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At least 415 records · Page 23Linked to original sources

PubMed2002

Minimal ventilation to prevent bronchopulmonary dysplasia in extremely-low-birth-weight infants.

OBJECTIVE: To determine whether minimal ventilation decreases death or bronchopulmonary dysplasia (BPD). STUDY DESIGN: Infants with birth weight 501 g to 1000 g and mechanically ventilated before 12 hours were randomly assigned to minimal ventilation (partial pressure of carbon dioxide [PCO(2)] target >52 mm Hg) or routine ventilation (PCO(2) target <48 mm Hg) and a tapered dexamethasone course or saline placebo for 10 days, using a 2 x 2 factorial design. The primary outcome was death or BPD at 36 weeks' postmenstrual age. RESULTS: After enrollment of 220 patients, the trial was halted because of unanticipated nonrespiratory adverse events related to dexamethasone therapy. The relative risk for death or BPD at 36 weeks in the minimal versus routine ventilation groups was 0.93 (95% CI, 0.77-1.12; P =.43). Ventilator support at 36 weeks was 1% in the minimal versus 16% in the routine group (P <.01). Major morbidities and long-term outcome were comparable in both treatment groups. CONCLUSIONS: With the sample size studied, minimal ventilation did not reduce the incidence of death or BPD. The reduced ventilator support at 36 weeks in the minimal ventilation group warrants further study of this intervention.

Anti-Inflammatory Agents↗

PubMed2003

Enteral glutamine supplementation and morbidity in low birth weight infants.

OBJECTIVE: To determine if glutamine-supplemented enteral nutrition decreased the incidence of nosocomial sepsis in neonates. METHODS: In a multicenter (n = 20) clinical trial, we randomly allocated infants (n = 649) with birth weight between 500 and 1250 g, who were <7 days of age, and had no major anomalies to receive enteral glutamine supplementation (0.3 g/kg/day) or sterile water (placebo) for the first 28 days. The primary outcome variable was the number of infants who had blood culture-proven nosocomial sepsis between 7 days' and 36 weeks' postmenstrual age. RESULTS: Infants were assigned to placebo (n = 335) or to glutamine supplementation (n = 314). Neonates assigned to glutamine were similar to those assigned placebo for demographic characteristics and nutritional support during the first week. There was no difference in the occurrence of culture-proven nosocomial sepsis (33.7% vs 30.9%) or suspected sepsis (51.6% vs 47.1%) between the placebo and glutamine groups; however, neonates treated with glutamine less often had gastrointestinal dysfunction (7.5% vs 2.5%, P <.01) and severe neurologic sequelae (15.1% vs 10.4%, P =.08). CONCLUSIONS: At a dose of 0.3 g/kg/day, enteral glutamine does not appear to reduce nosocomial sepsis in premature neonates.

Adolescent↗

PubMed2003

A comparison of three vitamin A dosing regimens in extremely-low-birth-weight infants.

OBJECTIVE: Vitamin A supplementation reduces bronchopulmonary dysplasia (BPD)/death in extremely low birth weight neonates. It was hypothesized that compared with the standard regimen of 5000 IU 3 times per week for 4 weeks, (1) a higher dose (10,000 IU 3 x per week) would increase serum retinol and retinol binding protein (RBP) and lower relative dose responses (RDR), and (2) once-per-week dosing (15,000 IU once per week) would lead to equivalent levels, RBP, and RDR. STUDY DESIGN: Extremely low birth weight neonates (n = 120) receiving O(2)/mechanical ventilation at 24 hours were randomly assigned to (1) standard, (2) higher dose, or (3) once-per-week regimens. Measures of vitamin A deficiency were serum retinol <20 microg/dL, RBP <2.5 mg/dL, and/or RDR >10% on day 28. BPD was defined as O(2)/mechanical ventilation at 36 weeks' postmenstrual age. RESULTS: Groups were similar at enrollment (median gestational age, 25 weeks; birth weight, 689 g). Possible toxicity was seen in <5%. The higher dose regimen did not increase retinol or RBP, decrease RDR, or improve outcomes. Infants in the once-per-week regimen had lower retinol levels and higher RDR without an effect on outcomes. CONCLUSIONS: Compared with the standard regimen, once-per-week dosing worsened, and higher doses did not reduce, vitamin A deficiency. Therefore, the standard regimen is recommended.

