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PubMedDate not supplied

Co-bedding versus single-bedding premature multiple-gestation infants in incubators.

OBJECTIVE: To compare the physiological stability and behavioral effects of co-bedding with those of single-bedding premature multiple-gestation infants in incubators as well as the psychological effects on their parents. DESIGN: Prospective, randomized, repeated measure. PARTICIPANTS: Convenience sample of 16 infants and 8 parents in the co-bedded group, and 21 infants and 11 parents in the control group. INTERVENTIONS: Infants in the study group were co-bedded in incubators. MAIN OUTCOME MEASURES: Baseline and posttesting for parental state anxiety, maternal attachment, and parental satisfaction measures; infant sleep-wake synchronicity; physiological measures; and stress cue measures during baseline and activity. MAIN RESULTS: Repeated measures 5 (time) x 2 (group) analysis of variance found significant differences in infant daily weight, feeding amount, and high-activity heart rate. There was no difference in parental state anxiety, maternal attachment, and parental satisfaction scores by group, except for higher baseline parental satisfaction scores in the co-bedded group. CONCLUSIONS: This research demonstrated the safety of co-bedding multiple-gestation infants in incubators but did not find any significant clinical improvement in infant or parental outcomes with co-bedding. Neonatal intensive-care unit providers should educate staff and parents about the potential benefits of co-bedding and consider developing policies and procedures for co-bedding in both incubators and cribs. Co-bedding of multiple-gestation infants may be provided as an adjunctive developmental care strategy if parents desire this intervention.

Female↗
PubMed2005

Human milk pumping rates of mothers of singletons and mothers of multiples.

Rates of breastfeeding are increasing, but the methods by which human milk is fed to infants is not well described. Using a retrospective survey design, the authors collected information about infant feeding from mothers of term, preterm, singleton, and multiple-gestation infants (n=346). Human milk feeding methods were characterized as solely at the breast, pumped only, or a combination. Sixty-eight percent of mothers in the study fed their infants at least some human milk; 77% of these mothers reported pumping milk. There was no difference in the percentage of pumping based on multiple gestation or length of pregnancy. Feeding human milk solely at the breast at early postpartum time points was associated with longer durations of human milk feeding overall. More research is needed to better understand why mothers choose pumping over direct human milk feedings and to evaluate the health outcomes associated with this practice.

Adult↗
PubMed2004

Number of transferred embryos: how to reduce multiple pregnancies.

Because the diagnostic tools for predicting whether an early cleavage stage embryo can lead to a viable pregnancy are still elusive, transfer of more than one embryo remains quite common. However, the only way to reduce multiple pregnancies, considered as the main adverse effect of assisted reproductive technology, is to transfer a single embryo. In countries such as Switzerland and Germany, the law allows cryopreservation only at the 2-pronuclear stage. This restricts considerably the possibility of selecting the embryos to be transferred. Therefore, a good cryopreservation program at the 2-pronuclear stage is an essential tool to optimize the efficiency of in vitro fertilization (IVF). We therefore recommend the Cumulated Singleton Delivery Rate (CUSIDERA) as a measure of standard IVF efficiency. This rate averages approximately 23.5% when calculated over the last 10 years in our unit and reaches a value above 35% for patients with more than 10 zygotes. Elective single-embryo transfers and the decrease of iatrogenic multiple pregnancies in IVF remain dependent on better prognostic tools for the appropriate selection of patients, gametes, and zygotes.

Cryopreservation↗
PubMed2003

Gp130-mediated signaling is necessary for normal osteoblastic function in vivo and in vitro.

Previous studies have shown that mice missing gp130, the common receptor subunit for many cytokines, die at or before birth with multiple skeletal abnormalities. Furthermore, interactions between PTH and gp130 signaling have suggested that gp130 signaling might influence calcium homeostasis. We, therefore, examined the function of osteoblasts, osteoclasts, and calcium homeostasis in gp130(-/-) mice, both in vivo and in vitro. Osteoblasts from these mice exhibit widespread abnormalities, including decreased alkaline phosphatase mRNA and protein, both in vivo and in osteoblast cultures. Although osteoclast number is increased in gp130(-/-) fetuses, these osteoclasts exhibit abnormalities in the resorptive organelle and the ruffled border, and the mice are mildly hypocalcemic. Although the hypocalcemia is associated with secondary hyperparathyroidism, the increase in PTH does not explain the increase in osteoclast number because removal of the PTH gene in gp130(-/-) fetuses does not importantly change osteoclast number. Calvarial bone resorption in response to PTH is defective, as is the ability of osteoblastic cells from gp130(-/-) mice to stimulate osteoclastogenesis from normal precursors in vitro or to increase receptor activator of nuclear factor-kappa B ligand mRNA levels after exposure to PTH. These studies demonstrate the importance of gp130 signaling for osteoblast function and calcium homeostasis.

