home *** CD-ROM | disk | FTP | other *** search
| Unknown | 1992-06-06 | 432.9 KB |
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MacOS 8.1
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Win98
|
DOS
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| Confidence | Program | Detection | Match Type | Support
|
|---|
| 66%
| dexvert
| OS/2 Installation Package (archive/os2InstallPackage)
| ext
| Supported |
| 1%
| dexvert
| BeOS Installation Package (archive/beOSInstallPackage)
| ext
| Unsupported |
| 1%
| dexvert
| Newton Package (archive/newtonPackage)
| ext
| Unsupported |
| 1%
| dexvert
| Independence War 2 mod Package (other/independenceWar2ModPackage)
| ext
| Unsupported |
| 100%
| file
| data
| default
|
|
hex view+--------+-------------------------+-------------------------+--------+--------+
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|00000010| 00 00 16 00 00 00 30 30 | 00 00 00 01 8e 05 00 00 |......00|........|
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|00000430| 37 36 00 00 00 01 92 20 | 05 00 1c 15 00 00 37 37 |76..... |......77|
|00000440| 00 00 00 01 ae 35 05 00 | 76 14 00 00 37 38 00 00 |.....5..|v...78..|
|00000450| 00 01 24 4a 05 00 84 18 | 00 00 37 39 00 00 00 01 |..$J....|..79....|
|00000460| a8 62 05 00 b1 0c 00 00 | 38 30 00 00 00 01 59 6f |.b......|80....Yo|
|00000470| 05 00 74 13 00 00 38 31 | 00 00 00 01 cd 82 05 00 |..t...81|........|
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|00000490| 00 00 38 33 00 00 00 01 | 81 a9 05 00 16 0f 00 00 |..83....|........|
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|000004c0| 00 01 c4 d1 05 00 d7 0f | 00 00 38 37 00 00 00 01 |........|..87....|
|000004d0| 9b e1 05 00 84 11 00 00 | 38 38 00 00 00 01 1f f3 |........|88......|
|000004e0| 05 00 19 0f 00 00 38 39 | 00 00 00 01 38 02 06 00 |......89|....8...|
|000004f0| 38 0d 00 00 39 30 00 00 | 00 01 70 0f 06 00 41 14 |8...90..|..p...A.|
|00000500| 00 00 39 31 00 00 00 01 | b1 23 06 00 1b 11 00 00 |..91....|.#......|
|00000510| 39 32 00 00 00 01 cc 34 | 06 00 b3 1a 00 00 39 33 |92.....4|......93|
|00000520| 00 00 00 01 7f 4f 06 00 | fa 13 00 00 39 34 00 00 |.....O..|....94..|
|00000530| 00 01 79 63 06 00 2a 0d | 00 00 39 35 00 00 00 01 |..yc..*.|..95....|
|00000540| a3 70 06 00 b2 11 00 00 | 39 36 00 00 00 01 55 82 |.p......|96....U.|
|00000550| 06 00 25 15 00 00 39 37 | 00 00 00 01 7a 97 06 00 |..%...97|....z...|
|00000560| 6f 0d 00 00 39 38 00 00 | 00 01 e9 a4 06 00 33 0e |o...98..|......3.|
|00000570| 00 00 39 39 00 00 00 01 | 1c b3 06 00 6e 10 00 00 |..99....|....n...|
|00000580| 00 00 00 00 00 00 8a c3 | 06 00 00 00 00 00 24 55 |........|......$U|
|00000590| 6e 69 71 75 65 5f 49 44 | 7b 59 52 42 30 37 35 30 |nique_ID|{YRB0750|
|000005a0| 30 7d 0d 0a 24 54 69 74 | 6c 65 7b 45 76 61 6c 75 |0}..$Tit|le{Evalu|
|000005b0| 61 74 69 6f 6e 20 6f 66 | 20 4d 61 73 6b 2d 42 61 |ation of| Mask-Ba|
|000005c0| 67 20 56 65 6e 74 69 6c | 61 74 69 6f 6e 20 69 6e |g Ventil|ation in|
|000005d0| 20 52 65 73 75 73 63 69 | 74 61 74 69 6f 6e 20 6f | Resusci|tation o|
|000005e0| 66 20 49 6e 66 61 6e 74 | 73 7d 0d 0a 24 41 75 74 |f Infant|s}..$Aut|
|000005f0| 68 6f 72 7b 0d 0a 4b 61 | 6e 74 65 72 2c 20 52 4b |hor{..Ka|nter, RK|
|00000600| 7d 0d 0a 24 41 66 66 69 | 6c 69 61 74 69 6f 6e 7b |}..$Affi|liation{|
|00000610| 53 74 61 74 65 20 55 6e | 69 76 20 6f 66 20 4e 65 |State Un|iv of Ne|
|00000620| 77 20 59 6f 72 6b 2c 20 | 53 79 72 61 63 75 73 65 |w York, |Syracuse|
|00000630| 7d 0d 0a 24 53 75 62 6a | 65 63 74 7b 56 65 6e 74 |}..$Subj|ect{Vent|
|00000640| 69 6c 61 74 69 6f 6e 20 | 6d 61 73 6b 2d 62 61 67 |ilation |mask-bag|
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|00000660| 69 6f 6e 20 6f 66 20 6e | 65 77 62 6f 72 6e 3b 0d |ion of n|ewborn;.|
|00000670| 0a 52 65 73 75 73 63 69 | 74 61 74 69 6f 6e 20 77 |.Resusci|tation w|
|00000680| 69 74 68 20 6d 61 73 6b | 2d 62 61 67 20 76 65 6e |ith mask|-bag ven|
|00000690| 74 69 6c 61 74 69 6f 6e | 2c 20 6f 66 20 6e 65 77 |tilation|, of new|
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|000006c0| 68 20 6d 61 73 6b 2d 62 | 61 67 20 76 65 6e 74 69 |h mask-b|ag venti|
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|000007b0| 61 62 6c 65 7b 54 61 62 | 6c 65 20 4f 6d 69 74 74 |able{Tab|le Omitt|
|000007c0| 65 64 7d 0d 0a 24 43 6f | 6d 6d 65 6e 74 61 74 6f |ed}..$Co|mmentato|
|000007d0| 72 7b 44 2e 20 4e 69 63 | 68 6f 6c 73 2c 20 4d 2e |r{D. Nic|hols, M.|
|000007e0| 44 2e 7d 0d 0a 0d 0a 43 | 6f 70 79 72 69 67 68 74 |D.}....C|opyright|
|000007f0| 20 28 63 29 20 59 65 61 | 72 20 42 6f 6f 6b 20 4d | (c) Yea|r Book M|
|00000800| 65 64 69 63 61 6c 20 50 | 75 62 6c 69 73 68 65 72 |edical P|ublisher|
|00000810| 73 2c 20 49 6e 63 2e 2c | 20 31 39 38 39 0d 0a 0d |s, Inc.,| 1989...|
|00000820| 0a 31 39 38 39 20 59 65 | 61 72 20 42 6f 6f 6b 20 |.1989 Ye|ar Book |
|00000830| 6f 66 20 50 65 64 69 61 | 74 72 69 63 73 20 28 52 |of Pedia|trics (R|
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|00000850| 54 68 65 20 4e 65 77 62 | 6f 72 6e 0d 0a 0d 0a 2d |The Newb|orn....-|
|00000860| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000870| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000880| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000890| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000008a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 0d |--------|-------.|
|000008b0| 0a 45 76 61 6c 75 61 74 | 69 6f 6e 20 6f 66 20 4d |.Evaluat|ion of M|
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|000008e0| 74 69 6f 6e 20 6f 66 20 | 49 6e 66 61 6e 74 73 0d |tion of |Infants.|
