Showing papers by "Hospital for Sick Children published in 1978"
TL;DR: A laboratory learning task is used to document that between one and two hours after the administration of a single dose of methylphenidate, the drug exerts its maximum effect on performance in a learning task in the laboratory.
Abstract: This report introduces a method for obtaining behavioral time-response information for a short-acting psychotropic drug (methylphenidate [Ritalin]) that is widely used to treat behaviorally hyperactive children We used a laboratory learning task to document that between one and two hours after the administration of a single dose of methylphenidate, the drug exerts its maximum effect on performance in a learning task in the laboratory This effect on cognitive performance dissipates within the same day This rapid and transient effect of methylphenidate makes it possible to classify patients in a single day into those who respond favorably and those who respond adversely to the drug in terms of its effect on cognitive behavior
206 citations
TL;DR: The results indicate that the small premature infant has a limited hepatic excretory function and suggest that excreteory immaturity is an important factor in the susceptibility of these infants to cholestasis associated with long-term IV alimentation.
Abstract: We measured the levels of serum conjugates of cholic acid (SCCA) by radioimniunoassay in 32 newborn infants during the course of intravenous (IV) alimnentation (study group 1, birth weight > 2 kg; study group 2, birth weight <2 kg) and compared them to those of two groups of weight-matched control subjects and one group of normal infants and adults. Fasting SCCA levels in the two newborn control groups were significantly higher than those of normal infants and adults, and a significant postprandial elevation in SCCA level was present in the smaller of the two newborn control groups. During the first two weeks of alimentation only one patient had an elevated SCCA level (< 2 SD above that of control subjects), without other abnormalities of liver function. In study group 1 patients who received alimentation for more than two weeks, significant increases in mean peak SCCA level occurred and seven of eight patients had elevated levels. Three patients became jaundiced and had high alkaline phosphate values. Group 2 patients who received alimentation for more than two weeks were unaffected. Therefore, the appearance of liver abnormalities was related to body mass and duration of IV alimentation. The presence of documented or suspected sepsis, withholding of oral feedings, or the use of Intralipid could not be specifically related to SCCA levels. These results indicate that the small premature infant has a limited hepatic excretory function and suggest that excretory immaturity is an important factor in the susceptibility of these infants to cholestasis associated with long-term IV alimentation.
65 citations
TL;DR: Studying the responses of 28 intubated infants to direct bronchial mucosal stimulation with a fine catheter found paradoxical responses to irritant stimulation may be related to immaturity of vagal myelination, and may be an important factor in the frequency of silent aspiration and apnea in premature infants.
Abstract: Absence of cough and gag reflexes has been noted in premature infants, but pulmonary irritant reflexes have not been studied. Irritant receptors respond to deflation, direct stimulation, or inhalation of irritant gases, resulting in an increased inspiratory effort. We have studied the responses of 28 intubated infants to direct bronchial mucosal stimulation with a fine catheter. Six of ten infants whose gestation was 35 weeks or more consistently showed a "mature" response, with an increase in inspiratory effort, while only one of 18 infants less than 35 weeks consistently showed this response. The premature infants showed variable responses. Fifty-eight of 93 stimulations produced an increased inspiratory effort, followed by marked slowing or apnea, while 20 stimulations resulted in slowing or apnea alone. These paradoxical responses to irritant stimulation may be related to immaturity of vagal myelination, and may be an important factor in the frequency of silent aspiration and apnea in premature infants.
59 citations
TL;DR: Preliminary findings demonstrate that the trait of physical attractiveness is subject to reliable social judgments from the earliest days of life, and that social experience may affect these judgments.
Abstract: In one study 20 nurses experienced in the care of premature infants and 20 nurses without such experience rated physical attractiveness of five randomly selected premature infants. Significant agreement in ordering the infants according to attractiveness was found among nurses in both groups. In a second study, 20 nurses who had cared for a particular premature infant and 20 matched nurses who had not, rated the attractiveness of the infant. Having cared for a particular infant increased the nurses' ratings of its attractiveness. These preliminary findings demonstrate that the trait of physical attractiveness is subject to reliable social judgments from the earliest days of life, and that social experience may affect these judgments. The potential role of these judgments in modifying the infant's social environment is a topic for future research.
48 citations
TL;DR: Unilateral megalencephaly is a rare anomaly of the brain which causes enlargement of a lobe or an nentire hemisphere and the radiological features are a poorly defined unusual mass effect on PEG, angiography and CT scan.
