Diagnosing otitis media: a workshop.
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Biomedical subjects
Publications and source records attributed to G Medellin.
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To determine if the transition to extrauterine life is facilitated by skin-to-skin contact, six relatively low risk preterm infants experienced six continuous hours of skin-to-skin contact on their mothers' chests beginning within 30 minutes of birth. Heart and respiratory rates and oxygen saturation remained within normal limits and all infant temperatures rose rapidly to thermoneutral range. Two infants developed grunting respirations by the time skin-to-skin contact began, but the grunting disappeared with warm, humidified oxygen and continuous skin-to-skin contact. All infants were fully breastfeeding and ready for discharge by 24-48 hours postbirth. Early skin-to-skin contact was safe and seemed beneficial for these relatively low risk preterm infants.
The hypothesis that brief ischemia (preconditioning) protects the isolated heart from prolonged global ischemia was tested. Isovolumic rat hearts were preconditioned with either 5 min of ischemia followed by 5 min of perfusion (P1) or two 5-min episodes of ischemia separated by 5 min of perfusion (P2). Control hearts received no preconditioning. All hearts received 40 min of sustained ischemia and 30 min of reperfusion. Preconditioning (P1 or P2) significantly (P less than 0.0005) improved recovery of the rate-pressure product; percentage recoveries were 17.8 +/- 3.2 (n = 14), 59.9 +/- 5.5 (n = 6), and 46.4 +/- 4.7 (n = 8) for control, P1, and P2, respectively. Improved functional recovery of preconditioned hearts was associated with reduced end-diastolic pressure and improved myocardial perfusion. During the 40-min ischemic period, myocardial pH decreased from approximately 7.4 to 6.3 +/- 0.1 (n = 7) in the control hearts and to 6.7 +/- 0.1 (n = 7) in the preconditioned hearts (P less than 0.01). Also during the 40-min ischemic period, myocardial lactate (expressed as nmol/mg protein) increased to 146 +/- 11 (n = 7) and 101 +/- 12 (n = 8) in control and preconditioned hearts, respectively (P less than 0.02). The results demonstrate that a brief episode of ischemia can protect the isolated rat heart from a prolonged period of ischemia. This protection is associated with decreased tissue acidosis and anaerobic glycolysis during the sustained ischemic period.
A descriptive study of eleven healthy preterm infants was conducted in which cardiorespiratory (heart and respiratory rates, oxygen saturation), thermal (abdominal, toe and tympanic temperatures) and state behavior responses to two hours of paternal skin-to-skin contact within the first 17 hours of birth in Colombia, South America were evaluated. Infant physiologic and behavioral state measures were recorded each minute as was paternal skin temperature and behavior. Infant heart and respiratory rates increased during paternal contact as did abdominal and core temperatures. Fathers were able to keep their infants sufficiently warm, and five infants became hyperthermic (tympanic temperature greater than 37.5 degrees C) despite cooling measures while being held in this climate. Infants slept most of the time while being held and fathers seldom gazed at, spoke to, or touched their infants while holding them. When mothers are unavailable, fathers may be an alternate source of warmth and comfort to infants.