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PubMed1979

The efficacy of prophylactic antibiotics in cesarean section.

The objective of this investigation was to determine the effectiveness of cefazolin-cephalothin administration as a prophylactic regime in patients undergoing cesarean section. The study was to randomized, double-blind, placebo-controlled investigation. Cefazolin, 1.0 gm or placebo was administered intramuscularly on call to the operating room, and cephalothin, 2.0 gm, or placebo was administered intravenously at 6, 12, and 24 hours postoperatively. Ninety-five patients were included in the study with 49 in the placebo group and 46 in the drug group. Nineteen patients developed 28 infections in the placebo group while eight patients developed eight infections in the drug group (P = less than 0.05). Eight patients in the placebo group developed infections at two or more sites whereas no patient in the drug-treated group developed multiple infections. No infant developed infection and no overgrowth of bacteria occurred. This study supports the concept of preoperative antibiotic administration being beneficial to the obstetric patient.

Anti-Bacterial Agents↗
PubMed1978

Risk factors in early-onset neonatal group b streptococcal infections.

Newborn infants with "early-onset" disease due to group B beta hemolytic streptococcus were studied over a 40-month period. Clinical presentations included asymptomatic bacteremia, mild transient illness, respiratory distress, meningitis, and overwhelming sepsis. Chronologically, 18 were ill at birth; 10 became ill after a symptom-free period; and four were asymptomatic. Sixty-six percent of the cases weighted less than 2500 grams, and 56% were born to mothers whose amniotic membranes were ruptured for over 20 hours. All 15 of the deaths occurred in low birth weight infants who were criticially ill from birth. A review of 128 consecutive deliveries of infants weighing under 2000 grams revealed 28 cases with prolonged ruptured membranes, and three of these 28 infants developed group B streptococcal infection. The infant of the colonized gravid woman in premature labor or with prolonged ruptured membranes is clearly at risk, and these results suggest that the management of "early-onset" disease should begin prior to delivery.

Female↗
PubMed1975

Assisted ventilation in infants with meconium aspiration syndrome.

In a retrospective analysis of infants born with meconium staining over an 18-month period at Cook County Hospital, 32 infants met two of the three criteria for the diagnosis of meconium aspiration syndrome: (1) history of meconium in the oropharynx or trachea; (2) clinical evidence of respiratory distress; and (3) x-ray evidence of aspiration pneumonia. Seventeen infants developed respiratory failure; nine of these infants died. One infant without respiratory failure died of sepsis. Analysis of sequential arterial blood pH and gas tension showed that nonsurviving infants had persistently high PCO2 and A-a gradient in spite of initiation of assisted ventilation. These changes seem to be related to severe right-to-left shunting and ventilation perfusion abnormalities. The data further suggest that asphyxia and acidosis occur well before the infant is born and that intrapartum monitoring to recognize fetal asphyxia may help in improving morbidity and mortality from meconium aspiration syndrome.

Blood Gas Analysis↗
PubMed1975

Nosocomial and maternally acquired herpesvirus hominis infections. A report of four fatal cases in neonates.

Four fatal cases of neonatal herpes simplex infection occurred during a two-month period in the perinatal intensive care unit of a hospital. Virus isolation or serologic studies, or both, implicated herpesvirus hominis type 2 in all four cases. Three of the infants developed symptoms in the first week of life and were probably infected in utero or at delivery. The fourth infant did not develop signs of illness until age 6 weeks, an interval much longer than that expected with disease acquired at birth. An epidemiologic investigation indicated that the most likely source of this fourth infant's herpes infection was by indirect contact with one of the other three infected neonates. Nosocomial spread of herpes simplex virus within a hospital nursery, although uncommon, may pose an added risk to the newborn infant if nursery techniques among infants are compromised.

Adolescent↗
PubMed1978

The birth and early development of a captive sifaka, Propithecus verreauxi coquereli.

We report here our observations on parturition and infant development up to five months in a captive sifaka, Propithecus verreauxi coquereli. Comparisons are made with other reports of Propithecus. In describing the acquisition of developmental landmarks, a distinction is made between the first sighting of a behavior pattern and its regular occurrence in the infant's repertoire. We describe the development of locomotor abilities, grooming, feeding, play, and social interactions. In general, maturation of Propithecus is slow relative to species of the genus Lemur.

Animals↗
PubMed1978

[Cholestatic jaundice and hypophosphataemia in parenterally-fed premature infants--coincidence or causal connection? (author's transl)].