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|00000920| 0d 0a 41 6d 20 4a 20 44 | 69 73 20 43 68 69 6c 64 |..Am J D|is Child|
|00000930| 20 31 34 31 3a 37 36 31 | 2d 37 36 33 2c 20 4a 75 | 141:761|-763, Ju|
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|00000970| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
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|00000a80| 6e 67 20 74 6f 20 70 72 | 6f 76 69 64 65 20 61 20 |ng to pr|ovide a |
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|00000ab0| 61 6e 63 65 20 6f 66 20 | 31 2e 35 20 6d 6c 2f 63 |ance of |1.5 ml/c|
|00000ac0| 6d 20 6f 66 20 77 61 74 | 65 72 2c 20 77 68 69 63 |m of wat|er, whic|
|00000ad0| 68 20 72 65 73 65 6d 62 | 6c 65 64 20 74 68 61 74 |h resemb|led that|
|00000ae0| 20 6f 66 20 61 0d 0a 70 | 61 74 69 65 6e 74 20 77 | of a..p|atient w|
|00000af0| 69 74 68 20 73 74 69 66 | 66 20 6c 75 6e 67 73 2e |ith stif|f lungs.|
|00000b00| 20 20 54 68 65 20 70 65 | 72 66 6f 72 6d 61 6e 63 | The pe|rformanc|
|00000b10| 65 20 6f 66 20 62 6f 74 | 68 20 73 65 6c 66 2d 69 |e of bot|h self-i|
|00000b20| 6e 66 6c 61 74 61 62 6c | 65 20 72 65 73 75 73 63 |nflatabl|e resusc|
|00000b30| 69 74 61 74 69 6f 6e 0d | 0a 62 61 67 73 20 61 6e |itation.|.bags an|
|00000b40| 64 20 61 6e 65 73 74 68 | 65 73 69 61 20 62 61 67 |d anesth|esia bag|
|00000b50| 73 20 77 61 73 20 65 76 | 61 6c 75 61 74 65 64 2e |s was ev|aluated.|
|00000b60| 0d 0a 20 20 20 20 20 52 | 65 73 75 73 63 69 74 61 |.. R|esuscita|
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|00000b80| 65 6e 65 72 61 6c 6c 79 | 20 70 65 72 66 6f 72 6d |enerally| perform|
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|00000bc0| 74 61 62 6c 65 29 2e 20 | 20 4f 6e 6c 79 20 34 20 |table). | Only 4 |
|00000bd0| 6f 66 20 35 30 20 6f 70 | 65 72 61 74 6f 72 73 20 |of 50 op|erators |
|00000be0| 66 61 69 6c 65 64 20 74 | 6f 20 70 65 72 66 6f 72 |failed t|o perfor|
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|00000c20| 20 68 79 70 65 72 76 65 | 6e 74 69 6c 61 74 65 20 | hyperve|ntilate |
|00000c30| 61 6e 64 20 74 6f 20 75 | 73 65 0d 0a 65 78 63 65 |and to u|se..exce|
|00000c40| 73 73 69 76 65 20 70 72 | 65 73 73 75 72 65 73 2e |ssive pr|essures.|
|00000c50| 20 20 54 65 63 68 6e 69 | 63 61 6c 20 70 72 6f 62 | Techni|cal prob|
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|00000c70| 65 73 74 68 65 73 69 61 | 20 62 61 67 20 6c 65 64 |esthesia| bag led|
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|00000cc0| 6c 61 74 69 6f 6e 20 77 | 61 73 0d 0a 73 69 67 6e |lation w|as..sign|
|00000cd0| 69 66 69 63 61 6e 74 6c | 79 20 6c 6f 77 65 72 20 |ificantl|y lower |
|00000ce0| 77 69 74 68 20 74 68 65 | 20 61 6e 65 73 74 68 65 |with the| anesthe|
|00000cf0| 73 69 61 20 62 61 67 20 | 28 46 69 67 20 31 2d 31 |sia bag |(Fig 1-1|
|00000d00| 29 2e 20 20 49 6e 20 35 | 20 69 6e 73 74 61 6e 63 |). In 5| instanc|
|00000d10| 65 73 0d 0a 76 65 6e 74 | 69 6c 61 74 69 6f 6e 20 |es..vent|ilation |
|00000d20| 77 61 73 20 69 6e 74 65 | 72 72 75 70 74 65 64 20 |was inte|rrupted |
|00000d30| 66 6f 72 20 61 74 20 6c | 65 61 73 74 20 35 20 73 |for at l|east 5 s|
|00000d40| 65 63 6f 6e 64 73 20 77 | 68 65 6e 20 74 68 65 20 |econds w|hen the |
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|00001ab0| 43 68 61 70 74 65 72 20 | 31 2d 2d 54 68 65 20 4e |Chapter |1--The N|
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|00002e40| 4d 2e 44 2e 7d 0d 0a 0d | 0a 43 6f 70 79 72 69 67 |M.D.}...|.Copyrig|
|00002e50| 68 74 20 28 63 29 20 59 | 65 61 72 20 42 6f 6f 6b |ht (c) Y|ear Book|
|00002e60| 20 4d 65 64 69 63 61 6c | 20 50 75 62 6c 69 73 68 | Medical| Publish|
|00002e70| 65 72 73 2c 20 49 6e 63 | 2e 2c 20 31 39 38 39 0d |ers, Inc|., 1989.|
|00002e80| 0a 0d 0a 31 39 38 39 20 | 59 65 61 72 20 42 6f 6f |...1989 |Year Boo|
|00002e90| 6b 20 6f 66 20 50 65 64 | 69 61 74 72 69 63 73 20 |k of Ped|iatrics |
|00002ea0| 28 52 29 0d 0a 0d 0a 43 | 68 61 70 74 65 72 20 31 |(R)....C|hapter 1|
|00002eb0| 2d 2d 54 68 65 20 4e 65 | 77 62 6f 72 6e 0d 0a 0d |--The Ne|wborn...|
|00002ec0| 0a 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |.-------|--------|
|00002ed0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002ee0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002ef0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002f00| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002f10| 2d 0d 0a 53 6e 2d 50 72 | 6f 74 6f 70 6f 72 70 68 |-..Sn-Pr|otoporph|
|00002f20| 79 72 69 6e 20 55 73 65 | 20 69 6e 20 74 68 65 20 |yrin Use| in the |
|00002f30| 4d 61 6e 61 67 65 6d 65 | 6e 74 20 6f 66 20 48 79 |Manageme|nt of Hy|
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|00002f80| 42 4f 20 49 6e 63 6f 6d | 70 61 74 69 62 69 6c 69 |BO Incom|patibili|
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|00002fa0| 44 72 75 6d 6d 6f 6e 64 | 20 47 53 2c 20 4d 61 6e |Drummond| GS, Man|
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|00002fc0| 20 53 2c 20 56 61 6c 61 | 65 73 20 54 0d 0a 28 52 | S, Vala|es T..(R|
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|00002fe0| 48 6f 73 70 2c 20 4e 65 | 77 20 59 6f 72 6b 3b 20 |Hosp, Ne|w York; |
|00002ff0| 4d 65 74 65 72 61 20 4d | 61 74 65 72 6e 69 74 79 |Metera M|aternity|
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|00003020| 63 73 20 38 31 3a 34 38 | 35 2d 34 39 38 2c 20 41 |cs 81:48|5-498, A|
|00003030| 70 72 69 6c 20 31 39 38 | 38 0d 0a 2d 2d 2d 2d 2d |pril 198|8..-----|
|00003040| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003050| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003060| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003070| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003080| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 0d 0a 0d 0a 41 |--------|---....A|