Abstract: Unilateral megalencephaly is a rare anomaly of the brain which causes enlargement of a lobe or an nentire hemisphere. The radiological features of the disease are a poorly defined unusual mass effect on PEG, angiography and CT scan. Pathologically, the disease is thought to be due to abnormal cell migration in the 3rd month in utero.
27 citations
TL;DR: A proposed reference method for serum creatinine has been developed under the auspices of the Committee on Reference Methods and Reference Materials of the Canadian Society of Clinical Chemists and demonstrated a statistically significant high bias in interlaboratory studies in which this procedure was used for reference.
25 citations
TL;DR: Literature was reviewed concerning lateral asymmetries of brain and behavior in normal and pathological populations of left-and right-handers.
Abstract: Literature was reviewed concerning lateral asymmetries of brain and behavior in normal and pathological populations of left-and right-handers. Cerebral asymmetries of structure and function are less pronounced in left-handers as a group than in right-handers as a group, and variability is greater in left-handers.
21 citations
TL;DR: The procedure had few complications and Anatomic detail of intraventricular obstruction was good, and with CT additional physiologic information can be obtained.
Abstract: Forty-three infants and children underwent conventional or CT ventriculography after instillation of metrizamide into the ventricular system. The procedure had few complications. Anatomic detail of intraventricular obstruction was good. With CT additional physiologic information can be obtained.
14 citations
TL;DR: It is believed that the exquisite pathologic anatomy obtained by CTMM obviates all neuroradiologic techniques other than a preliminary anteroposterior and lateral spinal roentgenograph.
Abstract: Computed tomographic metrizamide myelography (CTMM) has developed into a highly sophisticated and accurate neuroradiologic technique in the diagnosis of childhood spinal dysrhaphic states. Of the 84 patients studied by this technique, 31 with the dysrhaphic spine also had lesions such as a tethered and low conus, diastematomyelia, or neuroenteric cysts. We believe that the exquisite pathologic anatomy obtained by CTMM obviates all neuroradiologic techniques other than a preliminary anteroposterior and lateral spinal roentgenograph.
13 citations
TL;DR: In vivo applications are presented to show that the method using an interference-free enzyme reagent in a modified Auto-Analyzer whole blood glucose concentration can be monitored continuously and interpreted in terms of the actual plasma glucose concentration and is suitable for use in systems such as the ‘artificial endocrine pancreas’.
Abstract: A practical method for continuous blood glucose analysis in vivo is described. Using an interference-free enzyme reagent in a modified Auto-Analyzer whole blood glucose concentration can be monitored continuously and interpreted in terms of the actual plasma glucose concentration. The method uses a novel technique for preheating the sample diluent without introducing additional time delays, consumes whole blood at a rate of 0.05 ml/min, and demonstrates a transport delay of 148 s. Other improvements include an average baseline drift of −0.11 mg/dl/h and a mean change in sensitivity of −0.4% after 8.5 h. In vitro glucose recovery studies comparing whole blood to the corresponding plasma samples show the method is precise (101.3±0.7%), linearly proportional (slope of 1.007±0.012) and highly correlated (>0.998) over the range of 0 to 500mg/dl, with reference to a Beckman glucose analyzer. In vivo applications are presented to show that this method is suitable for use in systems such as the ‘artificial endocrine pancreas’.
7 citations
TL;DR: It is concluded that the livers of malignant hyperthermia susceptible pigs are either normal or else, if abnormal, the abnormalities are sufficiently benign as to be not measurably expressed.
Abstract: We have perfused malignant hyperthermia susceptible and normal isolated pig livers with halothane for one hour. The liver temperatures, oxygen and carbon dioxide tensions, the base deficits and lactate concentrations in blood entering and leaving the liver have been measured at the beginning and at the end of the perfusion. Statistical analysis has shown that there are no significant differences in these parameters between the beginning and the end of the perfusion period or between the normal and the malignant hyperthermia susceptible livers. We conclude, therefore, that the livers of malignant hyperthermia susceptible pigs are either normal or else, if abnormal, the abnormalities are sufficiently benign as to be not measurably expressed.
TL;DR: Since 1973, an oscillatory modification of “diffusion respiration” has been explored which, perhaps, may widen the understanding of some particularities in the dynamics of intrapulmonary gas flow.
Abstract: Since 1973 we have explored an oscillatory modification of “diffusion respiration” which, perhaps, may widen the understanding of some particularities in the dynamics of intrapulmonary gas flow.
