Sphygmomanometer Cuff for the Newborn

A 'Standard' cuff of cloth and rubber, specified by the British Standards Institution as suitable for use in the newborn, was found to give readings 4–48 mm. Hg higher than those obtained with a specially constructed 'plastic' cuff, whose readings had previously been shown to correspond reasonably well with direct measurements.
A newer specimen of the 'Standard' cuff gave readings 4–36 mm. Hg higher still.
The range of variation between readings made after successive reapplications of the 'plastic' cuff was 0–4 mm. Hg and of the 'Standard' cuff 8–20 mm. Hg.
The apparent spontaneous fluctuation of the systolic pressure in newborn babies at rest over periods of minutes was 0–12 mm. Hg (mean 5.1).
There was little difference between the pressures recorded in the right and left arms of each of 10 babies.     

Factors affecting the increasing incidence of severe non-haemolytic neonatal jaundice.

Neonatal hyperbilirubinaemia is increasing in frequency. In view of conflicting evidence about the possible causes, retrospective analyses have been carried out among babies born during six months of 1974. Preliminary analysis confirmed the over-riding importance of preterm birth (before 37 weeks), but only one of 17 such cases could be attributed to ill-judged artificial induction of labor. For the main analysis, the incidence of eight possibly relevant antecedent factors was compared in 46 cases of hyperbilirubinaemia (unconjugated bilirubin more than 15 mg per 100 ml in term babies and more than 13 mg per 100 ml in some preterm babies) and in 92 controls matched for sex and gestational age. Induction of labour by "primary" oxytocin infusion and artificial rupture of the membranes was very significantly more common in the index cases (p less than 0-01), but there was no difference in the incidence of "secondary" oxytocin, used to accelerate spontaneous labour. Evidence of uterin unresponsiveness suggests that the natural onset of labour was being anticipated by at least some days in many of the index cases and this could prevent the natural "priming" of the fetal enzyme systems. An excess of epidural analgesia in the mothers of the index cases was probably due to its association with the need for pain relief during "primary" oxytocin infusions. The higher incidence of postnatal weight loss in the index cases presumably contributed to the hyperbilirubinaemia.     

Surgical approaches to facial nerve deficits

The facial nerve is one of the most commonly injured cranial nerves. Once injured, the effects on form, function, and psyche are profound. We review the anatomy of the facial nerve from the brain stem to its terminal branches. We also discuss the physical exam findings of facial nerve injury at various levels. Finally, we describe various reconstructive options for reanimating the face and restoring both form and function.     

Recurrent hemoptysis with Penicillium marneffei and Stenotrophomonas maltophilia in Job’s syndrome

Pulmonary infection caused by the opportunistic organisms Penicillium marneffei and Stenotrophomonas maltophilia in patients with Job’s syndrome is rare and not well documented. The case of a 30-year-old man with Job’s syndrome who developed recurrent pneumonia and lung abscesses caused by P marneffei and S maltophilia, complicated by massive hemoptysis, is described. Bronchial artery embolization was successful in controlling the hemoptysis; however, the infection proved fatal despite appropriate antimicrobial therapy. A brief review of the literature on Job’s syndrome and its associated infective pulmonary manifestations is also presented.