|00003090| 62 73 74 72 61 63 74 0d | 0a 0d 0a 20 20 20 20 20 |bstract.|... |
|000030a0| 53 6e 2d 70 72 6f 74 6f | 70 6f 72 70 68 79 72 69 |Sn-proto|porphyri|
|000030b0| 6e 20 69 73 20 61 20 70 | 6f 74 65 6e 74 20 63 6f |n is a p|otent co|
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|000036a0| 20 20 41 64 6d 69 6e 69 | 73 74 72 61 74 69 6f 6e | Admini|stration|
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|00003ae0| 65 0d 0a 74 6f 20 73 74 | 61 6d 70 20 6f 75 74 20 |e..to st|amp out |
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|00003b00| 65 20 63 6f 6d 70 6c 65 | 74 65 6c 79 2e 20 20 42 |e comple|tely. B|
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|00003ca0| 61 6e 64 20 4d 69 6c 6b | 20 49 6e 74 61 6b 65 20 |and Milk| Intake |
|00003cb0| 69 6e 20 4a 61 75 6e 64 | 69 63 65 64 20 4e 65 6f |in Jaund|iced Neo|
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|00003ce0| 0a 52 6f 62 65 72 74 73 | 2c 20 53 41 7d 0d 0a 24 |.Roberts|, SA}..$|
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|00003d50| 77 62 6f 72 6e 3b 0d 0a | 4e 65 77 62 6f 72 6e 20 |wborn;..|Newborn |
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|00003d70| 20 62 65 68 61 76 69 6f | 72 20 61 6e 64 20 6d 69 | behavio|r and mi|
|00003d80| 6c 6b 20 69 6e 74 61 6b | 65 20 69 6e 3b 0d 0a 4d |lk intak|e in;..M|
|00003d90| 69 6c 6b 20 69 6e 74 61 | 6b 65 20 61 6e 64 20 73 |ilk inta|ke and s|
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|00003db0| 69 6e 20 6a 61 75 6e 64 | 69 63 65 20 69 6e 20 6e |in jaund|ice in n|
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|00003e10| 6c 79 20 48 75 6d 20 44 | 65 76 7d 0d 0a 24 56 6f |ly Hum D|ev}..$Vo|
|00003e20| 6c 75 6d 65 7b 31 36 7d | 0d 0a 24 50 61 67 65 7b |lume{16}|..$Page{|
|00003e30| 37 33 2d 38 34 7d 0d 0a | 24 44 61 74 65 7b 4a 61 |73-84}..|$Date{Ja|
|00003e40| 6e 75 61 72 79 20 31 39 | 38 38 7d 0d 0a 24 59 42 |nuary 19|88}..$YB|
|00003e50| 56 6f 6c 7b 31 39 38 39 | 20 59 65 61 72 20 42 6f |Vol{1989| Year Bo|
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|00003e80| 0d 0a 24 59 42 45 64 69 | 74 6f 72 7b 44 72 73 2e |..$YBEdi|tor{Drs.|
|00003e90| 20 4f 73 6b 69 20 61 6e | 64 20 53 74 6f 63 6b 6d | Oski an|d Stockm|
|00003ea0| 61 6e 7d 0d 0a 24 54 61 | 62 6c 65 7b 54 61 62 6c |an}..$Ta|ble{Tabl|
|00003eb0| 65 20 4f 6d 69 74 74 65 | 64 7d 0d 0a 24 43 6f 6d |e Omitte|d}..$Com|
|00003ec0| 6d 65 6e 74 61 74 6f 72 | 7b 46 2e 41 2e 20 4f 73 |mentator|{F.A. Os|
|00003ed0| 6b 69 2c 20 4d 2e 44 2e | 7d 0d 0a 0d 0a 43 6f 70 |ki, M.D.|}....Cop|
|00003ee0| 79 72 69 67 68 74 20 28 | 63 29 20 59 65 61 72 20 |yright (|c) Year |
|00003ef0| 42 6f 6f 6b 20 4d 65 64 | 69 63 61 6c 20 50 75 62 |Book Med|ical Pub|
|00003f00| 6c 69 73 68 65 72 73 2c | 20 49 6e 63 2e 2c 20 31 |lishers,| Inc., 1|
|00003f10| 39 38 39 0d 0a 0d 0a 31 | 39 38 39 20 59 65 61 72 |989....1|989 Year|
|00003f20| 20 42 6f 6f 6b 20 6f 66 | 20 50 65 64 69 61 74 72 | Book of| Pediatr|
|00003f30| 69 63 73 20 28 52 29 0d | 0a 0d 0a 43 68 61 70 74 |ics (R).|...Chapt|
|00003f40| 65 72 20 31 2d 2d 54 68 | 65 20 4e 65 77 62 6f 72 |er 1--Th|e Newbor|
|00003f50| 6e 0d 0a 0d 0a 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |n....---|--------|
|00003f60| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003f70| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003f80| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003f90| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003fa0| 2d 2d 2d 2d 2d 0d 0a 53 | 75 63 6b 69 6e 67 20 42 |-----..S|ucking B|
|00003fb0| 65 68 61 76 69 6f 75 72 | 20 61 6e 64 20 4d 69 6c |ehaviour| and Mil|
|00003fc0| 6b 20 49 6e 74 61 6b 65 | 20 69 6e 20 4a 61 75 6e |k Intake| in Jaun|
|00003fd0| 64 69 63 65 64 20 4e 65 | 6f 6e 61 74 65 73 0d 0a |diced Ne|onates..|
|00003fe0| 0d 0a 41 6c 65 78 61 6e | 64 65 72 20 47 53 2c 20 |..Alexan|der GS, |
|00003ff0| 52 6f 62 65 72 74 73 20 | 53 41 0d 0a 28 55 6e 69 |Roberts |SA..(Uni|
|00004000| 76 20 48 6f 73 70 20 6f | 66 20 53 6f 75 74 68 20 |v Hosp o|f South |
|00004010| 4d 61 6e 63 68 65 73 74 | 65 72 2c 20 45 6e 67 6c |Manchest|er, Engl|
|00004020| 61 6e 64 29 0d 0a 45 61 | 72 6c 79 20 48 75 6d 20 |and)..Ea|rly Hum |
|00004030| 44 65 76 20 31 36 3a 37 | 33 2d 38 34 2c 20 4a 61 |Dev 16:7|3-84, Ja|
|00004040| 6e 75 61 72 79 20 31 39 | 38 38 0d 0a 2d 2d 2d 2d |nuary 19|88..----|
|00004050| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004060| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004070| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004080| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004090| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 0d 0a 0d 0a |--------|----....|
|000040a0| 41 62 73 74 72 61 63 74 | 0d 0a 0d 0a 20 20 20 20 |Abstract|.... |
|000040b0| 20 50 65 64 69 61 74 72 | 69 63 69 61 6e 73 20 61 | Pediatr|icians a|
|000040c0| 72 65 20 66 61 6d 69 6c | 69 61 72 20 77 69 74 68 |re famil|iar with|
|000040d0| 20 74 68 65 20 6a 61 75 | 6e 64 69 63 65 64 20 6e | the jau|ndiced n|
|000040e0| 65 77 62 6f 72 6e 20 77 | 68 6f 20 61 70 70 65 61 |ewborn w|ho appea|
|000040f0| 72 73 20 72 65 6c 75 63 | 74 61 6e 74 0d 0a 74 6f |rs reluc|tant..to|
|00004100| 20 66 65 65 64 2e 20 20 | 54 6f 20 69 6e 76 65 73 | feed. |To inves|
|00004110| 74 69 67 61 74 65 20 6e | 75 74 72 69 74 69 76 65 |tigate n|utritive|
|00004120| 20 73 75 63 6b 69 6e 67 | 2c 20 6d 69 6c 6b 20 63 | sucking|, milk c|
|00004130| 6f 6e 73 75 6d 70 74 69 | 6f 6e 2c 20 73 75 63 6b |onsumpti|on, suck|
|00004140| 69 6e 67 20 61 62 69 6c | 69 74 79 2c 0d 0a 61 6e |ing abil|ity,..an|
