Search PubMed⌕ Search

Biomedical subjects

D A Frank

Publications and source records attributed to D A Frank.

86 records · Page 5Linked to original sources
PubMed1987

Commercial discharge packs and breast-feeding counseling: effects on infant-feeding practices in a randomized trial.

A randomized controlled trial was conducted to evaluate two interventions for prolonging the duration of breast-feeding in a multiethnic sample of 343 low-income urban women. One intervention compared research breast-feeding bedside counseling by a trained counselor, who also made eight telephone calls during the first 3 months of the infant's life, with the routine breast-feeding counseling provided in the hospital by nurses. The other intervention compared commercial discharge packs provided by formula companies with research discharge packs designed to be consistent with the WHO Code of Marketing of Breastmilk Substitutes. When infants were 4 months old, a telephone interviewer unaware of treatment status contacted 95% (324/343) of the women to determine the infants' feeding and health histories. Compared with routine counseling, research counseling delayed the first introduction of solid foods to the infant's diet (P = .03, one-tailed) but did not exert a statistically significant effect on breast-feeding by 4 months' postpartum. Women who received the research discharge pack, compared with those who received the commercial pack, were more likely to prolong exclusive breast-feeding (P = .004, one-tailed), to be partially breast-feeding at 4 months postpartum (P = .04, one-tailed), and to delay the daily use of solid foods in the infant's diet (P = .017, one-tailed). Among the women who received research counseling, the research discharge pack was associated with lower rates of rehospitalization of infants than was the commercial pack (1% v 14%; P = .014, two-tailed). We conclude that in high-risk maternity populations, commercial discharge materials for breast-feeding women should be replaced by materials consistent with the WHO Code.

Adult↗
PubMed1986

Regulation of protein phosphotyrosine content by changes in tyrosine kinase and protein phosphotyrosine phosphatase activities during induced granulocytic and monocytic differentiation of HL-60 leukemia cells.

About 1.5% of phosphorylated amino acid residues of HL-60 promyelocytic leukemia cells are phosphotyrosine. Induction of granulocytic differentiation by exposure to dimethylsulfoxide decreased tyrosine phosphorylation to 0.2%. A maximum 3-fold increase in tyrosine kinase activity and a 7-fold increase in protein phosphotyrosine phosphatase activity accompanied this change. Monocytic differentiation induced by 12-O-tetradecanoylphorbol-13-acetate, caused a decrease in phosphotyrosine levels to 0.1%; tyrosine kinase activity maximally increased 2-fold, and protein phosphotyrosine phosphatase activity increased 11-fold in these differentiated cells. Thus, although total tyrosine kinase activity markedly increased during differentiation, this was counteracted by an even greater elevation in protein phosphotyrosine phosphatase activity. The findings support the concept that tyrosine phosphorylation is important in the regulation of growth and differentiation of leukemia cells.

Cell Differentiation↗
PubMed1986

Maternal marijuana use and neonatal outcome: uncertainty posed by self-reports.

To assess the validity of self-reported marijuana use during pregnancy, this study randomly allocated pregnant women into a group who were told their urine would be tested for marijuana, alcohol, and other drugs and another group not so tested. Women told they would be tested reported more marijuana use during pregnancy than did untested women. Moreover, urine assays identified more women who used marijuana during pregnancy than were willing to admit it in the interview even after being told their urine would be tested. No differences in reported drinking or cigarette smoking during pregnancy were found between tested and untested women.

Adult↗
PubMed1986

Impact of maternal work outside the home during pregnancy on neonatal outcome.

The impact of mothers' work during pregnancy upon neonatal outcome has not been fully elucidated. A study of maternal health habits and neonatal outcome conducted from 1977 to 1979 at Boston City Hospital assessed the effects of paid work outside the home during pregnancy, particularly third trimester work in a standing position, upon duration of gestation and intrauterine growth, while controlling for potentially confounding variables. Postpartum, 1,690 low-income women were interviewed to provide detailed information on their sociodemographic and health characteristics. Of the 1,507 women whose work status during pregnancy could be classified, 55% did not perform paid work outside the home or attend school, 7% worked into the third trimester in a standing position, and 38% had other work histories or attended school. Infants were examined according to a standard protocol by pediatricians blind to mothers' work history. There was no significant relationship between the mothers' work history during pregnancy and the infants' length of gestation, weight, or head circumference at birth, when confounding variables were controlled statistically by multiple regression analyses. However, women who worked in a standing position into the third trimester delivered infants who were longer than infants born either to mothers with other work histories or to mothers who did not work or attend school. Healthy women with uncomplicated low-risk pregnancies who feel well enough to attend school or work during pregnancy, even in a job requiring some standing, may do so without fear that their infant will suffer shortened gestation or impaired intrauterine growth.

