Radiation dose to Malaysian infants from natural radionuclides via consumption of powdered milk

Energy Technology Data Exchange (ETDEWEB)

Uwatse, Onosohwo Bemigho; Olatunji, Michael Adekunle; Khandaker, Mayeen Uddin; Amin, Yusoff Mohd. [Department of Physics, University of Malaya, Kuala Lumpur 50603 (Malaysia)

2015-04-24

Milk is the basic food stuff for the infants because they generally consume more milk on a daily basis as its minerals and proteins are essential for their growth and development, therefore, it is very important to assess the natural radioactivity levels and the associated dose in the widely consumed powered infant’s milk. As a result, 14 brands of infant’s powdered milk were collected from different supermarkets around Selangor, Malaysia and analysed for {sup 226}Ra, {sup 232}Th and {sup 40}K activities. The obtained mean activity of {sup 226}Ra, {sup 232}Th and {sup 40}K are 3.05±1.84, 2.55±2.48 and 99.1±69.5 Bqkg{sup −1}, respectively. Among the analysed milk samples, the brand from Philippines (Lactogen) showed low level of radioactivity while Singaporean brand (S26 SMA Gold) showed the highest. The estimated mean annual effective doses due to the ingestion of natural radionuclides in the sampled milk are 635 and 111 µSv for infant ≤ 1y and infant 1-2y, respectively. The obtained dose value does not yet pose any significant radiological hazards to the population under investigation comparing with the 1.0 mSvy{sup −1} recommended by ICRP for all ages.

Radiation dose to Malaysian infants from natural radionuclides via consumption of powdered milk

International Nuclear Information System (INIS)

Uwatse, Onosohwo Bemigho; Olatunji, Michael Adekunle; Khandaker, Mayeen Uddin; Amin, Yusoff Mohd.

2015-01-01

Milk is the basic food stuff for the infants because they generally consume more milk on a daily basis as its minerals and proteins are essential for their growth and development, therefore, it is very important to assess the natural radioactivity levels and the associated dose in the widely consumed powered infant’s milk. As a result, 14 brands of infant’s powdered milk were collected from different supermarkets around Selangor, Malaysia and analysed for 226 Ra, 232 Th and 40 K activities. The obtained mean activity of 226 Ra, 232 Th and 40 K are 3.05±1.84, 2.55±2.48 and 99.1±69.5 Bqkg −1 , respectively. Among the analysed milk samples, the brand from Philippines (Lactogen) showed low level of radioactivity while Singaporean brand (S26 SMA Gold) showed the highest. The estimated mean annual effective doses due to the ingestion of natural radionuclides in the sampled milk are 635 and 111 µSv for infant ≤ 1y and infant 1-2y, respectively. The obtained dose value does not yet pose any significant radiological hazards to the population under investigation comparing with the 1.0 mSvy −1 recommended by ICRP for all ages

Intubation conditions in young infants after propofol and remifentanil induction with and without low-dose rocuronium.

Science.gov (United States)

Gelberg, J; Kongstad, L; Werner, O

2014-08-01

Bolus injections of intravenous propofol and remifentanil can be used in the tracheal intubation of infants and children, but relatively large doses are needed. We hypothesised that addition of a small bolus of rocuronium would ensure good intubation conditions when modest propofol and remifentanil doses were used. Seventy infants between 3 weeks and 4 months of age were randomised to receive either placebo or rocuronium. Anaesthesia was induced with IV propofol, 3 (3-5) mg/kg [median (range)]. Rocuronium (0.2 mg/kg) or placebo was then injected, followed 15 s later by 2 μg/kg remifentanil. One anaesthetist attempted tracheal intubation 1 min after the rocuronium/placebo injection and used the 'Copenhagen scoring system' to assess intubation conditions. The neuromuscular effect of 0.2 mg/kg rocuronium was recorded in another eight, already intubated, infants using thumb accelerometry during train-of-four stimulation of the ulnar nerve. Intubation conditions were classified as 'poor' in 14 of 34 (41%) patients given placebo and in 10 of 36 (28%) patients given rocuronium (P = 0.32). There were four failed first attempts at intubation in the placebo group and none in the rocuronium group (P = 0.051). Maximum neuromuscular depression occurred 4 (3-8) after injection of 0.2 mg/kg rocuronium. Intubation conditions were poor in almost one third of the patients receiving propofol-remifentanil. Adding a low-dose rocuronium did not significantly improve intubation conditions. © 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Dose response and efficacy of a live, attenuated human rotavirus vaccine in Mexican infants.

Science.gov (United States)

Ruiz-Palacios, Guillermo M; Guerrero, M Lourdes; Bautista-Márquez, Aurora; Ortega-Gallegos, Hilda; Tuz-Dzib, Fernando; Reyes-González, Leticia; Rosales-Pedraza, Gustavo; Martínez-López, Julia; Castañón-Acosta, Erika; Cervantes, Yolanda; Costa-Clemens, SueAnn; DeVos, Beatrice

2007-08-01

Immunization against rotavirus has been proposed as the most cost-effective intervention to reduce the disease burden associated with this infection worldwide. The objective of this study was to determine the dose response, immunogenicity, and efficacy of 2 doses of an oral, attenuated monovalent G1[P8] human rotavirus vaccine in children from the same setting in Mexico, where the natural protection against rotavirus infection was studied. From June 2001 through May 2003, 405 healthy infants were randomly assigned to 1 of 3 vaccine groups (virus concentrations 10(4.7), 10(5.2), and 10(5.8) infectious units) and to a placebo group and were monitored to the age of 2 years. The vaccine/placebo was administered concurrently with diphtheria-tetanus toxoid-pertussis/hepatitis B/Haemophilus influenzae type b vaccine at 2 and 4 months of age. After the administration of the first vaccine/placebo dose, weekly home visits to collect information regarding infant health were conducted. Stool samples were collected during each gastroenteritis episode and tested for rotavirus antigen and serotype. The vaccine was well tolerated and induced a greater rate of seroconversion than observed in infants who received placebo. For the pooled vaccine groups, efficacy after 2 oral doses was 80% and 95% against any and severe rotavirus gastroenteritis, respectively. Efficacy was 100% against severe rotavirus gastroenteritis and 70% against severe gastroenteritis of any cause with the vaccine at the highest virus concentration (10(5.8) infectious units). The predominant infecting rotavirus serotype in this cohort was wild-type G1 (85%). Adverse events, including fever, irritability, loss of appetite, cough, diarrhea, and vomiting, were similar among vaccinees and placebo recipients. This new oral, live, attenuated human rotavirus vaccine was safe, immunogenic, and highly efficacious in preventing any and, more importantly, severe rotavirus gastroenteritis in healthy infants. This vaccine

A dose-response study of dexmedetomidine administered as the primary sedative in infants following open heart surgery.

Science.gov (United States)

Su, Felice; Nicolson, Susan C; Zuppa, Athena F

2013-06-01

To evaluate the dose-response relationship of dexmedetomidine in infants with congenital heart disease postoperative from open heart surgery. Prospective open-label dose-escalation pharmacokinetic-pharmacodynamic study. Tertiary pediatric cardiac ICU. Thirty-six evaluable infants, 1-24 months old, postoperative from open heart surgery requiring mechanical ventilation. Cohorts of 12 infants were enrolled sequentially to one of the three IV loading doses of dexmedetomidine (0.35, 0.7, and 1 mcg/kg) over 10 minutes followed by respective continuous infusions (0.25, 0.5, and 0.75 mcg/kg/hr) for up to 24 hours. Dexmedetomidine plasma concentrations were obtained at timed intervals during and following discontinuation of infusion. Pharmacodynamic variables evaluated included sedation scores, supplemental sedation and analgesia medication administration, time to tracheal extubation, respiratory function, and hemodynamic parameters. Infants achieved a deeper sedation measured by the University of Michigan Sedation Scale score (2.6 vs 1) despite requiring minimal supplemental sedation (0 unit doses/hr) and fewer analgesic medications (0.07 vs 0.15 unit doses/hr) while receiving dexmedetomidine compared with the 12-hour follow-up period. Thirty-one patients were successfully extubated while receiving the dexmedetomidine infusion. Only one patient remained intubated due to oversedation during the infusion. While receiving dexmedetomidine, there was a decrease in heart rate compared with baseline, 132 versus 161 bpm, but there was an increase in heart rate compared with postinfusion values, 132 versus 128 bpm. There was no statistically or clinically significant change in mean arterial blood pressure. Dexmedetomidine administration in infants following open heart surgery can provide improved sedation with reduction in supplemental medication requirements, leading to successful extubation while receiving a continuous infusion. The postoperative hemodynamic changes that occur in

Infant pain-related negative affect at 12 months of age: early infant and caregiver predictors.

Science.gov (United States)

Din Osmun, Laila; Pillai Riddell, Rebecca; Flora, David B

2014-01-01

To examine the predictive relationships of early infant and caregiver variables on expressed pain-related negative affect duration at the 12-month immunization. Infants and their caregivers (N = 255) were followed during immunization appointments over the first year of life. Latent growth curve modeling in a structural equation modeling context was used. Higher levels of initial infant pain reactivity at 2 months and caregiver emotional availability averaged across 2, 4, and 6 months of age were related to larger decreases in the duration of infant negative affect over the first 6 months of life. Longer duration of infant negative affect at 2 months and poorer regulation of infant negative affect over the first 6 months of life predicted longer durations of infant negative affect by 12 months. Infant negative affect at 12 months was a function of both infant factors and the quality of caregiver interactive behaviors (emotional availability) in early infancy.

Image quality and dose optimisation for infant CT using a paediatric phantom

Energy Technology Data Exchange (ETDEWEB)

Lambert, Jack W.; Phelps, Andrew S.; Courtier, Jesse L.; Gould, Robert G.; MacKenzie, John D. [University of California, San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States)

2016-05-15

To optimise image quality and reduce radiation exposure for infant body CT imaging. An image quality CT phantom was created to model the infant body habitus. Image noise, spatial resolution, low contrast detectability and tube current modulation (TCM) were measured after adjusting CT protocol parameters. Reconstruction method (FBP, hybrid iterative and model-based iterative), image quality reference parameter, helical pitch and beam collimation were systematically investigated for their influence on image quality and radiation output. Both spatial and low contrast resolution were significantly improved with model-based iterative reconstruction (p < 0.05). A change in the helical pitch from 0.969 to 1.375 resulted in a 23 % reduction in total TCM, while a change in collimation from 20 to 40 mm resulted in a 46 % TCM reduction. Image noise and radiation output were both unaffected by changes in collimation, while an increase in pitch enabled a dose length product reduction of ∝6 % at equivalent noise. An optimised protocol with ∝30 % dose reduction was identified using model-based iterative reconstruction. CT technology continues to evolve and require protocol redesign. This work provides an example of how an infant-specific phantom is essential for leveraging this technology to maintain image quality while reducing radiation exposure. (orig.)

The missing link: mothers' neural response to infant cry related to infant attachment behaviors.

Science.gov (United States)

Laurent, Heidemarie K; Ablow, Jennifer C

2012-12-01

This study addresses a gap in the attachment literature by investigating maternal neural response to cry related to infant attachment classifications and behaviors. Twenty-two primiparous mothers and their 18-month old infants completed the Strange Situation (SS) procedure to elicit attachment behaviors. During a separate functional MRI session, mothers were exposed to their own infant's cry sound, as well as an unfamiliar infant's cry and control sound. Maternal neural response to own infant cry related to both overall attachment security and specific infant behaviors. Mothers of less secure infants maintained greater activation to their cry in left parahippocampal and amygdala regions and the right posterior insula consistent with a negative schematic response bias. Mothers of infants exhibiting more avoidant or contact maintaining behaviors during the SS showed diminished response across left prefrontal, parietal, and cerebellar areas involved in attentional processing and cognitive control. Mothers of infants exhibiting more disorganized behavior showed reduced response in bilateral temporal and subcallosal areas relevant to social cognition and emotion regulation. No differences by attachment classification were found. Implications for attachment transmission models are discussed. Copyright © 2012 Elsevier Inc. All rights reserved.

Randomized, open-label, single-dose, crossover, relative bioavailability study in healthy adults, comparing the pharmacokinetics of rabeprazole granules administered using soft food or infant formula as dosing vehicle versus suspension.

Science.gov (United States)

Thyssen, An; Solanki, Bhavna; Treem, William

2012-07-01

A sprinkle capsule formulation containing enteric-coated, delayed-release rabeprazole granules is being developed for the treatment of children with gastrointestinal reflux disease. The granules are designed to be mixed with vehicles that facilitate delivery to children, who may be unable to swallow solid formulations. The primary objective of this study-conducted on the sponsor's initiative-was to compare the bioavailability of rabeprazole granules when mixed with various dosing vehicles (small amount of soft food or infant formula) with that of a rabeprazole suspension with inactive vehicle granules (reference), to determine which dosing vehicle can be used to deliver rabeprazole in children. Tolerability was also assessed. This single-center, single-dose, randomized, open-label, 5-period crossover study was conducted in 35 healthy adult subjects. In a randomized sequence, fasting subjects received a single dose of 10-mg rabeprazole granules per treatment period, mixed with small amounts of 1 of 5 dosing vehicles (a strawberry-flavored suspension of rabeprazole granules with inactive vehicle granules reconstituted with water, yogurt [1 tablespoon], applesauce [1 tablespoon], or infant formula [5 mL], or a suspension of rabeprazole granules with inactive vehicle tablet reconstituted with water). Full plasma pharmacokinetic (PK) profiles of rabeprazole and its thioether metabolite were collected; concentrations were estimated via LC-MS/MS. PK properties were estimated using noncompartmental methods; 90% CIs around least squares mean test-to-reference ratios were calculated for C(max) and AUC values. All treatment-emergent adverse events (TEAEs) were recorded and assessed for severity (mild, moderate, or severe) and relationship to study drug. A total of 35 subjects were enrolled (mean age, 38 years; 54.3% female; 100% white; mean weight, 71.4 kg). Thirty-four subjects completed the study. Rabeprazole and rabeprazole thioether plasma PK properties were comparable

Neutron- and photon-activation detection limits in breast milk analysis for prospective dose evaluation of the suckling infant

International Nuclear Information System (INIS)

Tsipenyuk, Yu.M.; Firsov, V.I.; Cantone, M.C.

2009-01-01

Complex situations related to the environment, as in the regions affected by the Chernobyl accident and regions in which nuclear weapons testing were undertaken, as in Semipalatinsk, could be reflected in the trace element content in mothers' milk. The evaluation of fractional transfer to milk of ingested or inhaled activity and of the corresponding dose coefficients for the infant, following a mothers' radioactive intake, can take advantage from wide-ranging studies of elemental and radionuclide contents in mothers' milk. In this work the possibility to determine elements, such as Ru, Zr, Nb, Te, Ce, Th, U, in milk powder has been investigated. Although results from elemental analyses of breast milk are to be found in the literature, the determination of the identified elements has attracted poor attention since they are not considered essential elements from a biological point of view. Nevertheless, in the case of radioactive releases to the environment, such data could be of interest in evaluation of dose to the breast-fed infant

Relations between maternal attachment representations and the quality of mother-infant interaction in preterm and full-term infants.

Science.gov (United States)

Korja, Riikka; Ahlqvist-Björkroth, Sari; Savonlahti, Elina; Stolt, Suvi; Haataja, Leena; Lapinleimu, Helena; Piha, Jorma; Lehtonen, Liisa

2010-06-01

The aim of the study was to assess the relationship between maternal representations and the quality of mother-infant interaction in a group of preterm and full-term infants. The study groups consisted of 38 mothers and their preterm infants (quality of mother-infant interaction was studied using the Parent-Child Early Relational Assessment (PCERA) method at 6 and 12 months of the infant's corrected age. The results showed that maternal representations are related to the quality of mother-infant interaction in a parallel manner in preterm and full-term infants and their mothers. Furthermore, distorted representations were more strongly related to a higher number of areas of concern in mother-infant interaction than other representation classifications. Our results underline the importance of combined assessment of the subjective experiences of the mother and the quality of mother-infant interaction in clinical follow-up. This is the first study to describe the relation between maternal attachment representations and the quality of mother-infant interaction involving preterm infants. Copyright 2010 Elsevier Inc. All rights reserved.

Effective dose equivalent to breast fed infants due to artificial and natural radioactivity

International Nuclear Information System (INIS)

Campos Venuti, G.; Felici, F.; Grisanti, A.; Grisanti, G.; Risica, S.; Simula, S.

1988-01-01

After the Chernobyl accident, the Italian National Institute of Health (ISS), with the collaboration of the Epidemiological Unit of Latium District, started a research devoted to the study of the radioactive contamination of human milk in Latium. The motivation is three-fold, namely: to measure the contamination of a food product utilised for infants in order to assess the corresponding dose to breast-fed infants; to clarify any possible correlations between radioactive levels in human milk and those in the total body; to correlate the levels in human milk with those in the maternal diet

The missing link: Mothers’ neural response to infant cry related to infant attachment behaviors

Science.gov (United States)

Laurent, Heidemarie K.; Ablow, Jennifer C.

2012-01-01

This study addresses a gap in the attachment literature by investigating maternal neural response to cry related to infant attachment classifications and behaviors. Twenty-two primiparous mothers and their 18-month old infants completed the Strange Situation Procedure (SS) to elicit attachment behaviors. During a separate functional MRI session, mothers were exposed to their own infant’s cry sound, as well as an unfamiliar infant’s cry and control sound. Maternal neural response to own infant cry related to both overall attachment security and specific infant behaviors. Mothers of less secure infants maintained greater activation to their cry in left parahippocampal and amygdala regions and the right posterior insula. consistent with a negative schematic response bias. Mothers of infants exhibiting more avoidant or contact maintaining behaviors during the SS showed diminished response across left prefrontal, parietal, and cerebellar areas involved in attentional processing and cognitive control. Mothers of infants exhibiting more disorganized behavior showed reduced response in bilateral temporal and subcallosal areas relevant to social cognition and emotion regulation. No differences by attachment classification were found. Implications for attachment transmission models are discussed. PMID:22982277

SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment.

Science.gov (United States)

Moon, Rachel Y

2011-11-01

Despite a major decrease in the incidence of sudden infant death syndrome (SIDS) since the American Academy of Pediatrics (AAP) released its recommendation in 1992 that infants be placed for sleep in a nonprone position, this decline has plateaued in recent years. Concurrently, other causes of sudden unexpected infant death occurring during sleep (sleep-related deaths), including suffocation, asphyxia, and entrapment, and ill-defined or unspecified causes of death have increased in incidence, particularly since the AAP published its last statement on SIDS in 2005. It has become increasingly important to address these other causes of sleep-related infant death. Many of the modifiable and nonmodifiable risk factors for SIDS and suffocation are strikingly similar. The AAP, therefore, is expanding its recommendations from being only SIDS-focused to focusing on a safe sleep environment that can reduce the risk of all sleep-related infant deaths including SIDS. The recommendations described in this report include supine positioning, use of a firm sleep surface, breastfeeding, room-sharing without bed-sharing, routine immunization, consideration of a pacifier, and avoidance of soft bedding, overheating, and exposure to tobacco smoke, alcohol, and illicit drugs. The rationale for these recommendations is discussed in detail in this technical report. The recommendations are published in the accompanying "Policy Statement--Sudden Infant Death Syndrome and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment," which is included in this issue (www.pediatrics.org/cgi/doi/10.1542/peds.2011-2220).

A novel six consecutive monthly doses of palivizumab prophylaxis protocol for the prevention of respiratory syncytial virus infection in high-risk preterm infants in Taiwan.

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Hsin Chi

Full Text Available Respiratory syncytial virus (RSV circulates year round in Taiwan. A novel six consecutive monthly doses of palivizumab for RSV prevention protocol has been approved for high risk preterm infants since December 2010. This study aimed to determine the clinical effectiveness and safety of this novel protocol for the prevention of RSV infection.From April 2011 to March 2013, we enrolled infants born at ≤28 weeks gestation and infants born at ≤35 weeks gestation with chronic lung disease (CLD who received palivizumab prophylaxis as study group and followed up for 12 months. Historic control, those who were born and followed up between July 2000 and June 2008, were retrieved for propensity score matching. Primary endpoint was RSV-related hospitalization, and secondary endpoints included the length of hospital stay and intensive care unit (ICU care.We enrolled 127 infants (108 infants born at ≤28 weeks and 19 infants born at 29-35 weeks with CLD. They completed 6-dose palivizumab as scheduled. Among the study group, the RSV-related hospitalizations were 2 (1.6% within 6 months and 5 (3.9% within 12 months after discharge. We matched 127 infants in the control group with 127 infants in the study group by propensity score matching. The reduction of RSV-related hospitalization rates were 86% (10.2% vs 1.6%, p = 0.002 within 6 months after discharge and 78% (15.7% vs 3.9%, p = 0.004 within 12 months after discharge. Compared to the control group, the rate of ICU care significantly decreased from 7.1% to 0.8% (p = 0.024 within 6 months after discharge and from 7.9% to 0.8% (p = 0.014 within 12 months after discharge. Adverse events were recorded in 6.4% injections.Six monthly intramuscular administration of palivizumab is effective for prevention of RSV hospitalization in regions with no single seasonal peak of RSV infection such as Taiwan.

Nighttime parenting strategies and sleep-related risks to infants.

Science.gov (United States)

Volpe, Lane E; Ball, Helen L; McKenna, James J

2013-02-01

A large social science and public health literature addresses infant sleep safety, with implications for infant mortality in the context of accidental deaths and Sudden Infant Death Syndrome (SIDS). As part of risk reduction campaigns in the USA, parents are encouraged to place infants supine and to alter infant bedding and elements of the sleep environment, and are discouraged from allowing infants to sleep unsupervised, from bed-sharing either at all or under specific circumstances, or from sofa-sharing. These recommendations are based on findings from large-scale epidemiological studies that generate odds ratios or relative risk statistics for various practices; however, detailed behavioural data on nighttime parenting and infant sleep environments are limited. To address this issue, this paper presents and discusses the implications of four case studies based on overnight observations conducted with first-time mothers and their four-month old infants. These case studies were collected at the Mother-Baby Behavioral Sleep Lab at the University of Notre Dame USA between September 2002 and June 2004. Each case study provides a detailed description based on video analysis of sleep-related risks observed while mother-infant dyads spent the night in a sleep lab. The case studies provide examples of mothers engaged in the strategic management of nighttime parenting for whom sleep-related risks to infants arose as a result of these strategies. Although risk reduction guidelines focus on eliminating potentially risky infant sleep practices as if the probability of death from each were equal, the majority of instances in which these occur are unlikely to result in infant mortality. Therefore, we hypothesise that mothers assess potential costs and benefits within margins of risk which are not acknowledged by risk-reduction campaigns. Exploring why mothers might choose to manage sleep and nighttime parenting in ways that appear to increase potential risks to infants may

Objective factors affecting the image quality of low-dose cranial CT of infant

International Nuclear Information System (INIS)

Xie Na; Gan Yungen; Wang Hongwei; Zeng Hongwu; Cao Weiguo; Sun Longwei

2010-01-01

Objective: To investigate the objective factors that affect the image quality of infant cranial CT using different mAs. Materials and Methods: Ninety infants were divided into three groups randomly. The maximum anteroposterior diameter (MAPD) of skull of each infant was measured. Three reference levels, cerebellar, basal ganglia and centrum semiovale levels were selected respectively. Only one level was studied in each group and scanned with 150, 100 and 80 mAs. The subjective quality grade and the objective noise of all images were recorded and analysed statistically. Results: The average MAPD of ninety patients was (148.0±17.4) mm. On the cerebellar level, the subjective quality grade was lower than the other two levels, which were 6.3%, 9.4% and 22.9% respectively when mAs were 150, 100 and 80 mAs. Both quality grade of image and objective noise were significantly correlated with MAPD. Conclusions: The inherent high noise of cerebellar level and MAPD were the objective factors that affect the image quality of low-dose cranial CT of infant. (authors)

Assessment of Dose to the Nursing Infant from Radionuclides in Breast Milk

Energy Technology Data Exchange (ETDEWEB)

Leggett, Richard Wayne [ORNL; Eckerman, Keith F [ORNL

2010-03-01

A computer software package was developed to predict tissue doses to an infant due to intake of radionuclides in breast milk based on bioassay measurements and exposure data for the mother. The package is intended mainly to aid in decisions regarding the safety of breast feeding by a mother who has been acutely exposed to a radionuclide during lactation or pregnancy, but it may be applied to previous intakes during the mother s adult life. The package includes biokinetic and dosimetric information needed to address intake of Co-60, Sr-90, Cs-134, Cs-137, Ir-192, Pu-238, Pu-239, Am-241, or Cf-252 by the mother. It has been designed so that the library of biokinetic and dosimetric files can be expanded to address a more comprehensive set of radionuclides without modifying the basic computational module. The methods and models build on the approach used in Publication 95 of the International Commission on Radiological Protection (ICRP 2004), Doses to Infants from Ingestion of Radionuclides in Mothers Milk . The software package allows input of case-specific information or judgments such as chemical form or particle size of an inhaled aerosol. The package is expected to be more suitable than ICRP Publication 95 for dose assessment for real events or realistic planning scenarios in which measurements of the mother s excretion or body burden are available.

How do parents' depression and anxiety, and infants' negative temperament relate to parent-infant face-to-face interactions?

Science.gov (United States)

Aktar, Evin; Colonnesi, Cristina; de Vente, Wieke; Majdandžić, Mirjana; Bögels, Susan M

2017-08-01

The present study investigated the associations of mothers' and fathers' lifetime depression and anxiety symptoms, and of infants' negative temperament with parents' and infants' gaze, facial expressions of emotion, and synchrony. We observed infants' (age between 3.5 and 5.5 months, N = 101) and parents' gaze and facial expressions during 4-min naturalistic face-to-face interactions. Parents' lifetime symptoms of depression and anxiety were assessed with clinical interviews, and infants' negative temperament was measured with standardized observations. Parents with more depressive symptoms and their infants expressed less positive and more neutral affect. Parents' lifetime anxiety symptoms were not significantly related to parents' expressions of affect, while they were linked to longer durations of gaze to parent, and to more positive and negative affect in infants. Parents' lifetime depression or anxiety was not related to synchrony. Infants' temperament did not predict infants' or parents' interactive behavior. The study reveals that more depression symptoms in parents are linked to more neutral affect from parents and from infants during face-to-face interactions, while parents' anxiety symptoms are related to more attention to parent and less neutral affect from infants (but not from parents).

Infant Physical Attractiveness, Affect, Temperament, and Gender in Relation to Tester Behavior

OpenAIRE

Hart, Andrea D.

1996-01-01

Easily observable infant characteristics have been shown to influence others; perceptions of infant competence. This study examined the relation between infant characteristics and a tester's willingness to repeat opportunities for the infant to pass items during administration of a cognitive test. Results showed that infant physical attractiveness was related to lower elicited infant performance (the ratio of items initially failed). Positive affect was related to higher test scores. Because ...

Intravenous paracetamol with a lower dose is also effective for the treatment of patent ductus arteriosus in pre-term infants.

Science.gov (United States)

Tekgündüz, Kadir Şerafettin; Ceviz, Naci; Caner, İbrahim; Olgun, Haşim; Demirelli, Yaşar; Yolcu, Canan; Şahin, İrfan Oğuz; Kara, Mustafa

2015-08-01

Haemodynamically significant patent ductus arteriosus is a significant cause of morbidity and mortality in pre-term infants. This retrospective study was conducted to investigate the usefulness of lower-dose paracetamol for the treatment of patent ductus arteriosus in pre-term infants. A total of 13 pre-term infants who received intravenous paracetamol because of contrindications or side effects to oral ibuprofen were retrospectively enrolled. In the first patient, the dose regimen was 15 mg/kg/dose, every 6 hours. As the patient developed significant elevation in transaminase levels, the dose was decreased to 10 mg/kg/dose, every 8 hours in the following 12 patients. Echocardiographic examination was conducted daily. In case of closure, it was repeated after 2 days and when needed thereafter in terms of reopening. A total of 13 patients received intravenous paracetamol. Median gestational age was 29 weeks ranging from 24 to 31 weeks and birth weight was 950 g ranging from 470 to 1390 g. The median postnatal age at the first intravenous paracetamol dose was 3 days ranging from 2 to 9 days. In 10 of the 13 patients (76.9%), patent ductus arteriosus was closed at the median 2nd day of intravenous paracetamol ranging from 1 to 4 days. When the patient who developed hepatotoxicity was eliminated, the closure rate was found to be 83.3% (10/12). Intravenous paracetamol may be a useful treatment option for the treatment of patent ductus arteriosus in pre-term infants with contrindication to ibuprofen. In our experience, lower-dose paracetamol is effective in closing the patent ductus arteriosus in 83.3% of the cases.

Evaluation of image quality and radiation dose of thoracic and coronary dual-source CT in 110 infants with congenital heart disease

International Nuclear Information System (INIS)

Saad, Moez Ben; Rohnean, Adela; Sigal-Cinqualbre, Anne; Adler, Ghazal; Paul, Jean-Francois

2009-01-01

There are only a few reports on the diagnostic accuracy, and the technical and clinical feasibility, of multidetector CT (MDCT) in infants with congenital heart disease (CHD). To evaluate the image quality and radiation dose of DSCT in babies with CHD. From November 2006 to November 2007, 110 consecutive infants with CHD referred for pre- or postoperative CT evaluation were included. All these infants had a spiral angiothoracic DSCT scan after injection of 300 mg/ml iopromide at 0.5-1 ml/s with a power injector using a low-dose protocol (80 kVp and 10 mAs/kg). Of these infants, 34 also underwent an ECG-gated coronary CT scan for evaluation of the course of the coronary arteries. No serious adverse events were recorded. The mean dose-length product was 8±6 mGy.cm (effective dose 0.5±0.2 mSv) and 21±9 mGy.cm (effective dose 1.3±0.6 mSv) during the non-ECG-gated spiral acquisition and ECG-gated acquisition, respectively. Diagnostic quality images were achieved with the spiral acquisition in 89% of cases. Compared to the spiral mode, ECG-gated acquisition significantly improved the visualization of the coronary arteries, with a diagnostic rate of 91% and 84% for the left and right coronary arteries, respectively. DSCT together with iopromide at 300 mg/ml is a valuable tool for the routine clinical evaluation of infants with CHD. ECG-gated acquisition provides reliable visualization of the course of the coronary arteries. (orig.)

Dose from radiological examinations

International Nuclear Information System (INIS)

Imamura, Keiko; Uji, Teruyuki; Sakuyama, Keiko; Fujikawa, Mitsuhiro; Fujii, Masamichi

1976-01-01

Relatively high gonad doses, several hundred to one thousand mR, have been observed in case of pelvis, hip-joint, coccyx, lower abdomen and lumber examination. Dose to the ovary is especially high in barium enema and I.V.P. examinations. About 12 per cent of the 4-ray examination are high-dose. The gonad dose is relatively high in examination of abdomen and lower extremities, in infants. The dose to the eyes is especially high, 1.0 to 2.5R per exposure, in temporal bone and nasal sinuses tomography. X-ray doses have been compared with dose limits recommended by ICRP and with the gonad dose from natural radiations. The gonad dose in lumbar examination, barium enema, I.V.P. etc. is as high as the maximum permissible dose per year recommended by ICRP. Several devices have been made for dose reduction in the daily examinations: (1) separating the radiation field from the gonad by one centimeter decreases the gonad dose about one-half. (2) using sensitive screens and films. In pelvimetry and in infant hip-joint examination, the most sensitive screen and film are used. In the I.V.P. examination of adult, use of MS screen in place of FS screen decreases the dose to one-third, in combination with careful setting of radiation field, (3) use of grid increases the dose about 50 percent and the lead rubber protection (0.1mm lead equivalent) decreases the gonad dose to one-thirtieth in the spinal column examination of infant, (4) A lead protector, 1mm thickness and 2.5cm in diameter, on the eyes decreases the dose to about one-eighth in the face and nead examinations. These simple and effective methods for dose reduction. Should be carried out in as many examinations as possible in addition to observing dose limits recommended by ICRP. (Evans, J.)

Determination of 210Po concentration in commercially available infant formulae and assessment of daily ingestion dose

OpenAIRE

Prabhath, Ravi K.; Sreejith, Sathyapriya R.; Nair, Madhu G.; Rao, D.D.; Pradeepkumar, K.S.

2015-01-01

A study has been conducted to estimate the concentration of natural radioactive polonium in commercially available packaged infant food formulae available in Mumbai, India and the corresponding daily dose normalized based on its shelf life. Eleven most popular international brands of infant formulae were sourced from market and three aliquots from each sample were analysed for concordant results. Autodeposition method onto a silver planchet from hot dilute acid solution followed by alpha spec...

Randomized controlled trial comparing different single doses of intravenous paracetamol for placement of peripherally inserted central catheters in preterm infants

NARCIS (Netherlands)

D.W.E. Roofthooft (Daniella); S.H. Simons (Sinno); R.A. Lingen (Richard); D. Tibboel (Dick); J.N. van den Anker (John); I.K.M. Reiss (Irwin); M. van Dijk (Monique)

2017-01-01

markdownabstract__Background:__ The availability of a safe and effective pharmacological therapy to reduce procedural pain in preterm infants is limited. The effective analgesic single dose of intravenous paracetamol in preterm infants is unknown. Comparative studies on efficacy of different

Symptomatic acquired zinc deficiency in at-risk premature infants: high dose preventive supplementation is necessary.

Science.gov (United States)

Barbarot, Sébastien; Chantier, Emilie; Kuster, Alice; Hello, Muriel; Roze, Jean-Christophe; Blouin, Eric; Stalder, Jean-François

2010-01-01

Zinc is a cofactor for several enzymes involved in many metabolisms. Zinc deficiency induces various disorders such as acrodermatitis enteropathica, either inherited or acquired. We report three cases of premature infants (24-31 wks gestational age) with low birthweight (650 to 940 g) and enteropathy, two of whom presented with necrotizing enterocolitis. All infants were fed by total parenteral nutrition. At a chronological age ranging from 73 to 80 days, all infants developed a periorificial dermatitis. Before the onset of the first signs, they had received zinc supplementation ranging from 146% to 195% of the recommended dose (400 microg/kg/day). Increased zinc supplementation over a course of 6-18 days induced a complete resolution of symptoms in all cases. No abnormality in the neurologic examination and no recurrence were observed at the end of the zinc treatment. Low birthweight premature infants with enteropathy on total parenteral nutrition are at risk of developing zinc deficiency. The usual recommended zinc supplementation is probably insufficient for those infants. A delay in the diagnosis of zinc deficiency may lead to severe complications.

Multi-dose vitamin d supplementation in stable very preterm infants: Prospective randomized trial response to three different vitamin D supplementation doses.

Science.gov (United States)

Bozkurt, Ozlem; Uras, Nurdan; Sari, Fatma Nur; Atay, Funda Yavanoglu; Sahin, Suzan; Alkan, Ayse Dogan; Canpolat, Fuat Emre; Oguz, Serife Suna

2017-09-01

Preterm newborns are born with lower vitamin D stores. Although vitamin D supplementation is recommended there is no consensus regarding the adequate dose of supplementation for preterm infants. To assess the effect of three different doses of vitamin D supplementation (400, 800 and 1000IU/d) in preterm infants ≤32weeks gestation on the prevalence of vitamin D deficiency and 25(OH) D levels at 36weeks postmenstrual age (PMA). Prospective randomized trial. 121 preterm infants with gestational age of 24-32weeks were randomly allocated to receive 400, 800 or 1000IU/d vitamin D. Serum concentration of 25(OH) D and the prevalence of vitamin D deficiency at 36weeks PMA. Vitamin D deficiency was defined as serum 25(OH) D concentrations vitamin D levels before supplementation. The average 25(OH) vitamin D concentrations at 36weeks PMA were significantly higher in 800IU (40±21.4ng/ml) and 1000IU group (43±18.9ng/ml) when compared to 400IU group (29.4±13ng/ml). The prevalence of vitamin D deficiency (2.5 vs 22.5; RR: 0.09; CI:0.01-0.74) and insufficiency (30 vs 57.5; RR:0.32; CI:0.13-0.80) was significantly lower in 1000IU group when compared to 400IU group at 36weeks PMA. 1000IU/d of vitamin D supplementation in preterm infants ≤32weeks gestation age effectively decreases the prevalence of vitamin D deficiency and leads to higher concentrations of 25(OH) vitamin D at 36weeks PMA TRIAL REGISTRATION: Clinical Trials.gov: NCT02941185. Copyright © 2017. Published by Elsevier B.V.

Relative Importance and Additive Effects of Maternal and Infant Risk Factors on Childhood Asthma.

Science.gov (United States)

Wu, Pingsheng; Feldman, Amy S; Rosas-Salazar, Christian; James, Kristina; Escobar, Gabriel; Gebretsadik, Tebeb; Li, Sherian Xu; Carroll, Kecia N; Walsh, Eileen; Mitchel, Edward; Das, Suman; Kumar, Rajesh; Yu, Chang; Dupont, William D; Hartert, Tina V

2016-01-01

Environmental exposures that occur in utero and during early life may contribute to the development of childhood asthma through alteration of the human microbiome. The objectives of this study were to estimate the cumulative effect and relative importance of environmental exposures on the risk of childhood asthma. We conducted a population-based birth cohort study of mother-child dyads who were born between 1995 and 2003 and were continuously enrolled in the PRIMA (Prevention of RSV: Impact on Morbidity and Asthma) cohort. The individual and cumulative impact of maternal urinary tract infections (UTI) during pregnancy, maternal colonization with group B streptococcus (GBS), mode of delivery, infant antibiotic use, and older siblings at home, on the risk of childhood asthma were estimated using logistic regression. Dose-response effect on childhood asthma risk was assessed for continuous risk factors: number of maternal UTIs during pregnancy, courses of infant antibiotics, and number of older siblings at home. We further assessed and compared the relative importance of these exposures on the asthma risk. In a subgroup of children for whom maternal antibiotic use during pregnancy information was available, the effect of maternal antibiotic use on the risk of childhood asthma was estimated. Among 136,098 singleton birth infants, 13.29% developed asthma. In both univariate and adjusted analyses, maternal UTI during pregnancy (odds ratio [OR] 1.2, 95% confidence interval [CI] 1.18, 1.25; adjusted OR [AOR] 1.04, 95%CI 1.02, 1.07 for every additional UTI) and infant antibiotic use (OR 1.21, 95%CI 1.20, 1.22; AOR 1.16, 95%CI 1.15, 1.17 for every additional course) were associated with an increased risk of childhood asthma, while having older siblings at home (OR 0.92, 95%CI 0.91, 0.93; AOR 0.85, 95%CI 0.84, 0.87 for each additional sibling) was associated with a decreased risk of childhood asthma, in a dose-dependent manner. Compared with vaginal delivery, C

Relative Importance and Additive Effects of Maternal and Infant Risk Factors on Childhood Asthma.

Directory of Open Access Journals (Sweden)

Pingsheng Wu

Full Text Available Environmental exposures that occur in utero and during early life may contribute to the development of childhood asthma through alteration of the human microbiome. The objectives of this study were to estimate the cumulative effect and relative importance of environmental exposures on the risk of childhood asthma.We conducted a population-based birth cohort study of mother-child dyads who were born between 1995 and 2003 and were continuously enrolled in the PRIMA (Prevention of RSV: Impact on Morbidity and Asthma cohort. The individual and cumulative impact of maternal urinary tract infections (UTI during pregnancy, maternal colonization with group B streptococcus (GBS, mode of delivery, infant antibiotic use, and older siblings at home, on the risk of childhood asthma were estimated using logistic regression. Dose-response effect on childhood asthma risk was assessed for continuous risk factors: number of maternal UTIs during pregnancy, courses of infant antibiotics, and number of older siblings at home. We further assessed and compared the relative importance of these exposures on the asthma risk. In a subgroup of children for whom maternal antibiotic use during pregnancy information was available, the effect of maternal antibiotic use on the risk of childhood asthma was estimated.Among 136,098 singleton birth infants, 13.29% developed asthma. In both univariate and adjusted analyses, maternal UTI during pregnancy (odds ratio [OR] 1.2, 95% confidence interval [CI] 1.18, 1.25; adjusted OR [AOR] 1.04, 95%CI 1.02, 1.07 for every additional UTI and infant antibiotic use (OR 1.21, 95%CI 1.20, 1.22; AOR 1.16, 95%CI 1.15, 1.17 for every additional course were associated with an increased risk of childhood asthma, while having older siblings at home (OR 0.92, 95%CI 0.91, 0.93; AOR 0.85, 95%CI 0.84, 0.87 for each additional sibling was associated with a decreased risk of childhood asthma, in a dose-dependent manner. Compared with vaginal delivery, C

Determination of 210Po concentration in commercially available infant formulae and assessment of daily ingestion dose

Directory of Open Access Journals (Sweden)

Ravi K. Prabhath

2015-07-01

Full Text Available A study has been conducted to estimate the concentration of natural radioactive polonium in commercially available packaged infant food formulae available in Mumbai, India and the corresponding daily dose normalized based on its shelf life. Eleven most popular international brands of infant formulae were sourced from market and three aliquots from each sample were analysed for concordant results. Autodeposition method onto a silver planchet from hot dilute acid solution followed by alpha spectrometry was performed for estimation of polonium. Radiochemical recovery was ascertained by the addition of 209Po tracer. Radiochemical recovery of 209Po tracer was ranged from 14.7 to 98.1 %. The 210Po concentration in the samples was in the range of 0.08–0.23 Bq kg−1 on measured date and the corresponding daily dose, calculated on normalized date which is at mid-point of the shelf life of the sample, was ranged from 0.04 to 0.89 μSv d−1 as per the recommended daily consumption. The annual committed effective dose estimated based on the average of daily dose was found to be 150 μSv.

Infant emotion regulation: relations to bedtime emotional availability, attachment security, and temperament.

Science.gov (United States)

Kim, Bo-Ram; Stifter, Cynthia A; Philbrook, Lauren E; Teti, Douglas M

2014-11-01

The present study examines the influences of mothers' emotional availability toward their infants during bedtime, infant attachment security, and interactions between bedtime parenting and attachment with infant temperamental negative affectivity, on infants' emotion regulation strategy use at 12 and 18 months. Infants' emotion regulation strategies were assessed during a frustration task that required infants to regulate their emotions in the absence of parental support. Whereas emotional availability was not directly related to infants' emotion regulation strategies, infant attachment security had direct relations with infants' orienting toward the environment and tension reduction behaviors. Both maternal emotional availability and security of the mother-infant attachment relationship interacted with infant temperamental negative affectivity to predict two strategies that were less adaptive in regulating frustration. Copyright © 2014 Elsevier Inc. All rights reserved.

Absorbed doses received by infants subjected to panoramic dental and cephalic radiographs

International Nuclear Information System (INIS)

Carrizales, L.; Carreno, S.

1998-01-01

The IAEA Report No. 115 recommends that each country or region can establish levels of absorbed doses for each radiographic technique employed in diagnostic. assuming the extended and expensive of this purpose, we have been to begin in a first step with the dentistry area, in order to estimate the dose levels received at crystalline and thyroid level in infants that go to an important public institution in our country to realize panoramic and cephalic radiographs. This work will serve to justify and impel a quality assurance program in Venezuela on the dentistry area which includes aspects such as training for the medical lap referring the justification of the radiological practice, optimization of X-ray units to produce an adequate image quality that delivers to patient an absorbed dose as much lower as reasonably it can be reached without diagnostic detriment. (Author)

Socioeconomic factors affecting infant sleep-related deaths in St. Louis.

Science.gov (United States)

Hogan, Cathy

2014-01-01

Though the Back to Sleep Campaign that began in 1994 caused an overall decrease in sudden infant death syndrome (SIDS) rates, racial disparity has continued to increase in St. Louis. Though researchers have analyzed and described various sociodemographic characteristics of SIDS and infant deaths by unintentional suffocation in St. Louis, they have not simultaneously controlled for contributory risk factors to racial disparity such as race, poverty, maternal education, and number of children born to each mother (parity). To determine whether there is a relationship between maternal socioeconomic factors and sleep-related infant death. This quantitative case-control study used secondary data collected by the Missouri Department of Health and Senior Services between 2005 and 2009. The sample includes matched birth/death certificates and living birth certificates of infants who were born/died within time frame. Descriptive analysis, Chi-square, and logistic regression. The controls were birth records of infants who lived more than 1 year. Chi-square and logistic regression analyses confirmed that race and poverty have significant relationships with infant sleep-related deaths. The social significance of this study is that the results may lead to population-specific modifications of prevention messages that will reduce infant sleep-related deaths. © 2013 Wiley Periodicals, Inc.

Infant mortality rates and structure in a town near a nuclear power enterprise

International Nuclear Information System (INIS)

Tret'yakov, F.D.; Voronina, Z.I.; Voronin, P.F.; Demin, S.N.

1991-01-01

The paper is devoted to analysis of the rates and structure of mortality of infants aged under 1 in a town, situated near a nuclear power enterprise (NPE). Altogether 38124 infants born in 1950-1978, were investigated. The dead infants (1160) were divided into 3 groups with relation to their parents' place of work: 1 - infants whose parents worked in the NPE; 2 - infants whose parents worked in town factories and offices; 3 - all infants in the town. The total doses of γ-irradiation for mothers were 10-400 cSv, those for fathers - 30-520 cSv, intrauterine irradiation of a fetus was 0.5-0.55 cSv. The individual effective equivalent dose of irradiation of the residents of the town was 17.3 cSv over 40 years. Occupational γ-irradiation of the parents at doses exceeding the maximum permissible ones in the first 10 years of work at the NPE made no effect on the mortality rates in infants of the first generation

Radiation dose estimates for adults and newborns from tungsten-178: based on distribution data in adult and infant animals

International Nuclear Information System (INIS)

Wiles, H.; Lacy, J.; LeBlanc, A.; Bricker, J.; Watson, E.; Stabin, M.

1987-01-01

Biodistribution and retention of tungsten-178 ( 178 W) were studied in adult and infant animals in order to extrapolate radiation dose estimates to human newborns and adults. Whole body retention and organ distribution of 178 W were determined at 0.5, 2, 8, 24 and 48 hours after blood-pool injection in infant and adult rats. Percent whole body retention and percent organ uptake per gram of tissue were higher in infant than adult rats at each time interval. When extrapolated to humans on the basis of percent injected activity kilogram per gram, most organs, except bone and kidney, showed higher uptake in newborns than adults. Total body radiation dose estimates for humans from 178 w based on these data were: 0.93 mGy/MBq (3.4 rad/mCi) for newborns and 0.024 mGy/MBq (0.089 rad/mCi) for adults. 13 refs.; 5 tabs

Very Low Dose Fetal Exposure to Chernobyl Contamination Resulted in Increases in Infant Leukemia in Europe and Raises Questions about Current Radiation Risk Models

Directory of Open Access Journals (Sweden)

Christopher C. Busby

2009-12-01

Full Text Available Following contamination from the Chernobyl accident in April 1986 excess infant leukemia (0–1 y was reported from five different countries, Scotland, Greece, Germany, Belarus and Wales and Scotland combined. The cumulative absorbed doses to the fetus, as conventionally assessed, varied from 0.02 mSv in the UK through 0.06 mSv in Germany, 0.2 mSv in Greece and 2 mSv in Belarus, where it was highest. Nevertheless, the effect was real and given the specificity of the cohort raised questions about the safety of applying the current radiation risk model of the International Commission on Radiological Protection (ICRP to these internal exposures, a matter which was discussed in 2000 by Busby and Cato [7,8] and also in the reports of the UK Committee examining Radiation Risk from Internal Emitters. Data on infant leukemia in the United Kingdom, chosen on the basis of the cohorts defined by the study of Greece were supplied by the UK Childhood Cancer Research Group. This has enabled a study of leukemia in the combined infant population of 15,466,845 born in the UK, Greece, and Germany between 1980 and 1990. Results show a statistically significant excess risk RR = 1.43 (95% CI 1.13 < RR < 1.80 (2-tailed; p = 0.0025 in those born during the defined peak exposure period of 01/07/86 to 31/12/87 compared with those born between 01/01/80 and 31/12/85 and 01/01/88 and 31/12/90. The excess risks in individual countries do not increase monotonically with the conventionally calculated doses, the relation being biphasic, increasing sharply at low doses and falling at high doses. This result is discussed in relation to fetal/cell death at higher doses and also to induction of DNA repair. Since the cohort is chosen specifically on the basis of exposure to internal radionuclides, the result can be expressed as evidence for a significant error in the conventional modeling for such internal fetal exposures.

Observational infant exploratory [14C]-paracetamol pharmacokinetic microdose/therapeutic dose study with accelerator mass spectrometry bioanalysis

Science.gov (United States)

Garner, Colin R; Park, Kevin B; French, Neil S; Earnshaw, Caroline; Schipani, Alessandro; Selby, Andrew M; Byrne, Lindsay; Siner, Sarah; Crawley, Francis P; Vaes, Wouter H J; van Duijn, Esther; deLigt, Rianne; Varendi, Heili; Lass, Jane; Grynkiewicz, Grzegorz; Maruszak, Wioletta; Turner, Mark A

2015-01-01

Aims The aims of the study were to compare [14C]-paracetamol ([14C]-PARA) paediatric pharmacokinetics (PK) after administration mixed in a therapeutic dose or an isolated microdose and to develop further and validate accelerator mass spectrometry (AMS) bioanalysis in the 0–2 year old age group. Methods [14C]-PARA concentrations in 10–15 µl plasma samples were measured after enteral or i.v. administration of a single [14C]-PARA microdose or mixed in with therapeutic dose in infants receiving PARA as part of their therapeutic regimen. Results Thirty-four infants were included in the PARA PK analysis for this study: oral microdose (n = 4), i.v. microdose (n = 6), oral therapeutic (n = 6) and i.v. therapeutic (n = 18). The respective mean clearance (CL) values (SDs in parentheses) for these dosed groups were 1.46 (1.00) l h–1, 1.76 (1.07) l h–1, 2.93 (2.08) l h–1 and 2.72 (3.10) l h–1, t1/2 values 2.65 h, 2.55 h, 8.36 h and 7.16 h and dose normalized AUC(0-t) (mg l–1 h) values were 0.90 (0.43), 0.84 (0.57), 0.7 (0.79) and 0.54 (0.26). Conclusions All necessary ethical, scientific, clinical and regulatory procedures were put in place to conduct PK studies using enteral and systemic microdosing in two European centres. The pharmacokinetics of a therapeutic dose (mg kg–1) and a microdose (ng kg–1) in babies between 35 to 127 weeks post-menstrual age. [14C]-PARA pharmacokinetic parameters were within a two-fold range after a therapeutic dose or a microdose. Exploratory studies using doses significantly less than therapeutic doses may offer ethical and safety advantages with increased bionalytical sensitivity in selected exploratory paediatric pharmacokinetic studies. PMID:25619398

Observational infant exploratory [(14)C]-paracetamol pharmacokinetic microdose/therapeutic dose study with accelerator mass spectrometry bioanalysis.

Science.gov (United States)

Garner, Colin R; Park, Kevin B; French, Neil S; Earnshaw, Caroline; Schipani, Alessandro; Selby, Andrew M; Byrne, Lindsay; Siner, Sarah; Crawley, Francis P; Vaes, Wouter H J; van Duijn, Esther; deLigt, Rianne; Varendi, Heili; Lass, Jane; Grynkiewicz, Grzegorz; Maruszak, Wioletta; Turner, Mark A

2015-07-01

The aims of the study were to compare [(14)C]-paracetamol ([(14)C]-PARA) paediatric pharmacokinetics (PK) after administration mixed in a therapeutic dose or an isolated microdose and to develop further and validate accelerator mass spectrometry (AMS) bioanalysis in the 0-2 year old age group. [(14)C]-PARA concentrations in 10-15 µl plasma samples were measured after enteral or i.v. administration of a single [(14)C]-PARA microdose or mixed in with therapeutic dose in infants receiving PARA as part of their therapeutic regimen. Thirty-four infants were included in the PARA PK analysis for this study: oral microdose (n = 4), i.v. microdose (n = 6), oral therapeutic (n = 6) and i.v. therapeutic (n = 18). The respective mean clearance (CL) values (SDs in parentheses) for these dosed groups were 1.46 (1.00) l h(-1), 1.76 (1.07) l h(-1), 2.93 (2.08) l h(-1) and 2.72 (3.10) l h(-1), t(1/2) values 2.65 h, 2.55 h, 8.36 h and 7.16 h and dose normalized AUC(0-t) (mg l(-1) h) values were 0.90 (0.43), 0.84 (0.57), 0.7 (0.79) and 0.54 (0.26). All necessary ethical, scientific, clinical and regulatory procedures were put in place to conduct PK studies using enteral and systemic microdosing in two European centres. The pharmacokinetics of a therapeutic dose (mg kg(-1)) and a microdose (ng kg(-1)) in babies between 35 to 127 weeks post-menstrual age. [(14)C]-PARA pharmacokinetic parameters were within a two-fold range after a therapeutic dose or a microdose. Exploratory studies using doses significantly less than therapeutic doses may offer ethical and safety advantages with increased bionalytical sensitivity in selected exploratory paediatric pharmacokinetic studies. © 2015 The British Pharmacological Society.

Attachment quality is related to the synchrony of mother and infant monitoring patterns.

Science.gov (United States)

Biro, Szilvia; Alink, Lenneke R A; Huffmeijer, Renske; Bakermans-Kranenburg, Marian J; Van IJzendoorn, Marinus H

2017-06-01

We investigated whether attachment quality is related to infant-mother dyadic patterns in monitoring animated social situations. Sixty 12-month-old infants and their mothers participated in an eye-tracking study in which they watched abstractly depicted distress interactions involving the separation of a "baby" and a "parent" character followed by reunion or further separation of the two characters. We measured infants' and their mothers' relative fixation duration to the two characters in the animations. We found that infant attachment disorganization moderated the correspondence between the monitoring patterns of infant-mother dyads during the final part of the animations resulting in reunion or separation. Organized infants and their mothers showed complementary monitoring patterns: the more the mothers focused their attention on the "baby" character, the more the infants focused their attention on the "parent" character, and vice versa. Disorganized infant-mother dyads showed the opposite pattern although the correlation was nonsignificant: mothers and their infants focused on the same character. The attachment-related differences in the nature of the synchrony in the attentional processes of infants and their mothers suggest that by 12 months the dyads' representations of social situations reflect their shared social-emotional experiences.

High-dose docosahexaenoic acid supplementation of preterm infants: respiratory and allergy outcomes.

Science.gov (United States)

Manley, Brett J; Makrides, Maria; Collins, Carmel T; McPhee, Andrew J; Gibson, Robert A; Ryan, Philip; Sullivan, Thomas R; Davis, Peter G

2011-07-01

Docosahexaenoic acid (DHA) has been associated with downregulation of inflammatory responses. To report the effect of DHA supplementation on long-term atopic and respiratory outcomes in preterm infants. This study is a multicenter, randomized controlled trial comparing the outcomes for preterm infants DHA diet) or soy oil (standard-DHA) capsules. Data collected included incidence of bronchopulmonary dysplasia (BPD) and parental reporting of atopic conditions over the first 18 months of life. Six hundred fifty-seven infants were enrolled (322 to high-DHA diet, 335 to standard), and 93.5% completed the 18-month follow-up. There was a reduction in BPD in boys (relative risk [RR]: 0.67 [95% confidence interval (CI): 0.47-0.96]; P=.03) and in all infants with a birth weight of DHA group at either 12 or 18 months (RR: 0.41 [95% CI: 0.18-0.91]; P=.03) and at either 12 or 18 months in boys (RR: 0.15 [0.03-0.64]; P=.01). There was no effect on asthma, eczema, or food allergy. DHA supplementation for infants of Pediatrics.

Growth and Neurodevelopmental Outcomes of Early, High-Dose Parenteral Amino Acid Intake in Very Low Birth Weight Infants: A Randomized Controlled Trial.

Science.gov (United States)

Balakrishnan, Maya; Jennings, Alishia; Przystac, Lynn; Phornphutkul, Chanika; Tucker, Richard; Vohr, Betty; Stephens, Bonnie E; Bliss, Joseph M

2017-03-01

Administration of high-dose parenteral amino acids (AAs) to premature infants within hours of delivery is currently recommended. This study compared the effect of lower and higher AA administration starting close to birth on short-term growth and neurodevelopmental outcomes at 18-24 months corrected gestational age (CGA). Infants Toddler Development, Third Edition at 18-24 months CGA. Secondary outcomes were growth parameters at 36 weeks CGA among infants surviving to hospital discharge, serum bicarbonate, serum urea nitrogen, creatinine, AA profiles in the first week of life, and incidence of major morbidities and mortality. No differences in neurodevelopmental outcome were detected between the high and low AA groups. Infants in the high AA group had significantly lower mean weight, length, and head circumference percentiles than those in the standard AA group at 36 weeks CGA and at hospital discharge. These differences did not persist after controlling for birth growth parameters, except for head circumference. Infants in the high AA group had higher mean serum urea nitrogen than the standard group on each day throughout the first week. Current recommendations for high-dose AA starting at birth are not associated with improved growth or neurodevelopmental outcomes.

Impact of Vitamin D Supplementation on Gross Motor Development of Healthy Term Infants: A Randomized Dose-Response Trial.

Science.gov (United States)

Wicklow, Brandy; Gallo, Sina; Majnemer, Annette; Vanstone, Catherine; Comeau, Kathryn; Jones, Glenville; L'Abbe, Mary; Khamessan, Ali; Sharma, Atul; Weiler, Hope; Rodd, Celia

2016-08-01

In addition to benefits for bone health, vitamin D is implicated in muscle function in children and adults. To determine if vitamin D dosage positively correlated with gross motor development at 3 and 6 months of age. We hypothesized that higher doses would be associated with higher scores for gross motor skills. A consecutive sample of 55 healthy, term, and breastfed infants from Montreal, Canada were recruited from a randomized trial of vitamin D supplementation between 2009 and 2012. Infants were randomized to 400 International Units (IU) (n = 19), 800 IU (n = 18) or 1,200 IU (n = 18) vitamin D3/day. Motor performance at 3 and 6 months was quantified by the Alberta Infant Motor Scale (AIMS). Plasma vitamin D3 metabolites were measured by tandem mass spectrometry. AIMS scores did not differ at 3 months. However, total AIMS scores and sitting subscores were significantly higher at 6 months in infants receiving 400 IU/day compared to 800 IU/day and 1,200 IU/day groups (p gross motor achievements were significantly higher in infants receiving 400 IU/day vitamin D. Our findings also support longer infants being slightly delayed.

