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Biomedical subjects

J K Fraley

Publications and source records attributed to J K Fraley.

24 records · Page 2Linked to original sources

Factors associated with umbilical catheter-related sepsis in neonates.

To determine factors associated with risk for umbilical catheter-related sepsis, we studied neonates with one or more catheters in place for more than 3 days. Among 225 infants with 357 umbilical catheters, catheter-related sepsis occurred in 14 infants (6%). Catheter-related sepsis occurred in 5% of infants with umbilical arterial catheters and in 3% of infants with umbilical venous catheters. Staphylococcal species accounted for 71% of cases of catheter-related sepsis. Multiple logistic regression analysis revealed that very low birth weight and longer duration of antibiotic therapy were significantly associated with risk for umbilical arterial catheter-related sepsis. Increased risk for umbilical venous catheter-related sepsis was best predicted by the simultaneous occurrence of higher birth weight and infusion of hyperalimentation solution. Catheter duration correlated with duration of antibiotic therapy and with infusion of hyperalimentation solution for both types of catheters; however, in the multivariable analysis, duration of catheterization was not found to be a significant independent predictor of risk for catheter-related sepsis for either type of catheter.

Anti-Bacterial Agents↗

Acquired monosaccharide intolerance in infants.

To determine the frequency with which acquired monosaccharide intolerance (AMI) occurs in infants less than 3 months of age, we performed a prospective descriptive study of infants admitted to the hospital for diarrhea. We searched for differences between the characteristics and causes of AMI in these infants and those of a cohort of similar-aged infants admitted with acute diarrhea (AD). Five hundred fifty-five infants less than 3 months of age admitted with diarrhea were enrolled. Nine percent of those infants had AMI, 40% had other forms of chronic diarrhea, and 51% had AD. The mean age at hospital admission was 32 days for the infants with AMI and 44 days for the infants with AD. The mean weight loss of AMI infants was 0.3 g/day since birth, and the mean weight gain was 14.3 g/day for AD infants. The mean dehydration by difference in weights at admission and 48 h postadmission was 5% for AMI and 3% for AD infants. Bacterial and viral causes of the diarrhea were similar. At admission to the hospital, infants in whom AMI subsequently developed were younger, more malnourished, had more prolonged diarrhea, and were more dehydrated than the AD infants. Malnutrition stands out as a significant antecedent factor that contributes to the development of AMI.

Acute Disease↗

Sources of variance in milk and caloric intakes in breast-fed infants: implications for lactation study design and interpretation.

Between-individual variation (BIV) and day-to-day variation (DDV) of total caloric and human milk intakes were examined in 17 infants. Nine were studied at months 5 and 6; 8 at months 6 and 7. All 17 were exclusively breast-fed for 5 full mo after which solid foods were added to the diet. Each infant was studied for five consecutive 24-h periods during which serial measurements were made of milk intake (test weighing) and solid food intake (pre- and postfeeding jar weighing). Total daily caloric intakes (kcal/day) were (mean +/- SD) 492 +/- 57, 547 +/- 70, and 567 +/- 98 at months 5, 6, and 7, respectively. Estimates of caloric intakes (kcal/kg/day) adjusted for body weight were 65.9 +/- 6.7, 72.6 +/- 11.2, and 70.9 +/- 13.0 at months 5, 6, and 7, respectively. Milk intakes (g/day) were 735 +/- 85, 640 +/- 106, and 562 +/- 214 at months 5, 6, and 7, respectively. BIV of milk intake increased after the introduction of solid foods. DDV (expressed as coefficient of variation) of caloric intake was nearly constant at each monthly observation and BIV increased from 8.8 at month 5 to 14.6 at month 7. The numbers of 24-h periods and subjects required for estimates of known precision of caloric and milk intakes of older breast-fed infants can be determined from these estimates of variance.

Adult↗

Comparison of hand- and electric-operated breast pumps.

Volume, fat and energy contents were measured in human milk samples collected over 2 24-h periods with either an electric or hand-operated breast pump. The energy content was significantly higher and the variance for this measurement was significantly lower in samples obtained by the electric pump. The type of pump used is an important consideration when the content of energy and other nutrients associated with the fat compartment in human milk is to be evaluated. This observation is especially pertinent to cross-study comparisons, eg studies of well- and malnourished populations.

Adult↗

Malnutrition in infants with acute diarrheal syndrome.

The data from the charts of 109 infants who were younger than 9 months of age and who had been hospitalized with acute diarrheal syndrome in 1978 were compared with data from the charts of 108 healthy infants of the same age range with the same sex and ethnic distributions who were attending well-child clinics serving the same geographic area during the same year. In a comparison of weight percentiles, 45.3% of the acute diarrheal syndrome patients and 11.3% of the well children were below the 10th percentile. When height percentiles were compared, 41.8% of the acute diarrheal syndrome patients and 15.3% of the well children were below the 10th percentile. The data indicate that malnutrition was a characteristic of infants with acute diarrheal syndrome who required hospitalization.

Acute Disease↗