Thesis (doctoral)--Freie Universität Berlin, 1979.

Neonatal sepsis remains a global health problem due to its significant contribution to morbidity and mortality. The blood culture is the most reliable method for detection of bacterial infections. However, the sensitivity of the latter method is low and using it as a gold standard in diagnosis of bacteremia is fraught with difficulties. Neutrophil CD64 levels are upregulated in response to inflammation and tissue injury. We quantitated neutrophil CD64 by flow cytometry in neonates with signs and symptoms suggestive of sepsis/infection within the 1st four weeks of life in a prospective observational study conducted at 3 hospitals in Johannesburg. Patients were classified into categories of infection namely definite, probable and possible according to signs and symptoms of infection and blood tests including blood culture results. Of 76 neonates, there was 1 infant with definite infection, 5 infants with probable, 30 infants with possible and 32 infants with no infection. The PMN CD64 at cut off of 1.8 had a high negative predictive value in ruling out definite (100%) or probable + definite infection (95.2%). We recommend the inclusion of PMN CD64 index into the diagnostic algorithm for neonatal sepsis, as it has a high negative predictive value and can be used to rule out infection. As the positive predictive value of the test was low in confirming infection, PMN CD64 should be used as a screening rather than confirmatory test.

dissertation submitted to the Faculty of Health Sciences for the degree of Masters in Medicine in the University of the Witwatersrand, Johannesburg. August ,2013 / South Africa is one of the countries in which neonatal mortality has either remained the same or decreased marginally over the past 20 years (1). Resource constraints result in early discharge of well newborns and curtailment of follow up home visits by nurses. This potentially high-risk group of infants may contribute to these neonatal deaths post hospital discharge. In addition, once a neonate has been home, they are no longer admitted to the neonatal unit but to the general paediatric wards that may lack specialized neonatal care. Numerous programs, algorithms, education drives and protocols have been devised in an attempt to improve the quality of healthcare offered to the newborn. These have led to a perceptible decline in the neonatal mortality and morbidity rates respectively. The neonatal mortality and morbidity rates remain unacceptably high however, particularly in resource poor settings. Aim: The aim was to determine the profile and outcome of neonates admitted to the general paediatric wards at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH). Methodology: Audit of all newborns (<28days) admitted to the general wards from 1 January 2011 to 30 April 2011. Patients transferred from other tertiary hospitals were excluded. Patients with incomplete records were also excluded Results: There were a total of 73 neonates admitted with a mean weight of 3.2kg (SD 0.65). The median age for 0-7 days was 4 days and for 8-28 days was 17 days. The majority of neonates 41/73 (56.2%) were male and 21/73 (28.8%) were HIV exposed. In the HIV exposed group only 16/21 (76%) were on HIV prophylaxis. Although antenatal care (ANC) was received by 76.7% of mothers, this is lower than ANC received by the general population. Lack of ANC could possibly be a risk factor for admission of neonates. Possible risk factors for serious illness included 8 (11%) were ex premature infants and 11 (15.1%) had a low birth weight (<2.5 kg). Individual indicators for severity of illness by World Health Organization (WHO) Integrated Management of Childhood and Neonate Illness (IMCNI) were used. The most frequent indicators were tachypnoea (RR>60) 34 (46.6%), jaundice 30 (41.1%) and only 1 (1%) presented with convulsions. Respiratory distress was very sensitive (100%) and relatively specific (76%) for detecting bronchopneumonia (BRPN) with a LR of 3.98. The other clinical indicators were neither specific nor sensitive in detecting serious illness. Most 45 (61%) were referred from the local clinic. The commonest diagnoses were bronchopneumonia (BRPN) 20 (27.4%), neonatal sepsis (NNS) 22 (30.1%) and jaundice 22 (30.1%). Two patients died (2.7%). Their diagnoses were NNS and BRPN Conclusions: There are a significant number of newborns admitted to the general paediatric wards, although the mortality rate in this group was low. IMCNI guidelines remain the most sensitive indicator of the need for admission, and “routine” blood investigations are often non-contributory Community based care and education programmes as well as targeted neonatal care in hospitals for this group is warranted.

