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Dosage response evaluation of luprostiol administered to pregnant sows.

Two trials were completed to investigate the effects of luprostiol in swine. The first trial was to evaluate parturition induced by various dosages of luprostiol compared with those of lutalyse or vehicle. Sows were assigned by random allotment to one of the following treatments on Day 112 of gestation: Group A, control (0 mg luprostiol); Group B (1.88 mg luprostiol); Group C (3.75 mg luprostiol); Group D (7.5 mg luprostiol); Group E (15 mg luprostiol); Group F (10 mg lutalyse). All prostaglandin-treated groups farrowed earlier than the controls (P<0.05), with Groups D (26.3 h), E (31.0 h) and F (25.8 h) having the shortest treatment-to-first-pig intervals, and Groups A (76.0 h), B (54.4 h) and C (40.0 h) having the longest intervals. Luprostiol-treated sows had the shortest farrowing time (P<0.05; range = 3.2 to 3.9 h). Significant differences were found for the time (min) between births: Group A (32.1), Group B (28.4), Group F (35.5) took longer than Group C (20.2), Group D (21.0) and Group E (21.6). In a second trial, 20 crossbred pregnant sows received either vehicle or luprostiol (7.5 mg) on Day 112 of gestation. Progesterone concentrations declined rapidly (P<0.05) in luprotiol treated females but were unchanged in control females during the 24-h collection period. The results of these trials show 7.5 mg luprostiol to be the most effective dose for inducing farrowing.

Journal Article↗

Effects of teat number on litter size in gilts.

This study was carried out to investigate the effects of teat number and interval at first estrus and mating on litter size in Duroc, Landrace and Yorkshire gilts. Gilt body weight at first estrus was from 101.5 kg to 115.3 kg and gilts normally attained puberty at 170.5-181.5 days of age. Breed differences among Duroc, Landrace and Yorkshire in body weight and age at first estrus and mating were found. Total teat number of Duroc, Landrace and Yorkshire were 12.5, 14.9 and 13.7, respectively. Teat interval from pectoral to inguinal region and from left to right at first estrus and mating did not show any differences among the breeds. In conclusion, 14 or more teat number compared to 11-13 teat number in gilts increased litter size at birth and at 21 day weaning.

Aging↗

Smoking as a risk factor for preinvasive and invasive cervical lesions in female sex workers in Venezuela.

OBJECTIVES: To determine whether the number of cigarettes smoked per day and years of smoking were risk factors for preinvasive and invasive cervical lesions in Venezuelan female sex workers. METHODS: The clinical history of 438 female sex workers (FSWs) was taken and each received a gynecological examination, a Pap smear, and a colposcopic examination. A colposcopically-guided cervical biopsy was taken when the epithelium appeared abnormal. RESULTS: The FSWs' mean age was 32.16+/-8 years. Age at first sexual intercourse was 15.9+/-2 years, parity was 4.1+/-2.3, live births were 3+/-3, and age at first delivery was 16.6+/-4.7 years. Cervical biopsies were performed in 84 FSWs. Sixty-four of them (76.2%) had preinvasive or invasive lesions and 47 (73.4%) were current smokers (Relative Risk) (RR), 1.26; 95% confidence interval (CI), 1.02-1.55; P<0.03]. FSWs who smoked more than 20 cigarettes per day had an increased RR to get a premalignant or malignant cervical lesion (RR, 1.27; 95% CI, 1.02-1.52; P<0.03). There was no statistically significant difference between FSWs who smoked 20 cigarettes or more per day and FSWs who smoked less than 20 cigarettes per day (RR, 1.36; 95% CI, 0.81-2.29; P<0.25). FSWs who had been smoking for 5 years or more were at risk to develop preinvasive or invasive cervical lesions (RR, 1.37; 95% CI, 1.01-1.86; P<0.04). CONCLUSIONS: The risk for FSWs to develop preinvasive or invasive cervical lesions increased with the number of cigarettes they smoked per day and their years of smoking.

Adolescent↗

Antenatal diagnosis of surgically correctable anomalies: effects of repeated consultations on parental anxiety.