TL;DR: The sophistication, accuracy, and safety of standard neuroradiological procedures have been increased by the accuracy andSafety of computed tomography, particularly in the premature infant.
Abstract: The development of paediatric neuroradiology is a specific persuasion within neuroradiology and has increased in scope and significance throughout the last ten years. The emergence of computed tomography has altered the indications for types of neuroradiological procedures in infants and children. The sophistication, accuracy, and safety of standard neuroradiological procedures have been increased by the accuracy and safety of computed tomography, particularly in the premature infant. There is a growing need for education and instruction in paediatric neuroradiological techniques and paediatric neuroradiological diseases within the neuroradiological fraternity as a whole.
TL;DR: One of the keys to the success of the meeting was the bringing together of many knowledgeable, thoughtful and artlcu!ate people from a variety of geographical areas and professional backgrounds who shared their experiences and perceptions of the complex problems all of us face in the authors' dealings with so difficult a group of youngsters.
Abstract: Before attempting to draw together and underline some of the main themes of the workshop, let me first express our thanks to the Laidlaw Foundation without whose generosity and encouragement this meeting could never have occurred. Such was the richness of our discussions over the . three days that it would be possible for someone with another professional background or orientation to select out an entirely different set of themes for discussion. One of the keys to the success of the meeting was the bringing together of .so ,many knowledgeable, thoughtful and artlcu!ate people from a variety of geographical areas and professional backgrounds who shared their experiences and perceptions of the complex problems all of us face in our dealings with so difficult a group of youngsters. I particularly thank the Foundation for bringing Drs. Donald Gair, (Boston), Albert Solnit (Yale), Marguente Warren (Albany), Miss Joan Cooper (Great Britain) and Dr. Hans Mohr from Germany to share their wisdom, their experiences and themselves with us. W?en dealing with a difficult, complex, multifaceted problem, it is all too easy to compound the issue by seizing one of two false but easy outs: to \"pass the buck\" to s?me other professional or agency, or to find someone to scapegoat for having mishandled or neglected his part of a com-
TL;DR: The modified Water's or clival-perpendicular position is especially useful in the diagnosis of posterior fossa disease and offers a view that is approximately coronal to the clivus and tentorium.
Abstract: The air gap type of CT scanner with tilting gantry allows the use of head positions other than the standard semi-axial. The modified Water's or clival-perpendicular position is especially useful in the diagnosis of posterior fossa disease. The position offers a view that is approximately coronal to the clivus and tentorium. The clival-perpendicular view easily separates the supraand infratentorial compartments. It also helps to differentiate extra- and intra-axial lesions and to locate the fourth ventricle, and it gives far better vertical orientation of posterior fossa pathology.
TL;DR: It is concluded that two trained individuals, one being preferably a physician, are necessary for safe transport of infants <1.5kg birthweight.
Abstract: The effect of transport of sick neonates by skilled personnel with necessary equipment on physiological parameters on admission to a neonatal intensive care unit and on outcome, was evaluated in a controlled study. In phase I routine care by staff from the hospital of birth was compared with that provided by a trained nurse/physician team. In phase II care in transport was provided for each infant by only one of the trained nurses of phase I. Results(mean±SD)for infants <1.5kg birthweight are presented: We conclude that two trained individuals, one being preferably a physician, are necessary for safe transport of infants <1.5kg birthweight.
TL;DR: In this article, the effects of various intakes of calcium (ranging from 100 to 250 mg/kg/24 h) and of sodium (1,5 and 3.0 mEq/ kg/24h) on the renal clearance of phosphorus (Cp) and various indices of parathyroid function were examined in very low birthweight infants.
Abstract: In an extensive study of mineral requirements of very low birthweight (VLBW) infants we have examined in detail various aspects of phosphorus (P)-homeostasis, such as the effect of a higher (by 50%) P-intake on the renal clearance of phosphorus (Cp) and various indices of parathyroid function. This report deals with the effects of various intakes of calcium (ranging from 100 to 250 mg/kg/24 h) and of sodium (1,5 and 3.0 mEq/kg/24 h) on the Cp and urinary excretion of P (UP) in rapidly growing VLBW infants. The purpose of the study was to determine the Cp in infants (a) on a prolonged “low” Ca intake (100 mg/kg/24 h); (b) the effect of calcium supplementation to a total daily Ca-intake of 175, 210, or 250 mg/kg; and (c) the effect of Na-supplementation.