Immunogenicity and safety of a novel monovalent high-dose inactivated poliovirus type 2 vaccine in infants: a comparative, observer-blind, randomised, controlled trial.

Science.gov (United States)

Sáez-Llorens, Xavier; Clemens, Ralf; Leroux-Roels, Geert; Jimeno, José; Clemens, Sue Ann Costa; Weldon, William C; Oberste, M Steven; Molina, Natanael; Bandyopadhyay, Ananda S

2016-03-01

Following the proposed worldwide switch from trivalent oral poliovirus vaccine (tOPV) to bivalent types 1 and 3 OPV (bOPV) in 2016, inactivated poliovirus vaccine (IPV) will be the only source of protection against poliovirus type 2. With most countries opting for one dose of IPV in routine immunisation schedules during this transition because of cost and manufacturing constraints, optimisation of protection against all poliovirus types will be a priority of the global eradication programme. We assessed the immunogenicity and safety of a novel monovalent high-dose inactivated poliovirus type 2 vaccine (mIPV2HD) in infants. This observer-blind, comparative, randomised controlled trial was done in a single centre in Panama. We enrolled healthy infants who had not received any previous vaccination against poliovirus. Infants were randomly assigned (1:1) by computer-generated randomisation sequence to receive a single dose of either mIPV2HD or standard trivalent IPV given concurrently with a third dose of bOPV at 14 weeks of age. At 18 weeks, all infants were challenged with one dose of monovalent type 2 OPV (mOPV2). Primary endpoints were seroconversion and median antibody titres to type 2 poliovirus 4 weeks after vaccination with mIPV2HD or IPV; and safety (as determined by the proportion and nature of serious adverse events and important medical events for 8 weeks after vaccination). The primary immunogenicity analyses included all participants for whom a post-vaccination blood sample was available. All randomised participants were included in the safety analyses. This trial is registered with ClinicalTrials.gov, number NCT02111135. Between April 14 and May 9, 2014, 233 children were enrolled and randomly assigned to receive mIPV2HD (117 infants) or IPV (116 infants). 4 weeks after vaccination with mIPV2HD or IPV, seroconversion to poliovirus type 2 was recorded in 107 (93·0%, 95% CI 86·8-96·9) of 115 infants in the mIPV2HD group compared with 86 (74·8%, 65·8

Persistence of bactericidal antibodies following early infant vaccination with a serogroup B meningococcal vaccine and immunogenicity of a preschool booster dose.

Science.gov (United States)

Snape, Matthew D; Saroey, Praveen; John, Tessa M; Robinson, Hannah; Kelly, Sarah; Gossger, Nicoletta; Yu, Ly-Mee; Wang, Huajun; Toneatto, Daniela; Dull, Peter M; Pollard, Andrew J

2013-10-15

The multicomponent serogroup B meningococcal (4CMenB) vaccine was recently licensed for use in Europe. There are currently no data on the persistence of bactericidal antibodies induced by use of this vaccine in infants. Our objective was to evaluate serogroup B-specific bactericidal antibodies in children aged 40-44 months previously vaccinated at 2, 4, 6 and 12 months of age. Participants given 4 doses of 4CMenB as infants received a fifth dose of the vaccine at 40-44 months of age. Age-matched participants who were MenB vaccine-naive received 4CMenB and formed the control group. We evaluated human complement serum bactericidal activity (hSBA) titres at baseline and 1 month after each dose of 4CMenB. Before a booster dose at enrolment, 41%-76% of 17 participants previously vaccinated with 4CMenB in infancy had hSBA titres of 4 or greater against 4 reference strains. Before vaccination in the control group (n = 40) these proportions were similar for strains 44/76-SL (63%) and M10713 (68%) but low for strains NZ98/254 (0%) and 5/99 (3%). A booster dose in the 4CMenB-primed participants generated greater increases in hSBA titres than in controls. As has been observed with other meningococcal vaccines, bactericidal antibodies waned after vaccination with 4CMenB administered according to an approved infant vaccination schedule of 2, 4, 6 and 12 months of age, but there was an anamnestic response to a booster dose at 40-44 months of age. If 4CMenB were introduced into routine vaccination schedules, assessment of the need for a booster dose would require data on the impact of these declining titres on vaccine effectiveness. ClinicalTrials.gov, no. NCT01027351.

Longitudinal relations among maternal depressive symptoms, maternal mind-mindedness, and infant attachment behavior.

Science.gov (United States)

Bigelow, Ann E; Beebe, Beatrice; Power, Michelle; Stafford, Anna-Lee; Ewing, Julie; Egleson, Anna; Kaminer, Tammy

2018-05-01

The relations among maternal depression risk, maternal mind-mindedness, and infants' attachment behavior were longitudinally examined in a community sample of mother-infant dyads. Maternal self-reported depression risk was measured at the infant ages of 6 weeks, 4 months, and 12 months. Maternal mind-mindedness, assessed from mothers' comments about infants' mental states (e.g., infants' thoughts, desires, or emotions), was measured during mother-infant interactions when infants were 4 months. Infants' attachment behavior was assessed at one year. Mothers' depression risk decreased over the infants' first year, with the sharpest decline between 6 weeks and 4 months. Mothers at risk for depression when infants were 6 weeks showed less appropriate mind-mindedness at 4 months. Mind-mindedness was not related to maternal depression risk at the infant age of 4 months or 12 months. Infants' degree of disorganized attachment behavior at one year was positively associated with maternal depression risk at 6 weeks and negatively associated with maternal appropriate mind-mindedness at 4 months. Mothers who are at risk for depression in their infants' early lives may be hampered in their capacity to respond appropriately to their infants' mental states. Infants with mothers who have difficulty responding appropriately to their mental states, as suggested by low appropriate mind-mindedness, may feel less known and recognized by their mothers, a key theme in the origins of disorganized attachment. Copyright © 2018 Elsevier Inc. All rights reserved.

Breastfeeding considerations of opioid dependent mothers and infants.

Science.gov (United States)

Hilton, Tara C

2012-01-01

The American Academy of Pediatrics (AAP) has a long-standing recommendation against breastfeeding if the maternal methadone dose is above 20 mg/day. In 2001, the AAP lifted the dose restriction of maternal methadone allowing methadone-maintained mothers to breastfeed. The allowance of breastfeeding among mothers taking methadone has been met with opposition due to the uncertainty that exists related to methadone exposure of the suckling infant. Methadone-maintained mothers are at higher risk for abuse, concomitant psychiatric disorders, limited access to healthcare, and financial hardship. Breastfeeding rates among methadone-maintained women tend to be low compared to the national average. This manuscript will discuss the implications for healthcare practitioners caring for methadone-maintained mothers and infants and associated risks and benefits of breastfeeding. This population of mothers and infants stands to obtain particular benefits from the various well-known advantages of breastfeeding.

Evaluation of image quality and radiation dose at prospective ECG-triggered axial 256-slice multi-detector CT in infants with congenital heart disease

Energy Technology Data Exchange (ETDEWEB)

Huang, Mei-ping; Liang, Chang-hong; Zhao, Zhen-jun; Liu, Hui; Li, Jing-lei; Zhang, Jin-e; Cui, Yan-hai; Yang, Lin; Liu, Qi-shun [Guangdong Academy of Medical Sciences, Guangdong General Hospital, Department of Radiology, Guangzhou (China); Ivanc, Thomas B.; Vembar, Mani [Philips Healthcare, CT Clinical Science, Highland Heights, OH (United States)

2011-07-15

There are a limited number of reports on the technical and clinical feasibility of prospective electrocardiogram (ECG)-gated multi-detector computed tomography (MDCT) in infants with congenital heart disease (CHD). To evaluate image quality and radiation dose at weight-based low-dose prospectively gated 256-slice MDCT angiography in infants with CHD. From November 2009 to February 2010, 64 consecutive infants with CHD referred for pre-operative or post-operative CT were included. All were scanned on a 256-slice MDCT system utilizing a low-dose protocol (80 kVp and 60-120 mAs depending on weight: 60 mAs for {<=}3 kg, 80 mAs for 3.1-6 kg, 100 mAs for 6.1-10 kg, 120 mAs for 10.1-15 kg). No serious adverse events were recorded. A total of 174 cardiac deformities, confirmed by surgery or heart catheterization, were studied. The sensitivity of MDCT for cardiac deformities was 97.1%; specificity, 99.4%; accuracy, 95.9%. The mean heart rate during scan was 136.7 {+-} 14.9/min (range, 91-160) with a corresponding heart rate variability of 2.8 {+-} 2.2/min (range, 0-8). Mean scan length was 115.3 {+-} 11.7 mm (range, 93.6-143.3). Mean volume CT dose index, mean dose-length product and effective dose were 2.1 {+-} 0.4 mGy (range, 1.5-2.8), 24.7 {+-} 5.9 mGy.cm (range, 14.7-35.8) and 1.6 {+-} 0.3 mSv (range, 1.1-2.5), respectively. Diagnostic-quality images were achieved in all cases. Satisfactory diagnostic quality for visualization of all/proximal/distal coronary artery segments was achieved in 88.4/98.8/80.0% of the scans. Low-dose prospectively gated axial 256-slice CT angiography is a valuable tool in the routine clinical evaluation of infants with CHD, providing a comprehensive three-dimensional evaluation of the cardiac anatomy, including the coronary arteries. (orig.)

Prelinguistic Relational Concepts: Investigating Analogical Processing in Infants

Science.gov (United States)

Ferry, Alissa L.; Hespos, Susan J.; Gentner, Dedre

2015-01-01

This research asks whether analogical processing ability is present in human infants, using the simplest and most basic relation--the "same-different" relation. Experiment 1 (N = 26) tested whether 7- and 9-month-olds spontaneously detect and generalize these relations from a single example, as previous research has suggested. The…

Health-related quality of life of infants from ethnic minority groups: the Generation R Study.

Science.gov (United States)

Flink, Ilse J E; Beirens, Tinneke M J; Looman, Caspar; Landgraf, Jeanne M; Tiemeier, Henning; Mol, Henriette A; Jaddoe, Vincent W V; Hofman, Albert; Mackenbach, Johan P; Raat, Hein

2013-04-01

To assess whether the health-related quality of life of infants from ethnic minority groups differs from the health-related quality of life of native Dutch infants and to evaluate whether infant health and family characteristics explain the potential differences. We included 4,506 infants participating in the Generation R Study, a longitudinal birth cohort. When the child was 12 months, parents completed the Infant Toddler Quality of Life Questionnaire (ITQOL); ITQOL scale scores in each ethnic subgroup were compared with scores in the Dutch reference population. Influence of infant health and family characteristics on ITQOL scale scores were evaluated using multivariate regression models. Infants from ethnic minority groups presented significantly lower ITQOL scale scores compared to the Dutch subgroup (e.g., Temperament and Moods scale: median score of Turkish subgroup, 70.8 (IQR, 15.3); median score of Dutch subgroup, 80.6 (IQR, 13.9; P ethnic minority status and infant health-related quality of life. However, these factors could not fully explain all the differences in the ITQOL scale scores. Parent-reported health-related quality of life is lower in infants from ethnic minority groups compared to native Dutch infants, which could partly be explained by infant health and by family characteristics.

Absorbed doses received by infants subjected to panoramic dental and cephalic radiographs; Dosis absorbida recibida por infantes sometidos a radiografias dentales panoramicas y cefalicas

Energy Technology Data Exchange (ETDEWEB)

Carrizales, L.; Carreno, S. [Instituto Venezolano de Investigaciones Cientificas. Laboratorio Secundario de Calibracion Dosimetrica. Carretera Panamericana Km. 11. Apartado Postal 21827, Caracas (Venezuela)

1998-12-31

The IAEA Report No. 115 recommends that each country or region can establish levels of absorbed doses for each radiographic technique employed in diagnostic. assuming the extended and expensive of this purpose, we have been to begin in a first step with the dentistry area, in order to estimate the dose levels received at crystalline and thyroid level in infants that go to an important public institution in our country to realize panoramic and cephalic radiographs. This work will serve to justify and impel a quality assurance program in Venezuela on the dentistry area which includes aspects such as training for the medical lap referring the justification of the radiological practice, optimization of X-ray units to produce an adequate image quality that delivers to patient an absorbed dose as much lower as reasonably it can be reached without diagnostic detriment. (Author)

Absorbed doses received by infants subjected to panoramic dental and cephalic radiographs; Dosis absorbida recibida por infantes sometidos a radiografias dentales panoramicas y cefalicas

Energy Technology Data Exchange (ETDEWEB)

Carrizales, L; Carreno, S [Instituto Venezolano de Investigaciones Cientificas. Laboratorio Secundario de Calibracion Dosimetrica. Carretera Panamericana Km. 11. Apartado Postal 21827, Caracas (Venezuela)

1999-12-31

The IAEA Report No. 115 recommends that each country or region can establish levels of absorbed doses for each radiographic technique employed in diagnostic. assuming the extended and expensive of this purpose, we have been to begin in a first step with the dentistry area, in order to estimate the dose levels received at crystalline and thyroid level in infants that go to an important public institution in our country to realize panoramic and cephalic radiographs. This work will serve to justify and impel a quality assurance program in Venezuela on the dentistry area which includes aspects such as training for the medical lap referring the justification of the radiological practice, optimization of X-ray units to produce an adequate image quality that delivers to patient an absorbed dose as much lower as reasonably it can be reached without diagnostic detriment. (Author)

Infant Language Development Is Related to the Acquisition of Walking

Science.gov (United States)

Walle, Eric A.; Campos, Joseph J.

2014-01-01

The present investigation explored the question of whether walking onset is related to infant language development. Study 1 used a longitudinal design (N = 44) to assess infant locomotor and language development every 2 weeks from 10 to 13.5 months of age. The acquisition of walking was associated with a significant increase in both receptive and…

High-Dose Micafungin for Preterm Neonates and Infants with Invasive and Central Nervous System Candidiasis.

Science.gov (United States)

Auriti, Cinzia; Falcone, Marco; Ronchetti, Maria Paola; Goffredo, Bianca Maria; Cairoli, Sara; Crisafulli, Rosamaria; Piersigilli, Fiammetta; Corsetti, Tiziana; Dotta, Andrea; Pai, Manjunath P

2016-12-01

High doses of micafungin are advocated in neonates with systemic candidiasis, but limited pharmacokinetic (PK) and safety data are available to support their use. Eighteen preterm neonates and infants with systemic candidiasis, three of whom had meningitis, were treated for at least 14 days with 8 to 15 mg/kg of body weight/day of intravenous micafungin. Plasma micafungin concentrations (four measurements for each patient) were determined after the third dose, and the cerebrospinal fluid (CSF) micafungin concentrations in three patients were also obtained. Population PK analyses were used to identify the optimal model, and the model was further validated using external data (n = 5). The safety of micafungin was assessed by measurement of the levels of liver and kidney function biomarkers. The mean age and weight at the initiation of treatment were 2.33 months (standard deviation [SD], 1.98 months) and 3.24 kg (SD, 1.61 kg), respectively. The optimal PK model was one that scaled plasma clearance to weight and the transaminase concentration ratio. The CSF of three patients was sampled, and the observed concentrations were between 0.80 and 1.80 mg/liter. The model-predicted mean micafungin area under the concentration-time curve over 24 h was 336 mg · h/liter (SD, 165 mg · h/liter) with the 10-mg/kg/day dosage. Eighteen of the 23 subjects (78.2%) had clinical resolution of their infection, but 5 had neurologic impairments. Among the transaminases, alkaline phosphatase measurements were significantly higher posttreatment, with a geometric mean ratio of 1.17 (90% confidence interval, 1.01, 1.37). Furthermore, marked elevations in the gamma-glutamyltransferase (GGT) level were observed in three patients treated with 10- to 15-mg/kg/day doses, and improvement of the GGT level was noted after a dose reduction. Higher weight-based doses of micafungin were generally well tolerated in neonates and infants and achieved pharmacokinetic profiles predictive of an effect

Infant, maternal, and geographic factors influencing gastroschisis related mortality in Zimbabwe.

Science.gov (United States)

Apfeld, Jordan C; Wren, Sherry M; Macheka, Nyasha; Mbuwayesango, Bothwell A; Bruzoni, Matias; Sylvester, Karl G; Kastenberg, Zachary J

2015-12-01

Survival for infants with gastroschisis in developed countries has improved dramatically in recent decades with reported mortality rates of 4-7%. Conversely, mortality rates for gastroschisis in sub-Saharan Africa remain as great as 60% in contemporary series. This study describes the burden of gastroschisis at the major pediatric hospital in Zimbabwe with the goal of identifying modifiable factors influencing gastroschisis-related infant mortality. We performed a retrospective cohort study of all cases of gastroschisis admitted to Harare Children's Hospital in 2013. Univariate and multivariate analyses were performed to describe infant, maternal, and geographic factors influencing survival. A total of 5,585 neonatal unit admissions were identified including 95 (1.7%) infants born with gastroschisis. Gastroschisis-related mortality was 84% (n = 80). Of infants with gastroschisis, 96% (n = 91) were born outside Harare Hospital, 82% (n = 78) were born outside Harare Province, and 23% (n = 25) were home births. The unadjusted odds of survival for these neonates with gastroschisis were decreased for low birth weight infants (age; OR, 0.06; 95% CI, 0.01-0.50), and for those born to teenage mothers (age; OR, 0.05; 95% CI, 0.01-0.46). There was also a trend toward decreased odds of survival for home births (OR, 0.16; 95% CI, 0.02-1.34) and for those born outside Harare Province (OR, 0.35; 95% CI, 0.10-1.22). Gastroschisis-related infant mortality in Zimbabwe is associated with well-known risk factors, including low birth weight, prematurity, and teenage mothers. However, modifiable factors identified in this study signify potential opportunities for developing innovative approaches to perinatal care in such a resource-constrained environment. Copyright © 2015 Elsevier Inc. All rights reserved.

Alberta Infant Motor Scale (AIMS) Performance of Greek Preterm Infants: Comparisons With Full-Term Infants of the Same Nationality and Impact of Prematurity-Related Morbidity Factors.

Science.gov (United States)

Syrengelas, Dimitrios; Kalampoki, Vassiliki; Kleisiouni, Paraskevi; Manta, Vassiliki; Mellos, Stavros; Pons, Roser; Chrousos, George P; Siahanidou, Tania

2016-07-01

Only a few studies have been conducted with the objective of creating norms of the Alberta Infant Motor Scale (AIMS) for the assessment of gross motor development of preterm infants. The AIMS performance of preterm infants has been compared with that of the Canadian norms of full-term infants, but not with that of full-term infants of the same nationality. Moreover, the possible impact of prematurity-related morbidity factors on AIMS performance is unknown. The aims of this study were: (1) to evaluate AIMS trajectory in a large population of Greek preterm infants and create norms, (2) to compare it with the AIMS trajectory of Greek full-term infants, and (3) to examine the possible influence of neonatal morbidity on AIMS scores in the preterm sample. This was a cross-sectional study. Mean AIMS scores were compared, per month (1-19), between 403 preterm infants (≤32 weeks of age, corrected for prematurity) and 1,038 full-term infants. In preterm infants, the association of AIMS scores with respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH) of grade ≤III, bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), and sepsis was assessed by hierarchical regression analysis. Alberta Infant Motor Scale scores were significantly lower in preterm infants than in full-term infants. Mean AIMS scores in preterm infants were significantly associated with RDS (b=-1.93; 95% CI=-2.70, -1.16), IVH (b=-0.97; 95% CI=-1.69, -0.25), and ROP (b=-1.12; 95% CI=-1.99, -0.24) but not with BPD or sepsis in hierarchical regression analysis. Alberta Infant Motor Scale norms were created for Greek preterm infants. This study confirms that AIMS trajectories of preterm infants are below those of full-term infants of the same nationality. The influence of morbidity factors, including RDS, IVH, and ROP, should be taken into account when administering the AIMS in preterm infants. © 2016 American Physical Therapy Association.

Roentgenography of hip-joint using tubus in infants

International Nuclear Information System (INIS)

Sakuyama, Keiko; Imamura, Keiko; Uji, Teruyuki; Fujikawa, Mitsuhiro; Ishikawa, Toru

1976-01-01

Roentgenography of hip-joint using tubus was discussed. This technique has been made at St. Marianna University, School of Medicine, in order to reduce the exposure dose in x-ray examination of congenital dislocation of hip-joint. The tubus is designed to butterfly-shaped. Only the site which is necessary for roentgenography of hip-joint is exposed, and the sexual gland is outside exposure. The exposure dose of the sexual gland using tubus is 1/10 in female infants and 1/30 in male infants of those without tubus (6.7 mR in male infants, 2.0 mR in female infants). There are some advantages in the tubus: it is clinically used for both sexes as well as reducing exposure doses, and it can be used widely from neonates to infants. (Serizawa, K.)

Psychomotor development in infants with Prader-Willi syndrome and associations with sleep-related breathing disorders.

Science.gov (United States)

Festen, Dederieke A M; Wevers, Maaike; de Weerd, Al W; van den Bossche, Renilde A S; Duivenvoorden, Hugo J; Otten, Barto J; Wit, Jan Maarten; Hokken-Koelega, Anita C S

2007-08-01

Prader-Willi syndrome (PWS) is a neurogenetic disorder with hypotonia, psychomotor delay, obesity, short stature, and sleep-related breathing disorders. The aim of this study was to evaluate the association between psychomotor development and sleep-related breathing disorders in PWS infants. Bayley Scales of Infant Development were performed in 22 PWS infants, with a median (interquartile range, IQR) age of 1.8 (1.1-3.4) y, and a body mass index SD score (BMISDS) of -0.5 (-1.3 to 1.6). We evaluated psychomotor development in relation to results of polysomnography. Median (IQR) mental and motor development was 73.1% (64.3-79.6%) and 55.2% (46.5-63.1%) of normal children, respectively. All infants had sleep-related breathing disorders, mostly of central origin. The apnea hypopnea index was not associated with psychomotor development. Only four infants had obstructive sleep apnea syndrome (OSAS). They had a significantly delayed mental development of 65.5% (60.0-70.3%) of normal. They had a median BMISDS of 1.4 (0.1-1.6), which tended to be higher than in those without OSAS. Our data indicate that psychomotor development in PWS infants is not related to central sleep-related breathing disorders, but infants with OSAS have more severely delayed mental development, suggesting that PWS infants should be screened for OSAS.

Dissociation between Features and Feature Relations in Infant Memory: Effects of Memory Load.

Science.gov (United States)

Bhatt, Ramesh S.; Rovee-Collier, Carolyn

1997-01-01

Four experiments examined effects of the number of features and feature relations on learning and long-term memory in 3-month olds. Findings suggested that memory load size selectively constrained infants' long-term memory for relational information, suggesting that in infants, features and relations are psychologically distinct and that memory…

Low-Dose Intravenous Paracetamol for Patent Ductus Arteriosus in Indomethacin-Resistant or Contraindicated Preterm Infants: Three Cases Reports.

Science.gov (United States)

Matsumura, Shun; Oshima, Ayumi; Fujinuma, Sumie; Tanaka, Kosuke; Nagano, Nobuhiko; Miyake, Fuyu; Masutani, Satoshi; Tamura, Masanori; Ueda, Keiko; Namba, Fumihiko

2017-10-01

Background  Although indomethacin (IND) is the standard treatment for hemodynamically significant patent ductus arteriosus (hsPDA) in Japan, it may be associated with renal impairment and gastrointestinal complications. The use of paracetamol for hsPDA closure has recently increased. Unlike IND, paracetamol does not have a peripheral vasoconstrictive effect and can be given to infants with contraindications to IND. Based on limited data available from randomized trials, paracetamol and IND seem to have similar effects. However, there have been no reports of the use of paracetamol for hsPDA in Japan. Cases  Our drug administration protocol was approved by the institutional ethics committee after purchasing a clinical trial insurance. In three premature infants in whom IND was contraindicated or ineffective, a 7.5 mg/kg of paracetamol was intravenously administered every 6 hour for 3 days after obtaining parental consents. A temporary hsPDA closure was observed in two of the three infants. However, all three infants eventually needed surgical closure. No side effects, such as hepatic and renal dysfunctions, and adverse events were reported. Conclusion  The intravenous administration of paracetamol was safe and feasible in premature infants with hsPDA. Future clinical trials with optimized dose and timing of administration are needed.

Neurodevelopment in preterm infants with and without placenta-related intrauterine growth restriction and its relation to perinatal and postnatal factors.

Science.gov (United States)

Candel-Pau, Júlia; Perapoch López, Josep; Castillo Salinas, Félix; Sánchez Garcia, Olga; Pérez Hoyos, Santiago; Llurba Olivé, Elisa

2016-01-01

Intrauterine-growth restriction is associated with impaired neurodevelopment. However, studies on early childhood neurodevelopment of premature infants with placenta-related intrauterine-growth restriction (IUGR) are scarce and heterogeneous. We aimed to analyze the impact of placenta-related IUGR on preschool age neurodevelopment in preterm infants, and to ascertain which prenatal and postnatal factors influence neurodevelopment in these infants. Prospective cohorts study: 48 placenta-related IUGR premature infants and 25 matched non-IUGR premature infants (mean gestational age: 31.4 and 31.6 weeks, respectively). Preschool neurodevelopment assessment with cognitive Bayley Scales III and with ASQ-III surveys (age interval: 34.07-42.50 months). Inter-cohort result comparison. Analysis of perinatal and environmental factors associated with impaired neurodevelopment in both cohorts. No statistically significant neurodevelopment differences were observed at preschool age between both preterm cohorts. Multivariate analysis of perinatal and environmental factors showed daycare, breastfeeding, higher parental educational level, and absence of severe neonatal morbidity to be associated with a lower risk of altered neurodevelopment at preschool age. Placenta-related IUGR does not have a significant impact on preschool neurodevelopment in our preterm patients. Instead, post-natal positive environmental factors such as parental educational level, breastfeeding, and daycare attendance make a difference towards an improvement in neurodevelopment in these infants.

Maternal anxiety versus depressive disorders: specific relations to infants' crying, feeding and sleeping problems.

Science.gov (United States)

Petzoldt, J; Wittchen, H-U; Einsle, F; Martini, J

2016-03-01

Maternal depression has been associated with excessive infant crying, feeding and sleeping problems, but the specificity of maternal depression, as compared with maternal anxiety remains unclear and manifest disorders prior to pregnancy have been widely neglected. In this prospective longitudinal study, the specific associations of maternal anxiety and depressive disorders prior to, during and after pregnancy and infants' crying, feeding and sleeping problems were investigated in the context of maternal parity. In the Maternal Anxiety in Relation to Infant Development (MARI) Study, n = 306 primiparous and multiparous women were repeatedly interviewed from early pregnancy until 16 months post partum with the Composite International Diagnostic Interview for Women (CIDI-V) to assess DSM-IV anxiety and depressive disorders. Information on excessive infant crying, feeding and sleeping problems was obtained from n = 286 mothers during postpartum period via questionnaire and interview (Baby-DIPS). Findings from this study revealed syndrome-specific risk constellations for maternal anxiety and depressive disorders as early as prior to pregnancy: Excessive infant crying (10.1%) was specifically associated with maternal anxiety disorders, especially in infants of younger and lower educated first-time mothers. Feeding problems (36.4%) were predicted by maternal anxiety (and comorbid depressive) disorders in primiparous mothers and infants with lower birth weight. Infant sleeping problems (12.2%) were related to maternal depressive (and comorbid anxiety) disorders irrespective of maternal parity. Primiparous mothers with anxiety disorders may be more prone to anxious misinterpretations of crying and feeding situations leading to an escalation of mother-infant interactions. The relation between maternal depressive and infant sleeping problems may be better explained by a transmission of unsettled maternal sleep to the fetus during pregnancy or a lack of daily

Patient-related factors influencing detectability of coronary arteries in 320-row CT angiography in infants with complex congenital heart disease.

Science.gov (United States)

Yamasaki, Yuzo; Kawanami, Satoshi; Kamitani, Takeshi; Sagiyama, Koji; Shin, Seitaro; Hino, Takuya; Nagata, Hazumu; Yabuuchi, Hidetake; Nagao, Michinobu; Honda, Hiroshi

2018-05-05

To investigate the performance of second-generation 320-row computed tomographic (CT) angiography (CTA) in detecting coronary arteries and identify factors influencing visibility of the coronary arteries in infants with complex congenital heart disease (CHD). Data of 60 infants (aged 0-2 years, median 2 months) with complex CHD who underwent examination using 320-row CTA with low-dose prospective electrocardiogram-triggered volume target scanning were reviewed. The coronary arteries of each infant were assessed using a 0-4-point scoring system based on the number of coronary segments with a visible course. Clinical parameters, the CT value in the ascending aorta, image noise, and the radiation dose were subjected to univariate and multivariate analyses. The mean coronary score for all examinations was 2.6 ± 1.5 points. The mean attenuation in the ascending aorta was 306.7 ± 66.2 HU and the mean standard deviation was 21.7 ± 4.4. The mean effective radiation dose was 1.27 ± 0.39 mSv. Multivariate regression analysis showed significant correlations between coronary score and body weight (p < 0.05) and between coronary score and the CT value in the ascending aorta (p < 0.02). Second-generation 320-row CTA with prospective electrocardiogram-triggered volume target scanning and hybrid iterative reconstruction allows good visibility of the coronary arteries in infants with complex CHD. Body weight and the CT value in the ascending aorta are important factors influencing the visibility of the coronary arteries in infants.

Pharmacokinetic comparison of acetaminophen elixir versus suppositories in vaccinated infants (aged 3 to 36 months): a single-dose, open-label, randomized, parallel-group design.

Science.gov (United States)

Walson, Philip D; Halvorsen, Mark; Edge, James; Casavant, Marcel J; Kelley, Michael T

2013-02-01

Because of practical problems and ethical concerns, few studies of the pharmacokinetics (PK) of acetaminophen (ACET) in infants have been published. The goal of this study was to compare the PK of an ACET rectal suppository with a commercially available ACET elixir to complete a regulatory obligation to market the suppository. This study was not submitted previously because of numerous obstacles related to both the investigators and the commercial entities associated with the tested product. Thirty infants (age 3-36 months) prescribed ACET for either fever, pain, or postimmunization prophylaxis of fever and discomfort were randomized to receive a single 10- to 15-mg/kg ACET dose either as the rectal suppository or oral elixir. Blood was collected at selected times for up to 8 hours after administration. ACET concentrations were measured by using a validated HPLC method, and PK behavior and bioavailability were compared for the 2 preparations. All 30 infants enrolled were prescribed ACET for postimmunization prophylaxis. PK samples were available in 27 of the 30 enrolled infants. Subject enrollment (completed in January 1995) was rapid (8.3 months) and drawn entirely from a vaccinated infant clinic population. There were no statistically significant differences between the subjects (elixir, n = 12; suppository, n = 15) in either mean (SD) age (10.0 [6.3] vs 12.4 [8.1] months), weight (8.6 [2.3] vs 9.4 [2.4] kg), sex (7 of 12 males vs 7 of 15 males), or racial distribution (5 white, 5 black, and 2 biracial vs 4 white and 11 black) between the 2 dosing groups (oral vs rectal, respectively). The oral and rectal preparations produced similar, rapid peak concentrations (T(max), 1.16 vs 1.17 hours; P = 0.98) and elimination t(½) (1.84 vs 2.10 hours; P = 0.14), respectively. No statistically significant differences were found between either C(max) (7.65 vs 5.68 μg/mL) or total drug exposure (AUC(0-∞), 23.36 vs 20.45 μg-h/mL) for the oral versus rectal preparations

Antibodies to biotinylated red blood cells in adults and infants: improved detection, partial characterization, and dependence on red blood cell-biotin dose.

Science.gov (United States)

Schmidt, Robert L; Mock, Donald M; Franco, Robert S; Cohen, Robert M; North, Anne K; Cancelas, José A; Geisen, Christof; Strauss, Ronald G; Vlaar, Alexander P; Nalbant, Demet; Widness, John A

2017-06-01

Biotin-labeled red blood cells (BioRBCs) are used for in vivo kinetic studies. Because BioRBC dosing occasionally induces antibodies, a sensitive and specific anti-BioRBC detection assay is needed. Aims were to 1) develop a gel card assay to evaluate existing, naturally occurring and BioRBC-induced plasma antibodies, 2) compare gel card and tube agglutination detection results, and 3) test for a relationship of antibody induction and BioRBC dose. Reagent BioRBCs were prepared using sulfo-NHS biotin ranging from densities 18 (BioRBC-18) to 1458 (BioRBC-1458) µg/mL RBCs. Among BioRBC-exposed subjects, gel card and tube agglutination results were concordant in 21 of 22 adults and all 19 infant plasma samples. Gel card antibody detection sensitivity was more than 10-fold greater than tube agglutination. Twelve to 16 weeks after BioRBC exposure, induced anti-antibodies were detected by gel card in three of 26 adults (12%) at reagent densities BioRBC-256 or less, but in none of 41 infants. Importantly, induced anti-BioRBC antibodies were associated with higher BioRBC dose (p = 0.008); no antibodies were detected in 18 subjects who received BioRBC doses less than or equal to BioRBC-18. For noninduced BioRBC antibodies, six of 1125 naïve adults (0.3%) and none of 46 naïve infants demonstrated existing anti-BioRBC antibodies using reagent BioRBC-140 or -162. Existing anti-BioRBCs were all neutralized by biotin compounds, while induced antibodies were not. The gel card assay is more sensitive than the tube agglutination assay. We recommend reagent BioRBC-256 for identifying anti-BioRBCs. Use of a low total RBC biotin label dose (≤ BioRBC-18) may minimize antibody induction. © 2017 AABB.

Frequency of Antiretroviral Resistance Mutations among Infants Exposed to Single-Dose Nevirapine and Short Course Maternal Antiretroviral Regimens: ACTG A5207.

Science.gov (United States)

Hitti, Jane; Halvas, Elias K; Zheng, Lu; Panousis, Constantinos G; Kabanda, Joseph; Taulo, Frank; Kumarasamy, Nagalingeswaran; Pape, Jean William; Lalloo, Umesh; Sprenger, Heather; Klingman, Karin L; Chan, Ellen S; McMahon, Deborah; Mellors, John W

2014-11-01

Intrapartum single-dose nevirapine (sdNVP) reduces HIV-1 perinatal transmission but selects NVP resistance among mothers and infants. We evaluated the frequency of antiretroviral resistance among infants with intrauterine HIV-1 infection exposed to sdNVP and maternal antenatal or breastfeeding antiretroviral therapy. This analysis included 429 infants from sub-Saharan Africa, India and Haiti whose 422 mothers received sdNVP plus maternal study treatment. At entry mothers had CD4>250/μL and were ART-naïve except for antenatal ZDV per local standard of care. Maternal study treatment started intrapartum and included ZDV/3TC, TDF/FTC or LPV/r for 7 or 21 days in a randomized factorial design. Infants received sdNVP study treatment and ZDV if local standard of care. Infant HIV RNA or DNA PCR and samples for genotype were obtained at birth and weeks 2, 4 and 12; infants who ever breast-fed were also tested at weeks 16, 24, 48 and 96. Samples from HIV-1-infected infants were tested for drug resistance by population genotype (ViroSeq). NVP or NRTI resistance mutations were assessed using the IAS-USA mutation list. Perinatal HIV-1 transmission occurred in 17 (4.0%) infants including 12 intrauterine infections. Resistance mutations were detected among 5 (42%) intrauterine-infected infants; of these, 3 had mutations conferring resistance to NVP alone, 1 had resistance to NRTI alone, and 1 had dual-class resistance mutations. Among the 2 infants with NRTI mutations, one (K70R) was likely maternally transmitted and one (K65R) occurred in the context of breastfeeding exposure to maternal antiretroviral therapy. Infants with intrauterine HIV infection are at risk of acquiring resistance mutations from exposure to maternal antiretroviral medications intrapartum and/or during breastfeeding. New approaches are needed to lower the risk of antiretroviral resistance in these infants.

Trajectories of mothers' emotional availability: relations with infant temperament in predicting attachment security.

Science.gov (United States)

Kim, Bo-Ram; Chow, Sy-Miin; Bray, Bethany; Teti, Douglas M

2017-02-01

The present study examined observations of parenting quality (mothers' emotional availability - EA) during infant bedtimes at 4 points across the infants' first year, assessing relations between levels and trajectories of EA and infant attachment at 12 months and the role of infant temperament in moderating these associations. The sample (N = 128) was predominantly Euro-American (82.5%) and at low socioeconomic risk. Latent growth curve modeling with latent basis coefficients indicated substantial individual differences in initial levels and slopes in EA trajectories across the first year. Both levels of maternal EA and EA trajectories across the first year predicted 12-month infant attachment security. Although maternal EA tended to decrease across the first year in the full sample, EA trajectories that showed a "bounce-back" between 6 and 12 months, suggesting more successful maternal adaptation to an expanding infant developmental repertoire, predicted greater infant security at 12 months. In addition, linkages between latent EA trajectories and 12-month attachment were moderated by 3-month infant temperamental reactivity and regulation. These findings indicate that infant attachment security is sensitive to both static and dynamic aspects of parenting quality across the first year, and that infant temperament can interact with both in predicting infant attachment.

Immunogenicity and safety of a quadrivalent meningococcal polysaccharide CRM conjugate vaccine in infants and toddlers.

Science.gov (United States)

Tregnaghi, Miguel; Lopez, Pio; Stamboulian, Daniel; Graña, Gabriela; Odrljin, Tatjana; Bedell, Lisa; Dull, Peter M

2014-09-01

This phase III study assessed the safety and immunogenicity of MenACWY-CRM, a quadrivalent meningococcal conjugate vaccine, administered with routine vaccines starting at 2 months of age. Healthy infants received MenACWY-CRM in a two- or three-dose primary infant series plus a single toddler dose. In addition, a two-dose toddler catch-up series was evaluated. Immune responses to MenACWY-CRM were assessed for serum bactericidal activity with human complement (hSBA). Reactogenicity and safety results were collected systematically. After a full infant/toddler series or two-dose toddler catch-up series, MenACWY-CRM elicited immune responses against the four serogroups in 94-100% of subjects. Noninferiority of the two- versus three-dose MenACWY-CRM infant dosing regimen was established for geometric mean titers for all serogroups. Following the three-dose infant primary series, 89-98% of subjects achieved an hSBA ≥ 8 across all serogroups. Immune responses to concomitant routine vaccines given with MenACWY-CRM were noninferior to responses to routine vaccines alone, except for pertactin after the two-dose infant series. Noninferiority criteria were met for all concomitant antigens after the three-dose infant series. MenACWY-CRM vaccination regimens in infants and toddlers were immunogenic and well tolerated. No clinically meaningful effects of concomitant administration with routine infant and toddler vaccines were observed. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Ways To Reduce the Risk of SIDS and Other Sleep-Related Causes of Infant Death

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... SIDS and Other Sleep-Related Causes of Infant Death Page Content Research shows that there are several ... SIDS and other sleep-related causes of infant death: The actions listed here and in Safe to ...

Radiation exposure of the gonads in infant brain computerized tomography

International Nuclear Information System (INIS)

Berndt, L.; Rosenkranz, G.; Tellkamp, H.

1988-01-01

In 61 babies and infants the gonadal dose due to brain computerized tomography was determined over the symphysis by thermoluminescent dosimetry. The average radiation dose was 43 mGy corresponding with data reported. Shielding of the testes in infants is an additional burden and worth discussing because of the low absolute gonadal dose

[FACTORS RELATED TO MORTALITY IN NECROTIZINGENTEROCOLITIS(NEC) IN NEONATES AND OLDER INFANTS

Science.gov (United States)

Ríos D , Hugo; Rivera M , Juan

1997-01-01

In order to determine the factors related to mortality in Necrotizing enterocolitis (NEC), medical records of neonates and older infants diagnosed of NEC in the Instituto de Salud del Niño between 1984 and 1993 were retrospectively reviewed. Only the cases with a reliable roentgenologic, surgical or pathologic diagnosis were included. Sixty cases (46 infants and 14 neonates) were found, with a higher incidence in males (37 males vs 23 females). Twenty six cases required surgical treatment. Overall mortality was 77%, with no significant differences between neonates and infants, nor between those who were operated or not. Moderate or severe malnutrition, diarrhea as an early clinical manifestations, bronchopneumonia, shock and poor nutricional management were found as factors related to mortality.

Mother-infant joint attention and sharing: relations to disorganized attachment and maternal disrupted communication.

Science.gov (United States)

Annie Yoon, Seungyeon; Kelso, Gwendolyn A; Lock, Anna; Lyons-Ruth, Karlen

2014-01-01

The normative development of infant shared attention has been studied extensively, but few studies have examined the impact of disorganized attachment and disturbed maternal caregiving on mother-infant shared attention. The authors examined both maternal initiations of joint attention and infants' responses to those initiations during the reunion episodes of the Strange Situation Procedure at 12 and 18 months of infant age. The mothers' initiations of joint attention and three forms of infant response, including shunning, simple joint attention, and sharing attention, were examined in relation to infant disorganized attachment and maternal disrupted communication. Mothers who were disrupted in communication with their infants at 18 months initiated fewer bids for joint attention at 12 months, and, at 18 months, mothers of infants classified disorganized initiated fewer bids. However, the infant' responses were unrelated to either the infant' or the mother' disturbed attachment. At both ages, disorganized infants and infants of disrupted mothers were as likely to respond to maternal bids as were their lower risk counterparts. Our results suggest that a disposition to share experiences with others is robust in infancy, even among infants with adverse attachment experiences, but this infant disposition may depend on adult initiation of bids to be realized.

Sodium bicarbonate causes dose-dependent increases in cerebral blood flow in infants and children with single ventricle physiology

Science.gov (United States)

Buckley, Erin M.; Naim, Maryam Y.; Lynch, Jennifer M.; Goff, Donna A.; Schwab, Peter J.; Diaz, Laura K.; Nicolson, Susan C.; Montenegro, Lisa M.; Lavin, Natasha A.; Durduran, Turgut; Spray, Thomas L.; Gaynor, J. William; Putt, Mary E.; Yodh, A.G.; Fogel, Mark A.; Licht, Daniel J.

2013-01-01

Background Sodium bicarbonate (NaHCO3) is a common treatment for metabolic acidemia, however little definitive information exists regarding its treatment efficacy and cerebral hemodynamic effects. This pilot observational study quantifies relative changes in cerebral blood flow (rCBF) and oxy and deoxy-hemoglobin concentrations (ΔHbO2 and ΔHb) due to bolus administration of NaHCO3 in patients with mild base deficits. Methods Infants and children with hypoplastic left heart syndrome (HLHS) were recruited prior to cardiac surgery. NaHCO3 was given as needed for treatment of base deficit. Diffuse optical spectroscopies were employed for 15 minutes post-injection to non-invasively monitor ΔHb, ΔHbO2 and rCBF relative to baseline prior to NaHCO3 administration. Results Twenty-two anesthetized and mechanically ventilated HLHS patients (1 day to 4 years old) received a median (interquartile range) dose of 1.1 (0.8, 1.8) mEq/kg NaHCO3 administered intravenously over 10–20 seconds to treat a base deficit of −4 (−6, −3) mEq/l. NaHCO3 caused significant dose-dependent increases in rCBF, however population averaged ΔHb or Δ4HbO2 compared to controls were not significant. Conclusions Dose-dependent increases in cerebral blood flow (CBF) caused by bolus NaHCO3 are an important consideration in vulnerable populations wherein risk of rapid CBF fluctuations does not outweigh the benefit of treating a base deficit. PMID:23403802

Communication-related allegations against physicians caring for premature infants.

Science.gov (United States)

Nguyen, J; Muniraman, H; Cascione, M; Ramanathan, R

2017-10-01

Maternal-fetal medicine physicians (MFMp) and neonatal-perinatal medicine physicians (NPMp) caring for premature infants and their families are exposed to significant risk for malpractice actions. Effective communication practices have been implicated to decrease litigious intentions but the extent of miscommunication as a cause of legal action is essentially unknown in this population. Analysis of communication-related allegations (CRAs) may help toward improving patient care and physician-patient relationships as well as decrease litigation risks. We retrospectively reviewed the Westlaw database, a primary online legal research resource used by United States lawyers and legal professionals, for malpractice cases against physicians involving premature infants. Inclusion criteria were: 22 to 36 weeks gestational age, cases related to peripartum events through infant discharge and follow-up, and legal records with detailed factual narratives. The search yielded 736 legal records, of which 167 met full inclusion criteria. A CRA was identified in 29% (49/167) of included cases. MFMp and/or NPMp were named in 104 and 54 cases, respectively. CRAs were identified in 26% (27/104) and 35% (19/54) of MFMp- and NPMp-named cases, respectively, with a majority involving physician-family for both specialties (81% and 74%, respectively). Physician-family CRAs for MFMp and NPMp most often regarded lack of informed consent (50% and 57%, respectively), lack of full disclosure (41% and 29%, respectively) and lack of anticipatory guidance (36% and 21%, respectively). This study of a major legal database identifies CRAs as significant causes of legal action against MFMp and NPMp involved in the care of high-risk women and infants delivered preterm. Physicians should be especially vigilant with obtaining genuine informed consent and maintaining open communication with families.

A face a mother could love: depression-related maternal neural responses to infant emotion faces.

Science.gov (United States)

Laurent, Heidemarie K; Ablow, Jennifer C

2013-01-01

Depressed mothers show negatively biased responses to their infants' emotional bids, perhaps due to faulty processing of infant cues. This study is the first to examine depression-related differences in mothers' neural response to their own infant's emotion faces, considering both effects of perinatal depression history and current depressive symptoms. Primiparous mothers (n = 22), half of whom had a history of major depressive episodes (with one episode occurring during pregnancy and/or postpartum), were exposed to images of their own and unfamiliar infants' joy and distress faces during functional neuroimaging. Group differences (depression vs. no-depression) and continuous effects of current depressive symptoms were tested in relation to neural response to own infant emotion faces. Compared to mothers with no psychiatric diagnoses, those with depression showed blunted responses to their own infant's distress faces in the dorsal anterior cingulate cortex. Mothers with higher levels of current symptomatology showed reduced responses to their own infant's joy faces in the orbitofrontal cortex and insula. Current symptomatology also predicted lower responses to own infant joy-distress in left-sided prefrontal and insula/striatal regions. These deficits in self-regulatory and motivational response circuits may help explain parenting difficulties in depressed mothers.

A dose response randomised controlled trial of docosahexaenoic acid (DHA) in preterm infants.

Science.gov (United States)

Collins, C T; Sullivan, T R; McPhee, A J; Stark, M J; Makrides, M; Gibson, R A

2015-08-01

Thirty one infants born less than 30 weeks׳ gestational age were randomised to receive either 40 (n=11), 80 (n=9) or 120 (n=11) mg/kg/day of docosahexaenoic acid (DHA) respectively as an emulsion, via the feeding tube, commenced within 4 days of the first enteral feed. Twenty three infants were enroled in non-randomised reference groups; n=11 who had no supplementary DHA and n=12 who had maternal DHA supplementation. All levels of DHA in the emulsion were well tolerated with no effect on number of days of interrupted feeds or days to full enteral feeds. DHA levels in diets were directly related to blood DHA levels but were unrelated to arachidonic acid (AA) levels. All randomised groups and the maternal supplementation reference group prevented the drop in DHA levels at study end that was evident in infants not receiving supplementation. Australian New Zealand Clinical Trials Registry: ACTRN12610000382077. Copyright © 2015 Elsevier Ltd. All rights reserved.

Considering job-related doses in Europe

International Nuclear Information System (INIS)

Anon.

1990-01-01

As part of its role of safeguarding nuclear workers the Commission of the European Community has created a European data bank on job-related doses. The data bank is intended to correlate jobs and workers doses and is a useful instrument to observe the collected doses of workers in nuclear power plants. Set up in 1980, the database covers doses in PWRs and BWRs. To create it a questionnaire is distributed to plant operators. The database responses provide information on (i) Trends in total collective doses, including those for some ancillary jobs. It is possible to see trends by calendar year and by fuel cycle number. (ii) Other trends such as dose in terms of installed power or dose in terms of power station design. (iii) Dose differences between power stations, normalized against the differences in dose rates. This is only possible for PWRs that monitor dose rates using the EPRI standard monitoring programme. (vi) The relative dose rate in each plant for a defined job. The questionnaire is not perfectly adapted to all the working criteria in nuclear power stations but it is an effective tool for implementing radiation protection. (author)

Effect of human rotavirus vaccine on severe diarrhea in African infants.

Science.gov (United States)

Madhi, Shabir A; Cunliffe, Nigel A; Steele, Duncan; Witte, Desirée; Kirsten, Mari; Louw, Cheryl; Ngwira, Bagrey; Victor, John C; Gillard, Paul H; Cheuvart, Brigitte B; Han, Htay H; Neuzil, Kathleen M

2010-01-28

Rotavirus is the most common cause of severe gastroenteritis among young children worldwide. Data are needed to assess the efficacy of the rotavirus vaccine in African children. We conducted a randomized, placebo-controlled, multicenter trial in South Africa (3166 infants; 64.1% of the total) and Malawi (1773 infants; 35.9% of the total) to evaluate the efficacy of a live, oral rotavirus vaccine in preventing severe rotavirus gastroenteritis. Healthy infants were randomly assigned in a 1:1:1 ratio to receive two doses of vaccine (in addition to one dose of placebo) or three doses of vaccine--the pooled vaccine group--or three doses of placebo at 6, 10, and 14 weeks of age. Episodes of gastroenteritis caused by wild-type rotavirus during the first year of life were assessed through active follow-up surveillance and were graded with the use of the Vesikari scale. A total of 4939 infants were enrolled and randomly assigned to one of the three groups; 1647 infants received two doses of the vaccine, 1651 infants received three doses of the vaccine, and 1641 received placebo. Of the 4417 infants included in the per-protocol efficacy analysis, severe rotavirus gastroenteritis occurred in 4.9% of the infants in the placebo group and in 1.9% of those in the pooled vaccine group (vaccine efficacy, 61.2%; 95% confidence interval, 44.0 to 73.2). Vaccine efficacy was lower in Malawi than in South Africa (49.4% vs. 76.9%); however, the number of episodes of severe rotavirus gastroenteritis that were prevented was greater in Malawi than in South Africa (6.7 vs. 4.2 cases prevented per 100 infants vaccinated per year). Efficacy against all-cause severe gastroenteritis was 30.2%. At least one serious adverse event was reported in 9.7% of the infants in the pooled vaccine group and in 11.5% of the infants in the placebo group. Human rotavirus vaccine significantly reduced the incidence of severe rotavirus gastroenteritis among African infants during the first year of life. (Clinical

Factors that elevate the internal radionuclide and chemical retention, dose and health risks to infants and children in a radiological-nuclear emergency

International Nuclear Information System (INIS)

Richardson, R. B.

2009-01-01

The factors that influence the dose and risk to vulnerable population groups from exposure and internal uptake of chemicals are examined and, in particular, the radionuclides released in chemical, biological, radiological, nuclear and explosive events. The paper seeks to identify the areas that would benefit from further research. The intake and body burdens of carbon and calcium were assessed as surrogates for contaminants that either act like or bind to hydrocarbons (e.g. tritium and 14 C) or bone-seeking radionuclides (e.g. 90 Sr and 239 Pu). The shortest turnover times for such materials in the whole body were evaluated for the newborn: 11 d and 0.5 y for carbon and calcium, respectively. However, their biokinetic behaviour is complicated by a particularly high percentage of the gut-absorbed dietary intake of carbon (∼16%) and calcium (∼100%) that is incorporated into the soft tissue and skeleton of the growing neonate. The International Commission on Radiological Protection dose coefficients (Sv Bq -1 ) were examined for 14 radionuclides, including 9 of concern because of their potential use in radiological dispersal devices. The dose coefficients for a 3-month-old are greater than those for adults (2-56 times more for ingestion and 2-12 times for inhalation). The age-dependent dose and exposure assessment of contaminant intakes would improve by accounting for gender and growth where it is currently neglected. Health risk is evaluated as the product of the exposure and hazard factors, the latter being about 10-fold greater in infants than in adults. The exposure factor is also approximately 10-fold higher for ingestion by infants than by adults, and unity for inhalation varying with the contaminant. Qualitative and quantitative physiological and epidemiological evidence supports infants being more vulnerable to cancer and neurological deficit than older children). (authors)

Sensitivity to structure in action sequences: An infant event-related potential study.

Science.gov (United States)

Monroy, Claire D; Gerson, Sarah A; Domínguez-Martínez, Estefanía; Kaduk, Katharina; Hunnius, Sabine; Reid, Vincent

2017-05-06

Infants are sensitive to structure and patterns within continuous streams of sensory input. This sensitivity relies on statistical learning, the ability to detect predictable regularities in spatial and temporal sequences. Recent evidence has shown that infants can detect statistical regularities in action sequences they observe, but little is known about the neural process that give rise to this ability. In the current experiment, we combined electroencephalography (EEG) with eye-tracking to identify electrophysiological markers that indicate whether 8-11-month-old infants detect violations to learned regularities in action sequences, and to relate these markers to behavioral measures of anticipation during learning. In a learning phase, infants observed an actor performing a sequence featuring two deterministic pairs embedded within an otherwise random sequence. Thus, the first action of each pair was predictive of what would occur next. One of the pairs caused an action-effect, whereas the second did not. In a subsequent test phase, infants observed another sequence that included deviant pairs, violating the previously observed action pairs. Event-related potential (ERP) responses were analyzed and compared between the deviant and the original action pairs. Findings reveal that infants demonstrated a greater Negative central (Nc) ERP response to the deviant actions for the pair that caused the action-effect, which was consistent with their visual anticipations during the learning phase. Findings are discussed in terms of the neural and behavioral processes underlying perception and learning of structured action sequences. Copyright © 2017 Elsevier Ltd. All rights reserved.

The relation of infant attachment to attachment and cognitive and behavioural outcomes in early childhood.

Science.gov (United States)

Ding, Yan-hua; Xu, Xiu; Wang, Zheng-yan; Li, Hui-rong; Wang, Wei-ping

2014-09-01

In China, research on the relation of mother-infant attachment to children's development is scarce. This study sought to investigate the relation of mother-infant attachment to attachment, cognitive and behavioural development in young children. This study used a longitudinal study design. The subjects included healthy infants (n=160) aged 12 to 18 months. Ainsworth's "Strange Situation Procedure" was used to evaluate mother-infant attachment types. The attachment Q-set (AQS) was used to evaluate the attachment between young children and their mothers. The Bayley scale of infant development-second edition (BSID-II) was used to evaluate cognitive developmental level in early childhood. Achenbach's child behaviour checklist (CBCL) for 2- to 3-year-olds was used to investigate behavioural problems. In total, 118 young children (73.8%) completed the follow-up; 89.7% of infants with secure attachment and 85.0% of infants with insecure attachment still demonstrated this type of attachment in early childhood (κ=0.738, pInfants with insecure attachment collectively exhibited a significantly lower mental development index (MDI) in early childhood than did infants with secure attachment, especially the resistant type. In addition, resistant infants were reported to have greater social withdrawal, sleep problems and aggressive behaviour in early childhood. There is a high consistency in attachment development from infancy to early childhood. Secure mother-infant attachment predicts a better cognitive and behavioural outcome; whereas insecure attachment, especially the resistant attachment, may lead to a lower cognitive level and greater behavioural problems in early childhood. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Fat emulsion tolerance in preterm infants of different gestational ages in the early stage after birth].

Science.gov (United States)

Tang, Hui; Yang, Chuan-Zhong; Li, Huan; Wen, Wei; Huang, Fang-Fang; Huang, Zhi-Feng; Shi, Yu-Ping; Yu, Yan-Liang; Chen, Li-Lian; Yuan, Rui-Qin; Zhu, Xiao-Yu

2017-06-01

To investigate the fat emulsion tolerance in preterm infants of different gestational ages in the early stage after birth. A total of 98 preterm infants were enrolled and divided into extremely preterm infant group (n=17), early preterm infant group (n=48), and moderate-to-late preterm infant group (n=33). According to the dose of fat emulsion, they were further divided into low- and high-dose subgroups. The umbilical cord blood and dried blood filter papers within 3 days after birth were collected. Tandem mass spectrometry was used to measure the content of short-, medium-, and long-chain acylcarnitines. The extremely preterm infant and early preterm infant groups had a significantly lower content of long-chain acylcarnitines in the umbilical cord blood and dried blood filter papers within 3 days after birth than the moderate-to-late preterm infant group (Pemulsion subgroup had a significantly higher content of short-, medium-, and long-chain acylcarnitines than the high-dose fat emulsion subgroup among the extremely preterm infants (Pemulsion subgroups within 3 days after birth. Compared with moderate-to-late preterm infants, extremely preterm infants and early preterm infants have a lower capacity to metabolize long-chain fatty acids within 3 days after birth. Early preterm infants and moderate-to-late preterm infants may tolerate high-dose fat emulsion in the early stage after birth, but extremely preterm infants may have an insufficient capacity to metabolize high-dose fat emulsion.

Risk of Injection-Site Abscess among Infants Receiving a Preservative-Free, Two-Dose Vial Formulation of Pneumococcal Conjugate Vaccine in Kenya

Science.gov (United States)

Burton, Deron C.; Bigogo, Godfrey M.; Audi, Allan O.; Williamson, John; Munge, Kenneth; Wafula, Jackline; Ouma, Dominic; Khagayi, Sammy; Mugoya, Isaac; Mburu, James; Muema, Shadrack; Bauni, Evasius; Bwanaali, Tahreni; Feikin, Daniel R.; Ochieng, Peter M.; Mogeni, Ondari D.; Otieno, George A.; Olack, Beatrice; Kamau, Tatu; Van Dyke, Melissa K.; Chen, Robert; Farrington, Paddy; Montgomery, Joel M.; Breiman, Robert F.; Scott, J. Anthony G.; Laserson, Kayla F.