Bronchopulmonary Dysplasia↗

PubMed2003

Maturation of the rectoanal inhibitory reflex in very premature infants.

OBJECTIVE: To characterize anal sphincter function in very premature infants < or =30 weeks' postmenstrual age (PMA) and to evaluate the time of maturation of the rectoanal inhibitory reflex (RAIR) by using a sleeve catheter. STUDY DESIGN: Anorectal manometry was performed in 16 healthy neonates (nine girls) with a mean PMA of 29 weeks (range, 27-30 weeks) and a birth weight of 640 to 1590 g (median, 1220 g) with a micromanometric assembly (outer diameter, 2.0 mm). The assembly incorporated a 1.5-cm-long sleeve sensor for measurement of resting anal sphincter pressures and relaxation, and four side holes recorded anal and rectal pressures. Rectal distention was performed with direct air insufflation to elicit the RAIR. RESULTS: The mean anal sphincter pressure, rectal pressure, and anal sphincter oscillation frequency were 24.5+/-11.4 mm Hg, 6.5+/-4.8 mm Hg, and 11.1+/-2.3/min, respectively. A normal RAIR could be elicited in 13 (81%) infants studied. In two infants, the RAIR could not be elicited because of a low anal sphincter pressure of only 5 mm Hg. In the other child, no RAIR was seen despite the repeated insufflation of at least 5 mL of air. CONCLUSION: The majority (81%) of premature infants older than 26 weeks' PMA have normal anorectal pressures and a normal RAIR.

Anal Canal↗

PubMed2005

Orbitofrontal cortex activity related to emotional processing changes across the menstrual cycle.

The orbitofrontal cortex (OFC) has been implicated in the representation of emotional stimuli, assignment of emotional valence/salience to stimuli, stimulus-reinforcement association learning, motivation, and socio-emotional control. Using functional magnetic resonance imaging in female subjects without premenstrual mood symptoms, we found that OFC activity to emotional linguistic stimuli varies depending on the menstrual cycle phase. Specifically, anterior-medial OFC activity for negative vs. neutral stimuli was increased premenstrually and decreased postmenstrually. The inverse pattern was seen in the lateral OFC. These findings suggest that specific subregional OFC activity to emotional stimuli is modulated across the menstrual cycle. The data also demonstrate that menstrual cycle phase is an important consideration in further studies attempting to elucidate the neural substrates of affective representation.

Adult↗

PubMed1993

Menstrual cycle effects on a VDT-based simulation task: cognitive indices and subjective ratings.

It is unclear whether the menstrual cycle affects the basics of performance, mainly task performance and cognitive functions. We examined menstrual cycle effects on VDT-based task performance, cognitive indices based on the signal-detection theory, and subjective ratings in questionnaires. We experimented in three phases: premenstrual, menstrual and postmenstrual phases. Previous studies reported premenstrual tension syndrome (PMST) in the premenstrual phase. Women used physiological and psychological strategies to cope during the menstrual phase. However, task performance, cognitive indices and subjective ratings showed no menstrual cycle effects. Thus, we can conclude that the information processing for the VDT-based task was not affected by menstrual cycle.

Adult↗

PubMed1998

Premenstrual symptoms in Mexican women with different educational levels.

Most women present some premenstrual symptoms, which may be influenced by diverse sociocultural factors. The authors studied the premenstrual symptoms of 89 healthy Mexican women living in rural areas and whose education ranged from no schooling to middle school attendance, and 182 women living in urban areas whose education ranged from elementary school to professional studies. The Menstrual Distress Questionnaire (R. H. Moos, 1968) was completed by all the women during the premenstrual and postmenstrual phases of one menstrual cycle. The percentage of women who reported mild symptoms was 87% on somatic scales and 86% on psychological scales. Premenstrual symptoms were more severe among women engaged in professional studies. Urban women reported more severe psychological symptoms than rural women. When women who were engaged in professional studies were excluded from the data analyses, no differences between the groups were found. Thus, it appears that the women's level of education affected premenstrual symptoms more than their rural or urban backgrounds did.

Adolescent↗

PubMed2004

Validation of a simplified netilmicin dosage regimen in infants.