A Dissertation submitted to the faculty of Medicine, University of the Witwatersrand, in partial fulfillment of the requirements for the Degree of Master of Medicine in paediatrics. / The aims of this study were to establish the incidence of perinatally and nosocomially acquired bacteraemia and funqaemia as determinad by blood and cerebrospinal fluid (CSF) isolates in the neonatal population seen at the Baraqwanath Neonatal Unit; to identify risk factors for infection and record the outcome. Other aims were to analyze tha susceptibility patterns of the organisms isolated with respect to changing antimicrobial policies and to compare these with previously reported studies. (Abbreviation abstract) / Andrew Chakane 2018

Thesis (M.S.)--University of Michigan, 1964.

Thesis (M.S.)--University of Michigan, 1964.

This study was undertaken primarily to investigate the plasma protein system in infants with IRDS, as compared with healthy premature infants, as it had previously been reported that the plasma protein concentration in affected infants was abnormally low. It was attempted further to establish biochemical and/or immunological criteria for diagnosis of the disease and to discover reasons for the low IgG concentrations and raised α-fetoprotein concentrations found in the sera of these infants. Maternal serum proteins were also studied during pregnancy and at and after delivery of the infant. Interrelationships between α-fetoprotein, Human Growth Hormone and other proteins, in immunochemical systems were investigated. In summary, the main conclusions reached were as follows: (i) The total serum-protein concentration in affected infants is much reduced, as compared with healthy premature infants of the same gestational age. (ii) In IRDS infants, the relative and absolute concentration, of IgG is extremely low, whereas concentrations of other immune globulins, as far as could be determined, are within normal limits. (iii) Mothers of affected infants have significantly lower concentrations both of serum IgG and of IgM, than mothers of healthy premature infants. These changes in the serum-proteins are present throughout pregnancy. By six weeks post-partum, the IgG level has returned to normal, but the IgM level remains low. Concentrations of IgA and total serum-protein are normal at all times. (iv) Examination of oedema fluid, urine, faeces and amniotic fluid for γ-globulin content, has excluded the possibility that IgG is being lost from the circulation by these routes. (v) IRDS infants have, in their serum, agglutinins of the IgM type directed against the intact maternal IgG molecule. Similar agglutinins are present in a minority of healthy premature infants. Both IRDS and healthy infants have agglutinins against IgG fragments, in approximately 50% of cases. Agglutinin titres against these are similar in the two groups, but the incidence of agglutinins against Bence Jones protein type Lis raised in IRDS. (vi) Affected infants have an elevated serum concentration of α-fetoprotein, which disappears from the serum during the: first week of post-natal life. (vii) The majority of pregnant women examined have been observed to have serum agglutinins directed against α-fetoprotein. These cross-react with albumin prepared from sera of healthy adult males α-fetoprotein has been found in the serum of many pregnant women, especially during the second trimester. (viii) Immunological interrelationships between α-fetoprotein human serum albumin, Human Growth Hormone and human IgG have been demonstrated. (ix) Infants suffering from Rh-isoimmunization exhibit a serum- protein pattern similar to that seen in IRDS. Biochemical and immunological criteria for the diagnosis of IRDS have thus been established. The data to be presented indicate the presence of an immunological factor in the aetiology of the disease.