2015-01-01

There is a theoretical risk of adverse events following immunization with a preservative-free, 2-dose vial formulation of 10-valent-pneumococcal conjugate vaccine (PCV10). We set out to measure this risk. Four population-based surveillance sites in Kenya (total annual birth cohort of 11,500 infants) were used to conduct a 2-year post-introduction vaccine safety study of PCV10. Injection-site abscesses occurring within 7 days following vaccine administration were clinically diagnosed in all study sites (passive facility-based surveillance) and, also, detected by caregiver-reported symptoms of swelling plus discharge in two sites (active household-based surveillance). Abscess risk was expressed as the number of abscesses per 100,000 injections and was compared for the second vs first vial dose of PCV10 and for PCV10 vs pentavalent vaccine (comparator). A total of 58,288 PCV10 injections were recorded, including 24,054 and 19,702 identified as first and second vial doses, respectively (14,532 unknown vial dose). The risk ratio for abscess following injection with the second (41 per 100,000) vs first (33 per 100,000) vial dose of PCV10 was 1.22 (95% confidence interval [CI] 0.37–4.06). The comparator vaccine was changed from a 2-dose to 10-dose presentation midway through the study. The matched odds ratios for abscess following PCV10 were 1.00 (95% CI 0.12–8.56) and 0.27 (95% CI 0.14–0.54) when compared to the 2-dose and 10-dose pentavalent vaccine presentations, respectively. In Kenya immunization with PCV10 was not associated with an increased risk of injection site abscess, providing confidence that the vaccine may be safely used in Africa. The relatively higher risk of abscess following the 10-dose presentation of pentavalent vaccine merits further study. PMID:26509274

Relations of Mothers' and Fathers' Reports of Infant Temperament, Parents' Psychological Functioning, and Family Characteristics.

Science.gov (United States)

Ventura, Jaqueline N.; Stevenson, Marguerite B.

1986-01-01

Examines 95 parents' reports of relations between infant termperament and parental psychological conditions, as well as familiy characteristics of socioeconomic status, birth order, and infant gender. (HOD)

Sodium Chloride Supplementation Is Not Routinely Performed in the Majority of German and Austrian Infants with Classic Salt-Wasting Congenital Adrenal Hyperplasia and Has No Effect on Linear Growth and Hydrocortisone or Fludrocortisone Dose.

Science.gov (United States)

Bonfig, Walter; Roehl, Friedhelm; Riedl, Stefan; Brämswig, Jürgen; Richter-Unruh, Annette; Fricke-Otto, Susanne; Hübner, Angela; Bettendorf, Markus; Schönau, Eckhard; Dörr, Helmut; Holl, Reinhard W; Mohnike, Klaus

2018-01-01

Sodium chloride supplementation in salt-wasting congenital adrenal hyperplasia (CAH) is generally recommended in infants, but its implementation in routine care is very heterogeneous. To evaluate oral sodium chloride supplementation, growth, and hydrocortisone and fludrocortisone dose in infants with salt-wasting CAH due to 21-hydroxylase in 311 infants from the AQUAPE CAH database. Of 358 patients with classic CAH born between 1999 and 2015, 311 patients had salt-wasting CAH (133 females, 178 males). Of these, 86 patients (27.7%) received oral sodium chloride supplementation in a mean dose of 0.9 ± 1.4 mmol/kg/day (excluding nutritional sodium content) during the first year of life. 225 patients (72.3%) were not treated with sodium chloride. The percentage of sodium chloride-supplemented patients rose from 15.2% in children born 1999-2004 to 37.5% in children born 2011-2015. Sodium chloride-supplemented and -unsupplemented infants did not significantly differ in hydrocortisone and fludrocortisone dose, target height-corrected height-SDS, and BMI-SDS during the first 2 years of life. In the AQUAPE CAH database, approximately one-third of infants with salt-wasting CAH receive sodium chloride supplementation. Sodium chloride supplementation is performed more frequently in recent years. However, salt supplementation had no influence on growth, daily fludrocortisone and hydrocortisone dose, and frequency of adrenal crisis. © 2017 S. Karger AG, Basel.

Azithromycin to prevent bronchopulmonary dysplasia in ureaplasma-infected preterm infants: pharmacokinetics, safety, microbial response, and clinical outcomes with a 20-milligram-per-kilogram single intravenous dose.

Science.gov (United States)

Viscardi, Rose M; Othman, Ahmed A; Hassan, Hazem E; Eddington, Natalie D; Abebe, Elias; Terrin, Michael L; Kaufman, David A; Waites, Ken B

2013-05-01

Ureaplasma respiratory tract colonization is associated with bronchopulmonary dysplasia (BPD) in preterm infants. Previously, we demonstrated that a single intravenous (i.v.) dose of azithromycin (10 mg/kg of body weight) is safe but inadequate to eradicate Ureaplasma spp. in preterm infants. We performed a nonrandomized, single-arm open-label study of the pharmacokinetics (PK) and safety of intravenous 20-mg/kg single-dose azithromycin in 13 mechanically ventilated neonates with a gestational age between 24 weeks 0 days and 28 weeks 6 days. Pharmacokinetic data from 25 neonates (12 dosed with 10 mg/kg i.v. and 13 dosed with 20 mg/kg i.v.) were analyzed using a population modeling approach. Using a two-compartment model with allometric scaling of parameters on body weight (WT), the population PK parameter estimates were as follows: clearance, 0.21 liter/h × WT(kg)(0.75) [WT(kg)(0.75) indicates that clearance was allometrically scaled on body weight (in kilograms) with a fixed exponent of 0.75]; intercompartmental clearance, 2.1 liters/h × WT(kg)(0.75); central volume of distribution (V), 1.97 liters × WT (kg); and peripheral V, 17.9 liters × WT (kg). There was no evidence of departure from dose proportionality in azithromycin exposure over the tested dose range. The calculated area under the concentration-time curve over 24 h in the steady state divided by the MIC90 (AUC24/MIC90) for the single dose of azithromycin (20 mg/kg) was 7.5 h. Simulations suggest that 20 mg/kg for 3 days will maintain azithromycin concentrations of >MIC50 of 1 μg/ml for this group of Ureaplasma isolates for ≥ 96 h after the first dose. Azithromycin was well tolerated with no drug-related adverse events. One of seven (14%) Ureaplasma-positive subjects and three of six (50%) Ureaplasma-negative subjects developed physiologic BPD. Ureaplasma was eradicated in all treated Ureaplasma-positive subjects. Simulations suggest that a multiple-dose regimen may be efficacious for microbial

Hospitalized Premature Infants Are Colonized by Related Bacterial Strains with Distinct Proteomic Profiles

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Christopher T. Brown

2018-04-01

Full Text Available During the first weeks of life, microbial colonization of the gut impacts human immune system maturation and other developmental processes. In premature infants, aberrant colonization has been implicated in the onset of necrotizing enterocolitis (NEC, a life-threatening intestinal disease. To study the premature infant gut colonization process, genome-resolved metagenomics was conducted on 343 fecal samples collected during the first 3 months of life from 35 premature infants housed in a neonatal intensive care unit, 14 of whom developed NEC, and metaproteomic measurements were made on 87 samples. Microbial community composition and proteomic profiles remained relatively stable on the time scale of a week, but the proteome was more variable. Although genetically similar organisms colonized many infants, most infants were colonized by distinct strains with metabolic profiles that could be distinguished using metaproteomics. Microbiome composition correlated with infant, antibiotics administration, and NEC diagnosis. Communities were found to cluster into seven primary types, and community type switched within infants, sometimes multiple times. Interestingly, some communities sampled from the same infant at subsequent time points clustered with those of other infants. In some cases, switches preceded onset of NEC; however, no species or community type could account for NEC across the majority of infants. In addition to a correlation of protein abundances with organism replication rates, we found that organism proteomes correlated with overall community composition. Thus, this genome-resolved proteomics study demonstrated that the contributions of individual organisms to microbiome development depend on microbial community context.

Hospitalized Premature Infants Are Colonized by Related Bacterial Strains with Distinct Proteomic Profiles

Science.gov (United States)

Xiong, Weili; Olm, Matthew R.; Thomas, Brian C.; Baker, Robyn; Firek, Brian; Morowitz, Michael J.; Hettich, Robert L.

2018-01-01

ABSTRACT During the first weeks of life, microbial colonization of the gut impacts human immune system maturation and other developmental processes. In premature infants, aberrant colonization has been implicated in the onset of necrotizing enterocolitis (NEC), a life-threatening intestinal disease. To study the premature infant gut colonization process, genome-resolved metagenomics was conducted on 343 fecal samples collected during the first 3 months of life from 35 premature infants housed in a neonatal intensive care unit, 14 of whom developed NEC, and metaproteomic measurements were made on 87 samples. Microbial community composition and proteomic profiles remained relatively stable on the time scale of a week, but the proteome was more variable. Although genetically similar organisms colonized many infants, most infants were colonized by distinct strains with metabolic profiles that could be distinguished using metaproteomics. Microbiome composition correlated with infant, antibiotics administration, and NEC diagnosis. Communities were found to cluster into seven primary types, and community type switched within infants, sometimes multiple times. Interestingly, some communities sampled from the same infant at subsequent time points clustered with those of other infants. In some cases, switches preceded onset of NEC; however, no species or community type could account for NEC across the majority of infants. In addition to a correlation of protein abundances with organism replication rates, we found that organism proteomes correlated with overall community composition. Thus, this genome-resolved proteomics study demonstrated that the contributions of individual organisms to microbiome development depend on microbial community context. PMID:29636439

High Rates of All-cause and Gastroenteritis-related Hospitalization Morbidity and Mortality among HIV-exposed Indian Infants

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Tripathy Srikanth

2011-07-01

Full Text Available Abstract Background HIV-infected and HIV-exposed, uninfected infants experience a high burden of infectious morbidity and mortality. Hospitalization is an important metric for morbidity and is associated with high mortality, yet, little is known about rates and causes of hospitalization among these infants in the first 12 months of life. Methods Using data from a prevention of mother-to-child transmission (PMTCT trial (India SWEN, where HIV-exposed breastfed infants were given extended nevirapine, we measured 12-month infant all-cause and cause-specific hospitalization rates and hospitalization risk factors. Results Among 737 HIV-exposed Indian infants, 93 (13% were HIV-infected, 15 (16% were on HAART, and 260 (35% were hospitalized 381 times by 12 months of life. Fifty-six percent of the hospitalizations were attributed to infections; gastroenteritis was most common accounting for 31% of infectious hospitalizations. Gastrointestinal-related hospitalizations steadily increased over time, peaking around 9 months. The 12-month all-cause hospitalization, gastroenteritis-related hospitalization, and in-hospital mortality rates were 906/1000 PY, 229/1000 PY, and 35/1000 PY respectively among HIV-infected infants and 497/1000 PY, 107/1000 PY, and 3/1000 PY respectively among HIV-exposed, uninfected infants. Advanced maternal age, infant HIV infection, gestational age, and male sex were associated with higher all-cause hospitalization risk while shorter duration of breastfeeding and abrupt weaning were associated with gastroenteritis-related hospitalization. Conclusions HIV-exposed Indian infants experience high rates of all-cause and infectious hospitalization (particularly gastroenteritis and in-hospital mortality. HIV-infected infants are nearly 2-fold more likely to experience hospitalization and 10-fold more likely to die compared to HIV-exposed, uninfected infants. The combination of scaling up HIV PMTCT programs and implementing proven health

Infant-Mother Attachment Classification: Risk and Protection in Relation to Changing Maternal Caregiving Quality

Science.gov (United States)

Developmental Psychology, 2006

2006-01-01

The relations between early infant-mother attachment and children's social competence and behavior problems during the preschool and early school-age period were examined in more than 1,000 children under conditions of decreasing, stable, and increasing maternal parenting quality. Infants' Strange Situation attachment classifications predicted…

Test-retest reliability of infant event related potentials evoked by faces.

Science.gov (United States)

Munsters, N M; van Ravenswaaij, H; van den Boomen, C; Kemner, C

2017-04-05

Reliable measures are required to draw meaningful conclusions regarding developmental changes in longitudinal studies. Little is known, however, about the test-retest reliability of face-sensitive event related potentials (ERPs), a frequently used neural measure in infants. The aim of the current study is to investigate the test-retest reliability of ERPs typically evoked by faces in 9-10 month-old infants. The infants (N=31) were presented with neutral, fearful and happy faces that contained only the lower or higher spatial frequency information. They were tested twice within two weeks. The present results show that the test-retest reliability of the face-sensitive ERP components is moderate (P400 and Nc) to substantial (N290). However, there is low test-retest reliability for the effects of the specific experimental manipulations (i.e. emotion and spatial frequency) on the face-sensitive ERPs. To conclude, in infants the face-sensitive ERP components (i.e. N290, P400 and Nc) show adequate test-retest reliability, but not the effects of emotion and spatial frequency on these ERP components. We propose that further research focuses on investigating elements that might increase the test-retest reliability, as adequate test-retest reliability is necessary to draw meaningful conclusions on individual developmental trajectories of the face-sensitive ERPs in infants. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Safety, immunogenicity, and protective efficacy of two doses of RIX4414 live attenuated human rotavirus vaccine in healthy infants.

Science.gov (United States)

Araujo, Eliete C; Clemens, Sue Ann C; Oliveira, Consuelo S; Justino, Maria Cleonice A; Rubio, Pilar; Gabbay, Yvone B; da Silva, Veronilce B; Mascarenhas, Joana D P; Noronha, Vânia L; Clemens, Ralf; Gusmão, Rosa Helena P; Sanchez, Nervo; Monteiro, Talita Antônia F; Linhares, Alexandre C

2007-01-01

To determine the safety, immunogenicity and efficacy of two doses of rotavirus vaccine in healthy Brazilian infants. A randomized, multicenter, double-blind, placebo-controlled trial was conducted in Brazil, Mexico and Venezuela. Infants received two oral doses of vaccine or placebo at 2 and 4 months of age, concurrently with routine immunizations, except for oral poliomyelitis vaccine (OPV). This paper reports results from Belém, Brazil, where the number of subjects per group and the viral vaccine titers were: 194 (10(4.7) focus forming units - FFU), 196 (10(5.2) FFU), 194 (10(5.8) FFU) and 194 (placebo). Anti-rotavirus (anti-RV) antibody response was assessed in 307 subjects. Clinical severity of gastroenteritis episodes was measured using a 20-point scoring system with a score of >or= 11 defined as severe GE. The rates of solicited general symptoms were similar in vaccine and placebo recipients. At 2 months after the second dose, a serum IgA response to RV occurred in 54.7 to 74.4% of vaccinees. No interference was seen in the immunogenicity of routine vaccines. Vaccine efficacy against any rotavirus gastroenteritis (RVGE) was 63.5% (95%CI 20.8-84.4) for the highest concentration (10(5.8) FFU). Efficacy was 81.5% (95%CI 44.5-95.4) against severe RVGE. At its highest concentration (10(5.8) FFU), RIX4414 provided 79.8% (95%CI 26.4-96.3) protection against severe RVGE by G9 strain. RIX4414 was highly immunogenic with a low reactogenicity profile and did not interfere with seroresponse to diphtheria, tetanus, pertussis, hepatitis B and Hib antigens. Two doses of RIX4414 provided significant protection against severe GE caused by RV.

Xanthophylls and eye health of infants and adults.

Science.gov (United States)

Moukarzel, Adib A; Bejjani, Riad A; Fares, Florence N

2009-01-01

Lutein and zeaxanthin are the only carotenoids present in the eye. They cannot be synthesized de novo and are specifically concentrated in the macula. They appear to have at least two major functions: to filter out blue light and thus prevent ensuing damages to the eye and to act as antioxidants. Infants are particularly at risk from both blue light and oxidative damage to eye tissues. Lutein is present in human milk but is not currently added to infant formulas. Fortifying formulae with lutein in order to match more closely human milk might help protect the infant's sensitive eyes. In adults, the exact pathogenesis of age-related maculopathy remains unknown. Light damage, inflammation, and the disruption of cellular processes by oxidative stress may play an important role in the degenerative process. Manipulation of intake of xanthophylls has been shown to augment macular pigment, therefore it is thought that carotenoid dietary supplements could prevent, delay, or modify the course of age-related maculopathy. However, definite evidence of the effect of carotenoids, the optimal doses to use, and the supplementation duration are still under investigation.

Plasma paracetamol concentrations and pharmacokinetics following rectal administration in neonates and young infants

DEFF Research Database (Denmark)

Hansen, Tom Giedsing; O'Brien, K; Morton, N S

1999-01-01

Despite widespread use in children pharmacokinetic data about paracetamol are relatively scarce, not the least in the youngest age groups. This study aimed to describe plasma paracetamol concentrations and pharmacokinetics of a single rectal paracetamol dose in neonates and young infants....

Pasteurization of mother's own milk for preterm infants does not reduce the incidence of late-onset sepsis.

Science.gov (United States)

Cossey, Veerle; Vanhole, Chris; Eerdekens, An; Rayyan, Maissa; Fieuws, Steffen; Schuermans, Annette

2013-01-01

Feeding preterm infants human milk has a beneficial effect on the risk of late-onset sepsis (LOS). Due to lack of microbiological standards, practices such as pasteurization of mother's own milk differ widely among neonatal intensive care units worldwide. To investigate whether pasteurization of mother's own milk for very-low-birth-weight (VLBW) infants influences the incidence and severity of infection-related outcomes. In this randomized controlled trial, preterm infants (gestational age pasteurized mother's own milk during the first 8 weeks of life. The primary outcome was the incidence of proven LOS. A dose-response relation was verified, i.e. the dependence of the risk of sepsis on the actual and cumulative quantities of mother's own milk. This study included 303 VLBW infants (mean birth weight: 1,276 g; mean gestational age: 29 weeks) whose baseline and nutritional characteristics were similar. The incidence of laboratory-confirmed sepsis was not statistically different in infants fed raw milk compared to infants who received pasteurized milk: 22/151 (0.15, CI: 0.08-0.20) and 31/152 (0.20, CI: 0.14-0.27), respectively (RR: 0.71; 95% CI: 0.43-1.17). A significant dose-response relation was observed between the adjusted quantity of enteral feeding and the risk of LOS, regardless of the type of feeding. For preterm infants, pasteurization of mother's own milk shows a trend towards an increase in infectious morbidity, although no statistical significance was reached. Practices should focus on collection, storage and labeling procedures to ensure the safety and quality of expressed milk. Copyright © 2012 S. Karger AG, Basel.

The Efficiency of Infants' Exploratory Play Is Related to Longer-Term Cognitive Development

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Muentener, Paul; Herrig, Elise; Schulz, Laura

2018-01-01

In this longitudinal study we examined the stability of exploratory play in infancy and its relation to cognitive development in early childhood. We assessed infants' (N = 130, mean age at enrollment = 12.02 months, SD = 3.5 months; range: 5–19 months) exploratory play four times over 9 months. Exploratory play was indexed by infants' attention to novelty, inductive generalizations, efficiency of exploration, face preferences, and imitative learning. We assessed cognitive development at the fourth visit for the full sample, and again at age three for a subset of the sample (n = 38). The only measure that was stable over infancy was the efficiency of exploration. Additionally, infants' efficiency score predicted vocabulary size and distinguished at-risk infants recruited from early intervention sites from those not at risk. Follow-up analyses at age three provided additional evidence for the importance of the efficiency measure: more efficient exploration was correlated with higher IQ scores. These results suggest that the efficiency of infants' exploratory play can be informative about longer-term cognitive development. PMID:29904360

Hepatitis B vaccination of premature infants: a reassessment of current recommendations for delayed immunization.

Science.gov (United States)

Losonsky, G A; Wasserman, S S; Stephens, I; Mahoney, F; Armstrong, P; Gumpper, K; Dulkerian, S; West, D J; Gewolb, I H

1999-02-01

Current American Academy of Pediatrics and United States Public Health Service Immunization Practices Advisory Committee recommendations for hepatitis B immunization in premature infants weighing birth born to hepatitis B surface antigen (HBSAg)-negative mothers are to delay the initiation of vaccination until such infants reach 2 kg or until 2 months of age. This proposal to delay vaccination at birth in these low-risk infants was based on limited studies not conducted in the United States. We sought to reassess current recommendations to delay administration of hepatitis B vaccine in low-risk premature infants by determining the immunogenicity of early hepatitis B vaccination in a US population and identifying variables associated with poor immunogenicity. A total of 148 infants birth and stratified to three birth weight groups: 1500 g. Recombinant hepatitis B vaccine was administered within the first week of life, at 1 to 2 months of age, and at 6 to 7 months of age. Serum obtained at birth and after the second and third doses of vaccine was tested for antibody to HBSAg. Variables associated with poor response were sought prospectively by collecting demographic and clinical data. A total of 118 subjects (83%) completed the study. Postsecond dose sera were available for 117 infants and postthird dose sera were available for 112 infants. The seroprotection rate (attaining >/=10 mIU/mL HBS antibody) after two doses was low (25%) regardless of birth weight; infants weighing birth had the poorest response (11%). The seroprotection response rate after three doses of vaccine increased with birth weight; infants weighing birth (groups 1 and 2) had lower rates of response (52% and 68%, respectively) than did infants weighing >1500 g at birth (group 3; 84% response rate). The seroprotection response rate of group 3 infants after three doses of vaccine, although low, could not be differentiated from the response rates reported for full-term infants using 95% confidence

Agriculture-related radiation dose calculations

International Nuclear Information System (INIS)

Furr, J.M.; Mayberry, J.J.; Waite, D.A.

1987-10-01

Estimates of radiation dose to the public must be made at each stage in the identification and qualification process leading to siting a high-level nuclear waste repository. Specifically considering the ingestion pathway, this paper examines questions of reliability and adequacy of dose calculations in relation to five stages of data availability (geologic province, region, area, location, and mass balance) and three methods of calculation (population, population/food production, and food production driven). Calculations were done using the model PABLM with data for the Permian and Palo Duro Basins and the Deaf Smith County area. Extra effort expended in gathering agricultural data at succeeding environmental characterization levels does not appear justified, since dose estimates do not differ greatly; that effort would be better spent determining usage of food types that contribute most to the total dose; and that consumption rate and the air dispersion factor are critical to assessment of radiation dose via the ingestion pathway. 17 refs., 9 figs., 32 tabs

Nutrition of preterm infants in relation to bronchopulmonary dysplasia

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Tschirch Edda

2011-02-01

Full Text Available Background The pathogenesis of bronchopulmonary dysplasia (BPD is multifactorial. In addition to prenatal inflammation, postnatal malnutrition also affects lung development. Methods A retrospective study was performed to analyse during the first two weeks of life the total, enteral and parenteral nutrition of premature infants ( Results Ninety-five premature infants were analysed: 26 with BPD (27 ± 1 weeks and 69 without BPD (28 ± 1 weeks. There was no statistical significant difference in the total intake of fluids, calories, glucose or protein and weight gain per day in both groups. The risk of developing BPD was slightly increased in infants with cumulative caloric intake below the minimal requirement of 1230 kcal/kg and a cumulative protein intake below 43.5 g/kg. Furthermore, the risk of developing BPD was significantly higher when infants had a cumulative fluid intake above the recommended 1840 ml/kg. In infants who developed BPD, the enteral nutrition was significantly lower than in non-BPD infants [456 ml/kg (IQR 744, 235 vs. 685 (IQR 987, 511]. Infants who did not develop BPD reached 50% of total enteral feeding significantly faster [9.6 days vs. 11.5]. Conclusions Preterm infants developing BPD received less enteral feeding, even though it was well compensated by the parenteral nutrient supply. Data suggest that a critical minimal amount of enteral feeding is required to prevent development of BPD; however, a large prospective clinical study is needed to prove this assumption.

Selenium deficiency and the effects of supplementation on preterm infants

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Renata Germano B. O. N. Freitas

2014-03-01

Full Text Available Objective: This study aimed to review the literature about blood concentrations of selenium associated with gestational age, feeding, supplementation and related clinical features in preterm infants. Data sources: Systematic review in the following databases: MEDLINE, PubMed, Google academics, SciELO. org, ScienceDirect (Elsevier and CINAHL-Plus with Full Text (EBSCO. Articles published up to January 2013 with the keywords "selenium deficiency", "selenium supplementation", "neonates", "infants", "newborn" and "preterm infants" were selected. Data synthesis: The studies reported that low blood selenium levels are associated with increased risk of respiratory diseases. Preterm infants, especially with low birth weight, presented lower selenium levels. Selenium deficiency has also been associated with the use of oral infant formula, enteral and parenteral nutrition (with or without selenium addition. The optimal dose and length of selenium supplementation is not well-established, since they are based only on age group and selenium ingestion by breastfed children. Furthermore, the clinical status of the infant affected by conditions that may increase oxidative stress, and consequently, selenium requirements is not taken into account. Conclusions: Prematurity and low birth weight can contribute to low blood selenium in premature infants. Selenium supplementation seems to minimize or prevent clinical complications caused by prematurity.

Feed-related Splanchnic Oxygenation in Preterm Infants With Abnormal Antenatal Doppler Developing Gut Complications.

Science.gov (United States)

Martini, Silvia; Aceti, Arianna; Beghetti, Isadora; Faldella, Giacomo; Corvaglia, Luigi

2018-05-01

Preterm infants with antenatal absent or reversed end diastolic flow (AREDF) in umbilical arteries are at major risk for gastrointestinal (GI) complications, such as necrotizing enterocolitis, intestinal perforation and feeding intolerance. Near-infrared spectroscopy provides continuous monitoring of splanchnic oxygenation (SrSO2) and may represent a useful tool to predict GI outcomes in this high-risk population. This observational, pilot study assessed feed-related SrSO2 patterns at enteral feeding introduction and full enteral feeding (FEF) achievement in twenty AREDF infants with gestational age ≤34 weeks. Enrolled infants were divided into 2 groups according to the development versus lack of GI complications. Infants developing GI complications showed significantly lower SrSO2 and increased splanchnic oxygen extraction in response to enteral feeds at both enteral feeding introduction and FEF. The potential role of these findings in predicting GI complications in AREDF preterm infants seems promising and deserves further evaluation.

PVC flooring is related to human uptake of phthalates in infants.

Science.gov (United States)

Carlstedt, F; Jönsson, B A G; Bornehag, C-G

2013-02-01

Polyvinyl chloride (PVC) flooring material contains phthalates, and it has been shown that such materials are important sources for phthalates in indoor dust. Phthalates are suspected endocrine-disrupting chemicals (EDCs). Consecutive infants between 2 and 6 months old and their mothers were invited. A questionnaire about indoor environmental factors and family lifestyle was used. Urinary metabolites of the phthalates diethyl phthalate (DEP), dibutyl phthalate (DBP), butylbenzyl phthalate (BBzP), and dietylhexyl phthalate (DEHP) were measured in the urine of the children. Of 209 invited children, 110 (52%) participated. Urine samples were obtained from 83 of these. Urine levels of the BBzP metabolite monobenzyl phthalate (MBzP) was significantly higher in infants with PVC flooring in their bedrooms (P flooring material may increase the human uptake of phthalates in infants. Urinary levels of phthalate metabolites during early life are associated with the use of PVC flooring in the bedroom, body area, and the use of infant formula. This study shows that the uptake of phthalates is not only related to oral uptake from, for example, food but also to environmental factors such as building materials. This new information should be considered when designing indoor environment, especially for children. © 2012 John Wiley & Sons A/S.

Transfer of L-selenomethionine-/sup 75/Se to human milk and the potential radiation dose to a breast-fed infant

Energy Technology Data Exchange (ETDEWEB)

Taylor, D M; McCready, V R; Cosgrove, D O [Heidelberg Univ. (Germany). Lehrstuhl fuer Strahlentoxikologie

1981-04-01

Following the administration of L-selenomethionine-/sup 75/Se for a pancreas scan of a lactating mother, it was shown that there was a rapid and high level of incorporation of /sup 75/Se into the breast milk and the milk proteins. Between 5 and 29 hours after injection, the /sup 75/Se concentration in the whole milk and the milk solids decreased by a factor of more than 2; from 29 to 123 hours the concentrations appeared to decrease exponentially with a biological half-time of 78 +- 6 hours. At 123 hours post injection the concentrations of /sup 75/Se in the milk was 68% of that in the maternal plasma. An estimate of the /sup 75/Se intake by the infant was made from the measurements made on the single urine sample obtained 41 hours after the last breast feed. A whole body radiation dose to the infant was estimated to be about 500 ..mu..Gy, i.e. about one-tenth of the ICRP dose equivalent limit for a member of the general public. If breast feeding had been allowed to continue, the whole boent localization tumours and the principles of transferring the experimental data from animals to human beings.

Maternal affect and quality of parenting experiences are related to amygdala response to infant faces.

Science.gov (United States)

Barrett, Jennifer; Wonch, Kathleen E; Gonzalez, Andrea; Ali, Nida; Steiner, Meir; Hall, Geoffrey B; Fleming, Alison S

2012-01-01

We examined how individual differences in mood and anxiety in the early postpartum period are related to brain response to infant stimuli during fMRI, with particular focus on regions implicated in both maternal behavior and mood/anxiety, that is, the subgenual anterior cingulate cortex (sgACC) and the amygdala. At approximately 3 months postpartum, 22 mothers completed an affect-rating task (ART) during fMRI, where their affective response to infant stimuli was explicitly probed. Mothers viewed/rated four infant face conditions: own positive (OP), own negative (ON), unfamiliar positive (UP), and unfamiliar negative (UN). Mood and anxiety were measured by the Edinburgh Postnatal Depression Scale (EDPS) and the State-Trait Anxiety Inventory-Trait Version (STAI-T); maternal factors related to parental stress and attachment were also assessed. Brain-imaging data underwent a random-effects analysis, and cluster-based statistical thresholding was applied to the following contrasts: OP-UP, ON-UN, OP-ON, and UP-UN. Our main finding was that poorer quality of maternal experience was significantly related to reduced amygdala response to OP compared to UP infant faces. Our results suggest that, in human mothers, infant-related amygdala function may be an important factor in maternal anxiety/mood, in quality of mothering, and in individual differences in the motivation to mother. We are very grateful to the staff at the Imaging Research Center of the Brain-Body Institute for their contributions to this project. This work was supported by an Ontario Mental Health Foundation operating grant awarded to Alison Fleming and a postdoctoral fellowship awarded to Jennifer Barrett.

Chloral hydrate sedation in radiology: retrospective audit of reduced dose

Energy Technology Data Exchange (ETDEWEB)

Bracken, Jennifer [Children' s University Hospital, Radiology Department, Dublin (Ireland); Royal Children' s Hospital, Department of Medical Imaging, Parkville, Victoria (Australia); Heaslip, Ingrid; Ryan, Stephanie [Children' s University Hospital, Radiology Department, Dublin (Ireland)

2012-03-15

Chloral hydrate (CH) is safe and effective for sedation of suitable children. The purpose of this study was to assess whether adequate sedation is achieved with reduced CH doses. We retrospectively recorded outpatient CH sedations over 1 year. We defined standard doses of CH as 50 mg/kg (infants) and 75 mg/kg (children >1 year). A reduced dose was defined as at least 20% lower than the standard dose. In total, 653 children received CH sedation (age, 1 month-3 years 10 months), 42% were given a reduced initial dose. Augmentation dose was required in 10.9% of all children, and in a higher proportion of children >1 year (15.7%) compared to infants (5.7%; P < 0.001). Sedation was successful in 96.7%, and more frequently successful in infants (98.3%) than children >1 year (95.3%; P = 0.03). A reduced initial dose had no negative effect on outcome (P = 0.19) or time to sedation. No significant complications were seen. We advocate sedation with reduced CH doses (40 mg/kg for infants; 60 mg/kg for children >1 year of age) for outpatient imaging procedures when the child is judged to be quiet or sleepy on arrival. (orig.)

Infant nutrition in Saskatoon: barriers to infant food security.

Science.gov (United States)

Partyka, Brendine; Whiting, Susan; Grunerud, Deanna; Archibald, Karen; Quennell, Kara

2010-01-01

We explored infant nutrition in Saskatoon by assessing current accessibility to all forms of infant nourishment, investigating challenges in terms of access to infant nutrition, and determining the use and effectiveness of infant nutrition programs and services. We also examined recommendations to improve infant food security in Saskatoon. Semi-structured community focus groups and stakeholder interviews were conducted between June 2006 and August 2006. Thematic analysis was used to identify themes related to infant feeding practices and barriers, as well as recommendations to improve infant food security in Saskatoon. Our study showed that infant food security is a concern among lower-income families in Saskatoon. Barriers that limited breastfeeding sustainability or nourishing infants through other means included knowledge of feeding practices, lack of breastfeeding support, access and affordability of infant formula, transportation, and poverty. Infant nutrition and food security should be improved by expanding education and programming opportunities, increasing breastfeeding support, and identifying acceptable ways to provide emergency formula. If infant food security is to be addressed successfully, discussion and change must occur in social policy and family food security contexts.

Using event-related potentials to study perinatal nutrition and brain development in infants of diabetic mothers.

Science.gov (United States)

deRegnier, Raye-Ann; Long, Jeffrey D; Georgieff, Michael K; Nelson, Charles A

2007-01-01

Proper prenatal and postnatal nutrition is essential for optimal brain development and function. The early use of event-related potentials enables neuroscientists to study the development of cognitive function from birth and to evaluate the role of specific nutrients in development. Perinatal iron deficiency occurs in severely affected infants of diabetic mothers. In animal models, severe perinatal iron deficiency targets the explicit memory system of the brain. Cross-sectional ERP studies have shown that infants of diabetic mothers have impairments in recognition memory from birth through 8 months of age. The purpose of this study was to evaluate longitudinal development of recognition memory using ERPs in infants of diabetic mothers compared with control infants. Infants of diabetic mothers were divided into high and low risk status based upon their birth weights and iron status and compared with healthy control infants. Infants were tested in the newborn period for auditory recognition memory, at 6 months for visual recognition memory and at 8 months for cross modal memory. ERPs were evaluated for developmental changes in the slow waves that are thought to reflect memory and the Nc component that is thought to reflect attention. The results of the study showed differences in development between the IDMs and control infants in the development of the slow waves over the left anterior temporal leads and age-related patterns of development in the NC component. These results are consistent with animal models showing that perinatal iron deficiency affects the development of the memory networks of the brain. This study highlights the value of using ERPs to translate basic science information obtained from animal models to the development of the human infant.

Weight-band dosing tables: simplifying paediatric art | Nuttall ...

African Journals Online (AJOL)

One of the obstacles to scaling up paediatric antiretroviral therapy (ART) coverage in resource-limited settings is the relative complexity of paediatric dosing. There is a need to simplify ART in order to facilitate treatment initiation and ongoing management of infants and children by health care providers, as well as to support ...

Relation between sleep status of preterm infants aged 1-2 years and mothers' parenting stress.

Science.gov (United States)

Asaka, Yoko; Takada, Satoshi

2013-08-01

The aim of this study was to compare infants' sleep measures through an actigraph and maternal parenting stress among preterm and full-term mothers, and to explore the factors affecting maternal parenting stress in relation to infants' sleep. The subjects were 44 pairs of mothers and children. Twenty-one were in the preterm group, and 23 were in the full-term group. Inclusion criteria for preterm infants were born at less than 36 weeks and birthweight of less than 2500 g. The Parenting Stress Index (PSI) Short Form assesses maternal perception of the degree of parenting stress: the children's domain, and the parent's domain. An actigraph was applied to assess the infants' sleep measures. The PSI showed significant differences, with high scores in parenting stress in the preterm group. Also, the number of mothers who complained about their infant's sleep issues was significantly higher in the preterm group. Most of the sleep measures showed improvement by their age in both preterm and full-term infants. Multiple linear regression analysis showed that sleep efficiency, longest sleep duration at nighttime accounted for 71% of stress in the children's domain of the PSI of the preterm group. The parenting stress among mothers of preterm infants was significantly higher than that of mothers of full-term infants. The mothers of preterm infants were concerned about their infant's nocturnal sleep quality. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.

Prospective multicenter observational study of 260 infants born to 259 opiate-dependent mothers on methadone or high-dose buprenophine substitution.

Science.gov (United States)

Lejeune, Claude; Simmat-Durand, Laurence; Gourarier, Laurent; Aubisson, Sandrine

2006-05-20

Specialized prenatal care and substitution programs improve the perinatal prognoses of pregnant drug-abusers and their infants. Although methadone is well documented, little is known about high-dose buprenorphine (HDB). This prospective, multicenter (n = 35) observational study included 259 women on maintenance during pregnancy: 39% on methadone and 61% on HDB. Major findings were: 46% of them received good prenatal care; 62% had peridural analgesia; 12.3% delivered prematurely (hydrochloride. No baby died. Newborns were discharged with their mothers (96%) or placed in foster care (4%). Comparing methadone with HDB, respectively, mean age at the maximum Lipsitz score was 81 h versus 66 h (P = 0.066). The perinatal medical and social prognoses for these 259 drug addicts and their infants appeared to be improved by specialized prenatal care and was similar for methadone or BHD substitution during pregnancy.

Dosimetry of iodine-123 for newborn and infant

International Nuclear Information System (INIS)

Guilhem, M.T.; Therain, F.

1987-01-01

Iodine-123 ( 123 I) is a radionuclide of choice of neonatal hypothyroidism diagnosis. It is important to know infant main organs adsorbed doses during a thyroid scan with 123 I. Absorbed doses are already available for adults: for infants, they must be transformed taking account of organs sizes and inter-organs distances. Calculations are done for commercially available 123 I(p,2n) and 123 I(p,5n). Important contamination of 124 I in 123 I(p,2n) increases considerably the absorbed-dose during thyroid scan of a newborn (the ratio 124 I/ 123 I doubles every 15h). For routinely used activities, thyroid absorbed dose, 24 h after end of production, is fifteen times higher with 123 I(p,5n) than with 99m Tc: for one month old child; total body absorbed dose is of the same order of magnitude [fr

Simultaneous measurement of milk intake and total energy expenditure in mixed-fed infants: Methodological approach and prediction of total body water

International Nuclear Information System (INIS)

Wells, J.C.K.; Davies, P.S.W.; Coward, W.A.

2000-01-01

Evaluation of the energy metabolism that underlies the new WHO breast-fed growth reference requires simultaneous measurements of milk volume intake (MVI) and total energy expenditure (TEE) by stable isotope methodologies. In young infants, such data is collected without difficulty using the dose-to-the-infant method. In older infants, where breast-milk is supplemented with non-milk foods, MVI must be measured by dosing the mother instead of the infant. This procedure would interfere with a simple measurement of infant TEE using the standard dose-to-the-infant method. Theoretically, this difficulty can be resolved by dosing the mother with deuterium and the infant with 18-oxygen, and using curve-peeling methods to calculate the infant deuterium kinetics. We propose to ascertain whether such an approach is viable in practice, such that MVI, TEE and body composition could all be measured simultaneously in mixed-fed infants. Where MVI in older infants is measured on its own, there is a need to predict infant body water in order to estimate the deuterium dilution space. Using a database of 234 infants aged 1.5 to 12 months, we provide new predictive equations by which such values may be obtained. (author)

Methadone and Metabolites in Hair of Methadone-Assisted Pregnant Women and Their Infants

Science.gov (United States)

Himes, Sarah K; Goodwin, Robert S; Rock, Colleen M; Jones, Hendrée E; Johnson, Rolley E; Wilkins, Diana G; Huestis, Marilyn A

2012-01-01

Methadone is the recommended pharmacotherapy for opioid-dependent pregnant women. The primary aims of this study were to determine whether a dose-concentration relationship exists between cumulative maternal methadone dose, methadone and metabolite concentrations in maternal hair during pregnancy and whether maternal hair methadone and metabolite concentrations predict neonatal outcomes. Materials and Methods Hair specimens were collected monthly from opioid-dependent mothers enrolled in methadone treatment and 4 of their infants. Hair specimens were segmented (3cm), washed (maternal hair only) and analyzed for methadone, 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP) and 2-ethyl-5-methyl-3,3-diphenylpyrroline (EMDP) by liquid chromatography tandem mass spectrometry. Results There was large inter-subject variability and no dose-concentration relationship for cumulative methadone dose and methadone, EDDP, EMDP or total concentrations in hair. For individual women, a positive trend was noted for cumulative methadone dose and methadone and EDDP concentrations in hair. There was a positive linear trend for cumulative methadone dose and EDDP/methadone ratio in maternal hair, perhaps reflecting methadone’s induction of its own metabolism. Maternal methadone concentrations were higher than those in infant hair, and infant EDDP hair concentrations were higher than those in maternal hair. Maternal methadone dose, and methadone and EDDP hair concentrations were not correlated with peak infant neonatal abstinence syndrome (NAS) scores, days to peak NAS, duration of NAS, time to NAS onset, birth length, head circumference or amount of neonatal morphine pharmacotherapy. Maternal cumulative 3rd trimester methadone dose was positively correlated with infant birth weight. Conclusion Methadone and EDDP in pregnant women’s hair are markers of methadone exposure and do not predict total methadone dose, nor neonatal outcomes from in utero methadone exposure. PMID

Attachment Avoidance Is Significantly Related to Attentional Preference for Infant Faces: Evidence from Eye Movement Data.

Science.gov (United States)

Jia, Yuncheng; Cheng, Gang; Zhang, Dajun; Ta, Na; Xia, Mu; Ding, Fangyuan

2017-01-01

Objective: To determine the influence of adult attachment orientations on infant preference. Methods: We adopted eye-tracking technology to monitor childless college women's eye movements when looking at pairs of faces, including one adult face (man or woman) and one infant face, with three different expressions (happy, sadness, and neutral). The participants ( N = 150; 84% Han ethnicity) were aged 18-29 years ( M = 19.22, SD = 1.72). A random intercepts multilevel linear regression analysis was used to assess the unique contribution of attachment avoidance, determined using the Experiences in Close Relationships scale, to preference for infant faces. Results: Women with higher attachment avoidance showed less infant preference, as shown by less sustained overt attentional bias to the infant face than the adult face based on fixation time and count. Conclusion: Adult attachment might be related to infant preference according to eye movement indices. Women with higher attachment avoidance may lack attentional preference for infant faces. The findings may aid the treatment and remediation of the interactions between children and mothers with insecure attachment.

Visual orienting and attention deficits in 5- and 10-month-old preterm infants.

Science.gov (United States)

Ross-Sheehy, Shannon; Perone, Sammy; Macek, Kelsi L; Eschman, Bret

2017-02-01

Cognitive outcomes for children born prematurely are well characterized, including increased risk for deficits in memory, attention, processing speed, and executive function. However, little is known about deficits that appear within the first 12 months, and how these early deficits contribute to later outcomes. To probe for functional deficits in visual attention, preterm and full-term infants were tested at 5 and 10 months with the Infant Orienting With Attention task (IOWA; Ross-Sheehy, Schneegans and Spencer, 2015). 5-month-old preterm infants showed significant deficits in orienting speed and task related error. However, 10-month-old preterm infants showed only selective deficits in spatial attention, particularly reflexive orienting responses, and responses that required some inhibition. These emergent deficits in spatial attention suggest preterm differences may be related to altered postnatal developmental trajectories. Moreover, we found no evidence of a dose-response relation between increased gestational risk and spatial attention. These results highlight the critical role of postnatal visual experience, and suggest that visual orienting may be a sensitive measure of attentional delay. Results reported here both inform current theoretical models of early perceptual/cognitive development, and future intervention efforts. Copyright © 2016 Elsevier Inc. All rights reserved.

Radioactivity content of Shiraz water supplies and its related effective dose

International Nuclear Information System (INIS)

Mehdizadeh, S.; Derakhshan, Sh.

2004-01-01

We are exposed naturally to ionizing radiation from cosmic rays and natural radionuclides in the air, ground, food and drinking water. When invested, naturally and radionuclides are distributed among body organs. The average concentrations of naturally occurring radionuclides in drinking water are used to estimated the annual effective dose equivalents. In this work, during October of 2002 to October of 2003, 37 samples from 29 different wells and Doroodzan dam were gathered in winter and summer and the gross Alfa and Beta, total uranium and Ra-226 activity in each sample were determined. The activity of Ra-226 was measured by Radon Emanation method and total uranium was determined using laser Fluorimetry. The mean concentration of Ra-226 was higher in summer but the uranium had higher concentration in winter. The mean concentration of Ra-226 and Uranium were 15.72±1.12 mBq.1 -1 and 9.44±1.14μg.1 -1 in winter ±μ and 29.46 2.18 mBq.1 -1 and 7.37 1.1 g.1 -1 in summer respectively. The average annual effective doses (Ra-226) of different age groups (Adults, children and infants) were equal to 2.37± 0.22, 5.42 ±0.43, 2.66±0.24, mSv.y 1 -1 and 0.136±0.02, 0.18±0.027 and 0.171±0.026 mSv.y -1 due to existence of uranium in drinking water. The results of this survey showed that the radioactive concentration of the radionuclides and their related effective doses are in the normal range and permissible levels. These results are comparable with those found by Atomic Energy Organization of Iran but different with the results of the limited project done during 1999 at Shiraz

Infant temperament moderates relations between maternal parenting in early childhood and children's adjustment in first grade.

Science.gov (United States)

Stright, Anne Dopkins; Gallagher, Kathleen Cranley; Kelley, Ken

2008-01-01

A differential susceptibility hypothesis proposes that children may differ in the degree to which parenting qualities affect aspects of child development. Infants with difficult temperaments may be more susceptible to the effects of parenting than infants with less difficult temperaments. Using latent change curve analyses to analyze data from the National Institute of Child Health and Human Development Study of Early Child Care, the current study found that temperament moderated associations between maternal parenting styles during early childhood and children's first-grade academic competence, social skills, and relationships with teachers and peers. Relations between parenting and first-grade outcomes were stronger for difficult than for less difficult infants. Infants with difficult temperaments had better adjustment than less difficult infants when parenting quality was high and poorer adjustment when parenting quality was lower.

Kinetics and dose calculations of amikacin in the newborn

DEFF Research Database (Denmark)

Sardemann, H; Colding, H; Hendel, J

1976-01-01

compartment model. The absorption was evaluated in 8 of the infants after intramuscular injection of 7.5 mg amikacin per kilogram of body weight. The absorption rate, estimated by the tmax, was significantly faster than reported in adults. The total body clearance and apparent volume of distribution were...... studied in 22 infants after the same dose of amikacin intramuscularly. The body clearance expressed in relation to body surface or body weight was significantly less than in adults and correlated with the postnatal age. No correlation could be demonstrated between clearance and gestational age or birth...... weight. The volume of distribution per kilogram was significantly greater than in adults. On the basis of the derived kinetic parameters, a dose schedule is presented. In 5 children there was a reasonable agreement between the measured and predicted serum levels....

Infant mortality among offspring of individuals living in the radioactively contaminated Techa River Area, Southern Urals

International Nuclear Information System (INIS)

Ostroumova, E.; Akleyev, A.; Hall, P.

2005-01-01

Massive discharge of liquid radioactive wastes into the Techa River in 1949-1956 by the industrial complex Mayak for production of plutonium for weapon resulted in protracted internal and external radiation exposure of the population living along the river. The Techa River Offspring Cohort comprises individuals born after December 31, 1949, whose one or both parents were exposed in the Techa riverside villages. The study group includes 7,897 individuals. About 40% of the Techa River Offspring Cohort members born in 1950-1956 could be exposed in utero and after birth. The mean dose estimates based on the Techa River Dosimetry System 2000 were: 0.07 Gy for parental gonads, 0.01 Gy for fetus and 0.02 Gy for postnatal exposure of bone marrow. Over 46 years of follow-up from 1950-1995, 916 subjects died and the cause of death was known in 93% of them. Out of 916 subjects dead, 456 (53%) died under 1 year of age, mainly due to respiratory tract diseases (38% of all infant deaths), infections (27%) and perinatal disorders (13%). It has been shown that the baseline infant mortality rate depends on gender, ethnicity and birth year. Radiation risk analysis was based on a simple parametric linear excess relative risk model with adjustment for gender, ethnicity and birth year. There was no evidence of increasing infant mortality risk with parental gonadal dose. The infant mortality rate significantly depended on fetal dose and dose to bone marrow received during the first year of life with a 3% increase in risk per 1 cGy of intrauterine and postnatal doses. (author)

Infant Abuse, Neglect, and Failure-to-Thrive: Mother-Infant Interaction.

Science.gov (United States)

Dietrich, Kim N.; And Others

This study was designed to investigate whether or not degree of child maltreatment is related in some meaningful way to the interactional characteristics of the mother/infant dyad and to the infant's developmental status. A group of 53 mother/infant dyads was divided into five diagnostic groups: nonaccidental trauma combined with…

Individual and job-related variation in infant feeding practices among working mothers.

Science.gov (United States)

Grzywacz, Joseph G; Tucker, Jenna; Clinch, C Randall; Arcury, Thomas A

2010-01-01

To document working mothers' infant feeding practices and delineate factors that may shape infant feeding. Cross-sectional data were obtained from a community sample of working women with 8-month old infants (n=199). Nearly all working mothers used commercially prepared foods like infant cereals, fruits, and vegetables. Approximately one-fifth fed infants french fries, sweetened beverages, and sweetened desserts. Unhealthy infant feeding was elevated among unmarried mothers, those with less education, and those with a nonstandard work schedule. Working mothers use commercially prepared foods for infant feeding. Socially disadvantaged working mothers' infant feeding may pose health and developmental risks.

Neurotoxic response of infant monkeys to methylmercury

Energy Technology Data Exchange (ETDEWEB)

Willes, R.F.; Truelove, J.F.; Nera, E.A.

1978-02-01

Four infant monkeys were dosed orally with 500 ..mu..g Hg/kg body wt./day (as methylmercury (MeHg) chloride dissolved sodium carbonate) beginning at 1 day of age. Neurological and behavioral signs of MeHg toxicity and blood Hg levels were monitored weekly. At first sign of MeHg intoxication, dosing with MeHg was terminated and the infants were monitored to assess reversal of the signs of MeHg toxicity. The first signs of MeHg toxicity, exhibited as a loss in dexterity and locomotor ability, were observed after 28 to 29 days of treatment; the blood Hg levels were 8.0 to 9.4 ..mu..g Hg/g blood. Dosing was terminated at 28 to 29 days of treatment but the signs of MeHg toxicity continued to develop. The infants became ataxic, blind, comatose and were necropsied at 35 to 43 days after initiating treatment with MgHg. The mercury concentrations in tissues analyzed after necropsy were highest in liver followed by occipital cortex and renal cortex. The mean blood/brain ratio was 0.21 +- 0.4. Histopathologic lesions were marked in the cerebrum with less severe lesions in the cerebellar nuclei. The Purkinje and granular cells of the cerebellar vermis appeared histologically normal. Lesions were not observed in the peripheral nervous system. The signs of MeHg intoxication, the tissue distribution of MeHg and histopathologic lesions observed in the infant monkeys were similar to those reported for adult monkeys.

Safety and immunogenicity of a novel quadrivalent meningococcal CRM-conjugate vaccine given concomitantly with routine vaccinations in infants.

Science.gov (United States)

Klein, Nicola P; Reisinger, Keith S; Johnston, William; Odrljin, Tatjana; Gill, Christopher J; Bedell, Lisa; Dull, Peter

2012-01-01

In phase II studies, MenACWY-CRM elicited robust immunologic responses in young infants. We now present results from our pivotal phase III infant immunogenicity/safety study. In this open-label phase III study, we randomized full-term 2-month-old infants to 4 doses of MenACWY-CRM coadministered with routine vaccines at 2, 4, 6, and 12 months of age or with routine vaccines alone. We monitored for local and systemic reactions and serious adverse events among all study participants and evaluated for sufficiency of the immune responses to MenACWY-CRM through serum bactericidal activity assay with human complement. Bactericidal antibodies were present in 94% to 100% of subjects against each of the serogroups in MenACWY-CRM after the 4-dose series and were 67% to 97% after the first 3 doses. Geometric mean titers were higher after the fourth dose of MenACWY-CRM compared with a single dose of MenACWY-CRM at 12 months of age for all serogroups (range of ratios, 4.5-38). Responses to 3 doses of routine vaccines coadministered with MenACWY-CRM were noninferior to routine vaccinations alone, except for small differences in pneumococcal serotype 6B responses after dose 3 but not dose 4 and pertactin after dose 3. Inclusion of MenACWY-CRM did not affect the safety or reactogenicity profiles of the routine infant vaccine series. A 4-dose series of MenACWY-CRM was highly immunogenic and well tolerated in young infants, and it can be coadministered with routine infant vaccines. Substantial immunity was conferred after the first 3 doses administered at 2, 4, and 6 months of age.

Social Interaction in Infants' Learning of Second-Language Phonetics: An Exploration of Brain-Behavior Relations.

Science.gov (United States)

Conboy, Barbara T; Brooks, Rechele; Meltzoff, Andrew N; Kuhl, Patricia K

2015-01-01

Infants learn phonetic information from a second language with live-person presentations, but not television or audio-only recordings. To understand the role of social interaction in learning a second language, we examined infants' joint attention with live, Spanish-speaking tutors and used a neural measure of phonetic learning. Infants' eye-gaze behaviors during Spanish sessions at 9.5-10.5 months of age predicted second-language phonetic learning, assessed by an event-related potential measure of Spanish phoneme discrimination at 11 months. These data suggest a powerful role for social interaction at the earliest stages of learning a new language.

Clinical Pharmacology of Fentanyl in Preterm Infants. A Review

Directory of Open Access Journals (Sweden)

Gian Maria Pacifici

2015-06-01

Full Text Available Fentanyl is a synthetic opioid that is very important in anesthetic practice because of its relatively short time to peak analgesic effect and the rapid termination of action after small bolus doses. The objective of this survey is to review the clinical pharmacology of fentanyl in preterm infants. The bibliographic search was performed using PubMed and EMBASE databases as search engines. In addition, the books Neofax: A manual of drugs used in neonatal care and Neonatal formulary were consulted. Fentanyl is N-dealkylated by CYP3A4 into the inactive norfentanyl. Fentanyl may be administered as bolus doses or as a continuous infusion. In neonates, there is a remarkable interindividual variability in the kinetic parameters. In neonates, fentanyl half-life ranges from 317 minutes to 1266 minutes and in adults it is 222 minutes. Respiratory depression occurs when fentanyl doses are >5 μg/kg. Chest wall rigidity may occur in neonates and occasionally is associated with laryngospasm. Tolerance to fentanyl may develop after prolonged use of this drug. Significant withdrawal symptoms have been reported in infants treated with continuous infusion for 5 days or longer. Fentanyl is an extremely potent analgesic and is the opioid analgesic most frequently used in the neonatal intensive care unit.

Crescimento de lactentes não-anêmicos suplementados com diferentes doses profiláticas de ferro Growth in non-anemic infants supplemented with different prophylactic iron doses

Directory of Open Access Journals (Sweden)

Danielle G. da Silva

2008-08-01

Full Text Available OBJETIVO: Comparar os efeitos de diferentes doses profiláticas de ferro sobre o crescimento e estado nutricional de lactentes não-anêmicos. MÉTODOS: Estudo do tipo prospectivo e randomizado. Lactentes de 5,0 a 6,9 meses de vida que atenderam aos critérios de inclusão e apresentaram hemoglobina capilar ≥ 11 g/dL foram alocados randomicamente em três grupos com doses profiláticas de suplemento de ferro (sulfato ferroso de 1 mg/kg/dia (n = 39, 2 mg/kg/dia (n = 36 e 25 mg/semana (n = 39. A suplementação durou 16 semanas. Foram avaliados peso e comprimento. O estado nutricional foi avaliado por meio dos escores z do peso/idade, comprimento/idade e peso/comprimento com base na referência da Organização Mundial da Saúde (2006. Os dados de morbidade foram obtidos durante as visitas mensais. RESULTADOS: Antes da suplementação, os grupos apresentaram similar estado nutricional. Não houve diferença entre os grupos na ingestão diária de nutrientes. Durante o estudo, o ganho de peso, o ganho de comprimento e os incrementos nos índices antropométricos não diferiram estatisticamente entre os grupos suplementados. A ocorrência e duração dos episódios de morbidade não diferiram estatisticamente entre os grupos. De modo geral, observaram-se melhorias nos índices peso/idade e peso/comprimento na população estudada, porém o comprimento/idade não apresentou diferenças antes e após a suplementação. CONCLUSÃO: As diferentes doses profiláticas de ferro não exerceram efeito diferenciado sobre o crescimento e estado nutricional dos lactentes não-anêmicos.OBJECTIVE: To compare the effects of different prophylactic iron doses on the growth and nutritional status of non-anemic infants. METHODS: Prospective randomized study. Infants aged 5.0 to 6.9 months who met the inclusion criteria and showed capillary hemoglobin ≥ 11 g/dL were randomly allocated into three groups who received the following prophylactic doses of iron

Ethnicity and gender related differences in extended intraesophageal pH monitoring parameters in infants: a retrospective study

Directory of Open Access Journals (Sweden)

Tolia Vasundhara

2005-07-01

Full Text Available Abstract Background Gastroesophageal reflux disease (GERD is believed to be more common in adult males as compared to females. It also has been shown in adults to be more common in Caucasians. We wanted to determine ethnicity and gender related differences for extended pH monitoring parameters in infancy. Methods Extended pH monitoring data (EPM from infants Results There were 569 infants, 388 controls, 181 with GERD (320 males, 249 females; 165 Caucasians, 375 AA. No statistical difference in EPM parameters was detected between genders in both groups. However, Caucasian infants had a significantly higher incidence of GERD than AA infants (p = 0.036. On stratifying by gender, Caucasian females had a significantly higher number of reflux episodes >5 minutes as compared to AA females in the control group (p = 0.05. Furthermore, Caucasian females with GERD showed an overall higher trend for all parameters. Caucasian males had a trend for higher mean number of reflux episodes as compared to AA males in the control group (p = 0.09. Conclusion Although gender specific control data do not appear warranted in infants undergoing EPM, ethnic differences related to an overall increased incidence of pathologic GERD in Caucasian infants should be noted.

