The 1H NMR spectra of the lipid region of human plasma from healthy adults, neonates, and patients with malignant and nonmalignant tumors have been recorded on a JNM-GX400 FT spectrometer operating at 399.6 MHz for protons. The chemical shifts of methylene and methyl groups of plasma lipids were measured with respect to the higher field component of the methyl proton resonance of the lactate molecule. The results show that there are changes in the chemical shifts of the methylene proton resonances among the plasma from healthy adults, adults with tumors, and neonates. The shifts observed in the case of cancer patients and neonates are in the direction opposite to the shift measured from the plasma of healthy adults. Thus, the observed changes cannot be explained by the activity in the cell proliferation of tissues which is high in the cases of both healthy neonates and patients with malignant tumors, but they most probably reflect the different lipoprotein compositions of neonates, healthy adults, and adults with tumors.
The objective of this study was to describe a population of children admitted to a tertiary care pediatric hospital with severe trauma to identify key areas for injury prevention research, and programming.
Retrospective chart review conducted on all children 0-17 years admitted to the Children's Hospital of Eastern Ontario (CHEO) between April 1, 1996, and March 31, 2000, following acute trauma. Each record was reviewed and assigned an ISS using the AIS 1990 revision. All cases with an ISS > 11 were included in the study.
There were 2610 trauma cases admitted to CHEO over the study period. Of these, 237 (9.1%) had severe trauma (ISS > 11). Sixty-two percent were male. Twenty-nine percent were between the ages of 10 and 14 years, 27% between 5 and 9 years, 16% between 15 and 17 years, 15% between 1 and 4 years, and 13% less than 1 year old. The most common mechanisms of injury were due to motor vehicle traffic (39%), falls (24%), child abuse (8%), and sports (5%). Of those resulting from motor vehicle traffic, 53 (57%) were occupants, 22 (24%) were pedestrians, and 18 (19%) were cyclists. When combining traffic and nontraffic mechanisms, 26 (11% of all severe trauma cases) occurred as a result of cycling incidents. The most severe injury in 65% of patients was to the head and neck body region.
Research efforts and activities to prevent severe pediatric trauma in our region should focus on road safety, protection from head injuries, avoidance of falls, and prevention of child abuse.
To determine whether birth and care in the highest-level hospitals (level III) compared with birth in or postnatal transfer to lower-level hospitals (level II) are associated with 5-year morbidity in very preterm children.
A cohort study.
All surviving 5-year-old children born very preterm (gestational age