|00004150| 64 20 62 65 68 61 76 69 | 6f 72 20 77 65 72 65 20 |d behavi|or were |
|00004160| 73 74 75 64 69 65 64 20 | 69 6e 20 32 37 20 66 75 |studied |in 27 fu|
|00004170| 6c 6c 2d 74 65 72 6d 20 | 66 6f 72 6d 75 6c 61 2d |ll-term |formula-|
|00004180| 66 65 64 20 6a 61 75 6e | 64 69 63 65 64 20 69 6e |fed jaun|diced in|
|00004190| 66 61 6e 74 73 20 77 68 | 6f 20 68 61 64 0d 0a 74 |fants wh|o had..t|
|000041a0| 6f 74 61 6c 20 73 65 72 | 75 6d 20 62 69 6c 69 72 |otal ser|um bilir|
|000041b0| 75 62 69 6e 20 6c 65 76 | 65 6c 73 20 6f 66 20 31 |ubin lev|els of 1|
|000041c0| 30 33 2d 32 37 30 2f 20 | 6d 75 5f 6d 6f 6c 5e 2d |03-270/ |mu_mol^-|
|000041d0| 31 20 64 75 72 69 6e 67 | 20 74 68 65 20 66 69 72 |1 during| the fir|
|000041e0| 73 74 20 77 65 65 6b 20 | 6f 66 0d 0a 6c 69 66 65 |st week |of..life|
|000041f0| 2e 0d 0a 20 20 20 20 20 | 4d 69 6c 6b 20 63 6f 6e |... |Milk con|
|00004200| 73 75 6d 70 74 69 6f 6e | 20 69 6e 63 72 65 61 73 |sumption| increas|
|00004210| 65 64 20 73 69 67 6e 69 | 66 69 63 61 6e 74 6c 79 |ed signi|ficantly|
|00004220| 20 77 69 74 68 20 61 67 | 65 2c 20 66 72 6f 6d 20 | with ag|e, from |
|00004230| 61 20 6d 65 61 6e 20 6f | 66 20 34 2e 38 37 20 6d |a mean o|f 4.87 m|
|00004240| 6c 0d 0a 70 65 72 20 6d | 69 6e 75 74 65 20 6f 6e |l..per m|inute on|
|00004250| 20 74 68 65 20 73 65 63 | 6f 6e 64 20 64 61 79 20 | the sec|ond day |
|00004260| 6f 66 20 6c 69 66 65 20 | 74 6f 20 31 30 2e 31 37 |of life |to 10.17|
|00004270| 20 6d 6c 20 70 65 72 20 | 6d 69 6e 75 74 65 20 6f | ml per |minute o|
|00004280| 6e 20 74 68 65 20 73 69 | 78 74 68 20 64 61 79 0d |n the si|xth day.|
|00004290| 0a 28 46 69 67 20 31 2d | 34 29 2e 20 20 54 68 65 |.(Fig 1-|4). The|
|000042a0| 72 65 20 77 61 73 20 61 | 20 73 69 67 6e 69 66 69 |re was a| signifi|
|000042b0| 63 61 6e 74 20 69 6e 63 | 72 65 61 73 65 20 69 6e |cant inc|rease in|
|000042c0| 20 61 63 74 69 76 65 20 | 73 75 63 6b 69 6e 67 20 | active |sucking |
|000042d0| 74 69 6d 65 20 66 72 6f | 6d 20 61 20 6d 65 61 6e |time fro|m a mean|
|000042e0| 0d 0a 6f 66 20 39 33 2e | 38 20 73 65 63 6f 6e 64 |..of 93.|8 second|
|000042f0| 73 20 6f 6e 20 74 68 65 | 20 73 65 63 6f 6e 64 20 |s on the| second |
|00004300| 64 61 79 20 74 6f 20 31 | 39 35 2e 30 39 20 73 65 |day to 1|95.09 se|
|00004310| 63 6f 6e 64 73 20 6f 6e | 20 74 68 65 20 74 68 69 |conds on| the thi|
|00004320| 72 64 20 64 61 79 2e 20 | 20 54 68 65 72 65 20 77 |rd day. | There w|
|00004330| 61 73 0d 0a 61 20 73 69 | 67 6e 69 66 69 63 61 6e |as..a si|gnifican|
|00004340| 74 20 69 6e 63 72 65 61 | 73 65 20 69 6e 20 73 75 |t increa|se in su|
|00004350| 63 6b 69 6e 67 20 70 72 | 65 73 73 75 72 65 20 66 |cking pr|essure f|
|00004360| 72 6f 6d 20 61 20 6d 65 | 61 6e 20 6f 66 20 36 33 |rom a me|an of 63|
|00004370| 20 6d 6d 20 48 67 20 6f | 6e 20 74 68 65 20 73 65 | mm Hg o|n the se|
|00004380| 63 6f 6e 64 0d 0a 64 61 | 79 20 74 6f 20 39 30 2e |cond..da|y to 90.|
|00004390| 35 20 6d 6d 20 48 67 20 | 6f 6e 20 74 68 65 20 73 |5 mm Hg |on the s|
|000043a0| 69 78 74 68 20 64 61 79 | 20 28 46 69 67 20 31 2d |ixth day| (Fig 1-|
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|000043c0| 20 73 69 67 6e 69 66 69 | 63 61 6e 74 0d 0a 63 6f | signifi|cant..co|
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|00004420| 72 65 6c 61 74 69 6f 6e | 20 62 65 74 77 65 65 6e |relation| between|
|00004430| 20 73 65 72 75 6d 20 62 | 69 6c 69 72 75 62 69 6e | serum b|ilirubin|
|00004440| 20 6c 65 76 65 6c 73 20 | 61 6e 64 20 6d 69 6c 6b | levels |and milk|
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|00004490| 77 62 6f 72 6e 73 20 61 | 70 70 65 61 72 20 6e 6f |wborns a|ppear no|
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|000047d0| 6b 20 4d 65 64 69 63 61 | 6c 20 50 75 62 6c 69 73 |k Medica|l Publis|
|000047e0| 68 65 72 73 2c 20 49 6e | 63 2e 2c 20 31 39 38 39 |hers, In|c., 1989|
|000047f0| 0d 0a 0d 0a 31 39 38 39 | 20 59 65 61 72 20 42 6f |....1989| Year Bo|
|00004800| 6f 6b 20 6f 66 20 50 65 | 64 69 61 74 72 69 63 73 |ok of Pe|diatrics|
|00004810| 20 28 52 29 0d 0a 0d 0a | 43 68 61 70 74 65 72 20 | (R)....|Chapter |
|00004820| 31 2d 2d 54 68 65 20 4e | 65 77 62 6f 72 6e 0d 0a |1--The N|ewborn..|
|00004830| 0d 0a 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |..------|--------|
|00004840| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004850| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004860| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004870| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004880| 2d 2d 0d 0a 54 68 65 20 | 55 6d 62 69 6c 69 63 61 |--..The |Umbilica|
|00004890| 6c 20 43 6f 72 64 20 54 | 77 69 73 74 3a 20 20 4f |l Cord T|wist: O|
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|000048c0| 0a 0d 0a 4c 61 63 72 6f | 20 52 56 2c 20 4a 6f 6e |...Lacro| RV, Jon|
|000048d0| 65 73 20 4b 4c 2c 20 42 | 65 6e 69 72 73 63 68 6b |es KL, B|enirschk|
|000048e0| 65 20 4b 0d 0a 28 55 6e | 69 76 2e 20 6f 66 20 43 |e K..(Un|iv. of C|
|000048f0| 61 6c 69 66 6f 72 6e 69 | 61 2c 20 53 61 6e 20 44 |aliforni|a, San D|
|00004900| 69 65 67 6f 29 0d 0a 41 | 6d 20 4a 20 4f 62 73 74 |iego)..A|m J Obst|
|00004910| 65 74 20 47 79 6e 65 63 | 6f 6c 20 31 35 37 3a 38 |et Gynec|ol 157:8|
|00004920| 33 33 2d 38 33 38 2c 20 | 4f 63 74 6f 62 65 72 20 |33-838, |October |
|00004930| 31 39 38 37 0d 0a 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |1987..--|--------|
|00004940| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004950| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004960| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004970| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004980| 2d 2d 2d 2d 2d 2d 0d 0a | 0d 0a 41 62 73 74 72 61 |------..|..Abstra|
