Necrotizing enterocolitis in older infants, children, and adolescents.
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Adolescent↗
Biomedical subjects
T J Moss
Publications and source records attributed to T J Moss.
Hepatic abscess in neonates.
Hepatic abscess in the neonatal period is a rare but serious disorder. To our knowledge, only 24 cases have been reported in the literature; this study presents 13 additional cases. The most common associated factors are sepsis, vessel cannulation, and abdominal surgery. The etiologic agent is variable. The abscess is usually multiple in the liver and involves other organs as well. In such instances, only supportive and vigorous antibiotic therapy can be offered. However, solitary liver abscess does occur, and this is theoretically amenable to surgical drainage. Thus, its recognition is of great importance.
Female↗
Pre-atherosclerotic lesions in Down syndrome.
Autopsy examination of seven non-institutionalised Down syndrome patients (age ten to twenty-five years) revealed normal prevalence of pre-atherosclerotic lesions. Atherosclerotic plaques were observed in one of these subjects (age fourteen years), refuting reported implications that this population is atheroma-free. However, atheromatous aortic lesions were not seen in an eighth subject (age fifty years), raising the possibility that an atheroma-free subgroup of patients with Down syndrome may exist.
Adolescent↗
Preatherosclerotic aortic lesions in cystic fibrosis.
Patients with cystic fibrosis have fat malabsorption, providing an experimental model for evaluation of the hypothesis that a low-fat intake may prevent atherosclerosis. We studied the frequency and extent of aortic precursor lesions (fatty streaks, early fibromusculoelastic lesions, late fibromusculoelastic lesions) found at autopsy in this disease as well as in other patients with debilitating disorders but with no apparent impairment of fat absorption. Fatty streaks were less common in the cystic fibrosis group, as were the late fibromusculoelastic lesions. There was no significant difference in the frequency, length, or thickness of the early fibromusculoelastic lesions. The findings suggest that fat may be responsible for progression but not initiation of the fibromusculoelastic precursor lesions, and support the concept that early restriction of dietary fat may prevent, delay, or otherwise modify atherosclerosis in the adult.
Adolescent↗
Association of hydrops fetalis with congenital neuroblastoma.
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Edema↗
Selection of medical students for graduate training: pass/fail versus grades.
We analyzed the performance of two cohorts of surgical residents: one from "pass/fail" and the other from "graded" medical schools. A performance index indicates that the group from graded schools performed significantly better (P less than 0.001). No resident from a pass/fail institution ranked above the 87th percentile, and this group accounted for 82 per cent of those ranking below the 15th percentile. A residency training program that seeks excellence among its trainees would do well to select preferentially students who apply from medical schools providing a specific class standing as part of the total evaluation of the student. It is suggested that the pass/fail controversy is symbolic of the erosion of standards that inevitably occurs when the university becomes involved in transient sociopolitical turmoil.
Education, Medical, Graduate↗
Effects of intra-uterine growth restriction on the control of breathing and lung development after birth.
1. Low birthweight is now recognized as an important risk factor for early postnatal respiratory illness and it is becoming evident that low birthweight can increase the risk for airway dysfunction in children and adults. Our studies have been aimed at determining how low birthweight, resulting from intra-uterine growth restriction (IUGR), affects the control of breathing and the structural and functional development of the lung. 2. We have measured ventilatory responsiveness to progressive hypoxia and progressive hypercapnia during the first weeks after birth in postnatal lambs in which IUGR was induced by chronic placental insufficiency. It was found that the postnatal increase in ventilatory sensitivity to hypoxia observed in control lambs was diminished in low birthweight lambs; in contrast, the sensitivity to hypercapnia was not affected. In other studies, we found that IUGR caused by maternal anaemia led to elevated CO2 levels during sleep and wakefulness. 3. Our findings suggest that the prenatal development of the brain-stem or respiratory chemoreceptors may be affected by intra-uterine factors associated with IUGR, such as foetal hypoxaemia or hypoglycaemia. It is also possible that the structure of respiratory muscles and, hence, their ability to maintain a high level of ventilation may be affected by IUGR. 4. Recently, we studied the influence of IUGR on foetal lung development, in particular its effects on foetal lung liquid, a major determinant of lung growth, as well as alveolar structure and pulmonary surfactant. Lung liquid secretion and volume, in relation to bodyweight, were unaffected; however, there was evidence of structural and functional immaturity in the lungs. In foetuses exposed to IUGR, the air-blood barrier was thicker and, after birth, the diffusing capacity of the lungs for carbon monoxide was lower. In contrast, surfactant protein gene expression was enhanced, particularly in foetuses with high levels of circulating cortisol. 5. Further studies are needed to characterize the effects of specific types of prenatal compromise on postnatal control of ventilation and lung function, to determine mechanisms underlying these effects and to determine the capacity for postnatal recovery.
Animals↗