Treatment of infants with distended gallbladder.
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Biomedical subjects
Publications and source records attributed to R L Saldanha.
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Cerebrospinal fluid (CSF) lactate dehydrogenase (LDH) was measured in 54 neonates with intracranial hemorrhage and compared with 82 control, 27 traumatic lumbar puncture, seven meningitis, and 30 asphyxiated newborns. Hospital data, neonatal outcomes, and long-term neurodevelopmental follow-up results were reviewed. CSF LDH was not significantly affected by traumatic lumbar puncture but was elevated in proportion to the severity of CNS hemorrhage as scored by computerized tomography. LDH was also significantly associated with subsequent seizures and hydrocephalus and abnormal long-term developmental outcome.
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Current federal policy, as reflected in the final Baby Doe rule, will have a chilling effect on the ability of doctors to care appropriately for severely disabled infants. The policy threatens to prolong life unjustifiably for such infants. It will force physicians to violate a duty to do no harm without compensating benefit. And it raises serious problems for the just distribution of health care.
Four ill preterm infants each had a severely dilated gallbladder that was detected as a right-upper-quadrant abdominal mass. In each infant, the diagnosis was suspected on physical examination and confirmed by ultrasound study. One extremely premature infant with respiratory distress syndrome died, and at autopsy, the gallbladder and biliary tree showed no abnormalities, except for severe gallbladder distention. In the other three infants, distention of the gallbladder resolved spontaneously.
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