Cited by 6.4k
University of New Mexico
Publishes on Neonatal Respiratory Health Research, Neonatal and fetal brain pathology, Congenital Heart Disease Studies. 19 papers and 7.2k citations.
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In a prospective study, 100 premature infants were studied with computed tomography (CT) brain scans within the first week of life. In 44 of these,hemorrhages originated from the subependymal germinal matrix, and ranged in severity from isolated germinal matrix hemorrhages to blood-filled, dilated ventricles with extension of hemorrhage into the brain parenchyma. A system of grading the severity of hemorrhage was developed. Grades I and II hemorrhages resolved spontaneously and grades III and IV were associated with progressive hydrocephalus. Asymptomatic hemorrhages that would not have been diagnosed on clinical grounds were detected by CT. This study offers a clearer understanding of the true incidence and natural history of cerebroventricular hemorrhage and associated hydrocephalus in premature neonates and may clarify etiologic factors and identify children at risk for subsequent neurologic abnormalities.
A study to evaluate criteria for operation was carried out in 61 infants with acute necrotizing enterocolitis (NEC). A total of 10 clinical, roentgenographic, and laboratory criteria were considered. Each proposed operative criterion was correlated with the documented presence or absence of intestinal gangrene in these infants. Indications for operation verified by this study were (1) pneumoperitoneum, (2) paracentesis findings positive for gangrenous intestine, (3) erythema of the abdominal wall, (4) a fixed abdominal mass, and (5) a persistently dilated loop of intestine on serial abdominal radiographs. The first two signs occurred frequently; the latter three were rare. Operative indications which proved to be invalid in this study were (1) clinical deterioration, (2) persistent abdominal tenderness, (3) profuse lower gastrointestinal hemorrhage, (4) the roentgenographic finding of gasless abdomen with ascites, and (5) severe thrombocytopenia. Twenty-four of the infants were operated on. The mortality rate among the infants operated on after free intestinal perforation had occurred (64%) was double that of infants operated on for intestinal gangrene without perforation (30%). Paracentesis may identify infants with intestinal gangrene prior to the development of perforation and may permit advantagenous timing of operation. This analysis of the frequency and reliability of proposed operative criteria may aid the surgical decision.