A report is presented of the chemical pathological findings in 14 premature and one full-term infant receiving almost exclusively parenteral nutrition during the first two weeks of life. Six infants developed cholestatic jaundice. The underlying diseases were the idiopathic respiratory distress syndrome in 10, gastroschisis in 3 and renal insufficiency in 1, while one was an otherwise healthy small for dates infant. After parenteral nutrition had been discontinued obstructive jaundice cleared by the third month of life except in one infant. Apart from the higher glucose intake during the second week, jaundiced infants principally differed from non-jaundiced infants by the development of significant hypophosphataemia. An attempt was made to correlate aetiologically the presence of cholestatic jaundice with the finding of hypophosphataemia on the possible basis of a disturbance of energy metabolism.

Abdominal Muscles↗
PubMed1979

Olfactory and visual differentiation of synthetically scented surrogates by infant squirrel monkeys.

Twelve infant squirrel monkeys were reared with distinctively colored and scented inanimate surrogates (Green/Floral or Black/Clove) and tested monthly from 1 to 6 months of age in 3 paired-comparison conditions that assessed the efficacy of synthetic olfactory cues and color cues as attractive properties of the surrogates. The infants developed specific attractions to both the rearing odor and color of the surrogates by approximately the end of Month 4, although substantial differences existed between the 2 rearing groups, particularly with respect to color responsiveness. When compared with previous findings on infant squirrel monkeys reared with naturally scented surrogates, odor preferences developed relatively late, suggesting that natural, species-typical odors may have inherently stronger attractive properties for Saimiri than arbitrary synthetic odors.

Age Factors↗
PubMed1978

The effects of therapy on the developmental scores of iron-deficient infants.

To test the hypothesis that iron deficiency in infants and children is associated with behavioral alterations, 24 infants with iron deficienty anemia, ages 9 to 26 months, were randomly assigned to a treatment and control group. Bayley Scales of Infant Development were administered before treatment with intramuscular iron or placebo; the test was readministered in five to eight days. Children treated with iron showed a significant increase in their scores on the Mental Development Index averaging a mean gain of 13.6 points in a mean time of 6.8 days. The treated group was found to become more alert and responsive and demonstrated improvement in tests of gross and fine motor coordination. These findings support the hypothesis that iron deficiency in infants produced developmental alterations and that these changes are rapidly reversible with iron therapy.

Anemia, Hypochromic↗
PubMed1978

Visual reinforcement audiometry (VRA) with young Down's syndrome children.

Visual Reinforcement Audiometry (VRA) was investigated with 41 Down's syndrome subjects between the ages of six months and six years. The VRA procedure involved monitoring a head-turn response to a complex noise signal presented in a sound field with an ascending presentation paradigm and reinforced by a complex visual reinforcer. Twenty-four of the infants and young children also were evaluated with the Bayley Scales of Infant Development (BSID) to allow for analysis of the efficacy of VRA as a function of developmental age. Results were as follows: (1) 28 (68%) of the infants and young children initially oriented towards the source of the auditory stimulus, (2) only a few of the subjects who did not initially orient could be taught to respond, (3) of the children who initially oriented or were taught to respond, thresholds were obtained on a large number (81%) in one visit, and (4) a systematic relationship was demonstrated between consistency of subject response using the VRA technique and BSID Mental Age Equivalent with 10 months being the critical age for determining the potential success of the procedure. In addition, the results implied a higher incidence of hearing loss in the Down's syndrome subjects than found in normal pediatric population.

Age Factors↗
PubMed1978

A comparison of two developmental instruments in evaluating children with Down's syndrome.

Twenty-one children with Down's syndrome were given both the Bayley Scales of Infant Development and the Gesell Developmental Schedules. Mental and motor developmental lags measured on the Bayley Scale were found to be significantly larger than comparable lags measured on the Gesell Schedules. Further, developmental lags for the mental and motor portions of the Bayley were not significantly different. For the Gesell, however, mental lag was significantly larger than motor lag. Finally, mental and motor lags increased with chronologic age on the Bayley, but only mental lag increased with age on the Gesell. These discrepancies indicate that for this population of infants the Bayley and the Gesell are not interchangeable assessments because they do not yield the same developmental patterns.

Age Factors↗
PubMed1977

Neonatal hypoglycemia resulting from islet cell adenomatosis. Successful treatment with total pancreatectomy.

A female infant developed apneic spells due to hypoglycemia at 73 hours of life. It was impossible to maintain the blood glucose level despite continuous intravenously given dextrose, cortisone, diazoxide, and a low-leucine diet. A subtotal pancreatectomy was performed but there was no evidence of islet cell adenoma. On second laparotomy, the head of the pancreas was removed, and on microscopic examination, islet cell adenomatosis was found. A good clinical recovery followed. Follow-up at age 3 years and 4 months shows apparently normal mental and physical development.

Adenoma, Islet Cell↗
PubMed1976

Protracted pneumonitis in young infants associated with perinatally acquired cytomegaloviral infection.

