No abstract

Bronchopleural fistula (BPF) produced by endotracheal suction catheter is a known cause of persistent pneumothorax in preterm infants in intensive care nurseries. This report describes the pulmonary pathology of a neonate who had sustained this injury. The observation suggests that the abnormal airflow results in severe damage of the involved lobe and an unusually mild bronchopulmonary dysplasia in the rest of the lung. This is in agreement with the fact that BPF acts as the path of least resistance for the oxygen-rich air from the ventilator.

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This study examined the records of the North Carolina Central Registry of Child Abuse and Neglect to determine which social, family and child characteristics were most influential in the decision to place a child in foster care. These records contained all theoretically relevant factors as well as demographic data. Analysis included the computation of odds ratios for foster care for each of 250 variables. A maximum likelihood binary logistic regression model was constructed to obtain the independent and cumulative contribution of each factor.During a 12 month period of 1978-79, 4611 families were reported for a first episode of confirmed child maltreatment. Approximately 15% of the families had children placed in foster care. Some expected variables such as parental stress factors (substance abuse)and types of abuse (burns and scalds) placed a child at a significant risk for placement in foster care (p < 0.05). However, less obvious factors such as referral source (law enforcement agencies) or geographic area also placed children at risk. Overall, our model explained little of the variance of these decisions (~2 = 0,168) and poorly predicted placement (sensitivity 66.3%, specificity 74.6%).Using existing data we were unable to adequately describe the decision process in selecting foster care. Among a large population of maltreated children, placement in foster care approximates a random process. Evaluation o f NIC o f very low b i r t h weight i n f a n t s (VLBW) has been based l a r g e l y on i n f a n t s treated i n r e f e r r a l centers. The c h a r a c t e r i s t i c s o f the population o f i n f a n t s from which the treated i n f a n t s come are unknown. To address the issue o f maternal residence, a1 1 VLBW (500-14999) 1 i v e b i r t h s i n Hami 1 tonWentworth County (1974 pop. 406,900) from 1964-69 and 1973-77 (before and a f t e r the introduction o f the McMaster Regional Perinatal Program) were reviewed. The newborn m o r t a l i t y a t f i n a l discharge by maternal residence was as follows:.582 t o .39j, a difference o f .185. Adjusting f o r maternal residence by applying 1964-69 m o r t a l i t y rates t o the number o f b i r t h s i n 1973-77 r e s u l t s i n an expected m o r t a l i t y r a t e o f .531. 28% (.051/.185) o f the decrease i n m o r t a l i t y i s "explained" by maternal residence. Maternal selection may introduce a bias i n the evaluation o f NIC o f VLBW i n f a n t s .