OBJECTIVE: To assess whether or not a correlation exists between antenatal consultations and parental anxiety. STUDY DESIGN: In total, 31 couples undergoing prenatal consultation after a diagnosis of a surgically correctable anomaly were asked to fill in a questionnaire (Spielberger State-Trait Anxiety Inventory) measuring anxiety levels (AL) both after the first consultation and at birth. Prenatal counselling was done by a perinatal team including paediatric surgeon, obstetrician, and psychologist. RESULTS: Malformations were: eight diaphragmatic hernias, 10 intestinal atresias, four abdominal masses, nine abdominal wall defects. Each fetus was subsequently followed up at regular intervals from diagnosis to birth. AL at birth were then compared with the number of antenatal consultations. A negative correlation (r=-0.688, p<0.001) was found between the number of consultations and the level of anxiety at birth. Patients having at least two consultations had significantly lower anxiety levels at birth. CONCLUSION: Irrespective of the type of malformation, there is evidence that having more than one antenatal consultation may significantly reduce AL at birth. Therefore, early antenatal diagnosis should be encouraged in order to increase as much as possible chances of repeated consultations for the prospective parents.

Adult↗

The transmission of campylobacter in piggeries; an epidemiological study.

The campylobacter infection of 10 sows and their piglets was monitored. These pigs were kept on two multiplier farms. Rectal faeces samples were taken from the sows shortly before littering and at different intervals after littering. Swab samples of rectal content were taken from six piglets per sow at different intervals after birth. Nine sows were shown to be infected with campylobacter before litter and all sows after litter, with an average colony count of 4.1 in log N g-1 of faeces. Half of the piglets became infected with campylobacter during the first week of life and 85%, after four weeks. Two genetic subtyping methods (ERIC-PCR and RFLP) were used to study the relationships between campylobacter isolates from sows and piglets. A large diversity of campylobacter subtypes was found. Nevertheless, piglets and their mothers often harboured campylobacter isolates with identical genetic subtyping profiles, suggesting that piglets become infected via their mothers. However, observed similarities in genetic subtyping profiles between campylobacters isolated on different farms made this difficult to prove.

Animals↗

Perceived religiousness is protective for colorectal cancer: data from the Melbourne Colorectal Cancer Study.

The perceived or self-reported degree of 'religiousness' was obtained by interview from 715 colorectal cancer patients and 727 age/sex matched community controls, as part of a large, comprehensive population-based study of colorectal cancer incidence, aetiology and survival (The Melbourne Colorectal Cancer Study) conducted in Melbourne, Australia. Self-reported or perceived 'religiousness', as defined in the study, was a statistically significant protective factor [relative risk (RR) = 0.70, 95% confidence interval (CI) = 0.6-0.9, P = 0.002]. This statistically significant protection remained after the previously determined major risk factors found in the study, namely a family history of colorectal cancer, dietary risk factors, beer consumption, number of children and age at birth of the first child, were statistically corrected for (P = 0.004). There was no association between Dukes' staging of the cancer and perceived degree of 'religiousness' (P = 0.42). Although self-reported or perceived 'religiousness' was associated with a median survival time of 62 months compared with 52 months in those self-reporting as being 'non-religious', this difference was not statistically significant (P = 0.64).

Adenocarcinoma↗

Predicting preschooler obesity at birth: the role of maternal obesity in early pregnancy.

OBJECTIVE: Knowing risk factors at birth for the development of childhood obesity could help to identify children who are in need of early obesity prevention efforts. The objective of this study was to determine whether children whose mothers were obese in early pregnancy were more likely to be obese at 2 to 4 years of age. METHODS: A retrospective cohort study was conducted of 8494 low-income children who were enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Ohio and were followed from the first trimester of gestation until 24 to 59 months of age. Measured height and weight data from WIC were linked to birth certificate records for children who were born in the years 1992-1996. Obesity among 2- to 4-year-olds was defined as a body mass index (BMI) > or =95th percentile for age and gender. Mothers were classified as obese (BMI > or =30 kg/m2) or nonobese (BMI <30 kg/m2) on the basis of BMI measured in the first trimester of the child's gestation. RESULTS: The prevalence of childhood obesity was 9.5%, 12.5%, and 14.8% at 2, 3, and 4 years of age, respectively, and 30.3% of the children had obese mothers. By 4 years of age, 24.1% of children were obese if their mothers had been obese in the first trimester of pregnancy compared with 9.0% of children whose mothers had been of normal weight (BMI 18.5 and <25 kg/m2). After controlling for the birth weight, birth year, and gender of the children plus the mothers' age, race/ethnicity, education level, marital status, parity, weight gain, and smoking during pregnancy, the relative risk of childhood obesity associated with maternal obesity in the first trimester of pregnancy was 2.0 (95% confidence interval [CI]: 1.7-2.3) at 2 years of age, 2.3 (95% CI: 2.0-2.6) at 3 years of age, and 2.3 (95% CI: 2.0-2.6) at 4 years of age. CONCLUSION: Among low-income children, maternal obesity in early pregnancy more than doubles the risk of obesity at 2 to 4 years of age. In developing strategies to prevent obesity in preschoolers, special attention should be given to newborns with obese mothers.