Two infants developed a protracted pneumonitis with lower respiratory obstruction beginning at one month of age. Lung biopsy in one suggested a viral etiology which prompted an extensive investigation of each infant for specific etiology. Virologic, serologic, immunologic, and electronmicroscopic studies indicated that cytomegalovirus was a major causative factor. The infections were apparently acquired at birth from infected maternal genital tracts and have persisted for prolonged periods of time. Evidence for gross immunologic defect as a precipitating cause was lacking. These infants serve to emphasize the possible pathologic potential of CMV when acquired in early life even in the absence of iatrogenic immunosuppression.

B-Lymphocytes↗
PubMed1979

Infant care: cache or carry.

To test the hypothesis that a characteristic infant-care pattern existed during most of human history, contemporary hunter-gatherers in a representative sample of world cultures were examined. Numerically coded measures of infant care revealed a uniform pattern. Mothers are the principal caregivers, providing extensive body contact day and night and prolonged breast-feeding. When not carried, the baby of hunter-gatherers has complete freedom of movement. Care is consistently affectionate, with immediate nurturant response to crying. Nonetheless, in most groups, children achieve early independence and by 2 to 4 years spend more than half the time away from the mother. In the United States this pattern of carrying that endured for one to three million years has been replaced by one resembling nesting or caching. Infants spend little time in body contact with caregivers and their movements are restricted by playpens, high chairs, or cribs. Of the minority who are breast-fed, half are weaned within a few weeks. Separate sleeping arrangements and delayed response to crying are regularly recommended. These remarkable transformations may profoundly alter infant development and maternal involvement.

Africa↗
PubMed1979

The response to an oral glucose load during convalescence from hypoxia in newborn infants.

The ability to tolerate an oral glucose load during convalescence from hypoxia was studied in four term and 11 premature appropriate-for-gestational-age infants by sequential measurements of the changes occurring in blood pH, bicarbonate, plasma lactic acid, and plasma glucose following an oral glucose load. All infants developed metabolic acidosis and lactic acidemia after the oral glucose load. The maximum fall in blood bicarbonate occurred at 30 minutes, and the maximum rise in plasma lactic acid concentration was attained at 60 minutes. The metabolic changes were found to be more severe in infants given the oral glucose load early in their convalescence and in those infants less than 10 days of age. The absorption of glucose was also decreased in these infants, as shown by a reduced rise in blood sugar. These observations indicate that newborn infants, term or premature, tolerate glucose loads poorly during convalescence from hypoxia.

Acidosis↗
PubMed1978

Rickets as a complication of intravenous hyperalimentation in infants.

Fifteen newborn infants developed roentgenographic evidence of rickets while on long-term intravenous hyperalimentation. In each instance, the initial diagnosis of rickets was suggested on the chest roentgenogram, where characteristic cupped and frayed upper humeral metaphyses were noted; subsequent knee and wrist roentgenograms substantiated these findings. Factors which may have predisposed to the development of rickets include inadequate doses of vitamin D, prematurity and a rapid change in body weight during hyperalimentation therapy.

Bone and Bones↗
PubMed1977

The Seattle Virus Watch. VII. Observations of adenovirus infections.

The following findings were made from observations of adenovirus (AV) infections in Seattle VW families, 1965-1969, which extended the 1961-1965 New York VW studies: That infections are predominantly enteric, may be abortive or invasive and followed by persistent intermittent excretion was confirmed. That such excretion is most characteristic of types 1, 2, 3 and 5 viruses may explain why these types were usually endemic. However, since observed duration of excretion was not increased despite a longer average observation period, persistent excretion appears not to continue indefinitely and generation-to-generation transmission now seems improbable. Unilike New York, alternate cycling of types 1 and 2 viruses was not seen. Among homotypic susceptibles, infection rates for the endemic types were highest in infants (greater than 90% for types 1 and 2), decreased with age in older children but increased in parents, perhaps because of closer contact with infants. Development of serum neutralizing antibody was most frequent (about 90%) after types 1 and 2 infection; in all cases, titers decayed over time. While delayed virus spread related to persistent intermittent excretion did occur, spread closely following new or renewed (after larger than or equal to 3 months) excretion was more important. Sibling introducers were more effective spreaders than infants, and duration of excretion was more important than mode. These data indicate that homotypic immunity is 85% protective against infection. A protective effect of heterotypic immunity could not be shown. Illness (chiefly respiratory and often febrile) was associated with 49% of infections in susceptibles and with 65% when respiratory shedding occurred. The contribution of AV to all infectious illness, based on virus-positive infections only, was 5% in infants and 3% in the 2-4-year age group; for febrile illness, the corresponding contributions were about 10% and 5%. Inclusion of infections discovered only be serology (49% of all infections) would greatly increase the contribution of AV to illness.

Adenoviridae↗