|00004990| 63 74 0d 0a 0d 0a 20 20 | 20 20 20 54 68 65 20 73 |ct.... | The s|
|000049a0| 70 69 72 61 6c 20 63 6f | 75 72 73 65 20 6f 66 20 |piral co|urse of |
|000049b0| 74 68 65 20 75 6d 62 69 | 6c 69 63 61 6c 20 63 6f |the umbi|lical co|
|000049c0| 72 64 20 76 65 73 73 65 | 6c 73 20 68 61 73 20 6c |rd vesse|ls has l|
|000049d0| 6f 6e 67 20 62 65 65 6e | 20 72 65 63 6f 67 6e 69 |ong been| recogni|
|000049e0| 7a 65 64 2e 0d 0a 54 68 | 65 20 63 61 75 73 65 20 |zed...Th|e cause |
|000049f0| 6f 66 20 74 68 65 20 74 | 77 69 73 74 20 69 73 20 |of the t|wist is |
|00004a00| 75 6e 6b 6e 6f 77 6e 2c | 20 62 75 74 20 65 76 69 |unknown,| but evi|
|00004a10| 64 65 6e 63 65 20 73 75 | 67 67 65 73 74 73 20 74 |dence su|ggests t|
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|00004a50| 20 61 74 20 62 69 72 74 | 68 20 64 65 70 65 6e 64 | at birt|h depend|
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|00004b20| 0d 0a 77 6f 75 6c 64 20 | 63 6f 72 72 65 6c 61 74 |..would |correlat|
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|00004b40| 75 61 6c 20 68 61 6e 64 | 65 64 6e 65 73 73 20 6f |ual hand|edness o|
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|00004b70| 72 65 63 74 69 6f 6e 20 | 6f 66 20 74 68 65 20 74 |rection |of the t|
|00004b80| 77 69 73 74 20 6f 66 20 | 65 61 63 68 20 75 6d 62 |wist of |each umb|
|00004b90| 69 6c 69 63 61 6c 20 63 | 6f 72 64 20 77 61 73 20 |ilical c|ord was |
|00004ba0| 72 65 63 6f 72 64 65 64 | 20 28 46 69 67 20 31 2d |recorded| (Fig 1-|
|00004bb0| 36 29 2e 20 20 4f 66 20 | 32 2c 38 30 31 0d 0a 73 |6). Of |2,801..s|
|00004bc0| 69 6e 67 6c 65 74 6f 6e | 20 70 6c 61 63 65 6e 74 |ingleton| placent|
|00004bd0| 61 73 20 73 74 75 64 69 | 65 64 20 73 69 6e 63 65 |as studi|ed since|
|00004be0| 20 74 68 61 74 20 74 69 | 6d 65 2c 20 6f 6e 6c 79 | that ti|me, only|
|00004bf0| 20 35 25 20 68 61 64 20 | 6e 6f 20 74 77 69 73 74 | 5% had |no twist|
|00004c00| 2e 20 20 4c 65 66 74 20 | 74 77 69 73 74 0d 0a 6f |. Left |twist..o|
|00004c10| 75 74 6e 75 6d 62 65 72 | 65 64 20 72 69 67 68 74 |utnumber|ed right|
|00004c20| 20 74 77 69 73 74 20 62 | 79 20 37 3a 31 20 28 54 | twist b|y 7:1 (T|
|00004c30| 61 62 6c 65 20 31 29 2c | 20 61 20 72 61 74 69 6f |able 1),| a ratio|
|00004c40| 20 73 69 6d 69 6c 61 72 | 20 74 6f 20 74 68 65 20 | similar| to the |
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|00004c60| 0a 72 69 67 68 74 2d 68 | 61 6e 64 65 64 20 70 65 |.right-h|anded pe|
|00004c70| 72 73 6f 6e 73 20 74 6f | 20 6e 6f 6e 2d 72 69 67 |rsons to| non-rig|
|00004c80| 68 74 2d 68 61 6e 64 65 | 64 20 70 65 72 73 6f 6e |ht-hande|d person|
|00004c90| 73 20 69 6e 20 74 68 65 | 20 67 65 6e 65 72 61 6c |s in the| general|
|00004ca0| 20 70 6f 70 75 6c 61 74 | 69 6f 6e 2e 0d 0a 20 20 | populat|ion... |
|00004cb0| 20 20 20 54 68 65 20 69 | 6e 63 69 64 65 6e 63 65 | The i|ncidence|
|00004cc0| 20 6f 66 20 70 6c 61 63 | 65 6e 74 61 6c 20 61 62 | of plac|ental ab|
|00004cd0| 6e 6f 72 6d 61 6c 69 74 | 69 65 73 20 77 61 73 20 |normalit|ies was |
|00004ce0| 6e 6f 74 20 73 69 67 6e | 69 66 69 63 61 6e 74 6c |not sign|ificantl|
|00004cf0| 79 20 64 69 66 66 65 72 | 65 6e 74 0d 0a 61 6d 6f |y differ|ent..amo|
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|00004d10| 61 6e 64 20 61 62 73 65 | 6e 74 20 74 77 69 73 74 |and abse|nt twist|
|00004d20| 20 67 72 6f 75 70 73 2c | 20 65 78 63 65 70 74 20 | groups,| except |
|00004d30| 66 6f 72 20 63 6f 6e 67 | 65 73 74 69 6f 6e 20 61 |for cong|estion a|
|00004d40| 6e 64 0d 0a 69 6e 66 6c | 61 6d 6d 61 74 69 6f 6e |nd..infl|ammation|
|00004d50| 20 28 54 61 62 6c 65 20 | 32 29 2e 20 20 41 6d 6f | (Table |2). Amo|
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|00004d70| 63 6f 72 64 73 20 77 69 | 74 68 20 61 20 73 69 6e |cords wi|th a sin|
|00004d80| 67 6c 65 20 75 6d 62 69 | 6c 69 63 61 6c 0d 0a 61 |gle umbi|lical..a|
|00004d90| 72 74 65 72 79 2c 20 74 | 68 65 20 6c 65 66 74 2d |rtery, t|he left-|
|00004da0| 74 6f 2d 72 69 67 68 74 | 20 74 77 69 73 74 20 72 |to-right| twist r|
|00004db0| 61 74 69 6f 20 77 61 73 | 20 32 2e 38 3a 31 2e 20 |atio was| 2.8:1. |
|00004dc0| 20 54 68 65 20 69 6e 63 | 69 64 65 6e 63 65 20 6f | The inc|idence o|
|00004dd0| 66 20 61 62 73 65 6e 74 | 20 74 77 69 73 74 0d 0a |f absent| twist..|
|00004de0| 77 61 73 20 31 35 25 2c | 20 77 68 69 63 68 20 69 |was 15%,| which i|
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|00004e00| 68 69 67 68 65 72 20 74 | 68 61 6e 20 74 68 61 74 |higher t|han that|
|00004e10| 20 66 6f 72 20 63 6f 72 | 64 73 20 77 69 74 68 20 | for cor|ds with |
|00004e20| 32 20 75 6d 62 69 6c 69 | 63 61 6c 0d 0a 61 72 74 |2 umbili|cal..art|
|00004e30| 65 72 69 65 73 2e 20 20 | 54 68 69 72 74 79 2d 73 |eries. |Thirty-s|
|00004e40| 65 76 65 6e 20 70 65 72 | 63 65 6e 74 20 6f 66 20 |even per|cent of |
|00004e50| 69 6e 66 61 6e 74 73 20 | 77 69 74 68 20 61 20 73 |infants |with a s|
|00004e60| 69 6e 67 6c 65 20 75 6d | 62 69 6c 69 63 61 6c 20 |ingle um|bilical |
|00004e70| 61 72 74 65 72 79 20 68 | 61 64 20 61 6e 0d 0a 61 |artery h|ad an..a|
|00004e80| 73 73 6f 63 69 61 74 65 | 64 20 6d 61 6a 6f 72 20 |ssociate|d major |
|00004e90| 73 74 72 75 63 74 75 72 | 61 6c 20 61 62 6e 6f 72 |structur|al abnor|
|00004ea0| 6d 61 6c 69 74 79 2c 20 | 6d 75 6c 74 69 70 6c 65 |mality, |multiple|
|00004eb0| 20 6d 61 6c 66 6f 72 6d | 61 74 69 6f 6e 20 73 79 | malform|ation sy|
|00004ec0| 6e 64 72 6f 6d 65 2c 20 | 6f 72 0d 0a 66 65 74 61 |ndrome, |or..feta|
|00004ed0| 6c 20 64 65 61 74 68 2e | 0d 0a 20 20 20 20 20 41 |l death.|.. A|
|00004ee0| 6d 6f 6e 67 20 31 38 34 | 20 74 77 69 6e 20 70 61 |mong 184| twin pa|
