Muscular strength at 5 years of children with a birthweight under 1500g

Abstract The hand-grip strength was measured as part of the 5-year neurodevelopmental assessment of 24 very low birthweight (VLBW) and 18 normal birthweight (NBW) children. Hand-grip strength was significantly lower in the VLBW children for left and right hands tested individually and for both hands used concurrently. Increasing hand-grip strength was significantly related to 5-year weight percentiles and to being in the NBW group. More of the VLBW children weighed less than the 10th percentile. After adjusting for the 5-year weight percentile, the hand-grip strength of VLBW children was still significantly lower than that for NBW children. This is another aspect of development in which VLBW children are disadvantaged.     

Assessment of short stature in very low birthweight children

Abstract  The aims of this study of short very low birthweight (VLBW) children at or after 8 years of age were to determine: (i) if there were any unsuspected organic causes for their growth failure; and (ii) whether any children might be suitable for treatment with synthetic growth hormone. Thirty-seven of 195(19%) VLBW children seen at 8 years had heights <10th centile, and of these only 40% (10/25) of families offered an assessment were concerned enough to have the child fully evaluated. No child had an unsuspected organic cause of short stature. The children's parents were significantly shorter than expected for Caucasians (mean parental height s.d. score =– 1.06 (s.d. 0.72), t =– 5.9, P<0.001). On average, the bone age of the short children was delayed by 14.9 months (s.d. 18.8 months) compared with chronological age ((=–3.4, P<0.01). When compared with their parents, the children's mean height s.d. score for their bone age was not significantly different (mean height s.d. score for bone age = - 0.83 (s.d. 1.3), t = 0.6, NS). Only three children qualified for treatment with synthetic growth hormone; all three had been small for gestational age at birth and had birthweights <1000 g. In conclusion, in short VLBW children, only a minority of families and children are likely to be concerned enough about short stature to be fully assessed; an unsuspected organic cause for growth failure is unlikely, and only a few will qualify for synthetic growth hormone therapy.     

Comparison of different bolus doses of morphine for patient-controlled analgesia in children

Forty children undergoing appendicectomy were allocated randomlyto receive one of two PCA regimens with morphine. Group B10received bolus doses of 10 µg kg^–1 and group B20received bolus doses of 20 µg kg^–1. In both groupsthere was a lockout interval of 5 min and a background infusionof 4 µg kg^–1 h^–1. Group B20 self-administeredconsiderably more morphine (P < 0.01) than group B10. Therewas no difference between the pain scores of the groups at rest.Group B20 had significantly (P < 0.05) smaller pain scoresduring movement than group B10 and the latter group sufferedsignificantly (P < 0.01) more hypoxaemic episodes than groupB20. There were no differences between the groups in the incidenceof vomiting, excess sedation or the amount of time spent asleepat night. (Br. J. Anaesth. 1994; 72: 160–163)     

Embolic Control of Massive Haematobilia After Liver Biopsy

Life threatening haematobilia following liver biopsy was successfully treated by percutaneous transcatheter embolization of the right hepatic artery. Complications of liver biopsy and aspects of their treatment are discussed.