Lancet
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A linear-array real-time ultrasound scanner was used to examine the brains of all 95 infants born at less than 33 weeks of gestation who were admitted to the neonatal unit of University College Hospital in 1979. Abnormalities were detected in 41 (43%). 36 infants had haemorrhages into the germinal layer (GLH) and/or ventricles (IVH). 8 infants had cerebral atrophy (together with GLH/IVH in 5 infants). 8 (13%) of 63 infants with normal scans or small (grade-I) GLH/IVHs died, whereas 19 (59%) of 32 infants with larger haemorrhages or other intracranial lesions died (p less than 0.0005). At follow-up, at a median corrected age of 45 weeks, only 2 (4%) of 53 infants with normal scans or grade-I haemorrhages had evidence of major neurodevelopmental handicaps, but 5 (38%) of 13 infants with more extensive haemorrhages or cerebral atrophy had major handicaps (p less than 0.005). Brain scanning with ultrasound in the first days of life identified most infants in the population studied who subsequently died or survived with handicaps severe enough to be detected within the first year.
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Reports from developed countries world wide describing the outcome for infants of very low birthweight (VLBW, less than or equal to 1500 g) born since 1946 show that, in general, mortality rates and the prevalence of major handicap in survivors were high until 1960. Since then the chances of healthy survival have trebled, whereas the handicap-rate has remained stable and relatively low at 6--8% of VLBW live births.
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10 059 civil servants and municipal employees, aged 40--65, were examined in the Israeli Ischaemic Heart Disease Study. 475 (4.72%) died during a 7-year follow-up. High density lipoprotein (HDL) cholesterol levels were determined in the last 6562 men entering the study. 305 (4.65%) of these men died. Coronary heart disease (CHD) accounted for 37% of the total deaths. ⋯ After adjustment for age and other risk factors the relation of coronary mortality to HDL cholesterol emerged as the dominant one. There was no clear-cut association between total of HDL cholesterol and cancer mortality. These results indicate that, particularly in older age-groups, measures designed to increase HDL cholesterol may prove as valuable in preventing CHD as those designed to reduce low density lipoprotein cholesterol.