|00004ef0| 69 72 73 20 36 35 25 20 | 77 65 72 65 20 63 6f 6e |irs 65% |were con|
|00004f00| 63 6f 72 64 61 6e 74 20 | 66 6f 72 20 6c 65 66 74 |cordant |for left|
|00004f10| 20 74 77 69 73 74 2c 20 | 34 25 20 66 6f 72 20 72 | twist, |4% for r|
|00004f20| 69 67 68 74 0d 0a 74 77 | 69 73 74 2c 20 61 6e 64 |ight..tw|ist, and|
|00004f30| 20 31 39 25 20 66 6f 72 | 20 31 20 6c 65 66 74 20 | 19% for| 1 left |
|00004f40| 61 6e 64 20 31 20 72 69 | 67 68 74 20 74 77 69 73 |and 1 ri|ght twis|
|00004f50| 74 20 28 54 61 62 6c 65 | 20 33 29 2e 20 20 41 6d |t (Table| 3). Am|
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|00005070| 69 6f 6e 20 77 69 74 68 | 20 73 69 6e 67 6c 65 20 |ion with| single |
|00005080| 75 6d 62 69 6c 69 63 61 | 6c 20 61 72 74 65 72 79 |umbilica|l artery|
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|00005110| 6e 63 72 65 61 73 65 64 | 20 69 6e 63 69 64 65 6e |ncreased| inciden|
|00005120| 63 65 20 6f 66 20 61 62 | 73 65 6e 74 20 74 77 69 |ce of ab|sent twi|
|00005130| 73 74 20 61 6d 6f 6e 67 | 20 69 6e 74 72 61 75 74 |st among| intraut|
|00005140| 65 72 69 6e 65 20 66 65 | 74 61 6c 20 64 65 61 74 |erine fe|tal deat|
|00005150| 68 73 0d 0a 61 6e 64 20 | 74 77 69 6e 73 20 77 61 |hs..and |twins wa|
|00005160| 73 20 6e 6f 74 65 64 2c | 20 73 75 67 67 65 73 74 |s noted,| suggest|
|00005170| 69 6e 67 20 74 68 61 74 | 20 64 65 63 72 65 61 73 |ing that| decreas|
|00005180| 65 64 20 66 65 74 61 6c | 20 6d 6f 76 65 6d 65 6e |ed fetal| movemen|
|00005190| 74 20 63 61 6e 20 69 6d | 70 65 64 65 20 74 68 65 |t can im|pede the|
|000051a0| 0d 0a 66 6f 72 63 65 73 | 20 74 68 61 74 20 6c 65 |..forces| that le|
|000051b0| 61 64 20 74 6f 20 6e 6f | 72 6d 61 6c 20 74 77 69 |ad to no|rmal twi|
|000051c0| 73 74 69 6e 67 2e 20 20 | 41 62 73 65 6e 63 65 20 |sting. |Absence |
|000051d0| 6f 66 20 74 77 69 73 74 | 20 6d 61 79 20 62 65 20 |of twist| may be |
|000051e0| 61 73 73 6f 63 69 61 74 | 65 64 20 77 69 74 68 0d |associat|ed with.|
|000051f0| 0a 61 64 76 65 72 73 65 | 20 70 72 6f 67 6e 6f 73 |.adverse| prognos|
|00005200| 65 73 2e 20 20 50 72 65 | 76 69 6f 75 73 20 73 74 |es. Pre|vious st|
|00005210| 75 64 69 65 73 20 68 61 | 76 65 20 6e 6f 74 20 69 |udies ha|ve not i|
|00005220| 6e 76 6f 6c 76 65 64 20 | 73 75 63 68 20 61 20 6c |nvolved |such a l|
|00005230| 61 72 67 65 20 73 74 75 | 64 79 0d 0a 70 6f 70 75 |arge stu|dy..popu|
|00005240| 6c 61 74 69 6f 6e 20 28 | 54 61 62 6c 65 20 35 29 |lation (|Table 5)|
|00005250| 2e 0d 0a 0d 0a 50 6f 73 | 74 2d 43 6f 6d 6d 65 6e |.....Pos|t-Commen|
|00005260| 74 0d 0a 0d 0a 20 20 20 | 20 20 49 20 77 6f 6e 64 |t.... | I wond|
|00005270| 65 72 20 69 66 20 43 68 | 61 72 6c 65 73 20 44 69 |er if Ch|arles Di|
|00005280| 63 6b 65 6e 73 20 65 76 | 65 72 20 65 78 61 6d 69 |ckens ev|er exami|
|00005290| 6e 65 64 20 74 68 65 20 | 75 6d 62 69 6c 69 63 61 |ned the |umbilica|
|000052a0| 6c 20 63 6f 72 64 20 6f | 66 20 4f 6c 69 76 65 72 |l cord o|f Oliver|
|000052b0| 0d 0a 54 77 69 73 74 3f | 20 20 57 61 73 20 74 68 |..Twist?| Was th|
|000052c0| 65 20 75 6d 62 69 6c 69 | 63 61 6c 20 63 6f 72 64 |e umbili|cal cord|
|000052d0| 20 74 68 65 20 69 6e 73 | 70 69 72 61 74 69 6f 6e | the ins|piration|
|000052e0| 20 66 6f 72 20 43 68 75 | 62 62 79 20 43 68 65 63 | for Chu|bby Chec|
|000052f0| 6b 65 72 20 74 6f 20 69 | 6e 76 65 6e 74 20 22 54 |ker to i|nvent "T|
|00005300| 68 65 0d 0a 54 77 69 73 | 74 22 3f 20 20 53 70 65 |he..Twis|t"? Spe|
|00005310| 61 6b 69 6e 67 20 6f 66 | 20 63 6f 72 64 73 2c 20 |aking of| cords, |
|00005320| 6e 75 63 68 61 6c 20 63 | 6f 72 64 73 20 61 72 65 |nuchal c|ords are|
|00005330| 20 61 73 73 6f 63 69 61 | 74 65 64 20 77 69 74 68 | associa|ted with|
|00005340| 20 61 6e 20 69 6e 63 72 | 65 61 73 65 64 0d 0a 70 | an incr|eased..p|
|00005350| 72 65 76 61 6c 65 6e 63 | 65 20 6f 66 20 76 61 72 |revalenc|e of var|
|00005360| 69 61 62 6c 65 20 66 65 | 74 61 6c 2d 68 65 61 72 |iable fe|tal-hear|
|00005370| 74 2d 72 61 74 65 20 64 | 65 63 65 6c 65 72 61 74 |t-rate d|ecelerat|
|00005380| 69 6f 6e 73 20 69 6e 20 | 74 68 65 20 66 69 72 73 |ions in |the firs|
|00005390| 74 20 61 6e 64 20 73 65 | 63 6f 6e 64 0d 0a 73 74 |t and se|cond..st|
|000053a0| 61 67 65 73 20 6f 66 20 | 6c 61 62 6f 72 20 61 6e |ages of |labor an|
|000053b0| 64 20 77 69 74 68 20 61 | 6e 20 69 6e 63 72 65 61 |d with a|n increa|
|000053c0| 73 65 64 20 69 6e 63 69 | 64 65 6e 63 65 20 6f 66 |sed inci|dence of|
|000053d0| 20 75 6d 62 69 6c 69 63 | 61 6c 20 61 72 74 65 72 | umbilic|al arter|
|000053e0| 79 20 61 63 69 64 65 6d | 69 61 0d 0a 28 48 61 6e |y acidem|ia..(Han|
|000053f0| 6b 69 6e 73 20 47 44 56 | 20 65 74 20 61 6c 3a 20 |kins GDV| et al: |
|00005400| 20 4f 62 73 74 65 74 20 | 47 79 6e 65 63 6f 6c 20 | Obstet |Gynecol |
|00005410| 37 30 3a 36 38 37 2c 20 | 31 39 38 37 29 2e 0d 0a |70:687, |1987)...|
|00005420| 20 20 20 20 20 54 68 65 | 20 74 77 69 73 74 20 69 | The| twist i|
|00005430| 6e 20 74 68 65 20 63 6f | 72 64 20 6d 61 79 20 70 |n the co|rd may p|
|00005440| 72 65 64 69 63 74 20 68 | 61 6e 64 65 64 6e 65 73 |redict h|andednes|
|00005450| 73 2c 20 61 6e 64 20 70 | 72 6f 62 6c 65 6d 73 20 |s, and p|roblems |
|00005460| 77 69 74 68 20 74 68 65 | 20 63 6f 72 64 20 61 74 |with the| cord at|
|00005470| 0d 0a 62 69 72 74 68 20 | 6d 61 79 20 68 61 76 65 |..birth |may have|
|00005480| 20 61 6e 20 69 6d 70 72 | 69 6e 74 69 6e 67 20 65 | an impr|inting e|
|00005490| 66 66 65 63 74 2e 20 20 | 41 73 20 64 69 73 63 75 |ffect. |As discu|
|000054a0| 73 73 65 64 20 69 6e 20 | 74 68 65 20 63 68 61 70 |ssed in |the chap|
|000054b0| 74 65 72 20 6f 6e 20 41 | 64 6f 6c 65 73 63 65 6e |ter on A|dolescen|
