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The development of infant intersensory perception: advantages of a comparative convergent-operations approach.

Despite impressive demonstrations of human infants' intersensory capabilities over the past several decades, there has been little focus on the contributions of prenatal and postnatal experience or the specific developmental processes underlying the emergence of intersensory functioning. Research with nonhuman animals has, however, provided a number of advances in understanding early intersensory perception. The authors explore the value of a comparative, convergent-operations approach to the study of early intersensory perception and examine how this approach has highlighted the study of (a) prenatal factors, (b) brain-behavior relations, and (c) context and experience variables contributing to infants' intersensory responsiveness. Examples of how human and animal research programs can cross-fertilize one another in their attempts to understand developmental processes underlying intersensory perception are considered.

Animals↗

Early development of infants 1000 g or less at birth.

In a 4-year period the neonatal survival rate for 26 infants weighing 501-750 g was 42% and for 81 infants weighing 751-1000 g it was 61%. All 59 surviving infants have been assessed at follow-up; 39 were at least 2 years old (corrected for prematurity) and data from the remaining 20 were derived from assessment at 1 year corrected age. Five children had cerebral palsy, 4 had multiple handicaps, 4 each had a sensory handicap, 2 had developmental delay, and 1 had a dilated right ventricle without clinical hydrocephalus. Twelve of the 16 children with defined handicaps were considered to have significant functional handicaps. Therefore, of the 107 infants in this series, 48 (45%) died, 12 (11%) survived with significant functional handicaps, and 47 (44%) were considered to be developing within the normal range. No significant differences in the incidence of handicap were observed between inborn and outborn children, boys or girls, those who were small or appropriate for gestation, those who weighed less than or equal to 750 g or greater than 750 g at birth, and those who required or did not require prolonged oxygen or ventilation.

Child Development↗

Analysis of strategies to successfully vaccinate infants in developing countries against enterotoxigenic E. coli (ETEC) disease.

Enterotoxigenic Escherichia coli (ETEC) is the most common bacterial cause of diarrhoea in the world, annually affecting up to 400,000,000 children under 5 years of age living in developing countries (DCs). Although ETEC possesses numerous antigens, the relatively conserved colonization factor (CF) antigens and the heat labile enterotoxin (LT) have been associated with protection and most vaccine candidates have exploited these antigens. A safe and effective vaccine against ETEC is a feasible goal as supported by the acquisition of protective immunity. The success of an ETEC vaccine targeting infants and children in DCs will depend on a combination of maximally antigenic vaccine preparations and regimens for their delivery which will produce optimal immune responses to these antigens. Vaccine candidates having a high priority for accelerated development and clinical testing for eventual use in infants would include inactivated ETEC or Shigella hybrids expressing ETEC antigens as well as attenuated ETEC strains which express the major CF antigens and LT toxin B-subunit, as well as attenuated Shigella, Vibrio cholerae and Salmonella typhi hybrids engineered to deliver antigens of ETEC. Candidates for an ETEC vaccine would have to meet the minimal requirement of providing at least 50% protection against severe disease in DCs during the first 2 years of life. The critical roadblock to achieving this goal has not been the science as much as the lack of a sufficiently funded and focused effort to bring it to realization. However, a Product Development Partnership to overcome this hurdle could accelerate the time lines towards when control of ETEC disease in DCs is substantially closer.

Adhesins, Escherichia coli↗

The development of infants' reaches for stationary and moving targets.

The organization of infants' reaching skill for stationary and moving targets was examined. While 58 term, healthy infants at 5.5, 8.5, and 11.5 months of age reached for and grasped a cloth-covered dowel, their reaches were videotaped for later slow-motion analysis. Analyses addressed infants' anticipatory adjustment of hand alignment, use of information from spinning and oscillating targets to update ongoing reaches, and ability to capture targets moving in depth. Infants at all ages made anticipatory adjustments of hand alignment, although the effectiveness of these adjustments improved with age. Regardless of age, infants also used dynamic information from spinning and oscillating targets to update ongoing reaches, but the way infants used this information was related to age. Developmental constancy characterized infants' reaches for approaching targets. By observing infants' reaches for stationary, spinning, and approaching targets, the study expands the range of conditions under which adaptive reaching skill has been examined and provides insight into the roles of anticipation and updating in the development of early manual skill.

Age Factors↗

Regulation of infant and developing rat testicular gonadotropin and prolactin receptors and steroidogenesis by treatments with human chorionic gonadotropin, gonadotropin-releasing hormone analogs, bromocriptine, prolactin, and estrogen.