Infant Sleep After Immunization: Randomized Controlled Trial of Prophylactic Acetaminophen

Science.gov (United States)

Gay, Caryl L.; Lynch, Mary; Lee, Kathryn A.

2011-01-01

OBJECTIVE: To determine the effects of acetaminophen and axillary temperature responses on infant sleep duration after immunization. METHODS: We conducted a prospective, randomized controlled trial to compare the sleep of 70 infants monitored by using ankle actigraphy for 24 hours before and after their first immunization series at ∼2 months of age. Mothers of infants in the control group received standard care instructions from their infants' health care provider, and mothers of infants in the intervention group were provided with predosed acetaminophen and instructed to administer a dose 30 minutes before the scheduled immunization and every 4 hours thereafter, for a total of 5 doses. Infant age and birth weight and immunization factors, such as acetaminophen use and timing of administration, were evaluated for changes in infant sleep times after immunization. RESULTS: Sleep duration in the first 24 hours after immunization was increased, particularly for infants who received their immunizations after 1:30 pm and for those who experienced elevated temperatures in response to the vaccines. Infants who received acetaminophen at or after immunization had smaller increases in sleep duration than did infants who did not. However, acetaminophen use was not a significant predictor of sleep duration when other factors were controlled. CONCLUSIONS: If further research confirms the relationship between time of day of vaccine administration, increased sleep duration after immunization, and antibody responses, then our findings suggest that afternoon immunizations should be recommended to facilitate increased sleep in the 24 hours after immunization, regardless of acetaminophen administration. PMID:22123869

Efficacy and Safety of Ibuprofen in Infants Aged Between 3 and 6 Months.

Science.gov (United States)

Ziesenitz, Victoria C; Zutter, Andreas; Erb, Thomas O; van den Anker, Johannes N

2017-08-01

Ibuprofen is a non-steroidal anti-inflammatory drug frequently administered to children of various ages for relief of fever and pain and is approved as an over-the-counter medication in many countries worldwide. Although there are extensive data on its efficacy and safety in children and adults, there are divergent dosing recommendations for analgesia and treatment of fever in infants, especially in the age group between 3 and 6 months of age. In this article, we have assessed the safety and efficacy of ibuprofen use in infants in an attempt to find the optimal method of pain and fever management in this specific age group. Based on the current evidence, short-term use of ibuprofen is considered safe in infants older than 3 months of age having a body weight above 5-6 kg when special attention is given to the hydration of the patient. Ibuprofen should be prescribed based on body weight using a dose of 5-10 mg/kg. This dose can be administered 3-4 times a day resulting in a maximum total daily dose of 30-40 mg/kg. The rectal route has been shown to be less reliable because of erratic absorption, especially in young infants. Since most efficacy and safety data have been derived from trials in infants with fever, future studies should focus on the efficacy of ibuprofen in young infants with pain.

Seasonal Variation in Solar Ultra Violet Radiation and Early Mortality in Extremely Preterm Infants.

Science.gov (United States)

Salas, Ariel A; Smith, Kelly A; Rodgers, Mackenzie D; Phillips, Vivien; Ambalavanan, Namasivayam

2015-11-01

Vitamin D production during pregnancy promotes fetal lung development, a major determinant of infant survival after preterm birth. Because vitamin D synthesis in humans is regulated by solar ultraviolet B (UVB) radiation, we hypothesized that seasonal variation in solar UVB doses during fetal development would be associated with variation in neonatal mortality rates. This cohort study included infants born alive with gestational age (GA) between 23 and 28 weeks gestation admitted to a neonatal unit between 1996 and 2010. Three infant cohort groups were defined according to increasing intensities of solar UVB doses at 17 and 22 weeks gestation. The primary outcome was death during the first 28 days after birth. Outcome data of 2,319 infants were analyzed. Mean birth weight was 830 ± 230 g and median gestational age was 26 weeks. Mortality rates were significantly different across groups (p = 0.04). High-intensity solar UVB doses were associated with lower mortality when compared with normal intensity solar UVB doses (hazard ratio: 0.70; 95% confidence interval: 0.54-0.91; p = 0.01). High-intensity solar UVB doses during fetal development seem to be associated with risk reduction of early mortality in preterm infants. Prospective studies are needed to validate these preliminary findings. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Chloral hydrate sedation in radiology: retrospective audit of reduced dose

International Nuclear Information System (INIS)

Bracken, Jennifer; Heaslip, Ingrid; Ryan, Stephanie

2012-01-01

Chloral hydrate (CH) is safe and effective for sedation of suitable children. The purpose of this study was to assess whether adequate sedation is achieved with reduced CH doses. We retrospectively recorded outpatient CH sedations over 1 year. We defined standard doses of CH as 50 mg/kg (infants) and 75 mg/kg (children >1 year). A reduced dose was defined as at least 20% lower than the standard dose. In total, 653 children received CH sedation (age, 1 month-3 years 10 months), 42% were given a reduced initial dose. Augmentation dose was required in 10.9% of all children, and in a higher proportion of children >1 year (15.7%) compared to infants (5.7%; P 1 year (95.3%; P = 0.03). A reduced initial dose had no negative effect on outcome (P = 0.19) or time to sedation. No significant complications were seen. We advocate sedation with reduced CH doses (40 mg/kg for infants; 60 mg/kg for children >1 year of age) for outpatient imaging procedures when the child is judged to be quiet or sleepy on arrival. (orig.)

Radiation exposure of infants and children in computed tomography

International Nuclear Information System (INIS)

Schmidt, T.; Stieve, F.E.

1980-01-01

The radiation exposure of infants and small children with Computed Tomography is different in several aspects from that of adults undergoing an identical examination. The surface dose at radiation entrance is higher in children because of a smaller body diameter for the same dose rate at the tube. The critical organ dose in the directly irradiated area is higher in children than in adults. The exposure of organs outside the examined area is also higher in children -because of short intervals- than in adults. The absorbed energy, i.e. integral dose, however, is lower in children than in adults because of the lesser volume. The differences between conventional procedures and Computed Tomography, are greater in children than in adults. Here, CT shows higher values than conventional explorations. As a result of the low number of examinations with CT, the contribution towards a genetically significant dose is currently, at least, relatively small [fr

Video feedback promotes relations between infants and vulnerable first-time mothers

DEFF Research Database (Denmark)

Kristensen, Ingeborg Hedegaard; Simonsen, Marianne; Trillingsgaard, Tea

2017-01-01

BACKGROUND: Supporting early mother-infant relationships to ensure infants' future health has been recommended. The aim of this study was to investigate whether video feedback using the Marte Meo method promotes a healthy early relationship between infants and vulnerable first-time mothers. Video...... feedback or usual care was delivered by health visitors during home visits in Danish municipalities. METHODS: This quasi-experimental study included pre- and post-tests of 278 vulnerable families. Mothers were allocated to an intervention group (n = 69), a comparison group (n = 209) and an exactly matched...... video subsample from the comparison group (n = 63). Data consisted of self-reported questionnaires and video recordings of mother-infant interactions. Outcomes were mother-infant dyadic synchrony (CARE-Index), maternal confidence (KPCS), parental stress (PSS), maternal mood (EPDS) and infant...

Defective organification of iodine in an infant demonstrated with 123J and gamma camera

International Nuclear Information System (INIS)

Goebel, R.; Leb, G.; Sulzer, M.; Graz Univ.

1979-01-01

A defective organification of iodine is demonstrated in a two year old male infant. The availability and a relatively simple radiation detector and storage system (gamma camera and 1600 word memory) gives a reasonable low radiation dose, allows correction for extrathyroid neck activity and obviates problems of collimation. (orig.) [de

Disparities in Infant Mortality by Race Among Hispanic and Non-Hispanic Infants.

Science.gov (United States)

Rice, Whitney S; Goldfarb, Samantha S; Brisendine, Anne E; Burrows, Stevie; Wingate, Martha S

2017-07-01

U.S.-born Hispanic infants have a well-documented health advantage relative to other minority groups. However, little published research has examined racial heterogeneity within the Hispanic population, in relation to health outcomes. The current study aims to explore possible implications of racial identification for the health of U.S. born Hispanic compared to non-Hispanic infants. Methods Data were drawn from 2007 to 2008 NCHS Cohort Linked Live Birth-Infant Death Files, restricted to deliveries of Hispanic black, Hispanic white, non-Hispanic black (NHB) and non-Hispanic white mothers (NHW) (n = 7,901,858). Adjusted odds ratios for first week mortality, neonatal, postneonatal, and overall infant mortality were calculated for each group, using NHW as the reference group. A distinct health gradient was observed in which NHB infants (n = 1,250,222) had the highest risk of first week (aOR 2.29, CI 2.21-2.37), neonatal (aOR 2.23, CI 2.17-2.30), postneonatal (aOR 1.74, CI 1.68-1.81), and infant mortality (aOR 2.05, CI 2.00-2.10) compared to NHW infants (n = 4,578,150). Hispanic black infants (n = 84,377) also experienced higher risk of first-week (aOR 1.28 (1.12-1.47), neonatal (aOR .27, CI 1.13-1.44), postneonatal (aOR 1.34, CI 1.15-1.56), and infant mortality (aOR 1.30, CI 1.18-1.43) compared to both NHW and Hispanic white infants (n = 1,989,109). Conclusions for Practice: Risk of infant mortality varies among Hispanic infants by race, with poorer outcomes experienced by Hispanic black infants. Compared to non-Hispanic infants of the same race, Hispanic black infants experience a smaller health disadvantage and Hispanic white infants have better or similar infant health outcomes. Our findings suggest implications of racial heterogeneity on infant health outcomes, and provide insight into the role of race as a social construct.

Association between obesity-related biomarkers and cognitive and motor development in infants.

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Camargos, Ana Cristina R; Mendonça, Vanessa A; Oliveira, Katherine S C; de Andrade, Camila Alves; Leite, Hércules Ribeiro; da Fonseca, Sueli Ferreira; Vieira, Erica Leandro Marciano; Teixeira Júnior, Antônio Lúcio; Lacerda, Ana Cristina Rodrigues

2017-05-15

This study aimed to verify the association between obesity-related biomarkers and cognitive and motor development in infants between 6 and 24 months of age. A cross-sectional study was conducted with 50 infants and plasma levels of leptin, adiponectin, resistin, soluble tumor necrosis factor receptors 1 and 2 (sTNFR1 and sTNFR2), chemokines, brain-derived neurotrophic factor (BDNF), serum cortisol and redox status were measured. The Bayley-III test was utilized to evaluate cognitive and motor development, and multiple linear stepwise regression models were performed to verify the association between selected biomarkers and cognitive and motor development. A significant association was found among plasma leptin and sTNFR1 levels with cognitive composite scores, and these two independents variables together explained 37% of the variability of cognitive composite scores (p=0.001). Only plasma sTNFR1 levels were associated and explained 24% of the variability of motor composite scores (p=0.003). Plasma levels of sTNFR1 were associated with the increase in cognitive and motor development scores in infants between 6 and 24 months of age through a mechanism not directly related to excess body weight. Moreover, increase in plasma levels of leptin reduced the cognitive development in this age range. Copyright © 2017 Elsevier B.V. All rights reserved.

Relations between Automatically Extracted Motion Features and the Quality of Mother-Infant Interactions at 4 and 13 Months.

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Egmose, Ida; Varni, Giovanna; Cordes, Katharina; Smith-Nielsen, Johanne; Væver, Mette S; Køppe, Simo; Cohen, David; Chetouani, Mohamed

2017-01-01

Bodily movements are an essential component of social interactions. However, the role of movement in early mother-infant interaction has received little attention in the research literature. The aim of the present study was to investigate the relationship between automatically extracted motion features and interaction quality in mother-infant interactions at 4 and 13 months. The sample consisted of 19 mother-infant dyads at 4 months and 33 mother-infant dyads at 13 months. The coding system Coding Interactive Behavior (CIB) was used for rating the quality of the interactions. Kinetic energy of upper-body, arms and head motion was calculated and used as segmentation in order to extract coarse- and fine-grained motion features. Spearman correlations were conducted between the composites derived from the CIB and the coarse- and fine-grained motion features. At both 4 and 13 months, longer durations of maternal arm motion and infant upper-body motion were associated with more aversive interactions, i.e., more parent-led interactions and more infant negativity. Further, at 4 months, the amount of motion silence was related to more adaptive interactions, i.e., more sensitive and child-led interactions. Analyses of the fine-grained motion features showed that if the mother coordinates her head movements with her infant's head movements, the interaction is rated as more adaptive in terms of less infant negativity and less dyadic negative states. We found more and stronger correlations between the motion features and the interaction qualities at 4 compared to 13 months. These results highlight that motion features are related to the quality of mother-infant interactions. Factors such as infant age and interaction set-up are likely to modify the meaning and importance of different motion features.

Aerosol delivery from spacers in wheezy infants: a daily life study

NARCIS (Netherlands)

H.M. Janssens (Hettie); E.M. Heijnen; V.M. de Jong; W.C.J. Hop (Wim); W.P. Holland (Wim); J.C. de Jongste (Johan); H.A.W.M. Tiddens (Harm)

2000-01-01

textabstractThe aims of this study were to assess and compare dose delivery and dose variability of pressurized metered dose inhalers (pMDI)/spacers in wheezy infants in daily life and to investigate factors influencing aerosol delivery. In an open randomized

Effects of Vitamin E in Neonates and Young Infants

Directory of Open Access Journals (Sweden)

Gian Maria Pacifici

2016-05-01

Full Text Available Vitamin E (alpha-tocopherol is a potent and natural antioxidant. Vitamin E is concentrated from soybean oil. The Committee on Fetus and Newborn of the Academy of the American of Pediatrics endorsed 1 to 2 mg/dl as the normal range of serum tocopherol level. Human infants are born with low stores of vitamin E, thus they require an adequate intake of vitamin E soon after birth. The optimum intravenous dose of vitamin E is 2.8 mg/kg per day (maximum 7 mg/kg per day. Treating very-low-birth-weight infants with 100 mg/kg vitamin E for >1 week results in levels >3.5 mg/dl and significantly reduces the risks of severe retinopathy, intracranial hemorrhage, hemolytic anemia, chronic lung disease, retrolental fibroplasia and incidence and severity of intraventricular hemorrhage, but increases the risks of sepsis, necrotizing enterocolitis and can cause retinal hemorrhage in very-low-birth-weight infants. Vitamin E supplementation prevents the isolated vitamin E deficiency that causes spinocerebellar symptoms. The major benefits arising from elevated dosages of vitamin E have been the relief of symptoms of vitamin E deficiency in infants with abetalipoproteinamia and chronic cholestasis. Excessive doses of vitamin E may result in side effects and careful monitoring of vitamin E is thus essential. Neonates born to mothers treated with high doses of vitamin E have significantly lower birth weight compared to neonates born to untreated mothers. Vitamin E is not teratogenic. The aim of this study was to review the effects of vitamin E in neonates and young infants.

Stavudine concentrations in women receiving postpartum antiretroviral treatment and their breastfeeding infants.

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Fogel, Jessica M; Taha, Taha E; Sun, Jin; Hoover, Donald R; Parsons, Teresa L; Kumwenda, Johnstone J; Mofenson, Lynne M; Fowler, Mary Glenn; Hendrix, Craig W; Kumwenda, Newton I; Eshleman, Susan H; Mirochnick, Mark

2012-08-15

First-line antiretroviral treatment regimens in resource-limited settings used in breastfeeding mothers often include stavudine (d4T). Limited data describing d4T concentrations in breast milk are available. We analyzed d4T concentrations in 52 mother-infant pairs using ultra-performance liquid chromatography-tandem mass spectrometry (lower limit of quantification: 5 ng/mL in plasma, 20 ng/mL in breast milk). Median (interquartile range) d4T concentrations were 86 (36-191) ng/mL in maternal plasma, 151 (48-259) ng/mL in whole milk, 190 (58-296) ng/mL in skim milk, and <5 (<5 to <5) ng/mL in infant plasma. Although d4T is concentrated in breast milk relative to maternal plasma, the infant d4T dose received from breast milk is very small and not clinically significant.

Dose-response relationship for life-shortening and carcinogenesis in mice irradiated at day 7 postnatal age with dose range below 1 Gy of gamma rays

International Nuclear Information System (INIS)

Sasaki, Shunsaku; Fukuda, Nobuo

2006-01-01

This study was designed to elucidate the dose-response relationships for life-shortening and tumorigenic effect in the dose range below 1 Gy of gamma rays delivered during the infant period. Female B6C3F 1 mice were irradiated with 0.10, 0.48 or 0.95 Gy at 7 days of age. All irradiated mice were allowed to live out their entire life span together with a simultaneously ongoing control group under a specific pathogen-free condition. Shortening of the mean life span was 1.58% in mice irradiated with 0.10 Gy, which was statistically significant. The coefficient of the linear dose-response relationship for life-shortening was 11.21% Gy -1 . The attributable death fraction for all causes of death in 0.10 Gy group reached 0.092. The excess relative risk for death rate from all causes was 0.102 in the group irradiated with 0.10 Gy. The coefficient of the linear dose-response relationship of the excess relative risk for death rate from all causes was 1.30 Gy -1 . The mean number of types of solid tumors at the time of death in mice irradiated with 0.10 Gy was distinctly larger than that in the control group. The excess relative risk for death rate from solid tumors was 0.45 in mice irradiated with 0.10 Gy. The coefficient of the linear dose-response relationship of excess relative risk for death rate from solid tumors was 4.52 Gy -1 . Increase in incidences of the pituitary, ovarian and adrenal tumors was observed in mice irradiated with 0.10 Gy. The results of the present study showed that infant mice are susceptible to solid tumor induction, especially of the endocrine organs. (author)

Hepatitis B maternal screening, infant vaccination, and infant prophylaxis practices in North Carolina.

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Pierce, R L; Smith, S; Rowe-West, B; Sterritt, B

1999-06-01

To determine if the Advisory Committee on Immunization Practices hepatitis B screening, vaccination, and prophylaxis recommendations were being followed in North Carolina, and to establish a baseline hepatitis B seroprevalence rate. A survey of mother and infant birthing facility medical records. Four birthing facilities selected from each of the 7 districts in North Carolina (a total of 28 facilities). A probability proportional to size survey design was used to select 4763 mother-infant record pairs. All records came from the 1996 birth cohort. Maternal hepatitis B screening status, infant vaccination status, infants prophylaxis status, hepatitis B seroprevalence rate, demographic and clinical predictors for maternal infection, failure to receive prenatal care or for whom status was unknown, failure to screen, and failure to vaccinate. Ninety-two percent of pregnant women were screened for hepatitis B surface antigen. Eighty-six percent of infants received dose 1 of the hepatitis B vaccine. Four of the 9 infants with mothers who were hepatitis B surface antigen-positive did not receive both vaccine and hepatitis B immune globulin. The hepatitis B seroprevalence rate was 0.2%. Mothers who were not screened for infection were 3.4 times more likely to have infants who were not vaccinated. White mothers were twice as likely not to have their child vaccinated as mothers of other races. Not all infants with hepatitis B-infected mothers were receiving vaccine and hepatitis B immune globulin as recommended. Seroprevalence of hepatitis B infection may be lower in North Carolina than in other states. Hepatitis B laboratory test results should be included in every mother's medical record.

Infant EEG and temperament negative affectivity: Coherence of vulnerabilities to mothers' perinatal depression.

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Lusby, Cara M; Goodman, Sherryl H; Yeung, Ellen W; Bell, Martha Ann; Stowe, Zachary N

2016-11-01

Associations between infants' frontal EEG asymmetry and temperamental negative affectivity (NA) across infants' first year of life and the potential moderating role of maternal prenatal depressive symptoms were examined prospectively in infants (n = 242) of mothers at elevated risk for perinatal depression. In predicting EEG, in the context of high prenatal depressive symptoms, infant NA and frontal EEG asymmetry were negatively associated at 3 months of age and positively associated by 12 months of age. By contrast, for low depression mothers, infant NA and EEG were not significantly associated at any age. Postnatal depressive symptoms did not add significantly to the models. Dose of infants' exposure to maternal depression mattered: infants exposed either pre- or postnatally shifted from a positive association at 3 months to a negative association at 12 months; those exposed both pre- and postnatally shifted from a negative association at 3 months to a positive association at 12 months. Prenatal relative to postnatal exposure did not matter for patterns of association between NA and EEG. The findings highlight the importance of exploring how vulnerabilities at two levels of analysis, behavioral and psychophysiological, co-occur over the course of infancy and in the context of mothers' depressive symptomatology.

Effects of antenatal steroids on protein metabolism in preterm infants on the first day of life

NARCIS (Netherlands)

de Pipaon, M.S.; Vanbeek, R.H.T.; Zimmermann, L.J.J.; Wattimena, D.J.L.; Quero, J.; Sauer, P. J. J.

Objective To analyze, in an existing cohort of infants, whether antenatal administered corticosteroids influence protein metabolism in preterm infants on the first day of life. Study design Three groups of infants were studied. The mothers of 25 infants had received 2 or more doses of

Prevaccination Rotavirus Serum IgG and IgA Are Associated With Lower Immunogenicity of Live, Oral Human Rotavirus Vaccine in South African Infants.

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Moon, Sung-Sil; Groome, Michelle J; Velasquez, Daniel E; Parashar, Umesh D; Jones, Stephanie; Koen, Antoinette; van Niekerk, Nadia; Jiang, Baoming; Madhi, Shabir A

2016-01-15

Live oral rotavirus (RV) vaccines have shown modest efficacy among children in African countries for reasons that are not completely understood. We examined the possible inhibitory effect of preexisting antirotavirus antibodies on immunogenicity of monovalent RV vaccine (RV1). Mother-infant pairs were enrolled at presentation for their routine immunization visit in Soweto, South Africa, when infants were aged 5-8 weeks. Infant serum samples were obtained before the first and second doses of RV1 and 1 month after the second dose. Maternal serum and breast milk samples were obtained prior to administration of each dose of RV1 to infants. RV-specific immunoglobulin G (IgG), IgA, and neutralizing activity in sera of infants and serum or breast milk samples of mothers were measured using enzyme-linked immunosorbent assays or a microneutralization test. Of the 107 serum pairs from infants who were seronegative for RV IgA at enrollment, we observed a strong positive association between IgG titers in pre-dose 1 sera of infants and mothers and significant negative associations between IgG titers in pre-dose 1 sera of infants and seroconversion to RV1 post-dose 1. Similarly, mothers whose infants' IgA seroconverted after RV1 had significantly lower pre-dose 1 IgG titers in sera than those whose infants did not seroconvert. High levels of preexisting serum IgG, including transplacentally acquired maternal IgG, appeared to have an inhibitory effect on the immunogenicity of RV1 among infants and may, in part, contribute to lower efficacy of RV vaccines in this and other low-income settings. Published by Oxford University Press for the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Patient dose in neonatal units

International Nuclear Information System (INIS)

Smans, K.; Struelens, L.; Smet, M.; Bosmans, H.; Vanhavere, F.

2008-01-01

Lung disease represents one of the most life-threatening conditions in prematurely born children. In the evaluation of the neonatal chest, the primary and most important diagnostic study is therefore the chest radiograph. Since prematurely born children are very sensitive to radiation, those radiographs may lead to a significant radiation detriment. Hence, knowledge of the patient dose is necessary to justify the exposures. A study to assess the patient doses was started at the neonatal intensive care unit (NICU) of the Univ. Hospital in Leuven. Between September 2004 and September 2005, prematurely born babies underwent on average 10 X-ray examinations in the NICU. In this sample, the maximum was 78 X-ray examinations. For chest radiographs, the median entrance skin dose was 34 μGy and the median dose area product was 7.1 mGy.cm 2 . By means of conversion coefficients, the measured values were converted to organ doses. Organ doses were calculated for three different weight classes: extremely low birth weight infants ( 2500 g). The doses to the lungs for a single chest radiograph for infants with extremely low birth weights, low birth weights and normal birth weights were 24, 25 and 32 μGy, respectively. (authors)

Growth pattern in Ethiopian infants - the impact of exposure to maternal HIV infection in relation to socio-economic factors.

Science.gov (United States)

König Walles, John; Balcha, Taye Tolera; Winqvist, Niclas; Björkman, Per

2017-01-01

Infants exposed to maternal HIV infection who remain HIV-uninfected (HIV-exposed/uninfected; HIV-EU) may be at increased risk of growth retardation, which could be due both to directly HIV-related effects and to socio-economic factors overrepresented among HIV-positive women. To investigate growth development at 9-12 months of age in HIV-EU infants participating in prevention of mother-to-child transmission (PMTCT) care compared to HIV unexposed (HIV-U) infants in relation to socio-economic conditions. Anthropometric and socio-economic data were collected retrospectively from PMTCT registers (for HIV-EU infants), with HIV-U controls recruited at measles vaccination at public health facilities in Ethiopia. Growth was compared with regard to HIV exposure and socio-economic variables in multivariate regression analysis. The following growth measurements were found for 302 HIV-EU and 358 HIV-U infants at 9-12 months of age, respectively: mean weight-for-age z-score (WAZ) 0.04 and -0.21, p growth and higher mean WAZ than HIV-U controls. Poor growth development was associated with socio-economic factors. This suggests health benefits from PMTCT participation for infant growth. Similar interventions could be considered for Ethiopian infants, irrespective of HIV exposure, with a particular focus on children with poor socio-economic status.

Unmasking of Partial Diabetes Insipidus during Stress but Not Maintenance Dosing of Glucocorticoids in an Infant with Septo-Optic Dysplasia

Directory of Open Access Journals (Sweden)

Loechner KarenJ

2011-03-01

Full Text Available Background. It is well acknowledged that glucocorticoid (GC replacement can unmask diabetes insipidus (DI in subjects with hypopituitarism. Objective. To increase the awareness and monitoring for transient and symptomatic DI in children with partial hypopituitarism during periods in which increased GC needs are required. Methods/Case. A 2-month-old female infant with septo-optic dysplasia (SOD; on thyroid and maintenance GC replacement therapy at 8 mg/m2/day developed transient DI during 2 separate episodes of stress (one hypothermia, one febrile when stress dosing of GC (25 mg/m2/day was instituted. Conclusion. Children not diagnosed with DI during initial evaluation for hypopituitarism may benefit from rescreening of serum sodium levels during acute periods of stress that demand "stress" GC dosing. This will permit treatment and/or increased vigilance for ensuing permanent DI.

Maternal vitamin D supplementation to meet the needs of the breastfed infant: a systematic review.

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Thiele, Doria K; Senti, Jeanine L; Anderson, Cindy M

2013-05-01

Maternal vitamin D insufficiency during lactation, related to lack of sun exposure and minimal intake of vitamin D from the diet, contributes to low breast milk vitamin D content and, therefore, infant vitamin D deficiency. The objective of this review was to examine the literature regarding evidence for achieving maternal vitamin D status that promotes sufficient vitamin D transfer from mother to infant exclusively from breast milk. PubMed and CINAHL databases were searched using the terms lactation or breastfeeding or milk, human and vitamin D. The resulting articles were further limited to those written in English, published within the last 10 years, and involving clinical or randomized controlled trials of humans. The search yielded 13 studies, 3 of which provide evidence for maternal intake of vitamin D and the correlation with exclusively breastfed infants' serum 25-hydroxyvitamin D level. A strong positive correlation exists between maternal vitamin D intake during exclusive breastfeeding and infant serum 25-hydroxyvitamin D levels. There is support to conclude that when maternal vitamin D intake is sufficient, vitamin D transfer via breast milk is adequate to meet infant needs. In the reviewed studies, doses up to 10 times the current recommended daily intake of vitamin D were needed to produce sufficient transfer from mother to breastfed infant. Further research is needed to refine the dose and gestational timing of maternal vitamin D supplementation. Due to the high rates of vitamin D deficiency during lactation and the correlations between vitamin D deficiency and multiple diseases, providers should consider monitoring lactating mothers' vitamin D status.

Fuzzy Relational Compression Applied on Feature Vectors for Infant Cry Recognition

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Reyes-Galaviz, Orion Fausto; Reyes-García, Carlos Alberto

Data compression is always advisable when it comes to handling and processing information quickly and efficiently. There are two main problems that need to be solved when it comes to handling data; store information in smaller spaces and processes it in the shortest possible time. When it comes to infant cry analysis (ICA), there is always the need to construct large sound repositories from crying babies. Samples that have to be analyzed and be used to train and test pattern recognition algorithms; making this a time consuming task when working with uncompressed feature vectors. In this work, we show a simple, but efficient, method that uses Fuzzy Relational Product (FRP) to compresses the information inside a feature vector, building with this a compressed matrix that will help us recognize two kinds of pathologies in infants; Asphyxia and Deafness. We describe the sound analysis, which consists on the extraction of Mel Frequency Cepstral Coefficients that generate vectors which will later be compressed by using FRP. There is also a description of the infant cry database used in this work, along with the training and testing of a Time Delay Neural Network with the compressed features, which shows a performance of 96.44% with our proposed feature vector compression.

Infant sleep and paternal involvement in infant caregiving during the first 6 months of life.

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Tikotzky, Liat; Sadeh, Avi; Glickman-Gavrieli, Tamar

2011-01-01

The goals of this study were to assess: (a) the involvement of fathers and mothers in overall and nighttime infant caregiving; (b) the links between paternal involvement in infant care and infant sleep patterns during the first 6 months. Fifty-six couples recruited during their first pregnancy, participated in the study. After delivery (1 and 6 months), both parents completed a questionnaire assessing the involvement of fathers relative to mothers in infant caregiving. Infant sleep was assessed using actigraphy and sleep diaries. Mothers were significantly more involved than fathers in daytime and nighttime caregiving. A higher involvement of fathers in overall infant care predicted and was associated with fewer infant night-wakings and with shorter total sleep time after controlling for breastfeeding. The findings highlight the importance of including fathers in developmental sleep research. Future studies should explore mechanisms underlying the relations between paternal involvement and infant sleep.

Persistence of the immune response after MenACWY-CRM vaccination and response to a booster dose, in adolescents, children and infants.

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Baxter, Roger; Keshavan, Pavitra; Welsch, Jo Anne; Han, Linda; Smolenov, Igor

2016-05-03

Persistence of bactericidal antibodies following vaccination is extremely important for protection against invasive meningococcal disease, given the epidemiology and rapid progression of meningococcal infection. We present an analysis of antibody persistence and booster response to MenACWY-CRM, in adolescents, children and infants, from 7 clinical studies. Immunogenicity was assessed using the serum bactericidal assay with both human and rabbit complement. Post-vaccination hSBA titers were high, with an age- and serogroup-specific decline in titers up to 1 y and stable levels up to 5 y The waning of hSBA titers over time was more pronounced among infants and toddlers and the greatest for serogroup A. However, rSBA titers against serogroup A were consistently higher and showed little decline over time, suggesting that protection against this serogroup may be sustained. A single booster dose of MenACWY-CRM administered at 3 to 5 y induced a robust immune response in all age groups.

Infant Statistical-Learning Ability Is Related to Real-Time Language Processing

Science.gov (United States)

Lany, Jill; Shoaib, Amber; Thompson, Abbie; Estes, Katharine Graf

2018-01-01

Infants are adept at learning statistical regularities in artificial language materials, suggesting that the ability to learn statistical structure may support language development. Indeed, infants who perform better on statistical learning tasks tend to be more advanced in parental reports of infants' language skills. Work with adults suggests…

Birth Order and Injury-Related Infant Mortality in the U.S.

Science.gov (United States)

Ahrens, Katherine A; Rossen, Lauren M; Thoma, Marie E; Warner, Margaret; Simon, Alan E

2017-10-01

The purpose of this study was to evaluate the risk of death during the first year of life due to injury, such as unintentional injury and homicide, by birth order in the U.S. Using national birth cohort-linked birth-infant death data (births, 2000-2010; deaths, 2000-2011), risks of infant mortality due to injury in second-, third-, fourth-, and fifth or later-born singleton infants were compared with first-born singleton infants. Risk ratios were estimated using log-binomial models adjusted for maternal age, marital status, race/ethnicity, and education. The statistical analyses were conducted in 2016. Approximately 40%, 32%, 16%, 7%, and 4% of singleton live births were first, second, third, fourth, and fifth or later born, respectively. From 2000 to 2011, a total of 15,866 infants died as a result of injury (approximately 1,442 deaths per year). Compared with first-born infants (2.9 deaths per 10,000 live births), second or later-born infants were at increased risk of infant mortality due to injury (second, 3.6 deaths; third, 4.2 deaths; fourth, 4.8 deaths; fifth or later, 6.4 deaths). The corresponding adjusted risk ratios were as follows: second, 1.84 (95% CI=1.76, 1.91); third, 2.42 (95% CI=2.30, 2.54); fourth, 2.96 (95% CI=2.77, 3.16); and fifth or later, 4.26 (95% CI=3.96, 4.57). Singleton infants born second or later were at increased risk of mortality due to injury during their first year of life in the U.S. This study's findings highlight the importance of investigating underlying mechanisms behind this increased risk. Published by Elsevier Inc.

The role of objects and effects in action imitation: Comparing the imitation of object-related actions vs. gestures in 18-month-old infants.

Science.gov (United States)

Kim, Ziyon; Óturai, Gabriella; Király, Ildikó; Knopf, Monika

2015-11-01

This study aimed to systematically investigate 18-month-old infants' imitation of object-related actions compared to motorically similar gestures. An additional goal of the study was to examine the role of action effects on infants' imitation of target actions. One group of infants (n=17) observed object-related actions and gestures leading to salient effects (sounds or visual resp. social effects), and the other group (n=16) watched the same actions without effects. Furthermore, this study examined whether infants show a consistent imitation ability for object-related actions and gestures. First, the present study showed that 18-month-old infants imitated object-related actions more frequently than gestures. Second, the presence of an effect significantly increased the imitation rate of object-related actions; however, this difference was not found for gestures. Third, indications for a general imitation ability were found as results on an individual level showed that object-related action imitation significantly correlated with gesture imitation. Implications of the results for theory and future studies are discussed with a focus on the role of objects and effects in 18-month-old infants' action imitation. Copyright © 2015 Elsevier Inc. All rights reserved.

Reduced schedules of 4CMenB vaccine in infants and catch-up series in children: Immunogenicity and safety results from a randomised open-label phase 3b trial.

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Martinón-Torres, Federico; Safadi, Marco Aurelio P; Martinez, Alfonso Carmona; Marquez, Pilar Infante; Torres, Juan Carlos Tejedor; Weckx, Lily Yin; Moreira, Edson Duarte; Mensi, Ilhem; Calabresi, Marco; Toneatto, Daniela

2017-06-16

This study evaluated the immunogenicity and safety of a licensed meningococcal serogroup B vaccine (4CMenB) administered alone according to reduced schedules in infants or catch-up series in children. In this open-label, multicentre, phase 3b study (NCT01339923), infants randomised 1:1:1 received 4CMenB: 2+1 doses at 3½-5-11months or 6-8-11months of age, 3+1 doses at ages 2½-3½-5-11months. Children aged 2-10years received 2 catch-up doses administered 2months apart. Immune responses were measured by hSBA assays against 4 strains specific for vaccine components fHbp, NadA, PorA and NHBA. Sufficiency of immune responses was defined in groups with 2+1 doses schedules as a lower limit ≥70% for the 97.5% confidence interval of the percentage of infants with hSBA titres ≥4, 1month post-dose 2 for fHbp, NadA, PorA. Adverse events were collected for 7days post-vaccination; serious adverse events (SAEs) throughout the study. 754 infants and 404 children were enrolled. Post-primary vaccination, 98-100% of infants across all groups developed hSBA titres ≥4 for fHbp, NadA, PorA, and 48-77% for NHBA. Sufficiency of immune responses in infants receiving 2+1 schedules was demonstrated for fHbp, NadA, PorA after 2 doses of 4CMenB, as pre-specified criteria were met. Following receipt of 2 catch-up doses, 95-99% of children developed hSBA titres ≥4 for 4CMenB components. Similar safety profiles were observed across groups. A total of 45 SAEs were reported, 3 of which were related to vaccination. Reduced infant schedules and catch-up series in children were immunogenic and safe, having the potential to widen 4CMenB vaccine coverage. GlaxoSmithKline Biologicals SA. Copyright © 2017. Published by Elsevier Ltd.

Efficacy, Immunogenicity and Safety of a Human Rotavirus Vaccine RIX4414 in Singaporean Infants.

Science.gov (United States)

Phua, Kong Boo; Lim, Fong Seng; Quak, Seng Hock; Lee, Bee Wah; Teoh, Yee Leong; Suryakiran, Pemmaraju V; Han, Htay Htay; Bock, Hans L

2016-02-01

This was the first study conducted to evaluate the efficacy of 2 oral doses of the human rotavirus vaccine, RIX4414 in Singaporean infants during the first 3 years of life. Healthy infants, 11 to 17 weeks of age were enrolled in this randomised (1:1), double-blinded, placebo-controlled study to receive 2 oral doses of RIX4414 vaccine/placebo following a 0-, 1-month schedule. Vaccine efficacy against severe rotavirus (RV) gastroenteritis (Vesikari score ≥11) caused by wild-type RV strains from a period starting from 2 weeks post-Dose 2 until 2 and 3 years of age was calculated with 95% confidence interval (CI). Immunogenicity and safety of the vaccine were also assessed. Of 6542 infants enrolled, 6466 were included in the efficacy analysis and a subset of 100 infants was included in the immunogenicity analysis. Fewer severe RV gastroenteritis episodes were reported in the RIX4414 group when compared to placebo at both 2 and 3 year follow-up periods. Vaccine efficacy against severe RV gastroenteritis at the respective time points were 93.8% (95% CI, 59.9 to 99.9) and 95.2% (95% CI, 70.5 to 99.9). One to 2 months post-Dose 2 of RIX4414, 97.5% (95% CI, 86.8 to 99.9) of infants seroconverted for anti-RV IgA antibodies. The number of serious adverse events recorded from Dose 1 until 3 years of age was similar in both groups. Two oral doses of RIX4414 vaccine was immunogenic and provided high level of protection against severe RV gastroenteritis in Singaporean children, during the first 3 years of life when the disease burden is highest.

The effect of introduction of axial cineangiography and echocardiography on contrast and radiation doses during cardiac catheterisation

International Nuclear Information System (INIS)

Sweet, E.M.; McLardy, J.L.

1984-01-01

The effects of routine preliminary echocardiography and adoption of axial cine angiography in a Paediatric Cardiac Investigation Centre were assessed in relation to contrast volume, fluoroscopy time and radiation dose. The results showed a significant increase in radiation dose with some reduction in fluoroscopy time in neonates and some increase in contrast volume used in infants [fr

Pharmacokinetics of oseltamivir in infants under the age of 1 year.

Science.gov (United States)

Dixit, Rashmi; Matthews, Slade; Khandaker, Gulam; Walker, Karen; Festa, Marino; Booy, Robert

2016-12-01

Oseltamivir is the only antiviral treatment recommended for influenza in young children over the age of 1 year. There is scant data on oseltamivir pharmacokinetics (PK) in infants clearance in infants time points afterwards, to calculate Cmax (ng/mL), Tmax (h), AUC0-t (ng h/mL) and time for AUC (h). Four children with influenza A received oral oseltamivir, 2.35-3 mg/kg/dose. This dose range produced a target oseltamivir carboxylate plasma concentration in excess of the proposed 12-h target AUC of 3800 ng h/mL, selected from earlier studies to avert resistance. One patient developed GIT adverse event: dry retching. Oseltamivir was well tolerated at a dose of 2.35-3 mg/kg/dose twice a day in infants under the age of 1 year. In general agreement with earlier data, these doses produced a target oseltamivir carboxylate plasma exposure in excess of the proposed 12-h target exposure of AUC equal to 3800 ng h/mL in two patients. The limited plasma concentration data in the remaining two patients were not inconsistent with the target exposure being reached.

Relation between birth weight and blood pressure: longitudinal study of infants and children

NARCIS (Netherlands)

L.J. Launer (Lenore); D.E. Grobbee (Diederick); A. Hofman (Albert)

1993-01-01

textabstractOBJECTIVE--To study the relation between birth weight and systolic blood pressure in infancy and early childhood. DESIGN--Longitudinal study of infants from birth to 4 years of age. SETTING--A middle class community in the Netherlands. PARTICIPANTS--476

An investigation into techniques for reducing doses from neo-natal radiographic examinations

Energy Technology Data Exchange (ETDEWEB)

Wraith, C.M.; Martin, C.J. [Aberdeen Royal Hospitals NHS Trust (United Kingdom). Dept. of Bio-Medical Physics and Bio-Engineering; Stockdale, E.J.N.; McDonald, S.; Farquhar, B. [Royal Aberdeen Children`s Hospital (United Kingdom)

1995-10-01

A survey of radiation doses received by infants having radiography in a neo-natal unit was undertaken at Aberdeen Maternity Hospital. Options for dose reduction recommended by the CEC Lake Starnberg Group were investigated. Techniques were implemented for clinical evaluation after assessments of image quality with test objects and phantoms. Clinical image quality of radiographs was evaluated by paediatric radiologists using CEC criteria. Results revealed a clear relationship between entrance dose and patient weight, indicating that reference doses for infants could be linked to weight. (author).

Infant mortality in India: use of maternal and child health services in relation to literacy status.

Science.gov (United States)

Gokhale, Medha K; Rao, Shobha S; Garole, Varsha R

2002-06-01

Slow reduction in infant mortality rate in the last couple of decades is a major concern in India. State-level aggregate data from the National Family Health Survey 1992 and micro-level data on rural mothers (n=317) were used for examining the influence of female literacy on reduction of infant mortality through increased use of maternal and child health (MCH) services. Illiteracy of females was strongly associated with all variables relating to maternal care and also with infant mortality rate. States were grouped into best, medium, and worst on the basis of female illiteracy (about 11%, 48.5%, and 75% respectively). Infant mortality rate (per 1,000 livebirths) was significantly (pIlliteracy of females had a more detrimental impact on rural than on urban areas. In the event of high female illiteracy, male literacy was beneficial for improving the use of services for reducing infant mortality rate. The micro-level study supported all major findings obtained for the national-level aggregate data. Programmes, like providing free education to girls, will yield long-term health benefits.

Common errors of drug administration in infants: causes and avoidance.

Science.gov (United States)

Anderson, B J; Ellis, J F

1999-01-01

Drug administration errors are common in infants. Although the infant population has a high exposure to drugs, there are few data concerning pharmacokinetics or pharmacodynamics, or the influence of paediatric diseases on these processes. Children remain therapeutic orphans. Formulations are often suitable only for adults; in addition, the lack of maturation of drug elimination processes, alteration of body composition and influence of size render the calculation of drug doses complex in infants. The commonest drug administration error in infants is one of dose, and the commonest hospital site for this error is the intensive care unit. Drug errors are a consequence of system error, and preventive strategies are possible through system analysis. The goal of a zero drug error rate should be aggressively sought, with systems in place that aim to eliminate the effects of inevitable human error. This involves review of the entire system from drug manufacture to drug administration. The nuclear industry, telecommunications and air traffic control services all practise error reduction policies with zero error as a clear goal, not by finding fault in the individual, but by identifying faults in the system and building into that system mechanisms for picking up faults before they occur. Such policies could be adapted to medicine using interventions both specific (the production of formulations which are for children only and clearly labelled, regular audit by pharmacists, legible prescriptions, standardised dose tables) and general (paediatric drug trials, education programmes, nonpunitive error reporting) to reduce the number of errors made in giving medication to infants.

Psychomotor development in infants with Prader-Willi syndrome and associations with sleep-related breathing disorders.

NARCIS (Netherlands)

Festen, D.A.M.; Wevers, M.; Weerd, A.W. de; Bossche, R.A. van den; Duivenvoorden, H.J.; Otten, B.J.; Wit, J.M.; Hokken-Koelega, A.C.S.

2007-01-01

Prader-Willi syndrome (PWS) is a neurogenetic disorder with hypotonia, psychomotor delay, obesity, short stature, and sleep-related breathing disorders. The aim of this study was to evaluate the association between psychomotor development and sleep-related breathing disorders in PWS infants. Bayley

The relative kicking frequency of infants born full-term and preterm during learning and short-term and long-term memory periods of the mobile paradigm.

Science.gov (United States)

Heathcock, Jill C; Bhat, Anjana N; Lobo, Michele A; Galloway, James C

2005-01-01

Infants born preterm differ in their spontaneous kicking, as well as their learning and memory abilities in the mobile paradigm, compared with infants born full-term. In the mobile paradigm, a supine infant's ankle is tethered to a mobile so that leg kicks cause a proportional amount of mobile movement. The purpose of this study was to investigate the relative kicking frequency of the tethered (right) and nontethered (left) legs in these 2 groups of infants. Ten infants born full-term and 10 infants born preterm (infants participated in the study. The relative kicking frequencies of the tethered and nontethered legs were analyzed during learning and short-term and long-term memory periods of the mobile paradigm. Infants born full-term showed an increase in the relative kicking frequency of the tethered leg during the learning period and the short-term memory period but not for the long-term memory period. Infants born preterm did not show a change in kicking pattern for learning or memory periods, and consistently kicked both legs in relatively equal amounts. Infants born full-term adapted their baseline kicking frequencies in a task-specific manner to move the mobile and then retained this adaptation for the short-term memory period. In contrast, infants born preterm showed no adaptation, suggesting a lack of purposeful leg control. This lack of control may reflect a general decrease in the ability of infants born preterm to use their limb movements to interact with their environment. As such, the mobile paradigm may be clinically useful in the early assessment and intervention of infants born preterm and at risk for future impairment.

Does a triplet birth pose a special risk for infant development? Assessing cognitive development in relation to intrauterine growth and mother-infant interaction across the first 2 years.

Science.gov (United States)

Feldman, Ruth; Eidelman, Arthur I

2005-02-01

To examine whether a triplet birth per se poses a risk to the development of infants' cognitive competencies and to the mother-infant relationship. Twenty-three sets of triplets were matched with 23 sets of twins and 23 singleton infants (n = 138) with respect to gestational age, birth weight, and medical and demographic features. Infants with perinatal asphyxia, intraventricular hemorrhage of grade 3 or 4, periventricular leukomalacia, or central nervous system infection were excluded from the study. At 6, 12, and 24 months of age, mother-infant interaction was observed and infants' cognitive development was tested with the Bayley II test. Mothers of triplets displayed lower levels of sensitivity at 6, 12, and 24 months and infants were less socially involved at 6 and 24 months, compared with singletons and twins. Triplets scored lower than singletons and twins on the Bayley Mental Developmental Index at 6, 12, and 24 months. A weight discordance of >15% was found for 15 triplet sets (65.2%). The discordant triplets showed decreased cognitive skills at 12 and 24 months, compared with their siblings, and received the lowest scores for maternal sensitivity. Hierarchical multivariate regression analysis revealed that greater medical risk at birth, multiple-birth status, lower maternal sensitivity, and reduced infant social involvement in the first 2 years were each predictive of lower cognitive outcomes at 2 years (R2 = 0.33). Triplets appear to be at higher risk for cognitive delays in the first 2 years of life, and discordant infants are at especially high risk. This delay is related in part to the difficulty of providing sensitive mothering to 3 infants at the same time. The findings may assist practitioners in guiding prenatal and postpartum parental care and management.

Flow-Synchronized Nasal Intermittent Positive Pressure Ventilation for Infants <32 Weeks' Gestation with Respiratory Distress Syndrome

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C. Gizzi

2012-01-01

Full Text Available Aim. To evaluate whether synchronized-NIPPV (SNIPPV used after the INSURE procedure can reduce mechanical ventilation (MV need in preterm infants with RDS more effectively than NCPAP and to compare the clinical course and the incidence of short-term outcomes of infants managed with SNIPPV or NCPAP. Methods. Chart data of inborn infants 0.4, respiratory acidosis, or intractable apnoea that occurred within 72 hours of surfactant administration. Results. Eleven out of 31 (35.5% infants in the NCPAP group and 2 out of 33 (6.1% infants in the SNIPPV group failed the INSURE approach and underwent MV (. Fewer infants in the INSURE/SNIPPV group needed a second dose of surfactant, a high caffeine maintenance dose, and pharmacological treatment for PDA. Differences in O2 dependency at 28 days and 36 weeks of postmenstrual age were at the limit of significance in favor of SNIPPV treated infants. Conclusions. SNIPPV use after INSURE technique in our NICU reduced MV need and favorably affected short-term morbidities of our premature infants.

Infants' Background Television Exposure during Play: Negative Relations to the Quantity and Quality of Mothers' Speech and Infants' Vocabulary Acquisition

Science.gov (United States)

Masur, Elise Frank; Flynn, Valerie; Olson, Janet

2016-01-01

Research on immediate effects of background television during mother-infant toy play shows that an operating television in the room disrupts maternal communicative behaviors crucial for infants' vocabulary acquisition. This study is the first to examine associations between frequent background TV/video exposure during mother-infant toy play at…

Hypersynchrony in MEG spectral amplitude in prospectively-identified 6-month-old infants prenatally exposed to alcohol

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Julia M. Stephen

2018-01-01

Full Text Available Early identification of children who experience developmental delays due to prenatal alcohol exposure (PAE remains a challenge for individuals who do not exhibit facial dysmorphia. It is well-established that children with PAE may still exhibit the cognitive and behavioral difficulties, and individuals without facial dysmorphia make up the majority of individuals affected by PAE. This study employed a prospective cohort design to capture alcohol consumption patterns during pregnancy and then followed the infants to 6 months of age. Infants were assessed using magnetoencephalography to capture neurophysiological indicators of brain development and the Bayley Scales of Infant Development-III to measure behavioral development. To account for socioeconomic and family environmental factors, we employed a two-by-two design with pregnant women who were or were not using opioid maintenance therapy (OMT and did or did not consume alcohol during pregnancy. Based on prior studies, we hypothesized that infants with PAE would exhibit broad increased spectral amplitude relative to non-PAE infants. We also hypothesized that the developmental shift from low to high frequency spectral amplitude would be delayed in infants with PAE relative to controls. Our results demonstrated broadband increased spectral amplitude, interpreted as hypersynchrony, in PAE infants with no significant interaction with OMT. Unlike prior EEG studies in neonates, our results indicate that this hypersynchrony was highly lateralized to left hemisphere and primarily focused in temporal/lateral frontal regions. Furthermore, there was a significant positive correlation between estimated number of drinks consumed during pregnancy and spectral amplitude revealing a dose-response effect of increased hypersynchrony corresponding to greater alcohol consumption. Contrary to our second hypothesis, we did not see a significant group difference in the contribution of low frequency to high frequency

Estimating Effective Dose of Radiation From Pediatric Cardiac CT Angiography Using a 64-MDCT Scanner: New Conversion Factors Relating Dose-Length Product to Effective Dose.

Science.gov (United States)

Trattner, Sigal; Chelliah, Anjali; Prinsen, Peter; Ruzal-Shapiro, Carrie B; Xu, Yanping; Jambawalikar, Sachin; Amurao, Maxwell; Einstein, Andrew J

2017-03-01

The purpose of this study is to determine the conversion factors that enable accurate estimation of the effective dose (ED) used for cardiac 64-MDCT angiography performed for children. Anthropomorphic phantoms representative of 1- and 10-year-old children, with 50 metal oxide semiconductor field-effect transistor dosimeters placed in organs, underwent scanning performed using a 64-MDCT scanner with different routine clinical cardiac scan modes and x-ray tube potentials. Organ doses were used to calculate the ED on the basis of weighting factors published in 1991 in International Commission on Radiological Protection (ICRP) publication 60 and in 2007 in ICRP publication 103. The EDs and the scanner-reported dose-length products were used to determine conversion factors for each scan mode. The effect of infant heart rate on the ED and the conversion factors was also assessed. The mean conversion factors calculated using the current definition of ED that appeared in ICRP publication 103 were as follows: 0.099 mSv · mGy -1 · cm -1 , for the 1-year-old phantom, and 0.049 mSv · mGy -1 · cm -1 , for the 10-year-old phantom. These conversion factors were a mean of 37% higher than the corresponding conversion factors calculated using the older definition of ED that appeared in ICRP publication 60. Varying the heart rate did not influence the ED or the conversion factors. Conversion factors determined using the definition of ED in ICRP publication 103 and cardiac, rather than chest, scan coverage suggest that the radiation doses that children receive from cardiac CT performed using a contemporary 64-MDCT scanner are higher than the radiation doses previously reported when older chest conversion factors were used. Additional up-to-date pediatric cardiac CT conversion factors are required for use with other contemporary CT scanners and patients of different age ranges.

SU-G-BRB-14: Uncertainty of Radiochromic Film Based Relative Dose Measurements

Energy Technology Data Exchange (ETDEWEB)

Devic, S; Tomic, N; DeBlois, F; Seuntjens, J [McGill University, Montreal, QC (Canada); Lewis, D [RCF Consulting, LLC, Monroe, CT (United States); Aldelaijan, S [King Faisal Specialist Hospital & Research Center, Riyadh (Saudi Arabia)

2016-06-15

Purpose: Due to inherently non-linear dose response, measurement of relative dose distribution with radiochromic film requires measurement of absolute dose using a calibration curve following previously established reference dosimetry protocol. On the other hand, a functional form that converts the inherently non-linear dose response curve of the radiochromic film dosimetry system into linear one has been proposed recently [Devic et al, Med. Phys. 39 4850–4857 (2012)]. However, there is a question what would be the uncertainty of such measured relative dose. Methods: If the relative dose distribution is determined going through the reference dosimetry system (conversion of the response by using calibration curve into absolute dose) the total uncertainty of such determined relative dose will be calculated by summing in quadrature total uncertainties of doses measured at a given and at the reference point. On the other hand, if the relative dose is determined using linearization method, the new response variable is calculated as ζ=a(netOD)n/ln(netOD). In this case, the total uncertainty in relative dose will be calculated by summing in quadrature uncertainties for a new response function (σζ) for a given and the reference point. Results: Except at very low doses, where the measurement uncertainty dominates, the total relative dose uncertainty is less than 1% for the linear response method as compared to almost 2% uncertainty level for the reference dosimetry method. The result is not surprising having in mind that the total uncertainty of the reference dose method is dominated by the fitting uncertainty, which is mitigated in the case of linearization method. Conclusion: Linearization of the radiochromic film dose response provides a convenient and a more precise method for relative dose measurements as it does not require reference dosimetry and creation of calibration curve. However, the linearity of the newly introduced function must be verified. Dave Lewis

Gentamicin Exposure and Sensorineural Hearing Loss in Preterm Infants.

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Aline Fuchs

Full Text Available To evaluate the impact of gentamicin exposure on sensorineural hearing loss (SNHL in very low birth weight (VLBW infants.Exposure to gentamicin was determined in infants born between 1993 and 2010 at a gestational age < 32 weeks and/or with a birthweight < 1500 g, who presented with SNHL during the first 5 years of life. For each case, we selected two controls matched for gender, gestational age, birthweight, and year of birth.We identified 25 infants affected by SNHL, leading to an incidence of SNHL of 1.58% in our population of VLBW infants. The proportion of infants treated with gentamicin was 76% in the study group and 70% in controls (p = 0.78. The total cumulated dose of gentamicin administered did not differ between the study group (median 10.2 mg/kg, Q1-Q3 1.6-13.2 and the control group (median 7.9 mg/kg, Q1-Q3 0-12.8, p = 0.47. The median duration of gentamicin treatment was 3 days both in the study group and the control group (p = 0.58. Maximum predicted trough serum levels of gentamicin, cumulative area under the curve and gentamicin clearance were not different between cases and controls.The impact of gentamicin on SNHL can be minimized with treatments of short duration, monitoring of blood levels and dose adjustment.

Object exploration in extremely preterm infants between 6 and 9 months and relation to cognitive and language development at 24 months.

Science.gov (United States)

Zuccarini, Mariagrazia; Guarini, Annalisa; Savini, Silvia; Iverson, Jana M; Aureli, Tiziana; Alessandroni, Rosina; Faldella, Giacomo; Sansavini, Alessandra

2017-09-01

Although early object exploration is considered a key ability for subsequent achievements, very few studies have analyzed its development in extremely low gestational age infants (ELGA- GA language skills. The present study examined developmental change in Motor Object Exploration (MOE) and different types of MOE (Holding, Oral, Manual and Manual Rhythmic Exploration) in 20 ELGA and 20 full term (FT) infants observed during mother-infant play interaction at 6 and 9 months. It also explored whether specific types of MOE were longitudinally related to 24-month language and cognitive abilities (GMDS-R scores). ELGA infants increased MOE duration from 6 to 9 months, eliminating the initial difference with FT infants. In addition, ELGA infants showed a different pattern of Oral Exploration, that did not increase at 6 months and decrease at 9 months. Oral and Manual Exploration durations at 6 months were longitudinally related to 24-month GMDS-R language and cognitive performance scores respectively. We discuss the relevance of assessing early exploratory abilities in ELGA infants in order to implement customized intervention programs for supporting the development of these skills. Copyright © 2017 Elsevier Ltd. All rights reserved.

ASSOCIATION BETWEEN INFANT NIGHTTIME-SLEEP LOCATION AND ATTACHMENT SECURITY: NO EASY VERDICT.

Science.gov (United States)

Mileva-Seitz, Viara R; Luijk, Maartje P C M; van Ijzendoorn, Marinus H; Bakermans-Kranenburg, Marian J; Jaddoe, Vincent W V; Hofman, Albert; Verhulst, Frank C; Tiemeier, Henning

2016-01-01

We tested whether mother-infant bed-sharing is associated with increased secure infant-mother attachment, a previously unexplored association. Frequency of bed-sharing and mothers' nighttime comforting measures at 2 months were assessed with questionnaires in 550 Caucasian mothers from a population-based cohort. Attachment security was assessed with the Strange Situation Procedure (M.D.S. Ainsworth, M.C. Blehar, E. Waters, & S. Wall, 1978) at 14 months. When using a dichotomous variable, "never bed-sharing" (solitary sleepers) versus "any bed-sharing," the relative risk of being classified as insecurely attached for solitary-sleeping infants (vs. bed-sharers) was 1.21 (95% confidence interval: 1.05-1.40). In multivariate models, solitary sleeping was associated with greater odds of insecure attachment, adjusted odds ratio (OR): 1.50, 95% CI = 1.02-2.20) and, in particular, with greater odds of resistant attachment, adjusted OR = 1.74, 95% CI = 1.10-2.76); and with a lower attachment security score, β = -0.12, t(495) = -2.61, p = .009. However, we found no evidence of a dose-response association between bed-sharing and secure attachment when using a trichotomous bed-sharing variable based on frequency of bed-sharing. Our findings demonstrate some evidence that solitary sleeping is associated with insecure attachment. However, the lack of a dose-response association suggests that further experimental study is necessary before accepting common notions that sharing a bed leads to children who are better or not better adjusted. © 2015 Michigan Association for Infant Mental Health.

