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PubMed1983

Direct computer recording of premature infants and nursery care: distress following two interventions.

Prematurely born neonates are born with an immature central nervous system. Temporal associates between care-giver interventions and infant biobehavioral responses can be recorded. A new methodology for continuous naturalistic computer-assisted recording of infants in nursery care is described. To illustrate a clinical implication of this recording, an infant's responses to two seemingly contrasted care-giver interventions were analyzed: chest physical therapy and close social interaction. There was significantly increased subtle as well as gross behavioral and physiologic distress following both chest physical therapy and close social interaction when compared with base line distress incidence. Perhaps timing of interventions is as consequential as their content toward safeguarding a preterm infant's developing autonomic regulation, motor patterns, and sleep/wake state.

Computers↗
PubMed1998

Pulmonary tuberculosis in five young infants with nursery exposure: clinical, radiographic and CT findings.

Clinical, radiographic (n = 5) and CT findings (n = 4) of five Korean infants ranging in age from 2 to 3 months with confirmed tuberculosis were retrospectively analysed. All of the patients were symptomatic, anergic to tuberculin, and had a positive culture of Mycobacterium tuberculosis in gastric aspirates. The probable source of infection was the hospital in which they were born. CT scans demonstrated hilar and mediastinal lymph node enlargement with central low attenuation and peripheral enhancement in all cases. CT may be useful in diagnosis by demonstrating characteristic adenopathy and disseminated disease in young infants.

Cross Infection↗
PubMed1982

Restriction endonuclease analysis of cytomegalovirus deoxyribonucleic acid as an epidemiologic tool.

The possibility of transmission of cytomegalovirus (CMV) from congenitally infected infants to susceptible medical personnel produces anxiety because the risks have not been defined. A physician conceived her first child while caring for an infant in the intensive care nursery who died with congenital CMV infection. The physician had serologic evidence of active CMV infection confirmed by isolation of virus from multiple sites. She elected to have her pregnancy interrupted. CMV was isolated from the placenta and fetal brain. Restriction enzyme analysis was employed to test all the CMV isolated for genetic relatedness. Virus isolated from the physician and her fetus was identical. The virus from the index nursery infant was different from the strain infecting the physician and her fetus. These data indicate that the physician acquired her virus from a source other than the index infant.

Abortion, Therapeutic↗
PubMed1999

Behavioral measurement of temperament in male nursery-raised infant macaques and baboons.

We define temperament as an individual's set of characteristic behavioral responses to novel or challenging stimuli. This study adapted a temperament scale used with rhesus macaques by Schneider and colleagues [American Journal of Primatology 25:137-155, 1991] for use with male pigtailed macaque (Macaca nemestrina, n = 7), longtailed macaque (M. fascicularis, n = 3), and baboon infants (Papio cynocephalus anubis, n = 4). Subjects were evaluated twice weekly for the first 5 months of age during routine removal from their cages for weighing. Behavioral measures were based on the subject's interactions with a familiar human caretaker and included predominant state before capture, response to capture, contact latency, resistance to tester's hold, degree of clinging, attention to environment, defecation/urination, consolability, facial expression, vocalizations, and irritability. Species differences indicated that baboons were more active than macaques in establishing or terminating contact with the tester. Temperament scores decreased over time for the variables Response to Capture and Contact Latency, indicating that as they grew older, subjects became less reactive and more bold in their interactions with the tester. Temperament scores changed slowly with age, with greater change occurring at younger ages. The retention of variability in reactivity between and within species may be advantageous for primates, reflecting the flexibility necessary to survive in a changing environment.

Age Factors↗
PubMed1986

Conservation of the fourth gene among rotaviruses recovered from asymptomatic newborn infants and its possible role in attenuation.