Infant (5-day-old) male rats were treated with hormonal regimens to alter their exposure to gonadotropins, prolactin (Prl), and estrogen, and the response of testicular endocrine functions was measured. Human chorionic gonadotropin (hCG) or a potent gonadotropin-releasing hormone agonist analog (GnRH-A) resulted in a short-lived decrease of testicular receptors (R) for luteinizing hormone (LH), but no deleterious effects were found on testicular capacity to produce testosterone (T), which is a typical response of the adult testis. Only GnRH-A, through probable direct testicular action, induced a relative blockade of C21 steroid side-chain cleavage that was observed in vitro upon hCG stimulation. Human chorionic gonadotropin treatment, but not GnRH-A treatment, increased testicular Prl-R. GnRH antagonist analog (GnRH-Ant) treatment did not affect testicular LH-R, but decreased Prl-R and testicular T production. Decrease of serum Prl by bromocriptine had no effect on testicular LH-R or Prl-R, but slightly decreased T production in vitro. Ovine Prl increased binding sites for LH/hCG. The postnatal rats were insensitive to negative effects of diethylstilbestrol when monitored by testis weight, T, and LH-R. In conclusion, the responses to changes in the hormonal environment differed greatly between infant and adult testes. Mainly positive effects of elevated gonadotropin and Prl levels were seen on infant rat Leydig cell functions. Likewise, decreased tropic hormone levels, and exposure to estrogen, were ineffective in bringing about the inhibitory actions seen in the adult.

Animals↗

Psychopathology in infancy.

The first three years of life present unique challenges to the study of psychopathology. We highlight four of the issues in a selective review of the developmental psychopathology of early childhood, including lack of specificity of risk and outcome variables, measurement difficulties, rapid developmental changes and the centrality of the relationship context in early childhood. We also highlight issues relevant to conceptualizations of disorders of infancy, emphasizing especially the need for efforts to validate clinical disorders. We consider two major domains of infant development that we believe are especially relevant to a discussion of psychopathology, namely, regulation of emotion and infant-caregiver attachment. Discussions of these two domains of infant development and their psychopathological extremes allow us to consider conceptualizations of psychopathology from the dual perspectives of developmental psychopathology and clinical disorders. We conclude by suggesting a number of strategies to build upon previous research.

Affective Symptoms↗

Transfusion-acquired human immunodeficiency virus infection in twelve neonates: epidemiologic, clinical and immunologic features.

Twelve neonates in 3 cohorts received blood transfusions from two donors who were infected with human immunodeficiency virus (HIV). All 12 infants developed laboratory and/or clinical evidence of HIV infection, usually in the first year of life. Ten of 12 infants had serum antibody to HIV when tested between 9 and 42 months of age. The two seronegative infants were severely hypogammaglobulinemic when they were tested. Nine infants developed a variety of illnesses attributable to HIV infection, but only 2 fulfilled criteria for the diagnosis of acquired immunodeficiency syndrome. In follow-up ranging from 2 1/2 to 4 years 5 patients (42%) have died. Four patients had HIV-associated illnesses but recovered and now have few if any symptoms attributable to HIV infection. Three children have never had signs or symptoms attributable to HIV. Immunologic abnormalities were present in all patients; the most consistent finding was a decrease in the proportion of T helper cells. Three patients had severe panhypogammaglobulinemia. The hypogammaglobulinemic infants had significantly lower numbers and percentages of T helper cells compared to the remaining patients (P less than 0.01). We conclude that exposure to HIV via transfusion in the neonatal period results in an extremely high rate of infection with substantial mortality and morbidity, but clinical recovery occurs in some patients. Also hypogammaglobulinemia may be more common in infants with HIV infection than previously appreciated.

Acquired Immunodeficiency Syndrome↗

Comparison of ophthalmic silver nitrate solution and erythromycin ointment for prevention of natally acquired Chlamydia trachomatis.

During prospective studies of infants born vaginally to women with cervical Chlamydia trachomatis infection, we evaluated 27 infants given 0.5% erythromycin ointment and 93 given 1% silver nitrate solution as eye prophylaxis, according to the preference of the parents or delivery room personnel. The cumulative proportion of infants developing chlamydial conjunctivitis was 25% for both groups (P = 0.37, Mantel-Cox test). The cumulative proportion of infants developing chlamydial infection at any anatomic site was 74% for those given erythromycin and 70% for those given silver nitrate (P = 0.93). The two groups did not differ significantly in cumulative proportions developing nonchlamydial conjunctivitis. These results indicate that, as it is routinely used in our hospital, erythromycin ointment was not more effective than silver nitrate as prophylaxis against chlamydial conjunctivitis. The influence of delayed administration on efficacy of prophylaxis requires further evaluation.

Chlamydia Infections↗

Twin gestation and perinatal follow-up in a woman with severe chronic renal failure managed without dialysis. A case report.