Body Mass Index↗

Modeling the effects of different infant feeding strategies on infant survival and mother-to-child transmission of HIV.

OBJECTIVES: We investigated how, under various conditions, the risk of mother-to-child transmission of HIV through breastfeeding compares with the risk of death from artificial feeding. METHODS: We developed a spreadsheet simulation model to predict HIV-free survival during 7 age intervals from 0 to 24 months for 5 different infant feeding scenarios in resource-poor settings. RESULTS: Compared with artificial feeding, breastfeeding during the first 6 months by HIV-positive mothers increases HIV-free survival by 32 per 1000 live births. After 6 months, as the age-specific mortality rate and risk of death caused by replacement feeding both decline, replacement feeding appears to be safer. CONCLUSIONS: Under conditions common in countries with high HIV prevalence, replacement feeding by HIV-infected mothers should not be generally encouraged until after the infant is approximately 6 months old.

Age Factors↗

Postnatal development of tracheal surface epithelium and submucosal glands in the ferret.

We explored the usefulness of the postnatal ferret as a model for early developmental events in the large airways, using light and scanning electron microscopy. In the first 28 postnatal days, ferret tracheal surface epithelium and glands undergo dramatic growth and development. Tracheal surface area increases 8-fold. At birth, ciliated cells are sparse (9.4 +/- 1.2% of total epithelial cells). A significant increase in ciliated cells is observed at weekly intervals and by day 28 the ciliated cell is the predominant cell type (54.2 +/- 2.8% of total epithelial cells). Secretory cells decrease from 66.4 +/- 1.0% at birth to 22.2 +/- 2.8% of total epithelial cells. Histochemical staining of the granules of the epithelial secretory cells changes from predominantly non-acidic (staining with PAS but not Alcian blue) to predominantly acidic (staining also with Alcian blue). During the same time interval, tracheal glands develop from intraepithelial cellular aggregates devoid of secretory granules at birth into complex, submucosal tubuloacinar structures composed predominantly of cells containing non-acidic secretory granules at 28 days. Therefore, infant ferrets offer an opportunity to examine the structural and functional components of the mucociliary clearance mechanism at developmental stages which occur prenatally in many laboratory animals and in humans.

Alcian Blue↗

Risk factors for early infant mortality in Sarlahi district, Nepal.

OBJECTIVES: Early infant mortality has not declined as rapidly as child mortality in many countries. Identification of risk factors for early infant mortality may help inform the design of intervention strategies. METHODS: Over the period 1994-97, 15,469 live-born, singleton infants in rural Nepal were followed to 24 weeks of age to identify risk factors for mortality within 0-7 days, 8-28 days, and 4-24 weeks after the birth. FINDINGS: In multivariate models, maternal and paternal education reduced mortality between 4 and 24 weeks only: odds ratios (OR) 0.28 (95% confidence interval (CI) = 0.12-0.66) and 0.63 (95% CI = 0.44-0.88), respectively. Miscarriage in the previous pregnancy predicted mortality in the first week of life (OR = 1.98, 95% CI = 1.37-2.87), whereas prior child deaths increased the risk of post-neonatal death (OR = 1.85, 95% CI 1.24-2.75). A larger maternal mid-upper arm circumference reduced the risk of infant death during the first week of life (OR = 0.88, 95% CI = 0.81-0.95). Infants of women who did not receive any tetanus vaccinations during pregnancy or who had severe illness during the third trimester were more likely to die in the neonatal period. Maternal mortality was strongly associated with infant mortality (OR = 6.43, 95% CI = 2.35-17.56 at 0-7 days; OR = 11.73, 95% CI = 3.82-36.00 at 8-28 days; and OR = 51.68, 95% CI = 20.26-131.80 at 4-24 weeks). CONCLUSION: Risk factors for early infant mortality varied with the age of the infant. Factors amenable to intervention included efforts aimed at maternal morbidity and mortality and increased arm circumference during pregnancy.

