. Effect of diazepam administered to mothers during labour on temperature regulation of neonate. Falls in temperature in the first nine hours after delivery were studied in a group of 12 babies whose mothers had received diazepam in labour, and in 13 comparable babies not exposed to diazepam. A significantly lower mean temperature was found in the test group within the first three hours. Cord blood levels of diazepam did not correlate with either maternal levels at delivery, the extent of the temperature drop, or the condition of the baby at birth, though there was an increased incidence of assisted delivery and resuscitation of the infants in the test group.Diazepam is proving to be a useful drug in the management of labour, not least because it has a pethidine-sparing effect (Niswander, 1969). It seems likely that it will be used increasingly and that it may be of considerable value to obstetricians dealing with pre-eclampsia or hypertension, because of its tranquillizing effects (Bepko, Lowe, and Waxman, 1965).It has been shown that diazepam crosses the placenta achieving concentrations in the fetus comparable to, or in excess of, the matemal levels (De Silva, D'Arconte, and Kaplan, 1964;Cavanagh and Condo, 1964). Bepko et al. (1965) and Niswander (1969) were unable to show any depressant effect on the Apgar score of babies which could be definitely attributed to diazepam administered to the mother.The impression was gained at Southmead Hospital that babies born to mothers treated with the drug were liable to sustain a larger temperature drop than babies not so treated, and it was in order to clarify this impression that the following study was undertaken.Material and Methods Twelve babies were studied whose mothers had been treated with diazepam because of a rise in blood pressure before or during labour. 13 similar babies whose mothers had not received diazepam were used as controls. Preterm infants were not accepted for the

SUMMARY Polygraphic methods were used to evaluate the percentage distribution of sleep and awake states and the mean duration of individual periods spent in these states in infants with Down's syndrome, bilirubinaemia and in a heterogeneous group of ‘high‐risk’ infants. Not unexpectedly, alterations from previously established normal values were found, as were differences in pattern between the groups. Infants with Down's syndrome spend more time awake at the expense of time in state 2 (active sleep), but prolonged sleep cycles are occasionally possible. Bilirubinaemic infants showed a drastic reduction in the amount of time spent in the awake states. Individual periods spent in state 2 were significantly longer, producing also a prolonged sleep cycle duration. The high‐risk group spent abnormally short periods in state 2 and none of the infants studied produced a long sleep cycle. The amount of time spent in awake states varied widely. Anti‐epileptic drugs induced more and longer individual periods of state 1 (quiet sleep) at the expense of state 2. The pathophysiological mechanisms behind these alterations in the state cycle are discussed. RÉSUMÉ Cycles de niveaux de vigilance chez les nouveaux‐nés anormaux Grâce à des méthodes polygraphiques, trois groupes de nourrissons de conditions anormales ont étéétudiés pour évaluer le pourcentage de temps passé dans chacun des divers états de sommeil et d'éveil ainsi que la durée des périodes individuelles passées dans ces différents états. Comme on pouvait s'y attendre des différences ont été observées non seulement par rapport aux valeurs établies antérieurement mais aussi avec les trois groupes. Les mongoliens passent plus de temps éveillés aux dépens du temps passé en stade 2 (sommeil actif), mais des cycles prolongés de sommeil ont pu êtren otés occasionnellement. Les nourrissons hyperbilirubinémiques ont montré une réduction considérable du temps passé dans les états de veille. Les périodes individuelles en stade 2 étaient significativement allongées et de ce fait, les plus longs cycles de sommeil étaient également allongés. Le groupe hétérogène des nourrissons à `hauts risques' présentait des périodes anormalement courtes en stade 2 et en aucun cas, il n'a été enregistré de longs cycles de sommeil. La quantité de temps passé en état de veille variait considérablement. Les médications anti‐épileptiques provoquaient un accroissement en nombre et en durée des périodes de stade 1 (sommeil tranquille) aux dépens des périodes du stade 2. Les mécanismes physio‐pathologiques sous jacents à ces altérations des cycles de vigilance sont discutés. ZUSAMMENFASSUNG Verhaltenszustandszyklen bei abnormen Neugeborenen Drei Gruppen von Kindern mit abnormen Bedingungen wurden mit polygraphischen Methoden untersucht, um den Prozentsatz der Zeit, die sie in jedem der verschiedenen Schlaf‐ und Wachzu‐stände verbringen, und die Dauer der einzelnen Perioden dieser Zustände zu berechnen. Erwartungsgemäß fanden sich Unterschiede nicht allein von früher festgestellten Werten, sondern auch ...

A 12-month-old Thoroughbred colt was presented for chronic recurrent respiratory disease characterised by persistent nasal discharge, intermittent pyrexia and coughing of several months' duration. These episodes were responsive to empirical antimicrobial therapy but returned once therapy was discontinued. History, physical examination and initial diagnostics were suggestive of bacterial pneumonia and possible underlying immunodeficiency. Serum immunoglobulin analysis and peripheral blood lymphocyte phenotyping revealed low serum IgG and IgM concentrations. In this 12-month-old colt, low serum IgG concentration was the most diagnostic parameter and supported a presumptive diagnosis of transient hypogammaglobulinaemia of the young. The colt responded favourably to repeated treatment with antimicrobials for bacterial pneumonia, and serial immunologic testing over the following months showed gradual increase in serum IgG and IgM concentrations, supporting the diagnosis of delayed development of humoral immunity in this patient.

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