ABSTRACT
The relation between Apgar score, meconium and acidaemia at birth and neonatal neurological morbidity was investigated in 805 vaginally born term infants whose birthweight was appropriate-for-dates (AFD). Presence or absence of meconium stained amniotic fluid was not related to the neonatal neurological condition. The 1-min and 3-min Apgar scores and the umbilical artery pH were related, but the variances explained in neonatal neurological optimality score were very low (0.9 and 0.5% respectively). Combination of Apgar score and pH slightly increased these percentages to 1.5. The highest frequency of neurologically deviant infants was, on the other hand, found in the group with a normal pH but low Apgar score. It is concluded that in AFD term infants nowadays the predictive value of a low Apgar score, acidaemia at birth and/or presence of meconium for the neonatal neurological morbidity is poor. Most neonatal neurological abnormalities must be due to other factors.
Subject(s)
Acidosis/congenital , Apgar Score , Meconium/analysis , Nervous System Diseases/congenital , Amniotic Fluid/analysis , Fetal Blood/analysis , Humans , Hydrogen-Ion Concentration , Infant, Newborn , RiskABSTRACT
After conversion from cyclosporine (Cys) only to prednisolone and azathioprine four months after cadaveric renal transplantation, effective renal plasma flow (ERPF), glomerular filtration rate (GFR) and filtration fraction (FF) all improve. However, this improvement is not uniform. GFR and FF improve in all patients after one week of combined Cys and prednisolone treatment. ERPF improves under the same circumstances only in recipients without previous rejection episodes. After discontinuation of Cys and addition of azathioprine ERPF improves further in all patients. These findings suggest the presence of a low grade rejection, together with Cys nephrotoxicity. The conversion procedure seems to be safe at least during a follow-up period of 9-14 months.
Subject(s)
Cyclosporins/administration & dosage , Kidney Transplantation , Azathioprine/administration & dosage , Drug Administration Schedule , Glomerular Filtration Rate , Humans , Prednisolone/administration & dosage , Renal CirculationABSTRACT
Concomitant application of intrathecal methotrexate (MTX) and cranial irradiation has been described as being able to cause brain abnormalities in patients with leukemia. In the investigation presented, rabbits were treated once weekly for 6 weeks with intraventricular MTX and irradiation. Cerebrospinal fluid (CSF) sampled at various time points after each treatment contained for the samples obtained 4 hours after treatment increasing amounts of MTX. This indicated a retardation in MTX clearance from the CSF. Such a retardation might contribute to the generation of brain abnormalities, although no data have as yet been obtained to prove this suggestion.
Subject(s)
Methotrexate/cerebrospinal fluid , Animals , Combined Modality Therapy , Female , Injections, Intraventricular , Male , Metabolic Clearance Rate/radiation effects , Methotrexate/toxicity , Rabbits , Radiotherapy/adverse effectsABSTRACT
A study was conducted of all children delivered in breech presentation from 1969 to 1977 in the university's department of obstetrics. One-fifth of the deliveries were by caesarean section. Perinatal mortality was high (13.2%) but was due almost exclusively to causes other than the birth itself. The 256 surviving children and their matched controls were neurologically examined at 18 months or at ages varying between 3 and 10 years. The attrition rate was 5.7%, but in most cases data on development were available. Significant differences between the study and control groups existed for only minor neurological dysfunctions. It is concluded that the main danger of breech presentation is in the associated complications of pregnancy and that there is no reason to advocate a higher frequency of abdominal delivery than the 20% found in this study.
Subject(s)
Breech Presentation , Labor Presentation , Nervous System Diseases/etiology , Cesarean Section , Female , Follow-Up Studies , Humans , Infant Mortality , Infant, Newborn , Male , Netherlands , Pregnancy , Sex Factors , TwinsABSTRACT
A study concerning the relationship between neonatal neurological abnormality and 3 parameters of pre- and perinatal condition in a birth cohort of 1507 infants was replicated in a second cohort of 1655 infants. The 3 parameters chosen were preterm birth, intrauterine growth retardation and neonatal acidemia. The neurological examination in the second cohort was carried out by other examiners than in the first cohort. The incidence of neurological abnormality was again found to be raised in all 3 categories and again least in the acidemic subgroup. Also the finding could be confirmed that only in about half of the neurologically abnormal infants could the 3 parameters have exerted any effect at all, which implies the necessity of further analysis. This replication study shows that neurological examination in the newborn period is a reliable tool for the evaluation of the condition of infants with respect to their pre- and perinatal history.
Subject(s)
Infant, Newborn, Diseases/embryology , Nervous System Diseases/congenital , Nervous System Malformations , Blood Gas Analysis , Female , Fetal Growth Retardation/complications , Humans , Infant, Newborn , Infant, Newborn, Diseases/etiology , Infant, Premature, Diseases , Nervous System Diseases/etiology , Neurologic Examination , PregnancyABSTRACT
The Groningen Perinatal Project is a follow-up study relating pre- and perinatal conditions to early and late neurological sequelae. A description is given of the first cohort of 1507 children, examined neurologically during the neonatal period, and of their mothers and their pregnancies. In this preliminary analysis three 'final pathways' are considered, i.e. intrauterine growth retardation, preterm birth and acidemia (pH in umbilical vein below 7.20). Significant relationships were found between the 'final pathways' and the neurological findings. Since, however, these relationships account for only a small part of the variance of the latter, it is concluded that the (cumulative) effect of other antenatal variables must be taken into account as well. Results of analyses to this effect will be reported in forthcoming publications.
Subject(s)
Acidosis/complications , Brain Damage, Chronic/etiology , Fetal Growth Retardation/complications , Infant, Newborn, Diseases/etiology , Infant, Premature , Adolescent , Adult , Female , Follow-Up Studies , Humans , Infant, Newborn , Neurologic Examination , PregnancyABSTRACT
Results of 44 second cadaveric kidney transplantations are reported and compared with the results of 149 primary cadaveric transplantations. No difference in patient survival is observed. Patients with a non-immunological first graft failure (NIF) had a better two year second graft survival (60%) when compared with patients with an immunological first graft failure (IF) (20%). This difference was not due to a higher degree of presensitisation in the IF group. The use of scarce cadaveric kidneys for retransplantation in patients whose first graft was rejected is considered questionable.
Subject(s)
Kidney Transplantation , Adult , Antilymphocyte Serum , Cadaver , Female , Graft Rejection , Graft Survival , Humans , Male , Time FactorsABSTRACT
In a statistical study the onset of idiopathic facial paralysis (Bell's palsy) in 241 patients, observed in a 3-year period, is studied in relation to atmospheric pressure. The hypothesis of no association is not rejected. Neither is the hypothesis rejected of uniform distribution of the occurrence of Bell's palsy during the same period.