Adolescent↗

[Hyaline membrane disease: mortality and maternal and neonatal risk factors].

OBJECTIVE: To identify maternal and neonatal risk factors associated with hyaline membrane disease and its mortality. PATIENTS AND METHOD: A case-control study with 41 newborns with hyaline membrane disease and 123 controls was made between September 2001 and February 2002 in the Hospital Civil de Guadalajara Dr. Juan I. Menchaca. The diagnosis of hyaline membrane disease was done with clinical and radiographic data. Maternal risk factors were obtained by direct interview with the mother; the newborn data were obtained of the clinical files. The association was measured with the odds ratios (OR) and the confidence interval of 95%. RESULTS: The frequency of hyaline membrane disease was of 6.8 per 1,000 live births. Mortality rate was of 2.8 per 1,000 live births. There were 17 deaths (41%). The risk factors associated with hyaline membrane were: illness during the first and second trimester of pregnancy, (OR: 3.28 [1.16-9.31]; OR: 8.88 [3.56-22.50], respectively), Apgar score lower than seven at the first minute (OR: 18.57 [4.50-88.67]), and masculine gender (OR: 2.58 [1.15-5.83]). CONCLUSIONS: Frequency and mortality were similar to the reported by other studies made in population samples. The exposure to illnesses during pregnancy and the low Apgar score were associated with the increased frequency of hyaline membrane disease.

Case-Control Studies↗

Probabilities of intercourse and conception among U.S. teenage women, 1971 and 1976.

One in five U.S. females have had intercourse by age 16, and two-thirds, by age 19. Almost all the experience is premarital. One in 10 U.S. women get pregnant before age 17; one-quarter before they are 19, and eight in 10 of these pregnancies are premarital. More than one-third of those who are sexually active premaritally have a premarital pregnancy before they turn 19, one-quarter by the time they are 17.

Actuarial Analysis↗

Urinary estrogen metabolites and breast cancer: a case-control study.

Preliminary studies suggest that the estrogen metabolite 16 alpha-hydroxyestrone is associated with breast cancer, whereas 2-hydroxyestrone is not. However, epidemiological studies evaluating this relationship and taking established risk factors for breast cancer into account are lacking. The purpose of this study was to examine the association of the ratio of the urinary estrogen metabolites (2-hydroxyestrone and 16 alpha-hydroxyestrone) and of the individual metabolites with breast cancer. A spot urine sample, a brief history, and clinical data were collected from breast cancer cases (n = 42) and from women coming to the hospital for a routine mammogram or attending a free breast cancer screening (n = 64). 2-Hydroxyestrone and 16 alpha-hydroxyestrone were measured by enzyme immunoassay, and the estrogen metabolite ratio (EMR; 2-hydroxyestrone:16 alpha-hydroxyestrone) was computed. Cases and controls were similar in terms of age (mean age of cases, 53.8 +/- 15.1 years, versus 54.2 +/- 10.4 years for controls; P = 0.9) and demographics. Mean EMR was not associated with breast cancer overall (1.67 +/- 0.80 versus 1.72 +/- 0.66; P = 0.7). However, in postmenopausal women, the mean EMR was significantly lower in cases compared to controls (1.41 +/- 0.73 versus 1.81 +/- 0.71; P = 0.05). The multivariate adjusted odds ratios for the intermediate and lowest tertiles of the EMR relative to the highest among postmenopausal women were 9.73 (95% confidence interval, 1.27-74.84) and 32.74 (95% confidence interval, 3.36-319.09), respectively. The test for trend was highly significant (P = 0.003). Analyses of the individual metabolites indicated that 16 alpha-hydroxyestrone was a strong risk factor. The EMR did not show any consistent associations with age, race/ethnicity, age at first birth, parity, body mass index, family history of breast cancer, smoking, or alcohol intake. These data suggest a strong, inverse association of the EMR and a strong positive association of 16 alpha-hydroxyestrone with breast cancer in postmenopausal women. Larger studies are needed to confirm these results and to assess the relationship of the EMR and of the individual metabolites with breast cancer, with attention to menopausal status and clinical factors and with adjustment for known breast cancer risk factors.