Animals↗
PubMed1979

Congenital abnormalities and Perthes' disease. Clinical evidence that children with Perthes' disease may have a major congenital defect.

This paper reports a high incidence of minor congenital anomalies in boys and girls with Perthes' disease compared with that in a control population. There is a similarity of the incidence of minor anomalies in the children with Perthes' disease to that in babies with a single major congenital defect. Multiple major defects were more numerous and more severe than in the control children. It is speculated that there may be a congenital abnormality affecting skeletal development which in some way makes the hip susceptible to Perthes' disease at a later date.

Abnormalities, Multiple↗
PubMed2002

Pittsburgh Registry of Infant Multiplets (PRIM).

This paper describes the Pittsburgh Registry of Infant Multiplets (PRIM; Pittsburgh, Pennsylvania), the results of pilot research conducted in this registry, and the plans for future studies. The main focus of the registry is on psychological development and the risk for behavioral disorders. Particularly, characteristics associated with antisociality and the risk for substance use disorders (e.g., aggressivity, hyperactivity/impulsivity), as well as language development and other traits (e.g., dental health) are among the research targets.

Child Behavior Disorders↗
PubMed1997

Secular trend in height in enlisted men and recruits from the Brazilian Navy born from 1970 to 1977.

This study presents data from a survey on height trends in Brazilian Navy enlisted men and recruits born from 1970 to 1977. The sample consisted of 52,574 enlisted men and 4,459 recruits ranging in age from 18.00 to 18.99 years. The statistical processing employed two-way analysis of variance procedure, simple linear regression comparing height and year of birth and multiple analysis controlling for schooling (regression coefficient) and the chi-square. The results show that enlisted men and recruits displayed height increments, characterizing a contemporary process of secular trend. Such increments were also present in the country's various macro-regions. The results were compared to a recent investigation of a national scope - the National Survey on Health and Nutrition (PNSN) - and both enlisted men and recruits displayed higher median height than that reported by the PNSN. Level of schooling for individuals in the Navy is high, far superior to that of the Brazilian population as a whole. This set of data suggests that young men enlisting in the Navy are on average of a higher socioeconomic status than the Brazilian population in general, which limits possibilities for extrapolating the findings from this research.

Journal Article↗
PubMedDate not supplied

[Secular trends in the stature of Brazilian Navy recruits born from 1940 and 1965].

The present paper reports data on secular trends in the stature of Brazilian Navy recruits born from 1940 to 1965. The final sample included 3269 individuals aged 18.00-18.99. Statistics performed were: ANOVA (one-way and two-way), Sheffe test, simple linear regression between stature and year of birth, and multiple linear regression adjusting for level of schooling (beta coefficient) and chi-square. Results indicated a progressive growth trend in stature of 0.1 cm/yr. for the country as a whole. The trend was also observed for nearly all regions and two out of three levels of schooling and can be explained by improvement in some of the country's health indicators. One important characteristic was a higher level of schooling observed among Navy recruits, suggesting that these individuals represent a highly select group, and that therefore data on the Navy cannot be applied directly to the Brazilian population as a whole.

Adolescent↗
PubMed1996

Maternal characteristics and inadequate prenatal care.

This study examined the effects of traditional risk factors on receipt of inadequate prenatal care when controlling for interactions of multiple factors. Birth certificate data on 11,936 births were obtained from a state birth cohort file. A logistic regression model indicated significant interactions between maternal ethnicity (black vs white), marital status, and education in the prediction of inadequate prenatal care. Examining only main effects and ignoring interactions can produce oversimplified conclusions about individual risk factors.

Adolescent↗
PubMed1994

Vaginal operative deliveries in Italy.

