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Biomedical subjects

L Furman

Publications and source records attributed to L Furman.

At least 19 recordsLinked to original sources
PubMed1998

Breastfeeding of very low birth weight infants.

This research examines the rate of breastfeeding among mothers of very low birth weight infants (VLBW, < 1500 grams), and the correlates of breast milk pumping and transition to nursing at the breast. Eighty-two mothers and their 69 singleton and 21 twin VLBW infants admitted to the Neonatal Intensive Care Unit (January 1-June 30, 1995) of an urban tertiary care hospital. Maternal demographic, infant birth, and neonatal data were compared according to breast or bottle feeding, and a telephone interview was administered retrospectively to mothers pumping breast milk at the time of the infant's discharge home. Of 39 mothers who chose to pump breast milk, 19 were still pumping at the time of the infant's discharge home. Only 8 made a successful transition to nursing at the breast. Mothers who continued pumping tended to be white, married, and older, and their infants had fewer neonatal complications. The rates of prolonged breast milk pumping and of nursing are very low. Specific interventions and better support might improve the success rates.

Adult↗
PubMed1996

Hospitalization as a measure of morbidity among very low birth weight infants with chronic lung disease.

OBJECTIVE: To examine the spectrum of hospitalization and rehospitalization among very low birth weight (VLBW, <1500 gm) infants with severe chronic lung disease during the first 2 years of life. POPULATION: All 124 VLBW infants admitted to our center from October 1988 to September 1990 who were oxygen and ventilator dependent at 21 days of age. One hundred infants survived to discharge, of whom two subsequently died. The 98 surviving infants are the subject of this report. METHODS: The duration of the neonatal stay, the use of a long-term care facility, and rehospitalizations were recorded to a postnatal age of 24 months. The duration of these hospitalizations and the total duration of hospitalization during the first year of life were correlated with demographic and perinatal risk factors and 20-month outcome. RESULTS: The 98 infants spent a median of 125 days (range, 44 to 365) of their first year hospitalized; the neonatal stay accounted for 85% of this time. Forty-nine of the infants (50%) were rehospitalized in their first year (median stay, 14 days), and 36 (37%) were rehospitalized in their second year (median stay, 7 days). Long-term care facility stay and rehospitalizations accounted for 6% and 9% of the first-year hospitalizations, respectively. A median of 9 days (range, 1 to 365) of the second year of life were spent in hospital. The infants rehospitalized during their first year of life did not differ significantly from those not requiring rehospitalization with regard to maternal demographic descriptors, birth data, severity of chronic lung disease, or measures of 20-month outcome. Both duration of neonatal stay and total hospital stay during the first year were significantly associated with all measures of chronic lung disease severity and with 20-month neurodevelopmental outcome measures, whereas the duration of rehospitalization was associated only with duration of oxygen dependence. CONCLUSION: Among infants with severe chronic lung disease, the total duration of hospitalization during the first year of life provides a better index of morbidity than the number or duration of rehospitalizations alone.

Chronic Disease↗
PubMed1995

Twenty-month outcome in ventilator-dependent, very low birth weight infants born during the early years of dexamethasone therapy.

We sought to examine the effect of the introduction of dexamethasone therapy on health, growth, and neurodevelopmental outcome in very low birth weight (VLBW) infants at 20 months of age. We compared outcomes in all 86 VLBW infants (mean birth weight 871 gm, mean gestational age 26.4 weeks) who were ventilator dependent on day 21 of life during the 2 years preceding October 1988 (period 1), when dexamethasone therapy became accepted clinical practice in our unit, with outcomes in all 124 infants (mean birth weight 891 gm, mean gestational age 26.9 weeks) with similar ventilator status during the subsequent 2 years (period 2). In addition, we compared outcomes in infants who received dexamethasone during period 2 with those in a concurrent cohort of less ill infants who were not given dexamethasone. There were no significant differences between periods 1 and 2 in mortality rates after 21 days (17% vs 21%), need for home oxygen (23% vs 25%), oxygen dependence at 20 months of corrected age (11% vs 10%), rate of neurosensory impairment (24% vs 25%), and mean Bayley Mental scores (81.5 vs 77.2) or Psychomotor Development Index (81.6 vs 71.1). Infants who received dexamethasone during period 2 had significantly more severe lung disease and poorer respiratory, growth, and developmental outcomes. We conclude that VLBW infants with ventilator-dependent chronic lung disease have very poor outcomes, even when treated with dexamethasone. More information is needed from prospective, randomized trials before dexamethasone can be accepted as routine therapy for chronic lung disease.

Child Development↗
PubMed1994

Menarche and menstrual function in patients with myelomeningocele.

The aim of this study was to assess menarchal age, to clarify the role of heredity in the timing of menarche, and to examine the management of menses in girls and young women with myelomeningocele. All female patients aged three years or older attending a tertiary-care hospital clinic were eligible. A questionnaire was administered to each menstruating patient and, when possible, a menstruating sibling control. Most biological descriptors of menses were comparable for patients and sibling controls, but management of menses, routine gynecological care and attitudes about family planning differed. Girls with myelomeningocele menstruated significantly earlier than the US mean (10.25 years); as did the girls' mothers (11.91 years), but not their sisters. This finding may have biological significance, and a larger sample size is needed to confirm or refute it.

Adolescent↗
PubMed1992

One hundred consecutive laparoscopic cholecystectomies performed in a rural hospital.

Laparoscopic cholecystectomy has quickly become the treatment of choice by most surgeons for the treatment of gallstone disease. The authors reviewed their first 100 consecutive patients undergoing laparoscopic cholecystectomy at a rural hospital. Twenty-three patients had previous abdominal procedures. The open insufflation technique was used on all patients with previous abdominal operations, with the exception of those who had an appendectomy only. Operative cholangiography was performed routinely and successfully on all patients, with the exception of the first seven because of nonavailability of a cholangiocath. In 54 percent of the first two-thirds of these patients, the operation was completed in less than 1.5 hours. In contrast, 88 percent of the last one-third of the patients were operated on within the same time period. All but 9 of the 100 patients were discharged within 24 hours of their surgery. Laparoscopic cholecystectomy can be performed safely and routinely in the rural hospital setting with results similar to those expected in larger metropolitan centers.

Cholangiography↗
PubMed1991

Identifying the referents of spoken messages: use of context and clarification requests by children with and without mental retardation.

The ability of children with mental retardation and of children without mental retardation matched to them on nonverbal MA to use (a) contextual information and (b) clarification requests to resolve referential ambiguity was evaluated. Each child pretended to be a storekeeper and responded to an adult customer's ambiguous requests. The context disambiguated the request in some cases, but not in others. Both groups of children selected the appropriate referent when the context was informative. Only the children without mental retardation appropriately requested clarification when the context was uninformative. Referential performance was not related to their receptive language level or nonverbal MAs.

Child↗
PubMed1989

Relation between the receptive language and mental age of persons with mental retardation.

The purpose of this study was to determine whether the development of receptive language lags behind nonverbal cognitive development in school age persons with mental retardation. The relation between receptive language and nonverbal MA was examined as a function of MA level and the linguistic form to be understood. Individual differences in the receptive language-MA relation were also investigated. Results indicated that the relation between receptive language and MA varied across MA levels, linguistic forms, and individuals at the same MA for listeners with mental retardation.

Age Factors↗