Adult↗

Determinants of survival in children with congenital abnormalities: a long-term population-based cohort study.

BACKGROUND: Today more children with birth defects survive early childhood because of improved medical care; however, little information is available about patterns of long-term mortality and survival in this population. In particular, it is not clear whether other birth characteristics, apart from birth defects, have any role in their mortality. METHODS: Two large cohorts of children with and without birth defects were followed for up to 17 years. More than 45,000 children with birth defects, and 45,000 matched children without birth defects born in Ontario between 1979 and 1986 were followed. Throughout the study period long-term survival rates and the risk of death were compared between the 2 cohorts. Birth characteristics were also examined to determine their effect on the risk of death. RESULTS: During the study the deaths of 3620 and 301 children with and without birth defects, respectively, were recorded, indicating that those with birth defects had a 13 times higher rate of mortality (relative risk [RR], 12.9, 95% confidence interval [CI], 12.1-13.7). Mortality rates in the birth-defects cohort remained higher even after 10-15 years. In both groups children of low gestational age and low birth weight had a higher risk of death. There was a strong dose-response relationship between the number of defects and the risk of death. CONCLUSIONS: Children born with abnormalities face many challenges throughout their lifetimes. If they survive the high mortality risk of the first year of life, they still have to face the considerably higher risk of death in the years to come. In addition to birth defects, other birth characteristics play an independent role in their mortality. These indicators could be used to identify high-risk children.

Adolescent↗

Timing of mother-to-child transmission of HIV-1 and infant mortality in the first 6 months of life in Harare, Zimbabwe.

OBJECTIVES: To examine the risks of intra-uterine (IU), intra- and early post-partum (IP/ePP) and late post-partum (LPP) mother-to-child transmission (MTCT) of HIV-1 and infant mortality in the first 6 months of life. METHODS: Whole blood was collected in ethylenediaminetetra-acetic acid at birth, 6 weeks, 3 and 6 months from 996 infants born to HIV-1 seropositive mothers. Polymerase chain reaction using Roche DNA amplification assay, version 1.5 (Roche Diagnostics Incorporation, Alameda, California, USA) was used to determine timing of MTCT. Logistic regression models determined risk factors for HIV-1 transmission and survival analyses examined mortality by timing of transmission. RESULTS: Two hundred and forty-nine mothers (30.7%) transmitted HIV-1 infection to their infants by 6 months of age. Eighty-nine infants [9.4%; 95% confidence interval (CI), 7.7-11.5], 104 infants (16.0%; 95% CI, 10.8-21.2) and 21 infants (5.3%; 95% CI, 1.6-12.2) were infected IU, IP/ePP and LPP respectively. Low maternal CD4 cell count and arm circumference were risk factors for IP/ePP transmission. Infant mortality was higher among infected infants than uninfected (P < 0.001, log rank test). Timing of infection, birth weight and maternal CD4 cell counts were important factors in predicting infant death. CONCLUSION: In the first 6 months of life, IU and IP/ePP transmission contributed more than three-quarters of the 30.7% MTCT. Our data, in addition to serving as a historical comparison, may be useful in designing and evaluating the efficacy of short course antiretroviral trials aimed at reducing MTCT in developing countries.

Adult↗

Pyloric stenosis and maternal Bendectin exposure.