Maternal anxiety is related to infant neurological condition, paternal anxiety is not

NARCIS (Netherlands)

Kikkert, Hedwig K.; Middelburg, Karin J.; Hadders-Algra, Mijna

Background: Parental anxiety and stress may have consequences for infant neurological development. Aims: To study relationships between parental anxiety or well-being and infant neurological development approximately one year after birth. Study design: Longitudinal study of a birth cohort of infants

Committed equivalent organ doses and committed effective doses from intakes of radionuclides

CERN Document Server

Phipps, A W; Kendall, G M; Silk, T J; Stather, J W

1991-01-01

This report contains details of committed equivalent doses to individual organs for intakes by ingestion and inhalation of 1 mu m AMAD particles of 359 nuclides by infants aged 3 months, by children aged 1, 5, 10 and 15 years, and by adults. It complements NRPB-R245 which describes the changes which have taken place since the last NRPB compendium of dose per unit intake factors (dose coefficients) and gives summary tables. Information on the way committed doses increase with the integration period is given in NRPB-M289. The information given in these memoranda is also available as a microcomputer package - NRPB-SR245.

Neurotoxic response of infant monkeys to methylmercury.

Science.gov (United States)

Willes, R F; Truelove, J F; Nera, E A

1978-02-01

Four infant monkeys were dosed orally with 500 microgram Hg/kg body wt./day /as methylmercury (MeHg) chloride dissolved sodium carbonate) beginning at 1 day of age. Neurological and behavioral signs of MeHg toxicity and blood Hg levels were monitored weekly. At first sign of MeHg intoxication, dosing with MeHg was terminated and the infants were monitored to assess reversal of the signs of MeHg toxicity. The first signs of MeHg toxicity, exhibited as a loss in dexterity and locomotor ability, were observed after 28--29 days of treatment; the blood Hg levels were 8.0--9.4 microgram Hg/g blood. Dosing was terminated at 28--29 days of treatment but the signs of MeHg toxicity continued to develop. The infants became ataxic, blind, comatose and were necropsied at 35--43 days after initiating treatment with MgHg. The mercury concentrations in tissues analyzed after necropsy were highest in liver (55.8 +/- 3.2 microgram Hg/g) followed by occipital cortex (35.6 +/- 4.8 microgram Hg/g) renal cortex (32.8 +/- 1.6 microgram Hg/g). The frontal and temporal cortices had 27.0 +/- 3.4 and 29.6 +/- 4.9 microgram Hg/g respectively while the cerebellar Hg concentration averaged 13.0 +/- 1.5 microgram Hg/g. The mean blood/brain ratio was 0.21 +/- 0.4. Histopathologic lesions were marked in the cerebrum with less severe lesions in the cerebellar nuclei. The Purkinje and granular cells of the cerebellar vermis appeared histologically normal. Lesions were not observed in the peripheral nervous system. The signs of MeHg intoxication, the tissue distribution of MeHg and histopathologic lesions observed in the infant monkeys were similar to those reported for adult monkeys.

Vaccination Coverage for Infants: Cross-Sectional Studies in Two Regions of Belgium

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Emmanuelle Robert

2014-01-01

Full Text Available Methods and Objectives. To estimate infant vaccination coverage in the French-speaking region of Belgium (Wallonia and in the Brussels-Capital Region, two cross-sectional studies were performed in 2012. A face-to-face questionnaire was administered by trained investigators. The objective was to evaluate infant vaccination coverage retrospectively in 18- to 24-month-old children. These studies offered the opportunity to assess some factors influencing vaccine uptake in infants. Results and Discussion. Approximately 99% of the children had received the first dose of IPV-DTaP, 90% the fourth dose, 94% the MMR vaccine, 97% the first dose of pneumococcal vaccine, and 90% the third dose. In both regions, when fitting a logistic model, the most associated factor was attendance at maternal and child clinics (MCH. No association was observed between vaccination coverage and the mother’s level of education. For the last immunization session, where the mother was a Belgian native and when she worked more hours, child was better immunized, but only in Brussels. Conclusion. Coverage for the fourth dose of hexavalent vaccine (DTaP-IPV-HBV/Hib needs to be increased. Indeed, additional effort is needed to increase HIB and pertussis coverage rates because the herd immunity threshold for these two diseases has not been reached.

Relation of Infant Vision to Early Cognitive and Language Status.

Science.gov (United States)

Duckman, Robert; Tulloch, Deborah

Relationships between infant visual skills and the development of object permanence and expressive language skills were examined with 31 infants in three groups: visually typical, visually atypical, and Down Syndrome. Measures used to evaluate visual status were: forced preferential looking, optokinetic nystagmus, and behavioral. Object permanence…

Transfer of alkaline earth elements in mothers' milk and doses from 45Ca, 90Sr and 226Ra

International Nuclear Information System (INIS)

Smith, T.J.; Phipps, A.W.; Fell, T.P.; Harrison, J.D.

2003-01-01

An international programme of work is currently under way to develop methods for calculating doses to infants from ingestion of radionuclides present in mothers' milk. This paper considers the special case of the alkaline earth elements. Models have been developed for 45 Ca, 90 Sr and 226 Ra and the sensitivity of results to various changes in parameter values is discussed. A complication when calculating doses from intakes of radium is that the International Commission on Radiological Protection has previously recommended that doses from decay products of radium should be calculated using element-specific biokinetic models (so-called independent biokinetics). An extension of this method to the models for breastfeeding is proposed. Preliminary estimates of the doses received by the infant for a number of maternal intake scenarios show that doses to the infant can exceed the corresponding adult dose, such as for 45 Ca (ratio = 3.1) while, in other cases such as 90 Sr, the infant dose can be a significant fraction of the adult dose. (author)

Relative safety profiles of high dose statin regimens

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Carlos Escobar

2008-06-01

Full Text Available Carlos Escobar, Rocio Echarri, Vivencio BarriosDepartment of Cardiology, Hospital Ramón y Cajal, Madrid, SpainAbstract: Recent clinical trials recommend achieving a low-density lipoprotein cholesterol level of <100 mg/dl in high-risk and <70 mg/dl in very high risk patients. To attain these goals, however, many patients will need statins at high doses. The most frequent side effects related to the use of statins, myopathy, rhabdomyolysis, and increased levels of transaminases, are unusual. Although low and moderate doses show a favourable profile, there is concern about the tolerability of higher doses. During recent years, numerous trials to analyze the efficacy and tolerability of high doses of statins have been published. This paper updates the published data on the safety of statins at high doses.Keywords: statins, high doses, tolerability, liver, muscle

Radon-222 related influence on ambient gamma dose.

Science.gov (United States)

Melintescu, A; Chambers, S D; Crawford, J; Williams, A G; Zorila, B; Galeriu, D

2018-04-03

Ambient gamma dose, radon, and rainfall have been monitored in southern Bucharest, Romania, from 2010 to 2016. The seasonal cycle of background ambient gamma dose peaked between July and October (100-105 nSv h -1 ), with minimum values in February (75-80 nSv h -1 ), the time of maximum snow cover. Based on 10 m a.g.l. radon concentrations, the ambient gamma dose increased by around 1 nSv h -1 for every 5 Bq m -3 increase in radon. Radon variability attributable to diurnal changes in atmospheric mixing contributed less than 15 nSv h -1 to the overall variability in ambient gamma dose, a factor of 4 more than synoptic timescale changes in air mass fetch. By contrast, precipitation-related enhancements of the ambient gamma dose were 15-80 nSv h -1 . To facilitate routine analysis, and account in part for occasional equipment failure, an automated method for identifying precipitation spikes in the ambient gamma dose was developed. Lastly, a simple model for predicting rainfall-related enhancement of the ambient gamma dose is tested against rainfall observations from events of contrasting duration and intensity. Results are also compared with those from previously published models of simple and complex formulation. Generally, the model performed very well. When simulations underestimated observations the absolute difference was typically less than the natural variability in ambient gamma dose arising from atmospheric mixing influences. Consequently, combined use of the automated event detection method and the simple model of this study could enable the ambient gamma dose "attention limit" (which indicates a potential radiological emergency) to be reduced from 200 to 400% above background to 25-50%. Copyright © 2018 Elsevier Ltd. All rights reserved.

Acoustic parameters of infant-directed singing in mothers of infants with down syndrome.

Science.gov (United States)

de l'Etoile, Shannon; Behura, Samarth; Zopluoglu, Cengiz

2017-11-01

This study compared the acoustic parameters and degree of perceived warmth in two types of infant-directed (ID) songs - the lullaby and the playsong - between mothers of infants with Down syndrome (DS) and mothers of typically-developing (TD) infants. Participants included mothers of 15 DS infants and 15 TD infants between 3 and 9 months of age. Each mother's singing voice was digitally recorded while singing to her infant and subjected to feature extraction and data mining. Mothers of DS infants and TD infants sang both lullabies and playsongs with similar frequency. In comparison with mothers of TD infants, mothers of DS infants used a higher maximum pitch and more key changes during playsong. Mothers of DS infants also took more time to establish a rhythmic structure in their singing. These differences suggest mothers are sensitive to the attentional and arousal needs of their DS infants. Mothers of TD infants sang with a higher degree of perceived warmth which does not agree with previous observations of "forceful warmth" in mothers of DS infants. In comparison with lullaby, all mothers sang playsong with higher overall pitch and slower tempo. Playsongs were also distinguished by higher levels of spectral centroid properties related to emotional expressivity, as well as higher degrees of perceived warmth. These similarities help to define specific song types, and suggest that all mothers sing in an expressive manner that can modulate infant arousal, including mothers of DS infants. Copyright © 2017 Elsevier Inc. All rights reserved.

Efficacy, immunogenicity, and safety of two doses of a tetravalent rotavirus vaccine RRV-TV in Ghana with the first dose administered during the neonatal period.

Science.gov (United States)

Armah, George E; Kapikian, Albert Z; Vesikari, Timo; Cunliffe, Nigel; Jacobson, Robert M; Burlington, D Bruce; Ruiz, Leonard P

2013-08-01

Oral rhesus/rhesus-human reassortant rotavirus tetravalent vaccine (RRV-TV) was licensed in 1998 but withdrawn in 1999 due to a rare association with intussusception, which occurred disproportionately in infants receiving their first dose at ≥90 days of age. This study examined RRV-TV for the prevention of rotavirus gastroenteritis (RV-GE) in Ghana, West Africa, with infants receiving the first dose during the neonatal period and the second before 60 days of age. In a double-blinded, randomized, placebo-controlled trial in Navrongo, Ghana, we recruited neonates to receive 2 doses of RRV-TV or placebo and followed them to age 12 months. In the intention-to-treat population of 998 infants, we measured a vaccine efficacy of 63.1% against RV-GE of any severity associated with any of the 4 serotypes represented in the vaccine and 60.7% against RV-GE associated with any rotavirus serotype. RRV-TV in a 2-dose schedule with the first dose during the neonatal period is efficacious in preventing RV-GE in rural Ghana. Neonatal dosing results in early protection and may be the optimum schedule to avoid or significantly reduce intussusception, now reported to be associated in international settings with the 2 most widely marketed, licensed, live virus, oral rotavirus vaccines.

Operation of the radiation dose registration system for decontamination and related works

International Nuclear Information System (INIS)

Ogawa, Tsubasa; Yasutake, Tsuneo; Itoh, Atsuo; Miyabe, Kenjiro

2017-01-01

The radiation dose registration system for decontamination and related works was established on 15 November 2013. Radiation dose registration center and primary contractors of decontamination and related works manage decontamination registration and management system. As of 31 March 2017, 384 primary contractors joined in the radiation dose registration system for decontamination and related works. 383,087 quarterly exposure dose records for decontamination and related works were registered. Based on the registered data provided by the primary contractors, radiation dose registration center has released the statistical data that represent the radiation control status for workers engaged in radiation work at the work areas of decontamination and related works, etc. The statistical data shows that there were 40,377 workers engaged in decontamination and related works in 2015. The average exposure dose for workers was 0.6 mSv in 2015. The maximum exposure dose for workers was 7.8 mSv in 2015. Dose distribution by age of workers shows the range of 60 to 64 years old were most engaged in decontamination and related works in 2015. Dose distribution by gender of workers shows 97% of workers were male in 2015. From 2012 to 2015, about 95% of workers were exposed to radiation less than 3 mSv. And about 80% of workers were exposed to radiation less than 1 mSv. The average exposure dose per year was ranged from 0.5 to 0.7 mSv. (author)

The relative biological effectiveness of out-of-field dose

International Nuclear Information System (INIS)

Balderson, Michael; Koger, Brandon; Kirkby, Charles

2016-01-01

Purpose: using simulations and models derived from existing literature, this work investigates relative biological effectiveness (RBE) for out-of-field radiation and attempts to quantify the relative magnitudes of different contributing phenomena (spectral, bystander, and low dose hypersensitivity effects). Specific attention is paid to external beam radiotherapy treatments for prostate cancer. Materials and methods: using different biological models that account for spectral, bystander, and low dose hypersensitivity effects, the RBE was calculated for different points moving radially out from isocentre for a typical single arc VMAT prostate case. The RBE was found by taking the ratio of the equivalent dose with the physical dose. Equivalent doses were calculated by determining what physical dose would be necessary to produce the same overall biological effect as that predicted using the different biological models. Results: spectral effects changed the RBE out-of-field less than 2%, whereas response models incorporating low dose hypersensitivity and bystander effects resulted in a much more profound change of the RBE for out-of-field doses. The bystander effect had the largest RBE for points located just outside the edge of the primary radiation beam in the cranial caudal (z-direction) compared to low dose hypersensitivity and spectral effects. In the coplanar direction, bystander effect played the largest role in enhancing the RBE for points up to 8.75 cm from isocentre. Conclusions: spectral, bystander, and low dose hypersensitivity effects can all increase the RBE for out-of-field radiation doses. In most cases, bystander effects seem to play the largest role followed by low dose hypersensitivity. Spectral effects were unlikely to be of any clinical significance. Bystander, low dose hypersensitivity, and spectral effect increased the RBE much more in the cranial caudal direction (z-direction) compared with the coplanar directions. (paper)

Attentional prioritization of infant faces is limited to own-race infants.

Directory of Open Access Journals (Sweden)

John Hodsoll

2010-09-01

Full Text Available Recent evidence indicates that infant faces capture attention automatically, presumably to elicit caregiving behavior from adults and leading to greater probability of progeny survival. Elsewhere, evidence demonstrates that people show deficiencies in the processing of other-race relative to own-race faces. We ask whether this other-race effect impacts on attentional attraction to infant faces. Using a dot-probe task to reveal the spatial allocation of attention, we investigate whether other-race infants capture attention.South Asian and White participants (young adults aged 18-23 years responded to a probe shape appearing in a location previously occupied by either an infant face or an adult face; across trials, the race (South Asian/White of the faces was manipulated. Results indicated that participants were faster to respond to probes that appeared in the same location as infant faces than adult faces, but only on own-race trials.Own-race infant faces attract attention, but other-race infant faces do not. Sensitivity to face-specific care-seeking cues in other-race kindenschema may be constrained by interracial contact and experience.

Regional Deprivation Index and Socioeconomic Inequalities Related to Infant Deaths in Korea.

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Yun, Jae-Won; Kim, Young-Ju; Son, Mia

2016-04-01

Deprivation indices have been widely used to evaluate neighborhood socioeconomic status and therefore examine individuals within their regional context. Although some studies on the development of deprivation indices were conducted in Korea, additional research is needed to construct a more valid and reliable deprivation index. Therefore, a new deprivation index, named the K index, was constructed using principal component analysis. This index was compared with the Carstairs, Townsend and Choi indices. A possible association between infant death and deprivation was explored using the K index. The K index had a higher correlation with the infant mortality rate than did the other three indices. The regional deprivation quintiles were unequally distributed throughout the country. Despite the overall trend of gradually decreasing infant mortality rates, inequalities in infant deaths according to the deprivation quintiles persisted and widened. Despite its significance, the regional deprivation variable had a smaller effect on infant deaths than did individual variables. The K index functions as a deprivation index, and we may use this index to estimate the regional socioeconomic status in Korea. We found that inequalities in infant deaths according to the time trend persisted. To reduce the health inequalities among infants in Korea, regional deprivation should be considered.

Ethical issues related to caring for low birth weight infants.

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Webb, Mary S; Passmore, Denise; Cline, Genieveve; Maguire, Denise

2014-09-01

Currently preterm births are the leading causes of newborn deaths and newborn mortality in developed countries. Infants born prematurely remain vulnerable to many acute complications and long-term disabilities. There is a growing concern surrounding the moral and ethical implications of the complex and technological care being provided to extremely low birth weight infants in neonatal intensive care units in the developed nations. The purpose of this study was to describe the ethical and moral issues that neonatal intensive care nurses experience when caring for low birth weight preterm infants and their families. A phenomenological method design was used to describe the lived experiences of nurses with ethical and moral issues encountered in the neonatal intensive care unit. One-on-one, semi-structured interviews using open-ended questions were used to gather data from the participants. The setting for this study was a 97-bed neonatal intensive care. A total of 16 female nurses were interviewed. Approval to conduct the research study was obtained from the institutional review board of the hospital where the study was conducted. Formal signed consent was obtained from each participant. To ensure confidentiality, each participant was asked to choose a confederate name to be used in the interview and the transcriptions. The thematic analysis identified five recurring themes: (a) at the edge of viability, (b) infant pain and discomfort, (c) crucial decisions, (d) communicating with parents, and (e) letting go. Neonatal intensive care unit nurses indicated that they often had challenges to their own sense of morality as they struggled to protect the infant from pain and unnecessary discomfort, provide care to an infant and their family whom they thought was faced with a lifetime of challenges and poor health, accepting decisions made by parents, and feeling as if parents were not adequately informed about outcomes. © The Author(s) 2014.

The efficacy of the upright position on gastro-esophageal reflux and reflux-related respiratory symptoms in infants with chronic respiratory symptoms.

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Jung, Woo Jin; Yang, Hyeon Jong; Min, Taek Ki; Jeon, You Hoon; Lee, Hae Won; Lee, Jun Sung; Pyun, Bok Yang

2012-01-01

Gastro-esophageal reflux (GER), particularly non-acid reflux, is common in infants and is a known cause of chronic respiratory symptoms in infancy. Recent guidelines recommended empirical acid suppression therapy and the head-up position in patients with suspected GER. However, the efficacy of the upright position in relieving GER and reflux-related respiratory symptoms in infants is unclear. We conducted this study to investigate the efficacy of the upright position on GER and reflux-related respiratory symptoms in infants with chronic respiratory symptoms. Thirty-two infants (21 male; median age, 5 months; range, 0 to 19 months) with unexplained chronic respiratory symptoms underwent multi-channel intraluminal esophageal impedance and pH monitoring. We retrospectively compared the frequencies of GER and reflux-related symptoms according to body position. A mean of 3.30 episodes of reflux per hour was detected. Overall, refluxes were more frequent during the postprandial period than the emptying period (3.77 vs. 2.79 episodes/hour, respectively; P=0.01). Although there was no significant difference in the total refluxes per hour between the upright and recumbent positions (6.12 vs. 3.77 episodes, P=0.10), reflux-related respiratory symptoms per reflux were significantly fewer in infants kept in an upright position than in a recumbent position during the postprandial period (3.07% vs. 14.75%, P=0.016). Non-acid reflux was the predominant type of reflux in infants, regardless of body position or meal time. The upright position may reduce reflux-related respiratory symptoms, rather than reflux frequency. Thus, it may be a useful non-pharmacological treatment for infantile GER disease resistant to acid suppressants.

Bioavailability of zinc, copper, and manganese from infant diets

International Nuclear Information System (INIS)

Bell, J.G.

1987-01-01

A series of trace element absorption experiments were performed using the Sprague-Dawley suckling rat put and infant rhesis monkey (Macaca mulatta) with extrinsic radiolabeling to assess the bioavailability of Zn, Cu, and Mn from infant diets and to examine specific factors that affect absorption of these essential nutrients. Bioavailability of Cu as assessed by 6 h liver uptake (% of 64 Cu dose) was highest from human milk and cow milk based formula and significantly lower from cow milk and soy based formula. Copper bioavailability from infant cereal products as assessed by whole body uptake (% of 64 Cu dose) in d 20 rats, 9 h postintubation, was low compared to the bioavailability from cow milk or human milk alone. 65 Zn uptake in d 20 rats, 9 h postintubation, was significantly lower from cereals fed alone or in combination with cow or human milk as compared to the uptake from the milks fed alone. Zn bioavailability varied among cereal diets, (lowest from cereals containing phytate and highest from cereal/fruit products). Mn bioavailability from infant diets was assessed using a modified suckling rat pup model. Bioavailability (24 h whole body retention of 54 Mn) was high from all milks and commercial formulas tested

Pre- and Post-Natal Maternal Depressive Symptoms in Relation with Infant Frontal Function, Connectivity, and Behaviors

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Soe, Ni Ni; Wen, Daniel J.; Poh, Joann S.; Li, Yue; Broekman, Birit F. P.; Chen, Helen; Chong, Yap Seng; Kwek, Kenneth; Saw, Seang-Mei; Gluckman, Peter D.; Meaney, Michael J.; Rifkin-Graboi, Anne; Qiu, Anqi

2016-01-01

This study investigated the relationships between pre- and early post-natal maternal depression and their changes with frontal electroencephalogram (EEG) activity and functional connectivity in 6- and 18-month olds, as well as externalizing and internalizing behaviors in 24-month olds (n = 258). Neither prenatal nor postnatal maternal depressive symptoms independently predicted neither the frontal EEG activity nor functional connectivity in 6- and 18-month infants. However, increasing maternal depressive symptoms from the prenatal to postnatal period predicted greater right frontal activity and relative right frontal asymmetry amongst 6-month infants but these finding were not observed amongst 18-month infants after adjusted for post-conceptual age on the EEG visit day. Subsequently increasing maternal depressive symptoms from the prenatal to postnatal period predicted lower right frontal connectivity within 18-month infants but not among 6-month infants after controlling for post-conceptual age on the EEG visit day. These findings were observed in the full sample and the female sample but not in the male sample. Moreover, both prenatal and early postnatal maternal depressive symptoms independently predicted children’s externalizing and internalizing behaviors at 24 months of age. This suggests that the altered frontal functional connectivity in infants born to mothers whose depressive symptomatology increases in the early postnatal period compared to that during pregnancy may reflect a neural basis for the familial transmission of phenotypes associated with mood disorders, particularly in girls. PMID:27073881

The Study of Maternal Perception of Preterm Infants and Some Related Factors in Selected Hospitals of Iran University of Medical Sciences

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M. Ghafoorie

2015-05-01

Full Text Available Background and Purpose: Appropriate maternal care is necessary to provide Physical growth and mental development of neonate which is related to establishing a good relationship between mother and infant. Positive perception of mothers to their neonates, creates a better relationship between them. Maternal perception of neonates is based on her understanding of biological behavior of the infant. Special features of prematurity, maternal stress and anxiety due to premature delivery are effective on maternal perceptions. The purpose of this study was to determine the maternal perception of premature infants as determining it’s related factors. Methods: In a cross-sectional design, 150 mothers of preterm infants who were been admitted to Neonatal intensive care units of 2 selected hospitals of Iran University of Medical Sciences, entered the study. Broussard questionnaire were used to measure the maternal perception. Data were analyzed by using descriptive statistical analysis and Kay square and Fisher's exact tests were used for analyzing the data. Results: Most of mother’s had a negative perception of their preterm infant. Based on the results, Mather’s job, fathers’ job, mothers’ age, husband’s support, desire about the pregnancy, history of miscarriage and still birth were related with perception of mothers of preterm infants. Discussion: Negative perceptions in mothers of preterm infants are prevalent and in some groups are in higher risk. As negative perception can have a role in developmental processes and cause problems in future, preparing circumstances to decrease mothers’ stress and providing facilities and interventions to increase mother-infant communications are essential. These are treatment team’s duties. The health care team can screen susceptible cases and by supportive interventions, it is possible to create better mother-baby relationship and prepare better care to prevent future developmental problems.

Digital disruption? Maternal mobile device use is related to infant social-emotional functioning.

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Myruski, Sarah; Gulyayeva, Olga; Birk, Samantha; Pérez-Edgar, Koraly; Buss, Kristin A; Dennis-Tiwary, Tracy A

2017-09-24

Mobile device use has become increasingly prevalent, yet its impact on infant development remains largely unknown. When parents use mobile devices in front of infants, the parent is physically present but most likely distracted and unresponsive. Research using the classic Still Face Paradigm (SFP) suggests that parental withdrawal and unresponsiveness may have negative consequences for children's social-emotional development. In the present study, 50 infants aged 7.20 to 23.60 months (M = 15.40, SD = 4.74) and their mothers completed a modified SFP. The SFP consisted of three phases: free play (FP; parent and infant play and interact), still face (SF; parent withdraws attention and becomes unresponsive), and reunion (RU; parent resumes normal interaction). The modified SFP incorporated mobile device use in the SF phase. Parents reported on their typical mobile device use and infant temperament. Consistent with the standard SFP, infants showed more negative affect and less positive affect during SF versus FP. Infants also showed more toy engagement and more engagement with mother during FP versus SF and RU. Infants showed the most social bids during SF and more room exploration in SF than RU. More frequent reported mobile device use was associated with less room exploration and positive affect during SF, and less recovery (i.e., engagement with mother, room exploration positive affect) during RU, even when controlling for individual differences in temperament. Findings suggest that the SFP represents a promising theoretical framework for understanding the impact of parent's mobile device use on infant social-emotional functioning and parent-infant interactions. © 2017 John Wiley & Sons Ltd.

[Laboratory and clinical studies on flomoxef in neonates and premature infants].

Science.gov (United States)

Motohiro, T; Maruoka, T; Nagai, K; Oki, S; Tsumura, N; Sasaki, H; Aramaki, M; Koga, T; Sakata, Y; Tominaga, K

1993-07-01

Flomoxef (FMOX), an oxacephem antibiotic of beta-lactam antibiotic family, was administered to 16 infants including 6 neonates and 10 premature infants at a dose of 20 or 40 mg/kg via intravenous injection, and plasma and urinary concentrations and the urinary recovery were determined. In addition, FMOX was administered via intravenous injection at daily doses averaging 85.5 mg/kg divided into 2 to 4 times for durations averaging 9 days to 96 infants from 0- to 90-day old (mainly neonates and premature infants). In 44 of the 96 infants with bacterial infections, clinical and bacteriological efficacies were evaluated, and prophylactic effects of FMOX were determined in the remaining 52 infants. Adverse reaction and laboratory tests abnormalities were evaluated also. The obtained results are summarized as follows. 1. Upon administration of FMOX at 20 or 40 mg/kg to neonates and premature infants via intravenous injection, plasma concentrations, half-lives and AUC were determined. In 3 neonates of 5, 7 and 16 days of ages administered with 20 mg/kg of FMOX, peak plasma concentrations of 62.5 to 99.7 micrograms/ml were achieved in 5 or 15 minutes after injection. Half-lives of FMOX in these neonates were 1.48 to 1.78 hours and AUC's were 112 to 161 micrograms.hr/ml. The same dose (20 mg/kg) of FMOX was administered to 3 premature infants of 5- 16- and 19-day of ages and initial blood samples were obtained at 5 minutes after injection from the 5-day old subject and at 15 minutes after injection from the 16-and 19-day old subjects. Peak plasma concentrations of 63.6 to 79.9 micrograms/ml were observed in the samples. Half-lives were 1.69 to 2.20 hours and AUC's were 174 to 201 micrograms.hr/ml. When 3 neonates (one 17-day old and two 24-day old subjects) were administered with 40 mg/kg of FMOX, peak plasma concentrations obtained at 5 minutes after injection were 99.7 to 122.0 micrograms/ml. Half-lives were 1.28 to 1.92 hours and AUC's were 170 to 357 micrograms

Sleeping like a baby: Examining relations between habitual infant sleep, recall memory, and generalization across cues at 10 months.

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Lukowski, Angela F; Milojevich, Helen M

2013-06-01

Previous research suggests that sleep is related to cognitive functioning in infants and adults. In the present study, we examined whether individual differences in infant sleep habits over the seven days prior to elicited imitation testing were associated with variability in (a) the encoding of 2-step event sequences and (b) memory for the presented information and generalization across cues after a 2-h delay in 10-month-olds. Significant correlations indicated that both daytime napping and nighttime sleep were related to encoding and generalization across cues after the 2-h delay; significant findings were not found in relation to baseline or delayed recall performance. We suggest that individual differences in infant sleep habits may be one mechanism underlying the observed variability in recall memory and generalization as these abilities are coming online late in the first year of life. Published by Elsevier Inc.

Development and verification of a pharmacokinetic model to optimize physiologic replacement of rhIGF-1/rhIGFBP-3 in preterm infants.

Science.gov (United States)

Chung, Jou-Ku; Hallberg, Boubou; Hansen-Pupp, Ingrid; Graham, Martin A; Fetterly, Gerald; Sharma, Jyoti; Tocoian, Adina; Kreher, Nerissa C; Barton, Norman; Hellström, Ann; Ley, David

2017-03-01

rhIGF-1/rhIGFBP-3 is being investigated for prevention of retinopathy of prematurity in extremely preterm infants. A population pharmacokinetic model was developed using data from phase I/II (Sections A-C) trials of rhIGF-1/rhIGFBP-3 and additional studies in preterm infants to predict optimal dosing to establish/maintain serum IGF-1 within physiological intrauterine levels. In Section D of the phase II study, infants (gestational age (GA) (wk+d) 23+0 to 27+6) were randomized to rhIGF-1/rhIGFBP-3, administered at the model-predicted dose of 250 µg/kg/d continuous i.v. infusion up to postmenstrual age (PMA) 29 wk+6 d or standard of care. An interim pharmacokinetic analysis was performed for the first 10 treated infants to verify dosing. Serum IGF-1 data were reviewed for 10 treated/9 control infants. Duration of therapy in treated infants ranged 1-34.5 d. At baseline (before infusion and <24 h from birth), mean (SD) IGF-1 was 19.2 (8.0) μg/l (treated) and 15.4 (4.7) μg/l (controls). Mean (SD) IGF-1 increased to 45.9 (19.6) μg/l at 12 h in treated infants, and remained within target levels for all subsequent timepoints. For treated infants, 88.8% of the IGF-1 measurements were within target levels (controls, 11.1%). Through the reported work, we determined appropriate rhIGF-1/rhIGFBP-3 dosing to achieve physiological intrauterine serum IGF-1 levels in extremely preterm infants.

Pain-related stress in the Neonatal Intensive Care Unit and salivary cortisol reactivity to socio-emotional stress in 3-month-old very preterm infants.

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Provenzi, Livio; Giusti, Lorenzo; Fumagalli, Monica; Tasca, Hilarj; Ciceri, Francesca; Menozzi, Giorgia; Mosca, Fabio; Morandi, Francesco; Borgatti, Renato; Montirosso, Rosario

2016-10-01

Very preterm (VPT) infants are hospitalized in the Neonatal Intensive Care Unit (NICU) and exposed to varying levels of skin-breaking procedures (pain-related stress), even in absence of severe clinical conditions. Repeated and prolonged pain exposure may alter hypothalamic-pituitary-adrenal (HPA) axis reactivity in VPT infants. During the post-discharge period, altered HPA axis reactivity has been documented in response to non-social stressors, using salivary cortisol as a biomarker. However, little is known about the effects of NICU pain-related stress on subsequent HPA axis reactivity to socio-emotional stress in infants. We examined the relationship between pain-related stress in NICU and HPA axis reactivity (i.e., salivary cortisol reactivity) to an age-appropriate socio-emotional condition in 37 healthy VPT infants compared to 53 full-term (FT) controls. The number of skin-breaking procedures was obtained across NICU stay for VPT infants. At 3 months (corrected age for prematurity), all infants participated in the maternal Face-to-Face Still-Face (FFSF) procedure, in order to assess HPA axis reactivity to socio-emotional stress (i.e., maternal unresponsiveness). VPT infants exhibited a blunted salivary cortisol reactivity, which was associated with the amount of skin-breaking procedures during NICU: greater pain-related stress predicted lower salivary cortisol reactivity, adjusting for neonatal confounders. These findings further advance our knowledge of how early exposure to pain-related stress in NICU contributes to the programming of an altered HPA axis reactivity to socio-emotional stress in 3-month-old VPT infants, even in the absence of major perinatal complications. Copyright © 2016 Elsevier Ltd. All rights reserved.

Linezolid for Infants and Toddlers With Disseminated Tuberculosis: First Steps.

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Deshpande, Devyani; Srivastava, Shashikant; Pasipanodya, Jotam G; Bush, Stephen J; Nuermberger, Eric; Swaminathan, Soumya; Gumbo, Tawanda

2016-11-01

 Infants and toddlers often present with disseminated and lymph node tuberculosis, in which Mycobacterium tuberculosis (Mtb) is predominantly intracellular. Linezolid, used to treat tuberculosis in adults, has not been formally studied in infants. Infants clear linezolid 5 times faster than adults and achieve lower 0- to 24-hour area under the concentration-time curves (AUC 0-24 ).  To mimic intracellular disease, we infected human-derived THP-1 macrophages with Mtb and inoculated hollow fiber systems. We performed dose-effect and dose-scheduling studies in which we recapitulated the linezolid half-life of 3 hours encountered in infants. Repetitive sampling for linezolid pharmacokinetics, Mtb intracellular burden, viable monocyte count, and RNA sequencing reads were performed up to 28 days.  The linezolid extracellular half-life was 2.64 ± 0.38 hours, whereas intracellular half-life was 8.93 ± 1.30 hours (r 2 = 0.89). Linezolid efficacy was linked to the AUC 0-24 to minimum inhibitory concentration (MIC) ratio (r 2 = 0.98). The exposure associated with maximal Mtb kill was an AUC 0-24 /MIC of 23.37 ± 1.16. We identified a 414-gene transcript on exposure to toxic linezolid doses. The largest number of genes mapped to ribosomal proteins, a signature hitherto not associated with linezolid toxicity. The second-largest number of differentially expressed genes mapped to mitochondrial enzyme inhibition. Linezolid AUC 0-24 best explained the mitochondrial gene inhibition, with 50% inhibition at 94 mg × hour/L (highest r 2 = 0.98).  We identified the linezolid AUC 0-24 /MIC target for optimal efficacy against pediatric intracellular tuberculosis, and an AUC 0-24 threshold associated with mitochondrial inhibition. These constitute a therapeutic window to be targeted for optimal linezolid doses in children with tuberculosis. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America.

Postural complexity influences development in infants born preterm with brain injury: relating perception-action theory to 3 cases.

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Dusing, Stacey C; Izzo, Theresa; Thacker, Leroy R; Galloway, James Cole

2014-10-01

Perception-action theory suggests a cyclical relationship between movement and perceptual information. In this case series, changes in postural complexity were used to quantify an infant's action and perception during the development of early motor behaviors. Three infants born preterm with periventricular white matter injury were included. Longitudinal changes in postural complexity (approximate entropy of the center of pressure), head control, reaching, and global development, measured with the Test of Infant Motor Performance and the Bayley Scales of Infant and Toddler Development, were assessed every 0.5 to 3 months during the first year of life. All 3 infants demonstrated altered postural complexity and developmental delays. However, the timing of the altered postural complexity and the type of delays varied among the infants. For infant 1, reduced postural complexity or limited action while learning to control her head in the midline position may have contributed to her motor delay. However, her ability to adapt her postural complexity eventually may have supported her ability to learn from her environment, as reflected in her relative cognitive strength. For infant 2, limited early postural complexity may have negatively affected his learning through action, resulting in cognitive delay. For infant 3, an increase in postural complexity above typical levels was associated with declining neurological status. Postural complexity is proposed as a measure of perception and action in the postural control system during the development of early behaviors. An optimal, intermediate level of postural complexity supports the use of a variety of postural control strategies and enhances the perception-action cycle. Either excessive or reduced postural complexity may contribute to developmental delays in infants born preterm with white matter injury. © 2014 American Physical Therapy Association.

Surfactant therapy in late preterm infants

Directory of Open Access Journals (Sweden)

Murat Yurdakök

2013-06-01

Full Text Available Late preterm (LPT neonates are at a high risk for respiratory distress soon after birth due to respiratory distress syndrome (RDS, transient tachypnea of the newborn, persistent pulmonary hypertension, and pneumonia along with an increased need for surfactant replacement therapy, continuous positive airway pressure, and ventilator support when compared with the term neonates. In the past, studies on outcomes of infants with respiratory distress have primarily focused on extremely premature infants, leading to a gap in knowledge and understanding of the developmental biology and mechanism of pulmonary diseases in LPT neonates. Surfactant deficiency is the most frequent etiology of RDS in very preterm and moderately preterm infants, while cesarean section and lung infection play major roles in RDS development in LPT infants. The clinical presentation and the response to surfactant therapy in LPT infants may be different than that seen in very preterm infants. Incidence of pneumonia and occurrence of pneumothorax are significantly higher in LPT and term infants. High rates of pneumonia in these infants may result in direct injury to the type II alveolar cells of the lung with decreasing synthesis, release, and processing of surfactant. Increased permeability of the alveolar capillary membrane to both fluid and solutes is known to result in entry of plasma proteins into the alveolar hypophase, further inhibiting the surface properties of surfactant. However, the oxygenation index value do not change dramatically after ventilation or surfactant administration in LPT infants with RDS compared to very preterm infants. These finding may indicate a different pathogenesis of RDS in late preterm and term infants. In conclusion, surfactant therapy may be of significant benefit in LPT infants with serious respiratory failure secondary to a number of insults. However, optimal timing and dose of administration are not so clear in this group. Additional

Radiation-related operator's dose distribution according to LLD(recording level)

International Nuclear Information System (INIS)

Park, Jae Duck

2008-01-01

Recently, the area of radiation usage is being enlarged by the industry's advancement over the world. And, the usage of radiation generator and radioisotope is increasing every year. So, they are researching actively how to protect operators from the radiation that causes direct or indirect harmfulness to radiation-related operators of the related institutions. Therefore, in case of operator's dose, not only the main dosimeter's correctness but also the reasonal evaluation to the read values becomes the important factor. From this view, LLD's application to the read dose value is being embossed more importantly than any other thing. So, this study tried to find out what change was generated in the personal dose and the group dose when LLD was applied based on the internal real operator's read value, for 3 years, 2005 - 2007, and find out the personal dose change after dividing them into the exposure group and the supervising group based on the common people's personal dose (1 mSv/y)

How crawling and manual object exploration are related to the mental rotation abilities of 9-month-old infants

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Gudrun eSchwarzer

2013-03-01

Full Text Available The present experiment examined whether the mental rotation ability of 9-month-old infants was related to their abilities to crawl and manually explore objects. Forty-eight 9-month-old infants were tested; half of them had been crawling for an average of 9.3 weeks. The infants were habituated to a video of a simplified Shepard-Metzler object rotating back and forth through a 240° angle around the longitudinal axis of the object. They were tested with videos of the same object rotating through a previously unseen 120° angle and with a mirror image of the display. All of the infants also participated in a manual object exploration task, in which they freely explored 5 toy blocks. The results showed that the crawlers looked significantly longer at the novel (mirror object than at the familiar object, independent of their manual exploration scores. The non-crawlers looking times, in contrast, were influenced by the manual exploration scores. The infants who did not spontaneously explore the toy blocks tended to show a familiarity preference, whereas those who explored the toy blocks preferred to look at the novel object. Thus, all of the infants were able to master the mental rotation task but it seemed to be the most complex process for infants who had no crawling experience and who did not spontaneously explore objects.

Long-Term Safety and Immunogenicity of a Tetravalent Live-Attenuated Dengue Vaccine and Evaluation of a Booster Dose Administered to Healthy Thai Children.

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Watanaveeradej, Veerachai; Simasathien, Sriluck; Mammen, Mammen P; Nisalak, Ananda; Tournay, Elodie; Kerdpanich, Phirangkul; Samakoses, Rudiwilai; Putnak, Robert J; Gibbons, Robert V; Yoon, In-Kyu; Jarman, Richard G; De La Barrera, Rafael; Moris, Philippe; Eckels, Kenneth H; Thomas, Stephen J; Innis, Bruce L

2016-06-01

We evaluated the safety and immunogenicity of two doses of a live-attenuated, tetravalent dengue virus vaccine (F17/Pre formulation) and a booster dose in a dengue endemic setting in two studies. Seven children (7- to 8-year-olds) were followed for 1 year after dose 2 and then given a booster dose (F17/Pre formulation), and followed for four more years (Child study). In the Infant study, 49 2-year-olds, vaccinated as infants, were followed for approximately 3.5 years after dose 2 and then given a booster dose (F17) and followed for one additional year. Two clinically notable events were observed, both in dengue vaccine recipients in the Infant study: 1 case of dengue approximately 2.7 years after dose 2 and 1 case of suspected dengue after booster vaccinations. The booster vaccinations had a favorable safety profile in terms of reactogenicity and adverse events reported during the 1-month follow-up periods. No vaccine-related serious adverse events were reported during the studies. Neutralizing antibodies against dengue viruses 1-4 waned during the 1-3 years before boosting, which elicited a short-lived booster response but did not provide a long-lived, multivalent antibody response in most subjects. Overall, this candidate vaccine did not elicit a durable humoral immune response. © The American Society of Tropical Medicine and Hygiene.

Infant Movement Motivation Questionnaire: development of a measure evaluating infant characteristics relating to motor development in the first year of life.

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Doralp, Samantha; Bartlett, Doreen

2014-08-01

This paper highlights the development and testing of the Infant Movement Motivation Questionnaire (IMMQ), an instrument designed to evaluate qualities of infant characteristics that relate specifically to early motor development. The measurement development process included three phases: item generation, pilot testing and evaluation of acceptability and feasibility for parents and exploratory factor analysis. The resultant 27-item questionnaire is designed for completion by parents and contains four factors including Activity, Exploration, Motivation and Adaptability. Overall, the internal consistency of the IMMQ is 0.89 (Cronbach's alpha), with test-retest reliability measured at 0.92 (ICC, with 95% CI 0.83-0.96). Further work could be done to strengthen the individual factors; however it is adequate for use in its full form. The IMMQ can be used for clinical or research purposes, as well as an educational tool for parents. Copyright © 2014 Elsevier Inc. All rights reserved.

Infant Mortality Statistics From the 2013 Period Linked Birth/Infant Death Data Set.

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Matthews, T J; MacDorman, Marian F; Thoma, Marie E

2015-08-06

This report presents 2013 period infant mortality statistics from the linked birth/infant death data set (linked file) by maternal and infant characteristics. The linked file differs from the mortality file, which is based entirely on death certificate data. Descriptive tabulations of data are presented and interpreted. The U.S. infant mortality rate was 5.96 infant deaths per 1,000 live births in 2013, similar to the rate of 5.98 in 2012. The number of infant deaths was 23,446 in 2013, a decline of 208 infant deaths from 2012. From 2012 to 2013, infant mortality rates were stable for most race and Hispanic origin groups; declines were reported for two Hispanic subgroups: Cuban and Puerto Rican. Since 2005, the most recent high, the U.S. infant mortality rate has declined 13% (from 6.86), with declines in both neonatal and postneonatal mortality overall and for most groups. In 2013, infants born at 37–38 weeks of gestation (early term) had mortality rates that were 63% higher than for full-term (39–40 week) infants. For multiple births, the infant mortality rate was 25.84, 5 times the rate of 5.25 for singleton births. In 2013, 36% of infant deaths were due to preterm-related causes of death, and an additional 15% were due to causes grouped into the sudden unexpected infant death category. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

The use of stable isotope dilution technique to determine the amount of breast milk consumed by infants

International Nuclear Information System (INIS)

Sajet, A. S.

2011-01-01

Exclusive breast feeding for six months to an infant, followed by the introduction of complementary food and continued with breast feeding is believed to be an optimal way of infants nutrition. There is a shortage in information about the amount of milk obtained from the infant's mother at least partially due to the difficulties associated with quantification of breast milk intake. The old technique, which depends on how the weight of the baby before and after breast feeding from mother, takes time and may be disturbing to the natural feeding pattern. It was possible to overcome these difficulties by using stable isotopes consumed by mother as D ose of deuterium oxide to mother i n particular dilution dose to mother and then move the dose from mother to baby through breast milk and this can calculate the total volume of breast milk consumed by the infant within 14 days since the dose oxide of deuterium consumed at first day. Dose of deuterium oxide to mother can also help to find out if there were any further quantity of water entering the child's body except breast milk, determine body composition for mother and infant, monitor the effects of programs strengthening food for pregnant mothers and lactating women in terms of quantity and quality of milk overnight, in addition to evaluating the effectiveness of programs to strengthen children's food. (author)

Dexmedetomidine Pharmacology in Neonates and Infants After Open Heart Surgery.

Science.gov (United States)

Su, Felice; Gastonguay, Marc R; Nicolson, Susan C; DiLiberto, MaryAnn; Ocampo-Pelland, Alanna; Zuppa, Athena F

2016-05-01

Dexmedetomidine is a highly selective α2-agonist with hypnotic, analgesic, and anxiolytic properties. Despite off-label administration, dexmedetomidine has found a niche in critically ill neonates and infants with congenital heart disease because of its minimal effects on respiratory function at sedative doses, facilitating early extubation and fast-track postoperative care. There are little pharmacokinetic data regarding newborns who have immature drug metabolizing capacity and who are at risk for reduced dexmedetomidine clearance and drug toxicity. The aim of this study was to determine the pharmacokinetics of dexmedetomidine in neonates and infants after open heart surgery. This study included 23 evaluable neonates (age, 1 day-1 month) and 36 evaluable infants (age, 1 month-24 months) after open heart surgery. Full-term neonates and infants requiring mechanical ventilation after open heart surgery received dexmedetomidine in a dose-escalation study. Dexmedetomidine was administered as a loading dose over 10 minutes followed by a continuous IV infusion up to 24 hours. Cohorts of 12 infants were enrolled sequentially to receive 0.35, 0.7, or 1 μg/kg dexmedetomidine followed by 0.25, 0.5, or 0.75 μg/kg/h dexmedetomidine, respectively. Cohorts of 9 neonates received 0.25, 0.35, or 0.5 μg/kg dexmedetomidine followed by 0.2, 0.3, or 0.4 μg/kg/h dexmedetomidine, respectively. Plasma dexmedetomidine concentrations were determined using a validated high-performance liquid chromatography-tandem mass spectrometry assay. A population nonlinear mixed effects modeling approach was used to characterize dexmedetomidine pharmacokinetics. Pharmacokinetic parameters of dexmedetomidine were estimated using a 2-compartment disposition model with weight allometrically scaled as a covariate on drug clearance, intercompartmental clearance, central and peripheral volume of distributions and age, total bypass time, and intracardiac shunting on clearance. Dexmedetomidine demonstrated

Maternal attitudinal inflexibility: longitudinal relations with mother-infant disrupted interaction and childhood hostile-aggressive behavior problems.

Science.gov (United States)

Najmi, Sadia; Bureau, Jean-Francois; Chen, Diyu; Lyons-Ruth, Karlen

2009-12-01

: The Personal Attitude Scale (PAS; Hooley, 2000) is a method that is under development for identifying individuals high in Expressed Emotion based on personality traits of inflexibility, intolerance, and norm-forming. In the current study, the goal was to measure the association between this maternal attitudinal inflexibility, early hostile or disrupted mother-infant interactions, and hostile-aggressive behavior problems in the child. In a prospective longitudinal study of 76 low-income mothers and their infants, it was predicted that maternal PAS scores, assessed at child age 20, would be related to difficulties in early observed mother-infant interaction and to hostile-aggressive behavioral difficulties in the child. Results indicated that maternal difficulties in interacting with the infant in the laboratory were associated with maternal PAS scores assessed 20 years later. Hostile-aggressive behavior problems in the child at age five were also predictive of PAS scores of mothers. However, contrary to prediction, these behavior problems did not mediate the association between mother-infant interaction difficulties and maternal PAS scores, indicating that the child's hostile-aggressive behavior problems did not produce the link between quality of early interaction and later maternal attitudinal inflexibility. The current results validate the PAS against observable mother-child interactions and child hostile-aggressive behavior problems and indicate the importance of future work investigating the maternal attitudes that are associated with, and may potentially precede, parent-infant interactive difficulties. These findings regarding the inflexible attitudes of mothers whose interactions with their infants are also disrupted have important clinical implications. First, once the stability of the PAS has been established, this measure may offer a valuable screening tool for the prenatal identification of parents at risk for difficult interactions with their children

Heterogeneity of Rotavirus Vaccine Efficacy Among Infants in Developing Countries.

Science.gov (United States)

Gruber, Joann F; Hille, Darcy A; Liu, G Frank; Kaplan, Susan S; Nelson, Micki; Goveia, Michelle G; Mast, T Christopher

2017-01-01

Rotavirus is the leading cause of severe diarrhea worldwide in young children. Although rotavirus vaccine efficacy is high in developed countries, efficacy is lower in developing countries. Here, we investigated heterogeneity of rotavirus vaccine efficacy by infant characteristics in developing countries. An exploratory, post hoc analysis was conducted using randomized controlled trial data of the pentavalent rotavirus vaccine (RV5) conducted in Africa and Asia (NCT00362648). Infants received either 3 doses of vaccine/placebo and were followed for up to 2 years. Within subgroups, vaccine efficacies and 95% confidence intervals (CIs) against rotavirus gastroenteritis (RVGE) were estimated using Poisson regression. We assessed heterogeneity of efficacy by age at first dose, gender, breastfeeding status and nutrition status. African children receiving the first dose at efficacy (23.7%; 95% CI: -8.2%-46.3%) than those vaccinated at ≥8 weeks (59.1%; 95% CI: 34.0%-74.6%). Marginally statistically significant differences were observed by age at first dose, gender and underweight status in Ghana and gender in Asian countries. Heterogeneity of efficacy was observed for age at first dose in African countries. This was an exploratory analysis; additional studies are needed to validate these results.

Treatment with exogenous surfactant stimulates endogenous surfactant synthesis in premature infants with respiratory distress syndrome

NARCIS (Netherlands)

Bunt, JEH; Carnielli, VP; Janssen, DJ; Wattimena, JLD; Hop, WC; Sauer, PJ; Zimmermann, LJI

2000-01-01

Objective: Treatment of preterm infants with respiratory distress syndrome (RDS) with exogenous surfactant has greatly improved clinical outcome. Some infants require multiple doses, and it has not been studied whether these large amounts of exogenous surfactant disturb endogenous surfactant

Stavudine (d4T) concentrations in women receiving post-partum antiretroviral treatment and their breastfeeding infants

Science.gov (United States)

Fogel, Jessica M.; Taha, Taha E.; Sun, Jin; Hoover, Donald R.; Parsons, Teresa L.; Kumwenda, Johnstone J.; Mofenson, Lynne M.; Fowler, Mary Glenn; Hendrix, Craig W.; Kumwenda, Newton I.; Eshleman, Susan H.; Mirochnick, Mark

2012-01-01

First-line antiretroviral treatment regimens in resource-limited settings used in breastfeeding mothers often include stavudine (d4T). Limited data describing d4T concentrations in breast milk are available. We analyzed d4T concentrations in 52 mother-infant pairs using ultra-performance liquid chromatography-tandem mass spectrometry (lower limit of quantification: 5 ng/ml in plasma, 20 ng/ml in breast milk). Median (interquartile range) d4T concentrations were 86 (36–191) ng/ml in maternal plasma, 151 (48–259) ng/ml in whole milk, 190 (58–296) ng/ml in skim milk, and <5 (<5-<5) ng/ml in infant plasma. While d4T is concentrated in breast milk relative to maternal plasma, the infant d4T dose received from breast milk is very small and not clinically significant. PMID:22614899

Age-related changes in the effects of stress in pregnancy on infant motor development by maternal report: The Queensland Flood Study.

Science.gov (United States)

Simcock, Gabrielle; Kildea, Sue; Elgbeili, Guillaume; Laplante, David P; Stapleton, Helen; Cobham, Vanessa; King, Suzanne

2016-07-01

The current study examined the effects of a natural disaster (a sudden onset flood) as a stressor in pregnancy on infant fine and gross motor development at 2, 6, and 16 months of age. Whether the timing of the stressor in pregnancy or sex of the infant moderated the impact of the prenatal maternal stress on motor development was also explored. Mothers' objective experiences of the flood, emotional reactions and distress, and their cognitive appraisal of the event were assessed retrospectively. Infants' fine and gross motor skills were assessed with the Ages and Stages Questionnaire, and results showed age-related changes in the effects of prenatal maternal stress on these domains. At 2 months, higher levels of prenatal maternal stress was positively related to infant motor development, yet at 6 and 16 months of age there was a negative association, particularly if flood exposure occurred later in pregnancy and if mothers had negative cognitive appraisals of the event. Results also showed differential effects of the maternal stress responses to the floods on infants' fine and gross motor development at each age and that infant sex did not buffer these effects. © 2016 Wiley Periodicals, Inc. Dev Psychobiol 58: 640-659, 2016. © 2016 Wiley Periodicals, Inc.

Occurrence of Methylmercury in Rice-Based Infant Cereals and Estimation of Daily Dietary Intake of Methylmercury for Infants.

Science.gov (United States)

Cui, Wenbin; Liu, Guangliang; Bezerra, Mayara; Lagos, Danielle A; Li, Yanbin; Cai, Yong

2017-11-08

Recent reports of elevated levels of methylmercury (MeHg) in rice revealed the possible occurrence of MeHg in infant rice cereals, leading to potential MeHg exposure through cereal consumption. Total mercury (THg) and MeHg levels in 119 infant cereal samples commonly marketed in the United States and China and estimated daily intake of MeHg through cereal consumption were determined. Concentrations of THg and MeHg in the tested cereal samples ranged from 0.35 to 15.9 μg/kg and from 0.07 to 13.9 μg/kg with means of 2.86 and 1.61 μg/kg, respectively. Rice-based cereals contained MeHg levels significantly higher than those of nonrice cereals, indicating that MeHg in rice could be source of MeHg in cereals. Cereal consumption could be a potential pathway of MeHg exposure for infants, as the EDI through cereal consumption amounted to 4-122% of the MeHg reference dose, suggesting the necessity of further evaluation of the potential health risk of dietary MeHg exposure to infants.

[Impact of maternal HIV status on family constructions and the infant's relational environment during the perinatal period].

Science.gov (United States)

Trocmé, N; Courcoux, M-F; Tabone, M-D; Leverger, G; Dollfus, C

2013-01-01

To assess whether maternal HIV-positive status negatively affects family construction and the child's psychological environment. Could this be responsible for behavioral problems observed in children infected with or affected by HIV? Interviews were conducted with 60 HIV+ mothers and their infants during the perinatal period, within 3 months of delivery, collected at the time of a pediatric outpatient visit within a PMTCT program. Half of the 60 mothers did not live with the infant's father, 56% of multiparous mothers were separated from their previous children. Sixty-five percent of the fathers were informed of the mother's HIV-positive status, although 90% of fathers who lived with the mothers were informed. During pregnancy, 80% of mothers reported psychological stress; after delivery, 72% of mothers suffered from not being allowed to breastfeed their infants, 43.5% expressed a fear of transmitting the infection to the child, and 40% avoided contacts with the infant. The impact of the mother's psychological stress and anxiety related to the risk of HIV transmission through breastfeeding and casual contacts were already noticeable in the first mother-child interrelations. Although the risk of MTC transmission in now very small, psychological troubles related to maternal HIV status may negatively affect the children's well-being and behavior, psychological support should be provided for mothers and children as part of comprehensive services. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Scoping calculation for components of the cow-milk dose pathway for evaluating the dose contribution from iodine-131

International Nuclear Information System (INIS)

Ikenberry, T.A.; Napier, B.A.

1992-12-01

A series of scoping calculations have been undertaken to evaluate The absolute and relative contribution of different exposure pathways to doses that may have been received by individuals living in the vicinity of the Hanford site. This scoping calculation (Calculation 001) examined the contributions of the various exposure pathways associated with environmental transport and accumulation of iodine-131 in the pasture-cow-milk pathway. Addressed in this calculation were the contributions to thyroid dose of infants and adult from (1) the ingestion by dairy cattle of various feedstuffs (pasturage, silage, alfalfa hay, and grass hay) in four different feeding regimes; (2) ingestion of soil by dairy cattle; (3) ingestion of stared feed on which airborne iodine-131 had been deposited; and (4) inhalation of airborne iodine-131 by dairy cows

Definition of dose intensity (DI), average relative DI and effective DI

International Nuclear Information System (INIS)

Alberto, P.

