Archives of disease in childhood
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Plasma salicylate concentration was monitored in 42 children on long-term salicylate therapy for rheumatoid arthritis. A given dose of salicylate per kg resulted in large variations in plasma levels, both between individuals and for a single individual at different times. ⋯ The addition of corticosteroid or ACTH therapy results in lower plasma levels of salicylate, and necessitates higher dosage of salicylate. After the introduction of routine monitoring of plasma salicylate, the incidence of toxic symptoms fell sharply.
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Surgical closure of a patent ductus arteriosus was performed in 8 low birthweight infants suffering from cardiorespiratory failure secondary to a large left-to-right shunt. Mortality from the operation was nil, but only 4 (50%) ultimately survived. Earlier intervention may reduce mortality in these high-risk infants.
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The fall in body temperature that occurs in babies soon after birth is influenced by the baby's weight and its environmental conditions. The rate of oxygen consumption 1 1/2 hours after birth was unrelated to body temperature and only slightly raised, indicating a limited thermogenic capacity. ⋯ Washing soon after birth caused a significant cooling. Healthy term babies were found to have a limited thermogenic response to a cool environment over the first 12 hour of life and efforts to limit heat losses should be concentrated on this period.
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Cooling is known to prolong survival in newborn animals when used before the onset of asphyxia. It has therefore been advocated as a treatment for birth asphyxia in humans. Since it is not possible to cool a human baby before the onset of birth asphyxia, experiments were designed to test the effect of cooling after asphyxia had already started. ⋯ After deliver they were placed in environmental temperatures of either 37 degrees C, 20 degrees C, or 0 degrees C and observed for spontaneous recovery. The animals who were cooled survived less often than those kept at 37 degrees C. The results of these experiments suggest that hypothermia has little to offer in the treatment of birth asphyxia in humans.
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In a programme to examine the effect of 5 months of swimming training on school-children with asthma, 46 children swam a total distance of 3608 km (2242 miles) during 2806 training sessions. On post-training re-examination, nonspecific effects of physical conditioning were detected including improved posture and fitness, reduced fat folds, and enhanced swimming ability. ⋯ Post-training questionnaires indicated a high degree of enthusiasm and acceptance of the programme by children and parents. No significant adverse effects were observed or reported during the study.