The aim of this study was to validate a simplified high-dosage, extended-interval netilmicin dosage regimen for infants. A total of 129 infants receiving 163 treatment courses of netilmicin (6 mg kg every 24 or 36 h depending on gestational age (GA), postnatal age and postmenstrual age) was analysed. Serum netilmicin concentrations were monitored before (Cmin), 30 min (C0.5h) after and 7.5 h (C7.5h) after the third dose. In 110 patients during first week of life mean C0.5h was 10.5 mg/l. Mean C0.5h was significantly lower (9.0 mg/l) in 38 infants older than 1 week of age. 14 of 15 patients with Cmin levels > or = 2 mg/l receiving netilmicin every 36 h were < 28 weeks of gestation. In the first week of life significant correlations between GA and elimination half-life (p < 0.001) and between plasma creatinine and elevated Cmin (p < 0.002) were found, but no correlation between C0.5h and GA. In this high-dosage regimen a dosing interval of 48 h for GA < 29 weeks, 36 h for GA 29-36 weeks and 24 h for full term babies seems appropriate, during first week of life, to avoid the majority of elevated trough levels and still obtain maximal therapeutic efficacy.

Ampicillin↗

PubMed1977

Sex ratio in a sample of human fetuses in Denmark, 1962-1973.

The sex ratio was determined in 791 fetuses from pregnant women in the Copenhagen area 1962-1973. All the mothers were sterilized in connection with an induced abortion. Eighty percent of the fetuses had a crown-rump length between 50 mm and 150 mm corresponding to postmenstrual age of 11-19 weeks. The sex ratio was 138. There was no association between length and sex ratio. The difference between this sex ratio and that for live births in Denmark 1962-1973 (105-9) is substantial.

Abortion, Induced↗

PubMedDate not supplied

Fetal growth from 12 to 26 weeks of gestation.

175 freshly aborted fetuses (including three pairs of twins), 12-26 weeks postmenstrual age and products of induced expulsion from 172 Kashmiri women, were observed for 12 anthropometric measurements, namely, crown-heel length, crown-rump length, trunk height, head length, head circumference upper-arm length, fore-arm length, hand length, thigh length, leg length, foot length and weight. The general pattern of age changes in various body dimensions conforms to the sigmoid nature of human fetal growth. Comparison of the present findings with those from other studies reveals no definite population trends. The mean values for various anthropometric variables of Kashmiri fetuses lie within the overall range of observations made by various authors.

Adult↗

PubMed1995

Pulse dexamethasone does not impair growth and body composition of very low birth weight infants.

OBJECTIVE: Evaluation of repeated pulses of dexamethasone (PDEX), given to improve cardiopulmonary outcome, on growth of very low birth weight (VLBW, < 1500 g) infants. METHODS: In this prospective, double-blind, randomized clinical trial, VLBW infants mechanically ventilated at 1 week of age received intravenous PDEX or saline placebo (P) for 3 days, every 10 days, until no supplemental oxygen or ventilation was required or 36 weeks postmenstrual age (PMA). Weight gain, fluid intake, caloric intake, and serum glucose were monitored throughout the study. Nutritional assessment at 36 weeks PMA consisted of weight, length, head circumference, skinfold thickness measures, body composition by total body electrical conductance, and bone mineral content (BMC) by single beam photon absorptiometry. RESULTS: 37 PDEX and 31 P infants survived at least 36 days and completed the protocol. Average daily weight gain, fluid intake and caloric intake were not different between groups. The pattern of weight gain (g/kg/day, mean +/- SD) was different: PDEX infants showed significant growth delay during (3.0 +/- 11.4) and immediately after (7.8 +/- 8.7) each pulse, with subsequent growth acceleration (18.3 +/- 8.2) until the next steroid pulse. In contrast, growth rate of P infants was constant (12.6 +/- 3.7) (p = 0.04). Hyperglycemia requiring insulin therapy occurred only in the PDEX group (10/37). The catch-up growth noted between pulses in the PDEX group was explained only in part by insulin therapy. At 36 weeks PMA, there were no differences between groups in body size, composition, or BMC. CONCLUSION: PDEX negatively affected glucose metabolism and growth patterns during and immediately after drug exposure. However, assessment near term gestational age showed similar body composition and size in both groups.

Body Composition↗

PubMed2003

Influence of oral contraceptive use on pain perception and blood pressure.