RNA-RNA hybridization was performed to assess the extent of genetic relatedness among human rotaviruses isolated from children with gastroenteritis and from asymptomatic newborn infants. 32P-labeled single-stranded RNAs produced by in vitro transcription from viral cores of the different strains tested were used as probes in two different hybridization assays: undenatured genomic RNAs were resolved by polyacrylamide gel electrophoresis, denatured in situ, electrophoretically transferred to diazobenzyloxymethyl-paper (Northern blots), and then hybridized to the probes under two different conditions of stringency; and denatured genomic double-stranded RNAs were hybridized to the probes in solution and the hybrids which formed were identified by polyacrylamide gel electrophoresis. When analyzed by Northern blot hybridization at a low level of stringency, all genes from the strains tested cross-hybridized, providing evidence for some sequence homology in each of the corresponding genes. However, when hybridization stringency was increased, a difference in gene 4 sequence was detected between strains recovered from asymptomatic newborn infants ("nursery strains") and strains recovered from infants and young children with diarrhea. Although the nursery strains exhibited serotypic diversity (i.e., each of the four strains tested belonged to a different serotype), the fourth gene appeared to be highly conserved. Similarly, each of the virulent strains tested belonged to a different serotype; nonetheless, there was significant conservation of sequence among the fourth genes of three of these viruses. Significantly, the conserved fourth genes of the nursery strains were distinct from the fourth gene of each of the virulent viruses. These results were confirmed and extended during experiments in which the RNA-RNA hybridization was carried out in solution and the resulting hybrids were analyzed by polyacrylamide gel electrophoresis. Under these conditions, the fourth genes of the nursery strains were closely related to each other but not to the fourth genes of the virulent viruses. Full-length hybrids did not form between the fourth genes from the nursery strains and the corresponding genes from the strains recovered from symptomatic infants and young children.

Diarrhea, Infantile↗
PubMed1985

Nosocomial rotavirus infections in a South African hospital nursery for white infants.

Rotavirus infections in a nursery ward for newborn white infants in South Africa do not apparently differ from those encountered in other temperate countries. Neonates began to excrete rotavirus as early as 2 days after birth; a peak incidence of excretion occurred during the winter months. After a period of 4 years the incidence of excretion remained virtually unchanged. Rotaviruses also colonized and spread very rapidly in a newly commissioned nursery ward, possibly via respiratory infections. Passively acquired antibodies had no influence on the prevention of infections but may play a role in the suppression of clinical symptoms since none of the newborn population studied developed gastro-enteritis. The immunosorbent electron microscopy technique used to detect rotaviruses in this study yielded results that compared well with results obtained previously by other techniques.

Antibodies, Viral↗
PubMed2002

Post-partum maternity 'blues' as a reflection of newborn nursing care in Japan.

OBJECTIVES: To investigate the prevalence of post-partum 'blues' in mothers whose babies are cared for in a newborn nursery, compared with mothers providing rooming-in care. METHODS: Japanese normal primiparous women were prospectively studied from 1998 to 1999. The newborns of these mothers were managed in the newborn nursery or by rooming-in care. To diagnose maternity 'blues' and 'depression', the Stein's Questionnaire and the Edinburgh Postnatal Depression Scale were used. RESULTS: Ninety-seven and 93 women were managed by newborn nursery care and by rooming-in care, respectively. Of these women, a total of 181 women were considered for analysis. 'Blues' was noted in 31 of 92 mothers (33.7%) receiving newborn nursery care and in 18 of 89 (20.2%) receiving rooming-in care with a significant difference (P<0.05), and in 49 of 181 (27.1%) as a whole. The daily Stein's scores changed significantly during the 10 days post-partum in each group (P<0.0001). Post-partum 'depression' was observed in three mothers (3.4%) in the newborn nursery care group and in four (4.8%) of the rooming-in care group, not a significant difference, and in seven (4.1%) as a whole. CONCLUSION: Maternity 'blues' is experienced by 25% or more of Japanese primiparous women delivering healthy babies via uncomplicated delivery. The system of newborn nursery infant care may be a potential causal factor for maternity 'blues', although it should be confirmed by a prospective randomized trial.

Adult↗
PubMed2006

Cold stress and hypoglycemia in the late preterm ("near-term") infant: impact on nursery of admission.