OBJECTIVE: To analyze the trends in vaginal operative deliveries in Italy. DESIGN: Analysis of information on all deliveries after the 28th week of gestation, routinely collected by the Italian Central Institute of Statistics using a standard form. SETTING: National data on all Italian deliveries in the period 1981-85. SUBJECTS: All deliveries occurred in Italy in the period. RESULTS: Forceps and vacuum delivery were reported in 1981 respectively in 0.9 and 2.1/100 deliveries. Similar percentages were observed during the whole considered quinquennium for vacuum extraction, but the forceps delivery rate decreased to 0.6/100 in 1985. Nulliparous women more frequently had an operative vaginal delivery: the rates of forceps and vacuum deliveries were respectively 1.1 and 3.7/100 in nulliparae and 0.3 and 1.0 in women reporting one or more previous births. There was a direct relationship between vacuum delivery rate and birth weight: vacuum deliveries were reported for respectively 0.9 and 2.3/100 infants weighing less than 2500 g and > or = 2500 g. Likewise, vaginal operative deliveries were more frequent in term or post-term births, and vacuum deliveries among singleton births than multiple ones (2.3 vs 1.7/100 deliveries). CONCLUSIONS: Operative vaginal delivery rates in Italy in the mid 1980's were lower than in most developed countries. The reasons for forceps and vacuum extraction were similar to other developed countries with regard to obstetric determinants, but some differences emerged for socio-demographic factors.

Adult↗
PubMed1996

Relationship between birth weight and biochemical measures of maternal nutritional status at delivery in Bangladeshi urban poors.

A cross-sectional study was carried out to investigate relationship of birth weight with selected biochemical indices of nutritional status of mothers at delivery in poor urban population of Dhaka, Bangladesh. One hundred and fifty one pregnant women of known gestational length, aged 20-30 years, who attended a local maternity hospital for delivery participated in this study. All of them were free from any pregnancy complications or diseases, and delivered a singleton fullterm baby. Socio-economic and obstetric history were taken by interview. Anthropometric data and blood samples were collected on the same day. Twenty per cent of the participants were anaemic (Hb < 11.0 g dl-1), 49% had subnormal (< 4.0 g dl-1) serum albumin and 32.5% had serum vitamin A lower than adequate level (< 30.0 micrograms dl-1). Mothers who gave birth to low birth weight babies had lower levels of haemoglobin (P = 0.06), serum albumin (P = 0.02) and serum vitamin A (P = 0.05) at delivery compared with the mothers who gave birth to normal weight babies. After adjustment for various confounding factors, only serum albumin level remained significantly lower in the mothers of low birth weight babies. Using multiple regression analysis for birth weight, the overall F-ratio was calculated to be 12.5 and was highly significant (P = 0.0000). The adjusted R2 was 0.32. Gestational age, father's occupation, mother's body weight and serum albumin level were found to have significant independent effect on birth weight.

Adult↗
PubMedDate not supplied

Lethal arthrogryposis multiplex congenital (fetal akinesia deformation sequence, FADS).

Arthrogryposis multiplex congenital (AMC) is the presence at birth of multiple congenital contractures in an intact skeleton. The severity of the condition is highly variable and the possible underlying causes are numerous. Fetal immobility and lesions of the brain, spinal cord, peripheral nerves and muscle, along with mechanical restriction of the fetus in utero are the pathogenic mechanisms that need to be considered. Etiological factors that have been implicated in the development of AMC include genetic conditions, infections, drugs, toxins, maternal hyperthermia, and maternal illness. This review will concentrate on the severe end of the spectrum of AMC that results in disease that is lethal pre- or postnatally, and will discuss the pathology, pathogenesis, etiology, and practical approach to this diversely expressed condition.

Arthrogryposis↗
PubMed1994

Adult T-cell leukemia/lymphoma in a Korean--a case report.

The clinicopathologic features of a Korean patient with adult T-cell leukemia/lymphoma(ATLL) are presented. A 51-year-old man, who has lived in Korea since birth, had multiple cutaneous nodules and multiple lymphadenopathy for the previous two months. A histopathologic study of the lymph node and skin lesion revealed T-cell non-Hodgkin's lymphoma of pleomorphic type, medium and large cell type. Peripheral blood examination showed leukemic features with 30% of abnormal lymphoid cells. HTLV-I proviral DNA pX region was detected in the DNA from peripheral blood mononuclear cells(PBMC) and the specific gag, pol, and env HTLV-I sequences were detected in the lymph node using polymerase chain reaction technique. Human T-cell leukemia/lymphoma type I(HTLV-I) antibodies were present in the serum. An immunophenotypic study of the lymph node revealed CD4 positive and CD8 negative helper/inducer T cell type surface markers. This case is the acute type, i.e. prototypic ATLL. He was treated with an intensive chemotherapy including cyclophosphamide, etoposide, doxorubicin, vincristine, and prednisone. Despite initial transient improvement, the tumor progressed after three cycles of the regimen and became refractory to further chemotherapy. These clinicopathologic findings, including the immunophenotypic analysis, established with certainty the diagnosis of HTLV-I-induced adult T-cell leukemia/lymphoma.

Antineoplastic Combined Chemotherapy Protocols↗