparable age. No significant differences were seen between the two groups, which indicates that normative data from non-selected premature infants can be obtained to identify ABR abnormality.

Audiometry↗
PubMed1981

Brainstem-evoked response audiometry: normative data from the preterm infant.

Brainstem-evoked response audiometry (BERA) was performed on 40 preterm infants who had low neonatal risk scores. Mean latencies for waves I and V were obtained from four age-groups, 33-34, 35-36, 37-38 and 39-40 weeks conceptional age. The results indicate that BERA is a valuable and reliable tool in assessment of auditory function in the preterm infant. Also for classification of abnormality it is recommended that 2 standard deviations from the mean latency of wave V be used.

Audiometry↗
PubMed1981

State of awakeness during visual fixation in preterm infants.

To demonstrate the presence of discriminable awake states in preterm infants, facial behaviors and visual fixation to a single patterned stimulus were recorded. Five healthy preterm infants born at a mean of 29 weeks' gestation were followed from 30 to 35 weeks' postmenstrual age. Behaviors (eye openness, movements, mouthing, and vocalizations) were recorded simultaneously with visual fixation measured by the corneal reflection technique. Test time was determined by the duration of time the infant remained awake before crying or closing eyes. The presence of both quiet awakeness and drowsiness was demonstrated. Younger infants spent more time in drowsiness, whereas older infants had more quiet awakeness. Visual pattern fixation was observed as early as 30 weeks. Fixation time increased with increasing postmenstrual age. More fixation was observed during quiet awakeness than during drowsiness.

Eye Movements↗
PubMed1980

Changing trends of neonatal and postneonatal deaths in very-low-birth-weight infants.

Advances in perinatal care have resulted in a decline in mortality of very-low-birth-weight infants (< 1.5 kilograms) and also in an extension of the mortality period. To determine the current relevance of neonatal mortality results as indicators of outcome, all deaths among 427 very-low-birth-weight infants admitted during 1975-1977 were documented. A total of 145 infants died; 90 of the deaths (62%) occurred during the early neonatal period (0 to 6 days), 35 (24%) in the late neonatal period (7 to 27 days), and 20 (14%) in the postneonatal period. Death in 17 of the 20 postneonatal losses was due to neonatal complications of prematurity, and 16 of the 20 deaths occurred during the initial hospitalization. The postponement of these deaths to the postneonatal period has important epidemiologic implications and indicates a need for a reconsideration of accepted reporting mechanisms for infants of very low birth weight.

Female↗
PubMed1980

Footwear.

Explore the source record for details and available documents.

Shoes↗
PubMed1978

Hazards of amniocentesis: an unidentifiable fragment.

A 38-year-old woman had amniocentesis performed for advanced maternal age. The karyotype of the cultured amniotic fluid cells showed a minute fragment in all cells analyzed, 47,XY+Fg. The fragment could not be identified. For medical reasons the pregnancy had to be terminated at 34 weeks. Both skin and blood cultures from the aborted fetus showed a 47,XY,21+ karyotype.

Abortion, Induced↗
PubMed1977

Neonatal pattern vision: a predictor of future mental performance?

The visual fixation responses of 33 high-risk neonates to patterned stimuli were rated as normal, suspect, or abnormal in an attempt to predict future intellectual performance. For comparison purposes, a neurologic examination was aslo administered. Follow-up studies based on autopsies and neurologic and psychological testing agreed with the neonatal visual preference ratings in 27 cases, but with the neurologic examination ratings in only 22 cases. This preliminary study suggests that neonatal visual testing is a promising technique for evaluating brain integrity in the newborn period.

Child, Preschool↗
PubMed1976

Neonatal respiratory distress following elective delivery. A preventable disease?

Twelve per cent of all infants with respiratory distress admitted to our neonatal intensive-care unit from November, 1973 to April, 1974, were born after elective intervention (15 cesarean sections and four vaginal inductions). All were white and 18/19 were private compared to yearly admissions of white (56 per cent) and private (57 per cent). Eighteen of 19 were admitted from the region via the transport service. Mean birth weight was 2.69 kilograms, with 18 infants over 2 kilograms. Pediatric gestational age from a physical and neurological evaluation ranged from 32 to 39 weeks (mean 36.2 weeks) in contrast to obstetric dating which ranged from 38 to 44 weeks (mean 39 weeks). The obstetric dating was 3 or more weeks greater than the pediatric age in 11 infants. Pulmonary disease included transient tachypnea (5) and respiratory distress syndrome (14). No prior documentation of pulmonary maturity had been obtained in any of these infants. Mean hospitalization was 23 days (range 1 to 140), with estimated costs of $3,421 per baby. Two infants died. Respiratory distress following elective delivery remains a potent source of on-going perinatal morbidity. Regional programs must direct increased educational efforts to eliminate this preventable disease.

Birth Weight↗
PubMed1976

Development of attention in preterm infants.

The quality of the awake state and attention in preterm infants has been evaluated by rating indices of attention such as widening of the eye, type of fixation, brightening, scanning, and cessation of sucking measured during visual fixation of patterns. Twenty-six infants ranging from 28 to 32 weeks' gestation at birth (mean, 31 weeks) were tested from one to four weeks postnatally until 36 weeks' gestation. Indices of attention were rated on a scale of 4 with an optimal mean index of 4. A progressive increase in behaviors associated with fixation of visual stimuli has been shown from 32 to 36 weeks of conceptual age. Mean scores ranged from 0.7 at 31 weeks' gestation to 1.8 at 34 weeks' and 2.7 at 36 weeks' gestation. The possibility therefore exists that by as early as 31 to 32 weeks from conception the human brain may be capable of waking states and thus able to process some sensory stimulation.rease in behaviors associated with fixation of visual stimuli has been shown from 32 to 36 weeks of conceptual age. Mean scores ranged from 0.7 at 31 weeks' gestation to 1.8 at 34 weeks' and 2.7 at 36 weeks' gestation. The possibility therefore exists that by as early as 31 to 32 weeks from conception the human brain may be capable of waking states and thus able to process some sensory stimulation.

Analysis of Variance↗