1995-01-01

The cytotoxic activity of cancer chemotherapy is related to the dose and to the amount of drug delivered per time unit. the significance of time in the effectiveness of a treatment program is frequently overlooked. The term of dose intensity (DI) is used to define the drug dose delivered per time unit and is expressed as mg/m 2 per week. A delay in the sequence of treatment cycles decreases the DI in the DI in the same proportion as a reduction of dose. Average relative DI corresponds to the mean DI of combined agents and is expressed as a fraction of a similar combination selected as a standard. Di is useful to compare the dose actually received with the prescribed dose. The relation of DI with tumor response or survival has not been fully demonstrated. A threshold DI level for therapeutic activity is evident. Above this threshold, a linear relationship of DI and effectiveness is not obvious, particularly regarding high-dose chemotherapy. The term of DI is more useful in its principle than in the significance of its calculated value. (authors). 19 refs., 3 tabs., 3 figs

Optimal Furosemide Therapy in Critically Ill infants

NARCIS (Netherlands)

M.M.J. van der Vorst

2007-01-01

textabstractFurosemide as continuous infusion is used in infants after cardiopulmonary bypass (CPB) surgery and during extracorporeal membrane oxygenation (ECMO). The currently used regimens which start with low dose (0.05 - 0.1 mg/kg.hr) may not be optimal in this group of patients with

Broadening the Study of Infant Security of Attachment: Maternal Autonomy-Support in the Context of Infant Exploration

Science.gov (United States)

Whipple, Natasha; Bernier, Annie; Mageau, Genevieve A.

2011-01-01

Although security of attachment is conceptualised as a balance between infants' attachment and exploratory behaviours, parental behaviours pertaining to infant exploration have received relatively little empirical attention. Drawing from self-determination theory, this study seeks to improve the prediction of infant attachment by assessing…

Mind-Mindedness in Adult and Adolescent Mothers: Relations to Maternal Sensitivity and Infant Attachment

Science.gov (United States)

Demers, Isabelle; Bernier, Annie; Tarabulsy, George M.; Provost, Marc A.

2010-01-01

This article examines the quality of maternal mind-mindedness among adult and adolescent mothers, using an assessment of the appropriateness and emotional valence of maternal mind-related comments while interacting with their infants. Twenty-nine adult mothers and 69 adolescent mothers participated in two assessments with their 18-month-old…

Mothers' labeling responses to infants' gestures predict vocabulary outcomes.

Science.gov (United States)

Olson, Janet; Masur, Elise Frank

2015-11-01

Twenty-nine infants aged 1;1 and their mothers were videotaped while interacting with toys for 18 minutes. Six experimental stimuli were presented to elicit infant communicative bids in two communicative intent contexts - proto-declarative and proto-imperative. Mothers' verbal responses to infants' gestural and non-gestural communicative bids were coded for object and action labels. Relations between maternal labeling responses and infants' vocabularies at 1;1 and 1;5 were examined. Mothers' labeling responses to infants' gestural communicative bids were concurrently and predictively related to infants' vocabularies, whereas responses to non-gestural communicative bids were not. Mothers' object labeling following gestures in the proto-declarative context mediated the association from infants' gesturing in the proto-declarative context to concurrent noun lexicons and was the strongest predictor of subsequent noun lexicons. Mothers' action labeling after infants' gestural bids in the proto-imperative context predicted infants' acquisition of action words at 1;5. Findings show that mothers' responsive labeling explain specific relations between infants' gestures and their vocabulary development.

Radiation dose to relations of patients treated with 131I

International Nuclear Information System (INIS)

Pant, G.S.; Sharma, S.K.; Bal, C.S.; Rakesh Kumar; Rath, G.K.

2003-01-01

Due to its efficacy and simplicity, radioiodine treatment of thyrotoxicosis and differentiated thyroid cancer (DTC) has become extremely popular. A large number of such patients are getting benefit with this treatment modality. Though the radiation dose to the relations of these patients, who may be in close proximity for some time after treatment have been mentioned as within safe limits but we do have sufficient data of our own in India. The life style and social conditions in India are very different than in the developed world. We have been measuring external dose in relations/attendants of these patients who have enough chance to come in close contacts with patients during and after their radioiodine treatment. The TL discs of CaSO 4 (Renentech Laboratories) were exposed to graded doses of gamma photons from 131 I for establishing a dose response relationship. The annealed discs from a given lot were measured for background counts and issued to the relations of patients who have maximum chance of being in proximity with the patient for 2 weeks. The TLDs were collected after a use of 2 weeks for dose estimation. We have so far studied 60 families with a total of 71 attendants. The external doses in all the persons attending the patients at home are well within safe prescribed limits. However, due to varied social and practical circumstances 5 persons exceeded 1 mSv dose. This is possibly due to travelling long distance by train immediately after discharge from the hospital when the accompanying person remains in close proximity throughout the journey. There are situations for non-ambulatory patients, when the attendants have to attend them for relatively longer period. (author)

Developmental changes rather than repeated administration drive paracetamol glucuronidation in neonates and infants

NARCIS (Netherlands)

E.H.J. Krekels (Elke); S. Van Ham (Saskia); K.M. Allegaert (Karel); J.N. de Hoon; D. Tibboel (Dick); M. Danhof (Meindert); C.A.J. Knibbe (Catherijne)

2015-01-01

textabstractPurpose: Based on recovered metabolite ratios in urine, it has been concluded that paracetamol glucuronidation may be up-regulated upon multiple dosing. This study investigates paracetamol clearance in neonates and infants after single and multiple dosing using a population modelling

Transfer of alkaline earth elements in mothers' milk and doses from {sup 45}Ca, {sup 90}Sr and {sup 226}Ra

Energy Technology Data Exchange (ETDEWEB)

Smith, T.J.; Phipps, A.W.; Fell, T.P.; Harrison, J.D

2003-07-01

An international programme of work is currently under way to develop methods for calculating doses to infants from ingestion of radionuclides present in mothers' milk. This paper considers the special case of the alkaline earth elements. Models have been developed for {sup 45}Ca, {sup 90}Sr and {sup 226}Ra and the sensitivity of results to various changes in parameter values is discussed. A complication when calculating doses from intakes of radium is that the International Commission on Radiological Protection has previously recommended that doses from decay products of radium should be calculated using element-specific biokinetic models (so-called independent biokinetics). An extension of this method to the models for breastfeeding is proposed. Preliminary estimates of the doses received by the infant for a number of maternal intake scenarios show that doses to the infant can exceed the corresponding adult dose, such as for {sup 45}Ca (ratio = 3.1) while, in other cases such as {sup 90}Sr, the infant dose can be a significant fraction of the adult dose. (author)

Influence of Infant Feeding Type on Gut Microbiome Development in Hospitalized Preterm Infants

Science.gov (United States)

Cong, Xiaomei; Judge, Michelle; Xu, Wanli; Diallo, Ana; Janton, Susan; Brownell, Elizabeth A.; Maas, Kendra; Graf, Joerg

2016-01-01

Background Premature infants have a high risk for dysbiosis of the gut microbiome. Mother’s own breastmilk (MOM) has been found to favorably alter gut microbiome composition in infants born at term. Evidence about the influence of feeding type on gut microbial colonization of preterm infants is limited. Objective The purpose of this study was to explore the effect of feeding types on gut microbial colonization of preterm infants in the neonatal intensive care unit (NICU). Methods Thirty-three stable preterm infants were recruited at birth and followed-up for the first 30 days of life. Daily feeding information was used to classify infants into six groups (mother’s own milk [MOM], human donated milk [HDM], formula, MOM+HDM, MOM+Formula, and HDM+forumla) during postnatal days 0–10, 11–20, and 21–30 after birth. Stool samples were collected daily. DNA extracted from stool was used to sequence the 16S rRNA gene. Exploratory data analysis was conducted with a focus on temporal changes of microbial patterns and diversities among infants from different feeding cohorts. Prediction of gut microbial diversity from feeding type was estimated using linear mixed models. Results Preterm infants fed MOM (at least 70% of the total diet) had highest abundance of Clostridiales, Lactobacillales, and Bacillales compared to infants in other feeding groups, whereas infants fed primarily human donor milk or formula had a high abundance of Enterobacteriales compared to infants fed MOM. After controlling for gender, postnatal age, weight and birth gestational age, the diversity of gut microbiome increased over time and was constantly higher in infants fed MOM relative to infants with other feeding types (p breast milk benefits gut microbiome development of preterm infants, including balanced microbial community pattern and increased microbial diversity in early life. PMID:28252573

Infant-onset eczema in relation to mental health problems at age 10 years: results from a prospective birth cohort study (German Infant Nutrition Intervention plus).

Science.gov (United States)

Schmitt, Jochen; Apfelbacher, Christian; Chen, Chih-Mei; Romanos, Marcel; Sausenthaler, Stefanie; Koletzko, Sibylle; Bauer, Carl-Peter; Hoffmann, Ute; Krämer, Ursula; Berdel, Dietrich; von Berg, Andrea; Wichmann, H-Erich; Heinrich, Joachim

2010-02-01

Cross-sectional studies suggest an association between eczema and mental health problems, but the temporal relationship is unclear. To assess the association between infant-onset eczema and mental health problems in a prospective study. Between 1995 and 1998, a birth cohort study was recruited and followed until age 10 years. Physician-diagnosed eczema, comorbidities, and a broad set of environmental exposures were assessed at age 1, 2, 3, 4, 6, and 10 years. First, we investigated the association between infant-onset eczema (age 1-2 years) and mental health problems at age 10 years according to the Strengths and Difficulties Questionnaire. Second, we analyzed the likelihood of mental health problems at age 10 years in relation to the course of eczema. A total of 2916 infants were eligible for analysis. Compared with participants never diagnosed as having eczema, children with infant-onset eczema had a significantly increased risk for possible/probable mental health problems (Strengths and Difficulties Questionnaire total score) at age 10 years (odds ratio, 1.49; 95% CI, 1.13-1.96) and for emotional symptoms (odds ratio, 1.62; 95% CI, 1.25-2.09). Eczema limited to infancy predicted a significantly higher risk for conduct problems at age 10 years. The strength of the association between eczema and emotional problems at age 10 years increased with increasing eczema persistence. Infants with eczema are at increased risk for mental health problems at age 10 years. Even if cleared afterward, eczema at age 1 to 2 years may cause persistent emotional and behavioral difficulties. Copyright 2010 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

Mother and Infant Talk about Mental States Relates to Desire Language and Emotion Understanding

Science.gov (United States)

Taumoepeau, Mele; Ruffman, Ted

2006-01-01

This study assessed the relation between mother mental state language and child desire language and emotion understanding in 15--24-month-olds. At both times point, mothers described pictures to their infants and mother talk was coded for mental and nonmental state language. Children were administered 2 emotion understanding tasks and their mental…

Infant and mother related outcomes from exposure to metals with endocrine disrupting properties during pregnancy

Energy Technology Data Exchange (ETDEWEB)

Rahman, A. [Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa (Canada); Kumarathasan, P. [Environmental Health Science and Research Bureau, Health Canada, Ottawa (Canada); Gomes, J., E-mail: jgomes@uottawa.ca [Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa (Canada); McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa (Canada)

2016-11-01

Background: Endocrine-related adverse health effects from exposure to heavy metals such as lead, arsenic, cadmium, and mercury are yet to be adequately described. The purpose of this review was to gain insight into maternal exposure to heavy metals, and to identify potential endocrine-related adverse health effects in the mother and the infant. Methods: Relevant databases were searched for original research reports and a total of 46 articles were retained for scrutiny. Required data was extracted from these studies and their methodology was assessed. Results: Impaired fetal growth was observed from exposure to all endocrine disrupting metals, while exposure to lead and arsenic were associated with spontaneous abortion, stillbirth and neonatal deaths. Maternal exposure to arsenic was associated with impaired glucose tolerance in these mothers. Conclusion: Impaired fetal growth, fetal loss, and neonatal deaths were significantly associated with heavy metals exposure during pregnancy; however, hypertension and gestational diabetes require further investigation. - Highlights: • Low and high dose exposure to lead was associated with low birth weight, preterm birth, stillbirths, spontaneous abortions and hypertension. • Exposure to arsenic was associated with fetal loss, stillbirths and spontaneous abortions. • Exposure to cadmium was associated with low birth weight. • Exposure to mercury was associated with spontaneous abortions and neurotoxic effects. • Exposure to copper was associated with low birth weight and spontaneous abortions and exposure to zinc was associated with low birth weight.

Infant and mother related outcomes from exposure to metals with endocrine disrupting properties during pregnancy

International Nuclear Information System (INIS)

Rahman, A.; Kumarathasan, P.; Gomes, J.

2016-01-01

Background: Endocrine-related adverse health effects from exposure to heavy metals such as lead, arsenic, cadmium, and mercury are yet to be adequately described. The purpose of this review was to gain insight into maternal exposure to heavy metals, and to identify potential endocrine-related adverse health effects in the mother and the infant. Methods: Relevant databases were searched for original research reports and a total of 46 articles were retained for scrutiny. Required data was extracted from these studies and their methodology was assessed. Results: Impaired fetal growth was observed from exposure to all endocrine disrupting metals, while exposure to lead and arsenic were associated with spontaneous abortion, stillbirth and neonatal deaths. Maternal exposure to arsenic was associated with impaired glucose tolerance in these mothers. Conclusion: Impaired fetal growth, fetal loss, and neonatal deaths were significantly associated with heavy metals exposure during pregnancy; however, hypertension and gestational diabetes require further investigation. - Highlights: • Low and high dose exposure to lead was associated with low birth weight, preterm birth, stillbirths, spontaneous abortions and hypertension. • Exposure to arsenic was associated with fetal loss, stillbirths and spontaneous abortions. • Exposure to cadmium was associated with low birth weight. • Exposure to mercury was associated with spontaneous abortions and neurotoxic effects. • Exposure to copper was associated with low birth weight and spontaneous abortions and exposure to zinc was associated with low birth weight.

Analysis of nevirapine (NVP) resistance in Ugandan infants who were HIV infected despite receiving single-Dose (SD) NVP versus SD NVP plus daily NVP up to 6 weeks of age to prevent HIV vertical transmission.

Science.gov (United States)

Church, Jessica D; Omer, Saad B; Guay, Laura A; Huang, Wei; Lidstrom, Jessica; Musoke, Philippa; Mmiro, Francis; Jackson, J Brooks; Eshleman, Susan H

2008-10-01

Single-dose nevirapine (SD NVP) at birth plus NVP prophylaxis for the infant up to 6 weeks of age is superior to SD NVP alone for prevention of vertical transmission of human immunodeficiency virus (HIV) through breastfeeding. We analyzed NVP resistance in HIV-infected Ugandan infants who received either SD NVP or extended NVP prophylaxis. We tested plasma HIV by using a genotyping assay (ViroSeq; Celera Diagnostics), a phenotypic resistance assay (PhenoSense; Monogram Biosciences), and sensitive point mutation assay (LigAmp, for K103N, Y181C, and G190A). When infants were 6 weeks old, ViroSeq detected NVP resistance in a higher proportion of infants in the extended NVP arm than in the SD NVP arm (21 of 25 [84%] vs. 12 of 24 [50%]; P = .01). Similar results were obtained with LigAmp and PhenoSense. In both study arms, infants who were HIV infected at birth frequently had NVP resistance detected. In contrast, infants in the extended NVP arm who were HIV infected after birth were more likely to have resistance detected at 6 weeks, compared with infants in the SD NVP arm. The use of extended NVP prophylaxis was also associated with detection of NVP resistance by ViroSeq at 6 months (7 of 7 [100%] infants in the extended NVP arm had resistance detected, compared with 1 of 6 [16.7%] infants in the SD NVP arm; P = .005). The use of extended NVP prophylaxis was associated with increased selection for and persistence of NVP resistance in HIV-infected Ugandan infants.

Radiation doses from some common paediatric X-ray examinations in Sudan

International Nuclear Information System (INIS)

Suliman, I.I.; Elshiekh, E.H.A.

2008-01-01

Radiation doses to patients from some common paediatric X-ray examinations were studied in three hospitals in Khartoum state (Sudan)). Entrance surface dose (ESD) was determined from exposure settings using DosCal software. Totally, 459 patients were included in this study. Mean ESDs obtained from anteroposterior projection for chest, skull, abdomen and pelvis for neonates falls in the range of 52-100, 115-169, 145-183, 204-242 μGy, respectively. For a 1-y-old infant, mean ESD range was 80-114, 153-202, 204-209, 181-264 μGy, respectively. Some doses for neonates and infants were exceeding the reference doses by >20%. The results highlighted that a good technique has to adhere to guidelines necessarily. As demonstrated elsewhere, patients' doses were high in departments using single-phase generators compared with those using constant potential. The results presented will serve as a baseline data needed for deriving reference doses for paediatric X-ray examinations in Sudan. (authors)

Medium-chain triglycerides in infant formulas and their relation to plasma ketone body concentrations.

Science.gov (United States)

Wu, P Y; Edmond, J; Auestad, N; Rambathla, S; Benson, J; Picone, T

1986-04-01

A mild ketosis is known to prevail in the mother, fetus, and newborn infant during the 3rd trimester and in the early neonatal period. It has been shown that during an equivalent period in the rat ketone bodies are readily oxidized and serve as key substrates for lipogenesis in brain. Since medium-chain triglycerides are known to be ketogenic, preterm infants may benefit from dietary medium-chain triglycerides beyond the point of enhanced fat absorption. Our objective was to determine the ketogenic response in preterm infants (gestational age: 33 +/- 0.8 wk) fed three different isocaloric formulas by measuring the concentrations of 3-hydroxybutyrate and acetoacetate in the plasma of these infants. At the time of entrance to the study the infants were receiving 110 kcal/kg/24 h. Study I (11 infants): the infants were fed sequentially in the order; PM 60/40 (PM), Special Care Formula (SCF), and Similac 20 (SIM). In SCF greater than 50% of the fat consists of medium-chain length fatty acids while PM and SIM contain about 25%. The concentration of 3-hydroxybutyrate in plasma was significantly higher when infants were fed SCF than PM and SIM [0.14 +/- 0.03, 0.06 +/- 0.01, and 0.05 +/- 0.01 mM, respectively (p less than 0.01)]. Study II (12 infants); the infants were fed SCF, then SIM, or the reverse. The concentration of acetoacetate in plasma was 0.05 +/- 0.01 and 0.03 +/- 0.01 mM when infants were fed SCF and SIM, respectively (0.1 greater than p greater than 0.05). The concentrations of 3-hydroxybutyrate in plasma were similar to those measured in study I for the respective formulas.(ABSTRACT TRUNCATED AT 250 WORDS)

SU-F-T-83: Infant Total Skin Electron Therapy Using Five Fields Technique

International Nuclear Information System (INIS)

Saleh, H; Howlin, T; Massey, V

2016-01-01

Purpose: We were presented with a 9 month old boy with Relapsed Acute Myeloid Leukemia (AML) involving the skin. The plan was to treat the entire skin using 6 MeV electrons with the infant under complete anesthesia. The purpose of this work is to commission the 6 MeV electron beam and to develop a technique that can be used to deliver total skin dose to infants with minimal patient immobilization. Methods: A baby mannequin phantom that mimics the child’s length was used to determine the best technique to treat the infant. The 76 cm long phantom was placed on the floor. The phantom was placed in four unique immobilization devices to simulate four different treatment positions (anterior, posterior, left lateral and right lateral). Radiochromic films were used to determine beam profile in both axial and radial directions, and percent depth dose (PDD). Absolute calibration of the machine output at 214 cm distance was measured using an Exradin A11 parallel-plate ion chamber. A 1.0 cm plexiglass scatter plate was inserted in the collimator. Mosfet dosimeters were used for dose verification for phantom and and patient. Results: At 214 cm source to surface distance (SSD) using gantry angle of + 20o from vertical beam flatness is + 10% in the radial direction over a region of 70 cm and + 4% in the axial direction over 60 cm. A five field arrangement was determined to optimally deliver the desired dose with > 90% uniformity. The fifth field was used to boost the head vertex. Conclusion: It is possible to treat sedated infants with total skin dose using five positions. Four positions were enough to cover the body and the fifth position boosts the vertex of the head. All fractions can be reproduced accurately daily because of the patient’s stable immobilization.

SU-F-T-83: Infant Total Skin Electron Therapy Using Five Fields Technique

Energy Technology Data Exchange (ETDEWEB)

Saleh, H; Howlin, T; Massey, V [University of Kansas Hospital, Overland Park, KS (United States)

2016-06-15

Purpose: We were presented with a 9 month old boy with Relapsed Acute Myeloid Leukemia (AML) involving the skin. The plan was to treat the entire skin using 6 MeV electrons with the infant under complete anesthesia. The purpose of this work is to commission the 6 MeV electron beam and to develop a technique that can be used to deliver total skin dose to infants with minimal patient immobilization. Methods: A baby mannequin phantom that mimics the child’s length was used to determine the best technique to treat the infant. The 76 cm long phantom was placed on the floor. The phantom was placed in four unique immobilization devices to simulate four different treatment positions (anterior, posterior, left lateral and right lateral). Radiochromic films were used to determine beam profile in both axial and radial directions, and percent depth dose (PDD). Absolute calibration of the machine output at 214 cm distance was measured using an Exradin A11 parallel-plate ion chamber. A 1.0 cm plexiglass scatter plate was inserted in the collimator. Mosfet dosimeters were used for dose verification for phantom and and patient. Results: At 214 cm source to surface distance (SSD) using gantry angle of + 20o from vertical beam flatness is + 10% in the radial direction over a region of 70 cm and + 4% in the axial direction over 60 cm. A five field arrangement was determined to optimally deliver the desired dose with > 90% uniformity. The fifth field was used to boost the head vertex. Conclusion: It is possible to treat sedated infants with total skin dose using five positions. Four positions were enough to cover the body and the fifth position boosts the vertex of the head. All fractions can be reproduced accurately daily because of the patient’s stable immobilization.

Iodine ingestion dose factors for the thyroid exposure of infants. Technical instructions 7. Jod-Ingestionsdosisfaktor fuer die Strahlenexposition der Schilddruese von Kleinkindern. Weisungsbeschluss 7

Energy Technology Data Exchange (ETDEWEB)

1976-01-01

For calculations of the thyroid exposure of infants via the pasture-cow-milk pathway, the dose factor = 8.8 x 10/sup 5/ rem x m/sup 3/ / Ci x s should be used for elementary iodine during the vegetation period. For the components of other chemical-physical forms of /sup 131/I, the above value should be multiplied by the following factors: 1) For iodine aerosols, by the factor 0.1; 2) for organic iodine, by the factor 0.01. The mean vegetation period in the Federal Republic of Germany is 6 months.

Fosfluconazole for Antifungal Prophylaxis in Very Low Birth Weight Infants

Directory of Open Access Journals (Sweden)

Daijiro Takahashi

2009-01-01

Full Text Available We conducted a retrospective case series study to evaluate the safety of fosfluconazole prophylaxis for preventing invasive fungal infection in VLBW infants with a central vascular access. Fosfluconazole was administered intravenously at a dose of 6 mg/kg everyday during which time a central venous catheter was placed. A total of 23 infants met the criteria for enrollment in our study. No cases of fungal infection were detected during the central venous catheter placement in the group. None of the infants had an elevated β-D-glucan, and all of them were still alive at discharge. Regarding the liver and renal function, no statistically significant differences were observed before and at the end of fosfluconazole prophylaxis. The results of this study demonstrate that fosfluconazole prophylaxis in preventing invasive fungal infection was well tolerated by VLBW infants. This is a first report to describe antifungal prophylaxis using fosfluconazole for VLBW infants.

Total and Differential Phylloquinone (Vitamin K1 Intakes of Preterm Infants from All Sources during the Neonatal Period

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Paul Clarke

2015-09-01

Full Text Available All newborns require phylloquinone after birth to prevent vitamin K deficiency bleeding. Babies born prematurely may be at particular risk of deficiency without adequate supplementation during infancy. The main sources of phylloquinone in preterm babies during the neonatal period are the prophylactic dose of phylloquinone given at birth, and that derived from parenteral and/or enteral feeding. This observational study formed part of a prospective, multicentre, randomised, controlled trial that examined the vitamin K status of preterm infants after random allocation to one of three phylloquinone prophylactic regimens at birth (0.5 or 0.2 mg intramuscularly or 0.2 mg intravenously. In this nutritional sub-study we quantified the proportional and total phylloquinone intakes of preterm infants within the neonatal period from all sources. Almost all infants had average daily phylloquinone intakes that were in excess of the currently recommended amounts. In infants who did not receive parenteral nutrition, the bolus dose of phylloquinone given at birth was the major source of phylloquinone intake, whereas in infants who received parenteral nutrition, the intake from the parenteral preparation exceeded that from the bolus dose by a ratio of approximately 3:1. Our study supports the concern of others that preterm infants who receive current parenteral nutrition formulations may be receiving excessive vitamin K.

Prenatal meditation influences infant behaviors.

Science.gov (United States)

Chan, Ka Po

2014-11-01

Meditation is important in facilitating health. Pregnancy health has been shown to have significant consequences for infant behaviors. In view of limited studies on meditation and infant temperament, this study aims to explore the effects of prenatal meditation on these aspects. The conceptual framework was based on the postulation of positive relationships between prenatal meditation and infant health. A randomized control quantitative study was carried out at Obstetric Unit, Queen Elizabeth Hospital in Hong Kong. 64 pregnant Chinese women were recruited for intervention and 59 were for control. Outcome measures were cord blood cortisol, infant salivary cortisol, and Carey Infant Temperament Questionnaire. Cord blood cortisol level of babies was higher in the intervention group (pmeditation can influence fetal health. Carey Infant Temperament Questionnaire showed that the infants of intervention group have better temperament (pmeditation in relation to child health. Present study concludes the positive effects of prenatal meditation on infant behaviors and recommends that pregnancy care providers should provide prenatal meditation to pregnant women. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

Radiation exposure of children in pediatric radiology, Pt. 8. Radiation doses during thoracoabdominal babygram and abdominal X-ray examination of the newborn and young infants

International Nuclear Information System (INIS)

Schneider, Karl; Seidenbusch, M.C.

2010-01-01

Purpose: Reconstruction of radiation doses for the thoracoabdominal babygram and the abdomen X-ray from radiographic settings and exposure data acquired at Dr. von Hauner's Kinderspital (children's hospital of the University of Munich, DvHK) between 1976 and 2007; comparison of these dose values with values reported in the literature; recommendation of a reference dose value for the thoracoabdominal babygram. Materials and Methods: The data from all X-ray examinations performed since 1976 at DvHK were stored electronically in a database. After 30 years of data collection, the database now includes 305 107 radiological examinations (radiographs and fluoroscopies), especially 1493 thoracoabdominal babygrams and 3632 abdomen X-rays of newborns and young infants. With the computer program PAeDOS, a specific dose reconstruction algorithm was developed. Results: the entrance dose values of thoracoabdominal babygrams and abdomen X-rays in DvHK could be reduced in the last 30 years by a factor of 5 to 8. They are far below the entrance dose values reported by other radiology departments in Europe. Nevertheless, a slight increase in the entrance doses that correlates with the introduction of a digital storage phosphor system could be observed in the last years. Conclusion: because nearly all radiosensitive body organs in early life are involved during a thoracoabdominal babygram and because of the high radiation sensitivity of newborns, thoracoabdominal babygrams should be performed in neonatology with caution. A dose value of 1.0 cGy cm 2 could serve as the actual reference dose value for the thoracoabdominal babygram of the newborn. (orig.)

Association of Placebo, Indomethacin, Ibuprofen, and Acetaminophen With Closure of Hemodynamically Significant Patent Ductus Arteriosus in Preterm Infants: A Systematic Review and Meta-analysis.

Science.gov (United States)

Mitra, Souvik; Florez, Ivan D; Tamayo, Maria E; Mbuagbaw, Lawrence; Vanniyasingam, Thuva; Veroniki, Areti Angeliki; Zea, Adriana M; Zhang, Yuan; Sadeghirad, Behnam; Thabane, Lehana

2018-03-27

Despite increasing emphasis on conservative management of patent ductus arteriosus (PDA) in preterm infants, different pharmacotherapeutic interventions are used to treat those developing a hemodynamically significant PDA. To estimate the relative likelihood of hemodynamically significant PDA closure with common pharmacotherapeutic interventions and to compare adverse event rates. The databases of MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception until August 15, 2015, and updated on December 31, 2017, along with conference proceedings up to December 2017. Randomized clinical trials that enrolled preterm infants with a gestational age younger than 37 weeks treated with intravenous or oral indomethacin, ibuprofen, or acetaminophen vs each other, placebo, or no treatment for a clinically or echocardiographically diagnosed hemodynamically significant PDA. Data were independently extracted in pairs by 6 reviewers and synthesized with Bayesian random-effects network meta-analyses. Primary outcome: hemodynamically significant PDA closure; secondary: included surgical closure, mortality, necrotizing enterocolitis, and intraventricular hemorrhage. In 68 randomized clinical trials of 4802 infants, 14 different variations of indomethacin, ibuprofen, or acetaminophen were used as treatment modalities. The overall PDA closure rate was 67.4% (2867 of 4256 infants). A high dose of oral ibuprofen was associated with a significantly higher odds of PDA closure vs a standard dose of intravenous ibuprofen (odds ratio [OR], 3.59; 95% credible interval [CrI], 1.64-8.17; absolute risk difference, 199 [95% CrI, 95-258] more per 1000 infants) and a standard dose of intravenous indomethacin (OR, 2.35 [95% CrI, 1.08-5.31]; absolute risk difference, 124 [95% CrI, 14-188] more per 1000 infants). Based on the ranking statistics, a high dose of oral ibuprofen ranked as the best pharmacotherapeutic option for PDA closure (mean surface under the

An algorithm for intelligent sorting of CT-related dose parameters

Science.gov (United States)

Cook, Tessa S.; Zimmerman, Stefan L.; Steingal, Scott; Boonn, William W.; Kim, Woojin

2011-03-01

Imaging centers nationwide are seeking innovative means to record and monitor CT-related radiation dose in light of multiple instances of patient over-exposure to medical radiation. As a solution, we have developed RADIANCE, an automated pipeline for extraction, archival and reporting of CT-related dose parameters. Estimation of whole-body effective dose from CT dose-length product (DLP)-an indirect estimate of radiation dose-requires anatomy-specific conversion factors that cannot be applied to total DLP, but instead necessitate individual anatomy-based DLPs. A challenge exists because the total DLP reported on a dose sheet often includes multiple separate examinations (e.g., chest CT followed by abdominopelvic CT). Furthermore, the individual reported series DLPs may not be clearly or consistently labeled. For example, Arterial could refer to the arterial phase of the triple liver CT or the arterial phase of a CT angiogram. To address this problem, we have designed an intelligent algorithm to parse dose sheets for multi-series CT examinations and correctly separate the total DLP into its anatomic components. The algorithm uses information from the departmental PACS to determine how many distinct CT examinations were concurrently performed. Then, it matches the number of distinct accession numbers to the series that were acquired, and anatomically matches individual series DLPs to their appropriate CT examinations. This algorithm allows for more accurate dose analytics, but there remain instances where automatic sorting is not feasible. To ultimately improve radiology patient care, we must standardize series names and exam names to unequivocally sort exams by anatomy and correctly estimate whole-body effective dose.

An algorithm for intelligent sorting of CT-related dose parameters.

Science.gov (United States)

Cook, Tessa S; Zimmerman, Stefan L; Steingall, Scott R; Boonn, William W; Kim, Woojin

2012-02-01

Imaging centers nationwide are seeking innovative means to record and monitor computed tomography (CT)-related radiation dose in light of multiple instances of patient overexposure to medical radiation. As a solution, we have developed RADIANCE, an automated pipeline for extraction, archival, and reporting of CT-related dose parameters. Estimation of whole-body effective dose from CT dose length product (DLP)--an indirect estimate of radiation dose--requires anatomy-specific conversion factors that cannot be applied to total DLP, but instead necessitate individual anatomy-based DLPs. A challenge exists because the total DLP reported on a dose sheet often includes multiple separate examinations (e.g., chest CT followed by abdominopelvic CT). Furthermore, the individual reported series DLPs may not be clearly or consistently labeled. For example, "arterial" could refer to the arterial phase of the triple liver CT or the arterial phase of a CT angiogram. To address this problem, we have designed an intelligent algorithm to parse dose sheets for multi-series CT examinations and correctly separate the total DLP into its anatomic components. The algorithm uses information from the departmental PACS to determine how many distinct CT examinations were concurrently performed. Then, it matches the number of distinct accession numbers to the series that were acquired and anatomically matches individual series DLPs to their appropriate CT examinations. This algorithm allows for more accurate dose analytics, but there remain instances where automatic sorting is not feasible. To ultimately improve radiology patient care, we must standardize series names and exam names to unequivocally sort exams by anatomy and correctly estimate whole-body effective dose.

Levels of infants' urinary arsenic metabolites related to formula feeding and weaning with rice products exceeding the EU inorganic arsenic standard.

Directory of Open Access Journals (Sweden)

Antonio J Signes-Pastor

Full Text Available Early childhood inorganic arsenic (i-As exposure is of particular concern since it may adversely impact on lifetime health outcomes. Infants' urinary arsenic (As metabolites were analysed in 79 infants by inductively coupled plasma-mass spectrometric detection (IC-ICP-MS to evaluate i-As exposure pre- and post-weaning. Levels of i-As in rice-based weaning and infants' foods were also determined to relate to urinary As levels. Higher As levels, especially of monomethylarsonic acid (MMA and dimethylarsinic acid (DMA, were found in urine from formula fed infants compared to those breastfed. Urine from infants post-weaning consuming rice-products resulted in higher urinary MMA and DMA compared to the paired pre-weaning urine samples. The European Union (EU has regulated i-As in rice since 1st January 2016. Comparing infants' rice-based foods before and after this date, little change was found. Nearly ¾ of the rice-based products specifically marketed for infants and young children contained i-As over the 0.1 mg/kg EU limit. Efforts should be made to provide low i-As rice and rice-based products consumed by infants and young children that do not exceed the maximum i-As level to protect this vulnerable subpopulation.

Measurement of the gonad dose of infants during X-ray examination of the hip

International Nuclear Information System (INIS)

Vana, N.; Krepler, P.; Harranek, C.

1977-01-01

To protect the gonads during X-ray examination of the hip joints a special lead shield of 1,5 mm Pb with a fenestration can be used. This window allows the delineation of all parts of the skeleton to make a correct diagnosis while all other parts, especially the gonads, are safely shielded. To check the effectiveness of this gonad protection direct dosimetric studies on the infants were performed with LiF and CaF 2 :Dy TL-dosimeters at different adjustments of the x-ray machine and with various screen-film combinations. To correct the energy response of the LiF and CaF 2 :Dy dosimeters in the energy range below 100 keV tandem dosimeters were used. From the ratio of indications by TLD-200/TLD-100 the effective energy of the x-ray spectrum can be estimated and therefrom the response of the high sensitive TLD-200 dosimeters determined. To measure the ovary dose the dosimeters were placed in the rectum on the tip of a tube. The lowest exposure values were registrated using rare earth intensifying screens and generator adjustment of 60 kV and 1 mAs: 0,12 mrad for the ovary and 0,03 - 0,07 mR for the testes

Bovine colostrum improves neonatal growth, digestive function, and gut immunity relative to donor human milk and infant formula in preterm pigs

DEFF Research Database (Denmark)

Rasmussen, Stine Ostenfeldt; Martin, Lena; Østergaard, Mette Viberg

2016-01-01

Mother's own milk is the optimal first diet for preterm infants, but donor human milk (DM) or infant formula (IF) is used when supply is limited. We hypothesized that a gradual introduction of bovine colostrum (BC) or DM improves gut maturation, relative to IF during the first 11 days after preterm...

A safety and pharmacokinetic dosing study of glucagon-like peptide 2 in infants with intestinal failure

DEFF Research Database (Denmark)

Sigalet, David L; Brindle, Mary E; Boctor, Dana

2017-01-01

BACKGROUND & AIMS: Glucagon-like peptide 2 (GLP-2) analogues are approved for adults with intestinal failure (IF), but no studies have included infants. This study examined the pharmacokinetics (PK), safety, and nutritional effects of GLP-2 in infants with IF. METHODS: With parental consent (Health...

Infant-Mother Attachment among the Dogon of Mali.

Science.gov (United States)

True, Mary McMahan; Pisani, Lelia; Oumar, Fadimata

2001-01-01

Examined infant-mother attachment in Mali's Dogon ethnic group. Found that distribution of Strange Situation classifications was 67 percent secure, 0 percent avoidant, 8 percent resistant, and 25 percent disorganized. Infant attachment security related to quality of mother-infant communication. Mothers of disorganized infants had significantly…

Mammography dose in relation to body mass index, race, and menopausal status

Energy Technology Data Exchange (ETDEWEB)

Schubauer-Berigan, M.K.; Frey, G.D.; Baron, L.; Hoel, D.G

2002-07-01

Mammography dose increases with compressed breast thickness (CBT), but few studies have examined other correlates of dose. The purpose of this study was to evaluate the relation between factors such as race, age, body mass index (BMI), CBT, and menopausal status and mammography screening dose, measured for 509 women in a US population. A multiple linear regression model was developed for dose, based on consideration of these factors as well as examination characteristics. BMI and number of films during examination were positively related to dose. After adjusting for these factors, high CBT also leads to higher dose. Whites receive lower doses than black women, but differences are slight after controlling for the effects of CBT and BMI, which were significantly higher among black women. Pre-menopausal women receive higher doses, after adjusting for all other factors, than post-menopausal women. Jointly, these factors account for approximately 75% to 80% of the variability in dose among this study population. Because rates of overweight are increasing in the US, average doses from mammography may be increasing as well. (author)

Mammography dose in relation to body mass index, race, and menopausal status

International Nuclear Information System (INIS)

Schubauer-Berigan, M.K.; Frey, G.D.; Baron, L.; Hoel, D.G.

2002-01-01

Mammography dose increases with compressed breast thickness (CBT), but few studies have examined other correlates of dose. The purpose of this study was to evaluate the relation between factors such as race, age, body mass index (BMI), CBT, and menopausal status and mammography screening dose, measured for 509 women in a US population. A multiple linear regression model was developed for dose, based on consideration of these factors as well as examination characteristics. BMI and number of films during examination were positively related to dose. After adjusting for these factors, high CBT also leads to higher dose. Whites receive lower doses than black women, but differences are slight after controlling for the effects of CBT and BMI, which were significantly higher among black women. Pre-menopausal women receive higher doses, after adjusting for all other factors, than post-menopausal women. Jointly, these factors account for approximately 75% to 80% of the variability in dose among this study population. Because rates of overweight are increasing in the US, average doses from mammography may be increasing as well. (author)

When Infants Talk, Infants Listen: Pre-Babbling Infants Prefer Listening to Speech with Infant Vocal Properties

Science.gov (United States)

Masapollo, Matthew; Polka, Linda; Ménard, Lucie

2016-01-01

To learn to produce speech, infants must effectively monitor and assess their own speech output. Yet very little is known about how infants perceive speech produced by an infant, which has higher voice pitch and formant frequencies compared to adult or child speech. Here, we tested whether pre-babbling infants (at 4-6 months) prefer listening to…

Understanding kangaroo care and its benefits to preterm infants

Directory of Open Access Journals (Sweden)

Campbell-Yeo ML

2015-03-01

Full Text Available Marsha L Campbell-Yeo,1–4 Timothy C Disher,1 Britney L Benoit,1 C Celeste Johnston,2,4,5 1School of Nursing, Dalhousie University, 2Department of Pediatrics, IWK Health Centre, 3Department of Psychology and Neuroscience, Dalhousie University, 4Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, 5Ingram School of Nursing, McGill University, Montréal, QC, Canada Abstract: The holding of an infant with ventral skin-to-skin contact typically in an upright position with the swaddled infant on the chest of the parent, is commonly referred to as kangaroo care (KC, due to its simulation of marsupial care. It is recommended that KC, as a feasible, natural, and cost-effective intervention, should be standard of care in the delivery of quality health care for all infants, regardless of geographic location or economic status. Numerous benefits of its use have been reported related to mortality, physiological (thermoregulation, cardiorespiratory stability, behavioral (sleep, breastfeeding duration, and degree of exclusivity domains, as an effective therapy to relieve procedural pain, and improved neurodevelopment. Yet despite these recommendations and a lack of negative research findings, adoption of KC as a routine clinical practice remains variable and underutilized. Furthermore, uncertainty remains as to whether continuous KC should be recommended in all settings or if there is a critical period of initiation, dose, or duration that is optimal. This review synthesizes current knowledge about the benefits of KC for infants born preterm, highlighting differences and similarities across low and higher resource countries and in a non-pain and pain context. Additionally, implementation considerations and unanswered questions for future research are addressed. Keywords: kangaroo care, skin-to-skin contact, infant, preterm, review

Caregiving Behaviors and Early Cognitive Development as Related to Ordinal Position in Preterm Infants

Science.gov (United States)

Cohen, Sarale E.; Beckwith, Leila

1977-01-01

Naturalistic home observations of 54 preterm infants and their caregivers were made when the infants were 1, 3, and 8 months of age. Differences were found in the kinds of everyday transactions which occur with preterm infants raised with and without siblings. (Author/JMB)

Radiation dose rates from adult patients undergoing nuclear medicine investigations

International Nuclear Information System (INIS)

Mountford, P.J.; O'Doherty, M.J.; Forge, N.I.; Jeffries, A.; Coakley, A.J.

1991-01-01

Adult patients undergoing nuclear medicine investigations may subsequently come into close contact with members of the public and hospital staff. In order to expand the available dosimetry and derive appropriate recommendations, dose rates were measured at 0.1, 0.5 and 1.0 m from 80 adult patients just before they left the nuclear medicine department after undergoing one of eight 99 Tc m studies, an 123 I thyroid, an 111 In leucocyte or a 201 Tl cardiac scan. The maximum departure dose rates at these distances of 150, 30 and 7.3 μSv h -1 were greater than those found in similar published studies of adult and paediatric patients. To limit the dose to an infant to less than 1 mSv, an 111 In leucocyte scan is the only investigation for which it may be necessary to restrict close contact between the infant and a radioactive parent, depending on the dose rate near the surface of the patient, the parent's habits and how fretful is the infant. It is unlikely that a ward nurse will receive a dose of 60 μSv in a working day if caring for just one radioactive adult patient, unless the patient is classified as totally helpless and had undergone a 99 Tc m marrow, bone or brain scan. The data and revised calculations of effective exposure times based on a total close contact time of 9 h in every 24 h period should allow worst case estimates of radiation dose to be made and recommendations to be formulated for other circumstances, including any future legislative changes in dose limits or derived levels. (author)

Adult Attachment Styles Associated with Brain Activity in Response to Infant Faces in Nulliparous Women: An Event-Related Potentials Study.

Science.gov (United States)

Ma, Yuanxiao; Ran, Guangming; Chen, Xu; Ma, Haijing; Hu, Na

2017-01-01

Adult attachment style is a key for understanding emotion regulation and feelings of security in human interactions as well as for the construction of the caregiving system. The caregiving system is a group of representations about affiliative behaviors, which is guided by the caregiver's sensitivity and empathy, and is mature in young adulthood. Appropriate perception and interpretation of infant emotions is a crucial component of the formation of a secure attachment relationship between infant and caregiver. As attachment styles influence the ways in which people perceive emotional information, we examined how different attachment styles associated with brain response to the perception of infant facial expressions in nulliparous females with secure, anxious, and avoidant attachment styles. The event-related potentials of 65 nulliparous females were assessed during a facial recognition task with joy, neutral, and crying infant faces. The results showed that anxiously attached females exhibited larger N170 amplitudes than those with avoidant attachment in response to all infant faces. Regarding the P300 component, securely attached females showed larger amplitudes to all infant faces in comparison with avoidantly attached females. Moreover, anxiously attached females exhibited greater amplitudes than avoidantly attached females to only crying infant faces. In conclusion, the current results provide evidence that attachment style differences are associated with brain responses to the perception of infant faces. Furthermore, these findings further separate the psychological mechanisms underlying the caregiving behavior of those with anxious and avoidant attachment from secure attachment.

Adult Attachment Styles Associated with Brain Activity in Response to Infant Faces in Nulliparous Women: An Event-Related Potentials Study

Directory of Open Access Journals (Sweden)

Xu Chen

2017-04-01

Full Text Available Adult attachment style is a key for understanding emotion regulation and feelings of security in human interactions as well as for the construction of the caregiving system. The caregiving system is a group of representations about affiliative behaviors, which is guided by the caregiver’s sensitivity and empathy, and is mature in young adulthood. Appropriate perception and interpretation of infant emotions is a crucial component of the formation of a secure attachment relationship between infant and caregiver. As attachment styles influence the ways in which people perceive emotional information, we examined how different attachment styles associated with brain response to the perception of infant facial expressions in nulliparous females with secure, anxious, and avoidant attachment styles. The event-related potentials of 65 nulliparous females were assessed during a facial recognition task with joy, neutral, and crying infant faces. The results showed that anxiously attached females exhibited larger N170 amplitudes than those with avoidant attachment in response to all infant faces. Regarding the P300 component, securely attached females showed larger amplitudes to all infant faces in comparison with avoidantly attached females. Moreover, anxiously attached females exhibited greater amplitudes than avoidantly attached females to only crying infant faces. In conclusion, the current results provide evidence that attachment style differences are associated with brain responses to the perception of infant faces. Furthermore, these findings further separate the psychological mechanisms underlying the caregiving behavior of those with anxious and avoidant attachment from secure attachment.

The eye of the begetter: predicting infant attachment disorganization from women's prenatal interpretations of infant facial expressions.

Science.gov (United States)

Bernstein, Rosemary E; Tenedios, Catherine M; Laurent, Heidemarie K; Measelle, Jeffery R; Ablow, Jennifer C

2014-01-01

Infant-caregiver attachment disorganization has been linked to many long-term negative psychosocial outcomes. While various prevention programs appear to be effective in preventing disorganized attachment, methods currently used to identify those at risk are unfortunately either overly general or impractical. The current investigation tested whether women's prenatal biases in identifying infant expressions of emotion--tendencies previously shown to relate to some of the maternal variables associated with infant attachment, including maternal traumatization, trauma symptoms, and maternal sensitivity--could predict infant attachment classification at 18 months postpartum. Logistic regression analyses revealed that together with women's adult history of high betrayal traumatization, response concordance with a normative reference sample in labeling infant expressions as negatively valenced, and the number of infant facial expressions that participants classified as "sad" and "angry" predicted subsequent infant attachment security versus disorganization. Implications for screening and prevention are discussed. © 2014 Michigan Association for Infant Mental Health.

Parental professional help-seeking for infant sleep.

Science.gov (United States)

Hsu, Pei-Wen; Wu, Wei-Wen; Tung, Yi-Ching; Thomas, Karen A; Tsai, Shao-Yu

2017-12-01

To explore the perceptions and experiences of parental professional help-seeking for infant sleep and sleep-related concerns. Infant sleep is a frequent concern for parents. However, very little is known about the reasons parents seek, do not seek or delay seeking professional attention about their concerns related to infant sleep. A qualitative study design was used. Twenty audio-taped interviews with parents of healthy 12-month-old infants were conducted at a university-affiliated hospital or parents' homes depending on where parents felt more comfortable discussing their personal views and medical help-seeking experiences. Thematic content analysis was performed to determine specific patterns and similarities within and between interview data. Three main themes developed from the interviews were as follows: (i) uncertainty about infant sleep; (ii) I can handle infant sleep; and (iii) I am not satisfied with the professional services provided for infant sleep. Overall, parents knew little about or misunderstood infant sleep behaviours. Lack of proper information and knowledge about infant sleep influenced parents' motivation for professional help-seeking and help-receiving. Parents who have consulted a healthcare professional but received unsatisfactory responses, such as an ambivalent attitude or insufficient assessment, reported being less motivated or unwilling to seek medical help again. Our study demonstrates the complexity of parental professional help-seeking and receiving for infant sleep. Findings suggest that parents perceive a wide range of barriers that influence the likelihood that they will seek professional advice for infant sleep. Reducing knowledge barriers and providing adequate attention at all well-infant visits would facilitate parental use of healthcare services to manage problematic infant sleep behaviours. © 2017 John Wiley & Sons Ltd.

Early social communication in infants with fragile X syndrome and infant siblings of children with autism spectrum disorder.

Science.gov (United States)

Hahn, Laura J; Brady, Nancy C; McCary, Lindsay; Rague, Lisa; Roberts, Jane E

2017-12-01

Little research in fragile X syndrome (FXS) has prospectively examined early social communication. To compare early social communication in infants with FXS, infant siblings of children with autism spectrum disorder (ASIBs), and typically developing (TD) infants. Participants were 18 infants with FXS, 21 ASIBs, and 22 TD infants between 7.5-14.5 months. Social communication was coded using the Communication Complexity Scale during the administration of Autism Observation Scale for Infants. Descriptively different patterns were seen across the three groups. Overall infants with FXS had lower social communication than ASIBs or TD infants when controlling for nonverbal cognitive abilities. However, infants with FXS had similar levels of social communication as ASIBs or TD infants during peek-a-boo. No differences were observed between ASIBs and TD infants. For all infants, higher social communication was related to lower ASD risk. Findings provide insight into the developmental course of social communication in FXS. The dynamic nature of social games may help to stimulate communication in infants with FXS. Language interventions with a strong social component may be particularly effective for promoting language development in FXS. Copyright © 2017 Elsevier Ltd. All rights reserved.

Evaluation of prolonged epidural chloroprocaine for postoperative analgesia in infants.

Science.gov (United States)

Ross, Emma L; Reiter, Pamela D; Murphy, Michael E; Bielsky, Alan R

2015-09-01

To describe the use and adverse effects of chloroprocaine for epidural analgesia in young infants for infusion durations greater than 3.5 hours. A retrospective cohort review of the electronic medical record over a 14-month period. The level IV neonatal intensive care unit of a 414-bed free-standing children's hospital. Eighteen infants (mean age, 1.7 ± 1.8 months [0.03-6.3]; mean weight, 3.8 ± 1.3 kg [1.56-6.9]; n = 10 [55%] males) received 1% chloroprocaine for epidural analgesia postoperatively for up to 96-hour duration and met criteria for inclusion. Dosing requirements, placement of epidural catheter, supplementary analgesic therapy, respiratory support, vital signs, and incidence of adverse events associated with local anesthetics were collected. Epidural catheter placement was caudal (n = 8), lumbar (n = 6), or thoracic (n = 4). Mean operative time was 2.48 ± 1 hour (1-5). Initial chloroprocaine dose was 1.3 ± 0.5 mL/h (0.4-2.5) (3.5 ± 1 mg/kg per hour [1.4-5]) with a maximum dose of 1.5 ± 0.6 mL/h (0.4-3) (4.2 ± 1.1 mg/kg per hour [2.2-6.1]). Duration of epidural analgesia was 48.3 ± 21.5 hours (10-96). Duration of epidural infusion did not influence dosing requirement, suggesting the absence of drug tachyphylaxis. All patients received intermittent doses of opioid and nonopioid pain medications while receiving chloroprocaine. Two mechanically ventilated patients required continuous infusion of opioids. No adverse events were directly attributed to chloroprocaine use. Epidural 1% chloroprocaine, in doses of 0.4-3 mL/h (1.5-6.1 mg/kg per hour), was well tolerated in both mechanically ventilated and spontaneously breathing infants for up to 96 hours with no identified adverse effects or tachyphylaxis. Copyright © 2015 Elsevier Inc. All rights reserved.

Markers of Oxidative Stress in Human Milk do not Differ by Maternal BMI But are Related to Infant Growth Trajectories.

Science.gov (United States)

Young, Bridget E; Patinkin, Zachary W; Pyle, Laura; de la Houssaye, Becky; Davidson, Barbara S; Geraghty, Sheela; Morrow, Ardythe L; Krebs, Nancy

2017-06-01

Objective Obesity in adults is associated with inflammation and oxidative stress. Whether or not this phenotype is reflected in human milk (HM) composition, or may impact infant growth remains unknown. We investigated whether HM from overweight/obese (OW/Ob) mothers exhibited higher concentrations of inflammatory cytokines and markers of oxidative stress. We also correlated these bioactive components with infant growth patterns. Methods This was an observational cohort of 56 breastfeeding mothers and their infants [33 normal weight (NW) and 23 OW/Ob]. Infants were followed until 6 months of age and HM collected at 2-weeks and 4-months. Results Markers of oxidative stress, 8-hydroxy-deoxyguanosine (8OHdG) and 4-hydroxynonenol (HNE), decreased in HM over time (p < 0.001) and did not differ between NW and OW/Ob women. Concentrations of inflammatory cytokines, IL-6, IL-8, and TNF-α, were all inter-correlated (p < 0.001) but did not differ between NW and OW/Ob women. HM fat, protein, lactose, and total calories did not differ between NW and OW/Ob women. Infant growth patterns did not differ by group. In a model of infant weight-for-length-Z score trajectory, there was a significant interaction between both lactose and 8OHdG with maternal group: HM lactose and 8OHdG concentrations were both positively associated with increases in WLZ trajectory only among infants breastfed by OW/Ob mothers. Conclusions for Practice HM composition was relatively stable between NW and OW/Ob women. In exclusively breastfed infants, HM concentrations of lactose and 8OHdG, a marker of oxidative stress, may contribute to regulation of infant weight gain, especially among infants of OW/Ob women.

Therapeutic drug monitoring of caffeine in preterm infants: Could saliva be an alternative to serum?

Science.gov (United States)

Chaabane, Amel; Chioukh, Fatma Z; Chadli, Zohra; Ben Fredj, Nadia; Ben Ameur, Karim; Ben Hmida, Hayet; Boughattas, Naceur A; Monastiri, Kamel; Aouam, Karim

2017-12-01

Evaluate whether saliva could be a useful alternative to serum for routine therapeutic drug monitoring of caffeine in preterm infants using the enzyme multiplied immunoassay technique (EMIT) assay. We conducted a prospective study including preterm infants (less than 34 weeks' amenorrhea) admitted to the intensive care and neonatal medicine department. All infants received 5, 10, 15, 20 and 25mg/kg/day of citrate caffeine intravenously from the first to the fifth day of birth, respectively. For each patient, two concomitant blood and saliva samples corresponding to the trough concentrations were collected 24hours after each caffeine dose. The caffeine concentrations were determined using the EMIT ® 2000 caffeine assay. Thirteen preterm infants were included. The saliva and the serum caffeine concentration increased proportionally to the administered dose. Saliva and serum kinetics were comparable and the saliva caffeine concentrations were correlated to the serum ones (r 2 =0.76). Saliva caffeine monitoring by EMIT is a valid, useful and safe alternative to serum in preterm infants. Copyright © 2017 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

The value of low-dose prospective ECG-gated dual-source CT angiography in the diagnosis of coarctation of the aorta in infants and children

Energy Technology Data Exchange (ETDEWEB)

Nie, P. [Shandong Provincial Key Laboratory of Diagnosis and Treatment of Cardio-Cerebral Vascular Diseases, Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong (China); Wang, X., E-mail: wxming369@yahoo.com.cn [Shandong Provincial Key Laboratory of Diagnosis and Treatment of Cardio-Cerebral Vascular Diseases, Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong (China); Cheng, Z.; Duan, Y.; Ji, X. [Shandong Provincial Key Laboratory of Diagnosis and Treatment of Cardio-Cerebral Vascular Diseases, Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong (China); Chen, J. [CT Research Collaboration, Siemens, Beijing (China); Zhang, H. [Department of Cardiovascular Surgery, Shandong Provincial Hospital, Jinan, Shandong (China)

2012-08-15

Aim: To investigate the value of prospective electrocardiogram (ECG)-gated dual-source computed tomography (DSCT) in the diagnosis of coarctation of the aorta (CoA). Materials and methods: Seventeen patients clinically suspected of having CoA underwent prospective ECG-gated DSCT angiography and transthoracic echocardiography (TTE). Surgery was performed in all patients. The diagnostic accuracy of DSCT angiography and TTE was compared with the surgical findings as the reference standard. Image quality was evaluated using a five-point scale. Effective radiation dose was calculated from the dose-length product (DLP). Results: CoA was diagnosed in 17 patients by DSCT angiography and in 16 patients by TTE. A total of 46 separate cardiovascular abnormalities were confirmed by surgical findings. The diagnostic accuracy of DSCT angiography and TTE was 96.32% and 97.06%, respectively. There was no significant difference in the diagnostic accuracy between DSCT angiography and TTE ({chi}{sup 2} = 0, p > 0.05). The mean score of image quality was 4.2 {+-} 0.8. The mean effective dose was 0.69 {+-} 0.09 mSv. Conclusion: Prospective ECG-gated DSCT with a low radiation dose is a valuable technique in the diagnosis of CoA in infants and children.

Prevention of Vitamin K deficiency bleeding in newborn infants

DEFF Research Database (Denmark)

Mihatsch, W. A.; Braegger, C P; Bronsky, J

2016-01-01

Vitamin K deficiency bleeding (VKDB) due to physiologically low vitamin K plasma concentrations is a serious risk for newborn and young infants and can be largely prevented by adequate vitamin K supplementation. The aim of this position paper is to define the condition, describe the prevalence......, discuss current prophylaxis practices and outcomes, and to provide recommendations for the prevention of VKDB in healthy term newborns and infants. All newborn infants should receive vitamin K prophylaxis and the date, dose, and mode of administration should be documented. Parental refusal of vitamin K...... prophylaxis after adequate information is provided should be recorded especially because of the risk of late VKDB. Healthy newborn infants should either receive 1 mg of vitamin K 1 by intramuscular injection at birth; or 3×2 mg vitamin K 1 orally at birth, at 4 to 6 days and at 4 to 6 weeks; or 2 mg vitamin K...

Treatment of acute diarrhea with Saccharomyces boulardii in infants.

Science.gov (United States)

Corrêa, Naflesia B O; Penna, Francisco J; Lima, Fátima M L S; Nicoli, Jacques R; Filho, Luciano A P

2011-11-01

The aim of the study was to determine whether an oral treatment with a commercial pharmaceutical product containing Saccharomyces boulardii would reduce the duration of diarrhea in infants with acute diarrhea. In the present double-blind, placebo-controlled study, 186 infants, 6 to 48 months old and hospitalized within 72 hours after the onset of acute diarrhea in 2 hospitals in Goiânia, Goiás, Brazil, were randomly assigned to receive twice per day for 5 days 200 mg of a commercial pharmaceutical product containing 4 × 10 viable cells of S boulardii or a placebo. Stool samples were submitted to search for rotavirus. Among the 176 infants who completed the trial, those treated with S boulardii (90) showed a reduction in diarrhea duration (P boulardii was given to children within 72 hours after the onset of acute diarrhea. The present study suggests a complementary treatment of acute diarrhea in infants with daily oral doses of S boulardii.

