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Biomedical subjects

Lawrence Noble

Publications and source records attributed to Lawrence Noble.

7 recordsLinked to original sources
PubMed2007

The effects of positioning on the Hering-Breuer reflex in the preterm infant.

The aim of this study was to determine the effect of positioning on the Hering-Breuer inflation reflex (HBIR) in the preterm infant. Seven, non-intubated, premature infants, ranging in birthweight from 732 to 1450 g with post-conceptual ages of 32-36 weeks were studied. In each infant, pulmonary function testing, including the HBIR was obtained using the SensorMedics 2600 during quiet sleep in the supine and prone position. The strength of the HBIR was quantified by the measurement of the percent prolongation of expiration after an occluded breath. Sleep states were categorized by the criteria of Prechtl. There was a significant difference in Hering-Breuer activity in the prone position versus the supine position with a consistently stronger reflex in the prone position. The mean percent prolongation of expiration was 237 +/- 108% in the prone position versus 95 +/- 32% in the supine position. Analysis of the data, using paired t-testing revealed a mean difference of 142 +/- 119% between prone and supine positions (P=0.028). Significant differences in the strength of the HBIR occur in relation to positioning in the preterm infant. Newborn positioning may affect pulmonary reflexes and may play a role in control of breathing.

Humans↗
PubMed2006

Psychiatric symptoms among postpartum women in an urban hospital setting.

The object of this study was to evaluate postpartum women for psychiatric symptomatology including cognitive disturbances, anxiety, depression, and anger to better meet their needs for support and involve them in the care of their infants. We interviewed 52 postpartum mothers at the Bronx Lebanon Hospital Center within 5 days of delivery and determined the presence of psychiatric symptoms using the 29-item Psychiatric Symptom Index. Despite the fact that adult mothers were happier they were pregnant (71.4% versus 29.4%; P = 0.010) and less likely to be worried about their baby's health (25.7% versus 52.9%; P = 0.003), adult mothers demonstrated higher depressive symptomatology ( P = 0.009), higher amounts of anger ( P = 0.004), and greater overall psychiatric symptomatology ( P = 0.005) than adolescent mothers. Mothers whose infants were in the neonatal intensive care unit did not report significantly higher psychiatric symptomatology than mothers whose infants were healthy. Physicians need to be aware of the high levels of depression and anger present among postpartum women so appropriate support can be given.

Adolescent↗
PubMed2004

Hering-Breuer reflex and sleep state in the preterm infant.

The aim of this study was to determine the effect of sleep state on the Hering-Breuer inflation reflex in the preterm infant. Seventeen nonintubated, premature infants, ranging in birth weight from 980-2,440 g with postconceptual ages of 30-36 weeks, were studied. In each infant, pulmonary function testing, including the Hering-Breuer inflation reflex, was obtained using the SensorMedics 2600 during active and quiet sleep states in supine position. The strength of the Hering-Breuer inflation reflex was quantified by the measurement of the percent prolongation of expiration after an occluded breath. Sleep states were categorized by the criteria of Prechtl. There was a significant difference in Hering-Breuer activity in active (REM) vs. quiet (non-REM) sleep, with a consistently stronger reflex in the active sleep state. The mean percent prolongation of expiration was 419% in active sleep vs. 87% in quiet sleep. Analysis of the data, using a paired t-test, revealed a mean difference of 331 +/- 185% between active and quiet sleep (P = 0.000). In conclusion, significant differences in the strength of the Hering-Breuer inflation reflex occur in relation to sleep state, and may explain the variability of the reflex described in previous studies. Measurement of the Hering-Breuer inflation reflex may be affected by pulmonary stretch receptors as well as chest wall afferents in the preterm infant.

Female↗
PubMed2003

Factors influencing initiation of breast-feeding among urban women.

The objective of our study was to identify factors associated with the initiation of breast-feeding in a poor urban area. One hundred postpartum, nonadolescent, non-drug using mothers, 50 breast-feeding and 50 formula feeding, were consecutively interviewed. Breast-feeding women were more likely to be born outside of the United States (42 versus 14%, p = 0.002), have more years of education (12.1 +/- 1.9 versus 10.9 +/- 1.7, p = 0.002), be employed either prior to or during pregnancy (38 versus 16%, p = 0.000), be married (46 versus 26%, p = 0.037), be a nonsmoker (86 versus 64%, p = 0.011), have more prenatal visits (8.4 +/- 7.3 versus 5.0 +/- 5.9, p = 0.010), or have a breast-feeding mother (48 versus 26%, p = 0.023). There were no differences in age or ethnicity. The father of the breast-feeding baby was more likely to be better educated (12.0 +/- 2.8 versus 10.5 +/- 3.6 years, p = 0.022) and to work full-time (68 versus 40%, p = 0.005). Eighty-four percent of formula feeders knew that breast milk was better for their babies but decided not to breast-feed due to concerns of pain, smoking, and work. Sixty-three percent of women made the choice to breast-feed prior to the pregnancy, 26% during the pregnancy, and 11% after delivery. Significantly more multiparas decided prior to the pregnancy compared with primaparas. We recommend that breast-feeding education should be started prior to the first pregnancy and tailored to the concerns of the women.

Black or African American↗
PubMed2003

Developments in neonatal technology continue to improve infant outcomes.

The past 20 years have yielded little success in reducing prematurity rates or decreasing the major morbidities of premature infants. Determination of interventions to decrease prematurity rates, and the development of methods to reduce premature neurologic damage, are the challenges for the next 20 years. With the advent of genetic analysis and the ability to study environmental and genetic interactions, we may be on the threshold of another significant decrease in mortality and morbidity in the premature infant.

Female↗