Severe renal insufficiency (serum creatinine greater than 2 mg/dL) during pregnancy has been associated with poor perinatal outcome. Even in the absence of maternal indications, hemodialysis has been suggested for fetal indications, although the influence of maternal renal failure on the newborn's development is unknown. The effects of the abnormal biochemical environment of dialysis on fetal growth and development are also unknown, and the small numbers of reported cases make it difficult to assess the indications for hemodialysis. A 35-year-old woman had a twin gestation and severe chronic renal failure. The pregnancy was managed without hemodialysis, and at 33 weeks' gestation two healthy newborns were delivered with cesarean section. Bailey scales of infant development at 14 months of age showed normal infant development. Hemodialysis is not indicated solely for fetal reasons in the patient with severe but stable renal failure in the absence of severe hypertension, pre-eclampsia, deteriorating renal status or intrauterine growth retardation.

Adult↗

Effect of early, short-term supplementation on weight and linear growth of 4-7-mo-old infants in developing countries: a four-country randomized trial.

The effect of supplementation on growth was tested by means of four similar controlled randomized trials in the Congo (n = 120), Senegal (n = 110), Bolivia (n = 127), and New Caledonia (n = 90). Four-month-old infants were randomly allocated to supplement or control groups. A cereal-based precooked porridge was offered twice daily for 3 mo and consumption was monitored. Both groups were free to eat local food. At 7 mo of age, all infants were still breast-fed in the Congo, Senegal, and Bolivia compared with 47% in New Caledonia. Mean daily consumption of the supplement varied among countries (558-790 kJ/d). Mean length at 4 mo was lowest in Bolivia, higher in Senegal and the Congo, and near the National Center for Health Statistics reference in New Caledonia. The mean 4-7 mo length increment was 0.48 cm higher for supplemented than for control infants in Senegal (P < 0.05), whereas weight increments did not differ. No significant effect was found in the other countries.

Body Height↗

A meta-analytic review of sex differences in facial expression processing and their development in infants, children, and adolescents.

Quantitative and qualitative reviews of the literature on sex differences in facial expression processing (FEP) have yielded conflicting findings regarding children. This study was designed to review quantitatively the literature on sex differences in FEP from infancy through adolescence and to evaluate consistency between the course of FEP development and predictions derived from preliminary theoretical models. Results, which indicate a female advantage at FEP, are consistent with predictions derived from an integrated neurobehavioral/social constructivist model. These findings suggest a need for research examining both neurological maturation and socialization as important factors in the development of sex differences in FEP and related skills. Possible directions for future study are discussed, with emphasis on the need to integrate the infant literature with research focused on older children and adults.

Adolescent↗

Ontogeny of hepatic and renal systemic clearance pathways in infants: part I.

Dramatic developmental changes in the physiological and biochemical processes that govern drug pharmacokinetics and pharmacodynamics occur during the first year of life. These changes may have significant consequences for the way infants respond to and deal with drugs. The ontogenesis of systemic clearance mechanisms is probably the most critical determinant of a pharmacological response in the developing infant. In recent years, advances in molecular techniques and an increased availability of fetal and infant tissues have afforded enhanced insight into the ontogeny of clearance mechanisms. Information from these studies is reviewed to highlight the dynamic and complex nature of developmental changes in clearance mechanisms in infants during the first year of life. Hepatic and renal elimination mechanisms constitute the two principal clearance pathways of the developing infant. Drug metabolising enzyme activity is primarily responsible for the hepatic clearance of many drugs. In general, when compared with adult activity levels normalised to amount of hepatic microsomal protein, hepatic cytochrome P450-mediated metabolism and the phase II reactions of glucuronidation, glutathione conjugation and acetylation are deficient in the neonate, but sulfate conjugation is an efficient pathway at birth. Parturition triggers the dramatic development of drug metabolising enzymes, and each enzyme demonstrates an independent rate and pattern of maturation. Marked interindividual variability is associated with their developmental expression, making the ontogenesis of hepatic metabolism a highly variable process. By the first year of life, most enzymes have matured to adult activity levels. When compared with adult values, renal clearance mechanisms are compromised at birth. Dramatic increases in renal function occur in the ensuing postpartum period, and by 6 months of age glomerular filtration rate normalised to bodyweight has approached adult values. Maturation of renal tubular functions exhibits a more protracted time course of development, resulting in a glomerulotubular imbalance. This imbalance exists until adult renal tubule function values are approached by 1 year of age. The ontogeny of hepatic biliary and renal tubular transport processes and their impact on the elimination of drugs remain largely unknown. The summary of the current understanding of the ontogeny of individual pathways of hepatic and renal elimination presented in this review should serve as a basis for the continued accruement of age-specific information concerning the ontogeny of clearance mechanisms in infants. Such information can only help to improve the pharmacotherapeutic management of paediatric patients.

Humans↗