Present dose limits and their relation to radiosensitivity of different organs and tissues

International Nuclear Information System (INIS)

Anon.

1987-01-01

Dose equivalent limits in relation to dose thresholds are considered for injury of various tissues and organs to evaluate the protection agains non-stochastic irradiation effects by the existing system of dose limitation for radiotherapeutic personnel. Data on tissue radiosensitivity in relation to non-stochastic effects, obtained from radiotherapeutic experience, are presented. Dose threshold values, derived for patients, with a correction in the direction of increase, may be applied to conditions of occupational exposure except for bone marrow, gonads and eye lens, where threshold doses are lower

Early postnatal calcium and phosphorus metabolism in preterm infants

NARCIS (Netherlands)

Christmann, Viola; de Grauw, Anne M.; Visser, Reina; Matthijsse, René P.; van Goudoever, Johannes B.; van Heijst, Arno F. J.

2014-01-01

Bone mineralisation in preterm infants is related to the supply of calcium (Ca) and phosphorus (P). We increased the amount of minerals in parenteral nutrition (PN) for preterm infants and evaluated postnatal Ca and P metabolism in relation to mineral and vitamin D (vitD) intake. Preterm infants,

Infant Cries Rattle Adult Cognition.

Directory of Open Access Journals (Sweden)

Joanna Dudek

Full Text Available The attention-grabbing quality of the infant cry is well recognized, but how the emotional valence of infant vocal signals affects adult cognition and cortical activity has heretofore been unknown. We examined the effects of two contrasting infant vocalizations (cries vs. laughs on adult performance on a Stroop task using a cross-modal distraction paradigm in which infant distractors were vocal and targets were visual. Infant vocalizations were presented before (Experiment 1 or during each Stroop trial (Experiment 2. To evaluate the influence of infant vocalizations on cognitive control, neural responses to the Stroop task were obtained by measuring electroencephalography (EEG and event-related potentials (ERPs in Experiment 1. Based on the previously demonstrated existence of negative arousal bias, we hypothesized that cry vocalizations would be more distracting and invoke greater conflict processing than laugh vocalizations. Similarly, we expected participants to have greater difficulty shifting attention from the vocal distractors to the target task after hearing cries vs. after hearing laughs. Behavioral results from both experiments showed a cry interference effect, in which task performance was slower with cry than with laugh distractors. Electrophysiology data further revealed that cries more than laughs reduced attention to the task (smaller P200 and increased conflict processing (larger N450, albeit differently for incongruent and congruent trials. Results from a correlation analysis showed that the amplitudes of P200 and N450 were inversely related, suggesting a reciprocal relationship between attention and conflict processing. The findings suggest that cognitive control processes contribute to an attention bias to infant signals, which is modulated in part by the valence of the infant vocalization and the demands of the cognitive task. The findings thus support the notion that infant cries elicit a negative arousal bias that is

Multi-risk infants: predicting attachment security from sociodemographic, psychosocial, and health risk among African-American preterm infants.

Science.gov (United States)

Candelaria, Margo; Teti, Douglas M; Black, Maureen M

2011-08-01

Ecological and transactional theories link child outcomes to accumulated risk. This study hypothesized that cumulative risk was negatively related to attachment, and that maternal sensitivity mediated linkages between risk and attachment. One hundred and twelve high-risk African-American premature infant-mother dyads participated. Psychosocial (maternal depression, stress and self-efficacy) and sociodemographic risk (poverty, maternal education, marital status) were maternal self-report (0-4 months). Infant health risk was obtained from hospital charts. Infant-mother attachment (12 months) and maternal sensitivity (4 months) were assessed with Q-sort measures. Psychosocial and sociodemographic risk, but not infant health risk, negatively related to attachment. Both were mediated by maternal sensitivity. The impact of risk domains on attachment security was mediated by maternal sensitivity. Results emphasize the need for early intervention programs targeting premature infants to identify and address environmental and personal factors that place parenting at risk. © 2011 The Authors. Journal of Child Psychology and Psychiatry © 2011 Association for Child and Adolescent Mental Health.

Breast milk intake and infant growth: an isotopic approach

International Nuclear Information System (INIS)

Bilal, R.; Roohi, S.

2000-01-01

The milk intake of the exclusively breast fed infants was measured with the help of Deuterium dilution method, previously established in our laboratory. The growth of excessively breast fed infants was monitored for size months and correlated with the milk intake. For the measurement of milk intake, saliva of mothers and urine of the infants was collected at 1, 2, 3, 4, 5, 6, 13 and 14 days after giving an appropriate oral dose of deuterium oxide. For determining the Hydrogen Isotope ratio (D/H(, the samples wee prepared utilizing Zn shot method and subsequently analyzed on Isotope ratio Mass Spectrometer. The results showed that mean breast milk intake of infants measured with Deuterium dilution method was 801 +- 262 gms/day at 31.15+- 7.7 days of age (n=17). at the age of 3 months, the milk intake increased to 998+- 397 gms/day. The growth data collected over six month period for 21 infants showed that they fall below the 50 percentile of National Center for Health Statistics (NCHS) for weight and length. The data suggests that although majority of infants were exclusively breast fed and the intake values were well above normal range yet their growth was far from optimum. (author)

Patterns of sensitization in infants and its relation to atopic dermatitis

DEFF Research Database (Denmark)

Jøhnke, Hanne; Norberg, Lene Annette; Vach, Werner

2006-01-01

Longitudinal studies in infant populations using validated diagnostic criteria of atopic dermatitis and sensitization are rarely reported, and disease definitions, testing procedures, age of study population and evaluation of objective markers vary between countries and studies. The objectives...... of this prospective birth cohort study were to investigate: (i) the prevalence, the cumulative incidence and the pattern of transient and persistent sensitization to common food- and aeroallergens in unselected infants, (ii) the association between sensitization and the development of atopic dermatitis (AD) and (iii......) the association between selected perinatal risk factors with respect to AD and post-natal sensitization. During a one-year period a cohort of 562 unselected newborns was established and followed up at the age of 3, 6, 9, 12 and 18 months of age. At all time points infants were examined clinically and by histamine...

A phase I randomized clinical trial of candidate human immunodeficiency virus type 1 vaccine MVA.HIVA administered to Gambian infants.

Directory of Open Access Journals (Sweden)

Muhammed O Afolabi

Full Text Available A vaccine to decrease transmission of human immunodeficiency virus type 1 (HIV-1 during breast-feeding would complement efforts to eliminate infant HIV-1 infection by antiretroviral therapy. Relative to adults, infants have distinct immune development, potentially high-risk of transmission when exposed to HIV-1 and rapid progression to AIDS when infected. To date, there have been only three published HIV-1 vaccine trials in infants.We conducted a randomized phase I clinical trial PedVacc 001 assessing the feasibility, safety and immunogenicity of a single dose of candidate vaccine MVA.HIVA administered intramuscularly to 20-week-old infants born to HIV-1-negative mothers in The Gambia.Infants were followed to 9 months of age with assessment of safety, immunogenicity and interference with Expanded Program on Immunization (EPI vaccines. The trial is the first stage of developing more complex prime-boost vaccination strategies against breast milk transmission of HIV-1.From March to October 2010, 48 infants (24 vaccine and 24 no-treatment were enrolled with 100% retention. The MVA.HIVA vaccine was safe with no difference in adverse events between vaccinees and untreated infants. Two vaccine recipients (9% and no controls had positive ex vivo interferon-γ ELISPOT assay responses. Antibody levels elicited to the EPI vaccines, which included diphtheria, tetanus, whole-cell pertussis, hepatitis B virus, Haemophilus influenzae type b and oral poliovirus, reached protective levels for the vast majority and were similar between the two arms.A single low-dose of MVA.HIVA administered to 20-week-old infants in The Gambia was found to be safe and without interference with the induction of protective antibody levels by EPI vaccines, but did not alone induce sufficient HIV-1-specific responses. These data support the use of MVA carrying other transgenes as a boosting vector within more complex prime-boost vaccine strategies against transmission of HIV-1 and

Relation between dose of bendrofluazide, antihypertensive effect, and adverse biochemical effects

DEFF Research Database (Denmark)

Carlsen, J E; Køber, L; Torp-Pedersen, C

1990-01-01

OBJECTIVE--To determine the relevant dose of bendrofluazide for treating mild to moderate hypertension. DESIGN--Double blind parallel group trial of patients who were given placebo for six weeks and then randomly allocated to various doses of bendrofluazide (1.25, 2.5, 5, or 10 mg daily) or place...... of bendrofluazide to treat mild to moderate hypertension is 1.25-2.5 mg a day. Higher doses caused more pronounced adverse biochemical effects including adverse lipid effects. Previous trials with bendrofluazide have used too high doses....... relations between dose and effect were shown for potassium, urate, glucose, total cholesterol, and apolipoprotein B concentrations. The 1.25 mg dose increased only urate concentrations, whereas the 10 mg dose affected all the above biochemical variables. CONCLUSION--The relevant range of doses...

Trends in infant bedding use: National Infant Sleep Position study, 1993-2010.

Science.gov (United States)

Shapiro-Mendoza, Carrie K; Colson, Eve R; Willinger, Marian; Rybin, Denis V; Camperlengo, Lena; Corwin, Michael J

2015-01-01

Use of potentially hazardous bedding, as defined by the American Academy of Pediatrics (eg, pillows, quilts, comforters, loose bedding), is a modifiable risk factor for sudden infant death syndrome and unintentional sleep-related suffocation. The proportion of US infants sleeping with these types of bedding is unknown. To investigate the US prevalence of and trends in bedding use, we analyzed 1993-2010 data from the National Infant Sleep Position study. Infants reported as being usually placed to sleep with blankets, quilts, pillows, and other similar materials under or covering them in the last 2 weeks were classified as bedding users. Logistic regression was used to describe characteristics associated with bedding use. From 1993 to 2010, bedding use declined but remained a widespread practice (moving average of 85.9% in 1993-1995 to 54.7% in 2008-2010). Prevalence was highest for infants of teen-aged mothers (83.5%) and lowest for infants born at term (55.6%). Bedding use was also frequently reported among infants sleeping in adult beds, on their sides, and on a shared surface. The rate of decline in bedding use was markedly less from 2001-2010 compared with 1993-2000. For 2007 to 2010, the strongest predictors (adjusted odds ratio: ≥1.5) of bedding use were young maternal age, non-white race and ethnicity, and not being college educated. Bedding use for infant sleep remains common despite recommendations against this practice. Understanding trends in bedding use is important for tailoring safe sleep interventions. Copyright © 2015 by the American Academy of Pediatrics.

Infant-mother and infant-sibling attachment in Zambia.

Science.gov (United States)

Mooya, Haatembo; Sichimba, Francis; Bakermans-Kranenburg, Marian

2016-12-01

This study, the first in Zambia using the Strange Situation Procedure (SSP) to observe attachment relationships and the "very first" observational study of infant-sibling attachment, examined patterns of infant-mother and infant-sibling attachment, and tested their association. We included siblings who were substantially involved in caregiving activities with their younger siblings. We hypothesized that infants would develop attachment relationships to both mothers and siblings; the majority of infants would be classified as securely attached to both caregivers, and infant-mother and infant-sibling attachment would be unrelated. The sample included 88 low-income families in Lusaka, Zambia (average of 3.5 children; SD = 1.5). The SSP distributions (infant-mother) were 59% secure, 24% avoidant and 17% resistant, and 46% secure, 20% avoidant, 5% resistant and 29% disorganized for three- and four-way classifications, respectively. The infant-sibling classifications were 42% secure, 23% avoidant and 35% resistant, and 35% secure, 23% avoidant, 9% resistant and 33% disorganized for three- and four-way classifications, respectively. Infant-mother and infant-sibling attachment relationships were not associated.

The effects of preterm birth on mother-infant interaction and attachment during the infant's first two years.

Science.gov (United States)

Korja, Riikka; Latva, Reija; Lehtonen, Liisa

2012-02-01

Early mother-infant relationships in preterm populations were evaluated in the context of a systematic review of the literature. A systematic search of three electronic databases (PsychINFO, PubMed and Cochrane Library) was undertaken. Three studies of maternal attachment, 18 studies of mother-preterm infant interaction and eight studies of infant attachment were included. Studies of preterm infant attachment were also evaluated using a meta-analysis. Studies of mother-preterm infant interactions showed that the differences in maternal interaction behavior between mothers of preterm infants and mothers of full-term infants seem to be most evident during the first six months of life. Differences in the preterm infant's interaction behavior seem also to continue for six months after birth. However, five of 18 studies showed an equal or even higher quality of mother-infant interaction in groups of preterm compared to groups of full-term infants. Studies of maternal and infant attachment indicated that preterm infants and their mothers are not at higher risk of insecure attachment than full-term infants and their mothers. The mother-preterm infant relationship is complex, and some relational patterns forecast greater psychological risk than others. It is important to decrease maternal stress and early separation in every possible way during hospitalization as well as after discharge. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

Impact of maternal antibodies and infant gut microbiota on the immunogenicity of rotavirus vaccines in African, Indian and European infants: protocol for a prospective cohort study.

Science.gov (United States)

Sindhu, Kuladaipalayam Natarajan C; Cunliffe, Nigel; Peak, Matthew; Turner, Mark; Darby, Alistair; Grassly, Nicholas; Gordon, Melita; Dube, Queen; Babji, Sudhir; Praharaj, Ira; Verghese, Valsan; Iturriza-Gómara, Miren; Kang, Gagandeep

2017-03-29

Gastroenteritis is the leading cause of morbidity and mortality among young children living in resource-poor settings, majority of which is attributed to rotavirus. Rotavirus vaccination can therefore have a significant impact on infant mortality. However, rotavirus vaccine efficacy in Sub-Saharan Africa and Southeast Asia is significantly lower than in high-income countries. Maternally derived antibodies, infant gut microbiota and concomitant oral polio vaccination have been proposed as potential reasons for poor vaccine performance in low-income settings. The overall aim of this study is to compare the role of maternally derived antibodies and infant gut microbiota in determining immune response to rotavirus vaccine in high-income and low-income settings, using the same vaccine and a similar study protocol. The study is an observational cohort in three countries-Malawi, India and UK. Mothers will be enrolled in third trimester of pregnancy and followed up, along with infants after delivery, until the infant completes two doses of oral rotavirus vaccine (along with routine immunisation). The levels of prevaccination maternally derived rotavirus-specific antibodies (IgG) will be correlated with infant seroconversion and antibody titres, 4 weeks after the second dose of rotavirus vaccine. Both within-country and between-country comparisons of gut microbiome will be carried out between children who seroconvert and those who do not. The impact of oral polio vaccine coadministration on rotavirus vaccine response will be studied in Indian infants. Ethical approvals have been obtained from Integrated Research Application System (IRAS, NHS ethics) in UK, College of Medicine Research and Ethics Committee (COMREC) in Malawi and Institutional Review Board (IRB), Christian Medical College, Vellore in India. Participant recruitment and follow-up is ongoing at all three sites. Analysis of data, followed by publication of the results, is expected in 2018. Published by the BMJ

Maternal smoking effects on infant growth

International Nuclear Information System (INIS)

Salazar, G.; Berlanga, R.; Garcia, C.; Vio, F.

2000-01-01

Maternal smoking is known to have adverse effects on birth weight, duration and volume of breast feeding. It also negatively affects maternal body composition and prolactin concentration at the end of pregnancy. The effect of smoking on longitudinal growth has not been studied thoroughly. Sixteen smoking mothers (S) during pregnancy and lactation (7.1 ± 4.4 cigarettes/day) and 22 non-smoking mothers (NS), were selected at delivery time, in Santiago, Chile. Infants were evaluated monthly and volume of breast milk was measured at one month by dose-to-infant deuterium dilution, as well as cotinine levels. The concentration of zinc, copper and iron in milk was measured by atomic absorption spectrophotometry (AAS). Zinc, copper and cadmium were also determined in the infant's hair at one and six months and once in the mother (beginning of lactation). Cotinine levels were determined at one and six months by a radio-immuno-analysis standard kit. In monthly visits to the house, additional formula/food intake to breast feeding was determined in a 48 hours questionnaire to the mother, as well as infant's morbidity was registered. At birth, weight and height were not significantly different, although higher in NS infants. Cotinine levels were 30 times higher in S-mothers compared to NS mothers and 12 times higher in their infants. Both S and NS infants grew within normality as defined by the National Centre for Health Statistics (NCHS) in the Z-scores curves (weight/age, height/age and weight/height). Breast milk was similar in a partial group of NS and S groups (730 ± 133 g/d, 736 ± 136 g/d) and there was no difference in the content of zinc, copper and iron in milk or hair, except for cadmium which was higher in infant's hair at one month of age. Significant differences in height and height/age were found from one to six months of age. Weight/height began to be significantly higher in S-infants from three months onward, due to their slower height growth. Another group of

Determination of the effects on learning and memory performance and related gene expressions of clothianidin in rat models.

Science.gov (United States)

Ozdemir, Hasan Hüseyin; Kara, Murat; Yumrutas, Onder; Uckardes, Fatih; Eraslan, Ersin; Demir, Caner F; Bal, Ramazan

2014-10-01

Clothianidin (CLO) is one of the pesticides used to protect against insects, and its potential toxic effects on cognitive functions are not clearly known. This study aims to evaluate the possible effects of dose-dependent CLO on learning and memory in infant and adult male rats and the expression of related genes in the hippocampus. Doses of 2, 8 and 24 mg/kg of CLO were administered to newborn infant and adult albino Winstar rats in the form of gavage and dissolved in vehicle matter. Their cognitive and learning functions were evaluated by the Morris water maze and probe tests. Expression levels of N-methyl D-aspartate 1 (GRIN1), muscuranic receptor M1, synoptophysin (SYP) and growth-associated protein 43 (GAP-43) of tissues isolated from the hippocampus were determined using the real-time PCR method. In the Morris water maze test, no change (p > 0.05) was exhibited in the adult and infant rats after CLO was applied, although there was a significant difference (p  0.05). Our study shows that exposure to high doses of CLO causes deterioration of cognitive functions in infant rats.

Survival and Neurodevelopmental Outcomes among Periviable Infants.

Science.gov (United States)

Younge, Noelle; Goldstein, Ricki F; Bann, Carla M; Hintz, Susan R; Patel, Ravi M; Smith, P Brian; Bell, Edward F; Rysavy, Matthew A; Duncan, Andrea F; Vohr, Betty R; Das, Abhik; Goldberg, Ronald N; Higgins, Rosemary D; Cotten, C Michael

2017-02-16

Data reported during the past 5 years indicate that rates of survival have increased among infants born at the borderline of viability, but less is known about how increased rates of survival among these infants relate to early childhood neurodevelopmental outcomes. We compared survival and neurodevelopmental outcomes among infants born at 22 to 24 weeks of gestation, as assessed at 18 to 22 months of corrected age, across three consecutive birth-year epochs (2000-2003 [epoch 1], 2004-2007 [epoch 2], and 2008-2011 [epoch 3]). The infants were born at 11 centers that participated in the National Institute of Child Health and Human Development Neonatal Research Network. The primary outcome measure was a three-level outcome - survival without neurodevelopmental impairment, survival with neurodevelopmental impairment, or death. After accounting for differences in infant characteristics, including birth center, we used multinomial generalized logit models to compare the relative risk of survival without neurodevelopmental impairment, survival with neurodevelopmental impairment, and death. Data on the primary outcome were available for 4274 of 4458 infants (96%) born at the 11 centers. The percentage of infants who survived increased from 30% (424 of 1391 infants) in epoch 1 to 36% (487 of 1348 infants) in epoch 3 (Pneurodevelopmental impairment increased from 16% (217 of 1391) in epoch 1 to 20% (276 of 1348) in epoch 3 (P=0.001), whereas the percentage of infants who survived with neurodevelopmental impairment did not change significantly (15% [207 of 1391] in epoch 1 and 16% [211 of 1348] in epoch 3, P=0.29). After adjustment for changes in the baseline characteristics of the infants over time, both the rate of survival with neurodevelopmental impairment (as compared with death) and the rate of survival without neurodevelopmental impairment (as compared with death) increased over time (adjusted relative risks, 1.27 [95% confidence interval {CI}, 1.01 to 1.59] and 1

Diuretic exposure in premature infants from 1997–2011

Science.gov (United States)

Laughon, Matthew M.; Chantala, Kim; Aliaga, Sofia; Herring, Amy H.; Hornik, Christoph P.; Hughes, Rachel; Clark, Reese H.; Smith, P. Brian

2014-01-01

Objective Diuretics are often prescribed off-label to premature infants, particularly to prevent or treat bronchopulmonary dysplasia (BPD). We examined their use and safety in this group. Study Design Retrospective cohort study of infants diuretics in 333 neonatal intensive care units from 1997–2011. We examined use of acetazolamide, amiloride, bumetanide, chlorothiazide, diazoxide, ethacrynic acid, furosemide, hydrochlorothiazide, mannitol, metolazone, or spironolactone combination. Respiratory support and FiO2 on the first day of each course of diuretic use were identified. Results Thirty-seven percent (39,357/107,542) of infants were exposed to at least 1 diuretic; furosemide was the most commonly used (93% with ≥1 recorded dose), followed by spironolactone, chlorothiazide, hydrochlorothiazide, bumetanide, and acetazolamide. Seventy-four percent were exposed to 1 diuretic at a time, 19% to 2 diuretics simultaneously, and 6% to 3 diuretics simultaneously. The most common combination was furosemide/spironolactone, followed by furosemide/chlorothiazide and chlorothiazide/spironolactone. Many infants were not receiving mechanical ventilation on the first day of each new course of furosemide (47%), spironolactone (69%), chlorothiazide (61%), and hydrochlorothiazide (68%). Any adverse event occurred on 42 per 1000 infant-days for any diuretic and 35 per 1000 infant-days for furosemide. Any serious adverse event occurred in 3.8 for any diuretic and 3.2 per 1000 infant-days for furosemide. The most common laboratory abnormality associated with diuretic exposure was thrombocytopenia. Conclusion Despite no FDA indication and little safety data, over one third of premature infants in our population were exposed to a diuretic, many with minimal respiratory support. PMID:24801161

Ameliorative effects of low dose/low dose-rate irradiation on reactive oxygen species-related diseases model mice

International Nuclear Information System (INIS)

Nomura, Takaharu

2008-01-01

Living organisms have developed complex biological system which protects themselves against environmental radiation, and irradiation with proper dose, dose-rate and irradiation time can stimulate their biological responses against oxidative stress evoked by the irradiation. Because reactive oxygen species are involved in various human diseases, non-toxic low dose/low dose-rate radiation can be utilized for the amelioration of such diseases. In this study, we used mouse experimental models for fatty liver, nephritis, diabetes, and ageing to elucidate the ameliorative effect of low dose/low dose-rate radiation in relation to endogenous antioxidant activity. Single irradiation at 0.5 Gy ameliorates carbon tetrachloride-induced fatty liver. The irradiation increases hepatic anti-oxidative system involving glutathione and glutathione peroxidase, suggesting that endogenous radical scavenger is essential for the ameliorative effect of low dose radiation on carbon tetrachloride-induced fatty liver. Single irradiation at 0.5 Gy ameliorates ferric nitrilotriacetate-induced nephritis. The irradiation increases catalase and decreases superoxide dismutase in kidney. The result suggests that low dose radiation reduced generation of hydroxide radical generation by reducing cellular hydroperoxide level. Single irradiation at 0.5 Gy at 12 week of age ameliorates incidence of type I diabetes in non-obese diabetic (NOD) mice through the suppression of inflammatory activity of splenocytes, and resultant apoptosis of β-cells in pancreas. The irradiation activities of superoxide dismutase and catalase, which coordinately diminish intracellular reactive oxygen species. Continuous irradiation at 0.70 mGy/hr from 10 week of age elongates life span, and suppresses alopecia in type II diabetesmice. The irradiation improved glucose clearance without affecting insulin-resistance, and increased pancreatic catalase activity. The results suggest that continuous low dose-rate irradiation protect

''Intraventricular'' hemorrhage and cystic periventricular leukomalacia in preterm infants: how are they related?

NARCIS (Netherlands)

Kusters, C.D.J.; Chen, M.L.; Follett, P.L.; Dammann, O.

2009-01-01

Intraventricular hemorrhage and cystic periventricular leukomalacia are often co-occurring characteristics of brain damage in preterm infants. Using data from 1016 infants born before 30 completed weeks' gestational age, we sought to clarify the relationship between severe intraventricular

Is infant exposure to antiretroviral drugs during breastfeeding quantitatively important? A systematic review and meta-analysis of pharmacokinetic studies

Science.gov (United States)

Waitt, Catriona John; Garner, Paul; Bonnett, Laura Jayne; Khoo, Saye Hock; Else, Laura Jayne

2015-01-01

Objectives The objectives of this study were to summarize antiretroviral drug concentrations in breast milk (BM) and exposure of breast-fed infants. Methods This was a systematic review of pharmacokinetic studies of HIV-positive women taking antiretrovirals that measured drugs in BM. The quality of pharmacokinetic and laboratory methods was assessed using pre-defined criteria. Pooled ratios and 95% CIs were calculated using the generalized inverse variance method and heterogeneity was estimated by the I2 statistic. PubMed Central, SCOPUS and LactMed databases were searched. No date or language restrictions were applied. Searches were conducted up to 10 November 2014. Clinical relevance was estimated by comparing ingested dose with the recommended therapeutic dose for each drug. Results Twenty-four studies were included. There was substantial variability in the clinical and laboratory methods used and in reported results. Relative to maternal plasma (MP), NRTIs accumulate in BM, with BM : MP ratios (95% CI estimates) from 0.89 to 1.21 (14 studies, 1159 paired BM and MP samples). NNRTI estimates were from 0.71 to 0.94 (17 studies, 965 paired samples) and PI estimates were from 0.17 to 0.21 (8 studies, 477 paired samples). Relative to the recommended paediatric doses, a breast-fed infant may ingest 8.4% (95% CI 1.9–15.0), 12.5% (95% CI 2.6–22.3) and 1.1% (95% CI 0–3.6) of lamivudine, nevirapine and efavirenz, respectively, via BM. Conclusions Transfer to untreated infants appears quantitatively important for some NRTIs and NNRTIs. The pharmacokinetic methods varied widely and we propose standards for the design, analysis and reporting of future pharmacokinetic studies of drug transfer during breastfeeding. PMID:25858354

Caregiver Soothing Behaviors After Immunization and Infant Attachment: A Longitudinal Analysis.

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Hillgrove-Stuart, Jessica; Pillai Riddell, Rebecca; Flora, David B; Greenberg, Saul; Garfield, Hartley

2015-01-01

There were 2 primary objectives to the current study: (1) to relate caregiver behavior trajectories across immunization appointments over the first year of life to subsequent infant attachment and (2) to relate caregiver behavior trajectories within each immunization appointment over the first year of life to subsequent infant attachment. A subsample of 130 caregivers and their infants were recruited from a sample of 760 caregivers who were part of an ongoing longitudinal cohort that videotaped infants' 2-, 4-, 6-, and 12-month immunization appointments. This subsample of caregivers and their infants (n = 130) were invited to participate in an assessment of attachment when infants were between 12 and 18 months of age at the local children's hospital. Caregiver proximal soothing behaviors were the only caregiver behaviors postimmunization that were related to subsequent infant attachment. Higher frequencies of caregiver proximal soothing at 12 months were related to infants' organized attachment, whereas steeper decreases in proximal soothing across the first year were associated with disorganized infant attachment. In addition, when caregivers engaged in proximal soothing for longer after their 12 month olds' immunizations, these infants were more likely to be secure or organized in their attachment. These results provide empirical support for the ecological validity of studying infant attachment in a pediatric pain context. The pediatric "well-baby" visit may provide a potential opportunity to feasibly integrate brief infant mental health screening and intervention.

Auditory Evoked Potentials and Hand Preference in 6-Month-Old Infants: Possible Gender-Related Differences in Cerebral Organization.

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Shucard, Janet L.; Shucard, David W.

1990-01-01

Verbal and musical stimuli were presented to infants in a study of the relations of evoked potential left-right amplitude asymmetries to gender and hand preference. There was a relation between asymmetry and hand preference, and for girls, between asymmetry and stimulus condition. Results suggest a gender difference in cerebral hemisphere…

Pharmacokinetics and absolute bioavailability of phenobarbital in neonates and young infants, a population pharmacokinetic modelling approach.

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Marsot, Amélie; Brevaut-Malaty, Véronique; Vialet, Renaud; Boulamery, Audrey; Bruguerolle, Bernard; Simon, Nicolas

2014-08-01

Phenobarbital is widely used for treatment of neonatal seizures. Its optimal use in neonates and young infants requires information regarding pharmacokinetics. The objective of this study is to characterize the absolute bioavailability of phenobarbital in neonates and young infants, a pharmacokinetic parameter which has not yet been investigated. Routine clinical pharmacokinetic data were retrospectively collected from 48 neonates and infants (weight: 0.7-10 kg; patient's postnatal age: 0-206 days; GA: 27-42 weeks) treated with phenobarbital, who were administered as intravenous or suspension by oral routes and hospitalized in a paediatric intensive care unit. Total mean dose of 4.6 mg/kg (3.1-10.6 mg/kg) per day was administered by 30-min infusion or by oral route. Pharmacokinetic analysis was performed using a nonlinear mixed-effect population model software). Data were modelled with an allometric pharmacokinetic model, using three-fourths scaling exponent for clearance (CL). The population typical mean [per cent relative standard error (%RSE)] values for CL, apparent volume of distribution (Vd ) and bioavailability (F) were 0.0054 L/H/kg (7%), 0.64 L/kg (15%) and 48.9% (22%), respectively. The interindividual variability of CL, Vd , F (%RSE) and residual variability (%RSE) was 17% (31%), 50% (27%), 39% (27%) and 7.2 mg/L (29%), respectively. The absolute bioavailability of phenobarbital in neonates and infants was estimated. The dose should be increased when switching from intravenous to oral administration. © 2013 Société Française de Pharmacologie et de Thérapeutique. Published by John Wiley & Sons Ltd.

Population pharmacokinetics of phenobarbital in infants with neonatal encephalopathy treated with therapeutic hypothermia.

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Shellhaas, Renée A; Ng, Chee M; Dillon, Christina H; Barks, John D E; Bhatt-Mehta, Varsha

2013-02-01

Phenobarbital is the first-line treatment for neonatal seizures. Many neonates with hypoxic ischemic encephalopathy are treated with therapeutic hypothermia, and about 40% have clinical seizures. Little is known about the pharmacokinetics of phenobarbital in infants with hypoxic ischemic encephalopathy who undergo therapeutic hypothermia. The objective of this study was to determine the effect of therapeutic hypothermia on phenobarbital pharmacokinetics, taking into account maturational changes. Level 3 neonatal ICU. Infants with hypoxic ischemic encephalopathy and suspected seizures, all treated with phenobarbital. Some of these infants also received treatment with therapeutic hypothermia. None. A retrospective cohort study of 39 infants with hypoxic ischemic encephalopathy treated with phenobarbital (20 were treated with therapeutic hypothermia and 19 were not). Data on phenobarbital plasma concentrations were collected in 39 subjects with hypoxic ischemic encephalopathy with or without therapeutic hypothermia. Using nonlinear mixed-effects modeling, population pharmacokinetics of phenobarbital were developed with a total of 164 plasma concentrations. A one-compartment model best described the pharmacokinetics. The clearance of phenobarbital was linearly related to body weight and matured with increasing age with a maturation half-life of 22.1 days. Therapeutic hypothermia did not influence the pharmacokinetic parameters of phenobarbital. Therapeutic hypothermia does not influence the clearance of phenobarbital after accounting for weight and age. Standard phenobarbital dosing is appropriate for the initial treatment of seizures in neonates with hypoxic ischemic encephalopathy treated with therapeutic hypothermia.

A retrospective evaluation of term infants treated with surfactant therapy

Directory of Open Access Journals (Sweden)

Özge Sürmeli-Onay

2015-04-01

Full Text Available Aim: To investigate the clinical and therapeutic characteristics and outcomes of term infants who received surfactant therapy (ST for severe respiratory failure in our neonatal intensive care unit (NICU. Methods: The medical records of term infants (gestational age ≥ 370/7 weeks who received ST between 2003-2012 in NICU of Hacettepe University Ihsan Dogramaci Children’s Hospital were evaluated retrospectively. Results: During ten years period, 32 term infants received ST; the mean gestational age was 38.1 ± 0.88 wk and the mean birth weight was 2,936 ± 665 g. The underlying lung diseases were severe congenital pneumonia (CP in 13 (40.6%, acute respiratory distress syndrome (ARDS in 5 (15.6%, meconium aspiration syndrome (MAS in 5 (15.6%, congenital diaphragmatic hernia (CDH in 4 (12.5%, respiratory distress syndrome in 3 (9.4% and pulmonary hemorrhage in 2 (6.3% infants. The median time of the first dose of ST was 7.75 (0.5-216 hours. Pulmonary hypertension accompanied the primary lung disease in 9 (28.1% infants. Mortality rate was 25%. Conclusion: In term infants, CP, ARDS and MAS were the main causes of respiratory failure requiring ST. However, further prospective studies are needed for defining optimal strategies of ST in term infants with respiratory failure.

The knowledge of pregnant teenagers on Speech Therapy related to maternal-infant health care - doi:10.5020/18061230.2007.p207

Directory of Open Access Journals (Sweden)

Daniela Carvalho Neves

2012-01-01

Full Text Available This study had as its objective to investigate the knowledge of pregnant teenagers on Speech Therapy related to maternal-infant health care. A qualitative analysis was made based on a thematic investigation of the subject matter. Ten pregnant teenagers with chronological age between ten and nineteen years old joined in the survey. They found themselves around the fifth and ninth months of gestation age, being attended at the Center of Pregnant TeenagersAttention Care at Fortaleza General Hospital. The collection of data involved the application of a semi-structured interview broaching topics that could identify what the pregnant teenagers knew about Speech Therapy and maternal-infant care. Education interventions, related to Speech Therapy health promotion, were also accomplished. The results pointed out that the pregnant teenagers’ level of knowledge on aspects such as: food transition and utensils, oral habits, language stimulation and hearing loss detection, was still incipient and unsatisfactory. It is concluded that the knowledge of the pregnant teenagers on Speech Therapy related to maternal-infant health care was unsatisfactory, which demonstrates the importance of education interventions related to human communication health care for this studied sample.

Human milk composition and infant growth

DEFF Research Database (Denmark)

Eriksen, Kamilla Gehrt; Christensen, Sophie Hilario; Lind, Mads Vendelbo

2018-01-01

PURPOSE OF REVIEW: This review highlights relevant studies published between 2015 and 2017 on human milk composition and the association with infant growth. RECENT FINDINGS: High-quality studies investigating how human milk composition is related to infant growth are sparse. Recent observational...... studies show that human milk concentrations of protein, fat, and carbohydrate likely have important influence on infant growth and body composition. Furthermore, some observational studies examining human milk oligosaccharides and hormone concentrations suggest functional relevance to infant growth....... For human milk micronutrient concentrations and microbiota content, and other bioactive components in human milk, the association with infant growth is still speculative and needs further investigation. The included studies in this review are all limited in their methodological design and methods but have...

International Comparisons of Infant Mortality and Related Factors : United States and Europe, 2010

NARCIS (Netherlands)

MacDorman, M.F.; Mathews, T.J.; Mohangoo, A.D.; Zeitlin, J.

2014-01-01

OBJECTIVES: This report investigates the reasons for the United States' high infant mortality rate when compared with European countries. Specifically, the report measures the impact on infant mortality differences of two major factors: the percentage of preterm births and gestational age-specific

Absolute and relative dose measurements with Gafchromic trade mark sign EBT film for high energy electron beams with different doses per pulse

International Nuclear Information System (INIS)

Fiandra, Christian; Ragona, Riccardo; Ricardi, Umberto; Anglesio, Silvia; Giglioli, Francesca Romana

2008-01-01

The authors have evaluated the accuracy, in absolute and relative dose measurements, of the Gafchromic trade mark sign EBT film in pulsed high-energy electron beams. Typically, the electron beams used in radiotherapy have a dose-per-pulse value of less than 0.1 mGy/pulse. However, very high dose-per-pulse electron beams are employed in certain linear accelerators dedicated to intraoperatory radiation therapy (IORT). In this study, the absorbed dose measurements with Gafchromic trade mark sign EBT in both low (less than 0.3 mGy per pulse) and high (30 and 70 mGy per pulse) dose-per-pulse electron beams were compared with ferrous sulfate chemical Fricke dosimetry (operated by the Italian Primary Standard Dosimetry Laboratory), a method independent of the dose per pulse. A summary of Gafchromic trade mark sign EBT in relative and absolute beam output determination is reported. This study demonstrates the independence of Gafchromic trade mark sign EBT absorption as a function of dose per pulse at different dose levels. A good agreement (within 3%) was found with Fricke dosimeters for plane-base IORT applicators. Comparison with a diode detector is presented for relative dose measurements, showing acceptable agreement both in the steep dose falloff zone and in the homogeneous dose region. This work also provides experimental values for recombination correction factor (K sat ) of a Roos (plane parallel) ionization chamber calculated on the basis of theoretical models for charge recombination.

Trends in Infant Bedding Use: National Infant Sleep Position Study, 1993–2010

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Colson, Eve R.; Willinger, Marian; Rybin, Denis V.; Camperlengo, Lena; Corwin, Michael J.

2015-01-01

BACKGROUND: Use of potentially hazardous bedding, as defined by the American Academy of Pediatrics (eg, pillows, quilts, comforters, loose bedding), is a modifiable risk factor for sudden infant death syndrome and unintentional sleep-related suffocation. The proportion of US infants sleeping with these types of bedding is unknown. METHODS: To investigate the US prevalence of and trends in bedding use, we analyzed 1993–2010 data from the National Infant Sleep Position study. Infants reported as being usually placed to sleep with blankets, quilts, pillows, and other similar materials under or covering them in the last 2 weeks were classified as bedding users. Logistic regression was used to describe characteristics associated with bedding use. RESULTS: From 1993 to 2010, bedding use declined but remained a widespread practice (moving average of 85.9% in 1993–1995 to 54.7% in 2008–2010). Prevalence was highest for infants of teen-aged mothers (83.5%) and lowest for infants born at term (55.6%). Bedding use was also frequently reported among infants sleeping in adult beds, on their sides, and on a shared surface. The rate of decline in bedding use was markedly less from 2001–2010 compared with 1993–2000. For 2007 to 2010, the strongest predictors (adjusted odds ratio: ≥1.5) of bedding use were young maternal age, non-white race and ethnicity, and not being college educated. CONCLUSIONS: Bedding use for infant sleep remains common despite recommendations against this practice. Understanding trends in bedding use is important for tailoring safe sleep interventions. PMID:25452654

Ethamsylate in the prevention of periventricular-intraventricular hemorrhage in premature infants.

Science.gov (United States)

Chen, J Y

1993-10-01

A random and controlled trial was conducted to evaluate the efficacy and safety of ethamsylate in the prevention of periventricular-intraventricular hemorrhage (PIVH) in premature infants. Between January 1990 and July 1992, 171 premature infants with a birth weight of ethamsylate 12.5 mg/kg (0.1 mL/kg from 250 mg/2mL ampoules) was given to group 1 intravenously within an hour of delivery and was followed by doses at six-hourly intervals for four days (total dose 200 mg/kg). Group 2 consisted of 85 premature infants with mean birth weight of 1.4 +/- 0.3 kg and mean gestational age of 30.4 +/- 2.2 weeks. Group 2 received 0.1 mL/kg normal saline intravenously in a similar fashion as the ethamsylate-treated group. Cranial ultrasound examinations were performed on postnatal days one, two, three, five, seven and 14. The incidence of PIVH in the ethamsylate-treated group was 24/86 (27.9%) and 39/85 (45.9%) in the control group (p ethamsylate-treated group was 9/86 (10.5%) and 20/85 (23.5%) in the control group (p ethamsylate therapy in this study.

Factors affecting successful closure of hemodynamically significant patent ductus arteriosus with indomethacin in extremely low birth weight infants.

Science.gov (United States)

Yang, Chuan-Zhong; Lee, Jiun

2008-05-01

The incidence of patent ductus arteriosus (PDA) is high in extremely low birth weight (ELBW) infants. Indomethacin has been widely used in the prophylaxis and treatment of hemodynamically significant PDA. This retrospective study was undertaken to identify factors such as birth weight, gestational age, gender, fetal growth retardation, ductal size, timing of the first dose of indomethacin and side effects of indomethacin, which may affect the successful closure of the PDA with indomethacin in ELBW infants. A cohort of 139 ELBW infants who had received indomethacin treatment for PDA during a consecutive period of more than three years (September 2000 to December 2003) was retrospectively analyzed. Administration of indomethacin was associated with closure of PDA in 108 (77.7%) of 139 ELBW infants, and only 19.4% of infants required surgical ligation of the ductus eventually. There was no significant relationship between closure of PDA with gestational age, gender, fetal growth retardation, and ductal size. A higher birth weight and early use of indomethacin after birth could significantly increase the closure rate of PDA (P<0.05). Side effects of indomethacin such as transient oliguria and hyponatremia during indomethacin therapy did not affect PDA closure. Indomethacin is effective for the treatment of PDA in ELBW infants. A higher rate of ductal closure is related to the increase of birth weight. PDA closure with indomethacin is age-related, and early administration of indomethacin could increase PDA closure and reduce the incidence of hyponatremia. There is no significant difference in major morbidities such as bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), and retinopathy of prematurity (ROP) after early treatment. Early screening for hemodynamically significant PDA in ELBW infants and early treatment with indomethacin are recommended.

Randomized controlled trial of a book-sharing intervention in a deprived South African community: effects on carer-infant interactions, and their relation to infant cognitive and socioemotional outcome.

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Murray, Lynne; De Pascalis, Leonardo; Tomlinson, Mark; Vally, Zahir; Dadomo, Harold; MacLachlan, Brenda; Woodward, Charlotte; Cooper, Peter J

2016-12-01

Consistent with evidence from high-income countries (HICs), we previously showed that, in an informal peri-urban settlement in a low-middle income country, training parents in book sharing with their infants benefitted infant language and attention (Vally, Murray, Tomlinson, & Cooper, ). Here, we investigated whether these benefits were explained by improvements in carer-infant interactions in both book-sharing and non-book-sharing contexts. We also explored whether infant socioemotional development benefitted from book sharing. We conducted a randomized controlled trial in Khayelitsha, South Africa. Carers of 14-16-month-old infants were randomized to 8 weeks' training in book sharing (n = 49) or a wait-list control group (n = 42). In addition to the cognitive measures reported previously, independent assessments were made at base line and follow-up of carer-infant interactions during book sharing and toy play. Assessments were also made, at follow-up only, of infant prosocial behaviour in a 'help task', and of infant imitation of doll characters' nonsocial actions and an interpersonal interaction. Eighty-two carer-infant pairs (90%) were assessed at follow-up. (Trial registration ISRCTN39953901). Carers who received the training showed significant improvements in book-sharing interactions (sensitivity, elaborations, reciprocity), and, to a smaller extent, in toy-play interactions (sensitivity). Infants in the intervention group showed a significantly higher rate of prosocial behaviour, and tended to show more frequent imitation of the interpersonal interaction. Improvements in carer behaviour during book sharing, but not during toy play, mediated intervention effects on all infant cognitive outcomes, and tended to mediate intervention effects on infant interpersonal imitation. Training in book sharing, a simple, inexpensive intervention that has been shown to benefit infant cognitive development in a low-middle income country, also shows promise for

Pharmacoepidemiology of opiate use in the neonatal ICU: Increasing cumulative doses and iatrogenic opiate withdrawal.

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Lewis, Tamorah; Erfe, Betty Luan; Ezell, Tarrah; Gauda, Estelle

2015-01-01

Neonatal intensive care unit (ICU) care involves use of opiates to treat postoperative, ventilated, or chronically ill infants. Opiates provide necessary analgesia and sedation, but the morbidities include prolonged neonatal abstinence syndrome (NAS) and extended length of stay for dose tapering. Our objective was to quantify trends in opiate exposure in a tertiary care NICU. The authors hypothesize that medical opiate exposure and resultant ICU-acquired NAS would increase over time. Retrospective cross-sectional cohort study. Tertiary care NICU. High-risk inborn infants admitted in fiscal years 2003-2004, 2007-2008, and 2010-2011. Average cumulative morphine exposure (all opiate doses converted to morphine equivalents) per time epoch was compared in cohorts of clinically similar infants. Linear regression was used to assess the primary outcome, assessing changes in opiate exposure over time. Sixty-three infants were included in the final analysis. The primary analysis assessing cumulative opiate exposure per infant showed an increase of 134 mg per time epoch (95% CI-12, 279 mg, p-value 0.071). There was a statistically significant increase in the percent of infants with a diagnosis of iatrogenic NAS, increasing from 9 to 35 to 50 percent (p-value 0.012).

Concurrent Relations between Face Scanning and Language: A Cross-Syndrome Infant Study.

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Dean D'Souza

Full Text Available Typically developing (TD infants enhance their learning of spoken language by observing speakers' mouth movements. Given the fact that word learning is seriously delayed in most children with neurodevelopmental disorders, we hypothesized that this delay partly results from differences in visual face scanning, e.g., focusing attention away from the mouth. To test this hypothesis, we used an eye tracker to measure visual attention in 95 infants and toddlers with Down syndrome (DS, fragile X syndrome (FXS, and Williams syndrome (WS, and compared their data to 25 chronological- and mental-age matched 16-month-old TD controls. We presented participants with two talking faces (one on each side of the screen and a sound (/ga/. One face (the congruent face mouthed the syllable that the participants could hear (i.e., /ga/, while the other face (the incongruent face mouthed a different syllable (/ba/ from the one they could hear. As expected, we found that TD children with a relatively large vocabulary made more fixations to the mouth region of the incongruent face than elsewhere. However, toddlers with FXS or WS who had a relatively large receptive vocabulary made more fixations to the eyes (rather than the mouth of the incongruent face. In DS, by contrast, fixations to the speaker's overall face (rather than to her eyes or mouth predicted vocabulary size. These findings suggest that, at some point in development, different processes or strategies relating to visual attention are involved in language acquisition in DS, FXS, and WS. This knowledge may help further explain why language is delayed in children with neurodevelopmental disorders. It also raises the possibility that syndrome-specific interventions should include an early focus on efficient face-scanning behaviour.

A randomized, phase 1/2 trial of the safety, tolerability, and immunogenicity of bivalent rLP2086 meningococcal B vaccine in healthy infants.

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Martinon-Torres, Federico; Gimenez-Sanchez, Francisco; Bernaola-Iturbe, Enrique; Diez-Domingo, Javier; Jiang, Qin; Perez, John L

2014-09-08

Neisseria meningitidis serogroup B (MnB) is a major cause of invasive meningococcal disease in infants. A conserved, surface-exposed lipoprotein, LP2086 (a factor H-binding protein [fHBP]), is a promising MnB vaccine target. A bivalent, recombinant vaccine targeting the fHBP (rLP2086) of MnB was developed. This phase 1/2 clinical study was designed to assess the immunogenicity, safety, and tolerability of a 4-dose series of the rLP2086 vaccine at 20-, 60-, 120-, or 200-μg dose levels in vaccine-naive infants when given with routine childhood vaccines. The study was to consist of two phases: a single-blind sentinel phase and an open-label full enrollment phase. During the sentinel phase, randomization of subjects to the next higher dose was delayed pending a 14-day safety review of dose 1 of the preceding dose cohort. The full enrollment phase was to occur after completion of the sentinel phase. Local reactions were generally mild and adverse events infrequent; however, after only 46 infants were randomized into the study, fever rates were 64% and 90% in subjects receiving one 20- or 60-μg rLP2086 dose, respectively. Most fevers were group and 1 subject in the 60-μg group experienced fevers >39.0°C; no fevers were >40.0°C. Due to these high fever rates, the study was terminated early. No immunogenicity data were collected. This report discusses the safety and acceptability of rLP2086 in infants after one 20- or 60-μg dose. Due to the high fever rate experienced in the 20- and 60-μg groups, rLP2086 in the current formulation may not be acceptable for infants. Copyright © 2014. Published by Elsevier Ltd.

Development of auditory event-related potentials in infants prenatally exposed to methadone.

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Paul, Jonathan A; Logan, Beth A; Krishnan, Ramesh; Heller, Nicole A; Morrison, Deborah G; Pritham, Ursula A; Tisher, Paul W; Troese, Marcia; Brown, Mark S; Hayes, Marie J

2014-07-01

Developmental features of the P2 auditory ERP in a change detection paradigm were examined in infants prenatally exposed to methadone. Opiate dependent pregnant women maintained on methadone replacement therapy were recruited during pregnancy (N = 60). Current and historical alcohol and substance use, SES, and psychiatric status were assessed with a maternal interview during the third trimester. Medical records were used to collect information regarding maternal medications, monthly urinalysis, and breathalyzer to confirm comorbid drug and alcohol exposures. Between birth and 4 months infant ERP change detection performance was evaluated on one occasion with the oddball paradigm (.2 probability oddball) using pure-tone stimuli (standard = 1 kHz and oddball = 2 kHz frequency) at midline electrode sites, Fz, Cz, Pz. Infant groups were examined in the following developmental windows: 4-15, 16-32, or 33-120 days PNA. Older groups showed increased P2 amplitude at Fz and effective change detection performance at P2 not seen in the newborn group. Developmental maturation of amplitude and stimulus discrimination for P2 has been reported in developing infants at all of the ages tested and data reported here in the older infants are consistent with typical development. However, it has been previously reported that the P2 amplitude difference is detectable in neonates; therefore, absence of a difference in P2 amplitude between stimuli in the 4-15 days group may represent impaired ERP performance by neonatal abstinence syndrome or prenatal methadone exposure. © 2013 Wiley Periodicals, Inc.

Determinants of Infant Behaviour IV.

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Foss, B. M., Ed.

This volume consists of reports of individual studies and surveys of research work on mother-infant interactions. It is divided into two parts. The first section presents a wide range of studies on mother-infant relations as exhibited in the behavior of animals. The second part, concerning human behavior, includes studies on the natural history of…

Human infants' learning of social structures: the case of dominance hierarchy.

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Mascaro, Olivier; Csibra, Gergely

2014-01-01

We tested 15-month-olds' capacity to represent social-dominance hierarchies with more than two agents. Our results showed that infants found it harder to memorize dominance relations that were presented in an order that hindered the incremental formation of a single structure (Study 1). These results suggest that infants attempt to build structures incrementally, relation by relation, thereby simplifying the complex problem of recognizing a social structure. Infants also found circular dominance structures harder to process than linear dominance structures (Study 2). These expectations about the shape of structures may facilitate learning. Our results suggest that infants attempt to represent social structures composed of social relations. They indicate that human infants go beyond learning about individual social partners and their respective relations and form hypotheses about how social groups are organized.

Household chaos, sociodemographic risk, coparenting, and parent-infant relations during infants' first year.

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Whitesell, Corey J; Teti, Douglas M; Crosby, Brian; Kim, Bo-Ram

2015-04-01

Household chaos is a construct often overlooked in studies of human development, despite its theoretical links with the integrity of individual well-being, family processes, and child development. The present longitudinal study examined relations between household chaos and well-established correlates of chaos (sociodemographic risk, major life events, and personal distress) and several constructs that, to date, are theoretically linked with chaos but never before assessed as correlates (quality of coparenting and emotional availability with infants at bedtime). In addressing this aim, we introduce a new measure of household chaos (the Descriptive In-home Survey of Chaos--Observer ReporteD, or DISCORD), wholly reliant on independent observer report, which draws from household chaos theory and prior empirical work but extends the measurement of chaos to include information about families' compliance with a home visiting protocol. Household chaos was significantly associated with socioeconomic risk, negative life events, less favorable coparenting, and less emotionally available bedtime parenting, but not with personal distress. These findings emphasize the need to examine household chaos as a direct and indirect influence on child and family outcomes, as a moderator of intervention attempts to improving parenting and child development, and as a target of intervention in its own right. (c) 2015 APA, all rights reserved).

Contribution of inhalation by food animals to man's ingestion dose

International Nuclear Information System (INIS)

Zach, R.

1985-01-01

Animals' inhalation (AI) pathway was evaluated for 57 radionuclides using infant dose predictions from the food-chain model LIMCAL. With ingestion transfer coefficients fMi to define transfer from the respiratory tract to milk, the AI pathway appeared to be insignificant compared to animals' plant ingestion, as implicitly assumed in most environmental assessment models for nuclear installations. Using ICRP Publication 30 respiratory clearance models for man to adjust ingestion transfer coefficients, animals' inhalation appeared to be important, particularly for some actinide radionuclides. The AI pathway also appeared to be significant relative to man's inhalation, especially for infants. The importance of the AI pathway varied greatly between radionuclides, and results strongly suggest that it cannot be ignored in environmental assessments. Until better data become available to implement this pathway fully, adjusted ingestion transfer coefficient values can be used for transfer from animals' respiratory tract to milk and other food products

Respiratory muscle activity related to flow and lung volume in preterm infants compared with term infants

NARCIS (Netherlands)

Hutten, Gerard J.; van Eykern, Leo A.; Latzin, Philipp; Thamrin, Cindy; van Aalderen, Wim M.; Frey, Urs

2010-01-01

Infants with chronic lung disease (CLD) have a capacity to maintain functional lung volume despite alterations to their lung mechanics. We hypothesize that they achieve this by altering breathing patterns and dynamic elevation of lung volume, leading to differences in the relationship between

Loperamide for treatment· of acute diarrhoea in infants and young ...

African Journals Online (AJOL)

controlled trial. Malcolm D. Bowie, Ivor D. Hill, Michael D. Mann. High-dose loperamide reduces stool output and shortens the duration of diarrhoea in infants receiving intravenous fluids for rehydration, but may cause potentially harmful side-effects in ...

Safety and immunogenicity of a parenteral P2-VP8-P[8] subunit rotavirus vaccine in toddlers and infants in South Africa: a randomised, double-blind, placebo-controlled trial.

Science.gov (United States)

Groome, Michelle J; Koen, Anthonet; Fix, Alan; Page, Nicola; Jose, Lisa; Madhi, Shabir A; McNeal, Monica; Dally, Len; Cho, Iksung; Power, Maureen; Flores, Jorge; Cryz, Stanley

2017-08-01

Efficacy of live oral rotavirus vaccines is reduced in low-income compared with high-income settings. Parenteral non-replicating rotavirus vaccines might offer benefits over oral vaccines. We assessed the safety and immunogenicity of the P2-VP8-P[8] subunit rotavirus vaccine at different doses in South African toddlers and infants. This double-blind, randomised, placebo-controlled, dose-escalation trial was done at a single research unit based at a hospital in South Africa in healthy HIV-uninfected toddlers (aged 2 to rotavirus vaccination). Block randomisation (computer-generated, electronic allocation) was used to assign eligible toddlers (in a 6:1 ratio) and infants (in a 3:1 ratio) in each dose cohort (10 μg, followed by 30 μg, then 60 μg if doses tolerated) to parenteral P2-VP8-P[8] subunit rotavirus or placebo injection. The two highest tolerated doses were then assessed in an expanded cohort (in a 1:1:1 ratio). Parents of participants and clinical, data, and laboratory staff were masked to treatment assignment. P2-VP8-P[8] vaccine versus placebo was assessed first in toddlers (single injection) and then in infants (three injections 4 weeks apart). The primary safety endpoints were local and systemic reactions within 7 days after each injection, adverse events within 28 days after each injection, and all serious adverse events, assessed in toddlers and infants who received at least one dose. In infants receiving all study injections, primary immunogenicity endpoints were anti-P2-VP8-P[8] IgA and IgG and neutralising antibody seroresponses and geometric mean titres 4 weeks after the third injection. This trial is registered at ClinicalTrials.gov, number NCT02109484. Between March 17, 2014, and Sept 29, 2014, 42 toddlers (36 to vaccine and six to placebo) and 48 infants (36 to vaccine and 12 to placebo) were enrolled in the dose-escalation phase, in which the 30 μg and 60 μg doses where found to be the highest tolerated doses. A further 114 infants were

CLINICAL STUDY OF SENNA ADMINISTRATION TO NURSING MOTHERS: ASSESSMENT OF EFFECTS ON INFANT BOWEL HABITS.

Science.gov (United States)

BALDWIN, W F

1963-09-14

Fifty nursing mothers were given regular doses of a senna compound (Senokot Granules) and 50 received mineral oil or magnesia (Magnolax) to determine whether senna was an effective laxative and whether senna affected the bowel habits of infants of nursing mothers. Senna laxative was effective in 49 of 50 mothers. Infant bowel habits were not affected by senna administration to nursing mothers. The evidence suggests that the active principles of senna if they are transmitted in breast milk have no effect on the evacuation patterns of nursed infants.

Infant Mortality

Science.gov (United States)

... After hours (404) 639-2888 Contact Media Infant Mortality Recommend on Facebook Tweet Share Compartir On This ... differences in rates among population groups. About Infant Mortality Infant mortality is the death of an infant ...

Age-related susceptibility to infection with diarrheagenic E. coli in infants from peri-urban areas of Lima, Peru

Science.gov (United States)

Ochoa, Theresa J.; Ecker, Lucie; Barletta, Francesca; Mispireta, Mónica L.; Gil, Ana I.; Contreras, Carmen; Molina, Margarita; Amemiya, Isabel; Verastegui, Hector; Hall, Eric R.; Cleary, Thomas G.; Lanata, Claudio F.