The purpose of this study was to examine the influence of oral contraceptive (OC) use on pain perception and blood pressure. Thirty women (15 using OC and 15 normally menstruating) reported to the laboratory once a week for 4 consecutive weeks. Blood pressure and heart rate were assessed, and then pressure was applied to the left forefinger for 2 minutes with the Forgione-Barber pain stimulator while participants indicated when the stimulus became painful (PT) and rated the intensity of pain (PR). Data were analyzed with a 2 (group) x 4 (trials) ANOVA. Results indicated no significant differences (P > 0.05) for PT or PR between the two groups of women across the 4 weeks. There was a significant trials effect for systolic blood pressure (SBP; P < 0.05), with SBP being higher premenstrually and menstrually compared with postmenstrually in both groups of women. It is concluded that OC use did not significantly influence pain perception or blood pressure.

Adult↗

PubMed2001

Early oral behaviour in preterm infants during breastfeeding: an electromyographic study.

UNLABELLED: The objectives were to increase the understanding of the characteristics of oral behaviour during breastfeeding in preterm infants and to validate direct observations of infant sucking. Twenty-six infants were investigated once by simultaneous observation and surface electromyography (EMG) at 32.1-37.1 postmenstrual weeks. The orbicularis oris muscle was used for data analysis, as it provided the most distinct registrations. High correlation coefficients were observed with respect to classifications of EMG data by two raters on the number of sucks per burst (r = 0.97) and duration of sucking bursts (r = 0.99). The agreement between direct observations of sucking and EMG data was high. The median for mean number of sucks per burst was 8 (range 2-33) and for longest burst 28 (5-96) sucks. Sucks with low and very high intensity constituted a median of 14 (1-94)% and 25 (0-87)% of all sucks. The range in mean sucking frequency was 1.0-1.8 sucks s(-1). Suck duration ranged from 0.6 to 1.1 s. There was a considerable variation between infants in the extent of mouthing. No association with maturational level appeared for any of the components in oral behaviour. CONCLUSION: EMG data provided evidence of early sucking competence in preterm infants during breastfeeding, with wide individual variations. Surface EMG and direct observation are recommended as valid methods in the evaluation of breastfeeding behaviour in preterm infants.

Breast Feeding↗

PubMed2004

Preschool outcome in children born very prematurely and cared for according to the Newborn Individualized Developmental Care and Assessment Program (NIDCAP).

AIM: Care based on the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) has been reported to exert a positive impact on the development of prematurely born infants. The aim of the present investigation was to determine the effect of such care on the development at preschool age of children born with a gestational age of less than 32 wk. METHODS: All surviving infants in a randomised controlled trial with infants born at a postmenstrual age less than 32 wk (11 in the NIDCAP group and 15 in the control group) were examined at 66.3 (6.0) mo corrected for prematurity [mean (SD)]. In the assessment we employed the Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R) for cognition, Movement Assessment Battery for Children (Movement ABC) for motor function, subtests of the NEPSY test battery for attention and distractibility, and the WHO definitions of impairment, disability and handicap. Exact binary logistic regression was employed. RESULTS: There were no significant differences between the intervention group in Full-Scale IQ 93.4 (14.2) [mean (SD)] versus the control group 89.6 (27.2), Verbal IQ 93.6 (16.4) versus 93.7 (26.8) or Performance IQ 94.3 (14.7) versus 86.3 (24.8). In the NIDCAP group 8/13 (62%) survived without disability and for the children with conventional care this ratio was 7/19 (37%). The corresponding ratios for surviving without mental retardation were 10/13 (77%) and 11/19 (58%), and for surviving without attention deficits 10/13 (77%) and 10/19 (53%). Overall, the differences were not statistically significant, although the odds ratio for surviving with normal behaviour was statistical significant after correcting for group imbalances in gestational age, gender, growth retardation and educational level of the parents. CONCLUSION: Our trial suggests a positive impact by NIDCAP on behaviour at preschool age in a sample of infants born very prematurely. However, due to problems of recruitment less than half of the anticipated subjects were included in the study, which implies a low power and calls for caution in interpreting our findings. Larger trials in different cultural contexts are warranted.

Case-Control Studies↗

PubMed2006

Better care of immature infants; has it influenced long-term pulmonary outcome?

