Objective-To examine whether birth weight is related to systolic blood pressure during adolescence.Design-Retrospective (comparative) cohort study. The observers who traced and studied the subjects were unaware oftheir case-control status.

It has been suggested that factors which influence low birth weight at term may be associated with reduced lung function in later life. This hypothesis was investigated in a comparative (retrospective) cohort study of 164 matched pairs of subjects where the observers responsible for tracing and studying the subjects were unaware of their case or control status. The subjects, born in Cardiff between 1975 and 1977, were of mean age 15*7 years. Cases (low birth weight (<2500 g) at term) were matched with controls (normal birth weight (3000-3800 g) at term) for sex, parity, place of birth, date of birth, and gestation. Lung function was measured using a portable spirometer.The corrected mean differences (95% confidence interval) in forced vital capacity (FVC) and flow when 500/0 or 25% of the FVC remains in the lungs between the cases and controls were respectively -41 ml (-140 to 58), -82 nml/sec (-286 to 122), and -83 nml/sec (-250 to 83). None of these differences were statistically significant. These results are inconsistent with the hypothesis that low birth weight at term is associated with reduced lung function in adolescence.

Factors that influence low birth weight at term may also be associated with subcutaneous fat patterning in later life. This hypothesis was investigated in a comparative (retrospective) cohort study. The subjects, born in Cardiff between 1975 and 1977, were of mean age 15.7 years. Cases (low birth weight (<2500 g) at term) were matched with controls (normal birth weight (3000-3800 g) at term) for sex, parity, place ofbirth, date ofbirth, and gestation. Subscapular skinfold (an index of central subcutaneous fat) and triceps skinfold (an index of peripheral subcutaneous fat) were measured using a Holtain skinfold caliper. The differences (cases minus controls) (95% confidence interval) for subscapular and triceps skinfolds were respectively -0.3 mm (-1.74 to 1.14) and -0.48 mm (-1.75 to 0.79). These findings are inconsistent with the hypothesis that low birth weight at term is associated with subcutaneous fat patterning in adolescence. (Arch Dis Child 1996;75:521-523)

SUMMARY The acute care and further management plans accorded to eight children, all already on treatment for epilepsy, admitted to hospital with a total of 17 episodes of convulsive status epilepticus were examined. Emergency treatment was appropriate, but longer‐term management tended to be less than adequate. The causes of status epilepticus were not considered before discharge on 10 occasions. Advice on simple preventative measures was rarely given to the parents. Junior staff require further training in these areas. RÉSUMÉ Etat de mal épileptique chez l'enfant suivi pour épilepsie: évaluation de la prise en charge Le traitement aigu et la prise en charge ultérieure portés à huit enfants, tous déjà traités pour épilepsie, admis à l'hôpital pour un total de 17 épisodes d'état de mal, ont été analysés. Le traitement d'urgence fut approprié mais la prise charge ultérieure fut loin d'étre adéquate. La cause de l'état de mal ne fut même pas recherchée avant la sortie pour 10 épisodes. Des simples conseils pour la prévention furent rarement données aux parents. Les services non spécialises devraient être mieux formés dans le domaine. ZUSAMMENFASSUNG Status epilepticus bei Kindern unter Epilepsietherapie: Beurteilung der Behandlung Es wurden Notfallversorgung und weitere Behandlung von acht Kindern untersucht, die alle schon wegen einer Epilepsie behandelt wurden und die wegen insgesamt 17 Episoden eines Status epilepticus im Krankenhaus aufgenommen wurden. Die Notfallversorgung war in Ordnung, aber die langfristige Betreuung war eher unzureichend. Bei 10 Fällen wurde über die Ursache des Status epilepticus erst bei der Entlassung nachgedacht. Die Eltern bekamen selten Ratschläge für einfache vorbeugende Maßnahmen. Die jungen Assistenten müssen in diesem Bereich besser ausgebildet werden. RESUMEN Estado epiléptico convulsivo en niños tratados por epilepsia: evaluateón de su manejo Se examinaron el cuidad en fase aguda y los planes de manejo posterior aplicados a ocho niños, todos con tratamiento antiepiléptico en curso, ingresados en el hospital con un total de 17 episodios de estado epiléptico convulsivo. El tratamiento de urgcncia era el apropiado, pero el manejo a largo plazo tendia a ser insuficiente. Las causas del estado epiléptico no fueron consideradas antes de ser dados de alta en 10 casos. Raramente se dieron a los padres consejos sobre medidas preventivas. El personal más joven necesita un entrenamiento adecuado en este campo.

The aim of this study was to audit the management of neonatal respiratory distress syndrome (RDS) in a geographically defined population using a retrospective peer review of case notes. The subjects were 49 infants of 24–36 wk gestation with a birthweight > 499 g, and dying as a consequence of prematurity at <1 y of age in Wales during 1996. Forty‐four infants (90%) were delivered in a unit with staff experienced in the management of preterm birth. Of the 30 infants <30 weeks'gestation, 29 (97%) received neonatal intensive care on a (sub)regional unit. Predelivery corticosteroids were indicated in 34 cases and administered in 31 (91%). Resuscitation at birth was indicated in 47 infants and conducted satisfactorily in 42 (89%). Temperature on admission to the neonatal unit was not recorded in 7 infants; in the other 42 it was >35.5°C in 21 (50%). Early surfactant therapy was administered to 31/34 (91%) infants still intubated 120 min after birth, but was given within 30 min to only 8 (24%). Mechanical ventilation was assessed in 41 infants and considered to be good in 23 (56%). Cardiovascular therapy was evaluated in 40 infants requiring active support and considered to be good in 31 (78%). We concluded that neonatal RDS was generally well managed, thermal care during resuscitation was poor, surfactant should be administered more promptly, and deficiencies in the management of ventilation were common and related mainly to poor anticipation and a slow response to problems.