2009-01-01

Background Diarrheagenic E. coli are being recognized as important pediatric enteropathogens worldwide. However, it is unclear whether there are differences in age-related susceptibility to specific agents, especially among infants. Methods We conducted a passive surveillance diarrhea cohort study of 1034 children from 2 to 12 months of age in Lima, Perú. Control stool samples were collected from randomly selected children without diarrhea. All samples were analyzed for common enteric pathogens and for the diarrheagenic E. coli by a multiplex real-time PCR. Results The most commonly isolated pathogens from 1065 diarrheal episodes were the diarrheagenic E. coli (31%), including enteroaggregative (15.1%) and enteropathogenic E. coli (EPEC) (7.6%). Diarrheagenic E. coli, Campylobacter and rotavirus were more frequently isolated from infants ≥ 6m. Diffusely adherent E. coli and enterotoxigenic E. coli (ETEC) were more frequently isolated in diarrheal samples than in controls in older infants (pfactors and with increased exposure to contaminated food and water. PMID:19857163

SU-F-18C-12: On the Relationship of the Weighted Dose to the Surface Dose In Abdominal CT - Patient Size Dependency

Energy Technology Data Exchange (ETDEWEB)

Zhou, Y; Scott, A; Allahverdian, J [Cedars-Sinai Medical Center, Los Angeles, CA (United States)

2014-06-15

Purpose: It is possible to measure the patient surface dose non-invasively using radiolucent dosimeters. However, the patient size specific weighted dose remains unknown. We attempted to study the weighted dose to surface dose relationship as the patient size varies in abdominal CT. Methods: Seven abdomen phantoms (CIRS TE series) simulating patients from an infant to a large adult were used. Size specific doses were measured with a 100 mm CT chamber under axial scans using a Siemens Sensation 64 (mCT) and a GE 750 HD. The scanner settings were 120 kVp, 200 mAs with fully opened collimations. Additional kVps (80, 100, 140) were added depending on the phantom sizes. The ratios (r) of the weighted CT dose (Dw) to the surface dose (Ds) were related to the phantom size (L) defined as the diameter resulting the equivalent cross-sectional area. Results: The Dw versus Ds ratio (r) was fitted to a linear relationship: r = 1.083 − 0.007L (R square = 0.995), and r = 1.064 − 0.007L (R square = 0.953), for Siemens Sensation 64 and GE 750 HD, respectively. The relationship appears to be independent of the scanner specifics. Conclusion: The surface dose to the weighted dose ratio decreases linearly as the patient size increases. The result is independent of the scanner specifics. The result can be used to obtain in vivo CT dosimetry in abdominal CT.

SU-F-18C-12: On the Relationship of the Weighted Dose to the Surface Dose In Abdominal CT - Patient Size Dependency

International Nuclear Information System (INIS)

Zhou, Y; Scott, A; Allahverdian, J

2014-01-01

Purpose: It is possible to measure the patient surface dose non-invasively using radiolucent dosimeters. However, the patient size specific weighted dose remains unknown. We attempted to study the weighted dose to surface dose relationship as the patient size varies in abdominal CT. Methods: Seven abdomen phantoms (CIRS TE series) simulating patients from an infant to a large adult were used. Size specific doses were measured with a 100 mm CT chamber under axial scans using a Siemens Sensation 64 (mCT) and a GE 750 HD. The scanner settings were 120 kVp, 200 mAs with fully opened collimations. Additional kVps (80, 100, 140) were added depending on the phantom sizes. The ratios (r) of the weighted CT dose (Dw) to the surface dose (Ds) were related to the phantom size (L) defined as the diameter resulting the equivalent cross-sectional area. Results: The Dw versus Ds ratio (r) was fitted to a linear relationship: r = 1.083 − 0.007L (R square = 0.995), and r = 1.064 − 0.007L (R square = 0.953), for Siemens Sensation 64 and GE 750 HD, respectively. The relationship appears to be independent of the scanner specifics. Conclusion: The surface dose to the weighted dose ratio decreases linearly as the patient size increases. The result is independent of the scanner specifics. The result can be used to obtain in vivo CT dosimetry in abdominal CT

Treatment of premature infants with pulmonary hypertension and right ventricular dysfunction with milrinone: a case series.

Science.gov (United States)

James, A T; Bee, C; Corcoran, J D; McNamara, P J; Franklin, O; El-Khuffash, A F

2015-04-01

Milrinone has been proposed as an effective treatment for pulmonary hypertension (PH) and right ventricular (RV) dysfunction. We aimed to determine the effect of milrinone therapy on clinical and echocardiography parameters of PH in preterm infants with elevated pulmonary pressures. A retrospective case review was conducted on infants milrinone for the treatment of PH and reduced RV function. Echocardiographic data were collected before and after treatment with milrinone, and serial clinical parameters were recorded over a 72h  period. Seven infants met the inclusion criteria with a median gestation and birth weight of 27.3 weeks and 1140 g, respectively. Four infants had a diagnosis of pulmonary hypoplasia with PH, and three infants were recipients in twin-to-twin transfusion syndrome who also developed PH. Nitric oxide was used in six infants before commencement of milrinone. Milrinone was commenced at a dose of 0.33 μg kg(-1) min(-1) to 0.5 μg kg(-1) min(-1) and continued for a median duration of 70 h. Use of milrinone was associated with a fall in oxygenation index and inhaled nitric oxide dose. Following an initial fall in blood pressure over the first 6 h, there was an increase in blood pressure over the subsequent 72 h. Echocardiographic data demonstrated an increase in indicators of myocardial performance and PH. One infant died before discharge. This case series suggests that milrinone may be a useful therapy for premature infants with echocardiography findings of PH and/or RH dysfunction. This data support the need for a randomised control trial to confirm its efficacy.

Dose and time relations in Hg(++)-induced tubular necrosis and regeneration

DEFF Research Database (Denmark)

Nielsen, J B; Andersen, H R; Andersen, O

1994-01-01

relationship is caused by a dose-related induction of kidney damage leading to increasing leakage of mercury through the kidneys. Histopathologic investigation revealed extensive necrosis of the proximal tubules in kidneys from mice exposed to 100 mumole HgCl2/kg or higher doses. Moreover, maximum renal damage...

DNA Methylation of Regulatory Regions of Imprinted Genes at Birth and Its Relation to Infant Temperament

Directory of Open Access Journals (Sweden)

Bernard F. Fuemmeler

2016-01-01

Full Text Available BACKGROUND DNA methylation of the differentially methylated regions (DMRs of imprinted genes is relevant to neurodevelopment. METHODS DNA methylation status of the DMRs of nine imprinted genes in umbilical cord blood leukocytes was analyzed in relation to infant behaviors and temperament (n = 158. RESULTS MEG3 DMR levels were positively associated with internalizing ( β = 0.15, P = 0.044 and surgency ( β = 0.19, P = 0.018 behaviors, after adjusting for birth weight, gender, gestational age at birth, maternal age at delivery, race/ethnicity, education level, smoking status, parity, and a history of anxiety or depression. Higher methylation levels at the intergenic MEG3-IG methylation regions were associated with surgency ( β = 0.28, P = 0.0003 and PEG3 was positively related to externalizing ( β = 0.20, P = 0.01 and negative affectivity ( β = 0.18, P = 0.02. CONCLUSION While the small sample size limits inference, these pilot data support gene-specific associations between epigenetic differences in regulatory regions of imprinted domains at birth and later infant temperament.

The effects of parental sensitivity and involvement in caregiving on mother-infant and father-infant attachment in a Portuguese sample.

Science.gov (United States)

Fuertes, Marina; Faria, Anabela; Beeghly, Marjorie; Lopes-dos-Santos, Pedro

2016-02-01

In the present longitudinal study, we investigated attachment quality in Portuguese mother-infant and in father-infant dyads, and evaluated whether attachment quality was related to parental sensitivity during parent-infant social interaction or to the amount of time each parent spent with the infant during play and in routine caregiving activities (e.g., feeding, bathing, play). The sample consisted of 82 healthy full-term infants (30 girls, 53 boys, 48 first born), and their mothers and fathers from mostly middle-class households. To assess parental sensitivity, mothers and fathers were independently observed during free play interactions with their infants when infants were 9 and 15 months old. The videotaped interactions were scored by masked coders using the Crittenden's CARE-Index. When infants were 12 and 18 months old, mother-infant and father-infant dyads were videotaped during an adaptation of Ainsworth's Strange Situation. Parents also described their level of involvement in infant caregiving activities using a Portuguese version of the McBride and Mills Parent Responsibility Scale. Mothers were rated as being more sensitive than fathers during parent-infant free play at both 9 and 15 months. There also was a higher prevalence of secure attachment in mother-infant versus father-infant dyads at both 12 and 18 months. Attachment security was predicted by the amount of time mothers and fathers were involved in caregiving and play with the infant, and with parents' behavior during parent-infant free play. (c) 2016 APA, all rights reserved).

Safe Sleep for Your Baby: Reduce the Risk of SIDS and Other Sleep-Related Causes of Infant Death

Science.gov (United States)

... Fast facts about SIDS: SIDS is the leading cause of death in babies 1 month to 1 year of ... baby to die suddenly and unexpectedly. Sleep-related causes of infant death are those linked to how or where a ...

Negative affect is related to reduced differential neural responses to social and non-social stimuli in 5-to-8-month-old infants: A functional near-infrared spectroscopy-study.

Science.gov (United States)

van der Kant, Anne; Biro, Szilvia; Levelt, Claartje; Huijbregts, Stephan

2018-04-01

Both social perception and temperament in young infants have been related to social functioning later in life. Previous functional Near-Infrared Spectroscopy (fNIRS) data (Lloyd-Fox et al., 2009) showed larger blood-oxygenation changes for social compared to non-social stimuli in the posterior temporal cortex of five-month-old infants. We sought to replicate and extend these findings by using fNIRS to study the neural basis of social perception in relation to infant temperament (Negative Affect) in 37 five-to-eight-month-old infants. Infants watched short videos displaying either hand and facial movements of female actors (social dynamic condition) or moving toys and machinery (non-social dynamic condition), while fNIRS data were collected over temporal brain regions. Negative Affect was measured using the Infant Behavior Questionnaire. Results showed significantly larger blood-oxygenation changes in the right posterior-temporal region in the social compared to the non-social condition. Furthermore, this differential activation was smaller in infants showing higher Negative Affect. Our results replicate those of Lloyd-Fox et al. and confirmed that five-to-eight-month-old infants show cortical specialization for social perception. Furthermore, the decreased cortical sensitivity to social stimuli in infants showing high Negative Affect may be an early biomarker for later difficulties in social interaction. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Randomized controlled trial of a book-sharing intervention in a deprived South African community: effects on carer-infant interactions, and their relation to infant cognitive and socio-emotional outcome

Science.gov (United States)

Murray, Lynne; De Pascalis, Leonardo; Tomlinson, Mark; Vally, Zahir; Dadomo, Harold; MacLachlan, Brenda; Woodward, Charlotte; Cooper, Peter J.

2017-01-01

Background Consistent with evidence from high income countries, we previously showed that, in an informal peri-urban settlement in a low-middle income country, training parents in book-sharing with their infants benefitted infant language and attention (Vally et al., 2015). Here, we investigated whether these benefits were explained by improvements in carer-infant interactions in both book-sharing and non-book-sharing contexts. We also explored whether infant socio-emotional development benefitted from book-sharing. Methods We conducted a randomized controlled trial in Khayelitsha, South Africa. Carers of 14–16 month-old infants were randomized to 8 weeks’ training in book-sharing (n = 49) or a wait list control group (n = 42). In addition to the cognitive measures reported previously, independent assessments were made at base line and follow-up of carer-infant interactions during book-sharing and toy play. Assessments were also made, at follow-up only, of infant pro-social behaviour in a ‘help task’, and of infant imitation of doll characters’ non-social actions and an interpersonal interaction. Eighty-two carer-infant pairs (90%) were assessed at follow-up. (Trial registration ISRCTN39953901). Results Carers who received the training showed significant improvements in book-sharing interactions (sensitivity, elaborations, reciprocity), and, to a smaller extent, in toy-play interactions (sensitivity). Infants in the intervention group showed a significantly higher rate of pro-social behaviour, and tended to show more frequent imitation of the interpersonal interaction. Improvements in carer behaviour during book-sharing, but not during toy play, mediated intervention effects on all infant cognitive outcomes, and tended to mediate intervention effects on infant interpersonal imitation. Conclusions Training in book sharing, a simple, inexpensive intervention that has been shown to benefit infant cognitive development in a low-middle income country, also

Influence of father-infant relationship on infant development: A father-involvement intervention in Vietnam.

Science.gov (United States)

Rempel, Lynn A; Rempel, John K; Khuc, Toan Nang; Vui, Le Thi

2017-10-01

We examined the extent to which fathers can be taught and encouraged to develop positive relationships with their children, especially in infancy, and the effects of this fathering intervention on infant development. A multifaceted relationally focused intervention was used to assist fathers in Vietnam to engage in responsive direct and indirect involvement with their infants and work together with the mother as part of a parenting team. Fathers and mothers from 13 communes in a rural and semiurban district were recruited to the intervention group. Intervention fathers received group and individual counseling before and after birth, an interactive print resource, community messages about fathering, and the opportunity to participate in a Fathers Club. Couples from 12 comparable communes in a noncontiguous district were recruited to the control group. Fathers and mothers completed questionnaires at the prebirth recruitment and at 1-, 4-, and 9-months postbirth. Intervention fathers demonstrated greater increase in knowledge and attitudes regarding father-infant relationships. Both fathers and mothers reported that fathers engaged in more affection, care-taking, and play in the early months of their infants' lives and fathers felt more attached to their infants right from birth. A developmental assessment at 9 months showed that intervention infants demonstrated higher levels of motor, language, and personal/social development. This study demonstrated that fathers can be taught to interact more sensitively, responsively, and effectively with their newborn infants. Their increased interaction and emotional attachment appears to lay the foundation for enhanced infant development. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Immunogenicity of a reduced schedule of meningococcal group C conjugate vaccine given concomitantly with the Prevenar and Pediacel vaccines in healthy infants in the United Kingdom.

Science.gov (United States)

Southern, Jo; Borrow, Ray; Andrews, Nick; Morris, Rhonwen; Waight, Pauline; Hudson, Michael; Balmer, Paul; Findlow, Helen; Findlow, Jamie; Miller, Elizabeth

2009-02-01

This study investigated the use of two doses of three different meningococcal group C conjugate (MCC) vaccines when given for primary immunization with a seven-valent pneumococcal conjugate vaccine (PCV7) and Pediacel, a combination product containing five acellular pertussis components, diphtheria and tetanus toxoids, Haemophilus influenzae type b (Hib) conjugate, and inactivated-poliovirus vaccine. The immune response after a single dose of MCC is also presented. Infants were randomized to receive two doses of one of the MCC vaccines and PCV7 at 2 and 3 months or at 2 and 4 months of age. Meningococcal group C serum bactericidal antibody (SBA) geometric mean titers, Hib-polyribosylribitol phosphate (PRP) immunoglobulin G (IgG) geometric mean concentrations (GMCs), and diphtheria and tetanus antitoxin GMCs, together with the proportions of infants achieving putative protective levels, were determined. A total of 393 infants were recruited. Following the first dose of NeisVac-C (MCC conjugated to tetanus toxoid), 97% of infants achieved protective levels (SBA titer of >or=8), compared with 80% and 53%, respectively, for Menjugate and Meningitec (both of which are conjugated to CRM(197)). SBA responses to MCC vaccines were not significantly different when administered at 2 and 3 or 2 and 4 months of age. Following two doses of each MCC, 98 to 100% of infants achieved protective levels. Both PRP IgG and tetanus responses were significantly enhanced when Pediacel was coadministered with NeisVac-C. This study demonstrates that NeisVac-C and Menjugate generate good immunogenicity after the first dose at 2 months of age when coadministered with PCV7 and Pediacel and merit further investigation in single-dose priming strategies.

Absorbed dose assessment in newborns during x-ray examinations

Science.gov (United States)

Taipe, Patricia K.; Berrocal, Mariella J.; Carita, Raúl F.

2012-02-01

Often a newborn presents breathing problems during the early days of life, i.e. bronchopneumonia, wich are caused in most of cases, by aspirating a mixture of meconium and amniotic fluid. In these cases, it is necessary to make use of a radiograph, requested by the physician to reach a diagnosis. This paper seeks to evaluate the absorbed doses in neonates undergoing a radiograph. For this reason we try to simulate the real conditions in a X-ray room from Lima hospitals. With this finality we perform a simulation made according a questionnaire related to technical data of X-ray equipment, distance between the source and the neonate, and its position to be irradiated. The information obtained has been used to determine the absorbed dose by infants, using the MCNP code. Finally, the results are compared with reference values of international health agencies.

Scatter radiation from chest radiographs: is there a risk to infants in a typical NICU?

International Nuclear Information System (INIS)

Trinh, Angela M.; Schoenfeld, Alan H.; Levin, Terry L.

2010-01-01

To evaluate the dose of scatter radiation to infants in a NICU in order to determine the minimal safe distance between isolettes. Dose secondary to scattered radiation from an acrylic phantom exposed to vertical and horizontal beam exposures at 56 kVp was measured at 93 cm and 125 cm from the center of the phantom. This corresponds to 2 and 3 ft between standard isolettes, respectively. For horizontal exposures, the dosimeter was placed directly behind a CR plate and scatter dose at 90-degrees and 135-degrees from the incident beam was also measured. Exposures were obtained at 160 mAs and the results were extrapolated to correspond to 2.5 mAs. Four measurements were taken at each point and averaged. At 125 cm and 93 cm there was minimal scatter compared to daily natural background radiation dose (8.493 μGy). Greatest scatter dose obtained from a horizontal beam exposure at 135 from the incident beam was still far below background radiation. Scatter radiation dose from a single exposure as well as cumulative scatter dose from numerous exposures is significantly below natural background radiation. Infants in neighboring isolettes are not at added risk from radiation scatter as long as the isolettes are separated by at least 2 ft. (orig.)

Macro-economic conditions and infant health: a changing relationship for black and white infants in the United States.

Science.gov (United States)

Orsini, Chiara; Avendano, Mauricio

2015-01-01

We study whether the relationship between the state unemployment rate at the time of conception and infant health, infant mortality and maternal characteristics in the United States has changed over the years 1980-2004. We use microdata on births and deaths for years 1980-2004 and find that the relationship between the state unemployment rate at the time of conception and infant mortality and birthweight changes over time and is stronger for blacks than whites. For years 1980-1989 increases in the state unemployment rate are associated with a decline in infant mortality among blacks, an effect driven by mortality from gestational development and birth weight, and complications of placenta while in utero. In contrast, state economic conditions are unrelated to black infant mortality in years 1990-2004 and white infant mortality in any period, although effects vary by cause of death. We explore potential mechanisms for our findings and, including mothers younger than 18 in the analysis, uncover evidence of age-related maternal selection in response to the business cycle. In particular, in years 1980-1989 an increase in the unemployment rate at the time of conception is associated with fewer babies born to young mothers. The magnitude and direction of the relationship between business cycles and infant mortality differs by race and period. Age-related selection into motherhood in response to the business cycle is a possible explanation for this changing relationship.

Nuclear abnormalities in cells from nasal epithelium: a promising assay to evaluate DNA damage related to air pollution in infants

Directory of Open Access Journals (Sweden)

Michelle Mergener

2014-12-01

Full Text Available OBJECTIVES: This study intends to provide a quick, easy, and inexpensive way to assess nuclear abnormalities such as micronuclei and bud frequencies; binucleated, karyorrhectic, karyolytic, pycnotic, and condensed chromatin cells in nasal scrapings of infants, which are particularly important for conducting genotoxic studies related to the inhaled atmosphere in pediatric populations. METHODS: Nasal swab samples were collected from 40 infants under 12 months of age using a small cytobrush. 2,000 cells from each infant sample were analyzed and classified according to the frequency of nuclear abnormalities. RESULTS: Rates of nuclear abnormalities found agree with values reported in other studies of neonates and children. This study found 0.13% of cells with micronuclei; 1.20% karyorrhexis; 0.03% pyknosis; 10.85% karyolysis; 1.11% condensed chromatin; 0.54 binucleated cells; and 0.02% nuclear bud. Differences were not observed between genders or environmental passive smoking, nor was any age correlation found. CONCLUSION: The assay proposed here is suitable for assessing the frequency of nuclear abnormalities from nasal cells in infants.

The Relation between Contingency Preference and Imitation in 6-8-Month-Old Infants

Science.gov (United States)

Klein-Radukic, Sarah; Zmyj, Norbert

2016-01-01

Detecting self-generated actions and imitating other-generated actions are important abilities in order to interact with others. The relationship between these domains was investigated in 6-8-month-old infants. In a contingency-preference task, infants observed their own legs on a real-time and a delayed video display. In an imitation task, the…

Task related doses in spanish light water reactors over the period 1990-1996

International Nuclear Information System (INIS)

Aroca, J.; Montesinos, J.J.; O'Donnell, P.; Amor, I.; Butragueno, J.L.

1998-01-01

In order to evaluate in depth the effectiveness of the practical application of the ALARA principle in Spanish nuclear facilities -7 PWR (6 Westinghouse and 1 KWU-Siemens) and 2 BWR (Generic Electric), and to have a further overview of dose trends, the CSN has analysed the task related doses data over the period 1990-1996. The scope of this analysis includes the collective dose and relative relevance for 18 different refuelling outage tasks, some sub-tasks, 12 department staff, and the main consolidated dose reduction-techniques and good practices. Data has been collected from the outage reports NPPs provide according to the CSN 1.5 Safety Guide format. (Author)

The introduction of the meningococcal B (MenB) vaccine (Bexsero®) into the national infant immunisation programme--New challenges for public health.

Science.gov (United States)

Ladhani, Shamez N; Campbell, Helen; Parikh, Sydel R; Saliba, Vanessa; Borrow, Ray; Ramsay, Mary

2015-12-01

The United Kingdom is the first country to introduce Bexsero(®) (GSK Biologicals), a multicomponent, protein-based vaccine against meningococcal group B (MenB), into the national infant immunisation programme. This vaccine is like no other licensed vaccine and poses a number of implementation and surveillance challenges in England. From 01 September 2015, UK infants were offered a reduced two dose primary immunisation schedule at 2 and 4 months followed by a booster at 12 months. Because of high rates of fever post-vaccination, parents were advised to give their infants three doses of prophylactic paracetamol, with the first dose given as soon as possible after the primary MenB vaccination dose. Since the vaccine only protects against 73-88% of MenB strains causing invasive disease in England, clinical isolates and PCR-positive samples will require extensive characterisation by the Meningococcal Reference Unit (MRU) at Public Health England (PHE) in order to monitor vaccine effectiveness and identify potential vaccine failures. PHE is also conducting detailed clinical and epidemiological surveillance to assess the impact of the MenB immunisation programme on the morbidity and mortality associated with invasive meningococcal disease in infants and young children. Copyright © 2015 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Self-Regulation and Infant-Directed Singing in Infants with Down Syndrome.

Science.gov (United States)

de l'Etoile, Shannon K

2015-01-01

Infants learn how to regulate internal states and subsequent behavior through dyadic interactions with caregivers. During infant-directed (ID) singing, mothers help infants practice attentional control and arousal modulation, thus providing critical experience in self-regulation. Infants with Down syndrome are known to have attention deficits and delayed information processing as well as difficulty managing arousability, factors that may disrupt their efforts at self-regulation. The researcher explored responses to ID singing in infants with Down syndrome (DS) and compared them with those of typically developing (TD) infants. Behaviors measured included infant gaze and affect as indicators of self-regulation. Participants included 3- to 9-month-old infants with and without DS who were videotaped throughout a 2-minute face-to-face interaction during which their mothers sang to them any song(s) of their choosing. Infant behavior was then coded for percentage of time spent demonstrating a specific gaze or affect type. All infants displayed sustained gaze more than any other gaze type. TD infants demonstrated intermittent gaze significantly more often than infants with DS. Infant status had no effect on affect type, and all infants showed predominantly neutral affect. Findings suggest that ID singing effectively maintains infant attention for both TD infants and infants with DS. However, infants with DS may have difficulty shifting attention during ID singing as needed to adjust arousal levels and self-regulate. High levels of neutral affect for all infants imply that ID singing is likely to promote a calm, curious state, regardless of infant status. © the American Music Therapy Association 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Maternal obesity and gestational weight gain are risk factors for infant death.

Science.gov (United States)

Bodnar, Lisa M; Siminerio, Lara L; Himes, Katherine P; Hutcheon, Jennifer A; Lash, Timothy L; Parisi, Sara M; Abrams, Barbara

2016-02-01

Assessment of the joint and independent relationships of gestational weight gain and prepregnancy body mass index (BMI) on risk of infant mortality was performed. This study used Pennsylvania linked birth-infant death records (2003-2011) from infants without anomalies born to mothers with prepregnancy BMI categorized as underweight (n = 58,973), normal weight (n = 610,118), overweight (n = 296,630), grade 1 obesity (n = 147,608), grade 2 obesity (n = 71,740), and grade 3 obesity (n = 47,277). Multivariable logistic regression models stratified by BMI category were used to estimate dose-response associations between z scores of gestational weight gain and infant death after confounder adjustment. Infant mortality risk was lowest among normal-weight women and increased with rising BMI category. For all BMI groups except for grade 3 obesity, there were U-shaped associations between gestational weight gain and risk of infant death. Weight loss and very low weight gain among women with grades 1 and 2 obesity were associated with high risks of infant mortality. However, even when gestational weight gain in women with obesity was optimized, the predicted risk of infant death remained higher than that of normal-weight women. Interventions aimed at substantially reducing preconception weight among women with obesity and avoiding very low or very high gestational weight gain may reduce risk of infant death. © 2015 The Obesity Society.

Doses from intakes of radionuclides by adults and young people

CERN Document Server

Greenhalgh, J R; Fell, T P

1985-01-01

This report describes a methodology for calculating doses from ingestion and inhalation of radionuclides by adults, children (aged 10) and infants (aged 1). The calculation scheme follows the procedures and uses the models described in ICRP Publication 30, except in a few instances which are discussed in detail. The methods described in this report have been used to calculate organ doses and effective doses per unit intake for a wide variety of nuclides and compounds. A selection of these doses is given in this report. It is intended that the full dose data base should be made generally available in due course.

Patient size and x-ray technique factors in head computed tomography examinations. I. Radiation doses

International Nuclear Information System (INIS)

Huda, Walter; Lieberman, Kristin A.; Chang, Jack; Roskopf, Marsha L.

2004-01-01

We investigated how patient age, size and composition, together with the choice of x-ray technique factors, affect radiation doses in head computed tomography (CT) examinations. Head size dimensions, cross-sectional areas, and mean Hounsfield unit (HU) values were obtained from head CT images of 127 patients. For radiation dosimetry purposes patients were modeled as uniform cylinders of water. Dose computations were performed for 18x7 mm sections, scanned at a constant 340 mAs, for x-ray tube voltages ranging from 80 to 140 kV. Values of mean section dose, energy imparted, and effective dose were computed for patients ranging from the newborn to adults. There was a rapid growth of head size over the first two years, followed by a more modest increase of head size until the age of 18 or so. Newborns have a mean HU value of about 50 that monotonically increases with age over the first two decades of life. Average adult A-P and lateral dimensions were 186±8 mm and 147±8 mm, respectively, with an average HU value of 209±40. An infant head was found to be equivalent to a water cylinder with a radius of ∼60 mm, whereas an adult head had an equivalent radius 50% greater. Adult males head dimensions are about 5% larger than for females, and their average x-ray attenuation is ∼20 HU greater. For adult examinations performed at 120 kV, typical values were 32 mGy for the mean section dose, 105 mJ for the total energy imparted, and 0.64 mSv for the effective dose. Increasing the x-ray tube voltage from 80 to 140 kV increases patient doses by about a factor of 5. For the same technique factors, mean section doses in infants are 35% higher than in adults. Energy imparted for adults is 50% higher than for infants, but infant effective doses are four times higher than for adults. CT doses need to take into account patient age, head size, and composition as well as the selected x-ray technique factors

Greater Caregiving Risk, Better Infant Memory Performance?

Science.gov (United States)

Rifkin-Graboi, Anne; Quan, Jeffry; Richmond, Jenny; Goh, Shaun Kok Yew; Sim, Lit Wee; Chong, Yap Seng; Francois-Bureau, Jean; Chen, Helen; Qiu, Anqi

2018-04-16

Poor early life care often relates to cognitive difficulties. However, newer work suggests that in early-life, adversity may associate with enhanced or accelerated neurodevelopment. We examine associations between postnatal caregiving risks (i.e., higher self-reported postnatal-anxiety and lower observed maternal sensitivity) and infant relational memory (i.e. via deferred imitation and relational binding). Using subsamples of 67-181 infants (aged 433-477 post-conceptual days, or roughly five to seven months since birth) taking part in the GUSTO study, we found such postnatal caregiving risk significantly predictive of "better" performance on a relational binding task following a brief delay, after Bonferroni adjustments. Subsequent analyses suggest that the association between memory and these risks may specifically be apparent amongst infants spending at least 50% of their waking hours in the presence of their mothers. Our findings echo neuroimaging research concerning similar risk exposure and larger infant hippocampal volume, and likewise underscore the importance of considering developmental context in understanding early life experience. With this in mind, these findings caution against the use of cognitive outcomes as indices of experienced risk. This article is protected by copyright. All rights reserved. © 2018 Wiley Periodicals, Inc.

Infant formula and early childhood caries

Directory of Open Access Journals (Sweden)

Saudamini Girish More

2018-01-01

Full Text Available The prevalence of early childhood caries (ECC is increasing worldwide. Impaired oral health could have a negative impact on the overall health of infants. ECC can continue to deteriorate the growth and development of the child in preschool stage. Feeding practices largely influence the occurrence of ECC. Infant formula is commonly used as supplements or substitutes for breast milk up to the first 2 years of age. The dietary sugars such as lactose and sucrose, present in the infant formula, could act as a favorable substrate and change the oral microflora. Infant formula constitutes of various minerals which are known to affect tooth mineralization including iron, fluoride, and calcium. A number of in vitro, animal, and human studies have been conducted to understand their effect on oral environment and microbiota. Exploring the scientific literature for different types of infant formula and their role in the etiopathogenesis of dental caries could give us an insight into the cariogenic potential of infant formula. Furthermore, this could be source of information for health practitioners as they are the ones who are first sought by parents for advice related to infant feeding.

Maternal Responses and Development of Communication Skills in Extremely Preterm Infants

Science.gov (United States)

Benassi, Erika; Guarini, Annalisa; Savini, Silvia; Iverson, Jana Marie; Caselli, Maria Cristina; Alessandroni, Rosina; Faldella, Giacomo; Sansavini, Alessandra

2018-01-01

The present study examined maternal responses to infants' spontaneous communicative behaviors in a sample of 20 extremely-low-gestational-age (ELGA) infants and 20 full-term (FT) infants during 30 minutes of play interaction when infants were 12 months of age. Relations between maternal responses and infants' communication skills at 12 and 24…

Diaper Dermatitis in Infants Admitted to Social Pediatrics Health Center: Role of Socio-demographic Factors and Infant Care.

Science.gov (United States)

Kayaoglu, Semra; Kivanc-Altunay, Ilknur; Sarikaya, Sezgi

2015-10-01

To determine infant diaper dermatitis (DD) at pediatrics health center; its relation to socio-demographic factors and infant care. The study included 113 infants aged 0-24 mo. Data on infants' age, sex, weight, mothers' education, nutrition, diaper change frequency, cleaning methods and prophylactic cream use were recorded. Infants with minimum one time rash, were accepted to have DD. Seventy six (67.3 %) infants had DD [32 girls (42.1 %), 44 boys (57 %), mean age: 6.5 mo]. Infants with DD had significantly higher age than those without (p 0.001). DD frequency in infants ≥4.5 mo-old was 5.8(2.4-13.7) times more than in infants ≤4.5 mo. Cleaning material types did not affect DD frequency. No significant difference was observed in DD with diaper change of ≤3 times and ≥4 times. Significant difference in DD increase was observed with supplementary food intake vs. without it (p 0.000). DD frequency in infants with supplementary food intake was 6.4 times (2.4-17.1) more than in those without it. Human milk intake was statistically significant in causing less occurrence of DD as shown in univariate model (p milk intake lessened the occurrence of DD. Mothers should be informed on dermatitis care and encouraged for breastfeeding.

Cardiopulmonary resuscitation (CPR)-related posterior rib fractures in neonates and infants following recommended changes in CPR techniques.

Science.gov (United States)

Franke, I; Pingen, A; Schiffmann, H; Vogel, M; Vlajnic, D; Ganschow, R; Born, M

2014-07-01

Posterior rib fractures are highly indicative of non-accidental trauma (NAT) in infants. Since 2000, the "two-thumbs" technique for cardiopulmonary resuscitation (CPR) of newborns and infants has been recommended by the American Heart Association (AHA). This technique is similar to the grip on an infant's thorax while shaking. Is it possible that posterior rib fractures in newborns and infants could be caused by the "two-thumbs" technique? Using computerized databases from three German children's hospitals, we identified all infants less than 12 months old who underwent professional CPR within a 10-year period. We included all infants with anterior-posterior chest radiographs taken after CPR. Exclusion criteria were sternotomy, osteopenia, various other bone diseases and NAT. The radiographs were independently reviewed by the Chief of Pediatric Radiology (MB) and a Senior Pediatrician, Head of the local Child Protection Team (IF). Eighty infants with 546 chest radiographs were identified, and 50 of those infants underwent CPR immediately after birth. Data concerning the length of CPR was available for 41 infants. The mean length of CPR was 11min (range: 1-180min, median: 3min). On average, there were seven radiographs per infant. A total of 39 infants had a follow-up radiograph after at least 10 days. No rib fracture was visible on any chest X-ray. The results of this study suggest rib fracture after the use of the "two-thumbs" CPR technique is uncommon. Thus, there should be careful consideration of abuse when these fractures are identified, regardless of whether CPR was performed and what technique used. The discovery of rib fractures in an infant who has undergone CPR without underlying bone disease or major trauma warrants a full child protection investigation. Copyright © 2014 Elsevier Ltd. All rights reserved.

Seroprevalence of transplacentally acquired measles antibodies in HIV-exposed versus HIV-unexposed infants at six months of age

Directory of Open Access Journals (Sweden)

Sneha Jain

2017-01-01

Interpretation & conclusions: Most HEI lacked measles antibodies at six months age and were, therefore, more vulnerable to measles than HUnI. Seroconversion in response to a single dose of measles vaccine administered at six months age was low in these infants, signifying the need of additional dose(s of measles/measles-containing vaccine.

Dose-response relations for stricture in the proximal oesophagus from head and neck radiotherapy

International Nuclear Information System (INIS)

Alevronta, Eleftheria; Ahlberg, Alexander; Mavroidis, Panayiotis; Al-Abany, Massoud; Friesland, Signe; Tilikidis, Aris; Laurell, Goeran; Lind, Bengt K.

2010-01-01

Background and purpose: Determination of the dose-response relations for oesophageal stricture after radiotherapy of the head and neck. Material and methods: In this study 33 patients who developed oesophageal stricture and 39 patients as controls are included. The patients received radiation therapy for head and neck cancer at Karolinska University Hospital, Stockholm, Sweden. For each patient the 3D dose distribution delivered to the upper 5 cm of the oesophagus was analysed. The analysis was conducted for two periods, 1992-2000 and 2001-2005, due to the different irradiation techniques used. The fitting has been done using the relative seriality model. Results: For the treatment period 1992-2005, the mean doses were 49.8 and 33.4 Gy, respectively, for the cases and the controls. For the period 1992-2000, the mean doses for the cases and the controls were 49.9 and 45.9 Gy and for the period 2001-2005 were 49.8 and 21.4 Gy. For the period 2001-2005 the best estimates of the dose-response parameters are D 50 = 61.5 Gy (52.9-84.9 Gy), γ = 1.4 (0.8-2.6) and s = 0.1 (0.01-0.3). Conclusions: Radiation-induced strictures were found to have a dose response relation and volume dependence (low relative seriality) for the treatment period 2001-2005. However, no dose response relation was found for the complete material.

Task related doses in Spanish pressurized water reactors over the period 1988-1992

Energy Technology Data Exchange (ETDEWEB)

O`Donnell, P.; Labarta, T.; Amor, I. [Subdireccion de Proteccion Radiologica, Madrid (Spain)

1995-03-01

In order to evaluate in depth the collective dose trend and its correlation with the effectiveness of the practical application of the ALARA principle in Spanish nuclear facilities, and base the different policy lines to promote this criteria, the CSN has fullfilled an analysis of the task related doses data over the period 1988-1992. Previously, the CSN had required to the utilities the compilation of their refuelling outage collective dose from 1988 according with a predeterminate number of tasks, in order to have available a representative and retrospective set of data in an homogeneous way and coherent with the international data banks on occupational exposure in NPP, as the CEC and the NEA ones. The scope of this analysis was the following: first, the collective dose summaries for outage tasks and departments for PWR and for BWR, including the minimum, maximum and average dose (and statistics data) for 18 different refuelling outage tasks and 12 personal departments for each generation of each type of rector, the task and department related collective dose trends in each plant and in each generation, and second, the dose reduction techniques having been used during that period in each plant and the relative level of adoption. In this presentation the main results and conclusions of the first part of the study are reviewed for PWR.

The relationship between planned and reported home infant sleep locations among mothers of late preterm and term infants.

Science.gov (United States)

Tully, Kristin P; Holditch-Davis, Diane; Brandon, Debra

2015-07-01

To compare maternal report of planned and practiced home sleep locations of infants born late preterm (34 0/7 to 36 6/7 gestational weeks) with those infants born term (≥37 0/7 gestational weeks) over the first postpartum month. Open-ended semi-structured maternal interviews were conducted in a US hospital following birth and by phone at 1 month postpartum during 2010-2012. Participants were 56 mother-infant dyads: 26 late preterm and 30 term. Most women planned to room share at home with their infants and reported doing so for some or all of the first postpartum month. More women reported bed sharing during the first postpartum month than had planned to do so in both the late preterm and term groups. The primary reason for unplanned bed sharing was to soothe nighttime infant fussiness. Those participants who avoided bed sharing at home commonly discussed their fear for infant safety. A few parents reported their infants were sleeping propped on pillows and co-sleeping on a recliner. Some women in both the late preterm and term groups reported lack of opportunity to obtain a bassinet prior to childbirth. The discrepancy between plans for infant sleep location at home and maternally reported practices were similar in late preterm and term groups. Close maternal proximity to their infants at night was derived from the need to assess infant well-being, caring for infants, and women's preferences. Bed sharing concerns related to infant safety and the establishment of an undesirable habit, and alternative arrangements included shared recliner sleep.

Regional differences in infant immunization against hepatitis B: did intervention work?

Science.gov (United States)

Takayama, J I; Iser, J P; Gandelman, A

1999-02-01

The impact of a community intervention to establish hospital nursery policies for universal newborn immunization against hepatitis B was determined by comparing primary care physician immunization practices in two counties, one intervention and one control. Surveys were mailed to 855 physicians in 1994; 322 of 533 respondents were eligible, with 155 from San Francisco (SF), the intervention county, and 167 from Sacramento (SAC), the control county. Adoption of universal hepatitis B immunization was defined as immunizing more than 90% of infants seen in 1993. Although similar proportions of physicians agreed, 79% in SF and 72% in SAC, 64% of SF physicians and 40% of SAC physicians adopted universal infant immunization (P < 0.0001). Universal immunization was greater for pediatricians than for family physicians (OR = 2.00, 95% CI 1.66-2.41) but less for physicians who perceived their patients population to be at low risk for hepatitis B compared to those who did not (OR = 0.60, 95% CI 0.45-0.79). While 94% of physicians in both counties indicated their willingness to provide the second and third doses of the hepatitis B vaccine if the first dose had been administered in the newborn nursery, 64% of SF in contrast to 30% of SAC physicians reported routine nursery administration of the vaccine (P < 0.0001). Primary care physician adoption of universal hepatitis B infant immunization and routine nursery administration of the first dose of the vaccine were both greater in San Francisco than in Sacramento, suggesting impact of a community intervention to increase hepatitis B immunization rates.

Gender-related differences of inguinal hernia and asymptomatic patent processus vaginalis in term and preterm infants.

Science.gov (United States)

Burgmeier, Christine; Dreyhaupt, Jens; Schier, Felix

2015-03-01

The aim of this study was to analyze the gender-related differences of inguinal hernia (IH) and patent processus vaginalis (PPV) in term and preterm infants. Over a nine-year-period 411 infants underwent laparoscopic herniorrhaphy within the first six months of life. 246 term (191 male; 55 female) and 165 preterm (118 male; 47 female) infants were included in this retrospective study. Initial presentation of IH and intraoperative anatomical findings of PPV were reviewed. We found that term boys (58.6%) and girls (58.2%) predominantly presented with right-sided IH whereas preterm boys (36.4%) and girls (44.7%) mostly presented with bilateral IH. Female babies had a higher incidence of initial left-sided IH. Term and preterm girls with initial left-sided hernia were found to have highest incidence of PPV. Male term babies with initial left-sided IH were found to have the lowest incidence of PPV (25.0%). The highest incidence of PPV in male was found in preterm boys with either left- or right-sided IH. Incidence and laterality of IH and PPV differ between term and preterm girls and boys. In open hernia repair decision concerning contralateral groin exploration should consider term/preterm birth as well as gender. Copyright © 2015 Elsevier Inc. All rights reserved.

Female parity, maternal kinship, infant age and sex influence natal attraction and infant handling in a wild colobine (Colobus vellerosus).

Science.gov (United States)

Bădescu, Iulia; Sicotte, Pascale; Ting, Nelson; Wikberg, Eva C

2015-04-01

Primate females often inspect, touch and groom others' infants (natal attraction) and they may hold and carry these infants in a manner resembling maternal care (infant handling). While natal attraction and infant handling occur in most wild colobines, little is known about the factors influencing the expression of these behaviors. We examined the effects of female parity, kinship, and dominance rank, as well as infant age and sex in wild Colobus vellerosus at Boabeng-Fiema Monkey Sanctuary, Ghana. We collected data via focal sampling of females in 2008 and 2009 (N = 61) and of infants in 2010 (N = 12). Accounting for the individuals who interacted with our focal subjects, this study includes 74 females and 66 infants in 8 groups. We recorded female agonistic interactions ad libitum to determine dominance ranks. We used partial pedigree information and genotypes at 17 short tandem repeat loci to determine kinship. We knew female parity, infant age and sex from demographic records. Nulliparous females showed more natal attraction and infant handling than parous females, which may suggest that interactions with infants are more adaptive for nulliparous females because they learn mothering skills through these behaviors. Compared to non-kin, maternal kin were more likely to handle infants. Maternal kin may be permitted greater access to infants because mothers are most familiar with them. Handlers may incur inclusive fitness benefits from infant handling. Dominance rank did not affect female interactions with infants. The youngest infants received the most natal attraction and infant handling, and male infants were handled more than female infants. The potential benefits of learning to mother and inclusive fitness, in combination with the relatively low costs of natal attraction and infant handling, may explain the high rates of these behaviors in many colobines. © 2014 Wiley Periodicals, Inc.

Vietnamese infant and childhood mortality in relation to the Vietnam War.

Science.gov (United States)

Savitz, D A; Thang, N M; Swenson, I E; Stone, E M

1993-08-01

There is obvious potential for war to adversely affect infant and childhood mortality through direct trauma and disruption of the societal infrastructure. This study examined trends in Vietnam through the period of the war. The 1988 Vietnam Demographic and Health Survey collected data on reproductive history and family planning from 4172 women aged 15 through 49 years in 12 selected provinces of Vietnam. The 13,137 births and 737 deaths to children younger than age 6 reported by the respondents were analyzed. For the country as a whole, infant and childhood mortality dropped by 30% to 80% from the prewar period to the wartime period and was stable thereafter. In provinces in which the war was most intense, mortality did not decline from the prewar period to the wartime period but declined after the war, consistent with an adverse effect during the wartime period. The data are limited by assignment of birth location on the basis of mother's current residence and by inadequate information on areas of war activity. Nonetheless, the data do not indicate a widespread, sizable adverse effect of the war on national infant and childhood mortality in Vietnam but suggest detrimental effects in selected provinces.

Scaling adult doses of antifungal and antibacterial agents to children.

Science.gov (United States)

Dawson, Thomas H

2012-06-01

My general pharmacokinetic scaling theory is discussed for the important matter of determining pediatric dosing for existing and new therapeutic drugs when optimal, or near-optimal, dosing for adults is known. The basis for the scaling is the requirement of a time-scaled likeness of the free-drug concentration time histories of children and adults. Broad categories of single and periodic dosing are considered. The former involves the scaling of dosage, and the latter involves both the dosage and schedule. The validity of the scaling relations is demonstrated by using measurements from previously reported clinical trials with adults and children (with ages generally 1 year or older) for the relatively new antifungal agent caspofungin and for the relatively new antibacterial agent linezolid. Standard pharmacodynamic effectiveness criteria are shown to be satisfied for the scaled dosage and schedule for children to the same extent that they are for the referenced adult. Consideration of scaling from adults to children is discussed for the case of new agents where no pediatric data are available and needed parameters are determined from in vitro measurements and preclinical animal data. A connection is also made between the allometric representation of clearance data and the dosing formulas. Limitations of the scaling results for infants because of growth and maturational matters are discussed. The general conclusion from this work is that the scaling theory does indeed have application to pediatric dosing for children, for both confirmation and refinement of present practice and guidance in pediatric treatment with new therapeutic agents.

Thyroid doses and risk to paediatric patients undergoing neck CT examinations

Energy Technology Data Exchange (ETDEWEB)

Spampinato, Maria Vittoria; Tipnis, Sameer; Huda, Walter [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Tavernier, Joshua [Medical University of South Carolina, College of Medicine, Charleston, SC (United States)

2015-07-15

To estimate thyroid doses and cancer risk for paediatric patients undergoing neck computed tomography (CT). We used average CTDI{sub vol} (mGy) values from 75 paediatric neck CT examinations to estimate thyroid dose in a mathematical anthropomorphic phantom (ImPACT Patient CT Dosimetry Calculator). Patient dose was estimated by modelling the neck as mass equivalent water cylinder. A patient size correction factor was obtained using published relative dose data as a function of water cylinder size. Additional correction factors included scan length and radiation intensity variation secondary to tube-current modulation. The mean water cylinder diameter that modelled the neck was 14 ± 3.5 cm. The mathematical anthropomorphic phantom has a 16.5-cm neck, and for a constant CT exposure, would have thyroid doses that are 13-17 % lower than the average paediatric patient. CTDI{sub vol} was independent of age and sex. The average thyroid doses were 31 ± 18 mGy (males) and 34 ± 15 mGy (females). Thyroid cancer incidence risk was highest for infant females (0.2 %), lowest for teenage males (0.01 %). Estimated absorbed thyroid doses in paediatric neck CT did not significantly vary with age and gender. However, the corresponding thyroid cancer risk is determined by gender and age. (orig.)

Health risk assessment of doses to patients\\' eyes from dental X-ray ...

African Journals Online (AJOL)

The skin entry dose to patients\\' eyes during dental x-ray examination was carried out on one hundred and ten patients comprising infants and adult of both sexes. The dose measurements was performed at Alpha dental centre, Ibadan, using Lithium fluoride thermoluminiscent dosimeters (TLD). The results of the study ...

Maintenance of the selected infant feeding methods amongst ...

African Journals Online (AJOL)

The focus of this study was to explore and describe influences on decision making related to infant feeding methods in the context of HIV and AIDS. Study objectives were: (1) to explore and describe the influences on decision making related to infant feeding methods selected by the mother during the antenatal period and ...

Cerebral blood flow and oximetry response to blood transfusion in relation to chronological age in preterm infants.

Science.gov (United States)

Banerjee, J; Leung, T S; Aladangady, N

2016-06-01

Preterm infants frequently receive blood transfusion (BT) and the aim of this study was to measure the effect of BT on cerebral blood flow and oxygenation in preterm infants in relation to chronological age. Preterm infants undergoing intensive care recruited to three chronological age groups: 1 to 7 (Group 1; n=20), 8 to 28 (Group 2; n=21) & ≥29days of life (Group 3; n=18). Pre and post-BT anterior cerebral artery (ACA) time averaged mean velocity (TAMV) and superior vena cava (SVC) flow were measured. Cerebral Tissue Haemoglobin Index (cTHI) and Oxygenation Index (cTOI) were measured from 15-20min before to 15-20min post-BT using NIRS. Vital parameters and blood pressure were measured continuously. Mean BP increased significantly, and there was no significant change in vital parameters following BT. Pre-BT ACA TAMV was higher in Group 2 and 3 compared to Group 1 (pBlood transfusion increased cTOI and cTHI and decreased ACA TAMV in all groups. PDA had no impact on the baseline cerebral oximetry and blood flow as well as changes following blood transfusion. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

An Overview of Infant Mortality Trends in Qatar from 2004 to 2014.

Science.gov (United States)

Al-Thani, Mohammed; Al-Thani, Al-Anoud; Toumi, Amine; Khalifa, Shams Eldin; Akram, Hammad

2017-09-09

Background Infant mortality is an important health indicator that estimates population well-being. Infant mortality has declined globally but is still a major public health challenge. This article provides the characteristics, causes, burden, and trends of infant mortality in Qatar. Methods Frequencies, percentages, and rates were calculated using data from birth-death registries over 2004-2014 to describe infant mortality by nationality, gender, and age group. We calculated the relative risks of the top causes of infant mortality among subgroups according to the 10 th Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10, Version 2016). Results During 2004-2014, 204,224 live births and 1,505 infant deaths were recorded. The infant mortality rate (IMR) averaged 7.4/1000 live births (males 8.1, females 6.6, non-Qataris 7.7, and Qataris 6.8). IMR declined 20% from 2004 to 2014. The decline in IMR was significant for the overall population of infants (p=0.006), male infants (p=0.04), females (p=0.006), and for non-Qatari males (p=0.007) and non-Qatari females (p=0.007). The leading causes of infant mortality were congenital malformations (all types) (34.5%), low birth weight (LBW) (27%), and respiratory distress of newborns (2.8%). Male infants had a higher risk of mortality than female infants due to a congenital malformation of lungs (p=0.02), other congenital malformations, not elsewhere classified (p=0.01), and cardiovascular disorders (p=0.05). Conclusion The study shows that infant mortality among male infants is high due to the top infant mortality-related disorders, and male infants have a higher risk of mortality than female infants.

Comparison of Congenital Abnormalities of Infants Conceived by Assisted Reproductive Techniques versus Infants with Natural Conception in Tehran.

Science.gov (United States)

Farhangniya, Mansoureh; Dortaj Rabori, Eshagh; Mozafari Kermani, Ramin; Haghdoost, Ali Akbar; Bahrampour, Abbas; Bagheri, Pezhman; A L Lancaster, Paul; Ashrafi, Mahnaz; Vosough Taqi Dizaj, Ahmad; Gourabi, Hamid; Shahzadeh Fazeli, Abolhassan

2013-10-01

In many countries, 1 to 3% of newborn infants are conceived by assisted reproductive techniques (ART). Despite the success of ART, there is concern about the risk of congenital malformations among these infants. We report our experience to determine whether use of ART is associated with an increase in major congenital malformations or adverse pregnancy outcomes. Historical cohort study of major congenital malformations (MCM) was performed in 978 births from January 2008 to December 2010. The data for this analysis were derived from a Tehran's ART linked data file by simple sampling method. In our study, the risk of congenital malformations was compared in 326 ART infants and 652 naturally conceived (NC) infants. We also performed multiple logistic regression analyses to calculate the odds ratio (OR) and 95% confidence intervals (CI) for the independent association of ART on each outcome. We found 56 infants with major congenital malformations, these included 29 NC infants (4.4%) and 27 ART infants (8.3%). In comparison with NC infants, ART infants had a significant 1.94-fold increased risk of MCM.After adjustment for maternal age, infant's sex stillbirth, abortion and type of delivery, we found a relatively small difference in risk (OR=2.04). In this study the majority (94.3%) of all infants were normal but 5.7% of infants had at least one MCM. The prevalence rate for the intracytoplasmic sperm injection (ICSI) was 6.5% for the In vitro fertilisation (IVF) group was 15.9% or 2.73-fold higher than ICSI group (P=0.018). Also we ignore the possible role of genotype and other unknown factors in causing more malformations in ART infants. Other studies have shown a slightly increased risk of major congenital malformations in pregnancies resulting from ART. Likewise, this study reports a greater risk of MCMs in ART infants than in naturally conceived infants. We also found evidence of a difference in risk of MCMs between IVF and ICSI. Musculoskeletal and urogenital

Birth weight trends among interracial black and white infants.

Science.gov (United States)

Parker, J D

2000-05-01

I examined time trends in low birth weight (LBW) and very low birth weight (VLBW) among interracial compared with single-race infants. Using natality data from 1978 through 1997 for singleton births to black and white parents, I calculated relative risks (RRs) of LBW and VLBW for interracial compared with single-race births, stratified by maternal race and adjusted for maternal characteristics. Among black mothers, interracial births had lower risks of LBW and VLBW than single-race births, and RRs were similar throughout the time period [for example, adjusted RR = 0.76 and 95% confidence interval (CI) = 0.73-0.80 for LBW in 1994-1997]. Among white mothers, interracial infants had higher risks of LBW than single-race infants; however, the adjusted RRs declined over the time period, from 1.22 (95% CI = 1.19-1.27) in 1978-1981 to 1.05 (95% CI = 1.03-1.08) in 1994-1997. Since 1978, there has been some relative improvement in birth outcomes for infants of white mothers and black fathers compared with single-race white births. There was, however, no relative improvement for black mother/black father infants relative to black mother/white father births.

Mild hypothermia for refractory focal status epilepticus in an infant with hemimegalencephaly

NARCIS (Netherlands)

Elting, Jan Willem; van der Naalt, Joukje; Fock, Johanna Maria

Hypothermia can reduce seizure frequency in animal models of status epilepticus, and its effectiveness in human status epilepticus has been reported occasionally. We report an infant with hemimegalencephaly who presented with generalized status epilepticus. After high dose intravenous drug therapy,

Symptoms of mothers and infants related to total volatile organic compounds in household products.

Science.gov (United States)

Farrow, Alexandra; Taylor, Hazel; Northstone, Kate; Golding, Jean

2003-10-01

The authors sought to determine whether reported symptoms of mothers and infants were associated significantly with the use of household products that raised indoor levels of total volatile organic compounds (TVOCs). Data collected from 170 homes within the Avon Longitudinal Study of Parents and Children (ALSPAC: a large birth cohort of more than 10,000) had determined which household products were associated with the highest levels of TVOCs. The latter data were collected over a period that approximated 6 mo of pregnancy and the infants' first 6 mo of life. This paper presents (a) the mothers' self-reports of the use of these products in their homes and (b) self-reported medical symptoms of mothers and infants postnatally. Higher TVOC levels were associated with air freshener and aerosol use. Infant diarrhea and earache were statistically significantly associated with air freshener use, and diarrhea and vomiting were significantly associated with aerosol use. Headache experienced by mothers 8 mo after birth was significantly associated with the use of air fresheners and aerosols; maternal depression was significantly associated with the use of air fresheners. The results of the study suggest a link between the use of products that raise indoor levels of TVOCs and an increased risk of certain symptoms among infants and their mothers.

Regulations Relating to Foodstuffs for Infants and Young Children

African Journals Online (AJOL)

RV

2010-11-22

Nov 22, 2010 ... published regulations1 in terms of section 15(1) of the Foodstuffs, Cosmetics and. Disinfectants Act.2 .... and support of appropriate and timely complementary feeding (weaning) practices with the use of local ... aim of the Code is "to contribute to the provision of safe and adequate nutrition for infants, by the ...

Comparison between apparent viscosity related to irradiation dose for corn starch and black pepper

International Nuclear Information System (INIS)

Casandroiu, T.; Oprita, N.; Ferdes, O.S.

1999-01-01

Dose-effect relationship was studied in the rheoviscometric behaviour of geliffied suspensions of irradiated corn starch and black pepper, as the variation of the apparent viscosity and the shear stress related to the dose. Irradiation has been performed up to 16 kGy. Black pepper was ground and sieved to three particle sizes to analyse also the influence of particle size on the apparent viscosity variation by dose. The rheoviscometric measurements have been carried out by a rotationary viscometer on geliffied suspensions of starch and black pepper, into equivalent starch concentration and alkalinised suspensions for pepper. For starch, shear stress variation by dose is exponential, where the coefficients depend on the shear rate. For black pepper, the curves of apparent viscosity relation to dose also fit an exponential equation and the influence of particle size is discussed, too. Viscometric behaviour similar to irradiation of both corn starch and black pepper could be attributed to starch degradation at relatively high doses and should be used to develop an identification and control method for the ionizing treatment of starch-based food materials. (author)

Attachment and Temperament Revisited: Infant Distress, Attachment Disorganization, and the Serotonin Transporter Polymorphism.

Science.gov (United States)

Brumariu, Laura E; Bureau, Jean-François; Nemoda, Zsofia; Sasvari-Szekely, Maria; Lyons-Ruth, Karlen

This study's aim was to evaluate whether infant disorganized attachment and infant proneness to distress exhibited differential relations to infant genetic factors as indexed by the serotonin transporter polymorphism. The role of the short allele of the serotonin transporter polymorphism (5-HTTLPR) in enhancing sensitivity to fearful and negative affect has been well-established (Canli & Lesch, 2007). In the current study, we used this known property of the short allele to provide a test of an important postulate of attachment theory, namely that infant attachment security or disorganization is not a function of the infant's proneness to distress. Participants were 39 parents and infants assessed between 12 and 18 months in the Strange Situation procedure. Genotype categories for the 5-HTTLPR (and rs25531) were created by both the original and the reclassified grouping system; infant proneness to distress was assessed directly in the Strange Situation Procedure. We also assessed maternal behavior at 18 months to evaluate whether any observed genetic effect indicated a passive effect through the mother. Consistent with previous findings, the 5-HTTLPR short allele was significantly related to the infant's wariness and distress, but was not related to attachment security or attachment disorganization. In addition, maternal disrupted interaction with the infant was not related to infant genotype or infant distress. Results support the concept that infant proneness to distress is associated with serotonergic factors while infant attachment security or disorganization is not a function of either 5-HTTLPR or behaviorally rated proneness to distress.

Caffeine is a risk factor for osteopenia of prematurity in preterm infants: a cohort study.