AIMS: To assess whether lung function in late childhood had improved in subjects born extremely prematurely in the early 1990s compared to the early 1980s, and whether neonatal factors in the respective periods had different impact on long-term pulmonary outcome. DESIGN: Population-based, controlled cohort study. Lung function was determined in 81 of 86 (94%) eligible subjects born with gestational age < or =28 weeks or birthweight < or =1000 g in Western Norway in 1982-85 (n=46) and 1991-92 (n=35), and in 81 matched control subjects born at term. RESULTS: The incidence of bronchopulmonary dysplasia was similar in the two periods. At follow-up, airway obstruction, hyper-responsiveness and pulmonary hyperinflation were similarly increased in both preterm cohorts compared to matched controls. Furthermore, current lung function was similarly related to neonatal respiratory disease in both birth-cohorts: FEV1 was reduced with respectively 18.6% and 18.7% of predicted in preterms dependent on supplemental oxygen at 36 weeks postmenstrual age. Lack of antenatal treatment with corticosteroids and prolonged neonatal oxygen treatment predicted similar significant airway obstruction in the two birth-cohorts. CONCLUSION: Preterms born in different eras of neonatology had similar long-term decreases in lung function. Long periods of oxygen supplementation are still required to salvage immature infants, and airway obstruction may still be a common long-term outcome.

Adolescent↗

PubMed2006

Nasal continuous positive airway pressure for neonatal back transfer.

We report the use of nasal continuous positive airway pressure (nCPAP) for neonatal back transfer of 51 babies. nCPAP may be used to provide safe respiratory support during back transportation of infants. Babies transferred on nCPAP were significantly smaller and of younger postmenstrual age than historical comparators who had to wait for transfer until independent of nCPAP. nCPAP transferred babies spent significantly less time on the intensive care unit.

Continuous Positive Airway Pressure↗

PubMed2005

Risk factors for delayed discharge home in very-low-birthweight infants:- a population-based study.

AIM: To identify risk factors for delayed discharge home in a population-based cohort of very-low-birthweight (VLBW) infants. METHODS: Demographic, pregnancy, perinatal, and neonatal data were collected in a national population-based database on VLBW infants born from 1995 through 2002. Multivariate analysis determined association with delayed discharge (discharge at a postmenstrual age >42 completed weeks). RESULTS: 882 infants with delayed discharge comprised 9.4% of survivors but accounted for 19.8% of total hospital days utilized until discharge home. Infants with delayed discharge compared to those discharged by term were born at an earlier mean gestational age, at a lower mean birthweight, and had a longer mean hospital stay. Delayed discharge was independently associated with decreasing birthweight (OR 1.25, 95% CI 1.19, 1.31), congenital anomalies (OR 4.80, 95% CI 3.66, 6.28), bronchopulmonary dysplasia (OR 5.88, 95% CI 4.60, 7.57), intraventricular hemorrhage grades 3-4 (OR 1.78, 95% CI 1.34, 2.36), sepsis (OR 1.87, 95% CI 1.54, 2.26), and surgically treated necrotizing enterocolitis (OR 20.20, 95% CI 12.85, 32.03). CONCLUSION: VLBW infants with congenital anomalies or severe complications of preterm birth are at increased risk for delayed discharge home. Early identification of these infants may enable interventions aimed at reducing the detrimental effects of prolonged hospitalization and promoting optimal transition from the hospital to the home environment.

Birth Weight↗

PubMed1998

Coping and appraisal of daily stressors predict heart rate and blood pressure levels in young women.

An anger-provocation paradigm was used to assess the effects of coping processes and appraisal of daily stressors on stress reactivity in 33 normotensive undergraduate women. Participants performed a mental arithmetic and an interpersonal conflict task during the pre- and postmenstrual phases of their menstrual cycles. Increased use of the emotion-focused coping processes of tension reduction and positive reappraisal was correlated with lower levels of baseline heart rate, whereas distancing was associated with higher levels of systolic blood pressure reactivity during the conflict task. Perceiving daily stressors as more stressful was associated with higher baseline diastolic blood pressure levels. The authors concluded that the transactional model of stress is useful for generating hypotheses about factors that predict heart rate and blood pressure levels in women.

Adaptation, Physiological↗