|000054c0| 74 0d 0a 4d 65 64 69 63 | 69 6e 65 2c 20 61 20 53 |t..Medic|ine, a S|
|000054d0| 77 65 64 69 73 68 20 73 | 74 75 64 79 20 28 4a 61 |wedish s|tudy (Ja|
|000054e0| 63 6f 62 73 6f 6e 20 42 | 20 65 74 20 61 6c 3a 20 |cobson B| et al: |
|000054f0| 20 41 63 74 61 20 50 73 | 79 63 68 69 61 74 72 20 | Acta Ps|ychiatr |
|00005500| 53 63 61 6e 64 20 37 36 | 3a 33 36 34 2c 20 31 39 |Scand 76|:364, 19|
|00005510| 38 37 29 0d 0a 73 68 6f | 77 65 64 20 74 68 61 74 |87)..sho|wed that|
|00005520| 20 73 75 69 63 69 64 65 | 73 20 69 6e 76 6f 6c 76 | suicide|s involv|
|00005530| 69 6e 67 20 61 73 70 68 | 79 78 69 61 74 69 6f 6e |ing asph|yxiation|
|00005540| 20 77 65 72 65 20 63 6c | 6f 73 65 6c 79 20 61 73 | were cl|osely as|
|00005550| 73 6f 63 69 61 74 65 64 | 20 77 69 74 68 0d 0a 61 |sociated| with..a|
|00005560| 73 70 68 79 78 69 61 20 | 61 74 20 62 69 72 74 68 |sphyxia |at birth|
|00005570| 2c 20 73 75 69 63 69 64 | 65 73 20 62 79 20 76 69 |, suicid|es by vi|
|00005580| 6f 6c 65 6e 74 20 6d 65 | 63 68 61 6e 69 63 61 6c |olent me|chanical|
|00005590| 20 6d 65 61 6e 73 20 77 | 65 72 65 20 61 73 73 6f | means w|ere asso|
|000055a0| 63 69 61 74 65 64 20 77 | 69 74 68 0d 0a 6d 65 63 |ciated w|ith..mec|
|000055b0| 68 61 6e 69 63 61 6c 20 | 62 69 72 74 68 20 74 72 |hanical |birth tr|
|000055c0| 61 75 6d 61 2c 20 61 6e | 64 20 73 75 69 63 69 64 |auma, an|d suicid|
|000055d0| 65 73 20 66 72 6f 6d 20 | 64 72 75 67 20 61 64 64 |es from |drug add|
|000055e0| 69 63 74 69 6f 6e 20 77 | 61 73 20 61 73 73 6f 63 |iction w|as assoc|
|000055f0| 69 61 74 65 64 20 77 69 | 74 68 0d 0a 6f 70 69 61 |iated wi|th..opia|
|00005600| 74 65 20 6f 72 20 62 61 | 72 62 69 74 75 72 61 74 |te or ba|rbiturat|
|00005610| 65 20 61 64 6d 69 6e 69 | 73 74 72 61 74 69 6f 6e |e admini|stration|
|00005620| 20 74 6f 20 6d 6f 74 68 | 65 72 73 20 64 75 72 69 | to moth|ers duri|
|00005630| 6e 67 20 6c 61 62 6f 72 | 2e 0d 0a 20 20 20 20 20 |ng labor|... |
|00005640| 54 68 65 20 6e 65 78 74 | 20 34 20 61 62 73 74 72 |The next| 4 abstr|
|00005650| 61 63 74 73 20 61 72 65 | 20 61 6c 6c 20 70 61 72 |acts are| all par|
|00005660| 74 20 6f 66 20 6f 75 72 | 20 6f 77 6e 20 73 68 6f |t of our| own sho|
|00005670| 72 74 20 63 6f 72 64 20 | 73 79 6d 70 6f 73 69 75 |rt cord |symposiu|
|00005680| 6d 2e 2d 2d 46 2e 41 2e | 0d 0a 4f 73 6b 69 2c 20 |m.--F.A.|..Oski, |
|00005690| 4d 2e 44 2e 0d 0a 24 55 | 6e 69 71 75 65 5f 49 44 |M.D...$U|nique_ID|
|000056a0| 7b 59 52 42 30 37 35 30 | 35 7d 0d 0a 24 54 69 74 |{YRB0750|5}..$Tit|
|000056b0| 6c 65 7b 55 6d 62 69 6c | 69 63 61 6c 20 43 6f 72 |le{Umbil|ical Cor|
|000056c0| 64 20 53 65 70 61 72 61 | 74 69 6f 6e 20 69 6e 20 |d Separa|tion in |
|000056d0| 74 68 65 20 4e 6f 72 6d | 61 6c 20 4e 65 77 62 6f |the Norm|al Newbo|
|000056e0| 72 6e 7d 0d 0a 24 41 75 | 74 68 6f 72 7b 0d 0a 4e |rn}..$Au|thor{..N|
|000056f0| 6f 76 61 63 6b 2c 20 41 | 48 0d 0a 4d 75 65 6c 6c |ovack, A|H..Muell|
|00005700| 65 72 2c 20 42 0d 0a 4f | 63 68 73 2c 20 48 7d 0d |er, B..O|chs, H}.|
|00005710| 0a 24 41 66 66 69 6c 69 | 61 74 69 6f 6e 7b 55 6e |.$Affili|ation{Un|
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|00005730| 3b 20 46 72 65 64 20 48 | 75 74 63 68 69 6e 73 6f |; Fred H|utchinso|
|00005740| 6e 20 43 61 6e 63 65 72 | 20 52 65 73 65 61 72 63 |n Cancer| Researc|
|00005750| 68 20 43 74 72 2c 20 53 | 65 61 74 74 6c 65 7d 0d |h Ctr, S|eattle}.|
|00005760| 0a 24 53 75 62 6a 65 63 | 74 7b 55 6d 62 69 6c 69 |.$Subjec|t{Umbili|
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|000057d0| 6f 75 72 6e 61 6c 7b 41 | 6d 20 4a 20 44 69 73 20 |ournal{A|m J Dis |
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|00005840| 0d 0a 24 43 68 61 70 74 | 65 72 7b 31 2d 36 7d 0d |..$Chapt|er{1-6}.|
|00005850| 0a 24 59 42 45 64 69 74 | 6f 72 7b 44 72 73 2e 20 |.$YBEdit|or{Drs. |
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|00005890| 65 6e 74 61 74 6f 72 7b | 46 2e 41 2e 20 4f 73 6b |entator{|F.A. Osk|
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|000058c0| 6f 6f 6b 20 4d 65 64 69 | 63 61 6c 20 50 75 62 6c |ook Medi|cal Publ|
|000058d0| 69 73 68 65 72 73 2c 20 | 49 6e 63 2e 2c 20 31 39 |ishers, |Inc., 19|
|000058e0| 38 39 0d 0a 0d 0a 31 39 | 38 39 20 59 65 61 72 20 |89....19|89 Year |
|000058f0| 42 6f 6f 6b 20 6f 66 20 | 50 65 64 69 61 74 72 69 |Book of |Pediatri|
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|00005920| 0d 0a 0d 0a 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |....----|--------|
|00005930| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005940| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005950| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005960| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005970| 2d 2d 2d 2d 0d 0a 55 6d | 62 69 6c 69 63 61 6c 20 |----..Um|bilical |
|00005980| 43 6f 72 64 20 53 65 70 | 61 72 61 74 69 6f 6e 20 |Cord Sep|aration |
|00005990| 69 6e 20 74 68 65 20 4e | 6f 72 6d 61 6c 20 4e 65 |in the N|ormal Ne|
|000059a0| 77 62 6f 72 6e 0d 0a 0d | 0a 4e 6f 76 61 63 6b 20 |wborn...|.Novack |
|000059b0| 41 48 2c 20 4d 75 65 6c | 6c 65 72 20 42 2c 20 4f |AH, Muel|ler B, O|
|000059c0| 63 68 73 20 48 0d 0a 28 | 55 6e 69 76 20 6f 66 20 |chs H..(|Univ of |
|000059d0| 57 61 73 68 69 6e 67 74 | 6f 6e 3b 20 46 72 65 64 |Washingt|on; Fred|
|000059e0| 20 48 75 74 63 68 69 6e | 73 6f 6e 20 43 61 6e 63 | Hutchin|son Canc|
|000059f0| 65 72 20 52 65 73 65 61 | 72 63 68 20 43 74 72 2c |er Resea|rch Ctr,|
|00005a00| 20 53 65 61 74 74 6c 65 | 29 0d 0a 41 6d 20 4a 20 | Seattle|)..Am J |
|00005a10| 44 69 73 20 43 68 69 6c | 64 20 31 34 32 3a 32 32 |Dis Chil|d 142:22|
|00005a20| 30 2d 32 32 33 2c 20 46 | 65 62 72 75 61 72 79 20 |0-223, F|ebruary |
