The effect of oxytocin in induced labour on neonatal jaundice.

A prospective study in 180 mothers and babies examined the effects of oxytocin in induced labour on plasma bilirubin levels in cord blood, as well as on the incidence of neonatal jaundice. Raised plasma bilirubin levels in cord blood, probably enhanced by breakdown of fetal red cells, appeared to be a dose dependent effect of oxytocin. Commensurate with this was the finding that a larger proportion of babies in the induced group manifested a greater severity of jaundice.     

Multifocal osteolysis with nephropathy

A patient with progressive osteolysis of the carpal and tarsal bones with glomerulonephritis of unusual severity is described. There was a notable absence of osteodystrophy in this and other reported cases who had chronic renal failure.     

Orofacial pain in young adults and associated childhood and adulthood factors: results of the population study, Wales, United Kingdom

Abstract – Objectives: The aim of the study was to investigate the prevalence of orofacial pain (OFP) among young adults (30–31 years old) and to determine the effect of childhood and adulthood risk factors on the occurrence of OFP. Methods: Prospective cohort study to investigate dental and social effects of malocclusion and effectiveness of orthodontic treatment was conducted in Wales, United Kingdom. At 20‐year follow‐up 337 subjects aged 30–31 participated (74% from previous follow‐up aged 19–20 and 33% from the baseline) and were asked about OFP. Results: The prevalence of OFP was 23% (95% CI: 19%, 28%). Childhood factors, socio‐demographic, lifestyle, health behavior factors, history of orthodontic treatment and tooth wear were not associated with OFP. Participants with OFP were more likely to report that their teeth did not fit together properly [odds ratio (OR) = 12.4, 95% CI: 2.7–56.5) and reported previous trauma to the jaws (2.3; 1.3–4.2). Both diurnal and nocturnal teeth clenching and grinding were significantly associated with OFP (3.1; 1.4–7.1). Participants with frequent headaches had increased risk of having OFP (3.7; 1.6–8.4) while having reported 4–10 types of pain in other parts of the body other than the head, was associated with OR = 9.2 (3.7–23.0). An increased tendency to have OFP was seen in those individuals with higher levels of psychological distress (2.3; 1.4–3.9), high score on Life Event Inventory (2.6; 1.3–5.3), depressive symptoms (2.2; 1.2–4.0) and stress (2.2; 1.2–4.0). High self‐esteem associated with lower risk of OFP (0.5; 0.3–0.9). Conclusions: This study shows that OFP is frequently reported by young adults aged 30–31 and supports a multifactorial etiology with factors from many domains, including local mechanical factors, psychological and co‐morbidities. However, none of the childhood factors considered in this study were associated with OFP in adulthood.     

Renovascular hypertension in neurofibromatosis

We present two patients with renovascular hypertension in association with neurofibromatosis. In both cases the diagnosis was established by angiography. The first patient suffered occlusion of the right renal artery combined with intrarenal arterial lesions. Treatment was by autotransplantation. The second patient suffered bilateral intrarenal arterial lesions alone and was treated medically. In both patients, control of the hypertension was established. We discuss the aetiology of renovascular hypertension in neurofibromatosis and consider its treatment.     

Pharyngeal residue across the lifespan: a first look at what’s normal

Objectives: Without good evidence, post‐swallow pharyngeal residue is considered abnormal. Our aim was to document residue from normal food and fluid boluses in young and elderly healthy populations. Design: Prospective, single‐blind assessment of residue severity from Fibreoptic Endoscopic Evaluation of Swallowing. Setting: Tertiary specialist ENT teaching hospital. Participants: Fifty‐one healthy participants; twenty‐one aged <40 and thirty aged 65+. Each swallowed six representative boluses. Outcomes: Two teams independently rated pharyngeal residue severity at 11 anatomical sites. Results: The mean residue scores were less than 1 when averaged across all boluses and anatomic sites. Differences due to age were slight. Conclusions: Our preliminary data indicate that substantial pharyngeal residue is not common in young or elderly, and probably indicates disordered swallowing.     

How well are parent held records kept and completed?

During 1986 and 1987 parents in part of the Oxfordshire district health authority were given their child's health and development records while in the other part of the health district the records remained with the clinic. Between August 1988 and February 1989 an audit was made of a sample of parents attending child health clinics in the two areas: the study examined 284 parents who had parent held records and 168 who did not; how many records were available and if not, why not; how well and by whom records were completed and parents' views on who they felt should keep the record. Interviews revealed that parents with a parent held record liked the scheme and were confident about remembering to take the record to the clinic. Those without experience were less confident and more concerned about losing the record. At the time of the audit 7% of parent held records had been lost or forgotten, but 5% of clinic held records were not available for inspection. Overall, parent held records were more likely to have comments contributed by parents and to be more thoroughly completed by professionals. The results suggest that parent held records are not only workable but desirable.