Lui Yat Chi. / Publication date from spine. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1995. / Includes bibliographical references (leaves 93-103). / Acknowledgment --- p.1 / Abstract --- p.2 / Chapter Chapter 1 --- Introduction --- p.3 / Chapter 1.1 --- Background --- p.3 / Chapter 1.2 --- Review of previous epidemiological studies of congenital abnormalities --- p.3 / Chapter 1.2.1 --- Limitation in comparing data with different studies --- p.4 / Chapter 1.3 --- Objectives --- p.4 / Chapter Chapter 2 --- Definition --- p.7 / Chapter 2.1 --- Terminology and definition --- p.7 / Chapter 2.1.1 --- The definition of clinical abnormality --- p.9 / Chapter 2.1.2 --- The current concepts in major and minor anomalies --- p.10 / Chapter 2.1.3 --- The definition of major and minor anomalies --- p.10 / Chapter 2.2 --- Major anomalies and minor anomalies --- p.11 / Chapter Chapter 3 --- Subjects and Methodology --- p.16 / Chapter 3.1 --- The introduction of methodology --- p.16 / Chapter 3.1.1 --- Background --- p.16 / Chapter 3.1.2 --- Different Methodologies and their limitations --- p.16 / Chapter 3.2 --- Methods --- p.17 / Chapter 3.2.1 --- Setting --- p.17 / Chapter 3.2.2 --- Design of the research data recording sheet --- p.18 / Chapter 3.2.3 --- Training --- p.18 / Chapter 3.2.3.1 --- "Training in paediatrics, orthopaedic and clinical genetic centre" --- p.18 / Chapter 3.2.3.2 --- End of training period --- p.19 / Chapter 3.2.4 --- Data Collection --- p.19 / Chapter 3.2.4.1 --- Subject selection --- p.19 / Chapter 3.2.4.2 --- Examination Procedures --- p.20 / Chapter 3.2.4.3 --- Cross checking of the examination --- p.25 / Chapter 3.2.4.4 --- Other sources of information --- p.25 / Chapter 3.3 --- Problems in screening --- p.26 / Chapter 3.4 --- Selection of variables --- p.26 / Chapter 3.5 --- Statistical analysis --- p.27 / Chapter Chapter 4 --- Results --- p.28 / Chapter 4.1 --- Sub-Classification of the newborn infants --- p.28 / Chapter 4.2 --- Weights and Measures --- p.29 / Chapter 4.2.1 --- Result --- p.29 / Chapter 4.2.2 --- Supplement (statistical analysis of Table 4， 5 & 6) --- p.30 / Chapter 4.3 --- The incidence of congenital abnormalities in Newborn Chinese --- p.31 / Chapter 4.4 --- Relationship between incidence of abnormalities and sex --- p.47 / Chapter 4.4.1 --- Result --- p.47 / Chapter 4.5 --- Relationship between incidence of abnormalities and maternal age --- p.53 / Chapter 4.5.1 --- Result --- p.53 / Chapter 4.5.2 --- Supplement (statistical analysis of Table 19) --- p.54 / Chapter 4.5.3 --- Supplement (statistical analysis of Table 21 & 22) --- p.56 / Chapter 4.6 --- Relationship between incidence of abnormalities and parity --- p.58 / Chapter 4.6.1 --- Result --- p.58 / Chapter 4.7 --- Relationship between incidence of abnormalities and mode of delivery --- p.59 / Chapter 4.7.1 --- Result --- p.59 / Chapter 4.7.2 --- Supplement (statistical analysis of Table 23 & 24) --- p.59 / Chapter 4.8 --- Other correlations --- p.62 / Chapter 4.8.1 --- Relationship between incidence of abnormalities and mode of delivery --- p.62 / Chapter 4.8.2 --- Supplement (statistical analysis of Table 25 & 26) --- p.63 / Chapter Chapter 5 --- Discussion --- p.65 / Chapter 5.1 --- Comparative prevalence of congenital anomalies among different studies --- p.65 / Chapter 5.2 --- Comparison of incidence of specific major abnormalities in different survey --- p.68 / Chapter 5.3 --- Relationship between abnormalities and different factors --- p.70 / Chapter 5.3.1 --- Maternal age --- p.70 / Chapter 5.3.2 --- Parity --- p.71 / Chapter 5.3.3 --- Mode of delivery --- p.72 / Chapter 5.4 --- Other correlations --- p.72 / Chapter 5.5 --- The prevalence of birth defects among different systems in this survey --- p.72 / Chapter 5.5.1 --- Central nervous system --- p.72 / Chapter 5.5.2 --- Cardiovascular system --- p.76 / Chapter 5.5.3 --- Alimentary system --- p.79 / Chapter 5.5.4 --- Musculoskeletal system --- p.81 / Chapter 5.5.4.1 --- Supplement (statistical analysis of Table Y) --- p.82 / Chapter 5.5.5 --- Multiple syndrome --- p.86 / Chapter Chapter 6 --- Conclusion --- p.89 / Chapter 6.1 --- Limitations and Benefits --- p.90 / Chapter 6.2 --- Future direction --- p.92 / References --- p.93 / Appendix --- p.104

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Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 4 uppsatser.