As part of a long-term follow-up of structural disorders present at birth or shortly thereafter in infants born at Group Health Cooperative of Puget Sound, all infants with a diagnosis of pyloric stenosis born between July 1, 1977 and June 30, 1982, were identified. Automated pharmacy profiles were examined to determine whether an association between maternal Bendectin use in the first trimester and infantile hypertrophic pyloric stenosis existed. Among the 3,835 women exposed to Bendectin while pregnant, in this group of 13,346 births, 13 had infants who developed pyloric stenosis, and among the 9,511 women not exposed, 13 had infants who developed pyloric stenosis, resulting in a risk ratio estimate of 2.5 (95% confidence interval (CI) 1.2-5.2). When mothers were divided according to the number of prescriptions for Bendectin filled, the relative risk estimate increased from 1.2 (95% CI 0.4-4.4) in women who filled only one prescription to 7.6 (95% CI 4.9-11.6) in women who filled five or more prescriptions for Bendectin during their pregnancy.

Adult↗

Predictors of early grade retention among children in the United States.

BACKGROUND: Despite increasing concerns regarding school readiness, little is known about child health correlates of early school failure among the general child population. The results of this study, conducted to investigate health and social factors associated with early grade retention in a nationally representative sample of children in the United States, are reported here. DESIGN: Analyses of data derived from interviews with parents of 9996 children ages 7 to 17 years who participated in the Child Health Supplement to the 1988 National Health Interview Survey. MAIN OUTCOME MEASURES: History of repeating kindergarten or first grade. RESULTS: Nationally, 7.6% of children repeated kindergarten or first grade. In a logistic regression model, factors independently associated with increased risk of grade retention were: poverty [Odds Ratio (OR) 1.7, 95% confidence interval (CI) 1.4, 2.1], male gender (OR 1.5, CI 1.3, 1.9), low maternal education (OR 1.4, CI 1.1, 1.8); deafness (OR 1.9, CI 1.4, 2.6), speech defects (OR 1.7, CI 1.1, 2.6), low birth weight (OR 1.6, CI 1.2, 2.2), enuresis (OR 1.6, CI 1.1, 2.2), and exposure to household smoking (OR 1.4, CI 1.1, 1.7). High maternal education (OR 0.6 CI 0.4, 0.9) and residence with both biological parents at age 6 years (OR 0.7, CI 0.6, 0.9) were independently associated with a decreased risk of retention. Recurrent otitis media, black race, and low maternal age, although associated with early grade retention in bivariate analyses, were not independently associated with grade retention in a model that controls for these other factors and for the age cohort of the child. Although omitted from the above predictive model because of uncertainty about its temporal relation to early grade retention in this dataset, behavior problems at the time of interview have a strong independent association (OR 1.9, CI 1.5, 2.5) with prior early retention. CONCLUSIONS: This is the first study that uses national data to investigate how health and social factors individually and collectively contribute to early grade retention. It demonstrates that early retention is common, that a number of extremely common child health problems are independently associated with it, and that the magnitude of the heightened risk associated with these problems is similar to that of many of the well-recognized and difficult to change family and social risk factors for early retention. The successful implementations of Pub L 99-457 (The Education for All Handicapped Children Act Amendments of 1986) services in communities nationwide, and the improvement in the educational performance of large numbers of children will be facilitated by pediatricians' advocacy and surveillance for problems that place children at risk for educational failure, and by effective referral to and collaboration with nonpediatric child and family services.

Adolescent↗

Regional and social differences in body mass index, and the prevalence of overweight and obesity among 18 year old men in Austria between the years 1985 and 2000.

The BMI data of four birth cohorts of totally 180,716 male 18 year old Austrian conscripts were documented in 5 year intervals starting 1985 and ending 2000 in order to analyze regional and social variety and a time trend of stature, body weight and BMI as well as the prevalence rates of overweight (defined as a BMI > 25.00) and obesity (BMI > 30.00). At first a marked time trend in BMI and overweight/obesity prevalence rates was found. Over the 15 years of investigation BMI increased significantly and the variation of BMI distribution increased too. The impact of educational level on BMI and the prevalence of overweight and obesity was also statistically significant. With increasing educational level BMI and the prevalence rates of overweight and obesity decreased significantly. Furthermore a significant regional variety in BMI and the prevalence rates of overweight and obesity were found. BMI and the prevalence rates of obesity and overweight decreased significantly from the Eastern part of Austria to the Western part. Both observations, e.g. the social and regional variety of obesity and overweight prevalence, were true of all 4 birth cohorts. From these results we can conclude that obesity and overweight represent an increasing health problem among young Austrian males. This is especially true of young men of low social status living in the eastern part of Austria.

Adolescent↗