Late preterm infants (34-37 weeks gestation) pose unique challenges to physicians and nurses involved in their care after birth. They may be cared for in different units within hospitals after birth, including Neonatal Intensive Care Units, Newborn Nurseries, or rooming in with the mother. As a result of their gestational age and birth weight, the late preterm infant is often assessed quickly and triaged identical to term infants. Such practice can potentially result in a lack of attention to important components for successful transition after birth. Cold stress and hypoglycemia are the two important problems in late preterm infants which require immediate treatment. Thus, surveillance of these and other physiological variables is needed to insure that they do not affect successful adaptation during the early hours and days after birth.

Adaptation, Physiological↗
PubMed2000

The initial care of newborn infants and subsequent hay fever.

BACKGROUND: Patterns of neonatal exposure to microorganisms have changed substantially over the last 100 years, and it has been suggested that this has influenced the risk of immune-mediated disease. Using a proxy measure, we tested the hypothesis that the initial handling of newborn infants, which is known to affect the pattern of exposure to microorganisms, may alter the risk of developing subsequent atopy, as indicated by hay fever. METHODS: Analysis was performed on 5,519 members of the 1970 British Cohort Study, a nationally representative birth cohort. Cohort members with hay fever were identified at intervals up to the age of 26 years. Details of neonatal care and childhood circumstances were recorded prospectively. Those who had spent their first night away from their mother in the communal infant nursery were selected as likely to have experienced atypical exposure compared with infants who remained with their mother. Adjustment was made for potential confounding factors in infancy and childhood by multiple logistic regression analysis. RESULTS: Unadjusted relative odds (with 95% CI) for developing hay fever among those spending the first night in the communal nursery, when compared with other infants who remained with the mother, were 1.48 (1.23-1.77), P<0.001. Comprehensive adjustment for the potential confounding factors, including feeding practices on the first day of life, markers of social and material circumstances, and region, did not substantially alter this relationship, with adjusted relative odds of 1.31 (1.08-1.59), P=0.005. CONCLUSIONS: While our proxy measure is associated with an increased risk of hay fever, further research is required to confirm that this is due to the pattern of infectious exposure in very early life. The results are consistent with the hypothesis that the first challenges are particularly important in the development of the newborn infant's immune system.

Adult↗
PubMed1984

Enteropathogenic Escherichia coli of classic serotypes associated with infant diarrhea: epidemiology and pathogenesis.

A series of O:H serotypes of E. coli were incriminated by epidemiologic studies in the period 1945-1960 as a cause of epidemic diarrhea in infant nurseries as well as a major cause of sporadic infant diarrhea in the community. The term enteropathogenic E. coli was coined to refer to these infant diarrhea-associated serotypes. In the early 1970s, with the advent of laboratory tests to assess heat-labile and heat-stable enterotoxin production and enteroinvasiveness of E. coli, the classic serotype enteropathogenic E. coli strains were found to lack those particular properties. These observations led some to question their pathogenicity. However, since 1978, enteropathogenic E. coli have come to be appreciated anew as a separate class of diarrheagenic E. coli that cause diarrhea by distinct pathogenic mechanisms. The pathogenesis of these strains, which have been shown to cause diarrhea in volunteers, appears to involve both an enteroadhesiveness step and production of a toxin identical to Shigella toxin. A 55- to 65-Mdalton plasmid is involved in the attachment of enteropathogenic E. coli to intestinal mucosa which results in a pathognomonic histopathologic lesion visualized by electron microscopy. The lesion involves dissolution of enterocyte microvilli by the bacteria, effacement of the enterocyte outer membrane, and formation of a pedestal around the bacterium at point of contact with the outer membrane of the enterocyte. Case-control epidemiologic studies carried out since 1975 document that enteropathogenic E. coli remain an important cause of sporadic infant diarrhea in the community with up to 30 per cent of cases of acute diarrhea in young infants in Brazil and South Africa being attributed to these pathogens. Although nursery epidemics of enteropathogenic E. coli diarrhea have virtually disappeared from industrialized countries, some sporadic enteropathogenic E. coli diarrhea in infants in the community continues to occur. The relative importance of enteropathogenic E. coli as a cause of sporadic diarrhea in both industrialized and developing countries needs to be reassessed. New diagnostic techniques are awaited to simplify this task.

Adult↗