Adolescent↗
PubMed1981

Fact or artifact: an analysis of artifact in high-resolution computed tomographic scanning of the sella.

Computed tomography (CT) artifacts within the sella turcica, associated with the bones of the skull base, were identified and examined by use of a human skull phantom immersed in water. These artifacts were identified in 63% of 27 clinical high-resolution CT scans performed on patients with suspected sellar or parasellar pathology. Intrasellar artifacts may be minimized or eliminated by careful choice of scanning plane. Identification and elimination of intrasellar CT artifacts are necessary for accurate interpretation of sellar image.

Adult↗
PubMedDate not supplied

Assessing unmet need for services for pediatric undernutrition. HSPH MPH Student Research Team.

Evaluation and treatment of undernourished children in Massachusetts has been provided since 1984 by the seven outpatient Growth and Nutrition (GN) Clinics administered by the Massachusetts Department of Public Health (MDPH). This study explored the potential unmet need for nutritional services among low-income, multiethnic children ages birth to 36 months presenting to an inner-city pediatric emergency department (ED). During March 1992, staff obtained weight and stature on all children under 36 months of age brought to the ED. A structured interview questionnaire obtained data on demographic characteristics, birth history, and participation in means-tested federal benefit programs and MDPH GN Clinics. Among 252 children with complete anthropometric data, 22 (8.9%) had at least one anthropometric index (weight-for-age, height-for-age, weight-for-height) below the fifth percentile. Birthweights < 2500 g were reported by 18.5% of caregivers; 58% of children with height-for-age less than the fifth percentile and 63% of those with weight-for-age less than the fifth percentile were low birthweight (LBW) (Fisher's exact test, P < .002 and P < .006, respectively). Thirteen percent of families had no health insurance, and 77.1% received Medicaid. Among 22 children with anthropometry less than the fifth percentile, one half to three quarters participated in federally funded programs including Special Supplemental Food Program for Women, Infants, and Children (WIC), Aid to Families With Dependent Children (AFDC), and Food Stamps, but only 11% had been referred to the GN Clinics. These findings suggest that federal means-tested benefit programs and MDPH GN Clinic services were underused by groups at nutritional risk.(ABSTRACT TRUNCATED AT 250 WORDS)

Anthropometry↗
PubMedDate not supplied

Seasonal variation in weight-for-age in a pediatric emergency room.

OBJECTIVE: The authors assess seasonal variations in the prevalence of low weight-for-age among young children visiting the pediatric emergency room of a city hospital. METHODS: We analyzed data on 11,118 children ages 6 to 24 months who visited the Boston City Hospital Pediatric Emergency Department between July 1989 and June 1992. Medical diagnoses were documented on a randomly selected subsample of 1,569 children. In addition, a questionnaire about food insecurity was administered to a convenience subsample of 269 families with children under 3 years of age. RESULTS: The percentage of children visiting the emergency room with weight-for-age below the fifth percentile was significantly higher for the three months following the coldest months than for the remaining months of the year, controlling for year of measurement. In the subsample, gastrointestinal illness was correlated with both season of measurement and weight-for-age, but the seasonal effect remained for the entire sample after controlling for dehydration. The questionnaire data suggested a relationship between economic stress and food insecurity that might help explain the seasonal effect. Families who were without heat or who were threatened with utility turnoff in the previous winter were twice as likely as other families to report that their children were hungry or at risk for hunger. CONCLUSIONS: Winter and early spring constituted periods of increased nutritional risk in the in this sample of predominantly low-income children, probably because of the increased caloric associated with cold stress and infections. Further research is needed to assess whether decreased caloric availability due to high heating costs, a "heat or eat" effect, also contributes to this phenomenon.

Age Factors↗