|00005a30| 31 39 38 38 0d 0a 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |1988..--|--------|
|00005a40| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005a50| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005a60| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005a70| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005a80| 2d 2d 2d 2d 2d 2d 0d 0a | 0d 0a 41 62 73 74 72 61 |------..|..Abstra|
|00005a90| 63 74 0d 0a 0d 0a 20 20 | 20 20 20 54 68 65 20 65 |ct.... | The e|
|00005aa0| 66 66 65 63 74 73 20 6f | 66 20 62 69 72 74 68 20 |ffects o|f birth |
|00005ab0| 77 65 69 67 68 74 2c 20 | 67 65 73 74 61 74 69 6f |weight, |gestatio|
|00005ac0| 6e 61 6c 20 61 67 65 2c | 20 74 79 70 65 20 6f 66 |nal age,| type of|
|00005ad0| 20 64 65 6c 69 76 65 72 | 79 2c 20 70 72 65 67 6e | deliver|y, pregn|
|00005ae0| 61 6e 63 79 0d 0a 61 6e | 64 20 6d 61 74 65 72 6e |ancy..an|d matern|
|00005af0| 61 6c 20 63 6f 6d 70 6c | 69 63 61 74 69 6f 6e 73 |al compl|ications|
|00005b00| 2c 20 74 79 70 65 20 6f | 66 20 66 65 65 64 69 6e |, type o|f feedin|
|00005b10| 67 2c 20 61 6e 64 20 75 | 6d 62 69 6c 69 63 61 6c |g, and u|mbilical|
|00005b20| 20 63 6f 72 64 20 63 61 | 72 65 20 6f 6e 0d 0a 75 | cord ca|re on..u|
|00005b30| 6d 62 69 6c 69 63 61 6c | 20 63 6f 72 64 20 73 65 |mbilical| cord se|
|00005b40| 70 61 72 61 74 69 6f 6e | 20 77 65 72 65 20 65 76 |paration| were ev|
|00005b50| 61 6c 75 61 74 65 64 20 | 64 75 72 69 6e 67 20 61 |aluated |during a|
|00005b60| 20 31 33 2d 6d 6f 6e 74 | 68 20 70 65 72 69 6f 64 | 13-mont|h period|
|00005b70| 20 69 6e 20 33 36 33 20 | 69 6e 66 61 6e 74 73 0d | in 363 |infants.|
|00005b80| 0a 66 6f 6c 6c 6f 77 65 | 64 20 74 68 72 6f 75 67 |.followe|d throug|
|00005b90| 68 20 74 68 65 20 66 69 | 72 73 74 20 36 20 77 65 |h the fi|rst 6 we|
|00005ba0| 65 6b 73 20 6f 66 20 6c | 69 66 65 2e 20 20 54 68 |eks of l|ife. Th|
|00005bb0| 65 20 64 61 74 65 20 6f | 66 20 63 6f 72 64 20 73 |e date o|f cord s|
|00005bc0| 65 70 61 72 61 74 69 6f | 6e 20 77 61 73 0d 0a 72 |eparatio|n was..r|
|00005bd0| 65 70 6f 72 74 65 64 20 | 62 79 20 6d 6f 74 68 65 |eported |by mothe|
|00005be0| 72 73 2c 20 61 73 20 77 | 65 6c 6c 20 61 73 20 74 |rs, as w|ell as t|
|00005bf0| 68 65 20 6f 63 63 75 72 | 72 65 6e 63 65 20 6f 66 |he occur|rence of|
|00005c00| 20 69 6e 66 65 63 74 69 | 6f 6e 2e 20 20 43 6f 72 | infecti|on. Cor|
|00005c10| 64 20 63 61 72 65 0d 0a | 63 6f 6e 73 69 73 74 65 |d care..|consiste|
|00005c20| 64 20 6f 66 20 61 6c 63 | 6f 68 6f 6c 20 73 77 61 |d of alc|ohol swa|
|00005c30| 62 20 61 6e 64 20 74 72 | 69 70 6c 65 20 64 79 65 |b and tr|iple dye|
|00005c40| 20 61 70 70 6c 69 63 61 | 74 69 6f 6e 20 69 6e 20 | applica|tion in |
|00005c50| 74 68 65 20 6e 75 72 73 | 65 72 79 20 61 6e 64 20 |the nurs|ery and |
|00005c60| 64 61 69 6c 79 0d 0a 61 | 6c 63 6f 68 6f 6c 20 73 |daily..a|lcohol s|
|00005c70| 77 61 62 20 61 74 20 68 | 6f 6d 65 2e 0d 0a 20 20 |wab at h|ome... |
|00005c80| 20 20 20 54 68 65 20 69 | 6e 74 65 72 76 61 6c 20 | The i|nterval |
|00005c90| 66 72 6f 6d 20 62 69 72 | 74 68 20 75 6e 74 69 6c |from bir|th until|
|00005ca0| 20 63 6f 72 64 20 73 65 | 70 61 72 61 74 69 6f 6e | cord se|paration|
|00005cb0| 20 72 61 6e 67 65 64 20 | 66 72 6f 6d 20 33 20 64 | ranged |from 3 d|
|00005cc0| 61 79 73 20 74 6f 20 34 | 35 20 64 61 79 73 0d 0a |ays to 4|5 days..|
|00005cd0| 28 6d 65 61 6e 2c 20 31 | 33 2e 39 20 64 61 79 73 |(mean, 1|3.9 days|
|00005ce0| 29 2e 20 20 49 6e 66 61 | 6e 74 73 20 64 65 6c 69 |). Infa|nts deli|
|00005cf0| 76 65 72 65 64 20 62 79 | 20 63 65 73 61 72 65 61 |vered by| cesarea|
|00005d00| 6e 20 73 65 63 74 69 6f | 6e 20 68 61 64 20 61 6e |n sectio|n had an|
|00005d10| 20 69 6e 63 72 65 61 73 | 65 64 0d 0a 69 6e 74 65 | increas|ed..inte|
|00005d20| 72 76 61 6c 20 66 6f 72 | 20 63 6f 72 64 20 73 65 |rval for| cord se|
|00005d30| 70 61 72 61 74 69 6f 6e | 20 74 68 61 6e 20 74 68 |paration| than th|
|00005d40| 6f 73 65 20 62 6f 72 6e | 20 76 61 67 69 6e 61 6c |ose born| vaginal|
|00005d50| 6c 79 20 28 6d 65 61 6e | 2c 20 31 35 2e 39 20 76 |ly (mean|, 15.9 v|
|00005d60| 73 2e 20 31 32 2e 39 0d | 0a 64 61 79 73 29 20 28 |s. 12.9.|.days) (|
|00005d70| 46 69 67 20 31 2d 37 29 | 2e 20 20 54 68 65 20 32 |Fig 1-7)|. The 2|
|00005d80| 20 67 72 6f 75 70 73 20 | 64 69 64 20 6e 6f 74 20 | groups |did not |
|00005d90| 64 69 66 66 65 72 20 77 | 69 74 68 20 72 65 73 70 |differ w|ith resp|
|00005da0| 65 63 74 20 74 6f 20 73 | 65 78 20 6f 66 20 69 6e |ect to s|ex of in|
|00005db0| 66 61 6e 74 2c 0d 0a 6d | 65 61 6e 20 62 69 72 74 |fant,..m|ean birt|
|00005dc0| 68 20 77 65 69 67 68 74 | 20 6f 72 20 67 65 73 74 |h weight| or gest|
|00005dd0| 61 74 69 6f 6e 61 6c 20 | 61 67 65 2c 20 74 79 70 |ational |age, typ|
|00005de0| 65 20 6f 66 20 66 65 65 | 64 69 6e 67 20 70 72 61 |e of fee|ding pra|
|00005df0| 63 74 69 63 65 2c 20 6f | 72 20 6d 61 74 65 72 6e |ctice, o|r matern|
|00005e00| 61 6c 0d 0a 63 6f 6d 70 | 6c 69 63 61 74 69 6f 6e |al..comp|lication|
|00005e10| 73 2e 20 20 45 78 63 65 | 70 74 20 66 6f 72 20 68 |s. Exce|pt for h|
|00005e20| 79 70 65 72 62 69 6c 69 | 72 75 62 69 6e 65 6d 69 |yperbili|rubinemi|
|00005e30| 61 2c 20 77 68 69 63 68 | 20 77 61 73 20 73 65 65 |a, which| was see|
|00005e40| 6e 20 61 70 70 72 6f 78 | 69 6d 61 74 65 6c 79 20 |n approx|imately |
|00005e50| 33 0d 0a 74 69 6d 65 73 | 20 6d 6f 72 65 20 66 72 |3..times| more fr|
|00005e60| 65 71 75 65 6e 74 6c 79 | 20 69 6e 20 69 6e 66 61 |equently| in infa|
|00005e70| 6e 74 73 20 77 69 74 68 | 20 63 6f 72 64 20 73 65 |nts with| cord se|
|00005e80| 70 61 72 61 74 69 6f 6e | 20 61 74 20 31 35 20 64 |paration| at 15 d|
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